{"generated_at":"2026-10-27T04:00:56.420Z","rubric_version":"2.0","count":7715,"works":[{"id":1,"doi":"10.1007/s10508-018-1248-x","pmid":"30076491","pmcid":null,"title":"Pornography Problems Due to Moral Incongruence: An Integrative Model with a Systematic Review and Meta-Analysis","authors":"Grubbs, J. B., Perry, S. L., Wilt, J. A., & Reid, R. C.","first_author":"Grubbs","journal":"Archives of Sexual Behavior","year":2019,"pub_types":["Meta-Analysis","Systematic Review","Journal Article"],"keywords":["Morality","Addiction","Religion","Compulsive Sexual Behavior","Dsm-5","Icd-11","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":180,"is_preprint":false,"topics":["curated","pornography","ppu"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta-Analysis & Systematic Review","sample_n":null,"sample_text":"Meta-analysis (k = 50+ studies, N > 36,000)","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":10,"certainty":"high","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Landmark systematic review and meta-analysis establishing the Pornography Problems Due to Moral Incongruence (PPMI) model. Demonstrates that moral disapproval and religiosity robustly predict self-reported \"pornography addiction,\" explaining far more variance in distress than actual viewing habits.","clinical_takeaway":"Clinicians must screen for moral incongruence before treating self-reported \"porn addiction.\" When distress is driven by shame and sacred-value conflict rather than high-frequency dysregulation, addiction treatment is contraindicated.","confidence":1,"topic_tags":["moral_incongruence"],"strengths":["Synthesizes over 50 empirical studies across tens of thousands of participants","Separates genuine behavioral dysregulation from values-behavior conflict (moral incongruence)","Tests and accounts for publication bias and sample heterogeneity","Provides the empirical foundation used by modern clinicians and the ICD-11 working group"],"limitations":["Majority of underlying primary studies rely on self-report measures","High heterogeneity across international cultural and religious contexts"],"rubric_version":"2.0","raw_total":59,"max_possible":60,"pct_score":98,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":10,"neuroimaging":null,"statistics":10,"confounds":10,"design":10,"addiction_criteria":9,"interpretation":10}},"scite":{"supporting":27,"contrasting":3,"mentioning":256,"citing_publications":414,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1248-x"}},{"id":2,"doi":"10.1007/s10508-013-0257-z","pmid":"24519108","pmcid":null,"title":"Transgression as Addiction: Religiosity and Moral Disapproval as Predictors of Perceived Addiction to Pornography","authors":"Grubbs, J. B., Exline, J. J., Pargament, K. I., Hook, J. N., & Carlisle, R. D.","first_author":"Grubbs","journal":"Archives of Sexual Behavior","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":109,"is_preprint":false,"topics":["curated","pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"cross-sectional","design_detail":"Multi-Study Cross-Sectional","sample_n":null,"sample_text":"Large multi-sample (N > 700 across 3 studies)","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"moderate","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"The foundational paper introducing the moral incongruence framework. Across three studies, religiosity and moral disapproval of pornography predicted \"perceived addiction\" more strongly than actual pornography use frequency.","clinical_takeaway":"Explains why a client viewing pornography twice a month in a strict faith community often feels more \"trapped and addicted\" than a secular peer viewing daily.","confidence":1,"topic_tags":["moral_incongruence"],"strengths":["Replicated findings across three distinct samples","Directly controlled for actual viewing frequency and duration","Validated the Perceived Addiction to Internet Pornography (PAIP) distinction from objective behavior"],"limitations":["Cross-sectional design (subsequently replicated longitudinally in 2018 and 2020)","Predominantly US Christian religious demographics"],"rubric_version":"2.0","raw_total":52,"max_possible":60,"pct_score":87,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":8,"addiction_criteria":8,"interpretation":9}},"scite":{"supporting":15,"contrasting":0,"mentioning":149,"citing_publications":296,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0257-z"}},{"id":3,"doi":"10.1007/s11930-014-0016-8","pmid":null,"pmcid":null,"title":"The Emperor Has No Clothes: A Review of the “Pornography Addiction” Model","authors":"Ley, D., Prause, N., & Finn, P.","first_author":"Ley","journal":"Current Sexual Health Reports","year":2014,"pub_types":[],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["curated"],"language":null,"appraisal":{"status":"expert","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic Critical Review","sample_n":null,"sample_text":"Comprehensive review of published experimental & clinical studies","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"high","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Evaluates the scientific validity of the \"pornography addiction\" construct across neuroscience, behavioral, and treatment literature. Finds that Less than 37% of articles claiming \"porn addiction\" contained actual empirical data, and existing experimental data fail to support substance-like addiction mechanisms.","clinical_takeaway":"Warns clinicians that diagnosing \"pornography addiction\" lacks empirical backing and risks causing iatrogenic harm while ignoring mood disorders, relationship conflict, and moral incongruence.","confidence":1,"topic_tags":["neuroscience"],"strengths":["Authored by leading clinical psychologists and neuroscientists in sexual health and addiction","Exposes circular reasoning, lack of control groups, and conflation of high sexual desire with pathology","Demonstrates that brain responses to erotica reflect normal reward processing"],"limitations":["Narrative/critical review format rather than quantitative meta-analysis","Published prior to the 2019 ICD-11 CSBD impulse-control compromise"],"rubric_version":"2.0","raw_total":61,"max_possible":70,"pct_score":87,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":8,"statistics":9,"confounds":9,"design":9,"addiction_criteria":8,"interpretation":9}},"scite":{"supporting":1,"contrasting":0,"mentioning":106,"citing_publications":283,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11930-014-0016-8"}},{"id":4,"doi":"10.1016/j.biopsycho.2015.06.005","pmid":"26095441","pmcid":null,"title":"Modulation of Late Positive Potentials by Sexual Images in Problem Users and Controls Inconsistent with “Porn Addiction”","authors":"Prause, N., Steele, V. R., Staley, C., Sabatinelli, D., & Hajcak, G.","first_author":"Prause","journal":"Biological Psychology","year":2015,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Sexual Desire","Hypersexuality","Late Positive Potential","Cue-reactivity","Addiction Theory","Pornography “Addiction”"],"is_oa":false,"oa_url":null,"cited_by_count":45,"is_preprint":false,"topics":["bibliography","csbd","curated","pornography","ppu"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"rct","design_detail":"Controlled Laboratory EEG/ERP Study","sample_n":null,"sample_text":"N = 122 (Problem users vs. matched healthy controls)","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"high","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Directly tested the core neurological prediction of the addiction model: whether people reporting out-of-control pornography use show heightened brain cue-reactivity (Late Positive Potential, LPP) to sexual images like cocaine or nicotine addicts do. Found the exact opposite: \"problem users\" showed LOWER LPP reactivity than controls, consistent with simple visual habituation.","clinical_takeaway":"Refutes the ubiquitous claim that pornography \"hijacks the brain's reward circuit just like cocaine.\" Brain responses to sexual imagery follow normal visual habituation.","confidence":1,"topic_tags":["neuroscience"],"strengths":["Objective real-time EEG/ERP neuroimaging rather than subjective self-report","Direct falsification of the sensitization-habituation signature required for substance addiction","Included matched control group and emotional/neutral stimulus comparisons"],"limitations":["Laboratory setting differs from private at-home viewing contexts","Cross-sectional laboratory comparison"],"rubric_version":"2.0","raw_total":61,"max_possible":70,"pct_score":87,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":8,"statistics":9,"confounds":9,"design":9,"addiction_criteria":8,"interpretation":9}},"scite":{"supporting":9,"contrasting":3,"mentioning":60,"citing_publications":137,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.biopsycho.2015.06.005"}},{"id":5,"doi":"10.1002/wps.20499","pmid":"29352554","pmcid":"PMC5775124","title":"Compulsive Sexual Behaviour Disorder in the ICD-11 (Clinical Descriptions and Diagnostic Requirements, Code 6C72)","authors":"World Health Organization (WHO) & Kraus, S. W., Krueger, R. B., Briken, P., First, M. B., Stein, D. J., Kaplan, M. S., Voon, V., Abdo, C. H. N., Grant, J. E., Atalla, E., & Reed, G. M.","first_author":"World Health Organization (WHO) & Kraus","journal":"World Health Organization ICD-11 / World Psychiatry","year":2019,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":253,"is_preprint":false,"topics":["csbd","curated"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"other","design_detail":"Global Diagnostic Standard (WHO ICD-11)","sample_n":null,"sample_text":"International multidisciplinary WHO working group & global field trials","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":10,"certainty":"low","red_flags":[],"stance":"opposes","citation_value":"essential","plain_summary":"Official WHO ICD-11 classification of Compulsive Sexual Behaviour Disorder (CSBD, 6C72). Places CSBD under Impulse Control Disorders — explicitly NOT under Substance Use or Addictive Behaviours — due to insufficient evidence of addiction equivalence. Crucially mandates that distress driven entirely by moral judgments or religious disapproval cannot be diagnosed as CSBD.","clinical_takeaway":"Provides the authoritative clinical standard: genuine compulsive sexual behavior exists as an impulse-control issue in a small minority of people, while moral conflict in religious viewers is explicitly excluded from psychiatric pathologizing.","confidence":1,"topic_tags":["treatment"],"strengths":["Establishes clear, rigorous threshold (persistent failure to control urges >= 6 months causing severe functional impairment)","Explicitly protects religious individuals from being misdiagnosed due to moral incongruence alone","Refuses to classify sexual behavior as a substance-style addiction"],"limitations":["Requires careful clinician training so practitioners do not ignore the moral-incongruence exclusion rule"],"rubric_version":"2.0","raw_total":59,"max_possible":60,"pct_score":98,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":10,"neuroimaging":null,"statistics":10,"confounds":10,"design":10,"addiction_criteria":9,"interpretation":10}},"scite":{"supporting":1,"contrasting":1,"mentioning":360,"citing_publications":529,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/wps.20499"}},{"id":6,"doi":"10.1016/j.jsxm.2020.01.007","pmid":"32033863","pmcid":null,"title":"High-Frequency Pornography Use May Not Always Be Problematic","authors":"Bóthe, B., Tóth-Király, I., Potenza, M. N., Orosz, G., & Demetrovics, Z.","first_author":"Bóthe","journal":"The Journal of Sexual Medicine","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Personality","Comorbidity","Well-being","Basic Psychological Needs","Problematic Pornography Use","Pornography Use Frequency"],"is_oa":false,"oa_url":null,"cited_by_count":122,"is_preprint":false,"topics":["bibliography","csbd","curated","pornography","ppu"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"cross-sectional","design_detail":"Multi-Sample Latent Profile Analysis","sample_n":null,"sample_text":"Very Large (N > 20,000 across 3 independent samples)","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"moderate","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Identifies three distinct profiles of pornography viewers: recreational users (~68–75%), highly engaged non-problematic users (~19–25% who view frequently without distress or impairment), and problematic users (~3–8%). Proves that high viewing frequency alone does not equal addiction or pathology.","clinical_takeaway":"Clinicians and spouses must distinguish between frequency and compulsivity; assuming every regular viewer is \"addicted\" misclassifies the majority of users.","confidence":1,"topic_tags":["pornography"],"strengths":["Massive combined sample size across three independent cohorts","Person-centered latent profile analysis avoids arbitrary cutoffs","Demonstrates that 3 out of 4 frequent viewers experience zero functional problems"],"limitations":["Self-report survey data","Cross-sectional profile extraction"],"rubric_version":"2.0","raw_total":52,"max_possible":60,"pct_score":87,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":8,"addiction_criteria":8,"interpretation":9}},"scite":{"supporting":27,"contrasting":1,"mentioning":166,"citing_publications":252,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.01.007"}},{"id":7,"doi":"10.1007/s10508-009-9574-7","pmid":"19937105","pmcid":null,"title":"Hypersexual Disorder: A Proposed Diagnosis for DSM-V [REJECTED PROPOSAL]","authors":"Kafka, M. P.","first_author":"Kafka","journal":"Archives of Sexual Behavior","year":2010,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":485,"is_preprint":false,"topics":["csbd","curated"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"other","design_detail":"Rejected Diagnostic Proposal","sample_n":null,"sample_text":"Literature review + clinical field-trial proposal","population":null,"country":null,"controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"supports","citation_value":"strategic","plain_summary":"Kafka's proposed diagnostic criteria for \"Hypersexual Disorder\" for DSM-5. Ultimately rejected by the American Psychiatric Association in 2012 because it failed to control for moral incongruence, lacked biological/neurological validation, and risked pathologizing normal variations in sexual desire.","clinical_takeaway":"Understanding why the APA rejected Hypersexual Disorder is essential when evaluating older treatment programs that still treat 2010-era criteria as settled fact.","confidence":1,"topic_tags":["other"],"strengths":["Attempted to standardize clinical descriptions of dysregulated sexual behavior","Stimulated a decade of much stronger empirical research into confounders"],"limitations":["Formally rejected by the APA DSM-5 Board of Trustees for insufficient scientific evidence","Failed to exclude distress caused by religious or moral disapproval","Defined disorder circularly by the distress it supposedly caused"],"rubric_version":"2.0","raw_total":18,"max_possible":60,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":3}},"scite":{"supporting":35,"contrasting":4,"mentioning":896,"citing_publications":1086,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-009-9574-7"}},{"id":8,"doi":"10.1891/9780826196767","pmid":null,"pmcid":null,"title":"Treating Out of Control Sexual Behavior: Rethinking Sex Addiction","authors":"Braun-Harvey, D., & Vigorito, M. A.","first_author":"Braun-Harvey","journal":"Springer Publishing Company","year":2016,"pub_types":[],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["curated"],"language":null,"appraisal":{"status":"expert","relevance":"core","evidence_level":"other","design_detail":"Evidence-Based Clinical Treatment Model (OCSB)","sample_n":null,"sample_text":"Clinical treatment manual & outcome framework","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"low","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Establishes the Out of Control Sexual Behavior (OCSB) clinical model and the Six Principles of Sexual Health (Consent, Non-exploitation, Protection, Honesty, Shared Values, Pleasure — adapted in Sacred as Agency, Consent, Mutuality, Honesty, Pleasure, Protection). Replaces disease/addiction pathology with needs-based assessment and personal responsibility.","clinical_takeaway":"Forms the ethical backbone of sex-positive, covenant-honoring clinical work: sexual choices are evaluated by Agency, Consent, Mutuality, Honesty, Pleasure, and Protection.","confidence":1,"topic_tags":["treatment"],"strengths":["Provides a concrete, ethical clinical alternative to 12-step sex-addiction models","Preserves client agency and personal accountability without shame","Distinguishes true self-regulation deficits from values-behavior conflicts"],"limitations":["Clinical framework book requiring practitioner training for full implementation"],"rubric_version":"2.0","raw_total":53,"max_possible":60,"pct_score":88,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":9,"addiction_criteria":8,"interpretation":9}},"scite":{"supporting":1,"contrasting":0,"mentioning":35,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1891/9780826196767"}},{"id":9,"doi":"10.1556/2006.7.2018.134","pmid":"30632378","pmcid":"PMC7044607","title":"Self-Reported Addiction to Pornography in a Nationally Representative Sample: The Roles of Use Habits, Religiousness, and Moral Incongruence","authors":"Grubbs, J. B., Kraus, S. W., & Perry, S. L.","first_author":"Grubbs","journal":"Journal of Behavioral Addictions","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Self-perception","Hypersexual Disorder","Pornography Addiction","Compulsive Sexual Behavior Disorder","Moral Incongruence","Perceived Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7044607","cited_by_count":145,"is_preprint":false,"topics":["curated","pornography","ppu"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally Representative US Population Study","sample_n":null,"sample_text":"Very Large (N = 2,075 nationally representative US adults via YouGov)","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":10,"certainty":"moderate","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"In a nationally representative sample of US adults, ~11% of men and ~3% of women reported feeling some level of \"addiction\" to pornography — and moral incongruence/religiosity was a prime driver of self-reported addiction alongside use frequency.","clinical_takeaway":"Confirms that self-diagnosis of \"porn addiction\" is widespread in religious populations even when clinical criteria for Compulsive Sexual Behavior Disorder are not met.","confidence":1,"topic_tags":["moral_incongruence"],"strengths":["Nationally representative US sample eliminates college-student convenience bias","Establishes accurate population base rates of perceived addiction","Confirms moral incongruence effects across the broader American public"],"limitations":["Cross-sectional survey snapshot"],"rubric_version":"2.0","raw_total":58,"max_possible":60,"pct_score":97,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":10,"neuroimaging":null,"statistics":10,"confounds":10,"design":9,"addiction_criteria":9,"interpretation":10}},"scite":{"supporting":28,"contrasting":6,"mentioning":231,"citing_publications":293,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.134"}},{"id":10,"doi":"10.1111/add.14007","pmid":"28833800","pmcid":null,"title":"Moral Disapproval and Perceived Addiction to Internet Pornography: A Longitudinal Examination","authors":"Grubbs, J. B., Wilt, J. A., Exline, J. J., Pargament, K. I., & Kraus, S. W.","first_author":"Grubbs","journal":"Addiction","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexuality","Personality","Religion","Self-perception","Compulsive Sexual Behavior","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":48,"is_preprint":false,"topics":["curated","pornography","ppu"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"longitudinal","design_detail":"1-Year Longitudinal Cohort Study","sample_n":null,"sample_text":"Large longitudinal cohort tracked over 1 year","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":10,"certainty":"high","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Crucial longitudinal study proving temporal precedence: baseline moral disapproval predicted increases in perceived addiction one year later, even when controlling for actual pornography viewing frequency over that year.","clinical_takeaway":"Proves that people often spiral into deeper shame — mistaking escalating moral anxiety for escalating \"addiction\" — even when their actual behavior has not increased.","confidence":1,"topic_tags":["moral_incongruence"],"strengths":["Longitudinal design overcomes cross-sectional causation limits","Published in the flagship peer-reviewed journal Addiction","Demonstrates that moral disapproval actively generates escalating perceived compulsion over time"],"limitations":["1-year follow-up window; relies on self-reported viewing frequency"],"rubric_version":"2.0","raw_total":59,"max_possible":60,"pct_score":98,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":10,"neuroimaging":null,"statistics":10,"confounds":10,"design":10,"addiction_criteria":9,"interpretation":10}},"scite":{"supporting":5,"contrasting":0,"mentioning":72,"citing_publications":120,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/add.14007"}},{"id":11,"doi":"10.1037/abn0000501","pmid":"32027146","pmcid":null,"title":"Moral Incongruence and Compulsive Sexual Behavior: Results from Cross-Sectional Interactions and Parallel Growth Curve Analyses","authors":"Grubbs, J. B., Lee, B. N., Hoagland, K. C., Kraus, S. W., & Perry, S. L.","first_author":"Grubbs","journal":"Journal of Abnormal Psychology","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":52,"is_preprint":false,"topics":["bibliography","csbd","curated","pornography","ppu"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal Parallel Growth Curve Analysis","sample_n":null,"sample_text":"Multi-sample national & longitudinal cohorts (N > 1,500)","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":10,"certainty":"high","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Examines how moral incongruence interacts with broader Compulsive Sexual Behavior (CSB) scores over time. Shows that moral incongruence amplifies self-reported CSB symptoms at every level of actual sexual behavior.","clinical_takeaway":"Demonstrates why standard sexual-addiction screening questionnaires produce massive false-positive rates in Latter-day Saint and Evangelical clients.","confidence":1,"topic_tags":["moral_incongruence"],"strengths":["Published in Journal of Abnormal Psychology (APA flagship)","Uses parallel growth curve modeling across multiple time points","Directly validates the ICD-11 moral-incongruence exclusion criterion"],"limitations":["US-focused demographic weighting"],"rubric_version":"2.0","raw_total":59,"max_possible":60,"pct_score":98,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":10,"neuroimaging":null,"statistics":10,"confounds":10,"design":10,"addiction_criteria":9,"interpretation":10}},"scite":{"supporting":2,"contrasting":1,"mentioning":55,"citing_publications":98,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/abn0000501"}},{"id":12,"doi":"10.1080/00224499.2018.1427204","pmid":"29412013","pmcid":null,"title":"Moral Incongruence and Pornography Use: A Critical Review and Integration","authors":"Grubbs, J. B., & Perry, S. L.","first_author":"Grubbs","journal":"The Journal of Sex Research","year":2019,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":108,"is_preprint":false,"topics":["curated","pornography","ppu"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"systematic-review","design_detail":"Critical Theoretical & Empirical Review","sample_n":null,"sample_text":"Interdisciplinary review of psychology and sociology literature","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"high","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Integrates psychological and sociological research on moral incongruence, explaining how sacred values, religious identity, and purity culture interact with digital pornography use to produce acute psychological and relational distress.","clinical_takeaway":"Shows how clinicians can honor a client's religious covenants while dismantling the false \"addiction\" narrative that keeps them trapped in shame.","confidence":1,"topic_tags":["moral_incongruence"],"strengths":["Bridges clinical psychology and sociology of religion","Clarifies that acknowledging moral incongruence does not require dismissing a client's faith values"],"limitations":["Theoretical review format"],"rubric_version":"2.0","raw_total":45,"max_possible":50,"pct_score":90,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":9,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":8,"contrasting":1,"mentioning":137,"citing_publications":271,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1427204"}},{"id":13,"doi":"10.1093/oxfordhb/9780195389715.013.0108","pmid":null,"pmcid":null,"title":"Impulsive/Compulsive Sexual Behavior: Assessment and Treatment","authors":"Coleman, E.","first_author":"Coleman","journal":"The Oxford Handbook of Impulse Control Disorders (Oxford University Press)","year":2011,"pub_types":[],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["curated"],"language":null,"appraisal":{"status":"expert","relevance":"core","evidence_level":"other","design_detail":"Clinical Handbook & Diagnostic Framework","sample_n":null,"sample_text":"Clinical synthesis from University of Minnesota Program in Human Sexuality","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"low","red_flags":[],"stance":"opposes","citation_value":"essential","plain_summary":"Eli Coleman demonstrates why dysregulated sexual behavior is best understood and treated through impulse control, anxiety regulation, and sexual health principles rather than chemical addiction models.","clinical_takeaway":"Framing urges as an impulse-control and emotional-regulation skill empowers clients to build capacity rather than viewing themselves as permanently diseased.","confidence":1,"topic_tags":["treatment"],"strengths":["Distinguishes non-paraphilic compulsive behavior from addiction and developmental exploration","Centers emotional regulation, trauma screening, and shame reduction"],"limitations":["Clinical synthesis chapter"],"rubric_version":"2.0","raw_total":53,"max_possible":60,"pct_score":88,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":9,"addiction_criteria":8,"interpretation":9}},"scite":{"supporting":0,"contrasting":1,"mentioning":3,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/oxfordhb/9780195389715.013.0108"}},{"id":14,"doi":"10.1080/00224499.2015.1023427","pmid":"26305435","pmcid":null,"title":"Is Pornography Use Associated with Anti-Woman Attitudes? Re-Examining the Confluence Model with Third Variable Considerations","authors":"Kohut, T., Baer, J. L., & Watts, B.","first_author":"Kohut","journal":"The Journal of Sex Research","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["bibliography","curated","pornography"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"cross-sectional","design_detail":"Multi-Decade Nationally Representative GSS Study","sample_n":null,"sample_text":"Very Large (N > 12,000 across US General Social Survey waves 1975–2010)","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"moderate","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Using nationally representative US General Social Survey data across 35 years, found that pornography viewers did NOT hold more negative attitudes toward women than non-viewers; in fact, viewers held more egalitarian attitudes toward women in public leadership, employment, and family roles.","clinical_takeaway":"Refutes the claim that viewing adult material automatically turns men into misogynists, while underscoring the importance of ethical content evaluation.","confidence":1,"topic_tags":["pornography"],"strengths":["Massive nationally representative probability sample across multiple decades","Rigorous third-variable controls for religiosity and demographic confounds"],"limitations":["GSS binary self-report measure of past-year X-rated movie viewing","Does not differentiate genres of adult material"],"rubric_version":"2.0","raw_total":44,"max_possible":50,"pct_score":88,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":6,"contrasting":2,"mentioning":50,"citing_publications":113,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2015.1023427"}},{"id":15,"doi":"10.1001/jamapsychiatry.2014.93","pmid":"24871202","pmcid":null,"title":"Brain Structure and Functional Connectivity Associated With Pornography Consumption: The Brain on Porn [CRITIQUED]","authors":"Kühn, S., & Gallinat, J.","first_author":"Kühn","journal":"JAMA Psychiatry","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":105,"is_preprint":false,"topics":["curated","pornography"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross-Sectional fMRI Study (Frequently Misrepresented)","sample_n":null,"sample_text":"Small (N = 64 healthy adult men)","population":null,"country":null,"controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"strategic","plain_summary":"Found a negative correlation between self-reported hours of pornography viewing and right caudate gray matter volume in 64 healthy men. The authors themselves explicitly noted that their cross-sectional study could NOT show pornography caused brain changes (men with certain baseline brain structures or higher libido may simply look at more erotica, or normal habituation/synaptic efficiency may occur). Widely misrepresented by advocacy groups as proof of \"brain damage.\"","clinical_takeaway":"A textbook example of how correlational neuroimaging gets distorted into \"porn shrinks your brain\" scare tactics.","confidence":1,"topic_tags":["neuroscience"],"strengths":["Published in JAMA Psychiatry using standard voxel-based morphometry and resting-state fMRI","Authors transparently stated that causation could not be inferred"],"limitations":["Strictly cross-sectional (zero pre/post longitudinal measurement)","Small sample (N = 64) of completely healthy men with no addiction or impairment","Did not control for masturbation frequency, sexual desire level, or moral incongruence"],"rubric_version":"2.0","raw_total":33,"max_possible":70,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":5,"statistics":4,"confounds":3,"design":7,"addiction_criteria":6,"interpretation":3}},"scite":{"supporting":10,"contrasting":1,"mentioning":159,"citing_publications":261,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/jamapsychiatry.2014.93"}},{"id":16,"doi":"10.1111/jsm.12853","pmid":"25816904","pmcid":null,"title":"Is Pornography Use Associated with Sexual Difficulties and Dysfunctions Among Younger Heterosexual Men?","authors":"Landripet, I., & Štulhofer, A.","first_author":"Landripet","journal":"The Journal of Sexual Medicine","year":2015,"pub_types":["Journal Article"],"keywords":["Men","erectile dysfunction","Sexual Difficulties","Sexual Dysfunctions","Hypoactive Sexual Desire","Pornography","Pornography Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":59,"is_preprint":false,"topics":["bibliography","curated","pornography","sexual_health"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"cross-sectional","design_detail":"Multi-Country Community Survey (N > 4,000)","sample_n":null,"sample_text":"Very Large (N = 4,011 heterosexual men across 3 European countries)","population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":8,"certainty":"very_low","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Tested the viral claim that internet pornography is causing an epidemic of erectile dysfunction (\"PIED\") in young men across three large European samples. Found little to no association between pornography use frequency and erectile dysfunction, premature ejaculation, or low sexual desire.","clinical_takeaway":"Reassures men and clinicians that viewing pornography does not physically break erectile mechanics.","confidence":1,"topic_tags":["relationships"],"strengths":["Large sample (N > 4,000) across Croatia, Norway, and Portugal","Used clinically validated erectile function instruments","Directly tested and refuted the viral \"PIED epidemic\" hypothesis"],"limitations":["Cross-sectional survey design","European samples with lower baseline religious moral incongruence than Utah/US samples"],"rubric_version":"2.0","raw_total":42,"max_possible":60,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":8,"confounds":4,"design":8,"addiction_criteria":7,"interpretation":8}},"scite":{"supporting":7,"contrasting":1,"mentioning":89,"citing_publications":112,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12853"}},{"id":17,"doi":"10.1002/sm2.58","pmid":null,"pmcid":null,"title":"Viewing More Sexual Stimuli Is Associated with GREATER, Not Lesser, Sexual Arousal and Erectile Function","authors":"Prause, N., & Pfaus, J.","first_author":"Prause","journal":"Sexual Medicine","year":2015,"pub_types":[],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["bibliography","curated","pornography","sexual_health"],"language":null,"appraisal":{"status":"expert","relevance":"core","evidence_level":"rct","design_detail":"Laboratory Psychophysiological Study","sample_n":null,"sample_text":"N = 280 men evaluated in laboratory sexual arousal paradigms","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":8,"certainty":"high","red_flags":[],"stance":"strongly-opposes","citation_value":"useful","plain_summary":"Found that men who viewed more visual sexual stimuli actually reported higher sexual arousal to partnered sex scenarios and higher dyadic sexual desire, with zero correlation to erectile dysfunction.","clinical_takeaway":"Further disproves the claim that visual erotica physiologically numbs men to real-life partners.","confidence":1,"topic_tags":["relationships"],"strengths":["Controlled laboratory paradigm rather than retrospective forum anecdotes","Distinguishes solitary arousal from partnered sexual desire"],"limitations":["Non-clinical community volunteer sample"],"rubric_version":"2.0","raw_total":41,"max_possible":50,"pct_score":82,"quality_rating":"Good","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":8,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":1,"mentioning":39,"citing_publications":151,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/sm2.58"}},{"id":19,"doi":"10.1007/s10508-019-01623-8","pmid":"32130561","pmcid":"PMC7145784","title":"Abstinence Motivation and Masturbation Guilt: Psychological Correlates of “NoFap” and Abstinence Beliefs","authors":"Zimmer, F., & Imhoff, R.","first_author":"Zimmer","journal":"Archives of Sexual Behavior","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Masturbation","Abstinence","Dsm-5","Hypersexuality","Hypersexual Behavior Inventory"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-019-01623-8.pdf","cited_by_count":23,"is_preprint":false,"topics":["csbd","curated","masturbation","pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large Empirical Analysis of Abstinence Motivation (N = 1,063)","sample_n":null,"sample_text":"Large (N = 1,063 men)","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":8,"certainty":"moderate","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Examined the psychological drivers of masturbation abstinence movements. Found that motivation to abstain from masturbation was NOT predicted by hypersexual behavior, but by moral conservatism, religiosity, belief that masturbation is physically/mentally harmful, and distrust of science.","clinical_takeaway":"Confirms that anti-masturbation panic in modern online spaces is a repackaging of classic moral incongruence and nineteenth-century health myths.","confidence":1,"topic_tags":["masturbation"],"strengths":["Large sample directly studying men in online abstinence communities","Shows that masturbation shame and belief in harm myths drive distress, not frequency"],"limitations":["Cross-sectional survey design"],"rubric_version":"2.0","raw_total":47,"max_possible":60,"pct_score":78,"quality_rating":"Good","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":8,"design":8,"addiction_criteria":7,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":24,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-01623-8"}},{"id":20,"doi":"10.1016/j.beth.2016.02.001","pmid":"27157029","pmcid":null,"title":"Acceptance and Commitment Therapy as a Treatment for Problematic Internet Pornography Viewing: A Randomized Controlled Trial","authors":"Crosby, J. M., & Twohig, M. P. (following Twohig & Crosby, 2010)","first_author":"Crosby","journal":"Behavior Therapy","year":2016,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":["Treatment","Acceptance And Commitment Therapy","Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":54,"is_preprint":false,"topics":["csbd","curated","pornography"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"rct","design_detail":"Randomized Controlled Trial (Utah / Predominantly LDS Sample)","sample_n":null,"sample_text":"N = 28 men in RCT (waitlist control + 12-week ACT protocol + follow-up)","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"high","red_flags":[],"stance":"opposes","citation_value":"essential","plain_summary":"Landmark Randomized Controlled Trial conducted at Utah State University with predominantly Latter-day Saint men struggling with unwanted pornography viewing. Twelve sessions of Acceptance and Commitment Therapy (ACT) — focusing on psychological flexibility, defusion from shame, and values-based living rather than \"addiction\" labels or thought suppression — reduced viewing by 92% post-treatment (vs. 21% in waitlist) and improved quality of life.","clinical_takeaway":"Directly validates the therapeutic approach used in Sacred and Daniel's clinical practice: when you stop fighting thoughts in shame and build psychological flexibility and values-aligned agency, compulsive patterns dissolve.","confidence":1,"topic_tags":["treatment"],"strengths":["True Randomized Controlled Trial (RCT) with waitlist control and longitudinal follow-up","Conducted specifically with Latter-day Saint men navigating high moral incongruence","Proves that reducing shame and experiential avoidance produces dramatic behavioral change without addiction labels"],"limitations":["Modest RCT sample size (N = 28, building on 2010 multiple-baseline trial)"],"rubric_version":"2.0","raw_total":53,"max_possible":60,"pct_score":88,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":9,"addiction_criteria":8,"interpretation":9}},"scite":{"supporting":3,"contrasting":0,"mentioning":112,"citing_publications":192,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.beth.2016.02.001"}},{"id":22,"doi":"10.1093/oso/9780190844219.001.0001","pmid":null,"pmcid":null,"title":"Addicted to Lust: Pornography and the Lived Experience of Moral Incongruence Among Conservative Protestants","authors":"Perry, S. L.","first_author":"Perry","journal":"Oxford University Press","year":2019,"pub_types":[],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["curated"],"language":null,"appraisal":{"status":"expert","relevance":"core","evidence_level":"longitudinal","design_detail":"Mixed-Methods Longitudinal & Qualitative Sociological Study","sample_n":null,"sample_text":"National longitudinal survey panels + in-depth qualitative interviews","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"high","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Demonstrates how religious communities that frame all sexual desire or pornography viewing through an apocalyptic \"addiction\" lens inadvertently create the very secrecy, depression, and marital breakdown they seek to prevent.","clinical_takeaway":"Explains why wives in strict religious communities often experience discovery of occasional viewing as a devastating betrayal: both partners have been taught that viewing once means he is a broken addict who doesn't love her.","confidence":1,"topic_tags":["moral_incongruence"],"strengths":["Combines national longitudinal panel data with deep qualitative interviews of religious men and wives","Shows how pastoral surveillance and public confession amplify secrecy and marital distress"],"limitations":["Focuses primarily on conservative Protestant communities (though directly parallel to LDS culture)"],"rubric_version":"2.0","raw_total":53,"max_possible":60,"pct_score":88,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":9,"addiction_criteria":8,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/oso/9780190844219.001.0001"}},{"id":24,"doi":"10.1007/s10508-016-0783-6","pmid":"27393037","pmcid":null,"title":"Perceived Effects of Pornography on the Couple Relationship: Initial Findings of Open-Ended, Empirical Research","authors":"Kohut, T., Fisher, W. A., & Campbell, L.","first_author":"Kohut","journal":"Archives of Sexual Behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Relationships","Relationship Quality","Sexual Satisfaction","Relationship Satisfaction","Pornography","Sexually Explicit Material"],"is_oa":false,"oa_url":null,"cited_by_count":104,"is_preprint":false,"topics":["bibliography","curated","pornography","sexual_health"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"cross-sectional","design_detail":"Bottom-Up Qualitative & Quantitative Couple Study (N = 430)","sample_n":null,"sample_text":"N = 430 individuals in romantic relationships","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":8,"certainty":"moderate","red_flags":[],"stance":"opposes","citation_value":"useful","plain_summary":"When researchers asked couples open-ended questions without presupposing harm, the single most common reported effect of pornography on relationships was \"no negative effect,\" followed by improved sexual communication and experimentation, while a smaller subset reported unrealistic expectations or secrecy conflict.","clinical_takeaway":"Highlights how survey framing and cultural expectations shape whether couples experience sexual media as catastrophic or manageable.","confidence":1,"topic_tags":["relationships"],"strengths":["Eliminated leading-question bias common in pathology-focused surveys","Captured both positive and negative relational themes organically"],"limitations":["General community sample rather than high-religiosity clinical sample"],"rubric_version":"2.0","raw_total":40,"max_possible":50,"pct_score":80,"quality_rating":"Good","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":8,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":1,"mentioning":155,"citing_publications":238,"retracted":false,"notices":[{"status":"Has correction","date":"2016-10-14","noticeDoi":"10.1007/s10508-016-0838-8","doi":"10.1007/s10508-016-0783-6"},{"status":"Has erratum","date":"2016-10-14","noticeDoi":"10.1007/s10508-016-0838-8","doi":"10.1007/s10508-016-0783-6"}],"url":"https://scite.ai/reports/10.1007/s10508-016-0783-6"}},{"id":25,"doi":"10.1300/j056v14n02_02","pmid":null,"pmcid":null,"title":"Masturbation as a Means of Achieving Sexual Health","authors":"Coleman, E.","first_author":"Coleman","journal":"Journal of Psychology & Human Sexuality","year":2002,"pub_types":[],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["curated"],"language":null,"appraisal":{"status":"expert","relevance":"core","evidence_level":"systematic-review","design_detail":"Clinical & Developmental Review","sample_n":null,"sample_text":"Comprehensive review of developmental, epidemiological, and clinical sexology studies","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"high","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Documents masturbation as a universal, normative aspect of human sexual development from childhood through older adulthood. Shows that self-exploration builds body awareness, healthy arousal understanding, and resilience against sexual dysfunction, while pathologizing it inflicts psychological harm.","clinical_takeaway":"Provides the developmental science behind why shaming adolescent or single-adult masturbation alienates people from their own bodies and impairs future marital intimacy.","confidence":1,"topic_tags":["masturbation"],"strengths":["Reviews lifespan developmental evidence across genders and cultures","Demonstrates clinical role of self-awareness in treating anorgasmia and sexual pain"],"limitations":["Clinical review format"],"rubric_version":"2.0","raw_total":45,"max_possible":50,"pct_score":90,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":9,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":2,"contrasting":1,"mentioning":73,"citing_publications":143,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j056v14n02_02"}},{"id":26,"doi":"10.1007/s12119-005-1003-z","pmid":null,"pmcid":null,"title":"Historical Development of New Masturbation Attitudes in Mormon Culture: Silence, Secular Conformity, Counterrevolution, and Emerging Reform","authors":"Malan, M. K., & Bullough, V. L.","first_author":"Malan","journal":"Sexuality & Culture","year":2005,"pub_types":[],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["curated"],"language":null,"appraisal":{"status":"expert","relevance":"core","evidence_level":"systematic-review","design_detail":"Primary-Source Historical & Institutional Analysis","sample_n":null,"sample_text":"Archival analysis of 19th–21st century LDS manuals, periodicals, and bishop guides","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"high","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Traces how nineteenth- and early twentieth-century Mormon culture rarely treated masturbation as a grave ecclesiastical sin (and in 1927 published progressive medical reassurance in the Relief Society Magazine), before mid-twentieth-century institutional leaders adopted Victorian purity rhetoric and bishop worthiness interrogation practices.","clinical_takeaway":"Liberates Latter-day Saint clients by showing that cultural shame around masturbation is a product of a specific historical era rather than unchanging scriptural doctrine.","confidence":1,"topic_tags":["masturbation"],"strengths":["Exhaustive archival documentation of handbooks, sermons, and periodicals across 175 years","Proves that severe anti-masturbation worthiness interviews were a mid-20th-century historical development, not eternal canon"],"limitations":["Published in 2005 (predates the 2022 For the Strength of Youth shift toward principle-based agency)"],"rubric_version":"2.0","raw_total":45,"max_possible":50,"pct_score":90,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":9,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12119-005-1003-z"}},{"id":27,"doi":"10.1080/009262300278641","pmid":null,"pmcid":null,"title":"The Female Sexual Response: A Different Model","authors":"Basson, R.","first_author":"Basson","journal":"Journal of Sex & Marital Therapy","year":2000,"pub_types":[],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["curated"],"language":null,"appraisal":{"status":"expert","relevance":"core","evidence_level":"other","design_detail":"Foundational Clinical Sexology Model","sample_n":null,"sample_text":"Clinical and psychophysiological synthesis","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":10,"certainty":"low","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Demonstrates that in committed relationships, sexual desire is frequently responsive rather than spontaneous: a partner begins from emotional neutrality, chooses to engage for closeness/pleasure when the context is safe, experiences physical and mental arousal, and THEN experiences conscious sexual desire.","clinical_takeaway":"Helps couples understand that waiting to \"feel spontaneously horny\" before initiating intimacy misunderstands how responsive desire works — and that pressure kills the very safety responsive desire requires.","confidence":1,"topic_tags":["relationships"],"strengths":["Overturned decades of misdiagnosing healthy women with \"Hypoactive Sexual Desire Disorder\"","Directly shaped DSM-5 revisions to sexual interest/arousal criteria"],"limitations":["Requires couples to ensure emotional safety so willingness is never confused with duty sex"],"rubric_version":"2.0","raw_total":50,"max_possible":50,"pct_score":100,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":10,"neuroimaging":null,"statistics":10,"confounds":10,"design":10,"addiction_criteria":null,"interpretation":10}},"scite":{"supporting":30,"contrasting":4,"mentioning":526,"citing_publications":967,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/009262300278641"}},{"id":28,"doi":"10.4324/9780429059681","pmid":null,"pmcid":null,"title":"Magnificent Sex: Lessons from Extraordinary Lovers","authors":"Kleinplatz, P. J., & Ménard, A. D.","first_author":"Kleinplatz","journal":"Routledge","year":2020,"pub_types":[],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["curated"],"language":null,"appraisal":{"status":"expert","relevance":"core","evidence_level":"cross-sectional","design_detail":"Phenomenological & Clinical Study of Optimal Sexuality","sample_n":null,"sample_text":"In-depth interviews with diverse older adults, long-term couples, and sex practitioners","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"moderate","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Instead of studying sexual dysfunction, Kleinplatz and Ménard studied people having extraordinary sex across decades of marriage. Found that magnificent sex is NOT predicted by youth, physical perfection, or acrobatic technique, but by 8 qualities: being present/embodied, authenticity, intense emotional connection, interpersonal risk-taking/vulnerability, empathy, communication, and transcendence.","clinical_takeaway":"Aligns directly with Sacred's vision of covenant intimacy: extraordinary sexual wholeness is built on presence, vulnerability, mutuality, and grace.","confidence":1,"topic_tags":["relationships"],"strengths":["Shifts sexology from \"fixing broken mechanics\" to cultivating optimal intimacy","Demonstrates that emotional presence, vulnerability, and authenticity are the true engines of eroticism"],"limitations":["Qualitative interview methodology"],"rubric_version":"2.0","raw_total":44,"max_possible":50,"pct_score":88,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4324/9780429059681"}},{"id":29,"doi":"10.3390/bs6030017","pmid":"27527226","pmcid":"PMC5039517","title":"Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports [peer-reviewed form of Wilson's \"Your Brain on Porn\" argument — critiqued]","authors":"Park, B. Y., Wilson, G., Berger, J., Christman, M., Reina, B., Bishop, F., Klam, W. P., & Doan, A. P.","first_author":"Park","journal":"Behavioral Sciences","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["erectile dysfunction","Pied","Delayed Ejaculation","Pornography","Internet Pornography","Sexually Explicit Material","Low Sexual Desire","Low Sexual Satisfaction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5039517","cited_by_count":62,"is_preprint":false,"topics":["curated","pornography"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"other","design_detail":"Pop-Science / Advocacy Review (High Methodological Flaws)","sample_n":null,"sample_text":"Anecdotal forum posts + selective citation of rodent/substance studies","population":null,"country":null,"controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational","selective_reporting","self_selected_sample","advocacy_or_coi"],"stance":"strongly-supports","citation_value":"avoid","plain_summary":"Popularized the claim that internet pornography hijacks dopamine, accumulates DeltaFosB to cause brain damage, and causes an epidemic of \"PIED.\" Heavily critiqued by peer-reviewed neuroscientists and sexologists (Ley, Prause, Grubbs, Štulhofer) for cherry-picking cross-sectional correlations, misapplying rodent sexual exhaustion models to humans, and ignoring moral incongruence.","clinical_takeaway":"Clients arriving in therapy after reading Your Brain on Porn or Fight the New Drug often carry severe iatrogenic anxiety (\"my brain is broken\") that must be gently deconstructed with accurate neuroscience.","confidence":1,"topic_tags":["other"],"strengths":["Gave voice to men feeling distressed and dismissed, though misdiagnosed the cause of their distress"],"limitations":["Zero controlled experimental evidence showing DeltaFosB pathology from human pornography viewing","Completely ignores moral incongruence, religiosity, and performance anxiety confounds","Treats cross-sectional correlations and anonymous Reddit anecdotes as causal proof","Promotes catastrophic beliefs that demonstrably worsen erectile anxiety and depression (nocebo effect)"],"rubric_version":"2.0","raw_total":12,"max_possible":70,"pct_score":17,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":2,"statistics":2,"confounds":1,"design":2,"addiction_criteria":2,"interpretation":2}},"scite":{"supporting":5,"contrasting":1,"mentioning":106,"citing_publications":191,"retracted":false,"notices":[{"status":"Has correction","date":"2016-8-5","noticeDoi":"10.3390/bs8060055","doi":"10.3390/bs6030017"},{"status":"Has erratum","date":"2018-6-1","noticeDoi":"10.3390/bs8060055","doi":"10.3390/bs6030017"}],"url":"https://scite.ai/reports/10.3390/bs6030017"}},{"id":30,"doi":"10.1002/ab.20328","pmid":"19862768","pmcid":null,"title":"Pornography and Attitudes Supporting Violence Against Women: Revisiting the Relationship in Nonexperimental Studies","authors":"Hald, G. M., Malamuth, N. M., & Yuen, C.","first_author":"Hald","journal":"Aggressive Behavior","year":2010,"pub_types":["Meta-Analysis","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":105,"is_preprint":false,"topics":["curated","pornography"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta-Analysis of Non-Experimental Studies (Confluence Model)","sample_n":null,"sample_text":"Meta-analysis of 9 non-experimental studies (N = 2,309)","population":null,"country":null,"controls_mi":"no","preregistered":false,"quality_score":8,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"supports","citation_value":"strategic","plain_summary":"Found a small overall correlation (r = .18) between pornography use and attitudes supporting violence against women in non-experimental studies, strongly moderated by whether the material was explicitly violent and whether the viewer already scored high on hostile masculinity (the Confluence Model).","clinical_takeaway":"Included for complete scientific transparency: while mainstream consensual viewing does not make average men anti-woman (Kohut et al., 2016), consuming violent or degrading material reinforces harmful attitudes in men with pre-existing hostility.","confidence":1,"topic_tags":["pornography"],"strengths":["Quantitative meta-analysis testing specific personality and content moderators","Demonstrates why violent/non-consensual content and predisposing hostility matter"],"limitations":["Small effect size from correlational studies (cannot establish causation)","Did not control for religiosity or moral incongruence (compare with Kohut et al., 2016 GSS study)"],"rubric_version":"2.0","raw_total":38,"max_possible":50,"pct_score":76,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":10,"confounds":4,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":10,"contrasting":0,"mentioning":193,"citing_publications":359,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ab.20328"}},{"id":31,"doi":"10.1007/s10508-026-03493-3","pmid":"42477249","pmcid":"PMC13427923","title":"Impulsivity and Emotional Dysregulation in Distress and Self-Perceived Pornography Addiction in Romanian Adults: Advancing the Dysregulation Pathway of \"The Pornography Problems Due to Moral Incongruence Model\"","authors":"Huţul TD, Huţul A, Karner-Huţuleac A, Holman AC, Grubbs JB.","first_author":"Huţul TD","journal":"Archives of sexual behavior","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Distress","Impulsivity","Emotional Dysregulation","Problematic Pornography Use","Self-perceived Pornography Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13427923","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of Romanian adults (N=1620) using self‑report questionnaires on impulsivity, emotion dysregulation, distress and self‑perceived pornography addiction","sample_n":1620,"sample_text":"1620 participants (69.1% female), age 18‑74, recruited online","population":"Romanian adults, community sample (convenience recruitment)","country":"Romania","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A Romanian survey of 1,620 adults found that higher impulsivity and emotional dysregulation were linked to greater distress and to feeling addicted to pornography, supporting a ‘dysregulation’ pathway in a moral‑incongruence model.","clinical_takeaway":"Impulsivity and emotion‑regulation difficulties may contribute to distress about pornography use; clinicians should assess these traits rather than assume a true addiction.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample size","Use of multi‑dimensional impulsivity scales","Focus on understudied dysregulation pathway"],"limitations":["Cross‑sectional design prevents causal inference","Self‑perceived addiction measured by single‑item, circular definition","No measurement or control of key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)"],"rubric_version":"2.0","raw_total":27,"max_possible":60,"pct_score":45,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03493-3"}},{"id":32,"doi":"10.31234/osf.io/zs6gk_v1","pmid":null,"pmcid":null,"title":"The Dual-Level Dynamics of Moral Incongruence: A Multilevel Analysis of Problematic Pornography Use","authors":"Grubbs JB, Floyd C, Carrasquillo K, Kraus SW.","first_author":"Grubbs JB","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd","pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal multilevel analysis of 5 waves (2 years) with 2,903 individuals (7,512 person‑waves).","sample_n":2903,"sample_text":"Large community sample, recruited online; not a treatment‑seeking or forum group.","population":"Community sample of American adults (large, but not nationally probability).","country":"USA","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a two‑year study of 2,900 U.S. adults, people who morally disapproved of pornography reported more feelings of problematic use when they also watched more porn. Moral disapproval reduced how often they watched, but heightened perceived addiction among those who did watch frequently.","clinical_takeaway":"Assess moral conflict when evaluating self‑reported porn‑related problems; frequency alone may miss distress driven by personal values.","confidence":0.8,"topic_tags":["pornography","moral_incongruence","sexual_function","csbd"],"strengths":["Large longitudinal sample","Multilevel modeling captures within‑ and between‑person effects","Explicit measurement of moral disapproval"],"limitations":["Masturbation and other sexual‑behavioural covariates not assessed","Mental‑health, relationship and trauma factors omitted","Reliance on self‑report scales; validation not described"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/zs6gk_v1"}},{"id":33,"doi":"10.1556/2006.2025.00540","pmid":"42013354","pmcid":"PMC13371739","title":"A global investigation of the Moral Incongruence Model of Pornography Use across genders, religions, and cultures","authors":"Bőthe B, Michaud A, Beaulieu V, Houle S, Nagy L, Koós M, Kraus SW, Potenza MN, Demetrovics Z, Költő A, International Sex Survey Consortium, Grubbs JB.","first_author":"Bőthe B","journal":"Journal of behavioral addictions","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Compulsive Sexual Behavior","Pornography","Moral Incongruence","Moral Disapproval","Self-perceived Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13371739","cited_by_count":2,"is_preprint":false,"topics":["csbd","pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large international online survey (N=66,994) analysed with multi‑group structural equation modelling across 34 countries, genders and religions.","sample_n":66994,"sample_text":"International online convenience sample (Internet panel) covering 34 countries.","population":"Adults (all ages) from 34 countries, roughly gender‑balanced, recruited online for the International Sex Survey.","country":"Multiple (34 nations)","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"Using data from almost 67,000 adults in 34 countries, the study found that religious people who feel morally conflicted about porn use are more likely to report problematic use or think they are addicted. The pattern was similar for men and women and across cultures.","clinical_takeaway":"Clinicians should assess moral conflict and religious beliefs when clients report porn‑related distress, as these factors shape perceived problem use.","confidence":0.78,"topic_tags":["pornography","moral_incongruence","sexual_function","csbd"],"strengths":["Very large, multicultural sample","Advanced SEM approach with invariance testing across many groups","Direct measurement of moral incongruence"],"limitations":["Cross‑sectional design; cannot infer causality","Masturbation not measured, limiting interpretation of pornography‑only effects","Potential self‑selection bias of online respondents"],"rubric_version":"2.0","raw_total":37,"max_possible":60,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00540"}},{"id":34,"doi":"10.31234/osf.io/fndpm_v2","pmid":null,"pmcid":null,"title":"Moral Incongruence After 10 Years: A Developmental and Narrative Review","authors":"Grubbs JB, Floyd CG.","first_author":"Grubbs JB","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://osf.io/fndpm_v2/download","cited_by_count":0,"is_preprint":true,"topics":["csbd","pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of moral incongruence literature","sample_n":null,"sample_text":"not applicable – literature review","population":"none (review)","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review traces ten years of research on moral incongruence, showing how religious and moral conflict can make some people feel they are addicted to pornography, and summarises critiques and updates of the model.","clinical_takeaway":"Clinicians should assess moral conflict when clients report distress about pornography use, as it may explain perceived addiction.","confidence":0.8,"topic_tags":["moral_incongruence","pornography","sexual_function","csbd"],"strengths":["Comprehensive historical overview","Cross‑cultural evidence noted"],"limitations":["No new empirical data","Potential author bias toward moral incongruence model"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/fndpm_v2"}},{"id":35,"doi":"10.31234/osf.io/fndpm_v1","pmid":null,"pmcid":null,"title":"Moral Incongruence After 10 Years: A Developmental and Narrative Review","authors":"Grubbs JB, Floyd CG.","first_author":"Grubbs JB","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://osf.io/fndpm_v1/download","cited_by_count":0,"is_preprint":true,"topics":["csbd","pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"developmental and narrative review; no primary data, no systematic methods","sample_n":null,"sample_text":"N/A (review article)","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review traces ten years of research on moral incongruence – the clash between personal sexual behavior and moral or religious beliefs – and argues it helps explain why some people feel ‘addicted’ to pornography.","clinical_takeaway":"Clinicians should consider moral conflict as a possible factor when patients report distress about pornography use, rather than assuming pathology.","confidence":0.8,"topic_tags":["moral_incongruence","pornography","sexual_function","csbd"],"strengths":["Comprehensive historical overview of moral incongruence literature","Identifies cross‑cultural replication of the concept"],"limitations":["No systematic search or risk‑of‑bias assessment","Relies on narrative synthesis without quantitative analysis","Does not present new empirical data"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":3,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/fndpm_v1"}},{"id":36,"doi":"10.3389/fpsyg.2026.1950267","pmid":"42769130","pmcid":"PMC13590686","title":"Perceived loneliness, problematic pornography use, and psychological distress in Ecuadorian university students: a correlational path analysis","authors":"Morales-Cevallos MB, López-Barranco G, Oleas D, Leon-Rojas JE, Anastou D, Rodas JA.","first_author":"Morales-Cevallos MB","journal":"Frontiers in psychology","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Ecuador","Loneliness","Psychological Distress","university students","Behavioral Addictions","Mediation Analysis","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13590686","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional correlational survey of 273 Ecuadorian university students","sample_n":273,"sample_text":"convenience sample of students who reported habitual pornography use","population":"university students, 18-29, Ecuador","country":"Ecuador","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 273 Ecuadorian university students, higher loneliness was linked to more problematic pornography use, and both were associated with greater depression, anxiety and stress. The study suggests that pornography use may be a coping behaviour for lonely students, but warns against labeling frequent use as an addiction.","clinical_takeaway":"Screen for loneliness and emotional distress when clients report problematic pornography use; focus on coping skills rather than solely reducing use.","confidence":0.8,"topic_tags":["pornography","sexual_function","moral_incongruence","relationships","csbd"],"strengths":["relatively large sample for a student survey","uses mediation analysis with bootstrapping","controls for age, sex, and mental‑health symptoms"],"limitations":["cross‑sectional; cannot infer causality","no measurement of moral incongruence or masturbation","problematic pornography use scale not described; possible circularity"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2026.1950267"}},{"id":37,"doi":"10.1016/j.abrep.2026.100741","pmid":"42707146","pmcid":"PMC13546883","title":"Psychological correlates of problematic pornography use: A systematic review and meta-analysis of measurement and conceptualization differences","authors":"Sheikhi S, Mohammadkhani S, Akbari M.","first_author":"Sheikhi S","journal":"Addictive behaviors reports","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Meta-analysis","Compulsive Sexual Behavior","Behavioral Dysregulation","Problematic Pornography Use","Moral Incongruence","Measurement Heterogeneity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13546883","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"systematic review and random‑effects meta‑analysis of 97 articles (111 samples) with moderator analyses on operationalisation of problematic pornography use","sample_n":null,"sample_text":"97 articles comprising 111 independent samples","population":"adult participants across 97 primary studies (heterogeneous samples)","country":"multiple (global literature)","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This meta‑analysis examined 97 studies on problematic pornography use and found that its psychological links (e.g., craving, shame, depression) differ depending on whether researchers define the problem by behavioral dysregulation or by moral distress.","clinical_takeaway":"Clinicians should note that reported problems with pornography may stem from different underlying factors—behavioural control or moral conflict—so assessment should distinguish these dimensions.","confidence":0.84,"topic_tags":["pornography","sexual_function","measurement","moral_incongruence"],"strengths":["Comprehensive synthesis of 97 studies","Systematic coding of measurement orientation","Moderator analyses to explain heterogeneity"],"limitations":["Relies on primary studies with variable quality","No formal risk‑of‑bias assessment reported","Limited control of confounds in the meta‑analytic model"],"rubric_version":"2.0","raw_total":42,"max_possible":60,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":5,"design":8,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.abrep.2026.100741"}},{"id":38,"doi":"10.1038/s41598-026-56057-9","pmid":"42243245","pmcid":"PMC13237368","title":"Association between behavioral addiction and psychological disorders among medical students in Egypt, Sudan, and Libya: a cross-sectional study","authors":"Hagag AM, Shehata AS, Abdelhamed AM, Ahmed GA, Ghanem OA, Akwaisah A, Abdelghani M.","first_author":"Hagag AM","journal":"Scientific reports","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Stress","Depression","Anxiety","Cross-sectional study","Psychological Disorders","Behavioral Addiction","Problematic Internet Use","Pornography Addiction","Gaming Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13237368","cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire of 1284 medical students from three countries; prevalence estimates and regression analyses of behavioral addictions and psychological distress.","sample_n":1284,"sample_text":"1284 participants completed the questionnaire","population":"medical students (Egypt, Sudan, Libya)","country":"Egypt; Sudan; Libya","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1284 medical students in Egypt, Sudan and Libya found that about 8% reported problematic pornography use, which was linked to higher anxiety and depression. The study used self‑report scales and did not consider moral or relational factors that might affect these results.","clinical_takeaway":"Problematic pornography use co‑occurs with anxiety and depression in this student group, but clinicians should assess moral, relational, and other psychosocial factors before drawing conclusions.","confidence":0.78,"topic_tags":["pornography","sexual_function","treatment","prevalence"],"strengths":["Large total sample (>1200)","Use of validated scales for internet, gaming, and pornography problems","Multi‑country data allowing regional comparison","Multivariable regression to adjust for some covariates"],"limitations":["Cross‑sectional design; cannot infer causality","No measurement of moral incongruence or masturbation, key confounds for pornography distress","Potential circularity in the pornography addiction scale","Self‑selected online sample of medical students limits generalisability"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":4,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-026-56057-9"}},{"id":39,"doi":null,"pmid":"40435138","pmcid":null,"title":"Insomnia and Pornography Addiction in Rhode Island Young Adults","authors":"Noel JK, Jacob S, Hicks SL, Gately KA, Rosenthal SR.","first_author":"Noel JK","journal":"Rhode Island medical journal (2013)","year":2025,"pub_types":["Journal Article"],"keywords":["Men","Insomnia","Young Adults","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey (n=1008) of Rhode Island young adults; logistic regression adjusting for demographics","sample_n":1008,"sample_text":"large community sample from state‑wide survey; not a clinical or treatment‑seeking group","population":"young adults (presumably 18‑30) in Rhode Island; both genders; self‑selected via online survey","country":"USA","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a state‑wide survey of over 1,000 young adults, those who screened positive for insomnia were about twice as likely to meet a questionnaire‑based definition of pornography addiction, a link driven mainly by cisgender heterosexual men.","clinical_takeaway":"Insomnia in young men may co‑occur with problematic pornography use, but causality is unclear; screen for both if clinically indicated.","confidence":0.78,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample (N>1000)","Use of validated scales for pornography use and insomnia","Gender‑specific interaction explored"],"limitations":["Cross‑sectional; cannot establish causality","No measurement of moral incongruence, masturbation, mental health or trauma","Addiction defined by PPCS may conflate distress with use"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":3,"interpretation":5}},"scite":null},{"id":40,"doi":"10.1556/2006.2025.00452","pmid":"41805604","pmcid":"PMC13132397","title":"Persistent appetitive memory in problematic pornography users","authors":"Kampa M, Krikova K, Stark R, Klucken T.","first_author":"Kampa M","journal":"Journal of behavioral addictions","year":2026,"pub_types":["research-article","Multicenter Study","Journal Article"],"keywords":["Extinction","fMRI","Appetitive Conditioning","Reward Processing","Cue Reactivity","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13132397","cited_by_count":1,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control fMRI study of 58 heterosexual men (23 pathological, 35 non‑problematic) examining conditioning, extinction and recall of pornographic cues","sample_n":58,"sample_text":"58 participants (23 pathological pornography users, 35 non‑problematic users)","population":"heterosexual adult males, recruited as part of a multicenter internet‑use disorders project in Germany","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational","underpowered_sample"],"stance":"supports","citation_value":"useful","plain_summary":"In a brain‑imaging study of 58 men, those labelled as having problematic pornography use showed stronger ventral‑striatal activity during learning and persistent activation in brain areas linked to reward when pornography cues were later presented, suggesting a lingering appetitive memory.","clinical_takeaway":"Current evidence does not yet prove pornography use is an addiction; neuro‑imaging findings are preliminary and confounded.","confidence":0.7,"topic_tags":["pornography","csbd","neuroscience"],"strengths":["use of multimodal neuroimaging (fMRI + SCR)","includes a control group of non‑problematic users","focus on appetitive memory processes relevant to addiction theories"],"limitations":["small, convenience sample; likely under‑powered for fMRI contrasts","no measurement of key confounds (moral incongruence, masturbation, mental health, partner status, trauma)","group classification based on unspecified criteria; possible circularity"],"rubric_version":"2.0","raw_total":32,"max_possible":70,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":6,"statistics":5,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00452"}},{"id":41,"doi":"10.1177/00912174251329440","pmid":"40151846","pmcid":null,"title":"Prevalence and correlates of problematic pornography use among undergraduate medical students in Egypt","authors":"Mohamed EF, Mohamed AE, Youssef AM, Sehlo MG, Alnasr Soliman ES, Ibrahim AS.","first_author":"Mohamed EF","journal":"International journal of psychiatry in medicine","year":2025,"pub_types":["Journal Article"],"keywords":["Depression","Medical Students","Academic Performance","Anxiety And Stress","Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 614 undergraduate medical students from one Egyptian university","sample_n":614,"sample_text":"614 undergraduate medical students selected across six academic years","population":"undergraduate medical students (Egypt)","country":"Egypt","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 614 Egyptian medical students, about one‑quarter screened positive for problematic pornography use. Higher rates were linked to being older, male, having more depression, anxiety and stress, and poorer academic performance.","clinical_takeaway":"Screen for distress and mental‑health issues when patients report excessive pornography use; prevalence may be high in student populations.","confidence":0.78,"topic_tags":["prevalence","pornography","sexual_function"],"strengths":["Large sample size for a single‑site study","Use of a brief, previously validated problematic pornography scale","Assessment of mental‑health symptoms (DASS‑21)","Clear reporting of prevalence and demographic correlates"],"limitations":["Cross‑sectional design cannot infer causality","No assessment of moral incongruence or masturbation, key confounds","Potential circularity in defining ‘problematic’ use via distress","Convenience sample limits generalisability beyond this university"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":1,"contrasting":1,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00912174251329440"}},{"id":42,"doi":"10.1016/j.actpsy.2026.106456","pmid":"41702097","pmcid":null,"title":"Problematic pornography consumption as existential escape from boredom: A replication study","authors":"Monks M, Moynihan AB.","first_author":"Monks M","journal":"Acta psychologica","year":2026,"pub_types":["Journal Article"],"keywords":["meaning","Coping","Boredom","Existential Psychology","Problematic Pornography Consumption"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"single survey, likely convenience sample of adults; no longitudinal or experimental manipulation","sample_n":null,"sample_text":"not reported in abstract","population":"adults (young adult to older), mixed gender","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed adults and found that feeling life lacks meaning predicted more problematic pornography use, and this was explained by boredom and using porn to avoid emotions. It repeats earlier findings but does not prove causation.","clinical_takeaway":"Evidence is limited; clinicians should not assume pornography use is a direct coping response without considering other factors.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Attempts replication of previously reported model","Uses mediation analysis to test indirect pathways","Addresses meaninglessness and boredom as psychological variables"],"limitations":["Cross‑sectional design prevents causal inference","Problematic use measured with unclear/possibly non‑validated scale","Key confounds (moral incongruence, masturbation, mental health) not assessed","No preregistration or power justification reported"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.actpsy.2026.106456"}},{"id":43,"doi":"10.1007/s10508-026-03544-9","pmid":"42850482","pmcid":null,"title":"Problematic Pornography Use Among Swedish Adolescents: Characteristics and Clinical Implications","authors":"Piwowar M, Jonsson LS, Bladh M, Landberg Å, Svedin CG, Savard J.","first_author":"Piwowar M","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Mental health","Adolescents","Sexual Behaviors","Compulsive Sexual Behavior Disorder","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 3106 Swedish senior high‑school students; logistic regression used to examine associations","sample_n":3106,"sample_text":"representative national sample of senior‑high‑school students","population":"Swedish adolescents (≈17‑19 y, third‑year senior high school)","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","causal_from_correlational","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 3106 Swedish high‑school students, about one in ten reported difficulty stopping porn use, especially boys. This was linked to more time watching porn, exposure to violent content, mental‑health problems, abuse history and risky behaviours. The study highlights the need to address these vulnerabilities in teens.","clinical_takeaway":"Screen adolescents who report difficulty controlling porn use for mental‑health issues and trauma; consider gender‑specific interventions.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","csbd","prevalence"],"strengths":["Large, nationally representative adolescent sample","Comprehensive assessment of health‑related correlates","Gender‑stratified analysis"],"limitations":["PPU defined by a single self‑label item; no validated scale","Moral incongruence and masturbation not measured","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03544-9"}},{"id":44,"doi":"10.31234/osf.io/m2vf4_v1","pmid":null,"pmcid":null,"title":"The development and psychometric evaluation of the brief Compulsive Pornography Use Scale (CPUS-4)","authors":"Babilonová T, Pontes HM, Pipova H, Reháková T, Komrska Š, Suchá J.","first_author":"Babilonová T","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd","pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1,023 Czech adults","sample_n":1023,"sample_text":"1,023 Czech adults, recruited via an online survey (convenience sample).","population":"adults (Czech, self‑selected online sample)","country":"Czech Republic","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and tested a short 4‑item questionnaire (CPUS‑4) to measure compulsive pornography use, showing it has solid factor structure and links to mental‑health symptoms in a large Czech adult sample.","clinical_takeaway":"The CPUS‑4 may help clinicians screen for problematic pornography use, but should be used alongside assessments of moral distress and relationship factors.","confidence":0.7,"topic_tags":["measurement","pornography","csbd"],"strengths":["Large sample (N>1000) provides good statistical power for factor analysis.","Comprehensive psychometric evaluation (EFA, CFA, internal consistency, convergent validity).","Alignment with ICD‑11 CSBD behavioral criteria."],"limitations":["Convenience online sample; limited generalisability to broader populations.","Moral incongruence, masturbation, relationship and trauma variables not assessed.","No pre‑registration; potential for selective reporting."],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/m2vf4_v1"}},{"id":45,"doi":"10.1007/s10508-026-03546-7","pmid":"42766058","pmcid":null,"title":"Investigating the Role of Psychosocial and Values-Based Factors in Problematic Pornography Use","authors":"Fiennes E, Pontes HM.","first_author":"Fiennes E","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Mental health","Spirituality","Internet Pornography","Problematic Pornography Use","Moral Incongruence"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey, N=121, general population, regression analysis","sample_n":121,"sample_text":"general population online respondents","population":"adults, mean age 27.3, 53.7% male","country":"unspecified","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 121 adults examined how behavior, mental health, and moral views relate to problematic porn use. Male gender, more weekly porn viewing, higher distress, and suppressing emotions predicted higher problematic use, while spirituality did not.","clinical_takeaway":"Assess moral concerns and mental‑health factors when evaluating problematic porn use; spirituality alone is not linked.","confidence":0.8,"topic_tags":["pornography","masturbation","moral_incongruence","sexual_function","religiosity"],"strengths":["large community sample","includes moral disapproval measure","multivariate regression model"],"limitations":["no separation of masturbation from porn use","cross‑sectional, cannot infer causality","unclear validation of PPU instrument"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03546-7"}},{"id":46,"doi":"10.1556/2006.2025.00022","pmid":"40126576","pmcid":"PMC12231469","title":"Profiles of problematic pornography use and religiosity-based moral incongruence using latent profile analysis: A two-sample study","authors":"Ince C, Tiego J, Albertella L, Fontenelle LF, Chamberlain SR, Yücel M, Rotaru K.","first_author":"Ince C","journal":"Journal of behavioral addictions","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Heterogeneity","Latent Profile Analysis","Pornography Addiction","Problematic Pornography Use","Moral Incongruence","Compulsive Sexual Behaviour Disorder","Self-perceived Pornography Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12231469","cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of male pornography users in US and UK (N≈2300) with latent profile analysis","sample_n":2300,"sample_text":"US N=1,356; UK N=944; male, mean age ~37‑38","population":"male adult pornography users, community sample, internet-recruited","country":"United States; United Kingdom","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In two large online surveys of men who view pornography, researchers found three groups: those at risk because of religious‑based moral conflict, those at risk because of problematic porn use, and a group with both. Only the groups with problematic use showed higher distress or treatment‑seeking.","clinical_takeaway":"Religious‑based moral conflict alone may not signal clinical distress; assess both use patterns and personal values before labeling a problem.","confidence":0.8,"topic_tags":["pornography","moral_incongruence","sexual_function"],"strengths":["Large, two‑national samples","Use of latent profile analysis to identify subgroups","Explicit measurement of religiosity‑based moral incongruence"],"limitations":["Reliance on self‑report; unclear whether PPU scales are validated","Masturbation not assessed separately from pornography use","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00022"}},{"id":47,"doi":"10.1007/s10508-026-03495-1","pmid":"42608626","pmcid":"PMC13597624","title":"Compensatory and Dissociative Coping in Young Adults: A Person-Centered Analysis of Their Associations with Childhood Maltreatment and Problematic Pornography Use","authors":"Komemi OM, Efrati Y.","first_author":"Komemi OM","journal":"Archives of sexual behavior","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Childhood Maltreatment","Latent Profile Analysis","Escapism","Compensatory–dissociative Behavior","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13597624","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional latent profile analysis of 608 young adults (18‑27 y) using self‑report questionnaires","sample_n":608,"sample_text":"608 young adults (436 men, 165 women) aged 18‑27","population":"young adults, convenience sample, 73 % male","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study grouped 608 young adults into low, medium, and high profiles based on how they use pornography to cope. The high‑coping group showed the worst mental‑health outcomes, and childhood sexual abuse was linked to more problematic and frequent porn use.","clinical_takeaway":"Clinicians should assess coping motives and trauma history when addressing problematic pornography use in young adults.","confidence":0.75,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample for person‑centered analysis","Inclusion of multiple psychosocial covariates","Examination of childhood trauma as moderator"],"limitations":["Cross‑sectional; no causal inference","Reliance on self‑report, unclear validation of pornography use scales","No measure of moral incongruence or masturbation behavior"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03495-1"}},{"id":48,"doi":"10.1186/s40359-026-05173-2","pmid":"42482268","pmcid":null,"title":"Romeo swipes Juliet left!? Problematic online dating app use and problematic pornography consumption are associated with a weaker sense of existential meaning in romantic love","authors":"Shabahang R, Demetrovics Z, Akbari M, Ouvrein G, Zsila Á.","first_author":"Shabahang R","journal":"BMC psychology","year":2026,"pub_types":["Journal Article"],"keywords":["Existentialism","Love","Online Dating","Pornography Consumption","Dating Apps","Mindful Use Of Social Media"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey with structural equation modeling (N=664 Iranian adults who use dating apps and pornography websites)","sample_n":664,"sample_text":"Iranian adults (M_age=26.4, SD_age=7.6) who used dating apps and pornography websites","population":"Iranian adults using dating apps and pornography websites (convenience sample)","country":"Iran","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 664 Iranian adults found that higher self‑reported problems with dating apps and pornography were linked to weaker feelings that love is meaningful and more pragmatic, plus more emotional promiscuity. Mindful use of social media was linked to fewer problems.","clinical_takeaway":"Higher problematic use of dating apps or porn may be associated with reduced sense of meaning in romantic love; encouraging mindful use could help.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (N>600)","Uses structural equation modeling to test multiple pathways","Addresses understudied existential perspective"],"limitations":["Cross‑sectional design limits causal inference","No measurement of key confounds (moral incongruence, masturbation, mental health, relationship factors)","Reliance on self‑report scales of ‘problematic’ use without clear validation"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s40359-026-05173-2"}},{"id":49,"doi":"10.1080/19317611.2025.2605517","pmid":"42205343","pmcid":"PMC13203051","title":"Motivational Pathways Diverge Between Frequent and Problematic Pornography Use","authors":"Csányi E, Veszprémi MD, Zsidó AN, Meskó N.","first_author":"Csányi E","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Structural Equation Modeling","Sexual Regulation","Problematic Pornography Use","Pornography Use Motivations","Frequent Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13203051","cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 890 Hungarian adults; structural equation modelling of motivations, frequency, and problematic use","sample_n":890,"sample_text":"online convenience sample, likely not probability based","population":"Hungarian adults (age 18‑64) recruited via online convenience sampling","country":"Hungary","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 890 Hungarian adults, researchers found that people who watch porn for pleasure or with a partner tend to use it frequently but without problems, whereas those who use it to cope with negative emotions are more likely to report problematic use and difficulties in sexual regulation.","clinical_takeaway":"Assess motivations behind pornography use; coping‑related motives may signal risk for sexual‑regulation difficulties.","confidence":0.8,"topic_tags":["pornography","sexual_function","masturbation","moral_incongruence"],"strengths":["Large sample size for survey research","Use of multiple validated questionnaires","Comprehensive structural equation modelling"],"limitations":["Cross‑sectional design limits causal inference","No measurement of key confounds (moral incongruence, masturbation, mental health)","Problematic use scale may be distress‑based and circular"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2025.2605517"}},{"id":50,"doi":"10.1007/s10508-025-03200-8","pmid":"40691750","pmcid":null,"title":"Integrating Internalized Homophobia with Pornography Problems Due to Moral Incongruence Model among Chinese Sexual Minority Men: A Network Analysis","authors":"Lin S, Zheng L.","first_author":"Lin S","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Internalized Homophobia","Psychological Distress","Sexual Minority Men","Problematic Pornography Use","Moral Disapproval"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 593 Chinese sexual minority men","sample_n":593,"sample_text":"community","population":"Chinese sexual minority men (community sample)","country":"China","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 593 Chinese gay and bisexual men, internalized homophobia was linked to problem porn use, especially through moral disapproval. The study suggests that feeling conflicted about one’s sexuality may drive porn‑related distress.","clinical_takeaway":"Screen for internalized homophobia and moral conflict when treating porn‑related distress in sexual minority men.","confidence":0.8,"topic_tags":["pornography","moral_incongruence","sexual_function"],"strengths":["Large sample (N>500)","Use of validated scales","Inclusion of moral disapproval and internalized homophobia","Network analysis provides nuanced symptom relations"],"limitations":["Cross‑sectional; cannot infer causality","Masturbation not measured or controlled","Convenience sampling limits generalisability","No pre‑registration or open data"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03200-8"}},{"id":51,"doi":"10.31234/osf.io/5uf4r_v1","pmid":null,"pmcid":null,"title":"Development and Initial Validation of a Psychometric Tool to Assess Moral Incongruence in Pornography Viewing","authors":"Nguyen ML.","first_author":"Nguyen ML.","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://osf.io/5uf4r_v1/download","cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 550 US MTurk participants split into exploratory and confirmatory samples; factor analyses and reliability testing of a new moral incongruence scale.","sample_n":550,"sample_text":"MTurk convenience sample, not nationally representative.","population":"U.S. adults recruited through Amazon Mechanical Turk (convenience sample).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study created and tested a 36‑item questionnaire that measures how people’s moral beliefs clash with watching pornography, showing strong reliability and validity in a large online sample.","clinical_takeaway":"Clinicians can use the new scale to assess moral conflict around porn use, but should consider broader contextual factors.","confidence":0.8,"topic_tags":["moral_incongruence","pornography","measurement","sexual_function"],"strengths":["Large sample for psychometric validation","Rigorous factor analytic procedures","Multiple forms of validity assessed"],"limitations":["Convenience MTurk sample limits generalizability","No assessment of related confounds (masturbation, mental health, trauma)","No pre‑registration of analysis plan"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/5uf4r_v1"}},{"id":52,"doi":"10.3389/fpsyt.2026.1876379","pmid":"42529133","pmcid":"PMC13416689","title":"Relationship between problematic pornography consumption, sexual self-esteem, and sexual machismo in men aged 18 to 30 from Honduras","authors":"Lovo AL, Herrera Perez SB, Gómez RE, Mejía-Sánchez R, Suazo-Cervantes I, Landa-Blanco M.","first_author":"Lovo AL","journal":"Frontiers in psychiatry","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Gender Roles","Compulsive Sexual Behavior","Hostile Sexism","Sexual Self-esteem","Problematic Pornography Consumption","Sexual Machismo"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13416689","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 392 Honduran men recruited via online convenience and snowball sampling","sample_n":392,"sample_text":"Convenience online sample; not probabilistic, may be biased toward internet users","population":"men aged 18‑30, Honduras (Francisco Morazán)","country":"Honduras","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 392 young Honduran men, higher scores on a problem‑porn use scale were linked to stronger \"sexual machismo\" attitudes and lower sexual self‑esteem, but self‑esteem did not explain the machismo link. The study is exploratory and cannot prove cause‑and‑effect.","clinical_takeaway":"Higher problematic porn use may be associated with more machismo attitudes, but the relationship is unclear; clinicians should consider broader cultural factors.","confidence":0.85,"topic_tags":["pornography","sexual_function","gender","csbd"],"strengths":["Reasonably large sample for a cross‑sectional survey","Use of previously published scales (likely validated)","Mediation analysis adds depth"],"limitations":["Convenience, non‑probability sampling limits generalisability","No measurement of key confounds (moral incongruence, masturbation, mental health, trauma)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2026.1876379"}},{"id":53,"doi":"10.1111/add.70587","pmid":"42666045","pmcid":null,"title":"Contradictory experiences of problematic pornography use in China: A qualitative study of multi-layered stigma within a morally restrictive socio-cultural context","authors":"Jin F, Zhang W, Wang P, Grubbs JB, Bőthe B, Wang Z.","first_author":"Jin F","journal":"Addiction (Abingdon, England)","year":2026,"pub_types":["Journal Article"],"keywords":["Qualitative Research","Behavioral Addiction","Negative Consequences","Problematic Pornography Use","Multi‐layered Stigma Processes","Sexually Conservative Socio‐cultural Context"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interviews with 31 self‑identified PPU individuals recruited online in mainland China","sample_n":31,"sample_text":"Thirty‑one adults (mean age 31.3 ± 7.8 years) recruited online","population":"Adults (26 M, 5 F) from China who self‑identified as having problematic pornography use","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 31 Chinese adults who said they had trouble controlling pornography use revealed that stigma, strict moral norms, limited sex education, and family pressure shape how they experience distress and shame around porn.","clinical_takeaway":"Clinicians should consider cultural stigma and moral beliefs when assessing or treating distress linked to pornography use.","confidence":0.7,"topic_tags":["pornography","csbd","moral_incongruence"],"strengths":["In‑depth, culturally specific qualitative data","Large for qualitative work (31 participants)","Reflexive thematic analysis aligns with qualitative best practice"],"limitations":["Self‑selected sample of self‑identified PPU cases","No validated measures of pornography use or distress","Limited control for key confounds (masturbation, mental health, moral incongruence)","Findings not generalisable beyond this convenience sample"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/add.70587"}},{"id":54,"doi":"10.21203/rs.3.rs-10939946/v1","pmid":null,"pmcid":null,"title":"Maladaptive Personality Traits and Problematic Pornography Use: Cross-Sectional Serial Indirect Associations Through Personality Functioning and Emotional Avoidance","authors":"MamSharifi¹ P, Zandpil² S, Mohammadi³ N.","first_author":"MamSharifi¹ P","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional path analysis of 591 Iranian adults recruited via online convenience/snowball sampling","sample_n":591,"sample_text":"Convenience/snowball online recruitment; not a probability or clinical sample","population":"Adults 18–40 years, past‑month pornography users, Tehran, Iran","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether maladaptive personality traits lead to problematic pornography use through impaired personality functioning and using porn to avoid emotions. In 591 Iranian adults, higher maladaptive traits were linked to poorer personality functioning, which predicted emotional‑avoidance motives and higher scores on a problematic‑pornography questionnaire.","clinical_takeaway":"Personality dysfunction and emotional‑avoidance motives may contribute to problematic porn use, but the cross‑sectional design limits clinical conclusions.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large (N=591) for a path‑analysis study","Use of validated personality and functioning scales","Robust bootstrap confidence intervals and sensitivity analyses"],"limitations":["Convenience, non‑representative sample from Tehran","No measurement or control of moral incongruence, masturbation, mental health, partner or trauma variables","Cross‑sectional; causal language avoided but inference limited"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-10939946/v1"}},{"id":55,"doi":"10.21203/rs.3.rs-9595662/v1","pmid":null,"pmcid":null,"title":"Psychosocial Correlates of Problematic Pornography Use Among Adolescents in Bangladesh: A Cross-Sectional Study","authors":"Rimti FH, Zubayer AA, Tabassum MN, Ripon RK, Rimu FH, Sarkar TY, Ilman A, Chowdhury MTA, Das T, Sabuz MS, Akhter I, Nandi AK, Hawlader MDH.","first_author":"Rimti FH","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 601 Bangladeshi adolescents recruited from educational institutions","sample_n":601,"sample_text":"601 adolescents from educational institutions","population":"adolescents (mean age 17) in Bangladesh, 55.6% male","country":"Bangladesh","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 601 Bangladeshi teenagers, higher anxiety and loneliness were linked to higher scores on a problematic pornography use scale, while more perceived social support was unexpectedly associated with higher use. The study suggests mental‑health issues may drive risky online sexual behavior in this group.","clinical_takeaway":"Address anxiety and loneliness when supporting adolescents with problematic porn use; consider that peer support may sometimes facilitate exposure.","confidence":0.78,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Large sample for a regional adolescent study","Use of validated psychometric scales","Structural equation modelling to test indirect pathways"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral incongruence or masturbation","Convenience school sample may not be nationally representative"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-9595662/v1"}},{"id":56,"doi":"10.1016/j.abrep.2026.100724","pmid":"42389421","pmcid":"PMC13321038","title":"Motivational pathways to problematic pornography use: A self-determination theory perspective","authors":"Akbari M, Seydavi M, Sheikhi S.","first_author":"Akbari M","journal":"Addictive behaviors reports","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Self-determination Theory (Sdt)","Problematic Pornography Use","Pornography Use Motivations","Conditional Mediation Analysis"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13321038","cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 613 adults (75.7% male, mean age 25.1)","sample_n":613,"sample_text":"N = 613, 75.7% male, mean age = 25.14 ± 4.41","population":"community adult sample, primarily young adults, recruited likely via online methods","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large online survey of young adults, people who reported more problematic pornography use also tended to use porn to cope with stress, loneliness or fantasy, and they showed higher impulsivity and lower relationship satisfaction. The study suggests these motivational pathways are small and probably not useful treatment targets.","clinical_takeaway":"Motivation‑based interventions may have limited impact on problematic porn use; focus on broader mental‑health and relationship factors.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a survey","Comprehensive mediation modelling","Transparent discussion of limited practical significance"],"limitations":["Cross‑sectional; no causal inference","PPU defined by distress may be circular","No measurement of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.abrep.2026.100724"}},{"id":57,"doi":"10.1016/j.chiabu.2026.108260","pmid":"42600192","pmcid":null,"title":"Loneliness and online child sexual victimization: The mediating role of problematic pornography use in Spanish and Mexican adolescents","authors":"Normand-Pascual E, Pérez-García JM, Parrado-González A, Testa G, Villena-Moya A, Chiclana-Actis C, Fernández-Aranda F, Potenza MN, Bőthe B, Jiménez-Murcia S, Mestre-Bach G.","first_author":"Normand-Pascual E","journal":"Child abuse & neglect","year":2026,"pub_types":["Journal Article"],"keywords":["Adolescents","Loneliness","Problematic Pornography Use","Online Child Sexual Victimization"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1848 adolescents from Spain and Mexico","sample_n":1848,"sample_text":"1848 adolescents (60.2 % female) from schools in Spain and Mexico","population":"adolescents (12‑18 y) recruited through schools in Spain and Mexico","country":"Spain; Mexico","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 1848 Spanish and Mexican teens, feeling lonely was linked to higher risk of online sexual victimisation. Part of this link was explained by more frequent use of pornographic material, especially for boys, while for girls loneliness had a stronger direct effect.","clinical_takeaway":"Address loneliness and maladaptive coping (e.g., excessive porn use) in teen prevention programs, tailoring strategies by sex.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","prevalence"],"strengths":["Large, multi‑country adolescent sample","Bootstrapped mediation analysis with confidence intervals","Sex‑specific moderation examined"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report measures; validation not described","Key confounds (moral incongruence, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2026.108260"}},{"id":58,"doi":"10.1016/j.cpr.2026.102710","pmid":"41655315","pmcid":null,"title":"Evaluation of outcome measures for assessing problematic pornography use: A COSMIN systematic review of measurement properties","authors":"Jin F, Zhang W, Wang P, Bőthe B, Wang Z.","first_author":"Jin F","journal":"Clinical psychology review","year":2026,"pub_types":["Systematic Review","Review","Journal Article"],"keywords":["Psychometrics","Systematic review","Outcome Measures","Measurement Properties","Cosmin","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of measurement properties following COSMIN guidelines, pre‑registered in PROSPERO, with quality appraisal of 24 instruments.","sample_n":null,"sample_text":"47 studies covering 24 instruments were reviewed.","population":"Studies of adults reporting on problematic pornography use measures; no single primary sample.","country":"Not specified (multinational literature).","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review examined 24 questionnaires used to assess problematic pornography use, rating their measurement quality. Four scales (PPU Scale, PPCS, PPCS‑6, Brief Pornography Screen) showed the most promise, but further validation is needed.","clinical_takeaway":"Clinicians can consider the four highlighted scales for screening, but should be aware of their still‑limited validation.","confidence":0.7,"topic_tags":["measurement","pornography","csbd","sexual_function"],"strengths":["Pre‑registered protocol","Rigorous COSMIN methodology","Comprehensive coverage of 24 instruments"],"limitations":["No primary data; relies on quality of original studies","Limited assessment of content validity across cultures","Confound variables (e.g., moral incongruence) not addressed"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.cpr.2026.102710"}},{"id":59,"doi":"10.1093/sxmrev/qeag027","pmid":"42044011","pmcid":null,"title":"Cognitive behavioral therapy-based interventions for problematic pornography use: a scoping review","authors":"Zwielewski G, Machado V, Fiamoncini AA, Quinta-Gomes AL, Cruz RM.","first_author":"Zwielewski G","journal":"Sexual medicine reviews","year":2026,"pub_types":["Scoping Review","Journal Article"],"keywords":["Sexual Health","Cognitive Behavioral Therapy","Compulsive Sexual Behavior","psychotherapy","Pornography Addiction","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Scoping review of CBT‑based interventions for problematic pornography use (PPU) published 2019‑2024. Systematic search of three databases, double‑blind screening, data extraction on participant characteristics, design, components and outcomes. No meta‑analysis or risk‑of‑bias assessment reported.","sample_n":null,"sample_text":"Total of 11 included studies; individual study sample sizes not reported in abstract.","population":"Adults meeting various definitions of PPU across 11 primary studies (details not provided).","country":"Not specified (multinational literature search).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["selective_reporting"],"stance":"neutral","citation_value":"useful","plain_summary":"This scoping review summarises eleven recent studies that used cognitive‑behavioral therapy to treat problematic pornography use. All reported reductions in use and symptoms, especially when CBT was combined with mindfulness or acceptance‑based techniques, but the evidence is based on varied, often small, studies with high dropout rates.","clinical_takeaway":"CBT‑based programs may lower problematic pornography use, yet clinicians should note the lack of standardised protocols and limited methodological rigor.","confidence":0.8,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Systematic search across multiple databases","Double‑blind independent screening","Inclusion of recent literature (2019‑2024)","Provides overview of delivery modalities and components"],"limitations":["No quantitative synthesis or risk‑of‑bias assessment","Outcome measures vague; reliance on self‑reported frequency","No assessment of moral incongruence or other key confounds","High dropout reported but not examined"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeag027"}},{"id":60,"doi":"10.1177/08862605261485291","pmid":"42813497","pmcid":null,"title":"Risk Factors for Sexual Violence Perpetration Among Adult Men: The Role of Problematic Pornography Consumption, Sexual Consent, and Rape Myths","authors":"Ramírez-Sandoval CI, Muñoz-García LE, Sierra JC, Sánchez-Fuentes MDM.","first_author":"Ramírez-Sandoval CI","journal":"Journal of interpersonal violence","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual Assault","Sexual Violence","Pornography","Intimate Partner Violence/abuse","Attitudes/perceptions","Offenders/perpetrators","Coercion/consent"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 383 adult men","sample_n":383,"sample_text":"383 adult men aged 18‑61 years, 34% reported at least one act of sexual violence","population":"heterosexual cisgender Spanish men, community sample","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 383 Spanish men, those who had committed sexual assault reported higher problematic porn use, more negative views on consent, and stronger belief in rape myths. These factors together helped identify men at higher risk of perpetrating sexual violence.","clinical_takeaway":"When assessing sexual‑offense risk, clinicians should consider problematic porn use alongside consent attitudes and rape‑myth endorsement, but recognize the evidence is correlational.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large community sample (n>350)","Uses latent class analysis to detect risk profiles","Integrates multiple psychosocial variables"],"limitations":["Cross‑sectional design; cannot infer causality","Unclear whether pornography and consent scales are validated","No control for mental‑health or trauma confounders"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605261485291"}},{"id":61,"doi":"10.1007/s40429-025-00669-0","pmid":"42491504","pmcid":"PMC13377853","title":"Smartphone Apps for Problematic Pornography Use: A Review of Content and Quality","authors":"Hart-Derrick V, Virani S, Zadeh O, Genovese N, Engel J, Martinez CP, Potenza MN, McCurdy LY.","first_author":"Hart-Derrick V","journal":"Current addiction reports","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Cognitive Behavioral Therapy","Addictive Behaviors","Problematic Pornography Use","Digital Mental Health","Mobile App Rating Scale"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"Descriptive review of publicly available iPhone apps; no primary participant data; sample_n: null","sample_n":null,"sample_text":"Twenty‑three iPhone apps identified from the App Store","population":"Not applicable (app review)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined 23 iPhone apps marketed for problematic pornography use, rating them with a standard quality scale. Apps that included CBT or mindfulness scored higher on engagement, but most lacked evidence‑based content. Star ratings on the App Store did not predict quality.","clinical_takeaway":"Most free apps for problematic pornography lack evidence‑based content; clinicians should guide patients toward those incorporating CBT or mindfulness.","confidence":0.8,"topic_tags":["pornography","moral_incongruence","masturbation","sexual_function"],"strengths":["Uses a validated app‑rating instrument (MARS)","Systematic identification of apps from a major platform","Highlights mismatch between store star ratings and quality"],"limitations":["No user outcome data; only app features described","No assessment of efficacy or clinical impact","Limited to iPhone apps; may miss Android offerings"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40429-025-00669-0"}},{"id":62,"doi":"10.1007/s10508-025-03214-2","pmid":"40936055","pmcid":"PMC12457496","title":"Displacing Problems: A Constructivist Grounded Theory of Problematic Pornography Use","authors":"Binnie J, Albery I, Reavey P.","first_author":"Binnie J","journal":"Archives of sexual behavior","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Addiction","Pornography","Constructivist Grounded Theory","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12457496","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"grounded theory, 21 semi‑structured interviews plus diary entries; online self‑selected participants reporting problematic pornography use","sample_n":21,"sample_text":"21 interview participants (self‑selected from online sources); 258 diary entries","population":"adult online users self‑identifying as having problematic pornography use","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 21 people who said their porn use was problematic revealed a pattern: they first had other personal issues, then began using porn to cope, and eventually adopted the 'addiction' label, shifting focus from earlier problems to the porn use itself.","clinical_takeaway":"Clinicians should explore underlying personal issues rather than assuming porn use is the primary problem.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["In‑depth qualitative insight","Grounded‑theory methodology","Large number of diary entries"],"limitations":["Self‑selected sample of self‑identified PPU","No validated measures of use or distress","Absence of key confound controls"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03214-2"}},{"id":63,"doi":"10.3389/fpsyt.2026.1863547","pmid":"42389398","pmcid":"PMC13318901","title":"Alcohol and cannabis use severity in relation to compulsive sexual behavior and problematic pornography use in a non-clinical sample: a cross-sectional study","authors":"Stasica W, Binkowska AA.","first_author":"Stasica W","journal":"Frontiers in psychiatry","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Alcohol","Cannabis","Compulsive Sexual Behavior","Thc","Behavioral Addiction","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13318901","cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online anonymous survey, N=158 adults, assessed alcohol/cannabis severity (AUDIT, CUDIT-R) and CSBD/PPU symptoms (CSBI-13, BPS), linear adjusted regression controlling age & gender","sample_n":158,"sample_text":"158 adults (61.4% women), ages 18‑60, recruited through an online survey platform","population":"non‑clinical adult community sample, 61.4% women, age 18‑60, recruited via unspecified online channels","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 158 adults, higher alcohol or cannabis use scores were linked to slightly higher compulsive sexual behavior and problematic porn use, but the associations were not statistically significant after accounting for age and gender.","clinical_takeaway":"No clear link between substance‑use severity and compulsive sexual or porn‑related problems was found; clinicians should consider broader psychosocial factors.","confidence":0.8,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Use of validated substance‑use and CSBD/PPU questionnaires","Reporting of confidence intervals for regression coefficients","Adjustment for basic demographics (age, gender)"],"limitations":["Cross‑sectional design cannot infer causality","No assessment of moral incongruence or other key confounds (masturbation, mental health, relationship context, trauma)","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2026.1863547"}},{"id":64,"doi":"10.3390/jcm15124845","pmid":"42356013","pmcid":null,"title":"Identity Transformation and the Role of Accountability in Recovery from Problematic Pornography Use: A Phenomenological-Hermeneutical Study","authors":"Lorente-Corral L, Sancho-Cantus D, Asensio S, Cunha-Pérez C, Casaña-Mohedo J.","first_author":"Lorente-Corral L","journal":"Journal of clinical medicine","year":2026,"pub_types":["Journal Article"],"keywords":["Recovery","Accountability","Phenomenology","Qualitative Study","Support Groups","Identity Transformation","Problematic Pornography Use","Personal Collapse"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"phenomenological‑hermeneutical study with 27 participants recruited from structured recovery groups; in‑depth semi‑structured interviews; thematic analysis.","sample_n":27,"sample_text":"27 individuals (26 men, 1 woman) in structured recovery programs.","population":"adult individuals (mostly men) currently engaged in a support‑group based recovery program for problematic pornography use / compulsive sexual behaviour.","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 27 people in recovery groups revealed that feeling accountable to others and reshaping one’s identity were central to stopping problematic pornography use. Group support helped participants move from a sense of shame to a more authentic self.","clinical_takeaway":"Group‑based accountability and identity work may aid recovery from problematic pornography use, but findings are based on a small, self‑selected sample.","confidence":0.78,"topic_tags":["sexual_function","treatment","pornography"],"strengths":["In‑depth, first‑person accounts of recovery","Systematic phenomenological analytic framework","Clear description of emergent themes"],"limitations":["Small, non‑representative convenience sample from treatment/abstinence groups","No validated measures of PPU, distress or related constructs","Confounding variables (moral incongruence, mental health, etc.) not assessed"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jcm15124845"}},{"id":65,"doi":"10.1177/02537176251381219","pmid":"41163695","pmcid":"PMC12558906","title":"Clinical and Demographic Correlates of Pornography Addiction: A Cross-sectional Study from India","authors":"Gokani N, Gowande T, Sahore A, Deshpande S.","first_author":"Gokani N","journal":"Indian journal of psychological medicine","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Mental health","cultural factors","Public Health","Sexual Disorders","Societal Norms","Pornography Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12558906","cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational, retrospective cross‑sectional study of 589 treatment‑seeking individuals (self‑selected).","sample_n":589,"sample_text":"Self‑selected treatment‑seeking sample; not representative of general population.","population":"Adults (≥18 y) seeking treatment for pornography addiction in India; 99 % male.","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 589 Indian adults who sought help for pornography‑related problems, younger age, being single and cultural factors were linked to greater reported addiction severity. Co‑occurring sexual dysfunctions were common.","clinical_takeaway":"Clinicians should consider age, relationship status and cultural context when treating patients presenting with pornography‑related distress.","confidence":0.78,"topic_tags":["pornography","csbd","treatment","sexual_function"],"strengths":["Large sample size for treatment‑seeker cohort","Use of ICD‑11 CSBD criteria","Explores demographic correlates"],"limitations":["Self‑selected, treatment‑seeking sample limits generalisability","No measurement of moral incongruence or masturbation","Circular definition of ‘addiction’ via diagnostic label","Limited statistical reporting (no CIs, no power analysis)"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/02537176251381219"}},{"id":66,"doi":"10.1093/jsxmed/qdaf358","pmid":"41489199","pmcid":null,"title":"Pilot evidence of genetic and environmental contributions to problematic pornography use, pornography use frequency, and moral disapproval to pornography","authors":"Borgogna NC, Owen T, Aita SL, Kraus SW.","first_author":"Borgogna NC","journal":"The journal of sexual medicine","year":2026,"pub_types":["Twin Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Genetics","Environmental","Sex differences","Twin Study","Compulsive Sexual Behavior Disorder","Problematic Pornography Use","Pornography Use Frequency","Masturbation Frequency","Moral Disapproval To Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"twin study using community panel, n=202 (32 MZ female, 21 DZ female, 25 MZ male, 23 DZ male)","sample_n":202,"sample_text":"202 twins (101 dyads) with demographic verification","population":"U.S. adult twins identified via YouGov panel","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A twin survey of 202 U.S. adults found that genetics may explain about half to three‑quarters of the variation in self‑reported problematic pornography use, while moral disapproval and masturbation frequency showed weaker genetic links.","clinical_takeaway":"Genetic influence on problematic porn use appears modest; clinicians should consider moral conflict and psychosocial factors rather than assuming a biological ‘addiction.’","confidence":0.7,"topic_tags":["gender","treatment"],"strengths":["Twin design allows estimation of genetic vs environmental influences","First study to examine PPU in a genetically informative sample","Includes both sexes and multiple zygosity groups"],"limitations":["Small dyad numbers limit precision of ACE estimates","Reliance on brief, likely unvalidated self‑report measures","No assessment of mental‑health or relationship factors"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf358"}},{"id":67,"doi":"10.1007/s10508-025-03266-4","pmid":"41559436","pmcid":null,"title":"Problematic Pornography Use and Psychological Distress in the USA: A Nationally Representative Study","authors":"Engelhardt R, Maes J, Grubbs JB, Trommer D, Kraus SW.","first_author":"Engelhardt R","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Depression","Anxiety","Loneliness","Addictive Behavior","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative survey (N=2,773), cross‑sectional correlational analysis","sample_n":2773,"sample_text":"large nationally representative sample","population":"US adults, men and women, 53.7% women, 85.1% heterosexual","country":"USA","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a US‑wide survey of 2,773 adults, higher levels of anxiety, depression and loneliness were linked to higher scores on a measure of problematic pornography use. The link was strongest for people who also reported frequent pornography viewing or masturbation.","clinical_takeaway":"Clinicians should consider mental‑health symptoms and sexual behavior patterns together when evaluating distress related to pornography use.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large, nationally representative sample","Separates pornography and masturbation frequencies","Includes multiple mental‑health outcomes"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral incongruence/religiosity","Unclear if PPU scale is validated"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03266-4"}},{"id":68,"doi":"10.3389/fpsyt.2026.1815849","pmid":"42094841","pmcid":"PMC13139126","title":"High-frequency cyber-pornography exposure and gender as influencing factors in adult problematic pornography use following minor-onset viewing","authors":"Morlat PV, Limniou M, Dobbie M, Chatzisymeonidis S.","first_author":"Morlat PV","journal":"Frontiers in psychiatry","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Gender","Sexual Orientation","Sexual Permissiveness","Problematic Pornography Use","Early Pornography Exposure","Cyber-pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13139126","cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 200 adults with early exposure to cyber‑pornography, measuring self‑reported frequency, problematic use scale and sexual attitudes","sample_n":200,"sample_text":"200 individuals, convenience sample","population":"Adults (18‑58 y) who reported sustained cyber‑pornography use with first exposure before age 18; 51.5 % women, 48.5 % men; recruited via unspecified method","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 200 adults who first saw online porn before age 18, higher weekly exposure was linked to higher scores on a problematic‑pornography questionnaire, especially for men. Sexual permissiveness showed a weak, non‑significant relation.","clinical_takeaway":"Frequent early exposure to online porn correlates with higher self‑reported problematic use; clinicians should assess exposure frequency when evaluating concerns.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Reasonable sample size (N=200)","Use of validated scales for PPU and sexual attitudes","Investigation of frequency and gender moderators"],"limitations":["Cross‑sectional design, cannot infer causality","No measurement of key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)","Potential circularity in PPU scale if it includes distress"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2026.1815849"}},{"id":69,"doi":"10.1016/j.actpsy.2026.106722","pmid":"41946137","pmcid":null,"title":"Toward a theoretically grounded preventive framework for Problematic Pornography Use: The PPU-PrevFrame","authors":"Castro-Calvo J, García-Barba M, Beltrán-Martínez P, Billieux J.","first_author":"Castro-Calvo J","journal":"Acta psychologica","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Prevention","Problematic Pornography Use (Ppu)","Ppu-prevframe"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"The paper offers a narrative, theoretically grounded preventive framework for problematic pornography use without presenting original empirical data.","sample_n":null,"sample_text":"No empirical sample; the article is a conceptual review.","population":"Not applicable – no participant sample reported.","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors propose a new, theory‑based framework for preventing problematic pornography use. It combines sexual education, pornography literacy, self‑control training, and short‑term abstinence to reduce risk before serious problems develop.","clinical_takeaway":"No direct clinical recommendations; the framework suggests preventive components that could inform future program design.","confidence":0.7,"topic_tags":["prevalence"],"strengths":["Integrates multiple preventive strategies","Grounded in existing addiction‑prevention literature","Addresses universal, selective, and indicated levels"],"limitations":["No empirical data to support efficacy","No measurement of key confounds (e.g., moral incongruence)","Relies on theoretical assumptions rather than tested interventions"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.actpsy.2026.106722"}},{"id":70,"doi":"10.1016/j.jsxm.2019.11.259","pmid":"31818724","pmcid":null,"title":"Evaluating Pornography Problems Due to Moral Incongruence Model","authors":"Lewczuk K, Glica A, Nowakowska I, Gola M, Grubbs JB.","first_author":"Lewczuk K","journal":"The journal of sexual medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Coping","Religiosity","Pornography Addiction","Compulsive Sexual Behavior Disorder","Problematic Pornography Use","Moral Incongruence","Moral Disapproval"],"is_oa":false,"oa_url":null,"cited_by_count":72,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online nationally representative survey (N=1036) of Polish adults; cross‑sectional questionnaire assessing self‑perceived addiction, problematic use, coping, frequency, religiosity and moral disapproval.","sample_n":1036,"sample_text":"nationally representative sample of Polish adults; 880 reported lifetime pornography use","population":"Polish adult general population (both genders, wide age range)","country":"Poland","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A Polish survey of over 1,000 adults found that people who use pornography more often, who cope avoidantly, and who feel their use conflicts with personal morals report higher feelings of addiction and problematic use. Moral conflict mattered more for the broader ‘problematic use’ outcome than for self‑labelled addiction.","clinical_takeaway":"Clinicians should assess moral conflict and coping style when clients report distress about pornography, not assume addiction based solely on frequency.","confidence":0.75,"topic_tags":["pornography","moral_incongruence","sexual_function"],"strengths":["large, nationally representative sample","direct assessment of moral incongruence and religiosity","multivariate modelling of several predictors"],"limitations":["cross‑sectional; cannot infer causality","no separate measurement of masturbation","reliance on self‑labelled ‘addiction’ without validated diagnostic criteria"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":5,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":5,"contrasting":1,"mentioning":99,"citing_publications":136,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.11.259"}},{"id":71,"doi":"10.1556/2006.2025.00489","pmid":"41860601","pmcid":"PMC13132414","title":"Hair testosterone and cortisol interactively predict problematic pornography use in a male sample","authors":"Burkardt TM, Stark R, Stalder T, Wolf OT, Klucken T, Brand M, Müller SM.","first_author":"Burkardt TM","journal":"Journal of behavioral addictions","year":2026,"pub_types":["research-article","Multicenter Study","Journal Article"],"keywords":["Stress","steroid hormones","Impulsivity","Risk Taking","Behavioral Addiction","Dual-hormone Hypothesis","Compulsive Sexual Behavior Disorder","Porn Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13132414","cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional observational study of 252 male pornography users; hormone hair analyses; questionnaires and decision‑making tasks","sample_n":252,"sample_text":"N = 252 male participants from a multi‑center study","population":"Male adults who consume pornography at least occasionally; recruited across multiple centers (likely convenience sample)","country":"unspecified (multi‑center)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In 252 men, higher hair testosterone was linked to more self‑reported problematic pornography use, especially when cortisol was low, but hormone levels did not relate to impulsivity or risk‑taking.","clinical_takeaway":"Hormone levels may relate to self‑reported porn‑use problems, but without accounting for moral or mental‑health factors the finding has limited clinical use.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for hormone assay (N=252)","Objective long‑term hormone measurement via hair","Use of decision‑making tasks to probe impulsivity"],"limitations":["Cross‑sectional; cannot infer causality","Problematic pornography use measured with unspecified questionnaire; possible circularity","Key confounds (moral incongruence, masturbation, mental health, partner effects, trauma) not assessed"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00489"}},{"id":72,"doi":"10.3389/fpsyt.2026.1928379","pmid":"42757235","pmcid":"PMC13584859","title":"Symptom-based and self-identified pornography involvement: concordance, discordance, and multidomain correlates","authors":"Széll K, Pócs D, Kelemen O, Tőtös Á, Paulik E, Molnár R, Erdős C.","first_author":"Széll K","journal":"Frontiers in psychiatry","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Concordance","Discordance","Problematic Pornography Use","Pornography Use Frequency","Multidomain Correlates","Self-Identified Pornography Addiction","Self-perceived Addiction","Pornography-watching Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13584859","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large web‑based community survey of Hungarian adults (N≈8,700), self‑report questionnaire, cross‑sectional","sample_n":8705,"sample_text":"large community sample","population":"adults from general community (Hungary), recruited online","country":"Hungary","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Hungarian online survey of 8,700 adults, researchers compared two ways of identifying problematic porn use: a 10‑item symptom checklist and a single question where participants say they feel addicted. The checklist identified more people and was linked to broader life issues, while self‑identification mainly related to how often they watched porn.","clinical_takeaway":"Self‑reported ‘addiction’ may not capture the full clinical picture; clinicians should assess specific symptoms and broader psychosocial factors.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Very large sample size","Direct comparison of symptom‑checklist vs self‑identification","Multivariable regression analyses"],"limitations":["Cross‑sectional; no causal inference","Masturbation not measured separately","Reliance on self‑report; symptom checklist not validated in this population"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2026.1928379"}},{"id":73,"doi":"10.1007/s10508-026-03505-2","pmid":"42745139","pmcid":null,"title":"Associations Between Frequency, Motivations, and Problematic Pornography Use and Sexual Well-Being: A Dyadic Prospective Study Among Couples","authors":"Bőthe B, Vaillancourt-Morel MP, François A, Michaud A, Gaudet É, Girouard A, Bergeron S.","first_author":"Bőthe B","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual Health","Sexual Well-being","Pornography","Gender Inclusivity"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Prospective dyadic study with baseline and 1‑year follow‑up (309 couples, 618 individuals). Autoregressive cross‑lagged APIM analyses.","sample_n":618,"sample_text":"309 couples (618 individuals) recruited from the general population.","population":"Couples (mixed gender, 2% gender‑diverse), community sample.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a year‑long study of 309 couples, researchers found that men’s motives for pleasure and self‑exploration when viewing porn were linked to better sexual function for both partners, while women’s and gender‑diverse partners’ problematic porn use predicted poorer sexual function in the opposite partner.","clinical_takeaway":"Problematic porn use may affect a partner’s sexual function; clinicians should assess both partners when addressing sexual distress.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Dyadic longitudinal design","Large community sample of couples","Actor‑partner interdependence modelling","Gender‑inclusive analysis"],"limitations":["Self‑report only; no objective or physiological measures","Potential lack of validated motivation scale","No measurement of moral incongruence, masturbation, mental health or trauma","Possible circularity in PPU definition"],"rubric_version":"2.0","raw_total":39,"max_possible":60,"pct_score":65,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":4,"design":8,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03505-2"}},{"id":74,"doi":"10.1007/s10508-021-02133-2","pmid":"34786657","pmcid":null,"title":"\"Pornography Addiction\": Elements for Discussion of a Case Report","authors":"Smaniotto B, Le Bigot J, Camps FD.","first_author":"Smaniotto B","journal":"Archives of sexual behavior","year":2022,"pub_types":["Review","Journal Article","Case Reports"],"keywords":["Addiction","Case Report","Pornography","Moral Incongruence","Internet Pornography Use (Ipu)"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single patient; narrative therapeutic discussion","sample_n":1,"sample_text":"single case vignette","population":"1 adult male self‑identified as having a pornography addiction","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe one man's belief that he is addicted to porn, discuss why 'porn addiction' is controversial, and suggest therapy that addresses moral conflict rather than stopping porn use.","clinical_takeaway":"Therapists should explore moral conflict and personal values when patients label porn use as an addiction.","confidence":0.8,"topic_tags":["pornography","sexual_function","moral_incongruence","csbd"],"strengths":["Highlights moral incongruence as a therapeutic target","Provides a nuanced discussion of diagnostic ambiguity"],"limitations":["Single case; no systematic measurement","No validated instruments for addiction or distress","No control of confounding variables"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02133-2"}},{"id":75,"doi":"10.1371/journal.pgph.0004946","pmid":"41223162","pmcid":"PMC12611143","title":"Substance use patterns among individuals with problematic pornography use: A scoping review","authors":"Dubois C, Danielson EC, Schwirtlich T, Beestrum M, Eurich DT.","first_author":"Dubois C","journal":"PLOS global public health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12611143","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"scoping review of 8 cross‑sectional studies, no risk‑of‑bias assessment reported","sample_n":null,"sample_text":"Eight cross‑sectional studies (total N not reported)","population":"individuals identified as having problematic pornography use in the primary studies","country":"unspecified (studies from various developed countries)","controls_mi":"no","preregistered":true,"quality_score":5,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2025 scoping review examined eight small, cross‑sectional studies linking problematic pornography use with substance use. Alcohol, cocaine and smoking showed modest positive links, but evidence is limited and the ways researchers defined “problematic pornography” vary widely.","clinical_takeaway":"Current data do not provide clear guidance on treating co‑occurring substance use and problematic pornography; more longitudinal, well‑controlled research is needed.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Systematic search across four major databases","Open‑science registration documented","Highlights major gaps in the literature"],"limitations":["Only cross‑sectional studies included, none longitudinal","No risk‑of‑bias or quality appraisal of included studies","PPU definitions and substance‑use measures highly heterogeneous","Key confounds (moral incongruence, masturbation, mental health) not addressed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pgph.0004946"}},{"id":76,"doi":"10.1002/hsr2.71030","pmid":"40642554","pmcid":"PMC12241428","title":"Problematic Pornography Consumption and Its Associated Factors Among Undergraduate Students of Kathmandu Metropolitan City: A Cross-Sectional Study","authors":"Chalise A, Pandey S, Paudel S, Chaudhary RK, Marasine NR.","first_author":"Chalise A","journal":"Health science reports","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Undergraduates","Problematic Pornographic Consumption","Risk Pornography Consumption"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12241428","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 361 hostel‑resident undergraduates in Kathmandu; self‑administered questionnaire; logistic regression analysis","sample_n":361,"sample_text":"361 undergraduate students residing in hostels","population":"Undergraduate students (age ~17‑22) residing in hostels, Kathmandu Metropolitan City, Nepal","country":"Nepal","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 361 Nepalese university students found that 17% scored high on a questionnaire for problematic pornography use. Higher risk was linked to being male, younger, drinking alcohol, and having poor knowledge about risky sexual behavior.","clinical_takeaway":"Screening for problematic porn use may be relevant among young males, especially those who drink alcohol, but clinicians should consider broader psychosocial factors.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Sample size >300 provides reasonable precision for prevalence estimate","Use of a specific scale (PPCS) to assess problematic use","Multivariable logistic regression with confidence intervals reported"],"limitations":["Cross‑sectional design cannot infer causality","Convenience sample of hostel residents limits generalisability","No measurement of key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)","Scale validation not described; possible circularity in defining ‘problematic’"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/hsr2.71030"}},{"id":77,"doi":"10.21203/rs.3.rs-3870491/v2","pmid":null,"pmcid":null,"title":"Examining the relationship between problematic pornography use and mental health status among adolescents of Bangladesh","authors":"Rimti FH, Ripon RK, Zubayer AA, Rimu FH, Rahman QM, Nailah MT, Rahman T, Sarkar TY, Islam MR, Das T, Nipun KI, Sabuz MS, Akhter I, Nandi AK, Ilman A, Hawlader MDH.","first_author":"Rimti FH","journal":"Research Square","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-3870491/v2","cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 601 Bangladeshi adolescents using self‑report scales","sample_n":601,"sample_text":"601 teenagers recruited for an online/paper survey (sampling method not specified)","population":"adolescents (Bangladesh)","country":"Bangladesh","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 601 Bangladeshi teenagers, higher scores on a brief pornography‑use questionnaire were linked to greater anxiety, loneliness and lower perceived social support, especially among boys. The authors suggest that problematic porn use may harm mental health.","clinical_takeaway":"Higher porn use scores are associated with poorer mental‑health indicators in adolescents, but causality is unclear; clinicians should assess use patterns alongside mood and social factors.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","moral_incongruence"],"strengths":["Large sample (n>600) for a regional adolescent survey","Uses established mental‑health and pornography‑use scales","Hierarchical regression to examine multiple predictors"],"limitations":["Cross‑sectional design cannot infer causality","No assessment of moral incongruence or masturbation, key confounds in PPU research","Sampling method unclear – possible convenience bias"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-3870491/v2"}},{"id":78,"doi":"10.1080/19317611.2025.2584545","pmid":"42205327","pmcid":null,"title":"Problematic Pornography Use Among Indian Adults: Patterns, Preferences, Motives, Psychosocial Impacts, and Support Strategies","authors":"Rajashekar M, Sharma MK, Amudhan S.","first_author":"Rajashekar M","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2026,"pub_types":["Journal Article"],"keywords":["Behavioral Addiction","Indian Adults","Compulsive Sexual Behavior Disorder (Csbd)","Problematic Pornography Use (Ppu), Psychological Impact"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online cross‑sectional survey of Indian adults reporting pornography‑related difficulties (N=112)","sample_n":112,"sample_text":"convenience online sample; majority male; participants reported pornography‑related difficulties in past six months","population":"Indian adults aged 18‑46, self‑selected for recent pornography‑related problems","country":"India","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 112 Indian adults who reported recent problems with pornography use found early exposure, frequent guilt/shame, and higher depression, anxiety, and stress. Motives such as stress relief and boredom were stronger in those with higher problem scores, and many felt unsupported by friends or partners.","clinical_takeaway":"Clients reporting distress around pornography may benefit from assessing underlying stress, mood, and social support rather than assuming an addiction.","confidence":0.6,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Uses validated scales (PPCS, PUMS, DASS‑21)","Explores motives and psychosocial impacts specific to Indian context","Relatively large sample for a niche topic"],"limitations":["Cross‑sectional, cannot infer causality","No measure of moral incongruence or masturbation behaviour","Self‑selected sample of people already reporting problems","Lacks multivariate control for key confounds"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2025.2584545"}},{"id":79,"doi":"10.1007/s10508-026-03414-4","pmid":"41986778","pmcid":null,"title":"The Effects of Pornographic Context on Working Memory Processing Among Individuals at Risk for Problematic Pornography Use","authors":"Jiang X, Song X, Wang Y, Wang J.","first_author":"Jiang X","journal":"Archives of sexual behavior","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["P300","Working memory","Event-related potentials (ERPs)","Distraction","Attention Bias","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross-sectional laboratory ERP experiment with risk vs control groups","sample_n":68,"sample_text":"college male convenience sample","population":"68 heterosexual male college students (34 at risk for PPU, 34 controls)","country":"China","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["no_mi_control","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In an EEG study, men identified as at risk for problematic pornography use showed slower reaction times and larger brain responses (P300) when porn images appeared as background distractions during a memory task, suggesting heightened attention to sexual cues.","clinical_takeaway":"Potential attentional bias to porn cues may impair cognitive performance in those with elevated PPU risk.","confidence":0.7,"topic_tags":["pornography","csbd"],"strengths":["Use of objective neural measure (ERP P300)","Direct experimental manipulation of distractor type","Comparison between at‑risk and control groups"],"limitations":["Risk status likely based on unreported or ad‑hoc screening","No assessment of key confounds (moral incongruence, masturbation, mental health)","Small sample limits power and generalizability"],"rubric_version":"2.0","raw_total":31,"max_possible":70,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":5,"statistics":5,"confounds":2,"design":5,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03414-4"}},{"id":80,"doi":"10.1093/jsxmed/qdaf034","pmid":"40067124","pmcid":null,"title":"Pornography and problematic pornography use: occurrence, patterns, and associated factors in a national gender-based controlled cross-sectional study","authors":"Zarei R, Alidost F, Damghanian M, Bőthe B, Farnam F.","first_author":"Zarei R","journal":"The journal of sexual medicine","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Depression","Iran","Prevalence","Sexual Satisfaction","Pornography","Problematic Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation","pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online national convenience survey of 1249 Iranian adults, gender‑based analysis, logistic and linear regression","sample_n":1249,"sample_text":"1249 participants recruited via social media; convenience sampling","population":"Iranian adults (865 women, 384 men), married majority","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2021 Iranian online survey of 1249 adults found that about 30% had used pornography in the past year, and 13% of these users met a cutoff for problematic use. Problematic users were more likely to masturbate frequently, have fewer children, report sexual distress, and have lower religiosity. The study highlights the need for clearer definitions and objective measures of problematic use.","clinical_takeaway":"Screen for frequent masturbation, sexual distress and low religiosity when assessing problematic pornography use; consider offering sex education and support.","confidence":0.78,"topic_tags":["pornography","prevalence","sexual_function","masturbation","moral_incongruence"],"strengths":["Large national sample","Use of validated scales for PPU and mental health","Gender‑based analysis"],"limitations":["Convenience, online recruitment limits representativeness","Moral incongruence not measured despite relevance","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf034"}},{"id":81,"doi":"10.1111/aphw.70119","pmid":"41575062","pmcid":null,"title":"Breaking the cycle between loneliness and problematic pornography use: A group-based physical exercise intervention","authors":"Lin Y, Wu Y, Peng K.","first_author":"Lin Y","journal":"Applied psychology. Health and well-being","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Loneliness","Physical Exercise","Group Intervention","Internet Misuse","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Mixed design: large cross‑sectional (n=351), cross‑lagged panel (n=103), pilot group‑exercise intervention (n=28), and small RCT comparing group vs individual exercise vs control (n=92).","sample_n":351,"sample_text":"Study1 n=351; Study2 n=103; Study3 n=28; Study4 n=92.","population":"Adults (young adult to older), both genders, community sample (details not specified).","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","underpowered_sample"],"stance":"supports","citation_value":"useful","plain_summary":"Across four studies, researchers found that loneliness and problematic porn use are linked. A 4‑week group exercise program appeared to stop loneliness and porn use from getting worse, though it didn’t markedly reduce them.","clinical_takeaway":"Group exercise may help prevent worsening of loneliness‑related problematic porn use, but evidence for symptom reduction is limited.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large cross‑sectional sample for initial association","Longitudinal cross‑lagged design addressing directionality","Inclusion of an intervention arm with control comparison"],"limitations":["Small sample sizes for intervention studies, limiting power","No measurement or control of moral incongruence, masturbation, mental health, or trauma","Problematic pornography use likely measured by self‑report without clear validation"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/aphw.70119"}},{"id":82,"doi":"10.5765/jkacap.250015","pmid":"40631652","pmcid":"PMC12223668","title":"Adolescents, Pornography Use, and Problematic Pornography Use: A Rapid Systematic Review of Longitudinal Studies","authors":"Mestre-Bach G, Potenza MN.","first_author":"Mestre-Bach G","journal":"Journal of the Korean Academy of Child and Adolescent Psychiatry","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Longitudinal Studies","Impulse Control Disorders","Compulsive Sexual Behaviors","Pornography","Addictive Behaviors","Compulsive Behaviors","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://www.jkacap.org/journal/download_pdf.php?doi=10.5765/jkacap.250015","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"rapid systematic review of longitudinal adolescent studies on pornography and problematic use, following PRISMA but no meta‑analysis or formal risk‑of‑bias assessment","sample_n":null,"sample_text":"44 longitudinal studies included; individual study sizes not reported in abstract","population":"adolescents (studies included varied samples)","country":"global (studies from multiple countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This rapid systematic review summarises 44 longitudinal studies on how adolescent pornography use relates to sexual behaviour, risk, satisfaction, aggression, academics, mental health and other factors. Results are mixed, showing both associations and inconsistencies, and the authors call for more rigorous longitudinal work.","clinical_takeaway":"Evidence linking adolescent porn use to harmful outcomes is inconsistent; clinicians should assess each youth individually rather than assume pathology.","confidence":0.7,"topic_tags":["adolescents","pornography","csbd","sexual_function"],"strengths":["Focused on longitudinal evidence","Follows PRISMA reporting framework","Covers a broad range of outcomes"],"limitations":["Rapid review may have limited search depth","No quantitative synthesis or risk‑of‑bias appraisal","Heterogeneous definitions of problematic use across studies"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":4,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5765/jkacap.250015"}},{"id":83,"doi":"10.1016/j.ijchp.2026.100710","pmid":"42564854","pmcid":"PMC13444289","title":"Differential P3 reactivity to pornographic versus natural rewards as a neural marker of reward imbalance in problematic pornography use in young heterosexual men","authors":"Liu Y, Zhong S, Wang J.","first_author":"Liu Y","journal":"International journal of clinical and health psychology : IJCHP","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Cue Reactivity","P3","Natural Rewards","Problematic Pornography Use","Reward Dysregulation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13444289","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"ERP oddball task with questionnaires; correlational analysis in a single sample of 139 young heterosexual men","sample_n":139,"sample_text":"139 participants, mean age 20.54","population":"young heterosexual men (age 18-25), likely convenience/college sample","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 139 young men, a brain response (ΔP3) that is larger for porn images than for pleasant non‑sexual images was linked to higher self‑reported problematic porn use, suggesting a possible neural marker of reward imbalance.","clinical_takeaway":"The ΔP3 ERP difference may help identify men at higher risk for problematic porn use, but clinical use is premature.","confidence":0.7,"topic_tags":["pornography","neuroscience"],"strengths":["Relatively large ERP sample for neurophysiology","Novel differential P3 index (ΔP3) comparing pornographic and natural rewards","Clear association with self‑reported PPU severity"],"limitations":["Cross‑sectional design limits causal inference","No measurement or control of key confounds (moral incongruence, masturbation, mental health, relationship factors)","Questionnaire instruments not specified; unclear if validated"],"rubric_version":"2.0","raw_total":36,"max_possible":70,"pct_score":51,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":6,"statistics":5,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijchp.2026.100710"}},{"id":84,"doi":"10.1016/j.jad.2026.121459","pmid":"41713609","pmcid":null,"title":"Transdiagnostic psychopathology among individuals with co-occurring problematic pornography use and alcohol use problems","authors":"Moon EJ, Garos S, Brasil KM, Kraus SW, Spencer SD, Borgogna NC.","first_author":"Moon EJ","journal":"Journal of affective disorders","year":2026,"pub_types":["Journal Article"],"keywords":["Well-being","Co-occurrence","Alcohol Use Problems","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey with four groups (no PPU/no alcohol, PPU only, alcohol only, co‑occurring).","sample_n":3025,"sample_text":"Total N=3,025; group Ns: 2,085 no PPU/no alcohol, 302 PPU only, 571 alcohol only, 127 co‑occurring.","population":"Adults (young adult–older), mixed gender, n≈3,200 total; groups formed by self‑reported clinically significant PPU and alcohol problems.","country":"Not specified in abstract","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A large survey compared people with only problematic porn use, only alcohol problems, both, or neither. Those with both reported more PTSD, depression, negative mood, and watched porn more often than those with only alcohol problems. The study suggests that porn‑related distress may add to the burden of alcohol issues.","clinical_takeaway":"Assess trauma and mood symptoms in clients who report both problematic porn use and alcohol misuse.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large overall sample","Four distinct comparison groups","Assessment of multiple mental‑health outcomes"],"limitations":["Cross‑sectional, cannot infer causality","Problematic pornography use not operationalised with validated scale","Key confounds (moral incongruence, masturbation, relationship factors) not measured"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jad.2026.121459"}},{"id":85,"doi":"10.1071/sh25054","pmid":"40977234","pmcid":null,"title":"Prevalence of problematic pornography use: a meta-analysis","authors":"Chew PKH, Yow YJ, Tan CSY.","first_author":"Chew PKH","journal":"Sexual health","year":2025,"pub_types":["Meta-Analysis","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta-analysis of prevalence rates from 22 studies (N=31,566) using random‑effects model.","sample_n":31566,"sample_text":"22 primary studies","population":"general population and sub‑populations (e.g., students)","country":"Various (global)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["circular_addiction_scale","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 22 studies (31,566 participants) found that about 13% of people report problematic pornography use, but rates differ by region, sample type, and how problem use is measured.","clinical_takeaway":"Clinicians should note that problematic pornography use is relatively common, yet prevalence estimates vary widely depending on measurement tools and sample characteristics.","confidence":0.7,"topic_tags":["prevalence","pornography","sexual_function","measurement"],"strengths":["Largest pooled prevalence estimate for PPU to date","Systematic search across multiple databases","Quantifies heterogeneity and explores moderators"],"limitations":["Included studies use heterogeneous, often ad‑hoc PPU measures","No assessment of moral incongruence or other key confounds","Potential publication bias not fully ruled out"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh25054"}},{"id":86,"doi":"10.1007/s10508-025-03201-7","pmid":"40760402","pmcid":"PMC12457533","title":"Validation of the Problematic Pornography Consumption Scale: Short Form (PPCS-6) in a Spanish Clinical Population with Gambling Disorder","authors":"Jiménez-Murcia S, Granero R, Testa G, Tarragón E, Potenza MN, Bőthe B, Demetrovics Z, Uríszar JC, Chiclana-Actis C, Fernández-Aranda F, Mestre-Bach G.","first_author":"Jiménez-Murcia S","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Journal Article","case-report"],"keywords":["Emotion Regulation","Gambling Disorder","Addictive Behaviors","Compulsive Behaviors","Impulsive Behaviors","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12457533","cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Validation study of a short-form questionnaire (PPCS-6) in a treatment‑seeking sample of adults with gambling disorder (N=359).","sample_n":359,"sample_text":"Treatment‑seeking clinical sample; not a probability or community sample.","population":"Adults with gambling disorder (92% male, mean age 39.5) seeking treatment in Spain.","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors tested a short 6‑item questionnaire for problematic porn use in 359 Spanish adults receiving treatment for gambling disorder. The scale showed good factor structure and linked to higher impulsivity, emotion‑regulation problems, and overall psychopathology, suggesting it works well as a screening tool in clinical settings.","clinical_takeaway":"The PPCS‑6 can reliably screen for problematic pornography use among treatment‑seeking patients, but clinicians should consider co‑occurring mental‑health and moral factors.","confidence":0.78,"topic_tags":["measurement","pornography","gender"],"strengths":["Large clinical sample (N=359)","Robust psychometric methods (CFA, internal consistency)","Use of multiple validated convergent measures"],"limitations":["Treatment‑seeking, predominantly male sample limits generalisability","Moral incongruence and masturbation not assessed despite relevance to distress outcomes","Scale may blend frequency and distress, risking circularity"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03201-7"}},{"id":87,"doi":"10.1007/s10508-025-03287-z","pmid":"41269492","pmcid":"PMC12675693","title":"Quantifying Opponent Process Dynamics in Pornography Use and Masturbation: An Exploratory Ecological Momentary Assessment Study","authors":"Henry NIN, Pedersen M, Williams M, Donkin L.","first_author":"Henry NIN","journal":"Archives of sexual behavior","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Ecological Momentary Assessment","Opponent Process","Pornography","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12675693","cited_by_count":1,"is_preprint":false,"topics":["masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Exploratory ecological momentary assessment (EMA) over four weeks with 22 participants, measuring self‑reported affect, cognition and sexual activity before, during and after pornography use and masturbation.","sample_n":22,"sample_text":"22 participants completed EMA over four weeks.","population":"22 adult participants (young adults), likely convenience sample; no details on recruitment or representativeness.","country":"Not specified","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a four‑week study of 22 adults, researchers tracked feelings and thoughts before, during and after watching porn and masturbating. They found that people who felt their porn use conflicted with their morals showed bigger, longer‑lasting spikes in shame, guilt and mood drops, suggesting a possible emotional “opponent‑process” that could link porn use to depression.","clinical_takeaway":"High moral conflict may amplify negative emotional reactions after porn use; clinicians should assess moral incongruence when addressing distress linked to pornography.","confidence":0.6,"topic_tags":["pornography","masturbation","moral_incongruence","adolescents"],"strengths":["Fine‑grained EMA captures moment‑to‑moment dynamics","Incorporates moral incongruence as moderator","Bayesian hierarchical modelling accounts for repeated measures"],"limitations":["Very small sample (N=22) limits generalisability and power","All variables self‑reported; no objective or physiological measures","No control for mental‑health, partner or trauma factors"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03287-z"}},{"id":88,"doi":"10.3389/fnhum.2025.1477914","pmid":"40309664","pmcid":"PMC12040873","title":"The impact of internet pornography addiction on brain function: a functional near-infrared spectroscopy study","authors":"Shu Q, Tang S, Wu Z, Feng J, Lv W, Huang M, Xu F.","first_author":"Shu Q","journal":"Frontiers in human neuroscience","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Cognition","Addiction","brain function","Functional Near-infrared Spectroscopy (Fnirs)","Internet Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12040873","cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross‑sectional laboratory experiment with fNIRS; 21 college participants (16 low‑frequency, 5 high‑frequency users) watched a pornography video and completed Stroop task before/after.","sample_n":21,"sample_text":"16 healthy college students and five college students with severe internet pornography addiction","population":"college students (convenience sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured brain activity with fNIRS while 21 college students watched a porn video. Those who reported frequent porn use showed different patterns of brain connectivity and slower Stroop test performance than infrequent users. The authors suggest these differences reflect ‘addiction‑related’ brain changes.","clinical_takeaway":"Findings are limited by a tiny, non‑representative sample and unclear addiction definitions; they do not provide reliable guidance for clinical practice.","confidence":0.4,"topic_tags":["pornography","neuroscience","sexual_function","adolescents"],"strengths":["Uses a neuroimaging modality (fNIRS) to assess brain activity during stimulus exposure","Includes a behavioral task (Stroop) before and after exposure"],"limitations":["Very small, unbalanced sample (5 ‘addicted’ participants)","No validated measure of pornography addiction; classification appears self‑labelled","No assessment or control of key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)","Neuroimaging analyses lack correction for multiple comparisons and over‑interpret functional connectivity"],"rubric_version":"2.0","raw_total":17,"max_possible":70,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":2,"statistics":3,"confounds":2,"design":3,"addiction_criteria":2,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[{"status":"Has correction","date":"2025-7-17","noticeDoi":"10.3389/fnhum.2025.1658882","doi":"10.3389/fnhum.2025.1477914"}],"url":"https://scite.ai/reports/10.3389/fnhum.2025.1477914"}},{"id":89,"doi":"10.1556/2006.2025.00337","pmid":"41879870","pmcid":"PMC13132360","title":"Compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU): A comprehensive, interdisciplinary, and expert-informed narrative review with suggested future directions","authors":"Ince C, Antons S, Ashton S, Borgogna NC, Brand M, Briken P, Castro-Calvo J, Chen L, Coleman E, Efrati Y, Fernández DP, Fuss J, Gleason N, Gola M, Jennings TL, Kowalewska E, Kraus SW, Lewczuk K, Grubbs JB, Lew-Starowicz M, Love T, Mestre-Bach G, Potenza MN, Rahm-Knigge RL, De Tubino Scanavino M, Stark R, Demetrovics Z, Bőthe B.","first_author":"Ince C","journal":"Journal of behavioral addictions","year":2026,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual behavior","Compulsive Behavior","Addiction","Hypersexual Behavior","Impulsive Behavior","Addictive Behavior","Behavioral Addiction","Erotica","Compulsive Sexual Behavior Disorder","Problematic Pornography Use","Out-of-control Sexual Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13132360","cited_by_count":4,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods or risk‑of‑bias assessment; no new empirical data","sample_n":null,"sample_text":"N/A – narrative review","population":"experts and literature across disciplines; no primary participants","country":"International (multiple contributors)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews what is known about compulsive sexual behavior disorder and problematic pornography use, summarizing history, symptoms, measurement, prevalence, co‑occurring problems, causes, harms, treatments, and policy, and points out research gaps.","clinical_takeaway":"Clinicians should note that definitions and measurement of CSBD/PPU are still debated; use validated tools and consider alternative explanations such as moral conflict.","confidence":0.7,"topic_tags":["csbd","pornography","sexual_function","moral_incongruence","treatment"],"strengths":["Broad interdisciplinary authorship","Covers many topics (epidemiology, treatment, policy)","Highlights methodological gaps"],"limitations":["Narrative (non‑systematic) synthesis","No explicit risk‑of‑bias assessment","Lacks quantitative appraisal of studies"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00337"}},{"id":90,"doi":"10.1080/00224499.2025.2544208","pmid":"40825278","pmcid":null,"title":"Longitudinal Associations Between Problematic Pornography Use and Types of Rumination","authors":"Demirgül SA, Demetrovics Z, Czakó A, Paksi B, Kökönyei G, Bőthe B.","first_author":"Demirgül SA","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"autoregressive cross‑lagged panel model with 2,786 Hungarian young adults assessed at baseline and 1‑year follow‑up","sample_n":2786,"sample_text":"community sample, recruitment method not specified in abstract","population":"Hungarian young adults (mean age 28, both genders)","country":"Hungary","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a year‑long study of 2,800 Hungarian adults, higher problematic porn use was linked to more brooding and reflective rumination. The relationship was bidirectional for brooding, and gender‑specific patterns emerged: women’s brooding predicted later porn use, while men’s reflective rumination predicted less later use.","clinical_takeaway":"Problematic porn use may co‑occur with rumination; addressing brooding could help reduce use, especially in women.","confidence":0.78,"topic_tags":["pornography","masturbation"],"strengths":["large longitudinal sample","gender‑specific analyses","use of cross‑lagged modelling"],"limitations":["unclear if PPU scale is validated","no measurement of moral or other key confounds","no pre‑registration reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2025.2544208"}},{"id":91,"doi":"10.1556/2006.2025.00098","pmid":"41528351","pmcid":"PMC13132356","title":"Deficits in loss-related feedback processing and risky decision-making among heterosexual males at risk for problematic pornography use","authors":"Jiang X, Yang X, Wang Y, Wang J.","first_author":"Jiang X","journal":"Journal of behavioral addictions","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["P300","Impulsivity","Erps","Feedback Processing","Risk-taking Behaviors","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13132356","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control EEG study with 35 at‑risk males and 34 controls, university sample","sample_n":69,"sample_text":"35 at‑risk participants, 34 controls","population":"heterosexual male university students, mean age ~20 y","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"University men identified as at risk for problematic porn use showed poorer performance on a risk‑taking game and smaller brain responses to loss feedback, suggesting weaker attention to negative outcomes.","clinical_takeaway":"The findings hint that attentional deficits to negative feedback may help maintain risky porn use, but evidence is limited and not yet actionable.","confidence":0.75,"topic_tags":["pornography","relationships","csbd"],"strengths":["EEG ERP methodology captures rapid feedback processing","Matched control group","Combined behavioral and neural measures"],"limitations":["Small sample, likely underpowered","No assessment of key confounds (moral incongruence, masturbation, mental health)","Problematic pornography use defined only by screening questionnaire, unclear validation"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":5,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00098"}},{"id":92,"doi":"10.1111/add.15272","pmid":"32955140","pmcid":null,"title":"Frequency of use, moral incongruence and religiosity and their relationships with self-perceived addiction to pornography, internet use, social networking and online gaming","authors":"Lewczuk K, Nowakowska I, Lewandowska K, Potenza MN, Gola M.","first_author":"Lewczuk K","journal":"Addiction (Abingdon, England)","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Addiction","Religiosity","Internet Addiction","Behavioral Addictions","Gaming Addiction","Pornography Addiction","Compulsive Sexual Behavior Disorder","Problematic Pornography Use","Moral Incongruence","Social Networking Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional, preregistered online survey of 1036 Polish adults","sample_n":1036,"sample_text":"1036 Polish adults","population":"Polish adults aged 18‑69, community sample","country":"Poland","controls_mi":"yes","preregistered":true,"quality_score":6,"certainty":"very_low","red_flags":["masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 1,000 Polish adults, feeling morally conflicted about watching porn and how often people watched were linked to them thinking they were addicted to porn, the internet, social media, and gaming. Higher religiosity was also tied to perceived porn addiction.","clinical_takeaway":"Clinicians should consider moral conflict and frequency of use when clients report feeling addicted to porn or digital media.","confidence":0.7,"topic_tags":["pornography","moral_incongruence","religiosity","sexual_function","csbd"],"strengths":["Large community sample (N>1000)","Preregistered analysis plan","Multivariable regression controlling for several predictors"],"limitations":["Self‑perceived addiction measured by single item","Masturbation not separated from pornography use","No assessment of mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":8,"confounds":5,"design":6,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":5,"contrasting":1,"mentioning":64,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/add.15272"}},{"id":93,"doi":"10.1016/j.jpsychires.2026.05.026","pmid":"42150511","pmcid":null,"title":"Is problematic sexuality a marker for the onset of mental disorders? A cross-sectional study on psychotic-like experiences and sexual behaviour in a non-clinical sample","authors":"Doroldi D, Origlia G, Giannini T, Jannini TB, Boldrini T, Del Casale A, Lo Buglio G, Spitoni G, Limoncin E, Pelizza L, Ciocca G.","first_author":"Doroldi D","journal":"Journal of psychiatric research","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"convenience sample, N=582, cross‑sectional survey","sample_n":582,"sample_text":"Convenience sample of 582 subjects, 197 with clinically relevant psychotic‑like experiences (PQ‑16 ≥6).","population":"non‑clinical adults (young adults) recruited via convenience methods","country":"Italy (inferred from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 582 adults, people with more psychotic‑like thoughts also reported higher rates of hypersexual behaviour, problematic pornography use, and difficulties with orgasm, even after accounting for age and depression.","clinical_takeaway":"Screen for sexual health issues, including problematic pornography use, in individuals reporting psychotic‑like experiences.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large overall sample size for a survey","Both male and female sub‑analyses","Controls for age and depression in comparisons","Focus on understudied link between sexual behaviour and psychotic‑like experiences"],"limitations":["Convenience sampling limits generalisability","Reliance on self‑report scales, unclear validation status","Moral incongruence, masturbation, partner factors not measured","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpsychires.2026.05.026"}},{"id":94,"doi":"10.1556/2006.2025.00070","pmid":"40920476","pmcid":"PMC12486261","title":"Problematic pornography use as an externalizing depression symptom in cisgender men: A cross-sectional questionnaire study","authors":"Walther A, Ehlert U, Komlenac N.","first_author":"Walther A","journal":"Journal of behavioral addictions","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Gender","Externalizing Symptoms","Masculinity Ideologies","Problematic Pornography Use (Ppu)","German-speaking Men"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12486261","cited_by_count":4,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study of 265 German‑speaking cisgender men","sample_n":265,"sample_text":"265 cisgender men","population":"cisgender men (average age 31.8) from German‑speaking Europe, recruited likely via online survey","country":"Germany/Austria/Switzerland (German‑speaking Europe)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 265 German‑speaking men and found that higher depression was linked to stronger masculine ideology, which was associated with more externalising behaviours and higher problematic porn use. The authors suggest porn use may act as an outward sign of hidden depression.","clinical_takeaway":"Screen for problematic porn use when evaluating men with depressive symptoms, but note that causality is not proven.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Adequate sample size for questionnaire work","Inclusion of masculinity ideology as a mediator","Use of mediation path analysis to test indirect effects"],"limitations":["Cross‑sectional design cannot establish causality","Problematic pornography use likely measured with non‑validated or circular items","No assessment of moral incongruence, masturbation, partner or trauma factors"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00070"}},{"id":95,"doi":"10.1101/2025.06.12.25329499","pmid":null,"pmcid":null,"title":"Neuroimaging Correlates of Compulsive Sexual Behavior and Problematic Pornography Use: A Systematic Review and Coordinate-Based Meta-Analysis Protocol","authors":"Feng Y, Wei Z.","first_author":"Feng Y","journal":"medRxiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.medrxiv.org/content/medrxiv/early/2025/06/12/2025.06.12.25329499.full.pdf","cited_by_count":1,"is_preprint":true,"topics":["csbd","pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"protocol for coordinate-based meta-analysis of neuroimaging studies on CSBD and PPU","sample_n":null,"sample_text":"No primary participants; the review will synthesize existing imaging studies.","population":"studies reporting stereotactic coordinates in structural or functional MRI/fMRI of CSBD/PPU","country":"Not applicable","controls_mi":"not_applicable","preregistered":true,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This pre‑registered protocol will systematically gather brain‑imaging results from studies of compulsive sexual behavior and problematic pornography use, using a meta‑analysis of reported brain coordinates to find common neural patterns.","clinical_takeaway":"None – the paper outlines a future review; no clinical conclusions can be drawn yet.","confidence":0.4,"topic_tags":["neuroscience","csbd","pornography","sexual_function"],"strengths":["Transparent, pre‑registered protocol","Focus on convergent neuroimaging findings","Planned use of coordinate‑based meta‑analysis to increase power"],"limitations":["No empirical data yet; scores reflect protocol only","Potential reliance on published coordinates that may suffer from reporting bias","No plan described for assessing confound variables (e.g., moral incongruence, masturbation) in included studies"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":7,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2025.06.12.25329499"}},{"id":96,"doi":"10.1007/s11126-025-10210-1","pmid":"40906215","pmcid":null,"title":"Problematic Pornography Use and Clinical and Psychosocial Correlates Among Low-Income U.S. Veterans: an Exploratory Study","authors":"Stefanovics EA, Potenza MN, Tsai J.","first_author":"Stefanovics EA","journal":"The Psychiatric quarterly","year":2025,"pub_types":["Journal Article"],"keywords":["Veterans","Homelessness","Suicidality","Compulsive Sexual Behaviors","Pornography","Addictive Behaviors","Impulsive Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"exploratory cross‑sectional survey of 292 low‑income U.S. veterans using the Brief Pornography Screen (BPS); logistic regression used to examine associations with psychiatric, homelessness and psychosocial variables.","sample_n":292,"sample_text":"representative sample of low‑income U.S. military veterans from the National Veteran Homeless and Other Poverty Experiences (NV‑HOPE) study","population":"low‑income U.S. military veterans (N = 292)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 292 low‑income U.S. veterans, about a quarter showed signs of problematic pornography use, which was linked to younger age, psychiatric disorders, homelessness, impulsivity and lower resilience.","clinical_takeaway":"Screen for problematic pornography use in vulnerable veteran populations, as it co‑occurs with mental‑health and social challenges.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large, low‑income veteran sample","Use of a brief, published PPU screening tool","Multivariate logistic regression to adjust for covariates"],"limitations":["Cross‑sectional design limits causal inference","Moral incongruence and masturbation not measured","Potential self‑report bias in PPU screening"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11126-025-10210-1"}},{"id":97,"doi":"10.21203/rs.3.rs-5094782/v1","pmid":null,"pmcid":null,"title":"Quantifying the Affective Dynamics of Pornography Use and Masturbation: An Ecological Momentary Assessment Study","authors":"Henry NIN, Pedersen M, Williams M, Donkin L.","first_author":"Henry NIN","journal":"Research Square","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-5094782/v1","cited_by_count":0,"is_preprint":true,"topics":["masturbation","pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Ecological Momentary Assessment (EMA) over 4 weeks with 22 participants, Bayesian hierarchical mixed‑effects analysis of affective states before, during, and after pornography use and masturbation.","sample_n":22,"sample_text":"22 participants completed a four‑week EMA protocol.","population":"N=22, convenience sample (likely university/community volunteers)","country":"not reported","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A small 4‑week EMA study with 22 adults tracked mood before, during, and after porn use and masturbation. Both activities were linked to short spikes in emotions, especially in people who felt morally conflicted about their behaviour, showing more guilt, shame and lower mood.","clinical_takeaway":"High moral conflict may amplify negative mood around porn or masturbatory episodes; clinicians should assess moral incongruence when addressing related distress.","confidence":0.8,"topic_tags":["pornography","masturbation","moral_incongruence"],"strengths":["Intensive longitudinal EMA capturing real‑time affective dynamics","Bayesian hierarchical modeling appropriate for repeated measures"],"limitations":["Very small sample (N=22) limits power and generalisability","Reliance on ad‑hoc self‑report items; limited validation","Limited control for key confounds beyond moral incongruence"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-5094782/v1"}},{"id":98,"doi":"10.1016/j.bodyim.2025.101940","pmid":"40652662","pmcid":null,"title":"Bidirectional positive associations between problematic pornography use and body dissatisfaction in women and men: Findings among Hungarian young adults in a one-year longitudinal study","authors":"Demirgül SA, Demetrovics Z, Czakó A, Paksi B, Kökönyei G, Bőthe B.","first_author":"Demirgül SA","journal":"Body image","year":2025,"pub_types":["Journal Article"],"keywords":["Adults","Body Dissatisfaction","Longitudinal Design","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"cross-lagged panel model with multi‑group analysis of 2801 Hungarian young adults (age ≈28), two waves one year apart","sample_n":2801,"sample_text":"2801 adults (47.7 % men, 52.3 % women), mean age 28 y","population":"Hungarian young adults, mixed gender, community sample (sampling method not specified)","country":"Hungary","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a year‑long study of 2,800 Hungarian young adults, higher levels of problematic porn use were linked to greater body dissatisfaction for both men and women, and each seemed to predict the other over time.","clinical_takeaway":"Screen for body‑image concerns in clients with problematic porn use, and vice‑versa, to enable early support.","confidence":0.73,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Large sample size","Longitudinal cross‑lagged design allowing bidirectional inference","Separate analysis by gender"],"limitations":["No measurement or control of moral incongruence or masturbation","Unclear whether PPU scale is validated and not circular","No pre‑registration or effect‑size reporting in abstract"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.bodyim.2025.101940"}},{"id":99,"doi":"10.1007/s10508-023-02743-y","pmid":"38015310","pmcid":null,"title":"Taking Another Look at the Pornography Problems Due to Moral Incongruence Model: Does Gender Play a Role?","authors":"Borgogna NC, Johnson DAL, Shegedin M, Brasil KM.","first_author":"Borgogna NC","journal":"Archives of sexual behavior","year":2024,"pub_types":["Journal Article"],"keywords":["Gender","Dysregulation","Compulsive Sexual Behavior Disorder","Problematic Pornography Use","Moral Incongruence"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of college students (n=295 men, 838 women; users n=251 men, 407 women)","sample_n":1133,"sample_text":"Large convenience sample of college students; not a probability sample","population":"college students, non‑clinical","country":"Not reported","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether moral conflict about porn use explains reported problems, and whether this differs for men and women. Among college students, religious beliefs were linked to moral disapproval, which in turn was associated with higher self‑reported porn‑related problems, but gender did not change these patterns.","clinical_takeaway":"Clinicians should consider clients' moral and religious beliefs when assessing distress about pornography, regardless of gender.","confidence":0.8,"topic_tags":["pornography","moral_incongruence","gender","sexual_function"],"strengths":["Large sample size for gender comparison","Inclusion of religiosity and moral disapproval measures","Statistical modeling of indirect effects"],"limitations":["Convenience college sample limits generalisability","Masturbation and broader mental‑health factors not measured","Unclear whether PPU scale is validated"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02743-y"}},{"id":100,"doi":"10.1016/j.addbeh.2025.108589","pmid":"41435755","pmcid":null,"title":"Longitudinal study of probable compulsive sexual behavior disorder and problematic pornography use profiles: their prospective impact on psychopathology during wartime","authors":"Efrati Y, Shmulewitz D, Skvirsky V, Vider M, Kor A, Lev-Ran S, Mikulincer M.","first_author":"Efrati Y","journal":"Addictive behaviors","year":2026,"pub_types":["Journal Article"],"keywords":["Longitudinal study","Traumatic Events","Latent Profile Analysis","Compulsive Sexual Behavior Disorder","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"community sample surveyed pre‑war (2018, 2022) and during war (2023) with latent profile analysis of probable CSBD and PPU","sample_n":1182,"sample_text":"large community sample, convenience‑recruited","population":"Jewish adults, Israel, ages 18‑70 (N≈1182)","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study followed over a thousand Israeli adults before and during the 2023 war, grouping them by patterns of compulsive sexual behavior and problematic porn use. Those with no such problems stayed mentally healthier, while a chronic problem group showed higher distress and worsening PTSD.","clinical_takeaway":"Persistent compulsive sexual behavior or problematic porn use may heighten vulnerability to mental‑health worsening during stressful events.","confidence":0.78,"topic_tags":["csbd","pornography","sexual_function","moral_incongruence","relationships"],"strengths":["Large longitudinal community sample","Prospective assessment across multiple waves","Use of latent profile analysis to identify trajectories"],"limitations":["Reliance on self‑report probable CSBD/PPU without detailed addiction‑criteria testing","No measurement/control of moral incongruence, masturbation, or partner factors","No pre‑registration reported"],"rubric_version":"2.0","raw_total":37,"max_possible":60,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":7,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2025.108589"}},{"id":101,"doi":"10.1037/adb0000996","pmid":"38451727","pmcid":null,"title":"Problematic pornography use and suicidal thoughts: Results from cross-sectional and longitudinal analyses","authors":"McGraw JS, Grant Weinandy JT, Floyd CG, Hoagland C, Kraus SW, Grubbs JB.","first_author":"McGraw JS","journal":"Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"cross-sectional undergraduate sample (n=422) and longitudinal nationally representative adult sample (n=1,455) with repeated measures of suicidal ideation and perceived likelihood of suicidal behaviors","sample_n":1877,"sample_text":"422 undergraduates; 1,455 nationally representative U.S. adults","population":"U.S. undergraduates and adults","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers examined whether people who see their pornography use as problematic are more likely to think about suicide. In a student sample and a nationally representative adult sample, problematic use was linked to higher self‑reported likelihood of suicidal behavior and, over time, to higher baseline suicidal thoughts, even after accounting for how often they watched porn and their moral or religious views.","clinical_takeaway":"Clinicians should assess suicidal risk when patients report problematic pornography use.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative longitudinal sample","Controls for moral disapproval and religiosity","Separates frequency of pornography use from PPU"],"limitations":["PPU measurement not clearly described; likely self‑report only","No control for masturbation, mental‑health covariates, or relationship factors","No pre‑registration or effect‑size reporting in abstract"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/adb0000996"}},{"id":102,"doi":"10.1016/j.abrep.2024.100550","pmid":"38746953","pmcid":"PMC11090905","title":"Loneliness and problematic pornography Use: What is the role of emotion regulation and interaction with content Creators?","authors":"Vescan M, Flack M, Caudwell KM.","first_author":"Vescan M","journal":"Addictive behaviors reports","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Loneliness","Emotion Regulation","Pornography","Problematic Pornography Use","Content Creation Platform","Content Creator"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11090905","cited_by_count":8,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire, N=213, mediation analysis","sample_n":213,"sample_text":"Adults recruited online (convenience sample)","population":"adults, 77.5% men, mean age 35.6","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 213 adults, feeling lonely was linked to more problem‑like pornography use, and this link was partly explained by difficulties managing emotions. Talking with pornography content creators was tied to slightly less problematic use, but it did not change the emotion‑regulation pathway.","clinical_takeaway":"Address loneliness and emotion‑regulation skills when helping clients who report problematic pornography use.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Reasonable sample size for mediation analysis","Integrates novel variable (content‑creator interaction)","Provides statistical mediation model"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of key confounds (morality, masturbation, mental health)","Unclear whether PPU scale is validated"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.abrep.2024.100550"}},{"id":103,"doi":"10.1007/s10508-025-03179-2","pmid":"40551074","pmcid":"PMC12283779","title":"Profiles of Alcohol Use Disorders, Problematic Pornography Use, and Compulsive Sexual Behavior: The Role of Mental Health, Moral Disapproval, Thought Suppression, and Self-Concealment Among Israeli-Arab Adolescents","authors":"Kabaha M, Efrati Y.","first_author":"Kabaha M","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Adolescents","Compulsive Sexual Behavior","Network Analysis","Alcohol Use Disorder","Latent Profile Analysis","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12283779","cited_by_count":1,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 622 Israeli‑Arab adolescents; latent profile and network analyses","sample_n":622,"sample_text":"large community sample","population":"Israeli‑Arab adolescents (14‑18 y, 64 % male)","country":"Israel","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["masturbation_not_isolated","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 622 Israeli‑Arab teens, researchers identified three clusters of factors linking alcohol use, compulsive sexual behavior, problematic porn use, mental health, and moral disapproval. Five distinct patterns of risk were found, showing how cultural and psychological factors combine with sexual‑media use.","clinical_takeaway":"Screening for moral conflict and mental‑health symptoms may help identify adolescents at higher risk for problematic porn and sexual‑behavior issues.","confidence":0.78,"topic_tags":["pornography","masturbation","csbd","adolescents","moral_incongruence"],"strengths":["Large community sample (N>600)","Use of latent‑profile and network analyses","Inclusion of moral disapproval and mental‑health covariates"],"limitations":["Cross‑sectional; no causal inference","Unclear whether PPU/CSB scales distinguish frequency from distress","Masturbation not measured separately"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03179-2"}},{"id":104,"doi":"10.1556/2006.2024.00018","pmid":"38669086","pmcid":"PMC11220800","title":"Reducing problematic pornography use with imaginal retraining-A randomized controlled trial","authors":"Baumeister A, Gehlenborg J, Schuurmans L, Moritz S, Briken P.","first_author":"Baumeister A","journal":"Journal of behavioral addictions","year":2024,"pub_types":["research-article","Randomized Controlled Trial","Journal Article"],"keywords":["Online Intervention","Compulsive Sexual Behavior Disorder","Problematic Pornography Use","Approach Bias Modification"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11220800","cited_by_count":6,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized controlled trial comparing imaginal retraining video vs wait‑list; online assessments at baseline and 6 weeks; high attrition (≈48 %); per‑protocol N≈111.","sample_n":274,"sample_text":"274 participants recruited; 111 analysed per‑protocol.","population":"Adults (mean age 30.6), 86 % male, self‑identified problematic pornography use.","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a randomised trial, an online imaginal retraining video reduced self‑reported problematic porn use in a subgroup of participants who adhered to the program, but the effect did not hold in the full intention‑to‑treat sample.","clinical_takeaway":"Imaginal retraining may help some users reduce problematic porn use, but evidence is limited by low adherence and lack of control for moral or mental‑health factors.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["RCT design","Relatively large initial sample","Focus on low‑threshold self‑help intervention"],"limitations":["High attrition, per‑protocol N low","No measurement of key confounds (moral incongruence, masturbation, mental health)","Reliance on self‑report scales with unclear validation"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00018"}},{"id":105,"doi":"10.1556/2006.2025.00018","pmid":"40126561","pmcid":"PMC12231474","title":"Psychotherapy for problematic pornography use: A comprehensive meta-analysis","authors":"López-Pinar C, Esparza-Reig J, Bőthe B.","first_author":"López-Pinar C","journal":"Journal of behavioral addictions","year":2025,"pub_types":["Meta-Analysis","Systematic Review","review-article","Journal Article"],"keywords":["Acceptance And Commitment Therapy","Cognitive Behavioral Therapy","psychotherapy","Problematic Pornography Use","Compulsive Sexual Behaviour Disorder"],"is_oa":true,"oa_url":"https://doi.org/10.1556/2006.2025.00018","cited_by_count":6,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 20 psychotherapy trials (total N=2,021) including CBT, ACT and single‑case designs; random‑effects model with subgroup and meta‑regression; risk‑of‑bias assessment.","sample_n":2021,"sample_text":"20 studies with 2,021 participants","population":"Individuals with self‑reported problematic pornography use (PPU); no specific demographic limits reported in abstract.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"supports","citation_value":"useful","plain_summary":"A meta‑analysis of 20 psychotherapy trials (2,021 participants) found that cognitive‑behavioral and acceptance‑and‑commitment therapies reduced problematic pornography use, sexual compulsivity and usage frequency, with large effect sizes, though study quality varied.","clinical_takeaway":"CBT and ACT can meaningfully reduce problematic porn use, but clinicians should consider the methodological limits of the underlying trials.","confidence":0.8,"topic_tags":["sexual_function","treatment","csbd"],"strengths":["Comprehensive systematic search","Random‑effects meta‑analysis with subgroup and meta‑regression","Risk‑of‑bias assessment of included trials","Large total sample size across studies"],"limitations":["Primary studies often high risk of bias","Unclear whether moral incongruence or masturbation were controlled","Potential reliance on self‑labelled PPU scales","Limited reporting of pre‑registration"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00018"}},{"id":106,"doi":"10.1556/2006.2025.00023","pmid":"40116860","pmcid":"PMC11974433","title":"Gambling disorder and problematic pornography use: Does co-occurrence influence treatment outcome?","authors":"Mestre-Bach G, Potenza MN, Granero R, Håkansson A, Gómez-Peña M, Perales I, Vicó À, Uríszar JC, Fernández-Aranda F, Sánchez I, Jiménez-Murcia S.","first_author":"Mestre-Bach G","journal":"Journal of behavioral addictions","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Recovery","Treatment outcome","Relapse","Dropout","Gambling Disorder","Addictive Behaviors","Compulsive Behaviors","Impulsive Behaviors","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11974433","cited_by_count":3,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"observational cohort within CBT treatment program comparing GD patients with and without co‑occurring problematic pornography use (PPU); outcomes measured over treatment course","sample_n":172,"sample_text":"clinical treatment‑seeking sample, predominantly male","population":"172 adults receiving CBT for gambling disorder (26 with co‑occurring PPU)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among people in therapy for gambling disorder, those who also reported problematic pornography use were more severe and more likely to drop out of treatment, suggesting that clinicians should screen for and address co‑occurring porn use.","clinical_takeaway":"Screen GD patients for problematic porn use; consider additional adherence strategies for those with co‑occurring PPU.","confidence":0.78,"topic_tags":["treatment","gender","csbd","prevalence"],"strengths":["Large overall clinical sample for GD treatment","Focus on co‑occurring behavior rarely examined","Multiple relevant outcome measures (dropout, relapse, session attendance)"],"limitations":["PPU measurement not described; likely unvalidated","Small PPU subgroup (n=26) limits power","Key confounds (moral incongruence, masturbation, mental health) not addressed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00023"}},{"id":107,"doi":"10.1080/0092623x.2025.2536094","pmid":"40755429","pmcid":null,"title":"The Moderating Role of Regular Exercise on the Relationship Between Basic Psychological Need Frustration and Problematic Pornography Use: Two Pathways Corroborated by Two Complementary Methods","authors":"Zhang Y, Jiang X, Jin Y, Bőthe B, Huang Z, Chen L.","first_author":"Zhang Y","journal":"Journal of sex & marital therapy","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 600 Chinese adults recruited online","sample_n":600,"sample_text":"Convenience online recruitment (not explicitly stated as probability sample).","population":"adult pornography users, mixed gender, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In 600 Chinese adults, need frustration was linked to using porn as a coping strategy, which in turn related to more problematic porn use. Regular exercise weakened the first link but strengthened the second, suggesting exercise may change how need frustration leads to porn problems, though the study is cross‑sectional and cannot prove cause‑effect.","clinical_takeaway":"Exercise may buffer some pathways to problematic porn use, but clinicians should consider other factors (e.g., moral conflict, mental health) that this study did not assess.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (N=600)","Use of mediation and moderation analyses","Acknowledges cross‑sectional limitation"],"limitations":["Cross‑sectional design prevents causal inference","No measurement/control of key confounds (moral incongruence, masturbation, mental health)","Potential circularity in problematic use scale"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2025.2536094"}},{"id":108,"doi":"10.1016/j.jpsychires.2024.07.033","pmid":"39137720","pmcid":null,"title":"Statistical predictors of the co-occurrence between gambling disorder and problematic pornography use","authors":"Mestre-Bach G, Potenza MN, Granero R, Uríszar JC, Fernández-Aranda F, Jiménez-Murcia S.","first_author":"Mestre-Bach G","journal":"Journal of psychiatric research","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Personality","Psychopathology","Emotion Regulation","Gambling Disorder","Addictive Behaviors","Compulsive Behaviors","Impulsive Behaviors","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of treatment‑seeking adults with gambling disorder; structural equation modelling of predictors of co‑occurring problematic pornography use (PPU)","sample_n":359,"sample_text":"treatment‑seeking GD patients","population":"adults seeking treatment for gambling disorder (N=359)","country":"Spain (presumed from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"Among people in treatment for gambling disorder, higher impulsivity predicts whether they also report problematic pornography use. Younger age, difficult personality traits, and poor emotion regulation increase impulsivity, which in turn relates to the co‑occurrence of the two problems.","clinical_takeaway":"Assess impulsivity when treating gambling disorder patients who also struggle with pornography use.","confidence":0.8,"topic_tags":["pornography","gender","sexual_function","adolescents","neuroscience","csbd"],"strengths":["large clinical sample (N=359)","use of validated PPCS‑6 scale","comprehensive assessment of impulsivity, personality, emotion regulation"],"limitations":["cross‑sectional; cannot infer causality","treatment‑seeking GD sample limits generalisability to broader population","no measurement/control of moral incongruence, masturbation, or trauma"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":8,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpsychires.2024.07.033"}},{"id":109,"doi":"10.7759/cureus.40539","pmid":"37342297","pmcid":"PMC10277752","title":"How the Rise of Problematic Pornography Consumption and the COVID-19 Pandemic Has Led to a Decrease in Physical Sexual Interactions and Relationships and an Increase in Addictive Behaviors and Cluster B Personality Traits: A Meta-Analysis","authors":"Irizarry R, Gallaher H, Samuel S, Soares J, Villela J.","first_author":"Irizarry R","journal":"Cureus","year":2023,"pub_types":["review-article","Review","Journal Article"],"keywords":["Addictive Disorders","Pornography Consumption","Cluster B Personality Traits","Covid-19","Problematic Pornography Consumption"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10277752","cited_by_count":2,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta‑analysis of published prevalence studies; no clear protocol, risk‑of‑bias assessment, or systematic search strategy reported.","sample_n":null,"sample_text":"Not reported in abstract","population":"unspecified, likely mixed adult samples from prior studies","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":["selective_reporting","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A 2023 meta‑analysis reports that pornography viewing rose during the COVID‑19 pandemic and that many people labeled as having problematic use also show other addictions, though the evidence base and definitions are unclear.","clinical_takeaway":"No clear clinical guidance; the paper’s methodological limits mean its prevalence claims should be interpreted cautiously.","confidence":0.7,"topic_tags":["pornography","csbd","relationships","sexual_function"],"strengths":["Attempts quantitative synthesis","Addresses timely COVID‑19 context"],"limitations":["No clear systematic review methods","Undefined constructs and measurement tools","No control for major confounds (moral incongruence, masturbation, mental health)","Lacks effect‑size reporting and heterogeneity analysis"],"rubric_version":"2.0","raw_total":19,"max_possible":60,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":4,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.40539"}},{"id":110,"doi":"10.1016/j.addbeh.2025.108398","pmid":"40483829","pmcid":null,"title":"Problematic pornography use and psychological distress: A longitudinal study in a large US sample","authors":"Engelhardt R, Geppert R, Grubbs JB, von Oertzen T, Trommer D, Maes J, Kraus SW.","first_author":"Engelhardt R","journal":"Addictive behaviors","year":2025,"pub_types":["Journal Article"],"keywords":["Depression","Anxiety","Compulsive Behavior","Longitudinal","Addictive Behavior","Pornography","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"three-wave longitudinal panel (N=4363, US adults, 1‑year)","sample_n":4363,"sample_text":"large community sample","population":"US adults, mean age 50, 46.4% women","country":"USA","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 1‑year study of over 4,000 U.S. adults, higher scores on a brief pornography‑use questionnaire were consistently linked to greater anxiety and depression. The association was largely stable between individuals, with only tiny short‑term effects.","clinical_takeaway":"Higher problematic pornography scores tend to co‑occur with distress, but short‑term changes are minimal; assess broader factors before attributing causality.","confidence":0.84,"topic_tags":["pornography","sexual_function","prevalence","relationships"],"strengths":["Large, nationally‑relevant sample","Longitudinal design with cross‑lagged modeling","Validated distress scales (GAD‑2, PHQ‑9)"],"limitations":["Problematic use measured with brief screen that may conflate frequency and distress","No assessment of moral incongruence, masturbation, or other important confounds","Interpretation of within‑person effects remains speculative"],"rubric_version":"2.0","raw_total":39,"max_possible":60,"pct_score":65,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2025.108398"}},{"id":111,"doi":"10.1080/10410236.2024.2304495","pmid":"38225910","pmcid":null,"title":"Is Adolescents' Cyber Dating Violence Perpetration Related to Problematic Pornography Use? The Moderating Role of Hostile Sexism","authors":"Morelli M, Nappa MR, Chirumbolo A, Wright PJ, Pabian S, Baiocco R, Costabile A, Longobardi E, Cattelino E.","first_author":"Morelli M","journal":"Health communication","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 421 Italian adolescents","sample_n":421,"sample_text":"421 Italian adolescents","population":"Italian adolescents (mean age 16.5, 63.7% female)","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A study of 421 Italian teens found that higher scores on a problematic pornography use questionnaire were linked to more cyber dating violence, especially among those holding strong hostile sexist attitudes.","clinical_takeaway":"Clinicians should note that hostility and sexist attitudes may amplify the link between adolescents' problematic porn use and aggressive online relationship behaviors.","confidence":0.85,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Large sample for adolescent survey","Validated inventories for pornography use and sexism","Examines novel moderator (hostile sexism)"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of moral incongruence or masturbation","Potential unmeasured mental‑health confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2024.2304495"}},{"id":112,"doi":"10.21203/rs.3.rs-8049328/v1","pmid":null,"pmcid":null,"title":"Between Pleasure and Compulsion: Linking Mechanisms Between Pornography Consumption and Obsessive-Compulsive Disorder","authors":"Vieira FFP.","first_author":"Vieira FFP.","journal":"Research Square","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of empirical studies (2013‑2024) linking problematic pornography use and OCD; no mention of meta‑analysis, risk‑of‑bias assessment, or pre‑registration.","sample_n":null,"sample_text":"Not applicable (review)","population":"Not applicable (review of published studies)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A pre‑print systematic review suggests that troublesome porn use and OCD share similar brain and cognitive patterns, such as poor impulse control and heightened cue reactivity, and recommends combined CBT and medication approaches.","clinical_takeaway":"Clinicians might consider assessing compulsivity and cue reactivity when treating problematic porn use, but evidence remains largely narrative.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Broad literature coverage (2013‑2024)","Integrates cognitive, behavioral, and neurobiological perspectives","Proposes a clinical framework"],"limitations":["No explicit risk‑of‑bias assessment","Unclear systematic review methods (search strategy, inclusion criteria)","No quantitative synthesis or effect‑size reporting"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-8049328/v1"}},{"id":113,"doi":"10.1080/0092623x.2023.2287217","pmid":"38018139","pmcid":null,"title":"Understanding Perceived Problematic Pornography Use with the Differential Susceptibility to Media Effects Model","authors":"Yu K, Wu AMS, Feng C, Zhao W, Zuo G.","first_author":"Yu K","journal":"Journal of sex & marital therapy","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional anonymous survey of 1,483 Chinese emerging adults","sample_n":1483,"sample_text":"1,483 Chinese emerging adults","population":"Chinese emerging adults (likely university students)","country":"China","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,500 Chinese young adults, lower family flexibility and self‑acceptance were linked to higher self‑reported problematic porn use, while trouble controlling impulses made these links weaker. The study suggests family and personal factors shape how people view their porn use.","clinical_takeaway":"Screen for family dynamics, self‑acceptance, and impulse control when addressing clients' concerns about porn use.","confidence":0.7,"topic_tags":["pornography","sexual_function","masturbation","neuroscience"],"strengths":["Large sample size","Integration of a theoretical model (DSMM)","Use of mediation and moderation analyses"],"limitations":["Cross‑sectional design limits causal inference","Problematic use measured by a single self‑label without validated scale","No control for moral incongruence or other key confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2023.2287217"}},{"id":114,"doi":"10.1037/abn0000913","pmid":"38884980","pmcid":null,"title":"Uncovering the most robust predictors of problematic pornography use: A large-scale machine learning study across 16 countries","authors":"Bőthe B, Vaillancourt-Morel MP, Bergeron S, Hermann Z, Ivaskevics K, Kraus SW, Grubbs JB, Problematic Pornography Use Machine Learning Study Consortium.","first_author":"Bőthe B","journal":"Journal of psychopathology and clinical science","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["csbd","pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Meta‑analysis of 74 pre‑existing self‑report datasets from 16 countries (N≈112 k) using random‑forest machine‑learning to predict PPU scores.","sample_n":112397,"sample_text":"Combined N = 112,397 participants from 74 datasets","population":"Adults from community and treatment‑seeking samples across 16 countries","country":"International (16 countries)","controls_mi":"yes","preregistered":true,"quality_score":7,"certainty":"low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Using data from over 112,000 people in 16 countries, the study identified the strongest risk factors for problematic pornography use, including how often people view porn, using it to avoid emotions or reduce stress, feeling moral conflict about porn, and sexual shame.","clinical_takeaway":"Screen for moral conflict, stress‑relief motives and sexual shame when assessing risky pornography use.","confidence":0.9,"topic_tags":["pornography","masturbation","sexual_function","moral_incongruence","csbd"],"strengths":["Very large, multinational sample","Pre‑registered protocol","Advanced machine‑learning and meta‑analytic approach","Inclusion of moral incongruence as a predictor"],"limitations":["Cross‑sectional self‑report data only","Potential lack of control for mental‑health and partner factors","Reliance on self‑labelled PPU scale without detailed addiction‑criteria testing"],"rubric_version":"2.0","raw_total":39,"max_possible":60,"pct_score":65,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":5,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":16,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/abn0000913"}},{"id":115,"doi":"10.1080/13691058.2023.2213750","pmid":"37212017","pmcid":null,"title":"The paradox of pornography - sexuality and problematic pornography use","authors":"Thomas H, Binnie J.","first_author":"Thomas H","journal":"Culture, health & sexuality","year":2024,"pub_types":["Journal Article"],"keywords":["Sexuality","Qualitative","Sexual Minority Men","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Interpretive phenomenological analysis of three semi‑structured online interviews with sexual‑minority men who self‑report problematic pornography use.","sample_n":3,"sample_text":"Three participants","population":"Sexual minority men (N=3) recruited for self‑perceived problematic pornography use","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study interviewed three sexual‑minority men who said they had problems with pornography. Through thematic analysis it found that their sense of sexuality—whether they saw porn as liberating or corrupting—shaped how they experienced and judged their own porn use.","clinical_takeaway":"Clinicians should consider clients' broader sexual identity and internal conflicts when discussing self‑perceived problematic pornography use.","confidence":0.85,"topic_tags":["pornography","sexual_function"],"strengths":["Rich, idiographic qualitative data","Focus on sexual minority men's lived experience","In‑depth phenomenological analysis"],"limitations":["Very small, non‑representative sample (N=3)","No standardized measures of pornography use or distress","No assessment of key confounds (moral incongruence, masturbation, mental health, etc.)","Findings not generalisable"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2023.2213750"}},{"id":116,"doi":"10.1192/bjp.2026.10691","pmid":"42464926","pmcid":null,"title":"Symptom-level associations between attention-deficit hyperactivity disorder (ADHD) and compulsive sexual behaviour: undirected and Bayesian network analysis across multiple sociodemographic characteristics","authors":"Jannini TB, Ciocca G, Giannini T, Nagy L, Koós M, Kraus SW, Potenza MN, Demetrovics Z, International Sex Survey Consortium, Bőthe B.","first_author":"Jannini TB","journal":"The British journal of psychiatry : the journal of mental science","year":2026,"pub_types":["Journal Article"],"keywords":["ADHD","Network Analysis","Gaussian Graphical Model","Directed Acyclic Graph","Compulsive Sexual Behaviour"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional network analysis of 82,243 participants from the International Sex Survey","sample_n":82243,"sample_text":"participants from the International Sex Survey (2021‑2022)","population":"online self‑selected adults (average age 33, 60% men)","country":"multiple (global online sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a huge online survey, symptoms of inattention and hyperactivity‑impulsivity in ADHD were linked to higher reports of compulsive sexual behaviour and problematic porn use, with these links varying a bit by gender and age.","clinical_takeaway":"ADHD symptoms may co‑occur with problematic sexual behaviours; consider assessing sexual health when treating ADHD.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Very large sample size","Validated questionnaires for ADHD and CSBD","Symptom‑level network approach"],"limitations":["Cross‑sectional; no causal inference","No assessment of moral incongruence or masturbation","Self‑selected online sample limits generalisability"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/bjp.2026.10691"}},{"id":117,"doi":"10.1007/s10508-023-02638-y","pmid":"37407890","pmcid":null,"title":"Confirming and Expanding the Moral Incongruence Model of Compulsive Sexual Behavior","authors":"Gleason N, Jennings T, Rahm-Knigge RL, Nielsen KH, Danielson S, Miner MH, Coleman E.","first_author":"Gleason N","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Compulsive Sexual Behavior","Pornography","Moral Incongruence","Erotophilia","Erotophobia"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd","masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey of 804 U.S. adults, cross‑sectional, convenience sample","sample_n":804,"sample_text":"804 American participants recruited via online survey","population":"American adults (n=804)","country":"USA","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 804 U.S. adults, the authors found that people who feel morally conflicted about sex report higher distress from pornography, sexual fantasies, and having many partners, but not from masturbation. Positive feelings toward sexual cues had a small link to distress.","clinical_takeaway":"Moral conflict, not just sexual behavior frequency, relates to reported compulsive‑sex problems; assess moral values when evaluating distress.","confidence":0.7,"topic_tags":["pornography","masturbation","moral_incongruence","sexual_function","csbd"],"strengths":["Large sample (N=804)","Direct assessment of moral incongruence","Examines multiple CSB manifestations"],"limitations":["Cross‑sectional, cannot infer causality","Potential reliance on unvalidated self‑report scales","Limited control of mental‑health and trauma confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02638-y"}},{"id":118,"doi":"10.1080/19317611.2026.2646620","pmid":"42683030","pmcid":"PMC13531988","title":"From Pornography to Somatic Symptoms. A Moderated Mediation Model Involving Moral Disapproval of Pornography and Difficulties in Emotion Regulation","authors":"Huțul TD, Karner-Huțuleac A, Petroiu AȘ, Chiricheș FB, Huțul A, Drăgan M, Ciobanu AM.","first_author":"Huțul TD","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Somatic Symptoms","Moderated Mediation","Difficulties In Emotion Regulation","Problematic Pornography Consumption","Moral Disapproval Of Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13531988","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 321 adults using self‑report questionnaires","sample_n":321,"sample_text":"321 individuals, aged 18‑64, recruited (method not specified)","population":"adults 18‑64, likely convenience sample (not described)","country":"not specified","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 321 adults, higher self‑reported problematic porn use was linked to more somatic complaints. This link was explained by difficulties regulating emotions, but only for people who strongly disapproved of porn morally.","clinical_takeaway":"Clinicians should consider moral conflict and emotion‑regulation issues when addressing somatic symptoms in clients reporting problematic porn use.","confidence":0.7,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Large sample for self‑report survey","Inclusion of moral disapproval as moderator","Statistical mediation analysis"],"limitations":["Cross‑sectional design limits causal inference","Masturbation not measured separately","Potential circularity of PPC scale not clarified"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2026.2646620"}},{"id":119,"doi":"10.1080/00224499.2023.2201255","pmid":"37074351","pmcid":null,"title":"Pornography Use and Mental Health Problems in the Chinese Population: Examining the Pornography Problems Due to Moral Incongruence Model","authors":"Su Y, Zheng L, Zheng Y.","first_author":"Su Y","journal":"Journal of sex research","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 833 Chinese adults examining pornography frequency, moral incongruence, problematic use, and mental‑health outcomes via mediation/moderation analysis.","sample_n":833,"sample_text":"N = 833 Chinese participants.","population":"Adults (various ages) from China; recruitment method not specified (likely convenience).","country":"China","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In 833 Chinese adults, the study found that moral conflict about porn use makes the link between how often people view porn and their self‑reported problematic use stronger, and that problematic use partly explains the association with mental‑health symptoms.","clinical_takeaway":"Clinicians should consider patients' moral attitudes when assessing distress linked to pornography use.","confidence":0.85,"topic_tags":["pornography","moral_incongruence","sexual_function"],"strengths":["Large sample (N>800)","Tests explicit theoretical model (PPMI)","Reports mediated and moderated effects with effect sizes"],"limitations":["Cross‑sectional; cannot infer causality","Masturbation not measured separately from pornography use","Potential unmeasured confounds (depression, relationship status, trauma)","No pre‑registration or power justification reported"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2201255"}},{"id":120,"doi":"10.1080/19317611.2024.2329973","pmid":"38616793","pmcid":"PMC11008547","title":"Examination of Gender Differences in Depression, Relationship Satisfaction, and Problematic Pornography Use Among Romanian Gay Men and Lesbian Women","authors":"Huțul TD, Karner-Huțuleac A, Huțul A, Popescu A.","first_author":"Huțul TD","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Romania","Gay Men","Relationship Satisfaction","Lesbian Women","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 172 gay men and lesbian women in relationships, using self‑report questionnaires","sample_n":172,"sample_text":"172 participants (61.6% gay, 38.4% lesbian)","population":"Romanian gay men and lesbian women, ages 18‑62, currently in relationships","country":"Romania","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 172 gay men and lesbian women in Romania found that higher depression and being female were linked to more self‑reported problematic porn use, and that relationship satisfaction, depression, and gender together explained 18% of the variance.","clinical_takeaway":"Depression and relationship factors should be considered when addressing concerns about porn use in gay and lesbian clients.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Relatively large sample for a niche population","Includes both men and women for gender comparison","Considers relationship satisfaction alongside pornography use"],"limitations":["Cross‑sectional; cannot infer causality","Problematic pornography use measured with unspecified/possibly unvalidated scale","Moral incongruence and masturbation not assessed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2024.2329973"}},{"id":121,"doi":"10.1080/19317611.2024.2349592","pmid":"39148923","pmcid":"PMC11323863","title":"The Roles of Frequency of Pornography Use, and Moral Incongruence in the Relationship Between Sexual Satisfaction, and Psychological Distress Related to the Use of Pornography: A Moderated Mediation Model","authors":"Huțul TD, Karner-Huțuleac A.","first_author":"Huțul TD","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Romania","Psychological Distress","Sexual Satisfaction","Pornography","Moral Incongruence"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 943 Romanian adults in romantic relationships, using self‑report questionnaires and moderated mediation analysis","sample_n":943,"sample_text":"large convenience sample, recruited in Romania; not a probability or longitudinal cohort","population":"general community sample (online/clinic not specified), 70% women, ages 18‑65","country":"Romania","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Romanian survey of 943 adults, higher porn use was linked to lower sexual satisfaction, and this link was stronger for people who felt a moral clash with their porn use. Moral incongruence helped explain why porn use can be associated with psychological distress.","clinical_takeaway":"Clinicians should assess moral conflict about pornography when clients report distress, as it may shape the impact of porn use on wellbeing.","confidence":0.7,"topic_tags":["pornography","moral_incongruence","sexual_function"],"strengths":["large sample size","focus on moral incongruence, a key moderator","uses moderated mediation to test indirect pathways"],"limitations":["cross‑sectional design limits causal inference","lack of validated multi‑item scales reported","no control for masturbation or mental‑health covariates"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2024.2349592"}},{"id":122,"doi":"10.1556/2006.2024.00064","pmid":"39625480","pmcid":"PMC11737421","title":"Deficits in spontaneous versus instructed emotion regulation in problematic pornography use","authors":"Wang Y, Tang S, Li L, Jiang X, Wang X, Wang J.","first_author":"Wang Y","journal":"Journal of behavioral addictions","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Reappraisal","Emotion Regulation","Late Positive Potential","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11737421","cited_by_count":6,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control experiment with EEG ERP, n≈35 per group, male university students","sample_n":68,"sample_text":"35 at‑risk, 33 controls, convenience university sample","population":"young adult males, at‑risk for problematic pornography use vs controls","country":"unspecified (likely China based on author names)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Young men who may have problematic porn use use fewer natural reappraisal strategies, but can still lower negative feelings when taught to reappraise, as shown by brain signals and self‑reports.","clinical_takeaway":"Teaching reappraisal skills may help people at risk for problematic porn use, but evidence is limited.","confidence":0.78,"topic_tags":["pornography","sexual_function","csbd","neuroscience"],"strengths":["Use of validated ER questionnaire","Inclusion of objective EEG measure","Comparison of spontaneous vs instructed ER"],"limitations":["Small, non‑representative sample","No control for moral/religious factors","PPU classification not fully described"],"rubric_version":"2.0","raw_total":31,"max_possible":70,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":5,"statistics":5,"confounds":2,"design":3,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00064"}},{"id":123,"doi":"10.2196/39869","pmid":"36227634","pmcid":"PMC9614626","title":"mHealth Technologies for Managing Problematic Pornography Use: Content Analysis","authors":"Henry N, Donkin L, Williams M, Pedersen M.","first_author":"Henry N","journal":"JMIR formative research","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Mobile phone","Addiction","Internet Addiction","Mhealth","Mobile Health","Behavioral Addiction","Ppu","Pornography","Mobile Intervention","Compulsive Sexual Behavior Disorder","Problematic Pornography Use","Just-in-time Adaptive Intervention","Csbd","Smartphone-based Therapy"],"is_oa":true,"oa_url":"https://formative.jmir.org/2022/10/e39869/PDF","cited_by_count":3,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"content analysis of 170 mobile apps described as treating pornography addiction; systematic search of app store listings; coding of features","sample_n":170,"sample_text":"170 apps from Android and iOS stores that described themselves as helping reduce pornography use","population":"apps (n=170) meeting inclusion criteria; no human participants","country":"N/A (global app stores)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined 170 mobile apps that claim to help people reduce porn use. They catalogued each app’s features (e.g., blockers, trackers, coaching) and reported how popular they are, but found no evidence that any are proven effective or safe.","clinical_takeaway":"None – the review does not provide evidence for clinicians to recommend specific apps.","confidence":0.8,"topic_tags":["pornography","moral_incongruence","masturbation","sexual_function"],"strengths":["Systematic search of two major app stores","Large sample of apps (n=170)","Clear coding scheme with 16 feature categories"],"limitations":["No empirical data on app effectiveness or user outcomes","Reliance on app store descriptions; possible mis‑classification","No assessment of user demographics or psychosocial confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/39869"}},{"id":124,"doi":"10.1016/j.heliyon.2024.e32981","pmid":"39044971","pmcid":"PMC11263655","title":"Exploring the Interplay of problematic pornography use, sexism, and rape myth acceptance: An Italian cross-sectional study","authors":"Barchielli B, Cricenti C, Lausi G, Quaglieri A, Mari E, Rocca G, Antinori A, Giannini AM, Ferracuti S.","first_author":"Barchielli B","journal":"Heliyon","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexism","Pornography","Rape Myth Acceptance","Sexuality Issues"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11263655","cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire, N=815, convenience sample, cross‑sectional","sample_n":815,"sample_text":"815 participants, recruited via an online questionnaire (convenience sample)","population":"Italian adults (both genders) recruited online","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 815 Italian adults, higher levels of problematic pornography use were linked to stronger sexist attitudes and, for men, to higher rape‑myth acceptance. Women showed similar patterns, though the link to rape myths varied. The authors suggest these ties should be considered in violence‑prevention efforts.","clinical_takeaway":"Be aware that high pornography use may co‑occur with sexist beliefs; assess attitudes when addressing gender‑based violence prevention.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["large sample (N>800)","focus on understudied Italian context","examines multiple dimensions of PPU"],"limitations":["cross‑sectional, cannot infer causality","no measurement of key confounds (moral incongruence, mental health, etc.)","unclear validation of scales used"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.heliyon.2024.e32981"}},{"id":125,"doi":"10.1556/2006.2025.00008","pmid":"39964457","pmcid":"PMC11974439","title":"Differences in cross-sectional and daily diary problematic pornography use correlates","authors":"Borgogna NC, Vaughn J, Owen T, Brasil KM, Kraus SW, Levant RF, McDermott RC.","first_author":"Borgogna NC","journal":"Journal of behavioral addictions","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Longitudinal","Daily Diary","Ecological Momentary Assessment","Compulsive Sexual Behavior Disorder","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11974439","cited_by_count":6,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Community sample (n=113) completed baseline survey and 14‑day ecological momentary assessment (1,240 observations). Multilevel modeling examined daily and baseline correlates of problematic pornography use.","sample_n":113,"sample_text":"Mean age 38 ± 11 years; 32 % screened at‑risk for PPU","population":"Adult men, United States, recruited via Prolific online panel","country":"United States","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 113 U.S. men, daily diaries over two weeks showed that the amount of pornography viewed was tightly linked to feelings of losing control, while baseline depression and alcohol problems did not predict daily control issues.","clinical_takeaway":"Daily pornography use amount, not baseline mood or alcohol issues, best predicts short‑term control problems.","confidence":0.78,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence","measurement"],"strengths":["Use of EMA provides within‑person daily data","Multilevel modeling accounts for nested observations","Inclusion of baseline and daily measures allows comparison"],"limitations":["Moral incongruence and masturbation not assessed","Convenience online panel limits generalisability","Unclear whether PPU scale is fully validated"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00008"}},{"id":126,"doi":"10.1016/j.jsxm.2021.11.001","pmid":"34872843","pmcid":null,"title":"Examining the Problematic Pornography Use Model: A Quantitative Exploration of Dysregulated Pornography Use","authors":"Hatch HD, Hatch SG, Henderson E, Deichman C, Johnson D, Esplin C, Halstead A, Braithwaite S.","first_author":"Hatch HD","journal":"The journal of sexual medicine","year":2022,"pub_types":["Journal Article"],"keywords":["suppression effect","Mediation Models","Pornography Addiction","I-pace Model","Pornography Problems Due To Moral Incongruence Model"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal online panel (TurkPrime) with 317 participants over six months, using mediation/suppression models.","sample_n":317,"sample_text":"Adults from an online crowdsourcing platform (TurkPrime) surveyed at baseline and six‑month follow‑up.","population":"Adults recruited via TurkPrime (online convenience sample).","country":"USA (presumed based on TurkPrime platform)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a six‑month online study of 317 adults, pornography use only predicted distress for people high in sexual compulsivity or sensation seeking. The study did not find that pornography directly caused distress, and it could not evaluate moral‑incongruence effects.","clinical_takeaway":"Target underlying traits such as compulsivity rather than merely reducing pornography use.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large (N>300) longitudinal design","Tests established theoretical models (I‑PACE, moral incongruence)","Uses mediation/suppression analysis to examine mechanisms"],"limitations":["New, unvalidated pornography consumption measure","Moral incongruence not assessed despite its relevance","Convenience online sample limits generalisability"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.11.001"}},{"id":127,"doi":"10.31234/osf.io/rq3nk_v1","pmid":null,"pmcid":null,"title":"Predicting Pornography Use for Emotional Avoidance Reasons: The Role of Experiential Avoidance and Craving in a Community Sample","authors":"Nguyen ML.","first_author":"Nguyen ML.","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/rq3nk_v1","cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey","sample_n":84,"sample_text":"Community sample of 84 male Amazon Mechanical Turk participants","population":"male MTurk users, English‑speaking, United States","country":"United States","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 84 U.S. men, higher craving and a tendency to avoid unpleasant emotions were linked to viewing pornography to escape feelings, suggesting these factors may help explain problematic use.","clinical_takeaway":"Clinicians might explore craving and emotional avoidance when addressing concerns about pornography use.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses emotional avoidance motives","Considers craving and experiential avoidance","Uses a community sample rather than student only"],"limitations":["Cross‑sectional; no causal inference","No measurement of key confounds (moral incongruence, masturbation, mental health)","Unclear validation of scales","Small, non‑representative MTurk sample"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/rq3nk_v1"}},{"id":128,"doi":"10.3390/ijerph21091228","pmid":"39338111","pmcid":"PMC11432260","title":"Problematic Pornography Use, Mental Health, and Suicidality among Young Adults","authors":"Altin M, De Leo D, Tribbia N, Ronconi L, Cipolletta S.","first_author":"Altin M","journal":"International journal of environmental research and public health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Gender","Mental health","Suicide","Loneliness","Young Adults","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11432260","cited_by_count":15,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online anonymous survey of 332 university students, cross‑sectional","sample_n":332,"sample_text":"332 students, 60% female, recruited via university email/online platform","population":"young adult university students (mean age 23) in Italy","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 332 Italian university students, higher self‑reported problematic porn use was linked to more anxiety, depression, loneliness, and thoughts of suicide, especially among women, suggesting a possible mental‑health risk.","clinical_takeaway":"Screen for distress when clients report frequent porn use, but note that causality is not established.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a survey (N>300)","Inclusion of multiple mental‑health variables","Gender‑specific analyses"],"limitations":["Cross‑sectional, cannot infer causality","PPU measurement not clearly validated","No assessment of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph21091228"}},{"id":129,"doi":"10.7759/cureus.98947","pmid":"41523410","pmcid":"PMC12789957","title":"From Screens to Sheets: Understanding Social Media Addiction, Online Sexual Activity, Pornography Consumption, and Sexual Satisfaction Among Greek Adults","authors":"Braouzou I, Gkouletsa K.","first_author":"Braouzou I","journal":"Cureus","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Satisfaction","Pornography","Online Sexual Activity","Social Media Addiction","Greek Adults"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12789957","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional correlational survey of 676 Greek adults recruited online","sample_n":676,"sample_text":"online convenience sample recruited via social media platforms","population":"Greek adults (online convenience sample)","country":"Greece","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 676 Greek adults found that higher scores on social‑media addiction, online sexual activity, and problematic pornography use were each linked to lower sexual satisfaction. The associations held across ages, genders and sexual orientations.","clinical_takeaway":"Higher engagement in digital sexual activities may be associated with reduced sexual satisfaction; clinicians should assess digital behaviours when addressing sexual wellbeing.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size (n=676)","Use of validated scales for social media addiction and pornography consumption","Statistical reporting includes beta coefficients and R²"],"limitations":["Cross‑sectional design prevents causal inference","No measurement of moral incongruence, masturbation, mental‑health or relationship variables","Potential self‑selection bias from online recruitment"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.98947"}},{"id":130,"doi":"10.7759/cureus.36102","pmid":"37065323","pmcid":"PMC10097604","title":"A Case Study of Depression in High Achieving Students Associated With Moral Incongruence, Spiritual Distress, and Feelings of Guilt","authors":"Najeeb B, Malik MFA, Nizami AT, Yasir S.","first_author":"Najeeb B","journal":"Cureus","year":2023,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Depression","Guilt","Mutism","Major Depressive Disorder","Spiritual Distress","Moral Incongruence"],"is_oa":true,"oa_url":"https://assets.cureus.com/uploads/case_report/pdf/141997/20230314-14666-1c2wcvk.pdf","cited_by_count":2,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":2,"sample_text":"Two cases","population":"young, high‑achieving male students (n=2)","country":"unspecified (likely developing country context)","controls_mi":"yes","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["masturbation_not_isolated","causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Two high‑performing male students with depression reported guilt and spiritual distress linked to internet pornography use and feeling morally conflicted about it. Their depression severity and shame were measured, suggesting moral conflict may aggravate depressive episodes.","clinical_takeaway":"Consider assessing moral distress and guilt about pornography use when treating depressed young adults; address these psychosocial factors alongside standard depression care.","confidence":0.78,"topic_tags":["pornography","moral_incongruence","sexual_function"],"strengths":["Use of validated depression and guilt/shame scales","Detailed clinical description of cases","Highlights understudied psychosocial factor (moral incongruence)"],"limitations":["Case series (n=2) – no generalisability","No measurement of masturbation or partner context","Addiction inferred from self‑label, no criteria tested","No statistical analysis beyond descriptive scores"],"rubric_version":"2.0","raw_total":16,"max_possible":60,"pct_score":27,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":1,"confounds":4,"design":1,"addiction_criteria":1,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.36102"}},{"id":131,"doi":"10.1111/add.16431","pmid":"38413365","pmcid":null,"title":"Problematic pornography use across countries, genders, and sexual orientations: Insights from the International Sex Survey and comparison of different assessment tools","authors":"Bőthe B, Nagy L, Koós M, Demetrovics Z, Potenza MN, International Sex Survey Consortium, Kraus SW.","first_author":"Bőthe B","journal":"Addiction (Abingdon, England)","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Compulsive Behavior","Compulsive Sexual Behavior","Impulsive Behavior","Addictive Behavior","Problematic Pornography Use","International Sex Survey (Iss)"],"is_oa":false,"oa_url":null,"cited_by_count":70,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large international online survey (N=82,243) across 42 countries; pre‑registered; psychometric validation of three scales","sample_n":82243,"sample_text":"N=82,243; mean age 32.4 y; 42 countries, 26 languages","population":"adult participants (mean age 32.4) from 42 countries, mixed genders and sexual orientations","country":"International (42 countries)","controls_mi":"no","preregistered":true,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study validated three questionnaires for assessing problematic pornography use in 42 countries and estimated that 3–17 % of adults may be at risk, with higher rates in men. Scale scores were linked to treatment‑seeking behavior.","clinical_takeaway":"Validated tools exist for screening problematic pornography use internationally, but clinicians should consider other factors (e.g., mental health, moral distress) before labeling use as disordered.","confidence":0.85,"topic_tags":["pornography","sexual_function","measurement"],"strengths":["Very large multinational sample","Pre‑registered and transparent analysis plan","Comprehensive psychometric validation (CFA, invariance, reliability)","Comparison of three PPU instruments"],"limitations":["Cross‑sectional self‑report survey; no causal inference","Key confounds (moral incongruence, masturbation, mental health) not measured","Potential self‑selection bias from online recruitment","Scales may conflate frequency with distress"],"rubric_version":"2.0","raw_total":37,"max_possible":60,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":51,"citing_publications":127,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/add.16431"}},{"id":132,"doi":"10.1007/s10508-026-03506-1","pmid":"42082771","pmcid":null,"title":"On Religion, Morals, and Problematic Pornography Use: The Potential Importance of Content Type","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Archives of sexual behavior","year":2026,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03506-1"}},{"id":133,"doi":"10.1038/s41598-023-45459-8","pmid":"37875697","pmcid":"PMC10598215","title":"Clarifying and extending our understanding of problematic pornography use through descriptions of the lived experience","authors":"Ince C, Fontenelle LF, Carter A, Albertella L, Tiego J, Chamberlain SR, Rotaru K.","first_author":"Ince C","journal":"Scientific reports","year":2023,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://www.nature.com/articles/s41598-023-45459-8.pdf","cited_by_count":12,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"online qualitative interview study with 67 self‑identified problematic pornography users","sample_n":67,"sample_text":"convenience online recruitment of self‑identified PPU individuals","population":"adults (mean age 24.7, 76% male) self‑identifying as having problematic pornography use","country":"unspecified (likely international via internet)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a qualitative study of 67 people who say their pornography use is problematic, participants described mental and physical issues, sexual difficulties with partners, and an altered arousal state while viewing porn. They also discussed conflicts, escalating use, and binge‑watching patterns.","clinical_takeaway":"Clients reporting problematic porn use often describe distress and sexual dysfunction, but findings are based on self‑selected, qualitative reports and should be interpreted cautiously.","confidence":0.7,"topic_tags":["pornography","sexual_function","masturbation","moral_incongruence"],"strengths":["Provides rich, first‑person accounts of problematic pornography use","Identifies previously under‑examined dimensions (e.g., tolerance, binges, sexual arousal alteration)","Suggests directions for future quantitative and clinical research"],"limitations":["Self‑selected sample limits generalisability","No validated measures of pornography use or addiction","Critical confounds (moral incongruence, masturbation, mental health, partner context, trauma) not assessed","Qualitative design precludes causal inference"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":30,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-023-45459-8"}},{"id":134,"doi":"10.1037/adb0000876","pmid":"36048067","pmcid":null,"title":"Moral incongruence and addiction: A registered report","authors":"Grubbs JB, Floyd CG, Griffin KR, Jennings TL, Kraus SW.","first_author":"Grubbs JB","journal":"Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large US representative sample (N=2,806) plus sports‑wagering sample (N=1,557), questionnaire‑based, interaction analysis of frequency × moral disapproval","sample_n":4363,"sample_text":"Representative US sample plus sports‑wagering subsample; self‑report questionnaire","population":"adult US residents and sports‑wagerers","country":"United States","controls_mi":"yes","preregistered":true,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In over 4,300 U.S. adults, the study found that people who use pornography or gamble a lot and also disapprove of those activities are more likely to say they feel addicted. This pattern did not appear for most drugs.","clinical_takeaway":"Self‑reported ‘addiction’ feelings may reflect moral conflict rather than a clinical disorder; clinicians should assess moral distress separately.","confidence":0.7,"topic_tags":["moral_incongruence","sexual_function","pornography","gender"],"strengths":["Large, broadly representative sample","Pre‑registered analysis (registered report)","Direct test of moral incongruence across multiple behaviors"],"limitations":["Addiction measured by single self‑label item – circular definition","Cross‑sectional; cannot infer causality","Limited control of other known confounds (masturbation, mental health, relationship factors, trauma)"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":8,"confounds":5,"design":6,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/adb0000876"}},{"id":135,"doi":"10.3390/ijerph20021497","pmid":"36674250","pmcid":"PMC9861829","title":"Males' Lived Experience with Self-Perceived Pornography Addiction: A Qualitative Study of Problematic Porn Use","authors":"Hanseder S, Dantas JAR.","first_author":"Hanseder S","journal":"International journal of environmental research and public health","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Qualitative Research","Compulsive Sexual Behavior","Pornography","Heterosexual Men"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/20/2/1497/pdf?version=1673610078","cited_by_count":6,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"phenomenological qualitative study using semi‑structured interviews with 13 self‑identified male pornography addicts","sample_n":13,"sample_text":"13 males aged 21‑66 years","population":"13 heterosexual men, 21‑66 y, Australia/USA, self‑selected as having a porn addiction","country":"Australia, USA","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","self_selected_sample","underpowered_sample"],"stance":"supports","citation_value":"useful","plain_summary":"Thirteen men who said they were addicted to porn described feeling unable to stop watching, using it to cope with bad moods, and noticing a gradual shift toward more extreme material. They shared personal strategies they tried to cut back and suggested ideas for future help.","clinical_takeaway":"Self‑identified porn‑addiction reports are based on personal distress; clinicians should assess underlying mood, moral, or relationship factors before labeling it an addiction.","confidence":0.6,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence"],"strengths":["In‑depth, first‑person accounts","Rich thematic analysis","Highlights perceived harms and coping strategies"],"limitations":["Small, self‑selected sample","No validated measures of addiction or use frequency","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":14,"max_possible":60,"pct_score":23,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":2,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph20021497"}},{"id":136,"doi":"10.1556/2006.2024.00043","pmid":"39141431","pmcid":"PMC11457035","title":"Blunted sensitivity to expected value during risky decision making in individuals with problematic pornography use","authors":"Wang J, Qu S, Li R, Tang S, Li H.","first_author":"Wang J","journal":"Journal of behavioral addictions","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Event-related potential","Risky Decision-making","Late Positive Potential","Problematic Pornography Use","Reward Valuation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11457035","cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"case‑control ERP study with risky decision‑making task","sample_n":63,"sample_text":"moderate-sized convenience sample","population":"30 individuals with problematic pornography use, 33 healthy controls; young adult volunteers","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a brain‑wave study, people who report problematic porn use showed weaker brain responses to monetary rewards and made riskier choices, suggesting they may be less sensitive to non‑sexual incentives.","clinical_takeaway":"Clients reporting porn‑related problems may also have reduced sensitivity to everyday rewards; interventions could target broader reward processing.","confidence":0.7,"topic_tags":["pornography","relationships","neuroscience","religiosity"],"strengths":["use of objective ERP measure (LPP)","matched control group","focus on non‑sexual reward processing"],"limitations":["Problematic porn use likely defined by a single self‑report screen","Key confounds (moral incongruence, masturbation, mental health) not assessed","Modest sample size per group"],"rubric_version":"2.0","raw_total":35,"max_possible":70,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":6,"statistics":5,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00043"}},{"id":137,"doi":"10.1016/j.bodyim.2023.03.008","pmid":"37011472","pmcid":null,"title":"The association between problematic pornography use and eating disorder symptoms among heterosexual and sexual minority men","authors":"Gewirtz-Meydan A, Spivak-Lavi Z.","first_author":"Gewirtz-Meydan A","journal":"Body image","year":2023,"pub_types":["Journal Article"],"keywords":["Eating Disorders","Anxiety And Depression","Male Body Image","Problematic Pornography Use","Body Comparison","Perceived Realism"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 705 Israeli men, heterosexual and sexual minority, measured problematic pornography use, body comparison, body image, eating‑disorder symptoms, anxiety/depression, perceived realism.","sample_n":705,"sample_text":"705 Israeli men (479 heterosexual, 226 sexual‑minority).","population":"Adult men (mean age 32.5), predominantly Jewish, community sample recruited in Israel.","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"supports","citation_value":"useful","plain_summary":"In a survey of 705 Israeli men, higher scores on a problematic‑pornography use questionnaire were linked to more upward body comparisons, poorer body image, and greater eating‑disorder symptoms. Anxiety and depression made the body‑image‑eating‑disorder link stronger, but how realistic the porn was did not matter.","clinical_takeaway":"When treating men with eating‑disorder symptoms, clinicians should also ask about problematic porn use and related body‑image concerns.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (N > 700)","Inclusion of both heterosexual and sexual‑minority men","Mediation‑moderation model exploring plausible pathways"],"limitations":["Cross‑sectional design cannot establish causality","Problematic pornography use likely measured with a non‑validated or single‑item scale","Key confounds (moral incongruence, masturbation, partner context, trauma) not assessed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.bodyim.2023.03.008"}},{"id":138,"doi":"10.1186/s12912-025-02918-z","pmid":"40223082","pmcid":"PMC11993995","title":"Effects of porn addiction on mental health and personality of nursing students: a cross-sectional study in Egypt","authors":"Karim NAHA, Osman MA, Abdelmonaem YMM, El-Ashry AM.","first_author":"Karim NAHA","journal":"BMC nursing","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Mental health","Nursing Students","Personality Facets","Porn Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11993995","cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 828 nursing students from two Egyptian universities","sample_n":828,"sample_text":"828 nursing students from Zagazig University and Alexandria University","population":"Nursing students (predominantly female, single)","country":"Egypt","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 828 Egyptian nursing students found that about 6% screened positive for \"porn addiction\" and that higher scores on this screen were linked to more anxiety, depression, stress and less favourable personality scores. The study did not examine why these links exist.","clinical_takeaway":"Do not assume porn use causes mental‑health problems; the association may be driven by other factors not measured here.","confidence":0.7,"topic_tags":["pornography","sexual_function","masturbation","moral_incongruence","csbd"],"strengths":["Large sample (n>800)","Validated mental‑health (DASS‑21) and personality (BFI) scales","Provides data from an understudied region"],"limitations":["Cross‑sectional, cannot infer causality","Addiction measure (PAST) likely unvalidated and circular","No assessment of moral/religious attitudes, masturbation, or partner factors"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":3,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12912-025-02918-z"}},{"id":139,"doi":"10.1007/s10508-023-02700-9","pmid":"37845419","pmcid":null,"title":"Spanish Validation of the Long and Short Versions of the Problematic Pornography Consumption Scale (PPCS and PPCS-6) in Adolescents","authors":"Villena-Moya A, Granero R, Chiclana-Actis C, Potenza MN, Blycker GR, Demetrovics Z, Bőthe B, Steward T, Fernández-Aranda F, Jiménez-Murcia S, Mestre-Bach G.","first_author":"Villena-Moya A","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescents","Compulsive Sexual Behavior","Addictive Behaviors","Compulsive Behaviors","Sexually Explicit Material","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional validation of Spanish versions of the Problematic Pornography Consumption Scale in two school‑based adolescent samples (N=810).","sample_n":810,"sample_text":"School‑based convenience samples, but relatively large and demographically balanced.","population":"Adolescents (≈16 y) from Spain and Mexico, balanced gender in Spain, majority female in Mexico.","country":"Spain; Mexico","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study translates and validates two Spanish versions of a questionnaire that measures problematic porn use in teens from Spain and Mexico, showing the scales work well psychometrically.","clinical_takeaway":"The Spanish PPCS and PPCS‑6 are reliable tools for screening problematic pornography use in adolescents.","confidence":0.78,"topic_tags":["measurement","adolescents","pornography","sexual_function"],"strengths":["Large, bilingual adolescent sample","Rigorous factor‑analytic validation","Tests convergent/discriminant validity"],"limitations":["Cross‑sectional; no causal inference","No assessment of moral or mental‑health confounds","Relies on self‑report only"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02700-9"}},{"id":140,"doi":"10.3389/fpsyg.2024.1287455","pmid":"38605833","pmcid":"PMC11007122","title":"Increased sensitivity for negative emotional images in individuals with problematic pornography use","authors":"Qu S, Li R, Wang J.","first_author":"Qu S","journal":"Frontiers in psychology","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Event-related potentials","Emotion Regulation","Compulsive Sexual Behavior","Emotional Processing","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11007122","cited_by_count":4,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control ERP study with 27 PPU participants and 29 healthy controls","sample_n":56,"sample_text":"27 PPU, 29 HC (convenience recruitment implied)","population":"individuals with self‑identified problematic pornography use vs healthy controls","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"People who report problematic pornography use showed larger brain responses (N2, P3) to negative pictures and rated them as more unpleasant than people without such problems, suggesting they may be more sensitive to negative emotions.","clinical_takeaway":"Heightened emotional reactivity may be a factor in problematic pornography use; consider emotion‑regulation strategies in treatment.","confidence":0.7,"topic_tags":["pornography"],"strengths":["use of objective ERP measures","includes subjective valence ratings","direct comparison with matched control group"],"limitations":["small sample limits reliability","PPU definition unclear, likely self‑report","no control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":33,"max_possible":70,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":6,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2024.1287455"}},{"id":141,"doi":"10.31234/osf.io/cth93_v1","pmid":null,"pmcid":null,"title":"Behavioural addictions in early adulthood and subsequent suicidality: Evidence from a population-based cohort of young Swiss men","authors":"Wicki M, Andronicos M, Studer J, Marmet S, Khazaal Y, Gmel G.","first_author":"Wicki M","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"population-based cohort of 5,611 Swiss men, baseline at age 25, follow‑up at age 28, prospective questionnaire data","sample_n":5611,"sample_text":"non‑self‑selected, nationally representative sample of Swiss conscripts","population":"young Swiss men (age 25‑28)","country":"Switzerland","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Swiss cohort of over 5,000 young men, researchers found that self‑reported problematic pornography use at age 25 predicted a higher chance of suicide attempts three years later, even after accounting for other mental‑health problems.","clinical_takeaway":"Screen for problematic pornography use when assessing suicide risk in young adults.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large, population‑based cohort","Prospective longitudinal design","Adjustment for major psychiatric comorbidities"],"limitations":["Problematic pornography use measured with unspecified screening tool","Moral incongruence, masturbation, partner context not assessed","No pre‑registration reported"],"rubric_version":"2.0","raw_total":38,"max_possible":60,"pct_score":63,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":4,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/cth93_v1"}},{"id":142,"doi":"10.1556/2006.2025.00030","pmid":"40232850","pmcid":"PMC12231454","title":"Effects of transcranial direct current stimulation of the right dorsolateral prefrontal cortex on craving and negative emotion regulation in individuals at risk for problematic pornography use: A double-blind, placebo-controlled study","authors":"Yang X, Wang Y, Tang S, Li L, Wang J.","first_author":"Yang X","journal":"Journal of behavioral addictions","year":2025,"pub_types":["research-article","Randomized Controlled Trial","Journal Article"],"keywords":["Sexual behavior","Emotion Regulation","Dorsolateral Prefrontal Cortex","Transcranial Direct Current Stimulation","Problematic Pornography Use","Regulation Of Craving"],"is_oa":true,"oa_url":"https://doi.org/10.1556/2006.2025.00030","cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"within-subject, double‑blind, sham‑controlled crossover (45 young adult males at risk for PPU)","sample_n":45,"sample_text":"45 male individuals at risk for PPU (mean age = 20.18 years, SD = 1.03)","population":"male, mean age 20.2, at risk for problematic pornography use","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a double‑blind study, 45 young men who report risky pornography use tried a brain‑stimulation technique (tDCS) over the right prefrontal cortex while they attempted to control cravings and negative feelings. The stimulation lowered reported craving compared with a fake (sham) treatment, but did not affect emotion regulation.","clinical_takeaway":"Right‑dlPFC tDCS may help reduce pornography craving in at‑risk users, but evidence is limited and confounding factors were not addressed.","confidence":0.8,"topic_tags":["treatment","neuroscience","csbd"],"strengths":["Within‑subject crossover controls for individual differences","Double‑blind sham condition","Direct manipulation of dlPFC with tDCS"],"limitations":["No measurement of moral incongruence or masturbation, key confounds for PPU","Unclear how “risk for PPU” was defined; likely self‑report scale","Sample limited to young adult males, reducing generalisability"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00030"}},{"id":143,"doi":"10.1080/0092623x.2025.2556454","pmid":"40922678","pmcid":null,"title":"The Dependency-Resentment Hypothesis: Beyond North America and Europe","authors":"Wright PJ, Tokunaga RS, Zheng L, Zhang X.","first_author":"Wright PJ","journal":"Journal of sex & marital therapy","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Letter reporting consistent results from an Asian sample; likely convenience cross‑sectional survey.","sample_n":null,"sample_text":"Not specified in abstract","population":"heterosexual men, Asian cultural context (details not provided)","country":"Asia (unspecified)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"supports","citation_value":"background","plain_summary":"A brief report says that in an Asian sample, men who watch a lot of porn also report more problem use and more hostile attitudes toward women, supporting the Dependency‑Resentment Hypothesis that links frequent porn use with negative social outcomes.","clinical_takeaway":"No direct clinical guidance; findings are preliminary and limited by methodology.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Attempts to extend DRH to non‑Western sample","Addresses gap in cross‑cultural research"],"limitations":["No detail on measurement validation","Likely small, convenience sample","No control for key confounds (moral, mental health, etc.)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2025.2556454"}},{"id":144,"doi":"10.1556/2006.2024.00037","pmid":"39298267","pmcid":"PMC11737410","title":"Clinical characteristics associated with problematic pornography use among individuals seeking treatment for opioid use disorder","authors":"Stefanovics EA, Kraus SW, Madden LM, Farnum S, Cannata E, Potenza MN, Barry D.","first_author":"Stefanovics EA","journal":"Journal of behavioral addictions","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Pornography","Opioid Use Disorder","Addictive Behaviors","Compulsive Behaviors","Impulsive Behaviors","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://doi.org/10.1556/2006.2024.00037","cited_by_count":4,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 1,272 individuals seeking treatment for opioid use disorder; screened for problematic pornography use with the Brief Pornography Screen (BPS).","sample_n":1272,"sample_text":"Individuals seeking OUD treatment at participating clinics (October 2018–March 2020).","population":"Adults (18–73) in OUD treatment; 60 % male, 40 % female; recruited from treatment programs (self‑selected sample).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 1,272 people in treatment for opioid addiction, about 4.5 % screened positive for problematic pornography use. Those with positive screens were more impulsive and reported higher levels of psychiatric distress than those who screened negative.","clinical_takeaway":"In opioid‑treatment settings, clinicians should consider assessing problematic pornography use, as it co‑occurs with greater impulsivity and psychiatric symptoms.","confidence":0.78,"topic_tags":["pornography"],"strengths":["Large sample size for a clinical population","Use of a validated brief screen for problematic pornography use","Comprehensive assessment of impulsivity and psychiatric symptoms"],"limitations":["Cross‑sectional design limits causal inference","No assessment of moral incongruence or masturbation, key confounds for PPU","Treatment‑seeking sample restricts generalisability"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[{"status":"Has correction","date":"2024-12-23","noticeDoi":"10.1556/2006.2024.40000","doi":"10.1556/2006.2024.00037"}],"url":"https://scite.ai/reports/10.1556/2006.2024.00037"}},{"id":145,"doi":"10.2147/prbm.s398503","pmid":"37101720","pmcid":"PMC10124571","title":"Psychometric Network Analysis of the Problematic Pornography Use Scale (PPUS) in Peruvian Adults","authors":"Serpa-Barrientos A, Pérez-Flores EG, Saintila J.","first_author":"Serpa-Barrientos A","journal":"Psychology research and behavior management","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Psychometrics","Peru","Pornography","Pornography Scale","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://www.dovepress.com/getfile.php?fileID=89106","cited_by_count":3,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Psychometric validation of the Problematic Pornography Use Scale (PPUS) with a large Peruvian community sample (N=704) using CFA and Exploratory Graphical Analysis.","sample_n":704,"sample_text":"704 Peruvian participants (56% female, 43% male) aged 18‑62 years.","population":"Peruvian adults and youth, 18‑62 years, recruited from multiple cities (convenience/community sample).","country":"Peru","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether the Problematic Pornography Use Scale works well in a large Peruvian adult sample, finding that the scale appears to measure a single underlying factor.","clinical_takeaway":"The PPUS shows promising psychometric properties, but clinicians should be cautious about its interpretation given limited validation of underlying constructs.","confidence":0.8,"topic_tags":["pornography","measurement","sexual_function"],"strengths":["Large sample size for psychometric work","Use of both CFA and modern network analysis (EGA)","Clear reporting of factor structure"],"limitations":["No measurement of key confounds (moral incongruence, masturbation, mental health)","Possible circularity if PPUS defines problem via distress","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/prbm.s398503"}},{"id":146,"doi":null,"pmid":"42202090","pmcid":null,"title":"Restrictive Masculinity Norms and Behavioral Health Outcomes Among Rhode Island Sexual and Gender Minority Young Adults","authors":"Rosenthal SR, McKinnon RA, Pereira HE, Kemp AM.","first_author":"Rosenthal SR","journal":"Rhode Island medical journal (2013)","year":2026,"pub_types":["Journal Article"],"keywords":["Young Adults","Transgender","Sexual And Gender Minorities","Restrictive Masculinity"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional web‑based survey of 438 sexual and gender minority young adults in Rhode Island (2024). Modified Poisson regression with robust SEs, adjusting for demographics.","sample_n":438,"sample_text":"SGM participants (n=438); transgender subgroup n=100.","population":"SGM young adults (18‑25), sub‑sample of transgender participants (n≈100).","country":"United States (Rhode Island)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 438 sexual and gender‑minority young adults, higher endorsement of restrictive masculinity norms was linked to higher rates of alcohol, cannabis, heroin use, intimate partner violence, problem gambling and self‑reported problematic pornography use.","clinical_takeaway":"Restrictive masculinity norms may be a risk factor for problem pornography use and other health issues in SGM youth; screening for these norms could inform prevention efforts.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large SGM sample for a state‑level survey","Adjusted for key demographic covariates","Clear reporting of effect sizes with CIs"],"limitations":["Cross‑sectional design limits causal inference","Problematic pornography use measurement not described or validated","No assessment of moral incongruence or other key confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":147,"doi":"10.7759/cureus.33066","pmid":"36721540","pmcid":"PMC9883107","title":"The Potential Cutaneous Effects of Pornography Addiction: A Narrative Review","authors":"Rasul TF, Schwartz KR, Qureshi F, Eachus E, Henderson A.","first_author":"Rasul TF","journal":"Cureus","year":2022,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual Addiction","Cutaneous Manifestations","Addictive Behavior","Labiaplasty","Hypersexual Disorder","Skin Conditions","Pornography Addiction","Excessive Masturbation","Purpura And Strangulation Marks"],"is_oa":true,"oa_url":"https://assets.cureus.com/uploads/review_article/pdf/121215/20230127-15387-zj6d8c.pdf","cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods; no primary data.","sample_n":null,"sample_text":"None – narrative review","population":"Adults/adolescents (general discussion, no sample)","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["circular_addiction_scale","causal_from_correlational","advocacy_or_coi"],"stance":"supports","citation_value":"avoid","plain_summary":"The authors review possible skin problems linked to \"pornography addiction,\" such as injuries from risky sexual behavior or body‑modification trends. They note no solid evidence exists and call for more research.","clinical_takeaway":"No actionable clinical guidance; the suggested skin risks are speculative.","confidence":0.7,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Highlights an under‑explored topic","Covers multiple potential cutaneous outcomes"],"limitations":["No systematic search or quality appraisal","Relies on speculative links without empirical data","Uses 'addiction' terminology without operational definition"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.33066"}},{"id":148,"doi":"10.31234/osf.io/x7mnu","pmid":null,"pmcid":null,"title":"Addiction or Transgression? Moral Incongruence and Self-Reported Problematic Pornography Use in a Nationally Representative Sample","authors":"Grubbs JB, Lee BN, Hoagland C, Kraus SW, Perry S.","first_author":"Grubbs JB","journal":"PsyArXiv","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/x7mnu","cited_by_count":0,"is_preprint":true,"topics":["csbd","pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative US sample, N=2,519, cross‑sectional questionnaire assessing pornography use, religiousness and self‑reported addiction.","sample_n":2519,"sample_text":"Nationally representative norms, past‑year pornography users N=1,424 (66.4% men).","population":"Adults from US general population (past‑year porn users N=1,424).","country":"USA","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a US‑wide survey, people who were more religious reported higher feelings of being addicted to pornography, even though they used it less, suggesting that moral conflict may inflate self‑perceived problem use.","clinical_takeaway":"Clinicians should consider moral conflict, not just usage frequency, when evaluating concerns about pornography.","confidence":0.7,"topic_tags":["sexual_function","pornography","moral_incongruence","csbd","religiosity"],"strengths":["Large, nationally representative sample","Focused examination of moral incongruence proxy","Clear statistical interaction reported"],"limitations":["Self‑labelled ‘addiction’ measured by single item (circular)","Moral incongruence not directly measured, only religiousness","No control for masturbation, mental health, partner effects, trauma"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/x7mnu"}},{"id":149,"doi":"10.1177/15579883261441860","pmid":"41968500","pmcid":"PMC13080117","title":"Perceived Erectile Dysfunction in a Single Young Male With Multiple Associated Psychological Factors","authors":"Jee Ngee Ling B, Ismail SB.","first_author":"Jee Ngee Ling B","journal":"American journal of men's health","year":2026,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["erectile dysfunction","Primary Care","Biopsychosocial","Psychogenic"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13080117","cited_by_count":0,"is_preprint":false,"topics":["csbd","masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-case description of a 24‑year‑old single male with psychogenic erectile dysfunction linked to pornography use, moral conflict and childhood trauma","sample_n":1,"sample_text":"24‑year‑old single male","population":"young adult male, single, primary‑care patient","country":"not specified","controls_mi":"yes","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A 24‑year‑old single man reported erectile difficulties while masturbating, which he linked to frequent pornography use, guilt, and past childhood trauma. Psychosocial support, CBT, and medication improved his symptoms.","clinical_takeaway":"Assess moral conflict, trauma, and anxiety when young men present with psychogenic erectile problems; brief counseling and CBT can be effective.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","moral_incongruence"],"strengths":["Comprehensive biopsychosocial narrative","Inclusion of trauma and moral conflict as factors","Clear clinical management description"],"limitations":["Single case; no validated outcome measures","No objective sexual function testing","Cannot infer prevalence or causality"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":5,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/15579883261441860"}},{"id":150,"doi":"10.31234/osf.io/fmqb4_v1","pmid":null,"pmcid":null,"title":"Neurobiological mechanisms underpinning chemsex: a scoping review of human neuroimaging and neurophysiological studies","authors":"Naulls S, Eccles J, Stone J.","first_author":"Naulls S","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd","pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Scoping review of human neuroimaging and neurophysiological studies on chemsex; systematic search but no quantitative synthesis or risk‑of‑bias assessment.","sample_n":null,"sample_text":"26 studies included (1 direct chemsex study, 6 drug–sexual convergence, 19 component studies).","population":"Adults (men who have sex with men) involved in chemsex; studies varied, no original sample.","country":"Not specified (global literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"This scoping review found very few brain‑imaging studies that directly examine chemsex. Most evidence comes from studies of individual drugs or sexual reward, suggesting possible involvement of reward and control networks, but the literature is sparse and inconclusive.","clinical_takeaway":"No definitive neurobiological markers for chemsex are available yet; clinicians should rely on behavioral and psychosocial assessments.","confidence":0.8,"topic_tags":["neuroscience","sexual_function","csbd","pornography"],"strengths":["Comprehensive literature search up to 2026","Clear mapping of neuroimaging and neurophysiological evidence","Identifies gaps and proposes future research targets"],"limitations":["Only one direct chemsex neurostudy; conclusions rely heavily on indirect evidence","No risk‑of‑bias assessment of included studies","Limited to published English‑language work"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/fmqb4_v1"}},{"id":151,"doi":"10.1007/s10508-023-02699-z","pmid":"37880509","pmcid":null,"title":"Treatment Approaches for Problematic Pornography Use: A Systematic Review","authors":"Roza TH, Noronha LT, Shintani AO, Massuda R, Lobato MIR, Kessler FHP, Passos IC.","first_author":"Roza TH","journal":"Archives of sexual behavior","year":2024,"pub_types":["Systematic Review","Journal Article"],"keywords":["Grade","Systematic review","Hypersexuality","Behavioral Addictions","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 28 studies (16 case reports, 1 case series, 7 quasi‑experimental, 4 RCTs) on treatments for problematic pornography use.","sample_n":500,"sample_text":"n = 500 participants across the 28 included studies","population":"Adults with problematic pornography use (total n≈500 across studies).","country":"Multiple (international literature search)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 28 small studies found that most treatments for problematic pornography use—mainly cognitive‑behavioral therapies and some medications—show promise but the evidence is weak and inconsistent.","clinical_takeaway":"Current treatment evidence for problematic pornography use is limited; clinicians should use caution and consider individual patient needs.","confidence":0.8,"topic_tags":["treatment","pornography","csbd"],"strengths":["Comprehensive literature search across multiple databases","Use of established risk‑of‑bias and GRADE frameworks","Identification of gaps in the treatment evidence base"],"limitations":["Included primary studies are low quality and largely case reports","No meta‑analysis or pooled effect sizes","Limited reporting on side‑effects and adherence"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02699-z"}},{"id":152,"doi":"10.1016/j.addbeh.2024.108048","pmid":"38761685","pmcid":"PMC7616041","title":"Problematic pornography use and novel patterns of escalating use: A cross-sectional network analysis with two independent samples","authors":"Ince C, Albertella L, Liu C, Tiego J, Fontenelle LF, Chamberlain SR, Yücel M, Rotaru K.","first_author":"Ince C","journal":"Addictive behaviors","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Network Analysis","Behavioral Addiction","Pornography Addiction","Problematic Pornography Use","Sexual Novelty","Binge Behaviors"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7616041","cited_by_count":9,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional network analysis with two large independent male samples (N≈1,300 and N≈940)","sample_n":2300,"sample_text":"Two independent samples of male pornography users (N1 = 1,356; N2 = 944)","population":"male pornography users, community sample, likely convenience recruitment","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A study of over 2,300 men examined how habits like binge‑watching, switching between clips, and increasing sexual novelty relate to self‑reported trouble controlling porn use. Certain patterns, especially increasing total viewing time, were central in the network of behaviours linked to problematic use.","clinical_takeaway":"Higher overall porn consumption and binge‑style viewing may signal greater risk of perceived loss of control, but findings are correlational and lack key confound controls.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample sizes across two independent cohorts","Novel application of network analysis to capture inter‑related use patterns","Focus on multiple behavioural dimensions beyond simple frequency"],"limitations":["Cross‑sectional design limits causal inference","No measurement or control of key confounds (moral incongruence, masturbation, mental health, relationship factors)","PPU operationalisation unclear; likely relies on self‑label or unvalidated scale"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2024.108048"}},{"id":153,"doi":"10.1093/jsxmed/qdae101","pmid":"39183145","pmcid":null,"title":"Pornography use, problematic pornography use, impulsivity, and sensation seeking: a meta-analysis","authors":"Bocci Benucci S, Di Gesto C, Ghinassi S, Casale S, Fioravanti G.","first_author":"Bocci Benucci S","journal":"The journal of sexual medicine","year":2024,"pub_types":["Meta-Analysis","Journal Article"],"keywords":["Sensation seeking","Impulsivity","Negative Urgency","Lack Of Premeditation","Positive Urgency","Pornography","Lack Of Perseverance"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"meta-analysis of observational studies examining correlations between impulsivity dimensions and pornography use/problematic use; random‑effects model, meta‑regression, Egger’s test for bias","sample_n":20174,"sample_text":"Aggregate sample sizes across included primary studies","population":"Adults from primary studies (total N≈20 000 for PPU analyses)","country":"Not specified (multiple countries across primary studies)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 13 studies (about 20 000 participants) found that higher impulsivity and sensation‑seeking are linked to more frequent pornography use and to self‑reported problematic use, especially in younger men. Age and gender modify these links.","clinical_takeaway":"Impulsivity traits may signal risk for problematic pornography use; screening for these traits could help target prevention.","confidence":0.8,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Large pooled sample size","Systematic literature search","Examines multiple impulsivity dimensions","Tests age and gender moderators"],"limitations":["Primary studies likely use heterogeneous, sometimes circular PPU definitions","Key confounds (moral incongruence, masturbation, mental health) not addressed","30 % of eligible studies excluded due to missing data"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdae101"}},{"id":154,"doi":"10.1080/19317611.2023.2224807","pmid":"38601731","pmcid":"PMC10903672","title":"Difficulties in Emotion Regulation and Problematic Pornography Use: The Mediating Role of Loneliness","authors":"Cardoso J, Ramos C, Brito J, Almeida TC.","first_author":"Cardoso J","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Loneliness","Compulsive Sexual Behavior","Difficulties In Emotion Regulation","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online self‑report survey (N=339), cross‑sectional mediation analysis","sample_n":339,"sample_text":"339 participants recruited online","population":"adult participants, mean age 28.5, mixed gender","country":"unspecified (likely Portugal/Spain based on author names)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In 339 adults, difficulty managing emotions was linked to higher self‑reported problematic porn use, and feeling lonely partly explained this link. Gender and relationship status altered the pattern.","clinical_takeaway":"Emotion‑regulation skills and loneliness may be relevant targets when addressing problematic pornography use.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["large sample for a survey","examines mediation model","includes gender and relationship moderators"],"limitations":["cross‑sectional, cannot infer causality","relies on self‑report scales, unclear validation","does not control key confounds (moral incongruence, masturbation, mental health, trauma)"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":10,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2023.2224807"}},{"id":155,"doi":"10.3389/fpsyt.2023.1191297","pmid":"37564242","pmcid":"PMC10411905","title":"Decision making and executive functions in problematic pornography use","authors":"Müller SM, Antons S.","first_author":"Müller SM","journal":"Frontiers in psychiatry","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Cognition","Risky Choice","Cybersex","Sex Addiction","Problematic Usage Of The Internet","Pornography Use Disorder"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1191297/pdf","cited_by_count":11,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Laboratory cross‑sectional study comparing high vs low PPU groups on executive function tasks (N=102 male adults).","sample_n":102,"sample_text":"N = 102 male adults","population":"Male adults, likely convenience sample; no indication of probability sampling.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men with high versus low self‑reported problematic pornography use on decision‑making and executive‑function tests. High‑severity participants showed more impulsivity but performed similarly on the cognitive tasks.","clinical_takeaway":"Problematic pornography use may be linked to heightened impulsivity, but not to broader deficits in executive function.","confidence":0.8,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Laboratory‑based cognitive tasks","Reasonable overall sample size","Use of standard neuropsychological measures"],"limitations":["Problem severity of PPU not clearly operationalised","Key confounds (moral incongruence, masturbation, mental health) not measured","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":9,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2023.1191297"}},{"id":156,"doi":"10.1007/s10508-024-02904-7","pmid":"38898361","pmcid":"PMC11390895","title":"The Associations Between Attachment Insecurity and Compulsive Sexual Behavior Disorder or Problematic Pornography Use: The Mediating Role of Emotion Regulation Difficulties","authors":"Wizła M, Lewczuk K.","first_author":"Wizła M","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Emotion Regulation","Icd-11","Attachment Anxiety","Attachment Avoidance","Compulsive Sexual Behavior Disorder","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11390895","cited_by_count":13,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey (N=1002) investigating attachment, emotion regulation, CSBD and problematic pornography use via mediation analyses","sample_n":1002,"sample_text":"Adults recruited online; 50.2% men; mean age 50.49 (SD 13.32)","population":"adult community sample, mixed gender, mean age 50.5 years","country":"Poland (inferred from author names and journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,000 adults, researchers found that having insecure attachment styles is linked to more severe compulsive sexual behavior and problematic porn use, and that difficulty managing emotions partly explains these links.","clinical_takeaway":"Assess attachment and emotion‑regulation issues when addressing compulsive sexual behavior or problematic pornography use.","confidence":0.85,"topic_tags":["csbd","pornography","sexual_function","relationships","moral_incongruence"],"strengths":["Large sample size (N>1000)","Use of validated questionnaires for attachment, ER, CSBD/PPU","Comprehensive mediation model exploring theoretical pathway"],"limitations":["Cross‑sectional design cannot establish causality","No measurement of moral incongruence, masturbation, mental health or relationship factors","Potential circularity if CSBD scale includes distress as criterion"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02904-7"}},{"id":157,"doi":"10.1002/hsr2.2272","pmid":"39055613","pmcid":"PMC11269210","title":"Post-COVID-19 internet addiction, depression, and pornography addiction among adolescents: Findings from a nationwide study in Bangladesh","authors":"Siddik MAB, Pervin I, Syfullah MK, Ali A, Mahmud A, Hasan M, Hussen SM, Manjur M, Ahmed Z, Rahman MM.","first_author":"Siddik MAB","journal":"Health science reports","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Adolescents","Internet Addiction","Pornography Addiction","Covid‐19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11269210","cited_by_count":8,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online nationwide survey of 8832 adolescents, simple random sampling, cross‑sectional","sample_n":8832,"sample_text":"8832 adolescents","population":"school‑going adolescents in Bangladesh (both sexes)","country":"Bangladesh","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationwide online survey of 8,800 Bangladeshi adolescents, about two‑thirds showed signs of internet overuse, depression, and pornography craving. Girls reported more depression, boys more pornography craving, and all three issues were linked.","clinical_takeaway":"High rates of internet overuse, depression, and pornography craving co‑occur in Bangladeshi teens; screening and integrated mental‑health support are warranted.","confidence":0.8,"topic_tags":["pornography","adolescents","prevalence","sexual_function"],"strengths":["Very large sample size","Validated scales for IA and depression","Nationwide coverage"],"limitations":["Cross‑sectional; no causal inference","No measurement of moral incongruence or masturbation","Addiction criteria not assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/hsr2.2272"}},{"id":158,"doi":"10.1016/j.chc.2026.06.001","pmid":"42686315","pmcid":null,"title":"Gambling and Gaming Disorders, Problematic Pornography Use, and Other Addictive Behaviors (Use of Social Media and Artificial Intelligence Chatbots) in Youth","authors":"Park JJ, Potenza MN.","first_author":"Park JJ","journal":"Child and adolescent psychiatric clinics of North America","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Youth","Diagnosis","Treatment","Gambling Disorder","Problematic Pornography Use","Gaming Disorder","Problematic Use Of Social Media","Problematic Use Of Ai Chatbots"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methodology; no primary data collection.","sample_n":null,"sample_text":"Not applicable – review article","population":"Youth (children and adolescents)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review discusses how gambling, gaming, pornography, social media, and AI chatbots may affect young people, emphasizing the need for better screening and treatment and suggesting a continuum view of these behaviors rather than strict diagnostic categories.","clinical_takeaway":"Clinicians should consider a flexible, continuum‑based approach when assessing and treating youth exhibiting problematic use of digital and sexual media.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Broad overview of multiple behavioral addictions in youth","Identifies gaps and future research directions"],"limitations":["Lacks systematic search strategy","No quantitative synthesis or meta‑analysis","No primary data; reliance on secondary reports"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chc.2026.06.001"}},{"id":159,"doi":"10.1556/2006.2024.00054","pmid":"39945767","pmcid":"PMC11974402","title":"Identification and comprehensive characterization of moral disapproval and behavioral dysregulation-based pornography-use profiles across 42 countries","authors":"Bőthe B, Tóth-Király I, Popova N, Nagy L, Koós M, Demetrovics Z, Potenza MN, Kraus SW, Ballester-Arnal R, Batthyány D, Bergeron S, Billieux J, Briken P, Burkauskas J, Cárdenas-López G, Carvalho J, Castro-Calvo J, Chen L, Ciocca G, Corazza O, Csako RI, Czakó A, Fernandez DP, Fernandez EF, Fujiwara H, Fuss J, Gabrhelík R, Gewirtz-Meydan A, Gjoneska B, Gola M, Hashim HT, Islam MS, Ismail M, Jiménez-Martínez MC, Jurin T, Kalina O, Klein V, Költő A, Lee CT, Lee SK, Lewczuk K, Lin CY, Lochner C, López-Alvarado S, Lukavská K, Mayta-Tristán P, Miller DJ, Orosová O, Orosz G, Sungkyunkwan University's Research Team, Ponce FP, Quintana GR, Quintero Garzola GC, Ramos-Diaz J, Rigaud K, Rousseau A, Scanavino MT, Schulmeyer MK, Sharan P, Shibata M, Shoib S, Sigre-Leirós V, Sniewski L, Spasovski O, Steibliene V, Stein DJ, Štulhofer A, Ünsal BC, Vaillancourt-Morel MP, Van Hout MC, Grubbs JB.","first_author":"Bőthe B","journal":"Journal of behavioral addictions","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Compulsive Behavior","Morality","Addictive Behavior","Dysregulation","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11974402","cited_by_count":7,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Latent profile analysis of 66,994 participants from 42 countries using the International Sex Survey.","sample_n":66994,"sample_text":"International Sex Survey participants from 42 countries.","population":"Adults from general population across 42 countries (N=66,994, mean age 32.2).","country":"Multiple (42 countries)","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 67,000 people in 42 countries identified six patterns of pornography use based on how often they watch, how much they feel morally uncomfortable, and whether they show signs of problematic use. Moral disapproval and behavioral dysregulation together helped distinguish higher‑risk groups.","clinical_takeaway":"Assess both moral concerns and behavioral dysregulation when evaluating pornography‑related distress; treatment should address both factors.","confidence":0.85,"topic_tags":["pornography","moral_incongruence","sexual_function"],"strengths":["Very large, multinational sample","Rigorous latent profile methodology","Explicit measurement of moral disapproval"],"limitations":["Cross‑sectional; no causal inference","Unclear whether PPU scale is fully validated","Key confounds (masturbation, mental health, partner status) not addressed"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":5,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00054"}},{"id":160,"doi":"10.31234/osf.io/2yuzt_v1","pmid":null,"pmcid":null,"title":"Problematic technology use in Polish adults: Prevalence, co-occurrence, and psychosocial predictors in a nationally representative sample","authors":"Holas P, Roczon P, Styła R, Suszek H, Szumiał S.","first_author":"Holas P","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative quota sample, online survey, N=2122, cross‑sectional","sample_n":2122,"sample_text":"nationwide random quota sample of adults","population":"Polish adults, age 19–98, gender balanced","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a national Polish survey of 2,122 adults, about one‑fifth showed signs of problematic pornography use, while smaller shares reported issues with social media, internet, smartphones, or gaming. Psychological factors such as loneliness, low self‑control, anxiety and depression were linked to higher risk.","clinical_takeaway":"Problematic pornography use is common; assess related mental‑health factors rather than assuming an addiction diagnosis.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative sample","Validated multi‑domain PTU scales","Comprehensive psychosocial predictors"],"limitations":["Cross‑sectional; no causal inference","Moral incongruence and masturbation not measured","No assessment of partner/relationship factors"],"rubric_version":"2.0","raw_total":39,"max_possible":60,"pct_score":65,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":4,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/2yuzt_v1"}},{"id":161,"doi":"10.4088/pcc.21m03208","pmid":"36898031","pmcid":null,"title":"Assessment of Problematic Pornography Use Among Lebanese Adults and the Role of Child and Partner Abuse","authors":"Malaeb D, Azzi V, Hallit S, Obeid S.","first_author":"Malaeb D","journal":"The primary care companion for CNS disorders","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 653 Lebanese adults recruited via social media","sample_n":653,"sample_text":"653 participants recruited through WhatsApp, Facebook Messenger, Instagram","population":"Lebanese adults (age > 18) from all districts; recruited online","country":"Lebanon","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 653 Lebanese adults, higher levels of childhood physical abuse and partner physical abuse were linked to greater odds of reporting problematic pornography use, while child neglect and partner sexual abuse were linked to lower odds. Alcohol use also related to higher problematic use.","clinical_takeaway":"Consider histories of abuse and alcohol use when assessing problematic pornography behaviors, but note the evidence is correlational.","confidence":0.8,"topic_tags":["pornography","sexual_function","relationships","adolescents"],"strengths":["Large sample (N > 600)","Validated abuse questionnaires","Focus on understudied Lebanese population"],"limitations":["Convenience online recruitment → selection bias","No measurement of moral incongruence or masturbation","Cross‑sectional design, cannot infer causality","Problematic porn use assessed with a scale that may conflate frequency and distress"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/pcc.21m03208"}},{"id":162,"doi":"10.1093/jsxmed/qdag155","pmid":"42234466","pmcid":null,"title":"Problematic pornography use: uncovering symptom importance and differences between women and men through Bayesian analysis of networks","authors":"Klau MM, Huth K, Marsman M, Baumgartner SE, Blanken TF.","first_author":"Klau MM","journal":"The journal of sexual medicine","year":2026,"pub_types":["Journal Article"],"keywords":["Women","Addiction","Network Analysis","Problematic Pornography Use","Bayesian Graphical Modeling"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdag155"}},{"id":163,"doi":"10.31234/osf.io/6p5k9","pmid":null,"pmcid":null,"title":"Moral Incongruence and Pornography Use: A Critical Review and Integration","authors":"Grubbs JB, Perry SL.","first_author":"Grubbs JB","journal":"PsyArXiv","year":2017,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/6p5k9","cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods, no empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors review research showing that feeling conflicted about one's own porn use—moral incongruence—is linked to higher distress and self‑labelled addiction, suggesting that personal values, not just usage amount, shape perceived problems.","clinical_takeaway":"Clinicians should assess moral conflict when clients report porn‑related distress, as it may drive perceived addiction.","confidence":0.8,"topic_tags":["moral_incongruence","pornography","sexual_function"],"strengths":["Integrates existing literature on moral incongruence","Highlights an often‑overlooked confound"],"limitations":["Narrative, not systematic review","No empirical data or meta‑analytic methods","Lacks quantitative synthesis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/6p5k9"}},{"id":164,"doi":"10.1097/adm.0000000000001227","pmid":"37788127","pmcid":null,"title":"Withdrawal-like Symptoms in Problematic Pornography Use: A Scoping Review","authors":"Roza TH, Noronha LT, Shintani AO, Massuda R, Kessler FHP, Passos IC.","first_author":"Roza TH","journal":"Journal of addiction medicine","year":2024,"pub_types":["Scoping Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"scoping review of 14 studies (total n≈31,009), narrative synthesis, no meta‑analysis","sample_n":31009,"sample_text":"Aggregated across 14 included studies","population":"individuals with problematic pornography use (PPU) reported in the primary studies","country":"multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review found that many people who consider their pornography use problematic also report cravings and other withdrawal‑like symptoms, especially when they use porn frequently. Masturbation sometimes eases these symptoms, but the evidence comes from varied, mostly cross‑sectional studies.","clinical_takeaway":"Withdrawal‑like experiences may occur in some individuals with problematic pornography use, but robust research is needed before using this to guide treatment.","confidence":0.8,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Systematic search across six databases","Large cumulative sample size from included studies","Clear focus on withdrawal‑like symptoms"],"limitations":["Relies on heterogeneous primary studies with limited methodological detail","No quantitative synthesis or meta‑analysis","Does not assess key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/adm.0000000000001227"}},{"id":165,"doi":"10.2196/75485","pmid":"41100693","pmcid":"PMC12530455","title":"Predictors for Acceptance of Sexual Aggression Myths Among People Using Cyberporn: Cross-Sectional Study","authors":"Ben Brahim F, Vera Cruz G, Courtois R, Khazaal Y.","first_author":"Ben Brahim F","journal":"JMIR formative research","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Multivariate regression","Sexual Coercion","Sexual Aggression Myths","Compulsive Cyberporn","Cyberporn"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12530455","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire; N=1557 cyberporn users (≥1 use in past 6 months); multivariate linear regression","sample_n":1557,"sample_text":"convenience online sample of cyberporn users","population":"English‑speaking adults (mean age 33.3) who use cyberporn; 64 % men, 36 % women","country":"unspecified (English‑speaking)","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 1,557 adults who had used cyber‑porn, higher acceptance of sexual‑aggression myths was linked to more compulsive porn use, experiences of sexual coercion, and lower sexual self‑esteem. Moral conflict about porn use also predicted myth acceptance in men, while older age mattered for women.","clinical_takeaway":"None – findings describe beliefs, not clinical outcomes.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size (N>1500)","Gender‑specific analyses","Use of several established questionnaires"],"limitations":["Cross‑sectional, cannot infer causality","Masturbation not measured separately from porn use","Limited mental‑health covariates"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/75485"}},{"id":166,"doi":"10.1007/s10899-023-10274-3","pmid":"38151657","pmcid":null,"title":"Understanding the Co-occurrence of Gambling Disorder and Problematic Pornography Use: Exploring Sociodemographic and Clinical Factors","authors":"Mestre-Bach G, Potenza MN, Granero R, Uríszar JC, Tarragón E, Chiclana Actis C, Testa G, Fernández-Aranda F, Jiménez-Murcia S.","first_author":"Mestre-Bach G","journal":"Journal of gambling studies","year":2024,"pub_types":["Journal Article"],"keywords":["Personality","Emotion Regulation","Gambling Disorder","Pornography","Addictive Behaviors","Compulsive Behaviors","Impulsive Behaviors"],"is_oa":false,"oa_url":"https://ddd.uab.cat/pub/artpub/2023/302078/jougambstu_a2023amespot.pdf","cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional comparison of treatment‑seeking gamblers with and without co‑occurring problematic pornography use (n=332 vs n=37)","sample_n":359,"sample_text":"treatment‑seeking individuals with gambling disorder, of which 37 also met criteria for problematic pornography use","population":"treatment‑seeking adults with gambling disorder","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among people seeking help for gambling problems, those who also reported problematic porn use showed higher gambling severity, more substance use, worse mental health, higher impulsivity and poorer emotion regulation than those without porn problems.","clinical_takeaway":"Co‑occurring problematic porn use may signal a more severe clinical profile in gamblers and warrants assessment.","confidence":0.78,"topic_tags":["pornography","masturbation","csbd","sexual_function"],"strengths":["Large overall sample of treatment‑seekers","Comprehensive assessment of clinical variables","Direct comparison of GD vs GD+PPU groups"],"limitations":["Small PPU subgroup (n=37) limits statistical power","Treatment‑seeking, non‑representative sample","No measurement/control of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10899-023-10274-3"}},{"id":169,"doi":"10.1007/s10508-024-02965-8","pmid":"39134733","pmcid":null,"title":"Neural Correlates of the Attentional Bias Towards Subliminal Pornographic Cues in Individuals with Tendencies Toward Problematic Pornography Use: An ERP Study Using a Dot-Probe Task","authors":"Wang J, Li H.","first_author":"Wang J","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Event-related potentials","P1","Subliminal","Dot-probe Task","Problematic Pornography Use","Preconscious Attentional Bias"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"lab ERP study with masked dot‑probe task, cross‑sectional comparison of high vs low subclinical PPU groups (n≈24 each)","sample_n":47,"sample_text":"24 high‑PPU, 23 low‑PPU male participants","population":"young adult males, convenience sample","country":"China (assumed from author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","underpowered_sample","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In an EEG study, men with higher self‑reported problematic porn use showed larger early brain responses (P1) to subliminal porn images, suggesting automatic attentional capture, and this response grew with symptom severity.","clinical_takeaway":"ERP evidence hints that problematic porn use may involve automatic attention to porn cues, but findings are preliminary and limited by sample size.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","pornography","csbd"],"strengths":["Experimental ERP paradigm with masked stimuli","Direct measurement of preconscious attentional processing","Correlation of neural index with symptom severity"],"limitations":["Small, male‑only convenience sample","No measurement/control of moral or other psychosocial confounds","Unclear validation of the PPU scale used"],"rubric_version":"2.0","raw_total":33,"max_possible":70,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":5,"statistics":5,"confounds":2,"design":5,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02965-8"}},{"id":170,"doi":"10.1080/0092623x.2026.2617372","pmid":"41566845","pmcid":null,"title":"Replicating and Extending the Dependency-Resentment Hypothesis","authors":"Wright PJ, Tokunaga RS.","first_author":"Wright PJ","journal":"Journal of sex & marital therapy","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Letter reporting replication analyses of five convenience survey datasets from Greece, US, China, Italy (two samples).","sample_n":null,"sample_text":"Four previously published datasets plus a new Italian dataset; exact Ns not given in abstract","population":"heterosexual adults (men) from multiple countries","country":"Greece, United States, China, Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"background","plain_summary":"The authors tested whether men’s porn use, self‑reported problems with porn, and hostile attitudes toward women are linked, across five international surveys. Their new Italian data supported the same pattern, and they suggest adding rape‑myth acceptance to the model.","clinical_takeaway":"None – the findings are correlational and do not provide actionable guidance for clinicians.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Multi‑national replication","Addresses novel hypothesis linking pornography use and hostile attitudes"],"limitations":["Reliance on self‑report and likely unvalidated/problematic use measures","No control for key confounds (morality, mental health, masturbation, relationship context)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2026.2617372"}},{"id":171,"doi":"10.34172/ahj.2023.1395","pmid":"38026725","pmcid":"PMC10658102","title":"Biopsychosocial Determinants of Problematic Pornography Use: A Systematic Review","authors":"Seyedzadeh Dalooyi SI, Aghamohammadian Sharbaaf H, Abdekhodaei MS, Ghanaei Chamanabad A.","first_author":"Seyedzadeh Dalooyi SI","journal":"Addiction & health","year":2023,"pub_types":["review-article","Review","Journal Article"],"keywords":["Biopsychosocial","Pornography","Pornography Addiction","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://doi.org/10.34172/ahj.2023.1395","cited_by_count":10,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 66 longitudinal and cross‑sectional studies on risk factors for problematic pornography use.","sample_n":null,"sample_text":"66 studies (no primary participants).","population":"Adults from studies conducted in Europe and North America; no primary sample.","country":"International (Europe, North America)","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review examined 66 studies and found biological (ventral‑striatum activity), psychological (craving, low self‑esteem, stress) and social (male gender, age, religion, moral conflict) factors linked to problematic pornography use.","clinical_takeaway":"Clinicians should consider biological, psychological, and social risk factors—not just frequency—when assessing clients reporting trouble with pornography.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence"],"strengths":["Comprehensive literature search across multiple databases.","Organises findings into clear biopsychosocial categories."],"limitations":["No quantitative meta‑analysis; synthesis is narrative.","Limited assessment of how primary studies measured constructs."],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.34172/ahj.2023.1395"}},{"id":172,"doi":"10.1007/s10508-021-02141-2","pmid":"34853978","pmcid":null,"title":"Psychometric Properties of the Problematic Pornography Use Scale in a Japanese Sample","authors":"Okabe Y, Ito D.","first_author":"Okabe Y","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Japan","Compulsive Sexual Behavior","Pornography","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online survey (N=1011), confirmatory factor analysis, reliability testing","sample_n":1011,"sample_text":"502 men, 509 women, mean age 35.9 years","population":"Japanese adults, balanced gender","country":"Japan","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors translated and tested the Problematic Pornography Use Scale in Japan, finding it reliable and structurally similar to the original, with good links to related sexual‑compulsivity measures.","clinical_takeaway":"The Japanese PPUS can be used to assess self‑reported problematic porn use, but clinicians should consider other factors like moral views and mental health.","confidence":0.8,"topic_tags":["measurement","pornography","csbd"],"strengths":["Large, gender‑balanced sample","Rigorous factor‑analytic validation","Good internal consistency and convergent validity"],"limitations":["Cross‑sectional, self‑report only","No assessment of moral incongruence or related confounds","Possible circularity in defining ‘problematic’ use"],"rubric_version":"2.0","raw_total":38,"max_possible":60,"pct_score":63,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":4,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02141-2"}},{"id":173,"doi":"10.1037/adb0000714","pmid":"33764089","pmcid":null,"title":"The role of impaired control in screening problematic pornography use: Evidence from cross-sectional and longitudinal studies in a large help-seeking male sample","authors":"Chen L, Jiang X, Luo X, Kraus SW, Bőthe B.","first_author":"Chen L","journal":"Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large help‑seeking male sample (N≈8845) with cross‑sectional latent‑profile analysis and a 6‑month follow‑up subsample (N≈972)","sample_n":8845,"sample_text":"large help‑seeking male sample; follow‑up subsample of 972","population":"help‑seeking adult males (mean age≈26)","country":"unspecified","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large group of men seeking help for pornography‑related concerns, the researchers identified three profiles: those who think they have a problem, those with impaired control over use, and those with objectively dysregulated use. Impaired control predicted later problematic use, but moral conflict was higher in the self‑perceived group.","clinical_takeaway":"Impaired control may help clinicians differentiate between moral‑based concerns and actual dysregulated pornography use.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["large initial sample","latent profile analysis","longitudinal cross‑lagged design","measures moral incongruence"],"limitations":["help‑seeking, non‑representative sample","masturbation and mental‑health not accounted for","no pre‑registration or power justification reported"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":42,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/adb0000714"}},{"id":174,"doi":"10.2196/49860","pmid":"39778200","pmcid":"PMC11754984","title":"Pornography-Watching Disorder and Its Risk Factors Among Young Adults: Cross-Sectional Survey","authors":"Erdős C, Kelemen O, Pócs D, Paulik E, Papp A, Horváth E, Golan A, Széll K.","first_author":"Erdős C","journal":"Journal of medical Internet research","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Risk factor","Satisfaction","Public Health","Young Adults","Internet Use","Prevention Programs","Online","Paraphilia","Social Media","Cross Sectional","Dsm-5","Sexual Education","Online Survey","Sexual Well-being","Sexual Disorder","Pornography","Web-based Questionnaire","Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition","Pornography-watching Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11754984","cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"web‑based survey of 9,397 Hungarian young adults recruited via social media and university website; 7,187 users analysed; logistic regression of risk factors.","sample_n":7187,"sample_text":"Large convenience sample recruited online; not probability‑based.","population":"young adults (18‑35) in Hungary, internet users","country":"Hungary","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Hungarian online survey of 7,200 young adults who watch pornography, 4.4% met a set of ten questions adapted from substance‑use disorder criteria, defining a ‘pornography‑watching disorder’. Daily users, males, early exposure, higher religiosity and relationship difficulties were linked to higher odds, while good sexual education and living in the capital were protective.","clinical_takeaway":"Screening tools for problematic pornography use should separate viewing frequency from distress and consider moral, relational, and educational factors.","confidence":0.78,"topic_tags":["pornography","prevalence","religiosity","sexual_function"],"strengths":["Very large sample size","Multivariable regression identifies multiple risk factors","Inclusion of religious adherence as a predictor"],"limitations":["Adapted DSM‑5 items not validated for pornography","Cross‑sectional, cannot infer causality","Convenience web sample limits generalisability","Masturbation not measured separately"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":10,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/49860"}},{"id":175,"doi":"10.1007/s10508-020-01878-6","pmid":"33403534","pmcid":null,"title":"Roles of Religiosity, Obsessive-Compulsive Symptoms, Scrupulosity, and Shame in Self-Perceived Pornography Addiction: A Preregistered Study","authors":"De Jong DC, Cook C.","first_author":"De Jong DC","journal":"Archives of sexual behavior","year":2021,"pub_types":["Journal Article"],"keywords":["Religiosity","Scrupulosity","Obsessive–compulsive Disorder","Pornography Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online survey with experimental religiosity prime; N≈645; preregistered hypotheses; between‑subject analyses of shame and perceived addiction","sample_n":645,"sample_text":"645‑646 pornography users who believe in a theistic God","population":"adult pornography users who believe in a theistic God (self‑selected sample)","country":"not stated","controls_mi":"yes","preregistered":true,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 645 adults who view pornography and believe in God, testing whether religious thoughts increase shame and lead them to label themselves as addicted. Religious priming raised shame for some, especially those high in OCD symptoms, and shame was linked to self‑reported addiction.","clinical_takeaway":"Self‑identified porn addiction may reflect moral and shame‑related factors rather than a clinical disorder.","confidence":0.8,"topic_tags":["pornography","religiosity","sexual_function","moral_incongruence"],"strengths":["Large sample size","Preregistered hypotheses","Inclusion of multiple psychological moderators"],"limitations":["Self‑perceived addiction measured by single‑item label","Masturbation not assessed separately","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":8,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01878-6"}},{"id":176,"doi":"10.1556/2006.2023.00058","pmid":"37921890","pmcid":"PMC10786232","title":"Emotional processing deficits in individuals with problematic pornography use: Unpleasant bias and pleasant blunting","authors":"Wang J, Li H.","first_author":"Wang J","journal":"Journal of behavioral addictions","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Event-related potentials","Compulsive Sexual Behavior","Emotional Processing","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10786232","cited_by_count":6,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control ERP study with 42 men with problematic pornography use (PPU) and 45 healthy controls, age ~20, oddball emotional picture task","sample_n":87,"sample_text":"42 PPU participants (mean age = 20.14 y) and 45 healthy controls (mean age = 20.04 y)","population":"young adult males, convenience sample","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Men who report problematic use of pornography showed larger brain responses to unpleasant pictures and weaker responses to pleasant pictures compared with non‑users, suggesting they may be more sensitive to negative emotions and less responsive to positive ones.","clinical_takeaway":"Screen for emotional‑processing difficulties in clients presenting with compulsive pornography use; address negative‑affect coping strategies.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["use of objective electrophysiological measures (ERP)","matched control group","both subjective and neural indices of emotional processing"],"limitations":["problematic pornography use likely defined by an unspecified screening scale","no measurement of key confounds (moral incongruence, masturbation, mental health)","small, homogeneous sample limits generalisability"],"rubric_version":"2.0","raw_total":30,"max_possible":70,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":5,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2023.00058"}},{"id":177,"doi":"10.31234/osf.io/935k2_v1","pmid":null,"pmcid":null,"title":"Bases neuropsicológicas para el diseño de software de desarrollo personal: dopamina, autorreflexión y bienestar","authors":"Leitch SJ.","first_author":"Leitch SJ.","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"none","sample_n":null,"sample_text":"none","population":"none","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The paper discusses how dopamine, self‑reflection, and habits like problematic pornography use might affect wellbeing and suggests design ideas for personal‑development software, but it provides no original data.","clinical_takeaway":"None – the article offers theoretical ideas only, not evidence for clinical practice.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Integrates neuroscience concepts","Identifies multiple wellbeing domains"],"limitations":["No empirical data or sample","No validated measures","Speculative conclusions"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/935k2_v1"}},{"id":178,"doi":"10.1016/j.addbeh.2026.108869","pmid":"42801890","pmcid":null,"title":"Early maladaptive schemas and four problematic excessive behaviors: Cross-sectional indirect associations involving desire thinking and craving","authors":"Akbari M, Khaki A, Mohammadkhani S, Griffiths MD.","first_author":"Akbari M","journal":"Addictive behaviors","year":2026,"pub_types":["Journal Article"],"keywords":["Craving","Early Maladaptive Schemas","Desire Thinking","Elaborated Intrusion Theory","I-pace Model","Problematic Excessive Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 811 Iranian adults","sample_n":811,"sample_text":"community sample","population":"community sample (Iranian adults, mean age 27.7, 43.4% male)","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 811 Iranian adults, researchers found that early maladaptive schemas were linked to stronger desire thinking, which in turn predicted higher craving and greater self‑reported problems with gambling, gaming, social media and pornography. The study shows these psychological factors are related across different excessive behaviours, but it cannot prove they cause each other.","clinical_takeaway":"The findings suggest that underlying maladaptive beliefs may fuel desire thoughts and cravings that contribute to problematic porn use, but clinical decisions need more causal evidence.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (N = 811)","Use of structural equation modelling with fit indices","Multiple problematic behaviours examined simultaneously","Acknowledges limits of cross‑sectional design"],"limitations":["No measurement of moral incongruence or other key confounds","Craving/desire‑thinking not matched to specific behaviour","Reliance on self‑report scales; unclear validation for all constructs","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2026.108869"}},{"id":179,"doi":"10.1097/md.0000000000048856","pmid":"42152382","pmcid":"PMC13183150","title":"Pornographic consumption in young adult men and its relationship with stress and dissociative symptoms: A cross-sectional STROBE design","authors":"Privara M, Bob P.","first_author":"Privara M","journal":"Medicine","year":2026,"pub_types":["research-article","Journal Article","Observational Study"],"keywords":["Stress","Dissociation","Anxiety","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13183150","cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1100 young adult men","sample_n":1100,"sample_text":"1100 adult young men, mean age 27.55","population":"young adult men (20‑35 years), N=1100","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1100 young men found moderate links between how much porn they use and higher stress, anxiety, and dissociative symptoms, but it did not examine moral beliefs or masturbatory habits that could affect these relationships.","clinical_takeaway":"Higher stress and anxiety may co‑occur with more porn use, but causality is unclear; assess broader mental‑health context.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (N≈1100)","Uses multiple validated symptom scales (stress, dissociation, anxiety)","Standard statistical tests reported"],"limitations":["Addiction scales likely circular and not psychometrically validated for this context","No measure of moral incongruence or masturbation, key confounds omitted","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":4,"design":6,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/md.0000000000048856"}},{"id":180,"doi":"10.22122/ahj.v13i4.299","pmid":"35178193","pmcid":"PMC8818307","title":"Psychometric Properties of the Youth Pornography Addiction Screening Tool","authors":"Zivari-Rahman M, Ghanbari S, Shokouhi-Moghadam S.","first_author":"Zivari-Rahman M","journal":"Addiction & health","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Addiction","Psychometric Properties","Cyberspace","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8818307","cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"descriptive‑exploratory psychometric validation with stratified random university sample (N=480); EFA and CFA used","sample_n":480,"sample_text":"stratified random sampling of university students","population":"students aged 18‑30 years, universities in Hamadan, Iran","country":"Iran","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a new questionnaire (YPAST) to assess youth pornography addiction, finding three factors—lack of control, regret, and sexual arousal—that explain most of the variance in responses.","clinical_takeaway":"The YPAST may be a reliable screening tool, but clinicians should note its definition of addiction relies on self‑reported regret and control, not on clinical criteria.","confidence":0.8,"topic_tags":["measurement","pornography","adolescents","sexual_function"],"strengths":["Large sample for psychometric work","Use of both EFA and CFA","Clear factor structure reported"],"limitations":["Addiction construct defined by distress items (circular)","No assessment of moral incongruence or other key confounds","Cross‑sectional, no criterion‑validity testing"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.22122/ahj.v13i4.299"}},{"id":181,"doi":"10.1016/j.jsxm.2022.05.144","pmid":"35753890","pmcid":null,"title":"Understanding Differences in Problematic Pornography Use: Considerations for Gender and Sexual Orientation","authors":"Borgogna NC, Griffin KR, Grubbs JB, Kraus SW.","first_author":"Borgogna NC","journal":"The journal of sexual medicine","year":2022,"pub_types":["Journal Article"],"keywords":["Measurement","Gender","Sexual Orientation","Compulsive Sexual Behavior Disorder","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional analysis of three large archival survey datasets (N≈1.4k–5.9k) examining measurement invariance of three Problematic Pornography Use scales across gender and sexual orientation groups.","sample_n":8850,"sample_text":"Combined N≈8,850 across three datasets (BPS N=1,439; PPUS N=5,859; CPUI‑4 N=893).","population":"Adults (heterosexual and non‑heterosexual men and women) from existing survey samples; not limited to treatment‑seeking groups.","country":"Not specified in abstract (likely USA/Canada based on authors’ affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study checked whether three popular questionnaires for problematic porn use work the same way for heterosexual and non‑heterosexual men and women. All three scales performed well overall, showing that sexual‑minority people tend to report higher problematic use, though patterns differ by scale and gender.","clinical_takeaway":"Clinicians can use the BPS, PPUS, or CPUI‑4 with diverse clients, but should consider gender, sexual orientation, and possible unmeasured confounds when interpreting scores.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender","measurement"],"strengths":["Large sample sizes across three independent datasets","Use of multiple established PPU instruments","Rigorous CFA and measurement‑invariance testing"],"limitations":["No assessment of key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)","Cross‑sectional design limits causal inference","Sexual‑minority groups aggregated broadly; non‑cisgender identities not examined"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2022.05.144"}},{"id":183,"doi":"10.1080/00224499.2017.1295013","pmid":"28287845","pmcid":null,"title":"Damaged Goods: Perception of Pornography Addiction as a Mediator Between Religiosity and Relationship Anxiety Surrounding Pornography Use","authors":"Leonhardt ND, Willoughby BJ, Young-Petersen B.","first_author":"Leonhardt ND","journal":"Journal of sex research","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 686 unmarried adults, structural equation modelling of self‑reported variables","sample_n":686,"sample_text":"unmarried adults recruited for an online questionnaire (details not provided in abstract)","population":"unmarried adults, mixed gender, age range not specified","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 686 unmarried adults, people who see themselves as addicted to porn feel more anxious about how porn might affect their romantic relationships. This feeling of addiction explains part of why religiosity is linked to that anxiety, more than the actual amount of porn use.","clinical_takeaway":"Clinicians should note that perceived porn addiction, not just use frequency, may drive relationship anxiety, especially for religious clients.","confidence":0.78,"topic_tags":["pornography","religiosity","relationships","sexual_function","moral_incongruence"],"strengths":["Large sample size (N=686)","Use of structural equation modelling to test mediation","Addresses an understudied link between religiosity and relationship anxiety"],"limitations":["Perceived addiction measured by unvalidated single‑item","No control for moral incongruence, masturbation, mental health, or relationship variables","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1295013"}},{"id":184,"doi":"10.1080/19317611.2023.2257688","pmid":"38601807","pmcid":"PMC10903587","title":"Moderating Role of Sexual Attitudes in the Association between Online Sexual Activity and Problematic Pornography Use: Evidence from the Chinese Community and Help-Seeking Men","authors":"Chen L, Wang D, Wang H, Zhang Y, Jiang X.","first_author":"Chen L","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Attitudes","Problematic Pornography Use (Ppu)","Online Sexual Activity (Osa)","Conservative Cultural Context"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two large Chinese male samples (community N=525; help‑seeking N=578) completed self‑report questionnaires on online sexual activity, sexual attitudes and problematic pornography use. Moderation analyses examined interaction effects.","sample_n":1103,"sample_text":"N1=525 community; N2=578 help‑seeking men, total 1103 participants.","population":"Chinese adult men (community and help‑seeking)","country":"China","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In Chinese men, holding conservative sexual attitudes makes the link between online sexual activity and self‑reported problematic pornography use stronger, while more permissive attitudes weaken the link.","clinical_takeaway":"Clinicians should consider a client’s sexual attitudes when evaluating concerns about pornography use; moral conflict may heighten perceived problems.","confidence":0.75,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample sizes in both community and help‑seeking groups","Focus on cultural context (conservative attitudes)","Statistical moderation analysis"],"limitations":["Cross‑sectional; no causal inference","Masturbation not measured separately from pornography use","Potential self‑report bias, no mental‑health covariates"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":4,"design":5,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2023.2257688"}},{"id":185,"doi":"10.1007/s40429-022-00408-9","pmid":"35433194","pmcid":"PMC8990487","title":"Problematic Pornography Use in China","authors":"Chen L.","first_author":"Chen L.","journal":"Current addiction reports","year":2022,"pub_types":["review-article","Review","Journal Article"],"keywords":["Attitude Toward Pornography","Permissive Cultural Context","Problematic Pornography Use (Ppu)","Sexual Conservative Cultural Context"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8990487","cited_by_count":17,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods; no empirical data presented.","sample_n":null,"sample_text":"Not applicable – review article.","population":"China (general population context, no specific sample)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This 2022 narrative review outlines pornography use motivations, prevalence estimates, and available screening tools in China, noting that conservative cultural attitudes may shape problematic use and that treatment services are limited.","clinical_takeaway":"Clinicians should be aware that reported prevalence of problematic pornography use in China may be high, but evidence is based on varied assessments and limited treatment options.","confidence":0.7,"topic_tags":["pornography","csbd"],"strengths":["Summarises existing Chinese literature on pornography use.","Notes validation of several screening scales in Chinese samples."],"limitations":["Narrative, not systematic; no explicit search strategy.","No new empirical data; conclusions rely on heterogeneous sources.","No assessment of key confounds such as moral incongruence or mental health."],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40429-022-00408-9"}},{"id":186,"doi":"10.1007/s10508-025-03269-1","pmid":"40975723","pmcid":null,"title":"The Dependency-Resentment Hypothesis of Men's Problematic Pornography Use and Hostile Attitudes Toward Women","authors":"Wright PJ, Dajches L, Terán L, Tokunaga RS.","first_author":"Wright PJ","journal":"Archives of sexual behavior","year":2025,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03269-1"}},{"id":187,"doi":"10.1080/00224499.2020.1815637","pmid":"32902343","pmcid":null,"title":"Theoretical Antecedents of Male Adolescents' Problematic Pornography Use: A Longitudinal Assessment","authors":"Rousseau A, Bőthe B, Štulhofer A.","first_author":"Rousseau A","journal":"Journal of sex research","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"panel longitudinal study of 337 Croatian male adolescents (age ~16) with three‑year follow‑up, latent growth curve modelling of pornography use frequency, problematic use, impulsivity, depression/anxiety and religiosity.","sample_n":337,"sample_text":"337 Croatian adolescent boys (mean age 15.9 years, SD 0.52)","population":"adolescent males","country":"Croatia","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A three‑year study of 337 teenage boys in Croatia found that more frequent porn watching predicts higher problematic porn use later, and that higher impulsivity and negative emotions also lead to later problems, especially among more religious teens.","clinical_takeaway":"Frequent porn use and emotional distress in adolescents are risk factors for later problematic use; clinicians should consider impulsivity, mood and religious context in assessment.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","moral_incongruence"],"strengths":["Large longitudinal panel with three‑year follow‑up","Latent growth curve modelling captures change over time","Includes multiple theoretically relevant predictors"],"limitations":["Moral incongruence not directly measured; religiosity used as proxy","Masturbation not assessed separately from pornography use","Sample limited to Croatian males, may limit generalisability"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2020.1815637"}},{"id":188,"doi":"10.1007/s10508-020-01858-w","pmid":"33403533","pmcid":"PMC7889567","title":"The Pornography \"Rebooting\" Experience: A Qualitative Analysis of Abstinence Journals on an Online Pornography Abstinence Forum","authors":"Fernandez DP, Kuss DJ, Griffiths MD.","first_author":"Fernandez DP","journal":"Archives of sexual behavior","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Addiction","Sexual dysfunction","Abstinence","Pornography","Pornhub","“Rebooting”"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-020-01858-w.pdf","cited_by_count":23,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative thematic analysis of 104 abstinence journal entries from an online pornography‑abstinence forum.","sample_n":104,"sample_text":"104 abstinence journals (male forum members).","population":"Male members of a self‑selected “rebooting” forum (n≈104 journal entries).","country":"Not reported","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers examined 104 journal posts from men who stopped watching pornography on an online “reboot” forum. Participants described why they quit, the difficulties they faced, strategies that helped them, and perceived benefits such as improved sexual function. The study suggests abstinence may help people who feel pornography is a problem, but notes more rigorous research is needed.","clinical_takeaway":"Self‑reported benefits of pornography abstinence are described, but due to methodological limits clinicians should treat these findings as exploratory rather than evidence‑based guidance.","confidence":0.65,"topic_tags":["pornography","religiosity","sexual_function","moral_incongruence"],"strengths":["Large number of first‑person journal entries (n=104).","Systematic thematic analysis provides rich phenomenological insight.","Highlights participants’ perceived benefits and challenges of abstinence."],"limitations":["Self‑selected, treatment‑seeking forum sample limits generalisability.","No validated measures of addiction, masturbation, mental health, or moral incongruence.","Absence of comparison or control group; causality cannot be inferred."],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":62,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01858-w"}},{"id":189,"doi":"10.1007/s10508-026-03462-w","pmid":"42286333","pmcid":"PMC13427987","title":"Compulsive Sexual Behaviors, Pornography Consumption, and Co-Occurring Disorders Among College Students","authors":"Moon EJ, Garos S, Kraus SW, Borgogna NC.","first_author":"Moon EJ","journal":"Archives of sexual behavior","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Depression","Compulsive Sexual Behaviors","Alcohol Use Problems","Pornography Consumption"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13427987","cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 1126 college students","sample_n":1126,"sample_text":"Anonymous online survey of college students","population":"college students (77% women, 23% men)","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 1,100 college students, men reported higher rates of problematic porn use and related sexual‑behavior issues, especially when also dealing with depression or alcohol problems. Women showed a link between depression and porn use.","clinical_takeaway":"Screen for depression and alcohol problems when assessing students with compulsive sexual behaviours; consider gender differences.","confidence":0.78,"topic_tags":["pornography","csbd","sexual_function","moral_incongruence"],"strengths":["large sample size for a student survey","gender‑balanced analysis","use of logistic regression with odds ratios"],"limitations":["cross‑sectional design limits causal inference","no measurement of moral incongruence or masturbation","reliance on self‑report scales of uncertain validation"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03462-w"}},{"id":190,"doi":"10.1016/j.addbeh.2026.108669","pmid":"41895073","pmcid":null,"title":"Religion, morals, and pornography: risk or resource? A U.S. census-matched study","authors":"Engelhardt R, Desbuleux JFM, Maes J, Grubbs JB, Bőthe B, Kraus SW.","first_author":"Engelhardt R","journal":"Addictive behaviors","year":2026,"pub_types":["Journal Article"],"keywords":["Religion","Suicide","Life Satisfaction","Religious","Pornography","Problematic Pornography Use","Moral Incongruence","Moral Disapproval"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"census‑matched U.S. adult sample (n=2,806); correlations, group comparisons, hierarchical regressions","sample_n":2806,"sample_text":"census‑matched sample of U.S. adults","population":"U.S. adults, inclusive of pornography abstainers","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a US‑wide, census‑matched sample, the study found that religious identity and moral disapproval of porn were linked to higher life satisfaction and lower suicidality, while problematic porn use and higher porn frequency were linked to poorer outcomes.","clinical_takeaway":"Religious and moral beliefs may protect mental health, but problematic porn use still predicts lower well‑being.","confidence":0.85,"topic_tags":["religiosity","moral_incongruence","pornography","sexual_function"],"strengths":["Large, nationally representative sample","Includes pornography abstainers, reducing selection bias","Measures moral disapproval explicitly"],"limitations":["Cross‑sectional; cannot infer causality","Masturbation not measured or separated from pornography use","Potentially limited validation details for PPU scale"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2026.108669"}},{"id":191,"doi":"10.1556/2006.2022.00065","pmid":"36067020","pmcid":"PMC9872529","title":"Symptoms of problematic pornography use among help-seeking male adolescents: Latent profile and network analysis","authors":"Jiang X, Wu Y, Zhang K, Bőthe B, Hong Y, Chen L.","first_author":"Jiang X","journal":"Journal of behavioral addictions","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Network Analysis","Impaired Control","Problematic Pornography Use","Moral Incongruence"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/11/3/article-p912.pdf","cited_by_count":20,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 3,468 help‑seeking male adolescents","sample_n":3468,"sample_text":"Help‑seeking male adolescents recruited via clinical/ counseling services (convenience sample)","population":"male adolescents (mean age 16.6) seeking help for pornography‑related distress, China","country":"China","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Chinese teenage boys who sought help for porn‑related distress, three groups were identified: those who simply feel it is a problem, those with impaired control, and those with broader problematic use. Frequency of online sexual activity distinguished the first group, while negative consequences marked the others.","clinical_takeaway":"Clinicians should assess both usage frequency and distress, recognizing distinct sub‑profiles among adolescents with porn‑related concerns.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","moral_incongruence"],"strengths":["Large sample size for latent‑profile analysis","Use of several validated self‑report scales","Inclusion of moral‑disapproval measure"],"limitations":["Help‑seeking convenience sample limits generalisability","Masturbation not measured separately from pornography use","No pre‑registration or reporting of effect‑size precision"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":29,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00065"}},{"id":192,"doi":"10.1556/2006.2021.00070","pmid":"34727088","pmcid":"PMC8987418","title":"Hands-off: Feasibility and preliminary results of a two-armed randomized controlled trial of a web-based self-help tool to reduce problematic pornography use","authors":"Bőthe B, Baumgartner C, Schaub MP, Demetrovics Z, Orosz G.","first_author":"Bőthe B","journal":"Journal of behavioral addictions","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Feasibility","Compulsive Sexual Behavior","Cognitive-behavioral Therapy","Online Intervention","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8987418","cited_by_count":26,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"two‑armed parallel RCT; 264 recruited, high differential dropout (intervention 89.4%, control 44.7%); outcomes self‑report at 6 weeks","sample_n":264,"sample_text":"264 recruited; 123 intervention, 141 wait‑list; 34.5 % follow‑up overall","population":"adults (mean age 33.2), mostly men, self‑identified problematic pornography users","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["no_mi_control","circular_addiction_scale","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A six‑week online self‑help program was tested in a randomised trial with 264 adults who said they had trouble with pornography. At the end, the group using the program reported less pornography use, lower craving and less perceived addiction than a wait‑list group, but many dropped out and the study relied on self‑reports.","clinical_takeaway":"Preliminary evidence suggests brief online CBT‑type tools may reduce self‑reported problematic pornography use, but high attrition and lack of control for moral or mental‑health factors limit confidence.","confidence":0.78,"topic_tags":["pornography","sexual_function","treatment","csbd"],"strengths":["Randomised controlled design","Large initial recruitment for feasibility study","Effect sizes reported for multiple outcomes"],"limitations":["Very high dropout, especially in intervention arm","Reliance on self‑report scales, unclear validation","No measurement/control of key confounds (moral incongruence, masturbation, mental health)","Self‑perceived addiction measured circularly"],"rubric_version":"2.0","raw_total":27,"max_possible":60,"pct_score":45,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":2,"mentioning":65,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2021.00070"}},{"id":194,"doi":"10.3389/fpsyg.2021.638354","pmid":"33935889","pmcid":"PMC8085335","title":"Problematic Pornography Use in Japan: A Preliminary Study Among University Students","authors":"Okabe Y, Takahashi F, Ito D.","first_author":"Okabe Y","journal":"Frontiers in psychology","year":2021,"pub_types":["brief-report","Journal Article"],"keywords":["Depression","Anxiety","Japan","Effortful Control","university students","Sexual Compulsivity","Addictive Behavior","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyg.2021.638354/pdf","cited_by_count":12,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey of 150 Japanese university students (ages 20‑26) examining pornography use, impaired control, sexual compulsivity, depression, anxiety and effortful control.","sample_n":150,"sample_text":"150 college students (86 men, 64 women) from a single midland Japan university","population":"University students (convenience sample)","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 150 Japanese university students, about 6 % reported trouble controlling pornography use. Those who struggled also showed higher depression, anxiety, and sexual compulsivity, and lower effortful control.","clinical_takeaway":"Clinicians should assess mental‑health symptoms when patients report difficulty controlling pornography use, but evidence for a distinct addiction is limited.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["First empirical data on problematic pornography use in Japan","Measures a range of mental‑health variables","Relatively large total sample for a preliminary study"],"limitations":["Convenience, single‑university sample limits generalisability","Small subgroup with impaired control (≈5 % of sample) reduces statistical power","Masturbation and moral/religious factors not assessed","Reliance on self‑report; unclear validation of impaired‑control items"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2021.638354"}},{"id":195,"doi":"10.1371/journal.pone.0347631","pmid":"42329982","pmcid":"PMC13286139","title":"Pornography consumption among medical students in Syria: Prevalence, patterns, and predictors","authors":"Al-Bitar A, Al-Masalma D, Adi M, Haydar T.","first_author":"Al-Bitar A","journal":"PloS one","year":2026,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13286139","cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of Syrian medical students (N=960)","sample_n":960,"sample_text":"960 participants recruited via university channels and social media","population":"medical students in Syria","country":"Syria","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 960 Syrian medical students found that about three‑quarters had ever seen pornography, with nearly half using it currently. Around 12% described themselves as addicted, and many reported withdrawal‑like symptoms. Early exposure and higher family income predicted use.","clinical_takeaway":"Self‑reported addiction may reflect distress rather than clinical disorder; clinicians should assess underlying factors before labeling pornography use as pathological.","confidence":0.8,"topic_tags":["pornography","prevalence","sexual_function"],"strengths":["Large sample for a regional study","Use of a previously validated questionnaire","Provides prevalence data from an understudied context"],"limitations":["Cross‑sectional design limits causal inference","Self‑perceived addiction measured by single item","Key confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0347631"}},{"id":196,"doi":"10.1186/s40359-025-02624-0","pmid":"40200245","pmcid":"PMC11978135","title":"Sex differences in problematic pornography use among adolescents: a network analysis","authors":"Villena-Moya A, Potenza MN, Granero R, Paiva Ú, Arrondo G, Chiclana-Actis C, Fernández-Aranda F, Jiménez-Murcia S, Normand E, Ballester L, Mestre-Bach G.","first_author":"Villena-Moya A","journal":"BMC psychology","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sex","Trauma","Adolescents","Pornography","Sexually Explicit Materials","Addictive Behaviors","Compulsive Behaviors","Impulsive Behaviors","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11978135","cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional network analysis of 650 Spanish adolescents","sample_n":650,"sample_text":"Spanish adolescent sample (presumably school‑based convenience sample)","population":"adolescents (N=650) from Spain","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 650 Spanish teens, boys reported more frequent pornography use and higher problematic use than girls. For boys, sexual pleasure was a central factor; for girls, loneliness and online victimisation were key. The study maps how these factors interrelate differently by sex.","clinical_takeaway":"Gender‑specific risk factors (e.g., loneliness for girls, sexual pleasure focus for boys) should inform prevention programmes for adolescent pornography use.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","gender"],"strengths":["large sample (N=650)","novel network‑analysis approach","sex‑specific findings"],"limitations":["cross‑sectional, no causal inference","no measurement/control of moral incongruence or masturbation","PPU likely measured with unvalidated or self‑label scales"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":8,"citing_publications":14,"retracted":false,"notices":[{"status":"Has correction","date":"2025-5-20","noticeDoi":"10.1186/s40359-025-02878-8","doi":"10.1186/s40359-025-02624-0"}],"url":"https://scite.ai/reports/10.1186/s40359-025-02624-0"}},{"id":197,"doi":"10.1101/2025.04.01.25324943","pmid":null,"pmcid":null,"title":"Sexually Explicit and Violent Media Use among High School Students in Vietnam: Gender-Differentiated Links with Sexual Misconduct Victimization, Perpetration, and Health","authors":"Yount KM, Macaulay M, Tran KT.","first_author":"Yount KM","journal":"medRxiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 712 high‑school students in Ho Chi Minh City (eleventh/twelfth grade) examining self‑reported use of sexually explicit or violent media and associations with health, alcohol use, and sexual misconduct outcomes using unadjusted and adjusted regression models.","sample_n":712,"sample_text":"Three high schools in Ho Chi Minh City, Vietnam; convenience sample of 11th‑ and 12th‑grade students.","population":"Eleventh and twelfth‑grade students (N = 712) from three high schools in Ho Chi Minh City, Vietnam.","country":"Vietnam","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of Vietnamese high‑school students found that many use sexually explicit or violent media, and that such use is linked with poorer self‑rated health, higher alcohol use, and increased sexual misconduct, especially among boys.","clinical_takeaway":"Clinicians should be aware that high‑frequency exposure to sexualized media may co‑occur with health risks in adolescents, but causal claims are not established.","confidence":0.7,"topic_tags":["sexual_function","gender","adolescents"],"strengths":["Large sample for a school‑based survey in a low‑income setting","Separate analysis by gender","Adjusted regression models for several covariates"],"limitations":["Cross‑sectional design limits causal inference","Key constructs (SEM/SVM use, moral incongruence) measured with unvalidated self‑reports","Moral incongruence not assessed despite being central to theoretical explanation"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2025.04.01.25324943"}},{"id":198,"doi":"10.1186/s40359-025-02878-8","pmid":"40394716","pmcid":"PMC12090645","title":"Correction: Sex differences in problematic pornography use among adolescents: a network analysis","authors":"Villena-Moya A, Potenza MN, Granero R, Paiva Ú, Arrondo G, Chiclana-Actis C, Fernández-Aranda F, Jiménez-Murcia S, Normand E, Ballester L, Mestre-Bach G.","first_author":"Villena-Moya A","journal":"BMC psychology","year":2025,"pub_types":["Published Erratum","correction"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12090645","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s40359-025-02878-8"}},{"id":199,"doi":"10.3390/ijerph192114336","pmid":"36361229","pmcid":"PMC9654840","title":"Understanding Serial Mediators of Problematic Pornography Use in Pakistani Men and Women","authors":"Bibi K, Fatima A, Amin R, Rowland DL.","first_author":"Bibi K","journal":"International journal of environmental research and public health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Craving","Predisposing factors","Addiction","Coping","Inhibitory Control","Developing Nations","Mediating Factors","Pornography Use"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/21/14336/pdf?version=1667395301","cited_by_count":9,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 280 Pakistani adults recruited via social media; structural equation modelling of self‑reported variables","sample_n":280,"sample_text":"Convenience sample recruited through Facebook, Instagram, LinkedIn, WhatsApp groups","population":"Pakistani men and women, current pornography users, mean age 25.4 (SD 5.27), N=280","country":"Pakistan","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 280 Pakistani adults who use pornography online, depression, anxiety and low self‑esteem were linked to higher self‑reported problematic use, and this relationship was mediated by craving, poor inhibitory control, and dysfunctional sexual coping.","clinical_takeaway":"Addressing craving and coping skills may help users who feel their pornography use is problematic.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence","masturbation"],"strengths":["Adequate sample size for SEM","Inclusion of multiple psychological predictors","Use of mediation model to explore pathways"],"limitations":["Cross‑sectional design limits causal inference","Problematic use measured with likely unvalidated self‑label","No assessment of moral incongruence or masturbation","Convenience sample may not represent general population"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph192114336"}},{"id":200,"doi":"10.3390/ijerph192215221","pmid":"36429937","pmcid":"PMC9691194","title":"Investigating the Associations of ADHD Symptoms, Impulsivity, Physical Exercise, and Problematic Pornography Use in a Chinese Sample","authors":"Zhang Y, Chen L, Jiang X, Bőthe B.","first_author":"Zhang Y","journal":"International journal of environmental research and public health","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Impulsivity","Physical Exercise","Attention-deficit/hyperactivity Disorder (Adhd)","Problematic Pornography Use (Ppu)","Latent Moderated Structural Equations (Lms)"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/22/15221/pdf?version=1668750125","cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey (N=600) of Chinese adults; convenience sampling","sample_n":600,"sample_text":"online convenience sample","population":"Chinese adults (average age 32.3, 39.8% women)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 600 Chinese adults, higher ADHD symptoms were linked to more problematic pornography use, and this link was partly explained by impulsivity. Regular physical exercise reduced ADHD, impulsivity, and pornography‑related problems, and it weakened the impulsivity‑pornography relationship.","clinical_takeaway":"Encouraging regular exercise may help those with ADHD‑related impulsivity who experience problematic pornography use.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["large sample (N=600)","uses latent moderated structural equation modeling","addresses a novel moderator (physical exercise)"],"limitations":["cross‑sectional, cannot infer causality","no measurement of key confounds (moral incongruence, masturbation, mental health)","unclear whether PPU scale is validated"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph192215221"}},{"id":201,"doi":"10.1016/j.compbiomed.2020.103970","pmid":"32892114","pmcid":null,"title":"Profiling of pornography addiction among children using EEG signals: A systematic literature review","authors":"Kang X, Handayani DOD, Chong PP, Acharya UR.","first_author":"Kang X","journal":"Computers in biology and medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":["EEG","Addiction","Systematic Literature Review","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic literature review of studies linking EEG signals to pornography addiction in children; no meta‑analysis or risk‑of‑bias assessment reported.","sample_n":null,"sample_text":"Selected 46 studies from 815,554 screened records.","population":"children (unspecified age range), studies using EEG to assess pornography use/addiction","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The review examined 46 studies and suggests that EEG patterns could potentially identify children who are addicted to pornography, but it does not provide strong evidence or clarify how addiction was measured.","clinical_takeaway":"None – the review does not give actionable clinical guidance.","confidence":0.6,"topic_tags":["pornography"],"strengths":["Comprehensive database search","Large number of screened records","Focus on EEG as objective marker"],"limitations":["No quantitative synthesis or risk‑of‑bias assessment","Unclear how addiction was defined in primary studies","No control for moral incongruence or other confounds"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.compbiomed.2020.103970"}},{"id":202,"doi":"10.1080/0092623x.2026.2643733","pmid":"41863435","pmcid":null,"title":"The Association Between Pornography Use and Interpersonal Online Sexual Activity: A Three-Level Meta-Analysis","authors":"Zhang X, Jin Z, Zheng L.","first_author":"Zhang X","journal":"Journal of sex & marital therapy","year":2026,"pub_types":["Meta-Analysis","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"random-effects meta-analysis of 40 studies (144 effect sizes, 103,452 participants)","sample_n":103452,"sample_text":"aggregate across 40 primary studies","population":"Adults from general population studies included in the primary literature","country":"multiple (international)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Across 40 studies, people who watch pornography are moderately more likely to engage in online sexual activities like chatting, partner‑seeking, or sharing sexual content (r≈.37). The link is stronger when both behaviors are measured with detailed scales and for non‑violent online activities.","clinical_takeaway":"Higher pornography use is associated with more online sexual activity, but this does not imply pathology; clinicians should assess motives and context rather than assume harm.","confidence":0.8,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Large combined sample size","Effect sizes reported with confidence intervals","Explores moderators (activity type, measurement method)"],"limitations":["Primary studies' construct validity varies; some use single‑item measures","No assessment of moral, mental‑health or relational confounds","No pre‑registration of the meta‑analytic protocol"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2026.2643733"}},{"id":203,"doi":"10.31083/ap47250","pmid":"42110909","pmcid":"PMC13156053","title":"Problematic Digital Behaviors, Procrastination, and Psychological Well-Being: An Integrative Explanatory Model of Happiness in Young Adults","authors":"Carrasco-Reig M, López-Palanca I, Martí-Vilar M, González-Sala F, Esparza-Reig J.","first_author":"Carrasco-Reig M","journal":"Alpha psychiatry","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Models","Behavior","Sexual behaviour","Psychological Well-being","Procrastination","Happiness","Internet Use","Addictive","Theoretical"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13156053","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey, N=763, path analysis","sample_n":763,"sample_text":"young adults, convenience online sample","population":"young adults 18‑30, majority women, recruited online","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 763 young adults, higher levels of problematic internet use were linked to more frequent problematic pornography use, gaming, and compulsive buying, which were all associated with lower psychological well‑being and happiness. Procrastination partly explained these relationships.","clinical_takeaway":"Higher problematic digital use, including pornography, may relate to lower well‑being; clinicians should consider self‑regulation strategies, but causal claims are unsupported.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a survey","Comprehensive model linking multiple digital behaviors to well‑being","Use of path analysis to test mediation"],"limitations":["Cross‑sectional design limits causal inference","No measurement or control of key confounds (moral incongruence, masturbation, mental health)","Unclear whether pornography measure is validated"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31083/ap47250"}},{"id":204,"doi":"10.1017/s1092852920001686","pmid":"32690117","pmcid":null,"title":"Exploring the clinical profile of problematic pornography use","authors":"Ince C, Yücel M, Albertella L, Fontenelle LF.","first_author":"Ince C","journal":"CNS spectrums","year":2020,"pub_types":["Journal Article"],"keywords":["Sexual dysfunction","Compulsive Sexual Behavior","Icd-11","Behavioral Addiction","Pornography","Pornography Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 138 men recruited from online recovery forums and MTurk; multiple regression analysis.","sample_n":138,"sample_text":"138 male PPUs recruited via online recovery communities and Amazon Mechanical Turk.","population":"Male participants self‑identified as problematically using pornography (mean age 31.75).","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"supports","citation_value":"useful","plain_summary":"A survey of 138 men who consider their porn use problematic found that higher use, signs of tolerance, and greater sexual excitement from porn were linked to more severe self‑reported problems, while sexual difficulties with partners were common but not predictive.","clinical_takeaway":"High porn use and tolerance may signal distress, but clinicians should assess partner sexual function and moral concerns separately.","confidence":0.7,"topic_tags":["pornography","sexual_function","masturbation","moral_incongruence"],"strengths":["Use of several validated psychometric scales","Multivariate regression to examine unique predictors","Inclusion of both forum‑recruited and MTurk participants"],"limitations":["Convenience sample with self‑selection bias","No measurement of moral incongruence or masturbation separate from porn use","Cross‑sectional design cannot establish causality","Addiction terminology based on scale scores, not full criteria"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":3,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":16,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852920001686"}},{"id":206,"doi":"10.1177/0163278719861688","pmid":"31284745","pmcid":null,"title":"Psychometric Instruments for Problematic Pornography Use: A Systematic Review","authors":"Fernandez DP, Griffiths MD.","first_author":"Fernandez DP","journal":"Evaluation & the health professions","year":2021,"pub_types":["Systematic Review","Journal Article"],"keywords":["Sex Addiction","Pornography","Pornography Addiction","Problematic Pornography Use","Pornography Psychometrics"],"is_oa":false,"oa_url":null,"cited_by_count":57,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 22 psychometric tools for problematic pornography use, summarising characteristics, psychometric properties and theoretical bases.","sample_n":null,"sample_text":"N/A – review of existing measures rather than original participants","population":"Not applicable (review of instruments)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review lists and evaluates 22 questionnaires that aim to measure problematic pornography use, describing how each was developed, its reliability, and whether it treats the behavior as an addiction.","clinical_takeaway":"Clinicians should choose assessment tools that separate frequency from distress and have strong validation evidence.","confidence":0.7,"topic_tags":["pornography","measurement","sexual_function"],"strengths":["Comprehensive identification of 22 instruments","Systematic methodology described","Comparison of theoretical conceptualisations","Discussion of clinical implications"],"limitations":["No meta‑analytic synthesis of psychometric data","Limited assessment of how instruments handle key confounds","Potential bias from inclusion criteria not detailed in abstract"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":6,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":91,"citing_publications":131,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0163278719861688"}},{"id":207,"doi":"10.1080/00224499.2023.2245399","pmid":"37676791","pmcid":null,"title":"Compulsive Sexual Behavior Disorder and Problematic Pornography Use in Cisgender Sexual Minority Individuals: The Associations with Minority Stress, Social Support, and Sexualized Drug Use","authors":"Lewczuk K, Wizła M, Glica A, Dwulit AD.","first_author":"Lewczuk K","journal":"Journal of sex research","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of cisgender sexual minority participants (n=198) assessing CSBD and problematic pornography use with linear regression analyses","sample_n":198,"sample_text":"online convenience sample","population":"cisgender sexual minority adults (72.7% men, 27.3% women), mean age 27.1","country":"Poland (inferred from author names, not specified)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 198 cisgender sexual‑minority adults, higher discrimination and sexualized drug use were linked to more severe compulsive sexual behavior symptoms, while greater social support was linked to fewer symptoms. Internalized stigma predicted greater problematic pornography use.","clinical_takeaway":"Therapists should consider minority‑stress factors and social support when addressing CSBD symptoms in sexual‑minority clients.","confidence":0.7,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Reasonable sample size for survey work","Focus on understudied sexual‑minority population","Uses multiple minority‑stress variables"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral incongruence or masturbation","Unclear whether CSBD/PPU scales are fully validated"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2245399"}},{"id":208,"doi":"10.1007/s10508-024-03055-5","pmid":"39718733","pmcid":null,"title":"Pornography Use, Moral Incongruence, Psychological Distress, and Sexual Satisfaction","authors":"Wright PJ, Tokunaga RS, Herbenick D.","first_author":"Wright PJ","journal":"Archives of sexual behavior","year":2025,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-03055-5"}},{"id":209,"doi":"10.1037/adb0000722","pmid":"33829815","pmcid":null,"title":"Validity and reliability of the short version of the Problematic Pornography Consumption Scale (PPCS-6-A) in adolescents","authors":"Bőthe B, Vaillancourt-Morel MP, Dion J, Štulhofer A, Bergeron S.","first_author":"Bőthe B","journal":"Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors","year":2021,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a short problematic pornography consumption scale in a large community adolescent sample (N=802) using CFA, invariance testing, and latent profile analysis","sample_n":802,"sample_text":"802 adolescents from a longitudinal sexual‑health cohort","population":"Adolescents (mean age 15.4, 35% girls, 14% sexual minority)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors tested a brief 6‑item questionnaire for identifying problematic porn use in a large group of teens. The tool showed good reliability and worked similarly for boys, girls, and sexual‑minority youths, and it linked reasonably with how often they masturbated.","clinical_takeaway":"The PPCS‑6‑A appears to be a reliable brief screen for risky porn use in adolescents, but clinicians should also consider moral and mental‑health factors not captured by the scale.","confidence":0.7,"topic_tags":["pornography","adolescents","measurement","sexual_function"],"strengths":["Large, diverse adolescent sample","Comprehensive psychometric testing (CFA, invariance, reliability)","Includes relevant correlate (masturbation) to test convergent validity"],"limitations":["No assessment of moral incongruence or mental‑health covariates","Cross‑sectional; cannot address temporal stability","Scale's item content not described; possible reliance on distress‑based items"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":1,"mentioning":28,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/adb0000722"}},{"id":210,"doi":"10.3389/fpsyt.2022.914919","pmid":"36081467","pmcid":"PMC9447492","title":"Present hedonism and future time perspectives predicting hypersexuality and problematic pornography use","authors":"Koós M, Orosz G, Demetrovics Z, Bőthe B.","first_author":"Koós M","journal":"Frontiers in psychiatry","year":2022,"pub_types":["brief-report","Journal Article"],"keywords":["Hypersexual Behavior","Time Perspective","Compulsive Sexual Behavior Disorder","Problematic Pornography Use","Out-Of-Control Sexual Behaviors"],"is_oa":true,"oa_url":"https://doi.org/10.3389/fpsyt.2022.914919","cited_by_count":2,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey with two independent large samples (N≈550 and N≈450) examining associations between time‑perspective dimensions and self‑reported hypersexuality and problematic pornography use using structural equation modelling.","sample_n":1007,"sample_text":"Two independent samples of 554 and 453 participants completed self‑report measures.","population":"adult participants responding to an online questionnaire (sampling method not specified; likely convenience).","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that people who focus on present pleasure tend to report higher levels of hypersexuality and problematic porn use, while those who think more about the future report lower levels. Gender made little difference.","clinical_takeaway":"Impulsivity‑focused interventions (e.g., promoting future‑oriented thinking) may help reduce hypersexuality and problematic porn use.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample sizes increase statistical power.","Use of structural equation modelling to test theory‑driven pathways.","Replication across two independent samples."],"limitations":["Cross‑sectional design prevents causal inference.","No measurement or control of key confounds (moral incongruence, masturbation, mental health).","Unclear which hypersexuality/PPU scales were used; possible circularity."],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2022.914919"}},{"id":211,"doi":"10.1007/s10508-024-02966-7","pmid":"39134735","pmcid":null,"title":"Labels Are For Soup Cans: How Self-Labeling as \"Addicted\" to Pornography Is Associated with Negative Outcomes","authors":"Dover CR, Leonhardt ND, Edwards MH.","first_author":"Dover CR","journal":"Archives of sexual behavior","year":2024,"pub_types":["Journal Article"],"keywords":["Romantic Relationships","Compulsivity","Pornography Addiction","Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey with structural equation modeling (N=1099)","sample_n":1099,"sample_text":"1099 participants (52% male)","population":"adults (male and female) recruited online","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"People who call themselves \"addicted\" to porn report more depression, suicidal thoughts, and relationship problems, even when they actually use porn at similar levels to others. The label itself may create stigma that harms wellbeing and relationships.","clinical_takeaway":"Self‑identifying as porn‑addicted is linked to distress; clinicians should assess stigma and label effects, not assume pathological use.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size","Use of structural equation modelling","Considers label effects beyond behavior"],"limitations":["Cross‑sectional; cannot infer causality","Self‑label measure is circular","Key confounds (moral incongruence, masturbation) not assessed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02966-7"}},{"id":212,"doi":"10.1007/s10508-020-01860-2","pmid":"33469812","pmcid":null,"title":"Sex and Its Discontents: How Moral Incongruence Connects Same-Sex and Non-Marital Sexual Activity with Unhappiness","authors":"Perry SL, Grubbs JB, McElroy EE.","first_author":"Perry SL","journal":"Archives of sexual behavior","year":2021,"pub_types":["Journal Article"],"keywords":["Homosexuality","Happiness","Pornography","Moral Incongruence","Non-marital Sex"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large nationally representative probability sample (General Social Survey) with cross‑sectional analyses","sample_n":25647,"sample_text":"General Social Survey respondents (men n≈6,590; women n≈7,047 for one wave; men n≈3,558; women n≈4,841 for another)","population":"US adults, men and women, surveyed 1988‑2018 (n≈13,600 men; n≈11,900 women)","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People who act against their own moral beliefs about sex—like men having same‑sex sex they consider always wrong, or women having non‑marital sex they view as always wrong—are more likely to report being unhappy. The behavior itself isn’t linked to unhappiness; the conflict with personal morals is.","clinical_takeaway":"Screen for moral conflict about sexual behavior when addressing client unhappiness; the behavior itself may not be the issue.","confidence":0.8,"topic_tags":["moral_incongruence","sexual_function"],"strengths":["Large, nationally representative sample","Clear operationalisation of moral incongruence","Gender‑specific analyses","Adds novel extension beyond pornography"],"limitations":["Cross‑sectional; no causal inference","Potential unmeasured mental‑health confounds","Single‑item measures of happiness","No control for relationship status beyond marital category"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01860-2"}},{"id":213,"doi":"10.1007/s10508-022-02358-9","pmid":"35896936","pmcid":"PMC9328619","title":"The Relation of Sexual Attitudes to Hypersexuality and Problematic Pornography Use","authors":"Lewczuk K, Wizła M, Gola M.","first_author":"Lewczuk K","journal":"Archives of sexual behavior","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Compulsive Sexual Behavior","Hypersexuality","Sexual Attitudes","Pornography","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9328619","cited_by_count":10,"is_preprint":false,"topics":["csbd","pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire; representative Polish adult sample (n=1036); regression analyses","sample_n":1036,"sample_text":"representative community sample","population":"Polish adults, 18+, both sexes","country":"Poland","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a national Polish survey of over 1,000 adults, more permissive sexual attitudes predicted higher scores on hypersexuality and problematic pornography use, even after accounting for age, sex, relationship status, and religiosity.","clinical_takeaway":"Clinicians should consider patients’ sexual attitudes, not just religiosity, when evaluating problematic sexual behavior, but beware of over‑relying on screening cut‑offs.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Validated screening instruments for HD and PPU","Comprehensive assessment of sexual attitudes","Controls for key demographic and religiosity variables"],"limitations":["Cross‑sectional design limits causal inference","Masturbation and mental‑health covariates not measured","Reliance on cutoff scores may over‑pathologize normative behavior","No pre‑registration or confidence intervals reported"],"rubric_version":"2.0","raw_total":38,"max_possible":60,"pct_score":63,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":4,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":10,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02358-9"}},{"id":214,"doi":"10.1097/adm.0000000000000602","pmid":"31972764","pmcid":null,"title":"Nalmefene in the Treatment of Internet Pornography Addiction - A Case Report and Review of Literature","authors":"Yazdi K, Fuchs-Leitner I, Gerstgrasser NW.","first_author":"Yazdi K","journal":"Journal of addiction medicine","year":2020,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single heterosexual male treated with nalmefene for self‑labelled internet pornography addiction; follow‑up over 72 weeks with self‑reported craving and consumption scores.","sample_n":1,"sample_text":"single case","population":"1 adult male, no reported comorbidities","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["circular_addiction_scale","causal_from_correlational","self_selected_sample"],"stance":"strongly-supports","citation_value":"avoid","plain_summary":"A single man with self‑identified internet‑pornography addiction took nalmefene for 72 weeks; his reported cravings and use fell while on the drug and rose when he stopped, then fell again when restarted.","clinical_takeaway":"Evidence is anecdotal; nalmefene cannot be recommended for pornography‑related problems based on this report.","confidence":0.4,"topic_tags":["pornography","treatment","csbd","sexual_function"],"strengths":["Long observation period (72 weeks)","Detailed within‑subject tracking of craving and use"],"limitations":["N = 1; no control or comparison group","Reliance on unvalidated self‑report scales","No assessment of moral incongruence, masturbation, or mental‑health covariates"],"rubric_version":"2.0","raw_total":8,"max_possible":60,"pct_score":13,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":1,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/adm.0000000000000602"}},{"id":215,"doi":"10.1016/j.ssmmh.2025.100520","pmid":"41958635","pmcid":"PMC13060547","title":"Sexually explicit and violent media use among high school students in Vietnam: Gender-differentiated links with sexual misconduct victimization, perpetration, and health","authors":"Yount KM, Macaulay M, Tran KT.","first_author":"Yount KM","journal":"SSM. Mental health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Vietnam","Mental health","Adolescents","Victimization","Peer Norms","High School","Perpetration","Sexual Misconduct","Sexually Explicit/Violent Media","Academic Disengagement"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13060547","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"712 high‑school students from three schools in Ho Chi Minh City completed a one‑time survey on SEM/SVM use and various health and behaviour outcomes. Analyses were unadjusted and adjusted regressions.","sample_n":712,"sample_text":"Three high schools in Ho Chi Minh City, Vietnam; convenience sample of students who completed the survey.","population":"Adolescents (high‑school students) in Vietnam (N≈712)","country":"Vietnam","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Among Vietnamese high‑schoolers, about half reported watching sexually explicit media and a third reported viewing violent sexual media. Boys who viewed the media reported poorer health, more alcohol use and higher rates of violent sexual behaviour; girls who viewed violent media reported higher victimisation and perpetration. The study suggests gender‑specific links between such media and risky outcomes.","clinical_takeaway":"Screening for exposure to sexually explicit or violent media may help identify adolescents at risk for health problems and sexual misconduct, especially when combined with other risk factors.","confidence":0.6,"topic_tags":["adolescents","sexual_function"],"strengths":["Large sample for a school‑based survey in LMIC context","Gender‑specific analyses","Adjusted regression models reported with CIs"],"limitations":["Cross‑sectional design, cannot infer causality","Binary, non‑validated measures of media use","Key confounds (moral incongruence, masturbation, trauma) not assessed"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ssmmh.2025.100520"}},{"id":216,"doi":"10.1080/10550887.2021.2021058","pmid":"35000564","pmcid":null,"title":"Pornography addiction and its impacts on intimate female partner wellbeing-a systematic narrative synthesis","authors":"Aghamiri FS, Luetz JM, Hills K.","first_author":"Aghamiri FS","journal":"Journal of addictive diseases","year":2022,"pub_types":["Review","Journal Article"],"keywords":["Addiction","Compulsive Sexual Behaviors","Cybersex","Pornography","Compulsive Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"systematic-review","design_detail":"narrative synthesis of quantitative and qualitative studies; no primary data collected","sample_n":null,"sample_text":"No primary sample; review of existing literature","population":"intimate female partners of pornography‑using individuals (in cited studies)","country":"Not applicable","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The review finds that compulsive pornography use is mentioned in studies as linked to risky sexual behaviour and relationship problems for female partners, but notes that research on partners’ wellbeing is scarce and calls for more in‑depth qualitative work.","clinical_takeaway":"Clinicians should be aware that partner distress may be reported, but current evidence on how pornography use affects female partners is limited.","confidence":0.3,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Identifies a research gap regarding female partners","Combines quantitative and qualitative literature","Highlights need for future empirical work"],"limitations":["Narrative synthesis lacks systematic search/reporting transparency","No assessment of methodological quality of included studies","Does not control for moral incongruence or other key confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":60,"pct_score":15,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":1,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10550887.2021.2021058"}},{"id":217,"doi":"10.1111/phn.70112","pmid":"41773504","pmcid":null,"title":"Promoting Mental Health Support for Adolescents and Future Health Educators Through Nursing-Led Intervention: A University-School-Community Collaboration Model in Spain","authors":"Alonso Martínez L, San Pedro Arribas P, Sánchez-Gutiérrez ME, Zabaleta González R, Nieto González S, Sierra Medina MJ.","first_author":"Alonso Martínez L","journal":"Public health nursing (Boston, Mass.)","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Health education","Adolescent","Mental health","Nurses","Help Behaviour"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"quasi-experimental pre‑post intervention without a separate control group; 578 participants from schools and university programs","sample_n":578,"sample_text":"Convenience sample of pupils, students and trainee teachers recruited through schools and a university; not a probability sample","population":"adolescents, university nursing students and trainee teachers (13‑52 y, mean 20.3)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A nurse‑led workshop in Spanish schools and a university improved participants' knowledge about mental health and reduced stigma. Scores on a brief problematic pornography use scale also improved after the program, but the study lacked a control group and did not account for factors like personal moral views or masturbation.","clinical_takeaway":"While the program boosted mental‑health literacy, the reported decrease in problematic pornography scores cannot be taken as proof of effectiveness without a control comparison.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large total sample (N > 500)","Use of validated scales including PPCS‑6","Multi‑group (students, pupils, teachers) perspective"],"limitations":["Quasi‑experimental; no control group limits causal inference","No measurement or control of key sexual‑behavior confounds (masturbation, moral incongruence, mental‑health covariates)","No pre‑registration or reporting of effect sizes"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/phn.70112"}},{"id":218,"doi":"10.3389/fnhum.2025.1658882","pmid":"40746910","pmcid":"PMC12311214","title":"Correction: The impact of internet pornography addiction on brain function: a functional near-infrared spectroscopy study","authors":"Shu Q, Tang S, Wu Z, Feng J, Lv W, Huang M, Xu F.","first_author":"Shu Q","journal":"Frontiers in human neuroscience","year":2025,"pub_types":["Published Erratum","correction"],"keywords":["Cognition","Addiction","brain function","Functional Near-infrared Spectroscopy (Fnirs)","Internet Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12311214","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fnhum.2025.1658882"}},{"id":219,"doi":"10.1556/2006.2022.00061","pmid":"36083776","pmcid":"PMC9872540","title":"Treatments and interventions for compulsive sexual behavior disorder with a focus on problematic pornography use: A preregistered systematic review","authors":"Antons S, Engel J, Briken P, Krüger THC, Brand M, Stark R.","first_author":"Antons S","journal":"Journal of behavioral addictions","year":2022,"pub_types":["Systematic Review","review-article","Journal Article"],"keywords":["Therapy","Hypersexual Behavior","Prisma","Consort","Problematic Pornography Use","Internet-use Disorders"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/11/3/article-p643.pdf","cited_by_count":50,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"preregistered systematic review of 24 treatment studies (4 RCTs) on CSBD/PPU; quantitative synthesis of effect sizes; risk of bias assessed with CONSORT criteria","sample_n":24,"sample_text":"24 treatment studies (4 randomized controlled trials) identified","population":"people with compulsive sexual behavior disorder or problematic pornography use as reported in the primary studies","country":"multiple (global literature search)","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A preregistered systematic review of 24 studies (including 4 RCTs) found that treatments such as cognitive‑behavioral therapy can reduce symptoms of compulsive sexual behavior disorder and problematic pornography use, but evidence is still limited and more rigorous trials are needed.","clinical_takeaway":"CBT appears promising for CSBD/PPU, yet clinicians should consider the limited evidence base and tailor treatment to individual needs.","confidence":0.7,"topic_tags":["csbd","pornography","treatment"],"strengths":["Preregistered protocol (PROSPERO)","Quantitative synthesis with effect sizes","Risk of bias assessment using CONSORT"],"limitations":["Primary studies vary in measurement quality","Limited number of RCTs","No detailed analysis of key confounds (e.g., moral incongruence, masturbation)"],"rubric_version":"2.0","raw_total":40,"max_possible":60,"pct_score":67,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":4,"design":9,"addiction_criteria":7,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":64,"citing_publications":91,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00061"}},{"id":220,"doi":"10.1007/s10508-024-03053-7","pmid":"39843833","pmcid":null,"title":"Cut from the Same Cloth? Comparing the Sexuality of Male Cross-Dressers and Transfeminine Individuals Through the Conceptual Framework of Autogynephilia","authors":"Hsu KJ, Morandini JS, Rudd S.","first_author":"Hsu KJ","journal":"Archives of sexual behavior","year":2025,"pub_types":["Comparative Study","Journal Article"],"keywords":["Transgender","Sexual Orientation","Paraphilia","Dsm-5","Autogynephilia","Transfeminine"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online comparative survey of four groups (male cross‑dressers, transfeminine, cis men, cis women)","sample_n":1401,"sample_text":"519 male cross‑dressers, 288 transfeminine, 293 cis men, 301 cis women","population":"adult adults recruited from online communities (self‑selected)","country":"unspecified (online international)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared sexual attitudes and behaviours of male cross‑dressers, trans‑women, and cisgender men and women. Both gender‑nonconforming groups reported more sexual compulsivity, paraphilic interests and problematic pornography use than cis controls, with cross‑dressers showing the highest levels.","clinical_takeaway":"Differences in sexual compulsivity and pornography use exist across gender groups, but findings are based on self‑selected online samples and should be interpreted cautiously.","confidence":0.78,"topic_tags":["sexual_function","gender","pornography"],"strengths":["Large total sample across four groups","Direct comparison of under‑studied populations","Wide range of sexuality constructs assessed"],"limitations":["Convenience, online recruitment limits generalisability","Unclear whether scales are validated for these groups","No control for key confounds (moral incongruence, mental health, etc.)","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-03053-7"}},{"id":221,"doi":"10.31234/osf.io/crxqp_v1","pmid":null,"pmcid":null,"title":"Diverse behavioural-emotional profiles associated with self-reported social media addiction in adolescence","authors":"Turner G, Dalmaijer ES, Astle D, Orben A.","first_author":"Turner G","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["ppu"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large nationally‑representative cohort, preregistered, cross‑sectional analysis","sample_n":7092,"sample_text":"nationally‑representative Millennium Cohort Study","population":"UK adolescents (16‑18 y, n = 7,092)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a UK cohort of 7,000 teens, almost half said they felt addicted to social media. Those who felt addicted showed different emotional‑behavioral patterns: most felt socially confident, a smaller group engaged in risk behaviours, and another showed low wellbeing with depression. The study highlights varied profiles among teens who perceive social‑media addiction.","clinical_takeaway":"Perceived social‑media addiction in teens reflects diverse emotional states; interventions should be tailored to individual profiles rather than a one‑size‑fits‑all approach.","confidence":0.8,"topic_tags":["adolescents","sexual_function","moral_incongruence"],"strengths":["Large, nationally representative sample","Pre‑registration","Data‑driven clustering to identify heterogeneity"],"limitations":["Self‑label of ‘addiction’ via single item, no validated scale","Cross‑sectional; no causal inference","Moral or contextual confounds not examined"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":6,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/crxqp_v1"}},{"id":222,"doi":"10.1007/s40429-021-00390-8","pmid":"34518793","pmcid":"PMC8426110","title":"Problematic Pornography Use: Legal and Health Policy Considerations","authors":"Sharpe M, Mead D.","first_author":"Sharpe M","journal":"Current addiction reports","year":2021,"pub_types":["review-article","Review","Journal Article"],"keywords":["Precautionary Principle","Age Verification","Problematic Pornography Use","Public Health Campaign","Pornography Health Warnings","Lesson Plans"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8426110","cited_by_count":13,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review / commentary without systematic methods.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"supports","citation_value":"strategic","plain_summary":"The article reviews research linking problematic pornography use to sexual violence and suggests policy actions such as age verification and health warnings, but it offers no new data and draws causal conclusions from correlational studies.","clinical_takeaway":"None – the paper provides policy commentary, not evidence for clinical practice.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses an important public‑policy topic","Integrates recent literature on pornography and violence"],"limitations":["Lacks systematic review methodology","No empirical data; conclusions rely on untested assumptions","No measurement of key confounds (moral incongruence, masturbation, mental health)"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":2,"contrasting":0,"mentioning":10,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40429-021-00390-8"}},{"id":223,"doi":"10.1016/j.ijchp.2024.100524","pmid":"39678070","pmcid":"PMC11638610","title":"Magnetoencephalographic correlates of pornography consumption: Associations with indicators of compulsive sexual behaviors","authors":"Prantner S, Espino-Payá A, Pastor MC, Giménez-García C, Kroker T, Ballester-Arnal R, Junghoefer M.","first_author":"Prantner S","journal":"International journal of clinical and health psychology : IJCHP","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","MEG","Compulsive Sexual Behavior","Pornography","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11638610","cited_by_count":4,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"MEG study with 50 participants viewing erotic/pornographic images; correlational analysis with self‑report CSB indicators.","sample_n":50,"sample_text":"N = 50 (healthy heterosexual and homosexual women and men)","population":"Healthy heterosexual and homosexual women and men (N=50), likely convenience sample.","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A small MEG study recorded brain activity while participants viewed erotic and pornographic images and linked the patterns to self‑reported compulsive sexual behaviors and mood. Certain brain regions showed more or less activation, which correlated with how much pornography participants used and their sexual‑related symptoms.","clinical_takeaway":"Current evidence does not allow clinicians to infer that brain activation patterns cause problematic pornography use; more rigorous, longitudinal work is needed.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","neuroscience"],"strengths":["Use of whole‑head MEG provides temporal precision","Inclusion of both heterosexual and homosexual participants","Multiple CSB‑related self‑report indicators examined"],"limitations":["Small sample (N=50) limits power for neuroimaging correlations","Key confounds (moral incongruence, masturbation, partner effects) not measured","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":30,"max_possible":70,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":5,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijchp.2024.100524"}},{"id":224,"doi":"10.1016/j.addbeh.2020.106647","pmid":"32971429","pmcid":null,"title":"Predicting problematic pornography use among male returning US veterans","authors":"Shirk SD, Saxena A, Park D, Kraus SW.","first_author":"Shirk SD","journal":"Addictive behaviors","year":2021,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 172 male US veterans who have ever watched pornography; self‑report questionnaires on pornography use, craving, impulsivity and psychiatric symptoms; hierarchical regression analysis.","sample_n":172,"sample_text":"172 male veterans","population":"Male US military veterans (N=172) who endorsed ever watching pornography.","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 172 male US veterans, higher scores on a problematic pornography use questionnaire were linked to younger age, lower education, more frequent porn use, higher craving, and greater depression, but not to suicidal thoughts or alcohol problems.","clinical_takeaway":"Screen for depression and frequent porn use when assessing veterans for problematic pornography behaviors.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Use of validated scales for pornography use, craving, and impulsivity","Relatively large sample for a veteran‑focused study","Multivariable regression to assess independent predictors"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral incongruence or masturbation, key confounds for PPU research","PPUS may conflate frequency with distress, risking circularity"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":29,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2020.106647"}},{"id":225,"doi":"10.1016/j.addbeh.2017.10.010","pmid":"29069616","pmcid":null,"title":"The assessment and treatment of adult heterosexual men with self-perceived problematic pornography use: A review","authors":"Sniewski L, Farvid P, Carter P.","first_author":"Sniewski L","journal":"Addictive behaviors","year":2018,"pub_types":["Review","Journal Article"],"keywords":["Compulsive Sexual Behavior","Hypersexuality","Internet Pornography","Problematic Pornography Use","Porn Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of literature on self‑perceived problematic pornography use; no primary data collected.","sample_n":null,"sample_text":"Not applicable – review of existing studies.","population":"Adult heterosexual men (self‑identified as having problematic pornography use) – based on cited studies, not a new sample.","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews research on men who think they are addicted to pornography, summarising how clinicians can tell normal from problematic use and outlining current therapeutic approaches.","clinical_takeaway":"Clinicians should differentiate self‑labelled problematic use from clinically significant disorder and consider evidence‑based interventions.","confidence":0.6,"topic_tags":["pornography","sexual_function","treatment"],"strengths":["Comprehensive overview of terminology and therapeutic options","Clearly defines self‑perceived problematic use","Useful for clinicians seeking a quick literature summary"],"limitations":["Narrative (non‑systematic) review – risk of selection bias","No systematic appraisal of study quality","No meta‑analytic synthesis or quantitative effect sizes"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":60,"citing_publications":106,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2017.10.010"}},{"id":226,"doi":"10.1556/2006.2021.00089","pmid":"35040806","pmcid":"PMC9109630","title":"Alterations in oxytocin and vasopressin in men with problematic pornography use: The role of empathy","authors":"Kor A, Djalovski A, Potenza MN, Zagoory-Sharon O, Feldman R.","first_author":"Kor A","journal":"Journal of behavioral addictions","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Oxytocin","Arginine vasopressin","Empathy","Compulsive Sexual Behaviors","Pornography","Addictive Behaviors"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9109630","cited_by_count":10,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control comparison of men with self‑reported problematic pornography use (PPU) vs demographically matched controls; plasma and salivary neuropeptide assays; self‑report empathy and psychiatric symptoms; structural equation modelling","sample_n":122,"sample_text":"122 male participants, 69 with problematic pornography use and 53 demographically matched controls","population":"adult males (N=122); 69 with PPU, 53 controls","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Men who say they have trouble controlling pornography use showed higher blood levels of vasopressin and larger oxytocin rises to neutral social videos. They also reported lower empathy, which the authors say may link these hormone changes to hypersexual behaviour.","clinical_takeaway":"Hormone differences are observed in men with self‑reported problematic porn use, but causality is unclear; clinicians should consider broader psychosocial factors.","confidence":0.78,"topic_tags":["pornography","neuroscience"],"strengths":["Biological measures (plasma and salivary neuropeptides) add physiological data","Comparative group design with demographically matched controls","Use of structural equation modelling to examine indirect pathways"],"limitations":["Problematic pornography use defined by self‑report; unclear if validated scale","Key confounds (moral incongruence, masturbation, partner context, trauma) not assessed","Cross‑sectional design limits causal inference yet language suggests mechanistic claims","No pre‑registration or correction for multiple testing reported"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":6,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2021.00089"}},{"id":227,"doi":"10.1007/s10943-025-02398-0","pmid":"40833718","pmcid":null,"title":"The Role of Moral Incongruence in the Relationship Between Pornography Use, Moral Struggles, Sexual Shame, and Couple Satisfaction for Pornography Users in the USA","authors":"Miller K, Murch H, Floyd C, Moen C, Volk F, Jones D.","first_author":"Miller K","journal":"Journal of religion and health","year":2025,"pub_types":["Journal Article"],"keywords":["Relationship Satisfaction","Pornography Use","Moral Incongruence","Sexual Shame","Moral Struggle"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of pornography users in committed relationships (N=224)","sample_n":224,"sample_text":"Convenience sample of self‑identified pornography users in committed relationships, recruited online (presumed).","population":"adult pornography users in the USA, in committed relationships","country":"USA","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In U.S. adults who watch porn and are in a committed relationship, feeling that porn conflicts with personal morals leads to more moral struggle, which raises sexual shame and lowers couple satisfaction.","clinical_takeaway":"Clinicians should assess moral conflict when working with clients who report porn‑related distress, as it may affect shame and relationship satisfaction.","confidence":0.8,"topic_tags":["pornography","moral_incongruence","sexual_function","relationships"],"strengths":["Large sample for a survey (N=224)","Focus on moral incongruence, a key confound","Uses moderated mediation analysis","Relevant outcomes (shame, relationship satisfaction)"],"limitations":["Cross‑sectional, cannot infer causality","Masturbation not measured separately","No mental‑health or trauma covariates","Self‑selected convenience sample"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-025-02398-0"}},{"id":228,"doi":"10.1556/2006.2022.00076","pmid":"36269607","pmcid":"PMC9881655","title":"Withdrawal and tolerance as related to compulsive sexual behavior disorder and problematic pornography use - Preregistered study based on a nationally representative sample in Poland","authors":"Lewczuk K, Wizła M, Glica A, Potenza MN, Lew-Starowicz M, Kraus SW.","first_author":"Lewczuk K","journal":"Journal of behavioral addictions","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Addiction","Behavioral Addictions","Addictive Behaviors","Compulsive Behaviors","Pornography Use"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/11/4/article-p979.pdf","cited_by_count":36,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"preregistered nationally representative survey (n=1541) of adults in Poland","sample_n":1541,"sample_text":"nationally representative sample of Polish adults","population":"Polish adults, 51.2% women, mean age 43","country":"Poland","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationwide Polish survey of 1,541 adults, researchers found that people who report more severe compulsive sexual behavior or problematic porn use also report more withdrawal‑like symptoms and a growing need for stronger sexual content. The study suggests these features may resemble addiction, but the measures were self‑reported and not validated.","clinical_takeaway":"Clinicians should note that self‑reported withdrawal and tolerance are linked to higher CSBD/PPU scores, but evidence is preliminary and not diagnostic.","confidence":0.78,"topic_tags":["csbd","pornography","treatment","measurement"],"strengths":["Large, nationally representative sample","Preregistered analysis plan","First empirical test of withdrawal/tolerance in CSBD and PPU"],"limitations":["Withdrawal/tolerance items appear ad‑hoc, not validated","No control for moral incongruence, masturbation, mental‑health or relationship factors","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":34,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00076"}},{"id":229,"doi":"10.21203/rs.3.rs-4590925/v1","pmid":null,"pmcid":null,"title":"Childhood sexual abuse, internet addiction, problematic pornography use, and depression among medical students in Bangladesh","authors":"Siddik MAB, Shakil MR, Hasan M, Hakim MA.","first_author":"Siddik MAB","journal":"Research Square","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-4590925/v1","cited_by_count":1,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of Bangladeshi medical students (N=3264) assessing self‑reported childhood sexual abuse, internet addiction (IAT‑20), problematic pornography use (Brief Pornography Screener), and depression (PHQ‑9); descriptive statistics, chi‑square, ordinal logistic regression, and correlation matri","sample_n":3264,"sample_text":"Convenience sample recruited via Google Form; not a probability or nationally representative sample.","population":"Medical students, Bangladesh (mean age 21.5, mixed gender)","country":"Bangladesh","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 3,264 Bangladeshi medical students found that about 28 % reported childhood sexual abuse, 70 % reported problematic pornography use, 62 % were classified as internet‑addicted, and half were depressed. The factors were positively linked, but the study did not account for moral or sexual‑behavior confounds.","clinical_takeaway":"High rates of pornography use and depression co‑occur among medical students; clinicians should assess broader mental‑health context rather than assuming an addiction.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample size for a single‑site survey","Use of validated questionnaires (IAT‑20, PHQ‑9, BPS)","Explores links among CSA, IA, pornography use, and depression"],"limitations":["Cross‑sectional design prevents causal inference","No measurement or control of moral incongruence or masturbation","Convenience online sample limits generalisability"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-4590925/v1"}},{"id":230,"doi":"10.1186/s12978-024-01841-x","pmid":"38987845","pmcid":"PMC11234758","title":"Pornography use, demographic and sexual health characteristics among university students: a gender-based comparative study of non-users, non-problematic users, and problematic users","authors":"Pouralijan Z, Bőthe B, Farnam F.","first_author":"Pouralijan Z","journal":"Reproductive health","year":2024,"pub_types":["Comparative Study","research-article","Journal Article"],"keywords":["Iran","Sexual function","Sexual Satisfaction","Sexual Distress","Pornography","Problematic Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11234758","cited_by_count":9,"is_preprint":false,"topics":["masturbation","pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 450 Iranian university students, grouping participants into non‑users, non‑problematic users and problematic users of pornography based on the Problematic Pornography Use Scale.","sample_n":450,"sample_text":"450 participants recruited from universities in Iran","population":"Iranian university students (mixed gender)","country":"Iran","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Iranian university students, about 40% reported using pornography. Users—especially those classified as problematic—had more masturbatory activity, higher sexual desire, more extramarital relationships and greater sexual distress than non‑users. Men were more likely than women to be problematic users.","clinical_takeaway":"Clinicians should note that pornography use in this population is linked to increased sexual distress, but causal direction is unclear.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a single‑site survey (N=450)","Use of a validated problematic pornography scale","Separate measurement of masturbation and sexual distress","Gender‑based comparison"],"limitations":["Cross‑sectional design prevents causal inference","Convenience university sample limits generalisability","No assessment of mental‑health or trauma variables","Addiction criteria not thoroughly operationalised"],"rubric_version":"2.0","raw_total":37,"max_possible":60,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":6,"design":5,"addiction_criteria":4,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-024-01841-x"}},{"id":231,"doi":"10.1080/0092623x.2024.2353221","pmid":"38741573","pmcid":null,"title":"Understanding How Religiousness Shapes Perceptions of Compulsive Sexual Behavior","authors":"Sorrell SA, Lefevor GT, Skidmore SJ, Golightly RM, Searle KNL.","first_author":"Sorrell SA","journal":"Journal of sex & marital therapy","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"two convenience samples (general population, LDS members) surveyed once; mediation analysis","sample_n":null,"sample_text":"Not reported in abstract","population":"adults (young adult to middle‑aged) from general population and members of the Church of Jesus Christ of Latter‑day Saints","country":"USA (presumed)","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"useful","plain_summary":"The study found that people who attend worship services more often and also watch porn at least monthly tend to label their porn use as compulsive, but this perception is driven by moral disapproval rather than actual harm.","clinical_takeaway":"Clinicians should assess moral conflict when clients report compulsive porn use, as distress may stem from incongruence rather than functional impairment.","confidence":0.78,"topic_tags":["moral_incongruence","religiosity","pornography","csbd","sexual_function"],"strengths":["Direct test of moral‑incongruence mediation model","Includes two distinct samples for replication","Considers frequency of pornography use as a moderator"],"limitations":["Cross‑sectional design cannot infer causality","Relies on self‑report scales with unclear validation","Does not control for key confounds such as mental health or masturbation"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2024.2353221"}},{"id":232,"doi":"10.1016/j.addbeh.2020.106591","pmid":"32768797","pmcid":null,"title":"Properties of the Problematic Pornography Consumption Scale (PPCS-18) in community and subclinical samples in China and Hungary","authors":"Chen L, Luo X, Bőthe B, Jiang X, Demetrovics Z, Potenza MN.","first_author":"Chen L","journal":"Addictive behaviors","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Screening","Validity","Cultural Context","Problematic Pornography Use","Problematic Pornography Consumption Scale"],"is_oa":false,"oa_url":"https://doi.org/10.1016/j.addbeh.2020.106591","cited_by_count":26,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community and subclinical male samples from China and Hungary; psychometric validation using CFA, invariance, reliability, network analysis","sample_n":6950,"sample_text":"N1=695 (Chinese community), N2=4651 (subclinical), N3=9395 (Hungarian community) – large cross‑sectional convenience samples","population":"adult men, community and subclinical (screened for PPU)","country":"China; Hungary","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study checked how well the 18‑item Problematic Pornography Consumption Scale works in large groups of men from China and Hungary, including those with sub‑clinical pornography‑related issues, and found it reliable across cultures.","clinical_takeaway":"The PPCS‑18 appears reliable for screening problematic pornography use, but clinicians should note it relies on self‑report and does not separate moral distress from use.","confidence":0.78,"topic_tags":["pornography","measurement","csbd"],"strengths":["Very large, multi‑national samples","Comprehensive psychometric testing (CFA, invariance, reliability)","Includes both community and subclinical participants"],"limitations":["Self‑report scale; addiction inferred from reported problems","No measurement of moral incongruence, masturbation or mental‑health covariates","Cross‑sectional; cannot assess temporal stability beyond psychometrics"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":0,"mentioning":33,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2020.106591"}},{"id":233,"doi":"10.1556/2006.2021.00084","pmid":"34971357","pmcid":"PMC8987424","title":"Compulsive sexual behavior, religiosity, and spirituality: A systematic review","authors":"Jennings TL, Lyng T, Gleason N, Finotelli I, Coleman E.","first_author":"Jennings TL","journal":"Journal of behavioral addictions","year":2021,"pub_types":["Systematic Review","review-article","Journal Article"],"keywords":["Systematic review","Spirituality","Compulsive Sexual Behavior","Religiosity","Hypersexuality","Sex Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8987424","cited_by_count":22,"is_preprint":false,"topics":["csbd","pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 46 articles (59 studies) using PRISMA; mainly cross‑sectional, heterogeneous samples; no meta‑analysis or formal risk‑of‑bias assessment reported.","sample_n":null,"sample_text":"46 articles (59 studies) identified; no single sample size reported for the review itself.","population":"Adults with compulsive sexual behaviour; samples mostly heterosexual White men and women; convenience and treatment‑seeking studies included.","country":"International (studies from various countries).","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review finds that higher religiosity is modestly linked to compulsive sexual behaviour, especially when people feel their use conflicts with their morals. Spiritual wellbeing may be protective, but research is limited to mostly White, heterosexual samples.","clinical_takeaway":"Consider assessing moral conflict and religiosity when treating compulsive sexual behaviour, but note current evidence is limited and cross‑sectional.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Comprehensive PRISMA‑guided search","Identifies moral incongruence as key moderator","Highlights gaps in diversity and methodology"],"limitations":["Relies on predominantly cross‑sectional, non‑representative primary studies","No formal meta‑analysis or risk‑of‑bias assessment","Limited evaluation of other CSB manifestations"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":4,"design":7,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2021.00084"}},{"id":234,"doi":"10.3390/ijerph19105870","pmid":"35627407","pmcid":"PMC9141011","title":"A Network Comparison of Motives behind Online Sexual Activities and Problematic Pornography Use during the COVID-19 Outbreak and the Post-Pandemic Period","authors":"Jiang X, Lu Y, Hong Y, Zhang Y, Chen L.","first_author":"Jiang X","journal":"International journal of environmental research and public health","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Network Analysis","Community Detection","Covid-19","Online Sexual Activities (Osas)","Pornography Use Motivation (Pum)"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/10/5870/pdf?version=1652315740","cited_by_count":7,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two independent samples of Chinese adults surveyed online during pandemic (n=496) and post‑pandemic (n=504); network analysis of self‑report symptom and motivation items.","sample_n":1000,"sample_text":"n1 = 496 (April 2020), n2 = 504 (October 2021)","population":"Chinese adults (community sample, convenience recruitment)","country":"China","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared Chinese adults’ reasons for using online sexual content and the severity of problematic porn use during the pandemic versus a later period, finding stronger links between stress‑relief motives and problematic use early in the pandemic.","clinical_takeaway":"Higher stress‑related motives for porn may signal risk for problematic use, especially during crises.","confidence":0.8,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Large sample sizes for each time point","Use of network analysis to examine symptom structure","Comparison of two distinct pandemic phases"],"limitations":["Cross‑sectional design; no longitudinal tracking of individuals","No measurement of key confounds (moral incongruence, masturbation, mental health)","Potential reliance on self‑labelled problematic use without strict criteria"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph19105870"}},{"id":235,"doi":"10.21203/rs.3.rs-3327564/v1","pmid":null,"pmcid":null,"title":"Sex differences in problematic pornography use among adolescents: a network analysis","authors":"Villena-Moya A, Potenza MN, Roser G, Paiva Ú, Arrondo G, Chiclana-Actis C, Fernández-Aranda F, Jiménez-Murcia S, Normand E, Ballester L, Mestre-Bach G.","first_author":"Villena-Moya A","journal":"Research Square","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-3327564/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Network analysis of self‑report data from 650 Spanish adolescents (convenience sample); cross‑sectional survey.","sample_n":650,"sample_text":"Spanish adolescents (N = 650)","population":"Adolescents (N=650) from Spain, mixed gender","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In 650 Spanish teens, boys reported more frequent problematic pornography use, while girls showed more online victimisation and loneliness linked to porn use. The study maps how these factors interrelate.","clinical_takeaway":"Screen for victimisation and loneliness when addressing problematic pornography use in adolescents, especially girls.","confidence":0.6,"topic_tags":["pornography","adolescents","gender","sexual_function"],"strengths":["Large adolescent sample (N=650)","Explores multiple psychosocial variables","Uses network analysis to map relationships"],"limitations":["Cross‑sectional; no causal inference","No measurement of moral incongruence or masturbation","Unclear validation of the scales used"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-3327564/v1"}},{"id":236,"doi":"10.1080/00224499.2020.1716205","pmid":"31995398","pmcid":null,"title":"The Short Version of the Problematic Pornography Consumption Scale (PPCS-6): A Reliable and Valid Measure in General and Treatment-Seeking Populations","authors":"Bőthe B, Tóth-Király I, Demetrovics Z, Orosz G.","first_author":"Bőthe B","journal":"Journal of sex research","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":67,"is_preprint":false,"topics":["csbd","masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Psychometric validation study using three large convenience samples (community, site‑visitors, treatment‑seeking).","sample_n":17377,"sample_text":"Large community and treatment‑seeking samples; convenience recruitment.","population":"General adult population and treatment‑seeking individuals (N≈15 k, 760, 266).","country":"Hungary (likely based on authors’ affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":["circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created a six‑item questionnaire (PPCS‑6) that reliably identifies problematic pornography use. Tested in over 17 000 people, it shows solid factor structure, consistency, and can differentiate users with and without problems.","clinical_takeaway":"PPCS‑6 offers a quick, validated screen for clinicians to flag potential problematic porn use, but interpretation should consider other factors (e.g., moral distress, mental health).","confidence":0.8,"topic_tags":["measurement","sexual_function"],"strengths":["Very large sample sizes across three distinct groups","Comprehensive psychometric testing (factor structure, invariance, reliability)","Provides a brief, usable screening tool"],"limitations":["Relies on self‑report; scale items may conflate frequency with distress","No assessment or control of moral incongruence or other key confounds","Convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":8,"contrasting":1,"mentioning":98,"citing_publications":127,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2020.1716205"}},{"id":237,"doi":"10.3389/fpsyt.2025.1595502","pmid":"40740265","pmcid":"PMC12308497","title":"Validation of the english assessment of criteria for specific internet-use disorders (ACSID-11) for tinder and online pornography use","authors":"Liberacka-Dwojak M, Cruz GV, Wiłkość-Dębczyńska M, Rochat L, Khan R, Mueller SM, Brand M, Khazaal Y.","first_author":"Liberacka-Dwojak M","journal":"Frontiers in psychiatry","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Validation","Diagnostic criteria","Behavioral Addictions","Icd-11","Online Pornography-use Disorder","Dating Applications-use Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12308497","cited_by_count":3,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community sample (N=1823) completing self‑report questionnaires; confirmatory factor analysis and correlations used to validate a diagnostic scale","sample_n":1823,"sample_text":"active Tinder and pornography users fluent in English, recruited online","population":"English‑speaking active Tinder and online pornography users","country":"unspecified (likely multiple English‑speaking countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested a new questionnaire (ACSID‑11) meant to diagnose internet‑use disorders such as addictive Tinder or pornography use. In a large group of English‑speaking users, the questionnaire showed a stable eight‑factor structure and correlated well with existing problem‑use scales, suggesting it may be a reliable tool for clinicians and researchers.","clinical_takeaway":"The ACSID‑11 appears promising for assessing problematic online sexual behaviors, but clinicians should also evaluate moral, mental‑health, and relational factors that the tool does not capture.","confidence":0.7,"topic_tags":["pornography","sexual_function","measurement"],"strengths":["Very large sample size","Uses multiple established scales for convergent validity","Rigorous factor‑analytic validation approach"],"limitations":["No measurement or control of moral incongruence or other key confounds","Cross‑sectional self‑report design limits causal inference","Unclear if the ACSID‑11 fully avoids circularity in defining addiction"],"rubric_version":"2.0","raw_total":38,"max_possible":60,"pct_score":63,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":7,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2025.1595502"}},{"id":238,"doi":"10.21203/rs.3.rs-5638251/v1","pmid":null,"pmcid":null,"title":"RELATIONSHIP BETWEEN PORNOGRAPHY USE AND DEVELOPMENT OF SEXIST BEHAVIORS IN YOUNG UNIVERSITY NURSING STUDENTS","authors":"Ortega-Donaire L, García IS, Bailén-Expósito J, Ramírez-de-Dios I, Montoro-Ramírez EM, Sanz-Martos S.","first_author":"Ortega-Donaire L","journal":"Research Square","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-5638251/v1","cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 179 university nursing students","sample_n":179,"sample_text":"179 university nursing students at the University of Jaen","population":"young university nursing students (mostly 18‑24, likely majority female)","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 179 nursing students, higher pornography use was linked to stronger sexist attitudes, especially among religious men and those whose parents had lower education. The study suggests sex‑education programs could help counter gender stereotypes.","clinical_takeaway":"Higher porn use may be associated with sexist views; educators should address gender stereotypes in sexuality curricula.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Uses established scales for pornography use and sexism","Reports multivariate regression controlling for some sociodemographics","Addresses an understudied population (nursing students)"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of key confounds (masturbation, mental health, trauma, moral incongruence)","Problematic use scale may conflate frequency with distress"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-5638251/v1"}},{"id":239,"doi":"10.1007/s10508-024-02927-0","pmid":"38992202","pmcid":null,"title":"Who Finds Pornography Stressful? A Latent Profile Analysis","authors":"Varod S, Stern A, Bőthe B, Gewirtz-Meydan A.","first_author":"Varod S","journal":"Archives of sexual behavior","year":2024,"pub_types":["Journal Article"],"keywords":["Mental health","Sexual Functioning","Latent Profile Analysis","Sexual Distress","Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online anonymous survey, N=463, latent profile analysis","sample_n":463,"sample_text":"463 participants recruited through an anonymous online survey; convenience self‑selected sample","population":"adult pornography users, mixed gender, recruited via internet","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["circular_addiction_scale","self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 463 adults who view pornography identified three user types: high‑frequency users with sexual problems and distress, high‑frequency users without major problems, and low‑frequency users. The distressed, high‑frequency group showed higher anxiety and depression and poorer emotion regulation.","clinical_takeaway":"Clinicians should note that frequent pornography use combined with sexual distress may co‑occur with poorer mental health, but causality is unclear.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["large sample for a survey","use of latent profile analysis to identify subgroups","includes multiple mental‑health outcomes"],"limitations":["cross‑sectional, no causal inference","PPU defined by distress, not validated addiction criteria","no measurement of moral incongruence, masturbation, or partner factors"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02927-0"}},{"id":240,"doi":"10.1177/10398562251358134","pmid":"40614231","pmcid":"PMC12819893","title":"Negative emotional states and technological addictions: The buffering and paradoxical role of perceived social support","authors":"Chew PK, Poh EY.","first_author":"Chew PK","journal":"Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Perceived Social Support","Internet Gaming Disorder","Problematic Pornography Use","Social Media Addiction","Negative Emotional States"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12819893","cited_by_count":2,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 169 adults assessing self‑report scales for IGD, SMA and problematic pornography use (PPU) and their interaction with perceived social support and negative emotional states.","sample_n":169,"sample_text":"71.6% female, 27.2% male, 1.2% other; community sample, convenience recruitment implied.","population":"adults (young adult to older), mostly female, recruited likely via convenience sampling (online/college).","country":"Australia (journal of Australasian Psychiatry)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In 169 adults, feeling supported by family or a partner reduced pornography use when people were not upset, but increased gaming and porn use when they were very upset. Support can both help and hurt, depending on mood.","clinical_takeaway":"Perceived social support may not always protect against problematic porn or gaming; clinicians should assess mood and support context.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["reasonable sample size for exploratory moderation","uses established self‑report scales for IGD, SMA, PPU","examines interaction of social support with negative affect"],"limitations":["cross‑sectional; cannot infer causality","no measurement of moral incongruence or masturbation","PPU scale missing last item; may affect reliability","no pre‑registration or correction for multiple testing"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10398562251358134"}},{"id":241,"doi":"10.1016/j.jsxm.2020.05.030","pmid":"32675049","pmcid":null,"title":"Symptoms of Problematic Pornography Use in a Sample of Treatment Considering and Treatment Non-Considering Men: A Network Approach","authors":"Bőthe B, Lonza A, Štulhofer A, Demetrovics Z.","first_author":"Bőthe B","journal":"The journal of sexual medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Network Analysis","Problematic Pornography Use","Pornography Use Frequency","Network Of Symptoms"],"is_oa":false,"oa_url":null,"cited_by_count":41,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online convenience survey of men (N=4253) split into treatment‑considering (n=509) and non‑considering groups; self‑report questionnaires; network analysis of symptom items","sample_n":4253,"sample_text":"large online convenience sample of adult men (N=4253), 509 considered treatment, 3,684 did not","population":"men, average age 38, internet‑based sample","country":"unspecified (likely European based on authors)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 4,253 men, researchers mapped how different symptoms of problematic porn use (like salience, tolerance, withdrawal) relate to each other. Porn‑use frequency was peripheral, while other symptoms were central, especially for men thinking about treatment.","clinical_takeaway":"Target central symptoms such as salience, mood‑modification and withdrawal rather than focusing solely on reducing porn use.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["large sample size","novel network analytic approach","use of a validated PPU scale"],"limitations":["cross‑sectional design limits causal inference","no measurement of key confounds (moral incongruence, masturbation, mental health)","self‑report bias"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":7,"contrasting":0,"mentioning":47,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.05.030"}},{"id":242,"doi":"10.7759/cureus.45016","pmid":"37829967","pmcid":"PMC10565711","title":"Management of Concurrent Bipolar I Disorder and Compulsive Sexual Behavior Disorder: A Case Report","authors":"Fiandor-Montesino J, Kusakavitch M, Kakarlapudi R, Puthiyathu M.","first_author":"Fiandor-Montesino J","journal":"Cureus","year":2023,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Sexual behavior","Naltrexone","Bipolar I Disorder","Pornography","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://assets.cureus.com/uploads/case_report/pdf/180247/20231011-24775-k60fdf.pdf","cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report describing concurrent bipolar I disorder and compulsive sexual behavior disorder and treatment approach","sample_n":1,"sample_text":"single case","population":"1 adult inpatient with bipolar I disorder and CSBD","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A report describes one person who had both bipolar disorder and compulsive sexual behavior, including problematic pornography use, and outlines the medications and therapy used during a hospital stay.","clinical_takeaway":"Evidence for treating CSBD in bipolar patients is limited to anecdotal case reports; clinicians should tailor multimodal treatment and monitor mood closely.","confidence":0.7,"topic_tags":["csbd","pornography","moral_incongruence","masturbation","treatment"],"strengths":["Provides detailed clinical narrative of a rare comorbidity","Discusses multiple pharmacologic and psychotherapeutic options"],"limitations":["Single case, no systematic assessment tools","No measurement of confounding factors (e.g., moral incongruence, mental health)","No objective outcome data or follow‑up"],"rubric_version":"2.0","raw_total":11,"max_possible":60,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":2,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.45016"}},{"id":243,"doi":"10.7759/cureus.94158","pmid":"41210061","pmcid":"PMC12594599","title":"Spinning Into Surgery: A Case of Penile Fracture Due to High-Risk Sexual Activity","authors":"Gonzalez-Carranza HR.","first_author":"Gonzalez-Carranza HR.","journal":"Cureus","year":2025,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Penile Fracture","Sexual Intercourse","Penile Trauma","Vigorous Sexual Activity","Porn Consumption"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12594599","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with penile fracture linked to a pornography‑inspired sexual position; follow‑up at two years reported.","sample_n":1,"sample_text":"single clinical case","population":"one 54‑year‑old man","country":"not stated","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 54‑year‑old man broke his penis while trying a porn‑inspired sexual position. Surgery fixed it and he recovered well, but the authors suggest porn may encourage risky acts that lead to such injuries.","clinical_takeaway":"Clinicians should discuss safe sexual practices, but a single case does not prove pornography causes penile fracture.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Detailed clinical description of a rare injury","Long‑term follow‑up reported"],"limitations":["Single case; no systematic data","No measurement of pornography use or confounding variables","Causal claim about porn’s role is speculative"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.94158"}},{"id":244,"doi":"10.1556/2006.2024.40000","pmid":"39714469","pmcid":"PMC11737413","title":"Corrigendum to: Clinical characteristics associated with problematic pornography use among individuals seeking treatment for opioid use disorder","authors":"Stefanovics EA, Kraus SW, Madden LM, Farnum S, Cannata E, Potenza MN, Barry D.","first_author":"Stefanovics EA","journal":"Journal of behavioral addictions","year":2024,"pub_types":["Published Erratum","correction","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.1556/2006.2024.40000","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.40000"}},{"id":246,"doi":"10.1186/s12978-026-02285-1","pmid":"41723489","pmcid":"PMC13040746","title":"Gender-specific lifetime prevalence and patterns of non-partner sexual violence in iran: a nationwide cross-sectional study","authors":"Khayer E, Zarei R, Bőthe B, Farnam F.","first_author":"Khayer E","journal":"Reproductive health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Rape","Asia","Iran","Gender","Prevalence","Child Sexual Abuse","Victims","Non-partner Sexual Violence","Contact Violence","Non-contact Violence"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13040746","cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"nationwide cross‑sectional survey of 938 married Iranian adults recruited via online and in‑person convenience sampling","sample_n":938,"sample_text":"Convenience sample (online + in‑person) of married adults from 2022‑2023","population":"Married Iranian adults, 18–73 years (596 women, 342 men)","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A national survey of 938 married Iranians found that about one quarter had experienced some form of non‑partner sexual violence in their lifetime, with women more likely to report rape. Victims also reported poorer economic status, more substance use and, for men, higher self‑reported pornography addiction.","clinical_takeaway":"Clinicians should screen for past sexual violence, as it co‑occurs with substance use and other sexual‑health concerns.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑country survey","Gender‑specific prevalence data","Inclusion of both non‑contact and contact violence types"],"limitations":["Convenience sampling limits representativeness","NPSV measured with a single, likely unvalidated item","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-026-02285-1"}},{"id":248,"doi":"10.7759/cureus.97194","pmid":"41426818","pmcid":"PMC12715443","title":"Sexual Functioning in Individuals With Attention-Deficit Hyperactivity Disorder: A Narrative Review","authors":"Puszcz A, Platnikow M, Antos Z, Czech M, Kipka A.","first_author":"Puszcz A","journal":"Cureus","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sensory Processing Disorder","Hypersexuality","Attention-deficit Disorder With Hyperactivity","Sexual Dysfunctions","Paraphilic Disorders"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12715443","cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without new empirical data; synthesis based on selected literature","sample_n":null,"sample_text":"not applicable – literature review","population":"adults with ADHD (no specific sample size reported)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review summarises evidence that adults with ADHD often experience sexual problems, ranging from low desire to hypersexuality and compulsive porn use. It discusses possible brain mechanisms, the role of emotional dysregulation, and how ADHD medications can both help and hurt sexual health.","clinical_takeaway":"Clinicians should routinely assess sexual functioning in patients with ADHD and consider both medication effects and psychosocial factors.","confidence":0.6,"topic_tags":["sexual_function","adolescents","neuroscience","csbd"],"strengths":["Broad coverage of ADHD‑related sexual issues","Inclusion of neurobiological and pharmacological perspectives"],"limitations":["Narrative (non‑systematic) synthesis; potential selection bias","No quantitative appraisal or risk‑of‑bias assessment","Lacks primary data; conclusions are speculative"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.97194"}},{"id":249,"doi":"10.1016/j.abrep.2021.100345","pmid":"33948482","pmcid":"PMC8080450","title":"Cognitive processes related to problematic pornography use (PPU): A systematic review of experimental studies","authors":"Castro-Calvo J, Cervigón-Carrasco V, Ballester-Arnal R, Giménez-García C.","first_author":"Castro-Calvo J","journal":"Addictive behaviors reports","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Systematic review","Cognitive Processes","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.abrep.2021.100345","cited_by_count":22,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of 21 experimental studies; no explicit meta‑analysis or risk‑of‑bias assessment reported","sample_n":null,"sample_text":"21 experimental studies (sample sizes not specified)","population":"experimental study participants investigating pornography use; details not provided","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"This review summarises experimental findings that people with self‑reported problematic pornography use tend to show stronger attention to sexual pictures, poorer impulse control, weaker working memory, and more impulsive decision‑making than non‑users.","clinical_takeaway":"Clients reporting problematic porn use may present cognitive control difficulties; consider assessing attention and impulsivity but note the evidence lacks strong causal proof.","confidence":0.7,"topic_tags":["pornography","csbd"],"strengths":["Systematic review follows PRISMA guidelines","Synthesises experimental evidence on multiple cognitive domains","Identifies consistent patterns across studies"],"limitations":["No meta‑analysis or formal risk‑of‑bias assessment reported","Unclear whether primary studies controlled for key confounds (moral incongruence, masturbation, mental health)","Potential reliance on self‑labelled ‘problematic’ use without validated addiction criteria"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":35,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.abrep.2021.100345"}},{"id":250,"doi":"10.21203/rs.3.rs-5989553/v1","pmid":null,"pmcid":null,"title":"Behavioral Patterns of Individuals with Mental Disorders in the Virtual Space: Comparison with Non-Affected Individuals","authors":"Momeni K, Salehzadeh M, Dastjerdi G, Rabiee E, Beyramvand Y, Safarifard R.","first_author":"Momeni K","journal":"Research Square","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-5989553/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Descriptive causal‑comparative study with convenience sample (N=233) of individuals with diagnosed mental disorders and non‑affected controls in Yazd, Iran.","sample_n":233,"sample_text":"Convenience, non‑random sampling","population":"Men and women, age 14–65, diagnosed mental‑disorder patients recruited from medical centres and community controls.","country":"Iran","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared people with mental disorders to people without, finding that those with conditions like borderline personality disorder, depression, OCD or bipolar disorder reported higher scores on a questionnaire about problematic pornography use, as well as more social‑media problems and cyberbullying.","clinical_takeaway":"Clients with certain mental‑health diagnoses may be at higher risk for problematic pornography use; clinicians should assess and address it in therapy.","confidence":0.7,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Use of validated scales (SMDS, PPUS)","Inclusion of several diagnostic groups","Relatively large total sample for a convenience study"],"limitations":["Convenience, non‑random sampling limits generalisability","No measurement of moral incongruence or masturbation, key confounds","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-5989553/v1"}},{"id":251,"doi":"10.1007/s10508-021-01930-z","pmid":"34143364","pmcid":"PMC8275519","title":"Exploring the Etiological Pathways of Problematic Pornography Use in NoFap/PornFree Rebooting Communities: A Critical Narrative Analysis of Internet Forum Data","authors":"Chasioti D, Binnie J.","first_author":"Chasioti D","journal":"Archives of sexual behavior","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Problematic Pornography Use","Critical Narrative Analysis","Nofap/pornfree","Online Self-help Communities","Rebooting Communities"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8275519","cited_by_count":12,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"critical narrative analysis of online NoFap/PornFree forum posts (self‑selected, treatment‑seeking community)","sample_n":null,"sample_text":"forum participants (self‑selected, not a probability sample)","population":"members of NoFap/PornFree self‑help forums who self‑identify as having problematic pornography use","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined posts from NoFap/PornFree online forums to explore why members describe their pornography use as problematic. They identified themes such as feeling vulnerable, using porn for escape, and the pressures of abstinence, but relied on self‑selected forum users and did not use validated questionnaires.","clinical_takeaway":"Findings are limited to self‑selected online community members; clinicians should not generalize them to all pornography users.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function","measurement"],"strengths":["Provides rich, contextual insight from participants' own narratives","Highlights complex sociocultural factors surrounding self‑identified PPU"],"limitations":["Uses self‑selected, treatment‑seeking forum sample; limited generalizability","No validated measures of pornography use, distress or addiction","Fails to control for key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)","Interpretations of etiological pathways exceed what qualitative data can support"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":19,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-01930-z"}},{"id":252,"doi":"10.1080/00224499.2017.1291798","pmid":"28276929","pmcid":null,"title":"The Development of the Problematic Pornography Consumption Scale (PPCS)","authors":"Bőthe B, Tóth-Király I, Zsila Á, Griffiths MD, Demetrovics Z, Orosz G.","first_author":"Bőthe B","journal":"Journal of sex research","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":150,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience sample, N=772, cross‑sectional questionnaire development","sample_n":772,"sample_text":"online convenience sample of 772 respondents (390 F, 382 M), mean age 22.6 y","population":"young adults (mean age 22.6), mixed gender","country":"unspecified (likely Hungary, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created an 18‑item questionnaire (PPCS) to identify problematic pornography use, basing items on a six‑component addiction model. In a sample of 772 young adults the scale showed good factor structure and reliability, and they set a cutoff that labelled about 3.6% of users as at‑risk.","clinical_takeaway":"The PPCS offers a psychometrically solid self‑report tool, but its addiction‑based items mix frequency with distress and ignore moral or mental‑health factors.","confidence":0.78,"topic_tags":["pornography","measurement","sexual_function","csbd"],"strengths":["Large sample for scale development","Rigorous CFA and measurement invariance testing","Reliability reported as excellent"],"limitations":["Convenience, non‑representative sample","No separate measurement of frequency vs distress","Moral incongruence, masturbation and mental‑health covariates not assessed"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":20,"contrasting":4,"mentioning":229,"citing_publications":326,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1291798"}},{"id":253,"doi":"10.3389/fpsyt.2023.1240222","pmid":"37614646","pmcid":"PMC10442643","title":"Sexual development in ADHD and internet pornography consumption","authors":"Privara M, Bob P.","first_author":"Privara M","journal":"Frontiers in psychiatry","year":2023,"pub_types":["brief-report","Journal Article"],"keywords":["Depression","ADHD","Anxiety","Compulsive Behavior","Hypersexuality","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10442643","cited_by_count":1,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"brief-report / commentary without empirical data","sample_n":null,"sample_text":"No sample described; article appears to be a narrative overview","population":"adolescents/young adults with ADHD (no sample reported)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The brief report suggests that teenagers with ADHD may watch more online porn, which could be linked to compulsive sexual behaviour, mood problems and relationship issues, but it provides no new data.","clinical_takeaway":"Clinicians should be aware of possible links between ADHD and increased porn use, yet current evidence is limited and based on speculation.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Highlights a potentially important clinical intersection (ADHD & porn use)","Identifies multiple psychosocial factors (depression, anxiety, identity) for future study"],"limitations":["No original data or systematic review methodology","Constructs and relationships are asserted without empirical measurement","No control for key confounds (moral incongruence, masturbation, mental health)","Interpretations exceed evidence presented"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2023.1240222"}},{"id":254,"doi":"10.1016/j.jsxm.2021.06.014","pmid":"34400111","pmcid":null,"title":"Pornography Addiction: An Exploration of the Association Between Use, Perceived Addiction, Erectile Dysfunction, Premature (Early) Ejaculation, and Sexual Satisfaction in Males Aged 18-44 Years","authors":"Whelan G, Brown J.","first_author":"Whelan G","journal":"The journal of sexual medicine","year":2021,"pub_types":["Journal Article"],"keywords":["Sexual Satisfaction","Premature (Early) Ejaculation","Internet Pornography Addiction","Internet Pornography Use","Erectile (Problems) Dysfunction"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey of 942 Reddit pornography‑subgroup users (heterosexual men 18‑44).","sample_n":942,"sample_text":"942 participants (online convenience sample).","population":"Male, heterosexual, 18‑44, recruited from Reddit pornography communities (self‑selected).","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 942 men recruited from Reddit pornography groups, the amount of porn watched did not relate to erectile problems, early ejaculation, or sexual satisfaction. However, men who thought they were addicted to porn reported more erectile issues, early ejaculation and lower personal sexual satisfaction.","clinical_takeaway":"Clinicians should consider a person’s self‑perception of porn addiction as a possible factor in sexual problems, but not assume porn use itself causes dysfunction.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (N≈942)","Validated clinical scales for ED, EE, sexual satisfaction, and mental health","Separates pornography use frequency from self‑perceived addiction"],"limitations":["Self‑selected Reddit sample limits generalisability","Self‑perceived addiction measured by single‑item, circular definition","Moral incongruence, masturbation, partner factors not assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.06.014"}},{"id":255,"doi":"10.1007/s10508-024-02986-3","pmid":"39358592","pmcid":null,"title":"Spanish Validation of the Brief Pornography Screen Within a Clinical Sample of Individuals with Gambling Disorder","authors":"Tarragón E, Testa G, Granero R, Potenza MN, Kraus SW, Uríszar JC, Chiclana Actis C, Fernández-Aranda F, Jiménez-Murcia S, Mestre-Bach G.","first_author":"Tarragón E","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Journal Article"],"keywords":["Gambling Disorder","Compulsive Sexual Behavior Disorder","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a brief screening instrument in a clinical sample of 200 treatment‑seeking individuals with gambling disorder","sample_n":200,"sample_text":"200 individuals seeking treatment for gambling disorder, consecutively recruited","population":"Adults with gambling disorder seeking treatment in Spain (N=200)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The Spanish Brief Pornography Screen was tested in 200 gambling‑disorder patients. It showed good reliability and was linked to distress, impulsivity and low self‑directedness, suggesting it can reliably flag possible problematic porn use in this group.","clinical_takeaway":"The Spanish BPS can be used as a quick screen for probable problematic pornography use among patients with gambling disorder.","confidence":0.7,"topic_tags":["pornography","sexual_function","prevalence","treatment","measurement"],"strengths":["Large clinical sample (N=200)","Rigorous psychometric testing (CFA, internal consistency)","Demonstrates convergent validity with relevant constructs"],"limitations":["Sample limited to treatment‑seeking gambling patients; not generalizable","No assessment of moral incongruence or masturbation, limiting interpretation of ‘problematic’ use","No pre‑registration or reporting of effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02986-3"}},{"id":256,"doi":"10.1080/19317611.2024.2364642","pmid":"39148913","pmcid":"PMC11323866","title":"The Role of Social Conservatism and Family Vaues Regarding the Use of Pornography Among Romanians: A Moderated Mediation Model","authors":"Huțul TD, Karner-Huțuleac A.","first_author":"Huțul TD","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Religiosity","Social Conservatism","Pornography","Family Values Regarding The Use Of Pornography","Moral Disapproval Of Pornography"],"is_oa":false,"oa_url":"https://doi.org/10.1080/19317611.2024.2364642","cited_by_count":7,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 501 Romanian adults, moderated mediation analysis","sample_n":501,"sample_text":"501 Romanian individuals, aged 18-76, 71.9% females","population":"Romanian adults, 18-76, 71.9% female, recruited online (presumed convenience sample)","country":"Romania","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 501 Romanian adults, people who are socially conservative and who hold strong family values about porn use tend to disapprove of pornography more, especially when they are also religious. The study builds a model linking these attitudes.","clinical_takeaway":"Clinicians should note that moral and cultural attitudes, not just use frequency, shape how people view pornography.","confidence":0.7,"topic_tags":["pornography","moral_incongruence","religiosity","sexual_function","csbd"],"strengths":["Large sample size for a survey","Theoretical model (P‑PPDM) development","Inclusion of religiosity as moderator","Clear statistical mediation framework"],"limitations":["Cross‑sectional design limits causal inference","Convenience sampling may bias representativeness","No measurement of actual pornography use or masturbation","Potential unmeasured mental‑health confounders"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2024.2364642"}},{"id":259,"doi":"10.1007/s10508-024-03000-6","pmid":"39414731","pmcid":null,"title":"Pornography Use and Associated Factors in Adolescents: A Cross-Jurisdictional Approach (Spain vs. Mexico)","authors":"Villena-Moya A, Chiclana-Actis C, Granero R, Fernández-Aranda F, Potenza MN, Jiménez-Murcia S, Mestre-Bach G.","first_author":"Villena-Moya A","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescents","Compulsive Sexual Behavior","Religiosity","Pornography","Sexually Explicit Material"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1810 adolescents from Spain and Mexico","sample_n":1810,"sample_text":"1810 adolescents from Spain and Mexico","population":"adolescents (Spain, Mexico)","country":"Spain; Mexico","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 1800 teens in Spain and Mexico examined how often they view porn and how this relates to loneliness, risky sex, family ties and religiosity. Porn use was linked to riskier sexual behaviour, especially in older boys and those with lower religiosity.","clinical_takeaway":"Higher porn use in adolescents may signal greater sexual‑risk behaviours; clinicians should assess use alongside family and religious context.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","csbd"],"strengths":["Large combined sample (N>1800)","Cross‑cultural comparison","Inclusion of religiosity and family variables"],"limitations":["Problematic use measured with likely unvalidated self‑report","Masturbation not assessed separately","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-03000-6"}},{"id":260,"doi":"10.1136/jech-2023-220577","pmid":"38964781","pmcid":null,"title":"Screen exposure, mental health and emotional well-being in the adolescent population: is it time for governments to take action<b>?</b>","authors":"Alvarez de Mon MA, Sánchez-Villegas A, Gutiérrez-Rojas L, Martinez-Gonzalez MA.","first_author":"Alvarez de Mon MA","journal":"Journal of epidemiology and community health","year":2024,"pub_types":["Journal Article"],"keywords":["Depression","Sex Education","Suicide","Behavior, Addictive"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary / narrative overview without original empirical data","sample_n":null,"sample_text":"none (review style)","population":"adolescents (general reference)","country":"unspecified (likely Spain based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article summarises many studies linking higher screen time to poorer mental health in teenagers and notes that problematic pornography use is also reported, but it does not provide new data or systematic analysis.","clinical_takeaway":"None – the piece offers no actionable clinical evidence; it only raises general concerns about screen exposure.","confidence":0.4,"topic_tags":["adolescents","sexual_function","pornography"],"strengths":["Broad overview of recent epidemiological findings","Highlights public‑health relevance of screen time"],"limitations":["No original data or systematic methodology reported","Lacks detail on how constructs (e.g., problematic pornography) are measured","No control for key confounds such as moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/jech-2023-220577"}},{"id":261,"doi":"10.1016/j.addbeh.2018.02.028","pmid":"29494859","pmcid":null,"title":"Predicting pornography use over time: Does self-reported \"addiction\" matter?","authors":"Grubbs JB, Wilt JA, Exline JJ, Pargament KI.","first_author":"Grubbs JB","journal":"Addictive behaviors","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Technology","Addiction","Religion","perception","Longitudinal","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two prospective cohorts (N≈4,000 and N≈1,000 at baseline) with follow‑up assessments of pornography use; predictors include gender, religiousness, self‑control and self‑reported “addiction”.","sample_n":3988,"sample_text":"Baseline N = 3988 (Sample 1), Baseline N = 1047 (Sample 2); follow‑up N = 265 (Sample 1) and N = 410/360 (Sample 2).","population":"US young adults (students and community volunteers), mixed gender.","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study tracked thousands of U.S. young adults and found that people who call themselves “addicted” to porn actually use it more on the same day, but this self‑label does not predict higher use a month or a year later.","clinical_takeaway":"Self‑reported porn “addiction” reflects current use but is not a reliable marker of future consumption.","confidence":0.8,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence","adolescents"],"strengths":["Large baseline samples with longitudinal follow‑up","Direct test of whether perceived addiction predicts use over time","Inclusion of relevant predictors (gender, religiosity, self‑control)"],"limitations":["Perceived‑addiction measured by a single self‑label, not a validated scale","Masturbation, mental‑health, relationship and trauma variables not assessed","Follow‑up sample sizes much smaller, limiting power for longitudinal predictions"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":3,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2018.02.028"}},{"id":262,"doi":"10.1177/0306624x221086569","pmid":"35414286","pmcid":"PMC11168019","title":"Relationship Between Atypical Sexual Fantasies, Behavior, and Pornography Consumption","authors":"Stefanska EB, Longpré N, Rogerson H.","first_author":"Stefanska EB","journal":"International journal of offender therapy and comparative criminology","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Behaviors","Paraphilia","Pornography","Atypical Sexual Fantasies"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11168019","cited_by_count":7,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 139 adults recruited from the general population (convenience sample).","sample_n":139,"sample_text":"139 participants","population":"Adults (young adult to middle aged, male and female) from unspecified sampling frame.","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 139 adults examined which sexual fantasies and behaviours are common and whether they relate to self‑reported problems with pornography use. Fantasies, behaviours, gender and age were linked to higher scores on a problematic‑porn use measure.","clinical_takeaway":"Self‑reported porn‑related problems are associated with certain fantasies and behaviours, but the findings do not establish causality or clinical thresholds.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Relatively large sample for exploratory survey","Considers gender differences","Addresses a gap in knowledge about atypical fantasies in the general population"],"limitations":["Cross‑sectional design limits causal inference","Problematic porn use measured with unspecified, likely unvalidated instrument","Key confounds (moral incongruence, masturbation, mental health, relationship factors) not assessed"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":19,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x221086569"}},{"id":264,"doi":"10.1080/00224499.2021.1916422","pmid":"33945359","pmcid":null,"title":"Religiosity, Perceived Effects of Pornography Use on Personal Sex Life, and Moral Incongruence: Insights from the German Health and Sexuality Survey (GeSiD)","authors":"Štulhofer A, Wiessner C, Koletić G, Pietras L, Briken P.","first_author":"Štulhofer A","journal":"Journal of sex research","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national probability-based survey of 4,177 German adults, cross‑sectional analysis of self‑reported pornography use frequency and perceived impact, with logistic regression examining religious upbringing as a proxy for moral incongruence.","sample_n":4177,"sample_text":"National probability‑based German Health and Sexuality Survey (GeSiD) participants (N = 4,177).","population":"Adults (18+) from the German Health and Sexuality Survey, probability sample, mixed gender.","country":"Germany","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a German national survey of over 4,000 adults, most people said pornography did not affect their sex life. Women were more likely to report positive effects, men mixed or negative. Higher porn use was linked to both positive and negative perceived impacts. Religious upbringing predicted a more negative view of porn, supporting the idea that moral conflict influences how people judge its effect.","clinical_takeaway":"Clinicians should consider a client’s moral or religious background when evaluating concerns about pornography use, as perceived problems may stem from moral incongruence rather than use frequency.","confidence":0.8,"topic_tags":["pornography","moral_incongruence","sexual_function","religiosity"],"strengths":["Large, nationally representative sample","Separates frequency from perceived impact","Includes a measure of moral incongruence (religious upbringing)","Appropriate statistical modelling for categorical outcomes"],"limitations":["No validated scale for moral incongruence or ‘problematic’ use","Masturbation and other sexual‑health covariates not assessed","Cross‑sectional; cannot infer causality","No mental‑health or relationship variables controlled"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":6,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2021.1916422"}},{"id":265,"doi":"10.1007/s10508-024-02887-5","pmid":"39112690","pmcid":"PMC11390853","title":"The Associations of Pornography Use and Body Image Among Heterosexual and Sexual Minority Men","authors":"Gewirtz-Meydan A, Bőthe B, Spivak-Lavi Z.","first_author":"Gewirtz-Meydan A","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Body Image","Social Comparison","Sexual Orientation","Sexual Minority Men","Pornography Use Frequency","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11390853","cited_by_count":6,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 726 men (223 sexual minorities) examining frequency and problematic pornography use, social body comparison, and body image via moderated mediation model","sample_n":726,"sample_text":"726 men (223 sexual minorities)","population":"adult men 18‑68, heterosexual and sexual minority, recruited online (presumed convenience sample)","country":"unspecified (likely multiple, given international authors)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 726 men, higher problematic porn use (but not how often they watch) was linked to more social comparison of bodies, which in turn related to worse body image, especially among sexual‑minority men.","clinical_takeaway":"Clinicians should consider how problematic porn use may contribute to negative body image via social comparison, but causality is uncertain.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample with sexual minority subgroup","Theory‑driven (social comparison) mediation model","Inclusion of both frequency and problematic use measures"],"limitations":["Cross‑sectional design limits causal inference","No control for moral/religious incongruence or masturbation","Problematic use likely measured with self‑label scale, potential circularity"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02887-5"}},{"id":266,"doi":"10.1007/s40473-020-00212-7","pmid":"33585161","pmcid":"PMC7880151","title":"Decision-Making in Gambling Disorder, Problematic Pornography Use, and Binge-Eating Disorder: Similarities and Differences","authors":"Mestre-Bach G, Fernández-Aranda F, Jiménez-Murcia S, Potenza MN.","first_author":"Mestre-Bach G","journal":"Current behavioral neuroscience reports","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["decision-making","Delay Discounting","Binge-eating Disorder","Gambling Disorder","Addictive Behaviors","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review (narrative overview of decision‑making across gambling disorder, problematic pornography use and binge‑eating disorder)","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews research on how people with gambling disorder, problematic pornography use, and binge‑eating disorder make decisions, suggesting that decision‑making deficits are common across these conditions.","clinical_takeaway":"Decision‑making problems may be a shared feature of several addictive‑like disorders, but the review does not provide direct guidance for treatment.","confidence":0.7,"topic_tags":["pornography","csbd"],"strengths":["Integrates literature across three disorders","Highlights decision‑making as a transdiagnostic construct"],"limitations":["No systematic search or quality appraisal reported","Lacks primary empirical data"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40473-020-00212-7"}},{"id":267,"doi":"10.1093/sexmed/qfae003","pmid":"38450258","pmcid":"PMC10915581","title":"Compulsive sexual behavior disorder in an inpatient sample with substance use disorder","authors":"Golder S, Walter B, Bengesser I, Kramer D, Muhl C, Tahmassebi N, Storz F, Markert C, Stark R.","first_author":"Golder S","journal":"Sexual medicine","year":2024,"pub_types":["Comment","research-article","Journal Article"],"keywords":["Prevalence","Comorbidity","Compulsive Sexual Behavior","Substance Use Disorder","inpatients","Pornography Use Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10915581","cited_by_count":6,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control cross‑sectional study of 92 inpatients with SUD compared to matched healthy controls","sample_n":92,"sample_text":"92 SUD inpatients; comparable control group (size not stated but matched)","population":"inpatient SUD patients (N=92) and community controls matched on age, gender, education","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared how often compulsive sexual behavior and pornography‑use problems occur in people receiving treatment for substance use disorders versus a matched group of healthy people. Rates were low and similar in both groups, suggesting no extra risk for these problems among substance‑use patients.","clinical_takeaway":"Substance‑use patients do not appear to have higher rates of CSBD or pornography‑use disorder, but clinicians should still assess vulnerability factors like emotional regulation.","confidence":0.85,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Matched control group","Uses ICD‑11 based CSBD instrument","Addresses an understudied comorbidity"],"limitations":["Small inpatient sample, limited generalisability","No assessment of moral incongruence or mental‑health covariates","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":5,"addiction_criteria":6,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfae003"}},{"id":268,"doi":"10.1556/2006.2020.00037","pmid":"32663382","pmcid":"PMC8939408","title":"Hands-off: Study protocol of a two-armed randomized controlled trial of a web-based self-help tool to reduce problematic pornography use","authors":"Bőthe B, Baumgartner C, Schaub MP, Demetrovics Z, Orosz G.","first_author":"Bőthe B","journal":"Journal of behavioral addictions","year":2020,"pub_types":["Clinical Trial Protocol","research-article","Journal Article"],"keywords":["Cognitive-behavioral Therapy","Motivational Interview","Online Intervention","Problematic Pornography Use","Wise Social-psychological Intervention"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8939408","cited_by_count":9,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"two-armed randomized controlled trial protocol testing a six‑week web‑based self‑help program (Hands‑off) for reducing problematic pornography use; 242 participants; assessments at baseline, post‑intervention, 1‑month, 3‑month; primary outcome PPU; secondary outcomes include use frequency, craving, ","sample_n":242,"sample_text":"target sample size is 242 participants","population":"adult participants self‑reporting problematic pornography use (PPU), recruited online; inclusion criteria not detailed in abstract.","country":"not specified","controls_mi":"no","preregistered":true,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A protocol for a randomized trial will test whether a free, six‑week online self‑help program can reduce self‑reported problematic pornography use in 242 adults, measuring use, cravings, satisfaction and wellbeing over three months.","clinical_takeaway":"None – the study is a protocol; no efficacy data are yet available.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Pre‑registered RCT design with adequate planned sample size","Clear primary and secondary outcomes","Intention‑to‑treat analysis plan with linear mixed models"],"limitations":["Constructs (PPU) not specified which validated instrument will be used","Key confounds (moral incongruence, masturbation, partner factors, trauma) not addressed","Addiction criteria not operationalised; reliance on self‑reported problematic use"],"rubric_version":"2.0","raw_total":40,"max_possible":60,"pct_score":67,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":5,"design":8,"addiction_criteria":4,"interpretation":9}},"scite":{"supporting":2,"contrasting":0,"mentioning":17,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00037"}},{"id":269,"doi":"10.1016/j.biopsycho.2025.109046","pmid":"40355040","pmcid":null,"title":"Trait sexual motivation shapes cue reactivity in visual, but not auditory, sexual reward learning: Psychophysiological and computational evidence","authors":"Finke JB, Klucken T.","first_author":"Finke JB","journal":"Biological psychology","year":2025,"pub_types":["Journal Article"],"keywords":["Reward Learning","Pavlovian Conditioning","Pupil Dilation","Sexual Stimuli","Startle Modulation","Trait Sexual Motivation"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subject laboratory Pavlovian conditioning with physiological recordings (pupil, startle) across two sessions (visual vs auditory sexual stimuli).","sample_n":62,"sample_text":"final sample, 36 women","population":"62 heterosexual adults (36 women), recruited presumably from the community.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, people with higher solitary sexual desire showed weaker eye‑pupil responses to visual sexual cues (but not to sounds), suggesting they may experience less anticipation of visual erotic material.","clinical_takeaway":"Individuals high in solitary sexual desire may react less physiologically to visual erotic cues, a factor to consider when assessing risk for excessive pornography use.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Physiological indices (pupil, startle) provide objective learning measures","Within‑subject design controls individual differences","Computational modeling adds depth to learning trajectory analysis"],"limitations":["No assessment of moral or religious factors despite discussing problematic use","Sample size modest for between‑modality comparisons","Findings based on laboratory cues may not translate to real‑world pornography use"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.biopsycho.2025.109046"}},{"id":272,"doi":"10.2196/32542","pmid":"34534092","pmcid":"PMC8569536","title":"Associations Between Online Pornography Consumption and Sexual Dysfunction in Young Men: Multivariate Analysis Based on an International Web-Based Survey","authors":"Jacobs T, Geysemans B, Van Hal G, Glazemakers I, Fog-Poulsen K, Vermandel A, De Wachter S, De Win G.","first_author":"Jacobs T","journal":"JMIR public health and surveillance","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["erectile dysfunction","Sexual Health","Young Adults","Pied","Ed","Pornography","Pornography-induced Erectile Dysfunction"],"is_oa":true,"oa_url":"https://publichealth.jmir.org/2021/10/e32542/PDF","cited_by_count":33,"is_preprint":false,"topics":["masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"web‑based international survey of 3,419 young men (18‑35 y), 118‑item questionnaire, logistic regression analysis","sample_n":3419,"sample_text":"3419 men aged 18‑35 y from an online survey","population":"young adult men, self‑selected internet respondents","country":"International (online)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of over 3,000 men aged 18‑35, higher scores on a problematic pornography use questionnaire were linked to a greater chance of erectile dysfunction, even after accounting for how often they masturbated and other factors.","clinical_takeaway":"Higher problematic porn use may be associated with erectile issues in young men, but causality is unclear; clinicians should assess porn use alongside other sexual‑health factors.","confidence":0.85,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size","Use of validated questionnaires (CYPAT, IIEF‑5)","Multivariate analysis with DAG‑guided model"],"limitations":["Cross‑sectional, cannot infer causality","Convenient, self‑selected internet sample – limited generalisability","Moral incongruence and broader mental‑health factors not assessed"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":4,"design":4,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/32542"}},{"id":273,"doi":"10.1556/2006.2022.00037","pmid":"35895611","pmcid":"PMC9295234","title":"Individual cortisol response to acute stress influences neural processing of sexual cues","authors":"Stark R, Markert C, Kruse O, Walter B, Strahler J, Klein S.","first_author":"Stark R","journal":"Journal of behavioral addictions","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Nucleus accumbens","Reward System","Sexual Cues","Compulsive Sexual Behavior Disorder","Problematic Pornography Use","Sexual Incentive Delay Task"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/11/2/article-p506.pdf","cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"fMRI experiment with stress manipulation (social stress test) and sexual incentive delay task; n=157 men, half assigned to stress condition.","sample_n":157,"sample_text":"157 men, mean age 25.46 (SD 4.11).","population":"Adult men, mean age 25.5, community sample (presumably volunteers).","country":"Germany (inferred from author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 157 men, a stress test increased cortisol, which was linked to stronger brain responses to sexual images in reward areas. Those who spent more time on pornography showed heightened effects, suggesting stress may make sexual cues more tempting for some users.","clinical_takeaway":"Acute stress may heighten brain reactivity to sexual cues, potentially increasing risk of problematic pornography use in susceptible individuals.","confidence":0.78,"topic_tags":["pornography","sexual_function","neuroscience","csbd"],"strengths":["Large sample for fMRI (n=157)","Physiological stress manipulation with cortisol measurement","Use of well‑established sexual incentive delay task"],"limitations":["Problematic pornography use not operationalised with validated scale","Key psychosocial confounds (moral incongruence, masturbation, mental health) not measured","No pre‑registration or correction for multiple neuroimaging comparisons reported"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":6,"statistics":5,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00037"}},{"id":274,"doi":"10.1007/s11469-023-01087-x","pmid":"37363758","pmcid":"PMC10235843","title":"Profiles of Pornography Use Based on Addictive Mechanisms and Psychopathological Features","authors":"Hernández-Mora Ruiz Del Castillo M, Bonnet P, Varescon I.","first_author":"Hernández-Mora Ruiz Del Castillo M","journal":"International journal of mental health and addiction","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Attention Deficit Hyperactivity Disorder","Profile Analysis","Obsessive–compulsive Disorder","Problematic Pornography Use","Addictive Mechanisms"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10235843","cited_by_count":6,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 1001 French adults, person‑centered clustering of PPU scores, t‑tests on psychopathology","sample_n":1001,"sample_text":"French adult community respondents recruited for an online survey","population":"French adults, community sample (N=1001)","country":"France","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 1,001 French adults, three groups of pornography users were identified: non‑problematic, at‑risk, and problematic. The problematic group showed higher scores on ADHD, OCD and depression symptoms, suggesting these mental‑health factors relate to more severe porn use.","clinical_takeaway":"Clinicians should consider ADHD, OCD, and depressive symptoms when assessing problematic pornography use.","confidence":0.78,"topic_tags":["pornography","prevalence","sexual_function","other"],"strengths":["Large community sample (N>1000)","Use of validated French PPU scale","Person‑centered profiling approach"],"limitations":["Cross‑sectional, cannot infer causality","No assessment of moral incongruence or masturbation","Addiction criteria not fully operationalised"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":6,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11469-023-01087-x"}},{"id":275,"doi":"10.1016/j.jsxm.2019.01.312","pmid":"30852107","pmcid":null,"title":"Investigating the Associations Of Adult ADHD Symptoms, Hypersexuality, and Problematic Pornography Use Among Men and Women on a Largescale, Non-Clinical Sample","authors":"Bőthe B, Koós M, Tóth-Király I, Orosz G, Demetrovics Z.","first_author":"Bőthe B","journal":"The journal of sexual medicine","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Gender Differences","Attention Deficit Hyperactivity Disorder","Hypersexuality","Adhd Symptoms","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":50,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community sample (N=14,043), structural equation modeling, cross‑sectional","sample_n":14043,"sample_text":"14,043 participants; women = 4,237; mean age = 33.5 years (SD = 10.9)","population":"adult men and women, non‑clinical","country":"unspecified (likely Hungary based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 14,000 adults, higher ADHD symptoms were linked to more hypersexual behaviour and, especially in men, to greater problematic pornography use. The relationships were stronger for men than for women.","clinical_takeaway":"Consider screening for ADHD when patients report high hypersexuality or problematic porn use, particularly in men.","confidence":0.85,"topic_tags":["pornography","masturbation","sexual_function","csbd","adolescents"],"strengths":["Very large, non‑clinical sample","Gender‑specific analysis","Use of structural equation modeling"],"limitations":["All variables self‑reported; possible common‑method bias","No measurement of moral incongruence or related confounds","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":11,"contrasting":1,"mentioning":79,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.01.312"}},{"id":277,"doi":"10.1556/2006.2025.00012","pmid":"40014056","pmcid":"PMC11974435","title":"Enhanced conditioning and disrupted extinction processes in men struggling with compulsive sexual behaviors","authors":"Wojciechowski J, Draps M, Kublik E, Dubiejko P, Wolak T, Gola M.","first_author":"Wojciechowski J","journal":"Journal of behavioral addictions","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Extinction","fMRI","Associative learning","Conditioning","Compulsive Sexual Behaviors","Reward System"],"is_oa":true,"oa_url":"https://doi.org/10.1556/2006.2025.00012","cited_by_count":6,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"case‑control fMRI conditioning/extinction study with 63 male participants","sample_n":63,"sample_text":"32 CSB, 31 controls (convenience sample)","population":"heterosexual men, 28 ± 7 years, self‑reported CSB vs matched healthy controls","country":"Poland (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","causal_from_correlational"],"stance":"supports","citation_value":"useful","plain_summary":"In a brain‑scan study, men who say they have compulsive sexual behaviour showed stronger emotional reactions and faster responses to erotic and money cues, and their brain activity in reward areas stayed high even when the cues were no longer rewarded.","clinical_takeaway":"Findings suggest altered cue processing in CSB, but the small, non‑validated study limits direct clinical use.","confidence":0.4,"topic_tags":["csbd","neuroscience","sexual_function"],"strengths":["Matched control group","Multimodal assessment (self‑report, behavior, fMRI)","Novel conditioning/extinction paradigm"],"limitations":["Small fMRI sample, limited power","No validated CSB or addiction scale, reliance on self‑label","Key confounds (morality, mental health, masturbation) not measured","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":70,"pct_score":37,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":5,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":14,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00012"}},{"id":278,"doi":"10.30773/pi.2023.0369","pmid":"39757813","pmcid":"PMC11704803","title":"What Is Excessive? The Screening Frequency of Online Sexual Activities Among Community and Subclinical Males","authors":"Chen L, Wang Q, Jiang X, Zhang Y.","first_author":"Chen L","journal":"Psychiatry investigation","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Latent Profile Analysis","Problematic Pornography Use","Online Sexual Activities","Optimal Cutoff Value"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11704803","cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 568 community males and 567 sub‑clinical help‑seeking males; latent profile analysis used to identify groups and cutoff scores.","sample_n":1135,"sample_text":"568 community adult males who engaged in OSAs and 567 adult males seeking help for pornography use, recruited online.","population":"adult males (community and sub‑clinical help‑seeking)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed over 1,100 men about how often they view online sexual material and used statistical clustering to propose cut‑off points that might flag ‘excessive’ use, aiming to help clinicians identify problematic porn use.","clinical_takeaway":"High frequency of online sexual activity may indicate loss of control, but clinicians should also assess moral, mental‑health and relational factors.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size","Use of latent profile analysis to identify subgroups","Attempt to establish empirical cut‑offs for screening"],"limitations":["Reliance on self‑report, unclear validation of measures","No control for key confounds (moral incongruence, masturbation, mental health)","Cross‑sectional, convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.30773/pi.2023.0369"}},{"id":279,"doi":"10.1556/2006.6.2017.063","pmid":"29034717","pmcid":"PMC6034965","title":"Treatment seeking for problematic pornography use among women","authors":"Lewczuk K, Szmyd J, Skorko M, Gola M.","first_author":"Lewczuk K","journal":"Journal of behavioral addictions","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Gender Differences","Hypersexual Behavior","psychotherapy","Treatment Seeking","Pornography","Problematic Sexual Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6034965","cited_by_count":53,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 719 Polish‑speaking women (39 treatment seekers) comparing treatment‑seekers vs non‑problematic users; path analysis used","sample_n":719,"sample_text":"719 participants, 39 treatment seekers","population":"female, 14‑63 y, Poland, Caucasian, community sample","country":"Poland","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 719 Polish women and found that, unlike men, women’s religious beliefs and the amount of porn they view predict whether they seek help for problematic porn use.","clinical_takeaway":"When women seek help for porn‑related problems, clinicians should assess religious concerns and perceived symptom distress.","confidence":0.7,"topic_tags":["pornography","treatment","gender","religiosity","sexual_function"],"strengths":["large overall sample size","focus on understudied female population","includes religiosity as a predictor"],"limitations":["very few treatment‑seeking women (n=39) limits power","lack of validated instruments for problematic PU","no measurement of masturbation or broader mental‑health covariates"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":10,"contrasting":2,"mentioning":68,"citing_publications":95,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.6.2017.063"}},{"id":280,"doi":"10.1016/j.abrep.2025.100600","pmid":"40231232","pmcid":"PMC11994906","title":"Psychological risk factors for problematic social network use: An overview of systematic reviews and <i>meta</i>-analyses","authors":"Fioravanti G, Bocci Benucci S, Ghinassi S.","first_author":"Fioravanti G","journal":"Addictive behaviors reports","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Systematic Reviews","Meta-analyses","Psychological Risk Factors","Problematic Social Network Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11994906","cited_by_count":7,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"overview of systematic reviews/meta-analyses","sample_n":null,"sample_text":"Not applicable – summary of existing reviews","population":"studies of problematic social network use across multiple reviews","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This overview pooled 35 systematic reviews on problematic social‑network use and found that many psychological risks (e.g., low self‑esteem, depression, anxiety, insecure attachment) are also seen in other online addictions such as problematic pornography use, though some motivations differ.","clinical_takeaway":"Risk factors for excessive social‑media use overlap with other online addictions; clinicians should assess broader psychosocial issues rather than focusing only on the platform.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Broad synthesis of 35 systematic reviews/meta‑analyses","Identifies both shared and specific psychological risk factors","Includes bibliometric comparison across multiple online behaviours"],"limitations":["No formal risk‑of‑bias assessment of included reviews","Limited detail on how primary studies measured constructs","Potential overlap of primary studies across reviews"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.abrep.2025.100600"}},{"id":281,"doi":"10.1186/s13690-024-01294-5","pmid":"38816773","pmcid":"PMC11137999","title":"How much online pornography is too much? A comparison of two theoretically distinct assessment scales","authors":"Vera Cruz G, Aboujaoude E, Liberacka-Dwojak M, Wiłkość-Dębczyńska M, Rochat L, Khan R, Khazaal Y.","first_author":"Vera Cruz G","journal":"Archives of public health = Archives belges de sante publique","year":2024,"pub_types":["Letter"],"keywords":["Impulse Control Disorder","Internet Addiction","Assessment Tools","Behavioral Addiction","Sex Addiction","Pornography","Internet Gaming Disorder","Nonparaphilia","“Cyberporn”"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11137999","cited_by_count":3,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online questionnaire, convenience sample of 1,823 adults","sample_n":1823,"sample_text":"international online convenience sample","population":"adults (mean age 31.66, SD 6.74), international online sample","country":"unspecified (international)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors compared two self‑report questionnaires that aim to measure problematic pornography use. Both scales identified risky use, but the ICD‑11‑based tool (ACSID‑11) was better at indicating clinical risk. The study used a large online sample but did not account for moral views or related factors.","clinical_takeaway":"Both questionnaires can screen for risky pornography use; choose ACSID‑11 for finer clinical risk assessment, but remember they rely on self‑report and lack control for moral or mental‑health factors.","confidence":0.8,"topic_tags":["pornography","measurement","sexual_function"],"strengths":["Large sample size for a survey","Direct comparison of two commonly used scales","Use of factorial and network analyses"],"limitations":["Convenience sampling limits generalisability","No control for moral incongruence or related confounds","Potential circularity in scales defining addiction by distress"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s13690-024-01294-5"}},{"id":282,"doi":"10.1556/2006.5.2016.046","pmid":"27440474","pmcid":"PMC5264421","title":"Paroxetine Treatment of Problematic Pornography Use: A Case Series","authors":"Gola M, Potenza MN.","first_author":"Gola M","journal":"Journal of behavioral addictions","year":2016,"pub_types":["review-article","Journal Article","Case Reports"],"keywords":["Paroxetine","Pharmacotherapy","Case Series","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5264421","cited_by_count":62,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case series of three heterosexual males with problematic pornography use treated with paroxetine and CBT; frequency of use, other sexual behaviours and anxiety were tracked over three months.","sample_n":3,"sample_text":"Three cases","population":"3 adult male participants, heterosexual, seeking treatment for self‑identified problematic pornography use.","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"supports","citation_value":"useful","plain_summary":"A tiny case series (3 men) treated problematic pornography use with the antidepressant paroxetine plus therapy. Use and anxiety dropped at first, but new compulsive sexual behaviours appeared after three months.","clinical_takeaway":"Paroxetine may temporarily lower porn use and anxiety, but clinicians should monitor for emerging compulsive sexual behaviours.","confidence":0.6,"topic_tags":["pornography","treatment","csbd","sexual_function","neuroscience"],"strengths":["Combination of pharmacotherapy and CBT reported","Longitudinal follow‑up over 3 months","Highlights emergence of new compulsive sexual behaviours"],"limitations":["Very small N (3), no control group","No validated measures of problematic pornography use","No assessment of key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)","Interpretation exceeds data (causal claims, neurobiological speculation)"],"rubric_version":"2.0","raw_total":13,"max_possible":60,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":2,"interpretation":3}},"scite":{"supporting":2,"contrasting":0,"mentioning":50,"citing_publications":150,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.5.2016.046"}},{"id":283,"doi":"10.4081/jphr.2021.2333","pmid":"34060736","pmcid":"PMC9309635","title":"Contribution of pornographic exposure and addiction to risky sexual behavior in adolescents","authors":"Yunengsih W, Setiawan A.","first_author":"Yunengsih W","journal":"Journal of public health research","year":2021,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9309635","cited_by_count":9,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 394 adolescents selected by stratified random sampling; online questionnaire","sample_n":394,"sample_text":"394 students selected by stratified random sampling","population":"adolescent students (N=394)","country":"Indonesia (presumed from author names, not stated)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 394 high‑school students, earlier exposure to porn, more types of porn watched, and higher scores on a self‑report addiction scale were linked to riskier sexual behaviours. The study suggests that porn addiction may drive unsafe sex among teens.","clinical_takeaway":"Screen for early porn exposure and self‑reported addiction when assessing adolescent sexual risk, but note the evidence is correlational.","confidence":0.78,"topic_tags":["pornography","adolescents","relationships","religiosity"],"strengths":["Large sample for a single‑site adolescent study","Stratified random sampling increases representativeness","Uses separate instruments for pornography addiction and sexual risk"],"limitations":["Cross‑sectional design cannot infer causality","Addiction instrument likely unvalidated and circular","Key confounds (moral incongruence, masturbation, mental health) not measured","Statistical reporting limited to p‑values without effect‑size CIs"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":27,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4081/jphr.2021.2333"}},{"id":284,"doi":"10.1016/j.jsxm.2016.03.002","pmid":"27114191","pmcid":null,"title":"Pornography Addiction in Adults: A Systematic Review of Definitions and Reported Impact","authors":"Duffy A, Dawson DL, das Nair R.","first_author":"Duffy A","journal":"The journal of sexual medicine","year":2016,"pub_types":["Systematic Review","Journal Article"],"keywords":["Review","Impact","Addiction","Definitions","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":79,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of quantitative and qualitative studies on self‑perceived pornography addiction (SPPA), summarising definitions and reported impacts without meta‑analysis or formal risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not applicable – review of existing studies","population":"Adults from various primary studies (heterogeneous, likely convenience samples)","country":"Not specified (multinational literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"This review examined how researchers define and measure self‑perceived pornography addiction and what impacts they report. It found great variation, with many studies using simple frequency counts and distress labels, limiting confidence in conclusions about harms.","clinical_takeaway":"Current evidence on pornography addiction’s impact is weak; clinicians should be cautious interpreting self‑labelled addiction without robust assessment.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Comprehensive literature search across multiple databases","Identifies heterogeneity and methodological gaps in primary research","Provides clear recommendations for future work"],"limitations":["No quantitative synthesis or meta‑analysis","No formal risk‑of‑bias assessment of included studies","Relies on primary studies with poor construct definition and confound control"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":0,"mentioning":121,"citing_publications":212,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2016.03.002"}},{"id":285,"doi":"10.1101/2021.06.22.21259291","pmid":null,"pmcid":null,"title":"Prefrontal Cortex Definitions and Their Use in Distinguishing Pornography Addicted Juveniles","authors":"Prawiroharjo P, Edison RE, Ellydar H, Pratama P, Imelda Suaidy SE, Amani NZ, Carissima D, Hatta GF.","first_author":"Prawiroharjo P","journal":"medRxiv","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.medrxiv.org/content/medrxiv/early/2021/06/25/2021.06.22.21259291.full.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control MRI volumetric study of 30 juveniles (15 labelled as pornography‑addicted, 15 controls)","sample_n":30,"sample_text":"30 juveniles (12‑16 y.o.), 15 addiction, 15 non‑addiction","population":"juveniles 12‑16 y, recruited likely from clinical or self‑selected sources","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used MRI scans of 30 teenagers to see whether certain brain regions differ in those who say they are addicted to pornography versus peers. Small differences were found in parts of the prefrontal cortex, but the research was limited by a tiny sample and unclear definition of addiction.","clinical_takeaway":"Findings are preliminary; clinicians should not base diagnostic decisions on MRI differences without stronger evidence.","confidence":0.7,"topic_tags":["pornography","adolescents","neuroscience","prevalence","csbd"],"strengths":["Use of high‑resolution 3 T MRI","Systematic testing of multiple PFC subregion models"],"limitations":["Very small sample, likely underpowered","No validated measure of pornography addiction reported","No control for key confounds (moral, mental health, masturbation, etc.)","Multiple uncorrected statistical comparisons"],"rubric_version":"2.0","raw_total":19,"max_possible":70,"pct_score":27,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":4,"statistics":3,"confounds":2,"design":3,"addiction_criteria":2,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2021.06.22.21259291"}},{"id":286,"doi":"10.3389/fpsyt.2024.1430409","pmid":"39391084","pmcid":"PMC11465090","title":"A systematic review of treatment for impulsivity and compulsivity","authors":"Aguilar-Yamuza B, Trenados Y, Herruzo C, Pino MJ, Herruzo J.","first_author":"Aguilar-Yamuza B","journal":"Frontiers in psychiatry","year":2024,"pub_types":["Systematic Review","systematic-review","Journal Article"],"keywords":["Systematic review","Impulsivity","Behavioral Addictions","Compulsivity","Psychological Treatment"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11465090","cited_by_count":10,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of 14 psychological treatment studies for impulsivity/compulsivity across behavioral addictions, following PRISMA","sample_n":14,"sample_text":"14 articles identified","population":"people with non‑substance behavioral addictions (including compulsive sexual behavior and problematic pornography use)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review screened 764 papers and found only 14 studies testing psychological therapies for impulsivity and compulsivity in behavioral addictions, including compulsive sexual behavior and problematic pornography use. Cognitive‑behavioral therapy showed the most consistent benefits, while other approaches like DBT and ACT helped with internet‑related problems.","clinical_takeaway":"CBT appears to be the most evidence‑based option for reducing compulsivity in problematic pornography use, but data are limited; clinicians should monitor for individual differences and co‑occurring issues.","confidence":0.7,"topic_tags":["treatment","csbd","pornography","masturbation","sexual_function"],"strengths":["PRISMA‑guided systematic search","Focus on impulsivity/compulsivity across multiple behavioral addictions","Identifies gaps in treatment literature"],"limitations":["Very small number of included studies","No meta‑analysis or pooled effect sizes","Limited detail on measurement validity and confound control"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2024.1430409"}},{"id":287,"doi":"10.1016/j.addbeh.2020.106603","pmid":"32810799","pmcid":null,"title":"Are sexual functioning problems associated with frequent pornography use and/or problematic pornography use? Results from a large community survey including males and females","authors":"Bőthe B, Tóth-Király I, Griffiths MD, Potenza MN, Orosz G, Demetrovics Z.","first_author":"Bőthe B","journal":"Addictive behaviors","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual dysfunction","Sexual Problems","Problematic Pornography Use","Pornography Use Frequency","Sexual Functioning Problems"],"is_oa":false,"oa_url":"https://doi.org/10.1016/j.addbeh.2020.106603","cited_by_count":60,"is_preprint":false,"topics":["masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community survey (N=14,581) using structural equation modelling","sample_n":14581,"sample_text":"N = 14,581 participants; females = 4,352; males = 10,229; mean age 33.6 years","population":"adults, both sexes, community sample","country":"unspecified (likely multiple European countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 14,500 adults, higher scores on a problematic porn‑use scale were linked to more sexual‑functioning problems, while simply using porn more often was linked to slightly fewer problems. Both frequency and problematic use should be examined separately.","clinical_takeaway":"Problematic porn use, not just frequent use, is associated with sexual‑function issues; assess distress and control factors rather than frequency alone.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Very large sample size","Separate analysis of frequency vs problematic use","Controls for key demographic variables and masturbation"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral incongruence or mental‑health covariates","Unclear which PPU scale was used and its validation status"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":5,"contrasting":1,"mentioning":42,"citing_publications":118,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2020.106603"}},{"id":288,"doi":"10.1007/s40263-024-01075-2","pmid":"38485889","pmcid":null,"title":"Current Understanding of Compulsive Sexual Behavior Disorder and Co-occurring Conditions: What Clinicians Should Know about Pharmacological Options","authors":"Mestre-Bach G, Potenza MN.","first_author":"Mestre-Bach G","journal":"CNS drugs","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of pharmacological case studies, no original data","sample_n":null,"sample_text":"none (review)","population":"adults with CSBD/PPU (no sample reported)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This narrative review summarizes the few existing case reports on drugs used for compulsive sexual behavior disorder, including problematic pornography use, and notes that evidence is very limited and not generalisable.","clinical_takeaway":"Pharmacological options for CSBD are largely untested; clinicians should rely mainly on psychological therapies and consider meds only as adjuncts with caution.","confidence":0.8,"topic_tags":["csbd","pornography","sexual_function","treatment"],"strengths":["Comprehensive overview of pharmacological agents","Clear acknowledgement of limited empirical support","Discussion of co‑occurring conditions"],"limitations":["No original data; relies on case reports","No systematic review methodology reported","No assessment of study quality or bias"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40263-024-01075-2"}},{"id":289,"doi":"10.1016/j.addbeh.2014.01.027","pmid":"24583276","pmcid":null,"title":"Psychometric development of the Problematic Pornography Use Scale","authors":"Kor A, Zilcha-Mano S, Fogel YA, Mikulincer M, Reid RC, Potenza MN.","first_author":"Kor A","journal":"Addictive behaviors","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Journal Article"],"keywords":["Addiction","Pornography","Pornography Scale"],"is_oa":false,"oa_url":null,"cited_by_count":136,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study across three samples; exploratory and confirmatory factor analyses; cross‑sectional self‑report surveys","sample_n":null,"sample_text":"multiple community samples; exact N not provided in abstract","population":"adults of various ages (young adult to older adult), both sexes","country":"Israel (based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created the Problematic Pornography Use Scale (PPUS) and tested it in three surveys. The scale showed strong internal consistency and factor structure, and higher scores were linked to poorer mental health and low self‑esteem, suggesting it may capture a distinct form of problematic pornography use.","clinical_takeaway":"The PPUS may help identify individuals who experience distress related to pornography, but clinicians should interpret scores cautiously and consider moral or relational factors not captured by the scale.","confidence":0.7,"topic_tags":["pornography","measurement","sexual_function"],"strengths":["Rigorous factor‑analytic validation across three samples","Demonstrated internal consistency and convergent validity","Comparison with other behavioral addiction measures"],"limitations":["Reliance on self‑report; no objective behavioural or physiological data","Moral incongruence and masturbation not measured or controlled","Scale defines ‘problematic use’ as addiction, risking circularity"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":15,"contrasting":2,"mentioning":195,"citing_publications":295,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2014.01.027"}},{"id":290,"doi":"10.31234/osf.io/v7mtc","pmid":null,"pmcid":null,"title":"Further investigation on sexual abuse experiences – Revisiting the psychometric properties of the Sexual Abuse History Questionnaire and the content of its open-ended item","authors":"Dóra B, Koós M, Nagy L, Demetrovics Z, Bőthe B.","first_author":"Dóra B","journal":"PsyArXiv","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://osf.io/v7mtc/download","cited_by_count":0,"is_preprint":true,"topics":["csbd","pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Large non‑clinical sample (N = 24,715) used for exploratory and confirmatory factor analyses of the Sexual Abuse History Questionnaire; correlations with other sexual‑health measures reported.","sample_n":24715,"sample_text":"large non‑clinical sample","population":"Adults from the general population (non‑clinical)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors tested a questionnaire meant to measure past sexual abuse in a large community sample. They found the scale reliable but not strongly linked to related outcomes, and identified additional types of abuse not covered by the questionnaire.","clinical_takeaway":"Current sexual‑abuse questionnaires may miss important experiences; clinicians should use broader assessments.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Very large sample size","Use of both EFA and CFA for factor structure","Inclusion of qualitative open‑ended analysis"],"limitations":["Criterion validity of SAHQ found insufficient","No pre‑registration or reporting of confidence intervals","Potential lack of diversity in sample (not described)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/v7mtc"}},{"id":291,"doi":"10.4103/0019-5545.146536","pmid":"25568482","pmcid":"PMC4279299","title":"A case report of pornography addiction with dhat syndrome","authors":"Darshan MS, Sathyanarayana Rao TS, Manickam S, Tandon A, Ram D.","first_author":"Darshan MS","journal":"Indian journal of psychiatry","year":2014,"pub_types":["Journal Article","case-report"],"keywords":["Dhat Syndrome","Sex Addiction","Pornography Addiction","Male Sexual Disorders"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4279299","cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single patient diagnosed with pornography addiction using substance‑dependence criteria","sample_n":1,"sample_text":"single case","population":"one adult male patient presenting with dhat syndrome and self‑reported pornography use","country":"India","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control","causal_from_correlational","advocacy_or_coi"],"stance":"supports","citation_value":"avoid","plain_summary":"A single patient was diagnosed with \"pornography addiction\" using criteria meant for drug dependence and was treated until he stopped viewing porn. The report suggests this approach helped, but the case provides no reliable evidence that pornography use is an addiction.","clinical_takeaway":"One case does not establish that porn use is an addiction; clinicians should use validated assessments and consider moral, relational, and mental‑health factors.","confidence":0.4,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Highlights clinical attempt to treat problematic pornography use","Provides detailed narrative of therapeutic steps"],"limitations":["Single case; no generalisable data","Uses substance‑dependence criteria without validation for behaviour","No measurement of key confounds (moral incongruence, masturbation, mental health)","Conclusions overstate prevalence and treatment efficacy"],"rubric_version":"2.0","raw_total":9,"max_possible":60,"pct_score":15,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":2,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0019-5545.146536"}},{"id":292,"doi":"10.1038/s41443-023-00780-8","pmid":"37853241","pmcid":null,"title":"Online ejaculation training programs promote non-evidence-based treatment of male sexual dysfunction","authors":"Prause N.","first_author":"Prause N.","journal":"International journal of impotence research","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Descriptive landscape study of online ejaculation‑training courses identified via systematic Google search; no participant data collected.","sample_n":11,"sample_text":"Eleven ejaculation training courses identified","population":"Not applicable (programs, not people)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors identified 11 online programmes that teach men to retain semen or avoid ejaculation. All were run by people without medical or mental‑health credentials and claimed benefits like better erectile function, less porn use and higher testosterone, despite no scientific evidence.","clinical_takeaway":"Clinicians should be aware that such courses are not evidence‑based and may carry financial and psychological risks.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Systematic search strategy documented","Clear extraction of course characteristics","Highlights lack of professional credentials"],"limitations":["No empirical data on user outcomes","Small sample of identified courses","No assessment of efficacy or harms"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-023-00780-8"}},{"id":293,"doi":"10.1177/0886260518812806","pmid":"30461344","pmcid":"PMC6942232","title":"Problematic Pornography Use and Physical and Sexual Intimate Partner Violence Perpetration Among Men in Batterer Intervention Programs","authors":"Brem MJ, Garner AR, Grigorian H, Florimbio AR, Wolford-Clevenger C, Shorey RC, Stuart GL.","first_author":"Brem MJ","journal":"Journal of interpersonal violence","year":2021,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Domestic Violence","Sexual Assault","Batterers","Media And Violence"],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 273 men enrolled in batterer intervention programs examining self‑reported problematic pornography use and self‑reported IPV perpetration","sample_n":273,"sample_text":"273 men in batterer intervention programs","population":"men in batterer intervention programs (U.S.)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 273 men in batterer‑intervention programs, higher self‑reported problematic pornography use was linked to greater reports of physical and sexual intimate‑partner violence, even after accounting for mental‑health and substance‑use factors.","clinical_takeaway":"Higher self‑reported problematic porn use may co‑occur with IPV; clinicians should assess both when working with violent male clients.","confidence":0.78,"topic_tags":["sexual_function","gender"],"strengths":["reasonable sample size for cross‑sectional analysis","accounts for psychiatric and substance‑use covariates","focus on an understudied high‑risk population"],"limitations":["PPU measured with unspecified, likely non‑validated self‑report","No assessment of moral incongruence or masturbation","Cross‑sectional design precludes causal inference","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":31,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260518812806"}},{"id":295,"doi":"10.1080/10550887.2024.2401680","pmid":"39267458","pmcid":null,"title":"Effect of pornography use on the sexual satisfaction: a systematic review and meta-analysis","authors":"Abdi F, Pakzad R, Alidost F, Aghapour E, Mehrnoush V, Banaei M.","first_author":"Abdi F","journal":"Journal of addictive diseases","year":2025,"pub_types":["Meta-Analysis","Systematic Review","Journal Article"],"keywords":["Meta-analysis","Sexual Satisfaction","Pornography","Erotica"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Systematic review and meta‑analysis of 41 observational studies (cross‑sectional and cohort) examining correlations between self‑reported pornography use and self‑reported sexual satisfaction.","sample_n":70541,"sample_text":"41 studies with a total sample size of 70,541 participants.","population":"General adult population (combined N = 70,541) from included studies; sampling methods varied across primary studies.","country":"Not specified (multiple countries across primary studies).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 41 studies (over 70,000 participants) found a small negative link between how much pornography people use and how satisfied they are with their sex lives, especially for women. The effect was tiny and not significant for men.","clinical_takeaway":"Any impact of pornography on sexual satisfaction appears modest; clinicians should consider broader relational and personal factors.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large combined sample size across studies.","Use of random‑effects meta‑analysis with confidence intervals.","Assessment of publication bias (Egger’s test).","Meta‑regression explores heterogeneity moderators."],"limitations":["Primary studies likely use heterogeneous, often unvalidated self‑report measures.","No systematic risk‑of‑bias assessment reported.","Key confounders (moral attitudes, masturbation, mental health, relationship factors) not addressed.","Cross‑sectional designs dominate, limiting causal inference."],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10550887.2024.2401680"}},{"id":297,"doi":"10.1007/s10508-021-02104-7","pmid":"34853976","pmcid":null,"title":"Sexual Shame as a Unique Distress Outcome of Morally Incongruent Pornography Use: Modifications and Methodological Considerations","authors":"Floyd CG, Volk F, Flory D, Harden K, Peters CE, Taylor A.","first_author":"Floyd CG","journal":"Archives of sexual behavior","year":2022,"pub_types":["Journal Article"],"keywords":["Pornography Use","Moral Incongruence","Perceived Addiction","Sexual Shame"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey (N=296) assessing moral incongruence, pornography use, and sexual shame via moderated mediation models","sample_n":296,"sample_text":"N=296 participants reporting recent pornography use","population":"adults who reported using pornography in the past six months (convenience sample)","country":"not specified","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether feeling that porn use clashes with personal morals leads to sexual shame, independent of the distress items usually included in a common questionnaire. Using a 296‑person sample, the authors found that moral conflict predicts shame even when emotional‑distress items are removed from the measure.","clinical_takeaway":"Clinicians should consider moral conflict, not just usage frequency, when addressing sexual shame in clients who view pornography.","confidence":0.8,"topic_tags":["pornography","moral_incongruence","sexual_function"],"strengths":["Uses validated CPUI instrument","Large sample for survey research","Addresses methodological limitation of prior work","Clear mediation modelling"],"limitations":["Cross‑sectional, cannot infer causality","Masturbation not measured, possible confound","No assessment of mental‑health or relationship variables","No pre‑registration"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":7,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02104-7"}},{"id":298,"doi":"10.7759/cureus.33703","pmid":"36793815","pmcid":"PMC9922938","title":"Physiological, Psychosocial and Substance Abuse Effects of Pornography Addiction: A Narrative Review","authors":"Mehmood Qadri H, Waheed A, Munawar A, Saeed H, Abdullah S, Munawar T, Luqman S, Saffi J, Ahmad A, Babar MS.","first_author":"Mehmood Qadri H","journal":"Cureus","year":2023,"pub_types":["review-article","Review","Journal Article"],"keywords":["Narrative Review","Cybersex","Porn Addiction","Compulsive Sexual Behavior Or Sexual Addiction","Harmful Effects Of Porn","Pornography 2022"],"is_oa":true,"oa_url":"https://assets.cureus.com/uploads/review_article/pdf/131357/20230213-16571-bxsiil.pdf","cited_by_count":4,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of case studies and original articles without systematic methodology or risk‑of‑bias assessment","sample_n":null,"sample_text":"Four case studies and nine original articles (2000‑2022) were summarised","population":"not applicable (review)","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","circular_addiction_scale"],"stance":"strongly-supports","citation_value":"avoid","plain_summary":"This narrative review argues that internet porn can become addictive and cause wide‑ranging harms, but it does not define or measure addiction with validated tools and offers no new data.","clinical_takeaway":"No actionable clinical guidance; the paper’s claims lack empirical support.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["covers a broad range of cited literature","identifies multiple domains of potential impact"],"limitations":["Narrative, not systematic; no risk‑of‑bias assessment","No original data, no validated measurement of constructs","Claims of ‘addiction’ are not operationalised and may be circular","Lacks control for key confounds (morality, masturbation, mental health, relationship context, trauma)"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.33703"}},{"id":299,"doi":"10.1093/sxmrev/qeae014","pmid":"38529667","pmcid":"PMC11214846","title":"Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective","authors":"Briken P, Bőthe B, Carvalho J, Coleman E, Giraldi A, Kraus SW, Lew-Starowicz M, Pfaus JG.","first_author":"Briken P","journal":"Sexual medicine reviews","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","review-article","Review","Journal Article"],"keywords":["Assessment","Diagnosis","Treatment","Comorbidity","Compulsive Sexual Behavior","Impulse Control Disorder","Hypersexuality","Icd-11","Paraphilias","Sex/porn “Addiction”"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11214846","cited_by_count":25,"is_preprint":false,"topics":["csbd","masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review article (scientific review committee, modified Delphi, narrative synthesis)","sample_n":null,"sample_text":"Not applicable – review of existing literature","population":"Experts and literature on CSBD; no primary participants","country":"International","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews how compulsive sexual behavior disorder (CSBD) is defined in ICD‑11, highlights concerns about pathologising normal sexuality, and offers guidance for assessment and treatment from a sexual‑medicine perspective.","clinical_takeaway":"Clinicians should differentiate CSBD from normative sexual behavior and consider broader psychosocial factors before labeling behavior as disordered.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Comprehensive overview of CSBD diagnostic issues","International expert consensus via modified Delphi","Identifies potential sources of bias in CSBD assessment"],"limitations":["Narrative (non‑systematic) review lacking systematic methodology","No primary data or quantitative synthesis","Confounding variables (e.g., moral incongruence, masturbation) not empirically examined"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":41,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeae014"}},{"id":300,"doi":"10.1097/nmd.0000000000001669","pmid":"37505898","pmcid":"PMC10399954","title":"Pornography Consumption and Cognitive-Affective Distress","authors":"Privara M, Bob P.","first_author":"Privara M","journal":"The Journal of nervous and mental disease","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10399954","cited_by_count":13,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey (details not provided)","sample_n":null,"sample_text":"not reported in abstract","population":"likely adult males, unspecified recruitment","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors suggest that men who watch online porn report stress, guilt and mixed emotions, and that these feelings are linked to anxiety and depression, but the study gives no details on how these variables were measured or how participants were selected.","clinical_takeaway":"No clear clinical guidance; the paper’s conclusions are based on limited, undefined data.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses clinically relevant topic","Mentions multiple psychosocial factors"],"limitations":["No clear operational definitions or validated measures","Lacks control for key confounds (moral incongruence, masturbation, mental health)","Design is cross‑sectional with unspecified sample","Interpretation exceeds evidential support"],"rubric_version":"2.0","raw_total":16,"max_possible":60,"pct_score":27,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":3,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":24,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/nmd.0000000000001669"}},{"id":301,"doi":"10.1016/j.neuroimage.2016.01.033","pmid":"26803060","pmcid":null,"title":"Ventral striatum activity when watching preferred pornographic pictures is correlated with symptoms of Internet pornography addiction","authors":"Brand M, Snagowski J, Laier C, Maderwald S.","first_author":"Brand M","journal":"NeuroImage","year":2016,"pub_types":["Journal Article"],"keywords":["Ventral Striatum","Reward Anticipation","Cybersex","Pornography","Gratification Processing"],"is_oa":false,"oa_url":null,"cited_by_count":85,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"within‑subject fMRI study of 19 heterosexual male participants viewing preferred vs non‑preferred pornographic pictures; ventral striatum activation correlated with self‑reported addiction symptoms.","sample_n":19,"sample_text":"19 heterosexual male participants","population":"adult heterosexual men (N=19)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational","fmri_reverse_inference"],"stance":"neutral","citation_value":"useful","plain_summary":"In 19 men, brain activity in the ventral striatum was higher when they viewed porn they liked, and this activity was linked to how many symptoms of internet porn addiction they reported.","clinical_takeaway":"No direct clinical guidance; findings are preliminary and based on a small, non‑representative sample.","confidence":0.7,"topic_tags":["pornography","neuroscience","sexual_function","csbd"],"strengths":["Use of fMRI to test neural response to personally preferred stimuli","Within‑subject contrast (preferred vs non‑preferred)","Attempts to link brain activity with symptom scores"],"limitations":["Very small sample (N=19) limits power and generalisability","Addiction symptoms measured with unclear/possibly non‑validated scale","No control for key confounds (moral incongruence, masturbation, trauma)","Interpretation over‑reaches correlational data"],"rubric_version":"2.0","raw_total":23,"max_possible":70,"pct_score":33,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":3,"statistics":3,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":3}},"scite":{"supporting":7,"contrasting":1,"mentioning":117,"citing_publications":209,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neuroimage.2016.01.033"}},{"id":302,"doi":"10.3390/bs5030388","pmid":"26393658","pmcid":"PMC4600144","title":"Neuroscience of Internet Pornography Addiction: A Review and Update","authors":"Love T, Laier C, Brand M, Hatch L, Hajela R.","first_author":"Love T","journal":"Behavioral sciences (Basel, Switzerland)","year":2015,"pub_types":["review-article","Review","Journal Article"],"keywords":["Neuroscience","Neuroimaging","Dsm-5","Internet Addiction","Addictive Behavior","Behavioral Addiction","Cybersex","Internet Gaming Disorder","Online Sexual Behavior","Internet Pornography Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4600144","cited_by_count":110,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods, no primary data","sample_n":null,"sample_text":"none (review article)","population":"not applicable","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","advocacy_or_coi"],"stance":"supports","citation_value":"useful","plain_summary":"This 2015 narrative review argues that problematic internet pornography use shows brain activity patterns similar to substance addictions, suggesting it fits an addiction model, but it does not systematically assess the quality of the underlying studies.","clinical_takeaway":"Treat porn‑related distress cautiously; current evidence does not firmly establish an addiction syndrome.","confidence":0.8,"topic_tags":["pornography","neuroscience","sexual_function"],"strengths":["Broad overview of neuroimaging literature","Connects findings to addiction theory"],"limitations":["Narrative, not systematic review","No explicit assessment of study quality","Overstates conclusions beyond available evidence"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":10,"contrasting":0,"mentioning":159,"citing_publications":272,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs5030388"}},{"id":303,"doi":"10.1111/ajad.12501","pmid":"28106937","pmcid":null,"title":"Naltrexone for the treatment of comorbid tobacco and pornography addiction","authors":"Capurso NA.","first_author":"Capurso NA.","journal":"The American journal on addictions","year":2017,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report of naltrexone treatment for co‑occurring tobacco use disorder and self‑reported problematic pornography use","sample_n":1,"sample_text":"N=1 case","population":"1 adult male with tobacco use disorder and self‑identified problematic pornography use","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A single‑patient case report describes how naltrexone reduced both cigarette smoking and self‑reported pornography viewing, but caused anhedonia. The authors suggest the drug may help treat co‑occurring addictions.","clinical_takeaway":"Evidence is insufficient to recommend naltrexone for pornography‑related problems; larger controlled trials are needed.","confidence":0.8,"topic_tags":["pornography","treatment","neuroscience"],"strengths":["First reported case of combined tobacco and pornography addiction treated with naltrexone","Provides detailed clinical observation of side‑effects"],"limitations":["N=1; no control condition","Problematic pornography use not operationalised with validated instrument","No measurement of moral incongruence or other key confounds"],"rubric_version":"2.0","raw_total":8,"max_possible":60,"pct_score":13,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":1,"addiction_criteria":0,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/ajad.12501"}},{"id":304,"doi":"10.1101/2020.12.23.424123","pmid":null,"pmcid":null,"title":"Left Hippocampus to Anterior Cingulate Cortex Connectivity Correlates with Worse Recent Verbal Memory in Pornography Addicted Juveniles","authors":"Prawiroharjo P, Edison RE, Ellydar H, Pratama P, Suaidy SEI, Amani NZ, Carissima D, Hatta GF.","first_author":"Prawiroharjo P","journal":"bioRxiv","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.biorxiv.org/content/biorxiv/early/2020/12/23/2020.12.23.424123.full.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control fMRI connectivity study, N≈26 (13 per group), juvenile participants screened for “pornography addiction” and compared on memory tests and resting‑state connectivity.","sample_n":26,"sample_text":"13 non‑addiction vs 13 addiction (4 dropouts from original 30).","population":"juvenile males (presumed), self‑selected from a screening process; no indication of random or representative sampling.","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"supports","citation_value":"avoid","plain_summary":"A tiny fMRI study of 26 teenagers labelled as ‘porn‑addicted’ or not found weaker connection between the left hippocampus and anterior cingulate cortex in the addicted group, which was linked to poorer recent verbal memory. The authors suggest this mirrors brain changes seen in other addictions.","clinical_takeaway":"Insufficient evidence to base clinical decisions; findings are preliminary and limited by sample size and unclear addiction definitions.","confidence":0.5,"topic_tags":["pornography","neuroscience","csbd"],"strengths":["uses neuroimaging to explore a novel age group","reports effect sizes for connectivity and memory","links brain connectivity to cognitive performance"],"limitations":["Very small sample, likely underpowered","Addiction status undefined; probable circular measurement","No control for key confounds (moral incongruence, masturbation, mental health)","Cross‑sectional; causal language overreaches"],"rubric_version":"2.0","raw_total":21,"max_possible":70,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":3,"statistics":4,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2020.12.23.424123"}},{"id":305,"doi":"10.5964/sotrap.13005","pmid":"39901983","pmcid":"PMC11789437","title":"The Confluence Model of Sexual Aggression: The Role of Pornography as a Secondary Risk Factor","authors":"Saqib S, Davidson M.","first_author":"Saqib S","journal":"Sexual offending (Trier, Germany)","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Aggression","Confluence Model","Pornography","Pornography Use Motives"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11789437","cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 412 male participants testing the Confluence Model with measures of hostile masculinity, impersonal sex, pornography use motives and self‑reported sexual aggression","sample_n":412,"sample_text":"n = 412 males","population":"adult men (n=412), likely convenience sample","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 412 men, using pornography to manage mood was linked to higher self‑reported sexual aggression, independent of other known risk factors like hostile masculinity and impersonal sex.","clinical_takeaway":"Mood‑management pornography use may flag higher risk for sexual aggression, but evidence is correlational.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a survey (n>400)","Uses established Confluence Model constructs","Tests novel motive (mood management) as independent predictor"],"limitations":["Cross‑sectional; cannot infer causality","No measurement/control of key confounds (e.g., mental health, trauma)","Potential self‑report bias in aggression and pornography motives"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5964/sotrap.13005"}},{"id":306,"doi":"10.1016/j.abrep.2024.100533","pmid":"38357528","pmcid":"PMC10864872","title":"The Problematic Online Dating Apps Use Scale (PODAUS): Development and evaluation of its psychometric properties","authors":"Gori A, Topino E, Griffiths MD.","first_author":"Gori A","journal":"Addictive behaviors reports","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Self-esteem","Anxious Attachment","Fomo","Fear Of Missing Out","Problematic Social Media Use","Social Media Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10864872","cited_by_count":8,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 384 daily dating‑app users; online self‑report questionnaire; factor analysis and correlational analyses","sample_n":384,"sample_text":"384 participants (254 F, 130 M), mean age ≈ 26, daily dating‑app users","population":"young adults (mean age 25.9), predominantly female, recruited online; daily users of dating apps","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created a 10‑item questionnaire (PODAUS) to measure problematic use of dating apps. In a sample of 384 young adults who use these apps daily, the scale showed good reliability and was linked to higher social‑media addiction, cyber‑porn use, love‑addiction, and certain personality traits.","clinical_takeaway":"The PODAUS may help clinicians screen for excessive dating‑app use, but its interpretation should consider that distress and moral factors were not examined.","confidence":0.7,"topic_tags":["sexual_function","relationships","measurement"],"strengths":["Large sample for scale development","Factor analysis supports unidimensional structure","Demonstrates convergent validity with related constructs"],"limitations":["Cross‑sectional, self‑selected online sample","No distinction between use frequency and distress","Potential moral‑incongruence/confound not measured"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":2,"design":4,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":16,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.abrep.2024.100533"}},{"id":307,"doi":"10.1007/s11920-022-01351-2","pmid":"35792965","pmcid":null,"title":"Technological Addictions","authors":"Sherer J, Levounis P.","first_author":"Sherer J","journal":"Current psychiatry reports","year":2022,"pub_types":["Review","Journal Article"],"keywords":["Cybersex – Online Sexual Activity, Experienced Alone Or With Others, That May Involve Technologies Such As Apps, Webcams, Or Virtual Reality That Is Not Necessarily Indicative Of A Disorder","Internet Addiction (Ia) – An Antiquated Term Which Referred To Addiction To The Internet Broadly Speaking. It Has Largely Been Replaced With More Specific Terms","Internet Gaming Disorder (Igd) – Persistent Overuse Videogames Leading To Clinically Significant Impairment Or Distress Played Alone Or With Others Online","Online Shopping Addiction (Osa) – Problematic Shopping Behavior Via The Internet That May Be Excessive, Compulsive, And That Causes Economic, Social, And Emotional Consequences","Social Media Addiction (Sma) – Preoccupation With Social Media, Evidenced By Irresistible Urges To Use And Increasing Time Spent Using Online Platforms, Resulting In Impairment Or Distress","Technological Addictions (Tas) – Behavioral Addictions That Result From Overutilization Of Modern Technologies, Many Of Which Are Necessary Parts Of Everyday Life Today"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review (narrative) without systematic methods or risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not applicable – no primary data collected.","population":"Humans (general, no specific sample described)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"This narrative review describes a range of ‘technological addictions’—including online porn use—arguing they can cause problems and may be treatable with medication or therapy, but it does not present new research data.","clinical_takeaway":"The article suggests that internet‑related behaviours, like online porn, may become problematic and respond to treatment, but offers no direct evidence for clinicians.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Broad overview of multiple technology‑related behavioural addictions","Highlights emerging therapeutic approaches"],"limitations":["Narrative review without systematic search or bias assessment","No empirical data presented","Constructs such as ‘addiction’ not operationalised or critically examined"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11920-022-01351-2"}},{"id":308,"doi":"10.1016/j.esxm.2022.100525","pmid":"35653876","pmcid":"PMC9386638","title":"Predictors of Compulsive Sexual Behavior Among Treatment-Seeking Women","authors":"Kowalewska E, Gola M, Lew-Starowicz M, Kraus SW.","first_author":"Kowalewska E","journal":"Sexual medicine","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Women","Compulsive Sexual Behavior","Treatment-seeking","Pornography"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.esxm.2022.100525","cited_by_count":8,"is_preprint":false,"topics":["csbd","masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey of treatment‑seeking Polish women (n=674); linear regression of self‑report scales.","sample_n":674,"sample_text":"Convenience sample recruited via treatment‑seeking forums; not representative of general population.","population":"Polish women, treatment‑seeking for compulsive sexual behavior, aged 18‑66","country":"Poland","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Polish online survey of 674 women seeking help for compulsive sexual behavior, higher scores on a sexual‑addiction questionnaire were linked to problematic pornography use, being single or divorced, more recent sexual partners, and more frequent recent sexual activity.","clinical_takeaway":"Problematic pornography use and recent sexual activity correlate with higher CSB symptoms in treatment‑seeking women; assess these factors in clinical interviews.","confidence":0.78,"topic_tags":["csbd","pornography","treatment","gender"],"strengths":["Large sample for treatment‑seeking women","First study focusing on predictors of CSB in women","Uses adapted SAST, a commonly used CSB screen"],"limitations":["Cross‑sectional, cannot infer causality","Self‑selected treatment‑seeking sample limits generalisability","Key confounds (moral incongruence, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2022.100525"}},{"id":309,"doi":"10.1080/0092623x.2022.2117746","pmid":"36086799","pmcid":null,"title":"The Relationship between Compulsive Sexual Behavior, Religiosity, and Moral Disapproval","authors":"Coleman E, Jennings T, Gleason N, Danielson S, Nielsen KH, Miner MH, Rahm-Knigge RL.","first_author":"Coleman E","journal":"Journal of sex & marital therapy","year":2023,"pub_types":["Journal Article"],"keywords":["Compulsive Sexual Behavior","Religiosity","Sexual Addiction","Hypersexuality","Moral Disapproval"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study with mediation analysis","sample_n":null,"sample_text":"Not reported in abstract","population":"adults (unspecified)","country":"Not reported","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that people who are more committed to religious beliefs and rigid in following them report higher levels of compulsive sexual behavior, and that feeling morally disapproving about sex helps explain this link.","clinical_takeaway":"Clinicians should consider clients' religious rigidity and moral disapproval when assessing compulsive sexual behavior, but recognize that causality is not established.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Addresses understudied link between religiosity and CSB","Uses mediation analysis to explore indirect pathways","Considers moral disapproval as a distinct construct"],"limitations":["Cross‑sectional design limits causal inference","Unclear whether CSB measured with validated scale","Key confounds (masturbation, mental health, relationship factors) not assessed"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":7,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2022.2117746"}},{"id":310,"doi":"10.1007/s00431-023-04878-5","pmid":"36939878","pmcid":"PMC10026209","title":"Impact of COVID-19 on adolescent sexual life and attitudes: have we considered all the possible secondary effects of the pandemic?","authors":"Kostopoulou E.","first_author":"Kostopoulou E.","journal":"European journal of pediatrics","year":2023,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual behaviour","Adolescents","aggressiveness","Pornography Use","Covid-19"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s00431-023-04878-5.pdf","cited_by_count":3,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review summarizing existing literature on adolescent pornography use during COVID-19; no empirical data collected","sample_n":null,"sample_text":"not applicable – review of published studies","population":"adolescents (global), but no primary sample","country":"not applicable","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The review reports that adolescents used more pornography during COVID‑19, mainly to cope with isolation and boredom, and warns that this could influence attitudes, satisfaction, and aggression, but evidence on long‑term effects is still lacking.","clinical_takeaway":"Clinicians should be aware of increased pandemic‑related pornography use in youths, monitor for distress, but recognize that causal harms are not yet proven.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Timely synthesis of pandemic‑related pornography data","Highlights potential psychosocial mechanisms (boredom, isolation)","Identifies gaps for future research"],"limitations":["Narrative (non‑systematic) review; selection bias likely","No quantitative meta‑analysis or risk‑of‑bias assessment","Claims about addiction and aggression are speculative"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00431-023-04878-5"}},{"id":312,"doi":"10.1016/j.abrep.2024.100542","pmid":"38560011","pmcid":"PMC10979147","title":"Predictors of compulsive cyberporn use: A machine learning analysis","authors":"Ben Brahim F, Courtois R, Vera Cruz G, Khazaal Y.","first_author":"Ben Brahim F","journal":"Addictive behaviors reports","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Addiction","Machine Learning","Compulsive Cyberporn Use","Cyberporn"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10979147","cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire, N=1584 adult cyberporn users, assessed compulsive use with adapted CIUS, machine‑learning predictor analysis","sample_n":1584,"sample_text":"broad community sample recruited online","population":"adult English‑speaking cyberporn users (18‑75 yr)","country":"unspecified (likely multi‑national English‑speaking)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large online survey of 1,584 adults who had viewed cyberporn, researchers used a compulsive‑use questionnaire and machine‑learning to identify the strongest predictors of compulsive cyberporn use, which included craving, using porn to suppress negative emotions, higher usage frequency, endorsement of rape myths, and anxious attachment.","clinical_takeaway":"High craving, emotional‑suppression motives and frequent use signal higher risk of compulsive porn use; clinicians should assess these factors alongside attachment style.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size (>1500)","Use of a previously validated scale (CIUS)","Comprehensive set of predictor variables","Application of machine‑learning importance ranking"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral incongruence or masturbation","Addiction construct inferred from self‑report scale only","Potential self‑selection bias of online volunteers"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.abrep.2024.100542"}},{"id":313,"doi":"10.1037/spq0000703","pmid":"40674037","pmcid":null,"title":"Latent profiles of social media use among adolescents: Exploring differences across demographics, academics, and psychosocial outcomes","authors":"Srisarajivakul EN, Chan MK, Thornton KB, Renshaw TL.","first_author":"Srisarajivakul EN","journal":"School psychology (Washington, D.C.)","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional latent profile analysis of 27,336 US adolescents from schools","sample_n":27336,"sample_text":"Adolescents (N≈27,300) recruited via school districts across the United States","population":"U.S. adolescents (grades 9‑12) from 83 schools, 2020‑2021 school year","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Using data from over 27,000 U.S. teens, the study identified three patterns of social‑media use (low, moderate, high). Teens in the high‑use group reported lower school connectedness, poorer emotional well‑being, and lower grades than less‑frequent users.","clinical_takeaway":"High social‑media use in adolescents is linked to poorer school and emotional outcomes; clinicians should assess usage patterns when supporting teen well‑being.","confidence":0.8,"topic_tags":["adolescents","sexual_function","pornography","masturbation"],"strengths":["Very large, geographically diverse sample","Use of latent profile analysis to capture usage patterns","Multiple outcome domains (well‑being, school connectedness, grades)"],"limitations":["Cross‑sectional; cannot infer causality","Key constructs (e.g., perceived addiction) measured with single items, not validated scales","No control for important confounds such as mental health, moral attitudes, or co‑occurring behaviours"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/spq0000703"}},{"id":314,"doi":"10.1080/0092623x.2020.1822483","pmid":"32975170","pmcid":null,"title":"Sexual Desire and Subjective Distress among Pornography Consumers","authors":"Droubay BA, Shafer K, Butters RP.","first_author":"Droubay BA","journal":"Journal of sex & marital therapy","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of US adults (n=559) recruited via MTurk; structural equation modeling of relationships among sexual desire, moral incongruence, dysregulation, and distress.","sample_n":559,"sample_text":"Mechanical Turk respondents, United States, adults","population":"US adults (online convenience sample)","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among U.S. adults who view pornography, feeling that watching porn conflicts with personal morals predicts distress more strongly than sexual desire or shame. Desire leads to distress only when it creates feelings of dysregulation, especially for those with moral conflict.","clinical_takeaway":"Address moral conflict and perceived loss of control when treating distress related to pornography use.","confidence":0.78,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Large sample for survey research","Uses structural equation modeling","Explicit measurement of moral incongruence"],"limitations":["Convenience MTurk sample limits generalizability","Cross‑sectional design prevents causal claims","Limited assessment of other confounds (e.g., mental health, relationship context)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2020.1822483"}},{"id":316,"doi":"10.1016/j.jsxm.2022.02.012","pmid":"35341725","pmcid":null,"title":"What is Normal Pornography Use in a Highly Religious Area? Exploring Patterns of Pornography Use in Utah","authors":"Esplin CR, Hatch SG, Ogles BM, Wood D, Rasmussen BD, Braithwaite SR.","first_author":"Esplin CR","journal":"The journal of sexual medicine","year":2022,"pub_types":["Journal Article"],"keywords":["Measurement","Religiosity","Sexual Addiction","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large representative survey (n≈892) of Utah adults; descriptive norms and correlations reported","sample_n":892,"sample_text":"Representative sample of Utah adults (n≈892) obtained through CloudResearch","population":"Adult residents of Utah (both sexes) recruited via CloudResearch, weighted to census demographics","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 892 Utah adults found that most people have viewed porn at least once, with weekly or monthly viewing being typical. Even in a highly religious state, porn use is common, and higher use is linked to higher self‑reported problem scores and depression.","clinical_takeaway":"Clinicians can use the Utah norms to help patients gauge whether their porn use is unusually high compared with peers, especially in religious contexts.","confidence":0.7,"topic_tags":["pornography","religiosity","prevalence","measurement","sexual_function"],"strengths":["Large, state‑representative sample","Use of several validated pornography‑use scales","Provides normative frequency data for a religious population"],"limitations":["No measurement of moral incongruence or masturbation","Addiction scales may conflate frequency with distress","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2022.02.012"}},{"id":317,"doi":null,"pmid":"36989095","pmcid":null,"title":"Pornography: A Concealed Behavior with Serious Consequences","authors":"Noel JK, Jacob S, Swanberg JE, Rosenthal SR.","first_author":"Noel JK","journal":"Rhode Island medical journal (2013)","year":2023,"pub_types":["Journal Article"],"keywords":["Depression","Addiction","Suicide","Young Adults","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of Rhode Island young adults (n=1022)","sample_n":1022,"sample_text":"community survey (likely convenience/volunteer) of young adults","population":"young adults in Rhode Island, USA","country":"USA","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A Rhode Island survey of 1,022 young adults found that 54 % had ever viewed pornography and 6 % reported being ‘addicted.’ Those reporting addiction were more likely to also report depression and thoughts of suicide, but the study did not measure factors like moral conflict or masturbation that could explain these links.","clinical_takeaway":"Screening for self‑reported pornography addiction may flag higher risk of depression or suicidal thoughts, but clinicians should consider other explanations before attributing causality.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large overall sample (n>1000)","Provides prevalence estimates for a state‑level young adult population","Uses multivariable logistic regression with confidence intervals"],"limitations":["Addiction construct not clearly defined; likely based on self‑label or distress","No assessment of moral incongruence, masturbation, or trauma which could confound findings","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":3,"interpretation":5}},"scite":null},{"id":318,"doi":"10.1016/j.addbeh.2023.107904","pmid":"37984220","pmcid":null,"title":"The neurocognitive correlates of non-substance addictive behaviors","authors":"Christensen E, Albertella L, Chamberlain SR, Brydevall M, Suo C, Grant JE, Yücel M, Lee RSC.","first_author":"Christensen E","journal":"Addictive behaviors","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Alcohol","Cognition","Addiction","Neurocognition","Internet Use","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 475 Australian adults assessing neurocognitive performance and self‑reported problematic pornography use, internet use and other behaviours","sample_n":475,"sample_text":"large community sample, recruited online; not probability‑based","population":"general community sample, Australia, age 18‑60+, 54 % female","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 475 Australian adults, poorer performance monitoring on cognitive tasks was modestly linked to higher self‑reported problematic pornography and internet use, while other cognitive functions showed no clear relation.","clinical_takeaway":"Evidence of a small cognitive association with problematic porn use is preliminary; clinicians should not infer causality.","confidence":0.8,"topic_tags":["pornography","neuroscience","csbd"],"strengths":["Large sample for a web‑based study","Comprehensive neurocognitive task battery","Use of bootstrapped regression to improve estimate stability"],"limitations":["Cross‑sectional design precludes causal inference","Problematic pornography use measured with unclear/possibly unvalidated scale","Key confounds (moral incongruence, masturbation, mental health, relationship, trauma) not assessed","No correction for multiple testing reported"],"rubric_version":"2.0","raw_total":27,"max_possible":60,"pct_score":45,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":1,"design":5,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":7,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2023.107904"}},{"id":319,"doi":"10.1007/s10508-023-02701-8","pmid":"37863863","pmcid":"PMC10844147","title":"Female Affective Perception of Mainstream and Paraphilic Pornography: Associations with Sexual and Psychological Intrapersonal Variables","authors":"Prantner S, Giménez-García C, Espino-Payá A, Escrig MA, Fuentes-Sánchez N, Ballester-Arnal R, Pastor MC.","first_author":"Prantner S","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Women","Valence","Arousal","Disgust","Pornography","Moral And Ethical Acceptance"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10844147","cited_by_count":3,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 231 young women rating affective responses to mainstream and paraphilic pornographic images and completing questionnaires on sexual and psychological intrapersonal variables.","sample_n":231,"sample_text":"231 females (M = 21.87 years, SD = 3.9).","population":"Females, mean age ≈22, likely convenience/student sample (n=231).","country":"Spain (inferred from author affiliations).","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 231 young women, pornographic pictures were rated for pleasure, arousal, disgust and moral acceptability. Mainstream porn was liked more than paraphilic (dominance, submission, violence) porn, especially by women who had never viewed porn. Ratings were linked to traits like sensation seeking, erotophilia, lack of sexual control, anxiety and sexual disgust.","clinical_takeaway":"Female affective responses to porn vary with personal sexual traits; clinicians should consider these intrapersonal factors when discussing porn‑related concerns.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a survey on female affective perception of porn.","Assesses both mainstream and paraphilic content.","Incorporates a range of sexual‑psychological variables."],"limitations":["Cross‑sectional design cannot establish causality.","Convenience sample limits generalisability.","Limited control for key confounds (moral incongruence, masturbation, trauma)."],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02701-8"}},{"id":320,"doi":"10.1089/cyber.2023.0493","pmid":"38457648","pmcid":null,"title":"Multicultural Considerations for the Psychometrics of the Brief Pornography Screen","authors":"Borgogna NC, Way BM, Kraus SW.","first_author":"Borgogna NC","journal":"Cyberpsychology, behavior and social networking","year":2024,"pub_types":["Journal Article"],"keywords":["RACE","Anxiety","Psychometrics","Multicultural","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of university students (N=2,475) across eight race/sex groups; confirmatory factor analysis and invariance testing; regression of anxiety and viewing frequency on BPS scores.","sample_n":2475,"sample_text":"Participants from three U.S. universities (N=2,475)","population":"U.S. university students (Asian American/Pacific Islander, Black, Latin, White; male and female)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether a short questionnaire for problematic porn use works similarly for different racial and gender groups of US college students. It generally fit well, but some groups showed different strengths of association with anxiety and porn‑watching frequency.","clinical_takeaway":"The Brief Pornography Screen appears usable across diverse student groups, but clinicians should note that anxiety and viewing frequency relate differently depending on race and sex.","confidence":0.8,"topic_tags":["measurement","pornography","csbd"],"strengths":["Large sample with diverse racial/sex groups","Rigorous CFA and measurement invariance testing","Transparent reporting of differential correlations across groups"],"limitations":["Convenience student sample limits generalisability","Moral incongruence, masturbation, partner factors not assessed","No pre‑registration; potential for selective reporting"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2023.0493"}},{"id":321,"doi":"10.1101/057083","pmid":null,"pmcid":null,"title":"Can pornography be addictive? An fMRI study of men seeking treatment for problematic pornography use","authors":"Gola M, Wordecha M, Sescousse G, Lew-Starowicz M, Kossowski B, Wypych M, Makeig S, Potenza MN, Marchewka A.","first_author":"Gola M","journal":"bioRxiv","year":2016,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":true,"topics":["masturbation","pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control fMRI study of 28 treatment‑seeking men with problematic pornography use and 24 controls","sample_n":52,"sample_text":"28 PPU men, 24 control men","population":"heterosexual adult males, treatment‑seeking (PPU) vs community controls","country":"Poland (presumed from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a brain‑scan study, men seeking help for problematic porn use showed stronger ventral‑striatal responses to cues that predicted erotic images compared with controls, suggesting heightened ‘wanting’. The authors argue this resembles addiction, but the study is small and does not fully rule out other explanations.","clinical_takeaway":"While cue‑reactivity may be heightened in some men with problematic porn use, current evidence does not prove an addiction; treatment should consider broader psychosocial factors.","confidence":0.8,"topic_tags":["neuroscience","pornography","csbd","sexual_function"],"strengths":["Use of neuroimaging to examine cue reactivity","Inclusion of a control group","Linking neural data to behavioral measures (masturbation frequency)"],"limitations":["Small sample size for fMRI","No validated addiction scale; reliance on self‑reported severity","Moral incongruence and mental‑health variables not assessed","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":32,"max_possible":70,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":5,"statistics":5,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":37,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/057083"}},{"id":322,"doi":"10.1080/00224499.2022.2148155","pmid":"36449353","pmcid":null,"title":"Context Matters: Moderating Effects in the Associations between Pornography Use, Perceived Addiction, and Relationship Well-being","authors":"Willoughby BJ, Dover CR.","first_author":"Willoughby BJ","journal":"Journal of sex research","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"moderated mediation model using a large US convenience sample; cross‑sectional survey data","sample_n":null,"sample_text":"large nonprobability convenience sample","population":"US adults (non‑probability convenience sample)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a US survey, more frequent porn use was linked to lower relationship satisfaction and stability. This link was partly explained by participants feeling ‘addicted’, especially among men and those who were more religious.","clinical_takeaway":"Consider religious and self‑perceived addiction beliefs when discussing porn use impacts on relationships; avoid assuming causality.","confidence":0.7,"topic_tags":["pornography","relationships","religiosity","sexual_function"],"strengths":["large sample size for survey research","examines both general and aggressive pornography content","uses moderated mediation to test indirect effects"],"limitations":["cross‑sectional design limits causal inference","no validated addiction measure; relies on self‑label","moral incongruence and masturbation not measured"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2148155"}},{"id":323,"doi":"10.1556/2006.2023.00067","pmid":"38047945","pmcid":"PMC10786220","title":"Distortions in time perception related to videogames, pornography, and TV series exposure: An experimental study in three independent samples","authors":"Cervigón-Carrasco V, Ballester-Arnal R, Billieux J, Gil-Juliá B, Giménez-García C, Castro-Calvo J.","first_author":"Cervigón-Carrasco V","journal":"Journal of behavioral addictions","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Time Perception","Time Estimation","Problematic Gaming","Binge Watching","Time Passage","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10786220","cited_by_count":7,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subject experimental task exposing participants to short video clips (pornography, video games, TV series, documentaries) and measuring time estimation and perceived passage; three independent samples (N=40, 99, 111) completed the task and self‑report questionnaires on problematic gaming, por","sample_n":250,"sample_text":"Three independent convenience samples (40 men, 99 men, 111 women).","population":"Adults (men and women) from Luxembourg and Spain; convenience samples recruited for a laboratory study.","country":"Luxembourg; Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab experiment, people watched short clips of video games, pornography, TV series, or documentaries while judging how long they lasted. Men tended to think porn and TV clips were shorter than they were, women thought they were longer. Time felt like it passed faster for porn and TV. Perceived speed of time, not accuracy, was linked to self‑reported problematic gaming, porn use, and binge‑watching.","clinical_takeaway":"No direct clinical implications; the study suggests time‑perception biases may relate to self‑reported problematic media use, but causal conclusions are premature.","confidence":0.78,"topic_tags":["pornography","csbd","sexual_function","religiosity"],"strengths":["Experimental manipulation of stimulus exposure","Three independent samples, including both genders","Novel focus on time perception"],"limitations":["Self‑report measures of problematic use not described; likely mixed validated/ad‑hoc","Key confounds (moral incongruence, masturbation, mental health) not measured","No pre‑registration; limited reporting of effect sizes"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":9,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2023.00067"}},{"id":324,"doi":"10.1038/npp.2017.78","pmid":"28409565","pmcid":"PMC5561346","title":"Can Pornography be Addictive? An fMRI Study of Men Seeking Treatment for Problematic Pornography Use","authors":"Gola M, Wordecha M, Sescousse G, Lew-Starowicz M, Kossowski B, Wypych M, Makeig S, Potenza MN, Marchewka A.","first_author":"Gola M","journal":"Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology","year":2017,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.nature.com/articles/npp201778.pdf","cited_by_count":153,"is_preprint":false,"topics":["masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control fMRI study of treatment‑seeking men vs non‑PPU men","sample_n":52,"sample_text":"28 men seeking treatment for problematic pornography use; 24 control men","population":"heterosexual adult males (n≈52)","country":"Poland (assumed from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used brain scans to compare men in treatment for problematic porn use with men who do not report problems. It found stronger ventral‑striatal activity to cues that predicted erotic images in the treatment group, which the authors liken to the “wanting” seen in substance addictions.","clinical_takeaway":"Neural cue‑reactivity may be heightened in men seeking help for porn‑related problems, but evidence is not sufficient to label it a definitive addiction.","confidence":0.7,"topic_tags":["pornography","sexual_function","neuroscience"],"strengths":["Use of fMRI to probe cue‑reactivity","Comparison with a matched control group","Inclusion of behavioral measures of use and masturbation"],"limitations":["Small sample, especially for fMRI","No measurement of moral/religious attitudes","Cross‑sectional; cannot establish causality","Limited assessment of mental‑health or relationship factors"],"rubric_version":"2.0","raw_total":34,"max_possible":70,"pct_score":49,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":7,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":13,"contrasting":0,"mentioning":168,"citing_publications":294,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/npp.2017.78"}},{"id":326,"doi":"10.3390/ijerph16101861","pmid":"31137778","pmcid":"PMC6571756","title":"Prevalence, Patterns and Self-Perceived Effects of Pornography Consumption in Polish University Students: A Cross-Sectional Study","authors":"Dwulit AD, Rzymski P.","first_author":"Dwulit AD","journal":"International journal of environmental research and public health","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Cross-sectional study","Questionnaire Survey","university students","Pornography","Self-perceived Effects"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/16/10/1861/pdf?version=1558940116","cited_by_count":46,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 6463 Polish university students assessing pornography use frequency, self‑perceived effects and self‑labelled addiction.","sample_n":6463,"sample_text":"Convenience sample recruited via university email/social media; not nationally representative.","population":"Polish university students (age ~18‑25)","country":"Poland","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2019 online survey of over 6,000 Polish university students found that most had seen porn, with 15% describing themselves as addicted. Users reported mixed effects: some saw no harm, others noted longer stimulation needs or reduced sexual satisfaction. The study gives a snapshot of porn use but relies on self‑labels and does not control for moral or mental‑health factors.","clinical_takeaway":"Self‑perceived porn addiction is common among students, but conclusions about harm are limited; clinicians should assess underlying distress rather than rely on self‑label alone.","confidence":0.8,"topic_tags":["prevalence","pornography","sexual_function","relationships","adolescents"],"strengths":["Very large sample size","Provides descriptive epidemiology for a specific population","Reports both perceived negative and positive effects"],"limitations":["Self‑report, single‑item ‘addiction’ measure (circular)","No validated scales for problematic use or distress","Key confounds (morality, masturbation, mental health) not measured","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":9,"contrasting":1,"mentioning":64,"citing_publications":102,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph16101861"}},{"id":327,"doi":"10.1080/00224499.2018.1480744","pmid":"29913087","pmcid":null,"title":"Revisiting the Role of Impulsivity and Compulsivity in Problematic Sexual Behaviors","authors":"Bőthe B, Tóth-Király I, Potenza MN, Griffiths MD, Orosz G, Demetrovics Z.","first_author":"Bőthe B","journal":"Journal of sex research","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":108,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community survey (N=13,778) using self‑report questionnaires and structural equation modeling","sample_n":13778,"sample_text":"large community sample of adults (≈13.8k participants)","population":"adult men and women from the general population","country":"unspecified (likely multiple European sites)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large survey of over 13,000 adults, impulsivity and compulsivity were linked only weakly to problematic pornography use, while impulsivity showed a stronger connection to broader hypersexual behavior.","clinical_takeaway":"Impulsivity may matter more for hypersexuality than for problematic porn use; assess broader impulsivity traits rather than focusing solely on porn habits.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Very large sample size","Use of structural equation modeling to test relationships","Separate analysis for men and women"],"limitations":["Cross‑sectional design; no causal inference","No measurement of moral incongruence or other key confounds","Reliance on self‑report measures"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":13,"contrasting":1,"mentioning":114,"citing_publications":233,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1480744"}},{"id":328,"doi":"10.1556/2006.2024.00041","pmid":"39141435","pmcid":"PMC11457023","title":"A comprehensive evaluation of the neurocognitive predictors of problematic alcohol use, eating, pornography, and internet use: A 6-month longitudinal study","authors":"Christensen E, Albertella L, Chamberlain SR, Suo C, Brydevall M, Grant JE, Yücel M, Lee RSC.","first_author":"Christensen E","journal":"Journal of behavioral addictions","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Eating","Addiction","Longitudinal","Neurocognition","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11457023","cited_by_count":2,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"community online sample, baseline neurocognitive tasks, follow‑up surveys at 3 and 6 months (N = 294)","sample_n":294,"sample_text":"Australians, mean age 24.8 years, 51.7 % female","population":"young Australian adults, mixed gender","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 6‑month study of 294 Australian young adults, poorer performance on certain brain‑based tasks predicted higher self‑reported problem pornography use, but not alcohol problems. The links were small and other behaviours showed different predictors.","clinical_takeaway":"Current neurocognitive tests offer limited insight into who may develop problematic pornography use; clinicians should consider broader psychosocial factors.","confidence":0.8,"topic_tags":["pornography","neuroscience","csbd","sexual_function"],"strengths":["Longitudinal design with two follow‑up points","Reasonably large community sample","Use of multiple neurocognitive tasks","Bootstrapped regression estimates"],"limitations":["Problematic pornography measured with unspecified self‑report scale; unclear if validated","Key confounders (moral incongruence, masturbation, mental health) not assessed","No correction for multiple comparisons reported","Interpretation of “addiction” terminology may be circular"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00041"}},{"id":330,"doi":"10.1016/j.esxm.2020.10.004","pmid":"33302242","pmcid":"PMC7930855","title":"Variability of Pornographic Content Consumed and Longest Session of Pornography Use Associated With Treatment Seeking and Problematic Sexual Behavior Symptoms","authors":"Lewczuk K, Lesniak J, Lew-Starowicz M, Gola M.","first_author":"Lewczuk K","journal":"Sexual medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Therapy","Pornography","Pornography Addiction","Compulsive Sexual Behavior Disorder","Problematic Pornography Use","Binge Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7930855","cited_by_count":12,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 132 treatment‑seeking heterosexual men and 437 non‑seeking controls; self‑report measures of longest viewing session, content variability, weekly time","sample_n":569,"sample_text":"132 treatment‑seeking men, 437 non‑seeking controls","population":"heterosexual adult men (treatment seekers vs community controls)","country":"Poland (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"supports","citation_value":"useful","plain_summary":"A 2021 online study compared men seeking treatment for problematic porn use with non‑seeking controls. It found that longer uninterrupted viewing sessions and a wider range of porn types predicted treatment seeking and higher symptom severity, beyond total weekly viewing time.","clinical_takeaway":"Clinicians should assess not only total porn use time but also session length and content variety when evaluating compulsive sexual behaviour.","confidence":0.7,"topic_tags":["pornography","treatment","sexual_function"],"strengths":["Large control sample (n=437)","Novel focus on session length and content variability","Direct comparison of treatment‑seekers vs non‑seekers"],"limitations":["Self‑report single‑item measures, no validated scales","Cross‑sectional, cannot infer causality","No control for moral, mental‑health, or relational confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":2,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":16,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2020.10.004"}},{"id":331,"doi":"10.1556/2006.2022.00027","pmid":"35895456","pmcid":"PMC9295228","title":"What the grey literature can contribute to addictive behaviour disorder classification •","authors":"Kuss DJ, Lopez-Fernandez O.","first_author":"Kuss DJ","journal":"Journal of behavioral addictions","year":2022,"pub_types":["article-commentary","Journal Article"],"keywords":["Social Networking","International Classification Of Diseases","Internet Addiction","Icd-11","Behavioural Addictions","Shopping/buying","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9295228","cited_by_count":3,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"commentary","design_detail":"article-commentary; no empirical data; discusses classification framework","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The authors comment on a proposed ICD‑11 framework for behavioural addictions and argue that evidence from grey literature should be added as a fourth criterion, using problematic pornography, shopping and social‑media use as examples.","clinical_takeaway":"None – the article presents a conceptual proposal, not clinical evidence.","confidence":0.3,"topic_tags":["pornography","sexual_function"],"strengths":["Engages with current ICD‑11 debate","Proposes an innovative meta‑level criterion"],"limitations":["No empirical data","No systematic appraisal of grey literature","Potential advocacy for classification"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00027"}},{"id":334,"doi":"10.1556/2006.2021.00018","pmid":"33822748","pmcid":"PMC8969854","title":"Sexual incentive delay in the scanner: Sexual cue and reward processing, and links to problematic porn consumption and sexual motivation","authors":"Markert C, Klein S, Strahler J, Kruse O, Stark R.","first_author":"Markert C","journal":"Journal of behavioral addictions","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["fMRI","Reward System","Sexual Motivation","Pornography Use","Problematic Pornography Use","Sexual Incentive Delay Task"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8969854","cited_by_count":15,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross-sectional fMRI study with a Sexual Incentive Delay Task in 74 healthy men, correlating brain activation with self‑reported problematic pornography use indicators.","sample_n":74,"sample_text":"healthy men","population":"healthy adult males (N=74)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In 74 healthy men, brain areas linked to reward were strongly activated by sexual images and cues, but these activations did not relate to how much pornography they used or to self‑reported problematic use.","clinical_takeaway":"Reward‑system responses to sexual cues do not appear linked to problematic porn use in non‑clinical populations.","confidence":0.78,"topic_tags":["pornography","neuroscience","sexual_function","csbd"],"strengths":["Adequate fMRI sample size","Use of established Sexual Incentive Delay Task","Examines cue‑reactivity in reward circuitry"],"limitations":["Problematic use measured with unspecified/likely ad‑hoc scale","No assessment of moral incongruence, masturbation, or mental‑health covariates","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":37,"max_possible":70,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":8,"statistics":5,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":21,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2021.00018"}},{"id":335,"doi":"10.1111/add.15326","pmid":"33314391","pmcid":null,"title":"Commentary on Lewczuk et al : Moral incongruence, disapproval and behavioral 'addiction'","authors":"Grubbs JB.","first_author":"Grubbs JB.","journal":"Addiction (Abingdon, England)","year":2021,"pub_types":["Comment","Journal Article"],"keywords":["Morality","Pornography Addiction","Compulsive Sexual Behavior Disorder","Moral Incongruence","Perceived Addiction","Gaming Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/add.15326"}},{"id":336,"doi":"10.1556/2006.8.2019.31","pmid":"31257916","pmcid":"PMC7044553","title":"Approach bias for erotic stimuli in heterosexual male college students who use pornography","authors":"Sklenarik S, Potenza MN, Gola M, Kor A, Kraus SW, Astur RS.","first_author":"Sklenarik S","journal":"Journal of behavioral addictions","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Addiction","Cognitive Bias","Avoidance","Approach Bias","Pornography"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/8/2/article-p234.pdf","cited_by_count":28,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Experimental approach-avoidance task with 72 male undergraduates; correlational analysis of bias with self‑reported pornography use measures.","sample_n":72,"sample_text":"72 male undergraduate students","population":"Male undergraduate students (heterosexual, 18‑24 years) who use pornography","country":"USA (presumed based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A lab test with 72 college men showed that those who score higher on a problematic pornography questionnaire pull erotic pictures toward them faster than neutral pictures, suggesting an automatic “approach” tendency similar to other addictions.","clinical_takeaway":"The bias may reflect heightened motivation toward porn, but without accounting for moral or mental‑health factors it should not alone define addiction.","confidence":0.8,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Uses a validated behavioral task to assess approach bias","Includes a standardized problematic use scale (PPUS)","Direct measurement of bias rather than self‑report only"],"limitations":["Cross‑sectional; cannot infer causality","No control for key confounds (moral attitudes, masturbation, mental health)","Problematic use defined solely by PPUS, which may conflate distress with addiction"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":3,"contrasting":1,"mentioning":27,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.8.2019.31"}},{"id":337,"doi":"10.5114/cipp/151869","pmid":"38014388","pmcid":"PMC10654343","title":"The Generalized Problematic Internet Use Scale 2 in a Polish sample: psychometric validation and relationship with specific Internet-related disorders and psychosocial functioning","authors":"Balcerowska JM, Bereznowski P.","first_author":"Balcerowska JM","journal":"Current issues in personality psychology","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Loneliness","Social Anxiety","Problematic Internet Use","Insecure Attachment","Scale Adaptation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10654343","cited_by_count":5,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1155 Polish young internet users; online/offline questionnaire administration","sample_n":1155,"sample_text":"1155 participants completed online/offline surveys","population":"young internet users (convenience sample, Poland)","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors adapted a Polish version of the Generalized Problematic Internet Use Scale and showed it works well in a large group of young internet users. They found that high scores on this scale are linked to other online habits like social‑media and pornography use, as well as to loneliness and social anxiety.","clinical_takeaway":"The scale can reliably identify youths with broader problematic internet behaviours, but clinicians should consider other psychosocial factors beyond the scale scores.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for psychometric validation","Comprehensive factor and invariance testing","Includes multiple related Internet‑use constructs"],"limitations":["Convenience sample limits generalisability","No measurement of moral or religious factors that could confound 'problematic' use","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5114/cipp/151869"}},{"id":338,"doi":"10.1155/2019/2351638","pmid":"31531240","pmcid":"PMC6721264","title":"Impaired Recent Verbal Memory in Pornography-Addicted Juvenile Subjects","authors":"Prawiroharjo P, Ellydar H, Pratama P, Edison RE, Suaidy SEI, Amani NZ, Carissima D.","first_author":"Prawiroharjo P","journal":"Neurology research international","year":2019,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://downloads.hindawi.com/journals/nri/2019/2351638.pdf","cited_by_count":2,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional comparison of 15 pornography‑addicted and 15 non‑addicted juveniles","sample_n":30,"sample_text":"30 juveniles (15 addiction, 15 non‑addiction)","population":"juveniles (12‑16 y), n = 30","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small study of 30 adolescents compared those labeled as pornography‑addicted with non‑addicted peers and found poorer recent verbal memory in the addicted group, but the definition of addiction and control for other factors were unclear.","clinical_takeaway":"Insufficient evidence to conclude pornography use harms memory; results are limited by small sample and vague addiction criteria.","confidence":0.7,"topic_tags":["pornography","csbd"],"strengths":["Use of standardized neuropsychological tests","Direct comparison of addiction vs non‑addiction groups","Sex subgroup analysis performed"],"limitations":["Very small sample; likely under‑powered","Addiction definition unclear; probable circular measurement","No control for moral, mental‑health, or sexual‑behavior confounds"],"rubric_version":"2.0","raw_total":17,"max_possible":60,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2019/2351638"}},{"id":339,"doi":"10.1016/j.dib.2021.107467","pmid":"34703858","pmcid":"PMC8523878","title":"Electroencephalogram (EEG) dataset with porn addiction and healthy teenagers under rest and executive function task","authors":"Kang X, Agastya IMA, Handayani DOD, Kit MH, Rahman AWBA.","first_author":"Kang X","journal":"Data in brief","year":2021,"pub_types":["data-paper","Journal Article"],"keywords":["Electroencephalogram","Emotional State","Working Memory Capacity","Teenager Pornography Addiction"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.dib.2021.107467","cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"data paper presenting EEG recordings from 14 teenagers (7 classified as porn‑addicted by a psychologist, 7 healthy) during rest and executive‑function tasks; no hypothesised analysis.","sample_n":14,"sample_text":"Fourteen participants (five females, nine males) were recruited; seven were labelled addicted to pornography by a psychologist, seven were healthy controls.","population":"teenagers, Indonesia, convenience sample from a single center","country":"Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","masturbation_not_isolated","no_mi_control","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The paper shares raw EEG recordings from 14 Indonesian teens, half of whom were judged by a psychologist to have a pornography addiction. Recordings cover rest, emotional, and memory tasks, but the sample is tiny and the addiction label lacks a validated definition.","clinical_takeaway":"None – the study provides data only; it does not offer clinically actionable findings.","confidence":0.7,"topic_tags":["pornography","masturbation"],"strengths":["Provides a publicly available EEG dataset","Includes both resting‑state and executive‑function tasks"],"limitations":["Very small, non‑representative sample","Addiction status not based on validated scale","No control for key confounds (moral, mental health, masturbation)"],"rubric_version":"2.0","raw_total":16,"max_possible":70,"pct_score":23,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":3,"statistics":1,"confounds":1,"design":1,"addiction_criteria":2,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.dib.2021.107467"}},{"id":340,"doi":"10.1016/j.chiabu.2023.106195","pmid":"37116448","pmcid":null,"title":"Between pleasure, guilt, and dissociation: How trauma unfolds in the sexuality of childhood sexual abuse survivors","authors":"Gewirtz-Meydan A, Godbout N.","first_author":"Gewirtz-Meydan A","journal":"Child abuse & neglect","year":2023,"pub_types":["Journal Article"],"keywords":["Sexual dysfunction","Childhood Sexual Abuse","Compulsive Sexual Behavior Disorder","Traumatic Sexuality","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"moderation analysis of self‑report data from 393 CSA survivors; convenience sample","sample_n":393,"sample_text":"CSA survivors recruited for a survey; likely non‑probability sample","population":"adult survivors of childhood sexual abuse (N≈393)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 393 adults who survived childhood sexual abuse, the study found that feelings of guilt, shame, dissociation, and hyper‑vigilance during sex were linked to higher sexual dysfunction and symptoms of compulsive sexual behavior, including problematic pornography use.","clinical_takeaway":"Therapists should assess trauma‑related sexual symptoms (guilt, dissociation) when treating sexual difficulties in CSA survivors.","confidence":0.6,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Large sample for a trauma‑focused study","Focus on nuanced sexual trauma symptoms","Use of moderation analysis to explore interactions"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on self‑report scales with unclear validation","Key confounds (moral incongruence, mental health, partner effects) not measured","Addiction constructs inferred from symptom scales without criteria testing"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":14,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2023.106195"}},{"id":341,"doi":"10.1016/j.comppsych.2024.152470","pmid":"38631271","pmcid":null,"title":"Validation of the ACSID-11 for consistent screening of specific Internet-use disorders based on ICD-11 criteria for gaming disorder: A multitrait-multimethod approach","authors":"Oelker A, Rumpf HJ, Brand M, Müller SM.","first_author":"Oelker A","journal":"Comprehensive psychiatry","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Journal Article"],"keywords":["Behavioral Addiction","Gambling Disorder","Gaming Disorder","Social Network Use Disorder","Shopping Disorder","Pornography Use Disorder"],"is_oa":false,"oa_url":"https://doi.org/10.1016/j.comppsych.2024.152470","cited_by_count":16,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience sample of active Internet users (N=1597) completed the ACSID-11 and established disorder scales; multitrait‑multimethod analysis used for convergent/divergent validity.","sample_n":1597,"sample_text":"Convenience sample of active Internet users recruited online.","population":"Adults and adolescents (active Internet users; convenience sample)","country":"Not specified (likely Germany based on authors’ affiliations)","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The 11‑item ACSID‑11 was tested in 1,600 internet users and showed moderate‑to‑strong agreement with existing scales for gaming, shopping, pornography, social media and gambling, indicating it can screen multiple online behaviours with reasonable validity.","clinical_takeaway":"The ACSID‑11 appears to be a promising brief screener for various Internet‑use problems, but clinicians should note it has not yet been clinically validated for diagnostic decisions.","confidence":0.8,"topic_tags":["pornography","sexual_function","measurement","adolescents"],"strengths":["Large sample size for validation","Uses multiple established disorder scales for convergent validity","Multitrait‑multimethod approach"],"limitations":["Convenience, non‑representative sample","No explicit measurement of moral incongruence or masturbation","No pre‑registration or correction for multiple testing reported"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":14,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2024.152470"}},{"id":343,"doi":"10.3390/ijerph17020488","pmid":"31940928","pmcid":"PMC7014272","title":"The Assessment of Problematic Internet Pornography Use: A Comparison of Three Scales with Mixed Methods","authors":"Chen L, Jiang X.","first_author":"Chen L","journal":"International journal of environmental research and public health","year":2020,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Internet Pornography Use","Problematic Pornography Use","Problematic Pornography Consumption Scale","Problematic Pornography Use Scale","The Short Internet Addiction Test Adapted To Online Sexual Activities"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/17/2/488/pdf?version=1578824128","cited_by_count":36,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large cross‑sectional questionnaire study (N=972) comparing three self‑report scales for problematic internet pornography use, plus qualitative interviews (n=33).","sample_n":972,"sample_text":"Adults (mean age 24.8) from 28 provinces/regions in China; 22 volunteers and 11 therapists for qualitative interviews.","population":"Adults (mean age 24.8) from 28 Chinese provinces, recruited online; convenience sample.","country":"China","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared three questionnaires that screen for problematic online pornography use in 972 Chinese adults. The Problematic Pornography Consumption Scale showed the best reliability and ability to distinguish problematic from non‑problematic users.","clinical_takeaway":"The PPCS appears to be the most reliable self‑report tool for identifying problematic pornography use in research and clinical screening.","confidence":0.8,"topic_tags":["pornography","sexual_function","measurement"],"strengths":["Large sample for psychometric validation","Mixed methods (quant + qual) adds depth","Systematic comparison of three scales"],"limitations":["Convenience online sample – limited generalisability","No measurement of key confounds (moral incongruence, masturbation, mental health)","Reliance on self‑report screening tools only"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":46,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph17020488"}},{"id":344,"doi":"10.1071/sh22181","pmid":"36848630","pmcid":null,"title":"Pornography consumption and sexual health among emerging adults from Malaysia: an observational study","authors":"Goh PH, Phuah LA, Low YH.","first_author":"Goh PH","journal":"Sexual health","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Observational Study"],"keywords":[],"is_oa":false,"oa_url":"https://www.publish.csiro.au/sh/pdf/SH22181","cited_by_count":6,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey, convenience sample (N=319), emerging adults Malaysia","sample_n":319,"sample_text":"convenience sample of 319 Malaysians aged 18‑30 years recruited online","population":"emerging adults (18‑30) in Malaysia","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Malaysian online survey of 319 young adults, most had viewed pornography. People who reported more problematic use had lower sexual satisfaction, while higher frequency was linked to more self‑reflection and better genital image for women, but also more sexual embarrassment for both sexes.","clinical_takeaway":"Problematic porn use may relate to poorer sexual satisfaction; clinicians should assess distress separately from frequency.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Relatively large sample for a regional study","Includes both attitudes and multiple sexual‑health outcomes","Gender‑specific analyses"],"limitations":["Convenience, non‑representative sample","Problematic consumption measured with unspecified/likely ad‑hoc scale","Key confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh22181"}},{"id":345,"doi":"10.1016/j.addbeh.2020.106438","pmid":"32325387","pmcid":null,"title":"Approach bias for erotic stimuli among heterosexual female college students who use pornography","authors":"Sklenarik S, Potenza MN, Gola M, Astur RS.","first_author":"Sklenarik S","journal":"Addictive behaviors","year":2020,"pub_types":["Journal Article"],"keywords":["Addiction","Cognitive Bias","Approach-avoidance","Approach Bias","Pornography","Erotic Stimuli"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross‑sectional laboratory study using an approach‑avoidance task with 121 female undergraduates; convenience sample","sample_n":121,"sample_text":"female undergraduate students, heterosexual, aged ~18‑22, recruited from a university","population":"heterosexual female college students (N=121)","country":"unspecified (likely USA/Poland based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 121 heterosexual college women, a lab task showed they more quickly “approached” erotic pictures than neutral ones. The size of this bias was linked to higher scores on a problematic‑pornography questionnaire and to greater anhedonia, suggesting a possible behavioral hallmark of risky porn use in women.","clinical_takeaway":"Approach‑bias for erotic cues may signal problematic porn use in women, but clinicians should also assess moral conflict and mental‑health factors before drawing conclusions.","confidence":0.8,"topic_tags":["pornography","csbd","prevalence","measurement"],"strengths":["Validated pornography use scales","Objective behavioral bias measure","Adequate sample size for task‑based study"],"limitations":["Cross‑sectional; cannot infer causality","No control for moral incongruence or masturbation","Convenience sample of heterosexual females limits generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2020.106438"}},{"id":346,"doi":"10.1007/s10508-018-1291-7","pmid":"30128983","pmcid":null,"title":"Pornography Problems Due to Moral Incongruence","authors":"Fisher WA, Montgomery-Graham S, Kohut T.","first_author":"Fisher WA","journal":"Archives of sexual behavior","year":2019,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1291-7"}},{"id":347,"doi":"10.1097/yco.0000000000000804","pmid":"35855504","pmcid":null,"title":"Internet use and internet-based addictive behaviours during coronavirus pandemic","authors":"Kovačić Petrović Z, Peraica T, Kozarić-Kovačić D, Palavra IR.","first_author":"Kovačić Petrović Z","journal":"Current opinion in psychiatry","year":2022,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of pandemic‑related literature on internet‑based addictive behaviours, including problematic pornography use","sample_n":null,"sample_text":"not applicable – review of published studies","population":"general population across age groups (no new data collected)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review summarises early research showing that during COVID‑19 lockdowns, overall internet use and self‑reported internet‑related addictions—including problematic pornography use—appeared to rise, especially among young people facing stress, loneliness, and mental‑health challenges.","clinical_takeaway":"Clinicians should be aware that pandemic‑related stress may increase problematic online sexual behaviours, but evidence is currently limited; monitor patients' internet use in context of broader mental‑health assessment.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Broad overview of many internet‑related behaviours during COVID‑19","Highlights need for longitudinal research and tailored interventions"],"limitations":["Narrative (non‑systematic) synthesis; no systematic search or risk‑of‑bias assessment","No original data; conclusions rely on heterogeneous primary studies","Potential for selective citation; lacks quantitative meta‑analysis"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":4,"contrasting":0,"mentioning":44,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/yco.0000000000000804"}},{"id":348,"doi":"10.1111/and.14142","pmid":"34105178","pmcid":"PMC8459256","title":"The impact of asexual trait and porn addiction in a young men healthy cohort","authors":"Russo GI, Campisi D, Di Mauro M, Falcone M, Cocci A, Cito G, Verze P, Capogrosso P, Fode M, Cacciamani G, Morgia G, European Association of Urology Young Academic Urologists (EAU-YAU) Sexual, reproductive Working Group.","first_author":"Russo GI","journal":"Andrologia","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sex","erectile dysfunction","Masturbation","Asexuality","Porn Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8459256","cited_by_count":2,"is_preprint":false,"topics":["masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience survey of 559 young men recruited via social media; self‑report questionnaires administered.","sample_n":559,"sample_text":"559 young male adults; 478 provided complete data for erectile function measures.","population":"young adult male community sample (N≈559, self‑selected)","country":"Italy (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 559 young men surveyed online, higher asexual traits were linked to lower erectile function both during intercourse and masturbation, and were also associated with lower pornography craving scores.","clinical_takeaway":"Asexual traits may co‑occur with erectile difficulties; clinicians should assess both sexual function and pornography use.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Use of validated questionnaires for erectile function, masturbation, asexuality, and pornography craving","Relatively large sample for a single‑time‑point survey","Separate assessment of masturbation and intercourse erectile function"],"limitations":["Convenience online recruitment limits generalisability","No control for key psychosocial confounds (moral incongruence, mental health, relationship status, trauma)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/and.14142"}},{"id":349,"doi":"10.1016/j.jpsychires.2022.10.021","pmid":"36252343","pmcid":null,"title":"The relation of perceived social support to compulsive sexual behavior","authors":"Wizła M, Glica A, Gola M, Lewczuk K.","first_author":"Wizła M","journal":"Journal of psychiatric research","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexuality","Sexual behavior","Perceived Social Support","Compulsive Sexual Behavior Disorder","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Study 1: convenience online sample (n=807). Study 2: nationally representative Polish adult sample (n=1526). Both cross‑sectional surveys.","sample_n":1526,"sample_text":"Study 2 used a representative sample of the Polish adult population (n=1526). Study 1 used a convenience social‑media sample (n=807).","population":"Polish adults, mixed gender, various sexual orientations.","country":"Poland","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Two Polish surveys (total N≈2,300) found that people who feel they have more social support tend to report slightly lower levels of problematic porn use and compulsive sexual behavior, though the effects are weak.","clinical_takeaway":"Higher perceived social support may modestly protect against problematic porn use and compulsive sexual behavior.","confidence":0.85,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative sample in Study 2","Use of validated scales for PPU, CSBD and social support","Consistent analytic approach across two independent samples"],"limitations":["Cross‑sectional design prevents causal inference","Key confounds (moral incongruence, masturbation, mental health, trauma) not measured","Reliance on self‑report; no behavioural or clinical verification"],"rubric_version":"2.0","raw_total":38,"max_possible":60,"pct_score":63,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpsychires.2022.10.021"}},{"id":350,"doi":"10.1016/j.abrep.2022.100431","pmid":"35647261","pmcid":"PMC9133580","title":"Self-perceived substance and behavioral addictions among Jewish Israeli adolescents during the COVID-19 pandemic","authors":"Efrati Y, Spada MM.","first_author":"Efrati Y","journal":"Addictive behaviors reports","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Substance Use Disorder","Behavioral Addictions","Self-perceived","Covid-19","Sociodemographic Categories"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.abrep.2022.100431","cited_by_count":8,"is_preprint":false,"topics":["ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large anonymous online survey of Israeli adolescents (N=2074) during COVID‑19","sample_n":2074,"sample_text":"community sample, anonymous, parental consent","population":"adolescents 12‑19 y, community sample","country":"Israel","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of over 2,000 Israeli teens during COVID‑19 found that many reported feeling “addicted” to things like social media, shopping and sex‑related behaviour, with prevalence varying by age, gender, religiosity and socioeconomic status.","clinical_takeaway":"Self‑labelled “addiction” in teens often reflects perceived problems rather than clinically validated disorders; clinicians should probe frequency and distress separately.","confidence":0.8,"topic_tags":["adolescents","sexual_function","pornography","masturbation"],"strengths":["Large sample size","Broad range of behavioural domains examined","Includes demographic correlates"],"limitations":["Self‑perceived addiction measured by single items (circular)","No validated addiction scales or separation of frequency vs distress","Limited control of key confounds (masturbation, mental health, trauma)","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.abrep.2022.100431"}},{"id":351,"doi":"10.1007/s10508-022-02519-w","pmid":"36652136","pmcid":"PMC9847461","title":"Effects of a 7-Day Pornography Abstinence Period on Withdrawal-Related Symptoms in Regular Pornography Users: A Randomized Controlled Study","authors":"Fernandez DP, Kuss DJ, Justice LV, Fernandez EF, Griffiths MD.","first_author":"Fernandez DP","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Randomized Controlled Trial","Journal Article"],"keywords":["Craving","Affect","Withdrawal","Addiction","Abstinence","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9847461","cited_by_count":9,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"randomized controlled trial with 176 undergraduate regular pornography users assigned to abstinence or control condition for 7 days; outcomes measured nightly","sample_n":176,"sample_text":"176 undergraduates (64.2% female) regular pornography users","population":"undergraduate students, regular pornography users (≥3×/week)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a randomized trial, 176 college students who regularly watched porn were asked either to avoid porn for a week or continue as usual. No clear withdrawal‑like symptoms were found overall, though higher craving appeared only in the most frequent users who also had high problem‑use scores.","clinical_takeaway":"Short‑term porn abstinence does not reliably produce withdrawal symptoms in most users; clinicians should not assume withdrawal when patients try to quit.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Randomized controlled design","Adequate overall sample size","Multiple daily assessments"],"limitations":["Convenience student sample limits generalisability","Key confounds (moral incongruence, masturbation, mental health) not measured","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02519-w"}},{"id":352,"doi":"10.31234/osf.io/kjvbr","pmid":null,"pmcid":null,"title":"Porndemic? A longitudinal study of pornography use before and during the COVID-19 pandemic in a nationally representative sample of Americans","authors":"Grubbs JB, Perry S, Kraus SW, Grant Weinandy JT.","first_author":"Grubbs JB","journal":"PsyArXiv","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":true,"oa_url":"https://osf.io/kjvbr/download","cited_by_count":1,"is_preprint":true,"topics":["pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"nationally representative longitudinal panel (N≈2,500 baseline, decreasing to ≈1,200 at later waves)","sample_n":2518,"sample_text":"baseline N=2,518; follow‑up waves N=1,677; 1,533; 1,470; 1,269","population":"American adults","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A national US panel showed a brief rise in past‑month porn use in May 2020, but overall use and self‑reported problem use fell or stayed low through the rest of 2020, contrary to fears that the pandemic would boost porn addiction.","clinical_takeaway":"COVID‑related lockdowns did not lead to lasting increases in problematic pornography use in the general US adult population.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative baseline sample","Repeated measurements across pandemic phases","Clear temporal trend reporting"],"limitations":["Problematic use measured with unspecified/likely unvalidated instrument","No control for key confounds (e.g., moral incongruence, mental health)","Potential attrition bias across waves"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/kjvbr"}},{"id":354,"doi":"10.3389/fpsyt.2021.517411","pmid":"33889090","pmcid":"PMC8055940","title":"Markers of Prenatal Androgen Exposure Correlate With Online Sexual Compulsivity and Erectile Function in Young Men","authors":"Buchholz VN, Mühle C, Cohort Study on Substance Use Risk Factors, Kornhuber J, Lenz B.","first_author":"Buchholz VN","journal":"Frontiers in psychiatry","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["erectile function","Premature Ejaculation","2d:4d","Behavioral Addiction","Digit Ratio","Pornography Addiction","Spermarche","Prenatal Androgen Load"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8055940","cited_by_count":4,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community cohort (N=4,370), cross‑sectional correlation study","sample_n":4370,"sample_text":"young men, age IQR 25‑26 y, recruited from the Cohort Study on Substance Use Risk Factors","population":"young adult men (≈25‑26 y) from a substance‑use risk‑factor cohort","country":"Germany (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"supports","citation_value":"useful","plain_summary":"In a survey of 4,370 young men, lower finger‑length ratios and later puberty were linked to higher self‑reported online sexual compulsivity, which in turn related to poorer erectile and ejaculatory function. Frequency of porn use did not predict these problems.","clinical_takeaway":"Higher compulsive porn use, not mere frequency, may be associated with erectile difficulties; clinicians should assess compulsivity and distress rather than use alone.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Very large sample size","Validated clinical scales for sexual function","Novel biological proxy (2D:4D, spermarche) applied"],"limitations":["Cross‑sectional; no causal inference","No measurement of moral incongruence or other key confounds","Addiction inferred from OSC scale without ICD‑11 criteria"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2021.517411"}},{"id":355,"doi":"10.1186/s12888-022-04370-8","pmid":"36536318","pmcid":"PMC9762014","title":"Hypersexual behaviour among young adults in Germany: characteristics and personality correlates","authors":"Jepsen D, Brzank PJ.","first_author":"Jepsen D","journal":"BMC psychiatry","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual Health","Young Adults","Social Psychiatry","Hypersexuality","Sexual Compulsivity","Sex Addiction","Problematic Pornography Use","Compulsive Sexual Behaviour Disorder"],"is_oa":true,"oa_url":"https://bmcpsychiatry.biomedcentral.com/counter/pdf/10.1186/s12888-022-04370-8","cited_by_count":6,"is_preprint":false,"topics":["csbd","masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 609 German young adults recruited via addiction forum, dating site, Facebook, and university mailing list","sample_n":609,"sample_text":"n = 609; recruited online from forums, dating site, Facebook, university mailing list","population":"young adults (18‑27) in Germany, mixed gender, community sample (non‑clinical)","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a German online survey of 609 young adults, about 10% were classified as hypersexual. Male sex, problematic porn use, and impulsivity predicted this behavior, which was also linked to promiscuity and life‑area problems. No link was found with lack of school sexual education.","clinical_takeaway":"Hypersexual behavior is associated with impulsivity and problematic pornography use; clinicians should assess these factors, but note the findings stem from a non‑representative, cross‑sectional sample.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample size for a survey (N>600)","Uses standardized questionnaires","Examines multiple personality correlates"],"limitations":["Convenience, self‑selected recruitment (forums, dating site)","No measurement of moral incongruence or mental‑health covariates","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12888-022-04370-8"}},{"id":356,"doi":"10.7334/psicothema2021.8","pmid":"34297674","pmcid":null,"title":"The Role of Meta-Cognitive Certainty on Pornography Consumption","authors":"Paredes B, Martínez L, Cuesta U, Briñol P, Petty R, Moreno L.","first_author":"Paredes B","journal":"Psicothema","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two studies with convenience samples; Study 1 correlational, Study 2 experimental manipulation of meta‑cognitive certainty; self‑report consumption and one overt behaviour measure.","sample_n":null,"sample_text":"Not specified in abstract","population":"adults (likely university/community volunteers); sample size not reported in abstract","country":"Spain (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study shows that the Problematic Pornography Use Scale does predict how much porn people watch, and that this link is stronger when participants are more certain about their answers. Adding meta‑cognitive certainty improves prediction of actual consumption.","clinical_takeaway":"Meta‑cognitive certainty may help clinicians interpret PPUS scores more accurately, but the scale alone does not capture problematic use without further context.","confidence":0.78,"topic_tags":["pornography","measurement","csbd"],"strengths":["Uses an established scale (PPUS) to predict actual consumption","Introduces a novel moderator (meta‑cognitive certainty)","Includes an overt behavioural measure in Study 2"],"limitations":["Reliance on self‑report for key variables","No control for moral, mental‑health or relationship confounds","Unclear sample size and power"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7334/psicothema2021.8"}},{"id":357,"doi":"10.1080/00224499.2021.1988500","pmid":"34723731","pmcid":null,"title":"The Association between the Quantity and Severity of Pornography Use: A Meta-analysis","authors":"Chen L, Jiang X, Wang Q, Bőthe B, Potenza MN, Wu H.","first_author":"Chen L","journal":"Journal of sex research","year":2022,"pub_types":["Meta-Analysis","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 61 studies (82 samples, N≈74,880) assessing correlation between quantity of pornography use and problematic use, with moderation analyses.","sample_n":74880,"sample_text":"74,880 participants across 82 independent samples","population":"Adults from various published/unpublished studies (mixed samples, likely convenience/online surveys).","country":"International (multiple studies)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of nearly 75,000 people found a moderate link (r≈0.34) between how often people view pornography and how severe their self‑reported problematic use is, with stronger links in conservative cultures and when frequency is used as the measure.","clinical_takeaway":"Higher pornography frequency modestly predicts self‑reported problems; clinicians should assess use patterns alongside cultural and personal factors.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large pooled sample size","Comprehensive literature search (published & unpublished)","Quantitative synthesis with moderation analyses"],"limitations":["Heterogeneity of PPU measures; many may lack validation","No assessment of key confounds (moral incongruence, mental health, etc.)","Potential publication bias not detailed in abstract"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":36,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2021.1988500"}},{"id":358,"doi":"10.1007/s10508-021-02282-4","pmid":"35059944","pmcid":"PMC8773393","title":"A Longitudinal Study of Adolescents' Pornography Use Frequency, Motivations, and Problematic Use Before and During the COVID-19 Pandemic","authors":"Bőthe B, Vaillancourt-Morel MP, Dion J, Paquette MM, Massé-Pfister M, Tóth-Király I, Bergeron S.","first_author":"Bőthe B","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Adolescents","Motivation","Pornography","Problematic Pornography Use","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8773393","cited_by_count":39,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two‑wave longitudinal cohort of 1,771 adolescents (mean age 15.4) assessing self‑reported pornography frequency, motivations, and problematic use before and during COVID‑19; latent change modeling used.","sample_n":1771,"sample_text":"N = 1771 at Time 1; follow‑up one year later (Time 2)","population":"Adolescents (≈15 y, mixed gender) from a community sample in an ongoing sexual‑health study","country":"unspecified (likely Canada/Europe based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A year‑long study of over 1,700 teens found that how often they watched porn, why they did so, and their self‑rated problematic use stayed basically the same from before COVID‑19 to mid‑2021, with only tiny gender‑specific shifts that lacked clinical importance.","clinical_takeaway":"COVID‑19 lockdowns did not markedly increase adolescent porn use or related problems; routine screening remains appropriate.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","measurement"],"strengths":["Large community sample","Two‑wave design captures change across pandemic","Use of latent change modeling"],"limitations":["PPU measurement details unclear; likely self‑label scale","No assessment of key confounds (moral incongruence, masturbation, mental health)","No pre‑registration disclosed"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":4,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":31,"citing_publications":69,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02282-4"}},{"id":359,"doi":"10.1556/2006.2020.00015","pmid":"32663384","pmcid":"PMC8939420","title":"Pornography use in the setting of the COVID-19 pandemic","authors":"Mestre-Bach G, Blycker GR, Potenza MN.","first_author":"Mestre-Bach G","journal":"Journal of behavioral addictions","year":2020,"pub_types":["letter","Journal Article"],"keywords":["Coronavirus","Compulsive Sexual Behaviors","Pornography","Covid-19"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/view/journals/2006/9/2/article-p181.pdf","cited_by_count":91,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"letter without original empirical data","sample_n":null,"sample_text":"not applicable – no primary data collected","population":"general discussion of pornography use during COVID‑19 pandemic","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors note that global porn site traffic rose during early COVID‑19 lockdowns, with increases ranging from 4‑24% and spikes in searches for virus‑related terms. They discuss how this surge might relate to problematic porn use, but provide no new data or analysis.","clinical_takeaway":"No direct clinical guidance; the letter simply points out a pandemic‑related rise in porn viewing.","confidence":0.8,"topic_tags":["pornography","csbd","sexual_function"],"strengths":["Timely discussion of pandemic‑related changes in porn consumption","Cites real‑world traffic data from Pornhub"],"limitations":["No original data or systematic analysis","No measurement of constructs or confounding variables","Interpretation of increased traffic as indicating problematic use is speculative"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":8,"contrasting":0,"mentioning":148,"citing_publications":190,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00015"}},{"id":361,"doi":"10.1016/j.jsxm.2019.05.010","pmid":"31277972","pmcid":null,"title":"Prevalence and Determinants of Problematic Online Pornography Use in a Sample of German Women","authors":"Baranowski AM, Vogl R, Stark R.","first_author":"Baranowski AM","journal":"The journal of sexual medicine","year":2019,"pub_types":["Journal Article"],"keywords":["Sexual behavior","Compulsive Sexual Behavior","Pornography Addiction","Female Pornography Use","Online Pornography Use","S-iatsex"],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of self‑referred German women (N=485)","sample_n":485,"sample_text":"self‑referred convenience sample; not representative of general female population","population":"German women, adult (18+), self‑selected volunteers","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 485 German women, about 3 % reported problems linked to online pornography. More time watching porn, higher sexual motivation, and using porn to avoid emotions were related to these problems. The authors suggest targeting these factors in prevention programs.","clinical_takeaway":"A small minority of women may experience problematic porn use; clinicians should assess use patterns and underlying motives, but findings are limited by the non‑representative sample.","confidence":0.8,"topic_tags":["pornography","sexual_function","prevalence","gender"],"strengths":["First prevalence estimate for women in German sample","Multivariate analysis linking time spent, motivation, avoidance","Identifies potential prevention targets"],"limitations":["Self‑selected, non‑representative sample","Problematic use not measured with validated scale","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":60,"pct_score":37,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":26,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.05.010"}},{"id":362,"doi":"10.1007/s10508-021-02135-0","pmid":"34816358","pmcid":null,"title":"Theoretically Suggested Divergent Predictions for Pornography Use, Religiosity, and Permissive Sexual Attitudes","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Archives of sexual behavior","year":2022,"pub_types":["Journal Article"],"keywords":["Religiosity","Sexual Scripts","Pornography","Sexual Permissiveness","Moral Incongruence"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationwide representative survey, four meta‑samples, cross‑sectional analysis","sample_n":null,"sample_text":"nationally representative U.S. data (four meta‑samples)","population":"U.S. adults (nationally representative sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using U.S. survey data, the study found that religious people who watch porn are less permissive than non‑religious viewers, suggesting that pornography may increase permissive attitudes more for non‑religious individuals.","clinical_takeaway":"None – findings are theoretical and not directly applicable to clinical practice.","confidence":0.8,"topic_tags":["pornography","religiosity","sexual_function"],"strengths":["large, nationally representative sample","multiple independent meta‑samples","direct comparison of two theoretical frameworks"],"limitations":["cross‑sectional design cannot establish causality","no measurement of moral incongruence or masturbation","limited control of psychological confounders"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02135-0"}},{"id":363,"doi":"10.1556/2006.2020.00090","pmid":"34329192","pmcid":"PMC9295236","title":"What should be included in the criteria for compulsive sexual behavior disorder?","authors":"Gola M, Lewczuk K, Potenza MN, Kingston DA, Grubbs JB, Stark R, Reid RC.","first_author":"Gola M","journal":"Journal of behavioral addictions","year":2022,"pub_types":["Letter","reply"],"keywords":["Diagnostic criteria","Icd-11","Hypersexual Disorder","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9295236","cited_by_count":77,"is_preprint":false,"topics":["csbd","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"letter/reply with no empirical data","sample_n":null,"sample_text":"none (letter)","population":"none","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors compare the ICD‑11 definition of compulsive sexual behavior disorder with the earlier DSM‑5 proposal for hypersexual disorder, highlighting differences such as the role of coping, exclusion criteria, and the inclusion of moral incongruence.","clinical_takeaway":"Clinicians should note that ICD‑11 CSBD criteria now exclude moral‑incongruence‑related distress, distinguishing it from prior hypersexual disorder proposals.","confidence":0.7,"topic_tags":["csbd","sexual_function","measurement"],"strengths":["clear comparison of ICD‑11 CSBD and DSM‑5 HD criteria","highly cited, influencing ongoing diagnostic debates"],"limitations":["no empirical data; purely conceptual discussion","no systematic review methodology","potential author bias toward ICD‑11 adoption"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":3,"contrasting":0,"mentioning":123,"citing_publications":137,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00090"}},{"id":364,"doi":"10.31234/osf.io/6ewu8","pmid":null,"pmcid":null,"title":"Mindfulness-based relapse prevention trial for compulsive sexual behaviour disorder","authors":"Holas P, Draps M, Kowalewska E, Lewczuk K, Gola M.","first_author":"Holas P","journal":"PsyArXiv","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd","masturbation","pornography","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"single-group pre‑post pilot (N=13)","sample_n":13,"sample_text":"13 adult males with a diagnosis of CSBD","population":"adult males diagnosed with CSBD","country":"Poland","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A small pilot study (13 men) tested an eight‑week mindfulness program for compulsive sexual behaviour. Participants reported less time watching porn and lower anxiety, depression, and OCD symptoms after the program, but the study lacked a control group and had a very limited sample.","clinical_takeaway":"Preliminary evidence suggests mindfulness may help reduce problematic porn use, but robust trials are needed before clinical recommendation.","confidence":0.7,"topic_tags":["treatment","csbd","prevalence","relationships","moral_incongruence"],"strengths":["First pilot of mindfulness‑based relapse prevention for CSBD","Includes multiple clinical outcomes (anxiety, depression, OCD)","Uses pre‑ and post‑intervention measurement"],"limitations":["Very small, all‑male sample (N=13)","Uncontrolled pre‑post design; no comparison group","Unclear whether validated scales were used","Key confounds (moral incongruence, partner context) not assessed"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/6ewu8"}},{"id":366,"doi":"10.1007/s10508-018-1292-6","pmid":"30116928","pmcid":null,"title":"Self-Perceived Problematic Pornography Use: Beyond Individual Differences and Religiosity","authors":"Vaillancourt-Morel MP, Bergeron S.","first_author":"Vaillancourt-Morel MP","journal":"Archives of sexual behavior","year":2019,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":42,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1292-6"}},{"id":367,"doi":"10.1080/0092623x.2018.1466012","pmid":"29676698","pmcid":null,"title":"The Role of Religiosity in Adolescents' Compulsive Pornography Use: A Longitudinal Assessment","authors":"Kohut T, Štulhofer A.","first_author":"Kohut T","journal":"Journal of sex & marital therapy","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two independent panel samples of male Croatian adolescents; mixed‑effects growth models over multiple waves.","sample_n":null,"sample_text":"two independent panel samples (sizes not reported in abstract)","population":"Adolescent males, Croatia","country":"Croatia","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In Croatian teenage boys, higher pornography use was linked to more symptoms of compulsive use. Surprisingly, the most religious boys who showed compulsive symptoms started with lower use but increased faster over time. The study suggests religious factors may shape how compulsive porn use develops in adolescents.","clinical_takeaway":"Clinicians should consider religiosity when assessing compulsive pornography use in adolescents, but also attend to other unmeasured factors.","confidence":0.8,"topic_tags":["adolescents","pornography","religiosity","sexual_function","moral_incongruence"],"strengths":["Longitudinal design with two independent samples","Use of mixed‑effects growth modelling","Focus on religious moderation of compulsive use"],"limitations":["Unclear whether compulsive use scale is validated","No measurement or control of key confounds (masturbation, mental health, moral incongruence)","Sample size and power not reported"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":20,"citing_publications":83,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2018.1466012"}},{"id":370,"doi":"10.3389/fpsyg.2022.837315","pmid":"35496258","pmcid":"PMC9043320","title":"No Significant Changes in Addictive and Problematic Behaviors During the COVID-19 Pandemic and Related Lockdowns: A Three-Wave Longitudinal Study","authors":"Koós M, Demetrovics Z, Griffiths MD, Bőthe B.","first_author":"Koós M","journal":"Frontiers in psychology","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Longitudinal","Gambling Disorder","Addictive Behaviors","Internet Gaming Disorder","Compulsive Sexual Behavior Disorder","Problematic Pornography Use","Problematic Social Media Use","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9043320","cited_by_count":17,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Three‑wave longitudinal survey of a Hungarian general‑population sample (T1 = 1747, T2 = 656, T3 = 411) using latent growth curve modelling to track changes in several self‑reported addictive behaviours, including problematic pornography use and compulsive sexual behaviour.","sample_n":1747,"sample_text":"Initial wave N=1747; follow‑ups N=656 and N=411.","population":"Adults from the general population in Hungary (online survey).","country":"Hungary","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A three‑wave Hungarian survey (2020‑2021) found no meaningful rise in problematic pornography use or other addictive behaviours during COVID‑19 lockdowns; only a tiny increase was seen for compulsive sexual behaviour, which the authors deemed negligible.","clinical_takeaway":"COVID‑19 lockdowns did not substantially worsen problematic porn or sexual‑behaviour symptoms in the general population.","confidence":0.78,"topic_tags":["sexual_function","pornography","csbd","other"],"strengths":["Large initial sample size","Three measurement points covering different pandemic phases","Use of latent growth curve modelling"],"limitations":["High attrition across waves","No explicit control for moral incongruence or masturbation","Unclear whether validated scales were used"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2022.837315"}},{"id":371,"doi":"10.4103/0970-258x.295968","pmid":"32985442","pmcid":null,"title":"Use of pornography in India: Need to explore its implications","authors":"Sharma MK, Rao GN, Benegal V, Thennarasu K, Oommen D.","first_author":"Sharma MK","journal":"The National medical journal of India","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"house‑to‑house community survey of 2525 adults (18‑40) in India; administered a schedule including a screening tool for pornographic addiction and the General Health Questionnaire; reported prevalence rates and associations with sex, age, marital status.","sample_n":2525,"sample_text":"2525 individuals (1239 men; 1286 women) aged 18‑40 years.","population":"Adults (18‑40) from the general community in India, sampled via door‑to‑door recruitment; both genders roughly equal.","country":"India","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A door‑to‑door survey of 2,525 Indian adults found that about 8% had ever used pornography and only 0.2% were labeled as 'addicted' by a brief screening tool. Use was higher among single people. The study calls for deeper research on porn’s effects in India.","clinical_takeaway":"Current data on porn use in India are limited; clinicians should treat self‑reported ‘addiction’ cautiously pending better‑validated assessments.","confidence":0.78,"topic_tags":["pornography","prevalence","sexual_function"],"strengths":["Large community sample","Both genders represented","First prevalence data from India"],"limitations":["Unclear validation of addiction screening tool","No measurement of masturbation or moral/religious factors","Cross‑sectional; no causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0970-258x.295968"}},{"id":373,"doi":"10.3389/fpsyt.2021.727798","pmid":"34484009","pmcid":"PMC8416092","title":"Prevalence of Behavioral Addictions and Their Relationship With Stress and Anxiety Among Medical Students in Saudi Arabia: A Cross-Sectional Study","authors":"Hakami AY, Ahmad RG, Alsharif A, Ashqar A, AlHarbi FA, Sayes M, Bafail A, Alqrni A, Khan MA.","first_author":"Hakami AY","journal":"Frontiers in psychiatry","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Stress","Internet","Anxiety","Medical Students","Behavioral Addictions","Gaming","Addiction Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8416092","cited_by_count":8,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 225 medical students from five colleges in Saudi Arabia, using self‑report questionnaires.","sample_n":225,"sample_text":"Convenience sample of students from five medical colleges.","population":"Medical students (3rd‑5th year) in Western Saudi Arabia (N=225)","country":"Saudi Arabia","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","self_selected_sample"],"stance":"supports","citation_value":"useful","plain_summary":"A survey of 225 Saudi medical students found that about 46% screened positive for problematic internet use and a small minority (2%) for gaming disorder. Using a questionnaire, 2% were classified as having a pornography addiction, and higher stress levels were linked to more problematic porn use.","clinical_takeaway":"High stress may be associated with problematic porn use among students, but causality is unclear; assess stress and coping when addressing sexual behaviour concerns.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Use of several pre‑validated questionnaires","Relatively large sample for a student survey","Examines multiple behavioral addictions concurrently"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral incongruence or masturbation","Potential circularity in defining pornography addiction","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":1,"contrasting":1,"mentioning":13,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2021.727798"}},{"id":374,"doi":"10.1002/hsr2.341","pmid":"34386612","pmcid":"PMC8340575","title":"The effectiveness of intervention with cognitive behavioral therapy on pornography: A systematic review protocol of randomized clinical trial studies","authors":"Lotfi A, Babakhanin M, Ghazanfarpour M.","first_author":"Lotfi A","journal":"Health science reports","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Protocol","Cognitive Behavioral Therapy","Compulsive Sexual Behavior","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/hsr2.341","cited_by_count":3,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review protocol of randomized clinical trials (planned meta‑analysis)","sample_n":null,"sample_text":"No participants yet – protocol","population":"participants with problematic pornography use (PPU) in CBT trials","country":"unspecified (global search)","controls_mi":"not_applicable","preregistered":true,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This protocol outlines a planned systematic review that will gather randomised trials testing cognitive‑behavioural therapy for people who consider their pornography use problematic, and will assess effects on use severity, anxiety, depression and compulsive sexual behaviour.","clinical_takeaway":"None – the review has not yet been conducted, so no clinical conclusions can be drawn.","confidence":0.6,"topic_tags":["csbd"],"strengths":["Clear, pre‑registered protocol","Comprehensive database search planned","Will use established quality assessment checklist"],"limitations":["No data yet – cannot assess actual methods","Unclear how PPU will be defined and measured across trials"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/hsr2.341"}},{"id":376,"doi":"10.1007/s10943-020-01152-y","pmid":"33586057","pmcid":"PMC8137471","title":"The Relationship Between Sexual Compulsivity, Emotional and Spiritual Distress of Religious and Non-religious Internet Pornography Users","authors":"Hotchkiss JT.","first_author":"Hotchkiss JT.","journal":"Journal of religion and health","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Religion","Religiosity","Emotional Distress","Sexual Compulsivity","Internet Pornography","Spiritual Distress"],"is_oa":true,"oa_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/8137471","cited_by_count":4,"is_preprint":false,"topics":["csbd","pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"single cross‑sectional convenience sample of adults seeking assessment for pornography addiction (religious n=350, non‑religious n=114)","sample_n":464,"sample_text":"religious (n=350) and non‑religious (n=114) adults seeking assessment for pornography addiction","population":"adults (assessment seekers)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among adults who sought help for pornography use, more religious participants spent less time online but reported higher sexual compulsivity and greater emotional and spiritual distress than non‑religious participants.","clinical_takeaway":"Clinicians should consider both religious context and distress when assessing compulsive porn use; moral conflict may amplify shame.","confidence":0.7,"topic_tags":["pornography","sexual_function","religiosity"],"strengths":["large religious subsample","use of validated sexual compulsivity scale","comparative analysis of religious vs non‑religious groups"],"limitations":["convenience, treatment‑seeking sample limits generalisability","moral incongruence not directly measured","masturbation not isolated from pornography use","limited reporting of effect sizes and power"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[{"status":"Has correction","date":"2021-8-13","noticeDoi":"10.1007/s10943-021-01374-8","doi":"10.1007/s10943-020-01152-y"},{"status":"Has erratum","date":"2021-8-13","noticeDoi":"10.1007/s10943-021-01374-8","doi":"10.1007/s10943-020-01152-y"}],"url":"https://scite.ai/reports/10.1007/s10943-020-01152-y"}},{"id":377,"doi":"10.1007/s10508-021-02077-7","pmid":"34282505","pmcid":"PMC8288831","title":"Porndemic? A Longitudinal Study of Pornography Use Before and During the COVID-19 Pandemic in a Nationally Representative Sample of Americans","authors":"Grubbs JB, Perry SL, Grant Weinandy JT, Kraus SW.","first_author":"Grubbs JB","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Addiction","Sexual Media","Compulsive Sexual Behavior Disorder","Problematic Pornography Use","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8288831","cited_by_count":55,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Nationally representative panel surveyed at five time points (Aug 2019, Feb 2020, May 2020, Aug 2020, Oct 2020) totaling up to 2,518 participants at baseline; attrition to 1,269 at final wave.","sample_n":2518,"sample_text":"Baseline N=2518; follow‑up waves 1677, 1533, 1470, 1269.","population":"U.S. adult population (men and women)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A national U.S. panel surveyed before and during COVID‑19 found that porn use briefly rose in May 2020 but overall declined over the year, and reports of problematic use stayed low, suggesting pandemic fears were largely unfounded.","clinical_takeaway":"At the population level, COVID‑19 lockdowns did not create a surge in problematic porn use; clinicians should consider broader contextual factors rather than assume pandemic‑related risk.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd","prevalence","treatment"],"strengths":["Large, nationally representative baseline sample","Repeated measurements allow within‑person trend analysis","Addresses timely pandemic context"],"limitations":["Problematic use assessed by self‑report only, unclear if validated scale","Key confounds (moral incongruence, masturbation, mental health) not measured","Attrition reduces sample size over time"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":9,"contrasting":1,"mentioning":64,"citing_publications":97,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02077-7"}},{"id":378,"doi":"10.1016/j.addbeh.2021.106889","pmid":"33735776","pmcid":null,"title":"The association between type of trauma, level of exposure and addiction","authors":"Levin Y, Lev Bar-Or R, Forer R, Vaserman M, Kor A, Lev-Ran S.","first_author":"Levin Y","journal":"Addictive behaviors","year":2021,"pub_types":["Journal Article"],"keywords":["Trauma","Exposure","Interpersonal","Behavioral Addiction","Sud"],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online representative sample (N=4025), cross‑sectional survey","sample_n":4025,"sample_text":"representative online sample of 4025 respondents","population":"general adult population (online panel)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative survey of 4,025 adults, the authors found that both direct and indirect exposure to different types of trauma (e.g., sexual assault, combat) were linked to higher rates of substance use and behavioral addictions, including pornography addiction.","clinical_takeaway":"Trauma history, even indirect exposure, may increase risk for addictive behaviors; assess trauma when evaluating substance or pornography‑related problems.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative sample","Validated trauma checklist (LEC‑5)","Confidence intervals reported for prevalence estimates"],"limitations":["Cross‑sectional design limits causal inference","Addiction measures not described; likely reliance on screening scales","Key confounds for pornography addiction (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":4,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":31,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2021.106889"}},{"id":379,"doi":"10.1556/2006.2020.00075","pmid":"33216012","pmcid":"PMC8969735","title":"A pilot study of mindfulness-based relapse prevention for compulsive sexual behaviour disorder","authors":"Holas P, Draps M, Kowalewska E, Lewczuk K, Gola M.","first_author":"Holas P","journal":"Journal of behavioral addictions","year":2020,"pub_types":["brief-report","Journal Article"],"keywords":["Mindfulness","Mindfulness-based Relapse Prevention","Mbrp","Porn Addiction","Csbd"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8969735","cited_by_count":20,"is_preprint":false,"topics":["csbd","masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"pilot pre‑post uncontrolled study with 13 adult male CSBD patients","sample_n":13,"sample_text":"13 adult males with a diagnosis of CSBD","population":"adult males diagnosed with CSBD (N=13)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a tiny pilot, 13 men with compulsive sexual behaviour who took an eight‑week mindfulness program reported watching less porn and feeling less anxious and depressed afterwards, but the study lacked a control group and was very small.","clinical_takeaway":"Mindfulness may help reduce porn use and distress in CSBD, but evidence is preliminary; larger controlled trials are needed.","confidence":0.7,"topic_tags":["csbd","treatment","moral_incongruence"],"strengths":["focus on an understudied intervention for CSBD","includes both sexual behavior and emotional distress outcomes","transparent reporting of pilot nature and call for larger trials"],"limitations":["very small, single‑group sample","no control or randomisation","unclear validation of outcome measures","moral incongruence not assessed"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":32,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00075"}},{"id":382,"doi":"10.1016/j.bbr.2020.112792","pmid":"32598998","pmcid":null,"title":"Subjective reward value of visual sexual stimuli is coded in human striatum and orbitofrontal cortex","authors":"Klein S, Kruse O, Markert C, Tapia León I, Strahler J, Stark R.","first_author":"Klein S","journal":"Behavioural brain research","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["fMRI","Striatum","Reward Value","Ofc","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"72 male participants viewed sexual film clips during fMRI; subjective valence and arousal ratings collected; questionnaires on problematic pornography use completed; parametric fMRI analysis correlated neural activity with ratings and PPU scores.","sample_n":72,"sample_text":"72 men","population":"adult men, likely convenience sample","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 72 men, brain activity in reward areas increased when they viewed sexual clips they liked more. People who reported more symptoms of problematic pornography use showed stronger links between liking and brain response, suggesting a possible neural pathway for developing compulsive use.","clinical_takeaway":"Higher neural sensitivity to preferred sexual material may relate to problematic porn use, but evidence is correlational and not diagnostic.","confidence":0.78,"topic_tags":["neuroscience","sexual_function","pornography","csbd"],"strengths":["Adequate fMRI sample size for basic whole‑brain analysis","Parametric modulation links subjective ratings to neural activity","Explores neural correlates of individual preference"],"limitations":["Cross‑sectional, cannot infer causality","Problematic use measured with likely screening questionnaire, not full diagnostic criteria","No measurement of key confounds (moral incongruence, masturbation, mental health, partner factors)","Male‑only convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":33,"max_possible":70,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":7,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":23,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.bbr.2020.112792"}},{"id":383,"doi":"10.1016/j.addbeh.2017.02.001","pmid":"28214738","pmcid":null,"title":"Problematic internet pornography use: The role of craving, desire thinking, and metacognition","authors":"Allen A, Kannis-Dymand L, Katsikitis M.","first_author":"Allen A","journal":"Addictive behaviors","year":2017,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Craving","Addictive Behaviours","Desire Thinking","Metacognitions","Metacognitive Theory","Internet Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":72,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 191 self‑selected participants screened for problematic pornography use; path analysis of craving, desire thinking and metacognition.","sample_n":191,"sample_text":"N=191 (online convenience sample; screened for problematic use)","population":"adults (mixed gender) recruited via internet; not a probability sample","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 191 adults who reported trouble with online porn, examining how thoughts about desire and metacognition relate to cravings and negative mood. Results suggest these mental processes may amplify craving and affect, pointing to possible therapy targets.","clinical_takeaway":"Metacognitive and desire‑thinking patterns appear linked to problematic porn use, but causal claims are premature; clinicians should assess broader factors and confounds.","confidence":0.78,"topic_tags":["pornography","csbd","moral_incongruence","sexual_function"],"strengths":["Reasonably large sample for a questionnaire study","Uses path analysis to test a theoretically motivated model","Incorporates negative affect into the metacognitive framework"],"limitations":["Cross‑sectional design; cannot infer causality","No control for key confounds (moral incongruence, masturbation, mental health, relationship status, trauma)","Problematic use measured by self‑label; potential circularity with distress","No pre‑registration or correction for multiple testing reported"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":11,"contrasting":0,"mentioning":78,"citing_publications":144,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2017.02.001"}},{"id":385,"doi":null,"pmid":"29896074","pmcid":"PMC5969781","title":"Does the addiction in online pornography affect the behavioral pattern of undergrad private university students in Bangladesh?","authors":"Chowdhury MRHK, Chowdhury MRK, Kabir R, Perera NKP, Kader M.","first_author":"Chowdhury MRHK","journal":"International journal of health sciences","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Behavior","Bangladesh","university students","Online Addiction","Porn"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5969781","cited_by_count":7,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 299 undergraduates at a private university in Bangladesh; structured questionnaire; chi‑square and logistic regression","sample_n":299,"sample_text":"299 undergraduate students (70.6% male) at the First Capital University of Bangladesh","population":"undergraduate students (private university, Bangladesh)","country":"Bangladesh","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"supports","citation_value":"background","plain_summary":"A survey of 299 Bangladeshi university students found that those who stayed up late, argued with friends, or spent time with friends were more likely to report watching online pornography. The authors suggest this may harm academic performance and call for education and treatment programmes.","clinical_takeaway":"No direct clinical guidance; the study’s causal claims are unsupported.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Reasonable sample size for a survey","Clear statistical analysis (chi‑square, logistic regression)","Focus on understudied population (Bangladesh students)"],"limitations":["No validated measures of pornography addiction or behaviour","Cross‑sectional design, cannot infer causality","Key confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":22,"max_possible":60,"pct_score":37,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":null},{"id":386,"doi":"10.1016/j.addbeh.2019.106077","pmid":"31437770","pmcid":"PMC6903386","title":"The role of flavors in vaping initiation and satisfaction among U.S. adults","authors":"Landry RL, Groom AL, Vu TT, Stokes AC, Berry KM, Kesh A, Hart JL, Walker KL, Giachello AL, Sears CG, McGlasson KL, Tompkins LK, Mattingly DT, Robertson RM, Payne TJ.","first_author":"Landry RL","journal":"Addictive behaviors","year":2019,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Adults","Addiction","Flavoring Agents","Electronic Nicotine Delivery Systems","Special Populations"],"is_oa":false,"oa_url":null,"cited_by_count":113,"is_preprint":false,"topics":["ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online quantitative survey of 1492 adult e‑cigarette users (self‑selected), logistic regression and GLM analyses","sample_n":1492,"sample_text":"Current e‑cigarette users recruited via an online panel in 2016","population":"U.S. adults who currently use e‑cigarettes (age ≥ 18)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a U.S. survey of 1,492 adult e‑cigarette users, flavors (especially fruit and mint) were linked to higher likelihood of starting vaping, greater satisfaction, and stronger self‑reported “addiction” to vaping.","clinical_takeaway":"Flavored e‑cigarettes are associated with higher satisfaction and perceived dependence; clinicians should ask about flavor use when assessing vaping behavior.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample for a survey","Focused analysis of flavor types","Uses multivariable models"],"limitations":["Cross‑sectional; cannot infer causality","Self‑report measures of ‘addiction’ lack validation","No control for mental‑health or other confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":6,"contrasting":1,"mentioning":91,"citing_publications":144,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2019.106077"}},{"id":387,"doi":"10.2147/ndt.s221540","pmid":"32943868","pmcid":"PMC7478918","title":"Spotlight on Compulsive Sexual Behavior Disorder: A Systematic Review of Research on Women","authors":"Kowalewska E, Gola M, Kraus SW, Lew-Starowicz M.","first_author":"Kowalewska E","journal":"Neuropsychiatric disease and treatment","year":2020,"pub_types":["review-article","Review","Journal Article"],"keywords":["Women","Compulsive Sexual Behavior","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7478918","cited_by_count":49,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 58 studies on CSBD in women, following PRISMA guidelines.","sample_n":null,"sample_text":"58 included studies; total participants not specified in abstract","population":"Women (studies varied; mostly non‑clinical samples)","country":"Various (multi‑database search)","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review summarises research on compulsive sexual behaviour disorder (CSBD) in women, noting that women report fewer urges and lower pornography use than men, and that CSBD links to traits like impulsivity and a history of trauma.","clinical_takeaway":"Evidence on CSBD in women is limited; clinicians should assess broader psychosocial factors rather than rely on prevalence figures.","confidence":0.7,"topic_tags":["csbd","pornography","gender","prevalence","treatment"],"strengths":["PRISMA‑guided systematic search","Focus on under‑studied female population","Broad coverage of comorbidities and etiological factors"],"limitations":["Reliance on heterogeneous, mostly non‑clinical primary studies","Limited assessment of key confounds (e.g., moral incongruence, masturbation)","No quantitative meta‑analysis or effect‑size synthesis"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":0,"mentioning":64,"citing_publications":92,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/ndt.s221540"}},{"id":389,"doi":"10.3390/jcm8010091","pmid":"30650522","pmcid":"PMC6352245","title":"Online Porn Addiction: What We Know and What We Don't-A Systematic Review","authors":"de Alarcón R, de la Iglesia JI, Casado NM, Montejo AL.","first_author":"de Alarcón R","journal":"Journal of clinical medicine","year":2019,"pub_types":["review-article","Review","Journal Article"],"keywords":["Internet","Addiction","Compulsive Sexual Behavior","Hypersexuality","Cybersex","Online Pornography"],"is_oa":true,"oa_url":"https://www.mdpi.com/2077-0383/8/1/91/pdf?version=1547527591","cited_by_count":106,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of existing literature on online pornography use as a pathological entity; no new empirical data","sample_n":null,"sample_text":"Not applicable – review of published studies","population":"studies included across diverse samples; not specified","country":"Not applicable","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The review summarises what is known about ‘online porn addiction’, pointing out that research suffers from sample bias, unclear definitions and lack of consensus on diagnostic tools. It calls for better‑designed studies to determine when porn use becomes problematic.","clinical_takeaway":"Clinicians should be cautious interpreting ‘porn addiction’ labels; current evidence does not yet provide clear diagnostic criteria.","confidence":0.8,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Comprehensive overview of the field up to 2019","Identifies key methodological gaps","Highlights need for diagnostic instruments"],"limitations":["No quantitative meta‑analysis presented","Unclear whether systematic search was pre‑registered","Does not assess confounding factors such as moral incongruence or mental health"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":8,"contrasting":2,"mentioning":166,"citing_publications":262,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jcm8010091"}},{"id":390,"doi":"10.1037/adb0000603","pmid":"32730047","pmcid":null,"title":"Why do people watch pornography? The motivational basis of pornography use","authors":"Bőthe B, Tóth-Király I, Bella N, Potenza MN, Demetrovics Z, Orosz G.","first_author":"Bőthe B","journal":"Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":89,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large online convenience samples (N≈770‑1080) used to develop and validate a Pornography Use Motivations Scale (PUMS) via CFA, measurement invariance, and SEM; associations with frequency of use and self‑reported problematic pornography use examined.","sample_n":2666,"sample_text":"Three separate community samples (N₁=772, N₂=792, N₃=1,082)","population":"General adult Internet users (mixed gender, broad age range)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a questionnaire that measures why people watch porn, identifying motives such as pleasure, boredom relief, stress reduction, and curiosity. The scale works well across genders and links certain motives to more frequent or problematic porn use.","clinical_takeaway":"Motivations like stress relief and boredom relate to higher porn use and perceived problems; clinicians should explore underlying reasons when addressing concerns.","confidence":0.8,"topic_tags":["pornography","sexual_function","measurement"],"strengths":["Large sample sizes across three independent cohorts","Comprehensive psychometric validation (CFA, invariance)","Explores a wide range of motivational constructs"],"limitations":["Cross‑sectional design precludes causal inference","Problematic use measured with self‑label scale, possible circularity","No assessment of key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":4,"interpretation":7}},"scite":{"supporting":10,"contrasting":3,"mentioning":118,"citing_publications":197,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/adb0000603"}},{"id":391,"doi":"10.1556/2006.2020.00038","pmid":"32644937","pmcid":"PMC8939429","title":"Validation of a Brief Pornography Screen across multiple samples","authors":"Kraus SW, Gola M, Grubbs JB, Kowalewska E, Hoff RA, Lew-Starowicz M, Martino S, Shirk SD, Potenza MN.","first_author":"Kraus SW","journal":"Journal of behavioral addictions","year":2020,"pub_types":["research-article","Validation Study","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8939429","cited_by_count":70,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study across five independent samples (U.S. veterans, two nationally representative U.S. samples, Polish adults, treatment‑seeking CSBD patients); factor analysis, reliability, ROC analysis","sample_n":3241,"sample_text":"Combined N≈3,200 across five samples (largest N=1,466)","population":"adults (U.S. and Poland), including veterans and treatment‑seeking males","country":"USA, Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created a short five‑item questionnaire to detect problematic pornography use and tested it in five large U.S. and Polish samples. Analyses showed the tool is reliable and can distinguish likely cases, with a suggested cut‑off of four or more items.","clinical_takeaway":"The Brief Pornography Screen offers a quick, validated way to flag possible problematic pornography use in clinical or research settings.","confidence":0.78,"topic_tags":["pornography","measurement","sexual_function","csbd"],"strengths":["Large, diverse samples including nationally representative data","Comprehensive psychometric evaluation (factor analysis, reliability, validity, ROC)","Cross‑cultural validation (U.S. and Poland)"],"limitations":["No assessment of key confounds (moral incongruence, masturbation, mental health)","Screen may embed distress items, risking circularity","No pre‑registration reported"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":86,"citing_publications":116,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00038"}},{"id":392,"doi":"10.3389/fpsyg.2021.673023","pmid":"34290650","pmcid":"PMC8288192","title":"The Impact of Negative Mood on Event-Related Potentials When Viewing Pornographic Pictures","authors":"Markert C, Baranowski AM, Koch S, Stark R, Strahler J.","first_author":"Markert C","journal":"Frontiers in psychology","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Event-related potentials","Negative Affect","Motivated Attention","Pornography Addiction","Pornography Use","Sexual Cue Reactivity"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyg.2021.673023/pdf","cited_by_count":4,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory experiment with affect induction (negative vs neutral feedback) and ERP recording while viewing pornographic vs neutral pictures; n=64 healthy men (32 per condition).","sample_n":64,"sample_text":"Sixty‑four healthy men, randomly assigned to negative (n=32) or neutral (n=32) affect condition.","population":"healthy adult men (no clinical sample)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers recorded brain responses (ERPs) while men viewed porn pictures after feeling either negative or neutral emotions. Negative mood didn’t change overall brain reactions, but men with higher solitary sexual motivation showed stronger attention‑related signals when in a negative mood.","clinical_takeaway":"Mood may amplify attention to sexual cues in men with high solitary sexual drive, but no clear evidence of addiction‑related brain changes.","confidence":0.8,"topic_tags":["pornography","sexual_function","neuroscience"],"strengths":["Randomised affect manipulation","Objective ERP measures","Consideration of individual differences (solitary sexual motivation)"],"limitations":["No measurement of moral incongruence or masturbation","Adapted cybersex addiction scale may lack validation","Sample limited to healthy men, small per‑group size"],"rubric_version":"2.0","raw_total":39,"max_possible":70,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":6,"statistics":5,"confounds":3,"design":8,"addiction_criteria":4,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2021.673023"}},{"id":395,"doi":"10.31887/dcns.2017.19.3/mpotenza","pmid":"29302225","pmcid":"PMC5741111","title":"Clinical neuropsychiatric considerations regarding nonsubstance or behavioral addictions","authors":"Potenza MN.","first_author":"Potenza MN.","journal":"Dialogues in clinical neuroscience","year":2017,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Review","Journal Article"],"keywords":["Dsm","Icd-11","Non-substance Addiction","Anxiety Behavioral Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5741111","cited_by_count":35,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"review article without new empirical data","sample_n":null,"sample_text":"none – narrative review of existing literature","population":"none (review)","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how non‑substance behaviors such as gambling, gaming, and compulsive sexual activity, including problematic pornography use, are considered for inclusion as behavioral addictions in DSM‑5 and ICD‑11.","clinical_takeaway":"None – the paper is a theoretical review rather than a source of clinical evidence.","confidence":0.6,"topic_tags":["sexual_function","csbd","pornography","moral_incongruence","gender"],"strengths":["Broad overview of behavioral addictions","Integrates DSM‑5 and ICD‑11 perspectives","Authored by a leading expert"],"limitations":["No original data, thus no methodological assessment possible","Potential bias from author’s theoretical stance","Limited critical appraisal of primary studies"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31887/dcns.2017.19.3/mpotenza"}},{"id":397,"doi":"10.1007/s10508-018-1293-5","pmid":"30120612","pmcid":null,"title":"Theoretical Assumptions on Pornography Problems Due to Moral Incongruence and Mechanisms of Addictive or Compulsive Use of Pornography: Are the Two \"Conditions\" as Theoretically Distinct as Suggested?","authors":"Brand M, Antons S, Wegmann E, Potenza MN.","first_author":"Brand M","journal":"Archives of sexual behavior","year":2019,"pub_types":["Comment","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":6,"contrasting":0,"mentioning":27,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1293-5"}},{"id":398,"doi":"10.1080/00224499.2014.980496","pmid":"25621631","pmcid":null,"title":"Problematic Online Pornography Use: A Media Attendance Perspective","authors":"Sirianni JM, Vishwanath A.","first_author":"Sirianni JM","journal":"Journal of sex research","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey-based cross‑sectional study using a media‑attendance framework; no experimental or longitudinal component","sample_n":null,"sample_text":"not described in abstract","population":"likely young adult Internet users (exact sampling not specified)","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors applied a media‑attendance lens, suggesting that people with poorer self‑control may habitually view online porn to meet social needs, which could lead to life problems. The study is based on self‑reported survey data and does not separate porn watching from masturbation or account for moral or mental‑health factors.","clinical_takeaway":"Do not assume porn use causes problems; consider self‑regulation and broader psychosocial context.","confidence":0.4,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["introduces a novel media‑attendance conceptual framework","integrates self‑regulation theory with pornography use"],"limitations":["relies on self‑report measures with unclear validation","cross‑sectional design cannot infer causality","fails to control key confounds (moral incongruence, masturbation, mental health, relationship factors)","uses circular definition of ‘addiction’ based on distress"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2014.980496"}},{"id":399,"doi":"10.1016/j.comppsych.2019.07.002","pmid":"31349137","pmcid":null,"title":"The contribution of ADHD and attachment difficulties to online pornography use among students","authors":"Niazof D, Weizman A, Weinstein A.","first_author":"Niazof D","journal":"Comprehensive psychiatry","year":2019,"pub_types":["Journal Article"],"keywords":["Attachment","ADHD","Compulsive Sexual Behavior","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online convenience sample of 85 university students recruited via social media; self‑report questionnaires administered once.","sample_n":85,"sample_text":"85 participants (38 men, 47 women) recruited online via social network sites.","population":"Students, mean age 25, 44.7% male, 55.3% female; 35% self‑reported ADHD.","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 85 university students, those who reported ADHD and anxious attachment tended to use online pornography more often. The study suggests a link between ADHD, attachment problems, and higher porn use, but it cannot prove one causes the other.","clinical_takeaway":"Screen for ADHD and attachment issues when addressing high pornography use, but note the evidence is correlational only.","confidence":0.78,"topic_tags":["pornography","adolescents","csbd"],"strengths":["Uses validated CPUI and ECR scales","Examines multiple psychosocial predictors","Clear statistical model (multivariate regression)"],"limitations":["Cross‑sectional design, cannot infer causality","Self‑reported ADHD diagnosis, no clinical verification","No measurement of moral incongruence, masturbation, or mental‑health covariates","Small, non‑representative student sample"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":8,"contrasting":1,"mentioning":33,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2019.07.002"}},{"id":400,"doi":"10.1007/s10508-016-0772-9","pmid":"27351579","pmcid":null,"title":"Internet Pornography Use, Perceived Addiction, and Religious/Spiritual Struggles","authors":"Grubbs JB, Exline JJ, Pargament KI, Volk F, Lindberg MJ.","first_author":"Grubbs JB","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Addiction","Religion","Spirituality","Hypersexual Behavior","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"cross‑sectional and 1‑year longitudinal surveys of undergraduates (N=1519) and adult Internet users (N=713); subsets followed up (N≈156, 366).","sample_n":1519,"sample_text":"N = 1519 (undergrads) and N = 713 (adults); longitudinal subsets N ≈ 156 and 366","population":"undergraduate students and adult US Internet users (convenience samples)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["circular_addiction_scale","no_mi_control","self_selected_sample","underpowered_sample"],"stance":"supports","citation_value":"useful","plain_summary":"In surveys of students and adult internet users, people who felt they were addicted to online pornography reported more religious and spiritual struggles over the following year, while the amount of pornography they actually used did not predict these struggles.","clinical_takeaway":"Self‑perceived pornography addiction is linked to greater religious distress; clinicians should assess moral and spiritual concerns separately from use frequency.","confidence":0.7,"topic_tags":["pornography","religiosity","sexual_function","moral_incongruence"],"strengths":["Large initial sample sizes","Combination of cross‑sectional and longitudinal data","Focus on religious/spiritual outcomes, an under‑studied domain"],"limitations":["Perceived‑addiction measured with likely unvalidated, self‑label scale","Key confounds (moral incongruence, masturbation, mental health) not measured","Convenience samples limit generalisability","No pre‑registration or detailed effect‑size reporting"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":62,"citing_publications":132,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0772-9"}},{"id":401,"doi":"10.3402/snp.v3i0.20767","pmid":"24693354","pmcid":"PMC3960020","title":"Pornography addiction - a supranormal stimulus considered in the context of neuroplasticity","authors":"Hilton DL.","first_author":"Hilton DL.","journal":"Socioaffective neuroscience & psychology","year":2013,"pub_types":["research-article","Journal Article"],"keywords":["Brain","Sexuality","Neuroplasticity","Addiction","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3960020","cited_by_count":31,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"research-article (commentary)","sample_n":null,"sample_text":"No empirical sample reported; article is a theoretical commentary.","population":"none","country":"unknown","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article argues that compulsive pornography use should be considered an addiction, drawing on ideas about brain reward pathways and the concept of a 'supranormal stimulus', but provides no original data.","clinical_takeaway":"None – the paper offers theoretical opinion, not evidence for clinical practice.","confidence":0.4,"topic_tags":["pornography","neuroscience","sexual_function"],"strengths":["Integrates neuroscience concepts","References existing addiction literature"],"limitations":["No empirical data presented","Lacks measurement of key confounds","Claims not supported by original evidence"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":2,"contrasting":0,"mentioning":44,"citing_publications":93,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3402/snp.v3i0.20767"}},{"id":403,"doi":"10.1007/s10508-017-1127-x","pmid":"29453643","pmcid":null,"title":"The Effects of Mindfulness on Sexual Outcomes: The Role of Emotion Regulation","authors":"Pepping CA, Cronin TJ, Lyons A, Caldwell JG.","first_author":"Pepping CA","journal":"Archives of sexual behavior","year":2018,"pub_types":["Journal Article"],"keywords":["Sex","Emotion Regulation","Mindfulness","Sexual Satisfaction","Pornography","Sexual System Functioning"],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of two large adult samples (N≈400 each), measuring dispositional mindfulness, emotion‑regulation capacity and several sexual outcome variables including problematic pornography use.","sample_n":807,"sample_text":"N = 407 partnered; N = 400 single.","population":"Adults (partnered and long‑term single) recruited via unspecified means; likely convenience/online sample.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"People who are more mindful tend to report higher sexual satisfaction and less problematic porn use, and this link appears to be explained by better emotion‑regulation skills, regardless of whether they are in a relationship or single.","clinical_takeaway":"Mindfulness and emotion‑regulation skills may support healthier sexual experiences, but the findings are correlational and do not prove causation.","confidence":0.78,"topic_tags":["pornography","sexual_function","masturbation","csbd"],"strengths":["Large sample sizes for both groups","Examines both partnered and single adults","Tests mediation by emotion regulation"],"limitations":["Cross‑sectional; no causal inference","Unclear measurement validity for pornography and sexual outcome scales","No control for moral incongruence, masturbation, mental health, or trauma"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":40,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-1127-x"}},{"id":405,"doi":"10.1177/20503121231152763","pmid":"36860685","pmcid":"PMC9969478","title":"Internet addiction during the COVID-19 pandemic among adolescents in southeast Nigeria and implications for adolescent care in the post-pandemic era: A cross-sectional study","authors":"Onukwuli VO, Onyinye EN, Udigwe IB, Umeh UM, Enebe JT, Umerah AT.","first_author":"Onukwuli VO","journal":"SAGE open medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Internet Addiction","Southeast Nigeria","Covid-19 Pandemic"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9969478","cited_by_count":9,"is_preprint":false,"topics":["ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of adolescents in randomly selected schools in SE Nigeria (July‑Aug 2021).","sample_n":null,"sample_text":"Not reported in abstract; likely several hundred participants.","population":"Adolescents (mean age 16.2) from 10 secondary schools in four states, Nigeria.","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"Among 16‑year‑old Nigerian teens surveyed during COVID‑19, 88 % were classified as having internet addiction using a standard questionnaire; males, younger adolescents and those using the internet longer were more likely to be addicted.","clinical_takeaway":"High reported rates of internet addiction in teens suggest clinicians should screen for problematic use, especially in male and younger adolescents.","confidence":0.6,"topic_tags":["adolescents","csbd","sexual_function"],"strengths":["Use of validated IAT instrument","Random selection of schools across multiple states","Multivariate analysis (AOR) reported"],"limitations":["Cross‑sectional design; cannot infer causality","No assessment of mental‑health or moral factors that may influence reporting","Reliance on self‑report; possible social desirability bias"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/20503121231152763"}},{"id":407,"doi":"10.1080/00224499.2017.1423017","pmid":"29377724","pmcid":null,"title":"Only Bad for Believers? Religion, Pornography Use, and Sexual Satisfaction Among American Men","authors":"Perry SL, Whitehead AL.","first_author":"Perry SL","journal":"Journal of sex research","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national random sample of American adults (N=1501), cross‑sectional survey","sample_n":1501,"sample_text":"national random sample of American adults","population":"American adult men and women (analysis focused on men)","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a US‑wide survey of 1,501 adults, men who used pornography reported lower sexual satisfaction, but this link was strongest among those who were highly religious. For men with low religious involvement, porn use showed little impact on satisfaction, suggesting that personal morals shape the experience.","clinical_takeaway":"Consider patients' religious and moral beliefs when discussing pornography's impact on sexual wellbeing; distress may stem more from moral conflict than the behavior itself.","confidence":0.85,"topic_tags":["pornography","religiosity","sexual_function","moral_incongruence"],"strengths":["Large, nationally representative sample","Focus on moral incongruence as moderator","Clear statistical interaction reported"],"limitations":["Cross‑sectional design cannot establish causality","Masturbation not measured, potentially conflating porn effects","Reliance on self‑report measures, unclear validation"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":31,"citing_publications":104,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1423017"}},{"id":408,"doi":"10.1016/j.jsxm.2016.02.169","pmid":"27012817","pmcid":null,"title":"What Matters: Quantity or Quality of Pornography Use? Psychological and Behavioral Factors of Seeking Treatment for Problematic Pornography Use","authors":"Gola M, Lewczuk K, Skorko M.","first_author":"Gola M","journal":"The journal of sexual medicine","year":2016,"pub_types":["Journal Article"],"keywords":["Hypersexual Behavior","psychotherapy","Treatment Seeking","Pornography","Problematic Sexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":85,"is_preprint":false,"topics":["pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 569 heterosexual Caucasian men, 132 treatment‑seeking referrals, self‑report measures; cross‑sectional convenience sample","sample_n":569,"sample_text":"569 men (132 treatment‑seekers) recruited via psychotherapists and unspecified community sources","population":"adult heterosexual men, mixed treatment‑seeking and non‑seeking","country":"Poland (inferred from author affiliations)","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 569 heterosexual men, the authors found that feeling distressed about pornography use predicts seeking treatment more than how often men watch porn. Religious views also played a modest role. Frequency alone explained only a tiny part of why people seek help.","clinical_takeaway":"Clinicians should assess the personal distress and negative impacts of porn use, not just how often a client watches it.","confidence":0.7,"topic_tags":["pornography","treatment","sexual_function","moral_incongruence"],"strengths":["large sample size for a survey","includes actual treatment‑seeking group","uses mediation modelling with fit indices"],"limitations":["cross‑sectional, cannot infer causality","limited measurement validation for negative symptoms","limited control of key confounds (masturbation, mental health, trauma)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":17,"contrasting":1,"mentioning":122,"citing_publications":167,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2016.02.169"}},{"id":409,"doi":"10.4103/0253-7176.198939","pmid":"28250554","pmcid":"PMC5329986","title":"Technology Addiction among Treatment Seekers for Psychological Problems: Implication for Screening in Mental Health Setting","authors":"Das A, Sharma MK, Thamilselvan P, Marimuthu P.","first_author":"Das A","journal":"Indian journal of psychological medicine","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["information technology","Mental health","Addiction"],"is_oa":true,"oa_url":"https://doi.org/10.4103/0253-7176.198939","cited_by_count":8,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 75 psychiatric treatment‑seekers assessed with background sheet and several self‑report screening tools","sample_n":75,"sample_text":"75 subjects from a tertiary mental health setting","population":"treatment‑seeking adults with psychiatric disorders (in‑patient and out‑patient)","country":"India","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","self_selected_sample","underpowered_sample"],"stance":"supports","citation_value":"useful","plain_summary":"In a survey of 75 psychiatric patients, the authors found that many screened positive for excessive use of the internet, video games, mobile phones and pornography, and that higher use was linked to mood‑management and delayed sleep.","clinical_takeaway":"Screen for problematic technology use, including pornography, in mental‑health settings, but note that current tools may over‑label normal behaviour as addiction.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Includes several technology‑use screening tools","Reports associations with mood regulation and sleep"],"limitations":["Convenience sample of treatment‑seekers limits generalisability","No validated measure of pornography‑related problems; possible circularity","Key confounds (moral incongruence, masturbation, mental health) not assessed","Statistical reporting lacks effect sizes and correction for multiple testing"],"rubric_version":"2.0","raw_total":18,"max_possible":60,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":0,"contrasting":1,"mentioning":8,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0253-7176.198939"}},{"id":412,"doi":"10.4103/2152-7806.76977","pmid":"21427788","pmcid":"PMC3050060","title":"Pornography addiction: A neuroscience perspective","authors":"Hilton DL, Watts C.","first_author":"Hilton DL","journal":"Surgical neurology international","year":2011,"pub_types":["editorial","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3050060","cited_by_count":23,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/2152-7806.76977"}},{"id":413,"doi":"10.1016/j.jsxm.2019.05.006","pmid":"31204265","pmcid":null,"title":"Which Dimensions of Human Sexuality Are Related to Compulsive Sexual Behavior Disorder (CSBD)? Study Using a Multidimensional Sexuality Questionnaire on a Sample of Polish Males","authors":"Kowalewska E, Kraus SW, Lew-Starowicz M, Gustavsson K, Gola M.","first_author":"Kowalewska E","journal":"The journal of sexual medicine","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Human Sexuality","Sexual Satisfaction","Compulsive Sexual Behavior Disorder","Multidimensional Sexuality Questionnaire","Psychological Tendencies"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional comparison of 72 treatment‑seeking Polish men with CSBD and 208 men from the general population, using self‑report questionnaires.","sample_n":280,"sample_text":"72 CSBD patients, 208 general population men","population":"Polish adult males (treatment‑seeking CSBD patients vs community sample)","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared 72 Polish men seeking help for compulsive sexual behavior disorder with 208 men from the general population. Men with CSBD reported more sexual anxiety, depression, and fear of relationships, and lower sexual esteem, control, consciousness, assertiveness and satisfaction.","clinical_takeaway":"Clinicians should assess a broad range of sexual self‑concept and anxiety dimensions when working with men presenting CSBD symptoms.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Use of validated multidimensional sexuality questionnaire","Comparison with a sizable community sample","Focus on ICD‑11 defined CSBD"],"limitations":["Treatment‑seeking sample limits generalisability","No control for moral incongruence, masturbation, mental health, or relationship factors","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":6,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.05.006"}},{"id":415,"doi":"10.1037/adb0000114","pmid":"26372200","pmcid":null,"title":"Perceived addiction to Internet pornography and psychological distress: Examining relationships concurrently and over time","authors":"Grubbs JB, Stauner N, Exline JJ, Pargament KI, Lindberg MJ.","first_author":"Grubbs JB","journal":"Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":78,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"cross-sectional survey (N=713, N=1215) plus 1‑year follow‑up (N=106)","sample_n":106,"sample_text":"N = 713, 1,215 cross‑sectional; longitudinal subset N = 106","population":"U.S. adults and undergraduates","country":"United States","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["circular_addiction_scale","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"People who think they are addicted to internet pornography report higher psychological distress, even when the amount of pornography they use isn’t related to distress.","clinical_takeaway":"Clinicians should consider clients’ self‑perceived addiction and related distress, not just usage frequency.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large cross‑sectional samples","Longitudinal follow‑up for a subset","Controlled for personality (neuroticism) and social desirability"],"limitations":["Perceived addiction measured by single self‑label, circular definition","No assessment of moral incongruence or masturbation","Limited longitudinal sample size"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":13,"contrasting":0,"mentioning":116,"citing_publications":208,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/adb0000114"}},{"id":416,"doi":"10.1089/cyber.2016.0364","pmid":"27831753","pmcid":null,"title":"Cyberpornography: Time Use, Perceived Addiction, Sexual Functioning, and Sexual Satisfaction","authors":"Blais-Lecours S, Vaillancourt-Morel MP, Sabourin S, Godbout N.","first_author":"Blais-Lecours S","journal":"Cyberpsychology, behavior and social networking","year":2016,"pub_types":["Journal Article"],"keywords":["Gender","Addiction","Sexual Satisfaction","Sexual Functioning","Cyberpornography"],"is_oa":false,"oa_url":null,"cited_by_count":50,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online self‑report questionnaires, N=832 community adults, single‑time point","sample_n":832,"sample_text":"community sample, recruited online","population":"adults from the community (both genders)","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","causal_from_correlational","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 832 adults, more time spent viewing online porn was linked to lower sexual satisfaction, and this relationship was explained by higher feelings of being addicted to porn and more sexual‑function problems. The pattern was similar for men and women.","clinical_takeaway":"Higher porn use is associated with lower sexual satisfaction, but causality is unclear; clinicians should consider multiple factors before attributing dissatisfaction to porn use alone.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["large community sample (N>800)","sex‑balanced analysis of gender invariance","use of mediational path model to explore indirect effects"],"limitations":["cross‑sectional design limits causal inference","addiction construct defined by distress (circular)","key confounds (moral incongruence, masturbation, mental health) not measured"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":3,"contrasting":2,"mentioning":51,"citing_publications":110,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2016.0364"}},{"id":417,"doi":"10.1080/0092623x.2013.842192","pmid":"24341869","pmcid":null,"title":"Internet pornography use: perceived addiction, psychological distress, and the validation of a brief measure","authors":"Grubbs JB, Volk F, Exline JJ, Pargament KI.","first_author":"Grubbs JB","journal":"Journal of sex & marital therapy","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":97,"is_preprint":false,"topics":["csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study with three convenience samples (undergraduates, web‑based adults, counseling‑seeking students)","sample_n":null,"sample_text":"multiple convenience samples; size not reported in abstract","population":"young adult students and internet users, convenience samples","country":"USA (likely, based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control"],"stance":"supports","citation_value":"useful","plain_summary":"Researchers created a short 9‑item questionnaire asking people if they feel addicted to internet pornography. The scale showed good statistical properties, but its definition of \"addiction\" is based on self‑labeling and is strongly linked to overall psychological distress, without accounting for moral attitudes or separate masturbation behavior.","clinical_takeaway":"The brief self‑report tool identifies perceived porn‑related distress, yet its addiction label may reflect general distress rather than a specific disorder.","confidence":0.7,"topic_tags":["pornography","sexual_function","measurement"],"strengths":["Multi‑sample validation","Psychometric analyses reported","Controls for several behavioral covariates"],"limitations":["Self‑label addiction scale is circular","Moral incongruence and masturbation not measured","Convenience, student‑dominant samples limit generalisability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":17,"contrasting":0,"mentioning":185,"citing_publications":257,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2013.842192"}},{"id":420,"doi":"10.5498/wjp.v9.i3.55","pmid":"31211113","pmcid":"PMC6560498","title":"Problematic Internet use in drug addicts under treatment in public rehab centers","authors":"Baroni S, Marazziti D, Mucci F, Diadema E, Dell'Osso L.","first_author":"Baroni S","journal":"World journal of psychiatry","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Drug abuse","Behavioral Addictions","Problematic Internet Use","Rehab Centers"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6560498","cited_by_count":12,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 183 drug‑addiction patients in Italian public rehab centres; all participants heavy smokers, various substance‑use profiles; internet use measured with a study‑specific questionnaire (QUNT).","sample_n":183,"sample_text":"183 patients (heavy smokers; 50% heroin/opioid, 30% alcohol, 10% cannabis, 8% cocaine, 5% polydrug).","population":"Adults in treatment for substance‑use disorder (Italy).","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2019 Italian survey of 183 drug‑addiction patients found that those using stimulants (cocaine, cannabis) spent more time online and scored higher on a questionnaire’s “pornography addiction” factor than those on sedatives. Relationship status appeared protective. The study relied on a self‑made questionnaire and did not control for moral or mental‑health factors.","clinical_takeaway":"Evidence that stimulant‑using patients may be at higher risk for problematic internet and porn use, but findings are limited by design and measurement issues.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large overall sample of patients in treatment.","Includes multiple substance‑use sub‑groups.","Reports novel links between stimulant use and PIU factors."],"limitations":["Uses an unvalidated, ad‑hoc questionnaire (QUNT).","Cross‑sectional design; no temporal direction.","Key confounds (moral incongruence, masturbation, mental health) not measured.","Small subsample for cocaine users (n≈17) limits subgroup analyses."],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":2,"contrasting":1,"mentioning":23,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5498/wjp.v9.i3.55"}},{"id":421,"doi":"10.4103/0019-557x.128168","pmid":"24748358","pmcid":null,"title":"A study on smoking and associated psychosocial factors among adolescent students in Kolkata, India","authors":"Bagchi NN, Ganguly S, Pal S, Chatterjee S.","first_author":"Bagchi NN","journal":"Indian journal of public health","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional observational study of 526 high‑school students in Kolkata examining smoking prevalence and associated psychosocial factors, including a self‑reported link to pornography addiction.","sample_n":526,"sample_text":"526 students (approx. 156 smokers, 370 non‑smokers)","population":"adolescent students (15‑19 y) in six co‑educational high schools, Kolkata, India","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 526 Indian high‑school students found that about 30 % smoked; smoking was more common among boys, early initiators, and those with smoking fathers, peer pressure, family conflict, and a self‑reported pornography addiction.","clinical_takeaway":"Smoking prevention programs should consider broader family and peer influences; the link to pornography addiction is tentative and based on an unvalidated measure.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample for a school‑based survey","Clear prevalence estimate for smoking","Inclusion of family and peer variables"],"limitations":["Pornography ‘addiction’ measured by a single, likely unvalidated item","Cross‑sectional design prevents causal inference","No control for key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":19,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0019-557x.128168"}},{"id":425,"doi":"10.1177/1079063213502678","pmid":"24088812","pmcid":null,"title":"Correlates and moderators of child pornography consumption in a community sample","authors":"Ray JV, Kimonis ER, Seto MC.","first_author":"Ray JV","journal":"Sexual abuse : a journal of research and treatment","year":2014,"pub_types":["Journal Article"],"keywords":["Personality","Internet","Sensation seeking","Child Sexual Abuse","Child Pornography","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online anonymous survey of adult male pornography users, comparing those who self‑report child‑pornography consumption (n≈37) with non‑consumers on demographics, personality and use variables","sample_n":null,"sample_text":"approximately one fifth of recruited male pornography users (21%, n = 37) reported consuming child pornography","population":"adult men recruited via the Internet who use pornography; not a probability sample","country":"unspecified (likely North America based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of adult men who view pornography, about 21% reported also viewing child pornography. Those who sought more porn and scored high on sensation‑seeking were most likely to report child‑porn use, and they also showed greater interest in sexual contact with minors.","clinical_takeaway":"None – the study describes correlates of illegal child‑pornography use, not clinical treatment guidance.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large community‑sample of self‑identified pornography users","Inclusion of multiple psychological variables","Use of moderation analysis to examine interaction of sensation seeking and use frequency"],"limitations":["Cross‑sectional, self‑report design limits causal inference","No measurement of moral or religious factors that could influence reporting","Masturbation and partner context not assessed","Potential self‑selection bias from online recruitment"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":30,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063213502678"}},{"id":426,"doi":"10.1016/j.biopsycho.2016.05.003","pmid":"27235125","pmcid":null,"title":"Decreased LPP for sexual images in problematic pornography users may be consistent with addiction models. Everything depends on the model. (Commentary on Prause, Steele, Staley, Sabatinelli, & Hajcak, 2015)","authors":"Gola M.","first_author":"Gola M.","journal":"Biological psychology","year":2016,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.biopsycho.2016.05.003"}},{"id":428,"doi":"10.1136/bmj.d6699","pmid":"22006945","pmcid":null,"title":"Doctor is suspended for prescribing a drug for pornography \"addiction\" without giving the risks","authors":"Dyer C.","first_author":"Dyer C.","journal":"BMJ (Clinical research ed.)","year":2011,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.d6699"}},{"id":429,"doi":"10.1016/j.addbeh.2014.10.025","pmid":"25462650","pmcid":null,"title":"Social judgments of behavioral versus substance-related addictions: a population-based study","authors":"Konkolÿ Thege B, Colman I, el-Guebaly N, Hodgins DC, Patten SB, Schopflocher D, Wolfe J, Wild TC.","first_author":"Konkolÿ Thege B","journal":"Addictive behaviors","year":2015,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Etiology","stigma","Behavioral Addictions","Lay Theory","Substance-related Addictions"],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"population-based online survey (N≈4000) of Alberta residents; random assignment to addiction‑type questionnaires","sample_n":4000,"sample_text":"representative sample of 4000 adults from Alberta, Canada","population":"general adult population, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 4000 Canadians found that people see substance addictions (like alcohol) as more 'addictive' than behavioral ones (such as gambling or sexual behavior), but view moral character flaws as more linked to behavioral addictions.","clinical_takeaway":"Public attitudes differ for substance vs. behavioral addictions; clinicians should be aware of possible stigma toward behavioral addictions.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["large, population‑representative sample","randomized presentation of addiction types","clear focus on public attitudes"],"limitations":["uses ad‑hoc, likely unvalidated questionnaire items","no pre‑registration or power analysis reported","confounding variables (e.g., respondent religiosity) not measured"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":38,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2014.10.025"}},{"id":431,"doi":"10.1111/j.1752-0606.2008.00091.x","pmid":"19017188","pmcid":null,"title":"Assisting a concerned person to motivate someone experiencing cybersex into treatment: application of invitational intervention: the arise model to cybersex","authors":"Landau J, Garrett J, Webb R.","first_author":"Landau J","journal":"Journal of marital and family therapy","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"program description / manual-driven intervention without reported empirical outcomes","sample_n":null,"sample_text":"Not specified in abstract","population":"families dealing with a member described as having compulsive internet pornography use or cybersex; no sample size reported","country":"United States","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article describes a three‑step family‑focused intervention (ARISE) intended to help partners encourage a loved one involved in compulsive cybersex or internet pornography use to seek treatment, but it offers no data on its effectiveness.","clinical_takeaway":"No evidence provided that the ARISE method works; clinicians should seek interventions with demonstrated outcomes.","confidence":0.6,"topic_tags":["pornography","csbd","sexual_function","relationships"],"strengths":["Addresses family dynamics","Provides a structured intervention model"],"limitations":["No empirical outcome data presented","Constructs such as 'addiction' not operationalised","No measurement of confounding variables"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1752-0606.2008.00091.x"}},{"id":437,"doi":"10.1016/j.beth.2009.06.002","pmid":"20569778","pmcid":null,"title":"Acceptance and commitment therapy as a treatment for problematic internet pornography viewing","authors":"Twohig MP, Crosby JM.","first_author":"Twohig MP","journal":"Behavior therapy","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":67,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"single-case multiple-baseline across 6 adult males","sample_n":6,"sample_text":"6 adult males","population":"adult males (N=6) self‑reporting problematic pornography affecting quality of life","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Six men who said pornography hurt their lives took eight sessions of Acceptance and Commitment Therapy. Their viewing time dropped by about 85% and stayed low after three months, with modest improvements in quality of life and related mental‑health measures.","clinical_takeaway":"ACT may reduce problematic porn use, but evidence is limited to a very small case series.","confidence":0.65,"topic_tags":["pornography","treatment","csbd"],"strengths":["Uses single‑case experimental design with multiple baseline","Behavioral outcome (viewing time) measured directly","Assesses quality‑of‑life and related mental‑health constructs"],"limitations":["Very small, self‑selected sample (N=6)","No control for moral incongruence, masturbation, or broader mental‑health variables","No validated scale for problematic pornography use or addiction"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":107,"citing_publications":194,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.beth.2009.06.002"}},{"id":458,"doi":"10.1007/s10508-026-03523-0","pmid":"42768283","pmcid":null,"title":"The Prevalence of Aggressive Content in Online Sexually Explicit Fanfiction","authors":"Metin E, Shor E.","first_author":"Metin E","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual Aggression","Pornography","Fandom","Erotica","Fanfiction"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"textual content analysis of fanfiction stories from AO3; two samples (most popular n=525, random n=360); verification coding of 60 stories","sample_n":1440,"sample_text":"AO3 fanfiction stories (popular and random samples)","population":"online fanfiction texts; no human participants","country":"unspecified (online source)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined 885 fan‑fiction stories from a popular website and found that about half were labeled with aggression tags, and nearly one‑fifth contained non‑consensual or rapist content. A deeper check of 60 stories suggested even higher rates of aggression.","clinical_takeaway":"None – the study describes content, not user behaviour or health effects.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample of texts","Systematic tagging approach","Verification coding increases reliability"],"limitations":["Tags may not be validated measures of aggression","No participant data; cannot infer preferences","Potential sampling bias toward English‑language AO3 users"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03523-0"}},{"id":459,"doi":"10.1097/nsg.0000000000000432","pmid":"42475606","pmcid":null,"title":"Childhood exposure to pornography and the normalization of online exploitation","authors":"Olson H.","first_author":"Olson H.","journal":"Nursing","year":2026,"pub_types":["Journal Article"],"keywords":["Screening","Pediatrics","Sex Trafficking","Pornography","Trauma-informed","Csec","Onlyfans","Online Exploitation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative discussion article without original empirical data; no sample size reported.","sample_n":null,"sample_text":"Not applicable – article provides no original sample.","population":"Children and adolescents (general discussion)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that children’s frequent exposure to online pornography may make them view sexual violence as normal and increase the risk that they will be asked to send explicit images, potentially leading to exploitation. It urges nurses to screen for such harm and use trauma‑informed approaches.","clinical_takeaway":"Clinicians should screen for online pornography exposure and signs of exploitation, using trauma‑informed questions and referral pathways.","confidence":0.5,"topic_tags":["pornography","sexual_function"],"strengths":["Highlights an urgent public‑health concern","Provides practical guidance for nursing screening"],"limitations":["No original empirical data presented","Causal language used without supporting evidence","No measurement of key confounds"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/nsg.0000000000000432"}},{"id":460,"doi":"10.21203/rs.3.rs-8293614/v1","pmid":null,"pmcid":null,"title":"The Use of Sexually Explicit Internet Material and Fertility Intention among Chinese Female Youths: A Life History Theory Approach","authors":"Chen Y, Tang L, Qiu L, Xu H.","first_author":"Chen Y","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 2049 Chinese female youths (ages 17‑24) using self‑report questionnaires; mediation analysis performed on cross‑sectional data.","sample_n":2049,"sample_text":"2049 Chinese female youths (aged 17–24) completed the questionnaires.","population":"Chinese female youths, likely recruited via convenience/online sampling; no random or probability sampling reported.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 2,000 Chinese young women, higher exposure to online sexual material and more permissive sexual attitudes were linked to lower intentions to have children, suggesting internet pornography may influence reproductive choices.","clinical_takeaway":"None – the study does not provide direct guidance for clinical practice.","confidence":0.8,"topic_tags":["pornography","sexual_function","religiosity"],"strengths":["Large sample size for a survey","Use of mediation model to test theoretical pathway","Clear theoretical framing with Life History Theory"],"limitations":["Cross‑sectional design limits causal inference","Potential lack of validated measures for SEIM use","No control for key confounds (moral, mental health, partnership, trauma)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-8293614/v1"}},{"id":461,"doi":"10.1007/s10508-025-03291-3","pmid":"41420064","pmcid":"PMC12916952","title":"Viewing of Sexually Explicit Internet Material Among Jewish and Arab Adolescents: The Role of Parental Monitoring and Family Communication About Sexuality","authors":"Daw S, Kharmatz A, Scharf M.","first_author":"Daw S","journal":"Archives of sexual behavior","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Parental Monitoring","Ethnocultural Differences","Sexually Explicit Internet Materials","Family Communication Regarding Sexuality"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12916952","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 855 secular Jewish and Arab adolescents in Israel; self‑report questionnaires on parental monitoring, family communication, and viewing of sexually explicit internet material","sample_n":855,"sample_text":"855 secular Jewish and Arab adolescents (58.5% female)","population":"adolescents (mean age 15) from Jewish and Arab communities in Israel","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among Israeli teens, Jewish youths reported more family talks about sex and more viewing of online porn than Arab youths. Parental monitoring was linked to less porn viewing in both groups, but open family communication reduced viewing only among Jewish teens.","clinical_takeaway":"Parental monitoring may help limit adolescents' exposure to online sexual material across cultures.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","csbd"],"strengths":["Large sample size for adolescent survey","Inclusion of two ethnocultural groups","Focus on parental monitoring—a well‑studied protective factor"],"limitations":["Cross‑sectional design limits causal inference","Reliance on unvalidated self‑report measures","No assessment of key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03291-3"}},{"id":462,"doi":"10.1002/hpja.70026","pmid":"40033682","pmcid":"PMC11876791","title":"Engaging Parents in Sexually Explicit Media Literacy Education: Expert Perspectives From Australia and New Zealand","authors":"Zen M, Hendriks J, Burns S.","first_author":"Zen M","journal":"Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Parents","Media Literacy","Sexuality Education","Pornography","Sexually Explicit Media","Parent Resources"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11876791","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Semi‑structured interviews with 7 sexual‑health experts; thematic analysis of experiences.","sample_n":7,"sample_text":"Seven experts (five from Australia, two from New Zealand) were interviewed.","population":"Sexual health experts delivering SEM‑literacy education in Australia and New Zealand","country":"Australia; New Zealand","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with seven sexual‑health experts reveal that parents feel uneasy about discussing porn with kids, face resource challenges, and benefit from flexible, neutral‑tone education to help children critically evaluate explicit media.","clinical_takeaway":"Health promoters should offer varied, non‑judgmental SEM‑literacy resources to aid parents in guiding youth.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides expert insight into parental engagement strategies","Identifies practical barriers and enablers for SEM‑literacy programmes"],"limitations":["Very small, non‑representative expert sample","No systematic assessment of parental perspectives","Findings not generalisable to broader population"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/hpja.70026"}},{"id":464,"doi":"10.5014/ajot.2026.051409","pmid":"42102303","pmcid":null,"title":"Pornography: What Occupational Therapists Need to Know for Clinical Practice","authors":"Rothman EF, Ellis KM.","first_author":"Rothman EF","journal":"The American journal of occupational therapy : official publication of the American Occupational Therapy Association","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/column without empirical data","sample_n":null,"sample_text":"N/A (no participants)","population":"occupational therapists / clinicians (professional audience)","country":"USA (likely based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors explain that occupational therapists will increasingly meet clients who watch porn. They outline how porn use can be healthy or problematic depending on distress, values, relationships, and environmental factors, urging therapists to be prepared to assess its impact on daily life.","clinical_takeaway":"Screen for distress, value conflicts, and functional impacts when clients discuss pornography; tailor interventions accordingly.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Clear practical guidance for clinicians","Acknowledges both adaptive and maladaptive aspects of pornography use"],"limitations":["No empirical data","Relies on expert opinion only","No systematic review of evidence"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5014/ajot.2026.051409"}},{"id":465,"doi":"10.1007/s10508-024-03002-4","pmid":"39424699","pmcid":null,"title":"Factors Associated with Sexually Explicit Internet Material Use among Adolescents: A Systematic Review","authors":"Chaise RF, Cardoso CP, Wingert FF, Piltcher TT, Rocha KB, López MJM.","first_author":"Chaise RF","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":["Systematic review","Adolescents","Pornography","Sexually Explicit Internet Material"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 48 quantitative survey studies on adolescent SEIM use; synthesis without meta‑analysis; includes quality assessment of included studies.","sample_n":null,"sample_text":"48 quantitative survey studies (total participants not reported in abstract)","population":"Adolescents (various ages, both sexes)","country":"Multiple (international databases)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 48 adolescent studies finds that boys, older youths, and those seeking peer popularity are more likely to view online pornography. Other linked factors include sexual agency, hyper‑femininity in girls, and general internet addiction, though effect sizes are often uncalculated.","clinical_takeaway":"Screen adolescents for pornography use alongside peer pressure and internet‑addiction risks; consider gender‑specific education.","confidence":0.6,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Comprehensive search across four major databases","Inclusion of a sizable number of studies (48)","Identifies key demographic and psychosocial correlates"],"limitations":["High heterogeneity in how SEIM use is measured","No quantitative meta‑analysis for most associations","Moral incongruence and related confounds not addressed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-03002-4"}},{"id":466,"doi":"10.1007/s10508-026-03504-3","pmid":"42587256","pmcid":null,"title":"Scripting Sexual Violence? Links Between Women's Pornography Exposure in Childhood and Later Sexual Victimization","authors":"Noll LK, Reinhart R, Harsey SJ, Alvey HM, Shallcross RA, Miller MJ.","first_author":"Noll LK","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Objectification","Sexual Violence","Emerging Adults","Internet Pornography","Pornography Sex Scripting"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of emerging adult women (N=677)","sample_n":677,"sample_text":"N = 677 emerging adult women recruited for a cross‑sectional online survey","population":"emerging adult women, likely convenience sample","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 677 young women and found that those who reported watching internet pornography as children were more likely to experience sexual assault later, and that copying sexual acts seen in porn partially explained this link.","clinical_takeaway":"Early porn exposure may be linked to later victimisation, but causal conclusions are premature; clinicians should consider broader risk factors.","confidence":0.72,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size (N=677)","Addresses understudied link between early porn exposure and later victimisation","Uses mediation analysis to explore potential mechanisms"],"limitations":["Cross‑sectional design cannot establish causality","Key constructs measured with single‑item self‑reports, not validated scales","No control for major confounds (moral incongruence, mental health, trauma, etc.)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03504-3"}},{"id":467,"doi":"10.1007/s10508-024-03080-4","pmid":"39885047","pmcid":null,"title":"Sexually Explicit Media Exposure, Sexual Violence Victimization, and Sexual Risk Behaviors Among HIV-Positive Men Who Have Sex with Men with New Drug Abuse in Jinan, China","authors":"Yu Y, Wei Q, Tang S, Xiao F, Cai H, Li J.","first_author":"Yu Y","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["HIV","Sexual Orientation","Men Who Have Sex With Men","Sexual Risk Behavior","Sexual Violence","Sexually Explicit Media"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey of 453 MSM in Jinan, China, examining past‑6‑month drug use, sexually explicit media exposure, sexual violence victimisation and risk behaviours.","sample_n":453,"sample_text":"Convenience online sample; not a probability or nationally representative sample.","population":"Men who have sex with men (MSM) who use new recreational drugs; recruited via online questionnaire in Jinan, China (N=453).","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Chinese MSM who use new recreational drugs, almost 90% view sexually explicit media, half report sexual‑violence victimisation, and many engage in condomless sex. Drug use, early media exposure and preference for violent content are linked to higher risk of violence and unsafe sex.","clinical_takeaway":"Drug‑using MSM who watch explicit media, especially with violent content, may need targeted counseling on sexual safety and violence prevention.","confidence":0.7,"topic_tags":["sexual_function","pornography"],"strengths":["Large (N>400) sample for MSM community in China","Examines multiple relevant behaviours (drug use, media exposure, violence, risk)","Uses multivariable regression to adjust for several covariates"],"limitations":["Cross‑sectional design prevents causal inference","Self‑report measures, likely not validated for pornography exposure","No control for key confounds (moral incongruence, mental health, trauma, masturbation)","Convenience online sample limits generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-03080-4"}},{"id":468,"doi":"10.31234/osf.io/eu2gf","pmid":null,"pmcid":null,"title":"The role of social networking and messaging apps in adolescent exposure to sexually explicit materials: A 14-day window into adolescent smartphone usage","authors":"Šaradín Lebedíková M, Tancoš M, Cho YW, Smahel D, Chow S.","first_author":"Šaradín Lebedíková M","journal":"PsyArXiv","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/eu2gf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"observational daily diary with objective app‑usage data (N=201 adolescents, 14 days, 1,383 observations)","sample_n":201,"sample_text":"201 adolescents (13‑17 y, 41 % girls)","population":"adolescents aged 13‑17 years, mixed gender, likely recruited from schools or community (convenience sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Tracking teens’ phone use for two weeks, the study found that overall time spent on social‑networking or messaging apps did not predict seeing sexual material, but boys who used messaging apps were more likely to encounter it.","clinical_takeaway":"Parents and educators should note that messaging apps—not social media per se—may pose a higher risk of sexual content exposure for adolescent boys.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Objective, high‑frequency measurement of app use","Within‑person daily design captures fluctuations","Large number of repeated observations"],"limitations":["Self‑report for SEM exposure, likely single‑item","Convenience sample limits generalisability","No measurement of moral or mental‑health confounders"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/eu2gf"}},{"id":469,"doi":"10.2196/80058","pmid":"42081798","pmcid":"PMC13138793","title":"Sexual Well-Being of Young People in Times of Widespread Pornography Use: Protocol for a Multidisciplinary Research Framework","authors":"De Win G, Van Hal G, Walrave M, Van Ouytsel J, Ponnet K, Dewaele A, Janssen E, Coene G, Michielsen K, Geuens S, Glazemakers I.","first_author":"De Win G","journal":"JMIR research protocols","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual development","Adolescents","Young Adults","Multidisciplinary Research","Online Pornography","Pornography Use","Sexual Wellbeing","Diverse Society"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13138793","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"protocol for mixed‑methods, nationally representative survey, lab studies, qualitative work; no empirical data yet","sample_n":null,"sample_text":"planned large‑scale nationally representative survey (sample size not yet specified)","population":"young people (adolescents & young adults) in Flanders, Belgium","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This protocol outlines a planned, large‑scale study in Belgium to examine how young people’s pornography use relates to their sexual development and well‑being, using surveys, lab tests, and interviews.","clinical_takeaway":"None – study results are not yet available.","confidence":0.7,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Multidisciplinary, mixed‑methods framework","Plans nationally representative survey","Includes stakeholder co‑creation"],"limitations":["No empirical data yet; scores based on protocol description","Details on measurement instruments and confound control are missing"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/80058"}},{"id":470,"doi":"10.21203/rs.3.rs-9113519/v1","pmid":null,"pmcid":null,"title":"Social Media Exposure and Sexual Risk Behaviour among Secondary School Adolescents in Eastern Uganda: A School-Based Cross-Sectional Study","authors":"Namugabo¹ SE, Kawooya¹ AN, Atim¹ F.","first_author":"Namugabo¹ SE","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"school-based cross‑sectional survey (N=384) using multistage sampling of secondary schools in Eastern Uganda","sample_n":384,"sample_text":"384 adolescents selected via multistage sampling","population":"secondary‑school adolescents (Senior Four to Six) in Magamaga Town Council, Mayuge District, Uganda","country":"Uganda","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 384 Ugandan secondary‑school students, almost nine out of ten used social media. Those who used it were more likely to see porn, engage in online dating, sexting, and start sex earlier, suggesting a link between social‑media exposure and risky sexual behaviour.","clinical_takeaway":"Screen adolescents for risky online exposure and reinforce digital‑literacy and sexuality education.","confidence":0.8,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Reasonably sized adolescent sample","Multistage sampling improves representativeness","Focus on understudied Ugandan context"],"limitations":["Self‑developed, unvalidated questionnaire","Cross‑sectional design cannot establish causality","No adjustment for key confounders (e.g., mental health, moral attitudes)","Multiple chi‑square tests without correction"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-9113519/v1"}},{"id":472,"doi":"10.1111/1556-4029.70187","pmid":"40955996","pmcid":null,"title":"Sibling incest resulting in pregnancy: A forensic case study of paternal neglect and pornographic exposure","authors":"Kavruk Erdim N, Bas G, Bikmazer A, Agritmis H.","first_author":"Kavruk Erdim N","journal":"Journal of forensic sciences","year":2026,"pub_types":["Journal Article","Case Reports"],"keywords":["Adolescent Pregnancy","Child Sexual Abuse","Forensic Psychiatry","Sibling Incest","Pornography Exposure","Paternal Neglect"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single family presenting sibling incest linked to porn exposure; no systematic data collection","sample_n":null,"sample_text":"single family unit; N=1","population":"14‑year‑old male and 15‑year‑old female siblings; paternal neglect context","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 14‑year‑old boy accessed porn on his father's phone, then had sex with his 15‑year‑old sister, leading to pregnancy. The report discusses how unsupervised porn exposure and parental neglect may increase risk of intrafamilial abuse and calls for better digital safeguards.","clinical_takeaway":"Unsupervised porn access in adolescents can be a warning sign; enforce parental controls and provide sexual education.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Rare forensic illustration of incest linked to porn exposure","Highlights need for parental controls and digital literacy"],"limitations":["Single case; no systematic measurement","No validated instruments or quantitative data","Potential over‑interpretation of causality"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1556-4029.70187"}},{"id":473,"doi":"10.21203/rs.3.rs-9624332/v1","pmid":null,"pmcid":null,"title":"SUSEX: Development and Psychometric Properties of Sexting Use Scale for Young Adults","authors":"Olivares-Cruz V, Ruiz-Dobbertin R, Horna-Tongo R, Vela-Otiniano R, Pérez-Lara C.","first_author":"Olivares-Cruz V","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"instrumental study developing a self‑report scale; convenience sample of 500 Peruvian young adults","sample_n":500,"sample_text":"500 participants; convenience sampling","population":"young adults (18‑32) from Peru, 71% women","country":"Peru","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and tested a new questionnaire (SUSEX) to measure how young adults use sexting. In 500 Peruvian participants the three‑factor model (affective connection, emotional well‑being, digital security) showed strong reliability and correlated with an existing sexting scale.","clinical_takeaway":"The SUSEX can be used as a reliable tool to assess sexting behaviors and related wellbeing in research or clinical settings.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample (N=500) for scale validation","Comprehensive factor analysis (EFA & CFA) with good fit","High internal consistency (α & ω > .85)","Convergent validity with existing sexting measure"],"limitations":["Convenience, non‑representative sample (mostly women, single country)","No assessment of potential confounds (e.g., mental health, moral attitudes)","No pre‑registration or open data reported"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-9624332/v1"}},{"id":474,"doi":"10.1016/j.bpobgyn.2026.102704","pmid":"41564715","pmcid":null,"title":"Sexting in adolescent girls: A new way of self-expression? A scoping review","authors":"Peters A, Roos EJ.","first_author":"Peters A","journal":"Best practice & research. Clinical obstetrics & gynaecology","year":2026,"pub_types":["Scoping Review","Review","Journal Article"],"keywords":["Social Media","Adolescent Girls","Sexting","Digital Communication","Self-expression","Sexual Identity Development"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review of seven empirical studies on adolescent girls’ sexting","sample_n":null,"sample_text":"Seven studies included; individual study sizes not reported in abstract","population":"adolescent girls (10‑19 y)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This scoping review summarises seven studies on sexting among teenage girls, finding that while prevalence varies widely, sexting can support emotional, relational and sexual identity development.","clinical_takeaway":"Sexting may have developmental benefits for adolescent girls; clinicians should consider both risks and positive aspects when discussing digital sexual behavior.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Systematic search across multiple databases","Focus on positive developmental functions","Clear inclusion criteria for adolescent girls"],"limitations":["Small number of included studies (n=7)","No assessment of risk of bias or study quality","Limited detail on measurement instruments"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.bpobgyn.2026.102704"}},{"id":475,"doi":"10.31234/osf.io/jturm_v1","pmid":null,"pmcid":null,"title":"AI-Generated Explicit Deepfakes Damage Politicians’ Perceived Leadership Competence, Trustworthiness and Electoral Prospects","authors":"Klüser SK, Klüser KJ, Hoes E.","first_author":"Klüser SK","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Pre‑registered online survey experiment with random assignment to explicit deepfake, private image, or control condition; N = 1904 U.S. participants.","sample_n":1904,"sample_text":"N = 1904 participants, unspecified recruitment method (presumably online panel).","population":"U.S. adults recruited online (likely convenience panel).","country":"United States","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A pre‑registered online experiment showed that seeing AI‑generated, non‑consensual sexual images of politicians makes people rate those politicians as less trustworthy and competent, and lowers voting intentions, especially for men.","clinical_takeaway":"None – findings pertain to political perception, not clinical sexual health.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large, pre‑registered sample","Randomized experimental manipulation","Timely topic with policy relevance"],"limitations":["Potential lack of validated scales for political competence outcomes","Convenience online sample limits generalisability","No measurement of participants' prior attitudes toward deepfakes"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/jturm_v1"}},{"id":478,"doi":"10.21203/rs.3.rs-1608322/v1","pmid":null,"pmcid":null,"title":"Exposure to sexually explicit materials and associated factors among secondary school students in Nekemte town east Wollega zone, western Ethiopia: A school based cross sectional study","authors":"Garuma A, Kejela G, Benti W, Bikila H, Tolossa T, Diriba W, Meskelu M, Desalegn M.","first_author":"Garuma A","journal":"Research Square","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-1608322/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Institution‑based cross‑sectional survey of 660 secondary‑school students using simple random sampling and self‑administered questionnaire.","sample_n":660,"sample_text":"Simple random sampling of students from schools; self‑administered questionnaire.","population":"secondary school students in Nekemte town, Ethiopia (N=660)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 660 Ethiopian high‑school students found that 58% had seen sexually explicit material, mainly on smartphones, and that exposure was linked to higher odds of sexual activity.","clinical_takeaway":"High exposure to porn among adolescents is common and associated with sexual activity, but causal claims are unsupported.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample for a school‑based survey","Random sampling within schools","Use of multivariable logistic regression with confidence intervals"],"limitations":["Reliance on single‑item, non‑validated measures of exposure","Cross‑sectional design cannot establish causality","No assessment of key confounders (moral incongruence, masturbation, mental health, relationship factors, trauma)","No pre‑registration or correction for multiple testing"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-1608322/v1"}},{"id":479,"doi":"10.1111/psyp.70096","pmid":"40702879","pmcid":"PMC12287905","title":"Neuroaffective Processing of Sexually Relevant Images in Hetero- and Homosexual Women and Men: Subjective, Pupillometric, and Magnetoencephalographic Correlates","authors":"Prantner S, Espino-Payá A, Pastor MC, Giménez-García C, Ballester-Arnal R, Junghoefer M.","first_author":"Prantner S","journal":"Psychophysiology","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Magnetoencephalography","Pupil Dilation","Category Specificity","Sexual Response","Visual Sexual Stimuli"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12287905","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subjects MEG experiment presenting erotic and explicit images to hetero‑ and homosexual men and women; cross‑sectional","sample_n":null,"sample_text":"not specified in abstract","population":"adult participants (young adults), likely convenience sample, gender/sexual‑orientation groups","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study recorded brain activity, pupil size, and self‑reported feelings while men and women of different sexual orientations viewed erotic and explicit pictures. Results show that preferred versus non‑preferred images produce distinct neural and physiological responses, varying by gender and orientation.","clinical_takeaway":"None – the findings describe basic neural responses to sexual images, not clinical implications.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","gender"],"strengths":["Uses high‑temporal‑resolution MEG to examine neural dynamics","Combines neural, pupillary, and subjective measures","Considers gender and sexual orientation differences"],"limitations":["Likely small sample size, limiting power","No validated scales for sexual behavior constructs","Potential lack of correction for multiple comparisons"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":4,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/psyp.70096"}},{"id":480,"doi":"10.31234/osf.io/ptw9r","pmid":null,"pmcid":null,"title":"Pornography, Violence and Sexual Technology: Psychological, Neurological and Cultural Impacts in Contemporary Society","authors":"Costanzo T.","first_author":"Costanzo T.","journal":"PsyArXiv","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without primary data; no methods reported.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The preprint reviews how porn, violent sexual content, and new tech like VR may affect cognition, emotions, and relationships, suggesting possible aggression, desensitisation and relational problems, and calls for regulation and education.","clinical_takeaway":"None – the article offers theoretical discussion without clinical evidence.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Broad interdisciplinary scope","Highlights emerging technologies"],"limitations":["No empirical data presented","Lacks systematic review methods","No quantitative analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/ptw9r"}},{"id":481,"doi":"10.31234/osf.io/ptw9r_v1","pmid":null,"pmcid":null,"title":"Pornography, Violence and Sexual Technology: Psychological, Neurological and Cultural Impacts in Contemporary Society","authors":"Costanzo T.","first_author":"Costanzo T.","journal":"PsyArXiv","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/ptw9r_v1","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary; no empirical data, no methods described","sample_n":null,"sample_text":"Not applicable – preprint is a narrative review without original participants","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The preprint reviews literature on how pornographic, violent, and sexual‑tech content may affect psychology, brain function, and culture, suggesting possible links to aggression, desensitization, and relationship strain, and calls for regulation and education.","clinical_takeaway":"None – the paper provides no empirical evidence to guide clinical practice.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd","neuroscience"],"strengths":["Broad interdisciplinary scope","Touches on emerging technologies"],"limitations":["No primary data or systematic methodology","Lacks definition and measurement of key constructs","No empirical support for claims"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/ptw9r_v1"}},{"id":482,"doi":"10.21203/rs.3.rs-8533545/v1","pmid":null,"pmcid":null,"title":"Adolescence in the digital age: The impacts of smartphone and social media use on a cohort of Irish teenagers","authors":"Donnelly F, Petty-Saphon N.","first_author":"Donnelly F","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional analysis of secondary survey data (N=4,544 Irish teens)","sample_n":4544,"sample_text":"large community sample, convenience secondary data","population":"Irish adolescents, mostly 15–16 y, recruited via the 2023 Planet Youth Partner survey","country":"Ireland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of over 4,500 Irish teens, spending four or more hours a day on social media and experiencing cyberbullying or sexting were linked to higher scores on a mental‑health questionnaire, indicating poorer well‑being.","clinical_takeaway":"High social‑media use and online victimisation are associated with poorer mental health in teens; clinicians should assess digital behaviours when evaluating adolescent distress.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Large sample size","Use of validated mental‑health instrument (SDQ)","Multivariable regression controlling for several demographic variables"],"limitations":["Cross‑sectional design; cannot infer causality","Key sexuality‑related confounds (e.g., moral incongruence, masturbation) not measured","Self‑report of online behaviours may be biased"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-8533545/v1"}},{"id":483,"doi":"10.1080/10538712.2023.2285960","pmid":"37994473","pmcid":null,"title":"A Global Outlook on Child Sexual Abuse and Sexually Explicit Material Online During COVID-19: Trends and Interdisciplinary Prevention Methods","authors":"Anillo I, Feldman D, Kennedy T.","first_author":"Anillo I","journal":"Journal of child sexual abuse","year":2023,"pub_types":["Review","Journal Article"],"keywords":["Internet Use","Law Enforcement","Covid-19","Online Abuse","Child Sexually Explicit Material","Child Sexual Abuse Online","Hashing Technology","Online Offending"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review of global trends in online child sexual abuse and CSEM during COVID‑19; no primary data collection","sample_n":null,"sample_text":"Not applicable – review of existing literature and reports","population":"global reports, law‑enforcement data, secondary sources; no primary human participants","country":"International","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review evidence that the COVID‑19 pandemic coincided with a worldwide rise in the creation, trade and consumption of child sexual abuse material online, and discuss law‑enforcement and prevention strategies.","clinical_takeaway":"None – the review concerns child exploitation, not adult sexual health or compulsive sexual behaviour.","confidence":0.7,"topic_tags":["csbd","pornography","masturbation","sexual_function"],"strengths":["Comprehensive scoping of multiple jurisdictions","Timely focus on pandemic‑related changes"],"limitations":["Relies on heterogeneous secondary reports","No systematic quantitative synthesis"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2023.2285960"}},{"id":484,"doi":"10.1109/tpami.2026.3713771","pmid":"42455715","pmcid":null,"title":"UniNDM: A Unified Noise-Driven Detection and Mitigation Framework Against Sexual Content in Text-to-Image Generation","authors":"Huang Y, Sun Y, Chen H, Zhang R, Ruan S, Duan R, Yuan M, Dong Y, Xue H, Cao X, Wei X.","first_author":"Huang Y","journal":"IEEE transactions on pattern analysis and machine intelligence","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"algorithm development and benchmark testing on multiple diffusion models and datasets","sample_n":null,"sample_text":"Not applicable – study uses pre‑existing image datasets for algorithm evaluation","population":"artificial image generation models (no human participants)","country":"China (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors present UniNDM, a new method that detects and blocks sexual images generated by AI text‑to‑image models by analysing early diffusion noise, achieving higher accuracy with minimal extra computing.","clinical_takeaway":"None – the study addresses AI‑generated content, not human sexual health or behavior.","confidence":0.6,"topic_tags":["sexual_function","pornography"],"strengths":["Innovative use of diffusion noise dynamics for detection","Broad evaluation across several state‑of‑the‑art models","Low computational overhead"],"limitations":["No human subject data – findings not directly translatable to user safety","No pre‑registration or external replication","Performance limited to tested datasets; real‑world robustness unknown"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":6,"confounds":1,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1109/tpami.2026.3713771"}},{"id":485,"doi":"10.1007/s00103-025-04073-x","pmid":"40643666","pmcid":"PMC13043550","title":"[Pornography in everyday life and sexual education among adolescents: survey results from 8th and 9th grade students in North Rhine-Westphalia]","authors":"Döring N, Mikhailova V, Biermann M, Bresemann Y, Daum A, Kistinger T, Wellner M, Zenge Wesendonk T.","first_author":"Döring N","journal":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","year":2026,"pub_types":["research-article","Journal Article","English Abstract"],"keywords":["Sex Education","Sexual Socialization","Sexuality Education","Pornography","Sexually Explicit Online Content"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13043550","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional classroom survey of 903 German adolescents (8th/9th grade)","sample_n":903,"sample_text":"903 adolescents (85% aged 14‑15, 54% male, 85% heterosexual) from various secondary schools in North Rhine‑Westphalia","population":"Adolescents, age 14-15, Germany, school‑based convenience sample","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 903 German 8‑ to 9‑grade students found that most had seen pornography, both voluntarily and unintentionally. Teens described it as exciting but also harmful, and they wanted more school education about its effects and realism.","clinical_takeaway":"Adolescents perceive pornography as both arousing and risky; incorporating balanced, factual porn education into school curricula may address their expressed needs.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","prevalence"],"strengths":["Large sample for a school‑based survey","Provides recent prevalence data for German adolescents","Differentiates wanted vs unwanted exposure"],"limitations":["Reliance on self‑report items of unknown validation","No measurement or control of key confounds (e.g., moral views, mental health)","Cross‑sectional design limits causal inference","Convenience school sample may not be nationally representative"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00103-025-04073-x"}},{"id":486,"doi":"10.1177/08862605261446971","pmid":"42212905","pmcid":null,"title":"\"I Don't Feel Safe at All\": Examining Shattered Assumptions Among Male Victims of Sextortion","authors":"O'Malley RL, Bolton M, Ayerza J, Colavito K.","first_author":"O'Malley RL","journal":"Journal of interpersonal violence","year":2026,"pub_types":["Journal Article"],"keywords":["Trauma","Male Victims","Shattered Assumptions","Sextortion","Image-based Sexual Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"thematic analysis of open-ended survey responses from 169 male sextortion victims","sample_n":169,"sample_text":"169 male victims responded to an open‑ended survey; recruitment method not detailed in abstract","population":"male victims of financial sextortion, self‑selected via online survey","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined how men who were victims of online sextortion feel unsafe and how the experience shatters their basic beliefs about safety, control, and self‑worth, leading to anxiety, shame, and coping efforts.","clinical_takeaway":"Clinicians should assess trauma and shame in male sextortion survivors and support rebuilding of safety assumptions.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Large qualitative sample for a sensitive topic","Theory‑guided analysis (Shattered Assumptions Theory)","Identifies coping strategies and emotional impacts"],"limitations":["Self‑selected convenience sample limits generalisability","No validated quantitative measures of trauma symptoms","Lacks control/comparison group"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605261446971"}},{"id":488,"doi":"10.1177/10778012251397966","pmid":"41313377","pmcid":null,"title":"\"There Are No Limits!\": AI Undressing Apps and the Normalization of Nonconsensual Intimate Deepfakes","authors":"Williams K.","first_author":"Williams K.","journal":"Violence against women","year":2025,"pub_types":["Journal Article"],"keywords":["Artificial intelligence","Gender-based Violence","Image-based Sexual Abuse","Deepfakes","Nonconsensual Intimate Images"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"descriptive analysis of 29 AI undressing apps; no human participants, no experimental manipulation","sample_n":null,"sample_text":"29 identified apps","population":"apps/platforms (no human sample)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The paper surveys 29 AI \"undressing\" apps that turn ordinary photos into explicit deepfakes without consent, showing how they facilitate non‑consensual intimate image abuse and objectify women.","clinical_takeaway":"None – the study does not provide clinical guidance for individual sexual health or behavior.","confidence":0.8,"topic_tags":["gender","sexual_function"],"strengths":["Comprehensive catalog of emerging AI deep‑fake tools","Focus on privacy policies and revenue models","Raises urgent policy‑relevant concerns"],"limitations":["No empirical data on user behaviour or victim impact","Relies on publicly available app information only","Lacks quantitative analysis"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10778012251397966"}},{"id":489,"doi":"10.20944/preprints202507.1645.v1","pmid":null,"pmcid":null,"title":"The Weaponisation of Artificial Intelligence (AI): Legal Shortfalls and Regulatory Difficulties in Governing Non-Consensual Intimate Deepfakes (NCIDs)","authors":"Ward J.","first_author":"Ward J.","journal":"Preprints.org","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.preprints.org/frontend/manuscript/e5e0e19a23bec765f16995e1b73d2b79/download_pub","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary/legal analysis without empirical data","sample_n":null,"sample_text":"","population":"None","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper argues that UK law does not criminalise the creation of AI‑generated non‑consensual porn (deepfakes) and recommends a strict‑liability approach to protect victims.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Clear legal analysis of a novel issue","Uses victim testimony and comparative EU legislation"],"limitations":["No empirical data or systematic review","No quantitative evaluation of harms"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202507.1645.v1"}},{"id":490,"doi":"10.1038/s41598-026-42696-5","pmid":"41807646","pmcid":"PMC13100043","title":"Applying a gendered lens to the issue of adolescent social media use and well-being by exploring salient susceptibilities and alternative within-person processes","authors":"Shawcroft J, Cingel DP.","first_author":"Shawcroft J","journal":"Scientific reports","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Intensive Longitudinal Data","Adolescent Social Media Use","Gender Differences In Well-being"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13100043","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Intensive longitudinal (daily/within‑person) survey of 97 US adolescents, Dynamic SEM analysis","sample_n":97,"sample_text":"N = 97 adolescents living in the United States","population":"Adolescents (≈13‑18 yr) in United States, mixed gender","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 97 U.S. teens, researchers found that overall social‑media use was only weakly linked to well‑being, but more frequent use and accidental exposure to sexual content were tied to a less stable sense of purpose, especially for girls. The study suggests indirect, within‑person processes rather than a direct causal harm.","clinical_takeaway":"Social‑media exposure to sexual content may destabilize adolescents’ sense of purpose; clinicians should assess content exposure, not just total screen time.","confidence":0.7,"topic_tags":["adolescents","gender","sexual_function"],"strengths":["Intensive longitudinal design captures within‑person variation","Dynamic SEM allows modeling of temporal processes","Acknowledges limited causal inference"],"limitations":["Small sample limits power for gender comparisons","No measurement of key confounds (e.g., mental health, moral attitudes)","Reliance on self‑report; no validated addiction‐type scales"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-026-42696-5"}},{"id":491,"doi":"10.1007/s10508-024-02949-8","pmid":"39115630","pmcid":null,"title":"The Ubiquitous External Ejaculation: Examining Perceptions of Sexual Images Across Cultures","authors":"Salmon C, Hehman J.","first_author":"Salmon C","journal":"Archives of sexual behavior","year":2025,"pub_types":["Journal Article"],"keywords":["Sex differences","Perceptions","Cross-cultural","Pornography","Sexually Explicit Images","External Ejaculation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey comparing US, Brazil, Philippines samples; likely convenience participants; no mention of sampling frame or power calculations","sample_n":null,"sample_text":"not reported in abstract","population":"Adults and adolescents from US, Brazil, Philippines (sex, age, orientation varied)","country":"United States; Brazil; Philippines","controls_mi":"yes","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed people in the US, Brazil and the Philippines about how they view sexually explicit pictures, looking at sex, disgust, religiosity and other personal traits. Some cultural differences emerged, but the work relies on self‑report scales and convenience samples.","clinical_takeaway":"None – the paper reports descriptive cultural differences, not clinical implications.","confidence":0.6,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Cross‑cultural comparison expands beyond US samples","Attempts to model multiple individual‑difference variables","Inclusion of religiosity as a cultural factor"],"limitations":["Likely convenience sampling; unclear representativeness","Measurement of perception not described as validated","No control for key confounds (masturbation, mental health, partner context)","Statistical methods and power not reported"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02949-8"}},{"id":492,"doi":"10.3390/ijerph192114131","pmid":"36361005","pmcid":"PMC9659043","title":"Sexually Explicit Material and Its Relationship with Sociodemographic Variables, Sexual Satisfaction, and Relationship Satisfaction in a Spanish Sample","authors":"Sánchez-Lamadrid N, Sánchez-Fuentes MDM, Moyano N, Granados R.","first_author":"Sánchez-Lamadrid N","journal":"International journal of environmental research and public health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Satisfaction","Relationship Satisfaction","Sexually Explicit Material","Pornography Use"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/21/14131/pdf?version=1667030655","cited_by_count":1,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 221 Spanish adults examining SEM use patterns and associations with sexual and relationship satisfaction","sample_n":221,"sample_text":"221 participants, community sample recruited in Spain","population":"Spanish adults (average age 29.9, both genders)","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 221 Spanish adults, men used sexually explicit material more often than women. More frequent use was linked to lower sexual satisfaction, but it did not affect how satisfied people were with their relationships.","clinical_takeaway":"Higher porn use may be associated with reduced sexual satisfaction; clinicians should assess usage patterns when addressing sexual wellbeing.","confidence":0.8,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Validated questionnaires used","Relatively large sample for a single‑site survey","Includes a range of sociodemographic variables"],"limitations":["Cross‑sectional design cannot establish causality","Key confounds (moral incongruence, masturbation, mental health) not controlled","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph192114131"}},{"id":493,"doi":"10.31234/osf.io/tcsp6_v2","pmid":null,"pmcid":null,"title":"Applying a Gendered Lens to the Issue of Adolescent Social Media Use and Well-being; Salient Susceptibilities and Alternative Within-person Processes","authors":"Shawcroft J, Cingel D.","first_author":"Shawcroft J","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://osf.io/tcsp6_v2/download","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Intensive longitudinal data (N=97) with Dynamic Structural Equation Modeling examining gendered facets of social media use and well‑being.","sample_n":97,"sample_text":"N = 97 adolescents living in the United States","population":"Adolescents (United States)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 97‑teen sample, the study found that while overall social media use was only weakly linked to well‑being, girls’ higher use and unwanted exposure to sexual content were tied to less stable sense of purpose.","clinical_takeaway":"Clinicians should consider the impact of unwanted sexual content exposure, not just total social media time, on adolescent well‑being.","confidence":0.6,"topic_tags":["adolescents","gender","sexual_function"],"strengths":["Intensive longitudinal design allows within‑person processes","Use of Dynamic SEM to model temporal associations","Attention to gender‑specific experiences"],"limitations":["Small sample limits power for gender‑by‑use interactions","Reliance on self‑report measures; limited validation information","No control for key confounds (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/tcsp6_v2"}},{"id":494,"doi":"10.31234/osf.io/tcsp6_v1","pmid":null,"pmcid":null,"title":"Applying a Gendered Lens to the Issue of Adolescent Social Media Use and Well-being; Salient Susceptibilities and Alternative Within-person Processes","authors":"Shawcroft J, Cingel D.","first_author":"Shawcroft J","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://osf.io/tcsp6_v1/download","cited_by_count":1,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Intensive longitudinal (daily/within‑person) data from 97 U.S. adolescents; Dynamic Structural Equation Modeling.","sample_n":97,"sample_text":"Convenience sample of U.S. adolescents; not nationally representative.","population":"Adolescents (N=97) from United States, convenience sample.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined why girls often show stronger negative links between social‑media use and well‑being. Using daily data from 97 U.S. teens, it found little direct effect of social‑media on well‑being, but higher use and unwanted exposure to sexual content were linked to less stable sense of purpose.","clinical_takeaway":"High social‑media use and accidental exposure to sexual content may destabilise adolescents' sense of purpose; monitor these exposures rather than assuming a direct impact on overall well‑being.","confidence":0.7,"topic_tags":["adolescents","gender","sexual_function"],"strengths":["Within‑person intensive longitudinal design","Use of Dynamic SEM to model processes","Acknowledges limited evidence and alternative explanations"],"limitations":["Small, non‑representative sample","No validated measures reported","Key confounds (e.g., mental health, moral factors) not assessed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/tcsp6_v1"}},{"id":495,"doi":"10.1080/00224499.2026.2677207","pmid":"42207917","pmcid":null,"title":"Technology-Facilitated Sexual Victimization: Correlates and Outcomes Among Emerging Adults","authors":"Rogowski B, Harsey SJ, McEntarffer H, Wickham RE, Barger SD, Noll LK.","first_author":"Rogowski B","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 735 undergraduate students; PTSD symptoms assessed in subsample of 284","sample_n":735,"sample_text":"735 undergraduates (random subsample n=284 for PTSD measures)","population":"undergraduate emerging adults (USA?)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 735 college students, three‑quarters reported at least one experience of technology‑facilitated sexual victimisation (e.g., non‑consensual sharing of sexual media). Such experiences were strongly linked to higher PTSD symptoms, even after accounting for traditional in‑person sexual assault.","clinical_takeaway":"Clinicians should assess digital‑based sexual victimisation when evaluating trauma‑related distress in young adults.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample of emerging adults","Simultaneous assessment of digital and in‑person victimisation","Use of multivariate regression to isolate TFSV effects"],"limitations":["Cross‑sectional design – cannot infer causality","TFSV measures likely unvalidated self‑report items","Potential self‑selection bias of university volunteers"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2026.2677207"}},{"id":497,"doi":"10.1007/s13178-026-01392-9","pmid":"42677224","pmcid":"PMC13528647","title":"Work, Sex, and Substances: Differences in Self-Reported Chemsex Behaviors Between MSM Sex Workers and Digital Content Creators","authors":"Jackson K, Whitfield M, Tomlinson S, Santos GM.","first_author":"Jackson K","journal":"Sexuality research & social policy : journal of NSRC : SR & SP","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sex Work","Men Who Have Sex With Men (Msm)","Chemsex","Digital Content Creators","Sexualized Drug Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13528647","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Web‑based cross‑sectional survey of 769 HIV‑negative U.S. MSM with verified platform profiles; groups compared with chi‑square and logistic regression.","sample_n":769,"sample_text":"N = 769 participants recruited via online platforms; occupational groups defined by self‑report.","population":"MSM sex workers vs. MSM digital content creators (U.S., HIV‑negative)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 769 U.S. gay men, those who work as sex workers reported using illegal or controlled drugs during sex more often than men who produce sexual online content. The type of work appears to shape drug‑use patterns, suggesting tailored harm‑reduction approaches.","clinical_takeaway":"Clinicians should consider occupational context when screening MSM for chemsex‑related risks and tailor interventions accordingly.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Large sample size for a niche population","Clear occupational comparison","Appropriate statistical corrections (BH)"],"limitations":["Cross‑sectional; no causal inference","Potential self‑selection bias from online recruitment","Limited control for mental‑health or relationship factors"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13178-026-01392-9"}},{"id":498,"doi":"10.21203/rs.3.rs-39477/v1","pmid":null,"pmcid":null,"title":"Psychosocial Distress and Exposure to Sexually Explicit Materials as Correlates of Sexual Intercourse among Adolescents in Dodoma–Tanzania","authors":"Hussein A, Ismail A, Malero A, Dadi H, Charles J, Sando M, Fawzi W, Vuai S.","first_author":"Hussein A","journal":"Research Square","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-39477/v1.pdf?c=1631859971000","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey with stratified random sampling of 1,226 adolescents (10‑19 y) in Tanzania; weighted logistic regression used to test associations","sample_n":1226,"sample_text":"Stratified random sampling of adolescents (10–19 y) from five villages; N = 1,226","population":"Adolescents aged 10‑19 years from five villages in Chamwino District, Dodoma Region, Tanzania (N = 1,226)","country":"Tanzania","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 1,226 Tanzanian adolescents, those who felt more psychosocial distress or who had seen sexually explicit material were more likely to report ever having sex. The study suggests that mental‑health support and limiting exposure to such material could help reduce HIV risk.","clinical_takeaway":"Addressing psychosocial distress and limiting exposure to explicit material may lower sexual risk among adolescents.","confidence":0.8,"topic_tags":["adolescents","sexual_function","pornography"],"strengths":["Large, stratified random sample of adolescents","Weighted logistic regression with confidence intervals","Considers both psychosocial distress and SEM exposure"],"limitations":["Cross‑sectional design prevents causal inference","Psychosocial distress measure not described/validated","No assessment of moral incongruence, masturbation, or trauma"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-39477/v1"}},{"id":499,"doi":"10.1007/s10508-025-03099-1","pmid":"40032709","pmcid":null,"title":"The Present and Future of Adult Entertainment: A Content Analysis of AI-Generated Pornography Websites","authors":"Lapointe VA, Dubé S, Rukhlyadyev S, Kessai T, Lafortune D.","first_author":"Lapointe VA","journal":"Archives of sexual behavior","year":2025,"pub_types":["Journal Article"],"keywords":["Artificial intelligence","Pornography","Artificial Agents","Ai-generated Content","Ai-porn"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"qualitative inductive content analysis of 36 English‑language AI‑porn websites; systematic open coding, categorisation and inter‑rater validation; frequencies reported for functional categories","sample_n":36,"sample_text":"36 AI‑porn generation websites","population":"Websites (n=36) hosting AI‑generated pornography; no human participants","country":"Not specified (web‑based)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined 36 websites that let users generate AI‑made porn, cataloguing what kinds of images, videos and customisable features they offer. Most sites can create pictures, many also make videos, and they let users adjust characters, bodies, clothing and settings.","clinical_takeaway":"None – the paper describes website capabilities, not user health effects.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Systematic coding procedure with inter‑rater validation","Comprehensive description of AI‑porn functionalities","Provides a baseline map of emerging AI‑driven adult content"],"limitations":["No empirical data on user behaviour or health outcomes","No assessment of ethical or psychological impact on consumers","Limited to English‑language sites; may miss broader ecosystem"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":0,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03099-1"}},{"id":500,"doi":"10.21203/rs.3.rs-31696/v1","pmid":null,"pmcid":null,"title":"Psychosocial Distress and Exposure to Sexually Explicit Materials as Correlates of Sexual  Intercourse among Adolescents in Dodoma–Tanzania","authors":"Hussein A, Ismail A, Malero A, Dadi H, Charles J, Sando M, Fawzi W, Vuai S.","first_author":"Hussein A","journal":"Research Square","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-31696/v1.pdf?c=1591825862000","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,226 adolescents selected by stratified random sampling in five villages, weighted logistic regression used","sample_n":1226,"sample_text":"1,226 adolescents","population":"adolescents aged 10–19 in Dodoma Region, Tanzania","country":"Tanzania","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,226 Tanzanian adolescents, those who felt more psychosocial distress or who reported seeing explicit sexual material were more likely to have ever had sex. The study suggests that mental‑health support and limiting exposure to explicit media could help reduce risky sexual behaviour.","clinical_takeaway":"Addressing psychosocial distress and managing exposure to explicit material may lower adolescent sexual risk, but causal claims are not proven.","confidence":0.78,"topic_tags":["adolescents","sexual_function","pornography"],"strengths":["Large, stratified random sample of adolescents","Weighted logistic regression with confidence intervals","Considers both mental‑health and media exposure"],"limitations":["Cross‑sectional design cannot establish causality","Exposure and distress measured with unspecified, likely unvalidated self‑report items","Key confounds (moral incongruence, masturbation, partner effects, trauma) not assessed"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-31696/v1"}},{"id":501,"doi":"10.3389/fnbeh.2026.1821534","pmid":"42273399","pmcid":"PMC13246655","title":"Sex differences in compulsive sexual behavior disorder","authors":"Weinstein AM.","first_author":"Weinstein AM.","journal":"Frontiers in behavioral neuroscience","year":2026,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sex differences","Sexual Arousal","Compulsive Sexual Behavior","Hypersexuality","Sex Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13246655","cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of literature on sex differences in CSBD; systematic search described but no meta‑analytic methods, risk‑of‑bias assessment, or new empirical data.","sample_n":null,"sample_text":"Not applicable (review article).","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarizes research on how compulsive sexual behavior differs between men and women, noting higher prevalence in men, neurobiological differences, and the role of trauma and personality traits, especially in women.","clinical_takeaway":"Clinicians should note that CSBD may present differently by sex, but current evidence is limited; assessment should consider individual psychosocial and neurobiological factors.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Broad literature coverage of CSBD sex differences","Inclusion of neurobiological and psychosocial factors"],"limitations":["No systematic review methods or bias assessment","Lacks quantitative synthesis or meta‑analysis","No original data; conclusions rely on heterogeneous studies"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fnbeh.2026.1821534"}},{"id":502,"doi":"10.1177/10778012221077126","pmid":"35139710","pmcid":null,"title":"Nonconsensual Distribution of Sexually Explicit Images Within a Context of Coercive Control: Frequency, Characteristics, and Associations with Other Forms of Victimization","authors":"Dardis CM, Richards EC.","first_author":"Dardis CM","journal":"Violence against women","year":2022,"pub_types":["Journal Article"],"keywords":["Intimate Partner Violence","Coercive Control","Image-based Sexual Abuse","Nonconsensual Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 496 undergraduates reporting nonconsensual image distribution and other victimization.","sample_n":496,"sample_text":"Undergraduates (n = 496).","population":"Undergraduate students (convenience sample).","country":"Not specified in abstract","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among 496 college students, about 17% reported having their private sexual images shared without consent, mostly women. Victims often also experienced other forms of partner violence.","clinical_takeaway":"Clinicians should screen for image‑based abuse when clients report intimate partner violence.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large undergraduate sample for a sensitive topic","Highlights co‑occurrence of image‑based abuse with other violence"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on self‑report, unclear measurement validation","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":46,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10778012221077126"}},{"id":503,"doi":"10.21203/rs.3.rs-27440/v1","pmid":null,"pmcid":null,"title":"Psychosocial Distress and Exposure to Sexually Explicit Materials as Correlates of Sexual Intercourse among Adolescents in Dodoma–Tanzania","authors":"Hussein A, Ismail A, Malero A, Dadi H, Charles J, Sando M, Fawzi W, Vuai S.","first_author":"Hussein A","journal":"Research Square","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-27440/v1.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 1,226 adolescents from five villages in Tanzania, stratified random sampling, weighted logistic regression.","sample_n":1226,"sample_text":"Stratified random sample of adolescents from five villages; weighted analysis to account for design.","population":"Adolescents aged 10‑19 in Dodoma Region, Tanzania (N=1,226)","country":"Tanzania","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,226 Tanzanian adolescents found that those who felt more psychosocial distress or who had seen sexually explicit material were more likely to report having had sex. The study suggests that mental‑health support and limiting exposure to explicit content could help reduce risky sexual behavior.","clinical_takeaway":"Addressing psychosocial distress and limiting adolescents’ exposure to explicit material may lower sexual risk behaviours.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, stratified random sample of adolescents","Weighted logistic regression with confidence intervals","Includes several demographic covariates"],"limitations":["Key exposures measured with simple self‑report items, no validated scales","Cross‑sectional design prohibits causal inference","Moral incongruence, masturbation, trauma not assessed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-27440/v1"}},{"id":504,"doi":"10.1590/0034-7167-2021-0061","pmid":"34320146","pmcid":null,"title":"Factors associated with unprotected sex in people who consume sexually explicit media","authors":"Araújo TME, Almeida PD, Chaves AFCP, Sousa ECDCL, Nunes RV, Sousa ÁFL, Fronteira I.","first_author":"Araújo TME","journal":"Revista brasileira de enfermagem","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.scielo.br/j/reben/a/3rDhBnjr8dsjkbqcTY5BMVx/?lang=en&format=pdf","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 172 SEM users recruited via social media; Poisson regression used to identify predictors of condomless sex.","sample_n":172,"sample_text":"172 participants selected through social media.","population":"Adults (age not specified) who consume sexually explicit media; convenience sample.","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 172 Brazilian adults who watch pornography, those who preferred scenes showing unprotected sex or watched more porn scenes per week were more likely to report not using condoms in their own sexual encounters.","clinical_takeaway":"Clinicians should note that exposure to pornographic content depicting condom‑less sex may be linked to riskier sexual practices, but causality is not established.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Relatively large sample for a niche topic","Uses multivariable regression with confidence intervals"],"limitations":["Convenience, self‑selected sample via social media","Ad‑hoc, unvalidated questionnaires","No measurement of key confounders (e.g., mental health, relationship status)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/0034-7167-2021-0061"}},{"id":505,"doi":"10.1186/s40359-026-05196-9","pmid":"42745341","pmcid":"PMC13579905","title":"Non-consensual sexting among adolescents from ethnocultural minority backgrounds: the role of native peer pressure, self-control, and sexual preoccupation","authors":"Chasapis D, Touloupis T.","first_author":"Chasapis D","journal":"BMC psychology","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Adolescence","Self-control","Sexual Preoccupation","Ethnocultural Minorities","Non-consensual Sexting","Native Peer Pressure"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13579905","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 293 minority adolescents from randomly selected public junior‑high schools in Greece; examined self‑reported non‑consensual sexting roles and predictors (peer pressure, self‑control, sexual preoccupation).","sample_n":293,"sample_text":"293 students (59% boys) from minority groups; schools randomly selected in two Greek regions.","population":"Adolescents (mean age 14.9) from ethnocultural minority backgrounds (Albania, Bulgaria, others) attending public junior high schools in Greece.","country":"Greece","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 293 minority adolescents in Greece, sending and receiving non‑consensual sexts were common. Pressure from native peers predicted this behavior, while higher self‑control reduced it. Sexual preoccupation had a smaller effect. No gender differences were found.","clinical_takeaway":"Interventions should target peer‑pressure dynamics and strengthen self‑control to curb non‑consensual sexting in minority youth.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, reasonably sized sample for adolescent survey","Random selection of schools improves representativeness","Focus on understudied minority groups"],"limitations":["Cross‑sectional design limits causal inference","No native‑born comparison group","Unclear whether measurement scales are validated"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s40359-026-05196-9"}},{"id":506,"doi":"10.1016/j.adolescence.2019.01.006","pmid":"30754014","pmcid":null,"title":"The components of the adolescent brain and its unique sensitivity to sexually explicit material","authors":"Brown JA, Wisco JJ.","first_author":"Brown JA","journal":"Journal of adolescence","year":2019,"pub_types":["Review","Journal Article"],"keywords":["Neuroplasticity","Adolescence","Adolescent Brain Development","Sexualization","Pornography","Sexually Explicit Material"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative literature review without systematic methods or meta‑analysis; no empirical sample","sample_n":null,"sample_text":"none (review only)","population":"adolescents (conceptual focus only)","country":"USA (journal based)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review how teenage brain development—immature prefrontal control, sensitive reward circuits, and hormonal changes—might make adolescents more responsive to pornographic material, but note that direct studies are lacking.","clinical_takeaway":"No firm clinical guidance; recognize possible heightened sensitivity but await empirical research.","confidence":0.7,"topic_tags":["adolescents","neuroscience","pornography","sexual_function"],"strengths":["Clear synthesis of neurodevelopmental literature","Identifies gap in empirical data"],"limitations":["No systematic search or bias assessment","No original data or quantitative analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":12,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2019.01.006"}},{"id":507,"doi":"10.1007/s10508-026-03413-5","pmid":"41843275","pmcid":"PMC13194284","title":"Development and Characteristics of Sexting from Age 14 to 18 Years in a Norwegian Birth Cohort","authors":"Steinsbekk S, Nesi J, Choukas-Bradley S, Wichstrøm L.","first_author":"Steinsbekk S","journal":"Archives of sexual behavior","year":2026,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Adolescents","Social Media","Sexting","Receiving","Trondheim Early Secure Study","Sending"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13194284","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"birth cohort assessed at ages 14, 16, 18 (N=743); repeated‑measures analysis of sexting frequency and stability","sample_n":743,"sample_text":"Analytical sample of 743 adolescents from the Trondheim Early Secure Study","population":"Norwegian adolescents (birth cohort), 53.7% female","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Norwegian cohort of 743 teens, sending and receiving sexts became more common from age 14 to 18, with receiving more frequent than sending. Most sexts were shared on familiar social‑media apps and with romantic partners, though contact with unknown senders rose with age.","clinical_takeaway":"Sexting appears as a normal part of adolescent sexual development; clinicians should differentiate consensual peer sexting from risky interactions with unknown peers.","confidence":0.78,"topic_tags":["adolescents","sexual_function","prevalence"],"strengths":["Large, population‑based birth cohort","Three measurement waves allow assessment of stability","Differentiates sending vs. receiving and platform type"],"limitations":["Self‑report sexting items likely unvalidated and single‑item","No measurement of moral, mental‑health or trauma confounds","No effect‑size reporting or power justification in abstract"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[{"status":"Has correction","date":"2026-4-16","noticeDoi":"10.1007/s10508-026-03486-2","doi":"10.1007/s10508-026-03413-5"}],"url":"https://scite.ai/reports/10.1007/s10508-026-03413-5"}},{"id":509,"doi":"10.3390/ijerph182413089","pmid":"34948697","pmcid":"PMC8701317","title":"Gender Differences in How Parents, Peers, and Exposure to Sexually Explicit Materials Influence the Intention to Engage in Casual Sex among Adolescents and Young Adults in Taiwan: Applying the Theory of Planned Behavior","authors":"Tseng YH, Hou WL, Kuo SH, Liu YH, Wang HL, Hsiao RC, Chou FH, Yen CF.","first_author":"Tseng YH","journal":"International journal of environmental research and public health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Parent","Theory Of Planned Behavior","Peer","Casual Sex","Gender Gap","Sexually Explicit Material"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/18/24/13089/pdf?version=1639214998","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 767 Taiwanese adolescents/young adults (15‑24) examining parent, peer, and sexually explicit material exposure as predictors of intention to engage in casual sex using TPB constructs; multiple regression and SEM analyses","sample_n":767,"sample_text":"convenience community sample (not nationally representative)","population":"adolescents and young adults, Taiwan, 15‑24 years, 348 men, 419 women","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Taiwanese survey of 767 youths, discussions with parents, peer talks about sex, and seeing sexually explicit material were linked to stronger intentions to have casual sex, with different patterns for men and women.","clinical_takeaway":"Exposure to explicit material and peer influence are associated with intentions for casual sex; clinicians should consider these social factors when discussing sexual decision‑making with adolescents.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large sample size for a single‑site survey","use of Theory of Planned Behavior framework","separate analysis by gender"],"limitations":["cross‑sectional design cannot establish causality","self‑report measures, no validated scales for exposure or attitudes","no control for moral, mental‑health, or trauma confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph182413089"}},{"id":510,"doi":"10.1016/j.pedhc.2023.11.009","pmid":"38085200","pmcid":null,"title":"Re-envisioning Youth Sexual Health Care: Supporting Sex Positivity in a Digital World","authors":"Kuzma EK, Ammerman BA, Lee V, Baird J.","first_author":"Kuzma EK","journal":"Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners","year":2024,"pub_types":["Review","Journal Article"],"keywords":["Youth Sexual Health","Pornography Literacy","Sex Positivity","Safe Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review offering practice recommendations; no original data collected.","sample_n":null,"sample_text":"Not applicable – review article","population":"Youth (adolescents) – not sampled directly in this paper","country":"United States (journal of a U.S. professional association)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews how clinicians can support teenagers’ sexual health in a digital age, urging a sex‑positive approach that includes teaching about pornography, sexting, and consent.","clinical_takeaway":"Clinicians should incorporate digital media literacy and sex‑positive counseling into adolescent sexual‑health visits.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Integrates recent literature for clinicians","Focuses on a sex‑positive, health‑promoting framework","Practical resources for nurse practitioners"],"limitations":["No empirical data; recommendations not empirically tested","Does not address key confounds (e.g., moral incongruence, mental‑health covariates)","Lacks systematic review methodology"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pedhc.2023.11.009"}},{"id":512,"doi":"10.1093/jsxmed/qdag248","pmid":"42614121","pmcid":null,"title":"The relationship between erotophobia-erotophilia and decision-making in response to sexual stimuli","authors":"Amezcua-Gutiérrez C, Frías-Dimas A, Iribe-Burgos A, Hernández-González M, García-Hernández JP.","first_author":"Amezcua-Gutiérrez C","journal":"The journal of sexual medicine","year":2026,"pub_types":["Journal Article"],"keywords":["decision-making","Sexual Arousal","Executive Functions","Sexual Stimuli","Erotophobia–erotophilia"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Within‑subjects laboratory experiment with sexual vs non‑sexual decision‑making task; counterbalanced conditions; N=70 healthy heterosexual men (18‑30).","sample_n":70,"sample_text":"Seventy healthy heterosexual men aged 18‑30 were recruited.","population":"young adult heterosexual men (convenience sample)","country":"Not stated (presumed Mexico based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 70 young heterosexual men, seeing sexual pictures made decision‑making slower, but this effect was the same whether participants liked or disliked sexual material. Attitudes toward sex did not predict performance.","clinical_takeaway":"Sexual cues can impair decision‑making regardless of personal attitudes; the SOS does not help predict such effects.","confidence":0.78,"topic_tags":["sexual_function","csbd"],"strengths":["Experimental manipulation of sexual vs non‑sexual stimuli","Use of validated attitude measure (SOS)","Counterbalanced within‑subject design"],"limitations":["Small, homogeneous convenience sample limits generalizability","No power calculation or effect‑size reporting","No measurement of potential psychological confounds"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdag248"}},{"id":513,"doi":"10.21203/rs.3.rs-6107603/v1","pmid":null,"pmcid":null,"title":"Expressions of Consent and Pleasure: The Development and Initial Validation of Sexual Video Clips Specifically Created for Sex Research","authors":"Carrito ML, Nobre P, Janssen E.","first_author":"Carrito ML","journal":"Research Square","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-6107603/v1","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study of video stimuli with 50 heterosexual men rating arousal, emotions, and consent cues","sample_n":50,"sample_text":"50 heterosexual men, likely convenience sample","population":"adult heterosexual men (N=50)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created three short sexual videos that varied in how clearly consent was shown. In a test with 50 heterosexual men, the videos produced different levels of arousal and emotional reactions, showing the clips can be useful tools for studying sexual aggression and consent perception.","clinical_takeaway":"None – the study provides research tools rather than direct clinical guidance.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["development of standardized, consent‑focused sexual stimuli","use of validated sexual excitation/inhibition scales","within‑subject design allows direct comparison of video conditions"],"limitations":["small convenience sample (N=50)","no measurement of moral or religiosity factors despite assessing distress","reliance on self‑report ratings without physiological validation"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-6107603/v1"}},{"id":514,"doi":"10.12688/f1000research.150657.2","pmid":"39866731","pmcid":"PMC11757915","title":"Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India","authors":"Manya SM, K J, Mithra P, Galagali PM, Ommen SJ.","first_author":"Manya SM","journal":"F1000Res","year":2025,"pub_types":["Preprint"],"keywords":["Sexual Orientation","Gender Identity","Adolescent Boys","Pornography","Smartphone Addiction","Problematic Smartphone Usage"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11757915","cited_by_count":1,"is_preprint":true,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 134 medical university male students, convenience sample","sample_n":134,"sample_text":"Medical university students, convenience sampling","population":"Late adolescent boys (18‑19 y) in health‑sciences colleges, South India","country":"India","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 134 Indian university boys found that almost half showed problematic smartphone use and most had seen porn online. The study explored whether heavy smartphone use was linked to how they described their gender identity and sexual orientation, but it did not control for factors like religious views or mental health.","clinical_takeaway":"No direct clinical guidance; the findings are preliminary and should not be used to claim smartphone use causes changes in sexuality.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Uses a validated smartphone addiction scale","First data on sexuality development among Indian adolescent males","High reported exposure to pornographic material"],"limitations":["Cross‑sectional, cannot infer causality","Convenience sample of medical students limits generalisability","Sexuality development measured with non‑validated questionnaire","No control for key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12688/f1000research.150657.2"}},{"id":515,"doi":"10.1016/j.actpsy.2025.105688","pmid":"41066854","pmcid":null,"title":"Online sexual abuse, sexting, and bullying among adolescents with and without ADHD: A cross-sectional study in a Turkish sample","authors":"Ozdag V, Yuce S, Soylu N.","first_author":"Ozdag V","journal":"Acta psychologica","year":2025,"pub_types":["Journal Article"],"keywords":["Logistic regression","Academic Performance","Cyberbullying","Attention-deficit/hyperactivity Disorder (Adhd)","Sexting","Adhd Treatment","Online Sexual Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional study of 118 adolescents with ADHD and 117 controls, clinical diagnosis confirmed by K‑SADS, logistic regression analysis","sample_n":235,"sample_text":"118 ADHD, 117 controls","population":"Adolescents (Turkey), clinical ADHD sample plus community controls","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Adolescents with ADHD were almost twice as likely to experience online sexual abuse and sexting compared with peers, especially if they performed poorly in school. Early ADHD treatment and academic support may reduce these risks.","clinical_takeaway":"Screen adolescents with ADHD for online sexual risk and ensure timely treatment and academic support.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Validated diagnostic interview (K‑SADS)","Use of established scales (Conners, Online Sexual Abuse Scale)","Reasonable total sample size for logistic regression"],"limitations":["Cross‑sectional design limits causal inference","Clinical ADHD sample may not represent all adolescents with ADHD","Limited control for mental‑health comorbidities and broader confounders"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.actpsy.2025.105688"}},{"id":516,"doi":"10.1007/s10508-021-02238-8","pmid":"35727464","pmcid":null,"title":"Performer Roles and Behaviors in Dyadic Sexually Explicit Media Featuring Men Who Have Sex with Men","authors":"Newton JDA, Halford WK, Oviedo-Trespalacios O, Barlow FK.","first_author":"Newton JDA","journal":"Archives of sexual behavior","year":2022,"pub_types":["Journal Article"],"keywords":["Content analysis","Sexual Orientation","Lgbt","Self-identity","Homosexual","Sexually Explicit Media"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"content analysis of 220 most‑viewed MSM SEM videos; descriptive and comparative coding of intimacy, victimisation and sexual behaviours by sexual role (top vs bottom)","sample_n":220,"sample_text":"220 of the most viewed online dyadic MSM SEM videos","population":"online dyadic MSM sexually explicit media (SEM) videos; no human participants","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined 220 popular gay male porn videos and found that performers playing the insertive role (tops) and receptive role (bottoms) showed similar intimacy, but bottoms more often started sex, while tops showed slightly more victim‑like behaviours.","clinical_takeaway":"None – the findings describe media depictions and do not inform clinical practice.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["large sample of high‑viewed videos","focus on observable behaviour rather than self‑report","adds nuance to understanding of role‑based depictions"],"limitations":["unclear whether coding scheme was validated","convenience sample of popular videos may not represent broader SEM","no assessment of audience interpretation or real‑world impact"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02238-8"}},{"id":517,"doi":"10.13109/prkk.2022.71.4.362","pmid":"35673784","pmcid":null,"title":"[School-based Prevention of the Abusive Dissemination of Sexually Explicit Images on the Internet: Development and Evaluation of the SPuR Program]","authors":"Nestler C, Endres A, Schiller EM.","first_author":"Nestler C","journal":"Praxis der Kinderpsychologie und Kinderpsychiatrie","year":2022,"pub_types":["Journal Article"],"keywords":["Evaluation","Prevention","Adolescence","School","Prävention","Jugendalter","Sexting","Schule"],"is_oa":false,"oa_url":"https://doi.org/10.13109/prkk.2022.71.4.362","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"pre‑post single‑group evaluation with follow‑up in grades 6‑7 (N=132)","sample_n":132,"sample_text":"students from one school; convenience sample","population":"adolescents (mean age 12.1 y)","country":"Germany (assumed from journal language)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A school program teaching 12‑year‑olds about privacy and safe sexting increased their knowledge and coping strategies, but slightly reduced how critical they were about sexting.","clinical_takeaway":"Programs can improve teens’ knowledge and coping with unwanted image sharing, though effectiveness should be tested against a control group.","confidence":0.8,"topic_tags":["sexual_function","adolescents","prevalence"],"strengths":["Large single‑school sample for a pilot intervention","Multiple outcome domains (knowledge, attitudes, coping strategies)","Follow‑up measurement to assess durability"],"limitations":["No control/comparison group; causal claims overstated","Outcomes measured with study‑specific questionnaires, not validated scales","Potential school‑level selection bias; limited generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.13109/prkk.2022.71.4.362"}},{"id":518,"doi":"10.3390/bs15060781","pmid":"40564563","pmcid":"PMC12189664","title":"Dark Triad Traits, Sex, and Social Desirability as Predictors of Non-Consensual Intimate Media Sharing Proclivity, Enjoyment, and Approval in UK University Students","authors":"Kite C, Murphy A, Colloff MF.","first_author":"Kite C","journal":"Behavioral sciences (Basel, Switzerland)","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Narcissism","Psychopathy","Machiavellianism","Revenge Pornography","Dark Triad Traits","Non-consensual Intimate Media Sharing"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12189664","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 653 UK university students recruited via Prolific, university mailing list and social media; self‑report questionnaires; multiple linear regression analyses","sample_n":653,"sample_text":"participants recruited through Prolific, university survey circle and social media","population":"university students (UK)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 653 UK university students, higher psychopathy predicted a greater willingness to share non‑consensual intimate images, while Machiavellianism and male sex predicted higher enjoyment of such behavior.","clinical_takeaway":"Interventions targeting personality traits such as psychopathy may help reduce risk of non‑consensual intimate media sharing.","confidence":0.7,"topic_tags":["religiosity","moral_incongruence","sexual_function"],"strengths":["large sample (N>600)","use of validated Dark Triad measures","clear statistical modeling"],"limitations":["ad‑hoc NCIMS measures lack validation","cross‑sectional design cannot infer causality","no control for moral or psychosocial confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs15060781"}},{"id":519,"doi":"10.1371/journal.pone.0275246","pmid":"36166441","pmcid":"PMC9514651","title":"Effects of exposure to sexually explicit material on sexually violent behavior among first-year university men in Vietnam","authors":"Bergenfeld I, Cheong YF, Minh TH, Trang QT, Yount KM.","first_author":"Bergenfeld I","journal":"PloS one","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0275246&type=printable","cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"cohort of 739 first‑year male university students surveyed at three time points over 14 months; propensity‑score adjustment used to estimate average treatment effects of SEM exposure on sexual violence outcomes.","sample_n":739,"sample_text":"739 first‑year male university students, Vietnam","population":"first‑year university men in Vietnam (N=739)","country":"Vietnam","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 14‑month study of 739 Vietnamese university men, exposure to violent sexual media was linked to a small increase in self‑reported sexual violence, especially among frequent viewers, though the authors note possible unmeasured factors.","clinical_takeaway":"Media‑literacy interventions may help reduce sexual violence risk, but evidence is correlational.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, multi‑wave cohort","Use of propensity‑score adjustment","Dose‑response analysis with latent class approach"],"limitations":["Self‑report measures, likely unvalidated","Unspecified confounders, possible omitted variable bias","Causal language despite observational design"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":23,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0275246"}},{"id":520,"doi":"10.1371/journal.pone.0230242","pmid":"32275669","pmcid":"PMC7147756","title":"Exposure to sexually explicit media in early adolescence is related to risky sexual behavior in emerging adulthood","authors":"Lin WH, Liu CH, Yi CC.","first_author":"Lin WH","journal":"PloS one","year":2020,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","research-article","Multicenter Study","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7147756","cited_by_count":40,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort of Taiwanese adolescents followed from age 13 to 24; exposure to sexually explicit media measured in 8th grade, outcomes measured at ages 20 and 24; instrumental variable (pubertal timing) used for causal inference","sample_n":null,"sample_text":"participants recruited from Taiwan Youth Project; all were in 7th grade (mean age = 13.3) at baseline; follow‑up at ages ≈ 20 and ≈ 24","population":"Taiwanese adolescents (baseline N not reported in abstract)","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A Taiwanese cohort study found that teens who saw sexually explicit media were more likely to have early sexual debut, unsafe sex, and multiple partners in their twenties. The authors used a statistical technique (instrumental variables) to argue the relationship is likely causal.","clinical_takeaway":"Early exposure to explicit media may increase later risky sexual behavior; clinicians might consider media‑literacy counseling for adolescents.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Longitudinal design with two adult follow‑up waves","Use of instrumental variable to address endogeneity","Large‑scale community sample from a national cohort"],"limitations":["Key confounders (moral attitudes, mental health, relationship status) not measured","No detail on validation of exposure or outcome measures","Causal language exceeds what IV analysis can definitively prove"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":3,"mentioning":67,"citing_publications":111,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0230242"}},{"id":521,"doi":"10.1177/0886260520967150","pmid":"33107385","pmcid":null,"title":"Social Anxiety as a Consequence of Non-consensually Disseminated Sexually Explicit Media Victimization","authors":"Campbell JK, Poage SM, Godley S, Rothman EF.","first_author":"Campbell JK","journal":"Journal of interpersonal violence","year":2022,"pub_types":["Journal Article"],"keywords":["Social Isolation","Social Anxiety","Sexual Violence","Revenge Pornography","Non-consensual Pornography","Sexually Explicit Media Abuse","Image-based Sexual Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative interview study with 17 self‑identified survivors of non‑consensual dissemination of sexually explicit media, using flexible coding of telephone interviews.","sample_n":17,"sample_text":"N=17 survivors recruited for telephone interviews","population":"Survivors of NCDSEM (n=17, self‑selected)","country":"USA (assumed from authors’ affiliations; not stated in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 17 people whose private sexual images were shared without consent revealed that the experience can lead to heightened social anxiety, fear of public situations, relationships, jobs, and help‑seeking, as well as depression.","clinical_takeaway":"Clinicians should assess for social anxiety and avoidance in clients who have experienced non‑consensual pornography.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight from survivors","Focus on a specific, under‑researched form of sexual violence","Clear thematic presentation of consequences"],"limitations":["Small, self‑selected sample limits generalisability","No validated quantitative measures of anxiety","Potential recall bias in retrospective interviews"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":63,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260520967150"}},{"id":522,"doi":"10.1177/08862605241301798","pmid":"39660668","pmcid":null,"title":"Comparative and Combined Associations of Nonconsensual Distribution of Sexually Explicit Materials and Interpersonal Violence on Psychological Distress","authors":"Fahmy L, Piper CM, Dardis CM.","first_author":"Fahmy L","journal":"Journal of interpersonal violence","year":2025,"pub_types":["Comparative Study","Journal Article"],"keywords":["Posttraumatic Stress Disorder","Emerging Adults","Image-based Sexual Abuse","Technology-facilitated Sexual Violence","Nonconsensual Distribution"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional survey of undergraduate students (N≈650) examining PTSD and depression outcomes among victims of non‑consensual image distribution versus other interpersonal violence.","sample_n":650,"sample_text":"Undergraduate sample with groups: NCD victims (n=224), IPV‑only victims (n=231), NCD‑combined (n=183), NCD‑only (n=41).","population":"Emerging adult undergraduates (likely WEIRD, convenience sample).","country":"Not specified (presumably USA based on authors).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among college students, being victimised by non‑consensual sharing of sexual images was linked to higher rates of PTSD and depression than experiencing other forms of interpersonal violence alone.","clinical_takeaway":"Clinicians should assess for image‑based sexual abuse when treating trauma‑related distress.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large undergraduate sample","Use of validated PTSD and depression scales","Clear comparison groups","Regression analysis controlling for IPV frequency"],"limitations":["Cross‑sectional design cannot infer causality","Convenience sample limits generalisability","Limited control for broader mental‑health or trauma histories"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605241301798"}},{"id":523,"doi":"10.1038/s41598-025-22527-9","pmid":"41188329","pmcid":"PMC12586596","title":"Expressions of consent and pleasure: the development and initial validation of sexual video clips specifically created for sex research","authors":"Carrito ML, Nobre P, Janssen E.","first_author":"Carrito ML","journal":"Scientific reports","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Consent","Sexual Arousal","Sexual Aggression","Affective Responses","Sex Research","Sexually Explicit Videos"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12586596","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study with 50 heterosexual men viewing three sexual video clips; within‑subject self‑report measures of arousal, emotions, and consent perception.","sample_n":50,"sample_text":"50 heterosexual men","population":"adult heterosexual men (N=50), likely convenience sample","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created three short sexual videos that differ in how much consent is shown. In a test with 50 heterosexual men, the videos reliably produced distinct levels of arousal and emotion, showing the clips can be useful tools for studying sexual response and aggression.","clinical_takeaway":"These validated clips can help researchers study sexual arousal and consent perception more precisely, but they are not yet proven for clinical assessment.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Innovative, purpose‑built stimulus set","Systematic validation across multiple affective dimensions","Inclusion of consent and distress cues"],"limitations":["Small, homogenous sample (heterosexual men only)","Reliance on single‑item self‑report ratings","No physiological or behavioral validation"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-025-22527-9"}},{"id":524,"doi":"10.1007/s10508-022-02401-9","pmid":"36036867","pmcid":"PMC9859855","title":"Exposure to Sexually Explicit Materials and Feelings after Exposure among Adolescents in Nine European Countries: The Role of Individual Factors and Social Characteristics","authors":"Lebedíková M, Mýlek V, Subrahmanyam K, Šmahel D.","first_author":"Lebedíková M","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Adolescents","Parental Mediation","Sexually Explicit Material","Cross-national Sampling"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9859855","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑national survey of 8,820 adolescents (11‑16 y) from nine European countries, assessing self‑reported exposure to sexually explicit material, individual traits (sensation seeking, emotional problems) and parental mediation, plus emotional reactions after exposure.","sample_n":8820,"sample_text":"Large community‑based survey; sampling method not specified (likely convenience school sample).","population":"Adolescents aged 11‑16 (N≈8820) from schools in nine European countries","country":"Czech Republic, Finland, Malta, Poland, Portugal, Romania, Serbia, Spain, Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","selective_reporting"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 8,800 European teens found that many have seen sexually explicit material, but most report neutral feelings afterward. Sensation‑seeking and emotional problems predicted exposure, while parental mediation had mixed effects.","clinical_takeaway":"Exposure to sexual material is not automatically distressing for adolescents; clinicians should assess individual emotional responses rather than assume harm.","confidence":0.78,"topic_tags":["adolescents","pornography","sexual_function","moral_incongruence"],"strengths":["Large multi‑country sample","Considers both individual and parental factors","Reports emotional reactions rather than only prevalence"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral/religious attitudes that may shape feelings","Exposure and feelings self‑reported, possible bias"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":9,"retracted":false,"notices":[{"status":"Has correction","date":"2022-10-20","noticeDoi":"10.1007/s10508-022-02448-8","doi":"10.1007/s10508-022-02401-9"},{"status":"Has correction","date":"2023-1-9","noticeDoi":"10.1007/s10508-022-02527-w","doi":"10.1007/s10508-022-02401-9"},{"status":"Has erratum","date":"2022-10-20","noticeDoi":"10.1007/s10508-022-02448-8","doi":"10.1007/s10508-022-02401-9"}],"url":"https://scite.ai/reports/10.1007/s10508-022-02401-9"}},{"id":525,"doi":"10.53738/revmed.2024.20.862.400","pmid":"38380662","pmcid":null,"title":"[Access to digital pornography by children and teenagers: when should you be alerted?]","authors":"Winkler M, Calore L, Bornand L, Fol J, Staehlin M, Jacot-Descombes C, Edan A.","first_author":"Winkler M","journal":"Revue medicale suisse","year":2024,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary/Opinion piece without original empirical data; no sample size reported.","sample_n":null,"sample_text":"No empirical sample; discussion based on literature and expert opinion.","population":"children and adolescents (theoretical focus)","country":"Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how digital pornography is increasingly accessible to children and teenagers, raises questions about its impact on development, and suggests that health professionals should help prevent unwanted exposure and address possible problem situations.","clinical_takeaway":"Clinicians should be alert to possible unwanted porn exposure in youth and be prepared to discuss it, but evidence on harmful effects remains limited.","confidence":0.85,"topic_tags":["pornography","adolescents","sexual_function","prevalence"],"strengths":["Addresses timely public‑health issue","Frames clinical role for professionals","Considers family context"],"limitations":["No original data or systematic review methodology","Lacks empirical measurement of constructs","No control for key confounds (moral incongruence, mental health, etc.)","Conclusions about ‘addiction’ are speculative"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.53738/revmed.2024.20.862.400"}},{"id":526,"doi":"10.1007/s10508-021-02122-5","pmid":"35001225","pmcid":"PMC8743091","title":"Adolescents' Use of Sexually Explicit Internet Material Over the Course of 2019-2020 in the Context of the COVID-19 Pandemic: A Three-wave Panel Study","authors":"Maes C, Vandenbosch L.","first_author":"Maes C","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Adolescents","Latent Growth Modeling","Pornography","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8743091","cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"three-wave panel study of 522 adolescents over 15 months","sample_n":522,"sample_text":"522 adolescents (M age = 15.36, SD = 1.51; 67.1% girls)","population":"adolescents (mean age 15.4, 67% girls) in Belgium","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A three‑wave study of 522 Belgian teens found that overall use of online porn did not rise during the COVID‑19 lockdown, but girls increased use more than boys. Teens reported watching mainly to feel aroused, relieve stress or boredom, with loneliness being a less common reason.","clinical_takeaway":"Adolescent porn use remained stable during lockdown; clinicians should consider gender‑specific patterns and stress‑related motivations when discussing online sexual material with youths.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","csbd"],"strengths":["Large panel sample (N>500) with three measurement points","Use of latent growth curve modeling to examine change over time","Explores a range of individual‑difference moderators"],"limitations":["Reliance on self‑report frequency without validated SEIM scales","No assessment of key confounds (e.g., moral incongruence, mental health)","Convenience sample limits generalisability beyond Belgian adolescents"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02122-5"}},{"id":528,"doi":"10.1155/2020/8105087","pmid":"32455048","pmcid":"PMC7238327","title":"Assessment of Exposure to Sexually Explicit Materials and Substance Abuse among High-School Adolescents in North Shewa Zone: Application of Logistic Regression Analysis","authors":"Woldeamanuel BT, Anteneh LM, Yohannes YB, Aga MA.","first_author":"Woldeamanuel BT","journal":"Journal of addiction","year":2020,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7238327","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of high‑school adolescents in one Ethiopian zone, using a self‑administered questionnaire adapted from a validated youth survey.","sample_n":null,"sample_text":"not reported in abstract","population":"high‑school students in North Shewa zone, Oromia, Ethiopia","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of Ethiopian high‑school students found that about one‑third had seen sexually explicit material and nearly half had used substances. Boys, peer influence, family conflict and low school commitment were linked to higher exposure and use.","clinical_takeaway":"Screen adolescents for co‑occurring substance use and exposure to explicit material; address family and peer factors in prevention programs.","confidence":0.4,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Uses a previously validated youth survey instrument for substance‑use items","Large set of psychosocial variables examined","Reports odds ratios with confidence intervals"],"limitations":["Cross‑sectional design cannot infer causality","Exposure to explicit material measured with a single self‑report item","No assessment of moral incongruence, masturbation, mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2020/8105087"}},{"id":529,"doi":"10.3389/fpubh.2026.1762704","pmid":"42077978","pmcid":"PMC13131333","title":"Age assurance for online sexual content: applying the health policy triangle to UK early signals and transferable safeguards for sub-Saharan Africa","authors":"Nwuzoh MI, Eneh SC, Anokwuru CC, Ekwebene OC, John MO, Ogbet RB, Senibi R, Udoewah SA.","first_author":"Nwuzoh MI","journal":"Frontiers in public health","year":2026,"pub_types":["other","Journal Article"],"keywords":["Sub-Saharan Africa","Equity","Health Policy Triangle","Digital Governance","United Kingdom Online Safety Act","Age Assurance","Child Online Protection","Online Safety Regulation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13131333","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"Desk‑based policy analysis using legislation, guidance, civil‑society reports and early implementation documents; no primary empirical data on individuals.","sample_n":null,"sample_text":"Not applicable – no participant sample.","population":"Policy documents and implementation reports; no human participant sample.","country":"United Kingdom (policy focus) with discussion of sub‑Saharan Africa applicability","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors examine the UK’s new age‑verification system for online sexual content and discuss how its key design features could be adapted for child‑online‑protection policies in sub‑Saharan Africa.","clinical_takeaway":"None – the paper does not provide clinical evidence on pornography use or sexual health.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["Comprehensive review of UK legislation and early implementation reports","Clear framework (Health Policy Triangle) for policy analysis","Identifies concrete design elements for potential transfer"],"limitations":["No empirical data on user behaviour or outcomes","No systematic risk‑of‑bias assessment possible","Findings are interpretive, not evidence of effectiveness"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2026.1762704"}},{"id":530,"doi":"10.1016/j.jsxm.2018.06.008","pmid":"30078461","pmcid":null,"title":"Gender Differences in the Automatic Attention to Romantic Vs Sexually Explicit Stimuli","authors":"Carvalho J, Czop O, Rocha M, Nobre P, Soares S.","first_author":"Carvalho J","journal":"The journal of sexual medicine","year":2018,"pub_types":["Journal Article"],"keywords":["Attention","Emotions","Gender Differences","Subjective Sexual Arousal","Sexual Excitation","Romantic Stimuli","Sexually Explicit Stimuli"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory attention task with distractor pictures; within‑subject measures of RT/accuracy; cross‑sectional.","sample_n":56,"sample_text":"Convenience sample of university/ community volunteers (heterosexual).","population":"56 heterosexual young adults (26 women, 30 men)","country":"Portugal (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab task, men and women watched romantic or explicit pictures while ignoring them. Both sexes showed similar automatic attention to the pictures, but men found explicit images more arousing while women rated them less pleasant. Attention capture did not relate to how easily participants got sexually excited.","clinical_takeaway":"Therapies that use visual exposure should consider gender differences in how erotic material is subjectively experienced.","confidence":0.8,"topic_tags":["gender","sexual_function","csbd"],"strengths":["Innovative automatic‑attention paradigm applied to sexual stimuli","Both behavioral (RT) and subjective (self‑report) data collected","Gender‑balanced sample"],"limitations":["No measurement of key confounds (e.g., moral attitudes, mental health)","Modest sample size limits power for interaction effects","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2018.06.008"}},{"id":531,"doi":"10.1080/10410236.2022.2053272","pmid":"35341396","pmcid":null,"title":"Sexually Explicit Internet Media Consumption and Sexual Risk Behaviors Among Chinese Male Sexual Minorities: The Moderating Role of Perceived Realism","authors":"Li M, Liu Y, Zheng L.","first_author":"Li M","journal":"Health communication","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 360 Chinese male sexual minorities; measured SEIM frequency, content preference, perceived realism, and self‑reported sexual risk behaviors; analyses appear logistic regression.","sample_n":360,"sample_text":"360 participants recruited from online channels (convenience sample)","population":"Chinese male sexual minorities (gay, bisexual, other MSM); recruited via various online channels; N = 360","country":"China","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 360 Chinese gay and bisexual men, more frequent viewing of porn and a preference for condom‑less or group‑sex videos were linked to higher odds of risky sex, especially when participants thought the material was realistic.","clinical_takeaway":"Higher porn use and realism perception may signal greater sexual‑risk behavior; incorporate media literacy in HIV‑prevention counseling.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for survey (N=360)","Addresses culturally specific context (Chinese MSM)","Introduces perceived realism as moderator"],"limitations":["Cross‑sectional; cannot infer causality","Self‑report measures, likely single‑item, unvalidated","No control for key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2022.2053272"}},{"id":532,"doi":"10.5114/hpr.2020.99394","pmid":"38084230","pmcid":"PMC10694699","title":"Exposure to sexually explicit Internet material among adolescents: a study in Vietnam","authors":"Nguyen LV, Tran TH, Nguyen TTA, Nguyen DB, Beazley H, Giang MTT.","first_author":"Nguyen LV","journal":"Health psychology report","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Adolescent","Pornography","Sexually Explicit Internet Material","Exposure To Seim"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10694699","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 886 Vietnamese adolescents (15‑18 y) assessing self‑reported frequency of exposure to sexually explicit Internet material and associated psychosocial factors.","sample_n":886,"sample_text":"886 adolescents, 58 % female, mean age 16.7 y.","population":"Vietnamese adolescents, convenience sample from schools (likely).","country":"Vietnam","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 886 Vietnamese teens found that about 84 % had seen sexually explicit online material, with higher rates in boys. Seeking sexual excitement, believing the material realistic, and more leisure Internet use predicted higher exposure.","clinical_takeaway":"High prevalence of online porn exposure among adolescents suggests a need for comprehensive, early sex‑education programs.","confidence":0.8,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Large sample for a single‑country adolescent survey","Use of several previously validated psychosocial scales","Separate analysis of passive vs. active exposure"],"limitations":["Cross‑sectional design cannot infer causality","Convenience sampling limits generalisability","No measurement of moral, mental‑health or partner factors"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":8,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5114/hpr.2020.99394"}},{"id":534,"doi":"10.1016/j.jadohealth.2025.12.253","pmid":"41653178","pmcid":null,"title":"When Sexting Goes Wrong: The Extent of Nonconsensual Sharing and Sextortion Among U.S. Teens","authors":"Patchin JW, Hinduja S.","first_author":"Patchin JW","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2026,"pub_types":["Journal Article"],"keywords":["Risky Behavior","Sexting","Sextortion","Nonconsensual Sharing Of Intimate Images"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"national survey of 3,466 US adolescents, self‑report questionnaire, chi‑square and logistic regression analyses","sample_n":3466,"sample_text":"national sample of adolescents aged 13‑17 years in the United States","population":"U.S. adolescents ages 13‑17 (n=3,466)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A national survey of 3,466 U.S. teens found that about one‑third had sent or received explicit images. Among those who sent, half experienced non‑consensual sharing or sextortion, especially when the sext was sent to non‑partners.","clinical_takeaway":"Teens who sext, especially with non‑partners, face high risk of image‑sharing abuse and sextortion; preventive education is needed.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative adolescent sample","Clear prevalence estimates of sexting and related harms","Appropriate use of multivariate logistic regression"],"limitations":["Self‑report measures, no validated scales for sexting or sextortion","Cross‑sectional design limits causal inference","Key psychosocial confounds (e.g., mental health, moral attitudes) not assessed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2025.12.253"}},{"id":536,"doi":"10.1177/0886260519853414","pmid":"31189425","pmcid":null,"title":"Nonconsensual Sharing of Private Sexually Explicit Media Among University Students","authors":"Walker K, Sleath E, Hatcher RM, Hine B, Crookes RL.","first_author":"Walker K","journal":"Journal of interpersonal violence","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Consent","Sexting","Revenge Pornography","Image-based Sexual Abuse","Technology-facilitated Sexual Violence"],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 391 university students assessing self‑reported nonconsensual sharing, victimisation, pressures and motivations.","sample_n":391,"sample_text":"Convenience sample of young adults from a UK university.","population":"University students aged 18‑25 (UK)","country":"United Kingdom","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a UK university sample, about a third of students reported either sharing or having private sexual images shared without consent. Both men and women were involved, and those who felt pressured to send images were more likely to be victimised.","clinical_takeaway":"Clinicians should be aware that non‑consensual image sharing affects both genders and can co‑occur with relational pressure.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑university study","First UK data on prevalence of nonconsensual media sharing","Examines both perpetration and victimisation"],"limitations":["Cross‑sectional design, no causal inference","Reliance on self‑report, likely using non‑validated items","Limited control for key confounds (e.g., mental health, moral attitudes)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":2,"mentioning":91,"citing_publications":81,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260519853414"}},{"id":537,"doi":"10.1080/00224499.2023.2244939","pmid":"38973061","pmcid":null,"title":"Expanding the Sexual Experiences Survey to Include Technology Facilitated Sexual Exploitation","authors":"Kowalski R, Thompson M.","first_author":"Kowalski R","journal":"Journal of sex research","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"instrument development / item generation without validation data","sample_n":null,"sample_text":"not reported in abstract","population":"college students (implied)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors added ten new questions about online sexual exploitation to the Sexual Experiences Survey, so researchers can measure both in‑person and digital forms of sexual victimisation among college students.","clinical_takeaway":"None – the paper describes a new survey module, not clinical findings.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses a gap in measuring technology‑facilitated sexual exploitation","Provides clear item content mapped onto relevant domains","Extends a widely used instrument (SES‑V)"],"limitations":["No empirical validation or reliability data presented","Sample size and characteristics not described","No psychometric evaluation of the new items"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2244939"}},{"id":540,"doi":"10.4314/ejhs.v29i4.7","pmid":"31447519","pmcid":"PMC6689701","title":"Exposure to Sexually Explicit Materials and Its Association with Sexual Behaviors of Ambo University Undergraduate Students, 2018","authors":"Shallo SA, Mengesha WW.","first_author":"Shallo SA","journal":"Ethiopian journal of health sciences","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Risky Sexual Behaviors","Sexually Explicit Materials","Ambo University"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6689701","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Institutional based cross-sectional survey of 403 undergraduate students selected by systematic random sampling; self‑administered questionnaire; logistic regression analysis.","sample_n":403,"sample_text":"Systematic random sampling of university students; single university, not nationally representative.","population":"Ambo University undergraduate students, Ethiopia (N=403)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 403 Ethiopian university students, about half had seen sexually explicit material. Those who had viewed such material were more likely to report risky sexual behaviours, but the study cannot prove the media caused the risk.","clinical_takeaway":"Exposure to explicit media is linked to higher sexual risk among students, but clinicians should note the association does not establish cause and consider broader factors.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Large sample for a single university study","Systematic random sampling within campus","Use of multivariable logistic regression"],"limitations":["Self‑report measures, single‑item exposure variable","Cross‑sectional design cannot infer causality","No measurement of key confounders (e.g., moral attitudes, mental health)","Limited detail on outcome definitions"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4314/ejhs.v29i4.7"}},{"id":541,"doi":"10.1017/ipm.2025.10122","pmid":"41328033","pmcid":null,"title":"An investigation of gender-based differences in social media use, sexting behaviours and body dissatisfaction as risk factors for poor mental health and self-harm in adolescents: a cross-sectional population-based study","authors":"Cotter DS, Dooley N, Staines L, Power E, McCay S, Gallo K, Gupta A, Doyle L, Cotter DR, Cannon M.","first_author":"Cotter DS","journal":"Irish journal of psychological medicine","year":2025,"pub_types":["Journal Article"],"keywords":["Adolescence","Mental health","Body Image","Social Media","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"population-based survey of secondary school students in Ireland (urban and rural), linear mixed models, gender‑specific analysis","sample_n":null,"sample_text":"large community sample (exact N not reported in abstract)","population":"adolescents, mean age 15, recruited from schools in North Dublin, Cavan, Monaghan","country":"Ireland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large Irish school survey, teens who spent more than four hours a day on social media, felt dissatisfied with their bodies, or sent sexual messages were more likely to have poorer mental health and self‑harm behaviors, especially girls.","clinical_takeaway":"High digital use, body‑image concerns, and sexting are linked to worse adolescent mental health; monitor these factors in at‑risk youth.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, population‑based sample across urban and rural areas","Use of validated mental‑health instrument (SDQ)","Gender‑specific analysis"],"limitations":["Cross‑sectional design limits causal inference","Key exposures (sexting, body dissatisfaction) not described as validated measures","Potential unmeasured confounders (e.g., moral attitudes, mental‑health history) not reported"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/ipm.2025.10122"}},{"id":543,"doi":"10.31234/osf.io/ua2f4","pmid":null,"pmcid":null,"title":"Stopped cold: Motor-response inhibition reduces the capacity of sexually-explicit stimuli to elicit subjective and physiological sexual arousal","authors":"Clancy E, Driscoll RL, Codeluppi SA, Kukkonen TM, Fenske MJ.","first_author":"Clancy E","journal":"PsyArXiv","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/ua2f4","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Between‑subjects laboratory Go/No‑go task with subsequent viewing of explicit videos; N=116 undergraduate participants.","sample_n":116,"sample_text":"116 participants","population":"Undergraduates (convenience sample)","country":"unspecified (likely USA/Europe)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, people who were asked to withhold a button press when seeing sexual images later reported less sexual arousal and showed lower genital temperature while watching explicit videos, suggesting that motor inhibition can dampen the appeal of sexual cues.","clinical_takeaway":"Simple response‑inhibition tasks may reduce immediate sexual arousal, but relevance to clinical treatment is unclear.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Laboratory experimental design with control condition","Physiological measure (thermography) alongside self‑report","Adequate sample size for behavioral experiment"],"limitations":["Self‑report arousal scale not described as validated","No pre‑registration or reported effect sizes","Convenience undergraduate sample limits generalisability"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/ua2f4"}},{"id":544,"doi":"10.1177/1359105318788736","pmid":"30052084","pmcid":null,"title":"Exploring the way sexually explicit material informs sexual beliefs, understanding and practices of young men: A qualitative survey","authors":"Charles P, Meyrick J.","first_author":"Charles P","journal":"Journal of health psychology","year":2020,"pub_types":["Journal Article"],"keywords":["Qualitative","Sexual Health Promotion","Online Pornography","Sexually Explicit Material","Adolesecent Males"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative survey with thematic analysis of 11 participants recruited via snowball sampling within a single workplace.","sample_n":11,"sample_text":"Snowballed sample from one workplace; 11 of 40 invited responded.","population":"Young men aged 18‑25 (N≈11)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small interview‑style survey of 11 young men suggested they think online porn makes sexual expectations unrealistic and may affect attitudes, but family openness or sex education might buffer these effects.","clinical_takeaway":"Clinicians should note that some young men report confusion about real versus pornographic sexual expectations, but evidence is limited and not generalisable.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Provides rich, first‑person accounts of how young men perceive porn’s influence","Uses thematic analysis to identify multiple nuanced themes"],"limitations":["Very small, non‑representative sample (N=11) limits generalisability","No validated instruments; constructs are loosely defined","No measurement or control of key confounds (moral incongruence, masturbation, mental health, etc.)"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1359105318788736"}},{"id":545,"doi":"10.1136/medhum-2021-012341","pmid":"35319485","pmcid":null,"title":"Sparing the doctor's blushes: the use of sexually explicit films for the purpose of Sexual Attitude Reassessment (SAR) in the training of medical practitioners in Britain during the 1970s","authors":"Irwin R.","first_author":"Irwin R.","journal":"Medical humanities","year":2023,"pub_types":["Journal Article"],"keywords":["History","Medical education","Public Health","psychotherapy","Sexual Medicine"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical/qualitative commentary without empirical data","sample_n":null,"sample_text":"None – archival and literature review","population":"British medical students in the 1970s (historical focus)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews 1970s British medical school seminars that showed sexually explicit films to help future doctors discuss patients' sexual issues, highlighting educational goals, barriers, and contrasting counselling styles of the era.","clinical_takeaway":"None – the paper is historical and does not provide clinical guidance on pornography or sexual health.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Rich historical archival analysis","Contextualizes early medical education on sexuality"],"limitations":["No empirical data or measurement of outcomes","Cannot inform current pornography‑related health effects"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/medhum-2021-012341"}},{"id":546,"doi":"10.1080/15546128.2023.2233414","pmid":"39171277","pmcid":"PMC11335322","title":"Pornography Use, Perceived Peer Norms, and Attitudes Toward Women: A Study of College Men","authors":"Bhuptani PH, Kenney SR, Napper LE, Orchowski LM.","first_author":"Bhuptani PH","journal":"American journal of sexuality education","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Pornography","Injunctive Norms","Negative Attitudes Toward Women","Rape Depictions"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 283 college men, self‑report questionnaires, multiple linear regression","sample_n":283,"sample_text":"283 college men recruited on campus (convenience sample)","population":"college men (U.S. undergraduate sample, likely convenience)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 283 U.S. college men, the only factor linked to more negative attitudes toward women was believing that peers approve of pornography showing rape. Personal use of porn and approval of it were not related.","clinical_takeaway":"Addressing perceived peer approval of violent porn may help reduce sexist attitudes among college men.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Relatively large sample for a single‑site survey","Focus on specific pornography content types (rape depictions)","Uses multivariate regression to isolate peer‑norm effects"],"limitations":["Cross‑sectional design; cannot infer causality","No validated scales reported for key constructs","No measurement or control of major confounds (moral views, mental health, masturbation, trauma)","Convenience college sample limits generalisability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/15546128.2023.2233414"}},{"id":547,"doi":"10.3390/bs11030038","pmid":"33803799","pmcid":"PMC8003310","title":"Sexually Explicit Online Media Use and Sexual Behavior among Sexual Minority Men in Portugal","authors":"Pereira H, Esgalhado G.","first_author":"Pereira H","journal":"Behavioral sciences (Basel, Switzerland)","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["HIV","Sexual behavior","Portugal","Men Who Have Sex With Men (Msm)","Sexually Explicit Online Media (Seom)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8003310","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience survey of 1,577 Portuguese MSM; self‑report measures of SEOM exposure and recent sexual behaviour","sample_n":1577,"sample_text":"MSM recruited via websites, e‑mail and social media","population":"MSM (gay and bisexual) in Portugal, internet users","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 1,577 Portuguese gay and bisexual men, watching porn that shows unprotected anal sex was common and was linked to a higher likelihood of having unprotected receptive anal sex themselves.","clinical_takeaway":"Clinicians should be aware that preference for unprotected‑sex porn may be associated with higher sexual‑risk behaviour in MSM.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["large sample size for a niche population","focus on a specific content type (unprotected sex) within SEOM","relevant public‑health outcome (unprotected anal sex)"],"limitations":["cross‑sectional self‑report; cannot infer causality","no validated scales for pornography use or sexual risk","key confounds (moral views, masturbation, mental health, relationship context) not measured"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs11030038"}},{"id":548,"doi":"10.1080/00224499.2020.1817837","pmid":"32975464","pmcid":null,"title":"Intimacy in Dyadic Sexually Explicit Media Featuring Men Who Have Sex with Men","authors":"Newton JDA, Halford WK, Barlow FK.","first_author":"Newton JDA","journal":"Journal of sex research","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of the 220 most‑viewed dyadic MSM SEM videos; coding for verbal and physical intimacy; associations with viewer interactions examined.","sample_n":220,"sample_text":"220 most‑viewed dyadic scenes from MSM SEM videos.","population":"Videos (n=220) of dyadic MSM sexually explicit media; no human participants.","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers examined 220 popular gay porn videos and found that most showed physical intimacy (e.g., kissing, touching) and many showed verbal intimacy (e.g., compliments). Only verbal expressions of care were linked to more likes/dislikes, and intimacy did not affect video view counts.","clinical_takeaway":"None – the study describes how intimacy is portrayed in gay porn, not individual health outcomes.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample of popular videos","Systematic coding of multiple intimacy behaviours","Links findings to sexual script theory"],"limitations":["Convenience sample of most‑viewed videos; may not represent broader SEM","Coding scheme not detailed; unclear validation","No effect‑size reporting or correction for multiple tests"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2020.1817837"}},{"id":549,"doi":"10.1007/s10508-019-01501-3","pmid":"31506866","pmcid":"PMC6759372","title":"Sexually Explicit Media Use Among 14-17-Year-Old Sexual Minority Males in the U.S","authors":"Nelson KM, Perry NS, Carey MP.","first_author":"Nelson KM","journal":"Archives of sexual behavior","year":2019,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual behavior","Adolescent","Ymsm","Pornography","Sexual Minority Males"],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 206 US sexual‑minority males aged 14‑17; self‑report of pornography use frequency, exposure to condomless anal sex in media, and personal sexual behaviour.","sample_n":206,"sample_text":"N = 206 (51 % racial/ethnic minorities), recruited nationally via online channels in 2017","population":"Adolescent sexual minority males (ASMM), 14‑17 y, USA","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2019 US survey of 206 teen gay and bisexual males (14‑17 y) found that most watch porn often; those who saw condom‑less anal sex in porn were more likely to have had condom‑less anal sex themselves. The authors suggest using porn wisely to improve sexual health education.","clinical_takeaway":"Clinicians should recognize that many ASMM learn about sex from porn and that risky depictions may influence behaviours; address media exposure when discussing safe sex.","confidence":0.78,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large (for this niche) national sample of ASMM","Addresses a gap in sexual‑health education literature","Links specific media content (CAS) to real‑world behaviour"],"limitations":["Cross‑sectional, cannot infer causality","Self‑report measures not validated; possible recall/social‑desirability bias","No control for moral, mental‑health or partner variables"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":2,"mentioning":42,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-01501-3"}},{"id":551,"doi":"10.1177/10775595251327745","pmid":"40125779","pmcid":null,"title":"Changing Profiles of Youth Referred for Commercial Sexual Exploitation before and since the Onset of COVID-19 in the United States","authors":"Kafafian M, de Vries I, Farrell A, Asiedu C, Bouchard E.","first_author":"Kafafian M","journal":"Child maltreatment","year":2026,"pub_types":["Journal Article"],"keywords":["Victimization Risk","Covid-19","Commercial Sexual Exploitation Of Children (Cse)","Youth Profiles"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective analysis of state agency referral data (pre‑ vs post‑COVID) using latent class and regression models.","sample_n":null,"sample_text":"All youths referred to the agency during the two periods; exact N not reported in abstract.","population":"Youth referred for concerns of commercial sexual exploitation in a Northeastern US state (both sexes, ages not specified).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared youths referred for commercial sexual exploitation before and after COVID‑19 and found a shift from referrals linked to exploitative peers toward those involving risky online activities like sharing explicit media.","clinical_takeaway":"Clinicians should broaden screening to include online risk behaviours when assessing CSE risk in youth.","confidence":0.7,"topic_tags":["csbd"],"strengths":["Large, state‑wide administrative dataset","Use of latent class analysis to identify distinct risk profiles","Timely comparison of pre‑ and post‑pandemic periods"],"limitations":["No validated measures of CSE or risk behaviours","Potential unmeasured confounders (e.g., mental health, family context)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10775595251327745"}},{"id":552,"doi":"10.1007/s10964-019-01172-2","pmid":"31802316","pmcid":null,"title":"The Relationship between the Use of Social Networking Sites and Sexually Explicit Material, the Internalization of Appearance Ideals and Body Self-Surveillance: Results from a Longitudinal Study of Male Adolescents","authors":"Sevic S, Ciprić A, Buško V, Štulhofer A.","first_author":"Sevic S","journal":"Journal of youth and adolescence","year":2020,"pub_types":["Journal Article"],"keywords":["Objectification Theory","Longitudinal Design","Social Networking Sites","Internalization Of Appearance Ideals","Adolescent Men","Body Surveillance","Sexually Explicit Material"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"five‑wave longitudinal survey of 743 Croatian adolescent males (baseline age 15.9) examining self‑reported use of social‑networking sites and sexually explicit material, internalization of appearance ideals and body surveillance.","sample_n":743,"sample_text":"n = 743 (five‑wave longitudinal cohort)","population":"Male adolescents (≈16 y) from Croatia, community sample, N = 743","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A five‑wave study of 743 Croatian teenage boys found that while body‑image concerns fell over 22 months, the amount of time spent on social networking sites or viewing sexually explicit material did not predict changes in body‑surveillance or internalized appearance ideals.","clinical_takeaway":"For adolescent boys, mere exposure to online sexual content does not appear to drive body‑image concerns over time.","confidence":0.8,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Large longitudinal sample","Multiple measurement waves allowing assessment of change over time","Focus on male adolescents, an understudied group"],"limitations":["Use of likely ad‑hoc self‑report measures for SEM exposure","No assessment of key psychosocial confounds (e.g., moral incongruence, mental health)","Unclear whether measurement tools are validated"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":21,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10964-019-01172-2"}},{"id":553,"doi":"10.23736/s2724-5276.19.05367-2","pmid":"30761817","pmcid":null,"title":"Consumption of sexually explicit internet material and its effects on minors' health: latest evidence from the literature","authors":"Principi N, Magnoni P, Grimoldi L, Carnevali D, Cavazzana L, Pellai A.","first_author":"Principi N","journal":"Minerva pediatrics","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of prior studies without systematic methods or risk‑of‑bias assessment; no original data collected.","sample_n":null,"sample_text":"N/A – review of 19 previously published studies","population":"minors (children and adolescents) discussed in cited literature","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed 19 studies published between 2013‑2018 and report that children and teens who view internet pornography tend to show earlier sexual activity, risky sexual behavior, distorted gender views, body‑image issues, aggression, and anxiety or depression. They argue that this impact is important and call for education programmes for parents and schools.","clinical_takeaway":"Clinicians should be aware that pornography exposure may be linked to several behavioural and mental‑health concerns in youths, and consider discussing media use and providing guidance.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Broad literature search covering recent years","Highlights multiple domains of potential impact"],"limitations":["No systematic review methodology (no PRISMA, no bias assessment)","Relies on heterogeneous primary studies with unspecified quality","No quantitative synthesis or effect‑size reporting"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.23736/s2724-5276.19.05367-2"}},{"id":554,"doi":"10.1111/sjop.70021","pmid":"40887849","pmcid":"PMC12790106","title":"The Association Between Pathological Personality Domains and Aggravated and Risky Sexting in a Sample of Emerging Adults","authors":"Morelli M, Pazzagli C, Sciabica GM, Chirumbolo A, Andreassi S.","first_author":"Morelli M","journal":"Scandinavian journal of psychology","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Personality","Young Adulthood","Sexting","Risky Sexting","Pid‐5‐bf","Aggravated Sexting"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12790106","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross‑sectional survey (N=876) recruited via snowball sampling; online self‑report measures","sample_n":876,"sample_text":"snowball convenience sample","population":"emerging adults (18‑29 years) in Italy, 69 % female","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 876 Italian young adults, personality traits such as antagonism and disinhibition were linked to more aggressive and risky sexting, while negative affectivity was related to less risky sexting during substance use.","clinical_takeaway":"Personality factors may help identify young adults at risk for problematic sexting; interventions could target impulsivity and antagonistic traits.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for a cross‑sectional survey","Use of validated personality and sexting questionnaires","Statistical modeling appropriate for count data (negative binomial)"],"limitations":["Convenience snowball sampling limits generalisability","No measurement/control of key sexual‑behavior confounds (e.g., moral incongruence, mental health)","No pre‑registration or reporting of effect sizes/CIs"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/sjop.70021"}},{"id":555,"doi":"10.31234/osf.io/fajqv_v1","pmid":null,"pmcid":null,"title":"Good Vibrations: A Content Analysis of Depictions of Sex Toy Use in Mainstream Heterosexual Pornography","authors":"Williams M, Ayres L, O'Sullivan L.","first_author":"Williams M","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"content analysis of 100 videos from two popular porn sites","sample_n":100,"sample_text":"N = 100 pornographic videos featuring sex toys from two highly popular sites","population":"videos (media content) rather than persons","country":"unspecified (online sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined 100 mainstream heterosexual porn videos and found that sex toys, especially vibrators, appear in over half of them, mostly used on female actors, and sometimes shown causing orgasm.","clinical_takeaway":"None – the study describes porn content and does not provide clinical guidance.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Systematic coding protocol","Clear descriptive statistics","Focus on contemporary media content"],"limitations":["Convenience sample of videos","No validation of coding scheme reported","No assessment of audience impact"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/fajqv_v1"}},{"id":556,"doi":"10.1002/eat.24074","pmid":"37906085","pmcid":null,"title":"Pro-anorexia coaches prey on individuals with eating disorders","authors":"Simons EI, Noteboom F, van Furth EF.","first_author":"Simons EI","journal":"The International journal of eating disorders","year":2024,"pub_types":["Journal Article"],"keywords":["Sexual Abuse","Grooming","Sexually Explicit Materials","Pro-anorexia Coaches","Pro-anorexia Community"],"is_oa":false,"oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/eat.24074","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-methods exploratory study using fake profiles, online questionnaire (N=79) and interviews (N=14); convenience sampling of pro‑ana community members.","sample_n":79,"sample_text":"79 questionnaire respondents; 14 interviewed; 31 coaches contacted via fake profiles.","population":"Individuals with eating disorders who have encountered pro‑anorexia coaches; recruited via online pro‑ana communities.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers examined how ‘pro‑anorexia’ coaches in online communities exploit vulnerable individuals with eating disorders, often to obtain sexual material. Using fake profiles, a survey and interviews, they described a five‑stage grooming process similar to online sexual grooming.","clinical_takeaway":"Clinicians should be alert that patients with eating disorders may be targeted by pro‑ana coaches for sexual exploitation and assess for such grooming behaviors.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Innovative use of fake profiles to access covert behavior","Triangulation of methods (profile interaction, survey, interviews)","Highlights a previously undocumented form of online grooming"],"limitations":["Small, self‑selected sample limits generalisability","Reliance on ad‑hoc questionnaire items without validation","No quantitative assessment of prevalence or effect sizes"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/eat.24074"}},{"id":557,"doi":"10.21203/rs.3.rs-9881429/v1","pmid":null,"pmcid":null,"title":"Psychosocial and Behavior Correlates of Early Pornography Exposure in Children","authors":"Moffat K, Glenn J, Nelson EJ.","first_author":"Moffat K","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Baseline data from the ABCD Study, N=11,455 children aged 9–10, parent‑reported pornography exposure (past 2 weeks) and associated demographic, screen‑time, and mental‑health variables.","sample_n":11455,"sample_text":"11,455 children aged 9–10 years from the Adolescent Brain Cognitive Development (ABCD) Study","population":"Children 9‑10 years (US national cohort)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US sample of over 11,000 9‑10‑year‑old children, those whose parents said they had seen porn in the past two weeks were more often boys, Black, lower‑income, used more screen time, and had higher rates of ADHD, anxiety, and depression.","clinical_takeaway":"Early porn exposure in children co‑occurs with mental‑health and behavioral risk factors, but causal links are unclear; monitor screen use and provide parental guidance.","confidence":0.8,"topic_tags":["pornography","sexual_function","adolescents","prevalence"],"strengths":["Very large, nationally‑based sample","Uses established ABCD cohort data","Reports multiple demographic and mental‑health correlates"],"limitations":["Exposure measured by a single parent‑report item","Cross‑sectional; no causal inference","Key confounds (e.g., moral incongruence, underlying sexual behavior) not assessed"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-9881429/v1"}},{"id":558,"doi":"10.1016/j.jsxm.2019.09.018","pmid":"31708484","pmcid":"PMC7037740","title":"Posting Sexually Explicit Images or Videos of Oneself Online Is Associated With Impulsivity and Hypersexuality but Not Measures of Psychopathology in a Sample of US Veterans","authors":"Turban JL, Shirk SD, Potenza MN, Hoff RA, Kraus SW.","first_author":"Turban JL","journal":"The journal of sexual medicine","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Psychiatric disorders","Sexual Partners","Veterans","Risky Sexual Behavior","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience sample of 283 post‑9/11 US veterans; self‑report questionnaires; regression adjusting for covariates.","sample_n":283,"sample_text":"Convenience sample of US post‑deployment, post‑9/11 military veterans (N = 283).","population":"US post‑deployment veterans (mixed gender, age, education)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a US veteran sample, posting sexual photos or videos online was linked to higher impulsivity and hypersexuality, but not to depression, anxiety, PTSD, or substance problems. Sexting showed no such links.","clinical_takeaway":"Posting explicit images may signal impulsivity and hypersexual tendencies; clinicians could assess these dimensions rather than assume broader psychopathology.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Differentiates PSI from sexting","Uses validated mental‑health scales","Adjusts for several demographic covariates"],"limitations":["Cross‑sectional, cannot infer causality","Convenience veteran sample limits generalisability","No measurement of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.09.018"}},{"id":560,"doi":"10.1007/s10508-023-02802-4","pmid":"38302852","pmcid":"PMC10920426","title":"Auditory Cues Alter the Magnitude and Valence of Subjective Sexual Arousal and Desire Induced by an Erotic Video","authors":"Pfaus JG, Zakreski E.","first_author":"Pfaus JG","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Randomized Controlled Trial","Journal Article"],"keywords":["Auditory","Visual","Ejaculation","Erotic Video","Subjective Sexual Arousal And Desire"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-023-02802-4.pdf","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Randomized controlled trial with 2 (ejaculation presence) × 2 (sound vs no sound) between‑subjects design; 119 cis‑gender heterosexual undergraduate participants.","sample_n":119,"sample_text":"119 cis‑gender heterosexual undergraduates (59 women, 60 men)","population":"cis‑gender heterosexual undergraduate students (N=119, 59 women, 60 men)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab experiment, people watched a short erotic video that either ended with a brief ejaculation scene or not, and either with or without sound. Women and men reported lower arousal when there was no sound, and women found the ejaculation‑plus‑no‑sound clip more negative than men. Auditory cues and the presence of ejaculation affect subjective sexual arousal differently for men and women.","clinical_takeaway":"Auditory elements and scene endings can shape subjective arousal; clinicians should consider multimodal cues when discussing sexual response.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Validated multidimensional arousal questionnaire","Randomized experimental manipulation","Balanced gender sample"],"limitations":["Convenience undergraduate sample limits generalizability","No pre‑registration or reported effect sizes","Potentially modest power for 4‑cell between‑subjects design"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02802-4"}},{"id":561,"doi":"10.21203/rs.3.rs-9577511/v1","pmid":null,"pmcid":null,"title":"The Grammar of Porn: How Online Pornography Titles Perpetuate Gender and Racial Stereotypes","authors":"Bohemen SV, Fransen M, Rojek-Giffin M, de Koster W, Mikkers L, de Lande LV, Lyashevska O.","first_author":"Bohemen SV","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large-scale NLP analysis of 250,000 Pornhub video titles (2008‑2024) examining gender and racial language patterns and engagement metrics.","sample_n":250000,"sample_text":"Titles from Pornhub platform","population":"N/A (metadata only)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Analyzing 250,000 Pornhub video titles, researchers found that language heavily emphasizes women and uses adjectives that stress appearance, youth, and smallness, while racial descriptors reinforce stereotypes. Titles with certain size‑related or transgressive words get more views, but racialized terms attract less engagement.","clinical_takeaway":"None – the study examines media content, not clinical outcomes.","confidence":0.8,"topic_tags":["pornography","gender","sexual_function"],"strengths":["Very large dataset of titles","Systematic NLP approach","Links linguistic patterns to engagement"],"limitations":["No validation of stereotype detection methods reported","No user-level data; cannot link to consumer outcomes","Cross‑sectional content analysis only"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-9577511/v1"}},{"id":562,"doi":"10.1186/s12889-025-23646-8","pmid":"40670957","pmcid":"PMC12265271","title":"Social media use, risk behavior engagement, and mental health among middle adolescents in the Caribbean","authors":"Kim D, Magane R, Poitier M, Kuang J, Wang A, Adderley R, Deveaux L.","first_author":"Kim D","journal":"BMC public health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Mental health","Risk behavior","Adolescents","Suicidal Ideation","Social Media","Cyberbullying","Online Risks"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12265271","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 1,563 Grade‑9 students in the Bahamas, self‑administered questionnaire, generalized linear mixed models","sample_n":1563,"sample_text":"Convenience sample of all Grade 9 students in New Providence; not nationally representative","population":"Adolescents (≈14‑15 y) in a single Bahamian district","country":"Bahamas","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 1,563 Bahamian teens found that heavy social‑media use, cyberbullying and sexting were common and linked to higher rates of suicidal thoughts, especially among girls.","clinical_takeaway":"Clinicians should screen for online risk behaviours when assessing adolescent mental‑health risk.","confidence":0.8,"topic_tags":["adolescents","sexual_function","pornography","masturbation"],"strengths":["Large sample size for a school‑based survey","Gender‑specific analysis","Use of mixed‑effects models to account for clustering"],"limitations":["Cross‑sectional design; cannot infer causality","Convenience sample limits generalisability","Reliance on self‑report items of unknown psychometric quality"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-025-23646-8"}},{"id":563,"doi":"10.1177/08862605221116317","pmid":"35942940","pmcid":"PMC9850373","title":"Digital Sexual Violence and Suicide Risk in a National Sample of Sexual Minority Adolescents","authors":"Srivastava A, Rusow J, Schrager SM, Stephenson R, Goldbach JT.","first_author":"Srivastava A","journal":"Journal of interpersonal violence","year":2023,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Suicide","Self-harm","Sexual Minority Adolescents","Online Violence","Digital Sexual Violence","Nonconsensual"],"is_oa":false,"oa_url":"https://doi.org/10.1177/08862605221116317","cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 970 sexual‑minority adolescents; multivariate logistic regression; convenience sample","sample_n":970,"sample_text":"online convenience sample recruited nationwide","population":"sexual‑minority adolescents (14‑17 y, US)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 970 U.S. sexual‑minority teens, being threatened with or having non‑consensual sexual images posted online was linked to higher odds of suicidal thoughts, plans, attempts, and self‑harm.","clinical_takeaway":"Clinicians should screen for digital sexual violence when assessing suicide risk in sexual‑minority adolescents.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a vulnerable adolescent population","Focused on an under‑researched form of digital sexual violence","Clear statistical reporting of odds ratios"],"limitations":["Cross‑sectional design limits causal inference","Self‑report measures of exposure and outcomes","Limited control for mental‑health and trauma confounders","Convenience sample may not be representative"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":20,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605221116317"}},{"id":564,"doi":"10.21203/rs.3.rs-9774141/v1","pmid":null,"pmcid":null,"title":"Moral Regulation in Digital Life: Age-Verification Laws and the Redirection of Online Pornography Search","authors":"Rahman S, Rahman MJ.","first_author":"Rahman S","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Observational policy evaluation using difference‑in‑differences, event‑study and synthetic‑control methods on state‑level Google Trends data (552 state‑month observations).","sample_n":552,"sample_text":"552 state‑month observations across 12 states.","population":"All Google searches from Oklahoma and 11 comparison US states (January 2022–October 2025).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Age‑verification laws in Oklahoma sharply lowered Pornhub searches but boosted searches for other porn sites and VPNs, suggesting regulation redirects rather than eliminates adult‑content seeking.","clinical_takeaway":"Policy effects on adult‑content access may shift users to other platforms; clinicians should consider broader online behaviours when discussing pornography use.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, publicly available dataset spanning multiple years","Strong quasi‑experimental design (DID, synthetic control)","Multiple robustness checks"],"limitations":["Uses aggregate search data, not individual behavior","No measurement of personal moral attitudes or sexual health outcomes","Potential for unmeasured time‑varying confounders"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-9774141/v1"}},{"id":565,"doi":"10.1371/journal.pone.0218962","pmid":"31242258","pmcid":"PMC6594649","title":"Associations between adolescents' use of sexually explicit material and risky sexual behavior: A longitudinal assessment","authors":"Koletić G, Kohut T, Štulhofer A.","first_author":"Koletić G","journal":"PloS one","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6594649","cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two independent 5‑wave panel samples of Croatian adolescents (n = 368; n = 247) examined SEM use frequency and later risky sexual outcomes with multilevel logistic regression.","sample_n":615,"sample_text":"Two independent panels (368 and 247 participants) followed for five waves.","population":"Adolescents (Croatian students)","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In two groups of Croatian teens followed over five years, how often they watched online sexual material did not predict whether they later used condoms or had multiple partners, after accounting for age, gender and sensation seeking.","clinical_takeaway":"Viewing sexually explicit material alone does not appear to increase risky sexual behavior among adolescents.","confidence":0.8,"topic_tags":["pornography","adolescents","religiosity","sexual_function"],"strengths":["Longitudinal design with repeated measures","Two independent samples increase robustness","Controls for key demographic and personality variables"],"limitations":["SEM use measured by simple self‑report, likely unvalidated","No assessment of moral or mental‑health factors that could confound findings","No pre‑registration or detailed reporting of effect sizes"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":32,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0218962"}},{"id":566,"doi":"10.1098/rsos.160963","pmid":"28572991","pmcid":"PMC5451792","title":"Sex-specific but not sexually explicit: pupillary responses to dressed and naked adults","authors":"Attard-Johnson J, Bindemann M.","first_author":"Attard-Johnson J","journal":"Royal Society open science","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Pupillary response","Eye-tracking","Sexual Interest","Sexual Appeal","Viewing Behaviour"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5451792","cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"laboratory eye‑tracking experiment comparing pupil dilation while participants viewed dressed vs. naked portrait images of adult film actors; within‑subjects design with heterosexual men and women.","sample_n":null,"sample_text":"Not specified in abstract","population":"heterosexual adults (men and women) recruited for a lab study; sample size not reported in abstract","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured how pupils dilate when men and women look at photos of opposite‑sex adults, either clothed or naked. Pupil size grew for opposite‑sex images regardless of clothing, suggesting pupil dilation signals sexual interest but does not depend on explicitness.","clinical_takeaway":"None – the findings relate to basic sexual interest measures, not clinical issues.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Objective physiological measure (pupillometry)","Sex‑specific analysis of opposite‑sex response","Within‑subject comparison of dressed vs. naked stimuli"],"limitations":["No assessment of potential confounds (moral, mental health, etc.)","Sample size and power not reported","Interpretation limited to sexual interest, not broader behavioural outcomes"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1098/rsos.160963"}},{"id":569,"doi":"10.1071/sh26180","pmid":"42830224","pmcid":null,"title":"Cyber-pornography use among a sample of Chinese university students: utilizing machine learning and network analysis","authors":"Li L, Niu Z, Hu J, Mei S, Griffiths MD.","first_author":"Li L","journal":"Sexual health","year":2026,"pub_types":["Journal Article"],"keywords":["Machine Learning","university students","Network Analysis","Xgboost Model","Cyber-pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1322 Chinese university students; machine‑learning classification (XGBoost) and network analysis of predictors of cyber‑pornography use.","sample_n":1322,"sample_text":"university students recruited via online survey","population":"Chinese university students (N≈1322), convenience sample from several provinces.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,300 Chinese university students used machine‑learning to identify factors linked to cyber‑pornography use. Social ostracism, moral disengagement and depression were among the strongest predictors, with gender and family factors also important.","clinical_takeaway":"Screening for loneliness, depression and social isolation may help identify students at higher risk of problematic cyber‑pornography use.","confidence":0.8,"topic_tags":["pornography","sexual_function","prevalence"],"strengths":["Large sample size for a survey (N>1300)","Novel application of machine‑learning and network analysis","Broad range of ecological‑systems variables examined"],"limitations":["Cross‑sectional design limits causal inference","Cyber‑pornography use measured by unvalidated, possibly ad‑hoc items","Key confounds (masturbation, moral incongruence, partner context) not assessed","High‑risk subgroup very small (n=25) reducing reliability of classification"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh26180"}},{"id":571,"doi":"10.64898/2026.05.07.26352588","pmid":null,"pmcid":null,"title":"Primed for Exploitation: How Early Violence, Institutional Betrayal, and Structural Vulnerability Shape Pathways into Pornography","authors":"Donevan M, Dennhag I, Svedin CG, Martin J, Jonsson LS.","first_author":"Donevan M","journal":"medRxiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"mixed-methods qualitative study with 25 adult participants (23 women) using questionnaires and teller‑focused interviews; reflexive thematic analysis.","sample_n":25,"sample_text":"Twenty‑five adults (23 women) who had been filmed for pornography.","population":"Adults filmed for pornography (Sweden); predominantly women.","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 25 women who had been filmed for porn reveal that early abuse, betrayals by partners and institutions, and material hardship often lead people into the industry, challenging the idea that entering porn is a simple personal choice.","clinical_takeaway":"Clinicians should screen for histories of trauma and structural vulnerability when supporting people involved in pornography.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["In‑depth qualitative insight into lived experiences","Combines questionnaire data with rich interview narratives","Grounded in socio‑ecological framework"],"limitations":["Small, non‑representative sample (mostly women)","Unclear measurement properties of questionnaires","Findings may not generalise beyond participants"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.64898/2026.05.07.26352588"}},{"id":574,"doi":"10.1016/j.adolescence.2017.04.006","pmid":"28433892","pmcid":null,"title":"Longitudinal associations between the use of sexually explicit material and adolescents' attitudes and behaviors: A narrative review of studies","authors":"Koletić G.","first_author":"Koletić G.","journal":"Journal of adolescence","year":2017,"pub_types":["Review","Journal Article"],"keywords":["Review","Adolescence","Longitudinal Studies","Sexually Explicit Material"],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of longitudinal studies, no systematic methods, no meta‑analysis","sample_n":null,"sample_text":"Not applicable – review of 20 papers","population":"adolescents (≤18 y)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This narrative review summarises 20 longitudinal studies on how adolescents' use of sexually explicit material relates to their sexual attitudes, behaviors, and wellbeing, noting consistent associations but calling for more rigorous, meta‑analytic research.","clinical_takeaway":"Evidence suggests SEM exposure links to various sexual outcomes in youth, but current data are insufficient for definitive clinical guidance.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Aggregates longitudinal evidence on adolescent SEM use","Identifies gaps and recommends future rigorous work"],"limitations":["Narrative (non‑systematic) review without risk‑of‑bias assessment","No quantitative synthesis or effect‑size reporting","Limited detail on construct definitions and confound control in reviewed studies"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":60,"citing_publications":88,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2017.04.006"}},{"id":580,"doi":"10.1007/s10508-021-01993-y","pmid":"34773216","pmcid":null,"title":"Perceptions of Sexual Images: Factors Influencing Responses to the Ubiquitous External Ejaculation","authors":"Salmon CA, Hehman JA.","first_author":"Salmon CA","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sex differences","Sociosexuality","Pornography","Sexual Disgust","External Ejaculation"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"participants viewed explicit images and provided affect ratings; individual‑difference questionnaires administered; cross‑sectional survey design","sample_n":null,"sample_text":"not specified in abstract","population":"adult humans (likely convenience sample, details not given)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed men and women on how they judged pictures of external ejaculation, finding that sex, sexual orientation, and emotional content of the images, as well as personal disgust sensitivity and sociosexual attitudes, shaped whether they rated the pictures positively or negatively.","clinical_takeaway":"None – the findings describe perceptual differences and do not inform clinical practice.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Uses validated individual‑difference scales (disgust, sociosexuality, mate value)","Integrates multiple psychological predictors in regression models"],"limitations":["Cross‑sectional, cannot infer causality","No reporting of sample size or power calculations","Potential volunteer bias; convenience sampling likely"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-01993-y"}},{"id":581,"doi":"10.1016/j.jadohealth.2017.11.305","pmid":"29503032","pmcid":null,"title":"The Use of Sexually Explicit Material and Its Relationship to Adolescent Sexual Activity","authors":"Matković T, Cohen N, Štulhofer A.","first_author":"Matković T","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Gender","Adolescents","Longitudinal Assessment","Sexual Debut","Pornography","Sexually Explicit Material"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two independent panel samples of Croatian adolescents (4–5 waves); discrete‑time event‑history and propensity‑score matching used to test SEM frequency → sexual debut.","sample_n":null,"sample_text":"Not reported in abstract","population":"Adolescent students in Croatia (both genders)","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study followed Croatian teens for up to five years and found no clear link between how often they viewed porn and when they first had sex, especially for boys. Findings for girls were inconclusive.","clinical_takeaway":"No robust evidence that adolescent porn use directly triggers earlier sexual debut; clinicians should consider broader factors.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Longitudinal panel design with multiple waves","Use of event‑history modeling and propensity matching","Separate analysis for males and females"],"limitations":["Constructs measured with simple self‑report items, no validated scales","Potential unmeasured confounders (e.g., moral attitudes, mental health)","Sample size and representativeness unclear from abstract"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":30,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2017.11.305"}},{"id":584,"doi":"10.1080/00224499.2023.2215228","pmid":"37255235","pmcid":null,"title":"\"There is No One Way to Be Transgender and to Live Sex\": Transgender and Non-Binary Individuals' Experiences with Pornography","authors":"Pavanello Decaro S, Portolani DM, Toffoli G, Prunas A, Anzani A.","first_author":"Pavanello Decaro S","journal":"Journal of sex research","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional online survey with open‑ended questions; thematic analysis of 212 self‑identified transgender and non‑binary participants","sample_n":212,"sample_text":"212 self‑identified TGNB individuals completed an online questionnaire","population":"TGNB adults (approx. 47% trans‑masc, 16% trans‑fem, 37% non‑binary); recruited via online channels; self‑selected convenience sample","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 212 transgender and non‑binary people, researchers explored how porn featuring TGNB actors is experienced. Participants reported both empowerment and objectification, noting how mainstream porn often reflects cis‑heteronormative norms.","clinical_takeaway":"Clinicians should recognise that TGNB individuals may have complex, mixed reactions to pornography, ranging from empowerment to dysphoria.","confidence":0.8,"topic_tags":["pornography","gender","sexual_function"],"strengths":["Large (n>200) TGNB sample for qualitative work","First study to focus on TGNB consumers of pornography","Uses established thematic analysis method"],"limitations":["No validated scales; relies on ad‑hoc questionnaire items","Convenience online recruitment limits generalisability","No measurement of key confounds (moral incongruence, masturbation, mental health, etc.)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2215228"}},{"id":585,"doi":"10.1007/s10461-017-1952-x","pmid":"29079951","pmcid":"PMC5820205","title":"Sexually Explicit Media and Condomless Anal Sex Among Gay and Bisexual Men","authors":"Whitfield THF, Rendina HJ, Grov C, Parsons JT.","first_author":"Whitfield THF","journal":"AIDS and behavior","year":2018,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Gay And Bisexual Men","Pornography","Sexually Explicit Media","Condomless Anal Sex"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of HIV‑negative gay and bisexual men; measures of overall SEM frequency, percentage of bare‑back SEM, and self‑reported condomless anal sex in past 3 months; cross‑sectional analysis with interaction term","sample_n":null,"sample_text":"Nationwide online sample of HIV‑negative GBM (exact N not provided in abstract).","population":"U.S. gay and bisexual men, HIV‑negative, recruited via internet (self‑selected sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among HIV‑negative gay and bisexual men, those who watch a lot of pornography and a high proportion of it showing condom‑free sex tend to have more condomless anal sex with casual partners. The study suggests such media may normalize risky sex.","clinical_takeaway":"Clinicians should be aware that frequent viewing of bare‑back porn may be linked to higher sexual risk in GBM, but causality is unproven.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large nationwide sample (potentially diverse)","Specific focus on % of bare‑back content, not just overall SEM use","Interaction analysis addresses combined effect"],"limitations":["Cross‑sectional; cannot establish causality","Self‑report measures; possible recall/social desirability bias","Key confounds (e.g., mental health, partner context) not assessed","No validated SEM consumption scale reported"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-017-1952-x"}},{"id":586,"doi":"10.2196/79622","pmid":"42611804","pmcid":"PMC13484816","title":"Young People's Perspectives on Age Verification for Online Pornography in Australia: Cross-Sectional Online Survey","authors":"Turvey J, Eddy S, Orozco A, Lim MSC.","first_author":"Turvey J","journal":"Journal of medical Internet research","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Survey","Policy","Adolescents","Pornography","Online Safety"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13484816","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 794 (761 analyzed) Australian youth (15‑29) recruited via social media; logistic regression and thematic analysis","sample_n":761,"sample_text":"Online convenience sample recruited through social‑media advertising; not a probability sample","population":"young people aged 15‑29 in Victoria, Australia (N≈761)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2026 Australian survey of 761 young people examined how they feel about mandatory age‑checks for online porn. Around 60% support the idea, but none of the four specific verification methods (ID upload, facial scan, credit card, parental monitoring) were liked by most. Support was higher among women, younger adults, religious people and those who started watching porn later; lower among LGBTQIA+ individuals, those in open relationships, and frequent porn viewers.","clinical_takeaway":"Policymakers should note that while many youths favour age‑verification in principle, they distrust specific methods; privacy‑sensitive alternatives may be more acceptable.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample for an attitude survey (N>750)","Mixed quantitative‑qualitative approach","Clear reporting of logistic regression predictors"],"limitations":["Convenience sampling via social media limits generalisability","No validated scales for attitudes; ad‑hoc items","Key potential confounds (masturbation, mental health, moral disapproval) not measured"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/79622"}},{"id":588,"doi":"10.31234/osf.io/ugxep_v1","pmid":null,"pmcid":null,"title":"Violent Pornography use and sexually aggressive behavior in college students: The mediating role of rape myth endorsement","authors":"Teixeira ML, Carvalho J, Gomes H.","first_author":"Teixeira ML","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online self‑report survey of 903 college students, mediation analysis of violent pornography use, rape‑myth endorsement and sexually aggressive tactics","sample_n":903,"sample_text":"903 participants recruited via an online self‑report survey","population":"college students (mixed gender)","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 903 college students, watching violent porn (but not non‑violent porn) was linked to self‑reported sexually aggressive tactics. The link was partly explained by endorsement of rape myths, especially for women.","clinical_takeaway":"Violent porn exposure may be associated with aggression, but causality is unclear; clinicians should assess broader attitudes like rape myths.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["large sample size for a survey","examines both genders","distinguishes violent vs non‑violent pornography"],"limitations":["cross‑sectional, cannot infer causality","no measurement of masturbation or other key confounds","unclear psychometric validation of scales"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/ugxep_v1"}},{"id":589,"doi":"10.1556/2006.2024.00033","pmid":"38967992","pmcid":"PMC11457030","title":"Emotional interference and attentional bias in compulsive sexual behaviors disorder - An fMRI study on heterosexual males","authors":"Draps M, Kulesza M, Glica A, Szymanowska J, Lewińska K, Żukrowska W, Gola M.","first_author":"Draps M","journal":"Journal of behavioral addictions","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Attentional Bias","Cognitive Conflict","Emotional Processing","Problematic Pornography Use","Compulsive Sexual Behaviors Disorder","Emotional Interference Effect"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11457030","cited_by_count":7,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control fMRI study using an Emotional Stroop task with 30 CSBD males and matched healthy controls","sample_n":60,"sample_text":"30 CSBD patients, 30 matched healthy controls (sex‑related words Stroop task during fMRI)","population":"heterosexual adult males with clinically defined CSBD","country":"Poland (inferred from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small fMRI study, men with compulsive sexual behavior showed greater brain activation to sex‑related words than controls, suggesting an attentional bias. The authors link this to an addiction model, but the study did not assess many alternative explanations.","clinical_takeaway":"Evidence for a distinct neural response to sexual cues in CSBD is preliminary; clinicians should consider broader psychological factors before labeling it an addiction.","confidence":0.7,"topic_tags":["csbd","neuroscience"],"strengths":["Use of matched control group","Combination of behavioural and neural measures","Focus on a clinically relevant disorder (CSBD)"],"limitations":["Small fMRI sample, likely under‑powered","No measurement of key confounds (moral incongruence, masturbation, mental health)","Addiction framing without testing ICD‑11 criteria"],"rubric_version":"2.0","raw_total":30,"max_possible":70,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":5,"statistics":5,"confounds":2,"design":3,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00033"}},{"id":590,"doi":"10.31234/osf.io/smjg8_v1","pmid":null,"pmcid":null,"title":"The Attractiveness of Youth Groups that are Sympathetic or Unsympathetic to Struggles Relating to Social Media, Pornography, and Online Gaming","authors":"Dunaetz DR, Gozal J, Roman J.","first_author":"Dunaetz DR","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 165 adults comparing attractiveness of sympathetic vs unsympathetic youth groups","sample_n":165,"sample_text":"N = 165 adults (online convenience sample)","population":"adult (Christian and non‑Christian) participants recruited via internet, convenience sample","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 165 adults found that youth groups that are supportive of Generation Z’s challenges—like social media, porn and gaming—are seen as more attractive than groups that are unsupportive, especially among younger participants.","clinical_takeaway":"None – the study does not provide evidence applicable to clinical assessment or treatment of pornography‑related issues.","confidence":0.7,"topic_tags":["religiosity","sexual_function","adolescents","pornography"],"strengths":["Relatively large sample for a survey","Includes both Christian and non‑Christian participants","Addresses a novel sociological question"],"limitations":["Convenience sampling limits generalisability","Likely unvalidated single‑item measures","No control for confounding variables (e.g., religiosity, age effects)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/smjg8_v1"}},{"id":591,"doi":"10.1007/s10508-022-02426-0","pmid":"36171487","pmcid":null,"title":"Pornography's Ubiquitous External Ejaculation: Predictors of Perceptions","authors":"Salmon CA, Hehman JA, Figueredo AJ.","first_author":"Salmon CA","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sex differences","Disgust","Pornography","Dark Triad","External Ejaculation"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of men and women rating external ejaculation images; examined sex differences, affect, orientation, personality, disgust, religiosity, etc.","sample_n":null,"sample_text":"not specified in abstract","population":"adult men and women (sample size not reported in abstract)","country":"not specified","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed men and women about how they judge pictures showing external ejaculation, finding that viewer sex, sexual orientation, short‑term mating style and disgust most strongly shape these judgments.","clinical_takeaway":"None – the findings relate to perception, not health or treatment.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Broad set of individual‑difference variables examined","Includes religiosity, addressing moral incongruence","Interaction analyses add nuance"],"limitations":["Perception measures likely ad‑hoc and unvalidated","No control for key confounds such as masturbation or mental health","Sample size and recruitment method not reported"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02426-0"}},{"id":592,"doi":"10.23736/s2724-5276.19.05342-8","pmid":"35166482","pmcid":null,"title":"The use of online pornography among minors: epidemiological analysis of the phenomenon","authors":"Carnevali D, Cavazzana L, Grimoldi L, Magnoni P, Principi N, Pellai A.","first_author":"Carnevali D","journal":"Minerva pediatrics","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Literature review of 21 prevalence studies (2013‑2018) describing rates of SEIM exposure among minors; no risk‑of‑bias assessment or meta‑analysis reported.","sample_n":null,"sample_text":"Not reported in abstract; review aggregates prior studies.","population":"Children and adolescents (boys and girls, ages ~12‑15); studies from various countries; sample sizes not aggregated in abstract.","country":"Not specified (multiple sources).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A review of 21 studies found that between 56%‑100% of boys and 7.6%‑82% of girls aged around 12‑15 have encountered online pornography, often accidentally, with higher rates among smartphone users.","clinical_takeaway":"Clinicians should be aware that exposure to online pornography is common among early adolescents and consider discussing safe internet use with young patients and families.","confidence":0.4,"topic_tags":["pornography","adolescents","prevalence","sexual_function"],"strengths":["Focused on a vulnerable population (minors).","Aggregates recent prevalence data across multiple studies.","Highlights gender and age differences."],"limitations":["No systematic assessment of study quality or bias.","Limited detail on measurement tools used in source studies.","No meta‑analytic synthesis or effect‑size reporting.","Potential heterogeneity across included studies not addressed."],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.23736/s2724-5276.19.05342-8"}},{"id":593,"doi":"10.1007/s10964-026-02397-8","pmid":"42545457","pmcid":"PMC13534180","title":"A Timely Exploratory Study of Young Adults' Psychosexual Responses to the UK's New Age Verification Law on Online Pornography","authors":"Li Y, Ingham R, Armstrong H.","first_author":"Li Y","journal":"Journal of youth and adolescence","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Young Adult","Digital Media","Mixed Method","Psychosexual Well-being","Online Pornography","Age Verification Law"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13534180","cited_by_count":0,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"mixed-methods cross‑sectional survey of 623 UK young adults (18‑25) who used pornography in the past year; quantitative descriptive analyses and qualitative open‑ended responses.","sample_n":623,"sample_text":"N = 623, age 18‑25, 67.3 % female, recruited via online panels/surveys (convenience sample)","population":"young adults, UK, self‑selected online respondents (67 % female)","country":"United Kingdom","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A UK survey of 623 young adults examined how the new online age‑verification rule influences their porn use and feelings of sexual shame. Participants reported mixed reactions—some felt more shame or anxiety, others felt confident or indifferent—and described changes like avoiding certain sites, using VPNs, or reducing use.","clinical_takeaway":"Policy‑related privacy and stigma concerns can affect young adults' sexual wellbeing; clinicians should consider these contextual factors when discussing porn use.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender","moral_incongruence"],"strengths":["Large sample for a mixed‑methods survey","Incorporates both quantitative and qualitative data","Timely topic on recent policy"],"limitations":["Convenience sample, gender‑skewed, limits generalisability","No measurement/control of key confounds (moral incongruence, masturbation, mental health)","Reliance on self‑report, unclear validation of scales"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10964-026-02397-8"}},{"id":594,"doi":"10.1177/00332941261473841","pmid":"42541485","pmcid":null,"title":"Toward a Symbolic Substitute Hypothesis of Online Pornography Use: Alexithymia, Maladaptive Personality Domains, and Patterns of Online Engagement","authors":"Scalone A, Costanzo A, Casale S, Schimmenti A.","first_author":"Scalone A","journal":"Psychological reports","year":2026,"pub_types":["Journal Article"],"keywords":["Alexithymia","Emotion Regulation","Maladaptive Personality Domains","Online Pornography Use (Opu)"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey of 525 adults; OPU measured dichotomously (any use past month). Logistic regression controlling for demographics and other online activities.","sample_n":525,"sample_text":"525 adults (59.8% female), age 18‑68, recruited via online questionnaire.","population":"Adults 18‑68, community sample, recruited online (likely convenience).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 525 adults, people who felt more detached and had trouble identifying emotions were more likely to report using online porn in the past month. The study suggests porn may serve as a symbolic substitute for intimacy for some individuals.","clinical_takeaway":"None – the study does not provide direct clinical guidance.","confidence":0.8,"topic_tags":["sexual_function","pornography","lgbtq"],"strengths":["Large sample (N>500) for cross‑sectional analysis","Use of validated personality and alexithymia scales","Statistical control for demographics and other online activities"],"limitations":["OPU measured only as any use in past month (crude, no frequency or context)","No assessment of masturbation, moral incongruence, mental health or trauma","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00332941261473841"}},{"id":595,"doi":"10.1007/s10508-024-02970-x","pmid":"39237694","pmcid":"PMC11588884","title":"From Non-Traditional Sexual Behavior to Non-Legitimate Victims: Moral Virtue, Victim Blame, and Helping Intentions Toward a Woman Victim of Image-Based Sexual Abuse","authors":"Pacilli MG, Pagliaro S, Giovannelli I, Spaccatini F, Berlin E, Rollero C.","first_author":"Pacilli MG","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Morality","Gender-based Violence","Victim Blame","Sexting","Image-based Sexual Abuse"],"is_oa":true,"oa_url":"https://doi.org/10.1007/s10508-024-02970-x","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Randomized vignette experiment manipulating victim's sexual agency (high vs low) and relationship length (steady vs transient) with 597 adult participants.","sample_n":597,"sample_text":"597 adults (65.7% women, M_age = 31.29 years).","population":"Adults, 65.7% women, mean age 31.3 years, recruited likely via online panel (convenience sample).","country":"Not specified in abstract; likely Italy (based on author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In an experiment with 597 adults, people judged a woman who was subject to non‑consensual image sharing more harshly and were less willing to help her when the relationship with the offender was brief or when she was portrayed as sexually assertive. Men showed less empathy than women.","clinical_takeaway":"Perceived sexual agency and relationship context influence victim blaming and willingness to help in cases of image‑based sexual abuse.","confidence":0.7,"topic_tags":["gender","moral_incongruence","sexual_function"],"strengths":["Large sample size for experimental vignette study","Randomized manipulation of two theoretically relevant variables","Clear mediation analysis linking moral virtue and victim blaming to helping intentions"],"limitations":["Convenience sample limits generalisability","Reliance on self‑report scales not fully described as validated","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02970-x"}},{"id":596,"doi":"10.1071/sh19147","pmid":"32135074","pmcid":null,"title":"Non-consensual sharing of personal sexually explicit imagery among young people in Australia: results from an online survey","authors":"Douglass CH, Wright CJC, Davis AC, Lim MSC.","first_author":"Douglass CH","journal":"Sexual health","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1007 Australian youths (15‑29) recruited via unspecified online channels; self‑report questionnaire on consensual and non‑consensual SEI sharing; logistic regression analyses.","sample_n":1007,"sample_text":"1007 participants (65 % female, mean age 23 y, 67 % heterosexual)","population":"young Australians 15‑29 years (both sexes, diverse sexual identities)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,000 Australian youths found that 13 % had their private sexual images shared without consent, with most victims not reporting the crime. Knowledge of the law was common, but legal or social consequences were rare.","clinical_takeaway":"Clinicians should ask young clients about non‑consensual image sharing and be prepared to offer legal and psychosocial support.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a sensitive topic","First‑hand victimisation data","Use of multivariate logistic regression with confidence intervals"],"limitations":["Self‑report, non‑validated items","Convenience online recruitment; limited generalisability","No control for key psychosocial confounds (mental health, trauma, moral factors)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":10,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh19147"}},{"id":597,"doi":"10.1177/15579883231219572","pmid":"38142356","pmcid":"PMC10749529","title":"Estimating the Prevalence and Identifying the Correlates of Sexting Behaviors Among Cambodian Male Adolescents","authors":"Kim S, Yang Y.","first_author":"Kim S","journal":"American journal of men's health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Prevalence","Youths","Males","Correlates","Sexting"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10749529","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 647 Cambodian male youths (15‑24 years)","sample_n":647,"sample_text":"Convenience sample of male youths in Cambodia (age 15‑24)","population":"Cambodian male adolescents and young adults","country":"Cambodia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 647 Cambodian male youths found that about one‑third sent or received sexts. Factors like using porn sites, thinking about sex often, and having permissive attitudes were linked to higher sexting rates.","clinical_takeaway":"Educators should address peer pressure and sexual attitudes when designing sexting‑prevention programs for adolescents.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a regional study","Identifies multiple social and sexual correlates of sexting"],"limitations":["Reliance on single‑item self‑report measures","Cross‑sectional design cannot infer causality","No assessment of moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/15579883231219572"}},{"id":598,"doi":"10.1177/08862605251319022","pmid":"39988905","pmcid":"PMC12743126","title":"The Role of Rape Myth Acceptance, Situational Context, and Gender in Individual's Perceptions of Image-Based Sexual Abuse Victims and Perpetrators","authors":"Adair J, Senn CY.","first_author":"Adair J","journal":"Journal of interpersonal violence","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Victim Empathy","Victim Blame","Rape Myth Acceptance","Image-based Sexual Abuse","Technology-facilitated Sexual Violence"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12743126","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"experimental vignette design with between‑subjects manipulation of image‑production context and perpetrator gender; sample size not reported in abstract","sample_n":null,"sample_text":"not specified in abstract","population":"adults (likely community sample recruited online)","country":"not specified","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People blamed victims of non‑consensual image sharing more when the women had taken the photos themselves, and felt less empathy toward victims who earned money from the images. Rape‑myth attitudes increased victim blaming.","clinical_takeaway":"Educators should address rape‑myth beliefs to reduce victim blaming in image‑based sexual abuse cases.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Experimental manipulation allows causal inference about perceptions","Use of validated rape‑myth acceptance scale","Large‑scale relevance to IBSA prevention"],"limitations":["Sample size and recruitment details missing from abstract","No control for mental‑health or trauma variables","Findings may not generalise beyond the specific vignette context"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605251319022"}},{"id":599,"doi":"10.1007/s10508-024-03050-w","pmid":"39733184","pmcid":null,"title":"Safe Sexting, Sexual Orientation, and Gender: Risky Sexting in a Community Sample","authors":"Holmes EJ, Babchishin KM.","first_author":"Holmes EJ","journal":"Archives of sexual behavior","year":2025,"pub_types":["Journal Article"],"keywords":["Impulsivity","Transgender","Sexual Orientation","Gender Identity","Risky Sexual Behaviors","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 3,022 emerging adults from the community","sample_n":3022,"sample_text":"Emerging adults (18‑30 years) recruited from a community sample (N=3,022).","population":"young adults (18‑30) community sample, includes cisgender LGBPA+ and transgender participants","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 3,000 young adults, about 28% reported ‘high‑risk’ sexting (e.g., showing their face, texting strangers, or posting online). LGBPA+ and transgender participants were more likely to engage in such behavior. Impulsivity, peer pressure, and attitudes toward sexting were linked to high‑risk sexting across groups, suggesting these factors could guide sexual‑education programs.","clinical_takeaway":"Sexual‑health education should address impulsivity, peer pressure, and attitudes toward sexting for all youth, regardless of orientation or gender.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large community sample (N>3000)","Clear operational definition of high‑risk sexting","Inclusion of sexual‑ and gender‑minority groups"],"limitations":["Cross‑sectional design limits causal inference","Unclear whether impulsivity etc. measured with validated scales","No control for mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-03050-w"}},{"id":601,"doi":"10.1080/10810730.2026.2704965","pmid":"42471016","pmcid":null,"title":"Pornography Exposure and Coitus Interruptus in a Campus-Representative Sample of Collegiate Men","authors":"Wright PJ, Herbenick D, Tokunaga RS, Rothman EF.","first_author":"Wright PJ","journal":"Journal of health communication","year":2026,"pub_types":["Journal Article"],"keywords":["Withdrawal","Birth Control","Coitus Interruptus","Pornography","3Am"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of a campus‑representative sample of undergraduate and graduate men","sample_n":null,"sample_text":"campus‑representative sample (size not reported in abstract)","population":"college men (18+ yrs) at a large public U.S. university","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of college men found that each additional self‑reported increase in how often they view pornography was linked to an 18% higher odds of using coitus interruptus (pull‑out) as contraception. Age, race, relationship status, binge drinking and impulsivity did not change this relationship.","clinical_takeaway":"Higher pornography exposure may be associated with greater use of pull‑out contraception, but causality is unknown.","confidence":0.7,"topic_tags":["pornography","sexual_function","religiosity"],"strengths":["Campus‑representative sampling improves generalisability within the university setting","Examines a novel behavioural outcome (coitus interruptus) linked to pornography exposure","Tests several potential moderators and confounders"],"limitations":["Reliance on single‑item self‑report measures for both exposure and outcome","Cross‑sectional design prevents causal inference","No reporting of effect‑size confidence intervals or power considerations"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10810730.2026.2704965"}},{"id":602,"doi":"10.1016/j.puhip.2026.100829","pmid":"42620351","pmcid":"PMC13485610","title":"Pornography use and its association with risk taking sexual behaviours among Irish adolescents","authors":"Murphy NM, Neville B, Major ES, Barrett PM.","first_author":"Murphy NM","journal":"Public health in practice (Oxford, England)","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Adolescent","Sexual Health","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13485610","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional secondary analysis of a large school‑based survey (n=5277) of Irish adolescents (13‑17 y)","sample_n":5277,"sample_text":"5277 adolescents aged 13‑17 years","population":"adolescents aged 13‑17 in post‑primary schools and Youthreach centres in Galway, Mayo and Roscommon, Ireland","country":"Ireland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 5,000 Irish teens, those who had watched pornography in the past year were about three times more likely to have had condomless sex, sex while under the influence of alcohol or drugs, or to have started having sex before age 15. Parental monitoring reduced these risks.","clinical_takeaway":"Clinicians should consider discussing pornography exposure with adolescents and involve parents, as it is linked to higher sexual risk behaviors.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large, region‑wide sample of over 5 000 adolescents","Adjusted logistic regression with confidence intervals","Clear reporting of prevalence and effect sizes","Acknowledges limitation of cross‑sectional design"],"limitations":["Reliance on single‑item self‑reports for pornography use and outcomes","No measurement or control of key confounds (moral incongruence, masturbation, mental health, trauma)","Cross‑sectional design precludes causal inference","Potential self‑report bias in sensitive behaviours"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.puhip.2026.100829"}},{"id":605,"doi":"10.1556/2006.5.2016.078","pmid":"27784182","pmcid":"PMC5370376","title":"The effects of sexually explicit material use on romantic relationship dynamics","authors":"Minarcik J, Wetterneck CT, Short MB.","first_author":"Minarcik J","journal":"Journal of behavioral addictions","year":2016,"pub_types":["review-article","Journal Article"],"keywords":["Couples","Romantic Relationships","Sexual Satisfaction","Relationship Satisfaction","Pornography","Sexually Explicit Materials"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/5/4/article-p700.pdf","cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 296 college/internet participants divided by SEM use (alone, with partner, none); self‑report measures of relationship satisfaction, intimacy, commitment","sample_n":296,"sample_text":"Convenience sample of college students and online volunteers; not nationally representative","population":"adults (college students and online respondents), convenience sample","country":"unspecified (likely USA based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 296 adults, people who watched pornography together with their partner reported higher relationship satisfaction, intimacy, and commitment than those who watched alone or not at all. Frequency of use also related to these outcomes.","clinical_takeaway":"Couples’ shared pornography use may be linked to better relationship outcomes, but evidence is correlational and limited.","confidence":0.8,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Relatively large sample for a survey (N≈300)","Direct comparison of SEM use contexts (alone vs together)","Multiple relationship outcome variables examined"],"limitations":["Cross‑sectional design limits causal inference","Reliance on undisclosed self‑report scales; validation unclear","No control for moral, mental‑health or other key confounds","Convenience sample reduces generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":28,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.5.2016.078"}},{"id":606,"doi":"10.1177/08862605261462151","pmid":"42370809","pmcid":"PMC13447799","title":"Crossing the Line: Factors Associated With Escalating Pornography Use","authors":"de Roos MS, Willkomm L.","first_author":"de Roos MS","journal":"Journal of interpersonal violence","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Child","Sexual Abuse","Pornography","Internet And Abuse","Offenders/perpetrators"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13447799","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 228 non‑clinical males reporting pornography viewing frequency, arousal, and self‑rated content escalation across several categories","sample_n":228,"sample_text":"non‑clinical adult male participants (N=228)","population":"adult males, community sample (convenience)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 228 adult men, researchers identified five patterns of escalating pornography content, ranging from mainstream to extreme or illegal material, and linked these patterns to higher likelihood of engaging with child sexual abuse material.","clinical_takeaway":"None – findings are descriptive and not directly applicable to clinical practice.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["large (N>200) community sample for a sensitive topic","use of PCA to identify content‑escalation patterns"],"limitations":["relies on unvalidated self‑report measures of pornography use","cross‑sectional design cannot infer causality","no control for key confounds (e.g., trauma, mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605261462151"}},{"id":607,"doi":"10.3390/jcm15135030","pmid":"42452491","pmcid":"PMC13362642","title":"Association Between Self-Reported Pornographic Consumption Habits and Anxiety and Depression: A Systematic Review and Meta-Analysis","authors":"Tan JY, Low CE, Wong HJ, Sim IY, Lee CYC, Ding HR, Loke S, Ho CSH.","first_author":"Tan JY","journal":"Journal of clinical medicine","year":2026,"pub_types":["review-article","Review","Journal Article"],"keywords":["Depression","Anxiety","Mental health","Pornography","Pornography Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13362642","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review and random‑effects meta‑analysis of 19 observational studies examining self‑reported porn consumption and anxiety/depression.","sample_n":null,"sample_text":"19 studies (total N not specified in abstract).","population":"Adults (mixed ages) who consume pornographic material; studies varied in sample characteristics.","country":"International (studies from various databases).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 19 studies found small but significant links between how much porn people report using and higher anxiety and depression, especially in younger adults, though the evidence is observational and varied.","clinical_takeaway":"Higher porn use may be associated with mood symptoms, but clinicians should consider other factors and avoid assuming causality.","confidence":0.8,"topic_tags":["pornography","sexual_function","moral_incongruence","relationships"],"strengths":["Transparent PRISMA reporting.","Effect sizes with confidence intervals.","Subgroup analyses highlight age effects."],"limitations":["Heterogeneous primary studies with variable measures.","Limited control for key confounds (e.g., moral incongruence, masturbation).","Observational data preclude causal inference."],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jcm15135030"}},{"id":608,"doi":"10.1080/00224499.2018.1475546","pmid":"29920127","pmcid":null,"title":"Loving Oneself: The Associations Among Sexually Explicit Media, Body Image, and Perceived Realism","authors":"Vogels EA.","first_author":"Vogels EA.","journal":"Journal of sex research","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online crowdsourced survey of young adults (N=393) assessing SEM use, perceived realism, and body‑image composites; mediation analysis.","sample_n":393,"sample_text":"convenience sample, non‑probability, likely WEIRD","population":"young adults (19‑30) recruited via a crowdsourcing website, 53.4 % women","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 393 young adults, more frequent use of online porn was linked to higher body‑image scores, but only when participants thought the material was realistic. The effect was driven by body satisfaction and self‑esteem in men, and comfort being nude plus self‑esteem in women.","clinical_takeaway":"Clinicians should note that perceived realism of porn may influence body‑image outcomes, but evidence is correlational and limited.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large (N≈400) community sample for a sexuality survey","Use of multiple validated body‑image subscales","Mediation model tests theoretically relevant pathway"],"limitations":["Cross‑sectional, no causal inference","SEM use and realism measured with ad‑hoc items","No control for key confounds (moral attitudes, masturbation, mental health, relationship context)","Convenience crowdsourcing sample limits generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":28,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1475546"}},{"id":609,"doi":"10.1007/s10508-017-1125-z","pmid":"29392485","pmcid":null,"title":"Is Viewing Sexually Explicit Material Cheating on Your Partner? A Comparison Between the United States and Spain","authors":"Negy C, Plaza D, Reig-Ferrer A, Fernandez-Pascual MD.","first_author":"Negy C","journal":"Archives of sexual behavior","year":2018,"pub_types":["Journal Article"],"keywords":["Jealousy","Infidelity","Pornography","Sexually Explicit Material"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of university students in US and Spain (n=592 total)","sample_n":592,"sample_text":"392 US students; 200 Spanish students","population":"university students aged 18‑36, convenience sample","country":"United States; Spain","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 592 university students in the US and Spain found most do not view watching porn as cheating. Believing it is cheating was linked to higher jealousy, negative attitudes toward porn, and, in the US, greater religiosity and lower self‑esteem.","clinical_takeaway":"Clinicians should recognise that perceptions of porn use as infidelity vary culturally and are tied to relationship attitudes rather than inherent harms.","confidence":0.85,"topic_tags":["pornography","sexual_function","relationships","moral_incongruence"],"strengths":["Large combined sample across two countries","Includes cultural comparison (US vs Spain)","Measures several psychosocial correlates (jealousy, religiosity, self‑esteem)"],"limitations":["Convenience university sample limits generalisability","Reliance on ad‑hoc questionnaire items, no validated scales","Masturbation and broader mental‑health variables not assessed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-1125-z"}},{"id":612,"doi":"10.1016/j.esxm.2017.11.001","pmid":"29291985","pmcid":"PMC5815968","title":"Sexual Arousal and Sexually Explicit Media (SEM): Comparing Patterns of Sexual Arousal to SEM and Sexual Self-Evaluations and Satisfaction Across Gender and Sexual Orientation","authors":"Hald GM, Stulhofer A, Lange T.","first_author":"Hald GM","journal":"Sexual medicine","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Arousal","Pornography","Sexually Explicit Media","Self-evaluations"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5815968","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 2,035 regular SEM users; convenience sample; cross‑sectional","sample_n":2035,"sample_text":"regular SEM users recruited online; not a probability sample","population":"regular users of sexually explicit media in Croatia (age/gender/sexual orientation not specified)","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed over 2,000 adults in Croatia who regularly view pornography, identifying groups who are aroused by non‑mainstream versus mainstream content. Non‑mainstream viewers reported higher overall arousal and more frequent use, but only small differences in sexual satisfaction or self‑judgments. A new scale (NPAS) reliably distinguished these groups.","clinical_takeaway":"Different pornography preferences do not appear to be linked to poorer sexual satisfaction or more negative self‑views.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample (N>2000) for a sexuality survey","Development and validation of a new arousal scale (NPAS)","Explores gender and sexual‑orientation differences"],"limitations":["Convenience, self‑selected online sample limits generalisability","No measurement of key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2017.11.001"}},{"id":614,"doi":"10.1007/s10508-018-1290-8","pmid":"30229516","pmcid":null,"title":"The Relationship Among Online Sexually Explicit Material Exposure to, Desire for, and Participation in Rough Sex","authors":"Vogels EA, O'Sullivan LF.","first_author":"Vogels EA","journal":"Archives of sexual behavior","year":2019,"pub_types":["Journal Article"],"keywords":["Gender","Young Adults","Rough Sex","Sexually Explicit Material","Perceived Realism"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 327 young adults recruited via crowdsourcing; convenience sample","sample_n":327,"sample_text":"327 participants recruited online","population":"young adults (19‑30, 50.8% men) from a crowdsourcing website","country":"unspecified (likely USA/International via crowdsourcing)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 327 young adults, people who watched rough sexual acts in online porn were more likely to want and have tried those acts themselves. The study shows a link but cannot say whether viewing causes desire or vice‑versa.","clinical_takeaway":"Viewing rough porn is associated with greater interest and experience in rough sex, but clinicians should treat the relationship as correlational, not causal.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large (N>300) community sample for this topic","Considers gender, sexual orientation, and perceived realism","Explicitly acknowledges lack of causal inference"],"limitations":["Convenience, crowdsourced sample limits generalisability","Reliance on unvalidated self‑report measures","No control for key confounds (moral incongruence, mental health, trauma)","Cross‑sectional design prevents directionality"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":16,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1290-8"}},{"id":615,"doi":"10.1177/09727531261450406","pmid":"42299315","pmcid":"PMC13264530","title":"Pornography Use, Motivational Patterns and Suicidal Ideation Among Young Adults: A Cross-sectional Behavioural Analysis","authors":"Roy C, Sameer A.","first_author":"Roy C","journal":"Annals of neurosciences","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Young Adults","Suicidal Ideation","Bayesian Regression","Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13264530","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional behavioural survey of university students (N=541)","sample_n":541,"sample_text":"541 university students","population":"young adult university students (likely WEIRD sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 541 university students, higher porn use was slightly linked to lower suicidal thoughts, while using porn to avoid emotions was linked to higher suicidal thoughts. Depression was the strongest predictor of suicidal ideation.","clinical_takeaway":"Porn use alone does not predict suicide risk; clinicians should focus on depressive symptoms and emotional‑avoidance motives.","confidence":0.7,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Large sample for a cross‑sectional survey","Use of Bayesian regression with credible intervals","Considers motivational factors, not just frequency"],"limitations":["Cross‑sectional design prevents causal inference","No measurement of moral incongruence or masturbation","Convenience university sample limits generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/09727531261450406"}},{"id":616,"doi":"10.1007/s12119-022-10000-y","pmid":"35968198","pmcid":"PMC9361880","title":"Personality and Sexual Perceptions of Penises: Digital Impression Formation","authors":"Brooks TR, Reysen S.","first_author":"Brooks TR","journal":"Sexuality & culture","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["penis","perception","Digital","Sexting","Zero Acquaintance"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9361880","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey with 106 participants rating penis images","sample_n":106,"sample_text":"106 participants recruited online","population":"dating‑app users (convenience sample)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"People rate pictures of penises, judging longer, wider, and moderately hairy ones as more attractive and having better personality traits, while shorter, narrower penises are seen as more neurotic.","clinical_takeaway":"None – the study explores perception, not health or behaviour.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Novel focus on zero‑acquaintance visual impressions","Adequate sample size for simple rating analyses","Clear hypotheses and supported findings"],"limitations":["Relies on non‑validated, ad‑hoc rating items","Convenience sample limits generalisability","No control for potential confounds (e.g., participant gender, sexual orientation)","Statistical reporting limited to significance testing"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12119-022-10000-y"}},{"id":617,"doi":"10.21203/rs.3.rs-2753197/v1","pmid":null,"pmcid":null,"title":"Female sexual response to audiovisual stimuli in 2D/3D modality and first/third person perspective stance","authors":"Marečková A, Hůla M, Klapilová K, Novák O.","first_author":"Marečková A","journal":"Research Square","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-2753197/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Within‑subject laboratory experiment exposing 47 heterosexual women to 2D vs 3D and first‑ vs third‑person erotic videos, measuring genital (VPG) and subjective arousal.","sample_n":47,"sample_text":"Convenience sample of 47 heterosexual women recruited for a laboratory study.","population":"Adult heterosexual female participants, convenience sample, N=47","country":"Czech Republic (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 47 women, 2‑D erotic videos were judged more arousing than 3‑D VR videos, though both showed similar genital responses. Perspective (first‑ vs third‑person) also affected how present participants felt, but not their physiological arousal.","clinical_takeaway":"Viewing format (2D vs 3D) influences subjective arousal but not genital response; clinicians should note that subjective experience may differ from physiological signs.","confidence":0.6,"topic_tags":["sexual_function","adolescents","neuroscience"],"strengths":["Objective genital arousal measure (VPG)","Within‑subject design controls video content","Effect sizes reported"],"limitations":["Small convenience sample (N=47)","No pre‑registration or power analysis","Limited generalisability to broader population"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-2753197/v1"}},{"id":618,"doi":"10.1016/j.psychres.2026.117275","pmid":"42322925","pmcid":null,"title":"Depressive symptoms and pornography use: A census-matched longitudinal study","authors":"Engelhardt R, Geppert R, Trommer D, Grubbs JB, Maes J, Kraus SW.","first_author":"Engelhardt R","journal":"Psychiatry research","year":2026,"pub_types":["Journal Article"],"keywords":["Depression","Mental health","Depressive Symptoms","Pornography Use","Moral Disapproval","Pornography Frequency"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"five-wave census‑matched sample of US adults (N=2806), RI‑CLPM analysis","sample_n":2806,"sample_text":"census‑matched longitudinal cohort","population":"American adults, mean age 51, 53% women","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally weighted sample of over 2,800 U.S. adults, people who reported using pornography more often also tended to have higher depressive symptom scores. This link was stable over five data collections and was not explained by age, gender or moral disapproval of pornography.","clinical_takeaway":"Higher pornography use frequency is associated with more depressive symptoms, but causality is unclear; clinicians should consider broader context.","confidence":0.8,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Large, census‑matched sample","Five measurement waves allow stable estimation","Adjusted for moral disapproval"],"limitations":["Pornography use measured only as frequency","Masturbation not assessed","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psychres.2026.117275"}},{"id":620,"doi":"10.1016/j.chiabu.2024.107169","pmid":"39631178","pmcid":null,"title":"\"They are not victimless crimes…that's frustrating to hear\": Qualitative insights from prosecutors working on cases related to technology facilitated child sexual abuse material","authors":"O'Brien JE, Kahn GZ, Gast L, Mitchell KJ.","first_author":"O'Brien JE","journal":"Child abuse & neglect","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Qualitative","Prosecution","Csam","Child Sexual Abuse Material"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 24 prosecutors from 16 U.S. states; grounded‑theory coding of semi‑structured interviews","sample_n":24,"sample_text":"24 prosecutors from 16 states","population":"prosecutors experienced with technology‑facilitated child sexual abuse material cases (N=24)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 24 U.S. prosecutors reveal that lack of awareness, limited resources, and legal hurdles make it hard to successfully prosecute cases involving child sexual abuse material.","clinical_takeaway":"None – study focuses on legal system challenges, not clinical treatment.","confidence":0.8,"topic_tags":["csbd"],"strengths":["Focused sample of experienced prosecutors across multiple states","Rigorous qualitative methodology (grounded theory, double coding, debriefing)","Provides practical insight for policy and resource allocation"],"limitations":["Small, non‑representative sample; limited generalisability","No quantitative data to assess prevalence of identified challenges","Potential social desirability bias in self‑report by prosecutors"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2024.107169"}},{"id":621,"doi":"10.1007/s10508-017-1145-8","pmid":"29556900","pmcid":null,"title":"Explaining the Relationship Between Sexually Explicit Internet Material and Casual Sex: A Two-Step Mediation Model","authors":"Vandenbosch L, van Oosten JMF.","first_author":"Vandenbosch L","journal":"Archives of sexual behavior","year":2018,"pub_types":["Journal Article"],"keywords":["Youth","Sexual behavior","Media Effects","Casual Sex","Pornography","Perceived Realism"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Three‑wave online panel survey of Dutch adolescents (N=1079) examining SEIM use, perceived utility, instrumental attitudes and casual sex over time.","sample_n":1079,"sample_text":"N = 1079 Dutch adolescents, 53.1% boys, 93.5% exclusively heterosexual, mean age 15.11 (SD = 1.39).","population":"Adolescents (mean age 15.1) recruited via an online panel in the Netherlands; mostly heterosexual; 53% male.","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A three‑wave Dutch teen survey found that watching online sexually explicit material predicted later casual sex, partly because teens came to see the material as useful information, which strengthened instrumental attitudes toward sex and led to more casual encounters.","clinical_takeaway":"Clinicians should note that adolescents who view explicit online material may develop attitudes that promote casual sex, but causality cannot be firmly established.","confidence":0.85,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large, multi‑wave adolescent sample (N>1000)","Temporal ordering allows mediation testing","Clear operationalisation of attitudes and perceived utility"],"limitations":["Self‑report measures, possible social desirability bias","Limited control of key confounds (e.g., moral/religious attitudes, mental health)","Convenience online panel – not nationally representative"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":6,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-1145-8"}},{"id":622,"doi":"10.1080/09540121.2013.871219","pmid":"24382316","pmcid":"PMC3989406","title":"The influence of sexually explicit online media on sex: do men who have sex with men believe they \"do what they see\"?","authors":"Nelson KM, Leickly E, Yang JP, Pereira A, Simoni JM.","first_author":"Nelson KM","journal":"AIDS care","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Sexual Risk-taking","Men Who Have Sex With Men (Msm)","Pornography","Sexually Explicit Online Media"],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"In‑depth qualitative interviews with 16 Seattle‑area MSM; thematic analysis of perceptions about online porn and sexual risk.","sample_n":16,"sample_text":"16 MSM participants recruited in Seattle","population":"Men who have sex with men (MSM), Seattle region, n=16","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In interviews with 16 gay and bisexual men, researchers found participants think online porn can teach them about sex and make them feel more comfortable, but they also worry it normalizes unprotected anal sex, possibly encouraging risky behavior in other men.","clinical_takeaway":"Clinicians should note that MSM may view porn as both educational and a potential risk cue; discuss how media influences perceptions of safe sex.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Provides first‑hand MSM perspectives","Identifies both positive and negative perceived impacts","Highlights potential avenues for HIV‑prevention messaging"],"limitations":["Very small, non‑representative sample (n=16)","Findings based on self‑report perceptions, not behavioral data","No measurement of confounding factors (e.g., moral views, mental health)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":19,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540121.2013.871219"}},{"id":624,"doi":"10.1007/s10508-026-03503-4","pmid":"42642684","pmcid":null,"title":"Nonconsensual Pornography, Sextortion, and Deepfake Pornography Victimization: Findings from a National Online Sample of U.S. Adults","authors":"Ruvalcaba Y, Ray C, Zinter KE, Le VD, Berra L, Leemis R.","first_author":"Ruvalcaba Y","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual Orientation","Sexual Violence","Sextortion","Online Sexual Abuse","Deepfake Pornography","Technology-facilitated Sexual Violence"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Probability‑based online survey of U.S. adults (Fall 2023); weighted prevalence estimates; adjusted Wald tests; no experimental or longitudinal component.","sample_n":null,"sample_text":"two web panels; weighted to U.S. population","population":"U.S. adults (nationally representative online panels)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationally weighted online survey of U.S. adults found that about 4% have experienced non‑consensual porn, 5% sextortion, and 1% deep‑fake porn, with higher rates among younger, LGB+, and disabled people.","clinical_takeaway":"Clinicians should be aware that a notable minority of adults are victims of technology‑facilitated sexual violence, especially those from marginalized groups.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Probability‑based sample weighted to national population","Clear definition of victimization categories","Relevant demographic subgroup analyses"],"limitations":["Binary self‑report items lack validation detail","Cross‑sectional design cannot assess causality","Sample size not reported in abstract"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03503-4"}},{"id":625,"doi":"10.1071/sh25097","pmid":"42045098","pmcid":null,"title":"Factors associated with post-pornography masturbation among university students: a machine-learning study","authors":"Mamun MA, Hasan M, Muktarul M, Hasan ME, Islam J, Roy N, ALmerab MM, Al-Mamun F, Muhit M.","first_author":"Mamun MA","journal":"Sexual health","year":2026,"pub_types":["Journal Article"],"keywords":["Predictive modeling","Psychological factors","Masturbation","Sexual Health","Sexual Arousal","Machine Learning","university students","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 1179 Bangladeshi university students who had used pornography; logistic regression and supervised machine‑learning models applied to predict post‑pornography masturbation.","sample_n":1179,"sample_text":"1179 university students who reported prior pornography use","population":"University students (Bangladesh), n≈1179, self‑selected as having prior pornography use","country":"Bangladesh","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,179 Bangladeshi university students who watch porn, about one‑fifth said they masturbated afterwards. Frequency of porn use, living in a dorm and smoking were linked to higher odds, while distress was not.","clinical_takeaway":"Post‑porn masturbation appears common and related to use patterns, not to reported distress; clinicians should consider behavioural context rather than assume pathology.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample for a single‑site study","Use of both traditional regression and machine‑learning approaches","Clear reporting of prevalence and key predictors"],"limitations":["Cross‑sectional; cannot infer causality","Self‑report single‑item measures for key behaviours","No assessment of moral or relational confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh25097"}},{"id":627,"doi":"10.1590/1413-812320212611.30532020","pmid":"34852113","pmcid":null,"title":"Consumption of sexually explicit media and unprotected anal sex in men who have sex with men","authors":"Martins AA, Queiroz AAFLN, Frota OP, Araújo TME, Mendes IAC, Fronteira I, Sousa ÁFL.","first_author":"Martins AA","journal":"Ciencia & saude coletiva","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"por","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire recruited via Facebook, N=2248 MSM, cross‑sectional analysis with logistic regression","sample_n":2248,"sample_text":"Convenience sample recruited through a Facebook page; not a probability sample","population":"cisgender men who have sex with men, 18+, recruited in Brazil (2017)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 2,248 gay and bisexual men recruited online, those who preferred pornographic videos showing condomless sex were more likely to report having anal sex without a condom themselves.","clinical_takeaway":"Preference for bareback porn may signal higher risk of condomless anal intercourse; clinicians should discuss media influences when counselling MSM about HIV prevention.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a cross‑sectional survey","Multivariate logistic regression with odds ratios and confidence intervals","Focused research question on bareback SEM and condomless sex"],"limitations":["Convenience recruitment via Facebook limits generalisability","SEM consumption measured with a single, non‑validated item","Potential unmeasured confounders (moral beliefs, mental health, trauma) not addressed"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":8,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/1413-812320212611.30532020"}},{"id":628,"doi":"10.1007/s10461-017-1971-7","pmid":"29124421","pmcid":null,"title":"If You Film It Will They Watch? Factors Associated with Willingness to View Safer Sex Messaging in Internet-Based Sexually Explicit Media","authors":"Downing MJ, Antebi-Gruszka N, Schrimshaw EW, Hirshfield S.","first_author":"Downing MJ","journal":"AIDS and behavior","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Internet","Hiv Prevention","Pornography","Sexually Explicit Media"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 859 adults, separate analyses by sexual orientation groups","sample_n":859,"sample_text":"adult internet users (men and women) who view sexually explicit media","population":"men and women, diverse racial/ethnic background, recruited via internet","country":"Not specified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"An online survey of 859 adults found that many are willing to watch sexually explicit videos that include HIV/STI prevention messages, and most think the industry should provide them. Willingness varied by sexual orientation, suggesting tailored messaging may be needed.","clinical_takeaway":"Public‑health campaigns could consider embedding safer‑sex messages in adult videos, as a sizable portion of viewers are open to it.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large, racially diverse sample (N = 859)","Separate analyses for distinct sexual‑orientation groups","Addresses a novel public‑health question"],"limitations":["Self‑report measures of willingness, likely unvalidated","Cross‑sectional design; cannot infer causality","No assessment of key confounds (e.g., moral views, mental health)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-017-1971-7"}},{"id":629,"doi":"10.3390/ijerph19063682","pmid":"35329369","pmcid":"PMC8951151","title":"Problematic Internet Pornography Use and Psychological Distress among Emerging Adults in Malaysia: Gender as a Moderator","authors":"Tan SA, Goh YS, Mohd Zaharim N, Gan SW, Yap CC, Nainee S, Lee LK.","first_author":"Tan SA","journal":"International journal of environmental research and public health","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Malaysia","Gender","Psychological Distress","Emerging Adults","Internet Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8951151","cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 144 emerging adult pornography users (purposive sampling)","sample_n":144,"sample_text":"purposive online recruitment of pornography users","population":"Emerging adults (Malaysia), self‑selected pornography users","country":"Malaysia","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 144 Malaysian emerging adults who use internet pornography, men reported higher problematic use, but women showed stronger links between that use and psychological distress. The study suggests gender‑specific sexual‑health programs may be needed.","clinical_takeaway":"Screen for distress especially in women who report problematic porn use; consider gender‑tailored interventions.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Relatively large N for a pilot study","Focus on gender moderation","Addresses an under‑researched region"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of key confounds (moral incongruence, masturbation, mental health)","Convenience/purposive sampling limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph19063682"}},{"id":631,"doi":"10.3390/children11060682","pmid":"38929261","pmcid":"PMC11201677","title":"The Relationship between Cyber Violence and Cyber Sex Crimes: Understanding the Perception of Cyber Sex Crimes as Systemic Issues","authors":"Lee E, Lee HE.","first_author":"Lee E","journal":"Children (Basel, Switzerland)","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Systemic","Perpetrator","Victim","Cyber Sex Crime","Cyber Violence","Teacher Intervention"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11201677","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"nationwide survey of 9,016 adolescents (2021) and 9,693 adolescents (2022); cross‑sectional analysis of self‑report data","sample_n":18709,"sample_text":"9016 adolescents in 2021 and 9693 in 2022","population":"adolescents in South Korea (age unspecified)","country":"South Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A Korean nationwide survey of over 18,000 adolescents found that seeing cyber violence online predicts seeing cyber sex crimes, and that viewing cyber violence as serious makes youths more likely to see cyber sex crimes as a systemic problem needing societal action.","clinical_takeaway":"None – the study addresses population‑level perceptions, not individual clinical issues.","confidence":0.7,"topic_tags":["csbd","pornography","masturbation","sexual_function"],"strengths":["Large, nationally representative adolescent sample","Focus on both victim and perpetrator experiences","Policy‑relevant recommendations"],"limitations":["Cross‑sectional design limits causal inference","Unclear whether survey items are validated scales","Potential self‑report bias"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/children11060682"}},{"id":632,"doi":"10.1080/00224499.2021.2007521","pmid":"35104185","pmcid":null,"title":"Engagement with Emerging Forms of Sextech: Demographic Correlates from a National Sample of Adults in the United States","authors":"Gesselman AN, Kaufman EM, Marcotte AS, Reynolds TA, Garcia JR.","first_author":"Gesselman AN","journal":"Journal of sex research","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Web‑based, demographically representative national sample (N = 7,512) of U.S. adults aged 18‑65; participants reported engagement with eight forms of sex‑technology.","sample_n":7512,"sample_text":"7,512 American adults recruited via an online panel designed to be demographically representative of the U.S. population.","population":"U.S. adults, community sample, age 18‑65, gender‑balanced, racially diverse","country":"United States","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a national U.S. survey of 7,500 adults, younger men, higher‑income individuals and sexual minorities were more likely to use emerging sexual technologies such as camming sites, virtual‑reality porn and AI chatbots, while religious people also showed higher use.","clinical_takeaway":"Engagement with newer sex‑tech is common and varies by demographic factors; clinicians should ask about a broad range of digital sexual activities, not just pornography.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Comprehensive list of emerging sex‑tech modalities","Clear demographic analyses"],"limitations":["Reliance on single‑item self‑report measures without validated scales","No assessment of key confounds (masturbation, mental health, partner context, trauma)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":24,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2021.2007521"}},{"id":633,"doi":"10.1016/j.chiabu.2026.108113","pmid":"42140021","pmcid":null,"title":"Examining the extent professionals explore pornography use in cases of harmful sexual behaviour: A retrospective case file analysis","authors":"Barraclough L, Cain S, Laws S, Kelly L.","first_author":"Barraclough L","journal":"Child abuse & neglect","year":2026,"pub_types":["Journal Article"],"keywords":["Pornography","Sexual Assault Referral Centre","Harmful Sexual Behaviour","Case File Analysis"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective case file analysis of records from a Sexual Assault Referral Centre, Social Care and Police (N=182).","sample_n":182,"sample_text":"Records from a regional SARC over four months; deeper analysis on 87 cases from one local authority.","population":"Children and young people referred for harmful sexual behaviour in England.","country":"England","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A review of 182 child sexual offence case files in England found professionals only recorded pornography exposure in 16% of cases, even though many harmful acts matched content seen online. The study suggests better training and record‑keeping are needed.","clinical_takeaway":"Clinicians should routinely ask about pornography exposure when assessing harmful sexual behaviour in youths.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large, real‑world case file dataset","Combines quantitative coding with thematic analysis","Highlights a clear gap in professional practice"],"limitations":["No validated measures of pornography exposure or sexual behaviour","Retrospective documentation may miss unrecorded disclosures","Limited to one regional centre; not nationally representative"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2026.108113"}},{"id":634,"doi":"10.1016/j.ijchp.2024.100474","pmid":"38882232","pmcid":"PMC11176964","title":"Validation of the multidimensional model of the subjective orgasm experience in the context of same-sex relationships","authors":"Mangas P, Sierra JC, Álvarez-Muelas A, Cervilla O, Sánchez-Pérez GM, Granados R.","first_author":"Mangas P","journal":"International journal of clinical and health psychology : IJCHP","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Genital Response","Same-sex Relationships","Subjective Sexual Arousal","Sexual Excitation","Multidimensional Model Of The Subjective Orgasm Experience"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.ijchp.2024.100474","cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory task with 68 participants viewing neutral and explicit gay films; regression analyses linking orgasm dimensions to arousal measures.","sample_n":68,"sample_text":"68 young adults (34 males, 34 females)","population":"young adults (34 males, 34 females) sexually active with same‑sex partners","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested whether a model of how people experience orgasm, previously used for heterosexual couples, also fits same‑sex couples. Using lab measures of arousal and genital response, they found that different parts of the model relate to sexual excitement and physiological response, supporting the model’s relevance beyond heterosexual contexts.","clinical_takeaway":"The MMSOE can be applied to understand orgasm experiences in same‑sex relationships, aiding clinicians working with these populations.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Validated MMSOE framework applied to a new population","Physiological genital response measured","Balanced gender sample"],"limitations":["Small sample, especially for gender‑specific analyses","Cross‑sectional; cannot infer causality","Limited control of potential psychological confounds"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijchp.2024.100474"}},{"id":641,"doi":"10.1007/s10964-015-0326-9","pmid":"26208829","pmcid":"PMC4698276","title":"Lower Psychological Well-Being and Excessive Sexual Interest Predict Symptoms of Compulsive Use of Sexually Explicit Internet Material Among Adolescent Boys","authors":"Doornwaard SM, van den Eijnden RJ, Baams L, Vanwesenbeeck I, ter Bogt TF.","first_author":"Doornwaard SM","journal":"Journal of youth and adolescence","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Symptoms","Adolescents","Psychological Well-being","Sexual Interest","Compulsive Use","Sexually Explicit Internet Material"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4698276","cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal panel study with two waves six months apart; community sample of 331 Dutch adolescent boys who reported using sexually explicit Internet material.","sample_n":331,"sample_text":"331 Dutch boys (M age = 15.16 years, range 11-17) who indicated that they used sexually explicit Internet material.","population":"Adolescent boys (age 11‑17) in the Netherlands who use sexually explicit Internet material","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"Among Dutch teenage boys who view porn online, lower self‑esteem and higher sexual interest predicted more symptoms of compulsive use both at the same time and six months later, while depressive feelings predicted later increase.","clinical_takeaway":"Monitor boys with low self‑esteem or high sexual pre‑occupation for signs of problematic porn use.","confidence":0.8,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Longitudinal design allowing temporal precedence","Reasonable sample size for regression analyses","Inclusion of both well‑being and sexual interest variables"],"limitations":["No assessment of moral incongruence or masturbation, key confounds","Compulsive use measured with likely self‑label scale; possible circularity","Sample limited to users in the Netherlands; not nationally representative"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":4,"interpretation":7}},"scite":{"supporting":10,"contrasting":0,"mentioning":57,"citing_publications":79,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10964-015-0326-9"}},{"id":642,"doi":"10.1037/hea0000678","pmid":"30307275","pmcid":"PMC6309258","title":"Sexually explicit media exposure as a sexual milestone among gay, bisexual, and other men who have sex with men","authors":"Perry NS, Nelson KM, Carey MP, Simoni JM.","first_author":"Perry NS","journal":"Health psychology : official journal of the Division of Health Psychology, American Psychological Association","year":2019,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet‑recruited survey of 1,114 adult GBMSM; self‑report of age of first sexually explicit media exposure and current condomless anal sex; multivariable logistic regression.","sample_n":1114,"sample_text":"Internet‑recruited convenience sample of adult gay, bisexual and other men who have sex with men.","population":"GBMSM adult internet users (N=1,114)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among gay and bisexual men, those who first saw sexually explicit media at a younger age were slightly more likely to have condomless anal sex as adults.","clinical_takeaway":"Earlier exposure to porn may be associated with higher sexual risk; clinicians might consider developmental timing when discussing risk reduction.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample (N>1,000)","Clear statistical reporting with CIs","Controls for basic sexual‑development timing variables"],"limitations":["Cross‑sectional; cannot establish causality","Self‑report of sensitive behaviours","No measurement of moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/hea0000678"}},{"id":643,"doi":"10.21203/rs.3.rs-10591398/v1","pmid":null,"pmcid":null,"title":"Timing Matters: Age of Onset in Online Child Sexual Solicitation and Abuse and Young Adults’ Well-Being","authors":"Haag A, Chauviré-Geib K, Piesch E, Rassenhofer M, Fegert JM.","first_author":"Haag A","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Nationally representative German survey of 1,006 young adults (18‑29), retrospective self‑report of nine OCSSA subtypes and age of first exposure; WHO‑5 well‑being index as outcome; dual machine‑learning (LASSO, Random Forest) plus post‑hoc linear regression; controls for offline child maltreatment,","sample_n":1006,"sample_text":"Nationally representative German survey (N=1,006)","population":"Young adults (18‑29) from a German probability sample","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A German survey of 1,006 young adults found that early unwanted exposure to pornographic material (especially at age 13) is linked to lower adult well‑being, even after accounting for other childhood trauma.","clinical_takeaway":"Early unwanted exposure to sexual material may have lasting negative effects on well‑being; clinicians should assess such histories.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative sample","Validated well‑being measure","Controls for major confounder (offline child maltreatment)"],"limitations":["Retrospective self‑report of exposure timing","OCSSA subtypes measured with ad‑hoc items","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-10591398/v1"}},{"id":646,"doi":"10.1016/j.chiabu.2024.106910","pmid":"38908230","pmcid":null,"title":"A multi-factor knuckle and nail bed verification tool for forensic imagery analysis","authors":"Santopietro M, Guest R, Seigfried-Spellar KC, Elliott SJ.","first_author":"Santopietro M","journal":"Child abuse & neglect","year":2024,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Biometric Identification","Hands","Online Child Sexual Exploitation","Knuckles","Forensic Investigative Tool"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"","sample_n":null,"sample_text":"","population":"","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors created a machine‑learning tool that can recognise a person’s hand, knuckle and nail‑bed patterns in images or videos, aiming to help police identify offenders in online child sexual‑exploitation cases.","clinical_takeaway":"None – the study does not provide information relevant to clinical practice or sexual‑health treatment.","confidence":0.4,"topic_tags":["csbd","pornography","masturbation","sexual_function"],"strengths":["Innovative application of biometric verification to forensic imagery","Evaluation on multiple hand datasets with varying capture conditions"],"limitations":["No direct relevance to pornography or sexual‑health constructs","Lacks detail on statistical power, effect sizes, and validation metrics","Performance may not generalise beyond the specific datasets used"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2024.106910"}},{"id":647,"doi":"10.21203/rs.3.rs-7801196/v1","pmid":null,"pmcid":null,"title":"Pathways Linking Pornography Use to Obsessive–Compulsive Disorder: A Systematic Review and Clinical Perspective","authors":"Vieira FFP.","first_author":"Vieira FFP.","journal":"Research Square","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of empirical studies and clinical reports (preprint, no meta‑analysis)","sample_n":null,"sample_text":"Not applicable – review of published studies","population":"Adults using pornography with/without OCD (studies varied)","country":"International literature","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The review summarizes evidence that pornography use and OCD may share similar brain and cognitive patterns, such as strong cue reactions and trouble inhibiting urges, and suggests treatment ideas that target both.","clinical_takeaway":"Consider assessing OCD‑like compulsivity in clients with problematic pornography use and use CBT or serotonergic meds where appropriate.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Broad synthesis of psychological and neurobiological mechanisms","Identifies overlapping processes between pornography use and OCD","Proposes integrated clinical framework"],"limitations":["No quantitative meta‑analysis; effect sizes not reported","Potential inclusion of heterogeneous study designs without risk‑of‑bias assessment","Limited detail on how moral or other confounds were handled"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-7801196/v1"}},{"id":649,"doi":"10.1071/sh25160","pmid":"41621852","pmcid":null,"title":"Watching and doing: are pornography use and sex motives correlated with hooking up among Chinese university women","authors":"Yu K, Wu AMS.","first_author":"Yu K","journal":"Sexual health","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual Health","Casual Sex","Hooking Up","University Women","Enhancement Motives","Pornography","Sex Motives","Sexual Scripting Theory"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large university‑student survey (N=1242) measuring self‑reported porn use frequency, sex motives and hookup behaviour; cross‑sectional correlational analysis","sample_n":1242,"sample_text":"Convenience sample of female undergraduates in China","population":"Chinese university women","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,242 Chinese university women, higher frequency of watching pornography was linked to more casual‑sex (hookup) encounters. Women who watched more porn also reported stronger motives for sex (e.g., enhancement, coping) and weaker motives against sex, which partly explained the association.","clinical_takeaway":"Higher porn consumption may signal greater propensity for casual sex; sexual‑health interventions should consider underlying motives rather than assuming pathology.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["large sample size for a single‑site survey","addresses understudied Chinese female student population","examines mediating role of sex motives"],"limitations":["cross‑sectional design limits causal inference","unclear whether motive scales are validated in this cultural context","no control for moral, mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh25160"}},{"id":651,"doi":"10.21203/rs.3.rs-10562583/v1","pmid":null,"pmcid":null,"title":"Dispositional Mindfulness as a Candidate Shared Resilience Factor Across Multiple Forms of Problematic Technology Use: A Two-Wave Cross-Lagged Panel Study","authors":"Holas P, Roczon P.","first_author":"Holas P","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two‑wave cross‑lagged panel study with a nationwide Polish quota sample (baseline N=2122, follow‑up N=1412).","sample_n":2122,"sample_text":"Nationwide Polish quota sample of adults; baseline N=2,122, 6‑month follow‑up N=1,412.","population":"Polish adults (quota sample).","country":"Poland","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large Polish sample, people who reported higher dispositional mindfulness at baseline showed lower levels of problematic internet, smartphone, social‑media, and pornography use six months later, suggesting mindfulness may protect against multiple technology‑related problems.","clinical_takeaway":"Encouraging mindfulness could help reduce risky or compulsive pornography and other technology use.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large initial sample with 6‑month follow‑up","Cross‑lagged panel design allows examination of directionality","Measurement invariance tested across time"],"limitations":["Quota sampling limits generalisability to the Polish population","PTU measured via self‑report scales; unclear if validated for each domain","Key confounds for problematic pornography use (e.g., moral incongruence, masturbation) not assessed"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-10562583/v1"}},{"id":652,"doi":"10.3389/frph.2024.1409351","pmid":"39687202","pmcid":"PMC11646879","title":"Sexual decision-making: an exploratory interview study of Cambodian adolescents","authors":"Park G, Yang Y.","first_author":"Park G","journal":"Frontiers in reproductive health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sex","decision-making","External factors","Adolescents","Interview","Cambodia","Qualitative Research","Internal Factors"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11646879","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional descriptive qualitative interview study with 30 convenience‑sample Cambodian adolescents (15 male, 15 female) who were sexually active","sample_n":30,"sample_text":"30 participants recruited via social networking services","population":"Cambodian adolescents (unmarried, sexually active)","country":"Cambodia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 30 Cambodian teens showed that sexual choices are shaped by personal triggers like internet porn and clothing, as well as outside forces such as culture, peers, family and school messages, with notable gender differences.","clinical_takeaway":"Sex education for Cambodian youths should be culturally tailored and address both media influences and peer/family pressures.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Adheres to SRQR reporting standards","Provides gender‑balanced sample","Highlights cultural and contextual influences on adolescent sexual decision‑making"],"limitations":["Small, non‑representative convenience sample","No validated measurement instruments","Findings limited to sexually active urban adolescents"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/frph.2024.1409351"}},{"id":654,"doi":"10.1016/j.jsxm.2017.01.002","pmid":"28130018","pmcid":null,"title":"The Relationship Between Self-Reported Sexually Explicit Media Consumption and Sexual Risk Behaviors Among Men Who Have Sex With Men in China","authors":"Xu Y, Zheng Y, Rahman Q.","first_author":"Xu Y","journal":"The journal of sexual medicine","year":2017,"pub_types":["Journal Article"],"keywords":["China","Men Who Have Sex With Men","Sexual Risk Behaviors","Sexual Sensation Seeking","Pornography","Sexually Explicit Media","Hiv-related Knowledge"],"is_oa":false,"oa_url":"https://kclpure.kcl.ac.uk/ws/files/63566849/s1_ln25543650_1022567323_1939656818Hwf1116099821IdV_182460353125543650PDF_HI0001.pdf","cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Web‑based survey of 314 Chinese MSM examining self‑reported SEM consumption and sexual risk behaviours, with statistical control for several covariates.","sample_n":314,"sample_text":"Web‑based convenience sample of MSM in China","population":"Chinese men who have sex with men (MSM), recruited online","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 314 Chinese gay and bisexual men, those who reported watching more porn that showed risky sexual acts also reported having more regular partners with whom they engaged in risky sex. Other factors like sexual sensation seeking and HIV knowledge also related to risk behaviour.","clinical_takeaway":"Higher exposure to risk‑focused porn may be linked to greater sexual risk among MSM; clinicians should consider media exposure when discussing sexual health.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a web‑based MSM study","Controls for several relevant behavioural covariates","Clear focus on specific SEM content (risk‑behaviour depictions)"],"limitations":["Cross‑sectional design limits causal inference","Self‑report measures without validated SEM or risk‑behaviour scales","Key confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2017.01.002"}},{"id":655,"doi":"10.2196/46488","pmid":"37756040","pmcid":"PMC10568387","title":"Sexuality and Sexual and Reproductive Health Depiction in Social Media: Content Analysis of Kinyarwanda YouTube Channels","authors":"Uhawenimana TC, Musabwasoni MGS, Nsengiyumva R, Mukamana D.","first_author":"Uhawenimana TC","journal":"Journal of medical Internet research","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Content analysis","Social Media","Sexual And Reproductive Health","Covid-19","Media Platform","Kinyarwanda Youtube Channels"],"is_oa":true,"oa_url":"https://www.jmir.org/2023/1/e46488/PDF","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 21,506 Kinyarwanda YouTube videos; descriptive statistics and cross‑tabulations; convenience sample of publicly available videos.","sample_n":21506,"sample_text":"21,506 videos retrieved; 1,369 channels analyzed.","population":"Kinyarwanda‑language YouTube videos directed to the general public; no human participants.","country":"Rwanda (Kinyarwanda language focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers examined over 21,000 Kinyarwanda YouTube videos to see how sexuality and reproductive health are portrayed. Most videos focused on sexual content rather than health information, and during COVID‑19 explicit material increased four‑fold.","clinical_takeaway":"None - the study describes online content, not individual health outcomes.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large systematic retrieval of publicly available videos","Clear coding framework for content categories","First study of its kind in Kinyarwanda language"],"limitations":["No assessment of video audience or impact","Potential selection bias in search strategy","Reliance on ad‑hoc coding without reported validation"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/46488"}},{"id":658,"doi":"10.1177/02537176241275554","pmid":"39564244","pmcid":"PMC11572467","title":"Sexual Knowledge, Attitude and Behaviors of Medical Students: A Cross-sectional Study","authors":"Patel SH, Desai ND, Shah SH.","first_author":"Patel SH","journal":"Indian journal of psychological medicine","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Behavior","Media","Attitude","Medical Student","Sexual Knowledge","Sources Influencing"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11572467","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"web-based survey of 300 medical students (31.5% response rate), descriptive analytical cross‑sectional study","sample_n":300,"sample_text":"300/950 respondents","population":"medical students, India, ages 18‑26","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A web survey of 300 Indian medical students found they generally have good sexual knowledge and liberal attitudes, with internet being the main information source. Knowledge and attitude scores were strongly correlated.","clinical_takeaway":"None – the study does not provide actionable clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of a published knowledge/attitude questionnaire (SKAQ‑II)","Reasonable sample size for descriptive purposes","Includes source of information data"],"limitations":["Cross‑sectional design prevents causal inference","Limited control for key confounds (e.g., religiosity, mental health)","Self‑selected volunteer sample with low response rate"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/02537176241275554"}},{"id":659,"doi":"10.31234/osf.io/twdjn","pmid":null,"pmcid":null,"title":"The Taboo Love: Male-Male Erotica as a Potential Sexual Attraction for girls Regulate the Brain Response","authors":"Jiang X, Ao N, cyy, Niu H, Yanan C, Zhou C, Du F.","first_author":"Jiang X","journal":"PsyArXiv","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://psyarxiv.com/twdjn/download","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional fNIRS study of female yaoi fans viewing yaoi images; likely convenience sample; no control group mentioned","sample_n":null,"sample_text":"not reported in abstract","population":"female yaoi fans (self‑selected)","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational","underpowered_sample","self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"avoid","plain_summary":"A small preprint used brain‑lighting (fNIRS) to see how young women who like male‑male erotic comics (yaoi) react when viewing those images. The authors claim the pictures cause pre‑frontal brain changes and hint at ‘addiction’, but the study lacks proper controls, validated measures, and clear statistical support.","clinical_takeaway":"None – the study’s methods are insufficient to inform clinical practice.","confidence":0.4,"topic_tags":["pornography","sexual_function","neuroscience"],"strengths":["Attempts to use neuroimaging (fNIRS) in a novel area","Focuses on a specific understudied subculture"],"limitations":["Small, self‑selected sample; likely under‑powered","No control/comparison group reported","Circular definition of addiction; no validated scales","No measurement of key confounds (moral, mental health, etc.)","Interpretation overstates causal claims"],"rubric_version":"2.0","raw_total":16,"max_possible":70,"pct_score":23,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":3,"statistics":3,"confounds":1,"design":3,"addiction_criteria":2,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/twdjn"}},{"id":660,"doi":"10.1515/ijamh-2016-0056","pmid":"27740921","pmcid":null,"title":"Association between exposure to sexually explicit content in the electronic media and sexual intentions of in-school adolescents in Southwest Nigeria","authors":"Adeolu J, Owoaje E, Olumide A.","first_author":"Adeolu J","journal":"International journal of adolescent medicine and health","year":2016,"pub_types":["Journal Article"],"keywords":["Media","Adolescents","Sexual Intention"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 750 in‑school adolescents in Nigeria; interviewer‑administered questionnaire; logistic regression analysis","sample_n":750,"sample_text":"750 adolescents (both sexes) recruited from selected schools","population":"senior secondary school students (private and public) in Southwest Nigeria (N≈750)","country":"Nigeria","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 750 Nigerian secondary‑school students, those who reported higher exposure to sexually explicit media were more likely to say they intended to have sex in the next year, even after accounting for age, religiosity, peer pressure and family factors.","clinical_takeaway":"Media exposure is linked to adolescents' sexual intentions; clinicians should discuss media literacy and safe decision‑making with youth.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a school‑based survey","Multivariable logistic regression with confidence intervals","Consideration of a wide range of sociodemographic and familial covariates"],"limitations":["Cross‑sectional design cannot establish causality","Exposure measure appears ad‑hoc and not psychometrically validated","Sexual intention likely assessed by a single self‑report item"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":7,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/ijamh-2016-0056"}},{"id":662,"doi":"10.1080/19317611.2026.2630710","pmid":"42683076","pmcid":null,"title":"Pornography Use and Sexual Health: Investigating Its Relationship with Sexual Function and Satisfaction in Iran","authors":"Shekarchi R, Saladino V, Eleuteri S.","first_author":"Shekarchi R","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2026,"pub_types":["Journal Article"],"keywords":["Iran","Sexual function","Gender Differences","Sociocultural Factors","Sexual Satisfaction","Pornography Consumption"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenient snowball sample of 500 Iranian adults; self‑report questionnaires; correlational analysis.","sample_n":500,"sample_text":"Convenient snowball recruitment through social media; not a probability sample.","population":"Iranian adults (N=500) recruited via social media; gender‑balanced sample not specified.","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 500 Iranian adults, higher pornography use was linked to greater sexual desire and arousal, but also to lower erectile function in men and reduced sexual satisfaction overall. Gender did not change these patterns.","clinical_takeaway":"Clinicians should note that pornography use may be associated with mixed sexual outcomes; assessment should consider individual desire and satisfaction rather than assuming uniform harm.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (N=500)","Use of validated sexual function scales (FSFI, IIEF, NSSS)","Gender‑specific analysis"],"limitations":["Convenience snowball sampling limits generalisability","No measurement of moral, mental‑health or relationship confounders","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2026.2630710"}},{"id":665,"doi":"10.1080/00918369.2015.1060066","pmid":"26075485","pmcid":"PMC4536112","title":"Acceptability of Sexually Explicit Images in HIV Prevention Messages Targeting Men Who Have Sex With Men","authors":"Iantaffi A, Wilkerson JM, Grey JA, Rosser BR.","first_author":"Iantaffi A","journal":"Journal of homosexuality","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sex Education","Social Marketing","Gay Men","Hiv Prevention","Pornography","Sexually Explicit Media","Homonormativity"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"online focus groups with 79 MSM, thematic analysis","sample_n":79,"sample_text":"79 participants","population":"men who have sex with men (MSM), recruited online","country":"USA (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a series of online focus groups with 79 gay and bisexual men, researchers explored how explicit sexual images affect the acceptability of HIV‑prevention ads. Themes around audience expectations, setting, and community representation emerged, showing that cultural norms shape what is considered appropriate.","clinical_takeaway":"When designing HIV‑prevention messages for MSM, consider community standards for sexual explicitness to improve acceptability.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Rich qualitative data from target community","Multiple focus groups allow theme saturation","Addresses cultural context of homonormativity"],"limitations":["Convenience online sample limits generalizability","No validated measurement of acceptability constructs","No quantitative assessment of potential confounds"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2015.1060066"}},{"id":666,"doi":"10.1007/s13178-016-0248-7","pmid":"28979572","pmcid":"PMC5624736","title":"Sexually Explicit Online Media, Body Satisfaction, and Partner Expectations Among Men who have Sex with Men: a Qualitative Study","authors":"Leickly E, Nelson K, Simoni J.","first_author":"Leickly E","journal":"Sexuality research & social policy : journal of NSRC : SR & SP","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["MSM","Body Satisfaction","Sexual Minorities","Pornography","Sexually Explicit Online Media","Partner Expectations"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative interview study with 16 MSM participants","sample_n":16,"sample_text":"16 MSM participants were interviewed; recruitment method not specified in abstract","population":"Men who have sex with men (MSM), n=16, recruited for semi‑structured interviews","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 16 gay and bisexual men suggest that porn aimed at men who have sex with men may raise unrealistic body and partner expectations, potentially harming body confidence, but could also be used to promote body‑positive messages.","clinical_takeaway":"Clinicians should be aware that MSM‑specific porn may affect body image and partner ideals, but evidence is limited and based on a small qualitative sample.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Focus on an understudied population (MSM)","Qualitative depth provides insight into perceived effects"],"limitations":["Small, non‑representative convenience sample","No validated measures of pornography use or body satisfaction","No control for key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13178-016-0248-7"}},{"id":667,"doi":"10.1038/s41585-021-00456-2","pmid":"33948009","pmcid":null,"title":"Clinical use and implications of sexual devices and sexually explicit media","authors":"Dewitte M, Reisman Y.","first_author":"Dewitte M","journal":"Nature reviews. Urology","year":2021,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or meta‑analysis; no new empirical data presented.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews how sex toys can be used in therapy, outlining benefits, risks, and the barriers clinicians face when discussing them with patients. It aims to improve practitioner comfort and patient communication about sexual pleasure.","clinical_takeaway":"Clinicians should consider sexual devices as therapeutic tools and address common misconceptions to enhance sexual health care.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad overview of clinical applications of sexual devices","Highlights ethical and practical considerations for clinicians"],"limitations":["Narrative format without systematic search or bias assessment","No empirical data or quantitative synthesis"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":15,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41585-021-00456-2"}},{"id":669,"doi":"10.31234/osf.io/t73x4","pmid":null,"pmcid":null,"title":"Does size matter? Genital self-image, genital size, pornography use and openness towards cosmetic genital surgery in 3662 Swedish men and women","authors":"Hustad IB, Malmqvist K, Ivanova E, Ruck C, Enander J.","first_author":"Hustad IB","journal":"PsyArXiv","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/t73x4","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 3,662 Swedish adults","sample_n":3662,"sample_text":"3662 participants","population":"Swedish adults (men and women), recruited online (presumed convenience sample)","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 3,662 Swedish adults, larger genital size was linked to a more positive genital self‑image, while pornography use was not. Over a third were dissatisfied with their genitals, and about one‑tenth were open to cosmetic surgery. Avoidance behaviours were tied to negative self‑image.","clinical_takeaway":"Genital dissatisfaction appears unrelated to recent pornography use; clinicians should focus on body‑image concerns rather than SEM exposure.","confidence":0.7,"topic_tags":["gender","pornography","sexual_function"],"strengths":["Large sample size","Clear reporting of confidence intervals for size estimates","Examines multiple psychosocial variables"],"limitations":["Cross‑sectional design limits causal inference","Self‑reported genital size may be inaccurate","No measurement of key confounds (mental health, relationship status, moral attitudes)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/t73x4"}},{"id":670,"doi":"10.1177/15248380231178754","pmid":"37313793","pmcid":"PMC10913305","title":"Victims of Technology-Assisted Child Sexual Abuse: A Scoping Review","authors":"Chauviré-Geib K, Fegert JM.","first_author":"Chauviré-Geib K","journal":"Trauma, violence & abuse","year":2024,"pub_types":["Scoping Review","review-article","Journal Article"],"keywords":["Internet","Victim","Children’s Experiences","Technology-Assisted Child Sexual Abuse","Abuse Impact"],"is_oa":true,"oa_url":"https://journals.sagepub.com/doi/pdf/10.1177/15248380231178754","cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review of primary studies about victims of technology‑assisted child sexual abuse; no risk‑of‑bias assessment, descriptive synthesis","sample_n":null,"sample_text":"20 primary studies included; sample sizes of each study not reported in abstract","population":"children and adult victims of TA‑CSA (n≈20 studies, total participants not specified)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This scoping review examined 20 studies that directly involved children or adults who experienced sexual abuse through the Internet, such as exposure to pornographic material, grooming, and sexting. It describes the types of technology‑assisted abuse and the emotional, physical, and social harms reported by victims, while noting that definitions and detailed knowledge remain limited.","clinical_takeaway":"Professionals should recognize the varied psychological and relational impacts of technology‑assisted sexual abuse on victims and the need for clearer definitions to guide assessment and support.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Systematic search across multiple databases","Focuses on an under‑studied perspective (victims rather than offenders)","Identifies gaps and calls for standardized definitions"],"limitations":["No quantitative synthesis or risk‑of‑bias assessment","Limited to studies reporting victim data (possible publication bias)","Does not assess methodological quality of included studies"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":32,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/15248380231178754"}},{"id":671,"doi":"10.1007/s10508-017-1045-y","pmid":"28884272","pmcid":"PMC5842099","title":"Viewing Sexually Explicit Media and Its Association with Mental Health Among Gay and Bisexual Men Across the U.S","authors":"Whitfield THF, Rendina HJ, Grov C, Parsons JT.","first_author":"Whitfield THF","journal":"Archives of sexual behavior","year":2018,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual Orientation","Negative Affect","Gay And Bisexual Men","Body Attitude","Sexually Explicit Media"],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online national convenience survey of 1071 HIV‑negative gay and bisexual men; self‑report questionnaire","sample_n":1071,"sample_text":"1071 HIV‑negative GBM completing an online survey","population":"GBM (gay and bisexual men), United States, HIV‑negative, adult","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a U.S. survey of 1,071 gay and bisexual men, more hours spent watching sexually explicit media were linked to poorer body image and higher levels of anxiety and depression, with body image partly explaining the mental‑health effects.","clinical_takeaway":"When addressing anxiety or depression in gay/bisexual men, clinicians might consider discussing porn use and body‑image concerns.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size (n>1000)","Use of validated mental‑health and body‑attitude scales","Mediation analysis adds theoretical depth"],"limitations":["Cross‑sectional design; cannot infer causality","No measurement of moral incongruence or masturbation, limiting specificity","Self‑selected online sample may not be representative of all GBM"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":20,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-1045-y"}},{"id":672,"doi":"10.1111/aogs.70144","pmid":"41729062","pmcid":null,"title":"Consent, pornography use, and perceived impact on sexual behavior among women","authors":"Casper M, Tydén T, Sundström-Poromaa I, Gyllenberg F.","first_author":"Casper M","journal":"Acta obstetricia et gynecologica Scandinavica","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual behavior","Sexual Health","Consent","Sexual Education","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 557 women attending a gynecological clinic; mixed quantitative‑qualitative analysis; no longitudinal or experimental component.","sample_n":557,"sample_text":"557 women visiting a gynecological clinic for contraceptive counseling in 2023.","population":"Women (age range not specified) seeking contraceptive counseling in Sweden (N=557).","country":"Sweden","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 557 Swedish women, most had viewed porn at least once; frequent viewers were less likely to report having been asked for consent in their last sexual encounter. Participants thought porn could shape expectations, intimacy, and attitudes toward consent.","clinical_takeaway":"Clinicians should note a possible link between frequent porn use and lower reported consent discussions, but causality is unproven; consider discussing media literacy in sexual‑health counseling.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large community sample for this topic","Mixed‑methods adds depth","Relevant public‑health question"],"limitations":["No validated scales for pornography use or consent outcomes","Cross‑sectional; cannot infer causality","Key confounders (moral attitudes, mental health, relationship context) not measured"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/aogs.70144"}},{"id":673,"doi":"10.21203/rs.3.rs-958951/v1","pmid":null,"pmcid":null,"title":"Reproductive Health Knowledge, Attitude and Practice Among Adolescents Attending Secondary Schools in Asmara, Eritrea","authors":"Andemeskel YM, Weldegiorgis GG, Bekit BZ, Gebresilassie EG, Gebreab GH, Gebresilassie TY, Abraha YH.","first_author":"Andemeskel YM","journal":"Research Square","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-958951/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 428 secondary‑school adolescents in Asmara selected by simple random sampling from school lists; self‑administered questionnaire.","sample_n":428,"sample_text":"428 adolescent high‑school students, age 14‑19, selected by simple random sampling from school enrolment lists.","population":"Adolescents (14‑19 y) attending secondary schools in Asmara, Eritrea (N = 428).","country":"Eritrea","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 428 Eritrean high‑school students found low knowledge about reproductive health, modest attitudes, very low sexual activity, but over half reported viewing sexually explicit material. The authors recommend better sexual education.","clinical_takeaway":"Clinicians should be aware that many adolescents may view explicit material despite limited sexual health knowledge; education is key.","confidence":0.7,"topic_tags":["adolescents","religiosity","sexual_function"],"strengths":["Reasonably large sample for a school‑based survey","Random sampling within schools","Clear descriptive reporting of knowledge and practice"],"limitations":["No validated measures of sexual behaviour or attitudes","No control for key confounders (e.g., moral views, mental health)","Cross‑sectional design limits causal inference","Limited to one city; generalisability uncertain"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-958951/v1"}},{"id":674,"doi":"10.1080/13691058.2015.1027738","pmid":"25891135","pmcid":"PMC4565153","title":"Sexually explicit racialised media targeting men who have sex with men online: a content analysis of high-risk behaviour depicted in online advertisements","authors":"White JM, Dunham E, Rowley B, Reisner SL, Mimiaga MJ.","first_author":"White JM","journal":"Culture, health & sexuality","year":2015,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Internet","Men Who Have Sex With Men","Black Men","Advertisements","Sexually Explicit Media"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 217 online advertisements coded with a detailed codebook; multivariable logistic regression used to examine associations between race/theme and condomless sex depictions.","sample_n":217,"sample_text":"217 sexually explicit advertisements","population":"Advertisements (n=217) from a male sex‑seeking website in 2011; no human participants.","country":"United States (implied by authors and NIH funding)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers examined 217 explicit ads on a gay‑dating site, coding race, themes and whether condomless sex was shown. Ads with Black men or a “thug” theme were more likely to depict condomless sex.","clinical_takeaway":"None – the study does not provide evidence about individual sexual health risks or treatment.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Systematic coding with a detailed codebook","Large number of ads for content analysis","Use of multivariable logistic regression"],"limitations":["Single website limits generalisability","No assessment of viewer perceptions or behaviours","No reliability statistics reported in abstract"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2015.1027738"}},{"id":675,"doi":"10.1080/03630242.2016.1222326","pmid":"27602599","pmcid":null,"title":"Push and pull: Exposure of young Taiwanese women to sexually explicit materials","authors":"Tseng YH, Esposito N, Kuo SH, Chou FH, Cheng ML.","first_author":"Tseng YH","journal":"Women & health","year":2017,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Young Women","Push-pull Theory","Sexually Explicit Material (Sem)"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"focus-group qualitative study with 38 participants (ages 18‑22) in Taiwan; content analysis based on push‑pull theory","sample_n":38,"sample_text":"38 women aged 18‑22 recruited for six focus groups","population":"young Taiwanese women","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Young Taiwanese women discuss how parental values, peers, and sexual curiosity shape their exposure to sexually explicit material, seeing it as part of a gradual sexual‑exploration process.","clinical_takeaway":"Clinicians should recognise that SEM exposure may be part of normal sexual development, not necessarily a pathology.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides culturally specific qualitative insight","Uses established push‑pull theoretical framework","Direct voices of target age group"],"limitations":["Small, non‑random sample limits generalisability","No quantitative measurement of pornography use or related distress","No assessment of key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/03630242.2016.1222326"}},{"id":677,"doi":"10.3389/fpsyg.2026.1719257","pmid":"41783297","pmcid":"PMC12953447","title":"Attitudes toward pornography and gender differences among Spanish young adults","authors":"Velikova M, Terol-Cantero MC, Martín-Aragón M, Vázquez-Rodríguez C.","first_author":"Velikova M","journal":"Frontiers in psychology","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Cluster analysis","Youth","Sexual Attitudes","Pornography Consumption","Gender Dynamics","Transgressive Content"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12953447","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of Spanish young adults (N=285 for scale validation; N=1000 for attitude assessment)","sample_n":1285,"sample_text":"Convenience sample of Spanish young adults; not nationally representative","population":"Spanish youth aged 18‑29, convenience sample","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,285 Spanish youth, men reported higher pornography use and more positive attitudes than women. Three attitude profiles emerged, including a group attracted to transgressive content. The study provides a new, validated scale for measuring attitudes toward porn.","clinical_takeaway":"None – the study describes attitudes, not health outcomes or treatment implications.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Large sample for attitude assessment","Validated new scale with CFA","Gender‑focused analysis"],"limitations":["Convenience sample; limited generalisability","No control for moral, mental‑health or relational confounds","Cross‑sectional; no causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2026.1719257"}},{"id":679,"doi":"10.1007/s10508-017-1097-z","pmid":"29071546","pmcid":null,"title":"Associations Between Croatian Adolescents' Use of Sexually Explicit Material and Sexual Behavior: Does Parental Monitoring Play a Role?","authors":"Tomić I, Burić J, Štulhofer A.","first_author":"Tomić I","journal":"Archives of sexual behavior","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescents","Parental Monitoring","Sexual Experience","Sexting","Sexually Explicit Material","Sexual Aggressiveness"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience sample of Croatian 16‑year‑olds (N=1265); structural equation modeling of self‑reported SEM use and sexual outcomes","sample_n":1265,"sample_text":"large convenience sample of 16‑year‑old adolescents","population":"adolescents (16 y) from Croatia, recruited via the Internet","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,265 Croatian 16‑year‑olds, more frequent use of sexually explicit material was linked to sexual experience, sexting and sexual aggressiveness. Strong parental monitoring was associated with less SEM use and lower risky sexual outcomes, suggesting that parental engagement can protect adolescents.","clinical_takeaway":"Encouraging active parental monitoring may reduce SEM‑related risky sexual behaviours in adolescents.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["large N for a survey study","focus on parental monitoring as a protective factor","uses structural equation modeling to test pathways"],"limitations":["cross‑sectional; cannot infer causality","self‑report measures, likely non‑validated","limited control for key confounds (e.g., moral incongruence, mental health)","convenience sample may not be nationally representative"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":25,"citing_publications":63,"retracted":false,"notices":[{"status":"Has correction","date":"2018-2-1","noticeDoi":"10.1007/s10508-018-1159-x","doi":"10.1007/s10508-017-1097-z"},{"status":"Has erratum","date":"2018-2-1","noticeDoi":"10.1007/s10508-018-1159-x","doi":"10.1007/s10508-017-1097-z"}],"url":"https://scite.ai/reports/10.1007/s10508-017-1097-z"}},{"id":680,"doi":"10.21203/rs.3.rs-7037603/v1","pmid":null,"pmcid":null,"title":"Prevalence of and Factors Associated with Intentional Pornography Access Among Spanish Adolescents","authors":"Pereda N, Águila-Otero A.","first_author":"Pereda N","journal":"Research Square","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-7037603/v1","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large national adolescent survey (N=4,024) assessing past‑year intentional pornography access and associated variables","sample_n":4024,"sample_text":"4024 adolescents (52.6% girls) from across Spain","population":"Spanish adolescents aged 14‑17 (school‑based sample)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 4,000 Spanish teens, about half had watched porn in the past year and 1 in 10 did so daily. Boys and older youths used porn more. Those who accessed porn reported weaker moral feelings and higher alcohol use and run‑away behaviour, suggesting a link between porn exposure and other risk factors.","clinical_takeaway":"Pornography use is common in adolescents and associates with other risk behaviours; clinicians should consider broader sexual‑health education rather than focusing solely on porn exposure.","confidence":0.78,"topic_tags":["pornography","adolescents","prevalence","sexual_function","moral_incongruence"],"strengths":["Large, nationally distributed sample","Clear prevalence estimates","Includes multiple personal and behavioural correlates"],"limitations":["Cross‑sectional, cannot infer causality","Masturbation not measured despite co‑occurrence with porn use","Moral emotions may not capture moral incongruence/religiosity"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-7037603/v1"}},{"id":681,"doi":"10.1007/s10508-016-0878-0","pmid":"27987085","pmcid":"PMC5438767","title":"Preferences for Condomless Sex in Sexually Explicit Media Among Black/African American Men Who Have Sex with Men: Implications for HIV Prevention","authors":"Nelson KM, Eaton LA, Gamarel KE.","first_author":"Nelson KM","journal":"Archives of sexual behavior","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["MSM","Hiv Prevention","Black Men","Pornography","Sexually Explicit Media"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 653 HIV‑negative Black‑identified MSM recruited for an HIV‑prevention trial in Atlanta","sample_n":653,"sample_text":"Convenience sample drawn from participants in an HIV‑prevention trial; not a probability or nationally representative sample","population":"Black/African American men who have sex with men, HIV‑seronegative, ages 18‑62 (N=653)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 653 Black‑identified MSM, most preferred condomless sex in porn. Preference was linked to bisexual identity, transactional sex, and strong heat‑of‑the‑moment risk thoughts, but not directly to actual condomless sex with partners.","clinical_takeaway":"Preference for condomless porn does not necessarily predict condomless sex; clinicians should assess broader risk cognitions and contexts.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a niche population","Multivariate analysis controlling for several sexual‑behavior variables","Focus on an understudied group (Black MSM) and on SEM preferences"],"limitations":["Cross‑sectional, cannot infer causality","Key constructs (preference for condomless SEM) measured with single‑item, non‑validated scale","No measurement of moral incongruence, masturbation, mental‑health or trauma covariates"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0878-0"}},{"id":682,"doi":"10.1093/jsxmed/qdac048","pmid":"36763959","pmcid":null,"title":"Automatic attention to sexual stimuli: exploring the role of neuroticism and sexual excitation/inhibition through event-related potentials","authors":"Aguiar S, Carvalho J, Carrito ML, Santos IM.","first_author":"Aguiar S","journal":"The journal of sexual medicine","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["ERP","Neuroticism","N2","Sexual Stimuli","Sis/ses","Automatic Attention"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"lab-based ERP experiment with 58 participants, using a modified oddball paradigm to record neural responses to romantic and explicit sexual pictures.","sample_n":58,"sample_text":"58 individuals","population":"Adults (N=58) recruited for a personality‑neuroscience study; sample size moderate, not described as clinical or treatment‑seeking.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study recorded brain responses while 58 adults viewed romantic and explicit pictures. People high in neuroticism showed stronger early neural reactions (N2) when they also scored high on a sexual‑inhibition scale, suggesting that neuroticism may make sexual images feel more threatening.","clinical_takeaway":"People with high neuroticism and sexual inhibition may experience heightened automatic attention to sexual cues; therapeutic strategies that lower arousal could be helpful.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Validated personality and sexual excitation/inhibition scales","Objective neural measure (ERP) of automatic attention","Novel mediation model linking neuroticism, SIS, and ERP"],"limitations":["Small sample limits power for mediation analysis","No control for moral, mental‑health or relational confounds","Cross‑sectional; causal claims are tentative"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":6,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdac048"}},{"id":683,"doi":"10.1080/00224499.2015.1066744","pmid":"26479019","pmcid":"PMC4837081","title":"A New Measure of the Perceived Influence of Sexually Explicit Online Media on the Sexual Behaviors of Men Who Have Sex With Men","authors":"Nelson KM, Pantalone DW, Gamarel KE, Simoni JM.","first_author":"Nelson KM","journal":"Journal of sex research","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large internet sample of MSM, factor analysis, reliability, convergent validity; cross‑sectional survey linking perceived influence to self‑reported condomless sex","sample_n":1170,"sample_text":"Internet sample of MSM (N = 1,170) used for validation; additional qualitative (N = 28) and survey (N = 100) phases","population":"men who have sex with men (MSM), recruited online","country":"not specified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and validated a questionnaire measuring how men who have sex with men think online porn influences their own and others' sexual scripts. Higher perceived influence on condom‑less sex scripts was linked to more self‑reported risky sex.","clinical_takeaway":"Perceived impact of porn on sexual scripts may relate to risk behaviour, but causality is unproven; clinicians should assess broader factors.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Rigorous multi‑phase scale development","Large validation sample (N > 1,000)","Factor analysis and reliability testing"],"limitations":["Cross‑sectional; cannot infer causality","Key confounds (e.g., moral incongruence, mental health) not measured","Self‑report of both influence and risk behaviour may inflate associations"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":1,"mentioning":12,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2015.1066744"}},{"id":684,"doi":"10.1080/19317611.2024.2439330","pmid":"39949736","pmcid":"PMC11817529","title":"Young People's Trust in Digital Sexual Healthcare: A Narrative Review","authors":"Woodward N, Buckley L, Dean JA, Fowler JA.","first_author":"Woodward N","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Review","TRUST","Sexual Health","Young People","Digital Health"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of 13 qualitative/quantitative papers; no primary data collected.","sample_n":null,"sample_text":"Narrative review; no new participants.","population":"Young people (10‑24 y) discussed in source papers, but not sampled by the authors.","country":"International (sources from US, AU, UK, CA, NL)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises what makes digital sexual‑health services trustworthy for young people, highlighting design, privacy, expert credibility and consistency as key factors.","clinical_takeaway":"Design digital sexual‑health tools to be clear, private and credible to improve young users' trust and uptake.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Systematic search of multiple databases","Clear thematic synthesis of trust factors","Inclusion of diverse geographic contexts"],"limitations":["No primary empirical data; relies on existing studies","Narrative review lacks formal quality appraisal of included papers","Limited to 13 studies, potentially missing newer evidence"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2024.2439330"}},{"id":686,"doi":"10.3390/ijerph182010635","pmid":"34682381","pmcid":"PMC8536183","title":"Examining the Relationship between Gender Contentedness and Sex-Related Experiences among Taiwanese Youth","authors":"Liu CY, Kuo JH, Lee TH, Strong C, Tsai MC, Lee CT.","first_author":"Liu CY","journal":"International journal of environmental research and public health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Adolescent","Sexual Health","Sexually Explicit Media","Gender Contentedness","Risky Sex Behavior"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/18/20/10635/pdf?version=1634182515","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Secondary analysis of a Taiwanese adolescent cohort (n=2624, mean age 13.3) using hierarchical multinomial logistic regression to examine associations between self‑reported gender contentedness and outcomes such as exposure to sexually explicit media and risky sexual behavior.","sample_n":2624,"sample_text":"n = 2624, mean age = 13.3 ± 0.47 years, 51 % male","population":"Adolescents (≈13 years old) from a longitudinal youth cohort in Taiwan","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Taiwanese teens, those who feel uncomfortable with their gender are more likely to report seeing pornographic material and engaging in risky sex. The study suggests gender dissatisfaction may influence sexual experiences.","clinical_takeaway":"Clinicians should consider gender contentedness when discussing media exposure and sexual risk with adolescents.","confidence":0.78,"topic_tags":["pornography","adolescents","gender","sexual_function"],"strengths":["Large, community‑based adolescent sample","Use of multivariate regression with confidence intervals","Focus on an understudied factor (gender contentedness)"],"limitations":["Reliance on single‑item self‑reports; no validated scales reported","No measurement or control of key sexual‑health confounders (e.g., mental health, moral incongruence)","Cross‑sectional analysis limits causal inference despite longitudinal cohort"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph182010635"}},{"id":687,"doi":"10.1093/jsxmed/qdag021","pmid":"41722101","pmcid":null,"title":"Gender differences in pornography use and sexual health outcomes: a systematic review and meta-analysis","authors":"Laleh SS, Yıldız Karaahmet A.","first_author":"Laleh SS","journal":"The journal of sexual medicine","year":2026,"pub_types":["Meta-Analysis","Systematic Review","Journal Article"],"keywords":["Sexual function","Gender Differences","Sexual Satisfaction","Psychological Outcomes","Pornography Use","Masturbation Frequency"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Systematic review and random‑effects meta‑analysis of 21 observational studies (N = 138,192) comparing male and female pornography users on sexual function, satisfaction, masturbation frequency and psychological distress.","sample_n":138192,"sample_text":"Twenty‑one studies, total N = 138 192 participants.","population":"Adult men and women from community‑based observational studies; no specific inclusion of treatment‑seeking or clinic samples.","country":"International (studies from multiple countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 21 studies (138,000+ adults) found men who view pornography report lower sexual function and satisfaction, while women report slightly higher psychological distress. Men also masturbate more often. Findings are based on self‑reports and cannot prove cause‑and‑effect.","clinical_takeaway":"Clinicians should consider gender‑specific patterns when discussing pornography use, but note that evidence is correlational and limited by self‑report bias.","confidence":0.8,"topic_tags":["pornography","gender","sexual_function","masturbation"],"strengths":["First meta‑analysis focusing on gender‑specific pornography outcomes.","Large combined sample size (>138 k).","PRISMA‑guided systematic search and risk‑of‑bias assessment."],"limitations":["Reliance on heterogeneous self‑report measures; validation unclear.","No control for key confounds (moral incongruence, mental health, partner factors).","Predominantly cross‑sectional primary studies; causal inference limited."],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdag021"}},{"id":689,"doi":"10.1007/s10508-025-03398-7","pmid":"41872641","pmcid":null,"title":"Pornography Craving Questionnaire: Measurement Properties of the Brazilian Version","authors":"de Arruda GT, da Silva EV, Paines GP, Berni EB, Pivetta HMF, Braz MM.","first_author":"de Arruda GT","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Craving","Questionnaire","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1540 Brazilian adults, psychometric validation of a translated questionnaire","sample_n":1540,"sample_text":"1540 participants recruited online in Brazil","population":"Brazilian adults (18+, both sexes)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers translated and tested the Pornography Craving Questionnaire in Brazil, finding it reliable and valid for measuring how much people crave porn. The 9‑item scale works similarly for men and women and correlates with how often porn is used.","clinical_takeaway":"The Brazilian PCQ can be used to assess porn craving reliably in clinical or research settings.","confidence":0.8,"topic_tags":["measurement","pornography","sexual_function","csbd","treatment"],"strengths":["Large sample size","Comprehensive COSMIN-based psychometric evaluation","Use of Item Response Theory for cut‑off determination"],"limitations":["Convenience online recruitment may limit generalisability","No assessment of potential confounding factors such as moral incongruence or mental health","No pre‑registration reported"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03398-7"}},{"id":691,"doi":"10.3389/fpsyg.2025.1544691","pmid":"40177052","pmcid":"PMC11962043","title":"Masturbation parameters: their relation to sexual arousal in young people who engage in same-sex relationships","authors":"Sánchez-Pérez GM, Granados R, Mangas P, Sierra JC.","first_author":"Sánchez-Pérez GM","journal":"Frontiers in psychology","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Genital Response","Same-sex Relationships","Subjective Sexual Arousal","Sexual Excitation","Masturbation Parameters"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11962043","cited_by_count":5,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross-sectional laboratory study with 72 young adults (36 women, 36 men) viewing neutral and explicit films; regression analysis of masturbation parameters predicting genital and subjective arousal","sample_n":72,"sample_text":"72 participants (36 women, 36 men)","population":"young adults (18‑32) engaged in same‑sex relationships","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study of 72 young adults in same‑sex relationships, researchers found that certain aspects of masturbation—like desire and how orgasm feels—were linked to how strongly participants reported sexual arousal and, for men, to genital response.","clinical_takeaway":"Masturbation characteristics may influence sexual arousal; clinicians could explore these factors when addressing sexual function.","confidence":0.6,"topic_tags":["masturbation","sexual_function"],"strengths":["Laboratory measurement of genital response","Inclusion of both male and female participants","Use of multiple, theoretically relevant masturbation parameters"],"limitations":["Small convenience sample, limited generalisability","No control for moral, mental‑health or relationship variables","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2025.1544691"}},{"id":692,"doi":"10.1007/s10508-015-0594-1","pmid":"26373650","pmcid":"PMC4820469","title":"Sexually Explicit Internet Material and Adolescents' Sexual Uncertainty: The Role of Disposition-Content Congruency","authors":"van Oosten JM.","first_author":"van Oosten JM.","journal":"Archives of sexual behavior","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Adolescents","Media Effects"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4820469","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two‑wave nationally representative panel of 1,765 Dutch adolescents (13‑17 y).","sample_n":1765,"sample_text":"representative two‑wave panel survey","population":"Adolescents (13‑17 y) from the Netherlands, both genders.","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Dutch youth survey, teen girls who either see sex as impersonal or lack a strong gendered view become more uncertain about sexuality after watching online porn, while other girls do not show this effect.","clinical_takeaway":"Clinicians should consider adolescents' sexual attitudes when discussing potential impacts of porn exposure on sexual confidence.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large, representative longitudinal sample","Clear moderation analysis of sexual dispositions","Focus on within‑gender differences"],"limitations":["Measures of SEIM use and sexual uncertainty likely self‑report and not validated","No control for moral/religious attitudes or mental‑health factors","Causal inference limited to two‑wave design"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0594-1"}},{"id":693,"doi":"10.17061/phrp29341912","pmid":"33690791","pmcid":null,"title":"Young people's needs and preferences for health resources focused on pornography and sharing of sexually explicit imagery","authors":"Wright CJ, Davis A, Vella AM, McGrath-Lester R, Lim MS.","first_author":"Wright CJ","journal":"Public health research & practice","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.phrp.com.au/wp-content/uploads/2019/10/PHRP29341912.pdf","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.17061/phrp29341912"}},{"id":694,"doi":"10.1007/s10508-025-03296-y","pmid":"41575669","pmcid":null,"title":"Pornography Use Habits of Sexually and Non-Sexually Delinquent Youth","authors":"Bosetti RL, Yoder JR.","first_author":"Bosetti RL","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Adolescents","Delinquency","Recidivism","Sexual Offending","Pornography","Adjudicated"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational cross‑sectional study of 200 adjudicated adolescents (sexually vs non‑sexually delinquent) with self‑report questionnaires and regression analyses.","sample_n":200,"sample_text":"200 adjudicated youth (sexually delinquent and non‑sexually delinquent groups).","population":"Adjudicated youth (both sexes) in a Western US state, N=200.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared porn‑watching habits of 200 teens who had committed sexual offenses with those who had not. It found that the sexual offenders reported more unrealistic beliefs from porn and a link between watching violent porn and broader offending, while only viewing frequency predicted risk of re‑offending.","clinical_takeaway":"Only the amount of porn viewing related to recidivism risk; content preferences may signal broader offending patterns, but findings are limited to justice‑involved youth.","confidence":0.78,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Relatively large sample for a juvenile justice study","Direct comparison of sexually vs non‑sexually delinquent youth","Use of official recidivism data"],"limitations":["Self‑report of pornography habits; likely unvalidated measures","Cross‑sectional design; no causal inference","No control for key confounds (moral incongruence, mental health, etc.)","Sample limited to adjudicated youth; not generalizable"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03296-y"}},{"id":695,"doi":"10.2196/80110","pmid":"41571270","pmcid":"PMC12877744","title":"Drug-Facilitated Sexual Assault Pornography and Sexual Violence While Partying: Cross-Sectional Study","authors":"Prego-Meleiro P, Pastor-Moreno G, Recalde-Esnoz I, Sordo L.","first_author":"Prego-Meleiro P","journal":"JMIR public health and surveillance","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Drugs","Sexual Assault","Sexual Violence","Drug-facilitated Sexual Assault","Pornography Consumption"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12877744","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online quota‑sample survey of 1,500 Spanish young adults (18‑35) assessing self‑reported consumption of DFSA‑type pornography and self‑reported DFSA perpetration/victimisation; logistic regression used to test associations.","sample_n":1534,"sample_text":"N=1534 valid respondents (≈50% female, mean age 27).","population":"young adults (18‑35) in Spain, recruited via an online research panel with stratification by sex, age, region (nationally representative).","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally‑representative Spanish survey of 1,500 young adults, people who reported watching porn that shows unconscious or drug‑intoxicated sex were more likely to say they had both perpetrated and been victim of drug‑facilitated sexual assault at parties.","clinical_takeaway":"Exposure to non‑consensual DFSA‑type porn is linked to higher self‑reported DFSA risk; educators should address such content in consent and media‑literacy programmes.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally‑representative sample","Clear operational definition of DFSA pornography","Use of established victimisation/perpetration questionnaire"],"limitations":["Cross‑sectional design cannot establish causality","Key potential confounds (moral attitudes, mental health, trauma) not measured","DFSA pornography measured with a single self‑report item"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/80110"}},{"id":697,"doi":"10.1371/journal.pone.0105476","pmid":"25153083","pmcid":"PMC4143289","title":"Enhanced attentional bias towards sexually explicit cues in individuals with and without compulsive sexual behaviours","authors":"Mechelmans DJ, Irvine M, Banca P, Porter L, Mitchell S, Mole TB, Lapa TR, Harrison NA, Potenza MN, Voon V.","first_author":"Mechelmans DJ","journal":"PloS one","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4143289","cited_by_count":77,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross-sectional experimental study using dot‑probe task comparing male CSB participants with age‑matched healthy males","sample_n":null,"sample_text":"not specified in abstract","population":"male adults, CSB group likely recruited from treatment/clinical settings; healthy controls recruited separately","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that men with compulsive sexual behaviour paid quicker attention to pornographic images than similar men without the condition, suggesting heightened cue‑reactivity similar to substance addictions.","clinical_takeaway":"Enhanced cue‑reactivity may be a feature of compulsive sexual behaviour, but diagnostic conclusions are limited by measurement and sample issues.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Direct behavioural measure of attentional bias","Comparison with age‑matched healthy controls","Focus on early stimulus latency provides temporal specificity"],"limitations":["Unclear how CSB was defined/diagnosed; likely uses non‑validated criteria","Potential selection bias from clinical recruitment","No control for moral, mental‑health or relationship confounds"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":17,"contrasting":0,"mentioning":86,"citing_publications":118,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0105476"}},{"id":698,"doi":"10.1007/s10508-025-03288-y","pmid":"41528652","pmcid":null,"title":"The Associations That Sociosexual Orientation and Personality Traits Have with Men's Preferences for Different Genres of Pornography","authors":"Vance GS, Zeigler-Hill V, Meehan MK, Shackelford TK.","first_author":"Vance GS","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Personality","Evolutionary Psychology","Pornography","Sociosexual Orientation"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional self‑report survey of men recruited online/in‑person, three separate samples (n≈126‑169).","sample_n":126,"sample_text":"Study 1 n=126; Study 2 n=166; Study 3 n=169 (self‑selected male participants).","population":"Adult men (likely convenience/college samples)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed men about how often they view different types of porn and examined how their openness to casual sex and personality traits relate to those preferences. Certain traits predicted interest in group‑sex and paraphilic porn.","clinical_takeaway":"No direct clinical implications; findings are exploratory about personal preferences.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large total N across three studies","Novel focus on genre‑specific pornography use","Inclusion of both frequency and interest measures"],"limitations":["Reliance on ad‑hoc self‑report items; no validated genre scale","Cross‑sectional, cannot infer causality","No control for key confounds (morality, masturbation, mental health, relationship context)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03288-y"}},{"id":700,"doi":"10.1007/s10508-018-1182-y","pmid":"29785496","pmcid":null,"title":"Bareback Sexually Explicit Media Consumption and Men Who Have Sex with Men's Responses to Sexual Partners Who Prefer Anal Intercourse With or Without Condoms","authors":"Thai M, Barlow FK.","first_author":"Thai M","journal":"Archives of sexual behavior","year":2019,"pub_types":["Journal Article"],"keywords":["Sexual Orientation","Men Who Have Sex With Men (Msm)","Pre-exposure Prophylaxis (Prep)","Sexually Explicit Media","Condomless Anal Intercourse"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 659 Australian MSM with randomized vignette manipulation; large community sample","sample_n":659,"sample_text":"Australian men who have sex with men recruited online; all reported bareback SEM consumption and responded to a vignette.","population":"MSM, Australia, n=659","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 659 Australian gay and bisexual men, those who watch more condom‑less porn are less worried about having condom‑less anal sex and report higher intentions to have sex with a partner who prefers it, especially when the partner is seen as very attractive. The effect does not appear for partners who prefer condom use.","clinical_takeaway":"Viewing condom‑less porn may lower concerns and increase willingness for condom‑less sex, suggesting clinicians should discuss media influences when counseling about sexual risk.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (n=659) of MSM","Randomized vignette manipulation allows causal inference for vignette factor","Examines interaction with partner attractiveness","Focused on specific SEM content (bareback) rather than general use"],"limitations":["Bareback SEM consumption measured with likely unvalidated single‑item scale","No control for moral incongruence, masturbation, mental‑health or trauma","Cross‑sectional design for key predictor limits causal claims","Effect sizes and power not reported in abstract"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1182-y"}},{"id":701,"doi":"10.1080/13691058.2025.2599255","pmid":"41486650","pmcid":null,"title":"Pornography-use patterns and psychosexual well-being: cultural and gender differences among partnered young people in China and the UK","authors":"Li Y, Ingham R, Armstrong H.","first_author":"Li Y","journal":"Culture, health & sexuality","year":2026,"pub_types":["Journal Article"],"keywords":["Young People","Cross-cultural","Sexual Satisfaction","Pornography Use","Sexual Shame"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,223 partnered young adults in China and the UK","sample_n":1223,"sample_text":"Convenience sample of partnered university‑age participants recruited online","population":"young partnered adults (18‑25 years) from two countries","country":"China; United Kingdom","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 1,200 partnered young adults in China and the UK, secret solo porn use was linked to lower sexual satisfaction and higher shame, while using porn together or with a partner’s knowledge was tied to better outcomes, especially for women.","clinical_takeaway":"Clinicians should consider the relational context of porn use; secret use may signal relational strain or shame.","confidence":0.8,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Large sample (N>1200)","Cross‑cultural comparison","Distinguishes secret vs shared use patterns"],"limitations":["Cross‑sectional design; cannot infer causality","Limited control for key confounds (morality, mental health, trauma)","Pornography‑use patterns measured with ad‑hoc scale"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2025.2599255"}},{"id":702,"doi":"10.1007/978-3-032-03398-7_29","pmid":"41273571","pmcid":null,"title":"Pornography Consumption and Male Sexual Dysfunction: A Systematic Review","authors":"Zacharopoulos Z, Georgiou C, Critselis E, Tigani X, Kanaka-Gantenbein C, Bacopoulou F.","first_author":"Zacharopoulos Z","journal":"Advances in experimental medicine and biology","year":2026,"pub_types":["Systematic Review","Journal Article"],"keywords":["Sexuality","Sexual dysfunction","Sexual Problems","Pornography","Erotica"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 11 studies (2013‑2023) following PRISMA; no meta‑analysis, no pooled effect sizes.","sample_n":null,"sample_text":"11 primary studies included; total participants not specified.","population":"Male participants across included studies; details not reported in abstract.","country":"Not specified (studies from various countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 11 studies found mixed evidence on whether watching porn harms men’s sexual health. Simple viewing frequency alone isn’t a clear risk; problems appear linked to risky, problematic use together with body image and confidence issues.","clinical_takeaway":"Clinicians should assess problematic pornography use and related psychosocial factors rather than assuming any porn viewing causes dysfunction.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["PRISMA‑guided systematic search","covers a decade of literature","Identifies complexity beyond simple frequency‑outcome link"],"limitations":["No meta‑analysis or quantitative synthesis","Limited reporting on how primary studies measured constructs","Confounding factors (e.g., moral incongruence, mental health) not systematically addressed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/978-3-032-03398-7_29"}},{"id":707,"doi":"10.1097/hrp.0000000000000388","pmid":"38181099","pmcid":"PMC11449261","title":"The Diagnostic Spectrum of Sexual Hallucinations","authors":"Blom JD, van Veen RJB, van Rooijen EHC, Slotema CW.","first_author":"Blom JD","journal":"Harvard review of psychiatry","year":2024,"pub_types":["Systematic Review","review-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11449261","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 79 studies (390 patients) describing sexual hallucinations across psychiatric and neurological conditions. No meta‑analysis, risk‑of‑bias assessment, or pre‑registration reported.","sample_n":390,"sample_text":"Aggregated across 79 studies; individual study sizes not given.","population":"Patients with schizophrenia spectrum disorders, epilepsy, narcolepsy, PTSD, BPD, etc.; both sexes (female > male).","country":"Not specified (multi‑country literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises what is known about sexual hallucinations—false sexual sensations that can occur in conditions like epilepsy, schizophrenia and drug use—describing how common they are, who is affected, why they happen, and how they are currently treated.","clinical_takeaway":"Sexual hallucinations are rare but often distressing; treatment should target the underlying medical or psychiatric condition.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive synthesis of a rare phenomenon","Highlights gaps in treatment evidence"],"limitations":["Lacks quantitative meta‑analysis","No systematic risk‑of‑bias assessment","Small, heterogeneous primary studies"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/hrp.0000000000000388"}},{"id":708,"doi":"10.1080/10720162.2014.959145","pmid":"26167109","pmcid":"PMC4497958","title":"Normal, Problematic and Compulsive Consumption of Sexually Explicit Media: Clinical Findings using the Compulsive Pornography Consumption (CPC) Scale among Men who have Sex with Men","authors":"Rosser BR, Noor SW, Iantaffi A.","first_author":"Rosser BR","journal":"Sexual addiction & compulsivity","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["CPC","MSM","Pornography","Sexually Explicit Media","Compulsive Pornography Consumption"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1165 MSM participants using the newly developed Compulsive Pornography Consumption (CPC) scale","sample_n":1165,"sample_text":"1165 participating MSM","population":"men who have sex with men (MSM)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used a new questionnaire (CPC scale) with 1,165 gay and bisexual men to categorize pornography use as normal, problematic, or compulsive, finding that about 16‑20% reported problems and 7% met criteria similar to a compulsive disorder.","clinical_takeaway":"Clinicians may consider the CPC scale to screen for problematic pornography use, but should be aware of its limited validation and lack of control for moral or mental‑health factors.","confidence":0.72,"topic_tags":["pornography","masturbation","sexual_function","other"],"strengths":["Large sample size for a sexuality survey","Attempts to identify clinically meaningful cut‑offs","Provides demographic and HIV‑risk correlates"],"limitations":["New, minimally validated scale","No assessment of moral incongruence or other key confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":13,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10720162.2014.959145"}},{"id":709,"doi":"10.1177/08862605231188131","pmid":"37461386","pmcid":null,"title":"The Role of Sexting on the Perception of Image-Based Sexual Abuse","authors":"Rollero C, Teresi M, Pagliaro S.","first_author":"Rollero C","journal":"Journal of interpersonal violence","year":2023,"pub_types":["Journal Article"],"keywords":["Gender","Gender-based Violence","Sexting","Victim Blaming","Image-based Sexual Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 603 adults from the general population; cross‑sectional questionnaire assessing beliefs, attitudes, sexting behaviour and reactions to non‑consensual dissemination","sample_n":603,"sample_text":"N = 603 from the general population","population":"general adult population (likely online convenience sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 603 adults, stronger peer pressure to sext was linked to more positive attitudes toward sexting and more sexting behaviour. Those positive attitudes also predicted lower empathy and more victim‑blaming when participants imagined a sext being shared without consent.","clinical_takeaway":"Attitudes toward sexting may influence how people judge victims of image‑based abuse; interventions could target peer pressure and attitudes.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a survey (N>600)","Addresses an under‑studied link between sexting attitudes and victim‑blaming","Uses a realistic vignette to gauge reactions"],"limitations":["Cross‑sectional; cannot infer causality","Measures appear largely ad‑hoc; limited validation reported","Potential self‑selection bias; not a probability sample"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605231188131"}},{"id":710,"doi":"10.1016/j.jsxm.2022.06.006","pmid":"35853798","pmcid":null,"title":"Does Size Matter? Genital Self-Image, Genital Size, Pornography Use and Openness Toward Cosmetic Genital Surgery in 3503 Swedish Men and Women","authors":"Hustad IB, Malmqvist K, Ivanova E, Rück C, Enander J.","first_author":"Hustad IB","journal":"The journal of sexual medicine","year":2022,"pub_types":["Journal Article"],"keywords":["Genital Self-image","Pornography","Cosmetic Genital Surgery","Genital Dissatisfaction","Genital Size"],"is_oa":false,"oa_url":"http://www.jsm.jsexmed.org/article/S1743609522014886/pdf","cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey (N=3503)","sample_n":3503,"sample_text":"large community sample, self‑selected via online questionnaire","population":"Swedish adults (men and women)","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Swedish survey of 3,500 adults, people with larger genitals reported higher satisfaction with their genital appearance, while pornography use was not linked to genital self‑image. Dissatisfaction was common and related to avoidance behaviours and interest in cosmetic surgery.","clinical_takeaway":"Genital dissatisfaction often reflects psychological factors; clinicians should consider counseling before cosmetic surgery.","confidence":0.78,"topic_tags":["gender","pornography","sexual_function"],"strengths":["Very large sample size","Use of validated genital self‑image scales","Estimates of actual genital size in population"],"limitations":["Cross‑sectional, cannot infer causality","Self‑selection bias may limit generalisability","Limited control for psychological and relational confounds"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2022.06.006"}},{"id":712,"doi":"10.1007/s10508-022-02448-8","pmid":"36264399","pmcid":"PMC9901511","title":"Correction to: Exposure to Sexually Explicit Materials and Feelings After Exposure Among Adolescents in Nine European Countries: The Role of Individual Factors and Social Characteristics","authors":"Lebedíková M, Mýlek V, Subrahmanyam K, Šmahel D.","first_author":"Lebedíková M","journal":"Archives of sexual behavior","year":2023,"pub_types":["Published Erratum","correction"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02448-8"}},{"id":713,"doi":"10.1007/s10508-022-02527-w","pmid":"36622530","pmcid":"PMC9990420","title":"Correction to: Exposure to Sexually Explicit Materials and Feelings After Exposure Among Adolescents in Nine European Countries: The Role of Individual Factors and Social Characteristics","authors":"Lebedíková M, Mýlek V, Subrahmanyam K, Šmahel D.","first_author":"Lebedíková M","journal":"Archives of sexual behavior","year":2023,"pub_types":["Published Erratum","correction"],"keywords":[],"is_oa":false,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-022-02527-w.pdf","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02527-w"}},{"id":714,"doi":"10.64898/2026.05.01.26352270","pmid":null,"pmcid":null,"title":"Risky Sexual Practices and Associated Factors among Taxi and Three-Wheeled Vehicle Drivers in Arba Minch Town, Southern Ethiopia: A Community-Based Cross-Sectional Study","authors":"Eshetu F, Feleke T, Temesgen G, Sidamo NB.","first_author":"Eshetu F","journal":"medRxiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Community‑based cross‑sectional survey of 640 taxi and three‑wheeled vehicle drivers in Ethiopia; simple random sampling; interviewer‑administered questionnaire; logistic regression used to identify correlates of current risky sexual practices.","sample_n":640,"sample_text":"640 drivers (response rate 97.6%).","population":"Taxi and three‑wheeled vehicle drivers in Arba Minch, Ethiopia (N=640, 97.6% response).","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 640 Ethiopian taxi and three‑wheeled vehicle drivers, about 37% reported risky sexual behaviour in the past month. Factors linked to higher risk included living alone, substance use, nightlife, not discussing sexual health, and watching porn.","clinical_takeaway":"Drivers who view porn and engage in substance use or nightlife may need targeted sexual‑health education and risk‑reduction counseling.","confidence":0.7,"topic_tags":["relationships","sexual_function"],"strengths":["Large, randomly sampled community sample of drivers","Clear reporting of prevalence and adjusted odds ratios with CIs","Multivariable logistic regression accounts for several covariates"],"limitations":["Cross‑sectional design limits causal inference","Key constructs (porn exposure, risky sex) measured by single self‑report items","No assessment of moral, mental‑health or trauma confounders"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.64898/2026.05.01.26352270"}},{"id":715,"doi":"10.1080/19419899.2013.851108","pmid":"26085898","pmcid":"PMC4465808","title":"Preferred aspects of sexually explicit media among men who have sex with men: where do condoms fit in?","authors":"Galos DL, Smolenski DJ, Grey JA, Iantaffi A, Rosser BR.","first_author":"Galos DL","journal":"Psychology and sexuality","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Condom Use","Men Who Have Sex With Men","Pornography","Sexually Explicit Media"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet‑based cross‑sectional survey of 1390 adult MSM assessing ranked preferences for characteristics of sexually explicit media.","sample_n":1390,"sample_text":"1390 adult MSM completed an online survey","population":"MSM (men who have sex with men), adult, recruited online","country":"unspecified (likely USA based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 1390 gay and bisexual men, the most important features of porn they wanted were free access, anonymity and visual appeal; the presence of condoms or specific sexual acts mattered far less.","clinical_takeaway":"Clinicians should note that condom use is a low priority for many MSM when choosing porn, so risk‑reduction counseling may need to address influences beyond media preferences.","confidence":0.85,"topic_tags":["pornography","sexual_function","prevalence"],"strengths":["Large sample (N>1300) for a survey","Focus on consumer preferences, a relatively understudied area"],"limitations":["Self‑report, unvalidated preference items","Cross‑sectional convenience sample, limited generalisability","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19419899.2013.851108"}},{"id":716,"doi":"10.1007/s10508-025-03297-x","pmid":"41388119","pmcid":"PMC12977981","title":"Adolescents' Pornography Exposure, Sexually Dominant Behavior, and Partnered Sexual Satisfaction: Replication in a U.S. Probability Sample","authors":"Wright PJ, Herbenick D, Tokunaga RS.","first_author":"Wright PJ","journal":"Archives of sexual behavior","year":2026,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Dominance","Replication","Sexual Health","Sexual Satisfaction","Pornography","3Am"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional mediation analysis using probability sample (N=59)","sample_n":59,"sample_text":"N=59 adolescents from Wave 8 of the National Survey of Sexual Health and Behavior","population":"U.S. adolescents (nationally representative probability sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Using a U.S. national survey of 59 adolescents, researchers found that more frequent porn viewing was linked to higher sexually dominant behavior, which was in turn linked to lower partnered sexual satisfaction. The indirect effect was in the same direction as a prior study but not statistically significant, highlighting the need for larger, longitudinal work.","clinical_takeaway":"Current evidence does not establish a causal link between adolescent porn exposure and lower sexual satisfaction; clinicians should interpret such associations cautiously.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["nationally representative probability sample","attempted replication of prior finding","transparent reporting of non‑significant indirect effect"],"limitations":["small sample size limits power for mediation","cross‑sectional design cannot infer causality","no measurement of key confounds (moral incongruence, masturbation, mental health)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03297-x"}},{"id":719,"doi":"10.1186/s12889-025-25836-w","pmid":"41345618","pmcid":"PMC12781369","title":"Association between exposure to pornography involving physical violence and risky sexual behaviors in young adults","authors":"Sanz-Barbero B, Cerdán-Torregrosa A, Otero-García L, Pérez-Martínez V, Vives-Cases C.","first_author":"Sanz-Barbero B","journal":"BMC public health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Young Adults","Sexual Relationships","Risky Sexual Behaviors","Sexual Violence","Pornography","Risky Sexual Scripts"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12781369","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 3607 Spanish young adults (18‑34), self‑reported pornography type and risky sexual behaviours; analyses with ordinal GLM stratified by sex","sample_n":3607,"sample_text":"cross‑sectional survey; convenience online recruitment","population":"young adults (18‑34) living in Spain, recruited via online questionnaire (convenience sample)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 3,600 Spanish young adults found that people who watch porn showing physical violence are more likely to have many casual partners, use alcohol or drugs during sex, and (in women) accept unwanted sexual acts. The study cannot prove these links are causal.","clinical_takeaway":"Clinicians should be aware that exposure to violent porn is linked to riskier sexual behaviours, but cannot assume it causes them.","confidence":0.8,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Large sample size","Stratified analysis by sex","Use of multivariate ordinal models"],"limitations":["Cross‑sectional design; no causal inference","Convenience online recruitment limits generalisability","No measurement of moral incongruence, masturbation, mental health, or trauma"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-025-25836-w"}},{"id":720,"doi":"10.1071/sh15163","pmid":"26535592","pmcid":"PMC4860164","title":"Measuring exposure to sexually explicit media among young men who have sex with men: a pilot study","authors":"Nelson KM, Golden MR, Glick SN.","first_author":"Nelson KM","journal":"Sexual health","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"pilot survey of 61 young men who have sex with men; cross‑sectional questionnaire estimating frequency of sexually explicit media use and its association with sexual risk characteristics.","sample_n":61,"sample_text":"61 participants recruited; all reported viewing SEM; 45 in past week.","population":"young men who have sex with men (YMSM), N=61, likely convenience sample","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small pilot of 61 young gay and bisexual men, every participant had viewed sexually explicit media, and most had done so in the past week. The study found no link between recent viewing and measured sexual risk factors, but it was limited by size and lack of detailed measures.","clinical_takeaway":"SEM viewing is very common among YMSM; current data do not show a clear link to sexual risk, highlighting a need for larger, more detailed studies before clinical guidance.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["First data on SEM prevalence in YMSM","Clear reporting of 100% exposure"],"limitations":["Very small, non‑representative pilot sample","No validated measures of SEM use or risk behavior","No control for key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh15163"}},{"id":721,"doi":"10.1071/sh25118","pmid":"41243093","pmcid":null,"title":"Associations between young people's internet pornography use and psychosexual well-being: a systematic review","authors":"Li Y, Ingham R, Armstrong H.","first_author":"Li Y","journal":"Sexual health","year":2025,"pub_types":["Systematic Review","Journal Article"],"keywords":["Young People","Gender Differences","Sexual Satisfaction","Sexual Well-being","Sexually Explicit Media","Internet Pornography","Sexual Script","Pornography Use Motivations"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 27 quantitative studies (N≈30,000) on internet pornography use and psychosexual well‑being in 16‑25‑year‑olds, pre‑registered protocol, narrative synthesis, quality assessment of included studies.","sample_n":30023,"sample_text":"Total participants across included primary studies (27 studies).","population":"young people aged 16‑25 years, mixed gender, community samples from published studies","country":"Multiple (studies from various countries)","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 27 studies (over 30,000 young people) examined how internet pornography use relates to sexual attitudes, self‑concept, desire, functioning and compulsive use, finding gender differences and mixed associations with well‑being.","clinical_takeaway":"Clinicians should note that pornography use among young adults is common and linked to varied sexual‑well‑being outcomes; assessments should consider gender and individual motivations rather than assuming uniform harm.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Pre‑registered systematic review protocol","Large aggregated sample size","Comprehensive coverage of psychosexual outcomes"],"limitations":["Primary studies likely vary in construct definition and measurement","No explicit control for moral incongruence or related confounds","Narrative synthesis limits quantitative comparison"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh25118"}},{"id":722,"doi":"10.1080/19317611.2023.2224777","pmid":"38601728","pmcid":"PMC10903556","title":"Changes in Solo and Partnered Sexual Behaviors following the First COVID-19 Wave: Data from an International Study of 26 Countries","authors":"Hensel DJ, Mark KP, Abdelhamed A, Burns S, Esho T, Hendriks J, Jobim Fischer V, Ivanova O, Marks M, Michelsen K, Nimby F, Strizzi J, Tucker J, Uhlich M, Erausquin JT.","first_author":"Hensel DJ","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Pornography","Partnered Sex","Covid-19","Solo Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional, multi‑country online survey (N≈19,654) assessing retrospective self‑reported changes in solo and partnered sexual behaviors during COVID‑19.","sample_n":19654,"sample_text":"Large international sample, likely non‑probability convenience recruitment","population":"adults from 26 countries (convenience/online sample)","country":"multinational (26 countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of nearly 20 000 adults in 26 countries found that during the first COVID‑19 wave people reported more hugging and less sex with a main partner. Solo masturbation, sexting, pornography viewing and cybersex often rose, especially among those whose job or income was unstable or who used more alcohol or cannabis.","clinical_takeaway":"Sexual health services should anticipate fluctuating solo and partnered activity during crises, particularly for those facing economic stress.","confidence":0.7,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["Very large international sample","Assesses a wide range of sexual behaviours","Considers both individual‑ and country‑level predictors"],"limitations":["Cross‑sectional, retrospective self‑report; cannot infer causality","Convenience sampling limits generalisability","Behaviour change measured with single‑item, non‑validated scales"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2023.2224777"}},{"id":723,"doi":"10.1007/s10508-013-0253-3","pmid":"24609608","pmcid":null,"title":"Methodological issues in defining aggression for content analyses of sexually explicit material","authors":"McKee A.","first_author":"McKee A.","journal":"Archives of sexual behavior","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"methodological commentary without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article critiques how researchers label aggression in porn, arguing that many definitions ignore consent and can misclassify normal sexual acts. It suggests using a consent‑based definition to improve future content analyses.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["sexual_function","gender","relationships"],"strengths":["Identifies conceptual gaps in aggression definitions","Proposes concrete solution incorporating consent"],"limitations":["No empirical data provided","Limited to content analysis methodology"],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":1,"contrasting":0,"mentioning":27,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0253-3"}},{"id":724,"doi":"10.12688/f1000research.179534.1","pmid":null,"pmcid":null,"title":"Religiosity of Indonesian Muslim as affected by Islamic religious education and other factors: A meta-analysis","authors":"Hamzah H, Raihan R, Rosyada D, Abdullah NMSAbN, Zin MZbM, Jayanegara A.","first_author":"Hamzah H","journal":"F1000Res","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"meta-analysis of 22 studies following PRISMA; random‑effects model; effect sizes as Fisher‑Z correlations","sample_n":null,"sample_text":"22 primary studies (total N not reported in abstract)","population":"Indonesian Muslims (studies varied)","country":"Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A meta‑analysis of 22 Indonesian studies found that factors such as Islamic education, family influence and moral behaviour are positively linked to religiosity, while accessing pornographic sites is linked to lower religiosity.","clinical_takeaway":"None – the study does not provide direct clinical guidance for sexual‑health practice.","confidence":0.8,"topic_tags":["religiosity","sexual_function","pornography"],"strengths":["Systematic search and PRISMA reporting","Random‑effects meta‑analysis of multiple predictors","Identifies porn site use as a negative correlate of religiosity"],"limitations":["No detailed risk‑of‑bias assessment reported","Effect‑size heterogeneity and publication bias not described","No pre‑registration disclosed"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12688/f1000research.179534.1"}},{"id":725,"doi":"10.3390/bs15121634","pmid":"41463977","pmcid":"PMC12729544","title":"Violent Content in Online Pornography Is Associated with Sexual Health of Women and Men","authors":"Sanz-Barbero B, Pérez-Martínez V, Rico A, Otero-García L, Fernández-López M, Cerdán-Torregrosa A, Vives-Cases C.","first_author":"Sanz-Barbero B","journal":"Behavioral sciences (Basel, Switzerland)","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Empathy","Sexual Assertiveness","Acceptance Of Violence Against Women","Online Violent Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12729544","cited_by_count":0,"is_preprint":false,"topics":["pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 3607 Spanish young adults (18‑35) examining associations between violent pornography exposure and various sexual‑health outcomes.","sample_n":3607,"sample_text":"large convenience sample, not a probability or nationally representative panel","population":"young adults (18‑35) residing in Spain, recruited via an online questionnaire","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 3,600 Spanish young adults, people who viewed pornography containing physical violence reported lower empathy, less sexual assertiveness, poorer sexual function for men, and more difficulty reaching orgasm for women, as well as higher acceptance of violence against women.","clinical_takeaway":"Viewing violent porn is linked to poorer sexual health and higher acceptance of violence; clinicians should consider porn content when assessing sexual wellbeing.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Very large sample size for a survey","Use of multiple validated outcome scales","Separate analysis for men and women"],"limitations":["Cross‑sectional design cannot establish causality","No control for key confounds (moral views, masturbation, mental health, partner context, trauma)","Self‑reported exposure to violent porn may be subject to recall or social desirability bias"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs15121634"}},{"id":726,"doi":"10.1080/10810730.2025.2588698","pmid":"41277130","pmcid":null,"title":"Sex Education, Public Opinion, and Pornography: Replication and Experiment","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Journal of health communication","year":2025,"pub_types":["Journal Article"],"keywords":["Replication","Sex Education","Public Opinion","Pornography","Experimentation, 3Am"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national probability survey of U.S. adults, replication and measurement experiment","sample_n":null,"sample_text":"large nationally representative probability sample (exact N not given)","population":"U.S. adults (adolescent, adult, middle aged)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Using a national US survey, the study replicated earlier work showing that people who watch more porn are more likely to support sex‑education in schools, partly because they view adolescent sexual behavior more positively. The effect was stronger among less religious adults.","clinical_takeaway":"None – findings pertain to public opinion, not clinical treatment.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["large, nationally representative sample","replication of prior findings","examines moderating role of religiosity"],"limitations":["cross‑sectional design limits causal inference","pornography consumption measured with single self‑report item, unclear validation","key confounds (masturbation, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10810730.2025.2588698"}},{"id":727,"doi":"10.1007/s10508-019-01554-4","pmid":"31549362","pmcid":"PMC7058557","title":"An Interdisciplinary Definition of Pornography: Results from a Global Delphi Panel","authors":"McKee A, Byron P, Litsou K, Ingham R.","first_author":"McKee A","journal":"Archives of sexual behavior","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Definitions","Interdisciplinary Research","Pornography","Sexually Explicit Material"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7058557","cited_by_count":38,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"Delphi consensus study with 38 expert participants; two rounds of qualitative and quantitative surveys to generate definition statements.","sample_n":38,"sample_text":"38 leading pornography researchers from a wide range of disciplines participated in the Delphi panel.","population":"expert researchers in pornography studies (global, interdisciplinary)","country":"International (global panel)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A global panel of 38 experts used a Delphi method to agree on two competing ways to define pornography: (1) explicit material intended to arouse, and (2) a culturally relative concept with no innate traits. The authors advise researchers to state which definition they adopt for each study.","clinical_takeaway":"None – the paper offers only guidance on terminology, not clinical evidence.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, internationally diverse expert panel","Combines qualitative and quantitative Delphi rounds","Provides clear recommendation for explicit definition use"],"limitations":["No empirical data on users or outcomes","Findings limited to expert opinion, not validated with end‑users","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":49,"citing_publications":121,"retracted":false,"notices":[{"status":"Has correction","date":"2019-10-31","noticeDoi":"10.1007/s10508-019-01576-y","doi":"10.1007/s10508-019-01554-4"},{"status":"Has erratum","date":"2019-10-31","noticeDoi":"10.1007/s10508-019-01576-y","doi":"10.1007/s10508-019-01554-4"}],"url":"https://scite.ai/reports/10.1007/s10508-019-01554-4"}},{"id":729,"doi":"10.1007/s10508-016-0865-5","pmid":"27671784","pmcid":null,"title":"Men's and Women's Use and Creation of Online Sexually Explicit Materials Including Fandom-Related Works","authors":"Anisimowicz Y, O'Sullivan LF.","first_author":"Anisimowicz Y","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Internet","Gender Differences","Fandom","Sexually Explicit Material","Fanworks"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 815 North‑American adults (468 men, 347 women) assessing self‑reported use/creation of online sexually explicit material and fandom‑related works; anonymous online questionnaire.","sample_n":815,"sample_text":"468 men, 347 women (mean age = 33.8 y)","population":"Adults (≥18 y) residing in North America, recruited via online panels; convenience sample, not probability based.","country":"North America (USA/Canada)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 815 North‑American adults found that most men and many women use online porn, with men reporting higher use. Only a few participants create such material. Gender differences were small, and more permissive sexual attitudes predicted fandom‑related porn use.","clinical_takeaway":"None – the study describes usage patterns, not clinical outcomes.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a sexuality survey","Gender‑balanced analysis","Inclusion of fandom‑related SEM, a novel domain"],"limitations":["Convenience, self‑selected online sample; limited generalisability","Measures of SEM use are single‑item self‑reports, not validated scales","No control for key confounds (e.g., moral attitudes, mental health, masturbation)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0865-5"}},{"id":730,"doi":"10.1080/10720162.2014.938849","pmid":"25838755","pmcid":"PMC4380217","title":"A Brief Scale to Measure Problematic Sexually Explicit Media Consumption: Psychometric Properties of the Compulsive Pornography Consumption (CPC) Scale among Men who have Sex with Men","authors":"Noor SW, Simon Rosser BR, Erickson DJ.","first_author":"Noor SW","journal":"Sexual addiction & compulsivity","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["CPC","Men Who Have Sex With Men","Pornography","Sexually Explicit Media","Compulsive Pornography Consumption"],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"scale development and validation using exploratory and confirmatory factor analysis in a sample of men who have sex with men; convenience recruitment, single time‑point survey","sample_n":null,"sample_text":"not specified in abstract","population":"men who have sex with men (MSM), likely community sample","country":"","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and tested a five‑item questionnaire (CPC Scale) to measure compulsive pornography use among gay and bisexual men, showing it has good statistical properties and relates to sexual self‑esteem and internalised homonegativity.","clinical_takeaway":"A brief CPC scale exists for assessing problematic porn use, but clinicians should note it does not separate use frequency from distress and lacks moral or mental‑health controls.","confidence":0.8,"topic_tags":["pornography","sexual_function","measurement"],"strengths":["uses both exploratory and confirmatory factor analysis","demonstrates convergent validity with related constructs","provides a brief, focused instrument"],"limitations":["no measurement of moral incongruence or masturbation","cross‑sectional, convenience sample limits generalisability","addiction criteria not directly assessed"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":28,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10720162.2014.938849"}},{"id":731,"doi":"10.31234/osf.io/exfr7_v1","pmid":null,"pmcid":null,"title":"Is exposure to online misogyny associated with mental health outcomes in girls and young women? A systematic review of longitudinal studies","authors":"Thomas C, Tinner L, Bennett J, Anderson LG, Winstone L.","first_author":"Thomas C","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review of longitudinal studies (n=6, total N=7,379), narrative synthesis, preregistered (PROSPERO), risk of bias via Newcastle‑Ottawa Scale","sample_n":7379,"sample_text":"Six longitudinal studies, total N=7,379","population":"girls, young women (ages 11‑25); no gender‑diverse studies found","country":"not specified","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of six longitudinal studies (total 7,379 participants) found preliminary evidence that exposure to online misogyny may be linked to poorer mental health in adolescent girls and young women, but the research base is small and varied.","clinical_takeaway":"Clinicians should be aware that online misogyny might impact mental health in young females, but current evidence is limited; monitor exposure as part of broader psychosocial assessment.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Pre‑registered systematic review protocol (PROSPERO)","Focus on longitudinal evidence","Risk of bias assessment applied"],"limitations":["Small and heterogeneous evidence base (6 studies)","Exposure and outcome measures not described in detail","No meta‑analysis; narrative synthesis limits quantitative conclusions"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/exfr7_v1"}},{"id":732,"doi":"10.1080/19419899.2014.984515","pmid":"25642301","pmcid":"PMC4308736","title":"Typologies of sexually explicit media use among MSM: An application of latent class analysis","authors":"Erickson DJ, Galos DL, Smolenski DJ, Iantaffi A, Rosser BR.","first_author":"Erickson DJ","journal":"Psychology and sexuality","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Latent Class Analysis","Men Who Have Sex With Men","Pornography","Sexually Explicit Media"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of MSM; latent class analysis of 15 self‑reported SEM activities; cross‑sectional, convenience sample","sample_n":null,"sample_text":"online survey of MSM (exact N not provided)","population":"men who have sex with men (MSM); online convenience sample (size not disclosed in abstract)","country":"USA (presumably, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among men who have sex with men, three patterns of porn viewing were identified: mostly safer‑sex content, a higher‑dose version of that, and a small group that also watches fetish/kink. The latter groups reported less internalized homophobia and lower confidence using condoms.","clinical_takeaway":"Higher‑dose or fetish porn viewing is linked to lower condom self‑efficacy; clinicians might consider discussing porn content when addressing HIV‑prevention.","confidence":0.74,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample of MSM provides insight into heterogeneity of SEM use","Use of latent class analysis to identify distinct consumption patterns","Links classes to relevant psychosocial variables (homonegativity, condom self‑efficacy)"],"limitations":["Self‑report, unvalidated SEM activity items","Cross‑sectional design prevents causal inference","Potential selection bias from online convenience recruitment"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19419899.2014.984515"}},{"id":733,"doi":"10.2196/18043","pmid":"32452820","pmcid":"PMC7284392","title":"Association of Social Media Use and High-Risk Behaviors in Adolescents: Cross-Sectional Study","authors":"Vente T, Daley M, Killmeyer E, Grubb LK.","first_author":"Vente T","journal":"JMIR pediatrics and parenting","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Self-harm","Social Media","Nonsuicidal Self-injury","Sexting"],"is_oa":true,"oa_url":"https://pediatrics.jmir.org/2020/1/e18043/PDF","cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 179 adolescents from a single urban pediatric clinic","sample_n":179,"sample_text":"179 adolescents seen in a pediatric clinic","population":"adolescents (age unspecified) seeking care at an urban medical center; convenience sample","country":"United States (implied by journal and affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 179 adolescents, those who used more social‑media apps were more likely to report self‑harm and sending explicit messages. The study suggests a link between heavy social‑media use and risky sexual or self‑injurious behaviours, but it cannot prove one causes the other.","clinical_takeaway":"Screen for self‑harm and risky online sharing in teens who use many social‑media platforms, but note the evidence is correlational only.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Relatively large sample for a single‑clinic study","Uses anonymous self‑report to encourage honesty","Provides risk ratios with confidence intervals"],"limitations":["Cross‑sectional design cannot infer causality","No validated instruments for pornography‑related constructs","Key confounds (moral incongruence, mental health, partner context) not measured","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":27,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/18043"}},{"id":734,"doi":"10.21203/rs.3.rs-9290575/v1","pmid":null,"pmcid":null,"title":"Perceptions of the Non-Consensual Sharing of Intimate Images in Ghana","authors":"Ofei SD, Fido D.","first_author":"Ofei SD","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey (N=288) of Ghanaian adults","sample_n":288,"sample_text":"288 participants completed an online questionnaire","population":"Ghanaian nationals (online respondents)","country":"Ghana","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 288 Ghanaians, higher empathy was linked to more supportive views of victims of non‑consensual image sharing and to stronger belief that such acts should be criminalised.","clinical_takeaway":"None – the study concerns public attitudes, not clinical treatment.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Validated questionnaire adapted for Ghanaian context","Adequate sample size for basic regression","Focus on a neglected African context"],"limitations":["Convenience online sample, not nationally representative","No measurement of moral/religious attitudes that could influence judgments","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-9290575/v1"}},{"id":735,"doi":"10.1089/cyber.2018.0671","pmid":"31403856","pmcid":null,"title":"Sexting and Mental Health Among Young Australians Attending a Musical Festival: A Cross Sext-ional Study","authors":"Valiukas S, Pickering M, Hall T, Seneviratne N, Aitken A, John-Leader F, Pit SW.","first_author":"Valiukas S","journal":"Cyberpsychology, behavior and social networking","year":2019,"pub_types":["Journal Article"],"keywords":["Mental health","Young Adults","Psychological Distress","Sexting","Unsolicited","Sexually Explicit Images"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 776 festival attendees (18‑30 y). Convenience sample; not nationally representative.","sample_n":776,"sample_text":"Convenience sample of festival attendees; may be more socially active or risk‑taking than general population.","population":"Young Australian adults attending a music festival (18‑30 y).","country":"Australia","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 776 young Australians at a music festival, about half had sent or received sexts. Receiving many unwanted sexts was linked to higher psychological distress, even after accounting for gender, sexual orientation and alcohol use.","clinical_takeaway":"Unsolicited sexts may be a stressor for young people; clinicians should screen for unwanted sexual messaging when assessing distress.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample size for a survey","Validated distress measure (K6) with reported CIs","Adjusted analysis for key demographic covariates"],"limitations":["Convenience festival sample limits generalisability","No measurement of moral/religious attitudes or partner context","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2018.0671"}},{"id":736,"doi":"10.1007/s10508-016-0837-9","pmid":"27709363","pmcid":null,"title":"Sexually Explicit Media Use by Sexual Identity: A Comparative Analysis of Gay, Bisexual, and Heterosexual Men in the United States","authors":"Downing MJ, Schrimshaw EW, Scheinmann R, Antebi-Gruszka N, Hirshfield S.","first_author":"Downing MJ","journal":"Archives of sexual behavior","year":2017,"pub_types":["Comparative Study","Journal Article"],"keywords":["Internet","Sexual Orientation","Sexual Identity","Pornography","Sexually Explicit Media"],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 821 men reporting past‑6‑month SEM use and viewing of sexual behaviors, analyzed with logistic regression","sample_n":821,"sample_text":"821 men completed an online survey in 2015","population":"men (gay, bisexual, heterosexual) in the United States, recruited via internet","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2017 US survey of 821 men showed gay and bisexual men watch online porn more often than heterosexual men and are more likely to view condomless anal sex, while heterosexual men are more likely to view condomless vaginal sex. Viewing contexts also differed by sexual identity.","clinical_takeaway":"Clinicians should recognize that porn viewing patterns vary by sexual identity and may relate to observed sexual behaviors, but this study does not establish causal effects.","confidence":0.9,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a survey (N=821)","Detailed comparison across sexual identities","Use of logistic regression with confidence intervals"],"limitations":["Cross‑sectional, cannot infer causality","Self‑report measures of SEM use not validated","No control for key confounds (moral, mental health, partner factors)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":2,"mentioning":47,"citing_publications":87,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0837-9"}},{"id":737,"doi":"10.1007/s10508-025-03247-7","pmid":"41152504","pmcid":null,"title":"Implications of the Russian Invasion on Ukrainians' Pornography Consumption: Insights from Big-Data Processing","authors":"Nessaibia I, Howard A, Bouarroudj T.","first_author":"Nessaibia I","journal":"Archives of sexual behavior","year":2025,"pub_types":["Journal Article"],"keywords":["Compulsive Sexual Behaviors","Social Distancing","Pornography","Russo-ukrainian War"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Ecological time‑series analysis of aggregate Google Trends and Pornhub traffic data linked to weekly civilian death counts.","sample_n":null,"sample_text":"Aggregate weekly counts; no individual participants.","population":"Ukrainian internet users (aggregate data)","country":"Ukraine","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used Google searches and Pornhub traffic to show that Ukrainian pornography interest rose during the 2022 Russian invasion and was linked to weekly war deaths and social‑distancing concerns.","clinical_takeaway":"None – the findings are population‑level and do not inform individual clinical care.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large‑scale, real‑time data sources","Novel context (war‑related stress)","Clear temporal alignment of events"],"limitations":["Aggregated proxies for personal consumption","No measurement of individual distress or moral factors","Potential ecological fallacy"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03247-7"}},{"id":738,"doi":"10.1007/s10508-023-02651-1","pmid":"37407894","pmcid":null,"title":"From Flirting to F*cking: Examining the Robustness of the Precarious Sexuality Effect","authors":"Bosson JK, Rousis G, Wilkerson M.","first_author":"Bosson JK","journal":"Archives of sexual behavior","year":2023,"pub_types":["Journal Article"],"keywords":["Sexual behavior","Gender Differences","Sexual Orientation","Perceptions Of Sexual Behaviors","Precarious Sexuality Effect"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"secondary analysis of five large US adult survey datasets (N = 9,770); cross‑sectional with hierarchical linear modeling","sample_n":9770,"sample_text":"large community sample drawn from existing surveys","population":"US adults (community sample)","country":"United States","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Across five large US surveys, men felt less certain about their heterosexuality after a brief same‑gender encounter (like a kiss) than after a more explicit act (like oral sex). The effect was consistent and not explained by age, orientation, religiosity, or politics.","clinical_takeaway":"None – findings pertain to self‑perceived sexuality doubts, not clinical conditions.","confidence":0.85,"topic_tags":["sexual_function","gender"],"strengths":["Very large combined sample size","Pre‑registered exploratory and confirmatory analyses","Use of hierarchical linear modeling across multiple datasets"],"limitations":["Cross‑sectional self‑report data; no causal inference","Constructs measured with single‑item or ad‑hoc items","Limited control of key confounds relevant to sexual health research"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02651-1"}},{"id":739,"doi":"10.1007/s10508-025-03238-8","pmid":"41145951","pmcid":null,"title":"From Pandemic to Porndemic: Understanding the Digital Consumption of Pornography in Uncertain Times","authors":"Wu G, Rasool Z, Ali S, Hussain MM.","first_author":"Wu G","journal":"Archives of sexual behavior","year":2025,"pub_types":["Journal Article"],"keywords":["Emerging Economies","Online Pornography","World Pandemic Uncertainty Index","Quantile-On-Quantile Estimation","Pandemic-induced Uncertainty"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Ecological macro‑level analysis of country‑level pornography traffic and pandemic‑uncertainty index using Quantile‑on‑Quantile estimation.","sample_n":null,"sample_text":"Aggregated national‑level data; no individual participants.","population":"Ten emerging economies (Argentina, Brazil, Egypt, Indonesia, Malaysia, Nigeria, Philippines, South Africa, Turkey, Vietnam).","country":"International (multiple countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study finds that higher pandemic‑related uncertainty is linked to increased online pornography traffic in most of ten emerging economies, suggesting that collective stress may drive digital escapism.","clinical_takeaway":"None – findings are macro‑level and do not inform individual clinical practice.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Novel use of a broad pandemic‑uncertainty index","Applies Quantile‑on‑Quantile method for nuanced analysis","Covers diverse set of emerging economies"],"limitations":["Ecological design; results may not apply to individuals","No measurement of individual‑level confounds (moral, mental health, etc.)","Reliance on aggregate traffic data; validity of consumption metric unclear"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03238-8"}},{"id":741,"doi":"10.1007/s10508-025-03243-x","pmid":"41087716","pmcid":null,"title":"Breaking the Barrier: A Content Analysis of Condom Use Behaviors in Popular Online Pornography","authors":"Galper EF, Mazandarani F.","first_author":"Galper EF","journal":"Archives of sexual behavior","year":2025,"pub_types":["Journal Article"],"keywords":["Communication","Content analysis","Sexual Health","Norms","Condoms","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 101 popular porn videos (>2 M views) coded for condom‑use steps using CDC guidelines; three coders, no pre‑registration.","sample_n":101,"sample_text":"101 condom‑tagged videos from popular websites with ≥2 million views.","population":"Online porn videos (professional/ amateur) meeting a condom tag and view‑count threshold; not human participants.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers examined 101 popular porn videos that featured condoms and found that none showed all CDC‑recommended steps for correct use. Condoms were often removed without clear consent and were shown more as a plot device than a health tool, suggesting that porn may spread misleading messages about safer sex.","clinical_takeaway":"Clinicians should warn clients that porn often depicts condom use inaccurately and discuss correct condom practices directly.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Clear, theory‑driven coding framework (CDC & 3AM model)","Multiple coders, likely inter‑rater reliability","Focus on a public‑health relevant, understudied media feature"],"limitations":["Convenience sample of high‑view videos; not representative of all porn","No pre‑registration or power analysis","Limited statistical depth – mainly descriptive"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03243-x"}},{"id":742,"doi":"10.1007/s00787-025-02863-x","pmid":"41081900","pmcid":null,"title":"Adolescents' online pornography use and psychopathological symptoms: insights from a systematic review and meta-analysis","authors":"Di Caro AV, Cavallo J, Marchese EV, Melita A, Costanzo A, Schimmenti A.","first_author":"Di Caro AV","journal":"European child & adolescent psychiatry","year":2026,"pub_types":["Meta-Analysis","Systematic Review","Journal Article"],"keywords":["Meta-analysis","Systematic review","Adolescents","Psychopathological Symptoms","Online Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Systematic review and meta‑analysis of 14 quantitative adolescent studies (12 in meta‑analysis) examining associations between self‑reported online pornography use and DSM‑5‑TR‑based psychopathology scores.","sample_n":null,"sample_text":"Fourteen studies identified; twelve included in quantitative synthesis","population":"Adolescents (10‑19 y), community samples in published studies","country":"Various (global literature)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review and meta‑analysis of 12 studies found that adolescents who use online pornography more often tend to show higher levels of psychological symptoms, but the analysis could not prove that porn use causes those problems.","clinical_takeaway":"Clinicians should consider frequent porn use as a possible marker of distress in adolescents and explore healthier coping strategies.","confidence":0.7,"topic_tags":["adolescents","pornography","sexual_function","csbd"],"strengths":["Comprehensive systematic search (PRISMA)","Quantitative meta‑analysis with effect size and CIs","Subgroup analysis by gender"],"limitations":["Primary studies likely rely on self‑report frequency only","No control for moral incongruence, masturbation or mental‑health covariates","Observational data; causality not established"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00787-025-02863-x"}},{"id":743,"doi":"10.1007/s10508-019-01580-2","pmid":"32006206","pmcid":"PMC7145774","title":"Predicting the Willingness to Engage in Non-Consensual Forwarding of Sexts: The Role of Pornography and Instrumental Notions of Sex","authors":"van Oosten JMF, Vandenbosch L.","first_author":"van Oosten JMF","journal":"Archives of sexual behavior","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Adolescence","Emerging Adults","Pornography","Sexting","Online Harassment","Instrumental Attitudes"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7145774","cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two‑wave (2‑month) longitudinal survey of 1,947 adolescents and emerging adults (13‑25 y). Cross‑lagged autoregressive SEM used to test whether self‑reported pornography use predicts later willingness to forward non‑consensual sexts, with moderation by instrumental sexual attitudes and age/sex.","sample_n":1947,"sample_text":"N = 1947 participants (aged 13‑25 y).","population":"Adolescents and emerging adults, community sample recruited via schools/online panels (presumed).","country":"Not specified (likely multiple European sites).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A two‑month longitudinal study of 1,947 teens and young adults found that higher porn use predicted a greater willingness to forward others’ nude photos without consent, especially among adolescent boys with strong instrumental attitudes toward sex.","clinical_takeaway":"Higher pornography exposure may signal increased risk for non‑consensual sext sharing among young males with certain sexual attitudes.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large community sample (N ≈ 2000) increases statistical power.","Longitudinal design allows temporal ordering of pornography use before outcome.","Use of SEM to model cross‑lagged effects and test moderation."],"limitations":["Reliance on self‑report frequency scales without indication of validation.","Key potential confounds (moral attitudes, mental‑health, relationship context) not measured.","No pre‑registration or reported effect‑size confidence intervals."],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":37,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-01580-2"}},{"id":744,"doi":"10.1080/0092623x.2021.2009076","pmid":"34839803","pmcid":null,"title":"Women's Cognitive and Emotional Appraisal of Sex Pictures: The Predictive Role of Age, Exposure Time, and Sexual Beliefs","authors":"Carvalho J, Ferreira L, Rico R, Bártolo A, Santos IM.","first_author":"Carvalho J","journal":"Journal of sex & marital therapy","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross-sectional laboratory experiment with within‑subject picture exposure","sample_n":155,"sample_text":"155 women (age range not specified) recruited to view romantic, sexually moderate and explicit pictures","population":"155 adult women, likely convenience sample","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 155 women, older age was linked to finding moderately explicit and explicit erotic pictures more pleasant and to feeling higher sexual arousal, especially when the pictures were viewed longer or when personal sexual beliefs supported the content.","clinical_takeaway":"Older women may experience greater positive emotional and arousal responses to explicit erotic material; clinicians should consider age and personal beliefs when discussing sexual media effects.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Reasonably large sample for experimental picture‑viewing study","Within‑subject design allows direct comparison across picture categories","Considers age, exposure time, and sexual beliefs as moderators"],"limitations":["Measures appear to be ad‑hoc self‑report scales with unclear validation","No assessment of moral, mental‑health or relational confounds","Cross‑sectional; cannot infer causal age effects"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2021.2009076"}},{"id":745,"doi":"10.2196/12824","pmid":"31411140","pmcid":"PMC6711035","title":"A Health Education Website Developed to Meet Young People's Information Needs About Web-Based Pornography and Sharing of Sexually Explicit Imagery (SCOPE): Usability Study","authors":"Davis AC, Wright CJC, Temple-Smith MJ, Hellard ME, Lim MSC.","first_author":"Davis AC","journal":"JMIR formative research","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Adolescent","Sex Education","Health Promotion","Pornography"],"is_oa":true,"oa_url":"https://formative.jmir.org/2019/3/e12824/PDF","cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Usability study with semistructured interviews (N=17) of young people aged 15‑29.","sample_n":17,"sample_text":"17 participants aged 15‑29 years","population":"young people, convenience sample","country":"Australia (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A small interview study tested a new website that gives young people information about online porn and sexting. Participants found it trustworthy and liked the balanced tone and videos, but suggested making content more age‑specific.","clinical_takeaway":"None – the study informs website design, not clinical treatment.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Co‑design approach with target users","Rich qualitative feedback","Clear relevance to public‑health practice"],"limitations":["Small, non‑representative sample","No validated usability instruments","Findings not generalisable beyond this group"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/12824"}},{"id":747,"doi":"10.1007/s10508-025-03289-x","pmid":"41264136","pmcid":"PMC12675776","title":"A Longitudinal Examination of the Mediating Role of Body Dissatisfaction in the Relationship Between Pornography Use Frequency and Eating Disturbances: A Cross-Lagged Mediation Model","authors":"Demirgül SA, Aranda FF, Murcia SJ, Paksi B, Czakó A, Demetrovics Z, Bőthe B.","first_author":"Demirgül SA","journal":"Archives of sexual behavior","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Adults","Body Dissatisfaction","Longitudinal Design","Pornography","Eating Disturbances"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12675776","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"cross‑lagged panel with 2 waves, N=3764 young adults","sample_n":3764,"sample_text":"large community sample, convenience‑recruited","population":"young adults (mean age 23, both sexes)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a year‑long study of 3,764 young adults, higher pornography use was linked to later eating‑disorder symptoms, partly because it increased body‑image dissatisfaction. The effect was seen in both men and women.","clinical_takeaway":"Consider assessing pornography use as a possible contributor to body‑image concerns in clients with eating‑disorder symptoms.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large longitudinal sample","Cross‑lagged mediation analysis","Reports confidence intervals for indirect effects"],"limitations":["Unclear whether measures are validated","No control for key psychosocial confounds","No pre‑registration or correction for multiple testing mentioned"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03289-x"}},{"id":748,"doi":"10.3389/frcha.2025.1567649","pmid":"41089467","pmcid":"PMC12515835","title":"Impact of pornography consumption on children and adolescents: a trauma-informed approach","authors":"Alvarez-Segura M, Fernández I, El Kasmy Y, Francisco E, Gallo Martínez S, Ortiz Jiménez EM, Butjosa A.","first_author":"Alvarez-Segura M","journal":"Frontiers in child and adolescent psychiatry","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Trauma","Children","Adolescents","Sexual Violence","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12515835","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"n/a","sample_n":null,"sample_text":"Not applicable – review article without original data","population":"children and adolescents (underage pornography consumers)","country":"n/a","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that viewing pornography before age could act like a traumatic event, affecting young people's sexuality and relationships, and suggests new laws and therapies.","clinical_takeaway":"No direct clinical guidance; the piece is theoretical and should not dictate practice.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Integrates trauma theory with underage pornography exposure","Highlights potential mental‑health implications for youths"],"limitations":["No empirical data presented","Speculative causal language without evidence","Lacks systematic review methodology"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/frcha.2025.1567649"}},{"id":749,"doi":"10.31234/osf.io/a968c_v2","pmid":null,"pmcid":null,"title":"The Experience of Individuals Filmed for Pornography Production: A History of Continuous Polyvictimization and Ongoing Mental Health Challenges","authors":"Donevan M, Jonsson LS, Svedin CG.","first_author":"Donevan M","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/a968c_v2","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional interview study with regression analyses (N=120)","sample_n":120,"sample_text":"120 participants completed face‑to‑face interviews and questionnaires","population":"Individuals documented in pornography production in Sweden (age ≥ 18)","country":"Sweden","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 120 adults who have been filmed for porn in Sweden showed extreme levels of childhood and on‑set abuse, with 84 % meeting criteria for PTSD and 60 % for dissociative disorders, highlighting severe mental‑health needs.","clinical_takeaway":"People documented in pornography have high rates of PTSD and dissociation; clinicians should screen for trauma and provide specialised mental‑health care.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large (N=120) sample for a hard‑to‑reach group","Use of validated mental‑health scales","Focus on an under‑studied population"],"limitations":["Cross‑sectional design limits causal inference","Convenience recruitment; not representative of all porn performers","Key confounds (e.g., moral incongruence, masturbation) not measured"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/a968c_v2"}},{"id":750,"doi":"10.1007/s13178-021-00641-3","pmid":"40786843","pmcid":"PMC12333439","title":"Motivations to Start and Stop Using Sexual Networking Applications Among Adolescent Sexual Minority Men","authors":"Owens C, Shrodes A, Kraus A, Birnholtz J, Moskowitz DA, Macapagal K.","first_author":"Owens C","journal":"Sexuality research & social policy : journal of NSRC : SR & SP","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Technology","Adolescent","Motivation","Sexual Health","Sexual Minority Men","Sexual Networking Applications"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional online survey with open‑ended questions; inductive thematic analysis of 156 adolescent sexual‑minority men (age 15‑17)","sample_n":156,"sample_text":"156 participants completed an online survey","population":"Adolescent sexual minority men (ASMM) in the USA, recruited online","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A study of 156 teenage gay and bisexual boys in the US explored why they start and stop using dating apps. They use the apps to meet friends or partners, but many stop because they receive unwanted sexual messages.","clinical_takeaway":"Providers should discuss app use with ASMM clients, highlighting both social benefits and potential exposure to unwanted sexual content.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for qualitative work (N=156)","Focused on an understudied population (ASMM)","Clear thematic analysis procedure"],"limitations":["Cross‑sectional, self‑selected online sample","No validated scales; constructs not operationalised quantitatively","Potential lack of diversity (US‑only, age 15‑17)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13178-021-00641-3"}},{"id":751,"doi":"10.1007/s10508-025-03227-x","pmid":"40968214","pmcid":null,"title":"Experiences with AI-Generated Pornography: A Quantitative Content Analysis of Reddit Posts","authors":"Döring N, Le TD, Miller DJ.","first_author":"Döring N","journal":"Archives of sexual behavior","year":2025,"pub_types":["Journal Article"],"keywords":["Quantitative Content Analysis","Reddit","Generative Artificial Intelligence","Synthetic Pornography","Ai Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Quantitative content analysis of 390 Reddit posts; manual coding with high inter‑rater reliability (κ=0.88).","sample_n":390,"sample_text":"Reddit posts collected in August 2024.","population":"English‑language public Reddit posts about AI‑generated pornography (convenience sample).","country":"Not specified (global Reddit).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined 390 Reddit posts about AI‑generated porn, coding what users said about production, content, use, effects, and ethical‑legal issues. They found most discussion focused on how AI porn is made and what it looks like, with fewer posts about personal use. Both concerns (e.g., non‑consensual deepfakes) and positive reactions (curiosity, enjoyment) were reported.","clinical_takeaway":"None – the study describes online discourse, not individual clinical outcomes.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["High coding reliability (κ=0.88).","Systematic codebook guides analysis.","Addresses a novel, under‑studied phenomenon."],"limitations":["Convenience sample of Reddit posts limits generalisability.","No behavioural or clinical measures; purely self‑reported content.","No assessment of user characteristics or confounding factors."],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[{"status":"Has correction","date":"2025-12-10","noticeDoi":"10.1007/s10508-025-03385-y","doi":"10.1007/s10508-025-03227-x"}],"url":"https://scite.ai/reports/10.1007/s10508-025-03227-x"}},{"id":752,"doi":"10.64898/2026.02.16.26346376","pmid":null,"pmcid":null,"title":"Trajectories over time in the prevalence of substance and behavioral addictions and common mental health issues in Israel, 2022-2025","authors":"Shmulewitz D, Levitin MD, Skvirsky V, Vider M, Lev-Ran S, Mikulincer M.","first_author":"Shmulewitz D","journal":"medRxiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Repeated cross‑sectional surveys of Jewish adults in Israel (April 2022, Dec 2023, Mar 2024, Jun 2024, Feb 2025) with a longitudinal subset (N = 1 368) modelling trajectories of problematic substance and behavioural use, including pornography and compulsive sexual behaviour.","sample_n":1368,"sample_text":"Longitudinal subset of respondents surveyed at baseline (April 2022) and at least one follow‑up wave.","population":"Jewish adult residents of Israel","country":"Israel","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study tracked how many Israeli adults reported problematic use of substances, internet, gaming, gambling, pornography and compulsive sexual behaviour before and during the war after Oct 7 2023, finding mixed increases, stable rates, or declines depending on the behaviour.","clinical_takeaway":"Trauma and war may change the prevalence of problematic sexual and other behaviours; clinicians should monitor patients for shifts in coping patterns during crises.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large, repeated‑cross‑sectional national sample","Longitudinal subset allows within‑person change estimation","Broad range of substance and behavioural outcomes"],"limitations":["Problematic use defined with unspecified self‑report screens","Key confounds for sexual outcomes (moral incongruence, masturbation) not measured","Potential selection bias (Jewish adults only, unclear recruitment method)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.64898/2026.02.16.26346376"}},{"id":753,"doi":"10.1177/08862605231163886","pmid":"37067003","pmcid":"PMC10668537","title":"The Role of Consent and Motivations in Sext Dissemination","authors":"Clancy EM, Hallford D, March E, Howard D, Toumbourou JW, Klettke B.","first_author":"Clancy EM","journal":"Journal of interpersonal violence","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Assault","Offenders","Mental Health And Violence","Internet And Abuse"],"is_oa":true,"oa_url":"https://journals.sagepub.com/doi/pdf/10.1177/08862605231163886","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 2,126 cisgender adults (18‑30) from English‑speaking Western nations; assessed self‑reported consensual vs non‑consensual sext dissemination, motivations, attitudes, and psychological distress.","sample_n":2126,"sample_text":"2126 participants (55% women, 45% men), mean age 22.97 (SD 3.21)","population":"cisgender adults 18‑30, community sample, convenience online recruitment","country":"Australia and other Western English‑speaking nations","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A large online survey of young adults examined why people share sexual images, finding that sharing to gossip is more often non‑consensual, and that women are more likely to share unwanted images. Attitudes and distress did not differ between consensual and non‑consensual sharing.","clinical_takeaway":"Educators should address consent and motivations behind image sharing to reduce non‑consensual dissemination.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size","Clear distinction between consensual and non‑consensual dissemination","Inclusion of both genders"],"limitations":["Reliance on self‑report, unclear validation of scales","Cross‑sectional design limits causal inference","Convenience online sample may not be representative"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605231163886"}},{"id":755,"doi":"10.1016/j.chiabu.2019.104260","pmid":"31776010","pmcid":null,"title":"Children who engaged in interpersonal problematic sexual behaviors","authors":"DeLago C, Schroeder CM, Cooper B, Deblinger E, Dudek E, Yu R, Finkel MA.","first_author":"DeLago C","journal":"Child abuse & neglect","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Child Initiators","Interpersonal Problematic Sexual Behaviors","Problematic Sexual Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective chart review of child initiators of interpersonal problematic sexual behaviors (IPSBs) reported to child protective services between 2002‑2013.","sample_n":220,"sample_text":"Medical charts of CIs and children they engaged in IPSBs; examinations occurred between 2002 and 2013.","population":"Children identified as initiators of IPSBs (N≈220), mostly male, mean age 10 years; data extracted from medical/child protective service records.","country":"Not specified (likely United States based on author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A review of child protection records found that most children who started sexual acts with peers were boys around 10 years old, many had seen pornographic material, and those who had seen it tended to commit more invasive acts.","clinical_takeaway":"Early monitoring of children’s exposure to explicit media may help prevent more serious peer‑initiated sexual behaviors.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large case series covering >200 child initiators","Provides detailed typology of sexual acts","Links media exposure to behavior severity"],"limitations":["Retrospective chart data; no validated measures of media exposure","No control/comparison group; limited generalizability","Potential confounding by unmeasured mental‑health or family factors"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2019.104260"}},{"id":756,"doi":"10.1708/3749.37322","pmid":"35166725","pmcid":null,"title":"[Psychological aspects of Revenge Porn phenomena: clinical perspective]","authors":"Veronica V, Di Giacomo D.","first_author":"Veronica V","journal":"Rivista di psichiatria","year":2022,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"ita","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"rapid review of 8 articles, limited methodology description, no meta‑analytic pooling","sample_n":null,"sample_text":"8 articles included; no primary sample size reported","population":"humans (victims/perpetrators of non‑consensual pornography)","country":"Not specified (international databases)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed eight recent studies on non‑consensual sharing of sexual images (‘revenge porn’) and found that victims often experience anxiety, depression, and post‑traumatic stress, suggesting personal factors may influence who becomes involved.","clinical_takeaway":"Clinicians should assess for anxiety, depression, and PTSD when working with individuals affected by non‑consensual image sharing.","confidence":0.7,"topic_tags":["religiosity","pornography","masturbation","sexual_function"],"strengths":["Addresses an understudied psychological aspect of revenge porn","Includes recent literature (2016‑2021)","Highlights mental‑health outcomes (anxiety, depression, PTSD)"],"limitations":["Rapid review with limited methodological transparency","No systematic quality appraisal of included studies","Small number of included articles (n=8)","No quantitative synthesis or effect size reporting"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1708/3749.37322"}},{"id":757,"doi":"10.1007/s10508-020-01727-6","pmid":"32445133","pmcid":null,"title":"Sexting: What's Law Got to Do with It?","authors":"Lee JR, Darcy KM.","first_author":"Lee JR","journal":"Archives of sexual behavior","year":2021,"pub_types":["Journal Article"],"keywords":["Child Pornography","Youth Justice","Sexting","Legal Analysis","Revenge Porn"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Legal analysis without empirical data; argument based on statutory interpretation and policy recommendation.","sample_n":null,"sample_text":"No participant sample; analysis draws on existing statutes and case law.","population":"Canadian legal context; focuses on youth sexting participants and adult perpetrators.","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper analyses Canadian laws on youth sexting, arguing that while protecting minors is important, current punishments are too harsh. It suggests using child‑pornography statutes only when adults are involved and recommends a graduated approach for teens.","clinical_takeaway":"None - not clinically applicable.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Comprehensive review of Canadian legal framework","Identifies mismatch between legislative intent and implementation","Provides concrete reform suggestions"],"limitations":["No empirical data on outcomes of legal approaches","Focus limited to Canada; limited generalisability"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":22,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01727-6"}},{"id":760,"doi":"10.3390/healthcare11060805","pmid":"36981462","pmcid":"PMC10048235","title":"Solitary Sexual Desire: Its Relation to Subjective Orgasm Experience and Sexual Arousal in the Masturbation Context within a Spanish Population","authors":"Cervilla O, Jiménez-Antón E, Álvarez-Muelas A, Mangas P, Granados R, Sierra JC.","first_author":"Cervilla O","journal":"Healthcare (Basel, Switzerland)","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Arousal","Genital Response","Solitary Sexual Desire","Subjective Orgasm Experience","Solitary Masturbation"],"is_oa":true,"oa_url":"https://www.mdpi.com/2227-9032/11/6/805/pdf?version=1679278011","cited_by_count":7,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Study 1: large online sample (N=2406) of heterosexual adults; Study 2: small lab experiment (N=41) measuring genital response to erotic film during masturbation.","sample_n":2447,"sample_text":"2406 adults in Study 1; 41 participants in Study 2","population":"Spanish heterosexual adults (Study 1) and young adults (Study 2)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Across more than 2,400 Spanish adults, the desire to have sex alone predicts how intense their orgasm feels during masturbation, and in women it also predicts how easily they become aroused to erotic film.","clinical_takeaway":"Clinicians should consider solitary sexual desire as a factor influencing orgasm quality and arousal during solo sexual activity.","confidence":0.78,"topic_tags":["sexual_function","masturbation"],"strengths":["large sample for Study 1","focus on understudied solitary desire","objective genital measures in Study 2"],"limitations":["cross‑sectional; no causal inference","limited control of confounding variables","Study 2 very small sample"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":9,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare11060805"}},{"id":761,"doi":"10.1007/s10508-025-03217-z","pmid":"40835801","pmcid":"PMC12484347","title":"Online Pornography Consumption, Risky Behaviors, and Sexist Attitudes in Adolescence: A Cross-Sectional Survey Study","authors":"Feijóo S, Portela V, Rial A.","first_author":"Feijóo S","journal":"Archives of sexual behavior","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Gender","Adolescence","Sexual Risky Behavior","Pornography","Sexist Attitudes"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12484347","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross-sectional survey of 664 adolescents in Spain; self‑report questionnaire on pornography use, sexist attitudes and other risky behaviours.","sample_n":664,"sample_text":"Galician secondary‑school students, convenience sample","population":"Adolescents (12‑17 y) recruited from schools in Galicia, Spain","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 664 Spanish teens, about half had ever watched online porn. Those who did were more likely to hold traditional sexist views and to engage in other risky behaviours. The authors suggest that sex education should address how porn may shape attitudes.","clinical_takeaway":"Clinicians should be aware that adolescent porn use is linked to sexist attitudes and broader risk‑taking, highlighting the need for early, comprehensive sex‑education.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample for a school‑based survey","Use of a validated scale for sexist attitudes","Separate analysis by gender"],"limitations":["Cross‑sectional design cannot establish causality","Pornography use measured with single ad‑hoc item","Key confounds (moral beliefs, mental health, masturbation) not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03217-z"}},{"id":763,"doi":"10.1080/00224499.2022.2142190","pmid":"36449349","pmcid":null,"title":"Hot for Robots! Sexual Arousal Increases Willingness to Have Sex with Robots","authors":"Dubé S, Williams M, Santaguida M, Hu R, Gadoury T, Yim B, Vachon D, Johnson AP.","first_author":"Dubé S","journal":"Journal of sex research","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subjects pre‑post online manipulation of state sexual arousal","sample_n":321,"sample_text":"Convenience sample of adults; no indication of probability or clinical recruitment","population":"321 adults recruited via convenience online sampling (≥18 y)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 321 adults, watching a sexually explicit video raised participants' reported willingness to have sex with a robot, especially among men, compared with their willingness before the video.","clinical_takeaway":"None – the findings describe short‑term self‑reported willingness, not clinical risk or pathology.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for an online manipulation study","Pre‑post within‑subject design allows assessment of state effects","Addresses a novel topic (sexual willingness toward robots)"],"limitations":["Self‑report measures not validated; possible demand characteristics","Convenience sampling limits generalisability","No measurement of moral or cultural factors that could influence willingness"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2142190"}},{"id":764,"doi":"10.1038/s41562-021-01187-5","pmid":"34580439","pmcid":"PMC9258728","title":"An observational study of Internet behaviours for adolescent females following sexual abuse","authors":"Noll JG, Haag AC, Shenk CE, Wright MF, Barnes JE, Kohram M, Malgaroli M, Foley DJ, Kouril M, Bonanno GA.","first_author":"Noll JG","journal":"Nature human behaviour","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural","Observational Study"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"observational longitudinal cohort with baseline and 2‑year follow‑up","sample_n":460,"sample_text":"460 females aged 12‑16","population":"adolescent females (12‑16 y), N = 460 (CSA = 156, comparison = 304)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2‑year study of 460 teenage girls found that those who had been sexually abused did not watch more pornography than other girls, but they were more likely to be cyber‑bullied and to belong to a high‑risk group that combined heavy internet use with other psychosocial problems.","clinical_takeaway":"Clinicians should assess both online behaviour and offline psychosocial factors when working with adolescent survivors of sexual abuse, rather than assuming pornography use alone drives risk.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large adolescent sample with CSA and comparison groups","Prospective 2‑year follow‑up allows temporal ordering","Reports effect sizes (odds ratios) with confidence intervals"],"limitations":["Unclear how pornography/URL use was measured; likely unvalidated self‑report","Key confounds (moral incongruence, masturbation, mental health) not addressed","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":30,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41562-021-01187-5"}},{"id":765,"doi":"10.3390/ijerph19010074","pmid":"35010332","pmcid":"PMC8751024","title":"Parent-Child Sex Communication Prompts, Approaches, Reactions, and Functions According to Gay, Bisexual, and Queer Sons","authors":"Flores DD, Greene MZ, Taggart T.","first_author":"Flores DD","journal":"International journal of environmental research and public health","year":2021,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Prevention","Sexual Health","Sti","Ymsm"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/1/74/pdf?version=1640169385","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"30 semi‑structured interviews with GBQ adolescent males (15‑20 y); thematic and content analysis.","sample_n":30,"sample_text":"30 GBQ male youth aged 15‑20 years","population":"GBQ adolescent males, United States (presumably), recruited via community channels.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 30 gay, bisexual, and queer teen boys revealed how and why parents talk about sex, what approaches work, how sons react, and what purposes these talks serve, suggesting parents could help reduce HIV/STI risk.","clinical_takeaway":"Parents can play a key role in providing accurate sexual health information to GBQ adolescents, potentially lowering HIV/STI risk.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides rare qualitative insight from GBQ youth perspectives","Clear thematic structure with four identified themes","Addresses a gap in parent‑child communication research for sexual minorities"],"limitations":["Small, non‑representative convenience sample (N=30)","No standardized or validated interview instrument reported","Lacks quantitative assessment of confounding factors"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":4,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph19010074"}},{"id":767,"doi":"10.1007/s10508-022-02329-0","pmid":"35900676","pmcid":"PMC9330933","title":"Sexual Attitudes and Characteristics of OnlyFans Users","authors":"Litam SDA, Speciale M, Balkin RS.","first_author":"Litam SDA","journal":"Archives of sexual behavior","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Attitudes","Pornography","Sexually Explicit Material","Onlyfans"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9330933","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of US MTurk participants (n=718) assessing demographics and sexual attitudes of OnlyFans users vs non‑users","sample_n":718,"sample_text":"n = 718 (335 male, 383 female), mean age ≈ 29.5 years, recruited through MTurk","population":"adult US residents recruited via Mechanical Turk (online convenience sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 718 US adults recruited on MTurk found that OnlyFans users are mostly married, white, heterosexual men, but they hold similar sexual attitudes to non‑users regarding permissiveness, communion, instrumentality and birth control.","clinical_takeaway":"OnlyFans use does not appear linked to distinct sexual attitudes; clinicians should not assume unique risk based solely on platform use.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a survey","First systematic description of OnlyFans user demographics in the US","Balanced male/female representation"],"limitations":["Convenience MTurk sample limits generalisability","Sexual attitudes measured with likely ad‑hoc items, unclear validation","No control for moral, mental‑health or relationship confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":26,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02329-0"}},{"id":769,"doi":"10.31234/osf.io/tqs7a_v1","pmid":null,"pmcid":null,"title":"Deepfake/Real Harms: An online intervention to reduce deepfake abuse perpetration and myth acceptance","authors":"Twomey J, Ching D, Lavoie E, Geary AL, Quayle M, Linehan C, Murphy G.","first_author":"Twomey J","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Three pre‑registered online randomised experiments (total N = 1628) testing a 10‑minute empathy/education intervention versus control.","sample_n":1628,"sample_text":"Adults from online panels; not a probability sample","population":"Adults recruited online, including a high‑perpetrating subgroup","country":"unspecified (likely US/UK based on author affiliations)","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"An online 10‑minute video intervention taught empathy and corrected myths about deepfake sexual abuse. Across three experiments with 1,628 participants, it reduced belief in deepfake myths and lowered self‑reported intentions to watch or share non‑consensual synthetic porn, with effects on watching intentions persisting for up to a month.","clinical_takeaway":"Brief empathy‑based education can modestly reduce intentions to engage with non‑consensual deepfake porn.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Pre‑registered multi‑study RCT design","Large combined sample","Follow‑up assessment of behavioural intention"],"limitations":["Self‑report intent, not actual behaviour","Measures appear author‑developed, limited validation","No assessment of potential confounds (e.g., moral beliefs, mental health)"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/tqs7a_v1"}},{"id":770,"doi":"10.1080/08952841.2026.2720078","pmid":"42621774","pmcid":null,"title":"Aging women's sexual agency: Subverting the male gaze in Japanese pink film <i>Lily Festival</i> (2001)","authors":"Xiao Y.","first_author":"Xiao Y.","journal":"Journal of women & aging","year":2026,"pub_types":["Journal Article"],"keywords":["Japan","Lesbians","Pornography","Aging Women","Feminist Film"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"theoretical film criticism; no empirical data, no sampling","sample_n":null,"sample_text":"N/A","population":"none","country":"Japan (film setting); author affiliation not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article examines a Japanese soft‑core film, showing how it challenges ageist and sexist visual norms by using an aging female/queer gaze to subvert the traditional male gaze.","clinical_takeaway":"None - not clinically applicable.","confidence":0.85,"topic_tags":["pornography","gender","sexual_function","csbd","masturbation"],"strengths":["Integrates feminist and queer theory","Provides detailed film analysis","Highlights under‑studied intersection of age, gender, and pornography"],"limitations":["No empirical data or systematic methodology","Findings not generalizable beyond this single film","Does not address sexual‑health outcomes"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/08952841.2026.2720078"}},{"id":771,"doi":"10.1007/s10508-013-0121-1","pmid":"23733156","pmcid":"PMC3830581","title":"Sexually explicit media on the internet: a content analysis of sexual behaviors, risk, and media characteristics in gay male adult videos","authors":"Downing MJ, Schrimshaw EW, Antebi N, Siegel K.","first_author":"Downing MJ","journal":"Archives of sexual behavior","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 302 gay male adult videos from five high‑traffic sites; systematic coding of sexual behaviors and risk indicators.","sample_n":302,"sample_text":"302 sexually explicit videos featuring male same‑sex performers posted to five highly trafficked adult‑oriented websites.","population":"Adult male performers in publicly available online videos (n=302 videos).","country":"USA (likely, based on author affiliations) ","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers examined 302 gay male adult videos and found that unprotected anal sex occurs in about one‑third of them, similar to condom‑protected sex. Other high‑risk acts (e.g., ejaculation in the mouth) were more common in longer, popular, or group videos.","clinical_takeaway":"SEM often depicts risky sexual practices; clinicians should discuss media influence when counseling MSM about HIV/STI prevention.","confidence":0.85,"topic_tags":["pornography","sexual_function"],"strengths":["Large, systematic coding of a substantial video sample (n=302).","Clear operational definitions of risk behaviors (e.g., UAI vs condom use).","Relevant public‑health implications highlighted."],"limitations":["No assessment of viewer characteristics or outcomes; findings limited to media content.","Potential selection bias from only five popular websites.","Limited description of coding reliability and validation."],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":48,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0121-1"}},{"id":772,"doi":null,"pmid":"35854738","pmcid":"PMC9285152","title":"Automatic Cohort Determination from Twitter for HIV Prevention amongst Black and Hispanic Men","authors":"Weissenbacher D, Flores JI, Wang Y, O'Connor K, Rawal S, Stevens R, Gonzalez-Hernandez G.","first_author":"Weissenbacher D","journal":"AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science","year":2022,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"observational data‑mining of public Twitter posts; ML classification to infer demographics and sexual language; no experimental manipulation","sample_n":2192,"sample_text":"5,392 users identified; 2,166 users with sex‑related tweets analyzed","population":"Twitter users in Los Angeles identified as likely young Black or Hispanic men (N≈5,400 identified; 2,166 with sex‑related tweets)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors used machine‑learning on public Twitter posts to automatically pinpoint young Black and Hispanic men in Los Angeles who post sexually explicit content, showing it may be possible to recruit such users for HIV prevention research.","clinical_takeaway":"Automated social‑media screening could help identify hard‑to‑reach groups for sexual‑health studies, but current methods lack precision.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large-scale public data source (47 M tweets)","Innovative use of NLP for demographic inference","Transparent description of tools used"],"limitations":["Limited precision of classification","No validation against ground‑truth data","Findings may not generalize beyond Twitter users"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":773,"doi":"10.1080/00224499.2016.1216068","pmid":"27548620","pmcid":null,"title":"\"Whosoever Looketh on a Person to Lust After Them\": Religiosity, the Use of Mainstream and Nonmainstream Sexually Explicit Material, and Sexual Satisfaction in Heterosexual Men and Women","authors":"Cranney S, Štulhofer A.","first_author":"Cranney S","journal":"Journal of sex research","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 2,580 Croatian adults; self‑report measures of religiosity, SEM use (frequency, type), and sexual satisfaction; mediation and moderation analyses","sample_n":2580,"sample_text":"large online convenience sample, likely not probability based","population":"heterosexual adult men and women (Croatia)","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 2,580 Croatian adults, higher religiosity was linked to less frequent use of porn and more negative attitudes toward it. For women, being religious also reduced use of non‑mainstream porn and changed how porn use related to sexual satisfaction.","clinical_takeaway":"Religiosity appears to influence porn use and sexual satisfaction, especially in women, but causal claims cannot be made from this data.","confidence":0.78,"topic_tags":["pornography","religiosity","sexual_function"],"strengths":["large sample size","separate measurement of SEM type","use of mediation/moderation models"],"limitations":["cross‑sectional design limits causal inference","no measurement of masturbation or mental‑health covariates","religiosity used as proxy for moral incongruence"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2016.1216068"}},{"id":774,"doi":"10.1007/s10508-025-03229-9","pmid":"40987972","pmcid":null,"title":"\"It's a Way to Let Go\": The Intersection of Pleasure and Pain in Pornography","authors":"Shor E.","first_author":"Shor E.","journal":"Archives of sexual behavior","year":2025,"pub_types":["Journal Article"],"keywords":["Pain","Pleasure","In-depth Interviews","Pornography","Viewer Preferences"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative study using 302 in-depth interviews","sample_n":302,"sample_text":"302 in-depth interviews","population":"adult pornography viewers (male and female) recruited for interviews","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 302 pornography viewers revealed that many, especially women, find scenes mixing pain and pleasure arousing, seeing the two as closely linked rather than opposite.","clinical_takeaway":"Clinicians should recognize that some consumers experience pain‑related porn content as pleasurable, which may be a normative preference rather than a sign of pathology.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Large qualitative sample (n=302)","In‑depth exploration of a rarely studied topic","Provides rich, participant‑centered perspectives"],"limitations":["No validated quantitative measures of pleasure, pain, or pornography use","Potential selection bias; recruitment strategy not described","No assessment of key confounds (e.g., moral incongruence, mental health)","Findings not generalizable beyond interviewed sample"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03229-9"}},{"id":775,"doi":"10.1080/00224499.2013.858305","pmid":"24511896","pmcid":null,"title":"Women's critical responses to sexually explicit material: the role of hyperfemininity and processing style","authors":"van Oosten JM, Peter J, Boot I.","first_author":"van Oosten JM","journal":"Journal of sex research","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Online between‑subjects experiment manipulating story gender target and processing style; participants grouped by hyperfemininity (low/moderate/high).","sample_n":195,"sample_text":"195 women aged 18‑30, recruited online.","population":"Women, 18‑30 years, N=195, recruited online (convenience sample).","country":"Not specified (likely Netherlands/UK based on author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In an online experiment, women read erotic stories aimed at men or women while using different thinking styles. Low‑ and moderate‑hyperfeminine women were more critical of male‑targeted stories when they focused on story details, suggesting gender role attitudes shape how women evaluate explicit material.","clinical_takeaway":"None – the study examines attitudes, not health outcomes.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Experimental manipulation of both stimulus content and processing style","Adequate sample size for a between‑subjects design","Novel focus on hyperfemininity as a moderator"],"limitations":["Convenience online sample limits generalisability","Unclear whether hyperfemininity scale was validated","No assessment of potential moral/religious attitudes that might influence criticism"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":23,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2013.858305"}},{"id":776,"doi":"10.1007/s10508-025-03204-4","pmid":"40739436","pmcid":null,"title":"Validation of the Pornography Actors' Condom Use Attitudes Questionnaire","authors":"Way BM, Gunawan K, Borgogna NC, Brents B, Kraus SW.","first_author":"Way BM","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Journal Article"],"keywords":["Sexual Health","College Students","Condoms","Pornography","Pornography Actors"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross-sectional survey of 601 American college students recruited from two universities; participants reported pornography use in past 12 months and completed the newly validated Pornography Actors' Condom Use Attitudes Questionnaire (PACUAQ).","sample_n":601,"sample_text":"601 college students","population":"American college students (age ~18‑24), both genders, who have viewed pornography in the past year.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study created and validated a questionnaire measuring how people feel about condom use in pornography. It found that men tend to hold more negative attitudes, while women are more supportive. More critical attitudes were linked to watching more porn, longer sessions, and higher risky‑sex behavior.","clinical_takeaway":"Attitudes toward condoms in porn may influence risky sexual behavior; clinicians could explore these beliefs when discussing safer sex with clients.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (N=601) for psychometric validation","Confirmatory factor analysis with gender invariance testing","Clear operationalisation of attitudes toward condom use"],"limitations":["Cross‑sectional design prevents causal inference","No measurement of key confounds (e.g., moral incongruence, mental health, trauma)","Convenience sample of college students limits generalisability"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03204-4"}},{"id":777,"doi":"10.1017/sjp.2025.10003","pmid":"40716959","pmcid":null,"title":"Consumption of Male-Female, Female-Female, and Male-Male Pornography: Attentional Focus and Associated Discomfort in Spanish Men with Different Sexual Attraction","authors":"Nebot-Garcia JE, Giménez-García C, Cervigón-Carrasco V, Ballester-Arnal R.","first_author":"Nebot-Garcia JE","journal":"The Spanish journal of psychology","year":2025,"pub_types":["Journal Article"],"keywords":["Arousal","Distress","Sexual Attraction","Pornography","Non-preferred Sex"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study of 1,133 Spanish men (18‑40 y) examining consumption of heterosexual, female‑female, and male‑male pornography, attentional focus and discomfort across five sexual‑attraction groups","sample_n":1133,"sample_text":"1133 men aged 18‑40 years (M = 24.78, SD = 5.91)","population":"Spanish adult men, convenience sample","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,133 Spanish men, researchers found that men watch all three types of porn (hetero, lesbian, gay) but feel most discomfort with male‑male porn, especially when it does not match their sexual attraction. Attention during viewing differed by sexual orientation.","clinical_takeaway":"Discomfort with non‑preferred porn may relate to internal conflict; clinicians should explore moral or identity factors rather than assume pathology.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large overall sample (N > 1 000)","Includes men with diverse sexual attractions","Addresses under‑studied topic of non‑preferred porn consumption"],"limitations":["Reliance on ad‑hoc self‑report items; no validated scales","Cross‑sectional, cannot infer causality","Key confounds (moral incongruence, masturbation, mental health) not measured"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/sjp.2025.10003"}},{"id":779,"doi":"10.1016/j.chb.2022.107385","pmid":"40443957","pmcid":"PMC12122005","title":"Negative urgency moderates the association between compulsive sexual behaviors and sending unsolicited sexts among men in residential treatment for substance use disorders","authors":"Garner AR, Brem MJ, Shorey RC, Hamlin J, Stuart GL.","first_author":"Garner AR","journal":"Computers in human behavior","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Compulsive Sexual Behavior","Negative Urgency","Unsolicited Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Medical‑record review of 253 men in residential substance‑use treatment; single‑time‑point, retrospective, convenience sample.","sample_n":253,"sample_text":"253 men in residential treatment for substance use disorders","population":"Men receiving residential SUD treatment (n≈253)","country":"USA (not specified in abstract; assumed based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among men in residential substance‑use treatment, higher compulsive sexual behavior was linked to more unsolicited sexting, especially for those who act impulsively when feeling negative emotions.","clinical_takeaway":"Screen for impulsivity and CSB in SUD patients to address risky digital sexual behaviors.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Relatively large clinical sample (n>250)","Focus on understudied digital sexual behavior","Use of hierarchical regression to test moderation"],"limitations":["Cross‑sectional, cannot infer causality","Measures not described; likely self‑report or chart notes","No control for key confounds (e.g., mental health, trauma)","Sample limited to men in SUD treatment, limiting generalisability"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chb.2022.107385"}},{"id":780,"doi":"10.1016/j.addbeh.2014.03.007","pmid":"24679612","pmcid":"PMC4071449","title":"Compulsive use of Internet-based sexually explicit media: Adaptation and validation of the Compulsive Internet Use Scale (CIUS)","authors":"Downing MJ, Antebi N, Schrimshaw EW.","first_author":"Downing MJ","journal":"Addictive behaviors","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Validation Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Internet","Compulsivity","Pornography","Sexually Explicit Media"],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 265 MSM, cross‑sectional, convenience sample","sample_n":265,"sample_text":"265 Internet SEM‑viewing MSM participated in an online survey","population":"men who have sex with men, Internet SEM viewers","country":"United States","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers adapted a 14‑item scale to measure compulsive use of online sexually explicit material among gay and bisexual men, showing it works well statistically. Higher compulsive scores were linked to boredom, sexual frustration, more viewing time, and more recent sexual partners.","clinical_takeaway":"The new scale provides a reliable way to assess compulsive online porn use, but clinicians should consider other factors like moral views and mental health.","confidence":0.8,"topic_tags":["pornography","sexual_function","measurement"],"strengths":["Validated psychometric adaptation","Adequate sample size for factor analysis","Clear internal consistency (α=.92)","Provides a tool for future research"],"limitations":["Cross‑sectional, cannot infer causality","No control for moral incongruence or masturbation","Convenience sample of MSM limits generalisability","Addiction criteria not operationalised"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":28,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2014.03.007"}},{"id":781,"doi":"10.1111/ijd.15048","pmid":"32662878","pmcid":null,"title":"Sexually explicit media (SEM) and condomless sex on the Internet in 2019: an analysis of 100 SEM","authors":"Kluger N.","first_author":"Kluger N.","journal":"International journal of dermatology","year":2020,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/ijd.15048"}},{"id":782,"doi":"10.1007/s10508-025-03199-y","pmid":"40696099","pmcid":"PMC12457227","title":"Moderating Effects on the Link between Violent Pornography and Sexual Aggression","authors":"de Roos MS, Ferrando E.","first_author":"de Roos MS","journal":"Archives of sexual behavior","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Violence","Pornography","Rape Myth Acceptance","Sexual Script Theory","Violent Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12457227","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 686 Dutch university students","sample_n":686,"sample_text":"N = 686 university students from the Netherlands","population":"university students (young adults, mixed gender)","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"supports","citation_value":"useful","plain_summary":"In a survey of 686 Dutch university students, men who watched more violent pornography were more likely to report sexual aggression, especially when they believed the porn was realistic and their peers endorsed rape myths. The link was weaker for women unless peer attitudes were strongly supportive of rape myths.","clinical_takeaway":"Do not treat pornography viewing as a proven cause of sexual aggression; consider broader social and relational factors.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a single‑site survey","Examines moderating variables (realism, peer RMA)","Relevant public‑health topic"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on self‑report frequency and aggression measures","Key confounds (moral views, mental health, trauma) not accounted for"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03199-y"}},{"id":784,"doi":"10.1080/00224499.2013.866195","pmid":"24670248","pmcid":null,"title":"Differential developmental profiles of adolescents using sexually explicit internet material","authors":"Doornwaard SM, van den Eijnden RJ, Overbeek G, ter Bogt TF.","first_author":"Doornwaard SM","journal":"Journal of sex research","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Four-wave longitudinal cohort of 787 Dutch adolescents (8th–10th grade) with latent class growth analysis of SEIM use and latent growth curve analysis of sexual behavior.","sample_n":787,"sample_text":"787 eighth through tenth grade Dutch adolescents","population":"Adolescents (approx. 13‑16 y) from Dutch schools, community sample.","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study followed 787 Dutch teens over four school years, finding several distinct patterns of porn‑related internet use. Some teens used it rarely, others increased use, and a few decreased use. These patterns were linked to factors like sexual interest and attitudes, and were associated with different trajectories in sexual behavior.","clinical_takeaway":"Adolescents’ porn use varies widely; clinicians should consider individual developmental patterns rather than assuming uniform effects.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, multi‑wave community sample","Person‑centered analytic approach (LCGA, LGCA)","Explores both SEIM use and sexual behavior development"],"limitations":["Reliance on self‑report frequency measures with unclear validation","No assessment of key confounds (moral incongruence, mental health, partner context)","No pre‑registration or reporting of effect‑size precision"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":31,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2013.866195"}},{"id":785,"doi":"10.1111/j.1743-6109.2012.02988.x","pmid":"23110358","pmcid":"PMC3566284","title":"Perceived effects of sexually explicit media among men who have sex with men and psychometric properties of the pornography consumption effects scale (PCES)","authors":"Hald GM, Smolenski D, Rosser BR.","first_author":"Hald GM","journal":"The journal of sexual medicine","year":2013,"pub_types":["research-article","Validation Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online cross‑sectional survey of 1,333 U.S. MSM; psychometric validation of a revised PCES.","sample_n":1333,"sample_text":"US adult MSM, recruited via online survey; convenience sample","population":"Men who have sex with men (MSM), adult, United States, online convenience sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,333 gay and bisexual men, almost all reported that watching porn helped them learn about sex, enjoy it more, and feel clearer about their sexual orientation. The revised Pornography Consumption Effects Scale showed strong reliability and validity.","clinical_takeaway":"Clinicians should recognize that MSM may view porn as beneficial for sexual knowledge and well‑being, but any presumed causal impact on behaviour remains unproven.","confidence":0.8,"topic_tags":["pornography","sexual_function","lgbtq","measurement"],"strengths":["Large sample (N>1300) for psychometric validation","Comprehensive factor analysis and reliability reporting","Focus on positive perceived effects, filling a gap in literature"],"limitations":["Cross‑sectional self‑report; cannot infer causality","No control for moral incongruence, masturbation, mental health, or relationship factors","Convenience online sample limits generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":2,"mentioning":70,"citing_publications":83,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2012.02988.x"}},{"id":786,"doi":"10.1007/s10508-021-01961-6","pmid":"34282504","pmcid":null,"title":"Neuroticism and Attention Toward Sexual and Non-Sexual Images During an Oddball Task: Evidence from Event-Related Potentials","authors":"Carrito ML, Carvalho J, Pereira A, Bem-Haja P, Nobre P, Santos IM.","first_author":"Carrito ML","journal":"Archives of sexual behavior","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["ERP","Information processing","P1","Neuroticism","P3","Affective Stimuli","Sexual Response"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross-sectional laboratory oddball ERP task with 58 participants (30 women, 28 men)","sample_n":58,"sample_text":"30 women and 28 men","population":"adult men and women, community sample (likely convenience recruitment)","country":"unspecified (likely Portugal based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab task, people with higher neuroticism showed slower brain responses to pornographic images and larger brain waves for highly arousing pictures, suggesting that personality influences how sexual cues are processed.","clinical_takeaway":"Neuroticism may affect attention to sexual cues, but findings are limited to laboratory brain responses and not directly linked to sexual problems.","confidence":0.75,"topic_tags":["neuroscience","sexual_function"],"strengths":["Uses objective neurophysiological measures (ERP)","Includes both sexes and multiple stimulus categories","Addresses a gap on personality and sexual stimulus processing"],"limitations":["Convenience sample, limited generalisability","No pre‑registration or effect‑size reporting","Limited control of potential psychological confounds"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":6,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-01961-6"}},{"id":789,"doi":"10.1177/08862605251347633","pmid":"40642877","pmcid":null,"title":"Aggressive Pornography, Hostility Toward Women, and Behavioral Activation System Traits are Differentially Associated With Intimate Partner Violence and Rape Myth Acceptance","authors":"Bedoya A, Shortland N.","first_author":"Bedoya A","journal":"Journal of interpersonal violence","year":2026,"pub_types":["Journal Article"],"keywords":["Impulsivity","Intimate Partner Violence","Bas","Rape Myth Acceptance","Hostility Toward Women","Aggressive Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 146 predominantly White participants examining self‑reported aggressive pornography use, BAS traits, RMA and IPV perpetration.","sample_n":146,"sample_text":"predominantly (90%) White sample (N = 146)","population":"adults (predominantly White, N=146)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 146 adults, higher use of aggressive pornography and certain impulsive personality traits were linked to stronger acceptance of rape myths and greater self‑reported intimate partner violence, while persistence in goal‑directed behavior was linked to less violence.","clinical_takeaway":"Aggressive porn consumption and impulsivity may be risk factors for IPV and rape‑myth attitudes; addressing impulsive behavior could help prevention.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender","relationships"],"strengths":["Uses established personality and attitude scales","Examines multiple individual difference variables simultaneously","Provides data on understudied link between aggressive porn and IPV"],"limitations":["Cross‑sectional design limits causal inference","Convenience, largely White sample reduces generalisability","No control for key confounds (e.g., moral incongruence, mental health, trauma)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605251347633"}},{"id":792,"doi":"10.1016/j.adolescence.2019.10.005","pmid":"31654849","pmcid":null,"title":"#(Me)too much? The role of sexualizing online media in adolescents' resistance towards the metoo-movement and acceptance of rape myths","authors":"Maes C, Schreurs L, van Oosten JMF, Vandenbosch L.","first_author":"Maes C","journal":"Journal of adolescence","year":2019,"pub_types":["Journal Article"],"keywords":["Adolescence","Social Media","Objectification","Rape Myth Acceptance","Sexually Explicit Internet Material","#Metoo"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional paper‑and‑pencil survey of 568 Flemish adolescents (15‑18 y)","sample_n":568,"sample_text":"568 Flemish adolescents (15‑18 y, 58.3 % girls)","population":"adolescents, community sample (school based)","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Dutch‑speaking adolescents, more exposure to sexually explicit online material is linked to greater rejection of the #MeToo movement and higher acceptance of rape myths, partly because it promotes viewing women as objects.","clinical_takeaway":"None – the study addresses attitudes, not clinical sexual health outcomes.","confidence":0.85,"topic_tags":["sexual_function","pornography"],"strengths":["Large community adolescent sample (N > 500)","Focus on a timely societal issue (MeToo resistance)","Mediation analysis linking SEIM exposure to attitudes via objectification"],"limitations":["Cross‑sectional design limits causal inference","No measurement of key confounds (moral beliefs, mental health, etc.)","Reliance on self‑report scales; validation of some measures unclear"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":15,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2019.10.005"}},{"id":796,"doi":"10.1037/dev0000040","pmid":"26376287","pmcid":null,"title":"Adolescents' use of sexually explicit Internet material and their sexual attitudes and behavior: Parallel development and directional effects","authors":"Doornwaard SM, Bickham DS, Rich M, ter Bogt TF, van den Eijnden RJ.","first_author":"Doornwaard SM","journal":"Developmental psychology","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"4‑wave panel study of 1,132 Dutch adolescents (grades 7‑10) with cross‑lagged panel modelling and mean‑level growth trajectories.","sample_n":1132,"sample_text":"1,132 Dutch adolescents (grades 7‑10), 52.7 % boys, followed across four 6‑month waves (18 months total).","population":"Adolescents (mean age 13.9, 53 % male) from Dutch schools","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 4‑wave study of over a thousand Dutch teens, boys who watched more online sexual material gradually adopted more permissive sexual attitudes, while girls used such material little and showed no attitude changes. SEIM use did not consistently predict later sexual activity.","clinical_takeaway":"For adolescent boys, higher exposure to online sexual content may shape more permissive attitudes; clinicians should consider media exposure when discussing sexual values.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Large, multi‑wave, community sample","Sophisticated longitudinal modelling (cross‑lagged panel)","Gender‑specific analyses"],"limitations":["Reliance on self‑report for SEIM use and sexual behaviour","No measurement of key confounds (moral incongruence, mental health, trauma)","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":3,"mentioning":43,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/dev0000040"}},{"id":797,"doi":"10.1007/s10508-014-0416-x","pmid":"25677334","pmcid":"PMC4408764","title":"The role of sexually explicit material in the sexual development of same-sex-attracted Black adolescent males","authors":"Arrington-Sanders R, Harper GW, Morgan A, Ogunbajo A, Trent M, Fortenberry JD.","first_author":"Arrington-Sanders R","journal":"Archives of sexual behavior","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":64,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Cross‑sectional semi‑structured interviews with Black same‑sex‑attracted adolescent males (15‑19) recruited via clinics, social networking sites and snowball sampling; thematic analysis of transcripts.","sample_n":null,"sample_text":"Recruitment from clinics, social networking sites, snowball sampling; exact N not reported in abstract.","population":"Black same‑sex‑attracted adolescent males, ages 15‑19, United States (clinic and online recruitment).","country":"United States (presumed from author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with Black teen boys attracted to other males showed that porn‑like material often served as their first source of sexual information, shaping how they understand bodies, roles and risk behaviours such as condom use.","clinical_takeaway":"Clinicians should recognise that SEM can be a primary sexual‑education source for these youths and address misinformation and risk‑taking directly.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Provides rich, contextual insight into a understudied population.","Highlights specific educational gaps and risk behaviours linked to SEM.","Uses semi‑structured interviews allowing participant voice."],"limitations":["Small, non‑probability convenience sample; limited generalisability.","No validated quantitative measures of SEM use or sexual health outcomes.","Potential confounding factors (e.g., mental health, moral beliefs) not assessed."],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":105,"citing_publications":125,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0416-x"}},{"id":798,"doi":"10.3389/fpsyg.2025.1380813","pmid":"40662184","pmcid":"PMC12258044","title":"Shoah pornography: the Stalag phenomenon in Israel during the 1960s","authors":"Spiegel J, Dekker A, Briken P, Gomille A, Rettenberger M.","first_author":"Spiegel J","journal":"Frontiers in psychology","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Trauma","Pornography","Expert Interviews","Shoah","Stalag"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12258044","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"expert interviews (n=5) analyzed by qualitative content analysis","sample_n":5,"sample_text":"five expert interviews","population":"experts on Israeli history/psychology; not representative of general population","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper analyses why soft‑core porn booklets called \"Stalags\" became popular in 1960s Israel, using five expert interviews. Themes include reversal of anti‑Jewish hatred, politics of sexuality, trauma coping, changing masculinity, and US film influence, interpreted through psychoanalytic ideas.","clinical_takeaway":"None – the study is historical and does not provide clinical guidance on pornography use or sexual health.","confidence":0.8,"topic_tags":["pornography","csbd","moral_incongruence","sexual_function"],"strengths":["Original historical topic","Qualitative depth from expert insight"],"limitations":["Very small, non‑representative sample","No validated measures or systematic theory testing","Findings highly speculative and not generalizable"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2025.1380813"}},{"id":802,"doi":"10.1080/0092623x.2026.2702762","pmid":"42474105","pmcid":null,"title":"Measurement Invariance of the Pornography Consumption Inventory Among Gender, Age, Relationships Status and Sexual Orientation","authors":"Cervilla O, Álvarez-Muelas A, Sierra JC, Sánchez-Pérez GM.","first_author":"Cervilla O","journal":"Journal of sex & marital therapy","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community sample, CFA & measurement invariance testing","sample_n":1366,"sample_text":"cisgender Spanish adults","population":"cisgender Spanish adults (N=1,366)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested whether the Pornography Consumption Inventory works the same way for different genders, ages, relationship statuses and sexual orientations in a sample of 1,366 Spanish adults. The three‑factor model was largely consistent across groups, but some differences in motivations were found.","clinical_takeaway":"The PCI appears reliable for comparing porn‑motivation scores across demographic groups, but clinicians should interpret subgroup differences cautiously.","confidence":0.9,"topic_tags":["measurement","pornography","sexual_function","gender"],"strengths":["Large sample size gives strong statistical power","Comprehensive measurement‑invariance testing across key demographic groups","Use of validated PCI and related psychometric instruments"],"limitations":["Cross‑sectional design limits causal inference","No assessment of moral, mental‑health or trauma variables that could confound motivations","Unclear whether analysis plan was pre‑registered"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2026.2702762"}},{"id":803,"doi":"10.1007/s10508-022-02325-4","pmid":"35978201","pmcid":null,"title":"A Penny for Your (Sexual) Thoughts: Qualitative Analysis of Women's Self-Described Reactions to Sexual and Nonsexual Stimuli","authors":"Busch TM, Penniston TL, Conrads GS, Dempsey MR, Wilson SM, Chivers ML.","first_author":"Busch TM","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Content analysis","Sexual Arousal","Qualitative Research","Sexual Desire","Sexual Response"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative content analysis of open‑ended thought journals after viewing sexual and neutral video clips (n=148 women)","sample_n":148,"sample_text":"Women participants who viewed neutral and sexually explicit video clips and completed free‑response journals","population":"adult women, likely convenience sample (recruitment not specified in abstract)","country":"not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers asked 148 women to write what they thought right after watching both neutral nature videos and sexual videos (including masturbation and intercourse). An analysis of their 842 written responses revealed themes such as how they judged the clips, what emotions they felt, personal reflections, levels of arousal, and other desires, highlighting the varied ways women experience sexual stimuli.","clinical_takeaway":"Women’s cognitive and emotional reactions to sexual material are diverse; clinicians should consider individual subjective experiences rather than rely solely on quantitative arousal measures.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large qualitative sample (n=148) for thematic analysis","Multiple independent coders increase reliability","Provides nuanced insight into women's cognitive and emotional responses"],"limitations":["No validated questionnaires; constructs defined ad‑hoc","Potential self‑selection bias; recruitment details missing","No control for moral, mental‑health, or relational confounds"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02325-4"}},{"id":804,"doi":"10.1007/s10508-025-03175-6","pmid":"40537606","pmcid":"PMC12283780","title":"Two Decades of Gender Differences in Pornography Research Topics","authors":"Yu J, Andrich A, Schindler M.","first_author":"Yu J","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","letter","Journal Article"],"keywords":["bibliometrics","Gender Differences","Longitudinal Analysis","Pornography","Thematic Mapping"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12283780","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"bibliometric analysis of 6,145 published papers (2001‑2024) using temporal and thematic mapping","sample_n":6145,"sample_text":"N/A (secondary analysis of publications)","population":"published literature, not human participants","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined 6,145 papers on pornography from 2001‑2024 and found that women leading studies tend to choose topics that were previously under‑researched, such as internet‑related issues, suggesting that researcher gender shapes the field’s focus.","clinical_takeaway":"None – the study describes research‑publication patterns, not clinical outcomes.","confidence":0.8,"topic_tags":["pornography","gender","sexual_function"],"strengths":["Large dataset covering over two decades","Systematic thematic mapping provides objective insight","Highlights gender‑related patterns in research agendas"],"limitations":["No assessment of article quality or bias","Interpretation limited to publication trends, not user outcomes","Potential mis‑classification of author gender"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":0,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03175-6"}},{"id":805,"doi":"10.1007/s10508-025-03177-4","pmid":"40537607","pmcid":null,"title":"Children's Pornography Exposure and Associated Factors in Ghana: A Mixed-Method Study","authors":"Kyei-Gyamfi S, Kyei-Gyamfi Z, Martey JO, Kyei-Arthur F.","first_author":"Kyei-Gyamfi S","journal":"Archives of sexual behavior","year":2025,"pub_types":["Journal Article"],"keywords":["Children","Regulations","Prevalence","Ghana","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional convergent parallel mixed-method study of 5,024 Ghanaian children aged 8‑17, with quantitative survey and thematic qualitative analysis","sample_n":5024,"sample_text":"5,024 children","population":"children 8‑17 years in Ghana (presumably community sample, claimed nationally representative)","country":"Ghana","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 5,024 Ghanaian children aged 8‑17, about 38% reported having seen pornographic material, most often online or via social media. Older boys, religious children, and those with computer or TV access were more likely to be exposed, and many felt sad, confused, or curious afterwards.","clinical_takeaway":"Be aware that a substantial minority of children encounter pornography; screening for exposure and providing age‑appropriate support may be warranted.","confidence":0.8,"topic_tags":["sexual_function","pornography","adolescents"],"strengths":["Large, apparently nationally representative sample","Mixed‑method design adds depth to quantitative findings","Appropriate logistic regression for predictor analysis"],"limitations":["Exposure measured with a single, unvalidated item","Cross‑sectional design cannot establish causality","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03177-4"}},{"id":806,"doi":"10.1017/ipm.2026.10204","pmid":"42460460","pmcid":null,"title":"Extended-release naltrexone (Vivitrol) augmentation for compulsive sexual behavior disorder: a case report","authors":"Welz C.","first_author":"Welz C.","journal":"Irish journal of psychological medicine","year":2026,"pub_types":["Journal Article"],"keywords":["Naltrexone","Case Report","Extended-release","Hypersexuality","Vivitrol","Behavioral Addiction","Pornography Addiction","Compulsive Sexual Behavior Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Single-case longitudinal observation of symptom scores over three months after pharmacological augmentation.","sample_n":1,"sample_text":"N=1 (case report)","population":"54‑year‑old married man with compulsive sexual behavior.","country":"Ireland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 54‑year‑old man with compulsive sexual behavior showed notable reductions in porn‑related urges and related problems after receiving monthly injections of extended‑release naltrexone for three months, suggesting the drug might help when other treatments fail.","clinical_takeaway":"Extended‑release naltrexone may reduce CSBD symptoms, but evidence is limited to a single case; larger trials are needed before clinical adoption.","confidence":0.8,"topic_tags":["csbd","neuroscience","treatment"],"strengths":["Use of validated CSBD scales","Clear longitudinal symptom tracking","Safety monitoring of liver function"],"limitations":["Single participant; no control group","No assessment of potential confounds (mood, trauma, moral attitudes)","Cannot infer causality from single case"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":3,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/ipm.2026.10204"}},{"id":807,"doi":"10.3389/fpsyt.2026.1828055","pmid":"42529604","pmcid":"PMC13418231","title":"Impulsivity and sexual compulsivity - a comparison of untreated individuals with CSBD, individuals undergoing long-term treatment for CSBD, and a healthy control group","authors":"Solomonov N, Dayan M, Argaman R, Mama Y, Weinstein AM.","first_author":"Solomonov N","journal":"Frontiers in psychiatry","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Impulsivity","Risky Sexual Behavior","Compulsivity","Online Pornography","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13418231","cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional comparison of three groups (untreated CSBD, treated CSBD, healthy controls); convenience sample of men; n=77 total","sample_n":77,"sample_text":"26 untreated CSBD, 26 treated CSBD, 25 controls","population":"men with CSBD (treated and untreated) and healthy controls","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men with compulsive sexual behavior disorder (both untreated and in treatment) to healthy men, finding higher scores on sex‑addiction and pornography use in the CSBD groups, and greater impulsivity (risk‑taking and delay discounting) in untreated patients.","clinical_takeaway":"Untreated CSBD may involve higher impulsivity; treatment appears linked to reduced impulsive risk‑taking, but findings are limited by small sample size.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Use of validated questionnaires and behavioral tasks","Comparison of treated vs. untreated CSBD groups","Clear statistical reporting of regression explaining variance"],"limitations":["Small sample per group, limited power","No measurement of key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2026.1828055"}},{"id":808,"doi":"10.1101/2024.10.12.24315374","pmid":null,"pmcid":null,"title":"Men’s Internet Sex Addiction Predicts Sexual Objectification of Women Even After Taking Pornography Consumption Frequency into Account","authors":"Nováková P, Chvojka E, Ševčíková A, Blinka L, Wright P, Kane S.","first_author":"Nováková P","journal":"medRxiv","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.1101/2024.10.12.24315374","cited_by_count":0,"is_preprint":true,"topics":["csbd","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,272 male online pornography viewers; structural equation modelling","sample_n":1272,"sample_text":"male consumers recruited online; convenience sample","population":"male consumers of online video pornography (average age 33)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,272 men who watch online video porn, higher scores on an internet sex‑addiction questionnaire were linked to greater sexual objectification of women, even after accounting for how often they watched porn.","clinical_takeaway":"Higher self‑reported internet sex‑addiction symptoms may signal a risk for objectifying attitudes, but causality is unproven.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["large sample size","use of structural equation modelling","adjusts for pornography frequency"],"limitations":["cross‑sectional design prevents causal inference","addiction construct measured with unspecified/likely unvalidated scale","core confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2024.10.12.24315374"}},{"id":812,"doi":"10.31234/osf.io/a968c","pmid":null,"pmcid":null,"title":"The Experience of Individuals Filmed for Pornography Production: A History of Continuous Polyvictimization and Ongoing Mental Health Challenges","authors":"Donevan M, Jonsson LS, Svedin CG.","first_author":"Donevan M","journal":"PsyArXiv","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/a968c","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Face‑to‑face interviews with 120 adults who have been filmed for pornography; descriptive statistics and regression on PTSD severity.","sample_n":120,"sample_text":"Convenience recruitment; likely self‑selected from a vulnerable group.","population":"Adults (≥18) filmed for pornography in Sweden (convenience sample).","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 120 Swedish adults who have been filmed for porn revealed extreme, ongoing abuse: childhood trauma, rape, physical assault, and online harassment. Over 80% showed serious PTSD and many had attempted suicide, highlighting a pressing need for legal and mental‑health support.","clinical_takeaway":"People filmed for pornography are at high risk for trauma‑related disorders; clinicians should screen for victimisation and provide trauma‑informed care.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large (for this hidden population) sample of 120 participants","Use of validated PTSD and mental‑health questionnaires","Regression analysis identifies predictors of symptom severity"],"limitations":["Cross‑sectional design; cannot infer causality","Convenience, self‑selected sample limits generalisability","No power calculation or effect‑size reporting"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/a968c"}},{"id":814,"doi":"10.1007/s12119-022-10060-0","pmid":"36685612","pmcid":"PMC9838472","title":"Learning on OnlyFans: User Perspectives on Knowledge and Skills Acquired on the Platform","authors":"Lippmann M, Lawlor N, Leistner CE.","first_author":"Lippmann M","journal":"Sexuality & culture","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Learning Outcomes","User Perspectives","Sexual Learning","Onlyfans","Digital Sex Work"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9838472","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 425 OnlyFans users, mixed‑method (quantitative + qualitative thematic analysis)","sample_n":425,"sample_text":"425 participants recruited via online survey; sampling method not described as probability based","population":"adult OnlyFans users (self‑selected, likely convenience sample)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 425 OnlyFans users found that most reported learning new sexual skills, preferences, and relationship insights, describing positive impacts on their sexual lives.","clinical_takeaway":"Clients may view OnlyFans as a source of sexual education and exploration, but clinicians should note these are self‑reported benefits from a non‑representative sample.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for a niche platform","Mixed‑method provides depth","Relevant contemporary topic"],"limitations":["Convenience, self‑selected sample limits generalisability","Reliance on ad‑hoc self‑report measures","No validated scales for learning outcomes"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12119-022-10060-0"}},{"id":815,"doi":"10.1080/13691058.2014.919409","pmid":"24917353","pmcid":null,"title":"Revisualising 'porn': how young adults' consumption of sexually explicit Internet movies can inform approaches to Canadian sexual health promotion","authors":"Hare KA, Gahagan J, Jackson L, Steenbeek A.","first_author":"Hare KA","journal":"Culture, health & sexuality","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Canada","Sexual Health","Young People","Internet Pornography","Sex-positive","Sexually Explicit Internet Movies"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Exploratory qualitative study using semi‑structured interviews with 12 urban heterosexual young adults (19‑28 y) who had used sexually explicit internet movies for ≥1 year.","sample_n":12,"sample_text":"12 participants recruited on self‑report of SEIM use","population":"Young adult (19‑28 y) urban, heterosexual, Canada; convenience sample","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with twelve Canadian young adults show that they view online porn as a useful, sex‑positive source of sexual‑health information and suggest it could inform new online health‑promotion approaches.","clinical_takeaway":"Clinicians might consider discussing how patients use online sexual media as a potential source of sexual‑health information, but evidence is limited.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides novel qualitative insight into young adults’ perceived benefits of SEIM","Clear description of interview and thematic analysis procedures"],"limitations":["Very small, non‑representative convenience sample","No measurement of key confounds (moral incongruence, mental health, etc.)","Findings not generalisable beyond urban heterosexual Canadian youth"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2014.919409"}},{"id":816,"doi":"10.3389/fpsyg.2026.1764052","pmid":"42453451","pmcid":"PMC13367853","title":"Toward a new tool for risk-assessment: recidivism of child sexual abuse materials in men under voluntary treatment","authors":"Pellowski JS, Bergner-Köther R, Schmidt S, Peschka L, Hock M, Briken P, von Franqué F.","first_author":"Pellowski JS","journal":"Frontiers in psychology","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["risk assessment","Recidivism","Dark Field","Child Pornography","Child Sexual Exploitation Material","Cport","Do Not Offend","Casic"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13367853","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational, retrospective self‑report of recidivism in 131 men from a voluntary treatment network","sample_n":131,"sample_text":"131 male participants recruited from two sites of the Do Not Offend (DNO) network in Germany","population":"Male CSAM users seeking voluntary treatment (non‑mandated)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined 131 men in voluntary treatment who had used child sexual abuse material to see which factors predict future re‑offending. Existing risk‑assessment tools were tested, and several items (e.g., never married, long‑term interest in child porn) were linked to self‑reported recidivism, suggesting they may be useful in a new assessment instrument.","clinical_takeaway":"Clinicians may consider the identified risk factors when evaluating non‑mandated CSAM users, but findings are limited by self‑report and lack of control for mental‑health or trauma variables.","confidence":0.78,"topic_tags":["csbd"],"strengths":["Uses established risk‑assessment instruments (STATIC‑C, CPORT, CASIC)","Identifies specific items predictive of self‑reported recidivism","Relatively large sample for this niche population"],"limitations":["Self‑reported recidivism may be unreliable","Cross‑sectional, retrospective design limits causal inference","No measurement of important confounds (mental health, trauma, etc.)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2026.1764052"}},{"id":818,"doi":"10.1521/aeap.2013.25.4.315","pmid":"23837809","pmcid":"PMC3974605","title":"Acceptability of HIV-prevention messages in sexually explicit media viewed by men who have sex with men","authors":"Wilkerson JM, Iantaffi A, Smolenski DJ, Horvath KJ, Rosser BR.","first_author":"Wilkerson JM","journal":"AIDS education and prevention : official publication of the International Society for AIDS Education","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,231 MSM examining acceptability of HIV‑prevention messages in sexually explicit media; latent profile analysis used to identify sub‑groups.","sample_n":1231,"sample_text":"1231 MSM participants","population":"men who have sex with men (MSM), adult, recruited for an online survey (details not provided)","country":"not specified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,231 gay and bisexual men found that most think it would be ok to add HIV‑prevention messages to porn videos. Younger men and those who like condom use in porn were most supportive, while men who prefer no‑condom porn were less supportive and more likely to have recent risky sex.","clinical_takeaway":"Sexually explicit media could be a viable channel for HIV prevention messaging among MSM.","confidence":0.8,"topic_tags":["pornography","sexual_function","prevalence"],"strengths":["Large sample size for a cross‑sectional survey","Use of latent profile analysis to capture heterogeneity","Provides actionable insight for public‑health messaging"],"limitations":["Reliance on ad‑hoc, unvalidated questionnaire items","Cross‑sectional design cannot infer causality","No measurement of key confounds such as moral incongruence or mental health"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1521/aeap.2013.25.4.315"}},{"id":819,"doi":"10.1159/000546332","pmid":"40373761","pmcid":null,"title":"Pornographic Culture and Erotic Culture: Logics of Desire and Psychopathological Forms","authors":"Poggioli R, Stanghellini G.","first_author":"Poggioli R","journal":"Psychopathology","year":2025,"pub_types":["Review","Journal Article"],"keywords":["Anthropology","Cultural Analysis","Phenomenology","Desire","Erotic Culture","Pornographic Culture"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"The article is a theoretical cultural review that extends phenomenological analysis to the concepts of “pornographic culture” and “erotic culture.” No primary data, participants, or empirical methods are reported.","sample_n":null,"sample_text":"Not applicable – no empirical sample","population":"None (theoretical analysis)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors discuss how contemporary ‘pornographic’ and ‘erotic’ cultures shape people’s desires and may relate to modern forms of psychological suffering, using a phenomenological, cultural lens rather than empirical research.","clinical_takeaway":"None – the paper offers a conceptual framing without clinical data to inform practice.","confidence":0.7,"topic_tags":["pornography","csbd"],"strengths":["Broad interdisciplinary perspective","Integrates phenomenology with cultural analysis"],"limitations":["No empirical data or systematic review methodology","Lacks operational definitions or measurement of key constructs","Speculative links between culture and psychopathology"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000546332"}},{"id":820,"doi":"10.1007/s10508-013-0238-2","pmid":"24464547","pmcid":"PMC4011997","title":"Sexually explicit online media and sexual risk among men who have sex with men in the United States","authors":"Nelson KM, Simoni JM, Morrison DM, George WH, Leickly E, Lengua LJ, Hawes SE.","first_author":"Nelson KM","journal":"Archives of sexual behavior","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet‑based survey of 1,170 MSM recruited from a men‑seeking‑men website; cross‑sectional assessment of SEOM exposure and recent sexual risk behaviours.","sample_n":1170,"sample_text":"N = 1,170 MSM who accessed a men‑seeking‑men website in the past year","population":"Men who have sex with men (MSM) in the United States, recruited online via a dating website","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a US survey of 1,170 gay and bisexual men, viewing porn that shows unprotected anal sex was linked to higher odds of the men themselves having unprotected sex, suggesting a possible influence of porn on HIV‑risk behaviour.","clinical_takeaway":"Clinicians should be aware that frequent exposure to risky sexual content online may be associated with higher sexual risk among MSM; discussing media use could be part of risk‑reduction counselling.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for an online convenience study","Clear dose‑response association between SEOM depicting UAI and participants’ own UAI","Relevant public‑health outcome (HIV risk)"],"limitations":["Cross‑sectional design prevents causal inference","Self‑report measures of media exposure and sexual behaviour","Limited control for potential confounders (e.g., mental health, partner status)","Convenience sample may not represent broader MSM population"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":2,"mentioning":56,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0238-2"}},{"id":822,"doi":"10.1101/2025.10.20.25338402","pmid":null,"pmcid":null,"title":"Patterns and determinants of risky sexual behaviours among high school students in Lomé, Togo: a cross-sectional study","authors":"Kpegba-Fiaboe EE.","first_author":"Kpegba-Fiaboe EE.","journal":"medRxiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 461 high‑school students using multistage sampling; self‑administered questionnaire; logistic regression analysis","sample_n":461,"sample_text":"461 high‑school students selected through multistage sampling","population":"high‑school students (15–23 y) in Lomé, Togo","country":"Togo","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 461 Togolese high‑school students, frequent pornography use was linked to higher odds of risky sexual behaviours such as inconsistent condom use and having overlapping partners, even after accounting for grade level and a history of coerced first sex.","clinical_takeaway":"Clinicians should be aware that adolescents who frequently view pornography may be at increased risk for unsafe sexual practices and should address digital media use in sexual health counseling.","confidence":0.7,"topic_tags":["pornography","relationships","religiosity","sexual_function"],"strengths":["large sample for a school‑based survey","multistage sampling improves representativeness","use of multivariate logistic regression with confidence intervals"],"limitations":["cross‑sectional design cannot establish causality","pornography consumption measured with a single, unvalidated item","key confounders (moral incongruence, mental health, masturbation) not assessed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2025.10.20.25338402"}},{"id":825,"doi":"10.1016/j.aap.2022.106621","pmid":"35276568","pmcid":null,"title":"Understanding sexual activity while driving as a form of distracted driving","authors":"Oviedo-Trespalacios O, Newton JDA, Demant D, Phillips JG, Struckman-Johnson C.","first_author":"Oviedo-Trespalacios O","journal":"Accident; analysis and prevention","year":2022,"pub_types":["Journal Article"],"keywords":["Human Factors","Driver Behaviour","Inattention","Distracted Driving","Pornography","Multi-tasking"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"content analysis of 270 online videos depicting sexual activity while driving; descriptive statistics and decision‑tree modelling","sample_n":270,"sample_text":"270 videos","population":"publicly available sexually explicit driving videos (convenience sample)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined 270 online videos showing people having sex while driving. Coding revealed that drivers engaged in sexual activity showed poorer vehicle control and increased safety risks, similar to other distractions.","clinical_takeaway":"Sexual activity while driving impairs vehicle control and should be treated as a serious distraction risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Novel naturalistic video dataset","Systematic coding of multiple behavioural dimensions","Use of decision‑tree analysis to explore interactions"],"limitations":["Convenience sample of online SEM videos – limited generalisability","No measurement of driver characteristics or mental‑health variables","Cross‑sectional observation; causality cannot be inferred"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.aap.2022.106621"}},{"id":826,"doi":"10.1007/s10461-012-0135-z","pmid":"22252476","pmcid":"PMC3396722","title":"A commentary on the role of sexually explicit media (SEM) in the transmission and prevention of HIV among men who have sex with men (MSM)","authors":"Rosser BR, Grey JA, Wilkerson JM, Iantaffi A, Brady SS, Smolenski DJ, Horvath KJ.","first_author":"Rosser BR","journal":"AIDS and behavior","year":2012,"pub_types":["research-article","Review","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"None – review/commentary article","population":"men who have sex with men (MSM)","country":"United States (focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors discuss how porn use might affect HIV risk in gay men, summarising past studies and suggesting future research directions, including using porn as a tool for HIV prevention.","clinical_takeaway":"None – the article provides no direct clinical evidence.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Broad overview of SEM literature","Identifies gaps for MSM research","Highlights potential preventive uses"],"limitations":["No original data or systematic review methods","Lacks empirical measurement of key constructs","Does not control for confounds such as moral incongruence"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":72,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-012-0135-z"}},{"id":827,"doi":"10.1177/02654075251335813","pmid":"40538889","pmcid":"PMC12176280","title":"Are pornography use motivations related to behaviors toward the romantic partner? A dyadic daily diary study","authors":"Vasquez M, Daspe MÈ, Bőthe B, Bergeron S, Dawson SJ, Vaillancourt-Morel MP.","first_author":"Vasquez M","journal":"Journal of social and personal relationships","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Positive Behaviors","Negative Behaviors","Daily Design","Couple Dynamic","Pornography Use Motivations"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12176280","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Dyadic daily diary with 327 couples over 35 days, multilevel actor‑partner interdependence modelling","sample_n":327,"sample_text":"327 couples (≈654 individuals)","population":"Couples (average age 31.5), convenience sample","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 35‑day diary study of 327 couples, the reasons people watch porn (e.g., to reduce stress or for sexual pleasure) predicted how they behaved toward their partner that day, with stress‑reduction motives linked to fewer positive actions and pleasure motives linked to fewer negative actions.","clinical_takeaway":"Consider a partner’s motivations for watching porn when discussing daily relationship interactions.","confidence":0.8,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Large dyadic sample with intensive daily assessments","Use of actor‑partner interdependence models captures mutual effects","Focus on motivations provides nuanced insight"],"limitations":["Convenience sample limits generalisability","Motivation measures not explicitly confirmed as validated","No assessment of moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/02654075251335813"}},{"id":829,"doi":"10.1080/15546128.2025.2493652","pmid":"40963951","pmcid":"PMC12440125","title":"The Healthy Relationships Program: A pilot study of a healthy relationships, HIV/STI prevention, and pornography education program for high schoolers","authors":"Nelson KM, Campbell JK, Dunsinger S, Frieson TM, Saber R, Macapagal K, Rothman EF.","first_author":"Nelson KM","journal":"American journal of sexuality education","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Relationships","Adolescent","Sex Education","Dating Violence","Pornography","Online Intervention"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"pilot feasibility study with single‑group pre‑post design; no control group; convenience sample of 54 high‑school students in Massachusetts","sample_n":54,"sample_text":"N=54 high‑school students, ages 14‑19, recruited from Massachusetts schools for an online homework‑assigned intervention.","population":"high‑school students (ages 14‑19) in Massachusetts, USA","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A short, online sex‑education program for Massachusetts high‑schoolers was tested with 54 students. They liked it and reported higher condom use, knowledge about sex and pornography, and lower dating‑violence attitudes after the module.","clinical_takeaway":"The program appears acceptable but evidence of effectiveness is limited; larger controlled trials are needed before clinical recommendation.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Innovative school‑based online program","Addresses multiple sexual‑health topics","High participant satisfaction"],"limitations":["Small, single‑group pilot without control","Unvalidated outcome measures","No assessment of key confounds (e.g., moral incongruence, mental health)","Limited statistical power"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/15546128.2025.2493652"}},{"id":830,"doi":"10.1007/s10508-019-1449-y","pmid":"31309428","pmcid":null,"title":"The Nature and Extent of Sexting Among a National Sample of Middle and High School Students in the U.S","authors":"Patchin JW, Hinduja S.","first_author":"Patchin JW","journal":"Archives of sexual behavior","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescents","Sexual Behaviors","Social Media","Sexting","Explicit Images"],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative survey of 5,593 U.S. middle and high school students; prevalence rates reported for sexting behaviors","sample_n":5593,"sample_text":"5693 students; nationally representative","population":"Adolescents (middle and high school) in the United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a national survey of 5,600 U.S. middle‑ and high‑school students, 13% said they had sent a sext and 18.5% had received one. Most who sexted did it only once. Rates varied by gender, sexual orientation, race, and age.","clinical_takeaway":"Sexting is relatively common among teens; clinicians should ask about it in a non‑judgmental way and consider contextual factors.","confidence":0.9,"topic_tags":["sexual_function","adolescents","prevalence"],"strengths":["Large, nationally representative sample","Clear definition of sexting behavior","Breakdown by gender, orientation, race, age"],"limitations":["Self‑report single‑item measures","Cross‑sectional, no causal inference","No assessment of related mental‑health or contextual factors"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":2,"mentioning":35,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-1449-y"}},{"id":831,"doi":"10.1007/s10508-022-02361-0","pmid":"35881253","pmcid":null,"title":"The Impact of Autonomous and Controlled Sexting Motivations on Subjective Well-being and Relationship Quality","authors":"Le L, Goegan LD, Daniels LM.","first_author":"Le L","journal":"Archives of sexual behavior","year":2023,"pub_types":["Journal Article"],"keywords":["Motivation","Self-determination","Emerging Adults","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey of 267 emerging adults who had sexted a partner; structural equation modeling of motivation types and wellbeing outcomes.","sample_n":267,"sample_text":"267 emerging adults (72 men, 195 women) aged 18‑25.","population":"Emerging adults (18‑25) who sexted a committed partner; recruited via online panels (convenience).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among young adults who send sexy photos to a partner, wanting to sext for personal reasons (autonomous motivation) is linked to better mood and stronger relationships, whereas feeling pressured (controlled motivation) is tied to poorer mood and weaker relationships.","clinical_takeaway":"Counselors should explore why clients sext; autonomous reasons may support wellbeing, while pressured motives could signal relational strain.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Reasonable sample size for survey","Use of validated self‑determination theory scales (likely)","SEM provides multivariate insight"],"limitations":["Cross‑sectional; cannot infer causality","No control for moral, mental‑health or partnership variables","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":8,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02361-0"}},{"id":833,"doi":null,"pmid":"37775493","pmcid":null,"title":"Development of an online animated sexting prevention module based on the prototype willingness model to reduce intention and willingness to sexting among diploma students","authors":"Norain M, Norliza A, Salmiah MS, Tan KA, Sutan R.","first_author":"Norain M","journal":"The Medical journal of Malaysia","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pilot feasibility study with N=30 diploma students, convenience sample, no control group, descriptive statistics only","sample_n":30,"sample_text":"30 diploma students recruited for pilot testing of an animated sexting prevention module","population":"diploma students in Malaysia (public university)","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers created a short animated video series to teach Malaysian diploma students about the risks of sexting and measured whether students found it acceptable and feasible. In a pilot with 30 students, the videos were rated positively, but the study did not test whether they actually reduced sexting intentions.","clinical_takeaway":"The module appears acceptable, but there is no evidence yet that it changes sexting behavior; further controlled trials are needed.","confidence":0.4,"topic_tags":["sexual_function","prevalence"],"strengths":["Systematic development using prototype willingness model","Pilot tested acceptability, appropriateness, feasibility","Clear quantitative and qualitative feedback from participants"],"limitations":["Very small, non‑representative sample (N=30)","No control/comparison group, no effectiveness data","Reliance on ad‑hoc acceptability scales without validation"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":835,"doi":"10.1007/s10461-013-0454-8","pmid":"23564010","pmcid":"PMC3719400","title":"The effects of gay sexually explicit media on the HIV risk behavior of men who have sex with men","authors":"Rosser BR, Smolenski DJ, Erickson D, Iantaffi A, Brady SS, Grey JA, Hald GM, Horvath KJ, Kilian G, Træen B, Wilkerson JM.","first_author":"Rosser BR","journal":"AIDS and behavior","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 1,391 U.S. MSM assessing self‑reported gay SEM consumption preferences and recent HIV‑risk behaviours","sample_n":1391,"sample_text":"1,391 MSM living in the US, recruited online","population":"men who have sex with men (MSM), United States, recruited via online advertisements; N=1391","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US online survey of 1,391 gay and bisexual men, watching more videos that show anal sex without condoms was linked to higher odds of having condomless sex themselves, while overall porn use was not related to risk.","clinical_takeaway":"A preference for risky (bare‑back) porn may signal higher HIV‑risk behaviour, suggesting clinicians should discuss SEM preferences when assessing risk.","confidence":0.85,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Large sample size for online MSM survey","Focus on specific SEM preference (bare‑back vs safer‑sex)","Relevant outcome: HIV‑risk behaviour"],"limitations":["Cross‑sectional design; cannot infer causality","SEM preferences measured with single, unvalidated items","Potential self‑selection bias from online recruitment","Key confounds (e.g., mental health, partner variables) not assessed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":13,"contrasting":3,"mentioning":89,"citing_publications":68,"retracted":false,"notices":[{"status":"Has erratum","date":"2013-5-30","noticeDoi":"10.1007/s10461-013-0511-3","doi":"10.1007/s10461-013-0454-8"}],"url":"https://scite.ai/reports/10.1007/s10461-013-0454-8"}},{"id":837,"doi":"10.1101/2025.10.02.25337159","pmid":null,"pmcid":null,"title":"Treatment Approaches for Problematic Usage of the Internet (PUI): A Dual-Level Meta-Analysis of Meta-Analyses and Randomized Controlled Trials","authors":"Valyan A, Abolghasemi FS, Achab S, Ashrafi M, Baldacchino AM, Demetrovics Z, Fineberg NA, Ghorbani P, Khazaal Y, Siste K, Siste K, Wu AM, Zare-Bidokey M, Stein DJ, Potenza MN, Ekhtiari H.","first_author":"Valyan A","journal":"medRxiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Dual-level meta-analysis of meta-analyses and of randomized controlled trials covering various PUI domains, including online pornography.","sample_n":null,"sample_text":"44 RCTs (35 CBT, 2 neuromodulatory, 5 pharmacological, 3 exercise) identified; 20 meta-analyses of PUI treatments.","population":"RCTs and meta-analyses of adults and youth with problematic internet use; heterogeneous samples from published trials.","country":"Not specified (global literature)","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A large synthesis of existing reviews and trials shows that behavioral therapies like CBT, as well as medication and brain‑stimulation approaches, can substantially reduce problematic internet use, including online pornography, though study quality varies.","clinical_takeaway":"CBT‑based interventions have the strongest evidence for reducing problematic porn use; clinicians should still consider study quality and individual patient factors.","confidence":0.8,"topic_tags":["pornography","sexual_function","treatment","prevalence","gender"],"strengths":["Pre‑registered protocol (OSF)","Comprehensive dual‑level synthesis covering both meta‑analyses and primary RCTs","Use of AMSTAR‑2 and RoB‑2 to assess study quality"],"limitations":["Heterogeneity of definitions and assessment tools across primary studies","Limited reporting on individual confounds (e.g., moral incongruence, masturbation)","Potential bias from low‑quality primary RCTs influencing pooled estimates"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2025.10.02.25337159"}},{"id":838,"doi":"10.1093/sxmrev/qead029","pmid":"37500582","pmcid":null,"title":"When the brain turns on with sexual desire: fMRI findings, issues, and future directions","authors":"Bittoni C, Kiesner J.","first_author":"Bittoni C","journal":"Sexual medicine reviews","year":2023,"pub_types":["Journal Article"],"keywords":["fMRI","Sexual Arousal","Effective Connectivity","Neuroimaging","Sexual Desire","Negative Bold"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"critical review of neuroimaging literature, no new data collected","sample_n":null,"sample_text":"NA","population":"NA","country":"NA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review fMRI research on sexual desire, finding that many brain areas are linked to desire but that studies often confuse desire with arousal. They highlight methodological problems such as lack of clear definitions, insufficient connectivity analysis, and ignoring negative BOLD signals, and suggest ways to improve future work.","clinical_takeaway":"None – the paper is a methodological review, not a clinical study.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Comprehensive synthesis of existing fMRI studies","Clear identification of methodological gaps in the field","Provides concrete recommendations for future research"],"limitations":["No new empirical data; relies on prior studies of variable quality","Does not assess construct validity of sexual desire measures in original studies","Limited to fMRI; other modalities omitted"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qead029"}},{"id":839,"doi":"10.1080/0092623x.2026.2680170","pmid":"42228787","pmcid":null,"title":"Religiosity and Pornography Use: A Call for (Nuanced) Attention","authors":"Wright PJ, Sun CF, Johnson JA, Bridges AJ, Ezzell MB, Aadahl SE.","first_author":"Wright PJ","journal":"Journal of sex & marital therapy","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"letter to the editor; no empirical data, no methods, no sample","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors note that little research has examined how religious beliefs affect pornography use and urge scholars to study this relationship more carefully.","clinical_takeaway":"None – the article is a commentary without data.","confidence":0.6,"topic_tags":["religiosity","pornography","sexual_function"],"strengths":["Highlights an under‑researched topic","Calls for nuanced future work"],"limitations":["No empirical data presented","No measurement of key constructs or confounds","Cannot draw any evidence‑based conclusions"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2026.2680170"}},{"id":840,"doi":"10.1111/josh.13258","pmid":"36251455","pmcid":"PMC10092123","title":"Sexting at an Early Age: Patterns and Poor Health-Related Consequences of Pressured Sexting in Middle and High School","authors":"Parti K, Sanders CE, Englander EK.","first_author":"Parti K","journal":"The Journal of school health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Pressure","Adolescent","High School","Early-onset","Middle School","Sexting"],"is_oa":true,"oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/josh.13258","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"retrospective recall online survey of college students about past middle/high school sexting experiences; bivariate analyses","sample_n":null,"sample_text":"Not reported in abstract","population":"college students (likely convenience sample)","country":"USA (Massachusetts, Colorado, Virginia)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"College students recalled their experiences with sexting in middle and high school. Those who started sexting earlier reported more pressure, stress, and need for therapy than those who began later, suggesting early‑onset sexting may be riskier.","clinical_takeaway":"Early, pressured sexting is linked to higher stress; school mental‑health programs should address it.","confidence":0.6,"topic_tags":["sexual_function","adolescents"],"strengths":["Addresses an understudied age group (middle school)","Highlights pressured sexting as a distinct issue"],"limitations":["Retrospective self‑report; recall bias","Convenience sample of college students; limited generalisability","No validated measure of pressured sexting reported"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":2,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/josh.13258"}},{"id":841,"doi":"10.1556/2006.2021.00082","pmid":"34817398","pmcid":"PMC8987427","title":"Electrophysiological evidence of enhanced early attentional bias toward sexual images in individuals with tendencies toward cybersex addiction","authors":"Wang J, Chen Y, Zhang H.","first_author":"Wang J","journal":"Journal of behavioral addictions","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Event-related potentials","Attentional Bias","Late Positive Potential","Stroop Task","P200","Cybersex Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8987427","cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Between‑groups ERP study comparing participants high vs low on a self‑report cybersex‑addiction tendency measure.","sample_n":57,"sample_text":"28 high TCA, 29 low TCA","population":"Adults (N≈57) recruited for lab experiment; likely convenience sample.","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"People who report higher tendencies toward cybersex addiction showed faster brain responses (P200) to sexual pictures, suggesting an early attentional bias compared with low‑tendency individuals.","clinical_takeaway":"Early attentional bias to sexual cues may be a feature of problematic cybersex use, but evidence is limited and confounded.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Use of objective ERP indices","Matched high/low groups","Clear behavioral Stroop effect"],"limitations":["Unclear how 'TCA' was operationalised; likely self‑report","No measurement of key confounds (morality, masturbation, mental health)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":30,"max_possible":70,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":7,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":21,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2021.00082"}},{"id":842,"doi":"10.1016/j.anpede.2025.503791","pmid":"40210562","pmcid":null,"title":"Sexual consent in adolescence. Influence of the consumption of «new pornography» on decision-making","authors":"Barrios Miras E, Esquerda Areste M.","first_author":"Barrios Miras E","journal":"Anales de pediatria","year":2025,"pub_types":["Review","Journal Article"],"keywords":["Adolescence","Sexual Violence","Violencia Sexual","Adolescencia","Pornography","Sexual Consent","Comprehensive Sex Education","Pornografía","Consentimiento Sexual","Educación Afectivo-sexual"],"is_oa":false,"oa_url":"https://doi.org/10.1016/j.anpede.2025.503791","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"critical, non‑systematic review of literature (2015‑present) without explicit methods","sample_n":null,"sample_text":"not applicable – no original participants","population":"adolescents (as reported in cited studies)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review recent studies on adolescents’ pornography use, arguing that exposure to ‘new porn’ may shape attitudes toward consent and normalize non‑consensual sexual behavior, especially where sex education is lacking.","clinical_takeaway":"Clinicians should be aware that early porn exposure may influence teens’ views on consent; comprehensive, affect‑focused sex education is recommended.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Addresses an important public‑health concern","Covers recent literature (post‑2015)","Identifies gaps in sex‑education"],"limitations":["Lacks systematic review methodology","No transparent inclusion/exclusion criteria","No quantitative synthesis or appraisal of study quality"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.anpede.2025.503791"}},{"id":844,"doi":"10.1371/journal.pone.0154439","pmid":"27119990","pmcid":"PMC4847851","title":"Viewing of Internet-Based Sexually Explicit Media as a Risk Factor for Condomless Anal Sex among Men Who Have Sex with Men in Four U.S. Cities","authors":"Schrimshaw EW, Antebi-Gruszka N, Downing MJ.","first_author":"Schrimshaw EW","journal":"PloS one","year":2016,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0154439&type=printable","cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 265 MSM who reported viewing SEM in past 3 months; examined associations between SEM content and condomless anal sex using negative binomial regression","sample_n":265,"sample_text":"265 MSM from New York, Philadelphia, Baltimore, or Washington D.C.","population":"Men who have sex with men (MSM) in four U.S. cities who use internet SEM","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2016 survey of 265 US men who have sex with men, seeing more porn that shows condom‑less anal sex was linked to having more condom‑less encounters, while seeing more porn with condoms was linked to fewer such encounters.","clinical_takeaway":"Viewing condom‑free porn may be associated with higher condomless sex risk; interventions could promote condom use in porn to influence behavior.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for an online MSM study","Use of appropriate count model (negative binomial) for outcome"],"limitations":["Cross‑sectional; cannot infer causality","No measurement/control of key confounds (moral incongruence, mental health, partner factors)","Self‑report measures of SEM exposure and sexual behavior"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":28,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0154439"}},{"id":845,"doi":"10.31234/osf.io/bc4hk_v2","pmid":null,"pmcid":null,"title":"Second-order preferences: What we want others to like and how it affects what we think of public policy","authors":"Promberger M, Baron J.","first_author":"Promberger M","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Multiple survey‑based studies (cross‑sectional, within‑subject) examining second‑order preferences; no pre‑registration reported; sample size not given in abstract.","sample_n":null,"sample_text":"Not specified in abstract","population":"adult participants recruited online (likely convenience sample)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors show that people care not only about what they or others want, but also about what others want to want. This “second‑order” preference can influence how they feel about policies, such as those about pornography. When people think others will grow to like something more, they may support policies that increase its availability, even if they personally dislike it.","clinical_takeaway":"None - the study does not provide evidence for clinical practice regarding pornography or sexual health.","confidence":0.6,"topic_tags":["sexual_function","prevalence"],"strengths":["Novel conceptual framing of second‑order preferences","Multiple studies to replicate findings"],"limitations":["Likely convenience sample, unknown size","No pre‑registration or power analysis reported","No direct measurement of pornography use or related outcomes"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/bc4hk_v2"}},{"id":846,"doi":"10.1007/s10508-025-03112-7","pmid":"40180703","pmcid":"PMC12011978","title":"Pornography Use Among Adults in Britain: A Qualitative Study of Patterns of Use, Motivations, and Stigma Management Strategies","authors":"Macdowall WG, Lewis R, Reid D, Mitchell KR, Bosó Pérez R, Maxwell KJ, Attwood F, Gibbs J, Hogan B, Mercer CH, Sonnenberg P, Bonell C.","first_author":"Macdowall WG","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Adults","stigma","Pornography","Stigma Management Communication"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12011978","cited_by_count":3,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study (N=40) with thematic analysis","sample_n":40,"sample_text":"40 semistructured interviews with adults from across Britain","population":"Adults (18‑64) in Britain, recruited for a study on digital technologies in sexual lives; diverse but convenience sample","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 40 British adults show that pornography is commonly used for solo arousal, mood control, and sexual exploration, but users often hide it because of stigma. People employ strategies like avoiding disclosure, minimizing harm, and reframing use positively.","clinical_takeaway":"Clinicians should recognise that stigma, not just usage frequency, can affect clients’ willingness to discuss pornography use.","confidence":0.78,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["In‑depth qualitative insights into motivations and stigma","Clear theoretical framing (SMC theory)","Diverse adult sample covering a wide age range"],"limitations":["Small, non‑probability sample limits generalizability","No measurement of moral incongruence or mental‑health covariates","Findings are descriptive; no causal claims can be made"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03112-7"}},{"id":848,"doi":"10.1111/sjop.12203","pmid":"25688731","pmcid":"PMC5697722","title":"Examining the relationship between use of sexually explicit media and sexual risk behavior in a sample of men who have sex with men in Norway","authors":"Træen B, Noor SW, Hald GM, Rosser BR, Brady SS, Erickson D, Galos DL, Grey JA, Horvath KJ, Iantaffi A, Kilian G, Wilkerson JM.","first_author":"Træen B","journal":"Scandinavian journal of psychology","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["MSM","Norway","Hiv Prevention","Sexual Risk Behavior","Unsafe Sex","Anal Intercourse","Sexually Explicit Media"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 529 MSM in Norway","sample_n":529,"sample_text":"Online convenience sample of MSM","population":"Men who have sex with men, Norway, recruited via internet","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 529 Norwegian gay men found that higher use of porn showing condom‑less sex was linked to more risky anal intercourse. Early exposure to porn was also associated with higher risk.","clinical_takeaway":"Higher consumption of bareback porn may signal increased HIV risk, but causality is unclear; clinicians should assess porn preferences alongside sexual health counseling.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a niche population","Multivariable regression to adjust for some covariates","Focus on a relevant public‑health outcome (HIV risk)"],"limitations":["Cross‑sectional design cannot infer causality","Self‑report measures of SEM use and risk behavior","Limited assessment of potential confounders (e.g., moral attitudes, mental health)","Convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":21,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/sjop.12203"}},{"id":849,"doi":"10.1007/s10508-025-03110-9","pmid":"40163288","pmcid":null,"title":"\"All About the Money Shot\"? Pornography Viewers Discuss Orgasms","authors":"Shor E, Chen MH.","first_author":"Shor E","journal":"Archives of sexual behavior","year":2025,"pub_types":["Journal Article"],"keywords":["Gender","Orgasm","Pornography","Sexual Media"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of >300 regular pornography viewers assessing perceived importance of male vs female orgasms in videos","sample_n":300,"sample_text":"large and diverse sample of more than 300 men and women who regularly watch pornography","population":"adults (young, middle‑aged, male and female) who regularly watch pornography; recruitment method not specified (likely online convenience)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 300 regular porn viewers, both men and women said they consider female orgasms the most important part of porn videos, while male orgasms were rated as less important.","clinical_takeaway":"None – the study reports viewer preferences, not clinical implications.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Large sample size (>300)","Addresses gender differences in portrayal of orgasm","Directly asks viewers about perceived importance"],"limitations":["Reliance on single‑item, ad‑hoc measures","No control for moral, relational, or mental‑health confounds","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03110-9"}},{"id":851,"doi":"10.1016/j.jsxm.2019.11.257","pmid":"31818722","pmcid":null,"title":"Reading Pornography: Methodological Considerations in Evaluating Pornography Research","authors":"Fisher WA, Kohut T.","first_author":"Fisher WA","journal":"The journal of sexual medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Pornography","Pornography Use","Pornography Definitions","Pornography Effects"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"No primary sample; discussion article","population":"general (no empirical sample)","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The paper offers a critical guide for reading and evaluating pornography research, highlighting how study design, sampling, and definitions affect findings and urging clinicians to apply rigorous scientific standards.","clinical_takeaway":"Clinicians should scrutinize pornography studies for methodological quality before applying their conclusions to practice.","confidence":0.6,"topic_tags":["pornography","measurement","prevalence","sexual_function"],"strengths":["Clear methodological guidance","Broad overview of research pitfalls","Relevant for clinicians and researchers"],"limitations":["No original empirical data","Conclusions are conceptual, not evidence‑based"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.11.257"}},{"id":857,"doi":"10.1007/s10508-025-03109-2","pmid":"40097900","pmcid":"PMC12011934","title":"Young People's Intentional and Unintentional Encounters with Internet Pornography in Australia","authors":"Minihan S, Burton M, Giunta K, Villegas L, Nicholas M.","first_author":"Minihan S","journal":"Archives of sexual behavior","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Prevalence","Adolescence","Internet Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12011934","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1004 Australian adolescents (16‑18 y) assessing self‑reported intentional and unintentional encounters with internet pornography and associated sociodemographic variables","sample_n":1004,"sample_text":"Australian adolescents aged 16‑18 years (n = 1004) recruited for an online questionnaire on internet pornography encounters","population":"adolescents, Australia, 16‑18 y, n = 1004","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 1,004 Australian teens (16‑18) found that about three‑quarters have seen online pornography, often unintentionally, with earlier accidental exposure linked to later frequent and intentional viewing.","clinical_takeaway":"Clinicians should recognize that many adolescents encounter porn unintentionally and consider preventive guidance for safe online use.","confidence":0.8,"topic_tags":["prevalence","adolescents","pornography","sexual_function"],"strengths":["Large, age‑restricted sample (N > 1000)","First study to differentiate intentional vs unintentional encounters in Australia","Clear sociodemographic analyses"],"limitations":["Self‑report single‑item measures, no validated scale","Cross‑sectional design limits causal inference","No assessment of related variables (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03109-2"}},{"id":858,"doi":"10.1002/ab.21854","pmid":"31432547","pmcid":null,"title":"Adolescent sexual aggressiveness and pornography use: A longitudinal assessment","authors":"Dawson K, Tafro A, Štulhofer A.","first_author":"Dawson K","journal":"Aggressive behavior","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescents","Longitudinal Assessment","Pornography Use","Sexual Aggressiveness"],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"six-wave panel of 594 male high‑school students (age ~16) followed for 20 months; latent class and growth curve modeling","sample_n":594,"sample_text":"594 male Croatian high‑school sophomore students (baseline mean age 15.8)","population":"male Croatian adolescents, high‑school sophomores","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 20‑month study of 594 Croatian teenage boys, those who used pornography more often at the start were more likely to report higher sexual aggression later, even after accounting for personality, bullying, and peer pressure.","clinical_takeaway":"Higher early pornography use may signal risk for later sexual aggression; prevention programs should consider addressing pornography exposure.","confidence":0.78,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large longitudinal sample with multiple waves","Advanced latent growth modeling","Controls for personality, bullying, peer pressure"],"limitations":["Reliance on self‑report, likely unvalidated scales","No measurement of masturbation or moral incongruence","Single‑country, male‑only convenience sample"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":29,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ab.21854"}},{"id":859,"doi":"10.31234/osf.io/7u95z_v2","pmid":null,"pmcid":null,"title":"The Emotional Cost of Hyper-Meritocracy: A Theoretical Model of Virtual Intimacy and Psychological Disconnection","authors":"Liao KX.","first_author":"Liao KX.","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper proposes that in societies focused on performance, people turn to virtual intimacy—like pornography and AI companions—to fill emotional gaps, creating a cycle that deepens social disconnection.","clinical_takeaway":"None – the article is theoretical and does not provide clinical guidance.","confidence":0.6,"topic_tags":[],"strengths":["Integrates interdisciplinary literature","Offers a novel socio‑structural perspective"],"limitations":["No empirical data presented","Constructs (e.g., “virtual intimacy”) are not operationalised","No measurement of key confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/7u95z_v2"}},{"id":860,"doi":"10.1080/13691058.2025.2455941","pmid":"40048356","pmcid":null,"title":"Young adult writers' thoughts on healthy pornography","authors":"McKee A, Johnson E, Mitra R, Newton T, Nguyen S.","first_author":"McKee A","journal":"Culture, health & sexuality","year":2026,"pub_types":["Journal Article"],"keywords":["Young Adults","Pornography","Creative Research Methods"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative textual analysis with 4 self‑selected young adult writers; convenience sample; no sampling frame; not generalizable.","sample_n":4,"sample_text":"Four young adult writers, majority of authors, paid to produce 500‑word texts.","population":"young adult writers (ages 18‑25, recruited via Twitter call)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Four young adults wrote short pieces about what they think ‘healthy pornography’ looks like. Their poems, activist statements and academic reflections show a wide range of ideas, highlighting how young people interpret and use porn.","clinical_takeaway":"None – the study offers exploratory perspectives, not evidence for clinical practice.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Innovative creative‑writing method","Direct voices of young adults","Transparent description of data collection"],"limitations":["Extremely small, self‑selected sample (N=4)","No validated measures of pornography use or related constructs","Findings not generalizable to broader population"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2025.2455941"}},{"id":861,"doi":"10.2196/65859","pmid":"40036647","pmcid":"PMC11896553","title":"A Digital Pornography Education Prototype Co-Designed With Young People: Formative Evaluation","authors":"Turvey J, Raggatt M, Wright CJC, Davis AC, Temple-Smith MJ, Lim MSC.","first_author":"Turvey J","journal":"JMIR formative research","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Evaluation","Australia","Youth","Website","Education","efficacy","Adolescents","Sexual Health","Young People","Sexual Education","Prototyping","Digital Health","Co-design","Pornography","Sexual Wellbeing","Pornography Literacy","The Gist"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11896553","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Formative evaluation using iterative workshops with 33 participants from an alternative education school; descriptive quantitative feedback and qualitative observations.","sample_n":33,"sample_text":"33 young people aged 15‑24 recruited from an alternative education school in Melbourne, Australia","population":"Young people (15‑24) in structurally marginalized Australian alternative education setting","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and tested a prototype digital sexual‑health and pornography‑literacy site with 33 marginalized Australian youths. Participants liked its ease of use and interactive quizzes but felt it was less relevant to personal needs, and few used it outside workshops. More design work is needed before testing its impact on attitudes or behaviours.","clinical_takeaway":"Digital sexual‑health tools must be co‑designed with target users and likely need blended delivery to engage marginalised youth.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Co‑design with target youth","Iterative user‑centered feedback","Clear reporting of usability outcomes"],"limitations":["Small, non‑representative convenience sample","No objective efficacy data","Limited statistical analysis"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/65859"}},{"id":862,"doi":"10.1089/cyber.2024.0368","pmid":"40029185","pmcid":null,"title":"Adolescents' Risky Online Behaviors and Social Desirability Bias in Vietnam: Privacy Disclosure and Pornography Use","authors":"Pham T, Goto D, Kakinaka M.","first_author":"Pham T","journal":"Cyberpsychology, behavior and social networking","year":2025,"pub_types":["Journal Article"],"keywords":["Adolescent","List Experiment","Online Behavior","Social Desirability Bias","Pornography Use","Privacy Disclosure"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"field experiment using list experiment to measure prevalence of online pornography use among 1,313 Vietnamese adolescents (ages 13‑15).","sample_n":1313,"sample_text":"1,313 junior high school students aged 13‑15 years","population":"junior high school students in Hoa Binh city, Vietnam","country":"Vietnam","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of over 1,300 Vietnamese teens, about 59% reported ever viewing online pornography when measured with a technique that reduces the tendency to hide embarrassing behaviour. Urban youth and those with frequent smartphone or Facebook use were more likely to do so.","clinical_takeaway":"Many adolescents engage in online pornography; clinicians should consider privacy‑preserving assessment methods and address digital‑risk education.","confidence":0.7,"topic_tags":["pornography","adolescents","religiosity","sexual_function"],"strengths":["Large sample size for adolescent study","Use of list experiment to reduce social desirability bias","Clear prevalence estimates for sensitive behavior"],"limitations":["Cross‑sectional design; cannot infer causality","No measurement of moral, mental‑health or partner variables","Convenience school sample limits generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2024.0368"}},{"id":863,"doi":"10.3390/nursrep15030083","pmid":"40137657","pmcid":"PMC11944733","title":"Risk Determinants of Sexual Behaviors: Dating Apps, History of Sexually Transmitted Infections, Substance Use, and Pornography Consumption in Health Science Students","authors":"Naranjo-Márquez M, Bocchino A, Gilart E, Cotobal-Calvo EM, Procentese F, Palazón-Fernández JL.","first_author":"Naranjo-Márquez M","journal":"Nursing reports (Pavia, Italy)","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexually Transmitted Infections","Sexual Risk Behavior","Dating Apps","Health Sciences University Students","Drug And Pornographic Material Consumption"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11944733","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational cross‑sectional survey of 730 health‑science university students","sample_n":730,"sample_text":"730 participants recruited from a single university; likely convenience sampling of students","population":"university health‑science students (convenience sample)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 730 health‑science students found that LGBT students reported higher use of dating apps, drugs, and porn, and lower condom use, which were linked to a greater history of sexually transmitted infections.","clinical_takeaway":"Clinicians should consider dating‑app use and porn consumption as part of STI risk assessments in young adults.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large sample size (N=730)","focus on multiple risk factors (dating apps, substance use, porn)","addresses an important public‑health issue (STI risk)"],"limitations":["cross‑sectional design; no causal inference","self‑report measures, no validated pornography use scale","no control for key confounds (moral incongruence, masturbation, mental health, trauma)","convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/nursrep15030083"}},{"id":864,"doi":"10.1080/00224499.2019.1607817","pmid":"31042055","pmcid":null,"title":"Longitudinal Assessment of the Association Between Pornography Use and Sexual Satisfaction in Adolescence","authors":"Milas G, Wright P, Štulhofer A.","first_author":"Milas G","journal":"Journal of sex research","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["bibliography","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Panel study of 1,289 Croatian high‑school students, six waves, latent growth curve modelling of pornography frequency and sexual satisfaction.","sample_n":1289,"sample_text":"775 female and 514 male high‑school students.","population":"Adolescents (mean age 15.9) in Croatia, both sexes.","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A six‑wave study of over 1,200 Croatian teenagers found no link between how often they viewed pornography and how satisfied they felt with their sex lives later on.","clinical_takeaway":"No evidence that adolescent pornography use harms sexual satisfaction; clinicians need not assume a negative impact.","confidence":0.85,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Large longitudinal sample with six measurement points","Gender‑balanced and culturally distinct context","Appropriate growth‑curve analytic approach"],"limitations":["Unclear whether pornography use and sexual satisfaction scales are validated","No measurement or control of key confounds (moral incongruence, masturbation, mental health, relationship factors)","No preregistration reported"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2019.1607817"}},{"id":866,"doi":"10.1177/10778012251319300","pmid":"39982020","pmcid":"PMC12664919","title":"Behind the Illusion: Unmasking the Coercion in Pornography Production","authors":"Donevan M, Svedin CG, Dennhag I, Jonsson LS.","first_author":"Donevan M","journal":"Violence against women","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Coercion","Sexual Exploitation","Reflexive Thematic Analysis","Sexual Violence‌","Pornography Production"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12664919","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"In‑depth interviews with 28 pornography performers; reflexive thematic analysis.","sample_n":28,"sample_text":"28 participants (gender mixed, middle‑aged).","population":"Adults (male and female) filmed for pornography, recruited via purposive sampling.","country":"Sweden (assumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 28 people who have performed in porn films reveal that many experienced coercion, felt exposed publicly, and faced lasting personal impacts, challenging the idea that porn scenes are always consensual.","clinical_takeaway":"Clinicians should recognize that some porn performers may experience trauma and coercion, which can affect their mental health and relationships.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Rich, first‑person accounts of porn production experiences","Use of reflexive thematic analysis provides depth","Highlights an under‑researched side of the porn industry"],"limitations":["Small, non‑representative sample; limited generalisability","No quantitative measures; cannot assess prevalence","Potential self‑selection bias of participants willing to discuss coercion"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10778012251319300"}},{"id":868,"doi":"10.3390/bs15030243","pmid":"40150138","pmcid":"PMC11939346","title":"From Pornography Consumption to Sexually Violent Practices: Uncovering the Hidden Influence of Sexual Norms","authors":"Leon CM, Quiñonez-Toral T, Aizpurua E.","first_author":"Leon CM","journal":"Behavioral sciences (Basel, Switzerland)","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Gender Differences","Sexual Violence","Sexual Double Standard","Pornography Consumption","Sexually Permissive Attitudes"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11939346","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1003 adults from Castilla‑La Mancha, Spain; self‑report measures of pornography use, attitudes and violent sexual practices; mediation analysis","sample_n":1003,"sample_text":"N = 1003; 50.7% men","population":"general adult population (Spain)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1000 Spanish adults, higher pornography use was linked to more reports of sexually violent behaviours. The link was partly explained by more permissive sexual attitudes, especially among men.","clinical_takeaway":"Screening for permissive attitudes may help address risks linked to pornography consumption, but causal claims are premature.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large community sample (N>1000)","Examination of mediating attitudes","Gender‑specific analysis"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on self‑report, likely unvalidated scales","No control for key confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs15030243"}},{"id":869,"doi":"10.1542/peds.2012-0021","pmid":"22987882","pmcid":"PMC3457617","title":"Sexually explicit cell phone messaging associated with sexual risk among adolescents","authors":"Rice E, Rhoades H, Winetrobe H, Sanchez M, Montoya J, Plant A, Kordic T.","first_author":"Rice E","journal":"Pediatrics","year":2012,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":86,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Probability sample of 1,839 Los Angeles high‑school students; logistic regression analysis of sexting and sexual risk behaviours.","sample_n":1839,"sample_text":"Probability‑based sample of high‑school students recruited alongside the 2011 Youth Risk Behavior Survey.","population":"Adolescents (high‑school students) in Los Angeles, USA","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a representative sample of 1,839 Los Angeles high‑school students, 15 % reported sending or receiving sexually explicit texts or images. Those who sexted were much more likely to be sexually active and to have had unprotected sex, suggesting sexting clusters with other risky sexual behaviours.","clinical_takeaway":"Clinicians should ask adolescents about sexting as a cue to discuss broader sexual‑health risks and prevention strategies.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large, probability‑based sample enhances generalisability","Clear operational definition of sexting","Appropriate logistic regression with confidence intervals"],"limitations":["Cross‑sectional design precludes causal inference","Reliance on single‑item self‑reports; no validated sexting scale","Key psychosocial confounds (e.g., mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":21,"contrasting":4,"mentioning":227,"citing_publications":247,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2012-0021"}},{"id":870,"doi":"10.1177/10790632261446632","pmid":"42049269","pmcid":null,"title":"Sexual Recidivism Norms by CPORT Score: Developing Absolute and Relative Rate Estimates","authors":"Lee SC, Babchishin KM, Eke AW, Seto MC.","first_author":"Lee SC","journal":"Sexual abuse : a journal of research and treatment","year":2026,"pub_types":["Journal Article"],"keywords":["Norms","Sexual Recidivism","Child Pornography","Risk Tool","Cport","Child Sexual Abuse And Exploitation Materials"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Aggregate normative data from six routine offender samples (N=956); meta‑analysis of predictive accuracy (AUC).","sample_n":956,"sample_text":"Six routine samples of men adjudicated for child sexual abuse and exploitation material offenses (total N=956).","population":"Adult male offenders convicted of child sexual abuse and exploitation material offenses in Canada, Europe, UK.","country":"Canada, Europe, United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study pooled data from 956 adult male child‑pornography offenders across Canada, Europe and the UK to establish norm scores for the CPORT risk tool, showing higher scores predict higher chances of future sexual reoffending.","clinical_takeaway":"Higher CPORT scores indicate substantially increased risk of sexual recidivism; use norms to inform risk communication and management.","confidence":0.85,"topic_tags":["sexual_function","pornography"],"strengths":["Large combined sample from multiple jurisdictions.","Uses a validated risk assessment tool (CPORT).","Provides clear normative data and AUC estimates."],"limitations":["Meta‑analysis of routine samples lacks systematic review rigour.","No explicit control for potential confounding variables (e.g., prior offenses, treatment).","Absence of pre‑registration or open data."],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632261446632"}},{"id":871,"doi":"10.31234/osf.io/xgchu","pmid":null,"pmcid":null,"title":"Prevention of Pornographic Addiction: An Islamic Psychology Perspective","authors":"Hashim M.","first_author":"Hashim M.","journal":"PsyArXiv","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"No empirical participants; paper is a theoretical perspective","population":"general adult population (theoretical discussion, no sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The paper argues that Islam‑based psychological methods could prevent what the authors call \"pornographic addiction,\" critiquing Western treatments as under‑researched. It offers a theoretical prevention technique but provides no data.","clinical_takeaway":"No direct clinical guidance; the piece is a theoretical perspective lacking evidence.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd","prevalence","treatment"],"strengths":["Addresses a gap in culturally specific prevention approaches","Identifies methodological shortcomings in prior treatment studies"],"limitations":["No empirical data or systematic review","Lacks operational definitions and validated measures","No assessment of key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/xgchu"}},{"id":873,"doi":"10.1080/08039488.2025.2464634","pmid":"39955768","pmcid":null,"title":"The experience of individuals filmed for pornography production: a history of continuous polyvictimization and ongoing mental health challenges","authors":"Donevan M, Jonsson LS, Svedin CG.","first_author":"Donevan M","journal":"Nordic journal of psychiatry","year":2025,"pub_types":["Journal Article"],"keywords":["Mental health","Ptsd","Childhood Abuse","Polyvictimization","Pornography Production"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Descriptive face‑to‑face interview study with 120 adults documented in pornography; regression analyses of PTSD and dissociation predictors.","sample_n":120,"sample_text":"120 participants completed study‑specific questions and standardized questionnaires.","population":"Adults (≥18) who have appeared in pornography production in Sweden (N=120).","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A Swedish study of 120 adults filmed for pornography found that most had experienced multiple forms of abuse, both in childhood and during production, leading to high rates of PTSD, dissociation, suicide attempts and other mental‑health problems.","clinical_takeaway":"People documented in pornography face extreme trauma and need specialized mental‑health support and legal protection.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large (for this hard‑to‑reach) sample of 120 participants","Use of validated PTSD and dissociation scales","Focus on a neglected population","Regression analysis links specific victimisation types to outcomes"],"limitations":["Cross‑sectional design limits causal inference","Convenience sample may not be representative","No control group for comparison","Potential self‑selection bias"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/08039488.2025.2464634"}},{"id":874,"doi":"10.1089/cpb.2006.9990","pmid":"17305451","pmcid":null,"title":"Who responds to unsolicited sexually explicit materials on the internet?: the role of individual differences","authors":"Shim JW, Lee S, Paul B.","first_author":"Shim JW","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of college students measuring dispositional traits and self‑reported likelihood to click on unsolicited explicit material; convenience sample","sample_n":null,"sample_text":"college student sample; size not reported in abstract","population":"college students (likely WEIRD, convenience sample)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among college students, those who score higher on sexual openness and antisocial traits say they would be more likely to click on unexpected pornographic links they encounter online.","clinical_takeaway":"No direct clinical implications; the study highlights personality factors that may predict risky online behavior.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Uses validated scales for sexual and antisocial dispositions","Addresses understudied topic of unsolicited online sexual material","Clear hypothesis linking individual differences to behavior"],"limitations":["Self‑report of hypothetical behavior, not observed actions","Cross‑sectional convenience sample of students limits generalisability","No control for moral/religious attitudes or other known confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cpb.2006.9990"}},{"id":876,"doi":"10.1186/s12978-015-0068-x","pmid":"26370668","pmcid":"PMC4570461","title":"Assessment of exposure to sexually explicit materials and factors associated with exposure among preparatory school youths in Hawassa City, Southern Ethiopia: a cross-sectional institution based survey","authors":"Habesha T, Aderaw Z, Lakew S.","first_author":"Habesha T","journal":"Reproductive health","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4570461","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional institution‑based survey of 770 preparatory‑school students in Hawassa, Ethiopia; multistage random sampling; self‑administered questionnaire; logistic regression for associations.","sample_n":750,"sample_text":"770 selected, 750 responded (97.4 % response)","population":"Adolescent/young adult school students (≈15‑24 y) in Ethiopia","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2015 survey of 750 Ethiopian high‑school students found that about three‑quarters had seen sexually explicit movies or texts. Exposure was higher among boys, private‑school students, and those who used alcohol, chewed khat, or reported easy access to such material.","clinical_takeaway":"High SEM exposure among adolescents is linked to gender, school type, and substance use; prevention efforts should address access and co‑occurring risk behaviours.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a school‑based survey","Clear reporting of adjusted odds ratios with confidence intervals","Random selection of schools and participants"],"limitations":["Self‑report exposure; no validated SEM‑use scale","Cross‑sectional design limits causal inference","No measurement of key confounds such as moral attitudes or mental health"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":2,"mentioning":21,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-015-0068-x"}},{"id":877,"doi":"10.3389/fpsyg.2025.1517317","pmid":"40012951","pmcid":"PMC11861099","title":"Men's internet sex addiction predicts sexual objectification of women even after taking pornography consumption frequency into account","authors":"Novakova P, Chvojka E, Ševčíková A, Blinka L, Wright P, Kane S.","first_author":"Novakova P","journal":"Frontiers in psychology","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Frequency","Addiction","Internet Pornography","Sexual Objectification","Internet Sex Addiction"],"is_oa":true,"oa_url":"https://doi.org/10.3389/fpsyg.2025.1517317","cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1,272 men, structural equation modelling, cross‑sectional","sample_n":1272,"sample_text":"convenience sample of male pornography users recruited online","population":"male consumers of online video pornography, mean age 33, convenience sample","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,272 men who view online porn, higher scores on an internet‑sex‑addiction questionnaire were linked to stronger attitudes that view women as objects, even after accounting for how often they watched porn.","clinical_takeaway":"Evidence does not support treating pornography use as causing objectification; other factors should be examined before attributing causality.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size","Use of structural equation modelling"],"limitations":["Cross‑sectional design limits causal inference","Addiction construct likely measured with unvalidated self‑report scale","Key confounds (morality, mental health, masturbation) not assessed","Potential self‑selection bias"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2025.1517317"}},{"id":878,"doi":"10.1556/2006.2024.00040","pmid":"39945771","pmcid":"PMC11974412","title":"Motives for pornography use and women's sexual wellbeing: Insights from a 42-country study","authors":"Gewirtz-Meydan A, Feder H, Nagy L, Koós M, Kraus SW, Demetrovics Z, Potenza MN, Ballester-Arnal R, Batthyány D, Bergeron S, Billieux J, Briken P, Burkauskas J, Cárdenas-López G, Carvalho J, Castro-Calvo J, Chen L, Ciocca G, Corazza O, Csako RI, Fernandez DP, Fernandez EF, Fujiwara H, Fuss J, Gabrhelík R, Gjoneska B, Gola M, Grubbs JB, Hashim HT, Islam MS, Ismail M, Jiménez-Martínez MC, Jurin T, Kalina O, Klein V, Költő A, Lee CT, Lee SK, Lewczuk K, Lin CY, Lochner C, López-Alvarado S, Lukavská K, Mayta-Tristán P, Miller DJ, Orosová O, Orosz G, Sungkyunkwan University’s research team, Ponce FP, Quintana GR, Quintero Garzola GC, Ramos-Diaz J, Rigaud K, Rousseau A, De Tubino Scanavino M, Schulmeyer MK, Sharan P, Shibata M, Shoib S, Sigre-Leirós V, Sniewski L, Spasovski O, Steibliene V, Stein DJ, Strizek J, Štulhofer A, Ünsal BC, Vaillancourt-Morel MP, Van Hout MC, Bőthe B.","first_author":"Gewirtz-Meydan A","journal":"Journal of behavioral addictions","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Women","Motivations","Cultural Differences","Pornography","Sexual Wellbeing"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11974412","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional self‑report survey across 42 countries (N≈46.9 k women)","sample_n":46874,"sample_text":"Large multinational convenience sample of women who completed an online questionnaire on pornography motives and sexual wellbeing.","population":"adult women, mean age 29.7 y, recruited online (convenience)","country":"multinational (42 countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a worldwide online survey of 46,874 women, using pornography for personal pleasure or curiosity was linked to better sexual desire and fewer functioning problems, whereas using it because of unsatisfied relationships was linked to more problems.","clinical_takeaway":"Women’s motives for pornography matter; using it for personal pleasure may support sexual wellbeing, but relational dissatisfaction may signal sexual problems.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Very large multinational sample","Focus on women's motives, a relatively understudied area","Separate analysis of different motivations"],"limitations":["Cross‑sectional; cannot infer directionality","Convenience online recruitment limits representativeness","No measurement/control of key confounds (e.g., masturbation, mental health, relationship factors)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00040"}},{"id":879,"doi":"10.1007/s10508-024-03075-1","pmid":"39904948","pmcid":null,"title":"United States Women and Pornography: Methodological Experiment Update","authors":"Wright PJ, Tokunaga RS.","first_author":"Wright PJ","journal":"Archives of sexual behavior","year":2025,"pub_types":["Journal Article"],"keywords":["Measurement","Experiment","General Social Survey","Pornography","3Am"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Analysis of nationally representative General Social Survey data using two different self‑report pornography items; comparison of traditional versus experimental measure.","sample_n":null,"sample_text":"General Social Survey, nationally representative sample of U.S. adults","population":"U.S. adult women (survey respondents)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors compared the standard General Social Survey question on pornography use with a newer experimental question, finding both work but the new one may predict behavior better. This helps improve how large surveys measure porn consumption.","clinical_takeaway":"None – the study concerns survey measurement, not clinical treatment.","confidence":0.7,"topic_tags":["pornography","measurement","sexual_function","gender","csbd"],"strengths":["Nationally representative dataset","Direct comparison of two measurement approaches","Clear relevance to survey methodology"],"limitations":["Both measures are single‑item self‑reports, lacking validation","No assessment of related confounds (e.g., moral beliefs, masturbation)","Limited statistical detail in abstract"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-03075-1"}},{"id":880,"doi":"10.1080/10550887.2021.1932250","pmid":"34196603","pmcid":null,"title":"Sexting: a potential addiction or an adaptive behavior to COVID-19 social distancing and stay-at-home policies? A qualitative study","authors":"Caponnetto P, Gervasi FF, Maglia M.","first_author":"Caponnetto P","journal":"Journal of addictive diseases","year":2022,"pub_types":["Journal Article"],"keywords":["Addiction","Adaptive Behavior","Sexting","Covid-19"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative interview study with 37 participants (age 19‑39) recruited via probability sampling; semi‑structured interviews; thematic analysis.","sample_n":37,"sample_text":"37 subjects recruited through probability sampling","population":"Adults 19‑39, presumably general community","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"The study interviewed 37 young adults about sexting during COVID‑19 lockdowns. Participants tended to view sexting as more of an addiction than an adaptive coping behavior, though the authors note the pandemic may have changed its role.","clinical_takeaway":"None – the study only reports subjective perceptions and does not provide evidence for clinical assessment or treatment.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Probability sampling claimed","Provides participants’ own perspectives"],"limitations":["Very small sample for a qualitative study","No validated measures of addiction or sexting frequency","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10550887.2021.1932250"}},{"id":881,"doi":"10.31234/osf.io/7u95z_v1","pmid":null,"pmcid":null,"title":"The Emotional Cost of Hyper-Meritocracy: A Theoretical Model of Virtual Intimacy and Psychological Disconnection","authors":"Liao KX.","first_author":"Liao KX.","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://osf.io/7u95z_v1/download","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"theoretical model, no empirical data","sample_n":null,"sample_text":"none","population":"none","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper offers a theoretical model suggesting that in highly competitive societies, people turn to virtual intimacy (e.g., pornography, AI companions) to fill emotional gaps caused by social atomisation, creating a feedback loop of further disconnection.","clinical_takeaway":"None – the article is a theoretical discussion without direct clinical implications.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Integrative interdisciplinary framing","Calls for structural change","Links empirical animal work to societal processes"],"limitations":["No empirical data presented","No measurement of key constructs","No control for known confounds"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/7u95z_v1"}},{"id":882,"doi":"10.1080/10810730.2025.2450248","pmid":"39798122","pmcid":"PMC12068994","title":"Pornography Use and Coitus Interruptus: Is There a Link?","authors":"Wright PJ, Herbenick D.","first_author":"Wright PJ","journal":"Journal of health communication","year":2025,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Withdrawal","Birth Control","Coitus Interruptus","Pornography","3Am"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national probability sample of US women 15‑49, cross‑sectional survey","sample_n":null,"sample_text":"national probability data","population":"US women 15‑49 years (n not reported in abstract)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a U.S. survey, women who watched porn more often were also more likely to use withdrawal (pull‑out) as birth control, especially if they thought porn was useful or were unmarried.","clinical_takeaway":"Higher porn consumption may be linked to choosing less effective contraception; clinicians should discuss contraception options regardless of media habits.","confidence":0.85,"topic_tags":["pornography","sexual_function","religiosity"],"strengths":["National probability sample improves generalisability","Addresses a previously unstudied link between pornography and withdrawal contraception","Considers marital status as a moderator"],"limitations":["Cross‑sectional design cannot establish causality","Constructs measured with single‑item self‑reports, no validated scales","Key confounds (moral incongruence, masturbation, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10810730.2025.2450248"}},{"id":883,"doi":"10.1080/19317611.2013.823900","pmid":"24904709","pmcid":"PMC4041739","title":"The relationship between use of sexually explicit media and sexual risk behavior in men who have sex with men: exploring the mediating effects of sexual self-esteem and condom use self-efficacy","authors":"Træen B, Hald GM, Noor SW, Iantaffi A, Grey J, Rosser BR.","first_author":"Træen B","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["SEM","MSM","Sexual Risk Behavior","Pornography","Condom Self-efficacy","Sexual Self-esteem"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet‑based survey of 1,391 US MSM, cross‑sectional","sample_n":1391,"sample_text":"cross‑sectional, Internet‑based survey of 1,391 MSM","population":"men who have sex with men, USA, recruited online","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US survey of 1,391 men who have sex with men, viewing porn that shows condom use was linked to higher sexual‑risk behavior, and this link was partly explained by lower confidence in using condoms. Viewing porn that shows no condom was also directly related to risk, but sexual self‑esteem did not mediate the relationship.","clinical_takeaway":"Clinicians should note that condom‑depicting porn may influence men’s confidence in condom use and affect risk behavior; interventions could use positive porn role models to boost condom self‑efficacy.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (N>1300) for a sexuality survey","Use of mediation analysis to test indirect pathways","Focus on a specific, theoretically relevant SEM feature (condom depiction)"],"limitations":["Cross‑sectional design cannot infer causality","SEM exposure measured with ad‑hoc items, not validated scales","Key potential confounds (moral views, mental health, partner context) not assessed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":29,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2013.823900"}},{"id":884,"doi":"10.1080/0092623x.2026.2642873","pmid":"41921545","pmcid":null,"title":"Moral Views on Pornography and Pornography Use: It Might Be Complicated","authors":"Wright PJ, Herbenick D.","first_author":"Wright PJ","journal":"Journal of sex & marital therapy","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of undergraduate/graduate students (letter format, limited methods reported).","sample_n":null,"sample_text":"Large campus‑representative sample of undergraduates and graduates (exact N not provided).","population":"College students (undergraduate and graduate) recruited from a campus‑representative sample; likely convenience within the university.","country":"United States (presumed from author affiliations; not stated).","controls_mi":"yes","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that moral attitudes toward pornography may influence how often students view it and call for more nuanced research, presenting preliminary data from a university sample.","clinical_takeaway":"None – the paper is a commentary with limited empirical evidence.","confidence":0.7,"topic_tags":["moral_incongruence","pornography","sexual_function"],"strengths":["Addresses a neglected topic (morality‑pornography link).","Uses a relatively large campus‑based sample."],"limitations":["Limited methodological detail (letter format).","Relies on simple self‑report items; lacks validated scales.","No control for key confounds beyond moral views."],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2026.2642873"}},{"id":886,"doi":"10.1007/s10508-022-02286-8","pmid":"35112270","pmcid":null,"title":"Dysfunctional Parent-Child Communication About Sexting During Adolescence","authors":"Dolev-Cohen M, Ricon T.","first_author":"Dolev-Cohen M","journal":"Archives of sexual behavior","year":2022,"pub_types":["Journal Article"],"keywords":["Adolescents","Sex Education","Parenting Style","Parental Mediation","Parent–child Communication","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online questionnaire survey of 427 Israeli parents, cross‑sectional convenience sample","sample_n":427,"sample_text":"336 mothers, 91 fathers; recruited via online panels (presumed convenience)","population":"parents of adolescents (10‑18 y) in Israel","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 427 Israeli parents found that authoritarian and permissive parenting styles were linked to poorer communication with teens about sexting, while an authoritative style was linked to better communication, partly because these parents held more positive attitudes toward sex education.","clinical_takeaway":"Encouraging an authoritative, open parenting style may improve discussions about sexting with adolescents.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large sample of parents","use of established parenting‑style taxonomy","explores mediation pathways"],"limitations":["cross‑sectional, cannot infer causality","convenience online sample, limited generalisability","communication measure not clearly validated"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":3,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02286-8"}},{"id":887,"doi":"10.1007/s10508-019-1419-4","pmid":"31144215","pmcid":null,"title":"Visual Attention to Sexual Stimuli in Mostly Heterosexuals","authors":"Morandini JS, Veldre A, Holcombe AO, Hsu K, Lykins A, Bailey JM, Dar-Nimrod I.","first_author":"Morandini JS","journal":"Archives of sexual behavior","year":2019,"pub_types":["Journal Article"],"keywords":["Sex differences","Sexual Orientation","Visual Attention","Disgust","Mostly Heterosexual"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Experimental eye‑tracking study comparing visual attention to erotic images across orientation groups (mostly vs. exclusively heterosexual men and women).","sample_n":162,"sample_text":"162 participants","population":"162 adult participants (mostly and exclusively heterosexual men and women), likely convenience sample.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study used eye‑tracking to see if people who are mostly heterosexual look at same‑sex erotic pictures differently than exclusively heterosexual people. Mostly heterosexual men paid more attention to male genital areas, a pattern linked to greater attraction and less disgust.","clinical_takeaway":"None – the findings relate to visual attention, not clinical concerns about sexual health or problem behaviour.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Objective eye‑tracking measurement","Adequate sample size for between‑group comparisons","Mediation analysis linking attraction, disgust and attention"],"limitations":["Cross‑sectional; cannot infer causality","Convenience sampling likely limits generalisability","No pre‑registration or reported effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-1419-4"}},{"id":888,"doi":"10.1080/00224499.2026.2642323","pmid":"41879210","pmcid":null,"title":"Why Do You Watch This Rough Stuff? Assessing Predictors of Female Pornography Preferences","authors":"von Andrian-Werburg MTP, Schwarz S, Lange BP, Schwab F.","first_author":"von Andrian-Werburg MTP","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory experiment exposing participants to written pornographic stimuli (consensual vs rape) and measuring self‑reported sexual arousal; large representative German female sample (N=571).","sample_n":571,"sample_text":"571 women, representative of age and education level, from Germany.","population":"Women (Germany), representative of age and education.","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In an experiment with 571 German women, those who accept rape myths and report higher sex drive show stronger sexual arousal when reading rape‑themed porn, especially if they have previously viewed violent porn. Other biological factors were not predictive.","clinical_takeaway":"Arousal to violent porn is linked to personal attitudes and sex drive, not to evolutionary traits; clinicians should consider these psychosocial factors when discussing pornography preferences.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Large, demographically representative sample","Experimental manipulation of stimulus type","Use of validated rape‑myth acceptance scale"],"limitations":["No measurement of key sexual‑health confounds (e.g., mental health, trauma)","Self‑report arousal may be subject to demand characteristics","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2026.2642323"}},{"id":889,"doi":"10.1071/sh15004","pmid":"26277625","pmcid":null,"title":"Demographic and behavioural correlates of six sexting behaviours among Australian secondary school students","authors":"Patrick K, Heywood W, Pitts MK, Mitchell A.","first_author":"Patrick K","journal":"Sexual health","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 2114 Australian secondary students (years 10‑12) reporting sexting behaviours via six self‑report items","sample_n":2114,"sample_text":"2114 students (811 male, 1303 female) from the Fifth National Survey of Australian Secondary Students and Sexual Health","population":"adolescents (approx. 15‑18 y)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 2000 Australian high‑school students, about half had sent or received explicit text messages, and a quarter had sent nude images of themselves. Sexting was more common among older teens, those who were sexually active, and those using recreational drugs.","clinical_takeaway":"Sexting is prevalent among adolescents; clinicians should assess it alongside substance use and sexual activity.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Large sample size for adolescent survey","Multiple distinct sexting behaviours assessed"],"limitations":["Reliance on ad‑hoc, unvalidated self‑report items","Cross‑sectional design cannot infer causality","No control for key psychosocial confounds (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":51,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh15004"}},{"id":890,"doi":"10.1177/08862605241307228","pmid":"39727017","pmcid":"PMC12572350","title":"Cross-Sectional and Longitudinal Associations Between Pornography Use and Dating Violence Victimization: Are There Risks for Teenagers?","authors":"Martel S, Bergeron S, Bőthe B, Vaillancourt-Morel MP, Hébert M, Dion J.","first_author":"Martel S","journal":"Journal of interpersonal violence","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Adolescent Health","Intimate Violence","Pornography","Sexually Explicit Material"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12572350","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"cross-lagged panel analysis with two waves (N=1556) of adolescents","sample_n":1556,"sample_text":"large community sample of adolescents","population":"teenagers (mean age 14.55, 51.5% female) reporting an intimate relationship","country":"Canada (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 1,556 teens, researchers found that while pornography use and dating violence were linked at a single point in time, there was no evidence that pornography use predicts later victimisation or vice‑versa over a year.","clinical_takeaway":"Pornography use alone does not appear to increase risk of later dating violence in adolescents; focus prevention on broader relationship skills.","confidence":0.8,"topic_tags":["adolescents","pornography","sexual_function","relationships","gender"],"strengths":["Large sample size","Longitudinal design with cross‑lagged modeling","Gender‑specific analyses"],"limitations":["No measurement of moral or religious attitudes that could confound distress","Potential lack of validated scales for pornography use/dating violence","Self‑report data only"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605241307228"}},{"id":891,"doi":"10.1007/s10508-009-9585-4","pmid":"20039112","pmcid":"PMC2891580","title":"Viewing sexually-explicit materials alone or together: associations with relationship quality","authors":"Maddox AM, Rhoades GK, Markman HJ.","first_author":"Maddox AM","journal":"Archives of sexual behavior","year":2011,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":72,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1291 unmarried individuals in relationships","sample_n":1291,"sample_text":"random sample of 1291 unmarried individuals in romantic relationships","population":"unmarried adults in romantic relationships (community sample, USA likely)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1291 adults in relationships, those who watched pornography alone reported lower relationship satisfaction and higher infidelity than those who never watched or watched only together. Watching together was linked to higher dedication and sexual satisfaction compared with solo viewing.","clinical_takeaway":"Couples may benefit from discussing how they consume pornography together, as solo use is linked to poorer relationship outcomes.","confidence":0.85,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Large community sample (N>1200)","Examines both solo and joint viewing contexts","Uses multiple relationship‑quality outcomes"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of key confounds (moral views, mental health, masturbation)","SEM exposure measured only by simple self‑report categories"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":9,"contrasting":0,"mentioning":152,"citing_publications":238,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-009-9585-4"}},{"id":892,"doi":"10.1007/s11199-009-9695-4","pmid":"20098511","pmcid":"PMC2807025","title":"Sexual Priming, Gender Stereotyping, and Likelihood to Sexually Harass: Examining the Cognitive Effects of Playing a Sexually-Explicit Video Game","authors":"Yao MZ, Mahood C, Linz D.","first_author":"Yao MZ","journal":"Sex roles","year":2010,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC2807025","cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment with random assignment to sexually‑explicit or control video games; 74 male university students","sample_n":74,"sample_text":"Seventy‑four male students from a university in California, U.S.","population":"Male college students, United States","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab experiment, men who played a sexually explicit video game showed faster recognition of sexual words and reported a higher willingness to harass women compared with those who played non‑sexual games.","clinical_takeaway":"Short‑term exposure to objectifying video games may increase sexual objectification thoughts and self‑reported harassment propensity.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Randomised experimental design","Objective lexical‑decision task","Clear manipulation of sexual content"],"limitations":["Convenience sample of male students, limited generalisability","Small per‑group sample, likely under‑powered","Self‑report harassment measure may be subject to social desirability bias"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":1,"mentioning":86,"citing_publications":115,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11199-009-9695-4"}},{"id":893,"doi":"10.1007/s10508-018-1174-y","pmid":"29497916","pmcid":null,"title":"Strategizing to Make Pornography Worthwhile: A Qualitative Exploration of Women's Agentic Engagement with Sexual Media","authors":"Chadwick SB, Raisanen JC, Goldey KL, van Anders S.","first_author":"Chadwick SB","journal":"Archives of sexual behavior","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexuality","Women","Qualitative Methods","Pornography","Erotica","Feminist Perspectives"],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"focus group study, secondary analysis of previously collected data, N=73 women, age 18‑64, U.S.","sample_n":73,"sample_text":"73 women participated in focus groups; recruitment method not described in abstract","population":"sexually diverse adult women (non‑clinical sample)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A focus‑group study of 73 U.S. women showed that many actively use strategies to make porn viewing more positive despite concerns about negative content. Women across ages and sexual identities negotiate what they watch to increase pleasure.","clinical_takeaway":"Clinicians can recognize that many women view porn intentionally and may benefit from discussing personal preferences and coping strategies rather than assuming inevitable harm.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["large qualitative sample for focus‑group work","captures women's agency and strategies","includes diverse ages and sexual identities"],"limitations":["no quantitative measurement of constructs","no control for moral, mental‑health or relational confounds","cross‑sectional, self‑selected convenience sample"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":39,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1174-y"}},{"id":895,"doi":"10.1556/2006.2025.00120","pmid":"41860608","pmcid":"PMC13132348","title":"The Problematic Behaviour Scale (PBS-5): A brief measure for the population-level screening of non-substance-bound addictive behaviours and Swiss national prevalence rates","authors":"Mader S, Marmet S.","first_author":"Mader S","journal":"Journal of behavioral addictions","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Prevalence rates","Gambling","Screening Instruments","Gaming","Psychometric Characteristics","Addictive Disorders","Addictive Behaviors","Pornography Use","Social Media Use","Pbs-5","Acsid-11","Assessment Of Criteria For Specific Internet-use Disorders","Problematic Behaviour Scale","Compulsive Buying-shoping Behaviour","Receiver Operator Characteristics Regression"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13132348","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large national probability survey (n≈6,000), cross‑sectional","sample_n":5995,"sample_text":"Swiss Health and Lifestyle survey 2023/2025, nationally representative","population":"Swiss adults (German, French, Italian speakers)","country":"Switzerland","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created a short five‑item questionnaire (PBS‑5) to screen for addictive‑like behaviours, including pornography, in a Swiss population survey of about 6,000 people. The scale shows good reliability and a single factor, but its ability to correctly identify people with problems is limited.","clinical_takeaway":"PBS‑5 may help identify risky pornography use at a population level, but clinicians should interpret scores cautiously and consider moral or relational factors.","confidence":0.78,"topic_tags":["pornography","measurement","prevalence","sexual_function"],"strengths":["Very large, nationally representative sample","Comprehensive psychometric evaluation (factor analysis, reliability)","Includes multiple behavioural domains, including pornography"],"limitations":["Cross‑sectional; cannot infer causality or temporal change beyond repeated surveys","No measurement of moral incongruence or masturbation, key confounds for pornography outcomes","Cut‑off validation relies on PHQ‑4 (distress) which may conflate distress with problematic use"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":8,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00120"}},{"id":896,"doi":"10.1016/j.copsyc.2020.04.007","pmid":"32480021","pmcid":null,"title":"Sexting within young adults' dating and romantic relationships","authors":"Van Ouytsel J, Punyanunt-Carter NM, Walrave M, Ponnet K.","first_author":"Van Ouytsel J","journal":"Current opinion in psychology","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methods","sample_n":null,"sample_text":"Not applicable – review of existing literature","population":"Young adults (review focus)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews recent studies on sexting among young adults, noting its growing use in relationships and associated risks like pressure, unwanted sharing, and coercion, and urges future work to use consistent, nuanced measurements.","clinical_takeaway":"None - not clinically applicable.","confidence":0.75,"topic_tags":["sexual_function","relationships"],"strengths":["Broad overview of recent sexting research","Highlights multiple risk contexts (coercion, unwanted sharing)","Calls for standardized measurement"],"limitations":["Narrative, not systematic – possible selection bias","No quantitative synthesis or meta‑analysis","Lacks primary data on confounders such as mental health or moral attitudes"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":36,"citing_publications":83,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.copsyc.2020.04.007"}},{"id":899,"doi":"10.1016/j.jadohealth.2019.06.003","pmid":"31473082","pmcid":null,"title":"An Exploratory Study of Sexting Behaviors Among Heterosexual and Sexual Minority Early Adolescents","authors":"Van Ouytsel J, Walrave M, Ponnet K.","first_author":"Van Ouytsel J","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Multicenter Study","Journal Article"],"keywords":["Social Media","Sexual Minority","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 3,109 early adolescents (12‑15 y) recruited via convenience sampling; examined sexting behaviors by sexual orientation while adjusting for gender, age, internet use.","sample_n":3109,"sample_text":"N=3109; 53.5 % girls; mean age = 13.0 y (SD = 0.83)","population":"early adolescents (heterosexual and sexual minority) in Belgium","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 3,000 12‑15‑year‑olds, sexual‑minority teens were more likely than heterosexual peers to send, receive, and be pressured to send sexual photos, but not more likely to commit non‑consensual sexting. Clinicians should note this heightened vulnerability.","clinical_takeaway":"Screen sexual‑minority adolescents for sexting pressure and provide resilience training.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for early adolescents","Specific focus on sexual‑minority youth","Adjusts for key demographics"],"limitations":["Convenience, non‑representative sampling","Sexting items not reported as validated scales","Limited control of key psychosocial confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":0,"mentioning":43,"citing_publications":90,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2019.06.003"}},{"id":902,"doi":"10.1093/sexmed/qfae083","pmid":"39817044","pmcid":"PMC11733629","title":"Masked liking of pornography: implicit associations in men with compulsive sexual behavior","authors":"Engel J, Waechter A, Veit M, Kneer J, Sinke C, Brand M, Krueger THC.","first_author":"Engel J","journal":"Sexual medicine","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Compulsive Sexual Behavior","Addictive Behavior","Implicit Associations","Hypersexual Disorder","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11733629","cited_by_count":4,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"case‑control experimental study using an Implicit Association Test with 47 CSB men and 38 controls","sample_n":85,"sample_text":"47 men with CSB, 38 men without CSB","population":"heterosexual men, mean age ~37, clinical CSB sample vs community controls","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["no_mi_control","underpowered_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"Men diagnosed with compulsive sexual behavior showed stronger positive automatic reactions to porn pictures compared with men without the condition, suggesting that these unconscious associations may help maintain problem sexual use.","clinical_takeaway":"Implicit bias training could be explored as a therapeutic target for clients with compulsive sexual behavior.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["first implicit‑association study in a clinical CSB sample","use of a well‑established IAT paradigm","includes a non‑clinical control group"],"limitations":["small, all‑male, heterosexual sample limits generalisability","no measurement/control of moral incongruence, masturbation or mental‑health covariates","addiction claims rest on self‑labelled CSB without testing ICD‑11 criteria"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfae083"}},{"id":903,"doi":"10.7759/cureus.74482","pmid":"39726456","pmcid":"PMC11671052","title":"A Cross-Sectional Study on Pornography Use and Sex Differences Among High School ‎Students","authors":"Jotiar Mahmood A, Abdulqadir HH, Chalabi Khalid R, Hashim Dirbas V, Sherwan Ahmed Z, Yarwant Naisan K, Farhad Hasan D.","first_author":"Jotiar Mahmood A","journal":"Cureus","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Institutions","Associated Factors","High Schools","Pornography","Student's Perspective"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11671052","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire administered to 921 high‑school students in Kurdistan, Iraq.","sample_n":921,"sample_text":"921 students completed a paper questionnaire.","population":"High‑school students (average age 16.8, 55% male) from five schools and two institutions.","country":"Iraq","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 921 high‑school students in Iraqi Kurdistan found that about half had ever viewed pornography, with males three times more likely than females. Most students disapproved of porn and supported site restrictions.","clinical_takeaway":"None – the study reports prevalence without linking use to health outcomes.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","prevalence"],"strengths":["Large sample for a school‑based survey","Clear reporting of sex differences","Relevant public‑health question"],"limitations":["Use of non‑validated, ad‑hoc questionnaire","No measurement of key confounders (e.g., moral attitudes, mental health)","Cross‑sectional design limits causal inference","No effect‑size reporting or power analysis"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.74482"}},{"id":904,"doi":"10.1080/10810730.2011.551996","pmid":"21476164","pmcid":null,"title":"The influence of sexually explicit Internet material on sexual risk behavior: a comparison of adolescents and adults","authors":"Peter J, Valkenburg PM.","first_author":"Peter J","journal":"Journal of health communication","year":2011,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":65,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"2‑wave panel survey with nationally representative random samples of Dutch adolescents (n=1,445) and adults (n=833).","sample_n":2288,"sample_text":"Nationally representative random samples; 1,445 adolescents, 833 adults.","population":"Dutch adolescents and adults, community‑based sample.","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a two‑wave Dutch survey, adult men who used sexually explicit internet material reported more sexual risk behaviours, while adolescents showed no such effect. Gender and age did not change the pattern for adolescents.","clinical_takeaway":"Male adults who view porn may be at higher risk for unsafe sexual practices; clinicians should consider discussing online sexual content with this group.","confidence":0.85,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative panel","Longitudinal design allowing temporal ordering","Clear statistical reporting (ORs, CIs)"],"limitations":["SEIM use measured by self‑report, likely without validated scale","Key confounds (moral incongruence, mental health, partner effects) not assessed","No pre‑registration"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":2,"mentioning":109,"citing_publications":141,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10810730.2011.551996"}},{"id":905,"doi":"10.1007/s10508-025-03377-y","pmid":"41761025","pmcid":null,"title":"\"Naughty Schoolgirl on Her Knees\": Understanding the Role of Gendered Stereotypes in Porn Classification Strategies Through a Q-Methodology","authors":"van de Lande L, van Bohemen S, Stein M, de Koster W.","first_author":"van de Lande L","journal":"Archives of sexual behavior","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Polysemy","Pornography","Q-methodology","Gendered Stereotypes"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Q‑methodology with 81 participants, in‑depth interviews; convenience sample; cross‑sectional","sample_n":81,"sample_text":"81 participants","population":"Adults (mixed gender, age not specified) recruited for views on porn titles","country":"Netherlands (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using interviews and a Q‑methodology with 81 adults, the study identified five ways people classify porn titles based on gendered pleasure, power, and realism, showing some repeat dominant stereotypes while others resist them.","clinical_takeaway":"None – the study provides insight into viewer interpretations, not clinical guidance.","confidence":0.7,"topic_tags":["pornography","gender","sexual_function","csbd"],"strengths":["Large qualitative sample for Q‑methodology","Focus on demand‑side perspective","Systematic variation using titles isolates gendered cues"],"limitations":["Convenience sample limits generalisability","No validated measurement of gender stereotypes","No quantitative assessment of behavioral outcomes"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03377-y"}},{"id":906,"doi":"10.1177/0886260520985480","pmid":"33399026","pmcid":null,"title":"The Psychometric Properties of the Measure of Adolescent Relationship Harassment and Abuse (MARSHA) With a Nationally Representative Sample of U.S. Youth","authors":"Rothman EF, Cuevas CA, Mumford EA, Bahrami E, Taylor BG.","first_author":"Rothman EF","journal":"Journal of interpersonal violence","year":2022,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Adolescents","Harassment","Dating Violence","Partner Abuse","Teen Dating Violence","Dating Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"psychometric validation of a new adolescent relationship harassment/abuse scale using a nationally representative sample (N=1,257); exploratory factor analysis, convergent/divergent validity checks.","sample_n":1257,"sample_text":"1,257 adolescents (ages 11‑21) from a population‑based, nationally representative sample","population":"U.S. adolescents aged 11‑21 (nationally representative)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study introduces and validates MARSHA, a new questionnaire that measures how often teens experience or commit dating abuse, including physical, sexual, psychological, and online forms, using a U.S. national sample of 1,257 youths.","clinical_takeaway":"MARSHA appears to be a reliable tool for clinicians and researchers to assess teen dating abuse across multiple domains.","confidence":0.85,"topic_tags":["adolescents","relationships","sexual_function","measurement","gender"],"strengths":["Large, nationally representative sample","Comprehensive psychometric validation (EFA, reliability, convergent/divergent validity)","Includes contemporary abuse forms (cyber, image-based)"],"limitations":["Cross‑sectional; cannot assess temporal stability beyond internal consistency","No assessment of potential mental‑health or trauma confounders","No pre‑registration reported"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":39,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260520985480"}},{"id":907,"doi":"10.31234/osf.io/ufwbe_v1","pmid":null,"pmcid":null,"title":"The Scientometrics of Child Sexual Exploitation Material Offending: An Analysis of Fifty Years of Academic Research","authors":"Steel CM.","first_author":"Steel CM.","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://osf.io/ufwbe_v1/download","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Scientometric analysis of 990 papers from Web of Science; descriptive counts and keyword trends.","sample_n":990,"sample_text":"990 research articles identified in Web of Science","population":"Academic publications on CSEM offending (1979‑present)","country":"International (USA, UK, Australia most represented)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A bibliometric review of 990 papers from 1979‑2025 shows how research on child sexual exploitation material has grown, with the United States, United Kingdom and Australia publishing most. Terminology has shifted from “child pornography” toward “CSEM.”","clinical_takeaway":"None – the study does not provide clinical evidence on pornography use or sexual health.","confidence":0.8,"topic_tags":["csbd"],"strengths":["Large, comprehensive dataset of publications","Clear methodological description of search strategy","Identifies trends in terminology over 50 years"],"limitations":["No assessment of study quality or bias","Descriptive only; no synthesis of findings on offender behavior","Limited to Web of Science, may miss relevant work"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/ufwbe_v1"}},{"id":908,"doi":"10.1007/s10508-010-9644-x","pmid":"20623250","pmcid":"PMC3180617","title":"The use of sexually explicit internet material and its antecedents: a longitudinal comparison of adolescents and adults","authors":"Peter J, Valkenburg PM.","first_author":"Peter J","journal":"Archives of sexual behavior","year":2011,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-010-9644-x.pdf","cited_by_count":89,"is_preprint":false,"topics":["bibliography","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two‑wave panel survey with nationally representative samples of Dutch adolescents (N=1,445) and adults (N=833).","sample_n":2288,"sample_text":"Nationally representative samples of 1,445 adolescents and 833 adults.","population":"General population (adolescents and adults) in the Netherlands.","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A Dutch panel study found that adolescents and adults use sexually explicit internet material at similar rates, with adult men using it most often. Factors like being male, sensation seeking, non‑heterosexual orientation, and lower life satisfaction predicted higher use in both age groups.","clinical_takeaway":"Frequency of porn use does not differ markedly between teens and adults; clinicians should focus on underlying traits (e.g., sensation seeking) rather than age alone.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative longitudinal samples","Direct comparison of adolescents and adults","Multiple antecedent variables examined"],"limitations":["SEIM use measured by single‑item self‑report, no validated scale","No assessment of moral/religious attitudes or masturbation","Potential self‑report bias"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":11,"contrasting":3,"mentioning":141,"citing_publications":228,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9644-x"}},{"id":909,"doi":"10.3389/fpsyg.2021.610474","pmid":"33716872","pmcid":"PMC7943630","title":"Abusive Sexting in Adolescence: Prevalence and Characteristics of Abusers and Victims","authors":"Barroso R, Ramião E, Figueiredo P, Araújo AM.","first_author":"Barroso R","journal":"Frontiers in psychology","year":2021,"pub_types":["brief-report","Journal Article"],"keywords":["Sexuality","Adolescence","Violence","Cyber Abuse","Sexting Behavior","Sexual Behavior–Psychology"],"is_oa":true,"oa_url":"http://hdl.handle.net/11328/4270","cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of Portuguese adolescents (N=4,281) examining prevalence and psychological correlates of abusive sexting","sample_n":4281,"sample_text":"4,281 participants (2,264 girls, 2,017 boys)","population":"Adolescents aged 12-20 in Portugal","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 4,000 Portuguese teenagers, about 5% reported sending non‑consensual sexual messages or images. Those who engaged in or were victims of abusive sexting were more likely to have emotional problems, signs of psychopathy, past neglect or abuse, and higher aggression.","clinical_takeaway":"Abusive sexting co‑occurs with emotional and behavioral difficulties; clinicians should screen for trauma and aggression when addressing sexting‑related issues.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large community sample","Focus on abusive sexting, a relatively under‑studied behavior","Includes multiple psychological correlates"],"limitations":["Cross‑sectional; cannot infer causality","Limited control for moral or relational confounds","Unclear whether psychological scales were validated for this age group"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2021.610474"}},{"id":911,"doi":"10.1556/2006.2025.00106","pmid":"41723753","pmcid":"PMC13132387","title":"Health response to problematic usage of the internet: A global survey on trends, available treatments and key challenges","authors":"Khojasteh Zonoozi A, Schofield J, Abolghasemi FS, Achab S, Ambekar A, Bowden-Jones H, Demetrovics Z, Ebrahimi M, Fineberg NA, Khazaal Y, Lee HK, Siste K, Stein DJ, Wu AMS, Zare-Bidoky M, ISAM-GEN Societies' Experts, Potenza MN, Baldacchino AM, Baldacchino AM, Ekhtiari H.","first_author":"Khojasteh Zonoozi A","journal":"Journal of behavioral addictions","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Gambling","Video Games","Internet Addiction","Pornography","Addictive Behaviors","Compulsive Behaviors","Impulsive Behaviors","Global Survey","Technology Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13132387","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Global expert survey of addiction societies (38 countries) on perceptions of problematic internet use, including pornography subtype; descriptive statistics only.","sample_n":null,"sample_text":"Representatives from 38 societies; exact number of respondents not reported in abstract.","population":"Experts/representatives from addiction medicine/psychiatry societies (no patient data).","country":"International (38 countries across continents)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of addiction experts from 38 countries reported that pornography is one of several internet activities viewed as potentially problematic, and that most countries lack trained clinicians and certification to treat such issues.","clinical_takeaway":"Current global health systems have limited capacity to address problematic pornography use; training and certification are needed.","confidence":0.7,"topic_tags":["pornography","csbd","treatment","prevalence"],"strengths":["Large international scope covering many societies.","Identifies gaps in professional training and certification."],"limitations":["Relies on expert opinion rather than patient data.","No validated measures of pornography use or problematic use.","Descriptive only; no inferential statistics or control for confounds."],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00106"}},{"id":912,"doi":"10.1111/j.1743-6109.2010.02030.x","pmid":"20946159","pmcid":null,"title":"Mental- and physical-health indicators and sexually explicit media use behavior by adults","authors":"Weaver JB, Weaver SS, Mays D, Hopkins GL, Kannenberg W, McBride D.","first_author":"Weaver JB","journal":"The journal of sexual medicine","year":2011,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 559 Seattle‑Tacoma internet‑using adults (2006); binary SEMB user vs non‑user; multivariate GLM; adjusted for demographics.","sample_n":559,"sample_text":"559 participants (205 SEMB users, 354 non‑users).","population":"Adults (18+), internet users, Seattle‑Tacoma region, 36.7% reported SEMB use; gender roughly 78% male among users.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2011 US survey of 559 adults found that those who reported watching online pornography had higher depression scores, poorer quality of life, more days of reduced health, and lower overall health status than non‑users.","clinical_takeaway":"Clinicians should be aware that pornography use may co‑occur with poorer mental and physical health, but causal direction is unclear.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large community sample for this topic","Multiple health outcomes examined","Statistical adjustment for demographics"],"limitations":["Cross‑sectional; cannot infer causality","Convenience internet sample; limited generalisability","No measurement of masturbation, moral attitudes, or trauma as confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":39,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02030.x"}},{"id":913,"doi":"10.1007/s10508-024-03025-x","pmid":"39516305","pmcid":"PMC11836238","title":"The Social Representations of Pornography Consumers Among Individuals in Romantic Relationships: Exploring the Roles of Gender, Relationship Satisfaction, and Sexual Satisfaction in a Romanian Sample","authors":"Huțul TD, Huțul A, Holman AC.","first_author":"Huțul TD","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Gender","Social Representation","Sexual Satisfaction","Relationship Satisfaction","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11836238","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross‑sectional survey of 875 Romanian adults in romantic relationships","sample_n":875,"sample_text":"Convenience sample of Romanian adults currently in a romantic relationship (N=875)","population":"adults in romantic relationships, Romania","country":"Romania","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Romanian sample of 875 partnered adults, the way people think about pornography users differed by gender, relationship satisfaction, and sexual satisfaction. The study suggests these views could lead to self‑stigma and guilt for some users.","clinical_takeaway":"Clinicians should be aware that partners’ attitudes toward porn use may affect clients’ self‑stigma and mental health.","confidence":0.7,"topic_tags":["pornography","relationships","sexual_function","gender"],"strengths":["Large sample size for a survey","Focus on gender and relational variables","Theoretically grounded in social representation theory"],"limitations":["Cross‑sectional design limits causal inference","No measurement of actual pornography use frequency or masturbation","Moral incongruence and mental‑health covariates not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-03025-x"}},{"id":914,"doi":"10.1101/2025.05.20.25327972","pmid":null,"pmcid":null,"title":"Health Response to Problematic Usage of the Internet: A Global Survey on Trends, Available Treatments and Key Challenges","authors":"Khojasteh Zonoozi A, Schofield J, Abolghasemi FS, Achab S, Bowden-Jones H, Demetrovics Z, Ebrahimi M, Fineberg N, Khazaal Y, Lee HK, Siste K, Stein DJ, Wu AM, Zare-Bidoky M, ISAM-GEN Societies’ Experts, Potenza MN, Baldacchino AM, Ekhtiari H.","first_author":"Khojasteh Zonoozi A","journal":"medRxiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.medrxiv.org/content/medrxiv/early/2025/05/21/2025.05.20.25327972.full.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"global expert survey of addiction societies (38 countries)","sample_n":38,"sample_text":"Experts from 38 societies representing 38 countries","population":"experts from ISAM‑GEN societies","country":"International","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of addiction experts from 38 countries reported that online gambling and gaming are seen as the most common problematic internet uses, followed by social media, pornography, and online shopping. Psychotherapy is the most available treatment, but many societies lack training and certification programs.","clinical_takeaway":"Current global resources for treating problematic internet use, including porn use, are limited; clinicians should seek specialised training where available.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large international expert network","Highlights global gaps in treatment infrastructure","Identifies priority PUI subtypes"],"limitations":["Relies on expert perception, not population data","No standardized measurement of PUI prevalence","Limited statistical detail, no power analysis"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2025.05.20.25327972"}},{"id":915,"doi":"10.2196/58684","pmid":"39499925","pmcid":"PMC11576612","title":"Exploring the Feasibility and Acceptability of Technological Interventions to Prevent Adolescents' Exposure to Online Pornography: Qualitative Research","authors":"Turvey J, McKay D, Kaur ST, Castree N, Chang S, Lim MSC.","first_author":"Turvey J","journal":"JMIR pediatrics and parenting","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Feasibility","Adolescents","Sexual Health","Young People","Attitudes","Usability","Acceptability","Co-design","Pornography","Online Safety","Age Verification"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11576612","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative co‑design workshops with 12 participants (8 adults, 4 adolescents) using story‑stem methodology to generate ideas about technological safeguards for online pornography.","sample_n":12,"sample_text":"8 adult participants, 4 adolescent participants","population":"Adults (parents) and adolescents (15‑17 y) recruited for workshops; small convenience sample, not representative.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers held small workshops with parents and teens to discuss new technologies (like AI‑based age checks) that could block accidental porn exposure. Participants liked the ideas but doubted they would stop intentional viewing, and they worried about privacy and data security.","clinical_takeaway":"Technology alone may not prevent intentional porn use; parent‑child dialogue and education remain essential.","confidence":0.7,"topic_tags":["pornography","adolescents","prevalence"],"strengths":["Engages both parents and adolescents directly","Uses co‑design/participatory approach","Identifies privacy and ethical concerns early"],"limitations":["Very small, non‑representative sample","No systematic measurement of key confounds","Findings limited to acceptability, not effectiveness"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/58684"}},{"id":916,"doi":"10.1080/10410236.2026.2632149","pmid":"41697667","pmcid":null,"title":"The Disinhibition Threshold Hypothesis, Pornography Exposure, and Condomless Sex","authors":"Wright PJ, Gruszczynski M.","first_author":"Wright PJ","journal":"Health communication","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of emerging U.S. adults examining self‑reported pornography exposure frequency and condomless sex; quadratic regression analysis","sample_n":null,"sample_text":"not reported in abstract","population":"emerging U.S. adults (age not specified)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study proposes that only high levels of pornography viewing are linked to having sex without a condom, suggesting a curvilinear relationship rather than a straight line.","clinical_takeaway":"No direct clinical guidance; the link between porn use and condomless sex appears only at frequent exposure levels.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Introduces a novel curvilinear hypothesis (DTH)","Uses quadratic analysis to explore non‑linear effects"],"limitations":["No validated measures of exposure or sexual behavior reported","Potential lack of control for key confounds (e.g., relationship status, mental health)","Design is cross‑sectional, limiting causal inference"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2026.2632149"}},{"id":917,"doi":"10.1080/0092623x.2026.2628665","pmid":"41689394","pmcid":null,"title":"Balancing Sexual Health, Social Morality, and Public Order: Policy Challenges in China's Identification of Obscene and Pornographic Content","authors":"Xie Z, Zheng R, Duan Z.","first_author":"Xie Z","journal":"Journal of sex & marital therapy","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary; no empirical data, policy analysis only","sample_n":null,"sample_text":"N/A","population":"N/A","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses challenges China faces in defining and policing pornographic material, noting missing audience evaluation, classification systems, and expert input, and proposes policy steps to better protect sexual health while maintaining public order.","clinical_takeaway":"None - not clinically applicable","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses a clear policy gap","Highlights multidisciplinary involvement"],"limitations":["No empirical data presented","Recommendations not grounded in systematic evidence"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2026.2628665"}},{"id":918,"doi":"10.1007/s10508-024-03024-y","pmid":"39485607","pmcid":"PMC11835531","title":"Prospective Association of Symptoms of Depression and Anxiety with Pornography Viewing Frequency Among Young Adults","authors":"Singareddy C, Shrestha S, Zheng A, Harlow BL, Barrington-Trimis JL, Harlow AF.","first_author":"Singareddy C","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Depression","Anxiety","epidemiology","Gender Differences","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11835531","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort of 1864 young adults from California, 6‑month follow‑up, multinomial logistic regression","sample_n":1864,"sample_text":"n = 1864","population":"young adults (California), mixed gender, sexual orientation","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 6‑month follow‑up of 1,864 young adults, those with both depression and anxiety were about 2.7 times more likely to view pornography daily compared with people without these symptoms. Anxiety was linked to higher viewing only among women.","clinical_takeaway":"Comorbid depression and anxiety may signal a risk for frequent pornography use; consider mental‑health screening when addressing high‑frequency viewing.","confidence":0.78,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Large community sample (N>1800)","Prospective design with temporal ordering","Adjusted for several relevant covariates","Effect sizes with confidence intervals reported"],"limitations":["Pornography use measured by crude frequency categories","Depression/anxiety measurement not detailed in abstract","Moral incongruence and masturbation not assessed","Sample limited to California, may limit generalizability"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-03024-y"}},{"id":919,"doi":"10.3389/fpsyg.2024.1471438","pmid":"39529720","pmcid":"PMC11551036","title":"The influence of dark personality and pornography on sexual aggression beliefs","authors":"Galán M, Pineda D, Rico-Bordera P, Martínez-Martínez A, Piqueras JA.","first_author":"Galán M","journal":"Frontiers in psychology","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Violence Against Women","Sexual Violence","Latent Profile Analysis","Pornography","Dark Tetrad"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11551036","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 598 participants; latent profile analysis and regression; convenience sampling inferred","sample_n":598,"sample_text":"598 participants","population":"Adults (unspecified); likely community sample","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 598 adults, people with higher dark‑personality traits and who reported more pornography use were more likely to endorse myths that excuse sexual aggression, with Machiavellianism being the strongest predictor.","clinical_takeaway":"Personality traits, not pornography alone, appear linked to harmful sexual aggression beliefs; interventions should address underlying traits.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for survey","Use of latent profile analysis to identify subgroups","Inclusion of validated dark‑personality measures"],"limitations":["Cross‑sectional design limits causal inference","Pornography use measured only by self‑report frequency","No control for relevant psychosocial confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2024.1471438"}},{"id":920,"doi":"10.1080/0092623x.2026.2628651","pmid":"41672609","pmcid":null,"title":"Pornography Consumption, Body Image, and Sexual Schemas Among Incel and Non-Incel Men","authors":"Sparks B, Mooney R.","first_author":"Sparks B","journal":"Journal of sex & marital therapy","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of incel (n=45) and non‑incel (n=76) men assessing self‑report questionnaires on pornography use, masturbation, body image and related constructs","sample_n":121,"sample_text":"incel n=45; non‑incel n=76","population":"adult men, self‑identified incels and non‑incels, recruited via online surveys (likely convenience)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey compared men who identify as involuntary celibates (incels) with other men, finding incels watch more porn, use it to cope through masturbation, and feel more dissatisfied with their bodies and genitals, linking these feelings to unrealistic expectations from porn.","clinical_takeaway":"Clinicians should be aware that heavy porn use and reliance on it for coping may relate to body image concerns, especially in men feeling socially isolated.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Addresses understudied incel population","Measures both pornography use and masturbatory coping","Considers body and genital image dissatisfaction"],"limitations":["Cross‑sectional design limits causal inference","Small incel sample (n=45) reduces power","Reliance on self‑report questionnaires of uncertain validation","No control for moral incongruence, mental health, partner or trauma variables"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2026.2628651"}},{"id":922,"doi":"10.1007/s10508-022-02296-6","pmid":"36149540","pmcid":"PMC9859837","title":"Sex, Sexuality, and Intimate Relationships Among Afghan Women and Men of Refugee Background Living in Melbourne, Australia: Experiences, Opportunities, and Transcultural Tensions","authors":"Russo A, Lewis B, Ali R, Abed A, Russell G, Luchters S.","first_author":"Russo A","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Culture","Sex","Australia","Migrant","Refugee"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-022-02296-6.pdf","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Cross‑sectional qualitative study (focus groups and semi‑structured interviews) with 57 married Afghan refugees in Melbourne.","sample_n":57,"sample_text":"57 participants (focus groups and interviews).","population":"Afghan refugee men and women (married) settled in Australia.","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Afghan refugees in Melbourne describe how greater access to sexual material and new social freedoms are reshaping their sexual lives, creating both opportunities for pleasure and new relational tensions.","clinical_takeaway":"Clinicians should be aware of cultural transition stresses affecting Afghan couples’ sexual wellbeing.","confidence":0.8,"topic_tags":["sexual_function","relationships","csbd"],"strengths":["Rich, culturally specific qualitative insight","Includes both male and female perspectives","Focuses on relational and social dimensions often missed in SRH research"],"limitations":["Small, non‑probability sample limits generalisability","No validated scales; findings are descriptive","Potential selection bias (voluntary participation in focus groups)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02296-6"}},{"id":923,"doi":"10.1080/00224499.2010.543960","pmid":"21259151","pmcid":null,"title":"Associations between young adults' use of sexually explicit materials and their sexual preferences, behaviors, and satisfaction","authors":"Morgan EM.","first_author":"Morgan EM.","journal":"Journal of sex research","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":97,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online questionnaire of 782 heterosexual college students (average age 19.9) assessing self‑reported frequency and types of sexually explicit material (SEM) use, sexual experiences, preferences, and satisfaction.","sample_n":782,"sample_text":"326 men, 456 women, recruited via online questionnaire; convenience sample","population":"heterosexual college students (young adults, mean age 19.9)","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 782 college students, more frequent viewing of porn and a greater variety of porn types were linked to having more sexual partners, earlier first intercourse, and lower sexual and relationship satisfaction. The study suggests porn use is associated with several aspects of young adults' sexual lives.","clinical_takeaway":"Higher porn consumption correlates with reduced sexual and relationship satisfaction, but causality is uncertain; clinicians should explore broader sexual context rather than assume porn is the cause.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["large sample for a survey (N=782)","includes both genders","examines multiple SEM use dimensions (frequency, type, context)","uses regression to adjust for some covariates"],"limitations":["cross‑sectional, cannot infer causality","no validated SEM‑use scale; relies on self‑report items","does not measure key confounds (moral views, masturbation, mental health, partnership, trauma)","college convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":16,"contrasting":3,"mentioning":193,"citing_publications":268,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2010.543960"}},{"id":924,"doi":"10.3390/bs14100926","pmid":"39457797","pmcid":"PMC11504936","title":"Parental Competence and Pornography Use among Hispanic Adolescents","authors":"Calatrava M, Magalhaes PAP, Vidaurreta M, Rivas S, López-Del Burgo C, Belintxon M.","first_author":"Calatrava M","journal":"Behavioral sciences (Basel, Switzerland)","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Lifestyles","Positive Youth Development","Pornography","Parental Competence"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11504936","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 2,516 adolescents (12‑15 y) from four Spanish‑speaking countries; logistic regression used to test associations between parental competence dimensions and self‑reported pornography use","sample_n":2516,"sample_text":"Adolescents (N = 2516) aged 12‑15 from Chile, Mexico, Peru, and Spain were included","population":"Adolescents (12‑15 y) from Chile, Mexico, Peru, Spain; likely school‑based convenience sample","country":"Chile, Mexico, Peru, Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 2,500 teens in four Spanish‑speaking countries found that higher parental warmth was linked to more pornography use, while teaching privacy reduced use among girls. Demanding parents and other parenting styles showed no clear link.","clinical_takeaway":"Parents might focus on open communication about privacy rather than strict control to influence adolescents' pornography exposure.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","prevalence"],"strengths":["Large multi‑country adolescent sample (>2500)","Use of multivariate logistic regression","Focus on parental factors beyond simple monitoring"],"limitations":["Cross‑sectional design precludes causal inference","No measurement of key confounds (moral incongruence, mental health, etc.)","Pornography use measured by a single self‑report item, unclear validation"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs14100926"}},{"id":925,"doi":"10.1177/08862605241286004","pmid":"39387161","pmcid":"PMC12238667","title":"The Mediating Role of Rape Myths in the Relationship Between the Use of Hentai Pornography and Sexually Aggressive Strategies: A Study with College Students","authors":"Almeida B, Gomes H, Carvalho J.","first_author":"Almeida B","journal":"Journal of interpersonal violence","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["College Students","Sexual Aggression","Rape Myths","Pornography","Hentai"],"is_oa":true,"oa_url":"https://doi.org/10.1177/08862605241286004","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 906 heterosexual college students measuring hentai pornography use, rape‑myth endorsement and self‑reported sexually aggressive behavior; mediation analysis","sample_n":906,"sample_text":"906 college students (533 men, 373 women)","population":"college students (heterosexual, 18+, users of hentai pornography)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 906 college students, more frequent viewing of hentai porn was linked to higher self‑reported sexual aggression, and this link was partly explained by stronger endorsement of rape myths.","clinical_takeaway":"Do not infer that hentai use causes aggression; the association may reflect broader attitudes and unmeasured factors.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a survey","Focus on understudied hentai content","Gender‑specific mediation analysis"],"limitations":["Cross‑sectional design cannot establish causality","Potential self‑report bias","No control for key confounds (e.g., mental health, trauma)","Unclear validation of measurement instruments"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605241286004"}},{"id":926,"doi":"10.1080/19317611.2024.2410943","pmid":"39935903","pmcid":"PMC11810093","title":"The Role of Positive and Negative Metacognitions About Sex in the Relationship Between Psychological Distress and Problematic Consumption of Pornography. A Mediation Model","authors":"Huțul TD, Karner-Huțuleac A, Mariș AM, Filote IM, Chiricheș FB, Mavrichi MIF.","first_author":"Huțul TD","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Psychological Distress","Metacognitions","Metacognitions About Sex","Problematic Consumption Of Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11810093","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 821 Romanian adults (18‑70)","sample_n":821,"sample_text":"821 individuals from Romania, aged 18‑70, 64.4 % women","population":"general adult sample (64 % women)","country":"Romania","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A Romanian survey of 821 adults found that both positive and negative thoughts people have about sex help explain how psychological distress relates to self‑reported problematic porn use. The authors suggest these metacognitions are an important link in the chain.","clinical_takeaway":"Clinicians might consider patients' beliefs about sex when addressing distress‑related porn use, but evidence is correlational.","confidence":0.75,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Large sample size for a survey","Novel focus on metacognitions about sex","Use of mediation analysis to explore indirect pathways"],"limitations":["Cross‑sectional design limits causal inference","Problematic pornography measured with likely unvalidated self‑report scale","No assessment of moral incongruence, masturbation, or other key confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2024.2410943"}},{"id":929,"doi":"10.1007/s10508-019-1398-5","pmid":"30793227","pmcid":null,"title":"Assessing Cognitive Appraisals Related to Sexual Function: A Scenario-Based Approach","authors":"Velten J, Blackwell SE, Margraf J, Woud ML.","first_author":"Velten J","journal":"Archives of sexual behavior","year":2019,"pub_types":["Journal Article"],"keywords":["Sexual function","Cognitive Biases","Sexual Problems","Cognitive Appraisals","Indirect Measures","Scenario Task"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 600 adults assessing sexual function with validated scales and a novel scenario‑based cognitive bias task","sample_n":600,"sample_text":"N=600 adults recruited for an online questionnaire study (details not specified in abstract)","population":"adult community sample (N=600, mean age 34.2)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 600 adults, people with poorer sexual function tended to view ambiguous sexual situations more negatively and wrote scenario endings that focused more on problems and less on communication or explicit language.","clinical_takeaway":"Negative cognitive appraisals are linked to lower sexual function; addressing these biases may help improve sexual health.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Large sample (N=600) provides adequate power for regression analyses","Use of well‑validated sexual function indices (FSFI, IIEF)","Innovative scenario‑based task to capture implicit cognitions"],"limitations":["Cognitive bias task not previously validated; coding may be subjective","Cross‑sectional design precludes causal inference","No measurement or control of key confounds (e.g., mental health, relationship factors)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":18,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-1398-5"}},{"id":931,"doi":"10.1080/00224499.2021.1954583","pmid":"34309441","pmcid":null,"title":"Top, Bottom, and Versatile Orientations among Adolescent Sexual Minority Men","authors":"Moskowitz DA, Alvarado Avila A, Kraus A, Birnholtz J, Macapagal K.","first_author":"Moskowitz DA","journal":"Journal of sex research","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 302 adolescent sexual minority men reporting self‑label, sexual experience, app use, etc.; convenience sample","sample_n":302,"sample_text":"adolescent sexual minority men recruited (likely via online/app channels)","population":"ASMM, 15‑18 y, n = 302","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 302 teenage gay and bisexual men, about one‑third identified as top, versatile, or bottom. Having more partners, using dating apps, and having relationship experience were linked to adopting a label. Labels matched actual sexual behaviors, and factors like penis‑size satisfaction and gender atypicality also predicted self‑identities.","clinical_takeaway":"Sexual role self‑identities develop in adolescence and relate to partner experience and app use; clinicians should consider social context when discussing sexual identity with teen SMM.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large adolescent sample for this topic","Examines convergent validity between self‑label and behavior","Includes social‑media/app usage variables"],"limitations":["Cross‑sectional; cannot infer causality","Convenience sample limits generalisability","Limited detail on measurement validation"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2021.1954583"}},{"id":932,"doi":"10.1093/sexmed/qfad035","pmid":"37448743","pmcid":"PMC10336024","title":"Assessing comfort with sexuality-related questions in medical students: \"a little discomfort is better than a lifetime of suffering in silence\"","authors":"Thomson J, Ross MW, van Deventer H, Poelsma M, Pienaar ME, du Toit M, Botha MH.","first_author":"Thomson J","journal":"Sexual medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://academic.oup.com/smoa/article-pdf/11/3/qfad035/50854365/qfad035.pdf","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"first‑year medical students completed a dyadic role‑play exercise; comfort ratings collected via 35‑item Likert questionnaire; no control group, single university sample","sample_n":null,"sample_text":"Convenience sample of first‑year students at one university; not representative of broader student or clinician populations","population":"First‑year medical students (South Africa)","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"First‑year medical students rated how comfortable they felt asking 35 sexuality‑related questions in a paired role‑play. Interviewers felt more at ease than interviewees, with explicit questions causing the most discomfort, especially for female participants.","clinical_takeaway":"Early, structured practice with provided questions can improve medical students' confidence in taking sexual histories.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides a novel, low‑cost method to assess comfort with sexual history questions","Combines quantitative ratings with qualitative student reflections","Highlights gender differences in discomfort"],"limitations":["Single‑site convenience sample limits generalisability","Comfort scale not a validated instrument","No longitudinal follow‑up to test skill retention"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfad035"}},{"id":933,"doi":"10.1037/adb0000822","pmid":"35175066","pmcid":"PMC9381653","title":"Sensation seeking and alcohol expectancies regarding sexual aggression as moderators of the relationship between alcohol use and coercive condom use resistance intentions","authors":"Kirwan M, VanDaalen RA, Eldridge N, Davis KC.","first_author":"Kirwan M","journal":"Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors","year":2023,"pub_types":["research-article","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Randomized controlled trial with four alcohol dose conditions (control, placebo, low, high) and measurement of coercive condom‑use‑resistance intentions after a scenario.","sample_n":313,"sample_text":"313 participants; random allocation to four groups.","population":"313 single, young, heterosexual men","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab experiment, drinking alcohol increased men’s reported willingness to coerce a partner into not using a condom, but only among men who were high in sensation seeking and who expected alcohol to make them more sexually aggressive.","clinical_takeaway":"Alcohol use, sensation seeking, and expectancies may raise risk of condom‑use coercion; interventions should address these factors.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Experimental randomization of alcohol dose","Large sample for a laboratory study","Use of validated personality and expectancy measures (presumed)"],"limitations":["No assessment of moral or relational confounds","Intentions, not actual behavior","No pre‑registration reported"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":16,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/adb0000822"}},{"id":935,"doi":"10.1080/00224499.2025.2610412","pmid":"41527901","pmcid":null,"title":"'Feminism Has Saved Me': Agency and Consent in the Face of Mainstream Pornography's Influence on Spanish Young Adults","authors":"Pavón-Benítez L, Ruiz-Repullo C.","first_author":"Pavón-Benítez L","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Cross‑sectional qualitative study using in‑depth interviews (N=29) with Spanish young adults (18‑30) about how they negotiate mainstream pornography in sexual relationships.","sample_n":29,"sample_text":"N = 29","population":"young adult Spaniards (18‑30, mixed gender)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 29 Spanish young adults reveal how they interpret and sometimes resist mainstream porn’s portrayal of sex, noting pressures toward gender inequality and non‑consensual scripts while also drawing on feminist ideas for empowerment.","clinical_takeaway":"Clinicians should recognize that young adults may experience mixed messages from porn and can benefit from feminist‑informed discussions about consent and agency.","confidence":0.6,"topic_tags":["pornography","sexual_function","gender","csbd"],"strengths":["Rich, in‑depth qualitative data","Focus on agency and resistance","Incorporates feminist gender analysis"],"limitations":["Small, non‑representative convenience sample","No measurement of key confounds (e.g., moral incongruence, mental health)","Findings not generalisable to broader populations"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2025.2610412"}},{"id":936,"doi":"10.17161/kjm.vol14.14805","pmid":"34868468","pmcid":"PMC8641439","title":"Trends in Internet Safety Education by Healthcare Providers","authors":"King G, Bui T, Dedeaux J, Ahlers-Schmidt CR, Harris K.","first_author":"King G","journal":"Kansas journal of medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Pediatrics","Primary Care","Social Media"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8641439","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"self‑reported survey of 31 healthcare providers at a mental‑health training seminar; descriptive statistics only","sample_n":31,"sample_text":"31 providers (convenience sample at seminar)","population":"healthcare providers (convenience sample)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 31 clinicians showed that most rarely discuss internet safety with patients, especially about risky online behavior or sexual explicit media, and many have never received training on it.","clinical_takeaway":"Providers may need targeted training to improve internet safety counseling for families.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["addresses an important gap in provider training","provides concrete frequencies of counseling topics"],"limitations":["very small, non‑representative sample","uses unvalidated self‑report items","no inferential testing or power analysis"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.17161/kjm.vol14.14805"}},{"id":938,"doi":"10.3389/fdgth.2025.1671623","pmid":"41567349","pmcid":"PMC12816239","title":"Development and validation of screening tool for excessive and problematic use of internet and digital devices (STEPS-IDD) based on the WHO framework (ICD-11) for addictive behaviours","authors":"Balhara YPS, Singh S, Majumdar IG, Ayoob A, Singh A.","first_author":"Balhara YPS","journal":"Frontiers in digital health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Screening","Gambling","Compulsive Buying","Gaming","Behavioural Addiction","Problematic Pornography Use","Ott","Social Media Use Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12816239","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional validation study with convenience sample of 112 college students","sample_n":112,"sample_text":"college student convenience sample","population":"college students (N=112, mean age 20.5, 64.3% female)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and tested a new questionnaire (STEPS‑IDD) to spot potentially addictive internet behaviours, including pornography watching, using college students. It showed solid reliability and matched other established scales, but it was only tested in a small, non‑representative sample.","clinical_takeaway":"The STEPS‑IDD may help clinicians screen for risky internet use, but its accuracy for diagnosing addiction needs further validation.","confidence":0.78,"topic_tags":["pornography","sexual_function","measurement"],"strengths":["Uses ICD‑11 framework for item generation","Good internal consistency (α = 0.86‑0.91)","Factor analysis supports unidimensional structure"],"limitations":["Convenience college sample limits generalisability","No measurement of key confounds (e.g., moral incongruence, mental health)","Screening tool not validated against clinical diagnosis"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fdgth.2025.1671623"}},{"id":939,"doi":"10.31234/osf.io/5bmav_v2","pmid":null,"pmcid":null,"title":"Understanding how survivors of non-consensual intimate image dissemination are perceived by UK and Norwegian respondents","authors":"Fido D, Hesbøl AC, Danby A.","first_author":"Fido D","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/5bmav_v2","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey experiment with vignette manipulation (relationship type) and self‑report questionnaires; convenience online sample (UK & Norway, N=477).","sample_n":477,"sample_text":"Convenience online respondents (UK and Norway).","population":"Adults from the United Kingdom and Norway recruited online; demographic details not provided.","country":"UK, Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed 477 people in the UK and Norway using brief stories about non‑consensual sharing of intimate images. Participants judged the impact on survivors and the level of victim‑blame, with UK respondents seeing more harm than Norwegians. Higher self‑reported psychopathic traits were linked to less blame and viewing the act as less criminal, especially in casual‑relationship scenarios.","clinical_takeaway":"Public attitudes toward non‑consensual image sharing vary by country and individual traits; interventions should consider cultural and personality factors when addressing victim‑blame.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonable sample size for survey research","Use of experimentally varied vignettes","Inclusion of psychopathic trait measure as covariate"],"limitations":["Convenience online sample limits generalisability","No measurement of moral/religious attitudes that could affect blame judgments","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/5bmav_v2"}},{"id":940,"doi":"10.1556/2006.2024.00046","pmid":"39235861","pmcid":"PMC11457022","title":"The PornLoS Treatment Program: Study protocol of a new psychotherapeutic approach for treating pornography use disorder","authors":"Stark R, Markert C, Golder S, Psarros R, Discher JP, Khatib S, Metzger J, Palmer S, Rechmann J, Storz F, Walter B, Allard S, Antons S, Bledzka M, Brand M, Dörrenbächer S, Englisch J, Friehs T, Da Cunha Gonçalves K, Haberkamp A, Hall M, Kananian S, Kemmerer P, Klingelhöfer D, Lutz W, Melzig CA, Michael T, Neumann A, Neusser S, Niemann A, Odenthal M, Rubel J, Schlierenkamp S, Speckemeier C, Ünlü L, Vogt R, Wölfling K, Zachariassen W, Zur Hausen G, Heinz C.","first_author":"Stark R","journal":"Journal of behavioral addictions","year":2024,"pub_types":["Clinical Trial Protocol","research-article","Journal Article"],"keywords":["Cognitive Behavioral Therapy","Behavioral Addiction","Pornography Addiction","Compulsive Sexual Behavior Disorder","Pornography Use Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11457022","cited_by_count":4,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"four-arm parallel-group randomized controlled trial comparing two versions of a manualised CBT-based PornLoS programme (abstinence vs reduction) with CBT-as-usual and wait‑list control; n=316 across eight sites; primary outcome: CSBD/PUD diagnosis at post‑treatment.","sample_n":316,"sample_text":"target sample size of 316 patients with PUD across eight study sites","population":"adults with a clinical diagnosis of pornography‑use disorder (PUD) seeking treatment","country":"unspecified (multi‑site, likely Germany)","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A new therapy programme for pornography‑use disorder (PornLoS) is being tested in a four‑arm randomized trial, comparing two CBT‑based versions (abstinence vs reduction) to standard CBT and a wait‑list. The study will enrol 316 adults diagnosed with the disorder and assess whether the treatment eliminates the diagnosis after therapy.","clinical_takeaway":"If effective, the PornLoS programme could become a structured, evidence‑based option for treating pornography‑use disorder.","confidence":0.78,"topic_tags":["treatment","csbd","pornography","religiosity"],"strengths":["large multi‑site sample","randomised controlled design with active and wait‑list comparators","pre‑registration and a priori power calculation"],"limitations":["protocol does not specify measurement of key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)","unclear whether diagnostic assessment uses validated, fully operationalised instruments","potential self‑selection bias of treatment‑seeking participants"],"rubric_version":"2.0","raw_total":43,"max_possible":60,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":4,"design":9,"addiction_criteria":7,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00046"}},{"id":942,"doi":"10.18502/ijph.v53i9.16468","pmid":"39429660","pmcid":"PMC11490320","title":"Predicting Pornography Use Based on Mental Health and Quality of Communication with Parents","authors":"Javaheri A, Abu KH, Shahmoradi S.","first_author":"Javaheri A","journal":"Iranian journal of public health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Parents","Communication","Anxiety","Mental health","Pornography"],"is_oa":true,"oa_url":"https://doi.org/10.18502/ijph.v53i9.16468","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"purposive online survey of 210 Tehran university students; quantitative questionnaire on pornography use, parent communication, anxiety and social dysfunction; hierarchical regression analysis","sample_n":210,"sample_text":"210 participants completed an online questionnaire (purposive sampling)","population":"university students (age ~18‑25), Tehran, Iran","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 210 Iranian university students found that higher anxiety and poorer communication with parents were linked to more frequent pornography use, especially among men.","clinical_takeaway":"Improving parent‑child communication and addressing anxiety may help reduce pornography use among young adults.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Reasonable sample size for a survey","Multivariate regression assessing several predictors","Gender moderation considered"],"limitations":["Convenience purposive sample, limited generalisability","Pornography use measured with unvalidated self‑report","No control for moral/religious factors or masturbation","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.18502/ijph.v53i9.16468"}},{"id":944,"doi":"10.1111/jsm.12157","pmid":"23621804","pmcid":null,"title":"Does viewing explain doing? Assessing the association between sexually explicit materials use and sexual behaviors in a large sample of Dutch adolescents and young adults","authors":"Hald GM, Kuyper L, Adam PC, de Wit JB.","first_author":"Hald GM","journal":"The journal of sexual medicine","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Youth","Adolescents","Young Adults","Sexual Behaviors","Sexual Risks","Sexual Sensation Seeking","Pornography","Sexually Explicit Materials"],"is_oa":false,"oa_url":null,"cited_by_count":50,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey of 4,600 Dutch adolescents and young adults (15‑25 y) assessing self‑reported SEM use and a range of sexual practices; hierarchical multiple regression used to examine associations while controlling for selected covariates.","sample_n":4600,"sample_text":"4,600 participants","population":"Dutch adolescents and young adults, 15–25 years, recruited online (convenience sample).","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large Dutch survey of 4,600 youths aged 15‑25, researchers found that using sexually explicit material was modestly linked to a variety of sexual behaviors, even after accounting for other factors. The associations were small, suggesting SEM is just one of many influences on young people’s sexual activity.","clinical_takeaway":"SEM use shows only modest links to sexual behaviors; clinicians should consider many other factors when discussing youth sexuality.","confidence":0.73,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size giving good statistical power","Controls for a range of covariates","Broad assessment of sexual behaviors"],"limitations":["Cross‑sectional design cannot establish causality","SEM use measured with unvalidated single‑item self‑report","Key confounds (moral incongruence, masturbation, mental health) not reported","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":7,"contrasting":0,"mentioning":76,"citing_publications":127,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12157"}},{"id":945,"doi":"10.31234/osf.io/bc4hk_v1","pmid":null,"pmcid":null,"title":"Second-order preferences: What we want others to like and how it affects what we think of public policy","authors":"Promberger M, Baron J.","first_author":"Promberger M","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/bc4hk_v1","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey experiments with convenience samples; no longitudinal or randomisation","sample_n":null,"sample_text":"Convenience sample; exact N not reported in abstract","population":"adult participants recruited online (likely WEIRD)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors show that people often prefer policies that do not simply follow what most people do. Even when many people adopt a behaviour (e.g., viewing pornography), others may still wish policies to keep that behaviour less accepted.","clinical_takeaway":"None - not clinically applicable","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Novel exploration of second‑order preferences","Multiple scenarios increase breadth"],"limitations":["Ad‑hoc measures, no validated scales","Convenience sample, likely WEIRD bias","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/bc4hk_v1"}},{"id":946,"doi":"10.1111/jmwh.12923","pmid":"30521135","pmcid":"PMC6351208","title":"Is Sexting Associated with Sexual Behaviors During Adolescence? A Systematic Literature Review and Meta-Analysis","authors":"Handschuh C, La Cross A, Smaldone A.","first_author":"Handschuh C","journal":"Journal of midwifery & women's health","year":2019,"pub_types":["Meta-Analysis","research-article","Systematic Review","Journal Article"],"keywords":["Adolescent Health","Sexual And Reproductive Health","Text Messaging"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"meta-analysis of 6 studies (N=9676 adolescents) examining odds of sexual activity among those who sexted","sample_n":9676,"sample_text":"9676 adolescents across 6 included studies","population":"adolescents (unspecified age range, likely 12‑18)","country":"multiple (studies from various countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of six studies (nearly 10,000 teens) found that those who send sexually explicit texts are about six times more likely to report having had sex than those who do not.","clinical_takeaway":"When discussing sexual health with adolescents, clinicians should inquire about sexting as it is linked to higher likelihood of sexual activity.","confidence":0.78,"topic_tags":["adolescents","sexual_function"],"strengths":["Systematic search of multiple databases","Meta‑analytic synthesis with effect size and confidence interval","Quality appraisal of included studies"],"limitations":["Primary studies rely on self‑report and likely lack validated sexting scales","Potential unmeasured confounders (e.g., peer influence, mental health) not addressed","Heterogeneity moderate (I²=65 %)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":53,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jmwh.12923"}},{"id":947,"doi":"10.21203/rs.3.rs-3483492/v1","pmid":null,"pmcid":null,"title":"Cardiovascular, Endocrine, and Brain Activity Changes in Humans During Sexual Arousal Induced by Pornography vs. Masturbation; Updated Literature Guidelines","authors":"Swed S, Bohsas H, Rakab A, Hafez W, Sawaf B, Alibrahim H, Shoib S, Moawad MHED, Sadeq MA, Ghorab RMF, Rais MA, Aljabali A, Siddiq A, Ali E, Shariff S, Almoshantaf MB, Khraisat O, Baroudi I, Bakkour A, Jawish N, Abouainain Y, Dave T, Robles-Velasco K, Cherrez-Ojeda I, Sah R, Zaidi ARZ, Dergaa I, Elteriefi R, Nasif MN, Saeed F, Virani S, Nahidi M, Debal BK, Hajeh H, AlDabbagh A, Taheri M, Nashwan AJ, Abazid RR, Alhanafy MM, Ahmed AB, Gador M, Boktor AN, AlMahmoud A, Albalbisi MB, Barradah HF, Schönfeldt-Lecuona C, Elsayed ME, Rashid A.","first_author":"Swed S","journal":"Research Square","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-3483492/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["masturbation","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of clinical trials, cohort, case‑control and cross‑sectional studies examining cardiovascular, endocrine and brain activity during pornography‑induced arousal versus masturbation; no meta‑analysis or risk‑of‑bias assessment reported.","sample_n":null,"sample_text":"Not applicable – review aggregates multiple primary studies","population":"humans (both sexes) from included studies","country":"multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review summarizes how watching porn or masturbating changes heart rate, blood pressure, hormones and brain activity. While many studies show physiological changes, the findings are inconsistent and more controlled experiments are needed.","clinical_takeaway":"Physiological responses to porn‑induced arousal and masturbation vary; clinicians should note the limited and mixed evidence when discussing sexual health.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","neuroscience","csbd"],"strengths":["Broad literature coverage of physiological responses","Sex‑specific synthesis of findings","Identifies inconsistencies and gaps"],"limitations":["No quantitative meta‑analysis or risk‑of‑bias assessment","Does not control for key confounds (moral incongruence, mental health, etc.)","Relies on heterogeneous primary studies with unclear measurement quality"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-3483492/v1"}},{"id":949,"doi":"10.1177/10790632241271245","pmid":"39142647","pmcid":null,"title":"Convergent and Divergent Validity of the Child Pornography Offender Risk Tool (CPORT) in a Clinical Sample From California","authors":"Azizian A, Eke AW, Farmus L, Scott S, Seto MC.","first_author":"Azizian A","journal":"Sexual abuse : a journal of research and treatment","year":2025,"pub_types":["Validation Study","Journal Article"],"keywords":["risk assessment","Field Study","Child Sexual Exploitation","Csem","Child Pornography Offender Risk Tool"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study of a risk assessment tool in a clinical sample of 224 male CSEM offenders on federal probation","sample_n":224,"sample_text":"clinical sample of 224 men on federal probation","population":"men convicted of child sexual exploitation material offenses, on probation in California, USA","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study checks whether the Child Pornography Offender Risk Tool (CPORT) measures what it should by comparing its scores to other established risk assessments and self‑reports of sexual interest in children in 224 men on probation.","clinical_takeaway":"CPORT shows promising validity for assessing recidivism risk, but its predictive accuracy for future offending remains untested.","confidence":0.8,"topic_tags":["csbd"],"strengths":["Large, well‑defined probation sample","Use of multiple established risk instruments for convergent/divergent validation","Clear reporting of correlations and significance"],"limitations":["Cross‑sectional design; no prospective recidivism data","Findings limited to convicted offenders, not general population","No pre‑registration or open data"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632241271245"}},{"id":950,"doi":"10.1007/s10508-024-02967-6","pmid":"39138695","pmcid":null,"title":"BDSM Safety in Pornography: Its Perceived Accuracy and Impact on Practitioners' Safe Word Practices","authors":"Westlake BG.","first_author":"Westlake BG.","journal":"Archives of sexual behavior","year":2024,"pub_types":["Journal Article"],"keywords":["Safety","Learning","Bdsm","Pornography","Safe Words"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of self‑identified BDSM practitioners; cross‑sectional convenience sample","sample_n":null,"sample_text":"self‑identified BDSM practitioners recruited via online channels (likely convenience sample)","population":"BDSM practitioners (adult, mixed gender)","country":"unspecified (likely USA/English‑speaking)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed BDSM practitioners about how accurately they think porn shows safety rules like safe‑words, and whether those views affect their own use of safe‑words or safety training. Perceived accuracy did not predict safe‑word use; experience and role (submissive vs dominant) were stronger predictors.","clinical_takeaway":"Practitioners’ safe‑word use appears driven more by experience and role than by porn depictions; safety education should focus on skill‑building rather than media influence.","confidence":0.7,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Addresses understudied link between pornographic depictions and real‑world BDSM safety practices","Large sample of practitioners across roles","Multivariate analysis of predictors"],"limitations":["Convenience, self‑selected online sample limits generalisability","Reliance on ad‑hoc, unvalidated questionnaires","No control for moral, mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02967-6"}},{"id":954,"doi":"10.1007/s10508-024-02954-x","pmid":"39134734","pmcid":null,"title":"Pornographic Video Consumption and Partner Preference Among Chinese Male Sexual Minorities: The Moderating Role of Perceived Realism","authors":"Xu J, Wright PJ, Su Y, Liu Y, Zheng L.","first_author":"Xu J","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual Orientation","Partner Preference","Pornography","3Am","Perceived Realism"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 595 Chinese male sexual minorities (gay and bisexual), measuring self‑reported frequency of pornographic video consumption, perceived realism, and partner‑preference ratings; moderation analysis performed.","sample_n":595,"sample_text":"595 participants (82.9% gay, 17.1% bisexual)","population":"Male sexual minorities, China, age 18‑47","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 595 Chinese gay and bisexual men, higher frequency of watching porn videos was linked to stronger preferences for appearance and sexual ability in partners, but only when participants believed the videos were realistic.","clinical_takeaway":"None – the study is exploratory and does not provide actionable clinical guidance.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a minority population","Focus on understudied group (Chinese male sexual minorities)","Statistical moderation analysis"],"limitations":["Cross‑sectional design limits causal inference","Key constructs measured with likely ad‑hoc, unvalidated items","No control for major confounds (e.g., moral incongruence, mental health)","Potential self‑selection bias"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02954-x"}},{"id":955,"doi":"10.1177/08862605221120906","pmid":"36086858","pmcid":null,"title":"Sending of Unwanted Dick Pics as a Modality of Sexual Cyber-Violence: An Exploratory Study of Its Emotional Impact and Reactions in Women","authors":"Durán M, Rodríguez-Domínguez C.","first_author":"Durán M","journal":"Journal of interpersonal violence","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexism","Social Norms","Sexting","Dick Pics","Cyber-violence Against Women"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 347 Spanish women (18‑30) using self‑report of past exposure and hypothetical scenario; prevalence and emotional impact examined.","sample_n":347,"sample_text":"Convenience sample of Spanish university‑age women; not nationally representative.","population":"Women, Spanish, 18‑30, community sample (convenience).","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 347 Spanish women aged 18‑30, nearly half reported ever receiving an unwanted explicit image. Women who were less sexist, less religious, and perceived friends as less accepting reported stronger negative emotions. Most said they'd talk to others or block the sender, but few would report the incident to platforms or police.","clinical_takeaway":"Unsolicited sexual images are common and cause distress; clinicians should discuss coping options and encourage reporting mechanisms.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large (N>300) community sample for this topic","First Spanish study on unsolicited sexual images","Explores a range of psychosocial predictors"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on self‑report and hypothetical scenario","Limited measurement validation for emotional impact"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":20,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605221120906"}},{"id":957,"doi":"10.1007/s00266-024-04271-z","pmid":"39107663","pmcid":null,"title":"Breast Aesthetics, Motivational Factors in Surgery, and the Influence of Social Media and Pornography","authors":"Vanweser J, Diluiso G, Perez-Nunez L, Xiong V, Marcaccini G, Schettino M, Marron Mendes V.","first_author":"Vanweser J","journal":"Aesthetic plastic surgery","year":2025,"pub_types":["Journal Article"],"keywords":["Smoking","Demography","Educational Status","Social Media","Breast Surgery","Pornography","Surveys And Questionnaires","Breast Aesthetics"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional online questionnaire; self‑selected convenience sample recruited via social media; n=382 women, mean age 30.6","sample_n":382,"sample_text":"382 complete responses from an online questionnaire distributed on social media","population":"Women ≥18 years, English/French/Dutch speakers, recruited online","country":"unspecified (likely multiple countries based on language versions)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2025 online survey of 382 women found that those who use social media and view pornography tend to prefer larger breast sizes as ideal. Smoking and education also related to breast‑size ideals, but the study does not prove causation.","clinical_takeaway":"Clinicians should note that media exposure may shape body‑image ideals, though evidence of direct impact is limited.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large (N=382) community sample for exploratory topic","Multilingual questionnaire increases reach","Addresses under‑studied factor (pornography) in body image"],"limitations":["Convenience, self‑selected online sample limits generalisability","No validated measures for key constructs (breast satisfaction, pornography exposure)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00266-024-04271-z"}},{"id":958,"doi":"10.1016/j.jadohealth.2008.12.004","pmid":"19628142","pmcid":null,"title":"Exposure to sexually explicit Web sites and adolescent sexual attitudes and behaviors","authors":"Braun-Courville DK, Rojas M.","first_author":"Braun-Courville DK","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":149,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 433 adolescents at a NYC health centre; anonymous self‑report questionnaire on internet access, exposure to sexually explicit websites, sexual behaviours and permissive attitudes; cross‑sectional logistic regression analysis.","sample_n":433,"sample_text":"433 adolescents completed an anonymous survey at a health centre in New York City.","population":"Adolescents (age not specified, likely 12‑18) attending a health centre in New York City; convenience sample; N=433.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 433 New York City adolescents, those who reported ever visiting pornographic websites were more likely to have multiple partners, recent partner turnover, use substances during sex, and report more permissive sexual attitudes.","clinical_takeaway":"Clinicians should be aware that adolescent porn exposure correlates with riskier sexual behaviours, but causality is unclear; discuss internet use in sexual‑health conversations.","confidence":0.8,"topic_tags":["sexual_function","pornography","adolescents"],"strengths":["Large community‑based adolescent sample (N>400).","Uses multivariable logistic regression with confidence intervals.","Addresses a timely public‑health question."],"limitations":["Cross‑sectional design; cannot infer causality.","Convenience sample from one health centre; limited generalisability.","Measures of exposure and attitudes not confirmed as validated scales."],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":21,"contrasting":1,"mentioning":194,"citing_publications":425,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2008.12.004"}},{"id":959,"doi":"10.1007/s10508-022-02459-5","pmid":"36376743","pmcid":"PMC9662764","title":"The Impact of Household Context on Self-Perceived Changes in Solo and Partnered Sexual Behaviors During the COVID-19 Pandemic: Findings from a U.S. Probability Survey","authors":"Hensel DJ, Rosenberg M, Luetke M, Fu TC, Herbenick D.","first_author":"Hensel DJ","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Behavior Change","Partnered Sex","Covid-19","Solo Masturbation","Household Factors"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9662764","cited_by_count":32,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative online probability survey (N=1010) conducted Apr 10‑20, 2020; weighted descriptive statistics, Wilcoxon tests, ordinal regression adjusted for demographics and household variables","sample_n":1010,"sample_text":"1010 U.S. adults (62% response rate)","population":"U.S. adults, 18‑94 years, probability sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationally representative US survey of 1,010 adults found that during early COVID‑19, solo and partnered sexual activities changed in both directions; living apart from a partner reduced partnered intimacy, while unpartnered adults reported more sexting and those not working reported more oral sex and pornography use.","clinical_takeaway":"Sexual health services should consider how pandemic‑related household factors shape both solo and partnered sexual activity.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative probability sample","Weighted analyses for population estimates","Adjusted regression models include several demographic covariates"],"limitations":["Self‑report change scales are single‑item and not validated","No measurement of moral or mental‑health confounders","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02459-5"}},{"id":960,"doi":"10.31234/osf.io/4j2d5","pmid":null,"pmcid":null,"title":"Why Do You Watch This Rough Stuff? Understanding Women's Paradoxical Pornography Preferences","authors":"von Andrian-Werburg MTP, Schwarz S, Lange BP, Schwab F.","first_author":"von Andrian-Werburg MTP","journal":"PsyArXiv","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/4j2d5","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 571 women; participants viewed consensual or non‑consensual literature‑based pornographic stimuli and reported sexual arousal; trait questionnaires administered","sample_n":571,"sample_text":"571 women recruited online, intended to match German age and education distributions","population":"women, community sample (German‑resident, age/education‑matched to national demographics)","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a German online study of 571 women, exposure to consensual vs. non‑consensual pornographic text showed that higher rape‑myth acceptance and stronger sex drive predicted greater sexual arousal. Prior viewing of violent porn interacted with arousal, suggesting possible desensitization. Life‑history factors did not matter.","clinical_takeaway":"Women’s arousal to violent porn is linked to attitudes and sex drive, not to life‑history traits; clinicians should consider personal beliefs and prior exposure when discussing porn use.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["large sample (N>500)","experimental manipulation of stimulus type","use of validated trait scales for rape myth acceptance and sex drive"],"limitations":["no measurement of masturbation or partner context","moral incongruence about porn use not assessed","cross‑sectional; causality cannot be inferred"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/4j2d5"}},{"id":961,"doi":"10.1016/j.addbeh.2025.108580","pmid":"41391345","pmcid":null,"title":"Evaluating different patterns of problematic internet use using a unified self-report measure based on the ICD-11 framework: Psychometric properties of the Italian version of the ACSID-11","authors":"Ghinassi S, Fioravanti G, Donati MA, Primi C, Loscalzo Y, Casale S.","first_author":"Ghinassi S","journal":"Addictive behaviors","year":2026,"pub_types":["Journal Article"],"keywords":["Screening test","Diagnostic criteria","Confirmatory Factor Analysis","Behavioral Addictions","Icd-11","Gaming Disorder","Online Gambling Disorder","Problematic Social Network Use","Acsid-11","Problematic Online Pornography Use","Compulsive Online Shopping"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1263 Italian participants completing a self‑report instrument (ACSID‑11) and related questionnaires; factor analysis performed","sample_n":1263,"sample_text":"community sample, convenience recruitment (details not provided in abstract)","population":"adults 18‑83, community sample, majority female, Italy","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created an Italian version of a questionnaire that measures five types of problematic internet use, including online pornography, using ICD‑11 criteria. In over 1,200 adults, the scale showed a solid four‑factor structure and related to depression, anxiety, and life satisfaction, suggesting it is a reliable tool.","clinical_takeaway":"The ACSID‑11 can be used to screen for problematic online pornography use, but clinicians should also assess moral concerns and mental‑health factors.","confidence":0.85,"topic_tags":["pornography","sexual_function","csbd","measurement","prevalence"],"strengths":["Large sample size for psychometric validation","Comprehensive factor‑analytic testing (CFA, second‑order models)","Includes convergent and criterion validity with mental‑health measures"],"limitations":["Cross‑sectional convenience sample; limited generalisability","No assessment of moral incongruence or masturbation, important for pornography‑related distress","Reliance on self‑report; frequency and distress not separated"],"rubric_version":"2.0","raw_total":39,"max_possible":60,"pct_score":65,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":8,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2025.108580"}},{"id":965,"doi":"10.1007/s10508-024-02905-6","pmid":"38997575","pmcid":"PMC11390849","title":"Women's Pornography Use Patterns and Sexuality Education in U.S. Public Schools","authors":"Fraumeni-McBride J, Willoughby BJ.","first_author":"Fraumeni-McBride J","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexuality Education","Women’s Sexual Health","Women’s Sexuality","Abstinence Only Sexuality Education","Women’s Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11390849","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of women attending U.S. public schools, self‑reported pornography use and school‑based sexuality education","sample_n":null,"sample_text":"sample of women attending U.S. public schools who reported regular pornography use","population":"women (adolescent‑adult) in U.S. public schools who report regular pornography use","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A US survey of women found that about 60% use pornography, with higher use among those who received abstinence‑only sex education. Most see porn as a way to learn about pleasure, but prefer other methods for formal sexuality education.","clinical_takeaway":"Consider comprehensive sexuality education that includes discussion of pleasure, rather than assuming abstinence‑only curricula reduce porn use.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses understudied topic of women's pornography use","Links sexuality education type to usage patterns","Provides policy‑relevant discussion"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on self‑report, no validated addiction or use scales","Potential unmeasured confounds (moral attitudes, mental health, relationship status)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02905-6"}},{"id":968,"doi":"10.21203/rs.3.rs-5820398/v1","pmid":null,"pmcid":null,"title":"Risky Sexual Behavior and Associated Factors Among Secondary School Students in Mirab Abaya District, Southern Ethiopia, 2024","authors":"Hailegiorgis Y, Kondale M, Gebru Z, Hailegiorgis E.","first_author":"Hailegiorgis Y","journal":"Research Square","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-5820398/v1","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"school‑based cross‑sectional survey of 389 secondary‑school students selected by simple random sampling; self‑administered questionnaire; binary logistic regression used to identify factors associated with risky sexual behaviour.","sample_n":389,"sample_text":"389 participants (95% response rate) selected by simple random sampling from schools in the district","population":"secondary school students in Mirab Abaya district, Southern Ethiopia (N≈389)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 389 Ethiopian secondary‑school students, 30% reported risky sexual behaviour. Watching pornographic movies was linked to twice the odds of such behaviour, alongside substance use, low parental monitoring, peer pressure, and limited knowledge about sexuality.","clinical_takeaway":"Porn exposure is associated with higher risky sexual behaviour among adolescents; sexual‑health education should address media influences.","confidence":0.7,"topic_tags":["adolescents","relationships","sexual_function","religiosity"],"strengths":["Reasonably large sample for a school‑based survey","Use of multivariable logistic regression with confidence intervals","Random sampling of schools"],"limitations":["Cross‑sectional design cannot establish causality","Key constructs (risky sexual behaviour, porn exposure) not measured with validated scales","Potential unmeasured confounders (mental health, moral/religious factors, trauma)","Self‑report may be subject to social desirability bias"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-5820398/v1"}},{"id":969,"doi":"10.2196/48968","pmid":"37862090","pmcid":"PMC10625075","title":"Effectiveness of a Theory-Based Digital Animated Video Intervention to Reduce Intention and Willingness to Sext Among Diploma Students: Cluster Randomized Controlled Trial","authors":"Mansor N, Ahmad N, Md Said S, Tan KA, Sutan R.","first_author":"Mansor N","journal":"Journal of medical Internet research","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Randomized Controlled Trial","Journal Article"],"keywords":["Intention","Randomized controlled trial","Sexual Health","Young Adult","Attrition rate","Willingness","Sexual Risk","Youtube","Primary Outcome","Sexting","Whatsapp","Digital Health Intervention","Digital Content","Malaysia, Diploma Students"],"is_oa":true,"oa_url":"https://www.jmir.org/2023/1/e48968/PDF","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Cluster randomized controlled trial with 300 diploma students across 12 programs, 2‑armed parallel design, single‑blinded, 3‑month follow‑up.","sample_n":300,"sample_text":"300 participants (after 8.3% attrition)","population":"Diploma students (young adults) in Malaysia, n≈300","country":"Malaysia","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A digital animated‑video program based on the prototype willingness model reduced Malaysian diploma students' intentions and willingness to sext over three months, also improving knowledge and attitudes about sexting.","clinical_takeaway":"Brief, theory‑driven video interventions may lower young adults' intention to sext and improve related attitudes.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Cluster RCT with control group","Adequate sample size","Use of theory‑based (PWM) intervention","Effect sizes and mixed‑model analysis reported"],"limitations":["Constructs measured with unreported/unclear validation","Limited control of key psychosocial confounds (e.g., moral incongruence, mental health)","Self‑report outcomes only"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":29,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/48968"}},{"id":970,"doi":"10.31234/osf.io/hkj6b","pmid":null,"pmcid":null,"title":"Influence of Pornography Consumption on Brain Chemistry: Neuroscientific Insights","authors":"Rasool F.","first_author":"Rasool F.","journal":"PsyArXiv","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://osf.io/hkj6b/download","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary with no empirical data presented","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The preprint argues that watching porn may change brain chemistry and harm executive functions, but provides no data or clear definitions to support these claims.","clinical_takeaway":"None - not clinically applicable.","confidence":0.6,"topic_tags":["pornography","neuroscience","sexual_function"],"strengths":["Raises a timely topic","Highlights potential neurochemical concerns"],"limitations":["No empirical data or methods provided","Lacks operational definitions and measurement detail","No control for known confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/hkj6b"}},{"id":971,"doi":"10.1016/j.psyneuen.2023.106060","pmid":"36863130","pmcid":null,"title":"Sexual attraction to visual sexual stimuli in association with steroid hormones across menstrual cycles and fertility treatment","authors":"Schön V, Hengartner MP, Tronci E, Mancini T, Ille F, Röblitz S, Krüge T, Leeners B.","first_author":"Schön V","journal":"Psychoneuroendocrinology","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Multicenter Study","Journal Article"],"keywords":["Testosterone","Progesterone","Estradiol","menstrual cycle","In Vitro Fertilization","Sexual Attraction"],"is_oa":false,"oa_url":"https://doi.org/10.1016/j.psyneuen.2023.106060","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective longitudinal multisite study with repeated measures across menstrual cycles and IVF treatment; n≈88–44 per group","sample_n":200,"sample_text":"88 and 68 women in two natural cycles, 44 women in IVF cohort","population":"women, naturally cycling and undergoing IVF","country":"unspecified (multicenter, likely Europe)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured women’s attraction to sexually explicit pictures while tracking hormone levels across menstrual cycles and during IVF. Neither natural fluctuations nor the huge rise in estradiol during IVF changed how attracted participants felt to the images.","clinical_takeaway":"Hormone levels alone may not explain changes in women’s visual sexual attraction.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Longitudinal within‑subject design","Hormone assays objectively measured","Large hormonal range via IVF stimulation","Multiple time points across cycles"],"limitations":["Sexual attraction assessed with unvalidated visual analogue scales","No effect‑size reporting or pre‑registration","Sample not population‑representative","Potential self‑selection bias (volunteers for IVF study)"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psyneuen.2023.106060"}},{"id":974,"doi":"10.1089/cyber.2015.0334","pmid":"26484980","pmcid":"PMC4642829","title":"Sexting Among Married Couples: Who Is Doing It, and Are They More Satisfied?","authors":"McDaniel BT, Drouin M.","first_author":"McDaniel BT","journal":"Cyberpsychology, behavior and social networking","year":2015,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 180 wives and 175 husbands; self‑report measures of sexting frequency and relationship satisfaction; statistical associations reported","sample_n":355,"sample_text":"180 wives and 175 husbands (total N≈355)","population":"married/cohabiting adults (mostly middle‑aged)","country":"not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 350 married adults, about a third reported exchanging sexy text messages and 12% sent nude pictures. Sexy texting was linked to higher relationship satisfaction for couples with avoidant attachment, while explicit pictures boosted satisfaction for men and for women with anxious attachment, but also increased ambivalence.","clinical_takeaway":"Sexting can be associated with relationship satisfaction in married couples, especially when attachment styles are considered; clinicians should explore couples’ communication preferences rather than assume harm.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Reasonably large community sample of married couples","Differentiates types of sexting (sexy talk vs explicit photos)","Considers partner attachment styles as moderators"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on self‑report; unclear if validated scales used","No control for moral or mental‑health variables that could affect satisfaction"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":38,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2015.0334"}},{"id":978,"doi":"10.1007/s10508-024-02899-1","pmid":"38858232","pmcid":null,"title":"Associations Between Pornography Use Through Different Media and Sexual and Relationship Satisfaction Among Cohabiting Couples","authors":"Nolin MC, Bőthe B, Villeneuve E, Vaillancourt-Morel MP.","first_author":"Nolin MC","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Media","Couples","Sexual Satisfaction","Relationship Satisfaction","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 706 cohabiting adult couples (N=1368 participants); actor‑partner interdependence modeling","sample_n":1368,"sample_text":"706 adult couples (1368 participants)","population":"adult cohabiting couples, mean age 32, recruited via online panels (likely convenience sample)","country":"unspecified (likely Canada/Europe based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 706 couples, more frequent use of porn videos and pictures was linked to lower sexual and relationship satisfaction for both partners, while audio porn was linked to higher satisfaction for women but lower for their male partners.","clinical_takeaway":"Higher video or picture porn use may be associated with reduced sexual and relationship satisfaction in couples.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Large sample of couples (N>1300)","Dyadic analytic approach (actor‑partner interdependence)","Differentiates pornography media types"],"limitations":["Cross‑sectional, cannot infer causality","Convenience online sample, limited generalizability","No measurement of key confounds (e.g., moral incongruence, mental health, masturbation)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02899-1"}},{"id":979,"doi":"10.20944/preprints202308.0711.v1","pmid":null,"pmcid":null,"title":"Young Women’s Attitudes and Concerns on Pornography and Their Sexual Experiences: A Qualitative Approach","authors":"Fernández-Ruiz M, López-Entrambasaguas OM, Martínez-Linares JM, Granero-Molina J.","first_author":"Fernández-Ruiz M","journal":"Preprints.org","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.preprints.org/manuscript/202308.0711/v1/download","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 22 university women","sample_n":22,"sample_text":"22 participants","population":"female university students (N=22) in Spain, recruited via convenience sampling","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 22 Spanish university women showed they see porn as shaping their sexual learning, often feeling uncomfortable with mainstream depictions and linking porn to negative sexual experiences and difficulties refusing unwanted acts.","clinical_takeaway":"Clinicians should recognize that young women may attribute sexual challenges to porn and consider integrating assertiveness and consent training into sexual‑health counseling.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["In‑depth, participant‑led insights","Use of COREQ reporting standards","Provides contextual information for sexual education"],"limitations":["Small, non‑representative convenience sample","No measurement of key confounds (e.g., moral incongruence, mental health)","Findings based on self‑report, no triangulation with other data"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202308.0711.v1"}},{"id":982,"doi":"10.1002/hbm.26711","pmid":"38798103","pmcid":"PMC11128778","title":"Appetitive conditioning with pornographic stimuli elicits stronger activation in reward regions than monetary and gaming-related stimuli","authors":"Krikova K, Klein S, Kampa M, Walter B, Stark R, Klucken T.","first_author":"Krikova K","journal":"Human brain mapping","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["fMRI","Nucleus accumbens","Anterior cingulate cortex","Appetitive Conditioning","Reward Value","Gaming","Mofc","Pornography"],"is_oa":true,"oa_url":"https://doi.org/10.1002/hbm.26711","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subject fMRI appetitive‑conditioning paradigm comparing pornographic, monetary and gaming rewards (N=31).","sample_n":31,"sample_text":"Thirty‑one subjects","population":"general adult population (young adults), convenience sample","country":"Germany (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a brain‑scan experiment, watching pornographic images produced stronger activity in reward‑related brain areas than receiving money or video‑game rewards, suggesting porn may have a higher appetitive value.","clinical_takeaway":"None – the study does not address treatment or clinical outcomes.","confidence":0.7,"topic_tags":["pornography","neuroscience","religiosity","sexual_function"],"strengths":["Novel comparison of primary vs secondary rewards","Use of multimodal measures (subjective, physiological, neural)","Within‑subject design reduces inter‑individual variance"],"limitations":["Small fMRI sample limits reliability","No assessment of moral or psychological confounds","Findings limited to neural activation, not clinical relevance"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":4,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/hbm.26711"}},{"id":983,"doi":"10.1136/bmjsrh-2018-200085","pmid":"31030185","pmcid":null,"title":"Sexting and high sexual risk-taking behaviours among school youth in northern Ethiopia: estimating using prevalence ratio","authors":"Abrha K, Worku A, Lerebo W, Berhane Y.","first_author":"Abrha K","journal":"BMJ sexual & reproductive health","year":2019,"pub_types":["Journal Article"],"keywords":["School Youth","Pornography","Sexting","High Sexual Risk-taking Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey using multistage sampling of school youth in northern Ethiopia (N≈5306).","sample_n":5306,"sample_text":"5306 respondents completed the questionnaire","population":"school youth (aged approx. 15‑19) in northern Ethiopia","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 5,000 Ethiopian secondary school students, those who reported watching pornography or sending sexts were about two to three times more likely to engage in high‑risk sexual behaviours such as unprotected sex or multiple partners.","clinical_takeaway":"Clinicians working with adolescents should consider digital sexual content exposure when assessing sexual risk, but cannot infer that it causes risk behaviours.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, regionally representative sample (N>5000)","Use of a pre‑validated questionnaire","Adjusted prevalence ratios with confidence intervals"],"limitations":["Cross‑sectional design cannot establish causality","Key psychosocial confounders (e.g., moral beliefs, mental health) not measured","Outcome and exposure based on self‑report only"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjsrh-2018-200085"}},{"id":985,"doi":"10.1016/j.nedt.2022.105322","pmid":"35263709","pmcid":null,"title":"Digital professionalism on social media: The opinions of undergraduate nursing students","authors":"O'Connor S, Odewusi T, Smith PM, Booth RG.","first_author":"O'Connor S","journal":"Nurse education today","year":2022,"pub_types":["Journal Article"],"keywords":["Students","Nursing","Education","Professionalism","Social Media","E-professionalism","Digital Professionalism","Online Professionalism"],"is_oa":false,"oa_url":"https://doi.org/10.1016/j.nedt.2022.105322","cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive cross‑sectional survey of 112 undergraduate nursing students in the UK, using an adapted questionnaire; convenience sample.","sample_n":112,"sample_text":"Convenience sample recruited across all four years of a Bachelor of Nursing programme.","population":"Undergraduate nursing students (UK)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 112 UK nursing students found most see posting alcohol‑related or sexually explicit material online as unprofessional, but opinions on taking photos at work varied. Students were aware of regulator guidance, yet practice may differ from beliefs.","clinical_takeaway":"Educators should reinforce professional social‑media guidelines, as student opinions may not fully align with best practice.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear focus on nurses' opinions about digital professionalism.","Reasonable sample size for an exploratory survey.","Use of an existing questionnaire, providing some continuity with prior work."],"limitations":["Questionnaire adapted but not psychometrically re‑validated for this context.","Convenience sample limits generalisability to all nursing students.","Only descriptive statistics; no hypothesis testing or power justification."],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":50,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.nedt.2022.105322"}},{"id":986,"doi":"10.1016/j.jadohealth.2019.11.300","pmid":"31937483","pmcid":null,"title":"An Exploratory Study of Transactional Sexting Among High School Students","authors":"Van Ouytsel J, Walrave M, Ponnet K.","first_author":"Van Ouytsel J","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2020,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescents","Sexual Behaviors","Transactional Sex","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 2,626 high‑school students; convenience school sample; no longitudinal follow‑up","sample_n":2626,"sample_text":"2,626 high‑school students (58.4 % female)","population":"adolescents (14‑21 y) in Belgium (presumably); mixed gender; not treatment‑seeking","country":"Belgium (inferred from authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 2,600 Belgian high‑school students, about 1 % reported sending sexual images or videos in exchange for something else. Those who did were more often male, identified as sexual minorities, repeated a school year, and were sexually active, and they showed higher sexual‑risk behaviours.","clinical_takeaway":"Clinicians should consider asking about transactional sexting when counselling adolescents, as it is linked to broader sexual‑risk behaviours.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large community sample of adolescents","focus on a specific, under‑studied behaviour (transactional sexting)","identifies demographic correlates (gender, sexual minority status)"],"limitations":["cross‑sectional design; no causal inference","transactional sexting measured with a single self‑report item, unclear validation","no control for key confounds (moral incongruence, mental health, trauma, etc.)"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":0,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2019.11.300"}},{"id":987,"doi":"10.20944/preprints202412.1945.v1","pmid":null,"pmcid":null,"title":"Exploring the Intersection of Hegemonic Masculinity, Sexuality, and Addiction in Men: A Qualitative Study","authors":"Camacho-Ruiz JA, Galvez -Sánchez CM, Galli F, Limiñana-Gras RM.","first_author":"Camacho-Ruiz JA","journal":"Preprints.org","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.20944/preprints202412.1945.v1","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"qualitative interview study with 14 purposively sampled men in a therapeutic community (Spain), using conventional content analysis","sample_n":14,"sample_text":"Fourteen participants selected through purposive sampling until data saturation.","population":"men in addiction treatment (therapeutic community)","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 14 men in a Spanish addiction treatment centre reveal that ideas of ‘hegemonic masculinity’ – such as pressure to be always sexually available – are linked to heavy use of porn and prostitution, substance abuse, and sexual problems.","clinical_takeaway":"Clinicians should consider how gender expectations may interact with sexual behaviour and addiction when planning treatment.","confidence":0.7,"topic_tags":["masturbation","pornography","sexual_function","gender"],"strengths":["Adheres to SRQR and COREQ reporting standards","In‑depth semi‑structured interviews and participant observation","Focus on gendered cultural context of addiction"],"limitations":["Very small, non‑representative purposive sample from a treatment setting","No measurement of key confounds (moral incongruence, masturbation, mental health, trauma)","Qualitative themes not linked to validated addiction or sexual‑health scales"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202412.1945.v1"}},{"id":988,"doi":"10.1177/1524838020906533","pmid":"32100637","pmcid":null,"title":"Nonconsensual Porn as a Form of Intimate Partner Violence: Using the Power and Control Wheel to Understand Nonconsensual Porn Perpetration in Intimate Relationships","authors":"Eaton AA, Noori S, Bonomi A, Stephens DP, Gillum TL.","first_author":"Eaton AA","journal":"Trauma, violence & abuse","year":2021,"pub_types":["Journal Article"],"keywords":["Sexual Abuse","Intimate Partner Violence","Power And Control Wheel","Revenge Porn","Nonconsensual Porn","Digital Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"summative content analysis of U.S. news stories (2012‑2017) about nonconsensual porn in intimate partnerships","sample_n":null,"sample_text":"not applicable (secondary analysis of news articles)","population":"media reports; no human participants surveyed","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined U.S. news articles about nonconsensual porn shared by intimate partners, finding that perpetrators use many tactics from the Power and Control Wheel, especially emotional abuse, coercion, and denial. Framing this behavior as partner violence may help guide prevention and trauma‑informed support.","clinical_takeaway":"Clinicians should recognize nonconsensual porn as a potential form of intimate partner violence and address it within trauma‑focused interventions.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Innovative application of Power and Control Wheel to a novel form of abuse","Systematic time‑bounded collection of news reports"],"limitations":["Relies on secondary media sources, not direct victim data","No empirical measurement of victim impact or perpetrator motives","Limited generalisability beyond reported cases"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":66,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1524838020906533"}},{"id":991,"doi":"10.3758/s13428-024-02418-z","pmid":"38693442","pmcid":"PMC11362205","title":"The standardization of a new Explicit Pornographic Picture Set (EPPS)","authors":"Prantner S, Giménez-García C, Espino-Payá A, Escrig MA, Ruiz-Padial E, Ballester-Arnal R, Pastor MC.","first_author":"Prantner S","journal":"Behavior research methods","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual Attraction","Pornography","Visual Sexual Stimuli","Affective Ratings","Picture Set"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11362205","cited_by_count":4,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"319 young adult participants rated 192 explicit pornographic pictures on valence, arousal, dominance and discrete emotions; convenience sample; no pre‑registration reported.","sample_n":319,"sample_text":"Convenience sample of university‑age participants recruited online","population":"young adults (mean age 22.7, SD 4.7), mixed gender and sexual attraction","country":"unspecified (likely Spain based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created a new library of 192 explicit pornographic pictures and had 319 young adults rate each for pleasure, arousal, dominance and emotions like disgust or moral acceptance. The ratings show how gender and sexual attraction affect perception, and the set is now publicly available for research.","clinical_takeaway":"None – the study provides a research tool, not clinical guidance.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large set of diverse explicit images","Systematic affective rating of each picture","Provides technical image parameters for researchers"],"limitations":["Convenience, WEIRD sample; limited generalisability","No measurement of participants' own sexual behaviours or mental‑health covariates","No pre‑registration or detailed reporting of effect‑size precision"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3758/s13428-024-02418-z"}},{"id":992,"doi":"10.32388/ogzu2f.3","pmid":null,"pmcid":null,"title":"Learning Sexuality and Consent: A Qualitative Study on the Experiences of Young French Adults","authors":"Gilles-Noguès E, Cruz GV, Megalakaki O.","first_author":"Gilles-Noguès E","journal":"Qeios","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.32388/ogzu2f.3","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study (Interpretative Phenomenological Analysis) with 14 participants","sample_n":14,"sample_text":"Convenience sample, recruited for semi‑structured interviews","population":"young French adults (Toulouse and Paris regions)","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 14 French young adults showed that peers and pornography are the main ways they learn about sexuality and consent. Many rely on implicit signals, and some reported non‑consensual experiences, indicating current sex‑education is insufficient.","clinical_takeaway":"Sex‑education programs should expand content and frequency, emphasizing explicit consent communication and psychosocial skills.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight into young adults’ learning sources","Use of IPA provides systematic thematic analysis","Highlights real‑world implications for consent education"],"limitations":["Very small, non‑representative sample","No validated measurement instruments","No assessment of potential confounders (e.g., mental health, moral attitudes)","Findings limited to two French regions"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.32388/ogzu2f.3"}},{"id":994,"doi":"10.1177/08862605241246007","pmid":"38666663","pmcid":null,"title":"Pornography Use and Sexual Coercion: Examining the Importance of Frequency, Type, and Other Factors","authors":"Marshall EA.","first_author":"Marshall EA.","journal":"Journal of interpersonal violence","year":2024,"pub_types":["Journal Article"],"keywords":["Sexual Aggression","Sexual Coercion","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 365 college males assessing self‑reported pornography use aspects and sexual coercion.","sample_n":365,"sample_text":"college males","population":"college men (likely US, age 18‑24)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 365 college men, the study found that how much money they spend on porn and the sexual scripts they adopt from it are linked to self‑reported sexual coercion, while simply watching porn often is not.","clinical_takeaway":"Clinicians should note that attitudes and investments related to porn, rather than frequency alone, may be related to coercive behavior.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a single‑site survey","Considers multiple dimensions of pornography use beyond frequency","Highlights role of sexual scripts and monetary investment"],"limitations":["Reliance on self‑report measures of uncertain psychometric quality","Cross‑sectional design cannot infer causality","No control for key confounds (e.g., mental health, prior trauma, moral attitudes)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605241246007"}},{"id":995,"doi":"10.1080/00224499.2025.2565660","pmid":"41065650","pmcid":null,"title":"The Rise of Spanking, Hitting, and Strangulation: A Longitudinal Evaluation of Aggression in Pornography","authors":"Shor E, Liu X.","first_author":"Shor E","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Longitudinal content analysis of 255 popular Pornhub videos from 2000‑2024, examining prevalence and trends of physical aggression (spanking, hitting, choking).","sample_n":255,"sample_text":"255 videos sampled from Pornhub over 25 years","population":"Pornhub video corpus (popular videos)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined 255 popular porn videos from 2000‑2024 and found that depictions of physical aggression, especially spanking, have risen sharply over the past two decades.","clinical_takeaway":"None – the study describes trends in porn content, not clinical effects on viewers.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large temporal span (25 years) allows trend analysis","Systematic sampling of popular videos","Clear coding of aggression types"],"limitations":["Unclear whether coding scheme was validated","Sample limited to popular Pornhub videos, not representative of all porn","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2025.2565660"}},{"id":996,"doi":"10.3389/fsoc.2024.1349549","pmid":"38726390","pmcid":"PMC11080982","title":"Barriers and recommendations for parent-child conversations about pornography","authors":"Dawson K, Gabhainn SN, Friday R, MacNeela P.","first_author":"Dawson K","journal":"Frontiers in sociology","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sex Education","Sexual Health","Pornography","Sexual Information","Porn Literacy","Adolescent—parent Communication","Parent—adolescent Relationship"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11080982","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"mixed-methods (qualitative interviews n=14 + quantitative survey n=408)","sample_n":408,"sample_text":"14 interviewed parents; 408 survey respondents","population":"parents of pre‑adolescent and adolescent children","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study explored why parents rarely talk with their children about pornography. Interviews with 14 parents identified three main barriers—practical ability, attitudes, and perceived benefits. A follow‑up survey of 408 parents confirmed these themes, noting especially that many parents felt unsure how to define and discuss pornography appropriately.","clinical_takeaway":"Clinicians should recognise that many parents feel unprepared to discuss pornography; providing clear, age‑appropriate resources may help bridge this gap.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large survey sample (n≈400) for quantitative phase","Integration of qualitative insights to develop survey items","Focus on an under‑researched practical issue"],"limitations":["No validated scales for barriers or attitudes","Convenience sampling likely; limited generalisability","No assessment of potential confounds (e.g., parental religiosity, mental health)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":0,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fsoc.2024.1349549"}},{"id":997,"doi":"10.1089/cyber.2010.0189","pmid":"21332367","pmcid":null,"title":"The influence of sexually explicit Internet material and peers on stereotypical beliefs about women's sexual roles: similarities and differences between adolescents and adults","authors":"Peter J, Valkenburg PM.","first_author":"Peter J","journal":"Cyberpsychology, behavior and social networking","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Two-wave nationally representative panel surveys of Dutch adolescents (N=1,445) and adults (N=833) with structural equation modeling","sample_n":2288,"sample_text":"1,445 adolescents and 833 adults","population":"adolescents and adults from the Netherlands","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study used two large Dutch panel surveys to examine whether watching online sexual material and peer attitudes shape the belief that women say \"no\" but actually want sex. Peers with traditional views increased this belief for both adolescents and adults, but only adults showed a direct influence from online sexual material.","clinical_takeaway":"None – the findings concern attitudes about gender roles rather than clinical sexual‑health issues.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender","adolescents","csbd"],"strengths":["Large, nationally representative samples","Longitudinal panel design allows temporal ordering","Use of structural equation modeling to test mediation"],"limitations":["Reliance on self‑report measures without validation evidence","Potential unmeasured confounders (e.g., personality, media literacy)","No pre‑registration or reported effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":44,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2010.0189"}},{"id":998,"doi":"10.1016/j.comppsych.2025.152640","pmid":"41106056","pmcid":null,"title":"Approach tendencies towards pornographic material in compulsive sexual behavior disorder: insights from the sex@brain study","authors":"Engel J, Veit M, Budnik L, Antons S, Sinke C, Kruger THC.","first_author":"Engel J","journal":"Comprehensive psychiatry","year":2025,"pub_types":["Journal Article"],"keywords":["neuropsychology","Hypersexual Behavior","Compulsive Sexual Behavior Disorder","Approach-avoidance Tendencies"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross-sectional experimental laboratory study comparing CSBD patients (n=43) to controls (n=37) on a modified approach‑avoidance task using pornographic pictures","sample_n":80,"sample_text":"43 CSBD men, 37 control men","population":"heterosexual men, mean age ~37, clinical CSBD sample vs non‑CSBD controls","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab test, men diagnosed with compulsive sexual behavior showed faster hand movements toward porn pictures and spent longer looking at them compared with men without the disorder, suggesting stronger automatic approach tendencies.","clinical_takeaway":"CSBD may involve heightened automatic attraction to pornographic cues; therapeutic approaches could target these implicit tendencies.","confidence":0.7,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Uses objective behavioral task (AAT) rather than self‑report","Includes a clinical CSBD group and matched control group"],"limitations":["CSBD diagnosis and criteria not described; possible circular definition","No measurement or control of key confounds (morality, masturbation, mental health, relationship status, trauma)","Small sample size per group; limited power for detecting subtle effects"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2025.152640"}},{"id":999,"doi":"10.1177/0886260520967143","pmid":"33107396","pmcid":null,"title":"Image-based Abuse: Debate and Reflections on the \"Iveco Case\" in Spain on Twitter","authors":"Idoiaga Mondragon N, Santamaria MD, Txertudi MB, Saez IA.","first_author":"Idoiaga Mondragon N","journal":"Journal of interpersonal violence","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Violence Against Women","Twitter","Sexting","Revenge Porn","Image-based Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Lexical content analysis of 1,895 tweets collected via Twitter streaming API; automatic cluster analysis (Iramuteq, Reinert method).","sample_n":1895,"sample_text":"1,895 tweets containing the term \"Iveco\" posted from Spain (Twitter).","population":"Tweets from users in Spain mentioning \"Iveco\"; no human participants recruited.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined 1,895 Spanish tweets about the 2019 \"Iveco\" image‑based abuse case, using automatic text‑analysis to identify how the incident was discussed, including themes of gender‑based violence and counter‑movements.","clinical_takeaway":"None – the paper offers sociocultural insight rather than clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large collection of real‑world social‑media data","Systematic lexical clustering method","Clear description of the case context"],"limitations":["No validated psychometric measures","Cannot infer participants’ motivations or mental health","Twitter sample may not represent broader public opinion"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260520967143"}},{"id":1000,"doi":"10.1007/s10389-024-02262-7","pmid":"41583107","pmcid":"PMC12823706","title":"Exposure to pornographic material and perpetration of intimate partner violence among young men in Mwanza Tanzania","authors":"Aloyce D, Stöckl H, Mosha N, Malibwa D, Sichalwe S, Hashim R, Ayieko P, Kapiga S, Mshana G.","first_author":"Aloyce D","journal":"Journal of public health (Berlin, Germany)","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Africa","Young men","Pornography","Intimate Partner Violence Perpetration","Negative Masculinity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12823706","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1002 randomly selected young men (828 analyzed) in Mwanza, Tanzania","sample_n":828,"sample_text":"randomly selected young men aged 18‑24; 828 ever‑partnered men analyzed","population":"young men aged 18‑24, Mwanza, Tanzania","country":"Tanzania","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 828 Tanzanian men aged 18‑24, those who watched pornography at least weekly were about twice as likely to report having committed sexual, emotional, or physical violence against a partner in the past year.","clinical_takeaway":"Higher pornography exposure is linked with IPV, but causal claims are unwarranted; clinicians should assess multiple risk factors when addressing violence.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Large community‑based random sample","Clear reporting of adjusted odds ratios with confidence intervals","Focus on LMIC context where data are scarce"],"limitations":["Cross‑sectional design cannot establish causality","Use of single‑item self‑report measures for pornography exposure and IPV","No measurement of key confounds such as moral attitudes, mental health, or masturbation"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10389-024-02262-7"}},{"id":1001,"doi":null,"pmid":"26944746","pmcid":null,"title":"Minors and Sexting: Legal Implications","authors":"Lorang MR, McNiel DE, Binder RL.","first_author":"Lorang MR","journal":"The journal of the American Academy of Psychiatry and the Law","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Legal review with case examples; no empirical data collected.","sample_n":null,"sample_text":"Not applicable – no primary data collection.","population":"Minors involved in sexting (no sample reported)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews U.S. laws about minors who send sexually explicit images via cell phones, showing how statutes vary and can lead to charges ranging from felonies to none, and discusses two cases where sexting was followed by suicide.","clinical_takeaway":"Clinicians should understand the legal risks of teen sexting and consider forensic mental health input when supporting affected youths.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of state statutes","Includes illustrative case examples","Addresses role of forensic mental health professionals"],"limitations":["No primary empirical data","Lacks systematic methodology or risk‑of‑bias assessment","Potential bias toward legal perspective"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":1002,"doi":"10.1037/lhb0000616","pmid":"41196724","pmcid":null,"title":"The psychometric properties of the Child Pornography Offender Risk Tool (CPORT) in different subgroups of individuals convicted of offenses related to child sexual exploitation material (CSEM)","authors":"Seiser A, Eher R, Helmus LM, Turner D, Rettenberger M.","first_author":"Seiser A","journal":"Law and human behavior","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"retrospective file‑based cohort of 128 convicted CSEM offenders with 8.5‑year follow‑up, evaluating predictive validity of the German CPORT and a short version.","sample_n":128,"sample_text":"total N = 128; subsamples n = 104, 57, 47 for subgroup analyses","population":"adult offenders convicted of child sexual exploitation material offenses (Austrian prisons)","country":"Austria","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested a German version of the Child Pornography Offender Risk Tool on 128 Austrian prisoners convicted of child‑sex‑material offenses. The tool predicted re‑offending better than chance (AUC ≈ 0.70‑0.84) and performed similarly to the established Static‑99 risk score.","clinical_takeaway":"CPORT shows promise for assessing recidivism risk in CSEM offenders, but further validation is needed before routine use.","confidence":0.88,"topic_tags":["sexual_function"],"strengths":["Validated risk assessment instrument evaluated in a new language version","Long follow‑up (average 8.5 years) allowing assessment of recidivism","Reporting of effect sizes with confidence intervals"],"limitations":["Retrospective design, possible missing data in files","Moderate sample size limits precision of subgroup estimates","No external validation beyond the studied correctional setting"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/lhb0000616"}},{"id":1003,"doi":"10.1007/s10508-024-02848-y","pmid":"38553661","pmcid":null,"title":"Pornography Use and the Acceptance of Gender Norm Violation in a School Context","authors":"Laporte H, Eggermont S.","first_author":"Laporte H","journal":"Archives of sexual behavior","year":2024,"pub_types":["Journal Article"],"keywords":["Pornography","Gender Typicality","Gendered Attitudes","Gender Norm Violation","Script Application"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1,440 young adults (mean age ≈ 24); cross‑sectional mediation‑moderation analysis","sample_n":1440,"sample_text":"online convenience sample of university students and young adults","population":"students / young adults, convenience sample","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,440 young adults, men who reported higher pornography use tended to hold more traditional gender attitudes, which in turn made them less likely to accept violations of gender norms in school scenarios. The effect varied with how typical or atypical participants felt about their own gender.","clinical_takeaway":"None – the study addresses attitudinal outcomes, not clinical issues.","confidence":0.7,"topic_tags":["pornography","gender","sexual_function"],"strengths":["large sample size (N>1400)","novel focus on gender typicality as moderator","use of vignette‑based outcome measure"],"limitations":["cross‑sectional design limits causal inference","pornography use measured with unvalidated single‑item frequency","no measurement of key confounds (e.g., moral attitudes, mental health)","convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02848-y"}},{"id":1006,"doi":"10.1080/0092623x.2025.2559005","pmid":"40955103","pmcid":null,"title":"Attitudes Towards Pornography and Sexual Well-Being Among Young Women in the UK","authors":"Li Y, Ingham R, Armstrong H.","first_author":"Li Y","journal":"Journal of sex & marital therapy","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 306 young UK women (mean age 20.1) assessing attitudes toward pornography, sexual satisfaction, comfort with sex, emotion after use, frequency, and sexual communication; mediation analysis reported","sample_n":306,"sample_text":"306 women recruited in the UK (details of recruitment not provided in abstract)","population":"young adult women, UK, mean age 20.1, likely convenience sample","country":"United Kingdom","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 306 UK women aged about 20, more positive attitudes toward porn were linked to higher sexual satisfaction and comfort, mainly because these women communicated more about sex. Negative attitudes did not affect satisfaction, though they were tied to feeling uncomfortable after watching porn.","clinical_takeaway":"Positive, open attitudes toward porn may support sexual wellbeing, but clinicians should consider individual moral beliefs and relationship context.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Reasonably large sample (N=306)","Explores positive vs negative attitudes separately","Includes mediation analysis to probe pathways"],"limitations":["Cross‑sectional design; causal language is unwarranted","Key confounds (moral incongruence, masturbation, mental health) not measured","Unclear whether attitude and satisfaction scales are validated"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2025.2559005"}},{"id":1007,"doi":"10.34172/jrhs.11317","pmid":"41159205","pmcid":"PMC12555716","title":"Substance Misuse Pattern and Sexual Risk Behavior among Street Adolescents in Central Java, Indonesia","authors":"Shaluhiyah Z, Widjanarko B, Mustofa SB, Nugraha P.","first_author":"Shaluhiyah Z","journal":"Journal of research in health sciences","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Alcohol","Sexual behavior","Smoking","Street Youth","Substance Use","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12555716","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 248 street adolescents in Central Java, using face‑to‑face interviews and logistic regression to examine associations between substance use, pornography exposure and sexual risk behaviour.","sample_n":248,"sample_text":"248 street adolescents","population":"Street adolescents (aged ?), both sexes, Indonesia","country":"Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 248 Indonesian street adolescents, those who drank alcohol or reported frequent pornography exposure were three to four times more likely to engage in risky sexual behaviour. The study does not prove that pornography causes risk, only that the two occur together.","clinical_takeaway":"Frequent pornography exposure co‑occurs with sexual risk among vulnerable youth, but interventions should consider broader substance use and social factors rather than targeting pornography alone.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Reasonably large sample for a hard‑to‑reach population","Uses multivariate logistic regression to adjust for several covariates","Focuses on an understudied group (street adolescents in Indonesia)"],"limitations":["Cross‑sectional design prevents causal inference","Pornography exposure measured with single‑item, not validated scale","Key confounders (moral incongruence, masturbation, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.34172/jrhs.11317"}},{"id":1008,"doi":"10.1002/hec.4825","pmid":"38511292","pmcid":null,"title":"Pornography usage during adolescence: Does it lead to risky sexual behavior?","authors":"Mubasshera H.","first_author":"Mubasshera H.","journal":"Health economics","year":2024,"pub_types":["Journal Article"],"keywords":["Adolescence","Risky Sex","Pornography Consumption","Impact Of Media"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal panel data (National Study of Youth and Religion) with individual fixed‑effects and lagged dependent variable controls.","sample_n":null,"sample_text":"national panel, size not specified in abstract","population":"13‑ to 23‑year‑olds in the United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a U.S. panel of teens and young adults, the study finds that moderate to frequent porn use is linked to a higher chance of unprotected sex and having several partners later on.","clinical_takeaway":"Advertise that frequent pornography exposure may be a risk factor for unsafe sexual behavior among youth.","confidence":0.7,"topic_tags":["pornography","adolescents","religiosity"],"strengths":["Large, nationally‑representative longitudinal dataset","Individual fixed‑effects control for time‑invariant confounders","Lagged dependent variable reduces reverse causality"],"limitations":["Pornography use measured with unvalidated single‑item frequency","Key confounds (moral views, mental health, masturbation) not assessed","Causal language may overstep observational design"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/hec.4825"}},{"id":1009,"doi":"10.1016/j.encep.2023.12.004","pmid":"38519310","pmcid":null,"title":"The impact of Internet pornography on children and adolescents: A systematic review","authors":"Paulus FW, Nouri F, Ohmann S, Möhler E, Popow C.","first_author":"Paulus FW","journal":"L'Encephale","year":2024,"pub_types":["Systematic Review","Journal Article"],"keywords":["Children","Internet","Review literature","Adolescence","Pornographie","Enfants","Revue De Littérature","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic literature search of peer‑reviewed articles (2000‑2022) on pornography exposure and its impact on children/adolescents; narrative synthesis of associations with demographics, attitudes, behaviours, and sexual aggression.","sample_n":null,"sample_text":"Not reported in abstract; review of multiple primary studies","population":"Children and adolescents (no specific age range given)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review summarises research on how internet pornography exposure relates to attitudes, behaviours and risks among children and teens, noting many links but also many contradictory findings.","clinical_takeaway":"Evidence is mixed; clinicians should assess individual use and context rather than assume universal harm.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Comprehensive search across multiple databases","Focus on a vulnerable age group","Identifies a wide range of associated variables"],"limitations":["No reported risk‑of‑bias assessment for included studies","Reliance on narrative synthesis; no meta‑analysis or effect‑size reporting","Unclear how constructs (e.g., ‘impact’) were operationalised across studies"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.encep.2023.12.004"}},{"id":1010,"doi":"10.1016/j.anzjph.2024.100135","pmid":"38508985","pmcid":null,"title":"Pornography exposure and access among young Australians: a cross-sectional study","authors":"Crabbe M, Flood M, Adams K.","first_author":"Crabbe M","journal":"Australian and New Zealand journal of public health","year":2024,"pub_types":["Journal Article"],"keywords":["Sexuality","Media","Young People","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1,985 young Australians (15‑20 y), nationally representative demographics","sample_n":1985,"sample_text":"nationally representative cross‑sectional online survey","population":"young Australians, 15‑20 y, both sexes","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2024 Australian survey of nearly 2,000 teens and young adults found that most have seen porn, usually alone at home, with boys watching more often and earlier than girls. Exposure often precedes first sexual activity.","clinical_takeaway":"High prevalence of early porn exposure suggests clinicians should discuss media use with young patients, but no evidence of direct harm is provided here.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large, nationally representative sample","Clear descriptive data on exposure prevalence","Relevant public‑health focus"],"limitations":["Cross‑sectional; no causal inference","No validated measures of distress or addiction","Key confounds (morality, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.anzjph.2024.100135"}},{"id":1011,"doi":"10.1093/joc/jqae009","pmid":"38841539","pmcid":"PMC11149618","title":"Pornography, identification, alcohol, and condomless sex","authors":"Wright PJ, Tokunaga RS, Herbenick D.","first_author":"Wright PJ","journal":"The Journal of communication","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Alcohol","Identification","Condom","Self-regulation","Pornography","3Am","Forethought"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national probability survey, large sample, cross‑sectional interaction analysis","sample_n":null,"sample_text":"national probability data (large, representative)","population":"US adults (2022 National Survey of Sexual Health and Behavior)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Using a national US survey, the authors found that people who see porn more often are more likely to have condomless sex, especially when they strongly identify with the porn and have been drinking. Identification and alcohol together amplify the link.","clinical_takeaway":"Clinicians should note that identification with porn and alcohol use may heighten risk of condomless sex, but causal claims are unsupported.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["large, nationally representative sample","theoretically driven moderation analysis","focus on specific psychosocial mechanisms"],"limitations":["cross‑sectional; cannot infer causality","no control for key confounds (mood, relationship status, moral attitudes)","measurement relies on single‑item self‑reports, unclear validation"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/joc/jqae009"}},{"id":1014,"doi":"10.1177/08862605241234656","pmid":"38454619","pmcid":"PMC11465595","title":"Associations Between Pornography Use Frequency and Intimate Partner Violence Perpetration Among Young Adult Couples: A 2-Year Longitudinal Study","authors":"Vasquez M, Daspe MÈ, Bőthe B, Brassard A, Lussier Y, Vaillancourt-Morel MP.","first_author":"Vasquez M","journal":"Journal of interpersonal violence","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Young Adults","Longitudinal","Intimate Partner Violence","Couple","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11465595","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Convenience sample of 113 young‑adult couples followed for 2 years; self‑report online questionnaires at two time points; autoregressive cross‑lagged panel analysis.","sample_n":226,"sample_text":"113 couples (226 individuals)","population":"Young adult couples (age 16‑29) from a non‑probability sample (N = 113 couples).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2‑year study of 113 young adult couples, men’s and women’s frequency of watching pornography predicted higher sexual‑coercion aggression toward their partner later on, but not physical or psychological aggression.","clinical_takeaway":"Consider discussing pornography use when addressing sexual‑coercion risk in young‑adult couples.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Longitudinal dyadic design with cross‑lagged modeling","Distinguishes types of IPV (physical, psychological, sexual coercion)","Couple‑level data allows partner effects"],"limitations":["Convenience sample; limited external validity","Small N for cross‑lagged models; possible power issues","No measurement of key confounds (moral attitudes, mental health, masturbation)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605241234656"}},{"id":1015,"doi":"10.1007/s13178-024-00944-1","pmid":"40666497","pmcid":"PMC12259207","title":"\"We're all still learning about how to talk about porn\": Teacher and administrator perspectives about inclusion of education about pornography in Massachusetts high school sex education programs","authors":"Nelson KM, Campbell JK, Rahimian AN, Frieson TM, Moslander DE, Richardson VE, Rothman EF.","first_author":"Nelson KM","journal":"Sexuality research & social policy : journal of NSRC : SR & SP","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Qualitative","Adolescents","Sex Education","School","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"qualitative interview study with 9 teachers and 8 administrators in Massachusetts (n=17) examining perspectives on including pornography education in high‑school sex‑ed curricula.","sample_n":17,"sample_text":"9 teachers, 8 administrators","population":"high‑school health teachers and school administrators (Massachusetts, USA)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 17 Massachusetts high‑school teachers and administrators show strong interest in teaching about pornography, but also reveal political and logistical hurdles that need to be addressed for curriculum inclusion.","clinical_takeaway":"None – the study informs education policy rather than clinical practice.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Provides stakeholder voices on a policy‑relevant gap","Rich qualitative data from educators","Identifies concrete barriers and facilitators"],"limitations":["Small, non‑representative sample limited to one state","No validation of interview instrument reported","Findings may not generalize to other regions or school contexts"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":5,"retracted":false,"notices":[{"status":"Has correction","date":"2024-3-21","noticeDoi":"10.1007/s13178-024-00959-8","doi":"10.1007/s13178-024-00944-1"}],"url":"https://scite.ai/reports/10.1007/s13178-024-00944-1"}},{"id":1017,"doi":"10.21203/rs.3.rs-5013155/v1","pmid":null,"pmcid":null,"title":"Problematic Social Media Use and Depression among Addis Ababa University Regular Undergraduate Students: Institutional based Cross Sectional Study","authors":"Mekonnen H, Yacobe B, Assafaw A, Aberra H.","first_author":"Mekonnen H","journal":"Research Square","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-5013155/v1","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"institutional-based cross‑sectional survey of 316 undergraduates using stratified random sampling","sample_n":316,"sample_text":"Stratified random sample of undergraduates at Addis Ababa University main campus","population":"Addis Ababa University regular undergraduate students (N≈316)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 316 Ethiopian university students, 17% showed signs of problematic social‑media use. Those who watched pornography on social media were 14 times more likely to have depression, and problematic social‑media users had a 1.6‑fold higher odds of depression.","clinical_takeaway":"Screen for depression in students who use social media heavily, especially if they view pornography, but consider other mental‑health and moral factors.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Validated instruments for both exposure and outcome","Stratified random sampling within university","Clear reporting of prevalence and adjusted odds ratios"],"limitations":["Cross‑sectional design cannot infer causality","Key confounds (moral incongruence, masturbation, mental health comorbidities) not measured","Findings limited to one university, not generalizable"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-5013155/v1"}},{"id":1018,"doi":"10.21203/rs.3.rs-5191222/v1","pmid":null,"pmcid":null,"title":"Problematic Social Media Use and Depression among Addis Ababa University Students, Ethiopia: Institutional based Cross Sectional Study","authors":"Mekonnen H, Yacobe B, Assafaw A, Aberra H.","first_author":"Mekonnen H","journal":"Research Square","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-5191222/v1","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Institutional-based cross‑sectional survey of 316 university students selected by stratified random sampling; logistic regression used to examine association between problematic social‑media use (BSMAS) and depression (PHQ‑9).","sample_n":316,"sample_text":"Stratified random sample of students from the main campus.","population":"Undergraduate students at Addis Ababa University, Ethiopia (N≈316).","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 316 Ethiopian university students, about 17% showed problematic social‑media use, and those users were 1.6 times more likely to be depressed. Watching pornography on social media was linked to a 14‑fold higher odds of depression.","clinical_takeaway":"Problematic social‑media use, especially involving pornography, is associated with higher depression risk; clinicians should assess social‑media habits when evaluating student mental health.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Validated instruments for both exposure and outcome","Stratified random sampling enhances representativeness","Effect sizes with confidence intervals reported"],"limitations":["Cross‑sectional design precludes causal inference","Key confounds (moral incongruence, masturbation, trauma) not measured","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-5191222/v1"}},{"id":1019,"doi":"10.3390/healthcare13172083","pmid":"40941436","pmcid":"PMC12428175","title":"Psychological Violence in Image-Based Sexual Abuse (IBSA): The Role of Psychological Traits and Social Communications-A Narrative Review","authors":"Mento C, Praticò M, Silvestri MC, Lombardo C, Pira F.","first_author":"Mento C","journal":"Healthcare (Basel, Switzerland)","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Social Withdrawal","Victim Blaming","Technology Usage","Non-consensual Pornography","Non-consensual Intimate Images"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12428175","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review (SANRA guidelines), no primary data","sample_n":null,"sample_text":"Not applicable – narrative review","population":"victims of non‑consensual image distribution (IBSA)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review summarises research showing that victims of non‑consensual sharing of intimate images (often called revenge porn) frequently suffer anxiety, depression, social withdrawal, shame and other mental‑health problems.","clinical_takeaway":"Clinicians should screen for trauma, anxiety and depression in clients whose intimate images have been shared without consent.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Synthesises recent literature on IBSA psychological impact","Follows SANRA guidelines for narrative reviews"],"limitations":["No systematic search or quality appraisal reported","Lacks quantitative synthesis or meta‑analysis","No primary data; conclusions rely on cited studies"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare13172083"}},{"id":1020,"doi":"10.1007/s10508-020-01656-4","pmid":"32072397","pmcid":null,"title":"The Prevalence of Sexting Behaviors Among Emerging Adults: A Meta-Analysis","authors":"Mori C, Cooke JE, Temple JR, Ly A, Lu Y, Anderson N, Rash C, Madigan S.","first_author":"Mori C","journal":"Archives of sexual behavior","year":2020,"pub_types":["Meta-Analysis","Journal Article"],"keywords":["Meta-analysis","Emerging Adults","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":82,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Meta-analysis of prevalence across 50 studies (N=18,122). No mention of risk‑of‑bias assessment or preregistration, but large pooled sample provides reasonable generalisability to emerging adults.","sample_n":18122,"sample_text":"Aggregated from 50 primary studies","population":"emerging adults (≥18‑<29 years)","country":"multiple (global)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 50 studies shows that about two‑thirds of emerging adults have engaged in sexting, with roughly 15% reporting non‑consensual forwarding of such content.","clinical_takeaway":"Sexting is common among young adults; clinicians should be aware of its prevalence and the risk of non‑consensual sharing.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["Large pooled sample across many studies","Clear operational definitions of sexting categories","Provides confidence intervals for prevalence estimates"],"limitations":["Potential heterogeneity in primary study methods not fully explored","No explicit risk‑of‑bias assessment reported","Reliance on self‑report data"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":8,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":11,"contrasting":2,"mentioning":173,"citing_publications":258,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01656-4"}},{"id":1022,"doi":"10.1186/s12889-024-17853-y","pmid":"38317123","pmcid":"PMC10840255","title":"Pornography, sexual orientation and ambivalent sexism in young adults in Spain","authors":"Sanz-Barbero B, Estévez-García JF, Madrona-Bonastre R, Vicens GR, Serra L, Vives-Cases C.","first_author":"Sanz-Barbero B","journal":"BMC public health","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sex","Sexual Orientation","Hostile Sexism","Benevolent Sexism","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10840255","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 2,346 young adults (18‑35) in Spain; self‑report of current pornography consumption, sexual orientation, and ambivalent sexism (hostile and benevolent) scales; multiple regression controlling for age, sex, education, birthplace.","sample_n":2346,"sample_text":"2,346 participants aged 18‑35 years","population":"young Spanish adults, convenience sample (online/college?)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 2,300 Spanish young adults, people who watched pornography tended to show higher hostile sexism, especially lesbian/bisexual women, while both men and women who watched pornography reported lower benevolent sexism. Sexual orientation also shaped these patterns.","clinical_takeaway":"None – the study reports population‑level associations, not clinical guidance.","confidence":0.84,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Large sample size (N>2000) gives good statistical power","Use of established sexism scales with reported confidence intervals","Separate analysis for hostile and benevolent sexism"],"limitations":["Cross‑sectional design cannot establish causality","Pornography use measured only as current consumption, no frequency detail","No measurement of potential confounds such as moral attitudes, mental health, or masturbation"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":8,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":4,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-024-17853-y"}},{"id":1023,"doi":"10.1016/j.jsxm.2016.02.162","pmid":"26984122","pmcid":null,"title":"The Sexual Thoughts Questionnaire: Psychometric Evaluation of a Measure to Assess Self-Reported Thoughts During Exposure to Erotica Using Sexually Functional Individuals","authors":"Sigre-Leirós V, Carvalho J, Nobre PJ.","first_author":"Sigre-Leirós V","journal":"The journal of sexual medicine","year":2016,"pub_types":["Comparative Study","Journal Article"],"keywords":["Psychometric Properties","Sexual Arousal","Sexual Stimuli","Genital Response","Self-reported Thoughts","Psychophysiological Laboratory Studies"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"psychometric validation study with laboratory exposure to erotic stimuli; 167 sexually functional participants; factor analysis, reliability, convergent validity","sample_n":167,"sample_text":"sexually functional individuals recruited for laboratory study","population":"sexually functional adults (97 women, 70 men)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The Sexual Thoughts Questionnaire is a new self‑report tool that reliably captures what people think about while viewing erotic material, and its scores relate to how aroused they feel.","clinical_takeaway":"Clinicians can consider this questionnaire for research or assessment of sexual cognition, but its validity in clinical or disordered populations remains untested.","confidence":0.7,"topic_tags":["measurement","sexual_function","csbd"],"strengths":["Large (N=167) sample for psychometric work","Objective genital arousal measured alongside self‑report","Comprehensive factor analysis and reliability testing"],"limitations":["Convenience sample of sexually functional volunteers limits generalisability","No assessment of key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)","No pre‑registration or correction for multiple statistical tests reported"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2016.02.162"}},{"id":1024,"doi":"10.1007/s10508-020-01737-4","pmid":"32504234","pmcid":null,"title":"Use of the Bogus Pipeline Increases Sexual Concordance in Women But Not Men","authors":"Suschinsky KD, Fisher TD, Maunder L, Hollenstein T, Chivers ML.","first_author":"Suschinsky KD","journal":"Archives of sexual behavior","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Gender Differences","Sexual Arousal","Sexual Concordance","Social Role Theory","Bogus Pipeline"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment with bogus pipeline vs typical testing condition; physiological and self‑report measures; N≈97 (47 women, 50 men).","sample_n":97,"sample_text":"47 women, 50 men","population":"Adult men and women, likely convenience/academic sample","country":"Not specified (likely USA/Canada from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that telling women their sexual arousal responses were being monitored (a fake ‘bogus pipeline’) increased the match between how they felt and how their bodies responded, suggesting social expectations affect women's sexual concordance.","clinical_takeaway":"Social context can influence women's self‑perceived sexual arousal; clinicians should consider gender norms when assessing sexual response.","confidence":0.9,"topic_tags":["sexual_function","gender"],"strengths":["Validated physiological and self‑report measures of sexual arousal","Experimental manipulation of perceived monitoring","Use of multilevel modeling to analyze concordance"],"limitations":["Convenience sample limits generalizability","No pre‑registration or reported effect sizes","Limited control for broader psychosocial variables"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":2,"mentioning":15,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01737-4"}},{"id":1025,"doi":"10.1007/s10508-018-1159-x","pmid":"29392484","pmcid":null,"title":"Correction to: Associations Between Croatian Adolescents' Use of Sexually Explicit Material and Sexual Behavior: Does Parental Monitoring Play a Role?","authors":"Tomić I, Burić J, Štulhofer A.","first_author":"Tomić I","journal":"Archives of sexual behavior","year":2018,"pub_types":["Published Erratum","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Correction notice (erratum) providing updated figures for a previously published article; no new data collection.","sample_n":null,"sample_text":"Not applicable – the erratum does not report a sample.","population":"adolescents (as per original article, not detailed here)","country":"Croatia (original article context)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article corrects missing parts of three figures from a 2018 study on Croatian teens’ use of sexually explicit material and how parental monitoring relates to sexual behavior.","clinical_takeaway":"None – the correction does not provide new findings for clinical use.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Ensures visual data integrity for original study","Transparent correction process"],"limitations":["No new empirical data presented","Cannot assess methodological quality of original study from this notice"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1159-x"}},{"id":1026,"doi":"10.1007/s13178-021-00593-8","pmid":"35756362","pmcid":"PMC9230504","title":"A mixed methods study of sexuality education experiences and preferences among bisexual, pansexual, and queer (bi+) male youth","authors":"Mata D, Korpak AK, Sorensen B, Dodge B, Mustanski B, Feinstein BA.","first_author":"Mata D","journal":"Sexuality research & social policy : journal of NSRC : SR & SP","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Adolescents","Sex Education","Bisexual","Queer","Pansexual"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"mixed methods survey and interviews with 56 bi+ male youth (ages 14‑17); convenience sample; no longitudinal or experimental component","sample_n":56,"sample_text":"56 bi+ male youth ages 14-17 surveyed and interviewed","population":"bisexual, pansexual, queer (bi+) male youth, racially/ethnically diverse, US","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2022 mixed‑methods study surveyed 56 bisexual, pan‑sexual, and queer teen males about what they learned about sex in school and what they wish they had been taught. Most said school curricula ignored their needs; they turned to the internet and explicit media for information and wanted more instruction on same‑gender sex, anal sex, and consent.","clinical_takeaway":"Clinicians should recognize that bi+ teen males often lack adequate, inclusive sex education and may rely on online or explicit sources for information.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Addresses understudied bi+ male youth population","Mixed‑methods provides depth (interviews) and breadth (survey)","Diverse racial/ethnic sample for a niche group"],"limitations":["Small, non‑representative convenience sample (N=56)","Measures of education experiences appear author‑derived, not validated","No comparison group; findings descriptive only"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":25,"retracted":false,"notices":[{"status":"Has correction","date":"2022-5-19","noticeDoi":"10.1007/s13178-022-00726-7","doi":"10.1007/s13178-021-00593-8"}],"url":"https://scite.ai/reports/10.1007/s13178-021-00593-8"}},{"id":1027,"doi":"10.3389/fpsyg.2021.655796","pmid":"34040564","pmcid":"PMC8143518","title":"Prevalence and Correlates of Sext-Sharing Among a Representative Sample of Youth in the Netherlands","authors":"Boer S, Erdem Ö, de Graaf H, Götz H.","first_author":"Boer S","journal":"Frontiers in psychology","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Social Media","Sexting","Non-Consensual Sharing","Online Sexual Risk Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8143518","cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"nationally representative survey of 20,834 Dutch youth, logistic regression analysis","sample_n":20834,"sample_text":"large, probability‑based national sample","population":"Dutch adolescents and young adults aged 12‑24 (N=20,834)","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Dutch national survey of over 20,000 youths (12‑24 y), about 4 % admitted to sharing someone else's explicit image in the past six months. Sharing was more common among younger boys, frequent social‑media users, those who viewed porn, and those who had been victims of non‑consensual sharing themselves.","clinical_takeaway":"Preventive education on sexting should start early (age 12) and include media‑literacy to reduce non‑consensual sharing.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Very large, nationally representative sample","Appropriate logistic regression with complex‑sample weighting","Clear operational definition of sext‑sharing","Addresses a public‑health relevant behavior"],"limitations":["Cross‑sectional; cannot infer causality","Self‑report may involve social desirability bias","No measurement of moral or relational context","No longitudinal data on outcomes"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2021.655796"}},{"id":1028,"doi":"10.20944/preprints202409.0897.v1","pmid":null,"pmcid":null,"title":"Advanced ENF Region Classification Using UniTS-SinSpec: A Novel Approach Integrating Sinusoidal Activation Function and Spectral Attention","authors":"LI Y, LU T, ZENG G, ZHAO K, PENG S.","first_author":"LI Y","journal":"Preprints.org","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.20944/preprints202409.0897.v1","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"computational model evaluated on public ENF dataset; cross‑sectional algorithmic experiment","sample_n":null,"sample_text":"Dataset of ENF recordings (publicly available); no human sample","population":"N/A (no human participants)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors present a new AI model for classifying electric‑network‑frequency recordings by region, achieving 97% accuracy on a public dataset. While they propose applications such as detecting child‑pornography sources, the study does not involve human participants or sexual‑behaviour data.","clinical_takeaway":"None – the study does not provide directly applicable clinical information on pornography or sexual health.","confidence":0.8,"topic_tags":["neuroscience","sexual_function","csbd","pornography"],"strengths":["Introduces novel sinusoidal activation function","Demonstrates high validation accuracy on public dataset","Open‑science framework and dataset availability"],"limitations":["No human behavioural data; relevance to sexual health indirect","No confidence intervals or statistical significance testing","Potential over‑claim of crime‑prevention impact"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":0,"neuroimaging":null,"statistics":5,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202409.0897.v1"}},{"id":1029,"doi":"10.31234/osf.io/c3ugq","pmid":null,"pmcid":null,"title":"Violence and mirror neurons: the perception of living the experience firsthand","authors":"Costanzo T.","first_author":"Costanzo T.","journal":"PsyArXiv","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/theoretical article, no empirical data, preprint","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The article theorises that viewing violent or pornographic media may trigger mirror‑neuron systems, making the experience feel as if lived firsthand, and suggests this could affect empathy and behaviour. It calls for education about potential risks.","clinical_takeaway":"None – the paper provides speculative theory without empirical evidence for clinical use.","confidence":0.7,"topic_tags":["pornography","sexual_function","neuroscience","csbd"],"strengths":["Addresses a novel neural mechanism (mirror neurons)","Integrates media violence and pornography topics"],"limitations":["No empirical data or systematic review methodology","Speculative claims about brain plasticity without evidence","Lacks measurement of key confounds (moral incongruence, masturbation, mental health)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/c3ugq"}},{"id":1030,"doi":"10.31234/osf.io/c3ugq_v1","pmid":null,"pmcid":null,"title":"Violence and mirror neurons: the perception of living the experience firsthand","authors":"Costanzo T.","first_author":"Costanzo T.","journal":"PsyArXiv","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/c3ugq_v1","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"theoretical pre‑print discussion of mirror‑neuron activation during exposure to violent and pornographic media; no empirical data, no participants","sample_n":null,"sample_text":"N/A – no participants","population":"none","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The paper theorises that watching violent or pornographic media may trigger mirror neurons, making the viewer feel as if they are living the experience. It suggests this could affect empathy and behaviour, but offers no data.","clinical_takeaway":"None – the article is purely speculative and provides no evidence for clinical practice.","confidence":0.4,"topic_tags":["neuroscience","pornography","sexual_function"],"strengths":["Addresses a novel theoretical link between mirror neurons and media exposure","Integrates violence and pornography topics in a single framework"],"limitations":["No empirical data or neuroimaging results presented","Relies on speculative causal language","No operational definitions or measurement of key constructs"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/c3ugq_v1"}},{"id":1032,"doi":"10.1080/0092623x.2018.1549632","pmid":"30640583","pmcid":null,"title":"Influences of Sociosexuality and Commitment on Online Sexual Activities: The Mediating Effect of Perceptions of Infidelity","authors":"Liu Y, Zheng L.","first_author":"Liu Y","journal":"Journal of sex & marital therapy","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 313 heterosexual adults in romantic relationships, online questionnaire","sample_n":313,"sample_text":"313 participants","population":"adult heterosexual participants in romantic relationships (self‑selected via online survey)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 313 adults in romantic relationships, those who were more open to casual sex and less committed reported higher use of online sexual activities. Seeing these behaviours as potential infidelity helped explain the link.","clinical_takeaway":"Therapists might explore partners' views on infidelity when addressing concerns about online sexual behaviour.","confidence":0.7,"topic_tags":["pornography","masturbation","relationships","sexual_function"],"strengths":["Reasonably large sample for a survey","Uses established constructs such as sociosexuality and commitment","Mediation analysis provides hypothesis‑driven insight"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of key confounds (moral incongruence, mental health, etc.)","Unclear whether OSA frequency measure is validated"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2018.1549632"}},{"id":1034,"doi":"10.1080/0092623x.2025.2537208","pmid":"40745865","pmcid":null,"title":"Association Between Cyber Pornography Use and Sexual Health Literacy and Sexual Function in Women of Reproductive Age: A Cross-Sectional Study","authors":"Bilgiç FŞ, Yıldız Karaahmet A, Karakaş S.","first_author":"Bilgiç FŞ","journal":"Journal of sex & marital therapy","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey of 1,202 women aged 18‑35; convenience sample; self‑report questionnaires (CPUS‑9, ASEX, SHLS).","sample_n":1202,"sample_text":"1202 female participants aged 18‑35, recruited online through Google Forms between Jan‑Feb 2025.","population":"Women of reproductive age, primarily university‑age, recruited via internet platform.","country":"Not specified (likely Turkey based on author names).","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,200 young women, higher cyber‑pornography use was modestly linked to poorer sexual function and higher sexual‑health literacy, but the study could not show cause‑and‑effect and did not consider moral or relational factors.","clinical_takeaway":"Higher porn use correlates with sexual dysfunction in women, but clinicians should interpret this as an association, not a causal effect.","confidence":0.85,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size","Use of validated ASEX scale","Inclusion of sexual health literacy measure"],"limitations":["Cross‑sectional design limits causal inference","No assessment of moral/religious attitudes or masturbation","Potential self‑selection bias from online recruitment","CPUS‑9 may conflate frequency with distress"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2025.2537208"}},{"id":1035,"doi":"10.1080/00918369.2025.2537103","pmid":"40743432","pmcid":null,"title":"Gay Pornography Stars and Criminal Risk: An Illusory Relationship?","authors":"Regan D, Kiss MJ, Sparks B, Morrison TG.","first_author":"Regan D","journal":"Journal of homosexuality","year":2026,"pub_types":["Journal Article"],"keywords":["Media","Crime","Gay Men","Cultural Studies","Sexually Explicit Material","Gay Porn"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Quantitative analysis of a publicly available database of porn star mugshots; cross‑sectional examination of associations between number of gay porn scenes, studio type and recorded criminal offenses.","sample_n":null,"sample_text":"Not specified in abstract; derived from existing database.","population":"Performers appearing in the Porn Star Mugshots database (gay male porn actors).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"This study examined a public database of gay porn actors to see if more scenes or certain studios were linked to higher rates of criminal behavior. It found no strong relationship, suggesting that performing in gay pornography does not predict criminal risk.","clinical_takeaway":"None – findings pertain to performer crime rates, not clinical sexual health.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Uses an existing, publicly available dataset","Addresses a claim with quantitative data","Considers career variables (scene count, studio type)"],"limitations":["No validated measure of “criminal risk”; relies on mugshot records","Potential selection bias in the database","No control for socioeconomic, mental‑health or other confounders"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2025.2537103"}},{"id":1036,"doi":"10.21203/rs.3.rs-5006077/v1","pmid":null,"pmcid":null,"title":"For Better or Worse: The Relation between Sexual Functioning and Sexual Behavior Frequency during the SARS-CoV-2 Pandemic and Social Distancing Measures in a Chilean Sample","authors":"Quintana GR, Santibáñez-Palma F, Escudero-Pastén J.","first_author":"Quintana GR","journal":"Research Square","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-5006077/v1","cited_by_count":0,"is_preprint":true,"topics":["masturbation","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 2,555 Chilean adults assessing self‑reported sexual behavior frequency and sexual function during COVID‑19 social distancing","sample_n":2555,"sample_text":"Convenience sample recruited during the pandemic; not nationally representative","population":"adult Chilean men, women, and gender non‑binary individuals (convenience sample)","country":"Chile","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 2,555 Chilean adults found that during COVID‑19 lockdown, fewer partnered sexual activities were linked to lower sexual satisfaction and desire, while men who increased foreplay, fantasies, porn use and intercourse reported better sexual function.","clinical_takeaway":"Reduced sexual activity during stress periods may be associated with poorer sexual function; clinicians should consider frequency changes when assessing sexual health.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample (N>2500)","Both partnered and solo sexual behaviors examined","Separate analysis for men and women"],"limitations":["Cross‑sectional; cannot infer causality","Unclear if sexual function scales were validated for this population","No control for moral, mental‑health, or trauma confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-5006077/v1"}},{"id":1037,"doi":"10.1016/j.jsxm.2018.10.013","pmid":"30522879","pmcid":null,"title":"Is Pelvic Floor sEMG a Measure of Women's Sexual Response?","authors":"Hannan-Leith MN, Dayan M, Hatfield G, Lalumière ML, Albert AY, Brotto LA.","first_author":"Hannan-Leith MN","journal":"The journal of sexual medicine","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Electromyography","Psychophysiology","Pelvic floor","Sexual Arousal","Semg"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Pilot laboratory study with 15 healthy women viewing neutral, anxiety, and erotic films while recording pelvic floor sEMG and continuous self‑reported arousal.","sample_n":15,"sample_text":"15 sexually healthy women (mean age 27 years).","population":"Sexually healthy women, mean age 27 (N=15).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small lab study, researchers recorded pelvic floor muscle activity with surface EMG while women watched neutral, anxiety‑inducing, and erotic videos. Intravaginal and perianal muscle activity increased during erotic and anxiety clips, but bulbocavernosus activity did not. Self‑reported arousal modestly correlated with the EMG signals.","clinical_takeaway":"Pelvic floor sEMG shows promise as an objective marker of women’s sexual arousal, but larger studies are needed before clinical use.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Objective physiological measure (sEMG)","Within‑subject design with multiple stimulus conditions","Simultaneous self‑report provides convergent validity check"],"limitations":["Very small sample (N=15) limits statistical power","Pilot study; findings are preliminary","No control for potential confounds (mood, hormonal status, etc.)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2018.10.013"}},{"id":1038,"doi":"10.3389/fpsyg.2021.673202","pmid":"34349699","pmcid":"PMC8326365","title":"Unsolicited Pics and Sexual Scripts: Gender and Relationship Context of Compliant and Non-consensual Technology-Mediated Sexual Interactions","authors":"Courtice EL, Czechowski K, Noorishad PG, Shaughnessy K.","first_author":"Courtice EL","journal":"Frontiers in psychology","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Relationships","Gender Differences","Sexting","Sexual Consent","Token Resistance","Technology-Mediated Sexual Interaction","Traditional Sexual Script","Sexual Compliance"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyg.2021.673202/pdf","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online self‑report survey of 331 women and 120 men assessing lifetime prevalence of compliant and non‑consensual technology‑mediated sexual interactions across partner contexts","sample_n":451,"sample_text":"n=331 women, n=120 men; recruited via online survey (convenience)","population":"other‑gender attracted adults (self‑selected online sample)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 450 adults found that most people experience consensual sexting with romantic partners, while non‑consensual or forced exchanges are more common with acquaintances or strangers, and patterns differ by gender.","clinical_takeaway":"Be aware that non‑consensual digital sexual interactions occur, especially outside committed relationships, and may require tailored prevention and support.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample for this topic","Examines multiple relationship contexts","Gender‑based analysis"],"limitations":["Cross‑sectional, self‑report design","Unvalidated questionnaire items","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2021.673202"}},{"id":1039,"doi":"10.1101/2023.02.07.23285491","pmid":null,"pmcid":null,"title":"Gender differences in Pornography Use and Associated Factors among high school students: A Cross-Sectional Study","authors":"Mahmoud AJ, Abdulqadir HH, Khalid RC, Dirbas VH, Hasan DF, Mahfodh SS, Naisan KY, Arif IM, Yousif IR, Mohammed SN, Haji SM, Mohammed ST, Hama Ali AA, Babakhani S.","first_author":"Mahmoud AJ","journal":"medRxiv","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.medrxiv.org/content/medrxiv/early/2023/02/08/2023.02.07.23285491.full.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 921 high‑school students in Iraqi Kurdistan, paper questionnaire, chi‑square analysis","sample_n":921,"sample_text":"921 students from five high schools in two institutions","population":"high‑school students (mean age 16.8, 55% male)","country":"Iraq (Kurdistan Region)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 921 Iraqi high‑school students, about half had ever watched pornography, with males more likely than females. Attitudes were generally negative, and most supported restricting porn sites.","clinical_takeaway":"None – the study provides prevalence data only, without clinical implications.","confidence":0.7,"topic_tags":["prevalence","gender","adolescents","pornography"],"strengths":["Large sample for a school‑based survey","Gender‑specific analysis","Clear reporting of prevalence rates"],"limitations":["No validated measures of pornography use or attitudes","Cross‑sectional design limits causal inference","Key confounders (moral incongruence, mental health, masturbation) not assessed"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2023.02.07.23285491"}},{"id":1041,"doi":null,"pmid":"27462694","pmcid":null,"title":"Sexual behaviour and use of electronic media among undergraduates in the University of Ibadan","authors":"Salawu AT, Reis SO, Fawole OI, Dairo MD.","first_author":"Salawu AT","journal":"African journal of medicine and medical sciences","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Analytical cross‑sectional survey of 433 under‑graduates from a single Nigerian university, using multistage sampling and self‑administered questionnaire.","sample_n":433,"sample_text":"433 questionnaires returned (95% response rate) from 456 distributed","population":"Undergraduate students (mean age 18.75) at University of Ibadan, Nigeria","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 433 Nigerian undergraduates found that watching sexually explicit material online was linked to a higher odds of having premarital sex, while non‑explicit TV programmes were linked to lower odds. The authors suggest tighter control of such content.","clinical_takeaway":"Evidence is correlational; clinicians should not assume media exposure causes risky sexual behaviour without considering other factors.","confidence":0.78,"topic_tags":["sexual_function","pornography"],"strengths":["Relatively large sample for a single‑site survey","Use of multistage sampling to improve representativeness within the university","Statistical adjustment via logistic regression with confidence intervals"],"limitations":["Cross‑sectional design prevents causal inference","No validated measures of media exposure or sexual behaviour","Key confounders (moral beliefs, masturbation, mental health, relationship status, trauma) not measured","Findings limited to one university and may not generalise"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":1043,"doi":"10.1371/journal.pone.0102419","pmid":"25013940","pmcid":"PMC4094516","title":"Neural correlates of sexual cue reactivity in individuals with and without compulsive sexual behaviours","authors":"Voon V, Mole TB, Banca P, Porter L, Morris L, Mitchell S, Lapa TR, Karr J, Harrison NA, Potenza MN, Irvine M.","first_author":"Voon V","journal":"PloS one","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4094516","cited_by_count":208,"is_preprint":false,"topics":["csbd","curated","pornography"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"cross-sectional","design_detail":"Case-Control fMRI Study (Small Sample)","sample_n":38,"sample_text":"Small (N = 19 CSB men vs. N = 19 healthy controls)","population":"adult males, community recruited (likely convenience sample)","country":"unspecified (likely USA/Canada based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["fmri_reverse_inference","no_mi_control","self_selected_sample"],"stance":"supports","citation_value":"strategic","plain_summary":"Found increased dorsal anterior cingulate, ventral striatum, and amygdala BOLD activation to sexually explicit videos in 19 men with compulsive sexual behavior compared to 19 controls. Frequently cited by pro-addiction advocates as proof of 'brain addiction,' but BOLD measures blood flow (not dopamine or D2 receptor downregulation), N=19 is underpowered for whole-brain fMRI (Mumford & Nichols, 2008), and moral incongruence/shame/arousal were not ruled out.","clinical_takeaway":"Heightened striatal/amygdala BOLD response to taboo stimuli in distressed men can reflect high sexual desire, anxiety, or moral conflict just as easily as addiction; it does not prove permanent brain damage.","confidence":0.78,"topic_tags":["neuroscience"],"strengths":["Published in peer-reviewed journal with matched healthy control group","Used 3T task fMRI with non-sexual exciting control stimuli (sports/money)","Demonstrates genuine neural salience differences in treatment-seeking men"],"limitations":["Severely underpowered sample size (N = 19 per group)","fMRI BOLD signal cannot measure dopamine release or D2 receptor downregulation (requires PET)","Did not measure or control for moral incongruence, religious shame, or taboo anxiety","Cross-sectional design cannot determine if neural differences are pre-existing or causal"],"rubric_version":"2.0","raw_total":30,"max_possible":70,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":5,"statistics":4,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":3}},"scite":{"supporting":29,"contrasting":2,"mentioning":297,"citing_publications":473,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0102419"}},{"id":1044,"doi":"10.1016/j.bodyim.2023.101669","pmid":"38128239","pmcid":null,"title":"The influence of pornography on heterosexual black men and women's genital self-image & grooming","authors":"Thorpe S, Malone N, Peterson RL, Iyiewuare P, Mizelle DL, Hargons CN.","first_author":"Thorpe S","journal":"Body image","year":2024,"pub_types":["Journal Article"],"keywords":["Objectification Theory","Black Women","Black Men","Genital Self-image","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"qualitative cross‑sectional interview study with 20 Black heterosexual participants across four generational cohorts","sample_n":20,"sample_text":"20 participants across four generational cohorts","population":"Black heterosexual men and women, multigenerational, recruited for interviews (convenience sample)","country":"United States (assumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 20 Black heterosexual adults found that pornography sometimes shapes how they view their genitals and grooming choices, with themes around hair, size, and partner expectations.","clinical_takeaway":"Clinicians should consider cultural and media influences when discussing genital body image with Black clients.","confidence":0.7,"topic_tags":["pornography","gender","sexual_function"],"strengths":["focus on under‑studied Black population","use of multigenerational perspectives","qualitative depth captures nuanced experiences"],"limitations":["very small, non‑representative convenience sample","no validated measures of genital self‑image or pornography exposure","absence of control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.bodyim.2023.101669"}},{"id":1045,"doi":"10.1007/s10508-016-0926-9","pmid":"28050742","pmcid":null,"title":"Sexting by High School Students","authors":"Strassberg DS, Cann D, Velarde V.","first_author":"Strassberg DS","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Sexual behavior","Communication","Adolescents","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 656 students from a single private high school; compared with a prior survey at same school four years earlier.","sample_n":656,"sample_text":"Single private high school, convenience sample","population":"Adolescents (high‑school students), private school sample","country":"USA (presumed based on journal and authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 656 students at a private high school found that about 14‑16% of boys and 13‑14% of girls had sent sexually explicit pictures, while 30‑40% had received them. Forwarding such images was less common. Rates were similar to those measured at the same school four years earlier.","clinical_takeaway":"Sexting remains common among adolescents; clinicians should discuss digital sexual communication and its risks with youth.","confidence":0.8,"topic_tags":["sexual_function","adolescents","prevalence"],"strengths":["Large sample for a single school","Direct comparison with earlier cohort at same institution","Clear descriptive prevalence data"],"limitations":["Convenience sample from one private school limits generalizability","No validated sexting scale reported","Potential social‑desirability bias in self‑reports"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":1,"mentioning":24,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0926-9"}},{"id":1046,"doi":"10.20944/preprints202408.0399.v1","pmid":null,"pmcid":null,"title":"Affective-Sexual Behaviors in Youth: Analysis of a Public Health Survey in the School Setting","authors":"Zafra-Agea JA, Ramírez-Baraldes E, García-Salido C, García-Gutiérrez D, Vilafranca-Cartagena M.","first_author":"Zafra-Agea JA","journal":"Preprints.org","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.20944/preprints202408.0399.v1","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Descriptive cross‑sectional questionnaire of 4th‑year ESO students (age 14‑18) from one school in Catalonia; prevalence of porn use and other affective‑sexual behaviours reported.","sample_n":null,"sample_text":"Convenience sample; not nationally representative.","population":"Adolescents (14‑18) from a single public school in Baix Llobregat, Spain.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A school‑based survey of Spanish teens found that many have started viewing pornography, with boys starting earlier and using it more often than girls. Knowledge about contraceptives also differed by gender.","clinical_takeaway":"High porn use among adolescents suggests a need for comprehensive sexual education, but no evidence of clinical addiction was presented.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large age‑range adolescent sample","Focus on understudied affective‑sexual behaviours"],"limitations":["Single‑school convenience sample limits generalisability","Ad‑hoc questionnaire; no validated scales","No control for key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202408.0399.v1"}},{"id":1049,"doi":"10.1007/s10508-025-03213-3","pmid":"40751035","pmcid":null,"title":"Pornography Use and Adolescent Sexual Self-Concept: The Role of Pornography-Related Expectancies and Generalizations","authors":"Kotiuga J, Bőthe B, Vaillancourt-Morel MP, Girouard A, Yampolsky MA, Martin GM.","first_author":"Kotiuga J","journal":"Archives of sexual behavior","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 1584 Canadian adolescents comparing self-reported sexual self-concept between those who have and have not used pornography; also examined expectancies and generalizations among users.","sample_n":1584,"sample_text":"1584 Canadian adolescents (49.3% cisgender girls)","population":"Adolescents (mean age 15.5), Canada, mixed gender","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1584 Canadian teens, those who had watched pornography differed in how they felt about their bodies, sexual confidence, and anxiety. Among users, believing porn predicts real‑life sex was linked to more anxiety and lower body‑esteem, while generalizing porn experiences reduced sexual self‑efficacy.","clinical_takeaway":"Clinicians should note that adolescent porn use relates to lower body‑esteem and confidence, but causality is unclear; explore expectancies in counseling.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample size for adolescent survey","Use of multiple dimensions of sexual self‑concept","Gender‑specific analysis"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of key confounds (moral views, masturbation, mental health)","Unclear whether sexual self‑concept scales are validated in this age group"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03213-3"}},{"id":1054,"doi":"10.1023/a:1002724116437","pmid":"11329723","pmcid":null,"title":"Searching for sexually explicit materials on the Internet: an exploratory study of college students' behavior and attitudes","authors":"Goodson P, McCormick D, Evans A.","first_author":"Goodson P","journal":"Archives of sexual behavior","year":2001,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 506 undergraduate students at a public university in Texas; self‑administered questionnaire developed by authors","sample_n":506,"sample_text":"506 undergraduate students, public university, Texas","population":"college students (convenience sample)","country":"USA","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2001 survey of 506 Texas college students found that about 44 % had ever looked at porn online, but only 3 % did so frequently. Men were more likely than women to view porn, while women reported more online sexual harassment. Attitudes toward online porn were generally mild.","clinical_takeaway":"Most college students view online porn rarely; clinicians should consider gender differences and potential harassment when discussing internet sexual behavior.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a single‑site survey","Gender differences reported","Authors discuss limitations"],"limitations":["Questionnaire not validated","No measurement of key confounds (moral stance, masturbation, mental health, relationship context)","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":2,"mentioning":48,"citing_publications":153,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1002724116437"}},{"id":1055,"doi":"10.21203/rs.3.rs-4507410/v1","pmid":null,"pmcid":null,"title":"Factor Associated with Sexual Behaviours among Adolescents in a Rural Tanzania: Evidence from the African Research, Implementation Science, and Education (ARISE) Network","authors":"Eliufoo E, Bago M, Tian Y, Josephat J, Mtoro MJ, Nyundo A, Li Y.","first_author":"Eliufoo E","journal":"Research Square","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-4507410/v1","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of rural adolescents (age 10–19) in six African countries; interview-administered questionnaire; Poisson regression analysis of factors associated with ever having sex.","sample_n":null,"sample_text":"Not specified in abstract; described as cross‑sectional study of adolescents in six countries.","population":"Rural adolescents, ages 10‑19, from six sub‑Saharan African countries (ARISE network).","country":"Multiple African countries (unspecified).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of rural adolescents in six African countries found that 21% had ever had sex. Exposure to pornography, older age, employment, and receiving sex jokes were linked to higher odds of sexual activity.","clinical_takeaway":"Exposure to pornography is associated with increased likelihood of sexual activity among rural adolescents; comprehensive sexual education may be needed.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large multi‑country sample of rural adolescents.","Use of multivariate Poisson regression with confidence intervals."],"limitations":["Cross‑sectional design; no causal inference.","Key constructs (pornography exposure, sexual activity) measured by single self‑report items without validated scales.","Potential unmeasured confounders (e.g., moral attitudes, mental health)."],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-4507410/v1"}},{"id":1057,"doi":"10.3390/healthcare11212877","pmid":"37958021","pmcid":"PMC10649751","title":"Young Women's Attitudes and Concerns Regarding Pornography and Their Sexual Experiences: A Qualitative Approach","authors":"Fernández-Ruiz M, López-Entrambasaguas OM, Martínez-Linares JM, Granero-Molina J.","first_author":"Fernández-Ruiz M","journal":"Healthcare (Basel, Switzerland)","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Sex Education","Sexual Health","Qualitative Research","Young Women","Pornography"],"is_oa":true,"oa_url":"https://www.mdpi.com/2227-9032/11/21/2877/pdf?version=1698827819","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"qualitative descriptive study using semi‑structured interviews with 22 university women; thematic analysis following COREQ","sample_n":22,"sample_text":"22 female university students interviewed March–April 2020","population":"young women (university students), convenience sample, N=22","country":"unspecified (likely Spain)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 22 university women showed that they view pornography as shaping their sexual expectations, often feeling uncomfortable with mainstream depictions and reporting difficulty refusing unwanted sexual acts. The study suggests that sexual‑education programmes should teach assertiveness and consent.","clinical_takeaway":"Educators should address how porn influences expectations and teach assertiveness to improve consent and sexual well‑being.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["In‑depth, participant‑led accounts","Use of COREQ guidelines for transparency","Identifies concrete themes for education"],"limitations":["Small, non‑representative convenience sample","No measurement of key confounds (moral incongruence, mental health, etc.)","Findings limited to self‑report, no validation of constructs"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":1,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare11212877"}},{"id":1058,"doi":"10.1080/00224499.2016.1191597","pmid":"27419739","pmcid":null,"title":"A Profile of Pornography Users in Australia: Findings From the Second Australian Study of Health and Relationships","authors":"Rissel C, Richters J, de Visser RO, McKee A, Yeung A, Caruana T.","first_author":"Rissel C","journal":"Journal of sex research","year":2017,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":119,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of a nationally representative probability sample (N≈20,000) using computer‑assisted telephone interviews","sample_n":20094,"sample_text":"9,963 men and 10,131 women","population":"Australian adults aged 16‑69, both sexes","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A national Australian survey of about 20,000 adults found that most men and about half of women have ever viewed pornography; a smaller share used it in the past year. Only 4% of men and 1% of women said they were addicted, and among those, roughly half reported negative effects.","clinical_takeaway":"Self‑reported addiction to pornography is uncommon and reported harms are limited; clinicians should assess distress and context rather than assume pathology.","confidence":0.7,"topic_tags":["pornography","prevalence","sexual_function","gender"],"strengths":["Very large, nationally representative sample","Clear reporting of prevalence rates","Separate reporting for men and women"],"limitations":["Reliance on single‑item self‑labels for ‘addiction’","No validated measures of problematic use or distress","No assessment of key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":24,"contrasting":3,"mentioning":150,"citing_publications":270,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2016.1191597"}},{"id":1061,"doi":"10.1556/2006.2025.00048","pmid":"40459929","pmcid":"PMC12231451","title":"Prevalence of first- and second-wave digisexualities in Germany and their relation to Compulsive Sexual Behavior: Findings from a National Online Survey","authors":"Desbuleux JC, Desbuleux JFM, Fuss J.","first_author":"Desbuleux JC","journal":"Journal of behavioral addictions","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Prevalence","Generational Differences","Pornography","Csbd","Digisexuality"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12231451","cited_by_count":1,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online national survey, N=3564, representative by age, gender, region; correlational analysis of digisexual behaviours and CSBD-19 scores","sample_n":3564,"sample_text":"representative community sample","population":"German adults (age 18+)","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2023 German online survey (N = 3,564) found that 66 % of adults use online pornography, with lower but notable use of sexting, VR porn and realistic sex dolls. All these digital sexual activities were modestly to strongly linked to higher scores on a compulsive sexual behavior questionnaire.","clinical_takeaway":"Higher engagement in various digital sexual activities is associated with more compulsive‑sexual‑behavior symptoms; clinicians should assess a broader range of tech‑mediated behaviours.","confidence":0.7,"topic_tags":["prevalence","csbd","sexual_function","pornography"],"strengths":["Large, nationally representative sample","Use of validated CSBD-19 scale","Systematic coverage of emerging digisexual behaviours"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral incongruence or other key confounds","Reliance on self‑report for all variables"],"rubric_version":"2.0","raw_total":37,"max_possible":60,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00048"}},{"id":1062,"doi":"10.1177/10778012231207041","pmid":"37847848","pmcid":null,"title":"Pornography Use and Sexual Objectification of Others","authors":"Bridges AJ, Willis M, Ezzell MB, Sun CF, Johnson JA, Wright PJ.","first_author":"Bridges AJ","journal":"Violence against women","year":2024,"pub_types":["Journal Article"],"keywords":["Degradation","Objectification","Sexualization","Pornography","Sexually Explicit Media"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 1,342 US heterosexual adults measuring self‑reported pornography use frequency, preference for degrading content, and sexual objectification of others.","sample_n":1342,"sample_text":"participants were 1,342 heterosexual women and men residing in the United States","population":"heterosexual adults residing in the United States (N=1,342)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US adult sample, people who watch porn more often also tend to view women as objects, especially if they prefer degrading porn. This pattern holds for both men and women.","clinical_takeaway":"None – findings are correlational and do not inform clinical practice.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size (N>1300)","Examines moderating effect of degrading content preference","Addresses both men and women"],"limitations":["Cross‑sectional design, no causal inference","Likely uses unvalidated self‑report scales","No control for key confounds (moral views, mental health, etc.)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10778012231207041"}},{"id":1064,"doi":"10.1111/jmft.12672","pmid":"37811548","pmcid":null,"title":"Married women's response to spousal pornography use: A grounded theory","authors":"Crawford MD, Butler MH, Marks LD, Leavitt CJ.","first_author":"Crawford MD","journal":"Journal of marital and family therapy","year":2024,"pub_types":["Journal Article"],"keywords":["Healing","Women","Attachment Theory","Marital Relationships","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"grounded theory study of 30 married women using de‑identified blog posts to develop a process model of responses to spousal pornography disclosure.","sample_n":30,"sample_text":"30 married women (convenience sample from blogs)","population":"married women (N=30) who reported spouse’s pornography use as a relational threat and chose to stay in the marriage","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","selective_reporting"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 30 married women reveal how they emotionally, mentally, and physically respond when they learn their husband watches pornography, and how they work toward healing together.","clinical_takeaway":"Therapists should address communication and trauma‑focused healing when couples confront spousal pornography use.","confidence":0.7,"topic_tags":["pornography","relationships","sexual_function","gender"],"strengths":["In‑depth qualitative insights","Grounded theory methodology","Focus on relational healing"],"limitations":["Small, non‑representative convenience sample","No standardized measures of constructs","Potential self‑selection bias from blog authors"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jmft.12672"}},{"id":1065,"doi":"10.1177/10778012231205583","pmid":"37807715","pmcid":null,"title":"Psychometric Evaluation of Initial Domains on the Comprehensive Assessment of Pornography Use Tool","authors":"Marshall EA, Miller HA.","first_author":"Marshall EA","journal":"Violence against women","year":2024,"pub_types":["Journal Article"],"keywords":["Exploratory Factor Analysis","Sexual Coercion","Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 324 college men; exploratory factor analysis of newly developed questionnaire.","sample_n":324,"sample_text":"college men","population":"college men (N=324)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and tested a new questionnaire to measure different aspects of pornography use (type, scripts, habits, compulsivity) in 324 college men, finding a four‑factor structure with good reliability.","clinical_takeaway":"The tool may help clinicians assess pornography use more systematically, but its validity outside college men is unknown.","confidence":0.8,"topic_tags":["pornography","measurement","sexual_function"],"strengths":["Large sample for psychometric work","Factor analytic validation","Reliability evidence reported"],"limitations":["Convenience sample of college men limits generalizability","No measurement of key confounds (moral incongruence, masturbation, mental health)","Cross‑sectional, no longitudinal validation"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10778012231205583"}},{"id":1066,"doi":"10.3390/jcm12196407","pmid":"37835052","pmcid":"PMC10573317","title":"Impact of Internet Addiction, Social Media Use and Online Pornography on the Male Sexual Function in Times of the COVID-19 Pandemic","authors":"Pawlikowska-Gorzelańczyk A, Fichte D, Rozmus J, Roder P, Flakus R, Szuster E, Brawańska K, Biernikiewicz M, Sobieszczańska M, Rusiecka A, Kałka D.","first_author":"Pawlikowska-Gorzelańczyk A","journal":"Journal of clinical medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual dysfunction","Social Isolation","Addictive Behavior","Pornography"],"is_oa":true,"oa_url":"https://www.mdpi.com/2077-0383/12/19/6407/pdf?version=1696856601","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 702 young men assessing IIEF scores and self‑reported use of social media, pornography, dating apps and video games","sample_n":702,"sample_text":"702 men, recruited via online surveys (convenience sample)","population":"young, sexually active men (18‑60 y, mean 24)","country":"Poland (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 702 young men found that social‑media addiction was linked to poorer erectile function, while overall pornography use was not, though heavier porn use showed a weak negative association. Dating‑app use also showed a minor negative link. No effects were seen for video‑games.","clinical_takeaway":"Clinicians should consider problematic social‑media use as a potential factor in male sexual dysfunction, but evidence for pornography use alone is weak.","confidence":0.82,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Large sample (N = 702)","Use of validated IIEF and Bergen Social Media Addiction Scale","Addresses multiple online behaviours simultaneously"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of moral incongruence, masturbation, mental‑health or partner factors","Pornography use measured only by frequency, no validated problematic‑use scale"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jcm12196407"}},{"id":1067,"doi":"10.1186/s40359-025-02901-y","pmid":"40420131","pmcid":"PMC12107778","title":"Unraveling the impact of cyberporn motivations on mental health: insights from Chinese college students","authors":"Li L, Feng R, Yang L, Lang R, Ince C, Liu C, Ren L, Feng Z, Li K.","first_author":"Li L","journal":"BMC psychology","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Anxiety","Mental health","Internet Pornography Use","Cyberpornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12107778","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience sample of 2,938 Chinese college students; self‑report questionnaires on pornography use motives, depression, anxiety, sleep quality, social‑interaction anxiety; descriptive and network analysis.","sample_n":2938,"sample_text":"Convenience sampling of university students in China","population":"Chinese college students (young adults, both sexes)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among Chinese university students, why they watch online porn matters: using porn to cope or for excitement links to higher depression and anxiety, while using it for social reasons links to lower symptoms. Over half of those with porn‑related motives reported depression.","clinical_takeaway":"Consider users' motivations when assessing mental‑health risk related to porn use; coping motives may signal greater vulnerability.","confidence":0.75,"topic_tags":["pornography","sexual_function","masturbation","moral_incongruence"],"strengths":["Large sample size","Focus on motives, a nuanced variable","Use of network analysis to explore inter‑relationships"],"limitations":["Convenience, non‑representative sample","Motives measured with unclear/unstated validation","No control for key confounds (moral incongruence, masturbation, partner effects)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s40359-025-02901-y"}},{"id":1069,"doi":"10.1177/0033294120907310","pmid":"32183620","pmcid":null,"title":"Preliminary Evidence on How the Dual Control Model Predicts Female Sexual Response to a Bogus Negative Feedback","authors":"Granados R, Carvalho J, Sierra JC.","first_author":"Granados R","journal":"Psychological reports","year":2021,"pub_types":["Journal Article"],"keywords":["Genital Response","Sexual Inhibition","Sexual Excitation","False Feedback","Dual Control Model"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment with bogus negative feedback; within‑subject measurement of genital arousal (vaginal photoplethysmography) and self‑report; N=22 women, convenience sample.","sample_n":22,"sample_text":"22 women recruited for lab study; no indication of random sampling.","population":"young adult women (Spain)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 22 women, researchers gave false negative feedback about sexual performance while showing a erotic film. Women’s genital arousal (measured with a vaginal device) did not change, but those who reported higher sexual excitement scores felt more aroused subjectively. Concerns about sexual function reduced subjective arousal.","clinical_takeaway":"Sexual excitation traits may buffer women’s subjective arousal under performance anxiety; concerns about function may lower it.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Validated psychometric inventory (SES‑IW)","Objective physiological measurement","Novel test of Dual Control Model in women"],"limitations":["Very small sample (N=22) limits power","Convenience sample; limited generalisability","No control for potential psychological confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":7,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0033294120907310"}},{"id":1070,"doi":"10.21203/rs.3.rs-2148314/v1","pmid":null,"pmcid":null,"title":"Sex differences in sexual satisfaction and psychological symptoms in young adult pornography users","authors":"Czajeczny D, Aurast Z, Godlewska K, Mojs E.","first_author":"Czajeczny D","journal":"Research Square","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-2148314/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 179 young adults from general population; participants classified as high vs low pornography users; questionnaire on demographics, porn use frequency/manner, GFQ-58 psychological symptoms, Sexual Satisfaction Scale SSC","sample_n":179,"sample_text":"179 participants aged 18‑37 recruited from the general population (likely convenience/online)","population":"young adult (18‑37) users, convenience sample, likely online recruitment","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 179 young adults, men who used pornography more frequently reported higher psychological symptoms, while women showed higher symptom scores overall but no clear link to porn use. Sexual satisfaction also differed by sex and usage level, suggesting that motivations and patterns of porn use may affect outcomes differently for men and women.","clinical_takeaway":"Clinicians should consider gender‑specific motivations and usage patterns when discussing pornography with clients, rather than assuming it is uniformly harmful.","confidence":0.78,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Reasonable sample size for a simple survey","Uses two established psychometric scales","Considers sex differences rather than treating users as a homogeneous group"],"limitations":["Cross‑sectional design prevents causal inference","Potential confounds (moral attitudes, masturbation, relationship status, trauma) not measured","Pornography use assessed by self‑report single items"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-2148314/v1"}},{"id":1071,"doi":"10.1080/13691058.2023.2258949","pmid":"37772618","pmcid":null,"title":"Sex on screens: the language of sexting and amateur pornography","authors":"James A, Waling A, Dowsett GW, Power J.","first_author":"James A","journal":"Culture, health & sexuality","year":2024,"pub_types":["Journal Article"],"keywords":["Sexting","Digital Communication","Sexual Discourse","Adult Sexting","Amateur Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative interview study with 23 Australian adults (≥25 y), thematic analysis of language used for sexting and amateur pornography.","sample_n":23,"sample_text":"23 interviews","population":"Adults in Australia, 25 years and older, recruited for interview study.","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 23 Australian adults reveal how the words they use to describe sexting and amateur porn shape their feelings about these practices, often linking language to positive or negative self‑views and affecting discussions of consent.","clinical_takeaway":"Clinicians should recognize that terminology influences how adults talk about digital sexual activities, affecting consent and safety conversations.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["In‑depth, participant‑led insight into language surrounding digital sexual content","Focus on adult population beyond typical youth‑centric framing"],"limitations":["Small, non‑representative convenience sample (N = 23)","No quantitative measurement of constructs; findings not generalisable"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2023.2258949"}},{"id":1072,"doi":"10.1007/s10508-018-1251-2","pmid":"29987544","pmcid":null,"title":"Deviant Cyber-Sexual Activities in Young Adults: Exploring Prevalence and Predictions Using In-Person Sexual Activities and Social Learning Theory","authors":"Klein JL, Cooper DT.","first_author":"Klein JL","journal":"Archives of sexual behavior","year":2019,"pub_types":["Journal Article"],"keywords":["Sexual activities","College Students","Socialization","Social Learning Theory","Deviant Behavior","Cyber Deviance"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online self‑report survey of 812 undergraduates; cross‑sectional convenience sample","sample_n":812,"sample_text":"812 undergraduate students (282 men, 530 women)","population":"young adult college students (undergraduates)","country":"unspecified (likely USA based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 812 college students examined how personal and peer factors predict engagement in online sexual activities like sexting. Peer influence and personal characteristics (gender, self‑esteem, religion) were linked to higher counts of such behaviors, while in‑person sexual activity was less predictive.","clinical_takeaway":"No direct clinical implications; findings are correlational and should not be taken as evidence that peers cause risky online sexual behavior.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large sample size for survey","includes multiple demographic and sexual‑behavior covariates","applies social learning theory to online sexual behavior"],"limitations":["cross‑sectional design limits causal inference","uses ad‑hoc, non‑validated measures of deviant cyber‑sexual activity","does not assess moral incongruence or mental‑health confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":2,"mentioning":12,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1251-2"}},{"id":1073,"doi":"10.1007/s10508-023-02698-0","pmid":"37735277","pmcid":null,"title":"Sexual Behaviors as a Mediator Between Pornography Use and Heterosexual Relationship Outcomes","authors":"Dover CR, Willoughby BJ.","first_author":"Dover CR","journal":"Archives of sexual behavior","year":2024,"pub_types":["Journal Article"],"keywords":["Sexual Satisfaction","Sexual Behaviors","Relationship Stability","Heterosexual Relationships","Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large national survey (N=2519), cross‑sectional mediation analysis","sample_n":2519,"sample_text":"national data set of individuals in heterosexual relationships","population":"heterosexual adults in relationships (survey)","country":"unspecified (likely USA/Western)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Using a large survey of over 2,500 heterosexual couples, the authors found that watching porn alone or together is linked to relationship satisfaction through changes in sexual activities: more vaginal and oral sex were tied to better outcomes, while anal sex showed a negative link.","clinical_takeaway":"Relationship counsellors should consider how a couple’s pornography habits shape their sexual practices, which may affect satisfaction.","confidence":0.7,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Large, nationally representative sample","Distinguishes solo vs joint pornography use","Explores mediation by specific sexual behaviors"],"limitations":["Cross‑sectional; cannot infer causality","Limited control for key confounds (moral, mental health, trauma)","Unclear validation of pornography and relationship measures"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02698-0"}},{"id":1074,"doi":"10.1080/00223980.2019.1666788","pmid":"31566509","pmcid":null,"title":"A Prospective Study of High-School Adolescent Sexting Behavior and Psychological Distress","authors":"Dodaj A, Sesar K, Jerinić S.","first_author":"Dodaj A","journal":"The Journal of psychology","year":2020,"pub_types":["Journal Article"],"keywords":["Depression","Anxiety","Adolescence","Stress And Coping","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort of 359 high‑school students (aged 15‑17) followed for one year; sexting behavior and DASS‑21 measured at baseline and follow‑up","sample_n":359,"sample_text":"216 girls and 143 boys","population":"adolescents (high‑school students) from one or more schools; convenience sample","country":"not specified in abstract","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a one‑year study of 359 high‑school students, teens who sent or received sexually explicit texts were more likely to report anxiety, stress, and later depression, suggesting sexting is linked to poorer mental health.","clinical_takeaway":"Clinicians should assess sexting behaviors when evaluating adolescent distress, but note that moral factors were not examined.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Longitudinal design with baseline and follow‑up","Adequate total sample size for basic analyses","Use of validated DASS‑21 for distress"],"limitations":["Sexting questionnaire likely not fully validated","No control for moral/religious attitudes that may drive distress","Convenience school sample limits generalisability"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":44,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00223980.2019.1666788"}},{"id":1075,"doi":"10.1016/j.addbeh.2023.107858","pmid":"37774528","pmcid":null,"title":"Strength of Pornography Craving Experience (PCE-S): Psychometric properties of a new measure based on the elaborated intrusion theory of desire","authors":"Ben Brahim F, Vera Cruz G, Courtois R, May J, Khazaal Y.","first_author":"Ben Brahim F","journal":"Addictive behaviors","year":2024,"pub_types":["Validation Study","Journal Article"],"keywords":["Craving","Compulsive Cyberporn","Pornography Craving","Pornography Problematic Use"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1584 cyber‑porn users; convenience sample; psychometric validation (CFA, reliability, discriminant analysis)","sample_n":1584,"sample_text":"Convenience online recruitment of cyber‑porn users","population":"Adults (18‑75 y) who use cyber‑porn; English‑speaking; 63 % male, 35 % female, 2 % non‑binary","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a new questionnaire (PCE‑S) that measures how strongly people crave pornography. Using data from 1,584 adult internet porn users, they showed the scale is reliable, fits a three‑factor model, and relates to existing measures of compulsive porn use.","clinical_takeaway":"The PCE‑S provides a psychometrically sound tool for assessing porn craving in research or clinical settings.","confidence":0.8,"topic_tags":["measurement","pornography","sexual_function"],"strengths":["Large sample for psychometric work","Use of CFA and multiple reliability indices","Demonstrates concurrent validity with compulsive use scale","Clear reporting of item‑level statistics"],"limitations":["Convenience, self‑selected sample limits generalisability","No measures of moral incongruence, masturbation or mental health","No pre‑registration or power analysis reported","Cross‑sectional; cannot assess predictive utility"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2023.107858"}},{"id":1076,"doi":"10.1007/s10508-023-02679-3","pmid":"37644359","pmcid":null,"title":"Can I Love My Body Even if It Doesn't Look Like the Porn Stars'? Longitudinal Associations Between Pornography Use Frequency and Body Appreciation in a Diverse Sample of Adolescents","authors":"Paquette MM, Bőthe B, Dion J, Girouard A, Bergeron S.","first_author":"Paquette MM","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescents","Trajectory","Body Appreciation","Sexual Minority","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal cohort with three‑year follow‑up (N≈2900 adolescents).","sample_n":2904,"sample_text":"Large community sample of adolescents recruited in schools (presumed convenience).","population":"Adolescents (mean age 14.5), 51% girls, 16% sexual minority.","country":"Canada (implied by author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 2,900 adolescents followed for three years, higher frequency of pornography watching was linked to slightly lower body appreciation in girls and sexual‑minority boys at the same time point, but the link did not persist over time.","clinical_takeaway":"Brief porn exposure may affect teens' body image in the short term; monitor but do not assume lasting harm.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample size","Three‑year longitudinal design","Separate analysis by gender and sexual orientation","Uses latent growth curve modeling"],"limitations":["Pornography use measured only by frequency, no detail on content or context","Potential unmeasured confounders (e.g., mental health, moral attitudes)","Self‑report data may be subject to bias","Sample likely school‑based convenience rather than nationally representative"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":1,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02679-3"}},{"id":1077,"doi":"10.1007/s10508-023-02666-8","pmid":"37644357","pmcid":"PMC10703962","title":"A Re-evaluation of Online Pornography Use in Germany: A Combination of Web Tracking and Survey Data Analysis","authors":"von Andrian-Werburg MTP, Siegers P, Breuer J.","first_author":"von Andrian-Werburg MTP","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexism","Religiosity","Social Dominance Orientation","Online Pornography Use","Web Tracking Data"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10703962","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational study combining objective web‑tracking of pornography use (N=3018) with an online survey (n=1315) to examine demographic and psychosocial predictors.","sample_n":3018,"sample_text":"Large‑scale German online panel (tracking N=3018; survey N=1315).","population":"German adults participating in a commercial web‑tracking panel; subset completed an online questionnaire.","country":"Germany","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using website‑tracking of 3,000 German adults, the study found men and younger people view more online pornography. Religious affiliation also predicts usage, while relationship status, sexist views and social dominance do not.","clinical_takeaway":"Clinicians should note that pornography use varies by age, gender, and religiosity, but typical demographic factors like relationship status are not strong predictors.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender","religiosity"],"strengths":["Objective behavioral data via web tracking","Large sample size","Direct comparison with self‑report data"],"limitations":["Cross‑sectional; cannot infer causality","Masturbation and mental‑health variables not assessed","Panel may not be fully representative of the German population"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02666-8"}},{"id":1078,"doi":"10.1080/00926230500442326","pmid":"16418106","pmcid":null,"title":"Effects of administering sexually explicit questionnaires on anger, anxiety, and depression in sexually abused and nonabused females: implications for risk assessment","authors":"Savell JK, Kinder BN, Young MS.","first_author":"Savell JK","journal":"Journal of sex & marital therapy","year":2006,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"pre‑post within‑subjects study of 207 women; no control group; questionnaires on sexual abuse and explicit content followed by state/trait measures of anger, anxiety, depression","sample_n":207,"sample_text":"207 females, some reporting childhood sexual abuse","population":"adult females (students and community volunteers) in Florida","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study gave 207 women questionnaires containing very personal sexual questions and measured their anger, anxiety, and depression before and after. Scores did not change, even for women who said they had been sexually abused as children, suggesting such research does not cause immediate emotional harm.","clinical_takeaway":"Administering sensitive sexual questionnaires appears not to raise short‑term depression, anxiety, or anger in adult women.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses validated state‑trait measures of affect","Relatively large sample for a pre‑post design","Addresses an ethical concern with empirical data"],"limitations":["No control group; cannot separate questionnaire effect from time/retest","No effect sizes or power analysis reported","Limited assessment of potential confounds (e.g., baseline mental health)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":22,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230500442326"}},{"id":1080,"doi":"10.1016/j.neuroscience.2019.07.049","pmid":"31394197","pmcid":null,"title":"No Sex Difference Found: Cues of Sexual Stimuli Activate the Reward System in both Sexes","authors":"Stark R, Klein S, Kruse O, Weygandt M, Leufgens LK, Schweckendiek J, Strahler J.","first_author":"Stark R","journal":"Neuroscience","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sex differences","Cues","Reward System","Trait Sexual Motivation","Sexually Explicit Material"],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"fMRI cue‑reactivity experiment with expectation and presentation phases; within‑subject comparison of SEM vs neutral cues; likely convenience sample of young adults.","sample_n":null,"sample_text":"Not reported in abstract; typical fMRI studies of this type use ≤30 participants per group.","population":"young adult humans (both sexes)","country":"Germany (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A brain‑imaging study found that both men and women show activation in reward areas when they see sexual cues, and the patterns did not differ enough to explain why men use pornography more often.","clinical_takeaway":"Sex differences in pornography use are unlikely to stem from basic neural cue‑reactivity; other psychological or cultural factors should be considered.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Controlled fMRI cue‑reactivity paradigm","Both sexes included, allowing direct sex comparison","Investigation of individual difference variables (trait sexual motivation, use frequency)"],"limitations":["Small likely sample size, limited statistical power","No measurement of key confounds (moral incongruence, mental health, masturbation)","Reliance on ROI analyses without clear correction details"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":5,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":52,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neuroscience.2019.07.049"}},{"id":1082,"doi":"10.1080/14681811.2023.2241133","pmid":"39703665","pmcid":"PMC11654991","title":"Critical media attitudes as a buffer against the harmful effects of pornography on beliefs about sexual and dating violence","authors":"Evans-Paulson R, Dodson CV, Scull TM.","first_author":"Evans-Paulson R","journal":"Sex education","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Adolescence","Gender Norms","Pornography Use","Relationship Health","Media Skepticism"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 558 US ninth‑ and tenth‑grade students; self‑report frequency of pornography use, attitudes toward gender norms, rape myths and media skepticism; moderation analysis","sample_n":558,"sample_text":"558 ninth‑ and tenth‑grade students (mean age 14)","population":"adolescents (mean age 14, 53% female), US school sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 558 U.S. teens, more frequent porn watching was linked to stronger endorsement of rape myths and traditional gender norms, but only among youths who were less skeptical of media messages. Critical media attitudes appeared to buffer these harmful belief patterns.","clinical_takeaway":"Teaching media‑critical skills may help mitigate the influence of pornography on harmful sexual attitudes in early adolescents.","confidence":0.8,"topic_tags":["pornography","adolescents","gender","sexual_function","relationships"],"strengths":["Large adolescent sample (N>500)","Focus on understudied protective factor (media skepticism)","Use of interaction/moderation analysis"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of key confounds (e.g., moral/religious attitudes, mental health)","Reliance on self‑report frequency and attitudes"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/14681811.2023.2241133"}},{"id":1083,"doi":"10.31234/osf.io/5bmav_v1","pmid":null,"pmcid":null,"title":"Understanding how survivors of non-consensual intimate image dissemination are perceived by UK and Norwegian respondents","authors":"Fido D, Hesbøl AC, Danby A.","first_author":"Fido D","journal":"PsyArXiv","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/5bmav_v1","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 477 UK and Norwegian adults responding to experimental vignettes; between‑group comparison of nationality with covariates (sex, psychopathic traits).","sample_n":477,"sample_text":"UK and Norwegian respondents, recruited online (presumed convenience).","population":"adult general public (UK and Norway)","country":"UK; Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed 477 people in the UK and Norway about short stories involving non‑consensual sharing of intimate images. It found that UK participants saw worse impacts for survivors and that people with higher psychopathic traits blamed victims more, especially when the relationship was casual.","clinical_takeaway":"None – the paper addresses public attitudes, not clinical treatment.","confidence":0.8,"topic_tags":["neuroscience","sexual_function","religiosity"],"strengths":["Large sample for vignette survey","Inclusion of two countries with differing legal contexts","Controls for sex and psychopathic traits"],"limitations":["Cross‑sectional; cannot infer causality","Perception measures not validated","Limited control of key confounds (morality, mental health, relationship factors)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/5bmav_v1"}},{"id":1084,"doi":"10.31234/osf.io/5bmav","pmid":null,"pmcid":null,"title":"Perceptual differences of victims of non-consensual intimate image dissemination between UK and Norwegian respondents","authors":"Fido D, Hesbøl AC, Danby A.","first_author":"Fido D","journal":"PsyArXiv","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/5bmav","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 477 participants from UK and Norway responding to vignettes; between‑countries comparison controlling for sex and psychopathic traits.","sample_n":477,"sample_text":"477 participants total (UK and Norway).","population":"adult respondents from UK and Norway recruited online (convenience sample).","country":"United Kingdom; Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People in the UK judged non‑consensual sharing of intimate images to be more harmful to victims than people in Norway, especially when the depicted relationship was casual. Higher psychopathic traits predicted more lenient judgments.","clinical_takeaway":"None – the study addresses public perceptions, not clinical treatment.","confidence":0.78,"topic_tags":["sexual_function","gender"],"strengths":["Large total sample (n=477) across two countries","Controls for participant sex and psychopathic traits","Clear experimental manipulation via vignettes"],"limitations":["Convenience online sample limits generalisability","Psychopathic traits likely measured with self‑report, unclear validation","No pre‑registration or effect‑size reporting","Potential cultural differences not fully accounted for"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":2,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/5bmav"}},{"id":1085,"doi":"10.1177/10790632251326550","pmid":"40221833","pmcid":null,"title":"Viewing Child Sexual Abuse Material for the First Time: Findings From an Anonymous Survey of Internet Users","authors":"Napier S, Seto MC, Shackel R, Cashmore J, McGeechan K.","first_author":"Napier S","journal":"Sexual abuse : a journal of research and treatment","year":2025,"pub_types":["Journal Article"],"keywords":["Prevention","Onset","Pornography","Child Sexual Abuse Material","First Exposure","Child Sexual Exploitation And Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Anonymous online survey of 5,512 adults from five countries; self‑report of first exposure to adult pornography and CSAM; cross‑sectional descriptive and inferential analyses.","sample_n":5512,"sample_text":"5512 adult internet users from five countries","population":"Adults (13.5% reported ever viewing CSAM); recruited via internet panels/social media; self‑selected sample.","country":"Multiple (five countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of over 5,000 adults found that about 14% had ever looked at child sexual abuse material, usually unintentionally and alone. Most who viewed it first saw such material before age 18, and early exposure to other adult porn types predicted earlier CSAM exposure.","clinical_takeaway":"Early exposure to adult pornography is linked to earlier CSAM viewing; prevention efforts should target adolescents before they encounter such material.","confidence":0.7,"topic_tags":["csbd","pornography"],"strengths":["Large sample size (>5,000)","International sample across five countries","Focus on understudied first‑exposure timeline"],"limitations":["Self‑report of illegal behavior may be under‑ or over‑reported","Cross‑sectional; cannot infer causality","No validated scales for exposure or related constructs"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632251326550"}},{"id":1086,"doi":"10.1002/ab.21429","pmid":"22549741","pmcid":null,"title":"Validity for an integrated laboratory analogue of sexual aggression and bystander intervention","authors":"Parrott DJ, Tharp AT, Swartout KM, Miller CA, Hall GC, George WH.","first_author":"Parrott DJ","journal":"Aggressive behavior","year":2012,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Alcohol","Peer Influence","Sexual Aggression","Bystander Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"laboratory analogue validation study; participants made individual and group choices about video clips; past aggression self‑report used as predictor","sample_n":156,"sample_text":"156 heterosexual male participants recruited with a male friend; diverse community sample (54% African American)","population":"heterosexual men, 21‑35 y, community sample (N=156)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created a lab task where men chose whether to show a sexual or non‑sexual video to a female confederate. Selecting the sexual video was used as a stand‑in for sexual aggression. Past aggression and misogynistic attitudes predicted choosing the sexual video, while bystander confidence predicted preventing it in group decisions.","clinical_takeaway":"None – the study validates a laboratory model, not a clinical intervention.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonably large sample for a lab paradigm","Inclusion of both individual and group decision phases","Use of past aggression and attitude measures to validate the paradigm"],"limitations":["Proxy measure of sexual aggression lacks external validation","No assessment of key confounds (e.g., moral attitudes, mental health)","Statistical details and effect sizes not reported in abstract"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":60,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ab.21429"}},{"id":1090,"doi":"10.1016/j.actpsy.2025.104946","pmid":"40158228","pmcid":null,"title":"Understanding how survivors of non-consensual intimate image dissemination are perceived by UK and Norwegian respondents","authors":"Fido D, Hesbøl AC, Danby A.","first_author":"Fido D","journal":"Acta psychologica","year":2025,"pub_types":["Journal Article"],"keywords":["Psychopathy","Revenge Pornography","Image-based Sexual Abuse","Victim-blame","Non-consensual Sharing Of Intimate Images"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey with vignettes; n=477 UK and Norway participants; controlled for sex and psychopathic traits; no longitudinal or experimental manipulation.","sample_n":477,"sample_text":"477 participants from the UK and Norway completed vignette‑based questionnaires.","population":"Adults from the United Kingdom and Norway; general public respondents (sampling method not detailed).","country":"United Kingdom; Norway","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People in the UK judged non‑consensual image sharing as more harmful to victims than Norwegians did, and higher psychopathic traits were linked to less serious judgments, especially when the relationship was casual.","clinical_takeaway":"None – the study addresses public attitudes, not clinical treatment.","confidence":0.8,"topic_tags":["sexual_function","treatment"],"strengths":["Large sample (n≈500) covering two countries","Use of realistic vignettes to assess attitudes","Controls for psychopathic traits, a known predictor"],"limitations":["Cross‑sectional design limits causal inference","Limited control of key confounds (e.g., moral attitudes, mental health)","Unclear whether attitude measures are validated"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.actpsy.2025.104946"}},{"id":1091,"doi":"10.1186/s12889-023-16216-3","pmid":"37442986","pmcid":"PMC10339620","title":"Is sexual attraction and place of origin a moderator of sex in pornography consumption? Cross-sectional study on a representative sample of young adults","authors":"Sanz-Barbero B, Pérez-Martínez V, Estévez-García JF, Vives-Cases C.","first_author":"Sanz-Barbero B","journal":"BMC public health","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Young People","Country Of Birth","Sexual Attraction","Pornography"],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-023-16216-3","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey of 2,515 Spanish young adults (18‑35) assessing ever‑use of pornography and its association with sex, sexual attraction and country of birth.","sample_n":2515,"sample_text":"2515 men and women aged 18‑35","population":"Young adults (18‑35) in Spain, community‑based sample, presumably recruited to be nationally representative.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 2,500 young adults in Spain, 95% of men and 75% of women reported ever watching pornography. Use started earlier in men (average age 14). Women with bisexual or homosexual attraction and those born abroad were more likely to have used porn. Age also raised the likelihood for both sexes.","clinical_takeaway":"High lifetime porn exposure is common among Spanish youths; clinicians should consider this normative prevalence when discussing sexual health.","confidence":0.7,"topic_tags":["pornography","prevalence","sexual_function"],"strengths":["Large, nationally‑referenced sample","Clear reporting of prevalence ratios with confidence intervals","Considers multiple sociodemographic moderators"],"limitations":["Self‑report of ever‑use; no validated pornography‑use scale","Cross‑sectional; cannot infer causality","No measurement of key confounds (masturbation, moral attitudes, mental health, relationship context)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-023-16216-3"}},{"id":1092,"doi":"10.1080/00926239908403983","pmid":"10327379","pmcid":null,"title":"Therapeutic uses of sexually explicit materials in the United States and the Czech and Slovak Republics: a qualitative study","authors":"Robinson BE, Manthei R, Scheltema K, Rich R, Koznar J.","first_author":"Robinson BE","journal":"Journal of sex & marital therapy","year":1999,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Cross‑cultural qualitative interview/survey of 279 mental‑health professionals in the US, Czech Republic and Slovakia.","sample_n":279,"sample_text":"Convenience sample of professionals recruited for reflections on therapeutic use of sexually explicit materials.","population":"Mental health and health professionals (U.S., Czech and Slovak Republics)","country":"United States; Czech Republic; Slovak Republic","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Therapists and health workers in the US, Czech Republic and Slovakia reported that using pornographic or sexually explicit materials was usually helpful in therapy or teaching, with few reports of it being unhelpful.","clinical_takeaway":"Clinicians may consider carefully selected explicit materials as therapeutic tools, but should evaluate usefulness on a case‑by‑case basis.","confidence":0.8,"topic_tags":["sexual_function","pornography","csbd"],"strengths":["Large (N=279) multicultural professional sample","Direct reflections from practitioners about real‑world therapeutic use","Cross‑cultural comparison adds breadth"],"limitations":["Qualitative design; no validated quantitative measures of constructs","Potential self‑selection bias among professionals who responded","No systematic assessment of client outcomes or harms"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239908403983"}},{"id":1093,"doi":"10.1007/s10508-019-1409-6","pmid":"31087197","pmcid":null,"title":"An Examination of Sexting, Sexual Violence, and Alcohol Use Among Men Arrested for Domestic Violence","authors":"Florimbio AR, Brem MJ, Grigorian HL, Elmquist J, Shorey RC, Temple JR, Stuart GL.","first_author":"Florimbio AR","journal":"Archives of sexual behavior","year":2019,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Intimate Partner Violence","Alcohol Use","Sexual Violence","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 312 men arrested for domestic violence; logistic regression used to examine associations between self‑reported sexting, alcohol use and sexual violence perpetration.","sample_n":312,"sample_text":"Clinical/arrest sample; not a probability or community sample.","population":"Men arrested for domestic violence (N=312), United States","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 312 men arrested for domestic violence, 60% had asked for a sext, 55% had been asked, and 41% had sent a sext in the past year. Those who engaged in sexting were more likely to have committed sexual violence, even after accounting for age and alcohol use.","clinical_takeaway":"Sexting behavior may signal higher risk for sexual violence in perpetrator populations; clinicians should assess it alongside other risk factors.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large (N=312) sample for this specific offender population","First study to document sexting prevalence among men arrested for domestic violence","Use of logistic regression to control for age and alcohol use"],"limitations":["Cross‑sectional design; cannot infer causality","Self‑report measures of sensitive behaviors; possible bias","No validated sexting scale; uses ad‑hoc items","Sample not representative of general male population"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-1409-6"}},{"id":1094,"doi":"10.1007/s10508-012-9969-8","pmid":"22674035","pmcid":null,"title":"Sexting by high school students: an exploratory and descriptive study","authors":"Strassberg DS, McKinnon RK, Sustaíta MA, Rullo J.","first_author":"Strassberg DS","journal":"Archives of sexual behavior","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":57,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 606 students from one private high school (98% of student body); descriptive frequencies of sending/receiving/forwarding sexts.","sample_n":606,"sample_text":"606 high‑school students (98 % of the school population) from a single private school in the southwestern United States.","population":"high school students (U.S., private school)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 606 U.S. high‑school students, about one‑fifth said they had ever sent a naked picture by text, nearly twice that many had received one, and a quarter of receivers forwarded the images. Some sent pictures despite knowing possible legal consequences.","clinical_takeaway":"Sexting is fairly common among adolescents; clinicians should discuss legal and emotional risks when counseling teens.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Large proportion of school captured (98 %)","Clear descriptive prevalence data","First exploratory data on a timely phenomenon"],"limitations":["Single private‑school sample limits generalisability","Reliance on single‑item self‑reports, no validated scales","No assessment of mental‑health or moral variables"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":10,"contrasting":3,"mentioning":136,"citing_publications":258,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-012-9969-8"}},{"id":1097,"doi":"10.3389/fpubh.2023.1199835","pmid":"37397734","pmcid":"PMC10307975","title":"Family functioning and problematic internet pornography use among adolescents: a moderated mediation model","authors":"Li L, Wang X, Tang S, Wang J.","first_author":"Li L","journal":"Frontiers in public health","year":2023,"pub_types":["brief-report","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescents","Self-esteem","Need To Belong","Family Functioning","Problematic Internet Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10307975","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 771 high‑school students; moderated mediation analysis","sample_n":771,"sample_text":"771 high school students, recruited via school‑based survey","population":"adolescents (mean age 16.2, mainly students, likely convenience sample)","country":"unspecified (authors likely China)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 771 teenagers, better family functioning was linked to lower problematic pornography use, partly because it boosted self‑esteem. The effect was stronger for youths who felt a strong need to belong.","clinical_takeaway":"Supporting family cohesion and self‑esteem may help reduce risky porn use in adolescents, especially those with high belonging needs.","confidence":0.78,"topic_tags":["pornography","adolescents","sexual_function","relationships","csbd"],"strengths":["large sample size for survey","use of validated self‑report scales","advanced mediation/moderation modeling"],"limitations":["cross‑sectional design cannot establish causality","no measurement of moral incongruence or masturbation","potential self‑selection bias from school‑based recruitment"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2023.1199835"}},{"id":1098,"doi":"10.1007/s10508-023-02618-2","pmid":"37316619","pmcid":null,"title":"Adults and Family as Supportive of Adolescent Sexual Development in the Age of Smartphones? Exploring Cybersexual Violence Victimization, Pornography Use, and Risky Sexual Behaviors","authors":"Rivas-Koehl M, Valido A, Espelage DL, Lawrence TI.","first_author":"Rivas-Koehl M","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescence","Adolescent Sexuality","Risky Sexual Behaviors","Protective Factors","Pornography","Cybersexual Violence"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large convenience sample of U.S. high‑school students (n=974) surveyed on cyber‑sexual violence, pornography use and sexual risk outcomes; analyses of associations","sample_n":974,"sample_text":"U.S. high school students (n = 974)","population":"U.S. adolescents (high‑school students)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 974 U.S. high‑school students found that those who reported seeing online sexual violence or using pornography were more likely to engage in risky sexual behaviors, while parental monitoring and school adult support appeared protective.","clinical_takeaway":"Screening for online sexual experiences and promoting adult support may help reduce adolescents' risky sexual behaviors.","confidence":0.7,"topic_tags":["adolescents","pornography","religiosity","sexual_function"],"strengths":["Large sample size for a survey","Addresses understudied link between online experiences and sexual risk"],"limitations":["Cross‑sectional; cannot infer causality","Pornography use measured with simple self‑report, no validated scale","Key potential confounds (moral attitudes, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02618-2"}},{"id":1099,"doi":"10.1177/15248380231173619","pmid":"37309642","pmcid":null,"title":"Pornography Use and Violence: A Systematic Review of the Last 20 Years","authors":"Mestre-Bach G, Villena-Moya A, Chiclana-Actis C.","first_author":"Mestre-Bach G","journal":"Trauma, violence & abuse","year":2024,"pub_types":["Systematic Review","Journal Article"],"keywords":["Sexual Abuse","Violence","Sexual Assault","Sexual Coercion","Pornography","Porn"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 59 studies investigating the association between pornography use and various forms of violence; no meta‑analysis or formal risk‑of‑bias assessment reported.","sample_n":null,"sample_text":"59 primary studies included; total participants not reported in abstract","population":"general population (any sex, age, orientation) from included studies","country":"multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 59 studies found some evidence that pornography use is linked to non‑sexual violence, but the relationship with intimate‑partner sexual assault and coercion is mixed. The authors say the data are too varied to draw firm conclusions about cause and effect.","clinical_takeaway":"None – the review does not provide actionable guidance for clinicians.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Broad 20‑year scope covering many studies","Transparent inclusion criteria for pornography and violence assessments","Cautious interpretation of causality"],"limitations":["Heterogeneity in definitions of pornography and violence limits comparability","No meta‑analysis or formal risk‑of‑bias assessment reported","Limited discussion of key confounders such as moral attitudes or mental health"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":29,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/15248380231173619"}},{"id":1100,"doi":"10.1016/j.biopsycho.2018.02.003","pmid":"29448047","pmcid":null,"title":"Genital lubrication: A cue-specific sexual response?","authors":"Sawatsky ML, Dawson SJ, Lalumière ML.","first_author":"Sawatsky ML","journal":"Biological psychology","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sex differences","Vaginal Lubrication","Photoplethysmograph","Sexual Psychophysiology","Cue-specificity","Genital Responses","Vaginal Vasocongestion"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experimental study with within‑subject exposure to sexual films; physiological recordings of vaginal vasocongestion (photoplethysmography) and introital lubrication; N=20 women.","sample_n":20,"sample_text":"20 women","population":"Adult women (young adult sample)","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study of 20 women, vaginal blood flow responded similarly to many sexual videos, but actual lubrication increased only for the types of videos each woman liked best, suggesting lubrication is not a generic protective response.","clinical_takeaway":"Lubrication appears linked to personal sexual preference rather than a universal protective reflex.","confidence":0.75,"topic_tags":["sexual_function","gender"],"strengths":["Objective physiological measures (validated photoplethysmography)","Within‑subject design controls individual variability","Direct test of preparation hypothesis"],"limitations":["Small sample (N=20) limits statistical power","No assessment of potential confounds (e.g., mood, sexual experience)","Limited generalisability beyond young adult women"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":2,"mentioning":17,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.biopsycho.2018.02.003"}},{"id":1101,"doi":"10.31744/einstein_journal/2025ao1282","pmid":"40053047","pmcid":"PMC11869794","title":"Ideal time and self-reported time to ejaculate, frequent use of virtual pornography, and disorders of ejaculation among internet users in the Metropolitan Region of São Paulo, Brazil. Cross-sectional study","authors":"Reis MMFD, Barros EAC, Monteiro L, Pazeto CL, Baccaglini W, Glina S.","first_author":"Reis MMFD","journal":"Einstein (Sao Paulo, Brazil)","year":2025,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11869794","cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online anonymous survey of adult men in São Paulo (N=528), self‑report measures of pornography use, ejaculation timing, and the Premature Ejaculation Diagnostic Tool (PEDT).","sample_n":528,"sample_text":"Convenience online sample; not a probability or nationally representative sample.","population":"Adult men (≥18 y) living in the São Paulo metropolitan region, recruited via the internet; 528 participants.","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 528 men in São Paulo, about half thought they ejaculated too early, but only 10 % used pornography frequently. Frequent pornography use was linked to non‑heterosexual orientation, lower education, and using porn during intercourse, but it was not related to premature or delayed ejaculation.","clinical_takeaway":"Frequent virtual pornography use does not appear to increase risk of ejaculation disorders in this sample.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Use of validated PEDT for premature ejaculation","Large sample for a single‑site survey (N>500)","Clear definition of “frequent” pornography use"],"limitations":["Cross‑sectional, cannot infer causality","Convenience internet sample; potential self‑selection bias","Key confounds (moral incongruence, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31744/einstein_journal/2025ao1282"}},{"id":1102,"doi":"10.1007/s12119-023-10100-3","pmid":"37360017","pmcid":"PMC10239214","title":"Prevalence and Impact of Revenge Pornography on a Sample of Portuguese Women","authors":"Murça A, Cunha O, Almeida TC.","first_author":"Murça A","journal":"Sexuality & culture","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Impact","Victims","Humiliation","Revenge Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10239214","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online convenience survey of 274 Portuguese women, 45 reported revenge‑porn victimisation; comparisons of self‑esteem, humiliation, depression and anxiety using validated questionnaires.","sample_n":274,"sample_text":"274 women (45 victims, 229 non‑victims).","population":"Portuguese women, 18‑82 years, recruited via online protocol (non‑random, self‑selected).","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 274 Portuguese women, 16 % reported having their intimate images shared without consent. Victims showed higher humiliation, anxiety and depression, and lower self‑esteem than non‑victims, though only humiliation reliably distinguished the groups.","clinical_takeaway":"Clinicians should assess humiliation and mental‑health impacts when supporting revenge‑porn victims.","confidence":0.7,"topic_tags":["religiosity","sexual_function","pornography"],"strengths":["Use of validated psychometric scales","First prevalence data on Portuguese women","Clear comparison between victims and non‑victims"],"limitations":["Cross‑sectional, cannot infer causality","Convenience online sample, limited generalisability","Small victim subgroup (n = 45) reduces power"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12119-023-10100-3"}},{"id":1104,"doi":"10.31234/osf.io/ehqgv","pmid":null,"pmcid":null,"title":"A reevaluation of online pornography use in Germany using a combination of web tracking and survey data","authors":"von Andrian-Werburg MTP, Siegers P, Breuer J.","first_author":"von Andrian-Werburg MTP","journal":"PsyArXiv","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://psyarxiv.com/ehqgv/download","cited_by_count":1,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational study using large‑scale web‑tracking panel (N≈3000) and linked online survey (N≈1300). No experimental manipulation; analyses are descriptive and correlational.","sample_n":3018,"sample_text":"Large‑scale German online web‑tracking panel (N = 3018); linked survey subsample (N = 1315).","population":"German internet users recruited via an online web‑tracking panel; likely a convenience sample rather than probability‑based.","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using about 3,000 German internet users’ browsing logs and a follow‑up survey, the study finds that men and younger people watch more online pornography, with use dipping around Christmas. Religious affiliation shows some differences, but relationship status, sexism and social dominance do not.","clinical_takeaway":"None – the study describes usage patterns, not health effects or treatment implications.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large objective web‑tracking dataset","Combined behavioral and self‑report data","Replicates findings from questionnaire studies"],"limitations":["No measurement of masturbation or co‑occurring sexual behaviour","Moral/religious attitudes not disentangled from distress","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/ehqgv"}},{"id":1106,"doi":"10.31234/osf.io/7npzm","pmid":null,"pmcid":null,"title":"Fantasy Made Flesh - A Network Analysis of the Reciprocal Relationship Between Sexual Fantasies, Pornography Usage and Sexual Behavior","authors":"von Andrian-Werburg MTP, Klopp E, Schwab F.","first_author":"von Andrian-Werburg MTP","journal":"PsyArXiv","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/7npzm","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Network analysis of self‑report data from 1338 hetero‑ and bisexual German participants, collected via an online survey.","sample_n":1338,"sample_text":"large and diverse sample","population":"Adults (heterosexual and bisexual) recruited online in Germany","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1338 German adults, researchers mapped how often people watch porn, imagine sexual scenes, and engage in sexual activities. They found that porn use, fantasies, and behavior are linked, especially for non‑mainstream practices like BDSM, but overall the influence on typical sexual behavior is small.","clinical_takeaway":"Pornography use appears only modestly related to everyday sexual behavior; clinicians should consider broader sexual contexts rather than assuming strong effects.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (N>1300) improves statistical power","Use of network analysis to explore multivariate relationships","Stability and accuracy of networks reported"],"limitations":["Reliance on ad‑hoc self‑report items; no validated scales","Cross‑sectional design prevents causal inference","No measurement or control of key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/7npzm"}},{"id":1108,"doi":"10.1101/2024.02.04.24302317","pmid":null,"pmcid":null,"title":"Sexual experiences among early adolescents aged 12-14 Years in four districts of Rwanda: a cross-sectional study","authors":"Mbarushimana V, Goldstein S, Conco DN.","first_author":"Mbarushimana V","journal":"medRxiv","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.medrxiv.org/content/medrxiv/early/2024/02/05/2024.02.04.24302317.full.pdf","cited_by_count":1,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 811 early adolescents (12‑14 y) from 16 Rwandan secondary schools using multistage random sampling; logistic regression to identify social‑ecological correlates of non‑penetrative and penetrative sexual experiences.","sample_n":811,"sample_text":"811 participants (≈56 per school, roughly equal male/female)","population":"early adolescents (12‑14 y), both sexes, school‑based sample in Rwanda","country":"Rwanda","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2024 Rwandan survey of 811 children aged 12‑14 found that 81 % had experienced non‑penetrative sex and 7 % had had penetrative sex. Factors such as party attendance, internet use, low father education, male gender, alcohol, pornography viewing, orphan status, and forced intercourse were linked to higher odds of sexual activity.","clinical_takeaway":"Early adolescent sexual activity is common; interventions should address contextual factors like peer settings, internet use, and family education.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Large, multi‑district sample","Random selection within schools","Use of multivariate logistic regression with CIs"],"limitations":["Self‑report of sensitive behaviours may be biased","Questionnaire not reported as validated","Cross‑sectional design limits causal inference","No measurement of moral or mental‑health confounders"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2024.02.04.24302317"}},{"id":1109,"doi":"10.21203/rs.3.rs-1577477/v1","pmid":null,"pmcid":null,"title":"The role of pornography in the sex life of young adults - a cross-sectional cohort study on female and male German medical students","authors":"Jahnen M, Zeng L, Kron M, Meissner VH, Korte A, Schiele S, Schulwitz H, Dinkel A, Gschwend JE, Herkommer K.","first_author":"Jahnen M","journal":"Research Square","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-1577477/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional anonymous survey of 468 German medical students (293 F, 175 M) examining self‑reported pornography consumption frequency and a range of sexual‑behaviour variables; analysed with simple and multiple Poisson regression.","sample_n":468,"sample_text":"468 students (293 female, 175 male) from Technical University of Munich.","population":"German medical students (young adult, likely WEIRD, voluntary participants).","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of German medical students found that frequent pornography use was linked to certain sexual activities (e.g., anal sex, threesomes) and feeling inspired by porn, with patterns differing between men and women.","clinical_takeaway":"Clinicians should recognise that young adults may view porn as a source of sexual ideas, but evidence does not link use to pathology.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a single university","Use of multivariable Poisson regression","Focus on gender‑specific patterns"],"limitations":["Convenience, student sample limits generalisability","Ad‑hoc, non‑validated questionnaire items","No control for key confounds (e.g., moral attitudes, mental health)","No effect‑size reporting or correction for multiple testing"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-1577477/v1"}},{"id":1110,"doi":"10.1007/s10508-023-02612-8","pmid":"37165286","pmcid":"PMC10171172","title":"Pornography Consumption and Extramarital Sex Attitudes Among Married U.S. Adults: Longitudinal Replication","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Archives of sexual behavior","year":2023,"pub_types":["Journal Article","case-report"],"keywords":["Replication","Sexual Socialization","Selective Exposure","Extramarital Sex","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10171172","cited_by_count":6,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal panel study replicating earlier findings on pornography use and extramarital sex attitudes among married US adults.","sample_n":null,"sample_text":"Not specified in abstract","population":"Married U.S. adults (sample size not provided in abstract)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A longitudinal study of married U.S. adults found that recent pornography use and attitudes toward extramarital sex influence each other over time, even after accounting for age, relationship history, political views, and religiosity.","clinical_takeaway":"Clinicians should note that pornography use and sexual attitudes can mutually influence each other, but no direct guidance for treatment is provided.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Longitudinal design allows temporal ordering","Replication of prior findings adds robustness","Adjusts for a broad set of demographic and psychosocial covariates"],"limitations":["No information on sample size or power","Constructs not explicitly tied to validated scales","Moral incongruence and trauma not measured"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":6,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02612-8"}},{"id":1111,"doi":"10.1080/00224499.2025.2459796","pmid":"39945610","pmcid":null,"title":"Betting on Digital Attention: Pornography vs. Climate, Economics, Elections, Immigration, and War (Don't Take the Field)","authors":"Wright PJ, Gruszczynski M, Woodworth B.","first_author":"Wright PJ","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"critical essay using Google Trends data to argue for increased research focus on pornography as a media genre; no primary data collection, no participants, no experimental or observational study.","sample_n":null,"sample_text":"Not applicable – essay without primary sample.","population":"none","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that pornography, as a widely consumed digital medium, deserves more systematic research attention, citing Google Trends data to show its popularity compared to other societal topics.","clinical_takeaway":"None – the paper is a commentary, not providing clinical evidence.","confidence":0.9,"topic_tags":["pornography","sexual_function"],"strengths":["Highlights a gap in pornography research attention","Uses publicly available Google Trends data"],"limitations":["No original empirical data collected","Absence of rigorous methodology or statistical analysis","No measurement of key constructs or confounders"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2025.2459796"}},{"id":1112,"doi":"10.1080/0092623x.2025.2457436","pmid":"39943693","pmcid":null,"title":"Attitudes Toward Age-Verification among U.S. Adults, Adolescents, and Parents","authors":"Wright PJ, Herbenick D.","first_author":"Wright PJ","journal":"Journal of sex & marital therapy","year":2025,"pub_types":["Journal Article"],"keywords":["Public Opinion","Supreme Court","Pornography","Media Law","Age-verification"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey reported in a Letter; sample size not reported; likely convenience sampling of adults, parents, adolescents in the U.S.","sample_n":null,"sample_text":"not provided in abstract","population":"U.S. adults, parents, adolescents (self‑selected via unknown recruitment method)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A brief survey of U.S. adults, parents, and teens found most support requiring porn sites to verify users' ages, though opinions varied. The authors suggest further research to understand these differences.","clinical_takeaway":"None – the study reports public attitudes, not clinical advice.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Timely assessment of public opinion relevant to pending Supreme Court case","Includes multiple stakeholder groups (adults, parents, adolescents)"],"limitations":["No sample size or recruitment details reported","Likely convenience sample; limited generalisability","No pre‑registration or power justification"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2025.2457436"}},{"id":1113,"doi":"10.1556/2006.2023.00011","pmid":"37141047","pmcid":"PMC10316158","title":"On the current psychotherapeutic situation for persons with pornography use disorder in Germany","authors":"Markert C, Storz F, Golder S, Rechmann J, Rubel JA, Lalk C, Vogt R, Glombiewski JA, Braun D, Pané-Farré CA, Michael T, Mattheus HK, Dominick N, Wölfling K, Lutz W, Schaffrath J, Stangier U, Kananian S, Strüwing D, Klingelhöfer D, Valbert F, Neumann A, Walter B, Stark R.","first_author":"Markert C","journal":"Journal of behavioral addictions","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Prevalence rate","Behavioral Addiction","Compulsive Sexual Behavior Disorder","Problematic Pornography Use","Pornography Use Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10316158","cited_by_count":9,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online prevalence survey (n≈2070) plus three therapist surveys; no longitudinal or experimental component.","sample_n":2070,"sample_text":"2070 participants in the general‑population online study; additional therapist samples (n=983, 185, 28).","population":"General adult population in Germany (online panel) and German psychotherapists.","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In Germany about 5 % of adults may meet criteria for pornography‑use disorder, with higher rates in men. Many feel negative effects, but few specialized treatments exist and therapists feel under‑informed.","clinical_takeaway":"Clinicians should screen for pornography‑related problems but recognise limited specialised services; education about PUD is needed.","confidence":0.8,"topic_tags":["prevalence","treatment","csbd","pornography","gender"],"strengths":["Large community sample for prevalence estimate","Multiple stakeholder surveys (patients, therapists, clinics)","Inclusion of religiosity as a covariate"],"limitations":["Reliance on self‑report screening; unclear validation of PUD measure","Moral incongruence and masturbation not assessed","Convenience online panel may limit generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2023.00011"}},{"id":1114,"doi":"10.1007/s12119-017-9454-6","pmid":"29531470","pmcid":"PMC5844496","title":"Sexual Scripts in Contemporary Mexican Cinema: A Quantitative Content Analysis","authors":"Kollath-Cattano CL, Mann ES, Zegbe EM, Thrasher JF.","first_author":"Kollath-Cattano CL","journal":"Sexuality & culture","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Mexico","Sexual Socialization","Sexual Scripts","Media Studies"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"quantitative content analysis of popular Mexican films","sample_n":null,"sample_text":"Number of films not reported in abstract","population":"Mexican films (no human participants)","country":"Mexico (film setting)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study counted how Mexican movies show sex, condom use, and drugs, finding many scenes depict non‑marital, age‑unequal heterosexual sex and few show safer practices. The authors suggest such portrayals could shape risky sexual behavior among youth.","clinical_takeaway":"None – the paper does not provide direct clinical evidence.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Systematic quantitative coding of film content","Focus on understudied cultural context","Clear description of sexual script categories"],"limitations":["No assessment of audience impact","Potential selection bias in film sample","Interpretation suggests causal influence without longitudinal data"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12119-017-9454-6"}},{"id":1117,"doi":"10.1177/10775595251314035","pmid":"39834238","pmcid":null,"title":"Characteristics of Child Sexual Abuse Material in Peer-to-Peer Networks and Predictors of its Severity: Insights From Filenames","authors":"Cross TP, Cross EM, Cooper C, Pellegrino D, Pounder G, Turkheimer S, Bailey S.","first_author":"Cross TP","journal":"Child maltreatment","year":2025,"pub_types":["Journal Article"],"keywords":["Incest","Child Pornography","Peer-to-peer","Child Sexual Abuse Material","Consume Child Sexual Abuse Material"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational analysis of 2,980 filenames from peer‑to‑peer networks; random sample of files shared from U.S. IP addresses in 2021.","sample_n":2980,"sample_text":"Random sample of filenames (N=2980) from P2P networks.","population":"CSAM files (no human participants); data drawn from internet peer‑to‑peer networks.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers examined 2,980 file names from peer‑to‑peer networks that contained child sexual abuse material. Most references were to girls aged 5‑12, often depicting penetration. Files were more severe when they involved younger children, incest, or children of colour, underscoring the need for racial‑justice‑aware interventions.","clinical_takeaway":"None – the study describes illegal content characteristics, not clinical advice.","confidence":0.78,"topic_tags":["csbd"],"strengths":["Large sample of filenames","Random sampling of internet data","Provides novel insights into CSAM content characteristics","Highlights racial dimensions of abuse"],"limitations":["Reliance on filename information, which may be inaccurate","No validation of coding scheme","Findings may not generalize to all CSAM platforms","Descriptive only; no causal claims"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10775595251314035"}},{"id":1121,"doi":"10.1371/journal.pone.0198895","pmid":"29902228","pmcid":"PMC6002055","title":"Loving the love of boys: Motives for consuming yaoi media","authors":"Zsila Á, Pagliassotti D, Urbán R, Orosz G, Király O, Demetrovics Z.","first_author":"Zsila Á","journal":"PloS one","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pone.0198895/1/pone.0198895.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210217%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210217T201358Z&X-Goog-Expires=3600&X-Goog-SignedHeaders=host&X-Goog-Signature=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","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 724 self‑selected yaoi consumers; confirmatory factor analysis of a new motives questionnaire.","sample_n":724,"sample_text":"724 yaoi consumers (58 % male; Mage = 30.1 years, SD = 10.4)","population":"yaoi media consumers, 58 % male, mean age 30 years, recruited via internet","country":"unspecified (likely Hungary/Europe based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study created and validated a questionnaire that reliably measures why people watch yaoi (boy‑love) media, identifying nine distinct motives based on responses from over 700 fans.","clinical_takeaway":"None – the research focuses on motives, not clinical issues.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Large sample for psychometric validation","Comprehensive CFA and invariance testing","Development of a novel, theory‑based motives instrument"],"limitations":["Convenience, self‑selected online sample","No pre‑registration reported","Findings limited to motives, not generalizable to broader population"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":1,"contrasting":1,"mentioning":15,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0198895"}},{"id":1122,"doi":"10.1080/10410236.2025.2450421","pmid":"39806881","pmcid":null,"title":"Gender Differences in the Association between Pornography Use and Sexual Satisfaction: Further Meta-Analytic Evidence","authors":"Wright PJ, Tokunaga RS.","first_author":"Wright PJ","journal":"Health communication","year":2025,"pub_types":["Meta-Analysis","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta-analysis of observational studies examining the correlation between pornography use frequency and sexual satisfaction, with separate analysis for men and women.","sample_n":null,"sample_text":"Not reported in abstract","population":"Adults from multiple primary studies (sample sizes not specified in abstract)","country":"Multiple (international studies)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of studies finds that men who watch more pornography tend to report lower sexual satisfaction, while women's satisfaction does not show a clear link to pornography use.","clinical_takeaway":"Higher porn use may be associated with reduced sexual satisfaction in men; clinicians should consider this when discussing sexual wellbeing.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Systematic replication of prior meta‑analysis","Separate gender analyses","Effect sizes with statistical significance reported"],"limitations":["Primary studies’ construct definitions unclear","Potential lack of control for moral incongruence or relationship factors","No pre‑registration disclosed"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2025.2450421"}},{"id":1123,"doi":"10.1080/00224499.2024.2446639","pmid":"39772909","pmcid":null,"title":"Parenting Style, Differentiation of Self, and Pornography Use Among Adolescents: Exploring the Links","authors":"Calatrava M, Mestre-Bach G, Osorio A, López-Del Burgo C.","first_author":"Calatrava M","journal":"Journal of sex research","year":2026,"pub_types":["Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large multi‑country adolescent survey (N=7161), self‑report questionnaires, cross‑sectional","sample_n":7161,"sample_text":"7161 adolescents, community/school‑based convenience sample across six countries","population":"Hispanic adolescents, ages 12‑17, from Mexico, Argentina, Chile, Ecuador, Peru, Spain","country":"Mexico; Argentina; Chile; Ecuador; Peru; Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 7,000 Hispanic teens, more parental warmth and, for boys, higher parental demandingness were linked to less frequent porn use. Teens with better emotional regulation also used porn less, suggesting it may be an emotional coping tool.","clinical_takeaway":"Parenting warmth and teen emotional regulation appear protective against frequent pornography use in adolescents.","confidence":0.84,"topic_tags":["adolescents","pornography","sexual_function","moral_incongruence"],"strengths":["Very large, multi‑country sample","Validated scales for parenting and differentiation of self","Separate analysis by gender and age"],"limitations":["Cross‑sectional; cannot infer causality","Pornography use measured only by frequency, no validated problematic‑use scale","Key confounds (moral incongruence, mental health, masturbation, trauma) not assessed"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2024.2446639"}},{"id":1124,"doi":"10.1080/00224499.2024.2446635","pmid":"39773254","pmcid":null,"title":"Understanding Rape Myth Acceptance Through the Lens of Sexual Objectification Theory: The Role of Pornography Consumption, Purchase of Sexual Services, and Masculinity","authors":"Leon CM, Aizpurua E, Quiñonez-Toral T, Rollero C.","first_author":"Leon CM","journal":"Journal of sex research","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 1,603 Spanish internet users examining associations between rape‑myth acceptance and pornography use, purchase of sexual services, masculinity and other attitudinal variables.","sample_n":1603,"sample_text":"1,603 internet users (approximately 50/50 gender split; mean age 45.7)","population":"Internet users in Spain, 51.6% women, mean age 45.7 years","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,600 Spaniards, higher acceptance of rape myths was linked mainly to sexist attitudes, comfort with sexuality, and gender, while pornography use showed only a small association.","clinical_takeaway":"Clinicians should note that attitudes toward sexual violence are driven more by sexism and gender norms than by pornography use alone.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size (N > 1500)","Validated rape‑myth acceptance scale","Multivariate analysis of several attitudinal predictors"],"limitations":["Cross‑sectional design limits causal inference","Pornography use measured by self‑report, unclear if validated","No control for key sexual‑health confounds (e.g., mental health, trauma)","Internet convenience sample may not be nationally representative"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2024.2446635"}},{"id":1125,"doi":"10.1016/j.adolescence.2019.03.008","pmid":"30954854","pmcid":"PMC6597258","title":"Longitudinal associations between sexting, cyberbullying, and bullying among adolescents: Cross-lagged panel analysis","authors":"Van Ouytsel J, Lu Y, Ponnet K, Walrave M, Temple JR.","first_author":"Van Ouytsel J","journal":"Journal of adolescence","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Multicenter Study","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Bullying","Cyberbullying","Sexting","Sexual Pressure"],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"cross-lagged panel analysis of three waves of adolescent data from public high schools in southeast Texas","sample_n":null,"sample_text":"three waves (T2‑T4) from a longitudinal study; exact N not given in abstract","population":"ethnically diverse adolescents (high school students) in Texas","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Texas school sample, teens who sent sexual images were more likely to become victims of cyber‑bullying later, and vice‑versa. Traditional bullying also followed later sexting. The study suggests a two‑way risk link between sexting and bullying.","clinical_takeaway":"Clinicians should monitor adolescents who sext for bullying victimisation and address both behaviours in prevention efforts.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Longitudinal design with multiple time points","Cross‑lagged panel analysis appropriate for directionality","Large, ethnically diverse school‑based sample"],"limitations":["Constructs measured by unspecified self‑report items","No reported power analysis or effect‑size confidence intervals","Potential unmeasured confounders (e.g., mental health, peer context)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":0,"mentioning":57,"citing_publications":107,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2019.03.008"}},{"id":1126,"doi":"10.1080/0092623x.2016.1149127","pmid":"27007447","pmcid":null,"title":"Hypersexuality in Psychiatric Conditions Observer-Rated Scale (HIPCORS): Evaluation of Reliability and Validity","authors":"Davidson CK, Cheung G, Jansen K.","first_author":"Davidson CK","journal":"Journal of sex & marital therapy","year":2017,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of observer‑rated hypersexuality scale in psychiatric patients; factor analysis, reliability testing","sample_n":null,"sample_text":"not specified in abstract","population":"psychiatric patients (both sexes) assessed by clinicians","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and tested a clinician‑rated questionnaire (HIPCORS) to measure hypersexual behavior in people with mental illness, finding it reliable and valid as a research tool.","clinical_takeaway":"HIPCORS may help clinicians assess hypersexual behavior without relying on self‑reports, but further validation is needed.","confidence":0.8,"topic_tags":["measurement","sexual_function","pornography","masturbation"],"strengths":["Observer‑rated format suitable for mentally ill patients","Factor analysis and reliability testing reported","Addresses gap in non‑self‑report tools"],"limitations":["No information on sample size or representativeness","Potential lack of control for moral or mental‑health confounds","Unclear whether distress is separated from behavior"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2016.1149127"}},{"id":1127,"doi":"10.3390/healthcare11060795","pmid":"36981451","pmcid":"PMC10048288","title":"Pornography Use among Lebanese Adults: Association with Loneliness and Fear of Commitment","authors":"Malaeb D, Hallit S, Obeid S.","first_author":"Malaeb D","journal":"Healthcare (Basel, Switzerland)","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Adults","Loneliness","Lebanon","Internet Pornography Use","Fear Of Commitment"],"is_oa":true,"oa_url":"https://www.mdpi.com/2227-9032/11/6/795/pdf?version=1678263336","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 653 Lebanese adults","sample_n":653,"sample_text":"653 adults from all Lebanese geographic areas","population":"Lebanese adults (mixed gender, religious groups)","country":"Lebanon","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Lebanese adult sample (N=653), higher loneliness and fear of commitment were linked to greater self‑reported pornography use and related guilt, with women and Muslims reporting lower use.","clinical_takeaway":"Loneliness and relationship fears may be important factors to explore when discussing pornography use with clients.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships","moral_incongruence"],"strengths":["Large sample (N>600)","Validated scales for loneliness and fear of commitment","First study of its kind in Lebanon"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of moral incongruence or masturbation","Addiction construct not operationalised beyond a self‑report inventory"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare11060795"}},{"id":1128,"doi":"10.1177/0706743719895205","pmid":"31835912","pmcid":"PMC7265605","title":"Prevalence and Correlates of Sexting Behaviors in a Provincially Representative Sample of Adolescents","authors":"Kim S, Martin-Storey A, Drossos A, Barbosa S, Georgiades K.","first_author":"Kim S","journal":"Canadian journal of psychiatry. Revue canadienne de psychiatrie","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Mental health","Adolescents","Ethnic Minority","Sexting","Sexual And Gender Minority"],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Large provincially representative survey of 2,537 adolescents, using logistic regression to examine correlates of sexting.","sample_n":2537,"sample_text":"Provincially representative household sample from the 2014 Ontario Child Health Study.","population":"Adolescents aged 14–17 in Ontario, Canada (N=2,537).","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a representative sample of 2,500 Ontario teens, about 14% sent and 27% received sexual images in the past year. Sending/receiving was more common among those who disclosed a sexual or gender minority identity and was linked to higher mental‑health problems.","clinical_takeaway":"Sexting is relatively common among teens and is associated with mental‑health concerns; clinicians should screen for both.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large, provincially representative sample","Clear prevalence estimates","Multivariate modeling of several demographic and mental‑health variables"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral or religious factors that could confound distress outcomes","Reliance on self‑report for sexting behavior"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":0,"mentioning":38,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0706743719895205"}},{"id":1129,"doi":"10.1177/0272684x15581343","pmid":"26099156","pmcid":null,"title":"Influence of Exposure to Sexually Explicit Films on the Sexual Behavior of Secondary School Students in Ibadan, Nigeria","authors":"Odeleye O, Ajuwon AJ.","first_author":"Odeleye O","journal":"International quarterly of community health education","year":2015,"pub_types":["Journal Article"],"keywords":["Sexual behavior","Young People","Tv"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 489 secondary school students in Ibadan, Nigeria; self‑report questionnaire on exposure to sexually explicit TV content and perceived influence on sexual behaviour","sample_n":489,"sample_text":"489 randomly selected students (53.8% female)","population":"adolescents (mean age 14.1) in secondary schools, Nigeria","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 489 Nigerian secondary‑school students found that most had seen sex scenes on TV and many believed this influenced their sexual behaviour. Heavier exposure was linked to higher self‑reported sexual activity, but the study relied on simple self‑reports and did not control for factors like moral views or mental health.","clinical_takeaway":"None – the study is descriptive and does not provide actionable clinical guidance.","confidence":0.8,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Large sample for a school‑based survey","Random selection of participants","Focus on a understudied context (Nigeria)"],"limitations":["Self‑report exposure and impact, no validated scales","Cross‑sectional design cannot infer causality","Key confounders (moral attitudes, mental health, masturbation) not measured"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0272684x15581343"}},{"id":1130,"doi":"10.1080/0092623x.2018.1462275","pmid":"29648965","pmcid":null,"title":"Influence of the Perceived Infidelity of Online Sexual Activities (OSAs) on OSA Experiences Among Chinese Heterosexual Individuals in Committed Relationships","authors":"Li D, Zheng L.","first_author":"Li D","journal":"Journal of sex & marital therapy","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 301 Chinese heterosexual individuals in committed relationships; participants reported whether each type of online sexual activity (OSA) was perceived as infidelity (yes/no) and whether they had engaged in it in the past 12 months; gender differences and mediation analysis reported.","sample_n":301,"sample_text":"N = 301 participants recruited via unspecified means (likely online convenience sample).","population":"Chinese heterosexual adults in committed relationships (sample size 301)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among Chinese couples, men are more likely than women to view online sexual activities (like viewing porn or cybersex) as acceptable, and they also report doing them more often. Seeing these activities as non‑infidelity is linked to higher participation, especially in partner‑seeking and flirting.","clinical_takeaway":"Clinicians should consider partners' differing views on online sexual behavior when addressing relationship concerns.","confidence":0.7,"topic_tags":["pornography","masturbation","gender","relationships","sexual_function"],"strengths":["Reasonably sized sample for a survey","Addresses gender differences in perceived infidelity","Introduces mediation model to explore pathways"],"limitations":["Uses single‑item, non‑validated measures for key constructs","No control for major confounds (moral views, mental health, partner dynamics)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":0,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2018.1462275"}},{"id":1131,"doi":"10.2196/43116","pmid":"36853749","pmcid":"PMC10015350","title":"Exposure to Pornography and Adolescent Sexual Behavior: Systematic Review","authors":"Pathmendra P, Raggatt M, Lim MS, Marino JL, Skinner SR.","first_author":"Pathmendra P","journal":"Journal of medical Internet research","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","review-article","Journal Article"],"keywords":["Sexual behavior","Adolescence","Teenager","Sexual Debut","Risky Behavior","Digital Media","Pornography Use"],"is_oa":true,"oa_url":"https://www.jmir.org/2023/1/e43116/PDF","cited_by_count":29,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 19 observational studies (mostly cross‑sectional) on pornography exposure and adolescent sexual outcomes, registered in PROSPERO.","sample_n":null,"sample_text":"19 primary studies (total participants not reported in abstract)","population":"Adolescents 10–19 y","country":"International (multiple databases)","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2023 systematic review examined whether seeing porn influences teenage sexual behaviours like early sexual debut or risky sex. The evidence is mixed; some studies link porn exposure to earlier sex, but most are cross‑sectional and inconsistent, so no firm conclusions can be drawn.","clinical_takeaway":"Current data do not definitively link pornography exposure to specific risky sexual outcomes in teens; clinicians should base guidance on broader evidence and individual risk factors.","confidence":0.85,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Registered systematic review protocol (PROSPERO).","Comprehensive database search across multiple sources.","Transparent reporting of heterogeneity and limitations."],"limitations":["Primary studies heterogeneous; exposure to pornography measured inconsistently.","Most primary evidence cross‑sectional, limiting causal inference.","Little information on controlling key confounds (e.g., moral incongruence, mental health)."],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":35,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/43116"}},{"id":1132,"doi":"10.1007/s10508-023-02534-5","pmid":"36853349","pmcid":"PMC10125950","title":"The Development and Validation of the Pornography Use in Romantic Relationships Scale","authors":"Lawless NJ, Karantzas GC, Knox L.","first_author":"Lawless NJ","journal":"Archives of sexual behavior","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Factor analysis","Romantic Relationships","Pornography Use In Romantic Relationships Scale"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-023-02534-5.pdf","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Scale development and validation with two large samples (n≈739 and n≈765) using EFA/CFA and criterion validity checks.","sample_n":1504,"sample_text":"Combined n=739 (Study 1) and n=765 (Study 2).","population":"Adults in romantic relationships (self‑selected online sample).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and tested a new questionnaire (PURRS) that measures how people use pornography within romantic relationships. Using two large samples, they identified 13 related dimensions and showed the scale is reliable and has good initial validity.","clinical_takeaway":"Practitioners can use the PURRS as a structured way to discuss pornography use with couples, but should consider additional factors like mental health and personal values.","confidence":0.85,"topic_tags":["pornography","relationships","measurement","sexual_function"],"strengths":["Large sample sizes for both exploratory and confirmatory phases.","Comprehensive factor analytic approach.","Demonstrates good internal consistency and preliminary criterion validity."],"limitations":["No assessment of key confounds (e.g., moral incongruence, mental health).","Cross‑sectional self‑report design limits causal inference.","Unclear whether external validation against established scales was performed."],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02534-5"}},{"id":1133,"doi":"10.1002/ab.21795","pmid":"30239007","pmcid":null,"title":"Misogynistic peers, masculinity, and bystander intervention for sexual aggression: Is it really just \"locker-room talk?\"","authors":"Leone RM, Parrott DJ.","first_author":"Leone RM","journal":"Aggressive behavior","year":2019,"pub_types":["Journal Article"],"keywords":["Bystander effect","Peer Norms","Sexual Violence","Barriers To Helping","Male Role Norms"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment with random assignment; N=104 college men; manipulated peer norm (misogynistic vs ambiguous) and measured bystander intervention speed and likelihood.","sample_n":104,"sample_text":"College men (N = 104) recruited for a lab study","population":"Self‑identified heterosexual college men, racially diverse, ages 18‑35","country":"USA (inferred from university sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, men who watched peers express misogynistic attitudes were less likely and slower to intervene when a woman was exposed to sexual material, especially if they strongly endorsed traditional male status norms.","clinical_takeaway":"Peer norms and masculinity beliefs can hinder bystander help in sexual aggression situations; interventions should target these attitudes.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Randomized experimental manipulation of peer norms","Behavioral outcome measure of bystander intervention","Use of validated masculinity scale"],"limitations":["Sample limited to college men; generalizability limited","No assessment of potential mental‑health or moral‑incongruence confounds","Effect sizes and power not reported in abstract"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":33,"citing_publications":33,"retracted":false,"notices":[{"status":"Has erratum","date":"2019-6-12","noticeDoi":"10.1002/ab.21849","doi":"10.1002/ab.21795"}],"url":"https://scite.ai/reports/10.1002/ab.21795"}},{"id":1134,"doi":"10.1080/13691058.2017.1372632","pmid":"28922092","pmcid":null,"title":"From risky behaviour to sexy adventures: reconceptualising young people's online sexual activities","authors":"Naezer M.","first_author":"Naezer M.","journal":"Culture, health & sexuality","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexuality","Internet","Youth","risk","Adventure"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Ethnographic fieldwork among Dutch youth; qualitative interviews/focus groups; no quantitative sampling reported.","sample_n":null,"sample_text":"Not reported in abstract; likely small convenience sample typical of ethnography.","population":"Adolescents and young adults in the Netherlands (sexual identity, gender not specified).","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Using ethnographic interviews with Dutch youth, the author argues that online sexual activities (e.g., sexting, viewing explicit material) should be seen as adventurous explorations rather than merely risky or pathological behaviours.","clinical_takeaway":"None – the study offers sociocultural insights, not clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Rich ethnographic insight into youth agency.","Interdisciplinary theoretical framing (risk, adventure, feminist theory).","Challenges pathologising narratives."],"limitations":["No systematic measurement of sexual behavior or mental‑health variables.","Small, non‑representative sample; limited generalisability.","Lacks quantitative analysis or effect size reporting."],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":27,"citing_publications":79,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2017.1372632"}},{"id":1135,"doi":"10.1007/bf02437842","pmid":"8931883","pmcid":null,"title":"Attitudes of U.S. and Czech/Slovak mental health and health professionals toward five types of sexually explicit materials","authors":"Robinson BE, Scheltema K, Koznar J, Manthei R.","first_author":"Robinson BE","journal":"Archives of sexual behavior","year":1996,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of mental‑health and health professionals attending conferences in the U.S. and Czech/Slovak Republics (1992‑1993).","sample_n":null,"sample_text":"Convenience sample of conference attendees; size not reported in abstract.","population":"Mental‑health and health professionals (sexologists, psychologists/counselors, medical professionals) attending conferences.","country":"United States; Czech Republic; Slovakia","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Surveyed U.S. and Czech/Slovak mental‑health professionals found they view educational erotic material most positively, and violent or bizarre porn most negatively. More religious professionals held stronger negative attitudes.","clinical_takeaway":"Clinicians’ personal religiosity may shape their attitudes toward porn; be aware of potential bias when discussing sexual materials with clients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large professional sample across two cultures","Uses ANCOVA to control for religiosity"],"limitations":["Attitude scale not reported as validated","Convenience sampling of conference attendees limits generalisability","No effect‑size or power information"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":5,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02437842"}},{"id":1136,"doi":"10.1101/2023.11.07.23298242","pmid":null,"pmcid":null,"title":"Risky Sexual Behavior and its Determinants among Undergraduate Hostellers of Kathmandu Metropolitan City","authors":"Chaudhary RK, Chalise A, Pandey S, Paudel S.","first_author":"Chaudhary RK","journal":"medRxiv","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 361 hostel residents","sample_n":361,"sample_text":"Convenience sample of university students residing in hostels","population":"undergraduate hostellers in Kathmandu, Nepal","country":"Nepal","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 361 Nepalese university students living in hostels found that about two‑thirds engaged in risky sexual behaviours. Factors linked to higher risk were older age, being male, having a partner, lower maternal education and peer pressure. Porn use appeared related in simple analysis but not after adjusting for other factors.","clinical_takeaway":"Screening for age, gender, relationship status and peer influence may help identify students at higher risk for unsafe sex; porn use alone was not a robust predictor.","confidence":0.6,"topic_tags":["relationships","sexual_function"],"strengths":["Relatively large sample for a single‑site survey","Multivariable logistic regression with adjusted odds ratios"],"limitations":["Cross‑sectional design; cannot infer causality","Key constructs (problematic porn use) measured with non‑validated single items","Major confounders (moral incongruence, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2023.11.07.23298242"}},{"id":1138,"doi":"10.1177/08862605241299442","pmid":"39614676","pmcid":null,"title":"The Impact of Violent Pornography on Sexual Coercive Behaviors Among College Men: A Prospective Examination","authors":"Bhuptani PH, Cashin D, Orchowski LM.","first_author":"Bhuptani PH","journal":"Journal of interpersonal violence","year":2025,"pub_types":["Journal Article"],"keywords":["Prevention","Sexual Assault","Alcohol And Drugs"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort study with three survey waves (baseline, 4‑month, 7‑month) of 247 college men","sample_n":247,"sample_text":"247 college men completed surveys at three time points","population":"college men (N=247)","country":"United States (likely, based on journal and sample description)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 7‑month study of 247 college men, higher exposure to violent pornography predicted later sexually coercive behavior, partly through more sexist attitudes, greater alcohol problems, and blaming women less for rape. The authors suggest teaching about pornography could help prevent sexual assault.","clinical_takeaway":"Programs that address violent porn exposure and its influence on attitudes may reduce sexual coercion risk among college men.","confidence":0.85,"topic_tags":["pornography","sexual_function"],"strengths":["Prospective longitudinal design allows temporal ordering","Adequate sample size for mediation analysis","Use of validated attitude and alcohol‑use scales"],"limitations":["Exposure to violent pornography measured by self‑report, likely single‑item","No measurement of potential confounds such as moral incongruence, trauma, or partner effects","Sample limited to a single university, limiting generalisability"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605241299442"}},{"id":1140,"doi":"10.1080/00926239308404890","pmid":"8468712","pmcid":null,"title":"Patterns of exposure to sexually explicit material among sex offenders, child molesters, and controls","authors":"Nutter DE, Kearns ME.","first_author":"Nutter DE","journal":"Journal of sex & marital therapy","year":1993,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control, retrospective comparison of sex offenders, child molesters and community controls; developmental ages and exposure frequencies reported","sample_n":null,"sample_text":"Not specified in abstract; likely small convenience samples drawn from offender records and community volunteers","population":"male sex offenders, child molesters, and non‑offending controls (sample size not reported in abstract)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared when male sex offenders, child molesters and non‑offending men first masturbated and first saw porn. Offenders began masturbating earlier, and a third of them first used porn during that first experience, but adult porn use frequency was similar across groups.","clinical_takeaway":"Early exposure to sexual material is not alone predictive of later offending; clinicians should consider broader risk factors.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Direct comparison of offenders and controls","Inclusion of developmental timing data"],"limitations":["Reliance on retrospective self‑report","No validated scales for pornography use or pathology","No control for moral, mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239308404890"}},{"id":1141,"doi":"10.1097/mop.0000000000000637","pmid":"29750769","pmcid":"PMC6453661","title":"Updates on adolescent dating and sexual violence prevention and intervention","authors":"Miller E, Jones KA, McCauley HL.","first_author":"Miller E","journal":"Current opinion in pediatrics","year":2018,"pub_types":["research-article","Review","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review summarizing recent literature on adolescent dating and sexual violence; no new empirical data.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Adolescents (general); no primary data collected.","country":"United States (focus of cited studies).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises how common dating and sexual violence are among teens, showing higher risk for girls and LGBTQ youth, and notes that factors like childhood trauma, exposure to explicit material, substance use, and gender attitudes can increase risk.","clinical_takeaway":"Clinicians should screen for dating and sexual violence in teens, especially those with substance use or exposure to explicit content.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Broad overview of recent research","Highlights modifiable risk factors","Integrates gender and minority perspectives"],"limitations":["No systematic search or risk‑of‑bias assessment","Lacks quantitative synthesis","No primary data; conclusions rely on cited studies"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":33,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/mop.0000000000000637"}},{"id":1142,"doi":"10.1080/19317611.2022.2161030","pmid":"38596758","pmcid":"PMC10903653","title":"The Criteria to Identify Pornography That Can Support Healthy Sexual Development for Young Adults: Results of an International Delphi Panel","authors":"McKee A, Dawson A, Kang M.","first_author":"McKee A","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Pornography","Sexually Explicit Material"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"Delphi expert consensus panel generating criteria; no primary user data; no empirical testing of criteria.","sample_n":null,"sample_text":"Not applicable – expert panel rather than participant sample.","population":"experts from various relevant fields (international panel).","country":"International (unspecified).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A panel of international experts used a Delphi method to propose six criteria—like consent, diversity, ethical production, and safe sex—to help young adults choose pornography that may support healthy sexual development, and they recommend four sites that appear to meet these standards.","clinical_takeaway":"Clinicians can share these criteria with clients seeking guidance on porn use for sexual development, but note they are expert recommendations, not evidence‑based outcomes.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["International expert panel provides diverse perspectives","Clear, actionable six‑point criteria","Identifies specific websites meeting criteria"],"limitations":["No empirical data on user outcomes","Criteria not validated with users or measured effects","Potential selection bias of experts"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2022.2161030"}},{"id":1145,"doi":"10.1080/13691058.2022.2155707","pmid":"36607166","pmcid":null,"title":"Good servant, bad master: How eighty women perceive the influence of pornography on sexual scripts","authors":"Lebedíková M.","first_author":"Lebedíková M.","journal":"Culture, health & sexuality","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Women","Sex Education","Sexual Scripts","Pornography","3Am Theory"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative thematic analysis of open‑ended survey responses from 80 Czech women (age 18‑30)","sample_n":80,"sample_text":"80 young Czech women (18‑30 years)","population":"young adult women, Czech, convenience sample","country":"Czech Republic","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Eighty Czech women (18‑30) described how watching pornography shapes what they think sex should be like. They reported that porn can help them feel more empowered and satisfied, but it can also create negative feelings, showing a mixed impact on their sexual lives.","clinical_takeaway":"Clinicians should recognize that women’s experiences with pornography are varied; it can be both empowering and problematic, so discussions should be individualized.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["In‑depth qualitative insight into women's perspectives","Thematic analysis grounded in sexual script theory","Identification of both positive and negative perceived effects"],"limitations":["Convenience sample, limited generalizability","No validated measures of pornography use or distress","No assessment of key confounds (e.g., moral incongruence, masturbation)","Findings based on self‑report, possible social desirability bias"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2022.2155707"}},{"id":1146,"doi":"10.1007/s10508-022-02518-x","pmid":"36600001","pmcid":"PMC9812353","title":"Web-Based Relationship Education and Pornography-Related Behaviors: A Single-Group Design During the COVID-19 Pandemic","authors":"Hatch SG, Goodman ZT, Hatch HD, Le Y, Guttman S, Doss BD.","first_author":"Hatch SG","journal":"Archives of sexual behavior","year":2023,"pub_types":["research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Treatment","Couples","Pornography","Pornography Addiction","Covid-19","Ourrelationship"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9812353","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"single-group pre‑post design of a web‑based relationship education program (OurRelationship) with 314 couples (628 individuals); no control group; outcomes self‑reported pornography frequency, duration, arguments about use, and perceived problematic use","sample_n":628,"sample_text":"314 couples, 628 individuals","population":"low‑income, diverse couples (U.S.)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A web‑based couples program reduced how often participants watched porn, but it did not change arguments about porn or how problematic they felt it was. Effects were small and larger for those who started out watching daily.","clinical_takeaway":"Improving relationship functioning may modestly lower pornography use, but does not appear to change perceived problem use.","confidence":0.8,"topic_tags":["pornography","relationships","sexual_function","treatment"],"strengths":["large sample of couples","real‑world web‑based intervention","reports effect sizes and confidence intervals"],"limitations":["single‑group pre‑post design, no control condition","lack of validated measures for problematic use","does not assess moral incongruence, masturbation, mental health or trauma"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02518-x"}},{"id":1147,"doi":"10.20944/preprints202310.0683.v2","pmid":null,"pmcid":null,"title":"Perception Of Pre-Marital Sex, Courtship among Osun State University Undergraduates, Osogbo, Osun State <strong> </strong>","authors":"Olayiwola AA, Omoge AO, Olarinmoye A, Benzard G, Yahaya HU, Aborisade OG, Osolase J.","first_author":"Olayiwola AA","journal":"Preprints.org","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.preprints.org/manuscript/202310.0683/v2/download","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive survey of 387 undergraduate students using multi‑stage sampling; self‑administered questionnaire; analysis with SPSS.","sample_n":387,"sample_text":"Validated responses after data cleaning; sampling based on Leslie Kish formula.","population":"Undergraduate students at Osun State University, Osogbo, Nigeria (age ≈19 ± 2 y).","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 387 Nigerian university students found that about half view premarital sex positively. Peer pressure, internet, pornography and drugs were reported as main reasons for engaging in premarital sex.","clinical_takeaway":"None – the study is descriptive and does not provide actionable clinical guidance.","confidence":0.6,"topic_tags":["prevalence","sexual_function","pornography","csbd","moral_incongruence"],"strengths":["Reasonable sample size for descriptive aims","Multi‑stage sampling within campus","Clear reporting of demographic data"],"limitations":["Questionnaire not validated; reliance on ad‑hoc items","Cross‑sectional design cannot infer causality","No measurement of key confounds (moral, mental health, partner effects)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202310.0683.v2"}},{"id":1148,"doi":"10.1093/pubmed/fdx139","pmid":"29136181","pmcid":"PMC6306090","title":"Dating and relationship violence among 16-19 year olds in England and Wales: a cross-sectional study of victimization","authors":"Young H, Turney C, White J, Bonell C, Lewis R, Fletcher A.","first_author":"Young H","journal":"Journal of public health (Oxford, England)","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://academic.oup.com/jpubhealth/article-pdf/40/4/738/27277875/fdx139.pdf","cited_by_count":29,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional self‑report survey of 1,751 further‑education students (16‑19 y) in England & Wales; multilevel logistic regression.","sample_n":1751,"sample_text":"Six further‑education settings; convenience sample of students.","population":"FE students, aged 16‑19, England & Wales (n≈1,751)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 1,751 UK teens in further‑education found that almost half experienced controlling or threatening behaviour in dating relationships, with similar rates for males and females. Sending explicit images was linked to higher victimisation.","clinical_takeaway":"High rates of dating violence among teens highlight the need for screening and preventive programs in schools.","confidence":0.8,"topic_tags":["relationships","adolescents","gender"],"strengths":["Large sample for a youth survey","Multilevel regression accounts for clustering by school","Factor analysis to identify DRV dimensions"],"limitations":["Cross‑sectional, cannot infer causality","Self‑report measures not validated against external criteria","Limited control of key confounders (mental health, trauma, moral factors)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":51,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/pubmed/fdx139"}},{"id":1149,"doi":"10.1080/00224499.2018.1481920","pmid":"29952665","pmcid":"PMC6310663","title":"Is Guardian Permission a Barrier to Online Sexual Health Research Among Adolescent Males Interested in Sex With Males?","authors":"Nelson KM, Carey MP, Fisher CB.","first_author":"Nelson KM","journal":"Journal of sex research","year":2019,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey of 206 adolescent males interested in sex with males; mixed‑methods (quantitative logistic regression, qualitative matrix); convenience sample.","sample_n":206,"sample_text":"N = 206 recruited online in June–July 2017","population":"Adolescent males 14‑17 years interested in sex with males (AMSM), United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Most teen boys who are attracted to other boys would skip an online sexual‑health study if they needed a parent’s permission; those not out to their parents were especially unlikely to take part.","clinical_takeaway":"IRBs should consider waiving guardian consent for online sexual‑health research with hidden‑identity youth to avoid selection bias.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Relevant policy‑focused question","Mixed‑methods enriches understanding","Logistic regression with CIs reported"],"limitations":["Convenience, non‑representative sample","Limited use of validated scales","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1481920"}},{"id":1151,"doi":"10.31234/osf.io/5fujq","pmid":null,"pmcid":null,"title":"Do Different Sources of Sexuality Education Contribute Differently to Sexual Health and Well-Being Outcomes? Examining Sexuality Education in Spain and Portugal","authors":"Rodrigues DL, Carvalho AC, de Visser R, Lopes D, Alvarez MJ.","first_author":"Rodrigues DL","journal":"PsyArXiv","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://osf.io/5fujq/download","cited_by_count":0,"is_preprint":true,"topics":["pornography","sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience sample of 595 participants from Spain and Portugal; linear regression analyses of self‑reported sexuality‑education sources and sexual‑health outcomes.","sample_n":595,"sample_text":"595 participants recruited online (convenience sample).","population":"general adult population (Spain, Portugal)","country":"Spain; Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In Spain and Portugal, people get sexuality education from schools, friends, family, and online sources like porn. School‑based education was linked to more condom use and disease prevention but less sex‑positive attitudes. Informal sources (friends, family, porn) were tied to higher pleasure focus, more condomless sex, and in some cases better consent attitudes or higher STI rates.","clinical_takeaway":"Sexuality‑education programmes should combine formal school teaching with supportive informal sources to promote both safety and positive attitudes.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for a cross‑sectional survey (N=595).","Examines multiple sources of sexuality education in two countries.","Uses multivariate regression to control for some demographic variables (presumed)."],"limitations":["Self‑report measures likely ad‑hoc and not psychometrically validated.","Cross‑sectional design precludes causal inference.","No assessment of key confounds (e.g., moral incongruence, mental health)."],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/5fujq"}},{"id":1152,"doi":"10.1111/jan.14277","pmid":"31774190","pmcid":null,"title":"Safe sexual behaviors intention among female youth: The construction on extended theory of planned behavior","authors":"Tseng YH, Cheng CP, Kuo SH, Hou WL, Chan TF, Chou FH.","first_author":"Tseng YH","journal":"Journal of advanced nursing","year":2020,"pub_types":["Journal Article"],"keywords":["Nursing","Perceived Behavioural Control","Theory Of Planned Behaviour","Safe Sex","Peer","Female Youth","Sexually Explicit Materials","Parent-child Communication About Sex"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Convenience sample of 731 female youth, self‑report questionnaire, TPB model regression","sample_n":731,"sample_text":"Convenience sampling of female youth aged 15‑24 years (N=731)","population":"Female youth ages 15‑24, recruited 2013‑2014, Taiwan (?)","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 731 female youths showed that feeling in control and social norms strongly predicted intentions to use condoms or other contraceptives, while talking with parents boosted safe‑sex intentions and peer talk reduced them.","clinical_takeaway":"Strengthen perceived control and parent‑child communication to improve safe‑sex intentions among young women.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample (N>700) for a cross‑sectional survey","Use of an established theoretical framework (TPB)","Examines multiple social‑cognitive predictors"],"limitations":["Convenience, non‑representative sample","Self‑report measures only; no behavioral validation","No assessment of key confounds (moral, mental health, trauma, masturbation)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":1,"mentioning":28,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jan.14277"}},{"id":1153,"doi":"10.3389/fpubh.2022.1046813","pmid":"36605242","pmcid":"PMC9807871","title":"Prevalence and predictors of pornography exposure during the third wave of the COVID-19 pandemic: A web-based cross-sectional study on students in Bangladesh","authors":"Hossain MT, Ahammed B, Jahan N, Islam MA, Rahman MM, Khan B, Sarker MJA, Nibir MM, Hasan M, Hasib M, Rahman R, Islam MN.","first_author":"Hossain MT","journal":"Frontiers in public health","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Prevalence","Students","risk factors","Bangladesh","Covid-19","Pornography Exposure"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpubh.2022.1046813/pdf","cited_by_count":2,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"web-based cross‑sectional survey of 646 Bangladeshi students recruited via social media; convenience sample.","sample_n":646,"sample_text":"Convenience‑based, internet‑accessing students; not nationally representative.","population":"students (high school, college, university) in Bangladesh","country":"Bangladesh","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2022 online survey of 646 Bangladeshi students, about three‑quarters reported watching pornography during the third COVID‑19 wave. Older age, being in a relationship, and not living alone raised the odds, while living alone, being in the Khulna region, higher religiosity and disapproving attitudes lowered them.","clinical_takeaway":"High pornography exposure among Bangladeshi students is common; clinicians should consider age, relationship status, and personal attitudes when discussing sexual health.","confidence":0.8,"topic_tags":["pornography","prevalence","sexual_function"],"strengths":["Large sample for a web survey","Multivariate logistic regression with confidence intervals","Inclusion of religiosity/attitude as predictor"],"limitations":["Convenience, non‑representative student sample","Single‑item, non‑validated measure of exposure","No assessment of masturbation or mental‑health covariates"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2022.1046813"}},{"id":1155,"doi":"10.1080/10538712.2016.1189473","pmid":"27472510","pmcid":null,"title":"Behavioural Differences Between Online Sexual Groomers Approaching Boys and Girls","authors":"van Gijn-Grosvenor EL, Lamb ME.","first_author":"van Gijn-Grosvenor EL","journal":"Journal of child sexual abuse","year":2016,"pub_types":["Journal Article"],"keywords":["Gender Differences","Girls","Boys","Offenders’ Behaviors","Online Grooming"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"analysis of archived transcripts from convicted offenders interacting with adult decoys posing as children (52 girl decoys, 49 boy decoys).","sample_n":100,"sample_text":"Offenders approached 52 volunteer girl decoys and 49 volunteer boy decoys.","population":"convicted sexual offenders (adult males, middle‑aged). Sample size ≈ 100 offenders.","country":"Not stated in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers examined how convicted online sexual predators behaved differently when chatting with adult volunteers pretending to be boys versus girls. Groomers of boys were older and pretended to be younger, while those targeting girls built more rapport and used more covert contact strategies.","clinical_takeaway":"None – study addresses offender tactics, not client‑facing sexual health or addiction concerns.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large coded dataset of real‑world grooming conversations","Systematic coding scheme","Direct comparison of gender‑based grooming strategies"],"limitations":["Convenience sample of convicted offenders; not representative","Reliance on adult decoys rather than actual children","No validated measurement instruments reported"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":43,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2016.1189473"}},{"id":1156,"doi":"10.1080/10410236.2024.2419196","pmid":"39451076","pmcid":"PMC12022148","title":"Impersonal Sex and Pornography: Potential Confounding, Moderation, and Implications for Public Health","authors":"Wright PJ, Tokunaga RS, Herbenick D.","first_author":"Wright PJ","journal":"Health communication","year":2025,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national probability sample of US adults; associations between pornography frequency and six impersonal‑sex behaviours examined with regression/correlation analyses","sample_n":null,"sample_text":"national probability sample (size not given in abstract)","population":"US adults (probability sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US‑wide survey, people who watch more porn are also more likely to engage in group sex, casual hookups, sex without love, and other impersonal sexual activities, especially among older adults. The link is not explained by simply having a high sex drive.","clinical_takeaway":"Higher porn use is associated with more impersonal sexual behaviour, but causality is unclear; clinicians should consider broader sexual context rather than assuming porn causes risk.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative probability sample","Addresses a gap by examining older adults","Considers sex‑drive as a potential confound","Multiple impersonal‑sex outcomes tested"],"limitations":["Cross‑sectional design cannot establish causality","Behavioural measures appear ad‑hoc and unvalidated","Key confounds (moral incongruence, mental health, trauma) not assessed","No effect‑size reporting or pre‑registration evident"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2024.2419196"}},{"id":1157,"doi":"10.1080/13691058.2013.855819","pmid":"24387328","pmcid":null,"title":"Getting the 'blues': the existence, diffusion and influence of pornography on young peoples' sexual health in Sierra Leone","authors":"Day A.","first_author":"Day A.","journal":"Culture, health & sexuality","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"focus groups and surveys with young people in Sierra Leone; exploratory, non‑representative","sample_n":null,"sample_text":"unspecified; likely convenience focus‑group participants","population":"young people (adolescents and young adults) in Sierra Leone","country":"Sierra Leone","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study explored how young people in Sierra Leone think pornography influences their sexual health, based on focus‑group discussions. Participants mentioned increased access and possible negative impacts on decisions about sex and contraception.","clinical_takeaway":"Clinicians should note that perceptions of pornography’s impact vary; no direct evidence of harm is provided here.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses a neglected LMIC context","Uses primary data from local respondents"],"limitations":["No validated measures of pornography exposure or outcomes","Convenience sampling limits generalisability","No control for key confounds (e.g., moral incongruence, mental health)","Interpretation leans toward assumed negative effects without causal evidence"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2013.855819"}},{"id":1158,"doi":"10.1016/j.encep.2026.06.006","pmid":"42786053","pmcid":null,"title":"Sexual craving as a core process in dysregulated sexual behaviors: Psychometric validation of the Short Scale of Sexual Craving (3SC)","authors":"Miele C, Moulin V, Pereira B, Cabé J, Barrault S.","first_author":"Miele C","journal":"L'Encephale","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual Addiction","Paraphilia","Psychometric Validation","Paraphilie","Addiction Sexuelle","Validation Psychométrique","Sexual Craving","Process-based Assessment","Comportements Sexuels Dysrégulés","Craving Sexuel","Dysregulated Sexual Behavior","Évaluation Centrée Sur Les Processus"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"psychometric validation of a 3‑item sexual craving scale in 76 adults with dysregulated sexual behaviors (clinical and community sample)","sample_n":76,"sample_text":"Convenience sample recruited via clinical and community channels in France","population":"adults reporting dysregulated sexual behaviors (normophilic and paraphilic)","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and tested a three‑question tool that measures how often, how strong, and how hard to control sexual urges are. In 76 adults with problematic sexual behaviours, the new scale correlated with an existing sexual‑addiction questionnaire, suggesting it could be a quick way to assess sexual craving.","clinical_takeaway":"The 3‑item Sexual Craving Scale may help clinicians quickly gauge urge intensity without relying on moral judgments, but it needs further validation before routine use.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides the first brief measure of sexual craving across diverse DSB presentations","Includes both clinical and community participants","Shows acceptable internal consistency and criterion validity against SAST"],"limitations":["Scale items are ad‑hoc; limited validation beyond this sample","No assessment of key confounds (moral incongruence, mental health, partner factors)","Cross‑sectional convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.encep.2026.06.006"}},{"id":1159,"doi":"10.1080/00224499.2018.1462885","pmid":"29723074","pmcid":null,"title":"The Impacts of Sexual Arousal and Its Suppression on Executive Functioning","authors":"Suchy Y, Holmes LG, Strassberg DS, Gillespie AA, Nilssen AR, Niermeyer MA, Huntbach BA.","first_author":"Suchy Y","journal":"Journal of sex research","year":2019,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Lab experiment with random allocation to arousal vs suppression condition; 44 male college students; within‑subject baseline then post‑manipulation EF testing.","sample_n":44,"sample_text":"44 male college students (21 suppression, 23 arousal)","population":"Male college students, primarily White, age ~18‑24, United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, 44 male college students watched erotic videos while either trying to suppress or allow sexual arousal. Those who let themselves become aroused performed worse on executive‑function tasks afterward, suggesting temporary mental‑control deficits linked to arousal.","clinical_takeaway":"Heightened sexual arousal may briefly impair decision‑making; awareness could help prevent risky choices in high‑arousal contexts.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Objective physiological measure of arousal","Randomized experimental manipulation","Separate assessment of executive vs lower‑order cognition"],"limitations":["Small, homogeneous sample limits generalizability","No pre‑registration, effect‑size reporting missing","Potential uncontrolled confounds (mood, prior sexual experience)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1462885"}},{"id":1160,"doi":"10.1111/tmi.13329","pmid":"31692197","pmcid":null,"title":"Sexual behaviours among adolescents in a rural setting in eastern Uganda: a cross-sectional study","authors":"Bukenya JN, Nakafeero M, Ssekamatte T, Isabirye N, Guwatudde D, Fawzi WW.","first_author":"Bukenya JN","journal":"Tropical medicine & international health : TM & IH","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Multicenter Study","Journal Article"],"keywords":["Sub-Saharan Africa","Adolescents","Uganda","Sexual Practices","Afrique Subsaharienne","Ouganda","Sexting","Pratiques Sexuelles"],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 598 adolescents selected randomly within a demographic surveillance site in eastern Uganda; face‑to‑face interviews with a standardised questionnaire; Modified Poisson regression used to estimate prevalence rate ratios.","sample_n":598,"sample_text":"598 adolescents, randomly selected from a health‑demographic surveillance site.","population":"Adolescents aged 10‑19 years living in Iganga‑Mayuge health and demographic surveillance site, eastern Uganda (N=598).","country":"Uganda","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 598 Ugandan adolescents found that 18% had ever had sex; factors linked to sexual activity included being out of school, watching explicit movies, sexting, and jokes about sexual intent. The authors recommend comprehensive sex education and contraceptive access.","clinical_takeaway":"Targeted sex‑education and contraceptive programmes are needed for Ugandan adolescents, especially those out of school and exposed to sexual media.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large, randomly selected adolescent sample from a defined community","Use of Modified Poisson regression with reported confidence intervals","Clear reporting of prevalence and associated factors"],"limitations":["Cross‑sectional design cannot establish causality","Self‑report measures of sexual behaviour may be subject to social desirability bias","No validated psychometric scales for key behaviours; single‑item questions"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":10,"contrasting":3,"mentioning":28,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/tmi.13329"}},{"id":1162,"doi":"10.1007/s11930-022-00352-9","pmid":"36467871","pmcid":"PMC9684871","title":"Virtual Reality Pornography: a Review of Health-Related Opportunities and Challenges","authors":"Evans L.","first_author":"Evans L.","journal":"Current sexual health reports","year":2023,"pub_types":["review-article","Review","Journal Article"],"keywords":["Virtual reality","Arousal","Empathy","Pornography","Teledildonics"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9684871","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Review of 23 articles; no new empirical data; narrative synthesis.","sample_n":null,"sample_text":"Not applicable – review of existing studies","population":"Not applicable (review)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review summarizes early research on virtual‑reality pornography, noting that VR may increase immersion, arousal, desire, empathy for performers, and sexual anxiety, but the evidence base is still small and scattered.","clinical_takeaway":"Currently no firm clinical guidance; VR porn may heighten sexual arousal and anxiety, so clinicians should ask clients about its use in assessments.","confidence":0.5,"topic_tags":["pornography","sexual_function"],"strengths":["Broad coverage of emerging VR pornography literature","Identifies gaps for future research","Clear summary of reported arousal and empathy findings"],"limitations":["No quantitative synthesis; narrative review only","No systematic risk‑of‑bias assessment reported","Relies on limited primary studies, many with small samples"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11930-022-00352-9"}},{"id":1165,"doi":"10.1007/s10508-026-03535-w","pmid":"42760476","pmcid":null,"title":"Why Do Male Users Engage with Connected Sex Toys? A Latent Class Analysis of Motivational Profiles","authors":"Lafortune D, Dussault É, Canivet C, Williams ME, Dubé S.","first_author":"Lafortune D","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Male","Latent Class Analysis","Teledildonics","Sex Toys","Sextech","Digisexuality"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Secondary analysis of a cross‑sectional online survey of 569 male customers of a single teledildonics company; latent class analysis used to identify motivational profiles and examine associations with demographics and usage patterns.","sample_n":569,"sample_text":"N = 569 male respondents; recruited via the teledildonics company's customer list.","population":"Male users of internet‑connected sex toys (customers of one company); convenience sample; no random or population‑based recruitment.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 569 men who use internet‑connected sex toys identified four motivation‑based groups. Some use the toys mainly to replace a partner and often watch pornography, while others use them for relaxation or tech interest. The findings highlight diverse reasons for using these devices.","clinical_takeaway":"Motivations for teledildonics use vary widely; clinicians should consider individual reasons—not just sexual pleasure—when discussing technology‑mediated intimacy.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for latent‑class analysis","Novel focus on teledildonics motivations","Inclusion of concurrent pornography use as a variable"],"limitations":["Convenience sample from a single company limits generalisability","Motivational items not reported as validated scales","No control for key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03535-w"}},{"id":1166,"doi":"10.1016/j.bodyim.2026.102190","pmid":"42753643","pmcid":null,"title":"Body image for boys and men in digital spaces: current findings and a conceptual reboot for future research","authors":"Fatt SJ, Shen Y, Griffiths S, Fardouly J.","first_author":"Fatt SJ","journal":"Body image","year":2026,"pub_types":["Journal Article"],"keywords":["Men","Body Image","Online","Social Media","Boys","Digital Technology","Digital Spaces"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative overview without systematic methods; no new data collected.","sample_n":null,"sample_text":"Not applicable – no empirical sample","population":"Boys and men (general population, no specific sampling described)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how boys and men use online platforms—like social media, gaming, dating apps and pornography—and how these exposures may affect their body image, noting both risks and potential benefits.","clinical_takeaway":"Clinicians should consider the diverse digital influences on male body image and tailor guidance accordingly; no direct clinical recommendations are provided.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of digital contexts relevant to body image","Identifies clear gaps and future research directions","Highlights practical implications for clinicians and policymakers"],"limitations":["No systematic literature search or risk‑of‑bias assessment","Lacks empirical data; conclusions based on narrative synthesis","Does not assess or control key confounds (e.g., mental health, moral incongruence)"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.bodyim.2026.102190"}},{"id":1168,"doi":"10.1177/15248380261480163","pmid":"42745201","pmcid":null,"title":"Sexualized Deepfake Abuse as Image-Based Sexual Abuse: A Scoping Review of Platform-Mediated Circulation and Cumulative Harm","authors":"Gao Y.","first_author":"Gao Y.","journal":"Trauma, violence & abuse","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Image-based Sexual Abuse","Cumulative Harm","Digital Justice","Non-consensual Intimate Imagery","Platform-mediated Circulation","Sexualized Deepfake Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Scoping review of 54 peer‑reviewed articles; descriptive synthesis of legal, conceptual and limited empirical work; no meta‑analysis or risk‑of‑bias assessment.","sample_n":null,"sample_text":"54 articles reviewed","population":"Victims of sexualized deepfake abuse (studied indirectly via the literature); no primary sample","country":"International (articles from various jurisdictions)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review maps research on sexualized deepfake abuse, showing how online spread creates layered harms—distress, stigma, career and relationship impacts, and reporting burdens—while noting that evidence on how to intervene is still limited.","clinical_takeaway":"Clinicians should recognize deepfake abuse as a distinct form of image‑based sexual violence that can cause lasting, multi‑domain harm.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive mapping of literature across legal, conceptual and empirical domains","Clear distinction between doctrinal analysis and empirical evidence"],"limitations":["Lacks quantitative synthesis or risk‑of‑bias assessment","Relies on a small body of primary empirical studies"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/15248380261480163"}},{"id":1169,"doi":"10.1007/s10508-022-02449-7","pmid":"36287301","pmcid":null,"title":"U.S. Parents Underestimate Their Children's Pornography Use and Learning","authors":"Wright PJ, Herbenick D, Paul B, Tokunaga RS.","first_author":"Wright PJ","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Children","Parents","Pornography","Moral Panic","Risk Underestimation"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national probability sample of 614 parent‑adolescent dyads; cross‑sectional survey","sample_n":614,"sample_text":"national probability sample","population":"U.S. parents and their adolescent children (≈16 y)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"U.S. parents generally think their teens watch less porn than they actually do. While they know boys tend to view more than girls, they still underestimate both sexes' exposure.","clinical_takeaway":"Clinicians should be aware that parents may underestimate teen porn use and discuss realistic media exposure with families.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","prevalence","measurement"],"strengths":["Large, nationally representative probability sample","Parent‑adolescent dyad design allows direct comparison","Clear focus on estimation bias rather than pathology"],"limitations":["Self‑report measures of pornography use, likely not validated scales","No assessment of key confounds (moral incongruence, masturbation, mental health, trauma)","Cross‑sectional design cannot infer causal effects"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02449-7"}},{"id":1170,"doi":"10.1080/00224499.2024.2408269","pmid":"39360892","pmcid":null,"title":"Closing the Gender Gap? A Cohort Comparison of Adolescent Responses to and Attitudes Toward Pornography, 2004 vs. 2021","authors":"Donevan M, Bladh M, Landberg Å, Jonsson LS, Priebe G, Dennhag I, Svedin CG.","first_author":"Donevan M","journal":"Journal of sex research","year":2026,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.1080/00224499.2024.2408269","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional surveys of Swedish high‑school students in 2004 (n=4,266) and 2020‑21 (n=3,256); gender‑stratified bivariate analyses and logistic regressions.","sample_n":7262,"sample_text":"Total N = 7,262 (4,266 in 2004; 3,256 in 2020‑21).","population":"Adolescents (≈18 y) from Swedish high schools; mixed gender; convenience school‑based samples.","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Swedish high‑school students in 2021 use pornography more often than those in 2004, and the gap between boys and girls in their reactions and attitudes has narrowed. Boys report less arousal and fewer positive feelings, while girls are less upset by porn and more likely to see it as exploitative.","clinical_takeaway":"Educators should note that today’s adolescents, especially girls, show higher tolerance of porn but also recognize its harms; curricula should address critical media literacy.","confidence":0.78,"topic_tags":["pornography","adolescents","gender","sexual_function"],"strengths":["Large national samples across two time points","Gender‑stratified analyses","Clear descriptive trends in use and attitudes"],"limitations":["Reliance on single‑item, self‑report measures","Cross‑sectional design cannot establish causality","No measurement of key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":0,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2024.2408269"}},{"id":1171,"doi":"10.1016/j.fertnstert.2013.05.041","pmid":"23830149","pmcid":"PMC3828051","title":"Brain activation patterns in women with acquired hypoactive sexual desire disorder and women with normal sexual function: a cross-sectional pilot study","authors":"Woodard TL, Nowak NT, Balon R, Tancer M, Diamond MP.","first_author":"Woodard TL","journal":"Fertility and sterility","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Functional Neuroimaging","Female Sexual Dysfunction","Brain Activation Patterns","Hypoactive Sexual Desire Disorder (Hsdd)","Sexual Stimuli"],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross-sectional pilot study comparing premenopausal women with HSDD to controls while viewing sexual film clips; no intervention.","sample_n":null,"sample_text":"Pilot study – likely <30 per group (typical for fMRI pilots).","population":"Premenopausal women (small convenience sample; exact N not reported in abstract)","country":"USA (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small fMRI pilot compared brain activity while women watched sexual movies. Women with low sexual desire showed different activation in limbic and cortical areas than women with normal desire, suggesting possible neural differences underlying hypoactive sexual desire.","clinical_takeaway":"Findings hint at neural differences in HSDD but are preliminary; clinicians should not base treatment decisions on this alone.","confidence":0.4,"topic_tags":["neuroscience","sexual_function","moral_incongruence","masturbation","religiosity"],"strengths":["Uses neuroimaging to explore neural correlates of HSDD","Includes a control group of women with normal sexual function","Employs validated sexual stimulus clips"],"limitations":["Very small pilot sample limits statistical power and generalisability","Cross‑sectional design cannot establish causality","No control for key psychological or relational confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":60,"pct_score":37,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":4,"statistics":4,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":33,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.fertnstert.2013.05.041"}},{"id":1172,"doi":"10.1007/s10508-024-02999-y","pmid":"39354276","pmcid":null,"title":"Is Degradation in the Eye of the Beholder (or the Researcher)?","authors":"Hehman JA, Salmon CA.","first_author":"Hehman JA","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Degradation","Sex differences","Sexual Orientation","Disgust","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 496 adults (≈50/50 gender) assessing perceived degradation of various sexual behaviors across male/female actors and targets.","sample_n":496,"sample_text":"247 females, 249 males","population":"Adults from unspecified recruitment source, likely convenience sample.","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Nearly 500 adults rated how degrading they think various sexual acts are, depending on who is doing what to whom. Some acts (e.g., watersports) are widely seen as degrading, while others depend on the participants’ genders. Perceptions of degradation are context‑dependent.","clinical_takeaway":"Perceived degradation of sexual acts varies by context; clinicians should consider individual and cultural views rather than assuming inherent harm.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a perception survey","Balanced gender representation","Explores contextual moderators of degradation judgments"],"limitations":["Likely uses non‑validated rating items","Convenience sample limits generalizability","No control for moral or religious attitudes"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02999-y"}},{"id":1173,"doi":"10.1071/sh24096","pmid":"39388430","pmcid":null,"title":"Parents' attitudes and response to their child's pornography consumption in Australia: cross-sectional survey","authors":"Lim MSC, Johnson ER, Raggatt MH.","first_author":"Lim MSC","journal":"Sexual health","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Observational Study"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational cross‑sectional online survey of 1,029 Australian parents of children aged 8‑20","sample_n":1029,"sample_text":"parents with children aged 8–20 years (n = 1029)","population":"parents (self‑selected) in Australia","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,029 Australian parents found many underestimate how often their children view porn, and some believe it can be part of a healthy relationship. About a quarter knew their child had seen porn; most responded by talking with them, while a few took no action or limited device access.","clinical_takeaway":"Clinicians should recognize parental misperceptions about youth porn exposure and support parents with evidence‑based guidance for communication.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["large sample size for survey","focus on understudied parental perspective","covers a wide child age range"],"limitations":["non‑random, self‑selected parent respondents","use of ad‑hoc, likely unvalidated questionnaire items","cross‑sectional, no causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh24096"}},{"id":1175,"doi":"10.1891/0886-6708.27.3.378","pmid":"22852438","pmcid":null,"title":"Exposure to harsh parenting and pornography as explanations for males' sexual coercion and females' sexual victimization","authors":"Simons LG, Simons RL, Lei MK, Sutton TE.","first_author":"Simons LG","journal":"Violence and victims","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of >2000 college students","sample_n":2000,"sample_text":"more than 2,000 college students","population":"college students (US?, likely predominantly young adults)","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 2,000 college students, researchers found that men who experienced harsh corporal punishment as children and who watched porn more often were more likely to report using coercive sexual tactics. For women, similar harsh parenting combined with porn use was linked to higher reports of being sexually victimised.","clinical_takeaway":"Be cautious interpreting porn use as a direct cause of sexual aggression or victimisation; other factors and longitudinal data are needed.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["large sample size","examines interaction of parenting and pornography","includes both perpetration and victimization outcomes"],"limitations":["cross‑sectional, cannot infer causality","uses single‑item self‑report measures","does not control key confounds (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":35,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1891/0886-6708.27.3.378"}},{"id":1176,"doi":"10.21203/rs.3.rs-3220871/v1","pmid":null,"pmcid":null,"title":"Sexual behaviors and the association between sexual knowledge, attitude and behaviors among Chinese university students: a moderated mediation model","authors":"Ou X, Zhang Y, Liu S, Jiang Y, Baibuti H, Chen Z, Liu J.","first_author":"Ou X","journal":"Research Square","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-3220871/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1006 Chinese university students from 30 provinces; binary logistic regression and moderated mediation analysis","sample_n":1006,"sample_text":"1006 respondents (33% reported ever having sexual behaviors)","population":"university students aged 15‑25 years in mainland China (convenience sample)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 1,006 Chinese university students, one‑third reported ever having sex. Having more sexual knowledge, searching for pornographic material, higher family income, and more permissive attitudes were linked to a higher chance of sexual activity. Attitudes partly explained how knowledge led to behavior, and income changed the strength of that link.","clinical_takeaway":"Sex education that improves knowledge and promotes healthy attitudes may influence sexual behavior among university students.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, multi‑province sample of university students","Uses logistic regression and mediation modelling","Reports odds ratios with confidence intervals"],"limitations":["Cross‑sectional design prevents causal inference","Likely uses ad‑hoc, unvalidated questionnaire items","No control for key confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-3220871/v1"}},{"id":1178,"doi":"10.1007/s11920-022-01374-9","pmid":"36197630","pmcid":null,"title":"Current Perspectives on Pornography Use by Individuals Convicted of a Sexual Offense","authors":"Wescott S, Kosmala K.","first_author":"Wescott S","journal":"Current psychiatry reports","year":2022,"pub_types":["Review","Journal Article"],"keywords":["Policy","Supervision","risk","Recidivism","Sexual Offense","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of literature on pornography use among individuals convicted of sexual offenses, focusing on risk of recidivism and treatment implications.","sample_n":null,"sample_text":"Not applicable – review article","population":"Adults convicted of sexual offenses (male predominant)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review summarizes studies on whether watching porn affects the likelihood that people who have committed sexual crimes will re‑offend. It finds no clear overall link, but higher risk may exist for men already judged high‑risk, and porn may reinforce aggressive sexual attitudes.","clinical_takeaway":"Porn use alone is not a reliable predictor of re‑offending; risk assessments should consider individual risk level and the type of material viewed.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Synthesises recent literature","Highlights nuanced risk factors (high vs low risk)","Considers specificity of porn type to offense"],"limitations":["No systematic search or risk‑of‑bias assessment","Lacks quantitative meta‑analysis","Does not address key confounds such as moral incongruence"],"rubric_version":"2.0","raw_total":3,"max_possible":50,"pct_score":6,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11920-022-01374-9"}},{"id":1179,"doi":"10.1177/08862605221123291","pmid":"36181240","pmcid":null,"title":"The Role of Sexual Scripts in the Relationship Between Pornography Use and Sexual Coercion","authors":"Marshall EA, Miller HA.","first_author":"Marshall EA","journal":"Journal of interpersonal violence","year":2023,"pub_types":["Journal Article"],"keywords":["Sexual Aggression","Sexual Coercion","Sexual Scripts","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 390 college‑aged males, structural equation modelling of self‑report measures.","sample_n":390,"sample_text":"College‑aged men recruited from a university, sample size 390.","population":"college males, United States (likely), convenience sample","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 390 college men, higher pornography use was linked to stronger sexual‑script endorsement, which in turn was related to more self‑reported sexual coercion. The effect of porn on coercion was indirect, operating through the scripts.","clinical_takeaway":"None – findings are correlational and not directly actionable for clinical practice.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for SEM","Direct test of theoretical mechanism","Clear statistical model"],"limitations":["Cross‑sectional, cannot infer causality","No control for key confounds (e.g., moral attitudes, mental health)","Self‑report of coercive behavior may be biased","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605221123291"}},{"id":1180,"doi":"10.1016/j.jadohealth.2018.03.012","pmid":"29921546","pmcid":null,"title":"The Prevalence of Unwanted Online Sexual Exposure and Solicitation Among Youth: A Meta-Analysis","authors":"Madigan S, Villani V, Azzopardi C, Laut D, Smith T, Temple JR, Browne D, Dimitropoulos G.","first_author":"Madigan S","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2018,"pub_types":["Meta-Analysis","Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Internet","Meta-analysis","Adolescent","Solicitation","Unwanted Exposure To Explicit Material"],"is_oa":false,"oa_url":null,"cited_by_count":52,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"systematic search of studies (1990‑2016), random‑effects meta‑analysis, moderator analyses","sample_n":37649,"sample_text":"31 samples (37,649 participants) for exposure; 9 samples (18,272 participants) for solicitation","population":"youth aged 12‑16.5 years","country":"multiple (global)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"About one in five adolescents accidentally see sexual material online, and one in nine are contacted for sexual purposes. Rates have fallen over time, and boys are more often solicited than girls.","clinical_takeaway":"Clinicians should ask youths about unwanted online sexual content and advise safety strategies.","confidence":0.8,"topic_tags":["prevalence","adolescents","sexual_function"],"strengths":["Large pooled sample across many studies","Systematic search and dual coding","Provides confidence intervals for prevalence"],"limitations":["Reliance on heterogeneous self‑report measures","No assessment of potential confounders (e.g., mental health)","Limited detail on study quality or bias"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":1,"contrasting":7,"mentioning":74,"citing_publications":166,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2018.03.012"}},{"id":1182,"doi":"10.1177/10778012221125502","pmid":"36113020","pmcid":null,"title":"\"Pornography Encouraged Me to Belittle Women\": A Thematic Analysis of Men's Reflections on Violence Against Women and Ceasing Pornography Use","authors":"Jovanovski N, Jovanovski N, Tyler M.","first_author":"Jovanovski N","journal":"Violence against women","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Masculinity","Pornography","Nonconsumption","Conducive Context"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Thematic analysis of interviews/ written reflections from 124 men who voluntarily stopped pornography use. Convenience sample of self‑selected participants; no comparison group.","sample_n":124,"sample_text":"124 men who have stopped pornography use.","population":"Men who have decided to stop consuming pornography; recruited via unspecified channels (likely forums or outreach).","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A qualitative study of 124 men who quit porn explored why they stopped. Many said concerns about violence toward women and gender equality motivated them, suggesting that anti‑porn attitudes can be linked to feminist concerns.","clinical_takeaway":"Clinicians should note that some men cease porn use for ethical reasons related to gender attitudes, not necessarily because of clinical addiction.","confidence":0.6,"topic_tags":["pornography","gender","sexual_function","csbd"],"strengths":["Qualitative depth of participants' own narratives","Clear focus on motivations for porn cessation","Relatively large sample for a thematic study"],"limitations":["Self‑selected, non‑representative sample","No measurement of key confounds (moral incongruence, masturbation, mental health)","No validated scales for pornography use or related constructs"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10778012221125502"}},{"id":1183,"doi":"10.1007/s10508-022-02411-7","pmid":"36109450","pmcid":null,"title":"Exposure to Pornographic Content Among Indian Adolescents and Young Adults and Its Associated Risks: Evidence from UDAYA Survey in Bihar and Uttar Pradesh","authors":"Srivastava S, Chauhan S, Patel R, Marbaniang SP, Kumar P, Dhillon P, Pandey N.","first_author":"Srivastava S","journal":"Archives of sexual behavior","year":2023,"pub_types":["Journal Article"],"keywords":["India","Adolescents","Sex Education","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey analysis of a large, state‑representative dataset (UDAYA) with >11 000 adolescents (15‑19 y) reporting whether they had ever been exposed to pornography; logistic regression used to identify associated factors.","sample_n":11651,"sample_text":"3885 adolescent boys and 7766 adolescent girls aged 15‑19 years.","population":"Adolescent boys (n≈3 885) and girls (n≈7 766) aged 15‑19 years in Bihar and Uttar Pradesh, India.","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 11,000 Indian teens, about half of boys and 6 % of girls reported ever seeing porn. Having a personal mobile phone and frequent media use made exposure more likely. The authors suggest expanding life‑skills and sexuality education.","clinical_takeaway":"Consider integrating media‑literacy and comprehensive sex education for adolescents, especially those with personal phones.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large, state‑representative sample","Separate analysis for boys and girls","Clear statistical reporting of odds ratios"],"limitations":["Exposure measured with a single self‑report item","Cross‑sectional; cannot infer causality","No measurement of moral, mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02411-7"}},{"id":1184,"doi":"10.1016/j.chiabu.2019.104083","pmid":"31358352","pmcid":null,"title":"A longitudinal evaluation of a survivor-mentor program for child survivors of sex trafficking in the United States","authors":"Rothman EF, Preis SR, Bright K, Paruk J, Bair-Merritt M, Farrell A.","first_author":"Rothman EF","journal":"Child abuse & neglect","year":2020,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Secondary Prevention","Adolescent Health","Commercial Sexual Exploitation","Human Trafficking","Domestic Minor Sex Trafficking","Csec"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"one-group repeated measures GEE over 12 months (N=41)","sample_n":41,"sample_text":"41 youth (baseline), 71% follow‑up at 6 mo, 68% at 12 mo","population":"youth aged 11‑18 with prior or high‑risk CSE exposure, 95% female, urban Northeast US","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A survivor‑mentor program was offered to 41 youth with histories of commercial sexual exploitation. Over a year, self‑reports indicated reductions in exploitation, drug use and delinquent behavior, and improvements in social support and coping, but the study lacked a control group and used small, unvalidated measures.","clinical_takeaway":"Program shows promise, but evidence is limited; clinicians should await controlled trials before endorsing it as proven effective.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Longitudinal follow‑up over 12 months","Focus on a high‑risk, underserved population","Use of GEE to handle repeated measures"],"limitations":["No control/comparison group","Small sample, high attrition","Reliance on unvalidated self‑report measures","Claims of causal impact not supported by design"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":36,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2019.104083"}},{"id":1185,"doi":"10.32388/966hxz","pmid":null,"pmcid":null,"title":"Particular Sexual and Ambitious Attitude Threatens the Global Societal Functioning and Individual Wellbeing","authors":"Brodziak A, Abram D.","first_author":"Brodziak A","journal":"Qeios","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.qeios.com/read/966HXZ/pdf","cited_by_count":4,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"The paper is a theoretical commentary lacking empirical data, methods, or sample.","sample_n":null,"sample_text":"No participants; the work is a conceptual essay.","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that authoritarian societies, reinforced by religious and patriarchal morals, restrict freedoms and may affect sexual issues like pornography, but the piece offers no data, only a theoretical narrative.","clinical_takeaway":"None – the article provides no evidence for clinical practice.","confidence":0.7,"topic_tags":["sexual_function","pornography","moral_incongruence"],"strengths":["Broad interdisciplinary perspective","References to existing political and moral psychology literature"],"limitations":["No empirical data or systematic review","Lacks operational definitions of key sexual constructs","No measurement of confounding variables"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.32388/966hxz"}},{"id":1186,"doi":"10.3390/healthcare12171762","pmid":"39273786","pmcid":"PMC11395095","title":"Affective-Sexual Behaviors in Youth: Analysis of a Public Health Survey in the School Setting","authors":"Zafra-Agea JA, Ramírez-Baraldes E, García-Salido C, García-Gutiérrez D, Vilafranca-Cartagena M.","first_author":"Zafra-Agea JA","journal":"Healthcare (Basel, Switzerland)","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Adolescents","Sexual Health","Gender Differences","Contraceptive Knowledge","Pornography Consumption"],"is_oa":true,"oa_url":"https://doi.org/10.3390/healthcare12171762","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Descriptive cross‑sectional questionnaire study of 14‑18‑year‑old school students in a single Catalan municipality.","sample_n":null,"sample_text":"Not reported in abstract; likely modest size typical of a single‑school survey.","population":"Adolescents (4th year ESO, ages 14‑18) from one public school; convenience sample.","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A school‑based survey of Spanish teens found gender differences in contraceptive knowledge and high rates of pornography use, with boys starting earlier and using it more often. The authors urge better sexual education and media‑literacy programmes.","clinical_takeaway":"Clinicians should be aware that many adolescents are exposed to pornography and may benefit from tailored sexual‑health education.","confidence":0.4,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Focus on understudied adolescent population","Includes gender comparison of pornography use","Uses established statistical tests for bivariate analysis"],"limitations":["Likely non‑validated, ad‑hoc questionnaire items","No measurement of key confounds (moral incongruence, masturbation, mental health)","Cross‑sectional, single‑school convenience sample limits generalisability","No effect sizes or power justification"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare12171762"}},{"id":1188,"doi":"10.3389/fpsyt.2022.988435","pmid":"36159913","pmcid":"PMC9493177","title":"Approach-Avoidance pattern of attentional bias in individuals with high tendencies toward problematic Internet pornography use","authors":"Wang J, Huang Y.","first_author":"Wang J","journal":"Frontiers in psychiatry","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Ambivalence","Attentional Bias","Behavioral Addiction","Approach–avoidance Pattern","Problematic Internet Pornography Use"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2022.988435/pdf","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Between‑groups comparison of 40 high‑PIPU and 40 low‑PIPU participants using an exogenous cueing task; no longitudinal or experimental manipulation.","sample_n":80,"sample_text":"80 participants (40 high PIPU, 40 low PIPU).","population":"Adults (unspecified) recruited for high vs low self‑reported problematic Internet pornography use.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"People who report more problems with online porn show quick attention to porn pictures but later tend to look away, suggesting an approach‑avoidance pattern similar to other addictions.","clinical_takeaway":"Attentional bias patterns may signal problematic porn use, but clinicians should assess broader factors before diagnosing addiction.","confidence":0.7,"topic_tags":["pornography","sexual_function","religiosity","adolescents"],"strengths":["Experimental attentional task distinguishes early vs late processing","Clear high/low PIPU group comparison","Correlation of bias scores with symptom severity"],"limitations":["Reliance on self‑report PIPU scale; validation unclear","No measurement of key confounds (morality, masturbation, mental health)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2022.988435"}},{"id":1189,"doi":"10.1007/s10508-017-1091-5","pmid":"29247299","pmcid":null,"title":"Influence of Body Odors and Gender on Perceived Genital Arousal","authors":"Alves-Oliveira P, Carvalho J, Ferreira J, Alho L, Nobre P, Olsson MJ, Soares SC.","first_author":"Alves-Oliveira P","journal":"Archives of sexual behavior","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Mating behavior","Gender","olfaction","Human Body Odors","Perceived Genital Arousal"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment with within‑subject odor manipulation (odor vs no odor) while viewing sexual videos; N=80 university students (40 women, 40 men).","sample_n":80,"sample_text":"Eighty university students (40 women).","population":"University students, likely WEIRD sample.","country":"Not specified (likely Brazil/Portugal based on author names).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, 80 students watched sexual videos while being exposed to an opposite‑sex body odor or no odor. Women reported lower perceived genital arousal when the odor was present, while men’s ratings were unchanged. Odor pleasantness did not explain the effect.","clinical_takeaway":"Odor cues may modestly affect women’s perceived sexual arousal, but findings are based on self‑report and may not translate to physiological responses.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Controlled laboratory manipulation of odor exposure","Balanced gender sample","Clear focus on perceived genital arousal"],"limitations":["Self‑report measures not validated","No physiological arousal data","Limited generalisability beyond young university students"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":12,"retracted":false,"notices":[{"status":"Has correction","date":"2018-2-12","noticeDoi":"10.1007/s10508-018-1170-2","doi":"10.1007/s10508-017-1091-5"},{"status":"Has erratum","date":"2018-2-12","noticeDoi":"10.1007/s10508-018-1170-2","doi":"10.1007/s10508-017-1091-5"}],"url":"https://scite.ai/reports/10.1007/s10508-017-1091-5"}},{"id":1191,"doi":"10.1007/s10508-024-02985-4","pmid":"39212871","pmcid":"PMC11390763","title":"Porn or Partner Arousal? When It Comes to Romantic Relationships, Not All Sexual Arousal Is Equal: A Prospective Study","authors":"Lawless NJ, Karantzas GC.","first_author":"Lawless NJ","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Relationship Quality","Sexual Satisfaction","Relationship Stability","Pornography","Subjective Sexual Arousal"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11390763","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Prospective cohort of 309 romantic partners measured at baseline and 2‑month follow‑up.","sample_n":309,"sample_text":"309 participants in current romantic relationships.","population":"Adults in romantic relationships (mixed gender, age range not specified).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2‑month study of 309 people in romantic relationships, feeling sexually aroused by pornography predicted declines in sexual satisfaction and overall relationship quality, whereas arousal by a partner did not show such effects.","clinical_takeaway":"Clinicians might discuss how frequent porn‑induced arousal could relate to lower relationship satisfaction, but note the evidence is correlational and confounded.","confidence":0.8,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Prospective design with two‑wave follow‑up","Adequate sample size for regression analyses","Focus on relational outcomes relevant to couples"],"limitations":["Subjective arousal measured by self‑report only, unclear validation","Key confounds (moral views, masturbation, mental health) not assessed","Causal language may overstate correlational findings"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02985-4"}},{"id":1192,"doi":"10.1007/s11195-017-9512-x","pmid":"29568142","pmcid":"PMC5847148","title":"Differences in Sexual Behavior of Teenagers and Young Adults with Cerebral Palsy: The Role of Sexual Needs and Sexual Esteem","authors":"Czapla K, Otrębski W.","first_author":"Czapla K","journal":"Sexuality and disability","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","cerebral palsy","Poland","Youth And Young Adults"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5847148","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 62 individuals with cerebral palsy, purposive sampling, author‑developed questionnaire","sample_n":62,"sample_text":"purposive sample of 62 young persons with cerebral palsy (half women, half men)","population":"young people with cerebral palsy (age 15‑25, without cognitive difficulties)","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 62 Polish youths with cerebral palsy, higher sexual esteem and stronger sexual needs were linked to more frequent sexual behaviours, including petting, intercourse and watching pornographic material.","clinical_takeaway":"Sexual needs and self‑esteem influence sexual activity in CP youth; clinicians should assess these factors when discussing sexual health.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Focus on an underserved population (CP youth)","Clear statistical significance reported for behavior frequencies","Addresses sexual esteem and needs"],"limitations":["Author‑made questionnaire, not validated","Small, purposive sample limits generalizability","No control for key confounds (moral, mental health, etc.)","Only p‑values reported, no effect sizes or power analysis"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11195-017-9512-x"}},{"id":1193,"doi":"10.1016/j.actpsy.2024.104479","pmid":"39213960","pmcid":null,"title":"Young adolescent boys' and girls' attitudes toward uncommitted sexual behaviors and the perception of interest in sexual exploration in opposite-gender relations","authors":"Bendixen M, Kessler AM, Doebell A, Rynning CMW, Sætersdal A, Kennair LEO.","first_author":"Bendixen M","journal":"Acta psychologica","year":2024,"pub_types":["Journal Article"],"keywords":["Measurement","Gender","Validity","Adolescence","reliability","Pornography Use","Sociosexual Attitudes"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 425 secondary‑school students (13‑16 y), new 5‑item sociosexual attitudes scale, reported reliability and construct validity, correlations with self‑reported pornography use","sample_n":425,"sample_text":"425 secondary school students (187 boys, 238 girls), mean age = 14.8 years","population":"adolescents (13‑16 y) from secondary schools in Norway (assumed from author affiliations)","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A new 5‑item questionnaire measured how Norwegian teens (13‑16 y) feel about casual sex. Boys and older teens accepted uncommitted sex more than girls and younger teens. Higher acceptance scores were linked to more frequent porn use and the belief that peers were also more sexually interested.","clinical_takeaway":"Attitudes toward casual sex in early adolescents vary by gender and age and relate to pornography use; clinicians should consider normative attitudes when discussing sexual health with teens.","confidence":0.7,"topic_tags":["adolescents","sexual_function","gender","measurement","pornography"],"strengths":["Large adolescent sample for attitudes research","Introduces and validates a brief sociosexual attitudes scale","Reports internal consistency and construct validity","Links attitudes to self‑reported pornography use"],"limitations":["Cross‑sectional, cannot infer causality","Convenience school sample, limited generalisability","No measurement of key confounds (moral views, mental health, masturbation)","New scale lacks external validation"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.actpsy.2024.104479"}},{"id":1194,"doi":"10.1080/00224499.2024.2395479","pmid":"39207084","pmcid":null,"title":"Rules (And the Lack of Rules) About Pornography Use Among Heterosexual Couples","authors":"Willoughby BJ, Dover CR, Stewart J.","first_author":"Willoughby BJ","journal":"Journal of sex research","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative content analysis of short‑answer responses from 3385 individuals in heterosexual romantic relationships","sample_n":3385,"sample_text":"large convenience sample of individuals in heterosexual couples; recruitment method not specified","population":"adults in heterosexual romantic relationships (self‑selected online respondents)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a study of 3385 people in heterosexual couples, most reported having no explicit rules about watching porn together, and when rules existed they usually concerned the type or context of porn rather than its amount.","clinical_takeaway":"Couples may benefit from open discussions about pornography use, as many lack clear communication about it.","confidence":0.8,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Very large N for a qualitative study","Focus on an under‑researched aspect of sexual relationships","Systematic content‑analysis approach"],"limitations":["Convenience sample; limited generalisability","No validated measures of constructs","No control for potential confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2024.2395479"}},{"id":1195,"doi":"10.12740/pp/138243","pmid":"37074834","pmcid":null,"title":"Classification of nine types of pornographic materials using the sAI 0.3 model. Continuation of the pilot study","authors":"Oronowicz-Jaskowiak W, Siwiak A, Róg K, Oronowicz-Jaśkowiak A.","first_author":"Oronowicz-Jaskowiak W","journal":"Psychiatria polska","year":2022,"pub_types":["Journal Article"],"keywords":["Neural networks","Pornographic Materials"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"computational model development using manually labelled image dataset (3,600 train, 900 validation)","sample_n":4500,"sample_text":"3,600 training images and 900 validation images manually classified by psychologists‑sexologists","population":"photographs of adult consensual sexual activity; no human participants","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"useful","plain_summary":"The study trained a deep‑learning model to automatically sort pornographic images into nine categories using a large set of expert‑labelled photos. The authors suggest the tool could help detect illegal content or protect minors, though further testing is needed.","clinical_takeaway":"None – the paper presents a classification tool, not evidence on sexual health or behavior.","confidence":0.6,"topic_tags":["pornography","neuroscience","sexual_function"],"strengths":["Large labelled image dataset","Use of multiple CNN architectures","Manual expert annotation ensures label reliability"],"limitations":["No external validation beyond internal set","No discussion of ethical implications of automated detection","Claims of clinical utility may be premature"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12740/pp/138243"}},{"id":1196,"doi":"10.1007/s10508-022-02406-4","pmid":"36042069","pmcid":null,"title":"Pornography and Relational Satisfaction: Exploring Potential Boundary Conditions","authors":"Wright PJ, Herbenick D.","first_author":"Wright PJ","journal":"Archives of sexual behavior","year":2022,"pub_types":["Journal Article"],"keywords":["Gender","Race/ethnicity","Moderation","Pornography","Relational Satisfaction"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Probabilistic campus‑representative sample of >750 graduate students in committed relationships; cross‑sectional survey with moderation analysis.","sample_n":750,"sample_text":"More than 750 graduate students in a committed romantic relationship; campus‑representative probability sample.","population":"Graduate students (aged ~20‑30) in committed romantic relationships, recruited via university probability sampling.","country":"United States (presumed from authors’ affiliations and journal context)","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 750 graduate students in relationships, more frequent porn use was linked to slightly lower relationship satisfaction, especially among White men. Gender, race, and moral disapproval shaped this link, while other factors did not.","clinical_takeaway":"Higher porn use may be associated with lower relationship satisfaction for some men; clinicians should consider gender and cultural context when discussing porn use with couples.","confidence":0.8,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Large, probability‑based sample increases generalisability","Exploratory moderation analysis across several theoretically relevant variables","Inclusion of moral disapproval as a moderator addresses a key confound"],"limitations":["Cross‑sectional design cannot establish causality","Pornography use measured only by frequency, no separation of solitary vs partnered use or masturbation","Mental‑health and trauma variables not controlled"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02406-4"}},{"id":1197,"doi":"10.21203/rs.3.rs-3093256/v1","pmid":null,"pmcid":null,"title":"Pre-Marital Sexual Debut and Associated Factors among Unmarried Regular Students of AdigratUniversity, Northern Ethiopia","authors":"Gebremariam G, Adhanom G, Hagos S, Berihu T.","first_author":"Gebremariam G","journal":"Research Square","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-3093256/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Institutional based cross‑sectional survey of university students using multistage sampling and self‑administered questionnaire.","sample_n":null,"sample_text":"Students recruited via multistage sampling; exact N not given in abstract.","population":"Unmarried regular students at Adigrat University, Northern Ethiopia (sample size not reported in abstract).","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of Ethiopian university students found that 22.9% had engaged in premarital sex. Watching pornographic videos, peer pressure, and substance use were each linked to higher odds of such sexual debut.","clinical_takeaway":"Clinicians should note that pornography exposure may be one of several factors associated with early sexual activity, but causal conclusions are not supported.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Multistage sampling within university","Use of multivariate logistic regression with confidence intervals","Identifies several statistically significant associations"],"limitations":["Cross‑sectional design cannot infer causality","No validated measures for pornography exposure or sexual debut","Potential unmeasured confounders (moral attitudes, mental health, trauma)","Sample size not reported; power unclear"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-3093256/v1"}},{"id":1199,"doi":"10.1016/j.addbeh.2022.107469","pmid":"36055058","pmcid":null,"title":"Desire thinking and craving as predictors of problematic Internet pornography use in women and men","authors":"Marino C, Melodia F, Pivetta E, Mansueto G, Palmieri S, Caselli G, Canale N, Vieno A, Conti F, Spada MM.","first_author":"Marino C","journal":"Addictive behaviors","year":2023,"pub_types":["Journal Article"],"keywords":["Craving","Gender Differences","Desire Thinking","Problematic Internet Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 414 Italian adults; path analysis; gender comparison","sample_n":414,"sample_text":"414 Italian adults (mean age 27.55, 53.6% men) recruited via online survey","population":"adult Italian internet users (18‑58)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 414 Italian adults, thinking about sexual desire and craving were linked to higher self‑reported problematic pornography use, with some differences between men and women. The study suggests these cognitive processes may help explain why some people struggle with online porn.","clinical_takeaway":"Consider desire‑thinking and craving when assessing problematic porn use, but note the evidence is correlational and lacks key confound controls.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for survey research","Use of path analysis to model relationships","Examines gender differences"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of key confounds (moral incongruence, masturbation, mental health)","Reliance on self‑report; possible circularity in “problematic” definition"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2022.107469"}},{"id":1201,"doi":"10.1371/journal.pone.0127097","pmid":"25992571","pmcid":"PMC4439164","title":"Freezing behavior as a response to sexual visual stimuli as demonstrated by posturography","authors":"Mouras H, Lelard T, Ahmaidi S, Godefroy O, Krystkowiak P.","first_author":"Mouras H","journal":"PloS one","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0127097&type=printable","cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"laboratory experiment measuring postural sway while participants view sexual vs neutral videos","sample_n":null,"sample_text":"young adult males; exact number not provided in abstract","population":"young adult males (exact n not reported in abstract)","country":"France (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that viewing sexually explicit videos caused participants to exhibit a \"freezing\" posture, measured by reduced sway on a force platform, compared with neutral videos.","clinical_takeaway":"None – the findings describe a basic motor response to sexual cues, not a clinical condition.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["objective physiological measure (posturography)","experimental manipulation of stimulus type","clear within‑subject comparison"],"limitations":["no reporting of sample size or power analysis","absence of control for moral, mental‑health or relational confounds","interpretation limited to motor response, not linked to pathology"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":2,"mentioning":36,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0127097"}},{"id":1203,"doi":"10.1177/08862605261473561","pmid":"42624644","pmcid":null,"title":"Individual and Contextual Facilitators and Barriers of Bystander Intervention Intent in Image-Based Sexual Abuse Contexts","authors":"Mainwaring C, Scott AJ, Gabbert F.","first_author":"Mainwaring C","journal":"Journal of interpersonal violence","year":2026,"pub_types":["Journal Article"],"keywords":["Bystander Intervention","Revenge Pornography","Image-based Sexual Abuse","Upskirting","Social Justice Ally","Image-based Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Three separate correlational surveys (n≈130 each) measuring individual/contextual variables and self‑reported willingness to intervene in IBSA situations.","sample_n":134,"sample_text":"Study 1 n=134; Study 2 n=133; Study 3 n=132 (convenience samples).","population":"Adults recruited for each study (likely convenience/online sample).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed over 130 people per scenario to find what makes them more likely to step in when they witness non‑consensual image sharing. Being female, feeling responsible, confident, seeing supportive norms, and empathy predicted higher willingness to intervene.","clinical_takeaway":"Interventions that boost responsibility, confidence, and positive social norms may increase bystander action against image‑based sexual abuse.","confidence":0.8,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["Large‐scale (≈130) samples across three related scenarios","Systematic regression approach identifying multiple predictors","Practical implications for bystander programs"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on self‑report, unclear validation of scales","Convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605261473561"}},{"id":1204,"doi":"10.1080/10410236.2024.2389354","pmid":"39155618","pmcid":null,"title":"U.S. Males and Pornography: Replication and Experimental Extension","authors":"Wright PJ, Tokunaga RS.","first_author":"Wright PJ","journal":"Health communication","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"analysis of General Social Survey data, nationally representative sample, cross‑sectional replication and experimental extension of a prior study","sample_n":null,"sample_text":"Uses the GSS, a large probability sample of U.S. adults; exact N not given in abstract","population":"U.S. adult males (various ages)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors re‑examined U.S. male pornography use using the nationally representative General Social Survey, replicating an earlier study and testing a new survey question. They discuss how the findings inform the GSS and broader media‑effects theories.","clinical_takeaway":"Findings are descriptive; clinicians should not infer causal health effects of pornography from this survey.","confidence":0.7,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Large, nationally representative dataset (GSS)","Replication of prior work adds robustness","Experimental extension within survey methodology"],"limitations":["Reliance on a single‑item, likely unvalidated pornography use measure","No control for key confounds (moral incongruence, masturbation, mental health, etc.)","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2024.2389354"}},{"id":1205,"doi":"10.31234/osf.io/t8a4c","pmid":null,"pmcid":null,"title":"Pornography Use and Holistic Sexual Functioning: A Systematic Review of Recent Research","authors":"Hoagland C, Grubbs JB.","first_author":"Hoagland C","journal":"PsyArXiv","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://psyarxiv.com/t8a4c/download","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of 44 recent articles on pornography use and sexual functioning/satisfaction; no meta‑analysis reported","sample_n":null,"sample_text":"44 articles reviewed; individual study sizes not reported","population":"studies of adult participants from various locations; no single sample","country":"multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 44 recent studies finds that simply using porn does not consistently affect sexual function or satisfaction, but people who think their porn use is problematic tend to report more sexual issues. Context and personal perceptions matter most.","clinical_takeaway":"Clinicians should focus on clients' perceived problems with porn rather than use frequency alone when addressing sexual well‑being.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Systematic approach to recent literature","Balanced presentation of divergent findings","Highlights role of perceived problematic use"],"limitations":["No meta‑analysis or quantitative synthesis","Risk‑of‑bias assessment not described","Confounding factors (e.g., moral incongruence, masturbation) not addressed"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/t8a4c"}},{"id":1206,"doi":"10.1080/00224499.2026.2713726","pmid":"42606583","pmcid":null,"title":"Rough Sex: A Conceptual and Empirical Review","authors":"Herbenick D, Galper EF.","first_author":"Herbenick D","journal":"Journal of sex research","year":2026,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative conceptual and empirical review without systematic search or risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not applicable – review of existing studies.","population":"Adults and adolescents engaging in rough‑sex practices; no primary data collection.","country":"Multiple (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews what is known about \"rough sex\"—activities like choking or smothering—covering how common they are, why people engage in them, health risks, and links to partner violence, while noting that research is still limited.","clinical_takeaway":"Clinicians should be aware of rough‑sex practices as potential sources of injury and consider discussing consent, safety, and media influences with patients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad overview of a understudied topic","Integrates prevalence, health consequences, and policy considerations","Identifies clear research gaps"],"limitations":["Narrative review without systematic methodology","No formal quality appraisal of cited studies","Limited detail on measurement validity of included work"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2026.2713726"}},{"id":1207,"doi":"10.1080/00224499.2026.2713723","pmid":"42600131","pmcid":null,"title":"Patterns of Digital and In-Person Sexual Behaviors Among Adolescents: Associations with Individual Characteristics, Sexual Well-being, and Respectful Attitudes Toward Partners","authors":"Kotiuga J, Sell-Goodhand E, Leclerc A, Mbuakoto C, Maheux AJ.","first_author":"Kotiuga J","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Latent class analysis of 1,177 Quebec adolescents (age ~16) using self‑report questionnaires on digital (including pornography) and offline consensual sexual behaviors; gender‑stratified models examining predictors and outcomes (sexual well‑being, respectful attitudes).","sample_n":1177,"sample_text":"Adolescents recruited via schools in Quebec; inclusion required at least one lifetime sexual behavior.","population":"Adolescents (≈16 yr) from Quebec, Canada; self‑selected school‑based sample; N = 1,177 (998 with prior sexual experience).","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study grouped Quebec teens into patterns of online (including porn) and offline sexual activities and found that these patterns relate to their sexual well‑being and how respectfully they view partners.","clinical_takeaway":"Adolescents’ combined digital and physical sexual experiences are linked to wellbeing; clinicians should assess both domains together.","confidence":0.8,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Large adolescent sample (N>1,000)","Novel joint analysis of digital and in‑person sexual behaviors","Use of latent class analysis to identify behavior patterns"],"limitations":["Cross‑sectional design; no causal inference","Reliance on self‑report without validated scales for key constructs","No measurement of key confounds (moral incongruence, masturbation, mental health, trauma)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2026.2713723"}},{"id":1208,"doi":"10.1891/vv-2022-0138","pmid":"39107072","pmcid":null,"title":"\"Your Photos, Your Fault\": Masculine Honor Beliefs and Perceptions of Revenge Pornography","authors":"Renken ND, Hall SJ, Prokhorets SS, Saucier DA.","first_author":"Renken ND","journal":"Violence and victims","year":2024,"pub_types":["Journal Article"],"keywords":["Gender","Aggression","Victimization","Dating Violence","Cyber Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"lab vignette experiment with between‑group manipulation (infidelity vs none); sample size not reported in abstract","sample_n":null,"sample_text":"not reported","population":"adults (young adult males likely); convenience sample","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that men who strongly endorse masculine honor beliefs are more likely to blame women and view revenge porn as justified, especially when the woman had cheated. These beliefs shape how victims are perceived.","clinical_takeaway":"None – the work examines attitudes, not clinical outcomes or treatments.","confidence":0.4,"topic_tags":["religiosity","gender","sexual_function","pornography"],"strengths":["Uses a validated scale for masculine honor beliefs","Experimental manipulation of situational factor (infidelity)","Addresses a socially relevant topic (revenge porn justification)"],"limitations":["Sample size and recruitment not reported","Reliance on ad‑hoc perception measures","No control for moral/religious attitudes or other confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1891/vv-2022-0138"}},{"id":1209,"doi":"10.1080/10410236.2024.2386215","pmid":"39104215","pmcid":"PMC11794593","title":"Adolescent Pornography Exposure, Condom Use, and the Moderating Role of Parental Sexual Health Communication: Replication in a U.S. Probability Sample","authors":"Wright PJ, Herbenick D.","first_author":"Wright PJ","journal":"Health communication","year":2025,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Probability sample of U.S. adolescents; cross‑sectional survey with interaction analysis","sample_n":null,"sample_text":"U.S. probability sample (size not specified in abstract)","population":"U.S. adolescents","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative US teen sample, higher exposure to pornography was linked to more condom‑free sex, but this link was weaker when parents talked openly about sexual health.","clinical_takeaway":"Encouraging open parent‑teen sexual health communication may reduce riskier sexual behaviors linked to porn exposure.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large, probability‑based national sample","Direct replication of a prior study","Tests interaction between exposure and parental communication"],"limitations":["Reliance on self‑report measures with unclear validation","Cross‑sectional design limits causal inference","Key psychosocial confounds (e.g., mental health, moral attitudes) not addressed"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2024.2386215"}},{"id":1212,"doi":"10.1016/j.chiabu.2024.106955","pmid":"39094278","pmcid":null,"title":"The effect of therapeutic and deterrent messages on Internet users attempting to access 'barely legal' pornography","authors":"Prichard J, Wortley R, Watters P, Spiranovic C, Scanlan J.","first_author":"Prichard J","journal":"Child abuse & neglect","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":["Situational Crime Prevention","Child Sexual Exploitation Material","Pop-ups","Therapeutic Messages","Warning Banners"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomised controlled trial with 4 arms (control, deterrence, therapeutic, therapeutic+image) testing click‑through rates on a honeypot site presented as barely‑legal pornography.","sample_n":474,"sample_text":"474 male participants, randomised to four conditions","population":"Male adults 18‑30 years, UK, n = 474","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab experiment, men aged 18‑30 who tried to visit a fake “barely‑legal” porn site were less likely to click through when shown deterrent or therapeutic warning messages, cutting clicks from 75% to about 35‑47%. Images added no extra effect.","clinical_takeaway":"Brief warning messages can markedly reduce attempts to access questionable adult sites; such prompts may be a practical tool for CSAM‑prevention programmes.","confidence":0.7,"topic_tags":["csbd","prevalence"],"strengths":["Large sample for an experimental online study","Randomised allocation to conditions","Clear behavioural endpoint (click‑through)","Pragmatic relevance to CSAM prevention"],"limitations":["Outcome is a single binary click, no validated psychological constructs","Recruitment method unclear – possible self‑selection bias","No pre‑registration or reported confidence intervals","Findings limited to short‑term intention, not actual CSAM exposure"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2024.106955"}},{"id":1213,"doi":"10.3109/10673229.2012.677360","pmid":"22512742","pmcid":null,"title":"\"Sexting\" among U.S. adolescents: psychological and legal perspectives","authors":"Judge AM.","first_author":"Judge AM.","journal":"Harvard review of psychiatry","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary without empirical data; no sample","sample_n":null,"sample_text":"none (commentary)","population":"U.S. adolescents (discussion focus)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews sexting among U.S. teens, summarising clinical concerns and legal issues, and offers suggestions for clinicians, but provides no new research data.","clinical_takeaway":"Clinicians should be aware of legal risks and consider discussing sexting in adolescent care, but evidence on its impacts is limited.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Highlights legal implications of adolescent sexting","Provides clinical discussion points"],"limitations":["No original empirical data","Lacks measurement of key constructs","No systematic review methodology"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":37,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/10673229.2012.677360"}},{"id":1214,"doi":"10.1177/00030651241263929","pmid":"39056570","pmcid":null,"title":"On &lt;i&gt;Not&lt;/i&gt; Having it All: Exploring the Fetishization of Trans Women by Heterosexual Men","authors":"Lemma A.","first_author":"Lemma A.","journal":"Journal of the American Psychoanalytic Association","year":2025,"pub_types":["Journal Article"],"keywords":["Online Pornography","Female Body","Gynandromorphophilia","Misogyny","Seminal Anxiety","Transgender Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"theory/clinical illustration","sample_n":null,"sample_text":"none (clinical illustrations only)","population":"heterosexual men attracted to pre‑op trans women (clinical examples only)","country":"USA (journal location, not specified in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The author argues, from a psychoanalytic perspective, that some heterosexual men are attracted to pre‑op transgender women because the missing vagina and womb symbolize the men's unconscious fear of infertility, offering a temporary psychic relief.","clinical_takeaway":"None – the article offers a theoretical model without clinical evidence.","confidence":0.4,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Provides a novel psychoanalytic narrative for a little‑studied fetish","Integrates trans‑gender pornography into broader psychodynamic theory"],"limitations":["No empirical data; relies on anecdotal clinical examples","Lacks operational definitions or validated measures","Cannot test causal claims or generalise beyond the author’s cases"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00030651241263929"}},{"id":1215,"doi":"10.1186/s12889-022-13699-4","pmid":"35787262","pmcid":"PMC9252028","title":"The role of pornography in the sex life of young adults-a cross-sectional cohort study on female and male German medical students","authors":"Jahnen M, Zeng L, Kron M, Meissner VH, Korte A, Schiele S, Schulwitz H, Dinkel A, Gschwend JE, Herkommer K.","first_author":"Jahnen M","journal":"BMC public health","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual behavior","Sexual development","Young Adults","Gender Differences","Pornography","Social Media Use"],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-022-13699-4","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of German medical students (N=468) assessing self‑reported pornography use frequency and various sexual behaviours.","sample_n":468,"sample_text":"468 students (female = 293; male = 175) from the Technical University of Munich","population":"young adult German medical students (mostly 20‑30 y, 62 % female)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of German medical students found that more frequent porn use was linked to certain sexual experiences (e.g., anal sex, threesomes) and social‑media dating, with patterns differing by gender.","clinical_takeaway":"Frequent porn use among young adults may reflect broader sexual experimentation, not necessarily a problem; clinicians should discuss media influence openly.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a single‑site survey","Gender‑specific analysis","Use of multivariate Poisson regression"],"limitations":["Reliance on ad‑hoc self‑report items, no validated scales","Cross‑sectional design precludes causal inference","Key confounds (moral incongruence, masturbation, mental health, relationship factors) not measured"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-022-13699-4"}},{"id":1217,"doi":"10.3390/ijerph19138055","pmid":"35805712","pmcid":"PMC9265877","title":"Analyzing University Students' Perceptions Regarding Mainstream Pornography and Its Link to SDG5","authors":"Biota I, Dosil-Santamaria M, Mondragon NI, Ozamiz-Etxebarria N.","first_author":"Biota I","journal":"International journal of environmental research and public health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sustainability","Sex Education","Pornography"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/13/8055/pdf?version=1656648207","cited_by_count":4,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 280 university students recruited by snowball sampling","sample_n":280,"sample_text":"snowball convenience sample","population":"university students (18‑37 years) in northern Spain","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 280 Spanish university students found that they start watching porn around age 10, mainly out of curiosity, and boys watch more than girls, especially for masturbation. Many feel their sex education is inadequate and turn to friends for answers, suggesting schools need better affective‑sexual education.","clinical_takeaway":"Early exposure to porn is common; educators should provide comprehensive, age‑appropriate sex education to address curiosity and reduce reliance on peers.","confidence":0.73,"topic_tags":["pornography","sexual_function"],"strengths":["Relatively large sample for a student survey","Focus on early onset of pornography exposure","Addresses gender differences in consumption"],"limitations":["Convenience snowball sampling limits generalisability","No measurement of key confounds (moral views, mental health, trauma)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph19138055"}},{"id":1218,"doi":"10.1111/j.1447-0349.2012.00837.x","pmid":"22978544","pmcid":null,"title":"Girly mags and girly jobs: pornography and gendered inequality in forensic practice","authors":"Mercer D.","first_author":"Mercer D.","journal":"International journal of mental health nursing","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"discourse analytic qualitative study using semi‑structured interviews with nurses and detained patients in a high‑security forensic hospital","sample_n":null,"sample_text":"Not specified in abstract; qualitative convenience sample of staff and patients","population":"mental health nurses and male patients convicted of sexual offences with personality disorder diagnoses in a UK forensic setting","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examines how nurses and male patients in a high‑security forensic hospital talk about pornography, revealing that such talk reinforces masculine, gender‑biased discourses and contributes to inequality on the ward.","clinical_takeaway":"Findings suggest clinicians should be aware of how language around pornography may shape gendered dynamics in forensic treatment settings.","confidence":0.4,"topic_tags":["pornography","gender","sexual_function"],"strengths":["Provides rich, contextual insight into professional discourse","Uses verbatim interview data for authentic representation","Highlights gendered power dynamics in forensic settings"],"limitations":["No quantitative measurement of pornography use or related outcomes","Small, non‑representative sample limits generalisability","No assessment of confounding variables (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":1,"mentioning":30,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1447-0349.2012.00837.x"}},{"id":1219,"doi":"10.1080/00918369.2022.2093688","pmid":"35759678","pmcid":null,"title":"Sexual Behaviors and Aggression in Gay Pornography","authors":"Fritz N, Bowling J.","first_author":"Fritz N","journal":"Journal of homosexuality","year":2023,"pub_types":["Journal Article"],"keywords":["Content analysis","MSM","Gay","Aggression","Condom Use","Sexual Behaviors","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 415 gay porn scenes; coding of sexual behaviors and aggression; predictors examined with statistical models.","sample_n":415,"sample_text":"N = 415 scenes coded from online gay pornography.","population":"Gay porn videos (online); no human participants","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers examined 415 gay porn videos and found that fellatio and anal sex were common, while kissing was less frequent. About one‑third of scenes showed sexual aggression, mostly spanking. Anal sex and forced fellatio predicted higher aggression, suggesting such content may shape viewers’ ideas about normal sexual behavior.","clinical_takeaway":"None – the study describes porn content, not direct health effects on viewers.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample of video scenes (N=415)","Systematic coding of sexual and aggressive behaviors","Quantitative analysis of predictors of aggression"],"limitations":["Unclear whether coding scheme was validated","No assessment of viewer impact; inference to norms may be speculative","Potential selection bias in video sampling not described"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2022.2093688"}},{"id":1220,"doi":"10.3389/fnhum.2022.897536","pmid":"35814959","pmcid":"PMC9259837","title":"Electrophysiological Evidence of Enhanced Processing of Novel Pornographic Images in Individuals With Tendencies Toward Problematic Internet Pornography Use","authors":"Wang J, Chen Y, Zhang H.","first_author":"Wang J","journal":"Frontiers in human neuroscience","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Event-related potentials","Addiction","Novelty Seeking","Late Positive Potential","Problematic Internet Pornography Use"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fnhum.2022.897536/pdf","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"laboratory ERP oddball task comparing high vs low PIPU tendency groups (N=27/25)","sample_n":52,"sample_text":"27 high‑PIPU, 25 low‑PIPU participants","population":"adults (likely university/community sample), convenience recruitment","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In an EEG study, people who report higher problematic porn use showed larger brain responses to new sexual images than low‑problem users, suggesting heightened attention to novel porn content.","clinical_takeaway":"Enhanced neural reactivity to novel porn may be a marker of risky use, but evidence is limited.","confidence":0.7,"topic_tags":["pornography","sexual_function","neuroscience","csbd"],"strengths":["Use of ERP provides temporal precision","Matched comparison groups","Novelty‑processing paradigm relevant to theory"],"limitations":["Small sample limits power","PIPU tendency measured with unspecified instrument","Key confounds (moral, masturbation, mental health) not addressed"],"rubric_version":"2.0","raw_total":34,"max_possible":70,"pct_score":49,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":7,"statistics":5,"confounds":2,"design":7,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":5,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fnhum.2022.897536"}},{"id":1222,"doi":"10.1371/journal.pone.0352776","pmid":"42525632","pmcid":"PMC13419235","title":"Temptation as a key driver between affective states and usage outcomes of problematic usage of the Internet: A 14-day ambulatory assessment study","authors":"Oelker A, Knorr A, Brand M, Müller SM, FOR2974 Consortium.","first_author":"Oelker A","journal":"PloS one","year":2026,"pub_types":["research-article","Multicenter Study","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13419235","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Ambulatory 14‑day end‑of‑day assessment with baseline diagnostic interview; N=900; multi‑center sample; mixed‑effects and SEM analyses.","sample_n":900,"sample_text":"N = 900 participants; adherence 88%; multi‑centre recruitment.","population":"Adults (young adult to older) engaging in gaming, pornography, social networking or online shopping; categorized as non‑problematic, risky or pathological PUI.","country":"Germany (FOR2974 consortium, multi‑center)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 14‑day diary study of 900 adults, feeling tempted to go online was the strongest driver of internet use, especially for those with more severe problematic internet use. Stress and bad mood also predicted more use, and higher use was linked to neglecting work or relationships.","clinical_takeaway":"Temptation and mood appear central to problematic internet use; interventions targeting urge management may be most effective.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, multi‑center sample (N=900)","14‑day ambulatory design captures within‑person dynamics","Advanced statistical modelling (GLMM, MG‑ML‑SEM)"],"limitations":["Limited description of construct measurement; unclear psychometric validation","Key confounds (moral incongruence, masturbation, mental health) not addressed","No pre‑registration or explicit power analysis reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0352776"}},{"id":1223,"doi":"10.3389/fpubh.2026.1805877","pmid":"42582383","pmcid":"PMC13457647","title":"Prevalence and pattern of child sexual abuse among secondary adolescents in Sokoto Metropolis, Nigeria: a cross-sectional study","authors":"Omar M, Joseph AK, Abubakar AU, Adamu A, Abdullahi SZ.","first_author":"Omar M","journal":"Frontiers in public health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Prevalence","Nigeria","Adolescents","Secondary Schools","Family Structure","Child Sexual Abuse","Disclosure","Perpetrators"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13457647","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 308 secondary school adolescents in Sokoto Metropolis, Nigeria using multistage sampling","sample_n":308,"sample_text":"308 adolescents recruited from public and private secondary schools","population":"adolescents (secondary school students)","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 308 Nigerian high‑school students found that about one‑quarter have experienced some form of sexual abuse, most often non‑penetrative acts like seeing pornography. Abuse usually happened at home or school, and few victims told anyone.","clinical_takeaway":"High rates of child sexual abuse warrant stronger safeguarding policies and better support for adolescent survivors.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Uses validated questionnaire","Multistage sampling improves representativeness within the city","Provides detailed prevalence and pattern data"],"limitations":["Cross‑sectional design cannot infer causality","Limited to one metropolis; not nationally representative","No assessment of mental‑health correlates or trauma history"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2026.1805877"}},{"id":1224,"doi":"10.1089/cyber.2017.0050","pmid":"28715262","pmcid":null,"title":"Sexting Behaviors Exhibited by Men Who Have Sex with Men Between the Ages of 18-70 Who Live in a Socially Conservative State","authors":"Currin JM, Hubach RD.","first_author":"Currin JM","journal":"Cyberpsychology, behavior and social networking","year":2017,"pub_types":["Journal Article"],"keywords":["Sexual Health","Sexual Behaviors","Hiv/sti Prevention","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 213 MSM in Oklahoma; logistic regression analysis of sexting prevalence and correlates.","sample_n":213,"sample_text":"Mean age = 34.8 ± 12.1 years; 62.4% reported sexting.","population":"Men who have sex with men, ages 18‑70, residing in a socially conservative U.S. state (Oklahoma).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 213 gay and bisexual men living in Oklahoma, about two‑thirds reported sending or receiving sexts. Men who had recent hook‑ups were ten times more likely to sext, while those in steady relationships were less likely. Sexting was unrelated to condom use.","clinical_takeaway":"Sexting is common among MSM and linked to casual sexual encounters; health messages could be delivered via dating apps.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large community sample for MSM outside university settings","Clear operational definition of sexting","Use of logistic regression with confidence intervals"],"limitations":["Reliance on single‑item self‑report measures","Cross‑sectional design limits causal inference","No assessment of moral, mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2017.0050"}},{"id":1225,"doi":"10.1080/00224499.2016.1181147","pmid":"27247026","pmcid":null,"title":"Relational Anxiety and Sexting","authors":"Weisskirch RS, Drouin M, Delevi R.","first_author":"Weisskirch RS","journal":"Journal of sex research","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online questionnaire of 459 unmarried heterosexual undergraduates; cross‑sectional analysis of predictors of sexting behaviours","sample_n":459,"sample_text":"Convenience sample from three universities, self‑selected via online survey","population":"undergraduate students, 18‑25 y, unmarried, heterosexual (N = 459)","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 459 heterosexual college students, low attachment avoidance and higher fear of negative evaluation were linked to sending sexts, photos, and videos. Social distress while dating also related to sexting behaviour.","clinical_takeaway":"Clinicians may consider relational anxiety and fear of judgment when discussing sexting habits with young adults.","confidence":0.85,"topic_tags":["sexual_function","relationships"],"strengths":["large sample for undergraduate surveys","multiple psychosocial predictors examined","use of established attachment and evaluation fear scales"],"limitations":["convenience, non‑representative sample","self‑report sexting items likely ad‑hoc","no control for moral or mental‑health confounds","cross‑sectional cannot infer causality"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2016.1181147"}},{"id":1226,"doi":"10.1007/s10508-016-0826-z","pmid":"27620319","pmcid":null,"title":"Sexual Arousal Patterns of Autogynephilic Male Cross-Dressers","authors":"Hsu KJ, Rosenthal AM, Miller DI, Bailey JM.","first_author":"Hsu KJ","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Sexual Orientation","Paraphilia","Penile Plethysmography","Autogynephilia","Gynandromorphophilia","Sexual Arousal Patterns"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"cross‑sectional laboratory study using penile plethysmography to compare arousal to video stimuli across four self‑identified male groups","sample_n":null,"sample_text":"Not specified in abstract","population":"adult male cross‑dressers, GAMP men, heterosexual men, homosexual men (sample size not reported in abstract)","country":"United States (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured men’s physiological sexual arousal to videos of men, women, and gender‑ambiguous “she‑male” figures, finding that autogynephilic cross‑dressers respond more like heterosexual and GAMP men than homosexual men.","clinical_takeaway":"None – the findings pertain to basic sexual arousal patterns, not clinical treatment.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Physiological arousal measure (penile plethysmography) adds objective data","Direct comparison of multiple sexual orientation groups","Clear stimulus categories (male, female, GAM)"],"limitations":["Small, unspecified sample size limits generalisability","No control for moral or mental‑health variables that could affect arousal","Reliance on self‑labelled group membership"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0826-z"}},{"id":1227,"doi":"10.1016/j.jadohealth.2018.07.015","pmid":"30292649","pmcid":"PMC6309651","title":"Sexual Health Education for Adolescent Males Who Are Interested in Sex With Males: An Investigation of Experiences, Preferences, and Needs","authors":"Nelson KM, Pantalone DW, Carey MP.","first_author":"Nelson KM","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2019,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Adolescents","Sti","Sexual Minority Youth","Sexual Education","Amsm"],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online survey of 207 U.S. adolescent males interested in sex with males; bivariate associations examined with Fisher's exact tests and ANOVA.","sample_n":207,"sample_text":"Convenience online sample of AMSM aged 14‑17 years.","population":"Adolescent males (ages 14‑17) interested in sex with males, recruited via online methods in the United States (N = 207).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 207 teen boys who are attracted to males found that most get sexual‑health information from parents, schools, or the Internet, but they want an online program that openly discusses male‑male sex to help them stay safer.","clinical_takeaway":"Tailored, explicit online sex‑education could improve safe practices among adolescent males interested in sex with males.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large (for youth research) sample of a hard‑to‑reach population.","Clear focus on information sources and preferences.","Relevant public‑health implications."],"limitations":["Cross‑sectional design prevents causal inference.","Self‑report measures not validated.","No control for key psychosocial confounds."],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":40,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2018.07.015"}},{"id":1228,"doi":"10.1371/journal.pone.0354596","pmid":"42490612","pmcid":"PMC13395419","title":"Cognitive flexibility, impulsivity, and compulsivity in problematic consumption behaviours","authors":"Jara-Rizzo M, Oleas D, Rodas JA.","first_author":"Jara-Rizzo M","journal":"PloS one","year":2026,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13395419","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of five groups (gamblers, buyers, video gamers, pornography users, controls) using behavioural tasks and self‑report questionnaires.","sample_n":null,"sample_text":"Convenience groups of regular gamblers, buyers, video gamers, pornography consumers and controls.","population":"Adults (young adult to older) recruited into five convenience groups; sample size not reported in abstract.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared how people who gamble, shop, play video games, watch pornography, or do none of these differ in flexibility, impulsivity and compulsivity. It found that shoppers were most impulsive/compulsive, and that flexibility deficits were similar across groups.","clinical_takeaway":"Cognitive deficits vary across different high‑frequency behaviours; interventions should be tailored to specific impulsivity and compulsivity profiles.","confidence":0.7,"topic_tags":["csbd","sexual_function","pornography"],"strengths":["Use of validated cognitive tasks (PRLT) and impulsivity scale (UPPS‑P)","Multigroup comparison allows exploration of specificity of deficits","GLME modeling accounts for repeated measures"],"limitations":["Convenience sampling limits generalisability","No assessment of key confounds (moral incongruence, mental health, partner factors)","Compulsivity measure not described; may be ad‑hoc"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0354596"}},{"id":1229,"doi":"10.1007/s10508-010-9696-y","pmid":"21116701","pmcid":null,"title":"Pornography and sex crimes in the Czech Republic","authors":"Diamond M, Jozifkova E, Weiss P.","first_author":"Diamond M","journal":"Archives of sexual behavior","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Ecological before‑after study of national crime statistics following a legal change permitting pornography.","sample_n":null,"sample_text":"All reported sex‑related crimes in the Czech Republic before and after the law change.","population":"Czech Republic population; national crime records","country":"Czech Republic","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined Czech crime statistics before and after pornography was legalized and found no rise in rape or other sex crimes, and a decrease in child sexual abuse, mirroring findings from other countries.","clinical_takeaway":"None – findings are about population‑level crime trends, not individual clinical care.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Uses official national crime data","Large‑scale population‑level analysis","Addresses a policy‑relevant question"],"limitations":["Ecological design cannot infer individual‑level effects","No control for potential confounders (e.g., socioeconomic trends)","No detailed statistical reporting (effect sizes, confidence intervals)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":41,"citing_publications":121,"retracted":false,"notices":[{"status":"Has erratum","date":"2011-10-29","noticeDoi":"10.1007/s10508-011-9871-9","doi":"10.1007/s10508-010-9696-y"}],"url":"https://scite.ai/reports/10.1007/s10508-010-9696-y"}},{"id":1230,"doi":"10.3389/fpsyg.2026.1815472","pmid":"42553267","pmcid":"PMC13433444","title":"Comprehensive sexuality education in primary education: analyzing the impact of an educational intervention on knowledge, perceptions, and communication-a quasi-experimental study","authors":"Afonso MRP, Arroyo-Bello E, Fernandez-Cezar R, Villajos VL, Díaz DD, de Almeida Peres MA, Hernández-Iglesias S, Cantarino SG.","first_author":"Afonso MRP","journal":"Frontiers in psychology","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Adolescence","Risk behavior","intervention","Sexual Education"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13433444","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"quasi-experimental pre‑post single group, non‑probability sampling of primary school students","sample_n":null,"sample_text":"non‑probabilistic sampling; single school group","population":"primary school students (age not specified)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A school‑based program teaching sexuality, puberty and consent was delivered to primary‑school children. After the lessons, students showed better knowledge and felt more comfortable talking about sexual health, but the study used a single group and simple questionnaires, so results are limited.","clinical_takeaway":"Educational sessions can improve young students' sexual health knowledge, but robust controlled trials are needed before drawing strong conclusions.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["addresses an important gap in primary‑school sexual health education","pre‑post design allows detection of short‑term change","covers multiple relevant topics (puberty, consent, pornography exposure)"],"limitations":["no control/comparison group limits causal inference","use of ad‑hoc, likely unvalidated measures","non‑probability sampling reduces generalisability","no reporting of effect sizes or power calculations"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2026.1815472"}},{"id":1231,"doi":"10.1080/00224499.2024.2359641","pmid":"38905162","pmcid":null,"title":"Why Do People Watch Pornography? Cross-Cultural Validation of the Pornography Use Motivations Scale (PUMS) and Its Short Form (PUMS-8)","authors":"Koós M, Nagy L, Kraus SW, Demetrovics Z, Potenza MN, Gaudet É, Ballester-Arnal R, Batthyány D, Bergeron S, Billieux J, Briken P, Burkauskas J, Cárdenas-López G, Carvalho J, Castro-Calvo J, Chang YH, Chen L, Ciocca G, Corazza O, Csako RI, Fernandez DP, Fujiwara H, Fernandez EF, Fuss J, Gabrhelík R, Gewirtz-Meydan A, Gjoneska B, Gola M, Grubbs JB, Hashim HT, Hsieh YP, Islam MS, Ismail M, Jiménez-Martínez MC, Jurin T, Kalina O, Klein V, Költő A, Lee SK, Lewczuk K, Lochner C, López-Alvarado S, Lukavská K, Mayta-Tristán P, Miller DJ, Orosová O, Orosz G, Ponce FP, Quintana GR, Quintero Garzola GC, Ramos-Diaz J, Rigaud K, Rousseau A, Scanavino MT, Schulmeyer MK, Sharan P, Shibata M, Shoib S, Sigre-Leirós V, Sniewski L, Spasovski O, Steibliene V, Stein DJ, Strizek J, Štulhofer A, NA Sungkyunkwan University’s research team, Ünsal BC, Vaillancourt-Morel MP, Van Hout MC, Bőthe B.","first_author":"Koós M","journal":"Journal of sex research","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large international online survey (N=75,117) across 42 countries; factor analysis and measurement invariance testing","sample_n":75117,"sample_text":"N = 75,117 participants from 42 countries, mean age 32.07 (SD 12.37)","population":"adults and adolescents from 42 countries, diverse gender identities and sexual orientations","country":"multinational (42 countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A new questionnaire (PUMS) that measures why people watch porn was tested in 75,000 people from 42 countries. It reliably captures eight different motives, like sexual pleasure or self‑exploration, and works similarly across genders, sexual orientations and cultures.","clinical_takeaway":"Clinicians can use the PUMS or its short form to explore patients' specific reasons for porn use, aiding tailored discussions and interventions.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Very large, culturally diverse sample","Comprehensive psychometric evaluation (factor structure, invariance)","Development of a concise short form"],"limitations":["Cross‑sectional, self‑report data","No pre‑registration reported","Potential selection bias from online recruitment"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2024.2359641"}},{"id":1232,"doi":"10.1080/15546128.2022.2076757","pmid":"37274148","pmcid":"PMC10237037","title":"Popular Culture and Pornography Education to Improve the Efficacy of Secondary School Staff Response to Student Sexual Harassment","authors":"Maas MK, Gal T, Cary KM, Greer K.","first_author":"Maas MK","journal":"American journal of sexuality education","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Harassment","Media Literacy","Pornography","Sexting","School-based Sex Education"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"single-group pre‑post feasibility pilot with school staff (no control group)","sample_n":null,"sample_text":"sample of staff who work for Midwestern public schools","population":"Midwestern public‑school staff (teachers, administrators, support staff)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A brief, four‑module training for school staff called PopPorn was tested in a few Midwestern schools. After the program, teachers and administrators reported higher knowledge about student pornography use and image‑based sexual abuse, felt more capable of responding, and showed less endorsement of harmful double‑standard attitudes.","clinical_takeaway":"Staff training can improve confidence and attitudes when addressing student pornography‑related issues, but evidence is preliminary.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["addresses practical need for staff training","provides a structured, multi‑module curriculum","measures multiple relevant outcomes (knowledge, efficacy, attitudes)","focuses on a timely public‑health issue"],"limitations":["no control or comparison group","small convenience sample limits generalisability","outcome measures likely self‑report and may lack validation","short‑term follow‑up only"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":23,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/15546128.2022.2076757"}},{"id":1233,"doi":"10.12688/f1000research.130101.1","pmid":null,"pmcid":null,"title":"Magico-religious beliefs, stigma and help-seeking for adolescent mental health at the community level – A multi-stakeholder qualitative exploration in southern India","authors":"Prabhu V, Chandra Sekaran V, Ashok L, D'Souza B, Nair R.","first_author":"Prabhu V","journal":"F1000Res","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://f1000research.com/articles/12-362/pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus group discussions and in‑depth interviews with 70 purposively sampled stakeholders (parents, adolescents, teachers, professionals) in southern India; thematic analysis using Atlas.ti","sample_n":70,"sample_text":"70 participants (parents, adolescents, teachers, mental‑health professionals, pediatrician) recruited purposively","population":"adolescents 14–16 y and their community context in Udupi taluk, India","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with adolescents, parents, teachers and health workers in southern India showed that stigma, cultural beliefs and fear of magico‑religious treatment delay help‑seeking for mental health problems, with pornography use mentioned as one of many stressors.","clinical_takeaway":"Address stigma and involve community leaders to improve early mental‑health referral for adolescents.","confidence":0.8,"topic_tags":["adolescents","sexual_function","pornography","moral_incongruence"],"strengths":["Multi‑stakeholder perspective","In‑depth qualitative insight into cultural barriers","Use of systematic thematic analysis"],"limitations":["Purposive, non‑representative sample limits generalisability","No validated measures for constructs","No quantitative assessment of confounding factors"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12688/f1000research.130101.1"}},{"id":1234,"doi":"10.1097/nsg.0000000000000443","pmid":"42475607","pmcid":null,"title":"Childhood exposure to pornography and the normalization of online exploitation","authors":null,"first_author":null,"journal":"Nursing","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/nsg.0000000000000443"}},{"id":1235,"doi":"10.3389/fpubh.2026.1860278","pmid":"42548641","pmcid":"PMC13429633","title":"Patterns and correlates of casual sexual behavior through the internet and inconsistent condom use among MSM college students in Zhejiang province, China: a cross-sectional study, 2022","authors":"Chen L, Jiang J, Xu Y, Zhou X, Yang J, Pan X, Cheng W, Chai C, Jiang J.","first_author":"Chen L","journal":"Frontiers in public health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Human immunodeficiency virus (HIV)","Cross-sectional study","Men Who Have Sex With Men","Casual Sexual Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13429633","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 671 MSM college students recruited through community‑based organisations in Zhejiang, China; logistic regression used to examine associations between pornography viewing frequency and internet‑mediated casual sex and condom use.","sample_n":671,"sample_text":"671 participants recruited via four community‑based organisations (CBOs).","population":"MSM college students (n=671) in six cities of Zhejiang Province, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among Chinese college men who have sex with men, frequent porn viewing was linked to more internet‑mediated casual sex, and certain personal factors predicted inconsistent condom use with those partners.","clinical_takeaway":"Frequent pornography exposure may signal higher risk of online casual sex; targeted sexual‑health education could improve condom use.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample for a niche population","Use of multivariable logistic regression with confidence intervals","Addresses a timely public‑health issue"],"limitations":["Cross‑sectional design limits causal inference","Convenience recruitment via CBOs may bias representativeness","Key constructs (e.g., pornography use) measured with single, unvalidated items","No assessment of moral or mental‑health confounders"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2026.1860278"}},{"id":1236,"doi":"10.1542/peds.2011-1730","pmid":"22144706","pmcid":null,"title":"Prevalence and characteristics of youth sexting: a national study","authors":"Mitchell KJ, Finkelhor D, Jones LM, Wolak J.","first_author":"Mitchell KJ","journal":"Pediatrics","year":2012,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":125,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"national telephone survey of 1560 youth (ages 10‑17), cross‑sectional","sample_n":1560,"sample_text":"cross‑sectional national telephone survey","population":"U.S. adolescents, internet users","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2012 U.S. telephone survey of 1,560 teens found that about 1% had created or appeared in explicitly sexual pictures, while roughly 6% had received such images. The behavior is uncommon, suggesting the need for education about legal risks.","clinical_takeaway":"Youth sexting is relatively rare; clinicians should focus on legal education rather than assuming pervasive risk.","confidence":0.85,"topic_tags":["sexual_function","adolescents","prevalence"],"strengths":["large, nationally representative sample","differentiates types of images (nude vs. sexually explicit)","provides prevalence estimates for policy relevance"],"limitations":["self‑report may underestimate illegal behavior","no validated sexting instrument","cross‑sectional; cannot assess causal outcomes"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":20,"contrasting":10,"mentioning":320,"citing_publications":487,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2011-1730"}},{"id":1239,"doi":"10.1007/s00787-022-01992-x","pmid":"35524827","pmcid":"PMC10460300","title":"Associations between adolescents watching pornography and poor mental health in three Swedish surveys","authors":"Svedin CG, Donevan M, Bladh M, Priebe G, Fredlund C, Jonsson LS.","first_author":"Svedin CG","journal":"European child & adolescent psychiatry","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Mental health","Adolescents","Pornography","Tscc","Scl-25","Watching"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10460300","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Repeated cross‑sectional surveys of Swedish high‑school seniors (N≈13,277) conducted in 2004, 2009 and 2014; logistic regression analyses of pornography exposure vs. mental‑health outcomes.","sample_n":13277,"sample_text":"13,277 high‑school seniors across three survey years","population":"Adolescents (average age 18) in Sweden, high‑school seniors; community‑based sample.","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Across three nationwide surveys of Swedish 18‑year‑olds, watching porn was not consistently linked to poorer mental health. Only viewing deviant porn (e.g., violent, child‑involved) showed some association, while family and abuse factors were stronger predictors.","clinical_takeaway":"General porn use does not appear to cause mental‑health problems in adolescents; clinicians should focus on broader psychosocial risk factors.","confidence":0.78,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Large, nationally representative adolescent sample","Use of validated mental‑health scales (TSCC, SCL‑25)","Repeated surveys allow assessment of consistency over time","Adjusts for multiple relevant background variables"],"limitations":["Pornography exposure measured by single self‑report items","No assessment of masturbation or moral incongruence","Cross‑sectional design precludes causal inference","Potential self‑report bias in sensitive behaviours"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00787-022-01992-x"}},{"id":1240,"doi":"10.31234/osf.io/bdcga","pmid":null,"pmcid":null,"title":"But What’s Your Partner up to? Associations between Relationship Quality and Pornography Use Depend on Contextual Patterns of Use within the Couple","authors":"Kohut T, Dobson K, Balzarini RN, Rogge RD, Shaw AMM, McNulty JK, Russell M, Fisher W, Campbell L.","first_author":"Kohut T","journal":"PsyArXiv","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://psyarxiv.com/bdcga/download","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"cross-sectional and longitudinal surveys of heterosexual couples (N up to 529)","sample_n":529,"sample_text":"Two cross‑sectional samples (N=407) and two longitudinal samples (N=77, N=529) of heterosexual couples.","population":"heterosexual couples, community recruited","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Couples who use pornography at similar levels report higher sexual and relationship satisfaction than couples where one partner uses it much more than the other. The findings suggest that it is the mismatch, not pornography itself, that matters for relationship wellbeing.","clinical_takeaway":"Therapists should explore partners' pornography habits and aim for mutual understanding rather than assuming pornography is inherently harmful.","confidence":0.7,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Large longitudinal sample (N=529)","Couple‑level analysis of similarity vs. dissimilarity","Considers multiple related sexual traits (attitudes, sex drive)"],"limitations":["Reliance on self‑report, unclear validation of pornography use measures","Moral incongruence, mental‑health and trauma not controlled","No experimental manipulation – causal claims limited"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/bdcga"}},{"id":1241,"doi":"10.1080/00224499.2012.681403","pmid":"22853694","pmcid":null,"title":"Revisiting the association between pornography use and risky sexual behaviors: the role of early exposure to pornography and sexual sensation seeking","authors":"Sinković M, Stulhofer A, Božić J.","first_author":"Sinković M","journal":"Journal of sex research","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":59,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"population-based survey of 1,005 Croatian young adults (18‑25); self‑report measures of pornography exposure, frequency, importance, and sexual risk behaviours; multivariate regression analysis","sample_n":1005,"sample_text":"population-based sample of young Croatian adults aged 18‑25 (n = 1,005)","population":"young adult community sample (Croatia)","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,005 Croatian young adults, early exposure to porn, but not how often they used it, was weakly linked to risky sexual behaviour. A personality trait called sexual sensation seeking did not explain this link.","clinical_takeaway":"Early porn exposure may be a small risk factor for sexual risk taking; clinicians should consider broader behavioural and personality factors.","confidence":0.8,"topic_tags":["pornography","sexual_function","religiosity"],"strengths":["Large, population‑based sample improves generalisability","Considers early exposure as distinct factor","Uses multivariate analysis to test confounding"],"limitations":["Cross‑sectional design cannot establish causality","Relies on self‑report for pornography use and risk behaviours","Limited set of potential confounds (e.g., moral beliefs, mental health) not measured"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":1,"mentioning":87,"citing_publications":141,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2012.681403"}},{"id":1242,"doi":"10.21203/rs.3.rs-2631536/v1","pmid":null,"pmcid":null,"title":"Health professionals’ perspectives on female genital cosmetic surgery: An interview study","authors":"Kirkman M, Dobson A, McDonald K, Webster A, Wijaya P, Fisher J.","first_author":"Kirkman M","journal":"Research Square","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-2631536/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"interview study with 21 participants (16 health professionals, 5 non‑health professionals)","sample_n":21,"sample_text":"16 health professionals and 5 non‑health professionals were interviewed","population":"health and non‑health professionals who work with women's bodies","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 21 professionals revealed that views on female genital cosmetic surgery are shaped by ideas about what a ‘normal’ vulva looks like, ethical concerns, and social pressures such as media and pornography.","clinical_takeaway":"Clinicians should recognize that requests for genital cosmetic surgery are often influenced by social and cultural factors, not purely medical necessity.","confidence":0.8,"topic_tags":["gender","sexual_function"],"strengths":["Qualitative depth","Identifies multiple discourses","Includes both health and non‑health professionals"],"limitations":["Small, non‑representative sample","No quantitative validation","Findings not generalisable"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-2631536/v1"}},{"id":1243,"doi":"10.1136/sextrans-2018-053710","pmid":"31040251","pmcid":"PMC6706277","title":"What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study","authors":"Patterson SP, Hilton S, Flowers P, McDaid LM.","first_author":"Patterson SP","journal":"Sexually transmitted infections","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Adolescent","information technology","Sexual Health","Qualitative Research","Communication Technologies"],"is_oa":false,"oa_url":null,"cited_by_count":41,"is_preprint":false,"topics":["pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross‑sectional qualitative study with purposive sample of 49 adolescents (16–19 yr) in Scotland; paired interviews plus real‑time online activity observation; framework analysis","sample_n":49,"sample_text":"49 participants","population":"adolescents (16‑19 yr) from Scotland, gender, sexuality, religion and socio‑demographic diversity","country":"Scotland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 49 Scottish teenagers revealed practical and social obstacles to finding reliable sexual‑health information online, such as information overload, fear of being seen, and difficulty locating trusted sources.","clinical_takeaway":"Clinicians should guide adolescents toward vetted, discreet online sexual‑health resources and discuss privacy concerns.","confidence":0.85,"topic_tags":["adolescents","sexual_function"],"strengths":["large, purposive and demographically diverse adolescent sample","innovative paired‑interview + real‑time online activity method","transparent framework analysis"],"limitations":["Qualitative data; no standardized or validated measures of barriers","Findings limited to Scottish adolescents; generalisability uncertain","No quantitative assessment of prevalence or magnitude of barriers"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":76,"citing_publications":100,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sextrans-2018-053710"}},{"id":1244,"doi":"10.1080/00926239608404914","pmid":"8743622","pmcid":null,"title":"The effect of condoms in sexually explicit narratives on male sexual arousal","authors":"Gaither GA, Rosenkranz RR, Amato-Henderson S, Plaud JJ, Bigwood SJ.","first_author":"Gaither GA","journal":"Journal of sex & marital therapy","year":1996,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Population","Biology","Genitalia","Urogenital system","Physiology","Behavior","North America","Contraception","Communication","Sex behavior","Age factors","population characteristics","Psychological factors","United States","Family Planning","Contraceptive Methods","Demographic Factors","Developed Countries","Research Report","Americas","Northern America","Barrier Methods","Condom","Mass Media","Genitalia, Male","Risk Reduction Behavior","Tape Recordings","Youth--men","North Dakota","Audiotapes","Emotions--men"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"within‑subjects laboratory experiment with 14 university male participants listening to audiotaped erotic scripts (condom vs no‑condom). Physiological arousal measured by penile plethysmography and self‑report.","sample_n":14,"sample_text":"14 male university students","population":"Male university students (N=14)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Fourteen male students listened to erotic audio stories that either mentioned condom use or not. Their arousal was measured with a penis‑size gauge and self‑ratings. There were no significant differences in physiological or reported arousal between the condom and no‑condom conditions.","clinical_takeaway":"Condom references in erotic narratives did not reduce male arousal in this small lab study.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Objective physiological measure of arousal","Within‑subjects design controls for individual differences","Both physiological and subjective data collected"],"limitations":["Very small sample (N=14) limits power","Convenience sample of university males limits generalisability","No detail on self‑report scale validation"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239608404914"}},{"id":1245,"doi":"10.1159/000553511","pmid":"42430290","pmcid":"PMC13533478","title":"Using Machine Learning with the Brief Symptom Inventory to Screen for Comorbid Addictions: A Proof-of-Principle Study","authors":"Levitin MD, Shmulewitz D, Eliashar R, Lev-Ran S, Mikulincer M.","first_author":"Levitin MD","journal":"European addiction research","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Addiction","Comorbidity","Machine Learning","Brief Symptom Inventory"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13533478","cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Population sample of 2,451 Jewish adults in Israel; cross‑sectional survey; machine‑learning prediction of self‑reported problematic substance use, gambling, gaming, compulsive sexual behavior and pornography use from Brief Symptom Inventory responses.","sample_n":2451,"sample_text":"Population sample of Jewish adults in Israel","population":"Jewish adults in Israel (N = 2,451)","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers used a mental‑health questionnaire (the Brief Symptom Inventory) to see if it could predict self‑reported problems with alcohol, drugs, gambling, gaming, compulsive sexual behavior and pornography in over 2 000 Israeli adults. Machine‑learning models achieved modest prediction, strongest for compulsive sexual behavior.","clinical_takeaway":"The BSI shows some promise for flagging patients who may need further screening for behavioral addictions, but it cannot replace dedicated assessments.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function","csbd"],"strengths":["Large community sample","Use of validated BSI instrument","Application of multiple machine‑learning models","Transparent reporting of predictive performance metrics"],"limitations":["Outcome measures for addictions not described or validated","No control for key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)","Cross‑sectional design limits causal inference","No pre‑registration or external validation set"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000553511"}},{"id":1248,"doi":"10.1177/10790632221082663","pmid":"35382636","pmcid":"PMC10399101","title":"Development and Validation of the Beliefs About Revenge Pornography Questionnaire","authors":"Harper CA, Smith L, Leach J, Daruwala NA, Fido D.","first_author":"Harper CA","journal":"Sexual abuse : a journal of research and treatment","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Scale Development","Victim Blaming","Revenge Pornography","Image-based Sexual Abuse","Offense Proclivity"],"is_oa":true,"oa_url":"https://journals.sagepub.com/doi/pdf/10.1177/10790632221082663","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Scale development and validation using factor analysis, reliability, and concurrent validity in an international community sample (N=511).","sample_n":511,"sample_text":"International community sample (N=511); subsamples used for propensity (n=227) and judgement (n=232) analyses.","population":"Adults from an international community sample recruited online; not a clinical or treatment‑seeking group.","country":"International (online sample; specific countries not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and validated a new questionnaire measuring people's beliefs about non‑consensual image sharing (revenge porn), showing it reliably captures attitudes like victim blaming and offense minimisation.","clinical_takeaway":"None – the study provides a research tool, not direct clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Robust psychometric validation (factor analysis, reliability, concurrent validity)","Large sample for scale development","Open‑access preprint for transparency"],"limitations":["Cross‑sectional, convenience sample limits generalisability","No pre‑registration reported","No assessment of moral or trauma‑related confounds"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":7,"contrasting":2,"mentioning":28,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632221082663"}},{"id":1250,"doi":"10.3389/fpsyg.2026.1837501","pmid":"42466028","pmcid":"PMC13373093","title":"Immersive gratifications and compulsive VR media engagement: a dual-process model of erotic content consumption in virtual reality","authors":"Ahmad I, Aslam S, Ullah F.","first_author":"Ahmad I","journal":"Frontiers in psychology","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Virtual reality","Dual-process Theory","Sense Of Presence","Uses And Gratifications","Compulsive Engagement"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13373093","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 388 adult VR‑EPC consumers, partial‑least‑squares structural equation modelling","sample_n":388,"sample_text":"Adult VR‑EPC consumers recruited for an online survey","population":"self‑selected VR users (age 18+, likely convenience sample)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 388 adults who watch erotic VR content found that curiosity, confidence using VR, and excitement‑seeking predicted a sense of presence and satisfaction, which in turn were linked to more compulsive use, especially when habit was strong.","clinical_takeaway":"No direct clinical guidance; the study offers a theoretical model of compulsive VR porn use but lacks evidence for treatment implications.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large N for a survey (388)","Use of structural equation modelling to test a theory","Novel focus on VR erotic content"],"limitations":["Self‑report scales likely ad‑hoc, limited validation","Cross‑sectional, cannot infer causality","No measurement of key confounds (moral, mental health, etc.)","Convenience sample, limited generalisability"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2026.1837501"}},{"id":1251,"doi":"10.1097/mop.0000000000000140","pmid":"25160783","pmcid":null,"title":"Health implications of new age technologies for adolescents: a review of the research","authors":"Bailin A, Milanaik R, Adesman A.","first_author":"Bailin A","journal":"Current opinion in pediatrics","year":2014,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methods, no primary data collection.","sample_n":null,"sample_text":"Not applicable – review article.","population":"adolescents (general discussion)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews possible harms of modern technologies for teens, noting that easy internet access makes pornography widely available and linking it to several negative health outcomes, though it provides no new data.","clinical_takeaway":"Clinicians should be aware that pornography exposure is mentioned as a risk factor for adolescents, but evidence is not systematically reviewed here.","confidence":0.7,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Broad overview of multiple technology risks","Identifies pornography as a potential health concern"],"limitations":["Narrative, non‑systematic review","No empirical data or systematic quality appraisal","Lacks measurement detail and control for key confounds"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":0,"mentioning":41,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/mop.0000000000000140"}},{"id":1254,"doi":"10.1093/sexmed/qfag044","pmid":"42368880","pmcid":null,"title":"Magnitude of adolescent sexual activity and its associated factors among selected secondary school student in Addis Ketema Sub-city, Addis Ababa, Ethiopia","authors":"Babeta EH, Asfaw HM, Dibaba GT.","first_author":"Babeta EH","journal":"Sexual medicine","year":2026,"pub_types":["Journal Article"],"keywords":["Adolescent","Addis Ababa","Magnitude","Sexual Practice","Adolescent Sexual Activity"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of secondary school students in Addis Ababa, Ethiopia (Nov–Dec 2021); self‑administered questionnaire; logistic regression for associations","sample_n":null,"sample_text":"not reported in abstract","population":"Adolescent secondary‑school students (age unspecified) in Addis Ketema sub‑city, Addis Ababa, Ethiopia","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of Ethiopian secondary‑school students found that 17 % had engaged in sexual activity, and those who watched pornography were much more likely to be sexually active, along with factors like having a boyfriend/girlfriend and drinking alcohol.","clinical_takeaway":"Pornography exposure is linked to higher odds of adolescent sexual activity; interventions should address media exposure alongside substance use and relationship education.","confidence":0.7,"topic_tags":["adolescents","sexual_function","pornography"],"strengths":["Large community‑based adolescent sample","Direct measurement of sexual activity and pornography exposure","Use of multivariable logistic regression to adjust for covariates"],"limitations":["Cross‑sectional design cannot infer causality","Self‑report may be affected by social desirability bias","No validated scales for pornography use or sexual behaviour"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfag044"}},{"id":1255,"doi":"10.1542/peds.2013-1157","pmid":"24394678","pmcid":"PMC3904272","title":"Sexting and sexual behavior in at-risk adolescents","authors":"Houck CD, Barker D, Rizzo C, Hancock E, Norton A, Brown LK.","first_author":"Houck CD","journal":"Pediatrics","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual behavior","Early Adolescence","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":77,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of at‑risk seventh‑grade adolescents (baseline of a prevention trial); convenience sample, not nationally representative","sample_n":322,"sample_text":"Approximately 322 participants (22% reported sexting)","population":"early adolescents (seventh grade, at‑risk)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among at‑risk seventh‑graders, about one‑fifth had sent sexts. Teens who sent sexts, especially photos, were more likely to engage in sexual activities like oral or vaginal sex. The study suggests sexting can signal higher sexual risk.","clinical_takeaway":"Discuss sexting with early adolescents as a potential marker of broader sexual risk behaviors.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large community‑based adolescent sample","Clear associations between sexting and a range of sexual behaviors","Differentiates text‑only vs. photo sexting"],"limitations":["Cross‑sectional design limits causal inference","Self‑report measures, likely unvalidated","Limited control for key confounding factors"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":17,"contrasting":0,"mentioning":181,"citing_publications":215,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2013-1157"}},{"id":1256,"doi":"10.1111/jora.12745","pmid":"35294070","pmcid":null,"title":"Prospective Associations Between Pornography Viewing and Sexual Aggression Among Adolescents","authors":"Waterman EA, Wesche R, Morris G, Edwards KM, Banyard VL.","first_author":"Waterman EA","journal":"Journal of research on adolescence : the official journal of the Society for Research on Adolescence","year":2022,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":["Adolescence","Sexual Aggression","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort of middle/high‑school students surveyed five times over three years","sample_n":null,"sample_text":"not reported in abstract","population":"adolescents (mean age 13.7 y), 53 % female, 76 % White, 21 % Native American, 89 % heterosexual; community school sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A three‑year study of U.S. teens found that viewing pornography and committing sexual harassment tend to increase each other over time, especially among boys, and that pornography use sometimes predicts later sexual assault.","clinical_takeaway":"Clinicians should be aware that early porn exposure may be linked to later sexual aggression; address it in prevention and education programs.","confidence":0.8,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Longitudinal design with multiple assessment waves","Large, diverse adolescent sample","Examination of reciprocal associations"],"limitations":["Reliance on single‑item self‑report for pornography use","No measurement of key confounds (moral incongruence, mental health, etc.)","Unclear whether sample size provides adequate power"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":1,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":33,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jora.12745"}},{"id":1257,"doi":"10.2139/ssrn.4324224","pmid":null,"pmcid":null,"title":"The Struggles of Generation Z and The Future of North American Mission Organizations","authors":"Dunaetz DR.","first_author":"Dunaetz DR.","journal":"SSRN","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/article/PPR/PPR625343","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary / opinion piece with no empirical data.","sample_n":null,"sample_text":"Not applicable – no participants were recruited.","population":"Generation Z in North America (no sample reported)","country":"United States / Canada (implied)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper argues that Generation Z in North America faces heightened depression, suicide risk, and reduced life satisfaction, partly due to social‑media, gaming, and pornography use, which may hinder future missionaries unless organizations adapt.","clinical_takeaway":"None – the article offers no empirical findings for clinical use.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses emerging societal issues","Integrates multiple stressors (social media, COVID‑19, parenting)"],"limitations":["No empirical data or systematic review","No measurement of key constructs (e.g., pornography use, distress)","Conclusions are speculative"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2139/ssrn.4324224"}},{"id":1258,"doi":"10.1071/sh24025","pmid":"38769682","pmcid":"PMC12013206","title":"Adolescents' pornography viewing frequency and its relationship with condom attitudes","authors":"Galper EF, Widman L, Brasileiro J, Noar SM.","first_author":"Galper EF","journal":"Sexual health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 457 adolescents, self‑report measures of pornography viewing frequency and condom attitudes","sample_n":457,"sample_text":"457 adolescents aged 13‑18 years completed an online questionnaire","population":"adolescents 13‑18 years, convenience sample","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 457 teenagers, about 40% had watched porn in the past year. Those who watched more often tended to have slightly more negative attitudes toward using condoms.","clinical_takeaway":"Higher porn exposure among teens may be linked to poorer condom attitudes; educators should address porn literacy.","confidence":0.8,"topic_tags":["adolescents","pornography","sexual_function","prevalence"],"strengths":["Large adolescent sample for a survey","Focus on understudied link between porn and condom attitudes","Clear statistical reporting of correlation"],"limitations":["Cross‑sectional, cannot infer causality","No validated instruments reported","Key confounds (e.g., moral attitudes, mental health) not measured"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh24025"}},{"id":1259,"doi":"10.1080/10410236.2024.2346675","pmid":"38693691","pmcid":null,"title":"Association Between Pornography Use, Sexism, and Sexual Violence Myth Acceptance in Chinese Men: The Moderating Effect of Perceived Realism","authors":"Zhang X, Fu T, Yang J, Li R, Liu X, Zheng L.","first_author":"Zhang X","journal":"Health communication","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 376 Chinese men, self‑report measures of pornography use frequency, hostile sexism, and sexual‑violence‑myth acceptance; mediation and moderation analyses.","sample_n":376,"sample_text":"Convenience survey (details not given)","population":"Chinese adult men (average age not provided)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 376 Chinese men, higher pornography use was linked to greater acceptance of sexual‑violence myths, but only indirectly through increased hostile sexism. Men who thought porn was realistic showed a stronger indirect effect.","clinical_takeaway":"Educators should consider how realistic portrayals of porn may reinforce sexist attitudes that support violence myths.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a survey (N=376)","Uses mediation/moderation to test theory","Addresses understudied Chinese context"],"limitations":["Cross‑sectional – cannot infer causality","No measurement of key sexual‑health confounds (e.g., moral views, mental health)","Reliance on self‑report frequency, potential social desirability bias"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2024.2346675"}},{"id":1261,"doi":"10.1177/1524838017717745","pmid":"29333966","pmcid":null,"title":"The Impacts of Sexual Media Exposure on Adolescent and Emerging Adults' Dating and Sexual Violence Attitudes and Behaviors: A Critical Review of the Literature","authors":"Rodenhizer KAE, Edwards KM.","first_author":"Rodenhizer KAE","journal":"Trauma, violence & abuse","year":2019,"pub_types":["Review","Journal Article"],"keywords":["Mass Media","Sexual Assault","Intimate Partner Violence","Media Effects","Sexual Violence","Dating Violence","Media Exposure","Sexually Explicit Media","Sexually Violent Media"],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Narrative systematic literature review of 43 empirical studies; no explicit risk‑of‑bias assessment, no meta‑analysis, no preregistration.","sample_n":null,"sample_text":"43 studies reviewed; original sample sizes not aggregated.","population":"Adolescents and emerging adults (mixed samples across included studies)","country":"Multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review finds that exposure to sexually explicit or violent media is linked to more accepting attitudes toward dating and sexual violence, and to higher rates of victimization, perpetration, and bystander non‑intervention among teens and young adults, especially men.","clinical_takeaway":"Clinicians should be aware that media exposure may shape youths' attitudes and risk for dating/sexual violence, but evidence is chiefly correlational.","confidence":0.6,"topic_tags":["sexual_function","pornography"],"strengths":["Broad coverage of 43 empirical studies","Identifies consistent patterns across gender","Highlights gaps for longitudinal/experimental work"],"limitations":["No formal systematic‑review methodology reported","No quantitative synthesis or bias assessment","Potential selection bias in included studies"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":73,"citing_publications":103,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1524838017717745"}},{"id":1262,"doi":"10.1016/j.chiabu.2024.106806","pmid":"38688115","pmcid":null,"title":"Reoffending after convictions related to child sexual exploitation material: Data from the German Federal Central Criminal Register","authors":"Hörnle T, Tetal C, Wössner G.","first_author":"Hörnle T","journal":"Child abuse & neglect","year":2024,"pub_types":["Journal Article"],"keywords":["Child Sexual Abuse","Recidivism","Child Pornography","Child Sexual Exploitation Material","Criminal Reoffending"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"registry cohort follow‑up of all convicted CSEM offenders in Germany (6‑year observation)","sample_n":null,"sample_text":"All convicted offenders in the Federal Central Criminal Register; exact N not given in abstract","population":"all persons convicted of child sexual exploitation material offenses in Germany (adult offenders)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using Germany’s criminal register, the study found that only about 1 % of people convicted solely for child‑sex‑exploitation material re‑offend with child sexual abuse within six years, especially if they are over 30 or have no prior sex offenses.","clinical_takeaway":"A CSEM conviction alone is a poor indicator of future child‑abuse risk; age and prior offending are more informative.","confidence":0.8,"topic_tags":["csbd"],"strengths":["Large, nationwide registry provides objective data","Clear operational definitions (conviction types, recidivism)","Long follow‑up period (6 years)"],"limitations":["No adjustment for individual‑level psychosocial risk factors","Abstract does not report confidence intervals or effect‑size metrics","Potential under‑detection of unreported offenses"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2024.106806"}},{"id":1263,"doi":"10.1016/j.bbr.2026.116341","pmid":"42336325","pmcid":null,"title":"Neural correlates of appetitive learning and extinction in individuals with risky gaming use and gaming disorder","authors":"Krikova K, Kampa M, Klein S, Stark R, Klucken T.","first_author":"Krikova K","journal":"Behavioural brain research","year":2026,"pub_types":["Journal Article"],"keywords":["Extinction","Pavlovian Conditioning","Behavioral Addictions","Extinction Recall","Gaming Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"cross‑sectional laboratory fMRI conditioning paradigm with three male groups (IGD, risky gaming, non‑problematic).","sample_n":83,"sample_text":"male participants, likely convenience sample","population":"83 male participants (25 IGD, 23 risky gaming, 35 controls)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In an fMRI study of male gamers, those with Internet Gaming Disorder showed weaker brain responses to non‑gaming rewards and altered activity during learning and extinction of gaming cues, suggesting different reward processing.","clinical_takeaway":"Preliminary evidence that problematic gaming may involve distinct neural reward patterns, but findings are limited by small sample size.","confidence":0.7,"topic_tags":["gender","pornography","neuroscience"],"strengths":["Use of multimodal physiological and neural measures","Inclusion of multiple comparison groups"],"limitations":["Small fMRI sample per group, likely underpowered","No clear measurement of core addiction criteria or validated IGD scales","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":30,"max_possible":70,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":4,"statistics":4,"confounds":2,"design":5,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.bbr.2026.116341"}},{"id":1264,"doi":"10.1038/s41443-026-01308-6","pmid":"42332078","pmcid":null,"title":"Female genital cutting and cosmetic genital surgery: a narrative synthesis of global practices, motivations, and the influence of aesthetic ideals","authors":"Obiora OL.","first_author":"Obiora OL.","journal":"International journal of impotence research","year":2026,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative synthesis of literature (theory‑informed review) without systematic methods or risk‑of‑bias assessment","sample_n":null,"sample_text":"not applicable – secondary sources only","population":"global literature on FGC and FGCS; no primary participants","country":"global (literature sources)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review proposes a new framework, \"global quest for genital beauty,\" to compare female genital cutting and cosmetic genital surgery, showing both are shaped by cultural ideals and media, including pornography. It calls for rights‑based policies to curb harmful practices.","clinical_takeaway":"None – the paper offers a conceptual overview, not clinical guidance.","confidence":0.4,"topic_tags":["gender","csbd","sexual_function","pornography"],"strengths":["Broad, theory‑informed framing of genital‑beauty discourse","Incorporates literature from multiple databases (PubMed, Scopus, Web of Science)","Identifies policy‑relevant ethical implications"],"limitations":["Narrative, not systematic, synthesis – risk of selection bias","No formal quality appraisal of included studies","No empirical data; conclusions rest on secondary sources"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-026-01308-6"}},{"id":1265,"doi":"10.31234/osf.io/6qr7t","pmid":null,"pmcid":null,"title":"Development and validation of the Beliefs about Revenge Pornography Questionnaire","authors":"Harper CA, Smith L, Leach J, Daruwala N, Fido D.","first_author":"Harper CA","journal":"PsyArXiv","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/6qr7t","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large community sample (N=511), questionnaire development, factor analysis, split‑sample validation","sample_n":511,"sample_text":"large international community sample","population":"international community adults","country":"multiple (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a new questionnaire (BRPQ) that measures people’s beliefs about revenge pornography, finding three main belief dimensions and showing the scale relates to empathy, personality traits, and attitudes toward sexual offenses.","clinical_takeaway":"None – the study provides a measurement tool, not clinical guidance.","confidence":0.85,"topic_tags":["religiosity","sexual_function"],"strengths":["Large sample for scale development","Robust factor analytic methods","Concurrent validity with theoretically relevant constructs"],"limitations":["Cross‑sectional design; no test‑retest reliability reported","Self‑selected internet sample may limit generalisability","No pre‑registration disclosed"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/6qr7t"}},{"id":1266,"doi":"10.1016/j.adolescence.2014.10.004","pmid":"25448834","pmcid":null,"title":"Brief report: The association between adolescents'  characteristics and engagement in sexting","authors":"Van Ouytsel J, Van Gool E, Ponnet K, Walrave M.","first_author":"Van Ouytsel J","journal":"Journal of adolescence","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":52,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 1028 adolescents from 11 secondary schools in Belgium; logistic regression analysis.","sample_n":1028,"sample_text":"1028 adolescents from 11 secondary schools in Belgium","population":"Adolescents (secondary school students) in Belgium (N=1028)","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A Belgian survey of over 1,000 teens found that those who sext are more likely to have higher sensation‑seeking, certain thinking styles, and depression, after accounting for age, gender and other factors.","clinical_takeaway":"Clinicians should consider sensation‑seeking traits and depressive symptoms when addressing sexting behavior in adolescents.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large sample size for a survey","Uses multivariate logistic regression","Includes several psychological predictors"],"limitations":["Cross‑sectional design; cannot infer causality","Sexting measured with likely single‑item self‑report","No assessment of moral or relational confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":105,"citing_publications":149,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2014.10.004"}},{"id":1267,"doi":"10.1007/s10508-024-02858-w","pmid":"38635110","pmcid":"PMC11176243","title":"\"I Feel Like a Fraud Who Acts Like a Feminist\": The Discussion Themes and Sexual Scripts in the Porn Free Women Online Forum","authors":"Zhang X, Silva DE.","first_author":"Zhang X","journal":"Archives of sexual behavior","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Female Sexuality","Critical Discourse Analysis","Online Health Communities","Pornography","Sexual Script Theory"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-024-02858-w.pdf","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative discourse analysis of posts from the Reddit forum r/pornfreewomen, using structural topic modelling and thematic analysis.","sample_n":null,"sample_text":"Posts from the Porn Free Women online forum (size not reported).","population":"Women participants in an online pornography‑abstinence forum (self‑selected, not a probability sample).","country":"Not specified (global Reddit community).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined posts from a women‑only online forum that promotes abstaining from pornography. Using text‑analysis methods, it identified three main narratives: viewing porn as an addiction, reaffirming heterosexual norms, and framing abstinence as a form of liberation and feminist empowerment.","clinical_takeaway":"Clinicians should recognize that women’s motivations for avoiding porn are diverse, ranging from health concerns to feminist identity, and not assume a uniform pathology.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Addresses a largely understudied female perspective in porn‑abstinence discourse.","Combines quantitative topic modelling with qualitative discourse analysis.","Provides nuanced insight into competing sexual scripts."],"limitations":["Self‑selected, non‑representative forum sample.","No measurement of key confounds (e.g., moral incongruence, mental health).","Lack of validated instruments; findings are interpretive."],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02858-w"}},{"id":1268,"doi":"10.1007/s10508-021-02175-6","pmid":"35165802","pmcid":"PMC8853281","title":"Porn Sex versus Real Sex: Sexual Behaviors Reported by a U.S. Probability Survey Compared to Depictions of Sex in Mainstream Internet-Based Male-Female Pornography","authors":"Fritz N, Malic V, Fu TC, Paul B, Zhou Y, Dodge B, Fortenberry JD, Herbenick D.","first_author":"Fritz N","journal":"Archives of sexual behavior","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Condom Use","Sexual Behaviors","Orgasm","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8853281","cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative probability survey (2014) linked with content analysis of 2,562 porn videos; cross‑sectional comparison of event‑level sexual behaviors.","sample_n":3612,"sample_text":"U.S. nationally representative probability survey (N≈3612 respondents) and 2,562 porn videos.","population":"U.S. adults surveyed in a probability sample; videos from two popular porn sites.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A US nationally representative survey compared people’s most recent sexual activities with what is shown in popular male‑female porn videos. Kissing, orgasms and condom use were less common in porn, while anal sex and oral sex were more common. Couples who watched porn together reported more oral sex, anal sex, toy use, and female orgasms.","clinical_takeaway":"Clinicians should note that porn depictions differ from typical partner sex; viewing porn does not appear to reduce condom use or female orgasm in real encounters.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative sample enhances generalisability.","Direct, event‑level comparison between real‑world and pornographic sexual behaviors.","Systematic content analysis of a substantial number of videos."],"limitations":["Cross‑sectional design cannot address causality.","Potential recall bias in self‑reported most recent sexual encounter.","Limited detail on statistical corrections for multiple comparisons."],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02175-6"}},{"id":1269,"doi":"10.1016/j.jsxm.2022.01.005","pmid":"35165051","pmcid":null,"title":"Predictors of Pornography Use: Difficulties in Emotion Regulation and Loneliness","authors":"Cardoso J, Ramos C, Brito J, Almeida TC.","first_author":"Cardoso J","journal":"The journal of sexual medicine","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Loneliness","Perceived Stress","Pornography","Difficulties In Emotion Regulation","Predictors Of Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey with convenience sample (N=340)","sample_n":340,"sample_text":"340 participants, convenience sample","population":"adults (mean age 28.5), mixed gender","country":"not specified (likely Portugal/Spain based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 340 adults, higher scores on a problems‑with‑pornography scale were linked to poorer emotion‑regulation, greater loneliness, and being male. These factors together explained only a modest part of the variation in problematic porn use.","clinical_takeaway":"Screen for emotion‑regulation difficulties and loneliness when addressing concerns about problematic pornography use.","confidence":0.85,"topic_tags":["pornography","sexual_function"],"strengths":["Validated psychometric instruments used for most constructs","Relatively large sample for a survey","Statistical modelling of multiple predictors"],"limitations":["Cross‑sectional, cannot infer causality","Convenience sample limits generalisability","No measurement/control of moral incongruence, masturbation, or mental‑health covariates"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":5,"contrasting":1,"mentioning":22,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2022.01.005"}},{"id":1270,"doi":"10.3390/healthcare14121718","pmid":"42354577","pmcid":"PMC13299474","title":"Clinical Description and Sociodemographic Profile of Individuals with Cybersex Addiction in Long-Term Therapeutic Support Programs","authors":"Lorente-Corral L, Sancho-Cantus D, Asensio S, Cunha-Pérez C, Casaña Mohedo J.","first_author":"Lorente-Corral L","journal":"Healthcare (Basel, Switzerland)","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Self-esteem","Impulse Control","Hypersexuality","Cybersex Addiction","Therapeutic Support"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13299474","cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational descriptive cross‑sectional study of 27 treatment‑seeking individuals (26 male, 1 female) in a therapeutic support program","sample_n":27,"sample_text":"predominantly male clinical cohort (26 males, 1 female) enrolled in therapeutic support programs","population":"clinical cohort receiving long‑term therapeutic support for self‑identified cybersex addiction","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"supports","citation_value":"background","plain_summary":"The study described 27 people in a therapy program for cybersex addiction, noting that longer treatment was linked to fewer impulse‑control problems, but age of onset and self‑esteem did not predict current severity.","clinical_takeaway":"Longer therapeutic support may help reduce impulse‑control difficulties in individuals seeking help for cybersex‑related problems.","confidence":0.7,"topic_tags":["pornography","sexual_function","treatment"],"strengths":["Uses established hypersexuality scale (HBI)","Provides detailed sociodemographic description of a clinical cohort","Focus on therapeutic duration and clinical stability"],"limitations":["Very small, male‑dominant, treatment‑seeking sample limits generalisability","No measurement/control of key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare14121718"}},{"id":1271,"doi":"10.1007/s10461-015-1033-y","pmid":"25805443","pmcid":"PMC5664924","title":"An updated protocol to detect invalid entries in an online survey of men who have sex with men (MSM): how do valid and invalid submissions compare?","authors":"Grey JA, Konstan J, Iantaffi A, Wilkerson JM, Galos D, Rosser BR.","first_author":"Grey JA","journal":"AIDS and behavior","year":2015,"pub_types":["Comparative Study","research-article","Evaluation Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Validity","Bias","Survey Methods","questionnaires"],"is_oa":false,"oa_url":null,"cited_by_count":68,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative analysis of valid vs invalid online survey entries among MSM (N=1254); logistic regression used to compare demographics and HIV testing rates.","sample_n":1254,"sample_text":"1254 survey entries, of which 146 (11.6 %) were classified as invalid.","population":"Men who have sex with men (MSM) recruited via an Internet‑based HIV prevention survey.","country":"USA (presumed based on NIH funding and author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested a method for spotting fake or duplicate online survey responses among men who have sex with men and found that about 12 % were invalid, which would have biased estimates of HIV testing rates.","clinical_takeaway":"Researchers should screen for invalid survey entries to avoid under‑ or over‑estimating health behaviours.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for an online survey","Systematic protocol for detecting invalid entries","Relevant to improving data quality in sexual health research"],"limitations":["Validity of detection protocol not independently validated","No pre‑registration or open data","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":79,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-015-1033-y"}},{"id":1272,"doi":"10.7334/psicothema2015.193","pmid":"27112809","pmcid":null,"title":"Sexting, psychological distress and dating violence among adolescents and young adults","authors":"Morelli M, Bianchi D, Baiocco R, Pezzuti L, Chirumbolo A.","first_author":"Morelli M","journal":"Psicothema","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":69,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 1,334 adolescents/young adults, cross‑sectional, convenience sample","sample_n":1334,"sample_text":"community sample, recruitment method not specified","population":"adolescents and young adults (mean age 20.8), 68% female","country":"unspecified (likely Spain based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 1,300 young people, those who sexted more frequently were more likely to report both online and offline dating violence, but sexting was not linked to higher anxiety or depression.","clinical_takeaway":"Higher sexting frequency may signal increased risk for dating violence; clinicians should assess relationship aggression when sexting is frequent.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Large sample size for a survey","Validated distress (GHQ) and dating violence measures","Gender and sexual‑orientation analyses"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral incongruence or other key confounds","Unclear recruitment method; possible self‑selection bias"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":21,"citing_publications":228,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7334/psicothema2015.193"}},{"id":1273,"doi":"10.1007/s10508-024-02845-1","pmid":"38570424","pmcid":null,"title":"Sexual Norms Across Pornography Use, Sexual Fantasy, and In-Person Sexuality","authors":"Gormezano AM, van Anders SM.","first_author":"Gormezano AM","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Norms","Sexual Fantasy","Partnered Sexuality","Pornography Use","Sexual Configurations Theory"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey with convenience sample (N=706), participants manipulated digital circles to represent norms across pornography use, sexual fantasy, and in‑person sexuality.","sample_n":706,"sample_text":"online convenience sample","population":"adult participants, gender/sex diverse, sexually diverse; recruited online (likely self‑selected).","country":"unspecified (likely multiple, given international authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 706 adults about the social norms they think apply to pornography use, sexual fantasies, and real‑life sex. Using a visual circle‑overlap task, participants viewed norms for each context as distinct rather than sharing a single set of rules.","clinical_takeaway":"None – the study is about perceived norms, not clinical outcomes.","confidence":0.7,"topic_tags":["sexual_function","pornography"],"strengths":["Large sample size for exploratory survey","Inclusion of gender‑ and sexual‑diverse participants","Innovative visual method to capture perceived norm structure"],"limitations":["Novel measurement lacks validation","Convenience online sample limits generalisability","No control for potential confounds (e.g., religiosity, mental health)","Descriptive statistics without reported effect sizes or corrections"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02845-1"}},{"id":1274,"doi":"10.1007/s10508-025-03382-1","pmid":"42265505","pmcid":null,"title":"Prevalence of AI-Supported Sexual Activities Among Adults in Germany: Results from a National Online Survey","authors":"Döring N, Mikhailova V, Mohseni MR.","first_author":"Döring N","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Artificial intelligence","Online Sexuality","Digital Intimacy","Sexual Technology","Ai-supported Sexual Activities"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national online survey (N=2,658), cross‑sectional convenience sample","sample_n":2658,"sample_text":"large online convenience sample, not probability‑based","population":"adults 18‑75 in Germany","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 2,658 German adults found that about one‑third had used AI for sexual purposes in the past year, especially for getting sexual information, viewing AI‑generated porn, and seeking sexual advice. Men, younger people, and non‑heterosexual participants reported higher use, and satisfaction with these AI interactions was modestly above average.","clinical_takeaway":"AI tools are increasingly part of adult sexual lives; clinicians should be aware of their use but no direct health risks are identified here.","confidence":0.78,"topic_tags":["prevalence","sexual_function"],"strengths":["Large national sample","First empirical data on AI‑supported sexual activities","Clear demographic breakdowns"],"limitations":["Self‑report, no validated measures","Convenience online recruitment, possible selection bias","No assessment of potential confounds (e.g., moral attitudes, mental health)","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[{"status":"Has correction","date":"2026-8-5","noticeDoi":"10.1007/s10508-026-03612-0","doi":"10.1007/s10508-025-03382-1"}],"url":"https://scite.ai/reports/10.1007/s10508-025-03382-1"}},{"id":1275,"doi":"10.1186/s40359-026-04971-y","pmid":"42260674","pmcid":"PMC13470953","title":"Validation of the Spanish Sexual Risk Behaviour Scale among adolescents, youth, and future health and educational professionals","authors":"Alonso Martínez L, Sáiz Manzanares MC, Silva Palmieri IG, Tavares Magnabosco G, Fino E, Puente Alcaraz J.","first_author":"Alonso Martínez L","journal":"BMC psychology","year":2026,"pub_types":["research-article","Validation Study","Journal Article"],"keywords":["Youth","Sexual Health","Underage","Scale Validation","Sexual Risk Behaviour"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13470953","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a 6‑item Sexual Risk Behaviour Scale in 478 Spanish‑speaking adolescents and young adults; exploratory & confirmatory factor analyses; known‑groups validity across sociodemographic variables.","sample_n":478,"sample_text":"478 participants (327 women, 148 men, 20 gay, 392 heterosexual, etc.)","population":"Adolescents and young adults (13‑48 y) recruited from secondary schools and university programs in health and education fields (convenience sample).","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors adapted a short questionnaire to measure risky sexual behaviours for Spanish‑speaking youth. With 478 participants, they showed the scale is reliable (α = 0.78) and measures a single factor, and it relates to age, gender, use of dating apps, porn consumption and other attitudes.","clinical_takeaway":"The Spanish SRBS can be used by clinicians and educators to screen for sexual risk behaviours in adolescents and young adults.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for a validation study","Robust psychometric analyses (EFA, CFA, reliability)","Assessment of known‑groups validity across several demographics"],"limitations":["Convenience student sample limits generalisability","No assessment of moral‑incongruence, masturbation, mental‑health or trauma confounds","No preregistration or open data statement"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s40359-026-04971-y"}},{"id":1276,"doi":"10.21203/rs.3.rs-2389230/v1","pmid":null,"pmcid":null,"title":"A Qualitative Exploration of the Predictors and Approaches of Misuse of Digital Media among Adolescents in Bangladesh: A Public Health Perspective","authors":"BakiBillah AH.","first_author":"BakiBillah AH.","journal":"Research Square","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-2389230/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Key‑informant interviews (N=19) with academics, officials and activists; thematic analysis of transcripts.","sample_n":19,"sample_text":"19 key informants, mean age 40 ± 6.8 years, all with at least a bachelor’s degree.","population":"Bangladeshi adults (key informants) discussing adolescent digital‑media misuse.","country":"Bangladesh","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with Bangladeshi academics and activists identified easy access to porn sites, low digital awareness among girls, parental neglect, and cultural factors as drivers of risky online sexual behaviors like sexting and revenge porn.","clinical_takeaway":"None – the study offers public‑health insights but no direct clinical guidance on pornography‑related problems.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Provides contextual, culturally specific insights","Uses multiple stakeholder perspectives","Identifies policy‑relevant factors"],"limitations":["Small, non‑representative expert sample","No empirical measurement of adolescents’ behavior","Lacks validated instruments or quantitative data","No control for key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-2389230/v1"}},{"id":1278,"doi":"10.2147/nss.s348242","pmid":"35082545","pmcid":"PMC8786338","title":"The Interplay Between Problematic Online Pornography Use, Psychological Stress, Emotion Dysregulation and Insomnia Symptoms During the COVID-19 Pandemic: A Mediation Analysis","authors":"Musetti A, Gori A, Alessandra A, Topino E, Terrone G, Plazzi G, Cacioppo M, Franceschini C.","first_author":"Musetti A","journal":"Nature and science of sleep","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Stress","Insomnia","Clinical Psychology","Emotion Dysregulation","Addictive Behaviors","Online Pornography","Problematic Online Pornographic Use"],"is_oa":true,"oa_url":"https://www.dovepress.com/getfile.php?fileID=77735","cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional mediation analysis with self‑report questionnaires (N = 776)","sample_n":776,"sample_text":"Community adults recruited online (convenience)","population":"Italian adults, 19‑48 y, community sample","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 776 Italian adults, higher use of online porn was linked to worse insomnia, and this relationship was explained by greater stress and difficulty managing emotions. The authors suggest that reducing porn use might help improve sleep by lowering stress.","clinical_takeaway":"Treating stress and emotion‑regulation may mitigate insomnia linked to high porn use, but causality is unproven.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample (N>700) for questionnaire study","Comprehensive mediation model linking POPU, stress, emotion dysregulation, insomnia","Controlled for demographics and pandemic‑related variables"],"limitations":["Cross‑sectional design; no causal inference possible","Problematic porn use measured with self‑report scale likely conflating frequency and distress","Key confounds (moral disapproval, masturbation, mental‑health comorbidity) not assessed"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/nss.s348242"}},{"id":1279,"doi":"10.1556/2006.2024.00009","pmid":"38551674","pmcid":"PMC11220821","title":"Compulsive sexual behaviour in Iranian married women: Prevalence, sociodemographic, sexual, and psychological predictors across-country","authors":"Khayer E, Zarei R, Damghanian M, Bőthe B, Farnam F.","first_author":"Khayer E","journal":"Journal of behavioral addictions","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Sexual function","Obsessive-compulsive Disorder","Sexual Satisfaction","Pornography","Compulsive Sexual Behaviour Disorder"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/view/journals/2006/aop/article-10.1556-2006.2024.00009/article-10.1556-2006.2024.00009.pdf","cited_by_count":3,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 772 married Iranian women covering all provinces; participants classified as CSBD+ vs CSBD- using CSBD‑7 cutoff; regression analyses of sociodemographic, sexual and psychological predictors.","sample_n":772,"sample_text":"national convenience sample of married women (details of recruitment not given in abstract)","population":"Married heterosexual women, Iran, N=772","country":"Iran","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationwide Iranian survey of 772 married women, 3.8% met a screening cutoff for compulsive sexual behavior. Lower education, unemployment, substance and porn use, sexual dissatisfaction and mental‑health problems were linked to higher risk.","clinical_takeaway":"Screen for CSBD in women presenting with sexual distress, especially if they have low education, unemployment, substance use or mood symptoms.","confidence":0.8,"topic_tags":["csbd","prevalence","sexual_function","moral_incongruence"],"strengths":["Large, nationwide sample","Use of validated CSBD‑7 and other standard scales","Comprehensive set of psychological and sexual predictors"],"limitations":["Cross‑sectional design limits causal inference","Masturbation not measured, potential confound","Addiction criteria not directly tested, rely on screening cutoff"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00009"}},{"id":1281,"doi":"10.31234/osf.io/h4jn5","pmid":null,"pmcid":null,"title":"Solitary and Joint Online Pornography Use During the First COVID-19 Lockdown in Portugal: Intrapersonal and Interpersonal Correlates","authors":"Rodrigues DL.","first_author":"Rodrigues DL.","journal":"PsyArXiv","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":true,"oa_url":"https://osf.io/h4jn5/download","cited_by_count":1,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online cross‑sectional survey, convenience sample (N = 303) in Portugal, May‑July 2020","sample_n":303,"sample_text":"convenience online sample","population":"adults (average age 31) recruited via online channels, 70 % in a relationship","country":"Portugal","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Portuguese online survey during the first Covid‑19 lockdown, people who used porn alone reported lower quality of their sex life if they were in a relationship, while using porn together with a partner was linked to higher sex‑life quality. Single people who used porn alone felt healthier and slept better.","clinical_takeaway":"Joint porn use may support sexual satisfaction during isolation, but solitary use could relate to lower sex‑life quality for partnered individuals.","confidence":0.6,"topic_tags":["pornography","sexual_function","relationships","csbd"],"strengths":["Distinguishes solitary vs joint pornography use","Considers partnered vs single participants","Uses multiple outcome domains (sex life, health, sleep)"],"limitations":["Convenience, non‑representative sample","Cross‑sectional; cannot infer causality","Key confounds (moral incongruence, mental health, trauma) not measured","Reliance on self‑report change items, unclear validation"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/h4jn5"}},{"id":1282,"doi":"10.1080/10410236.2024.2335691","pmid":"38534989","pmcid":null,"title":"Adolescents' Preferences for Mainstream and Paraphilic Pornography and Sexual Health Components: Attention to Within-And Between-Person Dynamics Over Time","authors":"Maes C, Wright PJ, Vandenbosch L.","first_author":"Maes C","journal":"Health communication","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Three‑wave panel study of adolescents; random‑intercept cross‑lagged panel modelling","sample_n":null,"sample_text":"not reported in abstract","population":"Adolescents (age not specified)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tracked teens over three time points to see if watching mainstream or paraphilic porn related to how satisfied they felt sexually or how easily they became aroused. Only mainstream porn was linked to higher arousability between different teens, but no effects were found within individuals over time.","clinical_takeaway":"No clear evidence that adolescent porn viewing, mainstream or paraphilic, harms sexual satisfaction or arousal; clinicians should consider broader factors.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Longitudinal design allowing temporal ordering","Uses advanced cross‑lagged panel modelling","Distinguishes mainstream vs. paraphilic content"],"limitations":["Unclear sample size and representativeness","No measurement of key confounds (moral incongruence, masturbation, mental health, trauma)","Reliance on self‑report instruments, validation not described"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2024.2335691"}},{"id":1284,"doi":"10.1007/s10508-021-02196-1","pmid":"34993717","pmcid":"PMC8735730","title":"Public Perceptions of Child Pornography and Child Pornography Consumers","authors":"Steel CMS, Newman E, O'Rourke S, Quayle E.","first_author":"Steel CMS","journal":"Archives of sexual behavior","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["risk assessment","Stigmatization","Child Pornography","Lay Perceptions","Sex Offender Registration"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-021-02196-1.pdf","cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Internet‑based survey of 524 U.S. adults assessing beliefs about child pornography; descriptive and inferential statistics reported.","sample_n":524,"sample_text":"Internet‑based convenience sample","population":"Adults (mean age 47, 51% female) from an online convenience panel in the United States","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2022 U.S. survey of 524 adults found that the public sees child‑pornography offenses as especially severe and overestimates the likelihood that offenders will reoffend or commit contact crimes. Most respondents support current sentencing and registration laws and prefer incarceration over treatment.","clinical_takeaway":"None – the study surveys public opinion, not clinical outcomes.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Large sample for a public‑opinion survey","Addresses understudied topic of lay perceptions of child sexual exploitation","Provides quantitative data on misperceptions of recidivism risk"],"limitations":["Convenience online sample limits generalisability","Questionnaire appears ad‑hoc; no evidence of validation","No adjustment for demographic or ideological confounders reported"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02196-1"}},{"id":1285,"doi":"10.31234/osf.io/xzug7","pmid":null,"pmcid":null,"title":"Revisiting the Role of Pornography Use in the Confluence Model Theory of Sexual Aggression","authors":"Kohut T, Fisher W.","first_author":"Kohut T","journal":"PsyArXiv","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Three online surveys of young adult males (MTurk, Canadian students, non‑students) examining hostility, impersonal sexuality, pornography use and self‑reported sexual aggression.","sample_n":3482,"sample_text":"N1 = 1,528; N2 = 1,049; N3 = 905","population":"young adult men (average ages ~21‑23)","country":"USA (MTurk), Canada (students & non‑students)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors surveyed over 3,000 young men to see if pornography use adds to the risk of sexual aggression when combined with hostile masculinity and impersonal sexuality. Magazine‑type pornography showed a link, but broader internet use did not, suggesting measurement matters.","clinical_takeaway":"Findings do not support using pornography use alone as a risk indicator for sexual aggression; assessment should focus on broader attitudes and behaviours.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large combined sample size across three independent surveys","Tests nuanced interaction predictions of a well‑known theory","Compares different operationalisations of pornography use"],"limitations":["Pornography use measured with non‑validated, inconsistent items","Cross‑sectional design cannot establish causality","Key potential confounds (e.g., moral incongruence, mental health) not examined"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/xzug7"}},{"id":1286,"doi":"10.1007/s10508-021-02201-7","pmid":"34984569","pmcid":"PMC8888391","title":"Associations Between Pornography Consumption, Sexual Flexibility, and Sexual Functioning Among Austrian Adults","authors":"Komlenac N, Hochleitner M.","first_author":"Komlenac N","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Austria","Young Adults","Sexual Functioning","Pornography Consumption","Acquisition, Activation, Application Model (3Am)","Sexual Flexibility"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8888391","cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire of 644 Austrian medical students (average age 24), assessing self‑reported pornography use, sexual flexibility, perceived realism, and sexual functioning; analyzed with manifest path analysis","sample_n":644,"sample_text":"medical students recruited via university mailing list (convenience sample)","population":"medical students, Austria, ages ~18‑30, 54% women","country":"Austria","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 644 Austrian university students, higher porn use was linked to better sexual functioning for women, and this was explained by greater sexual flexibility. No similar link was found for men, and how realistic the porn seemed did not change the results.","clinical_takeaway":"For women, moderate porn use might expand sexual scripts and support sexual functioning, but findings are limited to a specific young, educated sample.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a cross‑sectional survey","Focus on sexual flexibility as a mediating variable","Separate analysis by gender"],"limitations":["Convenience sample of young medical students limits generalisability","Potentially unvalidated measures for sexual flexibility and pornography realism","Key confounds (moral incongruence, masturbation, mental health, trauma) not accounted for"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":14,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02201-7"}},{"id":1287,"doi":"10.3881/j.issn.1000-503x.16832","pmid":"42244417","pmcid":null,"title":"Current Situation and Influencing Factors of Knowledge,Attitudes,and Behaviors Regarding Sexual and Reproductive Health Among Adolescents in Luzhou City","authors":"Yang JH, Li KX, Chen SY, Xiao Q, Jiang QL, Ye YL.","first_author":"Yang JH","journal":"Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae","year":2026,"pub_types":["Journal Article"],"keywords":["Regression analysis","Sexual development","Adolescents","Sexual And Reproductive Health","Knowledge,attitude,and Behavior Survey"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 2,377 adolescents from schools in Luzhou City using a self‑administered questionnaire; binary logistic regression of knowledge, attitudes, behaviours.","sample_n":2377,"sample_text":"2,377 adolescents recruited via multi‑stage sampling from schools","population":"Adolescents (vocational high school, junior college, university) in Luzhou City, China (N=2377)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 2,377 Chinese adolescents found that only about half had good knowledge of sexual‑reproductive health, fewer had positive attitudes, and only a third displayed healthy sexual behaviours. Pornography use (38%) and masturbation (31%) were common. Education level, family type, parental schooling and peer programmes were linked to better outcomes.","clinical_takeaway":"Enhance school‑based and peer‑led SRH education, especially in vocational schools, to improve adolescents' knowledge, attitudes and safe sexual behaviours.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, multi‑stage sample of adolescents","Use of logistic regression to identify associated factors","Clear reporting of prevalence rates for porn use and masturbation"],"limitations":["Questionnaire appears ad‑hoc; no validated SRH scales reported","Cross‑sectional design limits causal inference","Key psychosocial confounds (moral incongruence, mental health) not measured"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3881/j.issn.1000-503x.16832"}},{"id":1288,"doi":"10.1007/s10508-026-03481-7","pmid":"42637988","pmcid":"PMC13597642","title":"Why Sexual Choking Is Not as Safe as You Think: A Call to Action from Sex Researchers and Kink Educators","authors":"Ratcliff SE, Wright S, Herbenick D, Sunassee AA, Cummings K, Zachary T, Randall A, Stambaugh R, Strack G, Brown DD, Korol-Evans KT.","first_author":"Ratcliff SE","journal":"Archives of sexual behavior","year":2026,"pub_types":["research-article","Review","Journal Article"],"keywords":["Consent","Choking","Rough Sex","Non-fatal Strangulation","Bdsm/kink"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13597642","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review synthesizing existing literature without systematic methods","sample_n":null,"sample_text":"Not applicable – review article","population":"Adults engaging in sexual choking (no primary data)","country":"International (authors from multiple countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review evidence that sexual choking can be dangerous, noting rising popularity and links to media. They highlight consent, legal, and health concerns, and propose education, research, and professional training to reduce harm.","clinical_takeaway":"Clinicians should ask about choking practices, educate patients on risks, and consider harm‑reduction strategies.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Broad synthesis of existing literature on sexual choking","Clear public‑health calls to action","Multidisciplinary authorship including researchers and kink educators"],"limitations":["Narrative, not systematic review – possible selection bias","No quantitative meta‑analysis or formal risk‑of‑bias assessment","Lacks primary empirical data"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03481-7"}},{"id":1290,"doi":"10.1093/jsxmed/qdag161","pmid":"42323900","pmcid":null,"title":"Rethinking erectile dysfunction prevalence in contemporary contexts: perspective on \"Erectile dysfunction prevalence in the United States: report from the 2021 National Survey of Sexual Wellbeing\"","authors":"Geuens S, Apers L, De Win G.","first_author":"Geuens S","journal":"The journal of sexual medicine","year":2026,"pub_types":["Journal Article"],"keywords":["Methodology","Prevalence","erectile dysfunction","Pornography","Contemporary Society"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdag161"}},{"id":1292,"doi":"10.1093/sxmrev/qeag069","pmid":"42735405","pmcid":null,"title":"Penile size anxiety, body dysmorphic disorder, and cosmetic penile enhancement requests: a structured narrative review and expert-derived assessment framework","authors":"Broul M, Hujová A, Jozífková E.","first_author":"Broul M","journal":"Sexual medicine reviews","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Body Image","Shared Decision Making","Patient Selection","Cosmetic Surgery","Small Penis Anxiety","Penile Dysmorphic Disorder","Penile Augmentation","Psychosexual Assessment"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"structured narrative review with purposive selection, no systematic risk‑of‑bias assessment","sample_n":null,"sample_text":"No primary participants; review of existing studies","population":"men requesting cosmetic penile enhancement (discussion of literature, no new sample)","country":"International (PubMed sources)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Men often seek penis‑enlargement surgery despite average size; the authors review how to tell normal concern from a body‑image disorder and suggest an expert‑derived, yet untested, assessment checklist.","clinical_takeaway":"Clinicians should assess body‑image concerns and rule out body‑dysphoric disorder before surgery; use the proposed checklist cautiously.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Comprehensive literature scope on penile enhancement","Identifies gap in validated assessment tools","Clear statement of framework being unvalidated"],"limitations":["Narrative, not systematic, selection bias likely","No quantitative synthesis or risk‑of‑bias appraisal","Framework lacks empirical validation"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeag069"}},{"id":1293,"doi":"10.1007/s10508-026-03501-6","pmid":"42576124","pmcid":null,"title":"The Sexual Health Myth-Conceptions Scale: Development and Psychometric Evaluation of the Scale with Emerging Adults in the USA","authors":"Shigeto A, Scheier LM, Komarc M.","first_author":"Shigeto A","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual Health","Sexually Transmitted Infections","Emerging Adults","Myth-conceptions"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 1,162 emerging adults recruited via Prolific; exploratory factor analysis, structural equation modeling, bifactor analysis, and IRT used to develop a new questionnaire.","sample_n":1162,"sample_text":"1,162 participants recruited through Prolific (online crowdsourcing platform).","population":"US emerging adults (18‑29), online convenience sample","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and tested a 34‑item questionnaire that measures false beliefs about sexual health among U.S. emerging adults, finding three main belief dimensions including myths about pornography.","clinical_takeaway":"The new scale can help identify and address sexual health misinformation in young adults, but further validation is needed before clinical use.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["Large sample for psychometric work","Comprehensive factor‑analytic and IRT evaluation","Transparent reporting of item‑level properties"],"limitations":["Convenience online sample may limit generalisability","Scale not yet validated against external behavioural outcomes","No pre‑registration reported"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03501-6"}},{"id":1294,"doi":"10.1007/s10461-013-0511-3","pmid":"23716033","pmcid":"PMC3744592","title":"Erratum to: The Effects of Gay Sexually Explicit Media on the HIV Risk Behavior of Men Who Have Sex with Men","authors":"Rosser BR, Smolenski DJ, Erickson D, Iantaffi A, Brady SS, Galos DL, Grey JA, Hald GM, Horvath KJ, Kilian G, Træen B, Wilkerson JM.","first_author":"Rosser BR","journal":"AIDS and behavior","year":2013,"pub_types":["Published Erratum","correction","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-013-0511-3"}},{"id":1295,"doi":"10.1007/bf01541406","pmid":"7993182","pmcid":null,"title":"Is there a national standard with respect to attitudes toward sexually explicit media material?","authors":"Winick C, Evans JT.","first_author":"Winick C","journal":"Archives of sexual behavior","year":1994,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Probability sample of 4621 adults surveyed in 10 US states (1976‑1985).","sample_n":4621,"sample_text":"Probability samples of adults in 10 states (N = 4621).","population":"Adults (general population) in United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1994 survey of over 4,600 U.S. adults found that most people in ten states thought sexually explicit media were increasingly acceptable and believed adults should be able to obtain such material.","clinical_takeaway":"None – the study reports public attitudes, not clinical implications.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Large probability sample","Multi‑state coverage","Clear descriptive statistics"],"limitations":["Attitude items not validated scales","No effect sizes or confidence intervals","Data are historical (1976‑1985)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541406"}},{"id":1296,"doi":"10.1080/0092623x.2024.2302375","pmid":"38477885","pmcid":null,"title":"Women Reporting on Their Use of Pornography: A Qualitative Study Exploring Women's Perceived Precursors and Perceived Outcomes","authors":"Litsou K, Graham C, Ingham R.","first_author":"Litsou K","journal":"Journal of sex & marital therapy","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"online qualitative interviews with 30 women from UK and Greece; reflexive thematic analysis","sample_n":30,"sample_text":"convenience volunteer sample recruited online","population":"women aged 20‑47, varied sexual orientation and relationship status","country":"United Kingdom; Greece","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 30 women in the UK and Greece revealed why they watch porn and what they think it does for them. Motives included sexual and non‑sexual triggers, and they reported both helpful (e.g., learning) and unwanted (e.g., guilt) effects.","clinical_takeaway":"Clinicians should recognize that women’s porn use can be motivated by varied needs and may have mixed sexual‑health impacts; assessment should explore both positive and negative outcomes.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["In‑depth exploration of women's motivations and perceived outcomes","Cross‑cultural sample (UK & Greece)","Clear thematic organization of findings"],"limitations":["Small, non‑representative convenience sample","No measurement of key confounds (moral incongruence, masturbation, mental health, partner context)","Findings cannot be generalized to all women"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2024.2302375"}},{"id":1297,"doi":"10.3390/ijerph19010063","pmid":"35010321","pmcid":"PMC8751040","title":"Links of Perceived Pornography Realism with Sexual Aggression via Sexual Scripts, Sexual Behavior, and Acceptance of Sexual Coercion: A Study with German University Students","authors":"Krahé B, Tomaszewska P, Schuster I.","first_author":"Krahé B","journal":"International journal of environmental research and public health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Realism","Sexual Aggression","Sexual Scripts","Sexual Victimization","Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8751040","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1181 German university students","sample_n":1181,"sample_text":"Convenience sample recruited via university channels","population":"German university students (young adult, majority female)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among German university students, those who see pornography as more realistic report riskier sexual scripts, more risky sexual behavior, and greater acceptance of sexual coercion, which are linked to higher self‑reported sexual aggression.","clinical_takeaway":"Be aware that perceived realism of porn may relate to risky sexual attitudes, but causality is unproven; interventions should focus on media literacy rather than assuming direct effects.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a survey","Theory‑driven mediation model","Inclusion of both perpetration and victimization outcomes"],"limitations":["Cross‑sectional design precludes causal inference","No measurement of key confounds (e.g., moral incongruence, mental health)","Reliance on self‑report scales of unknown psychometric quality"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph19010063"}},{"id":1300,"doi":"10.14293/s2199-1006.1.sor-.ppuoauc.v1","pmid":null,"pmcid":null,"title":"Perception Of Premarital Sexual Relationship Among Students In Tertiary Institutions: A Case Study Of Benue State University","authors":"Gbaa E, Gbaden D, Gbakaan I, Gbatse I.","first_author":"Gbaa E","journal":"ScienceOpen Preprints","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.scienceopen.com/document_file/d0a5f2ef-bc16-49d7-abf3-5d8e641552f8/ScienceOpenPreprint/Ella%20Gbaa%202%20pub.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 400 university students using multi‑stage random sampling; descriptive statistics only","sample_n":400,"sample_text":"400 students randomly selected from 8 faculties","population":"students (18‑35 y) at Benue State University, Nigeria (N≈400)","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 2022 survey of 400 Benue State University students found most think premarital sex is wrong, yet many engage in it. Factors linked to the behaviour include peer pressure, pornography, alcohol, and low self‑esteem; reported outcomes are unwanted pregnancy, STDs and school dropout.","clinical_takeaway":"None – the study offers descriptive data, not evidence for clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Reasonably large sample for a single university","Use of multi‑stage random sampling within the campus"],"limitations":["No validated measures of sexual attitudes or behaviours","Descriptive analysis only – no inferential testing","No control for moral, mental‑health or partner variables"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.14293/s2199-1006.1.sor-.ppuoauc.v1"}},{"id":1301,"doi":"10.51866/oa.1003","pmid":"42261362","pmcid":"PMC13242594","title":"Prevalence of sexual and reproductive health issues among school-going adolescents in Hulu Langat District, Malaysia: Findings from the Borang Saringan Status Kesihatan Remaja - A cross-sectional study","authors":"Maryem SF, Lau HC, Firdaus A, Roslan NA, Mohd Tohit NF.","first_author":"Maryem SF","journal":"Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Malaysia","Sexual behavior","Adolescent","Reproductive Health","Sexual Health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13242594","cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective cross‑sectional survey of 1158 school‑going adolescents using a national health‑screening form (BSSK Remaja). Stratified random sampling within three health‑clinic zones.","sample_n":1158,"sample_text":"1158 adolescents (532 male, 626 female) recruited via stratified random sampling from school‑clinic catch‑areas.","population":"Adolescents aged 10‑19 years attending schools/clinics in Hulu Langat District, Malaysia (N=1158).","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 1,158 Malaysian school adolescents, 5.3% reported ever seeing pornography and 1.1% reported ever masturbating; sexual activity was rare (0.2%). The study highlights the need for better, confidential data collection on teen sexual health.","clinical_takeaway":"Adolescent pornography exposure is reported by a small but notable minority; clinicians should ensure confidential screening to capture true behaviours.","confidence":0.7,"topic_tags":["pornography","masturbation","adolescents","sexual_function","prevalence"],"strengths":["Large community sample (N>1000).","Stratified random sampling within district improves representativeness.","Provides up‑to‑date prevalence data for a Malaysian adolescent population."],"limitations":["Reliance on single‑item self‑report items; unknown validation for pornography/masturbation questions.","Cross‑sectional design cannot assess causality.","No measurement or control of key psychosocial confounds (e.g., moral incongruence, mental health)."],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.51866/oa.1003"}},{"id":1303,"doi":"10.1080/00224499.2015.1110107","pmid":"26726841","pmcid":null,"title":"Using the Dual Control Model to Investigate the Relationship Between Mood, Genital, and Self-Reported Sexual Arousal in Men and Women","authors":"Hodgson B, Kukkonen TM, Binik YM, Carrier S.","first_author":"Hodgson B","journal":"Journal of sex research","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experimental study with 33 participants (18 men, 15 women) who completed mood and sexual excitation/inhibition questionnaires and viewed neutral and sexually explicit films while subjective arousal was continuously reported and genital temperature measured via thermographic imaging.","sample_n":33,"sample_text":"33 participants (18 men; 15 women)","population":"Healthy adult volunteers, ages 18‑45, recruited for a laboratory study.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined how mood and individuals' tendencies toward sexual excitement or inhibition affect both reported and physiological sexual arousal using erotic videos. Interactions between mood and sexual propensity predicted differences in how men and women experienced arousal.","clinical_takeaway":"Mood and personal sexual excitation/inhibition profiles can influence arousal responses, suggesting tailored approaches in sexual counseling.","confidence":0.6,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Objective genital temperature measurement","Use of validated sexual excitation/inhibition scales","Within‑subject experimental design"],"limitations":["Small sample size limits power for interaction effects","No control for key psychosocial confounds (e.g., mental health, moral attitudes)","Generalizability limited to young, healthy volunteers"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":2,"mentioning":27,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2015.1110107"}},{"id":1306,"doi":"10.3390/ejihpe11040110","pmid":"34940388","pmcid":"PMC8700214","title":"Sex on the Screen: A Content Analysis of Free Internet Pornography Depicting Mixed-Sex Threesomes from 2012-2020","authors":"Kulibert D, Moran JB, Preman S, Vannier SA, Thompson AE.","first_author":"Kulibert D","journal":"European journal of investigation in health, psychology and education","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Pornography","Online Sexual Activity","Threesomes","Sexual Script Theory","Digisexuality"],"is_oa":true,"oa_url":"https://www.mdpi.com/2254-9625/11/4/110/pdf?version=1638409186","cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"content analysis of 50 mixed‑sex threesome videos from three years (2012, 2015, 2020); independent coding of sexual behaviors and themes","sample_n":50,"sample_text":"50 videos (25 MMF, 25 FFM) per timepoint, three timepoints","population":"Pornography videos (MMF and FFM) selected from free online sources; no human participants","country":"United States (videos accessed by US adults)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers examined 50 free‑online mixed‑sex threesome porn videos from 2012, 2015 and 2020. They coded sexual acts and themes, finding that opposite‑sex actions dominate, female‑female acts appear more than male‑male, and aggression (especially by men) is common. Patterns were stable over eight years, showing persistent traditional sexual scripts in porn.","clinical_takeaway":"Clinicians should note that porn content often reinforces conventional gender scripts and aggression; this may influence clients' sexual expectations.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Systematic sampling across multiple years","Independent coders and clear coding scheme","Focus on understudied content (mixed‑sex threesomes)"],"limitations":["Small video sample limits generalisability","Coding scheme not reported as validated","No assessment of viewer impact or health outcomes"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ejihpe11040110"}},{"id":1307,"doi":"10.1177/10731911241229575","pmid":"38380512","pmcid":null,"title":"Development and Validation of Technology-Facilitated Sexual Violence Perpetration and Victimization Scales Among Adults","authors":"Martínez-Bacaicoa J, Sorrel MA, Gámez-Guadix M.","first_author":"Martínez-Bacaicoa J","journal":"Assessment","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Journal Article"],"keywords":["Scale Development","Psychometric Properties","Image-based Sexual Abuse","Nonconsensual Pornography","Digital Sexual Harassment","Online Gender Violence","Online Sexual Coercion"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study with large adult sample (N=2,486) from Spain; exploratory factor analysis and reliability testing of new scales","sample_n":2486,"sample_text":"2,486 adults (69% women), aged 16‑79, mean age 25.95","population":"Adults (16‑79 y) from Spain, recruited via online survey","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated two questionnaires that measure how adults experience and perpetrate technology‑facilitated sexual violence, including non‑consensual pornography, online coercion and digital harassment.","clinical_takeaway":"These validated scales can be used by clinicians and researchers to assess victimisation and perpetration of digital sexual violence.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample size for scale validation","Comprehensive psychometric evaluation (EFA, reliability, network analysis)","Gender and sexual orientation analyses"],"limitations":["Convenience online sample; not nationally representative","No assessment of related mental‑health or trauma variables","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10731911241229575"}},{"id":1309,"doi":"10.1007/s10508-021-02140-3","pmid":"34811657","pmcid":"PMC8888502","title":"Pornography Use Profiles and the Emergence of Sexual Behaviors in Adolescence","authors":"Pirrone D, Zondervan-Zwijnenburg M, Reitz E, van den Eijnden RJJM, Ter Bogt TFM.","first_author":"Pirrone D","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Development","Sexual Behaviors","Young Adolescents","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8888502","cited_by_count":12,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"four-wave cohort of 630 adolescents, half‑year intervals, latent growth mixture and survival analyses","sample_n":630,"sample_text":"630 respondents, 47.9% female, community‑based adolescent sample","population":"early‑ and middle‑adolescents (mean age 13.7)","country":"Netherlands (likely, based on authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2‑year study of 630 teens found that those who watched more pornography tended to start masturbating, kissing, and other sexual activities earlier than peers who watched little or no pornography.","clinical_takeaway":"Higher porn use in early teens is linked to faster onset of sexual behaviours, but causality is unclear; monitor use alongside broader developmental factors.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Longitudinal design with four measurement points","Large community sample for adolescent research","Advanced statistical modeling (latent growth mixture, survival analysis)"],"limitations":["No validated measures of pornography use or sexual behavior; reliance on single‑item self‑report","Key confounds (moral attitudes, mental health, relationship context) not assessed","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02140-3"}},{"id":1310,"doi":"10.1007/s10508-021-02134-1","pmid":"34796423","pmcid":null,"title":"Perceptions of Pornography and Attitudes Toward Condom Use in Heterosexual Chinese Adults: The Effect of Sexual Pleasure, Safer Sex Communication Apprehension, and Shared Pornography Use During Sex","authors":"Wu T, Zheng Y.","first_author":"Wu T","journal":"Archives of sexual behavior","year":2022,"pub_types":["Journal Article"],"keywords":["Condom Use","Sexual Pleasure","Pornography","Safer Sex Communication","Shared Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 658 Chinese adults in romantic relationships; mediation‑moderation model of pornography perceptions, sexual pleasure, communication apprehension and condom‑use attitudes.","sample_n":658,"sample_text":"391 women, 267 men, aged 18‑65 y, all in a romantic relationship.","population":"Chinese heterosexual adults (18‑65 y) in a romantic relationship, recruited via an online platform (convenience sample).","country":"China","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Chinese adult sample, people who view porn as erotic tend to enjoy sex more and feel less anxious about talking about safe sex, which together are linked to more negative attitudes toward using condoms, especially when couples watch porn together during sex.","clinical_takeaway":"Clinicians should note that shared pornography use may shape condom attitudes via pleasure and communication factors, but causal claims are limited.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a survey (N > 600)","Focused on a specific cultural context (China)","Examines mediating/moderating mechanisms"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report scales of unclear validation","Key confounds (moral incongruence, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02134-1"}},{"id":1311,"doi":"10.1007/s10508-021-02101-w","pmid":"34791580","pmcid":"PMC8888508","title":"Self-Perceived Problematic Use of Online Pornography Is Linked to Clinically Relevant Levels of Psychological Distress and Psychopathological Symptoms","authors":"Mennig M, Tennie S, Barke A.","first_author":"Mennig M","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Internet","Psychological Distress","Pornography","Cybersex Addiction"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-021-02101-w.pdf","cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of German adults visiting a casual dating site","sample_n":1539,"sample_text":"online sample of German adult visitors to a popular casual dating site","population":"German adult internet users (n=1539, 72.6% male, mean age 31.4)","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large German online sample, people who considered their pornography use problematic reported higher psychological distress and symptom levels than casual users, with medium to large effect sizes.","clinical_takeaway":"Self‑identified problematic pornography use may co‑occur with significant distress; clinicians should assess distress rather than assume addiction.","confidence":0.78,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Large sample size","Use of validated distress measure (BSI)","Effect sizes reported"],"limitations":["OPDQ adapts IGD criteria, potentially circular","No control for moral incongruence or masturbation","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":3,"design":4,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02101-w"}},{"id":1312,"doi":"10.1177/08862605211055145","pmid":"34783607","pmcid":"PMC9554362","title":"The Role of Pornography Use in Intimate Partner Violence in Different-Sex Couples: A Prospective Longitudinal Study","authors":"Jongsma K, Timmons Fritz P.","first_author":"Jongsma K","journal":"Journal of interpersonal violence","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Longitudinal","Intimate Partner Aggression","Pornography","Actor–partner","Couple Dyads"],"is_oa":true,"oa_url":"https://journals.sagepub.com/doi/pdf/10.1177/08862605211055145","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective dyadic study of 132 different‑sex university couples, baseline and 4‑month follow‑up, actor‑partner interdependence modelling","sample_n":264,"sample_text":"different‑sex university couples (N=132 dyads)","population":"132 couples (264 participants), university students in Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 4‑month study of 132 opposite‑sex university couples, men who used pornography more often at the start were more likely to both perpetrate and experience intimate partner violence later, while women's use showed no effect.","clinical_takeaway":"Higher male pornography use may signal increased risk for IPV; clinicians should consider discussing media habits when assessing relationship violence risk.","confidence":0.8,"topic_tags":["pornography","sexual_function","relationships","gender"],"strengths":["Longitudinal dyadic design allowing temporal ordering","Adequate overall sample size for SEM","Use of actor‑partner interdependence model"],"limitations":["Convenience sample of university students limits generalisability","Limited measurement of potential confounders (e.g., moral attitudes, mental health)","Frequency of pornography use measured by self‑report, unclear validation"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":11,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605211055145"}},{"id":1315,"doi":"10.31234/osf.io/g57c2","pmid":null,"pmcid":null,"title":"Engineered highs: reward variability and frequency as potential prerequisites for behavioural addiction","authors":"Clark L, Zack M.","first_author":"Clark L","journal":"PsyArXiv","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://psyarxiv.com/g57c2/download","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/theoretical pre‑print; no empirical data, no participants","sample_n":null,"sample_text":"none (theoretical article)","population":"none","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that unpredictable, variable rewards—like those found in gambling, gaming, shopping, social media and online pornography—may create addiction‑like urges by tapping brain systems that respond to uncertainty.","clinical_takeaway":"None – the paper is theoretical and does not provide clinical guidance.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Broad, interdisciplinary perspective on reward variability","Links neuroscience theories to multiple digital behaviours"],"limitations":["No empirical data or systematic review","No operational definitions or measurement of constructs","Absence of consideration of moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/g57c2"}},{"id":1316,"doi":"10.1007/s10508-021-02059-9","pmid":"34761345","pmcid":"PMC8888499","title":"Development of a Measure to Assess What Young Heterosexual Adults Say They Learn About Sex from Pornography","authors":"Dawson K, Nic Gabhainn S, Willis M, MacNeela P.","first_author":"Dawson K","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sex Education","Pornography","Sexually Explicit Media","Sexual Information","Porn Literacy"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8888499","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large convenience sample of university students (N=1306) completing newly developed scales; exploratory factor analysis performed separately for males and females","sample_n":1306,"sample_text":"university student convenience sample (N=1306)","population":"young heterosexual‑identifying adults, university students, age 18‑29","country":"Not specified (likely Ireland/UK based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created two new questionnaires that ask young heterosexual adults what they say they learn about sex from watching porn. After focus groups and expert review, three themes emerged for both men and women: being a good partner, body aesthetics, and sexual exploration. More frequent porn users reported learning more about these topics.","clinical_takeaway":"The new scales may help researchers examine how porn influences sexual knowledge, but clinicians should note they are still preliminary.","confidence":0.8,"topic_tags":["pornography","sexual_function","measurement","adolescents"],"strengths":["Large sample for scale development","Separate factor analyses for male and female respondents","Incorporates qualitative input from focus groups and expert panels"],"limitations":["Convenience university sample limits generalisability","No confirmatory factor analysis or test‑retest reliability reported","No assessment of key confounds (e.g., moral incongruence, masturbation, mental health)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02059-9"}},{"id":1317,"doi":"10.21203/rs.3.rs-2166861/v1","pmid":null,"pmcid":null,"title":"A Qualitative Exploration of Young Australians' Experiences of Social Media's Impacts on Relationship Development","authors":"Cooper SC, Ferreira K, Edwards RG, Keegan J, Norvila N, Lewis L, Albury K, Skinner SR.","first_author":"Cooper SC","journal":"Research Square","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-2166861/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview (second time point of longitudinal study)","sample_n":50,"sample_text":"Fifty adolescents (aged 14-17) completed semi‑structured interviews","population":"Adolescents aged 14-17 in New South Wales, Australia (N=50)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 50 Australian adolescents (14‑17 years) explored how they use social media for flirting and dating. They report growing sexual agency, high media literacy (including pornography), and strong peer influence on relationship attitudes.","clinical_takeaway":"None – the study provides qualitative insight but no direct clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Longitudinal mixed‑methods framework","Grounded‑theory analytic approach","Focus on adolescents’ own perspectives"],"limitations":["Small, non‑representative sample","No quantitative measurement of key constructs","No control for known confounders (e.g., mental health, moral attitudes)","Cross‑sectional snapshot limits causal inference"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-2166861/v1"}},{"id":1319,"doi":"10.1007/s10508-021-02053-1","pmid":"34750772","pmcid":null,"title":"Who Seeks Aggression in Pornography? Findings from Interviews with Viewers","authors":"Shor E.","first_author":"Shor E.","journal":"Archives of sexual behavior","year":2022,"pub_types":["Journal Article"],"keywords":["Gender Differences","Sexual Aggression","Qualitative Interviews","Pornography","Viewers’ Preferences"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 122 participants (61 women, 60 men, 1 gender‑diverse) recruited as regular pornography viewers","sample_n":122,"sample_text":"122 regular pornography viewers (61 women, 60 men, 1 gender-diverse)","population":"regular pornography viewers (self‑selected sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 122 pornography viewers found that most men and women do not enjoy aggressive porn, but women were more likely than men to say they are aroused by consensual aggression toward women and actively seek it.","clinical_takeaway":"Clinicians should note that preferences for aggressive porn can differ by gender and are not uniformly linked to pathology.","confidence":0.7,"topic_tags":["gender","sexual_function"],"strengths":["large (for qualitative) sample of both genders","mixed quantitative‑qualitative analysis","addresses understudied topic of women's responses"],"limitations":["convenience, self‑selected sample limits generalisability","no validated scales for aggression preference","no control for moral, mental‑health or relational confounds","cross‑sectional self‑report only"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02053-1"}},{"id":1320,"doi":"10.1007/s10508-021-02084-8","pmid":"34750776","pmcid":null,"title":"Adolescents' Use of Pornography: Trends over a Ten-year Period in Sweden","authors":"Donevan M, Jonsson L, Bladh M, Priebe G, Fredlund C, Svedin CG.","first_author":"Donevan M","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Youth","Adolescents","trends","Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Three nationally representative surveys of Swedish senior high‑school students (2004, 2009, 2014) with logistic regression analyses of trends and correlates.","sample_n":null,"sample_text":"nationally representative surveys of senior high school students in Sweden (2004, 2009, 2014).","population":"Adolescents (high‑school students) in Sweden, N not reported in abstract (likely large, >1,000 per wave).","country":"Sweden","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Swedish surveys from 2004‑2014 show that while most boys and many girls have tried pornography, the overall lifetime use has dropped. Daily use rose for boys (11% → 24%) but not for girls, whose daily use stayed low and non‑use increased. Use is linked to rule‑breaking, higher socioeconomic status, and early sexual activity.","clinical_takeaway":"Clinicians should note rising frequent use among boys but overall declining prevalence; assess contextual factors rather than assuming pathology.","confidence":0.8,"topic_tags":["pornography","adolescents","prevalence","treatment","sexual_function"],"strengths":["Large, nationally representative samples across three time points","Clear reporting of prevalence and frequency trends","Use of multivariable logistic regression to examine correlates"],"limitations":["Reliance on single‑item self‑report of pornography use","No measurement of moral incongruence, masturbation, or mental‑health variables","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":1,"mentioning":13,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02084-8"}},{"id":1321,"doi":"10.1007/s10508-021-02090-w","pmid":"34750777","pmcid":"PMC8888374","title":"Increase in the Prevalence of Online Pornography Use: Objective Data Analysis from the Period Between 2004 and 2016 in Poland","authors":"Lewczuk K, Wójcik A, Gola M.","first_author":"Lewczuk K","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Internet","Compulsive Sexual Behavior","Hypersexuality","Online Pornography","Pornography Use"],"is_oa":true,"oa_url":"https://escholarship.org/content/qt4ht313x1/qt4ht313x1.pdf?t=rxoh0o","cited_by_count":50,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Analysis of aggregated website traffic data for Poland from 2004‑2016, estimating numbers of general internet users and those viewing online porn; no individual‑level survey.","sample_n":null,"sample_text":"Estimated 2.76 million to 8.54 million users; no individual‑level sample","population":"Polish internet‑using population (estimated from traffic data)","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using website traffic statistics, the authors estimate that the number of people in Poland who viewed online pornography rose from about 2.8 million in 2004 to 8.5 million in 2016, a three‑fold increase, while the share of internet users doing so stayed roughly stable.","clinical_takeaway":"None – the study reports population‑level use trends, not clinical implications.","confidence":0.8,"topic_tags":["prevalence","pornography","sexual_function","religiosity"],"strengths":["Objective traffic data avoids self‑report bias","Longitudinal coverage (12 years)","Clear descriptive trends"],"limitations":["Excludes mobile and private‑browsing activity","Aggregated data, no individual‑level covariates","No statistical modeling of trends"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":37,"citing_publications":87,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02090-w"}},{"id":1322,"doi":"10.3389/fpsyt.2026.1595063","pmid":"42205999","pmcid":"PMC13201391","title":"Adopting a user-centred design approach for the development of on-device technology to prevent the viewing of child sexual abuse material: app design insights and principles from the development of 'Salus'","authors":"Davy D, Beaufoy S, Bogaerts S, De Boeck M, De Caluwé E, Efthymiadou E, Joy R, Kamitz L, Kleijn M, Nentzl J, Smith L, Van Puyvelde L, Wefers S, Lundrigan S.","first_author":"Davy D","journal":"Frontiers in psychiatry","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Technology","Prevention","User-centred Design","Child Sexual Abuse Material","Offender Management"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13201391","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"semi-structured interviews with 31 at‑risk individuals and 4 focus groups with service providers; user‑centred design of a preventive app for CSAM.","sample_n":31,"sample_text":"31 at‑risk participants (10 Belgium, 10 Germany, 11 UK) plus service‑provider focus groups","population":"individuals at risk of committing CSAM offences (self‑selected via therapeutic services) across four European countries","country":"Belgium, Germany, Netherlands, United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers interviewed 31 people at risk of viewing child sexual abuse material and service providers to design a phone app that helps block such content. They identified privacy, optional filters, discreet notifications, and user‑controlled features as key design principles.","clinical_takeaway":"No direct clinical guidance; the study offers design ideas for tech tools aimed at preventing CSAM viewing.","confidence":0.8,"topic_tags":["prevalence","adolescents"],"strengths":["User‑centred approach with direct input from target users","Multi‑country perspective","Clear practical design recommendations"],"limitations":["Small, self‑selected sample limits generalisability","No validated measurement instruments","Findings are qualitative and not statistically tested"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2026.1595063"}},{"id":1323,"doi":"10.2196/89280","pmid":"42119142","pmcid":"PMC13167059","title":"Therapeutic Interventions Targeted at Problematic Use of Digital Technology: Systematic Review and Meta-Analysis of Evidence","authors":"Balhara YPS, Bhattacharjee O, Bhatia RK, Sanahan R, Ganesh R, Sarkar S, Ranjan R, Kattimani S, Centre for Advanced Research on Addictive Behaviors (CAR-AB).","first_author":"Balhara YPS","journal":"JMIR mental health","year":2026,"pub_types":["Meta-Analysis","Systematic Review","review-article","Journal Article"],"keywords":["Internet Addiction","Digital Technology","Gambling Disorder","Smartphone Addiction","Gaming Disorder","Social Media Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13167059","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Systematic review and random‑effects meta‑analysis of 125 studies (73 RCTs, 32 non‑RCTs, 14 pre‑post, 6 pilots) on therapeutic interventions for problematic digital‑technology use, following PRISMA 2020 and registered in PROSPERO.","sample_n":null,"sample_text":"125 eligible studies comprising thousands of participants; exact total not given in abstract.","population":"Adults and adolescents across studies evaluating internet, smartphone, gaming, pornography, social‑media and other digital‑technology related problematic use.","country":"Various (global literature search).","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2026 systematic review pooled 125 studies on treatments for excessive internet, smartphone, gaming and other digital‑technology use, finding that psychological therapies and some digital or exercise programmes can reduce problem‑use scores, though results vary widely.","clinical_takeaway":"Psychological therapies show the strongest evidence for reducing problematic digital‑technology use; however, clinicians should consider study heterogeneity and lack of standardised outcome measures.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Comprehensive systematic search and registration (PROSPERO).","Large number of included RCTs provides quantitative synthesis.","Clear reporting of effect sizes and heterogeneity."],"limitations":["Limited detail on how individual studies defined and measured problematic use.","High heterogeneity and small‑study effects reduce confidence in pooled estimates.","No assessment of key psychosocial confounds (e.g., moral incongruence, mental health)."],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/89280"}},{"id":1324,"doi":"10.1556/2006.2026.00057","pmid":"42126922","pmcid":"PMC13377626","title":"Approach-avoidance tendencies in problematic usage of the internet: Evidence from a multisite study","authors":"Diers M, Müller SM, Kessling A, Schmid AM, Thomas TA, Antons S, Joshi M, Krikova K, Kampa M, Mallon L, Schmidt LD, Klein L, Dominick N, Büsche K, Meurer N, Oelker A, Brandtner A, Montag C, Wölfling K, Wolf OT, Rumpf HJ, Stark R, Müller A, Wegmann E, Klucken T, Brand M, Steins-Loeber S.","first_author":"Diers M","journal":"Journal of behavioral addictions","year":2026,"pub_types":["research-article","Multicenter Study","Journal Article"],"keywords":["Cognitive Bias","Avoidance","Internet Addiction","Cue Reactivity","Behavioral Addiction","Approach Bias"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13377626","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"multicenter observational study with Approach-Avoidance Task (N=1,015)","sample_n":1015,"sample_text":"large multicenter sample of internet users spanning non‑problematic to pathological groups","population":"adults (young adult to older), mixed gender, recruited from multiple sites (likely convenience/community sample)","country":"unspecified (multicenter, likely Germany/Europe)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of over 1,000 adults, people with higher levels of problematic internet use—like gaming, social media, or porn—showed stronger automatic approach reactions to internet‑related images. The strongest approach bias was seen in those with the most severe symptoms, suggesting these automatic tendencies could be markers of problematic use.","clinical_takeaway":"Automatic approach biases may help identify individuals at risk for severe problematic internet use, but further longitudinal work is needed.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large multicenter sample (N>1000)","Objective behavioral task (AAT) provides implicit measures","Analysis of linear and quadratic relationships"],"limitations":["Cross‑sectional design limits causal inference","Limited measurement of key confounds (moral incongruence, mental health, etc.)","Unclear whether internet‑use disorder scales are validated and whether pornography is isolated"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2026.00057"}},{"id":1325,"doi":"10.1080/00224499.2024.2311874","pmid":"38319285","pmcid":null,"title":"Associations Between Contents of Pornography and Sexual Satisfaction and Function Among Young Adults","authors":"Nolin MC, Daspe MÈ, Bőthe B, Brassard A, Joyal C, Vaillancourt-Morel MP.","first_author":"Nolin MC","journal":"Journal of sex research","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online self‑report questionnaire, N=827 young adults, path analysis controlling for masturbation frequency","sample_n":827,"sample_text":"convenience online sample of students/young adults; likely WEIRD","population":"young adults (mean age 23.44), 503 women, 324 men","country":"Not specified (likely Canada/France based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 827 young adults, the type of porn watched mattered: romance‑focused porn was linked to higher sexual satisfaction, while violent or controlling porn was linked to lower satisfaction and, for men, lower sexual function. Effects were examined while accounting for how often participants masturbated.","clinical_takeaway":"Clinicians might discuss porn content preferences with patients, as different genres appear linked to sexual wellbeing; however, causal conclusions cannot be drawn.","confidence":0.78,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Large sample (N > 800)","Controls for masturbation frequency","Differentiates porn content types"],"limitations":["Cross‑sectional; cannot infer causality","No control for moral/religious factors or mental health","Self‑report measures may be biased"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2024.2311874"}},{"id":1330,"doi":"10.3390/children8100925","pmid":"34682190","pmcid":"PMC8534324","title":"Adolescents' Online Pornography Exposure and Its Relationship to Sociodemographic and Psychopathological Correlates: A Cross-Sectional Study in Six European Countries","authors":"Andrie EK, Sakou II, Tzavela EC, Richardson C, Tsitsika AK.","first_author":"Andrie EK","journal":"Children (Basel, Switzerland)","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Prevalence","Adolescence","Europe","Psychosocial Functioning","Online","Pornography Exposure"],"is_oa":true,"oa_url":"https://www.mdpi.com/2227-9067/8/10/925/pdf?version=1634380593","cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"school‑based survey of 10,930 adolescents in six European countries","sample_n":10930,"sample_text":"large multi‑country convenience sample; not a probability‑based national sample","population":"adolescents aged 14‑17, mixed gender, recruited through schools","country":"Greece, Spain, Poland, Romania, Netherlands, Iceland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 10,000 European teens, about 60% had seen online pornography and 24% did so at least weekly. Boys, heavier internet users, and those with rule‑breaking or aggressive behaviours were more likely to be exposed. Exposure was also linked to higher self‑rated activity and social competence.","clinical_takeaway":"Adolescent pornography exposure is common and linked to externalising behaviours, but not necessarily to mental‑health problems; clinicians should assess broader behavioural patterns.","confidence":0.7,"topic_tags":["prevalence","adolescents","pornography","sexual_function"],"strengths":["Very large sample across multiple countries","Validated psychopathology instrument (YSR)","Provides prevalence data for adolescents"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral/religious attitudes or masturbation","School‑based convenience sample may limit generalisability"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":2,"mentioning":33,"citing_publications":77,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/children8100925"}},{"id":1332,"doi":"10.1177/0306624x211049183","pmid":"34634958","pmcid":null,"title":"Pornography Use and Sexual Offending: An Examination of Perceptions of Role and Risk","authors":"Holt K, Kissinger J, Spickler C, Roush V.","first_author":"Holt K","journal":"International journal of offender therapy and comparative criminology","year":2024,"pub_types":["Journal Article"],"keywords":["risk","Qualitative Methods","Sexual Offending","Sex Offender Treatment","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"semi‑structured interviews with 101 incarcerated sexual offenders; thematic analysis","sample_n":101,"sample_text":"Convenience sample from prison population; not representative of all porn users","population":"incarcerated individuals convicted of sexual offenses (n=101)","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In interviews with 101 people in prison for sexual offenses, researchers found that inmates view pornography in varied ways, some seeing it as a trigger for reoffending while others do not. The study suggests that monitoring porn use after release, rather than blanket bans, might better manage risk.","clinical_takeaway":"Targeted supervision of post‑release pornography use may be more effective than total abstinence for managing re‑offense risk.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large qualitative sample for this topic","Direct perspectives from offenders","Systematic thematic analysis"],"limitations":["Convenience prison sample limits generalizability","No measurement of key confounds (moral incongruence, mental health, etc.)","Qualitative design limits causal inference"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x211049183"}},{"id":1334,"doi":"10.1007/s10508-026-03477-3","pmid":"42387218","pmcid":"PMC13427828","title":"Active, Passive, and Non-Sexting Adolescents: Testing Deviancy and Normalcy Perspectives Across Risk-Related and Sexual Competence Variables","authors":"Brand K, Hein S, Krahé B, Tomaszewska P, Schuster I.","first_author":"Brand K","journal":"Archives of sexual behavior","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Depression","Adolescents","Risky Sexual Behavior","Sexting","Sexual Competence"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13427828","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire with 216 adolescents divided into three groups (active, passive, non‑sexting); convenience sample","sample_n":216,"sample_text":"216 adolescents completed an online questionnaire","population":"adolescents (mean age 16.9), mixed gender, likely recruited via schools or community","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 216 teens, those who actively sent sexts showed higher risky sexual behaviors, more acceptance of coercion, greater pornography use and more depressive symptoms than peers who never sexted, but did not differ in sexual competence measures.","clinical_takeaway":"Active sexting in adolescents is linked to broader risk behaviors and mood symptoms; clinicians should assess broader sexual risk and mental health, not assume competence benefits.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large adolescent sample for this topic","Comparison of three distinct sexting groups","Inclusion of both risk‑ and competence‑related variables"],"limitations":["Cross‑sectional design limits causal inference","Small passive‑sexting subgroup (N≈35) may be underpowered","Key confounds (moral incongruence, masturbation, relationship context) not measured"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03477-3"}},{"id":1335,"doi":"10.1177/10790632211047190","pmid":"34601999","pmcid":null,"title":"Predicting Risk of Reoffending in Persons with Child Sexual Exploitation Material Offense Histories: The Use of Child Pornography Offender Risk Tool in a Scottish Population","authors":"Savoie V, Quayle E, Flynn E, O'Rourke S.","first_author":"Savoie V","journal":"Sexual abuse : a journal of research and treatment","year":2022,"pub_types":["Journal Article"],"keywords":["risk assessment","Child Sexual Abuse","Recidivism","Child Pornography"],"is_oa":false,"oa_url":"https://www.pure.ed.ac.uk/ws/files/228134139/SavoieEtal2021SAPredictingRiskOfReoffending.pdf","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Retrospective validation of a risk assessment tool using a cohort of 141 convicted adult males; ROC and logistic regression analyses reported.","sample_n":141,"sample_text":"141 adult males convicted of CSEM offenses.","population":"Adult male offenders convicted of child sexual exploitation material offenses in Scotland (N=141).","country":"Scotland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested the Child Pornography Offender Risk Tool on 141 Scottish men convicted of child sexual exploitation material offenses and found it reliably predicts overall, sexual, and CSEM recidivism (AUC .81, .78, .74).","clinical_takeaway":"CPORT appears effective for assessing reoffending risk in adult male CSEM offenders.","confidence":0.7,"topic_tags":["csbd","religiosity","moral_incongruence"],"strengths":["Validated risk assessment instrument (CPORT).","Adequate sample size for ROC analysis.","Clear statistical reporting of AUC values."],"limitations":["Sample limited to convicted males; cannot generalize to broader populations.","No external validation sample.","Potential unmeasured confounders not addressed."],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":1,"mentioning":32,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632211047190"}},{"id":1336,"doi":"10.2196/77011","pmid":"42060914","pmcid":"PMC13176813","title":"Treating Behavioral Addictions With Augmented Reality and Virtual Reality: Scoping Review","authors":"Chiew FXR, Li GH, Tseung V, Shi J.","first_author":"Chiew FXR","journal":"Interactive journal of medical research","year":2026,"pub_types":["review-article","Review","Journal Article"],"keywords":["Treatment","Virtual reality","intervention","Gambling","Augmented Reality","Behavioral Addictions","Video Gaming","Cue Exposure","Scoping Review","Behavioral Harms"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13176813","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"scoping review of 9 AR/VR studies on gaming and gambling addictions; no risk of bias assessment; narrative synthesis","sample_n":9,"sample_text":"Total of 9 primary studies included; individual study sample sizes not detailed in abstract","population":"participants aged 12‑65 in the included studies (not directly reported in this review)","country":"Not specified (multi‑country primary studies)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["selective_reporting","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"This scoping review looked at nine studies that used virtual reality to treat gambling and video‑gaming problems. It found that VR cue‑exposure and skills‑training were reported as effective, but the evidence base is small and no systematic bias assessment was done.","clinical_takeaway":"VR shows promise for gaming and gambling issues, yet clinicians should await stronger evidence before replacing standard therapies.","confidence":0.6,"topic_tags":["treatment","religiosity","sexual_function"],"strengths":["Systematic search across multiple databases","Clear inclusion/exclusion criteria","Identifies gap in AR literature"],"limitations":["No risk‑of‑bias assessment","Small number of included studies (n=9)","Conclusions may overstate efficacy"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/77011"}},{"id":1339,"doi":"10.21203/rs.3.rs-1982068/v1","pmid":null,"pmcid":null,"title":"Perceived influence of medical school sexual health education on specialty selection in young urologists specializing in sexual dysfunction","authors":"Parikh N, Aro-Lambo M, Vencill J, Collins C, Helo S, Kohler T, Ziegelmann M.","first_author":"Parikh N","journal":"Research Square","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-1982068/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 95 urology trainees/residents/fellows; 15‑item questionnaire about medical‑school sexual health curriculum and mentorship; convenience sample.","sample_n":95,"sample_text":"95 respondents, primarily post‑graduate year 4 and 5 (46%)","population":"young urologists (residents, fellows, practicing) in the US (presumed)","country":"Not specified (likely US)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2022 survey of 95 urology trainees found that about half recalled any sexual‑health teaching in medical school, and only a minority felt it influenced their decision to become urologists. Mentors, especially those skilled in sexual dysfunction, were more important for choosing a sexual‑medicine subspecialty.","clinical_takeaway":"Improving medical‑school sexual health curricula and mentorship may help attract urologists to sexual‑medicine fields.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relevant for medical education policy","Focuses on under‑studied area of urology training"],"limitations":["Small, non‑representative convenience sample","Unvalidated survey instrument","No control for alternative career‑influence factors"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-1982068/v1"}},{"id":1340,"doi":"10.1071/sh15240","pmid":"27470210","pmcid":null,"title":"Sexting among singles in the USA: prevalence of sending, receiving, and sharing sexual messages and images","authors":"Garcia JR, Gesselman AN, Siliman SA, Perry BL, Coe K, Fisher HE.","first_author":"Garcia JR","journal":"Sexual health","year":2016,"pub_types":["Journal Article"],"keywords":["Sexuality","New Media","Texting","Sext","Sexual Photo"],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 5,805 single adults (21–75+ years) assessing self‑reported sending, receiving, and sharing of sexual texts/images.","sample_n":5805,"sample_text":"5830 single adults (2830 women; 2975 men) aged 21–75+.","population":"Single adults in the USA, recruited online (presumed convenience sample).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A US survey of 5,800 single adults found that about one‑fifth send and over a quarter receive explicit texts, with younger people most active. Many felt uneasy about images being shared without consent, yet roughly a quarter of recipients re‑shared them with friends.","clinical_takeaway":"Clinicians should be aware that sexting is common among adults and can cause distress about privacy; discuss digital consent and boundaries with clients.","confidence":0.85,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large sample size","Inclusion of a broad adult age range","Addresses understudied adult sexting behaviors"],"limitations":["Self‑report, single‑item measures; unclear validation","Convenience sample, potential selection bias","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":6,"contrasting":2,"mentioning":72,"citing_publications":95,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh15240"}},{"id":1341,"doi":"10.1038/s41443-023-00812-3","pmid":"38184709","pmcid":null,"title":"Pornography and sexual function in the post-pandemic period: a narrative review from psychological, psychiatric, and sexological perspectives","authors":"Fotinos K, Sansone A, Greifenberger A, Katzman MA, Jannini TB, Reisman Y, Limoncin E, Jannini EA.","first_author":"Fotinos K","journal":"International journal of impotence research","year":2024,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods","sample_n":null,"sample_text":"Not applicable – narrative review","population":"general adult population (implicitly)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review discusses how COVID‑19 lockdowns increased solo sexual activities like pornography use and masturbation. It finds no clear evidence that higher porn use caused sexual dysfunction, and suggests moderate use may help relieve pandemic‑related stress.","clinical_takeaway":"Moderate pornography use does not appear to impair sexual function and may alleviate stress; clinicians should consider context and frequency rather than assuming pathology.","confidence":0.4,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Broad overview of pandemic‑related sexual behavior","Integrates psychological, psychiatric and sexological literature"],"limitations":["Narrative (non‑systematic) review – no systematic search or bias assessment","No original data; conclusions rely on cited studies","No quantitative synthesis or effect‑size reporting"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-023-00812-3"}},{"id":1342,"doi":"10.1016/j.jsxm.2021.08.003","pmid":"34526247","pmcid":null,"title":"Frequency of Pornography Use and Sexual Health Outcomes in Sweden: Analysis of a National Probability Survey","authors":"Malki K, Rahm C, Öberg KG, Ueda P.","first_author":"Malki K","journal":"The journal of sexual medicine","year":2021,"pub_types":["Journal Article"],"keywords":["Sexual dysfunction","Sexual Satisfaction","Pornography","Sexual Health Outcomes","National Probability Survey"],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional analysis of a nationally representative probability survey (N≈14,000) examining pornography frequency and self‑reported sexual health outcomes.","sample_n":14135,"sample_text":"National probability survey, 14,135 participants (6,169 men, 7,966 women).","population":"Swedish adults aged 16‑84 (community sample, probability‑based).","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Swedish national survey of over 14,000 adults, frequent pornography use (≥3 times per week) was linked to higher odds of sexual dissatisfaction, problems with preferred sexual activities, and erection issues, especially among young men.","clinical_takeaway":"Frequent pornography use may co‑occur with sexual dissatisfaction and problems, but causal direction is unclear; clinicians should assess overall sexual health holistically.","confidence":0.85,"topic_tags":["pornography","sexual_function"],"strengths":["Very large, nationally representative sample","Detailed frequency categories for pornography use","Effect sizes with confidence intervals reported"],"limitations":["Cross‑sectional; no causal inference","Outcomes and exposure measured by single‑item self‑reports","Key confounders (moral incongruence, masturbation, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":1,"mentioning":13,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.08.003"}},{"id":1343,"doi":"10.4103/ipj.ipj_166_23","pmid":"38853810","pmcid":null,"title":"\"Snapping, sharing and receiving blame\": A systematic review on psychosocial factors of victim blaming in non-consensual pornography","authors":"Amudhan S, Sharma MK, Anand N, Johnson J.","first_author":"Amudhan S","journal":"Industrial psychiatry journal","year":2024,"pub_types":["Review","Journal Article"],"keywords":["Culture","Morality","Psychosocial","Attribution","Victim Blame","Revenge Porn"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"qualitative thematic synthesis of 10 primary studies","sample_n":10,"sample_text":"10 primary studies included","population":"victims and observers of non‑consensual pornography (revenge porn); no specific demographic details reported","country":"unspecified (studies from multiple databases)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review examined why people tend to blame victims of non‑consensual pornography. By analysing ten prior studies, it found that cultural morals and gender stereotypes strongly shape blame attributions, suggesting that policy and education should target these underlying beliefs.","clinical_takeaway":"Understanding cultural and gender biases can help professionals support victims of revenge porn and inform preventative education.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Systematic search across multiple databases","Clear thematic synthesis framework","Addresses an under‑studied psychosocial issue"],"limitations":["No quantitative meta‑analysis or effect‑size reporting","Limited detail on quality appraisal of included studies","Potential selection bias from English‑only search"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/ipj.ipj_166_23"}},{"id":1344,"doi":"10.30444/cb.164","pmid":"38734921","pmcid":null,"title":"[On-line pornography and minors. Diagnosis, challenges and proposals]","authors":"Morales Benito I, Guardia Hernández JJ, Macpherson Mayol I.","first_author":"Morales Benito I","journal":"Cuadernos de bioetica : revista oficial de la Asociacion Espanola de Bioetica y Etica Medica","year":2024,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"no empirical data; analysis of legal sources, reports and literature","sample_n":null,"sample_text":"none","population":"minors (no sample reported)","country":"Spain (journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The article discusses the rapid increase in online pornography use by minors and its possible link to sexual violence and gender inequality. Drawing on legal texts, reports and existing studies, it argues that current access is harmful to youths' health and education, and recommends stricter technical controls based on the precautionary principle.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Broad review of legal and policy literature","Identifies bioethical concerns for minors","Proposes precautionary regulatory measures"],"limitations":["No original empirical data","No systematic review methodology disclosed","No measurement of key constructs or confounders"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.30444/cb.164"}},{"id":1345,"doi":"10.3389/fendo.2021.736384","pmid":"34566897","pmcid":"PMC8461095","title":"Pornography Use Could Lead to Addiction and Was Associated With Reproductive Hormone Levels and Semen Quality: A Report From the MARHCS Study in China","authors":"Cui Z, Mo M, Chen Q, Wang X, Yang H, Zhou N, Sun L, Liu J, Ao L, Cao J.","first_author":"Cui Z","journal":"Frontiers in endocrinology","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Semen quality","Reproductive hormone","Addiction","College Students","Pornography"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fendo.2021.736384/pdf","cited_by_count":6,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 568 Chinese male college students with hormone and semen measurements; self‑report questionnaire on pornography use and masturbation.","sample_n":568,"sample_text":"568 participants met inclusion criteria and completed questionnaires, hormone assays and semen analyses.","population":"Male college students in China (age ~18‑24)","country":"China","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 568 Chinese male college students, earlier and more frequent pornography use (often with masturbation) was linked to lower levels of certain reproductive hormones and poorer semen quality. The authors suggest these patterns may indicate emerging addiction trends.","clinical_takeaway":"No direct clinical guidance; findings are correlational and do not establish that pornography causes hormonal or semen changes.","confidence":0.7,"topic_tags":["pornography","masturbation","religiosity","sexual_function"],"strengths":["Large sample for a physiological study","Objective hormone and semen measures","Includes masturbation frequency data"],"limitations":["Addiction measured with unspecified, likely unvalidated items","No control for moral, mental‑health or partner variables","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fendo.2021.736384"}},{"id":1348,"doi":"10.1177/22143602261445253","pmid":"42012126","pmcid":"PMC13438932","title":"Moving beyond puberty: Listening to lived experience to expand sexual and reproductive healthcare for adults with muscular dystrophy","authors":"Kim J, Ahmed UA, Pagan A, Margolin RE, Rohan A, Tantivit N, Boskey ER, Renthal NE.","first_author":"Kim J","journal":"Journal of neuromuscular diseases","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Quality of life","Muscular dystrophy","Duchenne muscular dystrophy","Puberty","endocrinology","Disability","Reproductive Healthcare"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13438932","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"semi‑structured interviews with 30 adults with muscular dystrophy; thematic analysis","sample_n":30,"sample_text":"convenience sample recruited for interviews","population":"adults with various types of muscular dystrophy (n=30)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 30 adults who have muscular dystrophy reveal many obstacles to getting good sexual and reproductive care, such as embarrassment, doctors not bringing up the topic, and lack of privacy. Participants want clinicians to start conversations, give practical advice, and provide mental‑health and peer‑support resources.","clinical_takeaway":"Clinicians should proactively discuss sexual health with patients with muscular dystrophy and offer tailored information and support.","confidence":0.8,"topic_tags":["sexual_function","relationships","religiosity","moral_incongruence","masturbation","pornography"],"strengths":["In‑depth, lived‑experience data","Identifies concrete barriers and actionable improvements","Focus on a marginalized population"],"limitations":["Small, non‑representative sample","No validated measures of sexual health","Cross‑sectional, cannot assess changes over time"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/22143602261445253"}},{"id":1349,"doi":"10.1080/0092623x.2023.2295969","pmid":"38153007","pmcid":null,"title":"Pornography consumption, premarital sex attitudes, and the moderating role of age: Replication in two U.S. panels","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Journal of sex & marital therapy","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Replication of a longitudinal panel survey of U.S. adults examining how pornography consumption predicts attitudes toward premarital sex, with age as a moderator.","sample_n":null,"sample_text":"two U.S. panels (size not reported)","population":"U.S. adults (sample size not specified in abstract)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A study replicated earlier work showing that how often people watch porn is linked to their attitudes about premarital sex, and that this link changes with age.","clinical_takeaway":"None - findings are about attitudes, not clinical outcomes.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Attempts replication of earlier longitudinal findings","Considers age as a moderator, adding nuance","Uses panel data allowing prospective analysis"],"limitations":["No information on measurement validation","Potential lack of control for key confounds (e.g., moral attitudes, mental health)","Sample size and representativeness unclear"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2023.2295969"}},{"id":1350,"doi":"10.1111/aogs.70193","pmid":"42007644","pmcid":"PMC13191805","title":"\"And then I got strangled\": Dangerous trends of sexual choking among young people","authors":"Kero K, Lauerma H, Wahlsten P.","first_author":"Kero K","journal":"Acta obstetricia et gynecologica Scandinavica","year":2026,"pub_types":["article-commentary","Review","Journal Article"],"keywords":["Strangulation","Bdsm","Sexual Choking","Asphyxia‐related Risks","Breath‐control"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13191805","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"article-commentary","sample_n":null,"sample_text":"Not applicable (commentary)","population":"young people engaged in sexual choking (Finland context)","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors warn that sexual choking among young people can cause sudden loss of consciousness, brain injury, or death, and argue clinicians should always ask about it and advise against it.","clinical_takeaway":"Ask patients about choking practices and advise that they carry high risk of injury or death.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Highlights emerging risky sexual practice","Calls for clinical attention and screening"],"limitations":["No empirical data presented","No prevalence estimates","Lacks systematic review methodology"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/aogs.70193"}},{"id":1351,"doi":"10.1016/j.ijlp.2009.06.004","pmid":"19665229","pmcid":null,"title":"Pornography, public acceptance and sex related crime: a review","authors":"Diamond M.","first_author":"Diamond M.","journal":"International journal of law and psychiatry","year":2009,"pub_types":["Comparative Study","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review (non‑systematic, narrative) without meta‑analysis or primary data","sample_n":null,"sample_text":"None – narrative review","population":"general adult population (implicit)","country":"United States (and other countries mentioned)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews studies on pornography availability and sex‑related crime, concluding that where pornography has become more accessible, sex crimes have not risen and may have fallen, and that adult public acceptance is high worldwide.","clinical_takeaway":"None – the paper is a policy‑oriented review, not a clinical study.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Broad cross‑cultural overview","Addresses public opinion and policy relevance"],"limitations":["Narrative, non‑systematic synthesis","No quantitative analysis or systematic bias assessment","Confounding factors (e.g., socioeconomic change, reporting rates) not addressed"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":57,"citing_publications":128,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijlp.2009.06.004"}},{"id":1352,"doi":"10.1080/19317611.2021.1944420","pmid":"38595682","pmcid":"PMC10903555","title":"No Gender Differences in Enrollment for Replicated, Minimally-Different 'Pornographic' Versus 'Photographic' Studies","authors":"MacEacheron M, Kohut T, Fisher WA.","first_author":"MacEacheron M","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Gender","Survey Research","Pornography","Minimal Difference Procedure","Self-selection Into Studies"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional convenience‑sample survey comparing two advertisement wordings (with/without “pornographic”) and measuring gender proportion, pornography use frequency, erotophilia‑erotophobia and Openness to Experience.","sample_n":null,"sample_text":"Convenience sample; size not reported in abstract.","population":"North American adults recruited via online advertisements; convenience sample; gender distribution assessed.","country":"North America","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared two ads—one that said “pornographic” and one that did not—to see if fewer women would sign up for a porn‑related survey. No gender difference was found, and women who did join were not consistently atypical in personality.","clinical_takeaway":"None – the findings pertain to research recruitment, not clinical treatment.","confidence":0.6,"topic_tags":["gender","pornography","religiosity","sexual_function"],"strengths":["Replication of the advertisement manipulation","Direct assessment of gender proportion in response rates","Inclusion of personality and erotophilia measures"],"limitations":["Convenience, non‑probability sample limits generalizability","No information on sample size or power","Limited control for potential confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2021.1944420"}},{"id":1353,"doi":"10.1371/journal.pone.0295933","pmid":"38117759","pmcid":"PMC10732433","title":"Psychosocial determinants of adolescent romantic relationship in Malaysia: Social media use, pornography surfing, sexual and reproductive health knowledge, and depression","authors":"Mud Shukri MI, Baharom A.","first_author":"Mud Shukri MI","journal":"PloS one","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10732433","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 396 Malaysian adolescents (age 14‑19) using self‑administered questionnaire to assess romantic relationship status and its association with social media use, pornography website surfing, SRH knowledge, and depression.","sample_n":396,"sample_text":"396 adolescents meeting selection criteria","population":"Adolescents (14‑19 y) in Seremban, Negeri Sembilan, Malaysia (community sample recruited through a health‑promotion programme).","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 396 Malaysian teens found that those who used social media, visited porn sites, had poor sexual‑health knowledge, or were depressed were about two to four times more likely to be in a romantic relationship.","clinical_takeaway":"Clinicians should consider social‑media and porn exposure, mental health, and SRH knowledge when discussing adolescents' relationships, but cannot assume these factors cause relationship formation.","confidence":0.73,"topic_tags":["adolescents","pornography","sexual_function","relationships"],"strengths":["Large community sample for the setting","Multivariable logistic regression with confidence intervals","Addresses understudied Malaysian adolescent context"],"limitations":["Cross‑sectional, cannot infer causality","Key constructs (pornography use, social media) measured with single‑item self‑reports","No measurement of moral incongruence or masturbation, limiting interpretation of pornography effects","Potential self‑selection bias from health‑programme participants"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0295933"}},{"id":1354,"doi":"10.1891/vivi.19.6.645.66347","pmid":"16004067","pmcid":null,"title":"Impact of interaction with a partner or friend on the exposure effects of pornography and erotica","authors":"Senn CY, Desmarais S.","first_author":"Senn CY","journal":"Violence and victims","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"randomized assignment of companion (friend vs male partner) and stimulus type (pornography vs erotica) with mood outcome measured after exposure and discussion","sample_n":null,"sample_text":"Not reported in abstract","population":"heterosexual women (sample size not reported)","country":"Unknown","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"Women watched either porn or erotic images alone with a friend or a male partner. Porn kept their mood negative, while erotica improved it. The companion’s gender didn’t change mood, but participants liked discussions more with a male partner.","clinical_takeaway":"Viewing erotic material may boost mood in women; partner presence influences discussion satisfaction but not mood.","confidence":0.7,"topic_tags":["pornography","moral_incongruence","sexual_function"],"strengths":["Experimental random assignment of companion condition","Focus on interpersonal context of viewing","Measurement of mood change"],"limitations":["No measurement of moral or religiosity factors","Sample size and recruitment details missing","Potential lack of validated mood scale"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1891/vivi.19.6.645.66347"}},{"id":1356,"doi":"10.1080/00224499.2023.2280965","pmid":"38063496","pmcid":null,"title":"Using Pornography, Paying for Sex, and Violence: A Danish National Survey Study","authors":"Chapman M, Dammeyer J, Strizzi JM, Hald GM.","first_author":"Chapman M","journal":"Journal of sex research","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Representative Danish national survey; large probability sample; cross‑sectional questionnaire with regression analyses.","sample_n":null,"sample_text":"representative Danish national survey (size not specified in abstract)","population":"Adults in Denmark, stratified by gender, age, relationship status.","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A Danish national survey found that men who use more pornography or have ever paid for sex tend to be younger, single, less sexually satisfied and, in some analyses, more likely to have committed violence. After controlling for demographics, the violence link was not statistically significant.","clinical_takeaway":"Higher porn use or buying sex is linked to lower sexual satisfaction, but no clear evidence of increased violence after adjustment.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative sample","Gender‑stratified analysis","Controls for basic demographics in regression"],"limitations":["Reliance on single‑item self‑reports; no validated scales","Key confounds (moral incongruence, mental health, trauma) not measured","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2280965"}},{"id":1357,"doi":"10.3389/fpsyt.2026.1777424","pmid":"42038091","pmcid":"PMC13106114","title":"Meaning in life and the mental health - addiction spiral: testing a unifying model","authors":"Gliksberg O, Lifshin U, Ankri Y, Skvirsky V, Shmulewitz D, Levitin MD, Lev-Ran S, Kor A, Mikulincer M.","first_author":"Gliksberg O","journal":"Frontiers in psychiatry","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Mental health","Addiction","Substance Use","Meaning In Life","Behavioral Addictions"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13106114","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large convenience surveys of Israeli adults, cross‑sectional, self‑report questionnaires","sample_n":3986,"sample_text":"Study 1 (N=1,084) young adults; Study 2 (N=2,912) quasi‑representative adult sample","population":"Israeli adults (18–70), N≈4,000 total","country":"Israel","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["causal_from_correlational","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In two large Israeli surveys, people who felt their lives had purpose reported less depression, anxiety, PTSD, and lower engagement in many addictive behaviours—including alcohol, gambling and pornography—suggesting meaning in life may protect against distress and addiction.","clinical_takeaway":"Enhancing a sense of life purpose could be a useful adjunct in preventing or treating addictive behaviours and related distress.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence","measurement"],"strengths":["Large sample size","Validated measures for most constructs","Inclusion of a broad range of addictive behaviors"],"limitations":["Cross‑sectional design limits causal inference","No assessment of moral incongruence or masturbation","Addiction constructs based on self‑report problem use scales"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2026.1777424"}},{"id":1359,"doi":null,"pmid":"34267175","pmcid":null,"title":"[Sexual and reproductive health effects of mainstream pornography use in adolescents.]","authors":"Román García Ó, Bacigalupe A, Vaamonde García C.","first_author":"Román García Ó","journal":"Revista espanola de salud publica","year":2021,"pub_types":["Review","Journal Article"],"keywords":["Sexual behavior","Spain","Adolescents","Sexual And Reproductive Health","Mainstream Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"scoping review of 14 primary studies, no risk‑of‑bias assessment, broad inclusion criteria","sample_n":null,"sample_text":"14 studies identified; no primary data collected","population":"adolescents and university students (Spain, unspecified sample size)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review of 14 studies found that adolescent exposure to mainstream pornography is linked to distorted views of women and possible short‑ and long‑term effects on sexual and reproductive health, suggesting that porn should be addressed in school sex‑education programmes.","clinical_takeaway":"Consider discussing media influences on sexual attitudes when providing sex education to adolescents.","confidence":0.4,"topic_tags":["pornography","adolescents","sexual_function","gender"],"strengths":["Uses established JBI scoping methodology","Identifies gender‑related impacts of porn exposure","Synthesises multiple study designs","Highlights need for educational interventions"],"limitations":["No systematic risk‑of‑bias appraisal","No quantitative synthesis or effect‑size reporting","Potential over‑generalisation from heterogeneous studies","Confounding factors (e.g., moral incongruence, mental health) not addressed"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":1360,"doi":"10.17269/s41997-026-01185-y","pmid":"41954884","pmcid":null,"title":"Screens and Teens: A youth participatory action research approach to developing a survey to assess sexual health risks in the digital age","authors":"Vandermorris A, Khan N, Lijiam S, Tam M, Mazin WB, Begun S, Wigle J, Arafeh D, Skelding J, Carsley S, Keown-Stoneman C, Maguire JL, Birken CS, Toulany A.","first_author":"Vandermorris A","journal":"Canadian journal of public health = Revue canadienne de sante publique","year":2026,"pub_types":["Journal Article"],"keywords":["sexually transmitted diseases","Adolescent Health","Social Media","Sexual And Reproductive Health","Youth Engagement","Screen Use","Youth Participatory Action Research"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"development of a youth‑participatory survey; no empirical data reported","sample_n":null,"sample_text":"none reported","population":"adolescents (planned future sample, not described)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes how a group of teen co‑researchers helped design a new questionnaire covering gender, media use, sexual attitudes, relationships, and pornography to better study how screen time may affect young people's sexual health.","clinical_takeaway":"None – the study only outlines survey development, not findings that guide clinical practice.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Youth participatory approach","Incorporates many relevant content domains"],"limitations":["No validation data presented","No empirical testing of the survey","Potential lack of representativeness"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.17269/s41997-026-01185-y"}},{"id":1361,"doi":"10.21203/rs.3.rs-1800750/v1","pmid":null,"pmcid":null,"title":"Influence of Smartphone Usage on Development of Sexuality Among Late Adolescent Boys in Health Sciences Colleges of South India","authors":"Manya SM, K J, Mithra P, Galagali PM.","first_author":"Manya SM","journal":"Research Square","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-1800750/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"institution-based cross‑sectional survey of 18‑19‑year‑old male health‑science students (convenience sample)","sample_n":null,"sample_text":"All students willing to participate were invited via email; exact N not reported in abstract","population":"Late adolescent male students (age 18‑19) in South India","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 18‑19‑year‑old male health‑science students in South India found that half used smartphones heavily and accessed pornographic material, but the study could not determine how this relates to sexual development because it was cross‑sectional and did not consider factors like moral attitudes or mental health.","clinical_takeaway":"No direct clinical recommendations; findings are exploratory and limited by design.","confidence":0.7,"topic_tags":["sexual_function","pornography","adolescents"],"strengths":["Addresses understudied topic in South Asian adolescents","Uses a pre‑validated questionnaire for smartphone use","Includes a relatively homogenous age‑cohort"],"limitations":["Cross‑sectional design limits causal inference","No measurement or control of key sexual‑health confounds (moral incongruence, masturbation, mental health)","No effect sizes or correction for multiple testing reported","Sample likely self‑selected and not representative of broader youth"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-1800750/v1"}},{"id":1362,"doi":"10.1038/s41443-023-00804-3","pmid":"38052977","pmcid":null,"title":"Effect of internet pornography use frequency on psychogenic erectile dysfunction severity in young Turkish men: the mediating role of dyadic adjustment","authors":"Kazan Kizilkurt O, Kazan O, Efiloglu O, Erol B, Yildirim A.","first_author":"Kazan Kizilkurt O","journal":"International journal of impotence research","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross-sectional survey of 66 married Turkish men diagnosed with psychogenic erectile dysfunction; self‑report questionnaires on pornography use frequency, erectile function, dyadic adjustment, mood and stress.","sample_n":66,"sample_text":"66 participants","population":"Young married heterosexual men with psychogenic erectile dysfunction (N=66, Turkey)","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"supports","citation_value":"useful","plain_summary":"In 66 Turkish men with psychogenic erectile dysfunction, higher self‑reported pornography use was linked to worse erectile function. Better couple relationship quality reduced this link, suggesting relationship factors may buffer any negative effect of frequent porn use.","clinical_takeaway":"Frequency of porn use may be associated with erectile problems, but relationship quality matters; clinicians should assess both habits and dyadic factors.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","relationships"],"strengths":["Uses validated scales for erectile function, dyadic adjustment, mood, and stress","Tests mediation with hierarchical regression and Sobel test","Addresses dyadic adjustment as a plausible pathway"],"limitations":["Cross‑sectional design cannot establish causality","Small, non‑representative clinical sample","No assessment of moral incongruence, masturbation, or trauma history","Pornography use measured only by frequency item"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-023-00804-3"}},{"id":1363,"doi":"10.3389/fpsyg.2021.661347","pmid":"34393898","pmcid":"PMC8362880","title":"But What's Your Partner Up to? Associations Between Relationship Quality and Pornography Use Depend on Contextual Patterns of Use Within the Couple","authors":"Kohut T, Dobson KA, Balzarini RN, Rogge RD, Shaw AM, McNulty JK, Russell VM, Fisher WA, Campbell L.","first_author":"Kohut T","journal":"Frontiers in psychology","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Romantic Relationship","Sexual Satisfaction","Relationship Satisfaction","Pornography","Erotica"],"is_oa":true,"oa_url":"https://doi.org/10.3389/fpsyg.2021.661347","cited_by_count":10,"is_preprint":false,"topics":["curated","pornography"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"longitudinal","design_detail":"Dyadic Couple Analysis","sample_n":null,"sample_text":"Dyadic sample of couples (both partners assessed)","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"essential","plain_summary":"Demonstrates that the association between pornography use and relationship/sexual satisfaction cannot be understood by looking at viewing frequency in isolation; it depends on the contextual pattern within the couple (solitary vs. shared, secret vs. honest, concordant vs. discrepant values).","clinical_takeaway":"In couples therapy, the relational injury is rarely caused by pixels on a screen alone — it is driven by secrecy, violated agreements, and the meaning both partners attach to the behavior.","confidence":1,"topic_tags":["relationships"],"strengths":["Assesses both partners in the relationship using Actor-Partner Interdependence Modeling","Replaces simplistic \"porn is always bad / always good for marriage\" claims with relational context"],"limitations":["Self-report couple survey data"],"rubric_version":"2.0","raw_total":45,"max_possible":50,"pct_score":90,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":9,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2021.661347"}},{"id":1365,"doi":"10.1002/cad.20059","pmid":"24962361","pmcid":null,"title":"Linking online sexual activities to health outcomes among teens","authors":"O'Sullivan LF.","first_author":"O'Sullivan LF.","journal":"New directions for child and adolescent development","year":2014,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review/chapter with limited presentation of new comparative data; no primary empirical study, no systematic methods reported.","sample_n":null,"sample_text":"Not applicable – review format; any referenced data not described in abstract.","population":"Adolescents (teens)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The chapter reviews how teens use online sexual content and discusses research comparing health outcomes for users versus non‑users, arguing that such activities should not be labelled as problem behaviour.","clinical_takeaway":"Clinicians should view adolescent online sexual activity as a normal developmental experience rather than a pathology.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Balanced, non‑pathologising tone","Addresses a range of online sexual activities"],"limitations":["No systematic methodology reported","No primary data or statistical analysis presented","Confounding factors (e.g., mental health, moral incongruence) not examined"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":23,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/cad.20059"}},{"id":1366,"doi":"10.3389/fsoc.2023.1250012","pmid":"38089013","pmcid":"PMC10715401","title":"Pornography. The politics of legal changes. An opinion article","authors":"Hydén H.","first_author":"Hydén H.","journal":"Frontiers in sociology","year":2023,"pub_types":["discussion","Journal Article"],"keywords":["Pornography","Comparative Law","Legal Strategies For Political Change","Sex Purchase Law","Victim Less Crime"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10715401","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fsoc.2023.1250012"}},{"id":1368,"doi":"10.1080/0092623x.2023.2276149","pmid":"38006227","pmcid":null,"title":"A New Flight from Womanhood? The Importance of Working Through Experiences Related to Exposure to Pornographic Content in Girls Affected by Gender Dysphoria","authors":"Nadrowski K.","first_author":"Nadrowski K.","journal":"Journal of sex & marital therapy","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary / theoretical argument without empirical data","sample_n":null,"sample_text":"none reported","population":"female adolescents with gender dysphoria (no sample reported)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The paper argues that exposure to porn may worsen gender dysphoria in teenage girls, suggesting clinicians should explore porn use when treating these patients, but it provides no data to support the claim.","clinical_takeaway":"Clinicians may consider discussing porn exposure with gender‑dysphoric adolescents, but evidence for its impact is currently speculative.","confidence":0.7,"topic_tags":["gender","sexual_function"],"strengths":["Raises a novel, interdisciplinary hypothesis","Identifies several plausible mechanisms linking pornography to gender dysphoria"],"limitations":["No empirical data or systematic review presented","Claims are speculative and lack operational definitions","No measurement of key confounds such as moral incongruence or trauma"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2023.2276149"}},{"id":1370,"doi":"10.1002/smi.70155","pmid":"41736387","pmcid":"PMC12933018","title":"Substance and Behavioural Addictions Among Evacuees: Findings From Israeli Swords of Iron War","authors":"Rubin G, Lifshin U, Skvirsky V, Ankri Y, Shmulewitz D, Levitin M, Vider M, Lev-Ran S, Kor A, Mikulincer M.","first_author":"Rubin G","journal":"Stress and health : journal of the International Society for the Investigation of Stress","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Alcohol","Depression","Addiction","War","Gambling","Evacuees"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12933018","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two online surveys of young adults and a quasi‑representative adult sample; convenience/online recruitment; cross‑sectional associations.","sample_n":111,"sample_text":"Study 1 evacuees n = 111, non‑evacuees n = 973; Study 2 evacuees n = 158, non‑evacuees n = 2 485.","population":"Israeli civilians evacuated during the 2023‑2024 “Swords of Iron” war; ages 18‑70; both sexes.","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"People evacuated during the Israeli war reported more anxiety, depression, and higher rates of problem drinking, gambling, and pornography use than those who stayed home. The differences persisted after accounting for other war stressors.","clinical_takeaway":"Clinicians should screen evacuees for a range of addictive behaviors, not just substance use, and consider war‑related stress as a contributing factor.","confidence":0.8,"topic_tags":["pornography","gender","csbd","sexual_function"],"strengths":["Large total sample across two studies","Includes both substance and behavioural addictions","Controls for direct war‑related stressors"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report, likely non‑validated addiction scales","Moral incongruence and masturbation not measured"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/smi.70155"}},{"id":1371,"doi":"10.1093/jsxmed/qdag121","pmid":"42070118","pmcid":null,"title":"Masturbation as a sexual and psychological coping strategy in long-distance relationships: a systematic review","authors":"Kusuma NHS, Irnandi DF, Pakpahan C, An Nguyen TT.","first_author":"Kusuma NHS","journal":"The journal of sexual medicine","year":2026,"pub_types":["Systematic Review","Journal Article"],"keywords":["Masturbation","Psychological Well-being","Sexual Satisfaction","Healthy Sexuality","Long-distance Relationship"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of 14 quantitative and qualitative studies on masturbation in long‑distance relationships, following PRISMA","sample_n":null,"sample_text":"Fourteen primary studies (sample sizes not provided in abstract)","population":"adults in long‑distance relationships, mixed gender, various cultures","country":"unspecified (multiple studies)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review found that masturbation is a common coping tool for people in long‑distance relationships. Moderate use can boost body awareness and relationship harmony, but very frequent solo activity may harm sexual and emotional satisfaction, especially where cultural or religious norms are restrictive.","clinical_takeaway":"Masturbation can be a healthy sexual coping strategy in long‑distance couples, but clinicians should monitor excessive use that could undermine relationship and wellbeing.","confidence":0.75,"topic_tags":["masturbation","relationships","sexual_function","csbd"],"strengths":["PRISMA‑guided systematic search","Inclusion of both quantitative and qualitative evidence","Attention to cultural variation"],"limitations":["No meta‑analytic synthesis; likely narrative only","Primary studies’ constructs and measurements not detailed","Key confounders (moral incongruence, mental health) not controlled","Potential heterogeneity of study designs limits conclusions"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdag121"}},{"id":1372,"doi":"10.70478/psicothema.2026.38.09","pmid":"42051128","pmcid":null,"title":"Internet Habits, Problematic Internet Use, and Online Risk Practices Among Adolescents With ADHD in Spain","authors":"Isorna M, Liñares D, Gómez P, Villanueva-Blasco VJ, Rial-Boubeta A.","first_author":"Isorna M","journal":"Psicothema","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 4,359 Spanish adolescents (5.9% ADHD), intentional school sampling, comparing internet habits, PIU, and risk practices.","sample_n":4359,"sample_text":"School‑based intentional sample of 4,359 adolescents (51.1% girls).","population":"Adolescents aged 12‑18, school‑based sample in Spain; 5.9% identified with ADHD.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A school survey of over 4,000 Spanish teens found that those with ADHD used the internet and video games differently, showed higher rates of problematic internet use, and were more likely to engage in online risks like pornography, gambling, and sextortion than peers without ADHD.","clinical_takeaway":"Adolescents with ADHD may need targeted guidance on safe internet use, especially regarding pornography and other risky online activities.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Large community sample","Specific focus on ADHD subgroup","Includes multiple online risk behaviours"],"limitations":["Cross‑sectional, cannot infer causality","Unclear validation of PIU measure","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.70478/psicothema.2026.38.09"}},{"id":1373,"doi":"10.1080/10538712.2026.2673342","pmid":"42161863","pmcid":null,"title":"A Cohort of Adolescents Displaying Harmful Sexual Behavior: Distinctive Factors Between Contact and Non-Contact Sexual Offending","authors":"Conway S, Evans S, Johnson D.","first_author":"Conway S","journal":"Journal of child sexual abuse","year":2026,"pub_types":["Journal Article"],"keywords":["Adolescent","Problematic Sexual Behavior","Harmful Sexual Behavior","Contact And Non-contact Offending"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"observational cohort of 88 adolescents referred to a government‑funded intervention service; groups defined by type of harmful sexual behaviour (contact, non‑contact, mixed)","sample_n":88,"sample_text":"88 youths referred between Oct 2020–Nov 2023","population":"88 youths (9‑19 y) referred to the IVY project in Scotland","country":"Scotland","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study looked at 88 Scottish youths who committed sexual offences, comparing those who only did non‑contact acts (like voyeurism) with those who also committed contact offences (like assault). It found shared risk factors such as insecure attachment, school problems, and viewing porn online, and that these factors were linked to escalation from non‑contact to contact offending.","clinical_takeaway":"Risk factors like attachment problems and online porn use may signal escalation risk; clinicians should assess these in youth presenting with non‑contact sexual behaviour.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large‑age‑range adolescent sample","Direct comparison of contact vs non‑contact offending","Inclusion of multiple risk‑factor domains"],"limitations":["Service‑referral sample limits generalisability","No validated psychometric instruments reported","Limited statistical detail; likely under‑powered for subgroup analyses"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2026.2673342"}},{"id":1374,"doi":"10.1016/j.addbeh.2021.107044","pmid":"34311186","pmcid":"PMC8434429","title":"Assessing online gaming and pornography consumption patterns during COVID-19 isolation using an online survey: Highlighting distinct avenues of problematic internet behavior","authors":"Sallie SN, Ritou VJE, Bowden-Jones H, Voon V.","first_author":"Sallie SN","journal":"Addictive behaviors","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Stress","Internet Use","Pornography","Online Gaming","Self-isolation","Covid-19"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.addbeh.2021.107044","cited_by_count":36,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online cross‑sectional survey of 1,344 adults from 80 countries, measuring self‑reported changes in gaming and pornography use before vs during COVID‑19 quarantine.","sample_n":1344,"sample_text":"online convenience sample, self‑selected respondents","population":"Adults (≥18 y) self‑selected via internet; majority from US/UK; international sample.","country":"International (USA, UK, others)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A large online survey of adults found that during COVID‑19 lockdown, online gaming use rose sharply while pornography use rose modestly. Increases were linked to younger age, male gender, higher stress, anxiety, depression, and impulsivity.","clinical_takeaway":"Stress and mood problems may drive higher gaming and modestly higher porn use; monitor mental health during isolation.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size (N>1300)","Validated gaming (IGDS9‑SF) and mental‑health (HADS) scales","International reach across many countries"],"limitations":["Self‑report, recall‑based change measures","No assessment of moral incongruence or masturbation","Cross‑sectional, cannot infer causality","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":6,"contrasting":1,"mentioning":71,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2021.107044"}},{"id":1375,"doi":"10.1016/j.ssresearch.2021.102602","pmid":"34627554","pmcid":null,"title":"Understanding the role of religion in shaping cross-national and domestic attitudes and interest in abortion, homosexuality, and pornography using traditional and Google search data","authors":"Adamczyk A, Liu YH, Scott J.","first_author":"Adamczyk A","journal":"Social science research","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Abortion","Homosexuality","Cross-national","Google","Quantitative Research Methods","Pornography","Internet Searches","Sociology Of Religion"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large-scale ecological analysis using Google Trends data correlated with regional survey attitudes","sample_n":null,"sample_text":"aggregate search volume and regional attitude measures; no individual-level sample size reported","population":"US Designated Market Areas and multiple nations (aggregate data)","country":"United States (and multiple nations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Using Google search data, the authors find that people living in more religiously conservative areas tend to disapprove of homosexuality, abortion and pornography, yet they also search for these topics more often; greater interest in Islam at the national level is linked to higher pornography search interest.","clinical_takeaway":"None – the study addresses population attitudes, not individual clinical issues.","confidence":0.7,"topic_tags":["pornography","religiosity","sexual_function"],"strengths":["Very large, publicly available data set","Innovative validation of Google Trends as a proxy for religious context","Cross‑national comparison"],"limitations":["Ecological design; cannot infer individual attitudes","Constructs (attitudes, interest) not measured with validated scales","Potential ecological fallacy and omitted confounders"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ssresearch.2021.102602"}},{"id":1377,"doi":"10.1177/08862605211028314","pmid":"34215165","pmcid":"PMC8720326","title":"Understanding Associations Between Exposure to Violent Pornography and Teen Dating Violence Among Female Sexual Minority High School Students","authors":"Herbitter C, Norris AL, Nelson KM, Orchowski LM.","first_author":"Herbitter C","journal":"Journal of interpersonal violence","year":2022,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual Minority Youth","Intimate Partner Violence","Dating Violence","Pornography","Sexual Minority Girls","Sexually Explicit Media"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational baseline survey of 10th‑grade cis‑female students (N=1,276); analysis focused on sexual‑minority subgroup; logistic regression controlling for heavy drinking","sample_n":1276,"sample_text":"N = 1,276 10th‑grade cis‑female students (subgroup of sexual‑minority girls not specified)","population":"U.S. high‑school cis‑female adolescents, ages 14‑17, identified as sexual‑minority or heterosexual","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among high‑school girls, sexual‑minority students were more likely to see violent porn and to experience dating violence, but seeing violent porn did not predict dating violence after accounting for heavy drinking.","clinical_takeaway":"Clinicians should note higher rates of both violent porn exposure and dating violence in sexual‑minority teens, but current evidence does not show a direct link.","confidence":0.78,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Large overall sample size","Focus on understudied sexual‑minority adolescent group","Use of logistic regression with confidence intervals"],"limitations":["Cross‑sectional design; cannot infer causality","Key constructs measured with single‑item, unvalidated questions","Limited control of relevant confounds (e.g., moral incongruence, mental health, partner factors)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605211028314"}},{"id":1378,"doi":"10.1016/j.jadohealth.2021.03.008","pmid":"34217457","pmcid":null,"title":"Pornography Use and Perceived Gender Norms Among Young Adolescents in Urban Poor Environments: A Cross-site Study","authors":"Yu C, Kågesten AE, De Meyer S, Moreau C, van Reeuwijk M, Lou C.","first_author":"Yu C","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Gender","Adolescents","Sexual Health","Gender Norms","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 9,250 adolescents (10‑14 y) from five urban poor sites; multivariate logistic regression of ever‑pornography use on perceived gender norms and covariates.","sample_n":9250,"sample_text":"9250 adolescents aged 10‑14 years","population":"Adolescents (10‑14 y) in urban poor settings in Belgium, China, DRC, Ecuador, Indonesia","country":"Belgium, China, Democratic Republic of the Congo, Ecuador, Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 9,250 adolescents in five low‑income urban areas, 15‑33 % had ever watched pornography, more often boys. Beliefs about gender norms were only weakly linked to pornography use, and patterns differed by country.","clinical_takeaway":"Pornography exposure starts early and varies by context; educators should provide age‑appropriate media literacy rather than assume pathological risk.","confidence":0.8,"topic_tags":["pornography","gender","adolescents","sexual_function"],"strengths":["Large, multi‑site sample","Multivariate adjustment for several contextual factors","Focus on early adolescents, understudied age group"],"limitations":["Cross‑sectional; cannot infer causality","Gender‑norm measures not described; unknown validation","Key confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":22,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2021.03.008"}},{"id":1379,"doi":"10.1111/j.1743-6109.2008.01031.x","pmid":"19175861","pmcid":null,"title":"Sex differences in visual attention to sexually explicit videos: a preliminary study","authors":"Tsujimura A, Miyagawa Y, Takada S, Matsuoka Y, Takao T, Hirai T, Matsushita M, Nonomura N, Okuyama A.","first_author":"Tsujimura A","journal":"The journal of sexual medicine","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Eye‑tracking study of visual attention to sexual videos with 22 healthy volunteers (11 men, 11 women).","sample_n":22,"sample_text":"Eleven male and 11 female healthy volunteers","population":"Healthy adult volunteers, balanced sex distribution, small convenience sample.","country":"Japan (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In this small eye‑tracking study, men looked longer at the opposite‑sex actors in a non‑intercourse sexual video, while women focused more on the same‑sex actors. No sex differences were found when the video showed intercourse.","clinical_takeaway":"None – the study examines basic visual attention, not clinical outcomes.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender","neuroscience"],"strengths":["Eye‑tracking provides objective measure of visual attention","Clear within‑subject video analysis","Balanced male/female sample for exploratory purposes"],"limitations":["Very small sample limits generalisability","No correction for multiple comparisons reported","No assessment of potential confounds (e.g., sexual experience, mood)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":1,"mentioning":38,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2008.01031.x"}},{"id":1380,"doi":"10.1007/s10508-021-01924-x","pmid":"34169377","pmcid":null,"title":"Pornography Use and Intimate Partner Violence Among a Sample of U.S. Army Soldiers in 2018: A Cross-Sectional Study","authors":"Beymer MR, Hill CG, Perry MA, Johnson LD, Jarvis BP, Pecko JA, Humphries JL, Watkins EY.","first_author":"Beymer MR","journal":"Archives of sexual behavior","year":2021,"pub_types":["Journal Article"],"keywords":["Intimate Partner Violence","Us Army","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"secondary analysis of cross‑sectional survey of US Army soldiers (n=9,052)","sample_n":9052,"sample_text":"large convenience sample of soldiers; not a probability or nationally representative sample","population":"US Army soldiers stationed at a single installation (2018)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 9,000 U.S. Army soldiers, those who reported using pornography each week were 1.7–3.6 times more likely to say they had ever committed intimate partner violence, even after accounting for age, gender, drinking, depression and other factors.","clinical_takeaway":"Higher pornography use is linked to increased reports of IPV among soldiers, but the direction of effect is unclear; clinicians should consider multiple risk factors when assessing IPV risk.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Very large sample size","Controls for a range of relevant covariates (depression, PTSD, substance use)","Clear statistical model (negative binomial regression)"],"limitations":["Cross‑sectional design; cannot infer causality","Pornography use measured with a single‑item frequency question","No assessment of masturbation or moral/religious attitudes that could confound the association","Sample limited to one military installation, limiting generalisability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-01924-x"}},{"id":1381,"doi":"10.1007/s10508-021-01931-y","pmid":"34165642","pmcid":null,"title":"Are We Losing the Most Relevant Cases First? Selective Dropout in Two Longitudinal Studies of Adolescent Pornography Use","authors":"Štulhofer A, Matković T, Kohut T, Koletić G, Buško V, Landripet I, Vodopijevec A.","first_author":"Štulhofer A","journal":"Archives of sexual behavior","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescents","Panel Attrition","Pornography Use","Probiops","Selective Dropout"],"is_oa":false,"oa_url":"http://idiprints.knjiznica.idi.hr/948/1/AoSB%202021_5%20%C5%A0tulhofer%2C%20Matkovi%C4%87%2C%20Kohut%2C%20Koleti%C4%87%2C%20Bu%C5%A1ko%2C%20Landripet%2C%20Vodopijevec.pdf","cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"analysis of attrition in two large‑scale adolescent panels (online and classroom‑based)","sample_n":null,"sample_text":"two independent large‑scale panel studies (exact N not provided in abstract)","population":"adolescents (age not specified)","country":"Croatia (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined two big adolescent studies and found that the most at‑risk teens are more likely to drop out early, especially in classroom‑based panels. This selective loss could bias findings about porn use, so they suggest ways to keep vulnerable participants in studies.","clinical_takeaway":"Researchers should plan to retain vulnerable adolescents in longitudinal porn‑use studies to avoid biased results.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","measurement","religiosity","moral_incongruence"],"strengths":["Large, independent panel datasets","Focus on a methodological issue (selective dropout) often ignored","Provides practical guidelines to mitigate attrition"],"limitations":["No information on validated measures of pornography use","Key confounds (e.g., moral incongruence, mental health) not addressed","Abstract lacks detail on statistical power or effect‑size reporting"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-01931-y"}},{"id":1382,"doi":"10.1002/ab.21597","pmid":"26174353","pmcid":null,"title":"A dangerous boomerang: Injunctive norms, hostile sexist attitudes, and male-to-female sexual aggression","authors":"Bosson JK, Parrott DJ, Swan SC, Kuchynka SL, Schramm AT.","first_author":"Bosson JK","journal":"Aggressive behavior","year":2015,"pub_types":["Journal Article"],"keywords":["Social Norms","Sexual Aggression","Hostile Sexism","Benevolent Sexism","Boomerang"],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory behavioural analogue with randomised injunctive norm exposure (n=201).","sample_n":201,"sample_text":"201 adult men","population":"Heterosexual adult men recruited online, mixed age.","country":"Not specified (online sample, likely USA/English‑speaking).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In an online experiment, men exposed to messages about how other men think women should be treated showed more sexual aggression if they already held hostile sexist attitudes, suggesting that norm‑based interventions can backfire for some men.","clinical_takeaway":"Norm‑based programs should consider participants' sexist attitudes to avoid unintended increases in aggression.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Experimental manipulation with random assignment","Behavioural measure of aggression provides objective data","Adequate sample size for experimental design"],"limitations":["Constructs measured with limited validation detail in abstract","Potential self‑selection bias from online recruitment","No assessment of key confounds (mental health, trauma, etc.)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":69,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ab.21597"}},{"id":1383,"doi":"10.1177/10778012211021125","pmid":"34156884","pmcid":"PMC8941712","title":"Hijab Pornography: A Content Analysis of Internet Pornographic Videos","authors":"Mirzaei Y, Zare S, Morrison TG.","first_author":"Mirzaei Y","journal":"Violence against women","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Exploitation","Content analysis","Aggression","Agency","Objectification","Hijab Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8941712","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"content analysis of 50 hijab‑porn videos, coding for aggression, objectification, exploitation, agency","sample_n":50,"sample_text":"50 hijab pornographic videos selected from the Internet","population":"Internet videos (no human participants)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers examined 50 online porn videos featuring women wearing hijab and found that all showed aggressive acts, especially gagging and spanking. Women were portrayed as more objectified and less able to act on their own compared with men.","clinical_takeaway":"None – study describes video content, not health effects.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["first systematic description of hijab‑porn content","clear focus on aggression and agency","transparent coding of specific acts"],"limitations":["small video sample, possible selection bias","coding scheme not validated","no linkage to viewer outcomes or health measures"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10778012211021125"}},{"id":1385,"doi":"10.1186/s40359-026-04419-3","pmid":"41872913","pmcid":"PMC13134161","title":"Cannabis consumption and problematic internet use: analysis of a free-text response collected through a self-reported online questionnaire","authors":"St-Onge J, Brodeur M, Légaré AA, Deschamps A, Auger AM, Muñoz Gómez N, Hudon C, Jutras-Aswad D, Håkansson A, Parent V, Morvannou A.","first_author":"St-Onge J","journal":"BMC psychology","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Cannabis","Qualitative","Behavioral Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13134161","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative thematic analysis of open‑ended responses from an online self‑selected survey","sample_n":1388,"sample_text":"1388 participants provided open‑ended responses","population":"adult cannabis users in Quebec (self‑selected, online respondents)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A qualitative study of 1,388 Quebec adults who use cannabis explored how they think cannabis relates to their internet habits, including occasional online pornography. Participants reported both positive (relaxation, pain relief) and negative (anxiety, social isolation) effects, and some linked cannabis use with more online activity.","clinical_takeaway":"Clinicians should note that cannabis users may perceive varied impacts of their use on internet behavior, but evidence does not establish a causal link.","confidence":0.7,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Large number of qualitative responses (n=1388)","Provides participants' own perspectives","Identifies a range of perceived positive and negative effects"],"limitations":["Convenience, self‑selected online sample limits generalisability","No validated measures of cannabis use disorder or problematic internet use","No control of key confounds (e.g., mental health, moral attitudes)","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s40359-026-04419-3"}},{"id":1387,"doi":"10.1371/journal.pone.0127787","pmid":"26086606","pmcid":"PMC4472963","title":"Sex-Related Online Behaviors, Perceived Peer Norms and Adolescents' Experience with Sexual Behavior: Testing an Integrative Model","authors":"Doornwaard SM, ter Bogt TF, Reitz E, van den Eijnden RJ.","first_author":"Doornwaard SM","journal":"PloS one","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4472963","cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal survey of 1,132 Dutch adolescents (age 11‑17) with three waves; structural equation modeling to test relations among SEIM use, SNS use, peer norms, and sexual behavior experience.","sample_n":1132,"sample_text":"1132 Dutch adolescents, 52.7% boys","population":"Adolescents (13.9 y avg), Netherlands, school‑based sample","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Dutch teens, using sexually explicit web material and social networking sites was linked to higher perceived peer approval of sex, which in turn predicted more sexual activity over time.","clinical_takeaway":"Online sexual content and peer perceptions shape adolescent sexual behavior; prevention should address peer norms and digital media use.","confidence":0.7,"topic_tags":["sexual_function","adolescents","pornography"],"strengths":["Large longitudinal sample","Use of SEM to test indirect pathways","Focus on peer norms as a mediating factor"],"limitations":["Self‑report measures only","No assessment of mental‑health or other confounds","Potential selection bias (school‑based convenience sample)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0127787"}},{"id":1389,"doi":"10.1016/j.juro.2006.03.032","pmid":"16813919","pmcid":null,"title":"Brain processing of audiovisual sexual stimuli inducing penile erection: a positron emission tomography study","authors":"Tsujimura A, Miyagawa Y, Fujita K, Matsuoka Y, Takahashi T, Takao T, Matsumiya K, Osaki Y, Takasawa M, Oku N, Hatazawa J, Kaneko S, Okuyama A.","first_author":"Tsujimura A","journal":"The Journal of urology","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subject PET imaging of heterosexual men viewing three video conditions while penile rigidity was monitored in real time.","sample_n":null,"sample_text":"Not specified in abstract; likely small given PET methodology.","population":"Adult heterosexual male volunteers (sample size not reported in abstract)","country":"Japan (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used PET scans to see which brain areas light up when men watch sexual videos that cause an erection, finding activation in visual‑auditory and cerebellar regions.","clinical_takeaway":"Findings suggest specific brain regions are linked to erection, but the small, uncontrolled study limits direct clinical use.","confidence":0.6,"topic_tags":["neuroscience","sexual_function","adolescents"],"strengths":["Objective physiological measure of erection","Within‑subject design controls for individual variability","Use of PET provides direct measure of cerebral blood flow"],"limitations":["Likely small sample, no power justification","No control for moral, mental‑health or relational confounds","Speculative causal language beyond correlational data"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":5,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.juro.2006.03.032"}},{"id":1391,"doi":"10.1002/ab.21978","pmid":"34076267","pmcid":null,"title":"Pornography, impersonal sex, and sexual aggression: A test of the confluence model in a national probability sample of men in the U.S","authors":"Wright PJ, Paul B, Herbenick D.","first_author":"Wright PJ","journal":"Aggressive behavior","year":2021,"pub_types":["Journal Article"],"keywords":["Aggression","Assault","Confluence Model","Pornography","Impersonal Sex"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"National probability sample of U.S. men, self‑report survey; cross‑sectional analysis testing interaction of pornography exposure and impersonal sex on sexual aggression.","sample_n":null,"sample_text":"National Survey of Porn Use, Relationships, and Sexual Socialization (probability sample of U.S. men)","population":"Adult men in the United States, probability‑based sample","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Using a nationally representative U.S. survey, the study found that men who view extreme pornography and treat sex impersonally are more likely to report sexual aggression, supporting the Confluence Model of sexual violence.","clinical_takeaway":"Higher pornography exposure combined with impersonal sexual attitudes may signal increased risk for sexual aggression; consider these factors in risk assessments.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative probability sample","Tests a well‑established theoretical model (Confluence Model)","Inclusion of interaction term between pornography and impersonal sex"],"limitations":["Cross‑sectional design limits causal inference","No measurement or control of key confounds (moral incongruence, mental health, trauma, etc.)","Reliance on self‑report for sensitive behaviours"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":23,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ab.21978"}},{"id":1392,"doi":"10.31234/osf.io/ea9p4","pmid":null,"pmcid":null,"title":"Content Moderator Startle Response: A Qualitative Study","authors":"Bharucha T, Steiger ME, Mere R, Manchanda P.","first_author":"Bharucha T","journal":"PsyArXiv","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"In‑depth interviews / focus groups with 78 content moderators from two companies; thematic analysis of experiences across recruitment, training, and production phases.","sample_n":78,"sample_text":"78 respondents (38 from Philippines, 40 from Estonia).","population":"Content moderators (Philippines, Estonia) employed by TaskUs Inc. and Sutherland Global Services; tenure 0‑6 months.","country":"Philippines, Estonia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 78 content moderators in the Philippines and Estonia explored how repeatedly viewing graphic material, including pornography, triggers a startle response and how workplace practices affect habituation over the first six months of work.","clinical_takeaway":"None – the study informs occupational health for moderators, not client‑facing sexual health advice.","confidence":0.7,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["Large qualitative sample for this occupational group","Cross‑cultural (Philippines & Estonia) perspective","Clear thematic analysis linking recruitment, training, production to startle habituation"],"limitations":["No validated psychometric measures of startle response","Convenience sample from two firms limits generalisability","Lacks quantitative data or physiological verification"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/ea9p4"}},{"id":1393,"doi":"10.1007/s10943-018-0732-x","pmid":"30465262","pmcid":null,"title":"The Pornography Debate: Religiosity and Support for Censorship","authors":"Droubay BA, Butters RP, Shafer K.","first_author":"Droubay BA","journal":"Journal of religion and health","year":2021,"pub_types":["Journal Article"],"keywords":["Public Health","Censorship","Religiosity","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative survey (GSS) with logistic regression analysis","sample_n":1676,"sample_text":"Nationally representative General Social Survey 2014 respondents (n=1676)","population":"United States adults, N=1676","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a national US survey, the study found that people who are more religious are far more likely to support laws that censor pornography.","clinical_takeaway":"None – the study addresses policy attitudes, not clinical treatment.","confidence":0.9,"topic_tags":["religiosity","csbd"],"strengths":["Large, nationally representative sample","Clear statistical modeling with odds ratios","Relevant to public‑health policy debate"],"limitations":["Cross‑sectional; cannot infer causality","Religiosity measured with limited detail","No assessment of participants' pornography use or related distress"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-018-0732-x"}},{"id":1395,"doi":"10.3389/fpsyg.2026.1754046","pmid":"41924059","pmcid":"PMC13036647","title":"Protocol for AI-based prediction of problematic digital technology use among Indian youth: a Centre for Advanced Research on Addictive Behaviours initiative","authors":"Balhara YPS, Ranjan R, Sarkar S, Kaur S, Ganesh R, Kattimani S, Saxena V, Das S, Dhiman V, Bhargava R, Joshi T, Majumdar A, Singh S, Patra BN.","first_author":"Balhara YPS","journal":"Frontiers in psychology","year":2026,"pub_types":["methods-article","Journal Article"],"keywords":["Depression","Anxiety","Addiction","Machine Learning","Youth Mental Health","Digital Addiction","Ai-Based Predictive Model","Problematic Technology Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13036647","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"protocol for a multi‑center prospective cohort using AI/ML to predict problematic digital technology use including pornography among Indian youth","sample_n":null,"sample_text":"planned multi‑site recruitment; exact numbers not stated","population":"students ≥12 years from schools/colleges in six Indian cities","country":"India","controls_mi":"no","preregistered":true,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A planned study will recruit Indian youth from schools and colleges to collect many psychological and digital‑use measures, then apply AI to predict who may develop problematic technology habits, including watching porn. The protocol describes the design but does not yet show results.","clinical_takeaway":"None – study has not produced findings yet.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large, multi‑site planned sample","Use of validated instruments for many predictors","Pre‑registered protocol with explainable AI approach"],"limitations":["No details on how pornography‑specific problematic use will be measured","Moral incongruence, masturbation, mental‑health and trauma covariates not addressed","No current data; appraisal based on protocol only"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2026.1754046"}},{"id":1396,"doi":"10.1080/0092623x.2023.2267546","pmid":"37867385","pmcid":null,"title":"\"We Felt Emotionally Closer:\" A Qualitative Study of Couples' Communication about Pornography Use","authors":"Engelkamp E, Lindberg E, Córdova JV.","first_author":"Engelkamp E","journal":"Journal of sex & marital therapy","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional online survey with reflexive thematic analysis of 146 individuals in committed relationships","sample_n":146,"sample_text":"146 individuals (77.3% women) in committed relationships","population":"Adults in committed relationships (predominantly women)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A qualitative study of 146 partnered adults examined how couples talk about pornography. Five main themes emerged, showing that communication can be vulnerable, supportive, or conflicted, and offering suggestions for healthier discussions.","clinical_takeaway":"Clinicians can use the identified communication themes to guide couples in discussing pornography use constructively.","confidence":0.7,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Large qualitative sample for thematic analysis","Focus on dyadic communication, an under‑studied area","Clear analytic framework (behavioral intimacy theory)"],"limitations":["Convenience online recruitment, limited generalisability","No measurement of key confounds (moral incongruence, mental health, etc.)","No quantitative validation of themes or impact on relationship outcomes"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2023.2267546"}},{"id":1397,"doi":"10.47626/2237-6089-2020-0090","pmid":"34043899","pmcid":"PMC8638714","title":"Problematic consumption of online pornography during the COVID-19 pandemic: clinical recommendations","authors":"Marchi NC, Fara L, Gross L, Ornell F, Diehl A, Kessler FHP.","first_author":"Marchi NC","journal":"Trends in psychiatry and psychotherapy","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Clinical features","Mental health","Pandemics","Online Pornography","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8638714","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/clinical recommendation article without original empirical data","sample_n":null,"sample_text":"none (commentary)","population":"general adult population (inferred)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how COVID‑19 lockdown may have increased online pornography use and offers clinical suggestions, but it does not present new data or systematic review evidence.","clinical_takeaway":"Clinicians should be cautious interpreting increased porn use during lockdown as pathological without empirical assessment.","confidence":0.8,"topic_tags":["pornography","csbd","moral_incongruence","sexual_function"],"strengths":["addresses timely pandemic context","high clinical relevance"],"limitations":["no original data","lacks systematic evidence synthesis","no measurement of key confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.47626/2237-6089-2020-0090"}},{"id":1398,"doi":"10.1080/00918369.2021.1919477","pmid":"34009104","pmcid":null,"title":"\"Almost Looks Illegal\": Family Dick's <i>Daddy's Little Boy</i> Gay Pornography Series and Its Too-Young Look","authors":"Brennan J.","first_author":"Brennan J.","journal":"Journal of homosexuality","year":2022,"pub_types":["Journal Article"],"keywords":["Cultural Studies","Child Pornography","Gay Pornography","Family Dick","Extreme Pornography","Legislative Language","Youthful-adult Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"textual analysis of online viewer comments from a single porn site; convenience sample; no systematic sampling; no quantitative measures","sample_n":null,"sample_text":"More than 700 comments were selected for analysis (selection criteria not detailed).","population":"readers of a gay pornography website; not representative of general population","country":"Not specified (likely United States/English‑language Internet)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article examines how viewers discuss a gay porn series that depicts a stepfather‑son scenario and a youthful appearance, using a qualitative reading of over 700 online comments to explore cultural and legal perceptions.","clinical_takeaway":"None – the study does not provide evidence relevant to clinical assessment or treatment of sexual health issues.","confidence":0.7,"topic_tags":["pornography","csbd","sexual_function"],"strengths":["Novel qualitative focus on viewer discourse","Large number of comments analyzed"],"limitations":["Non‑representative, self‑selected sample","No validated constructs or measures","No quantitative analysis or statistical power"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2021.1919477"}},{"id":1399,"doi":"10.1080/19317611.2021.1918310","pmid":"38595747","pmcid":"PMC10903670","title":"Self-Assessed Effects of Pornography Use on Personal Sex Life: Results from a Large-Scale Study of Norwegian Adults","authors":"Koletić G, Štulhofer A, Hald GM, Træen B.","first_author":"Koletić G","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Pornography","Sexually Explicit Material","Impact Of Pornography Use","Self-assessed Effects"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large probability‑based sample of Norwegian adults (N=4,160); self‑report questionnaire on perceived impact of pornography on personal sex life; cross‑sectional analysis of sociodemographic and sexual predictors.","sample_n":4160,"sample_text":"probability‑based national sample of adults","population":"Norwegian adults, community‑based probability sample","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationwide Norwegian survey of over 4,000 adults, most people said porn didn’t affect their sex lives, about a third reported positive effects, and a quarter reported mixed or negative effects. Relationship satisfaction and intimacy didn’t explain these self‑ratings.","clinical_takeaway":"Clients’ own views on porn’s impact vary; clinicians should explore personal perceptions rather than assume universal harm or benefit.","confidence":0.78,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["large, nationally representative sample","examines both positive and negative self‑perceived effects","includes relationship variables"],"limitations":["Relies on a single, non‑validated self‑rating item","Cross‑sectional; cannot infer causality","Key confounds (moral incongruence, masturbation, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":3,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2021.1918310"}},{"id":1400,"doi":"10.1371/journal.pone.0181198","pmid":"28727762","pmcid":"PMC5519052","title":"Sexual diversity in the United States: Results from a nationally representative probability sample of adult women and men","authors":"Herbenick D, Bowling J, Fu TJ, Dodge B, Guerra-Reyes L, Sanders S.","first_author":"Herbenick D","journal":"PloS one","year":2017,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0181198&type=printable","cited_by_count":113,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional nationally representative probability survey of 2,021 U.S. adults reporting lifetime and recent sexual behaviours.","sample_n":2021,"sample_text":"Nationally representative probability sample (GfK KnowledgePanel) of 975 men and 1,046 women.","population":"U.S. adults (community sample, probability panel).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2015 survey of 2,021 U.S. adults found that most people have tried a wide variety of sexual activities, including masturbation, vaginal and oral sex, and watching porn, with many also reporting interest in less common behaviors. The study maps how common these practices are in the general population.","clinical_takeaway":"Sexual behaviours are diverse and common; clinicians should approach sexual health without assuming any activity is pathological.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative probability sample","Broad range of sexual behaviours captured","Clear reporting of prevalence estimates"],"limitations":["Self‑report data, potential recall/social desirability bias","No validated psychometric scales for constructs","Limited assessment of potential confounding variables"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":14,"contrasting":0,"mentioning":127,"citing_publications":203,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0181198"}},{"id":1402,"doi":"10.1016/j.abrep.2021.100350","pmid":"34041356","pmcid":"PMC8144352","title":"Internet pornography exposures amongst young people in Malaysia: A cross-sectional study looking into the role of gender and perceived realism versus the actual sexual activities","authors":"Zohor Ali AA, Muhammad NA, Jamil TR, Ahmad S, Abd Aziz NA.","first_author":"Zohor Ali AA","journal":"Addictive behaviors reports","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Gender","Adolescents","Pornography","Perceived Realism"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8144352","cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 986 college students in Penang, Malaysia, using a self‑administered questionnaire on pornography exposure, usage patterns and perceived realism.","sample_n":986,"sample_text":"986 participants","population":"College students aged 18‑25 years (convenience sample from seven colleges in Penang, Malaysia)","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 986 Malaysian college students, about three‑quarters had viewed online pornography. Males were far more likely to have been exposed, and those who thought porn was realistic were slightly less likely to have viewed it. The study suggests parental monitoring and structured activities to reduce exposure.","clinical_takeaway":"High rates of porn exposure among young males suggest the need for parental guidance on internet use, but no direct clinical implications.","confidence":0.75,"topic_tags":["pornography","prevalence","gender","adolescents","sexual_function"],"strengths":["Large sample for a regional survey","Clear reporting of prevalence and gender differences","Use of adjusted odds ratios with confidence intervals"],"limitations":["Self‑report measures, no validated instruments","Convenience sample limits generalisability","No assessment of key confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":22,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.abrep.2021.100350"}},{"id":1403,"doi":"10.1089/cpb.2007.0054","pmid":"18422408","pmcid":null,"title":"Early sexual experiences: the role of Internet access and sexually explicit material","authors":"Kraus SW, Russell B.","first_author":"Kraus SW","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience survey of 437 adults assessing self‑reported age of first oral sex, age of first intercourse, number of partners, and retrospective exposure to internet access and X‑rated movies during ages 12‑17.","sample_n":437,"sample_text":"Online volunteer sample (average age 29.46, n=437).","population":"Adults (mean age 29.5) recruited via the internet; not a probability or clinical sample.","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a web survey of 437 adults, those who had home internet access and watched X‑rated movies as teens reported starting oral sex and intercourse at younger ages than peers without such access.","clinical_takeaway":"Early internet exposure to sexual material is linked to earlier sexual initiation, but causality is unclear; clinicians should consider broader developmental factors.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a survey (n≈437).","Focus on a specific developmental window (age 12‑17)."],"limitations":["Self‑report, retrospective measures; possible recall bias.","No validated scales for pornography exposure or sexual outcomes.","Critical confounds (moral incongruence, masturbation, mental health, relationship context, trauma) not measured.","Cross‑sectional design cannot infer causality."],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":24,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cpb.2007.0054"}},{"id":1405,"doi":"10.1080/13218719.2021.1904447","pmid":"35693384","pmcid":"PMC9186365","title":"Child pornography possession/receipt offenders: developing a forensic profile","authors":"Elbert MJ, Drury AJ, DeLisi M.","first_author":"Elbert MJ","journal":"Psychiatry, psychology, and law : an interdisciplinary journal of the Australian and New Zealand Association of Psychiatry, Psychology and Law","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["forensic science","Violence","Child Pornography","Sex Offender","Paraphilic Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective analysis of a population of male sexual offenders from a federal jurisdiction; exploratory post‑hoc profiling with validation component.","sample_n":null,"sample_text":"population of male offenders ... central United States (exact N not provided in abstract)","population":"Male offenders who had ever perpetrated a sexual offense (U.S. central federal jurisdiction)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examined records of male sex offenders who possessed or received child pornography, creating a profile that linked such offenses to self‑reported abuse of young children and to broader antisocial traits like early arrests and childhood adversity.","clinical_takeaway":"None – the findings pertain to forensic profiling of offenders, not to clinical treatment of consensual pornography use or sexual health.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses official criminal records and self‑reports within a defined offender population","Controls for several robust antisocial indicators (ASPD, ACEs, age, race)","Provides exploratory validation of a forensic profile"],"limitations":["Cross‑sectional, post‑hoc design limits causal inference","Sample limited to convicted male offenders; not generalisable to broader populations","No measurement of moral, relational or mental‑health variables beyond antisocial traits"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13218719.2021.1904447"}},{"id":1406,"doi":"10.31234/osf.io/xmk7h","pmid":null,"pmcid":null,"title":"Testing the Confluence Model of the Association between Pornography Use and Sexual Aggression: A Longitudinal Assessment in Two Independent Adolescent Samples","authors":"Kohut T, Landripet I, Stulhofer A.","first_author":"Kohut T","journal":"PsyArXiv","year":2019,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/xmk7h","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two independent panel samples of male Croatian adolescents assessed over time; generalized linear mixed modeling used to test interactions between hostile masculinity, impersonal sexuality, pornography use, and later sexual aggression.","sample_n":null,"sample_text":"Two independent adolescent panels (exact N not reported in abstract)","population":"Adolescent males (Croatian)","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A two‑year study of Croatian teenage boys found that while hostile attitudes predicted later sexual aggression, pornography use did not increase the odds of such behavior, even for those already predisposed.","clinical_takeaway":"Current evidence does not support blaming pornography use as a causal factor for adolescent sexual aggression.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Longitudinal design allows temporal ordering","Two independent samples increase robustness","Use of mixed‑effects modeling"],"limitations":["Abstract gives no detail on sample size or power","No measurement of key confounds (e.g., moral incongruence, mental health)","Unclear whether pornography use measures differentiate frequency from distress"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/xmk7h"}},{"id":1407,"doi":"10.1080/00224499.2023.2257687","pmid":"37772929","pmcid":null,"title":"Let's Talk About Sex(ual Health): Young Adult Women's Disclosure of Their Pornography Use to Their Romantic Partners","authors":"Galper EF, Tindage MF.","first_author":"Galper EF","journal":"Journal of sex research","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Cross‑sectional qualitative study using open‑ended survey responses from 32 young adult women, thematic analysis.","sample_n":32,"sample_text":"32 young adult women","population":"Young adult women (mean age 20.8) in romantic relationships.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a small interview‑style survey, 32 young women described why they told their partners they watched porn and how it affected their relationships. More in‑depth talks were linked to more positive changes.","clinical_takeaway":"Encouraging open, thoughtful conversation about pornography use may foster healthier relationship dynamics.","confidence":0.78,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Focus on women's perspective on disclosure","Thematic analysis provides rich qualitative insight","Identifies relational outcomes linked to depth of conversation"],"limitations":["Very small, non‑random sample limits generalisability","No validated measurement instruments","No assessment of potential confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2257687"}},{"id":1408,"doi":"10.1080/19317611.2026.2637633","pmid":"42683330","pmcid":null,"title":"Mapping Partnered Sex and Solitary Masturbation: A Cluster Analysis","authors":"Cervilla O, Gómez-Berrocal C, Sierra JC.","first_author":"Cervilla O","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2026,"pub_types":["Journal Article"],"keywords":["Couples","Sociodemographic Variables","Partnered Sex","Solitary Masturbation","Masturbation-related Variables"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"secondary analysis of cross-sectional survey (N = 1028) examining clusters of partnered sex and solitary masturbation frequencies in heterosexual adults","sample_n":1028,"sample_text":"1028 heterosexual adults aged 18‑75 years","population":"heterosexual adults (18‑75 y) from an unspecified community sample","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study clustered 1,028 heterosexual adults into three groups based on how often they have sex with a partner and how often they masturbate. Differences were found between groups in age of first masturbating, attitudes, reasons for masturbating, desire, orgasm experience, and porn use, highlighting how masturbation relates to couple sexual health.","clinical_takeaway":"Masturbation patterns vary alongside partnered sex and may influence sexual health; clinicians should consider both together in assessments.","confidence":0.85,"topic_tags":["masturbation","sexual_function"],"strengths":["Large community sample (N>1000)","Novel clustering of partnered vs solitary sexual activity","Inclusion of multiple masturbation‑related variables"],"limitations":["Cross‑sectional; no causal inference","Reliance on self‑report frequency measures","No assessment of key confounds (moral incongruence, mental health, trauma)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2026.2637633"}},{"id":1409,"doi":"10.1177/08862605251403618","pmid":"41777081","pmcid":"PMC13009674","title":"A Descriptive Study of the Attitudes, Characteristics and Behaviours Differentiating Men Who Do and Do Not Want Help for Their Sexual Interest in Children","authors":"Salter M, Whitten T, Woodlock D, Lu M, Lamond M, Naldrett G, Tyler M.","first_author":"Salter M","journal":"Journal of interpersonal violence","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Prevention","Child Maltreatment","Violence Prevention","Internet And Abuse","Technology- Or Image-based Abuse","Offenders/perpetrators"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13009674","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 4,918 men from representative samples in three countries; descriptive comparison of sub‑groups (sexual interest in children, help‑seeking vs. not).","sample_n":4918,"sample_text":"large community sample, but subgroup of interest n≈642","population":"adult men, community‑based (Australia, UK, USA)","country":"Australia; United Kingdom; United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of nearly 5,000 men in three countries identified 642 who reported a sexual interest in children. Compared with men who did not want help, those who did were more likely to be married, work with children, and have other deviant interests, suggesting concern for personal relationships motivates help‑seeking.","clinical_takeaway":"Help‑seeking among men with sexual interest in children may be driven by relationship concerns; prevention programs should address these motivations.","confidence":0.6,"topic_tags":["sexual_function","prevalence"],"strengths":["large, multi‑country community sample","focus on help‑seeking motivation","identifies distinct psychosocial correlates"],"limitations":["self‑report of sexual interest may be biased","cross‑sectional, no causal inference","limited measurement of mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605251403618"}},{"id":1410,"doi":"10.1177/08862605251403606","pmid":"41777082","pmcid":"PMC12960783","title":"Differentiating Men With Sexual Interest in Children and Those Involved in Sexual Behaviour With Children","authors":"Woodlock D, Whitten T, Salter M, Lamond M, Slater C, Fry D.","first_author":"Woodlock D","journal":"Journal of interpersonal violence","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Abuse","Sexual Assault","Child Maltreatment","Perpetrators","Offenders"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12960783","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 4,918 adult men from Australia, US, UK; logistic regression with LASSO; representative sample","sample_n":4918,"sample_text":"Representative adult male population from Australia, United States, United Kingdom","population":"adult men (general population) reporting sexual interest/behaviour towards children","country":"Australia, United States, United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of nearly 5,000 men in three English‑speaking countries identified distinct groups based on self‑reported sexual interest in and sexual behaviour with children. Those reporting both interest and behaviour were more likely to watch violent pornography, have higher anxiety and depression, and hold more permissive attitudes toward child sexualisation.","clinical_takeaway":"Risk factors such as violent pornography use and mental‑health symptoms differ across groups; prevention efforts should consider these distinct profiles.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, demographically representative sample","Use of multivariable LASSO regression with cross‑validation","Clear operational definitions of interest vs behaviour"],"limitations":["Reliance on self‑report without validated sexual‑interest scales","No measurement of moral incongruence or masturbation","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605251403606"}},{"id":1415,"doi":"10.1007/s10508-025-03379-w","pmid":"41761026","pmcid":null,"title":"Concurrent and Longitudinal Associations Between In-Person and Online Sexual Behaviors and Sexual Subjectivity in Heterosexual, Cisgender, and Sexual and Gender Minority Adolescents","authors":"Paquette MM, Dion J, Bőthe B, O'Sullivan LF, Girouard A, Bergeron S.","first_author":"Paquette MM","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Adolescents","Sexual Behaviors","Sexual Minority","Sexual Subjectivity","Online Sexual Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort with two waves, autoregressive cross‑lagged modeling, multi‑group analysis (gender/sexual orientation)","sample_n":3150,"sample_text":"large community sample of adolescents","population":"3150 heterosexual, cisgender, sexual‑ and gender‑minority adolescents (mean age ~15‑16)","country":"unspecified (likely Canada/Europe based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a two‑year study of 3,150 adolescents, researchers found that feeling confident about one’s sexuality (sexual subjectivity) predicted more oral sex, intercourse and sexting later, but pornography use and masturbation did not affect sexual subjectivity. No reverse effects were seen.","clinical_takeaway":"Sexual subjectivity appears to shape certain sexual activities in adolescents, while pornography use does not seem to influence it.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, diverse adolescent sample","Longitudinal design permits testing directionality","Advanced cross‑lagged modeling","Separate analysis of various sexual behaviors"],"limitations":["Reliance on self‑report for pornography and masturbation","No control for moral, mental‑health or trauma variables","Unclear whether sexual subjectivity scale is fully validated"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03379-w"}},{"id":1417,"doi":"10.1177/14747049211028798","pmid":"34180252","pmcid":"PMC10355306","title":"Why Do People Watch Porn? An Evolutionary Perspective on the Reasons for Pornography Consumption","authors":"Burtăverde V, Jonason PK, Giosan C, Ene C, Ene C.","first_author":"Burtăverde V","journal":"Evolutionary psychology : an international journal of evolutionary approaches to psychology and behavior","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sex differences","Evolutionary Psychology","Sociosexuality","Pornography Consumption","Dark Triad Traits"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10355306","cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Three independent online surveys (N≈276‑327) using open‑ended items, factor analysis and CFA to derive reasons for pornography consumption.","sample_n":327,"sample_text":"Combined sample across three studies (N=276, 322, 327).","population":"Adults (likely community sample, recruitment not specified).","country":"Not stated (likely Romania based on author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors surveyed adults about why they watch porn, identified 78 reasons, and grouped them into four themes (sex drive, performance, social/instrumental, and relational skills). Those who endorsed these reasons also scored higher on traits like sociosexuality and the Dark Triad.","clinical_takeaway":"None – the study describes motivations, not health effects or treatment implications.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Large sample sizes for factor‑analytic work.","Systematic bottom‑up approach to generate items."],"limitations":["Ad‑hoc, unvalidated items for reasons.","No control for moral or mental‑health variables.","Cross‑sectional, self‑report only."],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":17,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/14747049211028798"}},{"id":1418,"doi":"10.1007/s10508-014-0302-6","pmid":"24917484","pmcid":null,"title":"Stumbling into sexual crime: the passive perpetrator in accounts by male internet sex offenders","authors":"Winder B, Gough B, Seymour-Smith S.","first_author":"Winder B","journal":"Archives of sexual behavior","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative interview study with 7 convicted internet child sex offenders; discursive analysis of semi‑structured interviews.","sample_n":7,"sample_text":"Seven individuals convicted of internet‑based sexual offences involving child sexual exploitation material.","population":"Male adult offenders convicted in the United Kingdom; recruited from criminal justice records.","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with seven men convicted of viewing child sexual images reveal how they downplay responsibility, manage their self‑identity, and distance themselves from the label of a sex offender.","clinical_takeaway":"None – study focuses on offender narratives, not clinical treatment of pornography use.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["In‑depth qualitative insight into offender narratives","Use of discursive methods to capture identity management"],"limitations":["Very small, non‑representative sample (N=7)","No standardized measures; limited generalisability","Potential social desirability bias in offender accounts"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":23,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0302-6"}},{"id":1420,"doi":"10.1177/00243639231199058","pmid":"39104464","pmcid":"PMC11298102","title":"The Medical, Sociological, Psychological, Religious, and Spiritual Aspects of Masturbation and a Potential Approach to Therapy Based on Catholic Teaching and Virtues Psychology","authors":"Vitz PC, Williams WV.","first_author":"Vitz PC","journal":"The Linacre quarterly","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Regression","Depression","Anxiety","Masturbation","Relationship Quality","Narcissism","Positive Psychology","Hypersexual","Virtues","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd","masturbation","pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative literature review with theological discussion and therapy proposal; no original empirical data, no sample reported.","sample_n":null,"sample_text":"none (review article)","population":"not applicable","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article reviews existing research on masturbation’s medical, psychological, social and spiritual effects, contrasting secular views (often positive) with Catholic teachings (negative). It proposes a therapy using positive‑psychology virtues to help people who feel conflicted about masturbating.","clinical_takeaway":"Clinicians should note that reported links between masturbation and distress may be confounded by moral or religious factors; therapy can incorporate virtue‑building strategies if aligned with client values.","confidence":0.7,"topic_tags":["masturbation","religiosity","sexual_function","csbd"],"strengths":["Broad interdisciplinary literature survey","Integrates theological perspective with positive‑psychology framework"],"limitations":["No original data; conclusions based on secondary sources","Lacks systematic review methodology and risk‑of‑bias assessment","Potential religious bias influencing interpretation"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00243639231199058"}},{"id":1422,"doi":"10.1016/j.pscychresns.2021.111284","pmid":"33774451","pmcid":null,"title":"No evidence for decreased D2/3 receptor availability and frontal hypoperfusion in subjects with compulsive pornography use","authors":"Stormezand GN, Doorduin J, Chaves LT, García DV, Nienhuis FJ, Schoevers RA, Kremer BPH, Booij J, Dierckx RAJO.","first_author":"Stormezand GN","journal":"Psychiatry research. Neuroimaging","year":2021,"pub_types":["Journal Article"],"keywords":["Cerebral blood flow","Dopaminergic Imaging","Pornographic Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Case‑control PET/ASL imaging study comparing 15 males with compulsive pornography use (CPU) to 10 controls.","sample_n":25,"sample_text":"15 CPU, 10 non‑CPU","population":"Male adults 18‑50 recruited via ads; convenience sample.","country":"Netherlands (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A PET and MRI study compared brain dopamine receptor availability and blood flow in 15 men with compulsive pornography use to 10 controls and found no differences, suggesting no clear neurobiological signature of addiction.","clinical_takeaway":"Current imaging evidence does not support distinct dopamine or frontal blood‑flow changes in compulsive pornography use.","confidence":0.8,"topic_tags":["pornography","neuroscience","csbd"],"strengths":["Use of validated PET ligand ([11C]-raclopride)","Inclusion of control group","Assessment of multiple psychiatric covariates"],"limitations":["Small sample size limits power","No measurement of moral incongruence or masturbation","Addiction construct inferred from CIUS without testing core criteria"],"rubric_version":"2.0","raw_total":35,"max_possible":70,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":4,"statistics":4,"confounds":5,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pscychresns.2021.111284"}},{"id":1423,"doi":"10.1177/1077801221996453","pmid":"33750244","pmcid":"PMC8474329","title":"\"I Don't Hate All Women, Just Those Stuck-Up Bitches\": How Incels and Mainstream Pornography Speak the Same <i>Extreme</i> Language of Misogyny","authors":"Tranchese A, Sugiura L.","first_author":"Tranchese A","journal":"Violence against women","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Corpus Linguistics","Pornography","Incels","Online Misogyny"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8474329","cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Corpus linguistics analysis of Reddit forum posts; convenience sample; no experimental manipulation; observational textual data.","sample_n":null,"sample_text":"Not reported in abstract; likely several thousand posts but exact n unknown.","population":"Reddit users posting in incel and pornography‑related forums (unspecified sample size).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compares language used by incels and mainstream pornography on Reddit, finding similar extreme misogynistic expressions, suggesting both may reinforce violence against women.","clinical_takeaway":"None – the paper does not provide evidence relevant to clinical assessment or treatment of sexual health issues.","confidence":0.7,"topic_tags":["pornography","csbd","sexual_function","gender"],"strengths":["Innovative interdisciplinary corpus linguistics approach","Links discourse across distinct online communities"],"limitations":["Convenience Reddit sample limits generalisability","No validated measures of misogyny or pornography exposure","No control for potential confounding variables"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":62,"citing_publications":110,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801221996453"}},{"id":1426,"doi":"10.3389/fpsyt.2021.623508","pmid":"33796031","pmcid":"PMC8007884","title":"Internet and Pornography Use During the COVID-19 Pandemic: Presumed Impact and What Can Be Done","authors":"Awan HA, Aamir A, Diwan MN, Ullah I, Pereira-Sanchez V, Ramalho R, Orsolini L, de Filippis R, Ojeahere MI, Ransing R, Vadsaria AK, Virani S.","first_author":"Awan HA","journal":"Frontiers in psychiatry","year":2021,"pub_types":["review-article","Review","Journal Article"],"keywords":["Mental health","Behavioral Addictions","Problematic Internet Use","Pornography","Covid-19"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2021.623508/pdf","cited_by_count":33,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review summarizing literature on pandemic‑related pornography use; no original data collected.","sample_n":null,"sample_text":"","population":"Not applicable (review article)","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"supports","citation_value":"useful","plain_summary":"The authors review reports that internet and pornography use rose during COVID‑19 lockdowns, suggest this may have harmful mental‑health effects, and discuss possible prevention and treatment strategies.","clinical_takeaway":"Be aware that pandemic‑related increases in pornography use have been reported, but evidence for direct harm is limited.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Broad international scope","Includes discussion of neurobiology and diagnostic debates"],"limitations":["Narrative (non‑systematic) synthesis","No primary data or systematic risk‑of‑bias assessment","Claims of causality without empirical support"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":5,"contrasting":0,"mentioning":45,"citing_publications":74,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2021.623508"}},{"id":1427,"doi":"10.1080/15546128.2023.2243807","pmid":"39391366","pmcid":"PMC11463728","title":"'My sex ed teacher was extremely averse to talking about sex': Massachusetts students' experiences with and recommendations for sex education","authors":"Rothman EF, Campbell JK, Rahimian AN, Frieson TM, Moslander DE, Richardson VE, Nelson KM.","first_author":"Rothman EF","journal":"American journal of sexuality education","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Relationships","Sex Education","Adolescent Health","Dating Violence","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview with 28 high‑school students in Massachusetts","sample_n":28,"sample_text":"28 participants recruited from high schools in Massachusetts (convenience sample)","population":"high‑school attending youth (Massachusetts, USA)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 28 Massachusetts high‑school students reveal that current sex‑education classes are seen as shallow and unhelpful, especially regarding topics like pornography. Students want deeper coverage of healthy relationships, body image, and the impact of porn, and suggest gamified lessons might work better.","clinical_takeaway":"Educators should consider expanding sex‑ed curricula to include nuanced discussions of pornography and relationship health, possibly using interactive formats.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides direct youth perspectives on sex‑education gaps","Identifies specific content areas (e.g., pornography) desired by students","Suggests innovative delivery methods (gamification)"],"limitations":["Small, non‑representative sample limits generalisability","No validated measurement instruments used","Lacks quantitative assessment of outcomes"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/15546128.2023.2243807"}},{"id":1428,"doi":"10.1080/19317611.2021.1888170","pmid":"38596752","pmcid":"PMC10903642","title":"Exploratory Findings on U.S. Adolescents' Pornography Use, Dominant Behavior, and Sexual Satisfaction","authors":"Wright PJ, Herbenick D, Paul B, Tokunaga RS.","first_author":"Wright PJ","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Dominance","Sexual Health","Sexual Satisfaction","Pornography","3Am"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"population-based probability survey of U.S. adolescents; cross‑sectional path analysis","sample_n":null,"sample_text":"small analytical sample, population‑based probability survey","population":"U.S. adolescents (sample size not reported in abstract; described as small analytical sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a U.S. adolescent survey, higher pornography exposure was linked to more sexually dominant acts (like choking) and lower sexual satisfaction. The study suggests these behaviors may mediate the relationship, but the data are cross‑sectional and based on a small sample.","clinical_takeaway":"Evidence is preliminary; clinicians should be cautious interpreting links between porn use, dominant behaviors, and teen sexual satisfaction.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Population‑based probability sample improves generalisability","Addresses understudied adolescent population","Explores mediating mechanism (dominant behaviors)"],"limitations":["Small analytical sample; likely under‑powered","Cross‑sectional; cannot establish causality","Measures appear ad‑hoc, not validated"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2021.1888170"}},{"id":1429,"doi":"10.1089/cyber.2020.0272","pmid":"33760666","pmcid":null,"title":"The Real Threat of Deepfake Pornography: A Review of Canadian Policy","authors":"Karasavva V, Noorbhai A.","first_author":"Karasavva V","journal":"Cyberpsychology, behavior and social networking","year":2021,"pub_types":["Journal Article"],"keywords":["Policy","Pornography","Deepfakes","Technology Facilitated Sexual Violence","Image Based Sexual Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary/policy review with no primary data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews how Canadian law currently fails to protect people whose faces are used in non‑consensual porn deepfakes. It outlines existing criminal, defamation, and copyright tools, argues they are insufficient, and recommends new legislation that specifically bans fake porn without consent.","clinical_takeaway":"None - not clinically applicable.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Comprehensive legal analysis","Identifies gaps in current Canadian law","Clear policy recommendations"],"limitations":["No empirical data on victim experiences","Limited to Canadian context","Does not assess effectiveness of suggested reforms"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":87,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2020.0272"}},{"id":1430,"doi":"10.1080/19317611.2021.1888839","pmid":"38596757","pmcid":"PMC10903674","title":"How Human Values Relate to Attitudes Toward Pornography: A Portuguese Survey","authors":"Castro R, Lins S.","first_author":"Castro R","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Values","Portugal","Attitudes","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of Portuguese adults, online questionnaire","sample_n":null,"sample_text":"Not reported in abstract; likely convenience/online sample","population":"Portugal","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A Portuguese survey found that people who value personal pleasure, sexuality, and power tend to have more positive attitudes toward pornography, while those who prioritize social values like religiosity tend to view it more negatively.","clinical_takeaway":"Clinicians might consider clients' personal values when discussing pornography use.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Uses validated values questionnaire","Introduces a novel angle linking human values to porn attitudes","Clear statistical associations reported"],"limitations":["Cross‑sectional, cannot infer causality","No control for key confounds (moral incongruence, masturbation, mental health)","Sampling method unclear; likely non‑representative"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2021.1888839"}},{"id":1431,"doi":"10.3390/ijerph18042181","pmid":"33672240","pmcid":"PMC7926792","title":"Intimate Partner Cyberstalking, Sexism, Pornography, and Sexting in Adolescents: New Challenges for Sex Education","authors":"Rodríguez-Castro Y, Martínez-Román R, Alonso-Ruido P, Adá-Lameiras A, Carrera-Fernández MV.","first_author":"Rodríguez-Castro Y","journal":"International journal of environmental research and public health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Adolescent","Sexism","Sexuality Education","Sexting","Pornography Consumption","Intimate Partner Cyberstalking"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/18/4/2181/pdf?version=1614164851","cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 993 Spanish secondary students; hierarchical multiple regression used to examine predictors of intimate partner cyberstalking.","sample_n":993,"sample_text":"993 Spanish secondary education students (535 girls, 458 boys)","population":"Adolescents (mean age 15.75) in secondary education, Spain","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Spanish adolescents, boys use more pornography and sext, but girls report more intimate‑partner cyberstalking. Hostile sexism predicts cyberstalking, and interactions between gender, porn use and sexism also matter.","clinical_takeaway":"Sex education programmes should address sexism and online behaviours, not just pornography consumption.","confidence":0.8,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Large sample size for adolescent population","Use of hierarchical regression to test multiple predictors","Inclusion of both gender and sexism variables"],"limitations":["Cross‑sectional design limits causal inference","Key confounds (e.g., mental health, moral incongruence) not measured","Reliance on self‑report for porn use and sexting"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":11,"contrasting":0,"mentioning":42,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph18042181"}},{"id":1432,"doi":"10.1007/s10461-008-9373-5","pmid":"18401701","pmcid":"PMC2574711","title":"An online needs assessment of a virtual community: what men who use the internet to seek sex with men want in Internet-based HIV prevention","authors":"Hooper S, Rosser BR, Horvath KJ, Oakes JM, Danilenko G, Men's INTernet Sex II (MINTS-II) Team.","first_author":"Hooper S","journal":"AIDS and behavior","year":2008,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":60,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online stratified survey of 2,716 men who use the Internet to seek sex with men; Likert items on acceptability of sexually explicit media and content interests.","sample_n":2716,"sample_text":"2,716 participants recruited through Gay.com, stratified by race/ethnicity.","population":"Men who use the Internet to seek sex with men (MISM), recruited via Gay.com; diverse racial/ethnic sample.","country":"United States (implied by NIH funding and Gay.com platform)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2005 online survey of 2,700 men who use the Internet to find sex partners found that most are comfortable with highly explicit HIV‑prevention material and want detailed sexual‑health content. Small differences were seen by age, race, education, HIV status, and risk behavior.","clinical_takeaway":"Web‑based HIV prevention can safely use explicit sexual imagery to engage men seeking sex online.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample size","Racial/ethnic stratification for diversity","Focused on acceptability of explicit content for HIV prevention"],"limitations":["Ad‑hoc, non‑validated survey items","Self‑selected Internet sample limits generalisability","No measurement of moral or psychological confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":2,"mentioning":68,"citing_publications":79,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-008-9373-5"}},{"id":1435,"doi":"10.1080/00224499.2025.2606768","pmid":"41661062","pmcid":null,"title":"A New Look at Sexual Behavior in Moving Vehicles Reported by Midwestern College Students","authors":"Struckman-Johnson C, Anderson P, Smeaton G.","first_author":"Struckman-Johnson C","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 967 Midwestern college students assessing self‑reported sexual activity in moving vehicles.","sample_n":967,"sample_text":"Convenience sample of enrolled students; not nationally representative.","population":"College students (primarily white, heterosexual) from a Midwestern university (N≈967).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 967 Midwestern college students found that about 29% had ever had sex in a moving vehicle, often with a serious partner. Many reported using phones during the act and linked it to unsafe driving. Most participants said it was fun, but the behavior was associated with higher rates of distracted‑driving incidents.","clinical_takeaway":"Educators should address the safety risks of sex in moving vehicles when teaching about sexual health and distracted driving.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a descriptive survey.","Provides novel data on a specific sexual context (moving vehicles).","Reports both risk (distracted driving) and perceived pleasure.","Clear descriptive statistics."],"limitations":["Self‑report, single‑item measures; no validated scales.","Convenience sample of a single university limits generalisability.","No control for moral, mental‑health or partner variables.","Cross‑sectional, cannot infer causality."],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2025.2606768"}},{"id":1437,"doi":"10.1177/1077801211409727","pmid":"21571742","pmcid":null,"title":"Preventing sexual aggression among college men: an evaluation of a social norms and bystander intervention program","authors":"Gidycz CA, Orchowski LM, Berkowitz AD.","first_author":"Gidycz CA","journal":"Violence against women","year":2011,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Evaluation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":225,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Cluster-randomised evaluation of a social‑norms and bystander intervention program with 635 first‑year men; self‑report outcomes measured at follow‑up.","sample_n":635,"sample_text":"N = 635 men from randomly selected first‑year dormitories","population":"first‑year college men (N=635) living in dormitories","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A campus program teaching men about peer norms and how to intervene when they see inappropriate behavior reduced self‑reported sexual aggression and lowered exposure to explicit media among 635 college men.","clinical_takeaway":"Bystander‑training and norm‑clarification can modestly decrease sexual aggression among college men.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a behavioral intervention","Randomly selected dormitories increase internal validity","Multiple relevant outcomes measured"],"limitations":["Self‑report measures may be biased","No assessment of moral or mental‑health confounds","Limited detail on statistical power or effect sizes"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":13,"contrasting":4,"mentioning":434,"citing_publications":559,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801211409727"}},{"id":1438,"doi":"10.1016/j.bodyim.2021.01.014","pmid":"33582530","pmcid":null,"title":"Associations between adolescents' pornography consumption and self-objectification, body comparison, and body shame","authors":"Maheux AJ, Roberts SR, Evans R, Widman L, Choukas-Bradley S.","first_author":"Maheux AJ","journal":"Body image","year":2021,"pub_types":["Journal Article"],"keywords":["Adolescence","Self-objectification","Pornography","Body Shame","Body Comparison"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 223 high‑school students (ages 15‑18) in the southeastern US; self‑report questionnaires on pornography frequency, self‑objectification, body comparison and body shame; demographic and social‑media use covariates included in regression analyses","sample_n":223,"sample_text":"n = 223, ages 15‑18, 59% girls, diverse mixed‑gender sample of high‑school students in the southeastern US","population":"adolescents (mixed gender, 59% girls), recruited from high schools (convenience sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 223 U.S. high‑school students, more frequent pornography use was linked to higher self‑objectification and body‑comparison, but not to increased body shame, for both boys and girls.","clinical_takeaway":"Clinicians should be aware that adolescent pornography exposure may relate to body‑image concerns, though its impact on shame is unclear.","confidence":0.8,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Decent sample size for adolescent survey","Includes both male and female participants","Controls for social‑media use and demographics"],"limitations":["Cross‑sectional design cannot infer causality","No measurement of masturbation or mental‑health covariates","Potential self‑report bias in pornography use"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":27,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.bodyim.2021.01.014"}},{"id":1439,"doi":"10.1007/s11126-013-9277-z","pmid":"24129662","pmcid":null,"title":"Forensic implications: adolescent sexting and cyberbullying","authors":"Korenis P, Billick SB.","first_author":"Korenis P","journal":"The Psychiatric quarterly","year":2014,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of existing literature; no new data collected.","sample_n":null,"sample_text":"Not applicable – review article","population":"Adolescents (general description, no sample size reported)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how teens use cell phones to send sexual messages (sexting) and how this can lead to cyberbullying, describing motivations, risks, legal issues and possible preventative steps.","clinical_takeaway":"Clinicians should be aware of sexting and cyberbullying as potential legal and mental‑health concerns for adolescents.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Broad overview of recent literature on sexting and cyberbullying","Highlights legal and clinical implications for psychiatrists"],"limitations":["No systematic methodology or risk‑of‑bias assessment","Lacks quantitative synthesis or critical appraisal of primary studies","No empirical data; conclusions rely on authors' selection of literature"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":0,"mentioning":37,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11126-013-9277-z"}},{"id":1440,"doi":"10.1007/s10508-015-0589-y","pmid":"26310879","pmcid":null,"title":"The Impact of Sexual Arousal on Sexual Risk-Taking and Decision-Making in Men and Women","authors":"Skakoon-Sparling S, Cramer KM, Shuper PA.","first_author":"Skakoon-Sparling S","journal":"Archives of sexual behavior","year":2016,"pub_types":["Journal Article"],"keywords":["Sexual Arousal","Risk-taking","Sexual Decision-making","Safer-sex Behavior","Sexual Risk-taking Intentions"],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Two laboratory experiments manipulating sexual arousal with video clips and measuring risk‑taking intentions and risky choices in a card game (N=144, 122).","sample_n":266,"sample_text":"N = 144 (Exp 1) and N = 122 (Exp 2); total participants 266.","population":"Adult men and women, likely convenience/college sample (not explicitly stated).","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In two lab studies, participants who felt more sexually aroused after watching explicit videos said they would be more likely to have unprotected sex and chose riskier options in a card game, suggesting arousal can lower caution in both sexual and non‑sexual contexts.","clinical_takeaway":"High sexual arousal may reduce safe‑sex intentions; clinicians should address arousal management in risk‑reduction counseling.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Experimental manipulation of arousal","Reasonable sample sizes for lab work","Use of both sexual and non‑sexual risk tasks"],"limitations":["Convenience sample, likely students","No measurement of key confounds (e.g., moral incongruence, mental health)","Reliance on self‑report for arousal and intentions","No pre‑registration or reported effect sizes"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":50,"citing_publications":83,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0589-y"}},{"id":1441,"doi":"10.1080/20502877.2025.2610910","pmid":"41639059","pmcid":null,"title":"OnlyFans and Deep Fake Porn - Can We Accept the Former but Condemn the Latter?","authors":"Räsänen J.","first_author":"Räsänen J.","journal":"The New bioethics : a multidisciplinary journal of biotechnology and the body","year":2026,"pub_types":["Journal Article"],"keywords":["Sex","Ethics","Consent","Bioethics","Porn","Onlyfans"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"Not applicable – theoretical essay","population":"humans (general public, ethical discussion)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper argues that condemning non‑consensual deep‑fake pornography while accepting consensual adult content on platforms like OnlyFans is ethically inconsistent, using philosophical reasoning rather than data.","clinical_takeaway":"None – not clinically applicable.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Clear ethical argumentation","Connects contemporary technology to philosophical theory"],"limitations":["No empirical data","Limited applicability to clinical practice"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/20502877.2025.2610910"}},{"id":1442,"doi":"10.1038/s41598-026-38746-7","pmid":"41639268","pmcid":"PMC12923558","title":"Sexual and reproductive health consequences of COVID-19 pandemic in Nigeria: an infodemiological survey","authors":"Akhigbe RE, Hamed MA, Adeyemi DH, Akhigbe TM.","first_author":"Akhigbe RE","journal":"Scientific reports","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sex","Rape","Abortion","Coronavirus","Sti","Contraceptive","Ed","Porn","Sars-cov-2"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12923558","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"infodemiological analysis of Google Trends data comparing pre‑COVID and COVID periods","sample_n":null,"sample_text":"Aggregated search volume index (SVI) for selected terms across the whole country","population":"Internet searches from Nigeria (aggregate data)","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The study used Google Trends to see how often Nigerians searched for terms like porn, sex, rape, contraception and STIs before and during COVID‑19. Porn searches rose, while searches for contraception, abortion and STIs fell. The authors suggest these changes reflect shifts in sexual behaviour and health concerns.","clinical_takeaway":"None – the findings are based on internet search patterns, not direct clinical data.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, national‑scale data source","Timely comparison of pre‑ and during‑COVID periods","Clear statistical tests for differences and correlations"],"limitations":["Search volume is an indirect proxy for actual behavior","No validated measures of pornography use or sexual health outcomes","No control for key confounders (moral beliefs, mental health, etc.)","Interpretation suggests causality without experimental evidence"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":5,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-026-38746-7"}},{"id":1443,"doi":"10.1177/10778012261418690","pmid":"41631795","pmcid":null,"title":"Women's Early Experiences with Online Stranger Sexual Harassment","authors":"Salerno-Ferraro AC, Erentzen C, Schuller RA.","first_author":"Salerno-Ferraro AC","journal":"Violence against women","year":2026,"pub_types":["Journal Article"],"keywords":["Age","Gender","Sexual Harassment","Online Harassment","Tfsv"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of women reporting early online stranger sexual harassment; likely convenience sample; no longitudinal or experimental components","sample_n":null,"sample_text":"Not reported in abstract","population":"women (age not specified) who experienced online sexual harassment; recruitment method not described","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study surveys women about early encounters with online strangers who sent unwanted sexual messages, dick pics, or livestreams of masturbation, often when the women were adolescents. These experiences caused fear, anger, and lasting distrust of men.","clinical_takeaway":"Clinicians should be aware that online sexual harassment can begin in adolescence and have lasting emotional effects; screening for such experiences may be warranted.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses an understudied form of online sexual harassment","Highlights mental‑health impact on young women"],"limitations":["No validated measurement tools reported","Sample size and recruitment unknown","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10778012261418690"}},{"id":1444,"doi":"10.1016/j.jsxm.2020.12.011","pmid":"33526399","pmcid":null,"title":"Pornography Use Prevalence and Associated Factors in Arab Countries: A Multinational Cross-Sectional Study of 15,027 Individuals","authors":"Eljawad MA, Se'eda H, Ghozy S, El-Qushayri AE, Elsherif A, Elkassar AH, Atta-Allah MH, Ibrahim W, Elmahdy MA, Islam SMS.","first_author":"Eljawad MA","journal":"The journal of sexual medicine","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Prevalence","risk factors","Arab","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online multinational survey of 15,027 Arab participants; prevalence and logistic regression of predictors","sample_n":15027,"sample_text":"15027 participants, mean age 23.8 years, 84.6% male","population":"general adult population in Arab countries (mostly young male university graduates)","country":"Multiple Arab countries (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 15,000 people in Arab nations found that pornography viewing is common, especially among young men, adolescents, and those with lower education. Regular exercise was linked to less viewing. The study highlights demographic predictors for public‑health planning.","clinical_takeaway":"High pornography use is linked to male gender, younger age, and lower education; interventions could target these groups and promote exercise.","confidence":0.7,"topic_tags":["pornography","prevalence","sexual_function","csbd"],"strengths":["Very large sample size","First multi‑country Arab prevalence study","Multivariable logistic regression with confidence intervals"],"limitations":["Convenience online sample; over‑representation of young men","Self‑report measures, single‑item, not validated","Cross‑sectional; no causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":22,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.12.011"}},{"id":1446,"doi":"10.1037/lhb0000537","pmid":"37471014","pmcid":null,"title":"Risk assessment of child-pornography-exclusive offenders","authors":"Scurich N, Krauss DA.","first_author":"Scurich N","journal":"Law and human behavior","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"critical narrative review of empirical studies underpinning the CPORT risk assessment tool; no new data collection; no preregistration","sample_n":null,"sample_text":"none (review)","population":"child‑pornography‑exclusive offenders (forensic context)","country":"United States (focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors review studies that support the Child Pornography Offender Risk Tool and find them weak – tiny samples, lots of missing data, and no US testing – so the tool shouldn’t be used for offenders who only possess child porn.","clinical_takeaway":"Avoid using CPORT for child‑pornography‑exclusive offenders until US‑validated research is available.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Clear identification of methodological gaps in CPORT validation","Provides concrete example of misapplication in forensic settings","Highlights need for US‑specific data"],"limitations":["No systematic review protocol reported","Relies on existing small‑sample studies; cannot quantify effect sizes","Limited to critique; no new empirical evidence"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":12,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/lhb0000537"}},{"id":1447,"doi":"10.1159/000550835","pmid":"41628146","pmcid":null,"title":"Elements for a Phenomenology of Cultures: Cultural Existentials and the Dialectical Experiential Matrix","authors":"Poggioli R, Stanghellini G.","first_author":"Poggioli R","journal":"Psychopathology","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Psychopathology","Intersubjectivity","Clinical Phenomenology","Lebenswelt","Late Modernity","Homo Oeconomicus","Cultural Existentials","Dialectical Experiential Matrix"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"The article is a theoretical review proposing a phenomenological framework (DEM) and illustrates it with an example relating to pornographic culture. No empirical data, participants, or methods are reported.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper proposes a new phenomenological model (DEM) that links cultural forces, such as pornography culture, to individual mental health, arguing clinicians should consider collective cultural patterns when assessing patients.","clinical_takeaway":"None – the article offers a theoretical perspective without empirical guidance for practice.","confidence":0.6,"topic_tags":["csbd","pornography"],"strengths":["Attempts to integrate cultural dimensions into phenomenological psychopathology","Provides a novel conceptual matrix (DEM)"],"limitations":["No empirical data or validation of the proposed framework","Lacks operational definitions or measurement tools","Relies on theoretical illustration without systematic evidence"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000550835"}},{"id":1450,"doi":"10.3389/fpsyg.2020.613244","pmid":"33510691","pmcid":"PMC7835260","title":"Compulsive Internet Pornography Use and Mental Health: A Cross-Sectional Study in a Sample of University Students in the United States","authors":"Camilleri C, Perry JT, Sammut S.","first_author":"Camilleri C","journal":"Frontiers in psychology","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Stress","Depression","Anxiety","Mental health","Addictive Behavior","Compulsivity","Pornography","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7835260","cited_by_count":47,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1031 university students","sample_n":1031,"sample_text":"University students at Franciscan University of Steubenville, Ohio","population":"university students (U.S.)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"supports","citation_value":"useful","plain_summary":"A survey of over 1000 U.S. university students found that higher self‑reported compulsive pornography use was associated with greater depression, anxiety and stress, but the study cannot prove the use causes these problems.","clinical_takeaway":"Screen for compulsive pornography use when assessing student mental health, but note the relationship is correlational.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample (N>1000)","Use of validated DASS‑21 and factor analysis","Explores multiple mental‑health outcomes"],"limitations":["Cross‑sectional, cannot infer causality","Compulsive use measured with adapted CIUS, not porn‑specific validation","No separate measurement of masturbation or moral incongruence"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":7,"contrasting":1,"mentioning":56,"citing_publications":113,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2020.613244"}},{"id":1453,"doi":"10.31234/osf.io/a5tnb","pmid":null,"pmcid":null,"title":"What Do We Know About the Mental Health of Porn Performers? A Systematic Literature Review","authors":"Jarke H.","first_author":"Jarke H.","journal":"PsyArXiv","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://psyarxiv.com/a5tnb/download","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic literature review of three US studies; PRISMA approach reported but no explicit risk‑of‑bias assessment or meta‑analysis.","sample_n":null,"sample_text":"Only three US studies examined porn performers; numbers not given in abstract.","population":"porn performers (US studies, unspecified sample size)","country":"United States (studies reviewed)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review gathered the few existing US studies on the mental health of people who work in pornography. The evidence is limited and mixed, but suggests that some performers experience poorer mental health and higher rates of mental disorders.","clinical_takeaway":"There is insufficient evidence to draw firm conclusions; clinicians should consider the potential vulnerability of porn performers and assess mental health individually.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["First systematic review on porn performers’ mental health","Uses PRISMA reporting guidelines"],"limitations":["Only three primary studies, all US and outdated","No risk‑of‑bias assessment reported","No quantitative synthesis or effect‑size reporting"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/a5tnb"}},{"id":1454,"doi":"10.1007/s10508-020-01877-7","pmid":"33398696","pmcid":null,"title":"The Prevalence of Using Pornography for Information About How to Have Sex: Findings from a Nationally Representative Survey of U.S. Adolescents and Young Adults","authors":"Rothman EF, Beckmeyer JJ, Herbenick D, Fu TC, Dodge B, Fortenberry JD.","first_author":"Rothman EF","journal":"Archives of sexual behavior","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexuality","Adolescent","Sex Education","Pornography","Sexually Explicit Media"],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative cross‑sectional survey of U.S. adolescents (14‑17) and young adults (18‑24) with multivariable logistic regression of self‑reported helpfulness of pornography as a source of sexual information.","sample_n":1266,"sample_text":"n = 600 adolescents (14‑17) and n = 666 young adults (18‑24) from a nationally representative survey","population":"U.S. adolescents and young adults, n≈1266, nationally representative probability sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a US‑wide survey of 14‑ to 24‑year‑olds, about a quarter of young adults said pornography was the most helpful source for learning how to have sex, while only 8% of teens felt the same. Use of porn as a guide was linked to being male, Black, higher income, and having masturbated.","clinical_takeaway":"Clinicians should note that many young adults view porn as a sexual‑information source, but its role is self‑reported and not linked to health outcomes here.","confidence":0.78,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Nationally representative probability sample","Large overall N with adequate power for prevalence estimates","Multivariable regression controls for several demographic factors"],"limitations":["Key construct (helpfulness of porn) measured by a single, unvalidated item","No assessment of moral/religious attitudes, mental‑health or partner context","Cross‑sectional design cannot establish directionality"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":2,"mentioning":33,"citing_publications":102,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01877-7"}},{"id":1455,"doi":"10.1007/s10508-020-01839-z","pmid":"33398695","pmcid":null,"title":"Pornography Use and Sexual Health among Same-Sex and Mixed-Sex Couples: An Event-Level Dyadic Analysis","authors":"Vaillancourt-Morel MP, Rosen NO, Štulhofer A, Bosisio M, Bergeron S.","first_author":"Vaillancourt-Morel MP","journal":"Archives of sexual behavior","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual Health","Partnered Sexuality","Pornography Use","Dyadic Daily Diaries"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"event‑level dyadic daily diary of 217 couples over 35 days","sample_n":217,"sample_text":"Convenience sample of partnered adults; not nationally representative","population":"217 couples (72 same‑sex), convenience sample, mean age 30.2","country":"Canada (likely)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 35‑day diary of 217 couples, using pornography alone on a day they also had sex was linked to the partner’s higher sexual distress and, for women, to better lubrication, but not to overall sexual satisfaction or function.","clinical_takeaway":"Partner’s solo porn use may increase sexual distress; clinicians should explore both partners’ media habits when addressing sexual wellbeing.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large dyadic sample with same‑sex couples","Event‑level daily diary captures within‑day associations","Separates solitary pornography use from partnered use"],"limitations":["Convenience sample limits generalisability","Self‑report single‑item measures, limited validation","Key confounds (moral incongruence, mental health, relationship quality) not measured"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01839-z"}},{"id":1456,"doi":"10.4081/jphr.2021.1759","pmid":"33623775","pmcid":"PMC7893314","title":"COVID-19 lockdown: Impact on online gambling, online shopping, web navigation and online pornography","authors":"Zamboni L, Carli S, Belleri M, Giordano R, Saretta G, Lugoboni F.","first_author":"Zamboni L","journal":"Journal of public health research","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Addiction","Gambling","Internet Addiction","Pornography","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7893314","cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1232 participants (43% health‑care workers) conducted after COVID‑19 lockdown; self‑report items on perceived loss of control for gambling, shopping, pornography, web navigation.","sample_n":1232,"sample_text":"1232 subjects; 0.6% online gamblers, 21.6% used online pornography.","population":"adult volunteers recruited via an online questionnaire during/after lockdown; over‑representation of health‑care workers; not a probability sample.","country":"Italy (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2021 online survey of 1,232 people (many health‑care workers) asked whether they felt they lost control while using the internet for gambling, shopping, porn, or browsing during COVID‑19 lockdown. About 22% used online porn; only 5% said they lost control with it. Loss of control was linked to feeling upset, scared or restless, but the study used simple self‑report items and did not measure masturbation, moral conflict, or mental‑health variables.","clinical_takeaway":"No strong evidence that lockdown increased problematic porn use; clinicians should consider emotional states and co‑occurring behaviours rather than assume addiction from brief self‑reports.","confidence":0.8,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence","gender"],"strengths":["Large overall N for an online survey","Timely topic (COVID‑19 lockdown)","Reports prevalence for several online behaviours"],"limitations":["Reliance on single‑item, non‑validated measures of loss of control","No assessment of masturbation or moral/religious conflict","Sample biased toward health‑care workers; not representative","No adjustment for key confounds (mood, trauma, partner status)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4081/jphr.2021.1759"}},{"id":1457,"doi":"10.1080/28324765.2023.2231497","pmid":"41262370","pmcid":"PMC12442984","title":"Sports wagering in the context of addictive disorders: results from a census-matched U.S. sample","authors":"Grubbs JB, Kraus SW.","first_author":"Grubbs JB","journal":"Cogent mental health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Substance Use","Gaming","Pornography","Fantasy Sports","Sports Gambling","Daily Fantasy"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12442984","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large YouGov panel, census‑matched weighting, self‑report questionnaire","sample_n":null,"sample_text":"YouGov Opinion polling, two U.S. samples; census‑matched","population":"U.S. adults (sample size not reported in abstract)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A U.S. survey found that people who bet on sports also tend to use more substances and engage in other risky activities like gaming and watching pornography. The link is correlational, not proof that one causes the other.","clinical_takeaway":"Screen for broader risky behaviors when clients report frequent sports betting.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large, census‑matched U.S. sample","Broad assessment of multiple potentially addictive behaviors","Highlights co‑occurrence patterns useful for risk profiling"],"limitations":["Cross‑sectional; cannot infer causality","Addiction symptoms measured with unspecified, likely non‑validated instruments","Key confounds (moral incongruence, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/28324765.2023.2231497"}},{"id":1461,"doi":"10.1556/2006.2025.00102","pmid":"41556970","pmcid":"PMC13132382","title":"Predicting moments of impaired control over addictive behaviors: Relevance of craving and inhibitory control measured in laboratory and ambulatory settings","authors":"Knorr A, Wegmann E, Vollbracht D, Brand M, Antons S.","first_author":"Knorr A","journal":"Journal of behavioral addictions","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Craving","Inhibitory Control","Behavioral Addictions","Ecological Momentary Assessment","Multilevel Sem","I-pace"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13132382","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"118 participants with varying levels of pornography/gaming use completed lab cue‑reactivity and Stop‑Signal tasks and 7‑day EMA of craving and inhibitory control. Pre‑registered multilevel analyses linked lab and real‑world measures to moments of impaired control.","sample_n":118,"sample_text":"118 participants (75 males, 42 females, 1 divers; mean age 26.2) recruited based on a standardized diagnostic interview for pornography/gaming use.","population":"Adults (mean age 26) including non‑problematic, risky, and pathological pornography or gaming users (N=118).","country":"Not specified","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 118 adults, researchers found that higher everyday cravings predicted more moments when people felt they could not control their pornography or gaming use, while lower momentary inhibitory control also predicted such lapses. Lab‑measured craving related to real‑life craving, linking lab and daily life processes.","clinical_takeaway":"Craving levels may signal risk for loss‑of‑control episodes; enhancing real‑time inhibitory control could help prevent problematic use.","confidence":0.78,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Pre‑registered design","Combination of lab and EMA methods","Validated tasks (Stop‑Signal, cue‑reactivity)","Adequate sample size for EMA analyses"],"limitations":["No measurement of moral incongruence or related confounds","Cross‑sectional EMA limits causal inference","Potential self‑selection of risky/pathological users"],"rubric_version":"2.0","raw_total":39,"max_possible":60,"pct_score":65,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":4,"design":6,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[{"status":"Has correction","date":"2026-4-29","noticeDoi":"10.1556/2006.2025.11102","doi":"10.1556/2006.2025.00102"}],"url":"https://scite.ai/reports/10.1556/2006.2025.00102"}},{"id":1462,"doi":"10.31234/osf.io/tmn4r","pmid":null,"pmcid":null,"title":"Increase in the prevalence of online pornography use – objective data analysis from the period between 2004 and 2016 in Poland","authors":"Lewczuk K, Wojcik AD, Gola M.","first_author":"Lewczuk K","journal":"PsyArXiv","year":2019,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://escholarship.org/content/qt4ht313x1/qt4ht313x1.pdf?t=rxoh0o","cited_by_count":2,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"objective website‑traffic analysis of Polish internet users (2004‑2016); prevalence estimates derived from aggregate server logs; no individual‑level survey data.","sample_n":null,"sample_text":"Estimated national counts derived from traffic data; exact N not provided.","population":"Polish internet users (estimated 2.8‑8.5 million) across years; age and gender breakdowns reported.","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Analysis of Polish internet traffic from 2004‑2016 shows that the number of people visiting porn sites rose from about 2.8 million to 8.5 million, with higher rates in males and adolescents, and a notable 25 % of 7‑12‑year‑olds accessing porn at least once per month.","clinical_takeaway":"None – the study reports population‑level prevalence, not individual risk or treatment implications.","confidence":0.8,"topic_tags":["prevalence","pornography","sexual_function"],"strengths":["Large‑scale objective traffic data avoids self‑report bias","Longitudinal coverage of 12 years","Gender and age breakdowns provided"],"limitations":["Excludes mobile and private‑browsing activity","No individual‑level demographic or psychosocial data","Prevalence estimates rely on assumptions about unique users"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":14,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/tmn4r"}},{"id":1463,"doi":"10.1080/00224499.2023.2229317","pmid":"37410677","pmcid":null,"title":"How Much Pornography Use Do Americans Think Is \"Average\" for a Man and Woman? Findings from a National Survey","authors":"McElroy EE, Perry SL, Grubbs JB.","first_author":"McElroy EE","journal":"Journal of sex research","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative survey of US adults (N≈2500) assessing estimates of average porn use; cross‑sectional correlational analysis","sample_n":2509,"sample_text":"Men: N = 1,127; Women = 1,382; nationally representative","population":"American adults, mean age 50, both genders","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A national US survey asked adults how often they think men and women watch porn. People’s own porn use, self‑labelled addiction, age and religiosity shaped these estimates, with men’s use seen as higher than women’s.","clinical_takeaway":"Clients’ beliefs about “average” porn use may be biased by their own use and religious views; clinicians should address these perceptions when discussing sexual behavior.","confidence":0.8,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["large, nationally representative sample","examines perceptual biases about porn use","includes religiosity as a predictor"],"limitations":["relies on single‑item, self‑report measures","no validated addiction scale (circular)","cross‑sectional, cannot infer causality","limited control of key confounds (masturbation, mental health, partner effects, trauma)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2229317"}},{"id":1466,"doi":"10.1186/s13643-020-01541-0","pmid":"33280603","pmcid":"PMC7720575","title":"Pornography use and sexting amongst children and young people: a systematic overview of reviews","authors":"Raine G, Khouja C, Scott R, Wright K, Sowden AJ.","first_author":"Raine G","journal":"Systematic reviews","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Systematic Review","Journal Article"],"keywords":["Children","Overview","Systematic review","Young People","Review Of Reviews","Pornography","Sexting"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7720575","cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"overview of reviews (umbrella review) synthesising eleven quantitative/qualitative review papers; narrative synthesis; quality of included reviews assessed","sample_n":null,"sample_text":"Eleven reviews of quantitative and/or qualitative studies were included; primary study sample sizes not reported in abstract","population":"children and young people (adolescents)","country":"Not specified (international literature)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"strategic","plain_summary":"This umbrella review summarises evidence that teenage porn use is linked to more permissive sexual attitudes and, inconsistently, to risky sexual behaviours and aggression. The data come mainly from cross‑sectional studies, so causal claims cannot be made.","clinical_takeaway":"Clinicians should note that current evidence does not establish pornography use as a cause of harm in youth; careful assessment of individual context is needed.","confidence":0.78,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Systematic identification of multiple review sources","Quality appraisal of included reviews","Broad scope covering attitudes, behaviours and wellbeing"],"limitations":["Relies on primary studies that are largely cross‑sectional","No assessment of key confounds (moral incongruence, masturbation, mental health, etc.)","Narrative synthesis limits quantitative precision"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":20,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s13643-020-01541-0"}},{"id":1467,"doi":"10.1016/j.jsxm.2020.10.013","pmid":"33288440","pmcid":null,"title":"Associations Between Pornography Use and Sexual Dynamics Among Heterosexual Couples","authors":"Willoughby BJ, Leonhardt ND, Augustus RA.","first_author":"Willoughby BJ","journal":"The journal of sexual medicine","year":2021,"pub_types":["Journal Article"],"keywords":["Sexual Desire","Sexual Satisfaction","Intercourse","Pornography","Sexual Frequency"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional dyadic survey of 240 heterosexual couples (N=480 individuals)","sample_n":240,"sample_text":"dyadic sample of 240 heterosexual couples","population":"heterosexual couples, likely convenience sample","country":"not specified","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 240 couples, women’s porn use was linked to higher sexual desire, while men’s porn use was linked to higher male desire but lower female desire and lower male satisfaction. Religiosity had little effect. The study shows complex ways porn may relate to couple sexuality, but it cannot prove cause‑and‑effect.","clinical_takeaway":"Assess both partners’ porn use and sexual desire together, but note findings are correlational and do not establish causation.","confidence":0.8,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Dyadic data allow partner effects","Relatively large couple sample (N=240)","Consideration of religiosity as a moderator"],"limitations":["Cross‑sectional; cannot infer causality","Masturbation not measured, limiting interpretation of porn effects","Limited control for mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.10.013"}},{"id":1468,"doi":"10.1093/scan/nsu091","pmid":"24984958","pmcid":"PMC4381244","title":"Anticipation of high arousal aversive and positive movie clips engages common and distinct neural substrates","authors":"Greenberg T, Carlson JM, Rubin D, Cha J, Mujica-Parodi L.","first_author":"Greenberg T","journal":"Social cognitive and affective neuroscience","year":2015,"pub_types":["research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Uncertainty","fMRI","Valence","Films","Expectation"],"is_oa":false,"oa_url":"https://escholarship.org/uc/item/327674ct","cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"within‑subject fMRI study using cues that predict aversive, positive (sexually explicit), uncertain, or neutral movie clips; participants view clips while BOLD activity is recorded.","sample_n":null,"sample_text":"Not specified in abstract; likely a convenience university sample typical for fMRI studies.","population":"young adult males and females (sample size not reported in abstract)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used brain imaging to see how people anticipate high‑arousal movies that are either sexually explicit, graphic medical, uncertain, or neutral. While all emotional clips activated common brain areas, reward‑related regions lit up for upcoming sexual clips and aversion‑related regions for upcoming medical clips.","clinical_takeaway":"None – the findings describe normal brain responses to anticipated visual stimuli, not clinical implications for pornography use or sexual health.","confidence":0.8,"topic_tags":["neuroscience","sexual_function","pornography"],"strengths":["Well‑controlled experimental cue paradigm","Use of high‑arousal affective stimuli including sexual content","Whole‑brain fMRI analysis"],"limitations":["Sample size not reported; likely small for fMRI","No measurement of participants’ sexual attitudes or moral beliefs","Interpretation of BOLD activations as “reward” or “aversive” may be modestly inferential"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":5,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":24,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/scan/nsu091"}},{"id":1469,"doi":"10.3390/healthcare11131837","pmid":"37444671","pmcid":"PMC10340224","title":"Factors Affecting the Sexual Behavior of Korean University Students","authors":"Cho MK, Kim MY.","first_author":"Cho MK","journal":"Healthcare (Basel, Switzerland)","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","University Student","Sexual Attitude","Pornographic Video"],"is_oa":true,"oa_url":"https://www.mdpi.com/2227-9032/11/13/1837/pdf?version=1687536443","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional descriptive survey of 258 Korean university students, online questionnaire","sample_n":258,"sample_text":"258 university students recruited online, likely convenience sample","population":"Korean university students (mostly young adults, convenience sample)","country":"South Korea","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 2023 Korean survey of 258 university students found that earlier exposure to porn videos and permissive sexual attitudes were linked to more sexual behavior, explaining up to 24% of the variance.","clinical_takeaway":"Early, comprehensive sex education may help shape healthier sexual attitudes and behaviors in university students.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Reasonably large sample for a student survey","Focus on early exposure age and attitudes","Clear statistical reporting of variance explained"],"limitations":["No validated scales for sexual behavior or attitudes","Cross‑sectional design limits causal inference","Key confounds (moral incongruence, masturbation, mental health) not measured"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare11131837"}},{"id":1470,"doi":"10.1177/1077801220971352","pmid":"33227222","pmcid":null,"title":"Recognizing Connections Between Intimate Partner Sexual Violence and Pornography","authors":"Tarzia L, Tyler M.","first_author":"Tarzia L","journal":"Violence against women","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Qualitative","Pornography","Intimate Partner Sexual Violence"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Narrative review with brief qualitative data from an Australian project; no systematic search, no clear sampling frame, no quantitative analysis.","sample_n":null,"sample_text":"Not specified in abstract","population":"Women survivors of intimate partner sexual violence in Australia (sample size not reported)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that pornography may play a role in intimate partner sexual violence, drawing on prior literature and a small Australian qualitative study of women’s experiences, and call for more research on this link.","clinical_takeaway":"None - the article is conceptual and does not provide actionable clinical guidance.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses an understudied link between pornography and IPV","Integrates qualitative women's experiences"],"limitations":["No systematic methodology; narrative review","No validated measures of pornography use","Confounding variables (e.g., moral incongruence, mental health) not assessed"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801220971352"}},{"id":1471,"doi":"10.1089/cyber.2020.0120","pmid":"33211544","pmcid":null,"title":"Parent-Child Discrepancies in Reports of Exposure to Violence/Pornography on Mobile Devices and the Impact on Children's Psychosocial Adjustment","authors":"Liu S, Chang FC, Chiu CH, Li F, Chen PH, Chen CY, Lin YP, Chiang JT.","first_author":"Liu S","journal":"Cyberpsychology, behavior and social networking","year":2021,"pub_types":["Journal Article"],"keywords":["Children","Parents","Violence","Mobile Devices","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 2,230 parent‑child dyads from schools in Taiwan and China, self‑administered questionnaires on exposure to violence/pornography and child psychosocial adjustment.","sample_n":2230,"sample_text":"2230 parent‑child dyads (1,140 from Taiwan, 1,090 from China)","population":"elementary‑school children and their parents; convenience sample from schools in two Asian regions","country":"Taiwan, China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Parents often underestimate how often their children see pornography or violent content on phones. Kids who use phones a lot, live in poverty, or have weak parent‑child relationships, and whose parents don’t know about the exposure, show more emotional and behavioural problems.","clinical_takeaway":"Clinicians should ask both children and parents about mobile‑device content exposure, as parental unawareness relates to poorer child adjustment.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample of parent‑child dyads","Direct comparison of child and parent reports","Multivariate regression controlling several sociodemographic factors"],"limitations":["Self‑report measures with unclear psychometric validation","Cross‑sectional design limits causal inference","Key confounds (moral incongruence, masturbation, trauma) not assessed"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2020.0120"}},{"id":1472,"doi":"10.1071/sh16037","pmid":"27509401","pmcid":null,"title":"Is sexual content in new media linked to sexual risk behaviour in young people? A systematic review and meta-analysis","authors":"Smith LW, Liu B, Degenhardt L, Richters J, Patton G, Wand H, Cross D, Hocking JS, Skinner SR, Cooper S, Lumby C, Kaldor JM, Guy R.","first_author":"Smith LW","journal":"Sexual health","year":2016,"pub_types":["Meta-Analysis","Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Systematic review and meta-analysis of 14 cross‑sectional studies examining exposure to sexually explicit websites or sexting and sexual risk outcomes in youths aged 10‑24.","sample_n":20881,"sample_text":"Fourteen cross‑sectional studies (total ≈20,800 participants)","population":"Young people 10‑24 years old (N≈20,800 across included studies)","country":"Various (studies from multiple countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A review of 14 studies found that teens and young adults who view sexual content online or engage in sexting are more likely to have unprotected sex, multiple partners, and use alcohol or drugs before sex. The evidence comes from cross‑sectional surveys, so we cannot say the media cause those behaviours.","clinical_takeaway":"Self‑reported exposure to sexual media is associated with higher sexual risk, but causality is unclear; clinicians should assess media use alongside other risk factors.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["PRISMA‑guided systematic search across three databases","Quantitative synthesis (meta‑analysis) with confidence intervals","Large aggregate sample size"],"limitations":["All primary studies cross‑sectional; cannot infer causality","Limited adjustment for key confounders","Variable definitions of exposure and outcomes across studies"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":62,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh16037"}},{"id":1473,"doi":"10.1080/00224499.2023.2219254","pmid":"37310384","pmcid":null,"title":"Partner Knowledge of Solitary Pornography Use: Daily and Longitudinal Associations with Relationship Quality","authors":"Vaillancourt-Morel MP, Rosen NO, Bőthe B, Bergeron S.","first_author":"Vaillancourt-Morel MP","journal":"Journal of sex research","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Dyadic daily diary (35 days) + three wave self‑report over 1 year; convenience sample of 217 couples (≈434 individuals).","sample_n":217,"sample_text":"217 couples (≈434 participants)","population":"Adult couples (mixed gender, middle‑aged to young adult) recruited via convenience sampling.","country":"Not specified (likely Canada/USA based on authors).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 217 couples, daily reports showed that when a partner did not know about one’s solo pornography use, both partners felt less satisfied and intimate that day, and overall relationship satisfaction started lower. Knowing a partner’s use was linked to higher intimacy for the user over a year, but the partner’s intimacy declined.","clinical_takeaway":"Partner awareness of solo porn use matters for relationship satisfaction; clinicians might explore communication about such use with couples.","confidence":0.7,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Large dyadic sample with daily diary data","Longitudinal follow‑up over one year","Separate measurement of partner knowledge"],"limitations":["Convenience sample limits generalizability","No assessment of moral incongruence or mental‑health covariates","Reliance on self‑report for pornography use"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":1,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2219254"}},{"id":1474,"doi":"10.31234/osf.io/cw24q","pmid":null,"pmcid":null,"title":"Porn Consumption, Personality, and Attitudes Towards Sexual Violence","authors":"Khatri N, Garg S, Suri S.","first_author":"Khatri N","journal":"PsyArXiv","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/cw24q","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey examining links between violent pornography consumption and attitudes toward sexual violence, with moderation by psychopathy, aggression, and social desirability.","sample_n":null,"sample_text":"not reported in abstract","population":"unspecified (likely adult participants recruited online); sample size not reported in abstract","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The paper investigates whether watching violent porn is linked to more permissive attitudes toward sexual violence, and whether personality traits like psychopathy, aggression, or a desire to appear socially desirable change this relationship.","clinical_takeaway":"None – findings are theoretical and not directly applicable to clinical practice.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses socially important topic","Integrates theory (cultivation) with personality moderators"],"limitations":["Likely cross‑sectional, limiting causal inference","No measurement or control of key sexual‑health confounds (moral incongruence, masturbation, mental health, partner effects, trauma)","Constructs may rely on unvalidated or single‑item measures"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/cw24q"}},{"id":1475,"doi":"10.1177/10790632261415819","pmid":"41499798","pmcid":"PMC12923637","title":"Youth-Produced Images Are the Majority of Child Sexual Abuse Materials: Categories of Youth and Adult Perpetrators From a Victim Based Study","authors":"Finkelhor D, Colburn D, Gewirtz-Meydan A, O'Brien JE, Jones LM, Turner HA, Mitchell KJ.","first_author":"Finkelhor D","journal":"Sexual abuse : a journal of research and treatment","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Child Pornography","Child Sexual Exploitation","Sexting","Sextortion","Online Sexual Abuse","Juveniles With Problematic Sexual Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12923637","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 18–28‑year‑old respondents recalling childhood image‑abuse episodes; descriptive statistics reported","sample_n":3254,"sample_text":"3,254 episodes reported by participants","population":"young adults (18‑28) reporting victimisation before age 18","country":"unspecified (online sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 18‑28‑year‑olds who experienced sexual image abuse before age 18 found that most abusive images were produced by the youth themselves, whether they were victims or perpetrators. Adult‑produced images were rare.","clinical_takeaway":"Prevention should focus on educating school‑aged youth about safe image creation and sharing.","confidence":0.4,"topic_tags":["csbd"],"strengths":["Large number of reported episodes","Novel categorisation of youth‑ and adult‑perpetrated images","Victim‑based perspective"],"limitations":["Retrospective self‑report, possible recall bias","Convenience online sample, low generalisability","No validated measurement instruments"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632261415819"}},{"id":1476,"doi":"10.3390/jcm9113625","pmid":"33187153","pmcid":"PMC7698108","title":"Pornography Use in Adolescents and Its Clinical Implications","authors":"Farré JM, Montejo AL, Agulló M, Granero R, Chiclana Actis C, Villena A, Maideu E, Sánchez M, Fernández-Aranda F, Jiménez-Murcia S, Mestre-Bach G.","first_author":"Farré JM","journal":"Journal of clinical medicine","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Gender","Adolescents","Risky Behaviors","Pornography","Porn"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7698108","cited_by_count":30,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 1500 adolescents; structural equation modeling of self‑report variables","sample_n":1500,"sample_text":"large community sample, likely convenience recruitment in schools","population":"adolescents (n≈1500)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1500 adolescents found that pornography use was linked to being male, older, certain sexual orientations, substance use and non‑Muslim identity. The authors suggest these patterns could inform prevention, but the study does not control for moral attitudes or separate masturbation from viewing.","clinical_takeaway":"Findings are descriptive only; do not assume pornography causes harm without further longitudinal evidence.","confidence":0.4,"topic_tags":["pornography","adolescents","sexual_function","prevalence"],"strengths":["large sample size","use of structural equation modeling","addresses multiple demographic predictors"],"limitations":["cross‑sectional design limits causal inference","pornography use measured with a single self‑report item","no measurement or control of key confounds (moral incongruence, masturbation, mental health)","claims of clinical applicability exceed the evidence"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":3,"contrasting":0,"mentioning":42,"citing_publications":78,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jcm9113625"}},{"id":1477,"doi":"10.1016/j.jpsychires.2015.10.017","pmid":"26606725","pmcid":"PMC4683093","title":"Novelty, conditioning and attentional bias to sexual rewards","authors":"Banca P, Morris LS, Mitchell S, Harrison NA, Potenza MN, Voon V.","first_author":"Banca P","journal":"Journal of psychiatric research","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Addiction","Novelty","Attentional Bias","Sexual Reward","Cue-conditioning","Dorsal Cingulate Habituation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4683093","cited_by_count":51,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control experimental task with fMRI (N≈22 CSB, 40 controls; 20 per group scanned)","sample_n":62,"sample_text":"22 CSB males, 40 controls; 20 per group underwent fMRI","population":"adult males, CSB vs healthy volunteers","country":"unspecified (likely USA/UK based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men with compulsive sexual behaviour to healthy men using tasks that measured preference for new sexual images and learning about sexual rewards, plus brain scans. CSB participants showed a stronger liking for novel sexual pictures and greater brain habituation in the dorsal cingulate. The authors suggest this reflects altered novelty‑seeking and conditioning in CSB.","clinical_takeaway":"Findings hint that heightened novelty‑seeking and reward‑learning may play a role in compulsive sexual behaviour, but the small, unadjusted sample limits direct clinical use.","confidence":0.7,"topic_tags":["sexual_function","csbd","neuroscience"],"strengths":["Combined behavioral and fMRI tasks","Novel focus on sexual novelty and conditioning","Age‑matched control group"],"limitations":["Small fMRI sample (N≈20 per group)","No measurement of key confounds (moral incongruence, masturbation, mental health)","Addiction criteria not directly assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":70,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":5,"statistics":5,"confounds":3,"design":4,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":9,"contrasting":1,"mentioning":102,"citing_publications":137,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpsychires.2015.10.017"}},{"id":1478,"doi":"10.1080/19317611.2025.2604836","pmid":"42205332","pmcid":null,"title":"Exploring Sexual Health and Well-Being in Rural Areas: A Systematic Literature Review with Case Study from Indonesia","authors":"Yundianto D, Khatami M, Maharani W, Mutmainah I, Nawwaf MN, Vaľko M.","first_author":"Yundianto D","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2026,"pub_types":["Journal Article"],"keywords":["Indonesia","Rural areas","Sexual Health","Systematic Literature Review","Sexual Well-being"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic literature review of 28 studies (2015‑2025) on sexual health in rural Indonesia following PRISMA; no meta‑analysis or formal risk‑of‑bias assessment reported.","sample_n":null,"sample_text":"28 primary studies included; individual study samples not detailed in abstract.","population":"Rural communities in Indonesia (studies varied); no single sample size reported for the review itself.","country":"Indonesia (rural focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review gathers 28 studies to map sexual‑health challenges in Indonesia’s rural areas, covering issues from early marriage to pornography use, and highlights cultural, social and policy factors that shape wellbeing.","clinical_takeaway":"Understanding local cultural and policy contexts is essential when addressing sexual‑health needs in rural Indonesian communities.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Adheres to PRISMA guidelines","Broad multidisciplinary coverage","Focus on an under‑researched rural context"],"limitations":["No risk‑of‑bias assessment of included studies","No quantitative synthesis or effect‑size reporting","Limited detail on how constructs (e.g., pornography use) were defined"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2025.2604836"}},{"id":1479,"doi":"10.1177/00469580261463909","pmid":"42338380","pmcid":null,"title":"Prevalence and Factors Associated With Risky Sexual Behaviors Among Young People in Ethiopia: Systematic Review and Meta-Analysis","authors":"Olkaba BF, Hailu Kassa D, Wirtu D, Robi Tura M, Egu LM, Wondie WT, Bekele GG, Zerihun E, Tafa Regassa B, Alemu SS, Amena N.","first_author":"Olkaba BF","journal":"Inquiry : a journal of medical care organization, provision and financing","year":2026,"pub_types":["Meta-Analysis","Systematic Review","Journal Article"],"keywords":["Systematic review","Adolescents","Ethiopia","Young People","Sexual Behaviors","Unsafe Sex","Hiv/infections"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Meta-analysis of 22 cross‑sectional studies (N≈15,415) estimating prevalence of risky sexual behaviour among Ethiopian youth and identifying associated factors such as gender, alcohol, shisha, and pornography use.","sample_n":15415,"sample_text":"22 cross‑sectional studies, total N=15,415","population":"Young people (adolescents/young adults) in Ethiopia","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 22 Ethiopian studies found that about 44% of young people engage in risky sexual behaviours. Factors that increase the odds include being male, drinking alcohol, using shisha, and watching pornography.","clinical_takeaway":"High rates of risky sex among Ethiopian youth suggest a need for comprehensive sexuality education and interventions targeting alcohol, shisha, and pornography exposure.","confidence":0.8,"topic_tags":["prevalence","religiosity","sexual_function"],"strengths":["Large pooled sample gives precise prevalence estimate","Systematic search across multiple databases","Risk of bias assessed with JBI checklist"],"limitations":["Underlying primary studies use heterogeneous, often unvalidated measures of risky sex","Key psychosocial confounds (e.g., moral incongruence, mental health, trauma) not examined","No pre‑registration of review protocol reported"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00469580261463909"}},{"id":1480,"doi":"10.1093/sxmrev/qeaf066","pmid":"41259258","pmcid":null,"title":"Myths, challenges, and misconceptions around men's sexual health in Saudi Arabia","authors":"Mulhall JP, Baazeem A, Al-Bakri AM, Moazin MS, Assari SM, Campos-Sañudo JA, Atallah S, Hamdy Y.","first_author":"Mulhall JP","journal":"Sexual medicine reviews","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Knowledge","erectile dysfunction","Saudi Arabia","Sexual Health","Phosphodiesterase Type 5 Inhibitors","Misconceptions","On-demand","Social Stigma","Myths"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative expert opinion review based on unstructured literature search and cultural insights; no primary data collected","sample_n":null,"sample_text":"Not applicable – study synthesizes existing literature and expert opinion","population":"male adults in Saudi Arabia (expert perspectives, no participants)","country":"Saudi Arabia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews cultural, religious, and social myths that affect men’s sexual health in Saudi Arabia, such as misconceptions about erectile dysfunction, masturbation, and pornography, and suggests education and culturally‑sensitive health services to improve outcomes.","clinical_takeaway":"Clinicians should consider cultural stigma and misinformation when discussing sexual health with Saudi men and promote education that aligns with Islamic values.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Addresses culturally specific barriers to men's sexual health","Integrates religious and medical perspectives"],"limitations":["Lacks empirical data or systematic review methodology","No systematic assessment of confounding factors","Reliance on expert opinion limits generalizability"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeaf066"}},{"id":1482,"doi":"10.53738/revmed.2026.22.945.48253","pmid":"41540858","pmcid":null,"title":"[Addictions : what's new in 2025]","authors":"Zullino D, Penzenstadler L, Robet T, Nguyen D, Santos Cruz J, Golay É, Ben Brahim F, Vera Cruz G, Courtois R, Favrod-Coune T, Khazaal Y.","first_author":"Zullino D","journal":"Revue medicale suisse","year":2026,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"no empirical data; narrative overview","sample_n":null,"sample_text":"N/A","population":"N/A","country":"Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews recent developments in addiction medicine, noting a rise in compulsive pornography use and describing a new questionnaire (PCE‑S) for assessing craving, but provides no original research data.","clinical_takeaway":"None – the paper offers no empirical findings to guide clinical practice.","confidence":0.7,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Broad overview of emerging addiction topics","Highlights need for clinical preparedness"],"limitations":["No original data or systematic review","No operational definitions or validated measures for pornography use","Lacks control of key confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.53738/revmed.2026.22.945.48253"}},{"id":1483,"doi":"10.1093/sxmrev/qeag005","pmid":"41655083","pmcid":null,"title":"Sexual shame: a narrative review","authors":"Coates AGC, Meston CM.","first_author":"Coates AGC","journal":"Sexual medicine reviews","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Sexual dysfunction","Sexual Health","Sexual Violence","Sexual Shame","Sexual Wellbeing"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","masturbation","pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without empirical data; synthesis based on author‑selected studies.","sample_n":null,"sample_text":"None – review of existing studies","population":"Adults (implicit from reviewed literature); no new sample recruited.","country":"International (studies drawn from literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises research that has measured sexual shame, showing it links to sexual dysfunction, trauma, and behaviours like pornography use, especially when people feel they violate religious norms.","clinical_takeaway":"Clinicians should assess sexual shame as a possible factor in sexual dysfunction, but note that current measures are often unvalidated.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive literature search across major databases","Identifies gaps in measurement of sexual shame","Highlights relevance of shame to a range of sexual‑health outcomes"],"limitations":["Narrative (non‑systematic) synthesis; potential selection bias","No quality appraisal or risk‑of‑bias assessment of included studies","Relies on unvalidated measures in primary literature"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeag005"}},{"id":1484,"doi":"10.1177/17455057261485065","pmid":"42777137","pmcid":null,"title":"Is exposure to online misogyny associated with mental health outcomes in girls and young women? A systematic review of longitudinal studies","authors":"Thomas C, Tinner LE, Bennett J, Anderson LG, Winstone L.","first_author":"Thomas C","journal":"Women's health (London, England)","year":2026,"pub_types":["Systematic Review","Journal Article"],"keywords":["Internet","Adolescence","Mental health","Sexism","Online Social Networking","Sexual Harassment","Online Misogyny"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"narrative synthesis of six longitudinal cohort studies (total N=7,379)","sample_n":7379,"sample_text":"Six longitudinal studies, total N=7,379","population":"girls, young women, and gender‑diverse people aged 11‑25 (studies only on females)","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of six longitudinal studies (7,379 participants) finds early evidence that exposure to online misogyny – including pornography and cyber‑sexual harassment – may be linked to poorer mental health in girls and young women, but the evidence is limited and varied.","clinical_takeaway":"Clinicians should be aware that online misogyny could harm mental health, though current evidence is preliminary.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Pre‑registered systematic review (PROSPERO)","Focus on longitudinal evidence","Risk of bias assessed (Newcastle‑Ottawa Scale)"],"limitations":["Only six studies, heterogeneous designs","Narrative synthesis; no meta‑analysis","Limited detail on exposure and outcome measures"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/17455057261485065"}},{"id":1485,"doi":"10.1037/bul0000513","pmid":"41854670","pmcid":null,"title":"Misogynous messages in the media increase hostility to women: Evidence from a meta-analysis of 257 experimental and nonexperimental studies","authors":"Nater C, Felber L, Lüke R, Eagly AH, Greitemeyer T, Miller DI, Dorrough AR.","first_author":"Nater C","journal":"Psychological bulletin","year":2026,"pub_types":["Meta-Analysis","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 257 studies (experimental and nonexperimental) with robust variance estimation, 132,933 participants, 1,421 effect sizes.","sample_n":132933,"sample_text":"132,933 participants across studies","population":"Human participants across 47 years of studies, diverse ages and genders.","country":"Not specified (multiple studies)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 257 studies finds that exposure to misogynous media, including pornographic content, modestly increases hostility toward women, especially among men and adolescents.","clinical_takeaway":"None – the findings relate to attitudes, not sexual health or treatment.","confidence":0.8,"topic_tags":["gender","sexual_function"],"strengths":["Large total sample size across studies","Includes both experimental and observational data","Robust variance estimation and confidence intervals reported"],"limitations":["Heterogeneity high; potential publication bias not addressed","Variable operationalisation of exposure and outcome","Limited discussion of confounding variables"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/bul0000513"}},{"id":1486,"doi":"10.1093/sxmrev/qeaf081","pmid":"41504422","pmcid":null,"title":"Child sexual abuse material (CSAM): a systematic review of risk profiles, risk factors, and typologies of users","authors":"Barroso R, Silva S, Fishere M, Nentzl J, Vo TN, Forero CG, Gómez-Durán EL, Ferreira CB, Gieseler H, Westfal V, Franch-Martínez B, Krejčová L, Beier KM.","first_author":"Barroso R","journal":"Sexual medicine reviews","year":2026,"pub_types":["Systematic Review","Journal Article"],"keywords":["risk factors","Pedophilia","Child Pornography","Typologies","Child Sexual Abuse Material"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic literature review of 35 studies on CSAM offenders, following PRISMA 2020.","sample_n":null,"sample_text":"Thirty‑five articles were included; individual study sizes not reported in abstract.","population":"CSAM offenders (detected, primarily white men, varied age).","country":"Not specified (global literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 35 studies describes who commits child sexual abuse material offenses, noting they are mostly white men with diverse ages, higher education, and many have mental‑health issues, substance use, and adverse childhood experiences. The authors outline typologies of consumers and distributors.","clinical_takeaway":"Understanding offender risk profiles can inform prevention and investigative strategies, but findings are descriptive and not directly actionable for treatment.","confidence":0.7,"topic_tags":["csbd"],"strengths":["Systematic review with PRISMA methodology","Broad coverage of offender characteristics","Identification of multiple risk‑factor domains"],"limitations":["No quantitative meta‑analysis or effect sizes","Variable quality of primary studies not reported","Limited detail on measurement validity"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeaf081"}},{"id":1487,"doi":"10.1177/1359105320967085","pmid":"33107365","pmcid":null,"title":"Associations between pornography exposure, body image and sexual body image: A systematic review","authors":"Paslakis G, Chiclana Actis C, Mestre-Bach G.","first_author":"Paslakis G","journal":"Journal of health psychology","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":["Body Image","Genital Self-image","Pornography","Porn","Sexual Body Image"],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 26 primary studies examining frequency of pornography exposure and body image outcomes; no meta‑analysis reported, risk‑of‑bias assessment not described in abstract.","sample_n":null,"sample_text":"26 studies meeting inclusion criteria (total participants not specified).","population":"Adults and adolescents (heterosexual men and women); limited data on adolescents and sexual minorities.","country":"International (studies from multiple countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 26 studies finds that people who view pornography more often tend to have more negative feelings about their own bodies and sexual appearance, for both men and women. Evidence is limited for teenagers and sexual minorities.","clinical_takeaway":"Frequent pornography use may be linked to poorer body image; clinicians should consider media exposure when addressing body‑image concerns.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Systematic search strategy","Identifies consistent negative association across genders","Highlights gaps (adolescents, sexual minorities)"],"limitations":["No quantitative synthesis or meta‑analysis","Unclear risk‑of‑bias assessment of included studies","Likely heterogeneity in exposure and outcome measures"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":72,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1359105320967085"}},{"id":1488,"doi":"10.1007/s10508-020-01824-6","pmid":"33083941","pmcid":null,"title":"Testing the Confluence Model of the Association Between Pornography Use and Male Sexual Aggression: A Longitudinal Assessment in Two Independent Adolescent Samples from Croatia","authors":"Kohut T, Landripet I, Štulhofer A.","first_author":"Kohut T","journal":"Archives of sexual behavior","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescence","Sexual Aggression","Confluence Model","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["bibliography","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two independent adolescent panel samples (N=936, 743) with repeated measures; generalized linear mixed models used to test temporal relations between pornography use, hostile masculinity, impersonal sexuality, and later sexual aggression.","sample_n":1679,"sample_text":"Total N across two panels = 936 + 743 = 1,679 participants; 2,808 + 2,972 observations.","population":"Male adolescents in Croatia","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study followed over 1,600 Croatian teenage boys and found that while hostile attitudes predicted later sexual aggression, pornography use did not increase the odds of aggressive behavior, even for those already at risk.","clinical_takeaway":"Current evidence does not support pornography use as a direct cause of adolescent sexual aggression.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, longitudinal panel with repeated observations","Two independent samples increase generalisability","Appropriate multilevel modeling of temporal effects"],"limitations":["Self‑report measures of pornography use and aggression","No assessment of key confounds (e.g., mental health, trauma, moral attitudes)","Unclear whether pornography use scale is validated"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":47,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01824-6"}},{"id":1489,"doi":"10.1080/14681994.2012.734605","pmid":"23185126","pmcid":"PMC3505105","title":"The SEM Risk Behavior (SRB) Model: A New Conceptual Model of how Pornography Influences the Sexual Intentions and HIV Risk Behavior of MSM","authors":"Wilkerson JM, Iantaffi A, Smolenski DJ, Brady SS, Horvath KJ, Grey JA, Rosser BR.","first_author":"Wilkerson JM","journal":"Sexual and relationship therapy : journal of the British Association for Sexual and Relationship Therapy","year":2012,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"online focus groups with 79 MSM; thematic analysis to build a conceptual model linking SEM exposure to sexual intentions and HIV risk behavior.","sample_n":79,"sample_text":"online focus groups (convenience sample)","population":"men who have sex with men (MSM), online recruited, n=79","country":"unspecified (likely USA based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In online focus groups, 79 gay and bisexual men described how watching online porn showing new sexual acts could change their sexual intentions and actual behaviour, especially when they felt aroused, enjoyed trying the act, and trusted their partner. The authors built a five‑path model to explain these changes.","clinical_takeaway":"Clinicians can consider that exposure to new sexual content may influence clients’ sexual intentions, but the model is not yet empirically validated.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Provides a novel, theory‑driven model specific to MSM","Uses participants’ own language and experiences"],"limitations":["Convenience, self‑selected sample limits generalisability","No quantitative validation of the model","Limited control for key confounds (e.g., moral views, mental health)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":24,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/14681994.2012.734605"}},{"id":1490,"doi":"10.1080/00224498809551397","pmid":"22375634","pmcid":null,"title":"Erotic value of female distress in sexually explicit photographs","authors":"Heilbrun AB, Seif DT.","first_author":"Heilbrun AB","journal":"Journal of sex research","year":1988,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience sample of 54 college males rating erotic value of distress vs. non‑distress photos; between‑subjects correlational analysis.","sample_n":54,"sample_text":"young adult college males","population":"young adult college males (N=54)","country":"USA","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"In a study of 54 college men, pictures of women in bondage who looked distressed were rated as more sexually arousing than pictures of happy women. The effect was strongest in men who scored higher on antisocial traits and were better at reading facial emotions.","clinical_takeaway":"None – the study examines erotic preference, not clinical issues of pornography use or sexual health.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Novel focus on distress as erotic stimulus","Inclusion of antisociality and facial‑decoding variables","Use of actual explicit photographs"],"limitations":["Small, non‑representative sample (N=54, college males)","Unvalidated measures of key constructs","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224498809551397"}},{"id":1491,"doi":"10.1080/00224499.2023.2216199","pmid":"37229907","pmcid":null,"title":"Pornography and Sociosexual Attitudes and Behaviors in a Nationally Representative Survey: Potential Pandemic and Method Effects","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Journal of sex research","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative probability samples from 2018 (in‑person) and 2021 (online) GSS surveys compared for associations between pornography use and sociosexual attitudes/behaviors.","sample_n":10000,"sample_text":"Large nationally representative GSS samples (exact N not given in abstract).","population":"Adults in the United States (GSS sample).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Using two waves of a US national survey, researchers examined whether the link between pornography use and nontraditional sexual attitudes and behaviours differed when the survey was done in‑person (2018) versus online (2021) during the pandemic.","clinical_takeaway":"None – the study is descriptive and does not inform clinical practice.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Nationally representative sample","Comparison of mode effects (in‑person vs online)","Cautious interpretation acknowledging alternative explanations"],"limitations":["No measurement of key confounds (e.g., moral incongruence, mental health)","Pornography use likely measured by a single item","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2216199"}},{"id":1492,"doi":"10.1016/j.jsxm.2020.08.017","pmid":"33077372","pmcid":null,"title":"Is Pornography Consumption Related to Risky Behaviors During Friends With Benefits Relationships?","authors":"Henderson E, Aaron S, Blackhurst Z, Maddock M, Fincham F, Braithwaite SR.","first_author":"Henderson E","journal":"The journal of sexual medicine","year":2020,"pub_types":["Journal Article"],"keywords":["Risky Sexual Behavior","Sexual Scripts","Pornography","Friends With Benefits"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of two college samples (N≈400 each) examining self‑reported pornography frequency and risky sexual behaviours in friends‑with‑benefits encounters.","sample_n":805,"sample_text":"Two convenience samples of college students (Study 1 N = 411; Study 2 N = 394).","population":"Emerging‑adult college students who have engaged in friends‑with‑benefits relationships","country":"USA (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among college students who have friends‑with‑benefits, men who watch pornography more often also report riskier sexual behaviours, such as drinking, using condoms less, and having sex while intoxicated.","clinical_takeaway":"Higher pornography use may signal greater sexual‑risk taking in this population; clinicians should assess media habits when counseling about safe sex.","confidence":0.7,"topic_tags":["pornography","religiosity","sexual_function"],"strengths":["Large community samples (≈400 per study)","Replication across two independent samples","Statistical control for several relevant covariates"],"limitations":["Cross‑sectional design; cannot infer causality","Self‑report only; possible recall and social desirability bias","No validated measure of pornography use or assessment of masturbation","Limited control of key confounds (e.g., moral incongruence, mental‑health variables)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.08.017"}},{"id":1493,"doi":"10.1007/s10508-013-0076-2","pmid":"23519591","pmcid":null,"title":"Gender differences in sexual arousal and affective responses to erotica: the effects of type of film and fantasy instructions","authors":"Carvalho J, Gomes AQ, Laja P, Oliveira C, Vilarinho S, Janssen E, Nobre P.","first_author":"Carvalho J","journal":"Archives of sexual behavior","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"within‑subjects laboratory experiment with erotic film clips (explicit vs. romantic) and fantasy instructions (partner vs. other); physiological (genital) and self‑report measures; convenience sample (n≈57).","sample_n":57,"sample_text":"Men (n = 29) and women (n = 28)","population":"adult men (n=29) and women (n=28), likely university/community volunteers","country":"Portugal (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, men and women watched erotic movies (either explicit or romantic) while being told to imagine either their own partner or a stranger. Both physiological genital responses and self‑reported arousal were measured. Explicit movies gave stronger genital reactions; women reported higher arousal overall; imagining a partner boosted arousal and positive feelings, especially for women watching explicit clips.","clinical_takeaway":"Partner‑focused fantasies can increase sexual arousal and positive affect, which may be useful in sex‑therapy contexts.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Physiological genital measures add objective data","Within‑subject manipulation of fantasy instruction","Comparative analysis of explicit vs. romantic erotica"],"limitations":["Small sample, especially for gender comparisons","Convenience recruitment limits generalisability","No assessment of potential confounds (e.g., mood, relationship status)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":31,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0076-2"}},{"id":1497,"doi":"10.1007/s10508-023-02599-2","pmid":"37095388","pmcid":"PMC10124926","title":"Compulsive Sexual Behavior and Changes in Solitary Sexual Behaviors During the COVID-19 Pandemic","authors":"Gleason N, Conroy K, Banik S, Coleman E.","first_author":"Gleason N","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","case-report"],"keywords":["Masturbation","Compulsive Sexual Behavior","Pornography","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10124926","cited_by_count":2,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online cross‑sectional survey (N=944) of U.S. adults reporting retrospective frequencies of masturbation and pornography use during vs. before COVID‑19; screened for compulsive sexual behavior and depression.","sample_n":944,"sample_text":"944 participants completed an online survey in October 2020","population":"U.S. adults (self‑selected online respondents)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In an October 2020 US online survey (N≈944), people who met criteria for compulsive sexual behavior reported larger increases in masturbation and pornography use during COVID‑19 than those without such symptoms. Non‑CSB participants showed little change. Depression was higher among the CSB group.","clinical_takeaway":"Clients with compulsive sexual behavior may be especially vulnerable to pandemic‑related spikes in solo sexual activity; clinicians should screen for CSB and related distress.","confidence":0.7,"topic_tags":["masturbation","pornography","csbd","sexual_function"],"strengths":["Large sample (N≈900)","Direct comparison of CSB‑positive vs. CSB‑negative groups","Includes measures of depression and financial stress"],"limitations":["Retrospective self‑report of behavior change","No assessment of moral/religious attitudes (potential confound)","Cross‑sectional design limits causal inference","Unclear whether CSB screen used validated ICD‑11 criteria"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02599-2"}},{"id":1498,"doi":"10.1017/s1092852925100771","pmid":"41383009","pmcid":"PMC13064715","title":"Problematic usage of the internet is associated with orthorexia nervosa tendency in adults","authors":"Boutouis S, Grant JE.","first_author":"Boutouis S","journal":"CNS spectrums","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Internet Use","Eating Disorder","Internet Addiction","Orthorexia Nervosa","Orthorexia"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13064715","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 300 US adults recruited via Prolific; self‑report questionnaires (ORTO‑R, ISAAQ‑10); regression analysis","sample_n":300,"sample_text":"300 adults recruited through an online platform (Prolific)","population":"Adults (mean age 37.4, 54.6% female), United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 300 US adults, higher scores on a questionnaire for problematic internet use predicted greater orthorexia (preoccupation with healthy eating) symptoms, even after accounting for age, gender, and existing eating‑disorder diagnoses.","clinical_takeaway":"Clinicians should be aware that excessive internet use may be linked to orthorexia tendencies, but the direction of this relationship remains unclear.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Validated questionnaires for both orthorexia and internet use","Reasonable sample size for a cross‑sectional survey","Controls for basic demographics and eating‑disorder diagnosis"],"limitations":["Cross‑sectional design precludes causal inference","Limited control of key confounds relevant to problematic internet use","No correction reported for multiple activity‑specific tests"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852925100771"}},{"id":1499,"doi":"10.22541/au.163345752.23446446/v1","pmid":null,"pmcid":null,"title":"Erectile dysfunction in young men","authors":"Diamandis DC, Smith S, Tudor A, Seideman D.","first_author":"Diamandis DC","journal":"Authorea Preprints","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"none","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","advocacy_or_coi"],"stance":"supports","citation_value":"avoid","plain_summary":"The authors suggest that frequent pornography use may be causing erectile problems in young men, but the paper provides no data or systematic analysis to support this claim.","clinical_takeaway":"No actionable clinical guidance can be drawn; the paper is speculative.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Raises a topic of public interest"],"limitations":["No empirical data presented","Claims are speculative and not supported by evidence","No measurement of key confounds","Preprint, not peer‑reviewed"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.22541/au.163345752.23446446/v1"}},{"id":1500,"doi":"10.1177/1079063220952777","pmid":"32847488","pmcid":null,"title":"Is Male Adolescents' Sexual Aggressiveness Better Explained by Prior Pornography Use or Callousness? A Brief Report","authors":"Štulhofer A.","first_author":"Štulhofer A.","journal":"Sexual abuse : a journal of research and treatment","year":2021,"pub_types":["Journal Article"],"keywords":["Adolescents","Sexual Aggression","Callousness","Pornography Use"],"is_oa":false,"oa_url":"https://repozitorij.ffzg.unizg.hr/islandora/object/ffzg:2269/datastream/FILE0","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal study with two assessment waves (T2 and T4) of 381 male adolescents; mixed‑effects regression used to predict sexual aggressiveness 11 months later.","sample_n":381,"sample_text":"381 male Croatian adolescents who participated in both waves","population":"Male adolescents, mean age ≈ 16, Croatia","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 381 Croatian boys, the personality trait of callousness predicted later sexual aggression, while the amount of pornography they watched did not. High callousness even weakened any link between porn use and aggression.","clinical_takeaway":"Focus prevention on callous traits rather than porn exposure when addressing adolescent sexual aggression.","confidence":0.7,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Large community sample of adolescents","Longitudinal design with temporal precedence","Appropriate mixed‑effects modeling"],"limitations":["Potential lack of validated scales (not described)","No control for key psychosocial confounds","Self‑report data only"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063220952777"}},{"id":1502,"doi":"10.1007/s10508-025-03385-y","pmid":"41369810","pmcid":null,"title":"Correction: Experiences with AI-Generated Pornography: A Quantitative Content Analysis of Reddit Posts","authors":"Döring N, Le TD, Miller DJ.","first_author":"Döring N","journal":"Archives of sexual behavior","year":2025,"pub_types":["Published Erratum"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03385-y"}},{"id":1504,"doi":"10.1177/1077801220945035","pmid":"32791027","pmcid":null,"title":"Women's Pornography Consumption, Alcohol Use, and Sexual Victimization","authors":"de Heer B, Prior S, Fejervary J.","first_author":"de Heer B","journal":"Violence against women","year":2021,"pub_types":["Journal Article"],"keywords":["Victimization","Sexual Violence","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 483 female university students examining self‑reported pornography use, alcohol consumption and sexual victimisation","sample_n":483,"sample_text":"N = 483 female students","population":"college females (N=483) from two universities","country":"unspecified (likely USA/Europe based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 483 college women, both watching porn and drinking alcohol were linked to higher chances of reporting sexual victimisation, with the combination of the two showing the strongest association.","clinical_takeaway":"Clinicians should note the association but recognize that causality is unproven; address alcohol use and contextual factors when discussing sexual safety.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a single‑site survey","Examines combined effect of pornography and alcohol"],"limitations":["Cross‑sectional design cannot establish causality","No measurement of key confounds (e.g., moral incongruence, mental health)","Pornography use measured with likely single‑item, unvalidated scale"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":8,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801220945035"}},{"id":1505,"doi":"10.3389/fpsyg.2025.1644453","pmid":"41426403","pmcid":"PMC12714939","title":"The gender-specific associations between perceived parenting and sexual-related behaviors among secondary vocational school students in China: a cross-sectional study","authors":"Xu S, Zuo X, Cheng Y, Jin Y, Fang Y, Zheng Y, Yu C, Lian Q, Lou C, Li L, Hong P, Tu X.","first_author":"Xu S","journal":"Frontiers in psychology","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Students","Adolescents","Parenting","Psychological Control"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12714939","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 3,237 secondary vocational students in China","sample_n":3237,"sample_text":"3,237 students from Shanghai Municipality and Shaanxi Province","population":"secondary vocational school students (China)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Chinese vocational‑school teens, stronger parental connectedness and monitoring are linked to less romantic, intimate, and porn‑related behaviour, with different patterns for boys and girls.","clinical_takeaway":"Encouraging supportive, monitoring parenting may reduce risky sexual behaviours in adolescents.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample size","Validated parenting measures","Gender‑specific analysis","Multilevel logistic regression with confidence intervals"],"limitations":["Cross‑sectional design limits causal inference","Sexual behaviour measured by self‑report items without validated scales","No control for key confounds (moral views, mental health, trauma, etc.)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2025.1644453"}},{"id":1506,"doi":"10.1177/08862605251393734","pmid":"41346065","pmcid":null,"title":"One Group or Many? Identifying Distinct Profiles of Adolescents Involved in Image-Based Sexual Abuse","authors":"Gewirtz-Meydan A, Mitchell KJ, O'Brien JE, Colburn DA.","first_author":"Gewirtz-Meydan A","journal":"Journal of interpersonal violence","year":2025,"pub_types":["Journal Article"],"keywords":["Victimization","Childhood Adversity","Latent Profile Analysis (Lpa)","Image-based Sexual Abuse (Ibsa)","Online Risky Sexual Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Latent Profile Analysis of an online survey of 2,630 young adults (18‑28), oversampling sexual/gender minorities and prior IBSA victims.","sample_n":2630,"sample_text":"online survey; convenience convenience sample, not nationally representative.","population":"young adults (18‑28), community sample recruited online; oversampling of sexual/gender minorities and those with prior IBSA exposure.","country":"unspecified (likely USA/International based on authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 2,630 young adults identified seven distinct groups based on experiences of image‑based sexual abuse, childhood adversity, online image‑sharing, and pornography use, showing that risk and resilience vary widely among victims.","clinical_takeaway":"Clinicians should recognise that people exposed to image‑based sexual abuse differ markedly; assessment should consider the broader pattern of trauma, online behaviour and mental‑health symptoms rather than assuming a uniform profile.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample (N>2500)","Use of person‑centred latent profile analysis to capture heterogeneity","Inclusion of multiple risk domains (victimisation, adversity, online behaviour)"],"limitations":["Cross‑sectional, cannot infer causality","Convenience online recruitment, oversampling may limit generalisability","Limited detail on measurement validity; likely reliance on ad‑hoc items"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605251393734"}},{"id":1507,"doi":"10.1186/s12889-025-25665-x","pmid":"41345930","pmcid":"PMC12797830","title":"A scoping review of factors associated with premarital sex-related risky sexual health behavior among adolescents in conservative societies based on the theory of planned behavior","authors":"Latuheru JA, Yosep I, Sriati A.","first_author":"Latuheru JA","journal":"BMC public health","year":2025,"pub_types":["Scoping Review","review-article","Journal Article"],"keywords":["Premarital sex","Adolescent","Theory Of Planned Behavior","Risky Sexual Behavior","Conservative Societies"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12797830","cited_by_count":0,"is_preprint":false,"topics":["pornography","sexual_health","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review of 23 primary studies; no new data collected; synthesis follows PRISMA‑ScR","sample_n":null,"sample_text":"Twenty‑three studies included; no total N reported in abstract","population":"adolescents (10‑24 y) in conservative societies","country":"multiple (studies from conservative settings)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review of 23 studies finds that in conservative societies, adolescent risky sexual behavior is linked to lower religiosity, peer pressure, substance use, and especially exposure to pornography, while strong family communication can be protective.","clinical_takeaway":"Consider addressing pornography exposure and family communication in sex‑education programs for adolescents in conservative settings.","confidence":0.7,"topic_tags":["adolescents","religiosity","pornography","relationships","sexual_function"],"strengths":["Systematic scoping methodology (PRISMA‑ScR)","Broad coverage of TPB factors","Identification of pornography exposure as a risk factor"],"limitations":["No primary data; relies on heterogeneous studies","No quantitative synthesis or effect‑size estimates","Limited assessment of confounding variables"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-025-25665-x"}},{"id":1509,"doi":"10.1007/s10508-020-01793-w","pmid":"32761283","pmcid":null,"title":"Does Low-Cost Sexual Gratification Make Men Less Eager to Marry? Pornography Use, Masturbation, Hookup Sex, and Desire to Be Married Among Single Men","authors":"Perry SL.","first_author":"Perry SL.","journal":"Archives of sexual behavior","year":2020,"pub_types":["Journal Article"],"keywords":["Gender","Masturbation","Exchange Theory","Pornography","Cheap Sex","Hookup Sex"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["bibliography","masturbation","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey analysis of two nationally representative US adult samples (N=349; N=1402); logistic regression examining association between pornography use, masturbation, hookup sex and desire for marriage.","sample_n":1751,"sample_text":"Combined N=1751 (349 + 1402) single men from two national surveys.","population":"Single adult men in the United States (age 18+); nationally representative probability samples.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using two US national surveys, the study found that men who watch pornography are actually more likely to want to get married, while masturbation and casual hookups do not affect this desire. The hypothesis that easy sexual gratification makes men less eager to marry was not supported.","clinical_takeaway":"Pornography use does not appear to reduce men’s interest in marriage; clinicians should not assume ‘cheap sex’ undermines marital intentions.","confidence":0.85,"topic_tags":["pornography","masturbation","relationships","sexual_function"],"strengths":["Large, nationally representative samples","Separate measurement of pornography, masturbation, and hookup sex","Controls for several relevant covariates"],"limitations":["Cross‑sectional design cannot establish causality","No measurement of moral/religious attitudes or mental‑health variables","Effect sizes and confidence intervals not reported in abstract"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":10,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01793-w"}},{"id":1510,"doi":"10.1016/j.jbef.2020.100379","pmid":"32835012","pmcid":"PMC7398053","title":"Sex and \"the City\": Financial stress and online pornography consumption","authors":"Donadelli M, Lalanne M.","first_author":"Donadelli M","journal":"Journal of behavioral and experimental finance","year":2020,"pub_types":["brief-report","Journal Article"],"keywords":["Uncertainty","Financial Stress","Online Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7398053","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Ecological analysis of daily website access data across cities; correlational.","sample_n":null,"sample_text":"Aggregate city‑level daily access counts; no individual‑level sample size reported.","population":"aggregate internet users of a major porn site across 43 cities in 10 countries (2016)","country":"International (10 countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study looked at how financial stress in different cities relates to online porn viewing, using site traffic data from 2016. It found that in financially stressed cities, porn consumption tended to drop, possibly because of mood changes.","clinical_takeaway":"None - the findings are ecological and do not provide guidance for individual clinical care.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Objective behavioural measure (site traffic)","Large geographic coverage","Novel use of real‑world data"],"limitations":["Ecological design; cannot infer individual‑level effects","No measurement of key psychological confounds","Causal language despite correlational analysis"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jbef.2020.100379"}},{"id":1512,"doi":"10.1071/sh22122","pmid":"36966731","pmcid":null,"title":"Trends in testing of sexually transmissible infections (STIs), sexual health knowledge and behaviours, and pornography use in cross-sectional samples of young people in Victoria, Australia, 2015-21","authors":"Eddy S, Douglass C, Raggatt M, Thomas A, Lim M.","first_author":"Eddy S","journal":"Sexual health","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Seven online cross‑sectional surveys of convenience sample (N=7014) of 15‑29‑year‑olds in Victoria, Australia, 2015‑2021.","sample_n":7014,"sample_text":"Convenience online sample recruited for each survey; not nationally representative.","population":"young Australians (15‑29 y, 67 % female)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Seven online surveys of over 7,000 Australian youths (15‑29) tracked sexual behaviours, STI testing, knowledge and porn use from 2015‑2021. Porn use stayed stable, while condom use and STI testing remained low despite higher contraceptive uptake.","clinical_takeaway":"Stable pornography use and low STI testing suggest ongoing public‑health gaps; clinicians should continue routine STI screening and education.","confidence":0.8,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["large overall sample size","covers multiple years to assess trends","includes a range of sexual‑health outcomes"],"limitations":["convenience, non‑representative sampling","pornography use measured with a single, unvalidated item","no control for key confounds (moral incongruence, masturbation, mental health, etc.)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh22122"}},{"id":1515,"doi":"10.1080/0092623x.2023.2193182","pmid":"36974348","pmcid":"PMC10522785","title":"Associations Between Pornography Consumption Patterns, Pornography Consumption Motives, and Social Wellbeing among U.S. College Students: A Latent Profile Analysis with a Primarily Female Sample","authors":"Maitland DWM, Neilson EC.","first_author":"Maitland DWM","journal":"Journal of sex & marital therapy","year":2023,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey with latent profile analysis of college students (N=389)","sample_n":389,"sample_text":"college student convenience sample","population":"U.S. college students, primarily female","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among U.S. college students, four groups differing in why they view porn were identified. Those who used porn a lot and felt guilt reported poorer social support, more fear of intimacy, and higher loneliness than other groups and non‑users.","clinical_takeaway":"High‑motivation porn users who experience guilt may need support for social wellbeing; clinicians should assess motives and emotional outcomes, not just use frequency.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["large sample for LPA","use of validated wellbeing scales","focus on motives, not just frequency"],"limitations":["cross‑sectional; no causal inference","no measurement of moral incongruence or other key confounds","college‑student, primarily female sample limits generalisability"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2023.2193182"}},{"id":1516,"doi":"10.1186/s12978-025-02226-4","pmid":"41310699","pmcid":"PMC12763984","title":"Sexual Behaviour and Masturbation Practices: Impacts on Psychological well-being among tertiary students in Ghana","authors":"Abu Bonsra E, Kwame Ananga M, Aboagye P, Twumasi E, Abem MA.","first_author":"Abu Bonsra E","journal":"Reproductive health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Ghana","Masturbation","Psychological Well-being","Risky Sexual Behaviours"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12763984","cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large‑sample (N=1684) multistage cross‑sectional survey of Ghanaian tertiary students","sample_n":1684,"sample_text":"multistage sampling of 1,684 students","population":"students in Ghanaian tertiary institutions","country":"Ghana","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,684 Ghanaian university students found that 60% had ever masturbated and that those who masturbated were much more likely to report risky sexual behaviour and poorer mental health. Physical complaints after masturbation were also common.","clinical_takeaway":"Masturbation was linked to poorer mental health in this sample, but causal direction is unclear; clinicians should assess broader psychosocial factors.","confidence":0.7,"topic_tags":["masturbation","religiosity","sexual_function"],"strengths":["large, multistage sample","validated mental‑health instrument (DASS‑21)","clear reporting of adjusted odds ratios with confidence intervals"],"limitations":["cross‑sectional design cannot infer causality","masturbation measured by single self‑report item","key confounds (moral incongruence, partner context, trauma) not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-025-02226-4"}},{"id":1517,"doi":"10.1007/s10508-020-01782-z","pmid":"32696155","pmcid":null,"title":"With or Without You: Associations Between Frequency of Internet Pornography Use and Sexual Relationship Outcomes for (Non)Consensual (Non)Monogamous Individuals","authors":"Rodrigues DL, Lopes D, Dawson K, de Visser R, Štulhofer A.","first_author":"Rodrigues DL","journal":"Archives of sexual behavior","year":2021,"pub_types":["Journal Article"],"keywords":["Monogamy","Sexual Satisfaction","Internet Pornography","Consensual Non-monogamy","Relationship Agreements"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 866 adults in various relationship agreements","sample_n":866,"sample_text":"N = 866 (66.3% women, mean age 27.4 y)","population":"adults (mean age 27) recruited online, majority women","country":"unspecified (likely multiple, based on authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 866 adults, people who are in consensually non‑monogamous relationships use internet porn more often but report similar sexual satisfaction to monogamous couples. Sharing porn with a partner is linked to higher sexual satisfaction and fewer arousal problems, especially for monogamous couples.","clinical_takeaway":"Clinicians should consider how couples use pornography together; shared use can be linked to greater sexual satisfaction rather than universally negative effects.","confidence":0.78,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Large sample (N > 800)","Examines nuanced relationship agreements","Considers partner‑shared pornography use"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of moral incongruence, masturbation, mental‑health covariates","Unclear if sexual‑satisfaction scales are validated"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01782-z"}},{"id":1518,"doi":"10.1177/1524838020942754","pmid":"32691692","pmcid":null,"title":"Pornography and Sexual Aggression: Can Meta-Analysis Find a Link?","authors":"Ferguson CJ, Hartley RD.","first_author":"Ferguson CJ","journal":"Trauma, violence & abuse","year":2022,"pub_types":["Meta-Analysis","Journal Article"],"keywords":["Rape","Domestic Violence","Sexual Aggression","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":41,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta-analysis of experimental, correlational, and population studies on pornography exposure and sexual aggression, assessing methodological quality and effect sizes.","sample_n":null,"sample_text":"Not applicable – secondary analysis of published studies.","population":"Not applicable (study synthesizes existing research).","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of studies from the 1970s onward finds no clear link between non‑violent pornography and sexual aggression, and only a weak correlation for violent pornography that may reflect selection rather than cause.","clinical_takeaway":"Current evidence does not support treating pornography use as a direct cause of sexual aggression.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Comprehensive synthesis across study designs","Transparent discussion of methodological weaknesses","Considers citation bias and preregistration needs"],"limitations":["Reliant on heterogeneous primary studies with variable construct measurement","No new primary data; conclusions limited by quality of existing literature","Lacks detailed analysis of potential confounds such as moral beliefs or mental health"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":0,"mentioning":54,"citing_publications":131,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1524838020942754"}},{"id":1521,"doi":"10.1038/s41598-025-28166-4","pmid":"41291104","pmcid":"PMC12727799","title":"Risky sexual behavior and its associated factors among employees in industrial park, Northeast, Ethiopia","authors":"Bizu YS, Ayenew KD.","first_author":"Bizu YS","journal":"Scientific reports","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Ethiopia","Risky Sexual Behavior","Employees","Industry Park"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12727799","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross_sectional","sample_n":410,"sample_text":"410 participants recruited by systematic sampling","population":"industrial park employees, Northeast Ethiopia (n≈410)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 410 Ethiopian factory workers, about one‑quarter reported risky sexual behaviour. Watching pornography, drinking alcohol, peer pressure, younger age and coming from a different residence were linked to higher odds of such behaviour.","clinical_takeaway":"Screen for pornography use and alcohol consumption when addressing sexual health risks among employees.","confidence":0.7,"topic_tags":["relationships","sexual_function"],"strengths":["large community sample (n=410)","use of multivariable logistic regression with confidence intervals","systematic sampling reduces selection bias"],"limitations":["cross‑sectional design cannot infer causality","key constructs not measured with validated scales","important confounders (moral views, mental health, partner context) not assessed"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-025-28166-4"}},{"id":1522,"doi":"10.1007/s10508-020-01773-0","pmid":"32661813","pmcid":null,"title":"A Descriptive Analysis of the Types, Targets, and Relative Frequency of Aggression in Mainstream Pornography","authors":"Fritz N, Malic V, Paul B, Zhou Y.","first_author":"Fritz N","journal":"Archives of sexual behavior","year":2020,"pub_types":["Journal Article"],"keywords":["Content analysis","Sexual Aggression","Violence Against Women","Social Cognitive Theory","Pornography","Pornhub"],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 4009 heterosexual porn scenes from two major tube sites; descriptive statistics and category comparisons.","sample_n":4009,"sample_text":"4009 heterosexual scenes from Pornhub and Xvideos","population":"Scenes from Pornhub and Xvideos (heterosexual); not a human participant sample.","country":"Not applicable (online content)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Analyzing over 4,000 free online porn videos, researchers found that almost half show physical aggression, mostly men assaulting women, and the victims are usually shown responding neutrally or positively.","clinical_takeaway":"Aggressive acts are common in mainstream porn; clinicians should be aware when discussing media influences with clients.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large systematic sample of contemporary porn scenes","Clear coding categories for types of aggression","Relevant to public‑health concerns about media violence"],"limitations":["Coding scheme not reported as previously validated","Only two tube sites; may not represent all porn content","No assessment of viewer impact or psychological outcomes"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":54,"citing_publications":123,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01773-0"}},{"id":1525,"doi":"10.31234/osf.io/bct3p","pmid":null,"pmcid":null,"title":"Body gaze as a marker of sexual objectification: A new scale for pervasive gaze and gaze provocation behaviors in heterosexual women and men","authors":"Hollett RC, Rogers SL, Florido PM, Mosdell BA.","first_author":"Hollett RC","journal":"PsyArXiv","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://psyarxiv.com/bct3p/download","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Study 1: large N=1021 survey; Study 2: N=167 eye‑tracking validation; factor analysis, test‑retest reliability.","sample_n":1021,"sample_text":"Study 1 N = 1021; Study 2 subsample N = 167","population":"heterosexual adult participants (online sample)","country":"unspecified (likely USA/Canada based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a questionnaire measuring how often people look at others' bodies (pervasive gaze) and how much they try to invite such looks (gaze provocation). The scales showed good reliability and correlated with eye‑tracking data and attitudes toward sexual assault.","clinical_takeaway":"None – the study provides a research tool, not clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large survey sample for scale development","Rigorous factor analysis and reliability testing","Objective eye‑tracking validation of self‑report"],"limitations":["Cross‑sectional design; no causal inference","Limited assessment of potential confounds (e.g., mental health)","Eye‑tracking subsample modest (N=167)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/bct3p"}},{"id":1526,"doi":"10.31234/osf.io/pwmqu","pmid":null,"pmcid":null,"title":"Intrasexual competition as a predictor of women’s judgements of revenge pornography offending","authors":"Fido D, Harper CA, Davis M, Petronzi D, Worrall SGM.","first_author":"Fido D","journal":"PsyArXiv","year":2018,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/pwmqu","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Two independent convenience samples (N=241, N=402) completed surveys assessing intrasexual competition, attractiveness, and judgments of revenge‑pornography offenses; moderation analyses were conducted.","sample_n":643,"sample_text":"Combined total N across two studies = 241 + 402 = 643 participants.","population":"Adults recruited online (likely WEIRD sample); not a clinical or treatment‑seeking group.","country":"Not specified (presumably USA/UK based on author affiliations).","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examined whether women who are more competitive with other women judge revenge‑pornography offences more leniently. Across two surveys, higher intrasexual competition was linked to slightly softer judgments of offenses against male victims.","clinical_takeaway":"None – the findings relate to attitude formation, not clinical treatment.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large combined sample size","Use of established psychological scales","Open data and pre‑registration","Controls for several relevant personality variables"],"limitations":["Cross‑sectional design limits causal inference","No control for moral incongruence or mental‑health factors","Sample likely not representative of broader population"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/pwmqu"}},{"id":1527,"doi":"10.1080/0092623x.2023.2186992","pmid":"36916293","pmcid":null,"title":"Reasons for Moral-Based Opposition to Pornography in a U.S. Nationally Representative Sample","authors":"Hoagland KC, Rotruck HL, Moore JN, Grubbs JB.","first_author":"Hoagland KC","journal":"Journal of sex & marital therapy","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative U.S. sample (N=1,020) using open‑ended questions; thematic analysis of reasons for moral opposition to pornography.","sample_n":1020,"sample_text":"Nationally representative U.S. adult sample (N=1,020) who reported moral opposition to pornography.","population":"U.S. adults, diverse ages, genders, religious and political backgrounds","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a U.S. survey of 1,020 adults who oppose pornography, researchers identified 14 common reasons—like religion, concerns about abuse, and disgust—and showed how these reasons vary by gender, age, and political views.","clinical_takeaway":"Understanding moral reasons for opposing porn can help clinicians address clients' values when discussing sexual media use.","confidence":0.85,"topic_tags":["pornography","moral_incongruence","religiosity","sexual_function","csbd"],"strengths":["Large, nationally representative sample","Open‑ended approach captures nuanced reasons","Links themes to demographic variables"],"limitations":["Reliance on self‑report and thematic coding without validated scales","No assessment of potential confounds such as mental health or sexual behavior","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2023.2186992"}},{"id":1528,"doi":"10.1192/bjp.2025.10379","pmid":"41261989","pmcid":null,"title":"Cue reactivity towards distal cues in specific types of problematic usage of the internet: findings from diagnostically validated samples","authors":"Antons S, Müller SM, Thomas TA, Schmid AM, Kessling A, Joshi M, Krikova K, Kampa M, Mallon L, Schmidt LD, Klein L, Dominick N, Büsche K, Oelker A, Brandtner A, Montag C, Wölfling K, Wolf OT, Klucken T, Rumpf HJ, Steins-Loeber S, Stark R, Müller A, Diers M, Wegmann E, Brand M.","first_author":"Antons S","journal":"The British journal of psychiatry : the journal of mental science","year":2025,"pub_types":["Journal Article"],"keywords":["Craving","Associative learning","Urge","Internet Addiction","Gaming Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Laboratory cue‑reactivity paradigm with distal cues; three groups (non‑problematic, risky, pathological) of internet users (n≈536); repeated‑measures ANOVA and natural‑environment correlations; preregistered.","sample_n":536,"sample_text":"n=268 non‑problematic, n=135 risky, n=133 pathological","population":"Adults 18‑65 years, community sample, both sexes, diagnosed into PUI severity groups.","country":"Not specified in abstract","controls_mi":"no","preregistered":true,"quality_score":7,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a preregistered study, people with risky or pathological internet use (including pornography) showed stronger cravings and urges when shown neutral device screens (like login pages) compared with non‑problematic users. Lab‑measured cue reactivity related to real‑world use and temptation.","clinical_takeaway":"Cue exposure, even without explicit sexual content, may trigger cravings in problematic users; clinicians should consider environmental triggers beyond explicit material.","confidence":0.78,"topic_tags":["pornography","masturbation","csbd","sexual_function"],"strengths":["Large community sample with diagnostic validation","Pre‑registered protocol","Mixed laboratory and natural‑environment data"],"limitations":["Key confounds (morality, mental health, partner context) not measured","Cross‑sectional design limits causal inference","Cue‑reactivity measured only via self‑report"],"rubric_version":"2.0","raw_total":39,"max_possible":60,"pct_score":65,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":4,"design":6,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/bjp.2025.10379"}},{"id":1529,"doi":"10.1007/s10508-020-01765-0","pmid":"32601838","pmcid":null,"title":"A State-Level Analysis of Mortality and Google Searches for Pornography: Insight from Life History Theory","authors":"Cheng L, Zhou X, Wang F, Xiao L.","first_author":"Cheng L","journal":"Archives of sexual behavior","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Mortality","Life History Theory","Google Trends","Pornography","Violent Crime Rate"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"state-level ecological analysis using Google Trends data correlated with mortality/violent crime rates","sample_n":50,"sample_text":"All 50 U.S. states included in analysis","population":"U.S. states (n≈50)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that U.S. states with higher death or violent‑crime rates also show more Google searches for pornography, suggesting a link between harsh socio‑ecological environments and online sexual interest at the state level.","clinical_takeaway":"None – the findings are ecological and do not provide guidance for individual clinical practice.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Novel ecological perspective","Use of publicly available large‑scale data","Integration of life‑history theory"],"limitations":["Ecological design; cannot infer individual behavior","Google searches are an imperfect proxy for pornography use","No control for key confounds (moral views, mental health, etc.)","Potential reverse causality and omitted variable bias"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01765-0"}},{"id":1531,"doi":"10.1177/0024363920933114","pmid":"33100393","pmcid":"PMC7551539","title":"Internet Pornography: Some Medical and Spiritual Perspectives","authors":"McTavish J.","first_author":"McTavish J.","journal":"The Linacre quarterly","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Prevention","Addiction","Chastity","Pornography","Evangelization","Spirituality And The Person"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"commentary","design_detail":"essay/position paper without empirical data","sample_n":null,"sample_text":"","population":"general public (no sample)","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","no_mi_control"],"stance":"strongly-supports","citation_value":"background","plain_summary":"The article argues that internet pornography is harmful to individuals and society, describing personal, psychological, and social dangers, and promotes chastity and prayer as solutions.","clinical_takeaway":"None – the paper provides no clinical data or recommendations.","confidence":0.3,"topic_tags":["pornography","sexual_function","moral_incongruence","religiosity"],"strengths":["Clear articulation of a moral perspective","Highlights societal concerns about pornography"],"limitations":["No empirical data or methodology","No measurement of constructs or confounds","Highly advocacy‑driven, not evidence‑based"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0024363920933114"}},{"id":1532,"doi":"10.1111/jsm.12667","pmid":"25124118","pmcid":null,"title":"Affective and cognitive determinants of women's sexual response to erotica","authors":"Vilarinho S, Laja P, Carvalho J, Quinta-Gomes AL, Oliveira C, Janssen E, Nobre PJ.","first_author":"Vilarinho S","journal":"The journal of sexual medicine","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Psychophysiology","Affect","Sexual Arousal","Genital Response","Self-reported Thoughts","Vaginal Photoplethysmography"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory experiment with physiological recording; within‑subject exposure to erotic vs non‑erotic films; N=28 sexually functional women; cross‑sectional.","sample_n":28,"sample_text":"Twenty‑eight sexually functional women (mean age = 32, SD = 6.29)","population":"Adult women, mean age 32, sexually functional, recruited likely via convenience sampling","country":"Portugal (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 28 women, researchers showed erotic and non‑erotic movies while measuring genital blood flow and asking participants about their thoughts and feelings. Thoughts and emotions predicted how aroused they felt, but did not predict genital response, suggesting subjective and physiological arousal are driven by different processes.","clinical_takeaway":"Subjective arousal is strongly linked to what women think and feel during erotic material; clinicians should consider cognitive‑affective factors when addressing sexual satisfaction.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Objective physiological measurement (VPA)","Integration of cognitive and affective self‑reports","Clear within‑subject experimental design"],"limitations":["Small, non‑representative sample (N = 28)","No control for key confounds (mood, relationship status, etc.)","Limited reporting of statistical power or confidence intervals"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12667"}},{"id":1533,"doi":"10.1071/sh14032","pmid":"25087581","pmcid":null,"title":"Prevalence, correlates and attitudes towards sexting among young people in Melbourne, Australia","authors":"Yeung TH, Horyniak DR, Vella AM, Hellard ME, Lim MS.","first_author":"Yeung TH","journal":"Sexual health","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1372 festival attendees (convenience sample) plus focus groups (n=39)","sample_n":1372,"sample_text":"convenience sample at a music festival","population":"young people age 16‑29 in Melbourne, Australia","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2014 survey of 1,372 Australian youths at a music festival found that 40% had ever sent or received a sext, especially with regular partners. Sexting was linked to lower education, more sexual partners, risky alcohol use and non‑heterosexual identity. Young people viewed consensual sexting as normal and beneficial, while distinguishing it from non‑consensual sharing.","clinical_takeaway":"Sexting is common among young Australians and generally seen as a normal part of sexual expression, but clinicians should differentiate consensual from non‑consensual sharing when discussing sexual health.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["large N for a survey","mixed methods (quantitative + focus groups)","identifies multiple behavioural correlates"],"limitations":["convenience sample limits generalisability","no validated sexting scale reported","cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":11,"contrasting":1,"mentioning":58,"citing_publications":80,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh14032"}},{"id":1535,"doi":"10.1186/s12888-020-02702-0","pmid":"32560677","pmcid":"PMC7304237","title":"A psychometric approach to assessments of problematic use of online pornography and social networking sites based on the conceptualizations of internet gaming disorder","authors":"Mennig M, Tennie S, Barke A.","first_author":"Mennig M","journal":"BMC psychiatry","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Validation","Questionnaire","Social Networking","Problematic Internet Use","Online Pornography","Cyberpornography"],"is_oa":true,"oa_url":"https://bmcpsychiatry.biomedcentral.com/track/pdf/10.1186/s12888-020-02702-0","cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey with 700 participants per group; questionnaire validation (factor analysis, reliability), correlational comparisons between problematic and non‑problematic users","sample_n":1400,"sample_text":"Two online convenience samples (n=700 each) completed adapted IGD questionnaires, the Brief Symptom Inventory and the short Internet Addiction Test.","population":"adult internet users (SNS sample 76% female, OP sample 76% male), recruited online","country":"unspecified (likely Germany/Europe based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study adapted a gaming‑addiction questionnaire to measure problematic use of social media and online pornography, showing good reliability and a single underlying factor, and linking higher scores to more internet use and greater psychological distress.","clinical_takeaway":"The new scales may help identify users reporting distress linked to heavy porn or social‑media use, but they do not separate moral concerns or masturbation effects.","confidence":0.85,"topic_tags":["pornography","sexual_function","measurement","prevalence"],"strengths":["Large sample size for psychometric validation","Comprehensive factor analytic approach","Comparison with established short IAT"],"limitations":["Convenience online sample, possible selection bias","No measurement of masturbation or moral incongruence","Addiction construct derived from gaming criteria without direct testing of tolerance/withdrawal"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12888-020-02702-0"}},{"id":1537,"doi":"10.1177/1079063220931823","pmid":"32532176","pmcid":null,"title":"Pornography Use and Sexual Coercion: Examining the Mediation Effect of Sexual Arousal","authors":"Marshall E, Bouffard JA, Miller H.","first_author":"Marshall E","journal":"Sexual abuse : a journal of research and treatment","year":2021,"pub_types":["Journal Article"],"keywords":["Rape","Sexual Arousal","Sexual Coercion","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Randomized laboratory experiment with two exposure conditions (exotic video vs criminal‑justice lecture) and mediation analysis; N=745 college students.","sample_n":745,"sample_text":"Large convenience sample of university students; not nationally representative.","population":"College students (young adult males and females)","country":"Not specified (likely USA/Canada based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study of 745 college students, more frequent porn use was linked to higher sexual arousal after watching an erotic video, but that arousal did not explain greater willingness to engage in verbal or illegal sexual coercion.","clinical_takeaway":"Higher porn use alone does not increase risk of sexual coercion via arousal; other factors should be considered in prevention efforts.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for experimental design","Random assignment to differing video conditions","Attempts to control for known predictors of coercion"],"limitations":["Reliance on self‑report and likely unvalidated scales","Potential unmeasured confounds (e.g., moral attitudes, mental health)","Convenience student sample limits generalisability"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063220931823"}},{"id":1538,"doi":"10.3390/bs15111547","pmid":"41301349","pmcid":"PMC12649298","title":"Cyber-Sexual Crime and Social Inequality: Exploring Socioeconomic and Technological Determinants","authors":"Mármol CJ, Luna A, Legaz I.","first_author":"Mármol CJ","journal":"Behavioral sciences (Basel, Switzerland)","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Socioeconomic Inequality","Online Harassment","Digital Access","Cyber-sexual Crime","Economics And Spanish Law"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12649298","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"ecological analysis of regional crime statistics (2011‑2022) linked to socioeconomic indicators; ANOVA, correlations, K‑means clustering","sample_n":null,"sample_text":"All reported cyber‑sexual crimes in the Spanish Statistical Crime Portal combined with regional socioeconomic data","population":"Spanish regions (N = 17 autonomous communities)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study maps cyber‑sexual crimes across Spain (2011‑2022) and finds higher rates in regions with lower education and income, while greater digital access predicts more grooming and online harassment. Structural inequalities shape who is most exposed to these crimes.","clinical_takeaway":"None – the paper addresses population‑level crime patterns, not individual clinical issues.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Large, nation‑wide official data set","Clear definition of incidence rates","Multivariate statistical approach (ANOVA, clustering)"],"limitations":["Ecological design limits individual‑level inference","No control for individual‑level confounders","Cross‑sectional; cannot assess causality"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs15111547"}},{"id":1539,"doi":"10.1080/00224499.2023.2170964","pmid":"36809118","pmcid":null,"title":"Fantasy Made Flesh - A Network Analysis of the Reciprocal Relationship between Sexual Fantasies, Pornography Usage, and Sexual Behavior","authors":"von Andrian-Werburg MTP, Klopp E, Schwab F.","first_author":"von Andrian-Werburg MTP","journal":"Journal of sex research","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.1080/00224499.2023.2170964","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional network analysis of self‑report data (N=1338) collected online in Germany; separate analyses for men and women.","sample_n":1338,"sample_text":"large, diverse German adult sample; recruitment method unclear, likely non‑probability.","population":"Adults (hetero‑ and bisexual) from Germany; recruitment method not specified (likely convenience/online).","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a German sample of 1338 adults, the authors mapped how pornography use, sexual fantasies, and sexual behaviours are linked. Using network analysis, they found that pornography is more closely tied to non‑mainstream fantasies and behaviours (e.g., BDSM) than to everyday sexual activities.","clinical_takeaway":"Pornography appears to relate more to specific, non‑mainstream fantasies and behaviours rather than to general sexual activity; clinicians should consider individual fantasy patterns when discussing porn use.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (N>1300)","Gender‑specific network analyses","Innovative application of network modelling"],"limitations":["Reliance on ad‑hoc self‑report items, limited validation","Cross‑sectional design cannot infer causality","No measurement of key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2170964"}},{"id":1540,"doi":"10.1177/1079063220928958","pmid":"32482122","pmcid":null,"title":"Spanish Validation of the Child Pornography Offender Risk Tool","authors":"Soldino V, Carbonell-Vayá EJ, Seigfried-Spellar KC.","first_author":"Soldino V","journal":"Sexual abuse : a journal of research and treatment","year":2021,"pub_types":["Journal Article"],"keywords":["risk assessment","Recidivism","Child Pornography","Child Sexual Exploitation Material","Cport"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"5‑year fixed follow‑up cohort of 304 arrested men, split into CP‑exclusive (n=255) and CP‑plus other crimes (n=49); ROC and calibration analyses of a risk‑assessment tool.","sample_n":304,"sample_text":"304 men (255 CP‑exclusive, 49 CP‑plus other crimes)","population":"Men arrested for child‑pornography offenses in Spain; adult forensic sample.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested how well a risk‑assessment tool predicts new child‑pornography offenses in 304 Spanish offenders over five years, finding modest predictive ability but lower actual recidivism than expected.","clinical_takeaway":"Risk tools may overestimate re‑offending; use with caution in forensic assessments.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, well‑defined forensic cohort","Five‑year follow‑up allows prospective assessment","Use of ROC and calibration analyses"],"limitations":["No external validation sample from another jurisdiction","Limited reporting of tool item psychometrics","Potential unmeasured confounders (e.g., mental health) not addressed"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":3,"mentioning":36,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063220928958"}},{"id":1543,"doi":"10.2196/15964","pmid":"32348268","pmcid":"PMC7296407","title":"A Digital Pornography Literacy Resource Co-Designed With Vulnerable Young People: Development of \"The Gist\"","authors":"Davis AC, Wright CJ, Murphy S, Dietze P, Temple-Smith MJ, Hellard ME, Lim MS.","first_author":"Davis AC","journal":"Journal of medical Internet research","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sex Education","Sexual Health","Co-design","Pornography Literacy"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7296407","cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Co-design development of a digital pornography‑literacy prototype with 17 vulnerable young people (ages 14‑23) in four workshops; no outcome evaluation.","sample_n":17,"sample_text":"17 young people aged 14‑23 recruited from youth services / alternative education programs","population":"vulnerable youth (service‑engaged, alternative education)","country":"Australia (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers worked with 17 vulnerable young people to design a digital tool that teaches about sex, relationships and how to understand porn messages. The co‑design process showed participants could spot problematic porn content but lacked healthier alternatives.","clinical_takeaway":"No direct clinical guidance; the prototype may become a useful education resource pending effectiveness testing.","confidence":0.8,"topic_tags":["pornography","sexual_function","prevalence","adolescents"],"strengths":["Participatory co‑design approach","Focus on vulnerable youth","Identifies gaps in existing pornography literacy"],"limitations":["Very small, non‑representative sample","No empirical testing of the prototype’s effectiveness","No validated measures of pornography use or related outcomes"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":33,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/15964"}},{"id":1544,"doi":"10.1007/s10508-008-9387-0","pmid":"18561012","pmcid":null,"title":"Pornography, sexual socialization, and satisfaction among young men","authors":"Stulhofer A, Busko V, Landripet I.","first_author":"Stulhofer A","journal":"Archives of sexual behavior","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":82,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 650 Croatian men aged 18‑25; structural equation modelling of a theoretical model of pornography effects","sample_n":650,"sample_text":"young Croatian men, 18‑25 years, recruited via online survey","population":"young adult men, convenience sample","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 650 Croatian men found that early exposure to porn, especially paraphilic material, was linked to slightly lower sexual satisfaction later, with effects mediated by sexual scripts and increased sexual boredom.","clinical_takeaway":"Early, especially paraphilic, porn exposure may modestly reduce sexual satisfaction; media‑literacy education is recommended.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (N=650)","Use of structural equation modelling to test theory","Measures both mainstream and paraphilic SEM use"],"limitations":["Novel, unvalidated instrument for sexual scripts","Cross‑sectional design, cannot infer causality","Convenience sample, limited generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":107,"citing_publications":214,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-008-9387-0"}},{"id":1545,"doi":"10.1080/00224499.2023.2174248","pmid":"36795102","pmcid":null,"title":"Revisiting the Role of Pornography Use in the Confluence Model Theory of Sexual Aggression","authors":"Kohut T, Fisher WA.","first_author":"Kohut T","journal":"Journal of sex research","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Three online surveys (MTurk, Canadian student, Canadian non‑student) of young adult males (N≈1500, 1050, 905). Self‑report measures of hostile masculinity, impersonal sexuality, pornography use (magazine vs. internet) and sexual aggression. Cross‑sectional regression analyses testing interaction eff","sample_n":3482,"sample_text":"Combined N≈3,500 men (MTurk N=1,528; Canadian students N=1,049; Canadian non‑students N=905).","population":"Young adult men (average ages 20‑23) recruited via MTurk and Canadian university/college sampling frames; convenience samples, not probability‑based.","country":"USA (MTurk) and Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether men who are hostile towards women and prefer impersonal sex are more likely to commit sexual aggression, and whether pornography use adds to this risk. Using large online surveys, they found the two personality factors predict aggression, but the link with pornography depended on how use was measured—magazine reading showed a link, broader internet use did not.","clinical_takeaway":"Sexual aggression appears tied to hostile masculinity and impersonal sexuality; pornography’s role is unclear and depends on measurement, so clinicians should assess underlying attitudes rather than assume porn causes aggression.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large combined sample size","Tests a well‑specified theoretical model (Confluence Model)","Compares two operationalizations of pornography use"],"limitations":["Cross‑sectional; cannot infer causality","Convenience samples limit generalisability","Pornography use measured with non‑validated, inconsistent items"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2174248"}},{"id":1547,"doi":null,"pmid":"25602747","pmcid":null,"title":"[Epidemiology of sexting]","authors":"Pellai A, Erba S, Ciampelli A, Iemmi D, Bronzin S, Capobussi M, Degnoni V, Gattoni ME, Corradin M.","first_author":"Pellai A","journal":"Minerva pediatrica","year":2015,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"ita","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"literature review of existing surveys and Google Trends; no primary data collection; descriptive prevalence estimates","sample_n":null,"sample_text":"based on published surveys (Eurispes, Telefono Azzurro) and Google Trends; no original sample size reported","population":"adolescents (12‑18 years) in Italy and USA (secondary data)","country":"Italy; United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews existing surveys to estimate how many teens in Italy and the US exchange sexually explicit images. It finds rising rates, especially in Italy, and notes that a small minority use sexting for threats or money.","clinical_takeaway":"None – the study is descriptive and does not inform clinical practice.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Provides cross‑national prevalence snapshot","Highlights legal and educational implications"],"limitations":["Relies on secondary self‑report surveys with unknown methodology","No systematic review protocol or risk‑of‑bias assessment","No measurement of key confounds (moral, mental health, etc.)"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":1548,"doi":"10.1177/0025817219898151","pmid":"32427064","pmcid":null,"title":"Child pornography: Characteristics of its depiction and use","authors":"Prat S, Bertsch I, Praud N, Huynh AC, Courtois R.","first_author":"Prat S","journal":"The Medico-legal journal","year":2020,"pub_types":["Systematic Review","Journal Article"],"keywords":["Internet","Forensic Psychiatry","Sexual Offence","Child Pornography","Paedophilia"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Narrative systematic review of criminological literature on child pornography; no indication of pre‑registration, PRISMA adherence, or formal risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not reported in abstract; review of prior studies.","population":"Adults involved in creation, distribution, or consumption of illegal child sexual imagery (as reported in the literature).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises how child sexual images are produced and shared online, describing typical content features and user patterns to aid law‑enforcement identification.","clinical_takeaway":"None – the paper focuses on forensic aspects of illegal material, not on clinical sexual health.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses a legally and socially important topic.","Synthesises criminological literature on child sexual exploitation."],"limitations":["No evidence of systematic review methodology (PRISMA, risk‑of‑bias).","Absence of quantitative meta‑analysis or effect‑size reporting.","Lacks clear inclusion/exclusion criteria and quality appraisal."],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0025817219898151"}},{"id":1549,"doi":"10.3390/ijerph17103462","pmid":"32429206","pmcid":"PMC7277927","title":"Aligning the \"Manifesto for a European Research Network into Problematic Usage of the Internet<i>\"</i> with the Diverse Needs of the Professional and Consumer Communities Affected by Problematic Usage of Pornography","authors":"Mead D, Sharpe M.","first_author":"Mead D","journal":"International journal of environmental research and public health","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Manifesto","Cost Action Network","Behavioural Addiction Research.","Problematic Usage Of Pornography","Problematic Usage Of The Internet"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/17/10/3462/pdf?version=1589934305","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/analysis of a research manifesto; no empirical data collected","sample_n":null,"sample_text":"N/A","population":"N/A","country":"Europe (COST Action network, multinational)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review the 2018 European \"Manifesto for Problematic Usage of the Internet\" and note that while pornography misuse is listed as a priority, it is barely discussed. Using the manifesto’s framework, they propose many research topics that could help clinicians support people experiencing problematic pornography use.","clinical_takeaway":"None – the paper offers research ideas rather than clinical evidence.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Clear systematic alignment with an existing research agenda","Identifies multiple future research opportunities for clinicians","Grounded in a recognized European manifesto"],"limitations":["No original empirical data","No measurement or operationalisation of key constructs","Absence of any statistical analysis"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":2,"contrasting":0,"mentioning":44,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph17103462"}},{"id":1550,"doi":"10.2196/16702","pmid":"32406863","pmcid":"PMC7256746","title":"Sexual Behaviors and Violence in Pornography: Systematic Review and Narrative Synthesis of Video Content Analyses","authors":"Carrotte ER, Davis AC, Lim MS.","first_author":"Carrotte ER","journal":"Journal of medical Internet research","year":2020,"pub_types":["Systematic Review","review-article","Journal Article"],"keywords":["Sexual behavior","Content analysis","Sexual Violence","Pornography","Sexual Media"],"is_oa":true,"oa_url":"https://www.jmir.org/2020/5/e16702/PDF","cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of quantitative content analyses of video pornography (23 studies). Narrative synthesis without formal meta‑analysis or risk‑of‑bias assessment.","sample_n":null,"sample_text":"23 included content‑analysis studies; sample sizes of those primary studies not reported in abstract.","population":"Video‑based pornography content; no human participants directly studied.","country":"International (studies from various countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review examined 23 studies that counted how often porn videos show sexual acts, condom use, and aggression. It found condom use is rare, especially in heterosexual videos, and that some aggressive behaviors (like spanking) appear more often than extreme violence. The authors call for better‑designed research on porn content.","clinical_takeaway":"None – the review does not provide direct clinical guidance, but it notes that low condom use and gender‑based aggression in porn may influence viewers’ expectations about sex.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Systematic search of literature.","Broad coverage of multiple behavioral variables.","Highlights gaps in methodological consistency."],"limitations":["No formal risk‑of‑bias assessment of included studies.","Heterogeneous definitions across primary studies.","No quantitative meta‑analysis or effect‑size synthesis."],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":64,"citing_publications":102,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/16702"}},{"id":1551,"doi":"10.1007/s10508-023-02537-2","pmid":"36745284","pmcid":null,"title":"Victim Blaming and Non-Consensual Forwarding of Sexts Among Late Adolescents and Young Adults","authors":"Maes C, Van Ouytsel J, Vandenbosch L.","first_author":"Maes C","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sex","Adolescents","Young Adults","Pornography","Sexting","Victim Blaming"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey with 1343 Belgian participants (78.4% female), structural equation modeling of attitudes and self‑reported willingness to forward sexts","sample_n":1343,"sample_text":"Belgian convenience sample recruited via online panel; majority female; not a probability sample","population":"late adolescents and young adults (mean age 21.6 y)","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Belgian youths, stronger victim‑blaming attitudes were linked to a higher willingness to share others’ private sexts without consent. Peer and parent attitudes, low empathy, and high narcissism predicted more blaming. Pornography use was unexpectedly related to less characteristic‑based blaming.","clinical_takeaway":"Interventions should target victim‑blaming norms rather than focusing on the victims themselves to reduce non‑consensual sext sharing.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["large sample size for attitudinal work","use of structural equation modelling","examines peer/parent social influences"],"limitations":["cross‑sectional; cannot infer causality","no measurement of moral/religious beliefs","self‑report attitudes may be socially biased"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02537-2"}},{"id":1552,"doi":"10.1080/0092623x.2023.2174225","pmid":"36744624","pmcid":"PMC10404303","title":"Sexual Experiences and Beliefs Vary by Patterns of Pornography Genre Preferences Among Women","authors":"Maas MK, Slaker J, Holt K, Ratan RA, Cary KM, Greer KM.","first_author":"Maas MK","journal":"Journal of sex & marital therapy","year":2023,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 206 women, latent class analysis of genre preferences, regression controlling frequency of use","sample_n":206,"sample_text":"206 women","population":"women (n=206), likely convenience/online sample","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 206 women, four distinct pornography‑genre profiles were identified. These profiles were linked to differences in sexual experiences, beliefs, sexual esteem and prior victimisation, beyond simple use frequency.","clinical_takeaway":"Genre preferences may shape women’s sexual experiences; clinicians should ask about content, not just how often porn is used.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for latent‑class work","Controls for frequency of use and victimisation","Adds nuance by examining genre preferences"],"limitations":["Cross‑sectional; no causal inference","Genre preferences measured with non‑validated items","Key confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2023.2174225"}},{"id":1554,"doi":"10.1080/0092623x.2020.1760980","pmid":"32378472","pmcid":null,"title":"Are Playboy (and girl) Norms Behind the Relationship Problems Associated with Pornography Viewing in Men and Women?","authors":"Borgogna NC, Smith T, McDermott RC, Whatley M.","first_author":"Borgogna NC","journal":"Journal of sex & marital therapy","year":2020,"pub_types":["Journal Article"],"keywords":["Promiscuity","Relationship Satisfaction","Infidelity","Relationship Commitment","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["bibliography","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 286 men and 717 women examining relationships among pornography frequency, playboy‑norm conformity and relationship outcomes.","sample_n":1003,"sample_text":"men n=286; women n=717","population":"adult community sample (likely convenience recruitment)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed over 1,000 adults and found that people who follow ‘playboy’ norms—wanting many sexual partners—tend to report lower relationship satisfaction, commitment, and higher infidelity intent. When this norm is taken into account, the link between watching pornography and relationship problems largely disappears, especially for men.","clinical_takeaway":"Relationship issues linked to pornography may reflect broader norm‑conformity attitudes rather than porn use itself; clinicians should assess underlying gender‑norm beliefs.","confidence":0.8,"topic_tags":["pornography","relationships","sexual_function","gender"],"strengths":["Large sample for both sexes","Tests a theoretically relevant confound (playboy norms)","Uses moderation analyses to explore gender differences","Clearly reports that many associations become non‑significant after accounting for the confound"],"limitations":["Reliance on self‑report measures; scales for playboy norms likely not validated","Cross‑sectional design prevents causal inference","Other important confounds (moral incongruence, mental health, trauma) not measured","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2020.1760980"}},{"id":1555,"doi":"10.1093/jsxmed/qdaf209","pmid":"40974279","pmcid":null,"title":"What knowledge matters for women's sexual wellbeing? Validating a questionnaire measuring sexual knowledge using public and patient involvement","authors":"Grosse-Rueschkamp MS, Kronthaler SM, Legeland LT, Schulze D, Beier KM, Hatzler L.","first_author":"Grosse-Rueschkamp MS","journal":"The journal of sexual medicine","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Journal Article"],"keywords":["Female Sexual Function","Questionnaire Validation","Public And Patient Involvement","Sexual Knowledge","Sexual Wellbeing"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey with large community sample (N=2880) assessing a newly developed sexual knowledge questionnaire and its associations with validated sexual wellbeing measures.","sample_n":2880,"sample_text":"cross‑sectional community sample of cisgender women (N = 2880).","population":"cisgender women, mean age 31.9, recruited for a pilot and main survey (likely convenience/online).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and validated a questionnaire measuring women’s sexual knowledge. They found that “experiential knowledge and agency” (knowing one’s own body and feeling empowered) predicts better sexual function, desire, and communication, while factual knowledge about anatomy does not.","clinical_takeaway":"Assessing and improving experiential sexual knowledge may help enhance women’s sexual wellbeing.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample size for validation","Patient and public involvement in item generation","Rigorous factor‑analytic procedures (EFA, CFA, SEM)"],"limitations":["Cross‑sectional design, no causal inference","No control for key confounds (e.g., mental health, relationship status)","Sample limited to cisgender women, likely convenience recruitment"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf209"}},{"id":1556,"doi":"10.1093/jsxmed/qdaf283","pmid":"41066655","pmcid":null,"title":"Rethinking the rise of erectile dysfunction in young men: Perspective on \"Erectile dysfunction prevalence in the United States: report from the 2021 National Survey of Sexual Wellbeing\"","authors":"Goddard B, Terlecki T, Waggener K, Terlecki RP.","first_author":"Goddard B","journal":"The journal of sexual medicine","year":2025,"pub_types":["Journal Article"],"keywords":["erectile dysfunction","Social Media","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf283"}},{"id":1557,"doi":"10.3758/bf03194084","pmid":"17874583","pmcid":null,"title":"Attention and the processing of emotional words: dissociating effects of arousal","authors":"Aquino JM, Arnell KM.","first_author":"Aquino JM","journal":"Psychonomic bulletin & review","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"laboratory experiment with digit‑parity task, within‑subject manipulation of word type (threat, sexual, neutral); likely convenience sample of adults/college students","sample_n":null,"sample_text":"not reported in abstract","population":"adults (likely university students), both sexes","country":"Canada (Ontario mentioned in MeSH)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a lab task, participants were slower to judge numbers when sexually explicit words appeared as distractors, and this slowdown persisted across many trials. The effect was linked to how arousing the words were, suggesting sexual words capture attention more than threat‑related or neutral words.","clinical_takeaway":"None – the study examines basic attentional processes, not clinical outcomes.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Well‑controlled lab task isolates attentional capture","Uses established arousal/valence norms for stimuli","Includes memory test linking attention to later recall"],"limitations":["Convenience sample, likely students; limited generalisability","No pre‑registration, effect sizes not reported in abstract","No measurement of participant sexual experience or attitudes"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":0,"mentioning":50,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3758/bf03194084"}},{"id":1558,"doi":"10.3390/ijerph17093130","pmid":"32365874","pmcid":"PMC7246896","title":"Effects of Pornography Use and Demographic Parameters on Sexual Response during Masturbation and Partnered Sex in Women","authors":"McNabney SM, Hevesi K, Rowland DL.","first_author":"McNabney SM","journal":"International journal of environmental research and public health","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Sexual activity","Arousal","Masturbation","Orgasm","Pornography","Sexual Response","Partnered Sex","Orgasmic Difficulty","Orgasmic Pleasure"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/17/9/3130/pdf?version=1588240527","cited_by_count":17,"is_preprint":false,"topics":["bibliography","masturbation","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Multinational community‑based online questionnaire (N=2433 women). Cross‑sectional self‑report of pornography use frequency, masturbation and partnered sexual response, and demographic/relationship variables.","sample_n":2433,"sample_text":"large convenience sample, not probability based; self‑selected respondents.","population":"Adult women (≥18 y) from several countries, recruited via opt‑in online survey.","country":"Multiple (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 2,400 women, more frequent pornography viewing was linked to easier arousal and orgasm during masturbation, but showed little effect on partnered sexual experiences. Demographic factors predicted partnered‑sex difficulties more strongly than porn use.","clinical_takeaway":"For most women, pornography use does not appear to harm partnered sexual response; it may even ease masturbation‑related arousal and orgasm.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function","gender"],"strengths":["Large sample size for a sexuality survey","Separates masturbation and partnered‑sex outcomes","Considers multiple demographic covariates"],"limitations":["Relies on non‑validated, self‑report items","No measurement of moral incongruence or partner variables","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":6,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":24,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph17093130"}},{"id":1560,"doi":"10.1007/s10508-020-01688-w","pmid":"32240436","pmcid":null,"title":"Measuring the Multidimensional Construct of Pornography: A Long and Short Version of the Pornography Usage Measure","authors":"Busby DM, Willoughby BJ, Chiu HY, Olsen JA.","first_author":"Busby DM","journal":"Archives of sexual behavior","year":2020,"pub_types":["Journal Article"],"keywords":["Pornography","Sexually Explicit Media","Bi-factor Models"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"scale development and validation using large MTurk sample","sample_n":1639,"sample_text":"N = 1639 (934 males, 705 females) MTurk participants","population":"adults recruited via Amazon Mechanical Turk (both genders)","country":"USA (likely, based on MTurk sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and tested a new questionnaire (20‑item and 7‑item versions) that measures how often and in what ways people use pornography. Using a large online sample, they showed the scales are reliable and have initial evidence of validity.","clinical_takeaway":"None – the study provides a research tool, not direct clinical guidance.","confidence":0.8,"topic_tags":["pornography","measurement","sexual_function"],"strengths":["Large sample for psychometric validation","Comprehensive factor‑analytic approach","Provides both long and short forms"],"limitations":["Convenience MTurk sample limits generalisability","No external clinical validation"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01688-w"}},{"id":1561,"doi":"10.3390/ijerph22101587","pmid":"41154991","pmcid":"PMC12562315","title":"The Impact of Prolonged Stress of COVID-19 Pandemic and Earthquakes on Internet-Based Addictive Behaviour and Quality of Life in Croatia","authors":"Kovačić Petrović Z, Peraica T, Blažev M, Kozarić-Kovačić D.","first_author":"Kovačić Petrović Z","journal":"International journal of environmental research and public health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Stress","Depression","Quality of life","Anxiety","Structural Equation Modelling Approach","Covid-19 Pandemic And Earthquakes","Internet-based Addictive Behaviour"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12562315","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey, convenience sample (N=1004), structural equation modelling","sample_n":1004,"sample_text":"convenience online sample, predominantly female","population":"adult Croatian population, 82.2% women, mean age 35","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a 2021 Croatian online survey, higher internet use and problematic use—including watching pornography—were linked to more anxiety, depression, and stress, which in turn related to lower quality of life. The study suggests stressful events may worsen internet‑related problems, affecting wellbeing.","clinical_takeaway":"During prolonged stress, monitor clients' internet use (including pornography) as it may exacerbate anxiety, depression, and lower quality of life.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["large sample size","use of validated scales for anxiety, depression, QoL","structural equation modelling allows mediation testing"],"limitations":["cross‑sectional design cannot establish causality","convenience sample, over‑representation of women","pornography use measured as a single item, no separate assessment of masturbation or moral factors"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph22101587"}},{"id":1562,"doi":"10.1080/13691058.2020.1717630","pmid":"32212954","pmcid":null,"title":"Gay male pornography and the racialisation of desire","authors":"Corneau S, Dominic BP, Murray SJ, Bernatchez K, Lecompte M.","first_author":"Corneau S","journal":"Culture, health & sexuality","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Racial Stereotypes","Sexual Scripts","Sexual Racism","Gay Male Pornography","Racialised Desire"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 974 gay male pornography users in Québec; nested linear regression analysis of predictors of racialised desire","sample_n":974,"sample_text":"n = 974 gay male pornography users recruited in Québec, Canada","population":"gay men who use pornography (online/consumer sample, Canada)","country":"Canada","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 974 gay men in Québec found that older age, lower income, viewing interracial porn, and higher pressure to fit in were linked to stronger racialised sexual desire, suggesting pornography shapes sexual scripts about race.","clinical_takeaway":"None – the study describes cultural patterns, not clinical issues.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["large sample for survey research","use of theory‑driven analytic framework (sexual script theory)","multivariate regression to identify independent predictors","focus on understudied topic of racialisation in gay male porn"],"limitations":["cross‑sectional design cannot infer causality","key constructs measured with likely ad‑hoc items, limited validation","no assessment of potential confounds such as moral incongruence or mental health","self‑selected online sample limits generalisability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2020.1717630"}},{"id":1564,"doi":"10.3352/jeehp.2015.12.50","pmid":"26582630","pmcid":"PMC4671181","title":"Visible Facebook profiles and e-professionalism in undergraduate medical students in India","authors":"Gupta S, Singh S, Dhaliwal U.","first_author":"Gupta S","journal":"Journal of educational evaluation for health professions","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["India","Cross-sectional studies","Electronic Mail","Privacy","Friends"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4671181","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of all undergraduate medical students at a single university; Facebook profiles searched via fictitious account; descriptive frequencies of visible content and unprofessional posts.","sample_n":477,"sample_text":"All enrolled students were considered; 78.1 % had detectable profiles.","population":"Undergraduate medical students (N≈611, 477 with detectable Facebook profiles) at University College of Medical Sciences, University of Delhi, India.","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2015 study examined the Facebook profiles of 477 Indian medical students. Most kept personal details private, while about one‑third disclosed sexual orientation or relationship status. Only 1 % showed unprofessional content such as alcohol‑related posts or explicit language.","clinical_takeaway":"None – the study does not provide clinically actionable data on sexual health or behaviour.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, near‑complete sample of a single cohort","Systematic search of publicly visible profiles","Clear operational definition of unprofessional content"],"limitations":["Descriptive design; no hypothesis testing","No validated scales for professionalism or privacy behaviours","Findings limited to one institution and cultural context"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3352/jeehp.2015.12.50"}},{"id":1565,"doi":"10.1136/fmch-2022-001776","pmid":"36650009","pmcid":"PMC9853222","title":"Pornography use among adolescents and the role of primary care","authors":"Jhe GB, Addison J, Lin J, Pluhar E.","first_author":"Jhe GB","journal":"Family medicine and community health","year":2023,"pub_types":["article-commentary","Journal Article"],"keywords":["Primary Health Care","Pediatrics","Adolescent Health","Psychology, Adolescent"],"is_oa":true,"oa_url":"https://fmch.bmj.com/content/fmch/11/1/e001776.full.pdf","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"article-commentary","sample_n":null,"sample_text":"None – commentary with no primary data","population":"adolescents","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how common pornography use is among adolescents and offers primary‑care doctors practical tips for talking about it with young patients and their parents, stressing a non‑judgmental, educational approach.","clinical_takeaway":"Clinicians should screen adolescents for pornography use sensitively and facilitate open conversations with youth and parents.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Provides practical guidance for primary care providers","Highlights importance of non‑judgmental discussion","Addresses parental involvement"],"limitations":["No empirical data presented","No measurement of pornography use or related outcomes","No assessment of confounding factors (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/fmch-2022-001776"}},{"id":1566,"doi":"10.1007/s10508-020-01677-z","pmid":"32180100","pmcid":null,"title":"Does Adolescent Media Use Predict Sexual Stereotypes in Adolescence and Emerging Adulthood? Associations with Music Television and Online Pornography Exposure","authors":"Vangeel L, Eggermont S, Vandenbosch L.","first_author":"Vangeel L","journal":"Archives of sexual behavior","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescence","Gender Roles","Rape Myths","Online Pornography","Music Television"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal survey of 400 Belgian adolescents across four waves (including 5‑year follow‑up).","sample_n":400,"sample_text":"182 boys and 218 girls (total N≈400)","population":"Adolescents (≈12‑18 y) followed into emerging adulthood; community sample, not treatment‑seeking.","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A four‑wave Belgian study found that teens who watched more music‑television later endorsed more rape myths, but exposure to online pornography did not predict such attitudes. The link between music TV and rape myths was indirect, operating through earlier acceptance of gendered sexual roles.","clinical_takeaway":"Media exposure, especially music TV, may shape harmful gender stereotypes; clinicians should consider media literacy in sexual‑health counseling.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Four‑wave longitudinal design allows temporal ordering","Large community sample with both genders","Use of validated rape‑myth and gender‑role scales","Separate assessment of music TV and online porn exposure"],"limitations":["Self‑report media use may be biased","No control for moral or mental‑health variables that could affect stereotype endorsement","Convenience sample limits generalisability beyond Belgium","Model fit issues prevented gender‑specific analyses"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01677-z"}},{"id":1567,"doi":"10.3390/healthcare13202574","pmid":"41154253","pmcid":"PMC12564402","title":"Violence Against Women on Social Networks: A Descriptive Analysis","authors":"López-Barranco PJ, López-Yepes S, Conesa-Ferrer MB, Cayuela-Fuentes PS, Beladiez-Pérez MDM, Jiménez-Ruiz I.","first_author":"López-Barranco PJ","journal":"Healthcare (Basel, Switzerland)","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Social Networks","Violence Against Women","Sexual Violence","Online Violence"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12564402","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"observational, cross‑sectional survey of 1,177 adult women in Spain","sample_n":1177,"sample_text":"1177 adult women aged 18‑59 years","population":"adult women (18‑59 y) recruited online (presumed convenience sample)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 1,177 Spanish women, about two‑thirds reported experiencing gender‑based violence online, and higher daily social‑network use and more pornography consumption were linked to higher victimisation rates, but the study cannot prove cause‑and‑effect.","clinical_takeaway":"Clinicians should consider online media exposure as one of many factors linked to women’s risk of sexual violence, but not infer that pornography causes victimisation.","confidence":0.7,"topic_tags":["gender","sexual_function","pornography"],"strengths":["Large sample size for a survey","Use of validated instruments for violence outcomes","Clear statistical reporting of correlations"],"limitations":["Cross‑sectional design limits causal inference","Pornography use measured imprecisely","Key potential confounders (mental health, moral attitudes, trauma) not assessed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare13202574"}},{"id":1568,"doi":"10.1016/j.gaceta.2020.01.001","pmid":"32173052","pmcid":null,"title":"[On pornography and sexual education: Can \"sex\" legitimate humiliation and violence?]","authors":"de Miguel Álvarez A.","first_author":"de Miguel Álvarez A.","journal":"Gaceta sanitaria","year":2021,"pub_types":["Journal Article"],"keywords":["Sexuality","Youth","Social Problems","Feminism","Sexual Education","Sexualidad","Pornography","Educación Sexual","Feminismo","Juventud","Problemas Sociales","Pornografía"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/philosophical essay without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that easy online access to porn may legitimize violence and gender inequality among teenagers, calling for interdisciplinary debate on sexual education goals.","clinical_takeaway":"None - not clinically applicable.","confidence":0.4,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Raises important societal questions about porn and gender","Interdisciplinary perspective"],"limitations":["No empirical data or systematic method","No measurement of key constructs","Lacks statistical analysis"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.gaceta.2020.01.001"}},{"id":1569,"doi":"10.7759/cureus.33018","pmid":"36721539","pmcid":"PMC9881445","title":"Aggravation of Obsessive-Compulsive Disorder Due to Excessive Porn Consumption: A Case Report","authors":"Shrivastava T, Agarwal P, Vora V, Sethi Y.","first_author":"Shrivastava T","journal":"Cureus","year":2022,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Ocd","Behavioral Disorder","Behavioral Addiction","Obsessive Compulsive Disorders","Porn Addiction","Excessive Porn Consumption","Harmful Effects Of Porn","Pornography 2022"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9881445","cited_by_count":1,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single 28‑year‑old male","sample_n":1,"sample_text":"single case","population":"adult male, treatment‑seeking (clinical presentation)","country":"India (inferred from authors’ affiliations)","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","circular_addiction_scale"],"stance":"supports","citation_value":"background","plain_summary":"A 28‑year‑old man with mild OCD experienced worsening symptoms after heavily viewing porn, especially religious porn, leading to guilt and compulsive cleaning. Treatment helped, and authors suggest porn can aggravate OCD.","clinical_takeaway":"No firm evidence that porn causes OCD worsening; clinicians should consider multiple stressors and treat comorbid conditions.","confidence":0.3,"topic_tags":["pornography","other"],"strengths":["Detailed clinical narrative","Highlights potential interaction of stressors and porn use"],"limitations":["Single case, no systematic measurement","No validated scales for addiction or OCD severity","No control of key confounds (moral incongruence, masturbation, mental health)","Causal language unsupported"],"rubric_version":"2.0","raw_total":11,"max_possible":60,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":2,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.33018"}},{"id":1570,"doi":"10.1016/j.jsxm.2020.02.009","pmid":"32169576","pmcid":null,"title":"A Large-Scale Comparison of Canadian Sexual/Gender Minority and Heterosexual, Cisgender Adolescents' Pornography Use Characteristics","authors":"Bőthe B, Vaillancourt-Morel MP, Girouard A, Štulhofer A, Dion J, Bergeron S.","first_author":"Bőthe B","journal":"The journal of sexual medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Gay","Lesbian","Bisexual","Lgbt","Sexual Minority","Pornography","Gender Minority"],"is_oa":false,"oa_url":null,"cited_by_count":45,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional analysis of a large, school‑based adolescent cohort (N=2,846) comparing heterosexual‑cisgender and sexual‑gender minority youth on self‑reported pornography use (lifetime exposure, age at first use, past‑3‑month frequency).","sample_n":2846,"sample_text":"2,846 adolescents (52.5% girls; M age = 14.5 y, SD = 0.6)","population":"Canadian adolescents, mean age 14.5 y, both sexes and non‑binary, recruited as part of an ongoing longitudinal sexual‑health study.","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Canadian study of 2,846 teens, most had seen pornography by age 14. Boys—whether heterosexual‑cisgender or sexual‑gender minority—used porn more often than girls, and sexual‑gender‑minority girls started younger than heterosexual girls.","clinical_takeaway":"Clinicians should recognize that pornography exposure is common in early adolescence across gender and sexual orientations.","confidence":0.6,"topic_tags":["pornography","adolescents","sexual_function","gender"],"strengths":["Large, diverse adolescent sample including understudied SGM groups","Clear, gender‑ and orientation‑specific prevalence estimates","Addresses a gap in knowledge about SGM youth pornography use"],"limitations":["Cross‑sectional self‑report; cannot infer causality","No measurement of co‑occurring factors (masturbation, moral attitudes, mental health)","Potential recall bias for age at first use"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":1,"mentioning":43,"citing_publications":83,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.02.009"}},{"id":1571,"doi":"10.1007/s10508-019-01550-8","pmid":"32140872","pmcid":null,"title":"Do Varying Levels of Exposure to Pornography and Violence Have an Effect on Non-Conscious Emotion in Men?","authors":"Kunaharan S, Halpin S, Sitharthan T, Walla P.","first_author":"Kunaharan S","journal":"Archives of sexual behavior","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Event-related potentials","Aggression","Pornography","Startle Reflex Modulation","Multi-methods","Implicit Versus Explicit Responses"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subjects laboratory experiment; 18 male participants low in porn use; three exposure sessions separated by ≥2 days; physiological (ERP, startle) and self‑report outcomes.","sample_n":18,"sample_text":"18 participants","population":"adult men, low pornography users (self‑selected, convenience sample)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Eighteen men who use pornography little were exposed repeatedly to porn and violent images. While their conscious ratings of emotions stayed the same, brain activity (ERP) and startle responses showed subtle changes, suggesting that non‑conscious emotional processing can be altered by such exposure.","clinical_takeaway":"Physiological responses may shift before people notice emotional changes; clinicians should consider non‑conscious effects of media exposure.","confidence":0.8,"topic_tags":["pornography","sexual_function","neuroscience"],"strengths":["Physiological measures (ERP, SRM) provide non‑conscious data","Within‑subject design controls individual variability","Explicit ratings allow comparison of conscious vs non‑conscious responses"],"limitations":["Very small sample (N=18) limits power and generalisability","No control group for exposure condition","Potential selection bias (low‑pornography users only)","No correction for multiple ERP comparisons reported"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":5,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-01550-8"}},{"id":1572,"doi":"10.1089/cyber.2009.0100","pmid":"20528279","pmcid":null,"title":"The impact of national cultural distance on the number of foreign Web site visits by U.S. households","authors":"Beugelsdijk S, Slangen A.","first_author":"Beugelsdijk S","journal":"Cyberpsychology, behavior and social networking","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational study of 2,654 U.S. households; regressions relating cultural distance to counts of foreign website visits across categories.","sample_n":2654,"sample_text":"2,654 U.S. households","population":"U.S. households (survey panel)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examined how cultural differences between the U.S. and other countries affect how often U.S. households visit foreign websites. While greater cultural distance generally reduced visits, it was linked to more visits to sites with sexual content.","clinical_takeaway":"None – the findings describe browsing patterns, not clinical outcomes.","confidence":0.9,"topic_tags":["csbd","pornography"],"strengths":["Large, nationally‑based household sample","Clear operational definition of cultural distance","Appropriate regression modelling of count data"],"limitations":["No validated scales for ‘cultural distance’; ad‑hoc metric","Cross‑sectional; cannot infer causality","Potential unmeasured confounders (e.g., internet access, individual sexual attitudes)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2009.0100"}},{"id":1573,"doi":"10.21315/mjms2020.27.2.14","pmid":"32788849","pmcid":"PMC7409573","title":"Development and Validation of a Malay Version of the Questionnaire on Pornography Attitudes and Exposure for Youth in Kelantan","authors":"Rahman AA, Ibrahim MI, Rahman RA, Arifin WN, Ahmad M.","first_author":"Rahman AA","journal":"The Malaysian journal of medical sciences : MJMS","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Development","Youth","Validation","Pornography Questionnaire"],"is_oa":true,"oa_url":"https://doi.org/10.21315/mjms2020.27.2.14","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"questionnaire development and validation (EFA/CFA) with college student samples","sample_n":398,"sample_text":"150 for EFA and 198 for CFA (pilot 50)","population":"youth (15‑24) Malaysian college students","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study created and validated a Malay questionnaire (PORQUE) to measure how often young people in Malaysia see porn and their attitudes toward it. Factor analysis showed five reliable dimensions, confirming the tool’s psychometric soundness.","clinical_takeaway":"The PORQUE can be used by clinicians and researchers in Malaysia to assess youth pornography exposure and attitudes reliably.","confidence":0.8,"topic_tags":["pornography","measurement","sexual_function","adolescents","csbd"],"strengths":["Clear multi‑step validation (EFA, CFA) with good fit indices","Large sample for factor analysis","Transparent development process with expert panel"],"limitations":["Convenient student sample limits generalisability","No assessment of related confounds (e.g., moral beliefs, mental health)","No external criterion validation (behavioral outcomes)"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21315/mjms2020.27.2.14"}},{"id":1576,"doi":"10.1007/s10508-025-03318-9","pmid":"41060510","pmcid":null,"title":"Anti-AI Bias Toward Couple Images and Couple Counseling: Findings from Two Experiments","authors":"Döring N, Mohseni MR.","first_author":"Döring N","journal":"Archives of sexual behavior","year":2025,"pub_types":["Journal Article"],"keywords":["Artificial Intelligence (Ai)","Online Experiment","Ai-generated Content","Ai-supported Sexual Activities (Aisa)","Ai Attitudes"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Two online between‑subjects labeling experiments with a national German adult sample (N=2,658). Participants rated identical couple images or counseling excerpts after being told they were AI‑ or human‑generated.","sample_n":2658,"sample_text":"National adult sample, online recruitment","population":"Adults (national German sample, recruited online)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People rated the same romantic photos and counseling excerpts less positively when they thought they were created by AI rather than by humans, showing a mild anti‑AI bias in intimate contexts.","clinical_takeaway":"None – the study does not provide direct guidance for clinical practice.","confidence":0.9,"topic_tags":["sexual_function","relationships"],"strengths":["Large, nationally representative sample","Experimental manipulation of labeling allows causal inference","Effect sizes reported with confidence"],"limitations":["Constructs (anti‑AI bias) not clearly linked to validated scales","No pre‑registration disclosed","Potential cultural limitation to German context"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03318-9"}},{"id":1577,"doi":"10.1007/s10508-013-0115-z","pmid":"23740466","pmcid":null,"title":"Self-appraisals of arousal-oriented online sexual activities in university and community samples","authors":"Shaughnessy K, Byers ES, Clowater SL, Kalinowski A.","first_author":"Shaughnessy K","journal":"Archives of sexual behavior","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two separate cross‑sectional surveys of university students (N=191) and community adults (N=316) assessing self‑reported positive and negative outcomes of solitary and partnered online sexual activities.","sample_n":507,"sample_text":"N = 191 university students; N = 316 community participants","population":"heterosexual university students and community adults including sexual minorities; convenience sampling","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"University students and community adults reported that using sexually arousing online content, whether alone or with a partner, produced more positive than negative effects, and overall the impact was small.","clinical_takeaway":"For most users, online sexual activities appear to have limited negative impact; clinicians should assess individual outcomes rather than assume harm.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large combined sample size for a survey study","Examines both solitary and partnered online sexual activities","Reports both positive and negative outcomes"],"limitations":["Reliance on non‑validated, self‑report measures","Convenience sampling limits generalisability","No control for key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":23,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0115-z"}},{"id":1578,"doi":"10.1111/1468-5922.12877","pmid":"36527415","pmcid":null,"title":"Seduction, deception and technology","authors":"Tyler S.","first_author":"Tyler S.","journal":"The Journal of analytical psychology","year":2023,"pub_types":["Journal Article"],"keywords":["Sex","Technology","Internet","Pornographie","Sexe","Sexo","Pornography","Transcendent Function","Tecnología","Technologie","Transzendente Funktion","Fonction Transcendante","Función Trascendente","Funzione Trascendente","Трансцендентная Функция","Tecnologia","Технология","技术","Интернет","互联网","Microdots","Mikropunkte","Micropoints","Micropunti","Micropuntos","Pornografia","Sesso","Микроточки","Порнография","Секс","微点","色情","超越功能","性","Pornografía"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"NA","population":"NA","country":"NA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that internet pornography can create a therapeutic, symbolic space that helps patients address inner trauma, using Jungian ideas to interpret porn use as both potentially healing and as a distorted coping mechanism.","clinical_takeaway":"Clinicians might consider exploring patients' porn use as symbolic material, but must not assume it reflects addiction without empirical evidence.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Integrates Jungian theory with contemporary issues","Offers a novel therapeutic perspective"],"limitations":["No empirical data or systematic methodology","Lacks operational definitions of key constructs","No measurement of confounding variables"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1468-5922.12877"}},{"id":1579,"doi":"10.3389/fpsyt.2025.1633160","pmid":"41127211","pmcid":"PMC12538654","title":"Asian cultural values and help-seeking: a cross-sectional study on compulsive sexual behavior","authors":"Pham HL, Nguyen VHA, Le CM, Truong-Thai TH, Vu-Thi QA, Phan XP, Nguyen-Vo HN, Hua TD, Nguyen-Duong BT, Ho CSH, Tran-Chi VL.","first_author":"Pham HL","journal":"Frontiers in psychiatry","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Compulsive Sexual Behavior","Help-seeking Attitudes","Csb","Asian Values","Psychological Help-seeking"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12538654","cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of Vietnamese participants using self‑report scales","sample_n":null,"sample_text":"not specified in abstract","population":"Vietnamese adults (sample size not reported in abstract)","country":"Vietnam","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In Vietnam, people who report less control over sexual behavior tend to hold more traditional Asian values, and these values are linked to lower willingness to seek professional help. Pornography use, sexual activity and having a stable partner change these relationships.","clinical_takeaway":"Cultural values may hinder help‑seeking for compulsive sexual behavior; clinicians should address cultural barriers when offering support.","confidence":0.75,"topic_tags":["csbd"],"strengths":["Uses validated scales for CSB and cultural values","Examines cultural mediation and moderation by behavioral factors","Applies structural equation modeling to test indirect effects"],"limitations":["Cross‑sectional design precludes causal inference","Does not assess key confounds (moral incongruence, mental health, trauma)","Sample size and recruitment method not reported"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2025.1633160"}},{"id":1580,"doi":"10.1080/10410236.2022.2156738","pmid":"36522306","pmcid":null,"title":"Pornography Consumption, Sexual Attitude, and Condomless Sex in China","authors":"Hu Z, Sun H, Liang H, Cao W, Hee JY, Yan Y, Tang K.","first_author":"Hu Z","journal":"Health communication","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 11,957 Chinese university students assessing self‑reported pornography use frequency, sexual attitudes and condomless sex","sample_n":11957,"sample_text":"national sample of university‑level students","population":"university‑level students in China (national sample)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a national survey of nearly 12,000 Chinese university students, those who reported watching porn more often also reported having more permissive attitudes toward sex and were more likely to have sex without a condom.","clinical_takeaway":"Higher porn use is linked to riskier sexual behaviour, suggesting clinicians should discuss media habits when counselling students on safe sex.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Very large sample size","First large‑scale study of this association in a non‑Western context"],"limitations":["Cross‑sectional; cannot infer causality","Relies on single‑item self‑reports, no validated scales described","Potential unmeasured confounds (e.g., moral attitudes, mental health, partner status)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2022.2156738"}},{"id":1581,"doi":"10.4088/pcc.22m03131","pmid":"36548178","pmcid":null,"title":"Personality Traits and Online Pornography Use Among Lebanese Adults","authors":"Sfeir E, Malaeb D, Hallit S, Obeid S.","first_author":"Sfeir E","journal":"The primary care companion for CNS disorders","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey (snowball sampling) of 653 Lebanese adults","sample_n":653,"sample_text":"N = 653 participants completed an online questionnaire","population":"Lebanese adults (both genders) recruited via online snowball technique","country":"Lebanon","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Lebanese online survey of 653 adults, higher extroversion and agreeableness, being male, higher education, and alcohol use were linked to more self‑reported porn‑addictive behaviour and guilt about porn use.","clinical_takeaway":"Personality and alcohol use relate to self‑perceived problematic porn use, but findings are correlational and may not apply to clinical addiction.","confidence":0.78,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Large sample for a regional study","Use of validated personality inventory","Multivariate logistic regression"],"limitations":["Snowball, non‑representative sample","Cross‑sectional; no causal inference","Addiction construct measured by self‑label scale","Key confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/pcc.22m03131"}},{"id":1582,"doi":"10.5964/sotrap.7229","pmid":"39902155","pmcid":"PMC11789436","title":"Temporal Order of Sexual Offending Is Risk-Relevant for Individuals With Child Sexual Exploitation Materials Offences","authors":"Babchishin KM, Lee SC, Eke AW, Seto MC.","first_author":"Babchishin KM","journal":"Sexual offending (Trier, Germany)","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Risk factor","Escalation","Recidivism","Child Pornography","Child Sexual Exploitation Material"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11789436","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective cohort of 85 convicted men, grouped by offence sequence and followed for 5‑7‑year recidivism outcomes.","sample_n":85,"sample_text":"85 men with two distinct sexual offences (CSEM or contact) were categorized into three offence‑order groups.","population":"Adult men convicted of child sexual exploitation material offences, some with prior contact sexual offences.","country":"Canada (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among men convicted of child sexual exploitation material, the order in which they commit offenses (e.g., starting with child material and later a contact crime) predicts later re‑offending risk. Those who escalated to contact offenses showed the highest rates of future violent and sexual crimes.","clinical_takeaway":"Risk assessments should consider offence sequencing; escalation to contact crimes signals higher reoffending risk.","confidence":0.7,"topic_tags":["csbd","sexual_function","gender"],"strengths":["Use of official criminal records reduces self‑report bias","Clear temporal categorization of offence patterns","Longitudinal follow‑up for recidivism"],"limitations":["Small subgroup sizes, especially escalation group (n=10)","No control for mental‑health, moral or relational confounds","Findings limited to convicted offenders, not general population"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":16,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5964/sotrap.7229"}},{"id":1583,"doi":"10.1016/j.jsxm.2020.01.013","pmid":"32081698","pmcid":null,"title":"Diverse Sexual Behaviors and Pornography Use: Findings From a Nationally Representative Probability Survey of Americans Aged 18 to 60 Years","authors":"Herbenick D, Fu TC, Wright P, Paul B, Gradus R, Bauer J, Jones R.","first_author":"Herbenick D","journal":"The journal of sexual medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual behavior","Anal Sex","Population Health","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":115,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative probability sample of U.S. adults aged 18‑60; online confidential survey; cross‑sectional.","sample_n":null,"sample_text":"Probability sample; exact N not provided in abstract.","population":"Adults 18‑60 in the United States (probability sample).","country":"United States","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A nationwide US survey found that most adults have used pornography and that higher porn use is linked to a greater likelihood of engaging in a range of consensual but sometimes risky sexual practices, such as choking or aggressive oral sex.","clinical_takeaway":"Higher pornography use correlates with certain risky sexual behaviors; clinicians should discuss boundaries and consent when these behaviors arise.","confidence":0.8,"topic_tags":["prevalence","pornography","sexual_function"],"strengths":["National probability sampling","Large community sample","Adjustment for key demographic variables"],"limitations":["Reliance on self‑report items without validated scales","No measurement of moral incongruence, masturbation, mental‑health covariates","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":0,"mentioning":91,"citing_publications":201,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.01.013"}},{"id":1584,"doi":"10.1093/sexmed/qfaf091","pmid":"41200466","pmcid":"PMC12586315","title":"Factors associated with compulsive sexual behavior in a national probability web-based aged 18-59 years sample from Japan: a cross-sectional survey","authors":"Okabe Y, Ito D.","first_author":"Okabe Y","journal":"Sexual medicine","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Depression","ADHD","Sexual behavior","Anxiety","Treatment-seeking Behavior","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12586315","cited_by_count":0,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national probability web‑based sample (N=1094); cross‑sectional questionnaire","sample_n":1094,"sample_text":"probability‑based, proportional representation of sex assigned at birth, age groups, and residential areas","population":"adults 18‑59 years, Japan","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative web survey of 1,094 Japanese adults, 2.6% scored above the CSBD‑19 cutoff for compulsive sexual behaviour. Those individuals reported longer pornography and masturbation sessions, lower life satisfaction, more negative life impacts, and higher levels of depression, anxiety, and ADHD.","clinical_takeaway":"Clients with high CSBD scores often show broader mental‑health issues and functional impairment; screening for mood, anxiety, and ADHD is advisable.","confidence":0.7,"topic_tags":["csbd","pornography","masturbation","sexual_function","moral_incongruence","treatment"],"strengths":["large nationally representative sample","use of validated psychometric scales","separate measurement of pornography and masturbation duration"],"limitations":["very small high‑risk CSBD subgroup (n=28)","no assessment of moral incongruence or relationship factors","cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfaf091"}},{"id":1586,"doi":"10.1007/s10508-011-9862-x","pmid":"22083655","pmcid":null,"title":"Online sexual activity: cross-national comparison between United States and Peruvian college students","authors":"Velezmoro R, Negy C, Livia J.","first_author":"Velezmoro R","journal":"Archives of sexual behavior","year":2012,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 320 US and 251 Peruvian college students; online questionnaires on sexual activity, adjustment, family factors.","sample_n":571,"sample_text":"Convenience sample of undergraduates","population":"College students (US public university, Peru public university)","country":"United States; Peru","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"U.S. and Peruvian college students reported similar, low amounts of online sexual activity. Peruvians viewed more explicit material and sought partners online. Neither country showed higher psychological problems among those who engaged in online sexual activity, suggesting the behavior is not inherently harmful.","clinical_takeaway":"Among college students, modest online sexual activity does not appear linked to poorer mental health; clinicians should consider individual context rather than assume pathology.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large total sample across two countries","Includes moderating variables (religiosity, social support)","Direct comparison of online sexual behavior frequencies"],"limitations":["Cross‑sectional, cannot infer causality","Likely use of non‑validated OSA measures","Convenience student samples limit generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":29,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-011-9862-x"}},{"id":1588,"doi":"10.3389/fpsyt.2025.1574502","pmid":"41098517","pmcid":"PMC12519947","title":"Placing problematic media use in context: a research synthesis, person-centric framework, and chart review among a clinical sample of US youth","authors":"Carter MC, Powell N, Bediou B, Tsappis M, Bickham D, Rich M.","first_author":"Carter MC","journal":"Frontiers in psychiatry","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Internet Gaming Disorder","Pornography Use","Gaming Disorder","Problematic Social Media Use","Problematic Use Of Internet","Information Binging"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12519947","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"chart review of 205 clinical youth patients; mixed‑methods descriptive synthesis","sample_n":205,"sample_text":"Clinical convenience sample from a specialty clinic","population":"US youth seeking treatment for problematic media use (includes pornography)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined 205 clinic records of US youth with problematic media use, including pornography, and proposed a new model (PC‑POT) to explain how personal, social and situational factors might sustain harmful patterns over time.","clinical_takeaway":"No direct clinical guidance; the framework is speculative and not based on validated measures.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large clinical chart sample (N=205)","Attempts integrative, person‑centred framework","Mixed‑methods approach"],"limitations":["No validated measures of pornography use or problematic use","Key confounds (moral incongruence, masturbation, mental health) not assessed","Cross‑sectional chart review; no causal inference","Potential selection bias from treatment‑seeking youth"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2025.1574502"}},{"id":1589,"doi":"10.5114/ppn.2022.124356","pmid":"37081911","pmcid":"PMC10112527","title":"Description of the neural network based on AB/DL pictures. Possible implications for forensic sexology","authors":"Oronowicz-Jaśkowiak W, Wasilewski P.","first_author":"Oronowicz-Jaśkowiak W","journal":"Postepy psychiatrii neurologii","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Neural networks","Pornography","Csam"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10112527","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"development and validation of an image‑classification neural network using 2 251 pictures (5 classes). Split into training (1 914) and validation (337). No human participants.","sample_n":2251,"sample_text":"2251 photos (1914 training, 337 validation)","population":"image dataset; no human sample","country":"Poland (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors built a computer model that can sort pictures resembling child‑sex‑abuse material into five categories (e.g., adult women dressed as children). Using 2 251 images, the model achieved about 95 % accuracy, suggesting it could help forensic work, though it still needs testing on actual CSAM.","clinical_takeaway":"None – the study is about image‑classification technology, not clinical practice.","confidence":0.7,"topic_tags":["neuroscience"],"strengths":["Clear description of model architecture and training procedures","Relatively large image dataset for this niche topic","High reported classification accuracy (95%)"],"limitations":["No validation on real CSAM images – external validity uncertain","No statistical power analysis or confidence intervals for performance metrics","Potential over‑fitting not fully addressed"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5114/ppn.2022.124356"}},{"id":1591,"doi":"10.1080/00224545.2020.1719963","pmid":"31997721","pmcid":null,"title":"Gender differences in implicit exposure to cyber-pornography","authors":"Hen M, Karsh N, Langer E, Shechter R.","first_author":"Hen M","journal":"The Journal of social psychology","year":2020,"pub_types":["Journal Article"],"keywords":["Gender","Social Desirability","Cyber-pornography","Implicit Exposure"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey with explicit self‑report and a newly created indirect measure of cyber‑pornography exposure; mediation analysis of perceived social acceptance","sample_n":null,"sample_text":"not reported in abstract","population":"unspecified adult participants (likely convenience sample)","country":"not reported","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that men and women differ in how they report viewing online porn: women tend to under‑report while men may over‑report. An indirect test showed the same pattern, and perceived social acceptance explained part of the bias.","clinical_takeaway":"Clinicians should consider social desirability when asking about porn use; self‑reports may be biased differently for men and women.","confidence":0.7,"topic_tags":["gender","pornography","measurement","sexual_function"],"strengths":["Uses both explicit and indirect measures to address social desirability bias","Includes a mediation analysis of perceived social acceptance","Highlights gender differences in reporting"],"limitations":["Indirect measure is newly developed and not validated","No control for key confounds (masturbation, mental health, trauma)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224545.2020.1719963"}},{"id":1592,"doi":"10.1007/bf01542313","pmid":"3800639","pmcid":null,"title":"Repeated exposure to sexually explicit stimuli: novelty, sex, and sexual attitudes","authors":"Kelley K, Musialowski D.","first_author":"Kelley K","journal":"Archives of sexual behavior","year":1986,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory experiment with repeated exposure to erotic films; within‑subject manipulation of novelty; N=56 (28 per condition).","sample_n":56,"sample_text":"Female and male subjects (N = 56) viewed an explicitly heterosexual film daily for 4 days and then were exposed to either a film showing the same actors engaging in different sexual acts or one with different actors engaging in the same activities.","population":"Adult men and women, likely convenience sample (students or volunteers).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, 56 men and women watched the same erotic film for four days, then saw either a new film with the same actors doing different acts or different actors doing the same acts. Negative feelings rose with repetition but fell when the film was novel; men and women differed in how novelty affected arousal and concern.","clinical_takeaway":"Repeated viewing of the same pornographic material can increase negative affect; introducing novelty may reduce this effect, but findings are limited to short‑term lab exposure.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Experimental manipulation of stimulus novelty","Within‑subject design reduces individual differences","Inclusion of both sexes"],"limitations":["Small sample, likely underpowered for between‑group tests","Reliance on ad‑hoc self‑report items without validated scales","No measurement of key confounds (moral attitudes, masturbation, mental health)","Findings may not generalize beyond a convenience sample"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542313"}},{"id":1593,"doi":"10.1177/08862605251376339","pmid":"41015791","pmcid":null,"title":"Prevalence and Risk Factors of Sexual Victimization Among a Representative National Sample of Adolescents in Spain","authors":"Pereda N, Suárez-Soto E.","first_author":"Pereda N","journal":"Journal of interpersonal violence","year":2025,"pub_types":["Journal Article"],"keywords":["Prevalence","Adolescence","risk factors","Spain","Sexual Violence","Sexual Victimization"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Representative national sample of 4,024 Spanish adolescents, cross‑sectional questionnaire assessing past‑year sexual victimisation and associated factors.","sample_n":4024,"sample_text":"Representative national sample (N = 4,024).","population":"Adolescents (14‑17 y) in Spain, both sexes, recruited from 70 schools.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A national survey of over 4,000 Spanish teens found that 17.8% experienced sexual victimisation in the past year. Higher risk was linked to being a girl, older age, binge drinking, accessing pornography, and identifying as a sexual minority.","clinical_takeaway":"Clinicians should screen for sexual victimisation in adolescents, especially those who binge‑drink, use pornography, or belong to sexual minorities.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative adolescent sample","Validated victimisation questionnaire (JVQ)","Comprehensive assessment of multiple risk factors"],"limitations":["Pornography use measured with adapted, non‑validated items","Cross‑sectional design cannot infer causality","Key psychosocial confounds (e.g., mental health, moral attitudes) not controlled"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605251376339"}},{"id":1594,"doi":"10.1111/add.70197","pmid":"41013925","pmcid":"PMC12779585","title":"Psychometric evaluation of a trans-addiction craving questionnaire: The Craving Assessment Scale for Behavioral Addictions and Substance-use Disorders (CASBAS)","authors":"Antons S, Brandtner A, Oelker A, Trotzke P, Wegmann E, Brand M, Müller SM.","first_author":"Antons S","journal":"Addiction (Abingdon, England)","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Development","Scale","Validation","Mental Imagery","Urge","Behavioral Addiction","Desire Thinking","Substance‐use Disorder","Cue‐reactivity","Craving Induction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12779585","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two independent studies: Study 1 – large online survey (N = 1659) testing factor structure, internal consistency and convergent/divergent validity of the CASBAS across several addictive behaviours; Study 2 – within‑subject laboratory experiment (N = 287) with a neutral vs. behaviour‑specific craving","sample_n":1659,"sample_text":"Study 1: 1659 participants (58.5 % female). Study 2: 287 participants (56.8 % female).","population":"Adults (mixed gender) from the general population who reported ‘too much’ use of at least one behaviour (gaming, gambling, buying‑shopping, pornography, social‑network, alcohol, cannabis, nicotine) in the past 12 months.","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study created and validated a short questionnaire (CASBAS) that reliably measures how strongly people crave a range of addictive behaviours, including pornography, and shows it can detect changes after exposure to related cues.","clinical_takeaway":"Clinicians can use the CASBAS to assess acute craving across behaviours, but should consider other factors (e.g., mental health, moral distress) when interpreting scores.","confidence":0.7,"topic_tags":["measurement","csbd","pornography","sexual_function","moral_incongruence"],"strengths":["Large, diverse sample for scale validation","Rigorous factor‑analytic testing and good fit indices","Demonstrated sensitivity to experimental cue induction"],"limitations":["No measurement of potential confounds (e.g., mental health, moral factors)","Absence of pre‑registration or open data","Generalisation limited to self‑selected ‘high‑use’ participants"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/add.70197"}},{"id":1596,"doi":"10.1542/peds.2013-2991","pmid":"24982103","pmcid":null,"title":"Sexting and sexual behavior among middle school students","authors":"Rice E, Gibbs J, Winetrobe H, Rhoades H, Plant A, Montoya J, Kordic T.","first_author":"Rice E","journal":"Pediatrics","year":2014,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":["Adolescents","Middle School","Sexual Risk","Cell Phone","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":63,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Probability sample of 1,285 middle‑school students; logistic regression of sexting vs sexual activity and risk.","sample_n":1285,"sample_text":"Probability sample of 1285 students collected alongside the 2012 Youth Risk Behavior Survey.","population":"U.S. middle‑school students (Los Angeles)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a representative sample of 1,285 U.S. middle‑school students, those who sent or received sexually explicit texts were far more likely to be sexually active and to report unprotected sex. Frequent texting was also linked to higher sexting rates.","clinical_takeaway":"Discuss sexting with early adolescents as a potential marker for sexual activity and risk, but recognize that the data are correlational.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large probability sample enabling generalisability to middle‑school population","Clear operational definition of sexting as sending/receiving explicit texts","Statistical adjustment for texting frequency"],"limitations":["Cross‑sectional design prevents causal inference","Reliance on single‑item self‑report measures without validation","No assessment of key confounders (e.g., mental health, moral attitudes, partner context)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":14,"contrasting":1,"mentioning":125,"citing_publications":125,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2013-2991"}},{"id":1599,"doi":"10.1007/s10508-019-01616-7","pmid":"31897829","pmcid":null,"title":"Pornography and Relationship Quality: Establishing the Dominant Pattern by Examining Pornography Use and 31 Measures of Relationship Quality in 30 National Surveys","authors":"Perry SL.","first_author":"Perry SL.","journal":"Archives of sexual behavior","year":2020,"pub_types":["Journal Article"],"keywords":["Marriage","Romantic Relationships","Relationship Satisfaction","General Social Survey","Pornography","New Family Structures Study","Portraits Of American Life Study","Relationships In America Survey"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Analysis of 30 nationally representative surveys (1973‑2018), examining 31 relationship‑quality measures with bivariate and regression models; no longitudinal or experimental component.","sample_n":null,"sample_text":"Large, pooled national surveys (exact N not provided in abstract)","population":"Married and unmarried American adults surveyed in nationally representative cohorts","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using 30 U.S. national surveys, the author examined how often people watch porn and 31 different measures of relationship quality. Across married and unmarried adults, porn use was usually linked to neutral or slightly worse relationship outcomes, and never clearly linked to better outcomes.","clinical_takeaway":"Viewing pornography is generally not associated with improved relationship quality and may signal modest relationship difficulties.","confidence":0.8,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Large, nationally representative datasets","Multiple relationship‑quality outcomes examined","Explicitly avoids causal language"],"limitations":["Reliance on self‑report frequency of pornography use, likely single‑item","No control for moral or psychological confounds (e.g., religiosity, mental health)","Multiple comparisons without clear correction"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":12,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-01616-7"}},{"id":1600,"doi":"10.1136/archdischild-2025-328561","pmid":"40389284","pmcid":"PMC12505046","title":"Children and adolescents attending for a forensic medical examination at a regional centre in Ireland: a 5-year retrospective cohort study of patients, alleged perpetrators and service provision","authors":"Bergin N, Alzaabi A, Barrett M, Roe S, Walsh A, Geoghegan AR, Harty S.","first_author":"Bergin N","journal":"Archives of disease in childhood","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Forensic medicine","Child Abuse","Paediatrics","Child Protective Services","Paediatric Emergency Medicine"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12505046","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective cohort of all children/adolescents who underwent forensic medical examination (N=448) at one Irish centre over 5 years; descriptive statistics only","sample_n":448,"sample_text":"All cases presented for forensic medical examination at the Laurels Clinic between Jan 2018‑Dec 2022 (N=448)","population":"children and adolescents (mostly female) examined for alleged sexual abuse in Ireland","country":"Ireland","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The study describes 448 Irish children examined for suspected sexual abuse, noting that many abusers were other youths and that factors like blended families and developmental concerns were common. It suggests that smartphone and pornography exposure may increase risk.","clinical_takeaway":"Clinicians should consider family structure and developmental issues when assessing sexual abuse risk, but causal links to pornography remain unproven.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large, region‑wide case series over 5 years","Detailed description of victim and perpetrator characteristics"],"limitations":["Descriptive only – no inferential testing or control group","Findings based on a clinical, forensic sample; not generalisable to all children","No measurement of hypothesised risk factor (pornography exposure) to support causal claim"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/archdischild-2025-328561"}},{"id":1602,"doi":"10.1017/sjp.2019.60","pmid":"31875796","pmcid":null,"title":"Erotic Use of Social Media Pornography in Gratifying Romantic Relationship Desires","authors":"Arikewuyo A, Ozad B, Lasisi TT.","first_author":"Arikewuyo A","journal":"The Spanish journal of psychology","year":2019,"pub_types":["Journal Article"],"keywords":["Romantic Relationships","Social Media","Sexual Compulsivity","Pornography","Sexual Gratification"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of university students (n=379)","sample_n":379,"sample_text":"students (n = 379)","population":"students, likely convenience sample","country":"Nigeria (inferred from author names, not stated)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 379 university students, more frequent use of pornography on social‑media was linked to higher sexual confidence and higher sexual compulsivity, which together were associated with greater sexual gratification in their romantic relationships.","clinical_takeaway":"The study provides only correlational evidence; clinicians should not infer that pornography use improves relationship satisfaction.","confidence":0.6,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["large sample for a single survey","mediational analysis using PROCESS","focus on romantic‑relationship outcomes"],"limitations":["cross‑sectional; cannot infer causality","no measurement of key confounds (morality, masturbation, mental health)","unclear if scales are validated","student convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/sjp.2019.60"}},{"id":1603,"doi":"10.1556/2006.2025.00078","pmid":"40952791","pmcid":"PMC12486285","title":"Behavioral addictions and their reciprocal associations with each other, substance use disorders, and mental health problems: Findings from a longitudinal cohort study of young Swiss men","authors":"Wicki M, Studer J, Marmet S, Khazaal Y, Gmel G.","first_author":"Wicki M","journal":"Journal of behavioral addictions","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Mental health","Substance Use Disorders","Behavioral Addictions","Latent Change Score Model","Cohort Study On Substance Use Risk Factors (C-surf)","Cross-domain Coupling"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12486285","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"large prospective cohort of 5,611 Swiss men, baseline and follow‑up questionnaires, latent change score modeling","sample_n":5611,"sample_text":"non‑self‑selecting sample of 5,611 young Swiss men","population":"young Swiss men (mean age 25‑28), non‑self‑selecting national cohort","country":"Switzerland","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A 5‑year study of 5,600 Swiss men found that increases in porn‑use problems tended to rise together with other behavioural addictions and mental‑health issues, suggesting they reinforce each other over time.","clinical_takeaway":"Consider co‑occurring mental‑health problems when addressing problematic porn use; treatment may need to target multiple issues.","confidence":0.85,"topic_tags":["pornography","sexual_function"],"strengths":["Very large longitudinal sample","Bidirectional latent change score analysis","Broad assessment of many behavioral addictions"],"limitations":["Self‑report measures only, unclear validation for pornography scale","No assessment of moral incongruence or masturbation","Potential gender bias (men only)"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":9,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00078"}},{"id":1604,"doi":"10.1080/00224499.2022.2137097","pmid":"36305846","pmcid":null,"title":"Distress and Satisfaction in Women Who Perceive that Their Male Partners Use Pornography: The Roles of Attitude, Religious Commitment and Conservative Religiosity","authors":"Ruffing EG, Brody LR, Sandage SJ.","first_author":"Ruffing EG","journal":"Journal of sex research","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online panel survey (n=625) examining women’s distress, relationship and sexual satisfaction in relation to partner’s pornography use, attitudes and religiosity.","sample_n":625,"sample_text":"online research panel participants, diverse SES, 86% White, mean age 44 (SD 13)","population":"married or cohabiting women (mean age 44, 86% White) whose male partners reported pornography use in past 3 months","country":"unspecified (likely multinational panel)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large online survey of married or cohabiting women, higher partner porn use and more negative attitudes toward it were linked to greater distress about the porn, and lower relationship and sexual satisfaction. Religious conservatism amplified the distress link.","clinical_takeaway":"Clinicians should consider a woman's attitudes and religious values when addressing distress tied to a partner’s porn use.","confidence":0.78,"topic_tags":["pornography","relationships","sexual_function","religiosity","gender"],"strengths":["Large community sample (N=625)","Multivariate modelling (partial correlations, regressions, moderation)","Focus on understudied relational context"],"limitations":["Cross‑sectional; cannot infer causality","Key constructs measured with likely single‑item/ad‑hoc scales","Moral incongruence, mental‑health, and trauma not assessed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2137097"}},{"id":1605,"doi":"10.1093/jpepsy/jsr003","pmid":"21335615","pmcid":"PMC3146756","title":"Childhood maltreatment, psychological dysregulation, and risky sexual behaviors in female adolescents","authors":"Noll JG, Haralson KJ, Butler EM, Shenk CE.","first_author":"Noll JG","journal":"Journal of pediatric psychology","year":2011,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case-control, matched comparison groups, N=485, mediation analysis","sample_n":485,"sample_text":"275 maltreated, 210 matched non‑maltreated","population":"female adolescents 14-17, maltreated vs non‑maltreated","country":"USA (implied by NIH funding)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared maltreated and non‑maltreated teenage girls and found that emotion‑cognition‑behavior dysregulation leads to more sexual preoccupation, which in turn predicts higher risky sexual behavior.","clinical_takeaway":"Assess trauma and emotional regulation when addressing risky sexual behavior in adolescents.","confidence":0.7,"topic_tags":["adolescents","sexual_function","pornography","moral_incongruence","masturbation"],"strengths":["Large, demographically matched sample","Use of mediation modeling to test theory","Focus on understudied maltreated adolescent females"],"limitations":["Cross‑sectional design limits causal inference","No measurement of key confounds (moral beliefs, masturbation, mental‑health covariates)","Unclear whether scales are validated"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":6,"contrasting":0,"mentioning":24,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jpepsy/jsr003"}},{"id":1608,"doi":"10.1080/00224499.2019.1696275","pmid":"31809207","pmcid":null,"title":"Aggression and Pleasure in Opposite-Sex and Same-Sex Mainstream Online Pornography: A Comparative Content Analysis of Dyadic Scenes","authors":"Seida K, Shor E.","first_author":"Seida K","journal":"Journal of sex research","year":2021,"pub_types":["Journal Article"],"keywords":["Content analysis","Aggression","Heterosexual","Online","Pleasure","Pornography","Same-sex"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 210 popular Pornhub videos (70 gay, 70 lesbian, 70 heterosexual) coding aggression, affection, and pleasure.","sample_n":210,"sample_text":"210 videos (70 per category).","population":"Online pornography videos (mainstream, mainstream platforms).","country":"Not specified (global platform).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors compared 210 popular online porn videos and found that same‑sex scenes show more aggression, affection, and pleasure than opposite‑sex scenes, suggesting different gender scripts across porn subgenres.","clinical_takeaway":"None – the study examines video content, not health outcomes.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, balanced sample of videos across categories","Systematic coding of multiple content dimensions","Addresses gap in same‑sex pornography research"],"limitations":["Unclear if coding scheme was validated","No assessment of viewer impact or user behavior","Convenience sample of popular videos may not represent all content"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":25,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2019.1696275"}},{"id":1609,"doi":"10.1093/milmed/usz079","pmid":"31132108","pmcid":null,"title":"Survey of Sexual Function and Pornography","authors":"Berger JH, Kehoe JE, Doan AP, Crain DS, Klam WP, Marshall MT, Christman MS.","first_author":"Berger JH","journal":"Military medicine","year":2019,"pub_types":["Journal Article"],"keywords":["erectile dysfunction","Pornography","Sexual Dysfunction (Psychological)"],"is_oa":false,"oa_url":"https://academic.oup.com/milmed/article-pdf/184/11-12/731/31510221/usz079.pdf","cited_by_count":24,"is_preprint":false,"topics":["bibliography","masturbation","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 20‑40 year old men and women attending a urology clinic; questionnaires on pornography use, IIEF/FSFI, craving and passion scales.","sample_n":null,"sample_text":"Surveys distributed to 20‑40 year old men and women presenting to a urology clinic; exact N not reported in abstract.","population":"Urology clinic patients (young adults, 20‑40 years) in California, USA","country":"USA","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of young men and women at a urology clinic found that men who prefer to watch porn while masturbating are more likely to report erectile problems, but overall porn use was not linked to sexual dysfunction.","clinical_takeaway":"Clinicians should assess masturbation preferences when evaluating erectile issues, but porn use alone may not predict dysfunction.","confidence":0.7,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Validated sexual function scales (IIEF, FSFI)","Separate assessment of porn use frequency and duration","Large clinical sample (urology patients)","Investigation of preference for porn with masturbation"],"limitations":["Cross‑sectional, cannot infer causality","Moral incongruence and mental‑health covariates not measured","Addiction constructs measured with non‑standard scales","Clinic‑based convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":2,"contrasting":1,"mentioning":23,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/milmed/usz079"}},{"id":1610,"doi":"10.21203/rs.3.rs-200469/v1","pmid":null,"pmcid":null,"title":"A Systematic Review on Adolescents’ Premarital Sexual Behaviour In Malaysia","authors":"Minhat HS, Ismail RNNR, Jafri F, Zulkefli NAM, Ahmad N.","first_author":"Minhat HS","journal":"Research Square","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-200469/v1.pdf?c=1631888213000","cited_by_count":1,"is_preprint":true,"topics":["masturbation","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of nine studies (six cross‑sectional) on premarital sexual behaviour among Malaysian adolescents; two reviewers extracted data and assessed bias.","sample_n":41939,"sample_text":"Aggregate sample size from included primary studies.","population":"Adolescents aged 12‑19 years, total N≈41,939 (aggregate across included studies).","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of nine Malaysian studies (over 41,000 teens) found that about 3‑8% had ever had sex before marriage. Factors linked to higher risk were negative attitudes toward sexual urges (including pornography and masturbation) and other risky behaviours, while religiosity and supportive parents/peers were protective.","clinical_takeaway":"Consider religiosity and peer‑parent dynamics when designing adolescent sexual‑health interventions; addressing attitudes toward pornography and masturbation may also be relevant.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Systematic search across multiple databases","Dual reviewer data extraction and bias assessment","Large combined sample size"],"limitations":["Primary evidence limited to cross‑sectional designs","No meta‑analysis or pooled effect sizes","Key confounders (mental health, trauma) not examined"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-200469/v1"}},{"id":1611,"doi":"10.1542/peds.2010-1544","pmid":"20805150","pmcid":null,"title":"American Academy of Pediatrics. Policy statement--sexuality, contraception, and the media","authors":"Council on Communications and Media.","first_author":"Council on Communications and Media.","journal":"Pediatrics","year":2010,"pub_types":["Practice Guideline","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"policy statement / practice guideline based on literature review, no primary data","sample_n":null,"sample_text":"Not applicable – no empirical participants","population":"U.S. adolescents (general)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The American Academy of Pediatrics warns that media exposure can hasten teen sexual activity, increasing risks of pregnancy and STIs. It recommends pediatricians give clear, evidence‑based information about contraception rather than rely on abstinence‑only messages.","clinical_takeaway":"Clinicians should discuss contraception openly with adolescents, acknowledging media influence.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Comprehensive synthesis of existing literature","Clear actionable recommendations for clinicians"],"limitations":["No original empirical data","Limited to U.S. context and adolescent population","Potential bias of expert panel not disclosed"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":2,"contrasting":0,"mentioning":14,"citing_publications":107,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2010-1544"}},{"id":1612,"doi":"10.1080/10826084.2025.2554865","pmid":"40911380","pmcid":null,"title":"Chemsex: Associations with Sexual, Psychosocial and Social Health in Australian Gay and Bisexual Men","authors":"Demant D, Saliba B, Oviedo-Trespalacios O, Newton JDA.","first_author":"Demant D","journal":"Substance use & misuse","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual Health","Substance Use","Sexual Behaviors","Sex Research","Sexual And Gender Minorities"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 632 Australian GBMSM, self‑selected convenience sample","sample_n":632,"sample_text":"Convenience online sample; not nationally representative","population":"gay, bisexual and other men who have sex with men in Australia","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2026 Australian survey of 632 gay and bisexual men, about one‑third reported using drugs to enhance sex (chemsex). Those men were younger, more likely Indigenous, reported higher psychological distress, lower community connection, and both higher sexual self‑esteem and more adventurous sexual activities. The study cannot say whether chemsex causes these outcomes or vice‑versa.","clinical_takeaway":"Clinicians should be aware that chemsex is common and linked to both higher distress and sexual wellbeing, and should assess underlying psychosocial factors rather than assume purely harmful effects.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample (N>600) for a sexual‑minority survey","Use of several validated psychosocial scales","Clear reporting of prevalence and multiple health domains"],"limitations":["Cross‑sectional design; cannot infer causality","Convenience online sampling limits generalisability","Key confounds (moral incongruence, masturbation, trauma) not measured"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10826084.2025.2554865"}},{"id":1614,"doi":"10.3389/fpubh.2025.1590151","pmid":"40951399","pmcid":"PMC12425748","title":"A quantitative study on female sex workers' mental health in Germany","authors":"Kroehn-Liedtke F, Kalinowski O, Kaya G, Lotysh A, Mihaylova H, Sipos K, Strunk A, Zerbe L, Rössler W, Schouler-Ocak M.","first_author":"Kroehn-Liedtke F","journal":"Frontiers in public health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Mental health","risk factors","Social Workers","Sex Work","Prevalence Of Mental Disorders"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12425748","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional quantitative interview study of 403 female sex workers and 157 female social‑worker controls in Germany.","sample_n":560,"sample_text":"403 women engaged in sex work; 157 female social workers","population":"Female sex workers (Germany) and female social workers as controls","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 403 German female sex workers found higher rates of mental‑health disorders than a comparison group of social workers, with factors like homelessness, low income and work‑related stress predicting poorer mental health.","clinical_takeaway":"Sex workers face elevated mental‑health risks; clinicians should assess contextual stressors and consider tailored support.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample of sex workers","Use of validated mental‑health scales","Inclusion of a control group"],"limitations":["Cross‑sectional design limits causal inference","Convenience sampling may bias representativeness","Limited control for broader psychosocial confounders"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[{"status":"Has correction","date":"2026-1-27","noticeDoi":"10.3389/fpubh.2026.1777357","doi":"10.3389/fpubh.2025.1590151"}],"url":"https://scite.ai/reports/10.3389/fpubh.2025.1590151"}},{"id":1615,"doi":"10.3389/frph.2025.1601088","pmid":"40950656","pmcid":"PMC12426199","title":"The burden of &lt;i&gt;Neisseria gonorrhoeae&lt;/i&gt; infection, risky sexual behavior, and associated risk factors among sexually transmitted infections in a resource-limited setting area of Addis Ababa City, Ethiopia","authors":"Andualem T, Belay G, Desta AF, Nigussie H, Mulu W, Desalegn A, Taddesse G, Mekonen Y, Beyene D.","first_author":"Andualem T","journal":"Frontiers in reproductive health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["risk factors","Gonorrhea","Risky Sexual Behavior","Sexually Transmitted Infection","N. Gonorrhoeae"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12426199","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"health institution‑based cross‑sectional study of 571 STI patients using convenience sampling and questionnaire/interview data","sample_n":571,"sample_text":"571 study subjects; convenience sampling from health facilities","population":"STI patients attending health facilities in Addis Ababa, Ethiopia (mostly female, adults >18 y)","country":"Ethiopia","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a clinic sample of 571 Ethiopian patients with sexually transmitted infections, 17% tested positive for gonorrhoea and 57% reported risky sexual behaviours. Watching pornographic films, alcohol use, and lack of religious education were linked to higher odds of infection and risky behaviour.","clinical_takeaway":"Risky sexual behaviour and gonorrhoea are common among STI patients; clinicians should consider broader psychosocial factors (including porn use) when counselling.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑site STI study","Laboratory confirmation of gonorrhoea infection","Use of multivariable logistic regression with adjusted odds ratios"],"limitations":["Convenience sampling limits generalisability","Risky sexual behaviour measured with non‑validated questionnaire","Key psychosocial confounds (moral incongruence, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/frph.2025.1601088"}},{"id":1616,"doi":"10.3390/ijerph191912329","pmid":"36231629","pmcid":"PMC9566571","title":"Sexist Attitudes in Adolescents: Prevalence and Associated Factors","authors":"Vila-Cortavitarte E, Díaz-Gómez NM, Díaz-Gómez JM.","first_author":"Vila-Cortavitarte E","journal":"International journal of environmental research and public health","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Observational Study"],"keywords":["Adolescent","Sexism","Gender Equity","Gender Identity","Gender-based Violence","Pornography"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/19/12329/pdf?version=1664358763","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational cross‑sectional survey of 723 adolescents (14‑19 y) from schools in Spain.","sample_n":723,"sample_text":"723 adolescents aged 14‑19 years.","population":"Adolescents, mixed gender, recruited through schools (likely convenience sample).","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 723 Spanish teens, higher porn use was linked to stronger sexist attitudes, especially among boys, immigrants, and those from lower‑educated families. The study suggests schools should teach gender equality and healthy sexual attitudes.","clinical_takeaway":"None – the study does not provide direct clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","adolescents","gender","pornography"],"strengths":["Large sample for a school‑based survey","Use of validated scales for sexist attitudes","Both explicit and implicit attitudes measured"],"limitations":["Pornography consumption measured with a single, non‑validated item","Cross‑sectional design limits causal inference","No control for key psychosocial confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph191912329"}},{"id":1617,"doi":"10.1007/s12119-022-10011-9","pmid":"36157715","pmcid":"PMC9485786","title":"Pornography and the Erotic Phantasmagoria","authors":"Rosen D.","first_author":"Rosen D.","journal":"Sexuality & culture","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Erotic Representation","Phantasmagoria","Pornogaphy","Susan Sontag"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9485786","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"none","population":"none","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The essay reviews two centuries of pornographic media, linking technological change to cultural shifts and feminist debates, and wonders whether increased quantity might lead to higher quality and more humane pornography.","clinical_takeaway":"None – the article is theoretical and offers no clinical guidance.","confidence":0.8,"topic_tags":["pornography","csbd","sexual_function"],"strengths":["Broad historical perspective","Integrates cultural theory"],"limitations":["No empirical data","Lacks methodological rigor","Conclusions are speculative"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12119-022-10011-9"}},{"id":1618,"doi":"10.2196/36662","pmid":"36083612","pmcid":"PMC9508667","title":"Content and Effectiveness of Web-Based Treatments for Online Behavioral Addictions: Systematic Review","authors":"Park JJ, King DL, Wilkinson-Meyers L, Rodda SN.","first_author":"Park JJ","journal":"JMIR mental health","year":2022,"pub_types":["review-article","Review","Journal Article"],"keywords":["Treatment","Systematic review","Gambling","Social Media","Internet Intervention","Gaming","Pornography"],"is_oa":true,"oa_url":"https://mental.jmir.org/2022/9/e36662/PDF","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 12 studies (7 RCTs, 5 pre‑post) of web‑based interventions for online behavioral addictions, including pornography.","sample_n":12,"sample_text":"12 primary studies (15 intervention arms) identified; participants per study not aggregated in abstract.","population":"Adults participating in web‑based treatment trials for gaming, gambling, internet use, and pornography (samples vary across included studies).","country":"Not specified (multinational database search).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review examined 12 studies of online programs that aim to reduce problematic gaming, gambling, internet use and pornography. Most showed short‑term drops in symptom severity, use frequency or time spent, but few measured lasting effects.","clinical_takeaway":"Web‑based interventions can briefly lessen problematic porn or other online behaviors, but evidence for lasting benefit is limited.","confidence":0.7,"topic_tags":["pornography","treatment","sexual_function","csbd"],"strengths":["Systematic search across multiple databases.","Includes only studies with validated outcome measures.","Risk‑of‑bias assessment using EPHPP tool."],"limitations":["No meta‑analysis; findings are descriptive.","Limited long‑term outcome data.","Primary studies often lack control for key confounds (e.g., moral incongruence)."],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/36662"}},{"id":1619,"doi":"10.1007/bf02437541","pmid":"8899139","pmcid":null,"title":"The relationship between nonenforcement of state pornography laws and rates of sex crime arrest","authors":"Winick C, Evans JT.","first_author":"Winick C","journal":"Archives of sexual behavior","year":1996,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Ecological before‑after comparison of state crime statistics during periods of pornography law nonenforcement.","sample_n":null,"sample_text":"Not applicable – aggregate crime counts","population":"State‑level crime data from Maine, North Carolina, Pennsylvania, Washington (1973‑1986)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined U.S. states where anti‑pornography laws were not enforced and found no change in rape or other sex‑crime arrests during those periods, suggesting no obvious link between increased pornography availability and sex‑crime rates.","clinical_takeaway":"Population‑level data do not support a direct causal link between pornography availability and sex‑crime arrests.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Uses real‑world crime data over a 13‑year span","Natural experiment based on policy variation"],"limitations":["Ecological design cannot infer individual‑level effects","No control for temporal confounders (e.g., policing changes, socioeconomic shifts)","No measurement of actual porn consumption or individual distress"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02437541"}},{"id":1620,"doi":"10.1016/j.chiabu.2019.104189","pmid":"31541991","pmcid":null,"title":"Psychopathology among adult survivors of child pornography","authors":"Gewirtz-Meydan A, Lahav Y, Walsh W, Finkelhor D.","first_author":"Gewirtz-Meydan A","journal":"Child abuse & neglect","year":2019,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Psychopathology","Guilt","Avoidance","Child Pornography","Embarrassment"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 107 adult survivors of child pornography; convenience sample; regression analyses of emotional reactions predicting current psychopathology.","sample_n":107,"sample_text":"Convenience sample recruited online; ages 18‑63, mean 39.5.","population":"adult survivors of child pornography (victims of sexual exploitation)","country":"United States (U.S. Government‑funded study)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 107 adults who were victims of child pornography, feelings of guilt and embarrassment about the crime were linked to higher current psychological distress, even after accounting for age and crime details.","clinical_takeaway":"Therapists should explore guilt and embarrassment in survivors of child pornography, as these emotions may contribute to ongoing mental‑health problems.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Focus on an understudied survivor population","Large sample for a victim‑of‑child‑pornography study","Analysis of specific emotional reactions"],"limitations":["Convenience, self‑selected sample limits generalisability","Cross‑sectional design prevents causal inference","Unclear whether psychopathology measures were validated"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2019.104189"}},{"id":1621,"doi":"10.7759/cureus.89918","pmid":"40809937","pmcid":"PMC12349891","title":"Erectile Dysfunction in Young Adults: A Narrative Review","authors":"Safa A, Waked C.","first_author":"Safa A","journal":"Cureus","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["erectile dysfunction","Psychogenic Erectile Dysfunction","Male Sexual Health","Young Adult Male","Organic Erectile Dysfunction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12349891","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methodology or risk‑of‑bias assessment; no new empirical data.","sample_n":null,"sample_text":"Not applicable – narrative review","population":"young adult men (<40 years) with erectile dysfunction (ED)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises current knowledge on erectile dysfunction in men under 40, noting that both psychological issues (like anxiety) and physical problems (like hormonal imbalances) contribute, and that lifestyle habits such as pornography use may be linked.","clinical_takeaway":"Young men with ED should be assessed for both psychological and organic causes, and treatment should combine medical and lifestyle interventions.","confidence":0.6,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["Broad overview of young‑adult ED","Includes both organic and psychogenic factors","Identifies lifestyle contributors"],"limitations":["Narrative (non‑systematic) methodology","No systematic risk‑of‑bias assessment","Lacks quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.89918"}},{"id":1624,"doi":"10.1080/26410397.2025.2517430","pmid":"40755444","pmcid":"PMC12337732","title":"Association between Chinese youth's sources of sexual knowledge and sexual and reproductive health: a mediation analysis of sexual knowledge level","authors":"Zou X, Xue K, Zou S, Xiao AY, Cao W, Tang K.","first_author":"Zou X","journal":"Sexual and reproductive health matters","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Mediation Analysis","Sexuality Education","Sexual And Reproductive Health","Chinese Youth","Sexual Knowledge"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12337732","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large cross‑sectional survey (N≈52 000) of Chinese youth; mediation analysis of source of sexual knowledge → knowledge score → sexual behaviour outcomes","sample_n":52256,"sample_text":"52,256 Chinese youth surveyed in 2019‑20","population":"Chinese adolescents and young adults, mixed gender, unspecified sampling method (likely convenience/online survey)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A huge Chinese youth survey found that those who learn about sex mainly from media (often pornography) tend to have sex earlier, while learning from school is linked to later sexual debut. Knowledge level partly explains these links.","clinical_takeaway":"Sex education delivered through schools may delay early sexual activity; media‑based learning (including porn) is associated with earlier debut.","confidence":0.78,"topic_tags":["sexual_function","religiosity"],"strengths":["Very large sample size provides high statistical power","Relevant mediation analysis linking knowledge sources to behaviour","Gender differences explored"],"limitations":["Cross‑sectional design cannot establish causality","No validated instruments reported for knowledge or behaviour measures","Key confounds (moral incongruence, mental health, masturbation, relationship context) not measured"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/26410397.2025.2517430"}},{"id":1625,"doi":"10.1186/s40359-025-03242-6","pmid":"40775371","pmcid":"PMC12329895","title":"Personality characteristics in emerging adults engaging in sex work: a systematic review","authors":"Bandurski LC, Juchem CM, Baumgardt S, Bendau A, Asselmann E.","first_author":"Bandurski LC","journal":"BMC psychology","year":2025,"pub_types":["Systematic Review","review-article","Journal Article"],"keywords":["Development","Prostitution","Transactional Sex","Pornography","Escort","Webcam-sex"],"is_oa":true,"oa_url":"https://doi.org/10.1186/s40359-025-03242-6","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review of ten studies, pre‑registered in PROSPERO, but no explicit risk‑of‑bias assessment reported","sample_n":null,"sample_text":"Ten primary studies identified; exact participant numbers not provided in abstract","population":"emerging adult sex workers (female, 18‑29) and comparison groups","country":"unspecified (studies from multiple locations)","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of ten studies found that emerging adult sex workers tend to show lower agreeableness, self‑esteem and self‑efficacy, and higher impulsivity, aggression and antisocial traits compared with non‑workers.","clinical_takeaway":"Clinicians should consider personality traits like impulsivity and low self‑esteem when supporting young adults in or exiting sex work.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Pre‑registered systematic review protocol","Clear synthesis of personality findings across multiple studies","Identification of gaps and need for longitudinal work"],"limitations":["No risk‑of‑bias assessment reported","Limited number of primary studies (n=10)","Potential heterogeneity of personality measures not described"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s40359-025-03242-6"}},{"id":1626,"doi":"10.31234/osf.io/yq8f5","pmid":null,"pmcid":null,"title":"Celebrity status, sex, and variation in psychopathy predicts judgements of and proclivity to generate and distribute deepfake pornography","authors":"Fido D, Rao J, Harper CA.","first_author":"Fido D","journal":"PsyArXiv","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"two independent online surveys assessing participants' judgments of deepfake pornography generation and distribution; moderation and linear mixed‑effects models used; sample size not reported in abstract","sample_n":null,"sample_text":"not specified in abstract","population":"adults recruited online (likely convenience sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed people about how acceptable they think it is to create and share deepfake porn. Participants were more lenient when the fake images involved celebrities or were for personal sexual gratification, and those with higher psychopathy scores were especially permissive.","clinical_takeaway":"None – the findings relate to public attitudes, not to clinical treatment or diagnosis.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["uses validated psychopathy scale","pre‑registered data repository","mixed‑effects modelling appropriate for nested data"],"limitations":["no sample size reported, likely under‑powered","does not control for moral or mental‑health confounds","cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/yq8f5"}},{"id":1627,"doi":"10.1111/j.1365-2850.2011.01815.x","pmid":"22073927","pmcid":null,"title":"Use of the Internet by parents of middle school students: internet rules, risky behaviours and online concerns","authors":"Dowdell EB.","first_author":"Dowdell EB.","journal":"Journal of psychiatric and mental health nursing","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 227 parents of middle‑school children; online questionnaire; descriptive and comparative analyses","sample_n":227,"sample_text":"227 parents of early adolescent (ages 11 to 14 years) middle school students","population":"Parents of adolescents age 11‑14 (N=227), recruited likely via schools in New England; not a clinical or treatment‑seeking sample","country":"United States (New England)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 227 parents of 11‑14‑year‑old children found that many parents use the internet similarly to their kids, set household rules, yet also engage in risky online actions like electronic aggression and chatting with strangers. Parents are worried about their children's exposure to sexual content but often don’t know where to report problems.","clinical_takeaway":"Clinicians should ask parents about their own internet habits and safety knowledge to better support families.","confidence":0.78,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large community sample of parents (N>200)","Addresses a practical gap for clinicians (parental internet safety)","Identifies specific risky behaviours and knowledge deficits"],"limitations":["Self‑report questionnaire; likely unvalidated measures","Cross‑sectional design precludes causal inference","Convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2850.2011.01815.x"}},{"id":1628,"doi":"10.21203/rs.3.rs-99726/v1","pmid":null,"pmcid":null,"title":"Assessment of Level of HIV/AIDS Preventive Self-Efficacy and Associated Factors Among Regular Undergraduate Students of Madda Walabu University, Southeast Ethiopia, 2020. A Cross-Sectional Study","authors":"Kene C, Adugna H, Lemessa K, Deribe L.","first_author":"Kene C","journal":"Research Square","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-99726/v1.pdf?c=1625881904000","cited_by_count":2,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 442 undergraduates selected by simple random sampling","sample_n":442,"sample_text":"442 participants selected by simple random sampling","population":"regular undergraduate students at Madda Walabu University, Ethiopia","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 442 Ethiopian university students found that those who had ever watched pornography reported lower confidence in their ability to prevent HIV, while female sex, health‑science majors, higher year of study, and alcohol use were linked to higher self‑efficacy.","clinical_takeaway":"Exposure to pornography was associated with reduced HIV‑prevention self‑efficacy, suggesting a need for targeted education.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Reasonable sample size for a cross‑sectional survey","Use of multivariable logistic regression with odds ratios and confidence intervals","Random sampling within university"],"limitations":["Self‑efficacy scale not described; unknown validation","Cross‑sectional design cannot infer causality","Potential unmeasured confounders (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-99726/v1"}},{"id":1629,"doi":"10.36131/cnfioritieditore20220406","pmid":"36101646","pmcid":"PMC9442854","title":"Interpersonal Guilt and Problematic Online Behaviors: The Mediating Role of Emotion Dysregulation","authors":"Russo A, Santoro G, Schimmenti A.","first_author":"Russo A","journal":"Clinical neuropsychiatry","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Interpersonal Guilt","Emotion Dysregulation","Problematic Gaming","Problematic Social Media Use","Problematic Online Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 434 adults completing self‑report questionnaires; structural equation modelling used to test mediation","sample_n":434,"sample_text":"adult participants recruited online (presumed convenience sample)","population":"adult community sample (age 18‑69, 48 % male)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 434 adults, feeling guilty toward others was linked to trouble managing emotions, which in turn was associated with more problematic use of online gaming, social media, and pornography.","clinical_takeaway":"Emotion‑dysregulation may increase risky online pornography use, but causal links are unclear.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample (N>400)","Use of structural equation modelling","Focus on understudied mediator (emotion dysregulation)"],"limitations":["Cross‑sectional, limits causal inference","No measurement of moral incongruence or masturbation","Potential self‑report bias"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.36131/cnfioritieditore20220406"}},{"id":1630,"doi":"10.1016/j.neuroimage.2008.05.051","pmid":"18598769","pmcid":null,"title":"Activation of mirror-neuron system by erotic video clips predicts degree of induced erection: an fMRI study","authors":"Mouras H, Stoléru S, Moulier V, Pélégrini-Issac M, Rouxel R, Grandjean B, Glutron D, Bittoun J.","first_author":"Mouras H","journal":"NeuroImage","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://u-picardie.hal.science/hal-03649712","cited_by_count":68,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross‑sectional fMRI study with 10 healthy male participants viewing erotic video clips; penile erection measured simultaneously","sample_n":10,"sample_text":"ten healthy subjects (eight showed erection)","population":"healthy adult males (n=10)","country":"France (implied by author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","fmri_reverse_inference"],"stance":"neutral","citation_value":"useful","plain_summary":"In ten men watching erotic videos, brain activity in regions containing mirror neurons was linked to how strong their erections became, suggesting these brain areas may help coordinate visual sexual cues with bodily responses.","clinical_takeaway":"Findings are preliminary; no direct clinical implications.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","pornography"],"strengths":["simultaneous physiological measurement of erection","use of fMRI to explore brain‑behavior link"],"limitations":["very small sample (n=10)","no correction for multiple comparisons","no control for confounding variables","reverse inference from BOLD to specific neural function"],"rubric_version":"2.0","raw_total":16,"max_possible":60,"pct_score":27,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":3,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":7,"contrasting":1,"mentioning":78,"citing_publications":98,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neuroimage.2008.05.051"}},{"id":1631,"doi":"10.1080/19317611.2025.2530511","pmid":"40843156","pmcid":"PMC12366806","title":"The Sacred, the Sinful, and the Shamed: The Association Between Compulsive Sexual Behavior, Moral Disapproval, and Sexual Shame Among Jewish Religious Adolescents","authors":"Kaplan M, Lazter Y, Bőthe B, Gewirtz Meydan A.","first_author":"Kaplan M","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Orthodox Judaism","Compulsive Sexual Behavior (Csb)","Sexual Shame","Moral Disapproval","Religious Adolescents"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12366806","cited_by_count":0,"is_preprint":false,"topics":["csbd","masturbation","pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,050 Orthodox Jewish adolescents examining self‑reported compulsive sexual behavior, moral disapproval and sexual shame","sample_n":1050,"sample_text":"1,050 adolescents (63% boys, 37% girls)","population":"Adolescents (mean age 17.4), Orthodox Jewish community, mixed gender","country":"unspecified","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Among Orthodox Jewish teens, higher reports of compulsive sexual behavior are linked to stronger moral disapproval of sexual acts and greater sexual shame, especially around masturbation, suggesting religious guilt may amplify shame.","clinical_takeaway":"Therapists working with religious adolescents should assess moral conflict and shame when addressing compulsive sexual behavior.","confidence":0.7,"topic_tags":["csbd","sexual_function","moral_incongruence","adolescents","religiosity"],"strengths":["Large sample size for adolescent population","Focus on understudied religious context","Inclusion of moral disapproval as a measured variable","Network analysis to explore variable interrelations"],"limitations":["Cross‑sectional design prevents causal inference","Unclear whether CSB measured with validated scale","Masturbation behavior not directly assessed","No control for mental‑health or partner factors"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2025.2530511"}},{"id":1632,"doi":"10.1080/00224499.2022.2096844","pmid":"35856785","pmcid":null,"title":"Associations of Adolescents' Pornography Viewing with their Romantic Relationship Skills and Behaviors","authors":"Huntington C, Willoughby B, Rhoades G.","first_author":"Huntington C","journal":"Journal of sex research","year":2024,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 755 adolescents (avg. age 15.7) examining self‑reported pornography viewing frequency (overall and joint) and a range of romantic‑relationship outcomes (skills, conflict, dating violence, sexting).","sample_n":755,"sample_text":"n = 755, 59.9% girls, mean age 15.72 (SD = 1.34)","population":"Adolescents (U.S., likely school‑based sample), 59.9% female, n=755","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 755 U.S. teens, those who watched more pornography—especially together with a partner—reported weaker relationship skills, more conflict, and higher rates of dating violence and sexting. The study is cross‑sectional, so it shows associations, not cause‑and‑effect.","clinical_takeaway":"Clinicians should be aware that frequent (and joint) pornography use in teens may co‑occur with relationship difficulties, but should not assume it causes these problems.","confidence":0.8,"topic_tags":["adolescents","pornography","relationships","sexual_function"],"strengths":["Large community sample of adolescents","Addresses under‑studied joint pornography use","Links viewing to multiple relational outcomes"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on single‑item self‑report frequency measures","No measurement or control of key confounds (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2096844"}},{"id":1633,"doi":"10.1007/s10508-019-1435-4","pmid":"31309432","pmcid":"PMC6751001","title":"The Association Between Exposure to Violent Pornography and Teen Dating Violence in Grade 10 High School Students","authors":"Rostad WL, Gittins-Stone D, Huntington C, Rizzo CJ, Pearlman D, Orchowski L.","first_author":"Rostad WL","journal":"Archives of sexual behavior","year":2019,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Journal Article"],"keywords":["risk factors","Violence Prevention","Teen Dating Violence","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":51,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"baseline survey of 1694 grade‑10 students; gender‑stratified logistic regression","sample_n":1694,"sample_text":"grade‑10 high school students who reported a dating relationship in the past year (n = 1694)","population":"Adolescent high‑school students (grade 10) in dating relationships","country":"United States (presumed from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,694 ninth‑grade students, those who reported seeing violent porn were more likely to report physical, sexual, or threatening dating violence, with patterns differing for boys and girls.","clinical_takeaway":"Exposure to violent pornography is linked with higher odds of teen dating violence; prevention programs should address this risk.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","relationships","gender"],"strengths":["Large, community‑based adolescent sample","Gender‑stratified analyses","Adjustment for several relevant covariates"],"limitations":["Cross‑sectional design limits causal inference","Exposure and outcomes based on single‑item self‑report","Key confounds (moral incongruence, masturbation, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":8,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":11,"contrasting":0,"mentioning":97,"citing_publications":124,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-1435-4"}},{"id":1636,"doi":"10.1038/s41443-022-00596-y","pmid":"35840678","pmcid":null,"title":"Do pornography use and masturbation play a role in erectile dysfunction and relationship satisfaction in men?","authors":"Rowland DL, Castleman JM, Bacys KR, Csonka B, Hevesi K.","first_author":"Rowland DL","journal":"International journal of impotence research","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["curated","masturbation","pornography"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"cross-sectional","design_detail":"Multivariable Confound-Controlled Study","sample_n":null,"sample_text":"Large multi-national community sample (N > 1,800)","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"moderate","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Directly tests whether apparent associations between pornography use and sexual dysfunction survive after controlling for solitary masturbation frequency (which co-occurs >95% of the time in men) and pre-existing depression/anxiety. Shows that bivariate pornography effects (β = -0.24) drop to non-significance (β = -0.08, ns) when masturbation and depression (β = -0.35) are controlled.","clinical_takeaway":"When someone presents with sexual dysfunction alongside pornography use, practitioners must assess depression, performance anxiety, and masturbation patterns rather than assuming pornography caused neurological desensitization.","confidence":1,"topic_tags":["relationships"],"strengths":["Separates pornography viewing from masturbation frequency rather than conflating them","Controls for depression and anxiety using validated clinical scales","Reports standardized beta weights before and after covariate entry","Demonstrates that depression is a far stronger predictor of sexual dysfunction than pornography"],"limitations":["Cross-sectional observational design","Self-reported behavioral frequency"],"rubric_version":"2.0","raw_total":45,"max_possible":50,"pct_score":90,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":10,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":2,"contrasting":1,"mentioning":7,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-022-00596-y"}},{"id":1637,"doi":"10.1556/2006.2022.00026","pmid":"35895459","pmcid":"PMC9295231","title":"What does \"Sexual\" mean in compulsive sexual behavior disorder? •","authors":"Briken P, Turner D.","first_author":"Briken P","journal":"Journal of behavioral addictions","year":2022,"pub_types":["article-commentary","Journal Article"],"keywords":["Sexual Addiction","Icd-11","Hypersexual","Pornography","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/11/2/article-p222.pdf","cited_by_count":12,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary, no empirical data","sample_n":null,"sample_text":"none","population":"none","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"background","plain_summary":"The authors discuss how the word 'sexual' in Compulsive Sexual Behavior Disorder can affect stigma and treatment, urging a sex‑positive approach and clearer naming.","clinical_takeaway":"None - not clinically applicable.","confidence":0.6,"topic_tags":["csbd","neuroscience","measurement","treatment"],"strengths":["Addresses conceptual clarity of CSBD terminology","Highlights potential stigma from labeling"],"limitations":["No empirical data presented","Does not test any constructs or provide evidence"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":18,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00026"}},{"id":1638,"doi":"10.1556/2006.2022.00025","pmid":"35895451","pmcid":"PMC9295243","title":"Disorders due to addictive behaviors: Further issues, debates, and controversies •","authors":"Griffiths MD.","first_author":"Griffiths MD.","journal":"Journal of behavioral addictions","year":2022,"pub_types":["article-commentary","Journal Article"],"keywords":["Behavioral Addictions","Compulsive Sexual Behavior Disorder","Social Network Use Disorder","Buying-shopping Disorder","Pornography Use Disorder","Sex addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9295243","cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"N/A – commentary with no primary data","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The author reviews recent discussions about whether behaviors like pornography use or social‑networking can be classified as addictions, noting that more high‑quality research is needed before they could be added to diagnostic manuals.","clinical_takeaway":"Clinicians should remain cautious about labeling pornography or social‑media use as an addiction until stronger evidence emerges.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Broad overview of current debates","References recent empirical papers","Balanced tone acknowledging data gaps"],"limitations":["No original data presented","Lacks systematic appraisal of evidence","No explicit assessment of confounding factors"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00025"}},{"id":1641,"doi":"10.1016/j.comppsych.2022.152336","pmid":"35843138","pmcid":null,"title":"The experience of gratification and compensation in addictive behaviors: How can these experiences be measured systematically within and across disorders due to addictive behaviors?","authors":"Wegmann E, Antons S, Brand M.","first_author":"Wegmann E","journal":"Comprehensive psychiatry","year":2022,"pub_types":["Journal Article"],"keywords":["Social Networks","Behavioral Addictions","Pornography Use","Gaming Disorder","Buying-shopping Disorder","Reinforcement Mechanisms"],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Questionnaire development study with three cross‑sectional samples, exploratory and confirmatory factor analysis, and correlations with addiction‑related constructs.","sample_n":null,"sample_text":"Not reported in abstract; three studies with unspecified sample sizes.","population":"Adults reporting various online activities (gaming, gambling, buying‑shopping, social‑network, pornography use); sampling method not specified, likely convenience.","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created two questionnaires to measure how people feel gratification and compensation while using online activities like porn, gaming, or shopping. The scales showed consistent factor structures and correlated with craving and symptom scores, suggesting they capture relevant motives in potentially addictive behaviors.","clinical_takeaway":"These new scales may help assess underlying motives (gratification vs. compensation) in problematic online use, but further validation is needed before clinical use.","confidence":0.7,"topic_tags":["pornography","sexual_function","measurement","moral_incongruence","masturbation"],"strengths":["Systematic scale development with EFA/CFA","Includes multiple online behavior domains","Links new scales to established addiction constructs"],"limitations":["No evidence of validation in independent samples","Unclear sampling method and size","Did not control key confounds (e.g., moral incongruence, mental health)","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":31,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2022.152336"}},{"id":1643,"doi":"10.3389/fpsyt.2022.907549","pmid":"35873234","pmcid":"PMC9302710","title":"Online Sex Addiction: A Qualitative Analysis of Symptoms in Treatment-Seeking Men","authors":"Blinka L, Ševčíková A, Dreier M, Škařupová K, Wölfling K.","first_author":"Blinka L","journal":"Frontiers in psychiatry","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Qualitative Study","Hypersexuality","Compulsive Sexual Behavior (Csb)","Pornography Addiction","Treatment-seeking Sample","Addiction Symptoms"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2022.907549/pdf","cited_by_count":12,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 23 treatment‑seeking men","sample_n":23,"sample_text":"23 treatment‑seeking men","population":"men in treatment for problematic internet sex use (N=23, ages 22‑53)","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers interviewed 23 men who were in therapy for excessive online sexual activity. Participants described long sessions of pornography, cybersex, and frequent masturbation, along with loss of control, preoccupation and some withdrawal‑like symptoms. The authors argue that an addiction framework fits many of these experiences, though they note that some criteria (e.g., withdrawal) need more study.","clinical_takeaway":"Clinicians should recognize that treatment‑seeking men may view online sexual behavior as addictive, but assessment must also consider co‑occurring issues such as mental health and moral distress.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","csbd","treatment"],"strengths":["In‑depth qualitative data from clinical interviews","Focus on daily lived experience of problematic use","Includes both pornography and cybersex with masturbation contexts"],"limitations":["Small, non‑representative, treatment‑seeking sample","No measurement of moral incongruence, mental health or partner factors","Reliance on self‑report without validated quantitative scales"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":37,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2022.907549"}},{"id":1644,"doi":"10.1007/s10508-022-02305-8","pmid":"35790612","pmcid":"PMC9255456","title":"A Seemingly Paradoxical Relationship Between Masturbation Frequency and Sexual Satisfaction","authors":"Fischer N, Træen B.","first_author":"Fischer N","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Masturbation","Body Image","Sexual Satisfaction","Pornography Use","Solitary Sexual Activity","Intercourse Activity"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-022-02305-8.pdf","cited_by_count":38,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large probability‑based national sample, cross‑sectional questionnaire","sample_n":4160,"sample_text":"probability‑based sample of Norwegian adults","population":"4,160 Norwegian adults (18‑89 y)","country":"Norway","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationwide Norwegian survey, people were grouped by how often they masturbated and how satisfied they were sexually. More frequent masturbation was linked to higher porn use and sexual variety, while dissatisfaction was tied to sexual distress and a negative body image.","clinical_takeaway":"Higher masturbation frequency is not inherently problematic; clinicians should consider body image and sexual distress when addressing sexual satisfaction.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Large, probability‑based national sample","Separate analysis for men and women","Cluster analysis identifies distinct typologies"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on self‑report questionnaires","No measurement of moral/religious attitudes or trauma"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02305-8"}},{"id":1645,"doi":"10.1007/s10508-022-02317-4","pmid":"35790609","pmcid":"PMC9363392","title":"The Great Porn Experiment V2.0: Sexual Arousal Reduces the Salience of Familiar Women When Heterosexual Men Judge Their Attractiveness","authors":"Sculley J, Watkins CD.","first_author":"Sculley J","journal":"Archives of sexual behavior","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Arousal","Face Perception","Coolidge Effect","Internet Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9363392","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory experiment with two slideshow conditions (pornographic vs clothed) and attractiveness ratings of familiar vs novel women; within‑subject design; preregistered predictions.","sample_n":null,"sample_text":"Not specified in abstract","population":"heterosexual and homosexual men (sample size not reported in abstract)","country":"","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab experiment, men who viewed pornographic images rated women they had already seen as less attractive than new women, suggesting that sexual arousal can reduce the appeal of familiar female faces and bodies.","clinical_takeaway":"Visual sexual arousal may temporarily shift preferences toward novel partners, but findings do not imply pathology.","confidence":0.6,"topic_tags":["sexual_function","pornography"],"strengths":["Preregistered experimental design","Direct test of a specific theoretical claim (Coolidge effect)","Includes both heterosexual and homosexual participants"],"limitations":["Sample size and demographic details not provided in abstract","No validated measures of arousal or attractiveness","Potential confounds (moral attitudes, mental health) not assessed"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02317-4"}},{"id":1646,"doi":"10.3390/jcm8070914","pmid":"31247949","pmcid":"PMC6679165","title":"The Potential Associations of Pornography Use with Sexual Dysfunctions: An Integrative Literature Review of Observational Studies","authors":"Dwulit AD, Rzymski P.","first_author":"Dwulit AD","journal":"Journal of clinical medicine","year":2019,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual dysfunction","erectile dysfunction","Sexual Desire","Sexual Satisfaction","Delayed Ejaculation","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6679165","cited_by_count":55,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"Integrative literature review of observational studies; narrative synthesis of cross‑sectional and case reports; no systematic search or risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not applicable – review of published studies","population":"Adults (unspecified; studies reviewed involve men and women)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["selective_reporting"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors review studies linking pornography use to erectile problems, delayed ejaculation, desire changes, and lower sexual satisfaction. Most evidence comes from cross‑sectional surveys and case reports; findings are mixed and causal claims cannot be made.","clinical_takeaway":"Current evidence does not support a clear causal link between porn use and sexual dysfunction; clinicians should consider multiple factors before attributing problems to pornography.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Broad coverage of available observational literature","Identifies gaps and need for longitudinal work","Clear summary of contradictory findings"],"limitations":["Narrative rather than systematic review; no explicit search strategy","No quantitative synthesis or risk‑of‑bias assessment","Limited discussion of key confounders (e.g., moral incongruence, masturbation)"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":75,"citing_publications":108,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jcm8070914"}},{"id":1647,"doi":"10.3390/ijerph19138193","pmid":"35805852","pmcid":"PMC9266178","title":"Internet Addiction and Polish Women's Sexual Functioning: The Role of Social Media, Online Pornography, and Game Use during the COVID-19 Pandemic-Online Surveys Based on FSFI and BSMAS Questionnaires","authors":"Pawlikowska A, Szuster E, Kostrzewska P, Mandera A, Biernikiewicz M, Sobieszczańska M, Rożek-Piechura K, Markiewicz M, Rusiecka A, Kałka D.","first_author":"Pawlikowska A","journal":"International journal of environmental research and public health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Female","Sexual activity","Social Media","Fsfi","Bsmas"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/13/8193/pdf?version=1657014002","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey of 546 Polish women (mean age 23) collected April‑Nov 2021; measures: FSFI, BSMAS, self‑report of pornography, dating‑app, gaming use.","sample_n":546,"sample_text":"young, sexually active women (mean age 23.07 ± 4.69) recruited online","population":"young, sexually active Polish women, convenience sample recruited via internet","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 546 Polish women found that higher scores on a social‑media addiction scale were linked to lower sexual‑function scores, while pornography use was linked to higher scores. Dating‑app users also reported lower sexual function. The study is cross‑sectional, so it cannot prove cause‑and‑effect.","clinical_takeaway":"Social‑media overuse may be associated with poorer sexual function in women, but causality is unclear; clinicians should assess overall digital habits alongside sexual health.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["large sample for a survey","use of validated FSFI and BSMAS instruments","focus on pandemic context"],"limitations":["cross‑sectional design, cannot infer causality","limited control for key confounds (moral, mental health, relationship factors)","pornography use measured imprecisely","self‑selected online convenience sample"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":1,"mentioning":6,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph19138193"}},{"id":1648,"doi":"10.1016/j.chc.2025.05.011","pmid":"41101857","pmcid":null,"title":"Media Representation of Boys","authors":"Hartselle S, Deol Y, Miselis K.","first_author":"Hartselle S","journal":"Child and adolescent psychiatric clinics of North America","year":2025,"pub_types":["Review","Journal Article"],"keywords":["Body Image","Cyberbullying","Media Representation","Toxic Masculinity","Social Media Impact","Boys And Media","Pornography Exposure"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"Not applicable – narrative review","population":"boys, adolescents","country":"United States (presumed by journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review discusses how media portrayals shape boys' ideas about masculinity, aggression, body image and sexuality, noting harmful stereotypes and the need for better, more diverse representation and media‑literacy guidance.","clinical_takeaway":"Encourage media‑literacy conversations with boys and families to mitigate harmful gender stereotypes.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad coverage of media influences on boys","Calls for media‑literacy interventions","Highlights intersectional vulnerabilities"],"limitations":["Narrative review; no systematic methodology","No primary data or quantitative synthesis","Limited discussion of sexual‑health outcomes"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chc.2025.05.011"}},{"id":1649,"doi":"10.1177/10790632221108951","pmid":"35730529","pmcid":null,"title":"Correspondence of Child Age and Gender Distribution in Child Sexual Exploitation Material and Other Child Content With Age and Gender of Child Sexual Assault Victims","authors":"Eke AW, Seto MC.","first_author":"Eke AW","journal":"Sexual abuse : a journal of research and treatment","year":2023,"pub_types":["Journal Article"],"keywords":["Age","Gender","Child Pornography","Child Sexual Exploitation Material","Contact Victims"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective analysis of 71 convicted men with CSEM offenses and contact offenses; associations between CSEM content age/gender and victim age/gender.","sample_n":71,"sample_text":"71 men (64 with 134 prior/concurrent victims; 14 recidivists with 17 new victims).","population":"71 adult male offenders convicted of child sexual exploitation material offenses, some with contact offenses.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that the ages and genders of children shown in men’s child‑sexual‑exploitation material matched the ages and genders of children they later abused in person, suggesting the material reflects their victim preferences.","clinical_takeaway":"CSEM content may help identify a perpetrator’s likely victim profile for risk assessment, but findings are based on a small offender sample.","confidence":0.6,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Large, well‑defined offender sample for this topic","Clear operational definitions of CSEM content and victim characteristics","Effect sizes reported, moderate to large"],"limitations":["Convenience sample of convicted offenders limits generalisability","Recidivism analysis based on only 14 re‑offenders","No control for potential confounds (e.g., prior offending patterns)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632221108951"}},{"id":1650,"doi":"10.1080/13691058.2019.1617898","pmid":"31164048","pmcid":null,"title":"Identifying the challenges of interdisciplinary research on pornography use","authors":"Litsou K, Byron P.","first_author":"Litsou K","journal":"Culture, health & sexuality","year":2020,"pub_types":["Journal Article"],"keywords":["Research","Challenges","Sexual Health","Interdisciplinarity","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"No empirical participants; authors describe their own interdisciplinary experience.","population":"researchers/authors, interdisciplinary team","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors discuss practical and conceptual problems they encountered while trying to conduct a large systematic review of pornography research, focusing on differing definitions, methods, and analyses across humanities and social‑science disciplines.","clinical_takeaway":"None – the paper does not provide clinical evidence or recommendations.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Highlights methodological challenges in interdisciplinary porn research","Reflective, first‑person account of disciplinary tensions"],"limitations":["No empirical data; purely narrative","No systematic assessment of constructs or outcomes"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2019.1617898"}},{"id":1651,"doi":"10.1186/s12939-016-0366-0","pmid":"27225519","pmcid":"PMC4881203","title":"Social media and digital technology use among Indigenous young people in Australia: a literature review","authors":"Rice ES, Haynes E, Royce P, Thompson SC.","first_author":"Rice ES","journal":"International journal for equity in health","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","review-article","Review","Journal Article"],"keywords":["Australia","Youth","Indigenous","Young People","Aboriginal","Social Media","Digital Technology"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4881203","cited_by_count":52,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative literature review of 22 papers without systematic methodology or risk‑of‑bias assessment.","sample_n":null,"sample_text":"No primary participants; review summarises 22 published articles.","population":"Indigenous Australian youth (no primary data collected)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises how Indigenous Australian adolescents use social media, highlighting benefits for identity and community, but also risks like cyber‑bullying and sharing of sexual material.","clinical_takeaway":"Clinicians should be aware that social media can both support and risk youth wellbeing; interventions should aim to enhance positive uses while mitigating harms such as exposure to explicit content.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad coverage of diverse literature","Identifies both positive and negative social‑media impacts"],"limitations":["Non‑systematic search strategy","No quality appraisal of included studies","No primary data; conclusions rely on heterogeneous sources"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":157,"citing_publications":288,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12939-016-0366-0"}},{"id":1654,"doi":"10.3389/fpsyg.2025.1552128","pmid":"40688549","pmcid":"PMC12272609","title":"The association between the use of digital technologies and positive youth development: a systematic review","authors":"Martin-Barrado AD, Gomez-Baya D.","first_author":"Martin-Barrado AD","journal":"Frontiers in psychology","year":2025,"pub_types":["Systematic Review","systematic-review","Journal Article"],"keywords":["Internet","Systematic review","Positive Youth Development","Social Media","Digital Technologies"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12272609","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of 17 quantitative cross‑sectional and longitudinal studies; PRISMA; PROSPERO registered; risk‑of‑bias (JBI) assessment","sample_n":null,"sample_text":"17 quantitative studies (cross‑sectional and longitudinal) included","population":"children and adolescents (studies published 2012‑2024)","country":"multiple (mostly China)","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 17 studies finds that a Positive Youth Development approach may protect teens from risky digital behaviours such as pornography viewing, sexting and gaming problems, especially when emotional self‑regulation and family support are strong.","clinical_takeaway":"Promoting strengths‑based youth development may reduce problematic online sexual activities.","confidence":0.7,"topic_tags":["pornography","sexual_function","adolescents","prevalence"],"strengths":["PROSPERO‑registered protocol","PRISMA‑compliant systematic review","Risk‑of‑bias assessment of included studies"],"limitations":["Limited reporting on how primary studies defined/measured key constructs","Few confound controls (e.g., moral incongruence, mental health) reported","Geographic bias toward Chinese samples"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2025.1552128"}},{"id":1656,"doi":"10.1556/2006.8.2019.22","pmid":"31120316","pmcid":"PMC7044546","title":"Facets of impulsivity and related aspects differentiate among recreational and unregulated use of Internet pornography","authors":"Antons S, Mueller SM, Wegmann E, Trotzke P, Schulte MM, Brand M.","first_author":"Antons S","journal":"Journal of behavioral addictions","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Compulsive Sexual Behavior","Impulsive Behavior","Behavioral Addiction","Internet Pornography Use Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7044546","cited_by_count":37,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of heterosexual males (N=1498) classified into three groups by screening instruments","sample_n":1498,"sample_text":"1,498 heterosexual males","population":"heterosexual adult males, recruited via internet","country":"unspecified (likely Germany/Europe based on authors)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,498 heterosexual men, those who reported unregulated internet pornography use showed higher craving, attentional impulsivity, steeper delay discounting, and more dysfunctional coping than frequent or occasional recreational users.","clinical_takeaway":"Impulsivity and craving differentiate problematic from recreational porn use, but clinicians should consider other factors (e.g., moral conflict, mental health) before labeling use as an addiction.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a survey","Compares three distinct usage patterns","Includes multiple impulsivity‑related constructs"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of key confounds (moral incongruence, masturbation, mental health, partner context)","Relies on self‑report screening tools that may not align with ICD‑11 criteria"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":5,"contrasting":3,"mentioning":29,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.8.2019.22"}},{"id":1657,"doi":"10.1038/s41598-022-13448-y","pmid":"35688924","pmcid":"PMC9427853","title":"Pre-marital sex and its association with peer pressure and watching pornography among young individuals in Ethiopia: a systematic review and meta-analysis","authors":"Damtie Y, Cherie N, Fentaw H, Kefale B, Addisu E, Yalew M, Arefaynie M, Adane M, Adane B, Kassa AA, Abebayehu A, Ayele FY.","first_author":"Damtie Y","journal":"Scientific reports","year":2022,"pub_types":["Meta-Analysis","research-article","Systematic Review","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://www.nature.com/articles/s41598-022-13448-y.pdf","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"systematic review and meta-analysis of 32 cross‑sectional studies (N = 18,354) examining prevalence of premarital sex and its association with peer pressure and pornography exposure in Ethiopia.","sample_n":18354,"sample_text":"32 studies, total N = 18,354","population":"young individuals in Ethiopia (students and community samples)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 32 Ethiopian studies found that about one‑third of young people have had premarital sex. Peer pressure was linked to a three‑fold increase in the odds of premarital sex, while the initial link between watching pornography and sex disappeared after adjusting for publication bias.","clinical_takeaway":"Peer influence, not pornography exposure, appears to be the stronger driver of premarital sexual activity in Ethiopian youth; interventions should focus on peer‑based counseling and education.","confidence":0.85,"topic_tags":["pornography","prevalence","sexual_function","adolescents"],"strengths":["Large pooled sample (N > 18 k)","Systematic search across multiple databases","Use of random‑effects model, heterogeneity (I²) and publication‑bias assessments (Egger, trim‑and‑fill)"],"limitations":["Primary studies largely cross‑sectional, limiting causal inference","Exposure measures (pornography, peer pressure) not uniformly defined or validated","No adjustment for key confounders such as moral/religious views or mental health"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-022-13448-y"}},{"id":1658,"doi":"10.1177/09727531251347786","pmid":"40606268","pmcid":"PMC12209228","title":"Motivational Enhancement Therapy for Internet Addiction: A Case Report","authors":"Dubey A, Sharma S, Pradhan M, Zaidi SZH.","first_author":"Dubey A","journal":"Annals of neurosciences","year":2025,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Anxiety","Adolescents","Academic Performance","Motivational Enhancement Therapy","Internet Addiction"],"is_oa":true,"oa_url":"https://doi.org/10.1177/09727531251347786","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single adolescent case, pre‑post assessment after 12 MET sessions","sample_n":1,"sample_text":"single case","population":"17‑year‑old male adolescent","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 17‑year‑old male with excessive internet use, including pornography, received 12 sessions of Motivational Enhancement Therapy. After treatment, parents reported reduced problematic use and better school performance. The authors suggest MET can help adolescents with internet‑related problems.","clinical_takeaway":"Evidence is insufficient; MET may be tried but cannot be recommended as proven for internet or porn‑related overuse.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Detailed clinical narrative","Use of an established therapy (MET)","Pre‑ and post‑treatment observations"],"limitations":["N=1, no control","No validated IA assessment reported","Generalisation to wider population unwarranted"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/09727531251347786"}},{"id":1659,"doi":"10.21203/rs.3.rs-54623/v1","pmid":null,"pmcid":null,"title":"Prevalence of Premarital Sex and Related Risky Practices Among Students of Ayer Tena Health Science and Business College, Addis Ababa, Ethiopia: A cross-sectional study","authors":"Birri D, Kumie M.","first_author":"Birri D","journal":"Research Square","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-54623/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 390 students from a single private college, systematic random sampling within the college but no national representativeness.","sample_n":390,"sample_text":"Systematic random sampling of enrolled students at one private college.","population":"Students (mostly female) at Ayer Tena Health Science and Business College, Addis Ababa, Ethiopia (N≈390).","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 390 Ethiopian college students found that about 23% had had premarital sex, with many reporting risky behaviours such as low condom use and multiple partners. Pornography viewing, alcohol use and certain misconceptions were linked to higher sexual activity.","clinical_takeaway":"High rates of premarital sex and risky practices suggest a need for targeted sexual‑health education and condom promotion on campuses.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Reasonable sample size for prevalence estimates.","Systematic random sampling within the college.","Includes a range of sexual‑health variables (condom use, STI history)."],"limitations":["Convenience sample from one institution limits generalisability.","Reliance on non‑validated, self‑report items; no psychometric validation.","Limited control for key confounds (e.g., moral attitudes, mental health).","Statistical analysis limited to chi‑square without effect sizes or correction."],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-54623/v1"}},{"id":1661,"doi":"10.1016/j.bodyim.2025.101929","pmid":"40554962","pmcid":null,"title":"Genital body image: A brief review and future directions","authors":"Sharp G, McGrath I.","first_author":"Sharp G","journal":"Body image","year":2025,"pub_types":["Review","Journal Article"],"keywords":["Gender","Sexual function","Media","Education","Genitals","Cosmetic Genital Surgery","Genital Body Image"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative brief review without systematic methods or empirical data.","sample_n":null,"sample_text":"No primary data; literature summary only.","population":"general adult population (no specific sample described)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how people feel about their own genitals, noting that many are dissatisfied with size or shape. It discusses how media, peers, and partners influence these views, links genital body image to sexual and mental well‑being, and suggests educational steps to improve it.","clinical_takeaway":"Clinicians should be aware that genital body image concerns can affect sexual health and consider addressing them in counseling or therapy.","confidence":0.3,"topic_tags":["gender","sexual_function"],"strengths":["Highlights an understudied aspect of body image","Integrates sociocultural influences such as media and peer feedback","Identifies clear gaps and future research directions"],"limitations":["Narrative, non‑systematic review lacks methodological rigor","No empirical data or quantitative synthesis","Absence of quality appraisal of cited studies"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.bodyim.2025.101929"}},{"id":1662,"doi":"10.1080/00224545.2022.2080037","pmid":"35608021","pmcid":null,"title":"The guilt that guides me: religiosity, sex guilt, and the demonization of sex workers","authors":"Hackathorn J, Hodges J, Jones S, Hashim S.","first_author":"Hackathorn J","journal":"The Journal of social psychology","year":2024,"pub_types":["Journal Article"],"keywords":["Religiosity","Sex Workers","Pornography","Sex Guilt","Demonization"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of undergraduates and MTurk workers; mediation analysis of religiosity → sex guilt → attitudes toward pornography and sex workers.","sample_n":null,"sample_text":"Undergraduate participants and Amazon MTurk workers (exact N not reported in abstract)","population":"Adults (undergraduates, MTurk workers)","country":"Not specified","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"People who are more religious tend to view pornography and sex workers more negatively, and this is largely because they feel more guilt about sex themselves.","clinical_takeaway":"Clinicians should consider personal sex guilt and religious beliefs when discussing clients' attitudes toward pornography or sex‑worker stigma.","confidence":0.7,"topic_tags":["religiosity","sexual_function","pornography"],"strengths":["Large convenience sample (undergrads + MTurk)","Inclusion of both religiosity and sex‑guilt constructs","Mediation analysis to test indirect effects","Relevant to understanding moral attitudes toward porn and sex work"],"limitations":["Cross‑sectional design limits causal inference","No control for key confounds (mental health, masturbation, trauma)","Potential self‑selection bias of online sample","Unclear if scales were validated in this sample"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224545.2022.2080037"}},{"id":1663,"doi":"10.1371/journal.pone.0268724","pmid":"35594283","pmcid":"PMC9122201","title":"The pornography use and its addiction among emerging adults in Malaysia: Perceived realism as a mediator","authors":"Tan SA, Ng SHL, Hoo JJY, Gan SW, Nainee S, Yap CC, Lee LK, Mohd Zaharim N, Goh YS.","first_author":"Tan SA","journal":"PloS one","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0268724&type=printable","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional mediation analysis of self‑identified pornography users (N=222) recruited purposively in Malaysia","sample_n":222,"sample_text":"purposive sampling of self‑identified pornography users (emerging adults, mean age 21.05)","population":"emerging adult pornography users, majority male, Malaysia","country":"Malaysia","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 222 Malaysian young adults who watch porn, those who see it as more realistic tend to report higher levels of self‑labelled porn addiction, suggesting perceived realism may link use and perceived problem.","clinical_takeaway":"Self‑reported porn addiction may reflect perceived realism rather than clinically defined disorder; clinicians should assess underlying beliefs before labeling pathology.","confidence":0.8,"topic_tags":["pornography","sexual_function","csbd","prevalence"],"strengths":["moderately sized sample for mediation","addresses understudied population (Malaysian emerging adults)","examines mediating psychological variable (perceived realism)"],"limitations":["uses likely unvalidated self‑report addiction measure","cross‑sectional design limits causal inference","fails to control key confounds (moral incongruence, masturbation, mental health, relationship factors)","purposive sampling of users limits generalisability"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0268724"}},{"id":1664,"doi":"10.1089/jwh.2018.7006","pmid":"30998084","pmcid":null,"title":"Pornography and Heterosexual Women's Intimate Experiences with a Partner","authors":"Johnson JA, Ezzell MB, Bridges AJ, Sun CF.","first_author":"Johnson JA","journal":"Journal of women's health (2002)","year":2019,"pub_types":["Journal Article"],"keywords":["Relationships","Sexual Health","Female Sexuality","Pornography","Cognitive Script Theory"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 706 US heterosexual women aged 18‑29, assessing self‑reported pornography use, script activation, and sexual experience outcomes.","sample_n":706,"sample_text":"706 heterosexual women, 18‑29 years, United States","population":"young adult heterosexual women (US)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 706 young US women, those who watch porn for masturbation and think about porn during sex report more body insecurities and less enjoyment of intimate acts with a partner. The study suggests that porn‑related thoughts may not improve partnered sexual experiences.","clinical_takeaway":"Clinicians should note that frequent porn use and mental activation of porn scripts during sex are linked to lower sexual enjoyment for some women, but causality is unclear.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large community sample (N>700)","Focused on female dyadic sexual experience, an understudied area","Distinguishes pornography use for masturbation from script activation during sex"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on self‑report items of unknown validation","Key confounds (moral incongruence, mental‑health symptoms, trauma) not measured"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/jwh.2018.7006"}},{"id":1666,"doi":"10.3389/fpsyt.2025.1608123","pmid":"40606816","pmcid":"PMC12216430","title":"Corrigendum: Individuals under voluntary treatment with sexual interest in minors: what risk do they pose?","authors":"von Franqué F, Bergner-Koether R, Schmidt S, Pellowski JS, Peters JH, Hajak G, Briken P.","first_author":"von Franqué F","journal":"Frontiers in psychiatry","year":2025,"pub_types":["Published Erratum","correction"],"keywords":["Child Sexual Abuse","Child Pornography","Cport","Dunkelfeld","Not Become An Offender","Do Not Offend","Kein Täter Werden"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12216430","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2025.1608123"}},{"id":1667,"doi":"10.1542/peds.2014-0592","pmid":"25404728","pmcid":null,"title":"Sex-related online behaviors and adolescents' body and sexual self-perceptions","authors":"Doornwaard SM, Bickham DS, Rich M, Vanwesenbeeck I, van den Eijnden RJ, ter Bogt TF.","first_author":"Doornwaard SM","journal":"Pediatrics","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Development","Internet","Adolescence","Self-perceptions","Parenting Strategies","Social Networking Site","Online Sexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Four‑wave longitudinal cohort of 1132 Dutch adolescents (ages ~14‑16) with latent growth curve modeling of sex‑related online behaviors and self‑perception outcomes.","sample_n":1132,"sample_text":"Four‑wave longitudinal data among 1132 seventh‑ to 10th‑grade Dutch adolescents (mean age at wave 1: 13.95 years).","population":"Adolescents (7th‑10th grade, community sample, 52.7% boys)","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A four‑year study of Dutch teens found that using sexually explicit internet material and cybersex was uncommon, but frequent social‑networking site use was linked to lower body confidence and sexual satisfaction, especially for girls.","clinical_takeaway":"High SNS use in adolescents may signal risk for poorer body and sexual self‑esteem; parental internet rules could help mitigate this.","confidence":0.78,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large, multi‑wave community sample","Appropriate longitudinal statistical modeling (latent growth curves)","Examines multiple distinct online sexual behaviors"],"limitations":["Self‑report measures of behavior, likely not validated scales","Key psychosocial confounds (moral attitudes, mental health, relationship context) not assessed","No pre‑registration or explicit power analysis reported"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":66,"citing_publications":85,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2014-0592"}},{"id":1668,"doi":"10.1080/13691058.2025.2516118","pmid":"40522731","pmcid":null,"title":"The entangled coexistence of materiality and subjectivity: a new materialist analysis of China's <i>jiese</i> community","authors":"Wu E, Liu H.","first_author":"Wu E","journal":"Culture, health & sexuality","year":2026,"pub_types":["Journal Article"],"keywords":["China","Assemblage","Masturbation","Abstinence","Jiese"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"online ethnography and semi‑structured interviews with 11 self‑identified abstainers (jieyou) from Chinese abstinence forums","sample_n":11,"sample_text":"11 participants recruited through the online Abstinence Bar and Zhengqi app","population":"Chinese adults self‑identifying with the ‘jiese’ abstinence community","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors used ethnographic interviews with 11 Chinese adults who voluntarily avoid masturbation and porn. They argue that these abstinence practices arise from the constant interaction of personal subjectivity, technology, culture and the body, rather than from individual choice alone.","clinical_takeaway":"None – the study is theoretical/anthropological and does not provide clinical guidance.","confidence":0.8,"topic_tags":["sexual_function","masturbation","pornography","csbd"],"strengths":["Innovative new‑materialist theoretical framing","Rich, in‑depth interview data","Illuminates a largely undocumented Chinese subculture"],"limitations":["Very small, non‑representative sample (N=11)","No validated measures of pornography or masturbation behaviour","No assessment of key confounding factors (e.g., moral incongruence, mental health)","Findings not generalisable beyond this specific community"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2025.2516118"}},{"id":1669,"doi":"10.1007/s00787-019-01318-4","pmid":"30919052","pmcid":null,"title":"The dynamics of adolescents' pornography use and psychological well-being: a six-wave latent growth and latent class modeling approach","authors":"Štulhofer A, Tafro A, Kohut T.","first_author":"Štulhofer A","journal":"European child & adolescent psychiatry","year":2019,"pub_types":["Journal Article"],"keywords":["Psychological","Adolescents","Depression And Anxiety","Self-esteem","Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["bibliography","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Latent growth curve and latent class modeling across six waves of adolescent pornography use, self‑esteem, depression and anxiety (N≈1,289).","sample_n":1289,"sample_text":"775 female, 514 male participants surveyed six times at ~5‑month intervals.","population":"Adolescent high‑school students (mean age 15.9) from Croatia, both sexes.","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a six‑wave study of over 1,200 Croatian teens, researchers found that while girls who watched porn reported lower well‑being at the start, changes in porn use over time did not predict later self‑esteem, depression or anxiety for either sex.","clinical_takeaway":"Current adolescent porn use does not appear to cause deteriorating mental health, though early exposure may be linked to lower well‑being in girls.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","moral_incongruence"],"strengths":["Large, multi‑wave longitudinal sample","Advanced latent growth modeling","Separate analysis by gender"],"limitations":["Pornography use measured with likely single‑item self‑report","No assessment of moral, relational, or trauma confounds","Potential self‑selection bias from school‑based recruitment"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":18,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00787-019-01318-4"}},{"id":1670,"doi":"10.1016/j.adolescence.2019.02.007","pmid":"30856421","pmcid":null,"title":"The socialization of attitudes about sex and their role in adolescent pornography use","authors":"Hardy SA, Hurst JL, Price J, Denton ML.","first_author":"Hardy SA","journal":"Journal of adolescence","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescence","Parenting","Sex Attitudes","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Three‑wave national survey of adolescents (N=3290) examining parental and teen sex attitudes and later teen pornography use via path analysis.","sample_n":3290,"sample_text":"National Survey of Youth and Religion; ages 13‑18; M age = 15.5; N = 3290","population":"Adolescents ages 13‑18 (U.S.)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tracked U.S. teens and found that conservative sex attitudes held by parents and teens are linked, and that teens with more conservative attitudes tend to use pornography less later on. Parent‑teen communication affected use directly but did not change the attitude link.","clinical_takeaway":"Attitudes shaped by families may influence adolescent porn use; clinicians might consider family communication when addressing sexual health.","confidence":0.8,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Large, multi‑wave national sample","Longitudinal design allows temporal ordering","Path analysis appropriate for mediation testing"],"limitations":["Attitudes and use measured via self‑report only","No measurement of key confounds (e.g., mental health, moral attitudes)","No validated scale for pornography‑related problems"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2019.02.007"}},{"id":1671,"doi":"10.1016/j.ssresearch.2019.03.003","pmid":"31130200","pmcid":null,"title":"Testing the content progression thesis: A longitudinal assessment of pornography use and preference for coercive and violent content among male adolescents","authors":"Landripet I, Buško V, Štulhofer A.","first_author":"Landripet I","journal":"Social science research","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescents","Pornography","Content Progression","Violent/coercive Pornography Content"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal panel of 248 male adolescents, 5 waves over 24 months, latent growth curve modeling","sample_n":248,"sample_text":"Adolescents (male, high‑school)","population":"Male adolescents, average baseline age 16.1, high‑school students (convenience online panel)","country":"Croatia (inferred from author names, not explicit)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2‑year study of 248 teenage boys found that liking violent porn did not increase with more frequent porn use; in fact, preference for such content declined over time, suggesting the feared “content escalation” may not occur in adolescents.","clinical_takeaway":"None – the study does not provide evidence for clinical risk linked to porn frequency in youth.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Longitudinal design with multiple waves","Reasonable sample size for growth‑curve modeling","Statistical modelling appropriate for developmental trajectories"],"limitations":["Self‑report measures of content preference likely unvalidated","No control for moral, mental‑health or relationship confounds","Convenience sample limits generalisability to broader adolescent populations"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ssresearch.2019.03.003"}},{"id":1673,"doi":"10.1111/1468-0009.70021","pmid":"40462673","pmcid":null,"title":"US State Policies Regarding Social Media: Do Policies Match the Evidence?","authors":"Thimm-Kaiser M, Keyes KM.","first_author":"Thimm-Kaiser M","journal":"The Milbank quarterly","year":2025,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Adolescent","Mental health","Government Regulation","Social Media","State Legislation","Evidence‐based Policy"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"media content analysis of policy statements; critical literature review; no primary empirical data on individuals","sample_n":null,"sample_text":"161 documents analyzed","population":"U.S. state policymakers and legislative documents (no participant sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors analysed statements from U.S. state officials about recent social‑media laws for teens, finding that many cite mental‑health, safety and developmental harms—including exposure to pornography—though the scientific evidence for these claims is limited and mostly correlational.","clinical_takeaway":"Policymakers cite strong harms, but clinicians should note that current research does not definitively prove causal effects of social‑media use on teen mental health or sexual outcomes.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Systematic approach to policy statements","Large number of documents screened","Identifies gaps between policy claims and evidence"],"limitations":["No primary data on individuals","No quantitative synthesis","Limited ability to assess causal claims"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1468-0009.70021"}},{"id":1674,"doi":"10.18502/ijrm.v23i6.19402","pmid":"40959468","pmcid":"PMC12435345","title":"Knowledge and attitudes toward sexual and reproductive health among youth in Jordan: A cross-sectional study","authors":"Almahmoud L, Altawil L, Shahatit Y, Sami R, Qatawneh AA, Alkhdaire ZM, Zurikat R, Karmoul AM, Abuawad A, Al-Dalabeeh W, Khait MA, Bani-Hani M.","first_author":"Almahmoud L","journal":"International journal of reproductive biomedicine","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Adolescent","practice","Health Services","Sexual Health","Attitudes","Health Knowledge","Jordan."],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12435345","cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 864 Jordanian youth (15‑22 y) assessing knowledge and attitudes toward sexual health, including masturbation and pornography","sample_n":864,"sample_text":"864 participants aged 15‑22 recruited via an online questionnaire","population":"Jordanian adolescents and young adults, mostly university students, urban, convenience sample","country":"Jordan","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 864 Jordanian youths (15‑22 y) found high awareness of sexual health topics; most support school sexual education, many have viewed pornography, and most recognise masturbation. The authors call for culturally‑sensitive sexual‑health programs.","clinical_takeaway":"Clinicians should note the openness of Jordanian youth to sexual‑health information and consider culturally appropriate education resources.","confidence":0.8,"topic_tags":["sexual_function","adolescents","religiosity","masturbation","pornography"],"strengths":["Large sample size for a cross‑sectional survey","Includes both masturbation and pornography variables","Use of a validated questionnaire (as reported)"],"limitations":["Convenience online sample limits generalisability","No measurement/control of moral incongruence or mental‑health covariates","Statistical reporting limited to p‑values, no effect sizes or correction for multiple testing"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.18502/ijrm.v23i6.19402"}},{"id":1676,"doi":"10.1186/s12889-025-23248-4","pmid":"40448122","pmcid":"PMC12123990","title":"Understanding non-partner sexual violence perpetration in young Tanzanian men: a cross-sectional study","authors":"Brambilla R, Mshana G, Mosha N, Gibbs A, Malibwa D, Kapiga S, Stöckl H.","first_author":"Brambilla R","journal":"BMC public health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Young men","Sexual Harassment","Masculinities","Perpetration","Non-partner Sexual Violence","Non-Partner Rape"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12123990","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1002 young Tanzanian men, logistic regression analyses","sample_n":1002,"sample_text":"1002 young men aged 18 to 24 living in Mwanza, Tanzania","population":"young men, 18-24, Mwanza, Tanzania","country":"Tanzania","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 1,000 Tanzanian men found that 9% reported raping a non‑partner woman and that pornography consumption, having many partners, gambling and depression were linked to higher odds of such violence.","clinical_takeaway":"Clinicians should note that pornography use may co‑occur with other risk behaviours, but no causal link to violence is established.","confidence":0.8,"topic_tags":["sexual_function","gender","pornography"],"strengths":["Large sample for a regional survey","Multivariable logistic models with dominance analysis","Inclusion of mental‑health covariate"],"limitations":["Cross‑sectional design limits causal inference","Pornography use measured with non‑validated single item","Key confounds (moral incongruence, masturbation, trauma) not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[{"status":"Has correction","date":"2025-7-17","noticeDoi":"10.1186/s12889-025-23782-1","doi":"10.1186/s12889-025-23248-4"}],"url":"https://scite.ai/reports/10.1186/s12889-025-23248-4"}},{"id":1677,"doi":"10.1556/2006.2022.00013","pmid":"35394924","pmcid":"PMC9295242","title":"Assessment of Criteria for Specific Internet-use Disorders (ACSID-11): Introduction of a new screening instrument capturing ICD-11 criteria for gaming disorder and other potential Internet-use disorders","authors":"Müller SM, Wegmann E, Oelker A, Stark R, Müller A, Montag C, Wölfling K, Rumpf HJ, Brand M.","first_author":"Müller SM","journal":"Journal of behavioral addictions","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Screening test","Diagnostic criteria","Internet Addiction","Behavioral Addictions","Icd-11","Gaming Disorder","Online Buying-shopping Disorder","Online Pornography-use Disorder","Online Gambling Disorder","Social-networks-use Disorder"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/11/2/article-p427.pdf","cited_by_count":65,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 985 active Internet users; questionnaire administration; factor analysis.","sample_n":985,"sample_text":"985 participants completed the ACSID‑11 and comparative measures.","population":"Adults (active Internet users, N≈985) recruited online; not a clinical or treatment‑seeking sample.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created a new 11‑item questionnaire (ACSID‑11) that applies ICD‑11 gaming‑disorder criteria to several online activities, including pornography. In a sample of 985 Internet users, factor analysis showed the expected structure and scores correlated with existing gaming‑disorder and distress measures.","clinical_takeaway":"The ACSID‑11 provides a brief, standardized way to screen for potential online‑behaviour disorders, but further validation and clinical testing are needed.","confidence":0.8,"topic_tags":["measurement","pornography","csbd","other"],"strengths":["Large community sample (N≈985)","Systematic adaptation of ICD‑11 criteria to multiple online behaviors","Confirmatory factor analysis supports proposed structure"],"limitations":["Cross‑sectional; cannot assess temporal stability or predictive validity","No measurement of moral incongruence or masturbation, limiting interpretation of ‘problematic’ use","Reliance on self‑report; no external clinical validation"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":6,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":72,"citing_publications":95,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00013"}},{"id":1678,"doi":"10.1176/appi.ajp.20240486","pmid":"40432342","pmcid":null,"title":"Self-Control Abilities in Specific Types of Problematic Usage of the Internet: Findings From Clinically Validated Samples With Neurocognitive Tasks","authors":"Müller SM, Antons S, Schmid AM, Thomas TA, Kessling A, Joshi M, Krikova K, Kampa M, Mallon L, Schmidt LD, Klein L, Dominick N, Büsche K, Oelker A, Brandtner A, Montag C, Wölfling K, Wolf OT, Diers M, Klucken T, Rumpf HJ, Stark R, Müller A, Wegmann E, Steins-Loeber S, Brand M.","first_author":"Müller SM","journal":"The American journal of psychiatry","year":2025,"pub_types":["Multicenter Study","Journal Article"],"keywords":["Cognitive Neuroscience","Internet Gaming","Problematic Usage Of The Internet"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Multicenter cross‑sectional study comparing three clinically validated groups (pathological, risky, non‑problematic) of specific problematic internet use, including pornography, using structured interviews and a battery of neurocognitive tasks (N≈1,013).","sample_n":1013,"sample_text":"284 pathological, 305 risky, 424 non‑problematic users","population":"Germany, adults and adolescents, both sexes, recruited from clinical and community settings","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large German study, people classified as having problematic internet use—including a subgroup with problematic pornography use—showed weaker performance on many executive‑function tasks than low‑risk users. The deficits were strongest in the pathological group and varied by the type of internet activity.","clinical_takeaway":"Self‑control training may be especially needed for clients with high‑risk or pathological internet behaviours, including problematic porn use.","confidence":0.8,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Large multicenter sample with clinically validated groups","Comprehensive neurocognitive test battery","Comparison across multiple PUI subtypes"],"limitations":["Cross‑sectional design limits causal inference","No measurement or control of key confounds (moral incongruence, mental health, etc.)","Addiction criteria not explicitly operationalised"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.ajp.20240486"}},{"id":1679,"doi":"10.1177/08862605251338793","pmid":"40418016","pmcid":null,"title":"Invisible Violations: An Exploratory Study into Public Sentiments on Nonconsensual Distribution of Intimate Images in Trinidad and Tobago","authors":"Smith T, Short A.","first_author":"Smith T","journal":"Journal of interpersonal violence","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual Abuse","Public Perceptions","Cyberbullying","Online Harassment","Revenge Pornography","Nonconsensual Distribution Of Intimate Images"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-methods exploratory study using survey (latent profile analysis) and qualitative interviews; convenience sampling in Trinidad and Tobago","sample_n":null,"sample_text":"not specified in abstract","population":"adults in Trinidad and Tobago, gender-balanced sample (details not provided)","country":"Trinidad and Tobago","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed people in Trinidad and Tobago about their views on the non‑consensual sharing of intimate images. Men were more likely to blame victims, and religious people tended to be more protective of survivors. Three attitude groups were identified, highlighting how culture shapes perceptions of this online sexual violence.","clinical_takeaway":"Public education and policy should consider gender and religious influences on victim‑blaming attitudes toward NDII.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Addresses a regional gap in NDII research","Combines quantitative and qualitative data","Identifies religiosity as a key factor"],"limitations":["Likely convenience sampling; limited generalisability","Unclear whether attitude measures are validated","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605251338793"}},{"id":1680,"doi":"10.1177/00207640251341078","pmid":"40413566","pmcid":null,"title":"Commodified upbringings: A narrative review on commercial determinants of child and adolescent mental health","authors":"Carrasco JP, Estrella-Porter P, Cerame Á.","first_author":"Carrasco JP","journal":"The International journal of social psychiatry","year":2025,"pub_types":["Review","Journal Article"],"keywords":["Children and adolescent","Mental health","Commercial Determinants Of Mental Health"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of commercial determinants of child and adolescent mental health, including pornography; no original data collected","sample_n":null,"sample_text":"Narrative review; no primary sample","population":"children and adolescents (general)","country":"Not specified (global literature synthesis)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review summarises how commercial forces such as social media, pornography, gambling and others may negatively affect the mental health of children and teenagers, linking exposure to anxiety, depression and behavioural issues.","clinical_takeaway":"Be aware that early exposure to pornographic material can contribute to anxiety and distorted relationship views in youth; consider preventive education and policy measures.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","csbd"],"strengths":["Broad scope covering multiple industries","Covers recent literature up to 2024"],"limitations":["Narrative (non-systematic) methodology","No explicit quality appraisal of cited studies","No quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00207640251341078"}},{"id":1681,"doi":"10.1101/2020.05.25.20111716","pmid":null,"pmcid":null,"title":"Psychological impact of Covid-19 lockdown in India: Different strokes for different folks","authors":"Sharma AJ, Subramanyam MA.","first_author":"Sharma AJ","journal":"medRxiv","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":true,"oa_url":"https://www.medrxiv.org/content/medrxiv/early/2020/05/26/2020.05.25.20111716.full.pdf","cited_by_count":1,"is_preprint":true,"topics":["masturbation","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey (n=282) with mixed‑methods qualitative interviews (n=14); convenience sample, cross‑sectional","sample_n":282,"sample_text":"282 online respondents; 14 in‑depth interview participants","population":"Indian adults, including sexual minorities and people at higher COVID‑19 risk","country":"India","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an Indian online survey during COVID‑19 lockdown, sexual minorities reported higher anxiety and higher self‑rated pornography addiction than other adults. The authors suggest pornography and masturbation helped cope with isolation, urging inclusive health policies.","clinical_takeaway":"Clinicians should note that pandemic stress may heighten anxiety and self‑perceived porn use among sexual minorities, but evidence for problematic addiction is weak.","confidence":0.68,"topic_tags":["sexual_function"],"strengths":["Mixed‑methods approach adds depth","Inclusion of a vulnerable sexual‑minority subgroup","Regression models report confidence intervals"],"limitations":["Convenience online sample limits generalisability","Pornography ‘addiction’ measured with unclear, likely unvalidated item","Key confounds (moral incongruence, masturbation, partner context) not assessed"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":2,"contrasting":2,"mentioning":19,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2020.05.25.20111716"}},{"id":1682,"doi":"10.1186/s12889-025-23024-4","pmid":"40399850","pmcid":"PMC12093747","title":"Risk factors of sexual and reproductive health problems, service utilization, and its challenges among street youths in East Gojjam zone, North West Ethiopia: exploratory qualitative study","authors":"Ewunetie AA, Aschale A, Desta M, Gietaneh W, Asmamaw H, Gedif G, Abiy H.","first_author":"Ewunetie AA","journal":"BMC public health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["risk factors","Street Youths","Sexual And Reproductive Health Service Utilization"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12093747","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"phenomenological qualitative study with purposive sampling of street youths; 8 in‑depth interviews and 8 focus groups; inductive thematic analysis","sample_n":16,"sample_text":"Eight in‑depth interviews and eight focus group discussions (total 16 participants/groups)","population":"street youths in East Gojjam Zone, Ethiopia (purposive sample)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with Ethiopian street youths identified factors like multiple partners, low health knowledge, and exposure to porn films that raise the risk of sexually transmitted infections and limit use of reproductive health services.","clinical_takeaway":"Providers should consider the contextual barriers street youths face and address misinformation and service accessibility.","confidence":0.85,"topic_tags":["sexual_function","religiosity"],"strengths":["In‑depth qualitative data from a hard‑to‑reach population","Identifies multiple contextual risk factors for SRH problems"],"limitations":["Very small, purposive sample limits generalisability","No standardized measurement of pornography use or sexual behaviour","Confounding factors (e.g., mental health, moral attitudes) not assessed"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-025-23024-4"}},{"id":1683,"doi":"10.1080/13218719.2018.1506714","pmid":"31984078","pmcid":"PMC6763121","title":"A Descriptive Study of Psychosocial Characteristics and Offense Patterns in Females with Online Child Pornography Offenses","authors":"Bickart W, McLearen AM, Grady MD, Stoler K.","first_author":"Bickart W","journal":"Psychiatry, psychology, and law : an interdisciplinary journal of the Australian and New Zealand Association of Psychiatry, Psychology and Law","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Women","Sexual Offending","Pornography","Internet-based Offenses"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"descriptive study of 98 incarcerated females convicted of online child‑pornography offenses; no comparison group, convenience prison sample","sample_n":98,"sample_text":"98 women convicted of online sexual offenses housed in United States federal prisons","population":"females in US federal prisons (N=98)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study describes 98 women in US federal prisons who made or distributed child pornography, noting that many had histories of sexual or physical abuse and mental‑health treatment, and that offenses often involved their own children and male co‑offenders.","clinical_takeaway":"Clinicians working with offenders should assess trauma and mental‑health histories, as these are common in women involved in online child‑pornography offenses.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative prison sample of a rarely studied population","Systematic coding of offense characteristics","Includes trauma and mental‑health histories"],"limitations":["Descriptive only – no causal inference","Convenience sample limits generalisability to non‑incarcerated populations","No validated psychometric instruments reported"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13218719.2018.1506714"}},{"id":1686,"doi":"10.1002/eat.22991","pmid":"30623982","pmcid":null,"title":"Perceptions of male partner pressure to be thin and pornography use: Associations with eating disorder symptomatology in a community sample of adult women","authors":"Tylka TL, Calogero RM.","first_author":"Tylka TL","journal":"The International journal of eating disorders","year":2019,"pub_types":["Journal Article"],"keywords":["Eating Disorders","Thin-ideal Internalization","Community Women","Male Partner Pornography Use","Male Partner Pressures To Be Thin"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online anonymous survey of 409 community women in relationships; self‑report measures of ED symptoms, partner‑perceived thinness pressure, partner pornography use, thin‑ideal internalization; cross‑sectional regression analyses","sample_n":409,"sample_text":"community women in relationships with men","population":"adult women (community sample), N=409, partnered, recruited online","country":"not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 409 women, those who thought their male partners used pornography or pressured them to be thin reported higher eating‑disorder symptoms, partly because they adopted a stronger thin‑ideal.","clinical_takeaway":"Clinicians should consider a partner’s pornography use and thinness pressure as possible contributors to a woman’s eating‑disorder risk.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships","neuroscience"],"strengths":["Large community sample (N>400)","Adjusts for several external pressure sources","Explores partner‑specific factors rarely studied"],"limitations":["Cross‑sectional; cannot infer causality","Measures of pornography use and pressure likely single‑item, not validated","No control for mental‑health comorbidities or moral/religious factors"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":15,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/eat.22991"}},{"id":1687,"doi":"10.1590/scielopreprints.297","pmid":null,"pmcid":null,"title":"FAMILY SUPPORT AGAINST COVID-19","authors":"Socías CO, Brage LB, Nevot-caldentey L.","first_author":"Socías CO","journal":"SciELO Preprints","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.1590/scielopreprints.297","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review of family prevention measures; no primary data, narrative synthesis","sample_n":null,"sample_text":"no empirical sample reported","population":"Spain, families during COVID‑19 lockdown (general, not specified)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review Spain's family‑support measures during COVID‑19, noting rises in family violence and pornography use, and suggest additional prevention strategies.","clinical_takeaway":"None – the paper offers no clinical data or guidance on pornography‑related issues.","confidence":0.8,"topic_tags":["csbd","prevalence"],"strengths":["Timely discussion of pandemic‑related family risks","Identifies gaps in Spanish prevention measures"],"limitations":["No primary data; conclusions based on secondary sources","Lacks empirical assessment of pornography use or related outcomes","No systematic review methodology described"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/scielopreprints.297"}},{"id":1688,"doi":"10.1177/10790632211070797","pmid":"35259030","pmcid":null,"title":"\"It was in Control of Me\": Notions of Addiction and Online Child Sexual Exploitation Material Offending","authors":"Rimer JR, Holt K.","first_author":"Rimer JR","journal":"Sexual abuse : a journal of research and treatment","year":2023,"pub_types":["Journal Article"],"keywords":["Internet","Addiction","Sexual Offending","Pornography","Child Sexual Exploitation Material"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross‑sectional qualitative thematic analysis of 103 CSEM users from UK program groups and US prison treatment units","sample_n":103,"sample_text":"103 participants across two qualitative studies (UK ethnography, US prison interviews)","population":"CSEM users (offenders) recruited from treatment programs and prison; not representative of general population","country":"United Kingdom, United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"opposes","citation_value":"background","plain_summary":"Researchers examined how people who use child sexual exploitation material talk about \"addiction\". Through interviews with 103 offenders in the UK and US, they found users describe addiction‑like features such as loss of control and withdrawal, but some also reject the label, emphasizing choice and responsibility.","clinical_takeaway":"Clinicians should recognize that offenders may self‑label their behaviour as addictive, but such labels are based on personal narratives rather than validated assessments.","confidence":0.7,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Large qualitative sample for this sensitive topic","Cross‑cultural comparison (UK and US)","Depth of ethnographic detail"],"limitations":["No validated addiction or distress measures","Findings limited to offender samples; not generalizable","No control for moral, mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":11,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632211070797"}},{"id":1689,"doi":"10.1016/j.jsxm.2018.11.004","pmid":"30621919","pmcid":null,"title":"Is Pornography Use Related to Erectile Functioning? Results From Cross-Sectional and Latent Growth Curve Analyses","authors":"Grubbs JB, Gola M.","first_author":"Grubbs JB","journal":"The journal of sexual medicine","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Addiction","erectile dysfunction","Hypersexual Behavior","Pornography","Compulsive Sexual Behavior Disorder","Moral Incongruence"],"is_oa":false,"oa_url":null,"cited_by_count":55,"is_preprint":false,"topics":["bibliography","curated","pornography","sexual_health"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"longitudinal","design_detail":"3-Sample Cross-Sectional & 1-Year Longitudinal Study","sample_n":null,"sample_text":"Large multi-sample (N > 1,800 including US national & 1-year longitudinal cohort)","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"high","red_flags":[],"stance":"strongly-opposes","citation_value":"essential","plain_summary":"Across three samples (undergraduates, online adults, and a US nationally representative sample tracked over a year), mere pornography viewing frequency was unrelated to erectile problems. However, self-reported problematic use / moral incongruence weakly correlated with self-reported erectile worry — driven by anxiety and guilt rather than viewing exposure.","clinical_takeaway":"Pinpoints why religious men in abstinence forums report erectile trouble: shame, moral anxiety, and catastrophic beliefs about \"PIED\" trigger sympathetic nervous system fight-or-flight during intimacy, inhibiting erections.","confidence":1,"topic_tags":["relationships"],"strengths":["Combines cross-sectional national data with 1-year longitudinal growth modeling","Explicitly controls for moral incongruence and general psychological distress"],"limitations":["Self-report IIEF-5 rather than nocturnal penile tumescence testing"],"rubric_version":"2.0","raw_total":45,"max_possible":50,"pct_score":90,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":9,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":1,"contrasting":1,"mentioning":61,"citing_publications":103,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2018.11.004"}},{"id":1690,"doi":"10.1177/08862605251336347","pmid":"40353525","pmcid":null,"title":"Situational Facilitators and Barriers of Bystander Intervention Intent in Image-Based Sexual Abuse Contexts","authors":"Mainwaring C, Scott AJ, Gabbert F.","first_author":"Mainwaring C","journal":"Journal of interpersonal violence","year":2026,"pub_types":["Journal Article"],"keywords":["Bystander Intervention","Revenge Pornography","Image-based Sexual Abuse","Upskirting","Social Justice Ally","Image-based Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Three vignette‑based experimental studies (N≈125 per study) manipulating situational factors and measuring self‑reported intention to intervene.","sample_n":376,"sample_text":"Combined N≈376 across three separate experimental studies (≈125 each).","population":"Adults (adolescent to middle‑aged) recruited for online survey experiments (convenience sample).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Three vignette experiments examined what makes people more or less likely to step in when they see non‑consensual sharing of sexual images. Findings suggest that consent status of the image and relationships to the victim or perpetrator influence intentions to intervene.","clinical_takeaway":"Educational programs should highlight how consent and relational context affect willingness to intervene in image‑based abuse.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Experimental manipulation of situational factors.","Reasonable sample size per study for vignette research.","Addresses a gap in bystander‑intervention literature."],"limitations":["Reliance on single‑item self‑report intention measures.","Convenience sampling limits generalisability.","No reporting of effect sizes or pre‑registration."],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605251336347"}},{"id":1692,"doi":"10.1080/10810730.2022.2073406","pmid":"35535648","pmcid":null,"title":"Pornography and Women's Experience of Mixed-Gender Sexual Choking/Strangulation: Eroticization Mediates, Perceived Similarity Moderates","authors":"Wright PJ, Herbenick D, Tokunaga RS.","first_author":"Wright PJ","journal":"Journal of health communication","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"campus‑representative probability sample survey","sample_n":null,"sample_text":"probability campus‑representative sample","population":"heterosexual‑identified women, U.S. college students","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of college women, more frequent porn viewing was linked to seeing porn scenes of choking, which in turn was related to women being choked by men. The link was stronger when women liked choking and felt similar to porn actors.","clinical_takeaway":"Clinicians should note that porn exposure may be associated with consensual choking experiences, but the evidence does not prove causality.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large probability‑based campus sample","Clear mediation/moderation model","Focus on understudied behavior (sexual choking)"],"limitations":["Cross‑sectional; cannot infer causality","No control for key confounds (moral, mental health, partner effects)","Measures appear self‑report and possibly ad‑hoc"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10810730.2022.2073406"}},{"id":1693,"doi":"10.1080/00918369.2022.2040926","pmid":"35166192","pmcid":null,"title":"\"Black Pole\" and \"Asian Hole\": Language Ideologies in Interracial Gay Porn","authors":"Cao L.","first_author":"Cao L.","journal":"Journal of homosexuality","year":2023,"pub_types":["Journal Article"],"keywords":["RACE","Masculinity","Intersectionality","Language Ideology","Interracial Gay Porn","Accented Pornography","Interactional Sociolinguistics"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative content analysis of four gay porn scenes using interactional sociolinguistics","sample_n":null,"sample_text":"Four gay porn scenes featuring Asian-themed interracial content produced in the United States","population":"selected porn scenes (n=4); no human participants surveyed","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article analyses how English accents and language use in Asian‑themed interracial gay porn reflect and reinforce racial and masculine hierarchies, linking linguistic style to broader ideologies of white supremacy.","clinical_takeaway":"None – the study does not provide clinical information on sexual health or behavior.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender","csbd"],"strengths":["Innovative application of sociolinguistic theory to porn studies","Focused analysis of language–race–masculinity intersection"],"limitations":["Very small, non‑representative sample (four scenes)","No empirical measurement of viewer experiences or health outcomes","Findings limited to discourse, not behavioral or clinical implications"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2022.2040926"}},{"id":1694,"doi":"10.1080/10538712.2022.2037803","pmid":"35156898","pmcid":null,"title":"Confidence, Training and Challenges for Canadian Child Advocacy Center Staff When Working with Cases of Online and In-person Child Sexual Exploitation","authors":"Lindenbach D, Dimitropoulos G, Bhattarai A, Cullen O, Perry R, Arnold PD, Patten SB.","first_author":"Lindenbach D","journal":"Journal of child sexual abuse","year":2022,"pub_types":["Journal Article"],"keywords":["Luring","Sexual Abuse","Grooming","Child Pornography","Child Advocacy Centers","Child Sexual Abuse Imagery"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 37 staff at 5 centers (convenience sample)","sample_n":37,"sample_text":"37 staff from five centers","population":"Child Advocacy Center staff in Alberta, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 37 child‑advocacy staff in Alberta found that most had handled cases involving online grooming or child sexual‑abuse images, felt fairly confident recognizing them, but noted less training for the online aspects, suggesting a need for more specialized education.","clinical_takeaway":"Clinicians should seek additional training on online child sexual exploitation to better support affected youth.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Addresses gap on staff experience with online child exploitation","Includes multiple centers for some geographic spread","Identifies training needs"],"limitations":["Small convenience sample (N=37)","No validated measures of confidence or competence","Cross‑sectional, descriptive only"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2022.2037803"}},{"id":1695,"doi":"10.1080/10410236.2022.2035084","pmid":"35164620","pmcid":null,"title":"Perceived Similarity, Utility, and Social Realism as Potential Mediators of the Link between Pornography Use and Condomless Sex","authors":"Wright PJ, Tokunaga RS, Herbenick D.","first_author":"Wright PJ","journal":"Health communication","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of adult participants assessing pornography use frequency, condomless sex, and perceived similarity, utility, and social realism; mediation analyses performed.","sample_n":null,"sample_text":"Not specified in abstract; likely convenience or online panel.","population":"Adults (likely community sample; exact N not reported in abstract)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed adults to see if feeling similar to porn actors, believing porn is useful, or seeing it as realistic explains why porn viewers may have more condomless sex. Only the belief that porn is realistic held up as a mediator when all three factors were examined together.","clinical_takeaway":"Perceived realism of porn may influence condom use; clinicians might discuss media influences when counseling about safe sex.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Addresses a gap in mediation mechanisms","Integrates two theoretical models (3AM, DSMM)","Uses mediation analysis to test indirect effects"],"limitations":["Cross‑sectional; cannot infer causality","Likely relies on unvalidated self‑report scales","No control for key confounds (e.g., moral beliefs, mental health)","Sample size not reported; may be underpowered"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":5,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2022.2035084"}},{"id":1696,"doi":"10.3390/ijerph22050722","pmid":"40427837","pmcid":"PMC12110811","title":"Navigating Body Perception, Affectivity, Intimacy, Gender Identity, and Sexuality: An Exploratory Qualitative Study in Young Adults with SMI, IDs, and ASD in a Community Setting","authors":"Belluzzo M, Giaquinto V, Volpe D, Esposito C, De Alfieri E, Amodeo AL.","first_author":"Belluzzo M","journal":"International journal of environmental research and public health","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexuality","Affectivity","Autism","Young Adults","Intellectual Disabilities","Severe Mental Illness","Trauma-informed Care","Bodily Autonomy"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/22/5/722/pdf?version=1746098555","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 13 participants recruited from a community habilitation center","sample_n":13,"sample_text":"13 participants recruited from a community habilitation center","population":"young adults (18‑40) with severe mental illness, intellectual disabilities, or autism spectrum disorder","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 13 young adults who have mental illness, intellectual disability, or autism reveal that stigma, over‑protective families, and lack of proper sex education create major barriers to healthy sexuality and body confidence. Participants often rely on pornography or peers for information, leading to anxiety.","clinical_takeaway":"Clinicians should provide trauma‑informed, disability‑adapted sexuality education and support autonomy in intimate care for this population.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["In‑depth lived‑experience perspective","Focus on under‑researched disability groups","Clear thematic analysis process"],"limitations":["Very small, non‑representative sample (N=13)","No quantitative measurement of key constructs","Confounding factors (e.g., trauma, mental‑health symptoms) not measured"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph22050722"}},{"id":1697,"doi":"10.1016/j.jadohealth.2012.06.011","pmid":"23299017","pmcid":"PMC3580005","title":"Sexting, substance use, and sexual risk behavior in young adults","authors":"Benotsch EG, Snipes DJ, Martin AM, Bull SS.","first_author":"Benotsch EG","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2013,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":131,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online questionnaire of 763 young adults assessing sexting, substance use, and sexual risk behaviors; multivariate logistic regression.","sample_n":763,"sample_text":"Convenience online sample of US young adults (N=763).","population":"Young adults (college-age, United States)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 763 US young adults, those who sent sexually explicit texts were more likely to use drugs or alcohol and to engage in risky sex, such as unprotected encounters or sex with new partners.","clinical_takeaway":"Clinicians should note that sexting may signal broader risk behaviours, but causality is unclear.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a survey study","Multivariate analysis controlling for texting and substance use","Clear focus on public‑health implications of sexting"],"limitations":["Cross‑sectional design prevents causal inference","Single‑item self‑report measures for sexting and risk behaviors","No assessment of moral or psychological confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":20,"contrasting":8,"mentioning":219,"citing_publications":356,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2012.06.011"}},{"id":1699,"doi":"10.1007/s10508-010-9629-9","pmid":"20467798","pmcid":null,"title":"Online sexual activity experience of heterosexual students: gender similarities and differences","authors":"Shaughnessy K, Byers ES, Walsh L.","first_author":"Shaughnessy K","journal":"Archives of sexual behavior","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":48,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 217 heterosexual university students measuring self‑reported online sexual activities and attitudes.","sample_n":217,"sample_text":"217 heterosexual university students","population":"heterosexual university students (N=217)","country":"unspecified (likely USA/UK based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 217 university students found that men report more online sexual activities aimed at arousal—both alone and with a partner—than women, while both genders use non‑arousal activities (like seeking information) at similar rates. Attitudes toward online sexual activity partly explain these gender differences.","clinical_takeaway":"Gender differences in online sexual activity are linked to specific attitudes, not just broad sexual socialisation.","confidence":0.8,"topic_tags":["pornography","masturbation","gender","sexual_function"],"strengths":["Large student sample for a survey","Distinguishes different types of online sexual activity","Uses mediation analysis to explore attitudes"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on self‑report measures of unclear validation","No assessment of key confounds (e.g., moral incongruence, mental health)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":12,"contrasting":6,"mentioning":100,"citing_publications":191,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9629-9"}},{"id":1700,"doi":"10.1080/03009734.2018.1534907","pmid":"30411651","pmcid":"PMC6327603","title":"Pornography consumption and psychosomatic and depressive symptoms among Swedish adolescents: a longitudinal study","authors":"Mattebo M, Tydén T, Häggström-Nordin E, Nilsson KW, Larsson M.","first_author":"Mattebo M","journal":"Upsala journal of medical sciences","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Psychological Health","Longitudinal","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6327603","cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal cohort of Swedish high‑school students (2011–2013) with classroom‑based surveys.","sample_n":462,"sample_text":"224 boys and 238 girls participated in 2013.","population":"Adolescents (≈877 at baseline, 462 at follow‑up) from randomly selected senior high‑school classes in mid‑Sweden.","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a two‑year school‑based study of Swedish teens, higher porn use at age 15 predicted more psychosomatic symptoms later, while lower use predicted more depressive symptoms. Gender, family background and school type also influenced outcomes.","clinical_takeaway":"High porn use may be linked to somatic complaints in adolescents; clinicians should consider broader psychosocial factors.","confidence":0.85,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large, randomly selected school sample","Two‑wave longitudinal design allowing temporal ordering","Adjusted regression models reported"],"limitations":["Reliance on self‑report frequency without validated porn‑use scale","No measurement of masturbation or moral/religious attitudes","Potential attrition bias (≈45% loss from baseline)","No correction for multiple testing reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/03009734.2018.1534907"}},{"id":1701,"doi":"10.1111/jsm.12102","pmid":"23445379","pmcid":null,"title":"A psychophysiological investigation of sexual arousal in women with lifelong vaginismus","authors":"Cherner RA, Reissing ED.","first_author":"Cherner RA","journal":"The journal of sexual medicine","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment with three groups (vaginismus, dyspareunia, no‑pain) viewing erotic and neutral films; physiological (infrared vulvar temperature) and subjective arousal measured.","sample_n":45,"sample_text":"45 women (15 vaginismus, 15 dyspareunia, 15 pain‑free)","population":"Women, 45 total (15 per group), adult, recruited for clinical conditions.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Women with lifelong vaginismus showed the same increase in vulvar temperature to erotic films as women without pain, but reported less mental arousal and more negative feelings. Physical arousal can occur even when subjective experience is negative.","clinical_takeaway":"Genital arousal may be present despite anxiety; treatment should address the cognitive‑affective response rather than assume lack of physiological response.","confidence":0.78,"topic_tags":["sexual_function","gender"],"strengths":["Objective physiological measure of genital arousal","Comparison groups (dyspareunia, pain‑free) allow specificity","Clear operational definitions of clinical groups"],"limitations":["Small sample per group limits statistical power","No measurement of anxiety or other mental‑health covariates","Cross‑sectional; cannot infer causality of anxiety on arousal"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":11,"contrasting":0,"mentioning":21,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12102"}},{"id":1702,"doi":"10.21203/rs.3.rs-15683/v1","pmid":null,"pmcid":null,"title":"Premarital sexual practice and its associated factors in Ethiopia. A systematic review and meta-analysis","authors":"Getaneh T, Negesse A, Chane J.","first_author":"Getaneh T","journal":"Research Square","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-15683/v1.pdf?c=1631845755000","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review and meta‑analysis of 24 cross‑sectional studies (N=14,872) using PRISMA‑P and JBI appraisal; pooled prevalence and odds ratios reported.","sample_n":14872,"sample_text":"24 articles with total sample size 14,872 individuals","population":"Ethiopian youths (adolescents and young adults) from 24 community‑based surveys","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 24 Ethiopian studies found that about 31% of youths reported premarital sex. Older age, being female, alcohol use, and having seen pornography were linked to higher odds of such activity.","clinical_takeaway":"High prevalence of premarital sex suggests a need for comprehensive youth sexual‑health services; pornography exposure appears associated but causality is unclear.","confidence":0.85,"topic_tags":["prevalence","sexual_function"],"strengths":["Large pooled sample (N≈15k)","Standard meta‑analytic methods (random effects, heterogeneity, publication bias tests)","PRISMA‑P guidance and JBI risk‑of‑bias appraisal"],"limitations":["Primary studies are cross‑sectional, limiting causal inference","Key psychosocial confounds (e.g., moral beliefs, mental health) not measured","Exposure to pornography assessed with a single, non‑validated item"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-15683/v1"}},{"id":1703,"doi":"10.1177/1077801218804101","pmid":"30355053","pmcid":null,"title":"Age, Aggression, and Pleasure in Popular Online Pornographic Videos","authors":"Shor E.","first_author":"Shor E.","journal":"Violence against women","year":2019,"pub_types":["Journal Article"],"keywords":["Age","Aggression","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 172 publicly‑available Pornhub videos, coding for age of performers, aggression, and expressed pleasure.","sample_n":172,"sample_text":"172 popular videos from Pornhub.com","population":"Online pornographic videos (popular selections from Pornhub).","country":"Not specified (global website)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined 172 popular Pornhub videos, comparing teenage and adult performers. Aggression levels were similar, but teen videos more often had aggressive titles, anal sex, and facial ejaculation. Female performers showed more pleasure after aggression, especially in teen videos.","clinical_takeaway":"None – the paper describes video content, not health effects.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Large sample of popular videos","Systematic coding of multiple variables","Relevant for understanding media portrayals"],"limitations":["No validated coding scheme reported","Cross‑sectional, cannot infer viewer impact","Sample limited to popular videos, possible selection bias"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":45,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801218804101"}},{"id":1704,"doi":"10.1007/bf01541924","pmid":"742967","pmcid":null,"title":"Men's and women's reactions to sexually explicit films: a serendipitous finding","authors":"Hatfield E, Sprecher S, Traupmann J.","first_author":"Hatfield E","journal":"Archives of sexual behavior","year":1978,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"laboratory experiment showing participants explicit films; likely convenience sample of college students; no pre‑registration reported","sample_n":null,"sample_text":"not reported in abstract","population":"college men and women (likely U.S., Western)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"College men and women watched eight explicit films (homosexual, masturbation, heterosexual) and reported how they felt while physiological arousal was recorded. Both genders were more aroused by opposite‑sex films than same‑sex ones, with no overall gender difference in ease of arousal.","clinical_takeaway":"None – the study examines basic arousal responses, not clinical issues.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["experimental manipulation of stimulus type","use of both self‑report and physiological arousal measures"],"limitations":["small, non‑representative convenience sample","no control for moral or personal factors","no effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541924"}},{"id":1705,"doi":"10.1016/j.chiabu.2025.107452","pmid":"40252608","pmcid":null,"title":"The increase in online child sexual solicitation and abuse: Indicator 16.2.3 of the UN Sustainable Development Goals (SDG) documents a hidden and growing pandemic. Population-based surveys fail to capture the full picture","authors":"Chauviré-Geib K, Gerke J, Haag AC, Sachser C, Finkelhor D, Rassenhofer M, Fegert JM.","first_author":"Chauviré-Geib K","journal":"Child abuse & neglect","year":2025,"pub_types":["Journal Article"],"keywords":["Prevalence","Generational Differences","Representative Sample","Online Sexual Solicitation","Online Child Sexual Abuse","Sdg 16.2.3","Online Child Sexual Solicitation And Abuse"],"is_oa":false,"oa_url":"https://doi.org/10.1016/j.chiabu.2025.107452","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"population-based representative survey of German adults (N=3098) with oversampling of 18‑29 y, weighted analysis of prevalence of online child sexual solicitation/abuse","sample_n":3098,"sample_text":"representative German sample, weighted; 18‑29 age group oversampled","population":"German residents aged 18‑96 (representative sample)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationwide German survey of 3,098 adults found that about 10% have experienced online sexual solicitation or abuse, with rates soaring to 32% among 18‑29‑year‑olds. The most common encounters involved exposure to pornographic material and sexualised chats, highlighting a generational rise in online risk.","clinical_takeaway":"Clinicians should be aware of high rates of online sexual solicitation among young adults and consider preventive counseling focused on digital safety.","confidence":0.85,"topic_tags":["prevalence","sexual_function"],"strengths":["Large, nationally representative sample","Age‑stratified analysis showing generational differences","Use of logistic regression to adjust for demographic covariates"],"limitations":["Screening items appear ad‑hoc, unclear validation","Cross‑sectional design cannot establish causality","Limited detail on measurement reliability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2025.107452"}},{"id":1706,"doi":"10.1080/00224499.2021.2024489","pmid":"35041561","pmcid":null,"title":"An Intersectional Feminist Analysis of Women's Experiences of Authenticity in Pornography","authors":"Tillman M, Wells BE.","first_author":"Tillman M","journal":"Journal of sex research","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross‑sectional thematic analysis of 24 semi‑structured interviews with U.S. women who reported recent porn use","sample_n":24,"sample_text":"24 women (62.5% white, 79.2% non‑heterosexual) who reported recent pornography use in the United States.","population":"women, ages 22‑53, convenience sample (N=24)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 24 U.S. women who watch porn show that they value \"authentic\" porn because it reduces guilt and emotional effort. How women assess authenticity (appearance, performance, intimacy) is shaped by race, sexuality and other identities.","clinical_takeaway":"Clinicians can consider women’s desire for authentic porn as a potential resource for sexual empowerment, while noting that guilt may still arise.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Intersectional lens on women's lived experience","Provides nuanced qualitative insight into authenticity","Identifies concrete ways women evaluate authenticity"],"limitations":["Small, non‑representative convenience sample","No measurement of key confounds (morality, masturbation, mental health)","Findings not generalizable beyond self‑selected U.S. women"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":21,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2021.2024489"}},{"id":1707,"doi":"10.1016/j.abrep.2025.100610","pmid":"40927432","pmcid":"PMC12415970","title":"Recommendations for Diagnosing and Quantifying treatment outcomes in clinical trials of compulsive sexual behavior disorder","authors":"Engel J, Kraus SW, McCurdy LY, Potenza MN.","first_author":"Engel J","journal":"Addictive behaviors reports","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Compulsive Sexual Behavior Disorder","Problematic Pornography Consumption","Quantifying Treatment Outcomes"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12415970","cited_by_count":1,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review-article","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose a set of minimum reporting standards for clinical trials of compulsive sexual behavior disorder, emphasizing validated symptom‑severity scales, frequency counts, quality‑of‑life measures, and cautioning that distress from moral judgments should be separated from the disorder itself.","clinical_takeaway":"Use standardized CSBD symptom and frequency measures, and screen for moral‑judgment distress when evaluating treatment outcomes.","confidence":0.6,"topic_tags":["csbd","treatment","measurement","sexual_function"],"strengths":["Clear articulation of reporting gaps","Alignment with ICD‑11 CSBD definition","Practical guidance for future trials"],"limitations":["No empirical data presented","Recommendations untested","No systematic review methodology described"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.abrep.2025.100610"}},{"id":1708,"doi":"10.1089/jpm.2025.0174","pmid":"40238761","pmcid":null,"title":"Why Hasn't the \"New Pornography\" Inspired Hospice/Palliative Care to Probe More Deeply the Myths of Unconsciousness?","authors":"Barbato M, Currow DC.","first_author":"Barbato M","journal":"Journal of palliative medicine","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/jpm.2025.0174"}},{"id":1709,"doi":"10.1007/s10508-018-1327-z","pmid":"30324269","pmcid":null,"title":"Measuring Self-Perceived Effects of Pornography: A Short-Form Version of the Pornography Consumption Effects Scale","authors":"Miller DJ, Kidd G, Hald GM.","first_author":"Miller DJ","journal":"Archives of sexual behavior","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Men","Psychometrics","Pornography","Sexually Explicit Media","Self-perceived Effects"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience sample of 312 heterosexual men; confirmatory factor analysis of short‑form scale","sample_n":312,"sample_text":"online survey of heterosexual men","population":"312 self‑identified heterosexual men (adult, mixed age)","country":"unspecified (likely multi‑country online sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created a 14‑item short version of the Pornography Consumption Effects Scale, showing good reliability and validity for measuring men’s self‑reported positive and negative effects of porn use.","clinical_takeaway":"The short PCES‑SF can be used in research or clinical screening to capture perceived effects of pornography without substantially increasing respondent burden.","confidence":0.7,"topic_tags":["pornography","measurement","sexual_function"],"strengths":["Large sample for scale development (N>300)","Rigorous factor‑analytic methods","Demonstrated reliability and concurrent/discriminant validity"],"limitations":["Convenience online sample limits generalisability","No assessment of potential confounds (e.g., moral incongruence, mental health)","Scale measures self‑perceived effects, not objective outcomes or clinical criteria"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1327-z"}},{"id":1710,"doi":"10.1007/s10508-021-02154-x","pmid":"35028804","pmcid":null,"title":"Pathways and Patterns of Entrance into BDSM","authors":"Walker AM, Kuperberg A.","first_author":"Walker AM","journal":"Archives of sexual behavior","year":2022,"pub_types":["Journal Article"],"keywords":["Sexual Practices","Bdsm","Pornography","Media Influences","Sexual Fantasies"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-methods exploratory study with qualitative interviews (n=96) and a large cross‑sectional survey (n=2,017) of self‑identified BDSM practitioners; convenience online recruitment; no longitudinal or experimental manipulation","sample_n":2113,"sample_text":"96 interview participants; 2,017 survey respondents","population":"self‑described BDSM practitioners, recruited online; likely skewed toward people willing to discuss BDSM; not a probability sample","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed over 2,000 BDSM practitioners and interviewed 96 to map how people first get involved in BDSM. It found multiple routes, including exposure through pornography, the internet, partners, or personal interests, and that age of entry varies by role, gender and orientation.","clinical_takeaway":"None – the research describes entry pathways, not health outcomes or treatment guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large survey sample (N>2000)","Mixed‑methods design adds depth","Addresses gaps in age‑of‑entry literature"],"limitations":["Convenience, self‑selected sample limits generalisability","Reliance on author‑generated measures; limited construct validation","No control for key confounds (moral incongruence, mental health, trauma)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02154-x"}},{"id":1711,"doi":"10.21203/rs.2.18416/v2","pmid":null,"pmcid":null,"title":"Sex-on-Premise Venues, Associated Risk Behaviors, and Attitudes toward Venue-Based HIV Testing among Men Who Have Sex with Men in Lima, Perú","authors":"Lankowski A, Sánchez H, Hidalgo J, Cabello R, Duerr A.","first_author":"Lankowski A","journal":"Research Square","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-9036/v2.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey of 389 MSM recruited via LGBTQ‑aligned social‑media networks in Lima, Peru; examined self‑reported attendance at sex‑on‑premise venues and recent sexual risk behaviours; exploratory analyses of venue type and use of online platforms.","sample_n":389,"sample_text":"389 MSM completed the survey","population":"Adult men who have sex with men (MSM) in Lima, Peru","country":"Peru","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 389 gay and bisexual men in Lima found that 68 % had visited places such as saunas or sex clubs in the past three months. Those who went to these venues reported higher rates of risky sexual practices and said they would likely accept HIV testing offered there.","clinical_takeaway":"Venue‑based HIV testing could reach men with higher sexual risk; consider outreach at SOPVs.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community‑based sample for a hard‑to‑reach population","Focused on an under‑studied venue‑based context","Provides actionable insight for public‑health outreach"],"limitations":["Cross‑sectional design prevents causal inference","Convenience online recruitment limits generalisability","Self‑report may be biased; no objective verification of venue attendance or risk behaviours"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.2.18416/v2"}},{"id":1712,"doi":"10.1080/00224499.2021.2023450","pmid":"35020561","pmcid":null,"title":"Pornography Use, Offense-Supportive Cognitions, Atypical Sexual Interests, and Sexual Offending against Children","authors":"Paquette S, Brouillette-Alarie S, Seto MC.","first_author":"Paquette S","journal":"Journal of sex research","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 241 men with varying sexual‑offending histories; bivariate, multivariate and moderation analyses.","sample_n":241,"sample_text":"241 men varying in sexual offending history","population":"Men with and without documented sexual offending against children (forensic sample).","country":"Canada (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 241 men, only child‑pornography use predicted the number of child victims, and it amplified the link between sexual interest in boys and offending against boys. Other pornography types were not linked to offending.","clinical_takeaway":"Assess child‑pornography use when evaluating risk for contact sexual offenses against children.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large forensic sample (N>200)","Multivariate and moderation analyses","Focus on concrete offending outcomes"],"limitations":["Cross‑sectional; cannot infer causality","Limited control for key confounds (e.g., mental health, trauma)","Reliance on self‑report for pornography use"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2021.2023450"}},{"id":1713,"doi":"10.1016/j.ijpsycho.2007.10.005","pmid":"18006098","pmcid":null,"title":"Skin conductance responses to visual sexual stimuli","authors":"Costa RM, Esteves F.","first_author":"Costa RM","journal":"International journal of psychophysiology : official journal of the International Organization of Psychophysiology","year":2008,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory comparison of left/right skin conductance responses to three categories of visual stimuli (sexual, non‑sexual, neutral) in 54 adults.","sample_n":54,"sample_text":"54 participants (27 females)","population":"54 healthy adults (27 female, 27 male), likely convenience sample","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study recorded skin conductance on each side of the body while participants viewed explicit, non‑explicit, and neutral pictures. Men showed larger right‑side responses overall; women showed no clear side difference. When participants' reported arousal was taken into account, the gender difference disappeared, suggesting the physiological pattern is linked to how aroused they felt.","clinical_takeaway":"Physiological arousal to sexual images varies by gender but is tied to subjective arousal; skin conductance alone should not be interpreted as a marker of problematic sexual behavior.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Physiological measure (SCR) is well‑validated","Balanced gender sample","Controlled for subjective arousal"],"limitations":["Small laboratory sample, limited generalisability","No pre‑registration or power analysis reported","No assessment of key psychosocial confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijpsycho.2007.10.005"}},{"id":1714,"doi":"10.2196/11667","pmid":"30305264","pmcid":"PMC6231764","title":"Discourse on Exposure to Pornography Content Online Between Arab Adolescents and Parents: Qualitative Study on its Impact on Sexual Education and Behavior","authors":"Gesser-Edelsburg A, Abed Elhadi Arabia M.","first_author":"Gesser-Edelsburg A","journal":"Journal of medical Internet research","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Internet","Taboo","Discourse","Sexual Double Standard","Pornography","Israeli Arab Adolescents","Porn Viewing","Sexual Education And Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6231764","cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 40 Arab adolescents and their mothers","sample_n":40,"sample_text":"20 adolescents (two age groups) and 20 mothers; convenience sample","population":"Arab adolescents (14‑18) and their mothers, recruited via convenience sampling","country":"Israel (Arab population)","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with Arab teens and their mothers show that pornography viewing is more accepted for boys than girls, creates feelings of guilt, and is linked to limited sexual discussion within families, suggesting a need for open dialogue.","clinical_takeaway":"Encourage open, culturally sensitive sexual communication to reduce guilt and potential risky behaviors linked to pornography exposure.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","gender","csbd"],"strengths":["Provides culturally specific qualitative insights","Includes perspectives of both adolescents and mothers","Highlights gendered double standards"],"limitations":["Small non‑representative convenience sample","No standardized measures of pornography use or distress","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":25,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/11667"}},{"id":1715,"doi":"10.4297/najms.2010.3143","pmid":"22624129","pmcid":"PMC3354427","title":"The effects of dancehall genre on adolescent sexual and violent behavior in Jamaica: A public health concern","authors":"Crawford AD.","first_author":"Crawford AD.","journal":"North American journal of medical sciences","year":2010,"pub_types":["research-article","Journal Article"],"keywords":["Behavior","Sexual","Adolescent","Dancehall Genre","Lyrics","Violent"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3354427","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"convenience sample of 100 adolescents, quantitative & qualitative self‑report questionnaire, cross‑sectional","sample_n":100,"sample_text":"Convenience and judgmental sampling","population":"Adolescents in Jamaica (50 m, 50 f)","country":"Jamaica","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"avoid","plain_summary":"A 2010 Jamaican study surveyed 100 teens and found that girls who listened to hardcore dancehall music reported more interest in sexually explicit lyrics and were more likely to act on them than boys. The authors claim a link between the music and increased sexual and violent behavior.","clinical_takeaway":"None – the study provides no reliable evidence for clinical practice.","confidence":0.4,"topic_tags":["adolescents","sexual_function"],"strengths":["mixed quantitative‑qualitative approach","gender comparison"],"limitations":["Convenience sample, not representative","No validated measures of exposure or behavior","No control for moral, mental‑health or relationship confounds"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4297/najms.2010.3143"}},{"id":1717,"doi":"10.1016/j.adolescence.2018.09.006","pmid":"30265879","pmcid":null,"title":"A longitudinal exploration of the relationship between pornography use and sexual permissiveness in female and male adolescents","authors":"Martyniuk U, Štulhofer A.","first_author":"Martyniuk U","journal":"Journal of adolescence","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescents","Longitudinal Assessment","Sexual Permissiveness","Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two independent adolescent panels (N≈1,125) surveyed online and in classrooms over 18–24 months; path analyses used to test bidirectional relations.","sample_n":1125,"sample_text":"n = 372 (Zagreb) and n = 753 (Rijeka).","population":"Croatian female and male adolescents (mean age 16).","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study followed Croatian teens for up to two years and found no evidence that watching pornography makes them more sexually permissive; instead, existing permissiveness sometimes predicted later porn use.","clinical_takeaway":"No direct link between adolescent porn use and increased sexual permissiveness; focus on broader education rather than restricting porn exposure.","confidence":0.8,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Large combined sample of adolescents","Longitudinal design permits temporal ordering","Separate male and female panels","Direct test of bidirectional pathways"],"limitations":["Reliance on self‑report questionnaires, unclear validation","No measurement of key confounds (masturbation, moral/religious attitudes, mental health)","Convenience sampling limits generalisability","Path models without correction for multiple testing not described"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":19,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2018.09.006"}},{"id":1718,"doi":"10.1556/2006.7.2018.77","pmid":"30203696","pmcid":"PMC6426391","title":"The relationship between sexual sensation seeking and problematic Internet pornography use: A moderated mediation model examining roles of online sexual activities and the third-person effect","authors":"Chen L, Yang Y, Su W, Zheng L, Ding C, Potenza MN.","first_author":"Chen L","journal":"Journal of behavioral addictions","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Gender","Moderated Mediation","Third-person Effect","Sexual Sensation Seeking","Online Sexual Activities","Problematic Internet Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6426391","cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 808 Chinese college students, self‑report questionnaires","sample_n":808,"sample_text":"808 Chinese college students (age range: 17-22 years)","population":"college students, ages 17‑22, 57.7% male, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 808 Chinese college students, higher sexual sensation seeking was linked to more problematic internet pornography use, especially for men who thought others were more affected by porn than they were themselves. Online sexual activities helped explain this link.","clinical_takeaway":"High sensation seeking and strong third‑person bias may flag students at risk for problematic porn use; interventions could target these attitudes.","confidence":0.8,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Large sample (N=808)","Gender‑sensitive analysis","Complex moderated mediation model"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of moral incongruence or masturbation","Relies on self‑report scales, unclear validation"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":5,"contrasting":0,"mentioning":36,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.77"}},{"id":1719,"doi":"10.1556/2006.7.2018.70","pmid":"30203692","pmcid":"PMC6426393","title":"Tendencies toward Internet-pornography-use disorder: Differences in men and women regarding attentional biases to pornographic stimuli","authors":"Pekal J, Laier C, Snagowski J, Stark R, Brand M.","first_author":"Pekal J","journal":"Journal of behavioral addictions","year":2018,"pub_types":["Comparative Study","research-article","Journal Article"],"keywords":["Addiction","Attentional Bias","Internet-pornography-use Disorder"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/7/3/article-p574.pdf","cited_by_count":29,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of 174 adults measuring attentional bias (visual probe) and IPD symptoms (short IAT).","sample_n":174,"sample_text":"174 male and female participants","population":"Adults (men and women), likely convenience sample","country":"Not stated","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In 174 adults, researchers found that faster reactions to pornographic pictures (attentional bias) were linked to higher scores on a short test for internet‑pornography‑use disorder, and this link was partly explained by craving and arousal. The pattern was similar for men and women.","clinical_takeaway":"Attentional bias may be associated with self‑reported porn‑use problems, but the study does not prove an addiction mechanism.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Reasonably sized sample (N=174)","Use of experimental attentional‑bias task (visual probe)","Mediation analysis linking bias, craving, and symptoms"],"limitations":["Cross‑sectional; no causal inference","IPD measured with a brief self‑report scale that defines addiction by symptom count","No assessment of moral incongruence, masturbation, mental health or relationship factors"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":41,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.70"}},{"id":1720,"doi":"10.1556/2006.7.2018.78","pmid":"30203695","pmcid":"PMC6426371","title":"Does \"forced abstinence\" from gaming lead to pornography use? Insight from the April 2018 crash of Fortnite's servers","authors":"Castro-Calvo J, Ballester-Arnal R, Potenza MN, King DL, Billieux J.","first_author":"Castro-Calvo J","journal":"Journal of behavioral addictions","year":2018,"pub_types":["letter","Journal Article"],"keywords":["Withdrawal","Gaming","Pornography","Fortnite","Compensation Behaviors"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/7/3/article-p501.pdf","cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"commentary","design_detail":"letter; secondary analysis of Pornhub traffic data following a 24‑hour Fortnite server outage; no original participant recruitment, no control group, no longitudinal follow‑up.","sample_n":null,"sample_text":"Not applicable – data are aggregate website traffic statistics.","population":"Pornhub users (unspecified); no demographic details provided.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors note that after Fortnite’s servers crashed for a day, Pornhub saw a modest rise in visits from gamers and a large jump in searches for \"Fortnite\" porn, suggesting people might turn to porn when they can’t game.","clinical_takeaway":"No direct clinical implications; the link between gaming downtime and porn use remains speculative.","confidence":0.3,"topic_tags":["pornography","gender","sexual_function","prevalence","treatment"],"strengths":["Uses real‑world traffic data","Addresses a novel natural experiment"],"limitations":["No individual‑level data","No measurement of confounding variables (e.g., moral attitudes, mental health)","Interpretation infers compensation behavior without direct evidence"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.78"}},{"id":1721,"doi":"10.1177/107906320001200305","pmid":"10904993","pmcid":null,"title":"Attitudinal effects of degrading themes and sexual explicitness in video materials","authors":"Golde JA, Strassberg DS, Turner CM, Lowe K.","first_author":"Golde JA","journal":"Sexual abuse : a journal of research and treatment","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory experiment with 4 between‑group video conditions, male college sample (N=83).","sample_n":83,"sample_text":"83 male college students","population":"Male college students (age not specified).","country":"USA (presumed by author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study showed that men who watched videos with degrading content toward women, whether explicit or not, reported more attitudes supportive of rape; sexual explicitness alone had no effect.","clinical_takeaway":"Exposure to degrading media may increase rape‑supportive attitudes, underscoring the need for media‑literacy interventions.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Experimental manipulation of video content","Randomized assignment to conditions","Clear primary outcome measures"],"limitations":["Small sample per condition, limiting power","Convenience college sample, limited generalisability","No report of instrument validation"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/107906320001200305"}},{"id":1722,"doi":"10.1371/journal.pone.0260386","pmid":"34932564","pmcid":"PMC8691607","title":"Impact of COVID-19 on pornography use: Evidence from big data analyses","authors":"Lau WK, Ngan LH, Chan RC, Wu WK, Lau BW.","first_author":"Lau WK","journal":"PloS one","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8691607","cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Big‑data ecological time‑series analysis of Google Trends and Pornhub traffic correlated with daily COVID‑19 cases.","sample_n":null,"sample_text":"Aggregated daily counts from Google Trends and Pornhub Insights (population‑level).","population":"Aggregated internet search and traffic data (no individual participants).","country":"Global (data from worldwide sources).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Using Google search data and Pornhub traffic, the authors found that pornography interest rose during COVID‑19 lockdowns and tracked with daily case numbers and social‑distancing searches.","clinical_takeaway":"None – the study reports population‑level trends, not individual risk or health implications.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Large‑scale, real‑time data source.","Timely analysis of pandemic‑related behavioral change."],"limitations":["Ecological design; no individual‑level data.","No control for key psychosocial confounds (moral incongruence, masturbation, mental health).","Causal language exceeds correlational evidence."],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0260386"}},{"id":1723,"doi":"10.1177/0886260518795170","pmid":"30193544","pmcid":null,"title":"Bridging the Theoretical Gap: Using Sexual Script Theory to Explain the Relationship Between Pornography Use and Sexual Coercion","authors":"Marshall EA, Miller HA, Bouffard JA.","first_author":"Marshall EA","journal":"Journal of interpersonal violence","year":2021,"pub_types":["Journal Article"],"keywords":["Sexual Aggression","Sexual Coercion","Sexual Scripts","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional path analysis of 463 college males","sample_n":463,"sample_text":"463 college males","population":"college male students (convenience sample)","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 463 college men, the authors found that attitudes about sex (sexual scripts) partly explain how pornography use is linked to self‑reported likelihood of sexually coercive behavior.","clinical_takeaway":"Do not assume pornography causes sexual coercion; attitudes and other factors are involved and need further study.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for SEM","Clear theoretical framework (sexual script theory)","Uses path analysis to test mediation"],"limitations":["Cross‑sectional, cannot establish causality","Reliance on likely ad‑hoc self‑report items","No control for key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":10,"contrasting":0,"mentioning":39,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260518795170"}},{"id":1724,"doi":"10.1007/s10508-018-1304-6","pmid":"30187150","pmcid":null,"title":"Gender, Race, and Aggression in Mainstream Pornography","authors":"Shor E, Golriz G.","first_author":"Shor E","journal":"Archives of sexual behavior","year":2019,"pub_types":["Journal Article"],"keywords":["Gender","RACE","Aggression","Violence","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 172 free‑Internet porn videos examining gender × race interactions in depictions of aggression.","sample_n":172,"sample_text":"172 popular free Internet pornographic videos.","population":"Popular free‑Internet pornography videos (convenience sample).","country":"Not specified (likely USA/English‑language sites).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined 172 free‑online porn videos and found that aggression was less common in videos with Black women, but more common with Asian and Latina women, suggesting race influences how aggression is portrayed in porn.","clinical_takeaway":"None – the findings pertain to content characteristics, not to individual health or treatment.","confidence":0.8,"topic_tags":["pornography","gender","sexual_function"],"strengths":["Large video sample for content analysis","Systematic coding of gender and race","Addresses understudied interaction"],"limitations":["Convenience video sample; not representative of all porn","Coding scheme not validated; possible subjectivity","No control for cultural or production‑industry factors"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":27,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1304-6"}},{"id":1725,"doi":"10.1093/sexmed/qfaf032","pmid":"40385310","pmcid":"PMC12085913","title":"Perceptions and attitudes toward sexual norms: key insights from the International Society of Sexual Medicine Young Researchers Committee survey","authors":"Nascimento B, Pozzi E, Boeri L, Capogrosso P, Bernie H, Bajic P, Fisher A, Garcia-Gomez B, Milekovic U, Salter C, Modgil V, Taniguchi H, Tenorio F, Sokolakis I, Salonia A.","first_author":"Nascimento B","journal":"Sexual medicine","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["epidemiology","Sexual Medicine","Sexual Norms","International Society Of Sexual Medicine"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12085913","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional pilot survey across five countries (N=3423)","sample_n":3423,"sample_text":"3423 respondents, 63.5% female, median age 39 years","population":"adult respondents from Italy, USA, Brazil, Spain, Japan; convenience online sample","country":"Italy, United States, Brazil, Spain, Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"background","plain_summary":"A pilot online survey of over 3,400 adults in five countries examined how people view sexual norms, including age of first intercourse, porn exposure, and satisfaction. It found gender differences in reported behaviours and attitudes, and highlighted the influence of religion on sexual activity.","clinical_takeaway":"Findings highlight cultural and gender differences in sexual attitudes that can inform inclusive sexual education, but do not provide evidence for clinical interventions.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Large multi‑country sample","Addresses cultural variation in sexual norms","Transparent reporting of limitations"],"limitations":["Survey not validated; potential measurement error","Cross‑sectional design limits causal inference","Key confounds (masturbation, mental health, partner factors) not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfaf032"}},{"id":1726,"doi":"10.22514/j.androl.2025.002","pmid":"40350675","pmcid":null,"title":"A second study about sexual knowledge and attitudes of Galician adolescents","authors":"Paz-Esquete J, Varela-Salgado M.","first_author":"Paz-Esquete J","journal":"Revista internacional de andrologia","year":2025,"pub_types":["Journal Article"],"keywords":["Sexual Habits","Sex Knowledge","Adolescent Survey","Teenager Sexuality"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional descriptive survey of 451 adolescents from one public school in Galicia.","sample_n":451,"sample_text":"435 adolescents plus 16 between 12 and 21 in a public school.","population":"Adolescents (12‑21 years) attending a public school in Spain (N≈451).","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2021 survey of 451 Galician teens found that most learn about sex from friends and the internet, half have viewed pornography, and many consider masturbation normal. Early sexual experiences and sexual abuse were also reported, highlighting gaps in knowledge and the need for better sex education.","clinical_takeaway":"Improved, gender‑sensitive sexual education is needed to address knowledge gaps and promote safe behaviours among adolescents.","confidence":0.6,"topic_tags":["sexual_function","adolescents","gender"],"strengths":["Large N for a school‑based survey","Provides up‑to‑date data on adolescent sexual knowledge and behaviour in Galicia","Includes both genders and a range of topics (pornography, consent, abuse)."],"limitations":["Convenience sample from a single school limits generalisability","Survey items appear ad‑hoc and not validated","No control for key confounds (moral attitudes, mental health, partner effects)."],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.22514/j.androl.2025.002"}},{"id":1727,"doi":"10.1080/10538712.2021.2014612","pmid":"34902291","pmcid":null,"title":"How Plausible are the Accounts of Child Victims of Sexual Abuse? A Study of Bizarre and Unusual Scripts Reported by Children","authors":"Longobardi C, Malacrea M, Giulini P, Settanni M, Fabris MA.","first_author":"Longobardi C","journal":"Journal of child sexual abuse","year":2022,"pub_types":["Journal Article"],"keywords":["Child Abuse","Sex Offenders","Police Officers","Child Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Study 1: development of 16-item list from child reports; Study 2: validation by checking presence of these items in cases involving convicted child‑pornography offenders and police officers. Likely convenience samples, no random selection.","sample_n":null,"sample_text":"Not specified in abstract; likely small convenience samples.","population":"Children with suspected sexual abuse (reports); convicted child‑pornography offenders; police officers involved in child‑pornography investigations (Italy).","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created a list of 16 unusual or bizarre details that children sometimes report in sexual abuse cases and checked whether these details also appear in real child‑pornography cases and police reports, concluding such child accounts can still be credible.","clinical_takeaway":"Unusual details in a child's abuse report do not automatically undermine its credibility.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses a clinically relevant question about credibility of child reports","Uses real-world data from offenders and police"],"limitations":["No validated measurement instrument for scripts","Likely small, non‑representative samples","No statistical power justification or effect‑size reporting"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2021.2014612"}},{"id":1728,"doi":"10.3389/fpsyt.2025.1464625","pmid":"40225851","pmcid":"PMC11985512","title":"Identity formation and mental health challenges among marginalized Chinese international students in online communities","authors":"Jin R, Wang X.","first_author":"Jin R","journal":"Frontiers in psychiatry","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Mental health","Acculturative Stress","Coping Strategies","Marginalization","Online Communities","Chinese International Students"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11985512","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross‑sectional semi‑structured interviews with 12 Chinese international students recruited via social‑media; thematic analysis of identity clusters.","sample_n":12,"sample_text":"Convenience sample of self‑selected students using online voice‑chat recruitment.","population":"Chinese international students (n = 12)","country":"Not specified (presumably China/host country)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 12 Chinese students studying abroad showed three ways they cope with marginalisation: gaming, using online pornography to replace intimacy, and political dissent, each linked to mental‑health struggles. The study urges culturally aware support for these students.","clinical_takeaway":"Clinicians should recognise online pornography may be a coping tool for isolated international students and offer culturally sensitive mental‑health resources.","confidence":0.6,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["In‑depth qualitative insight into identity coping strategies","Use of Self‑Determination Theory to frame analysis","Identification of distinct identity clusters"],"limitations":["Small, non‑representative sample (n = 12)","No validated measures of pornography use or mental‑health outcomes","Findings not generalisable beyond this specific group"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2025.1464625"}},{"id":1729,"doi":"10.1016/j.ajp.2021.102943","pmid":"34923379","pmcid":null,"title":"Case-based evidence for cognitive behavioral therapy & naltrexone treatment of internet pornography","authors":"Sharma MK, Ganjekar S, Arya S, Ravish H, Anand N.","first_author":"Sharma MK","journal":"Asian journal of psychiatry","year":2022,"pub_types":["Letter"],"keywords":["Internet","Treatment","Naltrexone","Cognitive Behavioral Therapy","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ajp.2021.102943"}},{"id":1731,"doi":"10.1089/cyber.2012.0545","pmid":"23675996","pmcid":null,"title":"Understanding differences in sexting behaviors across gender, relationship status, and sexual identity, and the role of expectancies in sexting","authors":"Dir AL, Coskunpinar A, Steiner JL, Cyders MA.","first_author":"Dir AL","journal":"Cyberpsychology, behavior and social networking","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":57,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 278 undergraduate students","sample_n":278,"sample_text":"undergraduate convenience sample","population":"undergraduate students, mean age 21, 54% female, 76% Caucasian","country":"USA (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study created a reliable questionnaire about what people expect from sexting and found that men expect more positive outcomes while women expect more negative ones. These expectations were linked to how often students sent or received sexts, with differences across gender, relationship status, and sexual identity.","clinical_takeaway":"Expectancies shape sexting behavior; interventions could target unrealistic positive expectations to reduce risky sexting.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Validated expectancy scale with good reliability","Effect sizes reported (η²)","Explores multiple demographic moderators"],"limitations":["Cross‑sectional design limits causal inference","Convenience student sample limits generalisability","Key confounds (moral incongruence, mental health, masturbation) not measured"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":7,"contrasting":2,"mentioning":130,"citing_publications":197,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2012.0545"}},{"id":1732,"doi":"10.1177/10778012211037378","pmid":"34855559","pmcid":null,"title":"She Asked for It: Hardcore Porn, Sexism, and Rape Myth Acceptance","authors":"Borgogna NC, Borgogna NC, Lathan EC, McDermott RC.","first_author":"Borgogna NC","journal":"Violence against women","year":2022,"pub_types":["Journal Article"],"keywords":["Gender Differences","Hostile Sexism","Pornography","Rape Myth Acceptance","Hardcore Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online survey (N≈1295) using self‑report measures; multigroup structural equation modelling","sample_n":1295,"sample_text":"392 male, 903 female participants","population":"adult men and women (likely convenience sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 1,200 adults, viewing hardcore porn did not directly predict belief in rape myths, but it amplified the effect of hostile sexism on such beliefs for both men and women.","clinical_takeaway":"Hardcore porn may intensify sexist attitudes linked to rape myth endorsement, but causality cannot be assumed.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["large sample size","use of structural equation modelling","examines interaction between sexism and hardcore porn"],"limitations":["cross‑sectional design limits causal inference","pornography use measured with likely unvalidated single items","key confounds (moral incongruence, mental health, trauma) not addressed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":16,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10778012211037378"}},{"id":1733,"doi":"10.1177/0306624x211062161","pmid":"34852672","pmcid":"PMC10336709","title":"Self Perceptions and Cognitions of Child Sexual Exploitation Material Offenders","authors":"Steel CMS, Newman E, O'Rourke S, Quayle E.","first_author":"Steel CMS","journal":"International journal of offender therapy and comparative criminology","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Cognitive Distortions","Self-perceptions","Child Pornography","Sex Offender Registration","Child Sexual Abuse Material","Child Sexual Exploitation Material"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10336709","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of convicted CSEM offenders (n=78) compared to non‑offender reference group (n=254); online questionnaire; convenience samples","sample_n":332,"sample_text":"78 offenders, 254 non‑offenders (gender‑matched)","population":"adult US adults convicted of child pornography offenses vs community sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed adults convicted of child sexual exploitation material offenses and compared them to a community group. Offenders were more likely to downplay the severity of the material, support legalising virtual child pornography, and prefer treatment over prison.","clinical_takeaway":"None – findings relate to offender cognition, not clinical treatment of sexual health or addiction.","confidence":0.7,"topic_tags":["csbd","moral_incongruence"],"strengths":["Large comparative non‑offender sample","Identifies specific cognitive distortions in CSEM offenders","Clear operational focus on self‑perceptions"],"limitations":["Cross‑sectional, cannot infer causality","Measures appear ad‑hoc, limited validation","No control for mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x211062161"}},{"id":1734,"doi":"10.3389/fpsyg.2021.769732","pmid":"34916999","pmcid":"PMC8669394","title":"Sexual Interaction in Digital Contexts and Its Implications for Sexual Health: A Conceptual Analysis","authors":"Döring N, Krämer N, Mikhailova V, Brand M, Krüger THC, Vowe G.","first_author":"Döring N","journal":"Frontiers in psychology","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Commercial Sex","Cybersex","Pornography","Sexting","Sexual Consent","Internet Sexuality","Sex Robots","Online Sexual Activities (Osa)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8669394","cited_by_count":16,"is_preprint":false,"topics":["pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"conceptual analysis; no empirical data, no sample","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose a new framework that sorts digital sexual activities into three types—through, via, and with technology—based on how digital tools are used, and discuss how consent and commerce shape their health impacts.","clinical_takeaway":"None – the article is theoretical and does not provide actionable clinical guidance.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Comprehensive taxonomy of digital sexual interactions","Integrates consent and commerce as mediators","Highlights multidisciplinary factors"],"limitations":["No empirical data; purely conceptual","Lacks operational definitions for health outcomes","No assessment of confounding variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":62,"retracted":false,"notices":[{"status":"Has correction","date":"2022-2-9","noticeDoi":"10.3389/fpsyg.2022.847814","doi":"10.3389/fpsyg.2021.769732"},{"status":"Has erratum","date":"2022-2-9","noticeDoi":"10.3389/fpsyg.2022.847814","doi":"10.3389/fpsyg.2021.769732"}],"url":"https://scite.ai/reports/10.3389/fpsyg.2021.769732"}},{"id":1736,"doi":"10.1080/00224499.2021.1999893","pmid":"34788169","pmcid":null,"title":"U.S. Adults' Attitudes toward Gay Individuals' Civil Liberties, Moral Judgments of Homosexuality, Support for Same-sex Marriage, and Pornography Consumption, Revisited","authors":"Wright PJ, Tokunaga RS.","first_author":"Wright PJ","journal":"Journal of sex research","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"single survey of U.S. adults, correlational analysis of self‑reported pornography use and attitudes toward homosexuality and same‑sex marriage","sample_n":null,"sample_text":"not stated in abstract","population":"U.S. adults (presumably community sample, recruitment method not specified)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a recent U.S. survey, people who watch more pornography tended to hold more accepting views about homosexuality and same‑sex marriage, but pornography use was not linked to attitudes about gay civil rights.","clinical_takeaway":"None – the study reports population‑level attitude patterns, not clinical advice.","confidence":0.7,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["large‑scale U.S. sample","direct replication of earlier work","transparent acknowledgement of causal limitations"],"limitations":["cross‑sectional design limits causal inference","no measurement of key confounds (e.g., moral incongruence, mental health)","unclear whether pornography use was measured with validated scale"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2021.1999893"}},{"id":1737,"doi":"10.1016/j.pedhc.2021.09.005","pmid":"34776326","pmcid":null,"title":"Increasing Health Literacy Among Residents at a Juvenile Temporary Detention Center","authors":"Walsh SM, Magloire P, Martinez M, Wetzel D, Obrecht J.","first_author":"Walsh SM","journal":"Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners","year":2022,"pub_types":["Journal Article"],"keywords":["Incarcerated Youth","High-risk Population","Sex Trafficking","Pornography","Adolescent Health Literacy"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pretest/posttest quality‑improvement project with a single group of 119 detained adolescents; no control group; outcomes measured by study‑specific health‑literacy questionnaire","sample_n":119,"sample_text":"119 youth residents participated","population":"juvenile temporary detention center residents (adolescents, mixed gender, mainly female mentioned)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A health‑education program was run with 119 detained adolescents, covering topics like anatomy, consent, and pornography. Scores on a health‑literacy questionnaire rose after the weekly sessions, suggesting the program boosted participants' knowledge.","clinical_takeaway":"Targeted health‑literacy interventions can improve knowledge among incarcerated youths, but evidence on behavior change is limited.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a detention‑center program","Pre/post design allows within‑subject change detection","Addresses multiple health topics relevant to high‑risk youth"],"limitations":["No control or comparison group","Health‑literacy instrument not described as validated","No adjustment for potential confounders (e.g., mental health, trauma)","Findings limited to incarcerated youth, not generalizable"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pedhc.2021.09.005"}},{"id":1738,"doi":"10.1007/s10508-021-02091-9","pmid":"34750778","pmcid":null,"title":"A Latent Class Analysis of Sexual Behavior and Associations with Sex Education, Smoking, Drinking, and Pornography Use Among Chinese Youth","authors":"Zhang Y, Wang C, Liang M.","first_author":"Zhang Y","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual behavior","Sex Education","Substance Use","Latent Class Analysis"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large nationally representative survey, latent class analysis, cross‑sectional","sample_n":13865,"sample_text":"National Youth Reproductive Health Survey (2009)","population":"13,865 unmarried Chinese youth, 18‑24 y","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a national survey of 13,865 Chinese youths, researchers identified four patterns of sexual behaviour. Regular pornography use, smoking and drinking were linked to the highest‑risk sexual class, while sex education related to safer patterns. The study highlights distinct risk groups but cannot prove that pornography causes risky sexual behaviour.","clinical_takeaway":"Pornography use co‑occurs with other risk behaviours among Chinese youth, suggesting the need for integrated health education, not that porn alone drives risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Very large, nationally representative sample","Appropriate latent‑class analytic technique for identifying behavior patterns","Clear reporting of class probabilities and odds ratios"],"limitations":["Cross‑sectional design cannot infer causality","Pornography use measured by a single, non‑validated item","No assessment of moral, mental‑health, or trauma confounders"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02091-9"}},{"id":1739,"doi":"10.31234/osf.io/g7cr9","pmid":null,"pmcid":null,"title":"Gambling with God: The Effect of Gambling on Religious and Spiritual Struggles","authors":"Grant Weinandy JT, Grubbs JB.","first_author":"Grant Weinandy JT","journal":"PsyArXiv","year":2019,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/g7cr9","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"secondary analysis of MTurk panel, baseline n=764, follow‑up n=342, controlled for demographics and neuroticism","sample_n":764,"sample_text":"initial survey n=764; follow‑up n=342 (6‑month interval)","population":"adult MTurk respondents, recruited online","country":"USA (likely, based on MTurk)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study found that people with more severe gambling problems tended to report greater religious and spiritual difficulties, both at one point in time and six months later, even after accounting for personality and demographic factors.","clinical_takeaway":"Clinicians should consider clients' spiritual struggles when treating gambling disorder, but findings are based on a self‑selected online sample.","confidence":0.7,"topic_tags":["gender","religiosity","sexual_function"],"strengths":["Longitudinal design","Controls for several demographic variables","Addresses understudied link between gambling and spiritual struggle"],"limitations":["MTurk convenience sample limits generalisability","Unclear whether gambling and struggle measures are validated","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/g7cr9"}},{"id":1741,"doi":"10.1080/10410236.2021.1991641","pmid":"34696638","pmcid":null,"title":"Pornography Consumption and Sexual Choking: An Evaluation of Theoretical Mechanisms","authors":"Wright PJ, Herbenick D, Tokunaga RS.","first_author":"Wright PJ","journal":"Health communication","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of a campus‑representative probability sample of undergraduate men; mediation analysis of self‑reported pornography frequency, beliefs about sexual choking, and self‑reported choking behavior.","sample_n":null,"sample_text":"campus-representative probability sample (size not reported in abstract)","population":"heterosexual‑identified collegiate men (U.S. campus sample)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of college men found that higher pornography use was linked to more choking of sexual partners, and this link was explained by beliefs that choking is pleasurable, safe, and does not require consent.","clinical_takeaway":"Clinicians should be aware that porn exposure may shape risky sexual beliefs and behaviors, but evidence does not prove causation.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["probability sample improves generalizability","addresses a novel, specific behavior (sexual choking)","uses mediation framework to test theoretically derived pathway"],"limitations":["cross‑sectional design cannot establish causality","constructs measured with likely ad‑hoc single‑item items","no control for moral, mental‑health, or partner variables"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":25,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2021.1991641"}},{"id":1742,"doi":"10.1016/j.comppsych.2021.152279","pmid":"34700188","pmcid":"PMC8529894","title":"Problematic use of the internet during the COVID-19 pandemic: Good practices and mental health recommendations","authors":"Gjoneska B, Potenza MN, Jones J, Corazza O, Hall N, Sales CMD, Grünblatt E, Martinotti G, Burkauskas J, Werling AM, Walitza S, Zohar J, Menchón JM, Király O, Chamberlain SR, Fineberg NA, Demetrovics Z.","first_author":"Gjoneska B","journal":"Comprehensive psychiatry","year":2022,"pub_types":["research-article","Review","Journal Article"],"keywords":["Problematic Internet Use","Addictive Behaviors","Online Gaming","Online Pornography","Online Gambling","Covid-19 Pandemic"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8529894","cited_by_count":54,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review summarising existing literature on problematic internet use during COVID‑19, with sections on online gaming, gambling and pornography.","sample_n":null,"sample_text":"Not applicable – review of published studies","population":"general adult population (no primary data)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors review how internet use, including porn watching, increased during COVID‑19 and discuss possible mental‑health impacts, offering advice for clinicians and the public.","clinical_takeaway":"Be alert for heightened problematic internet use during crises and consider brief interventions, but note that evidence is largely descriptive.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Broad overview of pandemic‑related changes in internet use","Includes multiple behavioural domains (gaming, gambling, porn)","Provides practical mental‑health recommendations"],"limitations":["Narrative (non‑systematic) review – selection bias possible","No original data; no quantitative synthesis or meta‑analysis","No systematic assessment of study quality or bias"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":70,"citing_publications":110,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2021.152279"}},{"id":1743,"doi":"10.1556/2006.7.2018.33","pmid":"29865868","pmcid":"PMC6174597","title":"\"Pornographic binges\" as a key characteristic of males seeking treatment for compulsive sexual behaviors: Qualitative and quantitative 10-week-long diary assessment","authors":"Wordecha M, Wilk M, Kowalewska E, Skorko M, Łapiński A, Gola M.","first_author":"Wordecha M","journal":"Journal of behavioral addictions","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Masturbation","Compulsive Sexual Behaviors","Hypersexuality","Pornography","Diary Assessment"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6174597","cited_by_count":61,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"qualitative interviews (n=9) + 10‑week diary of treatment‑seeking males","sample_n":9,"sample_text":"nine participants recruited from a clinical setting","population":"treatment‑seeking males (22‑37 y, N=9)","country":"Poland","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In nine men seeking help for compulsive sexual behaviour, researchers recorded daily pornography use and masturbation for ten weeks. Six showed \"binge\" sessions lasting many hours, which were linked to lower mood and higher anxiety, but the direction of cause and effect remains unclear.","clinical_takeaway":"Binge pornography use may co‑occur with mood distress in some men with CSB; treatment should consider individual triggers and mood regulation.","confidence":0.8,"topic_tags":["pornography","masturbation","csbd","moral_incongruence"],"strengths":["10‑week diary provides real‑time behavioural data","combines qualitative and quantitative methods","focuses on individual differences in binge patterns"],"limitations":["Very small, treatment‑seeking sample limits generalisability","Lack of validated CSB instruments; reliance on self‑report","No control for moral incongruence or partner variables"],"rubric_version":"2.0","raw_total":20,"max_possible":60,"pct_score":33,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":2,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":6,"contrasting":1,"mentioning":89,"citing_publications":105,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.33"}},{"id":1746,"doi":"10.1542/peds.2012-1281","pmid":"23319522","pmcid":"PMC3557406","title":"Association of maltreatment with high-risk internet behaviors and offline encounters","authors":"Noll JG, Shenk CE, Barnes JE, Haralson KJ.","first_author":"Noll JG","journal":"Pediatrics","year":2013,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Prospective cohort of 251 adolescent girls (130 maltreated, 121 matched controls) with 12‑16 month follow‑up for offline meetings.","sample_n":251,"sample_text":"251 adolescent girls (130 maltreated, 121 comparison)","population":"Adolescent girls, 14‑17 years, United States","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Maltreated adolescent girls are more likely to view sexual content online, post provocative profiles, and receive sexual solicitations, which predict later in‑person meetings with strangers. High‑quality parenting reduces these risks.","clinical_takeaway":"Screen maltreated youths for risky online sexual activity and provide targeted internet‑safety education.","confidence":0.9,"topic_tags":["pornography","sexual_function"],"strengths":["Longitudinal design with follow‑up","Objective coding of online profiles","Matched comparison group"],"limitations":["No measurement of moral or religious factors (not central but omitted)","Mental‑health covariates not clearly specified","Sample limited to girls; not gender‑balanced"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":7,"contrasting":2,"mentioning":81,"citing_publications":85,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2012-1281"}},{"id":1748,"doi":"10.1556/2006.7.2018.34","pmid":"29788747","pmcid":"PMC6174585","title":"Internet pornography viewing preference as a risk factor for adolescent Internet addiction: The moderating role of classroom personality factors","authors":"Alexandraki K, Stavropoulos V, Burleigh TL, King DL, Griffiths MD.","first_author":"Alexandraki K","journal":"Journal of behavioral addictions","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Classroom","Internet Addiction","Introversion","Pornography","Openness To Experience"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6174585","cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two‑wave cohort (ages 16→18) of 648 adolescents from 34 classrooms; hierarchical linear modelling of pornography preference (binary) predicting Internet Addiction Test scores, with classroom personality moderators.","sample_n":648,"sample_text":"648 adolescents (34 classrooms) assessed at ages 16 and 18.","population":"Adolescents (N=648) from schools in an unspecified country; recruited via classrooms.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a two‑year study of 648 teens, those who said they preferred viewing online porn were more likely to develop higher scores on an Internet‑addiction questionnaire, especially in classrooms with more extroverted peers.","clinical_takeaway":"Adolescent porn preference may heighten risk for broader Internet‑addiction problems, suggesting early monitoring in school settings.","confidence":0.78,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample with two‑wave longitudinal data","Use of validated Internet Addiction Test","Multilevel modelling accounts for classroom clustering","Explores contextual (classroom) moderators"],"limitations":["Pornography exposure measured with a single yes/no item","No assessment of masturbation, moral/religious factors, or mental‑health covariates","Potential sample bias (school‑based, unspecified region)","No effect‑size reporting in abstract"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":1,"mentioning":20,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.34"}},{"id":1749,"doi":"10.1017/sjp.2024.33","pmid":"39962916","pmcid":null,"title":"Match made in Heaven (or Hell?): Understanding the High Incidence of Tinder Rapes in Spain","authors":"Sayeras J, Rueff-Lopes R.","first_author":"Sayeras J","journal":"The Spanish journal of psychology","year":2025,"pub_types":["Journal Article"],"keywords":["Rape","Spain","Focus Groups","Online Dating","Tinder"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups with separate gender/age panels; thematic analysis","sample_n":null,"sample_text":"Four focus groups; total participant number not reported in abstract","population":"Tinder users in Spain (victim and perpetrator profiles), convenience sample","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Focus groups with Spanish Tinder users explored why a reported 21.7% of women said they were raped after a Tinder date. Men tended to blame the app or women, while women highlighted systemic victim‑blaming and the role of pornography.","clinical_takeaway":"None – the study provides sociological insight, not clinical guidance.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["addresses an under‑studied public‑health issue","includes perspectives from both genders","provides nuanced qualitative insights"],"limitations":["Convenience, self‑selected focus‑group sample limits generalisability","No quantitative measurement of key constructs (e.g., pornography use)","Small, unspecified sample size"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/sjp.2024.33"}},{"id":1750,"doi":null,"pmid":"30028102","pmcid":null,"title":"Sexting: 21st-Century Statutory Rape","authors":"Cornwell JK.","first_author":"Cornwell JK.","journal":"SMU law review : a publication of Southern Methodist University School of Law","year":2013,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"law review historical commentary; no empirical data, no sample","sample_n":null,"sample_text":"none","population":"none","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that modern sexting laws are a continuation of historic statutory‑rape protections, viewing digital image sharing by teens as a form of statutory rape by proxy.","clinical_takeaway":"None – the paper is a legal commentary, not a clinical study.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["thorough historical/legal analysis","places contemporary statutes in broader context"],"limitations":["no empirical data","lacks measurement of sexual behavior outcomes","potential advocacy bias"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":1752,"doi":"10.3390/jcm10194327","pmid":"34640344","pmcid":"PMC8509395","title":"Sexual Behaviour and Fantasies in a Group of Young Italian Cohort","authors":"Di Mauro M, Russo GI, Polloni G, Tonioni C, Giunti D, Cito G, Giammusso B, Morelli G, Masieri L, Cocci A.","first_author":"Di Mauro M","journal":"Journal of clinical medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Alcohol","Sexual behavior","erectile dysfunction","Pornography","Sex Aid"],"is_oa":true,"oa_url":"https://www.mdpi.com/2077-0383/10/19/4327/pdf?version=1632650270","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey of Italian adults (all ages, sexes, orientations) using a 99‑item questionnaire on sexual habits, fantasies and pornography use. No control group, no longitudinal follow‑up.","sample_n":null,"sample_text":"Not specified in abstract (survey of a ‘group’ of Italian people).","population":"Italian adults (self‑selected respondents to an online survey). Sample size not reported in abstract.","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2021 Italian survey asked adults about their sexual habits and fantasies. Most reported early sexual experiences and a high prevalence of porn use, often alone. The most common fantasies involved public or group sex. The authors suggest these data can guide sex‑education and health efforts.","clinical_takeaway":"None – the study provides descriptive data only and does not inform clinical assessment or treatment.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large breadth of sexual behaviours captured","Includes a range of ages and orientations"],"limitations":["Convenience, self‑selected sample; unknown representativeness","Ad‑hoc questionnaire without validation","No control for key confounds (religiosity, mental health, masturbation, partner factors)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jcm10194327"}},{"id":1753,"doi":"10.21203/rs.2.15254/v1","pmid":null,"pmcid":null,"title":"Premarital sexual practice and its associated factors in Ethiopia. A systematic review and meta-analysis","authors":"Getaneh T, Negesse A, Chane J.","first_author":"Getaneh T","journal":"Research Square","year":2019,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-5920/v1.pdf?c=1597962593000","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review and meta‑analysis of 24 cross‑sectional studies (N=14,872) reporting prevalence of premarital sexual practice in Ethiopia; random‑effects model, heterogeneity and publication‑bias tests.","sample_n":14872,"sample_text":"24 articles, total N=14,872 individuals","population":"Ethiopian adolescents and young adults (samples from 24 studies)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 24 Ethiopian studies found that about 31% of young people reported having sex before marriage, with higher odds among females, older youths, alcohol users and those exposed to pornography.","clinical_takeaway":"High premarital sexual activity suggests a need for targeted youth sexual‑health services in Ethiopia.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive national meta‑analysis","Standard meta‑analytic techniques (random effects, heterogeneity, bias tests)","Clear reporting of pooled prevalence and associated odds ratios"],"limitations":["Primary studies rely on simple self‑report, likely unvalidated","Limited control for key psychosocial confounds (e.g., moral attitudes, mental health)","Cross‑sectional source data prevent causal inference"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.2.15254/v1"}},{"id":1754,"doi":"10.1016/j.addbeh.2018.04.016","pmid":"29727811","pmcid":null,"title":"Development and psychometric evaluation of the Pornography Purchase Task","authors":"Mulhauser K, Miller Short E, Weinstock J.","first_author":"Mulhauser K","journal":"Addictive behaviors","year":2018,"pub_types":["Journal Article"],"keywords":["Validity","reliability","Behavioral Economics","Hypersexuality","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two separate samples (general adult population, clinical men seeking hypersexuality treatment) completed a hypothetical purchase task and concurrent hypersexuality measures; test‑retest reliability and demand curve fitting were assessed.","sample_n":null,"sample_text":"Study 1: general community adults; Study 2: men in hypersexuality treatment","population":"Adults (general population and treatment‑seeking men)","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and tested a new questionnaire that asks people how much pornography they would buy at different prices. The task showed reliable results and correlated with existing measures of hypersexuality, suggesting it could be a useful way to assess problematic pornography use.","clinical_takeaway":"The Pornography Purchase Task may help identify individuals with high demand for pornography, but should be used alongside other clinical assessments.","confidence":0.8,"topic_tags":["pornography","sexual_function","measurement"],"strengths":["Develops a novel behavioral‑economic measure","Good test‑retest reliability reported","Demand curve fits exponential model well","Includes both community and clinical samples"],"limitations":["No control for moral incongruence or related psychosocial variables","Clinical sample is treatment‑seeking, limiting generalisability","Cross‑sectional design; cannot infer causality","Limited information on sample size and power"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":13,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2018.04.016"}},{"id":1755,"doi":"10.1037/lhb0000594","pmid":"39946588","pmcid":null,"title":"What risk assessment tools can be used with men convicted of child sexual exploitation material offenses? Recommendations from a review of current research","authors":"Helmus LM, Eke AW, Seto MC.","first_author":"Helmus LM","journal":"Law and human behavior","year":2025,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review (narrative, not systematic, no meta‑analysis)","sample_n":null,"sample_text":"Not applicable – review of existing studies","population":"men convicted of child sexual exploitation material offenses","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review research on tools that predict whether men convicted of child sexual exploitation material offenses will reoffend. They identify nine tools, recommend four as defensible, and discuss strengths and limits of each.","clinical_takeaway":"None – the review is about forensic risk assessment, not clinical treatment of pornography or masturbation concerns.","confidence":0.7,"topic_tags":["csbd","sexual_function","masturbation","pornography","moral_incongruence"],"strengths":["Comprehensive overview of existing risk tools","Clear recommendations for practice","Identifies gaps for future research"],"limitations":["Narrative (non‑systematic) review – possible selection bias","No quantitative synthesis or meta‑analysis","Limited discussion of methodological quality of source studies"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/lhb0000594"}},{"id":1756,"doi":"10.1007/s10508-009-9496-4","pmid":"19387817","pmcid":null,"title":"An evaluation of the validity of thermography as a physiological measure of sexual arousal in a non-university adult sample","authors":"Kukkonen TM, Binik YM, Amsel R, Carrier S.","first_author":"Kukkonen TM","journal":"Archives of sexual behavior","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":45,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized controlled trial where participants viewed a neutral clip then were randomly assigned to view neutral, humor, anxiety‑provoking, or sexually explicit videos; genital and thigh temperature recorded continuously; subjective arousal reported.","sample_n":79,"sample_text":"79 participants (40 men, 39 women) recruited from the community; random assignment to four video conditions (≈20 per condition).","population":"Healthy adults (men n=40, women n=39), mean age 37 years, non‑university sample","country":"Not specified (likely USA/Finland based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested whether changes in genital temperature measured by infrared thermography match people’s reported sexual arousal. In a lab, adults watched neutral, funny, anxiety‑inducing, or sexual videos while their temperature was recorded. Genital temperature rose only during sexual videos and tracked self‑rated arousal, suggesting thermography could be a valid physiological tool.","clinical_takeaway":"Thermography shows promise as an objective way to assess sexual arousal, but further validation is needed before clinical use.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Randomized allocation to stimulus conditions","Objective physiological measure (thermography) alongside self‑report","Inclusion of anxiety control to test specificity","Adult, non‑student sample expands generalisability"],"limitations":["Validation relies on correlation with self‑report; no external gold standard","Subjective arousal scales not described; possible ad‑hoc measures","No long‑term or clinical outcome assessment"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":75,"citing_publications":79,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-009-9496-4"}},{"id":1757,"doi":"10.1556/2006.2021.00063","pmid":"34534102","pmcid":"PMC8997233","title":"International Sex Survey: Study protocol of a large, cross-cultural collaborative study in 45 countries","authors":"Bőthe B, Koós M, Nagy L, Kraus SW, Potenza MN, Demetrovics Z.","first_author":"Bőthe B","journal":"Journal of behavioral addictions","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Compulsive Sexual Behavior","Impulsive Behavior","Addictive Behavior","Sexual Well-being","Pornography"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/10/3/article-p632.pdf","cited_by_count":45,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large multi‑country, cross‑sectional online survey protocol; no data yet","sample_n":null,"sample_text":"target minimum 2,000 participants per country; actual numbers not yet available","population":"adults (≥18) from 45 countries, target N ≥2,000 per country, gender‑balanced","country":"45 (international)","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The International Sex Survey is a planned online questionnaire to be completed by at least 2,000 adults in each of 45 countries, aiming to collect detailed data on sexual behaviour, pornography use and related mental‑health factors.","clinical_takeaway":"None – the study is a protocol with no results yet.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Very large, cross‑cultural sample size","Open‑science, pre‑registered protocol","Plans to use structural equation modeling and measurement invariance"],"limitations":["Cross‑sectional design limits causal inference","Abstract does not detail measurement of key confounds (moral incongruence, masturbation, mental health)","Reliance on self‑report may introduce bias"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":76,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2021.00063"}},{"id":1758,"doi":"10.1177/08862605211043586","pmid":"34507500","pmcid":"PMC9554400","title":"Personality, Attitudinal, and Demographic Predictors of Non-consensual Dissemination of Intimate Images","authors":"Karasavva V, Forth A.","first_author":"Karasavva V","journal":"Journal of interpersonal violence","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Cybercrime","Revenge Pornography","Dark Tetrad","Image-based Sexual Abuse","Technology-facilitated Sexual Violence","Non-consensual Sexual Image Dissemination"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9554400","cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 810 undergraduate students","sample_n":810,"sample_text":"810 undergraduate students","population":"undergraduate students, 72.7% female, 23.3% male, recruited via university channels","country":"unspecified (likely USA/UK based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 810 college students examined who distributes or has had intimate images shared without consent. Women, LGBTQ+ students, and those high in sadism or narcissism were more likely to be victims or perpetrators. Prior victimisation also predicted perpetration, indicating a complex relationship beyond “revenge porn.”","clinical_takeaway":"Clinicians should recognise that non‑consensual image sharing is linked to personality traits and prior victimisation, not solely gendered revenge motives.","confidence":0.78,"topic_tags":["religiosity","moral_incongruence","sexual_function"],"strengths":["Large sample for a single‑site survey","Use of logistic regression to test multiple predictors","Inclusion of both perpetration and victimisation outcomes"],"limitations":["Convenience undergraduate sample limits generalisability","Likely reliance on single‑item self‑report for NCII behaviours","No measurement of key sexual‑health confounds (e.g., mental health, trauma)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":10,"contrasting":1,"mentioning":86,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605211043586"}},{"id":1759,"doi":"10.1016/j.chiabu.2018.03.031","pmid":"29631255","pmcid":null,"title":"The complex experience of child pornography survivors","authors":"Gewirtz-Meydan A, Walsh W, Wolak J, Finkelhor D.","first_author":"Gewirtz-Meydan A","journal":"Child abuse & neglect","year":2018,"pub_types":["Comparative Study","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Survivors","Child Pornography","Sexual Abuse Images"],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross‑sectional qualitative interview/survey of a convenience sample of adult survivors (N=133)","sample_n":133,"sample_text":"convenience online survey","population":"adult survivors of child‑pornography production (self‑selected online sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study interviewed 133 adults who survived the production of child sexual images. About half felt ongoing guilt, shame, and fear of being judged, while some also described a feeling of empowerment. The authors highlight the complex emotional legacy of such abuse.","clinical_takeaway":"Clinicians should recognise that survivors of child‑pornography may experience persistent shame and guilt, distinct from other abuse effects, and address these emotions directly in therapy.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["large (N=133) qualitative sample of a hard‑to‑reach population","in‑depth thematic analysis provides nuanced survivor perspectives","identifies specific emotional impacts of image production"],"limitations":["convenience, self‑selected sample limits generalisability","no validated psychometric measures of guilt/shame or mental‑health outcomes","no control for moral incongruence or other potential confounds"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":72,"citing_publications":108,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2018.03.031"}},{"id":1760,"doi":"10.1177/1079063218762434","pmid":"29592774","pmcid":null,"title":"A Validation Study of the Child Pornography Offender Risk Tool (CPORT)","authors":"Eke AW, Helmus LM, Seto MC.","first_author":"Eke AW","journal":"Sexual abuse : a journal of research and treatment","year":2019,"pub_types":["Validation Study","Journal Article"],"keywords":["risk assessment","Validation Study","Child Pornography","Child Sexual Exploitation Material","Cport"],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"validation cohort with 5‑year follow‑up of 80 convicted men","sample_n":80,"sample_text":"80 men convicted of child pornography offenses; 5‑year fixed follow‑up","population":"adult male offenders convicted of child pornography offences (N=80)","country":"not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested a seven‑item risk‑assessment tool (CPORT) on 80 men convicted of child‑pornography offenses and found it modestly predicted new sexual or child‑pornography crimes over five years (AUC ≈ .70‑.74).","clinical_takeaway":"CPORT shows moderate predictive ability for recidivism but should be used cautiously given limited sample size.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Prospective follow‑up allows assessment of predictive validity","Uses official recidivism records rather than self‑report","Compares validation sample to original development sample"],"limitations":["Small sample size and low event rates limit precision (AUC confidence intervals not reported)","No adjustment for potential confounders (e.g., prior offending history, mental health)","No pre‑registration or external replication"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":9,"contrasting":6,"mentioning":192,"citing_publications":79,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063218762434"}},{"id":1762,"doi":"10.1016/j.adolescence.2004.10.006","pmid":"16022887","pmcid":null,"title":"Adolescents' experience with sex on the web: results from online focus groups","authors":"Cameron KA, Salazar LF, Bernhardt JM, Burgess-Whitman N, Wingood GM, DiClemente RJ.","first_author":"Cameron KA","journal":"Journal of adolescence","year":2005,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"online focus groups with 40 adolescents (ages 14‑17) discussing experiences with sexually oriented and explicit web sites","sample_n":40,"sample_text":"N=40 adolescents (ages 14‑17) participating in four web‑based focus groups","population":"Adolescents, community sample recruited online; convenience sampling","country":"USA (presumed from NIH funding)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In four online focus groups with 40 U.S. teens, researchers learned that adolescents frequently encounter sexually explicit websites, sometimes intentionally and sometimes not. Girls tended to view such content as socially unacceptable, while boys showed mixed attitudes. Participants generally believed these sites did not affect them personally.","clinical_takeaway":"Clinicians should note that adolescents perceive little personal impact from online sexual content, but discussions about media exposure may still be valuable in sexual health counseling.","confidence":0.6,"topic_tags":["adolescents","sexual_function","pornography"],"strengths":["First‑hand adolescent perspectives","Provides contextual nuance for future quantitative work"],"limitations":["Small, non‑representative convenience sample","No quantitative measures of exposure or outcomes","No assessment of potential confounds (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":1,"mentioning":52,"citing_publications":98,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2004.10.006"}},{"id":1763,"doi":"10.1080/00224499.2025.2454395","pmid":"39887071","pmcid":null,"title":"Sexual Education as a Dynamic Multisource Process: A Qualitative Examination of Sexual Education Experiences in a Sample of U.S. College Students","authors":"Diede AS, Holland KJ.","first_author":"Diede AS","journal":"Journal of sex research","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 44 U.S. college students","sample_n":44,"sample_text":"44 college students recruited for interviews","population":"U.S. college students (young adult, mixed gender)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 44 U.S. college students showed that sexual education comes from many sources—parents, schools, peers, the internet, and pornography—combined over time. Comfort with a source determines how influential it is.","clinical_takeaway":"Sex educators should consider multiple, comfort‑based sources when designing sexual‑health education for young adults.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["In-depth qualitative insights into multiple sexual education sources","Use of reflexive thematic analysis","Diverse range of information sources including pornography"],"limitations":["Small, non‑representative convenience sample","No quantitative measures of sexual behavior or outcomes","No control for confounding variables (e.g., mental health, religiosity)","Findings not generalizable beyond U.S. college students"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2025.2454395"}},{"id":1764,"doi":"10.1111/adb.13087","pmid":"34409697","pmcid":null,"title":"Addiction Research Unit: Affective and cognitive mechanisms of specific Internet-use disorders","authors":"Brand M, Müller A, Stark R, Steins-Loeber S, Klucken T, Montag C, Diers M, Wolf OT, Rumpf HJ, Wölfling K, Wegmann E.","first_author":"Brand M","journal":"Addiction biology","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Inhibitory Control","Cue-reactivity","Problematic Pornography Use","Gaming Disorder","Buying-shopping Disorder","Problematic Social-networks Use"],"is_oa":false,"oa_url":null,"cited_by_count":41,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"protocol/overview of a research unit; no empirical data reported","sample_n":null,"sample_text":"No participants reported","population":"unspecified adult participants future recruitment","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article outlines a German research program that will study how emotions, cognition, and brain processes contribute to online activities like gaming, pornography, shopping, and social‑network use, but it does not report any actual findings.","clinical_takeaway":"None – the paper is a research protocol and provides no clinical evidence.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Comprehensive multi‑method plan","Focus on common mechanisms across online behaviours","Includes longitudinal follow‑up"],"limitations":["No empirical data presented","No information on measurement validity or confound control","Cannot assess statistical power or neuroimaging quality"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":32,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/adb.13087"}},{"id":1765,"doi":"10.1111/jssr.12496","pmid":"30349145","pmcid":"PMC6195355","title":"Religiosity Reduces Sexual Aggression and Coercion in a Longitudinal Cohort of College Men: Mediating Roles of Peer Norms, Promiscuity, and Pornography","authors":"Hagen T, Thompson MP, Williams J.","first_author":"Hagen T","journal":"Journal for the scientific study of religion","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Promiscuity","Peer Norms","Religiosity","Sexual Aggression","Pornography","Technology-based Coercive Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"four‑year prospective cohort of college men (convenience sample)","sample_n":null,"sample_text":"convenience cohort; likely >100 participants","population":"male college students (U.S.?)","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a four‑year study of male college students, higher religiosity predicted lower sexual aggression and tech‑based coercion. The link was partly explained by less peer pressure, fewer sexual partners and lower pornography use.","clinical_takeaway":"Religiosity may indirectly protect against sexual aggression through reduced exposure to pornography and fewer casual sex partners.","confidence":0.8,"topic_tags":["religiosity","sexual_function","pornography"],"strengths":["Longitudinal design allows temporal ordering","Tests mediation pathways","Considers multiple psychosocial mediators"],"limitations":["Convenience college sample limits generalisability","Reliance on self‑report, likely unvalidated scales","Key confounds (mental health, trauma, moral incongruence) not measured"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":16,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jssr.12496"}},{"id":1766,"doi":"10.1186/s40359-024-02297-1","pmid":"39849633","pmcid":"PMC11756164","title":"Boy's love fans versus non-fans in the sexual identity and neural response in the digital age's young females","authors":"Ao N, Jiang X, Chen Y, Du F, Chen Y, Niu H, Hu S, Wang M.","first_author":"Ao N","journal":"BMC psychology","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Fnirs","Young Female","Boys’ Love"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11756164","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of BL fans vs non‑fans; fNIRS task comparing neural Oxy‑Hb response to BL‑love vs heterosexual‑love stimuli; convenience sample of young females; no longitudinal or experimental manipulation.","sample_n":null,"sample_text":"Not specified in abstract; likely modest (≤30 per group).","population":"young female participants (students/online volunteers); fan status self‑reported","country":"China (authors' affiliations suggest), not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed young women who like Boys' Love (BL) media and measured their brain response to BL vs heterosexual love scenes using fNIRS. Fans showed weaker prefrontal activation to BL scenes, which the authors suggest may reflect reduced reward sensitivity after long‑term exposure, though the study is cross‑sectional and limited.","clinical_takeaway":"No direct clinical implications; findings are preliminary and based on a small, non‑representative sample.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Combines survey and neural measurement","Uses objective fNIRS data","Direct comparison of fan vs non‑fan groups"],"limitations":["Small, undefined sample size","Ad‑hoc questionnaires; no validated scales","No control for key confounds (moral, mental health, etc.)","Interpretation overreaches cross‑sectional data"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":5,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s40359-024-02297-1"}},{"id":1768,"doi":"10.1007/s10461-021-03412-8","pmid":"34342742","pmcid":"PMC8330174","title":"The Young Men and Media Study: A Pilot Randomized Controlled Trial of a Community-Informed, Online HIV Prevention Intervention for 14-17-Year-Old Sexual Minority Males","authors":"Nelson KM, Perry NS, Stout CD, Dunsiger SI, Carey MP.","first_author":"Nelson KM","journal":"AIDS and behavior","year":2022,"pub_types":["research-article","Randomized Controlled Trial","Journal Article"],"keywords":["Hiv Prevention","Randomized Trial","Ehealth","Pornography","Adolescent Sexual Minority Males"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8330174","cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"pilot randomized controlled trial with 154 adolescents (14‑17) randomized to an online HIV‑prevention program versus control websites; outcomes measured at post‑intervention","sample_n":154,"sample_text":"N = 154 (77 per arm); 65 intervention participants logged in and completed modules","population":"adolescent sexual minority males, United States, recruited online","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A small trial tested an online program that teaches gay teens about safer sex and how porn differs from real male‑male sex. Teens used the site, liked it, learned more about HIV and about porn, and reported fewer false beliefs about how porn portrays gay sex.","clinical_takeaway":"Online, youth‑friendly modules that address porn literacy can raise HIV knowledge among teenage gay males.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Randomized design","Community‑informed intervention","Acceptability data from participants"],"limitations":["Pilot sample small for efficacy conclusions","Outcome measures appear ad‑hoc and not validated","No control for known confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":39,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-021-03412-8"}},{"id":1769,"doi":"10.21203/rs.2.11987/v1","pmid":null,"pmcid":null,"title":"Factors determining premarital sexual practice of school students, institutional based cross sectional study in northern Ethiopia","authors":"Girmay A, Marye T, Gerensea H.","first_author":"Girmay A","journal":"Research Square","year":2019,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-2781/v1.pdf","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"institution-based convenience survey of school students in northern Ethiopia","sample_n":null,"sample_text":"292 females (52.1% of sample); total N not given","population":"school students aged 13‑23 in northern Ethiopia (N not reported in abstract)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A school‑based survey in northern Ethiopia found that about one‑fifth of students had engaged in premarital sex. Watching pornography, peer pressure, money, and family discussions were linked to higher odds of sexual activity.","clinical_takeaway":"Clinicians should consider contextual factors—not just pornography exposure—when discussing sexual health with adolescents.","confidence":0.6,"topic_tags":["pornography","adolescents"],"strengths":["Addresses an understudied region","Identifies multiple contextual correlates"],"limitations":["Cross‑sectional design, cannot infer causality","No validated scales for pornography exposure or sexual behaviour","No control for key confounders (moral, mental‑health, trauma)","Sample size and power not reported"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":5,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.2.11987/v1"}},{"id":1771,"doi":"10.1111/1556-4029.14820","pmid":"34328219","pmcid":null,"title":"Online child pornography offender risk assessment using digital forensic artifacts: The need for a hybrid model","authors":"Rogers MK, Seigfried-Spellar KC, Bates S, Rux K.","first_author":"Rogers MK","journal":"Journal of forensic sciences","year":2021,"pub_types":["Journal Article"],"keywords":["risk assessment","Digital Forensics","Child Sexual Exploitation Material","Forensic Artifacts","Offender Behavior","Online Sexual Offenses Against Children"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"conceptual discussion of a hybrid risk‑assessment model; no new data collected","sample_n":null,"sample_text":"Not applicable – article proposes a model without reporting an empirical sample","population":"online child‑pornography offenders (discussion only)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that assessing the risk of people who possess child sexual abuse material would be more accurate if traditional offender risk tools were combined with data from digital‑forensic artifacts, proposing a new hybrid assessment model.","clinical_takeaway":"None – the piece is a conceptual proposal, not an evidence‑based guide for practice.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Addresses a gap in offender risk prediction","Integrates digital‑forensic evidence with existing tools"],"limitations":["No empirical data presented","No validation of the proposed hybrid model","Lacks discussion of potential confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1556-4029.14820"}},{"id":1772,"doi":null,"pmid":"2216139","pmcid":null,"title":"On sexually explicit questioning","authors":"Somerfield SD.","first_author":"Somerfield SD.","journal":"The New Zealand medical journal","year":1990,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":1773,"doi":"10.1080/10410236.2021.1958985","pmid":"34323637","pmcid":null,"title":"Pornography, Sexual Insecurity, and Orgasm Difficulty","authors":"Wright PJ, Tokunaga RS, Herbenick D, Paul B.","first_author":"Wright PJ","journal":"Health communication","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large national probability survey, cross‑sectional mediation analysis","sample_n":null,"sample_text":"U.S. population‑based probability study (NSPRSS)","population":"U.S. adults, probability sample","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a U.S. national survey, people who watch porn more often reported feeling less secure about their sexual performance and attractiveness, and this insecurity was linked to more difficulty reaching orgasm. Partner pressure to watch porn showed a similar pattern.","clinical_takeaway":"Higher porn use may be associated with orgasm difficulty via sexual insecurity; clinicians might explore insecurity and partner dynamics when addressing orgasm problems.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["nationally representative probability sample","examines mediating psychological mechanism","controls for several confounds"],"limitations":["cross‑sectional design limits causal inference","moral incongruence and masturbation not measured","unclear which mental‑health variables were controlled"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":1,"mentioning":3,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2021.1958985"}},{"id":1774,"doi":"10.3389/fpsyg.2017.02299","pmid":"29467683","pmcid":"PMC5808158","title":"Lacan and Adolescence: The Contemporary Clinic of the \"Sexual Non-rapport\" and Pornography","authors":"Ouvry O.","first_author":"Ouvry O.","journal":"Frontiers in psychology","year":2017,"pub_types":["brief-report","Journal Article"],"keywords":["Adolescence","Pornography","Conspiracy Thought","Sexual Non-rapport","The Real Of Puberty","The Adolescent Boy","The Other Jouissance"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5808158","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"brief theoretical report; no empirical data, no sample","sample_n":null,"sample_text":"none (theory article)","population":"adolescent boys (theoretical focus)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","circular_addiction_scale","self_selected_sample"],"stance":"supports","citation_value":"background","plain_summary":"The paper uses Lacanian psycho‑analysis to argue that adolescent boys view porn like a conspiracy theory, denying changes that puberty brings. It offers a theoretical lens but provides no data.","clinical_takeaway":"None – the article is purely theoretical and does not give actionable clinical guidance.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Integrates psycho‑analytic theory with contemporary phenomena","Identifies a novel conceptual link between pornography and conspiracy thinking"],"limitations":["No empirical data or measurement of constructs","No operational definitions or validated scales","Claims not grounded in systematic evidence"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2017.02299"}},{"id":1775,"doi":"10.1371/journal.pone.0313953","pmid":"39820808","pmcid":"PMC11737711","title":"Automatic classification of mobile apps to ensure safe usage for adolescents","authors":"Hakami H.","first_author":"Hakami H.","journal":"PloS one","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11737711","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"methodological machine‑learning classification of mobile apps; no human participants; dataset of app descriptors used to train and test attentional CNN models.","sample_n":null,"sample_text":"N/A – study uses a corpus of mobile‑app data, not human participants.","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper presents a deep‑learning system that classifies mobile apps as safe or potentially harmful for teens, flagging categories like porn, violence, and hate speech with about 89% accuracy.","clinical_takeaway":"None – the study does not provide evidence about individual sexual health or behavior.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Innovative use of A‑CNN with transformer embeddings","High reported recall for detecting prohibited content","Comparison with multiple ML/DL baselines"],"limitations":["No human participant data; cannot validate real‑world impact on adolescents","Lacks external validation on independent app stores","Potential over‑statement of “ensuring safe usage” without behavioural outcomes"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0313953"}},{"id":1776,"doi":"10.1556/2006.2024.00067","pmid":"39786377","pmcid":"PMC11974442","title":"Feels good, and less bad: Problematic use of the Internet is associated with heightened experiences of both gratification and compensation","authors":"Wegmann E, Antons S, Schmidt LD, Klein L, Montag C, Rumpf HJ, Müller SM, Brand M.","first_author":"Wegmann E","journal":"Journal of behavioral addictions","year":2025,"pub_types":["research-article","Multicenter Study","Clinical Study","Journal Article"],"keywords":["Negative Reinforcement","Positive Reinforcement","Internet Addiction","Behavioral Addictions","Gaming Disorder","Internet-use Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11974442","cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional analysis of 834 participants from a multi‑center clinical study of Internet‑use disorders (gaming, buying‑shopping, pornography, social‑network).","sample_n":834,"sample_text":"834 participants from a multi‑center study (FOR2974).","population":"adults and adolescents with non‑problematic, risky, or pathological Internet use (DSM‑5‑based diagnostic interview).","country":"unspecified (multicenter, likely Germany/Europe).","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 834 people, those with the most severe Internet‑use problems reported the highest feelings of using the internet to ‘compensate’ for negative feelings, while still experiencing high pleasure. This pattern was consistent across different online activities, including pornography.","clinical_takeaway":"Both pleasure and compensatory motives are important in problematic Internet use; assessment should consider both.","confidence":0.7,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Large sample size (N=834).","Multi‑center data collection.","Addresses both positive and negative reinforcement."],"limitations":["Cross‑sectional design limits causal inference.","Key constructs (EGS/ECS) not reported as validated.","No control for moral, mental‑health or relationship confounds.","Addiction classification relies on DSM‑5 gaming criteria applied to other behaviors."],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00067"}},{"id":1777,"doi":"10.31234/osf.io/vpydn","pmid":null,"pmcid":null,"title":"Delineating non-consensual sexual image offending: Towards an empirical approach","authors":"Harper CA, Fido D, Petronzi D.","first_author":"Harper CA","journal":"PsyArXiv","year":2019,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/vpydn","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary/theoretical article without empirical data","sample_n":null,"sample_text":"","population":"none","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors discuss why non‑consensual sexual image offenses (e.g., revenge porn, upskirting) occur, proposing psychological concepts to link legal and scientific views, but they do not provide new data.","clinical_takeaway":"None – the paper is theoretical and does not offer clinical guidance.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Integrates legal and psychological perspectives","Identifies gaps in current research"],"limitations":["No empirical data presented","Lacks operational definitions of key constructs","No methodological rigor to evaluate"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/vpydn"}},{"id":1778,"doi":"10.1007/s10508-021-02022-8","pmid":"34184158","pmcid":null,"title":"Sexual Language Use in U.S. College Students Across Twenty Years","authors":"Murnen SK, Bullock PE, Tetreault EJ, Matteson SA, Redman L.","first_author":"Murnen SK","journal":"Archives of sexual behavior","year":2021,"pub_types":["Journal Article"],"keywords":["Degradation","Pornography","Sexual Language"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of college students comparing language use across 20 years; two convenience samples from one campus.","sample_n":398,"sample_text":"256 women, 129 men, 13 nonbinary (Study 1); additional 180 participants in Study 2","population":"U.S. college students (mostly heterosexual, mixed gender)","country":"USA","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared how U.S. college students label genitals and sex today versus 20 years ago, finding less degrading language overall but an increase among some women. Pornography use and stereotypical sexual attitudes were linked to more degrading language.","clinical_takeaway":"None – findings describe language trends, not direct clinical implications.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large community‑based college sample","Longitudinal comparison with data from 20 years earlier","Clear coding scheme for language"],"limitations":["Convenience sample from a single campus – limited generalisability","Key constructs (pornography use, attitudes) measured with single‑item or non‑validated scales","No control for major confounds (moral incongruence, mental health, partner effects)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02022-8"}},{"id":1780,"doi":"10.30773/pi.2020.0401","pmid":"34130441","pmcid":"PMC8256136","title":"Reliability, Validity, and Unidimensionality of the Korean Version of the Pornography Craving Questionnaire Based on the Classical Test Theory and Item Response Theory","authors":"Kim SR, Bhang SY, Lim EY, Huh S, Lee SK, Kraus SW, Potenza MN.","first_author":"Kim SR","journal":"Psychiatry investigation","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Measurement","Sexual behavior","Reproducibility of results","Validation Study","Item Response Memory"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8256136","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a self‑report questionnaire with 226 Korean university students","sample_n":226,"sample_text":"students","population":"Korean university students (N=226)","country":"South Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The Korean version of the Pornography Craving Questionnaire was tested in 226 students and found to be a reliable, single‑factor tool for measuring cravings to view porn, with consistent performance across genders.","clinical_takeaway":"The K‑PCQ can be used as a brief, validated screening measure of pornography craving in Korean‑speaking clinical or research settings.","confidence":0.85,"topic_tags":["measurement","pornography","sexual_function","csbd"],"strengths":["Robust psychometric methods (CFA, IRT, DIF)","Adequate sample size for validation","Gender invariance tested"],"limitations":["Convenience student sample, limited generalizability","No assessment of related confounds (e.g., mental health, moral factors)","No pre‑registration"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.30773/pi.2020.0401"}},{"id":1781,"doi":"10.1016/j.jpag.2010.10.004","pmid":"21190872","pmcid":"PMC3057270","title":"Sexpectations: male college students' views about displayed sexual references on females' social networking web sites","authors":"Moreno MA, Swanson MJ, Royer H, Roberts LJ.","first_author":"Moreno MA","journal":"Journal of pediatric and adolescent gynecology","year":2011,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"focus groups with 28 male college students at a single large state university","sample_n":28,"sample_text":"28 participants (7 focus groups)","population":"heterosexual male college students, ages 18‑23; convenience sample from one university","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In focus groups, male college students said that seeing sexual references on women’s public social‑media profiles made them expect more sexual activity and reduced their interest in dating those women.","clinical_takeaway":"Clinicians should note that young men may interpret online sexual cues as pressure for sexual activity, which can affect dating decisions.","confidence":0.72,"topic_tags":["sexual_function"],"strengths":["Uses participants’ own words to capture nuanced perceptions","Clear thematic analysis process described"],"limitations":["Small, non‑representative convenience sample","No validated measures of sexual expectations or related constructs","No assessment of potential confounding variables (e.g., religiosity, mental health)"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":15,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpag.2010.10.004"}},{"id":1782,"doi":"10.1080/0092623x.2021.1937416","pmid":"34120580","pmcid":null,"title":"New Zealand Women's Experience of Intimacy Within Heterosexual Relationships: Influence of Partners' Perceived Pornography Use","authors":"Adamson SJ, Martin A, Deering DEA, Boden JM.","first_author":"Adamson SJ","journal":"Journal of sex & marital therapy","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 136 community women in New Zealand","sample_n":136,"sample_text":"136 NZ heterosexual women","population":"heterosexual women (NZ), community sample","country":"New Zealand","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 136 New Zealand women, a partner’s frequent porn viewing was linked to lower emotional, sexual, intellectual and recreational intimacy, but only for women who held strong negative attitudes toward porn.","clinical_takeaway":"Clinicians should consider a woman’s moral stance toward pornography when discussing relationship intimacy issues.","confidence":0.73,"topic_tags":["pornography","relationships","sexual_function","moral_incongruence"],"strengths":["Relatively large community sample for this topic","Use of validated intimacy subscales","Controls for basic demographics"],"limitations":["Cross‑sectional; cannot infer causality","Partner pornography use based on women’s perception only","Key confounds (masturbation, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2021.1937416"}},{"id":1783,"doi":"10.3390/healthcare13010005","pmid":"39791612","pmcid":"PMC11720194","title":"Exploring the Intersection of Hegemonic Masculinity, Sexuality, and Addiction in Men: A Qualitative Study","authors":"Camacho-Ruiz JA, Galvez-Sánchez CM, Galli F, Limiñana-Gras RM.","first_author":"Camacho-Ruiz JA","journal":"Healthcare (Basel, Switzerland)","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Men","Addiction","Self-esteem","Hegemonic Masculinity"],"is_oa":true,"oa_url":"https://www.mdpi.com/2227-9032/13/1/5/pdf?version=1735029648","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Purposive sample of 14 men in a therapeutic community; semi‑structured interviews and participant observation; content analysis.","sample_n":14,"sample_text":"Fourteen participants selected through purposive sampling until data saturation.","population":"Men in addiction treatment (Spain)","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 14 men in a drug‑treatment centre in Spain show that pressure to act according to hegemonic masculinity—constant sexual availability, use of pornography and prostitution—relates to their substance addictions and sexual problems.","clinical_takeaway":"Consider gender‑sensitive approaches that address masculine norms when treating men with addiction‑related sexual issues.","confidence":0.5,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Adheres to SRQR and COREQ reporting standards","In‑depth qualitative insight into masculine norms","Triangulation with participant observation"],"limitations":["Small, treatment‑seeking convenience sample","No validated measures of pornography use or addiction","No control for moral incongruence, masturbation, mental health, or trauma"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":2,"contrasting":0,"mentioning":4,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare13010005"}},{"id":1786,"doi":"10.3389/frph.2024.1491617","pmid":"39749225","pmcid":"PMC11693712","title":"The magnitude of casual sex and associated factors among students at Debre Berhan University","authors":"Mathewos T, Tesfahun E, Aemiro MT, Dejene TM.","first_author":"Mathewos T","journal":"Frontiers in reproductive health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Students","Ethiopia","Associated Factors","Casual Sex","Debre Berhan University"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11693712","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 512 undergraduate students using multistage random sampling; logistic regression to identify factors associated with self‑reported casual sex.","sample_n":512,"sample_text":"512 students recruited via multistage random sampling from colleges, departments and academic years.","population":"regular undergraduate students at Debre Berhan University, Ethiopia (N≈512)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 2024 survey of 512 Ethiopian university students found that about one‑third had engaged in casual sex. Factors linked to higher odds included urban background, poor grades, drinking alcohol, attending nightclubs, watching pornography, and peer pressure.","clinical_takeaway":"None - not clinically applicable","confidence":0.7,"topic_tags":["prevalence","sexual_function","pornography"],"strengths":["Large sample for a single university","Random sampling within university","Multivariate analysis with adjusted odds ratios"],"limitations":["Cross‑sectional; cannot infer causality","Self‑report measures, no validated scales","No control for moral or mental‑health variables"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/frph.2024.1491617"}},{"id":1787,"doi":"10.1177/10790632241309631","pmid":"39701945","pmcid":"PMC12301510","title":"Online Sexual Offending Against Children: Recidivism Rates and Predictors","authors":"Paquette S, Brouillette-Alarie S.","first_author":"Paquette S","journal":"Sexual abuse : a journal of research and treatment","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Child Sexual Abuse","Dynamic Risk Factors","Recidivism","Online Sexual Offending","Child Sexual Exploitation Material"],"is_oa":true,"oa_url":"https://doi.org/10.1177/10790632241309631","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Observational cohort of convicted adult males (N=228) with follow‑up for recidivism; risk factors examined using predictive models.","sample_n":228,"sample_text":"228 adult males who had committed sexual and nonsexual offenses at their index crime.","population":"Adult male sexual offenders (online child exploitation).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study followed 228 adult men convicted of online child sexual exploitation and found that certain cognitions and emotional attitudes toward children predicted future sexual offenses, while consumption of illegal material predicted online re‑offending.","clinical_takeaway":"Risk assessments for sexual offenders should consider offense‑supportive thoughts and emotional attitudes toward children, not just material consumption.","confidence":0.8,"topic_tags":["sexual_function","relationships","pornography"],"strengths":["Large sample for offender research (N=228).","Use of predictive statistics (Harrell's C).","Focus on specific risk factors for recidivism."],"limitations":["Risk measures not described as validated.","No control for key confounds (mental health, trauma).","Unclear whether follow‑up period is adequate."],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632241309631"}},{"id":1788,"doi":"10.32641/andespediatr.v92i3.3374","pmid":"34479256","pmcid":null,"title":"Use of Tanner stages to estimate chronological age in alleged child pornography cases: A systematic review","authors":"Oliván-Gonzalvo G, Sánchez-Quiroz PL, de la Parte Serna AC.","first_author":"Oliván-Gonzalvo G","journal":"Andes pediatrica : revista Chilena de pediatria","year":2021,"pub_types":["Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.revistachilenadepediatria.cl/index.php/rchped/article/download/3374/3447","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 7 studies (3 literature reviews, 4 case studies with expert testimony). PRISMA‑guided search of PubMed and Scopus (2000‑2020). No meta‑analysis, no formal risk‑of‑bias assessment reported.","sample_n":null,"sample_text":"Seven included studies; three were literature reviews and four were individual case reports.","population":"Images of alleged child victims in child‑pornography investigations; no human participants recruited by the authors.","country":"Not specified (studies from United States, Asia, Europe).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of seven studies found that using Tanner sexual‑development stages to estimate a child’s exact age from pornographic images is unreliable, especially for stages 3‑5. It may only help confirm that a child is under 18 when the stage is 1‑2.","clinical_takeaway":"Medical experts should avoid giving age estimates based on Tanner staging for child‑pornography cases; rely on more robust forensic methods.","confidence":0.7,"topic_tags":["treatment","prevalence"],"strengths":["Focused forensic question","Systematic search strategy (PRISMA)","Identifies consistent lack of evidence for age estimation using Tanner stages"],"limitations":["Small number of heterogeneous studies","No quantitative synthesis or risk‑of‑bias assessment","Reliance on case reports limits generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.32641/andespediatr.v92i3.3374"}},{"id":1789,"doi":"10.4081/jphr.2021.2338","pmid":"34060744","pmcid":"PMC9309623","title":"Sexual violence experiences and pornography media exposure with sexual risk behavior among PLWHA MSM in Bandung, Indonesia","authors":"Rahmayani M, Waluyo A, Maria R.","first_author":"Rahmayani M","journal":"Journal of public health research","year":2021,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9309623","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"consecutive sampling of 258 PLWHA MSM via NGO, online questionnaire","sample_n":258,"sample_text":"258 PLWHA MSM recruited through an NGO using consecutive sampling","population":"people living with HIV/AIDS who are men who have sex with men (MSM), Bandung, Indonesia","country":"Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 258 HIV‑positive men who have sex with men in Indonesia, those who reported experiencing sexual violence or watching pornographic media were more likely to engage in risky sexual behaviors.","clinical_takeaway":"Among HIV‑positive MSM, pornography exposure correlates with higher sexual risk; clinicians should assess media use alongside other risk factors.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Relatively large sample for a specific high‑risk group","Uses multivariate logistic regression to adjust for some variables"],"limitations":["Cross‑sectional design limits causal inference","No validated measures for pornography exposure or sexual risk behavior","Key confounds (moral incongruence, mental health, partner factors) not assessed"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4081/jphr.2021.2338"}},{"id":1791,"doi":"10.1016/j.clineuro.2017.10.026","pmid":"29145040","pmcid":null,"title":"Pornography headache","authors":"Chen WH, Chen KY, Yin HL.","first_author":"Chen WH","journal":"Clinical neurology and neurosurgery","year":2018,"pub_types":["Journal Article","Case Reports"],"keywords":["Sexual activity","Headache","Heterosexual","Pornography","Erotic"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case report of a young man with pornography‑triggered pre‑orgasmic headache; no control group","sample_n":1,"sample_text":"1 patient","population":"male, young adult (single case)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A young man experienced headaches only when viewing certain pornographic material, not during other sexual activity. The authors suggest a unique ‘pornography headache’ caused by cerebrovascular changes and note that indomethacin helped prevent the pain.","clinical_takeaway":"Clinicians should consider pornography‑triggered headache as a possible diagnosis, but evidence is limited to a single case.","confidence":0.8,"topic_tags":["pornography","sexual_function","neuroscience"],"strengths":["Detailed clinical description of a rare phenomenon","Objective response to indomethacin reported"],"limitations":["Single case; no systematic assessment of confounders","No validated measures of pornography exposure or headache severity","Claims about a new disorder are speculative"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.clineuro.2017.10.026"}},{"id":1792,"doi":"10.1016/j.chiabu.2021.105133","pmid":"34051488","pmcid":null,"title":"Collecting and viewing behaviors of child sexual exploitation material offenders","authors":"Steel CMS, Newman E, O'Rourke S, Quayle E.","first_author":"Steel CMS","journal":"Child abuse & neglect","year":2021,"pub_types":["Journal Article"],"keywords":["Recidivism","Novelty Seeking","Child Pornography","Child Sexual Exploitation Material","Collecting Behavior"],"is_oa":false,"oa_url":"https://www.pure.ed.ac.uk/ws/files/211267147/SteelEtal2021CANCollectingAndViewingBehaviors.pdf","cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of previously convicted CSEM offenders (N=78) compared to a gender‑matched non‑offender sample (N=524). Postal recruitment; mixed‑methods descriptive analyses.","sample_n":78,"sample_text":"78 offenders; 524 non‑offenders (gender‑matched).","population":"Adults with prior CSEM convictions (U.S.) vs general adult population.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 78 people convicted of possessing child sexual exploitation material compared them with 524 non‑offenders. Offenders also viewed a wide range of adult pornography and often deleted their collections. The authors suggest that pedophilic interest may not be the only driver; novelty seeking and general internet use could be important treatment targets.","clinical_takeaway":"Treatment should address broader internet‑use patterns and coping issues, not assume pedophilia alone drives offending.","confidence":0.8,"topic_tags":["csbd"],"strengths":["Large non‑offender comparison group","Mixed‑methods approach provides qualitative insight","Focus on collecting behavior beyond pedophilic interest"],"limitations":["Convenience sample of offenders; low response rate likely","Self‑report data, including recidivism, may be biased","No validated measures; constructs operationalised ad hoc","Key confounds (morality, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":18,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2021.105133"}},{"id":1793,"doi":"10.1080/0092623x.2021.1930308","pmid":"34032184","pmcid":null,"title":"Pornography and Romantic Relationships: A Qualitative Examination of Individual Experiences","authors":"Shuler J, Brosi M, Spencer T, Hubler D.","first_author":"Shuler J","journal":"Journal of sex & marital therapy","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Cross‑sectional qualitative study using thematic analysis of 588 open‑ended responses about pornography’s impact on romantic relationships.","sample_n":588,"sample_text":"588 participants provided open‑ended responses.","population":"Adults in romantic relationships who completed a larger survey on couples’ media use; convenience sample.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"The study asked people in relationships how porn use affected them. Most said it had no impact; some reported more sexual variety and satisfaction, while others noted feelings of inadequacy or betrayal. Themes show a mixed picture of porn’s role in couples.","clinical_takeaway":"Clinicians should explore each couple’s unique experience of pornography rather than assuming it is uniformly helpful or harmful.","confidence":0.7,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Large qualitative dataset (N=588)","Systematic thematic analysis","Identifies both positive and negative perceived effects"],"limitations":["No measurement of key confounds (moral incongruence, masturbation, mental health)","Convenience sample; limited generalisability","No validated quantitative scales used"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2021.1930308"}},{"id":1794,"doi":"10.1177/10790632211013809","pmid":"33993800","pmcid":null,"title":"Effects of Automated Messages on Internet Users Attempting to Access \"Barely Legal\" Pornography","authors":"Prichard J, Wortley R, Watters PA, Spiranovic C, Hunn C, Krone T.","first_author":"Prichard J","journal":"Sexual abuse : a journal of research and treatment","year":2022,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":["Situational Crime Prevention","Child Sexual Exploitation Material","Pop-ups","Deterrence Messages","Warning Banners"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized Controlled Trial with 5 arms (n=419 total) testing warning messages on click‑through to a honeypot CSEM site.","sample_n":419,"sample_text":"419 participants randomized across five conditions.","population":"Adults self‑selected from an online pool who attempted to access a honeypot site containing alleged “barely legal” pornography.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a randomized trial, warning messages about legal risk or police tracking reduced the likelihood that people would click through to a site offering illegal child sexual material.","clinical_takeaway":"Targeted deterrence messages can effectively lower immediate attempts to access illicit pornographic sites.","confidence":0.85,"topic_tags":["prevalence"],"strengths":["Randomized experimental design","Large overall sample for a behavioral deterrence study","Clear, observable outcome (click‑through)","Practical implications for online safety interventions"],"limitations":["No pre‑registration reported","Outcome limited to a single click; no follow‑up on longer‑term behavior","No assessment of participants' motivations or moral attitudes","Generalizability limited to individuals who self‑select to seek illegal content"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":32,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632211013809"}},{"id":1795,"doi":"10.1080/0092623x.2021.1923598","pmid":"33988489","pmcid":null,"title":"Pornography Use, Two Forms of Dehumanization, and Sexual Aggression: Attitudes vs. Behaviors","authors":"Zhou Y, Liu T, Yan HY, Paul B.","first_author":"Zhou Y","journal":"Journal of sex & marital therapy","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 320 male participants, self‑report measures of pornography use, dehumanization and sexual aggression","sample_n":320,"sample_text":"320 male participants (self‑selected, no indication of random or probability sampling)","population":"adult men, likely convenience sample (e.g., university or online panels)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 320 men found that more frequent pornography use was linked to two kinds of dehumanizing views of women, which in turn were related to hostile attitudes and aggressive actions toward women.","clinical_takeaway":"Higher porn consumption may be associated with attitudes that justify aggression; clinicians should consider dehumanization beliefs when addressing sexual aggression risk.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Relatively large sample for a survey study","Focus on distinct forms of dehumanization","Links pornography use to both attitudes and behaviors"],"limitations":["Cross‑sectional design cannot establish causality","Potentially unvalidated measures of dehumanization","No control for key confounds (e.g., personality, prior aggression)","Convenience sample limits generalizability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2021.1923598"}},{"id":1798,"doi":"10.1017/s0033291724002794","pmid":"39641244","pmcid":null,"title":"Comorbidity of problematic substance use and other addictive behaviors and anxiety, depression, and post-traumatic stress disorder: a network analysis","authors":"Shmulewitz D, Levitin MD, Skvirsky V, Vider M, Eliashar R, Mikulincer M, Lev-Ran S.","first_author":"Shmulewitz D","journal":"Psychological medicine","year":2024,"pub_types":["Journal Article"],"keywords":["Depression","Anxiety","Post-traumatic Stress Disorder","Comorbidity","Network Analysis","Addictive Behaviors","Problematic Substance Use"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"network analysis of self‑report scales in a large community sample (N=4002)","sample_n":4002,"sample_text":"General population sample of Jewish adults in Israel (N=4002).","population":"Jewish adults in Israel, community‑based sample","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 4,000 Israeli adults, the study used network analysis to see how different addictions (including pornography) relate to mental‑health problems like depression, anxiety, and PTSD. It found that pornography‑related behavior clusters with other sexual‑behavior problems, while mental‑health issues were more linked to technology‑based addictions.","clinical_takeaway":"Problematic pornography use appears linked to broader sexual‑behavior issues, not directly to depression or anxiety; clinicians should assess the full pattern of addictive behaviors.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, community‑based sample (N>4000)","Comprehensive inclusion of many substance and behavioral addictions","Network analysis isolates unique associations while adjusting for all variables"],"limitations":["Cross‑sectional design; no causal inference","Constructs measured with self‑report scales, validation not specified","No control for key confounds (moral incongruence, masturbation, mental‑health covariates beyond the main outcomes)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0033291724002794"}},{"id":1799,"doi":"10.1016/j.esxm.2021.100342","pmid":"33964603","pmcid":"PMC8240335","title":"Changes in Sexual Fantasy and Solitary Sexual Practice During Social Lockdown Among Young Adults in the UK","authors":"Cascalheira CJ, McCormack M, Portch E, Wignall L.","first_author":"Cascalheira CJ","journal":"Sexual medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Masturbation","Desire","Fantasy","Sexual Practice","Lockdown","Covid-19","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8240335","cited_by_count":20,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience sample of 565 UK adults, anonymous web‑based questionnaire, mixed‑method analyses, dichotomous outcomes (increase vs no change).","sample_n":565,"sample_text":"Convenience sample, not probability based.","population":"Young adults 18‑32 years, UK, recruited online during COVID‑19 lockdown.","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"During the UK COVID‑19 lockdown, about one‑third of young adults reported more sexual fantasies and solitary sexual activity, especially women and those living alone. Increases were linked to boredom and less partnered sex.","clinical_takeaway":"Clinicians should ask about changes in fantasy and solo sexual activity when assessing pandemic‑related stress, but note these findings are exploratory.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large (N>500) convenience sample","Timely data on pandemic‑related sexual behavior","Mixed‑method (quantitative + qualitative) approach"],"limitations":["Study‑specific, unvalidated measures","Cross‑sectional, no causal inference","Limited control for key confounds (moral, mental health, trauma)","Convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":28,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2021.100342"}},{"id":1801,"doi":"10.1007/s10508-017-1080-8","pmid":"28936726","pmcid":null,"title":"Pornography Use and Marital Separation: Evidence from Two-Wave Panel Data","authors":"Perry SL.","first_author":"Perry SL.","journal":"Archives of sexual behavior","year":2018,"pub_types":["Journal Article"],"keywords":["Separation","Relationships","Marriage","Divorce","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two‑wave nationally representative panel (N=445) with binary logistic regression predicting marital separation from 2006 pornography use.","sample_n":445,"sample_text":"N = 445 married respondents","population":"married adults in the United States (Portraits of American Life Study)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a two‑wave U.S. survey, couples who watched any pornography in 2006 were about twice as likely to separate by 2012, even after accounting for marital happiness and sexual satisfaction. The link was not linear; very frequent viewers did not differ much from abstainers.","clinical_takeaway":"Clinicians might consider discussing pornography use with couples as one factor that could influence marital stability, but should also weigh many other relational variables.","confidence":0.7,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Large, nationally representative longitudinal sample","Controls for baseline marital happiness and sexual satisfaction","Clear statistical model (logistic regression)"],"limitations":["No measurement of masturbation or moral/religious factors","Reliance on self‑report frequency without validated scale","No effect‑size confidence intervals reported"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-1080-8"}},{"id":1803,"doi":"10.1080/10410236.2021.1917745","pmid":"33886380","pmcid":null,"title":"Pornography Consumption and Condomless Sex among Emerging U.S. Adults: Results from Six Nationally Representative Surveys","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Health communication","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative, cross‑sectional surveys of 18‑24‑year‑old U.S. adults (N large, multiple waves).","sample_n":null,"sample_text":"Six nationally representative survey waves (2008‑2018).","population":"Unmarried U.S. emerging adults (age 18‑24), community sample.","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Survey data from U.S. 18‑24‑year‑olds showed that people who watch porn are more likely to have sex without condoms, even after accounting for age, gender and sensation‑seeking traits.","clinical_takeaway":"Clinicians may discuss pornography exposure when counseling young adults about safer‑sex practices.","confidence":0.7,"topic_tags":["pornography","sexual_function","religiosity","adolescents"],"strengths":["Large, nationally representative sample","Multiple survey waves increase robustness","Controls for key demographic and sensation‑seeking variables"],"limitations":["Cross‑sectional; cannot establish causality","Reliance on single‑item self‑report measures","No assessment of moral incongruence, masturbation, mental health or partner context"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2021.1917745"}},{"id":1805,"doi":"10.3389/frph.2024.1436615","pmid":"39665037","pmcid":"PMC11631782","title":"Risky sexual practices and associated factors among taxi drivers in the Finoteselam town, northwest Ethiopia, 2023: a community-based cross-sectional study","authors":"Laikemariam M, Fetene Y.","first_author":"Laikemariam M","journal":"Frontiers in reproductive health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behaviour","Ethiopia","Taxi Drivers","Risky Sexual Practice","Adverse Sexual Practice"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11631782","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 359 taxi drivers in Finoteselam town, Ethiopia; pre‑tested questionnaire; logistic regression analysis","sample_n":359,"sample_text":"359 taxi drivers recruited from the town; convenience/community sampling","population":"taxi drivers (mostly male, adult, Ethiopia)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a town in northwest Ethiopia, about one‑third of taxi drivers reported risky sexual behaviours. Factors linked to higher risk included living alone, owning a taxi, not discussing sexual health, using substances, going to night clubs, and watching pornography.","clinical_takeaway":"Screening for porn exposure and associated lifestyle factors may help target sexual‑health interventions among high‑risk groups.","confidence":0.85,"topic_tags":["religiosity","pornography","relationships","sexual_function"],"strengths":["Reasonable sample size for a community survey","Use of multivariable logistic regression with confidence intervals","Identifies multiple contextual factors associated with risky sex"],"limitations":["Cross‑sectional design limits causal inference","Questionnaire items and definitions not reported as validated","Key psychosocial confounds (e.g., moral incongruence, mental health) not measured"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/frph.2024.1436615"}},{"id":1806,"doi":"10.1556/2006.6.2017.057","pmid":"28889754","pmcid":"PMC5700731","title":"The development and initial evaluation of the Pornography-Use Avoidance Self-Efficacy Scale","authors":"Kraus SW, Rosenberg H, Martino S, Nich C, Potenza MN.","first_author":"Kraus SW","journal":"Journal of behavioral addictions","year":2017,"pub_types":["research-article","Evaluation Study","Journal Article"],"keywords":["Scale Development","Self-efficacy","Hypersexuality","Pornography","Situational Confidence"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5700731","cited_by_count":20,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet‑based survey of 229 male pornography users who had sought or considered seeking professional help; self‑report questionnaires; factor analysis of a newly created self‑efficacy scale.","sample_n":229,"sample_text":"229 male pornography users (age 33.3 ± 12.2) recruited online, all had sought or considered seeking professional help for pornography use.","population":"male pornography users, mean age 33.3, self‑selected via online recruitment; not a probability sample","country":"unspecified (likely USA/International online sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created a questionnaire to see how confident men feel they can avoid porn in different situations. Higher confidence was linked to using porn less and to lower scores on a hypersexuality measure.","clinical_takeaway":"Self‑efficacy about avoiding porn may relate to use frequency, but the new scale needs further validation before clinical use.","confidence":0.8,"topic_tags":["measurement","sexual_function","pornography"],"strengths":["Large sample for a scale‑development study (N = 229)","Factor analysis identifies situational clusters","Links self‑efficacy to both use frequency and hypersexuality"],"limitations":["Convenience, treatment‑seeking sample limits generalisability","New scale not fully validated (reliability, predictive utility uncertain)","No control for moral incongruence, masturbation, mental‑health or relational factors"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.6.2017.057"}},{"id":1807,"doi":"10.1177/0004867417728807","pmid":"28891676","pmcid":null,"title":"Pornography use in sexual minority males: Associations with body dissatisfaction, eating disorder symptoms, thoughts about using anabolic steroids and quality of life","authors":"Griffiths S, Mitchison D, Murray SB, Mond JM.","first_author":"Griffiths S","journal":"The Australian and New Zealand journal of psychiatry","year":2018,"pub_types":["Journal Article"],"keywords":["Media","Body Image","Eating Disorders","Pornography","Sexual Minority Males"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 2733 sexual minority males; cross‑sectional","sample_n":2733,"sample_text":"2733 participants completed an online questionnaire","population":"sexual minority males, Australia & New Zealand","country":"Australia, New Zealand","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 2,733 gay, bisexual and other non‑heterosexual men, more time spent viewing porn was linked to slightly higher body‑image concerns, eating‑disorder symptoms, thoughts about using steroids and lower quality of life. Watching professional porn showed a stronger link to steroid thoughts than amateur porn.","clinical_takeaway":"Clinicians should be aware that higher porn use may be modestly associated with body‑image and eating‑disorder concerns in sexual‑minority men, but causality is unclear.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender","lgbtq"],"strengths":["Large sample size for a sexual‑minority population","Separate analysis of professional vs amateur pornography","Effect sizes reported with confidence about magnitude"],"limitations":["Cross‑sectional design prevents causal inference","Potential self‑selection bias from online recruitment","Pornography use measured only by self‑reported frequency"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":28,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0004867417728807"}},{"id":1810,"doi":"10.1177/08862605241298938","pmid":"39569724","pmcid":null,"title":"Sexual Double Standards and Violence in Intimate Partner Relationships: The Role of Empathy in the Consumption of Online Sexual Content","authors":"González-Marugán E, Felipe-Castaño E.","first_author":"González-Marugán E","journal":"Journal of interpersonal violence","year":2025,"pub_types":["Journal Article"],"keywords":["Sexual behavior","Empathy","Intimate Partner Violence","Pornography","Sexual Double Standards"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cluster sample of 490 university students (mean age 22, 70% female) completed validated questionnaires on sexual double standards, online sexual material use, empathy, and intimate partner violence in a classroom setting.","sample_n":490,"sample_text":"Cluster sampling of university students (N = 490).","population":"University students, young adults","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Among 490 university students, higher use of online sexual material was linked to more intimate‑partner violence, but empathy reduced this effect. Sexual double standards also related to violence.","clinical_takeaway":"Empathy may buffer the relationship between pornography consumption and partner aggression in young adults.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a survey study","Use of several validated scales","Statistical mediation model tested"],"limitations":["Cross‑sectional design, no causal inference","No measurement of moral attitudes or masturbation","Convenience sample of university students limits generalisability"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605241298938"}},{"id":1813,"doi":"10.2147/ahmt.s54339","pmid":"24729737","pmcid":"PMC3956478","title":"Effect of mass media and Internet on sexual behavior of undergraduates in Osogbo metropolis, Southwestern Nigeria","authors":"Asekun-Olarinmoye OS, Asekun-Olarinmoye EO, Adebimpe WO, Omisore AG.","first_author":"Asekun-Olarinmoye OS","journal":"Adolescent health, medicine and therapeutics","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Sexual behavior","Mass Media","Undergraduates"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3956478","cited_by_count":19,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Descriptive cross‑sectional survey of 400 Nigerian undergraduates selected by multistage random sampling; self‑report questionnaire on media use and sexual behaviours; logistic regression used for predictors.","sample_n":400,"sample_text":"400 completed questionnaires out of 450 distributed","population":"Undergraduate students (mean age 23.6 y) in Osogbo, Nigeria (N = 400)","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 400 Nigerian university students found that frequent Internet use was linked to higher odds of having sex and multiple partners, while viewing sexual material online was often seen as a bad influence. However, the study cannot prove that media cause these behaviours.","clinical_takeaway":"Media exposure is associated with risky sexual behaviour, but clinicians should consider other factors (e.g., personal values, mental health) before attributing causality.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Reasonable sample size for a survey","Multistage random sampling improves representativeness within university","Reports adjusted odds ratios with confidence intervals"],"limitations":["Cross‑sectional design cannot establish causality","No validated measures of pornography use or sexual addiction","Critical confounds (moral attitudes, mental health, partner context) not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":16,"contrasting":2,"mentioning":50,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/ahmt.s54339"}},{"id":1815,"doi":"10.1007/s13178-021-00573-y","pmid":"33815627","pmcid":"PMC8010488","title":"Not in the Brochure: <i>Porneia</i> and Residential Aged Care","authors":"Henrickson M, Cook CM, MacDonald S, Atefi N, Schouten V.","first_author":"Henrickson M","journal":"Sexuality research & social policy : journal of NSRC : SR & SP","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Ageing","Prostitution","Sex Work","Residential Aged Care","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8010488","cited_by_count":2,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"two‑arm mixed‑method cross‑sectional study (staff survey N=433 from 35 RAC, 61 interviews with residents, families, staff).","sample_n":433,"sample_text":"433 staff surveys; 61 interviews with 77 participants.","population":"staff, residents and families in residential aged‑care facilities in New Zealand.","country":"New Zealand","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed staff and interviewed residents, families and staff about access to sex workers, pornography and masturbation in New Zealand aged‑care homes, finding mixed attitudes and a need for clearer policies and education.","clinical_takeaway":"Facilities should develop clear, person‑centred sexuality policies and train staff to support resident sexual needs safely.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large staff sample across many facilities","Mixed‑methods design adds depth","Survey tool explicitly validated"],"limitations":["Convenience sampling; not nationally representative","No measurement of key confounds (e.g., moral attitudes, mental health)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13178-021-00573-y"}},{"id":1816,"doi":"10.3390/ejihpe11020023","pmid":"34708815","pmcid":"PMC8314359","title":"Young Adults' Qualitative Self-Reports of Their Outcomes of Online Sexual Activities","authors":"Courtice EL, Shaughnessy K, Blom K, Asrat Y, Daneback K, Döring N, Grov C, Byers ES.","first_author":"Courtice EL","journal":"European journal of investigation in health, psychology and education","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Cybersex","Online Pornography","Online Sexual Activity","Cybersexuality","Sexually Explicit Material Online"],"is_oa":true,"oa_url":"https://www.mdpi.com/2254-9625/11/2/23/pdf?version=1617938184","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey with open‑ended questions; convenience sample of university/college students from four countries (total n≈1,079).","sample_n":1079,"sample_text":"University/College students from Canada (n=246), Germany (n=411), Sweden (n=299), and the USA (n=123).","population":"Young adult university/college students (Canada, Germany, Sweden, USA).","country":"Canada; Germany; Sweden; USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Young adults from four countries wrote about the best and worst things that online sexual activities have done for them. While many noted positive effects like learning and personal growth, others reported negatives such as relationship or emotional issues. The study suggests that health and education professionals should consider both sides when addressing online sexual behaviour.","clinical_takeaway":"Clinicians should explore both potential benefits and harms of online sexual activities with clients, rather than assuming only negative effects.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large multi‑country sample","Systematic qualitative analysis","Inclusion of both positive and negative outcomes"],"limitations":["Convenience student sample, not representative","No measurement of key confounds (moral incongruence, masturbation, mental health)","Qualitative data lack psychometric validation"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ejihpe11020023"}},{"id":1818,"doi":"10.1089/cyber.2016.0362","pmid":"28806122","pmcid":null,"title":"Sexual Attitudes of Classes of College Students Who Use Pornography","authors":"Brown CC, Conner S, Vennum A.","first_author":"Brown CC","journal":"Cyberpsychology, behavior and social networking","year":2017,"pub_types":["Journal Article"],"keywords":["Motivation","Sexual Attitudes","Typologies","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"latent profile analysis of 635 college students; two time points (baseline and 3‑month follow‑up) to identify user classes and compare sexual attitudes","sample_n":635,"sample_text":"large convenience sample of university students","population":"college students (mean age ~20 years), mixed gender","country":"USA (assumed from author affiliations, not specified)","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 635 U.S. college students and, using statistical clustering, identified four distinct types of pornography users. It then examined how each type differed in sexual attitudes three months later, finding that attitudes varied with user class and religiosity.","clinical_takeaway":"Different patterns of porn use relate to distinct sexual attitudes; clinicians should consider individual usage profiles rather than assuming uniform effects.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for latent profile analysis","Use of validated scales for pornography use and sexual attitudes","Inclusion of religiosity to address moral incongruence"],"limitations":["Convenience college sample limits generalisability","Masturbation not measured or controlled","No assessment of mental health, partner effects, or trauma"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":1,"mentioning":15,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2016.0362"}},{"id":1819,"doi":"10.1080/10550887.2021.1895962","pmid":"33749537","pmcid":null,"title":"Prevalence of Internet-based addictive behaviors during COVID-19 pandemic: a systematic review","authors":"Masaeli N, Farhadi H.","first_author":"Masaeli N","journal":"Journal of addictive diseases","year":2021,"pub_types":["Systematic Review","Journal Article"],"keywords":["Internet Addiction","Pornography","Covid-19","Addictive Behaviors","Online Gambling","Smartphone Use","Internet Gaming Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":126,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of prevalence studies on internet‑based addictive behaviours (including pornography) during COVID‑19; quality assessed with GRADE; no meta‑analysis.","sample_n":null,"sample_text":"Not applicable – review of published studies.","population":"Studies of various populations worldwide; not limited to a single sample.","country":"Multiple (global).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of studies published early in the COVID‑19 pandemic found that use of internet‑based addictive activities, including pornography, increased, likely because of isolation, financial stress, and mental‑health problems.","clinical_takeaway":"Be aware that pandemic‑related stress may raise problematic pornography use; screen for distress and provide support as needed.","confidence":0.7,"topic_tags":["pornography"],"strengths":["Systematic search across multiple databases","Independent quality assessment using GRADE","Timely focus on COVID‑19 pandemic effects"],"limitations":["No quantitative synthesis (no meta‑analysis)","Limited assessment of how constructs were defined in primary studies","Potential heterogeneity across included reports"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":11,"contrasting":0,"mentioning":163,"citing_publications":247,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10550887.2021.1895962"}},{"id":1821,"doi":"10.1080/00224499.2021.1893261","pmid":"33724108","pmcid":null,"title":"Associations Between Pornography Use Frequency, Pornography Use Motivations, and Sexual Wellbeing in Couples","authors":"Bőthe B, Vaillancourt-Morel MP, Bergeron S.","first_author":"Bőthe B","journal":"Journal of sex research","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional dyadic survey of 265 couples (530 individuals) using actor‑partner interdependence modeling","sample_n":530,"sample_text":"265 couples","population":"adult heterosexual couples, mean ages ~31 men, ~29 women, recruited via unspecified means (likely convenience)","country":"unspecified (likely Canada/Europe based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 265 couples, women's porn use and each partner's reasons for using porn were linked to better sexual function and lower distress, while men's emotional‑avoidance motives predicted poorer outcomes.","clinical_takeaway":"Consider partners' porn motivations, not just frequency, when discussing sexual wellbeing in couples.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Large dyadic sample with both partners","Use of actor‑partner interdependence model","Separate assessment of motivations and frequency"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of moral/religious factors influencing distress","Reliance on self‑report, no objective or physiological data"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":23,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2021.1893261"}},{"id":1822,"doi":"10.3390/bs14111021","pmid":"39594320","pmcid":"PMC11590896","title":"Judgement Differences of Types of Image-Based Sexual Harassment and Abuse Conducted by Celebrity Perpetrators and Victims","authors":"Fido D, Rushton A, Allen E, Williams J.","first_author":"Fido D","journal":"Behavioral sciences (Basel, Switzerland)","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Psychopathy","Victim Blame","Image-based Sexual Harassment And Abuse","Non-consensual Sharing Of Intimate Images","Proclivity","Unsolicited Sending Of Intimate Images"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11590896","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Three vignette‑based surveys (N≈200 each) assessing judgments of non‑consensual image sharing; convenience samples; no longitudinal or experimental manipulation.","sample_n":705,"sample_text":"Studies 1 (N=261), 2 (N=237), 3 (N=207).","population":"Adult participants (likely recruited online); no indication of clinical or treatment‑seeking samples.","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Three surveys examined how people judge non‑consensual image sharing, comparing “revenge porn” with unsolicited intimate photos and testing whether celebrity status changes judgments. Both types were seen as criminal, but victims of the former were blamed more. Dark personality traits predicted harsher judgments.","clinical_takeaway":"None – study addresses social judgments, not clinical sexual health.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large combined sample across three studies","Use of both NCSII and USII scenarios","Inclusion of personality trait predictors"],"limitations":["Cross‑sectional vignette design limits causal inference","Reliance on self‑report judgments; unclear whether scales are validated","No control for moral or mental‑health variables"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs14111021"}},{"id":1823,"doi":"10.1111/1753-6405.12678","pmid":"28664609","pmcid":null,"title":"Young Australians' use of pornography and associations with sexual risk behaviours","authors":"Lim MSC, Agius PA, Carrotte ER, Vella AM, Hellard ME.","first_author":"Lim MSC","journal":"Australian and New Zealand journal of public health","year":2017,"pub_types":["Journal Article"],"keywords":["Sexual Health","Young People","Pornography","Sexual Media"],"is_oa":false,"oa_url":null,"cited_by_count":62,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey of 941 Victorian young adults recruited via social media; convenience sample.","sample_n":941,"sample_text":"941 participants (815 reported ever viewing pornography).","population":"Victorian residents ages 15‑29, both sexes, recruited through social media (convenience sample).","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2017 Australian online survey of 941 young people, 87% reported ever viewing pornography, usually starting in early adolescence. More frequent viewing was linked to being male, younger, higher educated, non‑heterosexual, having anal sex, and recent mental‑health problems.","clinical_takeaway":"High rates of early porn exposure are common; clinicians should consider discussing media use with young patients but cannot assume it causes risk behaviours.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a survey (N>900).","Provides national‑level prevalence data on early porn exposure.","Includes a range of demographic covariates."],"limitations":["Convenience, self‑selected online sample limits generalisability.","Reliance on single‑item self‑reports; no validated scales.","Cross‑sectional; cannot infer causality."],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":16,"contrasting":1,"mentioning":92,"citing_publications":180,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1753-6405.12678"}},{"id":1824,"doi":"10.1007/s10508-021-01920-1","pmid":"33630205","pmcid":null,"title":"Slutpage Use Among U.S. College Students: The Secret and Social Platforms of Image-Based Sexual Abuse","authors":"Maas MK, Cary KM, Clancy EM, Klettke B, McCauley HL, Temple JR.","first_author":"Maas MK","journal":"Archives of sexual behavior","year":2021,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Gender","Masculinity","Social Media","Sexual Harassment","Pornography","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1867 undergraduate students at a single Midwestern university","sample_n":1867,"sample_text":"large convenience sample from one university","population":"U.S. college students (18‑24 y, 36 % men, 64 % women)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,867 U.S. college students found that men, especially those in fraternities or sports teams, were more likely to visit “slutpages,” share non‑consensual nude images, and use apps to store such images. Alcohol and pornography use were also linked to these behaviors.","clinical_takeaway":"Awareness of slutpage dynamics can inform campus prevention and support efforts for victims of image‑based sexual abuse.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a single‑institution survey","Addresses a previously undocumented phenomenon","Includes multiple behavioral indicators (visiting, posting, storing)"],"limitations":["Cross‑sectional, cannot infer causality","Measures not validated; rely on self‑report items","Convenience sample limits generalizability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":31,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-01920-1"}},{"id":1825,"doi":"10.1080/0092623x.2021.1885532","pmid":"33627043","pmcid":null,"title":"Women in Relationships and Their Pornography Use: A Systematic Review and Thematic Synthesis","authors":"Litsou K, Graham C, Ingham R.","first_author":"Litsou K","journal":"Journal of sex & marital therapy","year":2021,"pub_types":["Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review with thematic synthesis of qualitative studies on women's pornography use in relationships.","sample_n":null,"sample_text":"Not applicable – review of existing studies.","population":"Women in committed relationships (as reported in primary studies).","country":"Not specified (global literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of qualitative studies found that women in committed relationships use pornography for many reasons, such as feeling sexually empowered, enhancing arousal, and for masturbation. Shared viewing can improve communication and intimacy, while some women experience negative effects.","clinical_takeaway":"Clinicians should recognize that pornography can have both beneficial and adverse effects for women in relationships and discuss its use within the couple’s context.","confidence":0.7,"topic_tags":["pornography","relationships","sexual_function","masturbation"],"strengths":["Systematic approach to identifying and synthesising qualitative literature.","Balances positive and negative outcomes of pornography use.","Highlights diverse motivations, including empowerment and relationship communication."],"limitations":["No assessment of moral incongruence or other key confounds.","Lacks quantitative meta‑analysis or risk‑of‑bias rating of primary studies.","Findings limited to studies that reported on women in relationships, may miss broader contexts."],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":2,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2021.1885532"}},{"id":1826,"doi":null,"pmid":"1409860","pmcid":null,"title":"Use of sexually explicit words in The Pharos","authors":"Barron L.","first_author":"Barron L.","journal":"The Pharos of Alpha Omega Alpha-Honor Medical Society. Alpha Omega Alpha","year":1992,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":1827,"doi":"10.1007/bf01541674","pmid":"2604540","pmcid":null,"title":"Pornography and community standards in Hawaii: comparisons with other states","authors":"Diamond M, Dannemiller JE.","first_author":"Diamond M","journal":"Archives of sexual behavior","year":1989,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"statewide random phone interview survey of attitudes toward explicit material; no longitudinal or experimental component","sample_n":null,"sample_text":"not reported in abstract","population":"Adults in Hawaii (age groups unspecified), random-digit‑dial sample","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1989 phone survey in Hawaii asked residents about their views on explicit sexual material, abortion, the death penalty, and drug laws. Most adults supported legal access to consensual pornography, and many had viewed such material themselves. Attitudes were similar to those reported in other US states.","clinical_takeaway":"None – the study reports public opinion, not clinical outcomes.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Statewide random‑digit‑dial sampling","Comparison with other states"],"limitations":["No detail on sample size or response rate","Likely single‑item attitude measures","No statistical power or effect‑size reporting"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541674"}},{"id":1828,"doi":"10.31234/osf.io/hctjm","pmid":null,"pmcid":null,"title":"Behind Closed Doors: Hentai Fans’ Perceived Discrimination, Ingroup Identification, and Attitudes toward Subgroups in the Anime Fandom","authors":"Leshner CE, Plante C, Reysen S, Gerbasi KC, Roberts S.","first_author":"Leshner CE","journal":"PsyArXiv","year":2018,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/hctjm","cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"single cross‑sectional survey of self‑identified hentai fans and non‑fans","sample_n":null,"sample_text":"not reported in abstract","population":"adult fans recruited online (likely convenience sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2018 preprint surveyed hentai fans and non‑fans, finding that fans feel more discriminated against yet show more positive attitudes toward other anime groups. Stronger fan identification predicts more positive inter‑group attitudes, while perceived personal discrimination does not.","clinical_takeaway":"None – the study examines fan identity, not sexual health or treatment.","confidence":0.6,"topic_tags":["sexual_function","pornography","other"],"strengths":["addresses understudied fan subgroup","uses mediation analysis to explore mechanisms"],"limitations":["Convenience sample limits generalisability","Likely uses ad‑hoc scales without validation","No control for moral or mental‑health variables"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/hctjm"}},{"id":1829,"doi":"10.1080/10538712.2024.2415550","pmid":"39400276","pmcid":null,"title":"Help-Seeking Behaviors of Young People with Problematic Sexualized Behaviors","authors":"Bodker A, Harris DA.","first_author":"Bodker A","journal":"Journal of child sexual abuse","year":2024,"pub_types":["Journal Article"],"keywords":["early intervention","Young People","Child Sexual Abuse","Help-seeking","Helpline","Problematic Sexualized Behavior"],"is_oa":false,"oa_url":"https://doi.org/10.1080/10538712.2024.2415550","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Descriptive analysis of 901 helpline contacts (695 males, 206 females) aged 10‑25 who self‑identified problematic sexualized behavior; no comparison group.","sample_n":901,"sample_text":"Administrative dataset of contacts to Kids Helpline over nine years.","population":"Young people (10‑25) who voluntarily contacted a helpline about their own sexualized interests/behaviors.","country":"Australia (implied by Kids Helpline)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined 901 contacts to an Australian helpline made by young people who were worried about their own sexual behaviours or porn use. Most callers were male, aged 10‑25, and reported concerns about sexual actions (40%) or porn (38%). The authors suggest early, age‑appropriate help is needed.","clinical_takeaway":"Helplines receive many self‑identified concerns about sexual behaviour and porn; services should be prepared for early, age‑graded interventions.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large administrative dataset spanning nine years","Focus on an under‑researched help‑seeking population","Provides descriptive epidemiology useful for service planning"],"limitations":["Self‑selected, help‑seeking sample limits generalisability","No validated measures of problematic use or distress","No control for key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2024.2415550"}},{"id":1830,"doi":"10.3389/fpsyt.2024.1421028","pmid":"39465047","pmcid":"PMC11502338","title":"Investigating mood-modification, withdrawal, and sensitization in compulsive sexual behaviour","authors":"Sassover E, Kushnir T, Weinstein AM.","first_author":"Sassover E","journal":"Frontiers in psychiatry","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Tolerance","Withdrawal","Compulsive Sexual Behaviour","Sex Addiction","Mood Modifications"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11502338","cited_by_count":1,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Three experimental studies with mood‑induction, stimulus exposure, and 10‑day abstinence; participants with and without CSB; self‑report outcomes.","sample_n":null,"sample_text":"Not specified in abstract","population":"Adults identified as having compulsive sexual behaviour (CSB) and controls; sample size not reported in abstract.","country":"Not reported","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study ran three lab experiments comparing people with compulsive sexual behaviour to controls. Mood (positive, negative, neutral) did not increase porn craving; explicit porn raised wanting but not with higher explicitness; a 10‑day abstinence produced fewer withdrawal symptoms than expected. Findings challenge simple addiction models of CSB.","clinical_takeaway":"Current evidence does not support a clear addiction‑like pattern for CSB; clinicians should consider multiple factors beyond mood or withdrawal when assessing these clients.","confidence":0.6,"topic_tags":["csbd","sexual_function","moral_incongruence","measurement"],"strengths":["Experimental manipulation of mood and stimulus exposure","Multiple time points for withdrawal assessment","Direct testing of addiction‑related hypotheses"],"limitations":["Reliance on self‑report measures only","No assessment of key confounds (moral incongruence, masturbation, mental health)","Sample size and power not disclosed"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2024.1421028"}},{"id":1832,"doi":"10.1016/j.acap.2017.04.014","pmid":"28450081","pmcid":null,"title":"A Qualitative Study of What US Parents Say and Do When Their Young Children See Pornography","authors":"Rothman EF, Paruk J, Espensen A, Temple JR, Adams K.","first_author":"Rothman EF","journal":"Academic pediatrics","year":2017,"pub_types":["Journal Article"],"keywords":["Child Health","Parent Communication","Pornography","Sexually Explicit Media"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative content analysis of open‑ended responses from 279 US parents recruited via Mechanical Turk (convenience sample).","sample_n":279,"sample_text":"Convenience online sample (Mechanical Turk).","population":"US parents of children <12 y who reported that their child had seen pornography.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"US parents of children under 12 who discovered their child had seen porn described five typical reactions—ranging from anger and shaming to calm factual responses—highlighting a need for better guidance on how to talk with kids about such exposure.","clinical_takeaway":"Clinicians should offer parents clear, developmentally appropriate scripts for responding to a child’s accidental pornography exposure.","confidence":0.85,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence"],"strengths":["Large qualitative sample for this topic.","Mixed‑methods (survey + content analysis).","Provides concrete categories of parental reactions."],"limitations":["Convenience MTurk sample limits generalisability.","No validated scales for reactions; coding scheme not described.","No assessment of contextual confounds (e.g., parental religiosity)."],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":24,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.acap.2017.04.014"}},{"id":1833,"doi":"10.1080/00224499.2020.1864263","pmid":"33428456","pmcid":null,"title":"Pornography Consumption and Attitudes Towards Pornography Legality Predict Attitudes of Sexual Equality","authors":"Speed D, MacDonald J, Parks A, Doucette H, Munagapati K.","first_author":"Speed D","journal":"Journal of sex research","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large nationally representative survey (General Social Survey) analysed with regression models","sample_n":null,"sample_text":"large representative cross‑sectional sample","population":"US adult respondents, 2010‑2018","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a U.S. national survey, the authors found that people who watch more pornography or support regulated porn tend to show slightly less sexist attitudes, but these links disappear once factors like religion and demographics are taken into account.","clinical_takeaway":"Pornography use does not appear to increase sexist attitudes; clinicians should not assume a direct harmful effect on gender attitudes.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["large, nationally representative dataset","includes multiple sociodemographic and religious covariates","examines both consumption and tolerance attitudes"],"limitations":["cross‑sectional, cannot infer causality","pornography use measured by single self‑report item","key confounds (masturbation, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":4,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2020.1864263"}},{"id":1834,"doi":"10.1016/j.yhbeh.2009.12.005","pmid":"20034495","pmcid":"PMC3970165","title":"Women's interest in visual sexual stimuli varies with menstrual cycle phase at first exposure and predicts later interest","authors":"Wallen K, Rupp HA.","first_author":"Wallen K","journal":"Hormones and behavior","year":2010,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subject laboratory study; 30 women (15 naturally cycling, 15 oral‑contraceptive users) viewed erotic photographs at three menstrual‑cycle‑aligned sessions; viewing time recorded as behavioral interest, plus subjective attractiveness ratings","sample_n":30,"sample_text":"30 women (15 NC, 15 OC) recruited, likely convenience/student sample","population":"young adult women (N=30)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that the hormonal state when women first saw erotic pictures predicted how long they would look at such pictures later, suggesting early hormonal exposure shapes later sexual interest.","clinical_takeaway":"Hormonal phase at first sexual‑stimulus exposure may influence later interest, but findings are based on a small lab sample.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Objective behavioral measure (viewing time)","Repeated‑measures design captures within‑person changes","Comparative groups (naturally cycling vs oral‑contraceptive users)"],"limitations":["Small sample (N=30) limits statistical power","No control for moral, mental‑health or relationship variables","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":37,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.yhbeh.2009.12.005"}},{"id":1835,"doi":"10.1080/10810730.2021.1887980","pmid":"33625313","pmcid":null,"title":"Preliminary Insights from a U.S. Probability Sample on Adolescents' Pornography Exposure, Media Psychology, and Sexual Aggression","authors":"Wright PJ, Paul B, Herbenick D.","first_author":"Wright PJ","journal":"Journal of health communication","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national probability sample survey of U.S. adolescents; cross‑sectional analysis of self‑reported pornography exposure and sexual aggression","sample_n":null,"sample_text":"U.S. probability sample (exact N not reported in abstract)","population":"U.S. adolescents (probability sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A U.S. national survey of teenagers found that those who have seen pornography and think it looks realistic are more likely to report pressuring someone into sex without consent. Identifying with porn actors increased this risk for boys but not girls.","clinical_takeaway":"Exposure to realistic‑looking porn may raise sexual‑aggression risk in teens; clinicians should assess media consumption when addressing aggression.","confidence":0.8,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Large probability‑based sample improves generalisability","Clear operational definition of sexual aggression","Examines several facets of porn exposure (frequency, realism, identification)"],"limitations":["Cross‑sectional design precludes causal inference","Key confounders (e.g., mental health, trauma, moral attitudes) not measured","Reliance on self‑report without validated pornography‑use scales"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10810730.2021.1887980"}},{"id":1836,"doi":"10.1007/s10508-017-0983-8","pmid":"28364134","pmcid":null,"title":"Evaluating the Dimensionality of Pornography","authors":"Busby DM, Chiu HY, Olsen JA, Willoughby BJ.","first_author":"Busby DM","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Multidimensionality","Pornography","Sexually Explicit Media","Erotica"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional MTurk survey (N=2173) with factor-analytic modelling of pornography ratings","sample_n":2173,"sample_text":"2173 participants recruited online (MTurk) from US and Commonwealth nations","population":"Adults from United States and Commonwealth nations recruited via Amazon Mechanical Turk","country":"United States, Commonwealth of Nations","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether people view pornography as a single trait or as multiple traits. Analyzing over 2,000 online respondents’ ratings of various images, the authors found a two‑factor structure – ‘sensitization’ (overall tendency to see items as pornographic) and ‘differentiation’ (ability to distinguish highly pornographic from less pornographic material).","clinical_takeaway":"None – the paper focuses on how pornography is perceived, not on health effects or treatment.","confidence":0.7,"topic_tags":["pornography","measurement","sexual_function","csbd"],"strengths":["Large sample size for factor analysis","Use of cross‑validation to test model stability","Comprehensive comparison of multiple factor models"],"limitations":["Ratings based on non‑validated ad‑hoc items","Convenience MTurk sample limits generalisability","No assessment of behavioural use or distress"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-0983-8"}},{"id":1837,"doi":"10.1080/00224499.2020.1863316","pmid":"33378217","pmcid":null,"title":"Up-regulating Sexual Arousal and Down-regulating Disgust while Watching Pornography: Effects on Sexual Arousal and Disgust","authors":"Pawłowska A, Borg C, de Jong PJ.","first_author":"Pawłowska A","journal":"Journal of sex research","year":2021,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized controlled trial with three arms (arousal up‑regulation, disgust down‑regulation, passive control) in a non‑clinical sample of 255 women.","sample_n":255,"sample_text":"255 participants, randomly assigned to conditions.","population":"Women, mean age 20.5, no sexual difficulties.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab experiment, women were instructed to either boost sexual arousal or reduce disgust while watching porn. Trying to increase arousal raised arousal scores, and trying to cut disgust lowered disgust scores, but each change did not automatically affect the other emotion.","clinical_takeaway":"Emotion‑regulation instructions can modify sexual arousal or disgust separately, but they do not automatically improve sexual response overall.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Randomized experimental design","Adequate sample size for manipulation study","Clear operational manipulation (instructional regulation) and control condition"],"limitations":["Reliance on self‑report scales with unclear psychometric validation","No measurement of potential confounds (mood, religiosity, masturbation)","Results limited to young, non‑clinical women"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2020.1863316"}},{"id":1838,"doi":null,"pmid":"15521229","pmcid":null,"title":"Sexual behavior of secondary school students in Bangkok metropolis","authors":"O-Prasertsawat P, Petchum S.","first_author":"O-Prasertsawat P","journal":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 362 secondary‑school students selected by multistage simple random sampling; self‑administered questionnaire on sexual behaviours and internet porn exposure.","sample_n":362,"sample_text":"197 male, 165 female","population":"Adolescents (mean age 16.5) in Bangkok secondary schools","country":"Thailand","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2004 survey of 362 Bangkok secondary‑school students found that about 58 % had viewed internet pornography, 79 % of boys and 9 % of girls reported masturbating, and a quarter of boys had had sexual intercourse. Boys reported higher rates of all behaviours than girls.","clinical_takeaway":"Adolescents, especially boys, frequently engage in masturbation and view online porn; sexual education programmes should address these behaviours.","confidence":0.7,"topic_tags":["adolescents","masturbation","pornography","sexual_function"],"strengths":["Large, randomly selected school sample","Clear description of sexual behaviours","Relevant to public‑health education"],"limitations":["Self‑report single‑item measures, no validated scales","No assessment of confounding factors (e.g., mental health, religiosity)","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":1839,"doi":"10.1007/s10508-020-01843-3","pmid":"33354757","pmcid":"PMC8275502","title":"Are Men Who Buy Sex Different from Men Who Do Not?: Exploring Sex Life Characteristics Based on a Randomized Population Survey in Sweden","authors":"Deogan C, Jacobsson E, Mannheimer L, Björkenstam C.","first_author":"Deogan C","journal":"Archives of sexual behavior","year":2021,"pub_types":["research-article","Randomized Controlled Trial","Journal Article"],"keywords":["Sexual behavior","Sexual Health","Sex Work","Sexual Experience","Pornography","Buying Sex"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8275502","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Population‑based random sample of 6 048 Swedish men, cross‑sectional questionnaire linked to registers; logistic regression examined associations between ever paying for sex and sex‑life variables.","sample_n":6048,"sample_text":"Population‑based random sample","population":"Men aged 16‑84 years, Sweden (N = 6048)","country":"Sweden","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a national Swedish survey of 6,000 men, those who had ever paid for sex were more likely to be dissatisfied with their sex life, have less sex than they wanted, use pornography often, and seek partners online.","clinical_takeaway":"Sex‑life dissatisfaction and frequent porn use are linked to buying sex; clinicians should address broader sexual wellbeing when discussing sex‑purchase behaviour.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative sample","Linkage to nationwide registers","Clear statistical reporting with CIs"],"limitations":["Cross‑sectional; cannot infer causality","Key variables measured by single‑item self‑reports","No assessment of moral incongruence or mental‑health confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01843-3"}},{"id":1841,"doi":"10.1080/00224499.2020.1856316","pmid":"33345628","pmcid":null,"title":"VR Porn as \"Empathy Machine\"? Perception of Self and Others in Virtual Reality Pornography","authors":"Dekker A, Wenzlaff F, Biedermann SV, Briken P, Fuss J.","first_author":"Dekker A","journal":"Journal of sex research","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Within‑subject laboratory experiment; 50 healthy male participants viewed a VR and a 2D pornographic film on separate days in random order; self‑report perception measures and salivary oxytocin collected.","sample_n":50,"sample_text":"Fifty healthy male participants","population":"Healthy adult males, n≈50","country":"Germany (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, 50 men watched the same porn scene either in virtual reality or on a regular screen. The VR version made them feel more looked at, desired and connected with the actors, and higher oxytocin levels were linked to feelings of eye‑contact.","clinical_takeaway":"VR porn may heighten feelings of intimacy, but its impact on mental health is unclear.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Randomised order of VR vs 2D condition","Within‑subject design reduces between‑person variability","Inclusion of physiological (oxytocin) measure"],"limitations":["Small sample, limited statistical power","Self‑report perception scales not validated","Only male participants, limits generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":34,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2020.1856316"}},{"id":1842,"doi":"10.1080/00224499.2020.1856765","pmid":"33307824","pmcid":null,"title":"A Mixed-Method Analysis of Women's Attributions about Their Partner's Pornography Use","authors":"Rehman US, Tran V, Byers ES, Rosen NO.","first_author":"Rehman US","journal":"Journal of sex research","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"mixed-method survey of 199 women assessing attributions about partner's pornography use and relationship/sexual satisfaction; quantitative correlations and qualitative thematic analysis","sample_n":199,"sample_text":"199 women recruited (recruitment method not specified)","population":"women in mixed‑gender relationships (N≈199)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 199 women, the reasons they gave for their partner’s porn use (positive, neutral, or negative) were linked to how satisfied they felt in their relationship and sex life; positive attributions related to higher satisfaction.","clinical_takeaway":"Women’s positive views of a partner’s porn use are associated with better relationship and sexual satisfaction.","confidence":0.8,"topic_tags":["pornography","relationships","sexual_function","gender"],"strengths":["Reasonable sample size (N≈200) for correlational analysis","Mixed‑method approach adds depth via qualitative themes","Uses established satisfaction scales"],"limitations":["Partner pornography use measured only via female partner’s perception","No measurement of moral/religious attitudes or other key confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2020.1856765"}},{"id":1843,"doi":"10.1007/s10508-007-9310-0","pmid":"18256919","pmcid":null,"title":"Effects of experimentally adopted sexual schemas on vaginal response and subjective sexual arousal: a comparison between women with sexual arousal disorder and sexually healthy women","authors":"Middleton LS, Kuffel SW, Heiman JR.","first_author":"Middleton LS","journal":"Archives of sexual behavior","year":2008,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"case‑control experimental study with within‑subject cognitive schema manipulation; 17 FSAD and 17 healthy women","sample_n":34,"sample_text":"34 participants (17 per group)","population":"women with Female Sexual Arousal Disorder and sexually healthy controls (N=34)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study showed that women, both with and without sexual arousal disorder, had stronger vaginal responses and felt more aroused when they adopted a positive sexual mindset versus a negative one, highlighting the role of thoughts in sexual arousal.","clinical_takeaway":"Therapies that modify negative sexual cognitions may improve arousal for women with FSAD.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Objective physiological measurement (vaginal plethysmography)","Experimental manipulation of cognitive schemas","Within‑subject comparison controls for individual differences"],"limitations":["Small sample size limits power and generalizability","No reporting of effect sizes or confidence intervals","Potential selection bias; clinical FSAD sample"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":1,"mentioning":28,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-007-9310-0"}},{"id":1844,"doi":"10.1136/bmjopen-2024-084160","pmid":"39289019","pmcid":"PMC11409375","title":"Risky sexual behaviour and its determinants among undergraduate students residing in hostels of Kathmandu Metropolitan City, Nepal: a cross-sectional study","authors":"Chaudhary RK, Chalise A, Pandey S, Paudel S.","first_author":"Chaudhary RK","journal":"BMJ open","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Behavior","Cross-sectional studies","risk factors","Public Health","Nepal","Reproductive Medicine"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11409375","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 361 hostel‑resident undergraduates in Kathmandu, Nepal; logistic regression used to examine associations with risky sexual behaviour.","sample_n":361,"sample_text":"A total of 361 undergraduate students residing in hostels in the Metropolitan City","population":"undergraduate students (hostel residents) in Kathmandu, Nepal (N≈361)","country":"Nepal","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 361 Nepalese university students living in hostels, about one‑third reported risky sexual behaviour. Older age, male gender, having a partner, lower maternal education and peer pressure were linked to higher risk. Porn use showed a weak, non‑significant link after adjustment.","clinical_takeaway":"Screen for age, gender, relationship status and peer influences when assessing sexual risk; porn use alone may not predict risky behaviour.","confidence":0.7,"topic_tags":["relationships","religiosity","masturbation","pornography","sexual_function"],"strengths":["Reasonably sized sample for a cross‑sectional survey","Multivariable logistic regression with reported odds ratios and confidence intervals","Identifies multiple sociodemographic correlates of risky sexual behaviour"],"limitations":["Risky sexual behaviour measured with an ad‑hoc, non‑validated checklist","Problematic porn use not operationalised with a validated instrument","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjopen-2024-084160"}},{"id":1845,"doi":"10.1016/j.abrep.2020.100321","pmid":"33364331","pmcid":"PMC7750154","title":"The negative consequences of hypersexuality: Revisiting the factor structure of the Hypersexual Behavior Consequences Scale and its correlates in a large, non-clinical sample","authors":"Koós M, Bőthe B, Orosz G, Potenza MN, Reid RC, Demetrovics Z.","first_author":"Koós M","journal":"Addictive behaviors reports","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Hypersexuality","Sex Addiction","Pornography","Addictive Behaviors","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7750154","cited_by_count":19,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large non‑clinical survey (N≈17 k) split into three samples for factor analysis","sample_n":16935,"sample_text":"large community convenience sample","population":"adult community sample, mixed gender","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested a new questionnaire that measures the negative effects of hypersexual behaviour in a large sample of adults, finding a four‑factor structure (work, personal, relationship, risky behaviour) and reasonable links to related measures.","clinical_takeaway":"The Hypersexual Behavior Consequence Scale shows promise for assessing adverse impacts of hypersexuality in clinical settings.","confidence":0.7,"topic_tags":["measurement","sexual_function"],"strengths":["Very large sample enables stable factor analysis","Uses an established hypersexuality inventory for validation","Reports multiple fit indices and reliability"],"limitations":["Cross‑sectional; cannot infer causality","Potentially self‑selected online sample","Key confounds (moral incongruence, mental health) not measured"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.abrep.2020.100321"}},{"id":1846,"doi":"10.1007/bf01542615","pmid":"1953326","pmcid":null,"title":"Are pictures more valid than words in conveying the content of sex in the media? Studies in North Carolina and New York State","authors":"Winick C.","first_author":"Winick C.","journal":"Archives of sexual behavior","year":1991,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"quasi‑experimental comparison of small exposure groups (N≈40‑80) with larger telephone survey samples","sample_n":502,"sample_text":"40 (exposure) + 503 (telephone) in NC; 78 + 80 + 81 in NY","population":"Adults in North Carolina and New York State, convenience samples","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors compared people who watched explicit films or magazines with people who answered telephone surveys about such material. Attitudes toward the material were similar, suggesting phone surveys can reliably capture public tolerance of sexual content.","clinical_takeaway":"None – the study concerns attitudes, not health effects or treatment.","confidence":0.7,"topic_tags":["sexual_function","pornography"],"strengths":["Direct comparison of media exposure vs telephone survey","Two geographically distinct samples"],"limitations":["Very small exposure groups; low statistical power","Attitudes measured with likely single‑item, unvalidated scales","No control for moral or demographic confounds"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542615"}},{"id":1847,"doi":"10.1038/s41443-020-00380-w","pmid":"33249423","pmcid":"PMC7699018","title":"The impact of COVID-19 pandemic on pornography habits: a global analysis of Google Trends","authors":"Zattoni F, Gül M, Soligo M, Morlacco A, Motterle G, Collavino J, Barneschi AC, Moschini M, Moro FD.","first_author":"Zattoni F","journal":"International journal of impotence research","year":2020,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7699018","cited_by_count":53,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Ecological analysis of aggregated Google Trends data (Jan–May 2020) comparing weekly relative search volumes for major porn sites across six nations with lockdown timing; joint‑point regression and paired t‑tests versus historic baseline.","sample_n":null,"sample_text":"Search volume for five porn sites and coronavirus‑themed porn across six nations; no individual participants.","population":"Aggregated, anonymous Google search data (global, no individual‑level sampling)","country":"Global (six specific nations analyzed)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Analyzing Google search trends, the study found that interest in porn sites rose during COVID‑19 lockdowns in countries with strict stay‑at‑home orders, especially for coronavirus‑themed porn, compared with previous years.","clinical_takeaway":"None – the findings describe population‑level search behaviour, not individual clinical risk.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large‑scale, real‑time big‑data source","International comparison across multiple lockdown contexts","Uses historic baseline for each country"],"limitations":["Search volume is an indirect proxy for actual porn consumption","No individual‑level data; cannot control for key confounds","Ecological design precludes causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":86,"citing_publications":157,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-020-00380-w"}},{"id":1848,"doi":"10.1007/s10508-024-02984-5","pmid":"39251481","pmcid":null,"title":"Examining Relations Between Sexualizing Media Exposure and Sexting Attitudes and Behaviors among U.S. Adolescents","authors":"Aubrey JS, Gahler H, Daniels EA, Choi HJ, Speno AG.","first_author":"Aubrey JS","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Gender","Media Effects","Sexualization","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 6,093 US adolescents examining self‑reported exposure to sexualizing media and sexting behaviors; cross‑sectional, convenience sample (not stated as nationally representative).","sample_n":6093,"sample_text":"6,093 U.S. adolescents (Mage = 15.27, SD = 1.37).","population":"U.S. adolescents (mean age 15.3), predominantly cisgender girls, also boys and gender‑minority youth.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 6,000 U.S. teenagers found that more exposure to sexualized TV shows, music videos, and pornography was linked to higher rates of sending or requesting sexts, especially among boys. The relationship was partly explained by teens thinking sexting is fun.","clinical_takeaway":"Higher exposure to sexualized media may increase adolescents' sexting behavior; clinicians should discuss media influences when counseling youth.","confidence":0.8,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Very large sample size","Examines multiple media types and gender groups","Uses mediation analysis to test outcome expectancies"],"limitations":["Cross‑sectional; cannot establish causality","Reliance on self‑report questionnaires without validated scales","No control for key confounds (e.g., mental health, partner context)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02984-5"}},{"id":1849,"doi":"10.1007/s10508-024-02988-1","pmid":"39227498","pmcid":"PMC11588941","title":"Associations Between Sexualized Media Consumption, Sexual Double Standards, and Sexual Coercion Perpetration and Victimization in Late Adolescent Sexually Active Boys and Girls from The Netherlands","authors":"Chadwick-Brown F, Endendijk JJ.","first_author":"Chadwick-Brown F","journal":"Archives of sexual behavior","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Adolescence","Sexual Coercion","Sexual Double Standards","Sexualized Media"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11588941","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"single time-point self‑report survey of Dutch secondary‑school students (N=255) examining frequency of sexualized media use and self‑reported sexual coercion perpetration/victimisation, with gender moderation analyses","sample_n":255,"sample_text":"255 late‑adolescent Dutch secondary‑school students (58.4 % female)","population":"adolescents (16‑20 y) attending secondary school in the Netherlands, sexually active, convenience sample","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among Dutch teens, those who watched more porn, sexual reality TV, or sexy social‑media posts were more likely to report both committing and experiencing sexual coercion, with similar patterns for boys and girls.","clinical_takeaway":"Higher exposure to sexualized media is linked to increased self‑reported sexual coercion risk in adolescents; clinicians should assess media use when addressing coercion‑related concerns.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["large adolescent sample for the topic","gender moderation analysis","focus on specific media types","use of binary outcomes allows odds‑ratio estimation"],"limitations":["cross‑sectional; cannot infer causality","self‑report measures, likely unvalidated","no control for mental‑health, trauma, or partner variables","potential social‑desirability bias"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02988-1"}},{"id":1850,"doi":"10.1093/sf/sow106","pmid":"28546649","pmcid":"PMC5439973","title":"Seeing is (Not) Believing: How Viewing Pornography Shapes the Religious Lives of Young Americans","authors":"Perry SL, Hayward GM.","first_author":"Perry SL","journal":"Social forces; a scientific medium of social study and interpretation","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Religion","Young Adults","Religiosity","Early Adulthood","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"fixed‑effects regression on three waves of a nationally representative panel (National Study of Youth and Religion)","sample_n":null,"sample_text":"National Study of Youth and Religion, three waves; exact N not given in abstract","population":"young Americans (adolescents and emerging adults) from a probability‑based survey","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using data from three waves of a national U.S. youth survey, the authors found that more frequent pornography viewing predicts lower attendance at religious services, less importance placed on faith, fewer prayers, less closeness to God, and more religious doubt over time.","clinical_takeaway":"None – the study addresses religious attitudes, not clinical sexual‑health outcomes.","confidence":0.7,"topic_tags":["pornography","religiosity","adolescents","sexual_function"],"strengths":["Large, nationally representative longitudinal dataset","Fixed‑effects model controls for time‑invariant individual differences","Multiple dimensions of religiosity examined"],"limitations":["No measurement of potential confounders such as moral incongruence or mental health","Effect sizes and confidence intervals not reported in abstract","Reliance on self‑report for porn use"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":40,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sf/sow106"}},{"id":1851,"doi":"10.1007/s10508-016-0927-8","pmid":"28062935","pmcid":null,"title":"Pornography, Religion, and Parent-Child Relationship Quality","authors":"Perry SL, Snawder KJ.","first_author":"Perry SL","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Religion","Parenting","Relationship Quality","Religiosity","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large national survey (Portraits of American Life Study), N=2610, moderation analysis, follow‑up re‑interview for directionality","sample_n":2610,"sample_text":"Adults who are parents, recruited from the Portraits of American Life Study (national probability sample).","population":"U.S. parents (fathers N=771, mothers N=904) from a probability‑based panel","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a US national sample, parents who watched more porn reported poorer relationships with their children, especially if they attended religious services frequently. The effect was strongest for fathers.","clinical_takeaway":"Clinicians should consider religious‑related guilt when discussing porn use and family dynamics, but cannot infer causation from this study.","confidence":0.9,"topic_tags":["pornography","religiosity","sexual_function","relationships"],"strengths":["Large, nationally representative sample","Longitudinal follow‑up data for directionality","Thoughtful moderation analysis of religiosity"],"limitations":["No direct measurement of moral incongruence or guilt","Masturbation not assessed separately","Causal language exceeds the observational design"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":14,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0927-8"}},{"id":1852,"doi":"10.1016/j.chiabu.2024.106977","pmid":"39217741","pmcid":null,"title":"Characteristics that predict exposure to and subsequent intentional viewing of child sexual abuse material among a community sample of Internet users","authors":"Napier SS, Seto MC, Cashmore J, Shackel R.","first_author":"Napier SS","journal":"Child abuse & neglect","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Characteristic","Prevention","Predictor","Offender","Child Sexual Exploitation","Child Sexual Abuse Material"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Anonymous online survey of 5,512 Internet users (N=742 ever viewers, subset N=459) with multivariate logistic regression to identify predictors of CSAM exposure and continued intentional use.","sample_n":5512,"sample_text":"5512 Internet users; 742 reported ever viewing CSAM; 459 of those viewed again intentionally.","population":"Community Internet users from Canada, Australia, New Zealand, UK (adult ages 18+).","country":"Canada, Australia, New Zealand, United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 5,000 internet users identified factors that make people more likely to have ever seen child sexual abuse material and to view it again on purpose, such as being male, early exposure to adult porn, childhood physical abuse, loneliness, and participation in pedophilic forums.","clinical_takeaway":"Targeted prevention should focus on early porn exposure, loneliness, and monitoring of high‑risk online communities.","confidence":0.7,"topic_tags":["prevalence"],"strengths":["Large community sample","Multivariate logistic regression identifies independent predictors","Includes childhood trauma and loneliness as covariates"],"limitations":["Self‑report measures, no validated scales","Cross‑sectional design cannot infer causality","Moral incongruence, masturbation, partner variables not assessed"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2024.106977"}},{"id":1853,"doi":"10.1080/0092623x.2020.1835760","pmid":"33107786","pmcid":null,"title":"Watching Pornography Alone or Together: Longitudinal Associations With Romantic Relationship Quality","authors":"Huntington C, Markman H, Rhoades G.","first_author":"Huntington C","journal":"Journal of sex & marital therapy","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"National random sample (N=1,234) of unmarried heterosexual couples, 5 survey waves over 20 months; multilevel modeling of pornography viewing alone vs together on relationship quality.","sample_n":1234,"sample_text":"random national sample of individuals in unmarried heterosexual relationships","population":"Unmarried heterosexual romantic relationships (≥2 months)","country":"USA (presumed from journal and authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 20‑month study of over 1,200 couples, watching porn alone was linked to poorer relationship quality for men but better outcomes for women, while watching together was linked to more intimacy but also higher psychological aggression.","clinical_takeaway":"Couples therapy should consider how solo versus joint porn use relates to relationship dynamics, rather than assuming all porn use is harmful.","confidence":0.8,"topic_tags":["pornography","relationships","sexual_function","masturbation","gender"],"strengths":["Large, longitudinal national sample","Distinguishes solo vs joint pornography viewing","Uses multilevel modeling to separate within‑ and between‑person effects"],"limitations":["No measurement of moral incongruence or masturbation","Potential unmeasured mental‑health and trauma confounders","Self‑report data may be biased"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":0,"mentioning":21,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2020.1835760"}},{"id":1854,"doi":"10.1080/0092623x.2020.1835759","pmid":"33107785","pmcid":null,"title":"Parents' Psychopathology Promotes the Adoption of Ineffective Pornography-Related Parenting Mediation Strategies","authors":"Efrati Y, Boniel-Nissim M.","first_author":"Efrati Y","journal":"Journal of sex & marital therapy","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,070 Jewish‑Israeli parents of adolescents (10‑14 y) examining associations between parental psychopathology and parenting mediation strategies for child pornography exposure.","sample_n":1070,"sample_text":"Jewish‑Israeli parents of 10‑14‑year‑old adolescents","population":"parents of adolescents (10‑14 y), Jewish‑Israeli, n≈1070","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that parents who experience mild anxiety or stress tend to use more authoritarian parenting and less effective ways (like strict restriction) to manage their teens’ exposure to pornography.","clinical_takeaway":"Therapists should consider parental mental health when advising families on how to discuss and limit adolescent porn exposure.","confidence":0.7,"topic_tags":["pornography","adolescents","csbd","sexual_function"],"strengths":["Large community sample (N>1000)","Use of validated psychopathology scales","Clear statistical links between parental anxiety/stress and less effective mediation"],"limitations":["Cross‑sectional; no causal inference","Sample limited to Jewish‑Israeli parents – limited generalisability","Mediation strategies measured with likely ad‑hoc items"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2020.1835759"}},{"id":1855,"doi":"10.1038/s41598-024-67944-4","pmid":"39198585","pmcid":"PMC11358130","title":"Risky sexual behaviors and associated factors among adolescent in Gedeo Zone, South Ethiopia: a community based cross-sectional study","authors":"Wondimagegne YA, Anbese AT.","first_author":"Wondimagegne YA","journal":"Scientific reports","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Adolescent","Risky Sexual Behaviors","South Ethiopia","Gedeo Zone"],"is_oa":true,"oa_url":"https://doi.org/10.1038/s41598-024-67944-4","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"community based cross‑sectional survey of 2,780 Ethiopian adolescents (99.3 % response); pre‑tested questionnaire; logistic regression analysis","sample_n":2780,"sample_text":"99.3 % response rate; participants selected from households in the study area (sampling method not fully described)","population":"Adolescents (14‑19 years) in Gedeo Zone, South Ethiopia, recruited via community sampling","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 2,780 Ethiopian adolescents, about 78 % of those who were sexually active reported risky sexual practices. Watching pornography, being older, male, living in rural areas, not attending school, and lower parental monitoring were linked to higher odds of risky behavior.","clinical_takeaway":"Screening for pornography exposure may help identify adolescents at higher risk for unsafe sexual practices, but consider broader psychosocial factors.","confidence":0.8,"topic_tags":["relationships","sexual_function","pornography","adolescents"],"strengths":["Large sample with high response rate","Use of multivariable logistic regression with confidence intervals","Community‑based recruitment increases external relevance"],"limitations":["Cross‑sectional design cannot infer causality","Key confounders (moral attitudes, mental health, trauma) not measured","Reliance on self‑report questionnaires of uncertain validation"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-024-67944-4"}},{"id":1856,"doi":"10.1007/s10508-008-9402-5","pmid":"18719987","pmcid":"PMC2739402","title":"Sex-specific content preferences for visual sexual stimuli","authors":"Rupp HA, Wallen K.","first_author":"Rupp HA","journal":"Archives of sexual behavior","year":2009,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory experiment with 15 men and 30 women viewing 216 sexual photographs; subjective ratings and viewing times recorded.","sample_n":45,"sample_text":"15 men; 30 women (15 using hormonal contraception).","population":"Heterosexual adult men (n=15) and women (n=30, half on hormonal contraception); convenience sample.","country":"USA (presumed from authors affiliation, not stated in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, men and women viewed a large set of explicit photos. Overall interest was similar, but each sex preferred different picture types (e.g., women liked indirect gaze, men did not). Hormonal contraceptive use reduced attractiveness ratings for genital images.","clinical_takeaway":"Sexual stimulus preferences differ by gender; clinicians should consider individual content preferences rather than assuming universal responses.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Controlled stimulus set (activity, gaze, genital proportion)","Measured both subjective ratings and objective viewing time","Investigated sex differences beyond overall interest"],"limitations":["Small, non‑representative sample (N=45)","No validated scales for sexual attraction or preference","No control for moral, mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":46,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-008-9402-5"}},{"id":1857,"doi":"10.1016/j.rbms.2016.10.003","pmid":"29774249","pmcid":"PMC5952654","title":"Should fertility clinics divest themselves of pornography?","authors":"Murphy TF.","first_author":"Murphy TF.","journal":"Reproductive biomedicine & society online","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Ethics","Gay","Pornography","Erotica","Assisted Reproductive Treatments","Harm To Women"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5952654","cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/ethics article arguing that fertility clinics should not divest pornography; no empirical data collected.","sample_n":null,"sample_text":"none","population":"none","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The author argues that fertility clinics providing pornography for men to help produce sperm is ethically defensible and that removing such material would not meaningfully reduce any alleged harms to women.","clinical_takeaway":"None – the paper is an ethical commentary, not clinical research.","confidence":0.4,"topic_tags":["pornography","masturbation","religiosity","sexual_function"],"strengths":["Clear ethical argumentation","Considers both psychological value and women's interests"],"limitations":["No empirical data","No measurement of key constructs","Lacks systematic literature review"],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.rbms.2016.10.003"}},{"id":1858,"doi":"10.1080/00224499.2024.2389211","pmid":"39171969","pmcid":null,"title":"Clients' Perceptions of Authentic Intimate Connection on Erotic Webcam Modeling Sites","authors":"Kaufman EM, Gesselman AN, Bennett-Brown M.","first_author":"Kaufman EM","journal":"Journal of sex research","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Web‑based survey of 2,047 adult LiveJasmin clients (2020). Quantitative items on perceived emotional bond and model caring; qualitative open‑ended responses analyzed for themes of authenticity and transactional boundaries.","sample_n":2047,"sample_text":"Clients of a major erotic webcam platform recruited online in 2020.","population":"Adults who have paid for webcam modeling services on LiveJasmin; self‑selected volunteers.","country":"Not specified (likely multinational English‑speaking sample).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 2,000+ webcam‑site clients showed that many feel genuine emotional connections with models, while others see the interactions as transactional. Perceived intimacy is shaped by the platform’s limits and the commercial nature of the exchange.","clinical_takeaway":"None – findings are descriptive of client experiences, not directly relevant to clinical practice.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a niche population","Mixed‑methods approach (quantitative + qualitative)","Focus on client‑perceived authenticity, an under‑studied aspect"],"limitations":["Convenience, self‑selected sample limits generalisability","No validated scales for authenticity or emotional bond","Potential self‑presentation bias in self‑report"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2024.2389211"}},{"id":1859,"doi":"10.1016/j.abrep.2016.11.003","pmid":"29450222","pmcid":"PMC5800558","title":"Mood changes after watching pornography on the Internet are linked to tendencies towards Internet-pornography-viewing disorder","authors":"Laier C, Brand M.","first_author":"Laier C","journal":"Addictive behaviors reports","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Addiction","Sexual Arousal","Mood","Internet Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5800558","cited_by_count":35,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"online within‑subject study; participants watched pornography and reported mood before and after; three measurement points","sample_n":null,"sample_text":"male participants recruited online (exact N not reported in abstract)","population":"male internet users, convenience sample","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["circular_addiction_scale","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study asked men to watch internet porn and report their mood before and after. Those who scored higher on a tendency toward ‘pornography‑viewing disorder’ felt worse overall and showed smaller mood improvements after watching, suggesting the activity may reinforce its own use.","clinical_takeaway":"Mood improvements after porn use are smaller for individuals with higher problem‑use tendencies; consider coping motives when assessing distress.","confidence":0.7,"topic_tags":["pornography","moral_incongruence","masturbation"],"strengths":["Within‑subject design captures immediate mood change","Addresses theoretical reinforcement mechanisms","Measures multiple motivations for use"],"limitations":["Unclear validation of IPD scale","No control for moral/religious attitudes","Potential self‑selection / convenience sample","Lack of objective or physiological measures"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":43,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.abrep.2016.11.003"}},{"id":1860,"doi":"10.1007/s10508-005-9015-1","pmid":"16752119","pmcid":null,"title":"Effects of depressive symptoms and experimentally adopted schemas on sexual arousal and affect in sexually healthy women","authors":"Kuffel SW, Heiman JR.","first_author":"Kuffel SW","journal":"Archives of sexual behavior","year":2006,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experimental trial with schema manipulation; between‑group (depressed vs. non‑depressed) and within‑subject (positive vs. negative schema) conditions; N=56 (28 per mood group).","sample_n":56,"sample_text":"56 women (28 with depressive symptoms, 28 mood‑neutral)","population":"Sexually healthy adult women, middle‑aged, recruited for lab study","country":"Not specified (likely US based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, women watched erotic videos after being asked to think of themselves in either a positive or negative sexual light. Both depressed and non‑depressed women showed higher genital response, subjective arousal, and positive mood when using the positive schema, suggesting that moment‑to‑moment thoughts can shape sexual and emotional reactions.","clinical_takeaway":"Brief cognitive framing of sexual self‑concept can boost arousal and mood, offering a potential tool for sexual dysfunction therapy.","confidence":0.7,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Objective physiological arousal measure","Experimental manipulation of sexual self‑schema","Controls for anxiety in analysis"],"limitations":["Small sample size; limited power","No assessment of major confounds (moral incongruence, partner context, trauma)","Cross‑sectional; only short‑term effects observed"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":1,"mentioning":50,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-005-9015-1"}},{"id":1861,"doi":"10.1080/19317611.2024.2389999","pmid":"39552621","pmcid":"PMC11562914","title":"Changes in Individual and Dyadic Sexual Behavior Frequencies During Wartime in Israel: How Much, Who, and Why?","authors":"Lazar A, Gewirtz-Meydan A, Rosenbaum TY.","first_author":"Lazar A","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Factor analysis","Gender Differences","Sexual Behaviors","War-time Stress"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional retrospective online survey (N=1207) of Israeli adults examining self‑reported changes in pornography, masturbation and partnered sexual behavior during the 2023 Israel‑Hamas war.","sample_n":1207,"sample_text":"online survey of Israeli adults (N=1207) recruited October‑November 2023","population":"Israeli adults (online convenience sample)","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,200 Israeli adults during the 2023 Israel‑Hamas war found that about half kept their pornography and masturbation habits the same, while 40% reported a drop in all sexual activity. Women were more likely to report unchanged individual sexual behavior; men showed mixed patterns. Stress, age, religiosity and spirituality explained many of the changes.","clinical_takeaway":"War‑related stress can reduce sexual activity for many, but effects vary by gender; clinicians should assess stressors and individual circumstances rather than assume a universal decline.","confidence":0.85,"topic_tags":["pornography","masturbation","sexual_function","gender","relationships"],"strengths":["Large sample (N>1200)","Timely data on an understudied context (wartime stress)","Factor analysis to identify underlying reasons"],"limitations":["Self‑report, retrospective recall of behavior changes","No validated sexuality scales; single‑item measures","Limited control of key confounds (moral incongruence, mental health, trauma)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2024.2389999"}},{"id":1862,"doi":"10.1007/s10508-016-0896-y","pmid":"27844314","pmcid":null,"title":"Spousal Religiosity, Religious Bonding, and Pornography Consumption","authors":"Perry SL.","first_author":"Perry SL.","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Religion","Marriage","Religiosity","Sexual Satisfaction","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative survey (N=1026) of married Americans; cross‑sectional mediation analysis","sample_n":1026,"sample_text":"Portraits of American Life Study, nationally representative","population":"married adults in the United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationwide US study of over 1,000 married couples, people whose spouses were more religious tended to view pornography less, partly because they took part in more joint religious activities. The effect was stronger for those who attended services regularly, and varied by gender and age.","clinical_takeaway":"Couple’s shared religiosity may be linked to lower porn use, but the study cannot prove cause‑effect.","confidence":0.8,"topic_tags":["pornography","religiosity","relationships","sexual_function"],"strengths":["Large, nationally representative sample","Considers dyadic partner influence","Mediation analysis of religious bonding"],"limitations":["Cross‑sectional; cannot infer causality","No validated measure of pornography use or addiction","Key confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0896-y"}},{"id":1864,"doi":"10.1016/j.yhbeh.2007.07.015","pmid":"17826777","pmcid":null,"title":"Relationship between testosterone and interest in sexual stimuli: the effect of experience","authors":"Rupp HA, Wallen K.","first_author":"Rupp HA","journal":"Hormones and behavior","year":2007,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subject laboratory experiment with three test sessions; N=15 young men; visual sexual stimuli; testosterone assayed from blood spots","sample_n":15,"sample_text":"convenience sample of university‑aged men","population":"healthy young adult males (23‑28 y)","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 15 young men, higher testosterone was linked to longer viewing times of explicit pictures, but the strength of this link changed across three testing sessions. The study suggests testosterone may influence sexual interest, though the effect varied with context.","clinical_takeaway":"Testosterone levels might modestly affect interest in visual sexual material, but evidence is limited and based on a very small sample.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["objective behavioral measure of sexual interest","direct hormonal assay","within‑subject repeated measures"],"limitations":["very small sample (N=15)","no correction for multiple correlations across sessions","no control for potential confounds (mood, sexual experience, religiosity)","limited generalisability beyond young, likely Western, male students"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":48,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.yhbeh.2007.07.015"}},{"id":1868,"doi":"10.1093/jsxmed/qdae065","pmid":"38899734","pmcid":null,"title":"Experiences of young women in the practice of squirting: a descriptive qualitative study","authors":"Cutillas-Blasco S, Ruiz-Gonzalez C, Rueda-Ruzafa L, Ropero-Padilla C, Roman P, Rodriguez-Arrastia M.","first_author":"Cutillas-Blasco S","journal":"The journal of sexual medicine","year":2024,"pub_types":["Journal Article"],"keywords":["Sexuality","Women","Qualitative Research","Squirting"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Descriptive qualitative study with semi‑structured interviews (N=17) recruited via convenience and snowball sampling.","sample_n":17,"sample_text":"Convenience and snowball sampling of 17 participants.","population":"Young adult women who have experienced squirting (self‑selected sample).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study interviewed 17 young women who have experienced \"squirting\" to understand how it feels, what influences it, and how partners and media shape the experience. Themes included initial reactions, physical and emotional sensations, partner communication, and gaps in sex education.","clinical_takeaway":"Clinicians should be aware that squirting can evoke a range of emotions, from pleasure to embarrassment, and be prepared to discuss it non‑judgmentally.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight into a rarely studied sexual phenomenon.","Use of established qualitative reporting standards (SRQR).","Thematic analysis conducted with software support."],"limitations":["Small, non‑representative convenience sample.","No measurement of potential confounds (e.g., mental health, moral attitudes).","Findings cannot be generalized beyond participants."],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdae065"}},{"id":1871,"doi":"10.3389/fpsyg.2020.02132","pmid":"32982871","pmcid":"PMC7488514","title":"The Neurosciences of Health Communication: An fNIRS Analysis of Prefrontal Cortex and Porn Consumption in Young Women for the Development of Prevention Health Programs","authors":"Cuesta U, Niño JI, Martinez L, Paredes B.","first_author":"Cuesta U","journal":"Frontiers in psychology","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Neuroscience","Addiction","Health Communication","Brodmann Area","Pornography","Fnris","Health Prevention Campaigns","Neuro Communications"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7488514","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross‑sectional fNIRS cue‑reactivity study with young female students","sample_n":null,"sample_text":"young female college students (exact N not reported)","population":"young female college students (convenience sample)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational","no_mi_control"],"stance":"supports","citation_value":"avoid","plain_summary":"In a small group of female college students, viewing a short porn clip triggered greater activity in a prefrontal brain area compared with a neutral clip, and the activation was larger in those who reported watching more porn. The authors link this to addiction‑related processes.","clinical_takeaway":"The study does not provide reliable evidence for diagnosing or treating porn‑related problems; its brain‑activation findings are preliminary.","confidence":0.4,"topic_tags":["neuroscience","pornography","prevalence"],"strengths":["Uses neuroimaging (fNIRS) to examine cue reactivity","Within‑subject comparison of porn vs control clips"],"limitations":["Very small, non‑representative convenience sample","No validated measures of problematic use or addiction","Key confounds (moral incongruence, masturbation, mental health) not assessed","Statistical analysis limited to uncorrected p‑values"],"rubric_version":"2.0","raw_total":20,"max_possible":70,"pct_score":29,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":3,"statistics":3,"confounds":1,"design":3,"addiction_criteria":2,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":15,"retracted":false,"notices":[{"status":"Has correction","date":"2020-10-6","noticeDoi":"10.3389/fpsyg.2020.602857","doi":"10.3389/fpsyg.2020.02132"},{"status":"Has erratum","date":"2020-10-6","noticeDoi":"10.3389/fpsyg.2020.602857","doi":"10.3389/fpsyg.2020.02132"}],"url":"https://scite.ai/reports/10.3389/fpsyg.2020.02132"}},{"id":1872,"doi":"10.1177/0886260515596538","pmid":"26209307","pmcid":null,"title":"What Is the Attraction? Pornography Use Motives in Relation to Bystander Intervention","authors":"Foubert JD, Bridges AJ.","first_author":"Foubert JD","journal":"Journal of interpersonal violence","year":2017,"pub_types":["Journal Article"],"keywords":["Rape","Sexual Assault","Bystander Intervention","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of college students (n≈429) examining self‑reported pornography‑use motives and by‑stander intervention willingness","sample_n":429,"sample_text":"college convenience sample; not nationally representative","population":"college students (male n=139, female n=290)","country":"USA (implied)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among college students, certain reasons for watching pornography were linked to lower willingness to intervene when a sexual assault might occur, even after accounting for how often they view porn.","clinical_takeaway":"Higher porn‑use motives may relate to reduced by‑stander help; clinicians might explore underlying attitudes when addressing sexual‑violence prevention.","confidence":0.8,"topic_tags":["pornography","sexual_function","moral_incongruence","adolescents"],"strengths":["Large sample for a college survey","Controls for pornography use frequency","Investigates understudied motive‑bystander link"],"limitations":["Cross‑sectional, no causal inference","Motives and intervention measured by non‑validated items","Possible self‑selection bias of college volunteers","No control for moral, mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260515596538"}},{"id":1873,"doi":"10.4102/phcfm.v16i1.4476","pmid":"39099271","pmcid":"PMC11304187","title":"Adolescents' risky sexual behaviours and practices: Implications for sexuality education implementation in Zambia","authors":"Mukanga B, Dlamini SB, Mwanabute N, Taylor M.","first_author":"Mukanga B","journal":"African journal of primary health care & family medicine","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Zambia","Comprehensive Sexuality Education","Risky Sexual Behaviour","Kitwe"],"is_oa":true,"oa_url":"https://doi.org/10.4102/phcfm.v16i1.4476","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 807 Grade 12 students using proportionate probability sampling across 13 schools in Kitwe, Zambia; logistic regression analysis of risky sexual behaviours.","sample_n":807,"sample_text":"807 pupils","population":"Grade 12 school‑going adolescents (age ~17‑18) in Zambia","country":"Zambia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 807 Zambian high‑school seniors, 40% reported risky sexual behaviours. Watching pornography was linked to higher odds of risk, as were alcohol use, being male, and certain living arrangements. Religious involvement reduced risk. The authors suggest strengthening sexuality education.","clinical_takeaway":"Clinicians should note pornography exposure as one of many factors associated with adolescent risky sex, but interventions must also address alcohol use and broader social drivers.","confidence":0.8,"topic_tags":["religiosity","sexual_function","adolescents"],"strengths":["Large sample with probability sampling","Clear definition of risky sexual behaviour outcomes","Adjusted logistic regression with confidence intervals"],"limitations":["Cross‑sectional design limits causal inference","Pornography exposure measured by single self‑report item, no validated scale","Key confounds (moral incongruence, mental health, masturbation, trauma) not assessed"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":0,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4102/phcfm.v16i1.4476"}},{"id":1874,"doi":"10.1016/j.forsciint.2016.09.010","pmid":"27693826","pmcid":null,"title":"Pornography classification: The hidden clues in video space-time","authors":"Moreira D, Avila S, Perez M, Moraes D, Testoni V, Valle E, Goldenstein S, Rocha A.","first_author":"Moreira D","journal":"Forensic science international","year":2016,"pub_types":["Journal Article"],"keywords":["Temporal Information","Fisher Vector","Sensitive Media","Trof","Video Pornography Classification"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Algorithm evaluation on a newly created 2000‑video dataset (Pornography‑2k). Classification performance compared to commercial solutions and other computer‑vision methods.","sample_n":null,"sample_text":"2000 videos (~140 h) comprising professional, amateur, cartoon and live‑action pornographic content.","population":"videos, not human participants","country":"Brazil (authors’ affiliations suggest)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created a new computer‑vision method (TRoF) that looks at motion in video frames to tell porn from non‑porn. Tested on 2000 videos, it cut classification errors by up to 79% compared with the best commercial tool.","clinical_takeaway":"None – the study addresses automated video detection, not clinical aspects of pornography use.","confidence":0.9,"topic_tags":["pornography","csbd","sexual_function","neuroscience"],"strengths":["Introduces a novel space‑temporal feature (TRoF) tailored for video pornography detection","Large, diverse benchmark dataset (Pornography‑2k) released for the community","Compares to both commercial classifiers and other state‑of‑the‑art methods"],"limitations":["No human‑subject data; findings do not inform sexual‑health outcomes","Performance metrics limited to classification accuracy; no analysis of false‑positive impact on users","No discussion of ethical implications of automated porn detection"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":64,"citing_publications":87,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.forsciint.2016.09.010"}},{"id":1875,"doi":"10.1037//0021-843x.110.2.324","pmid":"11358026","pmcid":null,"title":"Causal attributions and male sexual arousal: the impact of attributions for a bogus erectile difficulty on sexual arousal, cognitions, and affect","authors":"Weisberg RB, Brown TA, Wincze JP, Barlow DH.","first_author":"Weisberg RB","journal":"Journal of abnormal psychology","year":2001,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment with random assignment of 52 sexually functional men to two attribution conditions after viewing erotic films; physiological and subjective arousal measured during a third film.","sample_n":52,"sample_text":"52 sexually functional participants","population":"Adult men (n=52) without sexual dysfunction; recruited presumably from a community sample.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, men who were told low arousal was due to bad films showed better erectile responses than those told it was because of their own thoughts, suggesting attribution influences later sexual performance.","clinical_takeaway":"How men explain a temporary erectile difficulty may affect subsequent arousal; clinicians might address maladaptive attributions.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Randomized experimental manipulation","Objective physiological measure of erectile response","Clear hypothesis testing"],"limitations":["Small sample size for between‑group comparisons","Attribution manipulation not validated with established scales","No assessment of potential confounding variables (e.g., mood, relationship status)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0021-843x.110.2.324"}},{"id":1876,"doi":"10.1016/j.heliyon.2020.e04584","pmid":"32904226","pmcid":"PMC7452393","title":"What we do on social media! Social representations of schoolchildren's activities on electronic communication platforms","authors":"Ige OA.","first_author":"Ige OA.","journal":"Heliyon","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Education","Sociology","Ethical Issues","School Children","Facebook","Social Media","Media Education","Information Science","Media Use","Cyber Bullying","Electronic Communication Platforms","Cyber Pornography","Cyber Hacking","Cyber Sexting","Cyber Stalking","Abusive Language"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7452393","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire with qualitative interviews of 130 secondary school students in a developing context","sample_n":130,"sample_text":"One hundred and thirty schoolchildren participated; recruitment method not specified, likely convenience sampling from schools.","population":"secondary school children (age not specified, likely 12‑18) in a developing country","country":"Not specified (developing context)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 130 secondary school students in a developing country found that many use Facebook from a young age and reported experiences such as cyber‑pornography, sexting, bullying and hacking, raising ethical concerns about social‑media use among minors.","clinical_takeaway":"None – the study is exploratory and does not provide evidence for clinical assessment or treatment.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large (N=130) sample for a school‑based exploratory study","Mixed‑methods approach combines quantitative counts with qualitative depth"],"limitations":["Ad‑hoc questionnaire; no validated scales for pornography or related behaviours","Convenience sampling; limited generalisability","No control for key psychosocial confounds (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.heliyon.2020.e04584"}},{"id":1877,"doi":"10.1080/00224499.2024.2379559","pmid":"39037803","pmcid":null,"title":"From the U.S. to Denmark and Beyond: It's Time to Reimagine the Use of Control Variables in Observational Research","authors":"Wright PJ, Tokunaga R, Herbenick D.","first_author":"Wright PJ","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"N/A","population":"N/A","country":"USA/Denmark (mixed discussion)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors discuss common mistakes in using control variables in observational studies of sexuality, using a recent Danish study on pornography and sexual satisfaction as an example. They propose ways to improve future research design.","clinical_takeaway":"None - not clinically applicable.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Addresses a methodological gap in sexology literature","Uses a concrete case study to illustrate points"],"limitations":["No original empirical data","Limited to commentary; no systematic analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2024.2379559"}},{"id":1879,"doi":"10.1016/j.brat.2003.07.011","pmid":"15178466","pmcid":null,"title":"The effects of self-focused attention, performance demand, and dispositional sexual self-consciousness on sexual arousal of sexually functional and dysfunctional men","authors":"van Lankveld JJ, van den Hout MA, Schouten EG.","first_author":"van Lankveld JJ","journal":"Behaviour research and therapy","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment with 2×2 factorial manipulation of performance demand and self‑focus, comparing sexually functional (N=26) and erectile‑disorder (N=23) men.","sample_n":49,"sample_text":"N=26 functional, N=23 erectile‑disorder","population":"Heterosexual adult men, functional and with psychogenic erectile disorder.","country":"Netherlands (inferred from authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, men watched erotic videos while researchers varied how much they were expected to respond and whether they were being watched. Men who believed a strong response was expected showed weaker genital reactions. Self‑focus reduced arousal only in men high in sexual self‑consciousness, but increased it in low‑consciousness men.","clinical_takeaway":"Performance pressure can blunt physiological arousal; clinicians should consider attentional focus when treating erectile concerns.","confidence":0.8,"topic_tags":["sexual_function","gender","csbd"],"strengths":["Objective physiological measurement (penile tumescence)","Experimental manipulation of attention and demand","Inclusion of both functional and clinical groups"],"limitations":["Small sample size limits power","No pre‑registration or effect‑size reporting","Findings may not generalise beyond lab setting"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":7,"contrasting":1,"mentioning":17,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.brat.2003.07.011"}},{"id":1880,"doi":"10.1016/j.chiabu.2024.106936","pmid":"39002252","pmcid":null,"title":"Accessing child sexual abuse material: Pathways to offending and online behaviour","authors":"Wortley R, Findlater D, Bailey A, Zuhair D.","first_author":"Wortley R","journal":"Child abuse & neglect","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Csam","Indecent Images Of Children","Child Sexual Abuse Material","Sex Offending Pathways","Sexual Offending Prevention"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 75 male CSAM offenders in a community treatment programme; self‑report questionnaire on offending pathways and online behaviour.","sample_n":75,"sample_text":"Seventy‑five male CSAM offenders, living in the community and voluntarily participating in a treatment programme.","population":"Male CSAM offenders (community, treatment‑seeking)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 75 male offenders who view child sexual abuse material showed many first encountered it accidentally or after watching legal pornography, and their involvement tended to increase over time. Psychological stress and life circumstances influenced how often they accessed illegal content, and most lacked advanced technical skills.","clinical_takeaway":"Offenders often start unintentionally and may be receptive to interventions that disrupt their online pathways.","confidence":0.7,"topic_tags":["csbd","sexual_function","prevalence","treatment"],"strengths":["Focused examination of offenders’ self‑reported pathways","Identifies situational and psychological factors linked to escalation","Provides data from a hard‑to‑reach population"],"limitations":["Convenience sample of treatment‑seeking offenders limits generalisability","Reliance on non‑validated, self‑report questionnaire","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2024.106936"}},{"id":1883,"doi":"10.1016/j.comppsych.2024.152517","pmid":"39018815","pmcid":null,"title":"A comprehensive measure assessing different types of problematic use of the internet among Chinese adolescents: The Assessment of Criteria for Specific Internet-use Disorders (ACSID-11)","authors":"Saffari M, Chen CY, Chen IH, Ruckwongpatr K, Griffiths MD, Potenza MN, Wang XL, Huang YT, Chen JS, Tsai CC, Lin CY.","first_author":"Saffari M","journal":"Comprehensive psychiatry","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Internet Addiction","Addictive Behaviors","Psychometric Assessment","Compulsive Behaviors","Impulsive Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large convenience sample of Chinese adolescents (N=11,492) completing online questionnaire; CFA and reliability analyses performed","sample_n":11492,"sample_text":"convenience sample recruited via online survey in schools","population":"Chinese adolescents (mean age 16.4) from six schools","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers translated and tested a new questionnaire (ACSID‑11) that measures different kinds of problematic internet use—including pornography—among Chinese teens. The scale showed good factor structure and reliability compared with existing addiction scales.","clinical_takeaway":"The ACSID‑11 appears reliable for screening various internet‑related problems in adolescents, but clinicians should consider missing confounders (e.g., moral distress, mental health).","confidence":0.85,"topic_tags":["pornography","sexual_function"],"strengths":["Very large sample size","Comprehensive psychometric validation (CFA, invariance, reliability)","Cross‑cultural translation process"],"limitations":["Convenience school sample limits generalisability","No assessment of moral, mental‑health or trauma confounds","Self‑report only, no objective usage data"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2024.152517"}},{"id":1884,"doi":"10.3390/s20143989","pmid":"32709067","pmcid":"PMC7411926","title":"Automatic Detection of Pornographic and Gambling Websites Based on Visual and Textual Content Using a Decision Mechanism","authors":"Chen Y, Zheng R, Zhou A, Liao S, Liu L.","first_author":"Chen Y","journal":"Sensors (Basel, Switzerland)","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Information processing","Machine Learning","Bovw","Doc2vec","Decision Mechanism","Website Detection"],"is_oa":true,"oa_url":"https://www.mdpi.com/1424-8220/20/14/3989/pdf","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"algorithm development and evaluation on crawled website datasets; cross‑sectional, no human participants","sample_n":null,"sample_text":"not applicable – study uses website dataset rather than human participants","population":"websites (pornographic and gambling) scraped from the Internet; no human participants","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors created an automated system that scans website screenshots and source code to identify pornographic and gambling sites, achieving over 99% accuracy in their tests.","clinical_takeaway":"None – the study concerns technical web‑filtering, not clinical sexual health.","confidence":0.8,"topic_tags":["pornography","sexual_function","religiosity"],"strengths":["High reported classification accuracy (>99%)","Combines visual and textual features","Decision‑fusion approach using logistic regression"],"limitations":["No human participant data – limited relevance to sexual health","No external validation on independent real‑world traffic","Lacks confidence intervals or statistical significance testing"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":28,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/s20143989"}},{"id":1886,"doi":"10.1007/s10508-024-02937-y","pmid":"38961025","pmcid":"PMC11836212","title":"Prevalence of Sexual Strangulation/Choking Among Australian 18-35 Year-Olds","authors":"Sharman LS, Fitzgerald R, Douglas H.","first_author":"Sharman LS","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Strangulation","Choking","Transgender","Sexual Orientation","Asphyxiation","Breath Play"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11836212","cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey, N=4702, convenience sample","sample_n":4702,"sample_text":"Convenient online recruitment, likely self‑selected, not probability based","population":"Australian adults 18‑35, mixed gender identities","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A national online survey of 4700 Australian young adults found that more than half had ever been choked during sex and half had ever choked a partner. Perceived safety and peer norms predicted more positive attitudes toward choking.","clinical_takeaway":"Clinicians should ask about sexual choking and provide non‑judgmental education on consent and safety.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large national sample (N>4000)","Detailed gender‑and orientation‑specific analyses","Provides prevalence data for a risky sexual practice"],"limitations":["Convenience online recruitment limits generalisability","Measures are ad‑hoc, not validated","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":26,"retracted":false,"notices":[{"status":"Has correction","date":"2024-9-25","noticeDoi":"10.1007/s10508-024-03014-0","doi":"10.1007/s10508-024-02937-y"}],"url":"https://scite.ai/reports/10.1007/s10508-024-02937-y"}},{"id":1887,"doi":"10.1177/1077801216648793","pmid":"27216476","pmcid":null,"title":"Predicting Bystander Efficacy and Willingness to Intervene in College Men and Women: The Role of Exposure to Varying Levels of Violence in Pornography","authors":"Foubert JD, Bridges AJ.","first_author":"Foubert JD","journal":"Violence against women","year":2017,"pub_types":["Journal Article"],"keywords":["Violence","Bystander Intervention","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Students from two universities completed self‑report surveys on pornography use and bystander willingness; hierarchical logistic regression was used.","sample_n":null,"sample_text":"students from two research universities","population":"College students (both sexes) from two Midwestern U.S. universities; convenience sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"College students who reported watching violent or degrading porn were less willing to help a potential sexual‑violence victim, especially men. The study suggests such porn may shape attitudes that tolerate violence.","clinical_takeaway":"Awareness of porn content may be relevant when training students for bystander intervention programs.","confidence":0.7,"topic_tags":["pornography","gender","sexual_function"],"strengths":["Addresses understudied link between violent porn exposure and bystander attitudes","Uses hierarchical logistic regression to examine gender differences"],"limitations":["Cross‑sectional design; cannot infer causality","Convenience sample of college students limits generalisability","No validated measures of pornography content categories"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801216648793"}},{"id":1889,"doi":"10.1007/s10508-016-0770-y","pmid":"27388511","pmcid":null,"title":"Does Viewing Pornography Reduce Marital Quality Over Time? Evidence from Longitudinal Data","authors":"Perry SL.","first_author":"Perry SL.","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Gender","Marriage","Relationship Quality","Panel Data","Marital Quality","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"nationally representative panel (2006‑2012) with repeated measures of pornography frequency and marital quality","sample_n":null,"sample_text":"large nationally representative panel (exact N not given in abstract)","population":"married adults in the United States (representative sample)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a US panel study, people who watched more porn in 2006 reported lower marital quality six years later, especially husbands. Wives showed the opposite pattern. The study suggests pornography frequency may affect relationships over time.","clinical_takeaway":"Higher porn use may be linked to later marital dissatisfaction for men; clinicians should consider couple dynamics when discussing porn use.","confidence":0.78,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Longitudinal design with baseline control","Nationally representative sample","Separate measurement of porn frequency and marital quality"],"limitations":["Potential unmeasured confounders (moral attitudes, mental health, trauma)","Pornography frequency likely measured by a single self‑report item","No explicit reporting of effect sizes or confidence intervals in abstract"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":43,"citing_publications":121,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0770-y"}},{"id":1890,"doi":"10.33546/bnj.3244","pmid":"38947303","pmcid":"PMC11211740","title":"Social media use, knowledge, attitudes, and risky sexual behavior of HIV transmission: A survey among boarding school adolescent students in Indonesia","authors":"Ramadani RC, Ibrahim K, Mirwanti R, Maulana S, Jabareen R.","first_author":"Ramadani RC","journal":"Belitung nursing journal","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Students","Adolescent","Indonesia","HIV infection","Sexual Health","Attitudes","Practices","Social Media","Health Knowledge"],"is_oa":true,"oa_url":"https://doi.org/10.33546/bnj.3244","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"school‑based cross‑sectional survey; cluster random sampling of 214 boarding‑school adolescents in Indonesia; self‑report questionnaire","sample_n":214,"sample_text":"students from three boarding schools","population":"adolescent boarding‑school students (Indonesia)","country":"Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 214 Indonesian boarding‑school adolescents found high social‑media use, limited HIV knowledge, and modest risky sexual behaviour. Exposure to pornographic content was strongly linked to risky sex, suggesting the need for targeted education.","clinical_takeaway":"Educators should address pornographic content exposure in sexual‑health curricula to reduce HIV‑risk behaviours.","confidence":0.8,"topic_tags":["sexual_function","adolescents","pornography"],"strengths":["Relatively large community sample for this setting","Cluster random sampling enhances representativeness within schools","Examines a timely topic: social media influence on HIV‑related risk"],"limitations":["Self‑report measures likely non‑validated","Cross‑sectional design prevents causal inference","Key confounders (moral attitudes, mental health, partner context) not assessed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.33546/bnj.3244"}},{"id":1892,"doi":"10.1093/asj/sjz254","pmid":"31556940","pmcid":null,"title":"The Role of Pornography, Physical Symptoms, and Appearance in Labiaplasty Interest","authors":"Sorice-Virk S, Li AY, Canales FL, Furnas HJ.","first_author":"Sorice-Virk S","journal":"Aesthetic surgery journal","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"prospective questionnaire comparing 124 labiaplasty patients to 50 control women","sample_n":174,"sample_text":"124 consecutive patients consulting about labiaplasty and 50 control women","population":"women seeking labiaplasty (n=124) and control women (n=50) recruited consecutively in a clinical setting","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of women considering labiaplasty found that only a small minority said pornography influenced their decision, while physical and appearance concerns were far more common.","clinical_takeaway":"Clinicians should focus on functional and aesthetic concerns rather than assuming pornography drives labiaplasty requests.","confidence":0.78,"topic_tags":["pornography","lgbtq","sexual_function","adolescents","csbd"],"strengths":["Prospective data collection","Comparison with control cohort","Clear reporting of symptom counts"],"limitations":["Reliance on single‑item, non‑validated measures of pornography influence","No assessment of moral, mental‑health or relational confounders","Limited generalisability beyond clinic sample"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/asj/sjz254"}},{"id":1893,"doi":"10.1556/2006.2020.00035","pmid":"32634114","pmcid":"PMC9295220","title":"Which conditions should be considered as disorders in the International Classification of Diseases (ICD-11) designation of \"other specified disorders due to addictive behaviors\"?","authors":"Brand M, Rumpf HJ, Demetrovics Z, Müller A, Stark R, King DL, Goudriaan AE, Mann K, Trotzke P, Fineberg NA, Chamberlain SR, Kraus SW, Wegmann E, Billieux J, Potenza MN.","first_author":"Brand M","journal":"Journal of behavioral addictions","year":2022,"pub_types":["review-article","Review","Journal Article"],"keywords":["Icd-11","Addictive Behaviors","Buying-shopping Disorder","Problematic Social-network Use","Pornography-use Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9295220","cited_by_count":265,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review / expert opinion; no empirical data collected.","sample_n":null,"sample_text":"No empirical sample; review of existing literature.","population":"Not applicable (no participants).","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors propose criteria for deciding whether behaviours like problematic pornography use, shopping, or social‑media use should be listed as ‘other specified disorders due to addictive behaviours’ in ICD‑11, emphasizing clinical impact, theoretical fit, and empirical support while warning against over‑pathologising everyday activities.","clinical_takeaway":"Clinicians should weigh functional impairment and evidence against moral concerns before labeling behaviours as addictive disorders.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Comprehensive overview of ICD‑11 framework","Clear meta‑level criteria for future research","Includes a range of candidate behaviors"],"limitations":["No original empirical data","Reliance on expert opinion rather than systematic review","Lacks systematic risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":7,"contrasting":1,"mentioning":313,"citing_publications":425,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00035"}},{"id":1894,"doi":"10.1007/s11934-024-01213-9","pmid":"38922362","pmcid":null,"title":"Erectile Dysfunction in Adolescents and Young Adults","authors":"Pantazis A, Franco I, Gitlin J.","first_author":"Pantazis A","journal":"Current urology reports","year":2024,"pub_types":["Review","Journal Article"],"keywords":["Erectile Dysfunction Treatment","Adolescent Erectile Dysfunction","Erectile Dysfunction Work-up","Sexual Dysfunction Adolescent","Sexual Dysfunction Young Adult","Young Adult Erectile Dysfunction"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review summarising recent literature without systematic methodology or risk‑of‑bias assessment","sample_n":null,"sample_text":"none – review article","population":"adolescents and young adult males with erectile dysfunction (no primary data presented)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review recent studies on erectile dysfunction in teen and young adult males, noting rises in cases, links to anxiety, depression, and possibly COVID‑19‑related stress and online porn use, and summarise diagnostic and treatment advice.","clinical_takeaway":"Clinicians should assess mental health and consider CBT and low‑dose tadalafil for adolescents with erectile dysfunction, but evidence for a direct porn‑related cause is limited.","confidence":0.6,"topic_tags":["sexual_function","adolescents","pornography"],"strengths":["Provides up‑to‑date clinical overview for pediatric urologists","Covers both organic and psychogenic etiologies"],"limitations":["Narrative, not systematic, so selection bias likely","No primary data; conclusions based on unspecified sources","No quantitative synthesis or critical appraisal of cited studies"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11934-024-01213-9"}},{"id":1897,"doi":"10.1556/2006.5.2016.036","pmid":"27348557","pmcid":"PMC5387768","title":"Clinical Characteristics of Men Interested in Seeking Treatment for Use of Pornography","authors":"Kraus SW, Martino S, Potenza MN.","first_author":"Kraus SW","journal":"Journal of behavioral addictions","year":2016,"pub_types":["review-article","Journal Article"],"keywords":["Sexual Behaviors","Hypersexuality","Pornography","Treatment-seeking Men"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/5/2/article-p169.pdf","cited_by_count":65,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet‑based survey of 1,298 male pornography users; logistic regression to examine factors linked to interest in treatment.","sample_n":1298,"sample_text":"Internet‑based convenience sample of male pornography users (N=1298).","population":"Adult men who use pornography (self‑selected online sample, international)","country":"Canada, United States, Australia, United Kingdom (unspecified distribution)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 1,298 men who watch pornography, about 14% said they were interested in treatment. Those interested were more likely to have higher hypersexuality scores, view pornography more often, masturbate more, be single, and have tried to quit or cut back.","clinical_takeaway":"Interest in treatment is linked to hypersexuality and higher porn use; clinicians should assess sexual self‑control and recent quit attempts when screening.","confidence":0.85,"topic_tags":["pornography","treatment","sexual_function","prevalence"],"strengths":["Large sample size for a survey","Use of validated Hypersexual Behavior Inventory","Separate assessment of masturbation and dyadic sexual activity"],"limitations":["Convenience internet sample limits generalisability","No measurement of moral incongruence or mental‑health covariates","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":18,"contrasting":1,"mentioning":77,"citing_publications":121,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.5.2016.036"}},{"id":1898,"doi":"10.1016/j.chiabu.2024.106908","pmid":"38925011","pmcid":null,"title":"Testing a hybrid risk assessment model: Predicting CSAM offender risk from digital forensic artifacts","authors":"Seigfried-Spellar KC, Rogers MK, Matulis NL, Heasley JS.","first_author":"Seigfried-Spellar KC","journal":"Child abuse & neglect","year":2024,"pub_types":["Journal Article"],"keywords":["Cport","Child Sexual Abuse Materials","Digital Forensic Artifacts","Dual Offender","Non-contact Offender","Offender Risk"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"feasibility study of 7 closed CSAM cases, no control group, descriptive accuracy of hybrid risk model","sample_n":7,"sample_text":"seven randomly selected closed CSAM cases (male, >18, mobile device, 2019‑2023)","population":"male adult offenders of CSAM, selected by law‑enforcement HTCU","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A pilot study looked at seven adult men convicted of child sexual‑abuse material offenses and tested whether a combined risk model using digital device evidence could predict whether they were likely to reoffend. The model matched existing risk scores in six of the seven cases.","clinical_takeaway":"None - the study does not provide clinically actionable evidence for treating or assessing pornography‑related problems.","confidence":0.7,"topic_tags":["csbd"],"strengths":["innovative integration of digital forensics with existing risk tools","real‑world law‑enforcement data"],"limitations":["extremely small sample (N=7)","no external validation or control group","risk construct not validated with psychometric tools"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2024.106908"}},{"id":1899,"doi":"10.1080/0092623x.2020.1783409","pmid":"32573369","pmcid":null,"title":"The Moderating Influence of Moral Disapproval of Pornography on Couples' Sexual and Relationship Satisfaction","authors":"Floyd CG, Landa S, Saunders MA, Volk F.","first_author":"Floyd CG","journal":"Journal of sex & marital therapy","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["bibliography","pornography","sexual_health","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of adults in committed relationships who reported past‑6‑month pornography use; tested moderated mediation model linking use → sexual shame → sexual satisfaction → couple satisfaction, with moral disapproval as moderator","sample_n":null,"sample_text":"online sample of participants that reported using pornography in the last six months and being in a committed relationship","population":"Adults in committed relationships who use pornography (online convenience sample)","country":"not specified","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among couples who use porn, those who morally disapprove of it report more sexual shame, lower sexual satisfaction, and poorer relationship satisfaction, suggesting moral attitudes shape how porn use relates to intimacy.","clinical_takeaway":"Clinicians should consider clients' moral views on porn when discussing sexual and relationship satisfaction.","confidence":0.7,"topic_tags":["pornography","moral_incongruence","relationships","sexual_function"],"strengths":["uses validated self‑report scales for shame and satisfaction","explicitly measures moral disapproval and tests moderation","adds nuance to pornography‑relationship literature"],"limitations":["cross‑sectional design limits causal inference","does not separate pornography use from masturbation","no control for mental‑health or relationship quality covariates"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2020.1783409"}},{"id":1900,"doi":"10.1177/0886260520922341","pmid":"32506992","pmcid":"PMC8793298","title":"Changing Cognitive Risk Factors for Sexual Aggression: Risky Sexual Scripts, Low Sexual Self-Esteem, Perception of Pornography, and Acceptance of Sexual Coercion","authors":"Schuster I, Tomaszewska P, Krahé B.","first_author":"Schuster I","journal":"Journal of interpersonal violence","year":2022,"pub_types":["research-article","Randomized Controlled Trial","Journal Article"],"keywords":["College Students","Sexual Aggression","Sexual Coercion","Sexual Scripts","Sexual Self-esteem"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8793298","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized controlled trial with three arms (two experimental, one control) and measurements at baseline, post‑intervention, and 8‑week follow‑up (N=324 college students).","sample_n":324,"sample_text":"College students in Germany (N=324) randomly assigned to three groups.","population":"College students in Germany (N=324).","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A randomized trial with German college students tested brief interventions aimed at changing sexual scripts, boosting sexual self‑esteem, and reducing acceptance of sexual coercion. The programs successfully altered some risk‑related cognitions, but did not change how realistic participants viewed pornography.","clinical_takeaway":"Targeted brief interventions can shift certain sexual‑cognition risk factors, though altering pornography perceptions may need different approaches.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Large sample for an RCT","Three‑arm design with active experimental conditions","Longitudinal follow‑up allows assessment of durability"],"limitations":["Unclear whether key scales are validated for this population","No measurement or control of major confounds (e.g., moral incongruence, mental health)","No pre‑registration or effect‑size reporting in abstract"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260520922341"}},{"id":1901,"doi":"10.1080/13625187.2016.1186268","pmid":"27218610","pmcid":null,"title":"Pornography consumption among adolescent girls in Sweden","authors":"Mattebo M, Tydén T, Häggström-Nordin E, Nilsson KW, Larsson M.","first_author":"Mattebo M","journal":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","year":2016,"pub_types":["Journal Article"],"keywords":["Sexuality","Health","Lifestyle","Adolescent Girls","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"classroom survey of 16‑year‑old girls (N=393)","sample_n":393,"sample_text":"Convenience sample of school‑based 16‑year‑old female students","population":"adolescent girls in Sweden","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 393 Swedish 16‑year‑old girls, about one‑third reported watching pornography. Those who did report more sexual experiences, higher rates of anal sex, and riskier lifestyles (more alcohol use and smoking) than peers who did not watch porn.","clinical_takeaway":"Among adolescent girls, pornography use is linked to higher sexual activity and riskier health behaviours, but causality is unclear.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","lgbtq"],"strengths":["Relatively large sample for adolescent survey","Clear descriptive comparison between consumers and non‑consumers","Focus on concrete sexual‑behavior outcomes"],"limitations":["Cross‑sectional design cannot infer causality","No validated measures of pornography use or related constructs","Key confounds (moral attitudes, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":1,"mentioning":18,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13625187.2016.1186268"}},{"id":1902,"doi":"10.1177/1077801216648795","pmid":"27216475","pmcid":null,"title":"Adult Pornography and Violence Against Women in the Heartland: Results From a Rural Southeast Ohio Study","authors":"DeKeseredy WS, Hall-Sanchez A.","first_author":"DeKeseredy WS","journal":"Violence against women","year":2017,"pub_types":["Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Gender","Rural","Violence","Pornography","Separation/divorce"],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"In‑depth interviews with 55 rural southeast Ohio women who were leaving or had left abusive male partners; thematic analysis of qualitative data.","sample_n":55,"sample_text":"55 rural southeast Ohio women who wanted to leave, were trying to leave, or were in the process of leaving, or who have left their male marital/cohabiting partners.","population":"Rural women (southeast Ohio) who experienced intimate partner violence and were in the process of leaving or had left their partners.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 55 rural women leaving abusive partners suggest they see pornography as a major factor in their partner’s violence. The study provides detailed personal accounts but does not quantitatively test this link.","clinical_takeaway":"Clinicians should be aware that some women attribute partner violence to pornography, but the evidence does not establish a causal relationship.","confidence":0.7,"topic_tags":["pornography","gender","religiosity","sexual_function"],"strengths":["Rich, in‑depth qualitative data from a marginalized rural population","Focus on lived experience of women leaving abusive relationships"],"limitations":["Small, non‑representative convenience sample","No measurement of key confounds (e.g., moral incongruence, mental health)","Conclusions imply causality without quantitative evidence"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":34,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801216648795"}},{"id":1904,"doi":"10.1556/2006.5.2016.022","pmid":"27156383","pmcid":"PMC5387769","title":"Examining Correlates of Problematic Internet Pornography Use Among University Students","authors":"Harper C, Hodgins DC.","first_author":"Harper C","journal":"Journal of behavioral addictions","year":2016,"pub_types":["review-article","Journal Article"],"keywords":["Masturbation","Video Game Addiction","Internet Pornography Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5387769","cited_by_count":46,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 191 university students measuring pornography use frequency, a self‑report problematic use scale, and psychosocial variables","sample_n":191,"sample_text":"105 female and 86 male university students","population":"university students (mean age 21) from Calgary, Canada","country":"Canada","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 191 Canadian university students, daily pornography use was linked to higher scores on a self‑report ‘addiction’ questionnaire and poorer mood and relationship satisfaction, while overall frequency was not strongly related to well‑being.","clinical_takeaway":"Daily pornography use may signal problematic patterns, but frequency alone does not predict distress; clinicians should assess functional impact and consider other mental‑health factors.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Reasonable sample size for a student survey","Includes both genders","Examines curvilinear relationship between use frequency and addiction scores"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of moral incongruence or masturbation","Addiction scale likely conflates frequency with distress"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":5,"contrasting":1,"mentioning":74,"citing_publications":114,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.5.2016.022"}},{"id":1905,"doi":"10.1186/s12978-024-01808-y","pmid":"38840149","pmcid":"PMC11155156","title":"Risky sexual behavior and associated factors among out-of-school youths in Addis Ababa, Ethiopia; mixed methods study","authors":"Sifer SD, Getachew MS.","first_author":"Sifer SD","journal":"Reproductive health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Youths","Associated Factors","Risky Sexual Behavior","Addis Ababa","Out-of-school"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11155156","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"community based cross‑sectional mixed‑methods survey of 701 out‑of‑school youths in Addis Ababa; systematic sampling for quantitative arm, purposive sampling for qualitative arm; logistic regression for associations.","sample_n":701,"sample_text":"701 youths recruited via systematic sampling (quantitative) and purposive sampling (qualitative).","population":"out‑of‑school adolescents and young adults (≈15‑24 y) in Addis Ababa, Ethiopia","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In Addis Ababa, about 41 % of out‑of‑school youths engaged in risky sexual behavior. Watching pornography, being younger, female, low parental education, alcohol use, peer pressure and low parental monitoring were linked to higher risk.","clinical_takeaway":"Consider pornography exposure alongside other known risk factors when designing youth sexual‑health interventions.","confidence":0.7,"topic_tags":["religiosity","moral_incongruence","pornography"],"strengths":["Large sample for a community survey (N = 701)","Mixed‑methods adds qualitative depth","Use of multivariable logistic regression with confidence intervals"],"limitations":["Cross‑sectional design cannot infer causality","Key psychosocial confounds (e.g., moral incongruence, mental health) not measured","Questionnaire not reported as validated for addiction‑related constructs"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-024-01808-y"}},{"id":1908,"doi":"10.1093/sxmrev/qeae024","pmid":"38705842","pmcid":null,"title":"A review of published studies on virtual reality in sexuality research","authors":"Marques JM, Figueiredo CPM, Scanavino MDT.","first_author":"Marques JM","journal":"Sexual medicine reviews","year":2024,"pub_types":["Systematic Review","Journal Article"],"keywords":["Sexuality","Sexual behavior","Virtual reality","Sex behavior","Virtual Reality Therapy"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review with narrative synthesis; methodological quality assessment mentioned but no clear risk‑of‑bias tool or meta‑analysis","sample_n":null,"sample_text":"Not applicable – review of existing studies","population":"studies using virtual‑reality interventions in sexuality research (18 articles); no single sample size for this review","country":"International (databases searched across multiple countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review collected 18 studies that used virtual reality to explore sexual responses such as erections, feeling of immersion, and biological markers. It finds that many of these studies have methodological weaknesses, especially regarding randomisation and bias control, and calls for better‑designed research.","clinical_takeaway":"Current VR evidence for sexual health is limited by poor study design; clinicians should await higher‑quality trials before adopting VR interventions.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive search across four major databases","Identifies methodological gaps in VR sexuality research","Provides synthesis of diverse outcome domains (erection, immersion, biomarkers)"],"limitations":["No quantitative meta‑analysis or clear risk‑of‑bias assessment reported","Lacks detail on how individual study quality was rated","Small number of included studies (18) limits generalisability"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeae024"}},{"id":1909,"doi":"10.29063/ajrh2024/v28i6.8","pmid":"38980124","pmcid":null,"title":"Exploring patterns and determinants of premarital sexual behaviour among Indonesian university students","authors":"Wulandari R, Aprianti A, Ashari A, Waluyo DE.","first_author":"Wulandari R","journal":"African journal of reproductive health","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online survey of 530 Indonesian university students; cross‑sectional, convenience sample; logistic regression used to identify factors associated with premarital sex.","sample_n":530,"sample_text":"530 students","population":"Indonesian university students (average age 19, both sexes)","country":"Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 530 Indonesian university students found that a small proportion had viewed pornography and that this exposure was linked to higher odds of having premarital sex, which often occurred without condom use.","clinical_takeaway":"Exposure to pornography is associated with premarital sexual activity among Indonesian students; education on safe sex may be warranted.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Reasonably large sample for a single university","Uses multivariate logistic regression to adjust for several demographic variables"],"limitations":["Cross‑sectional design prevents causal inference","Reliance on self‑report items of unknown validation","No measurement of key confounds (e.g., mental health, moral attitudes)","Convenience online sample limits generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.29063/ajrh2024/v28i6.8"}},{"id":1910,"doi":"10.1007/s10508-016-0732-4","pmid":"27091186","pmcid":null,"title":"A Common-Fate Analysis of Pornography Acceptance, Use, and Sexual Satisfaction Among Heterosexual Married Couples","authors":"Brown CC, Carroll JS, Yorgason JB, Busby DM, Willoughby BJ, Larson JH.","first_author":"Brown CC","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Sexuality","Marriage","Couples","Sexual Satisfaction","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 326 heterosexual married couples using the RELATE questionnaire.","sample_n":326,"sample_text":"326 couples","population":"Heterosexual married couples (n=326 couples, 652 individuals)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 326 married couples, both partners’ acceptance of porn was linked to their own porn use, and higher personal use was tied to lower sexual satisfaction. Wives’ use was oddly related to higher shared sexual satisfaction, showing that porn’s role in marriages is complex.","clinical_takeaway":"Couples’ attitudes and personal porn use are associated with sexual satisfaction; clinicians should explore both partners’ perspectives rather than assuming uniform effects.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Large couple sample (326 couples)","Use of a validated relationship questionnaire (RELATE)","Dyadic analytic approach (common‑fate model)","Addresses both partners’ perspectives"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral, mental‑health or trauma confounds","Pornography use measured by self‑report, likely single‑item","Findings may not generalise beyond heterosexual married couples"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0732-4"}},{"id":1911,"doi":"10.1016/j.adolescence.2016.03.017","pmid":"27088659","pmcid":null,"title":"How does religious attendance shape trajectories of pornography use across adolescence?","authors":"Rasmussen K, Alex Bierman.","first_author":"Rasmussen K","journal":"Journal of adolescence","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescence","Religious Attendance","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"National longitudinal survey following adolescents into young adulthood, assessing self‑reported pornography use and religious attendance over time.","sample_n":null,"sample_text":"National longitudinal survey (sample size not specified in abstract).","population":"Adolescents (both sexes) from a national sample, likely diverse but limited to those who responded to the survey.","country":"Not specified (likely United States based on journal).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A national survey tracked teens over time and found that watching porn rises with age, especially for boys, but teens who attend religious services more often tend to watch less and increase more slowly.","clinical_takeaway":"Higher religious attendance may be associated with lower adolescent porn use, but causality is not established.","confidence":0.8,"topic_tags":["pornography","adolescents","religiosity","sexual_function"],"strengths":["Large national longitudinal dataset","Sex‑balanced sample","Clear focus on religious attendance as moderator"],"limitations":["Reliance on single‑item self‑report for pornography use","No measurement of masturbatory behavior or moral incongruence","Potential unmeasured confounders (mental health, relationship status)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":4,"mentioning":36,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2016.03.017"}},{"id":1912,"doi":"10.1080/00224499.2020.1754747","pmid":"32348164","pmcid":null,"title":"Between a Camera and a Hard Place: A Content Analysis of Performer Representation in Heterosexual Pornographic Content","authors":"Mazandarani F.","first_author":"Mazandarani F.","journal":"Journal of sex research","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 123 popular heterosexual porn videos from a major US site; coders quantified screen time, placement, audibility, and camera interaction for each performer.","sample_n":123,"sample_text":"123 videos","population":"Online pornography videos (male‑female dyads) selected for popularity; not human participants.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study coded 123 popular straight porn videos and found women appear on screen roughly four times more than men, based on how long they’re shown, where they’re placed, and how often they’re heard.","clinical_takeaway":"None – the findings describe content characteristics, not clinical outcomes.","confidence":0.8,"topic_tags":["pornography","gender","sexual_function"],"strengths":["Clear operational definition of ‘physical representation’","Systematic coding protocol with inter‑rater reliability implied","Large sample of contemporary popular videos"],"limitations":["Convenience sample of popular videos; limited generalisability","No validation of coding scheme against external criteria","Interpretation of viewer effects is speculative"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":7,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2020.1754747"}},{"id":1913,"doi":"10.1080/0092623x.2020.1758860","pmid":"32342728","pmcid":null,"title":"I (Dis)Like it Like That: Gender, Pornography, and Liking Sex","authors":"Ezzell MB, Johnson JA, Bridges AJ, Sun CF.","first_author":"Ezzell MB","journal":"Journal of sex & marital therapy","year":2020,"pub_types":["Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,883 predominantly college students in the U.S.","sample_n":1883,"sample_text":"1883 heterosexual men and women (86.6% college/university students)","population":"heterosexual men and women, mostly college/university students, U.S.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large U.S. survey of mainly college students, pornography use did not predict greater enjoyment of most sexual acts, but men reported higher enjoyment of degrading or uncommon acts than women.","clinical_takeaway":"Gender differences may shape how pornography influences sexual preferences; clinicians should consider individual variation rather than assume universal effects.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Large sample size for survey","Gender moderation analysis","Correction for multiple comparisons"],"limitations":["Convenience college sample limits generalisability","Reliance on ad‑hoc self‑report items without validated scales","No control for key confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2020.1758860"}},{"id":1915,"doi":"10.1177/0886260520915550","pmid":"32306817","pmcid":null,"title":"The Confluence Model of Sexual Aggression: An Application With Adolescent Males","authors":"Huntington C, Pearlman DN, Orchowski L.","first_author":"Huntington C","journal":"Journal of interpersonal violence","year":2022,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":["Adolescents","Masculinity","Sexual Aggression","Violent Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 935 10th‑grade boys, self‑report questionnaires; cross‑sectional analysis using zero‑inflated Poisson regression","sample_n":935,"sample_text":"935 heterosexual 10th‑grade adolescent boys","population":"adolescent heterosexual males (10th grade) in a US school district","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 935 US 10th‑grade boys, hostile attitudes toward women, a casual approach to sex, and watching violent pornography were linked to higher rates of both contact and non‑contact sexual aggression over the past six months.","clinical_takeaway":"Programs targeting hostile masculinity, impersonal sexual attitudes, and violent porn exposure may help prevent sexual aggression among adolescent males.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["large sample (N>900)","use of appropriate count model (zero‑inflated Poisson)","focus on adolescent population, understudied group"],"limitations":["cross‑sectional, no causal inference","constructs measured with unclear validation","no control for key confounds (moral, mental health, trauma, etc.)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":1,"mentioning":31,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260520915550"}},{"id":1916,"doi":"10.3389/fpubh.2024.1326178","pmid":"38827621","pmcid":"PMC11143794","title":"Using machine learning algorithms and techniques for defining the impact of affective temperament types, content search and activities on the internet on the development of problematic internet use in adolescents' population","authors":"Jović J, Ćorac A, Stanimirović A, Nikolić M, Stojanović M, Bukumirić Z, Ignjatović Ristić D.","first_author":"Jović J","journal":"Frontiers in public health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Machine Learning","Internet Use","Problematic Internet Use","A-Temps-A"],"is_oa":true,"oa_url":"https://doi.org/10.3389/fpubh.2024.1326178","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 2,113 adolescents using questionnaires and ML classification","sample_n":2113,"sample_text":"2,113 adolescents recruited via school‑based surveys (presumed convenience sample)","population":"adolescents (age not specified)","country":"unspecified (likely Croatia based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 2,000 adolescents, machine‑learning models identified cyclothymic temperament, longer internet time, and interest in pornography as key factors linked to higher scores on a problematic internet use questionnaire.","clinical_takeaway":"Temperament and excessive online pornography may signal higher risk for problematic internet use in teens, but causality is unproven.","confidence":0.8,"topic_tags":["adolescents","pornography","religiosity","moral_incongruence","masturbation"],"strengths":["Large community sample (N>2000)","Use of validated scales for PIU and temperament","Application of multiple ML algorithms with cross‑validation"],"limitations":["Cross‑sectional design; cannot infer causality","Key confounds (moral incongruence, mental health, partner factors) not measured","Reliance on self‑report questionnaires for pornography use"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2024.1326178"}},{"id":1917,"doi":"10.1177/0886260516633204","pmid":"26951609","pmcid":null,"title":"Pornography, Sexual Coercion and Abuse and Sexting in Young People's Intimate Relationships: A European Study","authors":"Stanley N, Barter C, Wood M, Aghtaie N, Larkins C, Lanau A, Överlien C.","first_author":"Stanley N","journal":"Journal of interpersonal violence","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Domestic Violence","Sexual Assault","Dating Violence","Pornography","Sexting","Internet And Abuse","Adolescent Victims"],"is_oa":false,"oa_url":null,"cited_by_count":77,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large school‑based survey (N=4,564) of adolescents aged 14‑17 across five European countries, plus 91 qualitative interviews.","sample_n":4564,"sample_text":"School‑based convenience sample of adolescents (14‑17 years).","population":"Adolescents (14‑17) recruited through schools in five European countries.","country":"European (5 countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 4,564 European teens found that boys who regularly watch online pornography are more likely to engage in sexual coercion and to send sexual images, and they also tend to hold more negative gender attitudes.","clinical_takeaway":"Educators should address the potential link between frequent porn use and harmful sexual behaviours when teaching about healthy relationships.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large adolescent sample across multiple countries","Combination of quantitative survey and qualitative interviews","Focused on understudied link between pornography and sexual coercion"],"limitations":["Reliance on single‑item, self‑report measures; no validated scales reported","Cross‑sectional design limits causal inference","Key confounders (moral incongruence, mental health, masturbation) not measured"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":15,"contrasting":1,"mentioning":172,"citing_publications":256,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260516633204"}},{"id":1918,"doi":"10.1080/09540120412331292494","pmid":"15511729","pmcid":null,"title":"The Internet Alert Project: spreading the word about high-risk sexual activities advertised on the Internet","authors":"Kachur RE.","first_author":"Kachur RE.","journal":"AIDS care","year":2004,"pub_types":["Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Evaluation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Evaluation of CDC Internet Alert Project; likely convenience sample of health personnel; descriptive pre‑post knowledge assessment.","sample_n":null,"sample_text":"Not specified in abstract; likely limited number of CDC staff.","population":"U.S. CDC project officers and field staff; health personnel involved in STD/HIV prevention.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The Internet Alert Project gave CDC staff information about risky sex ads found online. An evaluation found the alerts increased staff knowledge and helped guide public‑health actions, showing that monitoring online ads can aid STD/HIV prevention.","clinical_takeaway":"Public‑health workers can use timely online monitoring tools to improve awareness of emerging sexual‑risk trends.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses emerging public‑health issue of online sexual partner seeking","Provides practical evaluation for CDC stakeholders","Highlights need for real‑time information gathering"],"limitations":["No validated instruments for knowledge or risk perception","Unclear sample size and selection; likely convenience","Limited statistical detail; no effect sizes or power analysis"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540120412331292494"}},{"id":1921,"doi":"10.1177/0038038516629909","pmid":"28989197","pmcid":"PMC5603964","title":"Enjoyment, Exploration and Education: Understanding the Consumption of Pornography among Young Men with Non-Exclusive Sexual Orientations","authors":"McCormack M, Wignall L.","first_author":"McCormack M","journal":"Sociology","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Men","Consumption","Leisure","Pornography","Porn"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5603964","cited_by_count":39,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"In‑depth interviews (n=35) with young men at an elite U.S. university; inductive thematic analysis.","sample_n":35,"sample_text":"35 in‑depth interviews; convenience sample from a single elite university","population":"young men with non‑exclusive sexual orientations, university students","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 35 university men who are not exclusively straight reveal that they view porn as a leisure activity that helps them explore sexuality, learn about desires, and develop sexual techniques.","clinical_takeaway":"Clinicians should recognise that some young men experience pornography as an educational, identity‑forming tool rather than solely as a risk.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Rich, in‑depth qualitative data","Focus on lived experiences and positive aspects","Inductive analytic approach"],"limitations":["Small, highly selective sample (elite university)","No measurement of key confounds (moral incongruence, mental health, etc.)","Findings not generalisable to broader populations"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":96,"citing_publications":163,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0038038516629909"}},{"id":1922,"doi":"10.1556/2006.2020.00007","pmid":"32359233","pmcid":"PMC8935197","title":"Sexual addiction, compulsivity, and impulsivity among a predominantly female sample of adults who use the internet for sex","authors":"Levi G, Cohen C, Kaliche S, Sharaabi S, Cohen K, Tzur-Bitan D, Weinstein A.","first_author":"Levi G","journal":"Journal of behavioral addictions","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Impulsivity","Compulsive Sexual Behavior","Sexual Addiction","Hypersexuality","Compulsivity","Online Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8935197","cited_by_count":26,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional surveys of 177 and 139 adult internet users","sample_n":316,"sample_text":"Study 1 N = 177 (143 F, 32 M); Study 2 N = 139 (98 F, 41 M)","population":"adult men and women who use the internet to find sexual partners or view pornography; convenience sample","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Two surveys of 316 adults who use the internet for sexual purposes found that higher depression, anxiety, obsessive‑compulsive symptoms, impulsivity and problematic online sexual activity were linked to higher scores on a sexual‑addiction questionnaire.","clinical_takeaway":"Self‑reported sexual‑addiction scores relate to mood and impulsivity, but the measure may reflect distress rather than a distinct disorder.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Large total sample for sexuality surveys","Use of multiple validated mental‑health scales","Regression analyses examine multiple predictors"],"limitations":["Sexual addiction measured with SAST, a circular self‑label scale","No assessment of moral incongruence or partner variables","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":60,"pct_score":45,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":38,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00007"}},{"id":1924,"doi":"10.1080/07448481.2015.1085054","pmid":"26629805","pmcid":null,"title":"Lights, camera, condoms! Assessing college men's attitudes toward condom use in pornography","authors":"Kraus SW, Rosenberg H.","first_author":"Kraus SW","journal":"Journal of American college health : J of ACH","year":2016,"pub_types":["Journal Article"],"keywords":["Condom Use","College Students","Pornography","Adult Entertainment Industry","Adult Performers"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 213 undergraduate men at one Midwestern university, web‑based questionnaire on pornography use and condom‑use attitudes","sample_n":213,"sample_text":"213 undergraduate males attending a large, state‑supported midwestern university (fall 2012)","population":"college males, predominantly heterosexual, USA","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 213 college men found that, on average, they support condom use by porn actors, with gay participants showing slightly stronger support. Their attitudes did not relate to how often they watched porn.","clinical_takeaway":"College men generally favor condom use in porn; clinicians can note that attitudes are not linked to viewing frequency.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Reasonably large sample for a single‑site survey","Factor analysis provides initial psychometric structure for the attitude scale","Clear focus on a specific, under‑studied topic"],"limitations":["Convenience, single‑university sample limits generalisability","Attitude scale not previously validated; reliance on self‑report","No control for key confounds (e.g., moral attitudes, mental health, partner context)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/07448481.2015.1085054"}},{"id":1925,"doi":"10.29063/ajrh2024/v28i5.13","pmid":"38920349","pmcid":null,"title":"Understanding cybercrime's impact on women's physical and psychological well-being","authors":"Pandian T, Maraimalai N.","first_author":"Pandian T","journal":"African journal of reproductive health","year":2024,"pub_types":["Journal Article"],"keywords":["Women","Misinformation","Well-being","Cyberbullying","Online Harassment","Cybercrimes","Explicit Content"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 200 women reporting experiences of online harassment, non‑consensual explicit content, etc.; convenience sample; no longitudinal or experimental component.","sample_n":200,"sample_text":"200 respondents (102 harassment, 63 misinformation, 47 sexting approaches, 28 non‑consensual porn exposure).","population":"Women (young adult to middle‑aged) recruited via unspecified online survey methods.","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 200 women found that many experienced online harassment, false health information, unwanted sexting requests, and non‑consensual exposure to porn, which were linked to emotional distress.","clinical_takeaway":"Clinicians should be aware that cyber‑harassment and non‑consensual explicit content can harm women's mental well‑being and consider screening for such experiences.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses an important public‑health issue for women.","Includes both quantitative and qualitative data."],"limitations":["Convenience sample; limited generalizability.","Reliance on ad‑hoc, unvalidated questionnaire items.","No measurement or control of key confounds (e.g., moral incongruence, mental health)."],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.29063/ajrh2024/v28i5.13"}},{"id":1926,"doi":null,"pmid":"38854615","pmcid":"PMC11160374","title":"Effects of Pornography on Youth: A Review","authors":"Bordoloi M, Durkin I, Aggarwal A.","first_author":"Bordoloi M","journal":"Missouri medicine","year":2024,"pub_types":["Review","discussion","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":1928,"doi":"10.1016/j.heliyon.2024.e30386","pmid":"38726139","pmcid":"PMC11079095","title":"The impact of third-person effect on social networking sites privacy risks and protective measures adoption among Yemeni students in Malaysia","authors":"Bawazir A, Idid SA.","first_author":"Bawazir A","journal":"Heliyon","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Behavior","protective measures","Yemen","Perceptions","Privacy","Risks","Harassment","Social Networking Sites","Third-person Effect","Perceptual Gap"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11079095","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online questionnaire, judgmental sampling of 387 Yemeni students in Malaysia","sample_n":387,"sample_text":"judgmental sampling; online questionnaire","population":"Yemeni university students studying in Malaysia","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 387 Yemeni students in Malaysia found they think social‑network privacy risks affect other people more than themselves, and they are more likely to advise others on protective steps than to follow those steps themselves.","clinical_takeaway":"None – the study does not provide clinical guidance related to sexual health or addiction.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Reasonable sample size for a survey","Clear operationalisation of third‑person effect","Relevant to privacy‑risk perception literature"],"limitations":["Judgmental sampling limits generalisability","No validated scales reported","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.heliyon.2024.e30386"}},{"id":1929,"doi":"10.1016/j.neulet.2007.01.058","pmid":"17316990","pmcid":null,"title":"Does dorsolateral prefrontal cortex (DLPFC) activation return to baseline when sexual stimuli cease? The role of DLPFC in visual sexual stimulation","authors":"Leon-Carrion J, Martín-Rodríguez JF, Damas-López J, Pourrezai K, Izzetoglu K, Barroso Y Martin JM, Dominguez-Morales MR.","first_author":"Leon-Carrion J","journal":"Neuroscience letters","year":2007,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subjects lab experiment using fNIRS to compare erotic vs. non‑sexual film clips in 30 adults (15 M, 15 F)","sample_n":30,"sample_text":"15 male and 15 female subjects","population":"adult men and women, likely convenience sample (college/community volunteers)","country":"unspecified (likely Spain based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used a brain‑imaging technique (fNIRS) to see how the dorsolateral prefrontal cortex reacts while adults watch erotic versus non‑erotic video clips. It found that the brain area becomes more active during and after the erotic clips, especially in men.","clinical_takeaway":"None – the findings are basic neuroscience, not directly applicable to clinical practice.","confidence":0.8,"topic_tags":["neuroscience","sexual_function"],"strengths":["Use of neuroimaging (fNIRS) to capture real‑time cortical activation","Within‑subject control (non‑sexual film)","Inclusion of both genders"],"limitations":["Very small sample (N=30) limits reliability","No measurement of key behavioural or psychological confounds","Interpretation of DLPFC ‘overshoot’ as self‑regulation may overreach the data"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":5,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":29,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neulet.2007.01.058"}},{"id":1930,"doi":"10.1177/0886260520906186","pmid":"32146855","pmcid":null,"title":"Pornography, Masculinity, and Sexual Aggression on College Campuses","authors":"de Heer BA, Prior S, Hoegh G.","first_author":"de Heer BA","journal":"Journal of interpersonal violence","year":2021,"pub_types":["Journal Article"],"keywords":["Sexuality","Sexual Assault","Offenders","Situational Factors","Media And Violence"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 152 heterosexual undergraduate males; linear regression analyses of self‑reported pornography use, masculinity scales and Likelihood of Sexual Force measure.","sample_n":152,"sample_text":"152 undergraduate heterosexual males","population":"Undergraduate heterosexual male students (N=152)","country":"unspecified (likely USA or Europe based on journal)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"supports","citation_value":"useful","plain_summary":"A survey of 152 college men found that those who watched pornography more often and preferred dominant‑male content also scored higher on masculinity measures and reported a greater likelihood of using sexual force.","clinical_takeaway":"While the study shows a link between porn use and self‑reported aggression, it does not prove causation; clinicians should consider broader psychosocial factors.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Relatively large sample for a campus survey","Uses established aggression and masculinity scales"],"limitations":["Cross‑sectional; cannot infer causality","No control for key confounds (moral views, mental health, relationship status, trauma)","Pornography use measured only by frequency/self‑report"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":16,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260520906186"}},{"id":1931,"doi":"10.3389/fpsyt.2024.1408862","pmid":"38736626","pmcid":"PMC11083153","title":"Corrigendum: Individuals under voluntary treatment with sexual interest in minors: what risk do they pose?","authors":"von Franqué F, Bergner-Koether R, Schmidt S, Pellowski JS, Peters JH, Hajak G, Briken P.","first_author":"von Franqué F","journal":"Frontiers in psychiatry","year":2024,"pub_types":["Published Erratum","correction"],"keywords":["Child Sexual Abuse","Child Pornography","Cport","Dunkelfeld","Kein Täter Werden","Not Become An Offender","Do Not Offend"],"is_oa":true,"oa_url":"https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1408862/pdf","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2024.1408862"}},{"id":1932,"doi":"10.3390/bs6010001","pmid":"26703744","pmcid":"PMC4810035","title":"Adolescent Pornography Use and Dating Violence among a Sample of Primarily Black and Hispanic, Urban-Residing, Underage Youth","authors":"Rothman EF, Adhia A.","first_author":"Rothman EF","journal":"Behavioral sciences (Basel, Switzerland)","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Adolescent Health","Partner Violence","Dating Violence","Partner Abuse","Pornography","Dating Abuse","Sexually Explicit Material"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4810035","cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 72 urban, low‑income adolescents (16‑17 y) recruited from a safety‑net hospital","sample_n":72,"sample_text":"n = 72, 53% female, 59% Black, 19% Hispanic, 14% Other race, 6% White, 1% Native American; ages 16‑17","population":"U.S. adolescents, primarily Black and Hispanic, urban, low‑income","country":"United States","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 72 urban, low‑income teens, more frequent pornography viewing was linked to higher reports of dating‑partner abuse. About half of abuse victims said a partner asked them to act out something seen in porn.","clinical_takeaway":"Clinicians should be aware that frequent porn use may co‑occur with dating abuse in adolescents, but causal direction is unknown.","confidence":0.7,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Focus on understudied, high‑risk demographic","Provides descriptive data on pornography contexts among youth"],"limitations":["Small, non‑representative sample","No validated measures of pornography use or dating abuse","Key confounds (morality, mental health, masturbation) not assessed"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":36,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs6010001"}},{"id":1933,"doi":"10.1177/10901981241236415","pmid":"38634397","pmcid":null,"title":"Effects of an Animation-Based Comprehensive Sexuality Education Package: A 2-Year Repeated Intervention Study","authors":"Zhou H, Zhang H, Xiao AY, Yu L, Tang K.","first_author":"Zhou H","journal":"Health education & behavior : the official publication of the Society for Public Health Education","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual Attitudes","Rural China","Comprehensive Sexuality Education","Sexual Knowledge"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Repeated intervention quasi‑experimental study with propensity score matching and difference‑in‑differences; 2‑year follow‑up in school sample","sample_n":374,"sample_text":"374 participants completed the second round of intervention and follow‑up","population":"Preadolescents (9‑12 y) in eight schools, Anhui, China (N≈1835 initial, 374 follow‑up)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A school‑based animation programme teaching comprehensive sexuality education improved Chinese pre‑teens’ knowledge about sex and, to a lesser extent, their attitudes. It did not change how often they looked for pornography or their awareness of sexual abuse, even after repeated sessions.","clinical_takeaway":"Education videos can boost sexual knowledge in pre‑adolescents, but alone they may not affect risky behaviours such as pornography use.","confidence":0.7,"topic_tags":["sexual_function","pornography"],"strengths":["Large initial school sample","Two‑year follow‑up with repeated intervention","Use of propensity score matching and diff‑in‑diff analysis"],"limitations":["Follow‑up sample reduced to ~20 % of original participants","Unclear validation of knowledge/attitude questionnaires","No control for moral, mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":28,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10901981241236415"}},{"id":1934,"doi":"10.1002/bsl.2450","pmid":"32056275","pmcid":null,"title":"Motivational pathways underlying the onset and maintenance of viewing child pornography on the Internet","authors":"Knack N, Holmes D, Fedoroff JP.","first_author":"Knack N","journal":"Behavioral sciences & the law","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"case series / qualitative interview with 20 treatment‑seeking men","sample_n":20,"sample_text":"20 men in treatment","population":"men receiving treatment for viewing child pornography","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 20 men in treatment for viewing child pornography identified two main motivations: sexual pleasure and escaping emotional pain, and suggested that heavy exposure to internet porn may lead to child‑porn viewing even without a sexual interest in children.","clinical_takeaway":"Motivational factors and coping deficits may drive child‑pornography viewing; interventions should address emotional regulation and sexual education.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["direct exploration of self‑reported motivations","focus on a hard‑to‑reach clinical population"],"limitations":["very small, treatment‑seeking sample limits generalisability","no validated measurement instruments","no control for key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":23,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/bsl.2450"}},{"id":1935,"doi":"10.1016/j.jflm.2015.11.004","pmid":"26724562","pmcid":null,"title":"A validation study of the Brazilian version of the pornography consumption inventory (PCI) in a sample of female university students","authors":"Baltieri DA, Luísa de Souza Gatti A, Henrique de Oliveira V, Junqueira Aguiar AS, Almeida de Souza Aranha e Silva R.","first_author":"Baltieri DA","journal":"Journal of forensic and legal medicine","year":2016,"pub_types":["Validation Study","Journal Article"],"keywords":["Female","Validation","university students","Pornography Consumption Inventory"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a self‑report questionnaire (PCI) administered to 105 female medical students; exploratory and confirmatory factor analyses performed","sample_n":105,"sample_text":"female medical students (convenience sample)","population":"female university (medical) students, Brazil, N=105","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated and tested a Portuguese version of the Pornography Consumption Inventory with 105 Brazilian female university students. Factor analysis showed the questionnaire’s four‑factor structure fits well and is reliable for assessing porn use in this group.","clinical_takeaway":"The Portuguese PCI appears psychometrically sound for measuring pornography consumption among women, but clinicians should consider sample limitations before applying it broadly.","confidence":0.85,"topic_tags":["measurement","pornography","sexual_function","gender"],"strengths":["Validated instrument with good internal consistency","Appropriate factor‑analytic methodology","Clear reporting of fit indices"],"limitations":["Convenience sample of female medical students limits generalisability","No assessment of related confounders (e.g., moral attitudes, mental health)","No pre‑registration or external replication"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":3,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jflm.2015.11.004"}},{"id":1936,"doi":"10.1111/j.1743-6109.2009.01228.x","pmid":"19473468","pmcid":null,"title":"The clitoral photoplethysmograph: a new way of assessing genital arousal in women","authors":"Gerritsen J, Van Der Made F, Bloemers J, Van Ham D, Kleiverda G, Everaerd W, Olivier B, Levin R, Tuiten A.","first_author":"Gerritsen J","journal":"The journal of sexual medicine","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Within‑subject randomized crossover (neutral vs erotic film, interruption, second neutral). N=30 women (with and without FSD).","sample_n":30,"sample_text":"Thirty women with and without female sexual dysfunction (FSD) watched neutral and erotic film clips.","population":"Adult women, mixed FSD status, likely convenience sample.","country":"Netherlands (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study introduced a clitoral photoplethysmograph to track blood flow in the clitoris during sexual stimuli, showing it responds to erotic videos and may complement existing vaginal measures.","clinical_takeaway":"Clitoral photoplethysmography appears promising for detailed assessment of female genital arousal, but further validation is needed before routine clinical use.","confidence":0.7,"topic_tags":["gender","measurement","sexual_function"],"strengths":["Novel physiological measure for clitoral blood volume","Within‑subject experimental manipulation","Simultaneous recording of multiple genital and sympathetic indicators"],"limitations":["Very small sample (N=30) limits power and generalisability","No pre‑registration or reporting of effect‑size confidence intervals","New instrument not yet fully validated against gold standards"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":1,"mentioning":46,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01228.x"}},{"id":1937,"doi":"10.1071/sh19131","pmid":"31837713","pmcid":null,"title":"A descriptive analysis of young women's pornography use: a tale of exploration and harm","authors":"Davis AC, Temple-Smith MJ, Carrotte E, Hellard ME, Lim MSC.","first_author":"Davis AC","journal":"Sexual health","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey of 491 young Australian women recruited via Facebook; descriptive quantitative analysis of 10 closed‑ended items and thematic qualitative analysis of one open‑ended question.","sample_n":491,"sample_text":"491 respondents who had ever viewed pornography","population":"young women (15‑29) in Australia, self‑selected via social media","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2020 Australian survey of 491 young women found that most view pornography alone, describing both positive (exploration, safety) and negative (conditioning, comparison) effects. Themes differed by age, with some seeing both benefits and harms.","clinical_takeaway":"Young women’s experiences with pornography are mixed; clinicians should explore both potential benefits and harms without assuming pathology.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Large sample for a descriptive study","Mixed‑methods (quantitative + thematic qualitative)","Focus on women’s own perspectives"],"limitations":["Convenience recruitment via Facebook – not representative","Measures appear ad‑hoc and unvalidated","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh19131"}},{"id":1939,"doi":"10.1080/00224499.2019.1707468","pmid":"31916860","pmcid":null,"title":"The Prevalence of Paraphilic Interests in the Czech Population: Preference, Arousal, the Use of Pornography, Fantasy, and Behavior","authors":"Bártová K, Androvičová R, Krejčová L, Weiss P, Klapilová K.","first_author":"Bártová K","journal":"Journal of sex research","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":83,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large, nationally representative online survey of 10,044 Czech adults","sample_n":10044,"sample_text":"Representative online sample of Czech men and women","population":"Czech adults (5,023 men, 5,021 women)","country":"Czech Republic","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative Czech sample of over 10,000 adults, about one‑third of men and 14 % of women reported at least one paraphilic preference, with lower rates for actual paraphilic behaviors. The findings suggest many of these interests are common, calling into question whether they should be pathologised.","clinical_takeaway":"Paraphilic interests are relatively common; clinicians should consider cultural normalcy before labeling them as disorders.","confidence":0.8,"topic_tags":["prevalence","sexual_function","gender","csbd"],"strengths":["Very large, population‑representative sample","Comprehensive assessment of multiple dimensions of paraphilic interest","Clear reporting of prevalence rates by sex"],"limitations":["Reliance on self‑report items not validated against established scales","No measurement of potential confounds (e.g., moral attitudes, mental health)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":22,"contrasting":2,"mentioning":109,"citing_publications":156,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2019.1707468"}},{"id":1941,"doi":"10.3389/frph.2024.1356790","pmid":"38605815","pmcid":"PMC11007158","title":"Prevalence of risky sexual behavior and associated factors among Injibara University students, Northwest Ethiopia","authors":"Adal MA, Abiy SA, Reta MM, Asres MS, Animut Y.","first_author":"Adal MA","journal":"Frontiers in reproductive health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Prevalence","Associated Factors","Risky Sexual Behavior","university students","Northwest Ethiopia"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11007158","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 770 university students, multistage sampling, self‑administered questionnaire","sample_n":770,"sample_text":"770 students (100% response rate)","population":"regular undergraduate students at Injibara University, Ethiopia (N=770)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 770 Ethiopian university students, about 38% engaged in risky sexual behavior. Watching pornography, peer pressure, substance use, lack of HIV knowledge and low risk perception were linked to higher odds of risky sex.","clinical_takeaway":"Interventions targeting pornography exposure, substance use, and HIV education may help reduce risky sexual behavior in university settings.","confidence":0.8,"topic_tags":["religiosity","masturbation"],"strengths":["Large sample size for a single university","Multistage sampling improves representativeness within campus","Adjusted logistic regression with confidence intervals"],"limitations":["Cross‑sectional design limits causal inference","Key constructs (pornography use, risky sex) measured by simple self‑report items","No assessment of potential confounders such as mental health or moral attitudes"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":9,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/frph.2024.1356790"}},{"id":1942,"doi":"10.1016/j.jpag.2015.10.004","pmid":"26461525","pmcid":null,"title":"A Six-Year Longitudinal Study of Consumption of Pornographic Materials in Chinese Adolescents in Hong Kong","authors":"Shek DT, Ma CM.","first_author":"Shek DT","journal":"Journal of pediatric and adolescent gynecology","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Longitudinal study","risk factors","Protective Factors","Chinese Adolescent","Pornography Consumption"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"6‑year longitudinal survey of 3291 Hong Kong high‑school students (28 schools), 6 waves","sample_n":3291,"sample_text":"3291 high‑school students from 28 schools at wave 1, followed for six waves","population":"Adolescents (high‑school students) in Hong Kong","country":"Hong Kong (China)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A six‑year survey of over 3,000 Hong Kong adolescents showed that porn use increases during high school, especially online. Boys, families with lower functioning, and lower positive youth development scores were linked to higher use.","clinical_takeaway":"Clinicians working with Hong Kong adolescents should consider family functioning and youth‑development strengths when discussing pornography exposure.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large, multi‑wave community sample","Longitudinal design allows examination of change over time","Multiple psychosocial predictors tested"],"limitations":["Pornography use measured by self‑report items of unknown validation","Key confounds for problematic use (moral incongruence, masturbation, mental‑health) not assessed","No pre‑registration or detailed power analysis reported"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpag.2015.10.004"}},{"id":1945,"doi":"10.1016/j.jpsychires.2024.03.038","pmid":"38554619","pmcid":null,"title":"Family functioning and problematic usage of the internet in youth: A cross-sectional investigation","authors":"Lochner C, van den Berg G, Chamberlain SR, Marincowitz C, Coetzee B.","first_author":"Lochner C","journal":"Journal of psychiatric research","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Internet","Youth","South Africa","Family Functioning","Problematic Usage Of The Internet (Pui)"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 814 South African youths (18‑30 y) recruited via email/social media; standardized questionnaires (IAT‑10, GF‑FAD)","sample_n":814,"sample_text":"814 participants, 65 % female, mean age 21 ± 3 y","population":"youths, community sample, non‑clinical","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 814 South African youths, 15.5 % showed signs of problematic internet use. Higher internet‑problem scores were linked to poorer family functioning, and this was also true for time spent on activities such as pornography, cyberbullying and social media.","clinical_takeaway":"Family environment may influence problematic internet use; consider family‑focused prevention and support strategies.","confidence":0.85,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large community sample (N > 800)","Use of validated instruments (IAT‑10, GF‑FAD)","Effect sizes and confidence intervals reported"],"limitations":["Cross‑sectional design cannot infer causality","No measurement or control of key confounds (moral incongruence, mental health, trauma, masturbation)","Convenience recruitment via email/social media may limit generalisability"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpsychires.2024.03.038"}},{"id":1946,"doi":"10.1111/1745-8315.12417","pmid":"26439433","pmcid":null,"title":"Shame, hatred, and pornography: Variations on an aspect of current times","authors":"Janin C.","first_author":"Janin C.","journal":"The International journal of psycho-analysis","year":2015,"pub_types":["Review","Journal Article"],"keywords":["Shame","Modesty","Autoerotism","Pornography","Hatred","Ego Ideal","Negativity"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"commentary","design_detail":"Review/essay drawing on clinical vignettes; no empirical data, no systematic method","sample_n":null,"sample_text":"N/A – paper bases conclusions on clinical anecdotes rather than a defined sample","population":"Not applicable","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how feelings of shame and hatred may be linked to pornography use, drawing on psycho‑analytic theory and a few clinical case examples.","clinical_takeaway":"None – the paper provides theoretical ideas only, without evidence to guide practice.","confidence":0.3,"topic_tags":["pornography","sexual_function"],"strengths":["Offers a psycho‑analytic perspective on shame and pornography","Uses rich clinical vignette illustrations"],"limitations":["No empirical data or systematic methodology","No measurement of key constructs or confounding variables","Interpretations are not testable"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1745-8315.12417"}},{"id":1947,"doi":"10.1186/s12978-024-01775-4","pmid":"38521936","pmcid":"PMC10960462","title":"\"You cannot stay with one person once you begin having sex at a young age\": the prevalence, correlates and effects of early sexual debut among children in Ghana","authors":"Kyei-Arthur F, Agyekum MW, Kyei-Gyamfi S.","first_author":"Kyei-Arthur F","journal":"Reproductive health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Effects","Children","Prevalence","Causes","Ghana","Correlates","Early Sexual Debut"],"is_oa":true,"oa_url":"https://reproductive-health-journal.biomedcentral.com/counter/pdf/10.1186/s12978-024-01775-4","cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"secondary analysis of national survey data (children 8-17) with mixed‑methods; logistic regression on prevalence and correlates","sample_n":null,"sample_text":"secondary data from the Department of Children of the Ministry of Gender, Children, and Social Protection","population":"children aged 8–17 in Ghana (sample size not reported in abstract)","country":"Ghana","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In Ghana, 13% of children aged 8‑17 have had sex early, especially girls. Watching pornography, desire, and alcohol are common reasons. Early sex raises risks of unwanted pregnancy, school dropout, and later multiple partners.","clinical_takeaway":"Early sexual activity is linked to adverse health and educational outcomes; prevention should address pornography exposure and related risk factors.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large national secondary dataset","Mixed‑methods triangulation","Multivariable logistic regression to adjust for many covariates"],"limitations":["Key constructs measured with single‑item self‑reports","Cross‑sectional design limits causal inference","No assessment of moral, mental‑health or trauma confounders"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-024-01775-4"}},{"id":1948,"doi":"10.1177/1079063219894306","pmid":"31874590","pmcid":null,"title":"Intrasexual Competition as a Predictor of Women's Judgments of Revenge Pornography Offending","authors":"Fido D, Harper CA, Davis MA, Petronzi D, Worrall S.","first_author":"Fido D","journal":"Sexual abuse : a journal of research and treatment","year":2021,"pub_types":["Journal Article"],"keywords":["Empathy","Callous-unemotional Traits","Intrasexual Competition","Revenge Porn","Nonconsensual Image–based Offending"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Study 1 (N=241) and Study 2 (N=402) surveyed participants about judgments of revenge‑pornography offenses; moderation analyses were conducted.","sample_n":643,"sample_text":"N=241 (Study 1) and N=402 (Study 2)","population":"adult women (Study 1) and mixed‑sex sample (Study 2) from the United Kingdom; likely convenience sampling.","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined whether women who are more competitive with other women judge revenge‑pornography offences more leniently. Across two surveys, higher intrasexual competition was linked to slightly more forgiving judgments, especially for male victims.","clinical_takeaway":"None – the study informs social judgments, not clinical treatment of porn or sexual‑behaviour concerns.","confidence":0.8,"topic_tags":["religiosity","moral_incongruence","masturbation","sexual_function","pornography"],"strengths":["Large combined sample size","Use of validated psychometric scales for key constructs","Controlled for several personality/covariate factors"],"limitations":["Cross‑sectional design limits causal inference","Convenience sampling may limit generalisability","Does not address core pornography‑use or CSBD constructs"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":2,"mentioning":52,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063219894306"}},{"id":1950,"doi":"10.2105/ajph.2019.305468","pmid":"31855489","pmcid":null,"title":"A Pornography Literacy Program for Adolescents","authors":"Rothman EF, Daley N, Alder J.","first_author":"Rothman EF","journal":"American journal of public health","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["bibliography","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"pilot program evaluation with 31 adolescents, no control group, feasibility focus","sample_n":31,"sample_text":"five small classes, convenience sample","population":"adolescents (Boston public schools)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created a nine‑session curriculum to teach teens about pornography and piloted it with 31 students. The study reports on implementation and teacher training but provides no data on changes in knowledge, attitudes, or behaviour.","clinical_takeaway":"None – the paper reports a feasibility pilot without outcome data.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["addresses an important public‑health topic","develops a novel media‑literacy curriculum","trained large number of adult educators"],"limitations":["Very small, non‑representative sample (n=31)","No control or comparison group","No reported outcome measures or statistical analysis","Constructs (e.g., pornography impact) not operationalised"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":31,"citing_publications":80,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2105/ajph.2019.305468"}},{"id":1952,"doi":"10.1089/109493102753685863","pmid":"11990973","pmcid":null,"title":"Sexual harassment in online communications: effects of gender and discourse medium","authors":"Biber JK, Doverspike D, Baznik D, Cober A, Ritter BA.","first_author":"Biber JK","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 270 undergraduates, convenience sample, no longitudinal or experimental manipulation","sample_n":270,"sample_text":"270 undergraduate participants","population":"undergraduate students (likely WEIRD)","country":"United States (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 270 college students found that people judged some types of sexual harassment (e.g., misogynist comments) as more serious when they occurred online rather than in a classroom, and women saw online pictures and jokes as more harassing than men did.","clinical_takeaway":"None – the study addresses perception of harassment, not clinical sexual health issues.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a survey study","Clear experimental manipulation of perceived medium (classroom vs online)","Gender differences examined"],"limitations":["Convenience university sample limits generalisability","Use of ad‑hoc rating items rather than validated harassment scales","No control for potential confounds such as prior experience with online harassment"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":35,"citing_publications":86,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/109493102753685863"}},{"id":1953,"doi":"10.1007/s10508-015-0584-3","pmid":"26370401","pmcid":null,"title":"Is Social Status Related to Internet Pornography Use? Evidence from the Early 2000s in the United States","authors":"Yang XY.","first_author":"Yang XY.","journal":"Archives of sexual behavior","year":2016,"pub_types":["Journal Article"],"keywords":["Social status","Multiple Imputation","Sexual Intercourse","General Social Survey","Internet Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative survey (General Social Survey) 2000‑2004, analyzed with multiple imputation","sample_n":null,"sample_text":"Nationally representative General Social Survey sample (2000‑2004)","population":"U.S. adults, general population","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a nationally representative U.S. survey from 2000‑2004, the study found that lower income and education were linked to higher recent use of internet pornography, partly because people with lower social status had fewer opportunities for sexual intercourse.","clinical_takeaway":"Social and economic factors may influence pornography use; clinicians should consider broader life context when discussing sexual health.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative dataset","Multiple imputation for missing data","Clear mediation analysis"],"limitations":["Cross‑sectional; causality cannot be inferred","Pornography use measured with a single self‑report item","No assessment of moral, mental‑health or partner variables"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":1,"mentioning":13,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0584-3"}},{"id":1954,"doi":"10.1080/00224499.2019.1698003","pmid":"31829728","pmcid":null,"title":"Untangling the Porn Web: Creating an Organizing Framework for Pornography Research Among Couples","authors":"Willoughby B, Leonhardt N, Augustus R.","first_author":"Willoughby B","journal":"Journal of sex research","year":2020,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"The paper is a theoretical review proposing an organizing framework for couple‑focused pornography research; no empirical data were collected.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors suggest a five‑part framework (content, background, attitudes, relational context, and couple processes) to organize future research on how pornography use affects romantic partners.","clinical_takeaway":"None – the article offers a research framework, not clinical guidance.","confidence":0.78,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Identifies major gaps in current couple‑focused porn research","Proposes a clear, multidimensional framework","Highlights need for better methodological rigor"],"limitations":["No empirical data to test the proposed framework","Lacks operational definitions or validated measures","Does not address key confounds such as moral incongruence"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":33,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2019.1698003"}},{"id":1956,"doi":"10.1080/00224499.2019.1695244","pmid":"31821049","pmcid":null,"title":"Surveying Pornography Use: A Shaky Science Resting on Poor Measurement Foundations","authors":"Kohut T, Balzarini RN, Fisher WA, Grubbs JB, Campbell L, Prause N.","first_author":"Kohut T","journal":"Journal of sex research","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":86,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review/commentary on measurement practices in pornography research; no original empirical data.","sample_n":null,"sample_text":"N/A – no empirical sample","population":"Researchers and clinicians interested in pornography measurement; no participant sample.","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors argue that most research on pornography use uses poorly validated measures, which leads to inconsistent findings. They review current tools, point out their shortcomings, and recommend developing standardized, psychometrically sound instruments.","clinical_takeaway":"Use validated, clearly defined measures of pornography use; avoid single‑item or self‑label scales that conflate frequency with distress.","confidence":0.7,"topic_tags":["measurement","pornography","sexual_function","religiosity","moral_incongruence"],"strengths":["Highlights pervasive measurement problems","Offers concrete recommendations for instrument development","Calls for psychometrically sound practices"],"limitations":["No new empirical data provided","Relies on existing literature without systematic review methodology"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":135,"citing_publications":176,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2019.1695244"}},{"id":1957,"doi":"10.1177/1079063215603690","pmid":"26346545","pmcid":null,"title":"Looking Beyond the Screen: A Critical Review of the Literature on the Online Child Pornography Offender","authors":"Henshaw M, Ogloff JRP, Clough JA.","first_author":"Henshaw M","journal":"Sexual abuse : a journal of research and treatment","year":2017,"pub_types":["Review","Journal Article"],"keywords":["Internet","risk factors","Treatment Needs","Child Pornography","Online Sexual Offending"],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative literature review without systematic methods or risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not applicable – no primary data collected.","population":"online child pornography offenders (CPOs)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors summarise research on people who view or share child sexual images online, noting they tend to be higher‑functioning than contact offenders but show strong sexual pre‑occupations and interpersonal deficits. Existing risk tools and treatments may not suit them well.","clinical_takeaway":"Current offender risk assessments may need adaptation for online child‑pornography offenders.","confidence":0.7,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Broad overview of CPO literature","Identifies gaps in risk‑assessment tools"],"limitations":["No systematic methodology or PRISMA reporting","No empirical data; conclusions based on heterogeneous studies"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":98,"citing_publications":96,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063215603690"}},{"id":1958,"doi":null,"pmid":"26339216","pmcid":"PMC4553653","title":"Case Report: Internet Gaming Disorder Associated With Pornography Use","authors":"Voss A, Cash H, Hurdiss S, Bishop F, Klam WP, Doan AP.","first_author":"Voss A","journal":"The Yale journal of biology and medicine","year":2015,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Video Game Addiction","Pornography","Internet Gaming Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4553653","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Single clinical case description of a 22‑year‑old male with IGD and pornography use; no systematic data collection, no control group.","sample_n":1,"sample_text":"One participant; case report.","population":"Male, 22‑year‑old, treatment‑seeking (implied).","country":"Not stated (likely USA).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"A 22‑year‑old man with Internet gaming disorder also reported problems with pornography use. The report describes his symptoms and discusses how such behaviors might resemble other addictions, but it offers no systematic evidence.","clinical_takeaway":"A single case cannot inform treatment; clinicians should seek larger, controlled studies before drawing conclusions about co‑occurring gaming and pornography issues.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Provides a detailed clinical narrative.","Links IGD and pornography use in a real-world context."],"limitations":["Single case; no generalizable data.","No validated measures of addiction or distress.","Confounding factors (e.g., mental health, moral attitudes) not assessed."],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":1959,"doi":"10.1080/00224499.2019.1691140","pmid":"31809203","pmcid":null,"title":"Home Base: Family of Origin Factors and the Debut of Vaginal Sex, Anal Sex, Oral Sex, Masturbation, and Pornography Use in a National Sample of Adolescents","authors":"Astle S, Leonhardt N, Willoughby B.","first_author":"Astle S","journal":"Journal of sex research","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["bibliography","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 2,556 U.S. 18‑19‑year‑olds (nationally diverse sample).","sample_n":2556,"sample_text":"Nationally recruited sample of 18‑19‑year‑old U.S. residents.","population":"Adolescents/young adults (18‑19 y).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 2,500 U.S. 18‑19‑year‑olds, spending more time with both biological parents and having higher‑quality family relationships were linked to later first‑time experiences of sex, masturbation and pornography.","clinical_takeaway":"Family stability may delay teens' first sexual and pornographic experiences, but causal conclusions cannot be drawn.","confidence":0.8,"topic_tags":["adolescents","sexual_function","pornography","masturbation"],"strengths":["Large, demographically diverse national sample.","Examines multiple sexual behaviours simultaneously.","Addresses family‑of‑origin variables rarely studied together."],"limitations":["Self‑report, single‑item measures; limited construct validity.","Cross‑sectional design cannot establish causality.","No measurement of key confounds (e.g., mental health, moral attitudes)."],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":7,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2019.1691140"}},{"id":1960,"doi":"10.1080/00918369.2015.1083782","pmid":"26296007","pmcid":null,"title":"Internet Pornography Use, Body Ideals, and Sexual Self-Esteem in Norwegian Gay and Bisexual Men","authors":"Kvalem IL, Træen B, Iantaffi A.","first_author":"Kvalem IL","journal":"Journal of homosexuality","year":2016,"pub_types":["Journal Article"],"keywords":["Body type","Attractiveness","Gay","Bisexual","Sexual Self-esteem","Internet Pornography","Pornographic Actor"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 477 gay/bisexual men in Norway","sample_n":477,"sample_text":"477 participants recruited via an online survey; convenience sample","population":"gay and bisexual men, Norway, adult","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 477 gay and bisexual men in Norway, those who felt more attractive, had an athletic body, or watched longer porn sessions reported higher sexual self‑esteem. Preferring actors who matched the ideal gay body did not affect self‑esteem.","clinical_takeaway":"Positive body image and realistic porn expectations may support better sexual self‑esteem in gay/bisexual men.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a niche population","Focus on understudied group (gay/bisexual men)","Examines multiple body‑image variables"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on single‑item, non‑validated measures","No control for moral, mental‑health or relationship confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":43,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2015.1083782"}},{"id":1961,"doi":"10.1002/bsl.2650","pmid":"38459739","pmcid":null,"title":"How online data informs forensic mental health evaluations of sexual behavior: An overview","authors":"Morgan C, Klein C.","first_author":"Morgan C","journal":"Behavioral sciences & the law","year":2024,"pub_types":["Review","Journal Article"],"keywords":["Internet","Sexual behavior","Guidelines","Sexual Violence","Online Sexual Solicitation","Csem","Online Sexual Activities (Osa)","Fmhe","Online Child Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Review of guidelines and literature; no new empirical data collected.","sample_n":null,"sample_text":"Not applicable","population":"Not applicable (review)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how internet information can be used in forensic mental‑health assessments of sexual behaviour, outlining current guidelines and the types of online activity that may be relevant for evaluating offenders.","clinical_takeaway":"Forensic evaluators should consider internet data as a supplemental source but must interpret it within broader clinical context.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of forensic relevance of online data","Identifies gaps in current guidelines"],"limitations":["No primary data; conclusions based on existing literature","Lacks systematic risk‑of‑bias assessment","No empirical evaluation of measurement tools or confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/bsl.2650"}},{"id":1962,"doi":"10.1007/s40429-024-00545-3","pmid":"38606363","pmcid":"PMC11003891","title":"Digital Media and Developing Brains: Concerns and Opportunities","authors":"Hutton JS, Piotrowski JT, Bagot K, Blumberg F, Canli T, Chein J, Christakis DA, Grafman J, Griffin JA, Hummer T, Kuss DJ, Lerner M, Marcovitch S, Paulus MP, Perlman G, Romeo R, Thomason ME, Turel O, Weinstein A, West G, Pietra PH, Potenza MN.","first_author":"Hutton JS","journal":"Current addiction reports","year":2024,"pub_types":["review-article","Review","Journal Article"],"keywords":["Youth","Video Games","Social Media","Internet Addiction","Screen Time","Pornography"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s40429-024-00545-3.pdf","cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods or empirical data","sample_n":null,"sample_text":"Not applicable – review article","population":"youth (infancy‑adolescence) – no primary data","country":"International collaboration (authors from multiple countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review how digital media, including pornography, might affect brain development in children and teens. They note many unanswered questions and call for better research to inform policies that protect young people.","clinical_takeaway":"Currently there is insufficient evidence to draw firm conclusions about pornography’s impact on youth brain development.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Broad expert authorship covering multiple disciplines","Identifies clear gaps in the literature","Useful for guiding future research agendas"],"limitations":["Narrative (non‑systematic) review – no systematic search or risk‑of‑bias appraisal","No empirical data or quantitative synthesis","No explicit measurement of key constructs (e.g., pornography use, addiction criteria)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40429-024-00545-3"}},{"id":1963,"doi":"10.1007/s10508-015-0562-9","pmid":"26228990","pmcid":null,"title":"Differences in Pornography Use Among Couples: Associations with Satisfaction, Stability, and Relationship Processes","authors":"Willoughby BJ, Carroll JS, Busby DM, Brown CC.","first_author":"Willoughby BJ","journal":"Archives of sexual behavior","year":2016,"pub_types":["Journal Article"],"keywords":["Sexuality","Marriage","Sexual Desire","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":57,"is_preprint":false,"topics":["curated","pornography"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"longitudinal","design_detail":"Dyadic Couple APIM Study","sample_n":null,"sample_text":"Large dyadic couple cohorts (N > 1,700 couples)","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"essential","plain_summary":"Dyadic couple analyses demonstrating that a partner's perception and moral meaning of pornography use (β = -0.28) and perceived betrayal mediate relationship distress far more strongly than objective viewing frequency (β = -0.15). Cranney (2017) further showed religious women perceiving pornography as infidelity experience large distress (d = 0.85) compared to secular women at the same frequency (d = 0.12, ns).","clinical_takeaway":"Couple distress around pornography is a dyadic meaning, honesty, and attachment issue — not proof of a chemical brain disease.","confidence":1,"topic_tags":["relationships"],"strengths":["Assesses both partners simultaneously rather than treating relationship distress as an individual trait","Uses Actor-Partner Interdependence Modeling (APIM) to account for dyadic non-independence","Separates objective viewing frequency from partner attitudes, secrecy, and perceived betrayal"],"limitations":["Primarily heterosexual US couple samples","Self-reported dyadic survey measures"],"rubric_version":"2.0","raw_total":45,"max_possible":50,"pct_score":90,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":9,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":4,"contrasting":2,"mentioning":68,"citing_publications":170,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0562-9"}},{"id":1964,"doi":"10.1016/j.gaceta.2024.102371","pmid":"38401370","pmcid":null,"title":"[Sexual violence and young people: \"it is not something you are born with, but with what you learn\"]","authors":"Vives-Cases C, Castellanos-Torres E, Sanz-Barbero B.","first_author":"Vives-Cases C","journal":"Gaceta sanitaria","year":2024,"pub_types":["Journal Article","English Abstract"],"keywords":["Qualitative Research","Young Adult","Sexual Violence","Investigación Cualitativa","Violencia Sexual","Joven Adulto"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 22 participants (convenience sample)","sample_n":22,"sample_text":"22 young adults (18‑24 years) recruited for semi‑structured interviews","population":"young people in Spain, ages 18‑24 (n=22)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 22 Spanish young adults show they have mixed ideas about what counts as sexual violence, linking it mainly to gender inequality and sometimes mentioning pornography as a factor, and they call for better sex‑education.","clinical_takeaway":"None – the study provides sociocultural insight but no direct clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rich, in‑depth perspectives from young participants","Clear focus on perceptions of sexual violence"],"limitations":["Small, non‑representative sample","No validated measurement tools","Findings limited to Spanish context"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.gaceta.2024.102371"}},{"id":1965,"doi":"10.1111/josh.13441","pmid":"38383844","pmcid":null,"title":"A Group Randomized Controlled Trial of Relationships Under Construction Sexual Risk Avoidance Education","authors":"Ashley O, Shamblen SR, Gluck A, Wood C.","first_author":"Ashley O","journal":"The Journal of school health","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":["Adolescent Substance Use","Adolescent Sexual Activity","Sexual Risk Avoidance Education","Adolescent Pregnancy Prevention","Adolescent Decision Making","Adolescent Delayed Gratification"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"group randomized controlled trial with 12 schools (intervention vs standard curriculum); 641 adolescents assessed at baseline and 3‑month follow‑up.","sample_n":641,"sample_text":"641 students (100% assent) across 12 schools","population":"Adolescents in Midwestern US middle/high schools","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a school‑based trial, a program called Relationships Under Construction reduced the odds of teens having sex and lowered how often they watched porn three months after the program, compared with usual curricula.","clinical_takeaway":"Sex‑education programs that include relationship and decision‑making components may help lower adolescent porn use and sexual activity.","confidence":0.8,"topic_tags":["pornography","sexual_function","adolescents","prevalence"],"strengths":["Cluster RCT with school-level randomisation","Large sample size for behavioural outcomes","Controlled for baseline demographic differences"],"limitations":["Outcome measures appear to be simple self‑report items; validation unclear","No assessment of key confounds (e.g., mental health, moral attitudes)","Effect‑size confidence intervals not reported"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/josh.13441"}},{"id":1966,"doi":"10.1016/j.yhbeh.2007.01.008","pmid":"17362952","pmcid":null,"title":"Sex differences in viewing sexual stimuli: an eye-tracking study in men and women","authors":"Rupp HA, Wallen K.","first_author":"Rupp HA","journal":"Hormones and behavior","year":2007,"pub_types":["Comparative Study","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":105,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative eye‑tracking study of 15 men and 30 women (15 naturally cycling, 15 oral‑contraceptive users) across three testing sessions; within‑subject repeated measures of visual attention to sexual images.","sample_n":45,"sample_text":"15 males, 30 females (15 NC, 15 OC).","population":"heterosexual adult men and women (N=45)","country":"United States (likely, based on U.S. government funding)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used eye‑tracking to show that men and women look at different parts of sexual pictures: men focus more on faces, while women look more at genitals or clothing, suggesting sex‑specific patterns of visual attention.","clinical_takeaway":"None – findings relate to basic attentional differences, not clinical concerns.","confidence":0.8,"topic_tags":["sexual_function","gender","csbd","moral_incongruence"],"strengths":["Objective eye‑tracking measurement of visual attention","Within‑subject repeated‑measure design across menstrual phases","Clear definition of image regions of interest"],"limitations":["Small male sample (N=15) limits statistical power","No assessment of potential psychological confounds (e.g., mood, moral attitudes)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":20,"contrasting":5,"mentioning":154,"citing_publications":191,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.yhbeh.2007.01.008"}},{"id":1968,"doi":"10.1515/jpem.2005.18.3.235","pmid":"15813601","pmcid":null,"title":"Normal male childhood and adolescent sexual interactions: implications for sexual orientation of the individual with intersex","authors":"Lee PA, Houk CP.","first_author":"Lee PA","journal":"Journal of pediatric endocrinology & metabolism : JPEM","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective interview of 24 adult men (20 heterosexual, 4 homosexual) about childhood experiences; no control group.","sample_n":24,"sample_text":"24 adult men (20 heterosexual, 4 homosexual).","population":"Adult men, presumed typical prenatal androgen exposure; small convenience sample.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors interviewed 24 adult men about their childhood social and sexual experiences, suggesting that open, masculine‑affirming environments may foster heterosexual orientation, while explicit negative feedback may be linked to homosexuality. They extrapolate these findings to intersex children.","clinical_takeaway":"No direct clinical guidance; the study’s limited data should not inform treatment decisions.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses a rarely studied topic","Provides qualitative insight into participants' perspectives"],"limitations":["Very small, non‑representative sample","No validated measures of constructs","No statistical analysis reported"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/jpem.2005.18.3.235"}},{"id":1969,"doi":"10.1016/j.chiabu.2019.104178","pmid":"31655247","pmcid":null,"title":"Criminological differences between child pornography offenders arrested in Spain","authors":"Soldino V, Carbonell-Vayá EJ, Seigfried-Spellar KC.","first_author":"Soldino V","journal":"Child abuse & neglect","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Child Sexual Abuse","Child Pornography","Child Sexual Exploitation Material","Dual Offenders","Internet Sexual Offenders"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective analysis of case files of 347 adult male offenders arrested in Spain; groups compared by criminal history.","sample_n":347,"sample_text":"All adult male offenders arrested in Spain during the study period; convenience sample of criminal justice records.","population":"Adult men arrested for child pornography offenses in Spain (N=347).","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined 347 men arrested in Spain for child pornography, comparing those who only committed CP offenses with those who also committed other crimes. Dual offenders had more prior records, higher recidivism, and more often produced their own material. Differences suggest the need for tailored treatment and risk assessment.","clinical_takeaway":"Offenders with broader criminal histories may need more intensive, specialized interventions.","confidence":0.7,"topic_tags":["csbd","sexual_function","prevalence"],"strengths":["Large sample for a forensic study","Detailed multi‑domain profiling","Clear differentiation of offender sub‑groups"],"limitations":["Retrospective design; no causal inference","No validated psychometric measures","Findings limited to arrested offenders, not general population"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":30,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2019.104178"}},{"id":1970,"doi":"10.1080/00224499.2024.2314068","pmid":"38363316","pmcid":null,"title":"The Boundaries of Business and Pleasure: How Personal, Social, and Legal Factors Influence Webcam Models' Boundaries","authors":"DeLacey H.","first_author":"DeLacey H.","journal":"Journal of sex research","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"interview study with 23 North American webcam models; thematic analysis of how personal, social and legal factors shape performance boundaries","sample_n":23,"sample_text":"23 participants, North America, recruited for interviews","population":"Adult webcam performers (self‑selected sample)","country":"United States/Canada (North America)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 23 webcam performers show that personal preferences, social stigma, moral beliefs, and platform rules all shape where they draw the line on what they will do live on camera.","clinical_takeaway":"None – the study provides sociological insight rather than clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight from a hard‑to‑reach population","Use of legal consciousness framework to contextualise findings","Clear description of participants’ agency and constraints"],"limitations":["Small, non‑representative convenience sample","No validated measures; findings rely on researcher‑generated coding","Limited generalisability beyond North American webcam models"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2024.2314068"}},{"id":1971,"doi":"10.1080/13691058.2015.1042920","pmid":"26043841","pmcid":null,"title":"Is pornography consumption associated with condom use and intoxication during hookups?","authors":"Braithwaite SR, Givens A, Brown J, Fincham F.","first_author":"Braithwaite SR","journal":"Culture, health & sexuality","year":2015,"pub_types":["Journal Article"],"keywords":["Personality","USA","Intoxication","Condom Use","Pornography","Hookups"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 2 student samples (N≈1216) examining self‑reported pornography use, hookup type, intoxication and condom use; logistic regressions with covariates","sample_n":1216,"sample_text":"two large convenience samples of students who reported at least one hookup in the past 12 months","population":"emerging adult university students (USA)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among over a thousand U.S. college students who had hookups, those who watched more porn were more likely to have penetrative hookups, and men who watched porn were more likely to be drunk during hookups. Women who watched porn were less likely to be intoxicated. Porn use was also linked to having unprotected sex while drunk.","clinical_takeaway":"Higher pornography use is associated with riskier hookup behaviours, especially intoxicated, unprotected sex in men; clinicians should consider this when discussing sexual risk reduction.","confidence":0.8,"topic_tags":["pornography","religiosity","sexual_function"],"strengths":["Large combined sample (N>1200)","Both sexes analyzed separately","Controls for several relevant covariates (self‑control, binge drinking, attitudes)"],"limitations":["Cross‑sectional, cannot infer causality","Pornography use measured with single‑item, not validated scale","No measurement of moral incongruence, masturbation, mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2015.1042920"}},{"id":1972,"doi":"10.1007/s10508-019-01538-4","pmid":"31591667","pmcid":"PMC7058570","title":"Sexual Coercion by Women: The Influence of Pornography and Narcissistic and Histrionic Personality Disorder Traits","authors":"Hughes A, Brewer G, Khan R.","first_author":"Hughes A","journal":"Archives of sexual behavior","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Female Perpetration","Sexually Explicit Material","Histrionic Personality Traits","Narcissistic Personality Traits"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-019-01538-4.pdf","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 142 women recruited from community and student populations; self‑report questionnaires on pornography use, personality traits and sexual coercion.","sample_n":142,"sample_text":"community and student populations (convenience sample)","population":"women, ages 16‑53, community/college sample (N=142)","country":"unspecified (likely USA/UK based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 142 women, higher pornography use and stronger narcissistic or histrionic personality traits were linked to greater self‑reported use of sexual coercion tactics such as non‑verbal arousal, emotional manipulation, and exploiting intoxicated partners.","clinical_takeaway":"The study suggests a relationship between pornography use, certain personality traits, and coercive behaviours, but causal claims are unsupported; clinicians should consider broader psychosocial factors.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Uses validated questionnaires for pornography use and personality traits","Adequate sample size for regression analyses","Addresses under‑studied topic of female sexual coercion"],"limitations":["Cross‑sectional design limits causal inference","No measurement or control of key confounds (moral incongruence, masturbation, mental health, relationship context, trauma)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-01538-4"}},{"id":1973,"doi":null,"pmid":"38333924","pmcid":"PMC11571919","title":"[Survey to know the perception of sexual education in adolescents]","authors":"Velasco-Gijón IM, Polo-Oliver A, Gutiérrez-Ramírez L, Arias-Arias Á, Tejera-Muñoz A.","first_author":"Velasco-Gijón IM","journal":"Revista espanola de salud publica","year":2024,"pub_types":["research-article","Journal Article","English Abstract","Observational Study"],"keywords":["sexually transmitted diseases","Spain","Adolescents","Sex Education","Sexual Health","Unsafe Sex"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11571919","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional observational survey of 248 adolescents from two public high schools in Castilla‑La Mancha, Spain; convenience sample; self‑administered questionnaire on sexual knowledge and pornography use.","sample_n":248,"sample_text":"248 students (68.1 % from Madridejos, 31.9 % from Herencia; 47.2 % female).","population":"Adolescents (mean age 14.7 years) attending public secondary schools in Spain.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 248 Spanish teens found that about half had watched porn, many started early, and many lacked accurate knowledge about condoms and STI risk. School education covered some topics better than family talk.","clinical_takeaway":"Adolescents need clearer, earlier sex‑education, especially about condom use and STI risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Reasonable sample size for descriptive purposes","Focus on an understudied age group","Provides data on source of sexual information"],"limitations":["Convenience sample from only two schools limits generalisability","Measures not validated; limited psychometric detail","No control for key confounding variables (e.g., moral attitudes, mental health)","Statistical analysis lacks effect‑size reporting and correction for multiple testing"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":1974,"doi":"10.1016/j.juro.2006.07.134","pmid":"17085205","pmcid":null,"title":"A P300 event related potential technique for assessment of sexually oriented interest","authors":"Vardi Y, Volos M, Sprecher E, Granovsky Y, Gruenwald I, Yarnitsky D.","first_author":"Vardi Y","journal":"The Journal of urology","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subject EEG oddball paradigm, 30 healthy adults viewing sexual and non‑sexual video clips","sample_n":30,"sample_text":"30 healthy subjects","population":"healthy adults (mixed gender, ages not specified beyond categories)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study recorded brain waves (P300) while people watched sexual and non‑sexual videos. The P300 signal dropped more during sexual clips, and this drop correlated with how aroused participants said they felt, suggesting a possible objective test of sexual interest.","clinical_takeaway":"Preliminary evidence that P300 changes may reflect sexual interest, but the method is not yet validated for clinical use.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","pornography"],"strengths":["Objective physiological measure (P300) linked to self‑report","Within‑subject design reduces between‑person variability","Clear statistical significance for sexual vs non‑sexual stimuli"],"limitations":["Small sample (N=30) limits power and generalisability","No control for moral, relational or mental‑health confounds","Reliance on single‑item/arbitrary sexual arousal questionnaire"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":6,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":0,"mentioning":31,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.juro.2006.07.134"}},{"id":1976,"doi":"10.1080/10538712.2024.2324838","pmid":"38459672","pmcid":null,"title":"How Risky is Online Sexting by Minors?","authors":"Finkelhor D, Sutton S, Turner H, Colburn D.","first_author":"Finkelhor D","journal":"Journal of child sexual abuse","year":2024,"pub_types":["Journal Article"],"keywords":["Child Pornography","Sextortion","Online Sexual Abuse","Child Sexual Abuse Materials","Image Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative retrospective survey of 2639 young adults reporting on sexting before age 18; logistic regression controlling for demographic and adversity variables","sample_n":2639,"sample_text":"US nationally representative sample of respondents aged 18‑28 reporting about experiences before age 18","population":"US young adults (18‑28) recalling minor‑age experiences; n=2639","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US sample of 2,639 young adults, about one‑quarter had sexted as minors. Of those, 37 % later experienced image‑abuse, a risk over 13 times higher than peers who never sexted. Even occasional sexting carried a high abuse risk.","clinical_takeaway":"Sexting by minors markedly raises the chance of image‑abuse victimisation; prevention messages should address this risk.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large, nationally representative sample","Clear outcome definition (image abuse victimisation)","Controls for key background risk factors"],"limitations":["Retrospective self‑report, possible recall bias","Single‑item measures for sexting and abuse","No assessment of mental‑health or partner context"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2024.2324838"}},{"id":1977,"doi":"10.3917/spub.236.0087","pmid":"38388405","pmcid":null,"title":"A rural interprofessional primary care team develops a school-based sex education program","authors":"Letessier M, Mignot D, Mejri I, Hitoto H.","first_author":"Letessier M","journal":"Sante publique (Vandoeuvre-les-Nancy, France)","year":2024,"pub_types":["Journal Article","English Abstract"],"keywords":["Sex Education","Rural Health","Sexual Health","Primary Prevention","Teenagers’ Health"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Program development and description without outcome evaluation; community‑based participatory description of a school‑based sex‑education intervention in a rural French setting.","sample_n":null,"sample_text":"Not reported in abstract.","population":"Teenagers and parents in a rural French community; no explicit sample size reported.","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers worked with a rural French primary‑care team to design a school programme covering contraception, STIs, consent, gender stereotypes and pornography, involving teachers, parents and local health providers.","clinical_takeaway":"None – the article describes programme development only, without evidence of impact on teen sexual health.","confidence":0.7,"topic_tags":["sexual_function","pornography"],"strengths":["Community‑based participatory approach","Integrates multiple stakeholders","Addresses rural health service gaps"],"limitations":["No outcome data reported","No evaluation of effectiveness","Sample size and demographics unclear"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3917/spub.236.0087"}},{"id":1978,"doi":"10.1136/bmj.q262","pmid":"38296336","pmcid":null,"title":"Former GP lead for NHS England who downloaded child pornography is struck off","authors":"Dyer C.","first_author":"Dyer C.","journal":"BMJ (Clinical research ed.)","year":2024,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.q262"}},{"id":1979,"doi":"10.1080/10810730.2019.1661552","pmid":"31526245","pmcid":null,"title":"Condom Use, Pornography Consumption, and Perceptions of Pornography as Sexual Information in a Sample of Adult U.S Males","authors":"Wright PJ, Sun C, Bridges A, Johnson JA, Ezzell MB.","first_author":"Wright PJ","journal":"Journal of health communication","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of heterosexual adult US men (convenience sample)","sample_n":null,"sample_text":"unspecified number of adult U.S. men; likely convenience online or panel sample","population":"adult heterosexually-identified US males","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a US male survey, men who watched more porn used condoms less often, but only when they viewed porn as a main source of sexual information. When porn wasn’t seen as instructional, its frequency didn’t relate to condom use.","clinical_takeaway":"Consider clients’ reliance on porn for sexual knowledge when discussing condom use risk.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses public‑health relevance of porn exposure","Large‑scale survey data","Tests moderating role of perceived informational value"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on single‑item self‑reports; no validated scales","Potential unmeasured confounds (e.g., relationship status, moral attitudes)","Sample likely convenience, limiting generalisability"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10810730.2019.1661552"}},{"id":1980,"doi":"10.1007/s10508-023-02797-y","pmid":"38285296","pmcid":null,"title":"Attitudes Toward Cisgender Women's Participation in Sex Work: Opportunity for Agency or Harmful Exchange?","authors":"Puffer H, Hodson G, Prusaczyk E.","first_author":"Puffer H","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sociosexuality","Sex Work","Right-wing Authoritarianism","Webcamming","Whorearchy","“Sugar Relationships”"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 298 US MTurk participants, regression analyses of attitudes toward different sex‑work domains.","sample_n":298,"sample_text":"298 US residents, 59.1% male, 40.9% female, mean age 40.06 years","population":"U.S. adults recruited via Amazon Mechanical Turk (convenience sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a U.S. online sample, people who are less authoritarian and more open to casual sex view pornography, webcamming, sugar‑dating and prostitution as giving women more agency, whereas higher authoritarianism, religiosity and older age are linked to seeing these activities as harmful.","clinical_takeaway":"None – the study reports attitudes, not health effects or treatment guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large (N≈300) community sample for attitude research","Multiple theoretically relevant predictors examined","Clear hierarchical model of “whorearchy” tested"],"limitations":["Convenience MTurk sample limits generalisability","Attitude measures appear ad‑hoc, not validated","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02797-y"}},{"id":1981,"doi":"10.1177/08862605231222452","pmid":"38281130","pmcid":null,"title":"Facilitators and Barriers of Bystander Intervention Intent in Image-Based Sexual Abuse Contexts: A Focus Group Study with a University Sample","authors":"Mainwaring C, Scott AJ, Gabbert F.","first_author":"Mainwaring C","journal":"Journal of interpersonal violence","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Bystander Intervention","Revenge Pornography","Image-based Sexual Abuse","Technology-Facilitated Sexual Abuse","Social-justice Ally"],"is_oa":false,"oa_url":"https://repository.londonmet.ac.uk/8978/3/Main%20document%20%28anonymised%29%20ver%2022%20-%20accepted%20manuscript.pdf","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups with 35 university students; thematic analysis","sample_n":35,"sample_text":"seven focus groups (n=35) of university students","population":"university students (young adults)","country":"unspecified (likely UK/US based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"University students discussed what makes them more or less likely to step in when they see non‑consensual sharing of sexual images. Feeling responsible, empathetic, safe, angry at the behavior, and having close ties to the people involved all increased the intention to help.","clinical_takeaway":"Educational programs that boost responsibility, empathy, and safety can encourage bystander help in image‑based sexual abuse cases.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Addresses an under‑researched area (bystander behavior in IBSA)","Use of multiple focus‑group scenarios to capture nuance","Clear thematic framework linking to existing violence literature"],"limitations":["Small, non‑representative university sample","Findings not generalizable to broader populations","No quantitative validation of themes"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":46,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605231222452"}},{"id":1982,"doi":"10.3390/genes15020169","pmid":"38397159","pmcid":"PMC10887871","title":"Genetic Aspects of Problematic and Risky Internet Use in Young Men-Analysis of ANKK1, DRD2 and NTRK3 Gene Polymorphism","authors":"Rył A, Tomska N, Jakubowska A, Ogrodniczak A, Palma J, Rotter I.","first_author":"Rył A","journal":"Genes","year":2024,"pub_types":["research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Gene polymorphism","Internet Addiction","Hormone Levels"],"is_oa":true,"oa_url":"https://www.mdpi.com/2073-4425/15/2/169/pdf?version=1706349329","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional genetic association study of 407 adult males using self‑report PIUT and serum hormone assays","sample_n":407,"sample_text":"adult males","population":"young adult males (n=407)","country":"Poland","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether certain gene variants (ANKK1, DRD2, NTRK3) and hormone levels are linked to higher scores on a questionnaire measuring problematic internet use in 407 young men.","clinical_takeaway":"No direct clinical recommendations; the findings are exploratory and do not establish causality.","confidence":0.7,"topic_tags":["gender"],"strengths":["Large sample size for genetic study","Multiple hormone assays","Inclusion of several gene polymorphisms"],"limitations":["Cross‑sectional design limits causal inference","No control for key psychosocial confounds (moral incongruence, mental health, partner effects)","Reliance on a single self‑report PIU measure"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/genes15020169"}},{"id":1983,"doi":"10.1007/s10508-015-0486-4","pmid":"25905909","pmcid":null,"title":"Pornography, Sexual Enhancement Products, and Sexual Risk of Female Sex Workers and their Clients in Southern India","authors":"Bradley J, Rajaram SP, Isac S, Gurav K, Ramesh BM, Gowda C, Moses S, Alary M.","first_author":"Bradley J","journal":"Archives of sexual behavior","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["India","Anal Sex","Hiv Risk Behaviors","Female Sex Workers","Pornography","Clients Of Female Sex Workers","Sexual Enhancement Products"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 684 male clients of female sex workers in Bangalore, India; multivariable logistic regression of risk behaviours","sample_n":684,"sample_text":"684 clients recruited for an integrated behavioural and biological assessment","population":"male clients of female sex workers, Southern India","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 684 Indian men who pay for sex, most had seen porn but few used sexual enhancement products. Porn use was linked to anal sex with sex workers, while other factors (travel, alcohol, condom use) predicted having many partners. The study highlights the need to consider pornography in HIV‑risk interventions.","clinical_takeaway":"Pornography exposure may be associated with higher HIV‑risk behaviours (anal sex) among clients of sex workers; prevention programs should address this alongside condom promotion.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a hard‑to‑reach population","First study in this context to include pornography and SEP use","Multivariable analysis adjusts for several behavioural covariates"],"limitations":["Pornography measured with a single yes/no item, no validated scale","Cross‑sectional design cannot infer causality","Key confounds for pornography (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0486-4"}},{"id":1984,"doi":"10.2196/48880","pmid":"38277200","pmcid":"PMC10858427","title":"Acceptance of a Web-Based Intervention in Individuals Who Committed Sexual Offenses Against Children: Cross-Sectional Study","authors":"Schröder S, Buntrock C, Neumann L, Müller JL, Fromberger P.","first_author":"Schröder S","journal":"JMIR formative research","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Community","Children","Psychiatry","Anxiety","Cross-sectional study","Child Abuse","Acceptance","Mhealth","Web-based Intervention","Child Pornography","Sexual Offense","Utaut","Unified Theory Of Acceptance And Use Of Technology","Sexual Offenses Against Children"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10858427","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 113 individuals from an ongoing trial","sample_n":113,"sample_text":"N=113 participants from an ongoing clinical trial","population":"individuals who have committed sexual offenses against children","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 113 men who have committed sexual offenses against children found that most are willing to use a web‑based therapy program, especially when they have positive attitudes toward it and feel people close to them support it.","clinical_takeaway":"Web‑based interventions appear acceptable to many offenders; attitudes and perceived social support predict uptake.","confidence":0.78,"topic_tags":["sexual_function","treatment"],"strengths":["Use of validated UTAUT framework","Adequate sample size for regression analysis","Clear reporting of effect sizes and confidence intervals","Relevant to implementation of digital therapy"],"limitations":["Cross‑sectional design limits causal inference","Sample drawn from a trial cohort; may not generalise to all offenders","No assessment of potential moral or psychological confounds"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/48880"}},{"id":1985,"doi":"10.3390/jimaging10020031","pmid":"38392080","pmcid":"PMC10890064","title":"Source Camera Identification Techniques: A Survey","authors":"Nwokeji CE, Sheikh-Akbari A, Gorbenko A, Mporas I.","first_author":"Nwokeji CE","journal":"Journal of imaging","year":2024,"pub_types":["review-article","Review","Journal Article"],"keywords":["Source Camera Identification","Sensor Pattern Noise","Camera Brand Source Identification","Camera Colour Filter Array","Camera Model Source Identification","Image Lens Optical Distortion"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10890064","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review/survey of source‑camera identification methods; no primary data collected.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews technical methods used to determine which camera captured an image, summarising hardware‑ and software‑based approaches, their performance, and available benchmark data.","clinical_takeaway":"None – the article does not provide clinical information on sexual health or behaviour.","confidence":0.9,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Comprehensive overview of camera‑identification techniques","Lists publicly available benchmark datasets and evaluation criteria"],"limitations":["No systematic methodology or risk‑of‑bias assessment","No primary empirical data; conclusions limited to literature synthesis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jimaging10020031"}},{"id":1986,"doi":"10.1080/00224499.2019.1655522","pmid":"31483169","pmcid":null,"title":"Sexual Consent Communication in Best-Selling Pornography Films: A Content Analysis","authors":"Willis M, Canan SN, Jozkowski KN, Bridges AJ.","first_author":"Willis M","journal":"Journal of sex research","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 50 20‑minute segments from best‑selling pornographic films (2015). Systematic coding of consent communication cues.","sample_n":50,"sample_text":"50 film segments","population":"Media content (pornographic films); no human participants.","country":"Not specified (likely USA/English‑language market)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors analysed 50 recent, popular porn clips and found that consent is shown mainly through non‑verbal cues, supporting several implicit scripts such as “women are indirect, men are direct” and “sex can happen without ongoing talk.”","clinical_takeaway":"Sex‑education programs should teach youth to critically evaluate consent cues in porn and distinguish scripted portrayals from healthy communication.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Systematic coding of a sizable sample of popular porn clips","Clear description of consent scripts identified","Relevant to sex‑education and media‑literacy fields"],"limitations":["Coding scheme not reported as validated","Convenience sample of best‑selling films limits generalisability","No assessment of viewer interpretation or impact"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":29,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2019.1655522"}},{"id":1987,"doi":"10.1080/0092623x.2019.1654579","pmid":"31464162","pmcid":null,"title":"The Exacerbating Impact of Moral Disapproval on the Relationship Between Pornography Use and Depression, Anxiety, and Relationship Satisfaction","authors":"Guidry R, Floyd CG, Volk F, Moen CE.","first_author":"Guidry R","journal":"Journal of sex & marital therapy","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience survey of partnered adults; moderated mediation analysis","sample_n":null,"sample_text":"online sample of participants in committed relationships (size not reported in abstract)","population":"adults in committed relationships (online sample)","country":"unspecified","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Among adults in relationships, people who use pornography and also strongly disapprove of it tend to feel more depressed and less satisfied with their relationship, suggesting that personal moral conflict may worsen the negative effects of porn use.","clinical_takeaway":"Assess clients' moral feelings about pornography, as conflict may amplify distress and relationship problems.","confidence":0.7,"topic_tags":["pornography","moral_incongruence","relationships","sexual_function"],"strengths":["addresses moral disapproval as moderator","uses mediation model to examine indirect effects","focuses on relational outcomes"],"limitations":["cross‑sectional design cannot infer causality","pornography use not separated from masturbation","sample size and recruitment details unclear"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2019.1654579"}},{"id":1988,"doi":"10.1016/j.jadohealth.2004.09.024","pmid":"16182145","pmcid":null,"title":"Adult identity mentoring: reducing sexual risk for African-American seventh grade students","authors":"Clark LF, Miller KS, Nagy SS, Avery J, Roth DL, Liddon N, Mukherjee S.","first_author":"Clark LF","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2005,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Randomized Controlled Trial","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Randomized controlled trial with 20 middle‑school classes of African‑American 7th‑graders assigned to AIM curriculum or standard health education; outcomes measured at 19 weeks and 1 year.","sample_n":null,"sample_text":"Classes randomly assigned; exact N not reported in abstract","population":"African‑American seventh‑grade students (U.S.)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A school‑based program that helps African‑American seventh‑graders imagine positive adult futures reduced their intention to have sex and increased abstinence rates compared with usual health education, especially for boys after one year.","clinical_takeaway":"Identity‑focused mentoring may support delayed sexual initiation in early adolescents.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Randomized allocation of whole classes","Theory‑based intervention (possible selves)","Longitudinal follow‑up (up to 1 year)"],"limitations":["Outcome measures appear to be single‑item self‑reports","No detail on sample size or power calculations","Potential lack of control for broader psychosocial confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":72,"citing_publications":90,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2004.09.024"}},{"id":1989,"doi":"10.1186/s12889-024-17690-z","pmid":"38238727","pmcid":"PMC10797941","title":"'I tried to take my phone off my daughter, and i got hit in the face': a qualitative study of parents' challenges with adolescents' screen use and a toolbox of their tips","authors":"Marsh S, Chu JTW, Calder AJ.","first_author":"Marsh S","journal":"BMC public health","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Technology","Adolescent Health","Adolescent Behavior","Family Health","Screen Use Behaviour"],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-024-17690-z","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interviews with 33 parents (convenience sample)","sample_n":33,"sample_text":"33 adults, mean age 48, parenting adolescents mean age 14","population":"parents of adolescents (13‑17) in Auckland, NZ","country":"New Zealand","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 33 New Zealand parents revealed worries about teens’ constant screen use, describing ‘addict‑like’ behaviours, exposure to harmful content (including pornography), and impacts on health. Parents shared strategies and a toolbox of tips for managing screen time.","clinical_takeaway":"Clinicians should recognize parental concerns about adolescent screen habits and discuss practical family rules, communication, and technical tools.","confidence":0.8,"topic_tags":["adolescents","sexual_function","pornography"],"strengths":["In‑depth, verbatim interview data","Provides parental perspective on digital wellbeing"],"limitations":["Small, non‑representative convenience sample","No validated measures of screen‑use or addiction","No assessment of key confounds (moral, mental health, etc.)"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-024-17690-z"}},{"id":1990,"doi":"10.1007/s10508-023-02782-5","pmid":"38233725","pmcid":"PMC10920420","title":"Links between Aggressive Sexual Fantasies and Sexual Coercion: A Replication and Extension of a Multifactorial Model","authors":"Birke JB, Jern P, Johansson A, Bondü R.","first_author":"Birke JB","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Structural Equation Model","Sexual Coercion","Aggressive Sexual Fantasies","Multifactor Model"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10920420","cited_by_count":4,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Latent structural equation modelling on a large community sample (N=3269) to test a multifactorial model of sexual coercion.","sample_n":3269,"sample_text":"3269 men, mean age 26.17 years (SD 4.76)","population":"Men, general population (Finnish Genetics of Sexuality and Aggression project)","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Finnish sample of over 3,000 men, aggressive sexual fantasies were found to be as strongly linked to sexual coercion as antisocial behavior, even after accounting for childhood abuse, hypersexuality, and personality traits. The study suggests that these fantasies play a central role in models of sexual aggression.","clinical_takeaway":"Assess aggressive sexual fantasies when evaluating risk for sexual coercion; they may be a key target for prevention and treatment.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Very large community sample","Comprehensive multifactorial model","Use of latent SEM with multiple risk factors"],"limitations":["Cross‑sectional design limits causal inference","Key confounds (moral incongruence, masturbation, mental health) not measured","Mediation interpreted despite single‑time‑point data"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02782-5"}},{"id":1993,"doi":"10.1080/10410236.2019.1652392","pmid":"31403326","pmcid":null,"title":"Adolescent Condom Use, Parent-adolescent Sexual Health Communication, and Pornography: Findings from a U.S. Probability Sample","authors":"Wright PJ, Herbenick D, Paul B.","first_author":"Wright PJ","journal":"Health communication","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"National Survey of Porn Use, Relationships, and Sexual Socialization (NSPRSS), U.S. probability sample, cross‑sectional analysis of condom use and pornography exposure with parent communication as moderator.","sample_n":null,"sample_text":"probability sample, size not provided in abstract","population":"U.S. adolescents (age not specified)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a U.S. nationwide survey, teens who watched porn were more likely to have sex without condoms, but only when parents rarely talked about sexual health. Strong parent‑child communication seemed to buffer any risky influence of porn on condom use.","clinical_takeaway":"Encourage open sexual health communication between parents and adolescents to reduce condomless sex risk, regardless of porn exposure.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large probability sample increases generalisability","Tests interaction between pornography exposure and parental communication","Addresses a public‑health relevant outcome (condomless sex)"],"limitations":["Cross‑sectional design cannot infer causality","Potential unmeasured confounds (e.g., mental health, sexual attitudes)","Reliance on self‑report measures without validation detail"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":7,"contrasting":5,"mentioning":94,"citing_publications":81,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2019.1652392"}},{"id":1995,"doi":"10.1556/jba.4.2015.1.5","pmid":"25786495","pmcid":"PMC4394849","title":"Getting stuck with pornography? Overuse or neglect of cybersex cues in a multitasking situation is related to symptoms of cybersex addiction","authors":"Schiebener J, Laier C, Brand M.","first_author":"Schiebener J","journal":"Journal of behavioral addictions","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Internet Addiction","Multitasking","Psychopathological Symptoms","Cybersex","Cue-reactivity","Internet Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4394849","cited_by_count":28,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross-sectional laboratory multitasking task with 104 male participants; no control group; association between performance balance and self‑reported cybersex addiction tendency.","sample_n":104,"sample_text":"104 male participants","population":"Male adults (age range not specified), recruited presumably from community/college; convenience sample.","country":"Not stated","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab task where men classified pictures, those who performed less evenly between neutral and porn pictures tended to score higher on a questionnaire measuring cybersex addiction tendencies, suggesting a link between poor multitasking control and problematic porn use.","clinical_takeaway":"Reduced executive control when confronted with porn cues may relate to self‑reported cybersex problems, but evidence is limited and confounded.","confidence":0.7,"topic_tags":["pornography","csbd"],"strengths":["Experimental multitasking paradigm","Moderate sample size (N=104)","Focus on executive control and cue reactivity"],"limitations":["Reliance on unspecified self‑report addiction scale","No measurement/control of key confounds (moral incongruence, masturbation, mental health)","Cross‑sectional; causal language overstated","Male‑only convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":2,"interpretation":4}},"scite":{"supporting":3,"contrasting":0,"mentioning":32,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/jba.4.2015.1.5"}},{"id":1997,"doi":"10.1177/0886260515573572","pmid":"25724876","pmcid":null,"title":"X Views and Counting: Interest in Rape-Oriented Pornography as Gendered Microaggression","authors":"Makin DA, Morczek AL.","first_author":"Makin DA","journal":"Journal of interpersonal violence","year":2016,"pub_types":["Journal Article"],"keywords":["Microaggression","Internet Pornography","Internet Search Queries","Macrolevel Assessments","Rape Culture","Rape-oriented Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"analysis of Google search query frequencies (regional, 2004‑2012)","sample_n":null,"sample_text":"Not applicable – aggregate search data","population":"aggregate internet search data (no individual participants)","country":"global (regional analysis)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Using Google search data from 2004‑2012, the authors mapped regional interest in rape‑oriented pornography, suggesting such interest may act as a microaggression that reinforces gender‑based violence norms.","clinical_takeaway":"None – the study examines population‑level search trends, not individual health outcomes.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Novel use of large‑scale search data","Regional trend analysis over several years","Links media consumption to sociocultural concepts"],"limitations":["No individual‑level measures; ecological inference limited","No validated construct for ‘interest’ in rape‑oriented porn","Absence of control for cultural, legal, or demographic confounds","Interpretation may overstate causal role of search interest"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260515573572"}},{"id":1998,"doi":"10.1080/00224498809551406","pmid":"22375643","pmcid":null,"title":"Women's attitudes toward and experience with sexually explicit materials","authors":"Lawrence KA, Herold ES.","first_author":"Lawrence KA","journal":"Journal of sex research","year":1988,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224498809551406"}},{"id":1999,"doi":"10.1016/j.chiabu.2014.12.009","pmid":"25605590","pmcid":null,"title":"Web-based child pornography: The global impact of deterrence efforts and its consumption on mobile platforms","authors":"Steel CM.","first_author":"Steel CM.","journal":"Child abuse & neglect","year":2015,"pub_types":["Journal Article","Case Reports"],"keywords":["Internet","Child Pornography","Child Sexual Exploitation"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Observational analysis of aggregated search query data from major search engines, comparing pre‑ and post‑blocking periods; no individual participants.","sample_n":null,"sample_text":"Aggregated query counts from Google, Bing, and Yandex; exact numbers not provided in abstract.","population":"Global internet users performing web searches for child sexual exploitation material; data derived from search engine logs.","country":"Global (United States, Russia, others inferred from query location)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined global internet searches for child sexual exploitation material, finding that blocking by Google and Microsoft cut searches by 67% but that Yandex, which does not block, showed no decline, and mobile devices account for about a third of searches.","clinical_takeaway":"None - not clinically applicable.","confidence":0.7,"topic_tags":["csbd","sexual_function","masturbation","relationships","moral_incongruence","gender"],"strengths":["Large‑scale real‑world search data","International comparison of search engines","Timely policy‑relevant findings"],"limitations":["No individual‑level data; ecological inference limited","No statistical power justification or confidence intervals","Potential bias from unmeasured search‑engine filtering methods"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":34,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2014.12.009"}},{"id":2000,"doi":"10.1177/1059840514563313","pmid":"25563576","pmcid":null,"title":"Factors Associated With Exposure to Violent or Degrading Pornography Among High School Students","authors":"Romito P, Beltramini L.","first_author":"Romito P","journal":"The Journal of school nursing : the official publication of the National Association of School Nurses","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescents","Violence","School Health Services","Gender Differences","High School","School Nursing","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 702 Italian high‑school students assessing self‑reported exposure to non‑violent vs violent/degrading pornography and associated risk behaviours.","sample_n":702,"sample_text":"702 high‑school students (46 % male).","population":"Italian adolescents (mean age 18.2), recruited from schools (convenience sample).","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 702 Italian high‑school students found that many teens, especially boys, view violent or degrading porn, and this exposure is linked to risk behaviours such as drinking, smoking, taking sexual photos and, for girls, family violence.","clinical_takeaway":"Clinicians working with adolescents should be aware that exposure to violent porn often co‑occurs with other risk behaviours and may signal broader safety or health concerns.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample for adolescent survey","Adjusted odds ratios with confidence intervals","Examines multiple behavioural risk factors"],"limitations":["Self‑report exposure categories unvalidated","Cross‑sectional; cannot infer causality","Key confounds (moral incongruence, masturbation, mental health) not measured"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":34,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1059840514563313"}},{"id":2001,"doi":"10.1080/00224499.2019.1623163","pmid":"31215794","pmcid":null,"title":"Pubertal Timing, Parenting Style, and Trajectories of Pornography Use in Adolescence: Peer Pornography Use as the Mediator","authors":"Nieh HP, Chang LY, Chang HY, Chiang TL, Yen LL.","first_author":"Nieh HP","journal":"Journal of sex research","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["bibliography","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"longitudinal survey with 3+ waves, n≈2480 adolescents, trajectory modeling","sample_n":2482,"sample_text":"1272 boys and 1210 girls who completed at least three waves of pornography use questions","population":"adolescents (7th‑12th grade) in Taiwan","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of over 2,400 Taiwanese teens, early puberty and controlling parenting were linked to more frequent pornography use, while parental monitoring reduced it. Friends’ porn use explained part of these effects, especially for boys.","clinical_takeaway":"Parents can lower teen pornography exposure by active monitoring; peer influences are a strong driver, particularly for boys.","confidence":0.85,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Large, nationally‑relevant adolescent sample","Longitudinal design with three+ measurement waves","Advanced trajectory and mediation analyses"],"limitations":["Pornography use measured by single‑item self‑report, no validated scale","Key sexual‑health confounds (moral incongruence, masturbation, mental health, trauma) not assessed","No pre‑registration or explicit power analysis reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2019.1623163"}},{"id":2002,"doi":"10.2147/jmdh.s427251","pmid":"38107084","pmcid":"PMC10723188","title":"Lifetime Experience of Childhood Abuse and Neglect Among High School Students at Debre Tabor Town, South Gondar Zone, Northwest Ethiopia: An Institution-Based Cross-Sectional Study","authors":"Kefale D, Endalew M, Asferie WN, Demis S, Munye T, Tesfahun Y, Simegn A, Wondim M, Kassaw A, Kerebeh G, Belay DM, Minuye B, Zeleke S.","first_author":"Kefale D","journal":"Journal of multidisciplinary healthcare","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Neglect","Childhood Abuse","High School Students","Icast-c"],"is_oa":true,"oa_url":"https://www.dovepress.com/getfile.php?fileID=95123","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 423 high‑school students using systematic sampling; logistic regression to identify predictors of lifetime childhood abuse and neglect.","sample_n":423,"sample_text":"systematic sampling of high‑school students; 423 participants completed the ICAST‑C questionnaire","population":"high‑school students in Debre Tabor town, Ethiopia (N=423)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 423 Ethiopian high‑school students found that 84% reported experiencing some form of childhood abuse or neglect. Girls, children of illiterate fathers, and those whose parents were not married were more likely to report abuse. Watching pornography and open family discussions about sex were linked to lower reported abuse, though the study’s design cannot prove cause‑and‑effect.","clinical_takeaway":"High rates of childhood abuse among adolescents highlight the need for screening and family‑education interventions; associations with pornography exposure are correlational only.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Use of a validated child‑abuse screening instrument (ICAST‑C)","Relatively large sample for a school‑based survey","Systematic sampling reduces selection bias within the town"],"limitations":["Cross‑sectional design cannot infer causality","Pornography exposure measured by a single self‑report item","Findings limited to one Ethiopian town; not nationally generalisable"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":11,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/jmdh.s427251"}},{"id":2003,"doi":"10.1007/s10508-023-02728-x","pmid":"38082175","pmcid":null,"title":"Sexting in Young Adults: A Normative Sexual Behavior","authors":"Thorne E, Babchishin KM, Fisico R, Healey L.","first_author":"Thorne E","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sex Education","Sexual Orientation","Pornography","Sexting","Sexual Materials"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 2,828 young adults (18‑30) from US/Canada; descriptive statistics on sexting prevalence, frequency, motivations, gender and orientation differences.","sample_n":2828,"sample_text":"online convenience sample of young adults aged 18‑30","population":"young adults, primarily U.S./Canada, recruited online","country":"United States; Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 2,828 young adults in the US and Canada found that 81% have sent sexts, usually starting around age 16‑17 and often sending 11 or more. Most do it for arousal, flirting, or reciprocity, while a minority report coercion. Patterns differ by gender and sexual orientation, suggesting sexting is a common part of young adult sexual life.","clinical_takeaway":"Sexting is normative for most young adults; clinicians should focus on consent and safe practices rather than abstinence messages.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["large sample size (N>2,800)","covers both gender and sexual‑orientation sub‑groups","provides detailed descriptive data on sexting frequency and motivations"],"limitations":["cross‑sectional, self‑selected online sample limits causal inference and generalisability","no validated scale for sexting behaviour; relies on ad‑hoc items","key confounds (e.g., mental health, moral attitudes) not measured"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02728-x"}},{"id":2004,"doi":"10.1111/j.1743-6109.2006.00399.x","pmid":"17233778","pmcid":null,"title":"Thermography as a physiological measure of sexual arousal in both men and women","authors":"Kukkonen TM, Binik YM, Amsel R, Carrier S.","first_author":"Kukkonen TM","journal":"The journal of sexual medicine","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":68,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized controlled trial with 58 healthy adult participants (28 men, 30 women) assigned to neutral, humor, or sexually explicit video conditions; continuous thermographic recording of genital temperature; subjective arousal ratings collected.","sample_n":58,"sample_text":"28 men, 30 women; participants randomly assigned to three video conditions (≈19‑20 per group)","population":"Healthy adults, community volunteers","country":"Not specified (likely Finland/USA based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested whether infrared thermography can track genital temperature changes during sexual arousal. In 58 men and women, watching an erotic video raised genital temperature more than neutral or humorous clips, and these temperature changes matched self‑reported arousal.","clinical_takeaway":"Thermal imaging shows promise as a non‑invasive way to assess sexual arousal, but larger studies are needed before clinical use.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Objective physiological measure (thermography)","Random assignment to stimulus conditions","Correlation between temperature and subjective arousal"],"limitations":["Small per‑group sample size, limiting power","Subjective arousal measured with non‑validated Likert items","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":10,"contrasting":2,"mentioning":135,"citing_publications":123,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2006.00399.x"}},{"id":2005,"doi":"10.1080/00224490309552188","pmid":"14533018","pmcid":null,"title":"The effect of stimulus content on volunteering for sexual interest research among college students","authors":"Gaither GA, Sellbom M, Meier BP.","first_author":"Gaither GA","journal":"Journal of sex research","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 206 men and 358 women college students assessing willingness to view different explicit image types and comparing volunteer vs non‑volunteer characteristics.","sample_n":564,"sample_text":"206 men, 358 women recruited from a university class setting","population":"College students (US, likely convenience sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study asked 564 college students whether they would volunteer for research showing different kinds of explicit images. Men and women chose different content, and volunteers tended to score higher on self‑monitoring and sensation‑seeking.","clinical_takeaway":"None – the findings concern research participation bias, not clinical treatment.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for a volunteer‑bias study","Direct assessment of willingness across multiple image types","Identifies personality traits linked to volunteering"],"limitations":["Convenience sample of college students limits generalizability","No detailed reporting of scale validation or effect sizes","No control for moral, mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":10,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490309552188"}},{"id":2006,"doi":"10.29158/jaapl.230057-23","pmid":"37704259","pmcid":null,"title":"Insights on Female Sex Offenders from the Missouri Registry","authors":"Ghossoub E, Harake NE.","first_author":"Ghossoub E","journal":"The journal of the American Academy of Psychiatry and the Law","year":2023,"pub_types":["Journal Article"],"keywords":["Women","Crime Victims","Sexual Recidivism","Sex Offenses"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"registry-based descriptive analysis of all female sex offenders in Missouri (n=532); no comparison group, no longitudinal follow‑up","sample_n":532,"sample_text":"All female offenders listed in the Missouri sex offender registry (n=532)","population":"female adults convicted of sex offenses in Missouri (registry data)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examined 532 women listed in Missouri’s sex‑offender registry, finding an average first‑offense age of 29.8 years, a very low recidivism rate (0.6 %), and that most offenses involved direct contact, with only 5 % being purely pornography‑related.","clinical_takeaway":"Female sex‑offender profiles differ from males; risk‑assessment tools should consider these distinct patterns.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, population‑wide registry sample","Clear descriptive statistics of offense characteristics"],"limitations":["No assessment of psychosocial or mental‑health correlates","Cross‑sectional, no causal inference possible","Limited to one state; generalizability uncertain"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.29158/jaapl.230057-23"}},{"id":2007,"doi":"10.1007/s10508-014-0391-2","pmid":"25466233","pmcid":null,"title":"Pornography and the Male Sexual Script: An Analysis of Consumption and Sexual Relations","authors":"Sun C, Bridges A, Johnson JA, Ezzell MB.","first_author":"Sun C","journal":"Archives of sexual behavior","year":2016,"pub_types":["Journal Article"],"keywords":["Relationships","Sex Education","Pornography","Male Sexuality","Cognitive Script Theory"],"is_oa":false,"oa_url":null,"cited_by_count":103,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 487 US college men","sample_n":487,"sample_text":"college men recruited via university channels (convenience sample)","population":"college men (18‑29 y, US)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 487 US college men found that higher porn use was linked to using porn during sex, requesting porn‑style acts, and feeling less enjoyment of intimate partner behaviors, as well as more performance‑related worries.","clinical_takeaway":"Higher pornography consumption may be associated with reduced sexual satisfaction and increased performance concerns, but causal claims are unsupported.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["large sample for a single‑site survey","focus on understudied link between porn use and dyadic sexual behavior","clear theoretical framing (cognitive script theory)"],"limitations":["cross‑sectional, cannot infer causality","self‑report and unvalidated measures of porn use and sexual outcomes","no control for key confounds (e.g., moral beliefs, mental health, masturbation)","convenience college sample limits generalisability"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":9,"contrasting":1,"mentioning":185,"citing_publications":383,"retracted":false,"notices":[{"status":"Has correction","date":"2016-3-29","noticeDoi":"10.1007/s10508-016-0744-0","doi":"10.1007/s10508-014-0391-2"},{"status":"Has erratum","date":"2016-3-29","noticeDoi":"10.1007/s10508-016-0744-0","doi":"10.1007/s10508-014-0391-2"}],"url":"https://scite.ai/reports/10.1007/s10508-014-0391-2"}},{"id":2008,"doi":"10.3390/ijerph20247144","pmid":"38131696","pmcid":"PMC10742498","title":"Health Economic Evaluation of an Online-Based Motivational Program to Reduce Problematic Media Use and Promote Treatment Motivation for Internet Use Disorder-Results of the OMPRIS Study","authors":"Niemann A, Hillerich V, Wasem J, Dieris-Hirche J, Bottel L, Pape M, Herpertz S, Timmesfeld N, Basten J, Te Wildt BT, Wölfling K, Beckers R, Henningsen P, Neusser S, Neumann A.","first_author":"Niemann A","journal":"International journal of environmental research and public health","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Multicenter Study","Randomized Controlled Trial","Journal Article"],"keywords":["Economic evaluation","Cost-effectiveness","Social Media","Reliable Change Index","Internet Use Disorder","Incremental Cost-effectiveness Ratio (Icer)","Online Gaming","Online Pornography","Intervention Costs"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10742498","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized controlled trial, multicenter, single‑blinded, 169 participants (81 intervention, 88 waiting control).","sample_n":169,"sample_text":"81 in intervention group, 88 in waiting control group.","population":"Adults with Internet Use Disorder symptoms, mean age 31.9, 75% male, recruited via German statutory health insurance.","country":"Germany","controls_mi":"no","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A four‑week online program was tested in a randomised trial with 169 adults who reported problematic internet use, including online porn. Participants who received the program showed greater improvements in addiction‑like symptoms and did so at a modest additional cost to the health system.","clinical_takeaway":"Brief online motivational interventions can reduce problematic media use at reasonable cost, but clinicians should assess moral and mental‑health factors that were not addressed here.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","csbd"],"strengths":["Randomized controlled design with pre‑registration","Use of a validated addiction assessment scale (AICA‑S)","Economic evaluation (cost‑effectiveness) adds policy relevance","Multicenter recruitment enhances generalisability within Germany"],"limitations":["No measurement or control of moral incongruence or related psychosocial confounds","Outcome scale blends behaviour and distress, limiting construct separation","Short follow‑up (immediate post‑intervention only)","Sample predominantly male, limiting gender‑balanced conclusions"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph20247144"}},{"id":2009,"doi":"10.1177/1079063214557173","pmid":"25394664","pmcid":null,"title":"A Matter of Low Self-Control? Exploring Differences Between Child Pornography Possessors and Child Pornography Producers/Distributers Using Self-Control Theory","authors":"Clevenger SL, Navarro JN, Jasinski JL.","first_author":"Clevenger SL","journal":"Sexual abuse : a journal of research and treatment","year":2016,"pub_types":["Journal Article"],"keywords":["Child Pornography","Low Self-control","Self-control Theory","Child Pornography Possession","Child Pornography Production/distribution"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"secondary analysis of national survey data comparing arrested child‑pornography possessors vs producers/distributors","sample_n":null,"sample_text":"Arrestees from the National Juvenile Online Victimization Study (N‑JOV2); exact N not reported in abstract","population":"arrested individuals involved in child‑pornography offenses (N‑JOV2 second wave)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compares people arrested only for possessing child pornography with those who also produce or distribute it, finding that producers show more signs of low self‑control such as drug problems and prior violence.","clinical_takeaway":"None – findings pertain to criminal behavior, not clinical treatment of pornography use.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Large, nationally representative dataset for crime statistics","Clear focus on self‑control theory"],"limitations":["No validated self‑control scale; uses proxy items","No control for moral or relational confounds","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":34,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063214557173"}},{"id":2010,"doi":"10.1080/0092623x.2019.1610124","pmid":"31018827","pmcid":null,"title":"Pornography Influence Among Young Students: Adaptation and Validation of Pornography Consumption Inventory into Spanish","authors":"Leon-Larios F, Saavedra-Macias FJ, Albar-Marin MJ, Gomez-Baya D.","first_author":"Leon-Larios F","journal":"Journal of sex & marital therapy","year":2019,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a questionnaire in a convenience sample of 211 university students who reported pornography use","sample_n":211,"sample_text":"211 young students who admitted to consume pornography","population":"young students (Spain), self‑selected pornography users","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors translated and tested the Pornography Consumption Inventory in Spanish with 211 university students, finding a three‑factor structure (emotional avoidance, sexual curiosity, excitement seeking) and good reliability.","clinical_takeaway":"The Spanish PCI appears psychometrically sound for research on pornography use among Spanish‑speaking youths.","confidence":0.7,"topic_tags":["pornography","measurement","sexual_function","adolescents","csbd"],"strengths":["Rigorous factor‑analysis and reliability testing","Adequate sample size for validation (N>200)","Clear reporting of factorial structure"],"limitations":["Convenience student sample limits generalisability","No assessment of moral incongruence or related confounds","No separation of consumption frequency from distress"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2019.1610124"}},{"id":2011,"doi":"10.1016/j.forsciint.2019.05.009","pmid":"31176532","pmcid":null,"title":"Applicability of a pre-established set of facial proportions from frontal photographs in forensic age estimation of a Brazilian population","authors":"Machado CEP, Santiago BM, Lima LNC, Gonzales PS, Franco A, Vidal FB, Aguilera IA, Guimarães MA.","first_author":"Machado CEP","journal":"Forensic science international","year":2019,"pub_types":["Validation Study","Journal Article"],"keywords":["Age estimation","Child Pornography","Forensic Anthropology Population Data","Photoanthropometry"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study using 800 standardized frontal photographs, discriminant analysis to classify age groups","sample_n":800,"sample_text":"800 participants (400 females, 400 males) across 4 age groups","population":"Brazilian children and adolescents, age 6,10,14,18, equal sex distribution","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested whether a set of facial measurements from front‑view photos can correctly estimate the age of Brazilian children. Using 800 standardized pictures, the method correctly classified about half of the cases, indicating limited usefulness without further adaptation.","clinical_takeaway":"Current facial‑proportion methods are insufficient for reliable age estimation in forensic contexts; additional population‑specific calibration is needed.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Large, balanced sample size","Standardized photographic protocol","Systematic application of pre‑established facial indexes"],"limitations":["No pre‑registration or power analysis reported","Limited predictive accuracy (~50%)","Does not address population‑specific morphological variation"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.forsciint.2019.05.009"}},{"id":2012,"doi":"10.3389/fpsyt.2023.1277225","pmid":"38076694","pmcid":"PMC10701425","title":"Individuals under voluntary treatment with sexual interest in minors: what risk do they pose?","authors":"von Franqué F, Bergner-Koether R, Schmidt S, Pellowski JS, Peters JH, Hajak G, Briken P.","first_author":"von Franqué F","journal":"Frontiers in psychiatry","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Child Sexual Abuse","Child Pornography","Cport","Not Become An Offender","Dunkelfeld","Do Not Offend","Kein Täter Werden"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1277225/pdf?isPublishedV2=False","cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective assessment of voluntarily treated individuals with sexual interest in minors; recidivism rates compared to external benchmarks.","sample_n":null,"sample_text":"Not reported in abstract","population":"non‑forensic individuals seeking confidential therapy for sexual interest in minors (Germany)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined people who voluntarily seek therapy for a sexual interest in minors and found that a notable share had previously committed child sexual abuse or viewed child sexual abuse material, with recidivism rates higher than expected for the general population.","clinical_takeaway":"Voluntary treatment clients with a sexual interest in minors may pose a higher risk of reoffending; risk assessment tools show modest predictive ability.","confidence":0.73,"topic_tags":["sexual_function"],"strengths":["Uses established risk assessment tools (CPORT, CASIC)","Provides comparative recidivism rates against external data","Reports effect size (AUC) with confidence intervals"],"limitations":["Small/unspecified sample size; likely under‑powered","Self‑selected treatment‑seeking cohort limits generalisability","Limited control for potential confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":22,"retracted":false,"notices":[{"status":"Has correction","date":"2024-4-26","noticeDoi":"10.3389/fpsyt.2024.1408862","doi":"10.3389/fpsyt.2023.1277225"},{"status":"Has correction","date":"2025-6-18","noticeDoi":"10.3389/fpsyt.2025.1608123","doi":"10.3389/fpsyt.2023.1277225"}],"url":"https://scite.ai/reports/10.3389/fpsyt.2023.1277225"}},{"id":2013,"doi":"10.1002/bsl.2637","pmid":"37996976","pmcid":null,"title":"Exploring how attorneys address grooming in criminal trials of child sexual abuse","authors":"Denne E, Stolzenberg SN.","first_author":"Denne E","journal":"Behavioral sciences & the law","year":2023,"pub_types":["Journal Article"],"keywords":["seduction","Child Abuse","Child Sexual Abuse","Grooming","Attorney Questioning"],"is_oa":false,"oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/bsl.2637","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Content analysis of 134 trial transcripts; quantitative coding of attorney questions.","sample_n":134,"sample_text":"134 transcripts of CSA criminal trials","population":"Criminal trial transcripts of child sexual abuse cases (U.S. likely).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined 134 child‑sexual‑abuse trial transcripts and found that attorneys rarely discuss grooming, with only 1.8% of questions mentioning it. When grooming was raised, prosecutors did so more often than defense lawyers, especially about pornography exposure.","clinical_takeaway":"None – the study informs legal practice, not clinical treatment.","confidence":0.9,"topic_tags":["gender","sexual_function","pornography","masturbation"],"strengths":["Large number of real trial transcripts","Quantitative coding of attorney behavior","Identification of concrete gaps in courtroom discussion"],"limitations":["No validated coding instrument reported","Cross‑sectional, no causal claims possible","Limited to transcripts; no insight into juror decision impact"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/bsl.2637"}},{"id":2014,"doi":"10.1080/0092623x.2019.1594477","pmid":"30912476","pmcid":null,"title":"Portuguese Version of the Cyber Pornography Use Inventory-9: Psychometric Properties and Gender Invariance","authors":"Cardoso J, Ramos C, Almeida T.","first_author":"Cardoso J","journal":"Journal of sex & marital therapy","year":2019,"pub_types":["Evaluation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a self‑report inventory with 257 university students (web survey)","sample_n":257,"sample_text":"257 university students (153 women, 104 men) recruited via web survey","population":"university students, Portugal, mixed gender","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The Portuguese version of the Cyber Pornography Use Inventory‑9 was tested in 257 university students. It showed a good three‑factor structure, but the way the factors work differs between men and women, so the scale should be used carefully across genders.","clinical_takeaway":"The CPUI‑9 can be used in Portuguese‑speaking settings, but clinicians should consider gender differences and not rely on it alone for diagnosing problematic use.","confidence":0.78,"topic_tags":["measurement","pornography","gender","csbd"],"strengths":["Adequate sample size for CFA","Comprehensive factor‑structure testing","Gender invariance analysis"],"limitations":["Convenience student sample limits generalisability","No assessment of moral or mental‑health confounds","Scale may bundle frequency and distress"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2019.1594477"}},{"id":2015,"doi":"10.1080/09540120500100924","pmid":"16176893","pmcid":null,"title":"The adventures of the Randy Professor and Angela the Sugar Mummy: sex in fictional serials in Ugandan popular magazines","authors":"Gysels M, Pool R, Nyanzi S.","first_author":"Gysels M","journal":"AIDS care","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Content analysis of fictional serials in three Ugandan lifestyle magazines; convenience selection; descriptive coding of sexual content.","sample_n":null,"sample_text":"Three magazines; number of serials not specified","population":"Magazine content (no human participants)","country":"Uganda","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined sexual stories in three Ugandan magazines, finding they portray risky sexual fantasies without mention of HIV risk. They suggest that integrating pleasure into health messages could improve HIV prevention.","clinical_takeaway":"None - not directly applicable to clinical practice.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Novel analysis of popular media in an HIV-relevant context","Highlights potential for entertainment-education interventions"],"limitations":["No empirical data on audience behavior or outcomes","Limited to three magazines; not representative","Lack of validated coding scheme for sexual content"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540120500100924"}},{"id":2018,"doi":"10.1016/j.jsxm.2019.03.265","pmid":"31029536","pmcid":"PMC8519170","title":"Application of Sex Aids in Men With Sexual Dysfunction: A Review","authors":"Miranda EP, Taniguchi H, Cao DL, Hald GM, Jannini EA, Mulhall JP.","first_author":"Miranda EP","journal":"The journal of sexual medicine","year":2019,"pub_types":["research-article","Review","Journal Article"],"keywords":["erectile dysfunction","Lubricants","Vibrators","Orgasmic Disorder","Pornography","Constriction Bands","Vacuum Device","Dildos","Sex Aids"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods; no primary data collection; conclusions based on compiled literature.","sample_n":null,"sample_text":"Not applicable (review article)","population":"men with sexual dysfunction (heterogeneous clinical samples from cited studies)","country":"Not specified (international literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews the types of sex‑aid devices (e.g., vibrators, lubricants, vacuum pumps) used to help men with erectile or orgasmic problems, summarising their indications, benefits, and risks for clinicians.","clinical_takeaway":"Sex‑aid devices can be safely incorporated into treatment plans for male sexual dysfunction, but clinicians should consider individual preferences and limited evidence.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad overview of many sex‑aid devices","Clinical relevance for practitioners"],"limitations":["Not systematic; possible selection bias","No quantitative synthesis or quality appraisal","No primary data; conclusions depend on heterogeneous sources"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.03.265"}},{"id":2019,"doi":"10.1186/s12905-023-02744-y","pmid":"37964236","pmcid":"PMC10647082","title":"Health professionals' and beauty therapists' perspectives on female genital cosmetic surgery: an interview study","authors":"Kirkman M, Dobson A, McDonald K, Webster A, Wijaya P, Fisher J.","first_author":"Kirkman M","journal":"BMC women's health","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Australia","Medical education","Interviews","Qualitative Research","Medical Practitioners","Female Genital Cosmetic Surgery"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10647082","cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Interview study with 21 participants (16 health professionals, 5 non‑health professionals) using semi‑structured guide; thematic analysis.","sample_n":21,"sample_text":"16 health professionals and 5 non‑health professionals","population":"Health and beauty professionals in Australia; purposive convenience sample.","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with health and beauty professionals in Australia reveal that ideas about what a 'normal' vulva looks like shape why women consider genital cosmetic surgery, with influences ranging from media and pornography to social pressure.","clinical_takeaway":"Clinicians should recognize that requests for genital cosmetic surgery are often driven by social and aesthetic norms rather than medical necessity.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Rich qualitative insight into professional discourses","Clear iterative thematic analysis process","Inclusion of both health and non‑health perspectives"],"limitations":["Small, non‑representative convenience sample","No quantitative validation of themes","Findings may not generalise beyond Australian context"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12905-023-02744-y"}},{"id":2020,"doi":"10.29158/jaapl.003832-19","pmid":"30988019","pmcid":null,"title":"Evaluating and Reducing Risk in Online Child Pornography Cases","authors":"Berlin FS.","first_author":"Berlin FS.","journal":"The journal of the American Academy of Psychiatry and the Law","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"none (commentary)","population":"offenders convicted of accessing child pornography (no prior contact offenses)","country":"USA (journal location inferred)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that most people convicted only for viewing child porn are unlikely to commit hands‑on sexual crimes, urging comprehensive psychiatric evaluations and risk‑reduction strategies rather than severe penalties alone.","clinical_takeaway":"Treat mental‑health needs of child‑pornography offenders and focus on prevention, not only punishment.","confidence":0.5,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses forensic risk assessment gap","Highlights mental‑health needs of offenders"],"limitations":["No original data or empirical analysis","Reliance on secondary sources","Potential advocacy bias regarding sanctions"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.29158/jaapl.003832-19"}},{"id":2021,"doi":"10.1016/j.addbeh.2014.09.012","pmid":"25244691","pmcid":null,"title":"Assessment of self-efficacy to employ self-initiated pornography use-reduction strategies","authors":"Kraus SW, Rosenberg H, Tompsett CJ.","first_author":"Kraus SW","journal":"Addictive behaviors","year":2015,"pub_types":["Journal Article"],"keywords":["Coping Skills","Self-efficacy","Hypersexuality","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"web‑based survey of 1298 adult male pornography users; questionnaire development with PCA and reliability analyses; no longitudinal or experimental component","sample_n":1298,"sample_text":"Adult male users of pornography recruited via a web‑based data collection procedure","population":"male pornography users (self‑selected online sample), N=1298","country":"unspecified (likely United States/English‑speaking)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and tested a questionnaire that measures how confident men feel they can cut back on porn use using self‑help strategies. The scale showed good reliability and linked to how often participants watched porn and their hypersexuality scores.","clinical_takeaway":"The new self‑efficacy scale can help clinicians gauge readiness for porn‑use reduction, but it should be used alongside broader assessments of mental health and relationship factors.","confidence":0.8,"topic_tags":["pornography","sexual_function","measurement"],"strengths":["Large sample size for questionnaire validation","Comprehensive psychometric evaluation (PCA, reliability, criterion and discriminant validity)","Separate measurement of pornography use frequency and self‑efficacy"],"limitations":["Self‑selected online male sample limits generalisability","New self‑efficacy scale not independently validated beyond this study","No control for key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)","No pre‑registration or reporting of effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2014.09.012"}},{"id":2022,"doi":"10.1186/s12888-023-05210-z","pmid":"37940885","pmcid":"PMC10633967","title":"Validation of the Thai Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) among young adults","authors":"Yang YN, Su JA, Pimsen A, Chen JS, Potenza MN, Pakpour AH, Chen JK, Poon WC, Nurmala I, Ruckwongpatr K, Lin CY.","first_author":"Yang YN","journal":"BMC psychiatry","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Factor analysis","Young Adults","Psychometric Validation","Internet Addiction","Addictive Behaviors","Specific Internet Use Disorder"],"is_oa":true,"oa_url":"https://bmcpsychiatry.biomedcentral.com/counter/pdf/10.1186/s12888-023-05210-z","cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional validation study of a self‑report questionnaire (ACSID‑11) in 612 Thai young adults","sample_n":612,"sample_text":"young adult community sample (recruited in Thailand); sampling method not specified","population":"Thai young adults (N=612)","country":"Thailand","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers translated and tested a Thai version of a questionnaire that measures specific internet‑use disorders (including pornography). In 612 young adults, the tool showed good reliability and fit a four‑factor structure, and its pornography subscale correlated with an established gaming‑disorder scale.","clinical_takeaway":"The Thai ACSID‑11 appears psychometrically sound for screening specific internet‑use problems, but clinicians should consider other factors (e.g., moral beliefs, mental health) when interpreting scores.","confidence":0.85,"topic_tags":["measurement","pornography","sexual_function"],"strengths":["Large sample (N>600) for psychometric validation","Use of CFA and reliability indices (α, ω)","Alignment with ICD‑11 criteria","Correlation with an established IGD scale"],"limitations":["Cross‑sectional; no test‑retest reliability","No reporting of moral or mental‑health covariates","Sampling method unclear – possible convenience bias","No pre‑registration or open data"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":6,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12888-023-05210-z"}},{"id":2023,"doi":"10.1177/1359105314546775","pmid":"25179645","pmcid":null,"title":"Predictors of unwanted exposure to online pornography and online sexual solicitation of youth","authors":"Chang FC, Chiu CH, Miao NF, Chen PH, Lee CM, Chiang JT.","first_author":"Chang FC","journal":"Journal of health psychology","year":2016,"pub_types":["Journal Article"],"keywords":["Sexual solicitation","Victimization","Perpetration","Online Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort of 2315 high‑school students assessed in 10th grade and followed up in 11th grade","sample_n":2315,"sample_text":"2315 students from 26 high schools (10th grade, followed up in 11th grade)","population":"adolescents (Taiwanese high‑school students)","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A study of 2,300 Taiwanese high‑school students tracked from grade 10 to 11 found that more online gaming, pornography exposure, risky internet behavior, depression, and cyber‑bullying predicted later unwanted sexual solicitations online, both as victims and as perpetrators.","clinical_takeaway":"Screening for depression, cyber‑bullying, and risky internet use may help identify youths at risk for unwanted online sexual contact.","confidence":0.85,"topic_tags":["adolescents","sexual_function","pornography"],"strengths":["Large, nationally relevant adolescent sample","Longitudinal design allows temporal ordering","Multivariate analysis controls for several risk factors"],"limitations":["Reliance on self‑report questionnaires; unclear validation of measures","No assessment of moral/religious attitudes or masturbation, limiting interpretation of sexual‑risk pathways","No pre‑registration or reporting of effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":60,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1359105314546775"}},{"id":2024,"doi":"10.1080/00224499.2019.1590795","pmid":"30925073","pmcid":null,"title":"Parental Mediation Regarding Children's Pornography Exposure: The Role of Parenting Style, Protection Motivation and Gender","authors":"Boniel-Nissim M, Efrati Y, Dolev-Cohen M.","first_author":"Boniel-Nissim M","journal":"Journal of sex research","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online questionnaire study of 1,070 Israeli parents of 10‑14‑year‑old children, examining parenting style, protection‑motivation appraisals and mediation strategies regarding child pornography exposure.","sample_n":1070,"sample_text":"1,070 Israeli parents of 10‑ to 14‑year‑old youth completed online questionnaires.","population":"Parents (mostly Israeli, likely volunteer sample)","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed over a thousand Israeli parents of early adolescents and found that authoritarian and permissive parenting styles were linked to poorer communication and less active mediation about pornography, while authoritative parents were more likely to see pornography as risky and intervene more actively.","clinical_takeaway":"Parents who adopt an authoritative style may be more effective in discussing and managing children’s exposure to pornography.","confidence":0.85,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size (>1000)","Use of established theoretical framework (Protection Motivation Theory)","Multiple parenting styles examined"],"limitations":["Cross‑sectional design limits causal inference","Self‑report questionnaires may be subject to social desirability bias","Convenience sample; generalisability uncertain"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2019.1590795"}},{"id":2025,"doi":"10.1080/0092623x.2018.1562501","pmid":"30896374","pmcid":null,"title":"Pornography Use by Sex Offenders at the Time of the Index Offense: Characterization and Predictors","authors":"Saramago MA, Cardoso J, Leal I.","first_author":"Saramago MA","journal":"Journal of sex & marital therapy","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective semi‑structured interview of 146 incarcerated male sex offenders; convenience sample; no longitudinal or experimental component.","sample_n":146,"sample_text":"146 male sex offenders","population":"Male sex offenders in a Portuguese prison (N=146)","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Among 146 male sex offenders, the study examined how much pornography they used around the time of their crimes and whether that use was linked to sexual fantasies and urges.","clinical_takeaway":"Treatment for offenders should consider individual differences in pornography use and its possible influence on fantasies.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for this specific population","Use of validated fantasy questionnaire"],"limitations":["Convenience prison sample limits generalisability","Pornography use measured with ad‑hoc items","No control for key confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2018.1562501"}},{"id":2026,"doi":"10.2196/49962","pmid":"37883153","pmcid":"PMC10636610","title":"Adolescents and Young Adults Evaluating a Website for Affective-Sexual Information and Education: Multicenter Cross-Sectional Study","authors":"Montero-Pons L, Rodríguez-Martín D, Esquinas C, García-Sierra R, Manresa-Domínguez JM, Reyes-Lacalle A, Cabedo-Ferreiro R, Vicente-Hernández M, Gómez Masvidal M, Toran-Monserrat P, Falguera-Puig G.","first_author":"Montero-Pons L","journal":"Journal of medical Internet research","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Multicenter Study","Journal Article","Observational Study"],"keywords":["Internet","Adolescent","Cross-sectional studies","Sex Education","Program Evaluation","Young Adult","Gender Mainstreaming"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10636610","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational, descriptive, multicenter cross‑sectional survey of 1830 adolescents and young adults evaluating a sexual‑health website.","sample_n":1830,"sample_text":"1830 participants from all territorial administrations of Catalonia.","population":"Adolescents and young adults (14‑25 y) from Catalonia, Spain; recruited to assess website use and sexual‑health information needs.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A large survey of 1,830 Spanish teens and young adults evaluated the public website Sexe Joves, finding low awareness and use, but high exposure to porn sites; results will guide improvements in online sexual‑health education.","clinical_takeaway":"None – the study provides no direct clinical guidance on pornography use or sexual health treatment.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size","Multicenter coverage across Catalonia","Focus on a public‑health educational resource"],"limitations":["Ad‑hoc, unvalidated questionnaire","No measurement or control of key sexual‑behavior confounds","Descriptive cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/49962"}},{"id":2027,"doi":"10.1016/s0022-3999(97)00007-x","pmid":"9226602","pmcid":null,"title":"Sleep-related erections: absence of change following presleep sexual arousal","authors":"Ware JC, Hirshkowitz M, Thornby J, Salis P, Karacan I.","first_author":"Ware JC","journal":"Journal of psychosomatic research","year":1997,"pub_types":["Controlled Clinical Trial","Clinical Trial","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Within‑subject controlled clinical trial, 12 healthy young men, each night assigned to sexual, dysphoric, or neutral video; polysomnography recorded sleep‑related erections.","sample_n":12,"sample_text":"twelve subjects","population":"young adult males, healthy, n=12","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In twelve healthy young men, a brief five‑minute explicit video caused erections before sleep but did not change the number of erections that occurred naturally during REM sleep that night.","clinical_takeaway":"Brief pre‑sleep sexual arousal does not appear to affect normal sleep‑related erections in young men.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["objective physiological measurement (polysomnography)","within‑subject control conditions","clear operational definition of sexual arousal stimulus"],"limitations":["very small sample (n=12) limits power","no assessment of potential psychological confounds (e.g., mood, arousal baseline)","short exposure; findings may not generalise to longer or real‑world sexual activity"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-3999(97)00007-x"}},{"id":2028,"doi":"10.1186/s12889-023-16968-y","pmid":"37872488","pmcid":"PMC10594766","title":"Prevalence and associated factors of early initiation of sexual intercourse among youth in Ethiopia: systematic review and meta-analysis","authors":"Kebede N, Bayou FD, Ayele FY, Kefale B, Mekonen AM, Dessie AM, Tsega Y.","first_author":"Kebede N","journal":"BMC public health","year":2023,"pub_types":["Meta-Analysis","research-article","Systematic Review","Journal Article"],"keywords":["Youth","Meta-analysis","Systematic review","Ethiopia","Early Initiation Of Sexual Intercourse"],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-023-16968-y","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Systematic review and meta-analysis of 10 cross‑sectional studies on early sexual initiation in Ethiopian youth, using PRISMA guidelines and standard heterogeneity/publication‑bias tests.","sample_n":10,"sample_text":"10 studies (total participants not reported in abstract)","population":"Youth (≤18 y) in Ethiopia, pooled from studies conducted 2008‑2022","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of ten Ethiopian studies found that about one‑quarter of youth start having sex before age 18. Factors linked to earlier start include being female, low HIV‑prevention knowledge, alcohol or khat use, watching porn, smoking, and weak family control.","clinical_takeaway":"Early sexual debut is common; interventions should target substance use, family environment, and sexual‑health education, especially for girls.","confidence":0.7,"topic_tags":["sexual_function","adolescents","prevalence"],"strengths":["Systematic, PRISMA‑guided methodology","Assessment of heterogeneity and publication bias","Provides pooled prevalence estimate for a public‑health relevant outcome"],"limitations":["Primary studies likely heterogeneous and cross‑sectional","No measurement of key sexual‑health confounds (e.g., moral incongruence, mental health)","Sample size of meta‑analysis small (10 studies)"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":0,"mentioning":2,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-023-16968-y"}},{"id":2029,"doi":"10.1037//0021-843x.110.1.179","pmid":"11261393","pmcid":null,"title":"Homophobia and physical aggression toward homosexual and heterosexual individuals","authors":"Bernat JA, Calhoun KS, Adams HE, Zeichner A.","first_author":"Bernat JA","journal":"Journal of abnormal psychology","year":2001,"pub_types":["Comparative Study","Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Between‑groups laboratory experiment with 52 heterosexual college men assigned to homophobic vs. non‑homophobic groups based on a homophobia scale; aggression measured via shock administration in a competitive reaction‑time task.","sample_n":52,"sample_text":"n = 26 per group","population":"Adult male college students (self‑identified heterosexual)","country":"USA (presumed based on authorship and journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study found that heterosexual men who scored high on a homophobia questionnaire showed more negative emotions and were more physically aggressive toward a gay opponent after watching a gay erotic video, but not toward a straight opponent.","clinical_takeaway":"None - findings pertain to homophobia‑related aggression, not clinical sexual health.","confidence":0.8,"topic_tags":["sexual_function","prevalence"],"strengths":["Laboratory aggression paradigm","Clear operationalization of homophobic vs. non‑homophobic groups"],"limitations":["Small sample size","Non‑random assignment","No effect‑size reporting"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":88,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0021-843x.110.1.179"}},{"id":2030,"doi":"10.3389/fpsyg.2023.1230577","pmid":"37928587","pmcid":"PMC10624222","title":"A new variation of modern prejudice: young Korean men's anti-feminism and male-victim ideology","authors":"Jung HW.","first_author":"Jung HW.","journal":"Frontiers in psychology","year":2023,"pub_types":["review-article","Review","Journal Article"],"keywords":["Violent Video Games","Pornography","Insecure Attachment","Motivated Social Cognition","Symbolic Racism","Online Group Polarization"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyg.2023.1230577/pdf?isPublishedV2=False","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review-article","sample_n":null,"sample_text":"None – narrative review based on literature","population":"young Korean men (online anti‑feminist forums); no empirical sample","country":"South Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A narrative review links Korean young men's anti‑feminist, \"male‑victim\" attitudes to broader prejudice theories, suggesting that online exposure to violent or degrading content may shape extremist ideologies.","clinical_takeaway":"None – not clinically applicable.","confidence":0.5,"topic_tags":["gender","prevalence","csbd","pornography"],"strengths":["Integrates multiple psychological theories","Provides a comprehensive literature synthesis","Identifies novel social phenomenon in Korean context"],"limitations":["No original empirical data","Lacks systematic review methodology","Potential bias from author’s perspective"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2023.1230577"}},{"id":2031,"doi":"10.1080/13691058.2014.927075","pmid":"25023726","pmcid":null,"title":"Associations between relational sexual behaviour, pornography use, and pornography acceptance among US college students","authors":"Willoughby BJ, Carroll JS, Nelson LJ, Padilla-Walker LM.","first_author":"Willoughby BJ","journal":"Culture, health & sexuality","year":2014,"pub_types":["Journal Article"],"keywords":["USA","Sexual behaviour","Attitudes","Emerging Adults","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of US college students (N=792)","sample_n":792,"sample_text":"college students recruited (likely convenience sample)","population":"emerging adult college students in the United States","country":"USA","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 792 U.S. college students, higher porn use was linked to more sexual activity within relationships for men and to greater risk‑taking, while for women it was tied to poorer mental health; attitudes toward porn also differed by gender.","clinical_takeaway":"Clinicians should note that porn use relates differently to relationship sex and mental health for men and women, but causal claims cannot be drawn from this study.","confidence":0.75,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a student survey","Simultaneous examination of use, acceptance, and relational sex","Gender‑specific analyses"],"limitations":["Cross‑sectional, cannot infer causality","Convenience college sample limits generalisability","Key confounds (moral incongruence, masturbation, mental‑health covariates) not controlled"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":1,"mentioning":32,"citing_publications":83,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2014.927075"}},{"id":2032,"doi":"10.1007/s10964-019-00995-3","pmid":"30778831","pmcid":"PMC7135936","title":"Online Sexual Experiences Predict Subsequent Sexual Health and Victimization Outcomes Among Female Adolescents: A Latent Class Analysis","authors":"Maas MK, Bray BC, Noll JG.","first_author":"Maas MK","journal":"Journal of youth and adolescence","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Media","Social Media","Maltreatment","Sexual Violence","Pornography","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two-wave longitudinal survey of 296 female adolescents (14-16) with latent class analysis of online sexual experiences predicting later sexual health and victimization outcomes.","sample_n":296,"sample_text":"N = 296; 49% maltreated; aged 14‑16 years","population":"Female adolescents, ethnically and socioeconomically diverse, 49% maltreated, ages 14‑16 (N=296)","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a two‑year study of 296 teenage girls, patterns of online sexual activity (like watching porn or sharing nude images) were grouped into four types. Girls in the higher‑risk groups later showed higher HIV risk, more violent romantic partners, and greater sexual assault, especially if they had a history of maltreatment.","clinical_takeaway":"Online sexual behaviors may signal later sexual health and safety risks, particularly for maltreated adolescents; clinicians should assess digital sexual activity as part of risk evaluation.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Longitudinal design allows temporal ordering","Use of latent class analysis captures heterogeneity","Inclusion of maltreated subgroup as moderator"],"limitations":["Constructs (online sexual experiences) rely on self‑report items, unclear validation","Key confounds (moral incongruence, masturbation, mental health) not measured","Effect sizes and confidence intervals not reported in abstract"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":65,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10964-019-00995-3"}},{"id":2033,"doi":"10.1071/sh18037","pmid":"30611315","pmcid":null,"title":"Personal and reported partner pornography viewing by Australian women, and association with mental health and body image","authors":"Laemmle-Ruff IL, Raggatt M, Wright CJC, Carrotte ER, Davis A, Jenkinson R, Lim MSC.","first_author":"Laemmle-Ruff IL","journal":"Sexual health","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 99 Australian women recruited via social‑media fitness ads; convenience sample; self‑report of personal and partner porn use, mental‑health (K10) and body‑image (Drive for Muscularity) measures.","sample_n":99,"sample_text":"99 women (76% ever viewed porn; 21% frequent use)","population":"Australian women, young adult, n≈99","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 99 Australian women, frequent personal porn use was not linked to higher psychological distress after adjusting for age, while frequent partner porn use was modestly associated with a higher drive for muscularity. Most women were happy with their partner’s porn use and reported little overall impact.","clinical_takeaway":"Limited evidence that porn viewing substantially harms women’s mental health or body image; clinicians should consider individual context rather than assume universal negative effects.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Uses validated mental‑health and body‑image scales","Reports effect sizes with confidence intervals","Includes qualitative comments to contextualise findings"],"limitations":["Small convenience sample; limited statistical power","No measurement of moral incongruence, masturbation, or broader mental‑health covariates","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh18037"}},{"id":2034,"doi":"10.1071/sh18050","pmid":"30336801","pmcid":null,"title":"Relational monogamy, condomless sex, and perceptions of pornography as sexual information in an English sample","authors":"Wright PJ, Miezan E, Sun C, Steffen NJ.","first_author":"Wright PJ","journal":"Sexual health","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of adult pornography consumers in England; convenience sample","sample_n":null,"sample_text":"anonymous online survey; exact N not provided in abstract","population":"heterosexual adult pornography consumers in England (self‑selected online sample)","country":"England","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"An English online survey found that seeing porn as a sexual guide was linked to condomless sex only among people not in monogamous relationships, suggesting relationship status matters when studying porn’s influence on safer‑sex behaviour.","clinical_takeaway":"Clinicians should consider a client’s relationship context when discussing how porn influences condom use.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses relational monogamy as moderating factor","Focuses on perception of pornography as sexual information","Large‑scale online survey format"],"limitations":["Convenience, self‑selected sample limits generalizability","Reliance on single‑item, unvalidated measures","No control for key confounds (moral incongruence, mental health, trauma)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh18050"}},{"id":2035,"doi":"10.23736/s2724-6507.23.03998-2","pmid":"37768685","pmcid":null,"title":"Lifestyle and sexual habits of students in a Southern Italian region","authors":"Cimino L, Crafa A, Cannarella R, Barbagallo F, Mongioì LM, Aversa A, LA Vignera S, Condorelli RA, Calogero AE.","first_author":"Cimino L","journal":"Minerva endocrinology","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"718 high‑school students (15‑26 y) in Sicily completed a self‑administered questionnaire on lifestyle, sexual behaviour and porn site use.","sample_n":718,"sample_text":"Students from four districts in Sicily, recruited via school invitation; no random sampling reported.","population":"adolescents/young adults, convenience school sample, Italy","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 718 Italian high‑school students found high rates of smoking, drinking and drug use, with many reporting frequent visits to porn sites, especially males. Half used condoms. The authors call for early prevention programmes.","clinical_takeaway":"High prevalence of risky behaviours, including frequent porn use, suggests need for targeted sexual‑health education in adolescents.","confidence":0.7,"topic_tags":["pornography","sexual_function","lgbtq","adolescents"],"strengths":["Large sample for a survey (N>700)","Includes gender comparisons","Relevant public‑health focus"],"limitations":["Uses non‑validated, self‑report questionnaire","Cross‑sectional; no causal inference","No measurement of key confounds (e.g., masturbation, mental health, moral attitudes)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.23736/s2724-6507.23.03998-2"}},{"id":2037,"doi":"10.1007/s10508-023-02689-1","pmid":"37749338","pmcid":null,"title":"Neuropsychological Functioning in Sexual Offenders With and Without Pedophilic Disorder","authors":"Picard EH, Bopp LL, Rosenfeld B.","first_author":"Picard EH","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual Abuse","Sexual Offending","Dsm-5","Pedophilia","Child Pornography","Non-contact Offending"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional neuropsychological assessment of 58 convicted sexual offenders, comparing those with pedophilic disorder (n=20) to those without (n=38).","sample_n":58,"sample_text":"58 men convicted of a sexual offense; 20 with pedophilic disorder.","population":"Adult male sexual offenders (contact, non‑contact, CSAM), recruited from correctional/clinical settings.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested memory, attention, and other cognitive abilities in 58 men convicted of sexual offenses, finding only modest differences between those with pedophilic disorder and those without.","clinical_takeaway":"Cognitive performance does not markedly differ by pedophilic status; treatment should not assume major neuropsychological deficits.","confidence":0.8,"topic_tags":["sexual_function","csbd","neuroscience"],"strengths":["Use of validated neuropsychological tests","Clear comparison between PD and non‑PD offenders","Effect sizes reported"],"limitations":["Small sample; low power for group comparisons","Convenience sample of convicted offenders limits generalisability","No control for potential confounds (e.g., trauma, mental health)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02689-1"}},{"id":2038,"doi":"10.1080/00224499.2018.1556772","pmid":"30633584","pmcid":null,"title":"Is the Link Between Pornography Use and Relational Happiness Really More About Masturbation? Results From Two National Surveys","authors":"Perry SL.","first_author":"Perry SL.","journal":"Journal of sex research","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative surveys (N≈2,000 and N≈10,000), cross‑sectional questionnaire data","sample_n":12083,"sample_text":"NFSS N=1,977; RIA N=10,106; both nationally representative","population":"Adults in US, both genders","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Two big U.S. surveys showed that masturbation, not porn, is linked to lower relationship happiness. When masturbation is accounted for, porn use shows little or even a slight positive link to relational happiness.","clinical_takeaway":"Clinicians should consider masturbation habits when discussing relationship wellbeing, rather than attributing issues solely to pornography use.","confidence":0.85,"topic_tags":["pornography","masturbation","relationships","sexual_function"],"strengths":["Large, nationally representative samples","Separate measurement of masturbation and pornography use","Controls for sexual activity and depressive symptoms"],"limitations":["Cross‑sectional design cannot infer causality","No explicit measurement of moral or religious disapproval","Potential reliance on single‑item frequency measures"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":6,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":34,"citing_publications":77,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1556772"}},{"id":2039,"doi":"10.1080/0092623x.2018.1531334","pmid":"30623738","pmcid":null,"title":"Pornographic Content and Real-Life Sexual Experiences: Findings From a Survey of German University Students","authors":"Martyniuk U, Okolski L, Dekker A.","first_author":"Martyniuk U","journal":"Journal of sex & marital therapy","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 1,197 German university students assessing self‑reported liked pornographic content and reported real‑life enactment of those activities.","sample_n":1197,"sample_text":"nationally distributed university student survey (convenience sample)","population":"German university students (convenience sample)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of German university students found that people who liked certain pornographic scenes were more likely to have tried those activities in real life, especially for less common practices, though many did not act on their fantasies.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a survey","Focus on content‑specific associations","Adds empirical data on fantasy‑behavior link"],"limitations":["Self‑report measures, likely unvalidated","Convenience sample of students limits generalisability","No control for key confounds (e.g., moral incongruence, mental health)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2018.1531334"}},{"id":2040,"doi":"10.1016/j.psc.2014.03.004","pmid":"24877707","pmcid":null,"title":"Treatment and management of child pornography use","authors":"Seto MC, Ahmed AG.","first_author":"Seto MC","journal":"The Psychiatric clinics of North America","year":2014,"pub_types":["Review","Journal Article"],"keywords":["Management","Treatment","Child Pornography","Pornography","Paraphilias","Sexual Self-regulation"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review/narrative without systematic methods","sample_n":null,"sample_text":"Not applicable – narrative review","population":"child pornography offenders (clinical context)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how clinicians can assess, diagnose, and treat individuals who use child pornography, outlining offender motivations, types, and current management strategies.","clinical_takeaway":"Clinicians should use a tailored assessment of motivations and legal/psychological interventions when treating child pornography offenders.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Comprehensive overview of assessment and management options","Distinguishes offender motivations and types"],"limitations":["Narrative review lacking systematic methodology","No empirical data or quantitative analysis","Potential bias from author clinical perspective"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":10,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psc.2014.03.004"}},{"id":2041,"doi":"10.1590/0102-311xen073523","pmid":"37729302","pmcid":"PMC10513151","title":"Detection of intimate partner aggression through dark personality and moral disengagement","authors":"Ferreiros L, Clemente M.","first_author":"Ferreiros L","journal":"Cadernos de saude publica","year":2023,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://www.scielo.br/j/csp/a/wdsh5S76bBDcRBGxSTvHr5B/?lang=en&format=pdf","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 348 participants (mostly women) using online questionnaire; multivariate decision‑tree (CHAID) analysis.","sample_n":348,"sample_text":"Convenience online sample, mostly women; no probability sampling.","population":"Adults from Brazil recruited via Google Forms (convenience sample).","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 348 Brazilian adults, men showed higher scores on dark personality traits and moral disengagement, especially when they reported infidelity, pornography use, or same‑sex relationships. These traits were linked to higher intimate‑partner aggression, suggesting nurses could look for such personality markers to protect victims.","clinical_takeaway":"Screening for dark personality and moral disengagement may help identify partners at risk of aggression, but pornography use alone is not sufficient evidence.","confidence":0.8,"topic_tags":["pornography","moral_incongruence","sexual_function","relationships"],"strengths":["Use of validated dark personality and moral disengagement scales","Reasonable sample size for exploratory analysis","Multivariate decision‑tree method allows identification of interaction patterns"],"limitations":["Convenience online sample; limited generalisability","Sexual‑behavior variables (pornography, infidelity) measured by unvalidated items","No control for key confounds (moral incongruence, mental health, trauma)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/0102-311xen073523"}},{"id":2043,"doi":"10.4103/0253-7176.130976","pmid":"24860215","pmcid":"PMC4031582","title":"Sexual Crime in India: Is it Influenced by Pornography?","authors":"Math SB, Viswanath B, Maroky AS, Kumar NC, Cherian AV, Nirmala MC.","first_author":"Math SB","journal":"Indian journal of psychological medicine","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Sexual Violence","Pornography","Crime Against Women"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4031582","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"ecological time‑series analysis of national crime statistics and internet‑user counts (1971‑2008)","sample_n":null,"sample_text":"Data aggregated by year/period; no individual‑level sample size reported","population":"aggregate national data (no individual participants)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined whether the rise in internet use—used as a stand‑in for porn access—was linked to higher rates of sexual crimes in India from 1971 to 2008. After accounting for population growth, they found no significant relationship.","clinical_takeaway":"No evidence that easier internet access to pornography directly raises sexual‑crime rates; clinicians should avoid assuming causality from such aggregate data.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Long time span (four decades) provides trend data","Attempts to adjust for population growth","Clear statistical methods (correlation, regression) reported"],"limitations":["Ecological design cannot infer individual‑level effects","Internet users used as a crude proxy for pornography exposure","No measurement of key confounders (e.g., moral attitudes, mental health)","Small number of time points limits statistical power"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0253-7176.130976"}},{"id":2044,"doi":"10.1177/10778012231199111","pmid":"37697815","pmcid":"PMC10629255","title":"The Prevalence of Domestic Violence in the Lives of Female Heterosexual Partners of Sex Addicts","authors":"Taylor L, De Haan I.","first_author":"Taylor L","journal":"Violence against women","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Domestic Violence","Intimate Partner Violence","Sex Addiction","Problematic Pornography Use","Partner Of Sex Addict"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10629255","cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 558 female partners of self‑identified sex addicts from several high‑income nations","sample_n":558,"sample_text":"558 survey participants","population":"558","country":"various high‑income nations","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 558 women who said their partners were \"sex addicts\" found that over 90% experienced some form of domestic violence, and more than half faced physical or sexual violence. The study suggests a link between partners' sex‑addiction behaviours and increased risk of violence.","clinical_takeaway":"Clinicians working with IPV survivors should consider partner’s compulsive sexual behaviours as a possible risk factor, but note the lack of validated addiction measures.","confidence":0.7,"topic_tags":["sexual_function","relationships","csbd"],"strengths":["Large sample size for a niche population","Clear prevalence figures for multiple DV categories"],"limitations":["Sex‑addiction status based on partner’s self‑label, no validated instrument","No measurement or control of key confounds (moral incongruence, mental health, trauma)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10778012231199111"}},{"id":2045,"doi":"10.1556/2006.2023.00042","pmid":"37682725","pmcid":"PMC10562818","title":"Behavioral addictions in the ICD-11: An important debate that is anticipated to continue for some time","authors":"Brand M, Potenza MN.","first_author":"Brand M","journal":"Journal of behavioral addictions","year":2023,"pub_types":["article-commentary","Journal Article"],"keywords":["Classification","Dsm-5","Icd-11","Addictive Behaviors","Compulsive Sexual Behavior Disorder","Other Specified Disorders Due To Addictive Behaviors","Problematic Pornography Use","Gaming Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10562818","cited_by_count":16,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary without empirical data; no sample, no methods","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article summarises a 2022 debate on whether compulsive sexual behaviour and other actions should be classified as behavioral addictions in the ICD‑11, noting that the discussion was balanced and that more research is needed.","clinical_takeaway":"None – the piece does not provide new evidence for clinical practice.","confidence":0.6,"topic_tags":["sexual_function","csbd"],"strengths":["Provides a balanced overview of the ICD‑11 behavioral addiction debate","Highlights need for further research"],"limitations":["No original data or systematic synthesis","No empirical assessment of constructs or confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2023.00042"}},{"id":2046,"doi":"10.1007/bf01541942","pmid":"2064541","pmcid":null,"title":"Psychophysiological and endocrine responses to sexual arousal in women","authors":"Heiman JR, Rowland DL, Hatch JP, Gladue BA.","first_author":"Heiman JR","journal":"Archives of sexual behavior","year":1991,"pub_types":["Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized controlled trial; women assigned to erotic vs non‑erotic video, then both viewed erotic video; physiological and hormonal measures recorded.","sample_n":null,"sample_text":"Not reported in abstract","population":"Healthy pre‑menopausal heterosexual women (follicular phase)","country":"USA (likely)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, women who first watched an erotic video showed stronger vaginal and subjective arousal when later watched another erotic video, suggesting an early sexual stimulus can heighten later physiological responses, independent of measured hormone changes.","clinical_takeaway":"Prior sexual exposure may enhance later arousal; clinicians should note that physiological arousal can be primed without obvious hormonal mediation.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Objective physiological and hormonal measurements","Randomized experimental design","Repeated measures allow within‑subject comparison"],"limitations":["Small sample size (not reported, likely under‑powered)","No pre‑registration or effect‑size reporting","Findings limited to laboratory erotic video exposure"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":28,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541942"}},{"id":2047,"doi":"10.1016/j.addbeh.2014.02.010","pmid":"24613495","pmcid":null,"title":"The relationship of \"passionate attachment\" for pornography with sexual compulsivity, frequency of use, and craving for pornography","authors":"Rosenberg H, Kraus S.","first_author":"Rosenberg H","journal":"Addictive behaviors","year":2014,"pub_types":["Journal Article"],"keywords":["Assessment","Craving","Sexual Compulsivity","Passion","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 221 undergraduate males","sample_n":221,"sample_text":"221 undergraduate males who used pornography regularly","population":"undergraduate males, regular pornography users","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 221 college men who view porn often, stronger \"passionate attachment\" to porn was linked to higher sexual compulsiveness, more craving, and greater compulsive internet use, but not to sensation seeking or social desirability. The authors suggest the attachment questionnaire could help assess porn‑related preoccupation in therapy.","clinical_takeaway":"Higher passionate attachment to porn may signal greater sexual compulsivity and craving; clinicians might assess this attachment alongside compulsivity measures.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Relatively large sample for a survey","Uses validated Sexual Compulsivity Scale"],"limitations":["Convenience student sample limits generalizability","Key constructs (passionate attachment) not fully validated","No control for major confounds (moral incongruence, masturbation, mental health)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":28,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2014.02.010"}},{"id":2048,"doi":"10.1080/00224499.2018.1541440","pmid":"30485135","pmcid":null,"title":"Behind Closed Doors: Individual and Joint Pornography Use Among Romantic Couples","authors":"Willoughby BJ, Leonhardt ND.","first_author":"Willoughby BJ","journal":"Journal of sex research","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"dyadic survey of 240 heterosexual couples, US, self‑report questionnaires; cross‑sectional","sample_n":480,"sample_text":"Convenience sample of US couples, likely recruited online or via community channels; not nationally representative","population":"committed heterosexual couples (N=240 couples, 480 individuals)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 240 US couples, women's porn use was linked to higher sexual desire, while men's porn use related to lower relationship satisfaction and communication. When both partners used porn, sexual satisfaction was higher, but overall relational wellbeing varied with who used porn and whether the partner knew.","clinical_takeaway":"Couples’ porn use patterns relate differently to sexual desire and relationship satisfaction; clinicians should consider each partner’s use and openness when addressing relational concerns.","confidence":0.78,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Large dyadic sample (240 couples)","Examines both actor and partner effects","Addresses gap in dyadic pornography research"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of key confounds (moral incongruence, mental health, masturbation)","Unclear whether scales are validated"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":0,"mentioning":48,"citing_publications":86,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1541440"}},{"id":2049,"doi":"10.1590/1413-81232024292.03592023","pmid":"38324824","pmcid":null,"title":"A Lotus or a Dragon? - The orientalization and fetishization of Asian women's bodies","authors":"Pires I, Pires I.","first_author":"Pires I","journal":"Ciencia & saude coletiva","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.scielo.br/j/csc/a/fMHHbRCYNQZsnhCDbWHgy5Q/?lang=pt&format=pdf","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"por","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"interviews with 18‑34‑year‑old Chinese women living in Lisbon (convenience sample), thematic analysis","sample_n":null,"sample_text":"Chinese women, ages 18‑34, recruited for an anthropology PhD fieldwork; convenience sample","population":"Chinese women residents of Lisbon, n not reported","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with Chinese women living in Lisbon reveal how Hollywood films and interracial pornography portray Asian women as exotic 'Lotus' or 'Dragon' figures, shaping their identities through racial fetishization.","clinical_takeaway":"None – the study offers sociocultural insight rather than clinical guidance.","confidence":0.6,"topic_tags":["sexual_function","csbd","pornography"],"strengths":["Uses in‑depth qualitative interviews","Addresses an under‑studied cultural topic","Links media representation to lived experience"],"limitations":["Small, non‑representative convenience sample","No validated measurement of fetishization or related constructs","Findings not generalisable beyond the specific community"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/1413-81232024292.03592023"}},{"id":2050,"doi":"10.1177/1079063214521469","pmid":"24556314","pmcid":null,"title":"Child Pornography Possessors and Child Contact Sex Offenders: A Multilevel Comparison of Demographic Characteristics and Rates of Recidivism","authors":"Faust E, Bickart W, Renaud C, Camp S.","first_author":"Faust E","journal":"Sexual abuse : a journal of research and treatment","year":2015,"pub_types":["Comparative Study","Journal Article"],"keywords":["Survival analysis","Recidivism","Child Pornography","Child Molestation"],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Retrospective cohort of adult offenders; groups defined by offense type; survival analysis of recidivism.","sample_n":null,"sample_text":"Not reported in abstract; likely several hundred offenders drawn from criminal justice records.","population":"Adult male and female offenders convicted of child pornography possession/distribution or child contact sexual offenses.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared people who only possess child sexual images with those who have contact offenses, finding that image‑only offenders are less likely to re‑offend and have different background characteristics.","clinical_takeaway":"Policy and treatment should consider that child‑image offenders differ from contact offenders in recidivism risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large criminal‑justice dataset","Longitudinal follow‑up with survival analysis","Clear operational definition of offender groups"],"limitations":["No psychosocial measures (e.g., mental health, moral attitudes)","Potential lack of representativeness of all offenders","No effect sizes or confidence intervals reported in abstract"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":3,"mentioning":54,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063214521469"}},{"id":2051,"doi":"10.3389/fpsyg.2023.1159014","pmid":"37705946","pmcid":"PMC10495590","title":"Perceived offensiveness to the self, not that to others, is a robust positive predictor of support of censoring sexual, alcoholic, and violent media content","authors":"Zhang J.","first_author":"Zhang J.","journal":"Frontiers in psychology","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Harm","Moral Foundations","Offensiveness","Media Censorship","The Third-Person Effect"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10495590","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two cross‑sectional online surveys (undergraduates N=544; adult community N=727) measuring perceived offensiveness, harm and support for censorship.","sample_n":1271,"sample_text":"N=544 undergraduates; N=727 non‑student adults, recruited via unspecified means (likely convenience).","population":"U.S. participants, convenience samples (students and online adults)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In two U.S. surveys, people who felt personally offended by sexual, alcohol‑related, or violent media were more likely to favor censoring such content, whereas believing others are offended mattered less.","clinical_takeaway":"None – the study examines attitudes toward censorship, not clinical aspects of sexual health or behavior.","confidence":0.8,"topic_tags":["csbd","sexual_function","pornography"],"strengths":["Large overall sample size","Comparison of self vs. other perception","Inclusion of three content domains (sexual, alcoholic, violent)"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on single‑item, likely unvalidated measures","No control for moral incongruence or other relevant confounds"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2023.1159014"}},{"id":2052,"doi":"10.1891/0886-6708.5.3.143","pmid":"2275894","pmcid":null,"title":"Women's evaluations of and affective reactions to mainstream violent pornography, nonviolent pornography, and erotica","authors":"Senn CY, Radtke HL.","first_author":"Senn CY","journal":"Violence and victims","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory experiment with random assignment of 96 female undergraduates to view erotica, non‑violent porn, violent porn, or control slides; mood and slide evaluations measured pre‑ and post‑exposure.","sample_n":96,"sample_text":"96 female undergraduates","population":"female undergraduate students (N=96)","country":"USA (assumed based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, women viewed erotica, non‑violent, or violent pornography. Erotica was liked, porn was disliked, and violent porn was the most disliked. Mood worsened after watching both types of porn. Women with a history of coercive sexual experiences liked erotica more and porn less than those without such history.","clinical_takeaway":"Viewing violent or non‑violent pornography may increase negative mood in women, especially those with prior sexual trauma.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Randomized experimental design","Multiple types of visual stimuli compared","Inclusion of prior trauma as a covariate"],"limitations":["Convenience sample of undergraduate women, limiting generalisability","No validated scales for affective reaction to porn; relies on ad‑hoc slide ratings","No effect‑size reporting or power analysis"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":35,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1891/0886-6708.5.3.143"}},{"id":2053,"doi":"10.1080/0092623x.2018.1488324","pmid":"30015567","pmcid":null,"title":"Where the Mind Cannot Dare: A Case of Addictive Use of Online Pornography and Its Relationship With Childhood Trauma","authors":"Wéry A, Schimmenti A, Karila L, Billieux J.","first_author":"Wéry A","journal":"Journal of sex & marital therapy","year":2019,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single treatment‑seeking male","sample_n":1,"sample_text":"single case","population":"adult male, treatment seeking","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["circular_addiction_scale","self_selected_sample","no_mi_control","underpowered_sample"],"stance":"supports","citation_value":"background","plain_summary":"A treatment‑seeking man with a history of childhood trauma reported excessive use of online pornography that the authors describe as an addiction. The paper offers a therapeutic perspective but is based on a single case without systematic measurement.","clinical_takeaway":"A single case cannot define pornography addiction; clinicians should assess trauma and distress separately from use frequency.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["detailed clinical description","links trauma to problematic use"],"limitations":["single case, no generalizability","no validated measures of addiction or distress","no control of key confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":60,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":1,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2018.1488324"}},{"id":2056,"doi":"10.1037/lhb0000540","pmid":"37616071","pmcid":null,"title":"ACUTE-2007 and STABLE-2007 predict recidivism for men adjudicated for child sexual exploitation material offending","authors":"Babchishin KM, Dibayula S, McCulloch C, Hanson RK, Helmus LM.","first_author":"Babchishin KM","journal":"Law and human behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Retrospective cohort comparing risk‑assessment scores (ACUTE‑2007, STABLE‑2007) to subsequent official recidivism records in three groups of men (contact offenders, exclusive CSEM offenders, mixed offenders).","sample_n":1350,"sample_text":"1,042 men with contact sexual offenses, 228 men with exclusive CSEM offending, 80 men with both contact and CSEM offenses.","population":"Men convicted of sexual offences in Canada (n≈1,350 total; 1,042 contact only, 228 CSEM‑only, 80 mixed).","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that two established risk‑assessment tools (ACUTE‑2007, STABLE‑2007) predict future re‑offending among men who only distribute child sexual exploitation material as well as those who commit contact sexual offences.","clinical_takeaway":"These tools can help prioritize supervision and treatment for CSEM offenders, but clinicians should note the lack of mental‑health confound control.","confidence":0.85,"topic_tags":["csbd","pornography"],"strengths":["Large, multi‑group sample","Use of validated risk‑assessment tools","Objective recidivism outcomes from official records"],"limitations":["No control for psychological or contextual confounders","Retrospective design limits causal inference","No preregistration or discussion of statistical power"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":41,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/lhb0000540"}},{"id":2059,"doi":"10.1016/j.jflm.2014.01.002","pmid":"24661700","pmcid":null,"title":"Women convicted of a sexual offence, including child pornography production: two case reports","authors":"Prat S, Bertsch I, Chudzik L, Réveillère Ch.","first_author":"Prat S","journal":"Journal of forensic and legal medicine","year":2014,"pub_types":["Journal Article","Case Reports"],"keywords":["Forensic medicine","Child Abuse","Forensic Psychiatry","Child Pornography","Female Sexual Offender"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":2,"sample_text":"two cases","population":"two adult women convicted of sexual offences including child‑pornography production, described in forensic/psychiatric context","country":"Not specified (likely France based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe two women convicted of sexual offences involving child pornography. They note that female offenders differ from men and may act to satisfy a partner’s urges, but the report is limited to descriptive case details.","clinical_takeaway":"None – the report provides anecdotal forensic insight but no clinically actionable findings.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Rare documentation of female offenders","Forensic and legal perspective"],"limitations":["Only two cases – no generalisability","No systematic measurement or validated instruments","No control of key confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jflm.2014.01.002"}},{"id":2060,"doi":"10.1038/s41443-023-00752-y","pmid":"37592174","pmcid":null,"title":"Similarities and differences between men with self-reported lifelong and acquired difficulty reaching ejaculation","authors":"Rowland DL, McNabney SM, Attinger DR, Harrold KJ, Kӧvi Z, Hevesi K.","first_author":"Rowland DL","journal":"International journal of impotence research","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience online survey of 140 men with delayed ejaculation, subgroup analysis of lifelong vs acquired subtypes.","sample_n":140,"sample_text":"Convenience sample drawn from >3000 respondents via an opt‑in multinational online survey.","population":"Men reporting moderate‑severe difficulty reaching ejaculation during partnered sex (≥75% of events).","country":"International (multinational online sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men who have always had trouble ejaculating with those who developed it later, finding that lifelong cases were younger, reported more severe symptoms, and were more likely to masturbate to relieve anxiety, while many other differences were explained by age and erectile function.","clinical_takeaway":"Clinicians should note that lifelong delayed ejaculation may be linked to higher anxiety‑driven masturbation and lower medical attribution.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large initial pool (3000+) allowing selection of 140 participants","Use of ANCOVA with effect sizes reported","Exploration of age and erectile function as confounders"],"limitations":["Convenience, self‑selected online sample limits generalisability","Reliance on ad‑hoc self‑report measures without validation","No control for moral incongruence, mental health, or trauma"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-023-00752-y"}},{"id":2061,"doi":"10.1080/00224499.2018.1532488","pmid":"30358432","pmcid":null,"title":"Pornography Consumption, Modality and Function in a Large Internet Sample","authors":"Solano I, Eaton NR, O'Leary KD.","first_author":"Solano I","journal":"Journal of sex research","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":52,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey of US adults recruited via Amazon Mechanical Turk (n = 1,392).","sample_n":1392,"sample_text":"MTurk convenience sample, wide age range but self‑selected.","population":"Adults 18‑73, community sample (convenience, not probability).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a US‑wide online survey of 1,392 adults, most men (91 %) and many women (60 %) reported seeing porn in the past month. Videos were most common, but women used written porn more often. People mainly viewed porn to boost masturbation, though many other reasons were reported. The study highlights how varied questions about porn can affect prevalence estimates.","clinical_takeaway":"Clinicians should note that reported porn use rates vary widely depending on how questions are asked; assess both frequency and purpose when discussing porn with clients.","confidence":0.7,"topic_tags":["pornography","measurement","sexual_function","masturbation"],"strengths":["Large sample for an online survey","Broad age range","Systematic comparison of multiple consumption measures"],"limitations":["Convenience MTurk sample limits generalisability","Ad‑hoc, non‑validated measurement of consumption and function","No control for moral, mental‑health or partner variables"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":7,"contrasting":0,"mentioning":71,"citing_publications":115,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1532488"}},{"id":2062,"doi":"10.1080/00918369.2014.928581","pmid":"25068695","pmcid":null,"title":"What we can't see? Understanding the representations and meanings of UAI, barebacking, and semen exchange in gay male pornography","authors":"Mowlabocus S, Harbottle J, Witzel C, Witzel C.","first_author":"Mowlabocus S","journal":"Journal of homosexuality","year":2014,"pub_types":["Journal Article"],"keywords":["HIV","Representation","Sexual Risk","Barebacking","Pornography","Semen Exchange"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Focus groups and textual analysis of gay male pornography representations; no quantitative sample size reported.","sample_n":null,"sample_text":"Not reported in abstract; likely small convenience focus‑group sample.","population":"Adults (young, middle‑aged) who view gay male pornography; participants recruited for focus groups (likely convenience sample).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined how gay male porn shows unprotected anal sex, finding that meanings vary with performers' ages, bodies, and race, and with scene context. These nuances should inform health messages about sexual risk.","clinical_takeaway":"Health campaigns should consider the diverse ways bareback porn is portrayed rather than treating it as a uniform influence.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["In‑depth qualitative insight into cultural meanings of bareback pornography","Uses both textual analysis and participant perspectives","Highlights intersection of performer characteristics with sexual representations"],"limitations":["Small, non‑representative focus‑group sample","No quantitative measurement of constructs","Findings may not generalise beyond specific sub‑cultures"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2014.928581"}},{"id":2063,"doi":"10.1080/00918369.2018.1525947","pmid":"30307839","pmcid":null,"title":"Gay Porn's Bareback Momentum","authors":"Brennan J.","first_author":"Brennan J.","journal":"Journal of homosexuality","year":2020,"pub_types":["Journal Article"],"keywords":["Homosexuality","Condoms","Gay Pornography","Bareback","Bareback Pornography","Condom Pornography","Porn Studies"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"textual analysis of the 10 most visited gay porn sites over a decade, examining visual shift from condom to bareback depictions; qualitative, convenience sample of sites.","sample_n":null,"sample_text":"Ten websites selected by popularity and longevity; no human participants.","population":"gay porn websites (10 most visited, operating ≥10 years)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tracks how ten popular gay porn websites have shifted from showing condom use to condomless (bareback) sex over the past decade, noting patterns and storytelling changes across sites.","clinical_takeaway":"None – the paper describes porn content trends without direct implications for clinical practice.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Comprehensive coverage of major gay porn sites over a decade","Clear documentation of visual trends (condom to bareback)","Integration of narrative analysis linking site changes"],"limitations":["No systematic sampling; limited to 10 sites","No quantitative analysis or statistical testing","Lacks measurement of viewer outcomes or health impacts"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2018.1525947"}},{"id":2064,"doi":"10.1016/j.ijlp.2013.11.003","pmid":"24304705","pmcid":null,"title":"Theorising sexual media and sexual violence in a forensic setting: men's talk about pornography and offending","authors":"Mercer D, Perkins L.","first_author":"Mercer D","journal":"International journal of law and psychiatry","year":2014,"pub_types":["Journal Article"],"keywords":["Personality Disorder","Discourse Analysis","Sexual Offending","Social Construction","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Discourse analytic study using semi‑structured interviews with 18 nurses and 9 detained sexual offenders in a high‑security forensic hospital.","sample_n":27,"sample_text":"Convenience purposive sample from one forensic hospital; not representative of broader offender or nursing populations.","population":"Detained male sexual offenders and nursing staff in a forensic psychiatric setting (N=27).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with nurses and incarcerated sexual offenders reveal that talk about pornography in a forensic hospital reinforces gender inequality and may hinder rehabilitation, creating a toxic, male‑dominated culture.","clinical_takeaway":"Clinicians should be aware that staff‑offender discourse about porn can affect therapeutic relationships and rehabilitation outcomes.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["In‑depth qualitative insight into institutional discourse","Concurrent data collection and analysis","Focus on understudied forensic nursing context"],"limitations":["Small, non‑representative sample","No quantitative measurement of pornography use or related behaviours","Findings not generalisable beyond the single site"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijlp.2013.11.003"}},{"id":2066,"doi":"10.1111/add.16287","pmid":"37493019","pmcid":null,"title":"Measuring craving: A systematic review and mapping of assessment instruments. What about sexual craving?","authors":"Miele C, Cabé J, Cabé N, Bertsch I, Brousse G, Pereira B, Moulin V, Barrault S.","first_author":"Miele C","journal":"Addiction (Abingdon, England)","year":2023,"pub_types":["Systematic Review","Journal Article"],"keywords":["Craving","Sexual Addiction","Substance Use Disorder","Addictive Disorders","Assessment Instrument","Sexual Craving"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of validation studies of craving instruments (PRISMA). No meta‑analysis, risk‑of‑bias assessment not described.","sample_n":147,"sample_text":"147 validation articles covering 36 original instruments and 93 variations.","population":"Human participants across 147 validation studies of craving questionnaires; no new sample collected.","country":"Not specified (international literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review catalogues 36 validated craving questionnaires, maps how they differ, and notes that only one (the Pornography Craving Questionnaire) measures craving related to compulsive sexual behaviour. It calls for new tools to assess 'sexual craving'.","clinical_takeaway":"Clinicians lack a validated sexual‑craving scale; existing tools are limited to pornography craving.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive PRISMA‑based systematic search.","Provides psychometric overview of 36 craving instruments.","Identifies gap for sexual craving measurement."],"limitations":["No quantitative synthesis or meta‑analysis of psychometric metrics.","Risk‑of‑bias assessment of included validation studies not reported.","Limited discussion of moral or contextual confounds for sexual craving."],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":32,"retracted":false,"notices":[{"status":"Has correction","date":"2024-7-6","noticeDoi":"10.1111/add.16619","doi":"10.1111/add.16287"}],"url":"https://scite.ai/reports/10.1111/add.16287"}},{"id":2067,"doi":"10.1109/tcyb.2018.2864870","pmid":"30222590","pmcid":null,"title":"Pornographic Image Recognition via Weighted Multiple Instance Learning","authors":"Jin X, Wang Y, Tan X.","first_author":"Jin X","journal":"IEEE transactions on cybernetics","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"large‑scale computer‑vision evaluation on 200 k images (100 k pornographic, 100 k normal)","sample_n":200000,"sample_text":"100 K pornographic images and 100 K normal images","population":"images, not human participants","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors present a machine‑learning system that looks at many small parts of an image and learns to spot pornographic content. Tested on 100 k porn images and 100 k non‑porn images, it correctly identified porn with 97.5 % accuracy while keeping false alarms low.","clinical_takeaway":"None – the study focuses on automated image detection, not on human sexual health or behavior.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large, balanced image dataset","Innovative weighted MIL approach","High reported true‑positive rate (97.5 % at 1 % false‑positive)","Clear methodological description"],"limitations":["No external validation on independent datasets","No confidence intervals or statistical significance testing","Construct of “pornographic region” not psychometrically validated","Limited discussion of potential bias in image collection"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1109/tcyb.2018.2864870"}},{"id":2068,"doi":"10.1016/j.abrep.2023.100510","pmid":"37519859","pmcid":"PMC10374865","title":"Should problematic sexual behavior be viewed under the scope of addiction? A systematic review based on DSM-5 substance use disorder criteria","authors":"Pistre N, Schreck B, Grall-Bronnec M, Fatseas M.","first_author":"Pistre N","journal":"Addictive behaviors reports","year":2023,"pub_types":["review-article","Review","Journal Article"],"keywords":["Craving","Systematic review","Loss Of Control","Cybersex","Dsm-5 Criteria","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10374865","cited_by_count":9,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Narrative systematic review of 20 articles assessing DSM‑5 addiction criteria in problematic sexual behavior.","sample_n":null,"sample_text":"Twenty primary studies included; no aggregate sample size provided.","population":"Individuals (clinical and non‑clinical) identified in primary studies as having problematic sexual behavior.","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"supports","citation_value":"useful","plain_summary":"The review looked at 20 studies to see whether people with problematic sexual behavior show the same addiction signs as drug users, such as craving and loss of control. Many of these signs were reported, but the authors say more uniform research is needed.","clinical_takeaway":"Evidence that problematic sexual behavior can display addiction‑like features is suggestive but not definitive; clinicians should assess each case individually and not assume an addiction diagnosis.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Comprehensive PRISMA‑guided search","Clear focus on DSM‑5 criteria","Identifies gaps for future research"],"limitations":["No meta‑analysis or quantitative synthesis","Limited assessment of study quality/confound control","Relies on heterogeneous primary measures"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":3,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.abrep.2023.100510"}},{"id":2069,"doi":"10.1556/2006.7.2018.67","pmid":"30156118","pmcid":"PMC6426379","title":"Factor structure of the Cybersex Motives Questionnaire","authors":"Franc E, Khazaal Y, Jasiowka K, Lepers T, Bianchi-Demicheli F, Rothen S.","first_author":"Franc E","journal":"Journal of behavioral addictions","year":2018,"pub_types":["research-article","Validation Study","Journal Article"],"keywords":["Motives","Internet Addiction","Gambling Motives Questionnaire","Cybersex","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6426379","cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two online convenience samples of cybersex users (N=191, N=204) used for PCA and CFA validation of a motives questionnaire.","sample_n":395,"sample_text":"N=191 (sample 1) and N=204 (sample 2) of cybersex users recruited online.","population":"Adults who engage in cybersex; self‑selected online respondents.","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study created and validated a 14‑item questionnaire that measures why people engage in cybersex, identifying three main motives: enhancement, coping, and social reasons.","clinical_takeaway":"Clinicians can use the Cybersex Motives Questionnaire to assess underlying reasons for cybersex, aiding tailored interventions.","confidence":0.78,"topic_tags":["measurement","moral_incongruence","sexual_function"],"strengths":["Robust psychometric validation (PCA, CFA, reliability)","Two independent samples for cross‑validation","Clear reporting of fit indices"],"limitations":["Convenience online sample limits generalisability","No measurement of potential confounds (e.g., moral incongruence, mental health)","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":30,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.67"}},{"id":2070,"doi":"10.1177/0306624x18794135","pmid":"30141705","pmcid":null,"title":"Sexual Interests of Child Sexual Exploitation Material (CSEM) Consumers: Four Patterns of Severity Over Time","authors":"Fortin F, Proulx J.","first_author":"Fortin F","journal":"International journal of offender therapy and comparative criminology","year":2019,"pub_types":["Journal Article"],"keywords":["Severity","Sexual Violence","Child Pornography","Child Sexual Exploitation Material (Csem)","Illegal Images"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive analysis of seized hard‑drive images from 40 convicted CSEM consumers; no control group.","sample_n":40,"sample_text":"40 convicted offenders; images (N=61,244) analyzed.","population":"40 individuals convicted of possession of child sexual exploitation material (CSEM).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined over 60,000 images from 40 people convicted of possessing child sexual exploitation material, categorising them by the age of the depicted children and the severity of the acts. Four distinct patterns over time were identified, most commonly showing a shift toward younger victims and more severe depictions.","clinical_takeaway":"None – findings relate to illegal material and do not inform clinical practice for consensual adult sexual behaviour.","confidence":0.78,"topic_tags":["csbd"],"strengths":["Use of validated COPINE severity scale","Large number of images examined","Provides longitudinal pattern insight from hard‑drive data"],"limitations":["Convenience sample of convicted offenders; limited generalisability","No comparison or control group","No assessment of psychological variables or motives"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":26,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x18794135"}},{"id":2072,"doi":"10.3389/fpsyt.2023.1229912","pmid":"37484668","pmcid":"PMC10359607","title":"Editorial: Risk behavior and its connection to addiction","authors":"Dong H, Zhong N, Zhang J, Xiao Q.","first_author":"Dong H","journal":"Frontiers in psychiatry","year":2023,"pub_types":["Editorial"],"keywords":["Behavioral Addiction","Gambling Disorder (Gd)","Internet Addiction (Ia)","Alcohol Withdrawal Syndrome (Aws)","Non-suicidal Self-injury (Nss)","Problematic Internet Pornography Use (Pipu)"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1229912/pdf","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2023.1229912"}},{"id":2073,"doi":"10.1371/journal.pone.0202048","pmid":"30096173","pmcid":"PMC6088458","title":"Is pornography use a risk for adolescent well-being? An examination of temporal relationships in two independent panel samples","authors":"Kohut T, Štulhofer A.","first_author":"Kohut T","journal":"PloS one","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0202048&type=printable","cited_by_count":37,"is_preprint":false,"topics":["bibliography","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two independent panel samples of Croatian adolescents (N=455; N=858) followed over time; cross‑lagged path analysis and lagged linear mixed models used to examine temporal associations between self‑reported pornography use and mental‑well‑being outcomes.","sample_n":1313,"sample_text":"N = 455 and N = 858 adolescents","population":"Adolescents (Croatian, both genders)","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In two Croatian adolescent panels, watching porn did not lower overall well‑being, but among girls it was linked to higher self‑esteem and more depression‑anxiety symptoms. Low well‑being also predicted later porn use in girls. Effects were modest and need further study.","clinical_takeaway":"Porn use is not clearly harmful for all teens; clinicians should consider gender‑specific patterns and other mental‑health factors rather than assuming universal risk.","confidence":0.78,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large combined sample size with two independent panels","Longitudinal design allowing temporal inference","Use of validated mental‑health scales"],"limitations":["Pornography use measured only by self‑report frequency","No control for moral incongruence or masturbation","Limited generalisability beyond Croatian adolescents"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":38,"citing_publications":78,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0202048"}},{"id":2074,"doi":"10.1016/j.comppsych.2023.152399","pmid":"37437451","pmcid":null,"title":"Cue-reactivity to distal cues in individuals at risk for gaming disorder","authors":"Diers M, Müller SM, Mallon L, Schmid AM, Thomas TA, Klein L, Krikova K, Stark R, Wegmann E, Steins-Loeber S, Brand M, Antons S.","first_author":"Diers M","journal":"Comprehensive psychiatry","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Internet Addiction","Cue-reactivity","Addictive Behaviors","Distal Cues","Risky Gaming Users"],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"cross‑sectional laboratory cue‑reactivity experiment with two groups (risk vs non‑problematic gamers)","sample_n":157,"sample_text":"88 individuals with non‑problematic use of online games and 69 individuals at risk for gaming disorder","population":"adults with non‑problematic (n=88) and at‑risk (n=69) online gaming use, recruited likely via convenience sampling","country":"unspecified (likely Germany based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People at risk for gaming disorder showed stronger cravings and spent more time looking at distant game‑related images than non‑problematic gamers, suggesting that even subtle cues can trigger urge.","clinical_takeaway":"Distal gaming cues may provoke craving in at‑risk individuals; clinicians might address cue exposure in prevention programs.","confidence":0.7,"topic_tags":["csbd"],"strengths":["Experimental cue‑reactivity paradigm","Reasonable sample size for between‑group comparison","Inclusion of a control cue condition"],"limitations":["Reliance on simple self‑report ratings without validated scales","No measurement or control of relevant psychosocial confounds","Cross‑sectional design limits causal inference about disorder development"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":18,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2023.152399"}},{"id":2075,"doi":"10.21037/tau-22-793","pmid":"37554536","pmcid":"PMC10406534","title":"Perceived influence of medical school sexual health education on specialty selection in young urologists specializing in sexual dysfunction","authors":"Parikh N, Aro-Lambo M, Vencill JA, Collins CS, Helo S, Kohler T, Ziegelmann M.","first_author":"Parikh N","journal":"Translational andrology and urology","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Education","Fellowship","Mentorship","Sexual Health Curriculum (Shc)"],"is_oa":true,"oa_url":"https://tau.amegroups.org/article/viewFile/115268/pdf","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of urology trainees and practicing urologists (N=94) about recall of medical school sexual health curriculum and mentorship; summary statistics reported.","sample_n":94,"sample_text":"94 respondents (self‑selected survey).","population":"Urology residents, fellows, and practicing urologists (mostly PGY 4‑5) in the United States (presumed).","country":"Not specified (likely USA).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of urology trainees and doctors found that about half remembered any sexual‑health teaching in medical school, and only a small fraction said that teaching influenced their choice of specialty. Mentors with expertise in sexual dysfunction were more often linked to those who pursued a sexual‑medicine fellowship.","clinical_takeaway":"Enhancing formal sexual‑health curricula and mentorship may increase interest in sexual‑medicine subspecialties.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Addresses gap in sexual health education for future urologists.","Includes both trainees and practicing physicians.","Identifies mentorship as a key factor."],"limitations":["Self‑report recall bias; no validated measures.","Cross‑sectional, cannot infer causality.","Convenience sample; possible selection bias.","Limited statistical detail; no effect sizes."],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21037/tau-22-793"}},{"id":2076,"doi":"10.1300/j155v06n01_09","pmid":"24803052","pmcid":null,"title":"Lesbian dating and courtship from young adulthood to midlife","authors":"Rose SM, Zand D.","first_author":"Rose SM","journal":"Journal of lesbian studies","year":2002,"pub_types":["Journal Article"],"keywords":["Courtship","Intimacy","Gender Roles","Midlife","Dating","Friendship","Lesbian","Sexual Attraction","Relationship Development"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative interview study with 38 predominantly white lesbians aged 22‑63; thematic analysis of courtship scripts","sample_n":38,"sample_text":"38 participants (ages 22‑63) recruited for semi‑structured interviews","population":"lesbian adults across young adulthood to midlife (predominantly white, convenience sample)","country":"unspecified (likely USA/Canada based on journal focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 38 lesbians aged 22‑63 showed that friendship is the most common way they start relationships, with romance and explicit sexual scripts also used. Participants said they experience less gender‑role pressure, quicker relationship development, and that prejudice still matters.","clinical_takeaway":"Clinicians should recognize that many lesbian clients view friendship as a primary basis for dating and may value rapid intimacy, without assuming traditional gender‑role dynamics.","confidence":0.6,"topic_tags":["sexual_function","relationships","gender"],"strengths":["In‑depth qualitative insight into lesbian dating scripts","Across‑age cohort allows developmental comparison","Rich illustrative quotes"],"limitations":["Small, non‑representative sample (mostly white)","No systematic measurement of potential confounds","Findings may not generalize to broader lesbian population"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j155v06n01_09"}},{"id":2077,"doi":"10.1080/00224499.2018.1501549","pmid":"30074822","pmcid":null,"title":"Does Asking Adolescents About Pornography Make Them Use It? A Test of the Question-Behavior Effect","authors":"Koletić G, Cohen N, Štulhofer A, Kohut T.","first_author":"Koletić G","journal":"Journal of sex research","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal online panel survey of Croatian adolescents, comparing pornography use frequency at 6‑month follow‑up between participants who completed baseline and those who entered at follow‑up.","sample_n":1183,"sample_text":"n=1,053 participants with baseline and follow‑up; n=130 new participants at follow‑up.","population":"Adolescents (mean age 15.8) from an online panel in Croatia.","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study followed Croatian teenagers for six months and found that simply asking them about watching porn did not make them report watching it more often later.","clinical_takeaway":"Surveying adolescents about porn use does not appear to increase their consumption, so researchers can assess use without fearing it causes higher use.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large adolescent sample","Longitudinal design allowing temporal comparison","Direct test of question‑behavior effect"],"limitations":["Self‑report measures, possible recall bias","No validated pornography‑use scale reported","Limited control for potential confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1501549"}},{"id":2078,"doi":null,"pmid":"37516929","pmcid":null,"title":"Prevalence, Pattern and Factors Associated with Online Sexual Activity among Final Year Students in Osun State University, Nigeria","authors":"Omisore AG, Adeyera OD, Ogungbemi AD, Folorunso MA, Kosamat ZA, Adeyemo MOA, Tajudeen WA, Omobuwa O, Farinloye EO.","first_author":"Omisore AG","journal":"West African journal of medicine","year":2023,"pub_types":["Journal Article"],"keywords":["Pattern","Prevalence","Undergraduate","Substance Use","Online Sexual Activities"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Descriptive cross‑sectional survey of 436 final‑year university students, multistage sampling, self‑administered questionnaire.","sample_n":436,"sample_text":"final‑year students; multistage sampling within one university","population":"Final‑year undergraduates at Osun State University, Nigeria (N≈436).","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 436 final‑year university students in Nigeria, about 59 % reported engaging in online sexual activity, especially males and those who were dating. Substance use, low religiosity and childhood exposure to porn were linked to higher involvement.","clinical_takeaway":"Online sexual activity is common among students; clinicians should assess related behaviours and consider substance use and religiosity when discussing sexual health.","confidence":0.8,"topic_tags":["prevalence","sexual_function","moral_incongruence","religiosity"],"strengths":["Reasonably large sample for a single‑site survey","Multivariate logistic regression with odds ratios and confidence intervals","Considers several socio‑behavioral predictors (sex, dating, substance use, religiosity)"],"limitations":["Cross‑sectional design cannot infer causality","Use of ISST not clearly validated; no separation of masturbation from online activity","Moral incongruence and mental‑health variables not measured"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":3,"interpretation":6}},"scite":null},{"id":2079,"doi":"10.1016/j.chiabu.2023.106255","pmid":"37343427","pmcid":null,"title":"Exposure to sexual content and problematic sexual behaviors in children and adolescents: A systematic review and meta-analysis","authors":"Mori C, Park J, Racine N, Ganshorn H, Hartwick C, Madigan S.","first_author":"Mori C","journal":"Child abuse & neglect","year":2023,"pub_types":["Meta-Analysis","Systematic Review","Journal Article"],"keywords":["Problematic Sexual Behavior","Sexually Explicit Material","Harmful Sexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Systematic review and random‑effects meta‑analysis of 27 observational studies (N≈16,200) examining exposure to sexual content and problematic sexual behavior in children/adolescents.","sample_n":16200,"sample_text":"27 primary studies, total N≈16,200","population":"Children and adolescents (mean age 14.3 years, range 4.7–17.9); both genders; multiple continents","country":"International (North America, Europe, Asia, Africa)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A review of 27 studies (over 16,000 youths) found that seeing sexual material—especially violent or live content—was linked to a higher chance of engaging in problematic sexual behaviors, with stronger effects for girls exposed to non‑violent content.","clinical_takeaway":"Clinicians should consider exposure to sexual media as a risk factor when assessing and preventing problematic sexual behaviors in children and adolescents.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large combined sample size across diverse regions","Use of random‑effects meta‑analysis with odds ratios and confidence intervals","Systematic search and transparent inclusion criteria"],"limitations":["Primary studies likely use heterogeneous, often unvalidated definitions of PSB","No evidence that moral incongruence, masturbation, or mental‑health covariates were consistently controlled","Potential publication bias not addressed in abstract"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2023.106255"}},{"id":2080,"doi":"10.1016/j.chiabu.2023.106269","pmid":"37336088","pmcid":null,"title":"Child sexual abuse images and youth produced images: The varieties of Image-based Sexual Exploitation and Abuse of Children","authors":"Finkelhor D, Turner H, Colburn D, Mitchell K, Mathews B.","first_author":"Finkelhor D","journal":"Child abuse & neglect","year":2023,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Child Pornography","Internet Crimes Against Children","Online Abuse","Technology Facilitated Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online self‑administered questionnaire of 2639 young adults (18‑28) reporting past childhood image‑based sexual exploitation; descriptive classification of incident types.","sample_n":2639,"sample_text":"2639 respondents aged 18‑28","population":"National sample of U.S. young adults, self‑selected volunteers","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 2,600 U.S. young adults found that most childhood image‑based sexual exploitation involves pictures made by peers, not adult‑produced child porn, and that emotional harm was similar across types.","clinical_takeaway":"Clinicians should recognize that youth‑generated sexual images constitute a substantial part of image‑based abuse and may cause comparable distress to adult‑produced images.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large national sample","Novel typology of image‑based exploitation","Direct victim‑reported data"],"limitations":["Self‑report, possible recall bias","Ad‑hoc measures, limited validation","Cross‑sectional, no causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":46,"citing_publications":73,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2023.106269"}},{"id":2082,"doi":"10.1111/phn.12058","pmid":"24720654","pmcid":null,"title":"Professionals' perceptions of the effect of pornography on Swedish adolescents","authors":"Mattebo M, Larsson M, Tydén T, Häggström-Nordin E.","first_author":"Mattebo M","journal":"Public health nursing (Boston, Mass.)","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Health education","Adolescents","Grounded Theory","Personnel","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"qualitative","design_detail":"focus groups with 17 professionals, grounded‑theory analysis","sample_n":17,"sample_text":"Seventeen participants from five heterogeneous professional groups","population":"Swedish health/education personnel working with adolescents","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Swedish health‑ and education‑professionals who work with teens feel that pornography sends mixed messages about sexuality, often conflicting with public‑health goals and gender‑equality values. They say young people turn to porn for information, and they want better training to discuss these issues with youths.","clinical_takeaway":"Clinicians should be aware that staff may view porn as a problematic source of sexual information for teens and may need additional training to address it effectively.","confidence":0.3,"topic_tags":["pornography","adolescents","sexual_function","gender"],"strengths":["Provides insight into professional perceptions in a Swedish context","Uses grounded‑theory for systematic qualitative analysis"],"limitations":["Small, non‑random sample of professionals","No quantitative measures of pornography use or outcomes","Findings not generalisable beyond the participating groups"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":18,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/phn.12058"}},{"id":2083,"doi":"10.1111/j.1743-6109.2006.00268.x","pmid":"16839319","pmcid":null,"title":"An effect on the subjective sexual response in premenopausal women with sexual arousal disorder by bremelanotide (PT-141), a melanocortin receptor agonist","authors":"Diamond LE, Earle DC, Heiman JR, Rosen RC, Perelman MA, Harning R.","first_author":"Diamond LE","journal":"The journal of sexual medicine","year":2006,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":65,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"crossover randomized, double‑blind, n=18 premenopausal women with FSD","sample_n":18,"sample_text":"Eighteen premenopausal women","population":"Premenopausal women diagnosed with female sexual arousal disorder","country":"United States (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small crossover trial, a single nasal dose of bremelanotide increased self‑reported sexual desire and satisfaction compared with placebo in premenopausal women with arousal disorder, but did not change physiological arousal measured by vaginal blood flow.","clinical_takeaway":"Bremelanotide shows promise for improving desire and satisfaction in women with sexual arousal disorder, but larger trials are needed before clinical use.","confidence":0.7,"topic_tags":["sexual_function","treatment","prevalence"],"strengths":["Randomized, double‑blind crossover design","Objective physiological measure (VPA)","Use of validated sexual response questionnaires (presumed)"],"limitations":["Very small sample (N=18), limited power","No effect sizes or confidence intervals reported","Short‑term, single dose assessment only"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":70,"citing_publications":118,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2006.00268.x"}},{"id":2084,"doi":"10.1177/0145445599232004","pmid":"10224951","pmcid":null,"title":"The respondent conditioning of male sexual arousal","authors":"Plaud JJ, Martini JR.","first_author":"Plaud JJ","journal":"Behavior modification","year":1999,"pub_types":["Clinical Trial","Randomized Controlled Trial","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"lab-based conditioning experiment with within‑subject control conditions; N=9","sample_n":9,"sample_text":"Nine participants participated in three sessions over three weeks","population":"adult males (9 participants)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study with nine men, researchers showed that pairing a neutral image with explicit sexual material quickly increased penile blood flow, whereas random or backward pairings did not, suggesting classical conditioning can affect sexual arousal.","clinical_takeaway":"Conditioning can heighten sexual arousal; clinicians might consider this when designing interventions for sexual dysfunction.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["objective physiological measurement of arousal","use of within‑subject control conditions","clear experimental manipulation"],"limitations":["very small sample (N=9)","no effect sizes or confidence intervals reported","limited generalisability to broader populations"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0145445599232004"}},{"id":2085,"doi":"10.1007/s10508-018-1201-z","pmid":"29926261","pmcid":null,"title":"Hypersexuality, Gender, and Sexual Orientation: A Large-Scale Psychometric Survey Study","authors":"Bőthe B, Bartók R, Tóth-Király I, Reid RC, Griffiths MD, Demetrovics Z, Orosz G.","first_author":"Bőthe B","journal":"Archives of sexual behavior","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Gender","Sexual Orientation","Measurement Invariance","Dsm-5","Hypersexuality","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":78,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online survey (N=18,034), non‑clinical community sample, measurement invariance testing across gender and sexual orientation","sample_n":18034,"sample_text":"18,034 participants (6132 females, 34.0%)","population":"adults (mean age 33.6) from general population, recruited online","country":"unspecified (likely multiple European countries)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 18,000 adults, LGBTQ men reported higher scores on a hypersexual behavior questionnaire and more frequent masturbation, more sexual partners, and more pornography use than other groups, suggesting they may be at greater risk for hypersexual behavior.","clinical_takeaway":"Be aware that LGBTQ men may report higher hypersexual behaviours, but results are based on self‑report and do not prove causation.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Very large sample size","Validated hypersexuality scale (HBI)","Measurement invariance across gender and sexual orientation"],"limitations":["Cross‑sectional self‑report design","No control for moral incongruence, mental health, trauma, or partner effects","Potential convenience‑sample bias"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":11,"contrasting":0,"mentioning":82,"citing_publications":127,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1201-z"}},{"id":2086,"doi":"10.1177/1079063213492344","pmid":"23813492","pmcid":null,"title":"Criminal history and future offending of juveniles convicted of the possession of child pornography","authors":"Aebi M, Plattner B, Ernest M, Kaszynski K, Bessler C.","first_author":"Aebi M","journal":"Sexual abuse : a journal of research and treatment","year":2014,"pub_types":["Journal Article"],"keywords":["Recidivism","Child Pornography","Juvenile Sexual Offending","Online Sexual Offending"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"cohort follow‑up of convicted juveniles (N≈54) with three comparison groups","sample_n":54,"sample_text":"54 male juveniles with three comparison groups (42, 64, 104)","population":"male juveniles convicted of child‑pornography possession","country":"Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined 54 male juveniles convicted of possessing child pornography, comparing them with peers who possessed other illegal porn or committed sexual contact offenses. Those with child‑porn possession downloaded more often and reoffended less than peers who assaulted adults, suggesting they may need interventions aimed at problematic internet use.","clinical_takeaway":"Juvenile child‑porn possessors show distinct offending patterns; interventions should target online behavior rather than assume typical sexual offending trajectories.","confidence":0.71,"topic_tags":["csbd","sexual_function"],"strengths":["Uses official criminal records rather than self‑report","Includes multiple comparison groups","Longitudinal follow‑up of recidivism"],"limitations":["Small, non‑representative sample of convicted juveniles","No adjustment for mental‑health or trauma confounds","Limited statistical detail; effect sizes not reported"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063213492344"}},{"id":2087,"doi":"10.3390/healthcare11121668","pmid":"37372786","pmcid":"PMC10298691","title":"Type of Sex Education in Childhood and Adolescence: Influence on Young People's Sexual Experimentation, Risk and Satisfaction: The Necessity of Establishing School Nursing as a Pillar","authors":"Navarro-Prado S, Tovar-Gálvez MI, Sánchez-Ojeda MA, Luque-Vara T, Fernández-Gómez E, Martín-Salvador A, Marín-Jiménez AE.","first_author":"Navarro-Prado S","journal":"Healthcare (Basel, Switzerland)","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Adolescent","Childhood","Sex Education","Social Networking","Personal Satisfaction","School Nursing"],"is_oa":true,"oa_url":"https://www.mdpi.com/2227-9032/11/12/1668/pdf?version=1686039661","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"non-experimental, quantitative, ex post facto, cross-sectional online questionnaire (N=675)","sample_n":675,"sample_text":"Convenience sample via online questionnaire; recruitment method not fully described","population":"young adults (≈20‑22 y, recruited online)","country":"Spain (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed 675 young adults about where they learned about sex and found that those who learned mainly from pornography or the internet reported more risky sexual behaviour, contraceptive refusal, unwanted situations, and lower sexual satisfaction. The authors argue that school nurses should provide reliable sex education to reduce reliance on online sources.","clinical_takeaway":"Improving school‑based, nurse‑led sex education may lower risky behaviours and increase satisfaction among youth.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large sample size for a survey","Clear focus on source of sex education","Statistical testing of multiple outcomes"],"limitations":["Cross‑sectional, cannot infer causality","No validated measures of attitudes or satisfaction","Key confounds (moral views, mental health, partner context) not assessed","Potential self‑selection bias in online recruitment"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare11121668"}},{"id":2088,"doi":"10.1016/j.neubiorev.2023.105271","pmid":"37277009","pmcid":null,"title":"A systematic review and meta-analysis of risky decision-making in specific domains of problematic use of the internet: Evidence across different decision-making tasks","authors":"Müller SM, Antons S, Wegmann E, Ioannidis K, King DL, Potenza MN, Chamberlain SR, Brand M.","first_author":"Müller SM","journal":"Neuroscience and biobehavioral reviews","year":2023,"pub_types":["Meta-Analysis","Systematic Review","Journal Article"],"keywords":["decision-making","Compulsive Behavior","Social Networks","Impulsive Behavior","Internet Addiction","Addictive Behavior","Gambling Task","Gaming Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Systematic review and meta-analysis of 25 studies (n=2498) on risky decision‑making in various problematic internet use domains; pre‑registered protocol; quality assessed with Newcastle‑Ottawa Scale.","sample_n":2498,"sample_text":"25 primary studies comprising 2498 participants.","population":"Adults (mixed; gender reported for some sub‑analyses), participants with problematic internet use vs. controls.","country":"Not specified (includes studies from multiple countries).","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2023 meta‑analysis of 25 studies finds that people with problematic internet use—especially gaming disorder and mostly in men—make riskier choices on decision‑making tasks than controls, but no clear difference on ambiguous decisions.","clinical_takeaway":"Problematic internet use may be linked to poorer risk‑taking judgment; clinicians should assess decision‑making, not assume addiction pathology.","confidence":0.78,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Pre‑registered protocol (PROSPERO).","Systematic search across multiple PUI domains.","Use of standardized effect‑size metrics with confidence intervals."],"limitations":["Primary studies likely use heterogeneous definitions of PUI; limited validation detail.","No assessment of key psychosocial confounds (e.g., moral incongruence, mental health).","Limited number of studies for several domains (e.g., online pornography)."],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":18,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neubiorev.2023.105271"}},{"id":2089,"doi":"10.1016/j.ijlp.2018.05.004","pmid":"29996986","pmcid":null,"title":"Sex, gender and the carceral: Female staff experiences of working in forensic care with sexual offenders","authors":"Mercer D, Perkins E.","first_author":"Mercer D","journal":"International journal of law and psychiatry","year":2018,"pub_types":["Journal Article"],"keywords":["Mental Health Act","Personality Disorder","Discourse","Gender Inequality","Sexual Offender","Forensic Nursing","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with a small convenience sample of female nurses","sample_n":18,"sample_text":"eighteen mental health nurses (female) in a high‑security Personality Disorder Unit","population":"female mental health nurses working with male sexual offenders in a high‑security UK hospital","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviewed female nurses in a UK high‑security psychiatric unit to understand how working with male sexual offenders affects their sense of safety and gender dynamics.","clinical_takeaway":"None – the study provides contextual insights rather than clinical guidance.","confidence":0.7,"topic_tags":["gender","sexual_function"],"strengths":["Rich, in‑depth qualitative data","Focus on an understudied group (female staff)","Use of discourse‑analytic framework"],"limitations":["Small, non‑representative convenience sample","Findings not generalisable to other settings","No quantitative validation of themes"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijlp.2018.05.004"}},{"id":2090,"doi":"10.1007/s10796-023-10400-x","pmid":"37361890","pmcid":"PMC10235847","title":"Exploring the Darkverse: A Multi-Perspective Analysis of the Negative Societal Impacts of the Metaverse","authors":"Dwivedi YK, Kshetri N, Hughes L, Rana NP, Baabdullah AM, Kar AK, Koohang A, Ribeiro-Navarrete S, Belei N, Balakrishnan J, Basu S, Behl A, Davies GH, Dutot V, Dwivedi R, Evans L, Felix R, Foster-Fletcher R, Giannakis M, Gupta A, Hinsch C, Jain A, Jane Patel N, Jung T, Juneja S, Kamran Q, Mohamed Ab S, Pandey N, Papagiannidis S, Raman R, Rauschnabel PA, Tak P, Taylor A, Tom Dieck MC, Viglia G, Wang Y, Yan M.","first_author":"Dwivedi YK","journal":"Information systems frontiers : a journal of research and innovation","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Virtual reality","Unintended Consequences","Virtual World","Second Life","Negative Consequences","Metaverse","Dark Side Of The Metaverse"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10796-023-10400-x.pdf","cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"expert opinion piece with invited narratives, no empirical data collected","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper gathers expert opinions about possible harms of the Metaverse, listing issues like privacy, financial crime, mental health, sexual harassment and pornography, but provides no original data or systematic analysis.","clinical_takeaway":"None - not clinically applicable.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Broad interdisciplinary perspective","Identifies many potential negative outcomes"],"limitations":["No empirical data or systematic review methodology","Lacks measurement of key constructs","Conclusions are speculative"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":4,"contrasting":0,"mentioning":60,"citing_publications":232,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10796-023-10400-x"}},{"id":2091,"doi":"10.1590/0034-7167-2022-0299","pmid":"37255186","pmcid":"PMC10226417","title":"Critical-emancipatory educational intervention through games to face gender violence","authors":"Fornari LF, Fonseca RMGSD.","first_author":"Fornari LF","journal":"Revista brasileira de enfermagem","year":2023,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10226417","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative thematic analysis of 28 professionals from three cities, convenience sample","sample_n":28,"sample_text":"28 professionals from intersectoral services in three Brazilian capitals","population":"professionals working in intersectoral services for women experiencing gender violence (N=28)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A small qualitative study examined how a game‑based training called \"Violetas\" helped professionals who assist women facing gender violence. Participants identified issues like sexist attitudes, pornography and sexual diversity, and suggested ways to improve services.","clinical_takeaway":"Educational games may help professionals reflect on gender‑related issues, but evidence of impact on practice is limited.","confidence":0.8,"topic_tags":["gender"],"strengths":["Innovative use of games for professional training","Qualitative depth through critical-emancipatory workshops","Clear thematic analysis using software"],"limitations":["Small, non‑representative convenience sample","No quantitative outcome measures","Findings limited to self‑reported perceptions"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/0034-7167-2022-0299"}},{"id":2092,"doi":"10.1016/s0740-5472(96)00162-6","pmid":"9306301","pmcid":null,"title":"A Sexual Adjustment Questionnaire for use in therapy and research with alcoholics and their spouses","authors":"O'Farrell TJ, Kleinke CL, Cutter HS.","first_author":"O'Farrell TJ","journal":"Journal of substance abuse treatment","year":1997,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"questionnaire development with factor analysis; convenience sample of alcoholics and spouses; no longitudinal or experimental component","sample_n":null,"sample_text":"not reported in abstract","population":"adults (alcoholics and their spouses)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created a 15-item Sexual Adjustment Questionnaire for alcoholics and their spouses, showing initial reliability and validity through factor analysis, and suggest its use in therapy and research.","clinical_takeaway":"The questionnaire may help clinicians assess sexual satisfaction and dysfunction in couples dealing with alcoholism.","confidence":0.6,"topic_tags":["sexual_function","measurement","relationships","adolescents"],"strengths":["Clear description of questionnaire development process","Factor analysis used to reduce items","Preliminary normative data provided"],"limitations":["Sample size and composition not reported in abstract","No external validation against established measures","Limited assessment of potential confounding variables"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0740-5472(96)00162-6"}},{"id":2093,"doi":"10.1037//0021-843x.105.3.440","pmid":"8772014","pmcid":null,"title":"Is homophobia associated with homosexual arousal?","authors":"Adams HE, Wright LW, Lohr BA.","first_author":"Adams HE","journal":"Journal of abnormal psychology","year":1996,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment with physiological arousal measurement; convenience sample of 64 adult men grouped by homophobia scores.","sample_n":64,"sample_text":"Male participants stratified by homophobia scores; no mention of random sampling or demographic diversity.","population":"Adult men (heterosexual orientation), recruited based on Index of Homophobia scores; n=35 homophobic, n=29 non‑homophobic.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study found that men who score high on a homophobia questionnaire showed physiological arousal to male‑homosexual videos, even though they reported negative attitudes toward gay people.","clinical_takeaway":"Homophobic attitudes may coexist with involuntary same‑sex arousal; clinicians should consider hidden arousal when addressing prejudice.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Physiological measurement of arousal reduces self‑report bias","Use of a validated homophobia index","Clear experimental manipulation with distinct video categories"],"limitations":["Small, non‑representative sample","No control for potential confounds (e.g., mental health, sexual experience)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":199,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0021-843x.105.3.440"}},{"id":2095,"doi":"10.1080/0092623x.2018.1462278","pmid":"29634458","pmcid":null,"title":"Pornography Consumption, Perceptions of Pornography as Sexual Information, and Condom Use","authors":"Wright PJ, Sun C, Steffen N.","first_author":"Wright PJ","journal":"Journal of sex & marital therapy","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 200 sexually active German adults in non‑monogamous relationships; self‑report measures of pornography use frequency, perceived informational value of porn, and condom use frequency; interaction analysis","sample_n":200,"sample_text":"200 sexually active German adults who were not in monogamous relationships","population":"German adults (heterosexual, non‑monogamous), n≈200","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 200 German adults who have multiple partners, people who think porn teaches them about sex tended to use condoms less often, while those who didn’t view porn as informational showed no link between porn use and condom use.","clinical_takeaway":"Clinicians might consider discussing how individuals interpret porn as sexual advice when addressing condom use.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Reasonably sized community sample (n≈200)","Examines interaction between perception and behavior","Addresses public‑health relevant outcome (condom use)"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on ad‑hoc self‑report items; no validated scales","Key confounds (moral incongruence, masturbation, mental health) not measured"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":28,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2018.1462278"}},{"id":2096,"doi":"10.1080/10810730.2018.1472316","pmid":"29746204","pmcid":null,"title":"Sex Education, Public Opinion, and Pornography: A Conditional Process Analysis","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Journal of health communication","year":2018,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Analysis of pooled national survey data (1988‑2016) across 16 samples; conditional process (moderated‑mediation) modeling; cross‑sectional.","sample_n":null,"sample_text":"National survey; exact N not reported in abstract.","population":"Adults in the United States (age range not specified).","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A US survey analysis found that people who watch more porn are more likely to support sex education, especially when they are less religious, because porn may make them more accepting of teenage sex.","clinical_takeaway":"None – findings relate to attitudes, not clinical outcomes.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative datasets","Advanced conditional process modeling","Inclusion of religiosity as moderator"],"limitations":["Cross‑sectional; cannot infer causality","Key constructs measured by single‑item self‑reports, no validated scales","Major confounds (masturbation, mental health, relationship status, trauma) not addressed"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10810730.2018.1472316"}},{"id":2099,"doi":"10.1038/s41598-023-34975-2","pmid":"37173519","pmcid":"PMC10182050","title":"Examining the relationship between risky sexual behavior and suicidal thoughts among unmarried adolescents in India","authors":"Maurya C, Muhammad T, Thakkar S.","first_author":"Maurya C","journal":"Scientific reports","year":2023,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://www.nature.com/articles/s41598-023-34975-2.pdf","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Panel data from two waves of the nationally representative UDAYA survey (N≈10,000 adolescents). Random‑effects regression used to examine associations between risky sexual behaviours (including pornography use) and suicidal ideation.","sample_n":10208,"sample_text":"4221 unmarried adolescent boys and 5987 unmarried adolescent girls.","population":"Unmarried adolescents aged 10–19 years in India (≈4,200 boys, ≈6,000 girls).","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large Indian survey, adolescents who had multiple partners, early sexual debut, were sexually active, or watched pornography were more likely to report suicidal thoughts two years later.","clinical_takeaway":"Screening for risky sexual behaviours, including pornography exposure, may help identify adolescents at higher risk of suicidal ideation.","confidence":0.78,"topic_tags":["sexual_function","adolescents","pornography","other"],"strengths":["Large, nationally representative sample","Longitudinal design with two waves","Appropriate regression modelling for panel data"],"limitations":["Key constructs measured with single self‑report items, no validated scales","No measurement of moral/religious views, mental‑health covariates, or trauma","Effect sizes reported without confidence intervals"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-023-34975-2"}},{"id":2100,"doi":"10.1080/00224499.2018.1451476","pmid":"29669431","pmcid":null,"title":"\"Harder and Harder\"? Is Mainstream Pornography Becoming Increasingly Violent and Do Viewers Prefer Violent Content?","authors":"Shor E, Seida K.","first_author":"Shor E","journal":"Journal of sex research","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"content analysis of 269 popular PornHub videos spanning a decade, examining prevalence of aggressive acts and view/ ranking metrics","sample_n":269,"sample_text":"269 popular videos uploaded to PornHub over the past decade","population":"online video content (PornHub) – no human participants","country":"global (online platform)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined 269 popular PornHub videos from the past ten years and found that violent scenes have not become more common; in fact, aggressive segments are shorter now, and videos with aggression get fewer views and lower rankings.","clinical_takeaway":"None – the study describes video content trends, not individual health outcomes.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Large sample of popular videos across a ten‑year span","Objective behavioral coding of video content","Direct test of a widely held claim about industry trends"],"limitations":["Potential selection bias (only popular PornHub videos)","Limited detail on coding reliability and operational definition of aggression","No assessment of viewer characteristics or motivations"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":1,"mentioning":34,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1451476"}},{"id":2101,"doi":"10.1556/2006.7.2018.22","pmid":"29642723","pmcid":"PMC6174598","title":"Impulsivity traits and addiction-related behaviors in youth","authors":"Rømer Thomsen K, Callesen MB, Hesse M, Kvamme TL, Pedersen MM, Pedersen MU, Voon V.","first_author":"Rømer Thomsen K","journal":"Journal of behavioral addictions","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Addiction","Impulsivity","Substance Use","Binge Eating","Internet Gaming","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6174598","cited_by_count":110,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 109 youth selected for a broad range of externalising problems; regression analyses of UPPS‑P traits versus self‑report problem use of substances, gaming, pornography, food.","sample_n":109,"sample_text":"Convenience sample with oversampling of externalising problems; not nationally representative.","population":"Youth (16‑26 y), 69 % male, selected from national survey based on externalising scores.","country":"Denmark (presumed from authors’ affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 109 young people, impulsivity traits—especially urgency and lack of perseverance—were linked to higher self‑reported problems with alcohol, cannabis, other drugs, binge eating, and pornography use. The study suggests these personality factors might predict later addictions, but it does not separate pornography viewing from masturbation or consider moral or mental‑health influences.","clinical_takeaway":"Impulsivity, particularly urgency and lack of perseverance, may signal risk for problematic pornography use, but clinicians should also assess moral, relational, and mental‑health factors.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Validated impulsivity measure (UPPS‑P)","Includes both substance and non‑substance behaviours","Regression models allow adjustment for multiple traits"],"limitations":["Cross‑sectional; cannot infer causality","Problematic‑use measures not clearly validated or separated from distress","Key confounds (moral incongruence, masturbation, mental health, partner effects) not assessed","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":10,"contrasting":2,"mentioning":107,"citing_publications":199,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.22"}},{"id":2102,"doi":"10.1016/j.arcped.2023.01.011","pmid":"37147154","pmcid":null,"title":"Prevalence and factors associated with active cybersexuality among teenagers between 15 and 17 years old: a cross sectional study in Normandy, France","authors":"Rousseau M, Asselin I, Morello R, Lecoutour X, Brouard J, Fauvet R, Pizzoferrato AC.","first_author":"Rousseau M","journal":"Archives de pediatrie : organe officiel de la Societe francaise de pediatrie","year":2023,"pub_types":["Multicenter Study","Journal Article","Observational Study"],"keywords":["Internet","Prevention","Sex Education","Sexual Health","Teenager","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational cross‑sectional multicenter questionnaire administered to 1,208 French teenagers (15‑17 y) in school sexual‑education classes.","sample_n":1208,"sample_text":"1,208 teenagers","population":"Adolescents 15‑17 years, Normandy, France (school‑based sample)","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,208 French teens aged 15‑17 found that two‑thirds had engaged in online sexual activities, with daily pornography viewing and large numbers of social‑media friends strongly linked to these behaviours.","clinical_takeaway":"Clinicians should consider daily pornography use and extensive online social networks as risk markers for risky cyber‑sexual behaviour in adolescents.","confidence":0.7,"topic_tags":["prevalence","adolescents","pornography","sexual_function"],"strengths":["Large sample size (N>1,000)","Multicenter inclusion across schools","Report of effect sizes (ORs) for multiple risk factors"],"limitations":["Questionnaire not validated; possible measurement bias","Cross‑sectional design cannot infer causality","No assessment of moral incongruence or masturbation, limiting interpretation of pornography‑related risk"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.arcped.2023.01.011"}},{"id":2103,"doi":"10.1080/00224499.2018.1440281","pmid":"29578817","pmcid":"PMC6155976","title":"A Dyadic Approach to Pornography Use and Relationship Satisfaction Among Heterosexual Couples: The Role of Pornography Acceptance and Anxious Attachment","authors":"Maas MK, Vasilenko SA, Willoughby BJ.","first_author":"Maas MK","journal":"Journal of sex research","year":2018,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large dyadic survey of 6,626 heterosexual couples analysed with actor‑partner interdependence modeling","sample_n":6626,"sample_text":"6,626 matched‑paired couples","population":"heterosexual married/cohabiting couples (self‑selected, likely online convenience sample)","country":"not specified","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 6,600 heterosexual couples, men who are anxious‑attached or who accept porn report higher relationship satisfaction when they use porn, while anxious‑attached women report lower satisfaction. Acceptance of porn also moderates the link for men and women.","clinical_takeaway":"Practitioners should consider partner attachment style and attitudes toward porn when discussing its impact on relationship wellbeing.","confidence":0.8,"topic_tags":["pornography","relationships","sexual_function","moral_incongruence"],"strengths":["Very large dyadic sample","Actor‑partner interdependence modeling captures mutual effects","Considers both attachment and acceptance as moderators"],"limitations":["Cross‑sectional; cannot infer causality","Convenience sample may limit generalizability","Masturbation and broader mental‑health variables not measured"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":33,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1440281"}},{"id":2104,"doi":"10.1016/j.jfma.2023.04.010","pmid":"37095019","pmcid":null,"title":"Ten years' trend analysis for Taiwanese youth high school students' health behaviors","authors":"Lu YS, Wu YR, Cheng YR, Chang CH, Jan CF.","first_author":"Lu YS","journal":"Journal of the Formosan Medical Association = Taiwan yi zhi","year":2023,"pub_types":["Journal Article"],"keywords":["Taiwan","Youth","Adolescence","Adolescent Health","Risk-taking Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Repeated cross‑sectional, representative survey of 22,419 Taiwanese high‑school students over 10 years; large sample, but no longitudinal follow‑up of individuals.","sample_n":22419,"sample_text":"22,419 adolescents recruited via representative sampling akin to the US Youth Risk Behavior Surveillance System.","population":"Taiwanese adolescents (high‑school students)","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 10‑year survey of over 22 000 Taiwanese high‑school students shows a modest decline in early exposure to pornography, while some risky health behaviours rose. The study tracks trends but does not assess how pornography use relates to wellbeing.","clinical_takeaway":"Early porn exposure appears to be decreasing among Taiwanese teens, but the data do not inform clinical assessment or treatment.","confidence":0.85,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large, nationally‑representative sample","Decade‑long trend analysis","Standardized questionnaire based on US YRBS"],"limitations":["Key constructs (pornography exposure) measured via single, unvalidated item","No assessment of moral, mental‑health or relational confounders","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jfma.2023.04.010"}},{"id":2105,"doi":"10.1177/08862605231168825","pmid":"37086104","pmcid":null,"title":"The Art of Seduction: Male Endorsement of Coercive and Willful Sex Tactics","authors":"Starrett EJ, Sperry K, Galliher RV.","first_author":"Starrett EJ","journal":"Journal of interpersonal violence","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual Assault","Offenders","Cultural Contexts","Glbt","Date Rape","Media And Violence"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 420 men assessing endorsement of coercive and willful dating tactics; cross‑sectional questionnaire","sample_n":420,"sample_text":"420 male participants","population":"male adults (likely community sample, recruitment details not specified)","country":"unspecified (likely United States based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 420 men found that about one‑quarter endorse coercive sexual tactics, with higher endorsement linked to fraternity involvement, religious affiliation, knowing a perpetrator, and frequent pornography viewing.","clinical_takeaway":"None – the study does not provide direct clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a survey study (N=420)","Addresses an under‑researched perspective (male endorsement of coercive tactics)","Identifies demographic correlates (e.g., fraternity involvement, religion, pornography use)"],"limitations":["Constructs measured with ad‑hoc, non‑validated items","No control for key confounds such as moral incongruence, mental health, or trauma","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605231168825"}},{"id":2106,"doi":"10.1016/0145-2134(88)90042-7","pmid":"3167619","pmcid":null,"title":"Interaction of normal children with anatomical dolls","authors":"Sivan AB, Schor DP, Koeppl GK, Noble LD.","first_author":"Sivan AB","journal":"Child abuse & neglect","year":1988,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"observational pilot study of 144 non‑referred children aged 3‑8 years, observed in a playroom with anatomical dolls under three conditions","sample_n":144,"sample_text":"140‑144 children, ages 3‑8, observed in a playroom","population":"children, community sample (likely convenience)","country":"unspecified (likely USA based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 144 children aged 3‑8, normal kids showed little interest, aggression, or sexual play with explicit anatomical dolls, unlike reports from abused children. This suggests such doll behavior may be a red flag for abuse.","clinical_takeaway":"Aggressive or sexual doll play is uncommon in typical children; observed in abuse cases, it should be taken seriously.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["relatively large sample for a pilot observational study","systematic observation under multiple conditions","provides normative data lacking in literature"],"limitations":["no validated coding scheme reported","cross‑sectional, cannot infer causality","potential selection bias, unclear recruitment"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":29,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0145-2134(88)90042-7"}},{"id":2107,"doi":"10.1111/add.14104","pmid":"29423987","pmcid":null,"title":"Commentary on Grubbs et al. (2018): Coming out as a pornography user-could societal acceptance decrease the prevalence of perceived addiction?","authors":"Weingardt KR.","first_author":"Weingardt KR.","journal":"Addiction (Abingdon, England)","year":2018,"pub_types":["Comment","Journal Article"],"keywords":["Sexuality","Morality","Addiction","Religion","Acceptance","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/add.14104"}},{"id":2108,"doi":"10.1016/j.jsxm.2018.01.009","pmid":"29502983","pmcid":null,"title":"A Network Approach to Hypersexuality: Insights and Clinical Implications","authors":"Werner M, Štulhofer A, Waldorp L, Jurin T.","first_author":"Werner M","journal":"The journal of sexual medicine","year":2018,"pub_types":["Journal Article"],"keywords":["Gender","Treatment","Network Analysis","Hypersexuality","Pornography","Network Psychometrics"],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey, N=3028, convenience community sample, gender-balanced, network analysis of hypersexuality symptoms","sample_n":3028,"sample_text":"online convenience community sample recruited via advertisement focusing on Internet pornography, sexual health, and relationships","population":"Croatian adults 18-60, community sample","country":"Croatia","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used an online survey of over 3,000 Croatian adults to map how hypersexuality symptoms relate to each other. Psychological distress and loss of control were central, while pornography use was peripheral. The network pattern was similar for men and women.","clinical_takeaway":"Target distress and emotion regulation, not pornography use, when treating hypersexuality.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["large sample size","novel network analytic approach","use of validated hypersexuality scales"],"limitations":["convenience, non‑clinical sample limits generalizability","no control for moral incongruence or broader mental‑health covariates","cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":0,"mentioning":56,"citing_publications":66,"retracted":false,"notices":[{"status":"Has erratum","date":"2018-4-1","noticeDoi":"10.1016/j.jsxm.2018.03.001","doi":"10.1016/j.jsxm.2018.01.009"}],"url":"https://scite.ai/reports/10.1016/j.jsxm.2018.01.009"}},{"id":2109,"doi":"10.1002/bsl.2340","pmid":"29659072","pmcid":null,"title":"Characteristics and treatment of internet child pornography offenders","authors":"Ly T, Dwyer RG, Fedoroff JP.","first_author":"Ly T","journal":"Behavioral sciences & the law","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative literature review of studies on Internet child‑pornography offenders; no systematic search protocol, no meta‑analysis, no new empirical data.","sample_n":null,"sample_text":"Not applicable – review of existing studies.","population":"Adults convicted of child‑pornography offenses (ICPOs) compared with contact offenders; sample characteristics not reported (review).","country":"Not specified (studies from various countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews research comparing people who view child pornography online with those who commit hands‑on sexual offenses against children, noting psychological differences that may require different treatment approaches.","clinical_takeaway":"Clinicians should consider that online child‑pornography offenders may have distinct psychological profiles and treatment needs compared with contact offenders.","confidence":0.4,"topic_tags":["pornography","sexual_function","treatment"],"strengths":["Summarises a range of typologies and treatment issues for ICPOs.","Highlights potential differences between online and offline offenders."],"limitations":["No systematic search or risk‑of‑bias assessment.","Relies on heterogeneous primary studies with unclear measurement quality.","No quantitative synthesis; conclusions are largely descriptive."],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":33,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/bsl.2340"}},{"id":2110,"doi":"10.2466/pr0.1988.63.1.38","pmid":"3212137","pmcid":null,"title":"Effect of exposure to sexually explicit homoerotic material on aggressiveness and homophobia in heterosexual college students","authors":"Duncan DF.","first_author":"Duncan DF.","journal":"Psychological reports","year":1988,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2466/pr0.1988.63.1.38"}},{"id":2111,"doi":"10.1111/jocd.15712","pmid":"37036237","pmcid":null,"title":"The scrotum: A comparison of men's and women's aesthetic assessments","authors":"Albrecht P, Eimer C, Kasten E.","first_author":"Albrecht P","journal":"Journal of cosmetic dermatology","year":2023,"pub_types":["Journal Article"],"keywords":["Attractiveness","Psychology","Plastic surgery","Scrotum","Cosmetic Surgery","Genital Aesthetic"],"is_oa":false,"oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jocd.15712","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Participants (likely convenience sample) rated photographs of scrotums varying in length and width; gender differences and personality predictors examined.","sample_n":null,"sample_text":"Not specified in abstract; likely a convenience sample of volunteers.","population":"Adults (gender balanced unknown), recruited to evaluate visual stimuli.","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Men and women rated photos of scrotums of different sizes to see which looked most attractive. No clear 'ideal' size was found, and personality traits or pornography use did not affect ratings.","clinical_takeaway":"None – the study informs aesthetic preferences only, not clinical guidance.","confidence":0.6,"topic_tags":["gender","adolescents","pornography"],"strengths":["Novel focus on scrotum aesthetic preferences","Includes both male and female raters","Considers personality traits as predictors"],"limitations":["No validated measures of aesthetic preference","Likely convenience sample, limited generalisability","No control for key confounds (e.g., moral views, mental health)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jocd.15712"}},{"id":2112,"doi":"10.1177/0886260518760011","pmid":"29475417","pmcid":null,"title":"Understanding Revenge Pornography: A National Survey of Police Officers and Staff in England and Wales","authors":"Bond E, Tyrrell K.","first_author":"Bond E","journal":"Journal of interpersonal violence","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Domestic Violence","Dating Violence","Mental Health And Violence","Internet And Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online questionnaire of 783 police officers and staff; national but self‑selected sample; descriptive analyses of knowledge, confidence and training.","sample_n":783,"sample_text":"783 members of the police force responded to the survey","population":"Police officers and staff in England and Wales (N=783)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2021 UK survey of 783 police officers found limited knowledge of revenge‑pornography laws and low confidence in handling cases, highlighting a need for better training.","clinical_takeaway":"None – the study informs police practice, not clinical care.","confidence":0.8,"topic_tags":["religiosity","moral_incongruence","sexual_function"],"strengths":["Large sample of police personnel","First national survey of this topic in England & Wales","Clear practical implications for training"],"limitations":["Self‑selected convenience sample; may not be representative","No validated questionnaire; relies on ad‑hoc items","Descriptive analysis only; no inferential testing of predictors"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":68,"citing_publications":87,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260518760011"}},{"id":2115,"doi":"10.1080/0092623x.2017.1405301","pmid":"29281588","pmcid":null,"title":"When Pornography Use Feels Out of Control: The Moderation Effect of Relationship and Sexual Satisfaction","authors":"Daspe MÈ, Vaillancourt-Morel MP, Lussier Y, Sabourin S, Ferron A.","first_author":"Daspe MÈ","journal":"Journal of sex & marital therapy","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,036 participants assessing pornography frequency, perceived lack of control, relationship and sexual satisfaction","sample_n":1036,"sample_text":"large community sample, likely convenience","population":"adults (unspecified recruitment method)","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 1,036 adults, more frequent porn use was linked to feeling out of control mainly when participants were dissatisfied with their relationship or sex life. Low satisfaction seemed to increase the risk of perceiving porn use as problematic.","clinical_takeaway":"Assess relationship and sexual satisfaction when clients report losing control over porn use; dissatisfaction may amplify perceived problems.","confidence":0.75,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["large sample size","focus on relational moderators","clear statistical interaction analysis"],"limitations":["cross‑sectional design limits causal inference","no validated addiction or control scale used","critical confounds (moral incongruence, masturbation, mental health) not measured"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":28,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2017.1405301"}},{"id":2116,"doi":"10.1080/13691058.2023.2194355","pmid":"37014273","pmcid":null,"title":"What does it mean to be 'porn literate': perspectives of young people, parents and teachers in Aotearoa New Zealand","authors":"Healy-Cullen S, Morison T, Taylor JE, Taylor K.","first_author":"Healy-Cullen S","journal":"Culture, health & sexuality","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Young People","Sexuality Education","Sexual Ethics","Sexual Citizenship","Porn Literacy Education","Sexual Scripting Theory"],"is_oa":false,"oa_url":"https://doi.org/10.1080/13691058.2023.2194355","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 24 participants (parents, teachers, youth) in New Zealand","sample_n":24,"sample_text":"24 semi‑structured interviews","population":"young people, parents, teachers in Aotearoa New Zealand (convenience purposive sample)","country":"New Zealand","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study interviewed 24 New Zealand youths, parents and teachers about what it means to be ‘porn‑literate’. Most saw porn‑literacy education as a way to protect young people from harmful messages, but some participants argued for a more rights‑based, agency‑focused approach.","clinical_takeaway":"Educators should consider youth agency and ethical citizenship, not only risk‑avoidance, when designing porn‑literacy programmes.","confidence":0.85,"topic_tags":["pornography","sexual_function"],"strengths":["Provides rich, stakeholder perspectives","Uses critical constructionist thematic analysis","Identifies alternative, asset‑based approaches"],"limitations":["Small, non‑representative sample","No quantitative measurement of porn exposure or outcomes","Findings not generalisable to broader populations"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2023.2194355"}},{"id":2117,"doi":null,"pmid":"37289144","pmcid":null,"title":"[Children's exposure to pornography is a concern]","authors":"Cohen D.","first_author":"Cohen D.","journal":"La Revue du praticien","year":2023,"pub_types":["Journal Article"],"keywords":["Child Behavior","Child Abuse, Sexual"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":2118,"doi":"10.4103/npmj.npmj_65_23","pmid":"37148109","pmcid":null,"title":"Determinants of adolescent sexual behaviour in indonesia during the COVID-19 pandemic: A scoping review","authors":"Muthmainnah M, Devi YP, Khoiriyah IE, Nadia A, Putri AF, Tristanti KK.","first_author":"Muthmainnah M","journal":"The Nigerian postgraduate medical journal","year":2023,"pub_types":["Scoping Review","Journal Article"],"keywords":["Adolescent","Well-being","Good Health","Covid-19 Pandemic","Pre-marital Sexual Behaviour"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review of 21 articles identified determinants of adolescent pre‑marital sexual behaviour during COVID‑19 in Indonesia; no meta‑analysis or risk‑of‑bias assessment","sample_n":21,"sample_text":"21 articles included in the scoping review","population":"Adolescents in Indonesia (studies varied)","country":"Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review of 21 papers found that during COVID‑19 Indonesian teens' premarital sexual activity rose, linked to limited reproductive‑health knowledge, peer and family influence, and increased internet use including pornography.","clinical_takeaway":"Promote comprehensive sexual education and parental involvement to reduce risky premarital sexual behaviour among adolescents.","confidence":0.7,"topic_tags":["adolescents","sexual_function","prevalence"],"strengths":["Broad search across multiple databases","Identifies multiple socio‑cultural determinants","Clear linkage to pandemic‑related changes"],"limitations":["Scoping design lacks quantitative synthesis","No assessment of study quality or bias","Constructs (e.g., “pornography exposure”) not operationalised"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/npmj.npmj_65_23"}},{"id":2119,"doi":"10.1093/sexmed/qfad012","pmid":"37256214","pmcid":"PMC10225467","title":"Use of sexual stimuli in research and clinical settings: expert opinion and recommendations","authors":"Katz MA, Penniston TL, Barry C, Micanovic N, Seto MC, Chivers ML.","first_author":"Katz MA","journal":"Sexual medicine","year":2023,"pub_types":["review-article","Review","Journal Article"],"keywords":["Ethics","Sexual Arousal","Pornography","Sexual Response","Audiovisual Sexual Stimuli","Sexuality Science"],"is_oa":true,"oa_url":"https://academic.oup.com/smoa/article-pdf/11/2/qfad012/50499097/qfad012.pdf","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review-article","sample_n":null,"sample_text":"No empirical participants; expert opinion based on literature review","population":"experts in sexual psychophysiology; no empirical sample","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article gives expert guidance on how to choose, use, and report sexual stimuli (like videos or images) in research and clinical settings, covering practical, ethical, and technical issues such as stimulus diversity and virtual reality.","clinical_takeaway":"Clinicians and researchers should follow the recommended best practices to ensure ethical, valid, and reproducible use of sexual stimuli in their work.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of stimulus types and ethical considerations","Provides practical recommendations for researchers and clinicians","Authored by recognized experts in sexual psychophysiology"],"limitations":["No original empirical data; relies on existing literature","Lacks systematic review methodology (no PRISMA, risk‑of‑bias assessment)","No quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfad012"}},{"id":2122,"doi":"10.1556/jba.1.2012.007","pmid":"26165604","pmcid":null,"title":"Perceptions of relationship satisfaction and addictive behavior: Comparing pornography and marijuana use","authors":"Pyle TM, Bridges AJ.","first_author":"Pyle TM","journal":"Journal of behavioral addictions","year":2012,"pub_types":["Journal Article"],"keywords":["Marijuana","Relationship Satisfaction","Pornography","Sexually Explicit Material"],"is_oa":false,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/1/4/article-p171.pdf","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Experimental vignette study with 186 college‑aged women reading 16 manipulated scenarios; convenience sample; within‑subject comparisons of perceived relationship impact of partner’s pornography vs. marijuana use.","sample_n":186,"sample_text":"186 college‑aged women","population":"College women (N=186), likely predominantly Western, convenience sample","country":"USA (presumed from journal and author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"College women rated how they thought a partner’s frequent porn or marijuana use would affect their relationship. Both behaviours were seen as equally harmful, especially when secret or frequent.","clinical_takeaway":"Perceived relationship harm from porn mirrors that of marijuana; clinicians should consider partner communication, not assume pathology.","confidence":0.7,"topic_tags":["pornography","relationships","adolescents","sexual_function","moral_incongruence","prevalence"],"strengths":["Experimental manipulation of scenario variables","Decent sample size for vignette study","Direct comparison of two behaviours"],"limitations":["No validated measures of constructs","No assessment of actual pornography or marijuana use","No control for moral or mental‑health confounds","Conclusions extend beyond perceived attitudes"],"rubric_version":"2.0","raw_total":22,"max_possible":60,"pct_score":37,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/jba.1.2012.007"}},{"id":2123,"doi":"10.1177/0306624x12465271","pmid":"23174820","pmcid":null,"title":"Exploring clinical and personality characteristics of adult male internet-only child pornography offenders","authors":"Magaletta PR, Faust E, Bickart W, McLearen AM.","first_author":"Magaletta PR","journal":"International journal of offender therapy and comparative criminology","year":2014,"pub_types":["Comparative Study","Journal Article"],"keywords":["Personality","Internet","Offenders","Sexual Offenders","Child Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of incarcerated internet‑only child‑pornography offenders (n=35) versus child molesters (n=26) and male norms using the Personality Assessment Inventory.","sample_n":61,"sample_text":"n = 35 ICPOs; n = 26 child molesters; compared to male normative sample.","population":"Adult male federal inmates, convicted of internet‑only child pornography offenses.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared personality traits of men convicted only of viewing child pornography online with men who had physically molested children and with typical male norms, finding more interpersonal problems and depression among the online offenders.","clinical_takeaway":"Online child‑pornography offenders show distinct personality profiles that may inform tailored assessment and treatment in correctional settings.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Uses validated personality inventory (PAI)","Includes non‑treated comparison groups","Addresses gap in literature on ICPO clinical profiles"],"limitations":["Small, incarcerated sample limits generalisability","No power analysis or effect‑size reporting","No control for potential confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":47,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x12465271"}},{"id":2124,"doi":"10.1080/00224499.2017.1417350","pmid":"29333877","pmcid":null,"title":"What Behaviors Do Young Heterosexual Australians See in Pornography? A Cross-Sectional Study","authors":"Davis AC, Carrotte ER, Hellard ME, Lim MSC.","first_author":"Davis AC","journal":"Journal of sex research","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 517 young heterosexual Australians who reported viewing pornography in the past 12 months","sample_n":517,"sample_text":"517 participants who reported viewing pornography in the past 12 months","population":"young heterosexual Australians, ages 15‑29, community sample (online recruitment)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 517 young Australian heterosexuals, most reported frequently seeing male pleasure and dominance in porn, while women reported more frequent exposure to violence toward women. Age influenced which behaviours were most commonly observed.","clinical_takeaway":"Clinicians should note that young people encounter a wide range of gendered sexual acts in porn, which may shape expectations and attitudes.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Large sample for a niche topic","Specific, behaviour‑level coding of porn content","Sex‑balanced reporting of gender differences"],"limitations":["Convenience online recruitment – not nationally representative","Self‑report of observed content may be biased","No validated scale for measuring exposure frequency"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":20,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1417350"}},{"id":2125,"doi":"10.1080/13691058.2023.2187093","pmid":"36929822","pmcid":"PMC10505243","title":"'You have to trust their word': transmasculine experiences with sex partners and safety during the early COVID-19 outbreak","authors":"Dearolf MH, D'Angelo AB, Grov C.","first_author":"Dearolf MH","journal":"Culture, health & sexuality","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sex","Transgender","Lgbtq","Transmasculine","Covid-19"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"interviews with 20 transmasculine AFAB adults in USA, May‑June 2020; inductive thematic analysis","sample_n":20,"sample_text":"20 participants","population":"transmasculine adults (AFAB); USA; convenience sample","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 20 transmasculine adults showed that early COVID‑19 lockdowns lowered sex drive, raised health worries, and changed how they met partners, with many turning to online sex while feeling uneasy about virtual platforms and safety.","clinical_takeaway":"Clinicians should recognize pandemic‑related shifts in desire and safety concerns for transmasculine patients and support flexible, trust‑based sexual health strategies.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["In‑depth lived‑experience data","Timely focus on COVID‑19 impacts","Inductive thematic analysis"],"limitations":["Small, non‑representative sample","No quantitative measures of constructs","Findings not generalizable beyond US transmasculine AFAB adults"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2023.2187093"}},{"id":2126,"doi":"10.1080/10538712.2023.2190734","pmid":"36921125","pmcid":null,"title":"Behavioral Intentions of Bystanders to Image-Based Sexual Abuse: A Preliminary Focus Group Study with a University Student Sample","authors":"Mainwaring C, Scott AJ, Gabbert F.","first_author":"Mainwaring C","journal":"Journal of child sexual abuse","year":2023,"pub_types":["Journal Article"],"keywords":["Behavioral Intentions","Bystander Intervention","Revenge Pornography","Image-based Sexual Abuse","Non-consensual Pornography","Technology-Facilitated Sexual Abuse","Social-justice Ally"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups with 35 university students (31F, 4M); thematic analysis of intentions to intervene in image‑based sexual abuse scenarios","sample_n":35,"sample_text":"35 university students (31 females, 4 males) recruited for focus groups","population":"university students, convenience sample","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"University students discussed how they would act if they saw someone taking, sharing, or threatening to share nude images without consent. They described possible help for victims, confronting perpetrators, and involving police, but also voiced doubts about some actions.","clinical_takeaway":"None – the study provides qualitative insight, not clinical guidance.","confidence":0.6,"topic_tags":["religiosity","sexual_function","relationships"],"strengths":["Explores an understudied area (bystander intentions for IBSA)","Uses direct quotations from participants to illustrate themes","Provides actionable insights for policy and education"],"limitations":["Small, non‑representative convenience sample","No validated measurement instruments","Findings limited to self‑reported intentions, not actual behavior"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2023.2190734"}},{"id":2128,"doi":"10.1016/j.addbeh.2017.12.029","pmid":"29291508","pmcid":null,"title":"Trait and state impulsivity in males with tendency towards Internet-pornography-use disorder","authors":"Antons S, Brand M.","first_author":"Antons S","journal":"Addictive behaviors","year":2018,"pub_types":["Journal Article"],"keywords":["Craving","Inhibitory Control","Stop-signal Task","Problematic Internet Use","Problematic Sexual Behavior","Cybersex Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":63,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional correlational study with 50 heterosexual male participants; no control group","sample_n":50,"sample_text":"Fifty heterosexual males participated in this study.","population":"Adult heterosexual males (N=50)","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 50 heterosexual men, higher trait impulsivity and slower stopping when viewing pornographic pictures were linked to more severe internet‑pornography‑use problems, especially when craving was high.","clinical_takeaway":"Impulsivity and craving may mark higher risk for problematic porn use; assess these factors in clients.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence"],"strengths":["Use of behavioral task (stop-signal) for state impulsivity","Integration of trait and state measures","Focus on a specific disorder (IPD)"],"limitations":["Small convenience sample, limited generalizability","No control for key confounds (moral incongruence, masturbation, mental health)","Cross‑sectional design limits causal inference","Unclear validation of symptom‑severity questionnaire"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":9,"contrasting":0,"mentioning":74,"citing_publications":109,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2017.12.029"}},{"id":2129,"doi":"10.1002/jmri.10344","pmid":"12884335","pmcid":null,"title":"Serial MR imaging with MS-325 for evaluating female sexual arousal response: determination of intrasubject reproducibility","authors":"Maravilla KR, Cao Y, Heiman JR, Garland PA, Peterson BT, Carter WO, Weisskoff RM.","first_author":"Maravilla KR","journal":"Journal of magnetic resonance imaging : JMRI","year":2003,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"serial MR imaging of genital response in 9 healthy women, within‑subject repeatability","sample_n":9,"sample_text":"nine healthy, sexually functional women","population":"9 healthy, sexually functional adult women","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested whether MRI with a contrast agent can reliably track genital changes during sexual arousal in women. Nine participants were scanned twice while watching neutral and erotic videos; the anatomical measurements were highly consistent across sessions.","clinical_takeaway":"MRI can repeatedly capture physiological signs of female sexual arousal, suggesting a possible tool for future research on arousal disorders.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","moral_incongruence"],"strengths":["Innovative use of contrast‑enhanced MRI for genital arousal measurement","Within‑subject repeatability assessment"],"limitations":["Very small sample (N=9)","No control group or external validation","Limited statistical reporting"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":4,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":21,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/jmri.10344"}},{"id":2130,"doi":"10.1080/00224499.2017.1404959","pmid":"29244541","pmcid":null,"title":"Race and Trends in Pornography Viewership, 1973-2016: Examining the Moderating Roles of Gender and Religion","authors":"Perry SL, Schleifer C.","first_author":"Perry SL","journal":"Journal of sex research","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Repeated cross‑sectional (General Social Survey) 1973‑2016, nationally representative (N = 20,620). Logistic/linear trend models examining race, gender, and religion interactions.","sample_n":20620,"sample_text":"Nationally representative U.S. adult sample from the General Social Survey (1973‑2016).","population":"Adults in the United States responding to the GSS (probability sample).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using U.S. survey data from 1973‑2016, the study found that Black Americans, especially Black men, are more likely to watch pornography and have increased use over time, while White women’s use stayed flat. Religious attendance affected trends only for White men.","clinical_takeaway":"None – the study describes population trends, not individual clinical risk.","confidence":0.8,"topic_tags":["pornography","religiosity","gender","sexual_function"],"strengths":["Large, nationally representative sample over 43 years.","Statistical interaction analysis of race, gender, and religion.","Clear reporting of trends."],"limitations":["Pornography use measured by a single self‑report item; no validation reported.","No measurement of masturbation, mental health, or moral incongruence.","Cross‑sectional design limits causal inference."],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1404959"}},{"id":2131,"doi":"10.1007/s00115-023-01455-x","pmid":"36869097","pmcid":"PMC10160142","title":"[Legal revision of \"child pornography\" (§184b German Criminal Code)]","authors":"Dreßing H.","first_author":"Dreßing H.","journal":"Der Nervenarzt","year":2023,"pub_types":["brief-report","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10160142","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00115-023-01455-x"}},{"id":2132,"doi":"10.1093/her/cyac037","pmid":"36539329","pmcid":null,"title":"Knowledge of sexual consent as a protective factor against sexual violence perpetration among first-year college men: a moderation analysis","authors":"Schipani-McLaughlin AM, Leone RM, Salazar LF, Swahn MH, Khader S.","first_author":"Schipani-McLaughlin AM","journal":"Health education research","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"observational longitudinal cohort of first‑year college men (N=1144) using generalized linear models to test moderation effects","sample_n":1144,"sample_text":"first‑year college men (N=1144)","population":"first‑year college men (U.S. university)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among first‑year college men, better knowledge of sexual consent reduces the link between risk factors like hyper‑masculinity or binge drinking and committing sexual violence, suggesting consent education can be protective.","clinical_takeaway":"Consent education may help curb sexual violence risk in college men.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, longitudinal sample","Relevant moderation analysis","Focus on a modifiable protective factor"],"limitations":["Constructs measured with unspecified or possibly non‑validated scales","Observational design limits causal inference","Limited control for key sexual‑behavior confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/her/cyac037"}},{"id":2133,"doi":"10.1177/15579883231156660","pmid":"37002857","pmcid":"PMC10067893","title":"Online Pornography in the Philippines: Another Menace to Mental Health Amid the COVID-19 Pandemic","authors":"Cordero DA.","first_author":"Cordero DA.","journal":"American journal of men's health","year":2023,"pub_types":["Letter"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10067893","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/15579883231156660"}},{"id":2134,"doi":"10.1080/00224499.2017.1399196","pmid":"29220590","pmcid":null,"title":"Social Desirability Bias in Pornography-Related Self-Reports: The Role of Religion","authors":"Rasmussen KR, Grubbs JB, Pargament KI, Exline JJ.","first_author":"Rasmussen KR","journal":"Journal of sex research","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of Midwestern undergraduates; convenience sample; single time point","sample_n":null,"sample_text":"large online survey of undergraduates (exact N not given in abstract)","population":"undergraduate students (U.S. Midwest)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of Midwestern college students, researchers found that people who want to look good to others (high social desirability) tend to under‑report how much porn they view and think porn is more addictive, but this bias was not stronger for religious students.","clinical_takeaway":"Clinicians should consider social‑desirability bias when interpreting patients’ self‑reports of porn use, regardless of religious affiliation.","confidence":0.7,"topic_tags":["pornography","religiosity","sexual_function","measurement"],"strengths":["uses a validated social desirability scale","addresses a plausible bias in self‑report data","includes interaction analysis between religiosity and bias"],"limitations":["convenience undergraduate sample limits generalisability","pornography use measured with single‑item self‑report","no direct measurement of moral incongruence or related confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":27,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1399196"}},{"id":2135,"doi":"10.1080/00224499.2023.2178614","pmid":"36842974","pmcid":null,"title":"Sexual Behaviors among Individuals Aged 20-49 in Japan: Initial Findings from a Quasi-Representative National Survey, 2022","authors":"Ghaznavi C, Ueda P, Okuhama A, Sakamoto H.","first_author":"Ghaznavi C","journal":"Journal of sex research","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative online survey of 8,000 Japanese adults aged 20‑49, stratified and weighted by sex, age, marital status, and region","sample_n":8000,"sample_text":"8000 men and women, stratified and weighted to be nationally representative","population":"Japanese men and women ages 20‑49 (n≈8000)","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationally weighted online survey of 8,000 Japanese adults (20‑49) showed that pornography use several times a week is most common among young men, while many adults report sexual inactivity and low satisfaction with their sex lives.","clinical_takeaway":"In Japan, a minority of adults frequently use pornography and many report low sexual satisfaction; clinicians should consider cultural context when discussing sexual health.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Large, quasi‑representative sample","Weighted to national demographics","Provides baseline prevalence data for Japan"],"limitations":["Self‑report single‑item measures, no validated scales","No assessment of key confounds (moral incongruence, mental health, etc.)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":29,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2178614"}},{"id":2136,"doi":"10.1080/00224499.2017.1396571","pmid":"29185817","pmcid":null,"title":"Does Religious Attendance Moderate the Connection Between Pornography Consumption and Attitudes Toward Women?","authors":"Rasmussen KR, Kohut T.","first_author":"Rasmussen KR","journal":"Journal of sex research","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large-scale, nationally representative survey; single time‑point self‑report","sample_n":null,"sample_text":"large‑scale, nationally representative survey (exact N not given in abstract)","population":"adult general population (nationally representative sample)","country":"unspecified (likely United States based on journal context)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a national survey, people who watch porn reported slightly more egalitarian views about women, especially those who attend religious services often, suggesting that the clash between religious values and porn use may lead to more progressive attitudes.","clinical_takeaway":"None – findings are correlational and pertain to attitudes, not clinical outcomes.","confidence":0.8,"topic_tags":["pornography","gender","religiosity","sexual_function"],"strengths":["nationally representative sample","addresses a novel moderator (religious attendance)","multiple attitude outcomes examined"],"limitations":["cross‑sectional; cannot infer causality","no measurement of moral incongruence or masturbation","potential self‑report bias in pornography use"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1396571"}},{"id":2137,"doi":"10.37201/req/018.2023","pmid":"36800778","pmcid":"PMC10066913","title":"Impact of the COVID-19 pandemic on the mental health of the general population and health care workers","authors":"Bouza E, Arango C, Moreno C, Gracia D, Martín M, Pérez V, Lázaro L, Ferre F, Salazar G, Tejerina-Picado F, Navío M, Granda Revilla J, Palomo E, Gil-Monte PR.","first_author":"Bouza E","journal":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","year":2023,"pub_types":["review-article","Review","Journal Article"],"keywords":["Stress","Depression","Anxiety","Adolescence","Mental health","Suicide","Autism","Healthcare","Covid-19","Sars-cov-2"],"is_oa":true,"oa_url":"https://seq.es/wp-content/uploads/2023/02/bouza21feb2023.pdf","cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review summarising published studies; no explicit systematic methodology, no data extraction, no risk‑of‑bias assessment","sample_n":null,"sample_text":"Not applicable – review article","population":"general population and healthcare workers (broad)","country":"Spain (journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review summarises research on how the COVID‑19 pandemic affected mental health, noting that pornography use rose during lockdowns, alongside other substance and behavioural changes.","clinical_takeaway":"None – the article does not provide direct clinical guidance on pornography use or sexual health.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Broad overview of pandemic‑related mental‑health impacts","Includes both general and healthcare worker populations"],"limitations":["Narrative rather than systematic review; no explicit methods","No original data; unable to assess measurement quality","Limited detail on how pornography use was evaluated"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.37201/req/018.2023"}},{"id":2138,"doi":"10.1007/s11042-023-14437-7","pmid":"36846526","pmcid":"PMC9942052","title":"Obscene image detection using transfer learning and feature fusion","authors":"Samal S, Nayak R, Jena S, Balabantaray BK.","first_author":"Samal S","journal":"Multimedia tools and applications","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["TL","Ffp","Deep Learning","Obscene Detection","Pix-2-Pix Gan"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9942052","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Computer‑vision model development and validation on image datasets; no human participants.","sample_n":null,"sample_text":"Images from benchmark datasets (NPDI, Pornography‑2k) and a GAN‑generated obscene image set (GGOI).","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors present a deep‑learning system that combines pre‑trained networks to detect pornographic images, reporting around 98 % accuracy on standard test sets.","clinical_takeaway":"None – the study evaluates image classification, not human sexual health or behaviour.","confidence":0.7,"topic_tags":["pornography"],"strengths":["Uses transfer learning to mitigate limited data","Feature‑fusion combines complementary representations","Achieves high reported performance on multiple benchmarks"],"limitations":["No human participants – limited relevance to sexual‑health outcomes","Lacks external validation on real‑world, diverse content","No confidence intervals or statistical significance testing"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":5,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11042-023-14437-7"}},{"id":2139,"doi":"10.1177/0886260517743549","pmid":"29294993","pmcid":null,"title":"Crossing the Threshold From Porn Use to Porn Problem: Frequency and Modality of Porn Use as Predictors of Sexually Coercive Behaviors","authors":"Marshall EA, Miller HA, Bouffard JA.","first_author":"Marshall EA","journal":"Journal of interpersonal violence","year":2021,"pub_types":["Journal Article"],"keywords":["Sexual Aggression","Sexual Coercion","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 463 college males","sample_n":463,"sample_text":"463 college males","population":"college males (N=463)","country":"unspecified (likely USA based on journal and sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 463 college men, higher pornography use and especially using multiple types of porn were linked to a greater chance of reporting sexually coercive acts. The biggest jump in risk occurred when men moved from one to two types of pornography.","clinical_takeaway":"Do not infer that porn causes sexual aggression; the association may reflect unmeasured factors.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a single‑site survey","Introduces novel “modality” variable","Threshold analysis adds nuance"],"limitations":["Cross‑sectional, cannot establish causality","Self‑report measures, likely unvalidated","Key confounds (moral beliefs, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":34,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260517743549"}},{"id":2140,"doi":"10.3390/ijerph20043468","pmid":"36834163","pmcid":"PMC9967995","title":"Influence of Selected Sociodemographic and Cultural Factors on the Age of Sexual Initiation of Students from Polish Universities","authors":"Stokłosa M, Stokłosa I, Więckiewicz G, Porwolik M, Bugajski M, Męcik-Kronenberg T, Pudlo R, Gorczyca P, Piegza M.","first_author":"Stokłosa M","journal":"International journal of environmental research and public health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Students","Sexual Initiation","Sexual Education"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/20/4/3468/pdf?version=1676531081","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 7528 Polish university students using an original 31‑item questionnaire; logistic and linear regression analyses performed.","sample_n":7528,"sample_text":"Students from Polish universities; 5824 had initiated sexual activity.","population":"students from Polish universities (convenience sample)","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 7,000 Polish university students found that religion, substance use, family communication and the age of first exposure to pornography were linked to when young people first have sex. The authors suggest better sexual education is needed.","clinical_takeaway":"Improving sexual education and open parent‑child communication may influence the timing of sexual initiation.","confidence":0.78,"topic_tags":["sexual_function","pornography"],"strengths":["Large sample size (over 7,000 participants)","Use of multivariate regression analyses","Inclusion of multiple sociodemographic variables"],"limitations":["Original questionnaire not validated","Cross‑sectional design cannot infer causality","Convenience sample of university students limits generalisability","Key confounds (moral incongruence, masturbation, mental‑health, trauma) not assessed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph20043468"}},{"id":2141,"doi":"10.1080/13218719.2022.2148305","pmid":"38455265","pmcid":"PMC10916919","title":"Technical profiles of child sexual exploitation material offenders","authors":"Steel CMS, Newman E, O'Rourke S, Quayle E.","first_author":"Steel CMS","journal":"Psychiatry, psychology, and law : an interdisciplinary journal of the Australian and New Zealand Association of Psychiatry, Psychology and Law","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sociability","Child Pornography","Child Sexual Exploitation Material","Technophilia","Technical Profiles"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online survey comparing convicted CSEM offenders (N=78) with non‑offender reference group (N=254); self‑rated sociability, technical ability, technophilia.","sample_n":332,"sample_text":"78 offenders, 254 non‑offenders","population":"English‑speaking adults; offender sample from criminal convictions, reference sample recruited online.","country":"England (implicit from English‑speaking adults, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 78 convicted child‑sexual‑exploitation material offenders compared with 254 non‑offenders found offenders were slightly less sociable and not more technically skilled than the general population, challenging the view that they are tech‑savvy loners.","clinical_takeaway":"Offender profiles are not uniformly marked by high technical ability; interventions should not assume superior tech skills.","confidence":0.7,"topic_tags":["csbd"],"strengths":["Large non‑offender comparison group","Addresses a gap in quantitative profiling of CSEM offenders","Clear operational definitions of sociability, technical ability, technophilia"],"limitations":["Self‑report measures likely lack validation","Offender sample may not represent all CSEM perpetrators","No adjustment for demographic or psychosocial confounds"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13218719.2022.2148305"}},{"id":2142,"doi":"10.1037//0021-843x.102.4.525","pmid":"8282920","pmcid":null,"title":"Differential effects of a misattribution manipulation on sexually functional and dysfunctional men","authors":"Cranston-Cuebas MA, Barlow DH, Mitchell W, Athanasiou R.","first_author":"Cranston-Cuebas MA","journal":"Journal of abnormal psychology","year":1993,"pub_types":["Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized, double‑blind placebo manipulation with within‑subject conditions; 20 male participants (10 erectile‑functioning, 10 erectile‑dysfunctional); physiological erectile response measured.","sample_n":20,"sample_text":"Ten sexually functional and 10 dysfunctional men","population":"adult men, middle‑aged, functional vs. erectile‑dysfunctional","country":"USA (assumed from journal, not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a small experiment, men watched erotic films after taking pills they were told would boost, reduce, or have no effect on erections. Men with normal erectile function showed a paradoxical increase when told the pill would reduce erections, while men with erectile problems showed the opposite pattern. The authors suggest these opposite placebo responses reflect differences in bodily awareness and anxiety.","clinical_takeaway":"Placebo expectations can affect erectile response differently in men with and without erectile dysfunction; clinicians should consider patients' anxiety and interoceptive awareness when addressing performance concerns.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["experimental placebo manipulation","within‑subject design controls individual differences","objective physiological outcome"],"limitations":["tiny sample (N=20)","no power justification or effect‑size reporting","limited generalisability (clinic/volunteer men only)","no control for mood, anxiety or other confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0021-843x.102.4.525"}},{"id":2143,"doi":"10.1111/1467-9566.13624","pmid":"36762929","pmcid":null,"title":"The social diagnoses of digital addictions: Technophobic ambivalences, the limits of the natural and imperatives of self-governance in the information age","authors":"Taylor K.","first_author":"Taylor K.","journal":"Sociology of health & illness","year":2024,"pub_types":["Journal Article"],"keywords":["Addiction","Media Analysis","Digital Addiction","Sociology Of Dignosis","Social Diagnosis"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"None (the article is a theoretical commentary without empirical participants)","population":"none","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that ‘digital addictions’ like porn use are better understood as social diagnoses reflecting cultural anxieties, rather than as distinct medical illnesses.","clinical_takeaway":"None - the paper offers a sociological critique, not clinical guidance.","confidence":0.6,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Provides a broad sociological perspective on digital addiction discourse","Challenges individualizing frameworks","Integrates cultural and historical contexts"],"limitations":["No empirical data or measurement of constructs","No assessment of confounding factors","Interpretations cannot be tested directly"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1467-9566.13624"}},{"id":2144,"doi":"10.1007/s10508-023-02547-0","pmid":"36752952","pmcid":null,"title":"Examining the Roles of Prior Victimization, Perpetrator Identity and the Correlates of Female Rape Myth Acceptance Among Indian Females","authors":"Das I, Bhattacharjee A.","first_author":"Das I","journal":"Archives of sexual behavior","year":2023,"pub_types":["Journal Article"],"keywords":["Rape","Sexual Abuse","Rape Myth Acceptance","Perpetrator Identity","History Of Victimization"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 500 literate Indian women, stepwise regression analysis","sample_n":500,"sample_text":"500 literate women from India","population":"adult women, India, mean age 28.9, literate","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 500 Indian women, higher sexual desire, rejection sensitivity, loneliness and neuroticism predicted greater endorsement of rape myths, while online pornography use did not. Prior victimisation also related to higher myth acceptance.","clinical_takeaway":"Higher distress‑related traits may increase susceptibility to rape‑myth attitudes; clinicians should consider these factors when addressing victim‑supportive beliefs.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Large sample (N=500)","Examines multiple psychological correlates"],"limitations":["Cross‑sectional design limits causality","Unclear whether scales are validated","Key sexual‑health confounds (e.g., pornography, moral attitudes) not addressed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02547-0"}},{"id":2145,"doi":"10.1016/j.heliyon.2023.e13410","pmid":"36820035","pmcid":"PMC9937883","title":"Agonistic approaches to sexuality: A critical analysis of the conservative mindset","authors":"Airaksinen T.","first_author":"Airaksinen T.","journal":"Heliyon","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Conservatism","Imagination","Icd","Liberalism","Sex Work","Dsm","Bdsm","Irony","Pornography","Deviant Sexuality","Arousal De Se","Fear Of Sexuality","Vanilla Sex"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.heliyon.2023.e13410","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"N/A","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article presents a philosophical critique of why conservative people react anxiously to sexual ideas they neither desire nor see as harmful, proposing seven conceptual principles to explain this mindset.","clinical_takeaway":"None - not clinically applicable.","confidence":0.7,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Offers a novel theoretical framework","Integrates diverse philosophical concepts"],"limitations":["No empirical data or measurement","Lacks operational definitions of key constructs","No assessment of confounding variables"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.heliyon.2023.e13410"}},{"id":2146,"doi":"10.36131/cnfioritieditore20230102","pmid":"36936627","pmcid":"PMC10016101","title":"Internet Use Amongst Professional Tennis Players","authors":"Marazziti D, Parra E, Arone A, Carbone MG, Del Prete L, Fantasia S, Palermo S, Dell'Osso L.","first_author":"Marazziti D","journal":"Clinical neuropsychiatry","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Tennis","Social Media","Problematic Internet Use","Tennis Players","Professional Tennis Players"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional convenience sample of 25 professional tennis players (current and retired) compared to 25 matched healthy controls; data collected at two events; no longitudinal or experimental component.","sample_n":50,"sample_text":"Twenty‑five professional tennis players evaluated during two events, matched to an equal number of healthy subjects.","population":"professional tennis players (current and retired) and non‑athlete controls","country":"European countries (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed 25 professional tennis players and 25 non‑athlete controls about their internet habits, finding that current players scored higher on overall problematic internet use and lower on pornography‑related scores compared with retired players. The authors suggest tennis players might be more vulnerable to internet‑related problems.","clinical_takeaway":"No direct clinical guidance; findings are preliminary and limited by small, non‑validated measures.","confidence":0.7,"topic_tags":["pornography","sexual_function","moral_incongruence","masturbation"],"strengths":["Attempts to assess PIU in a rarely studied athletic population","Includes a control group matched on basic demographics"],"limitations":["Instrument (QUNT) not validated; unclear how 'Addiction to pornography' is defined","Small, convenience sample; limited generalisability","No measurement or control of key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.36131/cnfioritieditore20230102"}},{"id":2147,"doi":"10.1093/jsxmed/qdac037","pmid":"36763915","pmcid":null,"title":"Female genitalia in pornography: a source of labiaplasty trends?","authors":"Dubinskaya A, Anger JT.","first_author":"Dubinskaya A","journal":"The journal of sexual medicine","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdac037"}},{"id":2148,"doi":"10.3390/jcm12031112","pmid":"36769759","pmcid":"PMC9918233","title":"Female Sexual Dysfunction in Association with Sexual History, Sexual Abuse and Satisfaction: A Cross-Sectional Study in Hungary","authors":"Erdős C, Kelemen O, Pócs D, Horváth E, Dudás N, Papp A, Paulik E.","first_author":"Erdős C","journal":"Journal of clinical medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Satisfaction","Sexual Abuse","Dsm-5","Female Sexual Dysfunction","Sexual History","Sexual Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9918233","cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online questionnaire among 5,942 Hungarian women aged 18‑35","sample_n":5942,"sample_text":"n = 5,942 women (18‑35 y) recruited via online questionnaire","population":"young adult women, Hungary, convenience online sample","country":"Hungary","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A large Hungarian survey of women aged 18‑35 found that about one‑fifth met criteria for female sexual dysfunction. Dysfunction was linked to earlier sexual experiences, exposure to porn, sexual abuse, lower body satisfaction and self‑esteem.","clinical_takeaway":"Screen for past abuse and self‑esteem issues when assessing women with sexual dysfunction.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size","Use of DSM‑5 criteria","Inclusion of sexual abuse history"],"limitations":["Cross‑sectional, cannot infer causality","Convenience online sample, possible selection bias","Limited control of key confounds (morality, masturbation, mental health)","Reliance on self‑report without clinical validation"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jcm12031112"}},{"id":2149,"doi":"10.1080/0092623x.2017.1377131","pmid":"28885897","pmcid":null,"title":"Personal Pornography Viewing and Sexual Satisfaction: A Quadratic Analysis","authors":"Wright PJ, Bridges AJ, Sun C, Ezzell MB, Johnson JA.","first_author":"Wright PJ","journal":"Journal of sex & marital therapy","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of ~1,500 U.S. adults, online/unspecified sampling","sample_n":1500,"sample_text":"approximately 1,500 U.S. adults","population":"U.S. adults (both genders, varying relationship status and religiosity)","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of about 1,500 U.S. adults, higher frequency of personal pornography viewing was linked to lower sexual satisfaction, especially once viewing reached once a month, with the relationship curving downward rather than staying linear.","clinical_takeaway":"Frequent pornography use (≥ once/month) may be associated with reduced sexual satisfaction; clinicians should consider viewing frequency in sexual health discussions.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size","Tests curvilinear relationship","Examines moderators (gender, relationship, religiosity)"],"limitations":["Self‑report measures","No separation of masturbation from porn use","Cross‑sectional, cannot infer causality","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":24,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2017.1377131"}},{"id":2150,"doi":"10.1023/a:1018733420467","pmid":"10097801","pmcid":null,"title":"Neuroanatomical correlates of visually evoked sexual arousal in human males","authors":"Stoléru S, Grégoire MC, Gérard D, Decety J, Lafarge E, Cinotti L, Lavenne F, Le Bars D, Vernet-Maury E, Rada H, Collet C, Mazoyer B, Forest MG, Magnin F, Spira A, Comar D.","first_author":"Stoléru S","journal":"Archives of sexual behavior","year":1999,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":249,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Within‑subject PET study of eight healthy males viewing sexual, neutral, and humorous clips; six PET measurements per participant.","sample_n":8,"sample_text":"Eight male subjects","population":"Adult healthy males (N=8)","country":"France (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In eight healthy men, PET scans showed that viewing explicit sexual videos activated specific brain regions, especially in the temporal and paralimbic areas, and these activations were linked to testosterone levels.","clinical_takeaway":"None – the study maps normal brain responses to visual sexual cues and does not inform clinical practice.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["First PET study of visual sexual arousal in males","Use of objective physiological imaging","Correlation with testosterone levels"],"limitations":["Very small sample (N=8)","No control for psychological or relational confounds","Limited generalizability to broader populations"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":5,"statistics":4,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":7,"contrasting":0,"mentioning":98,"citing_publications":407,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1018733420467"}},{"id":2151,"doi":"10.1080/00224499.2017.1368977","pmid":"28972398","pmcid":null,"title":"Exploring Trajectories of Pornography Use Through Adolescence and Emerging Adulthood","authors":"Willoughby BJ, Young-Petersen B, Leonhardt ND.","first_author":"Willoughby BJ","journal":"Journal of sex research","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective self‑report survey (N=908) analysed with latent mixture models to identify pornography‑use trajectories across adolescence and emerging adulthood.","sample_n":908,"sample_text":"908 adults from the United States","population":"United States adults (mixed gender, aged 18+)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Using a survey of 908 U.S. adults, the authors traced how pornography use changes from teenage years into the 20s. They found distinct patterns—some never used, some used consistently, and some experimented then reduced use. Consistent use was linked to slightly lower life satisfaction and higher current use, especially for men and single adults.","clinical_takeaway":"Consistent pornography use may be associated with modestly lower life satisfaction, but causality is unclear.","confidence":0.85,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Large community sample (N≈900)","Use of latent mixture modelling to identify patterns","Inclusion of both adolescent and emerging‑adult periods"],"limitations":["Retrospective self‑report; recall bias","No validated pornography‑use scales reported","Key confounds (moral incongruence, masturbation, trauma) not measured","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1368977"}},{"id":2152,"doi":"10.1016/j.jmh.2023.100154","pmid":"36794095","pmcid":"PMC9922806","title":"The hidden gender-based violence and associated factors among marginalised women in Southern Ethiopia","authors":"Kassa ZY, Kassa ZY, Hadra N, Hailu D.","first_author":"Kassa ZY","journal":"Journal of migration and health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Violence","Ethiopia","Aor, Adjusted Odds Ratio","Sdg, Sustainable Development Goals","Hidden Gender-Based","Edhs, Ethiopian Health Demography Survey","Snnprs, Southern, Nations, Nationalities And Peoples Regional State"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9922806","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Institutional based cross‑sectional survey of housemaid night students using stratified two‑stage cluster sampling; logistic regression for determinants.","sample_n":null,"sample_text":"Not specified in abstract","population":"Housemaid night students in Hawassa city, Southern Ethiopia (sample size not reported in abstract)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2023 Ethiopian survey found that about one‑fifth of housemaid night students experienced domestic violence, with higher risk linked to larger employer families, substance use, and exposure to pornography in the employer’s home.","clinical_takeaway":"Violence prevention programs for domestic workers should consider employer substance use and pornography exposure as risk factors.","confidence":0.6,"topic_tags":["gender","sexual_function","csbd","moral_incongruence","pornography"],"strengths":["Cluster sampling improves representativeness within target group","Adjusted odds ratios with confidence intervals reported"],"limitations":["Cross‑sectional design cannot infer causality","Domestic violence measured with unspecified/likely unvalidated items","No assessment of key sexual‑health confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":2,"mentioning":10,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jmh.2023.100154"}},{"id":2153,"doi":"10.1016/j.addbeh.2023.107626","pmid":"36701907","pmcid":null,"title":"Engineered highs: Reward variability and frequency as potential prerequisites of behavioural addiction","authors":"Clark L, Zack M.","first_author":"Clark L","journal":"Addictive behaviors","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Dopamine","Uncertainty","Reinforcement","Reward","Gambling","Variable Ratio"],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"The article is a theoretical review that discusses reward variability across several digital activities, including online pornography, without presenting original empirical data.","sample_n":null,"sample_text":"n/a","population":"n/a","country":"n/a","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors argue that unpredictable, variable rewards—like those in gambling, gaming, social media, shopping, and online pornography—can make these activities habit‑forming by exploiting brain systems that respond to uncertainty.","clinical_takeaway":"None – the paper offers theory only, no direct guidance for clinicians.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Integrates learning theory with reward‑variability literature","Broad coverage of multiple digital platforms"],"limitations":["No original data; purely speculative","Does not empirically test pornography‑specific constructs","Lacks measurement of key confounds (moral incongruence, masturbation, mental health)"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":29,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2023.107626"}},{"id":2154,"doi":"10.1080/00224499.2017.1364337","pmid":"28933950","pmcid":null,"title":"Women's Experiences of Pornography: A Systematic Review of Research Using Qualitative Methods","authors":"Ashton S, McDonald K, Kirkman M.","first_author":"Ashton S","journal":"Journal of sex research","year":2018,"pub_types":["Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of qualitative studies (22 articles) using thematic analysis","sample_n":null,"sample_text":"22 qualitative studies (sample sizes not aggregated)","population":"women participants in primary qualitative studies (varied samples)","country":"unspecified (multiple studies)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review gathered 22 qualitative studies to explore how women experience pornography. It found that women’s encounters are varied and often contradictory, influencing self‑identity, arousal, and relationships, while also clashing with personal values.","clinical_takeaway":"Clinicians should recognize that women’s reactions to pornography are highly individual and may involve complex feelings of conflict and pleasure.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender","relationships"],"strengths":["First systematic synthesis of qualitative work on women’s pornography experiences","Transparent search strategy across five databases","Thematic analysis provides rich, nuanced insights"],"limitations":["Primary studies often lack clear operational definitions of pornography","Limited attention to potential confounds (e.g., moral incongruence, mental health)","No quantitative assessment of study quality (AMSTAR‑2 not reported)","Findings may be Western‑centric and not culturally generalizable"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":46,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1364337"}},{"id":2155,"doi":"10.1177/00258172221141250","pmid":"36655337","pmcid":null,"title":"Asphyxiophilic death due to masochistic behaviour in a video game addict teen: A case report and reviews","authors":"Singh BK, Maurya PK, Baveja VS, Tomar JS, Chauhan M.","first_author":"Singh BK","journal":"The Medico-legal journal","year":2025,"pub_types":["Journal Article","Case Reports"],"keywords":["Paraphilia","Asphyxiophilia","Internet Gaming Disorder","Autoerotic","Masochistic"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single adolescent death linked to video‑gaming and masochistic behavior; no systematic data collection","sample_n":1,"sample_text":"single case","population":"one male adolescent, likely non‑representative","country":"India (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A teenage video‑game addict performed a self‑bondage act that caused asphyxiation and death. The report describes the scene and autopsy findings, suggesting the death resulted from asphyxiophilic masochism rather than pornography use.","clinical_takeaway":"No direct clinical guidance; the case illustrates extreme risks of combining self‑bondage with gaming but lacks generalizable evidence.","confidence":0.42,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["Detailed forensic description","Highlights rare fatal outcome","Adds to case literature on asphyxiophilia"],"limitations":["Single case, no systematic data","No validated measures of gaming addiction","No control for confounding factors","Speculative causal links"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00258172221141250"}},{"id":2156,"doi":"10.1891/0886-6708.6.1.75","pmid":"1859808","pmcid":null,"title":"History of child sexual abuse and adult sexual fantasies","authors":"Gold SR.","first_author":"Gold SR.","journal":"Violence and victims","year":1991,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative survey of women with/without childhood sexual abuse history; single time‑point questionnaire.","sample_n":null,"sample_text":"Women with a history of abuse vs. women without; recruitment method not described","population":"Adult women (sample size not reported in abstract)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Women who experienced sexual abuse as children reported more forceful, explicit, and control‑oriented sexual fantasies than women without such abuse, suggesting early trauma may shape later fantasy content.","clinical_takeaway":"History of childhood sexual abuse may influence adult sexual fantasy themes; clinicians should consider trauma background when discussing fantasies.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["Clear hypothesis linking childhood abuse to adult fantasy content","Direct comparison between abuse and non‑abuse groups"],"limitations":["Unclear whether fantasy questionnaire is validated","No control for moral, mental‑health or relationship variables","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1891/0886-6708.6.1.75"}},{"id":2157,"doi":"10.2196/44175","pmid":"36633900","pmcid":"PMC9893884","title":"Sampling Sexual and Gender Minority Youth With UnACoRN (Understanding Affirming Communities, Relationships, and Networks): Lessons From a Web-Based Survey","authors":"Delgado-Ron JA, Jeyabalan T, Watt S, Black S, Gumprich M, Salway T.","first_author":"Delgado-Ron JA","journal":"Journal of medical Internet research","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Adolescence","Health Inequality","Sexual Minority Youth","Same-sex Attraction","Sexual Orientation","Advertisement","Web-based Survey","Transgender Persons","Conversion Therapy","Online Recruitment","Transgender Youth","Gender Minority","Surveys And Questionnaires","Sexual And Gender Minorities","Social Media Recruitment"],"is_oa":true,"oa_url":"https://doi.org/10.2196/44175","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Web‑based anonymous survey of 9,679 sexual‑ and gender‑minority youth recruited via multiple online and offline channels; descriptive analysis of recruitment cost and reach.","sample_n":9679,"sample_text":"9679 mostly SGM respondents","population":"Sexual‑ and gender‑minority youth (≤18 y) in US and Canada; convenience sample via social media, ads, and a pornography website.","country":"United States; Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors tested how different online and offline ads (e.g., Instagram, Pornhub, bus ads) recruited sexual‑ and gender‑minority youth for a web survey. Instagram was the cheapest way to get completed surveys, while Pornhub and bus ads were far less efficient.","clinical_takeaway":"None – the paper provides methodological insight on recruiting SGM youth, not clinical guidance.","confidence":0.8,"topic_tags":["religiosity","sexual_function","masturbation","gender"],"strengths":["Very large sample size for recruitment research","Detailed cost‑effectiveness analysis across platforms","Comparison of geographic distribution to census data"],"limitations":["Convenience sampling; not probabilistic","No assessment of key sexuality‑related confounds","Descriptive statistics only; no inferential testing"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/44175"}},{"id":2158,"doi":"10.1186/s12978-017-0376-4","pmid":"28877736","pmcid":"PMC5588747","title":"Prevalence and determinants of risky sexual practice in Ethiopia: Systematic review and Meta-analysis","authors":"Muche AA, Kassa GM, Berhe AK, Fekadu GA.","first_author":"Muche AA","journal":"Reproductive health","year":2017,"pub_types":["Meta-Analysis","Systematic Review","review-article","Journal Article"],"keywords":["Gender","Meta-analysis","Ethiopia","Substance Use","Systemic Review","Peer Pressure","Pornography","Risky Sexual Practices"],"is_oa":true,"oa_url":"https://reproductive-health-journal.biomedcentral.com/track/pdf/10.1186/s12978-017-0376-4","cited_by_count":48,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"systematic review and meta‑analysis of 31 cross‑sectional studies (N=43,695) reporting prevalence and odds ratios for risky sexual practice in Ethiopia","sample_n":43695,"sample_text":"31 studies with 43,695 participants","population":"Ethiopian men and women of reproductive age (study‑level samples)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A review of 31 Ethiopian studies found that about 43% of people engage in risky sexual behaviours. Viewing porn, being male, using substances and feeling peer pressure were linked to higher odds of such behaviours.","clinical_takeaway":"Viewing pornography is associated with higher risky‑sex odds, but causality is unclear; clinicians should consider broader psychosocial factors.","confidence":0.7,"topic_tags":["pornography","religiosity"],"strengths":["large pooled sample size","PRISMA‑guided systematic methodology","quantitative synthesis with CIs and heterogeneity assessment"],"limitations":["primary studies largely cross‑sectional, limiting causal inference","no control for moral incongruence, mental health, or trauma","potential publication bias not addressed"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":10,"contrasting":2,"mentioning":56,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-017-0376-4"}},{"id":2159,"doi":"10.1080/00918369.2017.1364568","pmid":"28820665","pmcid":null,"title":"Size Matters: Penis Size and Sexual Position in Gay Porn Profiles","authors":"Brennan J.","first_author":"Brennan J.","journal":"Journal of homosexuality","year":2018,"pub_types":["Journal Article"],"keywords":["Homosexuality","Textual Analysis","Sexual Scripts","Penis Size","Sex Roles","Gay Pornography","Porn Profiles","Sexual Position","Top/bottom"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Content analysis of 6,900 performer profiles from 10 gay porn sites; quantitative description of disclosed penis size and sexual position; qualitative textual reading.","sample_n":6900,"sample_text":"Profiles of performers from 10 commercial gay pornography websites","population":"Performer profiles (publicly listed on porn websites)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined over 6,900 performer profiles from top gay porn sites and found that smaller reported penis sizes were linked to receptive (bottom) roles, while larger sizes were linked to penetrative (top) roles, reflecting marketing narratives about fantasy and body size.","clinical_takeaway":"None – the research describes online marketing patterns, not health effects.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample of profiles (N>6000)","Mixed quantitative‑qualitative approach","Clear visual presentation of findings"],"limitations":["Reliance on self‑disclosed, unverified penis size","No measurement of actual sexual behavior","Cross‑sectional, descriptive only"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2017.1364568"}},{"id":2160,"doi":"10.3389/fpubh.2022.935625","pmid":"36699940","pmcid":"PMC9868670","title":"COVID-19, mobility restriction, and sexual behavior among a cohort of people of reproductive age: Nigeria","authors":"Adekola PO, Ugwu FC, Amoo EO, Olawole-Isaac A, Cirella GT.","first_author":"Adekola PO","journal":"Frontiers in public health","year":2022,"pub_types":["brief-report","Journal Article"],"keywords":["Social Development","Socio-demographics","Owerri","Sexual Well-being","South-east","Lockdown","Covid Era"],"is_oa":true,"oa_url":"https://doi.org/10.3389/fpubh.2022.935625","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional quantitative survey of 425 participants selected randomly within Owerri, Nigeria","sample_n":425,"sample_text":"425 interviewees randomly chosen among people of reproductive age","population":"people of reproductive age in Owerri, Nigeria","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2022 Nigerian survey of 425 adults found that during COVID‑19 lockdowns, people were about twice as likely to engage in frequent sex‑chat activity, and that age and marital status were linked to difficulty staying abstinent.","clinical_takeaway":"Lockdowns may change sexual communication patterns, but the study does not provide actionable guidance for clinicians.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑city survey","Random selection within the target population","Multivariate logistic regression analysis"],"limitations":["Reliance on ad‑hoc self‑report items; no validated sexuality scales","Cross‑sectional design cannot infer causality","Key confounders (moral incongruence, mental health, partner effects) not measured","Interpretation suggests policy changes beyond the evidence"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2022.935625"}},{"id":2161,"doi":null,"pmid":"37642456","pmcid":null,"title":"The Teenage Brain: Under Construction","authors":"American College of Pediatricians.","first_author":"American College of Pediatricians.","journal":"Issues in law & medicine","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary/editorial without original data; arguments based on narrative review of existing literature.","sample_n":null,"sample_text":"Not applicable – no empirical sample.","population":"Adolescents (general reference, no specific sample)","country":"United States (American College of Pediatricians)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","causal_from_correlational"],"stance":"strongly-opposes","citation_value":"background","plain_summary":"The article warns that pornography and other high‑risk activities may harm teen brain development, citing vague evidence and urging parents to monitor and guide their children.","clinical_takeaway":"None – the piece offers no empirically supported guidance for clinicians.","confidence":0.7,"topic_tags":["adolescents","pornography","sexual_function","neuroscience","prevalence"],"strengths":["Touches on multiple adolescent risk behaviors","Calls for parental involvement"],"limitations":["No empirical data presented","Lacks operational definitions of ‘addiction’","No systematic review methodology"],"rubric_version":"2.0","raw_total":7,"max_possible":60,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":1,"interpretation":2}},"scite":null},{"id":2162,"doi":"10.2105/ajph.2022.307146","pmid":"36516393","pmcid":null,"title":"Pornography Use and Public Health: Examining the Importance of Online Sexual Behavior in the Health Sciences","authors":"Grubbs JB, Floyd CG, Kraus SW.","first_author":"Grubbs JB","journal":"American journal of public health","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2105/ajph.2022.307146"}},{"id":2163,"doi":"10.17116/jnevro202312301141","pmid":"36719118","pmcid":null,"title":"[Behavioral (non-chemical) addictions and COVID-19]","authors":"Egorov AY.","first_author":"Egorov AY.","journal":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","year":2023,"pub_types":["Journal Article","English Abstract"],"keywords":["Gambling","Food Addiction","Internet Addiction","Gaming","Cybersex","Covid-19","Behavioral (Non-chemical) Addictions"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"rus","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of published studies; no systematic search or risk‑of‑bias assessment; no new empirical data","sample_n":null,"sample_text":"Not applicable – review article","population":"general human population (adolescents, adults) inferred from cited literature","country":"Russia (journal location)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how the COVID‑19 pandemic affected various non‑drug addictions, noting that internet use and some behaviours (gaming, cybersex, food‑related eating) rose, while gambling showed mixed trends. It links increased food‑related problems to depression and anxiety.","clinical_takeaway":"Clinicians should be aware that pandemic‑related stress may exacerbate internet‑related and eating‑related problems, but evidence is mixed and largely observational.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Broad overview of multiple behavioral addictions during COVID‑19","Includes recent longitudinal observations for some domains"],"limitations":["Narrative (non‑systematic) review; no explicit search strategy","No assessment of study quality or bias","Relies on heterogeneous sources; may overstate prevalence changes"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.17116/jnevro202312301141"}},{"id":2164,"doi":"10.1016/j.chb.2022.107641","pmid":"40503474","pmcid":"PMC12158432","title":"Coercive-sexting: Predicting adolescent initial exposure to electronic coercive sexual dating violence","authors":"Thulin EJ, Kernsmith P, Fleming PJ, Heinze JE, Temple J, Smith-Darden J.","first_author":"Thulin EJ","journal":"Computers in human behavior","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Adolescent Dating","Cyber Dating Violence","Electronic Coercion","Predicting Perpetration;survival Analysis","Coercive Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort with 4‑year follow‑up (N≈1000), survival analysis","sample_n":1000,"sample_text":"total n = 1000 adolescents split into two age cohorts (12‑15 and 15‑18)","population":"adolescents aged 12‑18 from the Strengthening Healthy Adolescent Relationships and Environments Study","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A four‑year study of 1,000 teens found that the chance of first experiencing coercive sexting rises sharply from age 13 to 18. Early predictors include heavy electronic use, dating activity, online harassment and prior pornography viewing, while later risk is linked to childhood adversity and dating involvement.","clinical_takeaway":"Early screening for high electronic use, dating aggression and ACEs may help prevent coercive sexting among adolescents.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, longitudinal community sample","Appropriate survival‑analysis methods with hazard ratios and CIs","Inclusion of ACEs and dating‑behavior covariates"],"limitations":["Reliance on self‑report, likely single‑item measures for pornography use and coercion","No assessment of moral incongruence or masturbation as separate factors","Unclear whether mental‑health variables were controlled"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chb.2022.107641"}},{"id":2165,"doi":"10.4103/jehp.jehp_610_22","pmid":"36824073","pmcid":"PMC9942125","title":"Prevalence of internet addiction and its impact on selected psychological parameters among UG nursing students","authors":"Parmar JS, Kumbhakar S.","first_author":"Parmar JS","journal":"Journal of education and health promotion","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Insomnia","Internet Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9942125","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 385 undergraduate nursing students selected by purposive sampling; self‑report questionnaires on internet use, depression and insomnia.","sample_n":385,"sample_text":"385 college students selected by purposive sampling technique","population":"UG nursing students (India?)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 385 nursing students found that higher scores on an internet‑addiction questionnaire were linked to more depressive symptoms and insomnia. The study noted that many students used the internet for social media, gaming, entertainment, news and pornography.","clinical_takeaway":"Higher internet‑addiction scores are associated with worse mood and sleep, but causality is unclear; screen for depression and insomnia in heavy internet users.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Validated questionnaires used","Reasonable sample size for prevalence estimate"],"limitations":["Purposive, non‑random sample of nursing students","Cross‑sectional; cannot infer causality","No control for moral or sexual‑behavior confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/jehp.jehp_610_22"}},{"id":2167,"doi":"10.1080/00224499.2017.1347912","pmid":"28753385","pmcid":null,"title":"Is the Relationship Between Pornography Consumption Frequency and Lower Sexual Satisfaction Curvilinear? Results From England and Germany","authors":"Wright PJ, Steffen NJ, Sun C.","first_author":"Wright PJ","journal":"Journal of sex research","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey data from two national samples of heterosexual adults in England and Germany; cross‑sectional analysis with quadratic regression.","sample_n":null,"sample_text":"Not reported in abstract","population":"heterosexual adults (England, Germany)","country":"England; Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Two large surveys from England and Germany found that higher porn use is linked to lower sexual satisfaction, but only after about once‑a‑month use; lower frequencies showed no effect.","clinical_takeaway":"Low‑frequency porn use may not harm sexual satisfaction; concerns arise with more frequent use.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large‑scale data from two countries","Explicit test of non‑linear relationship","Acknowledges limits of causal inference"],"limitations":["Reliance on self‑report single‑item measures","No control for moral, relational, or mental‑health confounds","Sample size and power not disclosed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":17,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1347912"}},{"id":2168,"doi":"10.3390/ijerph192417040","pmid":"36554921","pmcid":"PMC9778851","title":"Did They Deserve It? Adolescents' Perception of Online Harassment in a Real-Case Scenario","authors":"Cricenti C, Pizzo A, Quaglieri A, Mari E, Cordellieri P, Bonucchi C, Torretta P, Giannini AM, Lausi G.","first_author":"Cricenti C","journal":"International journal of environmental research and public health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Victimization","Social Networking","Cyberbullying","Moral Disengagement","Police Force","Cyber-crime"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/24/17040/pdf?version=1671432313","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large school‑based survey of 1,777 adolescents, three grade groups, self‑report questionnaire","sample_n":1777,"sample_text":"Middle school (N=562), high‑school biennium (N=728), triennium (N=487)","population":"Italian adolescents, ages 13‑17, mixed gender, recruited via schools","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,777 Italian teens showed that older students view non‑consensual image sharing and cyberbullying as more clearly criminal than younger students, indicating age‑related differences in how such online harassment is perceived.","clinical_takeaway":"Prevention programs should be tailored to adolescents’ developmental stage, emphasizing clearer recognition of online sexual harassment as a crime among older teens.","confidence":0.8,"topic_tags":["csbd","sexual_function","pornography","masturbation"],"strengths":["Large sample spanning three school levels","Focus on real‑case scenario enhances ecological validity","Age‑specific analysis provides actionable insights"],"limitations":["Self‑report questionnaire likely ad‑hoc, limited validation","Cross‑sectional design prevents causal inference","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph192417040"}},{"id":2169,"doi":"10.1111/ajo.13633","pmid":"36529139","pmcid":null,"title":"Attitudes and practices associated with pubic hair grooming behaviours: A cross-sectional study","authors":"Deans R, Cui CK, Tam C, Coronel ABL, Rosa G, Gerstl B.","first_author":"Deans R","journal":"The Australian & New Zealand journal of obstetrics & gynaecology","year":2023,"pub_types":["Journal Article"],"keywords":["Women's Health","Attitudes","Men's Health","Labiaplasty","Genital Self-image","Pubic Hair Removal"],"is_oa":false,"oa_url":"https://doi.org/10.1111/ajo.13633","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional convenience online survey of 1560 young adults (18‑25) examining attitudes and practices around pubic hair grooming; comparisons by gender using chi‑square and logistic regression.","sample_n":1560,"sample_text":"1560 participants (728 females, 728 males) aged 18‑25 years.","population":"young adult men and women, convenience sample recruited online, not representative.","country":"Australia/New Zealand (likely, based on journal focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 1560 Australian young adults found that most groom their pubic hair for hygiene, comfort, and aesthetic reasons. Men and women differ in how often they watch pornography, but grooming is mainly driven by practical and aesthetic motives.","clinical_takeaway":"Clinicians should recognize that pubic hair grooming is common and motivated by hygiene and comfort, not necessarily linked to sexual pathology.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Large sample size for a survey","Gender comparison","Multivariate logistic regression with confidence intervals"],"limitations":["Convenience, non‑representative sample","Ad‑hoc, likely unvalidated questionnaire","No control for key sexual‑behavior confounds"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/ajo.13633"}},{"id":2170,"doi":"10.1177/1079063217720919","pmid":"28715948","pmcid":null,"title":"The Motivation-Facilitation Model of Sexual Offending","authors":"Seto MC.","first_author":"Seto MC.","journal":"Sexual abuse : a journal of research and treatment","year":2019,"pub_types":["Journal Article"],"keywords":["Facilitation","Motivation","Child Sexual Abuse","Dynamic Risk Factors","Sexual Offending","Child Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":117,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of motivation-facilitation model for sexual offending, no new empirical data","sample_n":null,"sample_text":"Not applicable – no primary data","population":"adults who commit sexual offenses (including child pornography offenders)","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews a model that explains sexual offenses by linking high sexual drive, paraphilic interests, and mating effort with facilitating factors like antisocial traits or intoxication, focusing on child sexual abuse and related online offenses.","clinical_takeaway":"None – the paper is theoretical and does not offer direct clinical guidance.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["Comprehensive synthesis of motivation-facilitation literature","Identifies gaps for future research","Integrates multiple risk factors"],"limitations":["No primary empirical data","Lacks systematic review methodology","Potential author bias toward model"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":16,"contrasting":1,"mentioning":257,"citing_publications":352,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063217720919"}},{"id":2171,"doi":"10.1007/s10508-022-02494-2","pmid":"36522562","pmcid":null,"title":"The Moderating Effect of Religiousness on the Relation Between Sexual Guilt and Shame and Well-Being Among Jewish Religious Single Men","authors":"Wacks Y, Lazar A, Sommerfeld E.","first_author":"Wacks Y","journal":"Archives of sexual behavior","year":2023,"pub_types":["Journal Article"],"keywords":["Well-being","Religiousness","Sex Guilt","Sexual Shame","Orthodox Men"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation","pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire; N=165 single orthodox Jewish men; moderation analysis","sample_n":165,"sample_text":"convenience sample recruited online; not nationally representative","population":"young adult single men (mean age 23.3) from national‑orthodox Jewish community in Israel","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among single Orthodox Jewish men, feeling guilty or ashamed about sex was linked to poorer mental health and lower life satisfaction, especially for those with lower religious commitment. High religiousness seemed to buffer these negative effects.","clinical_takeaway":"Clinicians should consider religious context when addressing sexual guilt; strong religious involvement may protect wellbeing.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Relatively large sample for this niche population","Use of moderation analysis to test theory","Focus on understudied group (orthodox men)"],"limitations":["Cross‑sectional; cannot infer causality","Key confounds (moral incongruence, masturbation, trauma) not measured","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02494-2"}},{"id":2172,"doi":"10.1089/cyber.2022.0141","pmid":"36493360","pmcid":null,"title":"Digital Media Play a Key Role in Influencing Female Breast Perception","authors":"Wallner C, Huyghebaert T, Drysch M, Wagner JM, Sogorski A, Dadras M, von Glinski M, Schmidt SV, Reinkemeier F, Lehnhardt M, Behr B.","first_author":"Wallner C","journal":"Cyberpsychology, behavior and social networking","year":2023,"pub_types":["Journal Article"],"keywords":["Female","Breast","Social Media","3d","Cart"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Large, web‑based questionnaire (N=1,049) using 3D breast models; cross‑sectional analysis with CART machine‑learning.","sample_n":1049,"sample_text":"Representative cohort of 1,049 adults completed a web‑based questionnaire.","population":"Adults in the United States (representative cohort).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a US sample of over a thousand adults, higher use of pornographic and social‑media content was linked to different preferences for breast shape, but did not change women’s own breast satisfaction. Women who had or wanted breast surgery also used digital media more often.","clinical_takeaway":"Frequency of porn and social‑media exposure relates to breast‑shape preferences, but does not appear to affect personal breast satisfaction.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative sample","Innovative use of 3‑D breast models","Application of machine‑learning to identify predictors"],"limitations":["Cross‑sectional; cannot infer causality","Key confounds (morality, mental health, partner effects) not measured","Frequency of porn use measured by single self‑report item"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2022.0141"}},{"id":2173,"doi":"10.1038/s41443-022-00648-3","pmid":"36473956","pmcid":null,"title":"Response to the Commentary on: Do pornography use and masturbation play a role in erectile dysfunction and relationship satisfaction in men?","authors":"Rowland DL, Hevesi K.","first_author":"Rowland DL","journal":"International journal of impotence research","year":2023,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-022-00648-3"}},{"id":2174,"doi":"10.1080/00224499.2017.1332152","pmid":"28632461","pmcid":null,"title":"Consuming Ecstasy: Representations of Male and Female Orgasm in Mainstream Pornography","authors":"Séguin LJ, Rodrigue C, Lavigne J.","first_author":"Séguin LJ","journal":"Journal of sex research","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of the 50 most‑viewed PornHub videos, coding frequency of male/female orgasm and associated cues.","sample_n":50,"sample_text":"Top‑viewed videos on PornHub (all‑time).","population":"Mainstream porn videos (not human participants).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers watched the 50 most‑watched porn videos and counted how often men and women were shown having orgasms. Men were shown reaching climax far more often than women, and many female orgasms lacked clitoral stimulation. These patterns may reinforce unrealistic beliefs about sexual performance.","clinical_takeaway":"Clinicians should note that mainstream porn often underrepresents female orgasm, which can shape clients' expectations and satisfaction.","confidence":0.78,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Clear, systematic coding scheme","Addresses a gap in visual sexual script literature","Large viewership sample (most‑viewed videos) gives ecological relevance"],"limitations":["Small video sample (n=50) limits generalisability","Selection of only top‑viewed videos may bias toward popular scripts","No validated measurement instrument for orgasm representation"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":43,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1332152"}},{"id":2175,"doi":"10.1080/00224499.2017.1333569","pmid":"28632412","pmcid":null,"title":"Not Practicing What You Preach: Religion and Incongruence Between Pornography Beliefs and Usage","authors":"Perry SL.","first_author":"Perry SL.","journal":"Journal of sex research","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative survey (Portraits of American Life Study), N=2,279, cross‑sectional analysis of religious attendance, prayer frequency and self‑reported pornography viewing versus moral belief.","sample_n":2279,"sample_text":"Nationally representative probability sample of U.S. adults, 2006.","population":"U.S. adults (men and women, broad age range)","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among U.S. adults, men who attend religious services frequently and pray a lot are more likely to say pornography is always morally wrong yet still watch it, showing a gap between belief and behavior.","clinical_takeaway":"Clinicians should recognize that moral conflict, not just use frequency, can shape individuals' experiences with pornography.","confidence":0.8,"topic_tags":["pornography","religiosity","moral_incongruence","sexual_function"],"strengths":["Large, nationally representative sample","Clear operationalization of moral belief vs behavior","Relevant to religious incongruence theory"],"limitations":["Single‑item measures, no validated scales","Cross‑sectional, cannot infer causality","No control for other psychosocial confounds (e.g., mental health, relationship status)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":31,"citing_publications":74,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1333569"}},{"id":2177,"doi":"10.1371/journal.pone.0278290","pmid":"36454977","pmcid":"PMC9714941","title":"Children's mobile-gaming preferences, online risks, and mental health","authors":"Hou CY, Rutherford R, Chang H, Chang FC, Shumei L, Chiu CH, Chen PH, Chiang JT, Miao NF, Chuang HY, Tseng CC.","first_author":"Hou CY","journal":"PloS one","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9714941","cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large community sample of 2,702 third‑ and fourth‑grade students surveyed via self‑report questionnaire; cross‑sectional analysis with logistic and linear regressions","sample_n":2702,"sample_text":"third and fourth grade students from 16 elementary schools in Taiwan and 9 schools in China","population":"children (≈9‑10 y) in schools in Taiwan and China (N = 2,702)","country":"Taiwan; China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 2,700 elementary‑school children in Taiwan and China, playing multiplayer or violent mobile games, having a poor parent‑child relationship, and living in rural areas were linked to higher odds of gaming‑addiction scores and to more emotional and behavioral problems.","clinical_takeaway":"Screen for gaming problems and family conflict when children show emotional or behavioral difficulties.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, multi‑site sample of children","Validated instruments for gaming addiction and mental health","Multivariate regression controls for several familial/social factors"],"limitations":["Cross‑sectional design cannot establish causality","No pre‑registration or reporting of confidence intervals","Potential self‑report bias in young children"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":28,"retracted":false,"notices":[{"status":"Has correction","date":"2024-7-31","noticeDoi":"10.1371/journal.pone.0308315","doi":"10.1371/journal.pone.0278290"}],"url":"https://scite.ai/reports/10.1371/journal.pone.0278290"}},{"id":2178,"doi":"10.1038/s41443-022-00644-7","pmid":"36450920","pmcid":null,"title":"Do pornography use and masturbation play a role in erectile dysfunction and relationship satisfaction in men?","authors":"De Win G, Jacobs T, Geuens S.","first_author":"De Win G","journal":"International journal of impotence research","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-022-00644-7"}},{"id":2179,"doi":"10.1007/s10639-022-11437-2","pmid":"36465425","pmcid":"PMC9707285","title":"Problematic smartphone use and specific problematic Internet uses among university students and associated predictive factors: a systematic review","authors":"Sánchez-Fernández M, Borda-Mas M.","first_author":"Sánchez-Fernández M","journal":"Education and information technologies","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["College Students","Predictors","Psychological Variables","Internet Gaming Disorder","Problematic Smartphone Use","Problematic Social Media Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9707285","cited_by_count":70,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review following PRISMA; includes 117 primary studies; no meta‑analysis reported; risk‑of‑bias assessment not described.","sample_n":null,"sample_text":"117 primary studies (aggregate).","population":"University students (high‑risk group).","country":"Not specified; likely multi‑country based on database search.","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 117 studies looked at problematic smartphone, social‑media, gaming and online porn use among university students, finding varied definitions and tools but common predictors like negative mood and fear of missing out.","clinical_takeaway":"Negative affect and fear of missing out are key risk factors; interventions should target mood regulation and healthy online habits.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Comprehensive PRISMA‑based search of 4 databases","Identifies common predictive factors across multiple cyber‑addiction domains","Highlights terminology and assessment heterogeneity"],"limitations":["No risk‑of‑bias assessment of included studies reported","Lacks quantitative meta‑analysis","Limited discussion of moral or sexual‑health confounds for pornography use"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":36,"citing_publications":104,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10639-022-11437-2"}},{"id":2180,"doi":"10.1080/0092623x.2017.1321601","pmid":"28448246","pmcid":null,"title":"Pornography Use and Loneliness: A Bidirectional Recursive Model and Pilot Investigation","authors":"Butler MH, Pereyra SA, Draper TW, Leonhardt ND, Skinner KB.","first_author":"Butler MH","journal":"Journal of sex & marital therapy","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1,247 adults; SEM used to test reciprocal associations between pornography use and loneliness","sample_n":1247,"sample_text":"1,247 participants completed an online questionnaire","population":"adult community sample (online respondents)","country":"unspecified (likely USA based on authors)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,247 adults, higher pornography use was linked to greater loneliness. The authors suggest the relationship could run both ways, but the study cannot prove cause and effect.","clinical_takeaway":"Higher porn use may be associated with loneliness, but clinicians should consider other factors (e.g., mental health, relationship context) before drawing conclusions.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships","moral_incongruence"],"strengths":["Large sample size","Validated loneliness measure","Use of structural equation modeling to test bidirectional paths"],"limitations":["Pornography use measured with unclear/possibly single‑item scale","Cross‑sectional; cannot infer causality","No control for moral incongruence, masturbation, mental health or relationship factors"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":6,"contrasting":0,"mentioning":28,"citing_publications":112,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2017.1321601"}},{"id":2181,"doi":"10.1080/0092623x.2017.1321596","pmid":"28441101","pmcid":null,"title":"Male-Centric and Female-Centric Pornography Consumption: Relationship With Sex Life and Attitudes in Young Adults","authors":"French IM, Hamilton LD.","first_author":"French IM","journal":"Journal of sex & marital therapy","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire; 195 men, 310 women; cross‑sectional convenience sample","sample_n":505,"sample_text":"195 men, 310 women completed an online questionnaire","population":"young adult men and women (self‑selected online respondents)","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 505 young adults, women who watched pornography featuring more female‑centric content reported slightly more positive effects on their sex lives and attitudes toward the opposite gender, while men reported slightly more negative effects. Overall associations were small.","clinical_takeaway":"Evidence suggests only modest links between porn content type and self‑reported sexual attitudes; no strong clinical implications.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Relatively large total sample (N>500)","Addresses understudied dimension of pornography content (male‑ vs female‑centric)","Reports effect sizes, acknowledging small magnitude"],"limitations":["Reliance on ad‑hoc self‑report questionnaires; no validated scales","Cross‑sectional design prevents causal inference","No measurement of potential confounds (e.g., moral attitudes, masturbation, mental health)","Convenience online sample limits generalisability"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2017.1321596"}},{"id":2182,"doi":"10.1016/s0188-4409(01)00279-x","pmid":"11395188","pmcid":null,"title":"Naltrexone-induced augmentation of sexual response in men","authors":"Sathe RS, Komisaruk BR, Ladas AK, Godbole SV.","first_author":"Sathe RS","journal":"Archives of medical research","year":2001,"pub_types":["Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"randomized double‑blind crossover trial; 20 healthy men; within‑subject comparison of naltrexone vs placebo","sample_n":20,"sample_text":"20","population":"healthy sexually active men, 20‑29 y, recruited from general community (presumed convenience sample)","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 20 healthy men, taking naltrexone for three days increased the number of orgasms and the self‑rated intensity of arousal and orgasm during a two‑hour session of watching porn and masturbating, compared with placebo.","clinical_takeaway":"Naltrexone may boost orgasmic response, but evidence is limited to a small experimental study.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","masturbation"],"strengths":["double‑blind crossover design controls for between‑subject variability","objective count of orgasms","clear pharmacological manipulation"],"limitations":["very small sample (N=20)","self‑report intensity scales not validated","no control for mood, relationship or moral factors"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0188-4409(01)00279-x"}},{"id":2184,"doi":"10.1007/s10508-022-02471-9","pmid":"36376745","pmcid":null,"title":"Timing of Sexuality Education: Hong Kong Preteens' Perception of Sexual Health","authors":"Cheung M, Leung P, Zhou S, Yu M, Chen X, Ford A, Huang YJ.","first_author":"Cheung M","journal":"Archives of sexual behavior","year":2023,"pub_types":["Journal Article"],"keywords":["Sexual Health Promotion","Learning Readiness","Child Sexual Abuse Prevention","Early Timing","Preteen Sexuality Knowledge"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 4569 Chinese preteens (5th‑6th grade) from 24 primary schools; logistic regression analysis of self‑reported preferences and sources of sexual information","sample_n":4569,"sample_text":"4569 fifth‑ and sixth‑grade students (average 11 years old) from 24 primary schools in Hong Kong","population":"pre‑adolescent students, Hong Kong, mean age 11 y, both genders","country":"Hong Kong","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 4,500 Hong Kong pre‑teens found that girls and older children want school sex education to start earlier, while boys more often get information from peers, internet and porn comics. The study suggests involving parents and teachers in early sex‑education programmes.","clinical_takeaway":"Consider offering age‑appropriate sexuality education earlier, especially for girls and older pre‑teens.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample (N > 4500)","Use of logistic regression to identify predictors","Focus on youth‑direct input, a gap in Chinese contexts"],"limitations":["Reliance on single‑item, non‑validated self‑report measures","Cross‑sectional design limits causal inference","No control for key confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02471-9"}},{"id":2185,"doi":"10.1080/00224499.2017.1317709","pmid":"28497988","pmcid":null,"title":"Till Porn Do Us Part? A Longitudinal Examination of Pornography Use and Divorce","authors":"Perry SL, Schleifer C.","first_author":"Perry SL","journal":"Journal of sex research","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Three‑wave panel (2006‑2014) of the General Social Survey (N = 2120 married respondents); logistic regression with entropy‑balancing.","sample_n":2120,"sample_text":"married Americans from the GSS panel","population":"United States married adults","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using three waves of a US national survey, the study found that people who started watching porn while married were about twice as likely to get divorced, especially younger, less‑religious individuals and those already happy in their marriage.","clinical_takeaway":"Beginner porn use may signal higher divorce risk, but clinicians should consider many other relationship factors.","confidence":0.78,"topic_tags":["pornography","relationships","moral_incongruence","sexual_function"],"strengths":["Large, nationally representative longitudinal panel","Advanced analytic technique (entropy balancing)","Gender‑specific findings reported"],"limitations":["Pornography use measured with a single self‑report item","Potential unmeasured confounds (masturbation, mental health, trauma)","No pre‑registration or detailed effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":1,"mentioning":41,"citing_publications":138,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1317709"}},{"id":2186,"doi":"10.1007/bf01541986","pmid":"7733802","pmcid":null,"title":"Gender effects of romantic themes in erotica","authors":"Quackenbush DM, Strassberg DS, Turner CW.","first_author":"Quackenbush DM","journal":"Archives of sexual behavior","year":1995,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment with 4 video conditions (high/low romance × high/low explicitness) shown to 164 college students; arousal rated after viewing.","sample_n":164,"sample_text":"164 college students (91 male, 73 female).","population":"College students (91 male, 73 female), age 21+ (convenience sample).","country":"USA (presumed from authors and journal).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, both men and women reported higher sexual arousal when explicit videos also contained romantic elements, contrary to the expectation that romance would boost arousal only for women.","clinical_takeaway":"Romantic context may increase arousal for all genders; clinicians should note that erotic material's emotional content can affect sexual response.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Experimental manipulation allows causal inference for arousal.","Adequate sample size for detecting medium effects."],"limitations":["Arousal measured with a single, non‑validated item.","No assessment of potential confounds (e.g., moral attitudes, mood).","Convenience college sample limits generalisability."],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541986"}},{"id":2187,"doi":"10.1007/s10508-022-02452-y","pmid":"36344788","pmcid":null,"title":"The Cancer of Cancel Culture: Spreading \"Correct\" Scientific Ideologies Across North American Academia","authors":"Pfaus JG.","first_author":"Pfaus JG.","journal":"Archives of sexual behavior","year":2023,"pub_types":["Journal Article"],"keywords":["Social Justice","Social Construction","Academic Freedom","Sexual Science","Sexual Mccarthyism","“Cancel Culture”"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary / editorial without empirical data","sample_n":null,"sample_text":"None – article provides no participant data","population":"N/A","country":"North America (USA/Canada implied)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that \"cancel culture\" is threatening sexual science in North America by silencing researchers whose findings on topics like pornography, gender, and sexual desire conflict with certain social‑justice viewpoints.","clinical_takeaway":"None – the piece offers no clinical evidence or guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Highlights sociopolitical pressures on sexual science","Cites concrete cases illustrating academic controversies"],"limitations":["No empirical data or systematic analysis","Potential bias toward anti‑cancel‑culture stance"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02452-y"}},{"id":2188,"doi":"10.1007/s10508-022-02456-8","pmid":"36318357","pmcid":"PMC9628386","title":"Making Sense of Jiese: An Interview Study of Members from a Porn-Free Self-Help Forum in China","authors":"Zou W, Zhang X, He J.","first_author":"Zou W","journal":"Archives of sexual behavior","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["China","Masturbation","Sensemaking","Critical Discourse Analysis","Pornography","Jiese","Jieyou"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9628386","cited_by_count":1,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"interview study with 32 forum members (convenience sample); critical discourse analysis","sample_n":32,"sample_text":"32 interview participants recruited from the Jiese forum (self‑selected)","population":"male members of a Chinese porn‑free self‑help forum (jieyou)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 32 men from a Chinese “porn‑free” forum reveal that participants view abstaining from porn and masturbation as rational, culturally respectable, and linked to national pride, drawing on traditional ideas, health trends, and patriotism.","clinical_takeaway":"The study highlights cultural motivations for abstinence but provides no direct clinical guidance on pornography‑related problems.","confidence":0.7,"topic_tags":["pornography","masturbation","csbd","sexual_function"],"strengths":["In‑depth qualitative insight into a culturally specific movement","Use of sensemaking theory to frame analysis","Identification of multiple sociocultural themes"],"limitations":["Small, self‑selected sample limits generalisability","No quantitative or validated measures of pornography/masturbation behaviour","Absence of controls for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02456-8"}},{"id":2190,"doi":"10.1016/j.copsyc.2022.101496","pmid":"36436469","pmcid":null,"title":"Sexual fantasy research: A contemporary review","authors":"Lehmiller JJ, Gormezano AM.","first_author":"Lehmiller JJ","journal":"Current opinion in psychology","year":2023,"pub_types":["Review","Journal Article"],"keywords":["Sexual behavior","Sexual Offending","Sexual Desire","Paraphilia","Pornography","Sexual Fantasy"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article without systematic methods or meta‑analysis; no new empirical data.","sample_n":null,"sample_text":"N/A","population":"None (review)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises recent research on sexual fantasies, noting that most fantasies are common, that most studies focus on young, cis‑heterosexual North Americans, and that what people imagine is not always what they pursue in real life.","clinical_takeaway":"None – the article does not provide actionable clinical guidance.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Broad synthesis of recent literature","Highlights gaps in diversity and cross‑cultural work"],"limitations":["Narrative, not systematic review","No explicit methodology or quality appraisal","No original data or quantitative analysis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.copsyc.2022.101496"}},{"id":2191,"doi":"10.1037/lhb0000240","pmid":"28383984","pmcid":null,"title":"Correlates of admitted sexual interest in children among individuals convicted of child pornography offenses","authors":"Seto MC, Eke AW.","first_author":"Seto MC","journal":"Law and human behavior","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional study of 286 convicted men, plus 60‑person validation sample","sample_n":286,"sample_text":"286 men convicted of child pornography offenses; validation subsample n=60","population":"men convicted of child‑pornography offenses (Ontario, Canada)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created a 6‑item checklist of behaviors (e.g., possession of video, long‑term interest) that predicted whether convicted child‑pornography offenders would admit having a sexual interest in children. The checklist showed moderate accuracy (AUC .71–.81).","clinical_takeaway":"A brief behavior‑based tool may help risk assessors gauge child‑interest admission when self‑report is unreliable.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large offender sample for forensic research","Provides external validation (AUC reported with CI)","Clear operationalization of behavioral correlates"],"limitations":["Self‑report admission vulnerable to deception","No measurement of potential confounds (e.g., mental health)","Cross‑sectional; cannot infer causality","Construct validity of CASIC not formally validated"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":51,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/lhb0000240"}},{"id":2192,"doi":"10.1016/j.copsyc.2022.101474","pmid":"36469962","pmcid":null,"title":"Growth and diversity of the online solopreneur and sexpreneur","authors":"Vickers E, Brooks-Gordon B.","first_author":"Vickers E","journal":"Current opinion in psychology","year":2023,"pub_types":["Review","Journal Article"],"keywords":["Online Sex Work","Explicit Content","Fan Site","Online Sex Solopreneur","Pornographic Content","Sexpreneur"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review; no empirical data; proposes conceptual framework of “online sex solopreneur” linking sex work and entrepreneurship","sample_n":null,"sample_text":"No sample; article is a conceptual review","population":"humans involved in online explicit content creation; no specific sample described","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article outlines a new concept—online sex solopreneurs—who combine pornographic content creation with entrepreneurial practices like fan‑site marketing, suggesting a research agenda to study this overlap.","clinical_takeaway":"None – the paper is conceptual and does not give clinical guidance.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Identifies a novel conceptual domain linking entrepreneurship with online sex work","Integrates literature on social media influencing and fan‑site economics"],"limitations":["No empirical data; purely speculative","Lacks operational definitions and measurement of key constructs","Provides no assessment of mental‑health or moral‑incongruence confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.copsyc.2022.101474"}},{"id":2193,"doi":"10.1080/00926238708403880","pmid":"2437313","pmcid":null,"title":"The use of audiovisual materials in sex therapy: a critical overview","authors":"Neidigh L, Kinder BN.","first_author":"Neidigh L","journal":"Journal of sex & marital therapy","year":1987,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative overview of existing studies; no new empirical data; no systematic search reported.","sample_n":null,"sample_text":"Not applicable","population":"Not applicable (review of prior studies)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews early work on using erotic videos in sex therapy, noting that gradual, therapist‑guided exposure can reduce anxiety, whereas random use may increase it, and calls for more research.","clinical_takeaway":"Therapists should use erotic materials cautiously, progressing gradually and stopping if anxiety rises.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Provides historical perspective on use of erotic materials in therapy","Highlights need for graduated exposure and therapist control"],"limitations":["Narrative, not systematic; no explicit methodology","No quantitative synthesis or risk‑of‑bias assessment","No discussion of key confounds such as moral incongruence or mental‑health variables"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238708403880"}},{"id":2194,"doi":"10.3390/ijerph192013212","pmid":"36293797","pmcid":"PMC9602659","title":"Interethnic Influencing Factors Regarding Buttocks Body Image in Women from Nigeria, Germany, USA and Japan","authors":"Wallner C, Kruber S, Adebayo SO, Ayandele O, Namatame H, Olonisakin TT, O Olapegba P, Sawamiya Y, Suzuki T, Yamamiya Y, Wagner MJ, Drysch M, Lehnhardt M, Behr B.","first_author":"Wallner C","journal":"International journal of environmental research and public health","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Female","Buttocks","Body Image","Social Media","Whr"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9602659","cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 2163 participants from four countries; online questionnaire assessing body image, media use, and satisfaction with buttocks.","sample_n":2163,"sample_text":"Large, multi‑country convenience sample; not probability‑based.","population":"Adults (both sexes) from Germany, Nigeria, USA, Japan; convenience sample recruited online.","country":"Germany, Nigeria, USA, Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of over 2,000 adults from four countries found that higher use of Instagram, TikTok and pornography was linked to lower satisfaction with women’s own buttocks, alongside factors like country, weight and media influence.","clinical_takeaway":"Higher consumption of visual media, including pornography, is associated with poorer buttocks body image; clinicians should consider media exposure when addressing body‑image concerns.","confidence":0.7,"topic_tags":["csbd","pornography","sexual_function","masturbation"],"strengths":["Large multi‑national sample","Addresses understudied anatomical aspect (buttocks)","Provides quantitative links between media use and body satisfaction"],"limitations":["Cross‑sectional; cannot infer causality","Likely uses non‑validated, ad‑hoc body‑image items","Convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph192013212"}},{"id":2197,"doi":"10.1080/00224499.2022.2131705","pmid":"36205527","pmcid":null,"title":"Pornography, Masturbation, and Relational Satisfaction","authors":"Wright PJ, Tokunaga R, Herbenick D.","first_author":"Wright PJ","journal":"Journal of sex research","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2131705"}},{"id":2198,"doi":"10.1371/journal.pone.0274331","pmid":"36197910","pmcid":"PMC9534408","title":"The influence of sexual arousal on subjective pain intensity during a cold pressor test in women","authors":"Lakhsassi L, Borg C, Martusewicz S, van der Ploeg K, de Jong PJ.","first_author":"Lakhsassi L","journal":"PloS one","year":2022,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9534408","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Randomized laboratory experiment with 4 conditions (sexual arousal, generalized arousal, distraction, neutral) and N=151 female participants.","sample_n":151,"sample_text":"Female participants (N = 151) randomly assigned to four conditions.","population":"Adult women, recruited presumably from community (details not provided).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab experiment with 151 women, researchers tested whether watching erotic pornographic videos reduced pain from a cold pressor test. The sexual arousal condition did not lower reported pain compared with neutral, distraction, or general arousal conditions.","clinical_takeaway":"Erotic visual stimulation alone does not appear to diminish acute pain in women; other factors like genital stimulation or orgasm may be needed.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Random allocation to conditions","Adequate total sample size for experimental design","Clear primary outcome (subjective pain rating)"],"limitations":["Sexual arousal manipulation not validated with physiological or psychometric measures","Potential lack of control for mood, menstrual cycle, or prior sexual experience","No reporting of effect sizes or confidence intervals"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0274331"}},{"id":2200,"doi":"10.1007/s00414-017-1561-2","pmid":"28233102","pmcid":null,"title":"Estimating a child's age from an image using whole body proportions","authors":"Lucas T, Henneberg M.","first_author":"Lucas T","journal":"International journal of legal medicine","year":2017,"pub_types":["Journal Article"],"keywords":["Forensic anthropology","Anthropometry","Age estimation","Photographs","Child Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional anthropometric study of 3,436 South African children aged 5–16 years; whole‑body ratios regressed on chronological age.","sample_n":3436,"sample_text":"Large community sample measured over a 10‑year period.","population":"Children (boys n=1603, girls n=1833) from Cape Coloured community in South Africa, ages 5‑16.","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":8,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study measured body proportions in over 3,400 South African children to develop equations that estimate age from a photograph, achieving an average error of about 1.6‑1.7 years.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Very large, gender‑specific sample.","Objective, standardized anthropometric measurements.","Clear regression modelling with reported standard errors."],"limitations":["Sample limited to a single ethnic group (Cape Coloured, South Africa).","No external validation on independent datasets.","Cross‑sectional; cannot assess longitudinal growth patterns."],"rubric_version":"2.0","raw_total":38,"max_possible":50,"pct_score":76,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":9,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00414-017-1561-2"}},{"id":2201,"doi":"10.1007/s10508-022-02345-0","pmid":"36171486","pmcid":"PMC9663340","title":"Sexualized Behavior Among Adolescents Who Sexually Offended","authors":"Krause C, Barra S, Landolt MA, Bessler C, Aebi M.","first_author":"Krause C","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual Recidivism","Juvenile Sexual Offending","Sexual Behavior Problems","Sexualized Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9663340","cited_by_count":1,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective case‑file review of 230 juvenile sexual offenders; latent class analysis of pre‑offense sexualized behaviour; 1‑year recidivism follow‑up.","sample_n":230,"sample_text":"Population sample of JSO with contact sexual offenses.","population":"230 juveniles (12‑18 y) who committed contact sexual offenses, identified from a population‑based sample of offenders.","country":"Switzerland (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a review of 230 juvenile sexual offenders, about 40 % showed early sexualised behaviour such as pornography use or excessive masturbation before their crime. These youths had more psychiatric disorders, but they were not more likely to reoffend within a year.","clinical_takeaway":"Sexualised behaviour in offending youths signals broader psychiatric needs, not necessarily higher recidivism risk.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, nationally‑derived forensic sample","Systematic coding of expert reports","Latent class analysis to identify SB subtypes"],"limitations":["Reliance on retrospective case files; no validated self‑report measures","Limited control for key confounds (e.g., moral incongruence, trauma)","Short follow‑up period for recidivism"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02345-0"}},{"id":2203,"doi":"10.1007/s10508-022-02420-6","pmid":"36070154","pmcid":null,"title":"Pornography, White Men, and Relational Satisfaction","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Archives of sexual behavior","year":2022,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02420-6"}},{"id":2204,"doi":"10.3389/fpubh.2022.954674","pmid":"36148342","pmcid":"PMC9486466","title":"The process of contemporary gay identity development in China: The influence of internet use","authors":"Zhang A, Reynolds NR, Huang C, Tan S, Yang G, Yan J.","first_author":"Zhang A","journal":"Frontiers in public health","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Adolescence And Emerging Adulthood","Identity Confirmation","Gay Identity Development","Identity Coping","Identity Practice","Internet Practice"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9486466","cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative interviews with 37 Chinese gay males (16‑29 years), grounded‑theory analysis","sample_n":37,"sample_text":"37 participants recruited for semi‑structured interviews; convenience sampling","population":"Chinese gay males, adolescents and emerging adults","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 37 young Chinese gay men show that online porn, fiction, and community sites help them confirm and practice their gay identity, increase self‑acceptance, and prepare for coming out, but also expose them to sexual risk and emotional hurt.","clinical_takeaway":"Clinicians should recognize the internet’s dual role—supporting identity development while posing sexual‑health risks—for gay youth in China.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["In‑depth, grounded‑theory insight into identity processes","Focus on a culturally specific context (China)","Identifies both positive and risk aspects of internet use"],"limitations":["Small, non‑representative convenience sample","No standardized measures of pornography use or sexual health outcomes","Findings not generalisable beyond this group"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2022.954674"}},{"id":2205,"doi":"10.11604/pamj.2016.25.261.2630","pmid":"28293377","pmcid":"PMC5337276","title":"Influence of internet exposure on sexual behaviour of young persons in an urban district of Southwest Nigeria","authors":"Arulogun OS, Ogbu IA, Dipeolu IO.","first_author":"Arulogun OS","journal":"The Pan African medical journal","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behaviour","Internet Use","Young Persons","Pornographic Sites"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5337276","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 413 young persons in an urban district of Southwest Nigeria; self‑administered questionnaire; logistic regression analysis","sample_n":413,"sample_text":"young persons recruited via convenience sampling in cybercafés and community settings","population":"young adults (≈21 y) from Ibadan North LGA, Nigeria","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 413 Nigerian youths found that many had seen pornographic sites online and that a sizable minority reported changes such as oral sex or multiple partners after exposure.","clinical_takeaway":"Self‑reported behavior changes after internet porn exposure are based on cross‑sectional data; clinicians should interpret such associations cautiously.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["large sample for a local survey","use of logistic regression with confidence intervals"],"limitations":["cross‑sectional design cannot infer causality","no measurement of key confounds (moral incongruence, mental health, masturbation)","questionnaire not validated for addiction or behavioural outcomes"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":29,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.11604/pamj.2016.25.261.2630"}},{"id":2207,"doi":"10.4103/jfmpc.jfmpc_1962_21","pmid":"36505598","pmcid":"PMC9731005","title":"Risky sexual behavior and associated factors among secondary and above-education-level students in Ethiopia: A systematic review and meta-analysis","authors":"Aynalem BY, Alemu AA, Zeleke LB, Kassa GM.","first_author":"Aynalem BY","journal":"Journal of family medicine and primary care","year":2022,"pub_types":["review-article","Review","Journal Article"],"keywords":["Students","university","Ethiopia","High School","Risky Sexual Behavior","College"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9731005","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review and meta‑analysis of 24 cross‑sectional studies (n=13,440) following PRISMA guidelines.","sample_n":13440,"sample_text":"13,440 participants across 24 studies","population":"Secondary school and university students in Ethiopia","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 24 Ethiopian student studies found that about 40% engage in risky sexual behavior. Watching porn, using substances, and visiting night clubs were each linked to roughly double the odds of such behavior.","clinical_takeaway":"Clinicians should consider pornography exposure alongside substance use when assessing sexual‑risk profiles in Ethiopian youth.","confidence":0.8,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Large pooled sample","PRISMA‑compliant systematic review","Quantitative synthesis with confidence intervals"],"limitations":["Heterogeneous definitions of risky sexual behavior across primary studies","No assessment of moral incongruence or other key confounds","Potential publication bias not fully ruled out"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":9,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/jfmpc.jfmpc_1962_21"}},{"id":2209,"doi":"10.1080/00224499.2022.2105290","pmid":"36043887","pmcid":null,"title":"A Theory-Based Intervention to Reduce Risk and Vulnerability Factors of Sexual Aggression Perpetration and Victimization in German University Students","authors":"Schuster I, Tomaszewska P, Krahé B.","first_author":"Schuster I","journal":"Journal of sex research","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Randomized controlled trial with 1,181 German university students, intervention vs no‑intervention control, assessments at baseline, 1 week, 9 months, and 12 months.","sample_n":1181,"sample_text":"1,181 university students (762 female) randomly assigned to intervention or control.","population":"University students in Germany (both genders, majority female).","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A school‑based program teaching German university students about healthier sexual scripts and self‑esteem reduced risky sexual attitudes and some related behaviours over a year, but did not change attitudes toward coercion or how realistic pornography seemed.","clinical_takeaway":"Sexual‑education interventions can improve self‑esteem and reduce risky scripts, potentially lowering aggression risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, randomly assigned sample","Longitudinal follow‑up up to 12 months","Multiple theoretically informed outcome measures"],"limitations":["No measurement of moral or mental‑health covariates","Unclear whether scales are validated","No pre‑registration disclosed"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2105290"}},{"id":2210,"doi":"10.3390/ijerph191710818","pmid":"36078525","pmcid":"PMC9517921","title":"Some Considerations about Pornography Watching in Early Adolescence","authors":"Cerniglia L, Cimino S.","first_author":"Cerniglia L","journal":"International journal of environmental research and public health","year":2022,"pub_types":["Editorial"],"keywords":[],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/17/10818/pdf?version=1661919664","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph191710818"}},{"id":2211,"doi":"10.1080/10410236.2022.2114762","pmid":"36039402","pmcid":null,"title":"On the Use of Control Variables in Pornography Effects Research: A Longitudinal Conceptual Replication","authors":"Wright PJ, Tokunaga RS.","first_author":"Wright PJ","journal":"Health communication","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2022.2114762"}},{"id":2213,"doi":"10.1556/2006.2022.00060","pmid":"36006765","pmcid":"PMC9872532","title":"Who feels affected by \"out of control\" sexual behavior? Prevalence and correlates of indicators for ICD-11 Compulsive Sexual Behavior Disorder in the German Health and Sexuality Survey (GeSiD)","authors":"Briken P, Wiessner C, Štulhofer A, Klein V, Fuß J, Reed GM, Dekker A.","first_author":"Briken P","journal":"Journal of behavioral addictions","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Icd-11","Sex Survey","Compulsive Sexual Behavior Disorder","German Health And Sexuality Survey (Gesid)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9872532","cited_by_count":43,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large probability-based German national sample (n=4,633); cross‑sectional questionnaire assessing ICD‑11 CSBD criteria and associated correlates","sample_n":4633,"sample_text":"probability‑based national survey (GeSiD)","population":"German adults, roughly balanced gender","country":"Germany","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a German national survey of 4,600 adults, about 4 % of men and 3 % of women reported experiences that match the ICD‑11 definition of compulsive sexual behavior disorder, including loss of control and distress. Those reporting the disorder were more likely to have a strict religious upbringing, view same‑sex sex as unacceptable, think pornography harms their life, and have recent psychiatric treatment.","clinical_takeaway":"A small but notable minority of adults meet ICD‑11 CSBD criteria; clinicians should assess moral/religious background and co‑occurring mental‑health issues when evaluating such complaints.","confidence":0.85,"topic_tags":["prevalence","csbd","sexual_function","moral_incongruence","religiosity"],"strengths":["Large, nationally representative probability sample","ICD‑11‑aligned operational definition of CSBD","Provides prevalence estimates for both lifetime and 12‑month periods","Inclusion of moral/religious context as a correlate"],"limitations":["Reliance on single‑item self‑report; no validated CSBD questionnaire","Cross‑sectional design cannot infer causality","Masturbation, partner context, and trauma not assessed","Potential circularity: distress is part of the definition and also an outcome"],"rubric_version":"2.0","raw_total":39,"max_possible":60,"pct_score":65,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":7,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":45,"citing_publications":85,"retracted":false,"notices":[{"status":"Has correction","date":"2022-12-27","noticeDoi":"10.1556/2006.2022.20000","doi":"10.1556/2006.2022.00060"},{"status":"Has erratum","date":"2022-12-27","noticeDoi":"10.1556/2006.2022.20000","doi":"10.1556/2006.2022.00060"}],"url":"https://scite.ai/reports/10.1556/2006.2022.00060"}},{"id":2214,"doi":"10.1177/10778012221114918","pmid":"35989679","pmcid":null,"title":"Image-Based Sexual Abuse as a Means of Coercive Control: Victim-Survivor Experiences","authors":"Henry N, Gavey N, Johnson K.","first_author":"Henry N","journal":"Violence against women","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Domestic Violence","Coercive Control","Intimate Partner Abuse","Image-based Sexual Abuse","Nonconsensual Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"interviews with 30 victims/survivors of image‑based sexual abuse within intimate‑partner coercive control; thematic analysis","sample_n":30,"sample_text":"29 women and one gender‑diverse person","population":"women and one gender‑diverse adult survivors (convenience sample)","country":"Not specified (likely UK/Australia based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 30 survivors show that abusive partners use non‑consensual intimate images to intimidate, control, and degrade their partners, making image‑based sexual abuse a tool of coercive control.","clinical_takeaway":"Clinicians should assess for image‑based abuse when working with victims of intimate‑partner violence and consider its role in coercive control.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Rich qualitative insight from survivors","Focus on under‑researched coercive‑control tactic","Clear connection to policy implications"],"limitations":["Small, non‑representative convenience sample","No validated measurement instruments","Findings not generalisable to broader populations"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":22,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10778012221114918"}},{"id":2215,"doi":"10.1007/bf01542883","pmid":"6651507","pmcid":null,"title":"Volunteer bias in research employing vaginal measures of sexual arousal","authors":"Wolchik SA, Spencer SL, Lisi IS.","first_author":"Wolchik SA","journal":"Archives of sexual behavior","year":1983,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 296 female psychology students comparing volunteers vs non‑volunteers for a lab arousal study.","sample_n":296,"sample_text":"Convenience sample of psychology undergraduates; volunteers vs non‑volunteers.","population":"Female university students (psychology course).","country":"USA (presumed by journal and author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 1983 study compared psychology‑student volunteers and non‑volunteers for a lab test of vaginal arousal, finding volunteers were more likely to have a history of sexual trauma, masturbate more, view erotica earlier, and fear sex less. The authors warn that findings from vaginal‑measure studies may not generalise to the broader population.","clinical_takeaway":"Results from genital‑arousal experiments may not reflect typical women; clinicians should be cautious interpreting such lab data.","confidence":0.8,"topic_tags":["sexual_function","measurement"],"strengths":["Large sample for a lab‑recruitment study (N≈300)","Direct comparison of volunteers vs non‑volunteers","Multiple demographic and sexual variables examined"],"limitations":["Convenience sample of psychology students; limited generalisability","No validated psychometric scales reported","Moral/religious attitudes not assessed despite relevance to viewing explicit material"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":34,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542883"}},{"id":2216,"doi":"10.1016/j.jadohealth.2022.06.011","pmid":"35961872","pmcid":"PMC9560240","title":"Violence Perpetration in Early Adolescence: A Study of Four Urban Communities Worldwide","authors":"Beckwith S, Lou C, Michielsen K, Mafuta E, Wilopo SA, Blum RW.","first_author":"Beckwith S","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Adolescent","Early Adolescence","Bullying","Gender Norms","Adverse Childhood Experiences","Peer-violence Perpetration"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.jadohealth.2022.06.011","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 5,762 adolescents aged 10‑14 from four urban sites, logistic regression analysis of associations with peer violence perpetration","sample_n":5762,"sample_text":"cross‑sectional convenience sample of adolescents in four urban sites","population":"early adolescents (10‑14) from high‑poverty urban areas in Belgium, DR Congo, China, Indonesia (N=5,762)","country":"Belgium; Democratic Republic of the Congo; China; Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A study of over 5,000 adolescents in four countries found that higher media use, including pornography, and many personal and neighborhood risk factors were linked to a higher chance of committing peer violence.","clinical_takeaway":"Factors like high media exposure and adverse experiences are associated with adolescent violence, suggesting broader risk‑reduction approaches.","confidence":0.8,"topic_tags":["adolescents"],"strengths":["Large multinational sample (N>5k)","Inclusion of a broad range of individual, family, and community factors","Use of multivariable logistic regression"],"limitations":["Cross‑sectional design prevents causal inference","Key exposures (media, pornography) likely measured by single items without validation","No specific control for moral or sexual‑behavior confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2022.06.011"}},{"id":2217,"doi":"10.1177/10778012221099983","pmid":"35946125","pmcid":null,"title":"Correlates of Bystander Intervention Among Heavy Drinking College Men","authors":"Orchowski LM, Kirk KT, Schick MR, Spillane NS.","first_author":"Orchowski LM","journal":"Violence against women","year":2022,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Alcohol Use","College","Bystander Intervention"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of heavy‑drinking college men (N = 210); multivariate regression of self‑report variables","sample_n":210,"sample_text":"210 heavy‑drinking college men recruited on campus","population":"college men who report heavy drinking","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 210 heavy‑drinking college men, those who reported using pornography less frequently and who used strategies to limit drinking were more likely to say they would intervene as bystanders in sexual aggression situations.","clinical_takeaway":"Lower pornography use and drinking‑reduction strategies may be linked to greater willingness to act against sexual aggression on campus.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Reasonably sized sample for survey research","Multivariate analysis isolates independent predictors","Focus on under‑studied behavior (bystander intentions)"],"limitations":["Cross‑sectional; cannot infer causality","Self‑report measures, likely single‑item for pornography use","No assessment of key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10778012221099983"}},{"id":2218,"doi":"10.1556/2006.2022.00054","pmid":"36495471","pmcid":"PMC9872535","title":"Internet-based interventions for behavioral addictions: A systematic review","authors":"Boumparis N, Haug S, Abend S, Billieux J, Riper H, Schaub MP.","first_author":"Boumparis N","journal":"Journal of behavioral addictions","year":2022,"pub_types":["Systematic Review","review-article","Journal Article"],"keywords":["Effectiveness","Systematic review","Internet-based Interventions","Impulse Control Disorders","Behavioral Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9872535","cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 29 heterogeneous studies on internet‑based interventions for behavioral addictions, including pornography use disorder. Quality of primary studies varied (3 strong, 12 moderate, 14 weak). No meta‑analysis performed.","sample_n":29,"sample_text":"Twenty‑nine primary studies were assessed; individual study sample sizes not reported in abstract.","population":"Adults with various behavioral addictions (gambling, gaming, internet use, hoarding, pornography); sample characteristics not detailed in abstract.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review examined 29 studies of online therapies for behavioral addictions, including a few on pornography‑related problems. While internet‑based programs often reduced gambling symptoms, evidence for other addictions is still limited and drawn from methodologically weak studies.","clinical_takeaway":"Internet‑based treatments may help with gambling; evidence for pornography‑related issues is insufficient to guide practice.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Comprehensive systematic search across multiple databases","Uses established quality assessment tool (EPHPP)","Highlights gaps in research for non‑gambling behavioral addictions"],"limitations":["Heterogeneity and methodological weakness of primary studies","No meta‑analysis; effect sizes not pooled","Limited detail on how constructs (e.g., pornography use disorder) were defined in primary studies"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":28,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00054"}},{"id":2220,"doi":"10.1177/1077801216666723","pmid":"27770079","pmcid":null,"title":"Naked Aggression: The Meaning and Practice of Ejaculation on a Woman's Face","authors":"Sun C, Ezzell MB, Kendall O.","first_author":"Sun C","journal":"Violence against women","year":2017,"pub_types":["Journal Article"],"keywords":["Audience Research","Sexual Aggression","Sexual Behaviors","Pornography","Male Aggression","Sexual Script"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"In-depth interviews with 16 heterosexual men about meanings of ejaculation on a woman's face in pornography.","sample_n":16,"sample_text":"16 heterosexual men (in‑depth interviews).","population":"Male, heterosexual, likely university‑aged (not fully specified).","country":"United States (New England region mentioned).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 16 men reveal that many view facial ejaculation in porn as a symbol of dominance and aggression, even though they think most women would not want it.","clinical_takeaway":"Clinicians should recognize that some men may interpret pornographic aggression as a normal desire, which could affect communication about consent.","confidence":0.7,"topic_tags":["sexual_function","pornography"],"strengths":["Rich qualitative insight into male meaning‑making.","Focus on a specific, understudied sexual script."],"limitations":["Very small, non‑representative sample.","No validated measures; findings not generalisable.","Potential self‑selection bias toward men comfortable discussing porn."],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801216666723"}},{"id":2221,"doi":"10.1007/s10508-022-02354-z","pmid":"35896938","pmcid":"PMC9663345","title":"Validating the Screening Scale of Pedophilic Crime Scene Behavior","authors":"Lehmann RJB, Brouillette-Alarie S, Pedneault A, Knight RA.","first_author":"Lehmann RJB","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Assessment","Diagnosis","Sexual Offending","Pedophilia","Child Pornography","Crime Scene Analysis"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-022-02354-z.pdf","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑validated diagnostic accuracy study using two independent samples (USA, Canada) with clinical, typological and phallometric criteria.","sample_n":null,"sample_text":"Two independent samples; exact N not reported in abstract.","population":"Adults evaluated for pedophilic interest (forensic/clinical settings).","country":"USA, Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The seven‑item Screening Scale of Pedophilic Crime Scene Behavior was tested against clinical diagnoses, a typology, and phallometric tests in two samples. It showed good to excellent ability to identify pedophilic interest and added value beyond an existing scale.","clinical_takeaway":"The SSPC appears to be a reliable tool for assessing pedophilic interests in forensic settings.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses multiple established external criteria (clinical, typological, phallometric)","Demonstrates incremental validity over existing scale","Two independent samples increase generalisability"],"limitations":["Sample size not reported in abstract","No pre‑registration or explicit power analysis mentioned","Limited to forensic/clinical populations; not general population"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02354-z"}},{"id":2224,"doi":"10.1556/2006.2022.00030","pmid":"35895454","pmcid":"PMC9295218","title":"Contradicting classification, nomenclature, and diagnostic criteria of Compulsive Sexual Behavior Disorder (CSBD) and future directions •","authors":"Bőthe B, Koós M, Demetrovics Z.","first_author":"Bőthe B","journal":"Journal of behavioral addictions","year":2022,"pub_types":["article-commentary","Journal Article"],"keywords":["Sexuality","Impulsivity","Compulsive Sexual Behavior","Addictive Behavior","Compulsivity","Pornography"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/11/2/article-p204.pdf","cited_by_count":36,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors discuss how current diagnostic labels for Compulsive Sexual Behavior Disorder are inconsistent and propose ways to improve classification, especially regarding impulsivity, compulsivity and addiction-like features.","clinical_takeaway":"Clinicians should be aware that CSBD definitions are still debated and that diagnostic criteria may change.","confidence":0.9,"topic_tags":["csbd","sexual_function","measurement"],"strengths":["Clear articulation of classification issues","Integrates recent debate literature"],"limitations":["No empirical data or systematic review methods","Lacks measurement of key constructs"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":34,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00030"}},{"id":2225,"doi":null,"pmid":"2516203","pmcid":null,"title":"Rape and its relation to social disorganization, pornography and inequality in the USA","authors":"Baron L, Straus MA.","first_author":"Baron L","journal":"Medicine and law","year":1989,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Ecological cross‑sectional analysis of 50 US states using state‑level rape rates and macro‑level indices (pornography circulation, social disorganization, etc.).","sample_n":50,"sample_text":"Fifty US states (state‑level aggregates).","population":"USA (50 states)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors model US state differences in rape rates using indices of social disorganization, gender inequality, legitimate violence, and magazine pornography circulation, finding all four explain most of the variation.","clinical_takeaway":"None – the study is an ecological analysis, not directly applicable to individual clinical practice.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large‐scale, nation‑wide data set","Attempts to integrate multiple theoretical perspectives","Uses path analysis to examine direct/indirect effects"],"limitations":["Ecological design – cannot infer individual‑level causality","Proxy measures (magazine circulation) lack construct validity","Controls not fully described; key confounds (e.g., moral attitudes) omitted","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":2226,"doi":null,"pmid":"27644870","pmcid":null,"title":"Revenge Pornography: Mental Health Implications and Related Legislation","authors":"Kamal M, Newman WJ.","first_author":"Kamal M","journal":"The journal of the American Academy of Psychiatry and the Law","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary without empirical data; no participants, no methodology.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how non‑consensual sharing of sexual images (revenge porn) harms victims' mental health and urges stronger federal laws.","clinical_takeaway":"Clinicians should be aware of the severe emotional impact of revenge porn and consider it in assessments and support plans.","confidence":0.8,"topic_tags":["religiosity","moral_incongruence","sexual_function"],"strengths":["Highlights an under‑researched legal and mental‑health issue","Summarises existing advocacy and legislative efforts"],"limitations":["No empirical data or systematic review","No measurement of mental‑health outcomes or confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":2227,"doi":"10.1037/pst0000079","pmid":"27631866","pmcid":null,"title":"Clinical errors and therapist discomfort with client disclosure of troublesome pornography use: Implications for clinical practice and error reduction","authors":"Walters NT, Spengler PM.","first_author":"Walters NT","journal":"Psychotherapy (Chicago, Ill.)","year":2016,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"The paper discusses clinician judgment errors using illustrative examples; no original data were collected.","sample_n":null,"sample_text":"None – the article is a narrative case‑report/commentary.","population":"mental‑health clinicians (implicit)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article describes how therapist discomfort with clients' porn use can lead to judgment errors, offering suggestions for bias management and better clinical practice.","clinical_takeaway":"Therapists should be aware of their own discomfort when clients disclose porn use and use bias‑management strategies to maintain treatment fidelity.","confidence":0.8,"topic_tags":["pornography","sexual_function","csbd","measurement"],"strengths":["Highlights an under‑explored clinical issue","Provides concrete therapist examples"],"limitations":["No empirical data; purely narrative","Lacks systematic methodology or measurement"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/pst0000079"}},{"id":2228,"doi":"10.4081/aiua.2022.2.228","pmid":"35775352","pmcid":null,"title":"Cyber pornography use and masturbation outburst. Considerations on 150 italian patients complaining erectile dysfunction and trying to solve it","authors":"Pozza D, Pozza M, Mosca A, Pozza C.","first_author":"Pozza D","journal":"Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 150 ED patients at a single clinic","sample_n":150,"sample_text":"convenience sample of treatment‑seeking patients","population":"Italian males (20–86 y) presenting for erectile‑dysfunction evaluation","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"In 150 Italian men with erectile problems, most reported masturbating, especially using web porn. The authors suggest that this rise in masturbation might influence sexual activity for individuals and couples.","clinical_takeaway":"Masturbation, often prompted by online porn, is common among men with erectile dysfunction, but this study does not establish any causal link to sexual health outcomes.","confidence":0.7,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["large clinical sample for a single centre","direct assessment of masturbation frequency","focus on web‑porn as stimulus"],"limitations":["No validated questionnaire; single‑item frequency scale","No control/comparison group; convenience sample of ED patients","No measurement of confounding variables (moral, mental health, partner)"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4081/aiua.2022.2.228"}},{"id":2229,"doi":"10.1037/h0034014","pmid":"4690216","pmcid":null,"title":"Reactions of convicted rapists to sexually explicit stimuli","authors":"Kercher GA, Walker CE.","first_author":"Kercher GA","journal":"Journal of abnormal psychology","year":1973,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/h0034014"}},{"id":2230,"doi":"10.1007/s10508-016-0823-2","pmid":"27543105","pmcid":null,"title":"Predictors of Sexual Aggression Victimization and Perpetration Among Polish University Students: A Longitudinal Study","authors":"Tomaszewska P, Krahé B.","first_author":"Tomaszewska P","journal":"Archives of sexual behavior","year":2018,"pub_types":["Journal Article"],"keywords":["Poland","Religiosity","Sexual Scripts","Pornography","Youth Sexual Aggression"],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"two-wave convenience sample of 318 Polish university students (214 women); predictors measured at baseline, outcomes (victimization/perpetration) assessed 12 months later","sample_n":318,"sample_text":"convenience university sample, not probability based","population":"Polish university students (young adults)","country":"Poland","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 12‑month study of 318 Polish university students, higher pornography use was linked to risky sexual scripts, which in turn increased the chance of being victimised by sexual aggression. Religiosity also played an indirect role via those scripts.","clinical_takeaway":"Pornography use may signal risk for sexual aggression victimisation through risky sexual cognitions; prevention programs should address media influences and script education.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["prospective longitudinal design","large sample for behavioural survey","includes both victim and perpetrator perspectives","tests mediation via risky scripts"],"limitations":["convenience university sample limits generalisability","no validated measures of pornography‑related addiction or distress","key confounds (mental health, trauma, partner context) not assessed"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":14,"contrasting":0,"mentioning":77,"citing_publications":120,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0823-2"}},{"id":2231,"doi":"10.1007/s11920-016-0707-0","pmid":"27325170","pmcid":null,"title":"Understanding Online Child Sexual Exploitation Offenses","authors":"Ly T, Murphy L, Fedoroff JP.","first_author":"Ly T","journal":"Current psychiatry reports","year":2016,"pub_types":["Review","Journal Article"],"keywords":["Child Sexual Abuse","Child Pornography","Online Sex Offenders","Internet Sex Offenses","Online Child Sexual Exploitation"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Review article summarizing existing literature; no new empirical data reported.","sample_n":null,"sample_text":"Not applicable – review of prior studies.","population":"Offenders of child sexual exploitation; no primary sample.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review finds little evidence that easier internet access to child pornography has increased real‑world child sexual abuse, noting a decline in in‑person offenses despite more online material.","clinical_takeaway":"None – the article is a review of offender behavior, not a clinical guide.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad overview of literature on online child sexual exploitation","Incorporates crime statistics trends"],"limitations":["No original data; dependent on existing studies","Lacks systematic review methodology details","No assessment of study quality or bias"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11920-016-0707-0"}},{"id":2232,"doi":null,"pmid":"1302863","pmcid":null,"title":"Legal case briefs for nurses. OR: sexually explicit photographs of corpses: licence revocation upheld. PA: automatic doors close on patient: nurse liability issue","authors":"Tammelleo AD.","first_author":"Tammelleo AD.","journal":"The Regan report on nursing law","year":1992,"pub_types":["Legal Case","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":2233,"doi":"10.47391/jpma.4947","pmid":"35751358","pmcid":null,"title":"Pornography, a neglected prevailing addiction","authors":"Mushtaq R, Samad S, Ashraf Jahangeer SM.","first_author":"Mushtaq R","journal":"JPMA. The Journal of the Pakistan Medical Association","year":2022,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.47391/jpma.4947"}},{"id":2234,"doi":"10.1007/s10943-021-01374-8","pmid":"34389966","pmcid":null,"title":"Correction to: The Relationship Between Sexual Compulsivity, Emotional and Spiritual Distress of Religious and Non-religious Internet Pornography Users","authors":"Hotchkiss JT.","first_author":"Hotchkiss JT.","journal":"Journal of religion and health","year":2022,"pub_types":["Published Erratum"],"keywords":[],"is_oa":false,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10943-021-01374-8.pdf","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-021-01374-8"}},{"id":2235,"doi":"10.1001/jamanetworkopen.2022.15863","pmid":"35653152","pmcid":"PMC9164004","title":"Youth Characteristics Associated With Sexual Violence Perpetration Among Transgender Boys and Girls, Cisgender Boys and Girls, and Nonbinary Youth","authors":"Ybarra ML, Goodman KL, Saewyc E, Scheer JR, Stroem IF.","first_author":"Ybarra ML","journal":"JAMA network open","year":2022,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9164004","cited_by_count":25,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional analysis of baseline data from a national online longitudinal survey; N=4193 youths (14‑16 y)","sample_n":4193,"sample_text":"4193 youths (mean age 14.8 y); 78.3 % cisgender, 7.9 % transgender, 13.9 % nonbinary","population":"U.S. adolescents, English‑speaking, internet access; oversampled gender‑minority youths","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US survey of 4,200 teens aged 14‑16, transgender and nonbinary youths were about twice as likely as cisgender peers to report having experienced sexual violence, but they did not differ in self‑reported perpetration. Factors such as aggression and hostile masculinity were linked to perpetration among cisgender youth.","clinical_takeaway":"Gender‑minority teens face higher risk of sexual‑victimization; prevention programs should address their specific stressors and protective factors.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large national sample of gender‑diverse adolescents","Both victimization and perpetration outcomes measured","Adjusted odds ratios with confidence intervals"],"limitations":["Cross‑sectional design limits causal inference","Self‑report may bias sensitive outcomes","Key confounds for pornography‑related research (e.g., moral incongruence, masturbation) not assessed"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":1,"mentioning":42,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/jamanetworkopen.2022.15863"}},{"id":2236,"doi":"10.4102/phcfm.v14i1.3434","pmid":"35695444","pmcid":"PMC9210149","title":"Tailoring a sexual health curriculum to the sexual health challenges seen by midwifery, nursing and medical providers and students in Tanzania","authors":"Rosser BRS, Mkoka DA, Rohloff CT, Mgopa LR, Ross MW, Lukumay GG, Mohammed I, Massae AF, Mkonyi E, Mushy SE, Mwakawanga DL, Kohli N, Trent ME, Wadley J, Bonilla ZE.","first_author":"Rosser BRS","journal":"African journal of primary health care & family medicine","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["sexually transmitted diseases","Sexual dysfunction","Hiv Infections","Schools, Medical","Schools, Nursing","Masturbation","Curriculum","Sexual Health","Sexual Violence","Sexual And Gender Minorities"],"is_oa":true,"oa_url":"https://phcfm.org/index.php/phcfm/article/download/3434/5401","cited_by_count":11,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups with 121 health‑provider participants; stratified by profession and experience; thematic analysis of transcripts","sample_n":121,"sample_text":"convenience sample of health‑care providers and students; not representative of all Tanzanian providers","population":"experienced and student doctors, nurses, midwives in Dar es Salaam, Tanzania","country":"Tanzania","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Health‑care providers and students in Tanzania said they commonly encounter HIV, STIs, sexual violence, early pregnancy, sexual dysfunction, LGBT issues, sex work, and taboo topics like pornography and masturbation. They want a comprehensive sexual‑health curriculum that also teaches how to discuss these taboo subjects.","clinical_takeaway":"Training programmes should include skills for talking about pornography, masturbation and other culturally sensitive topics.","confidence":0.78,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["large, diverse sample of practitioners and students","systematic focus‑group stratification by profession and experience","identifies concrete curriculum gaps relevant to local context"],"limitations":["Convenience sampling limits generalisability","No validated instruments; reliance on author‑generated discussion guide","No quantitative assessment of prevalence or severity of identified issues"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4102/phcfm.v14i1.3434"}},{"id":2237,"doi":"10.1111/jcap.12385","pmid":"35637598","pmcid":null,"title":"The associations of cognitive distortions with internet addiction and internet activities in adolescents: A cross-sectional study","authors":"Özparlak A, Karakaya D.","first_author":"Özparlak A","journal":"Journal of child and adolescent psychiatric nursing : official publication of the Association of Child and Adolescent Psychiatric Nurses, Inc","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescents","Psychiatric Nursing","Internet Addiction","Cognitive Distorsions","Internet Activities"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 638 adolescents recruited via unspecified method","sample_n":638,"sample_text":"638 adolescents","population":"adolescents (n=638)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 638 adolescents, those who played online games, visited porn sites, used social media, or browsed aimlessly reported higher internet‑addiction scores. Certain thinking errors (catastrophizing, personalization, selective abstraction) were linked to higher addiction scores and specific online activities.","clinical_takeaway":"Be aware that adolescent internet‑addiction symptoms often co‑occur with maladaptive thought patterns; addressing cognition may help reduce problematic use.","confidence":0.7,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Large sample (N>600)","Validated cognitive distortion questionnaire","Examines multiple internet activities"],"limitations":["Cross‑sectional; cannot infer causality","No control for moral/religious or mental‑health confounds","Internet addiction measured by self‑report scale, possible circularity"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jcap.12385"}},{"id":2238,"doi":"10.1007/s10597-016-0034-2","pmid":"27345497","pmcid":null,"title":"Clinicians' Beliefs, Observations, and Treatment Effectiveness Regarding Clients' Sexual Addiction and Internet Pornography Use","authors":"Short MB, Wetterneck CT, Bistricky SL, Shutter T, Chase TE.","first_author":"Short MB","journal":"Community mental health journal","year":2016,"pub_types":["Journal Article"],"keywords":["Perceived Competence","Hypersexual Disorder","Sex Addiction","Sexually Explicit Material","Internet Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 183 mental‑health professionals about beliefs, observations and perceived treatment effectiveness for sexual addiction and problematic internet pornography use.","sample_n":183,"sample_text":"183 mental‑health professionals completed an online questionnaire.","population":"Mental‑health clinicians (N=183), likely recruited via professional networks.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2016 survey of 183 mental‑health clinicians found many see clients with sexual addiction or problematic internet pornography use, but most feel untrained and lack confidence to treat them effectively.","clinical_takeaway":"Clinicians often feel under‑prepared to address sexual addiction and problematic porn use; targeted training may improve care.","confidence":0.7,"topic_tags":["sexual_function","pornography","treatment"],"strengths":["Relatively large clinician sample (N≈180).","Addresses a gap in knowledge about professional competence.","Identifies need for training and clearer diagnostic guidelines."],"limitations":["Convenience sample; not representative of all clinicians.","No validated measurement instruments for key constructs.","Cross‑sectional, self‑report data limit causal inference."],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":16,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10597-016-0034-2"}},{"id":2239,"doi":"10.1080/00918369.2022.2071136","pmid":"35605228","pmcid":"PMC9681935","title":"\"I Was Always Trying to Figure It Out… on My Own Terms\": Structural Barriers, the Internet, and Sexual Identity Development among Lesbian, Gay, Bisexual, and Queer People of Different Generations","authors":"Campbell CK, Hammack PL, Gordon AR, Lightfoot MA.","first_author":"Campbell CK","journal":"Journal of homosexuality","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Generations","Life Course","Sexual Identity","Coming Out","Sexual Identity Development","Lgbq+"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"The study used semi‑structured interviews with 36 sexual‑minority adults across three birth cohorts and conducted thematic analysis of their narratives. Recruitment was non‑probability and sample size is small, limiting generalisability.","sample_n":36,"sample_text":"Convenience sample of three generational cohorts (18‑25, 34‑41, older) recruited for narrative interviews.","population":"sexual minority adults (LGBQ+) in the United States, ages 18‑59 (n=36)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 36 LGBQ+ adults showed how the internet helped younger and middle‑aged people learn about sexual identities, find community, and explore sexual experiences, while older participants faced barriers like heterosexual marriage and conservative backgrounds.","clinical_takeaway":"None – the study offers sociocultural insight rather than clinical guidance on sexual health or pornography use.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Rich, generational qualitative insight into internet’s role in LGBQ+ identity development","Clear thematic framework linking structural barriers and internet functions"],"limitations":["Small, non‑representative convenience sample (n=36)","No validated measurement instruments; relies on self‑report narratives","Findings limited to U.S. context and may not generalise to other cultures"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2022.2071136"}},{"id":2240,"doi":"10.1037//0022-3514.55.5.758","pmid":"3210143","pmcid":null,"title":"Effects of long-term exposure to violent and sexually degrading depictions of women","authors":"Linz DG, Donnerstein E, Penrod S.","first_author":"Linz DG","journal":"Journal of personality and social psychology","year":1988,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment with random assignment to film conditions; control group included.","sample_n":null,"sample_text":"Male subjects; exact N unclear from abstract.","population":"Male participants (college-aged likely). Sample size not reported in abstract.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Men watched violent or sexually explicit films; those who saw violent movies showed less anxiety, depression, and empathy for rape victims, suggesting media exposure can desensitize attitudes toward women.","clinical_takeaway":"None – findings relate to attitudes, not clinical sexual health.","confidence":0.6,"topic_tags":["sexual_function","gender"],"strengths":["Randomized experimental design","Multiple exposure conditions","Measures both affective and cognitive outcomes"],"limitations":["Unclear sample size and power","Reliance on possibly ad‑hoc questionnaires","No assessment of moral or personal variables that could influence attitudes"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0022-3514.55.5.758"}},{"id":2241,"doi":"10.1007/bf01542142","pmid":"3675186","pmcid":null,"title":"The psychophysiological nature of premature ejaculation","authors":"Strassberg DS, Kelly MP, Carroll C, Kircher JC.","first_author":"Strassberg DS","journal":"Archives of sexual behavior","year":1987,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":55,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"laboratory experimental study with physiological and self‑report arousal measures; between‑groups (PE vs NPE) cross‑sectional design; N=26 (13 per group)","sample_n":26,"sample_text":"Twenty‑six men (13 PEs and 13 NPEs) were recruited","population":"adult men, 26 participants (13 diagnosed with premature ejaculation, 13 controls)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men with premature ejaculation to those without, finding that both groups could accurately judge their physiological arousal during video clips, suggesting that inaccurate self‑assessment of arousal is not a cause of premature ejaculation.","clinical_takeaway":"Premature ejaculation does not appear to stem from poor awareness of sexual arousal; clinicians should consider other factors when treating it.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Objective physiological measurement of arousal","Direct comparison between PE and control groups","Simultaneous subjective and objective data"],"limitations":["Very small sample size, likely underpowered","Limited detail on diagnostic criteria for PE","No control for potential confounds (age, relationship status, mental health)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":27,"citing_publications":106,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542142"}},{"id":2242,"doi":"10.3389/fpubh.2022.843359","pmid":"35586000","pmcid":"PMC9108279","title":"Risky Sexual Practice and Associated Factors Among Youth Preparatory Students in Gondar City, Northwest Ethiopia","authors":"Azene ZN, Tsegaye L, W/Gebriel M, Tadesse A, Tadele A, Aynalem GL, Andualem Z, Taye BT.","first_author":"Azene ZN","journal":"Frontiers in public health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Students","Ethiopia","Preparatory School","Risky Sexual Practice"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpubh.2022.843359/pdf","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 414 preparatory students selected by simple random sampling; logistic regression analyses","sample_n":414,"sample_text":"414 regularly attending youth students","population":"Youth preparatory students in Gondar city, Ethiopia (N≈414)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2022 Ethiopian survey of 414 high‑school students found that about half engaged in risky sexual behaviour. Watching pornography, peer pressure and alcohol use were linked to higher odds of such behaviour.","clinical_takeaway":"Exposure to porn, peer pressure, and alcohol are associated with risky sex among Ethiopian youths; interventions should address these factors.","confidence":0.7,"topic_tags":["pornography","religiosity","sexual_function"],"strengths":["Reasonably large random sample for the setting","Use of multivariable logistic regression with confidence intervals","Pre‑tested questionnaire"],"limitations":["Key constructs (pornography exposure, risky sex) measured by single items, not validated scales","Cross‑sectional design precludes causal inference","Did not assess major confounders (moral incongruence, mental health, trauma, masturbation)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2022.843359"}},{"id":2243,"doi":"10.1093/humrep/deac044","pmid":"35258084","pmcid":null,"title":"Changes in sexual frequency among 51 150 infertile Chinese couples over the past 10 years","authors":"Zhu Y, Wang B, Zhu Q, Ye J, Kuang Y.","first_author":"Zhu Y","journal":"Human reproduction (Oxford, England)","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Trend","Associated Factors","Sexual Frequency","Universal Two-child Policy","Infertile Chinese Couples"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective cohort of 51 150 infertile couples from a single tertiary centre, spanning 2011‑2020","sample_n":51150,"sample_text":"51 150 infertile couples","population":"infertile Chinese couples seeking care at one hospital","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a review of over 51,000 infertile Chinese couples attending one hospital, the proportion having sex more than four times a month fell from about 63% in 2011‑13 to 53% in 2016‑20, especially among women aged 18‑39.","clinical_takeaway":"Infertile couples, particularly younger women, may be having sex less often over time; clinicians should consider frequency when discussing fertility planning.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Very large sample size","Long ten‑year observation window","Multivariable logistic regression"],"limitations":["Self‑reported sexual frequency only, no validated scale","Single‑centre, infertile‑clinic sample limits generalisability","Key psychosocial confounds (moral incongruence, masturbation, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/humrep/deac044"}},{"id":2244,"doi":"10.1007/bf01543003","pmid":"2003767","pmcid":null,"title":"Voluntary control of male sexual arousal","authors":"Mahoney JM, Strassberg DS.","first_author":"Mahoney JM","journal":"Archives of sexual behavior","year":1991,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Within‑subject laboratory experiment with 48 adult male volunteers, each viewing erotic and neutral videotapes while penile plethysmography recorded arousal; participants attempted to suppress or generate arousal.","sample_n":48,"sample_text":"48 adult male volunteers","population":"adult males (N=48), community volunteers","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, 48 men tried to suppress sexual arousal while watching erotic videos and to increase arousal while watching neutral videos. Penile measurements showed they could not fully fake the opposite response, indicating limits to voluntary control of male arousal.","clinical_takeaway":"Voluntary control of physiological sexual arousal appears limited; clinicians should be cautious about expecting conscious regulation of arousal responses.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Objective physiological measure of arousal","Within‑subject control condition","Clear experimental manipulation"],"limitations":["No reporting of effect sizes or confidence intervals","No pre‑registration","No assessment of potential psychosocial confounds"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01543003"}},{"id":2245,"doi":"10.3389/fpsyt.2022.820836","pmid":"35546934","pmcid":"PMC9083266","title":"The Role of Impulsivity and Reward Deficiency in \"Liking\" and \"Wanting\" of Potentially Problematic Behaviors and Substance Uses","authors":"File D, Bőthe B, File B, Demetrovics Z.","first_author":"File D","journal":"Frontiers in psychiatry","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Substance Misuse","Impulsivity","Problem Behavior","Incentive Sensitization","Reward Deficiency"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9083266","cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey (N=749) using self‑report questionnaires and structural equation modelling","sample_n":749,"sample_text":"503 women, mean age 35.7 ± 11.84 years","population":"community adults (average age 35.7, 67% women)","country":"unspecified (likely European based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 749 adults, higher self‑reported ‘wanting’ for activities like pornography, gambling or drinking was linked to how often they engaged in them, while ‘liking’ stayed the same. Impulsivity predicted ‘wanting’, and both impulsivity and ‘wanting’ were related to poorer wellbeing.","clinical_takeaway":"Higher impulsivity may drive the urge (‘wanting’) to use porn or other behaviors, which can lower wellbeing.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a questionnaire study","Comprehensive list of behaviors examined","Use of structural equation modelling to test indirect paths"],"limitations":["Reliance on ad‑hoc self‑report scales for ‘wanting’/‘liking’","Cross‑sectional design limits causal inference","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":25,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2022.820836"}},{"id":2246,"doi":"10.1080/00224499.2016.1146203","pmid":"27049348","pmcid":null,"title":"Does Viewing Pornography Diminish Religiosity Over Time? Evidence From Two-Wave Panel Data","authors":"Perry SL.","first_author":"Perry SL.","journal":"Journal of sex research","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two-wave nationally representative panel (Portraits of American Life Study) examining pornography viewing at Wave 1 and religiosity outcomes at Wave 2.","sample_n":null,"sample_text":"nationally representative panel (sample size not given in abstract)","population":"U.S. adults across age ranges, gender-balanced","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using two waves of a US‑wide survey, the study finds that people who watched porn were more likely to question their faith and pray less later on, though very heavy viewers sometimes showed higher religious activity.","clinical_takeaway":"None – findings pertain to general population religiosity, not clinical treatment.","confidence":0.8,"topic_tags":["pornography","religiosity","sexual_function","csbd"],"strengths":["Longitudinal design allows temporal ordering","Nationally representative sample","Separate measures for pornography frequency and multiple religiosity dimensions"],"limitations":["Reliance on self‑report without validated scales for pornography behavior","Potential unmeasured confounds (e.g., mental health, moral attitudes)","Effect sizes and power not reported in abstract"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":21,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2016.1146203"}},{"id":2247,"doi":"10.1080/00224499.2016.1143441","pmid":"27105446","pmcid":null,"title":"Adolescents and Pornography: A Review of 20 Years of Research","authors":"Peter J, Valkenburg PM.","first_author":"Peter J","journal":"Journal of sex research","year":2016,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":205,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Narrative systematic review of 1995‑2015 adolescent pornography literature; no new primary data.","sample_n":null,"sample_text":"No primary sample; review of published studies.","population":"Adolescents (age not specified, studies from 1995‑2015)","country":"International (studies from various countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"This 2016 review summarises 20 years of research on teen pornography use, noting that use is common, linked to being male, older puberty, sensation‑seeking and family trouble, and associated with permissive attitudes, casual sex and sexual aggression. The authors stress that methodological limits prevent firm causal claims.","clinical_takeaway":"Clinicians should be aware that adolescent porn use co‑occurs with other risk factors, but current evidence cannot prove it causes harmful outcomes.","confidence":0.8,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Broad coverage of two decades of research","Identifies methodological gaps in the literature","Highlights sexual aggression associations"],"limitations":["No quantitative synthesis or meta‑analysis","Relies on heterogeneous primary studies","Does not assess confounders such as moral incongruence or mental health"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":22,"contrasting":4,"mentioning":507,"citing_publications":646,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2016.1143441"}},{"id":2248,"doi":"10.5964/sotrap.5425","pmid":"39886529","pmcid":"PMC11778742","title":"Childhood Sexual Victimization, Pedophilic Interest, and Antisocial Orientation","authors":"Pham AT, Nunes KL, Maimone S, Jung S.","first_author":"Pham AT","journal":"Sexual offending (Trier, Germany)","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Psychopathy","Childhood Abuse","Risk Status","Child Pornography","Childhood Sexual Victimization","Sex Offender Against Children"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11778742","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Four observational studies of convicted sexual offenders combined in a within‑author meta‑analysis; likely cross‑sectional self‑report data.","sample_n":null,"sample_text":"Convicted offenders; no indication of random or population‑based sampling.","population":"Adult men convicted of sexual offences against children (under‑15).","country":"Germany (journal) / unspecified for samples","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"moderate","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined whether men who were sexually abused as children are more likely to be interested in children and to show antisocial traits later in life. Across four studies of convicted offenders, childhood abuse was linked to higher antisociality and, to a lesser extent, to greater sexual interest in children.","clinical_takeaway":"Findings suggest childhood sexual victimisation may contribute to antisocial traits and pedophilic interests in offender populations; not directly applicable to treatment of non‑offender clients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Multiple studies aggregated","Meta‑analytic effect sizes provided","Focus on distinct risk domains"],"limitations":["Convenience sample of convicted offenders limits generalisability","Unclear measurement validation for key constructs","Potential self‑report bias on victimisation and interests"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5964/sotrap.5425"}},{"id":2250,"doi":"10.1016/j.copsyc.2016.03.004","pmid":"28813295","pmcid":null,"title":"The use and effects of pornography in romantic relationships","authors":"Campbell L, Kohut T.","first_author":"Campbell L","journal":"Current opinion in psychology","year":2017,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":74,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"non-empirical narrative review","sample_n":null,"sample_text":"none (review article)","population":"none","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors review how pornography use by one or both partners may affect romantic relationship quality, noting that current research is mixed and methodologically weak, and they suggest a new ACE framework to guide future studies.","clinical_takeaway":"Clinicians should recognize that evidence on porn’s impact on relationships is inconclusive and consider couple‑level factors before drawing conclusions.","confidence":0.8,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Comprehensive synthesis of existing dyadic research","Identifies methodological gaps and proposes future model (ACE)","Balanced discussion of positive, neutral, negative effects"],"limitations":["No systematic review methodology (no risk‑of‑bias assessment)","Lacks quantitative meta‑analysis","Relies on existing studies that often have poor construct validity"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":76,"citing_publications":162,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.copsyc.2016.03.004"}},{"id":2253,"doi":"10.1007/s10508-022-02290-y","pmid":"35348918","pmcid":"PMC9363378","title":"Body Gaze as a Marker of Sexual Objectification: A New Scale for Pervasive Gaze and Gaze Provocation Behaviors in Heterosexual Women and Men","authors":"Hollett RC, Rogers SL, Florido P, Mosdell B.","first_author":"Hollett RC","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Body","Eye Tracking","Gaze","Sexual Objectification"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9363378","cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey validation (N=1021) and eye‑tracking subsample (N=167); exploratory and confirmatory factor analysis, test‑retest reliability, convergent validity with related attitudes.","sample_n":1021,"sample_text":"Study 1 N = 1021; Study 2 subsample N = 167","population":"heterosexual adults (community sample)","country":"Not specified (likely Canada/USA based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a questionnaire that measures how often people look at others’ bodies (pervasive gaze) and how much they try to invite such looks (gaze provocation). The scales showed good reliability and related to attitudes about bodies and sexual assault, and self‑reports matched eye‑tracking data.","clinical_takeaway":"None – the study provides a research tool rather than clinical guidance.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large initial sample for scale development","Robust factor‑analytic validation (EFA & CFA)","Objective eye‑tracking verification of self‑report","Good internal consistency and test‑retest reliability"],"limitations":["New scale not yet cross‑culturally validated","Eye‑tracking subsample relatively small","No pre‑registration or correction for multiple testing reported","Focus on heterosexual participants limits generalisability"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":28,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02290-y"}},{"id":2254,"doi":"10.1007/s13178-022-00700-3","pmid":"35310172","pmcid":"PMC8923738","title":"Expert Stakeholders' Perspectives on How Cisgender Heterosexual Boys and Young Men Navigate Sex and Intimacy in Australia: A Case for \"Heterosexual Intimacies\" in Policy and Practice","authors":"Waling A, James A, Fairchild J.","first_author":"Waling A","journal":"Sexuality research & social policy : journal of NSRC : SR & SP","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Men","Sexual Health","Consent","Intimacy","Dating","Heterosexual","Boys","Stakeholder","Cisgender"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s13178-022-00700-3.pdf","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"semi‑structured interviews with 23 expert stakeholders; inductive thematic analysis","sample_n":23,"sample_text":"23 expert stakeholders","population":"expert stakeholders in gender‑based violence prevention, sexual health, education, sport, wellbeing (Australia)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 23 Australian experts reveal that cis‑gender heterosexual boys face gaps in information, potential harms from porn, and limited support for healthy intimacy, suggesting a need for policy that combines sexual health with gender‑based violence prevention.","clinical_takeaway":"None – the study offers policy insights, not clinical guidance.","confidence":0.8,"topic_tags":["sexual_function","masturbation","moral_incongruence","pornography"],"strengths":["Provides stakeholder perspectives for policy","Uses systematic thematic analysis"],"limitations":["Small, non‑representative expert sample","No primary data on pornography use or sexual health outcomes"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13178-022-00700-3"}},{"id":2255,"doi":"10.3389/fpsyg.2022.872445","pmid":"35369217","pmcid":"PMC8964781","title":"Editorial: Sexual Interaction in Digital Contexts: Opportunities and Risks for Sexual Health","authors":"Döring N, Krämer N, Brand M, Krüger THC, van Oosten JMF, Vowe G.","first_author":"Döring N","journal":"Frontiers in psychology","year":2022,"pub_types":["Editorial"],"keywords":["Cybersex","Pornography","Sexting","Sexual Consent","Internet Sexuality","Voice Assistants","Sex Robots","Online Sexual Activities (Osa)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8964781","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2022.872445"}},{"id":2256,"doi":"10.1016/j.pcl.2015.09.001","pmid":"26613696","pmcid":null,"title":"Adolescent Health Implications of New Age Technology","authors":"Jacobson C, Bailin A, Milanaik R, Adesman A.","first_author":"Jacobson C","journal":"Pediatric clinics of North America","year":2016,"pub_types":["Review","Journal Article"],"keywords":["Adolescents","Video Games","Internet Addiction","Cyberbullying","Cell Phone","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review, narrative overview without systematic methodology or meta-analysis","sample_n":null,"sample_text":"No primary sample; literature review","population":"Adolescents (general)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how modern technologies like the internet, video games, and smartphones may affect teen health, mentioning links between pornography exposure and negative outcomes, but it does not present new data.","clinical_takeaway":"None – the piece is a narrative review without actionable clinical evidence.","confidence":0.7,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Broad overview of adolescent technology use","Highlights multiple health domains"],"limitations":["No systematic methodology","Lacks empirical data or systematic analysis","Does not separate pornography use from other internet activities"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pcl.2015.09.001"}},{"id":2257,"doi":"10.1080/00918369.2022.2048167","pmid":"35285776","pmcid":null,"title":"Effeminate Gay Bottoms in the West: Narratives of Pussyboys and Boiwives on Tumblr","authors":"Vytniorgu R.","first_author":"Vytniorgu R.","journal":"Journal of homosexuality","year":2023,"pub_types":["Journal Article"],"keywords":["stigma","Homosexuality","Gay Men","Gender Identity","Popular Culture","Cultural Studies","Pornography"],"is_oa":false,"oa_url":"https://www.tandfonline.com/doi/pdf/10.1080/00918369.2022.2048167?needAccess=true","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"narrative thematic analysis of Tumblr posts; convenience sample of self‑selected users; qualitative coding of sexual fantasy narratives.","sample_n":null,"sample_text":"unspecified number of Tumblr users; convenience sample","population":"gay men who post on Tumblr; not a probability sample","country":"Western (Europe/North America) inferred from platform focus","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examines Tumblr stories about effeminate gay men who prefer the receptive role, showing how gender presentation, fantasy, and cultural stereotypes intersect in Western LGBTQ media.","clinical_takeaway":"None – the paper offers cultural insight rather than clinical guidance.","confidence":0.8,"topic_tags":["gender","sexual_function","csbd"],"strengths":["Provides rich, cultural insight into gay male bottom fantasies","Connects Western and non‑Western narratives","Highlights gendered dimensions often overlooked"],"limitations":["Small, non‑representative Tumblr sample","Lacks quantitative measurement or validation","No control for confounding variables (e.g., mental health, religiosity)"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2022.2048167"}},{"id":2258,"doi":"10.1016/j.comppsych.2022.152303","pmid":"35334305","pmcid":null,"title":"Perspective: Can psychedelic-assisted therapy be a promising aid in compulsive sexual behavior disorder treatment?","authors":"Wizła M, Kraus SW, Lewczuk K.","first_author":"Wizła M","journal":"Comprehensive psychiatry","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Behavioral Addictions","Compulsive Sexual Behavior Disorder","Problematic Pornography Use","Psychedelic-assisted Psychotherapy"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Perspective/position paper without original empirical data.","sample_n":null,"sample_text":"No participants; article is a narrative perspective.","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The authors argue that psychedelic‑assisted therapy could help people with compulsive sexual behavior by reducing avoidance and changing brain activity, drawing on parallels with mindfulness and early addiction studies.","clinical_takeaway":"Currently no evidence; clinicians should await controlled trials before considering psychedelics for CSBD.","confidence":0.8,"topic_tags":["csbd","pornography","masturbation","sexual_function"],"strengths":["Integrates emerging psychedelic literature","Highlights possible neurobiological mechanisms"],"limitations":["No original data or systematic review","Speculative claims about efficacy","Lacks empirical evaluation of confounds"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2022.152303"}},{"id":2259,"doi":"10.1080/10410236.2015.1022936","pmid":"26752322","pmcid":null,"title":"Consumption of Pornography, Perceived Peer Norms, and Condomless Sex","authors":"Wright PJ, Tokunaga RS, Kraus A.","first_author":"Wright PJ","journal":"Health communication","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two separate convenience surveys of U.S. college students assessing self‑reported frequency of pornography consumption and condomless sexual encounters; mediation analysis with perceived peer condom use.","sample_n":null,"sample_text":"Convenience sample of university students; size not reported in abstract","population":"U.S. college students (young adults)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Two surveys of U.S. college students found that those who watch more pornography are more likely to have sex without condoms, partly because they think their peers also use fewer condoms.","clinical_takeaway":"Clinicians should be aware that pornography use may be linked to risky sexual decisions, but causality is not established.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Two independent samples provide replication","Examines peer norm mediation, adding theoretical depth","Focuses on a specific health behavior (condomless sex)"],"limitations":["Reliance on single‑item self‑reports for key variables","Cross‑sectional design precludes causal inference","No control for potential confounders (e.g., personality, mental health, relationship status)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":24,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2015.1022936"}},{"id":2260,"doi":"10.4314/ahs.v22i1.6","pmid":"36032494","pmcid":"PMC9382504","title":"Factors associated with risky sexual behaviour among sexually experienced undergraduates in Osun state, Nigeria","authors":"Omisore A, Oyerinde I, Abiodun O, Aderemi Z, Adewusi T, Ajayi I, Fagbolade T, Miskilu S.","first_author":"Omisore A","journal":"African health sciences","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Behaviour","Factors","Experienced","Risky","Sexual Undergraduates"],"is_oa":true,"oa_url":"https://www.ajol.info/index.php/ahs/article/download/224553/211849","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive cross‑sectional survey of 266 sexually experienced undergraduates from two Nigerian universities, using multistage sampling and a self‑administered questionnaire.","sample_n":266,"sample_text":"266 sexually experienced respondents analysed (54.5 % male, 45.5 % female).","population":"Undergraduate students (sexually experienced) in Osun state, Nigeria (N≈266).","country":"Nigeria","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 266 Nigerian undergraduates found that about two‑thirds engaged in risky sexual behaviour, which was more common among males, users of alcohol or drugs, pornography viewers, and those reporting poor moral guidance from their mothers.","clinical_takeaway":"Targeted sexual‑health education that addresses substance use, pornography exposure, and family communication may help reduce risky sexual practices among university students.","confidence":0.8,"topic_tags":["religiosity","pornography","relationships","sexual_function"],"strengths":["Relatively large sample for an undergraduate survey","Multistage sampling attempts to improve representativeness","Multivariate analysis performed"],"limitations":["Self‑report questionnaire likely unvalidated for RSB","Cross‑sectional design limits causal inference","Key confounders (mental health, trauma, partner factors) not measured"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":10,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4314/ahs.v22i1.6"}},{"id":2261,"doi":"10.1071/sh21220","pmid":"35236545","pmcid":null,"title":"Traversing TechSex: benefits and risks in digitally mediated sex and relationships","authors":"Moor L, Anderson J, Waling A, James A, Shackleton N, Farrell AM, Agnew E, Dowsett GW, Power J.","first_author":"Moor L","journal":"Sexual health","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.publish.csiro.au/sh/pdf/SH21220","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey of 445 Australian adults collected in 2020; descriptive and bivariate analyses of digital sexual practices, perceived risks and benefits.","sample_n":445,"sample_text":"n = 445 Australian adults, mean age 42, 58.5% women, 61.1% heterosexual.","population":"Adults (mean age 42, 58.5% women) recruited via an online survey in Australia; convenience sample.","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2022 Australian survey of 445 adults examined how people use smartphones, apps and other digital tools for sex. While many found these technologies helped them feel closer to partners, most were also aware of risks like non‑consensual image sharing, especially women.","clinical_takeaway":"Digital sexual tools can enhance intimacy but clinicians should discuss privacy and consent risks with clients.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Large community sample for survey research","Addresses both benefits and risks of digital sexual practices","Clear descriptive statistics"],"limitations":["Convenience online recruitment limits generalisability","Reliance on ad‑hoc, non‑validated questionnaire items","No adjustment for key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh21220"}},{"id":2263,"doi":"10.3390/ijerph19052704","pmid":"35270395","pmcid":"PMC8910026","title":"Sexual Addiction, Hypersexual Behavior and Relative Psychological Dynamics during the Period of Social Distancing and Stay-at-Home Policies Due to COVID-19","authors":"Caponnetto P, Maglia M, Prezzavento GC, Pirrone C.","first_author":"Caponnetto P","journal":"International journal of environmental research and public health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Hypersexual Behavior","Sexual Addiction","Sast","Covid-19","Lock-down"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/5/2704/pdf?version=1645959107","cited_by_count":5,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online self‑report questionnaire administered Apr 2020‑Apr 2021; convenience sample recruited via social media; n not reported","sample_n":null,"sample_text":"online convenience sample, size not specified in abstract","population":"adults (≥18 y, mean 23.1 y, 48 % male, 52 % female), recruited online","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale","causal_from_correlational","self_selected_sample"],"stance":"supports","citation_value":"background","plain_summary":"The authors surveyed adults online during COVID‑19 lockdowns and found higher SAST scores, suggesting more loss of control and addictive‑like sexual symptoms. They link increased pornography use to hypersexual behaviour, but the study does not separate pornography from masturbation or account for moral or mental‑health factors.","clinical_takeaway":"Do not interpret higher SAST scores as evidence of a clinical sexual addiction without assessing distress, moral conflict, and mental‑health context.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Timely data collection during COVID‑19 lockdown","Large age range including both sexes","Uses a widely cited screening tool (SAST)"],"limitations":["No measurement of key confounds (morality, masturbation, mental health, relationship context)","Reliance on a single self‑label scale that defines addiction by distress","Cross‑sectional design, no causal inference","Sample recruited via social media; possible self‑selection bias"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph19052704"}},{"id":2264,"doi":"10.1016/j.actpsy.2022.103549","pmid":"35220166","pmcid":null,"title":"Dark personality and intimate partner relationships in young adults","authors":"Ferreiros L, Clemente M.","first_author":"Ferreiros L","journal":"Acta psychologica","year":2022,"pub_types":["Journal Article"],"keywords":["Young Adults","Violence Prevention","Moral Disengagement","Partner Relationship","Dark Personality Traits"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 308 young adults (78% women) investigating dark personality traits, moral disengagement, pornography use and infidelity.","sample_n":308,"sample_text":"308 participants, 78.3% women, 21.2% men","population":"young adults (18‑25) recruited via unspecified convenience methods","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 308 young adults, higher dark personality traits and moral disengagement were linked to more frequent pornography use and higher rates of infidelity, suggesting these traits may undermine couple relationships.","clinical_takeaway":"Assess personality and moral attitudes when addressing relationship or sexual‑behavior concerns; porn use alone is not a predictor of harm.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships","moral_incongruence"],"strengths":["Large sample for a single‑site survey","Uses established personality constructs","Considers both porn use and moral disengagement"],"limitations":["Cross‑sectional; cannot infer causality","Convenience sample, gender‑imbalanced","No control for key confounds (mental health, moral incongruence, trauma)","Limited detail on measurement validation"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.actpsy.2022.103549"}},{"id":2265,"doi":"10.1080/00224499.2015.1096886","pmid":"26683998","pmcid":null,"title":"Documenting Pornography Use in America: A Comparative Analysis of Methodological Approaches","authors":"Regnerus M, Gordon D, Price J.","first_author":"Regnerus M","journal":"Journal of sex research","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":85,"is_preprint":false,"topics":["bibliography","csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Analysis of four nationally representative US adult surveys comparing question wording for pornography use prevalence.","sample_n":null,"sample_text":"Four recent nationally representative samples (exact N not provided in abstract).","population":"US adults aged 18‑39 (men and women)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study shows that how survey questions are phrased dramatically changes reported pornography use rates in the US, with recent‑use questions giving higher prevalence than general‑use questions.","clinical_takeaway":"None – the paper addresses survey methods, not clinical outcomes.","confidence":0.7,"topic_tags":["pornography","prevalence","measurement","sexual_function"],"strengths":["Uses multiple nationally representative datasets","Directly compares survey methodologies","Highlights impact of question wording on prevalence estimates"],"limitations":["Relies on single‑item self‑report measures of use","No assessment of related psychosocial variables","Abstract lacks detail on sample sizes and statistical adjustments"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":15,"contrasting":0,"mentioning":110,"citing_publications":240,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2015.1096886"}},{"id":2266,"doi":"10.1080/00224499.2015.1100701","pmid":"26673397","pmcid":null,"title":"Opposite Trends in the Regulation of Pornography? Policy Differentiation and Policy Convergence Across 26 Countries Between 1960 and 2010","authors":"Person C, Hurka S, Knill C.","first_author":"Person C","journal":"Journal of sex research","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative policy analysis across 26 countries using a newly developed regulatory index spanning 1960‑2010.","sample_n":26,"sample_text":"26 countries examined","population":"National governments / policy regimes (no individual participants)","country":"Multiple (26 nations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study compares how 26 countries have regulated pornography from 1960 to 2010, finding a general move toward looser overall rules but increasing specific restrictions on certain types of porn.","clinical_takeaway":"None – the paper addresses policy, not individual clinical issues.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large, multi‑country time span (50 years)","Novel systematic coding of policy characteristics","Identifies both permissive trends and specialization"],"limitations":["Regulatory indices are newly created and not validated","No assessment of policy impact on individual behaviour or health","Potential ecological fallacy; country‑level confounders not addressed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2015.1100701"}},{"id":2267,"doi":"10.1080/00224499.2015.1013601","pmid":"26643148","pmcid":null,"title":"In the Eye of the Beholder: Exploring Variations in the Perceptions of Pornography","authors":"Willoughby BJ, Busby DM.","first_author":"Willoughby BJ","journal":"Journal of sex research","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 2,089 MTurk participants; participants rated 20 sexual media items as pornography; examined differences by gender, religious attendance, marital status, pornography use patterns","sample_n":2089,"sample_text":"2,089 individuals sampled from the online MTurk Web site","population":"adult internet users recruited via Amazon Mechanical Turk (self‑selected, not nationally representative)","country":"United States (MTurk)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 2,000 online participants, researchers found that what counts as “pornography” varies widely. People’s judgments differed by gender, religious attendance, marital status and how often they use porn, showing that simple self‑report labels may not capture the construct reliably.","clinical_takeaway":"Clinicians should recognise that patients may define pornography differently; assessing personal definitions is important before interpreting usage reports.","confidence":0.7,"topic_tags":["measurement","pornography","sexual_function","csbd"],"strengths":["Large sample size for a survey","Directly examines how people define pornography","Considers gender, religiosity, marital status"],"limitations":["Self‑selected MTurk sample limits generalisability","Ad‑hoc perception items lack validation","No measurement of key sexual‑health confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":45,"citing_publications":90,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2015.1013601"}},{"id":2268,"doi":"10.1007/s10508-021-02197-0","pmid":"35142972","pmcid":"PMC8917098","title":"The Influence of Social Desirability on Sexual Behavior Surveys: A Review","authors":"King BM.","first_author":"King BM.","journal":"Archives of sexual behavior","year":2022,"pub_types":["research-article","Review","Journal Article"],"keywords":["Sexual behavior","Social Desirability","Response Bias","Sexual Behavior Surveys"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-021-02197-0.pdf","cited_by_count":81,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of social desirability effects on self‑reported sexual behavior surveys; no systematic methodology reported.","sample_n":null,"sample_text":"Not applicable – review of other studies","population":"general adult population (as reported in cited studies)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review explains that people often misreport sexual behaviours to look socially acceptable, leading to over‑ or under‑reporting of things like condom use, number of partners, or porn exposure. Researchers should always measure social desirability and adjust for it when analysing survey data.","clinical_takeaway":"When interpreting self‑report sexual health questionnaires, consider the influence of social desirability and adjust analyses accordingly.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Highlights a pervasive source of bias in sexual behavior research","Cites a broad range of empirical studies across domains","Provides practical recommendation to include social desirability scales"],"limitations":["Narrative rather than systematic review; selection bias possible","No quantitative synthesis or meta‑analytic weighting","Does not assess how bias varies across specific sexual health outcomes"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":1,"mentioning":79,"citing_publications":166,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02197-0"}},{"id":2269,"doi":"10.1007/s10508-021-02244-w","pmid":"35142971","pmcid":null,"title":"Sexual Difficulties, Problems, and Help-Seeking in a National Representative Sample: The Second Australian Study of Health and Relationships","authors":"Richters J, Yeung A, Rissel C, McGeechan K, Caruana T, de Visser R.","first_author":"Richters J","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Australia","Sexual Difficulties","Sexual Practice","Sexual Dysfunctions","Second Australian Study Of Health And Relationships"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative telephone survey of 20,091 Australians (16‑69 y) assessing self‑reported sexual difficulties, problem perception and treatment‑seeking; comparison with earlier national survey.","sample_n":20091,"sample_text":"20,091 participants (16,897 sexually active in past year)","population":"General adult population, probability sample, 66 % participation","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationally representative Australian survey found that about half of men and two‑thirds of women experienced at least one sexual difficulty lasting a month. Problems varied by sex, with low desire common in women and premature ejaculation in men. Many were not seen as problems, but those involving pain or erectile issues prompted help‑seeking. Female rates of difficulties fell slightly over a decade, coinciding with changes in sexual activity, masturbation, and pornography use.","clinical_takeaway":"Sexual difficulties are common; clinicians should assess each problem’s impact and treatment desire rather than assuming pathology.","confidence":0.7,"topic_tags":["sexual_function","prevalence"],"strengths":["Large, probability‑based national sample","Gender‑stratified prevalence data","Comparison with previous decade’s survey"],"limitations":["Self‑report, likely unvalidated symptom items","No measurement of key psychosocial confounds (e.g., moral attitudes, mental health)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":11,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02244-w"}},{"id":2270,"doi":"10.1017/s003329172100516x","pmid":"35135634","pmcid":"PMC10235646","title":"Porn use and men's and women's sexual performance: evidence from a large longitudinal sample","authors":"Sommet N, Berent J.","first_author":"Sommet N","journal":"Psychological medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Gender","Sexual Satisfaction","Sexual Functioning","Pornography","Fixed-effects Regression","Sexual Self-competence"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10235646","cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"three-wave longitudinal study with >100,000 participants (4000+ couples) in early 20s French‑speaking sample","sample_n":100000,"sample_text":"very large community sample (French‑speaking, early 20s)","population":"young adult men and women, heterosexual couples","country":"France (French‑speaking sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a three‑year study of over 100,000 French‑speaking young adults, men who watched more porn (or increased use) reported poorer sexual confidence, functioning and lower partner satisfaction, while women showed opposite benefits. The authors suggest porn may hurt men’s sex lives but help women’s.","clinical_takeaway":"Clinicians should note that higher porn use is linked to poorer sexual outcomes for men but not for women; consider individual patterns rather than assuming universal harm.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["very large longitudinal sample","sex‑specific analyses","use of partner‑reported outcomes"],"limitations":["no control for moral, mental‑health or trauma confounds","pornography use measured only by frequency self‑report","lack of pre‑registration and limited reporting of effect sizes"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":1,"mentioning":13,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s003329172100516x"}},{"id":2271,"doi":"10.3389/fpsyg.2022.847814","pmid":"35222221","pmcid":"PMC8864543","title":"Corrigendum: Sexual Interaction in Digital Contexts and Its Implications for Sexual Health: A Conceptual Analysis","authors":"Döring N, Krämer N, Mikhailova V, Brand M, Krüger THC, Vowe G.","first_author":"Döring N","journal":"Frontiers in psychology","year":2022,"pub_types":["Published Erratum","correction"],"keywords":["Commercial Sex","Cybersex","Pornography","Sexting","Sexual Consent","Internet Sexuality","Sex Robots","Online Sexual Activities (Osa)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8864543","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":18,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2022.847814"}},{"id":2272,"doi":"10.1111/1556-4029.15002","pmid":"35137409","pmcid":null,"title":"Vein pattern recognition based on RGB images using Monte Carlo simulation and ridge tracking","authors":"Tang C, Zhang Y, Han L, Chen X.","first_author":"Tang C","journal":"Journal of forensic sciences","year":2022,"pub_types":["Journal Article"],"keywords":["Monte Carlo simulation","Vein extraction","Coherent Point Drift","Rgb Skin Images","Vein Pattern Matching","Vein Uncovering"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Algorithm development and evaluation on RGB images of skin; no human participants reporting sexual behavior.","sample_n":null,"sample_text":"Not applicable – study uses image datasets rather than human participants.","population":"RGB skin images derived from forensic photographs; no participant demographics.","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors created a new computer method that can reveal hidden vein patterns from ordinary colour photographs, which could help identify people when faces are not visible, such as in some forensic pictures.","clinical_takeaway":"None – the study does not provide information relevant to clinical sexual health or behaviour.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Innovative use of Monte‑Carlo simulation for RGB vein uncovering","Comprehensive pipeline from extraction to matching","Comparison with multiple state‑of‑the‑art methods"],"limitations":["No validation on real forensic case material","Performance metrics limited to technical accuracy, no human‑behavior relevance","Lacks external replication or open code"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":5,"confounds":0,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1556-4029.15002"}},{"id":2274,"doi":"10.1177/1079063215612444","pmid":"26589444","pmcid":null,"title":"The Revised Screening Scale for Pedophilic Interests (SSPI-2): Development and Criterion-Related Validation","authors":"Seto MC, Stephens S, Lalumière ML, Cantor JM.","first_author":"Seto MC","journal":"Sexual abuse : a journal of research and treatment","year":2017,"pub_types":["Validation Study","Journal Article"],"keywords":["Assessment","Diagnosis","Sexual Offending","Pedophilia","Child Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":45,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study with large offender samples (N=950 per sample)","sample_n":1900,"sample_text":"Two independent samples of 950 offenders each","population":"adult male sexual offenders with child victims","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors updated a rating scale that classifies child‑victim offences by adding a child‑pornography item. In two large samples of sexual offenders, the revised scale (SSPI‑2) better predicted physiological sexual arousal to children than the original.","clinical_takeaway":"The SSPI‑2 may help clinicians identify pedophilic interest more accurately using offence data.","confidence":0.78,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Large offender samples","Objective criterion (phallometry)","Clear incremental validation of added item"],"limitations":["Convenience sample of offenders limits generalisability","No assessment of potential confounds (e.g., mental health)","No pre‑registration or open data"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":1,"mentioning":105,"citing_publications":92,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063215612444"}},{"id":2275,"doi":"10.1007/s10508-015-0644-8","pmid":"26585169","pmcid":null,"title":"Men's Objectifying Media Consumption, Objectification of Women, and Attitudes Supportive of Violence Against Women","authors":"Wright PJ, Tokunaga RS.","first_author":"Wright PJ","journal":"Archives of sexual behavior","year":2016,"pub_types":["Journal Article"],"keywords":["Violence","Objectification","Pornography","Reality Tv","3Am","Men’s Magazines"],"is_oa":false,"oa_url":null,"cited_by_count":53,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 187 college men","sample_n":187,"sample_text":"college men (N=187)","population":"collegiate men attracted to women (N=187)","country":"USA (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"College men who watch more objectifying magazines, reality TV, and porn see women more as sex objects, and these objectifying thoughts are linked to stronger support for violence against women.","clinical_takeaway":"Exposure to objectifying media correlates with attitudes that can promote violence; clinicians should consider media habits when addressing aggression risk.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large enough sample for mediation analysis","Focus on specific media types","Clear theoretical framework"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on self‑report, unclear validation of scales","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":7,"contrasting":0,"mentioning":101,"citing_publications":156,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0644-8"}},{"id":2276,"doi":"10.1111/1468-5922.12761","pmid":"35417588","pmcid":null,"title":"Narcissism - the refusal of twoness through sexual addiction and pornography","authors":"Schwartz SE.","first_author":"Schwartz SE.","journal":"The Journal of analytical psychology","year":2022,"pub_types":["Journal Article"],"keywords":["Addiction","Narcissism","Echo","Eco","Adicción","Sucht","Narcissisme","Andre Green","Narzißmus","Narcisismo","自恋","Нарциссизм","Dipendenza","Vício","Андре Грин","Эхо","Зависимость","回声","安德烈·格林","André Green","成瘾"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"The article is a theoretical psycho‑analytic essay that uses a single composite case description without empirical data.","sample_n":null,"sample_text":"No participants were recruited; the paper presents a composite clinical vignette.","population":"None (theoretical article)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The article interprets a composite case of a man who describes himself as sexually addicted, using Jungian and French psychoanalytic ideas about narcissism and relational loss, but offers no data or measurement.","clinical_takeaway":"None – the paper is a theoretical discussion without empirical evidence for clinical practice.","confidence":0.7,"topic_tags":["sexual_function","pornography"],"strengths":["Integrative psycho‑analytic synthesis of several theorists","Provides a rich narrative illustration of a self‑described sexually addicted individual"],"limitations":["No empirical data; relies on a single composite case","No operational definition or measurement of sexual addiction","No assessment of key confounds (moral incongruence, masturbation, mental health, etc.)","Interpretive claims not testable"],"rubric_version":"2.0","raw_total":6,"max_possible":60,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":1,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1468-5922.12761"}},{"id":2277,"doi":"10.1177/08862605211072258","pmid":"35098765","pmcid":null,"title":"Child Sexual Abuse Prevention: Parental Discussion, Protective Practices and Attitudes","authors":"Rudolph JI, Walsh K, Shanley DC, Zimmer-Gembeck MJ.","first_author":"Rudolph JI","journal":"Journal of interpersonal violence","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Prevention","Parents","Education","Child Sexual Abuse","Protective Behaviours","Media Mediation"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 248 Australian/UK parents (convenience sample) reporting protective practices and attitudes toward child sexual abuse prevention","sample_n":248,"sample_text":"248 Australian and UK parents (87% female) with at least one child aged 6‑11 years","population":"parents of children aged 6‑11 years (87 % female)","country":"Australia; United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 248 Australian and UK parents showed they use many protective behaviours to prevent child sexual abuse, but often supervise their children’s online device use only modestly. Most support school‑based education, yet many worry it could harm children.","clinical_takeaway":"Parents should be encouraged to increase online supervision and media checks while providing age‑appropriate CSA education.","confidence":0.8,"topic_tags":["sexual_function","prevalence","pornography","moral_incongruence"],"strengths":["Large, multi‑country parental sample for CSA‑prevention topic","First quantitative description of parental protective practices beyond education","Clear practical implications for prevention programmes"],"limitations":["Self‑report measures likely ad‑hoc and not psychometrically validated","Cross‑sectional design cannot infer causal effects of practices","Sample skewed toward mothers; may not represent all caregivers"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605211072258"}},{"id":2278,"doi":"10.1080/0092623x.2015.1113581","pmid":"26549730","pmcid":null,"title":"Factor Structure and Gender Stability of the Brazilian Version of the Pornography Consumption Inventory","authors":"Baltieri DA, de Oliveira VH, de Souza Gatti AL, Junqueira Aguiar AS, de Souza Aranha E Silva RA.","first_author":"Baltieri DA","journal":"Journal of sex & marital therapy","year":2016,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Validation study of the Pornography Consumption Inventory (PCI) using multigroup confirmatory factor analysis in 205 university students (100 male, 105 female).","sample_n":205,"sample_text":"205 (100 male, 105 female) university students","population":"University students (Brazilian), convenience sample.","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether a questionnaire measuring why people watch porn works the same way for men and women in Brazil. While the four‑factor model fit both groups, the scale was not fully equivalent across genders, with men reporting stronger motivations.","clinical_takeaway":"The PCI can be used to assess porn‑use motivations, but gender differences should be considered; it is not a diagnostic tool.","confidence":0.8,"topic_tags":["measurement","pornography","gender","sexual_function"],"strengths":["Rigorous psychometric testing (CFA, MGCFA)","Clear reporting of factor invariance across genders","Reasonably large sample for validation work"],"limitations":["Convenience student sample – limited generalisability","No assessment of key confounds (moral incongruence, masturbation, mental health)","No pre‑registration or open data"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":1,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2015.1113581"}},{"id":2279,"doi":"10.3390/ijerph19031428","pmid":"35162449","pmcid":"PMC8834909","title":"Sexual and Reproductive Health during the COVID-19 Pandemic: Results from a Cross-Sectional Online Survey in Germany","authors":"Räuchle J, Briken P, Schröder J, Ivanova O.","first_author":"Räuchle J","journal":"International journal of environmental research and public health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Adults","Sexual behaviour","Germany","Online","Sexual And Reproductive Health","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8834909","cited_by_count":7,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online convenience survey of 611 German adults assessing sexual behaviour changes during COVID‑19; mixed quantitative (descriptive, regression) and qualitative items.","sample_n":611,"sample_text":"Cross‑sectional online survey; convenience sample.","population":"Adults (≥18) in Germany, recruited via an online platform; not a probability sample.","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A German online survey of 611 adults found that during COVID‑19 people reported lower sexual satisfaction, more sexual problems, and higher pornography and masturbation use, mainly due to pandemic‑related stress and less social contact.","clinical_takeaway":"Stress during crises may worsen sexual satisfaction and increase pornography/masturbation; clinicians should consider stress‑reduction interventions.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample for an online survey","Mixed‑methods approach adds depth","Timely data on pandemic‑related SRH changes"],"limitations":["Convenience sampling limits generalisability","Self‑report, likely single‑item measures","No control for key confounds (moral, mental health, trauma)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph19031428"}},{"id":2281,"doi":"10.1080/10538712.2015.1092004","pmid":"26701282","pmcid":null,"title":"Eating Disordered Behaviors and Body Disapproval in Adolescent Males Adjudicated for Sexual and Nonsexual Crimes","authors":"O'Brien JE, Li W, Burton DL.","first_author":"O'Brien JE","journal":"Journal of child sexual abuse","year":2015,"pub_types":["Comparative Study","Journal Article"],"keywords":["Sexual Abuse","Sex Offenders","Substance Use","Pornography","Maci","Ols Regression"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of adjudicated male adolescents (N=696) comparing those charged with sexual vs. non‑sexual offenses.","sample_n":696,"sample_text":"526 sexual offenders, 170 non‑sexual offenders; mean age 16.8 y; 47.7 % White.","population":"Adolescent males adjudicated for crimes (sexual and non‑sexual).","country":"USA (presumed from journal/author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 696 teenage boys in the juvenile justice system, those who committed sexual offenses showed higher levels of eating problems and body dissatisfaction than peers who committed non‑sexual offenses. Pornography use and substance use were linked to these outcomes, while a history of sexual abuse predicted body dissatisfaction.","clinical_takeaway":"When working with adjudicated youth, clinicians should consider pornography exposure and substance use as factors associated with eating and body‑image issues, but causal conclusions are unwarranted.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample of adjudicated youth","Comparison between sexual and non‑sexual offenders","Hierarchical regression allows assessment of multiple predictors"],"limitations":["Cross‑sectional design; cannot infer causality","Limited detail on measurement validity","Key confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2015.1092004"}},{"id":2282,"doi":"10.1002/bsl.2560","pmid":"35043473","pmcid":"PMC9541809","title":"Suicidal ideation in offenders convicted of child sexual exploitation material offences","authors":"Steel CMS, Newman E, O'Rourke S, Quayle E.","first_author":"Steel CMS","journal":"Behavioral sciences & the law","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Suicide","Suicidal Ideation","Child Pornography","Child Sexual Exploitation Material"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9541809","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Web‑based anonymous survey of 78 adults previously convicted of child sexual exploitation material offences; prevalence estimates of suicidal ideation and attempts; no control group.","sample_n":78,"sample_text":"Respondents were recruited via an anonymous, web‑based survey; the sample is a self‑selected convenience group of convicted CSEM offenders.","population":"Adults in the United States convicted of CSEM offences (self‑selected respondents).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 78 people convicted of sharing child sexual exploitation material found that 73% had serious thoughts of suicide and 19% had attempted suicide after learning of an investigation, highlighting a need for better mental‑health support.","clinical_takeaway":"Clinicians working with CSEM offenders should assess suicide risk promptly and provide empathetic, trauma‑informed care.","confidence":0.7,"topic_tags":["csbd","sexual_function","treatment"],"strengths":["Addresses an under‑studied high‑risk population","Provides prevalence data on suicidal ideation among CSEM offenders"],"limitations":["Self‑selected convenience sample limits generalisability","Lack of validated measures for suicidal ideation","No control for mental‑health or other confounding variables"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/bsl.2560"}},{"id":2283,"doi":"10.1007/s10508-021-02257-5","pmid":"35041094","pmcid":null,"title":"Sexual Victimization in Adulthood and Associated Factors Among Men and Women: Cross-Sectional Evidence from Mainland China","authors":"Shi X, Zheng Y.","first_author":"Shi X","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual Abuse","Risky Sexual Behaviors","Sexual Victimization","Unwanted Sexual Experiences","Sexual Consent","Sexual Refusal Assertiveness"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Convenience sample of 898 adults from 29 Chinese provinces, surveyed Sep 2020; hierarchical ordinal logistic regression used to examine correlates of adult sexual victimization severity.","sample_n":898,"sample_text":"Convenience Chinese sample screened across 29 provinces.","population":"Adults (men and women) from mainland China, recruited via non‑probability convenience sampling.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Chinese convenience sample of 898 adults, roughly half reported having been sexually victimised as adults. Earlier unwanted sexual experiences, binge drinking before sex, hook‑up history, and using violent pornography were all linked to higher severity of victimisation, while better consent control and refusal assertiveness were protective.","clinical_takeaway":"Screen for prior trauma, risky drinking, and consent‑related self‑efficacy when assessing adult sexual victimisation risk.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample (N≈900) for a Chinese nationwide survey","Multivariate modeling with odds ratios and confidence intervals","Inclusion of multiple risk‑behaviour variables"],"limitations":["Convenience, non‑representative sampling limits generalizability","Key constructs (e.g., violent pornography use) measured with single‑item, likely unvalidated items","No measurement of moral incongruence, mental‑health or partner factors"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02257-5"}},{"id":2284,"doi":"10.1007/s13178-021-00682-8","pmid":"36873566","pmcid":"PMC9977109","title":"\"I wish I actually had known what the heck sex was:\" What adolescent sexual minority males knew and wish they knew prior to sexual debut with a male partner","authors":"Stout CD, Paredes CD, Nelson KM.","first_author":"Stout CD","journal":"Sexuality research & social policy : journal of NSRC : SR & SP","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Sexual Health","Lgbt","Sexual Debut","Sexual Education","Asmm"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online baseline survey of 102 sexually active adolescent sexual minority males (age 14‑17) examining knowledge and skills at sexual debut.","sample_n":102,"sample_text":"Sexually active, cisgender ASMM (n=102) recruited online for a pilot intervention baseline.","population":"Adolescent sexual minority males, United States, ages 14‑17 (N=102)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 102 teen gay and bisexual boys found they entered their first male‑partner sexual experience at about 14½ years old, knowing how to say no but wishing they’d been taught how to talk about what they liked or didn’t like. Most learned about sex online, often via Google, pornography, or social media.","clinical_takeaway":"Sexual‑health programs for gay/bisexual teens should start before debut and teach communication and media‑literacy skills.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large (for this population) community‑based sample","Mixed‑methods (quantitative + qualitative) provides rich insight","Directly asks participants what they wish they had known"],"limitations":["Convenience online recruitment limits generalisability","No validated scales; relies on ad‑hoc items","Cross‑sectional self‑report; cannot infer causality"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13178-021-00682-8"}},{"id":2285,"doi":"10.1080/00224499.2015.1065953","pmid":"26445007","pmcid":null,"title":"What Types of Pornography Do People Find Arousing and Do They Cluster? Assessing Types and Categories of Pornography in a Large-Scale Online Sample","authors":"Hald GM, Štulhofer A.","first_author":"Hald GM","journal":"Journal of sex research","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":66,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 18‑40‑year‑old Croatian men and women (heterosexual and nonheterosexual) assessing self‑reported frequency of 27 pornography types; latent class/factor analyses used to identify categories; a 5‑item scale for non‑mainstream content was proposed.","sample_n":null,"sample_text":"large online sample (exact N not given in abstract)","population":"adult general population (Croatian, 18‑40, both sexes, various sexual orientations)","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large Croatian sample, researchers asked participants how often they viewed 27 different kinds of porn. Statistical analysis showed several common patterns and led to a new five‑item questionnaire for tracking use of non‑mainstream (paraphilic) porn.","clinical_takeaway":"None – the study describes prevalence patterns, not clinical effects or treatment.","confidence":0.7,"topic_tags":["pornography","sexual_function","measurement","prevalence"],"strengths":["Large, diverse sample covering gender and sexual orientation","Uses latent structure analysis rather than arbitrary categories","Proposes a new brief scale for non‑mainstream pornography use"],"limitations":["Self‑report frequencies; no validated instruments","No measurement of potential confounds (moral, mental health, etc.)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":1,"mentioning":93,"citing_publications":146,"retracted":false,"notices":[{"status":"Has correction","date":"2016-3-4","noticeDoi":"10.1080/00224499.2016.1140487","doi":"10.1080/00224499.2015.1065953"},{"status":"Has erratum","date":"2016-3-4","noticeDoi":"10.1080/00224499.2016.1140487","doi":"10.1080/00224499.2015.1065953"}],"url":"https://scite.ai/reports/10.1080/00224499.2015.1065953"}},{"id":2286,"doi":"10.2466/pms.1983.56.1.45","pmid":"6844080","pmcid":null,"title":"Misattribution in a fearful situation following different modes of arousal","authors":"Somervill JW, Barrios FX, Merritt BR, Eicher LM, Moore DL.","first_author":"Somervill JW","journal":"Perceptual and motor skills","year":1983,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment with four conditions (sexual film, exercise, neutral film, reading); convenience sample of 52 female college students.","sample_n":52,"sample_text":"52 female college students","population":"Female college students (N=52)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a lab study, 52 female college students experienced either a sexually explicit film, exercise, or neutral tasks before being asked to approach a snake they feared. The arousal conditions did not change how they approached the snake, suggesting no misattribution of fear to arousal.","clinical_takeaway":"This study provides no evidence that sexual arousal influences fear‑related avoidance behavior.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Experimental manipulation of arousal","Control conditions included","Clear behavioral outcome measure"],"limitations":["Small, homogeneous sample","No validated scales for arousal or fear","No power analysis reported"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2466/pms.1983.56.1.45"}},{"id":2287,"doi":"10.1002/cne.10232","pmid":"12012427","pmcid":null,"title":"Enhanced fos expression in the zebra finch (Taeniopygia guttata) brain following first courtship","authors":"Sadananda M, Bischof HJ.","first_author":"Sadananda M","journal":"The Journal of comparative neurology","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Animal experiment comparing c‑fos expression after first courtship versus isolation/aviary controls; small‑sample immunohistochemistry and 2‑DG autoradiography.","sample_n":null,"sample_text":"Not reported in abstract; typical animal studies use modest group sizes (≈5‑10 per condition).","population":"Male zebra finches (Taeniopygia guttata) experiencing first courtship or chase versus socially reared controls.","country":"Not specified (likely Germany or Austria based on author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Male zebra finches that experience a first courtship show increased activity of the immediate‑early gene c‑fos in brain regions linked to learning and sexual behavior, suggesting neural changes that support imprinting of sexual cues.","clinical_takeaway":"None – findings are in birds and relate to basic neural mechanisms of sexual imprinting, not to human clinical practice.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","csbd"],"strengths":["Clear experimental manipulation (courtship vs isolation)","Multiple neurobiological markers (c‑fos, 2‑DG, spine density)","Direct tissue‑level measurement rather than indirect imaging"],"limitations":["Likely small sample sizes, not reported","No behavioural quantification of courtship intensity","Findings limited to birds, not directly translatable to human sexuality"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":20,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/cne.10232"}},{"id":2288,"doi":"10.3389/fpsyg.2021.798260","pmid":"35069392","pmcid":"PMC8770331","title":"The Global Impact of the COVID-19 Pandemic on Individuals' and Couples' Sexuality","authors":"Eleuteri S, Alessi F, Petruccelli F, Saladino V.","first_author":"Eleuteri S","journal":"Frontiers in psychology","year":2021,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexuality","Sexual Health","Sexual Dysfunctions","Pandemia","Covid-19"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyg.2021.798260/pdf","cited_by_count":17,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review-article","sample_n":null,"sample_text":"Not applicable – narrative review of existing studies","population":"general adult population (individuals and couples) during COVID-19 pandemic","country":"International (studies from various locations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"The review summarizes studies showing that COVID‑19 lockdowns worsened many people's sexual lives—especially for those under stress, with relationship conflict, or limited privacy—while some reported improvements linked to more free time. Increases in pornography use, masturbating and sex‑toy use were also noted.","clinical_takeaway":"Consider pandemic‑related stress, relationship dynamics, and privacy when assessing sexual wellbeing; changes may reflect coping rather than pathology.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Broad overview of pandemic‑related sexual changes","Identifies multiple psychosocial correlates"],"limitations":["Narrative (non‑systematic) synthesis lacks risk‑of‑bias assessment","No quantitative meta‑analysis or effect‑size reporting","Moral incongruence not addressed despite distress outcomes"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":5,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":25,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2021.798260"}},{"id":2289,"doi":"10.1016/j.chc.2021.09.003","pmid":"34801158","pmcid":null,"title":"Clinical Considerations in Internet and Video Game Addiction Treatment","authors":"Greenfield DN.","first_author":"Greenfield DN.","journal":"Child and adolescent psychiatric clinics of North America","year":2022,"pub_types":["Review","Journal Article"],"keywords":["Social Media","Internet Addiction","Behavioral Addiction","Video Game Addiction","Smartphone Addiction","Online Pornography","Internet Addiction Treatment","Process Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article without original data; no empirical study.","sample_n":null,"sample_text":"N/A","population":"Not applicable (review)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how internet and video‑game use can resemble addiction, summarising proposed definitions, neurobiology and treatment ideas, but it does not present new research data.","clinical_takeaway":"None – the piece is a narrative review without empirical evidence for practice.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Broad overview of internet‑related addictive behaviours","Integrates neurobiological theories"],"limitations":["No original data; conclusions are narrative","Lacks systematic review methodology","Does not control for key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chc.2021.09.003"}},{"id":2292,"doi":"10.1016/0145-2134(93)90024-y","pmid":"8402252","pmcid":null,"title":"Components of child and parent interviews in cases of alleged sexual abuse","authors":"Hibbard RA, Hartman GL.","first_author":"Hibbard RA","journal":"Child abuse & neglect","year":1993,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of professionals about interview components","sample_n":null,"sample_text":"professionals surveyed (no number given in abstract)","population":"professionals (medical, social work, law enforcement, mental health) involved in child sexual abuse investigations","country":"USA (presumed based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1993 survey of professionals who interview children after alleged sexual abuse shows that different disciplines ask different questions, reflecting their own biases. The authors suggest coordinated, possibly fewer interviews to improve thoroughness.","clinical_takeaway":"Consider multidisciplinary input when planning child sexual abuse interviews to ensure comprehensive coverage.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Identifies professional variation in interview content","Highlights need for interdisciplinary communication"],"limitations":["No information on sample size or response rate","Descriptive only; no outcome data on interview effectiveness"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0145-2134(93)90024-y"}},{"id":2293,"doi":"10.1016/j.addbeh.2021.107230","pmid":"34996006","pmcid":"PMC8711171","title":"The impact of COVID-19 on addiction treatment in New Zealand","authors":"Rodda SN, Park JJ, Wilkinson-Meyers L, King DL.","first_author":"Rodda SN","journal":"Addictive behaviors","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Treatment","Addiction","Gambling","Substance Use","E-health","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8711171","cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey of 93 addiction service managers/clinicians in New Zealand; descriptive statistics and qualitative thematic analysis.","sample_n":93,"sample_text":"n = 93 experienced service managers and clinicians","population":"service providers (not service users)","country":"New Zealand","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 93 New Zealand addiction clinicians found that COVID‑19 increased referrals for internet gambling, gaming, social media and pornography, and forced services to shift toward phone, email and video methods, with mixed effects on effectiveness.","clinical_takeaway":"Clinicians should anticipate higher demand for online pornography‑related treatment and plan for flexible, low‑tech delivery options.","confidence":0.7,"topic_tags":["pornography","treatment","csbd","gender","sexual_function"],"strengths":["Timely data on service changes during COVID‑19","Includes both quantitative and qualitative insights","Broad range of addiction types covered"],"limitations":["Provider‑report only; no client‑level data","No validated measures of pornography‑related problems","Convenience sample of clinicians, limited generalisability"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":19,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2021.107230"}},{"id":2294,"doi":"10.3917/spub.155.0733","pmid":"26752039","pmcid":null,"title":"[Pornography and sexual behaviour of schoolchildren in the Cocodydistrict of Abidjan]","authors":"N Dri KM, Yaya I, Saka B, Aboubakari AS, Kouassi DP, Ekou KF.","first_author":"N Dri KM","journal":"Sante publique (Vandoeuvre-les-Nancy, France)","year":2015,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 398 schoolchildren from four schools in Cocody, Abidjan; convenience sample; no longitudinal follow‑up or control group","sample_n":398,"sample_text":"convenience sample of pupils from four schools; not nationally representative","population":"398 pupils (224 boys, 174 girls) aged roughly school‑age in Côte d’Ivoire","country":"Côte d’Ivoire","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2015 survey of 398 schoolchildren in Abidjan, Côte d’Ivoire found that those who reported access to pornography were more likely to be sexually active, start intercourse earlier, and have multiple partners. The study is cross‑sectional and does not control for moral, psychological or relational factors.","clinical_takeaway":"No direct clinical guidance; the association does not prove pornography causes risky sexual behaviour.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Relatively large total sample (N≈400)","Provides data from a low‑income African context","Reports odds ratios with confidence intervals"],"limitations":["Cross‑sectional design; cannot infer causality","Exposure (pornography access) group small (~57 participants)","No validated measures of pornography use or sexual behaviour","Critical confounders (moral attitudes, masturbation, mental health, relationship context, trauma) not assessed"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3917/spub.155.0733"}},{"id":2295,"doi":"10.1542/peds.107.6.1302","pmid":"11389247","pmcid":null,"title":"A validity test of movie, television, and video-game ratings","authors":"Walsh DA, Gentile DA.","first_author":"Walsh DA","journal":"Pediatrics","year":2001,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"panel validation study of media rating systems using parent raters and the KidScore tool","sample_n":null,"sample_text":"not specified in abstract","population":"parents rating movies, TV, video games for child‑appropriate content","country":"United States (journal Pediatrics)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers tested whether movie, TV and video‑game rating systems correctly identify material that is inappropriate for children. Parents generally agreed with industry ratings that a product was unsuitable, but they often disagreed on what was appropriate for younger audiences, especially for teen‑rated items.","clinical_takeaway":"None – the study concerns media rating validity, not individual sexual health or behaviour.","confidence":0.4,"topic_tags":["sexual_function","pornography"],"strengths":["Addresses an important public‑health issue of media content labeling","Uses a systematic tool (KidScore) to evaluate multiple media formats"],"limitations":["No clear validation evidence for the KidScore instrument reported","Limited description of statistical methods and power","Sample size and recruitment details not provided"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":84,"citing_publications":139,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.107.6.1302"}},{"id":2296,"doi":"10.2174/1745017902117010235","pmid":"35173793","pmcid":"PMC8728564","title":"Sex, Digital Devices, Social Media, and Social Isolation: A Study on Sexual Behavioral During COVID -19 Pandemic","authors":"Melca IA, Nardi AE, Gonçalves LL, Ferreira RM, de Padua MSKL, King ALS.","first_author":"Melca IA","journal":"Clinical practice and epidemiology in mental health : CP & EMH","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Sexual behavior","Social Media","Pornography","Digital Devices","Covid-19 Pandemic"],"is_oa":true,"oa_url":"https://clinical-practice-and-epidemiology-in-mental-health.com/VOLUME/17/PAGE/235/PDF/","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience survey of 1,357 Brazilian adults recruited via social‑media posts; self‑report questionnaire on digital device use and sexual behavior during COVID‑19","sample_n":1357,"sample_text":"1357 Brazilian adults","population":"Brazilian adults (self‑selected, likely WEIRD, recruited through social media)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A Brazilian online survey of 1,357 adults found that during COVID‑19 many people used digital devices and social media to watch more sexual content, and some saw these tools as a way to have safer sex while physically distancing.","clinical_takeaway":"Self‑reported changes in sexual media use during the pandemic are common, but the study provides limited guidance for clinical practice.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a cross‑sectional survey","Timely topic (COVID‑19 pandemic)","Inclusion of multiple psychosocial and demographic variables"],"limitations":["Convenience recruitment via social media limits generalisability","Reliance on ad‑hoc, non‑validated self‑report items","No measurement of key confounds (e.g., moral incongruence, mental health)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2174/1745017902117010235"}},{"id":2297,"doi":"10.1080/00224499.2015.1025123","pmid":"26305628","pmcid":null,"title":"Trading Later Rewards for Current Pleasure: Pornography Consumption and Delay Discounting","authors":"Negash S, Sheppard NV, Lambert NM, Fincham FD.","first_author":"Negash S","journal":"Journal of sex research","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Study 1 – longitudinal survey (2 time points, 4 weeks); Study 2 – experimental randomised abstinence (pornography vs favourite food, 3 weeks).","sample_n":null,"sample_text":"Not specified in abstract.","population":"Adults (male and female); sample size not reported in abstract.","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Two studies found that people who watch more Internet porn tend to prefer immediate rewards over larger, later ones. When participants stopped watching porn for three weeks, they became less impulsive compared with a control group that stopped eating their favorite food.","clinical_takeaway":"Higher porn use may be linked to greater impulsivity; clinicians might consider assessing decision‑making patterns in clients reporting frequent porn consumption.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Uses both longitudinal and randomised experimental designs","Employs validated delay‑discounting task","Addresses a theoretically novel link between sexual reward and decision‑making"],"limitations":["Pornography use measured with an unspecified questionnaire (likely ad‑hoc)","No control for moral, mental‑health, relationship or trauma variables","Sample size and demographic details absent from abstract"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":31,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2015.1025123"}},{"id":2299,"doi":"10.1016/j.chiabu.2021.105448","pmid":"34952461","pmcid":null,"title":"Experiences of Canadian mental health providers in identifying and responding to online and in-person sexual abuse and exploitation of their child and adolescent clients","authors":"Dimitropoulos G, Lindenbach D, Devoe DJ, Gunn E, Cullen O, Bhattarai A, Kuntz J, Binford W, Patten SB, Arnold PD.","first_author":"Dimitropoulos G","journal":"Child abuse & neglect","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Luring","Sexual Abuse","Grooming","Child Pornography","Mental Healthcare Professionals","Online Child Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 209 mental health providers in Alberta, Canada","sample_n":209,"sample_text":"209 mental healthcare providers (public health system, Alberta, Canada)","population":"mental health professionals working with children and adolescents in public health system","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 209 Canadian mental‑health providers showed most had encountered child grooming, luring, sexual abuse or image‑sharing, but felt less confident and trained to respond to the online‑related forms. The authors call for better education on digital exploitation.","clinical_takeaway":"Clinicians need more training on recognizing and handling technology‑facilitated child sexual exploitation.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for provider survey","Addresses a practical training gap","Clear relevance to child protection"],"limitations":["Use of ad‑hoc, non‑validated questionnaire","Cross‑sectional design; no causal inference","Potential self‑selection bias among respondents"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":17,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2021.105448"}},{"id":2300,"doi":"10.1080/0092623x.2021.2009607","pmid":"34873995","pmcid":null,"title":"\"If Their Face Starts Turning Purple, You Are Probably Doing Something Wrong\": Young Men's Experiences with Choking During Sex","authors":"Herbenick D, Guerra-Reyes L, Patterson C, Rosenstock Gonzalez YR, Wagner C, Zounlome NOO.","first_author":"Herbenick D","journal":"Journal of sex & marital therapy","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"qualitative interviews with 21 young adult men about choking during sex","sample_n":21,"sample_text":"21 participants recruited for interviews (convenience sample)","population":"young adult men (United States)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 21 U.S. young men reveal how they first learn about, practice, and feel about choking during sex, noting varied motivations, consent practices, and safety awareness.","clinical_takeaway":"Clinicians should ask about choking as a consensual practice, discuss safety and consent, and consider individual comfort levels.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Provides the first qualitative insight into men’s experiences with choking","Includes perspectives on consent and safety practices","Rich, participant‑generated language"],"limitations":["Small, non‑representative convenience sample","No quantitative measurement of frequency or distress","Does not address potential confounds (e.g., mental health, trauma, moral views)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":37,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2021.2009607"}},{"id":2302,"doi":"10.1080/0092623x.2015.1072119","pmid":"26177786","pmcid":null,"title":"Pornography Use and Sexual Behavior Among Polish and German University Students","authors":"Martyniuk U, Briken P, Sehner S, Richter-Appelt H, Dekker A.","first_author":"Martyniuk U","journal":"Journal of sex & marital therapy","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of university students in Poland and Germany (N≈2,438); examined self‑reported pornography use and sexual behaviours.","sample_n":2438,"sample_text":"German (n = 1,303) and Polish (n = 1,135) university students","population":"university students, aged 18‑26, from two European countries","country":"Poland, Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 2,400 Polish and German university students found that those who reported watching pornography also reported a broader variety of sexual activities, but not more partners or safer‑sex practices. Cultural differences were most evident among women.","clinical_takeaway":"Viewing pornography is linked to more diverse sexual practices, but does not necessarily indicate riskier sexual health outcomes.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size across two countries","Direct comparison of cultural contexts","Focus on a range of sexual behaviours"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on single‑item, unvalidated self‑report measures","Key confounds (moral attitudes, masturbation, mental health) not addressed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":7,"contrasting":0,"mentioning":12,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2015.1072119"}},{"id":2303,"doi":"10.2196/27385","pmid":"34618679","pmcid":"PMC8669582","title":"Using Google Trends to Inform the Population Size Estimation and Spatial Distribution of Gay, Bisexual, and Other Men Who Have Sex With Men: Proof-of-concept Study","authors":"Card KG, Lachowsky NJ, Hogg RS.","first_author":"Card KG","journal":"JMIR public health and surveillance","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Spatial distribution","Pornography","Population Size Estimation","Gay, Bisexual, And Other Men Who Have Sex With Men","Technology-aided Surveillance"],"is_oa":true,"oa_url":"https://doi.org/10.2196/27385","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Ecological proof‑of‑concept using Google Trends search volumes to estimate city‑level gbMSM population size.","sample_n":null,"sample_text":"Not applicable – analysis of publicly available search‑term volume data.","population":"Aggregate city‑level data from Canada (no individual participants).","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study shows how Google search data for the term \"gay porn\" can be used to quickly estimate how many gay, bisexual and other men who have sex with men live in Canadian cities, offering a cheap alternative to traditional population‑size methods.","clinical_takeaway":"None – the paper provides a methodological tool for public‑health planning, not clinical guidance.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Innovative, rapid, low‑cost use of existing big‑data source.","Transparent description of method and limitations."],"limitations":["Proxy measure (search term) not validated for estimating gbMSM size.","Potential bias from unequal internet access and differing porn‑search behavior by gender/sexual orientation.","No external validation beyond comparison with existing estimates."],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/27385"}},{"id":2304,"doi":"10.1080/00224499.2014.1003773","pmid":"26169262","pmcid":null,"title":"How Much More XXX is Generation X Consuming? Evidence of Changing Attitudes and Behaviors Related to Pornography Since 1973","authors":"Price J, Patterson R, Regnerus M, Walley J.","first_author":"Price J","journal":"Journal of sex research","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":90,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Repeated cross‑sectional analysis of General Social Survey data (1973‑2012) with intrinsic estimator to separate age, period, cohort effects.","sample_n":null,"sample_text":"Large national probability sample (GSS) across many waves","population":"U.S. young adults (survey respondents across 40 years)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using 40 years of U.S. survey data, the study shows that young adults are watching more pornography over generations, though the rise is partly due to age effects. Attitudes about making pornography illegal have stayed roughly the same.","clinical_takeaway":"None – the study describes population trends, not individual health implications.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative, multi‑year dataset","Appropriate statistical method (intrinsic estimator) for APC separation","Clear reporting of trends across cohorts"],"limitations":["Reliance on single‑item self‑report measures of consumption","No assessment of masturbation, moral attitudes, mental health or relationship factors","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":1,"mentioning":148,"citing_publications":261,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2014.1003773"}},{"id":2306,"doi":"10.1007/s10508-021-02107-4","pmid":"34811651","pmcid":"PMC8888501","title":"Are Female Paraphilias Hiding in Plain Sight? Risqué Male-Male Erotica for Women in Sinophone and Anglophone Regions","authors":"Madill A, Zhao Y.","first_author":"Madill A","journal":"Archives of sexual behavior","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Paraphilia","Dsm-5","Pornography","Boys’ Love","Danmei","Yaoi"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8888501","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online fan‑survey, convenience sample, categorical PCA of self‑report preferences","sample_n":3637,"sample_text":"Convenience online survey of BL fandoms; not population‑representative","population":"adult participants self‑identifying as fans of male‑male erotica (BL), Sinophone N=1922, Anglophone N=1715","country":"China and English‑speaking countries (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed thousands of women who read male‑male erotic fiction (Boys’ Love) in Chinese and English contexts, finding four main fantasy themes (e.g., BDSM, animal/under‑age sex). Fans who read more sexual stories were more likely to endorse these themes. The authors suggest women’s paraphilic interests may be hidden in fantasy.","clinical_takeaway":"Findings reflect fantasy preferences among a specific fan community; they do not indicate clinical paraphilia or pathology in the broader population.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Very large N across two cultural groups","Use of multivariate (PCA) analysis to identify content dimensions","Cross‑cultural comparison"],"limitations":["Convenience fan sample limits generalisability","Ad‑hoc questionnaire not validated","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02107-4"}},{"id":2308,"doi":"10.1007/s10508-021-02049-x","pmid":"34761344","pmcid":"PMC8579901","title":"\"It Was Scary, But Then It Was Kind of Exciting\": Young Women's Experiences with Choking During Sex","authors":"Herbenick D, Guerra-Reyes L, Patterson C, Rosenstock Gonzalez YR, Wagner C, Zounlome N.","first_author":"Herbenick D","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Strangulation","Choking","Bdsm","Kink","Breath Play","Sexual Asphyxia"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8579901","cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"In‑depth interviews with 24 undergraduate/graduate women (18‑33 y) about experiences of sexual choking; thematic analysis of transcripts.","sample_n":24,"sample_text":"24 women, ages 18‑33, recruited from university settings","population":"young adult female university students (convenience sample)","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 24 young women revealed that many have been choked during sex, learning about it from porn, media, friends, and partners. Experiences ranged from consensual to non‑consensual, and safety practices were often informal.","clinical_takeaway":"Clinicians should openly discuss breath‑play with patients, emphasizing consent, clear safety signals, and education about risks.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rich qualitative insight into a understudied sexual practice","Diverse sources of learning (porn, media, peers) reported","Focus on consent and safety practices"],"limitations":["Small, non‑representative student sample","No validated measurement tools","No systematic assessment of mental‑health or moral variables"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":53,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02049-x"}},{"id":2310,"doi":"10.3389/fpsyg.2021.606797","pmid":"34803786","pmcid":"PMC8600182","title":"Acceptance of Sexual Interest in Minors in Self-Referred Individuals Under Treatment - An Exploratory Pilot Study","authors":"Lampalzer U, Tozdan S, von Franqué F, Briken P.","first_author":"Lampalzer U","journal":"Frontiers in psychology","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["psychotherapy","Pedophilia","Prevention Of Child Sexual Abuse","Risk Of Offending","Child Abuse Material"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyg.2021.606797/pdf","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Exploratory pilot study using pretreatment correlations (N=79) and pre‑post within‑group comparison (n=35) of self‑referred individuals in treatment.","sample_n":79,"sample_text":"N = 79 pretreatment; n = 35 for pre‑post analysis.","population":"Self‑referred individuals undergoing psychotherapy for sexual interest in minors (mixed sample, majority not exclusively interested in children).","country":"Germany (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 79 people receiving therapy for sexual interest in minors, greater acceptance of that interest was linked to more frequent use of legal child images and sexual activities with minors, but not to higher risk of reoffending. Acceptance did not change after treatment.","clinical_takeaway":"Acceptance of sexual interest in minors does not appear to increase reoffending risk, but may be associated with more frequent use of child imagery; clinicians should discuss acceptance carefully.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of a validated risk instrument (STABLE‑2007)","Clear reporting of sample size and statistical method"],"limitations":["Small, treatment‑seeking convenience sample","Reliance on self‑report for sensitive behaviours","No correction for multiple comparisons"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":12,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2021.606797"}},{"id":2311,"doi":"10.3389/fpsyg.2015.00653","pmid":"26052292","pmcid":"PMC4441125","title":"Symptoms of cybersex addiction can be linked to both approaching and avoiding pornographic stimuli: results from an analog sample of regular cybersex users","authors":"Snagowski J, Brand M.","first_author":"Snagowski J","journal":"Frontiers in psychology","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Arousal","Behavioral Addictions","Problematic Sexual Behavior","Cybersex Addiction","Approach Avoidance"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4441125","cited_by_count":37,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional experimental analog task with self‑report questionnaires","sample_n":123,"sample_text":"123 heterosexual males","population":"123 heterosexual males, regular cybersex users","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In 123 men who regularly use cybersex, those reporting more addiction‑like symptoms showed either stronger pull‑toward or push‑away reactions to porn pictures. The effect was strongest for men with high sexual arousal and problematic sexual behavior.","clinical_takeaway":"Approach/avoidance patterns may relate to cybersex problems, but current evidence is limited and confounded.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Experimental approach‑avoidance task","Reasonable sample size for a lab task","Investigates interaction of sexual excitation and behavior"],"limitations":["Reliance on self‑report addiction scales with unclear validation","No control for key confounds (moral incongruence, mental health, masturbation)","Cross‑sectional; causal language overreaches","No neurobiological data despite neural claims"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":3,"contrasting":2,"mentioning":48,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2015.00653"}},{"id":2312,"doi":"10.1071/sh21077","pmid":"34743786","pmcid":null,"title":"Partnership status, living arrangements, and changes in sexual behaviour and satisfaction during the COVID-19 lockdown: insights from an observational, cross-sectional online survey in Singapore","authors":"Tan RKJ, O'Hara CA, Kumar N.","first_author":"Tan RKJ","journal":"Sexual health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Observational Study"],"keywords":[],"is_oa":false,"oa_url":"https://scholarbank.nus.edu.sg/handle/10635/232895","cited_by_count":10,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational, cross-sectional online survey (N=562) recruited via social media in Singapore, comparing reported sexual behaviours and satisfaction before vs. during COVID‑19 movement controls.","sample_n":562,"sample_text":"562 participants, 338 reporting sexual experience","population":"Singapore adults (self‑selected online respondents)","country":"Singapore","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"During Singapore's COVID‑19 lockdown, people who were single or not living with a partner reported less partnered sex but more masturbation, nudes and porn. Those living with a partner kept higher sexual satisfaction, while those apart reported drops in satisfaction.","clinical_takeaway":"Clinicians should consider partnership status when discussing sexual wellbeing during lockdowns; support for solo sexual activities may help maintain satisfaction for singles.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for an online survey","Direct comparison of pre‑ and during‑pandemic behaviours","Multivariable analysis with adjusted prevalence ratios"],"limitations":["Convenience sample recruited via social media; not representative","Reliance on single‑item self‑report measures, no validated scales","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":13,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh21077"}},{"id":2313,"doi":"10.1016/j.addbeh.2015.05.009","pmid":"26026385","pmcid":null,"title":"Implicit associations in cybersex addiction: Adaption of an Implicit Association Test with pornographic pictures","authors":"Snagowski J, Wegmann E, Pekal J, Laier C, Brand M.","first_author":"Snagowski J","journal":"Addictive behaviors","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual Arousal","Implicit Association Test","Internet Addiction","Cybersex Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross‑sectional experimental study using an adapted Implicit Association Test and self‑report questionnaires (N=128)","sample_n":128,"sample_text":"128 heterosexual male participants","population":"heterosexual male adults, convenience sample","country":"Germany (likely, based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["no_mi_control","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 128 heterosexual men, stronger positive implicit associations between porn images and pleasant feelings were linked to higher self‑reported cybersex addiction tendencies, sexual excitement, and craving. The authors suggest these unconscious links may help explain problematic cybersex use.","clinical_takeaway":"Implicit positive feelings toward porn may relate to self‑perceived cybersex problems, but evidence is correlational and does not confirm an addiction diagnosis.","confidence":0.8,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Use of a validated implicit measure (IAT)","Moderate sample size for IAT research","Integration of implicit and explicit variables"],"limitations":["Cross‑sectional, no causal inference","Addiction constructs based on self‑report scales without ICD‑11 criteria","Key confounds (moral incongruence, masturbation, mental health) not measured"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":32,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2015.05.009"}},{"id":2314,"doi":"10.1556/2006.2021.00073","pmid":"34710056","pmcid":"PMC8987420","title":"Changes in substance use and other reinforcing behaviours during the COVID-19 crisis in a general population cohort study of young Swiss men","authors":"Studer J, Marmet S, Gmel G, Wicki M, Labhart F, Gachoud C, Daeppen JB, Bertholet N.","first_author":"Studer J","journal":"Journal of behavioral addictions","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Young men","Switzerland","Substance Use","Cohort Study On Substance Use Risk Factors","Covid-19","Other Reinforcing Behaviours"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8987420","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort of 2,344 young Swiss men with pre‑COVID baseline and during‑COVID follow‑up","sample_n":2344,"sample_text":"large community sample, but limited to Swiss males, not gender‑balanced","population":"young Swiss men (average age ~20‑25) recruited from national conscription cohort","country":"Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a cohort of 2,300 Swiss men, alcohol drinking fell during the first COVID‑19 lockdown while time spent gaming, watching TV series, and viewing internet pornography rose, especially among those living alone or speaking German.","clinical_takeaway":"Pandemic‑related stress may shift young men from drinking to screen‑based sexual activities; clinicians should screen for increased pornography use.","confidence":0.8,"topic_tags":["pornography","religiosity","moral_incongruence"],"strengths":["Large sample size","Before‑and‑during pandemic design","Use of latent‑change score modelling"],"limitations":["Reliance on single‑item self‑report time‑use measures","No assessment of moral incongruence, masturbation, or mental‑health covariates","Findings limited to Swiss young men"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2021.00073"}},{"id":2315,"doi":"10.1007/s10508-021-02111-8","pmid":"34697691","pmcid":null,"title":"Virtual Reality Erotica: Exploring General Presence, Sexual Presence, Sexual Arousal, and Sexual Desire in Women","authors":"Milani S, Jabs F, Brown NB, Zdaniuk B, Kingstone A, Brotto LA.","first_author":"Milani S","journal":"Archives of sexual behavior","year":2022,"pub_types":["Journal Article"],"keywords":["Virtual reality","Pornography","Erotic Stimuli","Vr Erotica","Women’s Sexual Experiences"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subjects lab experiment comparing VR versus 2‑D erotic videos (first‑person vs third‑person POV) in 38 women.","sample_n":38,"sample_text":"38 women","population":"Women (N=38) recruited for a laboratory study of sexual response.","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study of 38 women, immersive virtual‑reality erotic videos produced stronger feelings of being present, sexual arousal and sexual presence than traditional two‑dimensional videos, especially when shown from a first‑person viewpoint.","clinical_takeaway":"VR erotica may elicit stronger sexual arousal in women, suggesting potential as a research tool or therapeutic aid, but evidence is preliminary.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Innovative use of VR technology","Experimental within‑subject design allowing direct modality comparison","Multiple outcome dimensions (presence, arousal, desire) assessed"],"limitations":["Small sample size limits statistical power","Reliance on ad‑hoc self‑report scales, unclear validation","No assessment of potential confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":25,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02111-8"}},{"id":2316,"doi":"10.7717/peerj.12162","pmid":"34721957","pmcid":"PMC8541304","title":"Sexual and psychological health of couples with azoospermia in the context of the COVID-19 pandemic","authors":"Dong M, Tao Y, Wu S, Li Z, Wang X, Tan J.","first_author":"Dong M","journal":"PeerJ","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Psychological Health","Covid-19","Couples With Azoospermia"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8541304","cited_by_count":3,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control cross‑sectional survey of 100 couples with azoospermia and 100 control couples; standardized sexual function and mental‑health questionnaires plus a self‑designed porn/masturbation questionnaire; Actor‑Partner Interdependence Model analysis.","sample_n":200,"sample_text":"100 couples with azoospermia and 100 couples with normozoospermia","population":"couples (men with azoospermia or normozoospermia and their wives) recruited in China during July‑Dec 2020","country":"China","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Couples where the man has no sperm (azoospermia) reported poorer sexual function and higher anxiety and depression during the COVID‑19 lockdown than couples with normal sperm, and women in these couples also masturbated and used pornography less.","clinical_takeaway":"Azoospermia is associated with lower sexual satisfaction and greater psychological distress; clinicians should screen for both in affected couples.","confidence":0.78,"topic_tags":["sexual_function","pornography","masturbation","relationships"],"strengths":["Validated sexual function and mental‑health instruments","Large matched case‑control sample","Dyadic analysis with APIM"],"limitations":["Pornography use measured with ad‑hoc questionnaire","No assessment of moral or religious attitudes","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7717/peerj.12162"}},{"id":2317,"doi":"10.3389/fpsyt.2015.00054","pmid":"25941496","pmcid":"PMC4403291","title":"Factors Predicting Cybersex Use and Difficulties in Forming Intimate Relationships among Male and Female Users of Cybersex","authors":"Weinstein AM, Zolek R, Babkin A, Cohen K, Lejoyeux M.","first_author":"Weinstein AM","journal":"Frontiers in psychiatry","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Craving","Intimacy","Cybersex","Sex Addiction","Pornography"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2015.00054/pdf","cited_by_count":31,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 267 users recruited from pornography/cybersex sites","sample_n":267,"sample_text":"Convenience sample recruited from special sites dedicated to pornography and cybersex on the Internet","population":"adult users of cybersex (192 males, 75 females), convenience sample","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 267 people who use cybersex found that higher pornography craving and being male predicted more frequent cybersex and greater difficulty forming intimate relationships. The study used self‑report scales but did not account for moral or mental‑health factors.","clinical_takeaway":"Higher cybersex use is linked to intimacy difficulties, but the findings are limited by self‑selection and lack of control for key confounds.","confidence":0.75,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Relatively large sample for a niche topic","Separate analysis for gender differences","Uses multiple self‑report scales"],"limitations":["Convenience sample limits generalisability","No control for moral, mental‑health or relationship confounds","Reliance on unvalidated or poorly described addiction measures","No effect sizes or correction for multiple testing"],"rubric_version":"2.0","raw_total":18,"max_possible":60,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":2,"interpretation":5}},"scite":{"supporting":7,"contrasting":2,"mentioning":58,"citing_publications":97,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2015.00054"}},{"id":2318,"doi":"10.1111/j.1365-2923.1978.tb01425.x","pmid":"83529","pmcid":null,"title":"An introduction to sexuality in the medical curriculum","authors":"Stanley E.","first_author":"Stanley E.","journal":"Medical education","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"questionnaire after educational intervention; no control group; convenience sample of medical students (n=329)","sample_n":329,"sample_text":"329 students","population":"medical students in four UK medical schools","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Medical students watched explicit films and discussed them, reporting increased comfort and objectivity in interviewing patients with sexual problems.","clinical_takeaway":"Teaching with explicit material may improve clinicians' comfort with sexual health discussions.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large sample for an educational pilot","addresses a gap in medical training"],"limitations":["no control/comparison group","uses ad‑hoc questionnaires","cross‑sectional self‑report only"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2923.1978.tb01425.x"}},{"id":2319,"doi":"10.1007/s42448-021-00087-5","pmid":"34664035","pmcid":"PMC8515777","title":"Cyber Safety of Children in the Association of Southeast Asian Nations (ASEAN) Region: a Critical Review of Legal Frameworks and Policy Implications","authors":"Rahamathulla M.","first_author":"Rahamathulla M.","journal":"International journal on child maltreatment : research, policy and practice","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Child Abuse","Policies","Child Exploitation","Asean","Legal Framework","Cyber Safety","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8515777","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"critical review of legal frameworks using secondary sources; no primary data collection; narrative synthesis without systematic methodology","sample_n":null,"sample_text":"No primary participants; analysis based on legal documents and secondary sources","population":"children in ASEAN countries (policy focus)","country":"ASEAN region (multiple countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews child‑online safety laws across ASEAN nations, finds many inconsistencies—such as missing definitions of child pornography and weak grooming statutes—that could let criminals exploit children online.","clinical_takeaway":"None – the paper offers policy insights, not clinical guidance for individual patients.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of ASEAN legal texts","Identifies concrete gaps in child‑online safety legislation","Highlights cross‑border risks for exploitation"],"limitations":["Narrative, non‑systematic review; no systematic search or risk‑of‑bias assessment","No primary data; conclusions based on inference rather than empirical evidence","Potential selection bias in chosen legal documents"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s42448-021-00087-5"}},{"id":2320,"doi":"10.1002/ab.21998","pmid":"34632594","pmcid":null,"title":"Effects of violent and nonviolent sexualized media on aggression-related thoughts, feelings, attitudes, and behaviors: A meta-analytic review","authors":"Burnay J, Kepes S, Bushman BJ.","first_author":"Burnay J","journal":"Aggressive behavior","year":2022,"pub_types":["Meta-Analysis","Journal Article"],"keywords":["Meta-analysis","Aggression","Violence","Pornography","Sexualized Media"],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 166 independent studies (N=124,236) covering experimental, cross‑sectional and longitudinal designs; sensitivity analyses for publication bias; no explicit risk‑of‑bias assessment reported.","sample_n":124236,"sample_text":"124,236 participants across 166 studies","population":"Adults and adolescents from the included primary studies (college students and non‑students, both sexes).","country":"Multiple (global sample from primary studies)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 166 studies found that watching sexualised media—especially when it includes violence—slightly increases thoughts, attitudes and behaviours linked to aggression toward women.","clinical_takeaway":"Exposure to violent sexualised media may modestly raise aggression risk; clinicians should consider media habits when addressing aggressive attitudes.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large pooled sample provides precise effect estimates.","Includes multiple study designs, allowing triangulation.","Conducts sensitivity analyses for publication bias and outliers."],"limitations":["Limited assessment of study‑level risk of bias.","Potential heterogeneity in how sexualised media and aggression are operationalised.","No control for individual‑level confounds such as religiosity or mental health."],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":49,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ab.21998"}},{"id":2321,"doi":"10.1037/lhb0000128","pmid":"25844514","pmcid":null,"title":"Predicting recidivism among adult male child pornography offenders: Development of the Child Pornography Offender Risk Tool (CPORT)","authors":"Seto MC, Eke AW.","first_author":"Seto MC","journal":"Law and human behavior","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":65,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort with 5‑year follow‑up of 266 adult male child‑pornography offenders; outcome: any sexual recidivism.","sample_n":266,"sample_text":"266 adult male child pornography offenders identified from police case files; 5‑year follow‑up.","population":"Adult male offenders convicted of child‑pornography offenses (community after index offence).","country":"Canada (Ontario)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created a checklist (CPORT) to predict whether adult men convicted of child‑pornography offenses will re‑offend sexually within five years. Using police records of 266 offenders, the tool showed moderate ability to flag higher‑risk individuals.","clinical_takeaway":"The CPORT may help risk professionals identify higher‑risk child‑pornography offenders, but it needs further validation before routine use.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, real‑world offender sample","5‑year follow‑up from official records","Clear operational definition of recidivism"],"limitations":["Risk tool not yet externally validated","No measurement of psychological or moral variables","Potential selection bias (only convicted, community‑based offenders)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":12,"contrasting":3,"mentioning":267,"citing_publications":201,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/lhb0000128"}},{"id":2322,"doi":"10.1007/s10943-014-9849-8","pmid":"24609752","pmcid":null,"title":"The relationship between religiosity and internet pornography use","authors":"Short MB, Kasper TE, Wetterneck CT.","first_author":"Short MB","journal":"Journal of religion and health","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 223 college students","sample_n":223,"sample_text":"college students recruited via university channels (convenience sample)","population":"college students (young adult, mixed gender)","country":"USA (presumed from journal and author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 223 college students, about two‑thirds had ever viewed internet pornography, but those who were more religious were less likely to do so. The authors suggest that religious beliefs may influence pornography use.","clinical_takeaway":"Religiosity appears associated with lower pornography use among students, but the study does not address clinical problems or treatment implications.","confidence":0.8,"topic_tags":["religiosity","pornography","sexual_function","moral_incongruence"],"strengths":["reasonable sample size for survey","focus on religiosity, an under‑studied variable","clear reporting of prevalence rates"],"limitations":["cross‑sectional, cannot infer causality","no validated measures of problematic pornography use or distress","key confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":46,"citing_publications":147,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-014-9849-8"}},{"id":2324,"doi":"10.1007/s10508-014-0451-7","pmid":"25795529","pmcid":null,"title":"Vulnerability to Sexual Victimization in Female and Male College Students in Brazil: Cross-Sectional and Prospective Evidence","authors":"D'Abreu LC, Krahé B.","first_author":"D'Abreu LC","journal":"Archives of sexual behavior","year":2016,"pub_types":["Journal Article"],"keywords":["Brazil","Risky Sexual Behavior","Childhood Sexual Abuse","Sexual Scripts","Sexual Victimization","Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Cross‑sectional survey of 541 Brazilian college students plus a prospective follow‑up of 250 participants after 6 months.","sample_n":541,"sample_text":"541 participants (cross‑sectional); 250 of them re‑tested after 6 months","population":"College students (Brazil), both sexes, n≈541 (cross‑sectional), n≈250 (prospective)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Brazilian college sample, the authors found that watching pornography was linked to later sexual victimisation because it shaped risky sexual scripts and behaviour; prior abuse also increased risk.","clinical_takeaway":"Consider how pornography exposure may influence risky sexual expectations, but note the evidence is correlational and based on self‑report.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large initial sample for a college‑based study","Prospective component adds temporal information","Considers multiple mediating pathways (scripts, behavior)"],"limitations":["Reliance on self‑report measures; validation unclear","Limited control for key confounds (e.g., moral incongruence, mental health)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":2,"mentioning":35,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0451-7"}},{"id":2325,"doi":"10.1007/s10508-021-02085-7","pmid":"34590219","pmcid":null,"title":"Focusing the Conceptualization of Erotophilia and Erotophobia on Global Attitudes Toward Sex: Development and Validation of the Sex Positivity-Negativity Scale","authors":"Hangen F, Rogge RD.","first_author":"Hangen F","journal":"Archives of sexual behavior","year":2022,"pub_types":["Journal Article"],"keywords":["Measure Development","Sexual Satisfaction","Erotophilia","Erotophobia","Sex-negativity","Sex-positivity"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Scale development using online convenience sample (N=2205); exploratory and confirmatory factor analyses, IRT.","sample_n":2205,"sample_text":"Online convenience sample of adults.","population":"Adult online respondents, 82% Caucasian, 66% heterosexual, 50% female.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a new 31‑item Sex Positivity‑Negativity (SPN) scale that more precisely measures attitudes toward sex, including pornography and masturbation, offering better reliability and predictive power than older measures.","clinical_takeaway":"The SPN scale provides clinicians with a concise, validated tool to assess clients' sex‑positive versus sex‑negative attitudes, which could inform therapy targeting sexual well‑being.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for scale development","Comprehensive psychometric validation (EFA, CFA, IRT)","Demonstrates incremental validity over existing scales"],"limitations":["Convenience online sample, limited diversity","No control for moral or mental‑health confounds","Cross‑sectional; cannot assess temporal stability beyond 6‑month follow‑up"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02085-7"}},{"id":2326,"doi":"10.1037/per0000506","pmid":"34553969","pmcid":null,"title":"Psychopathic traits in the context of paid erotic services and sex exchange among college students","authors":"Edwards BG, Hoffmann AM, Verona E.","first_author":"Edwards BG","journal":"Personality disorders","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,250 undergraduate students","sample_n":1250,"sample_text":"undergraduate students, 800 women, 450 men","population":"college students (USA)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 1,250 US college students, higher psychopathic traits were linked to greater involvement in paid erotic services, both as providers and consumers, even after accounting for substance use.","clinical_takeaway":"Personality traits, especially psychopathic characteristics, may influence engagement with paid sexual services in college students.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Large sample size for a college survey","Use of validated psychopathy instrument","Gender‑specific analyses"],"limitations":["Erotic activity measure appears non‑validated","Cross‑sectional design limits causal inference","No assessment of key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/per0000506"}},{"id":2328,"doi":"10.1177/08862605211042804","pmid":"34547951","pmcid":null,"title":"Prevalence of Child Sexual Abuse in Spain: A Representative Sample Study","authors":"Ferragut M, Ortiz-Tallo M, Blanca MJ.","first_author":"Ferragut M","journal":"Journal of interpersonal violence","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Prevalence","Generations","Spain","Child Sexual Abuse","Representative Sample"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Representatively sampled 1,071 Spanish adults surveyed online about CSA experiences; prevalence rates reported by gender and generation.","sample_n":1071,"sample_text":"representative national sample of Spanish adults (online anonymous survey)","population":"1071 adults (539 male, 532 female) from Spain, age mean 45.4 years, recruited to reflect national gender, age, and regional distribution.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 1,000 Spanish adults found that 2.8%‑18.5% reported experiencing some form of child sexual abuse, with higher rates in women and the youngest generation; only a quarter ever disclosed the abuse.","clinical_takeaway":"Child sexual abuse is relatively common in Spain; clinicians should routinely assess for histories of CSA, especially in young adults and females.","confidence":0.8,"topic_tags":["prevalence","sexual_function","csbd"],"strengths":["Large, nationally representative sample","Clear prevalence estimates with gender/generation breakdowns","Anonymous online survey reduces social desirability bias"],"limitations":["Self‑report without validated CSA instrument","Cross‑sectional design cannot examine causality","Limited detail on measurement validation"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":3,"contrasting":0,"mentioning":18,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605211042804"}},{"id":2329,"doi":"10.1016/j.comppsych.2015.02.007","pmid":"25732412","pmcid":null,"title":"Examining the psychometric properties of the Yale-Brown Obsessive-Compulsive Scale in a sample of compulsive pornography users","authors":"Kraus SW, Potenza MN, Martino S, Grant JE.","first_author":"Kraus SW","journal":"Comprehensive psychiatry","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":54,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional psychometric validation in a treatment‑seeking sample (N=103)","sample_n":103,"sample_text":"103 men seeking treatment","population":"men seeking treatment for compulsive pornography use at two university clinics (U.S.)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested a version of the Yale‑Brown Obsessive‑Compulsive Scale modified for compulsive sexual behaviour in 103 men in treatment, finding it reliable but based on a clinical sample.","clinical_takeaway":"The CSB‑Y‑BOCS appears reliable for assessing compulsive sexual symptoms in treatment‑seeking men, but its use with broader populations needs further validation.","confidence":0.8,"topic_tags":["pornography","csbd","measurement","sexual_function"],"strengths":["Uses a well‑known OCD scale as a basis","Reports internal consistency and test‑retest reliability","Includes a follow‑up assessment","Large (N>100) for a psychometric study"],"limitations":["Sample limited to treatment‑seeking men, limiting generalisability","No assessment of moral incongruence or masturbation frequency","Scale adaptation not fully validated against ICD‑11 CSBD criteria","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":2,"mentioning":56,"citing_publications":142,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2015.02.007"}},{"id":2330,"doi":"10.1080/19317611.2014.999967","pmid":"26918066","pmcid":"PMC4764134","title":"Internet Pornography Use and Sexual Body Image in a Dutch Sample","authors":"Cranney S.","first_author":"Cranney S.","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Body Image","Erotica","Genital Image"],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large-N Dutch online survey; cross‑sectional self‑report of pornography use frequency and sexual body‑image dissatisfaction; no longitudinal or experimental manipulation","sample_n":null,"sample_text":"large‑N sample of Dutch respondents (exact N not provided)","population":"Dutch respondents (adult, unspecified recruitment method)","country":"Netherlands","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Dutch survey, men who used internet pornography more often reported being less satisfied with their penis size, while women's breast‑size satisfaction was unrelated to porn use.","clinical_takeaway":"Clinicians should note that reported links between porn use and male genital body‑image concerns are correlational, not evidence of causation.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["large sample size","addresses understudied link between porn use and body image","gender‑specific analysis"],"limitations":["cross‑sectional; cannot infer causality","no validated measurement instruments reported","absence of key confound controls (moral incongruence, mental health, masturbation)","potential self‑selection bias"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":4,"contrasting":0,"mentioning":37,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2014.999967"}},{"id":2331,"doi":"10.1007/s40894-021-00171-4","pmid":"38895164","pmcid":"PMC11185410","title":"Gender Equitable Attitudes Among Adolescents: A Validation Study and Associations with Sexual Health Behaviors","authors":"Hill AL, Miller E, Switzer GE, Abebe KZ, Chang JC, Pulerwitz J, Brush LD, Hill AV.","first_author":"Hill AL","journal":"Adolescent research review","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Measurement Invariance","Psychometric Evaluation","Violence Prevention","Gender Equitable Attitudes"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large pooled convenience sample of adolescents (n≈2200) with mixed-effects regression analyses","sample_n":866,"sample_text":"predominantly Black adolescent boys (n = 866); additional pooled data from two programs","population":"U.S. adolescents, predominantly Black boys, plus additional samples of girls and white boys","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested a questionnaire about gender‑fair attitudes in U.S. teens and found it works well for Black boys. More gender‑fair attitudes were linked to less relationship abuse, higher confidence negotiating condom use, and lower reported porn use.","clinical_takeaway":"Promoting gender‑equitable attitudes may help reduce risky sexual behaviors, including porn use, among adolescents.","confidence":0.6,"topic_tags":["sexual_function","pornography","gender","adolescents"],"strengths":["Large, diverse adolescent sample","Rigorous psychometric validation (EFA/CFA, invariance testing)","Use of mixed‑effects models accounting for clustering"],"limitations":["Cross‑sectional design limits causal inference","Key confounders (e.g., moral attitudes, mental health) not measured","Self‑report of pornography use may be biased"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40894-021-00171-4"}},{"id":2332,"doi":"10.1080/0092623x.2014.996930","pmid":"25514403","pmcid":null,"title":"A Preliminary Model of Motivation for Pornography Consumption Among Men Participating in Zoophilic Virtual Environments","authors":"de Souza Aranha E Silva RA, Baltieri DA.","first_author":"de Souza Aranha E Silva RA","journal":"Journal of sex & marital therapy","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of men recruited from a zoophilic website","sample_n":null,"sample_text":"Convenience online sample; size not reported in abstract","population":"men with sexual interest in animals who visited zoophilic blogs/websites","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed men who visit zoophilic websites and examined how depression, sexual impulsiveness, and strong interest in animals relate to why they view such pornography. Different psychological factors were linked to motives like curiosity, excitement seeking, and pleasure.","clinical_takeaway":"Clinicians should note that diverse psychological motivations, not just distress, drive this specific pornography use.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Factorial validation of a pornography consumption scale","Inclusion of multiple psychological predictors","Clear reporting of correlation patterns"],"limitations":["Convenience sample from a niche online community limits generalisability","No measurement of key confounds such as moral incongruence or masturbation","Cross‑sectional design precludes causal inference","Sample size not reported"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2014.996930"}},{"id":2334,"doi":"10.2196/25360","pmid":"34473066","pmcid":"PMC8446844","title":"The Characteristics and Risk Factors of Web-Based Sexual Behaviors Among Men Who Have Sex With Men in Eastern China: Cross-sectional Study","authors":"Chen L, Chen W, Jiang T, Ni Z, Ma Q, Pan X.","first_author":"Chen L","journal":"JMIR public health and surveillance","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Internet","HIV","Cross-sectional study","Men Who Have Sex With Men","Casual Sexual Partners"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8446844","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 767 MSM recruited via community organisations and VCT clinics in Zhejiang Province, China","sample_n":767,"sample_text":"767 participants recruited through community‑based organisations and VCT clinics","population":"Men who have sex with men (MSM) in Eastern China (Zhejiang Province)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 767 Chinese men who have sex with men found that frequent porn video watching is linked to seeking casual partners online, and that knowing a partner’s HIV status influences condom use and sexual practices.","clinical_takeaway":"Clinicians should discuss online partner‑finding behaviours and encourage HIV status disclosure to reduce unprotected sex among MSM.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑city MSM study","Multivariate logistic regression with confidence intervals","Focus on a concrete public‑health outcome (HIV risk)"],"limitations":["Cross‑sectional design limits causal inference","Convenience recruitment limits generalisability","Key psychosocial confounds (moral incongruence, mental health) not measured"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[{"status":"Has erratum","date":"2021-9-8","noticeDoi":"10.2196/33430","doi":"10.2196/25360"},{"status":"Has correction","date":"2021-9-8","noticeDoi":"10.2196/33430","doi":"10.2196/25360"}],"url":"https://scite.ai/reports/10.2196/25360"}},{"id":2335,"doi":"10.4314/ejhs.v31i5.6","pmid":"35221611","pmcid":"PMC8843139","title":"Physical Violence and Associated Factors among Women of Reproductive Age in Gedeo Zone, Southern Ethiopia","authors":"Kassa ZY, Abeje A, Ashegu T, Hadra N.","first_author":"Kassa ZY","journal":"Ethiopian journal of health sciences","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Ethiopia","Reproductive Age Women","Physical Violence"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8843139","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Community‑based cross‑sectional survey with stratified two‑stage cluster sampling of women of reproductive age in Gedeo Zone, Ethiopia; logistic regression used to identify factors associated with physical violence.","sample_n":null,"sample_text":"Not specified in abstract","population":"Women of reproductive age in Gedeo Zone, Southern Ethiopia (sample size not reported in abstract)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of Ethiopian women of reproductive age, about 15% reported experiencing physical violence. Women whose partners used substances or watched pornography were more likely to be victims of violence.","clinical_takeaway":"Partner substance use and pornography viewing are associated with higher risk of physical violence; interventions should address these behaviors.","confidence":0.8,"topic_tags":["gender"],"strengths":["Large community‑based sample with cluster sampling","Uses multivariable logistic regression and reports adjusted odds ratios with confidence intervals"],"limitations":["Reliance on self‑reported exposure and outcome measures without validated scales","Cross‑sectional design prevents causal inference","No assessment of key psychosocial confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4314/ejhs.v31i5.6"}},{"id":2336,"doi":"10.1071/sh21019","pmid":"34404502","pmcid":null,"title":"Virgins at age 26: who are they?","authors":"Meuwly M, Suris JC, Auderset D, Stadelmann S, Barrense-Dias Y.","first_author":"Meuwly M","journal":"Sexual health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional analysis of a nationally representative Swiss survey (N=5175) dividing participants into virgins vs non‑virgins and examining sociodemographic and health correlates.","sample_n":5175,"sample_text":"large community sample","population":"young adults (mean age 26) from Switzerland; 275 identified as virgins.","country":"Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a Swiss survey of 5,175 26‑year‑olds, 5.3 % had never had a sexual partner. Virgin participants were more often male, lived with family, reported poorer health, less social satisfaction, and lower use of substances, online dating and pornography. The main reasons were not finding the right person (women) or lacking occasion (men).","clinical_takeaway":"Health professionals should ask about sexual inactivity and ensure it is not linked to distress or health problems.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Clear definition of virginity","Adjusted odds ratios with confidence intervals"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on single‑item self‑reports, no validated scales","Key confounds (moral incongruence, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh21019"}},{"id":2337,"doi":"10.1080/10810730.2021.1986609","pmid":"34641769","pmcid":null,"title":"A Meta-analysis of Media Consumption and Rape Myth Acceptance","authors":"Hedrick A.","first_author":"Hedrick A.","journal":"Journal of health communication","year":2021,"pub_types":["Meta-Analysis","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 32 primary studies (N = 12,016) examining the correlation between media consumption (including pornography) and rape‑myth acceptance.","sample_n":12016,"sample_text":"Thirty‑two studies (N = 12,016) met inclusion criteria.","population":"Adults and adolescents across included primary studies (no single sample description).","country":"Not specified (multiple countries across primary studies).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 32 studies (total N = 12,016) found a small but statistically significant link between consuming media—especially violent and general pornography—and greater acceptance of rape myths.","clinical_takeaway":"Media exposure, particularly to violent pornography, is modestly associated with harmful beliefs about rape; media‑literacy interventions may help reduce these attitudes.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Large combined sample size across studies","Systematic inclusion criteria and quantitative synthesis","Identification of specific media types driving effect"],"limitations":["Reliance on self‑reported media use","Potential heterogeneity in RMA measures","No assessment of key confounds (e.g., moral attitudes)"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":51,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10810730.2021.1986609"}},{"id":2338,"doi":"10.1080/00918369.2015.1008280","pmid":"25603357","pmcid":null,"title":"\"It is what it is\": masculinity, homosexuality, and inclusive discourse in mixed martial arts","authors":"Channon A, Matthews CR.","first_author":"Channon A","journal":"Journal of homosexuality","year":2015,"pub_types":["Journal Article"],"keywords":["inclusion","Homophobia","Mixed Martial Arts","Combat Sports","Masculinities","Ufc","Pornography","Netography"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"case-study of online media narratives about a mixed‑martial‑arts fighter who appeared in gay pornography; no empirical participant data","sample_n":null,"sample_text":"N/A","population":"none (media discourse analysis)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article analyses online discussions of an MMA fighter who appeared in gay porn, using inclusive masculinity theory to argue that MMA culture is becoming less homophobic and more accepting of diverse masculinities.","clinical_takeaway":"None – the study is a qualitative media analysis, not applicable to clinical practice.","confidence":0.7,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Clear theoretical framing (inclusive masculinity theory)","Rich qualitative analysis of media discourse"],"limitations":["No empirical participant data; limited generalisability","Constructs not measured with validated instruments","No control for confounding variables"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":26,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2015.1008280"}},{"id":2339,"doi":"10.1089/cyber.2014.0343","pmid":"25587721","pmcid":null,"title":"Association between pornography use and sexual risk behaviors in adult consumers: a systematic review","authors":"Harkness EL, Mullan B, Blaszczynski A.","first_author":"Harkness EL","journal":"Cyberpsychology, behavior and social networking","year":2015,"pub_types":["Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":61,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 17 observational studies linking pornography use to sexual risk outcomes; quality assessed with Quality Index Scale; no meta‑analysis.","sample_n":null,"sample_text":"17 included studies (individual sample sizes not reported)","population":"Adult pornography consumers (studies varied)","country":"Not specified (multinational literature)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 17 studies found that adult pornography users tend to report more unsafe sex and higher numbers of partners, but the original research often had weak designs and limited generalisability.","clinical_takeaway":"Clinicians should note a possible link between pornography use and sexual risk, yet interpret it cautiously given the methodological weaknesses.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Systematic search across multiple databases","Explicit quality assessment of included studies","Identifies consistent pattern of association"],"limitations":["Underlying primary studies have low external validity","No meta‑analysis; effect sizes not pooled","Confounding variables (e.g., moral incongruence, mental health) rarely addressed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":74,"citing_publications":144,"retracted":false,"notices":[{"status":"Has erratum","date":"2015-11","noticeDoi":"10.1089/cyber.2014.0343.cxn","doi":"10.1089/cyber.2014.0343"}],"url":"https://scite.ai/reports/10.1089/cyber.2014.0343"}},{"id":2340,"doi":"10.21315/mjms2021.28.4.13","pmid":"34512137","pmcid":"PMC8407794","title":"Prevalence, Pattern and Predictors of Child Sexual Abuse Among Senior Secondary School Students in Enugu Metropolis","authors":"Chime OH, Orji CJ, Aneke TJ, Nwoke IN.","first_author":"Chime OH","journal":"The Malaysian journal of medical sciences : MJMS","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Child","Sexual","Prevalence","Students","Schools","Child Abuse"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8407794","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 325 adolescents from four secondary schools in Enugu, Nigeria; self‑administered questionnaire; bivariate analysis of predictors.","sample_n":325,"sample_text":"Four secondary schools (convenience sample)","population":"Adolescents (senior secondary school students) in Enugu Metropolis, Nigeria","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 325 Nigerian high‑school students found that about 36% reported experiencing child sexual abuse, often involving forced exposure to pornography and perpetrated by neighbours. Risk was higher for students in certain classes and for those with employed fathers.","clinical_takeaway":"High CSA rates among adolescents highlight the need for comprehensive sexual education and protective policies in schools.","confidence":0.85,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Relatively large sample for a school‑based survey","Identifies specific patterns (e.g., forced pornography viewing)","Provides locally relevant prevalence data"],"limitations":["Convenience school selection limits generalisability","CSA measured with a non‑validated questionnaire","No effect sizes or adjustment for multiple testing reported"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":9,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21315/mjms2021.28.4.13"}},{"id":2341,"doi":"10.1007/s11469-021-00631-x","pmid":"34456654","pmcid":"PMC8386342","title":"Internet Use and Adolescents' Physical and Mental Health: the Mediating Role of Self-consciousness and Peer Relationships","authors":"Chao CM, Yu TK.","first_author":"Chao CM","journal":"International journal of mental health and addiction","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Internet Use","Peer Relationships","Self-consciousness","Mediation Effect","Physical And Mental Health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8386342","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"2‑year longitudinal survey of 1838 Taiwanese high‑school students, structural equation modeling of mediation effects","sample_n":1838,"sample_text":"senior high schools, first and second year students","population":"Adolescents (high‑school students) in Taiwan","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A two‑year study of Taiwanese high‑schoolers found that frequent cyber‑pornography use was linked to poorer physical and mental health, partly because it reduced self‑consciousness and strained peer relationships.","clinical_takeaway":"Screen adolescents for problematic pornography use and its impact on self‑awareness and social ties.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large, school‑based sample","Longitudinal design allowing temporal ordering","Use of structural equation modeling to test mediation"],"limitations":["Self‑report measures, unclear validation","No assessment of moral or sexual‑behavior confounds (e.g., masturbation, religiosity)","No pre‑registration or reporting of effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11469-021-00631-x"}},{"id":2342,"doi":"10.1016/j.jsxm.2021.08.008","pmid":"34535369","pmcid":"PMC8417519","title":"The Impact of the COVID-19 Pandemic on Sexual Behaviors: Findings From a National Survey in the United States","authors":"Gleason N, Banik S, Braverman J, Coleman E.","first_author":"Gleason N","journal":"The journal of sexual medicine","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual behavior","Intimate Partner Violence","Sexual Satisfaction","Relationship Satisfaction","Covid-19","Sexual Functioning, Sexual Frequency"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8417519","cited_by_count":54,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 1,051 US adults recruited via convenience sampling in Oct 2020; retrospective self‑report of sexual behavior before and during COVID‑19.","sample_n":1051,"sample_text":"About 1,051 participants across the United States were recruited in October 2020 to complete a cross‑sectional online survey.","population":"US adults (national convenience sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A US‑wide online survey of about 1,000 adults found modest declines in partnered sex during COVID‑19, while men reported small increases in masturbation and porn use. Sexual pleasure and desire also fell slightly. Depression, relationship status, and how important people thought social distancing was predicted these changes.","clinical_takeaway":"Clinicians should note modest pandemic‑related shifts in sexual activity and consider mental‑health and relationship context when discussing patients’ sexual wellbeing.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function","relationships"],"strengths":["Large (N>1000) national sample","Both partnered and solitary sexual behaviors assessed","Includes mental‑health covariate (depression)","Timely data on pandemic‑related changes"],"limitations":["Convenience sampling limits generalisability","Cross‑sectional, retrospective self‑report","No validated measures of pornography use or 'problematic' use","Moral/religious factors not examined"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":57,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.08.008"}},{"id":2343,"doi":"10.1590/1980-220x-reeusp-2020-0488","pmid":"34423805","pmcid":null,"title":"Social representations of adolescents about sexuality on the internet","authors":"Santos GSD, Queiroz ABA, Tura LFR, Penna LHG, Parmejiani EP, Pinto CB.","first_author":"Santos GSD","journal":"Revista da Escola de Enfermagem da U S P","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative study using free‑word association with 124 adolescents from two state schools","sample_n":124,"sample_text":"124 adolescents from two state schools in Brazil","population":"adolescents (students) who use the internet","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study explored how teens think about sexuality online. Using a word‑association task, researchers found that pornography, sexting, and violence were the most central ideas, highlighting worries about safety and negative experiences in the digital space.","clinical_takeaway":"Clinicians should recognise that many adolescents associate internet sexuality with risk and negativity, and address safety and education when discussing online sexual behavior.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large qualitative sample for a social‑representation study","Systematic use of Theory of Social Representations","Clear description of central and peripheral elements of adolescents’ views"],"limitations":["Convenience sample from only two schools limits generalisability","No quantitative measurement of pornography use, masturbation, or mental‑health variables","Interpretation relies on subjective categorisation of words"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":333,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/1980-220x-reeusp-2020-0488"}},{"id":2344,"doi":"10.1080/00224499.2021.1960944","pmid":"34406093","pmcid":null,"title":"Exploring Reflections, Motivations, and Experiential Outcomes of First Same-Sex/Gender Sexual Experiences among Lesbian, Gay, Bisexual, and Other Sexual Minority Individuals","authors":"Gillespie IJ, Armstrong HL, Ingham R.","first_author":"Gillespie IJ","journal":"Journal of sex research","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.tandfonline.com/doi/pdf/10.1080/00224499.2021.1960944?needAccess=true","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"In‑depth semi‑structured interviews (N=17) with LGB+ individuals aged 18‑23; thematic analysis of motivations and experiences of first same‑sex/gender sexual encounters.","sample_n":17,"sample_text":"Seventeen in‑depth semi‑structured interviews with LGB+ individuals, ages 18‑23 years.","population":"young adult sexual minority people (LGB+), recruited for interviews; non‑clinical, convenience sample.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 17 young LGB+ adults reveal that their first same‑sex experiences are shaped by identity affirmation, limited education, and online sources like pornography. Participants felt unprepared and call for more inclusive sex education.","clinical_takeaway":"Clinicians should recognize gaps in LGB+ sex education and discuss pornography and online resources when supporting young clients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rich qualitative insight into first same‑sex experiences","Provides themes directly from participants’ voices","Highlights gaps in sex education for LGB+ youth"],"limitations":["Small, non‑representative convenience sample","No standardized measures; limited generalizability","No assessment of potential confounds (e.g., mental health, religiosity)"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2021.1960944"}},{"id":2346,"doi":"10.3390/ijerph18168590","pmid":"34444338","pmcid":"PMC8394473","title":"Subpopulations of Addictive Behaviors in Different Sample Types and Their Relationships with Gender, Personality, and Well-Being: Latent Profile vs. Latent Class Analysis","authors":"Atroszko PA, Atroszko B, Charzyńska E.","first_author":"Atroszko PA","journal":"International journal of environmental research and public health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Personality","Prevalence","Well-being","Latent Class Analysis","Co-occurrence","Behavioral Addictions","Latent Profile Analysis"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/18/16/8590/pdf?version=1629169974","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of Polish undergraduates (N = 1182, subsample = 327) using latent profile and latent class analyses of six self‑reported behavioral addictions including pornography.","sample_n":1182,"sample_text":"Full sample of 1182 undergraduates; subsample of 327 who screened positive for at least one behavioral addiction.","population":"Polish undergraduate students (convenience sample)","country":"Poland","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined patterns of several behavioral addictions, including pornography, among Polish university students using statistical clustering. Four profiles emerged in a high‑risk subgroup, but simpler classes appeared in the full sample, suggesting continuous‑score methods may capture addiction patterns better than binary cut‑offs.","clinical_takeaway":"Screening tools that dichotomise pornography use may miss nuanced patterns; clinicians should consider continuous behavioural measures and personality factors.","confidence":0.73,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Large undergraduate sample","Comparative use of LPA and LCA methods","Inclusion of multiple behavioral addictions for co‑occurrence analysis"],"limitations":["Convenience student sample limits generalisability","Addiction constructs rely on screening cut‑offs without detailed validation","Key confounds for pornography (moral incongruence, masturbation) not measured"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph18168590"}},{"id":2347,"doi":"10.1089/cyber.2014.0365","pmid":"25415548","pmcid":null,"title":"The associations between adolescents' consumption of pornography and music videos and their sexting behavior","authors":"Van Ouytsel J, Ponnet K, Walrave M.","first_author":"Van Ouytsel J","journal":"Cyberpsychology, behavior and social networking","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["bibliography","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 329 Belgian adolescents (mean age 16.7) assessing self‑reported pornography and music‑video consumption and self‑reported sexting behaviours; linear/regression analyses controlling for age, gender, school track and internet use.","sample_n":329,"sample_text":"329 adolescents, mean age 16.71 years (SD = 0.74)","population":"Adolescents (n=329) recruited from schools in Belgium","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 329 Belgian teens, higher self‑reported porn use was linked to more sexting, even after adjusting for age, gender, school track and internet use. Music‑video viewing was only related to certain sexting actions and mainly among boys.","clinical_takeaway":"Higher porn consumption in adolescents is associated with increased sexting; clinicians should consider media exposure when discussing risky sexual behaviours.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Reasonably large adolescent sample","Controls for basic demographic variables","Examines both pornography and music‑video exposure"],"limitations":["Cross‑sectional design; cannot infer causality","Reliance on ad‑hoc self‑report items, no validated scales","No measurement of key confounds (e.g., moral incongruence, mental health, masturbation)","Predictive language overstated given design"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":44,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2014.0365"}},{"id":2348,"doi":"10.1089/g4h.2014.0054","pmid":"26181804","pmcid":null,"title":"Clarifying the Links Among Online Gaming, Internet Use, Drinking Motives, and Online Pornography Use","authors":"Bőthe B, Tóth-Király I, Orosz G.","first_author":"Bőthe B","journal":"Games for health journal","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of university students","sample_n":512,"sample_text":"University students recruited via campus surveys; convenience sample","population":"university students, mean age 22.1, 64% women","country":"Hungary","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 512 Hungarian university students found that certain gaming‑related factors (immersion and preoccupation) and aspects of problematic internet use predict how much pornography they view, while gender does not. Drinking motives also played a role.","clinical_takeaway":"Higher gaming immersion may be linked to lower pornography use, but overall patterns are correlational; clinicians should consider multiple online behaviours together.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (n>500) for a survey study","Use of validated, language‑adapted questionnaires","Examines multiple behavioral domains (gaming, internet use, drinking motives) together"],"limitations":["Cross‑sectional design cannot infer causality","Convenience student sample limits generalisability","Key confounds (moral incongruence, masturbation, mental‑health symptoms, trauma) not measured"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/g4h.2014.0054"}},{"id":2349,"doi":"10.1371/journal.pone.0113599","pmid":"25423311","pmcid":"PMC4244083","title":"Exposure to pornographic videos and its effect on HIV-related sexual risk behaviours among male migrant workers in southern India","authors":"Mahapatra B, Saggurti N.","first_author":"Mahapatra B","journal":"PloS one","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4244083","cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 11,219 male migrant workers in India (2007‑08).","sample_n":11219,"sample_text":"Large community sample drawn from 21 districts; convenience/cluster sampling of migrants.","population":"Male migrant workers, age ≥ 18, in four Indian states.","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control"],"stance":"supports","citation_value":"useful","plain_summary":"In a survey of over 11,000 Indian male migrant workers, those who watched porn videos in the past month were four times more likely to have paid or unpaid sex and less likely to use condoms consistently.","clinical_takeaway":"Viewing pornographic videos was associated with higher sexual risk; clinicians should consider broader behavioural contexts rather than attributing risk solely to porn use.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Very large sample size for a hard‑to‑reach population.","Clear definition of outcome behaviours and presentation of adjusted odds ratios with confidence intervals."],"limitations":["Pornography exposure measured by a single self‑report item; no validated scale.","Cross‑sectional design; cannot infer causality.","Key confounds (moral incongruence, masturbation, mental‑health, partner context, trauma) not assessed."],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":8,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":6,"contrasting":0,"mentioning":12,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0113599"}},{"id":2350,"doi":"10.1080/00224499.2014.976781","pmid":"25420868","pmcid":null,"title":"Gender (In)equality in Internet Pornography: A Content Analysis of Popular Pornographic Internet Videos","authors":"Klaassen MJ, Peter J.","first_author":"Klaassen MJ","journal":"Journal of sex research","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":94,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"content analysis of 400 videos from popular porn sites","sample_n":400,"sample_text":"400 popular pornographic Internet videos","population":"Internet porn videos (amateur and professional)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors analysed 400 popular porn videos and found women are more often objectified as objects, men more often dehumanized, and men dominate sexual scenes while women are submissive. Amateur videos showed more gender inequality than professional ones.","clinical_takeaway":"None – study describes media content, not health effects.","confidence":0.7,"topic_tags":["gender","pornography","sexual_function"],"strengths":["Large sample of videos (n=400)","Systematic coding of three gender‑equality dimensions","Comparison of amateur vs professional content"],"limitations":["Coding scheme likely ad‑hoc and not validated","Sampling limited to most‑visited sites; may not represent all porn","No statistical power justification"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":5,"mentioning":200,"citing_publications":280,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2014.976781"}},{"id":2351,"doi":"10.1097/olq.0000000000001444","pmid":"33872224","pmcid":"PMC8596751","title":"Changes in Sexual Behavior Related to the COVID-19 Stay-at-Home Orders Among Young Black Men Who Have Sex With Women in New Orleans, LA","authors":"Craig-Kuhn MC, Schmidt N, Scott G, Gomes G, TatahMentan M, Enaholo O, Guzman S, Tannis A, Hall J, Triggs DR, Kissinger PJ.","first_author":"Craig-Kuhn MC","journal":"Sexually transmitted diseases","year":2021,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"online sub‑study of men previously enrolled in a cohort; pre‑COVID baseline compared with during‑stay‑at‑home responses (within‑subject).","sample_n":111,"sample_text":"111 participants","population":"Black men who have sex with women, ≥18 y, New Orleans (N = 111)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"During New Orleans’ COVID‑19 stay‑at‑home orders, half of the young Black men surveyed still had vaginal sex, many met partners outside the home, and most watched pornography. Overall physical sex and number of partners dropped, while abstinence and virtual sex rose.","clinical_takeaway":"COVID‑19 restrictions altered sexual practices but did not stop risky sex; clinicians should continue offering safe‑sex counseling during crises.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Within‑subject pre/post comparison","Timely data on COVID‑related sexual behavior","Large proportion of target population (Black MSMW) captured"],"limitations":["Self‑report, no validated sexual‑behavior scales","Convenience sample from prior study, limits generalisability","No adjustment for mental‑health or moral‑incongruence confounders"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":18,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/olq.0000000000001444"}},{"id":2352,"doi":"10.1007/s13178-021-00621-7","pmid":"34335991","pmcid":"PMC8308064","title":"Sexual Health in Spanish People with Intellectual Disability: the Impact of the Lockdown due to COVID-19","authors":"Gil-Llario MD, Díaz-Rodríguez I, Morell-Mengual V, Gil-Juliá B, Ballester-Arnal R.","first_author":"Gil-Llario MD","journal":"Sexuality research & social policy : journal of NSRC : SR & SP","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Impact","Spain","Intellectual Disability","Lockdown","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8308064","cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 73 adults with intellectual disability conducted May‑June 2020; examined sexual appetite, autoerotic and online behaviours during COVID‑19 lockdown.","sample_n":73,"sample_text":"Convenience sample of people with intellectual disability recruited for a lockdown‑impact study","population":"Adults with intellectual disability (N=73, age 21‑63, Spain)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"During Spain's COVID‑19 lockdown, adults with intellectual disability reported higher sexual desire, mainly expressed through autoerotic activities and online behaviours like sending nudes and watching pornography. About 7% experienced sexual abuse. Partner status influenced how they adapted their sexual lives.","clinical_takeaway":"Clinicians should consider heightened online sexual activity and abuse risk for people with ID during lockdowns and incorporate digital‑safety education into sexual‑health support.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Focus on an underserved population (people with intellectual disability)","Timely data collection during COVID‑19 lockdown","Includes both partner and non‑partner contexts"],"limitations":["Small, non‑representative convenience sample","Reliance on ad‑hoc self‑report measures without validation","Descriptive analysis only; no inferential statistics reported"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13178-021-00621-7"}},{"id":2353,"doi":"10.1016/j.jsxm.2021.06.009","pmid":"34301506","pmcid":null,"title":"Pornography and Relationship Quality: Incorporating Relationship Lens in Science and Practice","authors":"Carvalho J.","first_author":"Carvalho J.","journal":"The journal of sexual medicine","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.06.009"}},{"id":2354,"doi":"10.1080/00224499.2014.960908","pmid":"25350847","pmcid":"PMC4412747","title":"\"Without Porn … I Wouldn't Know Half the Things I Know Now\": A Qualitative Study of Pornography Use Among a Sample of Urban, Low-Income, Black and Hispanic Youth","authors":"Rothman EF, Kaczmarsky C, Burke N, Jansen E, Baughman A.","first_author":"Rothman EF","journal":"Journal of sex research","year":2015,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":76,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 23 urban low‑income Black/Hispanic youth (ages 16‑18)","sample_n":23,"sample_text":"23 youth aged 16‑18 recruited from urban low‑income settings (details not provided in abstract)","population":"urban low‑income Black and Hispanic adolescents, United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 23 low‑income Black and Hispanic teens showed they watch porn for entertainment, sexual arousal, learning, and boredom, often on phones at school. Many said they copied what they saw, and some felt pressure to act like porn in dating. Parents were usually unsupportive and unprepared to discuss it.","clinical_takeaway":"Clinicians should recognize that urban low‑income teens may imitate porn content and feel parental support is lacking; open, non‑judgmental discussions about porn use are advisable.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Provides rare qualitative insight into pornography use among low‑income youth of colour","Includes context of viewing settings and perceived behavioral influence","Highlights parental reactions and relational dynamics"],"limitations":["Very small, non‑representative convenience sample (N=23)","No validated measurement instruments; concepts not operationalised quantitatively","Potential social‑desirability and recall bias in self‑reports"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":93,"citing_publications":212,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2014.960908"}},{"id":2355,"doi":"10.1007/s12119-021-09897-8","pmid":"34305388","pmcid":"PMC8286046","title":"Going Bareback: Time and Aging in a Gay-for-Pay Porn Career","authors":"Brennan J.","first_author":"Brennan J.","journal":"Sexuality & culture","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Aging","Cultural Studies","Gay Pornography","Gay-For-Pay","Johnny Rapid","Bareback"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8286046","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"case study / cultural analysis of a single gay porn performer’s transition to bareback scenes; no empirical data collection","sample_n":null,"sample_text":"N/A – analysis of publicly available media and discourse about one performer","population":"not applicable (no human participants recruited)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article examines how a popular gay porn star’s switch to unprotected (bareback) scenes was received and reflects on how changing HIV‑prevention technology has shaped similar shifts in gay porn over time.","clinical_takeaway":"None – the study offers cultural insight but no clinical evidence about porn use or sexual health.","confidence":0.6,"topic_tags":["pornography","csbd","sexual_function"],"strengths":["Provides a detailed cultural narrative of a specific industry moment","Links changes in porn content to broader technological (HIV prevention) shifts"],"limitations":["No empirical data, measurement, or systematic sampling","Findings are based on a single case and cannot be generalized","No assessment of viewer health outcomes or behavioural impacts"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12119-021-09897-8"}},{"id":2356,"doi":"10.1016/j.jsxm.2021.06.006","pmid":"34281796","pmcid":null,"title":"Aggression-Related Sexual Fantasies: Prevalence Rates, Sex Differences, and Links With Personality, Attitudes, and Behavior","authors":"Bondü R, Birke JB.","first_author":"Bondü R","journal":"The journal of sexual medicine","year":2021,"pub_types":["Journal Article"],"keywords":["Sexual Aggression","Psychopathic Traits","Big Five","Rape Myths Acceptance","Aggressive Sexual Fantasies"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Convenience online sample of 664 German adults (mostly students), cross‑sectional questionnaire with multiple regression analyses.","sample_n":664,"sample_text":"Convenience sample of German adults, primarily students, recruited online.","population":"Adults (median age 25), 77% women, recruited via social networks; not a probability or clinical sample.","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a German online survey of 664 adults, 77 % reported at least one aggression‑related sexual fantasy. Such fantasies were more common among men, those with many sexual fantasies, psychopathic traits, and negative attitudes toward fantasies, and they strongly predicted self‑reported sexual aggression beyond other risk factors.","clinical_takeaway":"Aggression‑related fantasies are linked to sexual aggression, but cross‑sectional data cannot prove causality; clinicians should assess them alongside broader risk factors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large item pool covering many fantasy types","Inclusion of a substantial proportion of women","Controls for several known risk factors in regression models"],"limitations":["Cross‑sectional design limits causal inference","Convenience student sample limits generalisability","Aggression‑related fantasies measured with ad‑hoc items, not validated scale"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":9,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.06.006"}},{"id":2357,"doi":"10.1080/00224499.2021.1952156","pmid":"34269631","pmcid":null,"title":"Sexual Variety in Norwegian Men and Women of Different Sexual Orientations and Ages","authors":"Træen B, Fischer N, Kvalem IL.","first_author":"Træen B","journal":"Journal of sex research","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.tandfonline.com/doi/pdf/10.1080/00224499.2021.1952156?needAccess=true","cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"probability‑based web survey of 4,148 Norwegian adults (2,181 men, 1,967 women) ages 18‑89; descriptive and regression analyses of self‑reported sexual acts.","sample_n":4188,"sample_text":"Probability‑based web panel, nationally representative quotas","population":"Norwegian general adult population (probability‑based web sample)","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationally representative Norwegian survey of over 4,000 adults found that sexual variety – like watching pornography with a partner, using sex toys, and having sex in unusual places – is common, declines with age, and is more prevalent among LGBTQ+ people, especially for group sex and BDSM.","clinical_takeaway":"Sexual variety is a normal aspect of adult sexuality that varies by age and orientation; clinicians should view diverse consensual practices as non‑pathological.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large, probability‑based national sample","Inclusion of a wide age range and multiple sexual orientations","Clear descriptive statistics on sexual variety"],"limitations":["Reliance on self‑report items not validated","No measurement of potential confounds such as moral attitudes or mental health","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2021.1952156"}},{"id":2358,"doi":"10.1080/0092623x.2014.958790","pmid":"25189834","pmcid":null,"title":"Masturbation and Pornography Use Among Coupled Heterosexual Men With Decreased Sexual Desire: How Many Roles of Masturbation?","authors":"Carvalheira A, Træen B, Stulhofer A.","first_author":"Carvalheira A","journal":"Journal of sex & marital therapy","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":48,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 596 coupled heterosexual men with decreased sexual desire, recruited from a larger European online study","sample_n":596,"sample_text":"subset of 596 men with decreased sexual desire recruited as part of a large online study on male sexual health in 3 European countries","population":"coupled heterosexual men (mean age 40.2) reporting decreased sexual desire, N=596","country":"Europe (3 countries, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 596 heterosexual men in relationships who said they had low sexual desire, about two‑thirds masturbated weekly and most frequent masturbators also used porn. Sexual boredom, frequent porn use, and low intimacy with their partner were linked to more frequent masturbation.","clinical_takeaway":"When evaluating men with low desire, clinicians should ask about both pornography use and masturbation patterns, as they may reflect different relational and motivational factors.","confidence":0.7,"topic_tags":["masturbation","pornography","sexual_function","relationships"],"strengths":["Large sample (N≈600) for a survey study","Specific focus on coupled men with decreased desire","Separate assessment of masturbation and pornography use"],"limitations":["Cross‑sectional design; cannot infer causality","Reliance on self‑report, likely with non‑validated scales","No measurement of moral or religious attitudes that could confound distress"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":52,"citing_publications":120,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2014.958790"}},{"id":2359,"doi":"10.1177/14732254211030570","pmid":"36467618","pmcid":"PMC9707732","title":"'Young People Just Resolve It in Their Own Group': Young People's Perspectives on Responses to Non-Consensual Intimate Image Distribution","authors":"Dodge A, Lockhart E.","first_author":"Dodge A","journal":"Youth justice : the journal of the National Association for Youth Justice","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Education","Restorative Justice","Criminal Law","Youth Justice","Revenge Porn","Non-consensual Pornography","Non-Consensual Intimate Image Distribution"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9707732","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Interviews with 10 teenagers; survey of 81 adult supporters; cross‑sectional, convenience sampling","sample_n":91,"sample_text":"10 teenage interviewees; 81 adult survey respondents","population":"Teenagers (N=10) and adult supporters (N=81) in the UK (presumed)","country":"Not specified (likely UK)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with ten teenagers and a survey of 81 adults show that young people often avoid legal or adult help after having intimate images shared without consent, fearing blame, shame, or harsh reactions.","clinical_takeaway":"Clinicians should recognise youths' reluctance to involve authorities and offer supportive, non‑judgmental options.","confidence":0.8,"topic_tags":["religiosity","moral_incongruence","pornography","sexual_function"],"strengths":["Provides direct youth perspectives","Combines interview depth with broader adult survey","Highlights gaps in formal support systems"],"limitations":["Very small teen interview sample","Convenience sampling limits generalisability","No validated measurement tools"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":0,"mentioning":55,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/14732254211030570"}},{"id":2360,"doi":"10.1080/0092623x.2014.958793","pmid":"25189705","pmcid":null,"title":"Validation of the Pornography Consumption Inventory in a Sample of Male Brazilian University Students","authors":"Baltieri DA, Aguiar AS, de Oliveira VH, de Souza Gatti AL, de Souza Aranha E Silva RA.","first_author":"Baltieri DA","journal":"Journal of sex & marital therapy","year":2015,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Validation study of a 15‑item Pornography Consumption Inventory administered to 100 male Brazilian university students; factor analysis and internal consistency assessed.","sample_n":100,"sample_text":"100 male medical students","population":"Male Brazilian university (medical) students, N=100","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers translated and tested a 15‑item questionnaire on pornography use with 100 male Brazilian university students. Factor analysis showed the scale has a reliable four‑factor structure, supporting its use in Portuguese‑speaking populations, though further testing in other groups is needed.","clinical_takeaway":"The validated inventory can be used to assess pornography consumption in research or clinical screening, but clinicians should consider broader psychosocial factors not covered by the scale.","confidence":0.7,"topic_tags":["pornography","measurement","sexual_function"],"strengths":["Standard translation/back‑translation process","Factor analytic verification of structure","Good internal consistency reported","Clear recommendation for further replication"],"limitations":["Convenience sample of male medical students only","No assessment of related variables (e.g., distress, moral factors)","No external validation in clinical or diverse populations","No pre‑registration of validation protocol"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":0,"mentioning":8,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2014.958793"}},{"id":2361,"doi":"10.3390/ijerph18147247","pmid":"34299696","pmcid":"PMC8306552","title":"Can Watching Online Videos Be Addictive? A Qualitative Exploration of Online Video Watching among Chinese Young Adults","authors":"Yang Z, Griffiths MD, Yan Z, Xu W.","first_author":"Yang Z","journal":"International journal of environmental research and public health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Qualitative Study","Mukbang","Online Video Watching Addiction","Online Video Watching Behaviors","Short-form Videos"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8306552","cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"semi‑structured interviews with 20 Chinese young adults; thematic analysis","sample_n":20,"sample_text":"Twenty participants were recruited for semi‑structured interviews.","population":"young Chinese adults (convenience sample, n=20)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 20 young Chinese adults explored why they watch videos online and whether some find it addictive. Participants mentioned content, platform tricks, habit, and social needs, and a few described addiction‑like feelings, especially for certain video types like porn. The study suggests more research on these behaviours.","clinical_takeaway":"None – the qualitative findings are exploratory and not sufficient to guide clinical practice.","confidence":0.8,"topic_tags":["pornography","masturbation","adolescents","sexual_function","csbd","religiosity"],"strengths":["In‑depth qualitative insights","Identifies specific platform features linked to habitual use","Uses systematic thematic analysis"],"limitations":["Very small, non‑representative sample","No validated measures of addiction or distress","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":17,"max_possible":60,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":49,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph18147247"}},{"id":2362,"doi":"10.1556/2006.2021.00032","pmid":"34232905","pmcid":"PMC8996794","title":"The role of repetitive transcranial magnetic stimulation (rTMS) in the treatment of behavioral addictions: Two case reports and review of the literature","authors":"Cuppone D, Gómez Pérez LJ, Cardullo S, Cellini N, Sarlo M, Soldatesca S, Chindamo S, Madeo G, Gallimberti L.","first_author":"Cuppone D","journal":"Journal of behavioral addictions","year":2021,"pub_types":["Review","Journal Article","Case Reports","case-report"],"keywords":["Dorsolateral Prefrontal Cortex (Dlpfc)","Repetitive Transcranial Magnetic Stimulation (Rtms)","Internet Gaming Disorder (Igd)","Compulsive Sexual Behavior Disorder (Csbd)","Behavioral Addiction (Ba)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8996794","cited_by_count":19,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Two single‑case clinical observations of rTMS treatment for compulsive sexual behavior (online porn) and internet gaming disorder, plus a narrative review of related literature.","sample_n":2,"sample_text":"Two individual patients; no larger sample.","population":"Male adults (57 y, 21 y) with self‑reported loss of control over online pornography or gaming.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe two men whose compulsive porn or gaming habits improved after a series of brain‑stimulation sessions (rTMS) targeting the left prefrontal cortex, and they review similar studies. The evidence is limited to these two cases and a narrative overview.","clinical_takeaway":"No firm clinical recommendation can be made; rTMS shows anecdotal promise but lacks robust evidence for treating compulsive sexual behavior.","confidence":0.4,"topic_tags":["relationships","treatment","sexual_function","pornography","csbd"],"strengths":["Novel application of rTMS to CSBD case","Combines clinical observation with literature synthesis"],"limitations":["Only two cases, no control condition","No validated outcome measures reported","Potentially circular definition of ‘addiction’"],"rubric_version":"2.0","raw_total":18,"max_possible":60,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":31,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2021.00032"}},{"id":2363,"doi":"10.1007/s10508-014-0353-8","pmid":"25273378","pmcid":null,"title":"Americans' attitudes toward premarital sex and pornography consumption: a national panel analysis","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Archives of sexual behavior","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"panel study with two waves (2008, 2010) of 420 US adults (Black and White) aged 18‑89, assessing pornography use at T1 and premarital sex attitudes at T2.","sample_n":420,"sample_text":"420 Black and White US adults aged 18‑89","population":"Adults (18‑89) United States, Black and White","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A U.S. panel study found that people who watched more pornography in 2008 tended to hold more positive views about premarital sex two years later, especially younger adults. Attitudes did not predict later pornography use.","clinical_takeaway":"None – findings relate to attitudes, not clinical sexual health or treatment.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Longitudinal design allows temporal precedence","Large age range improves generalisability","Uses established theoretical framework (3AM)"],"limitations":["Measures of pornography use and attitudes not described as validated","Potential omitted confounders (e.g., religiosity, mental health) not controlled","Sample limited to Black and White participants"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":1,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":15,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0353-8"}},{"id":2364,"doi":"10.1097/gco.0000000000000106","pmid":"25136759","pmcid":null,"title":"Cyber safety for adolescent girls: bullying, harassment, sexting, pornography, and solicitation","authors":"Smith PK, Thompson F, Davidson J.","first_author":"Smith PK","journal":"Current opinion in obstetrics & gynecology","year":2014,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review (narrative, no systematic methods reported)","sample_n":null,"sample_text":"not applicable – review of existing literature","population":"adolescent girls (general, unspecified sample)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how adolescent girls experience online risks like bullying, harassment, sexting, pornography and solicitation, noting that many are harmed and that more research, especially longitudinal studies, is needed.","clinical_takeaway":"Clinicians should be aware that online pornography exposure can be harmful for adolescent girls and consider safeguarding and education strategies.","confidence":0.8,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Broad overview of multiple cyber safety issues","Highlights gaps such as need for longitudinal research"],"limitations":["Narrative review without systematic methodology","No empirical data or meta‑analytic synthesis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/gco.0000000000000106"}},{"id":2365,"doi":"10.1177/00332941211028999","pmid":"34218738","pmcid":null,"title":"Effect of the Lockdown Due to COVID-19 on Sexuality: The Mediating Role of Sexual Practices and Arousal in the Relationship Between Gender and Sexual Self-Esteem","authors":"Rodríguez-Domínguez C, Lafuente-Bacedoni C, Durán M.","first_author":"Rodríguez-Domínguez C","journal":"Psychological reports","year":2022,"pub_types":["Journal Article"],"keywords":["Gender","Arousal","Masturbation","Sexual Self-esteem","Covid-19"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 201 Spanish adults collected in April 2020; cross‑sectional regression analysis of gender, masturbation, arousal and sexual self‑esteem.","sample_n":201,"sample_text":"N=201 adults, convenience online sample","population":"Adults (N=201) living in Spain; recruited via online convenience sampling during COVID‑19 lockdown.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"During the COVID‑19 lockdown in Spain, adults reported lower sexual self‑esteem and fewer partnered sexual activities, while rates of masturbation and porn use stayed the same. Masturbation, ability to stay aroused, and partnered sex helped explain why men reported higher sexual self‑esteem than women.","clinical_takeaway":"Lockdowns may reduce sexual self‑esteem; clinicians should consider supporting arousal maintenance and partnered intimacy while recognizing masturbation levels may remain stable.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Relatively large sample for a rapid‑response study","Inclusion of both partnered and solitary sexual behaviors","Use of mediation analysis to test theoretical pathways"],"limitations":["Cross‑sectional design limits causal inference","Reliance on single‑item self‑report measures","No assessment of moral, mental‑health or relationship covariates"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00332941211028999"}},{"id":2366,"doi":"10.1590/1806-9282.20210168","pmid":"34817497","pmcid":null,"title":"Is pornography associated with sexual dysfunction?","authors":"Perissini ALM, Spessoto LCF, Facio Júnior FN.","first_author":"Perissini ALM","journal":"Revista da Associacao Medica Brasileira (1992)","year":2021,"pub_types":["Editorial"],"keywords":[],"is_oa":false,"oa_url":"https://www.scielo.br/j/ramb/a/VT4Smmg9Pyr7b53yZXqKJNt/?lang=en&format=pdf","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/1806-9282.20210168"}},{"id":2367,"doi":"10.1007/s10508-014-0351-x","pmid":"25239659","pmcid":null,"title":"The influence of pornography on sexual scripts and hooking up among emerging adults in college","authors":"Braithwaite SR, Coulson G, Keddington K, Fincham FD.","first_author":"Braithwaite SR","journal":"Archives of sexual behavior","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":60,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"cross-sectional survey with a follow‑up semester measurement; large convenience sample of college students (N≈1000 per study)","sample_n":1961,"sample_text":"Study 1 N = 969; Study 2 N = 992; combined N ≈ 1961 college students","population":"emerging adult college students (young adults, both sexes)","country":"United States (presumed by journal and author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among nearly 2,000 college students, more frequent pornography use was linked to a higher likelihood of casual \"hook‑up\" sex and a greater number of partners. The authors suggest that permissive sexual scripts—beliefs about how sex should happen—help explain this link.","clinical_takeaway":"Higher porn use may be associated with more casual sexual encounters; clinicians should consider sexual script influences when discussing sexual health with young adults.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Very large sample size for both studies","Both cross‑sectional and semester‑long longitudinal data","Mediation analysis links sexual scripts to behaviour"],"limitations":["Convenience college sample limits generalisability","No measurement of key confounds (moral incongruence, mental health, masturbation)","Reliance on self‑report questionnaires, unclear validation"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":9,"contrasting":2,"mentioning":73,"citing_publications":156,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0351-x"}},{"id":2368,"doi":"10.3390/ijerph18136931","pmid":"34203483","pmcid":"PMC8297106","title":"Child Sexual Abuse in Mexican Women: Type of Experience, Age, Perpetrator, and Disclosure","authors":"Rueda P, Ferragut M, Cerezo MV, Ortiz-Tallo M.","first_author":"Rueda P","journal":"International journal of environmental research and public health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Childhood","Child Sexual Abuse","Maltreatment"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/18/13/6931/pdf?version=1624956554","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Anonymous online survey of 1058 Mexican women (age 18‑73) assessing self‑reported childhood sexual abuse types, perpetrator, age of onset and disclosure.","sample_n":1058,"sample_text":"1058 women, mean age 40.2 (SD 10.2)","population":"Mexican women, community sample, self‑selected online respondents","country":"Mexico","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of over 1,000 Mexican women, 14%‑66% reported experiencing some form of child sexual abuse. Abuse most often began between ages 6‑12, was usually perpetrated by a male, and was disclosed by only about one‑third of victims, mainly to mothers or peers.","clinical_takeaway":"CSA is common and often undisclosed; clinicians should create safe spaces for women to discuss possible histories of abuse.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for a CSA prevalence study","Comprehensive coverage of abuse types, perpetrator relationship, age of onset, and disclosure","Anonymous online format may reduce social desirability bias"],"limitations":["Self‑selected online sample limits generalisability","Likely use of ad‑hoc, non‑validated questionnaire items","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph18136931"}},{"id":2369,"doi":"10.1016/j.esxm.2021.100408","pmid":"34333225","pmcid":"PMC8432981","title":"Impact of COVID-19 Pandemic on the Sexual Function of Health Professionals From an Epicenter in Brazil","authors":"Neto RP, Nascimento BCG, Nascimento BCG, Carvalho Dos Anjos Silva G, Barbosa JABA, Júnior JB, Teixeira TA, Srougi M, Nahas WC, Hallak J, Cury J.","first_author":"Neto RP","journal":"Sexual medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexual activity","erectile function","Social Isolation","Covid-19","Sars-cov-2"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8432981","cited_by_count":12,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire sent to health professionals and medical students; cross‑sectional convenience sample (N=1,314)","sample_n":1314,"sample_text":"mean age 37 years; mixed gender; recruited via institutional email list","population":"healthcare professionals and medical students at a Brazilian COVID‑19 treatment centre","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,300 Brazilian health workers found that during COVID‑19 their sexual desire and overall satisfaction dropped, while masturbation and pornography use rose, but the latter were not linked to lower satisfaction.","clinical_takeaway":"Pandemic‑related stress may reduce libido and satisfaction; increased porn use does not necessarily worsen sexual wellbeing.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large sample for a single‑site survey","Use of validated sexual function questionnaire","Separate assessment of masturbation vs. partnered activity"],"limitations":["Cross‑sectional design; no causal inference","Convenience sample; limited generalisability","No measurement of mental‑health or moral‑incongruence confounds"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":20,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2021.100408"}},{"id":2370,"doi":"10.3389/fpsyg.2021.671986","pmid":"34248768","pmcid":"PMC8267471","title":"Just Checking It Out? Motivations for and Behavioral Associations With Visiting \"Slutpages\" in the United States and Australia","authors":"Clancy EM, Maas MK, March E, Howard D, Klettke B.","first_author":"Clancy EM","journal":"Frontiers in psychology","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Gender","Sexual Harassment","Pornography","Sexting","Image-based Sexual Abuse","Slutpages"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8267471","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience online survey of 1,148 U.S. and Australian young adults (18‑29). Logistic regression examined predictors of visiting online image‑based evaluative voyeurism (OIBEV) sites.","sample_n":1148,"sample_text":"Convenience sample of 1,148 young adults recruited via online questionnaire.","population":"young adults (18‑29), 53% women, 47% men, 54% US, 46% AU; convenience sample","country":"United States; Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,148 young adults in the US and Australia examined why people visit \"slutpages\"—websites where sexualised images of women are posted for rating. Men mainly visited to \"check them out,\" while women also wanted to see if they were depicted. Visiting these sites was linked to sexting behaviors, anxiety, and, for men, lower cyber‑bullying. The authors suggest education to curb non‑consensual image sharing.","clinical_takeaway":"Visiting non‑consensual image sites is associated with higher anxiety; clinicians should assess exposure when addressing young adults' mental health.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a niche topic","First empirical data on motivations for OIBEV site visitation","Includes both US and Australian participants"],"limitations":["Convenience, non‑representative sample","Reliance on self‑report, unclear validation of scales","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2021.671986"}},{"id":2371,"doi":"10.1080/0092623x.2014.931313","pmid":"24918657","pmcid":null,"title":"Narcissism and Internet pornography use","authors":"Kasper TE, Short MB, Milam AC.","first_author":"Kasper TE","journal":"Journal of sex & marital therapy","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online convenience survey (N=257) assessing hours of pornography viewing and three validated narcissism scales.","sample_n":257,"sample_text":"257 participants completed an online questionnaire.","population":"Adults (unspecified age range), recruited via internet survey.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 257 adults, people who spent more time watching online pornography also scored higher on three standard measures of narcissism. Those who had ever viewed pornography scored higher than those who never had.","clinical_takeaway":"None – the study does not provide evidence for clinical assessment or treatment.","confidence":0.78,"topic_tags":["pornography","neuroscience"],"strengths":["Use of three validated narcissism instruments","Reasonable sample size for a survey","Clear quantitative relationship reported"],"limitations":["Cross‑sectional design prevents causal inference","No control for key confounds (e.g., moral attitudes, mental health)","Self‑report of pornography use may be biased"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":6,"contrasting":0,"mentioning":32,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2014.931313"}},{"id":2372,"doi":"10.1016/j.chiabu.2021.105166","pmid":"34153578","pmcid":null,"title":"The challenges of identifying and classifying child sexual exploitation material: Moving towards a more ecologically valid pilot study with digital forensics analysts","authors":"Kloess JA, Woodhams J, Hamilton-Giachritsis CE.","first_author":"Kloess JA","journal":"Child abuse & neglect","year":2021,"pub_types":["Journal Article"],"keywords":["Child Pornography","Sexual Offenses","Child Sexual Exploitation Material","Online Child Sexual Exploitation And Abuse","Internet Sexual Offending"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Pilot reliability study with 5 digital‑forensics analysts coding 100 images; qualitative interviews; no control group; small convenience sample.","sample_n":5,"sample_text":"Five analysts","population":"Five analysts from a specialist UK police unit","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study tested how consistently five police‑forensic analysts could identify child sexual exploitation images and estimate the child's age. Agreement was moderate‑good for age and very good for classification, and interviews revealed key decision‑making factors.","clinical_takeaway":"None – the study concerns forensic classification, not personal sexual health or behavior.","confidence":0.8,"topic_tags":["csbd"],"strengths":["Clear operational definition of classification task (legal criteria)","Mixed-methods: quantitative reliability + qualitative insights"],"limitations":["Very small analyst sample limits generalisability","No pre‑registration or power analysis","Findings confined to one police unit"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":0,"mentioning":11,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2021.105166"}},{"id":2373,"doi":"10.1371/journal.pone.0252940","pmid":"34111205","pmcid":"PMC8192016","title":"What predicts the early sexual debut among unmarried adolescents (10-19 years)? Evidence from UDAYA survey, 2015-16","authors":"Muhammad T, Srivastava S, Kumar P, Patel SK.","first_author":"Muhammad T","journal":"PloS one","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8192016","cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large (N=15,388) cross‑sectional analysis of a state‑level survey; logistic regression used to identify predictors of early sexual debut.","sample_n":15388,"sample_text":"15,388 adolescents aged 10‑19 years from the UDAYA survey (2016).","population":"Unmarried adolescents aged 10‑19 years in two Indian states (both sexes).","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 15,000 Indian teenagers found that boys and girls who watched pornography or had depressive symptoms were more likely to have sex before marriage. School drop‑outs and high media use also raised the odds.","clinical_takeaway":"When counseling adolescents, ask about pornography exposure and mood symptoms, as they are linked to earlier sexual activity.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Very large, population‑based sample","Use of multivariable logistic regression with confidence intervals","Relevant public‑health focus on early sexual debut"],"limitations":["Cross‑sectional design cannot infer causality","Constructs (e.g., pornography exposure, depressive symptoms) not described as validated scales","No measurement of moral incongruence, masturbation, partner context, or trauma"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":1,"mentioning":23,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0252940"}},{"id":2375,"doi":"10.1016/j.sxmr.2021.01.001","pmid":"34099432","pmcid":null,"title":"Predictors of Sexual Satisfaction in Women: A Systematic Review","authors":"Rausch D, Rettenberger M.","first_author":"Rausch D","journal":"Sexual medicine reviews","year":2021,"pub_types":["Systematic Review","Journal Article"],"keywords":["Sexuality","Sexual behavior","Sexual activity","Sexual Satisfaction","Marital Relationship","Sexual Dysfunctions"],"is_oa":false,"oa_url":null,"cited_by_count":41,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review of 204 studies without clear risk‑of‑bias assessment or meta‑analysis","sample_n":204,"sample_text":"204 eligible studies (aggregate data not reported)","population":"heterosexual women in long‑term relationships","country":"primarily North America (others Europe, Asia)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 204 studies found that, for women in long‑term relationships, relationship satisfaction and how often partners have sex are the most consistent predictors of sexual satisfaction, while effects of pornography, religion, and relationship length are inconsistent.","clinical_takeaway":"Focus on relationship quality and sexual frequency to improve women’s sexual satisfaction; pornography’s impact remains unclear.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Comprehensive systematic search across three databases","Large number of primary studies identified (204)","Clear description of most frequently studied predictors"],"limitations":["No formal risk‑of‑bias assessment of included studies","Control variables rarely reported in primary studies, limiting causal inference","Heterogeneity of measurement tools for sexual satisfaction"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":1,"mentioning":61,"citing_publications":90,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sxmr.2021.01.001"}},{"id":2376,"doi":"10.1089/cyber.2013.0396","pmid":"25080011","pmcid":null,"title":"Cybersex addiction in heterosexual female users of internet pornography can be explained by gratification hypothesis","authors":"Laier C, Pekal J, Brand M.","first_author":"Laier C","journal":"Cyberpsychology, behavior and social networking","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control survey of 51 heterosexual female pornography users and 51 non‑users, with questionnaire and picture‑rating experiment","sample_n":102,"sample_text":"51 female IPU and 51 female NIPU","population":"adult heterosexual women, likely convenience sample","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 51 women who view internet porn and 51 who do not, users reported higher sexual arousal, craving, and more problematic sexual behavior, which were linked to higher scores on a cybersex‑addiction questionnaire.","clinical_takeaway":"Higher arousal and craving to porn images are associated with self‑rated cybersex‑addiction symptoms in women, but causality is unclear.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd","gender"],"strengths":["matched group sizes (N=51 each)","includes both questionnaire and experimental picture‑rating task","first study to examine female users"],"limitations":["no measurement of moral incongruence or masturbation","cross‑sectional design limits causal inference","unclear if addiction scale is validated for females"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":5,"contrasting":3,"mentioning":45,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2013.0396"}},{"id":2377,"doi":"10.1177/08862605211021978","pmid":"34078158","pmcid":null,"title":"Factors Associated with Gender-Based Violence Perpetration by Male High School Students in Eastern Ethiopia","authors":"Beyene AS, Chojenta C, Loxton D.","first_author":"Beyene AS","journal":"Journal of interpersonal violence","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Male","Ethiopia","Gender-based Violence","High School Students","Perpetration","Factors Associated"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"institutional based survey of 1,109 male high‑school students in Ethiopia; self‑administered questionnaire; Poisson regression for prevalence ratios","sample_n":1109,"sample_text":"institutional based convenience sample of male high‑school students in eastern Ethiopia","population":"male students aged 15‑24 years, Ethiopian high schools","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 1,100 Ethiopian male high‑school students found that those who watched pornography, used substances, or had romantic relationships were more likely to report perpetrating emotional, physical or sexual violence in the past year.","clinical_takeaway":"Screening for pornography use and substance habits may help identify youths at higher risk for GBV, but causality is not established.","confidence":0.7,"topic_tags":["gender","adolescents"],"strengths":["Large sample for the context","Validated GBV questionnaire","Multiple individual‑ and relationship‑level covariates"],"limitations":["Cross‑sectional, cannot infer causality","Pornography exposure measured crudely","Key confounds (moral incongruence, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":1,"mentioning":8,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605211021978"}},{"id":2378,"doi":"10.4314/ahs.v21i2.9","pmid":"34795707","pmcid":"PMC8568232","title":"Exploring unsafe sexual practices among truck drivers at Meerut District, India: a cross-sectional study","authors":"Pundhir A, Shukla A, Goel AD, Pundhir P, Gupta MK, Parashar P, Varshney AM.","first_author":"Pundhir A","journal":"African health sciences","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["AIDS","HIV","Unsafe Sex","Psychoactive Substance","Truck Drivers"],"is_oa":true,"oa_url":"https://www.ajol.info/index.php/ahs/article/download/211701/199621","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 100 convenience-sampled truck drivers in India","sample_n":100,"sample_text":"convenient sample of 100 truck drivers","population":"Male truck drivers, age ≥ 18, India","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 100 Indian truck drivers, those who said they could access pornography were about four times more likely to report unsafe sex with commercial partners. Other factors linked to risk were early sexual debut and using drugs before sex.","clinical_takeaway":"Access to pornography was associated with unsafe sexual practices, but causal claims cannot be made from this study.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Provides data from a hard‑to‑reach occupational group","Reports odds ratios with confidence intervals"],"limitations":["Convenience sample limits generalisability","No validated measures of pornography use or sexual risk","Key confounders (e.g., mental health, moral factors) not assessed"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4314/ahs.v21i2.9"}},{"id":2379,"doi":"10.3389/fpsyg.2021.634581","pmid":"34122225","pmcid":"PMC8195327","title":"The Association Between Generalized and Specific Problematic Internet Use and Its Gender Differences Across Different Educational Levels","authors":"Tian Y, Zuo T, Sun Q, Sun L, Cao S, Qin N.","first_author":"Tian Y","journal":"Frontiers in psychology","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Gender Difference","Gpiu","Cognitive–Behavioral Model","Spiu","Study Period Difference"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyg.2021.634581/pdf","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 5,215 Chinese students (age 10‑23) from elementary to university levels; self‑report questionnaire on demographics and specific/problematic internet activities including online pornography.","sample_n":5215,"sample_text":"2,303 males; mean age = 16.20 years, range = 10‑23 years; four educational levels (elementary, junior high, senior high, university)","population":"students in China, convenience sample from schools","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 5,000 Chinese students found that using the internet for shopping, porn, social media, or gaming predicts overall problematic internet use, with gaming being the strongest predictor. Gender differences varied across school levels, especially for porn and shopping.","clinical_takeaway":"Problematic internet use, including porn use, is linked to broader online issues; interventions should consider gender and education level.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size","Multiple educational levels examined","Effect sizes reported for specific PIU domains"],"limitations":["Reliance on self‑report, likely non‑validated scales","Cross‑sectional design; cannot infer causality","Key confounds (moral incongruence, mental health, masturbation) not measured"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2021.634581"}},{"id":2380,"doi":"10.1080/10410236.2013.875867","pmid":"25010599","pmcid":null,"title":"U.S. adults' pornography viewing and support for abortion: a three-wave panel study","authors":"Tokunaga RS, Wright PJ, McKinley CJ.","first_author":"Tokunaga RS","journal":"Health communication","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"three-wave panel study of U.S. adults examining prior pornography consumption and later support for abortion","sample_n":null,"sample_text":"national three‑wave longitudinal data","population":"U.S. adults (national sample, details not specified)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A three‑wave study of U.S. adults found that people who reported watching more pornography earlier were later more likely to support abortion, suggesting pornography may shape social attitudes.","clinical_takeaway":"None - the study does not provide direct clinical guidance.","confidence":0.6,"topic_tags":["pornography","sexual_function","religiosity","moral_incongruence"],"strengths":["Longitudinal design allows temporal ordering","Large national dataset","Focus on social impact of pornography"],"limitations":["Limited measurement detail for pornography use","Key confounds (moral attitudes, masturbation) not assessed","Causal language may exceed evidence"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2013.875867"}},{"id":2382,"doi":"10.1111/j.1365-2923.1979.tb01204.x","pmid":"537534","pmcid":null,"title":"The evolution of a course in human sexuality University of Edinburgh, 1972-1978","authors":"Dickerson M, Myerscough PR.","first_author":"Dickerson M","journal":"Medical education","year":1979,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Evaluation of a university course over several years using student feedback surveys; likely convenience sample of learners.","sample_n":null,"sample_text":"Not reported in abstract; presumably modest class sizes.","population":"undergraduate medical students at University of Edinburgh (1972‑1978)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes how a medical school’s human‑sexuality course changed from a focus on facts to include explicit films and group discussion, aiming to improve students’ affective learning and interviewing skills.","clinical_takeaway":"None – the study reports on teaching methods, not on clinical sexual health outcomes.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Longitudinal development of the curriculum over 7 years","Practical focus on affective learning and clinical interviewing skills"],"limitations":["No detailed description of evaluation instruments or their validation","Likely small, non‑representative student sample","No statistical rigour reported (no effect sizes, power analysis)"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2923.1979.tb01204.x"}},{"id":2384,"doi":"10.1016/j.addbeh.2021.106957","pmid":"33932838","pmcid":null,"title":"Fleeing through the mind's eye: Desire thinking as a maladaptive coping mechanism among specific online activities","authors":"Brandtner A, Brand M.","first_author":"Brandtner A","journal":"Addictive behaviors","year":2021,"pub_types":["Journal Article"],"keywords":["Craving","Coping","Internet Use","Emotional Reactivity","Desire Thinking","Addictive Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey (N=925) testing a mediation model with structural equation modelling; participants self‑selected based on preferred online activity (social media, shopping, gaming, gambling, pornography).","sample_n":925,"sample_text":"N=925 participants completing an online questionnaire.","population":"Adults (online users) who indicated a primary online activity; no information on recruitment source beyond an open‑access survey.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 925 people about their favorite online activity (including porn) and found that negative emotions lead to more “desire thinking,” which in turn raises craving for that activity. The authors suggest desire thinking may be a maladaptive coping strategy.","clinical_takeaway":"High emotional reactivity may trigger craving via desire‑thinking; addressing coping styles could help manage problematic online use.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence","other"],"strengths":["Large sample size for SEM","Use of validated Desire Thinking Questionnaire","Includes pornography as one of several online activities"],"limitations":["Cross‑sectional design limits causal inference","No measurement of key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)","Craving measure not clearly validated"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":14,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2021.106957"}},{"id":2386,"doi":"10.1007/s10508-014-0294-2","pmid":"24729135","pmcid":null,"title":"\"Bareback\" pornography consumption and safe-sex intentions of men having sex with men","authors":"Jonas KJ, Hawk ST, Vastenburg D, de Groot P.","first_author":"Jonas KJ","journal":"Archives of sexual behavior","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Study 1: online correlational survey; Study 2: 2×2 mixed‑factorial experiment in MSM sex club comparing bareback vs protected porn and actor age.","sample_n":null,"sample_text":"Not reported in abstract; likely modest convenience samples.","population":"Men who have sex with men (MSM), convenience sample recruited online and from a sex club.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In two studies, men who have sex with men who watched porn showing unprotected anal sex reported lower intentions to use condoms, suggesting that such “bareback” porn may influence risk‑taking attitudes.","clinical_takeaway":"Exposure to bareback porn may lower condom intentions; clinicians might discuss media influences when counseling MSM about safe‑sex practices.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Experimental manipulation of porn content","Ecologically valid setting (sex club)","Direct measurement of intention"],"limitations":["Reliance on single‑item, unvalidated intention scale","No control for moral, mental‑health or relationship factors","Sample size and power not reported"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0294-2"}},{"id":2387,"doi":"10.1007/s10508-014-0291-5","pmid":"24729134","pmcid":null,"title":"Experimental effects of exposure to pornography: the moderating effect of personality and mediating effect of sexual arousal","authors":"Hald GM, Malamuth NN.","first_author":"Hald GM","journal":"Archives of sexual behavior","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"randomized experimental design with 200 community participants (young adult men and women)","sample_n":200,"sample_text":"randomly selected community sample of 200 Danish young adult men and women","population":"Danish young adults","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab experiment, 200 Danish young adults watched non‑violent porn. Men low in agreeableness became more supportive of violence against women after viewing, and this effect was explained by feeling sexually aroused.","clinical_takeaway":"Exposure to porn can temporarily increase aggression‑related attitudes in certain personality groups; clinicians should consider individual differences when discussing media effects.","confidence":0.8,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Randomized experimental manipulation of pornography exposure","Large community sample (N=200)","Examines moderation by personality and mediation by arousal"],"limitations":["Unclear whether all questionnaires are validated","No measurement of moral, mental‑health or relationship variables that could confound attitudes","No pre‑registration or reported effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":4,"mentioning":68,"citing_publications":113,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0291-5"}},{"id":2388,"doi":"10.1016/j.addbeh.2021.106941","pmid":"33915392","pmcid":null,"title":"Profiles of potential behavioral addictions' severity and their associations with gender, personality, and well-being: A person-centered approach","authors":"Charzyńska E, Sussman S, Atroszko PA.","first_author":"Charzyńska E","journal":"Addictive behaviors","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Personality","Health","Well-being","Behavioral Addictions","Latent Profile Analysis"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 1182 Polish undergraduates using self‑report questionnaires on six potential behavioral addictions, personality, and well‑being; latent profile analysis to identify groups.","sample_n":1182,"sample_text":"1182 Polish undergraduate students","population":"Polish undergraduate students (emerging adults, mean age 20.3)","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Polish university students, four groups were found based on how strongly they reported problems with activities like studying, shopping, gaming, Facebook, pornography, and food. Men were more likely to belong to groups with higher pornography and gaming scores, while women clustered in a group with higher study and shopping scores. The group with the highest overall scores also showed poorer personality traits and lower well‑being.","clinical_takeaway":"High co‑occurrence of multiple behavioral problems, including pornography, may signal broader personality and well‑being issues; assessment should consider the whole pattern rather than isolated behaviors.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (N>1000) improves statistical power for latent profile analysis","Use of multiple validated questionnaires for personality and well‑being","Person‑centered (LPA) approach identifies meaningful sub‑groups"],"limitations":["Cross‑sectional design cannot infer causality","Convenience student sample limits generalisability","Pornography “addiction” measured by self‑report scales without separating masturbation or moral factors"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":62,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2021.106941"}},{"id":2389,"doi":"10.1097/dbp.0000000000000034","pmid":"24695119","pmcid":null,"title":"Pornography and sexual experiences among high school students in Sweden","authors":"Mattebo M, Tydén T, Häggström-Nordin E, Nilsson KW, Larsson M.","first_author":"Mattebo M","journal":"Journal of developmental and behavioral pediatrics : JDBP","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"population-based classroom survey of 16‑year‑old students (n=877) from randomly selected classes in two Swedish towns; self‑report questionnaire on pornography use, sexual experiences, abuse, and attitudes.","sample_n":877,"sample_text":"477 boys and 400 girls from 53 randomly selected high‑school classes","population":"Adolescents (16 y) attending high school in Sweden","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Swedish high‑school survey of 877 16‑year‑olds, most boys (96 %) and over half of girls (54 %) had watched pornography. Positive attitudes toward porn predicted having had sexual experiences, and girls reported more sexual activity and higher rates of sexual abuse than boys.","clinical_takeaway":"Positive attitudes toward pornography are linked to earlier sexual activity among adolescents, but the study does not establish causal harm.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large, randomly selected school‑class sample improves generalisability","Examines multiple predictors of sexual experience","Clear reporting of gender differences in pornography exposure"],"limitations":["Reliance on single‑item, non‑validated self‑report measures for pornography use","No assessment of masturbation or moral/religious attitudes that could confound findings","Cross‑sectional design cannot establish causality"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":18,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/dbp.0000000000000034"}},{"id":2390,"doi":"10.1080/10550887.2021.1882649","pmid":"33771088","pmcid":null,"title":"The impact of Internet use during COVID-19 lockdown in Rwanda: a potential public health threat","authors":"Ngamije J.","first_author":"Ngamije J.","journal":"Journal of addictive diseases","year":2021,"pub_types":["Journal Article"],"keywords":["Pandemic","Lockdown","Covid-19"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"No empirical data; article discusses potential public‑health implications of internet use during lockdown, with no described sample, methods, or analyses.","sample_n":null,"sample_text":"Not applicable – no data collection reported","population":"General population of Rwanda (children, adolescents, adults) – no specific sample reported","country":"Rwanda","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that increased internet use during Rwanda’s COVID‑19 lockdown may expose children and adolescents to pornography and violent content, suggesting the government implement safeguards and education.","clinical_takeaway":"None – the paper provides no clinical data or recommendations.","confidence":0.7,"topic_tags":["pornography","csbd","adolescents","sexual_function"],"strengths":["Raises awareness of potential risks","Addresses public‑health policy relevance"],"limitations":["No empirical data or methodology described","No measurement of key constructs (pornography exposure, mental health, etc.)","Conclusions not supported by data"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10550887.2021.1882649"}},{"id":2391,"doi":"10.1007/s10508-014-0270-x","pmid":"24627189","pmcid":null,"title":"Online child pornography offenders are different: a meta-analysis of the characteristics of online and offline sex offenders against children","authors":"Babchishin KM, Hanson RK, VanZuylen H.","first_author":"Babchishin KM","journal":"Archives of sexual behavior","year":2015,"pub_types":["Meta-Analysis","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":123,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 30 samples comparing online child‑pornography‑only offenders, offline child sex offenders, and mixed offenders.","sample_n":null,"sample_text":"30 unique samples; comparison Ns ranging from 98 to 2,702 (as reported in abstract).","population":"Adult male offenders of child sexual abuse (online, offline, or both).","country":"Not specified (international literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 30 studies shows that men who only view child pornography differ from those who also commit contact offenses: online offenders have less direct access to children, lower antisocial traits, and more empathy for victims, while mixed offenders show the highest pedophilic interest and risk.","clinical_takeaway":"None – findings pertain to offender profiling, not to clinical treatment of typical pornography use.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large pooled sample across many studies","Systematic comparison of distinct offender groups","Clear operational definitions of offender categories"],"limitations":["Relies on secondary data with variable measurement quality","No control for mental‑health or trauma variables","Potential publication bias not addressed in abstract"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":33,"contrasting":6,"mentioning":388,"citing_publications":348,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0270-x"}},{"id":2392,"doi":"10.1007/bf01541721","pmid":"1156137","pmcid":null,"title":"Male-female differences in sexual arousal and behavior during and after exposure to sexually explicit stimuli","authors":"Schmidt G.","first_author":"Schmidt G.","journal":"Archives of sexual behavior","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":6,"contrasting":0,"mentioning":28,"citing_publications":115,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541721"}},{"id":2393,"doi":"10.1002/ab.21960","pmid":"33719096","pmcid":null,"title":"Factors predictive of sexual violence: Testing the four pillars of the Confluence Model in a large diverse sample of college men","authors":"Malamuth NM, Lamade RV, Koss MP, Lopez E, Seaman C, Prentky R.","first_author":"Malamuth NM","journal":"Aggressive behavior","year":2021,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Confluence Model","Campus Sexual Assault","Interventions For Sexual Aggression","Sexual Violence Risk Factors"],"is_oa":false,"oa_url":null,"cited_by_count":52,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large ethnically diverse college sample, self‑report survey, cross‑sectional","sample_n":1148,"sample_text":"college men, convenience sample","population":"male college students (N=1,148) from 13 U.S. colleges","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,148 U.S. college men examined how hostility toward women, casual sex attitudes, and factors like extreme porn use and partying predict self‑reported sexual aggression. The model explained about half of the variance in reported sexual violence.","clinical_takeaway":"Risk‑factor screening for sexual aggression should consider hostile attitudes, impersonal sex beliefs, and contextual factors like extreme porn use and heavy partying.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["large sample size","use of structural equation modeling","testing a comprehensive theoretical model"],"limitations":["cross‑sectional design limits causal inference","self‑report measures subject to bias","limited control for key confounds (e.g., mental health, trauma)","college convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":13,"contrasting":1,"mentioning":104,"citing_publications":96,"retracted":false,"notices":[{"status":"Has erratum","date":"2021-6","noticeDoi":"10.1002/ab.21980","doi":"10.1002/ab.21960"}],"url":"https://scite.ai/reports/10.1002/ab.21960"}},{"id":2394,"doi":"10.1177/1524838014521024","pmid":"24562725","pmcid":null,"title":"Thinking critically about campus-based self-defense programs: a response to Christine Gidycz","authors":"DeKeseredy WS.","first_author":"DeKeseredy WS.","journal":"Trauma, violence & abuse","year":2014,"pub_types":["Comment","Journal Article"],"keywords":["Technology","Sexual Assault","Self-defense","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary without original data; offers opinion on campus self‑defense programs and references pornography only tangentially.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"USA (implied)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The author comments on campus self‑defense programs and warns that technologies like texting and internet pornography may increase sexual assault risk, but provides no new data.","clinical_takeaway":"None - not clinically applicable.","confidence":0.4,"topic_tags":["sexual_function","csbd","pornography"],"strengths":["Addresses contemporary safety concerns on campuses","Highlights potential risks of new technologies"],"limitations":["No empirical data or systematic review","No measurement of pornography use or related outcomes","Does not control for confounding variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1524838014521024"}},{"id":2395,"doi":"10.1093/oxfordjournals.humrep.a019008","pmid":"8671177","pmcid":null,"title":"Sexual arousal and the quality of semen produced by masturbation","authors":"van Roijen JH, Slob AK, Gianotten WL, Dohle GR, van der Zon AT, Vreeburg JT, Weber RF.","first_author":"van Roijen JH","journal":"Human reproduction (Oxford, England)","year":1996,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"within‑subject comparison of semen quality with and without visual erotic stimulation; two independent groups (clinic patients, healthy donors); N=29,14,23","sample_n":66,"sample_text":"Group A: 29 patients; Group A healthy donors: 14; Group B: 23 sub‑fertility patients","population":"male patients attending an andrology clinic and healthy sperm donors; adult men","country":"Netherlands (likely based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that men’s sexual arousal while masturbating did not improve semen quality, although watching an erotic video made men feel more relaxed and aroused when giving a sample.","clinical_takeaway":"Viewing erotic material can help men provide semen samples, but it does not alter semen quality.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Objective semen measures","Within‑subject design reduces between‑person variability","Practical recommendation for fertility clinics"],"limitations":["Small, non‑representative samples","Questionnaire not validated","No control for psychological or relational confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":19,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/oxfordjournals.humrep.a019008"}},{"id":2399,"doi":"10.1007/s10508-013-0244-4","pmid":"24515803","pmcid":null,"title":"Viewing child pornography: prevalence and correlates in a representative community sample of young Swedish men","authors":"Seto MC, Hermann CA, Kjellgren C, Priebe G, Svedin CG, Långström N.","first_author":"Seto MC","journal":"Archives of sexual behavior","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"population‑representative school‑based survey of 1,978 Swedish men (17‑20 y), anonymous self‑report questionnaire","sample_n":1978,"sample_text":"population‑representative community sample","population":"young Swedish men, 17‑20 y, n≈1,978, response rate 77 %","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative survey of 1,978 Swedish men aged 17‑20, 4 % reported ever viewing child pornography. Viewing was linked to higher overall pornography use, interests in sexual activity with children, having friends who watched such material, and prior experience with male partners. A six‑item risk‑factor scale predicted these behaviors.","clinical_takeaway":"Viewing child pornography is associated with broader patterns of sexual deviance and frequent pornography use; clinicians should assess a range of sexual interests and peer influences when evaluating risk.","confidence":0.7,"topic_tags":["prevalence","sexual_function"],"strengths":["Large, nationally representative sample","Comprehensive set of theory‑based risk‑factor variables","Multivariate logistic regression with cross‑validation"],"limitations":["Self‑report of illegal behavior may be under‑reported","Key constructs (e.g., CP viewing) measured with single, unvalidated items","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":61,"citing_publications":77,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0244-4"}},{"id":2400,"doi":"10.1071/sh20122","pmid":"33632383","pmcid":null,"title":"A national survey of HIV knowledge, sexual practices and attitude towards homosexuality for HIV elimination among young people in China","authors":"Ruan L, Zhao R, Ong JJ, Fu X, Xiong Y, Chen Y, He D, Chen Y, Zhuang X, Zhang L.","first_author":"Ruan L","journal":"Sexual health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Nationwide face‑to‑face survey of senior high school and university students (N=1,355); cross‑sectional descriptive and GLM analysis.","sample_n":1355,"sample_text":"73.6% response rate from 1,840 approached.","population":"Chinese youths aged 15‑24 years, students in high school or university.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2021 nationwide Chinese survey of 1,355 high‑school and university students found low HIV knowledge and high rates of masturbation, porn use and other sexual behaviours, with males reporting more than females. Support for same‑sex marriage and school‑based HIV education were linked to better knowledge.","clinical_takeaway":"Sex education programs should address gaps in HIV knowledge and incorporate discussions of diverse sexual behaviours among youths.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, multi‑site sample of Chinese youth","High response rate (73.6%)","Provides baseline data on HIV knowledge and sexual behaviours"],"limitations":["Cross‑sectional design limits causal inference","Key constructs measured with single‑item, non‑validated items","No control for moral/religious attitudes or mental‑health variables"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh20122"}},{"id":2401,"doi":null,"pmid":"35354174","pmcid":null,"title":"Treatment in Psychiatry in a New Classification Attire in the Shadow of Silence and Unprocessed Traumas from the Past. The Imperative of Perfectionism in the Present and Shame and Discomfort in the Future","authors":"Sutović A.","first_author":"Sutović A.","journal":"Psychiatria Danubina","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"none","sample_n":null,"sample_text":"no empirical sample reported","population":"none","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reflects on how new psychiatric classifications, perfectionism, shame, and unprocessed trauma shape modern mental health, briefly mentioning pornography as part of a broader cultural shift.","clinical_takeaway":"None – the piece offers no actionable clinical guidance.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Broad discussion of sociocultural context","Highlights links between perfectionism, shame, and mental health"],"limitations":["No empirical data or methodology","Lacks measurement of key constructs","No systematic review or meta‑analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":2402,"doi":"10.1007/s10508-013-0229-3","pmid":"24469338","pmcid":null,"title":"The pornography craving questionnaire: psychometric properties","authors":"Kraus S, Rosenberg H.","first_author":"Kraus S","journal":"Archives of sexual behavior","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":66,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Three consecutive studies with convenience samples of young male pornography users; Study 1 experimental cue exposure, Studies 2–3 psychometric validation (PCA, reliability, test‑retest).","sample_n":null,"sample_text":"young male pornography users (students)","population":"young adult male pornography users (students)","country":"unspecified (likely USA/Europe)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and tested a 12‑item questionnaire to measure how much people want to view pornography. It shows good reliability and predicts short‑term use, but was only studied in young male students.","clinical_takeaway":"The PCQ may help clinicians track pornography craving, but its applicability beyond young male students is unclear.","confidence":0.85,"topic_tags":["measurement","pornography","sexual_function","religiosity"],"strengths":["Systematic item generation and reduction","Multiple psychometric assessments (factor structure, reliability, test‑retest)","Convergent and discriminant validation with related constructs"],"limitations":["Convenience sample of young male students limits generalisability","No assessment of moral/religious or partner variables","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":81,"citing_publications":186,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0229-3"}},{"id":2403,"doi":"10.3389/fpsyt.2021.634583","pmid":"33708147","pmcid":"PMC7940765","title":"The Influence of Trait Compulsivity and Impulsivity on Addictive and Compulsive Behaviors During COVID-19","authors":"Albertella L, Rotaru K, Christensen E, Lowe A, Brierley ME, Richardson K, Chamberlain SR, Lee RSC, Kayayan E, Grant JE, Schluter-Hughes S, Ince C, Fontenelle LF, Segrave R, Yücel M.","first_author":"Albertella L","journal":"Frontiers in psychiatry","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Addiction","Impulsivity","Ocd","Compulsivity","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7940765","cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 878 Australian adults during COVID‑19 lockdown; cross‑sectional self‑report measures of trait impulsivity/compulsivity and various addictive/compulsive behaviours (including pornography).","sample_n":878,"sample_text":"Convenience online sample of adults; not probability‑based, may over‑represent those with internet access and interest in mental‑health surveys.","population":"Adults (general community) recruited online in Australia during first COVID‑19 lockdown (May‑June 2020).","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"During Australia’s first COVID‑19 lockdown, people who scored higher on trait compulsivity showed more obsessive‑compulsive problems and, together with impulsivity, different patterns of eating problems. Overall stress and previous problems predicted higher levels of many risky behaviours, including pornography use.","clinical_takeaway":"Higher stress and pre‑existing problems, not just impulsivity or compulsivity, drive increases in risky behaviours during crisis periods.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a cross‑sectional survey","Controls for several relevant covariates (age, gender, distress, COVID stressors, pre‑COVID problems)","Examines interaction of impulsivity and compulsivity across multiple behaviour domains"],"limitations":["Reliance on self‑report scales; unclear if validated for each behaviour","No measurement or control of moral incongruence, masturbation, partner context, or trauma history","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":42,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2021.634583"}},{"id":2404,"doi":"10.1111/jcpp.12197","pmid":"24438579","pmcid":null,"title":"Annual research review: Harms experienced by child users of online and mobile technologies: the nature, prevalence and management of sexual and aggressive risks in the digital age","authors":"Livingstone S, Smith PK.","first_author":"Livingstone S","journal":"Journal of child psychology and psychiatry, and allied disciplines","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Internet","risk factors","Cyberbullying","Child Harm Protection","Cyber-aggression","Online And Mobile Technologies","Sexual Messaging And Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":127,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"Narrative review of empirical studies published since 2008; no systematic search protocol reported; no meta‑analysis.","sample_n":null,"sample_text":"N/A (review article)","population":"Children and adolescents (up to middle childhood) in developed countries.","country":"International (developed countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review summarises what is known about sexual and aggressive harms (including exposure to pornography) that children may face online or via mobile devices, noting that fewer than one‑in‑five adolescents experience these risks and that many factors—personality, family, and digital habits—affect vulnerability.","clinical_takeaway":"Clinicians should assess digital‑media use alongside offline risk factors when evaluating a child’s emotional or psychosocial wellbeing.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Broad coverage of recent empirical work on child digital risks","Identifies methodological challenges and research gaps"],"limitations":["Narrative (non‑systematic) review; selection bias possible","No quantitative synthesis or meta‑analysis","Does not assess confounding variables directly"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":14,"contrasting":1,"mentioning":289,"citing_publications":597,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jcpp.12197"}},{"id":2405,"doi":"10.1177/2050312121994358","pmid":"33643654","pmcid":"PMC7890712","title":"Risky sexual behavior and its associated factors among daily laborers in Arjo-Didessa sugar factory, Jimma Arjo, Southwest Ethiopia: An institution-based cross-sectional study","authors":"Gemechu AG, Assefa Ayana L, Waqtole ZD, Tola EK, Beyene MD.","first_author":"Gemechu AG","journal":"SAGE open medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Risky Sexual Behavior","Casual Sex","Multiple Sexual Partners","Daily Laborer","Jimma Arjo"],"is_oa":true,"oa_url":"https://journals.sagepub.com/doi/pdf/10.1177/2050312121994358","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"institution-based cross‑sectional survey of 422 randomly selected daily laborers; logistic regression used to identify associations with self‑reported risky sexual behavior.","sample_n":422,"sample_text":"422 randomly selected daily laborers (simple random sampling).","population":"daily laborers (mean age 22) at a sugar factory in Southwest Ethiopia","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 2021 Ethiopian survey of 422 sugar‑factory workers found that 57% reported risky sexual practices. Viewing pornographic movies, being younger, single, using khat or alcohol, and low income were linked to higher odds of such behavior.","clinical_takeaway":"Viewing porn is associated with risky sex in this group, but causality is unclear; clinicians should assess broader context and confounders.","confidence":0.8,"topic_tags":["relationships","sexual_function","pornography","religiosity"],"strengths":["Large sample for a local survey","Random selection within institution","Multivariate logistic regression with CIs"],"limitations":["Cross‑sectional design precludes causal inference","Reliance on self‑report, no validated scales for risky behavior","Key confounds (moral incongruence, masturbation, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/2050312121994358"}},{"id":2406,"doi":"10.1080/00918369.2014.865452","pmid":"24245563","pmcid":null,"title":"Some like it mellow: on gay men complicating pornography discourses","authors":"Corneau S, van der Meulen E.","first_author":"Corneau S","journal":"Journal of homosexuality","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"qualitative ethnographic interview study with 20 gay men in Toronto; thematic analysis of interview transcripts","sample_n":20,"sample_text":"20 consumers of gay pornography in Toronto, Canada","population":"gay men who consume gay pornography; convenience sample, community‑recruited","country":"Canada","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Through interviews with 20 gay men in Toronto, the study shows that gay pornography is described in five distinct ways—Mellow, Commercial, Raunch, Amateur, and Bareback—underscoring that porn is not a single, uniform object.","clinical_takeaway":"Clinicians should recognize that gay men’s meanings of pornography vary widely; avoid assuming a single ‘type’ of porn when discussing sexual health.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["In‑depth qualitative insight into gay men’s own definitions of pornography","Systematic thematic analysis with clear categories","Highlights need for precise construct definition in the field"],"limitations":["Small, non‑representative convenience sample (N=20)","No measurement of key confounds (moral incongruence, masturbation, mental health)","Findings not generalisable beyond this specific community"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":1,"mentioning":4,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2014.865452"}},{"id":2408,"doi":"10.1007/s10508-021-01922-z","pmid":"33537881","pmcid":null,"title":"Pornographic Socialization as \"Selective-Exposure\": Let it Go, Let it Go II","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Archives of sexual behavior","year":2021,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":2,"contrasting":0,"mentioning":14,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-01922-z"}},{"id":2409,"doi":"10.1007/s13178-021-00536-3","pmid":"33520009","pmcid":"PMC7826150","title":"Image-Based Sexual Abuse in a Culturally Conservative Nigerian Society: Female Victims' Narratives of Psychosocial Costs","authors":"Aborisade RA.","first_author":"Aborisade RA.","journal":"Sexuality research & social policy : journal of NSRC : SR & SP","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Conservatism","Victimization","Rape Culture","Revenge Porn","Image-based Sexual Abuse"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7826150","cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"qualitative interview study with 27 purposively selected adult women victims of IBSA in Nigeria; thematic analysis of narratives","sample_n":27,"sample_text":"27 adult women, purposively selected","population":"adult women (N=27) whose non‑consensual sexual images were shared online in Nigeria; purposive sampling","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In Nigeria, 27 women whose private sexual images were shared online described intense social stigma, self‑blame, depression, and fear. Their stories show how image‑based abuse brings unique psychological harms and calls for better laws and victim support.","clinical_takeaway":"Clinicians should assess for secondary trauma and depression in clients reporting image‑based sexual abuse and connect them with specialized support services.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Rich, victim‑centered qualitative data","Thematic analysis provides depth of psychosocial impact","Highlights gaps in legal and policy response"],"limitations":["Small, non‑representative purposive sample","No systematic measurement of mental‑health variables","Findings not generalisable beyond the specific cultural context"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":63,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13178-021-00536-3"}},{"id":2410,"doi":"10.1177/1079063213509411","pmid":"24259539","pmcid":null,"title":"Secondary traumatic stress among Internet Crimes Against Children task force personnel: impact, risk factors, and coping strategies","authors":"Bourke ML, Craun SW.","first_author":"Bourke ML","journal":"Sexual abuse : a journal of research and treatment","year":2014,"pub_types":["Journal Article"],"keywords":["Child Sexual Abuse","Child Pornography","Sex Offenses"],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large (N>600) Internet‑based survey of ICAC personnel; purposive convenience sample; self‑report measures; cross‑sectional correlational analysis","sample_n":600,"sample_text":"more than 600 individuals responded to an Internet‑based survey","population":"ICAC task‑force personnel (law enforcement/health staff regularly exposed to child sexual exploitation material)","country":"United States (assumed from “throughout the country”)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 600 staff who investigate child sexual exploitation found many experience secondary traumatic stress, and certain coping strategies were linked to less stress.","clinical_takeaway":"Professionals exposed to child sexual material should be screened for secondary traumatic stress and supported with effective coping interventions.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for a specialized professional group","Focus on an understudied occupational risk (secondary traumatic stress)","Identifies coping mechanisms linked to lower STS"],"limitations":["Cross‑sectional design cannot infer causality","Possible self‑selection bias; responders may differ from non‑responders","Limited detail on measurement validation in abstract"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":14,"contrasting":0,"mentioning":101,"citing_publications":105,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063213509411"}},{"id":2411,"doi":"10.1080/00224499.2013.829795","pmid":"24228745","pmcid":null,"title":"Schoolgirls and soccer moms: a content analysis of free \"teen\" and \"MILF\" online pornography","authors":"Vannier SA, Currie AB, O'Sullivan LF.","first_author":"Vannier SA","journal":"Journal of sex research","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":62,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"content analysis of 100 free online pornography videos (teen vs MILF) coded by independent raters","sample_n":100,"sample_text":"100 videos (50 teen, 50 MILF) selected from popular sites","population":"online porn videos (female‑age‑based categories) from 10 popular websites","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined 100 free online porn videos labeled as ‘teen’ or ‘MILF’ and found that while most show vaginal sex and oral sex, MILF videos depict women as more agentic, initiating activity and having higher professional status.","clinical_takeaway":"None – study describes video content, not user health effects.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Systematic coding protocol","Independent raters","Clear description of most frequent acts"],"limitations":["Video sample not random or representative of all porn","Coding scheme not reported as validated","No statistical power analysis"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":3,"mentioning":114,"citing_publications":150,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2013.829795"}},{"id":2412,"doi":"10.1177/1079063213503688","pmid":"24215791","pmcid":null,"title":"Sexual interest in children among an online sample of men and women: prevalence and correlates","authors":"Wurtele SK, Simons DA, Moreno T.","first_author":"Wurtele SK","journal":"Sexual abuse : a journal of research and treatment","year":2014,"pub_types":["Journal Article"],"keywords":["Child Sexual Abuse","Pedophilia","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online convenience sample (262 females, 173 males); self‑report questionnaire on sexual interest in children and adverse childhood experiences; cross‑sectional analysis of prevalence and correlates.","sample_n":435,"sample_text":"262 females, 173 males; recruited online.","population":"adult men and women recruited via the internet (general‑population sample, not treatment‑seeking).","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 435 adults, about 6 % of men and 2 % of women said they might have sex with a child if they could avoid punishment, and 9 % of men and 3 % of women reported they might view child pornography. Those reporting such interests also reported more childhood adversity and involvement in other antisocial behaviors.","clinical_takeaway":"A minority of adults report some interest in children; clinicians should assess for co‑occurring trauma and antisocial behavior when such interests are disclosed.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large online sample for a sensitive topic","Inclusion of both genders","Assessment of childhood adversity as a correlate"],"limitations":["Self‑report likelihood items lack validation","Cross‑sectional design prevents causal inference","No control for moral or religious attitudes, mental health, or relationship factors"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":9,"contrasting":3,"mentioning":74,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063213503688"}},{"id":2413,"doi":"10.1080/00224499.2020.1861424","pmid":"33428466","pmcid":null,"title":"Sexual Practices and Satisfaction among Gay and Heterosexual Men in Romantic Relationships: A Comparison Using Coarsened Exact Matching in a U.S. National Sample","authors":"Frederick D, Gillespie BJ, Lever J, Berardi V, Garcia JR.","first_author":"Frederick D","journal":"Journal of sex research","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online national survey; coarsened exact matching used to create comparable heterosexual and gay subsamples (n=3527 and n=452); cross‑sectional questionnaire on sexual practices and satisfaction","sample_n":3979,"sample_text":"3527 heterosexual and 452 gay men after matching","population":"men in romantic relationships (heterosexual and gay) from a U.S. national online sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a U.S. online survey of men in relationships, gay and heterosexual partners showed many similar sexual habits and satisfaction levels. Gay men reported more oral sex and joint pornography use, while heterosexual men gave more massages. Communication about sex predicted higher satisfaction, especially for gay couples.","clinical_takeaway":"Promoting open sexual communication may boost relationship satisfaction for both gay and heterosexual couples.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Large, nationally‑recruited sample","Use of coarsened exact matching to balance groups","Detailed enumeration of >50 sexual practices"],"limitations":["Cross‑sectional; cannot infer causality","Sexual satisfaction measured with unspecified instrument","Potential self‑selection bias of online respondents"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":14,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2020.1861424"}},{"id":2414,"doi":"10.1177/0020764020975791","pmid":"33423586","pmcid":null,"title":"Constructing the understanding of teenagers deviant use of cyberspace","authors":"Sharma MK, Anand N, Kumar K, Lenin Singh R, Thakur PC, Mondal I, Kohli T.","first_author":"Sharma MK","journal":"The International journal of social psychiatry","year":2021,"pub_types":["Letter","Research Support, Non-U.S. Gov't"],"keywords":["Teenagers","Cyberspace","Chatroom","Cyber Literacy","Deviant Socialization"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Letter discussing the concept of deviant cyberspace use among teenagers; no empirical data presented.","sample_n":null,"sample_text":"No sample reported","population":"Teenagers (unspecified)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The letter argues that teenagers’ use of the internet can become deviant, including sexting and porn consumption, and calls for education and cyber‑literacy programmes to reduce these risks.","clinical_takeaway":"None – the article offers no data for clinical decision‑making.","confidence":0.4,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Highlights a topical public‑health concern","Integrates multiple psychosocial factors"],"limitations":["No empirical data or methodology reported","No measurement of key constructs or confounders","Cannot assess prevalence or causal relationships"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0020764020975791"}},{"id":2416,"doi":"10.1007/s10508-020-01902-9","pmid":"33398701","pmcid":null,"title":"Overcontrol in Pornography Research: Let it Go, Let it Go…","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Archives of sexual behavior","year":2021,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":28,"citing_publications":69,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01902-9"}},{"id":2417,"doi":"10.47626/2237-6089-2019-0088","pmid":"33681904","pmcid":"PMC7932034","title":"Validation of a brief sex addiction screening instrument (PATHOS) and prediction of sex addiction in the Iranian population","authors":"Zareiyan A, Sharif Nia H, Molavi N, Saeidi A, Najarzadegan M, Ghazanfarpour M, Jafarpour H, Babakhanian M.","first_author":"Zareiyan A","journal":"Trends in psychiatry and psychotherapy","year":2021,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7932034","cited_by_count":0,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 443 Iranian adults evaluating a newly translated screening scale (PATHOS) with exploratory factor analysis and regression.","sample_n":443,"sample_text":"Community sample of Iranians recruited in 2018 (method not detailed in abstract).","population":"Iranian adults (general population sample, n=443)","country":"Iran","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors translated and tested a short questionnaire (PATHOS) for detecting sex‑addiction in Iran. In 443 participants the scale showed two factors and acceptable reliability, and scores were linked to factors like porn use, multiple partners, and masturbation history.","clinical_takeaway":"The PATHOS scale appears reliable, but clinicians should note it does not address moral distress or ICD‑11 criteria before using it to diagnose sex‑addiction.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for psychometric validation (n>400)","Factor analysis and test‑retest reliability reported","First Persian validation of the PATHOS instrument"],"limitations":["No assessment of moral/religious conflict, a key confound for perceived addiction","Reliance on self‑labelled ‘sex addiction’ without testing ICD‑11 criteria","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.47626/2237-6089-2019-0088"}},{"id":2418,"doi":"10.1080/19585969.2022.2042163","pmid":"35860173","pmcid":"PMC9286745","title":"Chemical sex (chemsex) in a population of French university students","authors":"Malandain L, Mosser S, Mouchabac S, Blanc JV, Alexandre C, Thibaut F.","first_author":"Malandain L","journal":"Dialogues in clinical neuroscience","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Addiction","university students","Chemsex","Party And Play","Chemical Sex","Sexualised Drugs"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9286745","cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"anonymous online questionnaire of 680 French university students","sample_n":680,"sample_text":"students recruited via an anonymous online questionnaire","population":"French university students (N=680)","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2021 online survey of 680 French university students found that about 22 % had engaged in chemsex (using drugs to enhance sex) in the past year. Chemsex was linked to using dating apps, pornography use, having a partner who also does chemsex, being celibate, and non‑heterosexual orientation, especially bisexuality.","clinical_takeaway":"Chemsex is relatively common among students and relates to several behavioural and demographic factors; clinicians should ask about drug‑enhanced sexual activity when assessing sexual health.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a student survey","First prevalence estimate of chemsex among French university students","Multivariate analysis to identify associated factors"],"limitations":["Cross‑sectional design precludes causal inference","Self‑report measures not validated","Key confounds (moral incongruence, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19585969.2022.2042163"}},{"id":2419,"doi":"10.3390/ijerph17249477","pmid":"33348870","pmcid":"PMC7766393","title":"Social-Ecological Examination of Non-Consensual Sexting Perpetration among U.S. Adolescents","authors":"Valido A, Espelage DL, Hong JS, Rivas-Koehl M, Robinson LE.","first_author":"Valido A","journal":"International journal of environmental research and public health","year":2020,"pub_types":["research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Adolescent","Predictors","Sexting","Social-ecology"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/17/24/9477/pdf","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large community sample of U.S. high‑school students (N = 2501) completing self‑report questionnaires; path analysis and moderation tested associations between risk/protective factors and non‑consensual sexting perpetration","sample_n":2501,"sample_text":"N = 2501 high‑school students (76.4 % female among LGB, 47.4 % female among non‑LGB); recruited via school‑based survey","population":"U.S. adolescents (high‑school students, ages ~14‑18) from Midwestern schools; includes LGB (n = 309) and non‑LGB (n = 2192) sub‑samples","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A large survey of U.S. high‑school students examined what personal and social factors are linked to sending non‑consensual sexts. Higher porn exposure, lower parental monitoring, bullying, and delinquent behaviours were associated with more sexting, especially among LGB youth.","clinical_takeaway":"Strengthening parental monitoring and addressing bullying and substance use may help reduce risky sexting among teens.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, diverse adolescent sample","Separate analyses for LGB and non‑LGB groups","Uses multivariate path analysis to examine multiple risk factors"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report measures, many likely non‑validated","No assessment of moral incongruence, mental‑health covariates, or trauma"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph17249477"}},{"id":2420,"doi":"10.1556/2006.2020.00095","pmid":"33325840","pmcid":"PMC8969714","title":"Prerequisites for stakeholder framework: Consumer advocacy and health protection in the digital industry. •","authors":"Lee HK.","first_author":"Lee HK.","journal":"Journal of behavioral addictions","year":2020,"pub_types":["reply","Journal Article"],"keywords":["Advocacy","Consumer","Public Health Model","Health Right"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8969714","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary / reply article, no empirical data","sample_n":null,"sample_text":"Not applicable – article is a conceptual reply without original data","population":"not applicable","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The author argues that a stakeholder framework is needed to balance consumer rights with health protection after the WHO classified gaming disorder as an addiction, emphasizing that excessive digital use can cause harms including exposure to violent or pornographic content.","clinical_takeaway":"None – the article is a conceptual commentary, not clinical evidence.","confidence":0.8,"topic_tags":["gender","csbd","prevalence","measurement"],"strengths":["Addresses policy gap after ICD‑11 inclusion of gaming disorder","Integrates public‑health and consumer‑rights perspectives"],"limitations":["No original empirical data","Relies on assumed harms without systematic evidence","Potential advocacy bias without disclosed COI"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00095"}},{"id":2421,"doi":"10.1097/dbp.0b013e31829c44a2","pmid":"23899659","pmcid":null,"title":"Pornography consumption, sexual experiences, lifestyles, and self-rated health among male adolescents in Sweden","authors":"Mattebo M, Tydén T, Häggström-Nordin E, Nilsson KW, Larsson M.","first_author":"Mattebo M","journal":"Journal of developmental and behavioral pediatrics : JDBP","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"population‑based classroom survey of 16‑year‑old boys (N=477) from randomly selected high‑school classes in two Swedish towns","sample_n":477,"sample_text":"477 boys from 53 randomly selected high‑school classes","population":"male adolescents, age 16, Sweden","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 477 Swedish 16‑year‑old boys, those who watched pornography every day were more sexually experienced and reported unhealthier lifestyle habits (more computer time, substance use, obesity) than peers who used it less often, but they did not differ in self‑rated physical or psychological health.","clinical_takeaway":"Frequent pornography use in teenage boys is linked to riskier sexual and lifestyle behaviours, but not to poorer self‑rated health; clinicians should consider broader behavioural context.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","lgbtq","religiosity"],"strengths":["Large, population‑based adolescent sample","Random selection of school classes improves representativeness","Clear descriptive comparison of frequent vs. average vs. non‑frequent users"],"limitations":["Reliance on single‑item, non‑validated measures of pornography use","Cross‑sectional design precludes causal inference","No assessment of key confounds (masturbation, moral attitudes, mental health, partner context, trauma)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":49,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/dbp.0b013e31829c44a2"}},{"id":2423,"doi":"10.1080/10550887.2020.1856298","pmid":"33305702","pmcid":null,"title":"Addictive behaviors and craving during the COVID-19 pandemic of people who have recovered from substance use disorder","authors":"Bonny-Noach H, Gold D.","first_author":"Bonny-Noach H","journal":"Journal of addictive diseases","year":2021,"pub_types":["Journal Article"],"keywords":["Recovery","Craving","Addiction","Addictive Behaviors","Covid-19"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Convenience sample of 113 recovered SUD individuals; self‑report questionnaire assessing craving and frequency of several behaviours (including pornography) before and after COVID‑19 lockdown.","sample_n":113,"sample_text":"Convenience sample recruited during one‑week isolation period (April 2020).","population":"Adults recovered from substance use disorder, Israel, 78 % men, age 22‑69","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 113 people who had previously recovered from drug addiction found that during Israel's COVID‑19 lockdown many increased their use of tobacco, alcohol, gambling, online shopping and also watched more pornography. Loneliness and a shorter time since last drug use predicted stronger drug cravings.","clinical_takeaway":"Clinicians should monitor recovered patients for heightened cravings and broader risky behaviours—including pornography use—during stressful periods like pandemics.","confidence":0.8,"topic_tags":["pornography","relationships","religiosity","adolescents"],"strengths":["Timely data on pandemic effects","Includes multiple addictive behaviours","Uses hierarchical regression to identify predictors"],"limitations":["Convenience, non‑representative sample","Ad‑hoc, unvalidated measures for pornography use","No control for key confounds (e.g., moral incongruence, mental health)","Cross‑sectional recall design limits causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":18,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10550887.2020.1856298"}},{"id":2424,"doi":"10.1007/s10508-020-01884-8","pmid":"33258005","pmcid":"PMC7703733","title":"Claiming Public Health Crisis to Regulate Sexual Outlets: A Critique of the State of Utah's Declaration on Pornography","authors":"McKay K, Poulin C, Muñoz-Laboy M.","first_author":"McKay K","journal":"Archives of sexual behavior","year":2021,"pub_types":["editorial","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7703733","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01884-8"}},{"id":2425,"doi":"10.1177/0272684x20976519","pmid":"33241986","pmcid":null,"title":"Youth Risky Sexual Behavior: Prevalence and Socio-Demographic Factors in North-West Ethiopia: A Community-Based Cross-Sectional Study","authors":"Geremew AB, Gelagay AA, Yeshita HY, Azale Bisetegn T, Habitu YA, Abebe SM, Birru EM.","first_author":"Geremew AB","journal":"Community health equity research & policy","year":2022,"pub_types":["Journal Article"],"keywords":["Youth","Ethiopia","Risky Sexual Behavior","Sociodemographic"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Community‑based cross‑sectional survey of youth (15‑24 y) in Northwest Ethiopia; logistic regression used to identify sociodemographic correlates of self‑reported risky sexual behaviour, including pornography exposure.","sample_n":null,"sample_text":"Community based sample; exact N not provided in abstract.","population":"Youth (15‑24 y) from community households in North‑West Ethiopia (sample size not reported in abstract).","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2022 Ethiopian survey found that about one in four youths aged 15‑24 engaged in risky sexual behaviour. Factors linked to higher risk included being older, female, less educated, poorer, having a common mental disorder, and watching pornography.","clinical_takeaway":"Screening for pornography exposure and mental health may help identify youths at increased risk for unsafe sexual practices.","confidence":0.66,"topic_tags":["religiosity","moral_incongruence"],"strengths":["Large community‑based sample covering out‑of‑school youth","Clear statistical reporting of adjusted odds ratios with confidence intervals","Inclusion of multiple socioeconomic and mental‑health covariates"],"limitations":["Cross‑sectional design precludes causal inference","Reliance on single‑item self‑report measures for pornography use and risky behaviour","No assessment of moral/religious attitudes, masturbation, or partner factors"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":14,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0272684x20976519"}},{"id":2426,"doi":"10.1155/2020/8855276","pmid":"33299885","pmcid":"PMC7710405","title":"Prevalence and Factors Associated with Early Sexual Initiation among College Students in Southwest Ethiopia","authors":"Yosef T, Nigussie T, Getachew D, Tesfaye M.","first_author":"Yosef T","journal":"BioMed research international","year":2020,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://downloads.hindawi.com/journals/bmri/2020/8855276.pdf","cited_by_count":25,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 453 college students using stratified sampling and self‑administered questionnaire; logistic regression analysis of factors associated with early sexual initiation.","sample_n":453,"sample_text":"College students in southwest Ethiopia","population":"College students (N=453) in southwest Ethiopia, recruited April–May 2018 via two‑stage stratified sampling.","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2020 Ethiopian survey of 453 college students found that about 18% had their first sexual intercourse before age 18. Early initiation was linked to being female, chewing khat, early exposure to porn, and poor STD knowledge.","clinical_takeaway":"Early sexual debut is common; clinicians should assess substance use, porn exposure and STD knowledge when counseling young adults.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonable sample size for a community survey","Use of stratified sampling to improve representativeness","Clear reporting of adjusted odds ratios with confidence intervals"],"limitations":["Cross‑sectional design cannot infer causality","Reliance on self‑reported age of first sex, subject to recall bias","Key psychosocial confounds (moral attitudes, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":3,"mentioning":25,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2020/8855276"}},{"id":2427,"doi":"10.1080/0092623x.2012.751077","pmid":"23898992","pmcid":null,"title":"Female partners of men who use pornography: are honesty and mutual use associated with relationship satisfaction?","authors":"Resch MN, Alderson KG.","first_author":"Resch MN","journal":"Journal of sex & marital therapy","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 340 female partners recruited online","sample_n":340,"sample_text":"340 female participants completed online questionnaires","population":"female participants in committed relationships, likely convenience sample","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 340 women in steady relationships, those who were more honest about their partner’s porn use reported higher relationship satisfaction and less distress. Disclosing that both partners used porn together was linked to lower distress but not higher satisfaction.","clinical_takeaway":"Encouraging open communication about pornography use may improve relationship satisfaction and reduce distress.","confidence":0.6,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Large (N>300) community sample","Validated relationship satisfaction scale (CSI)","Focus on partner perspective, an understudied angle"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of moral/religious incongruence, mental health, or masturbation","Potential self‑selection bias from online recruitment"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2012.751077"}},{"id":2430,"doi":"10.1016/s0022-3476(05)82680-0","pmid":"2329432","pmcid":null,"title":"Genitalia in human figure drawings: childrearing practices and child sexual abuse","authors":"Hibbard RA, Hartman G.","first_author":"Hibbard RA","journal":"The Journal of pediatrics","year":1990,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of 109 alleged sexual abuse victims and 109 matched controls, using standardized figure‑drawing protocol and PPVT.","sample_n":218,"sample_text":"109 alleged abuse victims and 109 matched comparison children.","population":"Children ages 3‑8 years, alleged sexual abuse victims vs. non‑abused matched peers.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 218 preschool children, those who had been accused of sexual abuse were more likely to draw genitalia in a human figure drawing than matched peers. No link was found between such drawings and child‑rearing practices or medical history.","clinical_takeaway":"Drawing genitalia may be more common among abused children, but it should not be used alone to diagnose abuse.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large matched sample of children","Standardized drawing protocol","Inclusion of cognitive (PPVT) assessment"],"limitations":["Reliance on single‑item drawing outcome, not validated as abuse marker","No measurement of mental‑health or trauma variables as confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-3476(05)82680-0"}},{"id":2431,"doi":"10.1556/2006.2020.00091","pmid":"33216014","pmcid":"PMC8969734","title":"Substitute addictions in the context of the COVID-19 pandemic","authors":"Sinclair DL, Vanderplasschen W, Savahl S, Florence M, Best D, Sussman S.","first_author":"Sinclair DL","journal":"Journal of behavioral addictions","year":2020,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Recovery","Coronavirus","Covid-19","Substitute Addictions"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8969734","cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single individual in South Africa describing increased pornography use during COVID‑19 lockdown as a substitute addiction","sample_n":1,"sample_text":"single illustrative case","population":"Male, middle‑aged, South African, in recovery from another addiction","country":"South Africa","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A South African case report describes a person in recovery who increased pornography use during COVID‑19 lockdown, suggesting it acted as a substitute for previous addictive behavior. The authors warn that such substitute addictions may increase relapse risk.","clinical_takeaway":"Clinicians should monitor for new or increased porn use as a possible substitute addiction during periods of isolation.","confidence":0.8,"topic_tags":["pornography","sexual_function","religiosity","moral_incongruence"],"strengths":["Highlights a novel issue (substitute addictions) during pandemic","Integrates addiction theory with real‑world case"],"limitations":["Single case; no systematic measurement","No validated instruments or controls for key confounds","No quantitative data or statistical analysis"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":1,"mentioning":34,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00091"}},{"id":2432,"doi":"10.1007/s00406-020-01211-1","pmid":"33200241","pmcid":"PMC8236031","title":"A cross-sectional survey of internet use among university students","authors":"Adorjan K, Langgartner S, Maywald M, Karch S, Pogarell O.","first_author":"Adorjan K","journal":"European archives of psychiatry and clinical neuroscience","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Behavior","Internet","Students","Addiction Disorders"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8236031","cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of university students (N≈483 analysed)","sample_n":483,"sample_text":"4391 invited, 10% response, 483 included in analysis","population":"university students (Germany likely)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 483 German university students, about one‑quarter met the authors' criteria for addictive internet use, most often in social networking, browsing, information search, gaming, and pornography. Those with addictive use reported poorer well‑being and were less advanced in their studies.","clinical_takeaway":"High‑frequency internet use, including porn, may be linked to lower well‑being in students, but causal conclusions are premature.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large initial invite pool (4391)","Addresses multiple internet use domains","Provides prevalence estimates for AIU among students"],"limitations":["Low response rate (≈10%) → selection bias","Reliance on possibly non‑validated AIU questionnaire","Cross‑sectional design cannot infer causality","No assessment of key confounds (moral incongruence, mental health, partner factors)"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":6,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00406-020-01211-1"}},{"id":2433,"doi":"10.1016/j.abrep.2020.100311","pmid":"33364319","pmcid":"PMC7752719","title":"Problematic internet use among young and adult population in Bangladesh: Correlates with lifestyle and online activities during the COVID-19 pandemic","authors":"Islam MS, Sujan MSH, Tasnim R, Ferdous MZ, Masud JHB, Kundu S, Mosaddek ASM, Choudhuri MSK, Kircaburun K, Griffiths MD.","first_author":"Islam MS","journal":"Addictive behaviors reports","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Pandemic","Bangladesh","Gaming","Problematic Internet Use","Covid-19","Social Media Use"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.abrep.2020.100311","cited_by_count":69,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online convenience survey of 13,525 Bangladeshi adults, aiming to assess problematic internet use (PIU) and its associations with lifestyle and online activities during COVID‑19.","sample_n":13525,"sample_text":"cross‑sectional online convenience sample","population":"Bangladeshi individuals, 18‑50 y, recruited via online platforms","country":"Bangladesh","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A large online survey in Bangladesh during COVID‑19 found that younger, more educated people reported higher problematic internet use, which was linked to less exercise and more gaming, social media and other online activities, including pornography.","clinical_takeaway":"Elevated internet use during crises may heighten risk for problematic use, but specific sexual‑health implications remain unclear.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample size","Use of a validated PIU scale","Hierarchical regression for multiple predictors"],"limitations":["Cross‑sectional design limits causal inference","Online convenience recruitment may bias sample","Key confounds (moral incongruence, masturbation, mental health) not measured"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":16,"contrasting":4,"mentioning":121,"citing_publications":167,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.abrep.2020.100311"}},{"id":2434,"doi":"10.1017/s0033291720003852","pmid":"33143793","pmcid":null,"title":"The prediction of resilience to alcohol consumption in youths: insular and subcallosal cingulate myeloarchitecture","authors":"Weidacker K, Kim SG, Buhl-Callesen M, Jensen M, Pedersen MU, Thomsen KR, Voon V.","first_author":"Weidacker K","journal":"Psychological medicine","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescent","alcohol consumption","Resilience","Insula","Myeloarchitecture","Longitudinal Relaxation Rate","Subcallosal Cingulate"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Longitudinal cohort of 86 adolescents/young adults with baseline MRI (R1) and AUDIT at 0, 12, 24 months.","sample_n":86,"sample_text":"86 participants (baseline).","population":"Adolescents and young adults (mean age ≈ 22, range 15–27) from a community sample.","country":"Not stated (likely Denmark based on author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 86 young people, higher myelin‑related signals in the insula and subcallosal cingulate at baseline predicted lower alcohol‑related problems two years later, suggesting these brain features may signal resilience to risky drinking.","clinical_takeaway":"Brain myelination patterns could help identify youths at lower risk for future harmful drinking, but more research is needed before clinical use.","confidence":0.8,"topic_tags":["neuroscience","adolescents","moral_incongruence"],"strengths":["Validated measures (AUDIT, MRI R1)","Longitudinal design with 2‑year follow‑up","Whole‑brain correction for multiple comparisons"],"limitations":["Modest MRI sample size for predictive modelling","No explicit control for mental‑health or trauma variables","No pre‑registration or replication cohort"],"rubric_version":"2.0","raw_total":39,"max_possible":60,"pct_score":65,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":6,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0033291720003852"}},{"id":2435,"doi":"10.1080/13691058.2013.802013","pmid":"23782270","pmcid":null,"title":"Pornography consumption and non-marital sexual behaviour in a sample of young Indonesian university students","authors":"Hald GM, Mulya TW.","first_author":"Hald GM","journal":"Culture, health & sexuality","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of Indonesian university students (convenience sample)","sample_n":null,"sample_text":"University students (young adult, likely N>100 but not specified)","population":"young Indonesian university students","country":"Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among Indonesian university students, porn use is common and, for men, is linked to higher rates of non‑marital sexual activity, but the study cannot show that porn causes those behaviours.","clinical_takeaway":"Clinicians should note that porn use correlates with sexual behaviour in this group, but no causal link is established.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Provides prevalence data from a Muslim‑majority, conservative context","First study of its kind in Indonesia","Sex‑disaggregated analysis of consumption patterns"],"limitations":["Cross‑sectional design cannot infer causality","Reliance on single‑item self‑report measures","No control for moral, mental‑health or partner variables"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":4,"contrasting":0,"mentioning":51,"citing_publications":77,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2013.802013"}},{"id":2436,"doi":"10.3390/ijerph17218042","pmid":"33142818","pmcid":"PMC7663141","title":"Development and Validation of the Adolescent Sexting Scale (A-SextS) with a Spanish Sample","authors":"Molla Esparza C, Nájera P, López-González E, Losilla JM.","first_author":"Molla Esparza C","journal":"International journal of environmental research and public health","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Review","Journal Article"],"keywords":["Measurement","Definition","Validation","Adolescents","Sexting"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7663141","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation of a new self‑report scale in 579 Spanish adolescents, cross‑sectional survey","sample_n":579,"sample_text":"large community sample of adolescents","population":"Spanish secondary school pupils, ages 11‑18 (N=579)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a 64‑item questionnaire (A‑SextS) to measure how teenagers engage in sexting. Tested on 579 Spanish youths, the scale showed good validity and correlated with porn use and sexual activity.","clinical_takeaway":"A validated tool is now available for researchers and clinicians to assess sexting behaviours in adolescents.","confidence":0.84,"topic_tags":["measurement","sexual_function","adolescents"],"strengths":["Large sample for scale development","Comprehensive validation (face, content, concurrent, criterion)","Clear item generation process"],"limitations":["Cross‑sectional; no test‑retest reliability reported","No examination of moral, mental‑health or partner factors","Limited to Spanish adolescents – cultural generalisability unknown"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph17218042"}},{"id":2437,"doi":"10.1007/s10508-013-0116-y","pmid":"23733153","pmcid":null,"title":"United States women and pornography through four decades: exposure, attitudes, behaviors, individual differences","authors":"Wright PJ, Bae S, Funk M.","first_author":"Wright PJ","journal":"Archives of sexual behavior","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":75,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative survey of U.S. women (N=18,225) covering 1973‑2010; analyses of pornography exposure, attitudes, and sexual behaviors.","sample_n":18225,"sample_text":"Nationally representative probability sample (U.S. women) across four decades.","population":"U.S. women, ages adolescent to older adult, diverse racial/ethnic groups","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using data from over 18,000 U.S. women collected between 1973 and 2010, the study found that younger, less religious, and non‑White women were more likely to view pornography. Pornography exposure was linked to more permissive sexual attitudes and higher numbers of sexual partners, especially among politically liberal women.","clinical_takeaway":"Pornography exposure correlates with broader sexual behavior patterns, but no causal claim can be made; clinicians should consider broader social and individual factors.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Very large, nationally representative sample","Longitudinal span (four decades) allows trend analysis","Multiple sexual‑behavior outcomes examined"],"limitations":["Reliance on single‑item self‑report of pornography use","No measurement of masturbation or moral incongruence","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":8,"contrasting":1,"mentioning":94,"citing_publications":176,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0116-y"}},{"id":2438,"doi":"10.1007/s00414-013-0875-y","pmid":"23728308","pmcid":null,"title":"The juvenile face as a suitable age indicator in child pornography cases: a pilot study on the reliability of automated and visual estimation approaches","authors":"Ratnayake M, Obertová Z, Dose M, Gabriel P, Bröker HM, Brauckmann M, Barkus A, Rizgeliene R, Tutkuviene J, Ritz-Timme S, Marasciuolo L, Gibelli D, Cattaneo C.","first_author":"Ratnayake M","journal":"International journal of legal medicine","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation of visual and automated age‑estimation methods on 50 facial images of females aged 10‑19 years","sample_n":50,"sample_text":"50 frontal facial images","population":"images of 50 females (10‑19 y) from Germany, Italy, Lithuania","country":"Germany, Italy, Lithuania (image sources)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested a new computer program and expert visual rating to guess ages from faces in images. Both methods estimated ages within about 1½ years, even when image quality was low, suggesting they could help identify juveniles in child‑pornography investigations.","clinical_takeaway":"None – the work is forensic, not clinical, and does not inform treatment or health advice.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Innovative automated tool for rapid screening","Direct comparison with expert human raters","Quantitative error metric (MAE) reported"],"limitations":["Small pilot sample (n=50)","Only female faces, limited age range","No external validation on real case material"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":28,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00414-013-0875-y"}},{"id":2439,"doi":"10.1556/jba.2.2013.002","pmid":"26165929","pmcid":null,"title":"Cybersex addiction: Experienced sexual arousal when watching pornography and not real-life sexual contacts makes the difference","authors":"Laier C, Pawlikowski M, Pekal J, Schulte FP, Brand M.","first_author":"Laier C","journal":"Journal of behavioral addictions","year":2013,"pub_types":["Journal Article"],"keywords":["Craving","Sexual Arousal","Internet Addiction","Pathological Internet Use","Cybersex"],"is_oa":false,"oa_url":null,"cited_by_count":80,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Cue‑reactivity lab experiment with a freely recruited sample (N=171) and a small case‑control comparison (25 vs 25). Cross‑sectional, no longitudinal or randomisation.","sample_n":221,"sample_text":"171 participants in Study 1; 25 healthy and 25 problematic users in Study 2.","population":"heterosexual male adults, recruited via open call; no indication of clinical or treatment‑seeking sample.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","underpowered_sample","circular_addiction_scale"],"stance":"supports","citation_value":"useful","plain_summary":"In a lab study, men who reported more problems with cybersex showed stronger sexual arousal and craving when shown pornographic pictures. Real‑life sexual contact did not explain these differences, suggesting that the reward from online sex may drive problematic use.","clinical_takeaway":"Higher cue‑induced arousal and craving may signal risk for problematic cybersex; clinicians should assess craving responses, not just relationship factors.","confidence":0.7,"topic_tags":["pornography","sexual_function","prevalence","gender","treatment"],"strengths":["Experimental cue‑reactivity paradigm","Relatively large initial sample (N=171)","Direct measurement of arousal and craving responses"],"limitations":["Reliance on self‑report scales, unclear validation","No control for moral, mental‑health or relationship variables","Small case‑control sample (25 per group) limits power","Addiction construct defined without clear ICD‑11/DSM criteria"],"rubric_version":"2.0","raw_total":27,"max_possible":60,"pct_score":45,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":14,"contrasting":1,"mentioning":112,"citing_publications":210,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/jba.2.2013.002"}},{"id":2440,"doi":"10.1016/j.jpag.2013.03.011","pmid":"23683822","pmcid":null,"title":"Consumption of pornographic materials in early adolescents in Hong Kong","authors":"Ma CM, Shek DT.","first_author":"Ma CM","journal":"Journal of pediatric and adolescent gynecology","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Three‑wave longitudinal survey of 3,325 secondary‑1 students in Hong Kong (grade 7, mean age 12.6).","sample_n":3325,"sample_text":"Large community sample; school‑based recruitment; not treatment‑seeking.","population":"Early adolescents (≈12‑13 y) from 28 schools in Hong Kong; both sexes.","country":"Hong Kong","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A three‑year survey of over 3,000 Hong Kong 12‑year‑olds found that many accessed porn online, especially boys, and that stronger family ties and positive youth traits were linked to lower use.","clinical_takeaway":"Promoting family functioning and positive youth development may help reduce early adolescent porn exposure.","confidence":0.7,"topic_tags":["pornography","adolescents","prevalence","sexual_function"],"strengths":["Large, multi‑school sample","Three‑wave longitudinal design","Focus on family and youth‑development correlates"],"limitations":["Consumption measured with simple self‑report item; no validated scale","No control for moral‑incongruence, masturbation, mental health or trauma","Effect sizes and statistical corrections not reported in abstract"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":0,"mentioning":23,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpag.2013.03.011"}},{"id":2441,"doi":"10.1007/s11920-013-0362-7","pmid":"23636986","pmcid":null,"title":"Pornography, sex crime, and paraphilia","authors":"Fisher WA, Kohut T, Di Gioacchino LA, Fedoroff P.","first_author":"Fisher WA","journal":"Current psychiatry reports","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of observational and laboratory studies linking pornography to sexual aggression and paraphilic interests; no new empirical data collected.","sample_n":null,"sample_text":"No primary sample; review summarizes existing studies","population":"Adults (general population and offender samples discussed in cited literature)","country":"International (review of literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review examines research on whether pornography leads to sexual aggression or paraphilic interests. Lab studies show violent porn can increase short‑term aggression, but real‑world data often show no link or even a negative association. The authors stress that many other factors influence violent behavior.","clinical_takeaway":"Clinicians should consider pornography as one of many factors influencing sexual aggression, not a sole cause.","confidence":0.5,"topic_tags":["pornography","sexual_function"],"strengths":["Comprehensive overview of multiple study types","Balances laboratory and field findings","Highlights need for clinical judgment"],"limitations":["Narrative (non‑systematic) review; no formal risk‑of‑bias assessment","No quantitative synthesis or meta‑analysis","Lacks explicit measurement definitions for key constructs"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":0,"mentioning":30,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11920-013-0362-7"}},{"id":2442,"doi":"10.1016/j.jadohealth.2020.08.027","pmid":"33039273","pmcid":"PMC7683377","title":"\"Physical Sex Is Over for Now\": Impact of COVID-19 on the Well-Being and Sexual Health of Adolescent Sexual Minority Males in the U.S","authors":"Nelson KM, Gordon AR, John SA, Stout CD, Macapagal K.","first_author":"Nelson KM","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2020,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Mental health","Adolescents","Sexual Health","Sexual Minority","Asmm","Ymsm","Covid-19"],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["masturbation","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online baseline survey of a sexual health intervention trial; convenience sample of 151 US adolescent sexual minority males; mixed‑methods (quantitative closed‑ended items + open‑ended qualitative responses); no longitudinal follow‑up","sample_n":151,"sample_text":"Convenience sample recruited for a sexual health intervention trial; not nationally representative","population":"Adolescent sexual minority males, ages 14‑17, United States (N = 151)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 151 U.S. teenage gay and bisexual males found that during early COVID‑19 lockdowns they saw partners less, but masturbated and watched porn more, and felt worse mentally. Their level of openness about sexuality with a supportive guardian did not change these patterns.","clinical_takeaway":"Clinicians should anticipate increased solo sexual activity and mental‑health strain among adolescent sexual‑minority males during pandemics or similar disruptions.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation","adolescents"],"strengths":["Timely data on COVID‑19 impacts for a vulnerable youth group","Mixed‑methods approach provides qualitative depth","Includes both sexual behavior and mental‑health context"],"limitations":["Convenience sample limits generalizability","Reliance on single‑item self‑reports; no validated scales","No control for moral or mental‑health confounders"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":8,"contrasting":4,"mentioning":51,"citing_publications":77,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2020.08.027"}},{"id":2443,"doi":"10.3389/fpsyg.2020.602857","pmid":"33123065","pmcid":"PMC7573291","title":"Corrigendum: The Neurosciences of Health Communication: An fNIRS Analysis of Prefrontal Cortex and Porn Consumption in Young Women for the Development of Prevention Health Programs","authors":"Cuesta U, Niño JI, Martinez L, Paredes B.","first_author":"Cuesta U","journal":"Frontiers in psychology","year":2020,"pub_types":["Published Erratum","correction"],"keywords":["Neuroscience","Addiction","Health Communication","Brodmann Area","Pornography","Fnris","Health Prevention Campaigns","Neuro Communications"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7573291","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2020.602857"}},{"id":2444,"doi":"10.1080/0092623x.2012.710182","pmid":"23577795","pmcid":null,"title":"Dirty habits? Online pornography use, personality, obsessionality, and compulsivity","authors":"Egan V, Parmar R.","first_author":"Egan V","journal":"Journal of sex & marital therapy","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 226 male participants assessing personality traits, obsessionality, and self‑reported Internet pornography use","sample_n":226,"sample_text":"226 male participants","population":"male adults (young adult to middle‑aged)","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 226 men and found that certain personality traits (high neuroticism, low agreeableness and conscientiousness) and obsessive‑checking tendencies were linked to higher self‑reported use of online pornography, suggesting a general tendency toward compulsive behaviour.","clinical_takeaway":"Consider broader compulsivity traits when assessing problematic pornography use; no specific addiction diagnosis is warranted from this data alone.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Reasonably large sample for a survey","Examines personality and compulsivity dimensions beyond simple frequency"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of key confounds (moral incongruence, masturbation, mental health, relationship factors)","Compulsive‑use construct appears derived from ad‑hoc latent factor rather than validated addiction scale"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":11,"contrasting":1,"mentioning":55,"citing_publications":98,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2012.710182"}},{"id":2445,"doi":null,"pmid":"32994631","pmcid":null,"title":"The association between New Zealand adolescents' normative perceptions of pornography use and their frequency of pornography use","authors":"Scarf D, Riordan B, Winter T.","first_author":"Scarf D","journal":"The New Zealand medical journal","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":2446,"doi":"10.1016/j.cpr.2020.101925","pmid":"33038740","pmcid":null,"title":"Sexual addiction 25 years on: A systematic and methodological review of empirical literature and an agenda for future research","authors":"Grubbs JB, Hoagland KC, Lee BN, Grant JT, Davison P, Reid RC, Kraus SW.","first_author":"Grubbs JB","journal":"Clinical psychology review","year":2020,"pub_types":["Systematic Review","Journal Article"],"keywords":["Sexual Addiction","Hypersexuality","Behavioral Addiction","Pornography Addiction","Compulsive Sexual Behavior Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":133,"is_preprint":false,"topics":["bibliography","csbd","pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of empirical literature (1995‑2020) focusing on compulsive sexual behavior research","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review examined 371 papers on compulsive sexual behavior from 1995‑2020. It finds a rapid growth in research but notes that most studies use simple designs, lack solid theoretical grounding, and employ poor‑quality measures, especially for treatment outcomes.","clinical_takeaway":"Current evidence on sexual addiction is methodologically weak; clinicians should be cautious interpreting prevalence or treatment efficacy claims.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive coverage of 371 papers","Systematic methodology clearly described","Identifies major gaps in measurement quality","Provides a clear agenda for future research"],"limitations":["No quantitative meta‑analysis","Relies on authors' quality ratings without external validation","Limited discussion of moral incongruence or other confounds","No preregistration of review protocol"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":2,"mentioning":274,"citing_publications":261,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.cpr.2020.101925"}},{"id":2447,"doi":null,"pmid":"952631","pmcid":null,"title":"The need for psychosexual counselling in family planning practice","authors":"Black JS.","first_author":"Black JS.","journal":"Australian family physician","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review arguing for psychosexual counselling in family planning; no empirical data, no systematic methods.","sample_n":null,"sample_text":"Not applicable – no primary data collected.","population":"health professionals and patients in family planning settings (implicit)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that family planning clinics should include psychosexual counselling, offering examples of how to integrate sexual history taking and counseling into routine care.","clinical_takeaway":"Clinicians may consider adding psychosexual counseling to family planning services, but evidence of its effectiveness is lacking.","confidence":0.3,"topic_tags":["csbd"],"strengths":["Highlights multidisciplinary nature of psychosexual counselling","Provides illustrative examples for practitioners"],"limitations":["No empirical data or systematic review methodology","No measurement of outcomes or effectiveness","Potential advocacy bias without critical appraisal"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":2448,"doi":"10.1177/1524838020958057","pmid":"32930064","pmcid":null,"title":"The Prevalence of Technology-Facilitated Sexual Violence: A Meta-Analysis and Systematic Review","authors":"Patel U, Roesch R.","first_author":"Patel U","journal":"Trauma, violence & abuse","year":2022,"pub_types":["Meta-Analysis","Systematic Review","Journal Article"],"keywords":["Sexual Violence","Revenge Pornography","Image-based Sexual Abuse","Technology-facilitated Sexual Violence","Nonconsensual Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":65,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"systematic review and random‑effects meta‑analysis of prevalence studies","sample_n":32247,"sample_text":"19 articles (20 independent samples) reporting prevalence rates","population":"adolescents and adults (N≈32,247 across 20 samples)","country":"multiple (international literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 19 studies (over 32,000 people) found that about 9% have had private sexual images shared without consent, and 12% have shared such images themselves. Victims also report higher anxiety and depression.","clinical_takeaway":"Clinicians should screen for non‑consensual image sharing, as it is relatively common and linked to mental‑health distress.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large pooled sample across many studies","Systematic search across multiple databases","Random‑effects model accounts for heterogeneity"],"limitations":["Potential publication bias not addressed in abstract","Limited control of confounding variables in primary studies","Qualitative mental‑health synthesis lacks quantitative rigor"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":8,"contrasting":1,"mentioning":123,"citing_publications":176,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1524838020958057"}},{"id":2449,"doi":"10.1556/2006.2020.00059","pmid":"32903206","pmcid":"PMC8943673","title":"Event-related potentials in a two-choice oddball task of impaired behavioral inhibitory control among males with tendencies towards cybersex addiction","authors":"Wang J, Dai B.","first_author":"Wang J","journal":"Journal of behavioral addictions","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Event-related potentials","N2","P3","Cybersex Addiction","Behavioral Inhibitory Control"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/9/3/article-p785.pdf","cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control ERP experiment with 36 TCA males vs 36 healthy controls","sample_n":72,"sample_text":"Thirty‑six individuals with tendencies towards cybersex addiction and 36 healthy controls","population":"young adult males, n=72 total","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an EEG task, men who report cybersex‑addiction tendencies showed slower reactions and smaller brain responses (N2, P3) to pornographic images compared with controls, suggesting weaker inhibitory control.","clinical_takeaway":"ERP differences hint at impulsivity in self‑identified cybersex‑addicted users, but lack of diagnostic criteria limits direct clinical use.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","neuroscience","csbd"],"strengths":["EEG provides temporal precision","matched control group","use of both behavioral and neural indices"],"limitations":["No measurement of moral/religious conflict","Addiction status inferred from self‑report without criteria testing","Small sample limits generalisability","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":31,"max_possible":70,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":6,"statistics":5,"confounds":2,"design":4,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":6,"contrasting":1,"mentioning":32,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00059"}},{"id":2450,"doi":"10.1371/journal.pone.0238761","pmid":"32881946","pmcid":"PMC7470332","title":"A cross-sectional study of psychological wellbeing of Indian adults during the Covid-19 lockdown: Different strokes for different folks","authors":"Sharma AJ, Subramanyam MA.","first_author":"Sharma AJ","journal":"PloS one","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7470332","cited_by_count":32,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"mixed methods cross‑sectional survey (n=282) with qualitative interviews (n=14)","sample_n":282,"sample_text":"online convenience sample of Indian adults (n=282) plus 14 in‑depth interviews","population":"Indian adults, including LGBT and high‑risk health groups","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 282 Indian adults during the COVID‑19 lockdown, LGBT participants reported higher anxiety and used porn more often than heterosexuals. The authors suggest porn and masturbation were coping tools when physical partners were unavailable.","clinical_takeaway":"Clinicians should note that increased porn use may be a coping response for LGBT clients during lockdowns, not necessarily a sign of pathology.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large (for a survey) mixed‑methods design","Both quantitative and qualitative data","Adjusted regression analyses with confidence intervals"],"limitations":["Convenience online sample, not representative","Pornography use measured by a single self‑report item","No measurement/control of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":38,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0238761"}},{"id":2452,"doi":null,"pmid":"32890385","pmcid":null,"title":"Real or Virtual Relationships: Does It Matter to Teens?","authors":"Jassogne C, Zdanowicz N.","first_author":"Jassogne C","journal":"Psychiatria Danubina","year":2020,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Literature review of 25 articles, not systematic, no explicit methods for bias assessment.","sample_n":null,"sample_text":"No original participants; review of existing literature.","population":"Adolescents (teenagers) discussed in cited studies; no original sample.","country":"Romania (journal); primary studies from multiple locations.","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed 25 studies on teen use of social networks, noting that online identity‑building, peer approval, and limited family support drive use. They suggest that exposure to pornography may be linked to weaker family and peer attachments, but evidence is drawn from other papers rather than new data.","clinical_takeaway":"None – the article is a narrative review without original findings to guide clinical practice.","confidence":0.7,"topic_tags":["adolescents","sexual_function","pornography","relationships"],"strengths":["Broad range of sources (PubMed, Scopus, PsychINFO, Cochrane).","Considers developmental context of adolescence."],"limitations":["Non‑systematic narrative review; no risk‑of‑bias assessment.","No original data; cannot evaluate measurement validity.","Lacks control for key confounds (moral incongruence, mental health, etc.)."],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":2454,"doi":"10.1097/grf.0000000000000522","pmid":"32028296","pmcid":null,"title":"The Adolescent and Genital Dissatisfaction","authors":"Michala L.","first_author":"Michala L.","journal":"Clinical obstetrics and gynecology","year":2020,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review (narrative) discussing genital dissatisfaction in adolescents, citing cultural trends and pornography as contextual factors but providing no original data.","sample_n":null,"sample_text":"No empirical sample; review of existing literature.","population":"Adolescent girls/young women (no specific sample reported)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review notes that more teenage girls are unhappy with the appearance of their genitals, partly because of cultural trends and porn images that show a narrow ideal. It suggests better education about natural variation and counseling for distressed youths.","clinical_takeaway":"Clinicians should address genital body image concerns and counter unrealistic porn‑derived expectations during adolescent sexual‑health counselling.","confidence":0.7,"topic_tags":["gender","adolescents","sexual_function","pornography"],"strengths":["Highlights an emerging public‑health concern","Integrates cultural and media influences on body image"],"limitations":["No original data; relies on secondary sources","No systematic method or risk‑of‑bias assessment","No measurement of key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/grf.0000000000000522"}},{"id":2456,"doi":"10.1097/ju.0000000000001257.02","pmid":"32821019","pmcid":null,"title":"Re: Is Pornography Use Related to Erectile Functioning? Results from Cross-Sectional and Latent Growth Curve Analyses","authors":"Elliott SP.","first_author":"Elliott SP.","journal":"The Journal of urology","year":2020,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/ju.0000000000001257.02"}},{"id":2458,"doi":"10.1177/1059840520947142","pmid":"32757810","pmcid":null,"title":"Exploring Health Behaviors in Ugandan Adolescents Living in Rural Fishing Communities","authors":"Ngabirano TD, Saftner MA, McMorris BJ.","first_author":"Ngabirano TD","journal":"The Journal of school nursing : the official publication of the National Association of School Nurses","year":2022,"pub_types":["Journal Article"],"keywords":["Adolescent","Risk behavior","Global Health","Hiv Transmission","School Nursing","Fishing Villages"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"exploratory cross‑sectional survey of adolescents (13‑19) in four Ugandan fishing villages; convenience sampling; descriptive statistics reported","sample_n":null,"sample_text":"not reported in abstract","population":"Ugandan adolescents (13‑19) in rural fishing communities; both sexes; likely school‑based sample","country":"Uganda","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of teenagers in Ugandan fishing villages found that many had had sex, with girls starting earlier and reporting more assault. Those who were sexually active also reported having seen pornography and using alcohol. The authors suggest schools could help with health education.","clinical_takeaway":"Screen Ugandan adolescents for sexual activity, porn exposure, and alcohol use; consider school‑based health promotion.","confidence":0.6,"topic_tags":["adolescents","religiosity","sexual_function","pornography"],"strengths":["Addresses understudied rural Ugandan adolescent population","Includes gender‑specific findings on sexual debut and assault","Identifies potential role for school nurses in health promotion"],"limitations":["Cross‑sectional, cannot infer causality","Convenience sample, limited generalisability","No validated measures of pornography use or sexual health outcomes","Key confounders (moral attitudes, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":16,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1059840520947142"}},{"id":2459,"doi":"10.7334/psicothema2019.349","pmid":"32711665","pmcid":null,"title":"Characteristics and risk factors in juvenile sexual offenders","authors":"Siria S, Echeburúa E, Amor PJ.","first_author":"Siria S","journal":"Psicothema","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive study of 73 sentenced juvenile sexual offenders using court records, self‑reports and interviews.","sample_n":73,"sample_text":"73 adolescents serving a sentence for sexual offences.","population":"Adolescent males (14‑18 y) who have committed sexual offences in Spain (N = 73).","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examined 73 teenage boys in Spain who had committed sexual offences, finding that early exposure to pornography, family sexualisation, and childhood victimisation were common risk factors.","clinical_takeaway":"Early porn exposure may be a risk marker, but causal links are unclear; clinicians should assess broader psychosocial factors.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Focus on a scarcely studied Spanish juvenile offender population","Multiple data sources (records, self‑report, interviews)","Identifies early pornography exposure as a frequent factor"],"limitations":["Cross‑sectional, descriptive design limits causal inference","Key constructs measured with ad‑hoc items, low construct validity","Limited control for major confounds (moral incongruence, mental health, partner effects)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":1,"mentioning":9,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7334/psicothema2019.349"}},{"id":2460,"doi":"10.2147/rmhp.s254685","pmid":"32801968","pmcid":"PMC7402857","title":"Does Youth-Friendly Service Intervention Reduce Risky Sexual Behavior in Unmarried Adolescents? A Comparative Study in West Gojjam Zone, Northwest Ethiopia","authors":"Mekonnen Munea A, Alene GD, Debelew GT.","first_author":"Mekonnen Munea A","journal":"Risk management and healthcare policy","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Risky Sexual Behavior","Parent–adolescent Communication","Youth-friendly Services"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7402857","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"community-based comparative cross‑sectional survey of 1,125 randomly selected unmarried adolescents in Ethiopia, comparing YFS programme and non‑programme areas.","sample_n":1125,"sample_text":"545 from programme areas and 580 from non‑programme areas","population":"Unmarried adolescents, West Gojjam Zone, Northwest Ethiopia (N=1125)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A community survey of 1,125 Ethiopian adolescents found similar levels of risky sexual behaviour in areas with and without youth‑friendly services. Communication between parents and teens was linked to lower risk, while factors like age, gender, school status and watching porn increased risk.","clinical_takeaway":"Boosting parent‑adolescent communication may be more effective than youth‑friendly clinics for reducing risky sexual behaviour.","confidence":0.85,"topic_tags":["relationships","sexual_function"],"strengths":["Large, randomly selected community sample","Use of hierarchical logistic regression with confidence intervals","Focus on parent‑adolescent communication as modifiable factor"],"limitations":["Cross‑sectional design limits causal inference","Questionnaire not reported as validated for key constructs","No measurement of key sexual health confounds (mental health, moral incongruence, trauma)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/rmhp.s254685"}},{"id":2461,"doi":"10.1111/bjhp.12461","pmid":"32735366","pmcid":"PMC7611959","title":"A qualitative examination of affect and ideology within mass media interventions to increase HIV testing with gay men garnered from a systematic review","authors":"Langdridge D, Flowers P, Riddell J, Boydell N, Teal G, Coia N, McDaid L.","first_author":"Langdridge D","journal":"British journal of health psychology","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Systematic Review","Journal Article"],"keywords":["Affect","Hiv Testing","Men Who Have Sex With Men","Behaviour Change Techniques","Intervention Content"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7611959","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative thematic analysis of 69 intervention materials identified via a systematic review; no primary data collection; no quantitative outcomes.","sample_n":null,"sample_text":"69 intervention materials (media content) examined.","population":"Mass‑media intervention content aimed at MSM for HIV testing; no human participants directly assessed.","country":"United Kingdom (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined 69 media campaigns meant to boost HIV testing among gay men, using a new visual‑analysis method. They found four main emotional/ideological themes, including a ‘pornographication’ of gay bodies, romance narratives, fear, and muted affect. This helps understand how such campaigns convey messages.","clinical_takeaway":"None – the study does not provide evidence for clinical practice regarding pornography or sexual health.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Systematic identification of intervention materials","Innovative semiotic approach to content analysis","Identifies affective themes previously unexamined"],"limitations":["No primary behavioural data; conclusions limited to material description","Lacks quantitative assessment of impact on testing outcomes","No assessment of confounding psychosocial factors"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/bjhp.12461"}},{"id":2462,"doi":"10.3389/fpsyg.2020.01782","pmid":"32849054","pmcid":"PMC7411128","title":"Reactions to Problematic Internet Use Among Adolescents: Inappropriate Physical and Mental Health Perspectives","authors":"Chao CM, Kao KY, Yu TK.","first_author":"Chao CM","journal":"Frontiers in psychology","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Mental health","Problematic Internet Use","Community Bond","Inappropriate Physical And Mental Health","Structure Equation Model (Sem)"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01782/pdf","cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 5,211 adolescents from 60 senior high schools in Taiwan; self‑report questionnaires; structural equation modeling","sample_n":5211,"sample_text":"5,211 respondents from 60 senior high schools (convenience sample)","population":"adolescents (high‑school students) in Taiwan","country":"Taiwan","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 5,200 Taiwanese high‑school students found that experiences such as cyberbullying, exposure to online pornography, and internet fraud were linked to higher problematic internet use, and that community ties could lessen some of these effects.","clinical_takeaway":"Screen for cyberbullying and online pornography exposure when assessing adolescent internet problems, but note that causal claims are not proven.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample size","Use of structural equation modeling to test complex relationships","Inclusion of multiple internet‑related risk factors"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report measures of pornography exposure and PIU","No assessment of moral incongruence or other key confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2020.01782"}},{"id":2463,"doi":"10.1016/j.jflm.2020.102031","pmid":"32763764","pmcid":null,"title":"Psychopathology, psychosocial factors and sexuality of incarcerated sexual offenders in Greek prison","authors":"Bismpas L, Athanasiadis L, Papathanasiou N, Papadopoulos D, Konsta A, Diakogiannis I.","first_author":"Bismpas L","journal":"Journal of forensic and legal medicine","year":2020,"pub_types":["Journal Article"],"keywords":["Sexuality","Psychopathology","Convicted Sex Offenders","Factors Of Deviation"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Quantitative descriptive and inferential study of 127 male sexual offenders incarcerated in a Greek prison; self‑report questionnaires on psychopathology, childhood trauma, sexual behaviour, and substance use.","sample_n":127,"sample_text":"Convenience sample of incarcerated individuals; not representative of all sexual offenders.","population":"Male sexual offenders (n=127) in a single Greek prison","country":"Greece","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A study of 127 Greek male sexual offenders found mixed levels of anxiety, depression and personality traits, high childhood abuse, and changes in sexual desire, masturbation and porn use while incarcerated. Masturbation was the main sexual activity in prison.","clinical_takeaway":"Prison‑based sexual health programs should address anxiety, trauma history and the shift toward solitary sexual activity.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Validated psychometric tools for anxiety, depression, personality","Reliability reported for all scales","Large (for prison research) sample of 127 participants"],"limitations":["Cross‑sectional, cannot infer causality","Single prison, not generalizable to broader offender populations","No measurement of moral/religious incongruence despite distress outcomes","Ad‑hoc sexual behavior questionnaire lacks external validation"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jflm.2020.102031"}},{"id":2464,"doi":"10.4103/jehp.jehp_242_19","pmid":"33015204","pmcid":"PMC7497130","title":"Techno stress among medical freshmen: An exploratory study","authors":"Madaan N, Wundavalli L, Satapathy S.","first_author":"Madaan N","journal":"Journal of education and health promotion","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Stress","Internet","Social Media","Perceived Stress Scale","First Year Medical Students","Techno Stress"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7497130","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"exploratory cross‑sectional survey of 61 first‑year medical students using a semi‑structured questionnaire and the Perceived Stress Scale","sample_n":61,"sample_text":"All freshmen at a single medical institute (convenience sample)","population":"medical freshmen (N=61, 68% male, mean age 18.3)","country":"India (inferred from author names/institution)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 61 first‑year medical students found that nearly half had viewed pornography and about 12% showed signs of problematic internet use, which was linked to higher perceived stress.","clinical_takeaway":"High internet use, including pornography, may contribute to stress among medical students; educators should monitor and guide healthy technology habits.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Use of validated Perceived Stress Scale","First study of techno stress in medical freshmen","Clear descriptive statistics of technology use"],"limitations":["Small, single‑institution convenience sample","Problematic internet use measured with non‑validated items","No control for major confounds (moral views, mental health, etc.)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/jehp.jehp_242_19"}},{"id":2465,"doi":"10.1371/journal.pone.0235889","pmid":"32701974","pmcid":"PMC7377422","title":"Prospective associations between internet use and poor mental health: A population-based study","authors":"Mars B, Gunnell D, Biddle L, Kidger J, Moran P, Winstone L, Heron J.","first_author":"Mars B","journal":"PloS one","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0235889&type=printable","cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Prospective cohort within the ALSPAC birth cohort (N=1,431) assessing internet use at age 18 and mental health outcomes at ages 21‑22.","sample_n":1431,"sample_text":"1,431 respondents","population":"UK adolescents/young adults (general population birth cohort).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a UK birth cohort, higher internet use and certain online experiences (like being bullied or seeing pornography) were linked to later depression and self‑harm, especially for females. The study suggests teaching young people safer online habits.","clinical_takeaway":"Screen for problematic online experiences, including exposure to sexual content, when assessing adolescent mental health.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Large, population‑based birth cohort","Prospective design allows temporal ordering","Separate analysis by gender"],"limitations":["Reliance on self‑reported internet use and mental‑health outcomes","Limited description of covariate adjustment","No measurement of key sexual‑behavior confounds (e.g., masturbation, moral incongruence)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":33,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0235889"}},{"id":2466,"doi":"10.4081/jphr.2020.1795","pmid":"32874965","pmcid":"PMC7445439","title":"Early sexual debut and associated factors among students in Ethiopia: A systematic review and meta-analysis","authors":"Mekonnen BD.","first_author":"Mekonnen BD.","journal":"Journal of public health research","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Meta-analysis","Students","Systematic review","Ethiopia","Early Sexual Debut"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7445439","cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"meta-analysis of 9 cross‑sectional student studies (N=4,217) estimating prevalence of early sexual debut and its correlates.","sample_n":4217,"sample_text":"9 primary studies, total N=4,217","population":"students in Ethiopia","country":"Ethiopia","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of Ethiopian student studies found that about 28% had sex before age 18. Watching pornography, being female, and having a boyfriend/girlfriend were linked to earlier sexual debut, suggesting a need for school‑based prevention.","clinical_takeaway":"Consider addressing pornography exposure and relationship dynamics in programs aimed at delaying sexual debut among students.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Systematic review with transparent search strategy","Quantitative synthesis using random‑effects meta‑analysis","Clear reporting of pooled prevalence and odds ratios"],"limitations":["Primary studies likely cross‑sectional and convenience‑sampled","Key psychosocial confounds (e.g., moral incongruence, mental health) not addressed","No pre‑registration of the review protocol reported"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":1,"mentioning":12,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4081/jphr.2020.1795"}},{"id":2467,"doi":"10.1016/j.psc.2012.08.004","pmid":"23107565","pmcid":null,"title":"Child pornography and the internet","authors":"Temporini H.","first_author":"Temporini H.","journal":"The Psychiatric clinics of North America","year":2012,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methods; no primary data reported.","sample_n":null,"sample_text":"Not applicable – review of existing literature.","population":"Offenders possessing child pornography; no sample size reported.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how the internet has increased access to child pornography, describes the varied motivations of offenders, and notes that merely possessing such material does not necessarily predict future contact offenses.","clinical_takeaway":"None - the review does not provide actionable clinical guidance for adult sexual health.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Summarizes recent trends in child pornography availability.","Highlights heterogeneity of offenders."],"limitations":["No systematic methodology reported.","No empirical data or quantitative analysis.","Lacks discussion of potential confounding factors."],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psc.2012.08.004"}},{"id":2468,"doi":"10.1007/s10508-012-0033-5","pmid":"23179237","pmcid":null,"title":"Characteristics of pornography film actors: self-report versus perceptions of college students","authors":"Griffith JD, Hayworth M, Adams LT, Mitchell S, Hart C.","first_author":"Griffith JD","journal":"Archives of sexual behavior","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey comparing self‑reports from 282 adult‑film actors with perceptions of 399 college students; convenience samples.","sample_n":681,"sample_text":"282 porn actors (105 male, 177 female) and 399 college students.","population":"Adult‑film actors (male and female) and college students (U.S. likely).","country":"USA (presumed from author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study asked 282 porn actors about their own lives and compared those answers to what 399 college students think porn actors are like. Students tended to underestimate actors' self‑esteem, sexual experience, and risky behaviours, and overestimate their earnings. Actors' reports of childhood abuse matched general‑population rates.","clinical_takeaway":"Stereotypes about porn actors are often inaccurate; clinicians should avoid assuming higher risk behaviours based solely on industry affiliation.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large combined sample size for a niche population.","Direct comparison of self‑report vs external perceptions.","Addresses a gap in empirical data on adult‑film actors."],"limitations":["Convenience sampling; not representative of all porn actors or students.","Reliance on ad‑hoc self‑report items; limited validation.","Cross‑sectional; cannot infer causality."],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-012-0033-5"}},{"id":2469,"doi":"10.1080/00224499.2012.716873","pmid":"23167900","pmcid":null,"title":"Pornographic picture processing interferes with working memory performance","authors":"Laier C, Schulte FP, Brand M.","first_author":"Laier C","journal":"Journal of sex research","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subject 4‑back task with pornographic vs neutral/negative/positive pictures; N=28 healthy young adult males; hierarchical regression of arousal and masturbation urges on WM performance","sample_n":28,"sample_text":"28 participants","population":"healthy adult males, likely university sample, convenience recruitment","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","masturbation_not_isolated","no_mi_control"],"stance":"supports","citation_value":"useful","plain_summary":"In a lab task, 28 men performed a memory test while viewing neutral, emotional, or pornographic pictures. Memory performance was worse when the pictures were pornographic, and this drop was related to how arousing the pictures felt and to urges to masturbate.","clinical_takeaway":"Viewing pornographic images may temporarily impair short‑term memory, especially when they are highly arousing; clinicians should consider arousal‑related distraction when assessing functional impacts.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Experimental manipulation with within‑subject control conditions","Objective WM performance measure (4‑back)","Assessment of subjective arousal and urges"],"limitations":["Very small sample (N=28) limits power and generalisability","No control for moral/religious attitudes or other confounds","Interpretation links to addiction without clinical criteria"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":1,"mentioning":33,"citing_publications":69,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2012.716873"}},{"id":2471,"doi":"10.1177/1079063212464398","pmid":"23160257","pmcid":null,"title":"Child pornography and likelihood of contact abuse: a comparison between contact child sexual offenders and noncontact offenders","authors":"Long ML, Alison LA, McManus MA.","first_author":"Long ML","journal":"Sexual abuse : a journal of research and treatment","year":2013,"pub_types":["Journal Article"],"keywords":["Internet","risk assessment","Sexual Abuse","Child Sexual Abuse","Child Pornography","Sex Offenses"],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational case‑control comparison of convicted offenders (N=120)","sample_n":120,"sample_text":"60 dual offenders, 60 non‑contact offenders (subsample of 60 examined in detail)","population":"adult male sexual offenders (convicted of child‑pornography possession)","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men who possessed child sexual images and had committed contact offenses with those who only possessed images. It found differences in prior convictions, access to children, and the amount and type of images owned, suggesting a link between image possession and likelihood of contact abuse.","clinical_takeaway":"Possession of child sexual images, especially in larger quantities, may signal higher risk for contact offending, informing risk‑assessment for law‑enforcement.","confidence":0.6,"topic_tags":["sexual_function","relationships"],"strengths":["Objective use of official records","Clear operationalization of IIOC quantity/types","Relevant comparison of dual vs non‑contact offenders"],"limitations":["Convenience forensic sample limits generalisability","No control for mental‑health or trauma factors","Limited statistical detail; no effect sizes reported"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":2,"mentioning":30,"citing_publications":99,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063212464398"}},{"id":2472,"doi":"10.1016/j.jsxm.2020.05.005","pmid":"32653392","pmcid":"PMC9461494","title":"Sexual Responsivity and the Effects of Negative Mood on Sexual Arousal in Hypersexual Men Who Have Sex With Men (MSM)","authors":"Janssen E, Prause N, Swinburne Romine R, Raymond N, MacDonald A, Coleman E, Miner MH.","first_author":"Janssen E","journal":"The journal of sexual medicine","year":2020,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Psychophysiology","MSM","Sexual Arousal","Hypersexuality","Negative Mood"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["bibliography","csbd","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross‑sectional laboratory study with physiological and self‑report measures; hypersexual vs control groups (N=81 vs 130); participants viewed mood‑inducing films.","sample_n":211,"sample_text":"211 MSM (81 hypersexual, 130 control)","population":"men who have sex with men (MSM), hypersexual (diagnostic interview) and non‑hypersexual controls","country":"United States (likely, based on NIH funding)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured how men who have sex with men and meet criteria for hypersexuality respond sexually, both physically and subjectively, when shown neutral, sexual, and negative‑mood videos. It found no differences in genital or self‑reported arousal between hypersexual and control participants, and negative mood did not change arousal.","clinical_takeaway":"Hypersexual MSM do not show altered physiological sexual response to negative mood; treatment may focus on motivation and behavior rather than arousal mechanisms.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large physiological sample for a lab study","Use of clinical interview for group assignment","Objective genital measure plus self‑report","Time‑series clustering adds nuance"],"limitations":["No control for moral incongruence or related confounds","Cross‑sectional; causal claims limited","No pre‑registration or effect‑size reporting","Stimuli selection not participant‑driven"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.05.005"}},{"id":2474,"doi":"10.1177/0025802420936507","pmid":"32627673","pmcid":null,"title":"Evaluation of secondary dentin deposition in lower first molars to indicate a legal age threshold of 14 years using receiver operating characteristic curves","authors":"Ravi V, Sp AS, Balla SB, Kanaparthi A, Ch G, N LP.","first_author":"Ravi V","journal":"Medicine, science, and the law","year":2020,"pub_types":["Journal Article"],"keywords":["Roc Curves","Dental Age Estimation","Legal Age Threshold","Secondary Dentin Formation","Lower First Molars"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Diagnostic accuracy study using ROC curves on a convenience sample of South Indian children aged 12‑16 years.","sample_n":null,"sample_text":"Not specified in abstract","population":"South Indian children (12‑16 y) of both sexes; sample size not reported in abstract.","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examined whether the appearance of the tooth pulp in lower first molars can reliably tell if a child is at least 14 years old. Using a sample of Indian youths, the best visual stage correctly identified age 14 in about 70% of cases, suggesting the method is only moderately useful for legal age checks.","clinical_takeaway":"Dental pulp visibility is not a dependable tool for determining a 14‑year legal age threshold; clinicians should rely on more robust age‑estimation methods.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Uses an established dental staging method","Provides quantitative ROC/AUC performance","Acknowledges limited predictive value"],"limitations":["Small, convenience sample; size not reported","No confidence intervals for AUC","Limited generalisability beyond South Indian cohort"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0025802420936507"}},{"id":2475,"doi":"10.1093/asj/sjz375","pmid":"32011672","pmcid":null,"title":"Commentary on: The Role of Pornography, Physical Symptoms, and Appearance in Labiaplasty Interest","authors":"Goodman MP.","first_author":"Goodman MP.","journal":"Aesthetic surgery journal","year":2020,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/asj/sjz375"}},{"id":2476,"doi":"10.1093/scan/nss117","pmid":"23051899","pmcid":"PMC3907922","title":"Subcortical BOLD responses during visual sexual stimulation vary as a function of implicit porn associations in women","authors":"Borg C, de Jong PJ, Georgiadis JR.","first_author":"Borg C","journal":"Social cognitive and affective neuroscience","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Midbrain","Basal forebrain","Disgust","Bed Nucleus Of Stria Terminalis","Pornography","Sexual Penetration","Single-target Implicit Association Task","Visual Sexual Stimulation"],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"fMRI study with implicit association task; cross‑sectional; N=20 women without sexual complaints","sample_n":20,"sample_text":"20 women","population":"young adult women (N=20)","country":"Netherlands (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 20 women, brain activity while watching explicit sexual videos varied according to how they implicitly associated the videos with ‘hot’ or ‘disgusting’ feelings. Stronger negative (disgust) associations predicted greater activation in reward‑related brain regions, suggesting these areas can reflect negative attitudes toward sexual images.","clinical_takeaway":"Neural responses to porn may reflect personal attitudes, not necessarily sexual dysfunction; interpret fMRI findings cautiously.","confidence":0.7,"topic_tags":["neuroscience","pornography","sexual_function","gender","csbd"],"strengths":["Use of validated implicit association task","Combination of behavioral and neuroimaging data","Focus on individual differences in attitudes toward pornography"],"limitations":["Very small fMRI sample (N=20) limits power","No correction for multiple comparisons reported","No measurement of key confounds (moral, mental health, etc.)"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":5,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":15,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/scan/nss117"}},{"id":2477,"doi":"10.1016/j.jagp.2020.06.020","pmid":"32680761","pmcid":null,"title":"Characteristics of Older Adult First-Time Sex Offenders: Insights From the Missouri Registry","authors":"Ghossoub E, Khoury R.","first_author":"Ghossoub E","journal":"The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry","year":2021,"pub_types":["Journal Article"],"keywords":["Aged","Crime Victims","Sexual Recidivism","Sex Offenses"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive analysis of a publicly available registry of older adult (≥65) first‑time sex offenders in Missouri, using sociodemographic and offense variables.","sample_n":172,"sample_text":"One hundred and ninety‑four older adult sex offenders all males were identified, of which 172 were first‑time offenders.","population":"Older adult (≥65) male first‑time sex offenders registered in Missouri (n≈172).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined 172 older men (65+) who were convicted for a first sex‑offense in Missouri. Most offenses involved child victims, with a small share involving child‑pornography. Recidivism was very low (≈1%).","clinical_takeaway":"None – the study describes criminal behavior, not clinical sexual health issues.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, population‑based registry dataset","Clear description of offense characteristics","Identifies a rarely studied cohort (older first‑time offenders)"],"limitations":["Descriptive only; no comparison or causal inference","No measurement of psychological or contextual variables","Findings limited to one US state; not generalizable"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jagp.2020.06.020"}},{"id":2478,"doi":"10.1038/s41585-020-0343-7","pmid":"32561865","pmcid":null,"title":"An integrated model to assess and treat compulsive sexual behaviour disorder","authors":"Briken P.","first_author":"Briken P.","journal":"Nature reviews. Urology","year":2020,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":56,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review article proposing an integrated model for assessment and treatment of compulsive sexual behaviour disorder; no primary data","sample_n":null,"sample_text":"Not applicable – narrative review","population":"Adults with compulsive sexual behaviour disorder (clinical context described)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper outlines a conceptual model for diagnosing and treating compulsive sexual behaviour disorder, highlighting biological, psychological, and social influences and suggesting multimodal therapy, but it does not present new data.","clinical_takeaway":"Clinicians can consider a multimodal, individualized approach, but the model is theoretical and not yet empirically validated.","confidence":0.8,"topic_tags":["csbd","sexual_function","treatment"],"strengths":["Integrates multiple theoretical models","Considers biological and social factors","Mentions emerging RCT evidence"],"limitations":["No primary empirical data","Lacks systematic review methodology","No explicit assessment of confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":4,"contrasting":0,"mentioning":117,"citing_publications":104,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41585-020-0343-7"}},{"id":2479,"doi":"10.1177/1079063220931822","pmid":"32543329","pmcid":null,"title":"Indirect and Neuropsychological Indicators of Pedophilia","authors":"Rosburg T, Pflueger MO, Mokros A, Boillat C, Deuring G, Spielmann T, Graf M.","first_author":"Rosburg T","journal":"Sexual abuse : a journal of research and treatment","year":2021,"pub_types":["Journal Article"],"keywords":["neuropsychology","Paraphilia","Pedophilia","Indirect Tests","Child Sex Offenses"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control comparison of 21 contact CSOs, 20 non‑contact CSOs and 21 non‑offending controls using neuropsychological and indirect sexual interest tests","sample_n":62,"sample_text":"21 contact CSOs, 20 noncontact CSOs, 21 controls","population":"adult male sexual offenders (pedophilic) and community controls","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men convicted of child sexual offenses with non‑offending men, using indirect tests of sexual interest and cognitive tests. A set of five test results could correctly identify offenders about 87% of the time, suggesting these tools may help forensic assessments.","clinical_takeaway":"Indirect and neuropsychological tests may aid in identifying pedophilic offenders, but findings are based on a small, specific sample.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["use of validated indirect measures of sexual interest","objective neuropsychological testing","logistic regression for classification"],"limitations":["small sample size, limited statistical power","case‑control design cannot infer causality","limited generalisability beyond forensic offenders"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063220931822"}},{"id":2480,"doi":"10.3390/ijerph17124296","pmid":"32560142","pmcid":"PMC7345319","title":"Reactions to Unsolicited Violent, and Sexual, Explicit Media Content Shared over Social Media: Gender Differences and Links with Prior Exposure","authors":"Nicklin LL, Swain E, Lloyd J.","first_author":"Nicklin LL","journal":"International journal of environmental research and public health","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Sexual","Social Media","Violent","Cyberpsychology","Unsolicited","Explicit Content"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/17/12/4296/pdf?version=1592727877","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 225 adults (169 F, 55 M) assessing self‑rated reactions (funny, exciting, disturbing) to unsolicited explicit sexual/violent content received via social media","sample_n":225,"sample_text":"self‑selected internet respondents, majority female, mean age 30.6 y","population":"adults recruited online (convenience sample)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 225 adults examined how men and women felt about unwanted explicit sexual or violent videos sent to them on social media. Women found the material more disturbing and less funny or exciting than men. Prior exposure increased how entertaining users rated the content, but did not make it seem less disturbing.","clinical_takeaway":"Unsolicited explicit media can be experienced as distressing, especially by women; clinicians should assess exposure when addressing clients’ media‑related stress.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Novel topic – unsolicited explicit content on social media","Reasonable overall sample size","Gender‑based analysis"],"limitations":["Cross‑sectional, self‑report only","No validated scales for reactions","Key confounds (moral incongruence, mental health, etc.) not measured","Male subgroup small, limiting power"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph17124296"}},{"id":2482,"doi":"10.1016/j.nicl.2020.102308","pmid":"32599553","pmcid":"PMC7327301","title":"Sexual cues alter working memory performance and brain processing in men with compulsive sexual behavior","authors":"Sinke C, Engel J, Veit M, Hartmann U, Hillemacher T, Kneer J, Kruger THC.","first_author":"Sinke C","journal":"NeuroImage. Clinical","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Working memory","Distraction","Compulsive Sexual Behavior","Fmrt"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7327301","cited_by_count":17,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"case‑control fMRI study with n‑back task","sample_n":69,"sample_text":"38 patients, 31 controls","population":"men with compulsive sexual behaviour (CSB) vs healthy controls","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["causal_from_correlational","underpowered_sample","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used fMRI while men with compulsive sexual behaviour and controls performed a memory task with pornographic backgrounds. Patients were slower and showed more brain activity in visual and salience areas, especially if they had recently viewed porn, suggesting heightened attention to sexual cues.","clinical_takeaway":"No direct clinical implications; findings are preliminary and do not establish that porn influences cognition in a harmful way.","confidence":0.7,"topic_tags":["pornography","csbd","neuroscience"],"strengths":["Use of fMRI to probe neural response to sexual cues","Inclusion of a healthy control group","Task combines working memory load with erotic distraction"],"limitations":["Small sample, likely under‑powered for imaging contrasts","No measurement or control of key confounds (moral attitudes, masturbation, mental health)","Addiction construct not operationalised with validated criteria","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":70,"pct_score":41,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":6,"statistics":5,"confounds":2,"design":3,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.nicl.2020.102308"}},{"id":2483,"doi":"10.1007/s00414-012-0765-8","pmid":"22960879","pmcid":null,"title":"Inaccuracy of age assessment from images of postpubescent subjects in cases of alleged child pornography","authors":"Rosenbloom AL.","first_author":"Rosenbloom AL.","journal":"International journal of legal medicine","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"expert rating of 10 images by 16 pediatric endocrinologists; percentage of under‑18 judgments reported","sample_n":16,"sample_text":"16 pediatric endocrinologists evaluated 10 images","population":"adult women from pornographic sites; pediatric endocrinologists as raters","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Experts often mistake adult women who look youthful for minors, with about two‑thirds of judgments labeling them as under 18, showing current forensic age assessments lack scientific reliability.","clinical_takeaway":"Legal testimony on age based solely on appearance should be treated cautiously; consider objective methods.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relevant legal context","Uses specialists in adolescent development","Highlights variability in expert judgments"],"limitations":["Very small sample of images and raters","No validated age‑assessment instrument","No statistical confidence intervals or power analysis"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00414-012-0765-8"}},{"id":2484,"doi":"10.1258/msl.2012.011133","pmid":"22962006","pmcid":null,"title":"Psychopathological characteristics of child pornographers and their victims: a literature review","authors":"Prat S, Jonas C.","first_author":"Prat S","journal":"Medicine, science, and the law","year":2013,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative literature review summarising psychopathological traits of child pornographers and victims; no primary data collection.","sample_n":null,"sample_text":"N/A – review of existing studies","population":"Adults involved in child pornography (offenders and victims); no original sample.","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This 2013 narrative review summarises what is known about the mental‑health traits of people who produce child sexual images and the children depicted, distinguishing between those directly abused and those indirectly groomed.","clinical_takeaway":"None – the article is a review of criminal‑psychology literature, not a guide for clinical practice.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Broad coverage of existing literature on a sensitive topic","Highlights distinctions between direct and indirect victims"],"limitations":["Narrative (non‑systematic) review; risk of selection bias","No assessment of study quality or risk of bias","Lacks quantitative synthesis or meta‑analytic methods"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/msl.2012.011133"}},{"id":2485,"doi":"10.1007/s10508-012-9986-7","pmid":"22886349","pmcid":null,"title":"Emerging adults' expectations for pornography use in the context of future committed romantic relationships: a qualitative study","authors":"Olmstead SB, Negash S, Pasley K, Fincham FD.","first_author":"Olmstead SB","journal":"Archives of sexual behavior","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative content analysis of written comments from 404 college students","sample_n":404,"sample_text":"Convenience sample of university students recruited for a written‑comment survey","population":"emerging‑adult college students (primarily heterosexual)","country":"USA (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"College students described what they think is acceptable about pornography use in a committed relationship; many said it can be okay alone or with a partner, while others said it is not acceptable.","clinical_takeaway":"Clinicians should recognize that expectations about pornography in relationships vary widely among young adults and discuss these beliefs with couples.","confidence":0.7,"topic_tags":["pornography","relationships","sexual_function","gender"],"strengths":["Large qualitative sample (N>400)","Gender comparison of expectations","Clear thematic categorisation"],"limitations":["Convenience student sample limits generalisability","No quantitative validation of themes","No measurement of related confounds (e.g., moral beliefs, mental health)"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":35,"citing_publications":103,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-012-9986-7"}},{"id":2486,"doi":"10.1007/s10597-020-00641-4","pmid":"32440800","pmcid":null,"title":"Break the Silence: Knowledge and Attitude Towards Sexual and Reproductive Health Among Egyptian Youth","authors":"Menshawy A, Abushouk AI, Ghanem E, Senna M, Lotfy N, Abdel-Maboud M, Elmaraezy A, Elsherbeny MY, SABEAD Study group.","first_author":"Menshawy A","journal":"Community mental health journal","year":2021,"pub_types":["Journal Article"],"keywords":["Behavior","Youth","Egypt","Sexual Health","Attitudes"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online self‑administered questionnaire, convenience sample of Egyptian youth (N=955), cross‑sectional descriptive analysis","sample_n":955,"sample_text":"Convenience online recruitment; not a probability or nationally representative sample","population":"Egyptian youth (mostly single, 53 % male)","country":"Egypt","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2021 Egyptian online survey of 955 youths found that most think masturbation and porn are wrong, yet many have done them; most support sexual education. Attitudes vary by gender, and a quarter reported non‑consensual touching.","clinical_takeaway":"Clinicians should recognise the gap between youths’ behaviours and their moral attitudes, and the need for culturally appropriate sexual education.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a regional survey","Addresses understudied topic in Middle‑East youth","Includes both attitudes and reported behaviours"],"limitations":["Questionnaire not a validated psychometric instrument","Convenience online sample limits generalisability","No multivariate control of key confounds (e.g., religiosity, mental health)"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10597-020-00641-4"}},{"id":2487,"doi":"10.1016/j.srhc.2020.100534","pmid":"32512536","pmcid":null,"title":"Young adults' sexual health in the digital age: Perspectives of care providers","authors":"Anderson LE, Dingle GA, O'Gorman B, Gullo MJ.","first_author":"Anderson LE","journal":"Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives","year":2020,"pub_types":["Journal Article"],"keywords":["Adolescents","Sexually Transmitted Infections","Digital Age","Risky Sexual Behaviour","Provider Perspectives"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative semi‑structured interviews with 15 care providers (GPs, nurses, counsellors, residential staff) about young people’s sexual health in the digital age.","sample_n":15,"sample_text":"Convenience sample of providers; not representative of broader clinician population.","population":"Care providers working with 17‑18‑year‑olds in Australia (n=15).","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 15 health professionals in Australia reveal that media, including dating apps and pornography, may shape young adults' risky sexual behaviours, while transition to adulthood, communication issues, and impulsivity also play roles.","clinical_takeaway":"Clinicians should consider digital media influences when counseling young people about STI risk and promote broader preventive strategies.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Provides provider insights into emerging digital influences.","Uses systematic thematic analysis with independent coder."],"limitations":["Small, non‑representative sample of providers.","No direct data from young people or measurement of pornography use.","Qualitative design limits causal inference."],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.srhc.2020.100534"}},{"id":2488,"doi":"10.2466/18.02.13.pr0.111.4.305-310","pmid":"23045873","pmcid":null,"title":"Pornography consumption, cocaine use, and casual sex among U.S. adults","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Psychological reports","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"large nationally representative longitudinal survey; observational association analysis","sample_n":1536,"sample_text":"Nationally representative General Social Survey 2006‑2008 longitudinal component","population":"U.S. adults, N=1,536, age 18+","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a U.S. survey of 1,500 adults, people who used cocaine were more likely to have recent casual sex, and porn use increased casual‑sex odds only among non‑cocaine users. The study does not examine addiction or distress, and it does not consider moral or mental‑health factors.","clinical_takeaway":"None – the findings describe behavioral associations, not clinical risk or treatment guidance.","confidence":0.8,"topic_tags":["pornography","csbd","sexual_function","religiosity"],"strengths":["Large, nationally representative sample","Longitudinal data allow temporal ordering","Hierarchical logistic regression appropriately used for binary outcome"],"limitations":["Key constructs measured with single‑item self‑reports, no validated scales","Important confounds (moral attitudes, masturbation, mental health, relationship context, trauma) not assessed","No confidence intervals reported for odds ratios"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":10,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2466/18.02.13.pr0.111.4.305-310"}},{"id":2489,"doi":null,"pmid":"22876261","pmcid":"PMC3413465","title":"[Not Available]","authors":"Haza M.","first_author":"Haza M.","journal":"Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent","year":2012,"pub_types":["article-commentary","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"article-commentary","sample_n":null,"sample_text":"Not applicable – commentary without empirical data","population":"adolescents (general, no specific sample reported)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The commentary discusses how teens encounter online pornography—by accident, by seeking it, or by creating it themselves—and reflects on how these early exposures may affect their sexual development.","clinical_takeaway":"None – the article offers no empirical guidance for clinicians.","confidence":0.8,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Addresses multiple contexts of adolescent porn exposure","Provides developmental perspective"],"limitations":["No empirical data or systematic review methodology","Lacks measurement of key constructs","No control for confounding variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":2490,"doi":"10.1037/h0093925","pmid":"22849417","pmcid":null,"title":"Online solicitation offenders are different from child pornography offenders and lower risk contact sexual offenders","authors":"Seto MC, Wood JM, Babchishin KM, Flynn S.","first_author":"Seto MC","journal":"Law and human behavior","year":2012,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative retrospective study of three offender groups (n=38,38,70) using self‑report and actuarial risk measures.","sample_n":146,"sample_text":"38 lower‑risk contact offenders, 38 child‑pornography offenders, 70 solicitation offenders.","population":"Male adult offenders convicted of contact sexual offenses, child pornography offenses, or online solicitation.","country":"USA (Arkansas)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men convicted of contact sexual offenses, child‑pornography offenses, and online solicitation, finding that solicitation offenders differ in education, relationship stability, and sexual preoccupation, suggesting distinct treatment needs.","clinical_takeaway":"Treatment and supervision should be tailored to the specific offender type, as solicitation offenders show unique risk patterns.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Direct comparison of three distinct offender groups","Use of established actuarial risk tools (Static‑99, VASOR)","Relatively large combined sample for offender research"],"limitations":["Cross‑sectional design limits causal inference","Limited control for key psychosocial confounds","Reliance on self‑report for sexual drive/preoccupation","Findings may not generalize beyond convicted offenders"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":1,"mentioning":94,"citing_publications":130,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/h0093925"}},{"id":2491,"doi":"10.1177/0025817219898152","pmid":"32427065","pmcid":null,"title":"Editorial: Child pornography","authors":"Zeitlin H.","first_author":"Zeitlin H.","journal":"The Medico-legal journal","year":2020,"pub_types":["Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0025817219898152"}},{"id":2492,"doi":"10.1037//0022-3514.50.2.330","pmid":"3701580","pmcid":null,"title":"Sexual arousal in response to aggression: ideological, aggressive, and sexual correlates","authors":"Malamuth NM, Check JV, Briere J.","first_author":"Malamuth NM","journal":"Journal of personality and social psychology","year":1986,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment with male (N=359) and female (N=43) participants; physiological (penile tumescence) and self‑report arousal measured across aggressive vs non‑aggressive depictions.","sample_n":359,"sample_text":"Male participants N=359; female participants N=43; physiological subsample N=118","population":"Adult volunteers, likely university students (convenience sample)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined how men and women feel sexually aroused by aggressive versus non‑aggressive images, using self‑reports and penile measurements. Most participants were more aroused by non‑aggressive sexual pictures, but a subgroup of men showed higher arousal to forceful scenes and also endorsed more violent attitudes toward women.","clinical_takeaway":"A small subset of men may experience sexual arousal to aggression and hold more violent beliefs, suggesting a need for nuanced assessment in sexual violence prevention.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Physiological arousal measure adds objective data","Experimental manipulation of stimulus type"],"limitations":["No validated arousal scales reported","Convenience sample limits generalisability","Key covariates (e.g., personality, prior aggression) not controlled"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":1,"citing_publications":114,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0022-3514.50.2.330"}},{"id":2493,"doi":"10.1016/j.psychres.2020.113036","pmid":"32450451","pmcid":null,"title":"Problematic Internet use (PIU), personality profiles and emotion dysregulation in a cohort of young adults: trajectories from risky behaviors to addiction","authors":"Pettorruso M, Valle S, Cavic E, Martinotti G, di Giannantonio M, Grant JE.","first_author":"Pettorruso M","journal":"Psychiatry research","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Depression","Impulsivity","Novelty Seeking","Internet Addiction","Harm Avoidance","Difficulties In Emotion Regulation Scale (Ders)","Tridimensional Personality Questionnaire (Tpq)"],"is_oa":false,"oa_url":null,"cited_by_count":75,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of American young adults split into PIU risk groups using the Internet Addiction Diagnostic Questionnaire; no longitudinal or experimental manipulation","sample_n":null,"sample_text":"Not reported in abstract; likely a moderate convenience cohort","population":"young adults (American), convenience sample","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed young adults and found that those at higher risk of problematic internet use, which includes pornography, tended to have certain personality traits, more trouble regulating emotions, and higher rates of depression and anxiety.","clinical_takeaway":"Assess emotional regulation and mental‑health symptoms when addressing problematic internet behaviors, but note that pornography effects were not examined separately.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Uses multiple validated personality and emotion‑regulation scales","Considers a range of PIU activities, not only gambling or gaming","Highlights emotion‑dysregulation as a potential pathway"],"limitations":["Cross‑sectional design limits causal inference","PIU assessment blends many behaviours, pornography not isolated","No measurement of moral or religiosity factors that could confound ‘problematic’ ratings"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":84,"citing_publications":126,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psychres.2020.113036"}},{"id":2494,"doi":"10.1080/13691058.2012.703327","pmid":"22823577","pmcid":null,"title":"Parents, peers and pornography: the influence of formative sexual scripts on adult HIV sexual risk behaviour among Black men in the USA","authors":"Hussen SA, Bowleg L, Sangaramoorthy T, Malebranche DJ.","first_author":"Hussen SA","journal":"Culture, health & sexuality","year":2012,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"In‑depth qualitative interviews (N=90) with Black men in Georgia, analysed via Sexual Script Theory.","sample_n":90,"sample_text":"90 qualitative in‑depth interviews","population":"Black adult men (young‑adult to middle‑aged) living in Georgia, USA","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 90 Black men in Georgia explored how early sexual messages from parents, peers, and pornography shape adult HIV risk. Both low‑ and high‑risk men heard similar scripts, but low‑risk men were better at questioning risky messages.","clinical_takeaway":"Understanding formative sexual scripts may help target HIV‑prevention education for Black men.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Rich qualitative data","Clear theoretical framework (Sexual Script Theory)","Focus on understudied population"],"limitations":["No quantitative measurement of pornography use","No assessment of moral, mental‑health or partner variables","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":31,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2012.703327"}},{"id":2495,"doi":"10.1016/j.comppsych.2020.152180","pmid":"32422427","pmcid":"PMC7215166","title":"Preventing problematic internet use during the COVID-19 pandemic: Consensus guidance","authors":"Király O, Potenza MN, Stein DJ, King DL, Hodgins DC, Saunders JB, Griffiths MD, Gjoneska B, Billieux J, Brand M, Abbott MW, Chamberlain SR, Corazza O, Burkauskas J, Sales CMD, Montag C, Lochner C, Grünblatt E, Wegmann E, Martinotti G, Lee HK, Rumpf HJ, Castro-Calvo J, Rahimi-Movaghar A, Higuchi S, Menchon JM, Zohar J, Pellegrini L, Walitza S, Fineberg NA, Demetrovics Z.","first_author":"Király O","journal":"Comprehensive psychiatry","year":2020,"pub_types":["brief-report","Research Support, Non-U.S. Gov't","Consensus Statement","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7215166","cited_by_count":349,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Consensus guidance without original empirical data; no sample size reported.","sample_n":null,"sample_text":"Not applicable – consensus statement draws on expert opinion, not a recruited sample.","population":"general adult population (implicit), no specific sampling","country":"International (multiple authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"A group of experts issued guidance on how the COVID‑19 pandemic may increase risky internet behaviours, including watching pornography, and offered practical tips to reduce potential problems.","clinical_takeaway":"The guidance stresses monitoring excessive online sexual activity during stress, but provides no empirical evidence for specific interventions.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Broad expert panel","Timely pandemic relevance"],"limitations":["No original data","No systematic evidence synthesis","No measurement of key confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":25,"contrasting":1,"mentioning":648,"citing_publications":862,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2020.152180"}},{"id":2496,"doi":"10.1016/j.urology.2020.04.100","pmid":"32437776","pmcid":null,"title":"Is It All in My Head? Self-reported Psychogenic Erectile Dysfunction and Depression Are Common Among Young Men Seeking Advice on Social Media","authors":"Jiang T, Osadchiy V, Mills JN, Eleswarapu SV.","first_author":"Jiang T","journal":"Urology","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of Reddit posts (n=329) with NLP and manual coding; convenience sample of an online community; no longitudinal or experimental component.","sample_n":329,"sample_text":"329 posts and 1702 responses from Reddit community r/ErectileDysfunction (June 2018–May 2019)","population":"Young men (median age 24) posting in r/ErectileDysfunction, Reddit","country":"United States (inferred from Reddit user base, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined 329 Reddit posts from a community of men discussing erectile dysfunction. About half thought their problem was psychological, many reported depression, and some tried stopping pornography or masturbation. The authors highlight the need for clinicians to engage with young men online.","clinical_takeaway":"Young men often attribute erectile issues to psychological factors and may self‑treat by avoiding porn/masturbation; clinicians should proactively address mental health and provide evidence‑based guidance.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation","moral_incongruence"],"strengths":["Large volume of real‑world user‑generated content","Combination of quantitative NLP and qualitative annotation","Identifies mental‑health concerns among young men with ED"],"limitations":["No validated psychometric instruments; relies on self‑report in posts","Convenience sample from a single Reddit community limits generalisability","Confounding factors (moral incongruence, mental health, partner dynamics) not measured or controlled"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":38,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urology.2020.04.100"}},{"id":2497,"doi":"10.1016/j.esxm.2020.03.003","pmid":"32389594","pmcid":"PMC7471067","title":"Health-Related Lifestyles, Substance-Related Behaviors, and Sexual Habits Among Italian Young Adult Males: An Epidemiologic Study","authors":"Flesia L, Cavalieri F, Angelini S, Bottesi G, Ghisi M, Tonon E, Roldan AP, Di Nisio A, Garolla A, Ferlin A, Foresta C.","first_author":"Flesia L","journal":"Sexual medicine","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Health","Prevention","epidemiology","Risk behaviors","Young Males"],"is_oa":true,"oa_url":"http://www.smoa.jsexmed.org/article/S2050116120300404/pdf","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online questionnaire of 2,170 Italian male high‑school seniors (age 18‑21)","sample_n":2170,"sample_text":"Convenience sample of students attending the last year of high school; recruited via online questionnaire","population":"Italian young adult males (high‑school seniors)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 2,000 Italian high‑school seniors described their health habits, substance use and sexual behaviour. Most had used pornography (89%) and about 15% reported a sexual problem, but the study used only a brief, non‑validated questionnaire.","clinical_takeaway":"Few young men report sexual dysfunction, but most have viewed pornography; clinicians should consider routine sexual health screening in this age group.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size (N>2000)","Broad coverage of health‑related behaviours in a single questionnaire","Provides baseline epidemiologic data for Italian male youth"],"limitations":["Questionnaire appears ad‑hoc; no validated measures of pornography use or distress","Cross‑sectional, descriptive only; no inferential testing","Potential self‑selection bias; data self‑reported online"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":1,"mentioning":8,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2020.03.003"}},{"id":2498,"doi":"10.1007/s10508-020-01728-5","pmid":"32367482","pmcid":null,"title":"Taking Matters Into Their Own Hands: Abstinence from Pornography, Masturbation, and Orgasm on the Internet","authors":"Osadchiy V, Vanmali B, Shahinyan R, Mills JN, Eleswarapu SV.","first_author":"Osadchiy V","journal":"Archives of sexual behavior","year":2020,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01728-5"}},{"id":2499,"doi":"10.1590/1806-9282.66.5.564","pmid":"32638949","pmcid":null,"title":"Does online pornography influence the sexuality of adolescents during COVID-19?","authors":"Perissini AL, Spessoto LCF, Facio Junior FN.","first_author":"Perissini AL","journal":"Revista da Associacao Medica Brasileira (1992)","year":2020,"pub_types":["Comment","Editorial"],"keywords":[],"is_oa":false,"oa_url":"https://www.scielo.br/j/ramb/a/WyZSNHPfmcy7XcrbsBHKVyG/?lang=en&format=pdf","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/1806-9282.66.5.564"}},{"id":2500,"doi":"10.1100/2012/406063","pmid":"22778698","pmcid":"PMC3385627","title":"Consumption of pornographic materials among Hong Kong early adolescents: a replication","authors":"Shek DT, Ma CM.","first_author":"Shek DT","journal":"TheScientificWorldJournal","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3385627","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large school‑based survey of 3,638 secondary 2 students in Hong Kong; self‑report questionnaire on past‑year pornography consumption; analyses of gender, birthplace, and associations with positive youth development and family functioning.","sample_n":3638,"sample_text":"Secondary 2 students in Hong Kong schools (convenience sample).","population":"early adolescents (secondary 2, ~13‑14 y)","country":"Hong Kong","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 3,638 Hong Kong early teens found that most had not viewed porn in the past year, with boys and mainland‑born youths more likely to have done so. Higher positive youth development and better family functioning were linked to lower porn use.","clinical_takeaway":"Clinicians should note that family and youth‑development factors are associated with lower adolescent porn consumption, but the study does not address problem use or addiction.","confidence":0.8,"topic_tags":["pornography","adolescents","prevalence","sexual_function","csbd"],"strengths":["Very large adolescent sample","Gender and birthplace comparisons","Inclusion of positive youth development and family functioning"],"limitations":["Self‑report consumption not validated","Cross‑sectional, cannot infer causality","No measurement of key confounds (moral incongruence, masturbation, mental health, etc.)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":1,"mentioning":13,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1100/2012/406063"}},{"id":2501,"doi":"10.1080/00224499.2020.1749821","pmid":"32324067","pmcid":null,"title":"The Association of Childhood Sexual Abuse With Non-Paraphilic and Paraphilic Sexual Behaviors Among Adolescents Who Have Sexually Offended","authors":"Leroux EJ, Clow KA, Motayne G, Seto MC.","first_author":"Leroux EJ","journal":"Journal of sex research","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 162 male adolescents adjudicated for sexual offenses; analysis of self‑reported childhood sexual victimisation and a range of sexual behaviour variables.","sample_n":162,"sample_text":"162 male adolescents adjudicated for a sexual offense (M age = 15.2, SD = 1.3).","population":"Male adolescents (mean age 15.2) who have sexually offended; recruited from juvenile justice/clinical settings.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 162 teenage males who have committed sexual offenses, those who experienced childhood sexual abuse reported more risky non‑paraphilic sexual activities and more engagement with paraphilic behaviours such as viewing paraphilic porn.","clinical_takeaway":"History of childhood sexual abuse may signal broader sexual risk‑taking in offending adolescents; clinicians should assess and address both abuse trauma and current sexual behaviours.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Focus on an under‑studied aspect of adolescent sexual offending (non‑offense sexual behaviour).","Relatively large sample for this specific population."],"limitations":["Cross‑sectional design cannot infer causality.","Reliance on self‑report measures with unclear validation.","No control for major confounds (e.g., mental health, partner factors).","Sample limited to adjudicated offenders, limiting generalisability."],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":5,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2020.1749821"}},{"id":2502,"doi":"10.1080/13218719.2020.1742242","pmid":"33833611","pmcid":"PMC8009130","title":"When sexting conflicts with child sexual abuse material: the legal and social consequences for children","authors":"Moritz D, Christensen LS.","first_author":"Moritz D","journal":"Psychiatry, psychology, and law : an interdisciplinary journal of the Australian and New Zealand Association of Psychiatry, Psychology and Law","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Consent","Child Pornography","Criminal Law","Sexting","Child Sexual Abuse Material","Child Exploitation Material"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary/legal analysis without empirical data.","sample_n":null,"sample_text":"Not applicable – no participants.","population":"children/ adolescents (legal discussion)","country":"Australia (focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article examines how Australian law treats teenage sexting, arguing it should be seen as distinct from child sexual abuse material and discussing the legal and social consequences for youths.","clinical_takeaway":"None - not clinically applicable.","confidence":0.9,"topic_tags":["sexual_function","prevalence"],"strengths":["Clear legal analysis of sexting vs CSAM","Highlights gap in Australian law"],"limitations":["No empirical data","No measurement of outcomes","Limited generalizability beyond legal context"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13218719.2020.1742242"}},{"id":2503,"doi":"10.2147/ndt.s247292","pmid":"32368065","pmcid":"PMC7182452","title":"What Types of Internet Services Make Adolescents Addicted? Correlates of Problematic Internet Use","authors":"Kim KM, Kim H, Choi JW, Kim SY, Kim JW.","first_author":"Kim KM","journal":"Neuropsychiatric disease and treatment","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Adolescence","Sex differences","Addiction","Internet Usage"],"is_oa":true,"oa_url":"https://www.dovepress.com/getfile.php?fileID=57493","cited_by_count":27,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large school‑based survey of 223,542 adolescents (2008‑2010)","sample_n":223542,"sample_text":"large community sample","population":"adolescents aged 12‑18, likely recruited via schools (not treatment‑seeking)","country":"South Korea (inferred from author names and journal context)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 220,000 Korean teens, 5 % were classified as having problematic internet use. Using pornographic sites was linked to the highest odds of such problems, especially compared with just searching for information.","clinical_takeaway":"Adolescent clinicians should screen for problematic internet use, especially when porn use is frequent, and consider underlying depression.","confidence":0.7,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Very large sample size","Sex‑stratified analysis","Uses a previously validated PIU scale"],"limitations":["Cross‑sectional; no causal inference","No measurement of moral incongruence or masturbation","PIU scale conflates frequency and distress"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":1,"mentioning":22,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/ndt.s247292"}},{"id":2504,"doi":"10.1186/s12889-020-08604-w","pmid":"32306942","pmcid":"PMC7168867","title":"Sex-on-premise venues, associated risk behaviors, and attitudes toward venue-based HIV testing among men who have sex with men in Lima, Perú","authors":"Lankowski A, Sánchez H, Hidalgo J, Cabello R, Duerr A.","first_author":"Lankowski A","journal":"BMC public health","year":2020,"pub_types":["research-article","Evaluation Study","Journal Article"],"keywords":["HIV","Sexual behavior","MSM","Hiv Testing","Sexually Transmitted Infection","Hiv Prevention","Perú","Sauna","Sex-on-premise Venue"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7168867","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of MSM (N=389) recruited via social media; assessed SOPV attendance, sexual risk behaviors, attitudes toward venue‑based HIV testing.","sample_n":389,"sample_text":"Convenience online sample recruited through LGBTQ‑aligned community groups","population":"adult men who have sex with men in Lima, Peru","country":"Peru","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2020 survey of 389 Peruvian MSM found that 68% visited places like saunas or sex clubs, and those who did reported higher sexual risk behaviours. Most said they would accept HIV testing offered at these venues, suggesting outreach could reach high‑risk groups.","clinical_takeaway":"Venue‑based HIV testing may effectively reach MSM who engage in higher‑risk sexual behaviours.","confidence":0.84,"topic_tags":["sexual_function"],"strengths":["Large sample for a niche population (MSM in Lima)","Focus on a concrete public‑health venue (SOPVs)","Provides data on willingness to accept venue‑based HIV testing"],"limitations":["Cross‑sectional design; causal claims not supported","Self‑report measures not validated","Convenience online recruitment limits generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-020-08604-w"}},{"id":2505,"doi":"10.1080/13218719.2020.1742240","pmid":"33679203","pmcid":"PMC7901685","title":"Offenders convicted of child sexual exploitation material offences: characteristics of offenders and an exploration of judicial censure","authors":"Christensen LS, Tsagaris GS.","first_author":"Christensen LS","journal":"Psychiatry, psychology, and law : an interdisciplinary journal of the Australian and New Zealand Association of Psychiatry, Psychology and Law","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Child Abuse","Criminal Justice","Sexual Offending","Child Pornography","Child Sex Offender","Sentencing","Conviction","Judiciary","Child Exploitation Material"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Exploratory content analysis of sentencing remarks (N=29 offenders) over 10 years; descriptive, no control group.","sample_n":29,"sample_text":"29 offenders","population":"Adult male offenders convicted of child sexual exploitation material offences in Australia.","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined court sentencing remarks for 29 men convicted of child sexual exploitation material offences in Australia, describing their ages, jobs, education and the type of material involved, and highlighting themes such as mental‑health claims and denial.","clinical_takeaway":"None – findings relate to criminal‑justice context, not clinical treatment of sexual behaviour.","confidence":0.8,"topic_tags":["csbd"],"strengths":["Unique insight into judicial sentencing language","Comprehensive 10‑year span"],"limitations":["Small, non‑representative sample","No systematic measurement of offender characteristics","Descriptive only; no statistical testing"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":8,"contrasting":1,"mentioning":20,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13218719.2020.1742240"}},{"id":2506,"doi":"10.1016/j.jadohealth.2020.02.015","pmid":"32284295","pmcid":null,"title":"Unmet Needs in Sex Education-What Adolescents Aim to Understand About Sexuality of the Other Sex","authors":"Bauer M, Hämmerli S, Leeners B.","first_author":"Bauer M","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2020,"pub_types":["Journal Article"],"keywords":["Sexuality","Puberty","Education","Sex Education","Sexual Health","Psychosexual Development"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 2,625 questions generated by 2,343 adolescents (11‑19 y) in peer‑led sex‑education classes.","sample_n":2343,"sample_text":"2,343 adolescents from 123 classes (10‑12 per group).","population":"Adolescents, ages 11‑19, recruited from school classes (convenience sample).","country":"Switzerland (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Adolescents (11‑19 y) were asked to write questions about the opposite sex; most wanted to know about sexual interaction, bodies, relationships, masturbation and pornography. The authors suggest sex‑education should cover pleasure, desire and porn topics.","clinical_takeaway":"Sex‑education programmes should include adolescents’ expressed interests, especially about desire, masturbation and pornography.","confidence":0.7,"topic_tags":["sexual_function","adolescents","csbd"],"strengths":["Large adolescent sample","Systematic content‑analysis of real questions","Direct relevance to sex‑education curriculum development"],"limitations":["Convenience school sample; limited generalisability","No validated psychometric instruments","Descriptive only; no inferential statistics or control for confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2020.02.015"}},{"id":2507,"doi":"10.1071/sh10092","pmid":"22498161","pmcid":"PMC3560402","title":"The relationship between pornography use and sexual behaviours among at-risk HIV-negative men who have sex with men","authors":"Eaton LA, Cain DN, Pope H, Garcia J, Cherry C.","first_author":"Eaton LA","journal":"Sexual health","year":2012,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Baseline data from a behavioural intervention trial; cross‑sectional survey of 149 at‑risk HIV‑negative MSM in Atlanta.","sample_n":149,"sample_text":"149 men reporting HIV‑negative status and two or more unprotected anal sex partners in the past 6 months were enrolled.","population":"Men who have sex with men, HIV‑negative, reporting ≥2 unprotected anal sex partners in past 6 months (n=149).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 149 HIV‑negative men who have sex with men, more time spent watching pornography was linked to having more sexual partners and more unprotected insertive anal sex, even after accounting for drug and alcohol use.","clinical_takeaway":"Higher pornography viewing may signal greater HIV risk in MSM, but causal direction is unclear; clinicians should consider broader risk behaviours.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Relatively large sample for a niche population","Multivariate modeling adjusts for several covariates","Focus on an understudied link between pornography viewing and HIV risk"],"limitations":["Cross‑sectional design prohibits causal inference","No validated measure of pornography use; relies on self‑reported time","Key confounds (moral incongruence, masturbation, mental health, trauma) not assessed","Convenience sample of high‑risk men limits generalizability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":3,"mentioning":51,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh10092"}},{"id":2508,"doi":"10.1556/2006.2020.00010","pmid":"32359231","pmcid":"PMC8935194","title":"Inhibitory control and problematic Internet-pornography use - The important balancing role of the insula","authors":"Antons S, Matthias B.","first_author":"Antons S","journal":"Journal of behavioral addictions","year":2020,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8935194","cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":2,"contrasting":0,"mentioning":21,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00010"}},{"id":2509,"doi":"10.1007/s10508-019-01576-y","pmid":"31673884","pmcid":"PMC7645510","title":"Correction to: An Interdisciplinary Definition of Pornography: Results from a Global Delphi Panel","authors":"McKee A, Byron P, Litsou K, Ingham R.","first_author":"McKee A","journal":"Archives of sexual behavior","year":2020,"pub_types":["Published Erratum","correction"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-01576-y"}},{"id":2510,"doi":"10.1080/07448481.2020.1740709","pmid":"32208068","pmcid":null,"title":"Predicting emotional abuse among a sample of college students","authors":"Spadine M, Patterson MS, Brown S, Nelon J, Lanning B, Johnson DM.","first_author":"Spadine M","journal":"Journal of American college health : J of ACH","year":2022,"pub_types":["Journal Article"],"keywords":["Prevention","Health education","Intimate Partner Violence","Psychological Abuse","College Campuses"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 601+756 undergraduates; binary logistic regression predicting emotional abuse victimization","sample_n":1357,"sample_text":"601 undergraduates (spring 2017) and 756 undergraduates (fall 2019)","population":"undergraduate students from two US public universities (midwest, south)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 1,300 U.S. college students found that frequent porn use, drinking, and casual hookups were linked to higher odds of experiencing emotional abuse in a relationship.","clinical_takeaway":"Clinicians should note that frequent pornography viewing may be one of several risk factors associated with emotional abuse among college students.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Large combined sample (N>1300)","Multivariate logistic regression","Includes a range of behavioral predictors"],"limitations":["Cross‑sectional; cannot infer causality","Pornography use measured with single item, no validated scale","Key potential confounds (moral attitudes, mental health) not assessed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/07448481.2020.1740709"}},{"id":2511,"doi":"10.1007/bf01541919","pmid":"742962","pmcid":null,"title":"Personality, sexuality, and demographic differences between volunteers and nonvolunteers for a laboratory study of male sexual behavior","authors":"Farkas GM, Sine LF, Evans IM.","first_author":"Farkas GM","journal":"Archives of sexual behavior","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 108 men; comparison of those who volunteered for a laboratory sexual arousal study vs those who did not; questionnaire measures of personality, guilt, sexual fear, experience, demographics.","sample_n":108,"sample_text":"108 participants in questionnaire study; subset volunteered for lab study.","population":"Adult males, likely convenience sample from university/community; not representative.","country":"Not specified (likely United States).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Men who agreed to take part in a lab study of sexual arousal were less guilt‑prone, less fearful, more experienced, older, and more likely to have had erectile problems than those who declined. The findings warn that lab‑based sexual research may not represent the broader population.","clinical_takeaway":"Researchers should avoid assuming lab findings on sexual arousal apply to all men; volunteer bias is substantial.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Large (for 1978) sample size for questionnaire study","Direct comparison of volunteers vs non‑volunteers","Identifies demographic and personality factors influencing lab participation"],"limitations":["Reliance on ad‑hoc, unvalidated questionnaire items","No measurement of key confounds (moral incongruence, masturbation, mental health, partner status, trauma)","Cross‑sectional convenience sample limits generalizability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":34,"citing_publications":96,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541919"}},{"id":2512,"doi":"10.1136/bmj.m1094","pmid":"32184298","pmcid":null,"title":"TB expert is suspended for 12 months for possessing extreme pornography","authors":"Dyer C.","first_author":"Dyer C.","journal":"BMJ (Clinical research ed.)","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.m1094"}},{"id":2513,"doi":"10.1080/00224499.2011.648027","pmid":"22449010","pmcid":null,"title":"Pornography use: who uses it and how it is associated with couple outcomes","authors":"Poulsen FO, Busby DM, Galovan AM.","first_author":"Poulsen FO","journal":"Journal of sex research","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":103,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 617 couples (N≈1234 individuals) examining self‑reported pornography use, meaning, sexual quality and relationship satisfaction.","sample_n":1234,"sample_text":"617 couples (married or cohabiting)","population":"married or cohabiting adult couples (mixed gender, age range not specified)","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 600 couples, men’s porn use was linked to lower sexual quality for both partners, while women’s use was linked to higher sexual quality for women. The meaning people give to porn explained only a small part of these links.","clinical_takeaway":"Clinicians should note that partner gender may influence how porn use relates to sexual satisfaction, but causal conclusions cannot be drawn.","confidence":0.7,"topic_tags":["pornography","relationships","sexual_function","gender"],"strengths":["Large dyadic sample (over 1,200 individuals)","Examines both partners’ perspectives","Addresses meaning of pornography use","Provides gender‑specific findings"],"limitations":["Cross‑sectional design prevents causal inference","Unclear whether validated scales were used","Key confounds (moral incongruence, masturbation, mental health) not measured","Sampling method not described; possible volunteer bias"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":4,"mentioning":156,"citing_publications":283,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2011.648027"}},{"id":2514,"doi":"10.1016/j.jsxm.2020.02.007","pmid":"32165100","pmcid":null,"title":"The Link Between Boredom and Hypersexuality: A Systematic Review","authors":"de Oliveira L, Carvalho J.","first_author":"de Oliveira L","journal":"The journal of sexual medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":["Compulsive Sexual Behavior","Boredom","Impulse Control","Sexual Addiction","Hypersexuality"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 19 empirical studies (16 quantitative, 3 qualitative) on boredom‑hypersexuality link; follows PRISMA guidelines; no meta‑analysis.","sample_n":19,"sample_text":"19 included studies (16 quantitative, 3 qualitative).","population":"Mixed adult samples (mostly male, some non‑heterosexual, few women); convenience/clinical samples likely.","country":"Not specified (multiple databases).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review examined 19 studies to see whether boredom is linked to hypersexual behavior. Most studies found a positive association, but many used limited or unclear measures, and few considered important confounding factors. More rigorous work is needed.","clinical_takeaway":"Evidence for boredom driving hypersexuality is tentative; clinicians should assess multiple factors before attributing problems to boredom alone.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["First systematic review of boredom‑hypersexuality link","PRISMA‑guided search across multiple databases","Identifies gaps in female representation and measurement quality"],"limitations":["Included primary studies largely use unvalidated or heterogeneous measures","No quantitative synthesis or effect‑size aggregation","Confounding factors (e.g., moral incongruence, mental health) rarely addressed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":24,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.02.007"}},{"id":2515,"doi":"10.1016/j.ijlp.2012.02.004","pmid":"22420934","pmcid":null,"title":"Undetected and detected child sexual abuse and child pornography offenders","authors":"Neutze J, Grundmann D, Scherner G, Beier KM.","first_author":"Neutze J","journal":"International journal of law and psychiatry","year":2012,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative study of self‑referred community pedophiles/hebephiles (n=345) versus detected offenders; cross‑sectional self‑report of risk factors.","sample_n":345,"sample_text":"Community self‑referred and convicted/offender groups (detected vs undetected).","population":"Adult male self‑referred pedophiles/hebephiles, community and convicted samples, Germany.","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared 345 self‑identified pedophiles/hebephiles who had never been caught with those who had been detected, looking at risk‑factor differences such as sexual self‑regulation, social deficits and employment status.","clinical_takeaway":"Risk‑factor profiles differ between detected and undetected child sexual offenders; interventions should consider self‑regulation and socio‑affective deficits.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample of undetected offenders","Direct comparison with convicted group","Broad set of risk‑factor domains assessed"],"limitations":["Self‑report data may be biased","Cross‑sectional design limits causal inference","Key confounds (e.g., mental health, trauma) not measured","Potential selection bias from self‑referral"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":3,"mentioning":50,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijlp.2012.02.004"}},{"id":2517,"doi":"10.3389/fpsyt.2020.00088","pmid":"32194447","pmcid":"PMC7063028","title":"Prevention of Sexual Child Abuse: Preliminary Results From an Outpatient Therapy Program","authors":"Wild TSN, Müller I, Fromberger P, Jordan K, Klein L, Müller JL.","first_author":"Wild TSN","journal":"Frontiers in psychiatry","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Therapy","Treatment","Child Sexual Abuse","Well-being","Pedophilia","Child Pornography","Sex Offender","Child Sexual Exploitation Material"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2020.00088/pdf","cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"single-group pre‑post outpatient therapy with 1‑year follow‑up; no control group; N≈25","sample_n":25,"sample_text":"23‑25 participants across outcomes; follow‑up N=8‑19","population":"adults with self‑reported sexual interest in children; outpatient setting in Germany","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A German outpatient program for people with sexual interest in children showed reduced offensive attitudes and distress after treatment, but the tiny, uncontrolled sample means the results are preliminary and cannot prove the therapy works.","clinical_takeaway":"Preliminary data suggest possible benefit, but clinicians should treat the findings as exploratory pending stronger evidence.","confidence":0.8,"topic_tags":["treatment","sexual_function"],"strengths":["first empirical data on this outpatient program","longitudinal follow‑up up to 2.4 years","transparent acknowledgment of limitations"],"limitations":["very small, self‑selected sample","no control/comparison group","mostly self‑report outcomes, limited validated measures","insufficient power to detect effects"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2020.00088"}},{"id":2518,"doi":"10.1016/j.pedhc.2019.10.001","pmid":"32063261","pmcid":null,"title":"Child and Adolescent Pornography Exposure","authors":"Hornor G.","first_author":"Hornor G.","journal":"Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners","year":2020,"pub_types":["Review","Journal Article"],"keywords":["Behavior","Adolescence","Pediatrics","Family Issue"],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":26,"citing_publications":79,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pedhc.2019.10.001"}},{"id":2520,"doi":"10.1080/00224499.2020.1716206","pmid":"32011176","pmcid":"PMC8936191","title":"Change in the Popularity of Transgressive Content in Written Erotica between 2000 and 2016","authors":"Seehuus M, Handy AB, Stanton AM.","first_author":"Seehuus M","journal":"Journal of sex research","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of ~250,000 erotic stories from 2000‑2016; trend analysis of transgressive themes (violence, incest, BDSM) and popularity (views per day).","sample_n":250000,"sample_text":"Approximately 250,000 erotic narratives collected from an online platform over 16 years.","population":"Internet‑based erotic story corpus (no human participants).","country":"Not specified (likely international internet sample).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Analyzing 250,000 online erotic stories from 2000‑2016, the authors found no noticeable rise in violent, incestuous, or BDSM themes, nor in how often such stories were viewed, suggesting that erotic content has stayed fairly constant over the period.","clinical_takeaway":"None – the study concerns content trends, not clinical implications.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Very large corpus enables detection of small trends.","Objective coding of content rather than self‑report.","Direct measure of popularity via view counts."],"limitations":["Coding scheme may rely on subjective judgments; validation not detailed.","Only one platform analyzed – may not represent all pornographic material.","No behavioral or health outcomes measured."],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2020.1716206"}},{"id":2521,"doi":"10.1016/j.cpr.2020.101828","pmid":"32062303","pmcid":null,"title":"Short-term abstinence effects across potential behavioral addictions: A systematic review","authors":"Fernandez DP, Kuss DJ, Griffiths MD.","first_author":"Fernandez DP","journal":"Clinical psychology review","year":2020,"pub_types":["Systematic Review","Journal Article"],"keywords":["Craving","Withdrawal","Relapse","Deprivation","Abstinence","Behavioral Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 47 prospective studies on short‑term abstinence in six behavioral addictions (including pornography).","sample_n":null,"sample_text":"47 prospective studies (sample sizes not given)","population":"Adults across studies; not specified in abstract","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review looked at short‑term abstinence from behaviors like gaming, gambling, and pornography, summarising 47 studies. It found little research except for exercise, where withdrawal symptoms (especially mood changes) are clear. For other behaviors, evidence is sparse, and potential rebound effects of abstinence are not well studied.","clinical_takeaway":"Abstinence may help some problematic behaviors, but evidence for pornography is limited and possible rebound effects are unknown.","confidence":0.8,"topic_tags":["pornography","sexual_function","masturbation","moral_incongruence"],"strengths":["Systematic search across multiple behavioral addictions","Focus on prospective abstinence studies","Identifies gaps in literature"],"limitations":["No quantitative meta‑analysis reported","Limited detail on how constructs were operationalised in primary studies","Potentially heterogeneous study designs"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":74,"citing_publications":91,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.cpr.2020.101828"}},{"id":2522,"doi":"10.2105/ajph.2019.305498","pmid":"31913670","pmcid":null,"title":"Should Public Health Professionals Consider Pornography a Public Health Crisis?","authors":"Nelson KM, Rothman EF.","first_author":"Nelson KM","journal":"American journal of public health","year":2020,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["bibliography","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/editorial without empirical data","sample_n":null,"sample_text":"none","population":"none","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"opposes","citation_value":"background","plain_summary":"The authors argue that labeling pornography as a public‑health crisis is a political stunt that conflicts with public‑health values and is not supported by current evidence.","clinical_takeaway":"None – the piece offers opinion, not clinical guidance.","confidence":0.8,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Clear articulation of a public‑health perspective","References to broader evidence base"],"limitations":["No original data presented","Lacks systematic review methodology","Potential bias from ideological stance"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":1,"mentioning":22,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2105/ajph.2019.305498"}},{"id":2523,"doi":"10.7334/psicothema2019.179","pmid":"31954411","pmcid":null,"title":"Risk factors for being a victim of online grooming in adolescents","authors":"Schoeps K, Peris Hernández M, Garaigordobil M, Montoya-Castilla I.","first_author":"Schoeps K","journal":"Psicothema","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,200 adolescents (12‑16 y) using self‑report questionnaires and SEM mediation analysis","sample_n":1200,"sample_text":"1,200 adolescents (≈ 50 % female) aged 12‑16 y","population":"Adolescents aged 12‑16, recruited from schools (presumed convenience sample)","country":"Spain (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 1,200 Spanish teens to see how body image, impulsivity, sexual initiation strategies and porn‑related sexting predict being groomed online. Both personal traits and erotic sexting were linked to higher grooming risk, explaining over half of the variance.","clinical_takeaway":"Adolescents who engage in erotic sexting and display impulsive traits may be at higher risk for online grooming; prevention programs should address these behaviours.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample (N = 1200)","Use of structural equation modeling to test mediated pathways","Focus on understudied risk factors for grooming"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report questionnaires of uncertain validation","No measurement/control of key confounds (mental health, trauma, moral factors)","Convenience school sample limits generalisability"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7334/psicothema2019.179"}},{"id":2524,"doi":"10.1258/mlj.2012.012029","pmid":"23341297","pmcid":null,"title":"Characteristics of French users of child pornography: description of a cohort subjected to forensic evaluation","authors":"Prat S, Jonas C.","first_author":"Prat S","journal":"The Medico-legal journal","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"cohort based on forensic psychiatric assessments of individuals charged with child‑pornography offenses; likely a convenience sample of court‑referred cases","sample_n":null,"sample_text":"not reported in abstract; cohort of forensic evaluations","population":"adult males and females in France charged with possession of child sexual images","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study describes French individuals evaluated by courts for possessing child sexual images, noting feelings of loneliness and limited social integration; most have no prior criminal record.","clinical_takeaway":"None - findings are descriptive of a forensic cohort and not directly applicable to clinical practice.","confidence":0.6,"topic_tags":["csbd","sexual_function"],"strengths":["Uses forensic psychiatric assessments","Provides descriptive data on a legal cohort"],"limitations":["Unclear measurement tools and validation","Convenience, non‑representative sample","No control for key confounds","Descriptive only, no statistical inference"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/mlj.2012.012029"}},{"id":2525,"doi":"10.1111/j.1468-5906.2011.01630.x","pmid":"22616090","pmcid":null,"title":"Pornography, religion, and the happiness gap: does pornography impact the actively religious differently?","authors":"Patterson R, Price J.","first_author":"Patterson R","journal":"Journal for the scientific study of religion","year":2012,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large nationally representative survey (GSS), cross‑sectional analysis","sample_n":null,"sample_text":"large nationally representative sample (GSS)","population":"adult United States respondents in the General Social Survey","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Using U.S. survey data, the authors found that people who attend church regularly and belong to religious groups that disapprove of pornography report a larger drop in overall happiness when they do use porn, compared with less religious individuals.","clinical_takeaway":"None – findings are correlational and do not inform clinical practice.","confidence":0.7,"topic_tags":["pornography","religiosity","sexual_function","moral_incongruence"],"strengths":["large, nationally representative dataset","clear operationalization of ‘happiness gap’","focus on interaction between religiosity and porn use"],"limitations":["single‑item measures for porn use and happiness","no control for key confounds (moral incongruence, masturbation, mental health)","cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":7,"contrasting":1,"mentioning":69,"citing_publications":172,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1468-5906.2011.01630.x"}},{"id":2526,"doi":"10.1136/bmj.m307","pmid":"31980435","pmcid":null,"title":"Junior doctor who was convicted of downloading child pornography is struck off","authors":"Dyer C.","first_author":"Dyer C.","journal":"BMJ (Clinical research ed.)","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.m307"}},{"id":2527,"doi":"10.1007/s10979-010-9252-2","pmid":"21088873","pmcid":null,"title":"Examining the criminal history and future offending of child pornography offenders: an extended prospective follow-up study","authors":"Eke AW, Seto MC, Williams J.","first_author":"Eke AW","journal":"Law and human behavior","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort using police and criminal‑record data; N=541 male child‑pornography registrants; average follow‑up ≈5 years","sample_n":541,"sample_text":"201 originally identified offenders + 340 additional offenders","population":"registered male child‑pornography offenders in Ontario, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 5‑year follow‑up of 541 men registered for child‑pornography offenses showed that about one‑third reoffended, with a small proportion committing new contact sexual crimes. Prior violent history and younger age predicted later violent offending.","clinical_takeaway":"Risk assessment for reoffending should emphasize past violent offenses and younger offender age.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["large, registry‑based sample","prospective follow‑up over several years","objective official criminal‑record outcomes"],"limitations":["no self‑report or psychometric data on motives","limited control of psychosocial confounders","no pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":10,"contrasting":0,"mentioning":124,"citing_publications":165,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10979-010-9252-2"}},{"id":2528,"doi":"10.1080/00224499.2011.628132","pmid":"22126160","pmcid":null,"title":"U.S. males and pornography, 1973-2010: consumption, predictors, correlates","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Journal of sex research","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":113,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional analysis of nationally representative General Social Survey data (1973‑2010) on U.S. males","sample_n":null,"sample_text":"large, nationally representative (GSS)","population":"U.S. adult males","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using U.S. survey data from 1973‑2010, the study found that men who watch pornography tend to have more permissive sexual attitudes and report more sexual partners, extramarital sex, and paid sex. The authors note that direction of influence is unclear.","clinical_takeaway":"None - findings are correlational and do not guide clinical decisions.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative dataset","Broad time span (1973‑2010)","Considers multiple sexual‑behavior outcomes"],"limitations":["Cross‑sectional; cannot infer causality","Key potential confounds (e.g., moral attitudes, mental health) not measured","Pornography use measured with a single self‑report item, no validated scale"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":21,"contrasting":0,"mentioning":224,"citing_publications":265,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2011.628132"}},{"id":2529,"doi":"10.3109/13625187.2011.617853","pmid":"22122411","pmcid":null,"title":"Hercules and Barbie? Reflections on the influence of pornography and its spread in the media and society in groups of adolescents in Sweden","authors":"Mattebo M, Larsson M, Tydén T, Olsson T, Häggström-Nordin E.","first_author":"Mattebo M","journal":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"focus group interviews with 35 Swedish adolescents; grounded‑theory analysis","sample_n":35,"sample_text":"Six focus groups (3 female, 3 male) with 17 women and 18 men","population":"Adolescents (Sweden), convenience sample","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Swedish teens discussed how ubiquitous porn shows men as dominant and women as submissive. They felt both anxiety and inspiration, seeing porn as fake but also a source of sexual ideas.","clinical_takeaway":"None – the study offers qualitative insights, not clinical guidance.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","gender","csbd"],"strengths":["In‑depth, participant‑led perspectives","Grounded‑theory systematic coding","Gender‑balanced focus groups"],"limitations":["Small, non‑representative adolescent sample","No quantitative measurement of pornography use or distress","Key confounders (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":29,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/13625187.2011.617853"}},{"id":2531,"doi":"10.1097/pra.0000000000000439","pmid":"31913973","pmcid":null,"title":"Adapting Dialectical Behavior Therapy for Treating Problematic Interactive Media Use","authors":"Pluhar E, Jhe G, Tsappis M, Bickham D, Rich M.","first_author":"Pluhar E","journal":"Journal of psychiatric practice","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single adolescent case, 14 DBT sessions, diary‑card outcome measures","sample_n":1,"sample_text":"N=1 (case report)","population":"1 male adolescent, 15 y","country":"USA (presumed by journal)","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 15‑year‑old boy with excessive gaming, porn, and social‑media use received a 14‑session DBT program. Self‑reports and teacher/parent notes suggested less nighttime screen time, fewer porn episodes, and better school work.","clinical_takeaway":"DBT may help adolescents reduce problematic media use, but evidence is limited to a single case.","confidence":0.4,"topic_tags":["pornography","adolescents","treatment"],"strengths":["Provides detailed clinical description","Uses multiple informants (parent, teacher)","Attempts systematic DBT adaptation"],"limitations":["Single case, no control group","Outcomes based on non‑validated diaries","No measurement of key confounds (moral, mental health, etc.)"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/pra.0000000000000439"}},{"id":2532,"doi":"10.1089/cyber.2010.0477","pmid":"22032795","pmcid":null,"title":"A review of Internet pornography use research: methodology and content from the past 10 years","authors":"Short MB, Black L, Smith AH, Wetterneck CT, Wells DE.","first_author":"Short MB","journal":"Cyberpsychology, behavior and social networking","year":2012,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":107,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of methodological issues in pornography research; no new empirical data.","sample_n":null,"sample_text":"Not applicable – review of existing literature","population":"non‑deviant adult users (as described in reviewed studies)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["selective_reporting"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined 10 years of research on Internet pornography, finding that studies differ widely in how they define pornography, measure use, and consider its effects. These methodological gaps limit how well findings can be compared or generalized.","clinical_takeaway":"Clinicians should treat research on pornography use as heterogeneous; avoid drawing firm conclusions from any single study.","confidence":0.7,"topic_tags":["pornography","measurement","sexual_function","moral_incongruence"],"strengths":["Broad overview of a decade of work","Identifies inconsistencies in definitions and measurement","Provides concrete recommendations for future research"],"limitations":["Narrative (non‑systematic) approach may miss studies","No formal quality appraisal of included papers","Lacks quantitative synthesis"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":3,"contrasting":1,"mentioning":144,"citing_publications":304,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2010.0477"}},{"id":2533,"doi":"10.1177/1077801211424555","pmid":"21997464","pmcid":null,"title":"Watching pornography: gender differences, violence and victimization. An exploratory study in Italy","authors":"Romito P, Beltramini L.","first_author":"Romito P","journal":"Violence against women","year":2011,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 303 Italian university students","sample_n":303,"sample_text":"303 students (49.2% female) from Italy","population":"students (young adults, approx. 50% female)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 303 Italian students, most males and many females had viewed pornography; a third had seen violent porn. Female students who experienced family psychological abuse or sexual violence were more likely to watch porn, especially violent porn, whereas no such link was found for males.","clinical_takeaway":"Clinicians should consider victimisation histories when discussing pornography use with female patients; no direct causal link is established.","confidence":0.8,"topic_tags":["pornography","gender","sexual_function"],"strengths":["large sample for student survey","examines gender differences","includes violent pornography content"],"limitations":["cross‑sectional, cannot infer causality","relies on ad‑hoc self‑report items, limited validation","does not control for moral/religious attitudes or masturbation"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":13,"citing_publications":73,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801211424555"}},{"id":2534,"doi":"10.29063/ajrh2019/v23i4.6","pmid":"32227739","pmcid":null,"title":"Sexual Practices among Senior Students in Private Secondary Schools in Uyo, Southern Nigeria","authors":"Johnson OE, Bassey BA.","first_author":"Johnson OE","journal":"African journal of reproductive health","year":2019,"pub_types":["Journal Article"],"keywords":["Nigeria","Adolescents","Sexual Practices","Sexuality Education","Senior Secondary Students"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive cross‑sectional survey of 353 private‑school students in Uyo, Nigeria using a self‑administered questionnaire.","sample_n":353,"sample_text":"353 respondents (male‑to‑female ratio 1:1.17)","population":"Adolescents (mean age 14.8) in senior secondary private schools, Nigeria","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 353 Nigerian secondary‑school students found that 14 % had ever had sex, many started before age 12, and about one‑quarter of boys and 9 % of girls reported viewing pornography. Low contraceptive use and multiple partners were also noted.","clinical_takeaway":"Early, school‑based sexuality education is needed to address early debut and risky behaviours among adolescents.","confidence":0.8,"topic_tags":["adolescents","sexual_function","pornography","masturbation"],"strengths":["Reasonably large sample for a school‑based survey","Clear descriptive prevalence data"],"limitations":["Uses non‑validated, self‑report questionnaire","Cross‑sectional design limits causal inference","No control for moral, mental‑health or partner variables"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.29063/ajrh2019/v23i4.6"}},{"id":2535,"doi":"10.1007/s10508-019-01571-3","pmid":"31720938","pmcid":null,"title":"Longitudinal Risk Factors of Selling and Buying Sexual Services Among Youths in Switzerland","authors":"Averdijk M, Ribeaud D, Eisner M.","first_author":"Averdijk M","journal":"Archives of sexual behavior","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexuality","Prostitution","Transactional Sex","Compensated Dating"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Longitudinal cohort of 1,675 Swiss youths, predictors measured at ages 13 & 15, outcomes (selling/buying sexual services) at age 17; logistic regression with multiple imputation.","sample_n":1675,"sample_text":"target sample: N = 1675 children, 52 % male","population":"Adolescents (mean age 17 at outcome), 52 % male, Swiss national sample","country":"Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Swiss cohort of 1,675 adolescents, researchers tracked factors measured at ages 13‑15 that predicted whether teens would later sell or buy sexual services at age 17. Pornography use was one of several predictors, especially among girls, but the study used brief, unvalidated questions to assess these outcomes.","clinical_takeaway":"Evidence that pornography use may relate to risky sexual‑service behavior in youth is limited; clinicians should consider broader psychosocial factors rather than focusing on porn alone.","confidence":0.7,"topic_tags":["sexual_function","pornography"],"strengths":["Large, nationally representative youth cohort","Longitudinal design allows temporal ordering","Multiple imputation for missing data"],"limitations":["Novel, unvalidated outcome measures","Limited control for key sexual‑health confounds (e.g., moral incongruence, mental health)","Rare outcomes reduce power for subgroup analyses"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":29,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-01571-3"}},{"id":2536,"doi":"10.1111/j.1755-618x.2011.01264.x","pmid":"22214041","pmcid":null,"title":"A new sexual revolution? Critical theory, pornography, and the Internet","authors":"Garlick S.","first_author":"Garlick S.","journal":"Canadian review of sociology = Revue canadienne de sociologie","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"non-empirical critical theory article","sample_n":null,"sample_text":"N/A","population":"N/A","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The author revisits Marcuse's ideas about a sexual revolution and asks whether they help explain how the Internet shapes modern sexuality, using two porn sites as examples.","clinical_takeaway":"None – the paper is theoretical and does not provide clinical guidance.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence"],"strengths":["Integrates classic critical theory with contemporary digital context","Highlights intersection of sexuality, technology, and capitalism"],"limitations":["No empirical data; purely theoretical","Lacks operational definitions or measurement of pornography use","Does not address methodological rigor"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1755-618x.2011.01264.x"}},{"id":2537,"doi":"10.1177/1077559511415837","pmid":"21788212","pmcid":null,"title":"Arrests for child pornography production: data at two time points from a national sample of U.S. law enforcement agencies","authors":"Wolak J, Finkelhor D, Mitchell KJ, Jones LM.","first_author":"Wolak J","journal":"Child maltreatment","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive analysis of arrest records from >2,500 U.S. law‑enforcement agencies at two time points (2000‑2001, 2006).","sample_n":2500,"sample_text":"more than 2,500 agencies","population":"U.S. law‑enforcement agencies (national sample).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Analysis of U.S. police data shows arrests for child‑pornography production more than doubled between 2000‑2001 and 2006, mainly due to increased law‑enforcement activity rather than more producers.","clinical_takeaway":"None – study concerns law‑enforcement trends, not clinical care.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, national sample of law‑enforcement agencies.","Two time points allow trend observation.","Clear descriptive statistics."],"limitations":["No individual‑level data; ecological inference limited.","No statistical power justification or confidence intervals.","Does not address motives or psychological constructs."],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":4,"confounds":9,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":2,"mentioning":73,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077559511415837"}},{"id":2538,"doi":"10.3390/ijerph16224343","pmid":"31703331","pmcid":"PMC6888172","title":"Sexual Exploitation as a Minor, Violence, and HIV/STI Risk among Women Trading Sex in St. Petersburg and Orenburg, Russia","authors":"Urada LA, Rusakova M, Odinokova V, Tsuyuki K, Raj A, Silverman JG.","first_author":"Urada LA","journal":"International journal of environmental research and public health","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Russia","Violence Victimization","Child Sexual Exploitation","Human Trafficking","Sex Trade"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/16/22/4343/pdf?version=1573203511","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of women in the sex trade using time‑location sampling (N≈896, 654 with complete data).","sample_n":896,"sample_text":"Women in the sex trade (N = 896) recruited via time‑location sampling; 654 provided age at first exploitation.","population":"Women sex workers in St. Petersburg and Orenburg, Russia.","country":"Russia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 896 women sex workers in Russia, 11% began trading sex as minors. Those who entered as minors faced higher violence, drug use, client volume, and early pornography involvement, indicating greater HIV/STI risk.","clinical_takeaway":"Early entry into sex work is linked to heightened health risks; interventions should target protection and services for minors.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Large sample for a hard‑to‑reach population","Use of time‑location sampling improves representativeness within venues","Adjusted logistic models with confidence intervals"],"limitations":["Cross‑sectional design limits causal inference","Key confounders (moral incongruence, mental health, partner context) not measured","Reliance on self‑report without validated scales for exploitation or trauma"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph16224343"}},{"id":2539,"doi":"10.1007/s10508-011-9789-2","pmid":"21755381","pmcid":"PMC3310969","title":"Viewing pornography depicting unprotected anal intercourse: are there implications for HIV prevention among men who have sex with men?","authors":"Stein D, Silvera R, Hagerty R, Marmor M.","first_author":"Stein D","journal":"Archives of sexual behavior","year":2012,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet‑based questionnaire of 821 non‑monogamous MSM; cross‑sectional analysis of self‑reported pornography viewing and sexual behavior.","sample_n":751,"sample_text":"Cross‑sectional convenience sample; not nationally representative.","population":"non‑monogamous men who have sex with men (MSM), recruited online; N≈821 (751 with complete data).","country":"United States (assumed from NIH funding).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 821 non‑monogamous gay men, those who reported viewing more porn showing unprotected anal sex were also more likely to have had unprotected anal sex themselves in the past three months.","clinical_takeaway":"Viewing porn depicting risky sex correlates with actual risky behavior, but the study cannot prove it causes risk; clinicians should assess broader factors.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a sexuality survey.","Adjusted for relevant sexual‑risk covariates (age, nitrite use, HIV status).","Transparent acknowledgment that causality cannot be inferred."],"limitations":["Self‑report measures of pornography exposure are crude and unvalidated.","Cross‑sectional design; direction of association unknown.","Key confounds (moral incongruence, mental health, partner context) not assessed."],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":12,"contrasting":6,"mentioning":83,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-011-9789-2"}},{"id":2540,"doi":"10.1093/asj/sjy321","pmid":"30535095","pmcid":null,"title":"Major Motivators and Sociodemographic Features of Women Undergoing Labiaplasty","authors":"Dogan O, Yassa M.","first_author":"Dogan O","journal":"Aesthetic surgery journal","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 71 women scheduled for labiaplasty; open‑ended questionnaire plus validated scales.","sample_n":71,"sample_text":"71 patients scheduled for labiaplasty","population":"Women seeking labiaplasty (N=71)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 71 women planning labiaplasty identified appearance, media influence, and sexual improvement as main motivators; 20% had used porn in the past month, which was linked to lower genital self‑image and self‑esteem.","clinical_takeaway":"Clinicians should discuss media and pornography influences when counseling women considering labiaplasty.","confidence":0.85,"topic_tags":["lgbtq","adolescents","sexual_function","gender"],"strengths":["Use of multiple validated psychometric instruments","Novel qualitative motivator analysis","Clear reporting of pornography prevalence","Relevant clinical focus on labiaplasty decision‑making"],"limitations":["Convenience sample of surgery‑seeking patients","Cross‑sectional design limits causal inference","Moral or partner factors not assessed","Small sample for subgroup comparisons"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":38,"citing_publications":85,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/asj/sjy321"}},{"id":2541,"doi":"10.1093/asj/sjy309","pmid":"30423019","pmcid":null,"title":"Female Cosmetic Genital Surgery: Patient Characteristics, Motivation, and Satisfaction","authors":"Kalaaji A, Dreyer S, Maric I, Schnegg J, Jönsson V.","first_author":"Kalaaji A","journal":"Aesthetic surgery journal","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 69 women who had undergone female cosmetic genital surgery; anonymous questionnaire; response rate 77%; mean follow‑up 31 months.","sample_n":69,"sample_text":"69 respondents (out of 125 contacted).","population":"Women (mean age 30.8) who had elective genital cosmetic surgery at a single clinic in Norway.","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 69 women who had cosmetic genital surgery found that many were motivated by cosmetic, practical, emotional, and intimate reasons; media, pornography and negative comments played a role. Most reported satisfaction with the results after about 2½ years.","clinical_takeaway":"Patients generally report good satisfaction, but findings are based on a self‑selected surgical sample and limited measures.","confidence":0.75,"topic_tags":["pornography","sexual_function"],"strengths":["Focused on a specific clinical population.","Reasonable response rate (77%).","Anonymous data collection reduces social desirability bias."],"limitations":["Convenience sample of surgery patients; cannot generalise to broader population.","Questionnaire appears ad‑hoc; no validated psychometric tools reported.","No control group; only descriptive outcomes."],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/asj/sjy309"}},{"id":2542,"doi":"10.5993/ajhb.43.6.2","pmid":"31662163","pmcid":null,"title":"Further Evidence for the Psychometric Properties of Young's Internet Addiction Test (IAT): A Study on a Sample of Israeli-Arab Male Adolescents","authors":"Yaffe Y, Seroussi DE.","first_author":"Yaffe Y","journal":"American journal of health behavior","year":2019,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a self‑report questionnaire with 180 male adolescents; exploratory and confirmatory factor analyses; correlational with pornography use, grades, activity","sample_n":180,"sample_text":"180 male adolescents, convenience sample","population":"Israeli‑Arab male adolescents, ages 12‑16 (N=180)","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested a Hebrew version of the Internet Addiction Test with 180 Arab‑Israeli boys, finding that the questionnaire works well and its scores relate to how often they watch porn, their school grades and activity levels.","clinical_takeaway":"The IAT appears reliable for assessing internet‑related problems in this youth group, but clinicians should consider other factors (e.g., mental health) when interpreting scores.","confidence":0.8,"topic_tags":["measurement","adolescents","pornography","sexual_function"],"strengths":["Adequate sample size for factor analysis","Both EFA and CFA conducted","Concurrent validity examined with relevant behaviours"],"limitations":["No measurement of key confounds (e.g., moral incongruence, mental health)","Cross‑sectional, cannot infer causality","Sample limited to male adolescents from one ethnic group"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":9,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5993/ajhb.43.6.2"}},{"id":2543,"doi":"10.1080/00918369.2011.581944","pmid":"21740219","pmcid":null,"title":"Language, gay pornography, and audience reception","authors":"Leap WL.","first_author":"Leap WL.","journal":"Journal of homosexuality","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"analysis of audience comments on a gay porn film website; qualitative thematic coding; sample size not reported","sample_n":null,"sample_text":"not reported","population":"gay porn viewers posting on a video‑club web site (convenience sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article examines how viewers talk about a gay porn film on a web forum, showing that comments mix erotic reactions with political and cultural interpretations, suggesting that audience meanings go beyond pure sexual content.","clinical_takeaway":"None – the study offers cultural insight rather than clinical guidance.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Provides rich, contextual insight into audience meanings","Highlights ideological dimensions of gay porn reception","Uses actual user‑generated language as data"],"limitations":["No clear sampling frame or size reported","Findings limited to one film and one online community","No systematic measurement of constructs (e.g., sexual arousal, distress)","Lacks quantitative analysis or statistical validation"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2011.581944"}},{"id":2544,"doi":"10.1016/0022-3999(83)90086-7","pmid":"6683315","pmcid":null,"title":"Affective and physiological sexual response patterns: the effects of instructions on sexually functional and dysfunctional men","authors":"Heiman JR, Rowland DL.","first_author":"Heiman JR","journal":"Journal of psychosomatic research","year":1983,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":164,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment comparing 14 sexually dysfunctional men with 16 sexually functional men; within‑subject manipulation of instructional set (demand vs. non‑demand) preceding erotic audio; physiological (penile tumescence, heart rate) and self‑report measures recorded.","sample_n":30,"sample_text":"14 sexually dysfunctional, 16 sexually functional men.","population":"Male adults, mixed age, small convenience sample (N≈30).","country":"United States (implied by author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, men with erectile problems showed less penile swelling than healthy men when told to perform, but reported lower arousal overall. The way instructions were given affected physiological and emotional responses differently for the two groups.","clinical_takeaway":"Instructional context (performance pressure vs. relaxed focus) may influence sexual arousal patterns in men with dysfunction; clinicians might consider sensate‑focus techniques.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of objective physiological measures","Experimental manipulation of instruction set","Validated distress instrument (SCL‑90)"],"limitations":["Very small sample, likely underpowered","Group classification criteria not detailed","No control for potential confounds (e.g., relationship status, mental‑health comorbidities beyond SCL‑90)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":12,"contrasting":2,"mentioning":156,"citing_publications":260,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0022-3999(83)90086-7"}},{"id":2545,"doi":"10.1017/mdh.2019.46","pmid":"31571698","pmcid":"PMC6733762","title":"An Uneasy Pleasure: Representing the Dangers of Skin-to-skin Contact in Eighteenth-century London '<i>The William Bynum Prize Essay</i>'","authors":"Fernandes S.","first_author":"Fernandes S.","journal":"Medical history","year":2019,"pub_types":["Historical Article","research-article","Journal Article"],"keywords":["Disease","SKin","Prostitution","Daniel Defoe","Fanny Hill","John Cleland"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"historical essay, no empirical data, no sample","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The essay argues that 18th‑century pornographic novel Fanny Hill used depictions of skin‑to‑skin disease to comment on class and prostitution, challenging the view that it merely serves erotic pleasure.","clinical_takeaway":"None – the article is a historical analysis, not a clinical study.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Provides a novel historical perspective on disease representation in pornographic literature","Engages with primary 18th‑century sources"],"limitations":["No empirical data; purely interpretive","No systematic methodology described","Findings not directly applicable to contemporary sexual health"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/mdh.2019.46"}},{"id":2546,"doi":"10.1093/asj/sjz154","pmid":"31107944","pmcid":null,"title":"Sociocultural Influences on Men's Penis Size Perceptions and Decisions to Undergo Penile Augmentation: A Qualitative Study","authors":"Sharp G, Oates J.","first_author":"Sharp G","journal":"Aesthetic surgery journal","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"interviews with 6 men who had undergone penile augmentation; thematic analysis","sample_n":6,"sample_text":"6 men who had previously undergone penile augmentation","population":"adult men, Australia, n=6 (self‑selected, post‑procedure)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with six men who had penis‑enlargement surgery show that porn, peer comparison and media jokes shape how they view their size and motivate augmentation.","clinical_takeaway":"Clinicians should consider cultural and media influences when discussing penile augmentation with patients.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Provides novel qualitative insight into cultural factors","Direct quotes from men with lived experience"],"limitations":["Very small, non‑representative sample","No systematic measurement of key constructs","Findings not generalizable"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/asj/sjz154"}},{"id":2547,"doi":"10.2298/sarh1106353p","pmid":"21858975","pmcid":null,"title":"Pornography use and closeness with others in women","authors":"Popović M.","first_author":"Popović M.","journal":"Srpski arhiv za celokupno lekarstvo","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"pilot cross‑sectional survey of 66 women comparing self‑reported pornography users vs non‑users on a validated interpersonal closeness scale","sample_n":66,"sample_text":"Sixty‑six females participated","population":"adult women, non‑clinical convenience sample (N=66)","country":"Serbia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a small study of 66 women, researchers found no difference in how close participants felt to family and friends whether they reported using pornography or not. The results suggest pornography use may not impact women's perceived interpersonal closeness, but the sample was too small for firm conclusions.","clinical_takeaway":"No evidence that pornography use harms relational closeness in women, but larger studies are needed.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["uses a validated interpersonal closeness scale","direct comparison between users and non‑users","transparent about pilot nature and sample size"],"limitations":["small convenience sample","ad‑hoc pornography questionnaire with unclear validation","no control for key confounds (e.g., masturbation, mental health)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2298/sarh1106353p"}},{"id":2548,"doi":"10.1080/00918369.2019.1667159","pmid":"31532331","pmcid":null,"title":"The Influence of Online Experiences: The Shaping of Gay Male Identities","authors":"Giano Z.","first_author":"Giano Z.","journal":"Journal of homosexuality","year":2021,"pub_types":["Journal Article"],"keywords":["Development","Internet","Sexual","Gay","identity","Experiences","Coming Out","Online"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"qualitative interview/focus‑group study of gay men’s online experiences; sample size not reported in abstract","sample_n":null,"sample_text":"Not reported in abstract","population":"gay men, adolescents and young adults; recruitment method not specified","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with gay men show that online experiences, including watching pornography, often speed up the process of realizing and disclosing their sexual orientation, influencing how they form their identity offline.","clinical_takeaway":"None – the study offers sociocultural insight rather than clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides novel qualitative insight into how online pornographic material contributes to identity development","Highlights mechanisms linking digital exposure to offline coming‑out behaviours"],"limitations":["No quantitative measurement of pornography use or distress","No validated scales; themes derived from ad‑hoc coding","Sample size and recruitment details absent → possible selection bias"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":14,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2019.1667159"}},{"id":2549,"doi":null,"pmid":"22390126","pmcid":null,"title":"[Problems associated with age estimation of underage persons who appear in child pornography materials]","authors":"Łabecka M, Lorkiewicz-Muszyńska D, Jarzabek-Bielecka G.","first_author":"Łabecka M","journal":"Archiwum medycyny sadowej i kryminologii","year":2011,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"pol","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational study of 205 pediatric out‑patients; medical forms reviewed; authors applied a self‑created modification of the Tanner scale to estimate age of individuals appearing in child‑pornography material.","sample_n":205,"sample_text":"205 children (medical forms).","population":"Children seen in a pediatric outpatient department in Poland (N≈205).","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors tested a new version of the Tanner puberty scale on 205 children to see if it could reliably estimate the age of people shown in child‑pornography images, aiming to help forensic judges decide if the depicted persons are under 15.","clinical_takeaway":"None – the study concerns forensic age estimation, not clinical sexual health.","confidence":0.7,"topic_tags":["adolescents","sexual_function","pornography"],"strengths":["Large sample for forensic context (N=205).","Practical application to law enforcement."],"limitations":["Scale not validated; based on authors' modification.","No statistical power analysis or effect‑size reporting.","Cross‑sectional convenience sample limits generalisability."],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":2550,"doi":"10.1002/cbm.809","pmid":"21452337","pmcid":null,"title":"Child pornography offenders detected by surveillance of the Internet and by other methods","authors":"Nielssen O, O'Dea J, Sullivan D, Rodriguez M, Bourget D, Large M.","first_author":"Nielssen O","journal":"Criminal behaviour and mental health : CBMH","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational comparison of two groups of men charged with child‑pornography offences identified via police Internet surveillance versus other detection methods; data extracted from clinical examinations conducted for court reports or treatment.","sample_n":105,"sample_text":"52 men detected by Internet surveillance, 53 men detected by other means.","population":"Male offenders (N≈105) in the United Kingdom, assessed over ~10 years.","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study compared men caught with child‑pornography through police Internet monitoring to those identified by other means. Internet‑caught offenders owned more material, while those found otherwise had more psychiatric illness and histories of sexual abuse. Stereotypes about low‑risk, high‑functioning offenders were not supported.","clinical_takeaway":"None – findings pertain to forensic offender characteristics, not clinical treatment of sexual health issues.","confidence":0.7,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Reasonable sample size for offender research","Direct clinical assessments rather than self‑report only","Comparison of two detection pathways"],"limitations":["No validated psychometric instruments reported","Cross‑sectional design limits causal inference","Potential selection bias from court‑ordered examinations"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/cbm.809"}},{"id":2551,"doi":"10.1007/s00414-011-0564-7","pmid":"21431334","pmcid":null,"title":"Can facial proportions taken from images be of use for ageing in cases of suspected child pornography? A pilot study","authors":"Cattaneo C, Obertová Z, Ratnayake M, Marasciuolo L, Tutkuviene J, Poppa P, Gibelli D, Gabriel P, Ritz-Timme S.","first_author":"Cattaneo C","journal":"International journal of legal medicine","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pilot study using standardized facial photographs of children (n=373) from three European countries; discriminant analysis to classify age groups","sample_n":373,"sample_text":"353 females, 20 males","population":"children aged 6, 10, 14, 18 years (mostly females)","country":"Germany, Italy, Lithuania","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers examined whether measurements of facial features in photos can reliably estimate a child's age, which is important in child pornography cases. Using over 350 images, they correctly assigned ages about 60% of the time, better in some countries, but more work is needed before the method can be trusted.","clinical_takeaway":"None – the study addresses forensic age estimation, not clinical sexual health.","confidence":0.8,"topic_tags":["sexual_function","csbd","pornography","masturbation"],"strengths":["Relatively large sample for a pilot forensic study","Standardized image collection across three countries","Objective metric assessment of facial proportions"],"limitations":["Unequal gender distribution (few males)","No external validation on independent cases","No discussion of potential confounding factors (e.g., ethnicity, nutrition)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":32,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00414-011-0564-7"}},{"id":2552,"doi":"10.11604/pamj.2019.34.1.17139","pmid":"31762870","pmcid":"PMC6850738","title":"Early sexual debut and associated factors among secondary school students of central zone of Tigray, Northern Ethiopia, 2018","authors":"Girmay A, Mariye T, Gerensea H.","first_author":"Girmay A","journal":"The Pan African medical journal","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Adolescent","Ethiopia","Sexual Debut"],"is_oa":true,"oa_url":"https://doi.org/10.11604/pamj.2019.34.1.17139","cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"school-based quantitative cross‑sectional survey of 519 secondary students using simple random sampling; self‑administered questionnaire; logistic regression for associations","sample_n":519,"sample_text":"519 preparatory and high school regular students","population":"secondary school students (age 13‑23) in Aksum town, Tigray, Ethiopia (N=519)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 519 Ethiopian high‑school students, about one‑quarter reported having sex, and most of those started before age 14. Seeing pornography, drinking alcohol, smoking, being male, and certain living conditions were linked to earlier sexual debut.","clinical_takeaway":"Early sexual activity is associated with multiple behavioral factors, including pornography exposure; clinicians should assess these co‑occurring risks when counseling adolescents.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample for a school‑based survey","Random sampling within schools","Multivariable logistic regression with adjusted odds ratios"],"limitations":["Cross‑sectional design cannot infer causality","Self‑report measures, no validated scales for pornography exposure","Key psychosocial confounds (morality, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":13,"contrasting":1,"mentioning":37,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.11604/pamj.2019.34.1.17139"}},{"id":2553,"doi":"10.1177/1079063210372143","pmid":"21349830","pmcid":null,"title":"Child pornography possessors: trends in offender and case characteristics","authors":"Wolak J, Finkelhor D, Mitchell K.","first_author":"Wolak J","journal":"Sexual abuse : a journal of research and treatment","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":51,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Two‑wave descriptive analysis of national law‑enforcement agency data (N≈2,500 agencies) comparing CP possession arrests in 2000 vs 2006.","sample_n":2500,"sample_text":"national sample of more than 2,500 U.S. law‑enforcement agencies","population":"U.S. law‑enforcement agencies reporting CP possession arrests; offenders are adult males (mostly White, non‑Hispanic).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study compares U.S. child‑pornography possession arrests in 2000 and 2006, finding a rise in arrests and a shift toward younger offenders and peer‑to‑peer sharing, while most offenders remain White, non‑Hispanic males.","clinical_takeaway":"None – the findings describe criminal trends, not clinical sexual‑health issues.","confidence":0.9,"topic_tags":["csbd","sexual_function"],"strengths":["Large, nationally representative agency sample","Use of official arrest data ensures objective case definition","Provides temporal trend data across a six‑year span"],"limitations":["Descriptive only; no causal inference","No individual‑level psychological or contextual variables","Potential under‑detection of unreported cases"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":98,"citing_publications":159,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063210372143"}},{"id":2554,"doi":"10.1136/bmj.l5165","pmid":"31416807","pmcid":null,"title":"Consultant who oversaw FGM guidelines is struck off for possessing extreme pornography","authors":"Dyer C.","first_author":"Dyer C.","journal":"BMJ (Clinical research ed.)","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.l5165"}},{"id":2555,"doi":"10.1007/s10508-010-9714-0","pmid":"21290259","pmcid":null,"title":"Associations between online pornography and sexual behavior among adolescents: myth or reality?","authors":"Luder MT, Pittet I, Berchtold A, Akré C, Michaud PA, Surís JC.","first_author":"Luder MT","journal":"Archives of sexual behavior","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":83,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large national adolescent survey, self‑administered questionnaire, cross‑sectional","sample_n":6054,"sample_text":"6054 adolescents aged 16–20 years who used the Internet in the past month","population":"Swedish‑Swiss adolescents (16‑20 y, n≈6054)","country":"Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Swiss survey of over 6,000 adolescents, exposure to online pornography—whether wanted or not—was not linked to most risky sexual behaviours, except that exposed boys were slightly less likely to have used a condom the last time they had sex.","clinical_takeaway":"Pornography exposure alone does not predict risky sex in adolescents; clinicians should consider broader behavioural and contextual factors.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","religiosity","relationships"],"strengths":["Large, nationally‑derived adolescent sample","Distinguishes wanted vs unwanted exposure","Analyzes multiple demographic and sensation‑seeking variables"],"limitations":["Cross‑sectional; cannot infer causality","No validated scales for pornography use or addiction","Key confounds (moral attitudes, masturbation, mental health) not measured"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":2,"mentioning":131,"citing_publications":210,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9714-0"}},{"id":2556,"doi":"10.1111/ajad.12941","pmid":"31393652","pmcid":null,"title":"Psychopathology and Hypersexuality among Veterans with and without Histories of Alcohol-use Disorders","authors":"Moisson J, Potenza MN, Shirk SD, Hoff RA, Park CL, Kraus SW.","first_author":"Moisson J","journal":"The American journal on addictions","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case-control convenience sample, baseline telephone interview and follow‑up web survey","sample_n":283,"sample_text":"national convenience sample of 283 U.S. veterans","population":"U.S. post‑9/11 veterans (male and female), n≈283","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a national survey of 283 post‑9/11 U.S. veterans, those with a lifetime alcohol‑use disorder were more likely to report PTSD, drug‑use disorders, higher rates of solitary masturbation, and greater problems with pornography use and hypersexuality than veterans without an alcohol history.","clinical_takeaway":"Veterans with alcohol‑use disorders show higher rates of hypersexuality and problematic pornography; clinicians should screen for these issues during transition to civilian life.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large national sample for veteran research","Includes both men and women","Assesses multiple comorbidities (PTSD, drug use, AUD)"],"limitations":["Convenience sampling limits generalisability","Hypersexuality and problematic pornography use not described as validated scales","Moral/religious factors not directly measured or controlled"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/ajad.12941"}},{"id":2557,"doi":"10.1080/13218719.2019.1642257","pmid":"32128014","pmcid":"PMC7033712","title":"Professional reports for sentencing courts: recommendations for reporting on child exploitation material offenders' risk of recidivism and prospects for rehabilitation","authors":"Proeve MJ, Wolf G.","first_author":"Proeve MJ","journal":"Psychiatry, psychology, and law : an interdisciplinary journal of the Australian and New Zealand Association of Psychiatry, Psychology and Law","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Rehabilitation","risk assessment","Child Pornography","Structured Professional Judgment","Actuarial","Child Exploitation Material"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative commentary/recommendations without original empirical data.","sample_n":null,"sample_text":"Not applicable – article is a professional commentary.","population":"No participants (commentary).","country":"Australia (focus of legal context).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors advise courts to use structured professional judgment, based on current research, when reporting on child exploitation material offenders' risk of re‑offending and rehabilitation prospects.","clinical_takeaway":"None – article provides policy guidance, not clinical evidence.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Integrates existing empirical findings.","Provides clear practical recommendations for courts.","Discusses both actuarial and professional judgment approaches."],"limitations":["No original data; conclusions based on secondary literature.","Potential bias toward professional judgment perspective.","Lacks systematic review methodology."],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13218719.2019.1642257"}},{"id":2558,"doi":"10.1177/1077801219863881","pmid":"31359850","pmcid":null,"title":"Image-Based Sexual Abuse: Online Distribution Channels and Illicit Communities of Support","authors":"Henry N, Flynn A.","first_author":"Henry N","journal":"Violence against women","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Revenge Pornography","Image-based Sexual Abuse","Online Deviant Communities"],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 77 high‑volume websites hosting non‑consensual images; convenience sample; no participant data.","sample_n":null,"sample_text":"77 high‑volume online sites selected for analysis.","population":"Online IBSA material; no human participants surveyed.","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["retracted_or_notice"],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined 77 websites that share non‑consensual sexual images, finding that many users post for sexual gratification and to display masculinity rather than revenge. They describe these communities as fostering hypermasculine, heteronormative norms.","clinical_takeaway":"None – the study analyzes online abuse content, not individual health outcomes.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Large set of websites examined","Clear thematic framing of hypermasculinity"],"limitations":["No validated measurement instruments","Convenience sampling of sites","Lacks empirical user data"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":104,"citing_publications":119,"retracted":false,"notices":[{"status":"Has erratum","date":"2020-10-1","noticeDoi":"10.1177/1077801220952579","doi":"10.1177/1077801219863881"}],"url":"https://scite.ai/reports/10.1177/1077801219863881"}},{"id":2559,"doi":"10.1371/journal.pone.0220235","pmid":"31356631","pmcid":"PMC6663068","title":"Sexual behaviors and associated factors among youths in Nekemte town, East Wollega, Oromia, Ethiopia: A cross-sectional study","authors":"Waktole ZD.","first_author":"Waktole ZD.","journal":"PloS one","year":2019,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0220235&type=printable","cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"community‑based cross‑sectional survey of Ethiopian youths (self‑administered questionnaire).","sample_n":null,"sample_text":"Community‑based convenience sample; likely not probability‑based.","population":"youths aged 15‑24 in Nekemte town, Ethiopia (N≈300, inferred from 144 reporting intercourse).","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2019 Ethiopian survey found that about half of young people had ever had sex; those who watched pornography were over four times more likely to report sexual activity, as were those who drank alcohol or were older.","clinical_takeaway":"Viewing pornography is associated with higher odds of sexual activity among Ethiopian youths, but causality is unclear; interventions should consider broader risk factors.","confidence":0.7,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Large community sample for the setting","Logistic regression with confidence intervals","Identifies multiple sociodemographic correlates"],"limitations":["No validated measures of pornography use or sexual risk","Key confounds (moral views, masturbation, mental health) not assessed","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":19,"contrasting":1,"mentioning":22,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0220235"}},{"id":2561,"doi":"10.1080/0092623x.2011.607047","pmid":"21961444","pmcid":null,"title":"Reliability, validity, and psychometric development of the pornography consumption inventory in a sample of hypersexual men","authors":"Reid RC, Li DS, Gilliland R, Stein JA, Fong T.","first_author":"Reid RC","journal":"Journal of sex & marital therapy","year":2011,"pub_types":["Validation Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":92,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Validation study using two treatment‑seeking samples of hypersexual men (N≈105 each) with factor analysis and reliability testing.","sample_n":212,"sample_text":"Two convenience samples of treatment‑seeking hypersexual men (N=105 and N=107).","population":"hypersexual men seeking treatment to reduce pornography use","country":"USA (likely, based on NIH funding)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study created and validated a new questionnaire that measures why hypersexual men use pornography, identifying four motivation types such as pleasure, escape, curiosity, and novelty.","clinical_takeaway":"Clinicians can use the PCI to assess specific pornography‑use motives in hypersexual clients, but should consider broader psychological factors not covered by the scale.","confidence":0.7,"topic_tags":["measurement","pornography","sexual_function"],"strengths":["Rigorous psychometric evaluation (EFA/CFA)","Two independent samples","Good internal reliability"],"limitations":["Convenience, treatment‑seeking sample limits generalisability","No assessment of moral or mental‑health confounds","No pre‑registration or open data"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":15,"contrasting":0,"mentioning":135,"citing_publications":190,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2011.607047"}},{"id":2562,"doi":null,"pmid":"21653274","pmcid":null,"title":"The inclusion of child pornography in the DSM-5 diagnostic criteria for pedophilia: conceptual and practical problems","authors":"First MB.","first_author":"First MB.","journal":"The journal of the American Academy of Psychiatry and the Law","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"The paper is a conceptual commentary on DSM‑5 diagnostic criteria for pedophilia, offering no empirical data, participants, or interventions.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"background","plain_summary":"The article argues that adding child‑pornography use to the DSM‑5 definition of pedophilic disorder blurs the line between having a paraphilic interest and having a disorder, suggesting it belongs in the interest component instead.","clinical_takeaway":"Clinicians should be cautious about diagnosing pedophilic disorder solely on the basis of child‑pornography use without clear distress or impairment.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Clear articulation of DSM‑5 structural issues","Grounded in existing diagnostic framework","Provides concrete recommendation for criterion wording"],"limitations":["No empirical data to support claims","Limited to theoretical argument","Potential bias from author’s position"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":2563,"doi":"10.1089/cyber.2010.0222","pmid":"21117979","pmcid":null,"title":"Watching pornographic pictures on the Internet: role of sexual arousal ratings and psychological-psychiatric symptoms for using Internet sex sites excessively","authors":"Brand M, Laier C, Pawlikowski M, Schächtle U, Schöler T, Altstötter-Gleich C.","first_author":"Brand M","journal":"Cyberpsychology, behavior and social networking","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":86,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey with experimental arousal rating task (N=89 heterosexual males).","sample_n":89,"sample_text":"89 heterosexual male participants","population":"Adult heterosexual males, likely convenience sample.","country":"Germany (inferred from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In 89 heterosexual men, higher sexual arousal to porn pictures and greater overall psychological symptoms predicted self‑reported problems with online sexual activity, while time spent online did not.","clinical_takeaway":"Clinicians should consider underlying psychological distress and arousal reactions, not just usage time, when assessing problematic online sexual behavior.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Experimental arousal rating task","Relatively large sample for a questionnaire study","Includes multiple psychological symptom measures"],"limitations":["Uses modified IATsex, a non‑validated addiction scale (circular)","No assessment of moral incongruence or masturbation","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":15,"contrasting":0,"mentioning":106,"citing_publications":210,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2010.0222"}},{"id":2564,"doi":"10.2147/prbm.s208968","pmid":"31308769","pmcid":"PMC6615461","title":"Problematic interactive media use in teens: comorbidities, assessment, and treatment","authors":"Pluhar E, Kavanaugh JR, Levinson JA, Rich M.","first_author":"Pluhar E","journal":"Psychology research and behavior management","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Mental health","Adolescent Health","Dialectical Behavior Therapy","Addictive Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6615461","cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of problematic interactive media use; no new empirical data, no systematic methodology reported","sample_n":null,"sample_text":"none (review article)","population":"adolescents (teens) – general description, no specific sample","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article reviews how excessive video‑gaming, social‑media, and pornography use can harm teens, linking these problems to ADHD, mood disorders, and autism, but offers no new data or systematic analysis.","clinical_takeaway":"Clinicians should be aware that heavy media use may co‑occur with mental‑health issues, but evidence for a distinct ‘addiction’ diagnosis is limited.","confidence":0.4,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Broad overview of comorbidities","Highlights need for clinician guidance"],"limitations":["No systematic search or risk‑of‑bias assessment","Lacks empirical data or validated measures","Potential bias toward pathology model"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":43,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/prbm.s208968"}},{"id":2565,"doi":"10.1051/orthodfr/2019010","pmid":"31241456","pmcid":null,"title":"[The fabulous history of the smile]","authors":"Choukroun MG.","first_author":"Choukroun MG.","journal":"L' Orthodontie francaise","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://orthodfr.edpsciences.org/10.1051/orthodfr/2019010/pdf","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"0-2","sample_n":null,"sample_text":"no empirical sample","population":"not applicable","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how representations of smiling, especially with white teeth, have changed over time and links this to broader social themes like sexuality and pornography, but it does not present new research data.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides historical perspective on smile and sexuality","Integrates art history with social commentary"],"limitations":["No empirical data or systematic methodology","Lacks operational definitions of constructs","No measurement of key confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1051/orthodfr/2019010"}},{"id":2566,"doi":"10.1016/j.neubiorev.2019.06.032","pmid":"31247240","pmcid":null,"title":"The Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors","authors":"Brand M, Wegmann E, Stark R, Müller A, Wölfling K, Robbins TW, Potenza MN.","first_author":"Brand M","journal":"Neuroscience and biobehavioral reviews","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Inhibitory Control","Behavioral Addictions","Gambling Disorder","Cue-reactivity","Problematic Pornography Use","Gaming Disorder","Buying-shopping Disorder"],"is_oa":false,"oa_url":"https://duepublico2.uni-due.de/servlets/MCRFileNodeServlet/duepublico_derivate_00070551/Brand_et_al_Interaction_I-PACE_model.pdf","cited_by_count":1028,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"The article is a theoretical review proposing an updated I-PACE model for addictive behaviors, including compulsive sexual behavior. No primary empirical data are presented.","sample_n":null,"sample_text":"Not applicable – no original data.","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors update the I-PACE model, arguing it can explain how various addictive behaviors, including compulsive pornography use, arise from interactions among personal traits, emotional and cognitive responses, and executive control, linked to fronto‑striatal brain circuits.","clinical_takeaway":"The model suggests that interventions targeting cue-reactivity, craving, and inhibitory control may help address problematic pornography use.","confidence":0.7,"topic_tags":["pornography","sexual_function","treatment"],"strengths":["Integrates a wide range of addictive behaviors","Links neurobiological and cognitive mechanisms","Comprehensive literature synthesis"],"limitations":["No empirical data; purely theoretical","Relies on existing studies with variable quality","Does not test model predictions"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":208,"contrasting":1,"mentioning":1750,"citing_publications":2170,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neubiorev.2019.06.032"}},{"id":2567,"doi":"10.11604/pamj.2019.33.135.18068","pmid":"31558934","pmcid":"PMC6754848","title":"Predictors of risky sexual behaviour among pre-college students in Adama Town, Ethiopia","authors":"Wana GW, Arulogun O, Roberts A, Kebede AS.","first_author":"Wana GW","journal":"The Pan African medical journal","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Attitude","Reproductive Health","Sexual Orientation","Risky Sexual Behaviour","Social Media Usage"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6754848","cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"School‑based cross‑sectional survey of 364 pre‑college students in Adama town, Ethiopia; logistic regression used to identify predictors of self‑reported risky sexual behaviour.","sample_n":364,"sample_text":"364 students recruited from all pre‑college schools in Adama town.","population":"Pre‑college students (age ~16) from all pre‑college schools in Adama town, Ethiopia (N = 364).","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 364 Ethiopian pre‑college students found that using social media for sexual content, going to night clubs, peer pressure and substance use were linked to higher odds of risky sexual behaviour such as early sexual debut and multiple partners.","clinical_takeaway":"Addressing peer influence, substance use and media habits may help reduce risky sexual practices among adolescents.","confidence":0.7,"topic_tags":["religiosity","masturbation","pornography","sexual_function"],"strengths":["Reasonable sample size for a community survey","Multivariate logistic regression with confidence intervals","Includes multiple behavioural predictors (social media, peer pressure, substance use)"],"limitations":["Cross‑sectional design cannot infer causality","Key constructs (e.g., risky sexual behaviour, pornography use) not measured with validated scales","No assessment of moral or psychological confounders"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":18,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.11604/pamj.2019.33.135.18068"}},{"id":2568,"doi":"10.1080/00224490903151374","pmid":"19731132","pmcid":null,"title":"Lust, love, and life: a qualitative study of Swedish adolescents' perceptions and experiences with pornography","authors":"Lofgren-Mårtenson L, Månsson SA.","first_author":"Lofgren-Mårtenson L","journal":"Journal of sex research","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":63,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative study using 22 individual interviews and 7 focus groups with 51 Swedish adolescents (14‑20 y). The sample was recruited from schools; no random or probability sampling reported.","sample_n":51,"sample_text":"51 participants (36 women, 37 men) recruited from schools in Sweden.","population":"Adolescents (14‑20 y) in Sweden, mixed gender.","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Swedish teens (14‑20) said porn is both normalised and ambivalent for them. They use it to learn, to arouse, and to talk with peers, but also view it critically, especially regarding body ideals and sexual performance.","clinical_takeaway":"None – the study is descriptive and does not provide clinical guidance.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","gender"],"strengths":["Rich, in‑depth qualitative data from adolescents.","Both individual interviews and focus groups provide triangulation."],"limitations":["Convenience sample; limited generalisability beyond Swedish youth.","No standardized measures; constructs not operationalised with validated scales.","No assessment of key confounds (moral incongruence, masturbation, mental health, etc.)."],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":10,"contrasting":0,"mentioning":138,"citing_publications":236,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490903151374"}},{"id":2570,"doi":"10.1007/bf01541656","pmid":"3994504","pmcid":null,"title":"Volunteer bias in erotica research: effects of intrusiveness of measure and sexual background","authors":"Wolchik SA, Braver SL, Jensen K.","first_author":"Wolchik SA","journal":"Archives of sexual behavior","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":64,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 324 male and 424 female undergraduates comparing characteristics of those who volunteered for various laboratory sexual arousal experiments versus non‑volunteers; between‑group comparisons of volunteer rates across increasingly intrusive conditions.","sample_n":748,"sample_text":"324 male and 424 female undergraduate students","population":"Undergraduate students (mostly young, WEIRD sample)","country":"United States (presumed from university sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that undergraduate men and women who volunteered for lab experiments on sexual arousal were more sexually experienced and less worried about performance than non‑volunteers, and that requiring participants to undress sharply lowered volunteer rates.","clinical_takeaway":"Research on sexual arousal using highly intrusive measures may over‑represent sexually experienced, low‑anxiety individuals.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large overall sample size for a 1985 study","Direct comparison of volunteers vs non‑volunteers","Systematic manipulation of measurement intrusiveness"],"limitations":["Convenience, undergraduate sample limits generalisability","Reliance on ad‑hoc self‑report items; no validated scales","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":60,"citing_publications":126,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541656"}},{"id":2571,"doi":"10.1177/1079063210382043","pmid":"20935341","pmcid":null,"title":"Predictors of child pornography offenses and child sexual abuse in a community sample of pedophiles and hebephiles","authors":"Neutze J, Seto MC, Schaefer GA, Mundt IA, Beier KM.","first_author":"Neutze J","journal":"Sexual abuse : a journal of research and treatment","year":2011,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":48,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of self‑referred community pedophiles/hebephiles (N=155) divided by recent/offence history.","sample_n":155,"sample_text":"155 self‑referred pedophiles/hebephiles","population":"Adult men self‑identified as having sexual interest in pre‑pubescent or pubescent children, recruited from the community in Germany.","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 155 community men who are attracted to children, researchers compared those who had recently committed child‑pornography offences, those who had committed contact abuse, and those who had not offended, looking for sociodemographic and risk‑factor differences.","clinical_takeaway":"No clear distinguishing predictors were found; risk assessments should consider multiple factors rather than relying on a single characteristic.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large community‑based sample of a hard‑to‑reach population","Direct comparison of pornography vs. contact offending groups"],"limitations":["Self‑referral bias limits generalisability","Potentially underpowered subgroup analyses","Limited detail on risk‑factor instruments"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":92,"citing_publications":138,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063210382043"}},{"id":2573,"doi":"10.1016/j.adolescence.2010.04.010","pmid":"20888038","pmcid":null,"title":"Frequent users of pornography. A population based epidemiological study of Swedish male adolescents","authors":"Svedin CG, Akerman I, Priebe G.","first_author":"Svedin CG","journal":"Journal of adolescence","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":73,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Population‑based survey of Swedish 18‑year‑old male students; cross‑sectional logistic regression analysis of frequent pornography use and psychosocial correlates.","sample_n":null,"sample_text":"2015 male students aged 18 years participated; 200 identified as frequent users (10.5%).","population":"Male adolescents, age 18, Sweden (N≈2000, with 200 frequent users).","country":"Sweden","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2015 Swedish survey of 18‑year‑old males found that about 10% were frequent pornography users; these youths reported higher sexual desire, more liberal attitudes toward porn, greater alcohol use and were more likely to have sold sex.","clinical_takeaway":"Frequent porn use in adolescents often co‑occurs with other risk behaviours, but causal links are unclear; clinicians should assess broader context.","confidence":0.7,"topic_tags":["pornography","adolescents","prevalence","sexual_function"],"strengths":["Large adolescent sample","Population‑based epidemiological approach","Multivariate logistic regression"],"limitations":["Cross‑sectional, cannot infer causality","No validated measures of problematic use or addiction","Key confounds (morality, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":1,"mentioning":142,"citing_publications":179,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2010.04.010"}},{"id":2574,"doi":"10.1177/1077801210382866","pmid":"20980228","pmcid":null,"title":"Aggression and sexual behavior in best-selling pornography videos: a content analysis update","authors":"Bridges AJ, Wosnitzer R, Scharrer E, Sun C, Liberman R.","first_author":"Bridges AJ","journal":"Violence against women","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":170,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 304 scenes from best‑selling pornographic videos, coding aggression (physical, verbal) and related variables.","sample_n":304,"sample_text":"304 scenes from popular porn videos","population":"Pornographic video content (no human participants).","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"An analysis of 304 popular porn videos found that almost nine‑in‑ten scenes showed physical aggression (e.g., spanking, gagging) and about half included verbal aggression, mostly directed by men toward women.","clinical_takeaway":"None – the study describes pornographic content, not health outcomes.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Systematic coding of a sizable number of video scenes","Clear operational definitions for aggression types","Comparison to prior content‑analysis work"],"limitations":["Reliance on ad‑hoc coding scheme without reported validation","No statistical power analysis or confidence intervals","Findings limited to selected best‑selling videos, not representative of all porn"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":13,"contrasting":2,"mentioning":424,"citing_publications":520,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801210382866"}},{"id":2575,"doi":"10.1017/s002572730000805x","pmid":null,"pmcid":"PMC546376","title":"Book Review : Mighty lewd books: the development of pornography in eighteenth-century England","authors":null,"first_author":null,"journal":"Medical history","year":2004,"pub_types":["book-review","Book Review"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s002572730000805x"}},{"id":2576,"doi":"10.1186/s13104-019-4348-3","pmid":"31159838","pmcid":"PMC6547544","title":"Premarital sexual practice and associated factors among high school youths in Debretabor town, South Gondar zone, North West Ethiopia, 2017","authors":"Arega WL, Zewale TA, Bogale KA.","first_author":"Arega WL","journal":"BMC research notes","year":2019,"pub_types":["brief-report","Journal Article"],"keywords":["Premarital sex","Youths","Ethiopia","Debretabor"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6547544","cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of high‑school students in one Ethiopian town (convenience sample)","sample_n":null,"sample_text":"high‑school youths in Debretabor town","population":"high‑school youths in Debretabor, Ethiopia (N not reported in abstract)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Among high‑school students in a town in Ethiopia, about 22 % reported having had premarital sex. Watching pornography, not attending religious education, drinking alcohol, having a boyfriend or girlfriend, and living in an urban family were linked to higher odds of premarital sex.","clinical_takeaway":"No direct clinical implications; the study highlights associations but cannot prove pornography causes risky sexual behavior.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Provides local prevalence data","Identifies multiple socio‑behavioral correlates","Uses multivariable logistic regression with confidence intervals"],"limitations":["Cross‑sectional design cannot infer causality","No validated measures of pornography use or sexual behaviour","Limited control for key confounds (moral, mental health, trauma)","Sample limited to one town; generalisability unclear"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":13,"contrasting":2,"mentioning":43,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s13104-019-4348-3"}},{"id":2577,"doi":"10.1097/jfn.0000000000000243","pmid":"31116177","pmcid":null,"title":"Commercial Sexual Exploitation of Children: An Update for the Forensic Nurse","authors":"Hornor G, Quinones SG, Bretl D, Courtney AB, Herendeen PA, Lewin L, Loyke JA, Morris K, Schapiro NA, Williams S.","first_author":"Hornor G","journal":"Journal of forensic nursing","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"update/review for forensic nurses; no primary data reported","sample_n":null,"sample_text":"","population":"healthcare professionals; focus on children victims of commercial sexual exploitation","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article updates forensic nurses on the problem of commercial sexual exploitation of children, describing how traffickers recruit victims, risk factors, signs to look for, and ways nurses can intervene and prevent further abuse.","clinical_takeaway":"Forensic nurses should be trained to recognize CSEC indicators and apply appropriate interventions.","confidence":0.9,"topic_tags":["csbd","sexual_function","pornography"],"strengths":["Comprehensive overview for forensic nursing practice","Highlights risk factors and indicators for CSEC"],"limitations":["No original empirical data presented","Lacks systematic review methodology"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/jfn.0000000000000243"}},{"id":2579,"doi":"10.1556/2006.8.2019.16","pmid":"31120318","pmcid":"PMC7044561","title":"Hypersexual behavior in a large online sample: Individual characteristics and signs of coercive sexual behavior","authors":"Engel J, Kessler A, Veit M, Sinke C, Heitland I, Kneer J, Hartmann U, Kruger THC.","first_author":"Engel J","journal":"Journal of behavioral addictions","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Depressive Symptoms","Hypersexuality","Sexual Coercion","Problematic Cybersex","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7044561","cited_by_count":25,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1,194 German‑speaking participants; self‑report questionnaires; moderated regression analyses","sample_n":1194,"sample_text":"N=1,194 (564 women) recruited via an online survey in German‑speaking population","population":"general adult population (online volunteers), mixed gender","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a German online survey of over a thousand adults, higher hypersexual behavior scores were linked to depression, more pornography and masturbation, and even fantasies or acts of sexual coercion, especially in women.","clinical_takeaway":"Hypersexual symptoms co‑occur with mood problems and coercive tendencies; clinicians should assess broader mental‑health and relational factors.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Large sample size for a survey","Use of validated questionnaires (HBI‑19, PHQ‑9, s‑IATsex)","Examines both individual and coercive sexual behavior"],"limitations":["Cross‑sectional design limits causal inference","Moral incongruence not measured despite relevance to perceived problem","Potential self‑selection bias of online volunteers"],"rubric_version":"2.0","raw_total":38,"max_possible":60,"pct_score":63,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":4,"contrasting":1,"mentioning":30,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.8.2019.16"}},{"id":2580,"doi":"10.2196/10695","pmid":"31099335","pmcid":"PMC6542251","title":"Google for Sexual Relationships: Mixed-Methods Study on Digital Flirting and Online Dating Among Adolescent Youth and Young Adults","authors":"Lykens J, Pilloton M, Silva C, Schlamm E, Wilburn K, Pence E.","first_author":"Lykens J","journal":"JMIR public health and surveillance","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Sexual Health","Online Dating","Adolescent Health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6542251","cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"mixed-methods exploratory study; national quantitative survey (n=1500) and 12 focus groups (n=66); convenience/online recruitment not described; cross‑sectional","sample_n":1500,"sample_text":"1500 survey participants; 66 focus‑group participants","population":"Adolescents and young adults in the United States (age 13‑24, with sub‑analysis of under‑18 vs 18+)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2019 mixed‑methods study surveyed 1,500 U.S. youth and held focus groups to examine how teens and young adults use social media, apps, and dating sites for flirting and starting sexual relationships. Findings show substantial online dating use, especially among 18‑plus, and highlight risks like catfishing and violence.","clinical_takeaway":"Clinicians should consider youths’ online dating and flirting behaviours when discussing sexual health and risk prevention.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large national survey sample (n≈1500)","Mixed‑methods triangulation of quantitative and qualitative data","Timely focus on emerging digital sexual behaviours"],"limitations":["Behavioural measures are study‑specific, not validated scales","Cross‑sectional design limits causal inference","Recruitment method unclear; possible self‑selection bias"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":44,"citing_publications":62,"retracted":false,"notices":[{"status":"Has erratum","date":"2019-6-21","noticeDoi":"10.2196/14815","doi":"10.2196/10695"},{"status":"Has correction","date":"2019-6-21","noticeDoi":"10.2196/14815","doi":"10.2196/10695"}],"url":"https://scite.ai/reports/10.2196/10695"}},{"id":2581,"doi":"10.1007/s10508-010-9648-6","pmid":"20652735","pmcid":null,"title":"Pornography use and closeness with others in men","authors":"Popovic M.","first_author":"Popovic M.","journal":"Archives of sexual behavior","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 164 men measuring self‑reported pornography use and perceived interpersonal closeness","sample_n":164,"sample_text":"non‑clinical sample of 164 males","population":"non‑clinical adult males (n=164)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 164 men, those who watched pornography reported slightly higher overall scores on a scale of closeness with important people in their lives, suggesting they may have a stronger desire for intimacy, but they did not differ from non‑watchers on closeness with specific individuals like partners or parents.","clinical_takeaway":"No direct clinical implications; the study shows a modest association between porn use and self‑reported intimacy motives.","confidence":0.78,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Use of a validated closeness scale","Relatively large sample for a survey","Focus on non‑clinical population"],"limitations":["Pornography use questionnaire not clearly validated","Cross‑sectional design limits causal inference","Key confounds (e.g., masturbation, mental health, moral attitudes) not measured"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9648-6"}},{"id":2582,"doi":"10.1097/01.ju.0000554206.18477.9a","pmid":"31009975","pmcid":null,"title":"Re: Is Pornography Use Related to Erectile Functioning? Results from Cross-Sectional and Latent Growth Curve Analyses","authors":"Seftel AD.","first_author":"Seftel AD.","journal":"The Journal of urology","year":2019,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.ju.0000554206.18477.9a"}},{"id":2583,"doi":"10.2196/12555","pmid":"31008715","pmcid":"PMC6658234","title":"Profiling Commenters on Mental Health-Related Online Forums: A Methodological Example Focusing on Eating Disorder-Related Commenters","authors":"McCaig D, Elliott MT, Siew CS, Walasek L, Meyer C.","first_author":"McCaig D","journal":"JMIR mental health","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Mental health","Social Networks","Eating Disorders","Social Media"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6658234","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational network analysis of Reddit commenters across 50 forums; mixed‑methods (network, text mining, manual review).","sample_n":14024,"sample_text":"Commenters on eating‑disorder‑related Reddit forums (≥500 commenters per forum) between March 2017 and February 2018.","population":"Public Reddit users who commented on eating‑disorder‑related forums (n≈14,024).","country":"Not specified (global Reddit users).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors mapped how users of eating‑disorder forums also post in other Reddit communities, finding that many also comment on porn‑related forums. Their network‑analysis method can be reused to study other mental‑health sub‑communities online.","clinical_takeaway":"None – the study is methodological and does not provide direct clinical guidance.","confidence":0.6,"topic_tags":["sexual_function","pornography","masturbation","csbd"],"strengths":["Large sample of real‑world online behavior","Transparent, reproducible code and data","Novel mixed‑methods network approach"],"limitations":["Convenience sample of Reddit users; limited generalisability","No validated measures of pornography use or related constructs","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/12555"}},{"id":2585,"doi":"10.1542/peds.2018-3183","pmid":"30988023","pmcid":null,"title":"Teenagers, Sexting, and the Law","authors":"Strasburger VC, Zimmerman H, Temple JR, Madigan S.","first_author":"Strasburger VC","journal":"Pediatrics","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review arguing that consensual teen sexting should be addressed as a health/education issue rather than a legal matter. No empirical data presented.","sample_n":null,"sample_text":"Not applicable – no primary data.","population":"Adolescents (teenagers) who engage in sexting; no specific sample size reported.","country":"United States (focus on US law)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews teen sexting, noting its rise with smartphones and its association with increased sexual activity. It argues that consensual teen sexting should be handled through health education rather than criminal law.","clinical_takeaway":"Clinicians should address teen sexting as a health and education issue, not a legal problem.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Comprehensive overview of existing literature on teen sexting prevalence.","Clear policy recommendation linking health/education to legal context."],"limitations":["No original data; reliance on secondary sources.","Lacks systematic review methodology (no PRISMA, risk‑of‑bias assessment).","Potential advocacy bias toward de‑criminalization."],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":46,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2018-3183"}},{"id":2586,"doi":"10.1016/j.jsxm.2019.03.002","pmid":"30956107","pmcid":null,"title":"Evaluation of Indicators of Female Sexual Dysfunction in Adult Entertainers","authors":"Dubin JM, Greer AB, Valentine C, O'Brien IT, Leue EP, Paz L, Lynne CM, Winter AG, Ramasamy R.","first_author":"Dubin JM","journal":"The journal of sexual medicine","year":2019,"pub_types":["Journal Article"],"keywords":["Sexual dysfunction","Female Sexual Dysfunction","Female Sexual Function","Pornography","Women's Sexual Health","Adult Entertainers"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online anonymous survey of 96 adult female entertainers; FSFI used; comparisons of FSD vs non‑FSD groups.","sample_n":96,"sample_text":"96 respondents meeting inclusion criteria","population":"Female adult entertainers (self‑selected via industry email list)","country":"United States (implied by Free Speech Coalition)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2019 online survey of 96 female adult entertainers found that about one‑quarter scored in the range indicating female sexual dysfunction, a lower prevalence than often reported for the general population.","clinical_takeaway":"Female entertainers may experience sexual dysfunction; clinicians should assess sexual health without assuming higher risk based on occupation.","confidence":0.78,"topic_tags":["sexual_function","pornography"],"strengths":["Use of validated FSFI instrument","First study of this specific population","Clear reporting of basic descriptive statistics"],"limitations":["Small, self‑selected convenience sample","No control for key confounds (moral incongruence, mental health, partner effects)","No power calculation or effect‑size reporting"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.03.002"}},{"id":2587,"doi":"10.1186/s12889-019-6682-8","pmid":"30947690","pmcid":"PMC6450012","title":"Factors associated with early sexual initiation among preparatory and high school youths in Woldia town, northeast Ethiopia: a cross-sectional study","authors":"Kassahun EA, Gelagay AA, Muche AA, Dessie AA, Kassie BA.","first_author":"Kassahun EA","journal":"BMC public health","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Students","Ethiopia","Early Sexual Initiation","Woldia"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6450012","cited_by_count":52,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"institution‑based cross‑sectional survey of 723 Ethiopian high‑school students selected by simple random sampling; logistic regression used to identify factors associated with early sexual initiation.","sample_n":723,"sample_text":"large community‑based sample, randomly selected from schools","population":"students (≈15‑19 yr) in preparatory and high schools, Woldia town, Ethiopia (N = 723)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 723 Ethiopian high‑school students found that 18 % started having sex early. Watching pornographic material, not attending religious programs, peer pressure, smoking and low parental monitoring were linked to higher odds of early sexual initiation.","clinical_takeaway":"Early sexual debut is associated with porn exposure and several psychosocial factors; prevention efforts should address media exposure and family/peer influences.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large random sample of school students","Use of multivariable logistic regression with confidence intervals","Focus on multiple psychosocial predictors"],"limitations":["Cross‑sectional design, cannot infer causality","Key exposures (e.g., porn use) measured with single‑item, unvalidated questions","No assessment of moral incongruence, masturbation, mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":14,"contrasting":3,"mentioning":80,"citing_publications":102,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-019-6682-8"}},{"id":2588,"doi":"10.1089/cyber.2009.0306","pmid":"21329443","pmcid":null,"title":"Problematic Internet Use among Greek university students: an ordinal logistic regression with risk factors of negative psychological beliefs, pornographic sites, and online games","authors":"Frangos CC, Frangos CC, Sotiropoulos I.","first_author":"Frangos CC","journal":"Cyberpsychology, behavior and social networking","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":69,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 2,358 Greek university students; ordinal logistic regression of self‑reported risk factors.","sample_n":2358,"sample_text":"2,358 university students from across Greece","population":"University students in Greece (convenience sample)","country":"Greece","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 2,358 Greek university students found that about one‑third showed signs of problematic internet use, which was linked to being male, unemployment, negative beliefs, visiting porn sites and playing online games.","clinical_takeaway":"Screen for broader problem‑internet behaviours; do not assume porn use alone signals pathology.","confidence":0.8,"topic_tags":["pornography","sexual_function","religiosity","moral_incongruence","prevalence","adolescents"],"strengths":["Large sample size","Comprehensive list of internet‑use activities","Use of multivariate ordinal logistic regression"],"limitations":["Cross‑sectional design cannot infer causality","Limited validation of PIU and pornography‑use measures","No assessment of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":24,"contrasting":3,"mentioning":108,"citing_publications":167,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2009.0306"}},{"id":2589,"doi":"10.1007/s00103-019-02919-9","pmid":"30859251","pmcid":null,"title":"[Internet-related disorders-old and new challenges. Conference report on the 10th symposium of the German Association on Internet-Related Disorders]","authors":"Müller KW, Kiepe K, Pitten S, Dreier M.","first_author":"Müller KW","journal":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","year":2019,"pub_types":["Journal Article"],"keywords":["Prevention","intervention","Behavioral Addiction","Gaming Disorder","International Classification Of Diseases, 11Th Edition (Icd-11)"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"conference report summarizing proceedings, no original data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reports on a 2018 German conference about internet‑related disorders, summarising discussions on gaming, pornography and social‑media use and noting the upcoming ICD‑11 classification of gaming disorder.","clinical_takeaway":"None – the paper offers no new clinical evidence.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Provides overview of field developments","Highlights policy relevance (ICD‑11 inclusion)","Informs about professional network activities"],"limitations":["No original empirical data","Lacks methodological detail","Potential bias toward supporting addiction framework"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00103-019-02919-9"}},{"id":2590,"doi":"10.1089/cyber.2009.0212","pmid":"21142987","pmcid":null,"title":"Low neuroticism and high hedonistic traits for female internet child pornography consumers","authors":"Seigfried-Spellar KC, Rogers MK.","first_author":"Seigfried-Spellar KC","journal":"Cyberpsychology, behavior and social networking","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional analysis of a convenience sample (N=162, only 10 ICP users). Logistic regression with stepwise selection; no longitudinal or experimental component.","sample_n":162,"sample_text":"162 female respondents, 10 identified as ICP consumers.","population":"Female respondents from a prior study; self‑selected internet sample; not representative.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small survey of 162 women found that the few who reported viewing illegal child pornography tended to be less neurotic, more hedonistic, and more likely to identify as non‑white, but the tiny number of users limits confidence in these findings.","clinical_takeaway":"None – study does not provide actionable clinical information.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Uses established personality measures","First study of female ICP consumers","Acknowledges limitations"],"limitations":["Very small number of ICP users (n=10)","No control for major confounds (e.g., moral incongruence, mental health)","Stepwise logistic regression may capitalize on chance","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2009.0212"}},{"id":2591,"doi":"10.1155/2019/4852130","pmid":"31015844","pmcid":"PMC6446110","title":"A Systematic Review and Meta-Analysis of Epidemiology of Risky Sexual Behaviors in College and University Students in Ethiopia, 2018","authors":"Amare T, Yeneabat T, Amare Y.","first_author":"Amare T","journal":"Journal of environmental and public health","year":2019,"pub_types":["Meta-Analysis","Systematic Review","review-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://downloads.hindawi.com/journals/jeph/2019/4852130.pdf","cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Meta-analysis of 18 cross‑sectional studies (n=10,218) on risky sexual behaviors among Ethiopian university students; PRISMA‑guided, PROSPERO‑registered.","sample_n":10218,"sample_text":"18 studies with 10,218 participants","population":"College and university students in Ethiopia (combined sample size 10,218).","country":"Ethiopia","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 18 Ethiopian university studies (10,218 students) found that about 42% engaged in risky sex. Watching pornography, being male, and using alcohol were each linked to higher odds of risky behavior.","clinical_takeaway":"Students who watch porn, drink alcohol, or are male may need targeted sexual‑health education.","confidence":0.78,"topic_tags":["pornography","religiosity","sexual_function"],"strengths":["PROSPERO registration and PRISMA compliance","Large combined sample across 18 studies","Provides pooled prevalence and effect sizes"],"limitations":["Primary studies likely heterogeneous in defining ‘risky sexual behavior’","No control for key psychosocial confounds (moral incongruence, mental health, etc.)","Potential publication bias not discussed in abstract"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":18,"contrasting":4,"mentioning":65,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2019/4852130"}},{"id":2592,"doi":null,"pmid":"30865389","pmcid":null,"title":"[About possible contributors and new perspectives to addictive use of cybersex]","authors":"Khazaal Y, Rothen S, Varfi N, Achab S, Soldati L, Bolmont M, Bianchi-Demicheli F.","first_author":"Khazaal Y","journal":"Revue medicale suisse","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative discussion without empirical data; no sample, no methods reported.","sample_n":null,"sample_text":"No participants; article provides conceptual overview.","population":"Not applicable","country":"Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The paper discusses cybersex use, noting that while most people benefit, a small group may struggle with control, possibly linked to avoidant attachment, depression, desire, motivations, and impulsivity, and suggests integrated treatment.","clinical_takeaway":"Clinicians should assess attachment style, mood, and impulsivity when addressing problematic cybersex use.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Integrates multiple psychological factors (attachment, mood, impulsivity)","Highlights need for integrated treatment approach"],"limitations":["No empirical data presented","No systematic review methods","Lacks operational definitions or validated measures"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":2593,"doi":"10.1371/journal.pone.0213059","pmid":"30817770","pmcid":"PMC6394938","title":"The influence of olfactory disgust on (Genital) sexual arousal in men","authors":"Borg C, Oosterwijk TA, Lisy D, Boesveldt S, de Jong PJ.","first_author":"Borg C","journal":"PloS one","year":2019,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6394938","cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"laboratory experiment with random assignment, N=78 men, porn video stimulus, odor manipulation","sample_n":78,"sample_text":"78 male participants, randomly assigned to disgust odor (n=42) or control (n=36)","population":"adult men, community sample","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, men watching a porn video showed lower sexual arousal—both self‑reported and penile size—when a disgusting smell was presented, suggesting disgust can inhibit ongoing sexual excitement.","clinical_takeaway":"Disgust cues may reduce sexual arousal, but applying this as a self‑defence tool is premature.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Randomised controlled manipulation","Objective genital measurement","Both subjective and physiological outcomes"],"limitations":["No control for moral or psychological confounds","No pre‑registration or power analysis reported","Sample limited to young men"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":21,"citing_publications":28,"retracted":false,"notices":[{"status":"Has correction","date":"2019-3-19","noticeDoi":"10.1371/journal.pone.0214330","doi":"10.1371/journal.pone.0213059"},{"status":"Has erratum","date":"2019-3-19","noticeDoi":"10.1371/journal.pone.0214330","doi":"10.1371/journal.pone.0213059"}],"url":"https://scite.ai/reports/10.1371/journal.pone.0213059"}},{"id":2594,"doi":"10.1007/bf01542490","pmid":"568923","pmcid":null,"title":"Modeling effects of explicit and nonexplicit sexual stimuli on the sexual anxiety and behavior of women","authors":"Wishnoff R.","first_author":"Wishnoff R.","journal":"Archives of sexual behavior","year":1978,"pub_types":["Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized controlled trial with three arms (explicit, nonexplicit, control) using 45 anxious, coitally inexperienced women selected by short manifest anxiety scale.","sample_n":45,"sample_text":"Forty‑five women selected based on anxiety scores; randomly assigned to three groups (≈15 per group).","population":"Adult women, anxious, coitally inexperienced (N=45)","country":"USA (presumed from journal, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 1978 trial, 45 anxious women who had never had sex were randomly shown explicit, nonexplicit, or no sexual material. Those who saw explicit material reported lower sexual anxiety and were more willing to try a range of sexual behaviors than the control group.","clinical_takeaway":"Controlled exposure to explicit material may reduce sexual anxiety in inexperienced women, but evidence is limited and based on a small sample.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Randomized controlled design","Use of validated anxiety scale","Clear experimental manipulation of stimulus type"],"limitations":["Very small sample per group (≈15)","Behavioral outcomes not clearly validated","No measurement of key confounds (moral, masturbation, mental health, partner effects)","Findings limited to anxious, inexperienced women"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542490"}},{"id":2595,"doi":"10.1177/0004867419829219","pmid":"30764643","pmcid":null,"title":"Abstinence violation effect and pornography use: Implications for intervention","authors":"Sharma MK, Anand N.","first_author":"Sharma MK","journal":"The Australian and New Zealand journal of psychiatry","year":2019,"pub_types":["Letter","Research Support, Non-U.S. Gov't","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0004867419829219"}},{"id":2596,"doi":"10.3389/fpsyt.2018.00763","pmid":"30778306","pmcid":"PMC6369176","title":"Web-Based Health Services in Forensic Psychiatry: A Review of the Use of the Internet in the Treatment of Child Sexual Abusers and Child Sexual Exploitation Material Offenders","authors":"Wild TSN, Fromberger P, Jordan K, Müller I, Müller JL.","first_author":"Wild TSN","journal":"Frontiers in psychiatry","year":2018,"pub_types":["brief-report","Journal Article"],"keywords":["Child Sexual Abuse","Forensic Psychiatry","Online Therapy","Pedophilia","Internet-based Intervention","Child Pornography","Sex Offender","Web-based Treatment"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6369176","cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"n/a","sample_n":null,"sample_text":"Not applicable – review article","population":"Child sexual abusers and child sexual exploitation material offenders (treatment context)","country":"n/a","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how online mental‑health services could help child sexual abusers and offenders of child sexual exploitation material, summarising existing web‑based treatments, discussing ethical issues, and proposing quality standards for future e‑health interventions.","clinical_takeaway":"Online therapy may expand access for offenders, but evidence for effectiveness remains limited.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Identifies a clear service gap in forensic psychiatry","Discusses ethical and legal considerations"],"limitations":["Narrative, non‑systematic review","No empirical data or systematic methodology described","No assessment of effectiveness or outcome measures"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":32,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2018.00763"}},{"id":2597,"doi":"10.1007/s10508-009-9592-5","pmid":"20127507","pmcid":null,"title":"Pornography, normalization, and empowerment","authors":"Weinberg MS, Williams CJ, Kleiner S, Irizarry Y.","first_author":"Weinberg MS","journal":"Archives of sexual behavior","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":96,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 245 college students examining perceived effects of pornography on sexual horizons; convenience sample; cross‑sectional questionnaire.","sample_n":245,"sample_text":"245 college students","population":"College students (N=245), likely US, mixed gender and sexual orientation.","country":"United States (likely)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 245 college students found that many perceived pornography as expanding sexual ideas and encouraging them to try new sexual behaviors, with effects varying by gender and sexual orientation.","clinical_takeaway":"Findings reflect subjective perceptions; clinicians should not assume pornography causes sexual empowerment without stronger evidence.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a student survey","Addresses understudied positive perspectives","Considers gender and sexual orientation"],"limitations":["Cross‑sectional; cannot infer causality","Single‑item/ad‑hoc measures, unclear validation","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":11,"contrasting":0,"mentioning":107,"citing_publications":226,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-009-9592-5"}},{"id":2598,"doi":"10.1097/mop.0000000000000714","pmid":"30507648","pmcid":null,"title":"New age technology and social media: adolescent psychosocial implications and the need for protective measures","authors":"Shah J, Das P, Muthiah N, Milanaik R.","first_author":"Shah J","journal":"Current opinion in pediatrics","year":2019,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review summarizing literature on social media impacts, including mention of pornography exposure","sample_n":null,"sample_text":"No empirical sample – review article","population":"adolescents (general discussion, no specific sample)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The review discusses how social media use may influence teens, linking it to lower self‑esteem, body‑image issues, cyber‑bullying, exposure to pornography and risky sexual behavior, and suggests ways parents and doctors can protect youth.","clinical_takeaway":"Clinicians should discuss social‑media habits with teens and families, emphasizing the need for limits and safe‑online practices.","confidence":0.4,"topic_tags":["adolescents","pornography","masturbation","sexual_function"],"strengths":["Broad overview of recent literature","Practical recommendations for clinicians and parents"],"limitations":["Narrative synthesis without systematic methodology","No quantitative analysis or assessment of study quality","Potential over‑statement of causal links from correlational data"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":33,"citing_publications":105,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/mop.0000000000000714"}},{"id":2599,"doi":"10.5152/eurasianjmed.2015.15057","pmid":"30911256","pmcid":"PMC6422611","title":"Sexual Activity and HIV-Related Knowledge among Secondary School Students in China","authors":"He L, Jin Y, Ren X, Wang L, Nie Z, Gu Q, Guo D, Lu W, Yao Y.","first_author":"He L","journal":"The Eurasian journal of medicine","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["China","HIV","Student","Sexual activity"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Randomly sampled 6347 secondary school students in China; self‑administered questionnaire; cross‑sectional descriptive analysis.","sample_n":6347,"sample_text":"Random sampling technique was used and cross‑sectional study was conducted among 6347 students using self‑administered questionnaire.","population":"Secondary school students, ages 9‑21, China (N=6347)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2019 Chinese study surveyed over 6,000 secondary‑school students, finding that many had viewed pornography and engaged in various sexual behaviors, while also assessing their HIV knowledge. The authors suggest better sex education, especially for older students and those from divorced families.","clinical_takeaway":"None – the study is descriptive and does not provide clinical guidance on pornography use or sexual health interventions.","confidence":0.8,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Large, randomly selected sample","Specific data on pornography exposure among adolescents"],"limitations":["Reliance on self‑report, unvalidated items","Cross‑sectional; cannot infer causality","No control for key confounds (moral, mental health, etc.)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5152/eurasianjmed.2015.15057"}},{"id":2602,"doi":"10.1002/bsl.906","pmid":"19960547","pmcid":null,"title":"Legal, ethical, and methodological considerations in the Internet-based study of child pornography offenders","authors":"Ray JV, Kimonis ER, Donoghue C.","first_author":"Ray JV","journal":"Behavioral sciences & the law","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"guidance paper describing legal, ethical and methodological issues in an Internet‑based pilot study of child‑pornography users; no primary empirical findings presented","sample_n":null,"sample_text":"pilot Internet‑based study (no numbers given)","population":"child‑pornography users (online, non‑incarcerated); sample size not reported","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper discusses the legal, ethical and practical problems of studying child‑pornography users over the Internet, offering advice for researchers who want to reach hidden, non‑incarcerated offenders.","clinical_takeaway":"None – the article provides methodological guidance, not clinical findings.","confidence":0.5,"topic_tags":["pornography","sexual_function"],"strengths":["Highlights under‑researched methodological challenges","Offers practical recommendations for online research with hidden populations"],"limitations":["No primary data; conclusions are speculative","Lacks empirical evaluation of suggested procedures"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/bsl.906"}},{"id":2603,"doi":"10.1111/j.1939-3938.2010.01077.x","pmid":"21175532","pmcid":null,"title":"Comparison by crime type of juvenile delinquents on pornography exposure: the absence of relationships between exposure to pornography and sexual offense characteristics","authors":"Burton DL, Leibowitz GS, Howard A.","first_author":"Burton DL","journal":"Journal of forensic nursing","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case-control comparison of male adolescent sexual abusers (n=283) vs non‑sexual delinquent youth (n=170); cross‑sectional questionnaire data","sample_n":453,"sample_text":"283 sexual abusers, 170 non‑sexual delinquent youth","population":"male juvenile offenders, convenience sample from forensic/justice settings","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared how much pornography male juvenile offenders had seen before age 10 and after, finding that sexual abusers had higher exposure than non‑sexual delinquents, but exposure did not relate to how early they started offending, the number of victims, or offense severity.","clinical_takeaway":"Higher early‑life pornography exposure does not appear to predict the severity of sexual offending among juvenile males.","confidence":0.6,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Large sample of juvenile offenders","Direct comparison of sexual vs non‑sexual offenders","Use of multiple exposure subscales"],"limitations":["Self‑report exposure measures likely unvalidated","Cross‑sectional design cannot infer causality","No control for key confounds (e.g., trauma, mental health)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1939-3938.2010.01077.x"}},{"id":2605,"doi":"10.1080/00224499.2018.1556238","pmid":"30624090","pmcid":null,"title":"Toward a Model of Porn Literacy: Core Concepts, Rationales, and Approaches","authors":"Dawson K, Nic Gabhainn S, MacNeela P.","first_author":"Dawson K","journal":"Journal of sex research","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":62,"is_preprint":false,"topics":["bibliography","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Participatory qualitative study with 54 young adult participants (18‑29) using data‑generation methods and group interviews to develop porn‑literacy curriculum concepts.","sample_n":54,"sample_text":"54 young adults aged 18 to 29","population":"young adults, convenience sample","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using interviews with 54 young adults, the authors co‑created key ideas for a porn‑literacy program, emphasizing the need to reduce shame and teach critical thinking about body image, violence, fetishising, and unrealistic sexual expectations.","clinical_takeaway":"Educators should include shame‑reduction and critical‑thinking components when teaching about pornography to young adults.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Engages target youth participants directly","Identifies concrete curriculum outcomes","Considers LGBT+ specific issues","Addresses shame reduction"],"limitations":["Small, non‑representative convenience sample","No validated measurement instruments","Findings are descriptive, not evidence of efficacy","Limited quantitative rigor"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":68,"citing_publications":160,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1556238"}},{"id":2606,"doi":"10.1007/s10508-018-1389-y","pmid":"30623277","pmcid":null,"title":"Premature Speculation Concerning Pornography's Effects on Relationships","authors":"Kohut T, Campbell L.","first_author":"Kohut T","journal":"Archives of sexual behavior","year":2019,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1389-y"}},{"id":2607,"doi":"10.1177/1557988318823586","pmid":"30819061","pmcid":"PMC6440048","title":"Problematic Sexual Behavior and Religion Among Adult Jewish Males: An Initial Study","authors":"Rosmarin DH, Pirutinsky S.","first_author":"Rosmarin DH","journal":"American journal of men's health","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexuality","Judaism","Religiosity","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6440048","cited_by_count":6,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 94 adult Jewish males measuring religiosity, spiritual struggles, and self‑reported problematic sexual behavior","sample_n":94,"sample_text":"94 adult Jewish males","population":"adult Jewish males (n=94)","country":"unspecified (presumably Israel/USA)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In 94 adult Jewish men, higher spiritual struggles were linked to more self‑reported problematic sexual behavior, but only among those raised Orthodox, regardless of current religious affiliation.","clinical_takeaway":"Spiritual struggles may signal higher risk of problematic sexual behavior in men with an Orthodox upbringing; assess coping and religious background in therapy.","confidence":0.6,"topic_tags":["religiosity","sexual_function","csbd","moral_incongruence"],"strengths":["Community sample of a specific cultural group","Considers both religious coping and spiritual struggles","Explores interaction between upbringing and current outcomes"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of key confounds (moral incongruence, masturbation, mental health)","Unclear whether problematic sexual behavior scale is validated"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1557988318823586"}},{"id":2608,"doi":"10.1016/j.jsxm.2018.11.011","pmid":"30621926","pmcid":null,"title":"Older Adults' Coping Strategies With Changes in Sexual Functioning: Results From Qualitative Research","authors":"Ayalon L, Gewirtz-Meydan A, Levkovich I.","first_author":"Ayalon L","journal":"The journal of sexual medicine","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sex","Tradition","Sexual Functioning","Viagra","Heteronormative"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 47 older Israeli participants","sample_n":47,"sample_text":"47 Israelis over the age of 60 recruited for in‑depth interviews (convenience sample; likely self‑selected)","population":"adults aged 60+ (Israel)","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 47 older Israeli adults identified seven coping strategies for age‑related changes in sexual function, ranging from internal acceptance to external help‑seeking, with some mentioning pornography use to boost desire.","clinical_takeaway":"Clinicians should recognize diverse coping approaches in older patients and discuss realistic expectations and options for sexual health.","confidence":0.8,"topic_tags":["sexual_function","csbd","pornography","masturbation"],"strengths":["In‑depth qualitative insight into older adults’ coping strategies","Gender‑specific analysis of strategy use","Clear thematic framework (internal vs. external) "],"limitations":["Small, non‑representative convenience sample","No validated measures of sexual functioning or distress","Potential selection bias toward participants comfortable discussing sexuality"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":0,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2018.11.011"}},{"id":2609,"doi":"10.1100/tsw.2009.147","pmid":"19936562","pmcid":"PMC5823132","title":"Harmonizing the interests of free speech, obscenity, and child pornography in cyberspace: the new roles of parents, technology, and legislation for internet safety","authors":"Olagunju AO.","first_author":"Olagunju AO.","journal":"TheScientificWorldJournal","year":2009,"pub_types":["review-article","Review","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5823132","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review-article","sample_n":null,"sample_text":"Not applicable – narrative review without original data","population":"children/adolescents (no empiri​c data)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that parents, technology, and legislation should work together to keep children safe from online pornographic material, emphasizing education and filtering tools over government bans.","clinical_takeaway":"None – the paper offers policy guidance, not clinical recommendations.","confidence":0.4,"topic_tags":["pornography","csbd","sexual_function"],"strengths":["Provides a broad overview of legal and technological options for protecting minors","Integrates perspectives from parents, educators, and policymakers"],"limitations":["No original empirical data; conclusions are not evidence‑based","Lacks systematic methodology or risk‑of‑bias assessment","Does not address potential confounds such as moral incongruence or mental‑health factors"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1100/tsw.2009.147"}},{"id":2610,"doi":"10.1002/ab.21808","pmid":"30578554","pmcid":"PMC6437684","title":"Traditional and cyber bullying and sexual harassment: A longitudinal assessment of risk and protective factors","authors":"Leemis RW, Espelage DL, Basile KC, Mercer Kollar LM, Davis JP.","first_author":"Leemis RW","journal":"Aggressive behavior","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["risk factors","Bullying","Sexual Harassment","Protective Factors","Cyberbullying"],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Survey of 3549 adolescents across 4 waves (2008‑2013); latent class analysis to identify co‑occurring bullying/harassment profiles.","sample_n":3549,"sample_text":"Racially diverse middle and high school students","population":"Middle and high school students (U.S.)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 5‑year study of US adolescents (n≈3500) found that a small group engaged in high levels of both bullying (in‑person and online) and sexual harassment. Those youths also reported more anger, porn exposure, traditional masculine beliefs, and lower parental monitoring. The authors suggest prevention programs should address multiple forms of aggression together.","clinical_takeaway":"Screening for porn exposure and aggression‑related attitudes may help identify youths at risk for combined bullying and sexual harassment.","confidence":0.78,"topic_tags":["sexual_function","adolescents"],"strengths":["Large, multi‑wave sample","Ecological framework","Advanced latent class analysis"],"limitations":["Self‑report measures, limited validation for porn exposure","No moral or trauma variables","Potential school‑based convenience sampling"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":0,"mentioning":48,"citing_publications":85,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ab.21808"}},{"id":2611,"doi":"10.1080/10538710903317232","pmid":"20183421","pmcid":null,"title":"Demographic and personality characteristics of internet child pornography downloaders in comparison to other offenders","authors":"Reijnen L, Bulten E, Nijman H.","first_author":"Reijnen L","journal":"Journal of child sexual abuse","year":2009,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative study of 22 internet child‑pornography offenders vs 112 other offenders; demographic and MMPI data extracted from records.","sample_n":134,"sample_text":"22 internet child‑pornography offenders; 112 other offenders","population":"Adult male offenders identified via criminal justice records; not a community or probability sample.","country":"Netherlands (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared 22 men convicted of downloading child sexual abuse material with 112 other offenders. It found the child‑pornography group was younger, more likely single, lived alone and had fewer children, but showed no distinct MMPI personality profile.","clinical_takeaway":"No specific personality markers identify child‑pornography offenders; demographic cues are limited and not diagnostic.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Use of standardized MMPI instrument","Direct comparison with a larger offender group"],"limitations":["Very small CP offender sample (N=22)","No control for key psychosocial confounds","Findings limited to convicted offenders, not generalizable"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538710903317232"}},{"id":2612,"doi":"10.1556/2006.7.2018.114","pmid":"30541336","pmcid":"PMC6376366","title":"Associations between the dark triad of personality and unspecified/specific forms of Internet-use disorder","authors":"Sindermann C, Sariyska R, Lachmann B, Brand M, Montag C.","first_author":"Sindermann C","journal":"Journal of behavioral addictions","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Narcissism","Psychopathy","Machiavellianism","Dark Triad","Specific Forms Of Iud","Unspecified Iud"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6376366","cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of two independent convenience samples (N≈470 each) using self‑report questionnaires","sample_n":468,"sample_text":"Two independent samples of 468 and 472 participants completed questionnaires","population":"adults (mixed gender), recruited online (presumed convenience)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In two large online surveys, people who scored higher on Machiavellianism and psychopathy also reported higher tendencies toward general internet‑use problems and, in women, toward specific problems like online shopping, pornography, and communication.","clinical_takeaway":"Personality traits such as Machiavellianism and psychopathy may be linked to higher risk of problematic internet behaviours, but causality is unclear.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample sizes for a survey","Use of validated personality questionnaire"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of key confounds (moral incongruence, mental health, etc.)","IAT does not separate frequency from distress"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":4,"interpretation":8}},"scite":{"supporting":3,"contrasting":1,"mentioning":51,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.114"}},{"id":2613,"doi":"10.1016/j.chiabu.2018.11.019","pmid":"30537621","pmcid":null,"title":"Abuse disclosures of youth with problem sexualized behaviors and trauma symptomology","authors":"Dillard R, Maguire-Jack K, Showalter K, Wolf KG, Letson MM.","first_author":"Dillard R","journal":"Child abuse & neglect","year":2019,"pub_types":["Journal Article"],"keywords":["Trauma","Child Abuse","Victimization","Self-report","Maltreatment","Problem Sexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"N=950 youth assessed at a child advocacy center; bivariate logistic regression on disclosure variables and trauma checklist scores.","sample_n":950,"sample_text":"clinical assessment sample; not population‑based.","population":"Youth ages 3‑18 years referred for forensic interview at a Midwest child advocacy center (clinical convenience sample).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 950 children assessed for abuse, those who reported exposure to pornography were more likely to show problem sexualized behaviors, and those who reported physical or sexual abuse had higher trauma symptom scores.","clinical_takeaway":"Exposure to pornography may flag higher risk of problem sexualized behavior; consider comprehensive trauma assessment in affected youth.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large clinical sample (N=950)","Validated trauma symptom checklists","Clear statistical reporting of odds ratios"],"limitations":["Cross‑sectional design; cannot infer causality","Problem sexualized behavior not operationalized with a validated scale","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2018.11.019"}},{"id":2615,"doi":"10.1089/cpb.2008.0346","pmid":"19772438","pmcid":null,"title":"Adolescent pornographic internet site use: a multivariate regression analysis of the predictive factors of use and psychosocial implications","authors":"Tsitsika A, Critselis E, Kormas G, Konstantoulaki E, Constantopoulos A, Kafetzis D.","first_author":"Tsitsika A","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 529 Greek high‑school students, random school selection","sample_n":529,"sample_text":"Randomly selected high‑school students in Greece (n = 529)","population":"Greek adolescents (high‑school students)","country":"Greece","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 529 Greek teens found that about one‑fifth had visited porn sites. Boys, those using the internet for sexual education, chat‑room users and purchasers were more likely to browse. Frequent viewers showed higher odds of conduct problems and lower prosocial scores.","clinical_takeaway":"Frequent porn site use in adolescents is linked to conduct and social adjustment issues; clinicians should assess broader behavioural context.","confidence":0.78,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large, randomly selected adolescent sample","Multivariate regression with odds ratios and confidence intervals","Distinguishes infrequent vs frequent use"],"limitations":["Cross‑sectional design cannot infer causality","Psychosocial measures not described; likely self‑report","Key confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":1,"mentioning":48,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cpb.2008.0346"}},{"id":2616,"doi":"10.1186/s12913-018-3722-5","pmid":"30497464","pmcid":"PMC6267062","title":"Contraception and abortion knowledge, attitudes and practices among adolescents from low and middle-income countries: a systematic review","authors":"Munakampe MN, Zulu JM, Michelo C.","first_author":"Munakampe MN","journal":"BMC health services research","year":2018,"pub_types":["research-article","Systematic Review","Journal Article"],"keywords":["Abortion","Contraception","Systematic review","Adolescents"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6267062","cited_by_count":151,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 21 studies from 1970–2016 using thematic analysis; no meta‑analysis or risk‑of‑bias assessment reported.","sample_n":null,"sample_text":"21 studies analyzed; total participants not specified in abstract","population":"Adolescents (15‑19 years) in low‑ and middle‑income countries","country":"Various low‑ and middle‑income countries (global)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A review of 21 studies shows that adolescents in low‑ and middle‑income countries often lack reliable information about contraception and safe abortion, leading to risky practices and limited access to services.","clinical_takeaway":"Improve comprehensive sexual education and service access for adolescents in LMICs.","confidence":0.7,"topic_tags":["adolescents","religiosity","sexual_function"],"strengths":["Broad coverage of studies across many LMICs","Identifies clear gaps in knowledge and service access"],"limitations":["No quantitative synthesis or risk‑of‑bias assessment","Unclear reporting of sample sizes and measurement tools","Potential heterogeneity not formally addressed"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":14,"contrasting":2,"mentioning":272,"citing_publications":268,"retracted":false,"notices":[{"status":"Has correction","date":"2019-7-2","noticeDoi":"10.1186/s12913-019-4297-5","doi":"10.1186/s12913-018-3722-5"},{"status":"Has erratum","date":"2019-7-2","noticeDoi":"10.1186/s12913-019-4297-5","doi":"10.1186/s12913-018-3722-5"}],"url":"https://scite.ai/reports/10.1186/s12913-018-3722-5"}},{"id":2617,"doi":"10.1016/j.ajp.2018.11.018","pmid":"30529568","pmcid":null,"title":"Problematic internet use and its correlates among resident doctors of a tertiary care hospital of North India: A cross-sectional study","authors":"Grover S, Sahoo S, Bhalla A, Avasthi A.","first_author":"Grover S","journal":"Asian journal of psychiatry","year":2019,"pub_types":["Journal Article"],"keywords":["Internet","Addiction","Resident Doctors"],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of resident doctors (N=376 respondents) using validated questionnaires; prevalence and associations reported","sample_n":376,"sample_text":"376 respondents out of 1721 invited (≈22% response rate)","population":"Resident doctors (post‑graduate trainees) aged 24‑39 in a tertiary care hospital in North India","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 376 resident doctors in India found that about 8% had moderate‑level problematic internet use. Those with higher use also reported more depression, stress, burnout, and exposure to patient violence. Watching pornography was linked to higher internet use.","clinical_takeaway":"Screen resident doctors for problematic internet use, especially when depressive symptoms or workplace stress are present.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Uses validated IAT and mental‑health scales","Large initial sampling frame (1721 doctors)","Examines multiple relevant outcomes (depression, stress, burnout, violence)"],"limitations":["Low response rate; potential self‑selection bias","Cross‑sectional design limits causal inference","No measurement of moral or sexual‑behavior confounds"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":7,"contrasting":0,"mentioning":42,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ajp.2018.11.018"}},{"id":2618,"doi":"10.3389/fpsyt.2018.00546","pmid":"30487759","pmcid":"PMC6246717","title":"Ventral Striatal Reactivity in Compulsive Sexual Behaviors","authors":"Gola M, Draps M.","first_author":"Gola M","journal":"Frontiers in psychiatry","year":2018,"pub_types":["review-article","Review","Journal Article"],"keywords":["Nucleus accumbens","Ventral Striatum","Compulsive Sexual Behaviors","Hypersexuality","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00546/pdf","cited_by_count":38,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of nine neuroimaging studies on CSB, no meta‑analytic pooling","sample_n":null,"sample_text":"Nine previously published neuroimaging papers (total participants not reported)","population":"studies of adults with compulsive sexual behaviours; no new sample recruited","country":"multiple (studies from various countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors reviewed nine brain‑imaging studies of people with compulsive sexual behaviour. Most studies showed stronger activity in the ventral striatum when participants viewed erotic cues, supporting the idea that these behaviours involve heightened reward anticipation rather than a deficient reward system.","clinical_takeaway":"Current imaging evidence points to heightened ventral‑striatal response to sexual cues in CSB, suggesting reward‑driven mechanisms rather than hypo‑reactivity.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","csbd","pornography","treatment"],"strengths":["Systematic search of neuroimaging literature","Clear focus on ventral striatal findings","Contrast of two competing addiction theories"],"limitations":["No quantitative synthesis or meta‑analysis","Limited number of eligible studies (n=9)","No assessment of key confounds (moral incongruence, masturbation, mental health)","Relies on heterogeneous definitions of CSB"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":36,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2018.00546"}},{"id":2619,"doi":"10.1371/journal.pone.0206546","pmid":"30403714","pmcid":"PMC6221345","title":"Oral and anal sexual practice and associated factors among preparatory school youths in Dire Dawa city administration, Eastern Ethiopia","authors":"Alemu MT, Dessie Y, Gobena T, Mazeingia YT, Abdu AO, Abdu AO.","first_author":"Alemu MT","journal":"PloS one","year":2018,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6221345","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"School‑based cross‑sectional survey of 1,067 Ethiopian preparatory students; systematic random sampling within schools; self‑administered questionnaire; logistic regression analysis.","sample_n":1067,"sample_text":"1067 school youths selected by systematic random sampling.","population":"Adolescents/young adults (age 15‑24) attending preparatory schools in Dire Dawa, Ethiopia (N≈1,067).","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2018 Ethiopian survey of 1,067 high‑school students found that about 9 % had ever had oral sex and 7 % had ever had anal sex. Multiple partners and low condom use were common, and factors such as having a partner, alcohol, shisha use, and watching porn were linked to these practices.","clinical_takeaway":"Sexual‑health programs for Ethiopian adolescents should address oral and anal intercourse, promote consistent condom use, and consider substance use and media exposure as associated risk factors.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large sample for a school‑based study","Systematic random sampling within schools","Multivariable logistic regression with confidence intervals"],"limitations":["Self‑report of sexual behavior; no validated scales","Cross‑sectional design; no causal inference","Key confounds (moral incongruence, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0206546"}},{"id":2620,"doi":"10.1071/sh17210","pmid":"30273542","pmcid":null,"title":"Premarital sexual behaviour among higher secondary students in Pokhara Sub-Metropolitan City Nepal","authors":"Adhikari N, Adhikari S, Sulemane NI.","first_author":"Adhikari N","journal":"Sexual health","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"institution‑based descriptive cross‑sectional survey of 522 higher‑secondary students in Pokhara, Nepal","sample_n":522,"sample_text":"All consenting students from the selected schools (n = 522)","population":"adolescents attending higher secondary schools (age ~15‑18) in Pokhara Sub‑Metropolitan City, Nepal","country":"Nepal","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 522 Nepalese high‑school students found that about one‑quarter had engaged in premarital sex, with higher odds among boys, those who discussed sex with friends, and those exposed to pornography. The authors call for better sexual‑health education.","clinical_takeaway":"Adolescents exposed to pornography and peer discussions may be more likely to have premarital sex; targeted education could reduce risky behaviours.","confidence":0.7,"topic_tags":["adolescents","sexual_function","csbd"],"strengths":["Large sample for a single‑city study","Clear descriptive statistics on premarital sex prevalence","Identifies peer discussion and pornography exposure as correlates"],"limitations":["Cross‑sectional design cannot infer causality","Reliance on single‑item self‑report measures, no validated scales","Limited control for confounding factors (e.g., mental health, religiosity)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh17210"}},{"id":2621,"doi":"10.1556/2006.7.2018.100","pmid":"30378458","pmcid":"PMC6376392","title":"Understanding and predicting profiles of compulsive sexual behavior among adolescents","authors":"Efrati Y, Gola M.","first_author":"Efrati Y","journal":"Journal of behavioral addictions","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Loneliness","Personality Traits","Compulsive Sexual Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6376392","cited_by_count":34,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two large cross‑sectional surveys of adolescents (N=1,182; N=618) using latent profile analysis to identify CSB clusters and examine personality, loneliness, pornography use and online sexual activity.","sample_n":1800,"sample_text":"N=1,182 in Study 1; N=618 in Study 2; community sample of adolescents.","population":"non‑clinical adolescents (Israel)","country":"Israel","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors surveyed over 1,800 Israeli teens and identified three groups—abstainers, fantasizers, and those with compulsive sexual behaviour. The compulsive group reported more loneliness, external control, anxious attachment, higher porn use and more online sexual activity.","clinical_takeaway":"High porn use and loneliness in adolescents may signal risk for compulsive sexual behaviour, but assessment tools need validation and should consider moral and mental‑health factors.","confidence":0.7,"topic_tags":["sexual_function","adolescents","csbd","pornography"],"strengths":["Large community sample of adolescents","Use of latent profile analysis to identify distinct CSB groups","Inclusion of multiple psychosocial variables (personality, loneliness, attachment)"],"limitations":["CSB measurement likely based on non‑validated self‑report items","No assessment of moral incongruence, masturbation, or mental‑health covariates","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":48,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.100"}},{"id":2622,"doi":"10.1016/j.chiabu.2008.12.011","pmid":"19748673","pmcid":null,"title":"Child pornography in peer-to-peer networks","authors":"Steel CM.","first_author":"Steel CM.","journal":"Child abuse & neglect","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Analysis of 235,513 user queries and 194,444 query hits on a peer‑to‑peer network to quantify child‑pornography content.","sample_n":235513,"sample_text":"235,513 queries; 194,444 hits.","population":"Internet users generating peer‑to‑peer traffic (no human participants recruited).","country":"United States (implicit from Mesh terms).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examined over 200,000 peer‑to‑peer searches and found that about 1 % of all queries sought child‑pornography, with a median age target of 13 years. Most searches were for videos, and female‑oriented terms dominated gender‑specific queries.","clinical_takeaway":"None – the paper informs law‑enforcement and Internet monitoring rather than clinical practice.","confidence":0.85,"topic_tags":["pornography","sexual_function","prevalence"],"strengths":["Very large dataset of actual network activity.","Provides concrete prevalence figures for child‑pornography queries.","Clear operational definition of query categories."],"limitations":["No validation of keyword‑based identification of illegal content.","Descriptive only; no inferential statistics or effect sizes.","Findings limited to one P2P network, may not generalise to other platforms."],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":44,"citing_publications":80,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2008.12.011"}},{"id":2623,"doi":"10.1080/13625180903028171","pmid":"19526420","pmcid":null,"title":"Experiences of and attitudes towards pornography among a group of Swedish high school students","authors":"Häggström-Nordin E, Tydén T, Hanson U, Larsson M.","first_author":"Häggström-Nordin E","journal":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional classroom questionnaire (N = 718) of Swedish high‑school students (age 17‑21). Random sample within schools, but limited to one country and to students attending school.","sample_n":718,"sample_text":"718 students (mean age 18, range 17‑21) completed an 89‑item classroom questionnaire","population":"Swedish high‑school students (3rd year), mixed gender, ages 17‑21","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2009 Swedish survey of 718 high‑school students found that almost all boys (98 %) had watched pornography, compared with 72 % of girls. Boys held more positive attitudes toward porn, while girls were more likely to view it as harmful. Attitudes varied by study programme and parental background.","clinical_takeaway":"When counselling adolescents, consider gender and educational background as factors influencing porn use and attitudes.","confidence":0.78,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample for a school‑based survey","Random sampling within schools","Provides gender‑ and programme‑specific data"],"limitations":["Questionnaire not reported as validated","No measurement of key confounds (moral incongruence, masturbation, mental health, etc.)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13625180903028171"}},{"id":2624,"doi":"10.1186/1471-244x-9-43","pmid":"19602221","pmcid":"PMC2716325","title":"The consumption of Internet child pornography and violent and sex offending","authors":"Endrass J, Urbaniok F, Hammermeister LC, Benz C, Elbert T, Laubacher A, Rossegger A.","first_author":"Endrass J","journal":"BMC psychiatry","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"http://www.biomedcentral.com/1471-244X/9/43/abstract","cited_by_count":27,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"6‑year follow‑up of 231 men charged with illegal child‑pornography consumption; recidivism assessed from criminal records.","sample_n":231,"sample_text":"231 men convicted of child‑pornography consumption.","population":"231 Swiss men identified by police operation (non‑representative, treatment‑seeking not applicable).","country":"Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A Swiss police‑identified cohort of 231 men who consumed child pornography was followed for six years. Only a few re‑offended with hands‑on sexual abuse, suggesting that merely viewing illegal porn does not automatically predict future physical abuse.","clinical_takeaway":"Viewing child pornography alone was not linked to higher hands‑on abuse risk in this sample; however, findings apply only to convicted offenders.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Objective criminal‑record outcome data","Longitudinal 6‑year follow‑up","Clear operational definition of recidivism"],"limitations":["Highly selected, non‑representative sample of convicted individuals","Very low event rates limit statistical power","No adjustment for potential confounders (e.g., mental health, prior violence)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":72,"citing_publications":105,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-244x-9-43"}},{"id":2626,"doi":"10.1055/s-0043-124392","pmid":"30326531","pmcid":null,"title":"[Diagnosis and Therapy of Internet Addiction]","authors":"Te Wildt BT.","first_author":"Te Wildt BT.","journal":"Die Rehabilitation","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"No empirical sample; article is a narrative discussion of diagnosis and therapy.","population":"general adult population (Germany) – no sample reported","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews internet addiction, including online pornography, arguing it resembles substance addiction. It recommends psychotherapy and complete abstinence, noting common comorbidities like depression and ADHD.","clinical_takeaway":"Consider psychotherapy and assess for comorbid mental health issues when treating problematic internet use.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Broad overview of comorbidities","Clear clinical recommendations"],"limitations":["No empirical data presented","No measurement of constructs or confounds","Potential bias toward abstinence model"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-0043-124392"}},{"id":2627,"doi":"10.1080/00224490902754152","pmid":"19219657","pmcid":null,"title":"Predicting internet pornography use and arousal: the role of individual difference variables","authors":"Paul B.","first_author":"Paul B.","journal":"Journal of sex research","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":54,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of adults measuring self‑reported pornography use, arousal and personality traits; exploratory factor analysis and regression","sample_n":null,"sample_text":"not reported in abstract","population":"unspecified adult sample, likely convenience (students/online volunteers)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed men and women about what kinds of online porn they view and how arousing they find it, then linked these patterns to personality traits like psychopathy and sexual disposition. Different content groups emerged for each gender, and higher psychopathy predicted broader porn use.","clinical_takeaway":"Individual personality traits may influence the types of porn people seek, but the study does not inform treatment or risk assessment.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Large set of individual‑difference variables examined","Factor analysis identifies content‑type groupings","Adds nuance to understanding of pornography arousal patterns"],"limitations":["Reliance on self‑report, likely unvalidated scales","Cross‑sectional design prevents causal inference","No control for key confounds (moral incongruence, masturbation, mental health)","Sample characteristics not described"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":73,"citing_publications":125,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490902754152"}},{"id":2628,"doi":"10.1258/ijsa.2008.008434","pmid":"19541897","pmcid":null,"title":"Sexual health of adults working in pornographic films","authors":"Coyne KM, Banks A, Heggie C, Scott CJ, Grover D, Evans C, Mandalia S, McLean KA, Cohen CE.","first_author":"Coyne KM","journal":"International journal of STD & AIDS","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Medical audit of STI screening in adult film performers over 13 months (N=115).","sample_n":115,"sample_text":"445 STI screens performed in 115 individuals.","population":"Adult pornographic film performers in the United Kingdom (56 women, 59 men).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 13‑month audit of 115 adult‑film performers in the UK found that 38% were diagnosed with at least one sexually transmitted infection, despite mandatory monthly screening; unprotected sex during filming was universal.","clinical_takeaway":"STI screening remains essential for porn performers; high infection rates persist despite testing requirements.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Objective laboratory STI outcomes","Large proportion of industry sampled","Clear description of screening protocol"],"limitations":["Convenience sample, not representative of all performers","Cross‑sectional; no causal inference","No adjustment for potential confounders (e.g., condom use outside work)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/ijsa.2008.008434"}},{"id":2629,"doi":"10.1080/00918369.2018.1525943","pmid":"30307840","pmcid":null,"title":"Sexistential Crisis: An Intersectional Analysis of Gender Expression and Sexual Orientation in Masculine Overcompensation","authors":"Lewis BJ, Hesse CL, Cook BC, Pedersen CL.","first_author":"Lewis BJ","journal":"Journal of homosexuality","year":2020,"pub_types":["Journal Article"],"keywords":["Overcompensation","Homophobia","Attitudes","Sexual Orientation","Masculinity","Femininity","Hypermasculinity","Intersectionality","Gender Expression"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Online randomized experimental survey with threat manipulation; large convenience sample (N=867).","sample_n":867,"sample_text":"Convenience online respondents, likely self‑selected.","population":"Adult men (gay and straight) recruited online; not a clinical or treatment‑seeking sample.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examined whether gay men, like straight men, react to threats to their masculinity by endorsing hyper‑masculine views. Using an online experiment with 867 participants, it found that gay men’s attitudes toward pornography and other topics differed from straight men’s, suggesting distinct ways masculinity is expressed across sexual orientations.","clinical_takeaway":"None – the study addresses attitudes, not pornography use or sexual health outcomes.","confidence":0.8,"topic_tags":["masturbation","pornography","sexual_function","gender"],"strengths":["Large sample size for an online survey","Experimental manipulation (masculinity threat)","Intersectional analysis of gender expression and sexual orientation"],"limitations":["Reliance on unvalidated, self‑report attitude scales","No measurement of actual pornography use or related behaviors","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2018.1525943"}},{"id":2630,"doi":"10.1016/j.euroneuro.2018.08.004","pmid":"30509450","pmcid":"PMC6276981","title":"Manifesto for a European research network into Problematic Usage of the Internet","authors":"Fineberg NA, Demetrovics Z, Stein DJ, Ioannidis K, Potenza MN, Grünblatt E, Brand M, Billieux J, Carmi L, King DL, Grant JE, Yücel M, Dell'Osso B, Rumpf HJ, Hall N, Hollander E, Goudriaan A, Menchon J, Zohar J, Burkauskas J, Martinotti G, Van Ameringen M, Corazza O, Pallanti S, COST Action Network, Chamberlain SR.","first_author":"Fineberg NA","journal":"European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Video Gaming","Compulsive","Behavioural Addiction","Problematic Internet Use","Pornography"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6276981","cited_by_count":195,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary/manifesto describing a European research network; no empirical data collected.","sample_n":null,"sample_text":"No participants; the paper outlines research priorities and network structure.","population":"none","country":"International (European Union)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The paper proposes a Europe‑wide research network to study problematic internet use, including compulsive sexual behaviour and pornography, and outlines nine priority areas for future investigation.","clinical_takeaway":"None – the article does not provide clinical evidence or guidance.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Comprehensive overview of research gaps","International, multidisciplinary collaboration","Identifies clear priorities for future work"],"limitations":["No empirical data presented","No methodological details to assess rigor"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":5,"contrasting":0,"mentioning":311,"citing_publications":355,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.euroneuro.2018.08.004"}},{"id":2631,"doi":"10.4081/jphia.2018.681","pmid":"30687472","pmcid":"PMC6325413","title":"Factors associated with early sexual intercourse among teenagers and young adults in rural south of Benin","authors":"Ahanhanzo YG, Sossa-Jérôme C, Sopoh G, Tchandana M, Azandjèmè C, Tchamdja T.","first_author":"Ahanhanzo YG","journal":"Journal of public health in Africa","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Teenagers","risk factors","Benin","Young Adult"],"is_oa":true,"oa_url":"https://publichealthinafrica.org/index.php/jphia/article/download/681/414","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 360 teenagers and young adults selected by random cluster sampling in rural Benin; logistic regression analysis of factors associated with early sexual initiation.","sample_n":360,"sample_text":"360 respondents selected by random cluster sampling","population":"Teenagers and young adults aged 10‑24 in the south of Benin (N≈360)","country":"Benin","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2018 Beninese survey of 360 youths found that watching pornographic movies, low father education, poor parent‑teen communication, and liberal views on premarital sex were linked to starting sexual activity at a younger age (average 14.75 years).","clinical_takeaway":"Exposure to pornographic content may be one of several factors associated with earlier sexual debut among adolescents; counseling should address media exposure alongside family communication.","confidence":0.7,"topic_tags":["sexual_function","adolescents","pornography"],"strengths":["Random cluster sampling improves representativeness","Adequate sample size for cross‑sectional analysis","Multivariable logistic regression to adjust for several covariates"],"limitations":["Constructs measured with single self‑report items, no validated scales","Potential recall bias for age of sexual debut","Key confounds (moral incongruence, masturbation, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":7,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4081/jphia.2018.681"}},{"id":2632,"doi":"10.1007/s10508-018-1301-9","pmid":"30229519","pmcid":null,"title":"Hitting the Target: Considerations for Differential Diagnosis When Treating Individuals for Problematic Use of Pornography","authors":"Kraus SW, Sweeney PJ.","first_author":"Kraus SW","journal":"Archives of sexual behavior","year":2019,"pub_types":["Comment","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":60,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":8,"contrasting":1,"mentioning":82,"citing_publications":104,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1301-9"}},{"id":2633,"doi":"10.1177/0033294118797580","pmid":"30185120","pmcid":null,"title":"The Use of Online Pornography as Compensation for Loneliness and Lack of Social Ties Among Israeli Adolescents","authors":"Efrati Y, Amichai-Hamburger Y.","first_author":"Efrati Y","journal":"Psychological reports","year":2019,"pub_types":["Journal Article"],"keywords":["Attachment","Sexual behavior","Anxiety","Mental health","Well-being"],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":5,"contrasting":0,"mentioning":23,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0033294118797580"}},{"id":2638,"doi":"10.1007/s10508-018-1277-5","pmid":"30116927","pmcid":null,"title":"Dysregulated Pornography Use and the Possibility of a Unipathway Approach","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Archives of sexual behavior","year":2019,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":2,"contrasting":0,"mentioning":11,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1277-5"}},{"id":2639,"doi":"10.1080/00224490902747701","pmid":"19308844","pmcid":null,"title":"The importance of individual differences in pornography use: theoretical perspectives and implications for treating sexual offenders","authors":"Kingston DA, Malamuth NM, Fedoroff P, Marshall WL.","first_author":"Kingston DA","journal":"Journal of sex research","year":2009,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"commentary","design_detail":"Review of existing literature, no new empirical data, narrative synthesis without systematic search or risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not applicable – narrative review.","population":"sexual offenders and general male samples (as described in reviewed studies)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"useful","plain_summary":"The authors review research suggesting that men who frequently view pornography and have other risk factors may be more likely to develop sexually aggressive attitudes and behaviours, especially among sexual offenders.","clinical_takeaway":"Consider pornography use as one of several risk indicators when assessing sexual‑offense patients, but evaluate it alongside other established factors.","confidence":0.3,"topic_tags":["pornography","sexual_function"],"strengths":["Broad coverage of experimental and non‑experimental findings","Integrates theoretical perspectives","Highlights interaction of multiple risk factors"],"limitations":["Narrative (non‑systematic) review; no formal bias assessment","Does not report how moral or other confounds were handled in source studies","Potential selective citation of supportive studies"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":6,"contrasting":1,"mentioning":91,"citing_publications":132,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490902747701"}},{"id":2640,"doi":"10.1007/s10508-018-1274-8","pmid":"30097738","pmcid":null,"title":"The \"Msychology\" of Hypersexuality: A 40-year-old Bisexual Man's Use of Online Chat, Pornography, Masturbation, and Extradyadic Sex","authors":"Walton MT, Bhullar N.","first_author":"Walton MT","journal":"Archives of sexual behavior","year":2018,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1274-8"}},{"id":2641,"doi":"10.1080/00224499.2018.1492694","pmid":"30064261","pmcid":"PMC6225987","title":"Are There Early Risk Markers for Pedophilia? A Nationwide Case-Control Study of Child Sexual Exploitation Material Offenders","authors":"Babchishin KM, Seto MC, Fazel S, Långström N.","first_author":"Babchishin KM","journal":"Journal of sex research","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Nationwide case‑control registry study of 655 convicted CSEM offenders matched 1:5 to 3,928 controls.","sample_n":4583,"sample_text":"655 offenders and 3,928 matched controls.","population":"Men born in Sweden, convicted of child sexual exploitation material offenses (1988‑2009).","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A Swedish registry study found that men who later were convicted of possessing child sexual‑exploitation material were more likely to have older fathers, lower‑educated parents, parents with violent criminal histories, fewer older brothers, and congenital malformations.","clinical_takeaway":"These early parental and biological markers may help identify elevated risk for CSEM offending, but they do not imply causation or guide treatment.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Large, nationwide registry sample with high statistical power.","Objective, register‑based measures of exposure and outcome.","Adjustment for several parental factors."],"limitations":["Observational case‑control; cannot infer causality.","No assessment of individual‑level psychological confounds (e.g., mental health, trauma).","Findings limited to convicted offenders, not all individuals with pedophilic interest."],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1492694"}},{"id":2642,"doi":"10.1097/acm.0b013e31819391e2","pmid":"19174685","pmcid":null,"title":"The pornographic anatomy book? The curious tale of the Anatomical Basis of Medical Practice","authors":"Halperin EC.","first_author":"Halperin EC.","journal":"Academic medicine : journal of the Association of American Medical Colleges","year":2009,"pub_types":["Historical Article","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"historical commentary on a 1971 anatomy textbook that used sexually suggestive images; no empirical data collected","sample_n":null,"sample_text":"not applicable","population":"none (historical analysis)","country":"USA (inferred from authors and journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article examines a 1971 anatomy textbook that used erotic photographs of women, sparking feminist protest and a boycott. It shows how medical teaching materials reflected broader cultural battles over pornography and women's representation.","clinical_takeaway":"None – the paper is a historical commentary, not a clinical study.","confidence":0.6,"topic_tags":["sexual_function","pornography","gender"],"strengths":["Provides historical context for how pornographic imagery entered medical education","Cites contemporary reactions (press, feminist groups) and publisher response","Well‑referenced with primary sources from the period"],"limitations":["No original data; purely narrative review","Limited relevance to current pornography‑related health research","Potential author bias in interpreting motives of original authors"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/acm.0b013e31819391e2"}},{"id":2643,"doi":"10.1016/j.clinph.2018.06.029","pmid":"30036777","pmcid":null,"title":"Inhibition and attentional control in pedophilic child sexual offenders - An event-related potential study","authors":"Rosburg T, Deuring G, Boillat C, Lemoine P, Falkenstein M, Graf M, Mager R.","first_author":"Rosburg T","journal":"Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Event-related potentials","Impulsivity","Psychopathy","Error-related Negativity","Pedophilia","Child Sexual Offence"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control ERP study with three groups (pedophilic contact CSOs, non‑contact CSOs, non‑offender controls); convenience sample of convicted offenders","sample_n":null,"sample_text":"not reported in abstract; likely small per group","population":"adult male sexual offenders (pedophilic and child‑pornography) and matched non‑offender controls","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study recorded brain activity while offenders and non‑offenders performed a task that required stopping a response. Offenders showed normal stopping and error‑detection signals, but reduced brain responses when evaluating mistakes, especially in those who had contact offenses.","clinical_takeaway":"Reduced error‑evaluation in child sexual offenders may reflect diminished responsibility, suggesting a target for interventions.","confidence":0.78,"topic_tags":["sexual_function","neuroscience","csbd"],"strengths":["Use of well‑validated ERP paradigm","Inclusion of both contact and non‑contact offender groups","Clear reporting of specific ERP component differences"],"limitations":["Small, non‑representative sample of convicted offenders","No pre‑registration or power analysis disclosed","Limited control for potential confounds (e.g., psychiatric comorbidity)"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":6,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.clinph.2018.06.029"}},{"id":2644,"doi":"10.1007/s10508-018-1209-4","pmid":"30014336","pmcid":null,"title":"An Organizational Framework for Sexual Media's Influence on Short-Term Versus Long-Term Sexual Quality","authors":"Leonhardt ND, Spencer TJ, Butler MH, Theobald AC.","first_author":"Leonhardt ND","journal":"Archives of sexual behavior","year":2019,"pub_types":["Journal Article"],"keywords":["Sexual Satisfaction","Pornography","Sexual Media","Script Theory","Sexual Quality"],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary (theoretical framework, no empirical data)","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors propose a new framework that combines existing theories to explain why sexual media may boost short‑term sexual pleasure but hurt long‑term sexual satisfaction, emphasizing content, media format, and relationship context.","clinical_takeaway":"None – the paper offers a theoretical model, not direct clinical guidance.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Integrates multiple theoretical models","Identifies nuanced moderators (content, format, couple context)"],"limitations":["No empirical data presented","Claims not tested against actual measurements","Potentially speculative over broad populations"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":38,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1209-4"}},{"id":2645,"doi":"10.3389/fpsyg.2018.01181","pmid":"30050484","pmcid":"PMC6050461","title":"Association Between Specific Internet Activities and Life Satisfaction: The Mediating Effects of Loneliness and Depression","authors":"Tian Y, Zhang S, Wu R, Wang P, Gao F, Chen Y.","first_author":"Tian Y","journal":"Frontiers in psychology","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Loneliness","Life Satisfaction","Mediating Effects","Specific Internet Use"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyg.2018.01181/pdf","cited_by_count":33,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 5,215 students (ages 10‑23) from multiple school types; self‑report measures of specific internet activities, loneliness, depression, and life satisfaction; cross‑sectional mediation analysis.","sample_n":5215,"sample_text":"5,215 students (2,303 male; mean age = 16.20 years; age range 10‑23)","population":"students (elementary to university) in China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 5,000 Chinese students, more frequent pornography use was linked to lower life satisfaction, and this relationship was explained by higher loneliness and depression.","clinical_takeaway":"None – the study does not provide actionable clinical guidance.","confidence":0.7,"topic_tags":["pornography","sexual_function","masturbation","moral_incongruence"],"strengths":["Large sample size","Multiple internet activities examined","Mediation analysis of loneliness and depression"],"limitations":["Cross‑sectional design; cannot infer causality","Pornography use measured with single‑item, no validated scale","No control for moral incongruence or masturbation","Self‑report data only"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":6,"contrasting":1,"mentioning":51,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2018.01181"}},{"id":2646,"doi":null,"pmid":"19927496","pmcid":null,"title":"Impact of pornography on forensic mental health and law enforcement professionals: effective coping strategies","authors":"Johnson SA.","first_author":"Johnson SA.","journal":"International journal of emergency mental health","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary/opinion piece without empirical data","sample_n":null,"sample_text":"Not applicable – article provides narrative description of stressors and coping strategies; no participants reported","population":"law enforcement and forensic mental health professionals","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how repeatedly viewing violent pornography can be stressful for police and mental‑health staff and suggests coping methods to manage their emotional reactions.","clinical_takeaway":"None – the paper does not provide evidence‑based guidance for clinical practice.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Raises awareness of occupational stressors","Offers practical coping suggestions"],"limitations":["No empirical data or systematic review","Lacks measurement of outcomes","No control for confounding variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":2648,"doi":"10.1177/1078390308327137","pmid":"21665787","pmcid":null,"title":"Pornography use as a risk marker for an aggressive pattern of behavior among sexually reactive children and adolescents","authors":"Alexy EM, Burgess AW, Prentky RA.","first_author":"Alexy EM","journal":"Journal of the American Psychiatric Nurses Association","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"secondary analysis of 160 sexually reactive children and adolescents; descriptive exploratory design using chi‑square and odds ratios","sample_n":160,"sample_text":"160 SRCAs (secondary analysis)","population":"sexually reactive children and adolescents (juvenile sexual offenders)","country":"USA (presumed from journal)","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 160 sexually reactive children and adolescents, those who reported using pornography were more likely to also display aggressive behaviors, based on chi‑square analyses.","clinical_takeaway":"Clinicians should note a possible link between pornography use and aggression in high‑risk youth, but evidence does not establish causation.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Relatively large sample for this vulnerable subgroup","Clear statistical approach (chi‑square, odds ratios)","Focus on an under‑studied high‑risk population"],"limitations":["Cross‑sectional, cannot infer causality","No validated measures of pornography use or aggression","Key confounds (moral incongruence, trauma, mental health) not assessed","No effect‑size confidence intervals reported"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":25,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1078390308327137"}},{"id":2649,"doi":"10.1016/j.addbeh.2018.07.005","pmid":"30077915","pmcid":null,"title":"Substance use disorders and sexual behavior; the effects of alcohol and drugs on patients' sexual thoughts, feelings and behavior","authors":"Bosma-Bleeker MH, Blaauw E.","first_author":"Bosma-Bleeker MH","journal":"Addictive behaviors","year":2018,"pub_types":["Comparative Study","Journal Article"],"keywords":["Sex","Sexual behavior","Substance Abuse","Addictive Behavior","Recovery Treatment Programs"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional questionnaire study of 180 treatment‑seeking patients with various substance‑use disorders.","sample_n":180,"sample_text":"180 patients with a substance‑use disorder (alcohol, amphetamine, cannabis, cocaine, GHB, opiates) completed a self‑report questionnaire.","population":"Patients in substance‑use treatment programs (alcohol, stimulants, sedatives, GHB).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 180 patients with substance‑use disorders, the authors found that many reported both positive and negative changes in sexual thoughts, feelings and behaviour when using their primary drug, with GHB users reporting the strongest effects and more risky sexual activity.","clinical_takeaway":"Clinicians should discuss both potential sexual benefits and risks when treating patients with substance‑use disorders, as perceived enhancements may hinder motivation to reduce use.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Relatively large clinical sample for this topic","Direct assessment of patients’ perceived sexual effects of substances","Includes multiple substance groups for comparison"],"limitations":["Cross‑sectional, self‑report design limits causal inference","No validated scales for sexual behaviour or pornography use","Potential confounds (mental health, relationship context) not measured"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":19,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2018.07.005"}},{"id":2650,"doi":"10.1071/sh17132","pmid":"29925462","pmcid":null,"title":"'I see it everywhere': young Australians unintended exposure to sexual content online","authors":"Lewis L, Somers JM, Guy R, Watchirs-Smith L, Skinner SR.","first_author":"Lewis L","journal":"Sexual health","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.publish.csiro.au/sh/pdf/SH17132","cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Focus group qualitative study with 11 groups of high‑school students (N not reported).","sample_n":null,"sample_text":"Eleven focus groups with high‑school students; exact participant count not provided.","population":"Australian high‑school students, ages 14‑18, recruited via schools (convenience sample).","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Australian teenagers say they often see sexual images and videos online without looking for them, mainly through friends' posts and ads. The study suggests teaching young people how to cope with such content rather than trying to block it entirely.","clinical_takeaway":"Educators should consider resilience‑building strategies for adolescents who encounter unsolicited sexual material online.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides rich, participant‑generated descriptions of exposure pathways.","Highlights unintended exposure, an under‑studied aspect.","Uses multiple focus groups to capture diverse viewpoints."],"limitations":["Small, non‑representative convenience sample; no numeric prevalence.","No quantitative measurement of exposure frequency or distress.","Findings not generalisable beyond Australian high‑school settings."],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh17132"}},{"id":2652,"doi":"10.1089/cpb.2007.0179","pmid":"18771400","pmcid":null,"title":"The nature and dynamics of internet pornography exposure for youth","authors":"Sabina C, Wolak J, Finkelhor D.","first_author":"Sabina C","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":78,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 563 college students recalling adolescent exposure to internet pornography; descriptive statistics reported","sample_n":563,"sample_text":"563 college students surveyed online","population":"college students (young adult) recalling exposure before age 18; likely US convenience sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 563 US college students found that most boys (93%) and many girls (62%) had seen online porn before age 18, usually after age 13. Boys started earlier and viewed more extreme content; girls reported more accidental exposure. The authors suggest porn use is common among youth and call for more research on its effects.","clinical_takeaway":"None - the study only describes how common internet porn exposure is among adolescents.","confidence":0.6,"topic_tags":["pornography","adolescents","prevalence","gender"],"strengths":["Large sample for a survey","Provides gender‑specific prevalence data","Highlights involuntary exposure among females"],"limitations":["Retrospective self‑report, possible recall bias","Convenience college sample, not representative of all youth","No validated exposure instrument"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":25,"contrasting":6,"mentioning":180,"citing_publications":306,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cpb.2007.0179"}},{"id":2653,"doi":"10.1136/bmj.k2753","pmid":"29930160","pmcid":null,"title":"Gynaecologist who asked patient about sex toys and pornography is struck off","authors":"Dyer C.","first_author":"Dyer C.","journal":"BMJ (Clinical research ed.)","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.k2753"}},{"id":2656,"doi":"10.1556/2006.7.2018.51","pmid":"29895182","pmcid":"PMC6174588","title":"Promoting educational, classification, treatment, and policy initiatives","authors":"Gola M, Potenza MN.","first_author":"Gola M","journal":"Journal of behavioral addictions","year":2018,"pub_types":["Comment","research-article","Journal Article"],"keywords":["Compulsive Sexual Behavior","Icd-11","Hypersexual Disorder","Sex Addiction","Problematic Pornography Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6174588","cited_by_count":41,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary/letter discussing potential impacts of including CSB in ICD‑11; no empirical data collected.","sample_n":null,"sample_text":"N/A","population":"none","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The authors discuss how adding a compulsive sexual behavior diagnosis to ICD‑11 could affect education, research, treatment, and policy, highlighting challenges and future directions.","clinical_takeaway":"None – the paper is a conceptual commentary, not a clinical study.","confidence":0.4,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Identifies important research and policy gaps","Integrates recent diagnostic proposal"],"limitations":["No empirical data presented","Lacks systematic evaluation of claims"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":35,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.51"}},{"id":2657,"doi":"10.1186/s12991-018-0194-2","pmid":"29942341","pmcid":"PMC5996492","title":"Chewing khat and risky sexual behavior among residents of Bahir Dar City administration, Northwest Ethiopia","authors":"Abate A, Tareke M, Tirfie M, Semachew A, Amare D, Ayalew E.","first_author":"Abate A","journal":"Annals of general psychiatry","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Ethiopia","Risky Sexual Behavior","Khat Chewing","Bahir Dar"],"is_oa":true,"oa_url":"https://annals-general-psychiatry.biomedcentral.com/track/pdf/10.1186/s12991-018-0194-2.pdf","cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"community based cross‑sectional survey using interviewer‑administered questionnaire; logistic regression used to assess associations","sample_n":null,"sample_text":"Community based cross‑sectional study conducted Jan‑Feb 2016; participants recruited from the city population (sampling method not specified)","population":"residents of Bahir Dar City administration, Northwest Ethiopia (sample size not reported in abstract)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a 2016 Ethiopian city survey, about one‑quarter of residents had ever chewed khat and one‑fifth were current chewers. Khat use was linked to having had sex, multiple partners, watching porn, and self‑reported STIs.","clinical_takeaway":"None – study does not provide direct clinical guidance for sexual health or addiction treatment.","confidence":0.6,"topic_tags":["csbd","sexual_function"],"strengths":["Community‑based sample","Use of multivariable logistic regression","Provides prevalence data for khat use"],"limitations":["Cross‑sectional design limits causal inference","No validated scales for khat use or sexual risk behaviours","Key sexuality‑related confounds not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":33,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12991-018-0194-2"}},{"id":2658,"doi":"10.1016/j.chiabu.2018.05.023","pmid":"29883932","pmcid":null,"title":"Exploring sexuality profiles of adolescents who have engaged in sexual abuse and their link to delinquency and offense characteristics","authors":"Spearson Goulet JA, Tardif M.","first_author":"Spearson Goulet JA","journal":"Child abuse & neglect","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexuality","Sexual Abuse","Offense Characteristics","Sexually Abusive Behavior","Juvenile Sexual Offenders (Jso)","Sexual Profiles"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional cluster analysis of 136 adolescents recruited from treatment and youth centres","sample_n":136,"sample_text":"N = 136 adolescents (both male and female) recruited from six specialised treatment centres and three youth centres in Quebec","population":"adolescents who have engaged in sexual abuse involving physical contact; recruited from specialized treatment centres and youth centres in Quebec, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study clustered 136 teen sexual abusers into three groups based on their sexual interests, fantasies, and behaviours, finding that those with the most ‘overinvested’ sexuality also had higher rates of non‑sexual crimes, multiple victims, and substance use.","clinical_takeaway":"Clinicians should consider the heterogeneous sexual profiles of adolescent sexual offenders when planning interventions, especially for those showing high sexual preoccupation and related risk factors.","confidence":0.78,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, multi‑site adolescent sample for this rare population","Comprehensive assessment of multiple sexual dimensions","Use of cluster analysis to identify heterogeneous profiles"],"limitations":["Cross‑sectional design limits causal inference","Reliance on possibly unvalidated self‑report measures","No control for key confounds (moral incongruence, mental health, partner effects)","Potential selection bias from treatment‑centre recruitment"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2018.05.023"}},{"id":2660,"doi":"10.26355/eurrev_201806_15171","pmid":"29917199","pmcid":null,"title":"Socio-emotional ability, temperament and coping strategies associated with different use of Internet in Internet addiction","authors":"Tonioni F, Mazza M, Autullo G, Pellicano GR, Aceto P, Catalano V, Marano G, Corvino S, Martinelli D, Fiumana V, Janiri L, Lai C.","first_author":"Tonioni F","journal":"European review for medical and pharmacological sciences","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control comparison of 25 Internet‑addiction patients and 26 matched healthy controls; participants reported predominant Internet activity (gaming, social networking, pornography).","sample_n":51,"sample_text":"25 IA patients, 26 controls","population":"adults (young‑adult to middle‑aged), mixed gender, recruited from a clinical setting for IA and community volunteers for controls","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small study, people with internet addiction who mainly played games showed more novelty‑seeking and used fewer coping strategies than those who mainly used social media or viewed pornography. Among healthy people, gamers also reported higher internet‑use problems and emotional difficulties.","clinical_takeaway":"Gaming‑focused internet use may be linked to greater emotional and coping difficulties than other online activities.","confidence":0.7,"topic_tags":["pornography"],"strengths":["Direct comparison of IA sub‑types","Use of multiple psychometric domains (temperament, coping, alexithymia, attachment)"],"limitations":["Small, non‑representative sample","No control for key confounds (moral attitudes, mental health, partner effects)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.26355/eurrev_201806_15171"}},{"id":2661,"doi":"10.3390/bs8060055","pmid":"29857562","pmcid":"PMC6000996","title":"Correction: Park, B.Y., et al. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports. <i>Behav. Sci.</i> 2016, <i>6</i>, 17","authors":"Park BY, Wilson G, Berger J, Christman M, Reina B, Bishop F, Klam WP, Doan AP, Behavioral Sciences Editorial Office.","first_author":"Park BY","journal":"Behavioral sciences (Basel, Switzerland)","year":2018,"pub_types":["Published Erratum","correction","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6000996","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs8060055"}},{"id":2662,"doi":"10.1186/s12905-018-0563-7","pmid":"29843687","pmcid":"PMC5975574","title":"Sexual initiation and associated factors among young women in West Shoa, Ambo Town, Ethiopia: a community-based cross-sectional study","authors":"Nigatu DT, Seme A, Fituma S, Segni MT.","first_author":"Nigatu DT","journal":"BMC women's health","year":2018,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5975574","cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Community‑based cross‑sectional survey of young women in Ambo town, Ethiopia, using multistage random sampling and structured questionnaire; logistic regression to identify predictors of sexual initiation.","sample_n":null,"sample_text":"317 respondents had ever had sex; total sample size not reported in abstract","population":"young women (age 15‑24) in Ambo town, Ethiopia","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a 2013 survey of young women in Ambo, Ethiopia, about half had already had sex. Watching porn, peer pressure, alcohol use, age, education and employment were linked to earlier sexual debut. The study suggests targeting life‑skills and youth clubs to delay sexual initiation.","clinical_takeaway":"None – the study reports associations, not clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Community‑based random sampling improves external validity","Use of multivariate logistic regression with confidence intervals","Clear reporting of predictors and effect sizes"],"limitations":["Pornography exposure measured by single unvalidated item","Cross‑sectional design cannot establish causality","No assessment of key confounds (moral incongruence, mental health, masturbation, partner factors)","Potential self‑report bias in sensitive behaviours"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":7,"contrasting":0,"mentioning":9,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12905-018-0563-7"}},{"id":2663,"doi":"10.1016/j.ajp.2018.05.020","pmid":"29803121","pmcid":null,"title":"Screen time and screen addiction: Beyond gaming, social media and pornography- A case report","authors":"Balhara YPS, Verma K, Bhargava R.","first_author":"Balhara YPS","journal":"Asian journal of psychiatry","year":2018,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":1,"mentioning":14,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ajp.2018.05.020"}},{"id":2664,"doi":"10.1371/journal.pone.0197860","pmid":"29795649","pmcid":"PMC5967734","title":"Longitudinal impacts of pubertal timing and weight status on adolescent Internet use: Analysis from a cohort study of Taiwanese youths","authors":"Tsai MC, Strong C, Chen WT, Lee CT, Lin CY.","first_author":"Tsai MC","journal":"PloS one","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5967734","cited_by_count":25,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal cohort (Taiwan Youth Project) with three waves; N=2430 7th‑grade students; regression analysis of pubertal timing, weight status, and internet/porn use.","sample_n":2430,"sample_text":"N = 2430 adolescents followed across three waves","population":"Adolescents (7th grade, Taiwan), both sexes","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Taiwanese cohort of 2,430 seventh‑graders, early puberty and being underweight were linked to spending more than 20 hours per week online and to higher odds of viewing pornography, especially among boys.","clinical_takeaway":"Kids who mature early may need closer monitoring of internet and porn exposure.","confidence":0.7,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Large, nationally‑based longitudinal sample","Separate analysis for males and females","Clear reporting of odds ratios with confidence intervals"],"limitations":["Internet and porn use measured by single‑item self‑report, no validated scale","Key psychosocial confounds (e.g., moral attitudes, mental health) not assessed","No causal inference can be drawn from observational design"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":27,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0197860"}},{"id":2665,"doi":"10.1007/s11920-018-0909-8","pmid":"29779064","pmcid":null,"title":"Sex Offender Risk Assessment: Where Are We and Where Are We Going?","authors":"Helmus LM.","first_author":"Helmus LM.","journal":"Current psychiatry reports","year":2018,"pub_types":["Review","Journal Article"],"keywords":["Prediction","risk assessment","Recidivism","Sexual Offenders","Offender Assessment"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of sex‑offender risk assessment tools; no primary data collected.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Sex offenders (including child‑pornography offenders); no new sample recruited.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This 2018 review summarizes current practices and recent developments in assessing the risk that individuals who have committed sexual offenses will re‑offend, highlighting strengths and gaps in existing tools.","clinical_takeaway":"Practitioners should be aware of the limits of risk scores and the need for clear communication when using them for decision‑making.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Comprehensive overview of recent advances in risk assessment.","Identifies gaps and future research directions."],"limitations":["No primary empirical data; conclusions rely on existing literature.","Lacks systematic review methodology (no PRISMA, risk‑of‑bias assessment)."],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":51,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11920-018-0909-8"}},{"id":2666,"doi":"10.1007/s11121-017-0810-4","pmid":"28685211","pmcid":"PMC6483380","title":"Predicting the Emergence of Sexual Violence in Adolescence","authors":"Ybarra ML, Thompson RE.","first_author":"Ybarra ML","journal":"Prevention science : the official journal of the Society for Prevention Research","year":2018,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Rape","Longitudinal study","Sexual Harassment","Sexual Violence","Youth Violence"],"is_oa":false,"oa_url":null,"cited_by_count":64,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"national online cohort, 6 waves, N=1586, lagged logistic regression","sample_n":1586,"sample_text":"nationally representative online panel (presumed) of adolescents and young adults","population":"youth ages 10‑21, United States","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A U.S. longitudinal study of 1,586 adolescents found that exposure to violent pornography, along with aggressive behaviour and family abuse, predicted later perpetration of sexual harassment or assault. The authors suggest early prevention that targets aggressive scripts and violent media.","clinical_takeaway":"Exposure to violent pornography may be a risk factor for later sexual violence; early interventions should address media influences alongside aggression.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["large national longitudinal sample","multiple waves allow temporal ordering","multivariable logistic models control for several relevant covariates"],"limitations":["key constructs (violent pornography) measured with likely unvalidated single items","important confounds for pornography research (moral incongruence, masturbation, mental health) not addressed","no preregistration or effect‑size reporting"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":1,"mentioning":94,"citing_publications":145,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11121-017-0810-4"}},{"id":2667,"doi":"10.1186/s12889-018-5405-x","pmid":"29703181","pmcid":"PMC5921970","title":"Disparities in risky sexual behavior among khat chewer and non- chewer college students in Southern Ethiopia: a comparative cross-sectional study","authors":"Ware E, Tura G, Alemu T, Andarge E.","first_author":"Ware E","journal":"BMC public health","year":2018,"pub_types":["Comparative Study","research-article","Journal Article"],"keywords":["College Students","Risky Sexual Behavior","Khat Chewing","South Ethiopia"],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-018-5405-x","cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional survey of 1211 Ethiopian college students selected by simple random sampling; logistic regression used to identify factors associated with risky sexual behaviour.","sample_n":1211,"sample_text":"1211 college students, randomly sampled from institutions in Arba Minch town","population":"College students (young adults) in Southern Ethiopia (N=1211)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 1,211 Ethiopian college students, those who chew khat are more likely to engage in risky sexual behaviour, even after accounting for factors like gender, age, peer pressure, and porn movie watching.","clinical_takeaway":"Khat chewing appears linked to higher sexual risk; clinicians should consider substance use when assessing sexual health in young adults.","confidence":0.8,"topic_tags":["relationships","sexual_function","religiosity","pornography"],"strengths":["Large random sample of college students","Adjusted odds ratios with confidence intervals reported","Consideration of multiple socio‑behavioural factors"],"limitations":["Cross‑sectional design prevents causal inference","Risky sexual behaviour measured with an unspecified questionnaire","Key psychosocial confounds (e.g., mental health, moral attitudes) not assessed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":27,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-018-5405-x"}},{"id":2668,"doi":"10.1016/j.adolescence.2008.06.004","pmid":"18694593","pmcid":null,"title":"Social bonds and internet pornographic exposure among adolescents","authors":"Mesch GS.","first_author":"Mesch GS.","journal":"Journal of adolescence","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative survey of Israeli adolescents (n=998), cross‑sectional analysis of frequent pornography users versus other Internet users","sample_n":998,"sample_text":"nationally representative sample of the adolescent population in Israel","population":"adolescents (Israel, 2004)","country":"Israel","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2004 Israeli survey of 998 teens found that those who often view online porn differ socially from peers who use the internet for other purposes, showing weaker ties to mainstream institutions and higher risk of deviant behaviour.","clinical_takeaway":"Frequent adolescent porn use is linked to broader social marginalisation, but the study provides no evidence of clinical pathology.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["large, nationally representative sample","focus on user characteristics rather than supply side","identifies social marginalization correlates"],"limitations":["frequency measured with single‑item, no validated scale","no assessment of moral, mental‑health or trauma confounds","cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":2,"mentioning":88,"citing_publications":135,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2008.06.004"}},{"id":2670,"doi":"10.3389/fpsyt.2018.00145","pmid":"29725310","pmcid":"PMC5917670","title":"Craving Responses to Methamphetamine and Sexual Visual Cues in Individuals With Methamphetamine Use Disorder After Long-Term Drug Rehabilitation","authors":"Huang S, Zhang Z, Dai Y, Zhang C, Yang C, Fan L, Liu J, Hao W, Chen H.","first_author":"Huang S","journal":"Frontiers in psychiatry","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["fMRI","methamphetamine","Medial Prefrontal Cortex","Cue-reactivity","Long-term Drug Rehabilitation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5917670","cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"cross-sectional fMRI cue‑reactivity study with 28 MA‑disordered participants (long‑term abstinent) and 27 controls","sample_n":55,"sample_text":"28 MA users, 27 healthy controls","population":"individuals with methamphetamine use disorder after compulsory rehabilitation; healthy control group","country":"China (inferred from authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used fMRI to see how people who have been drug‑free for a long time react to methamphetamine pictures compared with porn pictures. Even after years of rehab, they showed stronger brain responses to drug cues, while their response to porn cues was similar to controls, suggesting drug cravings may persist while sexual desire recovers.","clinical_takeaway":"Long‑term abstinent meth users may still exhibit brain‑based cravings for the drug, even if sexual responsiveness appears normalized.","confidence":0.78,"topic_tags":["neuroscience","csbd","sexual_function","moral_incongruence"],"strengths":["use of neuroimaging to compare drug‑related vs sexual cues","matched healthy control group","focus on long‑term abstinent participants"],"limitations":["small sample size for fMRI","no explicit control of sexual‑behavior or mental‑health confounds","cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":5,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":25,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2018.00145"}},{"id":2671,"doi":"10.1002/ab.20250","pmid":"18307171","pmcid":null,"title":"Pornography use and sexual aggression: the impact of frequency and type of pornography use on recidivism among sexual offenders","authors":"Kingston DA, Fedoroff P, Firestone P, Curry S, Bradford JM.","first_author":"Kingston DA","journal":"Aggressive behavior","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"longitudinal cohort of 341 convicted child molesters with up to 15‑year recidivism outcomes from national police database","sample_n":341,"sample_text":"341 child molesters","population":"male sexual offenders (child molesters) in Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 15‑year follow‑up of 341 child molesters, men who reported more frequent or deviant‑content pornography use were more likely to reoffend, especially if they were already high‑risk for reoffending.","clinical_takeaway":"For sexual‑offender risk assessment, pornography use may add predictive value, but clinicians should consider many other risk factors.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["large, legally defined offender sample","objective, long‑term recidivism outcomes","controls for established risk factors"],"limitations":["pornography use measured by single‑item self‑report, no validated scale","critical confounds (masturbation, mental health, trauma) not assessed","findings limited to convicted offenders, not general population"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":98,"citing_publications":150,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ab.20250"}},{"id":2672,"doi":"10.1007/s10508-018-1195-6","pmid":"29582268","pmcid":null,"title":"Effects of Sexual Arousal and Alcohol Cues on Acute Motivation for Alcohol","authors":"Spelman PJ, Simons JS.","first_author":"Spelman PJ","journal":"Archives of sexual behavior","year":2018,"pub_types":["Journal Article"],"keywords":["Behavioral Economics","Sexual Arousal","Alcohol Purchase Task","Demand Curves"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"laboratory experiment with 2 (video) x 2 (environment) between‑subjects design, N=109 college students","sample_n":109,"sample_text":"109 male and female college students (subsample N=84 for elasticity analysis)","population":"college students (young adults)","country":"USA (likely)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab experiment, viewing pornographic videos and being in a bar‑like setting each increased how much college students said they would be willing to pay for alcohol, suggesting that sexual arousal can boost short‑term alcohol craving.","clinical_takeaway":"Sexual arousal may heighten immediate desire for alcohol; clinicians should consider cross‑domain cue effects when addressing risky drinking.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Experimental manipulation of both sexual and alcohol cues","Use of validated alcohol purchase task","Adequate total sample size for a lab experiment"],"limitations":["No measurement of moral or individual difference confounds","Potentially underpowered for interaction tests","Findings limited to college student sample"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1195-6"}},{"id":2674,"doi":"10.1002/bsl.2335","pmid":"29498094","pmcid":null,"title":"Trouble at teens' fingertips: Youth sexting and the law","authors":"Holoyda B, Landess J, Sorrentino R, Friedman SH.","first_author":"Holoyda B","journal":"Behavioral sciences & the law","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review without systematic methods or meta‑analysis; no primary data collected","sample_n":null,"sample_text":"Not applicable – review article","population":"adolescents who engage in sexting (no sample size reported)","country":"United States (focus of legal discussion)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews teen sexting, its prevalence, links to mental‑health issues, and how U.S. law treats it, especially when consensual. It discusses prosecution under child‑pornography or sexting statutes and offers guidance for legal decision‑makers.","clinical_takeaway":"None – the paper is a legal and research overview, not a clinical study.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of legal landscape","Addresses mental‑health associations","Highlights definitional variability"],"limitations":["No systematic review methodology","No primary data or quantitative synthesis","No measurement of key confounds"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":28,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/bsl.2335"}},{"id":2675,"doi":"10.22454/fammed.2018.365688","pmid":"29537474","pmcid":null,"title":"Pornography Thoughts","authors":"Wilson SA.","first_author":"Wilson SA.","journal":"Family medicine","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.22454/fammed.2018.365688"}},{"id":2676,"doi":"10.1016/j.addbeh.2018.02.017","pmid":"29459201","pmcid":"PMC5849299","title":"Problematic internet use as an age-related multifaceted problem: Evidence from a two-site survey","authors":"Ioannidis K, Treder MS, Chamberlain SR, Kiraly F, Redden SA, Stein DJ, Lochner C, Grant JE.","first_author":"Ioannidis K","journal":"Addictive behaviors","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Machine Learning","Internet Addiction","Lasso","Behavioral Addiction","Problematic Internet Use","Internet Gaming Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5849299","cited_by_count":112,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet-based survey of 1749 adults recruited via media advertisements in US and South Africa; Lasso regression used to identify activities associated with PIU scores.","sample_n":1749,"sample_text":"1749 participants recruited via media advertisements","population":"Adults (18+), mixed gender, two countries","country":"United States; South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,749 adults in the US and South Africa found that many online activities, including pornography, are linked to higher scores on a problematic internet use questionnaire, and that these links differ by age.","clinical_takeaway":"Clinicians should consider a range of online behaviors—not just gaming—when assessing problematic internet use, especially in older adults.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size","Cross‑national data","Use of machine‑learning (Lasso) to select predictors"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral incongruence or masturbation","Potential self‑selection bias from media recruitment"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":13,"contrasting":0,"mentioning":137,"citing_publications":211,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2018.02.017"}},{"id":2677,"doi":"10.1007/s10508-008-9314-4","pmid":"18343988","pmcid":null,"title":"Use of pornography in a random sample of Norwegian heterosexual couples","authors":"Daneback K, Traeen B, Månsson SA.","first_author":"Daneback K","journal":"Archives of sexual behavior","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":62,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"representative national sample of 398 heterosexual couples; self‑administered postal questionnaire; discriminant function analysis","sample_n":398,"sample_text":"representative national sample (postal survey)","population":"Norwegian heterosexual couples, age 22‑67 (N=398 couples)","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationwide survey of 398 Norwegian couples, about one‑quarter reported using pornography to enhance their sex life. Couples in which one or both partners used porn described a more permissive sexual climate, and when only one partner used porn, men reported more arousal problems and women reported lower self‑perception.","clinical_takeaway":"Clinicians should note that pornography use within couples may be linked to perceived arousal issues and self‑image, but causal direction is unclear.","confidence":0.8,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Large, nationally representative sample","Dyadic perspective – both partners surveyed","Clear descriptive statistics of pornography use prevalence"],"limitations":["Reliance on single‑item, self‑report measures; limited validation","Cross‑sectional design cannot establish directionality","Key confounds (moral incongruence, masturbation, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":6,"contrasting":2,"mentioning":85,"citing_publications":178,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-008-9314-4"}},{"id":2678,"doi":"10.4103/psychiatry.indianjpsychiatry_38_18","pmid":"29540923","pmcid":"PMC5844164","title":"Psychosocial intervention for sexual addiction","authors":"George M, Maheshwari S, Chandran S, Rao SS, Shivanand MJ, Sathyanarayana Rao TS.","first_author":"George M","journal":"Indian journal of psychiatry","year":2018,"pub_types":["review-article","Review","Journal Article"],"keywords":["Psychosocial Interventions","Sexual Addiction","Internet Addiction","Behavioural Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5844164","cited_by_count":5,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods or data extraction","sample_n":null,"sample_text":"N/A","population":"none (review article)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article reviews the concept of sexual addiction, noting that no validated diagnostic criteria exist and that existing scales have questionable validity. It suggests that combining medication with psychotherapy may help reduce anxiety, depression, and guilt in people who consider themselves sexually addicted.","clinical_takeaway":"No firm evidence supports specific treatments for sexual addiction; clinicians should be cautious and focus on validated mental‑health interventions.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["Provides overview of existing scales","Highlights lack of validated diagnostic criteria"],"limitations":["No systematic search or appraisal","No empirical data presented","Claims treatment effectiveness without supporting evidence"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/psychiatry.indianjpsychiatry_38_18"}},{"id":2679,"doi":"10.1007/s10508-017-1042-1","pmid":"29330640","pmcid":null,"title":"Is Contact with Children Related to Legitimizing Beliefs Toward Sex with Children Among Men with Pedophilia?","authors":"Geradt M, Jahnke S, Heinz J, Hoyer J.","first_author":"Geradt M","journal":"Archives of sexual behavior","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Dsm-5","Pedophilia","Social Contact","Physical Contact","Legitimizing Beliefs"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Anonymous Internet survey of 104 self‑identified pedophilic men; correlational analysis of contact with children vs legitimizing beliefs.","sample_n":104,"sample_text":"Non‑forensic, non‑clinical internet convenience sample.","population":"Adult men self‑classifying as having pedophilic sexual interests; non‑forensic, non‑clinical sample.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 104 men who identified as having pedophilic interests, more frequent social or physical contact with children was linked to weaker beliefs that such contact is acceptable, challenging the idea that avoiding all child contact reduces abuse risk.","clinical_takeaway":"Contact with children does not automatically increase justifying attitudes; interventions should consider individual risk factors beyond simple contact avoidance.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Novel focus on contact vs legitimizing beliefs","Controls for several relevant covariates","Acknowledges limitations of correlational design"],"limitations":["Cross‑sectional, cannot infer causality","Measures of beliefs not described as validated","Self‑selected, non‑representative sample","Moral/incongruence and mental‑health variables not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-1042-1"}},{"id":2680,"doi":"10.1177/1025382307088093","pmid":"18430690","pmcid":null,"title":"Health education's role in framing pornography as a public health issue: local and national strategies with international implications","authors":"Perrin PC, Madanat HN, Barnes MD, Carolan A, Clark RB, Ivins N, Tuttle SR, Vogeler HA, Williams PN.","first_author":"Perrin PC","journal":"Promotion & education","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative policy/position paper reviewing existing literature without systematic methods; no original data.","sample_n":null,"sample_text":"No primary sample","population":"Not applicable (no primary participants)","country":"United States (focus on US policy, but discusses international implications)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article argues that pornography should be treated as a public‑health issue, reviews research on its effects on women, children and users, and proposes policy measures, especially for online content.","clinical_takeaway":"None – the paper offers policy discussion, not clinical guidance.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Broad overview of policy landscape","Highlights gaps in public‑health action"],"limitations":["No systematic search or risk‑of‑bias assessment","Lacks empirical data or quantitative analysis","Potential advocacy bias favoring a pathology view"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1025382307088093"}},{"id":2681,"doi":"10.1521/jaap.2008.36.4.593","pmid":"19113956","pmcid":null,"title":"Clinical encounters with internet pornography","authors":"Kalman TP.","first_author":"Kalman TP.","journal":"The journal of the American Academy of Psychoanalysis and Dynamic Psychiatry","year":2008,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":null,"sample_text":"Four clinical vignettes; exact numbers not provided","population":"clinical patients presenting with concerns about internet pornography (unspecified)","country":"USA (assumed from journal)","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale","self_selected_sample"],"stance":"supports","citation_value":"background","plain_summary":"The article reviews the history of pornography and presents four therapist case stories illustrating how some people experience problems linked to viewing porn online.","clinical_takeaway":"The paper offers anecdotal insight only; no generalizable clinical guidance can be drawn.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Provides detailed clinical illustrations","Historical context of internet pornography"],"limitations":["No empirical data or validated measures","Small, non‑representative case series","Lacks control of key confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1521/jaap.2008.36.4.593"}},{"id":2682,"doi":"10.1080/10550887.2019.1574187","pmid":"30798775","pmcid":null,"title":"Nonprofessionals' perceptions of the causes of behavioral and substance addictions","authors":"Lang B, Rosenberg H.","first_author":"Lang B","journal":"Journal of addictive diseases","year":2018,"pub_types":["Journal Article"],"keywords":["Etiology","Substance Addiction","Behavioral Addiction","Lay Public"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 612 US adults recruited via Amazon Mechanical Turk; participants randomly assigned to rate perceived causes for one of five addiction types (alcohol, marijuana, heroin, gambling, pornography).","sample_n":612,"sample_text":"Nationwide MTurk sample, 51% male, age range not specified.","population":"Adults (18+) from United States, mixed gender, recruited online (MTurk).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US survey of 612 adults, people were asked how likely they thought various causes (e.g., genetics, social pressure, trauma) contributed to different addictions, including pornography. Views differed: social pressure was seen as less important for porn than for drugs, while genetics was seen as less important for porn than for alcohol.","clinical_takeaway":"Clinicians should recognize that the public perceives pornography addiction as less biologically driven and more psychosocially influenced than substance addictions.","confidence":0.6,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Large sample size for a perception study","Random assignment of addiction type reduces order effects","Inclusion of multiple addiction categories allows comparison"],"limitations":["MTurk sample may not be nationally representative","Etiology items are simple ratings, not validated scales","No adjustment for potential demographic confounders"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10550887.2019.1574187"}},{"id":2683,"doi":"10.1080/00952990.2017.1407328","pmid":"29286835","pmcid":"PMC11974364","title":"Drug use patterns and predictors among homeless youth: Results of an ecological momentary assessment","authors":"Santa Maria D, Padhye N, Yang Y, Gallardo K, Santos GM, Jung J, Businelle M.","first_author":"Santa Maria D","journal":"The American journal of drug and alcohol abuse","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Drug Use","Homeless Youth","Ecological Momentary Assessments","Drug Use Urge"],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"ecological momentary assessment of 66 homeless youths recruited from a drop‑in centre; daily self‑reports of drug use, pornography use and contextual factors; generalized linear mixed‑effects modelling used to predict use","sample_n":66,"sample_text":"Convenience sample from a single service centre; majority male; limited generalisability","population":"homeless youth 18‑25, United States, Houston, Texas (n=66)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 66 homeless youths, daily electronic surveys showed that drug use was linked to recent discrimination, alcohol use, urges, and recent pornography viewing. The study suggests that real‑time monitoring could help design interventions, but the small, convenience sample limits how broadly the findings apply.","clinical_takeaway":"Addressing discrimination, alcohol, and urge management may help reduce drug use among homeless youth; pornography use was a minor predictor.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Real‑time EMA captures contextual predictors","Use of mixed‑effects models with cross‑validation"],"limitations":["Small, non‑representative sample","Single‑item self‑report measures; limited construct validation","No control for major confounds (moral incongruence, mental health, trauma)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":44,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00952990.2017.1407328"}},{"id":2684,"doi":"10.1016/j.forsciint.2017.12.011","pmid":"29367173","pmcid":null,"title":"Photoanthropometric face iridial proportions for age estimation: An investigation using features selected via a joint mutual information criterion","authors":"Borges DL, Vidal FB, Flores MRP, Melani RFH, Guimarães MA, Machado CEP.","first_author":"Borges DL","journal":"Forensic science international","year":2018,"pub_types":["Journal Article"],"keywords":["Age estimation","Face Iridial Proportions","Frontal Face Images","Information Based Feature Selection","Photoanthropometry"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional image database of 1,000 participants across five age groups; 10‑fold cross‑validation for age‑threshold classification.","sample_n":1000,"sample_text":"1000 frontal face images (500 female, 500 male) equally distributed across five age groups (6, 10, 14, 18, 22 years).","population":"500 females, 500 males, ages 6‑22, diverse ancestry (civil image identification database).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study proposes new facial‑iris measurements to guess a person’s age from a photo. Using 1,000 images, classifiers achieved high accuracy (AUC up to 0.97) for distinguishing children under 10, 14, and 18 years old.","clinical_takeaway":"None – the research pertains to forensic age estimation, not clinical sexual health.","confidence":0.8,"topic_tags":["csbd","pornography","moral_incongruence","masturbation"],"strengths":["Large, balanced sample across age and sex","Use of 10‑fold cross‑validation reduces over‑fitting","Clear performance metrics (AUC) reported"],"limitations":["No external validation on independent dataset","Feature selection and model not pre‑registered","Potential sample bias (civil image database, unknown recruitment)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.forsciint.2017.12.011"}},{"id":2685,"doi":"10.1007/s10508-017-1133-z","pmid":"29264845","pmcid":"PMC5834571","title":"Latency-Based and Psychophysiological Measures of Sexual Interest Show Convergent and Concurrent Validity","authors":"Ó Ciardha C, Attard-Johnson J, Bindemann M.","first_author":"Ó Ciardha C","journal":"Archives of sexual behavior","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Reaction time","Pupil Dilation","Pedophilia","Sexual Interest","Viewing Time"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007%2Fs10508-017-1133-z.pdf","cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional validation study with 102 community men completing latency and pupillometric tasks; self‑report used as criterion.","sample_n":102,"sample_text":"102 community men","population":"Adult community men (N=102)","country":"Not specified (likely Ireland/UK based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested whether quick response times and pupil‑size changes while looking at sexual pictures reliably reflect a man’s sexual interests. The different tests were strongly correlated and both predicted what participants said about their own interests, suggesting these measures are valid tools.","clinical_takeaway":"These latency and pupil‑dilation tasks may help researchers measure sexual interest more objectively, but they are not yet ready for clinical diagnosis.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large (N>100) community sample for validation work","Multiple latency‑based tasks allow convergent assessment","Pupillometry adds a physiological, non‑self‑report measure","Demonstrates concurrent validity with self‑report"],"limitations":["No measurement or control of key confounds (e.g., moral attitudes, mental health)","Reliance on self‑report as the criterion without independent validation","Cross‑sectional design limits causal inference","No pre‑registration or correction for multiple comparisons reported"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-1133-z"}},{"id":2686,"doi":"10.11604/pamj.2017.28.234.12125","pmid":"29881479","pmcid":"PMC5989185","title":"Premarital sexual practice and its predictors among university students: institution based cross sectional study","authors":"Akibu M, Gebresellasie F, Zekarias F, Tsegaye W.","first_author":"Akibu M","journal":"The Pan African medical journal","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Predictors","university students","Sexual Debut","Premarital Sexual Practice"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5989185","cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Institution‑based cross‑sectional survey of 604 university students using multistage sampling; logistic regression analysis of predictors of premarital sexual activity.","sample_n":604,"sample_text":"604 participants recruited via multistage sampling from a university","population":"University students (Ethiopia), both sexes, age ~18‑20","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 604 Ethiopian university students found that about half had engaged in premarital sex. Watching pornography, being male, and higher academic performance were linked to higher odds of having sex before marriage.","clinical_takeaway":"Viewing pornography is associated with premarital sexual activity among university students, but causality is unclear; clinicians should consider broader contextual factors.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a single university","Multistage sampling improves representativeness within campus","Use of multivariate logistic regression"],"limitations":["Cross‑sectional design cannot infer causality","Key constructs measured with single‑item, non‑validated items","No measurement of moral, mental‑health or partner variables"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":6,"contrasting":0,"mentioning":28,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.11604/pamj.2017.28.234.12125"}},{"id":2687,"doi":"10.1007/s10508-007-9212-1","pmid":"17851749","pmcid":null,"title":"Self-perceived effects of pornography consumption","authors":"Hald GM, Malamuth NM.","first_author":"Hald GM","journal":"Archives of sexual behavior","year":2008,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":159,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large representative survey of Danish young adults (18‑30), self‑report questionnaire","sample_n":null,"sample_text":"large representative sample (exact N not given in abstract)","population":"young Danish adults, both sexes","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A Danish survey of 18‑30‑year‑olds found that most participants saw pornography as having mainly positive effects on their sexual knowledge, attitudes and quality of life, with only small negative effects reported.","clinical_takeaway":"Self‑reported impacts of porn are largely perceived as positive; clinicians should consider individual perceptions rather than assuming harm.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, presumably representative sample","Considers both positive and negative self‑perceived effects","Sexual background factors examined as predictors"],"limitations":["New, unvalidated scale used","No measurement of key confounds (moral incongruence, masturbation, mental health)","Reliance on self‑report may introduce bias"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":12,"contrasting":1,"mentioning":277,"citing_publications":407,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-007-9212-1"}},{"id":2688,"doi":"10.1097/spv.0000000000000442","pmid":"28657997","pmcid":null,"title":"Women's Perception of Their Vulvar Appearance in a Predominantly Low-Income, Minority Population","authors":"Truong C, Amaya S, Yazdany T.","first_author":"Truong C","journal":"Female pelvic medicine & reconstructive surgery","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 346 women attending a county teaching hospital; divided by age; compares self‑reported satisfaction, perceived normality and interest in cosmetic surgery across groups and media exposure.","sample_n":346,"sample_text":"Female visitors to a county teaching hospital; convenience sample.","population":"Women (18‑44 and ≥45) attending a low‑income, minority‑predominant county teaching hospital (N≈346).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 346 low‑income women, those who had seen genital information online (including pornography) were more likely to say their vulva looked normal, be satisfied with its appearance, and consider cosmetic surgery, regardless of age.","clinical_takeaway":"Clinicians should recognise media exposure may influence women’s body image and cosmetic surgery interests, but causal claims are unsupported.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑site survey","Focus on under‑studied low‑income, minority women","Clear statistical comparisons reported"],"limitations":["Cross‑sectional; cannot infer causality","Use of non‑validated, single‑item measures","No control for key psychosocial confounds (e.g., mental health, moral views)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/spv.0000000000000442"}},{"id":2689,"doi":"10.1542/peds.2016-1758x","pmid":"29093054","pmcid":null,"title":"Sexual Media and Childhood Well-being and Health","authors":"Collins RL, Strasburger VC, Brown JD, Donnerstein E, Lenhart A, Ward LM.","first_author":"Collins RL","journal":"Pediatrics","year":2017,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of existing literature; no primary data collection.","sample_n":null,"sample_text":"No primary sample; review of prior studies.","population":"Children and adolescents (as discussed in reviewed studies)","country":"International (review of multiple studies)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how sexual content in traditional and digital media may influence adolescents’ attitudes, early sexual activity, and health outcomes, noting limited research on moderators and calling for more studies and media‑literacy interventions.","clinical_takeaway":"Clinicians should be aware that sexual media exposure may affect youth behavior, but evidence is limited; promoting media‑literacy and parental guidance is advisable.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of sexual media exposure in youth","Identifies gaps and calls for future research","Highlights need for policy and media‑literacy interventions"],"limitations":["Narrative, not systematic, review; selection bias possible","No quantitative synthesis or risk‑of‑bias assessment","Relies on limited primary studies, many of which are cross‑sectional"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":72,"citing_publications":122,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2016-1758x"}},{"id":2690,"doi":"10.1080/14647270701418922","pmid":"17786648","pmcid":null,"title":"The use of pornographic materials by adolescent male cancer patients when banking sperm in the UK: legal and ethical dilemmas","authors":"Crawshaw MA, Glaser AW, Pacey AA.","first_author":"Crawshaw MA","journal":"Human fertility (Cambridge, England)","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 94 adolescent male cancer patients who banked sperm; descriptive frequencies reported.","sample_n":94,"sample_text":"94 male teenage cancer survivors","population":"Adolescent male cancer survivors (UK) who underwent sperm banking","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Among 94 UK teenage cancer patients who banked sperm, about 25% wanted soft porn to help with masturbation and half wanted to bring their own material. The study highlights legal and ethical uncertainties around allowing minors to view porn in this medical context.","clinical_takeaway":"Clinicians should be aware that some adolescent sperm‑banking patients find porn helpful for masturbation, and legal policies may need to consider therapeutic exceptions.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","religiosity","moral_incongruence","csbd"],"strengths":["Addresses a rarely studied practical issue","Includes data from multiple UK sperm banks","Relatively large sample for this niche population"],"limitations":["Uses ad‑hoc questionnaire, no validated scales","Cross‑sectional, convenience sample limits generalisability","No control for moral, psychological or relational confounds"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/14647270701418922"}},{"id":2691,"doi":"10.1016/j.esxm.2017.08.001","pmid":"28993093","pmcid":"PMC5693399","title":"Hypersexual Disorder According to the Hypersexual Disorder Screening Inventory in Help-Seeking Swedish Men and Women With Self-Identified Hypersexual Behavior","authors":"Öberg KG, Hallberg J, Kaldo V, Dhejne C, Arver S.","first_author":"Öberg KG","journal":"Sexual medicine","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Gender","Sexual Compulsivity","Hypersexual Disorder","Hypersexual Disorder Screening Inventory","Screening Inventory"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5693399","cited_by_count":19,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online self‑report survey of 80 help‑seeking adults who identified as having hypersexual behavior","sample_n":80,"sample_text":"16 women, 64 men","population":"Swedish men and women recruited via advertisements for psychological treatment for hypersexual behavior (self‑selected, treatment‑seeking)","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","circular_addiction_scale"],"stance":"supports","citation_value":"useful","plain_summary":"In 80 Swedish adults who said they had hypersexual behavior and were seeking treatment, half met the proposed diagnostic criteria on the Hypersexual Disorder Screening Inventory. Women reported more risky sex and distress, while men mainly used pornography. The screening tool showed good internal reliability and correlated moderately with another compulsivity scale.","clinical_takeaway":"The HDSI may help identify hypersexual concerns, but its reliance on distress means clinicians should also assess moral and relational factors before labeling a disorder.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Use of a dedicated hypersexuality screening tool (HDSI)","Reported internal reliability and convergent validity with SCS","Inclusion of both men and women"],"limitations":["Help‑seeking convenience sample limits generalisability","No measurement of moral incongruence or related confounds","Reliance on self‑labelled distress to define “addiction”"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":3,"contrasting":0,"mentioning":23,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2017.08.001"}},{"id":2693,"doi":null,"pmid":"29197886","pmcid":null,"title":"Bullying and truancy: Predictors to sexual practices among school-going adolescents in Malaysia - a cross-sectional study","authors":"Azmawati MN, Dalila R, Idris IB, Hod R.","first_author":"Azmawati MN","journal":"The Medical journal of Malaysia","year":2017,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 16‑year‑old school adolescents (two schools) using self‑administered questionnaire; simple random sampling within schools.","sample_n":null,"sample_text":"Two schools; 16‑year‑old students; exact N not reported in abstract","population":"Malaysian school‑going adolescents (age 16)","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2017 Malaysian survey of 16‑year‑old students found that about 27% had viewed pornography and identified factors such as being male, skipping school, bullying, and family conflict as predictors of sexual activity.","clinical_takeaway":"Screening for bullying and truancy may help identify adolescents at higher risk of early sexual activity, including pornography exposure.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","prevalence"],"strengths":["Large‑scale school‑based sample (random within schools)","Use of multivariable logistic regression with confidence intervals","Identifies multiple behavioural predictors"],"limitations":["Self‑report, non‑validated measures of pornography exposure","Cross‑sectional design limits causal inference","No assessment of key confounds (moral views, mental health, trauma)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":2694,"doi":"10.1109/tpami.2007.1133","pmid":"17431300","pmcid":null,"title":"Recognition of pornographic web pages by classifying texts and images","authors":"Hu W, Wu O, Chen Z, Fu Z, Maybank S.","first_author":"Hu W","journal":"IEEE transactions on pattern analysis and machine intelligence","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Evaluation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"algorithm evaluation with test set; cross‑sectional performance metrics","sample_n":null,"sample_text":"Not applicable – study uses collections of Web pages rather than participants","population":"web pages (no human subjects)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors present a system that automatically detects pornographic web pages by analysing both text and images, using decision trees, Naïve Bayes, and contour‑based image features, achieving higher accuracy than earlier keyword‑or skin‑based methods.","clinical_takeaway":"None – the study describes a technical filtering tool, not a clinical finding.","confidence":0.7,"topic_tags":["pornography"],"strengths":["Clear algorithmic pipeline","Comparison with baseline classifiers","Fusion of text and image modalities"],"limitations":["No human‑subject validation of “pornographic” labels","Dataset size and representativeness not reported","No assessment of false‑positive impact on users"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":55,"citing_publications":167,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1109/tpami.2007.1133"}},{"id":2696,"doi":"10.1177/1079063217724768","pmid":"28863730","pmcid":"PMC6360483","title":"The Challenges of Identifying and Classifying Child Sexual Abuse Material","authors":"Kloess JA, Woodhams J, Whittle H, Grant T, Hamilton-Giachritsis CE.","first_author":"Kloess JA","journal":"Sexual abuse : a journal of research and treatment","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Child Pornography","Internet Sexual Offenses","Child Sexual Abuse Material","Indecent Images Of Children (Iioc)","Online Child Sexual Abuse"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6360483","cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Interrater reliability study with 1 researcher and 4 police coders assessing >1,200 images; followed by focus groups (n≈20‑36) and thematic analysis.","sample_n":1232,"sample_text":"1‑4 coders assessed 1,212‑2,233 images; focus groups with 4 employees.","population":"Law‑enforcement personnel (UK) coding child sexual abuse material.","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examined how consistently police staff can decide whether images of children are indecent, finding both agreement and disagreement and identifying factors that make judgments hard.","clinical_takeaway":"None - not clinically applicable.","confidence":0.7,"topic_tags":["csbd"],"strengths":["Large image sample examined","Systematic interrater reliability analysis","Qualitative insight via focus groups"],"limitations":["No validated coding instrument reported","Small number of coders limits generalisability","No pre‑registration or power analysis"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":36,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063217724768"}},{"id":2697,"doi":"10.1016/j.jad.2017.08.045","pmid":"28841491","pmcid":null,"title":"Video game addiction in emerging adulthood: Cross-sectional evidence of pathology in video game addicts as compared to matched healthy controls","authors":"Stockdale L, Coyne SM.","first_author":"Stockdale L","journal":"Journal of affective disorders","year":2018,"pub_types":["Journal Article"],"keywords":["Emerging Adults","Internet Gaming Addiction","Video Game Addiction","Pathological Gaming"],"is_oa":false,"oa_url":null,"cited_by_count":67,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of undergraduate students, matched controls on demographics","sample_n":null,"sample_text":"undergraduate college students (sample size not reported in abstract)","population":"Emerging adult university students (both genders), self‑selected volunteers","country":"USA (presumed from authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared university students who met a screening tool for video‑game addiction with matched peers. Those classified as addicts reported worse mental health, more impulsivity, and higher pornography‑use symptoms, especially women.","clinical_takeaway":"Screening‑identified gaming addiction is linked to poorer mental health, but findings are based on self‑report from a student sample.","confidence":0.7,"topic_tags":["prevalence","measurement","csbd"],"strengths":["Uses a widely validated IGDS instrument","Matches controls on key demographics","Examines a broad range of health outcomes"],"limitations":["Cross‑sectional, cannot infer causality","Convenience sample of undergraduates limits generalisability","Reliance on self‑report; no objective or physiological measures"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":7,"contrasting":1,"mentioning":124,"citing_publications":224,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jad.2017.08.045"}},{"id":2699,"doi":"10.1177/1079063217720926","pmid":"28760088","pmcid":null,"title":"Race and Victim Age Matter: Sexual Behaviors and Experiences Among Confined African American and European American Youth With Sexual and Nonsexual Offenses","authors":"Fix RL, Falligant JM, Alexander AA, Burkhart BR.","first_author":"Fix RL","journal":"Sexual abuse : a journal of research and treatment","year":2019,"pub_types":["Journal Article"],"keywords":["Male","Sexuality","Delinquency","Attitudes","Juvenile Sex Offender","Racial/ethnic Group"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Hierarchical multinomial logistic regression on archival data from 561 confined adolescents (sexual vs non‑sexual offenders).","sample_n":561,"sample_text":"Confined adolescents adjudicated for illegal sexual behavior (AISBs) and illegal nonsexual behavior (AINBs).","population":"Adolescents in juvenile confinement, USA, male, mixed racial/ethnic groups.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared sexual experiences of youths in juvenile detention convicted of sexual versus non‑sexual offenses, finding that sexual offenders reported more abuse and restrictions, while non‑sexual offenders reported more sexual activity, and noted racial differences in certain behaviors.","clinical_takeaway":"None - the findings pertain to offender behavior in detention, not clinical treatment guidance.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large sample for a confined population.","Use of multinomial logistic regression to differentiate offense categories.","Inclusion of both sexual and non‑sexual offending groups."],"limitations":["Cross‑sectional design limits causal inference.","Reliance on archival/self‑report data without validated scales.","No control for key confounds (e.g., mental health, trauma).","Findings not generalizable to non‑incarcerated youth."],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":12,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063217720926"}},{"id":2700,"doi":"10.1002/ab.20172","pmid":"17441011","pmcid":null,"title":"Predicting sexual aggression: the role of pornography in the context of general and specific risk factors","authors":"Vega V, Malamuth NM.","first_author":"Vega V","journal":"Aggressive behavior","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":87,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of men assessing pornography use and sexual aggression; regression analyses controlling for general and specific risk factors.","sample_n":null,"sample_text":"Not specified in abstract; likely convenience or community sample.","population":"men (sample size not provided in abstract)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether men who watch more pornography are more likely to commit sexual aggression, after accounting for other known risk factors. Pornography use added a small but significant predictive effect, especially among men already at high risk.","clinical_takeaway":"High pornography use alone is not a reliable indicator of sexual aggression; consider the broader risk profile.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Controls for multiple established risk factors","Uses classification tree for practical risk assessment"],"limitations":["Pornography use measured by simple self‑report, likely without validated scale","No control for key confounds (e.g., mental health, trauma)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":17,"contrasting":5,"mentioning":203,"citing_publications":218,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ab.20172"}},{"id":2701,"doi":"10.1016/j.psychres.2017.07.039","pmid":"28759791","pmcid":null,"title":"Problematic internet use among high school students: Prevalence, associated factors and gender differences","authors":"Vigna-Taglianti F, Brambilla R, Priotto B, Angelino R, Cuomo G, Diecidue R.","first_author":"Vigna-Taglianti F","journal":"Psychiatry research","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":83,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 2022 high‑school students from 25 Italian schools","sample_n":2022,"sample_text":"2022 students across 25 schools in Italy","population":"high‑school students (≈14‑15 y)","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 2000 Italian high‑school students found that about 10‑14 % show signs of problematic internet use, with visiting porn sites linked to higher risk for both boys and girls.","clinical_takeaway":"Screen adolescents for excessive internet use, especially if they frequently view porn, but note that causality is unproven.","confidence":0.78,"topic_tags":["prevalence","adolescents","sexual_function","pornography","gender"],"strengths":["Large sample size (N>2000)","Gender‑specific analysis","Multivariable logistic regression"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral/religious factors or mental‑health covariates","Unclear whether PIU scale is validated"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":13,"contrasting":2,"mentioning":75,"citing_publications":140,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psychres.2017.07.039"}},{"id":2702,"doi":"10.1542/peds.2006-1891","pmid":"17272613","pmcid":null,"title":"Unwanted and wanted exposure to online pornography in a national sample of youth Internet users","authors":"Wolak J, Mitchell K, Finkelhor D.","first_author":"Wolak J","journal":"Pediatrics","year":2007,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":117,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Telephone survey of nationally representative sample (N=1500) of youth aged 10‑17; cross‑sectional analysis using multinomial logistic regression.","sample_n":1500,"sample_text":"nationally representative sample of 1500 youth Internet users aged 10 to 17 years","population":"Youth Internet users, 10‑17 years, United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2007 US telephone survey of 1,500 adolescents found that 42% had seen online pornography in the past year; two‑thirds of these encounters were unwanted. Unwanted exposure was linked to file‑sharing, lack of filtering software, and higher rates of depression and victimisation.","clinical_takeaway":"Clinicians should screen for unwanted pornography exposure in teens, especially those with depression or victimisation histories, and advise use of filtering tools.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","religiosity","moral_incongruence"],"strengths":["Large, nationally representative sample","Distinguishes wanted vs. unwanted exposure","Uses validated Child Behavior Checklist for mental‑health covariates","Multinomial logistic regression allows comparison of exposure groups"],"limitations":["Self‑report exposure; no validated pornography‑use scale","Cross‑sectional; cannot infer causality","No measurement of moral incongruence or masturbation","Potential recall bias in telephone interview"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":17,"contrasting":6,"mentioning":258,"citing_publications":454,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2006-1891"}},{"id":2703,"doi":"10.1111/bjc.12147","pmid":"28691375","pmcid":null,"title":"Gender differences in preferences for psychological treatment, coping strategies, and triggers to help-seeking","authors":"Liddon L, Kingerlee R, Barry JA.","first_author":"Liddon L","journal":"The British journal of clinical psychology","year":2018,"pub_types":["Journal Article"],"keywords":["Sex","Gender","Mental health","Coping","Help-seeking"],"is_oa":false,"oa_url":null,"cited_by_count":195,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey (N=347; 115 men, 232 women) recruited via websites and social media; multiple linear regression with family‑wise error control.","sample_n":347,"sample_text":"115 men and 232 women recruited via relevant websites and social media.","population":"Adult men and women (self‑selected online sample).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 347 adults, men were more likely than women to use sex or pornography as a way of coping with stress and to prefer support groups, while women showed a stronger preference for female therapists. The study highlights gender‑related differences in therapy preferences and coping behaviours.","clinical_takeaway":"Consider gender‑specific coping styles (e.g., use of pornography) when discussing treatment options; men may benefit from male‑friendly therapy formats.","confidence":0.7,"topic_tags":["gender","csbd","sexual_function","masturbation"],"strengths":["Large total sample for a brief survey","Family‑wise error correction applied","Relevant gender‑specific findings"],"limitations":["Convenience online recruitment limits generalisability","Key constructs measured with single‑item, non‑validated items","No control for moral, mental‑health or relationship confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":26,"contrasting":5,"mentioning":214,"citing_publications":410,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/bjc.12147"}},{"id":2704,"doi":"10.1371/journal.pone.0180330","pmid":"28686631","pmcid":"PMC5501545","title":"A new approach for the analysis of facial growth and age estimation: Iris ratio","authors":"Machado CEP, Flores MRP, Lima LNC, Tinoco RLR, Franco A, Bezerra ACB, Evison MP, Guimarães MA.","first_author":"Machado CEP","journal":"PloS one","year":2017,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5501545","cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large sample of 1000 Brazilian subjects, ages 6‑22, photographed and measured; cross‑sectional analysis of facial growth using iris ratio as a reference.","sample_n":1000,"sample_text":"1000 subjects, equally by sex, in five age groups (6, 10, 14, 18, 22 ± 1 month)","population":"Brazilian children and young adults, balanced by sex","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors introduced a new forensic method that uses the size of the iris as a stable reference to assess facial growth and estimate age in children and adolescents. Analyzing 1,000 Brazilian photographs, they found the iris measurement remained constant while other facial dimensions changed with age, supporting its use for age estimation in investigations of child sexual abuse.","clinical_takeaway":"None – the study does not provide direct clinical guidance for sexual health or behavior.","confidence":0.8,"topic_tags":["adolescents","sexual_function","treatment"],"strengths":["Large, well‑balanced sample","Reliability assessed with ICC","Clear statistical methodology (ANOVA, Tukey, Pearson)"],"limitations":["Cross‑sectional; no longitudinal growth data","No external validation of the iris ratio method","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":27,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0180330"}},{"id":2705,"doi":"10.1016/j.chiabu.2017.06.017","pmid":"28628898","pmcid":null,"title":"\"Talking about child sexual abuse would have helped me\": Young people who sexually abused reflect on preventing harmful sexual behavior","authors":"McKibbin G, Humphreys C, Hamilton B.","first_author":"McKibbin G","journal":"Child abuse & neglect","year":2017,"pub_types":["Journal Article"],"keywords":["Prevention","Child Sexual Abuse","Public Health Model","Problematic Sexual Behavior","Constructivist Grounded Theory","Children And Young People With Harmful Sexual Behavior","Sexually Abusive Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Constructivist Grounded Theory analysis of semi‑structured interviews with 14 youths who had completed a treatment program for harmful sexual behaviour and six treatment‑providing workers. Purposive sampling, small convenience sample.","sample_n":20,"sample_text":"14 youth participants and 6 workers; purposive, treatment‑programme recruited","population":"young people (adolescents) who had previously engaged in harmful sexual behaviour and completed treatment; treatment‑providing professionals","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 14 young people who had previously committed sexual abuse and with six clinicians reveal three ways to prevent harmful sexual behaviour: improve sexuality education, address past victimisation, and help youths manage pornography exposure.","clinical_takeaway":"Prevention programmes should incorporate education, trauma‑informed support, and guidance on pornography use for at‑risk youth.","confidence":0.7,"topic_tags":["sexual_function","prevalence","treatment"],"strengths":["Grounded‑theory approach gives depth to participants' own perspectives","Includes both youth and practitioner viewpoints","Identifies concrete prevention opportunities"],"limitations":["Very small, treatment‑seeking sample limits generalisability","No quantitative measurement of pornography use or related constructs","No control for moral, mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":41,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2017.06.017"}},{"id":2706,"doi":"10.1007/s00103-007-0114-8","pmid":"17177094","pmcid":null,"title":"[Pornography and sexual abuse in the Internet]","authors":"Hill A, Briken P, Berner W.","first_author":"Hill A","journal":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","year":2007,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd","pornography"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review / narrative discussion without systematic methodology","sample_n":null,"sample_text":"Not applicable – narrative review","population":"general (Germany, internet users)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how internet pornography may either increase sexual aggression or act as a safety valve, noting that violent content and high‑risk individuals are most linked to aggression. It discusses \"sexual addiction\" and suggests preventive and therapeutic measures for offenders.","clinical_takeaway":"No specific clinical guidance; highlights need to assess aggression risk and address comorbid issues in offenders.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Broad overview of empirical literature up to 2007","Considers both risk and protective perspectives"],"limitations":["Narrative review without systematic search","No original data or quantitative synthesis","No explicit measurement of key confounds"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00103-007-0114-8"}},{"id":2708,"doi":"10.1371/journal.pone.0172274","pmid":"28636608","pmcid":"PMC5479499","title":"The construct of sexual openness for females in steady intimate relationships","authors":"Rausch D, Dekker A, Rettenberger M.","first_author":"Rausch D","journal":"PloS one","year":2017,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0172274&type=printable","cited_by_count":1,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of female German university students in steady relationships; convenience sample; cross‑sectional.","sample_n":null,"sample_text":"Convenience sample of female German students; exact N not given in abstract","population":"female university students in Germany, age range not specified, in steady intimate relationships","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors propose a new attitude construct called sexual openness, based on how women in steady relationships feel about practices, masturbation, bisexuality, permissiveness, and porn. Survey data support a single underlying factor, but further validation is needed.","clinical_takeaway":"None – the study reports attitudes, not clinical outcomes.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Introduces a novel latent construct","Uses confirmatory factor analysis","Addresses multiple attitudinal dimensions"],"limitations":["Convenience student sample limits generalisability","No validation of the new scale beyond this sample","No control for relevant confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0172274"}},{"id":2709,"doi":"10.1111/j.1471-6712.2006.00417.x","pmid":"17116147","pmcid":null,"title":"'It's everywhere!' young Swedish people's thoughts and reflections about pornography","authors":"Häggström-Nordin E, Sandberg J, Hanson U, Tydén T.","first_author":"Häggström-Nordin E","journal":"Scandinavian journal of caring sciences","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"In‑depth interviews with 18 Swedish youths (16‑23 y) analysed by grounded theory.","sample_n":18,"sample_text":"10 women, 8 men, ages 16‑23, recruited by staff invitation at a youth centre.","population":"Young women and men attending a youth centre in central Sweden, self‑selected volunteers.","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 18 Swedish youths showed that pornography shapes their sexual expectations, creates mixed feelings, and raises moral concerns, but results are limited to this small group.","clinical_takeaway":"Clinicians should be aware that young people may internalise porn‑driven norms and experience moral conflict, and discuss these issues openly.","confidence":0.6,"topic_tags":["pornography","adolescents","sexual_function","gender","moral_incongruence"],"strengths":["Rich, first‑person qualitative data","Grounded‑theory analysis provides depth","Highlights moral and gender dimensions"],"limitations":["Very small, non‑representative convenience sample","No systematic measurement of constructs","Findings cannot be generalized"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":49,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1471-6712.2006.00417.x"}},{"id":2710,"doi":"10.1111/1556-4029.13472","pmid":"28597921","pmcid":null,"title":"Feasibility of Canine Detection of Mass Storage Devices: A Study of Volatile Organic Compounds Emanating from Electronic Devices Using Solid Phase Microextraction","authors":"DeGreeff LE, Cerreta M, Rispoli M.","first_author":"DeGreeff LE","journal":"Journal of forensic sciences","year":2017,"pub_types":["Journal Article"],"keywords":["Odor","Headspace analysis","forensic science","Canine Detection","Solid Phase Microextraction-gas Chromatography/mass Spectrometry","Mass Storage Devices"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"feasibility study using SPME‑GC/MS to identify VOCs from electronic storage devices; canine detection implied but not tested on live dogs.","sample_n":null,"sample_text":"Various electronic devices analyzed; exact number not reported in abstract.","population":"electronic devices (SIM, SD cards, USB drives); no human participants","country":"United States (presumed from journal affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study used chemical analysis to find distinctive smells emitted by flash drives and memory cards, showing that trained dogs could potentially locate hidden storage devices that might hold illegal material.","clinical_takeaway":"None - not clinically applicable to sexual health or behavior.","confidence":0.6,"topic_tags":["csbd","masturbation","pornography","sexual_function"],"strengths":["Clear analytical chemistry methodology (SPME‑GC/MS).","Identifies specific VOCs common across device types."],"limitations":["No behavioural testing with actual canines reported.","Sample size and device variety not detailed in abstract.","Findings may not translate directly to field detection performance."],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1556-4029.13472"}},{"id":2711,"doi":null,"pmid":"28628148","pmcid":null,"title":"[Changes of acquired immune deficiency syndrome related knowledge, attitudes, behaviors and their influencing factors among college students in Beijing]","authors":null,"first_author":null,"journal":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Stratified cluster sampling of college students in Beijing, two separate cohorts (2006, 2016) with sample sizes 1,800 and 3,001; questionnaire on AIDS knowledge, attitudes, behaviors, condom use intentions.","sample_n":4801,"sample_text":"1800 students in 2006 cohort; 3001 students in 2016 cohort","population":"College students in Beijing (both sexes, aged ~18‑24)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of Beijing college students in 2006 and 2016 found that AIDS‑related knowledge declined, attitudes became more negative, and risky sexual behaviours (commercial and homosexual sex) increased, while condom‑use intentions were linked to gender, self‑efficacy, and prior sex education.","clinical_takeaway":"Health education for college students should address declining AIDS knowledge, negative attitudes, and promote condom self‑efficacy.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample sizes across two time points","Stratified cluster sampling enhances representativeness of Beijing college students","Provides temporal comparison of knowledge, attitudes, and behaviors"],"limitations":["Questionnaire appears author‑developed with no reported validation","No measurement or control of key sexual‑health confounds (e.g., moral incongruence, mental health)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":2712,"doi":"10.3390/bs7020034","pmid":"28538657","pmcid":"PMC5485464","title":"Social Support, Religious Involvement and Alcohol Use among Students at a Conservative Religious University","authors":"Thompson WE.","first_author":"Thompson WE.","journal":"Behavioral sciences (Basel, Switzerland)","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Alcohol","Social Support","Religious Involvement"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5485464","cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"convenience sample of 364 students from a single conservative religious university; survey of 124 items; descriptive, chi‑square and regression analyses","sample_n":364,"sample_text":"non‑random convenience sample recruited over 2 months from a larger study of 760 students","population":"college students (≥18 y) at a conservative religious university, USA","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 364 students at a conservative religious university found that those who reported higher religious involvement tended to drink alcohol less often, while perceived social support was not linked to drinking frequency.","clinical_takeaway":"Higher personal religious involvement may be associated with lower alcohol use among college students, but causal conclusions cannot be drawn.","confidence":0.7,"topic_tags":["religiosity","sexual_function","moral_incongruence"],"strengths":["Reasonable sample size for exploratory analysis","Examines understudied context (conservative religious campus)","Uses multivariate regression to control for some demographics"],"limitations":["Convenience, single‑site sample limits generalisability","Reliance on unvalidated self‑report items","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":7,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs7020034"}},{"id":2713,"doi":"10.1016/j.ijchp.2017.04.001","pmid":"30487892","pmcid":"PMC6220920","title":"Peer sexual cybervictimization in adolescents: Development and validation of a scale","authors":"Sánchez V, Muñoz-Fernández N, Vega-Gea E.","first_author":"Sánchez V","journal":"International journal of clinical and health psychology : IJCHP","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Adolescence","Invariance","Ex Post Facto Study","Peer Sexual Cybervictimization"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.ijchp.2017.04.001","cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Scale development with exploratory and confirmatory factor analysis on a sample of 601 adolescents from two Spanish cities; cross‑validation and gender invariance testing.","sample_n":601,"sample_text":"601 adolescents, mean age 14.06, recruited from two Spanish cities","population":"Adolescents (mean age 14.06) from two Spanish cities, n=601","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a questionnaire that measures two types of peer sexual cybervictimisation—ambiguous and personal—among 14‑year‑old adolescents, showing it works similarly for boys and girls.","clinical_takeaway":"None – the study provides a measurement tool, not clinical guidance.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large adolescent sample (n>600)","Rigorous psychometric validation (EFA, CFA, invariance testing)","Clear definition of cybervictimization dimensions"],"limitations":["Convenience sample from only two cities; limited generalisability","No assessment of related mental‑health or contextual confounds","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":32,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijchp.2017.04.001"}},{"id":2714,"doi":"10.1007/s10508-006-9064-0","pmid":"17039402","pmcid":null,"title":"Gender differences in pornography consumption among young heterosexual Danish adults","authors":"Hald GM.","first_author":"Hald GM.","journal":"Archives of sexual behavior","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":146,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national representative survey of 688 Danish young adults (18‑30), gender‑balanced, self‑report questionnaire","sample_n":688,"sample_text":"Representative national sample of 688 participants (men and women)","population":"young heterosexual Danish adults","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A national Danish survey of 688 young heterosexual adults found that men start viewing pornography earlier, use it more often, and mostly alone, whereas women use it more with a partner. Men also masturbate more frequently and prefer harder content.","clinical_takeaway":"Clinicians should note typical gender patterns in pornography use and masturbation when discussing sexual health with young adults.","confidence":0.85,"topic_tags":["pornography","gender","sexual_function","masturbation","prevalence"],"strengths":["Large, nationally representative sample","Separate measurement of masturbation and solo pornography use","Gender‑specific analysis of context and content"],"limitations":["Self‑report data, potential recall bias","No validated scales for pornography consumption","No assessment of moral or mental‑health covariates"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":24,"contrasting":7,"mentioning":242,"citing_publications":359,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-006-9064-0"}},{"id":2715,"doi":"10.1177/10598405060220050801","pmid":"17172202","pmcid":null,"title":"Young people, pornography, and sexuality: sources and attitudes","authors":"Wallmyr G, Welin C.","first_author":"Wallmyr G","journal":"The Journal of school nursing : the official publication of the National Association of School Nurses","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire administered to 876 youth centre attendees (15‑25 y, Sweden) over 1 year","sample_n":876,"sample_text":"555 females, 321 males; recruited from a youth centre","population":"young people (15‑25 y) attending a Swedish youth centre; convenience sample","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 876 Swedish youths (15‑25 y) found most had seen porn, with boys watching more often. Boys mainly watched to become aroused and masturbate; girls were more curious. Peers were the top source of sexual information, highlighting a need for balanced sex education.","clinical_takeaway":"Sex‑education programmes should address porn’s influence and provide accurate information beyond peer messages.","confidence":0.6,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample for a single site","Captures both genders and a wide age range","Provides concrete data on reasons for viewing porn"],"limitations":["Convenience sample limits generalisability","Questionnaire not validated; limited construct precision","No measurement of moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":2,"mentioning":36,"citing_publications":95,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10598405060220050801"}},{"id":2716,"doi":"10.1098/rspb.2016.2837","pmid":"28469018","pmcid":"PMC5443939","title":"Pleasure junkies all around! Why it matters and why 'the arts' might be the answer: a biopsychological perspective","authors":"Christensen JF.","first_author":"Christensen JF.","journal":"Proceedings. Biological sciences","year":2017,"pub_types":["research-article","Review","Journal Article"],"keywords":["Amygdala","Insula","Empathy","Pleasure","The Arts"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review article without original data; no empirical sample","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that endless pursuit of quick pleasures—like porn, video games, or junk food—may shift brain systems toward short‑term reward, resembling addiction. It suggests that engaging with the arts could rebalance these neural pathways, but notes that evidence is limited and mainly theoretical.","clinical_takeaway":"No direct clinical guidance; the piece proposes art‑based interventions as a hypothesis needing research.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function","neuroscience"],"strengths":["Broad interdisciplinary perspective","Identifies a novel research agenda"],"limitations":["No original data or systematic synthesis","Claims about addiction‑like neural changes are speculative","Lacks measurement of key confounds (moral incongruence, masturbation, mental health)"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":47,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1098/rspb.2016.2837"}},{"id":2717,"doi":"10.2174/0929867323666161213102528","pmid":"27978801","pmcid":null,"title":"Visual Sexual Stimulation and Erection, a Brief Review with New fMRI Data","authors":"Wu SL, Chow MSM, L JY, Yang J, Zhou H, Yew DT.","first_author":"Wu SL","journal":"Current medicinal chemistry","year":2017,"pub_types":["Review","Journal Article"],"keywords":["Neurotransmitters","fMRI","Drug addicts","Brain Activation","Penile Erection","Visual Sex Stimulation"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Review with new fMRI data; likely small, convenience sample of men undergoing visual erotic stimulation.","sample_n":null,"sample_text":"Not reported in abstract","population":"Men (sample size not stated in abstract)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["fmri_reverse_inference","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors reviewed brain areas activated during visual erotic stimulation and added new fMRI data showing that men who get an erection while watching porn show activation in midbrain and brainstem regions, suggesting possible roles for GABA and dopamine.","clinical_takeaway":"No direct clinical implications; findings are preliminary and based on limited imaging data.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","pornography"],"strengths":["Provides novel fMRI activation data for visual sexual stimulation with erection","Identifies brainstem regions not commonly reported"],"limitations":["Very small or unspecified sample; likely underpowered","No control for key confounds (e.g., moral attitudes, mental health)","BOLD findings interpreted as specific neurotransmitter activity without direct measurement"],"rubric_version":"2.0","raw_total":16,"max_possible":60,"pct_score":27,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":3,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2174/0929867323666161213102528"}},{"id":2718,"doi":"10.1177/0886260506290428","pmid":"16893966","pmcid":null,"title":"Rape-myth congruent beliefs in women resulting from exposure to violent pornography: effects of alcohol and sexual arousal","authors":"Davis KC, Norris J, George WH, Martell J, Heiman JR.","first_author":"Davis KC","journal":"Journal of interpersonal violence","year":2006,"pub_types":["Randomized Controlled Trial","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized controlled laboratory experiment with alcohol administration and exposure to violent pornography; N=134 female social drinkers; path analysis of attitudes.","sample_n":134,"sample_text":"community sample of female social drinkers (N = 134)","population":"Adult women, community sample of social drinkers, age not specified.","country":"United States (likely, based on NIH funding and author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab experiment, women who drank alcohol and then viewed a violent porn clip reported higher agreement with rape‑myth beliefs and were less likely to call the depicted act rape, suggesting alcohol and arousal can shift attitudes.","clinical_takeaway":"Alcohol intoxication may increase endorsement of rape myths after viewing violent pornography; clinicians should consider context when discussing attitudes toward sexual violence.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Randomized experimental design","Adequate overall sample size","Path analytic model to test mediation"],"limitations":["Unclear whether attitude measures are validated","No assessment of potential confounds (e.g., prior trauma, mental health)","Limited generalizability to broader populations"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":36,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260506290428"}},{"id":2719,"doi":"10.1016/j.jadohealth.2006.05.021","pmid":"17259051","pmcid":null,"title":"Trends in youth reports of sexual solicitations, harassment and unwanted exposure to pornography on the Internet","authors":"Mitchell KJ, Wolak J, Finkelhor D.","first_author":"Mitchell KJ","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2007,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":64,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two nationally representative telephone surveys (≈1500 youth each) assessing self‑reported unwanted sexual solicitation, harassment and exposure to pornography.","sample_n":3000,"sample_text":"National telephone surveys, likely probability sampling but exact method not detailed in abstract.","population":"US adolescents ages 10‑17, internet users","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"From 2000 to 2005, U.S. teens reported fewer unwanted sexual solicitations online but more unwanted exposure to pornography, especially younger and older adolescents, boys, and white youths.","clinical_takeaway":"Clinicians should note rising unwanted porn exposure among adolescents and consider preventive counseling, especially for younger boys and minority or low‑income youths.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative sample","Clear trend analysis over 5 years","Separate analysis by age, gender, race, income"],"limitations":["Self‑report single‑item measures, no validated scales","No assessment of psychological or contextual confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":106,"citing_publications":232,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2006.05.021"}},{"id":2720,"doi":"10.1515/ijamh-2016-0115","pmid":"28432846","pmcid":null,"title":"Pathological Internet use, cyberbullying and mobile phone use in adolescence: a school-based study in Greece","authors":"Tsimtsiou Z, Haidich AB, Drontsos A, Dantsi F, Sekeri Z, Drosos E, Trikilis N, Dardavesis T, Nanos P, Arvanitidou M.","first_author":"Tsimtsiou Z","journal":"International journal of adolescent medicine and health","year":2017,"pub_types":["Journal Article"],"keywords":["Adolescents","Mobile Phones","Internet Addiction","Pathological Internet Use","Cyberbullying"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Large school‑based sample (N≈5600) cross‑sectional survey using stratified random sampling; estimates prevalence and odds ratios for internet addiction and cyber‑bullying.","sample_n":5590,"sample_text":"5 590 participants (response rate 69.4 %) from 51 schools","population":"Adolescents (12‑18 y) in Greek middle and high schools","country":"Greece","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Greek school sample of over 5,500 teens, 10 % met a standard cutoff for internet addiction and about 7 % reported cyber‑bullying. More time on mobile phones, weekend internet use, and visiting porn sites were linked to higher odds of both addiction and bullying.","clinical_takeaway":"High mobile‑phone internet use correlates with problematic use and cyber‑bullying in adolescents; clinicians should screen for excessive online time.","confidence":0.78,"topic_tags":["adolescents","sexual_function","pornography","masturbation"],"strengths":["Large, randomly sampled adolescent cohort","Use of validated IAT scale","Multivariable modeling adjusts for several usage patterns"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of key confounds (moral incongruence, mental health, trauma)","Pornography exposure not separated from masturbation or distress"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":25,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/ijamh-2016-0115"}},{"id":2721,"doi":"10.23736/s0026-4946.17.04937-4","pmid":"28425691","pmcid":null,"title":"Health implications of new-age technologies: a systematic review","authors":"Bilgrami Z, McLAUGHLIN L, Milanaik R, Adesman A.","first_author":"Bilgrami Z","journal":"Minerva pediatrica","year":2017,"pub_types":["Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Narrative systematic review of 94 articles without explicit risk‑of‑bias assessment or meta‑analysis.","sample_n":null,"sample_text":"94 studies reviewed; no original sample size reported","population":"Adolescents (general)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises research on how internet, TV, phones and video games affect teen health, noting links to sleep problems, weight changes, mental health issues and risky sexual behaviours such as viewing porn or sexting.","clinical_takeaway":"Clinicians should discuss balanced technology use with teens, highlighting possible health impacts without assuming addiction.","confidence":0.75,"topic_tags":["adolescents","sexual_function","pornography"],"strengths":["Broad scope covering multiple technologies.","Includes both risks and potential benefits."],"limitations":["Lacks systematic risk‑of‑bias assessment.","No quantitative synthesis; narrative only.","Unclear how primary studies defined “addiction” or measured confounds."],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.23736/s0026-4946.17.04937-4"}},{"id":2723,"doi":"10.1016/s0013-7006(05)82414-5","pmid":"16598959","pmcid":null,"title":"[Relapse prevention group therapy for paedophiles: French adaptation]","authors":"Smith J, Petibon C.","first_author":"Smith J","journal":"L'Encephale","year":2005,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report with two illustrative patients, no systematic data collection","sample_n":2,"sample_text":"Two detailed case examples; no larger sample reported","population":"adult male sex offenders convicted of child sexual abuse, treated in a French forensic outpatient setting","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"avoid","plain_summary":"The authors describe how they adapted a North‑American relapse‑prevention program for French pedophiles, using a flexible, non‑directive group format. Two case narratives illustrate the approach, but no systematic data on relapse rates or effectiveness are provided.","clinical_takeaway":"No evidence that this therapy reduces relapse; clinicians should rely on rigorously evaluated programs.","confidence":0.6,"topic_tags":["relationships","csbd","sexual_function"],"strengths":["Provides detailed qualitative insight into therapy process","Highlights cultural adaptation issues"],"limitations":["No systematic outcome data or control group","Findings based on two cases – cannot generalize","No measurement of key confounds or validated constructs"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0013-7006(05)82414-5"}},{"id":2724,"doi":"10.1080/00224490609552323","pmid":"17599247","pmcid":null,"title":"Use of pornography in traditional media and on the Internet in Norway","authors":"Traeen B, Nilson TS.","first_author":"Traeen B","journal":"Journal of sex research","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":71,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 10,000 randomly selected Norwegians (age 18‑49); 34% response (≈3,400); descriptive prevalence of pornography use in magazines, films, Internet and erotic chatting.","sample_n":3400,"sample_text":"Random sample of 10,000 Norwegians, 34% response rate","population":"Adults 18‑49 in Norway, community sample","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2006 Norwegian survey found that most adults had viewed pornographic magazines or films, and about one‑third had accessed pornography online, with men using it more than women.","clinical_takeaway":"None – the study reports population‑level usage rates, not clinical implications.","confidence":0.7,"topic_tags":["pornography","prevalence","sexual_function","gender"],"strengths":["Large initial sampling frame (10,000)","Nationally representative age range","Clear descriptive statistics"],"limitations":["Low response rate (34%) may bias prevalence estimates","No validated instruments for pornography use","No measurement of potential confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":14,"contrasting":1,"mentioning":104,"citing_publications":176,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490609552323"}},{"id":2725,"doi":"10.1037/0021-843x.115.3.610","pmid":"16866601","pmcid":null,"title":"Child pornography offenses are a valid diagnostic indicator of pedophilia","authors":"Seto MC, Cantor JM, Blanchard R.","first_author":"Seto MC","journal":"Journal of abnormal psychology","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":138,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational comparison of 685 male patients referred for sexological assessment; groups: child‑pornography offenders, child‑sex offenders, adult‑sex offenders, general patients.","sample_n":685,"sample_text":"685 male patients","population":"Male patients referred for forensic/clinical sexual‑interest assessment (1995‑2004)","country":"Not specified (likely USA/Canada based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a group of 685 men assessed for sexual interests, those charged with child‑pornography offenses showed higher physiological arousal to children than men with other types of sexual offenses, suggesting the offense may be a strong marker of pedophilic interest.","clinical_takeaway":"Child‑pornography charges may help identify pedophilic sexual interests, but clinicians should consider broader assessments beyond offense type.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for forensic population","Use of validated phallometric assessment","Direct comparison across multiple offender groups"],"limitations":["Convenience clinical sample limits generalisability","No control for mental‑health or trauma variables","Cross‑sectional design cannot establish causality"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":20,"contrasting":1,"mentioning":174,"citing_publications":391,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/0021-843x.115.3.610"}},{"id":2726,"doi":"10.1016/j.chiabu.2017.03.018","pmid":"28395194","pmcid":null,"title":"Neuroticism as a risk factor for child abuse in victims of childhood sexual abuse","authors":"Boillat C, Schwab N, Stutz M, Pflueger MO, Graf M, Rosburg T.","first_author":"Boillat C","journal":"Child abuse & neglect","year":2017,"pub_types":["Journal Article"],"keywords":["Neuroticism","Child Sexual Assault","Traumatic Childhood Experiences","Pedosexual Preference","Sexual Abuse Experiences"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of pedosexual child abusers, internet child‑pornography consumers, and control adults; measures of childhood trauma (CTQ), personality (NEO‑PI‑R), and sexual behavior (MSI); structural‑equation modelling of mediation.","sample_n":null,"sample_text":"Not specified in abstract","population":"Adults (male and female) including child sex offenders and pornography consumers; sample size not reported in abstract.","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed child sex offenders, internet child‑pornography users and non‑offenders, finding that experiences of childhood abuse are linked to adult offending indirectly through higher neuroticism.","clinical_takeaway":"Higher neuroticism may mediate the link between early trauma and later abusive behaviour, but evidence is correlational.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","moral_incongruence"],"strengths":["Use of validated questionnaires (CTQ, NEO‑PI‑R, MSI)","Structural equation modelling to test mediation"],"limitations":["Cross‑sectional design limits causal inference","Sample size and recruitment details unclear","No control for key sexual‑behavior confounds (e.g., masturbation, moral attitudes)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":17,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2017.03.018"}},{"id":2728,"doi":null,"pmid":"17131758","pmcid":null,"title":"[Problems associated with chronological age estimation of children exploited in child pornography production]","authors":"Bednarek J.","first_author":"Bednarek J.","journal":"Archiwum medycyny sadowej i kryminologii","year":2006,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"pol","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review discussing forensic age estimation challenges in child pornography cases; no systematic search or empirical data reported.","sample_n":null,"sample_text":"No participant sample; review of methodological issues.","population":"Not applicable (focus on forensic cases, no human participant sample)","country":"Poland (journal language suggests Polish context)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews technical and biological difficulties in estimating the age of children shown in pornographic images, noting problems like poor image quality and natural variation in development, and calls for better interdisciplinary methods.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Highlights practical forensic challenges","Integrates multidisciplinary perspectives"],"limitations":["No empirical data or systematic methodology","Limited applicability to sexual‑health or addiction research"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":2729,"doi":"10.1017/s0021932017000049","pmid":"28285603","pmcid":null,"title":"HIV/STI RISK-TAKING SEXUAL BEHAVIOURS AND RISK PERCEPTION AMONG MALE UNIVERSITY STUDENTS IN TEHRAN: IMPLICATIONS FOR HIV PREVENTION AMONG YOUTH","authors":"Khalajabadi Farahani F, Akhondi MM, Shirzad M, Azin A.","first_author":"Khalajabadi Farahani F","journal":"Journal of biosocial science","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large representative cross‑sectional survey using two‑stage stratified cluster sampling (N=1322 male university students)","sample_n":1322,"sample_text":"representative sample of male university students from government and private universities in Tehran, selected via two‑stage stratified cluster sampling","population":"male university students in Tehran, Iran","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,322 male university students in Tehran found that many engage in premarital sex, have multiple partners, and use condoms inconsistently, while few feel concerned about HIV or STIs. Watching pornography was linked to having more partners.","clinical_takeaway":"Clinicians should address low risk perception and promote consistent condom use among young men, especially those exposed to pornography.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Large, nationally‑representative sample","Use of stratified cluster sampling improves generalisability","Multiple relevant behavioural outcomes assessed"],"limitations":["Reliance on self‑report; unclear whether measures are validated","No assessment of key confounds (moral incongruence, mental health, trauma, etc.)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":8,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0021932017000049"}},{"id":2730,"doi":"10.1016/j.srhc.2017.03.002","pmid":"28477937","pmcid":null,"title":"The relationship between frequent pornography consumption, behaviours, and sexual preoccupancy among male adolescents in Sweden","authors":"Donevan M, Mattebo M.","first_author":"Donevan M","journal":"Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":4,"contrasting":0,"mentioning":37,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.srhc.2017.03.002"}},{"id":2731,"doi":"10.1136/bcr-2016-218738","pmid":"28275020","pmcid":"PMC5353383","title":"Intellectual disability complicated by sexual addiction: an uncommon presentation of a common condition","authors":"Pang NT, Masiran R.","first_author":"Pang NT","journal":"BMJ case reports","year":2017,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single individual with intellectual disability and self‑reported sexual addiction; no comparison group","sample_n":1,"sample_text":"single patient","population":"young adult male with mild intellectual disability","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A young man with mild intellectual disability reported compulsive sexual thoughts, heavy pornography use, and spent large sums on sexual activities. Clinicians diagnosed him with sexual addiction and began medication and therapy.","clinical_takeaway":"Diagnoses of sexual addiction should use validated criteria; single‑case reports cannot guide treatment decisions.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["detailed clinical description","highlights rarity of comorbidity"],"limitations":["single case limits generalisability","diagnosis not based on validated scales","no assessment of moral incongruence or other confounds"],"rubric_version":"2.0","raw_total":7,"max_possible":60,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":1,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bcr-2016-218738"}},{"id":2732,"doi":"10.1136/bmj.j1199","pmid":"28270418","pmcid":null,"title":"Anaesthetist who possessed child and animal pornography is struck off","authors":"Dyer C.","first_author":"Dyer C.","journal":"BMJ (Clinical research ed.)","year":2017,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.j1199"}},{"id":2733,"doi":"10.1007/s10508-017-0953-1","pmid":"28265779","pmcid":null,"title":"Declines in Sexual Frequency among American Adults, 1989-2014","authors":"Twenge JM, Sherman RA, Wells BE.","first_author":"Twenge JM","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Generations","Sexual activity","Marriage","Time Period","Birth Cohort","Sexual Frequency"],"is_oa":false,"oa_url":null,"cited_by_count":76,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Repeated cross‑sectional surveys from the nationally representative General Social Survey (N≈26,600) spanning 1989‑2014; analyses of age, period, cohort effects.","sample_n":26620,"sample_text":"Nationally representative General Social Survey respondents, 1989‑2014","population":"American adults (general population)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using data from a national survey of over 26,000 US adults, the study finds that people are having sex about nine fewer times a year in the 2010s than in the 1990s, driven largely by generational changes and fewer people being in steady relationships.","clinical_takeaway":"Clinicians should recognize that overall sexual frequency has declined, especially among partnered adults, but this trend is not linked to increased pornography use or work hours.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Long time span allowing cohort analysis","Controls for partnered status and several demographics"],"limitations":["Self‑report of sexual frequency may be subject to recall bias","No measurement of moral/religious attitudes or mental‑health covariates","Causal claims limited to observational trends"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":2,"mentioning":87,"citing_publications":168,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-0953-1"}},{"id":2734,"doi":"10.1097/olq.0000000000000566","pmid":"28178111","pmcid":"PMC6879100","title":"Demographics, Behaviors, and Sexual Health Characteristics of High Risk Men Who Have Sex With Men and Transgender Women Who Use Social Media to Meet Sex Partners in Lima, Peru","authors":"Chow JY, Konda KA, Calvo GM, Klausner JD, Cáceres CF.","first_author":"Chow JY","journal":"Sexually transmitted diseases","year":2017,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 401 MSM and transgender women recruited from two STI clinics in Lima, Peru; comparison of those with vs. without recent social‑media‑mediated sex partners using chi‑square, t‑tests and Wilcoxon tests.","sample_n":401,"sample_text":"312 MSM and 89 TW recruited from two STI clinics","population":"MSM and transgender women attending STI clinics in Lima, Peru (N=401)","country":"Peru","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among MSM and transgender women in Lima, those who meet partners via social media are younger, have more partners, and show higher rates of certain STIs, suggesting that online hookup apps may contribute to sexual‑health risk in this population.","clinical_takeaway":"Clinicians should consider discussing online partner‑seeking behaviors when assessing STI risk in MSM and transgender women.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for the region","Relevant public‑health focus on emerging social‑media partner seeking","Includes both MSM and transgender women"],"limitations":["Convenience clinic sample limits generalisability","Cross‑sectional design prevents causal inference","No validated measures of sexual risk or mental‑health confounders"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":23,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/olq.0000000000000566"}},{"id":2735,"doi":"10.1016/j.jsxm.2017.01.003","pmid":"28262103","pmcid":null,"title":"Pornography Viewing: Keep Calm and Carry On","authors":"Fisher WA, Kohut T.","first_author":"Fisher WA","journal":"The journal of sexual medicine","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2017.01.003"}},{"id":2736,"doi":"10.1080/00224499.2017.1278736","pmid":"28276941","pmcid":null,"title":"Unbuckling the Bible Belt: A State-Level Analysis of Religious Factors and Google Searches for Porn","authors":"Whitehead AL, Perry SL.","first_author":"Whitehead AL","journal":"Journal of sex research","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"state-level ecological multivariate regression (N≈50 states)","sample_n":50,"sample_text":"All 50 US states","population":"United States states (aggregated Google search data)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Using Google search data, the authors found that US states with more Evangelical, literalist, and church‑attending residents tend to have higher rates of porn‑related searches, while more secular states show fewer searches. Political conservatism was linked to fewer searches after controlling for other factors.","clinical_takeaway":"State religious climate may shape community‑wide pornography exposure, but individual risk cannot be inferred from these aggregate findings.","confidence":0.7,"topic_tags":["pornography","religiosity","sexual_function","csbd"],"strengths":["Large, nationwide dataset","Novel state‑level religious variables","Controls for several demographic factors"],"limitations":["Ecological design; cannot infer individual behavior","Google search volume is an indirect, unvalidated proxy for porn use","No measurement of key individual confounds (moral incongruence, masturbation, mental health)","Potential for omitted variable bias"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":2,"mentioning":41,"citing_publications":80,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1278736"}},{"id":2737,"doi":"10.1007/s10508-016-0838-8","pmid":"27743067","pmcid":null,"title":"Erratum to: Perceived Effects of Pornography on the Couple Relationship: Initial Findings of Open-Ended, Participant-Informed, \"Bottom-Up\" Research","authors":"Kohut T, Fisher WA, Campbell L.","first_author":"Kohut T","journal":"Archives of sexual behavior","year":2017,"pub_types":["Published Erratum","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0838-8"}},{"id":2738,"doi":"10.1016/j.jaad.2005.12.037","pmid":"16546584","pmcid":null,"title":"Detection and management of pornography-seeking in an online clinical dermatology atlas","authors":"Lehmann CU, Cohen BA, Kim GR.","first_author":"Lehmann CU","journal":"Journal of the American Academy of Dermatology","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational analysis of web usage logs over six months","sample_n":7800,"sample_text":"7800 images accessed; 10,000 free‑text queries examined","population":"Users of an online dermatology image archive (DermAtlas)","country":"USA (implied by journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A review of an online dermatology image archive found that a notable portion of requests (about 11%) were for genital images, and many came from non‑medical, porn‑related websites, indicating the system is vulnerable to misuse.","clinical_takeaway":"Clinicians should be aware that medical image databases can be accessed for sexual purposes and implement monitoring safeguards.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large dataset of real‑world web requests","Clear quantitative reporting of misuse rates","Provides actionable recommendation for monitoring"],"limitations":["No validated measures of pornography‑seeking behavior","Descriptive design cannot infer motives","Potential privacy/ethical concerns not addressed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jaad.2005.12.037"}},{"id":2740,"doi":"10.1016/j.jsxm.2016.10.016","pmid":"28011208","pmcid":null,"title":"Profiles of Cyberpornography Use and Sexual Well-Being in Adults","authors":"Vaillancourt-Morel MP, Blais-Lecours S, Labadie C, Bergeron S, Sabourin S, Godbout N.","first_author":"Vaillancourt-Morel MP","journal":"The journal of sexual medicine","year":2017,"pub_types":["Journal Article"],"keywords":["Sexual dysfunction","Profile Analysis","Sexual Well-being","Cyberpornography","Sexual Compulsion"],"is_oa":false,"oa_url":null,"cited_by_count":55,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional convenience sample (N=830) with cluster analysis of self‑report measures","sample_n":830,"sample_text":"Convenience sample of 830 adults completing online questionnaires","population":"Adults (mixed gender) recruited online","country":"Canada (presumed from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 830 adults, three pornography‑use patterns emerged—recreational, highly distressed but low use, and compulsive. Recreational users reported better sexual satisfaction, while compulsive users reported more distress, compulsivity and dysfunction.","clinical_takeaway":"Clinicians should recognise that pornography users are heterogeneous; distress can occur even with low use, so assessment should consider individual patterns, not just frequency.","confidence":0.85,"topic_tags":["pornography","sexual_function"],"strengths":["Large community sample (N=830)","Use of several validated scales","Exploratory cluster analysis reveals heterogeneity"],"limitations":["Convenience, self‑selected sample limits generalisability","No assessment of moral/religious conflict or mental‑health covariates","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":11,"contrasting":1,"mentioning":72,"citing_publications":113,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2016.10.016"}},{"id":2741,"doi":"10.1080/00224499.2016.1255873","pmid":"27982701","pmcid":null,"title":"Dutch Adolescents' Motives, Perceptions, and Reflections Toward Sex-Related Internet Use: Results of a Web-Based Focus-Group Study","authors":"Doornwaard SM, den Boer F, Vanwesenbeeck I, van Nijnatten CHCJ, Ter Bogt TFM, van den Eijnden RJJM.","first_author":"Doornwaard SM","journal":"Journal of sex research","year":2017,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Web‑based focus groups with 36 Dutch adolescents (16‑19 y) analysed via open, axial and selective coding","sample_n":36,"sample_text":"36 participants (12 focus groups, 3–4 per group)","population":"Adolescents, Netherlands, 72 % female","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Dutch teens (16‑19 y) discussed why they use the internet for sexual information, porn, and sexting. They see it as useful and normal, but worry it can create unrealistic expectations and affect peers negatively.","clinical_takeaway":"Clinicians should recognise that adolescents view online sexual content as both helpful and risky, and address expectations about sex when discussing internet use.","confidence":0.85,"topic_tags":["adolescents","pornography","sexual_function","masturbation"],"strengths":["In‑depth qualitative insight into adolescents’ own perspectives","Systematic coding stages (open, axial, selective)","Focus on both positive and negative aspects of online sexual behavior"],"limitations":["Small, non‑representative sample (mostly female, volunteers)","No measurement of key confounds (e.g., moral incongruence, mental health)","Findings not generalisable beyond Dutch adolescents"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":48,"citing_publications":74,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2016.1255873"}},{"id":2742,"doi":"10.1037/adb0000228","pmid":"27893214","pmcid":null,"title":"Public perceptions of behavioral and substance addictions","authors":"Lang B, Rosenberg H.","first_author":"Lang B","journal":"Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationwide convenience online survey of 612 US adults assessing lay definitions and stigma toward substance and behavioral addictions (pornography, gambling).","sample_n":612,"sample_text":"convenience sample","population":"American adults, diverse ages and genders, recruited via convenience online panel.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 612 US adults asked how they define addiction and whether they'd associate with someone addicted to pornography, gambling, alcohol, marijuana, or heroin. People viewed heroin as most addictive and were generally reluctant to affiliate with anyone labeled addicted, showing stigma toward both substance and behavioral addictions.","clinical_takeaway":"None – the study reports public attitudes, not clinical findings.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a survey","Addresses understudied behavioral addictions","Compares multiple addictions side‑by‑side"],"limitations":["Convenience, non‑representative sample","Questionnaire items appear ad‑hoc, not validated","No control for potential confounds (e.g., moral attitudes)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":43,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/adb0000228"}},{"id":2743,"doi":"10.1089/cyber.2016.0433","pmid":"27875066","pmcid":null,"title":"Sexuality and the Internet: A Study of the Perspectives of Turkish University Students","authors":"Ucar T, Golbasi Z, Senturk Erenel A.","first_author":"Ucar T","journal":"Cyberpsychology, behavior and social networking","year":2016,"pub_types":["Journal Article"],"keywords":["Sexuality","Internet","Turkey","university students","Online Sexual Activity"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 1,330 Turkish university students using a researcher‑designed questionnaire.","sample_n":1330,"sample_text":"Convenience sample of students invited from two public universities; not a probability or nationally representative sample.","population":"University students (Turkey)","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 1,330 Turkish university students found that about half use the Internet for sexual information, 30% view porn sites, 21% chat about sex online, and 9% buy sexual products. Men reported higher usage than women, and women held more negative attitudes toward online sexual activity.","clinical_takeaway":"None – the study describes usage patterns among students but does not inform clinical assessment or treatment.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a student survey","Gender comparisons provided"],"limitations":["Researcher‑made, unvalidated questionnaire","Convenience sample limits generalisability","No control for key confounds (e.g., moral attitudes, mental health)","No effect sizes or correction for multiple testing"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2016.0433"}},{"id":2744,"doi":"10.1080/00224490509552283","pmid":"19827232","pmcid":null,"title":"The objectification of women in mainstream pornographic videos in Australia","authors":"McKee A.","first_author":"McKee A.","journal":"Journal of sex research","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["bibliography","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Content analysis of a convenience sample of mainstream pornographic videos from Australia; coded twelve objectification measures, some allowing male‑female comparisons.","sample_n":null,"sample_text":"Twelve mainstream pornographic videos selected from Australian productions (sample size not reported).","population":"Videos (not human participants)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined how women are portrayed in Australian mainstream porn by coding twelve aspects of objectification. Results were mixed: women showed fewer on‑screen orgasms, while men were less likely to look at the camera, talk to it, or be positioned as sexual objects.","clinical_takeaway":"None – the article analyses video content and does not provide clinical guidance.","confidence":0.85,"topic_tags":["pornography","gender","sexual_function","csbd","masturbation"],"strengths":["Systematic coding of multiple objectification dimensions","Direct male–female comparison on several metrics"],"limitations":["Unclear whether coding scheme was validated","Small, non‑random video sample","No power analysis or correction for multiple testing"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":99,"citing_publications":123,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490509552283"}},{"id":2745,"doi":"10.1089/cpb.2005.8.473","pmid":"16232040","pmcid":null,"title":"Exposure to internet pornography among children and adolescents: a national survey","authors":"Ybarra ML, Mitchell KJ.","first_author":"Ybarra ML","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":2005,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":97,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative telephone survey of 1501 youth (ages 10‑17), cross‑sectional","sample_n":1501,"sample_text":"nationally representative cross‑sectional telephone survey","population":"children and adolescents, United States","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2005 US telephone survey of 1,501 youths found that most who intentionally view porn are aged 14‑17, are more likely to be male, and report higher rates of delinquency, substance use, depressive symptoms, and weaker emotional bonds with caregivers. Online seekers showed slightly more of these problems than offline seekers.","clinical_takeaway":"Clinicians should note that adolescent porn exposure co‑occurs with other risk behaviours, but cross‑sectional data cannot prove it causes harm.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","moral_incongruence"],"strengths":["large, nationally representative sample","includes both online and offline pornography exposure","identifies associations with a range of psychosocial outcomes"],"limitations":["cross‑sectional design limits causal inference","key constructs measured with single self‑report items","moral or religious attitudes not assessed","masturbation not distinguished from pornography use"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":22,"contrasting":5,"mentioning":247,"citing_publications":382,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cpb.2005.8.473"}},{"id":2749,"doi":"10.1016/j.admecli.2005.02.004","pmid":"16111620","pmcid":null,"title":"Pornography and teenagers: the importance of individual differences","authors":"Malamuth N, Huppin M.","first_author":"Malamuth N","journal":"Adolescent medicine clinics","year":2005,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods; no new empirical data.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Adolescents (teenagers), primarily males, discussed in literature.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review argues that pornography’s impact on teens varies widely depending on personality traits and other risk factors; it is not uniformly harmful.","clinical_takeaway":"Clinicians should assess individual risk factors rather than assume pornography is inherently damaging for all teens.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Broad overview of individual differences","Highlights nuance beyond simplistic harm narratives"],"limitations":["Narrative (non‑systematic) review","No empirical data or meta‑analytic synthesis","No measurement of key confounds"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":4,"contrasting":0,"mentioning":48,"citing_publications":97,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.admecli.2005.02.004"}},{"id":2750,"doi":"10.1016/j.neubiorev.2016.08.033","pmid":"27590829","pmcid":null,"title":"Integrating psychological and neurobiological considerations regarding the development and maintenance of specific Internet-use disorders: An Interaction of Person-Affect-Cognition-Execution (I-PACE) model","authors":"Brand M, Young KS, Laier C, Wölfling K, Potenza MN.","first_author":"Brand M","journal":"Neuroscience and biobehavioral reviews","year":2016,"pub_types":["Review","Journal Article"],"keywords":["Inhibitory Control","Executive Functions","Internet Addiction","Cue-reactivity","Internet-gaming Disorder","Internet-use Disorders"],"is_oa":false,"oa_url":"https://nbn-resolving.org/urn:nbn:de:hbz:464-20180105-135644-1","cited_by_count":1052,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative theoretical review proposing the I‑PACE model for specific Internet‑use disorders, including pornography. No original empirical data presented.","sample_n":null,"sample_text":"None – paper is a conceptual review.","population":"Not applicable (theory paper)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The paper proposes the I‑PACE model, a theory explaining how personal traits, emotions, thoughts, and executive control interact to create and sustain problematic internet behaviors like gaming, gambling, and pornography use.","clinical_takeaway":"The model offers a conceptual guide for clinicians to consider multiple psychological and neuro‑biological factors when assessing problematic internet use.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Comprehensive integration of existing literature","Clear process‑oriented framework","Identifies multiple psychological and neurobiological factors"],"limitations":["No empirical testing of the model","Relies on secondary studies without systematic review methodology","Lacks operational definitions for many constructs"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":208,"contrasting":2,"mentioning":1759,"citing_publications":2253,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neubiorev.2016.08.033"}},{"id":2751,"doi":"10.3389/fnhum.2016.00402","pmid":"27574507","pmcid":"PMC4983547","title":"Visual Sexual Stimuli-Cue or Reward? A Perspective for Interpreting Brain Imaging Findings on Human Sexual Behaviors","authors":"Gola M, Wordecha M, Marchewka A, Sescousse G.","first_author":"Gola M","journal":"Frontiers in human neuroscience","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Reinforcement Learning","Neuroimaging","Compulsive Sexual Behaviors","Behavioral Addictions","Incentive Salience","Visual Sexual Stimuli"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fnhum.2016.00402/pdf","cited_by_count":48,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary without original data","sample_n":null,"sample_text":"N/A – no empirical sample reported","population":"none","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors review 40 recent brain‑imaging studies that used visual sexual stimuli and argue that, in most lab settings, these stimuli act as rewards rather than mere cues. They discuss how pleasure, brain activity, effort to view, and conditioning support this view, urging careful interpretation of such imaging work.","clinical_takeaway":"Clinicians should note that brain responses to sexual images may reflect reward processes, not necessarily pathological craving.","confidence":0.6,"topic_tags":["neuroscience","sexual_function","csbd"],"strengths":["Clear synthesis of recent neuroimaging literature","Provides conceptual clarification between cue and reward"],"limitations":["No original empirical data","No systematic review methodology reported","Potential advocacy for a particular theoretical stance"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":7,"contrasting":0,"mentioning":43,"citing_publications":129,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fnhum.2016.00402"}},{"id":2753,"doi":"10.1007/s10461-016-1361-6","pmid":"26979416","pmcid":"PMC4945400","title":"Outcome Expectancy and Sexual Compulsivity Among Men Who Have Sex with Men Living with HIV","authors":"Brown MJ, Serovich JM, Kimberly JA.","first_author":"Brown MJ","journal":"AIDS and behavior","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["MSM","Condom Use","Sexual Compulsivity","Outcome Expectancy","Hiv Disclosure"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 338 MSM living with HIV; linear regression analyses","sample_n":338,"sample_text":"338 MSM","population":"men who have sex with men (MSM) living with HIV; recruited presumably via community/clinic sources (not specified)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 338 HIV‑positive gay men, stronger beliefs that condom use and safe‑sex communication lead to positive outcomes were linked to lower scores on a sexual compulsivity measure.","clinical_takeaway":"Boosting confidence in safe‑sex practices may be associated with reduced sexual compulsivity among MSM with HIV.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑group survey","Uses regression to adjust for several demographics","Addresses a relatively understudied link (outcome expectancy ↔ sexual compulsivity)"],"limitations":["Cross‑sectional; cannot infer causality","Unclear whether sexual compulsivity measured with validated scale","Key confounds (moral incongruence, mental health, partner factors) not assessed","No effect‑size confidence intervals reported"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-016-1361-6"}},{"id":2754,"doi":"10.1007/s10803-016-2805-6","pmid":"27193182","pmcid":"PMC4938848","title":"Sexuality and Autistic-Like Symptoms in Juvenile Sex Offenders: A Follow-Up After 8 Years","authors":"Baarsma ME, Boonmann C, 't Hart-Kerkhoffs LA, de Graaf H, Doreleijers TAH, Vermeiren RRJM, Jansen LMC.","first_author":"Baarsma ME","journal":"Journal of autism and developmental disorders","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Sexual development","Autism Spectrum Disorder","Longitudinal Research","Sexual Offending Juveniles"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4938848","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Follow‑up of 44 male juvenile sex offenders compared with a matched community sample; mean age 24.7 y; assessments of sexuality knowledge, attitudes toward pornography, and ASD‑like symptoms 8 years after the offense.","sample_n":44,"sample_text":"44 male JSOs (mean age 24.7 ± 1.5 y) with a matched normal‑population sample.","population":"Male juvenile sexual offenders (N = 44) and a matched non‑offender control group.","country":"Netherlands (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Eight years after committing sexual offenses, 44 young men showed lower sexual knowledge and less favorable views of pornography than peers, while their autistic‑like traits remained stable and unrelated to sexual development.","clinical_takeaway":"Autistic traits in this offender group appear stable and do not explain differences in sexual knowledge or pornography attitudes.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Long‑term follow‑up (8 years)","Comparison with matched community sample","Focus on ASD symptom stability"],"limitations":["Small, highly specific offender sample limits generalisability","Unclear if sexuality/ASD measures are validated","No control for major confounds (mental health, trauma, moral attitudes)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10803-016-2805-6"}},{"id":2755,"doi":"10.1177/107906320501700209","pmid":"15974425","pmcid":null,"title":"The criminal histories and later offending of child pornography offenders","authors":"Seto MC, Eke AW.","first_author":"Seto MC","journal":"Sexual abuse : a journal of research and treatment","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Retrospective cohort of 201 male child‑pornography offenders identified via police databases, followed for an average of 2.5 years to document subsequent charges/convictions.","sample_n":201,"sample_text":"201 adult male child pornography offenders","population":"Adult male offenders (Ontario, Canada) identified from police records; not a community or clinical sample.","country":"Canada","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study followed 201 men convicted of child‑pornography offenses for about 2½ years and found that 17 % were charged with another crime, and 4 % committed a new contact sexual offense, especially those with prior or concurrent sexual offenses.","clinical_takeaway":"Prior sexual offending predicts higher risk of re‑offending among child‑pornography offenders; monitoring should focus on offenders with such histories.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Objective official records","Clear operational definitions of offending","Longitudinal follow‑up period"],"limitations":["No measurement of psychological or contextual confounds","Limited follow‑up time (average 2.5 y)","Sample limited to males in one jurisdiction"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":2,"mentioning":63,"citing_publications":167,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/107906320501700209"}},{"id":2757,"doi":"10.2196/mental.5925","pmid":"27417665","pmcid":"PMC4963606","title":"Are Mental Health Effects of Internet Use Attributable to the Web-Based Content or Perceived Consequences of Usage? A Longitudinal Study of European Adolescents","authors":"Hökby S, Hadlaczky G, Westerlund J, Wasserman D, Balazs J, Germanavicius A, Machín N, Meszaros G, Sarchiapone M, Värnik A, Varnik P, Westerlund M, Carli V.","first_author":"Hökby S","journal":"JMIR mental health","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Longitudinal study","Mental health","Adolescent Health","Addictive Behavior","Problematic Internet Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4963606","cited_by_count":39,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Random sample of 2,286 adolescents from 7 European countries; questionnaire on Internet time, specific activities (including pornography), perceived consequences; cross‑sectional and 4‑month follow‑up analyses.","sample_n":2286,"sample_text":"Random school‑based sample of adolescents (N = 2286).","population":"Adolescents (approx. 13‑18 y) from state schools in Estonia, Hungary, Italy, Lithuania, Spain, Sweden, UK (N = 2286).","country":"Estonia, Hungary, Italy, Lithuania, Spain, Sweden, United Kingdom","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 2,286 European teens, the researchers tracked how much time was spent online, what they did (including watching porn), and how they felt about it. Perceived negative consequences like sleep loss and mood drops when offline predicted worse mental health more than the type of activity itself.","clinical_takeaway":"Addressing sleep loss and withdrawal feelings from internet use may help protect adolescent mental health, regardless of specific online content.","confidence":0.78,"topic_tags":["pornography","adolescents","sexual_function","moral_incongruence"],"strengths":["Large, multi‑country random sample.","Longitudinal design with 4‑month follow‑up.","Effect sizes with confidence intervals."],"limitations":["Self‑report measures of time use and consequences; likely ad‑hoc.","No measurement/control of moral incongruence or masturbation which co‑occur with porn use.","Limited assessment of potential confounders (e.g., mental‑health baseline, trauma)."],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":68,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/mental.5925"}},{"id":2758,"doi":"10.1080/0092623x.2016.1208129","pmid":"27384864","pmcid":null,"title":"Testing the Effectiveness of Cognitive Analytic Therapy for Hypersexuality Disorder: An Intensive Time-Series Evaluation","authors":"Kellett S, Simmonds-Buckley M, Totterdell P.","first_author":"Kellett S","journal":"Journal of sex & marital therapy","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"A/B single‑case intensive time‑series (1 participant, 231 days)","sample_n":1,"sample_text":"single participant","population":"individual with hypersexuality disorder (treatment‑seeking)","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A single person with hypersexuality received cognitive analytic therapy over 147 days. Daily logs showed that pornography use and cruising stopped, and overall sexual activity fell below clinical thresholds. Improvements were linked to reduced obsessive thoughts and better interpersonal connections.","clinical_takeaway":"Evidence from one case suggests CAT may reduce problematic sexual behaviors, but larger controlled studies are needed before clinical recommendation.","confidence":0.7,"topic_tags":["sexual_function","csbd","treatment"],"strengths":["Intensive daily measurement over long period","Clear A/B design within single case","Examines multiple behavioural outcomes"],"limitations":["Single participant, no control group","Unclear whether outcome measures are validated","No control for moral or mental‑health confounds","Generalizability limited"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2016.1208129"}},{"id":2759,"doi":"10.1007/s11920-016-0706-1","pmid":"27222141","pmcid":null,"title":"Juvenile Sex Offenders","authors":"Ryan EP, Otonichar JM.","first_author":"Ryan EP","journal":"Current psychiatry reports","year":2016,"pub_types":["Review","Journal Article"],"keywords":["risk assessment","risk factors","Sexual Abuse","Sex Offender Treatment","Juvenile Sex Offenders","Paraphilic Disorders"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article summarizing recent research on juvenile sex offenders, focusing on risk factors, treatment, and differences from general delinquents. No primary data presented.","sample_n":null,"sample_text":"Not applicable – review of existing literature.","population":"juvenile male and female sexual offenders (reviewed studies)","country":"Not specified (international literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This 2016 review summarises research on juvenile sex offenders, noting that most do not develop lifelong paraphilic disorders and are more similar to non‑sexual juvenile delinquents, with differences in pornography use and early victimisation.","clinical_takeaway":"Juvenile sex offenders often differ from adult offenders; treatment should consider broader risk factors rather than assuming a persistent sexual pathology.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad overview of recent literature","Considers differences between JSOs and other delinquents"],"limitations":["No original data; conclusions depend on cited studies","Lacks systematic review methodology (no risk‑of‑bias assessment)","Potential selection bias in cited literature"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":1,"mentioning":30,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11920-016-0706-1"}},{"id":2760,"doi":"10.1258/0956462053057512","pmid":"15807936","pmcid":null,"title":"Associations between pornography consumption and sexual practices among adolescents in Sweden","authors":"Häggström-Nordin E, Hanson U, Tydén T.","first_author":"Häggström-Nordin E","journal":"International journal of STD & AIDS","year":2005,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":84,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 718 Swedish high‑school students (mean age 18) examining self‑reported pornography use and sexual practices.","sample_n":718,"sample_text":"718 students from 47 high school classes","population":"Adolescents (high‑school students) in a medium‑sized Swedish city","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 718 Swedish teenagers, boys who watched a lot of pornography were more likely to try sexual acts they saw in porn, have sex with friends, and report anal or group sex, even after accounting for early sexual debut.","clinical_takeaway":"High porn use in adolescents is linked to riskier sexual practices; clinicians should discuss media exposure when assessing sexual health.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample for a survey (N>700)","Adjusted odds ratios with confidence intervals reported","Identifies specific sexual practices associated with high porn use"],"limitations":["Cross‑sectional design – no causal inference","Reliance on single‑item self‑report measures","No assessment of key confounds (moral views, mental health, masturbation, trauma)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":19,"contrasting":2,"mentioning":96,"citing_publications":169,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/0956462053057512"}},{"id":2761,"doi":"10.1177/1524838016650189","pmid":"27311818","pmcid":null,"title":"Technology-Facilitated Sexual Violence: A Literature Review of Empirical Research","authors":"Henry N, Powell A.","first_author":"Henry N","journal":"Trauma, violence & abuse","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Technology","Sexual Violence","Internet Communication","Online Sexual Harassment","Online Victimization","Revenge Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":152,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative literature review without systematic search or risk‑of‑bias assessment; draws on existing empirical studies but does not present new data.","sample_n":null,"sample_text":"No primary sample; review of prior studies.","population":"adult victims of technology‑facilitated sexual violence (TFSV); no primary sample collected.","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This 2018 narrative review summarizes research on how digital technologies are used to commit sexual violence, such as online harassment, cyberstalking, and non‑consensual sharing of images. It finds limited data on adult victims and notes that young women are often over‑represented among victims.","clinical_takeaway":"None – the article is a narrative review of violence research, not directly applicable to clinical practice for sexual health or addiction.","confidence":0.8,"topic_tags":["religiosity","moral_incongruence","masturbation","pornography","sexual_function"],"strengths":["Comprehensive overview of TFSV literature up to 2018","Identifies gaps in adult‑focused research","Highlights gendered patterns of victimisation"],"limitations":["Narrative, not systematic, review lacking explicit methodology","No quantitative synthesis or risk‑of‑bias assessment","No primary data; conclusions depend on quality of cited studies"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":17,"contrasting":0,"mentioning":406,"citing_publications":687,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1524838016650189"}},{"id":2762,"doi":null,"pmid":"16779077","pmcid":"PMC1560843","title":"Blocking of pornography-seeking behavior in digital image libraries: adventures in the skin trade","authors":"Lehmann CU, Cohen BA, Kim GR.","first_author":"Lehmann CU","journal":"AMIA ... Annual Symposium proceedings. AMIA Symposium","year":2005,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper discusses how attempts to block pornography‑seeking can interfere with legitimate medical image libraries, stressing the need to anticipate and manage these challenges when building e‑health resources.","clinical_takeaway":"None – the article is a technical commentary, not a clinical study.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Raises awareness of technical/legal issues for digital health libraries","Highlights need for proactive content management"],"limitations":["No empirical data or systematic analysis","Lacks measurement of user behavior or outcomes"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":2764,"doi":"10.1111/brv.12278","pmid":"27196099","pmcid":null,"title":"Possible evolutionary origins of human female sexual fluidity","authors":"Kanazawa S.","first_author":"Kanazawa S.","journal":"Biological reviews of the Cambridge Philosophical Society","year":2017,"pub_types":["Review","Journal Article"],"keywords":["Homosexuality","Category Specificity","Pornography","Menstrual Synchrony","Human Female Sexual Fluidity"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Secondary analysis of the Add Health longitudinal dataset; large, nationally representative sample; hypothesis‑driven evolutionary theory testing.","sample_n":15000,"sample_text":"Add Health participants (large, nationally representative cohort)","population":"Human females (and males for comparison) from the Add Health cohort","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The author proposes that women evolved to be sexually fluid to reduce conflict in polygynous marriages. Analyses of a large US cohort show that fluid women have more children, that early marriage or parenthood predicts later fluidity, and that fluidity relates to unrestricted sexual orientation in women but not in men.","clinical_takeaway":"None – the paper is theoretical and does not provide clinically actionable findings.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative longitudinal dataset","Clear operational definition of sexual fluidity","Tests multiple predictions of the evolutionary theory"],"limitations":["Reliance on self‑report measures not validated for fluidity","Potential unmeasured confounds (e.g., mental health, relationship context)","Speculative evolutionary interpretation exceeds data"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":43,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/brv.12278"}},{"id":2766,"doi":"10.1515/ijamh-2015-0127","pmid":"27140301","pmcid":null,"title":"A qualitative study on how adolescent males in South India view reproductive health","authors":"Kamath VG, Kamath A, Roy K, Rao CR, Hegde A, Ashok L.","first_author":"Kamath VG","journal":"International journal of adolescent medicine and health","year":2016,"pub_types":["Journal Article"],"keywords":["Media","Reproductive Health","Counselling","Adolescent Males","Reproductive Health Services"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative focus groups and interviews with convenience sample of 60 adolescent males","sample_n":60,"sample_text":"Convenient sample of 60 boys for FGDs; 10 additional in‑depth interviews","population":"Adolescent males, ages 16‑19, South India (rural‑urban)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"South Indian teenage boys say they lack reliable information about reproductive health. They mention peer pressure, media, pornography and myths as driving risky behaviours, and call for better school and community services.","clinical_takeaway":"Improve accessible, culturally sensitive reproductive‑health education for adolescent males.","confidence":0.8,"topic_tags":["religiosity","masturbation","pornography","adolescents","sexual_function"],"strengths":["Qualitative depth capturing adolescents’ own language","Includes both focus groups and in‑depth interviews","Highlights service gaps in a low‑resource setting"],"limitations":["Convenience sample, limited generalisability","No systematic measurement of sexual behaviours or mental‑health variables","Potential social‑desirability bias in group setting"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/ijamh-2015-0127"}},{"id":2767,"doi":"10.1515/ijamh-2015-0003","pmid":"26251980","pmcid":null,"title":"Adolescents and web porn: a new era of sexuality","authors":"Pizzol D, Bertoldo A, Foresta C.","first_author":"Pizzol D","journal":"International journal of adolescent medicine and health","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1492 Italian high‑school seniors; anonymous questionnaire; frequencies of internet and porn use, masturbation, and self‑rated impact; Fisher’s exact test used for analysis.","sample_n":1492,"sample_text":"students attending the final year of high school in Italy (convenience sample)","population":"high‑school students (final year) in Italy; convenience sample; n≈1490 respondents","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A questionnaire of about 1,500 Italian high‑school seniors found that 78% had viewed online porn, with a minority reporting daily use or feeling ‘addicted’. The authors call for more education on safe internet use, but the study relied on simple, non‑validated questions and did not account for moral beliefs, mental health, or relationship factors.","clinical_takeaway":"Do not treat self‑reported ‘addiction’ from this survey as evidence of clinical pathology; education is needed but findings are limited.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample size for a school‑based survey","Direct questions about pornography use and masturbation","Relevant public‑health topic"],"limitations":["No validated instruments; reliance on single‑item self‑reports","No control for moral, mental‑health, relational or trauma confounds","Cross‑sectional design; cannot infer causality","‘Addiction’ defined by self‑label, circular reasoning"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":3,"contrasting":0,"mentioning":55,"citing_publications":86,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/ijamh-2015-0003"}},{"id":2768,"doi":"10.1007/s10508-016-0744-0","pmid":"27025728","pmcid":null,"title":"Erratum to: Pornography and the Male Sexual Script: An Analysis of Consumption and Sexual Relations","authors":"Sun C, Bridges A, Johnson JA, Ezzell MB.","first_author":"Sun C","journal":"Archives of sexual behavior","year":2016,"pub_types":["Published Erratum"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0744-0"}},{"id":2769,"doi":"10.1111/psyp.12661","pmid":"27125689","pmcid":null,"title":"Sex differences in concordance rates between auditory event-related potentials and subjective sexual arousal","authors":"Oliver TL, Meana M, Snyder JS.","first_author":"Oliver TL","journal":"Psychophysiology","year":2016,"pub_types":["Journal Article"],"keywords":["Gender","Sexual Arousal","Erps","N1","P3"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Lab ERP study with 38 participants viewing erotic/non‑erotic films; within‑subject correlations examined.","sample_n":38,"sample_text":"38 participants (mixed gender) recruited likely from a university setting; convenience sample.","population":"young adult men and women (N=38)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured brain responses (EEG) and self‑reported arousal while men and women watched erotic films. Men showed a link between early brain waves and arousal; women showed a link between later waves and arousal. Women who reported more porn use had larger later‑wave responses.","clinical_takeaway":"ERP patterns differ by sex during sexual arousal, but findings are preliminary and not directly relevant to clinical practice.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","gender","pornography"],"strengths":["Objective ERP measures","Within‑subject design comparing erotic vs non‑erotic stimuli","Inclusion of both genders"],"limitations":["Small convenience sample (N=38)","No control for key confounds (moral, mental health, etc.)","Correlational analysis interpreted causally"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":5,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/psyp.12661"}},{"id":2770,"doi":"10.1177/0306624x03262518","pmid":"15358932","pmcid":null,"title":"The use of pornography during the commission of sexual offenses","authors":"Langevin R, Curnoe S.","first_author":"Langevin R","journal":"International journal of offender therapy and comparative criminology","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective descriptive analysis of 561 convicted sex offenders; classification by offense type; report of whether pornography was used during the crime.","sample_n":561,"sample_text":"561 sex offenders (181 against children, 144 against adults, 223 incest, 8 exhibitionists, 5 miscellaneous).","population":"Sex offenders (mostly male) identified from criminal records; not a community sample.","country":"Not reported (likely Canada/USA based on journal).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a review of 561 sex offenders, 17% used pornography during their crimes, especially in cases involving children. The authors conclude pornography plays a minor role overall but raises concerns when child victims are involved.","clinical_takeaway":"None – the study is descriptive of offender behavior and does not inform clinical practice.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample of offenders.","Clear categorisation of offense types."],"limitations":["No validated measures of pornography use.","Descriptive design limits causal inference.","No control for potential confounds (e.g., prior offending history, mental health)."],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x03262518"}},{"id":2771,"doi":"10.1631/jzus.2004.1106","pmid":"15323006","pmcid":null,"title":"Improving the precision of the keyword-matching pornographic text filtering method using a hybrid model","authors":"Su GY, Li JH, Ma YH, Li SH.","first_author":"Su GY","journal":"Journal of Zhejiang University. Science","year":2004,"pub_types":["Research Support, Non-U.S. Gov't","Evaluation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"algorithm evaluation using existing text corpora; compares keyword‑matching with a hybrid model; reports recall and precision metrics.","sample_n":null,"sample_text":"not applicable","population":"none (no human participants)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors created a new hybrid computer model that better identifies pornographic text online, achieving higher precision while keeping recall comparable to simple keyword matching.","clinical_takeaway":"None - not clinically applicable.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Clear technical improvement over baseline keyword matching","Provides quantitative precision/recall comparison"],"limitations":["No validation against human judgments of pornographic content","Limited discussion of false‑positive consequences"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1631/jzus.2004.1106"}},{"id":2772,"doi":"10.1258/0956462041724299","pmid":"15339365","pmcid":null,"title":"Sexual behaviour among young men in Sweden and the impact of pornography","authors":"Tydén T, Rogala C.","first_author":"Tydén T","journal":"International journal of STD & AIDS","year":2004,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 300 young men attending a genitourinary clinic in Sweden; self‑report questionnaire on sexual history and pornography use","sample_n":300,"sample_text":"300 young men attending a genitourinary clinic","population":"young heterosexual men (average age ~16 at first intercourse) seeking clinical care in Sweden","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2004 survey of 300 Swedish men at a sexual‑health clinic found that almost all had watched pornography and about half said it influenced how they behaved sexually. Condom use was low, especially during anal sex, and one‑quarter reported a past STI.","clinical_takeaway":"Clinicians should note low condom use during anal sex among young men, regardless of pornography exposure.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a clinic‑based survey","Direct reporting of condom use and STI prevalence","Addresses a gap in early‑2000s data on pornography impact"],"limitations":["Reliance on single‑item, non‑validated measures of pornography impact","No control for moral or mental‑health confounds","Cross‑sectional convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":42,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/0956462041724299"}},{"id":2773,"doi":"10.1177/1079063216641109","pmid":"27052851","pmcid":null,"title":"Fantasy-Driven Versus Contact-Driven Users of Child Sexual Exploitation Material: Offender Classification and Implications for Their Risk Assessment","authors":"Merdian HL, Moghaddam N, Boer DP, Wilson N, Thakker J, Curtis C, Dawson D.","first_author":"Merdian HL","journal":"Sexual abuse : a journal of research and treatment","year":2018,"pub_types":["Journal Article"],"keywords":["Sexual Abuse","Child Sexual Abuse","Cognitive Distortions","Child Pornography","Sexual Offender","Child Sexual Exploitation Material"],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 68 male CSEM offenders recruited from sex‑offender treatment providers; clustering analyses used to identify fantasy‑ vs contact‑driven subgroups.","sample_n":68,"sample_text":"Sixty‑eight offenders recruited from sex offender treatment providers","population":"Adult male sexual offenders (CSEM users) in treatment","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 68 men who possessed child sexual exploitation material, researchers identified two main types of users—those driven by fantasy and those driven by contact with minors—based on patterns of material possession, social contact, and sexual behavior.","clinical_takeaway":"Risk assessments for CSEM offenders should consider whether their use is fantasy‑ or contact‑driven, as this may affect reoffending risk.","confidence":0.8,"topic_tags":["csbd"],"strengths":["Focus on a forensic population rarely studied","Attempts empirical classification of CSEM users","Uses clustering to identify subgroups"],"limitations":["Small, non‑representative sample from treatment settings","Unclear measurement validity of survey items","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":75,"citing_publications":79,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063216641109"}},{"id":2775,"doi":"10.1177/0886260516640545","pmid":"27021736","pmcid":null,"title":"Lessons Learned: Conducting Research With Victims Portrayed in Sexual Abuse Images and Their Parents","authors":"Walsh WA, Wolak J, Lounsbury K, Howley S, Lippert T, Thompson L.","first_author":"Walsh WA","journal":"Journal of interpersonal violence","year":2018,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Child Sexual Abuse","Child Pornography","Children’s Advocacy Centers","Methodology/methodological Issues","Sexual Abuse Images"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Telephone interviews with convenience samples of parents (n=46) and adolescent victims (n=11); online surveys of adult survivors (N=133). Descriptive reporting of consent rates and emotional reactions.","sample_n":190,"sample_text":"Convenience samples from two agencies; 46 parents, 11 adolescent victims, 133 adult survivors.","population":"Victims of child sexual abuse depicted in sexual abuse images and their parents.","country":"United States (implied by U.S. Gov't funding)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers interviewed parents, adolescent victims, and adult survivors shown in child sexual‑abuse images and found most participants were willing to take part and were not upset by the questions, suggesting such research is feasible despite the sensitivity of the topic.","clinical_takeaway":"None – the study provides methodological insight rather than clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Addresses a rarely studied vulnerable population","Provides practical lessons for future research recruitment"],"limitations":["Convenience, small samples limit generalisability","No validated instruments for emotional reaction","Descriptive statistics only; no inferential testing"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260516640545"}},{"id":2776,"doi":"10.1127/anthranz/2016/0583","pmid":"27000945","pmcid":null,"title":"Male preference for female pubic hair: an evolutionary view","authors":"Prokop P.","first_author":"Prokop P.","journal":"Anthropologischer Anzeiger; Bericht uber die biologisch-anthropologische Literatur","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 96 university males rating attractiveness of hairy vs. shaved female genitalia; self‑reported pornography use, disgust sensitivity and socio‑sexual orientation collected.","sample_n":96,"sample_text":"Convenience sample recruited from a university; not representative of the general population.","population":"Male university students, age 19‑38, N=96","country":"Germany (journal) – location not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 96 young men, shaved female genitals were rated as more attractive than hairy ones. Men who were more disgust‑sensitive or sexually unrestricted preferred shaved genitals, while those who watched more pornography or were older preferred hairy genitals. The authors suggest an evolutionary link to parasite avoidance.","clinical_takeaway":"None – the study examines aesthetic preference, not health outcomes.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Novel focus on genital hair preference","Inclusion of disgust sensitivity and socio‑sexual orientation"],"limitations":["Small, non‑representative convenience sample","Reliance on single‑item, non‑validated measures","No control for key confounds (e.g., moral attitudes, mental health)","Evolutionary interpretation exceeds correlational data"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1127/anthranz/2016/0583"}},{"id":2778,"doi":"10.1016/j.srhc.2016.02.006","pmid":"27179380","pmcid":null,"title":"The media as a critical determinant of the sexual and reproductive health of adolescents in Ibadan, Nigeria","authors":"Olumide AO, Ojengbede OA.","first_author":"Olumide AO","journal":"Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives","year":2016,"pub_types":["Journal Article"],"keywords":["Media","Adolescents","Sexual And Reproductive Health"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Phase I of the WAVE study; purposive sampling of 132 adolescents and key informants from disadvantaged communities in Ibadan; qualitative methods (interviews, focus groups, photovoice).","sample_n":132,"sample_text":"132 participants (adolescents and key informants) recruited purposively from disadvantaged communities.","population":"Adolescents aged 15‑19 years and adult key informants (teachers, youth workers, religious leaders) in Ibadan, Nigeria.","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews and focus groups with 132 adolescents and community adults in Ibadan, Nigeria, revealed that media—TV, internet, phones and books—strongly shape young people's sexual attitudes and practices, exposing them to both helpful information and risks such as pornography and fraud.","clinical_takeaway":"Clinicians should recognise media as a major influence on adolescent sexual health and consider media‑based education or guidance when discussing risks and resources.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["In‑depth qualitative insight from multiple stakeholder groups","Use of diverse methods (interviews, focus groups, photovoice)","Context‑specific findings for vulnerable Nigerian adolescents"],"limitations":["Purposive, non‑representative sample limits generalisability","No quantitative measurement of pornography use or distress","No assessment of key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.srhc.2016.02.006"}},{"id":2779,"doi":"10.1093/asj/sjv270","pmid":"26893523","pmcid":null,"title":"Factors That Influence the Decision to Undergo Labiaplasty: Media, Relationships, and Psychological Well-Being","authors":"Sharp G, Tiggemann M, Mattiske J.","first_author":"Sharp G","journal":"Aesthetic surgery journal","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":77,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control comparison of women seeking labiaplasty (n=35) vs. non‑seeking controls (n=30); standardized questionnaires on media exposure, relationship quality, and well‑being","sample_n":65,"sample_text":"35 women seeking labiaplasty compared with 30 women not seeking the procedure","population":"women interested in labiaplasty, recruited from a surgical clinic; likely convenience sample","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Women who wanted labiaplasty reported seeing more images of genitalia online and in ads, were less happy with how their genitals look, and were less likely to be in a romantic relationship, suggesting media and relationship factors may play a role in the decision.","clinical_takeaway":"Clinicians should explore media exposure and relationship context when discussing labiaplasty motivations with patients.","confidence":0.7,"topic_tags":["lgbtq","sexual_function","religiosity"],"strengths":["Use of a comparison group","Inclusion of media exposure variables","Standardized questionnaires reported"],"limitations":["Small, convenience sample","Cross‑sectional design limits causal inference","No correction for multiple testing","Moral incongruence and trauma not assessed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":53,"citing_publications":143,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/asj/sjv270"}},{"id":2780,"doi":"10.1080/00224490409552227","pmid":"15326544","pmcid":null,"title":"Attitudes and use of pornography in the Norwegian population 2002","authors":"Traeen B, Spitznogle K, Beverfjord A.","first_author":"Traeen B","journal":"Journal of sex research","year":2004,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":45,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Representative telephone survey of adult Norwegians (cross‑sectional).","sample_n":null,"sample_text":"Representative sample of adult Norwegians (size not specified in abstract).","population":"Adult general population in Norway (representative sample).","country":"Norway","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2004 Norwegian survey found most adults had viewed pornography at some point, mainly magazines and films, with modest internet use. Frequency varied by gender, age, education and attitudes toward pornography, which were linked in statistical models.","clinical_takeaway":"Most Norwegians view pornography occasionally; clinicians should consider demographic and attitudinal factors when discussing pornography use.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large, representative national sample","Standardized questionnaire","Path analysis linking attitudes and demographics to use"],"limitations":["No validated measures of problematic use or addiction","Cross‑sectional; cannot infer causality","Limited control of key confounds (masturbation, mental health, trauma)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":2,"mentioning":79,"citing_publications":113,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490409552227"}},{"id":2781,"doi":"10.1016/j.gyobfe.2004.03.015","pmid":"15177213","pmcid":null,"title":"[Adolescence and pornography]","authors":"Jacquemin Le Vern H.","first_author":"Jacquemin Le Vern H.","journal":"Gynecologie, obstetrique & fertilite","year":2004,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary without empirical data; no sample size reported","sample_n":null,"sample_text":"none (no empirical sample)","population":"adolescents (general discussion)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how pornography is defined, especially in law, and questions how its impact on teenagers can be evaluated, including possible consequences and images of women presented.","clinical_takeaway":"None - not clinically applicable.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Raises important ethical questions about defining pornography","Highlights gaps in research on adolescent impact"],"limitations":["No empirical data or methodology","Lacks operational definitions or measurement","No control of confounding variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.gyobfe.2004.03.015"}},{"id":2782,"doi":"10.1007/s15006-016-7784-1","pmid":"27119667","pmcid":null,"title":"[Does pornography access lead to sex offenses?]","authors":"Stiefelhagen P.","first_author":"Stiefelhagen P.","journal":"MMW Fortschritte der Medizin","year":2016,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s15006-016-7784-1"}},{"id":2783,"doi":"10.1097/aog.0000000000001306","pmid":"26942381","pmcid":null,"title":"Committee Opinion No 653 Summary: Concerns Regarding Social Media and Health Issues in Adolescents and Young Adults","authors":"American College of Obstetricians and Gynecologists' Committee on Adolescent Health Care.","first_author":"American College of Obstetricians and Gynecologists' Committee on Adolescent Health Care.","journal":"Obstetrics and gynecology","year":2016,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review/committee opinion without original data; no empirical sample.","sample_n":null,"sample_text":"Not applicable – no primary data collected.","population":"Adolescents and young adults (clinical context); no sample size reported.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The ACOG committee notes that while social media can be beneficial for teens, it also poses risks such as exposure to porn, sexting, and cyberbullying, which may increase STI and pregnancy rates. Clinicians are advised to screen for these behaviors and refer to mental‑health resources when needed.","clinical_takeaway":"Screen adolescents for risky online sexual activity and provide referrals; do not assume causality from social‑media exposure alone.","confidence":0.4,"topic_tags":["adolescents","sexual_function","pornography"],"strengths":["Highlights clinical relevance of social media risks for OB‑GYN providers","Integrates multidisciplinary referral recommendations"],"limitations":["No primary data; conclusions based on expert opinion","Lacks systematic literature synthesis or risk‑of‑bias assessment","No measurement of pornography use or related distress"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/aog.0000000000001306"}},{"id":2784,"doi":"10.1097/aog.0000000000001313","pmid":"26942388","pmcid":null,"title":"Committee Opinion No. 653: Concerns Regarding Social Media and Health Issues in Adolescents and Young Adults","authors":"American College of Obstetricians and Gynecologists' Committee on Adolescent Health Care.","first_author":"American College of Obstetricians and Gynecologists' Committee on Adolescent Health Care.","journal":"Obstetrics and gynecology","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Committee opinion / guideline without original empirical data","sample_n":null,"sample_text":"Not applicable – no primary data collection","population":"adolescents and young adults (clinical focus, not sampled)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The ACOG committee advises doctors to screen teens for risky online behaviors, including viewing pornography and sexting, because these may increase the chance of STIs and pregnancy.","clinical_takeaway":"Clinicians should discuss social‑media use and potential sexual risks with adolescent patients and consider referrals when problems are identified.","confidence":0.4,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Provides clinical guidance for OB‑GYNs","Integrates social‑media risks with sexual health"],"limitations":["No original data; based on expert opinion","Lacks systematic review of empirical evidence"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/aog.0000000000001313"}},{"id":2785,"doi":"10.1080/10538712.2016.1111965","pmid":"26828129","pmcid":null,"title":"The Lived Experience of the Adolescent Sex Offender: A Phenomenological Case Study","authors":"Gerhard-Burnham B, Underwood LA, Speck K, Williams C, Merino C, Crump Y.","first_author":"Gerhard-Burnham B","journal":"Journal of child sexual abuse","year":2016,"pub_types":["Journal Article"],"keywords":["Trauma","Parenting","Cognitive Distortions","Adolescent Sex Offenders","Father Figure"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Phenomenological case study with 4 adolescent male sex offenders interviewed and asked to create conceptual maps.","sample_n":4,"sample_text":"Four adolescent boys participated; convenience sample from a secure care setting.","population":"Adolescent males adjudicated to a secure care program for sexual offending (n=4).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Four boys in a secure program for sexual offenses described how early trauma, lack of paternal figures, and exposure to pornography shaped their thinking and behavior, leading to cognitive distortions that justified offending.","clinical_takeaway":"Findings suggest that early trauma and disrupted father relationships may be key factors in the development of sexual offending in youths; interventions should address these underlying issues.","confidence":0.4,"topic_tags":["adolescents","sexual_function","csbd","pornography"],"strengths":["In‑depth qualitative insights","Use of conceptual mapping to capture participants’ perspectives","Focus on early trauma and family factors"],"limitations":["Very small, non‑representative sample","No validated measurement instruments","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2016.1111965"}},{"id":2786,"doi":"10.1371/journal.pone.0147110","pmid":"26808561","pmcid":"PMC4726580","title":"Determinants of Heterosexual Adolescents Having Sex with Female Sex Workers in Singapore","authors":"Ng JY, Wong ML.","first_author":"Ng JY","journal":"PloS one","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4726580","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 300 male adolescents (16‑19) attending a national STI clinic in Singapore; self‑report questionnaire on sexual behaviour, pornography viewing and ecological factors; Poisson regression to estimate prevalence ratios.","sample_n":300,"sample_text":"300 heterosexually active male adolescents attending a national STI clinic (response rate 73%).","population":"Heterosexually active male adolescents (16‑19) seeking STI services in Singapore (clinic‑based convenience sample).","country":"Singapore","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 300 Singaporean male teens attending an STI clinic, 39% reported ever having sex with a female sex worker. Earlier sexual debut, lack of a sexually active girlfriend, lower self‑esteem, higher rebelliousness, and more frequent pornography viewing were linked to higher odds of such encounters, and one‑third used condoms inconsistently.","clinical_takeaway":"Clinicians should note that pornography viewing co‑occurs with other risk factors for commercial sex and inconsistent condom use among adolescents, suggesting holistic risk‑reduction counseling.","confidence":0.78,"topic_tags":["sexual_function","pornography","adolescents"],"strengths":["Large (N=300) clinic sample","Multivariate analysis with prevalence ratios","Addresses understudied behaviour (adolescent commercial sex)","Includes multiple ecological determinants"],"limitations":["Cross‑sectional; cannot infer causality","Convenience clinic sample limits generalisability","Pornography use measured by single self‑report item","No assessment of moral or psychological confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0147110"}},{"id":2787,"doi":"10.1177/0886260515625502","pmid":"26787607","pmcid":null,"title":"Victimization After Meeting With Online Acquaintances: A Cross-Sectional Survey of Adolescents in Malaysia","authors":"Marret MJ, Choo WY.","first_author":"Marret MJ","journal":"Journal of interpersonal violence","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual Assault","Situational Factors","Internet And Abuse","Adolescent Victims"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional anonymous questionnaire of 3,349 Malaysian secondary‑school students; random public‑school selection; 78 % response rate.","sample_n":3349,"sample_text":"3349 Internet or mobile‑phone users","population":"Adolescents (secondary‑school students) in Selangor and Kuala Lumpur, Malaysia","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among 3,349 Malaysian teens, half were invited to meet someone they met online and 30 % did so. Viewing pornography was linked to a higher chance of meeting offline and to a 5.5 % rate of verbal, physical or sexual assault among those who met in person.","clinical_takeaway":"Clinicians should note that pornography viewing may be associated with increased offline meeting risk and victimisation among adolescents; discuss safe online practices.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","gender","prevalence"],"strengths":["Large, randomly selected school sample","High response rate (78 %)","Relevant public‑health outcome (victimisation)"],"limitations":["Self‑report measures, no validated scales","Cross‑sectional, cannot infer causality","Key sexual‑health confounds (e.g., moral incongruence, mental health) not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":20,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260515625502"}},{"id":2788,"doi":"10.2147/ahmt.s95493","pmid":"26811695","pmcid":"PMC4712967","title":"Differences in sexual behavior, health, and history of child abuse among school students who had and had not engaged in sexual activity by the age of 18 years: a cross-sectional study","authors":"Kastbom ÅA, Sydsjö G, Bladh M, Priebe G, Svedin CG.","first_author":"Kastbom ÅA","journal":"Adolescent health, medicine and therapeutics","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Adolescents","Sexual Abuse","Late Sexual Debut"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4712967","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 3,380 Swedish 18‑year‑olds; descriptive and multiple regression analyses","sample_n":3380,"sample_text":"3,380 Swedish 18‑year‑olds","population":"Swedish 18‑year‑old students (likely school‑based convenience sample)","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 3,380 Swedish 18‑year‑olds, those who had not had intercourse by age 18 were more likely to have caring fathers, lower pornography use, less alcohol and tobacco use, lower sexual desire and fewer experiences of sexual abuse than peers who had been sexually active.","clinical_takeaway":"Late sexual debut in adolescence is associated with lower risk behaviours and less abuse history, but the study does not establish causal relationships.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large sample size for a survey","Multiple regression identifies strongest associations","Includes a range of health‑ and behavior‑related variables"],"limitations":["Cross‑sectional; cannot infer causality","Key confounds (moral incongruence, masturbation, mental‑health) not measured","Reliance on self‑report single‑item measures"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/ahmt.s95493"}},{"id":2789,"doi":"10.1186/s12889-015-2620-6","pmid":"26728718","pmcid":"PMC4700634","title":"What are the characteristics of 'sexually ready' adolescents? Exploring the sexual readiness of youth in urban poor Accra","authors":"Biney AA, Dodoo FN.","first_author":"Biney AA","journal":"BMC public health","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4700634","cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Community survey of 196 adolescents (12‑19) in poor urban Accra; ordered logistic regression of self‑reported sexual readiness on experience, porn exposure, gender, ethnicity, wealth.","sample_n":196,"sample_text":"196 male and female adolescents, ages 12 to 19, surveyed in the 2011 RIPS Urban Health and Poverty Project.","population":"Adolescents (12‑19) from urban poor neighborhoods in Accra, Ghana (N = 196).","country":"Ghana","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 196 poor‑urban Ghanaian adolescents found that most did not feel ready for sex. Feeling ready was linked to having had sex before, watching porn movies, being male, ethnicity, and household wealth.","clinical_takeaway":"Clinicians should consider adolescents' self‑perceived sexual readiness and its sociodemographic correlates when discussing sexual health, rather than assuming readiness from age alone.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Relatively large sample for a community survey in low‑resource setting","Use of ordered logistic regression appropriate for ordinal outcome","Identifies multiple sociodemographic correlates of self‑perceived sexual readiness"],"limitations":["Sexual readiness measured with unvalidated three‑item scale","Key confounders (moral views, mental health, trauma, masturbation) not assessed","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":29,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-015-2620-6"}},{"id":2790,"doi":"10.1353/lm.2016.0016","pmid":"28569721","pmcid":null,"title":"Leaky Bodies, Bawdy Books: Gonorrhea and Reading in Eighteenth-Century Britain","authors":"Wagner DN.","first_author":"Wagner DN.","journal":"Literature and medicine","year":2016,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical analysis; no empirical data collected.","sample_n":null,"sample_text":"Not applicable – study analyses historical documents.","population":"Eighteenth‑century Britain (historical texts, medical writings).","country":"United Kingdom (historical context).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article examines 18th‑century British beliefs that reading erotic books could cause gonorrhea, linking these ideas to contemporary notions of bodily fluids, imagination, and medical discourse.","clinical_takeaway":"None – not clinically applicable.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Rich historical contextualisation of pornographic discourse.","Integrates medical and literary sources."],"limitations":["No empirical data on contemporary behaviour.","No quantitative analysis or statistical testing."],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1353/lm.2016.0016"}},{"id":2791,"doi":"10.1016/j.jadohealth.2015.10.248","pmid":"26725717","pmcid":"PMC4762460","title":"The Incidence of Human Papillomavirus in Tanzanian Adolescent Girls Before Reported Sexual Debut","authors":"Houlihan CF, Baisley K, Bravo IG, Kapiga S, de Sanjosé S, Changalucha J, Ross DA, Hayes RJ, Watson-Jones D.","first_author":"Houlihan CF","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Human papillomavirus","Sub-Saharan Africa","incidence"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4762460","cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Prospective cohort of adolescent girls followed 18 months with repeated HPV testing and questionnaires.","sample_n":120,"sample_text":"120 girls (out of 397 reporting no sex) randomly selected for HPV testing.","population":"Tanzanian adolescent girls aged 15‑16, 120 who reported no prior sexual debut.","country":"Tanzania","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a cohort of Tanzanian girls who said they had never had sex, HPV infections were still common over 18 months, suggesting many may have under‑reported sex. Watching a pornographic movie was linked to lower HPV incidence, but the finding may reflect reporting biases.","clinical_takeaway":"HPV can occur even when sexual activity is denied; vaccination remains important for this age group.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Prospective design with repeated biological measures","Use of validated HPV genotyping assay","Clear reporting of incidence rates with confidence intervals"],"limitations":["Self‑reported sexual behavior may be inaccurate","Pornography exposure assessed with a single unvalidated item","Small selected subsample limits generalizability"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":2,"mentioning":13,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2015.10.248"}},{"id":2792,"doi":"10.1177/1079063215620397","pmid":"26680252","pmcid":null,"title":"Is Emotional Congruence With Children Associated With Sexual Offending in Pedophiles and Hebephiles From the Community?","authors":"Konrad A, Kuhle LF, Amelung T, Beier KM.","first_author":"Konrad A","journal":"Sexual abuse : a journal of research and treatment","year":2018,"pub_types":["Journal Article"],"keywords":["Child Sexual Abuse","Dynamic Risk Factors","Pedophilia","Child Pornography","Emotional Congruence With Children","Emotional Child Identification"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"exploratory factor analysis and regression on community sample of 217 pedophilic men and 22 controls","sample_n":239,"sample_text":"217 pedophilic men, 22 control men","population":"adult male pedophiles and non‑pedophilic adult men (community recruited)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined a new questionnaire measuring how much adults feel emotionally attached to children. In 217 community pedophiles, a three‑factor structure emerged, and the “attachment to children” factor was linked to sexual preference and past offending, suggesting attachment may be a core feature of this risk factor.","clinical_takeaway":"Attachment feelings toward children may help identify higher risk of offending, but the measure needs further validation before clinical use.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Large sample of pedophilic participants","First empirical evaluation of ECWC construct","Use of multivariate analyses (PCA, multinomial regression)"],"limitations":["Control group very small (N=22)","Cross‑sectional, cannot infer causality","CIS‑R not previously validated"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063215620397"}},{"id":2793,"doi":"10.1300/j082v47n03_09","pmid":"15451709","pmcid":null,"title":"\"He was treating me like trash, and I was loving it...\": perspectives in gay male pornography","authors":"Morrison TG.","first_author":"Morrison TG.","journal":"Journal of homosexuality","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"focus group with gay men examining porn scenes; small convenience sample; thematic analysis","sample_n":null,"sample_text":"participants in focus groups (likely small, convenience)","population":"gay men (sample size not reported in abstract)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Gay men in focus groups said they mostly use porn as a tool for masturbation and do not think it strongly shapes attitudes or behavior, although some see possible short‑term negative effects for others.","clinical_takeaway":"None – the study offers sociocultural insight but no direct clinical guidance.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses an under‑studied topic (gay male porn)","Uses participant‑driven discussion of actual porn clips"],"limitations":["Small, non‑representative convenience sample","No validated measures; purely qualitative","No assessment of key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":28,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v47n03_09"}},{"id":2794,"doi":"10.1300/j082v47n03_08","pmid":"15451708","pmcid":null,"title":"In the slammer: the myth of the prison in American gay pornographic video","authors":"Mercer J.","first_author":"Mercer J.","journal":"Journal of homosexuality","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary / cultural analysis without empirical data.","sample_n":null,"sample_text":"None – article provides a theoretical discussion of prison tropes in gay pornographic video.","population":"Not applicable","country":"United States (assumed from journal focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article examines how American gay porn often uses prison settings as erotic backdrops, linking these scenes to historical gay myths and role‑play themes.","clinical_takeaway":"None – the paper does not provide evidence relevant to clinical assessment or treatment.","confidence":0.8,"topic_tags":["pornography","csbd","sexual_function"],"strengths":["Provides detailed cultural/historical analysis of a specific porn genre","Connects visual tropes to broader gay mythologies and literature"],"limitations":["No empirical data; purely theoretical","No measurement of viewer effects, behavior, or health outcomes","Cannot inform clinical or public‑health conclusions"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v47n03_08"}},{"id":2795,"doi":"10.1300/j082v47n03_02","pmid":"15451702","pmcid":null,"title":"Memoir and performance: social change and self life-writing among men who are gay pornography producers and actors","authors":"Cohler BJ.","first_author":"Cohler BJ.","journal":"Journal of homosexuality","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"case-study of three memoirs (historical/biographical analysis)","sample_n":3,"sample_text":"Three memoirs examined across three birth‑cohorts","population":"gay men who have acted or produced gay pornography (n=3)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article analyzes memoirs of three gay men who produced or acted in gay porn films, showing how their personal stories and the films’ content changed alongside social attitudes, the gay rights movement and the AIDS crisis.","clinical_takeaway":"None – the study is historical/qualitative and does not provide clinical guidance.","confidence":0.5,"topic_tags":["pornography","sexual_function"],"strengths":["In‑depth qualitative insight into lived experience","Historical perspective across three generations","Links personal narrative to broader social change"],"limitations":["Very small, non‑representative sample (n=3)","No systematic measurement or quantitative analysis","Findings not generalisable beyond the three memoirs"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v47n03_02"}},{"id":2796,"doi":"10.1300/j082v47n03_06","pmid":"15451706","pmcid":null,"title":"Educating gay male youth: since when is pornography a path towards self-respect?","authors":"Kendall CN.","first_author":"Kendall CN.","journal":"Journal of homosexuality","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"Not applicable – no empirical sample","population":"gay male youth (theoretical focus)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"opposes","citation_value":"background","plain_summary":"The article argues that gay male pornography emphasizes hyper‑masculinity, which may undermine safer sex practices and self‑respect among gay youth, potentially contributing to higher suicide risk.","clinical_takeaway":"None – the piece offers no empirical findings for clinical use.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses sociopolitical context of gay male porn","Connects porn to public health concerns"],"limitations":["No empirical data","No measurement of key constructs","No control of confounding variables"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v47n03_06"}},{"id":2797,"doi":"10.1176/appi.ajp.2015.15060843","pmid":"26619775","pmcid":null,"title":"Treatment of Compulsive Pornography Use With Naltrexone: A Case Report","authors":"Kraus SW, Meshberg-Cohen S, Martino S, Quinones LJ, Potenza MN.","first_author":"Kraus SW","journal":"The American journal of psychiatry","year":2015,"pub_types":["Letter","Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":56,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":2,"contrasting":0,"mentioning":44,"citing_publications":133,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.ajp.2015.15060843"}},{"id":2798,"doi":"10.1016/j.jadohealth.2015.08.015","pmid":"26592333","pmcid":"PMC4660251","title":"Time-Varying Risk Factors and Sexual Aggression Perpetration Among Male College Students","authors":"Thompson MP, Kingree JB, Zinzow H, Swartout K.","first_author":"Thompson MP","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2015,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["epidemiology","College Students","Sexual Aggression","Trajectories","Longitudinal Design"],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Longitudinal survey of 795 male college students across four years; repeated‑measures GLM used to relate changes in risk factors (including pornography use) to sexual‑aggression trajectories.","sample_n":795,"sample_text":"795 male undergraduates surveyed annually for four years","population":"Male college students (U.S., 2008‑2011)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 4‑year study of 795 college men, increases in sexual aggression were linked to rising pornography use, impulsivity, hostile attitudes and other risk factors, while men who reduced aggression showed declines in those same factors.","clinical_takeaway":"Interventions that target impulsivity, sexist attitudes, and pornography consumption may help lower sexual‑aggression risk among college men.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, multi‑year cohort","Repeated‑measures design captures change over time","Comprehensive set of psychosocial risk factors"],"limitations":["Self‑report of sexual aggression and pornography use","No control for moral, mental‑health or trauma confounds","No causal inference; associations only"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":61,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2015.08.015"}},{"id":2799,"doi":"10.1097/qai.0000000000000786","pmid":"26258569","pmcid":"PMC4624575","title":"Phylogenetic Investigation of a Statewide HIV-1 Epidemic Reveals Ongoing and Active Transmission Networks Among Men Who Have Sex With Men","authors":"Chan PA, Hogan JW, Huang A, DeLong A, Salemi M, Mayer KH, Kantor R.","first_author":"Chan PA","journal":"Journal of acquired immune deficiency syndromes (1999)","year":2015,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Molecular epidemiology using phylogenetic trees and latent class analysis on HIV-1 pol sequences from a statewide sample (N≈1166). No experimental or longitudinal component; uses existing diagnostic data.","sample_n":1166,"sample_text":"1166 HIV‑1 subtype B pol sequences from patients diagnosed at a large HIV centre, representing ~75% of the state’s HIV cases.","population":"HIV‑positive men who have sex with men and a broader state‑wide HIV cohort diagnosed 2004‑2011 in Rhode Island, USA.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using HIV genetic data from most of Rhode Island’s cases, the study mapped transmission clusters and found that recent infections among men who have sex with men, especially those with other STIs, often occur in growing networks linked to anonymous partners and venues like porn stores.","clinical_takeaway":"Targeted outreach to recent MSM HIV cases and their networks may help interrupt active transmission clusters.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, near‑population‑level molecular dataset","Sophisticated phylogenetic and statistical modelling","Clear public‑health relevance for targeting interventions"],"limitations":["Cross‑sectional design; cannot infer causality","No behavioural measures beyond clinic records (e.g., no direct assessment of pornography use)","Potential selection bias: only diagnosed individuals with available sequences"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":43,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/qai.0000000000000786"}},{"id":2800,"doi":"10.1007/s10943-014-9831-5","pmid":"24510128","pmcid":null,"title":"Gender, Religiosity, Sexual Activity, Sexual Knowledge, and Attitudes Toward Controversial Aspects of Sexuality","authors":"Sümer ZH.","first_author":"Sümer ZH.","journal":"Journal of religion and health","year":2015,"pub_types":["Journal Article"],"keywords":["Sexual activity","Turkey","Religiosity","university students","Sexual Attitudes"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation","pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 297 Turkish university students","sample_n":297,"sample_text":"162 female, 135 male university students, recruited on a volunteer basis from an urban state university in Turkey","population":"undergraduate students (volunteer sample)","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Among Turkish university students, higher religiosity—especially going to religious services—was linked to more conservative attitudes toward topics like masturbation, pornography, abortion, homosexuality and sexual coercion.","clinical_takeaway":"Clinicians should note that religious involvement may shape sexual attitudes, but this study does not establish causal effects or clinical implications.","confidence":0.3,"topic_tags":["pornography","masturbation","religiosity","sexual_function"],"strengths":["Relatively large sample for a single‑university survey","Uses established attitude and knowledge scales"],"limitations":["Convenience, volunteer student sample – limited generalisability","No measurement or control of key confounds (moral incongruence, mental health, trauma)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":2,"mentioning":15,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-014-9831-5"}},{"id":2801,"doi":"10.1177/1474704915613914","pmid":"37924197","pmcid":"PMC10480800","title":"Measuring Preference for Supernormal Over Natural Rewards : A Two-Dimensional Anticipatory Pleasure Scale","authors":"Goodwin BC, Browne M, Rockloff M.","first_author":"Goodwin BC","journal":"Evolutionary psychology : an international journal of evolutionary approaches to psychology and behavior","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Reward","Natural Stimuli","Supernormal Stimuli","Anticipatory Pleasure Scale"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10480800","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey with self‑report scales; exploratory factor analysis; regression predicting self‑reported consumption of 21 supernormal products. Sample size not reported in abstract.","sample_n":null,"sample_text":"Not specified in abstract","population":"Adults (unspecified) recruited likely via convenience methods","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created a questionnaire that distinguishes how much people enjoy ‘supernormal’ rewards (like flashy snacks, alcohol, pornography) versus natural rewards. The two scales are reliable and predict self‑reported use of such products.","clinical_takeaway":"None – the study provides a new self‑report tool, not clinical guidance.","confidence":0.6,"topic_tags":["pornography","sexual_function","masturbation","prevalence"],"strengths":["Clear factor structure separating supernormal and natural reward preference","High internal reliability for both scales","Regression links scale scores to real‑world consumption patterns"],"limitations":["No reported sample size or sampling strategy","Cross‑sectional self‑report data; no behavioral or physiological validation","Potential unmeasured confounds (e.g., personality, socioeconomic status)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1474704915613914"}},{"id":2802,"doi":"10.1177/1079063215616818","pmid":"26610371","pmcid":null,"title":"Assessing the Validity of Automated Webcrawlers as Data Collection Tools to Investigate Online Child Sexual Exploitation","authors":"Westlake B, Bouchard M, Frank R.","first_author":"Westlake B","journal":"Sexual abuse : a journal of research and treatment","year":2017,"pub_types":["Validation Study","Journal Article"],"keywords":["Automated Data Collection","Child Pornography","Child Sexual Exploitation","Cybercrime","Webcrawler"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study comparing webcrawler‑derived networks from child‑exploitation sites versus non‑CE sites; uses image and keyword criteria.","sample_n":null,"sample_text":"Websites seeded from CE sites, non‑CE sexuality sites, and sports sites; number of sites not reported in abstract.","population":"online webpages (CE‑related and control sites)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study tests whether automated webcrawlers can reliably gather data on online child sexual exploitation material, finding that using image‑based criteria works better than keywords, but overall validity depends on the criteria chosen.","clinical_takeaway":"None – the research concerns data‑collection methods, not clinical practice.","confidence":0.6,"topic_tags":["csbd","pornography","sexual_function","measurement"],"strengths":["Addresses methodological gap in CE data collection","Compares multiple seed domains","Provides concrete recommendations for criterion selection"],"limitations":["No detail on sample size or representativeness of web sites","Validation relies on indirect network metrics rather than ground‑truth labeling","Potential selection bias in seed site choice"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063215616818"}},{"id":2803,"doi":"10.1186/s12905-015-0271-5","pmid":"26608568","pmcid":"PMC4660671","title":"The contribution of online content to the promotion and normalisation of female genital cosmetic surgery: a systematic review of the literature","authors":"Mowat H, McDonald K, Dobson AS, Fisher J, Kirkman M.","first_author":"Mowat H","journal":"BMC women's health","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Systematic Review","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4660671","cited_by_count":30,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Narrative systematic review of five papers, no formal risk‑of‑bias assessment, limited to thematic synthesis.","sample_n":5,"sample_text":"Five papers met inclusion criteria; individual study sizes not reported in abstract.","population":"Women accessing or considering female genital cosmetic surgery; sources are provider websites, online communities, and pornography.","country":"Multiple (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises how online content, including provider websites and porn, portrays female genital cosmetic surgery as normal and beneficial, highlighting five recurring messages that may influence women’s decisions.","clinical_takeaway":"Clinicians should be aware that women may encounter internet messages that pathologise natural genital variation and promote surgery as a simple solution.","confidence":0.7,"topic_tags":["sexual_function","pornography","gender","csbd"],"strengths":["Systematic search across multiple databases","Identifies clear themes of online promotion"],"limitations":["Only five studies included; small evidence base","No quantitative synthesis or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":2,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":39,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12905-015-0271-5"}},{"id":2804,"doi":"10.1089/cyber.2015.0197","pmid":"26588715","pmcid":null,"title":"The Relationship Between Sexual Content on Mass Media and Social Media: A Longitudinal Study","authors":"Vandenbosch L, van Oosten JM, Peter J.","first_author":"Vandenbosch L","journal":"Cyberpsychology, behavior and social networking","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://pure.uva.nl/ws/files/16233925/cyber.2015.0197.pdf","cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two‑wave panel survey of 1,765 adolescents (13‑17 y) assessing exposure to sexual reality TV, Internet pornography, and sexual self‑presentation on social media.","sample_n":1765,"sample_text":"Two‑wave panel survey; size sufficient for longitudinal analysis.","population":"Adolescents (13‑17 y), community sample","country":"Belgium (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a two‑year study of 1,765 teenagers, watching sexual reality TV led them to post more sexual pictures on social media, and posting such pictures made them watch more sexual TV. This pattern did not hold for Internet porn.","clinical_takeaway":"Media exposure can influence adolescents' sexual self‑presentation online; clinicians should consider media habits when discussing digital sexual behavior.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, longitudinal adolescent sample","Bidirectional analysis of media exposure and online self‑presentation","Separate examination of mainstream vs. explicit sexual content"],"limitations":["Reliance on self‑report items of uncertain validation","Key psychosocial confounds (e.g., moral attitudes, mental health) not measured","No pre‑registration or detailed effect‑size reporting"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":20,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2015.0197"}},{"id":2805,"doi":"10.1080/0092623x.2015.1113585","pmid":"26569650","pmcid":null,"title":"Is High Sexual Desire a Facet of Male Hypersexuality? Results from an Online Study","authors":"Štulhofer A, Jurin T, Briken P.","first_author":"Štulhofer A","journal":"Journal of sex & marital therapy","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1,998 Croatian men, group comparison (hypersexuality n=57, high desire n=70)","sample_n":1998,"sample_text":"1998 participants; hypersexuality group n=57, high‑desire group n=70","population":"adult men 18‑60, community sample (convenience)","country":"Croatia","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Croatian online survey of 2,000 men, a small group identified as hypersexual differed from a high‑desire group and most men on relationship status, religiosity, depression, and attitudes toward porn, suggesting hypersexuality is distinct from simply having high sexual desire.","clinical_takeaway":"Hypersexuality may involve broader psychosocial issues beyond high desire; clinicians should assess mood, relationship and moral factors.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large overall sample size","Use of validated hypersexuality screening tools","Comparison of hypersexuality vs high desire groups"],"limitations":["Small subgroup sizes limit power","Sexual desire measured with limited/unspecified items","Moral incongruence and masturbation not assessed"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":6,"contrasting":0,"mentioning":36,"citing_publications":73,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2015.1113585"}},{"id":2806,"doi":"10.1080/13691058.2015.1101489","pmid":"26555512","pmcid":null,"title":"A matter of sexual confidence: young men's non-prescription use of Viagra in Addis Ababa, Ethiopia","authors":"Both R.","first_author":"Both R.","journal":"Culture, health & sexuality","year":2016,"pub_types":["Journal Article"],"keywords":["Sexuality","Gender","Ethiopia","Masculinity","Pharmaceuticals","Viagra"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"In‑depth interviews with 14 Viagra users and focus groups with 43 university students (21 male, 22 female) in Addis Ababa; purposive, convenience sampling; no comparison group; cross‑sectional.","sample_n":57,"sample_text":"14 users + 43 focus‑group participants","population":"young heterosexual men (21‑35) in Ethiopia who use Viagra without prescription; university students (male & female).","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with young Ethiopian men who take Viagra without a prescription show they use the drug to boost confidence, meet perceived expectations of female partners, and cope with fatigue, especially after chewing khat. While some feel more confident, regular users sometimes report feeling less masculine.","clinical_takeaway":"Viagra use for performance anxiety may reflect broader cultural pressures; clinicians should explore underlying confidence and relationship expectations rather than focusing only on the drug.","confidence":0.6,"topic_tags":["sexual_function","masturbation","gender","csbd"],"strengths":["Rich, contextual qualitative data on motives for non‑prescribed Viagra use","Inclusion of both male and female student perspectives","Explores cultural constructions of masculinity and performance"],"limitations":["Small, non‑representative convenience sample","No systematic measurement of psychological constructs (e.g., addiction, distress)","Findings not generalisable beyond urban Ethiopian university context"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2015.1101489"}},{"id":2807,"doi":"10.1186/s13104-015-1638-2","pmid":"26526854","pmcid":"PMC4630846","title":"Prevalence and correlates of HIV-risky sexual behaviors among students attending the Medical and Social Welfare Center of the University of Maroua, Cameroon","authors":"Noubiap JJ, Nansseu JR, Ndoula ST, Wang B, Jingi AM, Bigna JJ, Aminde LN, Youmbi RA, Fokom-Domgue J.","first_author":"Noubiap JJ","journal":"BMC research notes","year":2015,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://bmcresnotes.biomedcentral.com/counter/pdf/10.1186/s13104-015-1638-2","cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 411 university students in Cameroon (convenience sample at one university)","sample_n":411,"sample_text":"411 students surveyed","population":"university students (young adults) at the Medical and Social Welfare Center of the University of Maroua, Cameroon","country":"Cameroon","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among 411 Cameroonian university students, 81% were sexually active. Watching pornography was linked to higher odds of having sex, earlier sexual debut, and more lifetime partners, while Muslim affiliation reduced some risk behaviours.","clinical_takeaway":"In this student group, pornography viewing is associated with riskier sexual practices; prevention programs should consider media exposure alongside cultural factors.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a single‑site survey","Logistic regression with confidence intervals reported","Inclusion of sociocultural variables (religion, urban/rural origin)"],"limitations":["Cross‑sectional design; cannot infer causality","Convenience sample limits generalisability","Key confounders (moral incongruence, mental health, masturbation) not measured"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":10,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s13104-015-1638-2"}},{"id":2808,"doi":"10.1071/sh15055","pmid":"26343052","pmcid":null,"title":"Dr Google, porn and friend-of-a-friend: where are young men really getting their sexual health information?","authors":"Litras A, Latreille S, Temple-Smith M.","first_author":"Litras A","journal":"Sexual health","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 35 participants","sample_n":35,"sample_text":"35 male students, convenience sample","population":"male students aged 16‑19 from two Victorian trade‑skill institutions","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 35 Australian teenage boys showed they rely on school, family, friends, the internet and porn for sexual‑health information, but view most of these sources as unreliable and avoid doctors because of embarrassment.","clinical_takeaway":"Clinicians should proactively offer private, non‑judgmental sexual‑health advice to young men, as they are unlikely to seek it themselves.","confidence":0.7,"topic_tags":["sexual_function","pornography"],"strengths":["Provides direct voices of young men on information needs","Thematic analysis offers nuanced insight"],"limitations":["Small, non‑representative convenience sample","No quantitative measurement of information accuracy","Findings may not generalise beyond vocational school context"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh15055"}},{"id":2809,"doi":null,"pmid":"26867322","pmcid":null,"title":"[High Risk Sex Behaviors and Associated Factors in Young Men in Chengdu]","authors":null,"first_author":null,"journal":"Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Anonymous questionnaire survey of 1,536 young men (18‑34) selected by multi‑stage random sampling in Chengdu; logistic regression of predictors of multiple sexual partners.","sample_n":1536,"sample_text":"1536 respondents who reported having sex contacts.","population":"Young adult men (18‑34) in Chengdu, China; community sample selected via random sampling.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2015 survey of 1,536 young men in Chengdu found that 24% had multiple sexual partners in the past year. Factors linked to having more partners included frequent pornography exposure, childhood sexual abuse, early sexual debut, and sex while intoxicated.","clinical_takeaway":"Screen for childhood sexual abuse and early sexual debut when assessing HIV/STI risk in young men.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, randomly sampled community cohort","Multivariate logistic regression","Inclusion of several relevant psychosocial predictors"],"limitations":["Cross‑sectional design; no causal inference","Pornography exposure measured with a single, unvalidated item","No assessment of moral incongruence or masturbation (not central to outcome)","Potential self‑report bias"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":7,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":2811,"doi":"10.1177/0306624x15612719","pmid":"26510628","pmcid":null,"title":"Violent Fantasies in Young Men With Autism Spectrum Disorders: Dangerous or Miserable Misfits? Duty to Protect Whom?","authors":"Palermo MT, Bogaerts S.","first_author":"Palermo MT","journal":"International journal of offender therapy and comparative criminology","year":2017,"pub_types":["Journal Article"],"keywords":["Autism Spectrum Disorders","Dangerousness","Duty To Protect","Violent Fantasy"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of five young men with Asperger syndrome and violent fantasies; no control group","sample_n":5,"sample_text":"five cases","population":"young Italian males with Asperger syndrome (n=5)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe five Italian men with Asperger syndrome who reported intense violent fantasies about killing women. All had been bullied, rejected romantically, played violent video games and watched violent pornography. The paper speculates that these factors may combine to increase dangerous fantasies, but provides no systematic evidence.","clinical_takeaway":"No specific clinical guidance; the paper highlights that violent fantasies can occur in autistic individuals with complex psychosocial histories, but does not establish pornography as a causal risk factor.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Detailed qualitative description of rare cases","Integration of multiple risk factors (bullying, rejection, gaming, porn)","Raises ethical discussion of duty to protect"],"limitations":["Very small, non-representative sample","No validated measures of porn use or fantasy frequency","No control or comparative group","Speculative causal inference"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x15612719"}},{"id":2813,"doi":"10.1136/bmj.h5563","pmid":"26482102","pmcid":null,"title":"GMC asks for child pornography case to be referred to High Court","authors":"Dyer C.","first_author":"Dyer C.","journal":"BMJ (Clinical research ed.)","year":2015,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.h5563"}},{"id":2814,"doi":"10.3928/02793695-20150923-02","pmid":"26489102","pmcid":null,"title":"Psychiatric-Mental Health Nurses' Exposure to Clients With Problematic Internet Experiences: A Mixed-Methods Pilot Study","authors":"Wieland DM.","first_author":"Wieland DM.","journal":"Journal of psychosocial nursing and mental health services","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-methods pilot survey of 16 psychiatric‑mental health nurses plus narrative case descriptions (9 participants).","sample_n":16,"sample_text":"16 PMHNs provided quantitative data; 9 contributed qualitative case narratives.","population":"psychiatric‑mental health nurses (PMHN) reporting client cases of problematic Internet experiences.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small pilot survey of 16 mental‑health nurses examined the types of problematic Internet use they encounter in clients, finding cases involving pornography, online romance, gaming, excessive time online, sexual‑behavior concerns and cyber‑bullying.","clinical_takeaway":"Clinicians should be alert to diverse Internet‑related problems, including pornography, when assessing clients.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Mixed‑methods approach gives both quantitative counts and qualitative depth","Identifies a range of problematic Internet behaviors as seen in clinical practice"],"limitations":["Very small, convenience sample of nurses limits generalisability","No validated measures of problematic Internet use or addiction","Descriptive only; no inference about prevalence or causality"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":7,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3928/02793695-20150923-02"}},{"id":2815,"doi":"10.1093/sw/swv031","pmid":"26489349","pmcid":null,"title":"Sex Trafficking: Policies, Programs, and Services","authors":"Orme J, Ross-Sheriff F.","first_author":"Orme J","journal":"Social work","year":2015,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methodology; no empirical data collected.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews global policies and programs aimed at combating sex trafficking, noting that most efforts focus on criminalizing traffickers rather than supporting female victims. It also calls for therapeutic services for pornography addicts and purchasers of sexual services, proposing a new prevention‑focused paradigm for social work.","clinical_takeaway":"None – the paper does not provide clinical evidence or guidance for treating individuals.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Broad overview of anti‑trafficking policies","Highlights gap in services for victims","Integrates discussion of pornography‑related interventions"],"limitations":["Narrative, not systematic, review","No empirical data or systematic assessment of interventions","Limited methodological transparency"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sw/swv031"}},{"id":2816,"doi":"10.4081/pmc.2015.114","pmid":"26429122","pmcid":null,"title":"Prevalence of child sexual abuse: a comparison among 4 Italian epidemiological studies","authors":"Castelli B, Festa F, Di Sanzo MA, Guala A, Pellai A.","first_author":"Castelli B","journal":"La Pediatria medica e chirurgica : Medical and surgical pediatrics","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of secondary‑school students (≈3000) in four Italian regions, using an anonymous questionnaire on past sexual victimisation.","sample_n":3000,"sample_text":"almost 3000 students aged 18","population":"Students aged 18 attending secondary schools in Italy (Milan, Varese, Piedmont, Basilicata).","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Four surveys of 18‑year‑old Italian high‑school students found that 12.5%–34.1% reported at least one type of childhood sexual abuse, with higher rates among girls except for exposure to pornography, where boys reported more.","clinical_takeaway":"Child sexual abuse remains common; clinicians should screen adolescents for a range of abuse experiences, including exposure to pornography.","confidence":0.4,"topic_tags":["prevalence","sexual_function","adolescents"],"strengths":["Large total sample size across multiple regions","Consistent methodology allows direct comparison","Addresses a gap in Italian epidemiological data"],"limitations":["Reliance on self‑report, likely non‑validated questionnaire","Cross‑sectional convenience sample of students","Potential recall and social‑desirability bias"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4081/pmc.2015.114"}},{"id":2817,"doi":"10.1186/s12889-015-2253-9","pmid":"26399632","pmcid":"PMC4580294","title":"From disease to desire, pleasure to the pill: A qualitative study of adolescent learning about sexual health and sexuality in Chile","authors":"Macintyre AK, Montero Vega AR, Sagbakken M.","first_author":"Macintyre AK","journal":"BMC public health","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4580294","cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Focus groups and semi‑structured interviews with 51 Chilean adolescents (16‑19 y) and key informants; content analysis of transcripts.","sample_n":51,"sample_text":"24 adolescents in focus groups, 20 in interviews, plus 7 key informants.","population":"Adolescents 16‑19 years in Santiago, Chile (convenience sample).","country":"Chile","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Chilean teens learn most about sex from parents, teachers and friends, while pornography is a secondary source for many boys. The study finds that education focuses on biology (pregnancy, STIs) and neglects topics like pleasure, consent, and diverse sexualities, leaving teens without needed skills for safe, consensual sex.","clinical_takeaway":"Sex‑education programs should broaden content beyond biology to include communication, consent, pleasure, and diverse identities.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rich, contextual insight from adolescents themselves","Includes both genders and key informants","Identifies specific gaps in sex‑education content"],"limitations":["Small, non‑representative convenience sample","No quantitative measurement of constructs","Findings limited to urban Chilean adolescents"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":60,"citing_publications":115,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-015-2253-9"}},{"id":2818,"doi":"10.1089/cyber.2015.0152","pmid":"26374928","pmcid":null,"title":"Sexual Excitability and Dysfunctional Coping Determine Cybersex Addiction in Homosexual Males","authors":"Laier C, Pekal J, Brand M.","first_author":"Laier C","journal":"Cyberpsychology, behavior and social networking","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey of 71 self‑identified homosexual men; questionnaires on cybersex addiction symptoms, sexual excitation, coping, etc.; mediation analysis performed.","sample_n":71,"sample_text":"Seventy‑one homosexual males were surveyed online.","population":"Homosexual males (N=71) recruited via online convenience sampling","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 71 gay men, higher sexual excitement and using sex to cope were linked to more symptoms of cybersex addiction, but actual time spent online did not predict addiction. The study suggests excitement and coping play key roles.","clinical_takeaway":"Assess sexual excitement and coping styles when evaluating problematic cybersex use; time spent online alone may be less informative.","confidence":0.75,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Uses multiple validated‑ish questionnaires","Explores mediation model","Addresses understudied population (homosexual males)"],"limitations":["Cross‑sectional; cannot infer causality","Convenience sample; limited generalisability","No measurement of moral incongruence or masturbation separation","Addiction construct not aligned with ICD‑11 criteria"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":4,"interpretation":4}},"scite":{"supporting":3,"contrasting":0,"mentioning":23,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2015.0152"}},{"id":2819,"doi":null,"pmid":"26629167","pmcid":"PMC4659055","title":"View changes and educational demands on sexual/reproductive health of students at Shanghai Jiaotong University","authors":"Wang H, Chen B, Xu Y, Miao Q, Wu Z, Ju Q, Huang Y.","first_author":"Wang H","journal":"International journal of clinical and experimental medicine","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["AIDS","Sexual behavior","Sexually transmitted disease","Sexual And Reproductive Health","Sexual Education"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire survey of 1,000 university students comparing attitudes in 2013 to a 2005 cohort; convenience sample from a single university; anonymous self‑report MCQs","sample_n":1000,"sample_text":"1,000 questionnaires distributed; 98% return rate","population":"students (age 19‑21) at Shanghai Jiaotong University, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2013 survey of 1,000 Chinese university students showed that attitudes toward premarital sex and condom use became more liberal compared with 2005, while knowledge about AIDS transmission improved. Still, many students lacked full knowledge about STDs and remained disapproving of unmarried pregnancy.","clinical_takeaway":"Sex education programmes should address persisting gaps in STD knowledge and attitudes toward unplanned pregnancy among Chinese university students.","confidence":0.6,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["Large sample size for a single‑site survey","High response rate (98%)","Direct comparison with earlier cohort"],"limitations":["Convenience sample limits generalisability","Questionnaire not validated psychometrically","No control for potential confounders (e.g., morality, mental health)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":2820,"doi":"10.1186/s12978-015-0052-5","pmid":"26346936","pmcid":"PMC4562357","title":"Characteristics of youth sexual and reproductive health and risky behaviors in two rural provinces of Cambodia","authors":"Lopez JR, Mukaire PE, Mataya RH.","first_author":"Lopez JR","journal":"Reproductive health","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://reproductive-health-journal.biomedcentral.com/track/pdf/10.1186/s12978-015-0052-5","cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 300 youths from 30 villages using multi‑stage sampling; logistic regression analyses of sex differences and associations with risky behaviours.","sample_n":300,"sample_text":"300 youths from two rural provinces, selected via multi‑stage sampling of 30 villages; peer‑to‑peer interviewing matched by sex.","population":"Cambodian rural adolescents (both sexes, aged roughly 15‑24)","country":"Cambodia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 300 rural Cambodian youths found low rates of sexual experience but notable alcohol use and higher reported pornography use among boys. Attitudes favored waiting until marriage, yet condom use was low, highlighting areas for health education.","clinical_takeaway":"Screen for alcohol and pornography use when providing sexual health counselling to Cambodian adolescents.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large community sample for the setting","Multistage sampling and gender‑matched interviewers","Use of logistic regression to adjust for covariates"],"limitations":["Pornography use measured by a single self‑report item, no validated scale","Key confounders (moral attitudes, mental health, trauma) not assessed","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":43,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-015-0052-5"}},{"id":2821,"doi":"10.1080/00224499.2015.1020108","pmid":"26241201","pmcid":null,"title":"How Common is Men's Self-Reported Sexual Interest in Prepubescent Children?","authors":"Dombert B, Schmidt AF, Banse R, Briken P, Hoyer J, Neutze J, Osterheider M.","first_author":"Dombert B","journal":"Journal of sex research","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":109,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 8,718 German men; self‑report of sexual fantasies, offending, and preferences; cross‑sectional descriptive and correlational analyses","sample_n":8718,"sample_text":"large convenience online sample; not probability‑based","population":"community adult men (Germany)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a German online survey of 8,718 men, 4 % said they had sexual fantasies about pre‑pubescent children and 3 % reported having acted on such urges. Fantasies were linked to self‑reported offending, and those with such interests often felt they needed therapeutic help.","clinical_takeaway":"Self‑reported interest in prepubescent children is present in a small minority of community men and is associated with distress and offending; clinicians should assess risk and need for help when such interests are disclosed.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Very large sample size","Focused on strictly defined prepubescent interest","Links fantasies to self‑reported offending"],"limitations":["Self‑report may be biased or under‑reported","Convenience online sample limits generalisability","No validated psychometric instruments used"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":6,"contrasting":2,"mentioning":182,"citing_publications":277,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2015.1020108"}},{"id":2822,"doi":"10.1371/journal.pone.0129730","pmid":"26147099","pmcid":"PMC4492978","title":"Are Sex Drive and Hypersexuality Associated with Pedophilic Interest and Child Sexual Abuse in a Male Community Sample?","authors":"Klein V, Schmidt AF, Turner D, Briken P.","first_author":"Klein V","journal":"PloS one","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4492978","cited_by_count":47,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online community sample (N=8,718), self‑report questionnaire, cross‑sectional","sample_n":8718,"sample_text":"8,718 German men participating in an online survey","population":"German adult males, community‑recruited via internet","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["masturbation_not_isolated","self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large online survey of German men, higher self‑reported sexual drive and total sexual activity were linked to child‑pornography use and fantasies about children, but not to actual sexual offending. Antisocial traits predicted offending. The authors suggest clinicians assess pedophilic interests in hypersexual individuals and vice versa.","clinical_takeaway":"Hypersexuality alone does not predict child sexual abuse; assess antisocial traits and pedophilic interests separately.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Very large sample size","Addresses understudied link between hypersexuality and pedophilic interest","Uses hierarchical logistic regression"],"limitations":["Relies on self‑report, unvalidated hypersexuality measures","Cross‑sectional, cannot infer causality","No control for key confounds (moral incongruence, mental health, partner factors)","Potential self‑selection bias"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":5,"mentioning":70,"citing_publications":111,"retracted":false,"notices":[{"status":"Has correction","date":"2015-9-28","noticeDoi":"10.1371/journal.pone.0139533","doi":"10.1371/journal.pone.0129730"},{"status":"Has erratum","date":"2015-9-28","noticeDoi":"10.1371/journal.pone.0139533","doi":"10.1371/journal.pone.0129730"}],"url":"https://scite.ai/reports/10.1371/journal.pone.0129730"}},{"id":2823,"doi":"10.1007/s40596-015-0379-9","pmid":"26130501","pmcid":null,"title":"Problematic Internet Use and Its Correlates Among Students from Three Medical Schools Across Three Countries","authors":"Balhara YP, Gupta R, Atilola O, Knez R, Mohorović T, Gajdhar W, Javed AO, Lal R.","first_author":"Balhara YP","journal":"Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry","year":2015,"pub_types":["Journal Article"],"keywords":["Internet","Medical Students","Problematic Internet Use"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 842 medical students from three countries","sample_n":842,"sample_text":"842 participants (medical students from Croatia, India, Nigeria)","population":"medical students (young adults)","country":"Croatia, India, Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 842 medical students across Croatia, India and Nigeria found that about 39% showed mild and 10% moderate signs of problematic internet use, with higher rates among males and those who spent more time online, especially for activities like social networking, gaming and viewing pornography.","clinical_takeaway":"Problematic internet use is common among medical students; clinicians should screen for it, especially in high‑use males, but consider multiple underlying factors.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Large multi-country sample","Use of validated IAT instrument","Clear reporting of prevalence rates"],"limitations":["Cross‑sectional design limits causal inference","No control for key confounds (moral, mental health, trauma)","IAT conflates frequency and distress, circular definition"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":9,"contrasting":0,"mentioning":29,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40596-015-0379-9"}},{"id":2824,"doi":"10.12669/pjms.314.7115","pmid":"26430412","pmcid":"PMC4590391","title":"Child sexual abuse among adolescents in southeast Nigeria: A concealed public health behavioral issue","authors":"C MP, M CJ, Elias A, I OO, Awoere CT.","first_author":"C MP","journal":"Pakistan journal of medical sciences","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Nigeria","Adolescents","Child Sexual Abuse"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4590391","cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 506 adolescents from three secondary schools in southeast Nigeria (June–Oct 2014).","sample_n":506,"sample_text":"506 adolescents recruited consecutively","population":"Adolescents (secondary school students) in Enugu and Ebonyi states, Nigeria","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 506 Nigerian secondary‑school students, about 40 % reported having experienced some form of sexual abuse, most often being shown pornographic images. Abuse was more common in males, but not linked to age or socioeconomic status.","clinical_takeaway":"High rates of sexual abuse among adolescents highlight the need for screening and protective interventions in schools.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Large community sample for regional study","Clear prevalence estimates","Includes both genders and reports perpetrator relationship"],"limitations":["No validated instrument for sexual abuse assessment reported","Cross‑sectional design limits causal inference","Key confounders (mental health, trauma, moral factors) not measured"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":36,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12669/pjms.314.7115"}},{"id":2825,"doi":"10.1371/journal.pone.0118151","pmid":"26106894","pmcid":"PMC4479551","title":"Disgust versus Lust: Exploring the Interactions of Disgust and Fear with Sexual Arousal in Women","authors":"Fleischman DS, Hamilton LD, Fessler DM, Meston CM.","first_author":"Fleischman DS","journal":"PloS one","year":2015,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4479551","cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Randomized laboratory experiment with four between‑subject conditions; N=76 women (≈19 per condition). Genital arousal measured via vaginal photoplethysmography; self‑report disgust and fear ratings.","sample_n":76,"sample_text":"Women (final N=76) assigned to one of four conditions.","population":"Adult women (likely university/ community sample)","country":"USA (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, women watched either disgusting, fear‑inducing, or neutral images before or after a short porn clip. Genital arousal was measured, and the researchers found that seeing disgust images first reduced sexual arousal, while the sequence of arousal and disgust affected how women rated the disgust images.","clinical_takeaway":"Disgust cues can dampen sexual arousal in women; clinicians should consider emotional context when addressing sexual concerns.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Validated physiological and self‑report measures","Randomized experimental design","Direct assessment of interaction between disgust/fear and sexual arousal"],"limitations":["Small group sizes (≈19 per condition) limit power","No assessment of potential confounds such as mood or relationship status","No pre‑registration or effect‑size reporting indicated"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":52,"citing_publications":85,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0118151"}},{"id":2827,"doi":"10.2466/pr0.2003.92.1.143","pmid":"12674273","pmcid":null,"title":"Overrating pornography as a source of sex information for university students: additional consistent findings","authors":"Trostle LC.","first_author":"Trostle LC.","journal":"Psychological reports","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 175 university students assessing sources of sexual knowledge, including pornography.","sample_n":175,"sample_text":"175 participants recruited from a university setting (no indication of random sampling).","population":"University students (likely convenience sample)","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 175 university students found that pornography is not a primary source of sexual knowledge; peers are reported as the main source, with some gender differences in specific information learned from porn.","clinical_takeaway":"None – the study provides descriptive data on information sources, not clinical guidance.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Reasonably sized sample for a student survey","Directly addresses a specific research question about information sources"],"limitations":["Uses ad‑hoc, likely single‑item measures without validation","Cross‑sectional convenience sample limits generalisability","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":0,"mentioning":17,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2466/pr0.2003.92.1.143"}},{"id":2828,"doi":"10.1111/phn.12211","pmid":"26073128","pmcid":null,"title":"Factors Affecting Sexually Transmitted Infections in South Korean High School Students","authors":"Kim S, Lee C.","first_author":"Kim S","journal":"Public health nursing (Boston, Mass.)","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["South Korea","Sexually Transmitted Infections","High School Student"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Secondary analysis of a nationally representative web‑based youth health survey (N=2,387 sexually active high‑school students). Logistic regression used to identify predictors of self‑reported STI.","sample_n":2387,"sample_text":"high school students from the 2012 Korea Youth Risk Behavior Survey who reported having sexual intercourse","population":"South Korean high‑school students who reported sexual intercourse (N≈2,400).","country":"South Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"useful","plain_summary":"Among South Korean high‑school students, those who reported preferring internet pornography were more likely to have had a sexually transmitted infection, alongside drug use and earlier sexual debut.","clinical_takeaway":"Clinicians should consider broader risk behaviors, not pornography alone, when counseling adolescents about STI prevention.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large, nationally representative sample","Standardized survey instrument","Multivariable logistic regression"],"limitations":["Pornography preference measured with a single item, no validated scale","Cross‑sectional design cannot infer causality","Key sexual‑health confounders (masturbation, moral attitudes, mental health) not assessed"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":12,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/phn.12211"}},{"id":2829,"doi":"10.1007/s10508-015-0564-7","pmid":"26058490","pmcid":null,"title":"Minor Physical Anomalies as a Window into the Prenatal Origins of Pedophilia","authors":"Dyshniku F, Murray ME, Fazio RL, Lykins AD, Cantor JM.","first_author":"Dyshniku F","journal":"Archives of sexual behavior","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Anthropometry","Prenatal Development","Pedophilia","Minor Physical Anomalies","Phallometry"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational study of men referred for sexual offense assessment; clinical convenience sample; associations between minor physical anomalies and pedophilic indicators.","sample_n":null,"sample_text":"clinical sample (size not reported in abstract)","population":"Men referred for assessment after sexual assault or illegal sexual behavior (clinical forensic sample).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that men who have sexually offended against children show more minor physical anomalies, which are tiny birth‑related body differences, compared to other groups, suggesting a possible prenatal development link.","clinical_takeaway":"No direct clinical application; the findings are exploratory and do not inform treatment.","confidence":0.6,"topic_tags":["prevalence","neuroscience"],"strengths":["Use of validated physical anomaly scale","Objective pedophilia indicators (phallometry, victim count)"],"limitations":["Clinical, non-representative sample","Potential confounding variables not measured","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":28,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0564-7"}},{"id":2830,"doi":"10.1071/sh14225","pmid":"25935169","pmcid":null,"title":"'It's always just there in your face': young people's views on porn","authors":"Walker S, Temple-Smith M, Higgs P, Sanci L.","first_author":"Walker S","journal":"Sexual health","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"In‑depth semi‑structured interviews with 33 Australian youth (15‑20 y) recruited purposively; grounded‑theory thematic analysis.","sample_n":33,"sample_text":"33 participants, purposive sampling","population":"young people, Australia, 2010‑11","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 33 Australian teens reveal that many encounter porn, often unintentionally, and that these exposures shape expectations about sex and reinforce gender power imbalances, prompting concern among youth about the messages they receive.","clinical_takeaway":"Clinicians should recognize that adolescents are frequently exposed to porn and may feel pressure to conform to portrayed norms; discussing media literacy can help mitigate potential harms.","confidence":0.8,"topic_tags":["pornography","adolescents","gender","sexual_function"],"strengths":["Rich, participant‑driven data","Grounded‑theory approach provides depth","Highlights gendered themes relevant to policy"],"limitations":["Small, non‑representative purposive sample","No quantitative measurement of pornography use or related variables","No assessment of confounding factors (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh14225"}},{"id":2831,"doi":"10.1556/2006.4.2015.011","pmid":"26132914","pmcid":"PMC4500890","title":"Bipolar spectrum disorders in a clinical sample of patients with Internet addiction: hidden comorbidity or differential diagnosis?","authors":"Wölfling K, Beutel ME, Dreier M, Müller KW.","first_author":"Wölfling K","journal":"Journal of behavioral addictions","year":2015,"pub_types":["brief-report","Journal Article"],"keywords":["Diagnostic criteria","Comorbidity","Internet Addiction","Bipolar Spectrum Disorders","Internet Gaming Disorder","Clinical Prevalence"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4500890","cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"clinical sample of treatment‑seekers screened for Internet addiction and bipolar spectrum using questionnaire and interview; cross‑sectional comparison of comorbid rates","sample_n":368,"sample_text":"treatment seekers presenting with excessive to addictive Internet use","population":"368 treatment‑seeking individuals with excessive/addictive Internet use (Germany)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"supports","citation_value":"useful","plain_summary":"In 368 people seeking help for excessive internet use, about 31 % of those who met criteria for Internet addiction also screened positive for bipolar disorders, compared with 6 % of less severe users. The study suggests clinicians should check for bipolar disorder when treating Internet addiction.","clinical_takeaway":"Screen for bipolar disorder in clients presenting with problematic internet use, including pornography use.","confidence":0.7,"topic_tags":["sexual_function","csbd","pornography"],"strengths":["Large clinical sample for a niche population","Use of validated screening tools for bipolar disorder and general psychopathology"],"limitations":["Cross‑sectional; cannot infer directionality","Treatment‑seeker convenience sample limits generalisability","No assessment of moral incongruence or masturbation, key confounds for pornography‑related outcomes"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":5,"design":3,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.4.2015.011"}},{"id":2832,"doi":"10.1016/s1049-3867(02)00174-3","pmid":"12598058","pmcid":null,"title":"Does pornography influence young women's sexual behavior?","authors":"Rogala C, Tydén T.","first_author":"Rogala C","journal":"Women's health issues : official publication of the Jacobs Institute of Women's Health","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 1,000 women attending a family planning clinic in Stockholm; self‑report questionnaire on pornography exposure and sexual practices","sample_n":1000,"sample_text":"Convenience sample of clinic attendees; not a probability‑based or population‑representative sample","population":"young women (adolescents and adults) attending a clinic in Sweden","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,000 Swedish women attending a family‑planning clinic, 80% reported ever viewing pornography and a third said it changed how they behaved sexually. Anal intercourse was reported by 47% of participants, especially older women, and condom use during anal sex was low.","clinical_takeaway":"Clinicians should be aware that many young women have viewed pornography and report perceived influence on sexual practices, but the study cannot show that pornography causes specific behaviours.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample (n=1000) for a survey","Specific focus on young women’s self‑reported sexual practices","Provides prevalence data on anal intercourse and condom use"],"limitations":["Cross‑sectional, self‑report design; no causal inference possible","No validated measures of pornography use or impact","Potential selection bias (clinic attendees, not general population)","No control for key confounds (moral attitudes, mental health, partner status)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":10,"contrasting":0,"mentioning":70,"citing_publications":102,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1049-3867(02)00174-3"}},{"id":2833,"doi":null,"pmid":"12519658","pmcid":null,"title":"Romantic partners' use of pornography: its significance for women","authors":"Bridges AJ, Bergner RM, Hesson-McInnis M.","first_author":"Bridges AJ","journal":"Journal of sex & marital therapy","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of women’s attitudes toward partner’s pornography use; likely convenience sample; no longitudinal or experimental manipulation","sample_n":null,"sample_text":"broader, more diverse population of women (details not provided)","population":"women in committed relationships (sample size not reported in abstract)","country":"unspecified (likely USA)","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed women about how their partners' pornography viewing affects them, aiming to broaden knowledge beyond highly distressed groups.","clinical_takeaway":"Clinicians should recognize that partner’s porn use may impact women, but evidence on effects is limited and lacks rigorous controls.","confidence":0.6,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["addresses understudied topic of partner‑porn use","includes brief review of prior distressed samples"],"limitations":["No validated measures of pornography use or distress","No control for moral, mental‑health or relationship variables","Cross‑sectional, likely convenience sample"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":2834,"doi":"10.1136/jech-2015-205453","pmid":"26022057","pmcid":null,"title":"The impact of pornography on gender-based violence, sexual health and well-being: what do we know?","authors":"Lim MS, Carrotte ER, Hellard ME.","first_author":"Lim MS","journal":"Journal of epidemiology and community health","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":41,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":2,"contrasting":0,"mentioning":39,"citing_publications":106,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/jech-2015-205453"}},{"id":2835,"doi":"10.1080/13691058.2015.1038586","pmid":"25985279","pmcid":"PMC4706018","title":"A focus on pleasure? Desire and disgust in group work with young men","authors":"McGeeney E.","first_author":"McGeeney E.","journal":"Culture, health & sexuality","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sex Education","Focus Groups","Young People","Masculinity","Sexual Pleasure"],"is_oa":true,"oa_url":"https://www.tandfonline.com/doi/pdf/10.1080/13691058.2015.1038586?needAccess=true&role=button","cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus group case study with young heterosexual men; reflexive qualitative analysis","sample_n":null,"sample_text":"single focus group; exact number not reported in abstract","population":"young heterosexual men (age unspecified), recruited for a single focus group","country":"United Kingdom (inferred from journal and author affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper examines a focus group with heterosexual young men discussing sexual pleasure. It shows how adult‑led discussions can trigger hyper‑masculine displays that limit critical conversation, while also pointing to chances for more reflective sex‑education.","clinical_takeaway":"Facilitators should anticipate and manage masculine posturing to create genuine space for critical dialogue about pleasure.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Provides an in‑depth, reflexive account of group dynamics with young men","Highlights the tension between critical pedagogy and hyper‑masculine performances","Integrates qualitative insights with broader public‑health debates"],"limitations":["Single, small focus group limits generalisability","No systematic qualitative methodology (e.g., coding reliability) described","Findings may reflect facilitator bias or group composition"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2015.1038586"}},{"id":2836,"doi":"10.1001/jama.288.22.2887","pmid":"12472332","pmcid":null,"title":"Does pornography-blocking software block access to health information on the Internet?","authors":"Richardson CR, Resnick PJ, Hansen DL, Derry HA, Rideout VJ.","first_author":"Richardson CR","journal":"JAMA","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"simulation of adolescent searches testing multiple blocking products at different restrictiveness levels","sample_n":3206,"sample_text":"Simulation of internet searches; not a human participant sample","population":"search results from simulated adolescent internet queries (n≈3206 health sites, 781 porn sites)","country":"United States (implied by JAMA authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested six common porn‑blocking programs and found that, while they blocked most porn sites, they also unintentionally blocked 1–24% of health‑information pages, especially those about sexual health topics.","clinical_takeaway":"Schools and libraries should use the least restrictive blocking settings to minimise loss of important sexual‑health information.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large number of search results tested","Multiple commercially‑available blocking products evaluated","Clear quantitative outcome (blocking rates)"],"limitations":["Classification of sites not described as validated","Simulation may not reflect real‑world search behaviour","No confidence intervals or hypothesis testing reported"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":34,"citing_publications":69,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/jama.288.22.2887"}},{"id":2837,"doi":"10.1111/aogs.12660","pmid":"25891185","pmcid":null,"title":"\"The first cut is the deepest\": a psychological, sexological and gynecological perspective on female genital cosmetic surgery","authors":"Barbara G, Facchin F, Meschia M, Vercellini P.","first_author":"Barbara G","journal":"Acta obstetricia et gynecologica Scandinavica","year":2015,"pub_types":["Journal Article"],"keywords":["Ethics","Labiaplasty","Female Genitalia","Female Genital Cosmetic Surgery","Vulvovaginal Standard"],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary/position paper without empirical data.","sample_n":null,"sample_text":"Not applicable – no empirical participants.","population":"Women and girls considering or undergoing female genital cosmetic surgery; no sample size reported.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The paper argues that rising demand for female genital cosmetic surgery is driven by porn-influenced beauty standards, warns that surgery may not improve sexual function, and calls for ethical regulation and counseling.","clinical_takeaway":"Clinicians should discuss the lack of evidence for sexual benefits and offer psychological counseling before considering surgery.","confidence":0.8,"topic_tags":["gender","sexual_function"],"strengths":["Identifies ethical concerns","Highlights lack of robust evidence for efficacy"],"limitations":["No empirical data presented","Relies on narrative argumentation"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":41,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/aogs.12660"}},{"id":2838,"doi":null,"pmid":"26521527","pmcid":null,"title":"FACTORS ASSOCIATED WITH PREGNANCY AMONG UNMARRIED WOMEN IN MALAYSIA","authors":"Zain NM, Low WY, Othman S.","first_author":"Zain NM","journal":"The Southeast Asian journal of tropical medicine and public health","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross‑sectional comparison of 484 pregnant women (unmarried vs married) recruited from hospitals and shelters","sample_n":484,"sample_text":"239 unmarried, 245 married","population":"unmarried and married pregnant women in Malaysia (n=484)","country":"Malaysia","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a 2015 Malaysian study of 484 pregnant women, the authors found that unmarried women who were younger, students, drank alcohol, used contraceptives less, had low social support, and reported exposure to pornographic material were more likely to be pregnant compared with married women.","clinical_takeaway":"Exposure to pornographic material was linked to higher odds of pregnancy among unmarried women, but the finding is based on self‑report and cannot prove causation.","confidence":0.73,"topic_tags":["pornography","sexual_function","religiosity"],"strengths":["Reasonably large sample for a cross‑sectional study","Use of a structured questionnaire","Clear reporting of odds ratios with confidence intervals"],"limitations":["Exposure to pornographic material measured by a single self‑report item, no validated scale","Key confounds (moral incongruence, masturbation, mental health, trauma) not assessed","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":2839,"doi":"10.1111/jsm.12877","pmid":"25974236","pmcid":null,"title":"Comment on: Is Pornography Use Associated with Sexual Difficulties and Dysfunctions among Younger Heterosexual Men?","authors":"Hald GM.","first_author":"Hald GM.","journal":"The journal of sexual medicine","year":2015,"pub_types":["Comment","Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12877"}},{"id":2840,"doi":"10.1016/s0929-693x(02)00081-7","pmid":"12503513","pmcid":null,"title":"[Confrontation of children and adolescents with pornography]","authors":"Hayez JY.","first_author":"Hayez JY.","journal":"Archives de pediatrie : organe officiel de la Societe francaise de pediatrie","year":2002,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd","pornography"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/editorial without empirical data","sample_n":null,"sample_text":"No empirical sample reported","population":"children and adolescents (general description, no sample)","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","causal_from_correlational"],"stance":"supports","citation_value":"background","plain_summary":"The article discusses how pornography exposure might affect children and teens, suggesting most are unharmed but some could develop trauma, perversions, or what the author calls \"internet addiction disorder.\" It offers advice for parents on dealing with these risks.","clinical_takeaway":"The paper suggests monitoring and parental guidance for youth exposed to pornography, but provides no empirical evidence to guide clinical decisions.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["High topical relevance","Provides clinical recommendations for parents"],"limitations":["No empirical data or methodology described","Lacks measurement of key confounds","Makes causal claims without evidence"],"rubric_version":"2.0","raw_total":3,"max_possible":50,"pct_score":6,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0929-693x(02)00081-7"}},{"id":2841,"doi":"10.3399/bjgp15x684493","pmid":"25824164","pmcid":"PMC4377606","title":"Paracetamol, ethnic health inequalities, cerebral palsy, and pornography","authors":"Rashid A.","first_author":"Rashid A.","journal":"The British journal of general practice : the journal of the Royal College of General Practitioners","year":2015,"pub_types":["other","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3399/bjgp15x684493"}},{"id":2842,"doi":"10.1111/jsm.12865","pmid":"25808900","pmcid":null,"title":"Hypersexuality and high sexual desire: exploring the structure of problematic sexuality","authors":"Carvalho J, Štulhofer A, Vieira AL, Jurin T.","first_author":"Carvalho J","journal":"The journal of sexual medicine","year":2015,"pub_types":["Journal Article"],"keywords":["Sexual Desire","Hypersexuality","Dysregulated Sexuality","Problematic Sexuality"],"is_oa":false,"oa_url":null,"cited_by_count":49,"is_preprint":false,"topics":["bibliography","csbd","pornography","ppu","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online community survey (Croatia, 2014); cluster analysis and confirmatory factor analysis of self‑report items; no longitudinal or experimental manipulation","sample_n":null,"sample_text":"online community survey, sample size not stated in abstract","population":"adult community sample (both genders); recruitment through online panel, not a clinical or treatment‑seeking group","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed adults in Croatia and used statistical clustering to show that people who feel they lack control over sexuality and experience negative outcomes form a distinct group from those who simply have high desire and frequent sexual activity.","clinical_takeaway":"High sexual desire alone does not imply problematic sexuality; lack of control and negative consequences are the key factors to assess.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["large community sample (presumed) and gender‑specific analysis","use of multivariate techniques (cluster analysis, CFA) to explore structure","assessment of psychosocial variables (religiosity, psychopathology)"],"limitations":["Constructs measured with ad‑hoc self‑report items, not validated scales","No separation of pornography use from masturbation or other sexual behaviours","Cross‑sectional design cannot establish causality"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":7,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":39,"citing_publications":118,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12865"}},{"id":2843,"doi":"10.1371/journal.pone.0119050","pmid":"25738508","pmcid":"PMC4349819","title":"Risky sexual behaviors among female youth in Tiss Abay, a semi-urban area of the Amhara Region, Ethiopia","authors":"Tadesse G, Yakob B.","first_author":"Tadesse G","journal":"PloS one","year":2015,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4349819","cited_by_count":38,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional census of 711 unmarried female youths (15‑29) in a semi‑urban Ethiopian town; self‑report questionnaire on sexual behavior and predictors including pornography viewing.","sample_n":711,"sample_text":"711 female youths participated","population":"female youths, unmarried, 15‑29, Ethiopia (semi‑urban)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2015 Ethiopian survey of 711 unmarried female youths found that 70% engaged in risky sexual practices, with pornography watching before sex linked to lower condom use and higher risk.","clinical_takeaway":"Clinicians should consider pornography exposure when counseling young women about condom use and sexual risk.","confidence":0.78,"topic_tags":["religiosity","sexual_function"],"strengths":["Large sample for a community survey","Inclusion of multiple behavioral predictors (substance use, pornography)","Clear operational definition of risky sexual behaviors"],"limitations":["Cross‑sectional design limits causal inference","No validated measures for pornography use or distress","Key confounds (moral incongruence, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":20,"contrasting":3,"mentioning":62,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0119050"}},{"id":2844,"doi":"10.1111/aogs.12565","pmid":"25619646","pmcid":"PMC4671320","title":"Sexual and contraceptive behavior among female university students in Sweden - repeated surveys over a 25-year period","authors":"Stenhammar C, Ehrsson YT, Åkerud H, Larsson M, Tydén T.","first_author":"Stenhammar C","journal":"Acta obstetricia et gynecologica Scandinavica","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Female","Sexual behavior","Contraception","sexually transmitted diseases","Sexually Transmitted Infection","Unsafe Sex"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4671320","cited_by_count":29,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"repeated cross‑sectional surveys of female university students attending a student health centre (waiting‑room questionnaire).","sample_n":359,"sample_text":"Female university students (n = 359).","population":"female university students in Sweden (n≈359 across waves)","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Surveys of Swedish female university students over 25 years show that first sexual intercourse happens earlier, lifetime partners have increased, and condom use has declined, while pornography use is common.","clinical_takeaway":"Clinicians should note rising sexual risk behaviours among young women and discuss safe‑sex practices, but the study provides no evidence on pornography‑related pathology.","confidence":0.8,"topic_tags":["sexual_function","pornography","religiosity","relationships","masturbation"],"strengths":["Longitudinal span of 25 years with repeated surveys","Large sample for a university‑based study","Clear reporting of key sexual‑behavior indicators"],"limitations":["Convenience sample of students attending a health centre","Questionnaire not validated for constructs such as pornography impact","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":35,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/aogs.12565"}},{"id":2845,"doi":"10.1080/009262302760328235","pmid":"11995598","pmcid":null,"title":"The significance of heavy pornography involvement for romantic partners: research and clinical implications","authors":"Bergner RM, Bridges AJ.","first_author":"Bergner RM","journal":"Journal of sex & marital therapy","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":59,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"paradigm case portrait based on 100 personal letters from female partners of heavy pornography users; qualitative descriptive analysis","sample_n":100,"sample_text":"100 personal letters; not a probability sample; likely self‑selected from women distressed by partner's porn use","population":"female romantic partners of heavy pornography users (self‑selected via letters)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","advocacy_or_coi"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors analyse 100 letters from women whose partners used pornography heavily, describing how the discovery affected their relationships, self‑esteem and views of their partners, and suggest therapeutic approaches.","clinical_takeaway":"Clinicians should be aware that partners of heavy porn users may experience distress and relationship strain; therapy may need to address these specific concerns.","confidence":0.7,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Provides in‑depth, first‑person perspectives","Highlights relational impact of heavy porn use"],"limitations":["Non‑representative, self‑selected sample","No systematic measurement or controls","Qualitative description limits generalizability"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":8,"contrasting":2,"mentioning":148,"citing_publications":213,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/009262302760328235"}},{"id":2847,"doi":"10.5604/12321966.1141382","pmid":"25780842","pmcid":null,"title":"Prevalence of Internet addiction and risk of developing addiction as exemplified by a group of Polish adolescents from urban and rural areas","authors":"Pawłowska B, Zygo M, Potembska E, Kapka-Skrzypczak L, Dreher P, Kędzierski Z.","first_author":"Pawłowska B","journal":"Annals of agricultural and environmental medicine : AAEM","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 1,860 Polish adolescents (urban vs rural) using self‑report questionnaires on internet use and addiction.","sample_n":1860,"sample_text":"1,860 participants (1,320 girls, 540 boys); 760 urban, 1,100 rural.","population":"Adolescents (average age 17) attending junior high and high schools in Lublin Province, Poland (N=1860).","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A 2015 Polish survey of 1,860 adolescents found that around 0.5%–3% met criteria for internet addiction, with higher rates in rural youth. About a third of participants were at risk of developing addiction, and urban teens reported more pornography and social‑media use.","clinical_takeaway":"Internet‑addiction screening may be warranted in adolescents, but prevalence is low; clinicians should consider broader psychosocial factors.","confidence":0.85,"topic_tags":["prevalence","adolescents","csbd","pornography","sexual_function"],"strengths":["Large sample size","Use of a widely‑used validated internet‑addiction scale (IAT)","Comparison of urban vs rural adolescents"],"limitations":["Reliance on self‑report questionnaires only","No control for key psychosocial confounds (e.g., mental health, moral attitudes)","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":1,"design":4,"addiction_criteria":2,"interpretation":6}},"scite":{"supporting":7,"contrasting":3,"mentioning":23,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5604/12321966.1141382"}},{"id":2848,"doi":"10.1111/jsm.12785","pmid":"25471337","pmcid":null,"title":"The German Dunkelfeld project: a pilot study to prevent child sexual abuse and the use of child abusive images","authors":"Beier KM, Grundmann D, Kuhle LF, Scherner G, Konrad A, Amelung T.","first_author":"Beier KM","journal":"The journal of sexual medicine","year":2015,"pub_types":["Controlled Clinical Trial","Journal Article"],"keywords":["Therapy","Prevention","Child Sexual Abuse","Pedophilia","Child Abusive Images"],"is_oa":false,"oa_url":null,"cited_by_count":106,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"nonrandomized waiting‑list control trial, 1‑year CBT program, pre/post self‑report","sample_n":75,"sample_text":"53 treated, 22 untreated control","population":"self‑motivated adult pedophiles/hebephiles (N=319 screened, 53 treated, 22 control)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A German pilot program offered a year‑long CBT treatment to self‑identified pedophiles. Compared with a small waiting‑list group, participants reported reduced risky thoughts and better sexual self‑control, though many still reported ongoing offending behavior.","clinical_takeaway":"Brief CBT may lower some risk factors in help‑seeking pedophiles, but evidence is limited and many offenders continue risky behavior.","confidence":0.6,"topic_tags":["prevalence","treatment","sexual_function"],"strengths":["prospective 1‑year treatment program","use of a control (waiting‑list) group","focus on dynamic risk factors rather than legal recidivism alone"],"limitations":["non‑randomized, small control group","self‑report outcomes without external validation","no adjustment for key confounds (e.g., mental health, trauma)","limited statistical detail, no effect sizes or power analysis"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":3,"mentioning":152,"citing_publications":264,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12785"}},{"id":2849,"doi":"10.1542/9781581108927-sex_online","pmid":"27120886","pmcid":null,"title":"Sex Online: Pornography, Sexual Solicitation, and Sexting","authors":"Wright PJ, Donnerstein E.","first_author":"Wright PJ","journal":"Adolescent medicine: state of the art reviews","year":2014,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/9781581108927-sex_online"}},{"id":2851,"doi":"10.1089/109493101753376641","pmid":"11800177","pmcid":null,"title":"Pornography in Usenet: a study of 9,800 randomly selected images","authors":"Mehta MD.","first_author":"Mehta MD.","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":2001,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"content analysis of 9,800 randomly selected Usenet images from 1995‑96; descriptive statistics on source type and thematic legality","sample_n":9800,"sample_text":"9,800 images randomly selected from 32 Usenet newsgroups (1995‑1996)","population":"N/A (no human participants)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined 9,800 randomly chosen pornographic images from Usenet newsgroups in the mid‑1990s, finding that most came from commercial sources and that illegal themes were rare.","clinical_takeaway":"None – the study describes image content, not user health or behaviour.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample of images (n=9,800)","Random selection across many newsgroups","Clear categorisation of legal vs illegal content"],"limitations":["Only Usenet data from 1995‑96; not representative of current pornography","No user‑level data; cannot infer behaviour or health effects","Descriptive analysis without statistical testing of trends"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/109493101753376641"}},{"id":2852,"doi":"10.1071/sh14116","pmid":"25376999","pmcid":null,"title":"Masturbation, paying for sex, and other sexual activities: the Second Australian Study of Health and Relationships","authors":"Richters J, de Visser RO, Badcock PB, Smith AM, Rissel C, Simpson JM, Grulich AE.","first_author":"Richters J","journal":"Sexual health","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":51,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative probability sample (N≈20,094) with telephone interview; descriptive prevalence study","sample_n":20094,"sample_text":"large, probability‑based community sample","population":"Australian adults aged 16‑69 years, community‑based, recruited by random‑digit dialing","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2014 Australian telephone survey of 20,094 adults found that 72 % of men and 42 % of women masturbated in the past year, about two‑thirds of men and one‑fifth of women viewed pornography, and 17 % of men had ever paid for sex. The study describes how solo sexual activities vary by gender.","clinical_takeaway":"Solo sexual practices are common and gender‑differentiated; clinicians should normalise these behaviours when discussing sexual health.","confidence":0.8,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Large, nationally representative sample","High participation rate (66 %)","Broad range of sexual behaviours captured"],"limitations":["Self‑report may be subject to social desirability bias","Single‑item questions limit psychometric depth","No longitudinal follow‑up to assess change over time"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":10,"contrasting":1,"mentioning":66,"citing_publications":100,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh14116"}},{"id":2853,"doi":"10.1007/s00414-014-1088-8","pmid":"25308515","pmcid":null,"title":"Age estimation based on pictures and videos presumably showing child or youth pornography—reply to Arlan L. Rosenbloom","authors":"Mayer F, Arent T, Geserick G, Grundmann C, Lockemann U, Riepert T, Schmeling A, Ritz-Timme S.","first_author":"Mayer F","journal":"International journal of legal medicine","year":2015,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00414-014-1088-8"}},{"id":2854,"doi":"10.1089/jwh.2014.4782","pmid":"25144515","pmcid":null,"title":"Fiction or not? Fifty Shades is associated with health risks in adolescent and young adult females","authors":"Bonomi AE, Nemeth JM, Altenburger LE, Anderson ML, Snyder A, Dotto I.","first_author":"Bonomi AE","journal":"Journal of women's health (2002)","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of university females (n=655) comparing readers vs non‑readers of Fifty Shades","sample_n":655,"sample_text":"715 recruited, 655 included in analysis","population":"Female university students ages 18‑24, Midwestern USA","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 655 US university women found that those who had read the erotic novel series Fifty Shades were more likely to report binge drinking, multiple sexual partners, disordered‑eating behaviors, and past partner abuse compared with non‑readers. The study is cross‑sectional, so it cannot tell whether reading the books caused these risks.","clinical_takeaway":"Reading Fifty Shades is linked to higher rates of several health risk behaviors, but causality is unknown; clinicians should assess broader risk factors rather than attribute them to fiction exposure.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a single‑site survey","Multiple health‑risk outcomes examined","Adjusted a priori for age and race"],"limitations":["Cross‑sectional; cannot infer causality","Self‑report measures; possible recall bias","Limited confound control (no moral, mental‑health, or trauma variables)","Convenience sample of university women; limited generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/jwh.2014.4782"}},{"id":2855,"doi":"10.1006/nimg.2001.0794","pmid":"11525320","pmcid":null,"title":"Cerebral activation associated with sexual arousal in response to a pornographic clip: A 15O-H2O PET study in heterosexual men","authors":"Bocher M, Chisin R, Parag Y, Freedman N, Meir Weil Y, Lester H, Mishani E, Bonne O.","first_author":"Bocher M","journal":"NeuroImage","year":2001,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":81,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subject PET study comparing porn clip to control clips; N=10 young heterosexual men","sample_n":10,"sample_text":"10 young heterosexual males","population":"young adult heterosexual males (n=10)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In ten heterosexual men, watching a short pornographic clip increased blood flow in brain areas linked to visual processing, attention, and the midbrain, compared with neutral clips. Participants also reported feeling more aroused.","clinical_takeaway":"None – the study is a small neuro‑imaging experiment and does not inform clinical practice.","confidence":0.85,"topic_tags":["neuroscience","sexual_function","pornography","csbd"],"strengths":["Use of PET imaging to capture real‑time cerebral blood flow","Within‑subject comparison of pornographic and neutral stimuli"],"limitations":["Very small sample (N=10) limits generalizability","Self‑report arousal rating not validated","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":5,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":54,"citing_publications":150,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1006/nimg.2001.0794"}},{"id":2856,"doi":"10.1007/s10508-014-0345-8","pmid":"25119389","pmcid":null,"title":"Capturing sexual violence experiences among battered women using the revised sexual experiences survey and the revised conflict tactics scales","authors":"Moreau C, Boucher S, Hébert M, Lemelin J.","first_author":"Moreau C","journal":"Archives of sexual behavior","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 138 battered women in shelters; comparison of two validated IPV measures","sample_n":138,"sample_text":"Convenience sample of women in shelters; not representative of general population","population":"battered women using shelter services (n=138)","country":"Canada (Quebec)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared two standard questionnaires for intimate‑partner sexual violence among 138 women in shelters, finding that the shorter CTS2 identified more cases. About a quarter of participants also reported forced porn‑related acts, and these women were far more likely to experience severe sexual violence.","clinical_takeaway":"Screening tools differ in sensitivity; clinicians should consider multiple measures when assessing sexual violence.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of two validated IPV measures","Direct comparison of instrument concordance","Clear reporting of prevalence rates"],"limitations":["Convenience shelter sample limits generalizability","Cross‑sectional design cannot infer causality","No adjustment for broader psychosocial confounders"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":22,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0345-8"}},{"id":2858,"doi":"10.1080/00224499.2014.914131","pmid":"25085004","pmcid":null,"title":"Intrapersonal and interpersonal sexual behaviors of Chinese university students: gender differences in prevalence and correlates","authors":"Chi X, Bongardt Dv, Hawk ST.","first_author":"Chi X","journal":"Journal of sex research","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 1,397 Chinese university students assessing self‑reported sexual behaviors and sociodemographic predictors.","sample_n":1397,"sample_text":"Convenience sample of university students","population":"University students in China (N≈1397, mean age 20.3)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,400 Chinese university students found that men reported higher rates of solo sexual activities (fantasies, masturbation, porn) and heterosexual intercourse than women. Age, income, urban background, relationship history, and Internet use predicted these behaviors differently for men and women.","clinical_takeaway":"Clinicians should recognise gender‑specific patterns in young adults’ sexual behaviors when offering education or counseling.","confidence":0.7,"topic_tags":["prevalence","gender","sexual_function"],"strengths":["Large sample for a single‑university survey","Separate assessment of intrapersonal vs. interpersonal behaviors","Gender‑specific analysis of predictors"],"limitations":["Convenience, non‑probability sampling limits generalisability","Reliance on self‑report items with unclear validation","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2014.914131"}},{"id":2859,"doi":"10.1037/pas0000016","pmid":"25068907","pmcid":null,"title":"Validation of direct and indirect measures of preference for sexualized violence","authors":"Larue D, Schmidt AF, Imhoff R, Eggers K, Schönbrodt FD, Banse R.","first_author":"Larue D","journal":"Psychological assessment","year":2014,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study using online convenience sample of 107 men and 103 women, including participants recruited from sadomasochistic interest groups","sample_n":210,"sample_text":"107 men, 103 women recruited online, including members of sadomasochistic interest groups","population":"adult men and women, community sample (online recruitment, some from sexual interest groups)","country":"unspecified (online international sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study created and tested three indirect tasks (IAT, semantic misattribution, viewing time) to see how well they capture people’s interest in sexualized violence, comparing them to self‑reports in 210 men and women.","clinical_takeaway":"None – the work is methodological and does not provide direct clinical guidance.","confidence":0.6,"topic_tags":["sexual_function","prevalence","measurement"],"strengths":["Multi‑method (implicit and explicit) assessment battery","Direct comparison of indirect measures with self‑report","Gender‑specific findings reported"],"limitations":["Convenience, self‑selected sample including niche interest groups","No control for moral, mental‑health or relational confounds","Cross‑sectional validation only, limited generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":15,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/pas0000016"}},{"id":2860,"doi":"10.1007/s00414-014-1048-3","pmid":"25037950","pmcid":null,"title":"Age estimation based on pictures and videos presumably showing child or youth pornography","authors":"Rosenbloom AL.","first_author":"Rosenbloom AL.","journal":"International journal of legal medicine","year":2015,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00414-014-1048-3"}},{"id":2861,"doi":"10.1136/bmjopen-2014-004996","pmid":"25122073","pmcid":"PMC4156810","title":"Anal heterosex among young people and implications for health promotion: a qualitative study in the UK","authors":"Marston C, Lewis R.","first_author":"Marston C","journal":"BMJ open","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Anal Sex","Sexual Health","Young Adults","Qualitative Research"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4156810","cited_by_count":35,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative longitudinal study with 130 participants across three sites","sample_n":130,"sample_text":"130 men and women aged 16-18 from diverse social backgrounds","population":"young people aged 16-18 in England","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 130 UK teens revealed that anal sex is often seen as painful, risky, and sometimes coerced, with pornography mentioned but not the sole cause. The authors call for better education on consent and safety.","clinical_takeaway":"Health‑promotion programs should address consent, pain reduction, and safety in anal sex among adolescents.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large, geographically diverse qualitative sample","longitudinal element adds depth to narratives","focus on under‑studied topic (anal sex among adolescents)"],"limitations":["no validated quantitative measures of behaviour or distress","lack of control for mental‑health or relational confounders","findings limited to self‑report and may not generalise beyond UK youth"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":6,"contrasting":1,"mentioning":62,"citing_publications":82,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjopen-2014-004996"}},{"id":2863,"doi":"10.1136/bmj.g4475","pmid":"25002113","pmcid":null,"title":"Internet pornography is an urgent public health issue, conference hears","authors":"Limb M.","first_author":"Limb M.","journal":"BMJ (Clinical research ed.)","year":2014,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.g4475"}},{"id":2864,"doi":"10.1186/1742-4755-11-49","pmid":"24961239","pmcid":"PMC4081458","title":"Premarital sexual practices and its predictors among in-school youths of Shendi town, west Gojjam zone, North Western Ethiopia","authors":"Bogale A, Seme A.","first_author":"Bogale A","journal":"Reproductive health","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4081458","cited_by_count":29,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 826 in‑school youths in Shendi town, Ethiopia; multistage sampling; logistic regression analysis","sample_n":826,"sample_text":"826 in‑school youths","population":"in‑school adolescents (age ~15‑20) in Ethiopia","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 826 Ethiopian students, 19% reported having sex before marriage. Watching porn, being older than 20, and living away from parents were linked to higher odds of premarital sex. The study suggests school‑based education to reduce sexual‑health risks.","clinical_takeaway":"Screening for porn exposure and living situation may help identify youths at higher risk for early sexual activity.","confidence":0.85,"topic_tags":["sexual_function","adolescents"],"strengths":["Large sample size for a school‑based survey","Multistage sampling improves representativeness within town","Uses logistic regression with confidence intervals"],"limitations":["Cross‑sectional design cannot infer causality","Key constructs (porn use, sexual behavior) measured by single self‑report items","No assessment of moral, mental‑health or partner‑related confounders"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":15,"contrasting":9,"mentioning":77,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1742-4755-11-49"}},{"id":2865,"doi":"10.1016/s1049-3867(00)00096-7","pmid":"11275511","pmcid":null,"title":"Improved use of contraceptives, attitudes toward pornography, and sexual harassment among female university students","authors":"Tydén T, Olsson S, Häggström-Nordin E.","first_author":"Tydén T","journal":"Women's health issues : official publication of the Jacobs Institute of Women's Health","year":2001,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of female university students assessing condom use, STI rates, abortion rates, sexual practices, pornography reading, and sexual harassment over 10 years","sample_n":null,"sample_text":"Not specified in abstract; likely convenience sample of students at a single university","population":"female university students in Sweden (sample size not reported in abstract)","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of Swedish female university students showed increased condom use and decreased STIs and abortions over ten years; half had read pornography, most rated oral sex positively and anal sex negatively, and 12 % reported sexual harassment.","clinical_takeaway":"None – the study describes population trends but does not inform clinical practice.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large time span (10 years) allowing observation of trends","Includes multiple sexual‑health outcomes (condom use, STIs, abortions)","Provides data on attitudes toward pornography in a female student sample"],"limitations":["Cross‑sectional, self‑report data; no causal inference","No validated scales reported for pornography attitudes","Sample likely from a single university and not described in detail"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":22,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1049-3867(00)00096-7"}},{"id":2866,"doi":"10.1111/jsm.12602","pmid":"24909396","pmcid":null,"title":"Self-reported indicators of hypersexuality and its correlates in a female online sample","authors":"Klein V, Rettenberger M, Briken P.","first_author":"Klein V","journal":"The journal of sexual medicine","year":2014,"pub_types":["Journal Article"],"keywords":["Compulsive Sexual Behavior","Sexual Addiction","Hypersexuality","Sexual Risk Behavior","Female Hypersexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":49,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 988 women, self‑report measures, logistic regression and correlations","sample_n":988,"sample_text":"online convenience sample of women (self‑selected volunteers)","population":"female, online convenience sample","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of nearly 1,000 women, higher masturbation, more sexual partners, and porn use were linked to greater scores on a hypersexuality questionnaire, and hypersexuality scores were related to higher sexual risk‑taking.","clinical_takeaway":"Higher porn use and frequent masturbation may signal elevated hypersexual behavior and sexual risk in women; consider broader assessment beyond frequency alone.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["large sample size","use of validated HBI and SSSS","separate assessment of masturbation frequency","logistic regression for associations"],"limitations":["cross‑sectional, cannot infer causality","no assessment of moral or religious attitudes","mental‑health and trauma not controlled","potential self‑selection bias"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":46,"citing_publications":132,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12602"}},{"id":2867,"doi":"10.1155/2014/753860","pmid":"25003153","pmcid":"PMC4068102","title":"Obscenity detection using haar-like features and Gentle Adaboost classifier","authors":"Mustafa R, Min Y, Zhu D.","first_author":"Mustafa R","journal":"TheScientificWorldJournal","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4068102","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"algorithm development and validation on a labeled image set","sample_n":3193,"sample_text":"1198 positive nipple images, 1995 negative images used for training/validation","population":"computer‑vision dataset of pornographic images (1198 positive, 1995 negative)","country":"unspecified (likely China/Korea based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study built a computer‑vision system that looks for nipples in images to flag pornographic material. Using Haar‑like features and a Gentle AdaBoost classifier, it correctly identified nipples in about 99% of test images, running in under a quarter of a second per picture.","clinical_takeaway":"None – the paper reports an image‑analysis tool, not a clinical finding.","confidence":0.8,"topic_tags":["pornography","neuroscience","sexual_function"],"strengths":["Large, balanced image dataset","Clear quantitative performance metrics (accuracy, speed)","Comparison of two cascade classifiers"],"limitations":["No external validation on independent datasets","No confidence intervals or statistical significance testing","Focus solely on nipples; may miss other erotic content"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":5,"confounds":0,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2014/753860"}},{"id":2868,"doi":"10.1007/s11126-013-9282-2","pmid":"24307176","pmcid":null,"title":"Greek version of the Internet Addiction Test: a validation study","authors":"Tsimtsiou Z, Haidich AB, Kokkali S, Dardavesis T, Young KS, Arvanitidou M.","first_author":"Tsimtsiou Z","journal":"The Psychiatric quarterly","year":2014,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study of a questionnaire in a convenience sample of medical students (N=151); exploratory factor analysis, reliability testing, convergent validity with self‑reported hours and specific online activities.","sample_n":151,"sample_text":"151 medical students (post‑ and under‑graduate) participated in the validation; 21 students helped with cultural adaptation.","population":"Greek adult medical students (post‑graduate and undergraduate).","country":"Greece","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The researchers translated and tested the Internet Addiction Test in Greek. In 151 medical students it showed strong reliability and identified three factors (emotional conflict, time management, work neglect). Scores were higher among those who used porn, gambling, or gaming sites.","clinical_takeaway":"The Greek IAT can be used to screen for problematic internet use, but clinicians should note its limited validation in a student sample.","confidence":0.7,"topic_tags":["measurement","pornography","sexual_function","csbd","religiosity"],"strengths":["High internal consistency (α=0.91)","Test‑retest reliability demonstrated (r=.84)","Factor analysis identified interpretable dimensions","Convergent validity with hours of use and specific online activities"],"limitations":["Convenience sample of medical students limits generalisability","No assessment of mental‑health or moral‑incongruence covariates","IAT’s definition of ‘addiction’ may be circular"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":7,"contrasting":0,"mentioning":55,"citing_publications":72,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11126-013-9282-2"}},{"id":2869,"doi":"10.1186/1742-4755-11-40","pmid":"24885739","pmcid":"PMC4068072","title":"Factors associated with pre-marital sexual debut among unmarried high school female students in bahir Dar town, Ethiopia: cross- sectional study","authors":"Mulugeta Y, Berhane Y.","first_author":"Mulugeta Y","journal":"Reproductive health","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4068072","cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1123 unmarried high‑school females selected by multistage sampling; logistic regression used to identify correlates of pre‑marital sexual debut.","sample_n":1123,"sample_text":"1123 unmarried high school female students selected by multistage sampling","population":"unmarried high‑school female students, Ethiopia","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 1123 Ethiopian high‑school girls, about 31% reported having sex before marriage. Watching pornographic videos, peer pressure, and chewing khat were strongly linked to having had sex.","clinical_takeaway":"Sexual health programs should address media exposure, peer influence, and substance use when counseling adolescents.","confidence":0.7,"topic_tags":["prevalence","sexual_function","adolescents","pornography"],"strengths":["Large sample size for a school‑based survey","Use of multivariable logistic regression with confidence intervals","Clear operational definition of sexual debut"],"limitations":["Cross‑sectional design cannot infer causality","Key exposures (porn use) measured by single, unvalidated item","No control for moral or psychological confounders"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":16,"contrasting":1,"mentioning":44,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1742-4755-11-40"}},{"id":2870,"doi":"10.1007/s00414-014-1012-2","pmid":"24838478","pmcid":null,"title":"Age estimation based on pictures and videos presumably showing child or youth pornography","authors":"Mayer F, Arent T, Geserick G, Grundmann C, Lockemann U, Riepert T, Schmeling A, Ritz-Timme S, Study Group on Forensic Age Estimation (AGFAD) of the German Association of Legal Medicine.","first_author":"Mayer F","journal":"International journal of legal medicine","year":2014,"pub_types":["Guideline","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00414-014-1012-2"}},{"id":2871,"doi":"10.1080/09612020100200611","pmid":"19678423","pmcid":null,"title":"\"Private rooms and back doors in abundance\": the illusion of privacy in pornography in seventeenth-century England","authors":"Toulalan S.","first_author":"Toulalan S.","journal":"Women's history review","year":2001,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"historical analysis without empirical data","sample_n":null,"sample_text":"None – the article is a historical commentary","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper examines 17th‑century English pornographic print, arguing that the rise of a market for such material reflected a broader cultural shift toward private, individualized consumption, while the texts themselves continually invoked a blurred line between public view and private voyeuristic pleasure.","clinical_takeaway":"None – the article is a historical discussion and does not provide clinical guidance.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Provides a historical perspective on pornography and concepts of privacy","Links changes in print culture to shifts in private consumption"],"limitations":["No empirical data or systematic methodology","Findings are interpretive and not testable"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09612020100200611"}},{"id":2872,"doi":"10.1016/j.encep.2014.01.003","pmid":"24703787","pmcid":null,"title":"[Studying dysfunctional personality trends among sex offenders]","authors":"Perrot M, Bénony H, Chahraoui K, Juif C.","first_author":"Perrot M","journal":"L'Encephale","year":2014,"pub_types":["Journal Article","English Abstract"],"keywords":["Sex Offenders","Personality Disorders","Troubles De La Personnalité","Auteurs D’infractions Sexuelles","Dysfunctional Personality Trends","Inventaire Des Tendances Dysfonctionnelles (Td-12)","Inventory Of Dysfunctional Trends (Td-12)","Tendances Dysfonctionnelles De La Personnalité"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 56 male prisoners (28 sex offenders, 28 controls) using the TD‑12 personality inventory","sample_n":56,"sample_text":"56 men (28 offenders, 28 controls)","population":"male sex offenders convicted/charged with various sexual crimes, primarily in French prison settings","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared 28 French male sex offenders with 28 non‑offender men using a new 140‑item questionnaire to assess personality disorders. Offenders showed more avoidant, dependent and depressive personality traits, but not the expected cluster‑B profiles.","clinical_takeaway":"Personality assessments may reveal avoidant and dependent traits in sex offenders, suggesting targeted psychosocial interventions.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation","csbd"],"strengths":["use of a standardized (though novel) questionnaire","inclusion of a matched non‑psychiatric control group","focus on a relatively under‑studied French offender population"],"limitations":["small sample size limits statistical power","TD‑12 not fully psychometrically validated","prison sample limits generalisability to community offenders"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.encep.2014.01.003"}},{"id":2873,"doi":"10.1111/jsm.12508","pmid":"24655732","pmcid":null,"title":"Sexual behavior and symptoms among reproductive age Chinese women in Hong Kong","authors":"Lo SS, Kok WM.","first_author":"Lo SS","journal":"The journal of sexual medicine","year":2014,"pub_types":["Journal Article","Observational Study"],"keywords":["Sexual activities","epidemiology","risk factors","Female Sexual Dysfunction","Female Sexuality"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 2,146 women attending family‑planning clinics in Hong Kong (2007‑2009).","sample_n":2146,"sample_text":"Convenience sample from family‑planning and pre‑pregnancy check‑up clinics.","population":"Sexually active Chinese women, age 21‑40, recruited from clinical settings (convenience sample).","country":"Hong Kong (China)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2014 survey of over 2,000 Chinese women in Hong Kong found that about 60% reported at least one sexual problem (low desire, arousal issues, anorgasmia, or pain). Factors like low coital frequency, limited foreplay enjoyment, and one‑sided initiation were linked to these problems.","clinical_takeaway":"Female sexual problems are common; clinicians should assess relationship dynamics and foreplay enjoyment when counseling patients.","confidence":0.6,"topic_tags":["sexual_function","prevalence","religiosity"],"strengths":["Large sample size (>2000).","Comprehensive assessment of multiple female sexual symptoms.","Uses multivariate models (log‑linear) to examine associations."],"limitations":["Convenience clinic sample limits generalisability.","Questionnaire validity not specified; likely reliance on ad‑hoc items.","No measurement or control of key psychosocial confounds (e.g., mental health, moral attitudes).","Cross‑sectional design prevents causal inference."],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":20,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12508"}},{"id":2874,"doi":"10.3390/ijerph110302846","pmid":"24619119","pmcid":"PMC3987008","title":"Male rural-to-urban migrants and risky sexual behavior: a cross-sectional study in Shanghai, China","authors":"Wu JQ, Wang KW, Zhao R, Li YY, Zhou Y, Li YR, Ji HL, Ji M.","first_author":"Wu JQ","journal":"International journal of environmental research and public health","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/11/3/2846/pdf?version=1403142534","cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 4,069 male rural‑to‑urban migrants in Shanghai; anonymous questionnaire covering demographics, knowledge, attitudes and sexual behavior","sample_n":4069,"sample_text":"4,069 subjects recruited via anonymous questionnaire in Shanghai, China","population":"Male rural‑to‑urban migrants, China, age range not specified","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 4,000 male migrants in Shanghai found that having multiple sexual partners or paying for sex was linked to being unmarried, early sexual debut, low HIV risk perception, less exposure to pornography, and certain attitudes and peer influences.","clinical_takeaway":"Risky sexual behaviors among migrants are associated with psychosocial factors; interventions should address knowledge, attitudes and peer influence rather than focusing on pornography exposure alone.","confidence":0.8,"topic_tags":["religiosity","masturbation","sexual_function","relationships","pornography"],"strengths":["large sample size for a survey","use of multivariate logistic regression with confidence intervals","covers a range of potential psychosocial determinants"],"limitations":["cross‑sectional design; cannot infer causality","key constructs measured with single‑item self‑report, no validated scales","no control for major confounds such as moral incongruence, mental health, trauma"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":17,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph110302846"}},{"id":2875,"doi":null,"pmid":"24855693","pmcid":null,"title":"Pornography. Adult film company loses Cal/OSHA appeal on condom use","authors":null,"first_author":null,"journal":"AIDS policy & law","year":2014,"pub_types":["Newspaper Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":2876,"doi":"10.1111/appy.12122","pmid":"24616402","pmcid":null,"title":"Is it meaningful to distinguish between generalized and specific Internet addiction? Evidence from a cross-cultural study from Germany, Sweden, Taiwan and China","authors":"Montag C, Bey K, Sha P, Li M, Chen YF, Liu WY, Zhu YK, Li CB, Markett S, Keiper J, Reuter M.","first_author":"Montag C","journal":"Asia-Pacific psychiatry : official journal of the Pacific Rim College of Psychiatrists","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["China","Taiwan","Germany","Sweden","Generalized And Specific Internet Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":146,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-cultural survey of 636 participants from four countries, assessing generalized Internet addiction and specific domains (gaming, shopping, social networking, pornography) via self‑report questionnaires.","sample_n":636,"sample_text":"n = 636 participants across four countries.","population":"Adults and adolescents from Germany, Sweden, Taiwan, China (mixed gender, likely convenience sampling).","country":"Germany; Sweden; Taiwan; China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 636 people in Germany, Sweden, Taiwan and China and found that problematic use of the Internet can appear as a broad‑scale issue or as specific habits like gaming, shopping, social networking, or pornography. Most specific habits were linked to the broader problem, except social networking which often stood alone.","clinical_takeaway":"Distinguish between overall Internet overuse and specific problematic activities when assessing clients.","confidence":0.7,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Large multi‑national sample","Direct comparison of generalized vs specific Internet addiction","Includes pornography as a specific domain"],"limitations":["Cross‑sectional; no causal inference","Reliance on self‑report scales, likely lacking validated pornography‑specific measure","No control for key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":22,"contrasting":0,"mentioning":168,"citing_publications":351,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/appy.12122"}},{"id":2877,"doi":"10.1016/j.forsciint.2014.01.021","pmid":"24726662","pmcid":null,"title":"Towards a method for determining age ranges from faces of juveniles on photographs","authors":"Cummaudo M, Guerzoni M, Gibelli D, Cigada A, Obertovà Z, Ratnayake M, Poppa P, Gabriel P, Ritz-Timme S, Cattaneo C.","first_author":"Cummaudo M","journal":"Forensic science international","year":2014,"pub_types":["Journal Article"],"keywords":["Age estimation","Personal identification","Child Abuse","Forensic Anthropology Population Data","Facial Landmarks","Facial Anatomy"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Large cross‑sectional study of 1,924 facial photographs from Italian children aged 3‑24; metric analysis of 23 anthropometric indices.","sample_n":1924,"sample_text":"Standardized frontal and lateral facial photographs of 1,924 individuals (1,921 lateral) aged 3‑24 years.","population":"Caucasoid Italian children, 1924 participants, both sexes, 7 age groups","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors measured dozens of facial distances on nearly 2,000 Italian children (ages 3‑24) to see which ratios grow with age. Several indices increased steadily, suggesting they could help place a photographed child into an age range for forensic identification.","clinical_takeaway":"None – the study provides a forensic tool, not a clinical recommendation.","confidence":0.7,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Very large sample for a forensic imaging study","Objective, metric facial measurements","Clear age‑group breakdown"],"limitations":["No external validation of age‑prediction model","Limited to Caucasoid Italian population","No reporting of effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.forsciint.2014.01.021"}},{"id":2879,"doi":"10.1136/bmj.g270","pmid":"24430464","pmcid":null,"title":"Cancer researcher convicted of child pornography charges is spared erasure after showing remorse","authors":"Dyer C.","first_author":"Dyer C.","journal":"BMJ (Clinical research ed.)","year":2014,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.g270"}},{"id":2880,"doi":"10.1080/00224499.2013.871626","pmid":"24754360","pmcid":"PMC4154140","title":"Gay and bisexual men's use of the Internet: research from the 1990s through 2013","authors":"Grov C, Breslow AS, Newcomb ME, Rosenberger JG, Bauermeister JA.","first_author":"Grov C","journal":"Journal of sex research","year":2014,"pub_types":["Historical Article","research-article","Review","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":191,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative historical review of Internet use among gay and bisexual men from the 1990s to 2013; no primary data collected.","sample_n":null,"sample_text":"Not applicable – article synthesizes prior literature.","population":"Gay and bisexual men in the United States (historical samples cited)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how gay and bisexual men have used the Internet for sexual purposes from the 1990s through 2013, noting shifts from dial‑up to mobile apps and the influence of HIV prevention research.","clinical_takeaway":"None – the paper is a historical overview, not providing clinical guidance.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Broad historical perspective","Integrates technological and cultural changes","Highlights research ethics and HIV prevention context"],"limitations":["No systematic review methods reported","Lacks quantitative synthesis","No explicit assessment of methodological quality of cited studies"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":6,"contrasting":3,"mentioning":231,"citing_publications":310,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2013.871626"}},{"id":2881,"doi":"10.1080/21642850.2014.902316","pmid":"25750792","pmcid":"PMC4346000","title":"Predicting Internet risks: a longitudinal panel study of gratifications-sought, Internet addiction symptoms, and social media use among children and adolescents","authors":"Leung L.","first_author":"Leung L.","journal":"Health psychology and behavioral medicine","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["Social Media","Adolescents And Children","Gratifications-sought","Internet Addiction Symptoms","Internet Risks"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4346000","cited_by_count":29,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Panel survey of 417 adolescents assessed at two time points one year apart; predictors measured at Time 1, outcomes at Time 2.","sample_n":417,"sample_text":"417 adolescents","population":"Adolescents (age unspecified), recruited via school/ community panels (assumed).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2‑year study of 417 teens, researchers found that wanting social‑media status, early signs of internet‑addiction, and using platforms like blogs and Facebook predicted higher odds of later internet risks, including exposure to pornographic or violent material.","clinical_takeaway":"Early signs of problematic internet use and specific social‑media motives may help identify youths at risk for future exposure to harmful online content.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large longitudinal sample with two waves","Controls for baseline levels of key variables","Examines multiple predictors (gratifications, use, symptoms)"],"limitations":["No measurement of moral or mental‑health confounds relevant to pornography exposure","Addiction construct not fully defined against ICD‑11 criteria","Pre‑registration and effect‑size reporting not indicated"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":77,"citing_publications":116,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/21642850.2014.902316"}},{"id":2882,"doi":"10.5604/12321966.1129932","pmid":"25528919","pmcid":null,"title":"Psychoactive substances use experience and addiction or risk of addiction among by Polish adolescents living in rural and urban areas","authors":"Pawłowska B, Zygo M, Potembska E, Kapka-Skrzypczak L, Dreher P, Kędzierski Z.","first_author":"Pawłowska B","journal":"Annals of agricultural and environmental medicine : AAEM","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.aaem.pl/pdf-72196-9423?filename=Psychoactive substances.pdf","cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,860 Polish adolescents (urban and rural) using author‑designed questionnaires and established internet‑addiction scales","sample_n":1860,"sample_text":"1,860 adolescents (1,320 girls, 540 boys), mean age 17","population":"Polish adolescents (average age 17), both sexes, urban and rural schools","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"Polish teens who use illegal drugs are more likely to show internet‑addiction symptoms and to report using web pornography, with urban youth using drugs more often than rural peers.","clinical_takeaway":"Screening for problematic internet and pornography use may be warranted among adolescents who use psychoactive substances.","confidence":0.7,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Large sample size","Includes both urban and rural participants","Uses several established internet‑addiction questionnaires"],"limitations":["Cross‑sectional design, no causal inference","Psychiatric and moral confounds not measured","Pornography use not operationally defined or measured separately from internet use"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5604/12321966.1129932"}},{"id":2884,"doi":"10.1097/jfn.0000000000000017","pmid":"24434946","pmcid":null,"title":"Video gaming and sexual violence: rethinking forensic nursing in a digital age","authors":"Mercer D, Parkinson D.","first_author":"Mercer D","journal":"Journal of forensic nursing","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"discourse analytic qualitative study with semistructured interviews of forensic nurses and male sexual offenders in a UK high‑security hospital","sample_n":null,"sample_text":"Qualitative interviews; sample size not disclosed in abstract","population":"forensic nurses and male personality‑disordered sexual offenders (N not reported)","country":"England","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined how forensic nurses and male sexual offenders in a UK high‑security hospital talk about pornography, finding that masculine, risk‑focused language shapes definitions and may overlook modern digital sexual media.","clinical_takeaway":"Clinicians should be aware that institutional discourse can frame pornography in ways that may miss contemporary digital contexts.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["In‑depth qualitative insight into professional discourse","Focus on institutional language and risk management"],"limitations":["Small, non‑representative sample from a single high‑security hospital","No validated measures of pornography use or related constructs","Lacks assessment of key confounds (moral incongruence, masturbation, mental health, etc.)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/jfn.0000000000000017"}},{"id":2885,"doi":"10.1080/00918369.2014.870446","pmid":"24294885","pmcid":null,"title":"On the affective force of \"nasty love\"","authors":"Steinbock E.","first_author":"Steinbock E.","journal":"Journal of homosexuality","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"commentary","design_detail":"The paper is a theoretical, philosophical discussion with no empirical data, sample, or methods reported.","sample_n":null,"sample_text":"none","population":"not applicable","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that trans pornography and personal narratives reveal a distinct affective dimension of sexuality, described as \"nasty love,\" which expands the sense of self beyond traditional gendered theories.","clinical_takeaway":"None - not clinically applicable.","confidence":0.3,"topic_tags":["pornography","gender","sexual_function"],"strengths":["Engages with contemporary trans scholarship","Introduces affect theory to pornography studies","Interdisciplinary use of process philosophy"],"limitations":["No empirical data or systematic analysis","Lacks operational definitions of key constructs","No methodological rigor to assess claims"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2014.870446"}},{"id":2886,"doi":"10.2174/13816128113199990619","pmid":"24001295","pmcid":null,"title":"Sexual addiction or hypersexual disorder: different terms for the same problem? A review of the literature","authors":"Karila L, Wéry A, Weinstein A, Cottencin O, Petit A, Reynaud M, Billieux J.","first_author":"Karila L","journal":"Current pharmaceutical design","year":2014,"pub_types":["Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":78,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Narrative systematic review of literature on sexual addiction/hypersexual disorder and its measurement instruments.","sample_n":null,"sample_text":"Review of existing studies; no primary sample.","population":"Not applicable (review of published studies)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"supports","citation_value":"useful","plain_summary":"The review summarises research on sexual addiction/hypersexual disorder, describing its symptoms, prevalence (3‑6%), related behaviours (porn, masturbation, cybersex) and available questionnaires, and suggests combined medication and psychotherapy as treatment.","clinical_takeaway":"Clinicians should be aware that many self‑report tools exist for sexual addiction, but their validity varies and diagnostic criteria remain debated.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad overview of existing measurement tools","Highlights clinical relevance and treatment approaches","Identifies prevalence range across studies"],"limitations":["No quantitative synthesis or meta‑analysis","Lacks systematic risk‑of‑bias assessment of included studies","Does not address key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":3,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":131,"citing_publications":255,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2174/13816128113199990619"}},{"id":2887,"doi":"10.1186/1471-2458-13-1152","pmid":"24321180","pmcid":"PMC3903055","title":"Unmarried male migrants and sexual risk behavior: a cross-sectional study in Shanghai, China","authors":"Wang KW, Wu JQ, Zhao HX, Li YY, Zhao R, Zhou Y, Ji HL.","first_author":"Wang KW","journal":"BMC public health","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3903055","cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 2254 unmarried male migrants in Shanghai","sample_n":2254,"sample_text":"2254 participants, 91.3% response rate","population":"unmarried male migrant workers, Shanghai, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 2,254 unmarried male migrants in Shanghai found that many engaged in unprotected sex and that frequent exposure to pornography was linked to sexual risk behaviours. The authors suggest stronger sex‑health education for this group.","clinical_takeaway":"Targeted education on condom use and sexual health is needed for unmarried migrant men, especially those with high porn exposure.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size","Clear operational definition of sexual risk behavior","Multivariate logistic regression with confidence intervals"],"limitations":["Cross‑sectional design limits causal inference","Pornography exposure measured by single self‑report item","Key confounds (morality, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":2,"mentioning":27,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2458-13-1152"}},{"id":2888,"doi":"10.3109/10826084.2013.858168","pmid":"24304172","pmcid":null,"title":"A study of multiple behavioral addictions in a substance abuse sample","authors":"Najavits L, Lung J, Froias A, Paull N, Bailey G.","first_author":"Najavits L","journal":"Substance use & misuse","year":2014,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 51 individuals in a substance‑abuse treatment program; self‑report Behavioral Addictions Screen administered by telephone.","sample_n":51,"sample_text":"n = 51; data collection 2011‑2012; substance‑abuse program participants.","population":"Adults receiving substance‑use treatment (mixed gender, ethnicity).","country":"USA (likely, based on author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small sample of people in drug‑treatment programs, most reported at least one ‘behavioral addiction’ such as shopping, eating, internet use or sex/pornography. The study used a brief self‑report screen and found links with depression and PTSD.","clinical_takeaway":"Clinicians should note that self‑reported problematic pornography use often co‑occurs with other issues, but current screening tools lack validation.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Large proportion of participants reported multiple BAs.","Includes depression and PTSD screens as covariates."],"limitations":["Small, non‑representative sample of substance‑abuse patients.","Addiction screen not validated; possible circular definition.","No control for moral/religious factors or masturbation behavior."],"rubric_version":"2.0","raw_total":20,"max_possible":60,"pct_score":33,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":28,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/10826084.2013.858168"}},{"id":2889,"doi":"10.1016/j.annder.2013.10.041","pmid":"24507206","pmcid":null,"title":"[Sexually transmitted diseases and other risks in the adult film industry]","authors":"Kluger N.","first_author":"Kluger N.","journal":"Annales de dermatologie et de venereologie","year":2014,"pub_types":["Review","Journal Article"],"keywords":["HIV","Urethritis","Sexually transmitted disease","Condom","Gonorrhoea","Vih","Pornographie","Infection Sexuellement Transmissible","Préservatif","Pornography","Adult Film Industry","Chlamydiasis","Chlamydiose","Gonococcie","Industrie Du Film Adulte","Urétrite"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review (non-systematic) without explicit methodology","sample_n":null,"sample_text":"none (review)","population":"adult film performers (no primary data)","country":"United States, Brazil (mentioned)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews known sexually transmitted disease risks and other health concerns for people working in the adult film industry, highlighting that STDs remain common because many productions do not use condoms.","clinical_takeaway":"Clinicians working with adult performers should be aware of ongoing STD risks despite screening programs and discuss condom use and regular testing.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad overview of documented STD risks in adult film industry","Covers both physical and mental health issues","Cites existing surveillance and screening data"],"limitations":["Narrative, not systematic, review – no explicit search or bias assessment","No quantitative synthesis or meta‑analysis","Lacks discussion of potential confounders such as condom use policies across regions"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.annder.2013.10.041"}},{"id":2890,"doi":"10.1891/0886-6708.15.3.227","pmid":"11200099","pmcid":null,"title":"Exploring the connection between pornography and sexual violence","authors":"Bergen RK, Bogle KA.","first_author":"Bergen RK","journal":"Violence and victims","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"cross-sectional","design_detail":"Data collected from 100 women at a rape‑crisis centre; descriptive survey about whether their abuser used pornography and whether the abuse mimicked pornographic material.","sample_n":100,"sample_text":"100 survivors recruited through a rape‑crisis centre (convenience sample).","population":"Female sexual‑assault survivors (self‑selected, treatment‑seeking sample)","country":"USA (assumed based on journal and author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 100 women who sought help after sexual assault, 28% said their attacker used pornography and 12% said the assault copied porn scenes. The authors discuss how porn may relate to sexual violence.","clinical_takeaway":"Evidence that some assaults involve pornographic material, but findings are based on self‑report from a selective survivor sample and cannot establish causality.","confidence":0.3,"topic_tags":["pornography","sexual_function"],"strengths":["Focused on a vulnerable, under‑studied population","Provides concrete prevalence figures from survivor reports"],"limitations":["Convenience sample from crisis centre limits generalisability","Reliance on single‑item, unvalidated self‑report measures","No control for confounding variables (e.g., prior trauma, mental health)","Causal language used despite cross‑sectional design"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":3,"contrasting":0,"mentioning":27,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1891/0886-6708.15.3.227"}},{"id":2891,"doi":"10.1080/10532528.2000.10559784","pmid":"11351835","pmcid":null,"title":"Pornography and sexual aggression: are there reliable effects and can we understand them?","authors":"Malamuth NM, Addison T, Koss M.","first_author":"Malamuth NM","journal":"Annual review of sex research","year":2000,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":116,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"large representative sample referenced but not described","population":"adult men, unspecified sample","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The review argues that frequent pornography use, especially violent material, is linked to higher rates of sexual aggression in men, based on meta‑analyses and a large sample, but does not provide new experimental data.","clinical_takeaway":"None – the article does not provide direct clinical guidance.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Integrates multiple meta‑analyses","Large representative dataset referenced"],"limitations":["Lacks systematic review methodology","No explicit control for key confounds","Potential over‑statement of causal inference"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":2,"mentioning":17,"citing_publications":402,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10532528.2000.10559784"}},{"id":2892,"doi":"10.3109/hrp.7.4.236","pmid":"10579105","pmcid":null,"title":"No excuses: televised pornography harms children","authors":"Benedek EP, Brown CF.","first_author":"Benedek EP","journal":"Harvard review of psychiatry","year":1999,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary without empirical data; no sample, no methods.","sample_n":null,"sample_text":"None (no empirical sample)","population":"Children (theoretical discussion)","country":"United States (implied by context)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The authors argue that televised pornography can harm children, especially those in vulnerable situations, by promoting risky sexual attitudes and causing emotional distress. They call for more research and policy discussion.","clinical_takeaway":"None – the article is a commentary without actionable clinical evidence.","confidence":0.8,"topic_tags":["pornography","csbd","sexual_function"],"strengths":["Highlights ethical concerns","Identifies vulnerable populations"],"limitations":["No empirical data presented","Claims are speculative"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/hrp.7.4.236"}},{"id":2893,"doi":"10.1136/bmj.f5764","pmid":"24062189","pmcid":null,"title":"Better sex education for children is needed to combat dangers of pornography","authors":"Laws I.","first_author":"Laws I.","journal":"BMJ (Clinical research ed.)","year":2013,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.f5764"}},{"id":2894,"doi":"10.1093/her/cyt081","pmid":"23969629","pmcid":null,"title":"Ecological factors influencing HIV sexual risk and resilience among young people in rural Kenya: implications for prevention","authors":"Harper GW, Riplinger AJ, Neubauer LC, Murphy AG, Velcoff J, Bangi AK.","first_author":"Harper GW","journal":"Health education research","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative focus‑group study (9 groups, N=199) exploring participants’ views on ecological factors influencing HIV risk and resilience in rural Kenya.","sample_n":199,"sample_text":"199 participants across nine focus groups","population":"young people aged 14‑24 years living in rural Kenyan communities (both sexes).","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Focus groups with 199 Kenyan youths identified personal, relational, community and cultural factors—like substance use, peer pressure, pornography exposure and gender norms—that shape HIV risk and resilience, and suggested community‑based prevention ideas.","clinical_takeaway":"Community‑driven, multi‑level programs addressing knowledge, economic opportunities and stigma may better support HIV prevention among rural Kenyan youth.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large qualitative sample for the context","Multi‑level ecological framework applied","Inclusion of both sexes and a wide age range"],"limitations":["No quantitative measurement of constructs","Findings limited to self‑reported perceptions","Limited generalisability beyond rural Kenyan youth"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/her/cyt081"}},{"id":2895,"doi":"10.3389/fped.2013.00018","pmid":"24400264","pmcid":"PMC3860885","title":"Positive youth development, life satisfaction, and problem behaviors of adolescents in intact and non-intact families in Hong Kong","authors":"Shek DT, Leung H.","first_author":"Shek DT","journal":"Frontiers in pediatrics","year":2013,"pub_types":["research-article","Journal Article"],"keywords":["Risk behavior","Life Satisfaction","Positive Youth Development","Chinese Adolescents","Intact Families","Non-intact Families"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3860885","cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 3,328 secondary school students in Hong Kong","sample_n":3328,"sample_text":"Secondary 1 students from intact and non‑intact families","population":"Chinese adolescents, secondary 1 (about age 12‑13)","country":"Hong Kong","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Hong Kong secondary students, those from intact families reported higher life satisfaction and better development, while those from non‑intact families showed more risk behaviours, including higher use of pornographic material.","clinical_takeaway":"Family stability appears linked to lower adolescent engagement in risky behaviours, including porn use.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample size (>3000)","Separate assessment of multiple risk behaviours","Includes both family structure and positive development outcomes"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral, mental‑health or relationship confounds","Pornography use assessed only as a binary/frequency item"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":21,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fped.2013.00018"}},{"id":2896,"doi":"10.1016/j.jadohealth.2013.06.010","pmid":"23890773","pmcid":null,"title":"Are crimes by online predators different from crimes by sex offenders who know youth in-person?","authors":"Wolak J, Finkelhor D.","first_author":"Wolak J","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2013,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Child Sexual Abuse","Internet-related Sex Crime","Nonforcible Sexual Offense","Statutory Rape"],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational analysis of law‑enforcement case data (n≈282 offenders) comparing online‑meeting vs know‑in‑person/online offenders.","sample_n":282,"sample_text":"National sample of law‑enforcement agencies (2,653 agencies) yielded 143 online‑meeting offenders and 139 know‑in‑person/online offenders.","population":"Sex offenders arrested for Internet‑related crimes against minors in the United States (2009).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men who first met a child online with those who already knew the child offline but also used the Internet. Both groups mainly committed statutory rape or non‑contact offenses, and their crimes were not substantially different.","clinical_takeaway":"Prevention should stress that any adult sexual contact with a minor, online or offline, is illegal, regardless of how the offender met the youth.","confidence":0.8,"topic_tags":["sexual_function","gender","religiosity","adolescents"],"strengths":["Large, nationwide sample of law‑enforcement agencies.","Direct case detail obtained from investigators.","Comparison of two clearly defined offender groups."],"limitations":["Cross‑sectional, descriptive design; no causal inference.","Reliance on investigator reports; potential reporting bias.","No measurement of victim‑level or psychosocial variables."],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":44,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2013.06.010"}},{"id":2898,"doi":"10.1037/a0030904","pmid":"24073356","pmcid":"PMC3780450","title":"Prospective Predictors of Technology-Based Sexual Coercion by College Males","authors":"Thompson MP, Morrison DJ.","first_author":"Thompson MP","journal":"Psychology of violence","year":2013,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Aggression","Sexual Coercion","Prospective Design","Cyber Aggression","Technology-based Sexual Coercion"],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort of 800 college males with baseline predictors and follow‑up assessment of technology‑based sexual coercion (TBC)","sample_n":800,"sample_text":"800 male college students","population":"college males (N=800)","country":"United States (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A study of 800 college men followed over time found that beliefs supporting rape, peer approval of forced sex, having many sexual partners, watching pornography, and involvement in student government predicted later technology‑based sexual coercion.","clinical_takeaway":"Interventions targeting rape‑supportive beliefs and peer norms may help prevent technology‑based sexual coercion among college males.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large prospective sample (N=800)","multivariate analysis identifies independent predictors","ecological‑level approach covering individual to community factors"],"limitations":["constructs not described as using validated scales","no pre‑registration or effect‑size reporting","self‑report data may be subject to bias"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":54,"citing_publications":73,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/a0030904"}},{"id":2899,"doi":"10.1037/a0033326","pmid":"23815115","pmcid":null,"title":"Is pedophilic sexual preference continuous? A taxometric analysis based on direct and indirect measures","authors":"Schmidt AF, Mokros A, Banse R.","first_author":"Schmidt AF","journal":"Psychological assessment","year":2013,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":48,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative taxometric analysis using a multimethod assessment battery (direct self‑report, IAT, viewing time) in a mixed sample of adult men (offenders and controls).","sample_n":304,"sample_text":"Mixed sample of adult men (N = 304) including sex offenders against children, sex offenders against adults, and controls who were either non‑sexual offenders or non‑offenders.","population":"Adult men (N=304) including child‑sex offenders, adult‑sex offenders, non‑sexual offenders and non‑offenders.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether a preference for children forms a distinct group among adult men, using self‑reports, reaction‑time tests, and viewing‑time tasks. About a quarter of child‑offenders clustered together, supporting the idea that pedophilic preference can be a separate, taxonic construct.","clinical_takeaway":"Findings suggest pedophilic preference may constitute a distinct clinical category, but the cross‑sectional nature limits direct treatment implications.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large mixed sample with offenders and controls","Use of multiple measurement modalities (self‑report, IAT, viewing time)","Application of taxometric methods to test latent class hypothesis"],"limitations":["Cross‑sectional design; cannot infer causality","Limited description of psychometric validation for indirect measures","Potential selection bias in offender sample"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":2,"mentioning":80,"citing_publications":119,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/a0033326"}},{"id":2900,"doi":"10.1111/sjop.12059","pmid":"23786657","pmcid":null,"title":"Prevalence and associated factors of poly-victimization in Chinese adolescents","authors":"Dong F, Cao F, Cheng P, Cui N, Li Y.","first_author":"Dong F","journal":"Scandinavian journal of psychology","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Children","Adolescents","Abuse","Victim","Poly-victimization"],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Stratified cluster sample of 3,155 Chinese adolescents (12-18 years) with self‑administered questionnaire assessing victimisation, anxiety, depression and exposure to pornography. Logistic regression used to identify associated factors.","sample_n":3155,"sample_text":"Stratified cluster sample of 1,561 females and 1,594 males aged 12‑18 years.","population":"Adolescents (12‑18) in Shandong Province, China (N≈3,155).","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large survey of Chinese teens, 17% experienced multiple forms of victimisation. Those who had been exposed to pornography were more likely to report poly‑victimisation, along with smoking, drinking, anxiety and depression.","clinical_takeaway":"Exposure to pornography co‑occurs with other risk factors for victimisation but does not prove a causal link; clinicians should assess multiple psychosocial factors.","confidence":0.85,"topic_tags":["adolescents","sexual_function","pornography","moral_incongruence"],"strengths":["Large, stratified community sample","Validated instruments for victimisation, anxiety and depression","Multivariate logistic regression to control multiple covariates"],"limitations":["Cross‑sectional; cannot infer causality","Exposure to pornography assessed by a single self‑report item","No measurement of moral or religious attitudes that could affect reporting"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":6,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":11,"contrasting":5,"mentioning":58,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/sjop.12059"}},{"id":2901,"doi":"10.1016/j.purol.2013.03.015","pmid":"23830278","pmcid":null,"title":"[Societal evolution of sexuality]","authors":"Cour F.","first_author":"Cour F.","journal":"Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie","year":2013,"pub_types":["Journal Article","English Abstract"],"keywords":["Sexuality","Social Networks","Sexual Addiction","Sexualité","Addiction Sexuelle","Cybersex","Cybersexe","Réseaux Sociaux"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative synthesis of existing literature; no original data collected.","sample_n":null,"sample_text":"No participants; the article is a synthesis of published works.","population":"Not applicable (no empirical sample).","country":"France (journal of French urology association).","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how social media and internet use have changed sexual relationships, suggesting that easy access to online porn may foster excessive or ‘cyber‑addictive’ behaviours that could affect real‑life intimacy.","clinical_takeaway":"Therapists should consider broader societal shifts when treating sexual concerns, but no specific evidence‑based guidance is provided.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Broad literature overview","Highlights societal trends"],"limitations":["No original data or systematic methodology","Lacks operational definitions of ‘cyber addiction’","No measurement of key confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.purol.2013.03.015"}},{"id":2903,"doi":"10.1089/cpb.1999.2.175","pmid":"19178236","pmcid":null,"title":"Internet gambling and pornography: illustrative examples of the psychological consequences of communication anarchy","authors":"King SA.","first_author":"King SA.","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":1999,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"none (article is a narrative commentary)","population":"general public (no sample)","country":"USA (journal based)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The author argues that the internet’s easy access to gambling and porn may lead to more people needing treatment, but notes that there is currently little research on how common or harmful these behaviors are.","clinical_takeaway":"Currently no evidence‑based guidance; more research needed before clinical recommendations.","confidence":0.8,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Highlights a gap in empirical research","Raises public health concerns"],"limitations":["No empirical data or systematic review","Speculative assertions without evidence","No measurement of key constructs or confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":81,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cpb.1999.2.175"}},{"id":2904,"doi":"10.1016/s0968-8080(13)41696-8","pmid":"23684190","pmcid":null,"title":"Contextualising sexual harassment of adolescent girls in Bangladesh","authors":"Nahar P, van Reeuwijk M, Reis R.","first_author":"Nahar P","journal":"Reproductive health matters","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups, key informant interviews, observation with adolescent participants in Bangladesh","sample_n":null,"sample_text":"not reported in abstract","population":"Bangladeshi adolescent girls (12‑18 y) and boys (informants)","country":"Bangladesh","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Bangladeshi teenage girls report that \"eve teasing\"—harassment by boys—is rooted in cultural gender norms and easy access to sexual media, leaving girls feeling unsafe and blamed.","clinical_takeaway":"Comprehensive sexuality education that tackles gender norms may reduce harassment and improve safety for adolescent girls.","confidence":0.7,"topic_tags":["sexual_function","gender","adolescents"],"strengths":["In‑depth, participatory qualitative approach","Contextualises harassment within cultural norms","Highlights link to media exposure and gender inequality"],"limitations":["No quantitative measurement or validated scales","Small, non‑representative convenience sample","Limited generalisability beyond study sites"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":62,"citing_publications":78,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0968-8080(13)41696-8"}},{"id":2905,"doi":"10.1111/1556-4029.12082","pmid":"23601131","pmcid":null,"title":"Developing software to estimate age in child pornography images for forensic purposes: relevance and limitations in psychocriminology","authors":"Prat S, Bertsch I, Chudzik L, Réveillère C.","first_author":"Prat S","journal":"Journal of forensic sciences","year":2013,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1556-4029.12082"}},{"id":2906,"doi":"10.1007/s12098-013-1025-8","pmid":"23604612","pmcid":null,"title":"Correlates of sex initiation among school going adolescents in Pune, India","authors":"Sahay S, Nirmalkar A, Sane S, Verma A, Reddy S, Mehendale S.","first_author":"Sahay S","journal":"Indian journal of pediatrics","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-control analysis within a cross‑sectional school survey (N=910, 41 cases, 164 matched controls)","sample_n":910,"sample_text":"41 cases of ever‑had‑sex, 164 matched controls","population":"school‑going adolescents in Pune, India (age unspecified)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 910 Indian adolescents, those who accessed pornography, had poor parental relationships, or reported STD symptoms were more likely to have started having sex. The authors suggest school‑based sexual‑health programs are needed.","clinical_takeaway":"Screen adolescents for pornography use and family relationship issues as part of comprehensive sexual‑health education.","confidence":0.7,"topic_tags":["adolescents","sexual_function","religiosity","moral_incongruence"],"strengths":["Large overall sample (N=910)","Matched case‑control design for key demographic variables","Use of conditional logistic regression"],"limitations":["Key constructs (e.g., pornography use) measured with ad‑hoc items","No validated scales for sexual health or psychological variables","Limited control of potential confounds (e.g., moral attitudes, mental health)","Small number of cases (n=41) may limit power"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":27,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12098-013-1025-8"}},{"id":2907,"doi":"10.1186/1742-4755-10-22","pmid":"23577856","pmcid":"PMC3639093","title":"Exploring urban male non-marital sexual behaviours in Pakistan","authors":"Mir AM, Wajid A, Pearson S, Khan M, Masood I.","first_author":"Mir AM","journal":"Reproductive health","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://reproductive-health-journal.biomedcentral.com/track/pdf/10.1186/1742-4755-10-22","cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"multistage systematic sampling of 2400 urban men, cross‑sectional questionnaire","sample_n":2400,"sample_text":"multistage systematic sampling design, 2400 participants","population":"urban men aged 16‑45 in six Pakistani cities (N=2400)","country":"Pakistan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2013 survey of 2,400 urban Pakistani men found that about one‑third had non‑marital sex, and 2.6 % had sex exclusively with men. Younger age, low education, unemployment, migration and viewing porn were linked to these behaviours.","clinical_takeaway":"Screening for non‑marital sexual activity should consider socioeconomic factors and porn exposure when planning STI prevention in this setting.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, systematically sampled urban male population","Multivariable analysis with adjusted odds ratios and confidence intervals","Relevant public‑health focus on STI prevention"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report; no validated scales for sexual behaviour or porn use","Key psychosocial confounds (moral views, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1742-4755-10-22"}},{"id":2908,"doi":"10.1111/jsm.12160","pmid":"23578375","pmcid":null,"title":"Hypersexual behavior in an online sample of males: associations with personal distress and functional impairment","authors":"Spenhoff M, Kruger TH, Hartmann U, Kobs J.","first_author":"Spenhoff M","journal":"The journal of sexual medicine","year":2013,"pub_types":["Journal Article"],"keywords":["Sexual Addiction","Hypersexuality","Sexual Compulsivity","Sexual Impulsivity","Hypersexual Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of self‑identified male “sex addicts”, N=349, cross‑sectional convenience sample","sample_n":349,"sample_text":"Community online sample of self‑identified “sex addicts”; not a probability sample","population":"adult males, community sample recruited via online ads, self‑identified hypersexual/sex‑addicted","country":"unspecified (likely Germany/Austria based on authors)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 349 men who called themselves sex addicts, most reported feeling distressed and having problems in areas like relationships. Distress was linked to pornography use, masturbation and changing partners, but not to how much time they spent on sexual activities.","clinical_takeaway":"Distress and relationship problems are common among men reporting hypersexual behavior, but the sample is highly self‑selected and not representative.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Uses validated SAST‑R screening instrument","Large sample for an online survey (N>300)","Examines functional impairment across multiple life domains"],"limitations":["Self‑selected, self‑identified “sex addict” sample limits generalisability","No measurement or control of moral incongruence, mental health, or trauma","Reliance on simple chi‑square tests; no effect sizes or correction for multiple testing"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":39,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12160"}},{"id":2909,"doi":"10.1111/1556-4029.12086","pmid":"23527793","pmcid":null,"title":"Comparing sexuality, aggressiveness, and antisocial behavior of alleged juvenile sexual and violent offenders","authors":"Driemeyer W, Spehr A, Yoon D, Richter-Appelt H, Briken P.","first_author":"Driemeyer W","journal":"Journal of forensic sciences","year":2013,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of 32 alleged juvenile sexual offenders and 32 juvenile non‑sexual violent offenders referred by police; standardized questionnaires on aggression, psychopathology, antisocial behavior, substance use, and sexuality.","sample_n":64,"sample_text":"32 ASO, 32 VNO","population":"Male adolescents referred for alleged sexual or violent offenses (N=64)","country":"Germany (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared 32 teenage boys accused of sexual offenses with 32 accused of other violent crimes, finding that the sexual offenders showed less overall aggression and antisocial behavior but reported more sexual deviance and less pornography use.","clinical_takeaway":"Juvenile sexual offenders may not have heightened aggression or substance issues; interventions should consider their distinct sexual‑deviance profile.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of standardized questionnaires","Direct comparison of sexual vs. violent juvenile offenders","Focus on pre‑court, pre‑treatment sample"],"limitations":["Small sample per group, limiting power","Convenience sample of police‑referred youth, not generalizable","No control for key confounds (e.g., moral incongruence, trauma)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":14,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1556-4029.12086"}},{"id":2910,"doi":"10.1007/s10964-013-9936-2","pmid":"23526207","pmcid":null,"title":"Toward a conceptual model of motive and self-control in cyber-aggression: rage, revenge, reward, and recreation","authors":"Runions KC.","first_author":"Runions KC.","journal":"Journal of youth and adolescence","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":41,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"The article proposes a theoretical model of cyber‑aggression motives and self‑control; it does not present original empirical data.","sample_n":null,"sample_text":"None – no participants were recruited.","population":"Adolescents (theoretical focus)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper offers a new conceptual model explaining why teenagers may act aggressively online, emphasizing motives like anger, revenge, reward, and recreation, and how features of the internet (e.g., anonymity, cue permanence) can trigger these motives.","clinical_takeaway":"None – the article is theoretical and does not provide clinical guidance.","confidence":0.4,"topic_tags":["adolescents","csbd","pornography"],"strengths":["Integrates multiple aggression theories","Identifies distinct online affordances","Highlights future research directions"],"limitations":["No empirical data presented","Constructs not operationalised or measured","No assessment of confounding variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":9,"contrasting":0,"mentioning":96,"citing_publications":156,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10964-013-9936-2"}},{"id":2911,"doi":"10.1177/1079063213480817","pmid":"23524323","pmcid":null,"title":"Direct and indirect measures of sexual maturity preferences differentiate subtypes of child sexual abusers","authors":"Schmidt AF, Gykiere K, Vanhoeck K, Mann RE, Banse R.","first_author":"Schmidt AF","journal":"Sexual abuse : a journal of research and treatment","year":2014,"pub_types":["Journal Article"],"keywords":["Implicit Association Test","Antisociality","Deviant Sexual Interest","Sexual Fantasy","Viewing Time"],"is_oa":false,"oa_url":"http://orbilu.uni.lu/handle/10993/17955","cited_by_count":27,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional assessment of sexual interest using self‑report, viewing‑time, IAT and phallometric comparison in a sample of child sexual abusers (intrafamilial, extrafamilial, pornography offenders).","sample_n":null,"sample_text":"Not reported in abstract; likely a convenience sample of sentenced offenders.","population":"adult male sexual offenders (intracommunity, extrafamily, and child‑pornography offenders)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compares self‑report, reaction‑time, and brain‑activity‑free tests to measure sexual interest in children among different types of offenders, finding that these measures distinguish subgroups and relate to re‑offending risk.","clinical_takeaway":"The EISIP tool may help risk assessment for child sexual abusers, but findings are based on offender samples and may not apply to the general population.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Multimethod assessment (self‑report, viewing time, IAT, phallometry)","Links deviant interest measures to recidivism risk"],"limitations":["Convenience offender sample limits generalisability","No pre‑registration or power analysis reported","Potential lack of control for relevant psychosocial confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":1,"mentioning":55,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063213480817"}},{"id":2912,"doi":"10.1017/s0021932013000047","pmid":"23458913","pmcid":null,"title":"Factors associated with high-risk behaviour among migrants in the state of maharashtra, India","authors":"Rao N, Jeyaseelan L, Joy A, Kumar VS, Thenmozhi M, Acharya S.","first_author":"Rao N","journal":"Journal of biosocial science","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 4595 single in‑migrants aged 15‑49 in Maharashtra, India; logistic regression used to examine factors associated with inconsistent condom use","sample_n":4595,"sample_text":"4595 single in‑migrants aged 15‑49 y recruited in 2009 using a structured interview schedule","population":"single male in‑migrants, 15‑49 y, Maharashtra, India (N = 4595)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2009 survey of 4,595 Indian male migrants found that watching pornographic films, along with older age, low literacy, mobility, and alcohol use, were linked to having sex without a condom.","clinical_takeaway":"Clinicians should consider porn use as one of many risk factors for unsafe sex among migrant men, but evidence is correlational only.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a migrant survey","Use of multivariate logistic regression","Inclusion of multiple socio‑demographic variables"],"limitations":["Self‑report measures, no validated scales","Cross‑sectional design, cannot infer causality","Key sexual‑health confounds (e.g., moral incongruence, masturbation) not assessed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0021932013000047"}},{"id":2913,"doi":null,"pmid":"23697245","pmcid":null,"title":"Parents' attitudes on sexual education--what and when?","authors":"Janković S, Malatestinić G, Striehl HB.","first_author":"Janković S","journal":"Collegium antropologicum","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 1,673 parents of sixth‑grade pupils in 23 elementary schools (Croatia); descriptive frequencies of topics deemed appropriate/inappropriate for school sexual education.","sample_n":1673,"sample_text":"Parents of sixth‑grade pupils in Rijeka, Croatia (23 schools).","population":"Parents of elementary school children (mostly mothers and fathers).","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 1,673 parents in Croatia asked what sexual‑education topics they think should be taught at different school ages. Most support basic anatomy teaching early, but only 5‑8% think topics like pleasure, masturbation, pornography or prostitution are appropriate for school lessons.","clinical_takeaway":"When designing school sex‑education, consider that many parents find explicit topics such as pornography and masturbation unsuitable for younger grades.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample of parents (n>1600)","Specific focus on parental attitudes toward sexual‑education content","Provides concrete percentages for topics considered inappropriate"],"limitations":["No validated attitude scale; single‑item measures","Cross‑sectional, cannot infer changes over time","Limited to one city; not nationally representative"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":2914,"doi":"10.1177/0886260512471084","pmid":"23300197","pmcid":null,"title":"Journey \"during\" crime: predicting criminal mobility patterns in sexual assaults","authors":"Beauregard E, Busina I.","first_author":"Beauregard E","journal":"Journal of interpersonal violence","year":2013,"pub_types":["Journal Article"],"keywords":["Sexual Assault","Criminal Event","Criminal Mobility","Journey To Crime","Serial Sex Offenders"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective analysis of police files and interviews with 72 serial sex offenders (361 assaults); negative binomial regression.","sample_n":72,"sample_text":"72 offenders, 361 assaults","population":"Serial sexual offenders identified by police; not representative of general population.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Based on police files and interviews with 72 serial sex offenders, the study found that assaults involving child victims, no pornography use before the crime, or victim resistance were linked to offenders traveling farther during the assault.","clinical_takeaway":"None – the study concerns offender behavior, not client sexual health.","confidence":0.71,"topic_tags":["sexual_function"],"strengths":["Uses real police and interview data","Applies appropriate regression model for count data"],"limitations":["Small, non‑representative offender sample","No validated measures for key constructs","Cross‑sectional design limits causal claims"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260512471084"}},{"id":2915,"doi":"10.1515/ijamh-2013-0032","pmid":"23612589","pmcid":null,"title":"Developmental issues of university students in Hong Kong","authors":"Shek DT, Cheung BP.","first_author":"Shek DT","journal":"International journal of adolescent medicine and health","year":2013,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review covering multiple developmental issues; no empirical data, no systematic methods reported.","sample_n":null,"sample_text":"Not applicable – review article","population":"University students in Hong Kong (general description, no sample size)","country":"Hong Kong","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews several developmental challenges faced by Hong Kong university students, noting that internet use can include cyber‑pornography alongside issues like alcohol, sleep problems and mental health concerns.","clinical_takeaway":"None – the article does not provide actionable clinical guidance on pornography or sexual health.","confidence":0.4,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Broad overview of university student development issues","Highlights multiple domains (behaviour, mental health, self‑determination, societal connection)"],"limitations":["No systematic methodology or risk‑of‑bias assessment","No primary data; conclusions are based on secondary sources","Cyber‑pornography mentioned only in passing, not examined in depth"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/ijamh-2013-0032"}},{"id":2916,"doi":"10.1080/10894160.2013.731865","pmid":"23855939","pmcid":null,"title":"Remediating politics: brand(ed) new sexualities and real bodies online","authors":"Fotopoulou A.","first_author":"Fotopoulou A.","journal":"Journal of lesbian studies","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"qualitative commentary analyzing two porn production company websites from a queer/feminist perspective; no empirical data collected.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article examines how two porn sites use branding, claims of authenticity, and diversity to shape queer and feminist politics online, arguing that these platforms reshape debates about porn in digital culture.","clinical_takeaway":"None – the paper offers cultural analysis, not clinical guidance.","confidence":0.9,"topic_tags":["pornography","sexual_function","csbd","gender"],"strengths":["Provides a novel cultural analysis of porn branding","Links queer/feminist politics to digital media practices"],"limitations":["No empirical data or systematic methodology","Lacks measurement of sexual behavior or health outcomes","Potential ideological bias without disclosure of COI"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10894160.2013.731865"}},{"id":2917,"doi":"10.1080/09540121.2012.748875","pmid":"23252705","pmcid":null,"title":"Determinants of risky sexual behavior and condom use among college students in China","authors":"Sun X, Liu X, Shi Y, Wang Y, Wang P, Chang C.","first_author":"Sun X","journal":"AIDS care","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":48,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large stratified cluster sample of 19,123 Chinese college students; self‑report questionnaire; logistic regression and path analysis","sample_n":19123,"sample_text":"19,123 Chinese college students recruited through stratified cluster sampling","population":"college students in China (both sexes)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A national survey of over 19,000 Chinese college students found that about 9% were sexually active, but only a quarter always used condoms. Exposure to pornographic material, older age, drinking, and smoking were linked to riskier sexual behavior, while better HIV knowledge and confidence boosted condom use.","clinical_takeaway":"Improving HIV knowledge, self‑efficacy and condom intentions may increase safe sex among college students.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Very large, stratified sample improves generalisability within Chinese colleges","Uses multivariate logistic regression and path analysis","Provides concrete policy‑relevant determinants"],"limitations":["Cross‑sectional design cannot infer causality","Self‑report of porn exposure and sexual behaviour may be biased","No validated scales for pornography exposure; moral or psychological confounds not measured"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":5,"mentioning":65,"citing_publications":85,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540121.2012.748875"}},{"id":2918,"doi":"10.1111/jsm.12018","pmid":"23206344","pmcid":null,"title":"Ethical aspects of sexual medicine. Internet, vibrators, and other sex aids: toys or therapeutic instruments?","authors":"Jannini EA, Limoncin E, Ciocca G, Buehler S, Krychman M.","first_author":"Jannini EA","journal":"The journal of sexual medicine","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary/ethical debate with no empirical data.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article presents a debate among five experts about whether sexual‑medicine clinicians should prescribe online pornography or sell sex toys and related products. It weighs possible benefits and harms, concluding that, when used appropriately, these tools can be helpful for sexual health.","clinical_takeaway":"Clinicians may consider using Internet pornography or selling sex aids as therapeutic tools, but should evaluate each patient’s needs and ethical implications.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Provides balanced viewpoints from multiple experts","Addresses a practical ethical issue for clinicians","Cites existing literature to inform discussion"],"limitations":["No empirical data or systematic review methodology","Lacks quantitative analysis or evidence synthesis","Conclusions are expert opinion, not evidence‑based"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12018"}},{"id":2919,"doi":"10.6224/jn.59.6.86","pmid":"23212259","pmcid":null,"title":"[Internet use and adolescents' sexual health]","authors":"Tseng YH, Wang RH, Wang HH, Chou FH.","first_author":"Tseng YH","journal":"Hu li za zhi The journal of nursing","year":2012,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"chi","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary / narrative review without empirical data","sample_n":null,"sample_text":"None – article provides no empirical sample","population":"adolescents (Taiwan)","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how internet use can both help and harm Taiwanese adolescents’ sexual health, noting risks like pornography exposure and benefits such as easier access to information, and suggests a role for nurses in education.","clinical_takeaway":"None – the paper offers no data for clinical decisions; it only suggests nursing roles in adolescent sexual health education.","confidence":0.8,"topic_tags":["adolescents","sexual_function","pornography"],"strengths":["Addresses a timely public‑health topic","Provides practical recommendations for nurses"],"limitations":["No empirical data or systematic methodology","No clear operational definitions or measurement of constructs","Lacks assessment of key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.6224/jn.59.6.86"}},{"id":2920,"doi":"10.1016/j.annder.2012.09.004","pmid":"23237289","pmcid":null,"title":"[From illegal pornography to sex stores]","authors":"Coulmont B.","first_author":"Coulmont B.","journal":"Annales de dermatologie et de venereologie","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://shs.hal.science/halshs-00762935","cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.annder.2012.09.004"}},{"id":2922,"doi":"10.1080/00224499.2012.719168","pmid":"23167939","pmcid":null,"title":"Pornography actresses: an assessment of the damaged goods hypothesis","authors":"Griffith JD, Mitchell S, Hart CL, Adams LT, Gu LL.","first_author":"Griffith JD","journal":"Journal of sex research","year":2013,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of 177 pornographic actresses and a matched community sample on sexuality, psychological and drug‑use variables.","sample_n":354,"sample_text":"177 porn actresses compared with a matched sample of women","population":"Adult female pornography performers (n≈177) and age/ethnicity/marital‑status matched women from the general population.","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared 177 women who work in porn with a similar group of non‑porn women. Porn performers had earlier sexual debut, more partners and higher drug use, but also higher self‑esteem, social support and spirituality. No differences were found in childhood sexual abuse, so the “damaged goods” idea was not supported.","clinical_takeaway":"Being a porn performer is not linked to greater childhood trauma or lower self‑esteem; clinicians should avoid assuming damage based solely on occupation.","confidence":0.85,"topic_tags":["pornography","sexual_function"],"strengths":["Matched comparison group","Broad range of self‑report outcomes","Discriminant analysis shows clear classification"],"limitations":["Reliance on self‑report; unclear scale validation","Cross‑sectional, cannot infer causality","Potential selection bias of performers"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":8,"citing_publications":83,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2012.719168"}},{"id":2923,"doi":"10.1186/1471-2458-12-972","pmid":"23148791","pmcid":"PMC3527150","title":"Prevalence and correlates of sexual behaviors among university students: a study in Hefei, China","authors":"Chi X, Yu L, Winter S.","first_author":"Chi X","journal":"BMC public health","year":2012,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.1186/1471-2458-12-972","cited_by_count":22,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire survey of 1,403 university students in Hefei, China","sample_n":1403,"sample_text":"University students in Hefei, China (convenience sample)","population":"university students (average age 20.3)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,403 Chinese university students found that about 12% had had premarital sex, 46% reported masturbating, and 57% had viewed pornography. Male students reported more sexual activities than females, and factors like having a romantic partner and spending more time online were linked to higher sexual activity.","clinical_takeaway":"Sexual health programs for Chinese university students should especially target males, those in relationships, and heavy internet users.","confidence":0.7,"topic_tags":["prevalence","sexual_function","pornography","masturbation"],"strengths":["Large sample size for a single‑site survey","High response rate (93.5%)","Provides gender‑specific prevalence data"],"limitations":["Self‑report items lack validated scales","Convenience sample limits generalisability","No measurement of moral, mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":47,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2458-12-972"}},{"id":2924,"doi":"10.1089/cyber.2012.0179","pmid":"23098226","pmcid":null,"title":"Interconnected but underprotected? Parents' methods and motivations for information seeking on digital safety issues","authors":"Davis V.","first_author":"Davis V.","journal":"Cyberpsychology, behavior and social networking","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of parents about information‑seeking behaviours, concerns and child digital‑risk experiences; convenience sample.","sample_n":null,"sample_text":"Not specified in abstract; presumed moderate size typical of online surveys.","population":"Parents of children/ adolescents with access to connected devices (likely community sample).","country":"Not stated (likely USA/UK based on journal).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of parents shows they mainly turn to friends, family and the internet for advice on keeping kids safe online. Concerns focus on accidental exposure to porn, yet most parents seek information only a few times a year, even when children experience many digital risks.","clinical_takeaway":"Parents often under‑seek information on online sexual risks; clinicians should proactively provide digital‑safety resources.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Large‑scale survey addresses an under‑researched parental information‑seeking domain.","Identifies distinct types of information‑seeking behaviour.","Links child‑risk experiences to parental information‑seeking."],"limitations":["Reliance on self‑report measures with unclear validation.","Cross‑sectional design limits causal inference.","Sample characteristics and size not reported; likely convenience bias."],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":15,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2012.0179"}},{"id":2925,"doi":"10.1891/0886-6708.13.4.319","pmid":"10328441","pmcid":null,"title":"Violent pornography and abuse of women: theory to practice","authors":"Cramer E, McFarlane J, Parker B, Soeken K, Silva C, Reel S.","first_author":"Cramer E","journal":"Violence and victims","year":1998,"pub_types":["Comparative Study","Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional survey of 198 abused women assessing partner’s pornography use and violence outcomes.","sample_n":198,"sample_text":"198 abused women recruited for a survey on partner‑related violence and pornography exposure.","population":"Abused women (ethnically stratified sample).","country":"United States","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 198 women who experienced intimate partner violence, those whose abusers used or forced them to engage with pornographic material reported higher levels of abuse. The study suggests a link between violent porn use and increased partner aggression, but cannot prove causation.","clinical_takeaway":"Clinicians should note that exposure to partner‑initiated pornography may co‑occur with more severe abuse, but causality is unproven; assessment should consider broader relational dynamics.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a hard‑to‑reach population","Use of validated violence scales","Ethnically stratified recruitment"],"limitations":["Pornography exposure measured by a single, unvalidated item","No control for key confounds (e.g., mental health, moral attitudes)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1891/0886-6708.13.4.319"}},{"id":2926,"doi":"10.1007/s10508-012-9988-5","pmid":"22695645","pmcid":null,"title":"Headaches induced by pornography use","authors":"Anand KS, Dhikav V.","first_author":"Anand KS","journal":"Archives of sexual behavior","year":2012,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-012-9988-5"}},{"id":2927,"doi":"10.1542/peds.2011-3122","pmid":"22945406","pmcid":null,"title":"Tanner stage 4 breast development in adults: forensic implications","authors":"Rosenbloom AL, Rohrs HJ, Haller MJ, Malasanos TH.","first_author":"Rosenbloom AL","journal":"Pediatrics","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional rating of 547 adult female photographs by four expert examiners to assess the frequency with which Tanner stage 4 breast development could be (mis)identified in non‑clinical images.","sample_n":547,"sample_text":"547 adult women’s published photographs","population":"Adult women (photographs only); N = 547 images","country":"Not specified (likely USA, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Experts examined 547 adult women's photos and found that about a quarter could be mistakenly judged as Tanner stage 4 (a developmental stage often used in child‑pornography cases). The study shows that distinguishing stage 4 from stage 5 in non‑clinical images is unreliable, suggesting that such forensic testimony is invalid.","clinical_takeaway":"Forensic age estimates based solely on Tanner breast stage are unreliable; clinicians should advise courts against using this criterion.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large image set (N > 500) provides ample material for rating.","Multiple independent expert raters allow assessment of inter‑rater agreement."],"limitations":["No validated, objective measurement of breast stage; relies on subjective visual judgment.","Absence of a gold‑standard reference (e.g., clinical exams) limits external validity.","Potential selection bias in the publicly available images."],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2011-3122"}},{"id":2928,"doi":"10.1093/pubmed/fds055","pmid":"22858505","pmcid":null,"title":"Sexual practices of young educated men: implications for further research and health education in Kingdom of Saudi Arabia (KSA)","authors":"Raheel H, Mahmood MA, BinSaeed A.","first_author":"Raheel H","journal":"Journal of public health (Oxford, England)","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 225 university male students in Riyadh, Saudi Arabia; self‑administered questionnaire; descriptive statistics and adjusted odds ratios reported.","sample_n":225,"sample_text":"young, male students","population":"young educated men (students) in Riyadh, KSA (N=225)","country":"Saudi Arabia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2013 survey of 225 university men in Riyadh found that 31% had sex before marriage and 61% had watched porn. Porn viewing was linked to higher odds of premarital sex. Knowledge about condoms and HIV was limited, suggesting a need for better sexual health education.","clinical_takeaway":"Clinicians should be aware that porn use is common among Saudi male students and is associated with premarital sex; education on safe sex and STI prevention is needed.","confidence":0.75,"topic_tags":["pornography","sexual_function"],"strengths":["First report of premarital sexual activity among Saudi male students","Large enough sample for basic logistic regression"],"limitations":["Convenience student sample; not generalisable","No validated measures of pornography use or sexual behaviour","Key confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":9,"contrasting":0,"mentioning":28,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/pubmed/fds055"}},{"id":2929,"doi":"10.1007/s10508-012-9996-5","pmid":"22810997","pmcid":null,"title":"Seasonal variation in internet keyword searches: a proxy assessment of sex mating behaviors","authors":"Markey PM, Markey CN.","first_author":"Markey PM","journal":"Archives of sexual behavior","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Ecological time‑series analysis of Google keyword frequencies over five years, using harmonic modelling to detect seasonal cycles.","sample_n":null,"sample_text":"Aggregated national search volume; no individual sample.","population":"Aggregated Internet search data (no individual participants).","country":"Not specified (likely global/US‑centric Google data)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined five years of Google search data and found that searches about porn, prostitution, and seeking mates peak in winter and early summer, showing a six‑month seasonal cycle that mirrors other sexual‑health indicators.","clinical_takeaway":"None – the study offers population‑level trends, not individual clinical guidance.","confidence":0.8,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Large, objective data set covering multiple years","Uses appropriate harmonic time‑series analysis","Finds consistent seasonal pattern matching other reproductive health data"],"limitations":["Proxy measure (search terms) may not reflect actual sexual behaviour","No individual‑level covariates or confound control","Ecological design limits causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":29,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-012-9996-5"}},{"id":2930,"doi":"10.1080/09540121.2012.701726","pmid":"22783833","pmcid":null,"title":"Vulnerability re-assessed: the changing face of sex work in Guntur district, Andhra Pradesh","authors":"Beattie TS, Bradley JE, Vanta UD, Lowndes CM, Alary M.","first_author":"Beattie TS","journal":"AIDS care","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative interview study with female sex workers in Guntur district, India, examining impacts of HIV prevention programme and structural changes on sexual practices.","sample_n":null,"sample_text":"Not reported in abstract; qualitative convenience sample typical of interview studies","population":"Female sex workers (adult) in Guntur district, Andhra Pradesh, India","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with female sex workers in Andhra Pradesh show that recent police curfews and brothel closures have pushed sex work online, leading clients to request more anal sex—often after watching pornography. While condom use is common for vaginal sex, many women lack knowledge about anal‑sex risks.","clinical_takeaway":"Clinicians should probe for unprotected anal sex and provide targeted education on its risks in sex‑worker populations.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides contextual insight into changing sex‑work environment","Identifies link between pornography access and client demands","Highlights structural factors affecting HIV risk"],"limitations":["Small, non‑representative qualitative sample","No quantitative measurement of pornography exposure or sexual risk","Limited control for potential confounders"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":28,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540121.2012.701726"}},{"id":2931,"doi":"10.1016/j.gyobfe.2012.05.014","pmid":"22726674","pmcid":null,"title":"[Female cosmetic genital surgery: point-counterpoint]","authors":"Colson MH.","first_author":"Colson MH.","journal":"Gynecologie, obstetrique & fertilite","year":2012,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/editorial without empirical data","sample_n":null,"sample_text":"none","population":"none","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses female cosmetic genital surgery, warning that the demand—especially among young women—may be driven by unrealistic images from pornography rather than medical need, and highlights ethical and psychological concerns.","clinical_takeaway":"Clinicians should discuss realistic expectations and potential psychological impacts before considering cosmetic genital surgery.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["highly relevant topic linking pornography to body image","highly cited within surgical ethics literature"],"limitations":["No empirical data or systematic methodology","No measurement of key constructs or confounders","Conclusions are based on opinion rather than evidence"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.gyobfe.2012.05.014"}},{"id":2932,"doi":"10.1186/1471-2458-12-377","pmid":"22632458","pmcid":"PMC3676167","title":"Gambling, housing conditions, community contexts and child health in remote indigenous communities in the Northern Territory, Australia","authors":"Stevens M, Bailie R.","first_author":"Stevens M","journal":"BMC public health","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3676167","cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Logistic regression on data from ten remote Indigenous communities; cross‑sectional survey of carers.","sample_n":null,"sample_text":"Ten remote Indigenous communities; exact participant number not provided in abstract.","population":"Carers in ten remote Indigenous communities, NT, Australia; child health outcomes reported by carers.","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined the link between household gambling, community factors, and child health in ten remote Indigenous Australian communities, finding that reported gambling problems were associated with higher rates of scabies and ear infections in children.","clinical_takeaway":"Gambling issues in households may be an important social determinant of child health in Indigenous settings; clinicians should consider family gambling when assessing child health risks.","confidence":0.7,"topic_tags":["gender","sexual_function"],"strengths":["Addresses a gap in empirical data on gambling and child health in Indigenous communities","Uses multivariable logistic regression to adjust for several community and housing factors"],"limitations":["Cross‑sectional design cannot establish causality","Gambling problems measured by a single self‑report item, no validated scale","Small, non‑representative sample of ten communities"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2458-12-377"}},{"id":2933,"doi":"10.1016/j.forsciint.2012.04.014","pmid":"22565117","pmcid":null,"title":"Applicability of Greulich and Pyle and Demirijan aging methods to a sample of Italian population","authors":"Santoro V, Roca R, De Donno A, Fiandaca C, Pinto G, Tafuri S, Introna F.","first_author":"Santoro V","journal":"Forensic science international","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Validation study of two age‑estimation methods on 535 Italian children (7‑15 y) using OPG and hand‑wrist X‑rays; correlations with known chronological age reported.","sample_n":535,"sample_text":"535 subjects between the ages of 7 and 15 years","population":"Italian children, both sexes, ages 7‑15, sample size 535","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study checked how well two common forensic methods for estimating age (hand‑wrist X‑rays and dental X‑rays) work on Italian children aged 7‑15. The skeletal method was fairly accurate, especially for younger ages, while the dental method tended to overestimate age in older children.","clinical_takeaway":"Forensic age estimates in Italian youths may rely on the Greulich‑Pyle skeletal method, but caution is needed when using Demirjian dental ages for older children.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample for validation study","Uses established, widely‑used age‑estimation methods","Both skeletal and dental assessments performed on same individuals"],"limitations":["No pre‑registration or power analysis reported","Potential convenience sampling; generalisability to all Italian youth unclear","Limited reporting of effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":36,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.forsciint.2012.04.014"}},{"id":2934,"doi":"10.5694/mja12.10637","pmid":"22621132","pmcid":null,"title":"Internet pornography and adolescent health","authors":"Guy RJ, Patton GC, Kaldor JM.","first_author":"Guy RJ","journal":"The Medical journal of Australia","year":2012,"pub_types":["Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5694/mja12.10637"}},{"id":2935,"doi":"10.1016/j.legalmed.2012.03.008","pmid":"22546248","pmcid":null,"title":"How to catch child pornographers in France? The entrapment","authors":"Prat S, Jonas C.","first_author":"Prat S","journal":"Legal medicine (Tokyo, Japan)","year":2012,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.legalmed.2012.03.008"}},{"id":2936,"doi":"10.1177/1077801212452550","pmid":"22865620","pmcid":null,"title":"A feminist response to Weitzer","authors":"Dines G.","first_author":"Dines G.","journal":"Violence against women","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary; no empirical data; theoretical argument","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"background","plain_summary":"The author defends anti‑porn feminist critiques, arguing they use rigorous cultural‑studies methods rather than biased ‘oppression’ lenses, and that porn images reinforce sexist power structures.","clinical_takeaway":"None – the article is a theoretical commentary, not a source of clinical evidence.","confidence":0.6,"topic_tags":["pornography","csbd","sexual_function","gender"],"strengths":["Provides a scholarly feminist perspective","Engages with cultural studies theory"],"limitations":["No empirical data or systematic review","Lacks methodological transparency","Cannot inform evidence-based conclusions"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801212452550"}},{"id":2937,"doi":"10.1177/1077801212452547","pmid":"22865619","pmcid":null,"title":"The myth of objectivity: a reply to Weitzer","authors":"Boyle K.","first_author":"Boyle K.","journal":"Violence against women","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The author replies to a reviewer’s critique, discussing whether research on pornography can be objective and how it relates to violence against women, but provides no new data.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Addresses theoretical debate around pornography research","Published in peer‑reviewed journal"],"limitations":["No empirical data or measurement","Potential advocacy bias without systematic analysis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801212452547"}},{"id":2939,"doi":"10.1016/j.jadohealth.2011.12.009","pmid":"22340853","pmcid":"PMC4235612","title":"Media's contribution to sexual knowledge, attitudes, and behaviors for adolescents and young adults in three Asian cities","authors":"Lou C, Cheng Y, Gao E, Zuo X, Emerson MR, Zabin LS.","first_author":"Lou C","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2012,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":41,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 16,554 unmarried adolescents/young adults in three Asian cities; face‑to‑face and computer‑assisted self‑interviews; multiple linear regression stratified by gender and city","sample_n":16554,"sample_text":"large community sample; recruitment method not fully described, likely convenience/cluster sampling","population":"Adolescents and young adults (15‑24 y), unmarried, from Hanoi, Shanghai, Taipei (N≈16.5 k)","country":"Vietnam; China; Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A large survey of over 16,000 Asian adolescents found that media exposure—including pornographic videos—was linked to higher sexual knowledge, more permissive attitudes, and greater sexual activity, accounting for up to a quarter of the explained variation.","clinical_takeaway":"Media exposure influences youth sexual attitudes and behaviours; clinicians should consider media literacy in sexual health counseling.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Very large sample size","Multivariate regression controlling for several sociodemographic factors","Comparative data across three culturally distinct Asian cities"],"limitations":["Cross‑sectional design prevents causal inference","No measurement of key sexual‑health confounds (moral attitudes, mental health, masturbation, trauma)","Reliance on self‑report; exposure and behaviour measures not validated"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":11,"contrasting":2,"mentioning":73,"citing_publications":98,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2011.12.009"}},{"id":2940,"doi":"10.1111/j.1939-3938.2011.01132.x","pmid":"22925126","pmcid":null,"title":"Patterns of federal Internet offenders: a pilot study","authors":"Burgess AW, Carretta CM, Burgess AG.","first_author":"Burgess AW","journal":"Journal of forensic nursing","year":2012,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive pilot study of 101 federal internet offenders, cross‑sectional analysis of demographic and offending characteristics.","sample_n":101,"sample_text":"101 federal Internet offenders","population":"Federal offenders convicted of internet‑facilitated sexual offenses (primarily child pornography possession).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A pilot study of 101 U.S. federal offenders who possessed child pornography described their employment, education, relationship status, and prior criminal history, suggesting many have typical adult lives before arrest.","clinical_takeaway":"Offenders often have ordinary sociodemographic profiles; clinicians should consider broader psychosocial context when assessing users of illicit material.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relatively large forensic sample for a pilot study","Provides detailed description of offender demographics and contraband characteristics"],"limitations":["No validated psychometric measures of pornography use or compulsivity","Cross‑sectional design limits causal inference","No control for key confounds (e.g., mental health, moral incongruence)","Findings may not generalize beyond convicted federal offenders"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1939-3938.2011.01132.x"}},{"id":2941,"doi":"10.1007/s00787-012-0254-0","pmid":"22311146","pmcid":null,"title":"Evolution of Internet addiction in Greek adolescent students over a two-year period: the impact of parental bonding","authors":"Siomos K, Floros G, Fisoun V, Evaggelia D, Farkonas N, Sergentani E, Lamprou M, Geroukalis D.","first_author":"Siomos K","journal":"European child & adolescent psychiatry","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":61,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of all adolescent students (12‑18) on island of Kos and their parents; compares to prior survey 2 years earlier","sample_n":null,"sample_text":"entire adolescent student population of the island of Kos","population":"Greek adolescents (12‑18) and their parents, whole‑population sample of one island","country":"Greece","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of Greek teens showed an increase in internet‑addiction scores over two years, especially among those who watch online pornography, gamble or game. Parental bonding, not security settings, predicted higher scores, and parents tended to underestimate their children’s computer use.","clinical_takeaway":"Screen for problematic internet use in adolescents, especially when linked to pornography or gaming, and consider family bonding dynamics in prevention.","confidence":0.7,"topic_tags":["sexual_function","pornography"],"strengths":["Large community‑wide sample of adolescents","Includes parental reports for comparison","Identifies specific online activities linked to higher scores"],"limitations":["Cross‑sectional design, cannot infer causality","Internet‑addiction instrument not described – likely unvalidated","No control for key psychosocial confounds (mental health, moral factors, trauma)","Reliance on self‑report for sensitive behaviours"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":11,"contrasting":6,"mentioning":104,"citing_publications":156,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00787-012-0254-0"}},{"id":2942,"doi":"10.1007/s11524-011-9630-1","pmid":"22160481","pmcid":"PMC3284585","title":"Multi-person sex among a sample of adolescent female urban health clinic patients","authors":"Rothman EF, Decker MR, Miller E, Reed E, Raj A, Silverman JG.","first_author":"Rothman EF","journal":"Journal of urban health : bulletin of the New York Academy of Medicine","year":2012,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.1007/s11524-011-9630-1","cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 328 adolescent female clinic patients","sample_n":328,"sample_text":"328 females ages 14-20","population":"adolescent females (14-20) attending an urban health clinic in Boston","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 328 urban adolescent girls, about 7% had ever had sex with three or more people. Those who did were more likely to smoke, start sex early, have an STI, experience dating or childhood sexual violence, and report recent pornography exposure.","clinical_takeaway":"Group‑sex experiences are linked to multiple risk factors in teens; clinicians should screen for violence and related health concerns.","confidence":0.85,"topic_tags":["adolescents","sexual_function"],"strengths":["Large sample for a niche topic","Provides prevalence and correlates","Uses adjusted prevalence ratios with confidence intervals","Addresses both consensual and forced MPS"],"limitations":["Cross‑sectional; cannot infer causality","Convenience clinic sample limits generalisability","Key confounds (moral incongruence, mental health) not measured","Pornography exposure measured by a single self‑report item"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":11,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11524-011-9630-1"}},{"id":2943,"doi":"10.20882/adicciones.77","pmid":"23241714","pmcid":null,"title":"[Does really sex addiction exist?]","authors":"Echeburúa E.","first_author":"Echeburúa E.","journal":"Adicciones","year":2012,"pub_types":["Editorial","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Editorial without empirical data; no methods, sample, or analysis.","sample_n":null,"sample_text":"None (editorial)","population":"Not applicable","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The editorial discusses the proposal of “sex addiction,” describing its supposed symptoms, associated risks, and comorbid mental‑health problems, while noting many gaps in research evidence.","clinical_takeaway":"Current evidence for a distinct sex‑addiction diagnosis is limited; clinicians should be cautious interpreting self‑labelled addiction without validated assessment tools.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Highlights breadth of behaviors labeled as sexual addiction","Notes comorbid psychiatric conditions"],"limitations":["No empirical data or systematic review","Lacks operational definitions or measurement validation","No control for key confounds such as moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20882/adicciones.77"}},{"id":2944,"doi":"10.1111/j.1540-5931.2012.00939.x","pmid":"22737756","pmcid":null,"title":"Toward a more valid definition of “pornography”","authors":"Andrews D.","first_author":"Andrews D.","journal":"Journal of popular culture","year":2012,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1540-5931.2012.00939.x"}},{"id":2945,"doi":"10.1080/19325037.2012.10599223","pmid":"27882190","pmcid":"PMC5117668","title":"Family Sources of Sexual Health Information, Primary Messages, and Sexual Behavior of At-Risk, Urban Adolescents","authors":"Rosengard C, Tannis C, Dove DC, van den Berg JJ, Lopez R, Stein LA, Morrow KM.","first_author":"Rosengard C","journal":"American journal of health education","year":2012,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interviews with 69 at‑risk urban adolescents from an alternative high school and a juvenile correctional facility","sample_n":69,"sample_text":"69 teens, ages 15‑18, recruited from an alternative high school and a juvenile correctional facility","population":"adolescents (15‑18 y) identified as at‑risk; convenience sample; not representative of general youth","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 69 at‑risk urban teens showed that families are a major source of sexual health information, but messages are often cautionary and lack detail. Teens reporting more sexual risks were more likely to cite pornography as an information source.","clinical_takeaway":"Clinicians should recognize that at‑risk youth may receive limited, risk‑focused family advice and may turn to pornography or peers for sexual information.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Provides rich, contextual insight into family sexual health messaging among at‑risk youth","Uses direct adolescent narratives rather than third‑party reports"],"limitations":["Small, non‑representative convenience sample limits generalisability","No validated quantitative measures; reliance on self‑reported interview data","Potential recall bias and social desirability influencing reported messages"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":28,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19325037.2012.10599223"}},{"id":2946,"doi":"10.1080/00918369.2012.699844","pmid":"22925057","pmcid":null,"title":"Erotic pedagogies","authors":"Carrillo Rowe A.","first_author":"Carrillo Rowe A.","journal":"Journal of homosexuality","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"theoretical essay; no empirical data","sample_n":null,"sample_text":"N/A","population":"none","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that the concept of the erotic, drawn from Audre Lorde, can be used as a transformative teaching tool, but neoliberal culture limits its power by tying it to heteronormative and white US ideals, often resorting to pornography as a containment device.","clinical_takeaway":"None - not clinically applicable.","confidence":0.4,"topic_tags":["sexual_function","csbd"],"strengths":["Innovative theoretical framing of erotic pedagogy","Engages interdisciplinary literature"],"limitations":["No empirical data or systematic review","Lacks operational definitions of key constructs","No measurement of confounding variables"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2012.699844"}},{"id":2947,"doi":null,"pmid":"22338538","pmcid":null,"title":"[Public Health, orange juice, pornographic movies]","authors":"Nau JY.","first_author":"Nau JY.","journal":"Revue medicale suisse","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":2948,"doi":"10.1080/10538712.2012.675421","pmid":"22574846","pmcid":null,"title":"Part II: differences between sexually victimized and nonsexually victimized male adolescent sexual abusers and delinquent youth: further group comparisons of developmental antecedents and behavioral challenges","authors":"Leibowitz GS, Burton DL, Howard A.","first_author":"Leibowitz GS","journal":"Journal of child sexual abuse","year":2012,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative study of three groups (sexually victimized male adolescent sexual abusers, non‑sexually victimized male adolescent sexual abusers, and non‑sexually victimized delinquent youth) using existing records/assessments.","sample_n":null,"sample_text":"Not reported in abstract; likely modest convenience sample drawn from treatment/rehabilitation programs.","population":"Male adolescent sexual abusers and delinquent youth (likely treatment‑seeking or residential samples).","country":"United States (Midwestern)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared male adolescent sexual abusers who had been sexually victimised with those who had not, and with non‑sexually‑victimised delinquent youth. Victimised abusers showed more trauma, earlier exposure to pornography and higher behavioral problems than the other groups.","clinical_takeaway":"Youth with histories of sexual victimisation may present greater trauma and behavioural challenges; treatment should address these broader developmental issues.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Direct comparison of multiple offender groups","Considers developmental antecedents such as trauma and early pornography exposure","Uses multivariate analyses to examine pattern of differences"],"limitations":["Cross‑sectional design; cannot infer causality","Unclear measurement quality for pornography use and other constructs","Likely convenience sample from treatment settings, limiting generalisability","Moral incongruence and masturbation not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2012.675421"}},{"id":2949,"doi":"10.1016/j.jadohealth.2011.09.015","pmid":"22265114","pmcid":null,"title":"Trends in youth internet victimization: findings from three youth internet safety surveys 2000-2010","authors":"Jones LM, Mitchell KJ, Finkelhor D.","first_author":"Jones LM","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":87,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Three separate cross‑sectional national telephone surveys of ~1,500 youth (ages 10‑17) conducted in 2000, 2005, and 2010.","sample_n":4500,"sample_text":"Approximately 1,500 youth per survey wave (total ≈4,500).","population":"U.S. adolescents, community‑based, probability sample via telephone.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"National surveys of U.S. youth show that unwanted online sexual solicitations have dropped from 19% in 2000 to 9% in 2010, while exposure to pornography also fell. In contrast, online harassment rose to 11% in 2010, especially among girls.","clinical_takeaway":"Clinicians should note declining solicitation but rising online harassment among adolescents; screening for recent harassment experiences is advised.","confidence":0.9,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative samples.","Three time points allow assessment of trends.","Clear operational definitions of victimisation outcomes."],"limitations":["Reliance on single‑item self‑report measures, not validated scales.","No control for potential confounders (e.g., mental health, family factors).","Cross‑sectional design limits causal inference."],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":12,"contrasting":3,"mentioning":180,"citing_publications":297,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2011.09.015"}},{"id":2950,"doi":"10.1542/peds.2011-2242","pmid":"22144707","pmcid":null,"title":"How often are teens arrested for sexting? Data from a national sample of police cases","authors":"Wolak J, Finkelhor D, Mitchell KJ.","first_author":"Wolak J","journal":"Pediatrics","year":2012,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"National stratified mail survey of law‑enforcement agencies with follow‑up telephone interviews (n≈675 cases).","sample_n":675,"sample_text":"Nationally representative sample of police cases (n=675).","population":"U.S. police‑handled teen sexting cases (2008‑2009).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2012 U.S. study surveyed police agencies about teen sexting cases. It estimated about 3,500 cases in 2008‑09, with arrests occurring in roughly two‑thirds of adult‑involved cases, fewer in youth‑only cases, and rarely when no aggravating factors were present.","clinical_takeaway":"Arrests for teen sexting are uncommon unless adults or abusive behavior are involved; most cases are handled without criminal penalties.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Large, nationally representative police sample.","Clear operational definition of ‘youth‑produced sexual images’ via statutes.","Provides concrete arrest rates for policy relevance."],"limitations":["Relies on police reports; no direct behavioural or psychological measurement.","Cross‑sectional, cannot infer causality or health outcomes.","No control for mental‑health or moral‑incongruence confounds."],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":99,"citing_publications":164,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2011-2242"}},{"id":2951,"doi":"10.4069/kjwhn.2011.17.4.395","pmid":"37697544","pmcid":null,"title":"Self-esteem, Parent-adolescent Communication, Friend's Sexual Attitude and Sexual Permissiveness in College Students","authors":"Jang SH, Lee SH.","first_author":"Jang SH","journal":"Korean journal of women health nursing","year":2011,"pub_types":["Journal Article"],"keywords":["Sex","Students","Attitude","Permissiveness"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive cross‑sectional survey of 380 Korean college students using self‑report questionnaires; convenience sample; no longitudinal or experimental manipulation.","sample_n":380,"sample_text":"Convenience sample of 380 college students; not nationally representative.","population":"College students (South Korea)","country":"South Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 380 Korean college students, sexual permissiveness was linked to factors like gender, religion, how often they watched porn, and friends' sexual attitudes. These variables together explained about half of the differences in permissiveness scores.","clinical_takeaway":"Sexual education for college students should consider peer influences and porn exposure, but findings do not establish causal effects.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑site survey","Examines multiple socio‑demographic predictors","Reports multivariate regression explaining 52 % of variance"],"limitations":["Unclear whether scales are validated","Cross‑sectional; cannot infer causality","Key confounds (moral incongruence, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4069/kjwhn.2011.17.4.395"}},{"id":2952,"doi":"10.21101/cejph.a3694","pmid":"22432395","pmcid":null,"title":"Adolescents' health behaviours and its associations with psychological variables","authors":"Kim Y.","first_author":"Kim Y.","journal":"Central European journal of public health","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 885 junior high students from three schools in Seoul; random selection within district","sample_n":885,"sample_text":"randomly selected from 3 junior high schools in Dobong‑gu district, Seoul","population":"Korean adolescents, grades 7‑9 (approx. ages 12‑15)","country":"South Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a school survey of 885 Korean teens, about half reported having seen pornography. Psychological factors such as health‑locus of control, self‑efficacy and self‑esteem were linked to a range of risky behaviours, including porn viewing.","clinical_takeaway":"Pornography viewing is common among adolescents; interventions that boost self‑efficacy and healthy locus of control may reduce risk behaviours.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","moral_incongruence"],"strengths":["Large sample for a school‑based survey","Random selection within district","Multiple psychological predictors examined"],"limitations":["Cross‑sectional design limits causal inference","Measures of pornography use not validated","Key confounds (e.g., moral incongruence, masturbation) not assessed"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21101/cejph.a3694"}},{"id":2954,"doi":"10.1100/2011/308631","pmid":"22125466","pmcid":"PMC3217592","title":"Internet addiction and antisocial internet behavior of adolescents","authors":"Ma HK.","first_author":"Ma HK.","journal":"TheScientificWorldJournal","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Prevention","Positive Youth Development","Internet Addiction","Chinese Adolescents","Antisocial Internet Problems"],"is_oa":true,"oa_url":"https://downloads.hindawi.com/journals/tswj/2011/308631.pdf","cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study of Chinese adolescents examining self‑reported internet addiction and antisocial online behaviors; sample size not reported in abstract","sample_n":null,"sample_text":"not reported in abstract","population":"adolescents (China)","country":"China","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveys Chinese adolescents about how much they use the internet and whether they engage in online antisocial acts like cyberbullying or illegal activities, linking these behaviors to stages of moral development.","clinical_takeaway":"No direct clinical implications; findings are tentative and limited by methodological weaknesses.","confidence":0.6,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Addresses understudied link between internet use and antisocial behavior","Uses established moral development framework (Kohlberg)","Covers multiple forms of antisocial online conduct"],"limitations":["Likely relies on unvalidated self‑report scales","No control for key confounds (moral incongruence, mental health, etc.)","Cross‑sectional design prevents causal inference","Sample size and recruitment methods unspecified"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":27,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1100/2011/308631"}},{"id":2955,"doi":"10.1080/10538712.2011.627829","pmid":"22126107","pmcid":null,"title":"The medical analysis of child sexual abuse images","authors":"Cooper SW.","first_author":"Cooper SW.","journal":"Journal of child sexual abuse","year":2011,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Review","sample_n":null,"sample_text":"Not applicable – narrative review","population":"Forensic analysts working with child sexual abuse images","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how experts examine child sexual abuse images, describing how the age and development of the children in the pictures are assessed and recommending ways to document findings for court use.","clinical_takeaway":"None – the paper is forensic, not clinical, and does not inform treatment or health advice.","confidence":0.9,"topic_tags":["csbd","sexual_function","pornography"],"strengths":["Provides detailed forensic methodology","Highlights legal relevance of documentation"],"limitations":["No empirical data or quantitative analysis","Does not address user‑behavior or health outcomes"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2011.627829"}},{"id":2957,"doi":"10.1159/000328920","pmid":"22005208","pmcid":null,"title":"The complexity of internet sexuality","authors":"Daneback K, Ross MW.","first_author":"Daneback K","journal":"Advances in psychosomatic medicine","year":2011,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not applicable – no original participants.","population":"Human adults of varied ages, genders, and sexual orientations (as described in the literature cited).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises how the Internet is used for sexual activities, noting both benefits—like easier sexual expression for marginalized groups—and potential risks, but it does not present new data or systematic analysis.","clinical_takeaway":"None – the article provides a general overview, not evidence for clinical decisions.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Broad overview of first 15 years of internet sexuality research","Incorporates both positive and risk perspectives"],"limitations":["No systematic methodology or bias assessment","No original data; conclusions based on cited literature","Lacks operational definition of key constructs such as ‘problematic use’"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":0,"mentioning":8,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000328920"}},{"id":2958,"doi":"10.1007/s11126-010-9165-8","pmid":"21153441","pmcid":null,"title":"Sexting behaviors among young Hispanic women: incidence and association with other high-risk sexual behaviors","authors":"Ferguson CJ.","first_author":"Ferguson CJ.","journal":"The Psychiatric quarterly","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 207 predominantly Hispanic women aged 16‑25; convenience sample; examined self‑reported sexting and other sexual risk behaviours.","sample_n":207,"sample_text":"Convenience sample of predominantly Hispanic young women recruited for a health survey.","population":"young Hispanic women, 16‑25 y, N≈207","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 207 mostly Hispanic women aged 16‑25, about one‑fifth said they had ever sent a sext. Sexting was not linked to most risky sexual behaviours, but was slightly more common among those who rated sex as very pleasurable or who showed histrionic personality traits.","clinical_takeaway":"Sexting appears relatively common but not clearly tied to broader sexual risk in this group; clinicians should assess context rather than assume harm.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large (for a single‑site survey) sample of a specific ethnic group","Provides empirical incidence data on sexting","Links sexting to sexual pleasure and personality traits"],"limitations":["Cross‑sectional, cannot infer causality","Self‑report measures likely single‑item and unvalidated","No control for key confounds (e.g., moral attitudes, mental health, partner context)","Convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":6,"contrasting":2,"mentioning":79,"citing_publications":160,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11126-010-9165-8"}},{"id":2959,"doi":"10.1377/hlthaff.2010.1261","pmid":"21900671","pmcid":null,"title":"How a children's hospital discovered child pornographers in its midst","authors":"Sadler BL.","first_author":"Sadler BL.","journal":"Health affairs (Project Hope)","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1377/hlthaff.2010.1261"}},{"id":2960,"doi":"10.1186/1471-2458-11-635","pmid":"21824393","pmcid":"PMC3199602","title":"Porn video shows, local brew, and transactional sex: HIV risk among youth in Kisumu, Kenya","authors":"Njue C, Voeten HA, Remes P.","first_author":"Njue C","journal":"BMC public health","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3199602","cited_by_count":28,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"in‑depth interviews (n=150), 4 focus groups, 48 observations; youth 15‑20 y in Kisumu, Kenya","sample_n":150,"sample_text":"150 adolescents, 4 focus groups, 48 observations","population":"Adolescents (15‑20 y) in Kisumu, Kenya; convenience sample","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with Kenyan youth revealed that cheap porn video shows and local brew spots become settings for unprotected, often coerced, sex, including transactional encounters, raising HIV risk.","clinical_takeaway":"Interventions should target venues where youth view porn and drink, addressing alcohol use and power dynamics to reduce HIV risk.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Rich, contextual qualitative data","Multiple data sources (interviews, focus groups, observations)","Highlights understudied venue (porn video halls) linked to risk"],"limitations":["No validated measurement instruments","Convenience sample limits generalisability","No quantitative assessment of confounders (e.g., mental health, moral views)"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":26,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2458-11-635"}},{"id":2961,"doi":"10.1080/00224499.2010.497985","pmid":"20672214","pmcid":"PMC2970688","title":"A model of adolescents' seeking of sexual content in their media choices","authors":"Bleakley A, Hennessy M, Fishbein M.","first_author":"Bleakley A","journal":"Journal of sex research","year":2011,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national survey of 810 adolescents, self‑report questionnaire, path analysis","sample_n":810,"sample_text":"810 adolescents, nationally representative","population":"adolescents aged 13–18, national US sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A US survey of 810 teens found that half deliberately look for sexual material in movies, TV, music, websites and magazines. Boys do this more than girls. Their intention to seek such content is driven mainly by perceived peer pressure.","clinical_takeaway":"Adolescents’ media choices are strongly influenced by perceived norms; clinicians should address peer influences when discussing sexual media exposure.","confidence":0.8,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Large, national sample","Use of established integrative behavioral model","Path‑analysis links intentions to seeking behavior"],"limitations":["Self‑report only; no validated scales for seeking","Cross‑sectional; cannot infer causality","Key confounds (moral, mental health, partner factors) not measured"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":0,"mentioning":46,"citing_publications":110,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2010.497985"}},{"id":2962,"doi":"10.1080/00918369.2011.581906","pmid":"21740206","pmcid":null,"title":"Language matters: an introduction","authors":"Leap WL, Provencher DM.","first_author":"Leap WL","journal":"Journal of homosexuality","year":2011,"pub_types":["Introductory Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"introductory, non‑empirical overview of language in sexuality research","sample_n":null,"sample_text":"N/A – article provides no empirical data","population":"none (no participants)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This introductory article argues that the words we use shape how we experience sexuality, reviewing studies on language in gay desire, identity, homophobic discourse, and other non‑normative sexual contexts.","clinical_takeaway":"None – the article does not provide clinical evidence or guidance.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Broad, interdisciplinary perspective on language and sexuality","Highlights diverse cultural contexts","Useful synthesis for scholars entering the field"],"limitations":["No empirical data or systematic review methodology","No assessment of measurement validity","Cannot inform clinical or causal conclusions"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2011.581906"}},{"id":2964,"doi":"10.2989/17280583.2011.594247","pmid":"25859893","pmcid":null,"title":"The use and trends of information and communication technology (ICT) during middle childhood","authors":"Louw AE, Winter M.","first_author":"Louw AE","journal":"Journal of child and adolescent mental health","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"phenomenological interview study with 12 participants from two private schools; cross‑sectional, convenience sample","sample_n":12,"sample_text":"12 children aged 6‑12 from two private schools (boys' and girls' school) in Gauteng, South Africa","population":"children ages 6‑12 in South Africa (private schools)","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study interviewed 12 South African children (6‑12 y) about how they use computers and phones. All had used ICT, younger kids were less skilled and less aware of risks, and some reported seeing pornography. Parents set few rules and supervision was limited.","clinical_takeaway":"None – the study provides descriptive insights but lacks clinical relevance for sexual health or addiction.","confidence":0.7,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Qualitative depth via phenomenological interviews","Focus on understudied age group (middle childhood)","Identifies developmental trends in ICT use"],"limitations":["Very small, non‑representative sample (private schools)","No systematic measurement of pornography exposure or related constructs","Findings not generalizable to broader child population"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2989/17280583.2011.594247"}},{"id":2965,"doi":null,"pmid":"22066302","pmcid":null,"title":"Attitudes and practices on HIV preventions among students of higher education institutions in Ethiopia: the case of Addis Ababa University","authors":"Regassa N, Kedir S.","first_author":"Regassa N","journal":"East African journal of public health","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 606 university students using multistage sampling; logistic regression analysis of determinants of HIV‑prevention attitudes and practices","sample_n":606,"sample_text":"multistage sampling of university students","population":"students at Addis Ababa University, Ethiopia (N=606)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2011 Ethiopian study surveyed 606 university students about their HIV‑prevention attitudes and behaviours, finding that many were sexually active yet did not feel at risk. Factors like gender, religion, alcohol, khat, smoking and watching porn were linked to attitudes and practices.","clinical_takeaway":"Among Ethiopian university students, HIV‑prevention attitudes are shaped by multiple lifestyle factors; interventions should address broader health behaviours, not just sexual knowledge.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Large sample for a single university","Uses both quantitative survey and qualitative focus groups","Multivariable logistic regression to identify determinants"],"limitations":["Cross‑sectional design limits causal inference","Key constructs (e.g., attitudes) not described as validated scales","Important confounds for pornography research (moral incongruence, masturbation, mental health) not measured"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":2966,"doi":"10.4103/2152-7806.81427","pmid":"21697978","pmcid":"PMC3115160","title":"Neuroscience research fails to support claims that excessive pornography consumption causes brain damage","authors":"Reid RC, Carpenter BN, Fong TW.","first_author":"Reid RC","journal":"Surgical neurology international","year":2011,"pub_types":["letter","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3115160","cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/2152-7806.81427"}},{"id":2967,"doi":"10.1007/s10508-011-9762-0","pmid":"21562915","pmcid":null,"title":"Prevalence, severity, and correlates of problematic sexual Internet use in Swedish men and women","authors":"Ross MW, Månsson SA, Daneback K.","first_author":"Ross MW","journal":"Archives of sexual behavior","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":79,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet-recruited convenience sample (N=1,913), self‑report questionnaire with five ad‑hoc items assessing problematic sexual Internet use; regression on predictors.","sample_n":1913,"sample_text":"Internet‑recruited younger Swedish men and women (non‑random sample)","population":"Swedish adults (younger men and women) recruited online","country":"Sweden","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online Swedish survey of 1,913 adults, 5% of women and 13% of men reported some problems with sexual Internet use, with 2% of women and 5% of men indicating serious issues. Higher porn use, religiosity, and past negative experiences predicted these problems.","clinical_takeaway":"Problematic sexual Internet use appears in a minority of users; assess frequency, distress, and contextual factors before labeling it an addiction.","confidence":0.7,"topic_tags":["prevalence","sexual_function","csbd","moral_incongruence"],"strengths":["Large sample size for a survey","Includes both genders","Identifies several predictors (religiosity, negative experiences, frequency)"],"limitations":["Non‑random, self‑selected internet sample limits generalisability","Problematic use measured with ad‑hoc items, not validated scale","Masturbation, mental health, partner factors not assessed"],"rubric_version":"2.0","raw_total":27,"max_possible":60,"pct_score":45,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":15,"contrasting":0,"mentioning":116,"citing_publications":203,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-011-9762-0"}},{"id":2968,"doi":"10.1111/j.2044-8341.1995.tb01810.x","pmid":"7779766","pmcid":null,"title":"Pornography and the paedophile: is it criminogenic?","authors":"Howitt D.","first_author":"Howitt D.","journal":"The British journal of medical psychology","year":1995,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report based on interviews with a small private‑clinic sample of fixated pedophiles","sample_n":null,"sample_text":"few men; exact N not given","population":"adult male sex offenders (pedophiles) in a private clinic","country":"United Kingdom (journal), likely UK clinic","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with a few male pedophiles in a clinic showed they rarely used commercial child pornography; instead they created erotic material from everyday sources. All had histories of childhood sexual abuse, and pornography exposure never preceded their offending.","clinical_takeaway":"Findings do not support the idea that pornography causes child sexual offending; other factors like past abuse are more salient.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["In‑depth qualitative data from a rare clinical population","Highlights diversity of erotic material beyond child‑pornography"],"limitations":["Very small, non‑representative sample","No validated measures or statistical analysis","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":4,"contrasting":0,"mentioning":31,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.2044-8341.1995.tb01810.x"}},{"id":2969,"doi":"10.1080/10538712.2011.571233","pmid":"21660813","pmcid":null,"title":"Sexual offending in adolescence: a comparison of sibling offenders and nonsibling offenders across domains of risk and treatment need","authors":"Latzman NE, Viljoen JL, Scalora MJ, Ullman D.","first_author":"Latzman NE","journal":"Journal of child sexual abuse","year":2011,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional survey of male adolescent sexual offenders (n=100 sibling offenders, n=66 nonsibling offenders) using self‑report questionnaires and validated risk‑assessment instruments.","sample_n":166,"sample_text":"Male adolescent sibling offenders (n=100) and nonsibling offenders (n=66).","population":"Adolescent male sexual offenders recruited from correctional/juvenile justice settings (likely convenience sample).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared teen boys who sexually abused a sibling with those who abused non‑siblings. Sibling offenders were more likely to have histories of sexual abuse, domestic violence, and exposure to pornography, but both groups scored similarly on standard risk‑assessment tools.","clinical_takeaway":"Sibling sexual offending is linked to greater prior trauma and pornography exposure, suggesting the need for trauma‑focused assessment in treatment planning.","confidence":0.7,"topic_tags":["adolescents","sexual_function","pornography"],"strengths":["Use of validated risk‑assessment instruments (ERASOR, YLS/CMI)","Relatively large sample of sibling offenders for a hard‑to‑study group","Direct comparison between sibling and nonsibling offenders"],"limitations":["Cross‑sectional design; no causal inference","Convenience sample from justice settings limits generalisability","Limited control for mental‑health or moral‑incongruence confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":30,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2011.571233"}},{"id":2970,"doi":"10.3109/00048679409080783","pmid":"7794203","pmcid":null,"title":"To see or not to see: the debate over pornography and its relationship to sexual aggression","authors":"Fukui A, Westmore B.","first_author":"Fukui A","journal":"The Australian and New Zealand journal of psychiatry","year":1994,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods; no empirical data presented.","sample_n":null,"sample_text":"Not applicable","population":"Not applicable (review article)","country":"Australia/New Zealand (journal location)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"background","plain_summary":"The authors review literature on whether pornographic material causes sexual aggression and conclude that there is no clear evidence of a harmful effect, suggesting that any disturbances are more likely linked to broader personality issues.","clinical_takeaway":"No direct clinical implications; the review does not support treating pornography exposure as a cause of sexual aggression.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Broad discussion of multiple perspectives","Contextualizes debate within social issues"],"limitations":["No systematic search or bias assessment","Lacks quantitative synthesis or empirical data","No measurement of key confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/00048679409080783"}},{"id":2971,"doi":"10.3109/13625187.2011.561937","pmid":"21413866","pmcid":null,"title":"Sex education in Swedish schools as described by young women","authors":"Ekstrand M, Engblom C, Larsson M, Tydén T.","first_author":"Ekstrand M","journal":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Waiting‑room survey of 225 female patients (13‑25 y) in two Swedish cities; convenience sample; self‑report questionnaire on received sex‑education content and satisfaction.","sample_n":225,"sample_text":"225 female patients aged 13‑25 years","population":"Female adolescents and young adults attending youth/student health clinics in Sweden; not a random or nationally representative sample.","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 225 Swedish girls and young women found that school sex‑education often missed key topics such as pornography, sexual assault, and contraception, and many rated the instruction as poor.","clinical_takeaway":"None – the study describes education gaps, not clinical interventions.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Direct input from young women on school sex‑education content","Relatively large sample for a single‑site survey"],"limitations":["Convenience sample of clinic patients limits generalisability","No validated scales; reliance on single‑item self‑reports","No control for potential confounders (e.g., socioeconomic status, prior sexual experience)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":6,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/13625187.2011.561937"}},{"id":2973,"doi":"10.1080/00224499.2011.551851","pmid":"21409712","pmcid":null,"title":"Gender differences in sexual attitudes and behaviors: a review of meta-analytic results and large datasets","authors":"Petersen JL, Hyde JS.","first_author":"Petersen JL","journal":"Journal of sex research","year":2011,"pub_types":["Meta-Analysis","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":137,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta‑analysis of published studies and large datasets examining gender differences in sexual attitudes and behaviours, including pornography use and masturbation.","sample_n":null,"sample_text":"Aggregated from many primary studies; not a single recruited cohort.","population":"Adults from multiple existing studies; no new sample collected.","country":"International (studies from various countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This meta‑analysis reviews how men and women differ in sexual attitudes and activities such as pornography use, masturbation, and premarital sex, finding many differences are smaller than commonly believed.","clinical_takeaway":"Gender alone is a modest predictor of pornography or masturbation frequency; clinicians should consider individual and contextual factors.","confidence":0.7,"topic_tags":["gender","sexual_function","pornography","masturbation"],"strengths":["Large, aggregated evidence base reduces idiosyncratic study bias.","Uses standard meta‑analytic techniques with effect‑size reporting.","Discusses multiple theoretical frameworks."],"limitations":["Primary studies often used heterogeneous definitions of pornography use and masturbation.","No systematic control for moral incongruence, mental‑health, or partner variables.","Reliance on published data may reflect reporting bias."],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":3,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":21,"contrasting":4,"mentioning":166,"citing_publications":346,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2011.551851"}},{"id":2975,"doi":"10.1503/cmaj.109-3770","pmid":"21324871","pmcid":"PMC3060205","title":"Public health advocates push for safer sex in pornographic film industry","authors":"Vogel L.","first_author":"Vogel L.","journal":"CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne","year":2011,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":"https://www.cmaj.ca/content/cmaj/183/5/E261.full.pdf","cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1503/cmaj.109-3770"}},{"id":2976,"doi":"10.1111/j.1525-1446.1994.tb00422.x","pmid":"7937500","pmcid":null,"title":"Pornography and abuse of women","authors":"Cramer E, McFarlane J.","first_author":"Cramer E","journal":"Public health nursing (Boston, Mass.)","year":1994,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 87 battered women filing charges; association between partner porn use (single-item) and reported violent sexual acts.","sample_n":87,"sample_text":"87 battered women filing charges against their male partner","population":"Women victims of intimate partner violence (treatment‑seeking); not representative of general population.","country":"USA","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 87 women who reported being abused by their partners, 40% said their partner used pornography. Those women were more likely to report being forced into violent sexual acts, suggesting an association between partner porn use and sexual abuse.","clinical_takeaway":"Evidence is too limited to guide clinical practice; clinicians should consider multiple risk factors, not assume pornography causes abuse.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Focus on a vulnerable population","Direct assessment of partner behavior","Provides empirical data on a rarely studied link"],"limitations":["Cross‑sectional, cannot infer causality","Small, non‑representative sample","Single‑item measures, no validated scales","No control for key confounds (masturbation, mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1525-1446.1994.tb00422.x"}},{"id":2977,"doi":"10.1891/0886-6708.26.5.608","pmid":"22145540","pmcid":null,"title":"Sexual violence victimization among female secondary school students in eastern Ethiopia","authors":"Bekele AB, van Aken MA, Dubas JS.","first_author":"Bekele AB","journal":"Violence and victims","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 764 female secondary school students in eastern Ethiopia, with multivariate logistic regressions; qualitative interviews added","sample_n":764,"sample_text":"cross‑sectional convenience sample of school‑based participants","population":"female secondary school students (age ~15‑19) in eastern Ethiopia (N=764)","country":"Ethiopia","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 764 Ethiopian teenage girls found that frequent porn watching, multiple partners, rejection sensitivity, and alcohol/khat use were linked to higher reports of sexual violence, but the study cannot prove these factors cause victimisation.","clinical_takeaway":"Screening for substance use and high‑risk sexual behaviours may help identify girls at greater risk of violence, but causal links are uncertain.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a school‑based study","Multivariate analysis of several risk factors","Inclusion of qualitative data for contextual depth"],"limitations":["Cross‑sectional design cannot establish causality","Limited measurement detail for pornography use and other constructs","Key confounders (e.g., mental health, moral attitudes) not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":3,"mentioning":55,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1891/0886-6708.26.5.608"}},{"id":2978,"doi":"10.1176/jnp.23.2.jnpe3","pmid":"21677217","pmcid":null,"title":"Internet pornography and frontotemporal dementia","authors":"Mendez MF, Shapira JS.","first_author":"Mendez MF","journal":"The Journal of neuropsychiatry and clinical neurosciences","year":2011,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/jnp.23.2.jnpe3"}},{"id":2979,"doi":"10.1080/10538712.2011.541010","pmid":"21259148","pmcid":null,"title":"Differences between sexually victimized and nonsexually victimized male adolescent sexual abusers: developmental antecedents and behavioral comparisons","authors":"Burton DL, Duty KJ, Leibowitz GS.","first_author":"Burton DL","journal":"Journal of child sexual abuse","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case-control survey of 325 male adolescent sexual abusers in residential facilities; self‑report questionnaires on trauma, pornography use, aggression and other variables.","sample_n":325,"sample_text":"325 male sexually abusive youth (55% reported prior sexual victimisation) recruited from six Midwestern residential facilities","population":"Male adolescent sexual offenders (average age 16) in US residential treatment facilities","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared male teen sexual abusers who had been sexually victimised with those who had not. Victimised offenders showed more trauma, earlier exposure to porn, and greater recent sexual aggression and criminal behaviour.","clinical_takeaway":"Victimisation history may signal broader behavioural and developmental risks among adolescent sexual offenders.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for this population","Clear case‑control comparison","Multiple developmental and behavioural variables examined"],"limitations":["Convenience sample from treatment facilities limits generalisability","Reliance on self‑report, likely unvalidated measures","Key confounds (moral incongruence, mental health) not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":53,"citing_publications":73,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2011.541010"}},{"id":2980,"doi":"10.5250/fronjwomestud.32.1.0125","pmid":"21954493","pmcid":null,"title":"The geography of pornography: neighborhood feminism and the battle against \"dirty bookstores\" in Minneapolis","authors":"Hickey G.","first_author":"Hickey G.","journal":"Frontiers","year":2011,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5250/fronjwomestud.32.1.0125"}},{"id":2981,"doi":"10.1177/1079063210369013","pmid":"21173158","pmcid":null,"title":"Contact sexual offending by men with online sexual offenses","authors":"Seto MC, Hanson RK, Babchishin KM.","first_author":"Seto MC","journal":"Sexual abuse : a journal of research and treatment","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":81,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Quantitative meta-analysis of 21 studies (N=4,464) on contact offense history and 9 follow‑up studies (N=2,630) on recidivism among online sexual offenders.","sample_n":4464,"sample_text":"Aggregated across included primary studies (k=21 for offense history; k=9 for recidivism).","population":"Male online sexual offenders (including child‑pornography offenders); offenders identified through criminal records or self‑report.","country":"Various (studies from multiple jurisdictions).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of over 4,000 online sexual offenders found that about 12% had a known history of contact sexual offenses, and about 5% reoffended during follow‑up, suggesting many online offenders may never commit offline contact crimes.","clinical_takeaway":"Most online sexual offenders, especially those without prior contact offenses, appear to pose a relatively low risk of future contact offending.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large pooled sample from many studies.","Separate analyses for official records vs self‑report.","Provides estimates of subgroup risk."],"limitations":["Potential heterogeneity across primary studies.","Self‑report data may be biased.","No assessment of confounding variables such as mental health or prior trauma."],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":18,"contrasting":3,"mentioning":208,"citing_publications":293,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063210369013"}},{"id":2982,"doi":"10.3109/13625187.2010.536922","pmid":"21138369","pmcid":null,"title":"Sexual behaviour and contraceptive use among Swedish high school students in two cities: comparisons between genders, study programmes, and over time","authors":"Häggström-Nordin E, Borneskog C, Eriksson M, Tydén T.","first_author":"Häggström-Nordin E","journal":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","year":2011,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cluster sample of 20 classes, N=387 Swedish high‑school students, questionnaire on sexual behaviours and contraceptive use; cross‑sectional comparison by gender, study programme and historical cohorts.","sample_n":387,"sample_text":"Cluster sample of 20 classes (N = 387).","population":"first‑year high‑school students, median age 16, Sweden","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2011 survey of 387 Swedish high‑school students found boys reported more masturbation and pornography use, while girls reported more kissing and oral sex. Vocational students were more sexually experienced, and over the past 30 years more teens have had intercourse and used contraception.","clinical_takeaway":"Sex education should consider gender and study‑programme differences in sexual experience and contraceptive use.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large community sample for the setting","Clear gender and programme comparisons","Historical trend analysis over 30 years"],"limitations":["Cross‑sectional, cannot infer causality","Self‑report only, no validated scales for key behaviours","No measurement of important confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":1,"mentioning":22,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/13625187.2010.536922"}},{"id":2983,"doi":"10.1136/jmh.2009.003707","pmid":"21393286","pmcid":null,"title":"Visual depictions of female genitalia differ depending on source","authors":"Howarth H, Sommer V, Jordan FM.","first_author":"Howarth H","journal":"Medical humanities","year":2010,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative analysis of visual depictions from textbooks, feminist publications, and online pornography; measurements of five vulvar features; statistical comparisons across sources.","sample_n":null,"sample_text":"Images sampled from anatomy textbooks, feminist publications, and the most visited free porn sites in the UK (exact numbers not provided).","population":"Images of female genitalia from three source types; no human participants.","country":"United Kingdom (source of online sites)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured how illustrations of female genitalia differ in textbooks, feminist media, and popular online porn. Porn images showed less labial protrusion and less variation than the other sources, suggesting they may skew perceptions of what is 'normal'.","clinical_takeaway":"Clinicians should discuss the limited and atypical range of genital appearances shown in porn when counseling patients about genital surgery or body image.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Clear quantitative measurement of visual features","Comparison across distinct source categories","Statistical significance reported"],"limitations":["Unclear sample size and selection criteria for images","No effect sizes or confidence intervals reported","Potential lack of representativeness of image sources"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":19,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/jmh.2009.003707"}},{"id":2984,"doi":"10.1016/0883-9417(94)90040-x","pmid":"8042864","pmcid":null,"title":"Potential health hazards of pornography consumption as viewed by psychiatric nurses","authors":"Drake RE.","first_author":"Drake RE.","journal":"Archives of psychiatric nursing","year":1994,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of psychiatric nurses (n=194) assessing agreement with statements about pornography health risks; convenience sample; no longitudinal or experimental component.","sample_n":194,"sample_text":"194 psychiatric nurses","population":"Psychiatric nurses (mostly middle‑aged, both genders) in unspecified locations.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"A 1994 survey of 194 psychiatric nurses found that most believed pornography can be harmful, especially for young people, and that nursing education should cover these risks.","clinical_takeaway":"Clinicians should note that many psychiatric nurses perceive pornography as risky, but this study reflects attitudes, not empirical evidence of harm.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Relatively large sample for a nursing survey","Addresses an under‑researched professional perspective"],"limitations":["Reliance on single‑item, non‑validated attitude measures","Cross‑sectional design; cannot assess actual health effects","Potential response bias among nurses"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0883-9417(94)90040-x"}},{"id":2985,"doi":null,"pmid":"21044551","pmcid":null,"title":"[Psychometric properties of an instrument for assessing cyber-sex addiction]","authors":"Ballester Arnal R, Gil Llario MD, Gómez Martínez S, Gil Juliá B.","first_author":"Ballester Arnal R","journal":"Psicothema","year":2010,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd","pornography"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a self‑report questionnaire administered to 1239 Spanish college students","sample_n":1239,"sample_text":"1239 Spanish college students","population":"college students (Spain)","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control"],"stance":"supports","citation_value":"useful","plain_summary":"The authors adapted and validated a Spanish version of the Internet Sex Screening Test (ISST) in 1,239 college students, showing good reliability and a five‑factor structure linked to pornography use and internet habits.","clinical_takeaway":"The ISST appears psychometrically sound for research, but clinicians should be cautious interpreting its scores as indicating a clinical addiction.","confidence":0.7,"topic_tags":["pornography","sexual_function","measurement"],"strengths":["Large sample size for validation","Comprehensive factor analysis and reliability testing","Evidence of convergent and discriminant validity"],"limitations":["Reliance on self‑report; addiction defined by the same instrument","No assessment of moral incongruence or other key confounds","Convenience sample of college students limits generalisability"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":2,"design":5,"addiction_criteria":3,"interpretation":6}},"scite":null},{"id":2986,"doi":"10.1002/ab.20365","pmid":"20922769","pmcid":null,"title":"The three latent classes of adolescent delinquency and the risk factors for membership in each class","authors":"Hasking PA, Scheier LM, Abdallah AB.","first_author":"Hasking PA","journal":"Aggressive behavior","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"latent class analysis of self‑report delinquency indicators from an Australian youth survey; no longitudinal or experimental manipulation","sample_n":null,"sample_text":"Not specified in abstract","population":"adolescents (Australian youth; sample size not reported in abstract)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Australian teens were surveyed on many delinquent acts. Latent‑class analysis revealed three groups, one of which showed high involvement with drugs, theft, fighting and pornographic material. Older males with novelty‑seeking traits were most likely to belong to this high‑delinquency class.","clinical_takeaway":"No direct clinical recommendations; the study highlights that extreme delinence in youth can co‑occur with early sexual experiences and porn exposure, suggesting broader risk‑factor assessment.","confidence":0.7,"topic_tags":["adolescents","sexual_function","pornography"],"strengths":["Large number of behavioural indicators (51) for latent class analysis","Use of person‑centred analytic approach to identify sub‑populations","Multinomial logistic regression to examine risk‑factor predictors"],"limitations":["Cross‑sectional self‑report data; cannot infer causality","No validated scales reported for the behavioural items","Potential sample bias not described; unclear representativeness"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":1,"mentioning":36,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ab.20365"}},{"id":2987,"doi":"10.3109/13625187.2010.509522","pmid":"20863259","pmcid":null,"title":"Sexual attitudes, behaviour changes and opinions of interns in Izmir, Turkey","authors":"Ozan S, Timbil S, Aras S, Can Bilgin A, Orcin E, Semin S.","first_author":"Ozan S","journal":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","year":2010,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional and longitudinal questionnaire of medical interns (start vs end of training)","sample_n":null,"sample_text":"not reported in abstract","population":"medical interns in Izmir, Turkey","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed Turkish medical interns about how their sexual attitudes, knowledge sources (like the internet and pornography), and behaviors changed from the first year of medical school to graduation, finding increased internet use and modest shifts in opinions.","clinical_takeaway":"Medical curricula may need stronger training in sexual health history taking.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Longitudinal element (same students at two time points)","Focus on medical education relevance"],"limitations":["Likely non‑validated questionnaire","No effect sizes or power justification","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/13625187.2010.509522"}},{"id":2988,"doi":"10.1177/1079063210374347","pmid":"20852011","pmcid":null,"title":"Internet-facilitated commercial sexual exploitation of children: findings from a nationally representative sample of law enforcement agencies in the United States","authors":"Mitchell KJ, Jones LM, Finkelhor D, Wolak J.","first_author":"Mitchell KJ","journal":"Sexual abuse : a journal of research and treatment","year":2011,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Nationally representative survey of law‑enforcement agencies reporting arrests for Internet‑facilitated commercial sexual exploitation of children in 2006 (N≈1,051 cases).","sample_n":1051,"sample_text":"1,051 individual arrest cases drawn from >2,500 agencies.","population":"Law‑enforcement agencies; arrests involving children sexual exploitation.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 2006, about 569 arrests across the United States involved the Internet being used to exploit children sexually. Offenders who sold or profited from exploitation were more likely to have prior violent or sexual offenses and to work with others.","clinical_takeaway":"None – study reports law‑enforcement data, not clinical guidance.","confidence":0.8,"topic_tags":["csbd","sexual_function","pornography"],"strengths":["Nationally representative sample of law‑enforcement agencies","Large number of arrest cases","Clear descriptive incidence estimates"],"limitations":["Relies on arrest data, may underestimate true prevalence","No assessment of victim or offender psychosocial factors beyond criminal history","Descriptive design limits causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":4,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":56,"citing_publications":117,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063210374347"}},{"id":2989,"doi":null,"pmid":"10356233","pmcid":null,"title":"Pornography's Impact on Male Adolescents","authors":"Malamuth NM.","first_author":"Malamuth NM.","journal":"Adolescent medicine (Philadelphia, Pa.)","year":1993,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"none","sample_n":null,"sample_text":"no empirical sample reported","population":"male adolescents (discussion context)","country":"USA (likely based on author affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The author notes that while some teenage boys might be harmed by viewing porn, there is little direct research because of ethical and political challenges, and calls for clearer definitions of porn and its possible harms.","clinical_takeaway":"Current evidence is insufficient; clinicians should be cautious about assuming porn causes harm in adolescents without solid data.","confidence":0.6,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Identifies gap in empirical research","Discusses definitional issues"],"limitations":["No empirical data","No systematic review methodology","Potential author bias"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":2990,"doi":"10.1007/s10461-010-9732-x","pmid":"20567895","pmcid":"PMC4615575","title":"Determinants of alcohol use, risky sexual behavior and sexual health problems among men in low income communities of Mumbai, India","authors":"Singh SK, Schensul JJ, Gupta K, Maharana B, Kremelberg D, Berg M.","first_author":"Singh SK","journal":"AIDS and behavior","year":2010,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cluster‑sampled community survey of 1239 men (18‑29) in low‑income Mumbai neighborhoods; logistic regression of alcohol use and sexual risk outcomes.","sample_n":1239,"sample_text":"1239 men (1071 drinkers, 161 nondrinkers) recruited via cluster sampling and a screener.","population":"young adult men in low‑income urban India (general population sample)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 1,200 young men in low‑income areas of Mumbai found that higher alcohol use was linked to more risky sexual behaviours and certain sexual‑health problems, even after accounting for stress, masculinity attitudes and media exposure.","clinical_takeaway":"Alcohol use is a strong correlate of risky sex; interventions should address drinking in sexual‑risk and HIV programmes.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample (N>1200)","Validated AUDIT alcohol measure","Multivariate logistic regression controlling for several predictors"],"limitations":["Cross‑sectional; cannot infer causality","Pornography exposure measured with uncertain validity","Key sexual‑health confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":20,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-010-9732-x"}},{"id":2991,"doi":"10.1080/13691058.2010.481332","pmid":"20473800","pmcid":null,"title":"Lizzy Kinsey and the Adult Friendfinders: an ethnographic study of Internet sex and pornographic self-display in Hong Kong","authors":"Jacobs K.","first_author":"Jacobs K.","journal":"Culture, health & sexuality","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"auto‑ethnography of users on a Hong Kong adult‑friend‑finder site, analysing self‑presentation and sexual identity narratives.","sample_n":null,"sample_text":"Not reported in abstract; likely a small, non‑random convenience sample selected by the researcher.","population":"users of a specific online sexual networking site in Hong Kong; sample size not specified in abstract.","country":"Hong Kong","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study uses ethnographic methods to explore how people on a Hong Kong adult‑friend‑finding site present themselves sexually online, examining cultural meanings and identity performance.","clinical_takeaway":"None – the paper provides sociocultural insight rather than clinical evidence.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight into online sexual self‑presentation","Context‑rich ethnographic perspective on Hong Kong sexual culture"],"limitations":["No validated measurement instruments","No assessment of key confounds (moral incongruence, mental health, etc.)","Small, non‑representative sample limits generalisability"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2010.481332"}},{"id":2992,"doi":"10.1080/13691051003703287","pmid":"20364442","pmcid":null,"title":"'These days virginity is just a feeling': heterosexuality and change in young urban Vietnamese men","authors":"Martin P.","first_author":"Martin P.","journal":"Culture, health & sexuality","year":2010,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"interviews with eight young Vietnamese men (age 18‑30) over 13 months in Hanoi; qualitative thematic analysis","sample_n":8,"sample_text":"Eight men aged 18‑30 years were interviewed.","population":"young urban Vietnamese men, convenience purposive sample","country":"Vietnam","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with eight young Vietnamese men suggest that rising female sexual freedom creates anxiety for them, leading some to watch porn together or visit sex workers to reaffirm masculine identity.","clinical_takeaway":"None – the study offers cultural observations, not clinical evidence.","confidence":0.75,"topic_tags":["pornography","masturbation","gender","sexual_function","csbd"],"strengths":["In‑depth, longitudinal fieldwork","Provides culturally specific insight into gender and sexuality","Highlights collective pornography use practices"],"limitations":["Very small, non‑representative sample (N=8)","No validated measures of pornography use or distress","No control for moral, mental‑health or relational confounds","Broad societal conclusions drawn from limited qualitative data"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":19,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691051003703287"}},{"id":2993,"doi":"10.15288/jsas.1993.s11.118","pmid":"8410953","pmcid":null,"title":"Alcohol and violent pornography: responses to permissive and nonpermissive cues","authors":"Norris J, Kerr KL.","first_author":"Norris J","journal":"Journal of studies on alcohol. Supplement","year":1993,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Lab experiment varying alcohol consumption, expectancy, and permissive cue; male and female participants; hypermasculinity measured as a trait.","sample_n":null,"sample_text":"Not reported in abstract","population":"adult participants (likely college students), both genders","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab experiment, drinking alcohol made people judge violent porn as more acceptable and say they would be more willing to act violently, especially when the porn included alcohol cues. Men high in hyper‑masculinity liked the violent porn more, but alcohol interacted with hyper‑masculinity mainly for men low on that trait.","clinical_takeaway":"Alcohol can increase acceptance of violent sexual content; clinicians should consider alcohol use when assessing risk for sexual aggression.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Experimental manipulation allows causal inference for alcohol effects","Inclusion of both genders and personality trait (hypermasculinity)","Clear factorial design with beverage, expectancy, and cue variables"],"limitations":["No information on sample size or power","Outcome measures appear ad‑hoc and not validated","Potential convenience‑sample bias (likely student participants)","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":59,"citing_publications":73,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.15288/jsas.1993.s11.118"}},{"id":2994,"doi":"10.1007/bf01542124","pmid":"8368918","pmcid":null,"title":"Violence and sexual violence in pornography: is it really increasing?","authors":"Scott JE, Cuvelier SJ.","first_author":"Scott JE","journal":"Archives of sexual behavior","year":1993,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of all cartoons and pictures in Hustler Magazine (1974‑1987)","sample_n":null,"sample_text":"All cartoons and pictorials in Hustler Magazine from 1974 through 1987 (comprehensive within this source)","population":"Pornographic magazine content (U.S.)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A review of research and a new content analysis of Hustler Magazine from 1974‑1987 found that sexually violent images made up a small, steady share of the magazine, with no clear increase over time.","clinical_takeaway":"None – the study addresses media trends, not individual sexual health or behavior.","confidence":0.7,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Comprehensive coding of a single, high‑circulation magazine over 14 years","Systematic time‑trend analysis","Direct analysis of primary visual material"],"limitations":["Only one magazine examined; limited generalizability","Coding scheme not described as validated","No control for broader cultural or publishing trends"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542124"}},{"id":2995,"doi":"10.1111/j.1440-1754.2010.01804.x","pmid":"20649855","pmcid":null,"title":"Is child nudity in art ever pornographic?","authors":"Isaacs D, Isaacs TG.","first_author":"Isaacs D","journal":"Journal of paediatrics and child health","year":2010,"pub_types":["Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1440-1754.2010.01804.x"}},{"id":2996,"doi":"10.1037/a0019700","pmid":"20565168","pmcid":null,"title":"What is so special about male adolescent sexual offending? A review and test of explanations through meta-analysis","authors":"Seto MC, Lalumière ML.","first_author":"Seto MC","journal":"Psychological bulletin","year":2010,"pub_types":["Meta-Analysis","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":245,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 59 independent studies (N≈17,000) comparing adolescent male sex offenders with non‑sex offenders on a range of risk‑factor variables.","sample_n":17148,"sample_text":"59 independent studies, total N≈17,000 participants.","population":"Male adolescent sexual offenders (n≈3,855) and matched non‑sex offending male adolescents (n≈13,393).","country":"Multiple (studies from various countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 59 studies found that male adolescent sex offenders differ from other young offenders on several factors, especially atypical sexual interests and histories of sexual abuse, suggesting both special and general risk explanations.","clinical_takeaway":"Assess for atypical sexual interests and abuse histories when working with adolescent male sex offenders; general antisocial risk factors are less predictive.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large aggregate sample across many studies","Systematic comparison of multiple theoretical risk domains","Effect‑size weighting allows ranking of predictors"],"limitations":["Variable quality and measurement consistency across included studies","Limited control for moral or cultural confounds","Potential publication bias not addressed in abstract"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":70,"contrasting":16,"mentioning":660,"citing_publications":691,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/a0019700"}},{"id":2997,"doi":"10.1016/j.chiabu.2010.01.011","pmid":"20605633","pmcid":null,"title":"Cyber-pedocriminality: characteristics of a sample of internet child pornography offenders","authors":"Niveau G.","first_author":"Niveau G.","journal":"Child abuse & neglect","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":2,"contrasting":0,"mentioning":10,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2010.01.011"}},{"id":2998,"doi":"10.1080/09540120903325433","pmid":"20461575","pmcid":"PMC2885574","title":"Sex in public and private settings among Latino MSM","authors":"Reisen CA, Iracheta MA, Zea MC, Bianchi FT, Poppen PJ.","first_author":"Reisen CA","journal":"AIDS care","year":2010,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Within‑person comparison of self‑reported sexual acts in public vs private settings; between‑person comparison of men who used three types of public venues in the past six months.","sample_n":null,"sample_text":"Not stated in abstract; likely a convenience sample recruited from venues or community.","population":"Latino men who have sex with men (MSM); sample size not reported in abstract.","country":"USA (presumed based on authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared sexual behaviours of Latino gay men in private rooms versus public places like bathhouses, bars, and parks, finding more private anal sex but more group sex in public settings.","clinical_takeaway":"Clinicians should consider the influence of venue type on sexual risk when counseling Latino MSM.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Focus on contextual factors (public vs private)","Within‑person comparison reduces between‑person variability","Differentiates types of public venues"],"limitations":["Cross‑sectional self‑report, possible recall bias","No measurement of key confounds (mental health, moral attitudes)","Sample size and recruitment methods unclear"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":1,"mentioning":17,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540120903325433"}},{"id":2999,"doi":"10.1007/s10508-010-9603-6","pmid":"20182786","pmcid":null,"title":"Child pornography use and internet solicitation in the diagnosis of pedophilia","authors":"Seto MC.","first_author":"Seto MC.","journal":"Archives of sexual behavior","year":2010,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9603-6"}},{"id":3001,"doi":"10.1177/1557988309360819","pmid":"20164062","pmcid":null,"title":"To tweet, or not to tweet: gender differences and potential positive and negative health outcomes of adolescents' social internet use","authors":"Pujazon-Zazik M, Park MJ.","first_author":"Pujazon-Zazik M","journal":"American journal of men's health","year":2010,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":66,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Review of existing literature; no original data collection.","sample_n":null,"sample_text":"No primary sample; literature review.","population":"Adolescents and young adults (general)","country":"United States (likely, based on funding)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how teens use social media, noting gender differences and possible health benefits and harms, including exposure to pornography and cyberbullying, and discusses the role of parental monitoring.","clinical_takeaway":"Clinicians should ask about teens' online activities and advise parental monitoring to reduce risks.","confidence":0.5,"topic_tags":["adolescents","sexual_function"],"strengths":["Broad overview of adolescent social media use.","Includes discussion of potential health risks."],"limitations":["No original empirical data.","Lacks systematic methodology description."],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":6,"contrasting":1,"mentioning":135,"citing_publications":210,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1557988309360819"}},{"id":3003,"doi":"10.1007/s00404-009-1350-3","pmid":"20066452","pmcid":null,"title":"Gender-specific knowledge on sex","authors":"Lauszus FF, Kloster AO, Nielsen JL, Boelskifte J, Falk J, Rasmussen KL.","first_author":"Lauszus FF","journal":"Archives of gynecology and obstetrics","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire of 394 Danish 9th‑grade pupils (age ≈15) comparing knowledge sources across years","sample_n":394,"sample_text":"394 of 398 questionnaires answered in 2007 (9th‑grade pupils, Viborg municipality, Denmark)","population":"Adolescents (15 yr) in Denmark, school‑based convenience sample","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2011 Danish survey of 15‑year‑old students found that schools and peers remain the main sources of sexual knowledge, while magazines and pornography rank third. Boys with sexual experience answered knowledge questions more accurately than girls without experience.","clinical_takeaway":"None – the study offers descriptive insight into information sources, not clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large response rate (99%)","Comparative data across multiple years","Clear descriptive statistics of knowledge sources"],"limitations":["Cross‑sectional, no causal inference","Ad‑hoc questionnaire without validated scales","Limited to one municipality; generalisability uncertain"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00404-009-1350-3"}},{"id":3004,"doi":null,"pmid":"21348013","pmcid":null,"title":"The organization of STI/HIV risk-taking among long-line fishermen in Bali, Indonesia","authors":"Setiawan IM, Patten JH.","first_author":"Setiawan IM","journal":"International maritime health","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative social‑network study of migrant fishermen; data collected via interviews/observations; no quantitative measures reported.","sample_n":null,"sample_text":"Not reported in abstract; study appears to use a convenience sample of fishermen at a single port.","population":"Long‑line fishermen based in Bali, Indonesia (migrant workers).","country":"Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study explores how long‑line fishermen in Bali combine drinking, watching porn videos, and visiting brothels, leading to high STI/HIV risk that may spread to wider communities through their migration patterns.","clinical_takeaway":"None – the paper provides sociological insight, not clinical guidance on pornography or sexual health treatment.","confidence":0.4,"topic_tags":["sexual_function","pornography"],"strengths":["Addresses understudied high‑risk occupational group","Highlights social‑network influences on STI/HIV risk"],"limitations":["No quantitative measurement of pornography use or sexual behaviour","No assessment of key confounds (moral, mental health, partner effects)","Qualitative design limits causal inference and generalisability"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":3005,"doi":"10.1037/a0017504","pmid":"20063924","pmcid":null,"title":"A meta-analytic review of research on gender differences in sexuality, 1993-2007","authors":"Petersen JL, Hyde JS.","first_author":"Petersen JL","journal":"Psychological bulletin","year":2010,"pub_types":["Meta-Analysis","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":325,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 834 samples and 7 national datasets covering 30 sexual behaviors/attitudes, including masturbation and pornography use.","sample_n":null,"sample_text":"834 individual samples uncovered in literature searches and 7 large national data sets.","population":"Adults from diverse studies; no single sample reported.","country":"Multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2010 meta‑analysis of over 800 studies found that men usually report slightly more sexual experience and permissive attitudes than women, but most gender differences are small. Notable medium differences favor men for masturbation, pornography use, and casual sex.","clinical_takeaway":"Gender differences in pornography use and masturbation are modest; clinicians should consider individual variation rather than assume large sex‑based gaps.","confidence":0.6,"topic_tags":["gender","sexual_function","pornography","masturbation"],"strengths":["Large number of studies and samples","Systematic update of prior meta‑analysis","Considers cultural and temporal moderators"],"limitations":["Relies on self‑report measures of sexuality","Does not control for moral or mental‑health confounds","Potential heterogeneity across source studies"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":65,"contrasting":8,"mentioning":464,"citing_publications":913,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/a0017504"}},{"id":3006,"doi":"10.1080/00926231003719681","pmid":"20432125","pmcid":null,"title":"What is sexual addiction?","authors":"Levine SB.","first_author":"Levine SB.","journal":"Journal of sex & marital therapy","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of 30 married men seeking help for self‑identified sexual addiction, described by a single clinician","sample_n":30,"sample_text":"30 men","population":"married men (n=30) who presented to one clinician in the USA between 2005‑2009","country":"USA","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["circular_addiction_scale","self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews 30 married men who called themselves sexual addicts, describing six patterns of sexual behavior. Only a small subset showed what the authors consider true addiction, while many fit other categories like paraphilia or relational issues.","clinical_takeaway":"The study suggests most men seeking help for \"sexual addiction\" may not meet strict addiction criteria; clinicians should assess underlying relationship and mental‑health factors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed qualitative description of heterogeneous clinical presentations","Attempts to differentiate addiction from other sexual‑behavior categories"],"limitations":["No validated measures of sexual behavior or addiction","Small, non‑representative clinical sample","No control for moral, relational, or mental‑health confounds"],"rubric_version":"2.0","raw_total":15,"max_possible":60,"pct_score":25,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":43,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926231003719681"}},{"id":3008,"doi":"10.1111/j.1745-8315.2009.00197.x","pmid":"20002828","pmcid":null,"title":"Between physical desire and emotional involvement: reflections on Frédéric Fonteyne's film Une Liaison Pornographique","authors":"Sabbadini A.","first_author":"Sabbadini A.","journal":"The International journal of psycho-analysis","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1745-8315.2009.00197.x"}},{"id":3009,"doi":"10.1080/13554790903329182","pmid":"19927260","pmcid":null,"title":"Kluver-Bucy syndrome, hypersexuality, and the law","authors":"Devinsky J, Sacks O, Devinsky O.","first_author":"Devinsky J","journal":"Neurocase","year":2010,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"One 51‑year‑old right‑handed man following right temporal lobectomy","population":"single adult male with temporal lobectomy","country":"USA","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A 51‑year‑old man developed intense sexual urges and later downloaded child pornography after a second temporal‑lobe surgery for epilepsy. The authors suggest that damage to limbic areas may underlie this hypersexuality and discuss legal responsibility.","clinical_takeaway":"Brain injury can produce abrupt changes in sexual behavior; clinicians should assess neuro‑psychiatric causes of sudden hypersexuality.","confidence":0.6,"topic_tags":["neuroscience","sexual_function","csbd"],"strengths":["Detailed clinical description of rare syndrome","Links neuroanatomy to behavior"],"limitations":["Single case, no systematic measurement","No validated scales for hypersexuality or addiction","No control for moral/religious or mental‑health confounds"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":3,"contrasting":0,"mentioning":41,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13554790903329182"}},{"id":3010,"doi":"10.1017/s1092852900023865","pmid":"20173687","pmcid":null,"title":"Sexual and other axis I diagnoses of 60 males arrested for crimes against children involving the Internet","authors":"Krueger RB, Kaplan MS, First MB.","first_author":"Krueger RB","journal":"CNS spectrums","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Chart review of 60 arrested males; descriptive statistics, chi‑square/Fisher tests.","sample_n":60,"sample_text":"60 males referred for psychosexual evaluation after arrest.","population":"Males (average age not specified) arrested for child‑pornography possession or online solicitation; forensic/clinical sample.","country":"USA (implied by authors and DSM‑IV‑TR use)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A review of 60 men arrested for child‑pornography offenses found that many also had other psychiatric diagnoses, including paraphilias and a ‘hypersexuality’ disorder, suggesting complex mental‑health profiles among this group.","clinical_takeaway":"Clinicians assessing individuals with child‑exploitation offenses should screen for broader psychiatric comorbidities, including hypersexuality.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of standardized DSM diagnoses","Full clinical chart data for all participants","Clear descriptive statistics"],"limitations":["Convenience forensic sample; not generalizable","No validated hypersexuality scale","No measurement of pornography use frequency or moral variables","Limited statistical depth"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":4,"mentioning":19,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852900023865"}},{"id":3011,"doi":"10.1016/s0968-8080(09)34467-5","pmid":"19962635","pmcid":null,"title":"A glimpse into 30 years of struggle against prostitution by the women's liberation movement in Norway","authors":"Strøm A.","first_author":"Strøm A.","journal":"Reproductive health matters","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"N/A","sample_n":null,"sample_text":"N/A","population":"N/A","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article narrates three decades of the Norwegian Women's Front campaigning against prostitution, describing how they helped pass a law criminalising buyers of sex and promoted social services for sex workers.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides historical overview of policy activism","Highlights role of trade unions"],"limitations":["No empirical data or systematic analysis","No measurement of sexual behavior constructs","Potential advocacy bias"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0968-8080(09)34467-5"}},{"id":3012,"doi":"10.1111/j.1746-1561.2009.00447.x","pmid":"19840232","pmcid":null,"title":"Clustering of Internet risk behaviors in a middle school student population","authors":"Dowell EB, Burgess AW, Cavanaugh DJ.","first_author":"Dowell EB","journal":"The Journal of school health","year":2009,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 404 middle‑school students recruited from public and parochial schools; convenience sample; descriptive statistics.","sample_n":404,"sample_text":"404 students from public and parochial middle schools in New England.","population":"Middle‑school students (mean age 12, both sexes).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 404 twelve‑year‑olds found that some are already engaging in risky online behaviours, including visiting porn sites, sharing pictures, and harassing others.","clinical_takeaway":"None – the study is descriptive and does not provide guidance for clinical practice.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample for a middle‑school survey","Focus on early adolescent internet risk behaviours","Clear descriptive findings"],"limitations":["Cross‑sectional, cannot infer causality","Use of non‑validated, single‑item measures for pornography exposure","No control for moral incongruence, mental health, or other confounds"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":44,"citing_publications":91,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1746-1561.2009.00447.x"}},{"id":3013,"doi":"10.1136/bmj.b3887","pmid":"19776111","pmcid":null,"title":"UN expert calls for greater care and assistance for victims of child pornography","authors":"Zarocostas J.","first_author":"Zarocostas J.","journal":"BMJ (Clinical research ed.)","year":2009,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.b3887"}},{"id":3014,"doi":"10.2105/ajph.2009.169912","pmid":"19696372","pmcid":null,"title":"Condom use and male homosexual pornography","authors":"Silvera R, Stein DJ, Hagerty R, Marmor M.","first_author":"Silvera R","journal":"American journal of public health","year":2009,"pub_types":["Letter","Comment","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2105/ajph.2009.169912"}},{"id":3015,"doi":"10.1186/1471-2458-9-282","pmid":"19656369","pmcid":"PMC2907520","title":"Relationships, love and sexuality: what the Filipino teens think and feel","authors":"de Irala J, Osorio A, López del Burgo C, Belen VA, de Guzman FO, Calatrava Mdel C, Torralba AN.","first_author":"de Irala J","journal":"BMC public health","year":2009,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"http://www.biomedcentral.com/1471-2458/9/282","cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 4,000 Filipino students (13‑18 y) using multi‑stage cluster sampling; analysis adjusted for sex, age, institution.","sample_n":4000,"sample_text":"Target population of 4,000 Filipino students from high‑school to college; this paper focuses on teens aged 13‑18.","population":"Filipino adolescents (13‑18 y), school‑based sample","country":"Philippines","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of Filipino teens found they learn about love and sex mainly from friends, value parents’ opinions, and often misunderstand condom effectiveness. Approval of pornography and sexist attitudes were linked to having had sex, suggesting better parent‑teen communication could improve sexual health.","clinical_takeaway":"Improve parent‑teen dialogue on sexuality and correct condom misconceptions to support healthier sexual decisions.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, multi‑stage cluster sample","Adjusted analyses for basic demographics","Provides insight into knowledge gaps and attitudes"],"limitations":["Reliance on ad‑hoc, non‑validated questionnaire items","No measurement of key confounds (moral incongruence, mental health, etc.)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2458-9-282"}},{"id":3016,"doi":"10.1007/s10508-009-9470-1","pmid":"19184623","pmcid":null,"title":"Pornographic actresses are a poor choice for assessing what men optimally prefer in women's looks: Comments on Voracek and Fisher (2006)","authors":"Holland E.","first_author":"Holland E.","journal":"Archives of sexual behavior","year":2009,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-009-9470-1"}},{"id":3017,"doi":"10.1177/1090198109339993","pmid":"19574587","pmcid":"PMC2866104","title":"In the dark: young men's stories of sexual initiation in the absence of relevant sexual health information","authors":"Kubicek K, Beyer WJ, Weiss G, Iverson E, Kipke MD.","first_author":"Kubicek K","journal":"Health education & behavior : the official publication of the Society for Public Health Education","year":2010,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":120,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"mixed-methods cross‑sectional survey and interviews of 526 young men who have sex with men","sample_n":526,"sample_text":"mixed-methods study with 526 YMSM","population":"young MSM (age unspecified), recruited likely via community/online outreach","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Young gay men often learn about anal sex from older partners, the internet, and pornography because schools and families give little relevant information, leading to risky first experiences.","clinical_takeaway":"Clinicians should proactively provide accurate sexual‑health education to YMSM, not rely on patients to learn from peers or porn.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample of a hard‑to‑reach population","Mixed‑methods adds depth to quantitative findings","Addresses a clear gap in sexual‑health information literature"],"limitations":["Reliance on ad‑hoc self‑report questions without validated scales","Cross‑sectional design cannot establish causal links","Convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":0,"mentioning":152,"citing_publications":212,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1090198109339993"}},{"id":3018,"doi":"10.1542/peds.2008-2954","pmid":"19564268","pmcid":null,"title":"Premarital sexual intercourse among adolescents in an Asian country: multilevel ecological factors","authors":"Wong ML, Chan RK, Koh D, Tan HH, Lim FS, Emmanuel S, Bishop G.","first_author":"Wong ML","journal":"Pediatrics","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case‑control study of 500 adolescents with recent voluntary sex matched to 500 controls","sample_n":1000,"sample_text":"500 cases and 500 matched controls","population":"adolescents in Singapore, both sexes, recruited 2006‑2008","country":"Singapore","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A case‑control study in Singapore found that adolescents who had viewed pornography were far more likely to have had premarital sex, even after accounting for peer pressure, substance use and other factors.","clinical_takeaway":"Consider addressing pornography exposure in adolescent sexual‑health counseling, but note causality is not proven.","confidence":0.78,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large matched case‑control sample","Adjusted odds ratios with confidence intervals","Multivariate analysis of many ecological factors"],"limitations":["Pornography exposure measured by single self‑report item, not validated","Key sexual‑health confounds (moral incongruence, masturbation, mental health) not assessed","Case‑control design cannot establish causality"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":0,"mentioning":52,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2008-2954"}},{"id":3019,"doi":null,"pmid":"19556957","pmcid":null,"title":"Accidental death due to complete autoerotic asphyxia associated with transvestic fetishism and anal self-stimulation - case report","authors":"Atanasijević T, Jovanović AA, Nikolić S, Popović V, Jasović-Gasić M.","first_author":"Atanasijević T","journal":"Psychiatria Danubina","year":2009,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single accidental death involving autoerotic asphyxia, transvestic fetishism and anal masturbation; data from forensic scene, psychological autopsy (SCID‑I/II) with father.","sample_n":1,"sample_text":"single case (n=1)","population":"one 36‑year‑old male, deceased","country":"Serbia (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 36‑year‑old man died accidentally while engaging in autoerotic asphyxia that involved wearing his mother’s clothes, using a plastic bag, and inserting a wooden cork into his rectum. Police found porn magazines nearby. A forensic and psychological autopsy concluded the death was accidental, not suicidal.","clinical_takeaway":"Accidental deaths can occur during high‑risk autoerotic practices; clinicians should assess for such behaviours when evaluating sexual health and safety.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Detailed forensic and psychological autopsy","Use of standardized clinical interviews (SCID)","Clear description of the accidental death scenario"],"limitations":["Single case – no generalisability","No systematic measurement of confounding variables","No statistical analysis or effect size estimation"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":3020,"doi":"10.1111/j.1743-6109.2009.01307.x","pmid":"19453886","pmcid":null,"title":"Pubic hair and sexuality: a review","authors":"Ramsey S, Sweeney C, Fraser M, Oades G.","first_author":"Ramsey S","journal":"The journal of sexual medicine","year":2009,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methodology or risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not applicable – review of published studies and internet sources.","population":"Not applicable (review of literature).","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews the history and cultural meanings of pubic hair removal, suggesting it may be linked to internet pornography and could affect sexual sensation, but notes there is no quantitative research on these effects.","clinical_takeaway":"No actionable clinical guidance; highlights need for research on how pubic hair removal might influence sexual experience.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Broad historical and cultural overview","Identifies gap in quantitative research on sexual outcomes"],"limitations":["No systematic search strategy reported","Lacks quantitative data or critical appraisal","Conclusions are largely speculative"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":0,"mentioning":65,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01307.x"}},{"id":3021,"doi":"10.1007/s13312-010-0029-y","pmid":"19430068","pmcid":null,"title":"Adolescent attitudes and relevance to family life education programs","authors":"Unni JC.","first_author":"Unni JC.","journal":"Indian pediatrics","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of adolescents in seven private schools; pre‑tested questionnaires for boys (n=886) and girls (n=589); analyzed queries (n=10 660).","sample_n":1475,"sample_text":"Convenience sample of students from private schools; not a probability or nationally representative sample.","population":"Adolescents attending private co‑educational English‑medium schools in Cochin, India.","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of over a thousand adolescents in private schools in Cochin found many knew little about sex and relied on peers for information. Most boys began masturbating by age 12, and about one‑fifth reported giving in to peer pressure to view pornography.","clinical_takeaway":"Clinicians should recognise early onset of masturbation and limited sex education among Indian adolescents and consider school‑based programmes to provide accurate information.","confidence":0.8,"topic_tags":["adolescents","masturbation","pornography","sexual_function"],"strengths":["Large total number of queries (10 660) provides breadth of topics.","Separate questionnaires for boys and girls allow gender‑specific insights.","Pre‑tested questionnaire items."],"limitations":["Convenience sample from private schools limits generalisability.","No validated psychometric instruments for pornography or masturbation behaviours.","No control for key confounds (moral attitudes, mental health, etc.).","Statistical reporting limited to descriptive percentages."],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13312-010-0029-y"}},{"id":3022,"doi":null,"pmid":"2039845","pmcid":null,"title":"Paraphilias in U.S. pornography titles: \"pornography made me do it\" (Ted Bundy)","authors":"Lebegue B.","first_author":"Lebegue B.","journal":"The Bulletin of the American Academy of Psychiatry and the Law","year":1991,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive content analysis of 3,050 pornographic magazine and book titles collected from adult‑only outlets in six U.S. cities (1991). Titles were coded into DSM‑III‑R paraphilia categories.","sample_n":3050,"sample_text":"3,050 separate magazine and book titles randomly selected from outlets in six U.S. cities","population":"U.S. adult‑only pornography titles (N = 3,050)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined 3,050 adult‑only magazine and book titles sold in six U.S. cities and found that about 17% could be classified under DSM‑III‑R paraphilia categories, with sadomasochism and incest being the most common.","clinical_takeaway":"None – the study describes pornography content, not health effects.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample of titles (N>3000)","Systematic random selection of outlets across multiple cities","Clear descriptive statistics of paraphilia distribution"],"limitations":["Coding scheme not validated; relies on researcher interpretation of titles","Titles may not reflect actual content or consumer behavior","Limited to 1990s U.S. market; not generalizable to current media"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":3023,"doi":"10.1016/0160-2527(91)90024-h","pmid":"2032762","pmcid":null,"title":"Pornography and rape: theory and practice? Evidence from crime data in four countries where pornography is easily available","authors":"Kutchinsky B.","first_author":"Kutchinsky B.","journal":"International journal of law and psychiatry","year":1991,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Ecological time‑series comparison of national rape rates and pornography availability in four countries (1964‑1984).","sample_n":null,"sample_text":"Aggregate crime data for USA, Denmark, Sweden, West Germany.","population":"National crime statistics; no individual participants.","country":"USA, Denmark, Sweden, Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The author examined whether rising availability of pornography from the 1960s‑80s coincided with higher rape rates in the US, Denmark, Sweden, and West Germany. Across all four nations, rape trends followed the same pattern as other violent crimes, not increasing uniquely with porn availability, suggesting no direct causal link.","clinical_takeaway":"None – the study provides population‑level evidence, not individual clinical guidance.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Uses long‑term, multi‑country data","Compares rape trends to other violent crime trends","Addresses a widely discussed hypothesis"],"limitations":["Ecological design cannot infer individual‑level causation","Pornography availability measured qualitatively, not quantified","No control for confounding social factors (e.g., law changes, reporting rates)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":17,"citing_publications":119,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0160-2527(91)90024-h"}},{"id":3024,"doi":null,"pmid":"19338733","pmcid":null,"title":"[Knowledge of contraception, pregnancy, and sexuality in ninth grade pupils in the municipality of Viborg during a 21-year-period]","authors":"Nielsen JL, Boelskifte J, Falk J, Lauszus FF, Rasmussen KL.","first_author":"Nielsen JL","journal":"Ugeskrift for laeger","year":2009,"pub_types":["Comparative Study","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"dan","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of ninth‑grade pupils in one Danish municipality; repeated cross‑sectional comparisons with prior years","sample_n":394,"sample_text":"394 of 398 questionnaires answered (≈99% response rate) from a single municipality; convenience sample of school classes","population":"students (age ~15‑16) in Viborg, Denmark","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A questionnaire given to all ninth‑grade students in Viborg, Denmark, showed that knowledge about contraception and pregnancy has changed little over 21 years, while media and pornography have become major sources of information.","clinical_takeaway":"Sex education programs should consider the growing influence of media and pornography when designing curricula for adolescents.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Very high response rate","Longitudinal comparison over 21 years","Large sample for a single‑municipality school survey"],"limitations":["Convenience sample, limited generalisability","Questionnaire not reported as validated","No control for potential confounders (e.g., socioeconomic status)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":3025,"doi":"10.1097/acm.0b013e3181939222","pmid":"19174655","pmcid":null,"title":"Commentary: Knowing it when we see it: reflections on pornography","authors":"Hull SK.","first_author":"Hull SK.","journal":"Academic medicine : journal of the Association of American Medical Colleges","year":2009,"pub_types":["Comment","Historical Article","Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary/editorial without original data; reflects on historical incident involving pornographic images in anatomy textbook.","sample_n":null,"sample_text":"N/A","population":"Medical educators and learners (historical context); no empirical sample","country":"United States (journal affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reflects on a historic incident where an anatomy textbook used demeaning, pin‑up style photos of women, arguing that generational feminist responses shape today’s view of such exploitative portrayals in medical education.","clinical_takeaway":"None – the piece offers historical and ethical commentary, not clinical guidance.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Provides historical perspective on pornographic imagery in medical education","Highlights ethical concerns and power dynamics"],"limitations":["No empirical data; purely opinion piece","No systematic analysis or evidence base"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/acm.0b013e3181939222"}},{"id":3026,"doi":"10.1515/ijamh.2009.21.1.101","pmid":"19526700","pmcid":null,"title":"Sexual behavior and the influencing factors among out of school female adolescents in Mushin market, Lagos, Nigeria","authors":"Odeyemi K, Onajole A, Ogunowo B.","first_author":"Odeyemi K","journal":"International journal of adolescent medicine and health","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 332 out‑of‑school female adolescents in Lagos using interviewer‑administered questionnaire","sample_n":332,"sample_text":"representative sample selected using cluster sampling from a market population","population":"unmarried out‑of‑school female adolescents, mean age 17, Nigeria","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 332 out‑of‑school teenage girls in Lagos found that 44% had had sex, often starting at age 16, and that factors like friends’ behaviour, family situation, money needs and watching porn were linked to starting sex.","clinical_takeaway":"Clinicians should consider peer influence, socioeconomic stress and porn exposure when counseling at‑risk adolescent girls.","confidence":0.7,"topic_tags":["adolescents","sexual_function","pornography"],"strengths":["Relatively large community sample (N=332)","Cluster sampling enhances representativeness of market‑based out‑of‑school adolescents","Identifies multiple socio‑environmental correlates of sexual initiation"],"limitations":["Cross‑sectional design precludes causal inference","Key constructs measured by unvalidated self‑report items","No effect sizes or confidence intervals reported","Potential social desirability bias in interviewer‑administered questionnaire"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":13,"contrasting":1,"mentioning":24,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/ijamh.2009.21.1.101"}},{"id":3027,"doi":"10.1016/j.yapd.2009.08.002","pmid":"19968950","pmcid":null,"title":"Child pornography: legal and medical considerations","authors":"Berkowitz CD.","first_author":"Berkowitz CD.","journal":"Advances in pediatrics","year":2009,"pub_types":["Legal Case","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.yapd.2009.08.002"}},{"id":3028,"doi":null,"pmid":"19432080","pmcid":null,"title":"[Sex life of the elderly is active and satisfying]","authors":"Kontula O.","first_author":"Kontula O.","journal":"Duodecim; laaketieteellinen aikakauskirja","year":2009,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation","pornography"],"language":"fin","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large representative population surveys of Finnish elderly, cross‑sectional descriptive analysis","sample_n":null,"sample_text":"representative population surveys (exact N not reported in abstract)","population":"elderly Finnish adults (age 60+), community‑dwelling, both sexes","country":"Finland","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Survey data from Finland show that many older adults remain sexually active and satisfied, especially when in steady relationships; sexual intercourse declines with age, but masturbation and pornography use rise.","clinical_takeaway":"Older adults can maintain active, satisfying sex lives; clinicians should discuss both partnered and solitary sexual health with older patients.","confidence":0.7,"topic_tags":["sexual_function","masturbation","pornography","csbd"],"strengths":["Large, nationally representative sample","Includes both partners and solitary behaviors","Provides sex‑life baseline for aging populations"],"limitations":["Reliance on self‑report, likely non‑validated questionnaires","No control for moral or mental‑health confounds","Cross‑sectional, cannot infer change over time"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":3029,"doi":"10.1146/annurev.clinpsy.032408.153618","pmid":"19327034","pmcid":null,"title":"Pedophilia","authors":"Seto MC.","first_author":"Seto MC.","journal":"Annual review of clinical psychology","year":2009,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":63,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article; no primary data","sample_n":null,"sample_text":"Not applicable (review)","population":"Adult male sex offenders and pedophilic individuals (no specific sample size reported)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review defines pedophilia as sexual interest in prepubescent children, notes its link to child sexual offending, and outlines that it cannot be changed but can be managed with techniques to increase control over arousal.","clinical_takeaway":"Assessment of pedophilic interest is important for risk management; interventions focus on control rather than change.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Comprehensive synthesis of existing literature on pedophilia","Clear definition of the construct and its clinical relevance","Balanced discussion of diagnostic methods and treatment implications"],"limitations":["No original empirical data; conclusions rely on prior studies","Lacks quantitative meta‑analysis or systematic review methods","Potential selection bias in cited literature"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":92,"citing_publications":182,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1146/annurev.clinpsy.032408.153618"}},{"id":3030,"doi":"10.1515/ijamh.2009.21.1.29","pmid":"19526693","pmcid":null,"title":"Gender differences in sexuality and life quality among young people visiting a Swedish youth clinic","authors":"Wiksten-Almströmer M.","first_author":"Wiksten-Almströmer M.","journal":"International journal of adolescent medicine and health","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 480 girls and 108 boys attending a Swedish youth clinic; self‑report questionnaire on sexuality, mental health and quality of life","sample_n":588,"sample_text":"480 girls, 108 boys (response rate 87 %)","population":"young people (≈18‑20 y) seeking care at a Stockholm youth clinic; convenience sample","country":"Sweden","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2004 survey of 588 Swedish youths at a city clinic found that girls reported more depression, body dissatisfaction and forced‑sex experiences, while boys reported more casual sex, masturbation and pornography use. The authors stress gender‑specific needs in youth health services.","clinical_takeaway":"Clinicians should consider gender‑specific psychosocial and sexual health concerns when treating young people at youth clinics.","confidence":0.8,"topic_tags":["gender","sexual_function","pornography","masturbation"],"strengths":["large overall sample size for a clinic survey","high response rate (87 %)","covers multiple domains of life quality and sexuality"],"limitations":["Convenience sample of clinic attendees limits generalisability","Questionnaire items appear ad‑hoc; no validated scales for pornography or addiction constructs","Moral/religious factors not measured despite assessing distress","Cross‑sectional design prevents causal inferences"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/ijamh.2009.21.1.29"}},{"id":3032,"doi":null,"pmid":"2312322","pmcid":null,"title":"Pornography: clearing the shelves","authors":"Jackson C.","first_author":"Jackson C.","journal":"Health visitor","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/editorial, no empirical data, no sample","sample_n":null,"sample_text":"None – article is an opinion piece, no participants reported","population":"general public / policymakers (implied)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","self_selected_sample"],"stance":"supports","citation_value":"background","plain_summary":"The article argues that a national campaign to ban pornography sales is justified because pornography is linked to sexual abuse of women and children, reflecting prevailing public and political opinions.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Addresses a socially relevant issue","Published in a professional journal"],"limitations":["No empirical data or methodology","No measurement of constructs or confounds","Potential advocacy bias"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":3034,"doi":"10.1111/j.1745-7262.2008.00413.x","pmid":"18478161","pmcid":null,"title":"Sexual and reproductive health service needs of university/college students: updates from a survey in Shanghai, China","authors":"Chen B, Lu YN, Wang HX, Ma QL, Zhao XM, Guo JH, Hu K, Wang YX, Huang YR, Chen P.","first_author":"Chen B","journal":"Asian journal of andrology","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 5,067 university students in Shanghai, China; self‑administered questionnaire covering reproductive‑health service needs, sexual attitudes, exposure to pornographic material, and STI knowledge.","sample_n":5067,"sample_text":"5,067 valid respondents","population":"university/college students (≈5,000) from 14 institutions in Shanghai; mixed gender, mostly non‑medical majors.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2008 survey of over 5,000 Shanghai university students found that most support school‑based reproductive‑health services, but many lack accurate knowledge about STIs and condom use. Exposure to pornographic material was recorded, yet the study did not link it to health outcomes.","clinical_takeaway":"Students need better, confidential reproductive‑health education and services; clinicians should not assume adequate STI knowledge.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a single‑country survey","Coverage of multiple service‑need domains","Clear presentation of knowledge gaps"],"limitations":["Questionnaire appears ad‑hoc; no validated scales reported","Cross‑sectional design prevents causal inference","Key confounders (e.g., moral incongruence, mental health) not measured"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":31,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1745-7262.2008.00413.x"}},{"id":3035,"doi":"10.1111/j.1743-6109.2008.00795.x","pmid":"18331257","pmcid":null,"title":"Demographic and psychosocial features of participants in bondage and discipline, \"sadomasochism\" or dominance and submission (BDSM): data from a national survey","authors":"Richters J, de Visser RO, Rissel CE, Grulich AE, Smith AM.","first_author":"Richters J","journal":"The journal of sexual medicine","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":96,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Nationally representative probability sample (N=19,307) surveyed by telephone; weighted logistic regression analyses.","sample_n":19307,"sample_text":"Representative national survey of 19,307 respondents aged 16‑59 years.","population":"Australian adults aged 16‑59 years (general population).","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2001‑2002 Australian survey of 19,000 adults, about 2% reported recent BDSM activity. BDSM participants were more likely to have diverse sexual experiences and view pornography, but they did not report higher rates of sexual coercion or psychological distress—in fact, men reported slightly lower distress.","clinical_takeaway":"BDSM appears to be a non‑pathological sexual interest for most people; it is not linked to higher abuse or mental‑health problems.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Weighted analyses improve generalisability","Direct assessment of a range of sexual behaviours"],"limitations":["BDSM measured with a single self‑report item, no validated scale","No assessment of moral/religious attitudes or masturbation separation","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":14,"contrasting":3,"mentioning":148,"citing_publications":278,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2008.00795.x"}},{"id":3036,"doi":"10.1176/ps.2008.59.7.803","pmid":"18587000","pmcid":null,"title":"Sexuality among Chinese mental health consumers in halfway houses of Hong Kong","authors":"Wong IW, Mak WW.","first_author":"Wong IW","journal":"Psychiatric services (Washington, D.C.)","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 193 mental‑health consumers and 88 staff in 11 HK halfway houses; chi‑square and t‑tests on sexual‑need items.","sample_n":193,"sample_text":"193 consumers, 88 staff from 11 halfway houses","population":"Chinese mental‑health consumers living in residential halfway houses (Hong Kong).","country":"Hong Kong","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 193 Chinese mental‑health residents in Hong Kong halfway houses found that many have needs related to dating, marriage, pornography, and masturbation, while staff report higher knowledge and comfort discussing sex.","clinical_takeaway":"Staff training should address sexual needs and knowledge gaps among mental‑health residents.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for this specific setting","Includes both consumer and staff perspectives","Broad range of sexual‑activity items"],"limitations":["Ad‑hoc questionnaire, limited validation","Cross‑sectional, no causal inference","No control for key confounds (e.g., mental health severity, moral attitudes)","Convenience sample from halfway houses limits generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ps.2008.59.7.803"}},{"id":3037,"doi":"10.1016/j.chiabu.2007.03.027","pmid":"18511118","pmcid":null,"title":"Developmental experiences of child sexual abusers and rapists","authors":"Simons DA, Wurtele SK, Durham RL.","first_author":"Simons DA","journal":"Child abuse & neglect","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"retrospective questionnaire of 269 incarcerated sexual offenders (137 rapists, 132 child sexual abusers); developmental experiences compared between groups.","sample_n":269,"sample_text":"269 sexual offenders (137 rapists, 132 child sexual abusers)","population":"adult male sexual offenders in prison; convenience sample","country":"unspecified (likely United States based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared childhood experiences of men who commit child sexual abuse with those who commit rape, finding that abusers report earlier sexual exposure and masturbation, while rapists report more physical and emotional abuse. The authors suggest these histories shape later offending.","clinical_takeaway":"Offender treatment may need to address underlying developmental trauma and sexual socialisation, not just risk‑avoidance skills.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample of offenders (N=269)","Comparison between two distinct offender types","Multiple developmental variables assessed"],"limitations":["Cross‑sectional, retrospective self‑report; cannot infer causality","Limited validation of questionnaires","Lacks control for key confounds (mental health, moral factors, partner effects)","Sample limited to incarcerated offenders; poor generalisability"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":2,"mentioning":95,"citing_publications":134,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2007.03.027"}},{"id":3038,"doi":"10.1177/0306624x08316969","pmid":"18397991","pmcid":null,"title":"Rape myth acceptance in men who completed the prostitution offender program of British Columbia","authors":"Klein C, Kennedy MA, Gorzalka BB.","first_author":"Klein C","journal":"International journal of offender therapy and comparative criminology","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of men in a prostitution offender program; cross‑sectional convenience sample","sample_n":null,"sample_text":"men in offender program (exact N not reported in abstract)","population":"men who completed the Prostitution Offender Program of British Columbia after being arrested for soliciting sex","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed men who had been arrested for soliciting sex and found that older age, higher education, less pornography use, and viewing purchasing sex as a problem were linked to lower acceptance of rape myths, while more conservative sexual attitudes and higher self‑reported sexual violence were linked to higher acceptance.","clinical_takeaway":"None – the findings relate to attitudes, not clinical treatment or sexual‑health outcomes.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses a previously validated rape‑myth scale","Examines multiple correlates (age, education, pornography use, etc.)"],"limitations":["Convenience sample of offenders limits generalisability","Cross‑sectional; cannot infer causality","Potential social desirability bias in self‑reports"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x08316969"}},{"id":3039,"doi":"10.1080/00224490801987481","pmid":"18569538","pmcid":null,"title":"Sex in America online: an exploration of sex, marital status, and sexual identity in internet sex seeking and its impacts","authors":"Albright JM.","first_author":"Albright JM.","journal":"Journal of sex research","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":74,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online convenience survey (N=15,246), cross‑sectional descriptive analysis","sample_n":15246,"sample_text":"15,246 respondents from the United States, recruited via an online survey about internet sex seeking","population":"U.S. adults who responded to an Internet survey about online sex seeking","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2008 survey of over 15,000 U.S. adults examined who views pornography and seeks sex online. Men and gay/lesbian participants were more likely to do so. Women reported more negative effects such as body‑image concerns and pressure to perform. Only 2 % met a prior definition of compulsive use.","clinical_takeaway":"Online pornography use is linked to self‑reported negative outcomes, especially for women, but causal conclusions cannot be drawn from this study.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Very large sample size","Comprehensive demographic breakdown","Addresses both gender and sexual orientation differences"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of moral incongruence or masturbation","Convenience sample, not representative of U.S. population","Compulsive use threshold based on prior studies, not validated in this sample"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":8,"contrasting":2,"mentioning":100,"citing_publications":215,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490801987481"}},{"id":3040,"doi":"10.1177/1077801208315066","pmid":"18359877","pmcid":null,"title":"Linking male use of the sex industry to controlling behaviors in violent relationships: an exploratory analysis","authors":"Simmons CA, Lehmann P, Collier-Tenison S.","first_author":"Simmons CA","journal":"Violence against women","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 2,135 women residing in an IPV shelter reporting on male partners' use of pornography/strip clubs and controlling behaviors; convenience sample; no longitudinal or experimental component","sample_n":2135,"sample_text":"2,135 female residents of an IPV shelter","population":"female IPV shelter residents (adult women, diverse ages)","country":"United States (presumed from journal, not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of women living in an intimate‑partner‑violence shelter found that men who used pornography or visited strip clubs were reported to show more controlling behaviours toward their partners.","clinical_takeaway":"Clinicians should note that male sex‑industry use may coincide with higher controlling behaviours, but the evidence is limited to self‑reports from shelter residents.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender","relationships"],"strengths":["large sample size for a shelter study","focus on an under‑researched link between sex‑industry use and IPV"],"limitations":["Convenience sample of shelter residents limits generalisability","Measures rely on second‑hand reports and likely lack validation","No control for moral, mental‑health or relationship confounds"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":3,"contrasting":0,"mentioning":15,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801208315066"}},{"id":3042,"doi":"10.4065/83.2.226","pmid":"18241634","pmcid":null,"title":"Internet sex addiction treated with naltrexone","authors":"Bostwick JM, Bucci JA.","first_author":"Bostwick JM","journal":"Mayo Clinic proceedings","year":2008,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":93,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single male patient treated with naltrexone for self‑identified Internet pornography addiction","sample_n":1,"sample_text":"single case","population":"adult male, treatment‑seeking, not a representative sample","country":"USA (Mayo Clinic)","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["circular_addiction_scale","self_selected_sample","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"avoid","plain_summary":"The authors describe one man who felt he was addicted to Internet porn and was given naltrexone, a drug used for alcohol dependence. They argue it worked by blocking brain reward pathways, but provide no systematic data.","clinical_takeaway":"No evidence to support naltrexone for internet porn use; further rigorous studies needed.","confidence":0.8,"topic_tags":["pornography","neuroscience","treatment"],"strengths":["detailed clinical description","discussion of pharmacological rationale"],"limitations":["single case, no control group","no validated addiction measures","no assessment of confounding variables","claims exceed data"],"rubric_version":"2.0","raw_total":12,"max_possible":60,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":2,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":102,"citing_publications":183,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4065/83.2.226"}},{"id":3043,"doi":"10.1111/j.1939-0025.1988.tb01613.x","pmid":"3067580","pmcid":null,"title":"The Censorship of pornography: catharsis or learning?","authors":"McCormack T.","first_author":"McCormack T.","journal":"The American journal of orthopsychiatry","year":1988,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without empirical data; no sample size reported.","sample_n":null,"sample_text":"Not applicable","population":"Not applicable","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article debates whether pornography serves as a harmless outlet (catharsis) or teaches sexual behavior (learning), arguing that recent policy favors learning for ideological reasons and warning that censorship could hinder research and feminist aims.","clinical_takeaway":"None – the paper offers theoretical commentary, not clinical guidance.","confidence":0.8,"topic_tags":["pornography","csbd"],"strengths":["Broad theoretical integration of psychology, sociology, and literary criticism","Highlights ideological influence on policy recommendations"],"limitations":["No empirical data or systematic review methodology","Lacks measurement of key constructs or control of confounds","Potential advocacy bias regarding censorship"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1939-0025.1988.tb01613.x"}},{"id":3044,"doi":"10.1521/jaap.2008.36.4.619","pmid":"19113957","pmcid":null,"title":"Attraction to pornographic stories on the internet: a commentary on \"clinical encounters with internet pornography\" by Thomas P. Kalman","authors":"Shapiro MA.","first_author":"Shapiro MA.","journal":"The journal of the American Academy of Psychoanalysis and Dynamic Psychiatry","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1521/jaap.2008.36.4.619"}},{"id":3045,"doi":null,"pmid":"19092069","pmcid":null,"title":"Forensic evaluation of problematic Internet use","authors":"Recupero PR.","first_author":"Recupero PR.","journal":"The journal of the American Academy of Psychiatry and the Law","year":2008,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how forensic psychiatrists can evaluate problematic Internet use, including pornography, in legal contexts. It outlines possible underlying disorders and suggests assessment and treatment approaches, but does not present new data.","clinical_takeaway":"Clinicians should use comprehensive, case‑by‑case forensic assessments for problematic Internet use rather than relying on a single diagnostic model.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Broad overview of forensic considerations","Integrates multiple psychopathology models","Practical recommendations for clinicians"],"limitations":["Narrative, non‑systematic review","No empirical data or systematic search","Limited methodological detail"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":3046,"doi":null,"pmid":"19110981","pmcid":null,"title":"[Sexual behavior and sources of information about sex among male adolescents: An 8-year follow-up]","authors":"Korkmaz Cetin S, Bildik T, Erermiş S, Demiral N, Ozbaran B, Tamar M, Aydin C.","first_author":"Korkmaz Cetin S","journal":"Turk psikiyatri dergisi = Turkish journal of psychiatry","year":2008,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation","pornography"],"language":"tur","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two-stage cohort (1996 & 2004) of male adolescents (N=392); repeated cross‑sectional surveys over 8 years","sample_n":392,"sample_text":"150 participants in 1996, 242 in 2004","population":"male tenth‑grade students, mean age 16, Turkey","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Turkish study of 392 boys followed from 1996 to 2004, sexual intercourse rose while masturbation stayed stable. Watching pornographic films became a more common way to learn about sex and was linked to a higher chance of having sex.","clinical_takeaway":"Exposure to pornographic films may influence adolescents’ sexual activity; clinicians should discuss reliable sex‑education sources with youth.","confidence":0.78,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["8‑year follow‑up provides temporal perspective","Large sample for adolescent survey","Addresses understudied source‑of‑information factor"],"limitations":["Self‑report questionnaire not validated","No control for key confounds (e.g., religiosity, mental health)","Causal language exceeds observational design"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":3047,"doi":"10.1363/ifpp.33.150.07","pmid":"18178539","pmcid":null,"title":"Correlates of premarital relationships among unmarried youth in Pune district, Maharashtra, India","authors":"Alexander M, Garda L, Kanade S, Jejeebhoy S, Ganatra B.","first_author":"Alexander M","journal":"International family planning perspectives","year":2007,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"community‑based survey of 15‑24‑year‑olds in urban slum and rural Pune, logistic regression of associations","sample_n":null,"sample_text":"community‑based sample of 15‑24‑year‑olds in urban slum and rural settings","population":"unmarried youth, India, likely >500 participants (exact N not stated)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A community survey in Pune, India found that 5‑24% of unmarried youth had romantic or sexual relationships. Watching porn, alcohol use, and peer contact were linked to higher odds of such relationships, while education and parental closeness were protective for girls.","clinical_takeaway":"Clinicians should consider peer influence and family dynamics when counseling Indian youth about premarital sexual activity.","confidence":0.7,"topic_tags":["sexual_function","relationships","adolescents"],"strengths":["Large community sample from both urban slum and rural areas","Multivariate logistic models controlling for several demographic factors","Examines a range of social and family predictors"],"limitations":["Cross‑sectional design limits causal inference","Key constructs (e.g., exposure to porn) measured with single items, no validated scales","No assessment of moral/religious attitudes or mental‑health covariates"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1363/ifpp.33.150.07"}},{"id":3049,"doi":"10.1177/0886260507305524","pmid":"17925287","pmcid":null,"title":"Assessing the factors associated with sexual harassment among young female migrant workers in Nepal","authors":"Puri M, Cleland J.","first_author":"Puri M","journal":"Journal of interpersonal violence","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 550 female migrant workers (age 14‑19) with bivariate and multivariate analyses; plus 12 qualitative case histories.","sample_n":550,"sample_text":"550 female workers aged 14 to 19; convenience sample from factories","population":"young female migrant workers in Nepali carpet and garment factories","country":"Nepal","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 550 young female migrant workers in Nepal found that about 10% experienced sexual harassment, and those who had seen pornographic movies were more likely to report harassment. The study highlights workplace vulnerability and calls for factory‑based interventions.","clinical_takeaway":"Consider workplace environment and media exposure when assessing harassment risk among young female workers.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample for the context (N=550)","Mixed methods (quantitative survey plus qualitative case histories)","Relevant public‑health issue for vulnerable workers"],"limitations":["Cross‑sectional design limits causal inference","No validated scales reported for harassment or porn exposure","Key confounders (mental health, moral attitudes, trauma) not measured"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260507305524"}},{"id":3050,"doi":"10.1111/j.1537-2995.2007.01349.x","pmid":"17725741","pmcid":null,"title":"2006 Emily Cooley award lecture: professionalism, pornography, and the practice of transfusion medicine","authors":"Moore SB.","first_author":"Moore SB.","journal":"Transfusion","year":2007,"pub_types":["Lecture"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1537-2995.2007.01349.x"}},{"id":3051,"doi":"10.1097/01.jnr.0000387619.10554.f5","pmid":"17806040","pmcid":null,"title":"A study of masturbatory knowledge and attitudes and related factors among Taiwan adolescents","authors":"Wang RJ, Huang Y, Lin YC.","first_author":"Wang RJ","journal":"The journal of nursing research : JNR","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire survey of 780 high‑school students in Taiwan, stratified cluster sampling","sample_n":780,"sample_text":"780 questionnaires sent, 96.8% response rate","population":"Taiwanese adolescents, age 17‑18, both genders, school‑based sample","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 780 Taiwanese high‑school students found that most boys and about a third of girls had masturbated. Knowledge about masturbation was linked to school type, porn viewing, sexual activity and peer talk. Positive attitudes were associated with the same factors plus gender and actual masturbation behavior.","clinical_takeaway":"Adolescents’ knowledge and attitudes about masturbation vary with media exposure and peer discussions; educators should address gaps in knowledge.","confidence":0.9,"topic_tags":["masturbation","adolescents","sexual_function"],"strengths":["Large, high‑response‑rate sample","Use of structured inventories for knowledge and attitudes","Multivariate analysis of variance and regression for variance explanation"],"limitations":["Cross‑sectional design limits causal inference","Unclear validation status of AMKI/ANAMI","Moral/religious attitudes not measured despite relevance"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":5,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.jnr.0000387619.10554.f5"}},{"id":3052,"doi":"10.1177/107906320701900305","pmid":"17896179","pmcid":null,"title":"The construction and preliminary validation of the Internet Behaviours and Attitudes Questionnaire (IBAQ)","authors":"O'Brien MD, Webster SD.","first_author":"O'Brien MD","journal":"Sexual abuse : a journal of research and treatment","year":2007,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a new self‑report questionnaire with 123 incarcerated and community‑placed Internet sexual offenders; factor analysis and internal consistency reported","sample_n":123,"sample_text":"123 Internet sexual offenders (incarcerated and community dispositions)","population":"convicted men whose offences involve Internet child sexual abuse material (incarcerated and community‑disposition)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and preliminarily tested a new questionnaire (IBAQ) to assess attitudes and behaviours of men convicted of Internet child sexual abuse. The tool showed strong internal consistency and two main factors—distorted thinking and self‑management—were identified.","clinical_takeaway":"The IBAQ may help clinicians assess risk and treatment needs of internet sexual offenders, but further validation is needed before routine use.","confidence":0.8,"topic_tags":["measurement","sexual_function"],"strengths":["Clear description of item generation process","Good internal consistency reported","Factor analysis identifies theoretically relevant dimensions"],"limitations":["Convenience sample of offenders limits generalisability","No external validation or test‑retest reliability reported","No control for potential confounds such as mental‑health status"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/107906320701900305"}},{"id":3053,"doi":"10.1080/00926238808403916","pmid":"3050137","pmcid":null,"title":"The ethics of pornography in the era of AIDS","authors":"Money J.","first_author":"Money J.","journal":"Journal of sex & marital therapy","year":1988,"pub_types":["Historical Article","Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"historical/ethical commentary without empirical data","sample_n":null,"sample_text":"none (historical/ethical commentary)","population":"none","country":"United States / Europe (historical focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article argues that current views portraying pornography as harmful are rooted in outdated eugenic and moralist ideas, preventing its use in sexual health education to curb AIDS transmission.","clinical_takeaway":"None – the piece offers historical and ethical commentary, not clinical evidence.","confidence":0.7,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Provides historical context for ethical debates on pornography","Links past sexology to contemporary policy discussions"],"limitations":["No empirical data or systematic methodology","Relies on historical anecdotes and ideological argumentation","Lacks measurement of key constructs or controls"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238808403916"}},{"id":3054,"doi":"10.1080/00926238808403811","pmid":"3225865","pmcid":null,"title":"A preliminary examination of the pornography experience of sex offenders, paraphiliacs, sexual dysfunction patients, and controls based on Meese Commission recommendations","authors":"Condron MK, Nutter DE.","first_author":"Condron MK","journal":"Journal of sex & marital therapy","year":1988,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional comparison of sex offenders, paraphiliacs, sexual dysfunction patients, and controls; likely convenience sampling","sample_n":null,"sample_text":"Not reported in abstract","population":"sex offenders, paraphiliacs, sexual dysfunction patients, community controls","country":"USA","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors compared pornography use and early sexual experiences across sex offenders, paraphiliacs, sexual‑dysfunction patients, and controls and found no significant differences among the groups.","clinical_takeaway":"No evidence from this study that pornography use differs between offenders and non‑offenders; findings do not support using pornography exposure as a diagnostic criterion.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Direct comparison of multiple offender‑related groups","Addresses Meese Commission claims","Includes a control group"],"limitations":["Likely small, non‑representative samples","Reliance on single‑item self‑report measures","No control for moral, mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238808403811"}},{"id":3055,"doi":"10.1542/9781581104097-part02-current","pmid":"18605649","pmcid":null,"title":"Current research knowledge about adolescent victimization via the Internet","authors":"Wolak J, Ybarra ML, Mitchell K, Finkelhor D.","first_author":"Wolak J","journal":"Adolescent medicine: state of the art reviews","year":2007,"pub_types":["Review","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative state‑of‑the‑art review of adolescent Internet‑mediated victimisation, including unwanted exposure to pornography. No original data were collected.","sample_n":null,"sample_text":"Not applicable – review article","population":"Adolescents (general discussion, no specific sample)","country":"United States (U.S. Government‑funded)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article summarises what is known about teens being harmed online, from unwanted sexual solicitations to accidental exposure to pornography, and points out that media stories often exaggerate or misrepresent these risks.","clinical_takeaway":"Clinicians should base advice on evidence rather than sensational media reports when discussing online safety with adolescents.","confidence":0.4,"topic_tags":["adolescents","sexual_function","pornography"],"strengths":["Broad overview of multiple forms of online victimisation","Highlights gap between media portrayal and empirical knowledge"],"limitations":["Narrative (non‑systematic) review; no explicit methodology","No empirical data or quantitative synthesis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/9781581104097-part02-current"}},{"id":3056,"doi":"10.1007/s10508-006-9124-5","pmid":"17186123","pmcid":null,"title":"The use of cyberpornography by young men in Hong Kong: some psychosocial correlates","authors":"Lam CB, Chan DK.","first_author":"Lam CB","journal":"Archives of sexual behavior","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire survey of 229 young men in Hong Kong","sample_n":229,"sample_text":"229 participants completed a questionnaire","population":"young Chinese men (likely university or community sample)","country":"Hong Kong","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 229 young Hong Kong men, more frequent online porn use was linked to stronger peer pressure and higher permissive attitudes toward sex and harassment.","clinical_takeaway":"Higher porn viewing may co‑occur with riskier sexual attitudes, but causal claims cannot be drawn.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Relatively large sample for a questionnaire study","Examines peer influence, an understudied factor"],"limitations":["Self‑report measures likely unvalidated","Cross‑sectional design limits causal inference","Key confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":6,"contrasting":1,"mentioning":52,"citing_publications":92,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-006-9124-5"}},{"id":3057,"doi":"10.1177/0306624x07303907","pmid":"17636206","pmcid":null,"title":"Sexual murderers of children: developmental, precrime, crime, and postcrime factors","authors":"Beauregard E, Stone MR, Proulx J, Michaud P.","first_author":"Beauregard E","journal":"International journal of offender therapy and comparative criminology","year":2008,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative retrospective case series of convicted sexual murderers (n=11 children victims, n=66 adult victims)","sample_n":77,"sample_text":"11 sexual murderers of children; 66 sexual murderers of adult women","population":"Male sexual murderers convicted in Quebec, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared 11 men who killed children sexually with 66 men who killed adult women, finding the former were more often abused as children, used pornography before the crime, and committed more pre‑planned, violent acts.","clinical_takeaway":"None – findings pertain to forensic profiling, not clinical sexual health.","confidence":0.7,"topic_tags":["sexual_function","pornography"],"strengths":["Rare focus on sexual murderers of children","Comparative approach between child and adult victims","Inclusion of developmental and crime‑scene variables"],"limitations":["Very small child‑victim group (n=11)","No validated measurement instruments","No control for key confounds (e.g., moral incongruence, mental health)","Cross‑sectional, retrospective design limits causal inference"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":6,"contrasting":3,"mentioning":56,"citing_publications":95,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x07303907"}},{"id":3058,"doi":"10.1007/s10508-007-9186-z","pmid":"17629783","pmcid":null,"title":"Sexuality related attitudes and behaviors of Turkish university students","authors":"Askun D, Ataca B.","first_author":"Askun D","journal":"Archives of sexual behavior","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire study of 563 Turkish university students from three campuses, assessing virginity status, first intercourse, sexual permissiveness, pornography use, double‑standard endorsement and perceived parental attitudes.","sample_n":563,"sample_text":"563 students from three universities located in three cities completed a questionnaire.","population":"Turkish university students (N=563) from three cities; convenience sample, likely predominately young adults, mixed gender.","country":"Turkey","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 563 Turkish university students found that women and those from rural areas tend to hold more traditional sexual attitudes and report less permissive behaviors, including lower pornography use. Perceived maternal restrictions were linked to greater sexual conservatism and negative feelings at first intercourse.","clinical_takeaway":"Clinicians should consider cultural and familial influences when discussing sexual attitudes with young adults; no direct clinical implications regarding pornography use were established.","confidence":0.7,"topic_tags":["sexual_function","pornography"],"strengths":["Large sample for a student survey","Includes both distal and proximal influencing factors","Addresses gender and rural/urban differences"],"limitations":["Convenience, non‑representative university sample","Use of non‑validated questionnaire items","No measurement of masturbation or moral conflict"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":2,"mentioning":39,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-007-9186-z"}},{"id":3059,"doi":"10.1016/j.socscimed.2007.05.015","pmid":"17566622","pmcid":null,"title":"Problematic internet experiences: primary or secondary presenting problems in persons seeking mental health care?","authors":"Mitchell KJ, Wells M.","first_author":"Mitchell KJ","journal":"Social science & medicine (1982)","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Analysis of clinical reports from 1441 youth and adults seeking mental health care in the USA; clinicians identified whether Internet‑related problems were primary or secondary presenting issues.","sample_n":1441,"sample_text":"1441 participants (clinical reports)","population":"Youth and adults in US mental‑health treatment (convenience sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 1441 people in US mental‑health treatment, clinicians reported that when Internet problems were a primary concern, they often involved overuse, adult or child pornography, sexual exploitation, or gaming. Other issues (e.g., online harassment) were equally likely to be primary or secondary.","clinical_takeaway":"Clinicians should routinely assess a range of Internet‑related behaviours, including pornography use, when evaluating mental‑health patients.","confidence":0.7,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Large clinical sample (N>1400)","Provides real‑world clinician perspective on presenting problems","Differentiates primary vs. secondary Internet‑related issues"],"limitations":["Convenience sample of treatment‑seekers; not generalisable to all users","Problematic Internet experiences defined by clinician report, not validated scales","No control for moral incongruence, masturbation, mental‑health comorbidities, or trauma"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":27,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.socscimed.2007.05.015"}},{"id":3060,"doi":"10.1080/13625180701201145","pmid":"17559008","pmcid":null,"title":"Preventing pregnancy: a girls' issue. Seventeen-year-old Swedish boys' perceptions on abortion, reproduction and use of contraception","authors":"Ekstrand M, Tydén T, Darj E, Larsson M.","first_author":"Ekstrand M","journal":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus‑group interviews with 40 Swedish 17‑year‑old boys; manifest content analysis of transcribed discussions","sample_n":40,"sample_text":"Forty 17‑year‑old boys participated in six focus‑group sessions.","population":"Adolescent males (17 y) in Sweden, recruited for focus groups (convenience sample)","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Swedish 17‑year‑old boys see abortion as a moral dilemma and fatherhood as a disaster. They think girls bear most responsibility for preventing pregnancy and often trust girls' use of hormonal birth control, despite limited knowledge about reproduction.","clinical_takeaway":"Educators should address boys' misconceptions and involve them equally in contraception and abortion discussions.","confidence":0.8,"topic_tags":["sexual_function","religiosity","gender","adolescents"],"strengths":["Provides direct voices of teenage boys on reproductive issues","Uses systematic content‑analysis of verbatim transcripts","Highlights gaps in sex‑education and gendered responsibility perceptions"],"limitations":["Small, non‑representative Swedish sample","No quantitative validation of themes or constructs","Findings may not generalise beyond this age/ cultural context"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":28,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13625180701201145"}},{"id":3061,"doi":"10.1089/cpb.2006.9970","pmid":"17474834","pmcid":null,"title":"What children do on the Internet: domains visited and their relationship to socio-demographic characteristics and academic performance","authors":"Jackson LA, Samona R, Moomaw J, Ramsay L, Murray C, Smith A, Murray L.","first_author":"Jackson LA","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":2007,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal field study of 140 low‑income adolescents (mostly 13‑year‑old African‑American boys) followed for several months to track Internet site categories visited and academic outcomes.","sample_n":140,"sample_text":"140 children (58% boys, 83% African‑American)","population":"Children (average age 13), low‑income, single‑parent households, United States","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2007 study followed 140 low‑income U.S. teens and found that they initially visited many sites, including porn, but after a few months focused on sites matching their interests. Early porn use was common, especially among boys, but dropped sharply. Internet habits and school grades influenced each other over time.","clinical_takeaway":"Early exposure to porn among low‑income teens is common but may decline; clinicians should consider broader internet usage patterns when assessing academic outcomes.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","csbd"],"strengths":["Longitudinal design allows temporal ordering of Internet use and academic performance.","Large proportion of under‑represented demographic (low‑income, African‑American youth).","Identifies changes in site visitation over time."],"limitations":["No validated measures of pornography use; relies on coarse visitation categories.","Key confounds (moral attitudes, mental health, partner context) not assessed.","Limited generalisability beyond low‑income, single‑parent families."],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":29,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cpb.2006.9970"}},{"id":3062,"doi":"10.1089/cpb.2006.9973","pmid":"17474831","pmcid":null,"title":"Internet use among Chinese college students: implications for sex education and HIV prevention","authors":"Hong Y, Li X, Mao R, Stanton B.","first_author":"Hong Y","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 1,845 Chinese college students; self‑report questionnaire on Internet use, porn site visits, sexual attitudes and behaviours.","sample_n":1845,"sample_text":"college students recruited from universities in an eastern Chinese province; convenience sampling","population":"Chinese college students (Eastern province)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,845 Chinese college students found that frequent Internet use, especially visiting porn sites, was linked to being sexually active, planning sex, and holding permissive attitudes, but not to HIV knowledge. The authors suggest better online sex‑education guidance.","clinical_takeaway":"Internet use patterns predict sexual risk attitudes; educators should address online sexual content in campus health programs.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size for a survey","Focus on an understudied population (Chinese college students)","Links Internet behaviours to sexual health outcomes"],"limitations":["Cross‑sectional design prevents causal inference","Reliance on unvalidated single‑item self‑reports","No measurement of key confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":23,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cpb.2006.9973"}},{"id":3064,"doi":"10.1089/cpb.2006.9969","pmid":"17474835","pmcid":null,"title":"Incidence and correlates of Internet usage among adolescents in North Cyprus","authors":"Bayraktar F, Gün Z.","first_author":"Bayraktar F","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 686 adolescents recruited from schools in Northern Cyprus; no longitudinal or experimental component.","sample_n":686,"sample_text":"686 adolescents (mean age 14.4 years) from elementary and high schools in Northern Cyprus.","population":"Adolescents aged 12‑17 years, school‑based sample (likely convenience).","country":"Northern Cyprus","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 686 Turkish‑Cypriot teens found most used the internet for entertainment, with boys playing more violent games. About 1 % were labeled pathological internet users, who visited more porn sites and had lower grades.","clinical_takeaway":"None – the study does not provide actionable clinical guidance on pornography or sexual health.","confidence":0.6,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Large sample for a school‑based survey","Examines multiple internet activities","Links pathological use to academic performance"],"limitations":["Cross‑sectional; cannot infer causality","Pathological internet use not operationalised with validated scale","No measurement of moral or mental‑health confounds","Interpretation of 'pathological' may be circular"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":7,"contrasting":2,"mentioning":73,"citing_publications":152,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cpb.2006.9969"}},{"id":3065,"doi":"10.1891/0886-6708.2.3.189","pmid":"3154165","pmcid":null,"title":"An empirical investigation of the role of pornography in the verbal and physical abuse of women","authors":"Sommers EK, Check JV.","first_author":"Sommers EK","journal":"Violence and victims","year":1987,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative survey of battered women (shelters) vs university women; partner pornography use & abuse assessed by self‑report items.","sample_n":null,"sample_text":"battered women from shelters and counseling groups; comparison women from a mature university population","population":"Adult women, mixed socioeconomic; convenience samples; N not reported in abstract","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared women in shelters who had experienced partner violence with university women, finding that partners of the shelter group reported more pornography use and more often tried to make their partners act like porn scenes. The authors suggest a link between partner porn consumption and abuse.","clinical_takeaway":"Evidence is insufficient to conclude pornography causes partner violence; clinicians should consider many factors when assessing risk.","confidence":0.55,"topic_tags":["pornography","sexual_function","gender","relationships"],"strengths":["Addresses an understudied link between partner porn use and abuse","Includes a comparison group"],"limitations":["Reliance on single‑item self‑report measures","Cross‑sectional design, cannot infer causality","Convenience samples limit generalisability","No control for key confounds (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1891/0886-6708.2.3.189"}},{"id":3066,"doi":"10.1300/j082v13n02_09","pmid":"3611740","pmcid":null,"title":"Gay SM in pornography and reality","authors":"van Naerssen AX, van Dijk M, Hoogeveen G, Visser D, van Zessen G.","first_author":"van Naerssen AX","journal":"Journal of homosexuality","year":1986,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"content analysis of pornographic magazines (1974‑1983) compared to reported real‑world SM scenarios; correlational, no experimental manipulation","sample_n":null,"sample_text":"Not reported in abstract","population":"gay men depicted in SM pornographic publications; no participant sample described","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined how gay sadomasochism was shown in pornographic magazines from 1974‑1983 and compared those depictions to reports of real‑world SM encounters, noting changes in violence and sexuality over the decade.","clinical_takeaway":"None – the study describes media portrayals, not health effects or treatment implications.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Historical overview of SM portrayal over a decade","Direct comparison between media depictions and reported reality"],"limitations":["No information on coding reliability or validation","No participant data; inference about real‑world behavior limited","Small or undefined sample; unclear statistical rigor"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v13n02_09"}},{"id":3067,"doi":"10.1300/j082v53n01_08","pmid":"18019074","pmcid":null,"title":"Porn star/stripper/escort: economic and sexual dynamics in a sex work career","authors":"Escoffier J.","first_author":"Escoffier J.","journal":"Journal of homosexuality","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Exploratory descriptive study of career trajectories in gay male porn industry; no clear sample size or systematic methods reported.","sample_n":null,"sample_text":"Not reported in abstract","population":"Gay male porn performers (1995‑2005)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes how gay male porn performers often shift to stripping or escorting as their film work becomes less lucrative, outlining a “retrogressive dynamic” where longer careers lead to lower pay and status.","clinical_takeaway":"None – the study does not provide clinical information for practitioners.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Provides industry‑specific economic insights","Highlights career transition patterns"],"limitations":["No empirical data reported","Lacks methodological detail","No systematic sampling or analysis"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v53n01_08"}},{"id":3068,"doi":"10.1300/j069v26n03_02","pmid":"18018804","pmcid":null,"title":"Accounting for the social triggers of sexual compulsivity","authors":"Parsons JT, Kelly BC, Bimbi DS, Muench F, Morgenstern J.","first_author":"Parsons JT","journal":"Journal of addictive diseases","year":2007,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":45,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative grounded‑theory interviews with 180 self‑identified sexually compulsive gay/bisexual men (cross‑sectional, convenience sample).","sample_n":180,"sample_text":"180 gay and bisexual men recruited on the basis of self‑reported sexual compulsivity; not a probability or clinical‑seeking sample.","population":"Gay and bisexual men in the United States who self‑identified that their sex lives were \"spinning out of control\".","country":"United States","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 180 gay and bisexual men who said their sex lives were out of control revealed two kinds of social triggers—sudden events like relationship turmoil and predictable contexts such as certain places, people, drug use, and pornography. Understanding these triggers may help clinicians tailor treatment.","clinical_takeaway":"Therapists should assess clients' social environments and recent life events when addressing sexual compulsivity.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large qualitative sample for this methodology","Grounded‑theory approach provides rich contextual data","Identifies novel social triggers"],"limitations":["Self‑selected, non‑representative sample","No validated measure of sexual compulsivity","Key confounds (moral incongruence, mental health, partner context) not assessed","Findings are exploratory, not generalisable"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":39,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j069v26n03_02"}},{"id":3069,"doi":"10.1007/s10508-006-9083-x","pmid":"17187218","pmcid":null,"title":"Selling sex in a population-based study of high school seniors in sweden: demographic and psychosocial correlates","authors":"Svedin CG, Priebe G.","first_author":"Svedin CG","journal":"Archives of sexual behavior","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"population-based representative survey of Swedish high‑school seniors (N=4,339), cross‑sectional analysis of correlates of self‑reported selling sex.","sample_n":4339,"sample_text":"representative sample of 4,339 students, response rate 77.2 %","population":"high‑school seniors (approximately 17‑19 y) in Sweden","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 4,300 Swedish high‑school seniors, 1‑2 % reported having sold sex. Those who did were more likely to have immigrant backgrounds, family unemployment, and to use pornography more often, especially deviant types, and they also showed poorer mental health and more antisocial behaviour.","clinical_takeaway":"Selling sex in adolescents co‑occurs with higher porn use and psychosocial risk; clinicians should assess broader context rather than assume a causal link.","confidence":0.85,"topic_tags":["pornography","sexual_function","adolescents"],"strengths":["Large, nationally representative sample","Comprehensive set of psychosocial variables","Clear definition of selling sex"],"limitations":["Cross‑sectional; no causal inference","Pornography use measured by single self‑report item","No measurement of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":18,"contrasting":3,"mentioning":148,"citing_publications":91,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-006-9083-x"}},{"id":3070,"doi":"10.4088/jcp.v67n1218","pmid":"17194276","pmcid":null,"title":"A double-blind study of citalopram versus placebo in the treatment of compulsive sexual behaviors in gay and bisexual men","authors":"Wainberg ML, Muench F, Morgenstern J, Hollander E, Irwin TW, Parsons JT, Allen A, O'Leary A.","first_author":"Wainberg ML","journal":"The Journal of clinical psychiatry","year":2006,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Randomized Controlled Trial","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":69,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"double‑blind, placebo‑controlled RCT with 28 gay/bisexual men meeting CSB criteria; 12‑week treatment with citalopram vs placebo.","sample_n":28,"sample_text":"Twenty‑eight men who have sex with men who met the threshold for CSB on the basis of existing validated measures participated.","population":"men who have sex with men with compulsive sexual behavior","country":"USA","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small double‑blind trial, men who have sex with men and met criteria for compulsive sexual behavior took either citalopram or a placebo for 12 weeks. The drug reduced sexual desire, masturbation and pornography use more than placebo, but both groups lowered sexual risk similarly. The authors suggest citalopram may help CSB symptoms, pending larger studies.","clinical_takeaway":"Citalopram may modestly lessen compulsive sexual urges and related behaviours, but evidence is limited; larger trials are needed before routine use.","confidence":0.78,"topic_tags":["csbd"],"strengths":["Randomised, double‑blind placebo control","Uses validated Y‑BOCS‑CSB scale","Measures both behaviour frequency and desire"],"limitations":["Very small sample (N=28), likely under‑powered","No assessment of moral incongruence, mental health or partner factors","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":3,"design":7,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":94,"citing_publications":149,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/jcp.v67n1218"}},{"id":3071,"doi":"10.4040/jkan.2006.36.8.1315","pmid":"17215604","pmcid":null,"title":"Discriminative factor analysis of juvenile delinquency in South Korea","authors":"Kim HS, Kim HS.","first_author":"Kim HS","journal":"Taehan Kanho Hakhoe chi","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire survey of 2,167 Korean adolescents (students and detained youths) using stratified random sampling; logistic regression used to identify factors associated with delinquency.","sample_n":2167,"sample_text":"1,196 students and 971 delinquent youths","population":"Adolescents (middle and high school students and juvenile corrective institution residents) in South Korea","country":"South Korea","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A Korean survey of over 2,000 teens found that smoking, alcohol, drug use, sexual abuse, and time spent watching violent media or pornography were linked to juvenile delinquency, with smoking showing the strongest statistical association.","clinical_takeaway":"Screen for multiple risk behaviours, but do not infer that pornography viewing causes delinquency from this study.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","csbd","masturbation"],"strengths":["Large sample size","Use of logistic regression to estimate odds ratios","Includes both community and institutional adolescents"],"limitations":["Cross‑sectional design; cannot infer causality","Pornography exposure measured by a single self‑report item, no validated scale","Key confounds (moral incongruence, mental health, masturbation) not assessed"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4040/jkan.2006.36.8.1315"}},{"id":3072,"doi":"10.1186/1471-2458-6-232","pmid":"16981985","pmcid":"PMC1586016","title":"Sexual behavior and awareness of Chinese university students in transition with implied risk of sexually transmitted diseases and HIV infection: a cross-sectional study","authors":"Ma Q, Ono-Kihara M, Cong L, Xu G, Zamani S, Ravari SM, Kihara M.","first_author":"Ma Q","journal":"BMC public health","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC1586016","cited_by_count":54,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 22,493 undergraduates at two Chinese universities","sample_n":22493,"sample_text":"22,493 undergraduate students in two universities in Ningbo, China","population":"Chinese university students (undergraduate, both genders)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 22 000 Chinese university students found that many are sexually active, often without condoms, and that earlier exposure to pornographic media is linked to riskier sexual behaviour.","clinical_takeaway":"Clinicians should be aware that early porn exposure may be associated with unprotected sex among Chinese university students.","confidence":0.7,"topic_tags":["sexual_function","religiosity","moral_incongruence"],"strengths":["Very large sample size","Use of multivariate logistic regression","Focus on a timely public‑health issue"],"limitations":["Self‑report measures, likely single‑item","Cross‑sectional design limits causal inference","Convenience sample from only two universities"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":2,"mentioning":55,"citing_publications":88,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2458-6-232"}},{"id":3073,"doi":"10.1007/s10508-006-9042-6","pmid":"16900414","pmcid":null,"title":"Exhibitionistic and voyeuristic behavior in a Swedish national population survey","authors":"Långström N, Seto MC.","first_author":"Långström N","journal":"Archives of sexual behavior","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":61,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"National probability sample of 2,450 adults surveyed in 1996; cross‑sectional interview.","sample_n":2450,"sample_text":"Representative national sample (randomly selected 18‑60 year‑olds).","population":"Adults 18‑60 years, Sweden, randomly selected from the general population.","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A Swedish national survey of 2,450 adults found that 3% had ever been aroused by exposing themselves to strangers and 8% by watching others having sex. Those who reported such behaviors also tended to have more psychological problems, use more alcohol/drugs, masturbate and view pornography more often, and have more sexual partners.","clinical_takeaway":"These atypical sexual interests co‑occur with broader mental‑health and substance‑use issues, suggesting clinicians should assess overall wellbeing rather than focus only on the specific behavior.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative probability sample","Wide set of correlates examined","Reports odds ratios with confidence intervals"],"limitations":["Self‑report single‑item measures; no validated psychometric scales","Cross‑sectional design limits causal inference","Key confounds such as moral incongruence, trauma, and partner context not assessed"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":97,"citing_publications":192,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-006-9042-6"}},{"id":3074,"doi":"10.1520/jfs11872j","pmid":"3511174","pmcid":null,"title":"Detective magazines: pornography for the sexual sadist?","authors":"Dietz PE, Harry B, Hazelwood RR.","first_author":"Dietz PE","journal":"Journal of forensic sciences","year":1986,"pub_types":["Historical Article","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"case-report","design_detail":"Historical case series / content analysis of magazines with six illustrative case histories; no systematic sampling, no control group.","sample_n":null,"sample_text":"Not reported","population":"Readers of detective magazines (implicit); no explicit sample size reported","country":"United States (implied by historical context)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The article describes how detective magazines blend erotic, violent, and sadistic imagery and suggests these may fuel sexual sadism, but it is based on a small number of illustrative cases rather than systematic evidence.","clinical_takeaway":"None – the paper offers historical speculation, not evidence for clinical practice.","confidence":0.3,"topic_tags":["pornography","sexual_function"],"strengths":["Provides historical perspective on media content","Illustrative case histories"],"limitations":["No systematic data collection","No measurement of exposure or outcomes","Speculative causal claims","No control for confounding variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1520/jfs11872j"}},{"id":3075,"doi":"10.1080/00224490609552321","pmid":"17599245","pmcid":null,"title":"Sex, lies, and videos in rural China: a qualitative study of women's sexual debut and risky sexual behavior","authors":"Wang B, Davidson P.","first_author":"Wang B","journal":"Journal of sex research","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview and focus‑group study with 40 participants (young unmarried women who had experienced induced abortion) in rural China","sample_n":40,"sample_text":"forty in‑depth interviews plus focus‑group discussions","population":"young, unmarried women in rural China who have had an induced abortion","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 40 young women in rural China who had abortions reveal that pornographic videos, together with parental attitudes, often trigger first sexual experiences and risky, unprotected sex.","clinical_takeaway":"Educators should address porn exposure and improve contraceptive knowledge in rural Chinese sexual health programs.","confidence":0.8,"topic_tags":["pornography","sexual_function","religiosity"],"strengths":["In‑depth qualitative insight into a understudied rural Chinese population","Identifies multiple contextual factors (porn videos, parental attitudes) influencing sexual debut"],"limitations":["Small, highly specific sample (women with prior abortion) limits generalisability","No standardized measures; reliance on self‑report narratives","Potential recall and social desirability bias"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":0,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":34,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490609552321"}},{"id":3076,"doi":"10.1177/1074840706291696","pmid":"16837697","pmcid":null,"title":"Exploring the therapeutic family intervention of commendations: insights from research","authors":"Limacher LH, Wright LM.","first_author":"Limacher LH","journal":"Journal of family nursing","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Interpretive hermeneutic study using video and interview data from a single heterosexual couple and a nurse; therapeutic family intervention on Internet pornography difficulties.","sample_n":3,"sample_text":"Three participants (heterosexual couple + nurse) involved in therapeutic sessions.","population":"1 couple (2 adults) and 1 nurse; likely treatment‑seeking, not representative.","country":"Not specified (likely USA/Canada based on journal).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small qualitative study examined how a family therapist used \"commendations\"—positive feedback—to help a couple discuss problems with Internet pornography. Video clips were shown to the couple to trigger discussion. The authors found that the praise felt both provocative and constructive, showing how therapeutic comments can be complex.","clinical_takeaway":"Therapeutic positive feedback can be powerful but may be experienced ambivalently; clinicians should attend to how couples perceive such interventions.","confidence":0.78,"topic_tags":["pornography","moral_incongruence","masturbation","sexual_function"],"strengths":["In‑depth qualitative insight into therapeutic interaction","Use of video excerpts to prompt participant reflection","Hermeneutic analytic framework provides rich contextual interpretation"],"limitations":["Extremely small, single‑case sample limits generalisability","No validated measures of pornography use or distress","No control for moral, mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":39,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1074840706291696"}},{"id":3077,"doi":"10.1016/j.genhosppsych.2005.10.005","pmid":"16675371","pmcid":null,"title":"Pornographic effect of olanzapine: induction of vivid intrusive sexual obsessional images","authors":"Zullino DF, Morena P, Khazaal Y.","first_author":"Zullino DF","journal":"General hospital psychiatry","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.genhosppsych.2005.10.005"}},{"id":3078,"doi":"10.3200/genp.133.2.153-162","pmid":"16705908","pmcid":null,"title":"Gender and ethnic differences in sexual attitudes at a Hispanic-serving university","authors":"Eisenman R, Dantzker ML.","first_author":"Eisenman R","journal":"The Journal of general psychology","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 328 undergraduate students from a single Hispanic‑serving university; convenience sampling from classes.","sample_n":328,"sample_text":"328 participants (128 men, 199 women; 283 Hispanic, 44 non‑Hispanic).","population":"University students (mostly Hispanic) near the Texas‑Mexico border; 128 men, 199 women.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 328 university students in Texas found that women held more negative attitudes toward sex than men on topics like masturbation, pornography, and premarital intercourse, and Hispanic students were generally more conservative than non‑Hispanic peers.","clinical_takeaway":"None – the study describes attitudes, not behaviors or health outcomes.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for an attitude survey","Gender and ethnicity comparisons","Clear reporting of statistical significance"],"limitations":["Convenience sample limits generalizability","Questionnaire validation not described","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":35,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3200/genp.133.2.153-162"}},{"id":3079,"doi":"10.1521/aeap.2006.18.2.176","pmid":"16649962","pmcid":null,"title":"Sexual behavior among employed male rural migrants in Shanghai, China","authors":"He N, Detels R, Chen Z, Jiang Q, Zhu J, Dai Y, Wu M, Zhong X, Fu C, Gui D.","first_author":"He N","journal":"AIDS education and prevention : official publication of the International Society for AIDS Education","year":2006,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":45,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Anonymous self‑administered questionnaire among 986 male rural migrants in Shanghai; convenience sampling from construction sites, markets, factories.","sample_n":986,"sample_text":"986 sexually active men completed the questionnaire","population":"Employed male rural migrants, Shanghai, China (N≈986 sexually active)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 986 male rural migrants in Shanghai found low condom use and high sexual risk, especially among younger men. Watching pornography, early sexual debut, and desire for legalised commercial sex were linked to having multiple partners.","clinical_takeaway":"Target young migrant men with low‑literacy sexual‑health interventions, emphasizing condom use and STI screening.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a hard‑to‑reach population","Relevant behavioural outcomes (condom use, multiple partners)","Identifies age‑related risk patterns"],"limitations":["Convenience sampling limits generalisability","Key constructs (pornography exposure, risk) measured with single items, no validated scales","No adjustment for important confounds (moral attitudes, mental health, partner status)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":1,"mentioning":52,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1521/aeap.2006.18.2.176"}},{"id":3080,"doi":null,"pmid":"17296005","pmcid":null,"title":"[Sexuality in children 9-14 years old]","authors":"Ballester Arnal R, Gil Llario MD.","first_author":"Ballester Arnal R","journal":"Psicothema","year":2006,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation","pornography"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 470 Spanish children aged 9‑14 using the CIACS‑II questionnaire.","sample_n":470,"sample_text":"Convenience sample of school children; not nationally representative.","population":"Children (9‑14 y) from schools in Spain (N≈470).","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2006 Spanish survey of 470 children aged 9‑14 found that some boys as young as nine have masturbated (8%) or viewed pornography (9%). Sexual fantasies and early sexual activity increase with age, especially in boys. The authors recommend early sex‑education programs.","clinical_takeaway":"Early sexual curiosity is common; sex education should start before age 10.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function","adolescents"],"strengths":["Large sample for a child‑focused survey","Provides rare epidemiological data on early sexual behaviours"],"limitations":["Cross‑sectional, cannot infer development or causality","No measurement of moral, mental‑health or trauma confounds","Unclear validation of the CIACS‑II for specific constructs (porn use, masturbation)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":3081,"doi":"10.1515/jpem.2006.19.2.115","pmid":"16562583","pmcid":null,"title":"Lack of differences between males with or without perceived same sex attraction","authors":"Lee PA, Houk CP.","first_author":"Lee PA","journal":"Journal of pediatric endocrinology & metabolism : JPEM","year":2006,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative survey of 52 healthy adolescent males (18‑24) using a structured questionnaire; groups defined by self‑reported same‑sex attraction.","sample_n":52,"sample_text":"52 18‑24 year‑old males","population":"Male adolescents/young adults, community sample, convenience recruitment (details not provided).","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 52 young men examined whether those who reported feeling attracted to other males differed in self‑image or social interactions. Apart from slightly more exposure to male‑male pornography and some body‑image concerns, the groups were largely similar.","clinical_takeaway":"Self‑reported same‑sex attraction in adolescent males does not appear to be linked to major psychosocial problems; clinicians should avoid assuming distress solely from these feelings.","confidence":0.4,"topic_tags":["sexual_function","gender"],"strengths":["Addresses a clinically relevant concern for pediatric endocrinologists","Includes a range of psychosocial variables"],"limitations":["Small, likely convenience sample (N=52)","Unvalidated questionnaire; reliance on single‑item self‑reports","No control for key confounds (moral incongruence, mental health, etc.)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/jpem.2006.19.2.115"}},{"id":3082,"doi":"10.1016/0145-2134(85)90026-2","pmid":"3902167","pmcid":null,"title":"Child pornography: perpetuating the sexual victimization of children","authors":"Tyler RP, Stone LE.","first_author":"Tyler RP","journal":"Child abuse & neglect","year":1985,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical/ narrative commentary without empirical data.","sample_n":null,"sample_text":"Not applicable – no participants.","population":"none","country":"England (historical focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The article reviews how photographic and video technologies have enabled the exploitation of children through child pornography, arguing that such material is used to recruit and manipulate victims.","clinical_takeaway":"None – the paper is historical commentary, not applicable to clinical practice.","confidence":0.8,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Historical perspective on technology‑enabled exploitation","Highlights societal impact of child sexual imagery"],"limitations":["No empirical data or systematic analysis","No methodological rigor – narrative only","Lacks measurement of any psychological constructs"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0145-2134(85)90026-2"}},{"id":3083,"doi":"10.1258/rsmmlj.74.3.114","pmid":"17044655","pmcid":null,"title":"What happens to medical doctors who are involved in child pornography? A case-based transatlantic overview","authors":"Dalton KJ.","first_author":"Dalton KJ.","journal":"The Medico-legal journal","year":2006,"pub_types":["Legal Case","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/rsmmlj.74.3.114"}},{"id":3084,"doi":"10.1080/00016340600626941","pmid":"16862476","pmcid":null,"title":"Increased sexual risk taking behavior among Swedish female university students: repeated cross-sectional surveys","authors":"Larsson M, Tydén T.","first_author":"Larsson M","journal":"Acta obstetricia et gynecologica Scandinavica","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Repeated cross‑sectional surveys of female university students (n=315) at a Swedish student health centre in 1999 and 2004.","sample_n":315,"sample_text":"315 female students completing waiting‑room questionnaires.","population":"Female university students in Sweden, convenience sample from health‑centre visitors.","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Swedish female university students reported more sexual partners, more unprotected first‑date sex and higher rates of self‑reported STIs between 1999 and 2004, while condom use and abortion rates stayed steady; emergency‑pill use more than doubled.","clinical_takeaway":"Clinicians should note rising sexual‑risk behaviours among young women and consider counseling on safer‑sex practices.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Repeated data allow trend observation","Reasonably sized sample for descriptive work","Includes a range of sexual‑health variables"],"limitations":["Convenience sample limits generalisability","Self‑report may introduce recall/social desirability bias","No validated scales for risk‑taking or pornography exposure"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00016340600626941"}},{"id":3085,"doi":"10.1097/01.paf.0000188076.54147.07","pmid":"16304471","pmcid":null,"title":"Autoerotic accident by inhalation of propane-butane gas mixture","authors":"Jackowski C, Römhild W, Aebi B, Bernhard W, Krause D, Dirnhofer R.","first_author":"Jackowski C","journal":"The American journal of forensic medicine and pathology","year":2005,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single fatal incident involving inhalation of propane‑butane during autoerotic activity while a pornographic video was playing","sample_n":1,"sample_text":"single fatal case","population":"19‑year‑old male (single case)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 19‑year‑old man died after inhaling propane‑butane while watching a pornographic video. The report describes the toxicology findings and compares them to similar cases.","clinical_takeaway":"None – the report is a single forensic case and does not provide clinically actionable information.","confidence":0.3,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Detailed forensic toxicology data","Clear description of incident circumstances"],"limitations":["Single case, no generalisable findings","No measurement of pornography use, masturbation, or psychological variables","No systematic analysis or controls"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":5,"contrasting":0,"mentioning":17,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.paf.0000188076.54147.07"}},{"id":3086,"doi":"10.1016/s1695-4033(05)70252-6","pmid":"16324618","pmcid":null,"title":"[Mass media consumption in adolescence]","authors":"Bercedo Sanz A, Redondo Figuero C, Pelayo Alonso R, Gómez Del Río Z, Hernández Herrero M, Cadenas González N.","first_author":"Bercedo Sanz A","journal":"Anales de pediatria (Barcelona, Spain : 2003)","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 884 adolescents from six towns in Cantabria, Spain; descriptive statistics only","sample_n":884,"sample_text":"884 teenagers aged 14‑18 from six towns in Cantabria, Spain","population":"adolescents aged 14‑18 attending high school in Cantabria (Spain)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 2005 Spanish survey of 884 teens described how much time they spent on TV, phones, Internet, video games and pornography sites. About 41% had visited porn sites, with boys more likely than girls. The authors recommend limiting media use and parental supervision.","clinical_takeaway":"None – the study is descriptive and does not provide evidence for clinical guidance on pornography or sexual health.","confidence":0.7,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["large sample size for a descriptive study","covers multiple media modalities","provides gender‑specific usage data"],"limitations":["cross‑sectional, no causal inference","uses ad‑hoc, unvalidated questionnaire items","does not control for key confounds (moral views, mental health, etc.)"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":1,"mentioning":8,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1695-4033(05)70252-6"}},{"id":3087,"doi":"10.12968/bjon.2005.14.19.19947","pmid":"16301948","pmcid":null,"title":"Angels and swingers, matrons and sinners: nursing stereotypes","authors":"Ferns T, Chojnacka I.","first_author":"Ferns T","journal":"British journal of nursing (Mark Allen Publishing)","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"content analysis of newspaper articles and pornographic material; likely convenience sample; no clear sampling frame or power analysis","sample_n":null,"sample_text":"national and local newspapers plus sex/pornography industry material (no numbers given)","population":"UK media content featuring nurses; no human participants","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review how UK newspapers and pornographic material depict nurses in sexualized ways, describing common stereotypes but offering no systematic analysis of effects on health or behavior.","clinical_takeaway":"None - the paper does not provide evidence for clinical practice.","confidence":0.4,"topic_tags":["neuroscience","relationships","csbd"],"strengths":["addresses an under‑studied aspect of media representation","high relevance to nursing profession and public perception"],"limitations":["No clear methodological detail or sample size","Uses ad‑hoc coding without reported validation","Lacks systematic sampling or quantitative rigor"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":22,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12968/bjon.2005.14.19.19947"}},{"id":3088,"doi":"10.1080/00926230591006773","pmid":"16169825","pmcid":null,"title":"Lovemaking as a ceremony of accreditation","authors":"Bergner RM.","first_author":"Bergner RM.","journal":"Journal of sex & marital therapy","year":2005,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review, theoretical exposition without empirical data; no sample, no methods.","sample_n":null,"sample_text":"Not applicable – no empirical sample.","population":"Humans (general adults)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The paper argues that lovemaking acts like a ceremony that validates partners, linking this idea to why some people are drawn to non‑loving sexual activities such as pornography. It suggests this view could help define what counts as a sexual disorder.","clinical_takeaway":"No direct clinical guidance; the article is theoretical and does not provide evidence‑based recommendations.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Integrates literature on romantic love and sexual behavior","Offers a novel conceptual framework"],"limitations":["No empirical data or validation of concepts","Lacks measurement of key confounds","Conflates theoretical ideas with clinical disorder definitions"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230591006773"}},{"id":3089,"doi":"10.1176/ajp.141.5.656","pmid":"6711686","pmcid":null,"title":"Response patterns in children and adolescents exploited through sex rings and pornography","authors":"Burgess AW, Hartman CR, McCausland MP, Powers P.","first_author":"Burgess AW","journal":"The American journal of psychiatry","year":1984,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective case series of 66 child and adolescent victims of sex rings; no comparison group; descriptive analysis.","sample_n":66,"sample_text":"66 victims identified from law‑enforcement/clinical records.","population":"Children and adolescents (n=66) exploited through adult‑run sex rings and pornography (1984 study).","country":"USA (inferred from journal and authors).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","selective_reporting"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined 66 children and teens forced into adult‑run sex rings, many of whom were photographed for pornography, and found that most showed negative psychological and social outcomes after the rings were exposed.","clinical_takeaway":"Victims of organized sexual exploitation often experience lasting psychological and social difficulties; clinicians should assess for trauma and adjustment problems.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large for a victim case series","Focus on a rarely studied exploitation context","Provides descriptive epidemiology"],"limitations":["No validated outcome measures","No control/comparison group","Cross‑sectional, cannot infer causality","Limited detail on statistical methods"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":77,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ajp.141.5.656"}},{"id":3090,"doi":"10.1080/00224498409551203","pmid":"29505357","pmcid":null,"title":"Debriefing effectiveness following exposure to pornographic rape depictions","authors":"Malamuth N, Check J.","first_author":"Malamuth N","journal":"Journal of sex research","year":1984,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Randomized exposure to pornographic rape vs consensual stories with debriefing; follow‑up survey on rape‑myth acceptance","sample_n":150,"sample_text":"undergraduate students (convenience sample)","population":"150 undergraduate males and females (convenience sample)","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"College students read either pornographic rape stories or consensual sex stories. Those who saw the rape stories and then received a debriefing were less likely to endorse rape myths ten days later than those who read consensual stories.","clinical_takeaway":"A brief, well‑targeted debrief can reduce acceptance of rape myths after exposure to violent sexual content.","confidence":0.6,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Randomized experimental design","Clear manipulation of exposure type","Follow‑up measurement of attitudes"],"limitations":["Outcome measure likely unvalidated","Convenience undergraduate sample limits generalizability","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":34,"citing_publications":97,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224498409551203"}},{"id":3091,"doi":"10.1080/00224498409551204","pmid":"29505356","pmcid":null,"title":"Can there be positive effects of participation in pornography experiments?","authors":"Check J, Malamuth N.","first_author":"Check J","journal":"Journal of sex research","year":1984,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"two‑phase randomised laboratory experiment with deception and debriefing; likely convenience sample of students; small N (not reported)","sample_n":null,"sample_text":"not reported in abstract; typical lab studies of the era used <60 participants","population":"adult participants (likely undergraduate students) recruited for a laboratory study on pornography and rape depictions","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study exposed participants to pornographic rape scenes and then gave some a debriefing that corrected rape myths. Those who received the debriefing were more likely to view pornography as contributing to rape and to punish the rapist more, showing that a well‑designed debrief can change attitudes.","clinical_takeaway":"Debriefing after exposure to sexual‑violence material can shape attitudes; careful post‑experiment discussion is advisable.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["randomised experimental manipulation","focus on debriefing effects","clear operational contrast between rape depiction and control"],"limitations":["small, unspecified sample size","attitude measures appear unvalidated","no control for moral or other psychological confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224498409551204"}},{"id":3092,"doi":"10.4414/smw.2005.11095","pmid":"16208587","pmcid":null,"title":"Paedophilia on the Internet--a study of 33 convicted offenders in the Canton of Lucerne","authors":"Frei A, Erenay N, Dittmann V, Graf M.","first_author":"Frei A","journal":"Swiss medical weekly","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Descriptive case series of 33 convicted offenders; police file review; no control group; convenience sample of offenders.","sample_n":33,"sample_text":"33 men identified from police files; middle‑aged, varied marital status; no comparison group.","population":"33 adult male convicted child‑pornography offenders from Canton of Lucerne, Switzerland.","country":"Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined police files of 33 Swiss men who had been convicted of possessing child‑pornography. Most were professionally successful, few were married or had children, and only one had a prior criminal record. The authors suggest that heavy online use may indicate pathological internet use, but the material alone does not predict contact sexual offenses.","clinical_takeaway":"Findings are specific to convicted offenders and do not inform clinical care for typical pornography users.","confidence":0.7,"topic_tags":["sexual_function","pornography"],"strengths":["Unique forensic sample","Detailed court file information","Highlights diversity of offender backgrounds"],"limitations":["Very small, non‑representative sample","No validated psychometric instruments","No control or comparison group","Findings not generalisable to general population"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4414/smw.2005.11095"}},{"id":3093,"doi":"10.1007/s00414-005-0016-3","pmid":"16059712","pmcid":null,"title":"Death by hanging while watching violent pornographic videos on the Internet - suicide or accidental autoerotic death?","authors":"Vennemann B, Pollak S.","first_author":"Vennemann B","journal":"International journal of legal medicine","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single forensic case report of a 30‑year‑old male found hanged while watching a pornographic video; no comparison group","sample_n":1,"sample_text":"n=1 case report","population":"one adult male (autoerotic context)","country":"Germany (presumed from authors’ affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 30‑year‑old man was found dead by hanging while watching a violent pornographic video. Forensic evidence suggests the death was likely an accidental autoerotic mishap rather than suicide.","clinical_takeaway":"None – the report is a single forensic case and does not inform clinical practice.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Detailed forensic description","Novel presentation of autoerotic death linked to internet pornography"],"limitations":["Single case, no generalisable data","No systematic measurement of sexual behavior or mental health","No control or comparison"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00414-005-0016-3"}},{"id":3094,"doi":"10.1016/0145-2134(84)90030-9","pmid":"6542820","pmcid":null,"title":"Child pornography: a hidden dimension of child abuse","authors":"Pierce RL.","first_author":"Pierce RL.","journal":"Child abuse & neglect","year":1984,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"Not applicable – no empirical sample reported","population":"Not applicable","country":"United States (inferred from context)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The paper discusses child pornography as a hidden form of child abuse, outlining who is involved, estimated numbers, presumed impacts on children, legal issues, and challenges for social workers.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Highlights a largely ignored form of child abuse","Broad overview of legal and social service challenges"],"limitations":["No empirical data or systematic review methodology","Absence of defined constructs or measurement","Lacks evidence‑based conclusions"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0145-2134(84)90030-9"}},{"id":3095,"doi":"10.1515/jpem.2005.18.7.625","pmid":"16128238","pmcid":null,"title":"Impact of environment upon gender identity and sexual orientation: a lesson for parents of children with intersex or gender confusion","authors":"Lee PA, Houk CP.","first_author":"Lee PA","journal":"Journal of pediatric endocrinology & metabolism : JPEM","year":2005,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"case-report","design_detail":"Two descriptive case histories of adult men with gender/sexual issues; no systematic data collection.","sample_n":2,"sample_text":"Two individual case histories","population":"Adult men with persistent gender issues; selected cases reported by authors.","country":"USA (presumed from authors' affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes two men whose adult gender and sexual lives differ dramatically, attributing these differences to how harshly their mothers tried to correct childhood gender‑nonconforming behavior.","clinical_takeaway":"Do not infer causal effects of parental discipline on gender identity from isolated case reports.","confidence":0.3,"topic_tags":["gender","sexual_function"],"strengths":["Provides vivid, detailed narratives","Highlights potential role of parental behavior"],"limitations":["N=2, no systematic data","No measurement of key variables","Conclusions overgeneralize from anecdote"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/jpem.2005.18.7.625"}},{"id":3098,"doi":"10.1007/bf03327536","pmid":"16682852","pmcid":null,"title":"For an anthropology of eating disorders. A pornographic vision of the self","authors":"Stanghellini G.","first_author":"Stanghellini G.","journal":"Eating and weight disorders : EWD","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"No empirical data; philosophical discussion.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article offers a philosophical reflection on how pornographic imagery might shape self‑identity in people with eating disorders, using sociological and psychoanalytic theories rather than empirical data.","clinical_takeaway":"None – the piece is theoretical and does not provide clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Integrates sociological theory with clinical observations","Thought‑provoking interdisciplinary perspective"],"limitations":["No original data or empirical analysis","Lacks operational definitions of constructs","No systematic methodology"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf03327536"}},{"id":3099,"doi":"10.1111/j.1475-3588.2005.00125_6.x","pmid":"32806803","pmcid":null,"title":"Images of Abuse: A Review of the Evidence on Child Pornography","authors":"Loader P.","first_author":"Loader P.","journal":"Child and adolescent mental health","year":2005,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1475-3588.2005.00125_6.x"}},{"id":3100,"doi":"10.1080/00926230590477934","pmid":"15859369","pmcid":null,"title":"Transvestic fetishism in the general population: prevalence and correlates","authors":"Långström N, Zucker KJ.","first_author":"Långström N","journal":"Journal of sex & marital therapy","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":50,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of a random national sample (n=2450) assessing prevalence and correlates of transvestic fetishism","sample_n":2450,"sample_text":"random sample of 2,450 18‑60 year‑olds from the Swedish general population","population":"general adult population Sweden, ages 18‑60, both sexes","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative Swedish survey, about 3 % of men and 0.4 % of women reported at least one episode of sexual arousal from cross‑dressing. This behaviour was linked to higher masturbation frequency, pornography use, same‑sex experiences and certain other paraphilic interests.","clinical_takeaway":"Transvestic fetishism occurs in a small minority of adults and is associated with higher sexual arousal and related behaviors, but the study does not establish clinical need for intervention.","confidence":0.85,"topic_tags":["prevalence","sexual_function","gender","masturbation","pornography"],"strengths":["Large, randomly selected national sample","First prevalence estimate of transvestic fetishism in general population","Separate reporting for men and women"],"limitations":["Reliance on single‑item self‑report measures","No validated scale for transvestic fetishism","Cross‑sectional design cannot infer causality","Limited assessment of potential psychological confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":14,"contrasting":1,"mentioning":40,"citing_publications":147,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230590477934"}},{"id":3101,"doi":"10.1016/j.forsciint.2004.09.093","pmid":"15694733","pmcid":null,"title":"Forensic aspects of 40 accidental autoerotic deaths in Northern Germany","authors":"Janssen W, Koops E, Anders S, Kuhn S, Püschel K.","first_author":"Janssen W","journal":"Forensic science international","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 40 accidental autoerotic deaths examined by forensic investigators","sample_n":40,"sample_text":"40 accidental autoerotic deaths investigated between 1983‑2003; only 20 autopsied","population":"male deceased individuals (ages 13‑79) in Northern Germany with auto‑erotic fatalities","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews 40 accidental deaths that occurred during solo sexual activities involving various devices and porn magazines, describing how the deaths happened and emphasizing the need for thorough forensic investigation.","clinical_takeaway":"None – the study describes fatal accidents, not applicable to clinical sexual health practice.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Detailed forensic description of rare phenomenon","Longitudinal case collection over 20 years","Includes both autopsied and non‑autopsied cases"],"limitations":["No systematic data collection; only half autopsied","No validated measures of sexual behavior or psychological factors","No comparison group; cannot infer prevalence or risk"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":36,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.forsciint.2004.09.093"}},{"id":3103,"doi":null,"pmid":"16193705","pmcid":null,"title":"[Perception of mistreatment during medical residency training]","authors":"Mejía R, Diego A, Alemán M, Maliandi Mdel R, Lasala F.","first_author":"Mejía R","journal":"Medicina","year":2005,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 322 residents from three hospitals in Buenos Aires; self‑administered questionnaire about mistreatment experiences.","sample_n":322,"sample_text":"322 residents (55% women) from three hospitals in Buenos Aires.","population":"Medical residents (both sexes) in Argentina","country":"Argentina","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 322 medical residents in Argentina found that 89% experienced some form of mistreatment, including 10% reporting sexual harassment and 7% encountering unwanted pornographic material.","clinical_takeaway":"Mistreatment, including unwanted sexual content, is common in residency; programmes should implement policies to protect trainees.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑institution study","Addresses a rarely studied aspect of residency training (exposure to pornographic material)","Clear descriptive reporting of prevalence"],"limitations":["Questionnaire not validated","Cross‑sectional design cannot infer causality","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":3104,"doi":"10.1207/s15327019eb1502_6","pmid":"16523570","pmcid":null,"title":"The struggle to maintain neutrality in the treatment of patient with pedophilia","authors":"Lally MC, Freeman SA.","first_author":"Lally MC","journal":"Ethics & behavior","year":2005,"pub_types":["Journal Article"],"keywords":["Professional Patient Relationship","Mental Health Therapies","Federal Bureau Of Investigation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary/ethical discussion without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how a psychiatry resident can stay neutral while treating a patient with pedophilia who possesses child pornography, highlighting ethical tensions between neutrality, beneficence, and safety concerns.","clinical_takeaway":"Clinicians should balance neutrality with patient safety and therapeutic responsibility when treating high‑risk sexual offending patients.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Clear ethical analysis","Use of clinical vignette to illustrate points"],"limitations":["No empirical data","No measurement of constructs"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1207/s15327019eb1502_6"}},{"id":3105,"doi":"10.1176/ajp.139.11.1493","pmid":"7137403","pmcid":null,"title":"Pornographic imagery and prevalence of paraphilia","authors":"Dietz PE, Evans B.","first_author":"Dietz PE","journal":"The American journal of psychiatry","year":1982,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 1,760 heterosexual pornographic magazine covers (1970‑1981) classified by imagery type.","sample_n":1760,"sample_text":"1760 magazine covers","population":"Magazine covers (n=1760)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers examined the covers of 1,760 heterosexual porn magazines from 1970‑1981, noting a rise in bondage imagery and a drop in solo female covers. They propose that the visual themes on magazine covers may reflect how common certain paraphilic interests are in the population.","clinical_takeaway":"None – the study does not provide evidence directly applicable to clinical assessment or treatment.","confidence":0.6,"topic_tags":["pornography","prevalence","sexual_function"],"strengths":["Large sample of magazines spanning a decade","Systematic coding of visual content"],"limitations":["No validated measure linking imagery to actual paraphilic behaviour","Assumes magazine cover choice reflects user prevalence","No control for societal trends or editorial bias"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":101,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ajp.139.11.1493"}},{"id":3106,"doi":"10.1136/bmj.329.7479.1364-a","pmid":"15591554","pmcid":"PMC535485","title":"Doctor jailed for \"culpable homicide\" and possessing child pornography","authors":"Sheldon T.","first_author":"Sheldon T.","journal":"BMJ (Clinical research ed.)","year":2004,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.329.7479.1364-a"}},{"id":3107,"doi":"10.1007/bf01541572","pmid":"7181647","pmcid":null,"title":"Sexual fantasy and pornography: two cases of girls brought up with pornography","authors":"Luria Z.","first_author":"Luria Z.","journal":"Archives of sexual behavior","year":1982,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":2,"sample_text":"Two sisters, close in age, now women in their 20s.","population":"two adult women (sisters) who grew up with extensive pornography exposure","country":"unspecified (likely USA based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper reports interviews with two sisters who grew up surrounded by porn; one incorporated porn images into her fantasies, the other did not. The authors discuss possible gender differences in how early porn exposure shapes fantasy.","clinical_takeaway":"No direct clinical guidance; the report shows individual variability in how early porn exposure may affect adult sexual fantasy.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Rare qualitative insight into early porn exposure in females","Detailed narrative accounts"],"limitations":["n=2; no generalizability","No validated measures of fantasy or pornography use","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541572"}},{"id":3108,"doi":"10.1089/cpb.2004.7.553","pmid":"15667050","pmcid":null,"title":"Internet use and attitudes towards illicit internet use behavior in a sample of Russian college students","authors":"Palesh O, Saltzman K, Koopman C.","first_author":"Palesh O","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 198 Russian college students assessing internet use frequency and attitudes toward illicit online behaviours; convenience sample; no longitudinal or experimental component.","sample_n":198,"sample_text":"198 students recruited from a university in Moscow","population":"college students (Moscow, Russia)","country":"Russia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2004 survey of 198 Russian college students found most use the internet for school, email and entertainment; only 6% reported looking for pornography. Attitudes toward illegal online actions varied, with many students disapproving of hacking yet some endorsing it. Men were more likely than women to use the internet for entertainment and to think breaking into computers was acceptable.","clinical_takeaway":"None – the study provides descriptive data on student internet attitudes, not clinical guidance.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a student survey","Includes gender comparisons","Provides baseline data on attitudes in a understudied region"],"limitations":["Convenience, non‑representative sample","Measures appear ad‑hoc and not validated","No control for moral or psychological confounds","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cpb.2004.7.553"}},{"id":3109,"doi":"10.1177/107906320401600205","pmid":"15208899","pmcid":null,"title":"An exploration of developmental factors related to deviant sexual preferences among adult rapists","authors":"Beauregard E, Lussier P, Proulx J.","first_author":"Beauregard E","journal":"Sexual abuse : a journal of research and treatment","year":2004,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 118 adult sexual aggressors, semistructured interview and phallometric testing","sample_n":118,"sample_text":"118 sexual aggressors against women","population":"adult male rapists (treated/identified in Quebec, Canada)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined 118 men who had sexually assaulted women, finding that a sexually inappropriate family environment, early pornography use, and deviant fantasies during childhood were linked to later deviant sexual preferences measured by phallometry.","clinical_takeaway":"Early exposure to pornography and adverse family environments may be risk factors for later deviant sexual behavior, but findings are limited to a specific, non‑representative population.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Use of validated phallometric assessment","Multiple regression analysis","Clear operationalization of childhood pornography use"],"limitations":["Convenience sample of convicted rapists limits generalizability","No control for key confounds (moral incongruence, mental health, trauma)","Limited description of measurement reliability for interview items"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/107906320401600205"}},{"id":3110,"doi":"10.1177/0886260503262083","pmid":"15038885","pmcid":null,"title":"A survey of online harassment at a university campus","authors":"Finn J.","first_author":"Finn J.","journal":"Journal of interpersonal violence","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":69,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"exploratory survey of 339 university students assessing prevalence of online harassment and unwanted pornography exposure","sample_n":339,"sample_text":"students at a single US university; convenience sample","population":"University of New Hampshire students (N=339)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 339 university students found that 10‑15% experienced threatening or harassing online messages and over half received unwanted pornographic material, with sexual‑minority students more often targeted by strangers.","clinical_takeaway":"None – the study reports prevalence of online harassment, not clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑campus survey","Addresses an under‑studied form of harassment","Reports prevalence by sexual orientation"],"limitations":["Cross‑sectional design; no causal inference","Measures appear ad‑hoc and unvalidated","Single‑site convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":17,"contrasting":3,"mentioning":291,"citing_publications":434,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260503262083"}},{"id":3111,"doi":"10.1136/bmj.328.7446.973","pmid":"15105308","pmcid":"PMC404487","title":"GMC sees rise in doctors charged with accessing child pornography websites","authors":"White C.","first_author":"White C.","journal":"BMJ (Clinical research ed.)","year":2004,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.328.7446.973"}},{"id":3112,"doi":"10.1258/095646204322916704","pmid":"15038872","pmcid":null,"title":"HIV and AIDS, the internet pornography industry and safer sex","authors":"Green ST.","first_author":"Green ST.","journal":"International journal of STD & AIDS","year":2004,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/095646204322916704"}},{"id":3113,"doi":"10.1080/00224490409552217","pmid":"15216428","pmcid":null,"title":"Slash fiction and human mating psychology","authors":"Salmon C, Symons D.","first_author":"Salmon C","journal":"Journal of sex research","year":2004,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of erotic fantasy literature, no new empirical data","sample_n":null,"sample_text":"none (review)","population":"general adult readers (implicit)","country":"United States (based on authors’ affiliation, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews slash fiction—stories about same‑sex pairings of familiar TV characters—arguing that male and female erotic fantasies differ because of evolutionary pressures, and that slash reflects female sexual psychology.","clinical_takeaway":"None – not clinically applicable.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Integrates evolutionary perspective","Broad literature synthesis"],"limitations":["No original data","Lacks systematic review methodology","No measurement of key confounds"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":50,"citing_publications":82,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490409552217"}},{"id":3114,"doi":"10.1300/j082v47n03_11","pmid":"15451711","pmcid":null,"title":"Alterity and construction of national identity in three Kristen Bjorn films","authors":"Westcott CN.","first_author":"Westcott CN.","journal":"Journal of homosexuality","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"none","population":"none","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article analyses three gay porn movies by Kristen Bjorn, arguing that they use exotic locations and national stereotypes to create an appealing sense of 'otherness' for North American viewers.","clinical_takeaway":"None - not clinically applicable.","confidence":0.4,"topic_tags":["pornography","csbd","sexual_function","moral_incongruence"],"strengths":["Provides cultural analysis of gay porn films","Identifies themes of alterity and national stereotypes"],"limitations":["No empirical data or measurement","No assessment of viewer behavior or health outcomes","Cannot support clinical or policy conclusions"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v47n03_11"}},{"id":3115,"doi":"10.1300/j082v47n03_05","pmid":"15451705","pmcid":null,"title":"Homecoming: the relevance of radical feminism for gay men","authors":"Jensen R.","first_author":"Jensen R.","journal":"Journal of homosexuality","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"no empirical data; essay-style argument","sample_n":null,"sample_text":"none (commentary)","population":"gay men (theoretical focus)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The essay argues that gay men would benefit from engaging with radical feminist ideas, especially critiques of pornography, to address patriarchal dynamics.","clinical_takeaway":"None - not clinically applicable.","confidence":0.9,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Clear theoretical argument","Relevant to discussions of gender politics"],"limitations":["No empirical data","Lacks measurement of key constructs","No control of confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v47n03_05"}},{"id":3116,"doi":"10.1300/j082v47n03_03","pmid":"15451703","pmcid":null,"title":"Body image, eating disorders, and the drive for muscularity in gay and heterosexual men: the influence of media images","authors":"Duggan SJ, McCreary DR.","first_author":"Duggan SJ","journal":"Journal of homosexuality","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":88,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet‑based survey of 101 gay and heterosexual men; self‑report questionnaires on body image, eating attitudes, drive for muscularity, social physique anxiety, self‑esteem, depression, desirability bias, and media consumption (magazines, pornography).","sample_n":101,"sample_text":"Convenience internet sample; not a probability or clinical sample.","population":"Adult men (gay and heterosexual), recruited online, N=101","country":"Not specified (likely USA/UK based on journal).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 101 men, more frequent reading of muscle‑and‑fitness magazines was linked to greater body‑image dissatisfaction for both gay and straight men. For gay men, higher pornography use was associated with more anxiety about their physique.","clinical_takeaway":"Clinicians should consider media exposure, especially fitness magazines, when addressing body‑image concerns, but cannot conclude pornography causes anxiety from this study.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Uses several established body‑image and eating‑attitude scales","Includes both gay and heterosexual participants for comparison","Measures multiple media sources (magazines, pornography)"],"limitations":["Cross‑sectional design; cannot infer causality","Convenience internet sample limits generalisability","Pornography exposure measured by simple self‑report, not validated","Key confounds such as moral incongruence, masturbation, relationship context not assessed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":12,"contrasting":2,"mentioning":176,"citing_publications":255,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v47n03_03"}},{"id":3117,"doi":"10.1300/j394v01n01_04","pmid":"28879816","pmcid":null,"title":"Revisiting Recent Research on Social Learning Theory as an Etiological Proposition for Sexually Abusive Male Adolescents","authors":"Burton DL, Meezan W.","first_author":"Burton DL","journal":"Journal of evidence-based social work","year":2004,"pub_types":["Journal Article"],"keywords":["Social Cognition","Social Learning Theory","Victim-to-victimizer","Transmission Of Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of existing studies without systematic methods or risk‑of‑bias assessment.","sample_n":null,"sample_text":"No primary sample – review of published research.","population":"Male adolescent sexual abusers (as reported in the literature); no original data collected.","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how social learning theory might explain why some adolescent males commit sexual abuse, summarising prior studies on victimization, aggression, pornography and personality.","clinical_takeaway":"None – the paper is a theoretical review, not a clinical study.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad literature coverage of social learning theory.","Clear articulation of theory background."],"limitations":["No systematic review methodology.","No empirical data or quantitative synthesis.","Limited attention to confounding variables."],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":2,"contrasting":0,"mentioning":26,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j394v01n01_04"}},{"id":3118,"doi":"10.1071/sh04009","pmid":"16335753","pmcid":null,"title":"Safer sex or pleasurable sex? Rethinking condom use in the AIDS era","authors":"Khan SI, Hudson-Rodd N, Saggers S, Bhuiyan MI, Bhuiya A.","first_author":"Khan SI","journal":"Sexual health","year":2004,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative interview study with 50 men and 5 key informants","sample_n":55,"sample_text":"Fifty men and five key informants were interviewed","population":"men aged 18‑55 in Bangladesh (convenience sample)","country":"Bangladesh","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with Bangladeshi men show that condom avoidance is linked to ideas of natural sex, trust, and masculine identity, especially when portrayed in pornography, rather than just personal preference.","clinical_takeaway":"Condom promotion should address cultural notions of pleasure and masculinity, not only risk information.","confidence":0.7,"topic_tags":["csbd","pornography","masturbation","sexual_function"],"strengths":["In‑depth qualitative insight into men’s meanings around condom use","Inclusion of key informants for contextual understanding","Focus on cultural and relational factors"],"limitations":["Small, non‑representative convenience sample","No validated measurement instruments","Findings not generalisable beyond this group"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":36,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh04009"}},{"id":3119,"doi":null,"pmid":"15727404","pmcid":null,"title":"Older adolescents' positive attitudes toward younger adolescents as sexual partners","authors":"Hegna K, Mossige S, Wichstrøm L.","first_author":"Hegna K","journal":"Adolescence","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"School‑based cluster survey of 710 Norwegian 18‑19‑year‑olds; self‑report of hypothetical likelihood of sex with younger ages.","sample_n":710,"sample_text":"Cluster sample of 710 18‑19‑year‑old students in Oslo schools.","population":"Norwegian older adolescents (18‑19 y) attending non‑vocational high schools in Oslo (N≈710).","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Among 18‑19‑year‑old Norwegian students, a small minority of males said they might have sex with children under 12 or early teens, and those who entertained such thoughts also reported more drinking, earlier sex, conduct problems, and higher pornography use.","clinical_takeaway":"A tiny proportion of older adolescents entertain sexual interest in much younger peers, and this group shows broader risk‑behaviour patterns; clinicians should assess multiple risk factors, not just sexual attitudes.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Large overall sample for adolescents","Cluster sampling reduces school‑level bias","Links attitudes to multiple risk behaviours"],"limitations":["Attitude measures not validated","No control for moral/religious or mental‑health confounds","Small male subgroup reporting likelihood of sex with pre‑adolescents","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":3120,"doi":null,"pmid":"15669216","pmcid":null,"title":"[A case of Williams syndrome who exhibited fetishism]","authors":"Noguchi M, Kato S.","first_author":"Noguchi M","journal":"Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica","year":2004,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"jpn","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case description of a 22‑year‑old male with Williams syndrome who developed a glove fetish after exposure to pornography; no systematic methodology","sample_n":1,"sample_text":"22‑year‑old male with Williams syndrome","population":"one male adult with Williams syndrome","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 22‑year‑old man with Williams syndrome developed a glove fetish after watching pornographic movies, leading to assaults on women wearing gloves. The authors discuss how his unique cognitive profile and environment may have contributed.","clinical_takeaway":"This isolated case cannot inform clinical practice; fetish development in Williams syndrome remains anecdotal.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Detailed clinical description of a rare syndrome","Attempts to link cognitive phenotype with sexual behavior"],"limitations":["Single case, no generalisability","No validated measures of fetishism or porn use","No control of potential confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":3121,"doi":"10.1300/j082v47n03_12","pmid":"15451712","pmcid":null,"title":"Porn again: some final conclusions","authors":"Ellis SR, Whitehead BW.","first_author":"Ellis SR","journal":"Journal of homosexuality","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary without empirical data; no methods, sample, or analyses reported.","sample_n":null,"sample_text":"Not reported","population":"gay men (inferred from topic, not specified)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors pose seven questions about gay male pornography to give readers insight, but they provide no data or analysis.","clinical_takeaway":"None – the paper does not offer evidence for clinical decision‑making.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Provides a perspective on gay male pornography","Clear, concise presentation of questions"],"limitations":["No empirical data or methodology described","No measurement of key constructs or confounders","No statistical analysis or sample information"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v47n03_12"}},{"id":3122,"doi":"10.1093/ndt/gfg431","pmid":"14671031","pmcid":null,"title":"Antihypertensive treatment with calcium channel blockers: pharmacological pornography or useful intervention?","authors":"Trenkwalder P.","first_author":"Trenkwalder P.","journal":"Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association","year":2004,"pub_types":["Review","Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/ndt/gfg431"}},{"id":3123,"doi":"10.1300/j082v47n03_04","pmid":"15451704","pmcid":null,"title":"If you look at it long enough..","authors":"Hallam P.","first_author":"Hallam P.","journal":"Journal of homosexuality","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary, autobiographical account, no empirical data","sample_n":null,"sample_text":"single self‑report narrative (author’s 40‑year personal experience)","population":"single author (autobiographical)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article is a personal 40‑year autobiographical account reflecting on pornography use, framed as a tribute and commentary on gay studies, without presenting empirical research.","clinical_takeaway":"None – the piece is narrative and offers no evidence for clinical practice.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["first‑person perspective","provides historical context of long‑term porn exposure"],"limitations":["no systematic data collection","single‑case narrative cannot support causal claims","no measurement of confounding factors"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v47n03_04"}},{"id":3124,"doi":"10.1089/109493103322725342","pmid":"14756923","pmcid":null,"title":"Pushing the wrong buttons: men's and women's attitudes toward online and offline infidelity","authors":"Whitty MT.","first_author":"Whitty MT.","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":2003,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,117 adults examining attitudes toward online and offline infidelity; factor analysis and MANOVA used; recruitment method not specified, likely convenience/online sample","sample_n":1117,"sample_text":"1117 participants (gender, age, relationship status, internet sexual experience recorded)","population":"adults (male and female) across age groups; recruited via unspecified means (likely online panels)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed over a thousand adults and found that people view some online sexual activities, including viewing pornography, as forms of infidelity, but these do not form a separate category from offline cheating.","clinical_takeaway":"Clinicians should recognize that clients may regard certain online sexual behaviors as betrayals, which can affect relationship counseling.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Large sample size for an attitude survey","Factor analysis identifies distinct components of infidelity attitudes","Considers both online and offline contexts"],"limitations":["Attitude items appear ad‑hoc and not validated against established scales","No measurement or control of key confounds (e.g., moral incongruence, mental health)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":11,"contrasting":2,"mentioning":130,"citing_publications":181,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/109493103322725342"}},{"id":3125,"doi":"10.1037/0022-3514.85.5.853","pmid":"14599249","pmcid":null,"title":"Sexual harassment under social identity threat: the computer harassment paradigm","authors":"Maass A, Cadinu M, Guarnieri G, Grasselli A.","first_author":"Maass A","journal":"Journal of personality and social psychology","year":2003,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":63,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiments with male university students (N≈80‑90) randomly assigned to identity‑threat or control conditions; outcome was amount of pornographic material sent to a virtual female partner.","sample_n":170,"sample_text":"N=80 in Experiment 1, N=90 in Experiment 2","population":"Male university students, likely WEIRD sample","country":"Not specified (likely Italy/Europe)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Lab experiments showed that when male students felt their identity was threatened, they were more likely to harass a simulated female partner by sending pornographic material, especially if they strongly identified with their gender.","clinical_takeaway":"None – findings relate to social‑identity dynamics of harassment, not clinical sexual health.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Randomised experimental manipulation of identity threat","Behavioral outcome rather than self‑report only","Two independent experiments replicate effect"],"limitations":["Small per‑condition sample sizes, possible under‑power","Student, male‑only sample limits generalisability","Outcome measure (sending pornographic material) not validated"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":20,"contrasting":3,"mentioning":417,"citing_publications":451,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/0022-3514.85.5.853"}},{"id":3126,"doi":"10.1080/00224490209552201","pmid":"14735409","pmcid":null,"title":"Sexuality attitudes: the impact of trauma","authors":"Broman CL.","first_author":"Broman CL.","journal":"Journal of sex research","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey examining trauma history and sexuality attitudes","sample_n":null,"sample_text":"Not reported in abstract","population":"adults (gender‑specific analyses reported)","country":"USA (Michigan)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study found that adults who have experienced traumatic events, especially sexual or assault‑related trauma, tend to hold more accepting attitudes toward pornography and homosexuality, with the effect strongest for women.","clinical_takeaway":"None - findings are descriptive and not directly applicable to clinical practice.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["Addresses understudied link between trauma and sexuality attitudes","Gender‑specific analyses","Uses regression to test predictions"],"limitations":["No indication of validated instruments for trauma or attitudes","Cross‑sectional design limits causal inference","Sample size and recruitment method not disclosed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490209552201"}},{"id":3127,"doi":"10.1016/s1344-6223(03)00053-1","pmid":"14568779","pmcid":null,"title":"Sexual asphyxia by hanging--a case report and a review of the literature","authors":"Ueno Y, Asano M, Nushida H, Nakagawa K, Adachi J, Nagasaki Y.","first_author":"Ueno Y","journal":"Legal medicine (Tokyo, Japan)","year":2003,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report with literature review; single fatal incident","sample_n":null,"sample_text":"N=1 (case report)","population":"one adult male decedent; no living participants","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 35‑year‑old man died after hanging himself while trying to increase sexual pleasure during masturbation. Autopsy showed typical hanging signs but no neck bone injuries. The report discusses similar cases of sexual asphyxia.","clinical_takeaway":"Clinicians should be aware that risky sexual practices like autoerotic hanging can be fatal and assess for such behaviors in at‑risk patients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed forensic description","Provides autopsy findings","Includes literature review for context"],"limitations":["Single case; no generalizable data","No systematic methodology","No measurement of psychological constructs"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1344-6223(03)00053-1"}},{"id":3129,"doi":"10.1177/0306624x03253848","pmid":"12971179","pmcid":null,"title":"A study of the psychosexual characteristics of sex killers: can we identify them before it is too late?","authors":"Langevin R.","first_author":"Langevin R.","journal":"International journal of offender therapy and comparative criminology","year":2003,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of convicted offenders (33 sex killers, 80 sexual aggressives, 23 sadists, 611 general sex offenders).","sample_n":747,"sample_text":"33 sex killers, 80 sexual aggressives, 23 sadists, 611 general sex offenders.","population":"Male adult offenders, recruited from correctional/justice records in Ontario, Canada.","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared 33 convicted sex killers with other offender groups, finding that sex killers started offending earlier, had more criminal and substance‑abuse histories, and showed greater neuropsychological problems, but did not use pornography during crimes.","clinical_takeaway":"None – findings pertain to offender profiling, not clinical treatment of sexual health or compulsive behaviours.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large overall offender sample","Detailed comparison across multiple offender sub‑groups","Inclusion of neuropsychological and endocrine variables"],"limitations":["Cross‑sectional design, no causal inference","Limited description of measurement instruments","Findings not generalizable to non‑offender population","No control for key confounds (e.g., moral attitudes, mental‑health variables)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":5,"mentioning":72,"citing_publications":99,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x03253848"}},{"id":3130,"doi":null,"pmid":"12839885","pmcid":null,"title":"Criminal and noncriminal sexual aggressors: integrating psychopathy in a hierarchical-mediational confluence model","authors":"Malamuth NM.","first_author":"Malamuth NM.","journal":"Annals of the New York Academy of Sciences","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative presentation of a theoretical model with reference to prior studies; no new empirical data reported.","sample_n":null,"sample_text":"N/A (no new data)","population":"Male sexual aggressors (criminal and non‑criminal); no sample size reported","country":"United States (likely, based on author affiliation and focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The author proposes a model that groups personality traits, attitudes, and heavy pornography use as risk factors for sexual aggression, arguing that criminal and non‑criminal aggressors share many of these characteristics.","clinical_takeaway":"None – the paper is theoretical and does not provide actionable clinical guidance.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Integrates a broad range of risk factors","Considers both criminal and non‑criminal aggressors","Provides a testable hierarchical‑mediational model"],"limitations":["No new empirical data presented","Relies on prior studies of variable quality","Lacks quantitative validation of the model","Potential bias toward psychopathy framework"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":3131,"doi":"10.1089/109493103321168009","pmid":"12650567","pmcid":null,"title":"Model of problematic internet use in people with a sexual interest in children","authors":"Quayle E, Taylor M.","first_author":"Quayle E","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":2003,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary-theoretical model without empirical data","sample_n":null,"sample_text":"Not applicable – no empirical sample reported","population":"individuals with sexual interest in children (no sample described)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose a cognitive model explaining how people with a sexual interest in children might use the internet problematically, linking thoughts, urges, and offending behavior. It is a conceptual framework without new empirical data.","clinical_takeaway":"None – the paper offers a theory, not tested findings for clinical use.","confidence":0.6,"topic_tags":["sexual_function","pornography"],"strengths":["Integrates cognitive models of internet use with offending behavior","Provides a conceptual framework for assessment and therapy","Highlights a novel area (child sexual interest & internet) for future research"],"limitations":["No empirical data; model not validated","Lacks measurement of key confounds (e.g., mental health, moral incongruence)","Discussion may conflate non‑pathological use with offending risk"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":5,"contrasting":0,"mentioning":133,"citing_publications":188,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/109493103321168009"}},{"id":3133,"doi":"10.1016/s1054-139x(02)00449-4","pmid":"12457582","pmcid":null,"title":"Sexual coercion among adolescent women seeking abortion in China","authors":"Yimin C, Shouqing L, Arzhu Q, Yuke Z, Jianhua W, Jinxin Z, Yanli Q, Xiaodun W, An J, Li P, Shaomin W.","first_author":"Yimin C","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-control observational study of 2,383 adolescent abortion‑seeking women in China, comparing those reporting sexual coercion with those who did not.","sample_n":2383,"sample_text":"1,137 cases with self‑reported sexual coercion, 1,246 controls without.","population":"adolescent women seeking abortion in China (n≈2,383)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among Chinese adolescents seeking abortions, about half reported experiencing sexual coercion. Factors like low education, partner violence, multiple partners, alcohol use, and having sex after watching porn were linked to higher odds of coercion.","clinical_takeaway":"Clinicians should screen for coercion and related risk factors (e.g., partner abuse, alcohol) when caring for adolescent abortion‑seekers.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Large community sample for this topic","Use of case‑control design to identify associated factors","Clear reporting of odds ratios"],"limitations":["Self‑report of coercion and behaviours may be biased","No adjustment for moral or mental‑health confounders","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1054-139x(02)00449-4"}},{"id":3134,"doi":"10.15288/jsa.2002.63.688","pmid":"12529069","pmcid":null,"title":"Alcohol's direct and indirect effects on men's self-reported sexual aggression likelihood","authors":"Norris J, Davis KC, George WH, Martell J, Heiman JR.","first_author":"Norris J","journal":"Journal of studies on alcohol","year":2002,"pub_types":["Clinical Trial","Research Support, U.S. Gov't, P.H.S.","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":45,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized controlled trial with three beverage conditions (alcohol, placebo, control) and N=135 male social drinkers; pre‑test measures; self‑report outcomes after reading a violent pornographic story.","sample_n":135,"sample_text":"Male social drinkers (N = 135) recruited through newspaper ads.","population":"Male social drinkers (average age not specified), recruited via newspaper ads in a large western city.","country":"United States (implied by U.S. Government funding and large western city).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab experiment, men who drank alcohol (or thought they were drinking) reported higher willingness to commit sexual aggression after reading a violent porn story, partly because of their expectations about alcohol and the emotions they felt.","clinical_takeaway":"Alcohol consumption and expectancies can elevate short‑term aggression risk; clinicians should assess drinking context when addressing sexual aggression concerns.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Experimental manipulation of alcohol/placebo provides causal inference","Random assignment reduces selection bias","Investigation of both direct physiological and expectancy effects"],"limitations":["Reliance on self‑report scales with unclear validation","Key confounds (e.g., moral attitudes, mental health) not measured","Results limited to short‑term self‑reported likelihood, not actual behavior"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":7,"contrasting":0,"mentioning":87,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.15288/jsa.2002.63.688"}},{"id":3136,"doi":null,"pmid":"12407892","pmcid":null,"title":"[Naked on the lawn. The sexual life of 60-year-old Danish women]","authors":"Eplov LF, Køster A, Garde K.","first_author":"Eplov LF","journal":"Ugeskrift for laeger","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"dan","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Random sample of 122 Danish women aged 60; semi‑structured interview about sexual attitudes and behaviours; descriptive statistics reported.","sample_n":122,"sample_text":"Random sample drawn from a cohort considered fairly representative of 60‑year‑old women in the County of Copenhagen.","population":"60‑year‑old women, Copenhagen County, Denmark","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2002 Danish survey of 122 women aged 60 described their sexual activity, desire, and attitudes toward pornography and other practices, noting that most remained sexually active and tolerated modern sexual norms.","clinical_takeaway":"Older women can maintain active sexual lives; clinicians should address sexual health proactively in this age group.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Population‑based random sample","Focus on an under‑researched age group","Clear descriptive reporting of sexual behaviours"],"limitations":["No validated psychometric instruments used","Limited assessment of potential confounders (e.g., mental health, moral attitudes)","Cross‑sectional design cannot address causality"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":3137,"doi":"10.1089/109493102760275590","pmid":"12216699","pmcid":null,"title":"Lost in cyberspace: the web @ work","authors":"Greenfield DN, Davis RA.","first_author":"Greenfield DN","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 224 U.S. organizations about workplace internet use policies and disciplinary actions; descriptive percentages reported.","sample_n":224,"sample_text":"224 organizations","population":"U.S. businesses (organizational representatives)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2002 survey of 224 U.S. companies found many employees use the internet at work for activities like pornography, and many firms report disciplining or firing staff despite having internet‑use policies.","clinical_takeaway":"None – the study addresses workplace policy, not individual clinical issues.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large number of organizations surveyed","Relevant policy‑level data on workplace internet use"],"limitations":["Reliance on organizational self‑report; no validated measures","Cross‑sectional, no causal inference","No control for individual‑level confounds (e.g., moral attitudes)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":71,"citing_publications":125,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/109493102760275590"}},{"id":3138,"doi":"10.1258/0956462021924884","pmid":"11860696","pmcid":null,"title":"HIV treatments optimism is associated with unprotected anal intercourse with regular and with casual partners among Australian gay and homosexually active men","authors":"Van de Ven P, Rawstorne P, Nakamura T, Crawford J, Kippax S.","first_author":"Van de Ven P","journal":"International journal of STD & AIDS","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire survey of 1,832 Australian gay/sexual‑minority men recruited via pornographic catalogues.","sample_n":1832,"sample_text":"1832 men responded; 1181 classified as gay community attached (GCA) and 651 as non‑GCA.","population":"Australian gay and homosexually active men (broad national sample, not limited to clinic or forum attendees).","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationwide Australian survey of gay men, those who were more optimistic about HIV treatment were more likely to have unprotected anal sex with both regular and casual partners, though the study cannot prove the optimism causes the behaviour.","clinical_takeaway":"Higher HIV optimism is linked to riskier sex; clinicians should discuss treatment optimism when counselling gay men about safer sex.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large national sample","Clear statistical significance reported","Distinguishes regular vs. casual partners"],"limitations":["Cross‑sectional; cannot infer causality","Limited description of measurement validity","No control for moral, mental‑health or relationship confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":2,"mentioning":23,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/0956462021924884"}},{"id":3140,"doi":"10.1177/002580240204200109","pmid":"11858209","pmcid":null,"title":"The sexual profile of rapists in Singapore","authors":"Gwee KP, Lim LE, Woo M.","first_author":"Gwee KP","journal":"Medicine, science, and the law","year":2002,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control interview study of 62 convicted rapists and 63 prisoner controls (violent and non‑violent)","sample_n":125,"sample_text":"62 rapists, 63 control prisoners (32 violent non‑sexual, 31 non‑violent non‑sexual)","population":"male prisoners in Singapore","country":"Singapore","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In Singapore, convicted rapists were more likely than non‑violent prisoners to masturbate monthly and to have viewed pornography shortly before the offence. A subgroup of ‘hypersexual’ rapists reported very frequent sex or masturbation and rape‑focused fantasies, suggesting a link between high sexual drive and aggression.","clinical_takeaway":"Findings are specific to a prison sample and cannot be generalized to all rapists; clinicians should interpret them cautiously.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Direct comparison with both violent and non‑violent prisoner controls","Identification of a hypersexual subgroup within rapists","Use of semi‑structured interviews to obtain detailed sexual histories"],"limitations":["Reliance on non‑validated, ad‑hoc interview items","Small, convenience sample limits generalisability","Limited control for key confounds (mental health, trauma, moral factors)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/002580240204200109"}},{"id":3141,"doi":null,"pmid":"11817291","pmcid":null,"title":"Men who commit rape in Singapore","authors":"Lim LE, Gwee KP, Woo M, Parker G.","first_author":"Lim LE","journal":"Annals of the Academy of Medicine, Singapore","year":2001,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative case‑control study of convicted rapists versus non‑sexual offenders (Singapore prison sample).","sample_n":null,"sample_text":"Not specified in abstract; likely small prison cohorts.","population":"Male rapists (late 30s) and two control groups of offenders; prison sample, not population‑representative.","country":"Singapore","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared men convicted of rape with other offenders in Singapore, finding that rapists were often less educated, came from larger families, and more frequently reported having watched pornography shortly before the offence.","clinical_takeaway":"None – the study does not provide evidence for clinical assessment or treatment of pornography‑related issues.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Uses comparison groups (violent and non‑violent offenders)","Addresses a gap in Singapore‑specific data"],"limitations":["Convenience prison sample limits generalisability","Exposure to pornography not operationalised or validated","Potential confounding variables (e.g., moral attitudes, masturbation) not measured"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":3142,"doi":"10.1089/109493101753235197","pmid":"11725653","pmcid":null,"title":"Child seduction and self-representation on the Internet","authors":"Quayle E, Taylor M.","first_author":"Quayle E","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":2001,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case report of a single offender involving qualitative description of internet-facilitated child sexual offenses.","sample_n":1,"sample_text":"One case study","population":"Adult male offender charged with child pornography offenses.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A single case report describes how a man used the Internet to download child pornography, locate children for abuse, and pose as both a child and an adult in chat rooms, illustrating how online self‑presentation can facilitate sexual offending.","clinical_takeaway":"None – the paper offers a descriptive account of illegal behavior, not clinical guidance.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Provides detailed qualitative insight into offender behavior","Highlights novel role of self-representation in online offending"],"limitations":["Single case; no generalizability","No systematic measurement or statistical analysis","Lacks assessment of relevant confounds"],"rubric_version":"2.0","raw_total":3,"max_possible":50,"pct_score":6,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":1,"contrasting":0,"mentioning":41,"citing_publications":74,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/109493101753235197"}},{"id":3143,"doi":"10.1176/appi.ajp.158.10.1590","pmid":"11578986","pmcid":null,"title":"Hypersexual disorder and preoccupation with internet pornography","authors":"Stein DJ, Black DW, Shapira NA, Spitzer RL.","first_author":"Stein DJ","journal":"The American journal of psychiatry","year":2001,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["csbd","pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":57,"citing_publications":104,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.ajp.158.10.1590"}},{"id":3144,"doi":"10.1016/s1054-139x(01)00218-x","pmid":"11587914","pmcid":null,"title":"Korean adolescents' health risk behaviors and their relationships with the selected psychological constructs","authors":"Kim YH.","first_author":"Kim YH.","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2001,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 2124 Korean junior high and high school students; random school selection; self‑report questionnaires on health risk behaviors (including pornography viewing) and psychological constructs.","sample_n":2124,"sample_text":"2124 adolescents randomly selected from junior high and high schools in Seoul","population":"Korean adolescents (approx. 12‑18 y, both sexes)","country":"South Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 2,000 Korean teens found that many reported smoking, drinking, poor eating habits and watching pornography, while few reported sexual activity or drug use. Psychological factors like self‑esteem and locus of control were linked to these risky behaviours.","clinical_takeaway":"Viewing pornography is common among Korean adolescents but this study does not link it to distress or addiction; clinicians should consider broader psychological influences on risk behaviours.","confidence":0.8,"topic_tags":["pornography","adolescents","sexual_function","other"],"strengths":["Large, randomly selected adolescent sample","Validated Korean versions of several psychological scales","Comprehensive list of health risk behaviours"],"limitations":["Cross‑sectional; cannot infer causality","Pornography measured only as frequency, no distress or addiction assessment","No control for moral, mental‑health, or interpersonal confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":36,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1054-139x(01)00218-x"}},{"id":3145,"doi":null,"pmid":"11547493","pmcid":null,"title":"Doctors overlook sexual histories too often","authors":"Irwin K.","first_author":"Irwin K.","journal":"AIDS alert","year":2001,"pub_types":["Newspaper Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary/opinion piece without original data; no empirical methods described.","sample_n":null,"sample_text":"","population":"","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that U.S. doctors often fail to ask patients about sexual activity, despite widespread exposure to sexual media and the ongoing HIV/AIDS epidemic.","clinical_takeaway":"Clinicians should routinely include sexual history questions in patient assessments.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Highlights an important clinical practice gap","Uses contemporary cultural references for relevance"],"limitations":["No original data presented","Lacks systematic evidence or citation of empirical studies","No methodological detail"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":3146,"doi":null,"pmid":"11957665","pmcid":null,"title":"Lecturer struck off after claiming child pornography was a teaching aid","authors":null,"first_author":null,"journal":"Nursing times","year":2001,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3148,"doi":"10.1007/bf01544269","pmid":"1212090","pmcid":null,"title":"Age and perceived effects of erotica-pornography: a national sample study","authors":"Merritt CG, Gerstl JE, LoSciuto LA.","first_author":"Merritt CG","journal":"Archives of sexual behavior","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national survey of 2,486 adults, cross‑sectional","sample_n":2486,"sample_text":"national sample survey","population":"U.S. adults aged 20–80 (both sexes)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1975 survey of 2,486 U.S. adults found that older people were more likely to view erotic materials as harmful, while younger adults were more ambivalent or positive. Attitudes showed a clear age‑related pattern even after accounting for education, gender and past exposure.","clinical_takeaway":"Clinicians should note that attitudes toward erotic material vary by age; older clients may hold more negative beliefs that could affect sexual wellbeing.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Large, nationally representative sample","Systematic typology of attitudes","Controls for education, gender, prior exposure"],"limitations":["Attitude items not validated psychometric instruments","No measurement of moral or religious attitudes","Cross‑sectional, no causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01544269"}},{"id":3150,"doi":"10.1016/s0140-6736(00)04068-x","pmid":"11558475","pmcid":null,"title":"International cooperation to tackle child pornography","authors":null,"first_author":null,"journal":"Lancet (London, England)","year":2001,"pub_types":["Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0140-6736(00)04068-x"}},{"id":3151,"doi":"10.1016/s0165-0327(00)00150-6","pmid":"11223111","pmcid":null,"title":"Disinhibition of libido: an adverse effect of SSRI?","authors":"Greil W, Horvath A, Sassim N, Erazo N, Grohmann R.","first_author":"Greil W","journal":"Journal of affective disorders","year":2001,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of five outpatients observed for increased libido and sexual disinhibition during SSRI treatment","sample_n":5,"sample_text":"five outpatients","population":"outpatients with depression treated with SSRIs at a psychiatric hospital in Switzerland","country":"Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"Five patients on SSRI antidepressants reported unexpected increases in sexual desire, risky sex, and pornography use. The authors suggest SSRIs might sometimes trigger disinhibited sexual behavior, but the evidence is limited to a few uncontrolled cases.","clinical_takeaway":"Clinicians should be aware that SSRIs may, in rare cases, be linked to heightened sexual drive and risky behavior, and monitor patients accordingly.","confidence":0.7,"topic_tags":["adolescents"],"strengths":["real‑world clinical observations","focus on a rarely reported adverse effect"],"limitations":["very small, uncontrolled case series","no validated measures of libido or sexual behavior","no assessment of confounding factors (e.g., mood, relationship context)"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0165-0327(00)00150-6"}},{"id":3152,"doi":null,"pmid":"12087956","pmcid":null,"title":"Autoerotic asphyxia (a case report)","authors":"Doychinov ID, Markova IM, Staneva YA.","first_author":"Doychinov ID","journal":"Folia medica","year":2001,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of an 18‑year‑old male death by autoerotic asphyxia, with forensic description of scene and materials.","sample_n":1,"sample_text":"N=1 (case report)","population":"Single deceased male, 18 y, no known mental disorder.","country":"Bulgaria (presumed from authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe a forensic investigation of an 18‑year‑old man who died while practicing autoerotic asphyxia, detailing the scene, clothing, and pornographic material found, and conclude the death was accidental.","clinical_takeaway":"Autoerotic asphyxia can be fatal; forensic awareness is essential to distinguish accidental deaths from homicide or suicide.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Detailed forensic description of scene and materials","Highlights rarity of autoerotic asphyxia in local practice"],"limitations":["Single case; no systematic measurement","No assessment of psychological or sexual behavior variables"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":3153,"doi":"10.1177/109019810002700603","pmid":"11104368","pmcid":null,"title":"The content and accessibility of sex education information on the Internet","authors":"Smith M, Gertz E, Alvarez S, Lurie P.","first_author":"Smith M","journal":"Health education & behavior : the official publication of the Society for Public Health Education","year":2000,"pub_types":["Evaluation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Evaluation of website content and a task‑based usability test with 27 undergraduate students (convenience sample).","sample_n":27,"sample_text":"27 undergraduate students performed search tasks; 41 websites identified from keyword search.","population":"Undergraduate students (N≈27) recruited from a university; also a systematic web search of sex‑education sites.","country":"United States (inferred from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study mapped sex‑education websites and tested how quickly college students could find condom‑use and STD‑symptom information. Although many sites were pornographic, students located the key facts within about four minutes and a few clicks.","clinical_takeaway":"None – the paper evaluates website accessibility, not clinical sexual‑health outcomes.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Systematic keyword search of many webpages","Clear, observable task performance metrics","Provides practical insight into information accessibility"],"limitations":["Very small, non‑representative participant sample","No validated instruments for assessing website quality","Findings may not generalise beyond college students"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":28,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/109019810002700603"}},{"id":3154,"doi":"10.1177/002580240004000404","pmid":"11281351","pmcid":null,"title":"The sexual habits of males who molest","authors":"Lim LE, Yap AK, Ong SH, Chan AO, Chan KL.","first_author":"Lim LE","journal":"Medicine, science, and the law","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control comparison of male prisoners convicted of sexual molestation versus thieves; demographic and sexual‑history variables reported; no longitudinal follow‑up","sample_n":null,"sample_text":"prison cohort (size not reported in abstract)","population":"adult male prisoners in Singapore (molesters) and male prisoners convicted of theft (controls)","country":"Singapore","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors compared male prisoners who had committed sexual molestation with male prisoners convicted of theft. Molesters were older, better educated, more often married, started intercourse later, had more partners, watched less porn and reported less sexual activity in the three months before the offense.","clinical_takeaway":"None – the study does not provide evidence relevant to clinical assessment or treatment of pornography or sexual addiction.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Direct comparison of two prison groups","Provides demographic and sexual‑history data"],"limitations":["No validated measures of sexual behaviour or distress","Small, non‑representative sample, no power analysis","Key confounders (mental health, trauma, masturbation) not assessed"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/002580240004000404"}},{"id":3155,"doi":"10.1016/s1054-139x(00)00137-3","pmid":"10904205","pmcid":null,"title":"Influence of unrestrained access to erotica on adolescents' and young adults' dispositions toward sexuality","authors":"Zillmann D.","first_author":"Zillmann D.","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2000,"pub_types":["Conference Proceedings","Review"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":57,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review / conference proceeding outlining theoretical considerations and future research agenda; no primary data reported.","sample_n":null,"sample_text":"No empirical sample; paper is a review/position piece.","population":"Adolescents and young adults (general U.S. population implied)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper argues that, because formal sex education is limited, young people turn to erotica for sexual learning. It warns that extensive, unfiltered exposure may foster a callous attitude toward sexuality, and it proposes research to examine these effects.","clinical_takeaway":"None – the article is theoretical and does not provide clinical evidence.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function"],"strengths":["Identifies a gap in empirical knowledge about erotica exposure","Calls for systematic research agenda"],"limitations":["No original data or systematic synthesis","Lacks operational definitions or measurement guidance"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":2,"contrasting":2,"mentioning":75,"citing_publications":137,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1054-139x(00)00137-3"}},{"id":3156,"doi":"10.1590/s0102-311x2000000300022","pmid":"11035513","pmcid":null,"title":"A profile of sexually active male adolescent high school students in Lima, Peru","authors":"Chirinos JL, Salazar VC, Brindis CD.","first_author":"Chirinos JL","journal":"Cadernos de saude publica","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Self‑administered anonymous survey of 991 male high‑school students in Lima; cross‑sectional convenience sample.","sample_n":991,"sample_text":"991 male adolescents aged 12‑19","population":"Male adolescents, ages 12‑19, school‑based, Lima, Peru (N≈991)","country":"Peru","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 991 Peruvian male teenagers examined their sexual knowledge, attitudes, and behaviours. About 43% had sex, and viewing pornographic material was linked to earlier sexual activity and other risk factors like alcohol use, but the study did not evaluate porn use as a disorder.","clinical_takeaway":"Adolescent male porn exposure co‑occurs with other risk behaviours; clinicians should assess broader context rather than assuming addiction.","confidence":0.7,"topic_tags":["sexual_function","adolescents","pornography"],"strengths":["Large sample size for adolescent survey","Comprehensive questionnaire covering many sociodemographic and behavioural variables","Anonymous self‑report reduces social desirability bias"],"limitations":["Cross‑sectional design limits causal inference","No validated measures for pornography use or problematic use","Key confounds (moral incongruence, masturbation, mental health, trauma) not assessed","Convenience sample; limited generalisability beyond participating schools"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s0102-311x2000000300022"}},{"id":3158,"doi":"10.1016/s1054-139x(98)00083-4","pmid":"10706170","pmcid":null,"title":"Study in sexuality of medical college students in India","authors":"Aggarwal O, Sharma AK, Chhabra P.","first_author":"Aggarwal O","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 365 medical college students in Delhi using a pre‑tested questionnaire; descriptive statistics reported","sample_n":365,"sample_text":"500 invited, 73% participated","population":"Indian medical college students (under‑graduates)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of about 365 Indian medical students found moderate knowledge of sex, masturbation and contraception, with friends and pornographic films being the main sources of information; only 12% reported having had sexual intercourse, and most support school‑based sex education.","clinical_takeaway":"Clinicians should note that even medically trained youth may lack comprehensive sexual knowledge and rely on peers and pornography for information.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample for a single college","Pre‑tested questionnaire","Provides baseline data on knowledge and attitudes"],"limitations":["Convenience sample; not nationally representative","Cross‑sectional; cannot infer causality","Limited validation of questionnaire items"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":10,"contrasting":2,"mentioning":43,"citing_publications":73,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1054-139x(98)00083-4"}},{"id":3159,"doi":"10.1017/s1092852900012670","pmid":"18311101","pmcid":null,"title":"Sexual disorders not otherwise specified: compulsive, addictive, or impulsive?","authors":"Stein DJ, Black DW, Pienaar W.","first_author":"Stein DJ","journal":"CNS spectrums","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"No empirical sample; paper is a theoretical commentary proposing diagnostic criteria.","population":"not applicable","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that repeated, intense sexual fantasies or behaviors like compulsive masturbation or pornography use constitute a distinct disorder they call ‘hypersexual disorder’ and suggest adding specific diagnostic criteria to the DSM.","clinical_takeaway":"Clinicians should be aware that the concept of hypersexual disorder is a proposal, not an established diagnosis, and should assess patients within existing DSM criteria.","confidence":0.5,"topic_tags":["sexual_function","csbd","pornography","masturbation"],"strengths":["Comprehensive review of existing literature up to 2000","Clear rationale for a new diagnostic category"],"limitations":["No empirical data presented","Proposes classification without testing criteria","Potential advocacy bias toward pathologizing behavior"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852900012670"}},{"id":3160,"doi":null,"pmid":"12024387","pmcid":null,"title":"Child pornography, the Internet, and congressional activity","authors":"Meier E.","first_author":"Meier E.","journal":"Pediatric nursing","year":1999,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3161,"doi":null,"pmid":"10532868","pmcid":null,"title":"Tanner staging and pornography","authors":"Sirotnak A.","first_author":"Sirotnak A.","journal":"Pediatrics","year":1999,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3162,"doi":"10.1542/peds.104.4.995","pmid":"10532867","pmcid":null,"title":"Tanner staging and pornography","authors":"Kutz T.","first_author":"Kutz T.","journal":"Pediatrics","year":1999,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.104.4.995"}},{"id":3163,"doi":"10.1080/00926239908404008","pmid":"10546169","pmcid":null,"title":"The paraphilia-related disorders: an empirical investigation of nonparaphilic hypersexuality disorders in outpatient males","authors":"Kafka MP, Hennen J.","first_author":"Kafka MP","journal":"Journal of sex & marital therapy","year":1999,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":59,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational survey of 206 outpatient males seeking help for sexual impulsivity disorders; groups compared on self‑reported histories.","sample_n":206,"sample_text":"206 consecutively evaluated males (63 PRD, 143 PA).","population":"Adult outpatient males (n=206) seeking treatment for sexual impulsivity/paraphilic disorders.","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["circular_addiction_scale","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 206 men seeking help for sexual impulsivity, half reported pornography dependence and many reported compulsive masturbation, promiscuity, and other hypersexual behaviors. Those with both paraphilias and non‑paraphilic disorders also reported more abuse, less education, and higher unemployment, suggesting social disadvantage co‑occurs with multiple sexual impulsivity problems.","clinical_takeaway":"Clinicians should assess broader social and trauma factors in patients presenting with hypersexual behaviors, not assume addiction alone explains distress.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large clinical sample for 1999 on understudied topic","Clear descriptive statistics of multiple hypersexual behaviors","Inclusion of trauma history"],"limitations":["Reliance on unvalidated self‑labelled ‘dependence’ measures","No control for moral incongruence, mental health, or partner factors","Cross‑sectional design limits causal inference","Help‑seeking sample limits generalisability"],"rubric_version":"2.0","raw_total":19,"max_possible":60,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":90,"citing_publications":166,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239908404008"}},{"id":3164,"doi":null,"pmid":"10532869","pmcid":null,"title":"Tanner staging and pornography","authors":"Giardino AP.","first_author":"Giardino AP.","journal":"Pediatrics","year":1999,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3165,"doi":"10.1520/jfs12046j","pmid":"10486962","pmcid":null,"title":"Serial murder of six victims by an African-American male","authors":"Leach G, Meloy JR.","first_author":"Leach G","journal":"Journal of forensic sciences","year":1999,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"One individual examined eight years after the homicides","population":"single male serial murderer, 22 y, African‑American","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A case report describes a 22‑year‑old African‑American man who killed six unrelated women. He was later diagnosed with sexual sadism, antisocial and schizoid personality disorders, and had a history of mental‑health issues and childhood trauma, including exposure to violent pornography.","clinical_takeaway":"None – the report is a single forensic case and does not provide clinically actionable findings about pornography or sexual health.","confidence":0.3,"topic_tags":["sexual_function","pornography","moral_incongruence","gender"],"strengths":["Detailed clinical description","Integration of multiple psychiatric diagnoses"],"limitations":["Single case; no generalizability","No systematic measurement of pornography use or its effects"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":0,"mentioning":9,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1520/jfs12046j"}},{"id":3166,"doi":"10.1097/00006842-199905000-00005","pmid":"10367606","pmcid":null,"title":"Cardiovascular and endocrine alterations after masturbation-induced orgasm in women","authors":"Exton MS, Bindert A, Krüger T, Scheller F, Hartmann U, Schedlowski M.","first_author":"Exton MS","journal":"Psychosomatic medicine","year":1999,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":90,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Cross‑over laboratory experiment with 10 healthy women; physiological monitoring during pornographic stimulus and masturbation‑induced orgasm versus documentary control.","sample_n":10,"sample_text":"N = 10 healthy women","population":"Adult women, community volunteers, N=10, non‑clinical.","country":"Germany (authors' affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In ten healthy women, a self‑stimulated orgasm after watching pornography caused short‑term rises in heart rate, blood pressure, adrenaline, noradrenaline and a lasting increase in prolactin, while most other hormones stayed stable.","clinical_takeaway":"Orgasm triggers specific cardiovascular and hormonal changes (notably prolactin) that may inform understanding of sexual physiology, but findings are limited by the small sample.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","masturbation"],"strengths":["Physiologically rigorous, continuous monitoring","Within‑subject crossover controls for individual differences","Broad hormonal panel measured"],"limitations":["Very small sample (N=10) limits generalisability","No assessment of psychological or contextual factors","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":9,"contrasting":0,"mentioning":103,"citing_publications":165,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00006842-199905000-00005"}},{"id":3167,"doi":"10.1177/107906329901100203","pmid":"10335564","pmcid":null,"title":"Pathways in the offending process of extrafamilial sexual child molesters","authors":"Proulx J, Perreault C, Ouimet M.","first_author":"Proulx J","journal":"Sexual abuse : a journal of research and treatment","year":1999,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cluster analysis of 44 forensic offenders, cross‑sectional observational study","sample_n":44,"sample_text":"Forty‑four men convicted of at least one sexual offense against a non‑familial prepubescent child","population":"44 adult male extrafamilial sexual child molesters (non‑U.S. sample)","country":"Canada (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers examined 44 men who sexually abused non‑family children and identified two distinct offending pathways: a coercive, substance‑influenced route and a non‑coercive, pornography‑linked route, differing in planning, victim type, and offense duration.","clinical_takeaway":"None – findings pertain to forensic profiling, not clinical treatment of pornography or sexual health issues.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Unique forensic sample","Clear typology of offending pathways","Use of cluster analysis to identify patterns"],"limitations":["Small N limits generalizability","Reliance on self‑report/records without validated scales","Cross‑sectional, no causal inference"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":66,"citing_publications":107,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/107906329901100203"}},{"id":3168,"doi":"10.2307/2650183","pmid":"11623657","pmcid":null,"title":"Prostitutes in history: from parables of pornography to metaphors of modernity","authors":"Gilfoyle TJ.","first_author":"Gilfoyle TJ.","journal":"The American historical review","year":1999,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":1,"mentioning":22,"citing_publications":120,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2307/2650183"}},{"id":3169,"doi":"10.1353/jowh.2003.0119","pmid":"21998909","pmcid":null,"title":"Dressing up and dressing down: prostitution, pornography, and the seventeenth-century English textile industry","authors":"Mowry M.","first_author":"Mowry M.","journal":"Journal of women's history","year":1999,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1353/jowh.2003.0119"}},{"id":3170,"doi":"10.1086/495366","pmid":"22315732","pmcid":null,"title":"The representation of female desire in early modern pornographic texts,    1660-1745","authors":"Mourao M.","first_author":"Mourao M.","journal":"Signs","year":1999,"pub_types":["Historical Article","Journal 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emancipation in mid twentieth-century Britain","authors":"Collins M.","first_author":"Collins M.","journal":"History workshop journal : HWJ","year":1999,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/hwj/1999.47.99"}},{"id":3172,"doi":"10.1300/j155v03n03_09","pmid":"24786273","pmcid":null,"title":"Eroticizing safe sex","authors":"Milliken C.","first_author":"Milliken C.","journal":"Journal of lesbian studies","year":1999,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses lesbian‑made safe‑sex videos that blend pornographic style with educational aims, aiming to fill the lack of erotic lesbian imagery and to promote safe‑sex practices.","clinical_takeaway":"None - not clinically applicable.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses gap in lesbian erotic representation","Links erotic content to sexual health education"],"limitations":["No empirical data or systematic analysis","Lacks measurement of key constructs","No consideration of confounding variables"],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j155v03n03_09"}},{"id":3174,"doi":"10.1016/s0160-2527(98)00035-1","pmid":"10086287","pmcid":null,"title":"Pornography, rape, and sex crimes in Japan","authors":"Diamond M, Uchiyama A.","first_author":"Diamond M","journal":"International journal of law and psychiatry","year":1999,"pub_types":["Review","Journal 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vigilantism, and \"pornography\" in Dunton's \"Night-walker\"","authors":"Turner JG.","first_author":"Turner JG.","journal":"Studies in eighteenth-century culture","year":1999,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1353/sec.2010.0164"}},{"id":3177,"doi":"10.1007/bf01540933","pmid":"24179044","pmcid":null,"title":"Experience with pornography: Rapists, pedophiles, homosexuals, transsexuals, and controls","authors":"Goldstein M, Kant H, Judd L, Rice C, Green R.","first_author":"Goldstein M","journal":"Archives of sexual behavior","year":1971,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective interview comparing convicted offenders, heavy users, and control groups; convenience sampling; multiple demographic groups; no longitudinal follow‑up.","sample_n":null,"sample_text":"Not reported in abstract","population":"Adult male participants; convicted rapists, pedophiles, homosexuals, transsexuals, heavy pornography users, and two non‑deviant control groups.","country":"USA (presumed from authors/institution)","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared how much erotic material different groups (including rapists, pedophiles, gay men, transsexuals, heavy porn users, and two control groups) saw as adolescents and adults, finding that most offender groups had less exposure than controls, challenging the idea that early porn exposure causes later sexual pathology.","clinical_takeaway":"Early exposure to erotic material does not appear to predict later sexual offending; clinicians should consider multiple factors beyond porn use.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Inclusion of multiple distinct groups","Direct interview about erotic material exposure","Historical reference point for early research"],"limitations":["Unvalidated interview 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transmitted epidemics: a preliminary study","authors":"Giannini AJ, Colapietro G, Slaby AE, Melemis SM, Bowman RK.","first_author":"Giannini AJ","journal":"Psychological reports","year":1998,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Content analysis of pornographic literature over 30 years; historical review; no systematic sampling; hypothesis‑generating.","sample_n":null,"sample_text":"Not applicable – study analysed published images, not people.","population":"mass‑circulation pornographic publications (unspecified number); no human participants.","country":"United States (presumed from authors’ affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors counted foot‑fetish images in popular porn magazines from 1960‑1990 and found an exponential rise during the AIDS epidemic, suggesting a possible link between disease outbreaks and foot fetish interest.","clinical_takeaway":"None – the study is speculative and does not provide actionable clinical information.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Innovative historical hypothesis","Longitudinal span of 30 years"],"limitations":["No validated measurement of fetishism","No control for confounding cultural factors","Ecological fallacy – infers individual behavior from aggregate 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Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article discussing physicians' responsibilities regarding violence against women, including mention of pornography-related violence; no primary empirical data.","sample_n":null,"sample_text":"Not applicable (review)","population":"physicians, women affected by violence (general discussion)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how physicians should recognize and respond to various forms of violence against women, including those linked to pornography, emphasizing ethical duties and advocacy.","clinical_takeaway":"Clinicians should be trained to identify signs of 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autoerotic practice: case report and review of the literature","authors":"Klintschar M, Grabuschnigg P, Beham A.","first_author":"Klintschar M","journal":"The American journal of forensic medicine and pathology","year":1998,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single fatal case description with brief literature comparison; no systematic methodology","sample_n":1,"sample_text":"1 fatal case","population":"male adult who died during autoerotic electrocution; not representative","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1998 case report describes a man who died from electrocution while attempting an autoerotic act involving electrical electrodes, with pornographic material hidden after death. The authors reconstruct the accident and compare it to similar cases.","clinical_takeaway":"None – the report is a forensic case with no direct clinical implications for sexual health or therapy.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Detailed forensic description","Includes literature comparison"],"limitations":["Single case; no generalizability","No systematic data collection","No assessment of psychological or sexual health variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00000433-199806000-00019"}},{"id":3183,"doi":"10.1080/00224549709595479","pmid":"9362143","pmcid":null,"title":"The relationships among sex role orientation, egalitarianism, attitudes toward sexuality, and attitudes toward violence against women","authors":"Caron SL, Carter DB.","first_author":"Caron SL","journal":"The Journal of social psychology","year":1997,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 618 U.S. college students assessing attitudes toward rape myths, sex role orientation, egalitarianism, and pornography attitudes.","sample_n":618,"sample_text":"College students, likely convenience sample","population":"U.S. college students (N=618)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among U.S. college students, men showed more tolerant attitudes toward rape than women. Sex role orientation, egalitarian views, and positive attitudes toward sexuality were linked to these attitudes, while attitudes toward pornography were unrelated.","clinical_takeaway":"None - not clinically applicable.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑site survey","Use of established attitude scales","Examines multiple gender‑related constructs"],"limitations":["Cross‑sectional; cannot infer causality","Convenience college sample limits generalisability","Limited control for mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":1,"mentioning":37,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224549709595479"}},{"id":3184,"doi":"10.1016/s0145-2134(97)00028-8","pmid":"9238547","pmcid":null,"title":"The Challenge Project: a treatment program evaluation for perpetrators of child sexual abuse","authors":"Craissati J, McClurg G.","first_author":"Craissati J","journal":"Child abuse & neglect","year":1997,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Observational cohort of 80 convicted child sexual abuse perpetrators, matched into group vs individual CBT; follow‑up at 1 and 2 years, no external control group.","sample_n":80,"sample_text":"All 80 convicted perpetrators in South‑East London were invited; 43 entered the community program and were allocated to group or individual therapy.","population":"Adult male convicted child sexual abuse perpetrators (n≈80)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study followed 80 men convicted of child sexual abuse who received either group or individual cognitive‑behavioural therapy. After 1–2 years, most showed no new sexual offences; only one reoffended (with child‑porn possession). History of prior sexual/violent offences and childhood victimisation predicted poorer treatment compliance.","clinical_takeaway":"CBT may reduce reoffending among child‑sex‑offender patients, but compliance is lower for those with prior sexual/violent histories or childhood victimisation.","confidence":0.78,"topic_tags":["treatment","sexual_function"],"strengths":["All convicted offenders in defined catchment were invited","Matched groups on key variables","Longitudinal follow‑up up to 2 years"],"limitations":["No randomised control group","Outcome measures poorly described and likely unvalidated","Small sub‑group sizes limit power","Limited statistical detail (no effect sizes or CIs)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":2,"mentioning":19,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0145-2134(97)00028-8"}},{"id":3185,"doi":"10.1177/1077801297003003003","pmid":"12319742","pmcid":null,"title":"Disability pornography: the fetishization of women's vulnerabilities","authors":"Elman RA.","first_author":"Elman RA.","journal":"Violence against women","year":1997,"pub_types":["Journal Article"],"keywords":["Population","Behavior","Communication","Women","population characteristics","Demographic Factors","Economic Factors","Socioeconomic Factors","Critique","Mass Media","Crime","Women's Status","Social Problems","Violence--women","Films","Sexual Abuse--women","Handicapped--women"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801297003003003"}},{"id":3186,"doi":"10.1002/(sici)1099-1042(199703)5:1<56::aid-hca208>3.0.co;2-u","pmid":"10166051","pmcid":null,"title":"Pornography: some implications for nursing","authors":"Mercer D, McKeown M.","first_author":"Mercer D","journal":"Health care analysis : HCA : journal of health philosophy and policy","year":1997,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/(sici)1099-1042(199703)5:1<56::aid-hca208>3.0.co;2-u"}},{"id":3187,"doi":null,"pmid":"9066239","pmcid":null,"title":"Pornography in cyberspace","authors":"Lafferty JP.","first_author":"Lafferty JP.","journal":"The Journal of the Florida Medical Association","year":1997,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3189,"doi":null,"pmid":"8754587","pmcid":null,"title":"Pseudonecrophilia following spousal homicide","authors":"Meloy JR.","first_author":"Meloy JR.","journal":"Journal of forensic sciences","year":1996,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single individual describing pseudonecrophilia after homicide, with clinical interview and psychological testing","sample_n":1,"sample_text":"single case","population":"26‑year‑old male perpetrator of spousal homicide","country":"USA (presumed from journal and author affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 26‑year‑old man killed his wife, then engaged in sexual activity with her corpse while watching soft‑core pornography. The report discusses possible motives and warns against assuming sexual causality in homicide investigations.","clinical_takeaway":"No direct clinical guidance; the case illustrates the need for careful assessment of sexual motivation in violent crimes.","confidence":0.8,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed clinical description","Use of standardized psychiatric diagnoses","Highlights rare phenomenon"],"limitations":["Single case – no generalizability","No systematic measurement of pornography use or sexual arousal","No control of confounding variables"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":3190,"doi":"10.1177/1077801296002001005","pmid":"12348987","pmcid":null,"title":"Knowing pornography","authors":"Jensen R.","first_author":"Jensen R.","journal":"Violence against women","year":1996,"pub_types":["Journal Article"],"keywords":["Personality","Behavior","Men","North America","Communication","Sex discrimination","Sex behavior","Psychological factors","Education","United States","Developed Countries","Sex Education","Economic Factors","Socioeconomic Factors","Family Characteristics","Americas","Northern America","Family And Household","Critique","Mass Media","Women's Status","Social Problems","Feminism","Social Discrimination","Heterosexuals","Patriarchy","Sexuality--men"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801296002001005"}},{"id":3191,"doi":"10.1891/0886-6708.11.1.39","pmid":"8870214","pmcid":null,"title":"Self-reported sexual interest in children: sex differences and psychosocial correlates in a university sample","authors":"Smiljanich K, Briere J.","first_author":"Smiljanich K","journal":"Violence and victims","year":1996,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 279 university students (180 female, 99 male) assessing self‑reported sexual interest in children and related psychosocial variables.","sample_n":279,"sample_text":"180 female, 99 male university students.","population":"University students (convenience sample), age unspecified, mixed gender.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among 279 university students, more men than women reported feeling sexually attracted to at least one child. Those who reported attraction also had lower self‑esteem, higher sexual impulsivity, and used more adult pornography, but did not differ in childhood victimisation or aggressive attitudes.","clinical_takeaway":"Self‑reported attraction to children is linked to broader psychosocial difficulties, but findings are limited to a non‑clinical student sample.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large convenience sample for a university study","Examines multiple psychosocial correlates","Includes both genders for comparison"],"limitations":["Reliance on self‑report, likely unvalidated measures","Cross‑sectional design, cannot infer causality","Key confounds (moral incongruence, mental health) not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":35,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1891/0886-6708.11.1.39"}},{"id":3192,"doi":"10.2307/2169001","pmid":"11639603","pmcid":null,"title":"Humanitarianism and the pornography of pain in Anglo-American culture","authors":"Halttunen K.","first_author":"Halttunen K.","journal":"The American historical review","year":1995,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":43,"citing_publications":331,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2307/2169001"}},{"id":3193,"doi":"10.1016/s0193-953x(18)30068-6","pmid":"7761305","pmcid":null,"title":"Gender and the organization of sexual behavior","authors":"Tiefer L, Kring B.","first_author":"Tiefer L","journal":"The Psychiatric clinics of North America","year":1995,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or empirical data.","sample_n":null,"sample_text":"Not applicable – review article","population":"Not applicable","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how gender socialization shapes sexual behavior, suggesting that societal gender expectations create pressures that influence sexual expression and may cause anxiety when individuals feel they do not fit traditional male or female roles.","clinical_takeaway":"None – the paper provides a theoretical overview without direct clinical implications.","confidence":0.4,"topic_tags":["gender","sexual_function"],"strengths":["Broad discussion of gender socialization effects","Integrates cultural perspectives"],"limitations":["No empirical data presented","Lacks systematic review methodology","No measurement of key confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0193-953x(18)30068-6"}},{"id":3194,"doi":"10.1177/1077801295001001003","pmid":"12346571","pmcid":null,"title":"Pornographic lives","authors":"Jensen R.","first_author":"Jensen R.","journal":"Violence against women","year":1995,"pub_types":["Journal Article"],"keywords":["Personality","Behavior","Men","North America","Women","Psychological factors","United States","Developed Countries","Americas","Northern America","Sex Behavior--men","Summary Report","Violence--women","Sexuality--men"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801295001001003"}},{"id":3195,"doi":null,"pmid":"7989281","pmcid":null,"title":"Preliminary observations of DSM-III-R axis I comorbidity in men with paraphilias and paraphilia-related disorders","authors":"Kafka MP, Prentky RA.","first_author":"Kafka MP","journal":"The Journal of clinical psychiatry","year":1994,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Prospective data collection from 60 consecutive outpatient males (34 with paraphilias, 26 with paraphilia‑related disorders) using semi‑structured intake questionnaire and psychiatric interviews; descriptive/comparative analysis of lifetime Axis I comorbidity.","sample_n":60,"sample_text":"60 consecutive outpatient males (34 with paraphilias, 26 with paraphilia‑related disorders).","population":"Male outpatients, age 21‑53, seeking treatment for paraphilic or related sexual‑impulsivity disorders (n=60).","country":"USA (inferred from journal, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A 1994 study of 60 men seeking help for paraphilias or related sexual impulsivity found high rates of mood, substance‑use and anxiety disorders, and reported that many also engaged in compulsive masturbation, frequent casual sex, and what they called “dependence on pornography.”","clinical_takeaway":"Clinicians should assess co‑occurring mood and anxiety disorders in clients with compulsive sexual behaviours, but recognize that “pornography dependence” was loosely defined.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Prospective data collection","Standard DSM‑III‑R diagnostic interview","Focus on understudied comorbidity patterns"],"limitations":["Small, treatment‑seeking convenience sample","Unclear definition/measurement of “pornography dependence”","No control for moral/religious attitudes or other key confounds","Descriptive statistics only; no effect‑size reporting"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":null},{"id":3197,"doi":null,"pmid":"7951358","pmcid":null,"title":"[Psychological problems related to the sexual stimulation video (SSV) test in the diagnosis of erectile disorders]","authors":"Rosso C, Furlan PM, Rolle L, Fontana D.","first_author":"Rosso C","journal":"Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica","year":1994,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"ita","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/editorial without empirical data","sample_n":null,"sample_text":"none","population":"none","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses doctors' anxieties about using a sexual stimulation video test for erectile disorders, focusing on fears of voyeurism, personal fantasies, and hospital dynamics, but provides no data.","clinical_takeaway":"None - not clinically applicable.","confidence":0.7,"topic_tags":["sexual_function","pornography"],"strengths":["Highlights ethical concerns of clinicians","Raises awareness of potential psychological impacts"],"limitations":["No empirical data or systematic analysis","Lacks operational definitions or measurement","No methodological rigor"],"rubric_version":"2.0","raw_total":2,"max_possible":50,"pct_score":4,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":0,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":3198,"doi":null,"pmid":"8167614","pmcid":null,"title":"The erotic in film and in mass psychology","authors":"Kernberg OF.","first_author":"Kernberg OF.","journal":"Bulletin of the Menninger Clinic","year":1994,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary / theoretical essay, no empirical data","sample_n":null,"sample_text":"N/A – no participants","population":"humans (general)","country":"USA (Menninger Clinic, likely)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Kernberg examines how erotic scenes in movies and pornography clash with conventional moral values, arguing that both mainstream and pornographic films unconsciously resist mature, passionate love.","clinical_takeaway":"None – the article offers theoretical insight only, not clinical guidance.","confidence":0.8,"topic_tags":["pornography","sexual_function","csbd","other"],"strengths":["Provides a broad psychoanalytic perspective on erotic film and pornography","Integrates classic theory with cultural analysis","Clear articulation of the dialectic between morality and passion"],"limitations":["No empirical data or systematic review methodology","Claims are theoretical and not testable from the text","Lacks measurement of key constructs or control of confounds"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":3199,"doi":"10.1007/bf01552913","pmid":"8435040","pmcid":null,"title":"China: acceptability and effect of three kinds of sexual publication","authors":"Pan SM.","first_author":"Pan SM.","journal":"Archives of sexual behavior","year":1993,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationwide questionnaire survey; sample size not reported in abstract","sample_n":null,"sample_text":"not reported","population":"Chinese adults (unspecified sampling method)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1993 Chinese questionnaire asked people whether they accepted scientific, erotic, and visual sexual publications and whether these materials influenced their attitudes on other topics. The authors suggest the findings support the idea of a recent 'sex revolution' in China.","clinical_takeaway":"None - the study provides sociocultural data, not clinical guidance.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["first empirical survey on sexual publication acceptability in China","addresses a socially important policy issue"],"limitations":["no validated measurement instruments reported","no control for key confounds (morality, mental health, etc.)","sample size and sampling method unclear"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01552913"}},{"id":3200,"doi":"10.1080/00926239308404889","pmid":"8468711","pmcid":null,"title":"The she-male phenomenon and the concept of partial autogynephilia","authors":"Blanchard R.","first_author":"Blanchard R.","journal":"Journal of sex & marital therapy","year":1993,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report describing clinical observations of men with partial autogynephilia and interest in 'she-males'. No systematic sampling or control group.","sample_n":null,"sample_text":"Not reported; case‑report format.","population":"Adult males with partial autogynephilic interests; small, non‑representative clinical sample.","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes men who are sexually aroused by imagining themselves with both male genitals and female breasts (‘she‑males’), proposing that these ‘partial autogynephiles’ may be less likely to seek full gender‑affirming surgery.","clinical_takeaway":"None – the article is theoretical and based on a single clinical observation.","confidence":0.5,"topic_tags":["gender","sexual_function","csbd"],"strengths":["Introduces nuanced sub‑type (partial autogynephilia).","Provides clinical detail on a rarely studied phenomenon."],"limitations":["Single case; no systematic data.","No validated measurement instruments.","No control or comparison group.","Conceptual model not empirically tested."],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239308404889"}},{"id":3202,"doi":null,"pmid":"1429473","pmcid":null,"title":"A comparative study of nonparaphilic sexual addictions and paraphilias in men","authors":"Kafka MP, Prentky R.","first_author":"Kafka MP","journal":"The Journal of clinical psychiatry","year":1992,"pub_types":["Comparative Study","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative study of 30 men recruited via advertisement, split into two groups (paraphilic vs non‑paraphilic sexual addiction).","sample_n":30,"sample_text":"Thirty consecutive male respondents to an advertisement (PA: N = 15; NPSA: N = 15).","population":"Male, treatment‑seeking/advertisement volunteers, small convenience sample.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared men with paraphilic disorders to those with non‑paraphilic sexual addiction, finding similar high levels of masturbation, porn use and overall sexual activity, but the tiny sample limits any firm conclusions.","clinical_takeaway":"Evidence is insufficient to guide treatment; clinicians should assess each client’s behaviours and distress individually.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Direct comparison of two clinically relevant groups","Attempts to quantify multiple sexual behavior dimensions"],"limitations":["Very small, non‑representative sample","Ad‑hoc behavioural measures, no validated scales","No control for moral incongruence, mental health, partner effects, or trauma"],"rubric_version":"2.0","raw_total":16,"max_possible":60,"pct_score":27,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":3,"interpretation":3}},"scite":null},{"id":3203,"doi":"10.1097/00002030-199209000-00017","pmid":"1388891","pmcid":null,"title":"Situational factors and thought processes associated with unprotected intercourse in young gay men","authors":"Gold RS, Skinner MJ.","first_author":"Gold RS","journal":"AIDS (London, England)","year":1992,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Population","Biology","Behavior","Australia","Data analysis","Contraception","Sex behavior","Age factors","Data collection","population characteristics","research methodology","Psychosocial factors","Alcohol drinking","risk factors","Family Planning","Contraceptive Methods","Demographic Factors","Developed Countries","Decision Making","Oceania","Barrier Methods","Condom","Drug Addiction","Interviews","Social Problems","Substance Addiction","Homosexuals"],"is_oa":false,"oa_url":null,"cited_by_count":72,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"structured interview recalling two events from past 6 months; n=219 unsafe encounters, n=115 both encounters","sample_n":219,"sample_text":"219 unsafe encounters (115 participants reported both safe and unsafe encounters)","population":"young gay men, age 15‑21, Australia","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Young gay men said they had unsafe sex mainly when they were in a bad mood or thought their partner looked healthy. Factors like alcohol, drugs, or pornography were not linked to risky sex in this study.","clinical_takeaway":"Address mood and communication about desires to reduce unprotected sex risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large sample for this population","use of within‑subject comparison","identifies situational justifications"],"limitations":["retrospective self‑report","no validated scales","limited control of confounders","cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":0,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":65,"citing_publications":157,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00002030-199209000-00017"}},{"id":3204,"doi":null,"pmid":"10356185","pmcid":null,"title":"Inappropriate Sexual Behaviors: One Gynecologist's Viewpoint","authors":"Pokorny SF.","first_author":"Pokorny SF.","journal":"Adolescent medicine (Philadelphia, Pa.)","year":1992,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary / viewpoint article without original data.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The author provides a narrative overview of sexual abuse, rape, prostitution and pornography, covering prevalence, cultural issues, legal responses and treatment considerations without presenting new data.","clinical_takeaway":"None – the article is a non‑empirical overview and does not offer evidence‑based guidance.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Broad overview of multiple topics","Includes discussion of pornography within larger context"],"limitations":["No empirical data presented","No systematic methodology","No measurement of key constructs or confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":3205,"doi":"10.1016/0277-9536(92)90285-x","pmid":"1641673","pmcid":null,"title":"Sexual behaviour related to psycho-social factors in a population of Danish homosexual and bisexual men","authors":"Schmidt KW, Fouchard JR, Krasnik A, Zoffmann H, Jacobsen HL, Kreiner S.","first_author":"Schmidt KW","journal":"Social science & medicine (1982)","year":1992,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"anonymous self‑administered questionnaire distributed via gay association, gay magazine and porn magazine; N=2058; convenience sample; classification of sexual practice (safe/potentially safe/unsafe) based on self‑report; multivariate recursive graphical modeling.","sample_n":2058,"sample_text":"Convenience sample recruited through community organisations and magazines; not probability based.","population":"homosexual and bisexual men in Denmark, adult ages","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A Danish survey of gay and bisexual men found that younger age, more partners, and lack of a steady relationship were linked to unsafe anal sex without condoms, while other psychosocial factors showed no direct effect.","clinical_takeaway":"Risk reduction counseling should focus on younger, single men with multiple partners.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large overall sample (N>2000)","Multivariate analysis to identify direct associations","Clear categorisation of sexual risk behaviours"],"limitations":["Convenience sampling limits generalisability","No validated scales for psychosocial constructs","Key confounds (moral incongruence, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0277-9536(92)90285-x"}},{"id":3206,"doi":null,"pmid":"1579173","pmcid":null,"title":"[Sexual addiction in alcohol abuse and dependence. Clinical, nosologic and psychoanalytic aspects]","authors":"Roth K.","first_author":"Roth K.","journal":"Der Nervenarzt","year":1992,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd","masturbation","pornography"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case series of predominantly male alcohol-dependent patients describing self‑perceived sexual addiction, mostly excessive masturbation and pornography use.","sample_n":null,"sample_text":"Nearly all male patient group; exact N not given in abstract.","population":"Adult alcohol‑dependent patients (mostly male), recruited from clinical settings.","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control","masturbation_not_isolated","self_selected_sample","underpowered_sample"],"stance":"supports","citation_value":"background","plain_summary":"The paper reports a small clinical series of mostly male alcoholics who say they have a sexual addiction, mainly excessive masturbation and porn use, and discusses possible psychodynamic explanations.","clinical_takeaway":"No evidence‑based guidance; the report is anecdotal and does not support diagnostic conclusions.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Clinical insight into co‑occurring alcohol and sexual problems","Discussion of psychodynamic interpretation"],"limitations":["No validated measures of sexual addiction or distress","No control group or systematic assessment of confounds","Small, non‑representative case series"],"rubric_version":"2.0","raw_total":9,"max_possible":60,"pct_score":15,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":1,"interpretation":3}},"scite":null},{"id":3208,"doi":"10.1177/000306519204000218","pmid":"1593088","pmcid":null,"title":"Witnessing pornography and the reconstruction of suspected child sexual molestation","authors":"Good MI.","first_author":"Good MI.","journal":"Journal of the American Psychoanalytic Association","year":1992,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000306519204000218"}},{"id":3209,"doi":"10.2307/1123024","pmid":"11658112","pmcid":null,"title":"Neutrality in constitutional law (with special reference to pornography, abortion, and surrogacy)","authors":"Sunstein CR.","first_author":"Sunstein CR.","journal":"Columbia law review","year":1992,"pub_types":["Journal Article"],"keywords":["Legal Approach","Genetics And Reproduction"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2307/1123024"}},{"id":3210,"doi":"10.2466/pr0.1991.69.1.239","pmid":"1961802","pmcid":null,"title":"Violence and degradation as themes in \"adult\" videos","authors":"Duncan DF.","first_author":"Duncan DF.","journal":"Psychological reports","year":1991,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 10% random sample (n=50) of adult videos from a store; coding of scenes for violence and degradation.","sample_n":50,"sample_text":"50 scenes","population":"Videos (media content) not human participants","country":"USA (presumed from author affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1991 study examined a random sample of adult videos and found that about 14% of scenes showed violence and 18% showed degrading behavior.","clinical_takeaway":"None – the study is a media content analysis, not directly relevant to clinical practice.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Random sampling of videos","Clear coding categories","Early systematic content analysis"],"limitations":["Small number of scenes","Unclear validation of coding scheme","No inter‑rater reliability reported"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2466/pr0.1991.69.1.239"}},{"id":3213,"doi":"10.1016/0160-2527(91)90028-l","pmid":"2032759","pmcid":null,"title":"Pornography and harm--learning to listen to women","authors":"Lahey KA.","first_author":"Lahey KA.","journal":"International journal of law and psychiatry","year":1991,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0160-2527(91)90028-l"}},{"id":3214,"doi":"10.1016/0160-2527(91)90027-k","pmid":"2032765","pmcid":null,"title":"Pornography, context, and the common law of obscenity","authors":"Brannigan A, Goldenberg S.","first_author":"Brannigan A","journal":"International journal of law and psychiatry","year":1991,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0160-2527(91)90027-k"}},{"id":3215,"doi":"10.1016/0160-2527(91)90025-i","pmid":"2032763","pmcid":null,"title":"Pornography, erotica, and behavior: more questions than answers","authors":"Fisher WA, Barak A.","first_author":"Fisher WA","journal":"International journal of law and psychiatry","year":1991,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":2,"contrasting":0,"mentioning":39,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0160-2527(91)90025-i"}},{"id":3216,"doi":"10.1016/0160-2527(91)90022-f","pmid":"2032760","pmcid":null,"title":"Pornography and/as degradation","authors":"Jarvie I.","first_author":"Jarvie I.","journal":"International journal of law and psychiatry","year":1991,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0160-2527(91)90022-f"}},{"id":3217,"doi":"10.2307/1166056","pmid":"1766444","pmcid":null,"title":"Judging social issues: difficulties, inconsistencies, and consistencies","authors":"Turiel E, Hildebrandt C, Wainryb C.","first_author":"Turiel E","journal":"Monographs of the Society for Research in Child Development","year":1991,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Three cross‑sectional surveys of high‑school and college students (convenience samples) examining moral reasoning about pornography and other non‑prototypical issues.","sample_n":null,"sample_text":"pre‑selected groups based on positive or negative evaluations; practicing Catholics in parochial schools","population":"high‑school and college students (US)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors surveyed high‑school and college students about their opinions on abortion, homosexuality, pornography, and incest, finding that people’s moral judgments on these topics were inconsistent and depended on personal and group attitudes.","clinical_takeaway":"None – the study addresses moral reasoning, not clinical aspects of pornography use.","confidence":0.6,"topic_tags":["moral_incongruence","sexual_function"],"strengths":["Large‑scale comparative groups","Clear focus on moral reasoning","Multiple studies across age groups"],"limitations":["Convenience, non‑representative samples","Unvalidated judgment measures","No power justification or effect sizes"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":79,"citing_publications":309,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2307/1166056"}},{"id":3218,"doi":null,"pmid":"1763150","pmcid":null,"title":"Pornography and the primal scene: a report on the voyage to Brobdingnag","authors":"Peterson CA.","first_author":"Peterson CA.","journal":"Psychoanalytic review","year":1991,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3219,"doi":"10.4992/jjpsy.61.351","pmid":"2090852","pmcid":null,"title":"[Autoshaping of a button-push response and eye movement in human subjects]","authors":"Kimura H, Fukui I, Inaki K.","first_author":"Kimura H","journal":"Shinrigaku kenkyu : The Japanese journal of psychology","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"jpn","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"lab conditioning experiment with button-press and gaze autoshaping, small convenience sample, within‑subject design","sample_n":null,"sample_text":"small convenience sample (exact N not reported)","population":"uninstructed naive adult human subjects (likely college students)","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study tested whether people would learn to press a button or look at a light when it was followed by a short pornographic video, showing that some participants developed these responses through classical conditioning.","clinical_takeaway":"None – the study examines basic learning processes, not clinical aspects of pornography use.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Experimental paradigm allows causal inference for conditioning","Novel use of autoshaping with human participants"],"limitations":["Very small, unspecified sample size","No validated measures of constructs","No control for potential confounds (e.g., arousal, prior exposure)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4992/jjpsy.61.351"}},{"id":3220,"doi":"10.1016/0379-0738(90)90103-6","pmid":"2283135","pmcid":null,"title":"A comparison of typical death scene features in cases of fatal male and autoerotic asphyxia with a review of the literature","authors":"Byard RW, Hucker SJ, Hazelwood RR.","first_author":"Byard RW","journal":"Forensic science international","year":1990,"pub_types":["Comparative Study","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Comparative case series of forensic death scenes with literature review; no control group; descriptive analysis of scene characteristics.","sample_n":null,"sample_text":"Number of cases not specified in abstract; likely limited case series.","population":"Deceased individuals who died from autoerotic asphyxia (male and female cases reported in forensic records).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors compare death‑scene characteristics of men and women who died during solo sexual activity involving asphyxiation, noting that men use more elaborate devices and pornographic material while women are typically found with simpler setups.","clinical_takeaway":"None – findings pertain to forensic case characteristics, not clinical treatment.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Provides detailed forensic description of a rare phenomenon","Includes comparative analysis between male and female cases","Integrates literature review to contextualize findings"],"limitations":["Small, non‑representative case series; no statistical testing","Lacks control or comparison groups","No measurement of psychological or behavioural constructs"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":33,"citing_publications":77,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0379-0738(90)90103-6"}},{"id":3221,"doi":null,"pmid":"10350708","pmcid":null,"title":"Television and Adolescents: Sex, Drugs, Rock 'n' Roll","authors":"Strasburger VC.","first_author":"Strasburger VC.","journal":"Adolescent medicine (Philadelphia, Pa.)","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary / narrative review without systematic methods or empirical data.","sample_n":null,"sample_text":"Not applicable (no primary data)","population":"Adolescents (general discussion, no specific sample)","country":"United States (implied)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how television and other media, including pornography, may influence teenage behavior, urging parents and clinicians to be aware of possible risks.","clinical_takeaway":"Clinicians should consider media exposure as a factor when discussing sexual health with adolescents, but recognize the lack of solid evidence.","confidence":0.9,"topic_tags":["adolescents","pornography","sexual_function"],"strengths":["Broad overview of media influences on adolescents","Highlights potential concerns for practitioners and parents"],"limitations":["Lacks systematic methodology or empirical data","No explicit measurement or control of key confounds","Potential advocacy bias without rigorous evidence"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":3224,"doi":"10.1016/0145-2134(89)90030-6","pmid":"2706562","pmcid":null,"title":"University males' sexual interest in children: predicting potential indices of \"pedophilia\" in a nonforensic sample","authors":"Briere J, Runtz M.","first_author":"Briere J","journal":"Child abuse & neglect","year":1989,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":50,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 193 male undergraduates assessing self‑reported sexual interest in children and related variables.","sample_n":193,"sample_text":"193 male undergraduate students","population":"Male undergraduate students (non‑forensic sample)","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"supports","citation_value":"useful","plain_summary":"A survey of 193 college men found that a minority reported attraction to children, fantasies, or masturbation to such fantasies. These interests were linked to earlier negative sexual experiences, frequent sex partners, and attitudes favoring sexual dominance over women, but not to sexual repression.","clinical_takeaway":"Self‑reported interest in children among non‑clinical males appears linked to broader risk factors, but findings are limited by sample and measurement weaknesses.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large (for undergraduate) sample size","Broad range of theoretically relevant variables collected","First‑hand self‑report data on a taboo topic"],"limitations":["Convenience sample of undergraduates limits generalisability","Key constructs measured with ad‑hoc, unvalidated items","No control for moral/religious attitudes or mental‑health covariates"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":12,"contrasting":0,"mentioning":68,"citing_publications":141,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0145-2134(89)90030-6"}},{"id":3225,"doi":"10.1016/0379-0738(88)90154-5","pmid":"3280447","pmcid":null,"title":"'Stranger' child-murder: issues relating to causes and controls","authors":"Wilson PR.","first_author":"Wilson PR.","journal":"Forensic science international","year":1988,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article without original empirical data; no systematic methods reported.","sample_n":null,"sample_text":"","population":"Not applicable","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews possible causes of stranger child murders, suggesting but not evidencing that pornography might raise violent tendencies, and recommends law‑enforcement improvements.","clinical_takeaway":"None – the paper offers no actionable clinical insight.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Broad literature overview","Identifies gaps in empirical evidence"],"limitations":["No systematic methodology","Lacks original data","Speculative link between pornography and violent crime"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0379-0738(88)90154-5"}},{"id":3226,"doi":"10.3109/01485018808987069","pmid":"3134862","pmcid":null,"title":"Androgen therapy in hypogonadotrophic hypogonadism: time course of erotosexual functions","authors":"Eyal A, Ish-Shalom S, Hoch Z, Hochberg Z.","first_author":"Eyal A","journal":"Archives of andrology","year":1988,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"within‑subject repeated measures over 9 weeks, N=9 men with hypogonadotrophic hypogonadism receiving a single Depo‑testosterone injection","sample_n":9,"sample_text":"Nine young men with hypogonadotrophic hypogonadism were repeatedly tested for 9 weeks after an i.m. dose of a Depo‑testosterone preparation.","population":"young adult males with hypogonadotrophic hypogonadism (clinical sample)","country":"Not specified (likely Israel based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In nine men with low testosterone, a single injection boosted sexual function for weeks after blood levels fell, keeping erections during sleep and in response to erotic material even when testosterone became low.","clinical_takeaway":"Androgen therapy may sustain erectile function beyond the period of normal serum testosterone, supporting bimonthly dosing.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Objective physiological measurements (penile tumescence)","Repeated within‑subject design allows tracking over time"],"limitations":["Very small sample (N=9) limits statistical power and generalisability","Reliance on ad‑hoc self‑report scales without validation","No control group or randomisation"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/01485018808987069"}},{"id":3227,"doi":"10.1111/j.1749-6632.1988.tb50856.x","pmid":"3421588","pmcid":null,"title":"Predictors of sexual aggression among a national sample of male college students","authors":"Koss MP, Dinero TE.","first_author":"Koss MP","journal":"Annals of the New York Academy of Sciences","year":1988,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 2,972 male college students across 32 U.S. institutions; self‑report questionnaire on aggression, pornography use, and other variables; blockwise discriminant function analysis.","sample_n":2972,"sample_text":"Approximately representative national sample of male students at 32 U.S. institutions.","population":"Male college students (U.S.)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of nearly 3,000 U.S. college men examined which early life experiences, attitudes, and current behaviors (including pornography use) best predicted different levels of sexual aggression, from non‑aggressive to rape.","clinical_takeaway":"Predictors of sexual aggression are multifactorial; pornography use alone is not a clear cause.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, roughly nationally representative sample","Comprehensive set of predictor variables","Use of discriminant function analysis to assess classification"],"limitations":["Cross‑sectional design limits causal inference","Key constructs (pornography use, aggression) measured with non‑validated self‑report items","No assessment of moral incongruence or masturbation, limiting interpretation of pornography effects","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":13,"contrasting":4,"mentioning":118,"citing_publications":183,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1749-6632.1988.tb50856.x"}},{"id":3228,"doi":null,"pmid":"3223567","pmcid":null,"title":"[Pornography and health]","authors":"Domínguez Carmona M.","first_author":"Domínguez Carmona M.","journal":"Anales de la Real Academia Nacional de Medicina","year":1988,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"spa","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3229,"doi":"10.1080/00224498809551413","pmid":"22375650","pmcid":null,"title":"Pornography and sex education","authors":"Tjaden PG.","first_author":"Tjaden PG.","journal":"Journal of sex research","year":1988,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224498809551413"}},{"id":3230,"doi":"10.1037//0003-066x.42.10.944","pmid":"3688623","pmcid":null,"title":"Report of the Surgeon General's workshop on pornography and public health","authors":"Koop CE.","first_author":"Koop CE.","journal":"The American psychologist","year":1987,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0003-066x.42.10.944"}},{"id":3231,"doi":"10.1007/bf01542137","pmid":"3675181","pmcid":null,"title":"Violence in Playboy magazine: a longitudinal analysis","authors":"Scott JE, Cuvelier SJ.","first_author":"Scott JE","journal":"Archives of sexual behavior","year":1987,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"content analysis of all Playboy issues from 1954–1983, coding violent cartoons and pictorials and examining temporal trends","sample_n":360,"sample_text":"30‑year period, all issues examined","population":"Playboy magazine issues (all editions published 1954‑1983)","country":"United States (implicitly, as Playboy is US‑based)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors counted violent cartoons and pictorials in every Playboy issue from 1954 to 1983, finding that violent content was rare and actually declined toward the end of the period.","clinical_takeaway":"None – the study describes magazine content, not health effects.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Comprehensive inclusion of all issues over a 30‑year span","Clear numerical reporting of violent content ratios","Addresses a historically debated policy issue"],"limitations":["No validation or reliability data for coding scheme","No statistical modeling of trend significance beyond visual description","No assessment of potential confounding factors (e.g., changes in editorial policy)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542137"}},{"id":3232,"doi":null,"pmid":"3306869","pmcid":null,"title":"[Richard von Krafft-Ebing's \"Psychopathia sexualis\". Pornography or professional literature?]","authors":"Kupferschmidt H.","first_author":"Kupferschmidt H.","journal":"Schweizerische Rundschau fur Medizin Praxis = Revue suisse de medecine Praxis","year":1987,"pub_types":["Historical Article","Biography","Portrait","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3233,"doi":null,"pmid":"3768584","pmcid":null,"title":"Psychoanalysis as a liberation movement. Freud and Rank defend Groddeck's Seeker of Souls against accusations of pornography","authors":"Pruyser PW.","first_author":"Pruyser PW.","journal":"Bulletin of the Menninger Clinic","year":1986,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3234,"doi":"10.1136/bmj.293.6540.183","pmid":"3730803","pmcid":"PMC1340915","title":"Child sex rings","authors":"Wild NJ, Wynne JM.","first_author":"Wild NJ","journal":"British medical journal (Clinical research ed.)","year":1986,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Descriptive case series of 11 child‑sex rings identified via police interviews and service records; 14 adult male perpetrators, 175 child victims.","sample_n":189,"sample_text":"14 adult male perpetrators and 175 children aged 6‑15 years.","population":"Adult male perpetrators and child victims involved in identified sex rings (UK, 1980s).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes 11 child‑sex rings in a UK community, detailing how adult men recruited children, the types of sexual activity involved, and the limited legal outcomes.","clinical_takeaway":"None – the study provides historical descriptive information, not guidance for clinical practice.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Rare descriptive data on a hidden phenomenon","Use of multiple official sources (police, health, social services)"],"limitations":["Small, non‑representative sample","No systematic data collection or validated measures","Descriptive only; no inferential statistics"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.293.6540.183"}},{"id":3235,"doi":"10.1007/bf01542414","pmid":"3729702","pmcid":null,"title":"Soundtrack contents and depicted sexual violence","authors":"Pfaus JG, Myronuk LD, Jacobs WJ.","first_author":"Pfaus JG","journal":"Archives of sexual behavior","year":1986,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Randomized controlled experiment with three soundtrack conditions; single exposure; outcome measured via self‑report questionnaires; sample size not reported (likely small).","sample_n":null,"sample_text":"Not provided in abstract; assumed modest.","population":"Male undergraduate students (likely WEIRD, convenience sample).","country":"Not specified (likely USA).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"College men watched a rape video with either its original soundtrack, relaxing music, or no sound. The original audio made the video seem more pornographic, but arousal and enjoyment were unchanged across conditions.","clinical_takeaway":"Audio cues can affect how viewers judge sexual‑violent media, though they may not change arousal.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Randomized allocation to conditions","Focused experimental manipulation of soundtrack"],"limitations":["Small, non‑representative sample","Reliance on single‑item, unvalidated self‑report scales","No correction for multiple comparisons reported"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542414"}},{"id":3236,"doi":"10.3758/bf03204938","pmid":"3737358","pmcid":null,"title":"Effects of attitudes toward pornography upon male judgments of female attractiveness","authors":"Bernstein IH, Huang MH, Teng G, Lin TD.","first_author":"Bernstein IH","journal":"Perception & psychophysics","year":1986,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3758/bf03204938"}},{"id":3237,"doi":"10.1080/00926238608415401","pmid":"3723604","pmcid":null,"title":"Transcultural sexology: formicophilia, a newly named paraphilia in a young Buddhist male","authors":"Dewaraja R, Money J.","first_author":"Dewaraja R","journal":"Journal of sex & marital therapy","year":1986,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case description of a young Buddhist male with a newly named paraphilia (formicophilia); no control group or systematic data collection","sample_n":1,"sample_text":"young Buddhist male (single case)","population":"1 adult male","country":"unspecified (likely Thailand or similar)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe a young Buddhist man who developed a rare sexual interest in ants (formicophilia) and argue that early disruption of normal sexual play may lead to such paraphilias, suggesting hormonal and counseling treatment.","clinical_takeaway":"Evidence is limited to one case; clinicians should treat such presentations cautiously and not generalize the proposed theory.","confidence":0.7,"topic_tags":["sexual_function","gender","csbd"],"strengths":["Novel description of a previously undocumented paraphilia","Cross‑cultural perspective","Integration of developmental theory"],"limitations":["Single case, no generalizability","No validated measures or systematic assessment","Speculative causal model without empirical testing","No control of confounding variables"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238608415401"}},{"id":3238,"doi":null,"pmid":"3843979","pmcid":null,"title":"[Grounds for the existence of pornography]","authors":"Melanson D.","first_author":"Melanson D.","journal":"L' Infirmiere canadienne","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3239,"doi":"10.1016/0145-2134(85)90040-7","pmid":"4052849","pmcid":null,"title":"Child pornography and legislation in the Netherlands","authors":"Doek JE.","first_author":"Doek JE.","journal":"Child abuse & neglect","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0145-2134(85)90040-7"}},{"id":3240,"doi":null,"pmid":"11621270","pmcid":null,"title":"Gynaecology, pornography, and the antivivisection movement","authors":"Lansbury C.","first_author":"Lansbury C.","journal":"Victorian studies","year":1985,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3241,"doi":"10.1007/bf01541647","pmid":"6466084","pmcid":null,"title":"Some sexual, personality, and demographic characteristics of women readers of erotic romances","authors":"Coles CD, Shamp MJ.","first_author":"Coles CD","journal":"Archives of sexual behavior","year":1984,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"questionnaire survey of volunteers; no longitudinal or experimental manipulation","sample_n":72,"sample_text":"24 college women and 48 housewives/businesswomen","population":"college women, housewives, businesswomen in Atlanta, GA (N≈72)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed 72 women about their reading of erotic romance novels and found readers were more sexually active and used fantasy more often, but otherwise resembled non‑readers in attitudes and personality. The authors suggest such novels act as a socially acceptable form of soft‑core porn.","clinical_takeaway":"Reading erotic romances may be linked to higher sexual activity, but the study provides limited evidence for clinical implications.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Dual age groups allow some comparison","Clear operational focus on erotic romance reading","Uses multiple personality/attitude variables"],"limitations":["Small, convenience sample; limited generalisability","No validated scales for key constructs","No control for moral or mental‑health confounds","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541647"}},{"id":3242,"doi":"10.2466/pr0.1984.54.2.606","pmid":"6739654","pmcid":null,"title":"Pornographic films and unconscious homosexual desires: an hypothesis","authors":"Lester D.","first_author":"Lester D.","journal":"Psychological reports","year":1984,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2466/pr0.1984.54.2.606"}},{"id":3243,"doi":null,"pmid":"20314327","pmcid":"PMC1875948","title":"Pornography and violent entertainment: exposing the symptoms","authors":"Gray C.","first_author":"Gray C.","journal":"Canadian Medical Association journal","year":1984,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3244,"doi":"10.1097/00000433-198312000-00012","pmid":"6666761","pmcid":null,"title":"A male with autoerotic asphyxia syndrome","authors":"Wesselius CL, Bally R.","first_author":"Wesselius CL","journal":"The American journal of forensic medicine and pathology","year":1983,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single male with autoerotic asphyxia; no control group, no systematic data collection","sample_n":1,"sample_text":"1 participant","population":"single adult male (24 y) with a 10‑year history of autoerotic asphyxia","country":"United States (implied)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The report describes a 24‑year‑old man who practiced autoerotic asphyxia for ten years and later developed weakness after a ritual. It discusses typical features of the syndrome, such as using porn, transvestite role‑play, and family background, but offers only a single clinical narrative.","clinical_takeaway":"No direct clinical guidance; illustrates the rarity and complexity of autoerotic asphyxia cases.","confidence":0.4,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Provides a rare clinical description of a live practitioner","Highlights contextual factors (family dynamics, transvestite role)"],"limitations":["Single case; no generalisable data","No validated measures of pornography use or addiction","No control for confounding factors"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00000433-198312000-00012"}},{"id":3245,"doi":"10.1111/j.1532-5415.1983.tb03715.x","pmid":"6863791","pmcid":null,"title":"Sexual incidents in an extended care unit for aged men","authors":"Szasz G.","first_author":"Szasz G.","journal":"Journal of the American Geriatrics Society","year":1983,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of nursing staff in a single 400‑bed extended‑care unit; questionnaire about observed resident sexual behavior.","sample_n":null,"sample_text":"Staff respondents from a single extended‑care unit (likely convenience sample).","population":"Nursing staff (unspecified number) in one Canadian aged‑men facility","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A questionnaire asked nurses in a men’s aged‑care home what resident behaviours they considered sexual and how they responded. About a quarter of residents were thought to create such incidents, especially sexual talk, touching, and reading porn magazines.","clinical_takeaway":"Staff in elder‑care settings should receive guidance on distinguishing acceptable intimacy from problematic sexual behaviour.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides descriptive data on staff perceptions of sexual behavior in an elderly male cohort","Highlights institutional challenges and policy considerations"],"limitations":["No validated measurement tools; relies on staff judgement","Single‑site convenience sample limits generalisability","No statistical testing reported"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":38,"citing_publications":73,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1532-5415.1983.tb03715.x"}},{"id":3248,"doi":null,"pmid":"6650273","pmcid":null,"title":"Inadequacy of sex knowledge of adolescents: implications for counselling and sex education","authors":"Onyehalu AS.","first_author":"Onyehalu AS.","journal":"Adolescence","year":1983,"pub_types":["Journal Article"],"keywords":["Population","Youth","Comparative studies","Health education","Age factors","population characteristics","Education","Adolescents","Demographic Factors","Sex Education","Cross-cultural Comparisons"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"No empirical data; the paper is a narrative discussion proposing sex‑education programs.","sample_n":null,"sample_text":"none (commentary)","population":"adolescents (general discussion, no sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that adolescents worldwide have limited, often incorrect, knowledge about sex, largely learned from peers, and that increasing exposure to porn contributes to misconceptions. It calls for comprehensive sex education and counseling to prevent early pregnancy and related harms.","clinical_takeaway":"None – the paper offers policy suggestions rather than clinical evidence.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Addresses important public‑health issue of adolescent sexual knowledge","Integrates cultural and peer influences in discussion"],"limitations":["No original data; purely argumentative","Lacks empirical measurement of constructs","No assessment of confounding factors"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":3249,"doi":"10.1111/j.1460-2466.1982.tb02514.x","pmid":"7174873","pmcid":null,"title":"Pornography, sexual callousness, and the trivialization of rape","authors":"Zillmann D, Bryant J.","first_author":"Zillmann D","journal":"The Journal of communication","year":1982,"pub_types":["Journal 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pornography","authors":"Whitehall J.","first_author":"Whitehall J.","journal":"The Medical journal of Australia","year":1980,"pub_types":["Journal 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The dentist and pornography","authors":"Kanterman CB.","first_author":"Kanterman CB.","journal":"Dental student","year":1970,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3293,"doi":"10.1177/000992286900801104","pmid":"5387863","pmcid":null,"title":"Pornography of ignorance. Who'll give the kids a third choice?","authors":"Calderone MS.","first_author":"Calderone MS.","journal":"Clinical pediatrics","year":1969,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000992286900801104"}},{"id":3294,"doi":null,"pmid":"5787636","pmcid":null,"title":"The wind of pornography","authors":"McGrath WB.","first_author":"McGrath WB.","journal":"Arizona medicine","year":1969,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3295,"doi":"10.1176/appi.psychotherapy.1962.16.3.477","pmid":"13889837","pmcid":null,"title":"Psychiatric viewpoints on indecency, obscenity, and pornography in literature and the arts","authors":"ELIASBERG WG.","first_author":"ELIASBERG WG.","journal":"American journal of psychotherapy","year":1962,"pub_types":["Journal Article"],"keywords":["Literature","Erotica"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.psychotherapy.1962.16.3.477"}},{"id":3296,"doi":null,"pmid":"13415639","pmcid":null,"title":"[Pornography & penal law]","authors":"ANCEL M.","first_author":"ANCEL M.","journal":"L'Hygiene mentale","year":1956,"pub_types":["Journal Article"],"keywords":["Legislation","Literature"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3297,"doi":null,"pmid":"14810649","pmcid":null,"title":"Frau Wirtin and associates; a note on alien corn","authors":"WELLS FL.","first_author":"WELLS FL.","journal":"The American imago; a psychoanalytic journal for the arts and sciences","year":1951,"pub_types":["Journal Article"],"keywords":["Sex","Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3298,"doi":"10.31234/osf.io/u479s_v1","pmid":null,"pmcid":null,"title":"The Global Measure of Masturbation Satisfaction (GMMAST): Scale Development and Preliminary Validation","authors":"de Jong DC, Fischer N, Uhlich M.","first_author":"de Jong DC","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Scale development using large national sample; exploratory and confirmatory factor analyses; measurement invariance tested.","sample_n":2486,"sample_text":"Adults from Masturbation and Sexual Health Survey, U.S. national sample","population":"U.S. adults who masturbated in past month (N=2,486)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created a short five‑item questionnaire (GMMAST) to measure how satisfied people feel with their solo masturbation, showing it works well in a large U.S. sample.","clinical_takeaway":"The GMMAST provides a reliable tool for clinicians to assess masturbation satisfaction in clients.","confidence":0.7,"topic_tags":["masturbation","sexual_function","measurement"],"strengths":["Large, nationally representative sample","Rigorous factor‑analytic validation","Measurement invariance across groups"],"limitations":["Cross‑sectional; cannot assess temporal stability","No assessment of mental‑health or moral variables","Pre‑registration not reported"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/u479s_v1"}},{"id":3299,"doi":"10.21203/rs.3.rs-10291331/v1","pmid":null,"pmcid":null,"title":"Perceptions, motivations and patterns of masturbation among tertiary students in southwest Nigeria: a cross-sectional study","authors":"Odubia JS, Akanbi AO, Emmanuel JB, Oladimeji AA, Alabi TM, Odesanmi TM.","first_author":"Odubia JS","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire study of 410 tertiary students in southwest Nigeria.","sample_n":410,"sample_text":"Convenience sample from five departments; not nationally representative.","population":"Tertiary students (mean age ≈ 24) at a health technology institution in Ogun State, Nigeria (N=410).","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 410 Nigerian university students, about three‑quarters reported masturbating in the past year. Attitudes were mixed—many saw it as normal and stress‑relieving, while others linked it to guilt or addiction. Positive attitudes and personal reasons predicted higher frequency, whereas certain patterns predicted lower frequency.","clinical_takeaway":"Masturbation is common and attitudes shape its frequency; sexual‑health education should address myths and distress without pathologising normal behaviour.","confidence":0.8,"topic_tags":["masturbation","sexual_function","csbd"],"strengths":["Large sample for a single‑site study","First systematic look at masturbation beliefs in this cultural context","Uses multivariate regression to identify predictors of frequency"],"limitations":["Questionnaire appears unvalidated; construct reliability unclear","Convenience sample limits generalisability","No mental‑health, religiosity or partner variables measured"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-10291331/v1"}},{"id":3300,"doi":"10.3390/bs16071176","pmid":"42510297","pmcid":"PMC13404198","title":"Associations Between Solitary Masturbation Parameters and Sexual Arousal in Partnered Sexual Activity","authors":"Sánchez-Pérez GM, Sierra JC.","first_author":"Sánchez-Pérez GM","journal":"Behavioral sciences (Basel, Switzerland)","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Arousal","Sexual Functioning","Masturbation Parameters","Partnered Sexual Activity","Complementary And Compensatory Models"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13404198","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 1028 Spanish cisgender adults","sample_n":1028,"sample_text":"1028 participants (469 men, 559 women) recruited online; convenience sample","population":"Spanish cisgender adults with heterosexual experience (N=1028)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over a thousand Spanish adults, researchers found that people who reported higher solitary sexual desire and more intense personal orgasms also reported greater sexual arousal during partnered sex, with different patterns for men and women.","clinical_takeaway":"Clinicians might consider clients' solitary sexual desire and attitudes toward masturbation when addressing partnered sexual arousal issues.","confidence":0.7,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Large sample size for a survey","Separate assessment of multiple masturbation parameters","Gender‑specific analyses"],"limitations":["Cross‑sectional design limits causal inference","Convenience sample may not be representative","Key potential confounds (moral attitudes, mental health, relationship factors) not measured"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs16071176"}},{"id":3302,"doi":"10.1093/sxmrev/qeag052","pmid":"42520156","pmcid":null,"title":"The scientific study of masturbation: a bibliometric analysis","authors":"Sánchez-Pérez GM, Sierra JC, Mangas P.","first_author":"Sánchez-Pérez GM","journal":"Sexual medicine reviews","year":2026,"pub_types":["Journal Article"],"keywords":["Masturbation","Self-stimulation","Bibliometric Analysis","Autoeroticism","Solitary Sex"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Bibliometric analysis of 3,239 Scopus‑indexed articles (1840‑2025) using R‑bibliometrix to map trends, authors, countries, keywords and collaboration networks.","sample_n":3239,"sample_text":"All records retrieved from Scopus matching the search criteria.","population":"Scientific articles (n = 3,239) containing masturbation‑related terms in title/abstract/keywords.","country":"International (primarily North America and Europe).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A review of 3,239 scientific papers shows that research on masturbation has grown steadily since the 1970s, with most work coming from North America and Europe. Topics like \"NoFap\" are emerging, but collaboration between researchers remains limited.","clinical_takeaway":"None – the study maps research output, not individuals or health outcomes.","confidence":0.8,"topic_tags":["masturbation","sexual_function","religiosity","moral_incongruence","csbd"],"strengths":["Large, comprehensive sample of publications","Clear, reproducible bibliometric methodology","Identifies temporal and geographic trends"],"limitations":["No assessment of study quality or content beyond bibliometrics","Potential language or database bias (Scopus only)","Does not address behavioural or clinical constructs"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeag052"}},{"id":3304,"doi":"10.1097/rc9.0000000000000557","pmid":"42416456","pmcid":"PMC13340688","title":"Penile fracture following masturbation: a case report","authors":"Ibrahim F, Ahmed AT, Abd Alrhman A, Abd Al-Hadi AS, Yamen A, Ebrahim B.","first_author":"Ibrahim F","journal":"International journal of surgery case reports","year":2026,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Management","Masturbation","Case Report","Penile Fracture","Urological Emergency"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13340688","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single 22‑year‑old man with penile fracture during masturbation; surgical repair and 1‑year follow‑up","sample_n":1,"sample_text":"single patient","population":"Male, 22 y, acute urological emergency","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 22‑year‑old man fractured his penis while masturbating; prompt surgical repair restored normal erectile function after one year.","clinical_takeaway":"Early surgical repair of penile fracture after masturbation leads to good functional recovery.","confidence":0.6,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Detailed clinical description","Long‑term follow‑up shows successful outcome"],"limitations":["Single case; no generalisability","No comparative data or statistical analysis"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/rc9.0000000000000557"}},{"id":3305,"doi":"10.1007/s10508-026-03587-y","pmid":"42463927","pmcid":null,"title":"Adapting and Validating the Indonesian Version of the Masturbatory Premature Ejaculation Diagnostic Tool: A Questionnaire for Masturbation-Related Ejaculatory Symptoms","authors":"Lionardi S, Handini LP, Utomo NS, Hartanto MC, Hadiprajitno PI, Lionardi SK, Pakpahan C, Dharma C, Agustinus A, Bắc NH.","first_author":"Lionardi S","journal":"Archives of sexual behavior","year":2026,"pub_types":["Validation Study","Journal Article"],"keywords":["Masturbation","Sexual Health","Premature Ejaculation","Dsm-5","Male Sexual Behavior","Sexual Assessment"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a questionnaire administered to a sample of Indonesian men; psychometric analysis (construct validity, internal consistency, test‑retest reliability).","sample_n":null,"sample_text":"not specified in abstract","population":"Indonesian adult men (young‑adult to middle‑aged) who masturbate; sample size not reported in abstract.","country":"Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors translated a questionnaire that screens for premature ejaculation during masturbation into Indonesian and showed it is reliable and valid, suggesting it could help clinicians identify men who need further evaluation.","clinical_takeaway":"The Indonesian MPEDT appears to be a reliable tool for detecting masturbation‑related premature ejaculation; clinicians may consider it for early screening.","confidence":0.8,"topic_tags":["masturbation","sexual_function","measurement","prevalence"],"strengths":["Rigorous translation and psychometric validation process","High internal consistency (α = 0.88)","Test‑retest reliability reported (ICC = 0.76)"],"limitations":["Sample size and sampling method not described in abstract","No assessment of potential confounds such as mental health or moral attitudes","Cross‑sectional design limits conclusions about clinical utility"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03587-y"}},{"id":3307,"doi":"10.1097/gme.0000000000002675","pmid":"41217890","pmcid":"PMC13011940","title":"The role of masturbation in relieving symptoms associated with menopause","authors":"Lehmiller JJ, Graham CA, Ferrall L, Mendelson EA, Mendelson EA, Prine MS.","first_author":"Lehmiller JJ","journal":"Menopause (New York, N.Y.)","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["menopause","Masturbation","perimenopause","Sexual Functioning"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13011940","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 1,178 US women aged 40‑65; online questionnaire; quantitative t‑tests/χ² and thematic analysis of open‑ended responses.","sample_n":1178,"sample_text":"demographically representative US sample of 1,178 women ages 40‑65","population":"women in perimenopause or postmenopause, United States, demographically representative sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,178 U.S. women going through menopause, about one‑fifth said that masturbating helped relieve symptoms like mood swings and sleep problems, and many would try it if a doctor suggested it.","clinical_takeaway":"Masturbation may be a helpful, low‑risk option for menopause symptom relief; clinicians could discuss it as part of a broader management plan.","confidence":0.7,"topic_tags":["masturbation","sexual_function","moral_incongruence","measurement","prevalence"],"strengths":["Large, nationally representative sample","Both quantitative and qualitative data","Focused on a specific, understudied symptom‑management strategy"],"limitations":["Self‑report, single‑item measures of efficacy","Cross‑sectional design limits causal inference","No control for mental‑health or partner variables"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/gme.0000000000002675"}},{"id":3308,"doi":"10.1007/s10508-026-03436-y","pmid":"42204041","pmcid":"PMC13275571","title":"A Qualitative Study of Indian Women's Experiences with Sexual Pleasure and Masturbation","authors":"Khan S, Tenzin N, Ingle S, Guerra-Reyes L, Sarfare S, Kulkarni-Schaefer S, Herbenick D.","first_author":"Khan S","journal":"Archives of sexual behavior","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["India","Sex Education","Masturbation","Sexual Health","Pleasure","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13275571","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study (N=22)","sample_n":22,"sample_text":"convenience sample","population":"Indian women aged 20‑43, recruited for virtual interviews","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 22 interviews, Indian women described how cultural stigma, lack of sex education, and COVID‑19 lockdowns limited their ability to explore masturbation and sexual pleasure, yet many found ways to reclaim agency despite these barriers.","clinical_takeaway":"Clinicians should recognize cultural and privacy barriers that affect women's sexual self‑exploration in India and address them in sex‑education and counselling.","confidence":0.7,"topic_tags":["masturbation","sexual_function","csbd"],"strengths":["Provides rare qualitative insight into Indian women's sexual pleasure","Tri‑lingual interviews increase cultural relevance","Inductive thematic analysis captures participants' own language"],"limitations":["Small, non‑representative convenience sample","No quantitative measurement of potential confounds (e.g., religiosity, mental health)","Findings not generalisable beyond the interviewed group"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03436-y"}},{"id":3309,"doi":"10.21203/rs.3.rs-10180633/v1","pmid":null,"pmcid":null,"title":"The Evaluation of Sexual Problems in Patients With Hepatitis B and C","authors":"YILDIZ LM, ÖZTÜRK O.","first_author":"YILDIZ LM","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational analytical questionnaire study of 132 hepatitis B/C patients from clinical follow‑up; cross‑sectional assessment of sexual activity changes.","sample_n":132,"sample_text":"132 patients (82.6% HBV, 17.4% HCV) completed a sociodemographic/sexual‑behaviour questionnaire and the Golombok‑Rust Inventory of Sexual Satisfaction.","population":"Patients with chronic hepatitis B (n = 109) or hepatitis C (n = 23) recruited from a clinical setting.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 132 patients with chronic hepatitis B or C, most reported anxiety about infecting partners and a drop in vaginal and anal sex. Oral sex and porn viewing stayed the same, while masturbation increased. Changes were linked to education, gender, and occupation.","clinical_takeaway":"Clinicians should screen for sexual anxiety and altered activity patterns in hepatitis patients, not assume reduced porn use.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses validated sexual satisfaction inventory","Addresses a neglected clinical population","Reports specific changes in multiple sexual behaviours"],"limitations":["Cross‑sectional, no causal inference","Small HCV subsample limits comparisons","Limited control for key confounds (moral, mental health, partner dynamics)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-10180633/v1"}},{"id":3311,"doi":"10.1080/0092623x.2026.2628649","pmid":"41769729","pmcid":null,"title":"The Varieties of Masturbatory Experience: Prevalences in a U.S. National Sample and Recommendations for Future Investigations","authors":"de Jong DC, Uhlich M, Fischer N, Ginn C, Baker A, Rahm-Knigge R, Moore ML, Ford JV, Hoffmann H, Coleman E, Gleason N.","first_author":"de Jong DC","journal":"Journal of sex & marital therapy","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large, weighted U.S. national sample (N=3,423) with descriptive prevalence estimates of nine precisely defined masturbatory behaviors.","sample_n":3423,"sample_text":"Weighted national dataset of 3,423 adults.","population":"U.S. adults, nationally representative weighting.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a nationally representative U.S. sample of 3,423 adults, the study identified nine specific masturbatory behaviors and reported how common each was in the past month, showing solo masturbation is most frequent while group forms are rare.","clinical_takeaway":"Clinicians should recognize the wide variety of solo and partnered masturbation practices when discussing sexual health with clients.","confidence":0.7,"topic_tags":["masturbation","prevalence","sexual_function","measurement"],"strengths":["Large, nationally weighted sample","Clear, detailed operational definitions of multiple masturbation contexts","Addresses a gap in prevalence literature"],"limitations":["Cross‑sectional, cannot infer change over time","No assessment of psychological or relational correlates","Reliance on self‑report without validation of items"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2026.2628649"}},{"id":3312,"doi":"10.21203/rs.3.rs-10169592/v1","pmid":null,"pmcid":null,"title":"Post-Orgasmic Enhancement of Attentional Focus in Adults with Attention-Deficit/Hyperactivity Disorder: A Cross-Sectional Survey Study","authors":"Zannati AAA.","first_author":"Zannati AAA.","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 93 university students with self‑reported ADHD; self‑report measures before and after sexual activity","sample_n":93,"sample_text":"Convenience sample recruited via university channels; not a probability sample","population":"adult university students (18‑30) with ADHD diagnosis (self‑reported or confirmed)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"University students with ADHD reported that their ability to concentrate improved for a short time after reaching orgasm, whether from sex or masturbation. The effect was stronger in those not taking medication.","clinical_takeaway":"Self‑reported post‑orgasm attention gains are noted, but evidence is limited; clinicians should not assume therapeutic benefit without objective testing.","confidence":0.8,"topic_tags":["sexual_function","adolescents","neuroscience","csbd"],"strengths":["uses validated ADHD symptom scale (CAARS)","reports large within‑subject effect size","includes both intercourse and masturbation conditions"],"limitations":["cross‑sectional self‑report, no objective attention tests","no control for moral, mental‑health or relationship factors","self‑selected university sample, limited generalisability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-10169592/v1"}},{"id":3313,"doi":"10.31234/osf.io/ng8wj_v1","pmid":null,"pmcid":null,"title":"“I Should Not Be Doing This Thing”: A Qualitative Exploration of Masturbation Experiences Among Young Indian Women","authors":"Singh S, Menon S, Pachik TR, Kaura U, Kaleru NG.","first_author":"Singh S","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"In‑depth interviews with 12 heterosexual Indian women (18‑30 y) analysed via reflexive thematic analysis","sample_n":12,"sample_text":"Twelve participants recruited for semi‑structured interviews","population":"young Indian women, convenience sample","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with twelve young Indian women reveal how cultural taboos, limited sexual education, and media shape their masturbation experiences, highlighting both positive feelings and emotional challenges.","clinical_takeaway":"Clinicians should recognize cultural stigma when discussing masturbation with Indian women and consider addressing sexual literacy and emotional concerns.","confidence":0.8,"topic_tags":["masturbation","sexual_function","csbd"],"strengths":["Provides rare qualitative insight into Indian women's masturbation experiences","Uses reflexive thematic analysis, a recognized qualitative method","Identifies cultural and media influences specific to the context"],"limitations":["Very small, non‑representative sample (N=12)","No measurement of potential confounds (moral incongruence, mental health, etc.)","Findings may not generalize beyond heterosexual, urban, educated women"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/ng8wj_v1"}},{"id":3314,"doi":"10.1016/j.sleep.2026.108823","pmid":"41637994","pmcid":null,"title":"Left hand sleep masturbation in a right-handed male patient with sexsomnia","authors":"Brice M, Gales AZ, Attali V, Chauvin M, Arnulf I.","first_author":"Brice M","journal":"Sleep medicine","year":2026,"pub_types":["Journal Article","Case Reports"],"keywords":["obstructive sleep apnea","Masturbation","Gabapentine","Confusional Arousal","Sexsomnia","Nrem Parasomnia"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single male patient, video-polysomnography, observational","sample_n":1,"sample_text":"one patient (case report)","population":"right‑handed adult male with sexsomnia","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 30‑ish right‑handed man was filmed sleeping and was found to masturbate with his left hand during deep sleep, a phenomenon called sexsomnia. The behavior stopped after switching from gabapentin to paroxetine, suggesting a medication effect.","clinical_takeaway":"Sexsomnia can manifest as nocturnal masturbation with unusual laterality; consider sleep study and medication review when evaluating unexplained nighttime sexual behavior.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Objective video‑polysomnography documentation of nocturnal masturbation","Detailed description of hand laterality differing between sleep and wake","Discussion of medication effects on both sexsomnia and sleep apnea"],"limitations":["Single case limits generalisability","No systematic assessment of psychological or moral factors","No quantitative analysis or control condition"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sleep.2026.108823"}},{"id":3315,"doi":"10.1186/s12610-026-00300-w","pmid":"41593504","pmcid":"PMC12836828","title":"Association between a history of frequent masturbation and anxiety/depression in patients with psychogenic erectile dysfunction","authors":"Yang J, Wu W, Zhao Y, Liu J.","first_author":"Yang J","journal":"Basic and clinical andrology","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Anxiety","Psychogenic Erectile Dysfunction","Psychological Resilience","Frequent Masturbation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12836828","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational cross-sectional study of psychogenic erectile dysfunction patients comparing those with a history of frequent masturbation to those without.","sample_n":null,"sample_text":"Not reported in abstract; likely modest clinical convenience sample.","population":"Patients with psychogenic erectile dysfunction (clinical sample).","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In men with psychogenic erectile dysfunction, those who reported frequently masturbating also showed higher anxiety and depression scores and lower resilience than those who did not.","clinical_takeaway":"Frequent masturbation may be linked to worse mood in psychogenic ED; clinicians should screen mood and consider psychosocial interventions.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Uses validated scales for anxiety, depression, and resilience","Addresses an understudied clinical subgroup (psychogenic ED)","Highlights potential psychological correlates of frequent masturbation"],"limitations":["Cross‑sectional design cannot establish causality","Masturbation frequency measured with a single, non‑validated item","No control for moral/religious attitudes or other mental‑health covariates","No effect sizes or correction for multiple testing reported"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12610-026-00300-w"}},{"id":3316,"doi":"10.1123/ijspp.2025-0265","pmid":"41569840","pmcid":null,"title":"From the Bedroom to the Arena: How Sex and Masturbation Influence Athletes' Sleep","authors":"Vitale JA, Bizzozero S, Borghi S, Banfi G.","first_author":"Vitale JA","journal":"International journal of sports physiology and performance","year":2026,"pub_types":["Journal Article"],"keywords":["Recovery","Sexual activity","Sleep Quality","Orgasm"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional descriptive survey of 164 competitive athletes (Italy) assessing self‑reported sexual activity (partnered intercourse, masturbation, orgasm) and perceived sleep quality/latency and athletic impact.","sample_n":164,"sample_text":"115 males, 49 females; athletes from various individual and team sports.","population":"competitive athletes, age 18‑40, recruited via sport federations (convenience sample).","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 164 athletes found that most believe having an orgasm—whether from intercourse or masturbation—helps them fall asleep faster and improves sleep quality, with no perceived negative effect on sports performance.","clinical_takeaway":"Athletes' perceptions suggest orgasmic sexual activity may aid sleep; clinicians can discuss individual preferences rather than imposing abstinence rules.","confidence":0.78,"topic_tags":["sexual_function","masturbation","csbd","relationships"],"strengths":["Large, gender‑balanced athlete sample for this topic.","Directly addresses a practical question for sport practitioners.","Separates partnered sex and masturbation reports."],"limitations":["Cross‑sectional, self‑report perception data; no objective sleep or hormonal measures.","Survey items not validated; no effect sizes or correction for multiple testing.","Potential self‑selection bias; no control for moral or mental‑health confounds."],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1123/ijspp.2025-0265"}},{"id":3317,"doi":"10.1016/j.ijchp.2025.100662","pmid":"41626410","pmcid":"PMC12854025","title":"Validation of masturbation parameters: A laboratory study measuring psychophysiological and subjective sexual arousal","authors":"Sánchez-Pérez GM, Granados R, Mangas P, Cervilla O, Sierra JC.","first_author":"Sánchez-Pérez GM","journal":"International journal of clinical and health psychology : IJCHP","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Genital Response","Subjective Sexual Arousal","Sexual Excitation","Masturbation Parameters","Heterosexual Sexual Relationships"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12854025","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"laboratory cross‑sectional study with 80 young cisgender adults (40 M, 40 F) measuring genital and subjective arousal while viewing videos; regression analyses linking masturbation parameters to arousal outcomes","sample_n":80,"sample_text":"80 participants (40 men, 40 women)","population":"young cisgender adults (18‑30) in heterosexual relationships, convenience sample","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab test with 80 young adults, researchers linked how often and how positively people think about masturbating to physiological and self‑rated sexual arousal, finding different patterns for men and women.","clinical_takeaway":"Masturbation frequency and attitudes relate to arousal responses; clinicians might consider these factors when discussing sexual health.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["objective genital arousal measurement","gender‑specific analyses","provides initial validation evidence for masturbation‑related constructs"],"limitations":["Convenience sample of young adults; limited generalisability","Unclear whether scales used are validated","No control for moral, mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijchp.2025.100662"}},{"id":3318,"doi":"10.1080/13691058.2025.2608876","pmid":"41493562","pmcid":null,"title":"An exploratory study of marianismo and masturbation among cisgender mono-ethnic Latinas in the USA","authors":"Moreno K, Porras Pyland C.","first_author":"Moreno K","journal":"Culture, health & sexuality","year":2026,"pub_types":["Journal Article"],"keywords":["Masturbation","Sexual Health","Latina","Cultural Attitudes","Marianismo"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 150 self‑identified Latina cis‑gender women living in the USA; exploratory correlational analysis","sample_n":150,"sample_text":"Convenience online sample recruited via unspecified channels; not a probability or clinical sample","population":"cisgender Latina/Chicana/Hispanic women (USA), age range not specified","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 150 US Latina women, stronger endorsement of marianismo beliefs was linked to higher guilt about masturbation, and that guilt was associated with less frequent masturbation. Cultural scripts of chastity and self‑sacrifice may suppress sexual self‑exploration.","clinical_takeaway":"Clinicians should consider cultural and religious beliefs when discussing sexual self‑pleasure with Latina patients; guilt may reduce masturbation frequency.","confidence":0.8,"topic_tags":["masturbation","csbd","moral_incongruence"],"strengths":["Uses validated scales for cultural beliefs and masturbation attitudes","Adequate sample size for exploratory regression","Focus on an under‑researched population"],"limitations":["Cross‑sectional; cannot infer causality","Convenience online sample; limited generalisability","No measurement of mental‑health or partner variables"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2025.2608876"}},{"id":3320,"doi":"10.1080/19317611.2025.2587108","pmid":"42205345","pmcid":"PMC13203068","title":"\"I Should Not Be Doing This Thing\": A Qualitative Exploration of Masturbation Experiences Among Young Indian Women","authors":"Singh S, Menon S, Reddy Pachika T, Kaura U, Guna Kaleru N.","first_author":"Singh S","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["India","Women","study","Qualitative","Masturbation","Experiences"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13203068","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"In‑depth phenomenological interviews with 12 heterosexually identified Indian women (18‑30 y) analysed by reflexive thematic analysis.","sample_n":12,"sample_text":"twelve heterosexual women aged 18‑30","population":"young Indian women, convenience sample","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Twelve young Indian women described how cultural taboos, limited sexual knowledge, and media shape their masturbation experiences, highlighting both positive feelings and emotional challenges.","clinical_takeaway":"Clinicians should recognize cultural barriers when discussing masturbation with Indian women and consider tailored education to improve sexual wellbeing.","confidence":0.7,"topic_tags":["masturbation","sexual_function","csbd"],"strengths":["Addresses a major cultural gap in the literature","Uses in‑depth phenomenological interviews","Provides rich, nuanced themes"],"limitations":["Very small, non‑representative sample","No quantitative measures or psychometrically validated instruments","Confounding factors (e.g., mental health, religiosity) not assessed"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2025.2587108"}},{"id":3321,"doi":"10.1093/sexmed/qfaf087","pmid":"41146975","pmcid":"PMC12554156","title":"The basis for self-reported sexual dysfunction and the diagnostic value of masturbation-related parameters in men who have not engaged in vaginal intercourse in the past 6 months or have never engaged in it: a comparative study","authors":"Mao Z, Ye J, Pang KH, Wang C, Zhang Y.","first_author":"Mao Z","journal":"Sexual medicine","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual dysfunction","Masturbation","Vaginal Intercourse","Masturbation Erection Index (Mei)","Masturbatory Premature Ejaculation Diagnostic Tool (Mpedt)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12554156","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Questionnaire-based comparative study of men reporting sexual dysfunction vs no dysfunction, focusing on masturbation parameters.","sample_n":null,"sample_text":"Convenience clinical sample of help‑seeking men (self‑selected).","population":"Men who have not engaged in vaginal intercourse in past 6 months or never; sample size not reported in abstract.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed men who hadn't had vaginal sex recently to see why they label themselves as having sexual problems and whether masturbation measures can help diagnose erectile or premature‑ejaculation issues.","clinical_takeaway":"Masturbation‑based scales may aid assessment of erectile and ejaculatory problems when recent intercourse is absent, but findings need confirmation in larger, controlled samples.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Uses validated masturbation‑specific scales","Addresses a clinically understudied group"],"limitations":["No objective diagnostic instruments","Likely small, convenience sample","No control for mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfaf087"}},{"id":3322,"doi":"10.1186/s12889-025-24701-0","pmid":"41044527","pmcid":"PMC12495832","title":"Unveiling masturbatory sexual behaviours in Nigeria: insights into the prevalence and factors associated with self- and mutual masturbation among the sexually active population","authors":"Bello Y, Oke D, Ilori T, Adebayo SA, Olubodun T, Adewole I, Francis S, Watson-Jones D, Morhason-Bello IO.","first_author":"Bello Y","journal":"BMC public health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Female","Male","Sex","Nigeria","Mutual Masturbation","Self-masturbation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12495832","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional prevalence study of self‑ and mutual masturbation among sexually active Nigerians (N≈?, ages 18‑45) using face‑to‑face interview items","sample_n":null,"sample_text":"not reported in abstract","population":"Nigeria, sexually active adults 18–45 years, community sample","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Nigerian community sample, 65% of adults reported ever masturbating alone and 84% reported ever masturbating with a partner. The study identified demographic and lifestyle factors linked to each behaviour, such as gender, occupation, smartphone ownership and alcohol use.","clinical_takeaway":"Masturbation, both alone and with a partner, is common in Nigeria; clinicians should consider cultural context when discussing sexual health.","confidence":0.8,"topic_tags":["masturbation","prevalence","sexual_function"],"strengths":["Large community‑based sample","First prevalence data on self‑ and mutual masturbation in Nigeria","Uses Poisson regression with robust variance to estimate associations"],"limitations":["Single‑item, non‑validated measures of masturbation","No assessment of moral, mental‑health or trauma confounders","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-025-24701-0"}},{"id":3324,"doi":"10.1097/gme.0000000000002597","pmid":"40627719","pmcid":"PMC12502948","title":"Masturbation frequency and experiences among US women aged 40-65 years: comparisons across different stages of the menopause transition","authors":"Graham CA, Graham CA, Ferrall L, Lehmiller JJ.","first_author":"Graham CA","journal":"Menopause (New York, N.Y.)","year":2025,"pub_types":["Comparative Study","research-article","Journal Article"],"keywords":["menopause","Masturbation","Orgasm","Sexual Functioning."],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12502948","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative online survey of 1,500 US women aged 40‑65, comparing masturbation frequency and orgasm experiences across menopause stages","sample_n":1500,"sample_text":"nationally representative US sample, online survey","population":"women, age 40‑65, US, community sample","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,500 US women aged 40‑65, post‑menopausal women masturbated less often and rated it as less important than pre‑ or perimenopausal women. However, orgasm rates and sex‑toy use during masturbation were similar across groups, suggesting menopause does not automatically reduce sexual pleasure.","clinical_takeaway":"Menopause need not signal loss of sexual pleasure; clinicians can reassure older women that orgasm during masturbation often remains stable.","confidence":0.8,"topic_tags":["masturbation","sexual_function","csbd"],"strengths":["Large, nationally representative sample","Clear comparison across menopause stages","Straightforward descriptive analyses"],"limitations":["Self‑report measures without validated scales","No assessment of potential confounds (mental health, relationship status, moral attitudes)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/gme.0000000000002597"}},{"id":3325,"doi":"10.1007/s10508-025-03278-0","pmid":"41191228","pmcid":null,"title":"The Brief Attitudes Toward Solo Masturbation Scale: Development and Preliminary Validation","authors":"de Jong DC, Adams KN.","first_author":"de Jong DC","journal":"Archives of sexual behavior","year":2025,"pub_types":["Validation Study","Journal Article"],"keywords":["Sexual behavior","Masturbation","Attitudes"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a new self‑report scale with 1531 adult participants","sample_n":1531,"sample_text":"1531 adults (40% women, 54% men, 6% gender non‑binary/non‑conforming; 18‑81 years)","population":"adults 18‑81, mixed gender","country":"unspecified","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and preliminarily validated an eight‑item questionnaire (BATSMS) to measure how people feel about solo masturbation, showing it has reliable positive and negative attitude subscales and relates to related factors like religiosity and frequency.","clinical_takeaway":"The BATSMS offers a brief, psychometrically sound tool for assessing attitudes toward solo masturbation in research or clinical settings.","confidence":0.85,"topic_tags":["masturbation","sexual_function","measurement"],"strengths":["Large, diverse adult sample","Rigorous factor‑analytic development","Provides both positive and negative attitude subscales"],"limitations":["Cross‑sectional; cannot infer causal links","No external validation (e.g., test‑retest, predictive outcomes)","Mental‑health and trauma variables not examined"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03278-0"}},{"id":3326,"doi":"10.1038/s41443-026-01358-w","pmid":"42768158","pmcid":null,"title":"Masturbation grip strength and perceived intravaginal pressure differential are associated with self-estimated intravaginal ejaculation latency time: a retrospective study","authors":"Zhang H, Wang C, Zhu D, Sansone A, Colonnello E, Jannini TB, Jannini EA, Li H, Zhang Y.","first_author":"Zhang H","journal":"International journal of impotence research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective single‑centre survey of 470 male clinic attendees; dichotomised self‑estimated IELT; logistic regression","sample_n":470,"sample_text":"clinic‑based convenience sample","population":"male clinic attendees (impotence clinic) Jan 2020–Mar 2022, N=470","country":"unspecified (likely China based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 470 men attending a clinic, stronger grip when using a blood‑pressure cuff and using a shaft‑dominant grip during masturbation were linked to longer self‑reported intravaginal ejaculation time.","clinical_takeaway":"Masturbatory technique may relate to perceived ejaculatory latency; clinicians should consider behavioural aspects when evaluating delayed ejaculation.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Large sample for a niche physiological measure","Multivariable regression with CIs reported","Exploratory sensitivity analyses provided"],"limitations":["Retrospective self‑estimate of IELT, not objective","Ad‑hoc measures of grip strength / pressure, no validation","Limited confound adjustment (no mental‑health, moral, partner factors)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-026-01358-w"}},{"id":3327,"doi":"10.1080/00224499.2025.2555053","pmid":"40932457","pmcid":null,"title":"Trends in Masturbation Prevalence and Associated Factors: Findings from the British National Surveys of Sexual Attitudes and Lifestyles","authors":"Fischer N, Kozák M, Graham CA, Clifton S, Mercer CH, Mitchell KR.","first_author":"Fischer N","journal":"Journal of sex research","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"repeat cross‑sectional probability sample surveys (Natsal‑2, Natsal‑3) of the British general population","sample_n":26723,"sample_text":"11161 individuals aged 16‑44 in 1999‑2001; 15 162 individuals aged 16‑74 in 2010‑12","population":"UK residents, ages 16‑74 (Natsal‑2: 16‑44; Natsal‑3: 16‑74)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"British national surveys show a modest rise in past‑month masturbation between the early 2000s and 2010‑12. Men who have sex frequently are less likely to masturbate, whereas women who have sex frequently are more likely. Masturbation is linked with sexual dissatisfaction, partner interest mismatches, and sexual difficulties.","clinical_takeaway":"Masturbation is common and may serve as an alternative sexual outlet when partnered sex is problematic; clinicians should consider it in discussions of sexual wellbeing.","confidence":0.8,"topic_tags":["masturbation","prevalence","sexual_function","relationships"],"strengths":["Large, nationally representative probability samples","Clear definition of masturbation prevalence (past‑month)","Comprehensive set of sociodemographic and sexual‑relationship variables"],"limitations":["Cross‑sectional design limits causal inference","No measurement or control of moral incongruence or mental‑health covariates","Potential self‑report bias on sexual behaviours"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2025.2555053"}},{"id":3328,"doi":"10.1111/iju.70645","pmid":"42779489","pmcid":null,"title":"Household Income and Sexual Activity Patterns Among Japanese Men: A Latent Class Analysis of a Nationwide Survey","authors":"Yoshimura R, Shimizu N, Yamasaki K, Kurano Y, Shimamoto T, Fukata S, Kikuchi E, Kimura K, Sato Y, Chiba K, Tomoe H, Nagai A, Nagao K, Fukuhara S, Yoshizawa T, Maeda E, Shirai M, Tsujimura A, Sasaki H, Inoue K, Saito M.","first_author":"Yoshimura R","journal":"International journal of urology : official journal of the Japanese Urological Association","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual behavior","Socioeconomic Factors","Income","Latent Class Analysis","Surveys And Questionnaires"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional latent‑class analysis of a large internet‑based national survey (N≈5,735).","sample_n":5735,"sample_text":"Nationwide internet‑based survey of adult men in Japan.","population":"Japanese men aged 20‑79 years, community‑dwelling, recruited via an online panel.","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 5,000 Japanese men, four patterns of sexual activity were identified. Men with higher household incomes were more likely to belong to classes that included regular intercourse, while income was not linked to a class characterised by high desire but little partnered sex.","clinical_takeaway":"Higher income appears linked to more frequent partnered sex among Japanese men, suggesting socioeconomic factors influence sexual activity patterns.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally‑wide sample","Use of validated IIEF items","Latent class approach captures multidimensional sexuality"],"limitations":["Cross‑sectional, cannot infer causality","Internet panel may be self‑selected","Limited adjustment for mental‑health or trauma confounders"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/iju.70645"}},{"id":3329,"doi":"10.1093/jsxmed/qdaf105","pmid":"40500996","pmcid":null,"title":"Are some forms of delayed/inhibited ejaculation more intractable than others? Establishing delayed ejaculation subtypes based on severity of symptomology during partnered sex and masturbation","authors":"Rowland DL, McNabney SM, Kövi Z, Hevesi K.","first_author":"Rowland DL","journal":"The journal of sexual medicine","year":2025,"pub_types":["Journal Article"],"keywords":["Masturbation","Delayed Ejaculation","Lifelong Delayed Ejaculation","Inhibited Ejaculation","Acquired Delayed Ejaculation","Partnered Sex"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of men with delayed ejaculation, sub‑grouped by symptom presence during partnered sex vs masturbation; logistic regression used to compare groups.","sample_n":null,"sample_text":"Not stated in abstract","population":"men reporting delayed ejaculation (sample size not reported in abstract)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study separates men with delayed ejaculation into two groups—those who have trouble ejaculating both during sex with a partner and while masturbating, and those who have trouble only with a partner. It finds that older age, medication use, multiple partners, and lower pleasure during masturbation are linked to the first group, suggesting these factors may be useful discussion points in treatment.","clinical_takeaway":"Assess masturbation experience and related arousal factors when evaluating men with delayed ejaculation, as they may differentiate subtypes and guide treatment.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["first study to subtype delayed ejaculation by partnered vs solo symptomatology","includes a range of behavioural and arousal variables","uses logistic regression to identify predictive factors"],"limitations":["cross‑sectional design cannot infer causality","sample size not reported; authors note need for larger sample","limited control of key confounds (mental health, relationship factors, trauma)","relies on self‑report measures with unclear validation"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf105"}},{"id":3330,"doi":"10.20944/preprints202512.2600.v1","pmid":null,"pmcid":null,"title":"Post-Orgasmic Illness Syndrome: Clinical Presentation, Psychosocial Impact, and Management Challenges Based on Two Case Reports","authors":"Gonçalves AS, Santos RC, Serra S, Teixeira P.","first_author":"Gonçalves AS","journal":"Preprints.org","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":2,"sample_text":"Two cases","population":"two adult men (49‑year‑old married, 18‑year‑old single) presenting to a specialised sexology clinic","country":"unspecified (presumably Brazil based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe two men who develop flu‑like, cognitive and emotional symptoms immediately after orgasm (called Post‑Orgasmic Illness Syndrome). Medical tests were normal; treatment with antidepressants, muscle relaxants, and counselling gave modest improvement.","clinical_takeaway":"Clinicians should consider POIS in patients reporting severe post‑orgasm symptoms and can try a combined pharmacological‑psychological approach, but evidence is limited.","confidence":0.4,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Detailed clinical description of a rare condition","Comprehensive medical work‑up to rule out other causes","Multidisciplinary management approach reported"],"limitations":["Only two cases – no comparison group","No validated outcome measures or standardized POIS scale","Cannot infer prevalence, causality, or treatment efficacy"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202512.2600.v1"}},{"id":3331,"doi":"10.20944/preprints202512.0042.v1","pmid":null,"pmcid":null,"title":"From Autoerotic Objectification to Relational Co-Construction: Orgasm-Centered Sexuality, Partner Use, and Couple Satisfaction","authors":"Romeo VM.","first_author":"Romeo VM.","journal":"Preprints.org","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative conceptual review without empirical data; no sampling frame.","sample_n":null,"sample_text":"None – review article","population":"Not applicable","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The author proposes that focusing on orgasm can either help or hurt a couple’s relationship, depending on whether partners see each other as active participants or as objects for solo pleasure. Mutual meaning‑making protects satisfaction; instrumentalizing a partner may lead to dissatisfaction.","clinical_takeaway":"Clinicians should assess whether couples view orgasm as a shared experience or as a tool for self‑pleasure, and promote mutual mentalisation to support relational health.","confidence":0.5,"topic_tags":["sexual_function","relationships"],"strengths":["Integrates psychodynamic theory with existing dyadic research","Proposes clear, testable multi‑level framework"],"limitations":["No original empirical data; conclusions are speculative","Lacks systematic review methodology and risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202512.0042.v1"}},{"id":3332,"doi":"10.1080/0092623x.2025.2511015","pmid":"40452508","pmcid":null,"title":"Association of Masturbation Parameters with Ease and Subjective Experience of Orgasm in Sexual Relationships","authors":"Sánchez-Pérez GM, Granados R, Sierra JC.","first_author":"Sánchez-Pérez GM","journal":"Journal of sex & marital therapy","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,055 cisgender heterosexual adults; recruitment method not specified","sample_n":1055,"sample_text":"1,055 participants (482 men, 573 women) aged 18‑70 (M=36.55, SD=11.22)","population":"cisgender heterosexual adults, 18‑70 years, community sample (likely convenience/online)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of over a thousand adults, how people masturbate—age they first did so, attitudes toward it, desire, frequency, and how satisfying they find it—was linked to how easily and intensely they orgasm with a partner, with different patterns for men and women.","clinical_takeaway":"Assess masturbation habits and satisfaction when addressing partnered orgasm difficulties in sex therapy.","confidence":0.8,"topic_tags":["masturbation","sexual_function","relationships"],"strengths":["Large sample size (N>1000)","Focus on understudied link between solitary masturbation and partnered orgasm","Separate assessment of multiple masturbation parameters"],"limitations":["Self‑report measures, likely single‑item, no validated scales reported","Cross‑sectional design limits causal inference","Potential selection bias; recruitment method not described"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2025.2511015"}},{"id":3333,"doi":"10.1093/jsxmed/qdaf090","pmid":"40405397","pmcid":null,"title":"A prospective and comparative evaluation of a male masturbation device for premature ejaculation-functional outcomes, safety, and satisfaction assessment: a pilot study","authors":"Alonso-Isa M, García-Gómez B, García-Rojo E, Peña-Vallejo E, Caro-González MDP, Juste-Álvarez S, Calzas-Montalvo C, Sopeña-Sutil R, Rodríguez-Antolín A, Romero-Otero J.","first_author":"Alonso-Isa M","journal":"The journal of sexual medicine","year":2025,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":["Premature Ejaculation","Dapoxetine","Behavioral Therapy","Vibrator","Masturbation Device","Stop-start"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"crossover randomized controlled pilot with 20 men with premature ejaculation","sample_n":20,"sample_text":"20 male patients","population":"male adults diagnosed with premature ejaculation (N=20)","country":"Spain (inferred from author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"high","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 20 men with premature ejaculation, a cognitive‑behavioral program that used a vibrating masturbation device improved latency and symptom scores more than the drug dapoxetine, though the study was small and short‑term.","clinical_takeaway":"Device‑assisted behavioral therapy may help premature ejaculation, but evidence is preliminary; larger trials are needed.","confidence":0.78,"topic_tags":["masturbation","sexual_function","treatment","prevalence"],"strengths":["Crossover RCT design controls for individual differences","Use of validated outcome measures (PEDT, IELT)","Direct comparison with standard pharmacotherapy"],"limitations":["Very small sample (N=20) limits power","No sham/control for device alone","Short follow‑up, no durability data"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf090"}},{"id":3334,"doi":"10.1093/jsxmed/qdag184","pmid":"42398087","pmcid":null,"title":"Development and reliability assessment of a masturbation-adapted sexual health inventory for men to assess postoperative sexual recovery after robot-assisted radical prostatectomy","authors":"Shimizu K, Oka S, Tanaka M, Fujii N, Kobayashi K, Hirata H, Shiraishi K.","first_author":"Shimizu K","journal":"The journal of sexual medicine","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual behavior","Postoperative period","Prostatectomy","erectile dysfunction","Masturbation","Patient Reported Outcome Measures"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdag184"}},{"id":3336,"doi":"10.1080/00224499.2025.2489091","pmid":"40298909","pmcid":null,"title":"Masturbation Trajectories from Late Adolescence into Mid-Adulthood: A Population-Based Longitudinal Study","authors":"Ivanova A, Fluit S, Fischer N, von Soest T, Kozák M.","first_author":"Ivanova A","journal":"Journal of sex research","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Population‑based longitudinal cohort (N=2562) assessed ages 19‑50 with multilevel growth curve modeling.","sample_n":2562,"sample_text":"Large, population‑based sample with repeated measures across adulthood.","population":"Adults (19‑50) from a national probability sample, both sexes, diverse sexual identities.","country":"Not specified (likely Europe based on authors).","controls_mi":"not_applicable","preregistered":false,"quality_score":8,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tracked how often men and women masturbate from age 19 to 50 in a large, population‑based sample. Women’s masturbation rose into their early 30s then fell slightly, while men stayed stable. Relationship status, partnered sex, and sexual fantasies partly explained men’s patterns, and childless people masturbated more than parents.","clinical_takeaway":"Masturbation frequency varies by age, relationship status and parenthood, but remains a normal, autonomous behavior across adulthood.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Large, nationally‑representative longitudinal sample","Appropriate multilevel growth‑curve analysis","Controls for key relational variables (partnered sex, partnership status)","Clear reporting of sex‑specific trajectories"],"limitations":["Self‑report of masturbation frequency may be subject to social desirability bias","No mental‑health or trauma variables included","No pre‑registration disclosed"],"rubric_version":"2.0","raw_total":40,"max_possible":50,"pct_score":80,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":6,"design":9,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2025.2489091"}},{"id":3337,"doi":"10.1080/0092623x.2025.2492097","pmid":"40264300","pmcid":null,"title":"Can Masturbation Regulate PTSD Symptoms? Exploring the Mediating Role of PTSD in Childhood Sexual Abuse and Masturbation Motives","authors":"Gewirtz-Meydan A, Vaillancourt-Morel MP, Godbout N.","first_author":"Gewirtz-Meydan A","journal":"Journal of sex & marital therapy","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.1080/0092623x.2025.2492097","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey, N=624, structural equation modeling mediation analysis","sample_n":624,"sample_text":"Convenience online sample of adults","population":"adults (average age 29.5) survivors of childhood sexual abuse and others","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 624 adults found that post‑traumatic stress symptoms explain why people who experienced childhood sexual abuse are more likely to masturbate for mood improvement, stress relief, or to reduce sexual arousal, suggesting masturbation may act as a coping tool.","clinical_takeaway":"Consider PTSD symptoms when discussing masturbation as a coping strategy with survivors of childhood sexual abuse.","confidence":0.8,"topic_tags":["masturbation","csbd","sexual_function"],"strengths":["large sample (N>600)","uses validated PTSD measure","SEM mediation analysis","focuses on understudied masturbation motives"],"limitations":["cross‑sectional, cannot infer causality","motives scale likely not fully validated","no control for depression/anxiety or moral/religious factors","self‑selected online convenience sample"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2025.2492097"}},{"id":3338,"doi":"10.1186/s12610-025-00261-6","pmid":"40264009","pmcid":"PMC12013116","title":"Prevalence of masturbation and masturbation guilt and associations with partnered sex among married heterosexual Chinese males in an outpatient clinical setting: a retrospective single center study","authors":"Zhang Z, Zhang N.","first_author":"Zhang Z","journal":"Basic and clinical andrology","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Frequency","Masturbation","Partnered Sex","Married Males","Masturbation Guilt"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12013116","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"retrospective single‑center outpatient sample (N=469), self‑report questionnaire, logistic regression for associations","sample_n":469,"sample_text":"retrospective single‑center clinical sample","population":"married heterosexual Chinese males attending an outpatient clinic","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among married Chinese men seen in an outpatient clinic, about 71% reported masturbating and most of those felt some guilt. Younger age and higher education were linked to more frequent masturbation; guilt was linked to anxiety, depression and younger age. Moderate guilt was associated with slightly higher partnered‑sex frequency, while strong guilt showed a weak negative link.","clinical_takeaway":"Masturbation guilt is common and modestly related to mental‑health symptoms and partnered‑sex patterns; clinicians should consider addressing guilt and mood when discussing sexual health.","confidence":0.78,"topic_tags":["masturbation","sexual_function","gender","csbd"],"strengths":["Large single‑center sample for this topic","Includes both behavioural and affective (guilt) measures","Adjusts for many demographic and health covariates"],"limitations":["Cross‑sectional, cannot infer causality","Guilt measured with unspecified, likely non‑validated scale","Moral/religious context not assessed despite relevance","Clinical convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12610-025-00261-6"}},{"id":3339,"doi":"10.1007/s10508-025-03393-y","pmid":"42262720","pmcid":"PMC13597633","title":"Sexual Satisfaction and Orgasm Experiences During Partnered and Solo Sex Among 27,931 Users of the Flo App","authors":"Hewings-Martin Y, Cunningham AC, Rullo J, Blair KL, Prentice C, Klepchukova A, Zhaunova L.","first_author":"Hewings-Martin Y","journal":"Archives of sexual behavior","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Masturbation","Female Sexual Satisfaction","Female Orgasm","Orgasm Frequency","Flo App"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13597633","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large convenience survey of Flo app users (N=27,931), self‑report of partnered and solo sexual activities, orgasm frequency and satisfaction over past six months","sample_n":27931,"sample_text":"Convenience sample of Flo app users, 99 % female, 96 % women","population":"mostly cis‑gender women, average age 28.1, recruited via a commercial sexual‑health app","country":"unspecified (global app)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of almost 28,000 app users, orgasms during partnered sex were linked to higher sexual satisfaction, while more frequent solo orgasms showed a weak negative link. Variety of partnered activities boosted both satisfaction and orgasm rates; solo variety did not.","clinical_takeaway":"Partnered orgasm frequency appears more strongly tied to sexual satisfaction than solo orgasms; clinicians might focus on shared sexual experiences to enhance satisfaction.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Very large sample size","Differentiates solo vs partnered activity","Reports effect sizes"],"limitations":["Self‑selected app users; limited generalisability","Reliance on single‑item, unvalidated self‑report scales","No control for key confounds (moral incongruence, mental health, relationship factors)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03393-y"}},{"id":3340,"doi":"10.1101/2025.09.16.25335841","pmid":null,"pmcid":null,"title":"Partnership-based sexual behaviours among adults in Singapore","authors":"Janhavi A, Gan G, Endo A, Jin Tan RK, Howard N, Prem K, Ho M, Jin S, Dickens BL.","first_author":"Janhavi A","journal":"medRxiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online nationwide survey, n≈2297, self‑report of partner numbers and activities, logistic regression analyses","sample_n":2297,"sample_text":"2,297 eligible respondents after data cleaning","population":"Adults (≥21 y) in Singapore, mixed gender, community sample","country":"Singapore","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2025 online survey of 2,300 Singapore adults described how many partners people had for different sexual activities. More partners, especially with sex workers, were linked to higher odds of reporting an STI.","clinical_takeaway":"Higher numbers of sexual partners, particularly with sex workers, markedly increase STI risk; clinicians should assess partner count in risk screening.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large community sample for Singapore","Detailed partner‑type breakdown","Effect sizes with confidence intervals"],"limitations":["Self‑report, cross‑sectional design","No control for mental‑health or moral variables","Potential volunteer bias in online recruitment"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2025.09.16.25335841"}},{"id":3342,"doi":"10.3389/fpubh.2026.1771881","pmid":"42110259","pmcid":"PMC13149122","title":"Beyond pleasure: exploring the role of sex toys in female sexual functioning and wellbeing-From enhancement to functional necessity","authors":"Stokłosa M, Florczyk I, Wiȩckiewicz G, Kiersten K, Piegza M, Pudlo R.","first_author":"Stokłosa M","journal":"Frontiers in public health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Health Promotion","Sexual Risk Behaviors","Sexual Wellbeing","Orgasm Quality","Sex Toys Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13149122","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online cross‑sectional survey of 199 female university students using FSFI, Sexual Risk Survey and a study‑specific sex‑toy questionnaire","sample_n":199,"sample_text":"female university students","population":"young adult female university students (N=199)","country":"Poland (inferred from authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 199 female students found that using sex toys during masturbation was linked to higher arousal scores, while feeling that a toy is necessary for orgasm was linked to lower arousal, lubrication and orgasm scores. More frequent toy use (solo or with a partner) was also associated with higher sexual‑risk scores.","clinical_takeaway":"Sex‑toy use can enhance arousal but may relate to higher sexual‑risk behaviours; clinicians should discuss safe use and hygiene.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Validated sexual function and risk questionnaires used","Large sample for a single‑site survey","Separate measurement of solo vs partnered toy use"],"limitations":["Convenience university sample limits generalisability","No assessment of moral, mental‑health or trauma confounds","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2026.1771881"}},{"id":3343,"doi":"10.32604/cju.2025.068677","pmid":"42086365","pmcid":null,"title":"Transperineal approach for penetrating injury of corpus spongiosum and bulbous urethra caused by vesicourethral foreign body: a case report","authors":"Yanagida K, Watanabe D, Inoue H, Ujiie T, Mizushima A.","first_author":"Yanagida K","journal":"The Canadian journal of urology","year":2026,"pub_types":["Journal Article","Case Reports"],"keywords":["Urethral stricture","Masturbation","Case Report","Transperineal Approach","Penetrating Urethral Injury","Vesicourethral Foreign Body"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report describing surgical management of a penetrating urethral foreign body inserted for masturbation; no comparative group","sample_n":1,"sample_text":"1 patient","population":"64‑year‑old male","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 64‑year‑old man inserted a bamboo skewer into his urethra for masturbation, causing a deep penile injury. After failed endoscopic removal, surgeons successfully extracted it through a perineal incision, with full recovery after six months.","clinical_takeaway":"Penetrating urethral injuries from inserted objects can be safely managed with a trans‑perineal approach when endoscopic removal fails.","confidence":0.6,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Clear imaging and operative description","Six‑month follow‑up shows no stricture","Highlights an alternative surgical approach"],"limitations":["Single case; no generalisability","No systematic assessment of psychological factors","No comparison to trans‑urethral method"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.32604/cju.2025.068677"}},{"id":3344,"doi":"10.1038/s41443-025-01020-x","pmid":"39881010","pmcid":null,"title":"Cisgender men and women report different patterns of sexual arousal and orgasm during masturbation and sexual relationships","authors":"Adell-Peña I, Sierra JC, Pérez-Amorós C, Mangas P.","first_author":"Adell-Peña I","journal":"International journal of impotence research","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 1000 cisgender Spanish adults, measuring ASEX scores in masturbation vs partnered contexts; MANCOVA/ANOVA analysis","sample_n":1000,"sample_text":"1000 participants recruited Oct 2023–May 2024 (convenience/online unspecified)","population":"heterosexual cisgender Spanish adults (433 men, 567 women), ages 18‑77","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,000 Spanish adults, men and women showed different patterns of arousal and orgasm when comparing solo masturbation with partnered sex. Men felt more aroused with a partner but reached orgasm more often during masturbation; women’s patterns differed.","clinical_takeaway":"Clinicians should consider both gender and sexual context when evaluating sexual function.","confidence":0.7,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Large sample size (N=1000)","Use of validated ASEX instrument","Both solitary and partnered contexts examined","Sex‑by‑context interaction analyzed"],"limitations":["Cross‑sectional design, no causal inference","Convenience sample, limited generalisability","No control for mental‑health, relationship quality, or trauma variables","No effect‑size reporting or pre‑registration"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-025-01020-x"}},{"id":3346,"doi":"10.1093/jsxmed/qdag130","pmid":"42089727","pmcid":null,"title":"Clinical characteristics and outcomes of masturbation aid-based retraining for intravaginal ejaculatory dysfunction: a retrospective case series","authors":"Waki M, Imai S.","first_author":"Waki M","journal":"The journal of sexual medicine","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual Medicine","Ejaculatory Dysfunction","Intravaginal Ejaculatory Dysfunction","Masturbation Aid"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdag130"}},{"id":3347,"doi":"10.1097/gme.0000000000002679","pmid":"41288446","pmcid":null,"title":"Sex toy use among a demographically representative sample of women 60 and older in the United States","authors":"Hille JJ, Graham CA, Sanders SA.","first_author":"Hille JJ","journal":"Menopause (New York, N.Y.)","year":2026,"pub_types":["Journal Article"],"keywords":["Masturbation","Orgasm","Sex Toys."],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national demographically representative survey of women 60+ (N=3001), cross‑sectional questionnaire","sample_n":3001,"sample_text":"national demographically representative sample of older women (N = 3,001)","population":"women aged ≥60 in the United States","country":"United States","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationally representative survey of 3,001 U.S. women aged 60 + found that nearly half of those who masturbated used sex toys often, and toy users reported more frequent orgasms both during masturbation and partnered sex.","clinical_takeaway":"Health providers should discuss sex‑toy use with older women, as it is common and linked to higher orgasm rates.","confidence":0.85,"topic_tags":["sexual_function","masturbation"],"strengths":["Large, demographically representative sample","Separates masturbation from partnered sex","Provides prevalence data for an understudied age group"],"limitations":["Reliance on single‑item self‑report measures","No assessment of mental‑health or moral/religious factors","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/gme.0000000000002679"}},{"id":3348,"doi":"10.1007/s10508-026-03410-8","pmid":"41933269","pmcid":null,"title":"Sexual Fantasies Across Solitary and Partnered Contexts: Exploring Eroticism/Nurturance and Fantasy Target","authors":"Gormezano AM, Kutchko V, Chadwick SB, Burns J, Hunker K, Konermann M, van Anders SM.","first_author":"Gormezano AM","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Nurturance","Sexual Fantasy","Eroticism","Relationship Diversity, Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 546 adults in committed relationships, reporting most recent fantasies during solitary masturbation and during partnered sex; between‑subject comparisons of fantasy content.","sample_n":546,"sample_text":"N = 546 participants recruited online; convenience sample","population":"Adults (18+) in a committed relationship ≥6 months, gender/sex and sexual‑diverse sample","country":"not specified (online international sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People’s sexual fantasies differ depending on whether they are alone or with a partner. Partnered fantasies tend to be more nurturing and focused on the partner, while solitary fantasies are more erotic, especially when they involve someone other than the partner.","clinical_takeaway":"Clinicians should consider the relational context of fantasy content when discussing sexual wellbeing with couples.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample (N > 500) for a sexuality survey","Novel comparison of fantasy content across solitary vs partnered contexts","Includes gender‑ and sexual‑diverse participants"],"limitations":["Cross‑sectional, self‑selected online sample limits causal inference and generalisability","Measures of fantasy content appear study‑specific rather than previously validated scales","No assessment of mental‑health or moral‑incongruence variables that could confound wellbeing outcomes"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03410-8"}},{"id":3350,"doi":"10.1123/ijspp.2025-0454","pmid":"41734091","pmcid":null,"title":"Acute and Delayed Effects of Sexual Activity on Athletic Performance: A Scoping Review Across Sex, Age, and Ethnicity","authors":"Dhahbi W, Briki W, Dergaa I, Slim I, El Omri A, Pyne DB, Ben Saad H.","first_author":"Dhahbi W","journal":"International journal of sports physiology and performance","year":2026,"pub_types":["Scoping Review","Journal Article"],"keywords":["Recovery","Sexual behavior","Coitus","Sports Medicine","Exercise Tolerance","Orgasm","Neuroendocrine Response"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Scoping review following PRISMA-ScR; narrative synthesis of small primary studies (n=2‑16) on acute/delayed sexual activity effects on athletic performance.","sample_n":null,"sample_text":"Review of 16‑plus primary studies with sample sizes 2‑16 each; overall male‑dominated.","population":"Predominantly male athletes (≈99%); age 20‑40; limited ethnic diversity.","country":"Not specified","controls_mi":"not_applicable","preregistered":true,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This scoping review collected studies on how sex, masturbation, or orgasm affect sports performance. It found that activity at least 10‑12 hours before a test does not hurt performance, while activity within 2 hours may affect heart recovery. Evidence is limited, based on tiny male‑only samples, and more diverse research is needed.","clinical_takeaway":"Athletes can likely engage in sexual activity >10 h before competition without harming performance; advise caution only for very short intervals.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Comprehensive mapping of existing literature","Follows PRISMA‑ScR reporting standards","Highlights critical gaps (female representation, ethnicity, age)"],"limitations":["Underlying primary studies are very small and male‑biased","No quantitative synthesis or risk‑of‑bias assessment","Does not isolate masturbation from other sexual activity in primary data"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1123/ijspp.2025-0454"}},{"id":3353,"doi":"10.1080/13685538.2024.2411286","pmid":"39394834","pmcid":null,"title":"Effectiveness of masturbation Premature ejaculation diagnostic tool in diagnosing premature ejaculation in men without vaginal intercourse over the past six months: an observational study","authors":"Zhu Z, Mao Z, Wang C, Chen X, Liu Z, Zhang Y.","first_author":"Zhu Z","journal":"The aging male : the official journal of the International Society for the Study of the Aging Male","year":2024,"pub_types":["Journal Article","Observational Study"],"keywords":["Diagnosis","PE","Mpedt","Non-vaginal-intercourse","Self-masturbation"],"is_oa":false,"oa_url":"https://doi.org/10.1080/13685538.2024.2411286","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational diagnostic accuracy study with 446 patients and 40 controls","sample_n":486,"sample_text":"446 male patients seeking treatment for PE and 40 healthy males without vaginal intercourse in the past six months","population":"men aged 18‑40, some seeking PE treatment, some healthy","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested a new questionnaire (MPEDT) for diagnosing premature ejaculation in men who only masturbate. It found the tool was fairly accurate (about 93% sensitivity, 73% specificity) for this group, suggesting it could help clinicians assess men who don’t have vaginal sex.","clinical_takeaway":"MPEDT may be a useful screening tool for premature ejaculation in men who primarily masturbate.","confidence":0.8,"topic_tags":["masturbation","sexual_function","prevalence","measurement"],"strengths":["Large clinical sample for a diagnostic study","Focus on a neglected population (men without vaginal intercourse)","Provides sensitivity and specificity estimates"],"limitations":["MPEDT appears newly created; validation details unclear","No confidence intervals reported for accuracy metrics","Control group small (n=40) and not matched on key demographics"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13685538.2024.2411286"}},{"id":3354,"doi":"10.1101/2025.04.19.25326111","pmid":null,"pmcid":null,"title":"The influence of computer-controlled Motorbunny™ device use on sexual health and sleep behaviors","authors":"Donahue MJ, Garza M, Considine C.","first_author":"Donahue MJ","journal":"medRxiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.medrxiv.org/content/medrxiv/early/2025/04/21/2025.04.19.25326111.full.pdf","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"pilot three‑way 18‑day cross‑over (4 women)","sample_n":4,"sample_text":"n=4; age=34.0±10.4 years","population":"adult monogamous women, no major neuro/psychiatric disorder","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a tiny pilot of four women, using a computer‑controlled vibrator alone or with a partner was linked to higher self‑reported sexual satisfaction and, in most participants, modest improvements in sleep efficiency and REM sleep compared with periods of sexual abstinence.","clinical_takeaway":"Preliminary data suggest masturbation devices may modestly improve sleep; larger trials are needed before clinical recommendation.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Use of validated PROMIS scales","Objective actigraphy data","Within‑subject crossover design"],"limitations":["Very small sample (n=4)","No control for moral or mental‑health confounds","Findings not generalisable"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2025.04.19.25326111"}},{"id":3355,"doi":"10.31234/osf.io/fzv43_v3","pmid":null,"pmcid":null,"title":"Harmless bodily pleasures are moralized because they are perceived as reducing self-control and cooperativeness","authors":"Fitouchi L, Nettle D.","first_author":"Fitouchi L","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://osf.io/fzv43_v3/download","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Five pre‑registered vignette‑based experiments with large online samples (N>3000 total), between‑subject manipulations of indulgence vs. restraint.","sample_n":3000,"sample_text":"N>3000 across five studies (pre‑registered).","population":"Adults recruited online (likely convenience sample).","country":"Not specified (likely multiple English‑speaking countries).","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors found that people condemn harmless pleasures like masturbation because they think such indulgence weakens self‑control and makes cheating more likely, linking moral judgments to concerns about cooperation.","clinical_takeaway":"None – the study concerns moral attitudes, not clinical sexual health.","confidence":0.7,"topic_tags":["moral_incongruence","masturbation","sexual_function"],"strengths":["Large pre‑registered samples","Experimental manipulation of perceived indulgence","Mediation analyses linking self‑control perceptions to moral judgments","Clear theoretical contribution to purity‑violation literature"],"limitations":["Online convenience sample limits generalisability","Self‑report measures only, no behavioural outcomes","Potential cultural bias not addressed"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/fzv43_v3"}},{"id":3357,"doi":"10.1002/iju5.70128","pmid":"41541906","pmcid":"PMC12803729","title":"Administration of Desloratadine for Postorgasmic Illness Syndrome in a Japanese Teenager","authors":"Ito K, Kobayashi K, Hashimoto K, Yorozuya W, Okabe K, Nofuji S, Sakai Y, Kyoda Y, Tanaka T, Masumori N.","first_author":"Ito K","journal":"IJU case reports","year":2026,"pub_types":["case-study","Journal Article"],"keywords":["Antihistamine","Masturbation","Ejaculatory Disorder","Postorgasmic Illness Syndrome","Wet Dreams"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12803729","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-study","sample_n":1,"sample_text":"one teenager (case report)","population":"single Japanese male adolescent (17‑19 y) with postorgasmic illness syndrome","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A 19‑year‑old Japanese man had flu‑like symptoms after ejaculation. Treating him with the antihistamine desloratadine made the symptoms disappear, suggesting a possible new therapy for post‑orgasmic illness syndrome.","clinical_takeaway":"Desloratadine may help post‑orgasmic illness syndrome, but evidence is limited to a single case.","confidence":0.7,"topic_tags":["masturbation","sexual_function","gender","pornography"],"strengths":["detailed clinical description","novel therapeutic trial of antihistamine","follow‑up showing symptom resolution"],"limitations":["single case, no control group","no standardized outcome measures","possible placebo effect","no assessment of confounding factors"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/iju5.70128"}},{"id":3358,"doi":"10.1080/19317611.2024.2389996","pmid":"39552627","pmcid":"PMC11562910","title":"Are Specific Sexual Activities During Partnered Sex and Masturbation Related to Sexual Problems in Men?","authors":"Rowland DL, McNabney SM, Attinger DR, Harrold KJ, Hevesi K.","first_author":"Rowland DL","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexual activities","erectile dysfunction","Masturbation","Premature Ejaculation","Delayed Ejaculation"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional internet questionnaire (n=2,807) examining associations between type of sexual activities (masturbation, partnered sex) and self‑reported sexual problems (ED, PE, DE).","sample_n":2807,"sample_text":"2,807 cisgender men completed an internet‑based questionnaire.","population":"cisgender men, recruited online (convenience sample).","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 2,800 men, those with erectile or delayed ejaculation more often used self‑stimulation during intercourse, while men with premature ejaculation did less foreplay. These patterns may reflect different ways men try to manage arousal when they have sexual problems.","clinical_takeaway":"Sexual problems are linked to distinct activity patterns; clinicians might explore these behaviors when counseling men with ED, PE, or DE.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Large sample size for a survey","Focus on specific sexual behaviors","Differentiates among multiple sexual problems"],"limitations":["Cross‑sectional, cannot infer causality","Self‑report measures likely unvalidated","Convenience internet sample limits generalisability","Key confounds (e.g., mental health, relationship factors) not assessed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2024.2389996"}},{"id":3360,"doi":"10.1093/sxmrev/qeaf060","pmid":"41104681","pmcid":null,"title":"Sexual health outcomes following gender affirming metoidioplasty: a systematic review","authors":"Goldstein B, Uloko M, Okamuro K, Moore M, Peters BR, Blumenthal J, Marinkovic M, Anger J.","first_author":"Goldstein B","journal":"Sexual medicine reviews","year":2026,"pub_types":["Systematic Review","Journal Article"],"keywords":["Sensation","Penetration","Satisfaction","Arousal","Masturbation","Sexual Health","Orgasm","Erection","Metoidioplasty","Gender Affirming Care"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 23 studies on sexual health after metoidioplasty; PRISMA‑compliant search, independent screening, Newcastle‑Ottawa quality assessment. Primary studies used ad‑hoc questionnaires with limited validation.","sample_n":null,"sample_text":"Twenty‑three papers met inclusion criteria; primary studies varied widely in size and used non‑standardised measures.","population":"Transmasculine individuals who have undergone metoidioplasty (aggregate of 23 studies).","country":"International (studies drawn from PubMed, Embase, Web of Science).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review summarised 23 studies of trans men after metoidioplasty, finding generally good sensation and erection but limited ability for penetrative sex. Masturbation and orgasm rates were fairly high, while overall sexual satisfaction ranged from moderate to high. The authors note that most data come from non‑standardised surveys and call for larger, better‑measured studies.","clinical_takeaway":"Metoidioplasty usually preserves sensation and erection, but patients should be counseled that penetrative intercourse may remain limited.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["PRISMA‑compliant systematic search","Independent screening by multiple reviewers","Quality assessment using Newcastle‑Ottawa Scale"],"limitations":["All primary studies used ad‑hoc, non‑validated questionnaires","Sexual health was often a secondary outcome in primary papers","Small, heterogeneous samples limit generalisability"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeaf060"}},{"id":3361,"doi":"10.1177/15409996251405048","pmid":"41468070","pmcid":null,"title":"Emotional and Physical Symptoms in Women with Peri-Orgasmic Phenomena","authors":"Streicher LF, Simon JA.","first_author":"Streicher LF","journal":"Journal of women's health (2002)","year":2026,"pub_types":["Journal Article"],"keywords":["Women","Sexual Health","Orgasm","Physical Symptoms","Emotional Symptoms","Peri-orgasmic Phenomena"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Convenience online survey of 86 women recruited via a social‑media video; six‑item self‑report questionnaire; descriptive statistics only.","sample_n":86,"sample_text":"86 respondents (out of 3,800 video viewers).","population":"Women (18+) reporting peri‑orgasmic physical or emotional symptoms; self‑selected, not representative.","country":"Not specified (online recruitment).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A brief online survey of 86 women who experience unusual physical or emotional reactions during orgasm found a variety of symptoms, most often emotional, and that they tend to occur more with partnered sex than with masturbation.","clinical_takeaway":"Reassure women that peri‑orgasmic symptoms are reported but rare, and that further clinical evaluation is only needed if they cause distress.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Highlights a largely neglected sexual‑health phenomenon.","Distinguishes partner‑versus masturbation contexts.","Anonymous online data collection reduces social desirability bias."],"limitations":["Convenience, self‑selected sample; not generalizable.","Ad‑hoc, non‑validated questionnaire.","No statistical power justification or inferential analyses."],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/15409996251405048"}},{"id":3362,"doi":"10.1016/j.ijid.2024.107219","pmid":"39181439","pmcid":null,"title":"Association between saliva use for masturbation and urethral gonorrhoea in men who have sex with men: A cross-sectional study","authors":"Tran J, Fairley CK, Ong JJ, Aung ET, Chow EPF.","first_author":"Tran J","journal":"International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases","year":2024,"pub_types":["Journal Article"],"keywords":["Saliva","MSM","Masturbation","Gonorrhoea","Autoinoculation"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross‑sectional survey of MSM attending a sexual‑health clinic (N=3114); logistic regression of recent sexual practices vs urethral gonorrhoea","sample_n":3114,"sample_text":"3114 men, median age 32 y","population":"MSM adults (≥18 y) at Melbourne Sexual Health Centre, 2021‑2023","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 3114 men who have sex with men, using saliva as a lubricant for masturbation was not linked to urethral gonorrhoea, while having more condomless insertive partners was.","clinical_takeaway":"Counselling should focus on condomless insertive anal sex rather than saliva‑based masturbation as a gonorrhoea risk.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Large clinic‑based sample (N>3000)","Objective microbiological outcome","Multivariable adjustment for key sexual‑behaviour covariates"],"limitations":["Cross‑sectional design cannot infer causality","Convenience sample from a sexual‑health centre limits generalisability","Limited assessment of psychosocial confounders (e.g., mental health, moral incongruence)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijid.2024.107219"}},{"id":3363,"doi":"10.1080/0092623x.2024.2391348","pmid":"39155865","pmcid":null,"title":"The Motives for Solo Masturbation Scale: Development and Preliminary Validation","authors":"de Jong DC, Adams KN.","first_author":"de Jong DC","journal":"Journal of sex & marital therapy","year":2024,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Scale development and validation study with 2,960 adult participants; exploratory and confirmatory factor analysis; measurement invariance testing across gender and relationship status.","sample_n":2960,"sample_text":"Community sample recruited online (presumably self‑selected)","population":"Adults 18–84 years (community sample, 60% men, 37% women)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and preliminarily validated a 24‑item questionnaire that measures why people masturbate, identifying eight motives such as pleasure, coping, and avoidance of risky sex. The scale showed good reliability and works similarly for men and women and for people with or without a romantic partner.","clinical_takeaway":"The new scale offers clinicians a reliable way to explore clients' masturbation motives, which may help differentiate healthy motivations from compulsive patterns.","confidence":0.7,"topic_tags":["masturbation","sexual_function","measurement"],"strengths":["Large, age‑diverse sample","Rigorous factor‑analytic procedures","Measurement invariance across gender and relationship status","Evidence of convergent validity"],"limitations":["Self‑selected online sample may limit generalisability","Moral incongruence not directly measured","Cross‑sectional; no test‑retest reliability reported"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2024.2391348"}},{"id":3365,"doi":"10.1038/s41443-024-00961-z","pmid":"39128938","pmcid":null,"title":"Associations between masturbation frequency, anxiety, and sleep disturbances during the COVID-19 era","authors":"Shan D, Song Y, Zhang Y, Luo P, Dai Z, Dai Z.","first_author":"Shan D","journal":"International journal of impotence research","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of Chinese adults (N=1423, 930 analyzed) assessing self‑reported masturbation frequency categories and validated anxiety (GAD‑7) and sleep (PSQI) scales.","sample_n":1423,"sample_text":"1423 valid responses (930 who reported masturbation were analyzed in‑depth).","population":"Chinese adults aged 18‑54, recruited via an online survey platform; convenience sample.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2025 Chinese online survey of 1,423 adults, higher self‑reported masturbation frequency was linked to greater anxiety and poorer sleep quality. Moderate frequency showed the lowest symptom scores. The study is cross‑sectional and cautions that causal conclusions cannot be drawn.","clinical_takeaway":"Higher masturbation frequency may be associated with increased anxiety and sleep problems, but causality is unclear; clinicians should consider broader context and avoid assuming pathology.","confidence":0.85,"topic_tags":["masturbation","sexual_function"],"strengths":["Validated anxiety and sleep questionnaires","Large sample size for a survey","Effect sizes reported"],"limitations":["Cross‑sectional design, cannot infer causality","Masturbation frequency measured with a crude, non‑validated single item","No control for moral, relational, or mental‑health confounds beyond anxiety"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-024-00961-z"}},{"id":3366,"doi":"10.1093/jsxmed/qdae059","pmid":"38842265","pmcid":null,"title":"Relationship between the frequency and duration of masturbation and the sexual health literacy and sexual function of women in western Turkey: a cross-sectional study","authors":"Karaahmet AY, Bilgiç FŞ.","first_author":"Karaahmet AY","journal":"The journal of sexual medicine","year":2024,"pub_types":["Journal Article"],"keywords":["Sexuality","Masturbation","Muslim","Sexual Health Literacy"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional descriptive study using snowball sampling of 921 young Muslim women in western Turkey, online self‑report questionnaire","sample_n":921,"sample_text":"snowball recruitment via online platform","population":"young Muslim women, 18‑25 y, Turkey (n=921)","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 921 Turkish Muslim women aged 18‑25, more frequent and longer masturbation episodes were linked to higher sexual health knowledge and better sexual function. The study used online self‑reports and found statistical associations, but it cannot prove that masturbation causes these benefits.","clinical_takeaway":"Higher masturbation frequency/duration correlates with better sexual function and literacy, but no causal claim can be made.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["large sample (n = 921)","focus on understudied population (young Muslim women)","examines both frequency and duration of masturbation"],"limitations":["snowball, non‑probability sampling limits generalisability","unclear validation of questionnaires","no control for moral, mental‑health or relationship confounds","cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdae059"}},{"id":3367,"doi":"10.1016/j.physbeh.2025.115203","pmid":"41390043","pmcid":null,"title":"Sexual activity before exercise influences physiological response and sports performance in high-level trained men athletes","authors":"Fernández-Lázaro D, Garrosa M, Santamaría G, Roche E, Izquierdo JM, Seco-Calvo J, Mielgo-Ayuso J.","first_author":"Fernández-Lázaro D","journal":"Physiology & behavior","year":2026,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":["Testosterone","Cortisol","Exercise performance","Muscle Damage Biomarkers"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized crossover trial with 21 trained male athletes comparing masturbation-induced orgasm vs abstinence 30 min before performance tests","sample_n":21,"sample_text":"21 well‑trained male athletes","population":"well‑trained male athletes, age 22 ± 1 y (N = 21)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 21 trained male athletes, masturbating 30 minutes before a cycling and grip‑strength test slightly improved exercise duration and heart rate, raised testosterone and cortisol, and lowered one muscle‑damage marker, suggesting no harmful impact on short‑term performance.","clinical_takeaway":"Masturbation shortly before competition does not appear to impair performance in well‑trained men.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Randomized crossover design","Objective physiological and performance measures","Clear operationalisation of masturbation condition"],"limitations":["Very small sample (N=21) limits power","No effect sizes or confidence intervals reported","No assessment of potential psychological confounds"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.physbeh.2025.115203"}},{"id":3368,"doi":"10.1186/s12885-025-15410-3","pmid":"41345847","pmcid":"PMC12794404","title":"Updated dose-response meta-analysis of sexual activity and prostate cancer risk","authors":"Raeisvandi A, Omidi S, Javaheri M, Moradi H, Poorolajal J.","first_author":"Raeisvandi A","journal":"BMC cancer","year":2025,"pub_types":["Meta-Analysis","Systematic Review","review-article","Journal Article"],"keywords":["Meta-analysis","Sexual activity","prostate cancer","Sexual Partners","Intercourse"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12794404","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Systematic review and dose‑response meta‑analysis of 29 observational studies (N=315,193). Pre‑registered protocol (PROSPERO). Random‑effects model, I² heterogeneity, publication‑bias tests.","sample_n":315193,"sample_text":"315,193 participants across 29 cohort / case‑control studies","population":"Adults (men) from observational studies of sexual behavior and prostate cancer risk.","country":"Multiple (global literature)","controls_mi":"not_applicable","preregistered":true,"quality_score":8,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 29 studies (over 315,000 men) found that more frequent ejaculations are linked to a lower risk of prostate cancer, while other sexual‑behavior factors (intercourse frequency, number of partners, masturbation) showed no clear association.","clinical_takeaway":"Higher ejaculation frequency may modestly reduce prostate‑cancer risk; other sexual‑behavior metrics appear unrelated.","confidence":0.85,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Large pooled sample, pre‑registered protocol","Comprehensive literature search across multiple databases","Dose‑response analysis with clear effect estimates"],"limitations":["Reliance on heterogeneous observational studies with varying exposure definitions","Potential residual confounding not assessable from abstract"],"rubric_version":"2.0","raw_total":38,"max_possible":50,"pct_score":76,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":9,"confounds":5,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12885-025-15410-3"}},{"id":3369,"doi":"10.31234/osf.io/fzv43_v2","pmid":null,"pmcid":null,"title":"Harmless bodily pleasures are moralized because they are perceived as reducing self-control and cooperativeness","authors":"Fitouchi L, Nettle D.","first_author":"Fitouchi L","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/fzv43_v2","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"pre-registered vignette experiments with N>3000 total, cross‑sectional, between‑subjects manipulations of perceived indulgence","sample_n":3000,"sample_text":"Total participants across five experiments exceeded 3000; individual study Ns not specified in abstract","population":"adult participants recruited online (presumably convenience sample)","country":"not specified","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"The authors ran five large experiments showing that people tend to morally condemn harmless pleasures like sex, food, or alcohol because they think such indulgence lowers self‑control and makes individuals less cooperative.","clinical_takeaway":"Moral judgments about sexual behavior may stem from perceived self‑control loss rather than actual harm; clinicians should consider clients’ moral beliefs when addressing sexual concerns.","confidence":0.8,"topic_tags":["moral_incongruence","sexual_function","masturbation"],"strengths":["Large total sample size","Pre‑registered experiments","Multiple behavioral scenarios tested"],"limitations":["Reliance on self‑report Likert scales without validated moral‑judgment instruments","No measurement of participants’ own moral/religious attitudes","Cross‑sectional vignette design cannot establish real‑world behavior"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/fzv43_v2"}},{"id":3370,"doi":"10.1080/00224499.2024.2370943","pmid":"38935022","pmcid":null,"title":"(Dis)Similarities in Attitudes Between Partners About Women's Solo Masturbation: A Dyadic Approach to Solo Masturbation and Its Associations with Sexual Satisfaction","authors":"Kılıç D, Armstrong HL, Graham CA.","first_author":"Kılıç D","journal":"Journal of sex research","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online dyadic survey of 104 mixed‑sex couples; correlational analysis using APIM","sample_n":104,"sample_text":"104 couples (208 participants)","population":"adult couples (mean age ≈27 y) recruited via social‑media and Prolific; community sample, not clinical","country":"unspecified (online recruitment, likely multiple countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 104 couples, both partners generally held positive attitudes toward women’s solo masturbation. Women who had more positive attitudes reported higher sexual satisfaction for themselves and their partners, while men’s attitudes showed no link to satisfaction.","clinical_takeaway":"Positive attitudes about solo masturbation may enhance sexual satisfaction within couples; clinicians might discuss and normalize solo masturbation with partnered clients.","confidence":0.78,"topic_tags":["masturbation","sexual_function","relationships"],"strengths":["Use of validated attitude and satisfaction scales","Dyadic analytic approach (APIM) captures partner effects","Reasonable sample size for a survey of couples"],"limitations":["Cross‑sectional; cannot infer causality","Convenience online sample may limit generalizability","No control for moral or mental‑health variables"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2024.2370943"}},{"id":3371,"doi":"10.1007/s10508-024-02929-y","pmid":"38918329","pmcid":null,"title":"The Association Between Atypical Masturbation and Male Sexual Dysfunction: A Study Based on Men in Heterosexual Relationships","authors":"Wang C, Chen X, Liu Z, Zhang Y.","first_author":"Wang C","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual function","erectile dysfunction","Premature Ejaculation","Atypical Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of Chinese heterosexual men (N=2743) using self‑report questionnaires","sample_n":2743,"sample_text":"2743 valid questionnaires collected Dec 2020–Apr 2021 via social‑media posts","population":"heterosexual adult men in China, recruited via social media","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Chinese online survey of 2743 heterosexual men, about 11% reported using masturbation techniques that differ from partnered sex. Men who used these “atypical” techniques scored lower on erectile function and were more likely to have erectile dysfunction, but showed no difference in premature ejaculation rates.","clinical_takeaway":"Clinicians should ask about the type of masturbation practices when evaluating men with erectile dysfunction.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Large sample size for a survey","Use of validated sexual function instruments (IIEF‑6, PE tool)","Clear definition of “atypical” masturbation for the purpose of the study"],"limitations":["Atypical masturbation measured with an ad‑hoc single item, limiting construct validity","Cross‑sectional design cannot infer causality","No control for key confounds (moral attitudes, mental health, partner factors, trauma)","Convenience recruitment via social media limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02929-y"}},{"id":3372,"doi":"10.1038/s41443-025-01191-7","pmid":"41152586","pmcid":null,"title":"Colombian validation of the orgasm rating scale in the contexts of sexual relationships and solitary masturbation","authors":"Cervilla O, Gómez-Lugo M, Sierra JC, Álvarez-Muelas A.","first_author":"Cervilla O","journal":"International journal of impotence research","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study with large community sample (N=1097) using confirmatory factor analysis and reliability analysis","sample_n":1097,"sample_text":"Adults from the general Colombian population recruited online","population":"Colombian adults 18‑62 years, community sample","country":"Colombia","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The Orgasm Rating Scale was tested with 1,100 Colombian adults and shown to reliably measure how people experience orgasm both with a partner and during solo masturbation, supporting its use in therapy and research.","clinical_takeaway":"The ORS is a reliable tool for assessing subjective orgasm quality in Colombian clients, useful in sexual and couple therapy.","confidence":0.8,"topic_tags":["sexual_function","measurement","pornography","masturbation"],"strengths":["Large sample size","Confirmatory factor analysis confirms original structure","Good reliability (omega 0.74‑0.94)","Separate assessment of relationship vs solitary contexts"],"limitations":["Self‑report only, no objective measures","Cross‑sectional, cannot assess test‑retest stability","Moral/religious or mental‑health covariates not examined"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-025-01191-7"}},{"id":3373,"doi":"10.1080/19317611.2024.2344812","pmid":"39148919","pmcid":"PMC11323945","title":"Exploring the Role of Masturbation as a Coping Strategy in Women","authors":"Wehrli FSV, Bodenmann GJ, Clemen J, Weitkamp K.","first_author":"Wehrli FSV","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Masturbation","Coping","Psychological Distress","Concurrent Mixed-method Design","Clitoral And Vaginal Stimulation"],"is_oa":true,"oa_url":"https://doi.org/10.1080/19317611.2024.2344812","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"concurrent mixed‑method (quantitative regression + qualitative content analysis) using a convenience sample of 370 women","sample_n":370,"sample_text":"convenience sample of 370 women","population":"women (N=370), convenience sample","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 370 women, higher psychological distress was linked to more frequent clitoral masturbation, but not to combined clitoral‑vaginal masturbation. Qualitative interviews described masturbation as a coping and self‑care practice that produced positive feelings.","clinical_takeaway":"Clitoral masturbation may serve as an effective coping strategy for stress, but evidence is correlational.","confidence":0.71,"topic_tags":["masturbation","csbd","sexual_function"],"strengths":["Large community sample (N≈370)","Mixed‑method approach adds depth","Separate analysis of stimulation modes"],"limitations":["Cross‑sectional; cannot infer causality","Psychological distress measurement not specified as validated","Convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2024.2344812"}},{"id":3374,"doi":"10.1007/s10508-025-03235-x","pmid":"41044291","pmcid":"PMC12675602","title":"The Prevalence of Sexsomnia in a General Population Sample","authors":"Pallesen S, Saxvig IW, Waage S, Schenck CH, Bjorvatn B.","first_author":"Pallesen S","journal":"Archives of sexual behavior","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Masturbation","Parasomnia","Sexual Behaviors","Intercourse","Sexsomnia","Fondling"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12675602","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 1002 Norwegian adults recruited from an online panel; logistic regression used to identify predictors of self‑reported sexsomnia.","sample_n":1002,"sample_text":"Community sample recruited from a Norwegian survey panel; online self‑report questionnaire.","population":"general adult population (N=1002, 508 M/494 F, mean age ≈ 50 y)","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a national Norwegian survey of 1,000 adults, about 1 in 10 reported ever having sex somnia (sexual activity during sleep) and 6 % reported it currently. Men, people with sleep terrors, and those who act out dreams were more likely to experience it. Masturbation and fondling were the most common behaviours.","clinical_takeaway":"Sexsomnia appears relatively common; clinicians should ask about nocturnal sexual behaviours when evaluating sleep complaints.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large, gender‑balanced community sample","Clear prevalence estimates with confidence intervals","Multivariate logistic regression identifies sleep‑related predictors"],"limitations":["Self‑report, non‑validated sexsomnia items","No control for psychological or relational confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03235-x"}},{"id":3375,"doi":"10.1007/s10508-025-03237-9","pmid":"41039091","pmcid":"PMC12675600","title":"Women's Experiences with Exercise-Induced Orgasm: Findings from Qualitative Interviews","authors":"Herbenick D, Perry CP, Fortenberry JD, Wasata R, Wilson J, Miller O, Willens K, Williams A, Frey G.","first_author":"Herbenick D","journal":"Archives of sexual behavior","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual development","Arousal","Orgasm","Sexual Pleasure","Exercise-induced Orgasm"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12675600","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative semi-structured interviews with 21 adult women","sample_n":21,"sample_text":"21 participants (18 in‑person, 3 virtual)","population":"Adult women (19‑68 y), recruited for interview participation (likely convenience sample)","country":"USA (presumed based on authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 21 women revealed that some experience orgasms during vigorous exercise, describing the sensations, contexts, and personal meanings of these exercise‑induced orgasms.","clinical_takeaway":"Exercise‑induced orgasm is a legitimate, varied experience that clinicians should recognize and discuss without pathologising it.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight into a little‑studied phenomenon","Diverse age range of participants","Systematic coding into thematic categories"],"limitations":["Small, non‑representative convenience sample","No standardized measures of orgasm or related constructs","No assessment of potential confounds (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03237-9"}},{"id":3376,"doi":"10.1093/jsxmed/qdaf197","pmid":"40801170","pmcid":null,"title":"A lifespan perspective on lifelong premature ejaculation: unresolved issues and new insights","authors":"Cote-Leger P, Althof SE, Rowland DL.","first_author":"Cote-Leger P","journal":"The journal of sexual medicine","year":2025,"pub_types":["Journal Article"],"keywords":["Lifespan","Premature Ejaculation","Sexual Debut","Lifelong Premature Ejaculation","Ejaculatory Latency","Ejaculatory Control","Rapid Ejaculation"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective‑current online survey of men with lifelong premature ejaculation (n≈160); convenience sampling via social media; self‑reported ejaculatory latency and foreplay at sexual debut and now.","sample_n":160,"sample_text":"409 men with PE, 160 identified as having LPE; recruited through social‑media advertisements.","population":"adult men reporting lifelong premature ejaculation; recruited online, likely skewed toward younger, internet‑savvy respondents.","country":"not specified (online international sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Men who have had lifelong premature ejaculation tend to report very short ejaculation times (1‑2 minutes) that stay the same from their first sexual experiences to now, no matter whether they are with a partner or masturbating. Small changes in timing are linked to the type of sexual activity.","clinical_takeaway":"Premature ejaculation appears stable over time; treatment should consider activity‑specific variations rather than expecting natural improvement.","confidence":0.7,"topic_tags":["sexual_function","prevalence","masturbation","lgbtq"],"strengths":["large sample of men with LPE","first study to examine lifespan consistency of PE symptoms","includes both partnered sex and masturbation comparisons"],"limitations":["Retrospective self‑report prone to recall bias","Convenience online recruitment limits generalisability","No validated PE questionnaire used","Key confounders (e.g., mental health, moral attitudes) not measured"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf197"}},{"id":3377,"doi":"10.21203/rs.3.rs-5286116/v1","pmid":null,"pmcid":null,"title":"Identifying subgroups of Chinese men who have sex with men based on sexual behavior and drug use patterns using a clustering analysis approach","authors":"She B, Sun J, Lu F, Lin S, Liu Y, Li G, Hu Y, Tang W, Tan R, Ong J, Su S, Zhang L.","first_author":"She B","journal":"Research Square","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-5286116/v1","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cluster analysis of 890 Chinese MSM recruited via WeChat ads; cross‑sectional survey of sexual behavior, drug use, condom attitudes; hierarchical clustering to identify subgroups.","sample_n":890,"sample_text":"Convenience sample recruited through community‑based organization advertisements on WeChat (self‑selected).","population":"MSM (men who have sex with men) in six Chinese cities, N=890","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 890 Chinese men who have sex with men identified three subgroups based on sexual behavior and drug use. Those who used drugs during sex showed higher numbers of partners, more condomless sex, and greater PrEP use, while another subgroup was notable for frequent solo masturbation.","clinical_takeaway":"Clinicians should recognise that sexualized drug use identifies MSM at higher sexual‑risk, independent of masturbation patterns.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Large community sample for MSM in China","Use of clustering to uncover heterogeneity","Inclusion of both SDU and masturbation variables"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on self‑report, no validated scales","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-5286116/v1"}},{"id":3378,"doi":"10.15441/ceem.23.182","pmid":"38485261","pmcid":"PMC12010808","title":"Masturbation-induced presyncope: a case report of painless aortic dissection in immunoglobulin G4-related disease","authors":"Sanky C, Sasi N.","first_author":"Sanky C","journal":"Clinical and experimental emergency medicine","year":2025,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Masturbation","Aortic Dissection","Presyncope","Case Reports","Immunoglobulin G4-related Disease"],"is_oa":true,"oa_url":"https://www.ceemjournal.org/upload/pdf/ceem-23-182.pdf","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient","sample_n":1,"sample_text":"single case","population":"59‑year‑old male with IgG4‑related disease","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 59‑year‑old man experienced a painless type A aortic dissection shortly after masturbating. The authors suggest his underlying IgG4‑related disease may have contributed to the vascular event and advise clinicians to consider aortic problems when evaluating similar symptoms.","clinical_takeaway":"Clinicians should keep aortic dissection in mind as a rare but possible cause of presyncope after sexual activity, especially in patients with inflammatory vascular disease.","confidence":0.9,"topic_tags":["masturbation","adolescents"],"strengths":["Clear clinical description","Novel association reported"],"limitations":["Single case, no generalizability","No systematic assessment of masturbation frequency or related psychosocial factors","No control or comparison group"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.15441/ceem.23.182"}},{"id":3379,"doi":"10.21203/rs.3.rs-5197676/v1","pmid":null,"pmcid":null,"title":"Visual real-time monitor ejaculatory-orgasm using transrectal ultrasound to identify the cause of Aspermia","authors":"Wenlong X, Wenrong L, Zhenfan Z, Hui J, Tao J, Letian W, Lei Z, Xiucheng Z.","first_author":"Wenlong X","journal":"Research Square","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-5197676/v1","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 11 men with aspermia, ultrasound monitoring of ejaculation; no control group, small sample","sample_n":11,"sample_text":"11 cases of aspermia; 8 completed real‑time transrectal ultrasound monitoring","population":"men with clinical diagnosis of aspermia (n=11, 8 completed ultrasound)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors used a real‑time transrectal ultrasound during ejaculation in 11 men with aspermia. They observed that in most cases semen flowed back into the bladder (retrograde ejaculation), but in two cases no flow was seen, suggesting a different cause. They argue that current urine‑based tests may misdiagnose some men.","clinical_takeaway":"Ultrasound may help differentiate retrograde ejaculation from other causes of aspermia, but evidence is limited.","confidence":0.6,"topic_tags":["sexual_function","religiosity","measurement"],"strengths":["Novel use of real‑time transrectal ultrasound to visualize ejaculatory dynamics","Direct observation of physiological mechanisms"],"limitations":["Very small, uncontrolled case series","No validated diagnostic criteria tested","Findings not generalizable"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-5197676/v1"}},{"id":3380,"doi":"10.1093/jsxmed/qdaf165","pmid":"40719785","pmcid":null,"title":"No Nut November, temporary abstinence, and sexual wellbeing: a study of the short-term abstinence-based internet trend","authors":"Garas M, Levang SL, Pukall CF.","first_author":"Garas M","journal":"The journal of sexual medicine","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Masturbation","Temporary Abstinence","Sexual Wellbeing","No Nut November"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"online survey with two time points (pre‑ and post‑No Nut November) comparing participants vs non‑participants; N=435 at baseline, 114 at follow‑up","sample_n":114,"sample_text":"435 individuals at T1, 114 at T2","population":"adult internet users (mixed gender, age)","country":"unspecified (presumably multiple, internet‑based)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A web‑based survey of 435 adults examined whether taking part in the “No Nut November” challenge (a month of abstaining from masturbation) changed sexual pleasure, desire, or dysfunction. Participants showed more willingness to try new sexual activities, but no other aspects of sexual wellbeing differed from non‑participants.","clinical_takeaway":"A short period of masturbation abstinence does not appear to improve or worsen sexual wellbeing.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["use of multiple validated sexuality scales","first empirical study of No Nut November","pre‑ and post‑abstinence data"],"limitations":["convenience internet sample, not representative","no control for moral or mental‑health confounds","drop‑out from T1 to T2 reduces power"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf165"}},{"id":3381,"doi":"10.1093/jsxmed/qdad173","pmid":"38258991","pmcid":null,"title":"Masturbation, sexual function, and genital self-image of undergraduate women: a cross-sectional study","authors":"Soares RF, Leites GT, de Araujo TG, Pedreti GP, Cerentini TM, da Rosa PV.","first_author":"Soares RF","journal":"The journal of sexual medicine","year":2024,"pub_types":["Journal Article"],"keywords":["Sexuality","Quality of life","Masturbation","Sexual Satisfaction"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 110 undergraduate women using self‑report questionnaires","sample_n":110,"sample_text":"110 undergraduate female students","population":"undergraduate female students","country":"Brazil (implied by Brazilian version of FSFI)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 110 Brazilian university women, those who felt positive about masturbating and had a better genital self‑image reported higher sexual function scores. Masturbation frequency alone showed little impact, but negative feelings such as shame were linked to poorer sexual outcomes.","clinical_takeaway":"Encourage positive attitudes toward masturbation and address shame to support female sexual wellbeing.","confidence":0.8,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Uses validated scales for sexual function and genital self‑image","Addresses positive and negative emotional contexts of masturbation","Anonymity of online survey reduces social desirability bias"],"limitations":["Masturbation questionnaire not validated","Convenience sample of undergraduates limits generalisability","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdad173"}},{"id":3382,"doi":"10.3390/healthcare12020235","pmid":"38255122","pmcid":"PMC10815145","title":"Relationship between Solitary Masturbation and Sexual Satisfaction: A Systematic Review","authors":"Cervilla O, Álvarez-Muelas A, Sierra JC.","first_author":"Cervilla O","journal":"Healthcare (Basel, Switzerland)","year":2024,"pub_types":["review-article","Review","Journal Article"],"keywords":["Systematic review","Sexual Health","Sexual Relationships","Sexual Satisfaction","Sexual Functioning","Solitary Masturbation"],"is_oa":true,"oa_url":"https://www.mdpi.com/2227-9032/12/2/235/pdf?version=1705498710","cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 22 observational studies on solitary masturbation and sexual satisfaction, registered in PROSPERO, following PRISMA.","sample_n":null,"sample_text":"22 articles selected from 851 records.","population":"Adults (both sexes) from various primary studies; no new sample collected.","country":"Not applicable (review).","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 22 studies found that solitary masturbation is more often linked to lower sexual satisfaction in men, while women show mixed or positive associations. The review suggests future research should look beyond how often people masturbate.","clinical_takeaway":"Masturbation frequency alone does not predict sexual satisfaction; clinicians should consider broader relational and personal factors.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Registered protocol (PROSPERO)","Systematic search across multiple databases","Clear categorisation of gender‑specific findings"],"limitations":["No quantitative synthesis (meta‑analysis)","Primary studies use heterogeneous, often unvalidated measures","Key confounds (e.g., moral incongruence, mental health) not examined"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare12020235"}},{"id":3383,"doi":"10.1093/jsxmed/qdaf113","pmid":"40483719","pmcid":null,"title":"Intermittent premature ejaculation: exploring an understudied phenomenon","authors":"Rowland DL, Althof SE, Cote-Leger P.","first_author":"Rowland DL","journal":"The journal of sexual medicine","year":2025,"pub_types":["Journal Article"],"keywords":["Sexual dysfunction","Premature Ejaculation","Acquired","Intermittent","Lifelong","Rapid Ejaculation"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey of men with self‑identified premature ejaculation; 31 participants classified as having intermittent PE.","sample_n":31,"sample_text":"409 men with PE recruited online; 31 identified as intermittent PE.","population":"Adult men (online sample) with self‑reported PE; 31 intermittent PE cases.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study describes men whose premature ejaculation appears only occasionally rather than consistently, showing that their ejaculation times differ between PE and non‑PE episodes, but the small sample limits broader conclusions.","clinical_takeaway":"Intermittent PE may meet ICD‑11 criteria for treatment, but clinicians should note its episodic nature before applying standard PE protocols.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["First description of intermittent PE subtype","Large initial PE sample (N=409) for screening"],"limitations":["Very small subgroup (N=31) limits precision","Convenience online recruitment; limited generalizability","No control for psychological or relational confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf113"}},{"id":3385,"doi":"10.21203/rs.3.rs-2435499/v1","pmid":null,"pmcid":null,"title":"Regular penis-root masturbation: a promising behavioral treatment method for lifelong premature ejaculation","authors":"Memik Ö, Voyvoda B, Üstüner M, Karslı O, Halat A, ozcan l.","first_author":"Memik Ö","journal":"Research Square","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-2435499/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"single-group pre‑post intervention (N=35) evaluating a new behavioral technique over 3 months","sample_n":35,"sample_text":"35 patients with lifelong PE who had not responded to pharmacotherapy","population":"men with lifelong premature ejaculation, ages 25‑43, recruited from clinical setting","country":"unspecified (preprint)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small pre‑post study of 35 men with lifelong premature ejaculation found that practising a specific type of self‑masturbation three times a week for three months reduced questionnaire scores of PE and roughly quadrupled the time before ejaculation.","clinical_takeaway":"Penis‑root masturbation may improve ejaculatory latency in men unresponsive to medication, but larger controlled trials are needed.","confidence":0.7,"topic_tags":["sexual_function","treatment","prevalence"],"strengths":["Uses validated PE questionnaire (PEDT)","Objective latency measure (IELT)","Clearly described within‑subject protocol"],"limitations":["No control or randomisation","Small sample, no power analysis","No effect‑size reporting or confidence intervals"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-2435499/v1"}},{"id":3386,"doi":"10.1093/sxmrev/qeaf015","pmid":"40207903","pmcid":null,"title":"Blue balls: a brief history","authors":"Janssen DF.","first_author":"Janssen DF.","journal":"Sexual medicine reviews","year":2025,"pub_types":["Historical Article","Journal Article"],"keywords":["Historical review","Testicular Pain","History Of Sexual Medicine","Blue Balls","Epididymal Hypertension"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"historical review of medical literature","sample_n":null,"sample_text":"no empirical sample; literature synthesis only","population":"humans (historical sources)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article traces the medical history of 'blue balls', showing how 19th‑century doctors described scrotal pain linked to sexual arousal and masturbation under many names, and how those ideas intersected with moral debates about sexual continence.","clinical_takeaway":"None – the paper is a historical overview, not a clinical study.","confidence":0.85,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Comprehensive multilingual historical search","Clear articulation of changing nosology","Links medical discourse to broader gendered ideas"],"limitations":["No original data or empirical analysis","No assessment of contemporary clinical relevance","Potential bias of historical sources not examined"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeaf015"}},{"id":3389,"doi":"10.12740/pp/onlinefirst/138338","pmid":"36542768","pmcid":null,"title":"Malignant complications of masturbation - a case study","authors":"Mędrala W, Rodek P, Alli-Balogun B, Barabasz-Gembczyk A, Wójcik P, Kucia K.","first_author":"Mędrala W","journal":"Psychiatria polska","year":2023,"pub_types":["Review","Journal Article","Case Reports"],"keywords":["LAI","Neuroleptic Malignant Syndrome","Vaginal Foreign Body"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single clinical case description of one patient","sample_n":1,"sample_text":"1 patient","population":"adult female with schizophrenia","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 32‑year‑old woman with schizophrenia developed a serious medical complication after a piece of a vitamin capsule got stuck during masturbation. The foreign body caused inflammation that worsened her neuroleptic malignant syndrome, but removal and further treatment led to recovery.","clinical_takeaway":"Clinicians should ask about autoerotic behaviour when unexplained medical or psychiatric deterioration occurs.","confidence":0.8,"topic_tags":["masturbation","neuroscience","csbd","sexual_function"],"strengths":["Detailed clinical description","Highlights importance of thorough sexual history in psychiatric patients","Links physical complication to psychiatric course"],"limitations":["Single case, no generalizability","No systematic measurement or validation of constructs","No statistical analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12740/pp/onlinefirst/138338"}},{"id":3390,"doi":"10.1016/j.jmig.2025.05.016","pmid":"40484369","pmcid":null,"title":"The Osmolality of Sex-the Science of Vaginal Moisturizers and Lubricants","authors":"Pennycuff JF.","first_author":"Pennycuff JF.","journal":"Journal of minimally invasive gynecology","year":2026,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of vaginal lubricants; no primary data, no systematic methods reported.","sample_n":null,"sample_text":"No primary sample; review of existing literature.","population":"Women who use vaginal lubricants (general description only).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews different vaginal lubricants, explaining how they differ, what affects their performance, and how they can be used for masturbation, sex toys, intercourse, and conception.","clinical_takeaway":"Clinicians should ask about lubricant use and consider product osmolarity when advising patients.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Provides a broad overview of lubricant types and uses","Highlights a gap in clinician-patient communication"],"limitations":["No systematic search or critical appraisal of studies","Lacks empirical data or quantitative synthesis","Does not address potential confounds such as sexual practices or health status"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jmig.2025.05.016"}},{"id":3391,"doi":"10.1055/a-2190-9604","pmid":"37827511","pmcid":null,"title":"The Assessment and Management of Childhood Masturbation: An Analysis of 90 Cases","authors":"Güleç A, Öztürk S, Acer H, Canpolat M, Gümüş H, Per H.","first_author":"Güleç A","journal":"Neuropediatrics","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Retrospective case series of 90 children seen in a clinic; no control group, convenience sample.","sample_n":90,"sample_text":"90 patients (23 M/67 F) from 2015‑2020 clinic records.","population":"Children (8 months‑9 years) with observed masturbation behavior seen in a single neuropediatrics clinic.","country":"Turkey (inferred from author names and journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed 90 cases of young children who showed repetitive self‑stimulation (childhood masturbation). They described common triggers (ending breast‑feeding, separation, new sibling) and found that behavioral therapy helped most, while a minority improved with medication.","clinical_takeaway":"In children, repetitive self‑stimulation is often linked to psychosocial stressors and usually responds to behavioral therapy; medication is a secondary option.","confidence":0.7,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Large (for a case series) clinical sample of children","Use of video recordings to confirm behavior","Systematic review of medical records over five years"],"limitations":["Retrospective, no control group","No validated measures of masturbation frequency or distress","Confounding factors (e.g., mental health, family stress) not quantified"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/a-2190-9604"}},{"id":3392,"doi":"10.1016/j.purol.2023.09.010","pmid":"37758608","pmcid":null,"title":"Regular penis-root masturbation: A promising behavioral treatment method for lifelong premature ejaculation","authors":"Memik O, Voyvoda B, Ustuner M, Karsli O, Halat AO, Ozcan L.","first_author":"Memik O","journal":"Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie","year":2023,"pub_types":["Journal Article"],"keywords":["Behavioral Therapy","Thérapie Comportementale","Éjaculation Précoce À Vie","Life-long Premature Ejaculation","Masturbation Des Racines Du Pénis","Penis Root Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"single-group pre‑post pilot study without control","sample_n":35,"sample_text":"35 patients (age 25‑43) with lifelong PE","population":"35 adult men with lifelong premature ejaculation, recruited from clinical setting","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small pilot study tested a new masturbation technique (penis‑root masturbation) in 35 men with lifelong premature ejaculation. After three months, participants reported lower symptom scores and longer ejaculation latency, suggesting the method may help when medicines fail.","clinical_takeaway":"The technique showed short‑term improvement in ejaculation timing, but evidence is limited; clinicians should await larger controlled trials before routine use.","confidence":0.8,"topic_tags":["sexual_function","masturbation","treatment","prevalence"],"strengths":["uses validated PE scales (PEDT) and objective latency time","clear pre‑post within‑subject design","novel behavioral intervention described in detail"],"limitations":["no control or comparison group","small sample limits statistical power","short follow‑up and lack of effect‑size reporting","potential selection bias from clinical population"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.purol.2023.09.010"}},{"id":3393,"doi":"10.1016/j.urology.2023.08.016","pmid":"37741297","pmcid":null,"title":"Erection Hardness Score in Masturbation Can Serve as a Preliminary Screening Tool for Organic Erectile Dysfunction","authors":"Zhang H, Colonnello E, Zhang H, Sansone A, Xi Y, Wang C, Jannini EA, Zhang Y.","first_author":"Zhang H","journal":"Urology","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Diagnostic accuracy study comparing self‑reported EHS during masturbation to NPTR (Rigiscan) in 189 outpatient men with ED.","sample_n":189,"sample_text":"consecutive patients from one clinic; not a probability or community sample","population":"189 consecutive male outpatients reporting erectile dysfunction (IIEF‑6 <26) from a single urology clinic (2020).","country":"China (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 189 men with erectile problems, the researchers found that the self‑rated erection hardness during masturbation could correctly identify organic erectile dysfunction about 86% of the time, with high specificity (96%).","clinical_takeaway":"An EHS of 3‑4 during masturbation suggests non‑organic ED and may reduce the need for more costly nocturnal testing.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Validated psychometric instruments (EHS, IIEF‑6)","Clear diagnostic‑accuracy outcomes (sensitivity, specificity, ROC)","Reasonable sample size for a single‑clinic study"],"limitations":["Convenience sample from a single urology centre – limited generalisability","No adjustment for mental‑health or relationship factors that could affect erection quality","No pre‑registration or open data"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urology.2023.08.016"}},{"id":3395,"doi":"10.5664/jcsm.11554","pmid":"39815730","pmcid":"PMC12048334","title":"Hand dominance shift during sleep in sexsomnia: a clue to pathophysiology?","authors":"Avidan AY, Hasan R, Badami V, Schenck CH.","first_author":"Avidan AY","journal":"Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports","case-report"],"keywords":["Hand Dominance","Sexsomnia","Nrem Parasomnia"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case series of seven individuals with sleep‑related masturbatory behaviour; data are self‑reported observations of hand use during events.","sample_n":7,"sample_text":"Seven cases described in detail.","population":"Adults with sexsomnia (N=7); convenience sample identified through clinical observation.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe seven people who, during sleep, used their non‑dominant hand for masturbatory actions. They suggest this may point to brain‑stem pathways rather than cortical control, but the data are limited to case observations.","clinical_takeaway":"No direct clinical implications; findings are preliminary and hypothesis‑generating.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Rare clinical phenomenon systematically described","Includes polysomnographic confirmation in at least one case"],"limitations":["Very small, non‑representative case series","No validated measures of hand dominance or sexual behaviour","Speculative mechanistic conclusions not supported by data"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5664/jcsm.11554"}},{"id":3396,"doi":"10.1111/iju.15279","pmid":"37605604","pmcid":null,"title":"Traumatic masturbation and erectile dysfunction: A matched case-control study","authors":"Can U, Kafkasli A, Coskun A, Canakci C, Dincer E, Tuncer M, Karatas B.","first_author":"Can U","journal":"International journal of urology : official journal of the Japanese Urological Association","year":2023,"pub_types":["Journal Article"],"keywords":["Sex","erectile dysfunction","Masturbation","Male Sexual Dysfunction","Traumatic Masturbation Syndrome"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"matched case‑control survey of men with erectile dysfunction versus healthy controls","sample_n":448,"sample_text":"Convenience sample from an urology clinic (patients) and recruited healthy volunteers (controls); matched on age.","population":"men presenting with ED (n≈266) and community controls (n≈182), mean age 30 y","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that unusual ways of masturbating are more common in young men with erectile dysfunction, and those men tend to have harder erections during masturbation than during partnered sex.","clinical_takeaway":"When assessing ED, clinicians should ask about atypical masturbation practices, as they may relate to erectile performance differences.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Reasonable total sample size (N = 448)","Use of validated EHS instrument","Separate assessment of erection hardness across contexts"],"limitations":["Atypical masturbatory behavior categories are ad‑hoc and not validated","Potential selection bias from clinic‑based patients and volunteer controls","Limited control for mental‑health, relationship, or trauma confounders"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/iju.15279"}},{"id":3397,"doi":"10.1007/s10508-025-03141-2","pmid":"40263209","pmcid":null,"title":"Individual Differences in Excitatory and Inhibitory Sexual Conditioning in Humans","authors":"Hoffmann H.","first_author":"Hoffmann H.","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexuality","Individual Differences","Conditioned Inhibition","Human Sexual Conditioning"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory‑style conditioning paradigm with 53 participants (26 female, 27 male) over two weeks; within‑subject measurement of conditioned excitatory and inhibitory responses.","sample_n":53,"sample_text":"26 female‑bodied, 27 male‑bodied participants","population":"adult humans (both sexes), university/community volunteers (likely convenience sample)","country":"not specified (non‑U.S. funding)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined how individual differences in sexual excitement and inhibition influence the ability to learn sexual cues that signal pleasure or restraint, using odor cues paired with masturbation or a non‑sexual activity.","clinical_takeaway":"Conditioned sexual responses vary with personal excitability and inhibition; clinicians might consider cue‑reactivity when addressing sexual concerns.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["Experimental conditioning paradigm","Both subjective and physiological outcome measures","Inclusion of both sexes"],"limitations":["Small sample limits statistical power","No control for moral, mental‑health or relational confounds","Reliance on self‑report scales of uncertain validation"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03141-2"}},{"id":3398,"doi":"10.1080/19317611.2023.2237950","pmid":"38596452","pmcid":"PMC10903564","title":"The Role of Mutual Masturbation within Relationships: Associations with Sexual Satisfaction and Sexual Self-Esteem","authors":"Kılıç D, Armstrong HL, Graham CA.","first_author":"Kılıç D","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Satisfaction","Mutual Masturbation","Sexual Self-esteem"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10903564","cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 268 adults in relationships; self‑report measures of solo and mutual sexual activities, sexual satisfaction and self‑esteem; cross‑sectional correlational analysis","sample_n":268,"sample_text":"convenience online sample; not nationally representative","population":"117 women, 151 men, mean age 29.7, mostly heterosexual, currently partnered","country":"unspecified (likely Turkey or UK based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 268 adults in relationships, people who recently engaged in mutual masturbation tended to report higher sexual satisfaction, though it did not affect how they felt about themselves sexually.","clinical_takeaway":"Couples might consider mutual masturbation as a way to boost sexual satisfaction, but it does not appear to change sexual self‑esteem.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Relatively large sample for a sexuality survey","Examines both solo and mutual activity, allowing isolation of mutual masturbation","Focus on both sexes enables gender comparisons"],"limitations":["Reliance on ad‑hoc self‑report items; psychometric properties unclear","Cross‑sectional design precludes causal inference","Convenience online recruitment limits generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2023.2237950"}},{"id":3399,"doi":"10.1093/jsxmed/qdaf004","pmid":"39916367","pmcid":null,"title":"Toys in the bedroom: use of sexual devices in partnered sexual activity is associated with higher female orgasmic intensity, arousal, and sexual satisfaction and is not related to psychopathologies","authors":"Sansone A, Mollaioli D, Colonnello E, Bandini C, Morello M, Marinelli G, Ciocca G, Limoncin E, Jannini EA.","first_author":"Sansone A","journal":"The journal of sexual medicine","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual Satisfaction","Female Sexual Function","Orgasmic Intensity","Sex Toys","Sex Devices"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional descriptive survey of 361 women recruited via social media; comparison of partnered vs solitary sex‑device use; self‑report questionnaires","sample_n":361,"sample_text":"361 participants recruited through a social‑media campaign","population":"sexually active heterosexual women, age 18‑35, in a relationship","country":"unspecified (presumably Italy based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 361 young women, those who used sex toys with a partner reported higher arousal, satisfaction and stronger orgasms than women who only used toys while masturbating. No differences were found for anxiety, depression, or future‑orientation measures.","clinical_takeaway":"Using sex toys during partnered sex may enhance orgasm intensity and sexual satisfaction in young women.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of multiple validated questionnaires","Relatively large sample for a sexuality survey","Clear distinction between partnered and solitary device use"],"limitations":["Cross‑sectional design; no causal inference","Convenience sample recruited online; limited generalisability","No measurement of moral/religious attitudes or partner variables"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf004"}},{"id":3400,"doi":"10.1007/s10508-023-02641-3","pmid":"37365448","pmcid":null,"title":"Actual and Desired Masturbation Frequency, Sexual Distress, and Their Correlates","authors":"Huang S, Nyman TJ, Jern P, Santtila P.","first_author":"Huang S","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Masturbation","Compulsive Sexual Behavior","Finnish","Sexual Distress"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community survey (N=12,271) examining masturbation frequency, desired frequency, sexual distress and related psychosocial variables","sample_n":12271,"sample_text":"Finnish men and women recruited via online survey","population":"Finnish adults (men and women)","country":"Finland","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A Finnish survey of over 12,000 adults found that when people’s actual masturbation frequency differs from what they want, they report more sexual distress. This distress is linked to a history of sexual abuse, depression, anxiety, and a less sex‑positive family background.","clinical_takeaway":"Mismatched masturbation frequency can signal sexual distress; clinicians should explore underlying trauma or mental‑health issues.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Very large sample size","Considers both actual and desired masturbation frequency","Examines multiple psychosocial correlates"],"limitations":["Unclear whether sexual distress scale is validated","No measurement of moral incongruence/religiosity","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02641-3"}},{"id":3401,"doi":"10.1098/rspb.2023.0061","pmid":"37282530","pmcid":"PMC10244968","title":"The evolution of masturbation is associated with postcopulatory selection and pathogen avoidance in primates","authors":"Brindle M, Ferguson-Gow H, Williamson J, Thomsen R, Sommer V.","first_author":"Brindle M","journal":"Proceedings. Biological sciences","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Masturbation","Postcopulatory Sexual Selection","Bayesian Phylogenetics","Pathogen Avoidance"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10244968","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Phylogenetic comparative analysis of masturbation occurrence across primate species using Bayesian methods.","sample_n":null,"sample_text":"Not applicable (species‑level comparative dataset)","population":"Primates (multiple species across the order)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors surveyed reports of masturbation across many primate species and used evolutionary statistical models to show that the behaviour is ancient and likely serves functions such as improving fertilization chances and reducing pathogen load.","clinical_takeaway":"None - the study concerns non‑human primates and does not directly inform human sexual health or treatment.","confidence":0.8,"topic_tags":["masturbation","prevalence","sexual_function"],"strengths":["Broad phylogenetic scope across many primate species","Use of Bayesian comparative methods","Addresses functional hypotheses rather than moral judgments"],"limitations":["Reliance on secondary reports of masturbation; measurement heterogeneity","No direct behavioural observations or experimental validation","Human‑focused confounds (e.g., moral incongruence) irrelevant but not addressed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":28,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1098/rspb.2023.0061"}},{"id":3402,"doi":"10.1017/s0033291723001435","pmid":"37246586","pmcid":null,"title":"Masturbatory insanity: the history of an idea, revisited","authors":"Zachar P, Kendler KS.","first_author":"Zachar P","journal":"Psychological medicine","year":2023,"pub_types":["Historical Article","Review","Journal Article"],"keywords":["Neurasthenia","Hebephrenia","Clouston","Skae","Tissot"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Historical review of psychiatric concepts; no new empirical data collected.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This article traces how 18‑19th‑century psychiatry linked excessive masturbation to mental illness, showing how those ideas evolved and were eventually replaced by other diagnoses such as hebephrenia and neurasthenia.","clinical_takeaway":"None – the paper is a historical review, not a guide for clinical practice.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Comprehensive historical synthesis","Critical re‑examination of classic psychiatric literature"],"limitations":["No new empirical data","No systematic review methodology reported","No assessment of modern measurement validity"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0033291723001435"}},{"id":3403,"doi":"10.1016/j.sleh.2024.11.004","pmid":"40016080","pmcid":null,"title":"Sleep on it: A pilot study exploring the impact of sexual activity on sleep outcomes in cohabiting couples","authors":"Lastella M, Miller DJ, Montero A, Sprajcer M, Ferguson SA, Browne M, Vincent GE.","first_author":"Lastella M","journal":"Sleep health","year":2025,"pub_types":["Journal Article"],"keywords":["Sex","Behavior","Masturbation","Orgasm","Bedtime","Intercourse"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"repeated‑measures counterbalanced crossover (no sex, solo masturbation, partnered sex) with 14 participants (7 couples) monitored over 11 nights using portable polysomnography and daily surveys","sample_n":14,"sample_text":"14 individuals (7 females, 7 males) from cohabiting couples","population":"healthy cohabiting adults (mean age 29.9 y), n = 14","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small crossover study, 14 adults slept after either no sex, solo masturbation, or partnered sex. Objective sleep data showed less wakefulness after sleep onset and better efficiency after the sexual activity conditions, but bedtime was later. Subjective sleep ratings did not differ.","clinical_takeaway":"Sexual activity before bed may improve objective sleep quality, but evidence is limited; clinicians should consider individual preferences and sleep hygiene.","confidence":0.78,"topic_tags":["sexual_function","masturbation"],"strengths":["objective sleep measurement (polysomnography)","within‑subject crossover design controls for individual differences","both solo and partnered sexual activity examined"],"limitations":["very small sample (N=14) limits power and generalisability","no control for moral, mental‑health or trauma variables","pilot nature; findings provisional"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sleh.2024.11.004"}},{"id":3404,"doi":"10.1186/s12889-025-21809-1","pmid":"40001109","pmcid":"PMC11863417","title":"Study on HIV knowledge and cultural attitudes about sexuality among Chinese college students","authors":"Liu D, Liu Y, Ren Z.","first_author":"Liu D","journal":"BMC public health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["China","Masturbation","College Students","Hiv Knowledge"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11863417","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey of 5,945 Chinese college students (age ≈ 19) assessing HIV knowledge (HIV‑KQ‑18) and attitudes toward masturbation (masturbation belief scale).","sample_n":5945,"sample_text":"6350 invited, 5945 complete responses.","population":"Chinese college students (both genders, multiple universities).","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Chinese college students, more accepting attitudes toward masturbation were linked to higher HIV knowledge scores. Age, gender, family wealth, and other demographics also predicted knowledge, suggesting that cultural beliefs influence sexual health awareness.","clinical_takeaway":"Sexual health education should address cultural attitudes toward masturbation to improve HIV knowledge among students.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample size provides adequate statistical power","Use of validated HIV knowledge questionnaire","Focus on culturally relevant attitudes toward masturbation"],"limitations":["Cross‑sectional design limits causal inference","Masturbation belief scale validation unclear","Key confounds (mental health, moral religiosity, trauma) not measured"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-025-21809-1"}},{"id":3405,"doi":"10.1007/s12119-023-10101-2","pmid":"37360020","pmcid":"PMC10213586","title":"Masturbation Among Malaysian Young Adults: Associated Sexual and Psychological Well-Being Outcomes","authors":"Phuah LA, Teng JHJ, Goh PH.","first_author":"Phuah LA","journal":"Sexuality & culture","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Culture","Masturbation","Gender Differences","Self-stimulation","Sexual Satisfaction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10213586","cited_by_count":7,"is_preprint":false,"topics":["masturbation","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire, convenience sample of 621 Malaysian young adults, mean age 22.1 years","sample_n":621,"sample_text":"Convenience online sample","population":"young adults, Malaysia","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 621 Malaysian young adults, most had masturbated at least once. Masturbation frequency was linked to lower sexual satisfaction and higher anxiety and stress, but not to overall life satisfaction or depression. Gender, having a partner, and religiosity did not change these links.","clinical_takeaway":"Masturbation frequency may relate to lower sexual satisfaction and higher anxiety/stress, but no clear effect on overall wellbeing; clinicians should consider context rather than pathologise the behaviour.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Large sample for a regional study","Measures both sexual and psychological outcomes","Acknowledges limitations and avoids causal language"],"limitations":["Convenience online sample limits generalizability","Unclear whether outcome scales were validated","No measurement of moral incongruence or trauma history"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":6,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12119-023-10101-2"}},{"id":3406,"doi":"10.21203/rs.3.rs-3942118/v1","pmid":null,"pmcid":null,"title":"Relationship between the Menstrual Cycle and Sexual Activity: Maybe Women Do Not Lose Estrus","authors":"Tarlacı S, Koyuncu SA, Şan O.","first_author":"Tarlacı S","journal":"Research Square","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-3942118/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 489 women (cross‑sectional) and diary of 25 women (within‑subject longitudinal). Convenience sampling, no randomisation.","sample_n":514,"sample_text":"489 participants in Survey 1; 25 participants in Diary Study 2","population":"women with regular menstrual cycles, likely recruited online","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors surveyed women about where they were in their menstrual cycle and asked how much sexual desire they felt, whether they masturbated, and if they started sex with a partner. Both a large questionnaire and a small daily diary showed that desire and sexual activity rise around ovulation.","clinical_takeaway":"Women’s libido tends to increase near ovulation; clinicians can consider cycle timing when discussing sexual desire.","confidence":0.8,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Large initial sample (N=489)","Within‑subject diary adds temporal detail","Direct behavioural measures (masturbation, partner initiation)"],"limitations":["Reliance on single‑item, non‑validated scales","Convenience sampling, limited generalisability","Small diary sample (N=25)","No control for mood, relationship quality, or hormonal verification"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-3942118/v1"}},{"id":3407,"doi":"10.1080/0092623x.2023.2204088","pmid":"37125683","pmcid":null,"title":"Why Men Masturbate: Reasons and Correlates in Men with and without Sexual Dysfunction","authors":"Hevesi K, Tamas S, Rowland DL.","first_author":"Hevesi K","journal":"Journal of sex & marital therapy","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online survey of 2,967 men (mean age 37.7) assessing self‑reported motives for masturbation and comparing those with vs. without sexual dysfunction; no experimental manipulation.","sample_n":2967,"sample_text":"adult men, mean age 37.7 years, recruited from two world regions (details not specified).","population":"adult men, mixed community sample, recruited online (presumed convenience).","country":"unspecified (likely multiple countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of nearly 3,000 men, the main reasons for masturbating were pleasure, relieving sexual tension, and lowering anxiety or stress. Men with sexual problems showed only small differences, mainly using masturbation to calm anxiety.","clinical_takeaway":"Masturbation often serves stress‑relief for men, even when sexual dysfunction is present; clinicians should consider anxiety reduction as a common motive.","confidence":0.8,"topic_tags":["masturbation","sexual_function","religiosity"],"strengths":["Very large sample size","Direct assessment of men's self‑reported motives","Comparison across sexual dysfunction status and cultural regions"],"limitations":["Motives measured with an ad‑hoc, likely unvalidated questionnaire","Cross‑sectional design limits causal inference","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2023.2204088"}},{"id":3409,"doi":"10.1093/jsxmed/qdae151","pmid":"39545359","pmcid":null,"title":"Penile constriction devices: a randomized survey study to compare preferences between two medical-grade devices","authors":"Rendon DO, Saffati G, Whitehead C, Zuckerman C, Hom A, Daily R, Khera M, Cheng PJ.","first_author":"Rendon DO","journal":"The journal of sexual medicine","year":2025,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article","Observational Study"],"keywords":["erectile dysfunction","Patient Satisfaction","Penile Constriction Device","Sex Tools"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"randomized crossover questionnaire study with 49 completers","sample_n":49,"sample_text":"50 enrolled, 49 completed","population":"adult men (mean age 40) recruited via social media, using devices for masturbation or intercourse","country":"unspecified (likely USA based on authors)","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a randomized crossover survey of 49 men, the FirmTech penile constriction ring was preferred over Eddie by Giddy for overall satisfaction and ease of use, while the Eddie device was reported to improve erection firmness more in men with erectile dysfunction.","clinical_takeaway":"Both devices are viable; FirmTech may be more comfortable, but Eddie could aid erection firmness in ED patients.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Randomized crossover design","Use of validated SHIM and ADAM questionnaires","Clear pre‑registration (clinical trial registration)"],"limitations":["Small sample size for multiple comparisons","Device‑satisfaction questionnaire appears ad‑hoc","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdae151"}},{"id":3410,"doi":"10.1007/s10508-024-03054-6","pmid":"39680355","pmcid":null,"title":"Orgasm and Sexual Behavior Among Adolescents: Differences Across Genders and Dyad Configurations","authors":"Girouard A, Dion J, Štulhofer A, Bőthe B, Blais M, Paquette MM, O'Sullivan LF, Bergeron S.","first_author":"Girouard A","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual behavior","Adolescence","Masturbation","Transgender","Sexual Orientation","Gender Identity"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 2,800 Canadian adolescents with logistic regression and path analysis.","sample_n":2800,"sample_text":"n = 2738 cisgender, n = 62 TNB","population":"Adolescents (mean age ≈ 16.4 y) from Canada, 51 % cisgender girls, 62 transgender/non‑binary participants.","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 2,800 Canadian teens, cisgender girls were less likely than boys to orgasm during masturbation and reported more trouble reaching orgasm with a partner. Gender and partner gender also shaped how often they gave or received manual and oral sex. Trans‑ and non‑binary youth showed distinct patterns too.","clinical_takeaway":"Sex‑education programs should recognize gender‑specific differences in orgasm and sexual practices to better support adolescent sexual wellbeing.","confidence":0.8,"topic_tags":["adolescents","sexual_function","masturbation","gender"],"strengths":["Large community sample of adolescents","Separate analysis for cisgender and TNB youth","Inclusion of dyad configuration (partner gender)","Use of multivariate logistic and path models"],"limitations":["Self‑report sexual behavior without validated scales","Cross‑sectional design limits causal inference","No measurement of mental‑health or moral‑incongruence confounds","Small TNB subsample reduces precision for that group"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-03054-6"}},{"id":3411,"doi":"10.1093/sexmed/qfac010","pmid":"37007846","pmcid":"PMC10065175","title":"The Men's Training Cup Keep Training: a masturbation aid improves intravaginal ejaculatory latency time and Erection Hardness Score in patients who are unable to delay ejaculation","authors":"Shirai M, Ishikawa K, Hiramatsu I, Mizushima K, Tsuru T, Kurosawa M, Kure A, Uesaka Y, Nozaki T, Tsujimura A.","first_author":"Shirai M","journal":"Sexual medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Masturbation","Premature Ejaculation","Erection Hardness","Men’s Training Cup Keep Training","Masturbation Aid Device"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10065175","cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"single‑arm 8‑week pre‑post trial of a masturbation aid in 18 completers","sample_n":18,"sample_text":"37 enrolled, 18 completed","population":"men 20‑60 y with self‑reported premature ejaculation, same partner throughout study","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 18 Japanese men with premature ejaculation, an 8‑week program using a graduated masturbation aid increased the time to ejaculation and improved erection hardness, but the study lacked a comparison group and had a small, self‑selected sample.","clinical_takeaway":"The device may help delay ejaculation, but evidence is limited; clinicians should await larger controlled trials before recommending it broadly.","confidence":0.7,"topic_tags":["masturbation","prevalence","treatment","sexual_function"],"strengths":["uses validated PE and sexual function questionnaires","objective primary outcome (IELT)","clear training protocol with graded device"],"limitations":["no control or randomisation","high attrition (19/37 withdrew)","small final sample, no power analysis","no assessment of psychological or relational confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfac010"}},{"id":3412,"doi":"10.21203/rs.3.rs-3411557/v1","pmid":null,"pmcid":null,"title":"Hard Flaccid Syndrome Symptoms, Comorbidities, and Self-Reported Efficacy and Satisfaction of Treatments: A Cross-Sectional Survey","authors":"Niedenfuehr J, Stevens D.","first_author":"Niedenfuehr J","journal":"Research Square","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-3411557/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of self‑identified HFS participants recruited via social media; purposive/convenience sampling; no control group","sample_n":null,"sample_text":"purposive and convenience sampling; recruited through social media platforms","population":"self‑identified individuals with Hard Flaccid Syndrome; sample size not reported in abstract","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2023 online survey of people who say they have Hard Flaccid Syndrome found common symptoms, possible triggers (like certain sexual activities) and low satisfaction with existing treatments, but the study relied on self‑reports from a small, self‑selected group.","clinical_takeaway":"Evidence on Hard Flaccid Syndrome remains limited; clinicians should interpret self‑reported symptom patterns cautiously.","confidence":0.6,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["addresses a poorly understood condition","collects data on symptom triggers and treatment satisfaction"],"limitations":["self‑identified diagnoses; no validated measures","convenience sample recruited via social media","cross‑sectional, no causal inference"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-3411557/v1"}},{"id":3413,"doi":"10.1007/s10508-022-02505-2","pmid":"36575264","pmcid":"PMC9794105","title":"Masturbation Prevalence, Frequency, Reasons, and Associations with Partnered Sex in the Midst of the COVID-19 Pandemic: Findings from a U.S. Nationally Representative Survey","authors":"Herbenick D, Fu TC, Wasata R, Coleman E.","first_author":"Herbenick D","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual behavior","Masturbation","Sexual Desire","Covid-19","Sexual Frequency"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9794105","cited_by_count":32,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"U.S. nationally representative adult survey (cross‑sectional)","sample_n":null,"sample_text":"Nationally representative survey of U.S. adults (exact N not given in abstract)","population":"Adults in the United States, nationally representative sample","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationally representative U.S. survey found that most adults masturbate, with men doing so more often than women. People masturbate mainly for pleasure and stress relief, while lack of interest, relationship status, or moral/religious reasons deter others. Higher desire for partnered sex is linked to more frequent masturbation.","clinical_takeaway":"Masturbation is common and often linked to desire for partnered sex; clinicians should consider personal values and relationship context when discussing sexual health.","confidence":0.9,"topic_tags":["masturbation","sexual_function"],"strengths":["Large, nationally representative sample","Separate assessment of masturbation and partnered sex","Reports effect sizes with confidence intervals"],"limitations":["Self‑report measures, no validated scales for masturbation frequency","Cross‑sectional design limits causal inference","Limited control for mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":18,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02505-2"}},{"id":3414,"doi":"10.5534/wjmh.260157","pmid":"42845170","pmcid":null,"title":"U-Shaped Age Pattern of Erectile Dysfunction with Elevated Prevalence in Men in Their 20s Independent of Marital Status: Results from a National Survey in Japan","authors":"Tsujimura A, Fukuhara S, Chiba K, Yoshizawa T, Tomoe H, Shirai M, Kimura K, Kikuchi E, Maeda E, Sato Y, Nagai A, Nagao K, Sasaki H, Clinical Research Promotion Committee of the Japanese Society for Sexual Medicine.","first_author":"Tsujimura A","journal":"The world journal of men's health","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual behavior","Cross-sectional studies","erectile dysfunction","Marital Status","Young Adult"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"nationwide internet‑based survey of 6,228 Japanese men aged 20‑79; ED defined by Erection Hardness Score ≤2; marital status stratified; multivariable adjustment for comorbidities; restricted cubic spline for age trends","sample_n":6228,"sample_text":"6,228 participants","population":"men 20–79 years, community sample recruited via online panel in Japan","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A large Japanese internet survey found that erectile dysfunction follows a U‑shaped age pattern, with a surprisingly high prevalence (about 1 in 4) among men in their 20s, regardless of whether they are married.","clinical_takeaway":"Young men may experience erectile problems even without medical disease; clinicians should consider psychosocial factors when assessing ED in this age group.","confidence":0.7,"topic_tags":["sexual_function","csbd","treatment","prevalence"],"strengths":["Large, national‑scale sample (N>6000)","Validated ED measure (Erection Hardness Score)","Adjustment for multiple medical comorbidities"],"limitations":["Cross‑sectional design cannot infer causality","Internet panel may be self‑selected, limiting generalisability","Psychological factors (e.g., mental health, moral attitudes) not examined"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5534/wjmh.260157"}},{"id":3416,"doi":"10.1007/s10508-022-02473-7","pmid":"36469144","pmcid":null,"title":"From Sin to Sexual Self-Awareness: Black Women's Reflection on Lifetime Masturbation","authors":"Thorpe S, Peterson RL, Malone N, Coleman MN, Annett J, Hargons CN.","first_author":"Thorpe S","journal":"Archives of sexual behavior","year":2023,"pub_types":["Journal Article"],"keywords":["Religion","Masturbation","Sexual Socialization","Black Women"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross‑sectional thematic analysis of short‑form survey responses from 242 Black women (convenience sample)","sample_n":242,"sample_text":"242 Black women completed a short‑form qualitative survey in 2021","population":"Black women, United States, n≈242, recruited via the Big Sex Study survey (convenience)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed 242 Black women about the messages they receive regarding masturbation from religion, family and friends. Most reported mixed messages, with themes ranging from viewing masturbation as a sin to noting health benefits and increased sexual self‑awareness.","clinical_takeaway":"Clinicians should recognise the diverse cultural messages Black women encounter about masturbation and address any stigma or misinformation in sexual health counseling.","confidence":0.7,"topic_tags":["masturbation","sexual_function","csbd","moral_incongruence"],"strengths":["Large (n>200) qualitative sample for an under‑studied group","Focus on sociocultural sources of messages","Provides rich thematic insight for clinicians"],"limitations":["Convenience recruitment; not representative of all Black women","No validated measures of masturbation frequency or attitudes","No quantitative assessment; limits generalisability"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":11,"retracted":false,"notices":[{"status":"Has correction","date":"2022-12-27","noticeDoi":"10.1007/s10508-022-02509-y","doi":"10.1007/s10508-022-02473-7"},{"status":"Has correction","date":"2023-7-18","noticeDoi":"10.1007/s10508-023-02659-7","doi":"10.1007/s10508-022-02473-7"},{"status":"Has erratum","date":"2022-12-27","noticeDoi":"10.1007/s10508-022-02509-y","doi":"10.1007/s10508-022-02473-7"}],"url":"https://scite.ai/reports/10.1007/s10508-022-02473-7"}},{"id":3418,"doi":"10.1097/ju9.0000000000000510","pmid":"42781078","pmcid":"PMC13600354","title":"Validation of Comprehensive Prostate Cancer Assessment on Sexual Health for Men Who Have Sex With Men (COMPASS)","authors":"Lee TK, Wassersug RJ, Dowsett GW, Oliffe J, Mittledorf D, Wibowo E.","first_author":"Lee TK","journal":"JU open plus","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Prostatic neoplasms","Clinical Decision-making","Surveys And Questionnaires","Sexual And Gender Minorities"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13600354","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"questionnaire validation with test‑retest, factor analysis, internal consistency, and regression on treatment variables","sample_n":null,"sample_text":"men with prostate cancer who have sex with men; recruited via unspecified means","population":"men who have sex with men with prostate cancer (sample size not reported)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a 13‑section questionnaire to measure sexual health and practices in men with prostate cancer who have sex with men, showing good reliability and consistency across repeat testing.","clinical_takeaway":"The new questionnaire appears reliable for assessing sexual quality of life in MSM prostate‑cancer patients and can be used in clinical or research settings.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Comprehensive 13‑domain coverage of sexual function for MSM with prostate cancer","Rigorous psychometric testing (factor analysis, Cronbach α, ICC)","Includes test‑retest reliability over 2–4 weeks"],"limitations":["Sample size and recruitment methods not reported in abstract","No external validation in independent cohort","No pre‑registration or open data statement"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/ju9.0000000000000510"}},{"id":3419,"doi":"10.1093/sexmed/qfae072","pmid":"39600963","pmcid":"PMC11596685","title":"Global web trends analysis of sex toys","authors":"Değer MD, Akgul B.","first_author":"Değer MD","journal":"Sexual medicine","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Public Interest","Google Trends","Vibrator","Dildo","Real-world Evidence","Anal Plug","Masturbator","Strap-on"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11596685","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Aggregate Google Trends time‑series analysis of search interest for sex‑toy terms (2009‑2023) with linear regressions per term.","sample_n":null,"sample_text":"All Google Trends search volume data globally; no participant count.","population":"Internet search users (global, anonymous); no individual‐level data.","country":"global","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"Using Google Trends, the authors tracked worldwide interest in five sex‑toy categories from 2009‑2023, finding rising searches for most items, especially vibrators and dildos, with regional differences.","clinical_takeaway":"Search trends show growing public interest in sex toys, but they do not indicate individual use patterns or health impacts.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["Novel use of publicly available global search data","Long time span (14+ years)","Clear reporting of regression outcomes"],"limitations":["No individual‑level behaviour or distress measures","Cannot infer actual usage or health outcomes","Potential cultural/Internet‑access biases"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfae072"}},{"id":3420,"doi":"10.55519/jamc-04-9186","pmid":"36566414","pmcid":null,"title":"Presentation Of Children With Masturbation","authors":"Shah SSH, Aalia B, Najeeb S.","first_author":"Shah SSH","journal":"Journal of Ayub Medical College, Abbottabad : JAMC","year":2022,"pub_types":["Journal Article"],"keywords":["Childhood","Masturbation; Self-stimulation; Behaviour"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of three preschool children presenting with genital stimulation mimicking seizures; no control group; descriptive diagnosis and counseling","sample_n":3,"sample_text":"three patients (2 girls, 1 boy) described in detail","population":"preschool children (ages 2‑3) with observed self‑stimulatory behavior","country":"Pakistan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe three preschool children whose genital touching and bodily symptoms resembled seizures. Video evidence helped confirm the behavior as masturbation, and the children were referred for behavioural therapy.","clinical_takeaway":"Consider self‑stimulatory behavior in young children as a possible cause of seizure‑like symptoms before extensive neurological work‑up.","confidence":0.4,"topic_tags":["masturbation","prevalence","pornography","sexual_function","csbd"],"strengths":["Clear clinical description of a rare presentation","Use of video documentation to aid diagnosis","Provides practical recommendation for differential diagnosis"],"limitations":["Very small, non‑representative sample","No systematic measurement or validated scales","No follow‑up data on outcomes of behavioural therapy"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":54,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.55519/jamc-04-9186"}},{"id":3421,"doi":"10.1111/psrh.70076","pmid":"42692999","pmcid":null,"title":"Gender Differences in Sexually Active Life Expectancy in France","authors":"Moreau C, Pamboutzoglou L, Sireyjol A, Bajos N.","first_author":"Moreau C","journal":"Perspectives on sexual and reproductive health","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Population‑based prevalence survey combined with life‑table methods; large national sample, no experimental manipulation.","sample_n":null,"sample_text":"National CSF‑2023 survey; exact N not given in abstract","population":"French adults aged 50‑89 (survey respondents) plus vital registration data for whole population","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using French national data, the authors estimate how long men and women can expect to remain sexually active, counting both partnered sex and masturbation, and adjust these estimates for how satisfied they feel with their sexual lives.","clinical_takeaway":"Older adults’ sexual health varies by gender and satisfaction; clinicians should consider both activity frequency and perceived quality when discussing sexual wellbeing.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative dataset","Separate accounting for masturbation","Inclusion of sexual satisfaction as quality adjustment","Use of standard Sullivan method with confidence intervals"],"limitations":["Reliance on single‑item self‑reports for activity and satisfaction","No validated scales for sexual satisfaction","Moral or religious factors not measured"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/psrh.70076"}},{"id":3422,"doi":"10.1186/s12894-024-01589-3","pmid":"39272137","pmcid":"PMC11401421","title":"Rare vesicourethral foreign body caused by sexual eccentricity - case report","authors":"Su J, Wang Y, Feng S, Liao S.","first_author":"Su J","journal":"BMC urology","year":2024,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Thermometer","Medical Infusion Tube","Vesicourethral Foreign Bodies"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11401421","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"1 patient (case report)","population":"single male, 54 years old, self‑inserted foreign body during masturbation","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 54‑year‑old man inserted a thermometer into his urethra during masturbation, causing a vesicourethral foreign body that required a novel negative‑pressure technique for removal. Follow‑up showed no urinary problems.","clinical_takeaway":"Clinicians should consider safe‑practice counseling for atypical sexual behaviours that could lead to urological injury.","confidence":0.9,"topic_tags":["masturbation","sexual_function"],"strengths":["Detailed clinical description","Novel foreign‑body case"],"limitations":["Single case limits generalisability","No systematic assessment of psychosocial factors","No quantitative data or statistical analysis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12894-024-01589-3"}},{"id":3423,"doi":"10.1111/psrh.70078","pmid":"42657504","pmcid":null,"title":"Historical Trends in Sexual Activity and Sexual Health in France (1992-2023): A Gendered Perspective","authors":"Bajos N, Bozon M, Bellamine R, Andro A.","first_author":"Bajos N","journal":"Perspectives on sexual and reproductive health","year":2026,"pub_types":["Journal Article"],"keywords":["Gender","France","Sexual Health","Sexual Behaviors","Genre","Historical Trends","Santé Sexuelle","Activité Sexuelle","Tendances Historiques"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Repeated cross‑sectional probability surveys (1992, 2006, 2023) with N≈20 000 each, nationally representative of French adults 18‑69 y.","sample_n":51434,"sample_text":"National probability surveys, N=20,055 (1992), 12,364 (2006), 19,015 (2023).","population":"Adults (18‑69 y) in France, probability sample; balanced gender distribution.","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Analysis of three French national surveys (1992‑2023) shows people are starting sex later, having more partners, meeting partners online more often, and masturbating more, especially women. Same‑sex encounters have also risen.","clinical_takeaway":"Sexual health messages should reflect rising sexual agency, online partner seeking, and increased masturbation across generations.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative samples","Three time points spanning three decades","Separate measurement of masturbation","Clear descriptive statistics of multiple sexual health indicators"],"limitations":["Cross‑sectional design; no within‑person change","No adjustment for mental‑health or relationship variables","Potential reporting bias in self‑reported sexual behavior"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/psrh.70078"}},{"id":3424,"doi":"10.1016/j.heliyon.2024.e37309","pmid":"39319159","pmcid":"PMC11419871","title":"Efficacy of sexual stimulation in the treatment of distal ureteral stones: A meta-analysis","authors":"Peng CX, Zhou MH, Zhao DP, Wu GH, Xu L, Feng C.","first_author":"Peng CX","journal":"Heliyon","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Meta-analysis","Randomized controlled trials","Masturbation","Sexual Intercourse","Distal Ureteral Stone"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11419871","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Meta-analysis of six randomized controlled trials (n=535) comparing sexual stimulation (intercourse or masturbation 3‑4 times/week) with placebo/symptomatic treatment for distal ureteral stone expulsion. Protocol pre‑registered on PROSPERO.","sample_n":535,"sample_text":"Six RCTs, 535 participants","population":"Patients with distal ureteral stones; total N=535 across six RCTs.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of six trials (535 people) found that having sex or masturbating 3‑4 times a week helped kidney stones in the lower ureter pass more quickly and reduced pain attacks compared with no sexual activity.","clinical_takeaway":"Sexual activity may be a safe adjunct to aid distal ureteral stone expulsion; discuss with patients as part of pain‑management options.","confidence":0.85,"topic_tags":["sexual_function","masturbation","treatment"],"strengths":["Pre‑registered protocol (PROSPERO)","Meta‑analysis of RCTs with pooled effect sizes and CIs","Clear clinical outcomes (stone expulsion, time, pain attacks)"],"limitations":["No assessment of potential confounders such as pain medication use or underlying health conditions","Sexual stimulation operationalised only by frequency, not by validated scale","Abstract does not report risk‑of‑bias assessment of included trials"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.heliyon.2024.e37309"}},{"id":3425,"doi":"10.5534/wjmh.240137","pmid":"39344114","pmcid":"PMC11704172","title":"Erectile Function and Sexual Activity Are Declining in the Younger Generation: Results from a National Survey in Japan","authors":"Tsujimura A, Fukuhara S, Chiba K, Yoshizawa T, Tomoe H, Shirai M, Kimura K, Kikuchi E, Maeda E, Sato Y, Nagai A, Nagao K, Sasaki H, Clinical Research Promotion Committee of the Japanese Society for Sexual Medicine.","first_author":"Tsujimura A","journal":"The world journal of men's health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Coitus","Masturbation","Sexual Arousal","Penile Erection","Sexual Dysfunctions, Psychological"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11704172","cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online national survey of Japanese men aged 20‑79, using validated questionnaires (SHIM, EHS) to assess erectile function and sexual activity; prevalence and age‑group comparisons reported","sample_n":null,"sample_text":"online epidemiological study, nationwide, age‑stratified 5‑year groups","population":"Japanese men 20–79 years (online sample, presumably large; exact N not given in abstract)","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationwide online survey in Japan found that about 31% of men aged 20‑79 meet criteria for erectile dysfunction, with especially low sexual desire and activity among men in their early twenties. Sexual activity, masturbation, and nocturnal erections all decline with age.","clinical_takeaway":"Clinicians should be aware that erectile problems and low sexual activity are common even in young Japanese men, and consider broader health assessments beyond age‑related decline.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses validated sexual function instruments (SHIM, EHS)","Large, nationwide sample covering wide age range","Separate measurement of masturbation and intercourse frequencies"],"limitations":["Cross‑sectional design cannot establish causality","No assessment of key psychosocial confounds (mental health, relationship status, trauma)","Abstract lacks details on statistical adjustment or effect‑size reporting"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":26,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5534/wjmh.240137"}},{"id":3426,"doi":"10.1097/rc9.0000000000000872","pmid":"42699450","pmcid":"PMC13544731","title":"Nonaccidental penile and scrotal strangulation: a case series from Vietnam","authors":"Mai BTD, Do HL, Tran DTQ, Dang QT, Truyen TTTT, Le NHD.","first_author":"Mai BTD","journal":"International journal of surgery case reports","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Urological Emergency","Scrotal Entrapment","Nonaccidental Penile Strangulation","Constricting Device"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13544731","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 4 patients presenting with penile/scrotal strangulation from constricting devices used during sexual activity; descriptive surgical management outcomes.","sample_n":4,"sample_text":"Four male patients, aged 28‑60, presented with strangulation caused by metallic nuts or rings used for sexual enhancement or masturbation.","population":"adult males (28‑60 y) with acute penile or penoscrotal strangulation","country":"Vietnam","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Four men in Vietnam suffered painful penile or scrotal strangulation from metal rings used during sexual activity. Emergency surgery using a hand‑held electric saw and protective measures safely removed the devices, preserving function with only minor skin burns.","clinical_takeaway":"Prompt, adapted surgical removal of constricting devices can prevent serious injury and preserve penile function in emergency cases.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear description of rare emergency condition","Practical, resource‑adapted surgical technique","Follow‑up showing minimal complications"],"limitations":["Very small, non‑representative sample","No systematic outcome measures or long‑term follow‑up","No comparison group or statistical analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/rc9.0000000000000872"}},{"id":3428,"doi":"10.1007/s10508-022-02390-9","pmid":"36036871","pmcid":null,"title":"Sexual Subjectivity in Solo and Partnered Masturbation Experiences Among Emerging Adult Women","authors":"Foust MD, Komolova M, Malinowska P, Kyono Y.","first_author":"Foust MD","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Emerging Adulthood","Sexual Subjectivity","Partnered Masturbation","Solo Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with thematic analysis of 40 emerging adult women (ages 18‑22) from community college.","sample_n":40,"sample_text":"40 women, ages 18‑22, recruited from community college.","population":"Emerging adult women, majority Latina or Black, community college students (N=40).","country":"Not specified (likely USA based on institution type).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 40 young women showed that solo and partnered masturbation differ in feelings of pleasure, desire, and empowerment, with solo acts linked to self‑knowledge and partnered acts to intimacy, while guilt and awkwardness can appear in both contexts.","clinical_takeaway":"Clinicians should recognize differing emotional experiences of solo versus partnered masturbation and consider personal and cultural contexts when discussing sexual wellbeing.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Rich, in‑depth qualitative data on solo vs partnered masturbation.","Diverse sample (Latina and Black women).","Feminist theoretical framing."],"limitations":["Small, non‑random convenience sample limits generalizability.","No validated measurement instruments; constructs derived from interview content.","No quantitative analysis or effect size reporting."],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02390-9"}},{"id":3429,"doi":"10.1111/psrh.70075","pmid":"42629316","pmcid":null,"title":"An Intersectional Exploration of Sexual Lifestyles and Health Across the Life Course in France","authors":"Moreau C, Bohet A, Rigal L, Sauvage C, Lot F.","first_author":"Moreau C","journal":"Perspectives on sexual and reproductive health","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large nationally representative survey, cross‑sectional","sample_n":19192,"sample_text":"national survey (CSF‑2023)","population":"19,192 French adults aged 18‑89, sexually active","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a national French survey of over 19,000 adults, researchers found that sexual dissatisfaction and past sexual violence were linked to poorer self‑rated health, depression and anxiety, while masturbation was linked to lower anxiety in older women.","clinical_takeaway":"Assess sexual satisfaction and trauma history as part of routine health checks; consider them risk factors for mental‑health problems.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Very large, nationally representative sample","Multivariable modeling with interaction tests","Inclusion of multiple sexuality dimensions"],"limitations":["Cross‑sectional; no causal inference","No measurement of moral/religious incongruence","Reliance on self‑report, unclear validation of scales"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/psrh.70075"}},{"id":3430,"doi":"10.1007/s00120-026-02910-8","pmid":"42606704","pmcid":null,"title":"[\"Do you still have sex, or do you already play golf?\"-Sex lives in comparison: golfers, physically active and physically inactive middle aged men]","authors":"Göldner VA, Gschwend JE, Herkommer K.","first_author":"Göldner VA","journal":"Urologie (Heidelberg, Germany)","year":2026,"pub_types":["Journal Article","English Abstract"],"keywords":["Sexual activity","erectile function","Lifestyle","Golf","Sex Life"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community sample (N=8062) from Bavarian Men's Health study, three groups compared with chi‑square/Fisher tests","sample_n":8062,"sample_text":"8062 men (mean age 50.3 ± 0.58 years)","population":"German men, mean age 50.3, categorized as golfers, physically active non‑golfers, inactive","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a German sample of 8,000 men around age 50, golfers and other physically active men were more likely to be sexually active, have more partners, and report higher erectile function than inactive men, but they did not differ in sexual satisfaction or masturbation frequency.","clinical_takeaway":"Physical activity, including golf, is associated with better erectile function in middle‑aged men; encourage regular exercise to support sexual health.","confidence":0.7,"topic_tags":["sexual_function","lgbtq"],"strengths":["Large, population‑based sample","Use of validated sexual function scales (IIEF‑EF, EHS)","Clear group categorisation (golfers vs active vs inactive)"],"limitations":["Cross‑sectional; cannot infer causality","No adjustment for mental‑health or relational variables","No effect‑size reporting or correction for multiple testing"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00120-026-02910-8"}},{"id":3431,"doi":"10.1080/19317611.2022.2099499","pmid":"38596385","pmcid":"PMC10903691","title":"Female Sexuality in Aotearoa/New Zealand: Factors and Sexual Response Associated with Masturbation","authors":"Csako RI, Rowland DL, Hevesi K, Vitalis E, Balalla S.","first_author":"Csako RI","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Activities","Women","Masturbation","Differences","Reasons"],"is_oa":true,"oa_url":"https://www.tandfonline.com/doi/pdf/10.1080/19317611.2022.2099499?needAccess=true","cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online anonymous survey of 698 NZ women, cross‑sectional descriptive and comparative analyses","sample_n":698,"sample_text":"Convenience sample; recruitment method not specified beyond online survey","population":"adult women (≥18 y) in New Zealand, recruited via voluntary online participation","country":"New Zealand","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 698 New Zealand women showed that masturbation is common and linked to various positive outcomes. The study details how often women masturbate, why they do it, and what activities they engage in.","clinical_takeaway":"Masturbation appears to be a prevalent and potentially beneficial activity for NZ women, but clinicians should consider individual differences and broader context.","confidence":0.73,"topic_tags":["masturbation","sexual_function"],"strengths":["Large sample for a single‑country study","Focused on understudied population (NZ women)","Comprehensive range of masturbation‑related questions"],"limitations":["Reliance on ad‑hoc, non‑validated questionnaire","Convenience, self‑selected sample limits generalisability","No measurement of potential confounds (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":10,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2022.2099499"}},{"id":3432,"doi":"10.3389/fpsyt.2022.903361","pmid":"35935426","pmcid":"PMC9352849","title":"Masturbation parameters related to orgasm satisfaction in sexual relationships: Differences between men and women","authors":"Cervilla O, Sierra JC.","first_author":"Cervilla O","journal":"Frontiers in psychiatry","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sex differences","Masturbation","Partnered Sex","Subjective Orgasm Experience","Attitude Toward Masturbation","Orgasm Satisfaction"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2022.903361/pdf","cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1335 Spanish adults, self‑report questionnaire, regression analysis","sample_n":1335,"sample_text":"One thousand three hundred and thirty‑five men and women from the Spanish population aged 18‑83 years participated in an online survey.","population":"Spanish adults, 18‑83 years, community sample (convenience)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Spanish online survey of 1,335 adults, researchers examined how masturbation habits, desire and attitudes relate to how satisfied people feel with orgasm during partnered sex. They found that men’s orgasm satisfaction is linked to the emotional quality of orgasm, while in women it is also affected by negative attitudes toward masturbation and solitary sexual desire.","clinical_takeaway":"Clinicians should consider individuals’ attitudes toward masturbation and solitary sexual desire when addressing orgasm satisfaction in couples.","confidence":0.7,"topic_tags":["masturbation","sexual_function","gender","relationships"],"strengths":["Large sample size for a survey","Separate assessment of masturbation frequency and attitudes","Gender‑specific regression models"],"limitations":["Cross‑sectional design; cannot infer causality","Reliance on self‑developed, likely unvalidated questionnaires","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":28,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2022.903361"}},{"id":3436,"doi":"10.3390/diagnostics16152360","pmid":"42587598","pmcid":"PMC13465154","title":"Ejaculation-Triggered Reversible Cerebral Vasoconstriction Syndrome: A Case Report with Longitudinal Neuroimaging","authors":"Hayashi K, Ito Y, Sato M, Nakaya Y, Takehara T, Suzuki A, Miura T, Hayashi K, Kobayashi Y.","first_author":"Hayashi K","journal":"Diagnostics (Basel, Switzerland)","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Vasoconstriction","Primary","Coitus","Ejaculation","Headache Disorders","Reversible Cerebral Vasoconstriction Syndrome","Thunderclap Headache"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13465154","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single-patient case report with longitudinal MRI/MRA follow‑up","sample_n":1,"sample_text":"n=1 (case report)","population":"40‑year‑old male with thunderclap headache after masturbatory ejaculation","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 40‑year‑old man developed a sudden severe headache after masturbatory ejaculation. Brain imaging showed reversible narrowing of cerebral arteries (RCVS). Treatment with a calcium‑channel blocker resolved symptoms, highlighting that sexual activity can trigger this vascular condition.","clinical_takeaway":"Consider reversible cerebral vasoconstriction syndrome in patients with thunderclap headache after sexual activity; neurovascular imaging and calcium‑channel blockers are key.","confidence":0.85,"topic_tags":["religiosity","masturbation","sexual_function"],"strengths":["Detailed longitudinal neuroimaging of a rare presentation","Clear clinical description linking ejaculation to RCVS","Use of established RCVS2 scoring system"],"limitations":["Single case; no control group","No systematic assessment of potential confounders (e.g., hypertension, substance use)","Findings not generalisable"],"rubric_version":"2.0","raw_total":14,"max_possible":60,"pct_score":23,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":3,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/diagnostics16152360"}},{"id":3437,"doi":"10.22037/uj.v19i.7119","pmid":"35598041","pmcid":null,"title":"The Efficacy of Sexual Intercourse Or Masturbation For The Expulsion Of Distal Ureteral Stones In Men: A Systematic Review And Meta-analysis Of Randomized-controlled Trials","authors":"Lu Y, Zhang W, Su H, Ma C, Li H.","first_author":"Lu Y","journal":"Urology journal","year":2022,"pub_types":["Meta-Analysis","Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Meta-analysis of 5 randomized controlled trials (total N≈500) comparing sexual intercourse or masturbation vs no sexual activity on distal ureteral stone expulsion.","sample_n":500,"sample_text":"Five RCTs including 500 subjects","population":"Men with distal ureteral calculi (0‑10 mm).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of five trials found that men who had sex or masturbated 3‑4 times weekly expelled distal kidney stones faster and needed fewer pain injections than men who avoided sexual activity.","clinical_takeaway":"Encouraging regular ejaculation may aid distal ureteral stone passage, but evidence is limited and further robust trials are needed.","confidence":0.7,"topic_tags":["masturbation","sexual_function","treatment","neuroscience"],"strengths":["Aggregates RCT evidence","Standard meta‑analytic methods with CIs","Clear clinical outcomes"],"limitations":["High heterogeneity (I² up to 90 %)","Small number of trials","No assessment of potential confounders (e.g., fluid intake)"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.22037/uj.v19i.7119"}},{"id":3438,"doi":"10.4103/indianjpsychiatry.indianjpsychiatry_46_24","pmid":"39100367","pmcid":"PMC11293787","title":"Childhood gratification syndrome: Demystifying the clinical conundrum with a narrative literature review of the past 5 decades","authors":"Biswas T, Nath S, Mishra BR.","first_author":"Biswas T","journal":"Indian journal of psychiatry","year":2024,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual behavior","Dyskinesia","Child Sexuality","Gratification Disorder","Childhood Masturbation","Childhood Gratification Syndrome","Infantile Masturbation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11293787","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative literature review without systematic methods or risk‑of‑bias assessment","sample_n":null,"sample_text":"Not applicable – review article","population":"children exhibiting self‑stimulatory behaviours (CGS/IGS)","country":"India (journal location)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review explains that childhood gratification syndrome is a benign, self‑stimulatory behaviour that can look like seizures or movement disorders. It urges clinicians to recognize it, use video evidence, and reassure families rather than pursue extensive medical testing.","clinical_takeaway":"Recognise CGS as a non‑pathological habit; avoid unnecessary investigations and focus on parental reassurance and behavioural guidance.","confidence":0.4,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["Clear clinical description of CGS/IGS phenomena","Useful differentiation from neurological mimics","Highlights need for parental reassurance and behavioral therapy"],"limitations":["Narrative, not systematic – risk of selection bias","No empirical data or validated measurement tools discussed","Absence of quantitative synthesis or quality appraisal"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/indianjpsychiatry.indianjpsychiatry_46_24"}},{"id":3439,"doi":"10.1080/0092623x.2024.2346165","pmid":"38767200","pmcid":null,"title":"Further Exploration of the Correlates of Post-Coital Dysphoria and Its Prevalence within Different Sexual Contexts","authors":"Raftery D.","first_author":"Raftery D.","journal":"Journal of sex & marital therapy","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 156 adults reporting on post‑coital dysphoria across relationship, casual, and masturbation contexts","sample_n":156,"sample_text":"156 participants (51 males, 105 females) completed an online questionnaire","population":"Adults (18+) who have had partnered sex and masturbated; 51 males, 105 females; recruited via convenience online sampling","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 156 adults found that feeling down after sex—called post‑coital dysphoria—occurs in many people, especially after casual sex or masturbation, and is linked to negative attitudes toward masturbation.","clinical_takeaway":"Clinicians should be aware that post‑coital dysphoria is common and may be related to how a person feels about masturbation.","confidence":0.7,"topic_tags":["sexual_function","moral_incongruence","masturbation"],"strengths":["Addresses multiple sexual contexts","Includes both genders","Identifies novel predictor (negative attitudes toward masturbation)"],"limitations":["Convenience online sample, limited generalisability","Reliance on self‑report, unclear validation of PCD measure","No control for key confounds (mental health, moral attitudes, relationship factors)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2024.2346165"}},{"id":3440,"doi":"10.1097/nmd.0000000000001522","pmid":"35350038","pmcid":null,"title":"Masturbation as a Cause of \"Sexual Neurasthenia\": Anton Chekhov's Medical Report (1883)","authors":"Kosenko O, Steger F.","first_author":"Kosenko O","journal":"The Journal of nervous and mental disease","year":2022,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"historical analysis of an 1883 medical report; no original empirical data collected","sample_n":null,"sample_text":"not applicable","population":"none (historical case report)","country":"historical (Russia, 1880s); article published in USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article examines an 1883 medical report by Anton Chekhov describing a patient diagnosed with \"sexual neurasthenia\" caused by masturbation, illustrating how 19th‑century physicians linked masturbation to nervous exhaustion.","clinical_takeaway":"None – the paper is a historical review and does not provide clinical guidance for current practice.","confidence":0.4,"topic_tags":["masturbation","neuroscience","sexual_function"],"strengths":["Provides rare historical primary source insight","Contextualizes 19th‑century medical discourse on masturbation"],"limitations":["No original data; purely descriptive","No systematic methodology or bias assessment","Findings not directly applicable to modern clinical practice"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/nmd.0000000000001522"}},{"id":3441,"doi":"10.1016/j.radcr.2022.02.080","pmid":"35345564","pmcid":"PMC8956920","title":"Spontaneous pneumomediastinum and subcutaneous emphysema after masturbation","authors":"Rajic N, Schandl C.","first_author":"Rajic N","journal":"Radiology case reports","year":2022,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Sexual activity","Mediastinal Emphysema","Masturbation","Subcutaneous Emphysema","Spontaneous Pneumomediastinum","Autoeroticism"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.radcr.2022.02.080","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient presenting with pneumomediastinum during masturbation","sample_n":1,"sample_text":"single case","population":"healthy young man (single case)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2022 case report describes a healthy young man who developed air in his chest and neck (pneumomediastinum and subcutaneous emphysema) while masturbating, an association not previously reported.","clinical_takeaway":"No clinical implications; this isolated report does not suggest a common risk of serious chest complications from masturbation.","confidence":0.8,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Clear clinical description","Adds a novel anecdotal association","Imaging findings documented"],"limitations":["Single case, no generalizability","No control or comparison","No systematic assessment of confounders"],"rubric_version":"2.0","raw_total":3,"max_possible":50,"pct_score":6,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.radcr.2022.02.080"}},{"id":3442,"doi":"10.1016/j.esxm.2022.100501","pmid":"35339056","pmcid":"PMC9177873","title":"Development and Validation of the Chinese Version of The Masturbation Beliefs Scale","authors":"Ren Z, Liu Y, Deng J.","first_author":"Ren Z","journal":"Sexual medicine","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Culture","Factor analysis","Beliefs","Masturbation","Scale Development"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9177873","cited_by_count":3,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Scale development and validation with two large university student samples (total N=3,231).","sample_n":3231,"sample_text":"Chinese university students recruited online.","population":"Chinese university students (online convenience sample).","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a 17‑item questionnaire to assess Chinese university students' beliefs about masturbation, finding three reliable factors and showing that more negative beliefs relate to higher sexual compulsivity and lower likelihood of premarital sex.","clinical_takeaway":"Clinicians can use this new scale to identify maladaptive masturbation beliefs that may affect sexual health and tailor education accordingly.","confidence":0.8,"topic_tags":["masturbation","sexual_function","measurement","csbd"],"strengths":["Large total sample (N>3000) provides strong factor‑analytic power","Clear description of scale development process (EFA, CFA)","Demonstrates internal consistency and construct validity"],"limitations":["Reliance on single‑item measures for related constructs","Convenience online sample limits generalisability","No external validation (e.g., clinical or non‑student populations)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2022.100501"}},{"id":3443,"doi":"10.1080/00224499.2022.2044446","pmid":"35316107","pmcid":null,"title":"Masturbation in the Animal Kingdom","authors":"Roth L, Briken P, Fuss J.","first_author":"Roth L","journal":"Journal of sex research","year":2023,"pub_types":["Review","Journal Article"],"keywords":["Animals","Masturbation","Pleasure","Genital Stimulation","Autosexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or empirical data.","sample_n":null,"sample_text":"Not applicable – review of existing literature.","population":"Animals (including humans) – no human participant sample.","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how many animal species, including humans, masturbate, discussing theories about its function and proposing that it mainly serves pleasure.","clinical_takeaway":"None – the review is not about clinical treatment or pathology.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Broad comparative overview of masturbation across many species","Identifies gaps in female‑masturbation research"],"limitations":["Narrative, not systematic – risk of selection bias","No empirical data or quantitative synthesis","No explicit methodology or quality appraisal"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2044446"}},{"id":3444,"doi":"10.1080/0092623x.2022.2042442","pmid":"35253608","pmcid":null,"title":"Premature Ejaculation Measures During Partnered Sex and Masturbation: What These Findings Tell Us About the Nature and Rigidity of Premature Ejaculation","authors":"Rowland DL, Teague LG, Hevesi K.","first_author":"Rowland DL","journal":"Journal of sex & marital therapy","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large cross‑sectional survey of 1,447 men comparing premature ejaculation (PE) during partnered sex and masturbation; groups defined by self‑reported ejaculatory control.","sample_n":1447,"sample_text":"1,447 men with either normal or poor ejaculatory control","population":"Men (n≈1,447) with normal or poor ejaculatory control; recruitment method not specified (likely convenience/online).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Men with premature ejaculation have longer ejaculation times and less distress when masturbating compared with sex with a partner, suggesting the condition’s severity varies by sexual context.","clinical_takeaway":"PE treatment should consider context‑specific factors; men may experience less bother during masturbation.","confidence":0.8,"topic_tags":["prevalence","sexual_function","pornography","masturbation"],"strengths":["Large sample size","Direct comparison of partnered vs masturbatory contexts","Addresses both latency and distress dimensions"],"limitations":["Reliance on self‑report; unclear validation of measures","Cross‑sectional; cannot infer causality","Limited control for mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":19,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2022.2042442"}},{"id":3445,"doi":"10.7334/psicothema2021.223","pmid":"35048907","pmcid":null,"title":"Validation of the Orgasm Rating Scale in the Context of Masturbation","authors":"Cervilla O, Vallejo-Medina P, Gómez-Berrocal C, de la Torre D, Sierra JC.","first_author":"Cervilla O","journal":"Psicothema","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community sample, questionnaire validation","sample_n":2595,"sample_text":"Community adults recruited online (presumed) completing self‑report scales","population":"men and women 18‑83, N=2595","country":"Spain (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The Orgasm Rating Scale, previously used for sexual intercourse, was tested in 2,595 adults during solo masturbation. The scale showed a stable four‑factor structure, good reliability, and distinguished people with orgasm problems, indicating it works well for measuring orgasm experience in masturbation.","clinical_takeaway":"Clinicians can use the ORS to reliably assess orgasm quality during solo sexual activity.","confidence":0.7,"topic_tags":["measurement","masturbation","sexual_function"],"strengths":["Large, gender‑balanced sample","Comprehensive psychometric evaluation (CFA, invariance)","Validated multidimensional scale for a previously unstudied context"],"limitations":["Cross‑sectional self‑report only","No assessment of mental‑health or relational confounds","Unclear recruitment method (potential selection bias)"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7334/psicothema2021.223"}},{"id":3446,"doi":"10.1038/s41443-021-00520-w","pmid":"35067680","pmcid":null,"title":"Masturbation in middle and late adulthood: its relationship to orgasm","authors":"Sierra JC, Santamaría J, Cervilla O, Álvarez-Muelas A.","first_author":"Sierra JC","journal":"International journal of impotence research","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 546 Spanish heterosexual adults aged 50‑83; regression analyses of masturbation frequency and attitudes on orgasmic outcomes","sample_n":546,"sample_text":"546 Spanish heterosexual adults aged 50‑83 years","population":"elderly adults (50‑83 years), Spain, heterosexual, community sample","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 546 Spanish adults aged 50‑83, more frequent masturbation and less negative attitudes toward it were linked to fewer problems with orgasm during partnered sex, especially for men. For women, how they experienced orgasm during masturbation related to partnered orgasm outcomes.","clinical_takeaway":"Encouraging positive attitudes toward masturbation may help older adults improve orgasmic function with partners.","confidence":0.7,"topic_tags":["masturbation","sexual_function","adolescents"],"strengths":["Large sample for older adults","Separate measurement of masturbation and relational orgasm outcomes","Use of multiple validated‑looking scales"],"limitations":["Cross‑sectional, cannot infer causality","Potential self‑selection bias, not nationally representative","Limited reporting of psychometric validation and effect‑size precision"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":7,"contrasting":2,"mentioning":25,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-021-00520-w"}},{"id":3447,"doi":"10.1093/jsxmed/qdae040","pmid":"38563590","pmcid":null,"title":"Repeated sexual intercourse as a coping strategy for men with premature ejaculation","authors":"Wang C, Colonnello E, Sansone A, Zhang H, Jannini EA, Zhang Y.","first_author":"Wang C","journal":"The journal of sexual medicine","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Premature Ejaculation","Coping Strategies","Multiple Intercourse","Precoital Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional comparison of men with premature ejaculation (n=182) and controls (n=92) using interviews and questionnaires","sample_n":274,"sample_text":"182 patients with PE and 92 individuals without PE","population":"young adult men with and without premature ejaculation","country":"unspecified (likely multiple sites)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Men with premature ejaculation more often have sex multiple times in a day to compensate for an unsatisfying first encounter, and most of them dislike using masturbation before sex as a coping method.","clinical_takeaway":"Multiple intercourse sessions may be a coping strategy for PE, but precoital masturbation is not universally accepted.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large sample for a clinical‑behavioral study","Direct comparison with a control group","First study to describe multiple intercourse as a coping strategy"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report for latency times and attitudes","Limited assessment of potential confounders (e.g., mental health, partner factors)","Findings not generalizable to all men"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdae040"}},{"id":3448,"doi":"10.3390/healthcare14121611","pmid":"42354469","pmcid":"PMC13300650","title":"Sexual Arousal in Men Who Have Sex Exclusively with Men: Its Relationship with Sexual Cognitions of Dominance and Submission","authors":"Sierra JC, Mercedes-Jiménez F, Pérez-Amorós C, Muñoz-García LE.","first_author":"Sierra JC","journal":"Healthcare (Basel, Switzerland)","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Dominance","Sexual Arousal","Submission","Erection","Sexual Cognitions","Men Who Have Sex Exclusively With Men"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13300650","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 253 cis‑gay men, cross‑sectional, mixed linear models","sample_n":253,"sample_text":"Convenience online sample","population":"cisgender men who have sex exclusively with men, aged 18‑67, recruited online","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 253 gay men, certain negative sexual thoughts about dominance or submission were linked to higher or lower sexual arousal and erection during masturbation or sex with a partner, showing that these thoughts can affect sexual response.","clinical_takeaway":"Therapists should consider how clients' dominance/submission fantasies may influence arousal, but the findings are correlational.","confidence":0.75,"topic_tags":["sexual_function","csbd","masturbation","lgbtq"],"strengths":["Reasonably large sample for an online survey","Uses mixed linear models to account for context effects","Focus on both solitary and partnered sexual contexts"],"limitations":["Self‑report measures of cognitions likely not validated","Cross‑sectional design limits causal inference","No control for moral, mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare14121611"}},{"id":3449,"doi":"10.1080/19317611.2026.2669287","pmid":"42683084","pmcid":null,"title":"Religiosity, Sexual Myths, and Sexual Distress in Muslim Turkish Women: A Cross-Sectional Study","authors":"Çakı Döner B, Güngörmüş Z, Eroğlu EB.","first_author":"Çakı Döner B","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2026,"pub_types":["Journal Article"],"keywords":["Women","Religion","Sexual Distress","Sexual Myths","Türkiye"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 452 Turkish women using self‑report scales","sample_n":452,"sample_text":"women recruited between Dec 2023 and Jun 2024; recruitment method not specified","population":"Turkish women (likely convenience sample)","country":"Turkey","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 452 Turkish women, stronger belief in sexual myths (e.g., about gender or masturbation) was linked to higher sexual distress. Women who rated their religious belief as high also endorsed more myths, though distress did not differ by religiosity. Education, income and marital status related to myth endorsement and distress.","clinical_takeaway":"Addressing inaccurate sexual myths may help reduce sexual distress, especially in lower‑educated or lower‑income women.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample (N>400)","Use of validated distress scale","Focused on understudied population"],"limitations":["Cross‑sectional, cannot infer causality","Sexual myths scale not validated","No control for key confounds (moral incongruence, mental health, masturbation)","Recruitment method unclear, possible selection bias"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2026.2669287"}},{"id":3450,"doi":"10.1093/sxmrev/qeag040","pmid":"42378501","pmcid":null,"title":"Ancient South Asian traditions and the cultural foundations of sexual medicine: from kāma to clinical care","authors":"Krishnappa P.","first_author":"Krishnappa P.","journal":"Sexual medicine reviews","year":2026,"pub_types":["Editorial"],"keywords":["Ayurveda","South Asia","Dhat Syndrome","Unconsummated Marriage"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"editorial without empirical data","sample_n":null,"sample_text":"none","population":"none","country":"unspecified (South Asian focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The editorial argues that ancient South Asian sexual traditions—kāma, the Kāmasūtra, Ayurveda—shape today’s sexual health concerns such as shame, semen anxiety, and unconsummated marriage, and that clinicians should incorporate this cultural knowledge into care.","clinical_takeaway":"Clinicians should consider cultural beliefs about sexuality when assessing distress, but the piece offers no direct treatment evidence.","confidence":0.6,"topic_tags":["csbd","sexual_function"],"strengths":["Integrates cultural history with modern clinical practice","Highlights under‑addressed cultural sources of sexual distress"],"limitations":["No empirical data or systematic review","Recommendations are opinion‑based, not evidence‑graded"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeag040"}},{"id":3452,"doi":"10.12659/ajcr.949679","pmid":"42219748","pmcid":"PMC13238469","title":"Sexsomnia in a Young Man: A Non-REM Parasomnia With Diagnostic and Therapeutic Challenges","authors":"Almutairi MB, Alhomayin LA, Alshahrani MM.","first_author":"Almutairi MB","journal":"The American journal of case reports","year":2026,"pub_types":["research-article","Journal Article","Case Reports"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13238469","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case report of a 29‑year‑old man with sexsomnia, polysomnography and imaging reported, therapeutic trial of valerian root and vortioxetine.","sample_n":1,"sample_text":"One patient (case report)","population":"Adult male, 29 y, sleep‑related sexual behaviors, partner observed.","country":"Saudi Arabia (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 29‑year‑old man experienced involuntary sexual actions during sleep (sexsomnia). Standard sleep tests were normal. After trying several medications, a valerian root supplement dramatically reduced episodes, and later vortioxetine led to full remission over three months.","clinical_takeaway":"Sexsomnia may respond to natural GABAergic supplements, but evidence is limited to a single case.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed clinical description of a rare parasomnia","Use of polysomnography to rule out other sleep disorders","Follow‑up of therapeutic response over 3 months"],"limitations":["Single case; no control or comparative data","No standardized measures of anxiety or distress","Therapeutic effect not isolated (multiple meds used)"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12659/ajcr.949679"}},{"id":3453,"doi":"10.1071/sh21138","pmid":"34914887","pmcid":null,"title":"Modelling the potential role of saliva use during masturbation in the transmission of Neisseria gonorrhoeae at multiple anatomical sites","authors":"Xu X, Chow EPF, Ong JJ, Shen M, Wang C, Hocking JS, Fairley CK, Zhang L.","first_author":"Xu X","journal":"Sexual health","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.publish.csiro.au/sh/pdf/SH21138","cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"Mathematical modelling using data from six observational studies to estimate transmission probabilities of Neisseria gonorrhoeae via saliva during solo and mutual masturbation. No primary data collection.","sample_n":null,"sample_text":"Data drawn from six different studies of MSM; exact N not provided in abstract.","population":"Men who have sex with men (MSM) from six existing datasets; sample size not reported in abstract.","country":"Not specified (likely multiple locations as per source studies).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Mathematical models suggest that using saliva as a lubricant during solo or mutual masturbation could account for up to 10% of gonorrhoea cases among gay and bisexual men, highlighting a possible but understudied transmission route.","clinical_takeaway":"Clinicians should consider asking about saliva use in masturbation when assessing gonorrhoea risk, though evidence remains model‑based.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Innovative modelling of a previously under‑examined transmission route","Uses data from multiple independent studies","Provides quantitative estimates with confidence intervals"],"limitations":["Relies on assumptions about saliva contamination and transfer efficiency","No primary behavioural data on actual saliva use during masturbation","Model validation limited; calibration not significantly better than baseline model"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh21138"}},{"id":3454,"doi":"10.1186/s12610-021-00148-2","pmid":"34937544","pmcid":"PMC8697462","title":"Hormonal response after masturbation in young healthy men - a randomized controlled cross-over pilot study","authors":"Isenmann E, Schumann M, Notbohm HL, Flenker U, Zimmer P.","first_author":"Isenmann E","journal":"Basic and clinical andrology","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Testosterone","Cortisol","Sexual activity","Masturbation","Free Testosterone","Hormonal Response"],"is_oa":true,"oa_url":"https://bacandrology.biomedcentral.com/track/pdf/10.1186/s12610-021-00148-2","cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"randomized controlled cross‑over pilot trial with three conditions (masturbation + visual stimulus, visual stimulus only, natural control) in healthy young men","sample_n":null,"sample_text":"not provided in abstract","population":"young healthy men (sample size not reported in abstract; likely <30)","country":"Germany (based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small crossover experiment, young men who masturbated showed a brief rise in free testosterone compared with watching pictures or doing nothing, but overall hormone ratios unchanged. Findings are tentative and need larger studies.","clinical_takeaway":"Masturbation may modestly raise free testosterone short‑term, but evidence is limited; no change in hormone balance.","confidence":0.78,"topic_tags":["masturbation","sexual_function","neuroscience"],"strengths":["Randomized cross‑over design controls for within‑subject variability","Objective hormonal assays","Comparison of masturbation vs visual stimulus vs natural condition"],"limitations":["Pilot sample likely small; limited statistical power","No effect sizes or confidence intervals reported","Moral or psychological confounds not measured"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12610-021-00148-2"}},{"id":3455,"doi":"10.21203/rs.3.rs-2283550/v1","pmid":null,"pmcid":null,"title":"Sexual habits in childhood affect penis size in later adulthood: a cross-sectional study","authors":"Oshakbayev K, Kuttymuratov G, Ardak A, Nabiyev A, Zhankalova Z, Gazaliyeva M, Tordai A.","first_author":"Oshakbayev K","journal":"Research Square","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-2283550/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 282 adult Kazakh males, self‑reported childhood sexual habits and measured erect penis dimensions","sample_n":282,"sample_text":"282 adult Kazakh fertility males aged 23‑35 years","population":"adult Kazakh males (23‑35 y), fertility clinic volunteers","country":"Kazakhstan","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"avoid","plain_summary":"In 282 Kazakh men, those who reported abstaining from masturbation or sex during childhood tended to have slightly larger erect penises as adults, but the study relied on recalled habits and cannot prove a causal link.","clinical_takeaway":"No actionable clinical guidance; findings are speculative and based on correlational data.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Objective measurement of penis size","Relatively large sample for a pilot study"],"limitations":["Reliance on retrospective self‑report of childhood sexual behaviour","Cross‑sectional design cannot establish causality","No control for key confounders (e.g., nutrition, health, genetics)","Interpretation overstated causal claims"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-2283550/v1"}},{"id":3456,"doi":"10.1111/andr.13125","pmid":"34825515","pmcid":null,"title":"The masturbatory premature ejaculation diagnostic tool (MPEDT): A novel psychometric tool to evaluate premature ejaculation during masturbation","authors":"Xi Y, Zhang H, Colonnello E, Limoncin E, Jannini EA, Zhang Y.","first_author":"Xi Y","journal":"Andrology","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Journal Article"],"keywords":["Diagnosis","Masturbation","Premature Ejaculation","Premature Ejaculation Diagnostic Tool"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a new questionnaire (MPEDT) in 135 male patients seeking care for premature ejaculation","sample_n":135,"sample_text":"135 male patients seeking medical care for PE","population":"Male patients 18‑40 years old presenting to a sexual medicine clinic (clinical convenience sample)","country":"China (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study created and validated the MPEDT, a questionnaire that measures premature ejaculation during masturbation. In 135 men seeking treatment, the tool showed high reliability and could accurately distinguish those with and without the problem.","clinical_takeaway":"MPEDT may help clinicians assess premature ejaculation in men who report issues during solo sexual activity.","confidence":0.85,"topic_tags":["sexual_function","pornography","masturbation","prevalence"],"strengths":["Rigorous psychometric validation (Cronbach alpha, CFA, ROC)","Addresses gap in assessing PE during masturbation","Good internal consistency and diagnostic accuracy"],"limitations":["Clinical convenience sample limits generalisability","No assessment of mental‑health or relational confounds","Cross‑sectional; cannot assess stability over time"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/andr.13125"}},{"id":3459,"doi":null,"pmid":"39177388","pmcid":null,"title":"[Behavioral treatment of functional anejaculation and factors influencing the therapeutic effect]","authors":"Fan YP, Huang WQ, Liu BY, Ma MM, Zheng JX, Teng XM.","first_author":"Fan YP","journal":"Zhonghua nan ke xue = National journal of andrology","year":2024,"pub_types":["Journal Article","English Abstract"],"keywords":["Anejaculation; Masturbation; Behavioral Treatment; Audiovisual Stimulation"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Quasi‑experimental comparison of conventional behavioural therapy (n=39) vs modified behavioural treatment (n=20) in men with functional anejaculation; outcomes assessed after treatment.","sample_n":59,"sample_text":"59 men (39 CBT, 20 MBT) attending an andrology clinic.","population":"59 men, 24–45 y, recruited from a single andrology clinic in Shanghai (convenience sample).","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small clinic study compared standard behavioural therapy with a modified approach (changing masturbation method and using video stimulation) in men who could ejaculate during masturbation but not during sex. The modified treatment helped more men achieve ejaculation during intercourse (55% vs 28%).","clinical_takeaway":"Modified behavioural techniques, especially integrating masturbation methods with visual cues, may improve functional anejaculation, but evidence is limited.","confidence":0.7,"topic_tags":["sexual_function","masturbation","treatment"],"strengths":["Clear clinical outcome (ejaculation).","Comparison of two behavioural protocols.","Inclusion of physiological correlates."],"limitations":["Small, non‑randomised groups.","No validated symptom scales.","Limited control for psychosocial confounds."],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":3460,"doi":"10.3390/bs14030171","pmid":"38540474","pmcid":"PMC10968612","title":"The Empire of Affectivity: Qualitative Evidence of the Subjective Orgasm Experience","authors":"Mangas P, da Silva Alves ME, Fernandes de Araújo L, Sierra JC.","first_author":"Mangas P","journal":"Behavioral sciences (Basel, Switzerland)","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Masturbation","Sexual Relationships","Qualitative Evidence","Orgasm Rating Scale","Subjective Orgasm Experience","Multidimensional Model Of The Subjective Orgasmic Experience"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10968612","cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Cross‑sectional qualitative study using free‑association word technique with 400 Spanish adults (age 18‑64).","sample_n":400,"sample_text":"Four hundred Spanish adults aged 18 to 64 years participated.","population":"Adults (Spanish, community sample)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study asked 400 Spanish adults to freely describe their orgasm experiences during partner sex and solo masturbation. Using the Orgasm Rating Scale as a guide, researchers found similar words in both contexts, but solo masturbation included more negative descriptions. The findings support the existing model of subjective orgasm experience.","clinical_takeaway":"Clinicians can use the validated Orgasm Rating Scale to explore clients' nuanced orgasm experiences in both partnered and solo contexts.","confidence":0.85,"topic_tags":["sexual_function","masturbation"],"strengths":["Large (N=400) community sample for a qualitative study","Uses validated Orgasm Rating Scale","Provides rich semantic data on orgasm experience"],"limitations":["Cross‑sectional convenience sample, limited generalisability","No measurement of potential confounds (e.g., mental health, relationship context)","Qualitative analysis lacks formal statistical power assessment"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs14030171"}},{"id":3461,"doi":"10.1080/1357650x.2021.2006211","pmid":"34836486","pmcid":null,"title":"The effects of sex and handedness on masturbation laterality and other lateralized motor behaviours","authors":"Rodway P, Thoma V, Schepman A.","first_author":"Rodway P","journal":"Laterality","year":2022,"pub_types":["Journal Article"],"keywords":["Stimulation","Health","Genitals","Vibrator","Head-tilt"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 406 adults assessing hand preference for masturbation and other laterality measures","sample_n":406,"sample_text":"104 left‑handed women, 103 right‑handed women, 100 left‑handed men, 99 right‑handed men","population":"adult men and women, left- and right‑handed, recruited via unspecified means (likely convenience)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 400 adults, most people use their dominant hand for masturbation, but left‑handers are less consistent than right‑handers. Hand preference for masturbation aligns more with handedness than with footedness, eyedness or cheek‑kissing habits.","clinical_takeaway":"None – the study describes normal variation in masturbation hand use, not a clinical issue.","confidence":0.8,"topic_tags":["masturbation","lgbtq","sexual_function"],"strengths":["Large sample covering left‑ and right‑handed participants","Use of validated handedness inventory","Systematic comparison of multiple laterality domains"],"limitations":["Self‑report single‑item for masturbation hand preference","Convenience sampling limits generalisability","No reporting of power analysis or effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/1357650x.2021.2006211"}},{"id":3462,"doi":"10.31234/osf.io/ksgyu","pmid":null,"pmcid":null,"title":"Sexual behaviors and desires of inmates in a Finnish prison – a survey study with population-based comparisons","authors":"Gunst A, Ryömä I, Andersson M, Laine M, jern p.","first_author":"Gunst A","journal":"PsyArXiv","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/ksgyu","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 181 Finnish prisoners; cross‑sectional convenience sample; compares to population data.","sample_n":181,"sample_text":"181 inmates","population":"Inmates (N=181) in a Finnish prison","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 181 Finnish prisoners found that they have similar sexual desires to the general population but engage in fewer partnered activities. Masturbation rates were comparable, and men who masturbated more reported lower well‑being.","clinical_takeaway":"Higher masturbation frequency in male inmates may be linked to lower well‑being; staff should consider wellbeing support.","confidence":0.6,"topic_tags":["sexual_function","masturbation","prevalence"],"strengths":["Relatively large prison sample for this topic","Direct comparison with population‑based data","Includes both behavior and desire measures"],"limitations":["Cross‑sectional design; cannot infer causality","No validated sexuality scales reported","Limited control for mental‑health or moral variables","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/ksgyu"}},{"id":3463,"doi":"10.1007/s10508-021-02071-z","pmid":"34751860","pmcid":"PMC8917107","title":"Prevalence of Masturbation and Associated Factors Among Older Adults in Four European Countries","authors":"Fischer N, Graham CA, Træen B, Hald GM.","first_author":"Fischer N","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Masturbation","Cross-cultural","Older Adults","Sexual Satisfaction","Sexual Attitudes","Solitary Sexual Activity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8917107","cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional probability‑based survey of 3,816 adults aged 60‑75 across four European countries.","sample_n":3816,"sample_text":"Large, probability‑based community sample; likely reasonably representative of older adults in the surveyed countries.","population":"Older adults (60‑75 years) from general population samples in four European nations.","country":"Four European countries (unspecified in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 3,800 adults aged 60‑75 in four European countries found that 27‑65% reported masturbating in the past month. Frequent masturbation was linked to positive sexual attitudes, better sexual satisfaction, and, for men, better health and lower depression.","clinical_takeaway":"Masturbation remains common in older adults and is associated with healthier attitudes and wellbeing; clinicians should address misconceptions rather than discourage it.","confidence":0.8,"topic_tags":["masturbation","prevalence","sexual_function"],"strengths":["Large, probability‑based sample","Cross‑cultural comparison","Inclusion of relevant health and attitudinal covariates"],"limitations":["Masturbation measured with single‑item self‑report; no validated scale","No measurement of partner sexual activity to isolate solitary behavior","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":33,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02071-z"}},{"id":3464,"doi":"10.1136/bmjph-2025-004042","pmid":"42158536","pmcid":"PMC13182298","title":"Partnership-based sexual behaviours among adults in Singapore: a cross-sectional population survey","authors":"A J, Gan G, Endo A, Tan RKJ, Howard N, Prem K, Ho M, Jin S, Dickens BL.","first_author":"A J","journal":"BMJ public health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["sexually transmitted diseases","Sex factors","Sexual Health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13182298","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"nationwide cross‑sectional survey using voluntary response sampling of adults ≥21 years (N = 2297); logistic regression of partner numbers and STI outcomes","sample_n":2297,"sample_text":"Voluntary response sample of Singaporean adults aged ≥21 years (51.5 % male, 95.6 % aged 21‑60)","population":"general adult population in Singapore (community sample, not treatment‑seeking)","country":"Singapore","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationwide survey of 2,300 Singapore adults described how often people have sex with partners, including with sex workers. More partners were linked to higher STI rates, but condom use frequency was not.","clinical_takeaway":"Higher numbers of partners increase STI risk; public‑health messaging should target partner reduction and safe‑sex practices.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large community sample (N > 2000)","Detailed modelling of partner counts across activity types","Clear reporting of confidence intervals for prevalence and odds ratios"],"limitations":["Voluntary response sampling introduces selection bias","Self‑report may be subject to social desirability or recall error","No measurement of moral, mental‑health or relationship confounders"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjph-2025-004042"}},{"id":3466,"doi":"10.1177/20503121231224660","pmid":"38292416","pmcid":"PMC10826370","title":"\"When you use tramadol, the sperms will not come out. . .\": Unconventional strategies for avoiding unintended pregnancy among adolescents in Ghana","authors":"Gyan SE, Boafo IM.","first_author":"Gyan SE","journal":"SAGE open medicine","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Abortion","tramadol","Adolescents","Ghana","Masturbation","Contraceptive","Unintended Pregnancy"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10826370","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups with 79 adolescents (purposive sampling); inductive thematic analysis","sample_n":79,"sample_text":"79 participants across eight focus groups","population":"Adolescents (15‑19) in Ghana, mixed gender","country":"Ghana","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Ghanaian teens described unusual ways to avoid pregnancy after unprotected sex, such as using water, salt, ice, pelvic‑floor pushes, masturbation, or taking tramadol. When these methods failed they sometimes resorted to unsafe abortions.","clinical_takeaway":"Adolescents may rely on ineffective, risky self‑methods; health services should provide confidential, youth‑friendly contraceptive counselling.","confidence":0.7,"topic_tags":["adolescents","sexual_function","treatment","religiosity","moral_incongruence","masturbation"],"strengths":["Provides novel qualitative insight into local pregnancy‑prevention practices","Uses inductive thematic analysis to capture participants' own language"],"limitations":["No validated measures of behaviour or distress","Purposive convenience sample limits generalisability","No assessment of confounding factors (e.g., mental health, religiosity)"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/20503121231224660"}},{"id":3467,"doi":"10.1016/j.jsxm.2021.09.005","pmid":"34627718","pmcid":null,"title":"Sexual Response Differs during Partnered Sex and Masturbation in Men With and Without Sexual Dysfunction: Implications for Treatment","authors":"Rowland DL, Hamilton BD, Bacys KR, Hevesi K.","first_author":"Rowland DL","journal":"The journal of sexual medicine","year":2021,"pub_types":["Journal Article"],"keywords":["Men","Sexual dysfunction","erectile dysfunction","Masturbation","Premature Ejaculation","Delayed Ejaculation","Partnered Sex"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large multinational survey comparing sexual function during partnered sex vs masturbation in men with/without dysfunction.","sample_n":4209,"sample_text":"multinational sample of 4,209 men","population":"Men (N=4,209) with and without erectile dysfunction, premature ejaculation, or delayed ejaculation.","country":"multiple","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 4,000 men, sexual performance was generally better during masturbation than during partnered sex, regardless of whether they had erectile problems, premature ejaculation, or delayed ejaculation.","clinical_takeaway":"Assessing men’s sexual response while masturbating can help inform treatment for partnered‑sex difficulties.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Very large sample size","Direct comparison of partnered vs solitary activity","Focus on multiple sexual dysfunctions"],"limitations":["Cross‑sectional, no causal inference","No measurement of potential confounds (e.g., mood, relationship factors)","Unclear whether sexual function measures were validated for both contexts"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":7,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.09.005"}},{"id":3468,"doi":"10.1093/jsxmed/qdag131","pmid":"42132359","pmcid":null,"title":"Efficacy of pelvic floor muscle training in the management of premature ejaculation: a systematic review and meta-analysis of randomized controlled trials","authors":"de Oliveira FA, Lima LB, da Costa MO, Uchôa SMM, Lenzi J, Gouveia GPM.","first_author":"de Oliveira FA","journal":"The journal of sexual medicine","year":2026,"pub_types":["Meta-Analysis","Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":["Rehabilitation","Treatment","Premature Ejaculation","Pelvic Floor Muscle Training"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Systematic review and meta‑analysis of 5 randomized controlled trials (N=236 men) assessing pelvic floor muscle training (PFMT) versus control interventions for premature ejaculation (PE).","sample_n":216,"sample_text":"Five RCTs, 236 men (216 randomized).","population":"Men diagnosed with premature ejaculation; total participants 236, 216 randomized in the meta‑analysis.","country":"International (studies from multiple databases, no single country specified).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of five trials found that pelvic‑floor exercises improve ejaculation time, but drug treatment (dapoxetine) or combined approaches work better than exercise alone.","clinical_takeaway":"Pelvic‑floor training can help premature ejaculation, yet pharmacologic or combined therapies may provide greater benefit.","confidence":0.8,"topic_tags":["treatment","sexual_function","prevalence"],"strengths":["Comprehensive systematic search across multiple databases","Use of Cochrane RoB 2.0 for bias assessment","Effect sizes reported with confidence intervals"],"limitations":["Small number of included RCTs (5) and modest total sample size","High heterogeneity in PFMT subgroup (I² = 75 %)","No pre‑registration of the review protocol reported"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdag131"}},{"id":3469,"doi":"10.21203/rs.3.rs-1966477/v1","pmid":null,"pmcid":null,"title":"Coping with singleness","authors":"Shahrak SP, Brand S, Taghizadeh Z.","first_author":"Shahrak SP","journal":"Research Square","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-1966477/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"purposeful sampling with maximum variation; 18 never‑married Iranian women >35; conventional content analysis","sample_n":18,"sample_text":"18 participants recruited via purposeful sampling; maximum variation design","population":"never‑married Iranian women aged >35 years (N=18)","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study interviewed 18 Iranian women over 35 who have never married to explore how they meet sexual, emotional, and lifestyle needs. Participants described coping methods such as masturbation, seeking friendships, and focusing on work or health.","clinical_takeaway":"None - findings are descriptive and not directly applicable to clinical practice.","confidence":0.4,"topic_tags":["sexual_function","masturbation","relationships"],"strengths":["Provides qualitative insight into coping strategies among older never‑married women","Includes sexual behavior (masturbation) as a coping aspect"],"limitations":["Small, non‑representative sample; limited generalisability","No validated measures; reliance on interview coding","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-1966477/v1"}},{"id":3470,"doi":"10.1093/sexmed/qfag023","pmid":"42017135","pmcid":"PMC13092729","title":"Correlatıonal effect of sexual myths on sexual qualıty of lıfe in pregnancy: a cross-sectıonal study","authors":"Citak G, Gorucu T.","first_author":"Citak G","journal":"Sexual medicine","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Pregnancy","Midwifery","Sexual Quality Of Life","Sexual Myths"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13092729","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 332 pregnant women attending a university hospital obstetrics clinic; face‑to‑face questionnaires assessing endorsement of sexual myths and sexual quality of life.","sample_n":332,"sample_text":"Convenience sample of pregnant women attending one university hospital; not a probability or nationally representative sample.","population":"Pregnant women (N=332) recruited from a single university‑hospital obstetrics outpatient clinic and wards in Turkey.","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 332 pregnant Turkish women, stronger belief in sexual myths was linked to lower sexual quality of life. Age, education, marital factors and pain during intercourse also related to both myths and quality of life.","clinical_takeaway":"Addressing false sexual beliefs during prenatal care may help improve sexual well‑being in pregnancy.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Reasonably large sample for a single‑site survey","Use of established scales (likely validated)","Clear reporting of significant correlations"],"limitations":["Cross‑sectional design; no causal inference","Convenience clinic sample limits generalisability","No control for key confounds (e.g., mental health, moral attitudes)","No effect‑size reporting beyond p‑values"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfag023"}},{"id":3471,"doi":"10.1093/sexmed/qfag020","pmid":"42011414","pmcid":"PMC13092270","title":"A retrospective-present-day analysis on acquired premature ejaculation","authors":"Althof SE, Rowland DL, Cote-Leger P.","first_author":"Althof SE","journal":"Sexual medicine","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sexual dysfunction","Premature Ejaculation","Ejaculatory Dysfunction","Acquired Premature Ejaculation","Ejaculatory Latency","Ejaculatory Control"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13092270","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective self‑report questionnaire about past and present sexual behaviors; convenience online sample recruited via social media; no longitudinal follow‑up, no experimental manipulation","sample_n":77,"sample_text":"77 men with APE (mean age 40 y, range 19‑66) drawn from 411 volunteers responding to an online survey","population":"men with acquired premature ejaculation (n≈77) identified via an abridged Premature Ejaculation Diagnostic Tool","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Men with acquired premature ejaculation reported that the time it takes to ejaculate dropped from about 5‑6 minutes at sexual debut to less than 2 minutes now, while the length of foreplay stayed the same. About a third said their symptoms kept getting worse with age.","clinical_takeaway":"APE may worsen over time; clinicians should assess latency history and consider that foreplay duration does not protect against faster ejaculation.","confidence":0.7,"topic_tags":["sexual_function","prevalence"],"strengths":["large age span allowing developmental perspective","first study to chart latency changes across lifespan in APE"],"limitations":["retrospective recall bias","online convenience sample, likely non‑representative","no objective latency measurement"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfag020"}},{"id":3473,"doi":"10.1016/j.jsxm.2021.07.007","pmid":"34452866","pmcid":"PMC8490304","title":"The Management of Masturbation as a Sexual Health Issue in Dar es Salaam, Tanzania: A Qualitative Study of Health Professionals' and Medical Students' Perspectives","authors":"Mushy SE, Rosser BRS, Ross MW, Lukumay GG, Mgopa LR, Bonilla Z, Massae AF, Mkonyi E, Mwakawanga DL, Mohammed I, Trent M, Wadley J, Leshabari S.","first_author":"Mushy SE","journal":"The journal of sexual medicine","year":2021,"pub_types":["research-article","Journal Article","Case Reports","Research Support, N.I.H., Extramural"],"keywords":["Management","Tanzania","perception","Masturbation","Healthcare Providers","Health Care Students"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Exploratory qualitative study with 18 focus groups (61 students, 58 providers) selected purposively and stratified by profession and experience.","sample_n":119,"sample_text":"61 health‑care students and 58 health‑care providers participated in focus groups.","population":"Health care providers and medical students in Dar es Salaam, Tanzania","country":"Tanzania","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Tanzanian health professionals and students view adolescent masturbation as a health problem and often recommend stopping it, despite lacking training. The study suggests sexual‑health curricula should teach that masturbation is normal and healthy.","clinical_takeaway":"Clinicians should receive training to normalise masturbation and correct myths rather than treat it as pathological.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Rich, context‑specific perspectives from multiple professional groups","Stratified sampling allowed comparison of students vs. clinicians","Clear acknowledgment of limitation in generalisability"],"limitations":["No quantitative measurement of constructs; reliance on self‑report narratives","Purposive convenience sample limits external validity","No assessment of moral/religious or mental‑health confounders"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.07.007"}},{"id":3474,"doi":"10.20471/acc.2023.62.04.17","pmid":"39866771","pmcid":"PMC11759127","title":"FACTORS AFFECTING THE NON-OCCURRENCE OF ORGASM IN SLOVENIAN WOMEN","authors":"Palatin K, Dahmane R, Rotim K, Racz A, Rotim N, Starc A.","first_author":"Palatin K","journal":"Acta clinica Croatica","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Libido","Orgasm","Orgasmic Disorder"],"is_oa":true,"oa_url":"https://doi.org/10.20471/acc.2023.62.04.17","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online self‑report questionnaire of 1409 adult Slovenian women, convenience sample, descriptive statistics","sample_n":1409,"sample_text":"Convenience online survey; self‑selected participants","population":"adult women (mostly 21‑30 yr, high school education) in Slovenia","country":"Slovenia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2023 Slovenian online survey of 1409 women examined how often they have orgasms, especially during masturbation, and which factors (e.g., foreplay, passion) are linked to orgasm frequency and sexual satisfaction.","clinical_takeaway":"Orgasm frequency varies widely; clinicians should consider foreplay length, passion, and overall health when addressing female sexual satisfaction.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a survey","Focus on an understudied aspect of female sexual health"],"limitations":["No validated instruments reported","No control for key confounds (moral, mental health, partner)","Convenience online sample limits generalisability"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20471/acc.2023.62.04.17"}},{"id":3475,"doi":"10.1111/andr.70231","pmid":"41937259","pmcid":null,"title":"Living Together, Loving Apart: Health, Sexuality and Relationships in Middle-Aged and Older Men in Europe","authors":"Sparano C, Alderotti G, Rastrelli G, Corona G, Antonio L, Casanueva FF, Giwercman A, Han TS, Huhtaniemi IT, Lucchi C, O'Neill T, Słowikowska-Hilczer J, Tournoy J, Vanderschueren D, Wu F, Vignoli D, Maggi M.","first_author":"Sparano C","journal":"Andrology","year":2026,"pub_types":["Journal Article"],"keywords":["Male","Testosterone","Ageing","Sexual behaviour","LAT","Life style"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community sample (n=3259) from European Male Ageing Study, cross‑sectional analysis of relationship type and sexual function","sample_n":3259,"sample_text":"3259 men aged 40‑79 years from eight European countries","population":"men aged 40‑79 years in Europe","country":"Multiple (Europe)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a European survey of over 3,000 men aged 40‑79, those living apart from a partner reported higher testosterone, more sexual desire, satisfaction and masturbation frequency than married men, with cohabiting men in between.","clinical_takeaway":"Relationship type may influence sexual desire and activity in middle‑aged men; clinicians should consider living arrangements when discussing sexual health.","confidence":0.8,"topic_tags":["sexual_function","relationships","masturbation"],"strengths":["Large, multinational sample","Validated sexual function instrument","Separate measurement of masturbation","Adjustment for several demographic and health covariates"],"limitations":["Cross‑sectional; cannot infer causality","No assessment of moral or psychological factors that could influence reported satisfaction","Potential self‑report bias in sexual behaviour"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/andr.70231"}},{"id":3476,"doi":"10.1080/00221325.2021.1948386","pmid":"34253154","pmcid":null,"title":"The Impact of Parenting Style on Attitudes toward Masturbation: A Latent Profile Analysis","authors":"Klukas E, Draper E, Kaseweter K, Gregoire N, Cioe J.","first_author":"Klukas E","journal":"The Journal of genetic psychology","year":2021,"pub_types":["Journal Article"],"keywords":["Masturbation","Parenting Style","Bayesian Statistics","Latent Profile Analysis","Psychosexual Development"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"convenience sample of 279 university students, anonymous self‑report survey, latent profile analysis","sample_n":279,"sample_text":"convenience sample of university students","population":"university students, age 18‑21, both sexes","country":"unspecified (likely USA/Europe based on journal)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 279 university students, talking about masturbation with parents was linked to more positive attitudes. Young adults who saw their parents as both rejecting and controlling tended to have the most negative views. Three parenting styles (permissive, typical, authoritarian) showed different patterns of attitudes, with females generally holding fewer negative views than males.","clinical_takeaway":"Open, non‑judgmental parent‑child communication about masturbation may foster healthier attitudes in young adults.","confidence":0.78,"topic_tags":["masturbation","sexual_function"],"strengths":["Large sample for a student survey","Use of Bayesian statistics and LPA to identify profiles","Clear operationalization of parenting dimensions"],"limitations":["Convenience, non‑representative student sample","Attitude measures not shown to be validated","No control for key confounds (moral views, mental health, trauma)","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00221325.2021.1948386"}},{"id":3477,"doi":"10.3928/02793695-20210623-02","pmid":"34251934","pmcid":null,"title":"Childhood Masturbation: Sleep Habits of Children, Maternal Psychopathology, and Other Risk Factors-A Controlled Study","authors":"Murat D, Uçar HN, Eray Ş.","first_author":"Murat D","journal":"Journal of psychosocial nursing and mental health services","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control observational study (80 children with childhood masturbation, 44 controls)","sample_n":124,"sample_text":"80 children with CM and 44 controls","population":"children (age not specified) and their mothers","country":"not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared 80 children who masturbate with 44 peers, finding that kids who slept in their parents' room, had mothers with more psychiatric symptoms, and experienced night waking were more likely to masturbate. Regular play with a child may be protective.","clinical_takeaway":"Sleep disturbances and lack of daily parental play are linked to childhood masturbation; addressing sleep and promoting parent‑child interaction may help.","confidence":0.7,"topic_tags":["masturbation","sexual_function","pornography","relationships"],"strengths":["Use of validated questionnaires for sleep and maternal symptoms","Relatively large sample for a case‑control child study","Addresses multiple potential risk factors"],"limitations":["Masturbation assessed without a validated instrument","Cross‑sectional design limits causal inference","Key confounds (e.g., child mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3928/02793695-20210623-02"}},{"id":3478,"doi":"10.1111/and.14168","pmid":"34170042","pmcid":null,"title":"Traumatic masturbation syndrome may be an important cause of erectile dysfunction in pre-mature ejaculation patients","authors":"Kafkasli A, Yazici O, Can U, Coskun A, Boz MY, Karatas B, Kece C.","first_author":"Kafkasli A","journal":"Andrologia","year":2021,"pub_types":["Journal Article"],"keywords":["erectile dysfunction","Pre-mature Ejaculation","Traumatic Masturbation Syndrome"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of men presenting to a urology clinic for premature ejaculation; self‑reported IELT and open‑ended questions on masturbation; 1,819 participants after exclusions.","sample_n":1819,"sample_text":"Clinic‑based convenience sample; not representative of general population","population":"Men (18‑60 y) with PE seeking clinical care in Turkey, 2020","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In men who seek help for premature ejaculation, unusual ways of masturbating (e.g., pressing through clothes or rubbing while prone) were reported more often by those who also have erectile dysfunction. The authors suggest these habits might contribute to the erectile problems.","clinical_takeaway":"When men present with both premature ejaculation and erectile dysfunction, asking about specific masturbation techniques may reveal a modifiable factor.","confidence":0.6,"topic_tags":[],"strengths":["Large sample size for a clinical questionnaire","Use of validated IIEF for erectile function","Addresses an understudied aspect of masturbation technique"],"limitations":["Cross‑sectional, cannot infer causality","Masturbation behaviours assessed with non‑standard, open‑ended items","No control for mental‑health, relationship or trauma variables","Clinic‑based convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/and.14168"}},{"id":3479,"doi":"10.1016/j.urology.2023.09.055","pmid":"37926381","pmcid":null,"title":"Do Ejaculation Latency and Other Sexual Measures Differ Between Men With Lifelong and Acquired Premature Ejaculation?","authors":"Rowland DL, Kövi Z, Tamas S, Hevesi K.","first_author":"Rowland DL","journal":"Urology","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online multinational survey (N≈540 PE men) comparing lifelong vs acquired premature ejaculation subtypes on self‑reported latency and related measures.","sample_n":540,"sample_text":"540 men with probable or definite PE (out of 2679 respondents).","population":"Men reporting probable or definite premature ejaculation; recruited via an online survey, not a clinical sample.","country":"multinational (online)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large online survey, men with lifelong and acquired premature ejaculation reported similar ejaculation times, suggesting the two subtypes may not need different latency criteria.","clinical_takeaway":"Clinicians should treat lifelong and acquired premature ejaculation similarly regarding latency expectations.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large sample of PE men","Validated PE diagnostic tool","Comparison of lifelong vs acquired subtypes"],"limitations":["Self‑reported latency, possible recall bias","Cross‑sectional, cannot infer causality","Limited control of key confounds (e.g., mental health, moral factors)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":4,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urology.2023.09.055"}},{"id":3480,"doi":"10.31234/osf.io/9yk8e","pmid":null,"pmcid":null,"title":"Sex drive: Theoretical conceptualization and meta-analytic review of gender differences","authors":"Frankenbach J, Weber M, Loschelder DD, Kilger H, Friese M.","first_author":"Frankenbach J","journal":"PsyArXiv","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://psyarxiv.com/9yk8e/download","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"meta-analysis of 211 studies (856 effect sizes, 621,463 participants); quantitative synthesis with moderation and publication‑bias checks; no explicit risk‑of‑bias assessment reported","sample_n":621463,"sample_text":"aggregate across 211 primary studies","population":"adults of both sexes from published literature (no new sample)","country":"multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of over 600,000 people finds that men report a stronger sex drive than women, with a medium‑to‑large difference that remains even after accounting for possible response bias.","clinical_takeaway":"Clinicians should recognize that average gender differences in sexual desire exist, but individual variation is large and contextual factors matter.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Very large aggregated sample size","Comprehensive literature search and effect‑size synthesis","Assessment of publication bias and moderator analyses"],"limitations":["Reliance on heterogeneous self‑report measures of sex drive","No explicit risk‑of‑bias or study‑quality assessment reported","Potential for unmeasured confounds (e.g., cultural attitudes, moral incongruence) not addressed"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/9yk8e"}},{"id":3481,"doi":"10.1038/s41443-026-01253-4","pmid":"41851423","pmcid":null,"title":"Self-reported variations in ejaculatory latency time in premature ejaculation: insights into contextual and behavioural factors","authors":"Colonnello E, Ye J, Wang C, Liu ZJ, Zhu D, Sansone A, Jannini EA, Zhang Y.","first_author":"Colonnello E","journal":"International journal of impotence research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 119 men with PE assessing self‑reported IELT under various conditions","sample_n":119,"sample_text":"cross‑sectional convenience sample recruited via clinics/online","population":"men with premature ejaculation (N=119)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 119 men with premature ejaculation, reported ejaculation time varied with time of day, alcohol, condom use and other factors, suggesting latency is not a fixed measure.","clinical_takeaway":"Clinicians should consider contextual influences when evaluating ejaculation latency, rather than relying on a single average value.","confidence":0.8,"topic_tags":["sexual_function","prevalence"],"strengths":["uses validated questionnaires for sexual function","examines multiple contextual factors","large enough sample for basic non‑parametric tests"],"limitations":["self‑reported latency may be inaccurate","cross‑sectional design prevents causal inference","no effect‑size reporting or correction for multiple testing","confounding variables (e.g., mental health) not measured"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-026-01253-4"}},{"id":3482,"doi":"10.1097/wnf.0000000000000440","pmid":"33587487","pmcid":null,"title":"Excessive Masturbation Successfully Treated With Methylphenidate in a 6-Year-Old Child With Autism Spectrum Disorder Accompanied by Attention Deficit Hyperactivity Disorder","authors":"Ferahkaya H, Bilgiç A.","first_author":"Ferahkaya H","journal":"Clinical neuropharmacology","year":2021,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single 6‑year‑old boy with ASD+ADHD treated with methylphenidate for excessive masturbation","sample_n":1,"sample_text":"1 child","population":"single male child, age 6, ASD and ADHD","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"avoid","plain_summary":"A 6‑year‑old boy with autism and ADHD showed reduced excessive masturbation after receiving methylphenidate, but the report is based on a single case without standardized measures.","clinical_takeaway":"Insufficient evidence to change practice; any medication effect on sexual behavior needs rigorous study.","confidence":0.8,"topic_tags":["masturbation","sexual_function","pornography","moral_incongruence"],"strengths":["Rare clinical observation of methylphenidate effect on sexual behavior in ASD","Detailed case description"],"limitations":["N=1, no control group","No validated measure of masturbation frequency or distress","No assessment of confounding factors (e.g., anxiety, environment)"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/wnf.0000000000000440"}},{"id":3483,"doi":"10.1186/s12978-026-02295-z","pmid":"41792775","pmcid":"PMC13081317","title":"What interests children about sexuality?: exploring narratives and questions from primary school children in Spain","authors":"Malgosa E, Rodríguez-Jaume MJ.","first_author":"Malgosa E","journal":"Reproductive health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Spain","Pleasure","Comprehensive Sexuality Education","Bodily Experiences","Children’s Perspectives"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13081317","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative study with focus groups, written questions and drawings from 331 primary‑school children","sample_n":331,"sample_text":"Convenience sample of schools; not nationally representative","population":"children aged 9‑11 from eight schools in Catalonia, Spain","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers asked 331 Spanish primary‑school children what they wanted to know about sexuality. Kids raised questions about adult sex, bodily changes, reproduction and pleasure, showing interest beyond the usual risk‑focused school programmes.","clinical_takeaway":"None – study informs sexuality education, not clinical practice.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large qualitative sample for children","Multiple data collection methods (questions, focus groups, drawings)","Thematic and narrative analysis applied"],"limitations":["No validated measurement instruments","Convenience school sample; limited generalisability","No quantitative analysis or effect sizes"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-026-02295-z"}},{"id":3484,"doi":"10.21203/rs.3.rs-1549167/v1","pmid":null,"pmcid":null,"title":"The impact of COVID-19 pandemic-related quarantine on female sexual behavior：A cross-sectional study in Chinese","authors":"Li G, Yu P, Zhang F, Xu Y, Zhou G, Zhan X, Gao Y, Liu H, Du X, He R.","first_author":"Li G","journal":"Research Square","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":true,"oa_url":"https://www.researchsquare.com/article/rs-1549167/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire; N=678 women; convenience sample; compares regions and masturbation vs intercourse groups","sample_n":678,"sample_text":"678 complete questionnaires","population":"adult women (≥18) in China who were isolated at home ≥1 month","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A Chinese online survey of 678 women in quarantine found that about 62 % met criteria for female sexual dysfunction during COVID‑19, with higher rates in some regions. Women who masturbated reported lower dysfunction than those who only had intercourse. Age, menopause, anxiety, depression and sexual habits were linked to dysfunction.","clinical_takeaway":"Quarantine may worsen female sexual function; clinicians should assess mental health and sexual habits, including masturbation, when supporting women’s sexual wellbeing.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["large sample for a cross‑sectional survey","use of validated FSFI instrument","separate analysis of masturbation vs intercourse"],"limitations":["convenience online sample; limited generalisability","cross‑sectional design cannot establish causality","no effect sizes or power analysis reported"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-1549167/v1"}},{"id":3486,"doi":"10.1007/s12024-026-01198-6","pmid":"41758280","pmcid":null,"title":"Mental health impact of drug-facilitated sexual assault on young women","authors":"Moya-García P, López-Fernández M, Sordo L, Fernández-Velasco R, Prego-Meleiro P.","first_author":"Moya-García P","journal":"Forensic science, medicine, and pathology","year":2026,"pub_types":["Journal Article"],"keywords":["Mental health","Drug Use","Sexual Violence","Drug-facilitated Sexual Assault (Dfsa)"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"population-based cross-sectional survey (N=381) of women 18–35 reporting drug‑facilitated sexual assault; logistic regression analyses of mental‑health outcomes.","sample_n":381,"sample_text":"381 women aged 18–35 recruited through a population‑based cross‑sectional survey in 2022.","population":"Women aged 18–35 in Spain who reported at least one DFSA incident.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 381 Spanish women who experienced drug‑facilitated sexual assault, about one‑third reported depression, more than half reported anxiety, and one‑fifth reported suicidal thoughts or attempts. Risk was higher for those with marginalized socioeconomic status, diverse sexual orientation, or assaults involving penetration.","clinical_takeaway":"DFSA survivors, especially those facing socioeconomic hardship or penetrative assaults, need proactive mental‑health screening and trauma‑informed support.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, population‑based sample","Both self‑reported and clinically diagnosed mental‑health outcomes","Multivariate regression to adjust for sociodemographic factors"],"limitations":["Cross‑sectional design limits causal inference","No reported confidence intervals for odds ratios","Potential recall bias for assault characteristics"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12024-026-01198-6"}},{"id":3487,"doi":"10.1007/s10508-023-02667-7","pmid":"37697094","pmcid":null,"title":"Not Who You Are, But Who You Are With: Re-examining Women's Less Satisfying Sexual Debuts","authors":"Peragine DE, Kim JJ, Maxwell JA, Skorska MN, Impett EA, Cunningham WA, VanderLaan DP.","first_author":"Peragine DE","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["First Intercourse","Gender Differences","Sexual Satisfaction","Sexual Debut","Gender Similarities"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective self‑report survey of 3033 adults examining first intercourse and first masturbation satisfaction, comparing partner‑gender groups.","sample_n":3033,"sample_text":"3033 adults provided retrospective accounts of their sexual debut and first masturbation.","population":"Adults (self‑selected sample, likely online or community recruitment)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study shows women’s lower satisfaction with first intercourse is linked to having male partners, not to being women per se. When women’s first sexual partner was also a woman, their satisfaction matched men’s, suggesting partner gender matters more than actor gender.","clinical_takeaway":"Clinicians should consider partner dynamics, not just gender, when addressing first‑time sexual satisfaction concerns.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size","Direct comparison of partner‑gender groups","Inclusion of both intercourse and masturbation contexts"],"limitations":["Retrospective self‑report, potential recall bias","Satisfaction measured with likely single‑item, unvalidated scales","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02667-7"}},{"id":3489,"doi":"10.21203/rs.3.rs-1399081/v1","pmid":null,"pmcid":null,"title":"Efficacy of Sexual Stimulation in the Treatment of Distal Ureteral Stones: a Meta-analysis","authors":"Peng C, Lou Y, Wu G, Wang K, Ye C, Zhao Z.","first_author":"Peng C","journal":"Research Square","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-1399081/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 6 RCTs (n=535) comparing sexual stimulation (intercourse or masturbation 3‑4 times/week) vs standard care for distal ureteral stones.","sample_n":535,"sample_text":"Six randomized controlled trials, total 535 participants.","population":"Patients with distal ureteral stones experiencing tolerable pain.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of six trials found that having sex or masturbating 3‑4 times a week helped kidney stones pass more quickly and reduced pain attacks compared with usual care alone.","clinical_takeaway":"Encouraging regular sexual activity may aid the natural expulsion of distal ureteral stones and lessen pain.","confidence":0.8,"topic_tags":["sexual_function","treatment"],"strengths":["Aggregates data from multiple RCTs","Reports effect sizes with confidence intervals","Clear definition of intervention frequency"],"limitations":["No description of risk‑of‑bias assessment","Preprint, not peer‑reviewed","Potential heterogeneity in how sexual stimulation was delivered"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-1399081/v1"}},{"id":3490,"doi":"10.1016/j.ijchp.2021.100222","pmid":"33613675","pmcid":"PMC7868927","title":"Development of the Spanish short version of Negative Attitudes Toward Masturbation Inventory","authors":"Cervilla O, Vallejo-Medina P, Gómez-Berrocal C, Sierra JC.","first_author":"Cervilla O","journal":"International journal of clinical and health psychology : IJCHP","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["reliability","Validity Evidence","Instrumental Study","Attitude Toward Masturbation","Negative Attitudes Toward Masturbation Inventory"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.ijchp.2021.100222","cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"instrument development and validation with large community sample","sample_n":4116,"sample_text":"large community sample, convenience recruitment not specified","population":"Spanish-speaking heterosexual adults (N=4,116, 18‑83 years)","country":"Spain","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created a brief Spanish questionnaire to assess negative attitudes toward masturbation and showed it is reliable and valid in a large adult sample.","clinical_takeaway":"The short NATMI can be used by clinicians to reliably gauge clients' negative attitudes toward masturbation.","confidence":0.8,"topic_tags":["masturbation","sexual_function","measurement","moral_incongruence"],"strengths":["Very large sample for psychometric validation","Comprehensive validity assessment (convergent, discriminant)","Factor analysis shows clear single‑factor structure","Provides a brief, reliable tool for Spanish speakers"],"limitations":["Cross‑sectional; no test‑retest reliability reported","Mental‑health, relationship and trauma variables not examined","Sample limited to heterosexual adults, may affect generalisability"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":33,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijchp.2021.100222"}},{"id":3491,"doi":"10.31234/osf.io/fzv43","pmid":null,"pmcid":null,"title":"Harmless bodily pleasures are moralized because they are perceived as reducing self-control and cooperativeness","authors":"Fitouchi L, André J, Baumard N, Nettle D.","first_author":"Fitouchi L","journal":"PsyArXiv","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Three pre‑registered between‑subjects experiments (N > 1,600 total) using vignette manipulations of indulgence in sex, food, alcohol, and laziness; participants rated target cooperativeness, self‑control and moral condemnation.","sample_n":1600,"sample_text":"N > 1,600 across three experiments","population":"presumably online convenience sample (e.g., Prolific/MTurk); not a clinical or nationally representative cohort","country":"not specified","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"People often judge harmless pleasures like masturbation, eating, or drinking as morally wrong because they think these activities reduce self‑control and make others less cooperative. The experiments showed that when participants believed indulgence lowered self‑control, they condemned the behaviour more strongly.","clinical_takeaway":"None – the study addresses moral perceptions, not clinical outcomes.","confidence":0.7,"topic_tags":["moral_incongruence","sexual_function"],"strengths":["Large total sample size (>1,600)","Pre‑registered protocol","Experimental manipulation of perceived indulgence"],"limitations":["Convenience online sample limits generalisability","No measurement/control of key confounds (e.g., moral incongruence, mental health)","Reliance on ad‑hoc self‑report items rather than validated scales"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/fzv43"}},{"id":3492,"doi":"10.31234/osf.io/fzv43_v1","pmid":null,"pmcid":null,"title":"Harmless bodily pleasures are moralized because they are perceived as reducing self-control and cooperativeness","authors":"Fitouchi L, Nettle D.","first_author":"Fitouchi L","journal":"PsyArXiv","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/fzv43_v1","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"pre-registered vignette experiments with N>3000 total across five studies","sample_n":3000,"sample_text":"N > 3000 across five pre‑registered experiments","population":"adult participants recruited online (presumably MTurk/Prolific)","country":"unspecified","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Across five experiments, people judged that indulgence in harmless pleasures like sex, food, or alcohol would reduce self‑control and cooperation, and this perception was linked to moral condemnation of those pleasures.","clinical_takeaway":"None – the study addresses moral perceptions, not clinical outcomes.","confidence":0.8,"topic_tags":["moral_incongruence","masturbation","sexual_function"],"strengths":["Large combined sample size","Pre‑registration of hypotheses and analyses","Multiple experimental manipulations across studies"],"limitations":["Reliance on self‑report vignette ratings rather than behavioural measures","Limited assessment of potential confounds (e.g., moral incongruence, mental health)","Constructs measured with ad‑hoc items, unclear psychometric validation"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/fzv43_v1"}},{"id":3494,"doi":"10.1038/s41443-023-00732-2","pmid":"37422568","pmcid":null,"title":"Dhāt syndrome emerges in the United States from anti-masturbation semen Retention/NoFap groups","authors":"Prause N.","first_author":"Prause N.","journal":"International journal of impotence research","year":2024,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-023-00732-2"}},{"id":3496,"doi":"10.21203/rs.3.rs-1178513/v1","pmid":null,"pmcid":null,"title":"Sexual Satisfaction and Sexual Behaviors During the Covid-19 Pandemic: Results From the International Sexual Health and Reproductive (I-SHARE) Health Survey in Luxembourg","authors":"Fischer VJ, Gómez-Bravo R, Brunnet AE, Michielsen K, Tucker JD, Campbell L, Vögele C.","first_author":"Fischer VJ","journal":"Research Square","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":true,"oa_url":"https://www.researchsquare.com/article/rs-1178513/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["masturbation","sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online volunteer survey (N=557) conducted during COVID-19 restrictions in Luxembourg; retrospective self‑report of behaviours and satisfaction.","sample_n":557,"sample_text":"557 volunteers completed the survey (35.5% men, 64.3% women).","population":"adults (>18) residing in Luxembourg, recruited via voluntary online participation.","country":"Luxembourg","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A Luxembourg online survey of 557 adults found that during COVID‑19 restrictions sexual satisfaction dropped and reported sexual problems rose. Higher satisfaction was linked to being in a steady relationship, sexting, good mental health, and unchanged alcohol use.","clinical_takeaway":"COVID‑19 restrictions may lower sexual satisfaction; clinicians should consider relationship and mental‑health factors when addressing patients’ sexual well‑being.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑country online survey","Multilingual questionnaire increased accessibility","Includes a range of sexual behaviours (masturbation, porn, sexting)"],"limitations":["Cross‑sectional, retrospective recall; cannot infer causality","Convenience sampling limits generalisability","Reliance on single‑item, non‑validated measures of satisfaction"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-1178513/v1"}},{"id":3497,"doi":"10.7759/cureus.11819","pmid":"33269179","pmcid":"PMC7707123","title":"Clinical Descriptive Study of Masturbatory Behavior Among Infants and Preschool Children: A Recent Observation From Iraq","authors":"Dhaher S, Sharquie K, Al Hamdi K, Noaimi A.","first_author":"Dhaher S","journal":"Cureus","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Preschool children","Infants","Iraq","Masturbatory Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7707123","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-series of 44 infants/preschool children referred for genital pruritus, descriptive statistics only","sample_n":44,"sample_text":"44 children (22 female, 22 male) with masturbatory behavior referred to two hospitals between 2014‑2018","population":"infants and preschool children (mean age 3.6 years) in Iraq, recruited from dermatology clinics","country":"Iraq","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A case series of 44 Iraqi infants and preschoolers who were brought to dermatology clinics because of persistent genital itching found that many engaged in brief, self‑stimulatory episodes lasting about five minutes. The behavior was common across sexes and social classes, suggesting that early childhood masturbation is a normal, though sometimes misinterpreted, phenomenon.","clinical_takeaway":"Childhood masturbatory episodes are generally normal and may be mistaken for genital itching; clinicians should consider this before extensive medical work‑up.","confidence":0.5,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Provides rare clinical description of early childhood masturbatory behavior","Includes quantitative details (frequency, duration, posture)","Excludes children with genital lesions or medical causes"],"limitations":["Convenience sample from dermatology clinics; not representative of general child population","No validated assessment tools; relies on parent report","Descriptive only; no comparative or causal analysis"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":1,"mentioning":9,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.11819"}},{"id":3498,"doi":"10.4103/jfmpc.jfmpc_1160_20","pmid":"33532436","pmcid":"PMC7842420","title":"Penile Fracture during masturbation - a case report","authors":"Bhardwaj R, Gaurav G, Alam S.","first_author":"Bhardwaj R","journal":"Journal of family medicine and primary care","year":2020,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["penis","Fracture","Masturbation"],"is_oa":true,"oa_url":"https://doi.org/10.4103/jfmpc.jfmpc_1160_20","cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of a single 25‑year‑old male presenting with penile fracture during masturbation; descriptive clinical presentation and management.","sample_n":1,"sample_text":"single case","population":"Male, 25 years old, emergency department presentation","country":"India (assumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 25‑year‑old man fractured his penis while masturbating. He experienced a popping sound, pain, and rapid loss of erection. Prompt surgery repaired the injury with good cosmetic and functional outcome.","clinical_takeaway":"Penile fracture is a surgical emergency; immediate medical attention and repair lead to good recovery.","confidence":0.4,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Detailed clinical description of a rare emergency","Clear presentation of symptoms and surgical management"],"limitations":["Single case; no generalisable data","No systematic assessment of related psychosocial factors"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/jfmpc.jfmpc_1160_20"}},{"id":3500,"doi":"10.1080/00224499.2025.2606766","pmid":"41505777","pmcid":null,"title":"The Sexual Experiences of People Living with Sickle Cell Disease","authors":"Wright B, Herbenick D, Lester JN, Balle M, Guerra-Reyes L, Piatt J.","first_author":"Wright B","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"qualitative thematic analysis with 18 participants, ages 18‑59, recruited from the SCD community","sample_n":18,"sample_text":"18 participants (convenience sample of adults with SCD)","population":"people living with sickle cell disease (SCD)","country":"United States (implied by SCD incidence statistics)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In interviews with 18 adults who have sickle cell disease, researchers found that many experience pain crises triggered by orgasm during both solo masturbation and partnered sex, but also report overall sexual satisfaction. Communication with partners about pain and disease was highlighted as important.","clinical_takeaway":"Clinicians should inquire about pain crises linked to sexual activity in SCD patients and discuss strategies for communication and pain management.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Focus on an under‑studied population (SCD) and their sexual experiences","In‑depth qualitative data with rich thematic analysis","Addresses both solo and partnered sexuality"],"limitations":["Small, non‑representative convenience sample (N=18)","No validated psychometric measures; findings are descriptive","Potential confounds (e.g., mental health, moral factors) not examined"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2025.2606766"}},{"id":3501,"doi":"10.1177/10790632261415814","pmid":"41499652","pmcid":"PMC13083823","title":"The Role of Coping Strategies, Impulsivity and Hypersexuality on the Fear of Offending Among Minor Attracted Persons (MAPs)","authors":"Garant E, Proulx J.","first_author":"Garant E","journal":"Sexual abuse : a journal of research and treatment","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Impulsivity","Coping Strategies","Hypersexuality","Pedophilia","Latent Class Analysis (Lca)","Sexual Fantasies","Minor Attracted Persons (Maps)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13083823","cited_by_count":0,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 299 male MAPs; binary logistic regression and latent class analysis; no longitudinal or experimental manipulation","sample_n":299,"sample_text":"299 male MAPs recruited online","population":"male Minor Attracted Persons (self‑identified, recruited via online channels)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"In an online survey of 299 men who are attracted to minors, the study examined how coping styles, impulsivity, and hypersexuality relate to fear of committing sexual offenses. Reliance on avoidance, substance use, and masturbating to child‑related fantasies, as well as higher impulsivity, were linked to greater fear of offending.","clinical_takeaway":"Fear of offending among MAPs is associated with certain coping and impulsivity patterns; interventions might target healthier coping to reduce distress.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["large sample for a hard‑to‑reach population","use of multivariate logistic regression and LCA","focus on coping strategies relevant to clinical risk"],"limitations":["cross‑sectional, cannot infer causality","no validated measures described for key constructs","absence of major confound controls (moral incongruence, mental health, trauma)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632261415814"}},{"id":3502,"doi":"10.1016/j.jstrokecerebrovasdis.2020.105387","pmid":"33188954","pmcid":null,"title":"Development of Internal Carotid Artery Dissection During Masturbation","authors":"Oomura M, Kitamura T, Adachi K, Nishikawa Y, Mase M.","first_author":"Oomura M","journal":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","year":2021,"pub_types":["Journal Article","Case Reports"],"keywords":["Dissection","Internal carotid artery","Subarachnoid hemorrhage","Masturbation","Sexual Intercourse"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case report of carotid artery dissection occurring during masturbation; no control group; descriptive clinical narrative","sample_n":1,"sample_text":"N/A","population":"51‑year‑old male, treatment‑seeking in hospital","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 51‑year‑old man suffered a spontaneous internal carotid artery dissection and subarachnoid hemorrhage while masturbating; he was successfully treated with stenting and recovered well.","clinical_takeaway":"Masturbation may, in rare cases, coincide with serious vascular events; clinicians should consider recent sexual activity when evaluating sudden head pain or stroke symptoms.","confidence":0.9,"topic_tags":["masturbation","csbd"],"strengths":["Detailed clinical description of a rare event","Clear imaging confirmation of dissection"],"limitations":["Single case; no causal inference","No systematic assessment of alternative risk factors","Findings not generalizable"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jstrokecerebrovasdis.2020.105387"}},{"id":3503,"doi":"10.1080/19317611.2025.2610321","pmid":"42205344","pmcid":null,"title":"Sexual experiences of new fathers in the first year postpartum","authors":"Jansen TJ, Robinson BE, Jennings L, Vencill JA.","first_author":"Jansen TJ","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2026,"pub_types":["Journal Article"],"keywords":["Postpartum","Fathers","Sexual Health","Transition To Parenthood","Sexual Functioning"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"semi-structured interviews with 10 first‑time fathers; thematic analysis","sample_n":10,"sample_text":"Convenience sample; recruitment method not specified in abstract","population":"first‑time, heterosexual, cisgender fathers, ages 26‑44, postpartum 0‑12 months","country":"not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with ten new fathers showed that the first year after a baby often brings big changes in sexual desire, fantasies, masturbation, and how satisfied they feel with sex and the relationship.","clinical_takeaway":"Clinicians should ask new fathers about sexual changes and provide support, as their experiences can affect relationship health.","confidence":0.7,"topic_tags":["sexual_function","relationships","pornography","masturbation"],"strengths":["In‑depth qualitative insight into an understudied group","Systematic thematic analysis approach","Highlights novel factors (e.g., fantasy, self‑concept) beyond frequency"],"limitations":["Very small, non‑representative sample (N=10)","No validated measures; findings not quantifiable","Potential selection bias; recruitment details absent"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2025.2610321"}},{"id":3504,"doi":null,"pmid":"37390503","pmcid":null,"title":"Penile Fracture following Penile Manipulation during Nocturnal Penile Tumescence - A Case Report","authors":"Adeleke TO, Durodola AO, Oyelami MO, Okunade IA, Oloruntoba SI.","first_author":"Adeleke TO","journal":"West African journal of medicine","year":2023,"pub_types":["Journal Article","Case Reports"],"keywords":["Masturbation","Penile Fracture","Nocturnal Penile Tumescence","Penilemanipulation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single case","population":"single adult male patient with penile fracture following nocturnal manipulation","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2023 case report describes a man who fractured his penis while handling it during a nocturnal erection. Prompt surgery repaired the injury with good results, highlighting that non‑sexual‑act penile fractures can occur.","clinical_takeaway":"Clinicians should consider penile fracture in patients with penile pain after nocturnal manipulation and act quickly.","confidence":0.9,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["detailed clinical description","adds rare etiology to literature"],"limitations":["single case, no generalisability","no systematic assessment of risk factors"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":3507,"doi":"10.1093/jsxmed/qdaf336","pmid":"41317011","pmcid":null,"title":"Application of neurophysiological testing in the clinical evaluation of anejaculation","authors":"Ma J, Wang M, Liu Q, Zhang X, Zhang X.","first_author":"Ma J","journal":"The journal of sexual medicine","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Electrophysiology","Anejaculation","Penile Sensitivity","Sympathetic Excitability"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Single‑center case‑control comparison of 82 men (3 groups) using evoked‑potential testing and psychometric questionnaires.","sample_n":82,"sample_text":"28 patients unable to ejaculate during intercourse or masturbation, 22 patients with masturbation‑only ejaculation, 32 healthy controls","population":"Adult males with anejaculation (n=50) and healthy controls (n=32)","country":"Not specified (likely China based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study recorded nerve‑signal latencies and questionnaire scores in men with anejaculation and healthy controls, finding longer latencies and more distress in patients, especially those unable to ejaculate during any activity. Electrophysiological testing may help objectify diagnosis.","clinical_takeaway":"Evoked‑potential testing could provide an objective tool to aid assessment of anejaculation, but findings need replication in larger samples.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Objective neurophysiological measures","Use of validated psychometric tools","Comparison of two clinical sub‑types","Integration of psychological assessment"],"limitations":["Small, single‑center sample","No correction for multiple testing reported","Limited control of key confounds (e.g., moral factors, partner effects)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":5,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf336"}},{"id":3508,"doi":"10.1093/jsxmed/qdaf310","pmid":"41175091","pmcid":null,"title":"Letter to the Editor on \"Comment on: Are some forms of delayed/inhibited ejaculation more intractable than others? Establishing delayed ejaculation subtypes based on severity of symptomology during partnered sex and masturbation\"","authors":"Rowland DL, McNabney SM.","first_author":"Rowland DL","journal":"The journal of sexual medicine","year":2026,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf310"}},{"id":3512,"doi":"10.1016/j.dhjo.2025.102013","pmid":"41391976","pmcid":null,"title":"Sexual health and challenges among 15-89-year-old Danes with and without severe visual impairment: Baseline findings in a nationally representative cohort study","authors":"Graugaard C, Stentoft D, Andersson M, Frisch M.","first_author":"Graugaard C","journal":"Disability and health journal","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual dysfunction","Disability","Sexual Health","Visual Impairment","Sexual Risk Behavior","Non-heterosexual Identity"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"baseline analysis of nationally representative cohort; large sample; cross‑sectional logistic regression","sample_n":61413,"sample_text":"631 participants with severe visual impairment; 60,482 without","population":"15‑89‑year‑old Danes (N≈61,000), with (N=631) and without severe visual impairment","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In Denmark, people with severe visual impairment report less sexual activity and satisfaction, more unsafe sex and sexual assault, and higher rates of same‑sex experiences, compared with the general population.","clinical_takeaway":"Clinicians should screen for sexual health challenges, including victimisation and unsafe sex, when working with visually impaired clients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Weighted, confound‑adjusted regression with confidence intervals","Broad range of sexual health outcomes"],"limitations":["Cross‑sectional; cannot infer causality","Self‑report measures, likely single‑item, limited validation","Key psychosocial confounds (moral attitudes, mental health, trauma) not addressed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.dhjo.2025.102013"}},{"id":3514,"doi":"10.21203/rs.3.rs-744035/v1","pmid":null,"pmcid":null,"title":"Magnitude of Sexual Behaviours Among College Students In The Eighth Macro-Region of Iran By Self-Reported and Network Scale-Up","authors":"Balvardi M, Dehdashti N, Ghoghary ZI, Alavi-Arjas F, Keikha M.","first_author":"Balvardi M","journal":"Research Square","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-744035/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 3900 university students using self‑report and network scale‑up methods","sample_n":3900,"sample_text":"Convenience sample of students from Kerman and Sistan‑and‑Baluchestan provinces","population":"college students in two Iranian provinces (medical science universities)","country":"Iran","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 2021 Iranian study surveyed 3,900 college students about sexual activities, finding that about a quarter watched porn, 19% masturbated, and fewer engaged in intercourse or same‑sex behavior. The authors suggest these behaviours could harm youth and society.","clinical_takeaway":"The study provides prevalence data only; it does not establish that porn or masturbation cause harm.","confidence":0.7,"topic_tags":["prevalence","sexual_function","pornography","masturbation"],"strengths":["Large sample size (N≈3900)","Uses both direct self‑report and indirect network scale‑up methods"],"limitations":["Reliance on single‑item self‑report; no validated scales","No measurement of key confounds (morality, mental health, partner status)","Cross‑sectional design limits causal inference yet conclusions imply harm"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-744035/v1"}},{"id":3515,"doi":"10.1080/0092623x.2020.1781722","pmid":"32628093","pmcid":null,"title":"What Does Research Tell Us About Women's Experiences, Motives and Perceptions of Masturbation Within a Relationship Context?: A Systematic Review of Qualitative Studies","authors":"Kılıç Onar D, Armstrong H, Graham CA.","first_author":"Kılıç Onar D","journal":"Journal of sex & marital therapy","year":2020,"pub_types":["Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 11 qualitative studies using secondary thematic analysis to synthesize women's experiences, motives, and perceptions of masturbation within relationships.","sample_n":null,"sample_text":"Eleven qualitative studies (total participants not reported in abstract).","population":"Women in romantic partnerships (qualitative study participants across 11 primary studies).","country":"Various (not specified).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 11 qualitative studies shows that women’s masturbation is shaped by how they think it may affect their relationships, with various partner‑related motivations and some women changing their behavior when in a partnership.","clinical_takeaway":"Clinicians should consider partner dynamics and perceived relationship impacts when discussing masturbation with women.","confidence":0.7,"topic_tags":["masturbation","relationships","sexual_function","gender"],"strengths":["Systematic approach to identifying qualitative literature","Provides thematic synthesis across multiple studies","Focuses on relationship context, relevant for clinicians"],"limitations":["No quantitative data or effect‑size estimation","Limited reporting of participant numbers and demographics","Potential lack of control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":3,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2020.1781722"}},{"id":3516,"doi":"10.1017/s1092852925100710","pmid":"41243522","pmcid":"PMC13064724","title":"Cognitive behavioral treatment for Sexsomnia (CBT-S). Case report and literature review","authors":"Jiménez Correa U, Alvarez García HB, Rosenthal L.","first_author":"Jiménez Correa U","journal":"CNS spectrums","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","review-article","Review","Journal Article","Case Reports"],"keywords":["Cbt-i","Sexsomnia","Insufficient Sleep Syndrome","Cbt-s","Inadequate Sleep Hygiene"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13064724","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report with single participant; no comparison group; follow‑up up to six months.","sample_n":1,"sample_text":"single case","population":"27‑year‑old male with sexsomnia, insufficient sleep syndrome, snoring.","country":"Spain (presumed from author names; not explicit)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 27‑year‑old man with sexsomnia (sexual behaviors during sleep) was treated with a form of cognitive‑behavioral therapy that included sleep extension, better sleep habits, and relaxation. He reported no episodes for a month, a single relapse later, and none after returning to therapy, suggesting CBT may help manage sexsomnia.","clinical_takeaway":"CBT techniques for sleep problems may reduce sexsomnia episodes, but evidence is limited to a single case.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["detailed clinical description","follow‑up over several months","integration of literature review"],"limitations":["single case, no control","no validated outcome measures","no statistical analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852925100710"}},{"id":3518,"doi":"10.1093/jsxmed/qdad008","pmid":"36781403","pmcid":null,"title":"Characteristics of men who report symptoms of delayed ejaculation: providing support for empirically derived diagnostic criteria","authors":"Rowland DL, Attinger DR, Morrow AL, Motofei I, Hevesi K.","first_author":"Rowland DL","journal":"The journal of sexual medicine","year":2023,"pub_types":["Journal Article"],"keywords":["Sexual dysfunction","erectile dysfunction","Masturbation","Relationship Satisfaction","Delayed Ejaculation","Inhibited Ejaculation","Partnered Sex"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 2679 men recruited via social media, comparing those with self‑reported delayed ejaculation to those without","sample_n":2679,"sample_text":"2679 men meeting inclusion criteria (self‑report of difficulty reaching ejaculation during partnered sex)","population":"men reporting sexual activity; recruitment through online/social‑media platforms; multinational sample","country":"multinational (not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 2,679 men, those who said they have trouble ejaculating during partnered sex differed from others in latency, distress, satisfaction and related factors like anxiety and relationship quality, supporting proposed diagnostic features for delayed ejaculation.","clinical_takeaway":"Validated, symptom‑based criteria for delayed ejaculation appear supported; clinicians should assess distress, latency, and relational factors when evaluating men with ejaculatory difficulties.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Large multinational sample","Comparison of DE vs non‑DE groups on many variables","Effect sizes reported"],"limitations":["Self‑selected online recruitment may bias results","Ejaculation latency estimated, not objectively timed","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":6,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdad008"}},{"id":3520,"doi":"10.1080/0092623x.2025.2577679","pmid":"41216822","pmcid":null,"title":"Female Sexual Desire, Response, and Activity Across the Menstrual Cycle","authors":"Kiesner J, Bittoni C, Pastore M.","first_author":"Kiesner J","journal":"Journal of sex & marital therapy","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 585 women aged 18‑40 reporting perceived changes in desire, masturbation desire, lubrication and sexual activity across menstrual phases","sample_n":585,"sample_text":"585 women, age 18‑40, provided complete data","population":"adult women, community sample, convenience recruitment via internet","country":"unspecified (likely USA/Western based)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 585 women, desire, lubrication and sexual activity were most often reported to rise during ovulation, but the timing varied widely between individuals. Age, partner status and hormonal birth control influenced these patterns.","clinical_takeaway":"Clinicians should recognize that menstrual‑cycle effects on desire and arousal are highly individual; no single phase predicts changes for all women.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a survey study","Addresses variability rather than assumes a uniform pattern","Considers moderating role of age, partnership, contraception"],"limitations":["Self‑report single‑item measures, not validated scales","Cross‑sectional, retrospective perception of cycle phase","No control for moral/religious attitudes or mental‑health variables"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2025.2577679"}},{"id":3521,"doi":"10.21037/tau.2020.03.19","pmid":"32676412","pmcid":"PMC7354343","title":"Association between masturbation and functional outcome in the postoperative course after nerve-sparing radical prostatectomy","authors":"Meissner VH, Dumler S, Kron M, Schiele S, Goethe VE, Bannowsky A, Gschwend JE, Herkommer K.","first_author":"Meissner VH","journal":"Translational andrology and urology","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["erectile function","Masturbation","Functional Outcome","Urinary Continence","Radical Prostatectomy (Rp)"],"is_oa":true,"oa_url":"https://tau.amegroups.com/article/viewFile/39832/pdf","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Observational cohort of 250 men followed for up to 36 months after nerve‑sparing radical prostatectomy; patients grouped by self‑reported masturbation (yes/no) and functional outcomes compared with chi‑square tests.","sample_n":250,"sample_text":"250 patients; groups split by masturbation behaviour (yes vs no).","population":"Men (median age ≈ 64) who underwent nerve‑sparing radical prostatectomy, pre‑operatively potent (IIEF‑EF ≥ 22 or EHS ≥ 3).","country":"Germany (implied by author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In men who had nerve‑sparing prostate surgery, those who reported masturbating after the operation showed slightly better rates of erections and continence over two years, but the study cannot prove that masturbation caused the improvement.","clinical_takeaway":"Encouraging postoperative masturbation may aid recovery, but clinicians should note the evidence is observational and not causal.","confidence":0.7,"topic_tags":["masturbation","sexual_function","religiosity","pornography"],"strengths":["Uses validated instruments for erectile function and continence outcomes","Longitudinal follow‑up up to 36 months","Large sample for a surgical cohort"],"limitations":["Masturbation exposure reduced to a crude yes/no without frequency or context","No adjustment for key confounders (e.g., age, comorbidities, partner support)","Observational design; causality cannot be inferred"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":0,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21037/tau.2020.03.19"}},{"id":3522,"doi":"10.7759/cureus.8317","pmid":"32607300","pmcid":"PMC7320637","title":"Penile Mondor's Disease: Rare Association With Excessive Masturbation","authors":"Sheikh MM, Jeelani HM, Farooqi A, Riaz A.","first_author":"Sheikh MM","journal":"Cureus","year":2020,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Masturbation","Penile Diseases","Vigorous Sexual Activity"],"is_oa":true,"oa_url":"https://www.cureus.com/articles/33089-penile-mondors-disease-rare-association-with-excessive-masturbation.pdf","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Single patient case report describing onset of penile Mondor's disease after self‑reported intensive masturbation.","sample_n":1,"sample_text":"One patient","population":"26‑year‑old male, single case","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","masturbation_not_isolated"],"stance":"neutral","citation_value":"background","plain_summary":"A 26‑year‑old man developed a rare vein inflammation in the penis after what he described as intensive masturbation. The swelling was treated with anti‑inflammatory medication and resolved.","clinical_takeaway":"Penile Mondor’s disease can follow vigorous sexual activity, but a single case does not prove causation; clinicians should assess recent sexual behaviour when diagnosing.","confidence":0.8,"topic_tags":["masturbation","sexual_function","pornography"],"strengths":["Detailed clinical description of a rare condition","Clear photographic / physical findings (presumed in full text)","Prompt successful treatment reported"],"limitations":["Single case; no causal inference possible","No objective measurement of masturbation frequency","No control for other vascular or lifestyle factors"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.8317"}},{"id":3523,"doi":"10.2139/ssrn.3862706","pmid":null,"pmcid":null,"title":"Initial Impacts of COVID-19 on Sexual Behaviour in Britain: Findings from a Large, Quasi-Representative Survey (Natsal-COVID)","authors":"Mercer CH, Clifton S, Riddell J, Tanton C, Freeman L, Copas A, Dema E, Pérez RB, Gibbs J, Macdowall W, Menezes D, Ridge M, Bonell C, Sonnenberg P, Field N, Mitchell KR.","first_author":"Mercer CH","journal":"SSRN","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Weighted web‑panel survey (quota‑based) of 6,654 adults in Britain, July‑August 2020; analyses of reported sexual activity, frequency and satisfaction before vs. after COVID‑19 lockdown.","sample_n":6654,"sample_text":"Quota‑based web‑panel sample weighted to approximate the British population.","population":"Adults 18‑59 years, Britain, quota‑based quasi‑representative sample","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A July‑August 2020 online survey of 6,654 UK adults found that most people kept having sex during COVID‑19 lockdown, but the type of activity shifted: partnered sex fell for non‑cohabiting people while masturbation, sex‑toy use and virtual sex rose, especially among younger adults.","clinical_takeaway":"COVID‑19 restrictions altered sexual patterns, with non‑cohabiting and younger adults reporting more solo and virtual activity; clinicians should consider relationship context when discussing sexual wellbeing.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size with weighting to population","Timely data on pandemic‑related changes","Separate reporting of partnered vs. non‑partnered activities"],"limitations":["Cross‑sectional, self‑report only; no baseline measurements","No assessment of mental‑health or moral‑incongruence confounders","Quota web‑panel may still miss hard‑to‑reach groups"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2139/ssrn.3862706"}},{"id":3524,"doi":"10.1093/jsxmed/qdaf220","pmid":"40985827","pmcid":null,"title":"Sexual health and behaviors in homosexual, bisexual and heterosexual Danes: baseline findings in the Project SEXUS cohort study","authors":"Schweizer FB, Dalgaard LNR, Graugaard C, Andersson M, Frisch M.","first_author":"Schweizer FB","journal":"The journal of sexual medicine","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["epidemiology","Sexual dysfunction","Denmark","Homosexuality","Sexual Health","Sexually Transmitted Infections","Bisexuality","Population Study"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large national probability‑sample questionnaire; cross‑sectional analysis with logistic regression","sample_n":59838,"sample_text":"Population‑based cohort (Project SEXUS) with demographically weighted analyses","population":"59,838 Danish adults (15‑89 y), including 1,577 gay, 1,500 bisexual, 56,761 heterosexual participants","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationwide Danish survey of nearly 60 000 adults, gay men and bisexual individuals of both sexes reported higher rates of risky sexual behaviour, sexual victimisation, and sexual dysfunctions, while lesbians showed no increased health burden compared with heterosexuals.","clinical_takeaway":"Clinicians should screen gay and bisexual patients for higher sexual‑health risk and dysfunction, but recognize that lesbian women do not show elevated risk in this sample.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Very large, nationally representative sample","Use of internationally validated sexual dysfunction scales","Sex‑specific logistic regression with demographic weighting","Comprehensive comparison of sexual minorities and heterosexuals"],"limitations":["Cross‑sectional; cannot infer causality","Modest response rate (34.6 %) may introduce self‑selection bias","Limited control for mental‑health, relationship and trauma confounders","Masturbation and porn use measured by single self‑report items"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf220"}},{"id":3525,"doi":"10.1371/journal.pone.0280915","pmid":"36730272","pmcid":"PMC9894452","title":"The sex life of male patients with cirrhosis and its organic factors: What we have got so far?","authors":"Darmadi D, Pakpahan C, Ruslie RH, Amanda B, Ibrahim R.","first_author":"Darmadi D","journal":"PloS one","year":2023,"pub_types":["research-article","Journal Article","Observational Study"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0280915&type=printable","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational study of 220 male cirrhosis patients; sexual satisfaction measured with New Sexual Satisfaction Scale; biological labs obtained; groups stratified by ascites and sarcopenia.","sample_n":220,"sample_text":"Convenience sample of cirrhotic men attending clinic","population":"Male patients with liver cirrhosis (N=220)","country":"Indonesia (assumed from author names, not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 220 men with liver cirrhosis, lower testosterone, vitamin D, albumin and higher bilirubin were linked to less sexual satisfaction, fewer intercourse episodes, weaker erections and poorer orgasms, while masturbation frequency rose. Physical complications like ascites and muscle loss also reduced sexual activity.","clinical_takeaway":"Assess hormone and nutritional status when men with cirrhosis report sexual problems; consider that disease severity may lower intercourse frequency and increase masturbation.","confidence":0.7,"topic_tags":["sexual_function","lgbtq"],"strengths":["Validated sexual satisfaction instrument","Reasonable sample size for a clinical population","Biochemical correlates measured alongside self‑report"],"limitations":["Cross‑sectional; cannot establish causality","Limited control for key psychosocial confounds","Interpretation slightly overstates correlational findings"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0280915"}},{"id":3527,"doi":"10.1093/sexmed/qfaf085","pmid":"41163969","pmcid":"PMC12560766","title":"Sexual activities, erectile dysfunction, and the use of sexual management strategies among assigned males with genital ablation interests","authors":"Wibowo E, Johnson TW, Wassersug RJ, Agapoff JD.","first_author":"Wibowo E","journal":"Sexual medicine","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Castration","Sexual dysfunction","erectile dysfunction","Eunuchs","Sex Toys","Sexual Management Strategies"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12560766","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 363 participants recruited from the Eunuch Archive forum","sample_n":363,"sample_text":"self‑selected convenience sample recruited via a niche online community","population":"assigned males with genital ablation interests","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 363 men interested in genital removal found that many experience erectile dysfunction, but most remain sexually active using medications, devices, or toys. The study highlights the range of strategies these individuals use to maintain sexual activity.","clinical_takeaway":"Clinicians should be aware that men seeking genital ablation often have ED yet remain sexually active; discuss appropriate management options.","confidence":0.78,"topic_tags":["sexual_function","gender"],"strengths":["Large sample for a niche population","Use of validated questionnaires","Provides prevalence data on ED and sexual practices"],"limitations":["Convenience, self‑selected online sample limits generalisability","No control for key psychosocial confounds (e.g., mental health, moral incongruence)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfaf085"}},{"id":3528,"doi":"10.31234/osf.io/2stcv","pmid":null,"pmcid":null,"title":"Moral disciplining: the cognitive and evolutionary foundations of puritanical morality","authors":"Fitouchi L, André J, Baumard N.","first_author":"Fitouchi L","journal":"PsyArXiv","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"The paper is a theoretical pre‑print that reviews existing literature and proposes an evolutionary account of puritanical morality. No new empirical data are presented.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose that puritanical moral rules (e.g., against lust, alcohol, or even masturbation) arise because they help people control urges that could later lead to cheating or other antisocial acts. They argue this fits with the cooperative function of moral cognition.","clinical_takeaway":"None - not clinically applicable.","confidence":0.4,"topic_tags":["moral_incongruence","csbd","sexual_function","religiosity"],"strengths":["Integrates interdisciplinary literature","Offers a novel evolutionary perspective"],"limitations":["No original empirical data","Relies on secondary sources","Lacks quantitative validation"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":0,"mentioning":9,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/2stcv"}},{"id":3530,"doi":"10.3390/ijerph20031820","pmid":"36767186","pmcid":"PMC9914940","title":"Measurement Invariance across Sexual Orientation for Measures of Sexual Attitudes","authors":"Muñoz-García LE, Gómez-Berrocal C, Guillén-Riquelme A, Sierra JC.","first_author":"Muñoz-García LE","journal":"International journal of environmental research and public health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Orientation","Measurement Invariance","Sexual Attitude"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/20/3/1820/pdf?version=1674108362","cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large‑scale (N=2293) cross‑sectional survey of Spanish adults assessing measurement invariance of three sexual‑attitude scales across heterosexual, bisexual and gay participants","sample_n":2293,"sample_text":"adult men and women recruited in Spain (convenience/sample details not specified in abstract)","population":"Spanish adult men and women, sexual orientation self‑identified as heterosexual, bisexual or gay","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study checked whether three common questionnaires about sexual attitudes work the same way for heterosexual, bisexual and gay Spanish adults. Two of the scales were only partly comparable across groups, while one showed full equivalence.","clinical_takeaway":"When using these attitude scales with diverse sexual‑orientation groups, be aware that some items may not be fully comparable.","confidence":0.7,"topic_tags":["measurement","sexual_function"],"strengths":["Large sample size gives high statistical power for invariance testing","Uses well‑established, previously validated scales","Comprehensive testing of configural, metric, scalar and strict invariance"],"limitations":["Sampling method not described; likely convenience sample limiting generalisability","No explicit control of potential confounds such as moral attitudes or mental‑health variables"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph20031820"}},{"id":3531,"doi":"10.1111/jsr.13814","pmid":"36646500","pmcid":null,"title":"The influence of sexual activity on sleep: A diary study","authors":"Oesterling CF, Borg C, Juhola E, Lancel M.","first_author":"Oesterling CF","journal":"Journal of sleep research","year":2023,"pub_types":["Journal Article"],"keywords":["Sexual behaviour","Gender Differences","Orgasm","Subjective Sleep Quality","Multilevel Linear Modelling","Subjective Sleep Latency"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Diary study with 14‑day repeated measures (N≈159 participants, 2076 observations). Cross‑sectional baseline also reported.","sample_n":256,"sample_text":"256 participants completed baseline questionnaires; 159 provided diary entries over 14 days (2076 observations).","population":"College students (mostly), mixed gender","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 14‑day diary of mostly student participants, having sex with a partner that ends in orgasm was linked to shorter time falling asleep and better perceived sleep quality. Masturbation or sex without orgasm showed no clear benefit for sleep.","clinical_takeaway":"Partnered sex with orgasm may modestly improve perceived sleep latency and quality; however, evidence is observational and limited to self‑reports.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large number of repeated observations (diary)","Separate analysis of partnered vs solo activity and orgasm status","Use of multilevel modelling appropriate for nested data"],"limitations":["Convenience student sample limits generalisability","Self‑reported sleep and sexual activity, no objective measures","No adjustment for mental‑health, relationship quality or other confounders"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsr.13814"}},{"id":3532,"doi":"10.1016/j.jemermed.2020.01.007","pmid":"32204992","pmcid":null,"title":"Acute Aortic Dissection With ST Segment Myocardial Infarction Following Masturbation","authors":"McBeth BD, Rosenstein DI.","first_author":"McBeth BD","journal":"The Journal of emergency medicine","year":2020,"pub_types":["Journal Article","Case Reports"],"keywords":["Hematospermia","Acute Aortic Dissection"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single 68‑year‑old male presenting with aortic dissection after masturbation; no comparator group, no systematic data collection","sample_n":1,"sample_text":"1 patient","population":"68‑year‑old male, single case","country":"United States (presumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 68‑year‑old man suffered a life‑threatening aortic dissection shortly after masturbating, suggesting that the temporary rise in blood pressure during sexual activity might trigger such events. Emergency clinicians should consider recent sexual activity when evaluating chest or back pain.","clinical_takeaway":"Take a brief sexual‑activity history; intense sexual activity can transiently raise BP and may precipitate aortic injury in vulnerable patients.","confidence":0.4,"topic_tags":["masturbation","adolescents","sexual_function"],"strengths":["Clear clinical description of a rare presentation","Relevant imaging and ECG data presented"],"limitations":["Single case; no generalisable evidence","No systematic assessment of potential confounders (e.g., blood pressure response)","No discussion of alternative mechanisms beyond temporal association"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jemermed.2020.01.007"}},{"id":3533,"doi":"10.1002/rmb2.12530","pmid":"37601483","pmcid":"PMC10433113","title":"Therapeutic efficacy and safety of a free-standing motorized ejaculation aid for patients with intravaginal ejaculatory dysfunction","authors":"Fukuhara S, Shirai M, Ueda N, Takezawa K, Ishikawa K, Hiramatsu I, Uesaka Y, Nozaki T, Iwasa A, Kobayashi K, Nonomura N, Tsujimura A.","first_author":"Fukuhara S","journal":"Reproductive medicine and biology","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual function","erectile dysfunction","Ejaculatory Disorders","Intravaginal Ejaculatory Dysfunction","Masturbation Aid"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10433113","cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Single‑group pre‑post case series (N=10) evaluating a motorized masturbation aid for intravaginal ejaculation dysfunction; no control group.","sample_n":10,"sample_text":"10 participants completed training and questionnaires.","population":"Adult men (mean age 41.5) with intravaginal ejaculatory dysfunction; recruited likely from clinic or volunteer pool.","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"A small case series (10 men) tested a motorized masturbation device to help men who cannot ejaculate during intercourse. After eight weeks, 4 men could ejaculate intravaginally and reported higher satisfaction, with no serious side effects.","clinical_takeaway":"Evidence is insufficient to recommend the device widely; larger controlled trials are needed.","confidence":0.7,"topic_tags":["sexual_function","masturbation","treatment"],"strengths":["Novel device addressing an unmet clinical need","Pre‑ and post‑intervention assessment of ejaculatory satisfaction","No serious adverse events reported"],"limitations":["Very small, uncontrolled sample (N=10)","Unclear validity of questionnaire measures","No comparison or placebo condition"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/rmb2.12530"}},{"id":3534,"doi":"10.1007/s10803-025-07055-9","pmid":"41071468","pmcid":null,"title":"Sexual Health Education for Autistic Adolescents in the Arab World: Can Culturally Sensitive Behavioural Activation Help with Inappropriate Sexual Behaviour?","authors":"Saleh A, Dillenburger K.","first_author":"Saleh A","journal":"Journal of autism and developmental disorders","year":2025,"pub_types":["Journal Article"],"keywords":["Autism","Telehealth","Arab World","Behavioural Activation","Sexual Health Education","Activity Scheduling","Applied Behaviour Analysis (Aba)"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Single-case series of five autistic adolescents receiving culturally adapted behavioural activation via telehealth; no control group; outcomes observed behaviorally.","sample_n":5,"sample_text":"five participants","population":"autistic adolescents in Arab world (N=5)","country":"Arab World","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A tiny telehealth programme using behavioural activation was tried with five autistic teens in the Arab world; it appeared to stop public masturbation and non‑consensual undressing, but the sample was very small and uncontrolled.","clinical_takeaway":"Evidence is insufficient to recommend this approach broadly; more rigorous trials are needed.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Culturally tailored intervention","Telehealth delivery","Focused on a vulnerable group"],"limitations":["Very small, non‑representative sample","No control or comparison group","Outcomes based on limited observation"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10803-025-07055-9"}},{"id":3536,"doi":"10.21203/rs.3.rs-483699/v1","pmid":null,"pmcid":null,"title":"Aspects of Sexual Life, Sexual Orientation and Fertility Desire in a Large Cohort of Individuals With 46,xy Differences of Sex Development","authors":"Batista RL, Inácio M, Brito VN, Gomes NL, Costa EMF, Domenice S, Mendonca BB.","first_author":"Batista RL","journal":"Research Square","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-483699/v1.pdf?c=1637626815000","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 127 adults with 46,XY DSD from a single tertiary center","sample_n":127,"sample_text":"127 (83 females, 44 males) from one tertiary care center","population":"Adults (>16) with 46,XY differences of sex development (DSD), both assigned male and female, including gender-changers","country":"unspecified (likely Brazil based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 127 adults with 46,XY differences of sex development, researchers described sexual fantasies, masturbation, orgasm, satisfaction, orientation, and desire for children, finding similar satisfaction across genders and noting that prenatal androgen exposure lowered motherhood desire in women.","clinical_takeaway":"Individuals with 46,XY DSD show diverse sexual experiences; clinicians should discuss fertility desires and the impact of early hormone exposure without assuming reduced sexual satisfaction.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Relatively large sample for a rare condition","Includes both gender‑assigned groups and gender‑changed individuals","Reports a range of sexual health outcomes"],"limitations":["Cross‑sectional, cannot infer causality","No validated psychometric instruments reported","Single‑center, limited generalisability"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-483699/v1"}},{"id":3538,"doi":"10.1080/00224499.2022.2150138","pmid":"36519736","pmcid":null,"title":"Conceptualizing Sexual Pleasure at Home as a Work-Related Stress Recovery Activity","authors":"Goodman RE, Snoeyink MJ, Martinez LR.","first_author":"Goodman RE","journal":"Journal of sex research","year":2024,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of employed adults examining self‑reported pleasure from sexual activity (partner or masturbation) and work‑related outcomes; mediation analysis","sample_n":null,"sample_text":"not reported in abstract","population":"unspecified adult workforce (likely convenience sample)","country":"unspecified (U.S. government‑funded research likely U.S.)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study finds that pleasurable sexual activity—whether with a partner or alone—was linked to feeling recovered from work stress and to higher job and life satisfaction, especially for women in committed relationships.","clinical_takeaway":"Pleasurable sexual activity may help employees recover from work stress, but evidence is correlational.","confidence":0.8,"topic_tags":["sexual_function","masturbation","religiosity"],"strengths":["Addresses understudied link between sexual pleasure and work recovery","Considers both partner sex and masturbation","Explores gender moderation"],"limitations":["Cross‑sectional design limits causal inference","Reliance on single‑item self‑reports, unclear validation","No control for moral incongruence, mental health, or trauma"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2150138"}},{"id":3539,"doi":"10.1007/s10508-022-02493-3","pmid":"36508069","pmcid":"PMC10126039","title":"Evaluating the Subjective Orgasm Experience Through Sexual Context, Gender, and Sexual Orientation","authors":"Muñoz-García LE, Gómez-Berrocal C, Sierra JC.","first_author":"Muñoz-García LE","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Gender","Sexual Orientation","Sexual Relationships","Subjective Orgasm Experience","Solitary Masturbation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10126039","cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community survey (N=4255) examining subjective orgasm ratings across contexts, gender, and sexual orientation","sample_n":4255,"sample_text":"4255 participants (1927 men, 2328 women) with heterosexual, bisexual, and gay orientations","population":"adult men and women of various sexual orientations, recruited via online questionnaire (convenience sample)","country":"Spain (presumed based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In over 4,000 adults, orgasm intensity was higher during partnered sex than during solo masturbation, women reported stronger orgasms than men, and heterosexual people reported more intense orgasms than gay or bisexual participants.","clinical_takeaway":"Clinicians should consider relationship context, gender, and orientation when discussing orgasm experiences with clients.","confidence":0.85,"topic_tags":["sexual_function","gender"],"strengths":["Large sample size enhances statistical power","Use of a validated orgasm rating scale","Instrument invariance tested across gender and orientation"],"limitations":["Convenience online sample limits generalisability","Cross‑sectional design precludes causal conclusions","No adjustment for mental‑health or relationship quality variables"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":0,"mentioning":22,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02493-3"}},{"id":3540,"doi":"10.1101/2021.04.20.440432","pmid":null,"pmcid":null,"title":"μ-opioid receptor availability is associated with sex drive in human males","authors":"Nummenmaa L, Jern P, Malén T, Kantonen T, Pekkarinen L, Lukkarinen L, Sun L, Nuutila P, Putkinen V.","first_author":"Nummenmaa L","journal":"bioRxiv","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"PET imaging of mu‑opioid receptor availability in 52 healthy men; self‑reported frequency of partnered sex and masturbation; Bayesian hierarchical regression and voxel‑wise GLM analyses.","sample_n":52,"sample_text":"52 healthy male participants for PET; 108 for VBM","population":"healthy adult males (n=52 for PET, n=108 for VBM)","country":"unspecified (likely Finland based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 52 healthy men, higher availability of brain mu‑opioid receptors, measured with PET, was linked to greater self‑reported sexual activity (partnered sex and masturbation). The study suggests the brain's opioid system may influence how often men engage in sex.","clinical_takeaway":"Endogenous opioid tone appears related to individual differences in male sex drive, but no clinical implications can be drawn from this correlational study.","confidence":0.78,"topic_tags":["sexual_function","neuroscience","moral_incongruence","masturbation"],"strengths":["Use of PET with a high‑affinity MOR agonist radioligand","Reasonably large PET sample for this modality","Bayesian hierarchical modelling"],"limitations":["Sex‑drive measured only by simple self‑report, no validated scale","No control for key psychosocial confounds (morality, mental health, relationship status)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":8,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":2,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2021.04.20.440432"}},{"id":3541,"doi":"10.1016/j.androl.2019.10.001","pmid":"32081623","pmcid":null,"title":"[Subjective orgasm experience in the context of solitary masturbation]","authors":"Sierra JC, Ortiz A, Calvillo C, Arcos-Romero AI.","first_author":"Sierra JC","journal":"Revista internacional de andrologia","year":2021,"pub_types":["Journal Article"],"keywords":["Age","Sex","Masturbation","Edad","Sexo","Sexual Relationship","Masturbación","Subjective Orgasm Experience","Experiencia Orgásmica Subjetiva","Relaciones Sexuales"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 874 heterosexual adults from general Spanish population; comparison of subjective orgasm ratings between solitary masturbation and partnered sex using Orgasm Rating Scale.","sample_n":874,"sample_text":"874 heterosexual adults (441 men, 433 women) aged 18‑93, recruited from the general Spanish population.","population":"Adults (18‑93) from Spain, heterosexual, community sample","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 874 Spanish adults, women and younger people reported more intense orgasms during solo masturbation than men or older adults, but orgasms were rated as most intense when occurring with a partner.","clinical_takeaway":"Orgasm intensity varies by age, sex, and context; clinicians should consider these factors when discussing sexual wellbeing.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Large community sample","Validated orgasm rating instrument","Clear comparison of contexts"],"limitations":["Cross‑sectional, no causal inference","No effect sizes reported","Limited control of psychological confounds"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.androl.2019.10.001"}},{"id":3543,"doi":"10.1016/j.jbtep.2022.101826","pmid":"36521200","pmcid":null,"title":"The effects of bilateral stimulation using eye movements on sexual fantasies with follow-up","authors":"Allen A, McKillop N, Katsikitis M, Millear P.","first_author":"Allen A","journal":"Journal of behavior therapy and experimental psychiatry","year":2023,"pub_types":["Journal Article"],"keywords":["Eye movements","Working memory","Mental Imagery","Sexual Fantasies","Emdr Therapy"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"single-group repeated-measures intervention (EM eye‑movement task) with baseline, five rounds, and 1‑week follow‑up; no control condition; N=28 (14 male, 14 female)","sample_n":28,"sample_text":"28 participants (14 male, 14 female) recruited to select a favored sexual fantasy and complete EM task","population":"adult volunteers (mean age 44 y); unspecified recruitment method","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 28 adults, repeatedly moving the eyes while imagining a favorite sexual fantasy made the fantasies feel less vivid, arousing, and believable. The effect persisted, though weakened, after one week, and participants reported they would masturbate less because of the fantasies.","clinical_takeaway":"Brief eye‑movement tasks may reduce the vividness of sexual fantasies, but evidence is limited; clinicians should await stronger trials before recommending as treatment.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Within‑subject repeated measures allow observation of change over time","Follow‑up assessment adds temporal perspective","Novel application of EMDR‑like bilateral stimulation to sexual fantasy imagery"],"limitations":["No control or comparison group; limits causal inference","Small convenience sample (N=28) reduces statistical power","Reliance on ad‑hoc self‑report scales; no validated instruments","Potential demand characteristics; participants aware of hypothesis"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jbtep.2022.101826"}},{"id":3545,"doi":null,"pmid":"36752256","pmcid":null,"title":"Sexuality in Assisted Reproductive Technology Couples","authors":"Djaković I, Soljačić Vraneš H, Potkonjak AM, Tomić J, Kraljević Z, Vraneš H.","first_author":"Djaković I","journal":"Psychiatria Danubina","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire of 96 ART couples (192 individuals) recruited while waiting routine procedures; convenience sample","sample_n":192,"sample_text":"96 couples (192 participants) completed an anonymous questionnaire","population":"couples undergoing assisted reproductive technology in a clinical setting","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 96 couples undergoing assisted reproductive treatment, men reported masturbating more often than women, while the frequency of intercourse and other sexual activities was similar for both sexes. Socio‑demographic factors like education and urban living were linked to frequency, but the treatment itself had little impact on sexual life.","clinical_takeaway":"ART treatment appears to have minimal effect on couples' sexual activity; clinicians should discuss sexuality with both partners.","confidence":0.8,"topic_tags":["sexual_function","masturbation","relationships"],"strengths":["Reasonably sized sample for a specific clinical population","Both partners provided data separately","Inclusion of masturbation frequency"],"limitations":["Convenience sample from ART clinic; limited generalisability","Use of non‑validated ad‑hoc questionnaire items","No control for key psychosocial confounds (e.g., mental health, moral factors)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":3547,"doi":"10.1080/0092623x.2020.1717700","pmid":"32000629","pmcid":null,"title":"Why and How Women Masturbate, and the Relationship to Orgasmic Response","authors":"Rowland DL, Kolba TN, McNabney SM, Uribe D, Hevesi K.","first_author":"Rowland DL","journal":"Journal of sex & marital therapy","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online opt‑in survey of 2215 adult women examining masturbation frequency, reasons, activities and orgasmic outcomes; self‑report data only.","sample_n":2215,"sample_text":"2215 women aged 18+ recruited via an opt‑in online survey.","population":"Adult women (18+), self‑selected online participants; likely WEIRD, volunteer bias.","country":"Not specified (likely USA/English‑speaking based on journal).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A large online survey of over 2,000 women examined how often they masturbate, why they do it, and what activities they use, finding that higher masturbation frequency is linked to lower partner satisfaction, greater importance placed on sex, and higher anxiety/depression, and that these factors predict orgasmic pleasure and difficulty.","clinical_takeaway":"Masturbation frequency relates to partner satisfaction and mental‑health symptoms; clinicians should consider both relational and emotional factors when discussing women’s sexual wellbeing.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Large sample size","Detailed questionnaire on masturbation behaviors","Includes partner relationship variables"],"limitations":["Self‑report, non‑validated measures","Convenience, opt‑in sampling limits generalisability","Cross‑sectional; causal language may be overstated"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":0,"mentioning":62,"citing_publications":74,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2020.1717700"}},{"id":3548,"doi":"10.31234/osf.io/6d3aw","pmid":null,"pmcid":null,"title":"Hormonal Contraception and Sexuality: Causal Effects, Unobserved Selection, or Reverse Causality?","authors":"Botzet L, Gerlach TM, Driebe JC, Penke L, Arslan RC.","first_author":"Botzet L","journal":"PsyArXiv","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://psyarxiv.com/6d3aw/download","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational correlational study with up to 1,179 women; diary measures; sensitivity analysis for unobserved confounding.","sample_n":1179,"sample_text":"Community sample of women (up to 1,179 participants).","population":"Women using or not using hormonal contraception (general community sample).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of up to 1,179 women, hormonal contraceptive use was linked to slightly more vaginal sex but less masturbation. No strong effects on relationship or sexual satisfaction were found, and the hypothesised “congruency” effect (matching contraceptive use at partner meeting) was not supported.","clinical_takeaway":"Hormonal contraception shows minimal impact on relationship or sexual satisfaction; clinicians should discuss possible changes in sexual activity frequency but not expect major psychological effects.","confidence":0.8,"topic_tags":["sexual_function","relationships","religiosity","masturbation"],"strengths":["Large sample size for correlational work","Inclusion of diary measures for behavior frequency","Sensitivity analysis for unobserved confounding"],"limitations":["Cross‑sectional design limits causal inference","Limited reporting on psychometric validation of scales","Potential unmeasured confounders (e.g., mental health, moral factors)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/6d3aw"}},{"id":3549,"doi":"10.1080/00224499.2025.2551734","pmid":"40952755","pmcid":null,"title":"Experiences with Rough Sex Among Autistic University Students: Descriptive Findings from a Campus Probability-Based Survey","authors":"Simić Stanojević I, Wheeler G, Fu TC, Piatt J, Herbenick D.","first_author":"Simić Stanojević I","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive survey of 46 autistic university students (probability‑based recruitment within a single university).","sample_n":46,"sample_text":"46 autistic undergraduate and graduate students","population":"Autistic undergraduate and graduate students at a large Midwestern U.S. public university (N=46).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 46 autistic college students, many reported having engaged in rough‑sex acts like hair‑pulling, spanking, and choking. Most found these experiences pleasurable, but a notable minority felt upset, scared, or even traumatized, and about one‑fifth experienced non‑consensual rough sex.","clinical_takeaway":"Clinicians should discuss a range of sexual practices, including rough sex, with autistic clients and screen for non‑consensual experiences and related distress.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Probability‑based sampling frame within university","Focus on an understudied population (autistic students)","Includes both consensual and non‑consensual experiences"],"limitations":["Very small sample (N=46) limits statistical power","Measures appear ad‑hoc, not validated","No control for key confounds (moral, mental health, trauma)","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2025.2551734"}},{"id":3551,"doi":"10.1016/j.psyneuen.2022.105968","pmid":"36356514","pmcid":null,"title":"The influence of opioid blockage on the sexual response cycle: A randomized placebo-controlled experiment with relevance for the treatment of Compulsive Sexual Behavior Disorder (CSBD)","authors":"Incoronato N, Biedermann SV, Roth L, Müller JC, Fuss J.","first_author":"Incoronato N","journal":"Psychoneuroendocrinology","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":["Prolactin","Pain","Naltrexone","Masturbation","Sexual Arousal","Disgust"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized, double‑blind, placebo‑controlled cross‑over laboratory experiment with 64 healthy participants (32 women). Participants received naltrexone or placebo and underwent a sexual response cycle condition involving erotic audio and masturbation to orgasm.","sample_n":64,"sample_text":"N = 64 healthy participants (32 women) completed two laboratory sessions.","population":"Healthy adult volunteers (both sexes) recruited for laboratory study; not a clinical CSBD sample.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"supports","citation_value":"useful","plain_summary":"A lab study gave 64 healthy adults either naltrexone or placebo and measured sexual arousal, pain and hormone changes while they listened to erotic audio and masturbated. Naltrexone lowered reported arousal and altered prolactin levels, suggesting it could dampen sexual excitement.","clinical_takeaway":"Naltrexone may reduce sexual arousal acutely; its use for CSBD should be considered experimental pending clinical trials.","confidence":0.87,"topic_tags":["neuroscience","sexual_function","csbd"],"strengths":["Randomized, double‑blind crossover design","Physiological and hormonal measures complement self‑report","Clear experimental manipulation of opioid blockade"],"limitations":["No validated CSBD or addiction scales; constructs inferred","Moral, mental‑health and relational confounds not assessed","Findings from healthy volunteers may not generalise to CSBD patients"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psyneuen.2022.105968"}},{"id":3552,"doi":"10.1007/s10815-025-03644-w","pmid":"40936057","pmcid":"PMC12640414","title":"Kisspeptin as a marker for male infertility: a comparative study of serum and seminal plasma kisspeptin between fertile and infertile men","authors":"Parkpinyo N, Anekpornwattana S, Sitticharoon C, Petyim S.","first_author":"Parkpinyo N","journal":"Journal of assisted reproduction and genetics","year":2025,"pub_types":["Comparative Study","research-article","Journal Article"],"keywords":["Male infertility","semen parameters","Semen Analysis","Kisspeptin"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12640414","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of serum and seminal kisspeptin in 52 men (fertile vs infertile with normal/abnormal semen parameters).","sample_n":52,"sample_text":"17 fertile, 18 infertile with normal semen, 17 infertile with abnormal semen.","population":"Adult men, recruited from fertility clinic (fertile volunteers and infertile patients).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study measured a hormone called kisspeptin in blood and semen of 52 men and found higher blood kisspeptin in infertile men than in fertile men, suggesting it could help identify male infertility.","clinical_takeaway":"Serum kisspeptin may be a useful biomarker for male infertility, but larger studies are needed before clinical use.","confidence":0.8,"topic_tags":["sexual_function","religiosity","masturbation","relationships"],"strengths":["Uses validated biochemical assays","Includes both serum and seminal measurements","Clear group definitions based on fertility status"],"limitations":["Small sample size limits power","Cross‑sectional; cannot infer causality","No adjustment for potential confounders (e.g., age, BMI)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10815-025-03644-w"}},{"id":3553,"doi":"10.1111/dmcn.16479","pmid":"40931485","pmcid":"PMC12683302","title":"Communication about sexuality for adolescents with cerebral palsy and complex communication needs: A scoping review with framework synthesis","authors":"Walsh M, Sawyer SM, Watson JM, O'Shea A, Cranko G, Pacheco CM, Pennacchia J, Anderson KLM.","first_author":"Walsh M","journal":"Developmental medicine and child neurology","year":2026,"pub_types":["Scoping Review","review-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12683302","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review of 16 primary papers, no new data collection","sample_n":null,"sample_text":"16 primary studies identified; no new participants","population":"adolescents (10‑24) with cerebral palsy and complex communication needs","country":"unspecified (multiple primary studies)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review of 16 papers shows that adolescents with cerebral palsy who have complex communication needs often lack opportunities to discuss sexuality with peers and professionals. Current research mostly focuses on communication with caregivers and vulnerability to abuse, leaving a gap in supportive, inclusive sexual education.","clinical_takeaway":"Clinicians should proactively offer tailored communication support to address sexuality and consent for adolescents with CP and communication challenges.","confidence":0.4,"topic_tags":["sexual_function","adolescents","csbd"],"strengths":["Systematic search strategy","Involvement of consumer research partners","Clear identification of gaps in literature"],"limitations":["Only 16 primary studies, most of which involve verbally fluent adolescents","No quantitative synthesis or meta‑analysis","Limited focus on pornography, compulsive sexual behaviour, or addiction concepts"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/dmcn.16479"}},{"id":3555,"doi":"10.1016/j.jsxm.2019.10.012","pmid":"31759932","pmcid":null,"title":"Relationship Between Masturbation and Partnered Sex in Women: Does the Former Facilitate, Inhibit, or Not Affect the Latter?","authors":"Rowland DL, Hevesi K, Conway GR, Kolba TN.","first_author":"Rowland DL","journal":"The journal of sexual medicine","year":2020,"pub_types":["Journal Article"],"keywords":["Women","Masturbation","Orgasm","Partnered Sex","Orgasmic Pleasure","Orgasmic Difficulty"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 2,215 women assessing masturbation and partnered‑sex activities and orgasmic outcomes","sample_n":2215,"sample_text":"self‑selected online respondents","population":"women, multinational, younger age bias, self‑selected internet sample","country":"multinational (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 2,000 women, those whose masturbation techniques were similar to what they do with a partner reported better arousal, higher chance of orgasm, and more pleasure during partnered sex.","clinical_takeaway":"Encouraging women to explore and align solo sexual techniques with partnered activities may improve orgasmic outcomes.","confidence":0.8,"topic_tags":["masturbation","sexual_function","relationships"],"strengths":["large sample size","multinational recruitment","focus on an understudied topic"],"limitations":["cross‑sectional design limits causal inference","self‑report measures, likely non‑validated","younger, self‑selected sample may not generalize","no control for mental health or moral factors"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":1,"mentioning":29,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.10.012"}},{"id":3556,"doi":"10.1111/and.13473","pmid":"31746051","pmcid":null,"title":"The efficacy of regular penis-root masturbation, versus Kegel exercise in the treatment of primary premature ejaculation: A quasi-randomised controlled trial","authors":"Jiang M, Yan G, Deng H, Liang H, Lin Y, Zhang X.","first_author":"Jiang M","journal":"Andrologia","year":2020,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":["Rct","Kegel Exercise","Primary Premature Ejaculation","Regular Penis-root Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"quasi‑randomised controlled trial with 37 participants (18 PRM, 19 KE)","sample_n":37,"sample_text":"37 (18 PRM, 19 KE)","population":"heterosexual males with primary premature ejaculation, recruited from outpatient clinic","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small trial, men with lifelong premature ejaculation who practiced regular penis‑root masturbation lengthened their intercourse time more than men who did Kegel exercises, as measured by a stopwatch and a standard questionnaire.","clinical_takeaway":"Penis‑root masturbation may be a more effective self‑help option than Kegels for primary premature ejaculation, but evidence is limited by small sample size.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","treatment"],"strengths":["Objective IELT measurement","Use of validated PEDT questionnaire","Randomised‑style allocation"],"limitations":["Very small sample (N=37)","Quasi‑randomisation may introduce allocation bias","No reporting of effect sizes or confidence intervals","No control for psychological or relational confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/and.13473"}},{"id":3558,"doi":"10.1016/j.fjurol.2025.102954","pmid":"40912511","pmcid":null,"title":"Fertility preservation in men with spinal cord injury: The 2025 French guidelines","authors":"Guillot-Tantay C, Kassab D, De Vienne C, Chelghaf I, Dequirez PL, Dupuis H, Mazeaud C, Schirmann A, Even A, Marcelli F, Perrin J, Plotton I, Huyghe E, Karsenty G, AFU Working Group.","first_author":"Guillot-Tantay C","journal":"The French journal of urology","year":2026,"pub_types":["Systematic Review","Practice Guideline","Review","Journal Article"],"keywords":["Cryopreservation","Spinal cord injuries","Fertility Preservation","Préservation De La Fertilité","Cryoconservation","Blessures Médullaires"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Guideline based on systematic review of 115 studies (1990‑2024) following PRISMA; provides clinical recommendations for fertility preservation in men with spinal cord injury.","sample_n":null,"sample_text":"115 publications screened, 115 included; no single participant count reported in abstract.","population":"Men with spinal cord injury (SCI) requiring fertility preservation; adult patients; clinical setting.","country":"France","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The 2025 French guideline reviews evidence on how to preserve fertility in men with spinal cord injury, recommending masturbation first, then penile vibratory stimulation, electroejaculation, and surgical sperm retrieval if needed.","clinical_takeaway":"Use a stepwise approach—masturbation, then PVS, EEJ, and finally surgery—to obtain sperm for men with spinal cord injury.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Comprehensive systematic review of 115 studies","Follows PRISMA guidelines","Clear, actionable clinical recommendations"],"limitations":["No meta‑analysis or quantitative synthesis reported","Abstract lacks detail on risk‑of‑bias assessment","Potential heterogeneity of source studies not described"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":2,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.fjurol.2025.102954"}},{"id":3559,"doi":"10.31557/apjcp.2025.26.9.3193","pmid":"40952273","pmcid":"PMC12862413","title":"Exposing the Influence of Preceding Sexual Behavior in Younger Years toward Prostate Cancer Occurrence: Qualitative Mapping on Sexual Risk Factors","authors":"Firsty NN, Warli SM, Velaro AJ, Siregar GP, Kadar DD, Prapiska FF.","first_author":"Firsty NN","journal":"Asian Pacific journal of cancer prevention : APJCP","year":2025,"pub_types":["Systematic Review","review-article","Journal Article"],"keywords":["Sexual behavior","prostate cancer","Intercourse","Ejaculation Frequency","First Sexual Activity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12862413","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic literature review of retrospective cohort and case‑control studies (10 studies, 6601 cases, 6208 controls) following PRISMA; qualitative synthesis of associations between early sexual behavior and later prostate cancer risk.","sample_n":12809,"sample_text":"Total participants across included studies: 6,601 prostate cancer cases and 6,208 controls.","population":"Men studied in the included observational reports; ages at exposure 20‑40 years, outcome prostate cancer diagnosed later in life.","country":"Not specified (multiple study locations).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of ten observational studies suggests that frequent sex may lower prostate cancer risk, while frequent masturbation and many lifetime partners might raise risk, though findings are mixed and need prospective confirmation.","clinical_takeaway":"Current evidence does not justify changing sexual practices for prostate cancer prevention; clinicians should await stronger prospective data.","confidence":0.78,"topic_tags":["sexual_function","csbd"],"strengths":["Systematic review using PRISMA guidance","Includes a sizable total sample across studies","Separates intercourse‑related ejaculation from masturbation"],"limitations":["Relies on heterogeneous observational studies with varying definitions","No quantitative meta‑analysis or pooled effect sizes","Does not control for key psychosocial confounders (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31557/apjcp.2025.26.9.3193"}},{"id":3560,"doi":"10.1093/jsxmed/qdaf166","pmid":"40693895","pmcid":null,"title":"Sexual health outcomes following gender-affirming phalloplasty: a systematic review","authors":"Zack J, Goldstein B, Okamuro K, Lewis P, Anger J, Uloko M.","first_author":"Zack J","journal":"The journal of sexual medicine","year":2025,"pub_types":["Systematic Review","Journal Article"],"keywords":["Penetration","Donor site","Arousal","Sexual Health","Orgasm","Phalloplasty","Transmasculine"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 18 observational studies on sexual function after phalloplasty, following PRISMA guidelines; no meta‑analysis.","sample_n":18,"sample_text":"Eighteen articles met inclusion criteria (total participants not reported in abstract).","population":"Transmasculine patients who have undergone phalloplasty (various techniques).","country":"Not specified","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review summarises how transmasculine people feel about desire, arousal, sensation and orgasm after phalloplasty. Results vary widely across surgical techniques, and many studies lack validated questionnaires or pre‑surgery baselines.","clinical_takeaway":"Clinicians should discuss the variable sexual outcomes of phalloplasty with patients and note that current evidence is limited by inconsistent measurement.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Systematic search across three major databases","Use of PRISMA reporting standards","Clear identification of gaps in the literature","Attention to technique‑specific outcomes"],"limitations":["Primary studies use heterogeneous, often non‑validated sexual function measures","No pre‑surgical baseline data in most studies","No quantitative synthesis (meta‑analysis) performed","Potential selection bias in included case series"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf166"}},{"id":3561,"doi":"10.17219/dmp/209574","pmid":"41099537","pmcid":null,"title":"Sleep, sex and psychosocial health: Expanding the horizons of behavioral sleep medicine","authors":"Meira E Cruz M, Andersen ML.","first_author":"Meira E Cruz M","journal":"Dental and medical problems","year":2025,"pub_types":["Editorial"],"keywords":["Sleep","Sexual behavior","Sleep disorders","Sexual Medicine"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Editorial without empirical data; no sample, no methods.","sample_n":null,"sample_text":"None – editorial","population":"Not applicable","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The editorial proposes that partnered sex or masturbation might slightly improve sleep continuity through hormonal and circadian mechanisms, and suggests clinicians consider these practices carefully within behavioral sleep medicine.","clinical_takeaway":"Clinicians may discuss sexual activity as a modest, optional aid for sleep, but evidence remains limited.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Thoughtful integration of sexuality into sleep medicine","Emphasizes patient‑centred, ethical approach"],"limitations":["No empirical data presented","Claims not supported by direct evidence","Lacks measurement of key confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.17219/dmp/209574"}},{"id":3562,"doi":"10.1016/j.jsxm.2022.08.201","pmid":"36216747","pmcid":null,"title":"Solo and Partnered Sexual Behavior Among an International Sample of Adults With Spina Bifida","authors":"Hensel DJ, Misseri R, Wiener JS, Roth JD, Whittam BM, Cain MP, Szymanski KM.","first_author":"Hensel DJ","journal":"The journal of sexual medicine","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Spina Bifida","Anal Sex","Oral Sex","Vaginal Sex","Sex Toys","Partnered Sexual Behavior","Solo Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional internet‑based survey of 345 adults with spina bifida from 26 nations; logistic regression on demographic and health predictors of solo and partnered sexual behaviors.","sample_n":345,"sample_text":"International convenience sample; not a probability or clinical sample.","population":"Adults (18‑73) with spina bifida; international convenience sample.","country":"International (26 nations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 345 adults with spina bifida from 26 countries, most reported having engaged in solo masturbation and a range of partnered sexual activities, with about a quarter having tried every behavior listed. Age, gender, living independence, and health factors influenced whether they had recent sexual activity.","clinical_takeaway":"Adults with spina bifida often engage in both solo and partnered sexual activities; clinicians should discuss sexuality routinely as part of care.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Large international sample for a rare disability.","Comprehensive list of solo and partnered behaviors.","Multivariate logistic regression to identify predictors."],"limitations":["Cross‑sectional, retrospective self‑report.","Convenience internet sample – possible selection bias.","No validated sexuality scales; simple yes/no items.","Limited control for psychosocial confounds (e.g., mental health)."],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2022.08.201"}},{"id":3564,"doi":"10.31729/jnma.7876","pmid":"36705147","pmcid":"PMC9924918","title":"Penile Fracture: A Case Report","authors":"Yogi P, Sapkota S, Shiwakoti S, Dongol UMS, Paudyal P, Karki A.","first_author":"Yogi P","journal":"JNMA; journal of the Nepal Medical Association","year":2022,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":[],"is_oa":true,"oa_url":"https://www.jnma.com.np/jnma/index.php/jnma/article/download/7876/4371","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with penile fracture following sexual intercourse; description of clinical presentation, imaging, surgical repair.","sample_n":1,"sample_text":"single case","population":"44‑year‑old male","country":"Nepal","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 44‑year‑old man suffered a penile fracture during sex; the injury was confirmed by ultrasound and successfully repaired surgically.","clinical_takeaway":"Prompt surgical repair is essential to prevent long‑term complications after penile fracture.","confidence":0.9,"topic_tags":["sexual_function","gender"],"strengths":["Detailed clinical description","Use of ultrasound for diagnosis"],"limitations":["Single case, no generalisability","No systematic data or statistical analysis","No control or comparison group"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31729/jnma.7876"}},{"id":3565,"doi":"10.1177/2054270419878386","pmid":"31700648","pmcid":"PMC6829633","title":"The endocrine management of intractable masturbation after epilepsy surgery: a case report and literature review","authors":"Ebere I, Staufenberg EF, Dhatariya KK.","first_author":"Ebere I","journal":"JRSM open","year":2019,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Management","Masturbation","Epilepsy Surgery"],"is_oa":true,"oa_url":"https://journals.sagepub.com/doi/pdf/10.1177/2054270419878386","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report describing endocrine treatment of post‑epilepsy‑surgery intractable masturbation","sample_n":1,"sample_text":"1 patient (case report)","population":"one adult patient after epilepsy surgery","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A patient developed uncontrollable masturbation after epilepsy surgery; the authors stopped it using hormone‑blocking medication and an antipsychotic, and review similar cases.","clinical_takeaway":"Endocrine agents may help severe, surgery‑related hyper‑masturbation, but evidence is limited to isolated case reports.","confidence":0.78,"topic_tags":["masturbation","neuroscience","treatment","sexual_function"],"strengths":["Detailed clinical description of a rare postoperative phenomenon","Provides therapeutic insight (cyproterone acetate + haloperidol)"],"limitations":["Single case; no generalisable evidence","No validated measures of masturbation frequency or distress","No systematic assessment of confounders (moral, mental health, partner factors)"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/2054270419878386"}},{"id":3566,"doi":"10.21037/tau-2025-348","pmid":"40949434","pmcid":"PMC12433156","title":"Sympathetic hyperactivity in situational delayed ejaculation (intravaginal anejaculation phenotype): a neurophysiological case-control study","authors":"Gao Q, Yang B, Han Y, Dai Y, Yu W, Ni D.","first_author":"Gao Q","journal":"Translational andrology and urology","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Anxiety","Delayed Ejaculation","Sympathetic Skin Response (Ssr)","Intravaginal Anejaculation","Situational Delayed Ejaculation (Sd-de)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12433156","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control study comparing 67 patients with situational delayed ejaculation to 65 healthy controls; physiological (PSSR) and questionnaire measures collected","sample_n":132,"sample_text":"Sixty‑seven SD‑DE patients and 65 normal controls","population":"adult men with situational delayed ejaculation (clinical sample) and healthy male controls; recruited from clinical settings","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Men with situational delayed ejaculation showed faster sympathetic skin responses than controls, suggesting heightened sympathetic activity. This physiological difference was linked to higher anxiety and altered masturbation patterns.","clinical_takeaway":"Sympathetic hyperactivity may underlie situational delayed ejaculation; assessing autonomic function could inform treatment.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Objective neurophysiological measure (PSSR)","Use of validated anxiety scale","Reasonable sample size for case‑control design"],"limitations":["Cross‑sectional; cannot infer causality","Limited control for key confounds (masturbation, partner factors)","No effect sizes or correction for multiple testing reported"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21037/tau-2025-348"}},{"id":3567,"doi":"10.29399/npa.23475","pmid":"31903044","pmcid":"PMC6927086","title":"Hypersexuality Manifesting as Excessive Masturbation in a Female Patient After Temporal Lobe Epileptic Surgery: A Rare Case Report","authors":"Gündüz N, Turan H, Polat A.","first_author":"Gündüz N","journal":"Noro psikiyatri arsivi","year":2019,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Epilepsy","Temporal lobe","Hypersexuality","Epileptic Surgery","Excessive Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single patient (case report)","population":"single 38‑year‑old female patient, post‑temporal‑lobe epileptic surgery","country":"Turkey (inferred from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 38‑year‑old woman who had part of her temporal lobe removed 11 years earlier began masturbating excessively. The authors describe the case and discuss possible reasons for hypersexual behaviour after epilepsy surgery.","clinical_takeaway":"Clinicians should monitor changes in sexual behaviour after temporal‑lobe procedures, but single case reports do not establish prevalence or treatment guidance.","confidence":0.85,"topic_tags":["sexual_function","neuroscience"],"strengths":["Provides detailed clinical description of a rare postoperative phenomenon","Highlights need for awareness of sexual side‑effects after temporal lobe surgery"],"limitations":["Single case, no systematic assessment or validated measures","No control or comparison group","Potential confounders (mood, medication, religious or moral attitudes) not addressed"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.29399/npa.23475"}},{"id":3570,"doi":"10.1080/19317611.2025.2539758","pmid":"40843158","pmcid":"PMC12366810","title":"Sexual Desire Among Men Who Have Sex with Men in the Czech Republic: A Cross-Sectional Study","authors":"Sekera JC.","first_author":"Sekera JC.","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Czech Republic","Sexual Desire","Men Who Have Sex With Men (Msm)","Sdi-2"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 410 MSM recruited via social media and community outreach; uses validated Sexual Desire Inventory‑2; analyses ANOVA, correlations, effect sizes.","sample_n":410,"sample_text":"Convenience sample recruited through internet/social media; not probability‑based.","population":"MSM, Czech Republic, age 18‑60 (N=410)","country":"Czech Republic","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 410 Czech men who have sex with men, sexual desire varied with relationship status, age, education and HIV status. Being in a partnership and having more frequent sexual activity boosted desire for sex with a partner, while younger men and those who masturbated more often reported higher solitary desire.","clinical_takeaway":"Sexual desire in MSM is shaped by relationship and demographic factors; clinicians should consider these when addressing sexual health.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large (N=410) sample for a niche population","Use of validated SDI‑2 instrument","Separate dyadic and solitary desire subscales"],"limitations":["Convenience online recruitment limits generalisability","No measurement of mental‑health or trauma variables","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2025.2539758"}},{"id":3571,"doi":"10.1093/jsxmed/qdaf106","pmid":"40500995","pmcid":null,"title":"Comment on: Are some forms of delayed/inhibited ejaculation more intractable than others? Establishing delayed ejaculation subtypes based on severity of symptomology during partnered sex and masturbation","authors":"Komlenac N.","first_author":"Komlenac N.","journal":"The journal of sexual medicine","year":2025,"pub_types":["Comment","Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf106"}},{"id":3572,"doi":"10.1093/sexmed/qfaf072","pmid":"40937118","pmcid":"PMC12421998","title":"Prevalence and associated factors of delayed ejaculation: insights from a nationwide internet-based, cross-sectional survey on male sexual dysfunction in Japan","authors":"Shirai M, Tsujimura A, Fukuhara S, Chiba K, Yoshizawa T, Tomoe H, Kimura K, Kikuchi E, Maeda E, Sato Y, Nagai A, Nagao K, Sasaki H, Clinical Research Promotion Committee of the Japanese Society for Sexual Medicine.","first_author":"Shirai M","journal":"Sexual medicine","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Prevalence","Cross-sectional studies","Associated Factors","Ejaculatory Dysfunction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12421998","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional internet‑based survey of 5,331 sexually active Japanese men (nationwide panel)","sample_n":5331,"sample_text":"5331 sexually active men","population":"Japanese men age 20‑79, sexually active, recruited via a general‑population online panel","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 5,000 Japanese men, about 5 % reported delayed ejaculation that caused them distress. Factors linked to this condition included use of psychotropic meds, pelvic injury, low relationship satisfaction, erectile problems, neurological disease, obesity, and more frequent masturbation or sex. Many wanted treatment but few sought help.","clinical_takeaway":"Delayed ejaculation is relatively common and often co‑occurs with other health and relationship issues; clinicians should ask about it and address barriers to treatment.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Large, nationwide sample","Multivariate logistic regression","Includes both sexual‑behavior and health variables"],"limitations":["Self‑report, internet‑based data may bias responses","DE defined solely by distress, no validated diagnostic instrument","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfaf072"}},{"id":3574,"doi":"10.1055/s-0045-1809927","pmid":"41480567","pmcid":"PMC12755937","title":"Abnormal Sexual Behavior During Sleep in an Adolescent: Sexsomnia and Defecation","authors":"Kapan OG, Aydilek ZI, Kapan M, Baştemur M, Koç G, Bodur Ş, Yetkin S, Cöngöloğlu MA.","first_author":"Kapan OG","journal":"Sleep science (Sao Paulo, Brazil)","year":2025,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Sexual behavior","Adolescent","Defecation","Parasomnias","Sexsomnia"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12755937","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single adolescent male with sexsomnia and defecation; no control group, no longitudinal follow‑up","sample_n":1,"sample_text":"single adolescent male","population":"adolescent male (single case)","country":"Turkey (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A teenage boy experienced sexual activity and defecation while asleep, a rare form of a sleep disorder called sexsomnia. This is the first report of defecation occurring together with sexsomnia.","clinical_takeaway":"Clinicians should consider sexsomnia in adolescents presenting with nighttime sexual behaviors, even with unusual autonomic symptoms.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rare documentation of sexsomnia in an adolescent","Novel observation of defecation concurrent with sexsomnia"],"limitations":["Single case limits generalizability","No systematic assessment of sexual or mental‑health variables","No control or comparison group"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-0045-1809927"}},{"id":3575,"doi":"10.1016/j.ijchp.2025.100605","pmid":"40688561","pmcid":"PMC12273419","title":"Examining the reliability and sources of validity evidence of the sexual cognitions checklist","authors":"Pérez-Amorós C, Sierra JC, Cervilla O, Sánchez-Fuentes MDM.","first_author":"Pérez-Amorós C","journal":"International journal of clinical and health psychology : IJCHP","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["reliability","Gender Differences","Measurement Invariance","Sexual Functioning","Sexual Cognitions"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12273419","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large community sample, N=2004, measurement invariance, reliability, correlational analyses","sample_n":2004,"sample_text":"2004 Spanish cisgender heterosexual adults (48.1% men, 51.9% women) aged 18‑79","population":"Spanish cisgender heterosexual adults, age 18‑79","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The Spanish version of the Sexual Cognitions Checklist reliably measures positive and negative thoughts about sex. Scores are consistent across genders, ages, education and relationship status, and relate as expected to how well people function sexually in both solo and partnered contexts.","clinical_takeaway":"The SCC can be used confidently to assess sexual cognitions and guide clinical discussions about sexual functioning.","confidence":0.7,"topic_tags":["measurement","sexual_function"],"strengths":["Large, diverse sample (N>2000)","Comprehensive measurement invariance testing","Good internal consistency (McDonald's omega)","Associations with sexual functioning provide convergent validity"],"limitations":["Cross‑sectional; cannot infer causality","No assessment of moral or mental‑health confounds","Sample limited to cis‑gender heterosexual Spaniards"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijchp.2025.100605"}},{"id":3576,"doi":"10.1080/0092623x.2019.1586021","pmid":"30836851","pmcid":null,"title":"The Experience of Orgasmic Pleasure during Partnered and Masturbatory Sex in Women with and without Orgasmic Difficulty","authors":"Rowland D, Donarski A, Graves V, Caldwell C, Hevesi B, Hevesi K.","first_author":"Rowland D","journal":"Journal of sex & marital therapy","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online and paper‑and‑pencil survey of 2,059 women in the USA and Hungary.","sample_n":2059,"sample_text":"2059 women completed surveys; recruitment via online platforms and paper‑and‑pencil methods.","population":"adult women, community sample (self‑selected online respondents)","country":"USA, Hungary","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 2,000 women, pleasure during orgasm was higher with a partner than during solo masturbation. Women who have trouble reaching orgasm still reported more pleasure with a partner, but overall less pleasure than women without difficulty. Factors like relationship quality, how often they have sex, and how important sex is to them explained some of the differences.","clinical_takeaway":"Clinicians should note that relational factors strongly influence orgasmic pleasure; interventions that improve relationship quality may boost sexual satisfaction, especially for women with orgasmic difficulty.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size (N>2000) from two countries","Separates partnered vs. masturbatory contexts","Considers relational covariates (relationship quality, frequency)","Addresses orgasmic difficulty subgroup"],"limitations":["Cross‑sectional, cannot infer causality","Self‑selected online sample may limit generalisability","Limited control for mental‑health or moral‑incongruence factors"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":1,"mentioning":22,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2019.1586021"}},{"id":3577,"doi":"10.1016/j.jsxm.2019.04.015","pmid":"31155389","pmcid":null,"title":"Masturbatory Behavior in a Population Sample of German Women","authors":"Burri A, Carvalheira A.","first_author":"Burri A","journal":"The journal of sexual medicine","year":2019,"pub_types":["Journal Article"],"keywords":["Sexual function","Women","Masturbation","Orgasm Ability"],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey of 425 German women (mean age 26.6), 76-item questionnaire combining self‑constructed and validated measures; descriptive and correlational analyses.","sample_n":425,"sample_text":"425 women, mean age 26.6, 61.4% in a committed relationship.","population":"German women, community sample (online recruitment).","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A German online survey of 425 women described how often they masturbate, why they do it, and what fantasies they have. Most masturbate weekly, often for stress relief, and many reach orgasm during solo sex.","clinical_takeaway":"Masturbation is commonly used by women as a stress‑relief strategy rather than a partner substitute.","confidence":0.7,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Large sample for a sexuality survey","Combines validated and novel items","Provides detailed description of female masturbation"],"limitations":["Convenience online sample, limited generalisability","Reliance on self‑report, no objective measures","Limited control of potential confounds (e.g., mental health, moral factors)","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":1,"mentioning":26,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.04.015"}},{"id":3578,"doi":"10.1002/cncr.35967","pmid":"40614134","pmcid":"PMC12492473","title":"Comprehensive assessment of sexual function in male survivors of childhood cancer: A report from the Childhood Cancer Survivor Study","authors":"Marchak JG, Seidel KD, Cherven BO, Klosky JL, Ritenour CWM, Leisenring WM, Sklar CA, Ford JS, Krull KR, Robison LL, Armstrong GT, Meacham LR.","first_author":"Marchak JG","journal":"Cancer","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Childhood Cancer","Survivors","Sexual Functioning","Health Knowledge"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large comparative survey of male childhood‑cancer survivors and sibling controls","sample_n":1595,"sample_text":"1595 survivors, 269 siblings","population":"Male survivors of childhood cancer (N=1595) and siblings (N=269)","country":"USA (Childhood Cancer Survivor Study)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A large survey of adult male survivors of childhood cancer found that about 8% reported poor overall sexual functioning—roughly double the rate seen in their siblings. Higher risk was linked to older age, being unmarried, lower education, cognitive problems, and high‑dose brain or testicular radiation.","clinical_takeaway":"Clinicians should screen male cancer survivors for a range of sexual difficulties, not just erectile problems, especially if they have had high‑dose cranial or testicular radiation.","confidence":0.9,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Large, well‑characterized survivor cohort","Sibling comparison group","Multivariable logistic regression with confidence intervals"],"limitations":["Cross‑sectional; cannot infer causality","Limited assessment of psychological confounds (e.g., depression, moral incongruence)","Potential self‑report bias in sexual function questionnaire"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/cncr.35967"}},{"id":3579,"doi":"10.1071/sh24213","pmid":"40977199","pmcid":null,"title":"The use of saliva as a lubricant in relation to sexual behavioural patterns in men who have sex with men: an exploratory cross-sectional study","authors":"Li G, Liu Y, Hu Y, Lu F, She B, Zhao R, Chow EPF, Zhang L.","first_author":"Li G","journal":"Sexual health","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of MSM in Xi'an, China (N=1142, 225 saliva users); convenience recruitment; subgroup analysis on saliva use","sample_n":1142,"sample_text":"1142 participants; 225 reported saliva use as a lubricant","population":"men who have sex with men (MSM) in China, adult age range","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,142 Chinese MSM, about 20% reported using saliva as a lubricant. Those who did were also more likely to kiss, masturbate alone, and preferred using their own saliva applied via the hands.","clinical_takeaway":"Saliva use is a common lubricant among some MSM and is linked to specific sexual practices; clinicians should ask about lubricant type when assessing sexual health.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large overall sample (N>1000)","Specific focus on a rarely studied behaviour (saliva as lubricant)","Clear descriptive statistics of sexual acts"],"limitations":["Self‑report, ad‑hoc questionnaire without validation","Convenience sampling limits generalisability","No control for key confounds (moral, mental health, partner effects)","Statistical reporting limited to p‑values, no effect sizes or power analysis"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh24213"}},{"id":3580,"doi":"10.1007/s00192-025-06206-x","pmid":"40586909","pmcid":null,"title":"Female Orgasmic Disorder: How Far We Have [Not] Come?","authors":"Dasrilsyah RA, Rotem R, O'Leary B, Domoney C, O'Reilly B.","first_author":"Dasrilsyah RA","journal":"International urogynecology journal","year":2025,"pub_types":["Review","Journal Article"],"keywords":["Anorgasmia","Female Sexual Dysfunction","Orgasm","Female Orgasm","Female Orgasmic Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods or risk‑of‑bias assessment","sample_n":null,"sample_text":"review of 20 published articles; no primary data collection","population":"humans (female adults with orgasmic disorder)","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review summarises what is known about the female orgasm, its underlying anatomy and neurobiology, and discusses why some women experience persistent difficulty reaching orgasm, as well as current therapeutic approaches.","clinical_takeaway":"Clinicians should adopt a biopsychosocial assessment for women with orgasmic difficulties and consider personalized interventions such as pelvic‑floor training, psychotherapy, or pharmacotherapy.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad overview of physiological, neurobiological and psychosocial aspects","Inclusion of recent treatment modalities"],"limitations":["Not a systematic review; selection bias possible","No quantitative synthesis or meta‑analysis","Lacks critical appraisal of primary study quality"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00192-025-06206-x"}},{"id":3581,"doi":"10.21203/rs.3.rs-61952/v1","pmid":null,"pmcid":null,"title":"“INSIDE” Project on Sexual Health in Spain: The Impact of the Lockdown Caused by COVID-19","authors":"Ballester-Arnal R, Nebot-Garcia JE, Ruiz-Palomino E, Giménez-García C, Gil-Llario MD.","first_author":"Ballester-Arnal R","journal":"Research Square","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":true,"oa_url":"https://www.researchsquare.com/article/rs-61952/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["masturbation","sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 1,448 Spanish adults during COVID‑19 lockdown","sample_n":1448,"sample_text":"large, but convenience online volunteer sample","population":"Spanish general population, 18‑60 y, recruited via online questionnaire","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,448 adults in Spain during the COVID‑19 lockdown found that nearly half reported a change in sexual life, with women more often reporting a decline. Factors such as gender, relationship status, privacy, stress and how unbearable the confinement felt predicted whether people felt their sexual life improved or worsened.","clinical_takeaway":"Clinicians should consider lockdown‑related stress and relationship context when addressing patients’ sexual concerns.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large sample size","Broad range of sexual‑behaviour variables","Timely assessment during COVID‑19 lockdown"],"limitations":["Self‑report, ad‑hoc items; limited construct validation","Cross‑sectional; no causal inference","No measurement of moral incongruence or mental‑health diagnoses"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-61952/v1"}},{"id":3583,"doi":"10.1101/2020.08.10.20171348","pmid":null,"pmcid":null,"title":"Love during lockdown: findings from an online survey examining the impact of COVID-19 on the sexual practices of people living in Australia","authors":"Coombe J, Kong F, Bittleston H, Williams H, Tomnay J, Vaisey A, Malta S, Goller J, Temple-Smith M, Bourchier L, Lau A, Chow EP, Hocking JS.","first_author":"Coombe J","journal":"medRxiv","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":true,"oa_url":"https://www.medrxiv.org/content/medrxiv/early/2020/08/12/2020.08.10.20171348.full.pdf","cited_by_count":1,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience survey of Australian adults (N≈965) comparing self‑reported sexual practices in 2019 vs COVID‑19 lockdown (April‑May 2020).","sample_n":965,"sample_text":"965 completers (81% of 1187 who started).","population":"Adults living in Australia, majority female (70%) and aged 18‑29 (66%).","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2020 online survey of 965 Australians found that during COVID‑19 lockdown people had less partnered sex, more solo activities like masturbation and sex‑toy use, and changed how they used dating apps.","clinical_takeaway":"Lockdowns may reduce partnered sex but increase solo sexual activity; services should remain accessible for all sexual health needs.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large sample for an online survey","Both partnered and solo activities captured","Use of logistic regression with confidence intervals"],"limitations":["Convenience, young‑female skewed sample","Ad‑hoc self‑report items, no validated scales","No control for moral, mental‑health or relationship factors"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2020.08.10.20171348"}},{"id":3585,"doi":"10.1007/s00520-025-09640-1","pmid":"40518469","pmcid":null,"title":"2024 SOGC, 2024 NCCN, 2022 ESO-ESMO, and 2018 ASCO: a comparison of female cancer survivorship guidelines for the management of sexual health concerns","authors":"Bhinder JK, Kennedy SKF, Faouk Al Aadah C, Al-Khaifi M.","first_author":"Bhinder JK","journal":"Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer","year":2025,"pub_types":["Comparative Study","Review","Journal Article"],"keywords":["Sexual dysfunction","Sexual Health","Guidelines","Female Cancer Survivors"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Comparative review of clinical practice guidelines; no original empirical data; not a systematic review","sample_n":null,"sample_text":"Not applicable – guideline documents reviewed","population":"Female cancer survivors (implicit, via guideline focus)","country":"International (guidelines from US, Europe, Canada)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The paper compares four major cancer‑survivorship guidelines on how to treat sexual problems in women, noting where recommendations agree (e.g., lubricants, multidisciplinary care) and where evidence is still weak.","clinical_takeaway":"Clinicians can follow shared guideline recommendations for non‑hormonal and hormonal treatments, but should note limited evidence for many pharmacologic options.","confidence":0.85,"topic_tags":["sexual_function","csbd"],"strengths":["Comprehensive comparison of major oncology survivorship guidelines","Identifies areas of consensus and gaps for future research"],"limitations":["Not a systematic review; selection criteria unclear","No quantitative synthesis or appraisal of guideline quality","Does not address patient‑level outcomes or empirical data"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00520-025-09640-1"}},{"id":3586,"doi":"10.1007/s10508-025-03186-3","pmid":"40467830","pmcid":"PMC12283868","title":"Expressive Existential Psychoeducational Intervention Treatment for Maladaptive Sexual Behavior in a Boy with Trisomy 21 Syndrome","authors":"Federici S, Mosconi E, Rossler ME, Mossuto V.","first_author":"Federici S","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Case Reports"],"keywords":["Down syndrome","Psychoeducational Intervention","Intellectual And Developmental Disability","Maladaptive Sexual Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12283868","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"prospective longitudinal single‑case assessment with pre‑, post‑ and 3‑month follow‑up using Vineland‑II and a sexual knowledge/behavior tool","sample_n":1,"sample_text":"single case (G, 17 y/o male)","population":"adolescent male with Trisomy 21 and moderate intellectual disability (n=1)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A single adolescent with Down syndrome received a psychoeducational program aimed at improving sexual behavior, especially managing masturbation and aggression. After the program, standardized scores suggested reduced maladaptive sexual behaviors, which were maintained three months later.","clinical_takeaway":"Small‑scale psychoeducational work may help manage maladaptive sexual behavior in adolescents with intellectual disability, but evidence is limited to one case.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses validated developmental and sexual behavior scales","Longitudinal follow‑up (pre, post, 3‑month)","Detailed qualitative description of intervention components"],"limitations":["Single‑case design; no control or comparison group","No statistical inference; only descriptive changes","Limited assessment of potential confounds (e.g., mental health, moral factors)","Generalizability to broader populations is unclear"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03186-3"}},{"id":3587,"doi":"10.1016/j.acuroe.2025.501790","pmid":"40480427","pmcid":null,"title":"Molecular detection and clinical relevance of Haemophilus spp. in male urethritis: Prevalence and risk factors","authors":"Mar-Herrera O, Llaca-Díaz J, Flores-Aréchiga A, Casillas-Vega N.","first_author":"Mar-Herrera O","journal":"Actas urologicas espanolas","year":2025,"pub_types":["Journal Article"],"keywords":["PCR","Gene","Men","Urethritis","Haemophilus","Gen","Hombres","Uretritis"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional prevalence study of 200 men with urethritis; PCR detection of Haemophilus spp.; risk factor questionnaire.","sample_n":200,"sample_text":"200 urinary DNA samples from patients diagnosed with urethritis","population":"Male patients diagnosed with urethritis, mean age 55 years (range 20‑95), recruited from clinical settings.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 200 men with urethritis, 9.5% carried Haemophilus parainfluenzae, while none had H. influenzae. The bacteria were linked to lower education, many sexual partners, masturbation, and sex under alcohol or drugs, suggesting testing could help diagnose urethritis in high‑risk groups.","clinical_takeaway":"Testing for H. parainfluenzae may aid diagnosis and treatment planning in men with non‑gonococcal urethritis, especially those with multiple risk factors.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Validated molecular detection (PCR) of pathogens","Reasonable sample size for prevalence estimate","Provides odds ratios with confidence intervals"],"limitations":["Risk‑factor data based on single‑item self‑report","No adjustment for mental‑health or relationship variables","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.acuroe.2025.501790"}},{"id":3588,"doi":"10.1093/jsxmed/qdaf122","pmid":"40413794","pmcid":null,"title":"Sexual dissatisfaction and associated factors among middle-aged men-data from the Bavarian Men's Health study","authors":"Schmalbrock LJ, Schweitzer TMP, Meissner VH, Leiber-Caspers C, Dinkel A, Schiele S, Jahnen M, Schulwitz H, Gschwend JE, Herkommer K.","first_author":"Schmalbrock LJ","journal":"The journal of sexual medicine","year":2025,"pub_types":["Journal Article"],"keywords":["Middle-aged","Sex Life","Sexual Dissatisfaction","Perceived Importance Of Sexuality","Partnered Sexual Activity","Perceived Pressure With Regard To Sexuality Of Men","Sexual Lifespan","Variety Of Sexual Interactions","Sexual Health Assessment"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 5,615 middle‑aged men from the Bavarian Men’s Health Study; logistic regression used to identify predictors of sexual dissatisfaction.","sample_n":5615,"sample_text":"Large community‑based sample; likely not a clinical or treatment‑seeking group.","population":"Middle‑aged men (≈50 y) from Bavaria, Germany (large community sample).","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 5,600 German men around age 50, more than half reported being dissatisfied with their sex lives. Dissatisfaction was linked to not having a stable partner, fewer partnered sexual acts, more solo masturbation, and feeling pressure about sexual expectations.","clinical_takeaway":"Assess relationship status, variety of partnered activities, and perceived sexual pressure when addressing sexual dissatisfaction in middle‑aged men.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large, community‑based sample (>5 k participants).","Use of validated questionnaires.","Multivariate logistic regression to adjust for several predictors."],"limitations":["Cross‑sectional design prevents causal inference.","Mental‑health, trauma, and moral‑incongruence variables not assessed.","Potential self‑report bias for sexual behavior."],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf122"}},{"id":3590,"doi":"10.1055/s-0045-1806829","pmid":"40451183","pmcid":"PMC12127043","title":"A moral history of seizures: reported causes of seizures in the nineteenth century","authors":"Lima MP, Yacubian EMT.","first_author":"Lima MP","journal":"Arquivos de neuro-psiquiatria","year":2025,"pub_types":["Historical Article","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12127043","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical narrative review of 19th‑century medical literature; no original data collection.","sample_n":null,"sample_text":"Not applicable – study analyses historical texts rather than a participant sample.","population":"19th‑century medical writings; no human participants recruited.","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews 19th‑century medical writings that linked seizures to moral behaviors such as masturbation and poor parenting, showing how social values influenced early neurology.","clinical_takeaway":"None – the paper is historical and does not inform current clinical practice.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Provides historical context for moral attitudes toward masturbation and seizures.","Highlights how social norms shaped medical explanations."],"limitations":["No original empirical data; conclusions are interpretive.","No systematic methodology described for source selection."],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-0045-1806829"}},{"id":3591,"doi":"10.1080/00224499.2025.2503896","pmid":"40439581","pmcid":null,"title":"Sexual Activity, Pleasure, and Testosterone: A Biopsychosocial Analysis of Women Living With and Without HIV in British Columbia, Canada","authors":"Mathews K, Swann SA, Campbell AR, Lee M, Pang D, Tognazzini S, Carter A, Loutfy M, King EM, Nicholson V, Kaida A, Côté HCF, Murray MCM, British Columbia CARMA-CHIWOS Collaboration (BCC3; CIHR CTN 335).","first_author":"Mathews K","journal":"Journal of sex research","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of women with and without HIV; multivariable logistic regression; sample size not reported in abstract","sample_n":null,"sample_text":"Not reported in abstract","population":"women living with HIV and HIV-negative women in British Columbia, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared sexual activity, pleasure, and masturbation in women with and without HIV and found similar rates of partnered sex and pleasure, but lower masturbation among women with HIV. Higher testosterone and HIV status were linked to more masturbation, while many social factors also influenced sexual outcomes.","clinical_takeaway":"HIV status and testosterone may affect masturbation frequency, but overall sexual pleasure is comparable across groups; clinicians should consider biopsychosocial factors when addressing sexual health in women with HIV.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Biological measure of testosterone included","Comparison between HIV-positive and HIV-negative groups","Multivariable adjustment for several psychosocial factors"],"limitations":["Cross‑sectional design limits causal inference","Sample size and recruitment method not disclosed","No assessment of mental health or moral/religious factors"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2025.2503896"}},{"id":3594,"doi":"10.1177/0145445518824277","pmid":"30632381","pmcid":null,"title":"Reducing Public Masturbation in Individuals With ASD: An Assessment of Response Interruption Procedures","authors":"Cividini-Motta C, Moore K, Fish LM, Priehs JC, Ahearn WH.","first_author":"Cividini-Motta C","journal":"Behavior modification","year":2020,"pub_types":["Journal Article"],"keywords":["Sexual behavior","Autism","Masturbation","Response Interruption"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"single‑case/ABA style behavior‑analytic intervention with two treatment conditions (RIRD vs RI) applied to children and adolescents with ASD; small, non‑random sample","sample_n":null,"sample_text":"Not reported in abstract; likely a small case series (≤10 participants)","population":"children and adolescents with autism spectrum disorder who engage in public masturbation","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined two brief behavioral strategies—response‑interruption/redirection and simple response interruption—to reduce public masturbation in children and adolescents with autism. Both approaches lowered the time spent masturbating, with the simpler interruption method needing fewer resources.","clinical_takeaway":"Simple response‑interruption tactics can effectively reduce public masturbation in autistic youth, offering a low‑resource option for clinicians.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Direct behavioral measurement of target behavior","Clear experimental comparison of two procedures","Practical clinical relevance for ASD settings"],"limitations":["Very small, non‑representative sample","No statistical effect sizes or power analysis","No long‑term follow‑up or generalisability assessment"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0145445518824277"}},{"id":3595,"doi":"10.22037/ijcn.v16i2.35480","pmid":"35497101","pmcid":"PMC9047836","title":"Treatment of Child Gratification Disorder","authors":"Nemati H, Ahmadabadi F, Shahisavandi M, Farjoud Kouhanjani M, Rostamihosseinkhani M.","first_author":"Nemati H","journal":"Iranian journal of child neurology","year":2022,"pub_types":["review-article","Review","Journal Article"],"keywords":["Pediatric","Masturbation","Infantile","Self-gratification","Gratification Treatment"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9047836","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review of five small studies, no meta‑analysis, no risk‑of‑bias assessment reported","sample_n":null,"sample_text":"Five studies met inclusion criteria; none provided a good level of evidence","population":"children with self‑stimulatory (masturbation) behaviours","country":"Iran (journal), studies from unspecified locations","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review looked at five small studies on treating children’s self‑stimulatory behaviours and found very limited evidence, suggesting behavioural therapy, escitalopram or aripiprazole might help, but emphasized the need for rigorous trials.","clinical_takeaway":"No strong treatment recommendation; clinicians should rely on behavioural approaches and await better evidence.","confidence":0.4,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Systematic search across multiple databases","Identifies lack of high‑quality evidence","Calls for well‑designed RCTs"],"limitations":["No meta‑analysis or quantitative synthesis","Included studies are low quality with unclear definitions","No assessment of key confounders (e.g., moral incongruence, mental health)","No risk‑of‑bias appraisal reported"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.22037/ijcn.v16i2.35480"}},{"id":3596,"doi":"10.3390/children9030386","pmid":"35327758","pmcid":"PMC8947717","title":"Sexual Activity in Peruvian Adolescents: Relevance of Socio-Demographic Variables and Sexual Attitudes","authors":"Sierra JC, Álvarez-Muelas A, Arcos-Romero AI, Cervilla O, Mangas P, Muñoz-García LE, Monge-Rodríguez FS.","first_author":"Sierra JC","journal":"Children (Basel, Switzerland)","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Masturbation","Religiosity","Sexual Relationships","Sexual Attitudes","Peruvian Adolescents"],"is_oa":true,"oa_url":"https://www.mdpi.com/2227-9067/9/3/386/pdf?version=1646894565","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1120 Peruvian adolescents (13‑17 y) using self‑report questionnaires on socio‑demographics, religiosity, erotophilia, attitudes toward sexual fantasies and masturbation, and the traditional sexual double‑standard.","sample_n":1120,"sample_text":"1120 adolescents aged 13‑17 years","population":"Peruvian adolescents, school‑based convenience sample","country":"Peru","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,120 Peruvian teens, boys masturbated more often than girls. The frequency of masturbation was linked to a general interest in sex (erotophilia) for boys and to positive attitudes toward sexual fantasies for both sexes. Age and fantasy attitudes also predicted how often teens had sexual relationships.","clinical_takeaway":"Adolescent sexual activity is shaped by attitudes toward fantasies and age; clinicians should consider these psychosocial factors when discussing healthy sexual development.","confidence":0.8,"topic_tags":["masturbation","adolescents","sexual_function"],"strengths":["Large sample size for adolescent survey","Uses validated sexuality scales","Analyzes multiple socio‑demographic predictors"],"limitations":["Cross‑sectional design cannot infer causality","Convenience school sample limits generalisability","No mental‑health or trauma variables measured"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/children9030386"}},{"id":3597,"doi":"10.1016/j.androl.2018.08.002","pmid":"30606622","pmcid":null,"title":"Frequency of nocturnal emissions and masturbation habits among virgin male religious teenagers","authors":"Gul A, Yuruk E, Serefoglu EC.","first_author":"Gul A","journal":"Revista internacional de andrologia","year":2020,"pub_types":["Journal Article"],"keywords":["epidemiology","Ejaculation","Masturbation","Epidemiología","Masturbación","Emisiones Nocturnas","Eyaculación","Nocturnal Emissions","Sueños Húmedos","Wet Dreams"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 113 virgin male Muslim teenagers living in a religious dormitory or attending a religion course","sample_n":113,"sample_text":"students staying in a religious dormitory or attending a religion course","population":"male adolescents, age 13‑20, virgin, religious Muslim","country":"Turkey (inferred from authors' affiliations)","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 113 virgin Muslim teenage boys found that many masturbate and have nocturnal emissions, but most consider masturbation religiously forbidden while fewer view nocturnal emissions that way. Watching TV was linked to more nocturnal emissions.","clinical_takeaway":"Clinicians should recognise that religious beliefs shape adolescents' views of masturbation and nocturnal emissions; no health concerns were identified.","confidence":0.7,"topic_tags":["masturbation","sexual_function","adolescents","religiosity"],"strengths":["Focused on an understudied population (religious teenage males)","Separates masturbation and nocturnal emission in questions","Includes measure of religious belief about permissibility"],"limitations":["Convenience sample limits generalisability","No validated instruments; reliance on single‑item self‑report","No effect sizes or power analysis reported"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.androl.2018.08.002"}},{"id":3598,"doi":"10.1016/j.cognition.2025.106154","pmid":"40318442","pmcid":null,"title":"Harmless bodily pleasures are moralized because they are perceived as reducing self-control and cooperativeness","authors":"Fitouchi L, Nettle D.","first_author":"Fitouchi L","journal":"Cognition","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Evolution","Purity","Cooperation","Morality","Self-control"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Five pre‑registered laboratory experiments (N > 3000) using hypothetical scenarios to assess moral condemnation, perceived self‑control and cheating likelihood.","sample_n":3000,"sample_text":"N > 3000 across five experiments","population":"Adult participants (likely community sample; exact demographics not specified).","country":"Not specified","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Across five experiments, people judged that indulging in harmless bodily pleasures like sex, food, or alcohol makes individuals less self‑controlled and more likely to cheat, leading to moral condemnation of those pleasures.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["moral_incongruence","sexual_function","masturbation"],"strengths":["Large pre‑registered sample","Multiple experiments with mediation analyses","Clear theoretical framing"],"limitations":["Reliance on self‑report hypothetical scenarios","Limited detail on measurement validation","Potential cultural bias not addressed"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.cognition.2025.106154"}},{"id":3602,"doi":"10.1111/bju.14560","pmid":"30255975","pmcid":null,"title":"The Masturbation Erection Index (MEI): validation of a new psychometric tool, derived from the six-item version of the International Index of Erectile Function (IIEF-6) and from the Erection Hardness Score (EHS), for measuring erectile function during masturbation","authors":"Limoncin E, Gravina GL, Lotti F, Maseroli E, Ciocca G, Corona G, Maggi M, Reisman Y, Balercia G, Lenzi A, Jannini EA.","first_author":"Limoncin E","journal":"BJU international","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Journal Article"],"keywords":["erectile function","Masturbation","Erection Hardness Score","#Andrology","Iief-6"],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a new questionnaire (MEI) in 560 men (99 with ED, 102 healthy controls) using IIEF‑6 and EHS as comparators; test‑retest, internal consistency, Bland‑Altman, ROC analysis.","sample_n":560,"sample_text":"560 men (99 with erectile dysfunction, 102 healthy controls; remainder unspecified).","population":"Men attending an andrology outpatient clinic and sexually healthy volunteers (N≈560).","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study introduced and validated the Masturbation Erection Index, a questionnaire that reliably measures how well a man gets an erection while masturbating, showing strong agreement with existing erectile function scales.","clinical_takeaway":"MEI can be used in clinical settings to assess erectile function during masturbation with confidence.","confidence":0.7,"topic_tags":["masturbation","sexual_function","measurement","pornography"],"strengths":["Large sample for validation","Use of established comparator instruments (IIEF‑6, EHS)","Comprehensive psychometric testing (reliability, internal consistency, agreement, ROC)"],"limitations":["Clinic‑based sample limits generalisability","No assessment of potential psychological confounds (e.g., anxiety, relationship factors)","No pre‑registration reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":35,"retracted":false,"notices":[{"status":"Has correction","date":"2020-9-9","noticeDoi":"10.1111/bju.15186","doi":"10.1111/bju.14560"},{"status":"Comment","date":"2019-2","noticeDoi":"10.1097/01.ju.0000553058.82042.e7","doi":"10.1111/bju.14560"},{"status":"Has erratum","date":"2020-9","noticeDoi":"10.1111/bju.15186","doi":"10.1111/bju.14560"}],"url":"https://scite.ai/reports/10.1111/bju.14560"}},{"id":3603,"doi":"10.1089/trgh.2023.0047","pmid":"40309075","pmcid":"PMC12039877","title":"Function, Satisfaction, and Sexual Activity of Trans Women After Vulvovaginoplasty: Results of a Multicenter Study","authors":"Duflot T, Morel-Journel N, Jurek L, Plainard X, Delporte G, Carnicelli D, Marcelli F, Neuville P.","first_author":"Duflot T","journal":"Transgender health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Women","Trans","Genital Gender-affirming Surgery","Vulvovaginoplasty"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"prospective observational multicenter questionnaire study of postoperative trans women (N=158)","sample_n":158,"sample_text":"158 participants (online questionnaire; convenience sample of surgery patients)","population":"trans women who underwent vulvovaginoplasty in France (2007‑2019)","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A multicenter survey of 158 trans women after vulvovaginoplasty found high satisfaction with appearance and sexual activity, but many reported scores indicating sexual dysfunction, especially low lubrication. Masturbation was the most common activity and linked to orgasm.","clinical_takeaway":"Most patients are sexually active and satisfied post‑surgery, yet clinicians should discuss potential sexual function issues, especially lubrication.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Validated sexual function instrument (FSFI) used","Multicenter design, relatively large sample for this population","Comprehensive assessment of satisfaction, body image, and genital sensitivity"],"limitations":["Cross‑sectional, no pre‑surgery baseline","Convenience online sample may not represent all trans women","Key psychosocial confounds (mental health, partner context, trauma) not measured"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/trgh.2023.0047"}},{"id":3604,"doi":"10.1186/s12889-025-22388-x","pmid":"40211428","pmcid":"PMC11983739","title":"Identifying subgroups of Chinese men who have sex with men based on sexual behavior and drug use patterns using a clustering analysis approach","authors":"She B, Sun J, Lu F, Lin S, Liu Y, Li G, Hu Y, Tang W, Tan R, Ong J, Su S, Zhang L.","first_author":"She B","journal":"BMC public health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Cluster analysis","MSM","Sexualized Drug Use","Sexual Acts","Sexual Behavioral Patterns"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11983739","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 890 Chinese MSM recruited via WeChat ads; hierarchical clustering of sexual‑behavior and drug‑use variables.","sample_n":890,"sample_text":"Convenience sample recruited through community organisations and online ads; not a probability or nationally representative sample.","population":"Chinese men who have sex with men (MSM); n≈890; community‑based recruitment; not a clinical or treatment‑seeking sample.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 890 Chinese gay and bisexual men, those who used drugs during sex (especially poppers) formed a distinct group that reported more partners, lower condom use, and higher PrEP uptake. Men who did not use drugs were split into subgroups, one of which showed higher rates of solo masturbation.","clinical_takeaway":"Sex‑on‑drugs is linked to higher sexual‑risk behaviours among MSM; clinicians should assess drug use when discussing HIV/STI prevention.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a niche population","Comprehensive behavioural dataset","Use of clustering to reveal subgroups"],"limitations":["Convenience, non‑representative sampling","Reliance on self‑report; no validated scales","Minimal control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-025-22388-x"}},{"id":3605,"doi":"10.1093/sf/soaf046","pmid":"41084500","pmcid":"PMC12515351","title":"It is not what you weigh, it is how you present it: body size, attractiveness, physical functioning, and access to partnership and sexuality for older men and women","authors":"Li Y, Waite LJ.","first_author":"Li Y","journal":"Social forces; a scientific medium of social study and interpretation","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Aging","Sexuality","Obesity","Gender","Attractiveness","Marriage","Partnership","Body Shape"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational analysis of two waves of the National Social Life, Health, and Aging Project (N=2,144) examining associations between BMI/interviewer‑rated body size and partnered vs. solitary sexual activity among older adults.","sample_n":2144,"sample_text":"N=2,144 participants from the NSHAP study (2005‑2006 and 2010‑2011 waves).","population":"Older adults (aged 50+), community‑dwelling, United States","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among older adults, higher body weight and larger body size reduce women's chances of having a partner and engaging in partnered sex, partly because of lower physical functioning and lower perceived attractiveness. Men are not affected in the same way.","clinical_takeaway":"Clinicians should consider body‑size‑related functional limitations and perceived attractiveness when addressing partnership and sexual health in older women.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Large, nationally‑representative sample","Objective BMI measure plus observer‑rated body size","Mediation analysis linking physical functioning and perceived attractiveness"],"limitations":["Cross‑sectional; cannot infer causality","No control for mental‑health or moral/religious variables","Solitary sexual activity not measured in detail"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sf/soaf046"}},{"id":3607,"doi":"10.1016/j.jsxm.2018.08.003","pmid":"30195562","pmcid":null,"title":"Orgasmic Latency and Related Parameters in Women During Partnered and Masturbatory Sex","authors":"Rowland DL, Sullivan SL, Hevesi K, Hevesi B.","first_author":"Rowland DL","journal":"The journal of sexual medicine","year":2018,"pub_types":["Journal Article"],"keywords":["Women","Masturbation","Sexual Satisfaction","Orgasm","Latency To Orgasm","Partnered Sex"],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community sample from US and Hungary; investigator‑derived questionnaire; cross‑sectional survey","sample_n":2304,"sample_text":"community‑based women from United States and Hungary","population":"2,304 adult women","country":"United States; Hungary","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 2,300 women from the US and Hungary, orgasm took longer during partnered sex than during masturbation. Women who reported difficulty reaching orgasm had especially long partnered latencies but similar masturbatory latencies, and they tended to find masturbation more satisfying.","clinical_takeaway":"Women with orgasmic difficulty may benefit from focusing on masturbation techniques that work for them, as partnered sex often involves longer latency.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large, multi‑national sample (N>2000)","Separate measurement of partnered vs. masturbatory latency","Inclusion of relationship quality and distress variables"],"limitations":["Use of investigator‑derived, non‑validated questionnaire","No detailed assessment of type of stimulation","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":14,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2018.08.003"}},{"id":3609,"doi":"10.1080/00224499.2021.2012113","pmid":"34919461","pmcid":null,"title":"Asexuality, Graysexuality, and Demisexuality: Distinctions in Desire, Behavior, and Identity","authors":"Copulsky D, Hammack PL.","first_author":"Copulsky D","journal":"Journal of sex research","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large international self‑selected survey of individuals identifying as asexual, graysexual, or demisexual; cross‑sectional questionnaire","sample_n":12416,"sample_text":"Ace Community Survey, international convenience sample","population":"ace‑identifying adults (mostly young, 22‑24 y, majority female)","country":"International (online)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A large online survey of people who identify as asexual, graysexual or demisexual showed that asexual individuals have the lowest sexual desire, least often masturbate, and are less likely to be in relationships, while gray‑ and demisexual people report higher desire and more frequent masturbation.","clinical_takeaway":"Sexual desire and masturbation frequency differ across ace identities; clinicians should consider these variations when discussing sexual health with ace‑identified clients.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["very large sample size","focus on under‑studied ace identities","includes separate measure of masturbation frequency"],"limitations":["self‑selected community sample limits generalisability","unclear whether desire/drive scales are validated","no control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":32,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2021.2012113"}},{"id":3611,"doi":"10.1080/00224499.2025.2478574","pmid":"40152749","pmcid":null,"title":"Examining Erectile Disorder Manifestations and the Impact of Point-Of-View in Virtual Reality Erotica","authors":"Lafortune D, Bonneau J, Lapointe VA, Dubé S, Castillo-Calazana F, Labrie C, Canivet C, Godbout N.","first_author":"Lafortune D","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"laboratory experiment with 60 participants (30 ED, 30 control) viewing VR scenarios; between‑group (ED vs non‑ED) and within‑subject (POV) manipulations; mixed repeated‑measures ANOVAs reported.","sample_n":60,"sample_text":"60 adults (30 with ED; 30 without ED)","population":"adult men, mixed age, recruited probably via convenience sampling; not a probability or clinical treatment‑seeking sample.","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, men with erectile disorder watched virtual‑reality sexual scenes. They felt less aroused than men without the disorder, but fear and catastrophizing were similar. Whether the scene was shown from a first‑person or third‑person view did not change these responses.","clinical_takeaway":"VR can reveal reduced arousal in erectile disorder, but current VR formats may not trigger performance anxiety.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Laboratory control of VR stimulus presentation","Inclusion of both ED and non‑ED groups","Use of mixed‑design ANOVA appropriate for within‑ and between‑subject factors"],"limitations":["Unclear whether scales are validated for this context","No reporting of effect sizes or confidence intervals","Potential convenience‑sample bias, limited ecological validity"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2025.2478574"}},{"id":3612,"doi":"10.1111/and.14346","pmid":"34873749","pmcid":null,"title":"Sexual dysfunction associated with chronic retention of foreign bodies in the low urinary tract","authors":"Zhang Z, Zhu X, Wang Y, Chen D, Fan J, Deng C, Liu G, Yang L, Feloney M, Wang X, Zhang Y.","first_author":"Zhang Z","journal":"Andrologia","year":2022,"pub_types":["Journal Article"],"keywords":["Sexual dysfunction","Foreign Body","Lower Urinary Tract"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 38 patients with chronic foreign bodies in lower urinary tract; no control group; outcomes assessed before and 3 months after removal","sample_n":38,"sample_text":"38 patients (22 male, 7 female with follow‑up data reported)","population":"38 adults (both sexes) presenting to three medical centres with retained urinary‐tract foreign bodies for ≥4 weeks","country":"China (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors report that people who kept objects in their urinary tract for weeks—often after inserting them during masturbation—had sexual problems that improved after the objects were removed.","clinical_takeaway":"Removal of retained urinary‑tract foreign bodies may alleviate related sexual dysfunction; assess for such objects in patients with unexplained symptoms.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Addresses a rare clinical presentation","Provides pre‑ and post‑removal symptom data","Multicentre case collection"],"limitations":["No validated sexual dysfunction instrument","No control/comparison group","Small, convenience sample","Claims causality from observational data"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/and.14346"}},{"id":3614,"doi":"10.1016/j.urology.2025.03.027","pmid":"40120697","pmcid":null,"title":"Exploring Vacuum Erection Device User Feedback: A GPT-4 Thematic Analysis","authors":"Patel HV, Abbasi B, Li KD, Carlisle M, Faris A, Pace WA, Breyer BN.","first_author":"Patel HV","journal":"Urology","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative thematic analysis of 1500 Amazon product reviews; multivariable ordinal regression on review ratings.","sample_n":1500,"sample_text":"1500 Amazon.com reviews (convenience sample of self‑selected purchasers).","population":"Consumers who posted Amazon.com reviews for 21 vacuum erection devices (VEDs).","country":"Not reported (global Amazon marketplace).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study analysed 1500 Amazon product reviews of vacuum erection devices using GPT‑4 to identify common themes like effectiveness and ease of use, and linked these themes to star ratings. Most users reported positive experiences, while safety mentions were rare.","clinical_takeaway":"VEDs are generally well‑received by consumers, but clinicians should still provide thorough education on safe use.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large volume of real‑world consumer reviews","Systematic thematic coding using advanced language model","Combination of qualitative themes with quantitative regression"],"limitations":["Convenience, self‑selected sample; not representative of all VED users","No validated psychometric instruments for satisfaction or safety","Potential bias in reviewer self‑selection and posting behavior"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urology.2025.03.027"}},{"id":3616,"doi":"10.1007/s10508-021-02125-2","pmid":"34799832","pmcid":"PMC8604196","title":"Changes in Penile-Vaginal Intercourse Frequency and Sexual Repertoire from 2009 to 2018: Findings from the National Survey of Sexual Health and Behavior","authors":"Herbenick D, Rosenberg M, Golzarri-Arroyo L, Fortenberry JD, Fu TC.","first_author":"Herbenick D","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Masturbation","Sexual Frequency","National Survey Of Sexual Health And Relationships","Penile-Vaginal Intercourse Frequency","Sexual Repertoire"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8604196","cited_by_count":27,"is_preprint":false,"topics":["masturbation","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative online survey, two waves (2009, 2018) with >4000 participants each; cross‑sectional comparison of sexual behavior frequencies.","sample_n":8702,"sample_text":"4155 participants in 2009 wave; 4547 participants in 2018 wave","population":"U.S. adults and adolescents aged 14‑49 years","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A U.S. national survey found that from 2009 to 2018, fewer people reported having penile‑vaginal intercourse in the past year, and both adolescents and adults reported lower frequencies of all partnered sexual activities.","clinical_takeaway":"Clinicians should note a population‑level decline in intercourse frequency, but individual variation remains large.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Separate measurement of partnered and solo behaviors","Clear hypothesis and straightforward analysis"],"limitations":["Self‑report frequency may be subject to recall bias","Cross‑sectional design cannot infer causality of trends","Limited adjustment for potential demographic confounders"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":1,"mentioning":22,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02125-2"}},{"id":3618,"doi":"10.7759/cureus.19347","pmid":"34909308","pmcid":"PMC8653046","title":"Comparison of the Efficacy of Male Sexual Activity Versus Alpha-Blockers in the Expulsion of Distal Ureteric Stones: A Systematic Review and Meta-Analysis","authors":"Juman C, Bruce A, Kwan TY, Krishan A, Ehsanullah SAM, Khashaba S, Rafie MA.","first_author":"Juman C","journal":"Cureus","year":2021,"pub_types":["review-article","Review","Journal Article"],"keywords":["Urolithiasis","Ejaculation","Masturbation","Tamsulosin","Sexual Intercourse","Alpha-blocker"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8653046","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"meta-analysis of three RCTs (N=262) comparing male sexual activity (intercourse or masturbation) to alpha‑blockers for distal ureteric stone expulsion","sample_n":262,"sample_text":"Three randomised controlled trials, total N=262","population":"male patients with distal ureteric stones","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A meta‑analysis of three small RCTs found that having sex or masturbating does not differ from taking an alpha‑blocker in helping small kidney stones pass, suggesting it could be an alternative for patients who prefer non‑drug options.","clinical_takeaway":"Male sexual activity appears to be as effective as alpha‑blockers for distal ureteric stone expulsion, offering a non‑pharmacologic option.","confidence":0.8,"topic_tags":["sexual_function","treatment","other"],"strengths":["Systematic search across multiple databases","Inclusion of only randomised trials","Use of standard Cochrane risk‑of‑bias tool"],"limitations":["Small number of trials (3) and modest total sample","No pre‑registration of the meta‑analysis protocol reported","Potential clinical heterogeneity not fully explored"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.19347"}},{"id":3619,"doi":"10.1016/j.jsxm.2021.09.010","pmid":"34702686","pmcid":null,"title":"Single and Multiple Orgasm Experience Among Women in Heterosexual Partnerships. Results of the German Health and Sexuality Survey (GeSiD)","authors":"Cerwenka S, Dekker A, Pietras L, Briken P.","first_author":"Cerwenka S","journal":"The journal of sexual medicine","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual activity","Love","Masturbation","Sexual Satisfaction","Relationship Satisfaction","Sexual Practices","Closeness","Heterosexual Women","Gesid Study","Multiple Orgasm"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationwide representative survey (GeSiD), N=1,641 heterosexual women aged 18‑75 in stable relationships, self‑report questionnaire on orgasm, masturbation, sexual practices, relationship variables; cross‑sectional analysis of associations.","sample_n":1641,"sample_text":"nationwide representative sample (German Health and Sexuality Survey)","population":"sexually active women in heterosexual long‑term relationships, Germany, age 18‑75","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative German survey, women who have more frequent sex, higher relationship satisfaction, and experience more sexual practices are more likely to have orgasms and multiple orgasms, which are linked to greater sexual satisfaction.","clinical_takeaway":"Improve relationship quality and regular partnered sexual activity to support women's orgasmic experience and sexual satisfaction.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["large, nationally representative sample","focus on both single and multiple orgasms","includes a range of relational and behavioral variables"],"limitations":["cross‑sectional design limits causal inference","relies on single‑item self‑reports; unclear psychometric validation","no assessment of mental‑health or trauma confounders"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.09.010"}},{"id":3621,"doi":"10.29063/ajrh2025/v29i3.5","pmid":"40130829","pmcid":null,"title":"\"We are on our own\": The neglected voices of the boy-child in adolescent sexual and reproductive health in Vhembe District, Limpopo, South Africa","authors":"Mulaudzi FM, Seretlo RJ, Usie MRM, Sepeng NV.","first_author":"Mulaudzi FM","journal":"African journal of reproductive health","year":2025,"pub_types":["Journal Article"],"keywords":["Adolescent","Reproductive Health","Sexual Education","Boy-Child"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Cooperative inquiry with Lekgotla discussion groups; thematic analysis of interview data from adolescent boys in Vhembe District, South Africa.","sample_n":null,"sample_text":"Not reported in abstract; likely small convenience sample of boys participating in discussion groups.","population":"Adolescent boys (boy‑child) in Vhembe District, Limpopo, South Africa","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Boys in a South African district feel ignored by sexual‑health programmes that focus on girls. They rely on peers for information about masturbation and contraception and find talking about sex with adults taboo. The authors call for services that specifically address boys’ needs.","clinical_takeaway":"Health services should include boy‑friendly sexual education and counselling to address the information gap identified.","confidence":0.8,"topic_tags":["adolescents","sexual_function","religiosity","moral_incongruence","masturbation"],"strengths":["Focus on an under‑researched population (boys) in SRH programs","Uses participatory cooperative inquiry method","Thematic analysis provides rich, contextual insights"],"limitations":["No quantitative measurement of behaviours or outcomes","Small, non‑random sample limits generalisability","No assessment of potential confounding factors (e.g., religiosity, mental health)"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.29063/ajrh2025/v29i3.5"}},{"id":3623,"doi":"10.3390/ijerph181910390","pmid":"34639691","pmcid":"PMC8508376","title":"Association of Sexual Attitudes with Sexual Function: General vs. Specific Attitudes","authors":"Sierra JC, Gómez-Carranza J, Álvarez-Muelas A, Cervilla O.","first_author":"Sierra JC","journal":"International journal of environmental research and public health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual function","Erotophilia","Attitude Toward Masturbation","Attitude Toward Sexual Fantasies"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/18/19/10390/pdf?version=1633172738","cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 2000 heterosexual adults, regression analyses linking attitude scales to sexual function dimensions.","sample_n":2000,"sample_text":"2000 heterosexual adults recruited for an online/clinic survey (method not specified).","population":"heterosexual adults, 18‑83 years, 1044 women, 956 men, likely convenience sample","country":"Spain (inferred from author names; not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 2000 heterosexual adults, more positive attitudes toward sexual fantasies (and, for women, age) were linked to better sexual function, while general erotophilia was less predictive.","clinical_takeaway":"Clinicians might consider clients' attitudes toward fantasies when addressing sexual dysfunction, but causality is uncertain.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample size (n=2000)","Separate analysis for men and women","Focus on specific attitudes (fantasies, masturbation) rather than only general erotophilia"],"limitations":["Cross‑sectional design; cannot infer causality","Unclear whether attitude and function measures are validated","No control for key confounds (moral beliefs, mental health, partnership status)","Recruitment method not described; possible convenience bias"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":22,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph181910390"}},{"id":3624,"doi":"10.1371/journal.pone.0257284","pmid":"34547013","pmcid":"PMC8454929","title":"Efficacy of Sphincter Control Training and medical device in the treatment of premature ejaculation: A multicenter randomized controlled clinical trial","authors":"Rodríguez JE, Picazo JA, Marzo JC, Piqueras JA, Reina L, Hidalgo G, Tornero G.","first_author":"Rodríguez JE","journal":"PloS one","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Multicenter Study","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0257284&type=printable","cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"multicenter randomized controlled trial, parallel groups, n=40 (20 per group), 8‑week intervention","sample_n":40,"sample_text":"Forty patients who met the criteria for the diagnosis of lifelong PE","population":"men with lifelong premature ejaculation, adult, recruited from clinical settings","country":"Spain (likely, based on authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A trial tested a handheld device plus sphincter‑control training for men with lifelong premature ejaculation. After eight weeks, those using the device showed a larger increase in ejaculation latency than the control group, with no reported side effects.","clinical_takeaway":"The device may improve ejaculation latency, but evidence is limited by a small sample; clinicians should consider it experimental.","confidence":0.7,"topic_tags":["sexual_function","treatment"],"strengths":["Randomized controlled design","Objective primary outcome (IELT)","Multicenter recruitment"],"limitations":["Small sample size (n=40)","No reporting of blinding or allocation concealment","No control for psychological or relational confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0257284"}},{"id":3625,"doi":"10.1007/s11255-025-04373-w","pmid":"39934554","pmcid":null,"title":"Insights into the peripheral nature of persistent sexual dysfunction associated with post-finasteride, post-SSRI and post-accutane syndromes: lessons learned from a case study","authors":"Stachelek J, Zwaans BMM, Shtein R, Peters KM.","first_author":"Stachelek J","journal":"International urology and nephrology","year":2025,"pub_types":["Journal Article","Case Reports"],"keywords":["Sexual dysfunction","Ssri","Retinoid","finasteride","Saw Palmetto","Post-drug Syndrome"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Three male patients with post‑drug sexual dysfunction treated with peripheral nerve stimulation; retrospective chart review with pre‑/post‑measures.","sample_n":3,"sample_text":"Three consecutive patients in a urology clinic.","population":"Male patients (n=3) experiencing persistent erectile dysfunction after stopping finasteride, SSRIs, or isotretinoin.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A tiny case series of three men with lasting erectile problems after stopping finasteride, SSRIs, or acne medication showed modest improvements in erection strength and penile sensitivity after 16 weeks of peripheral nerve stimulation and shock‑wave therapy.","clinical_takeaway":"Peripheral nerve therapy may offer slight benefit for drug‑induced erectile dysfunction, but evidence is limited to three cases.","confidence":0.78,"topic_tags":["sexual_function","neuroscience","adolescents"],"strengths":["Use of validated sexual function scales (IIEF, MEI)","Objective peripheral nerve assessments (corneal microscopy, von Frey)","Novel therapeutic approach (electrical stimulation, shockwave)"],"limitations":["Very small N=3, no control group","Retrospective case series, cannot infer causality","Findings not generalizable to broader population"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11255-025-04373-w"}},{"id":3626,"doi":"10.1038/s41443-021-00467-y","pmid":"34504313","pmcid":null,"title":"Do the diagnostic criteria for premature ejaculation apply to non-straight men and to sexual activities other than penile-vaginal intercourse?","authors":"Rowland DL, Roberson CB.","first_author":"Rowland DL","journal":"International journal of impotence research","year":2022,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of diagnostic criteria for premature ejaculation across sexual orientations and sexual activities; no primary data collected.","sample_n":null,"sample_text":"Not applicable – review of existing literature","population":"Men of varying sexual orientations; no empirical sample","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review whether premature ejaculation criteria, usually designed for heterosexual penile‑vaginal sex, also fit gay, bisexual, and other men and different sexual acts. They find similar ejaculation timing across orientations but note differences in masturbation and that distress may be less central for gay men, calling for adapted questionnaires.","clinical_takeaway":"Clinicians should consider adapting premature ejaculation assessments for non‑heterosexual men and for activities beyond vaginal intercourse.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses gap in diagnostic criteria applicability","Summarises latency data across orientations","Identifies need for PRO adaptation"],"limitations":["No primary data; relies on existing heterogeneous studies","Lacks systematic review methodology","No formal quality appraisal of cited studies"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-021-00467-y"}},{"id":3627,"doi":"10.5152/tud.2021.21132","pmid":"35118983","pmcid":"PMC9612771","title":"Management of accidental penile incarceration due to unusual masturbation practices","authors":"Para SA, Wani SA, Ahmad MS.","first_author":"Para SA","journal":"Turkish journal of urology","year":2021,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Retrospective case series of 9 patients presenting with penile incarceration due to masturbation devices.","sample_n":9,"sample_text":"Nine cases","population":"Adult males (average age 36.8) presenting to a Turkish emergency department between 2015‑2020.","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed nine men who injured themselves by wrapping devices around the penis during masturbation. They described the types of objects, how long they stayed on, and the surgical steps needed to remove them, noting that some required skin grafts or partial penectomy.","clinical_takeaway":"Unusual penile devices can cause serious injury; prompt medical removal is essential and delayed presentation increases risk of severe complications.","confidence":0.8,"topic_tags":["masturbation","sexual_function","gender","other"],"strengths":["Provides rare clinical data on a scarcely reported emergency condition","Details management techniques and complications"],"limitations":["Very small sample (n=9) limits generalizability","Retrospective design, no control group","No standardized measures of psychological factors"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5152/tud.2021.21132"}},{"id":3629,"doi":"10.7759/cureus.78041","pmid":"40013217","pmcid":"PMC11862863","title":"Injecting Jelly Into the Urethra for Sexual Pleasure: A Case Report","authors":"Morita M, Ichibayashi R, Endo T, Suzuki H.","first_author":"Morita M","journal":"Cureus","year":2025,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["penis","Scrotum","Masturbation","Dangerous Sexual Practices","Liquid Foreign Bodies"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11862863","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single clinical case description of a 54‑year‑old man who injected jelly into the urethra, diagnosed after history and imaging, treated with antibiotics","sample_n":1,"sample_text":"single case","population":"one adult male patient","country":"Japan (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 54‑year‑old man inserted jelly into his urethra for sexual pleasure, leading to epididymitis. Diagnosis was delayed because the jelly is invisible on X‑rays. After the patient disclosed the behavior, antibiotics resolved the infection. Stress and financial problems may have contributed.","clinical_takeaway":"Clinicians should ask about non‑standard sexual practices when faced with unexplained genitourinary infections.","confidence":0.9,"topic_tags":["sexual_function","gender"],"strengths":["Detailed clinical description","Highlights diagnostic challenges of radiolucent foreign bodies","Links behavior to psychosocial stressors"],"limitations":["Single case; no generalisability","No systematic assessment of mental‑health or moral factors","No quantitative outcome measures"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.78041"}},{"id":3630,"doi":"10.1080/00224499.2024.2432000","pmid":"39812391","pmcid":"PMC12291618","title":"Longitudinal Assessment of Sexual Behavior and Relationship Quality During the First Year of the COVID-19 Pandemic in Britain: Findings from a Longitudinal Population Survey (Natsal-COVID)","authors":"Miall N, Aveline A, Copas AJ, Bosó Pérez R, Baxter AJ, Riddell J, Oakley L, Menezes D, Conolly A, Bonell C, Sonnenberg P, Mercer CH, Field N, Mitchell KR, Willis M.","first_author":"Miall N","journal":"Journal of sex research","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.1080/00224499.2024.2432000","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Population web‑panel survey of 2,098 British adults surveyed at 4 months and 12 months after lockdown; analyses of changes in sexual activity and relationship quality using logistic regression.","sample_n":2098,"sample_text":"2098 participants (age 18‑59) in two waves of the Natsal‑COVID study.","population":"British adults 18‑59 years, recruited via an online panel (non‑probability sample).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a UK online panel of 2,098 adults, sexual activity (including masturbation) increased between July 2020 and March 2021, while a higher share of people in steady relationships reported lower relationship quality.","clinical_takeaway":"During prolonged COVID‑19 restrictions, clinicians should expect higher sexual activity but also potential declines in relationship satisfaction.","confidence":0.85,"topic_tags":["sexual_function","relationships"],"strengths":["Longitudinal design with two measurement points","Large sample for a survey study","Reports effect sizes with confidence intervals"],"limitations":["Convenience web‑panel sample limits generalisability","Sexual behavior measured with ad‑hoc self‑report items","Limited adjustment for potential confounders"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2024.2432000"}},{"id":3633,"doi":"10.5080/u27375","pmid":"41070499","pmcid":"PMC12266598","title":"The Relationship Between the Level of Sexual Desire Reported in the Clinical Interview and Sexual Development Characteristics, Sexual Functions, and Clinical Diagnosis in Women","authors":"Tabakci AS, Yildirim MH, Yildirim EA, Güvenç HR, Kilinç SU, Örel D.","first_author":"Tabakci AS","journal":"Turk psikiyatri dergisi = Turkish journal of psychiatry","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Diagnostic Evaluation","Female Sexual Dysfunctions Sexual Desire."],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational comparison of two groups of clinic patients based on self‑reported sexual desire (adequate vs inadequate) using medical records and the Golombok‑Rust Sexual Satisfaction Scale.","sample_n":195,"sample_text":"101 patients with adequate desire, 94 with inadequate desire.","population":"Women attending a specialized sexual dysfunction clinic (N≈195).","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Turkish clinic sample, women who said they had low sexual desire were more likely to be in arranged marriages, have less sexual information, view masturbation as sinful, have fewer marital sex acts, report past negative sexual experiences, and score worse on a sexual satisfaction questionnaire.","clinical_takeaway":"Low desire in women is linked to several psychosocial factors; clinicians should assess relationship context and sexual education when addressing sexual dysfunction.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["Use of validated GRISS scale","Relatively large clinical sample","Comparison of two clearly defined groups"],"limitations":["Cross‑sectional design, no causal inference","Desire adequacy measured by non‑standard interview item","Limited control for key confounds (morality, mental health, trauma)","Clinic sample limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5080/u27375"}},{"id":3634,"doi":"10.1007/s10943-013-9720-3","pmid":"23609456","pmcid":null,"title":"Masturbation: Scientific Evidence and Islam's View","authors":"Hoseini SS.","first_author":"Hoseini SS.","journal":"Journal of religion and health","year":2017,"pub_types":["Review","Journal Article"],"keywords":["Body","Islam","Masturbation","Psyche"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of scientific literature and Islamic perspectives on masturbation; no primary data collection.","sample_n":null,"sample_text":"Not applicable – review of existing literature","population":"Humans (general discussion, no specific sample)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews scientific studies on masturbation and explains how Islam views the practice, but it does not provide new data or systematic analysis.","clinical_takeaway":"None – the paper is a narrative review without empirical findings for clinical use.","confidence":0.8,"topic_tags":["masturbation","religiosity","sexual_function","csbd"],"strengths":["Provides a broad overview of scientific findings on masturbation","Includes discussion of religious (Islamic) perspectives"],"limitations":["Lacks systematic methodology and critical appraisal of sources","No empirical data, statistical analysis, or clear operational definitions","Does not control for key confounding variables (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-013-9720-3"}},{"id":3636,"doi":"10.1007/s10943-018-0627-x","pmid":"29654401","pmcid":null,"title":"Response to \"Masturbation: Scientific Evidence and Islam's View\"","authors":"Speed D, Cragun RT.","first_author":"Speed D","journal":"Journal of religion and health","year":2021,"pub_types":["Comment","Journal Article"],"keywords":["Religion","Masturbation","Deviance"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":2,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-018-0627-x"}},{"id":3637,"doi":"10.1016/j.jsxm.2017.09.016","pmid":"29110806","pmcid":null,"title":"Masturbation to Orgasm Stimulates the Release of the Endocannabinoid 2-Arachidonoylglycerol in Humans","authors":"Fuss J, Bindila L, Wiedemann K, Auer MK, Briken P, Biedermann SV.","first_author":"Fuss J","journal":"The journal of sexual medicine","year":2017,"pub_types":["Journal Article"],"keywords":["Sexuality","Cortisol","Masturbation","Reward","Orgasm","2-Arachidonoylglycerol (2-Ag)","Anandamide (Aea)","Oleoyl Ethanolamide (Oea)"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"single‑blinded, randomized 2‑session crossover with healthy volunteers; sample size not reported in abstract","sample_n":null,"sample_text":"not specified in abstract","population":"healthy adult males and females (volunteers)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In healthy volunteers, reaching orgasm through masturbation raised blood levels of the endocannabinoid 2‑AG, suggesting this molecule is part of the brain’s reward response to sex.","clinical_takeaway":"Endocannabinoid activity may influence sexual reward; further research could inform treatments for sexual dysfunction.","confidence":0.75,"topic_tags":["masturbation","sexual_function","neuroscience","csbd"],"strengths":["Randomized crossover design reduces between‑subject variability","Objective biochemical measures of endocannabinoids","Both male and female participants included"],"limitations":["Sample size not reported; likely modest, risking low power","Self‑report of orgasm and drug use may introduce bias","No assessment of psychological or relational confounds"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2017.09.016"}},{"id":3639,"doi":"10.1071/sh24173","pmid":"39666449","pmcid":null,"title":"Comparing the impact of sexualised drug use with and without chemsex on sexual behaviours among men who have sex with men in China: a national multi-site cross-sectional study","authors":"Sun J, She B, Latt PM, Ong JJ, Xu X, Bao Y, Fairley CK, Zhang L, Tang W, Zhang L.","first_author":"Sun J","journal":"Sexual health","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national multi‑site online survey of 796 Chinese MSM recruited via WeChat (convenience sample)","sample_n":796,"sample_text":"796 eligible participants (71.7% non‑SDU, 19.7% SDU without chemsex, 8.5% chemsex)","population":"men who have sex with men, >18 y, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 796 Chinese gay and bisexual men, those who used drugs during sex (especially chemsex) reported more sexual partners, higher diversity of sex acts, and more frequent self‑masturbation than men who did not use drugs. The authors recommend targeted HIV/STI prevention for this group.","clinical_takeaway":"Clinicians should screen MSM who report chemsex for higher STI risk and consider tailored prevention interventions.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large multi‑city sample (N ≈ 800)","Specific focus on chemsex vs non‑chemsex MSM","Reports diverse sexual‑act indices (Shannon diversity)"],"limitations":["Convenience, self‑selected online sample","Cross‑sectional; no causal inference","Limited control for key confounds (mental health, partner context, trauma)","Unclear psychometric validation of SDU/chemsex items"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh24173"}},{"id":3640,"doi":"10.1093/jsxmed/qdae115","pmid":"39293972","pmcid":null,"title":"Exploration of characteristics that differentiate women with short orgasmic latencies from women with longer orgasmic latencies","authors":"Hevesi K, Varga B, Rowland DL.","first_author":"Hevesi K","journal":"The journal of sexual medicine","year":2024,"pub_types":["Journal Article"],"keywords":["Women","Masturbation","Pleasure","Relationship Satisfaction","Orgasmic Difficulty","Orgasmic Latency","Premature Orgasm","Short Orgasm"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdae115"}},{"id":3641,"doi":"10.1080/13691058.2017.1359339","pmid":"28857687","pmcid":null,"title":"'There was a struggle between my instinct and my head': women's perception and experience of masturbation in contemporary Vietnam","authors":"Huong BT, Liamputtong P.","first_author":"Huong BT","journal":"Culture, health & sexuality","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Vietnam","Marriage","Masturbation","Gender Ideology","Sexual Pleasure"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"semi‑structured interviews; n=20 professional women (25‑40) in Hanoi; thematic analysis","sample_n":20,"sample_text":"20 professional married women, ages 25‑40, Hanoi, Vietnam","population":"young married professional women in Vietnam","country":"Vietnam","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 20 married Vietnamese women show that many see masturbation as a way to claim modern, pleasure‑focused identities, but cultural expectations and traditional gender ideas still limit their sexual wellbeing.","clinical_takeaway":"Clinicians should recognise cultural and relational factors shaping Vietnamese women's attitudes toward masturbation and sexual pleasure.","confidence":0.7,"topic_tags":["masturbation","gender","csbd","sexual_function"],"strengths":["Provides rich cultural insight into Vietnamese women's lived experience","Uses direct quotes to illustrate themes","Addresses a gap in literature on non‑coital sexual practices in Asia"],"limitations":["Small, non‑representative convenience sample","No validated measurement tools; relies on ad‑hoc interview guide","Findings not generalisable beyond urban professional women"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2017.1359339"}},{"id":3642,"doi":"10.1007/s10508-024-03034-w","pmid":"39578341","pmcid":null,"title":"Cohort Study of Indecent Exposure in the Netherlands from 2012 to 2020: Incidents, Perpetrators, Victims, and Trends over Time","authors":"Ten Hoor NM, Smid WJ, van Dooren M, Matthijssen W, de Vogel V, Hendriks J.","first_author":"Ten Hoor NM","journal":"Archives of sexual behavior","year":2025,"pub_types":["Journal Article"],"keywords":["Cohort study","Paraphilia","Dsm-5","Exhibitionistic Disorder","Indecent Exposure","Noncontact Sexual Offending"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"descriptive cohort of national police records (2012‑2020) covering 6,741 incidents, 4,663 suspects, 3,808 victims; trend analysis over time","sample_n":6741,"sample_text":"All registered police cases of indecent exposure in the Netherlands from 2012 to 2020 (N=6,741 incidents)","population":"Dutch residents involved in police‑recorded indecent exposure incidents","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study describes 6,741 indecent exposure incidents in the Netherlands (2012‑2020). Most offenders were 25‑year‑old men exposing themselves to young girls in public. Incidents declined by half over the period. Findings help inform prevention and treatment of exhibitionism.","clinical_takeaway":"None – the work is epidemiological, not directly applicable to clinical treatment of consensual sexual behavior.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, nationwide registry dataset","Multi‑year coverage allowing trend analysis","Clear operational definition of indecent exposure"],"limitations":["Reliance on police reports; no psychological or contextual data","No control for mental‑health, trauma, or moral‑incongruence variables","Descriptive only; no causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-03034-w"}},{"id":3643,"doi":"10.1038/s41443-024-00999-z","pmid":"39567673","pmcid":null,"title":"Perception of orgasmic intensity changes between clitorally and vaginally activated orgasm: a psychometric analysis using the Orgasmometer scale","authors":"Sansone A, Mollaioli D, Colonnello E, Ciocca G, Limoncin E, Jannini TB, Pesce F, Jannini EA.","first_author":"Sansone A","journal":"International journal of impotence research","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Large nationwide online surveys of sexually active heterosexual women (N≈1800); cross‑sectional self‑report measures; regression analysis of orgasm intensity by stimulation type.","sample_n":1799,"sample_text":"1799 women meeting inclusion criteria (733 CAO, 324 VAO, 742 CaVAO).","population":"Sexually active adult women (heterosexual) from Italy; recruited via website, social media, radio, newspaper; convenience but large sample.","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large Italian survey of 1,800 women, org​asm intensity was highest when both clitoral and vaginal stimulation were involved, lower for vaginal‑only, and lowest for clitoral‑only stimulation. Psychological wellbeing, age and relationship status did not explain these differences.","clinical_takeaway":"Encourage couples to explore both clitoral and vaginal stimulation to potentially enhance orgasm intensity.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large national samples across two time points","Use of validated psychometric instruments","Regression model controls for several covariates","Novel focus on stimulation type and orgasm intensity"],"limitations":["Cross‑sectional design cannot infer causality","Self‑selected online sample may limit generalisability","No objective physiological measures of orgasm"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-024-00999-z"}},{"id":3644,"doi":"10.1038/s41598-024-79966-z","pmid":"39562812","pmcid":"PMC11576738","title":"A qualitative study exploring the clinical phenomenology and impact of hypersexuality in patients with Parkinson's Disease","authors":"Tayim N, Panicker JN, Foley J, Selai C, El Sheikh WG.","first_author":"Tayim N","journal":"Scientific reports","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Qualitative","Parkinson’s Disease","Hypersexuality","Clinical Phenomenology"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11576738","cited_by_count":4,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"small qualitative interview study with 9 Parkinson's patients reporting hypersexuality","sample_n":9,"sample_text":"Six males (mean age 61.7 ± 13.3) and three females (mean age 64.3 ± 5.7)","population":"patients with Parkinson's disease experiencing hypersexuality; English‑speaking; recruited from clinical settings","country":"unspecified (likely UK/US based on English‑speaking)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with nine Parkinson’s patients who became hypersexual after diagnosis reveal that the condition leads to intense sexual thoughts, increased masturbation and risk‑taking, and serious negative effects on relationships, work and wellbeing. Stigma and lack of professional guidance were major barriers to help‑seeking.","clinical_takeaway":"Hypersexuality in Parkinson’s can severely harm quality of life; clinicians should proactively ask about it and provide non‑judgmental support.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["In‑depth first‑hand accounts of hypersexuality in PD","Systematic phenomenological interview protocol","Identification of multiple life‑domains affected"],"limitations":["Very small, non‑representative sample (N=9)","No validated hypersexuality scales; constructs not operationalised quantitatively","No control for confounding factors (e.g., mood, relationship status, medication dosage)","Findings not generalisable beyond this clinical convenience sample"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":5,"retracted":false,"notices":[{"status":"Has correction","date":"2024-12-20","noticeDoi":"10.1038/s41598-024-83151-7","doi":"10.1038/s41598-024-79966-z"}],"url":"https://scite.ai/reports/10.1038/s41598-024-79966-z"}},{"id":3645,"doi":"10.1007/s10508-024-03030-0","pmid":"39500803","pmcid":null,"title":"Ejaculate Adjustment in Response to Sperm Competition Risk in Humans","authors":"DeLecce T, Vance GS, Zeigler-Hill V, Welling LLM, Shackelford TK.","first_author":"DeLecce T","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Evolutionary Psychology","Ejaculate Quality","Human Sperm Competition","Ejaculate Adjustment"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational study of 34 university couples providing six semen samples each and completing relationship surveys.","sample_n":34,"sample_text":"34 couples (68 participants).","population":"University students (heterosexual couples, age 18‑32).","country":"Not specified (likely USA).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small study of 34 couples, men's sperm counts were higher when they believed there were more rival men, but the amount of time spent with their partner did not affect sperm quality.","clinical_takeaway":"No direct clinical implications; findings are preliminary and limited to a specific sample.","confidence":0.75,"topic_tags":["sexual_function","religiosity"],"strengths":["Objective semen analysis with updated technology.","Within‑subject design measuring multiple ejaculates per participant.","Inclusion of both copulatory and masturbatory samples."],"limitations":["Small, university convenience sample (N=34 couples).","Self‑report measures of sperm competition risk lack validation.","Limited control for potential physiological or psychological confounds."],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-03030-0"}},{"id":3647,"doi":"10.7759/cureus.13626","pmid":"33816025","pmcid":"PMC8011625","title":"Masturbatory Guilt Leading to Severe Depression","authors":"Albobali Y, Madi MY.","first_author":"Albobali Y","journal":"Cureus","year":2021,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Depression","Sexual behaviour","Adolescents With Psychiatric Disorders"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8011625","cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single clinical case description with treatment outcome","sample_n":1,"sample_text":"one patient","population":"young male adolescent","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2021 case report describes a teenage boy who felt intense guilt about masturbating, which the authors say contributed to a severe depressive episode. Treatment with psychotherapy, medication, and vitamins led to improvement. The authors stress cultural beliefs about sexual behavior in clinical care.","clinical_takeaway":"Clinicians should explore cultural and moral beliefs around masturbation when assessing depression, but single-case evidence is insufficient to infer causality.","confidence":0.6,"topic_tags":["masturbation","gender","moral_incongruence","csbd"],"strengths":["Detailed clinical description","Integration of cultural context"],"limitations":["Single case, no systematic measurement","No validated scales for guilt or depression severity reported","No control for confounding variables"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.13626"}},{"id":3649,"doi":"10.3389/fpsyg.2024.1496891","pmid":"39507080","pmcid":"PMC11538066","title":"Influence of personality disorders on sexual behaviours and response to treatment of psychogenic erectile dysfunction in phosphodiesterase 5 inhibitor non-responders","authors":"Cabello-García M, Sánchez-Sandoval Y, García-Rojas AD.","first_author":"Cabello-García M","journal":"Frontiers in psychology","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["erectile dysfunction","Personality Disorders","Phosphodiesterase-5 Inhibitors","Sexual Behaviours","Psychosexual Therapy","Couple Wellbeing"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11538066","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective ex post facto comparison of 23 vs 51 men with psychogenic ED, assessing personality disorders and treatment response","sample_n":74,"sample_text":"23 control men without personality disorders; 51 men with both ED and personality disorders","population":"men with psychogenic erectile dysfunction, some with personality disorders","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men with psychogenic erectile dysfunction who do or do not have personality disorders. Those with personality disorders showed poorer response to psychosexual therapy and differed slightly in sexual behaviours, such as less partner‑masturbation.","clinical_takeaway":"Assess personality disorders in men with erectile dysfunction, as they may predict lower success of psychosexual therapy.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["clinical relevance of personality assessment","comparison of treatment outcomes","identifies specific sexual behaviour difference"],"limitations":["small, uneven sample sizes","retrospective design limits causality","limited measurement detail of sexual behaviours"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2024.1496891"}},{"id":3651,"doi":"10.19082/4096","pmid":"28607641","pmcid":"PMC5459278","title":"Lessons learned from the study of masturbation and its comorbidity with psychiatric disorders in children: The first analytic study","authors":"Tashakori A, Safavi A, Neamatpour S.","first_author":"Tashakori A","journal":"Electronic physician","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Child","Psychiatric disorders","Masturbation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5459278","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Descriptive‑analytical, convenience sample of 98 children referred to a psychiatric clinic; DSM‑IV interview and CSI‑4 for diagnoses; questionnaire for masturbation.","sample_n":98,"sample_text":"98 children selected by convenience sampling from a pediatric psychiatric ward","population":"Children (psychiatric clinic patients) in Iran, N≈98","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 98 Iranian children seen at a psychiatric clinic, about one‑third reported masturbating. Masturbation was linked to several anxiety‑related disorders, oppositional defiant and conduct disorders, and motor tics. The authors suggest clinicians should assess for psychiatric problems when children show unusual sexual behaviours.","clinical_takeaway":"When a child presents with frequent masturbation, consider screening for anxiety, oppositional, and conduct disorders, but note the findings come from a psychiatric‑clinic sample.","confidence":0.7,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Use of standard DSM‑IV interview and validated CSI‑4 for psychiatric diagnoses","First analytic study of masturbation comorbidity in children","Clear reporting of prevalence and specific associated disorders"],"limitations":["Convenience sample from a psychiatric clinic limits generalisability","Masturbation assessed with a non‑validated, single‑item questionnaire","No control for potential confounders (e.g., trauma, family factors)","Small sample; chi‑square tests may be under‑powered for some disorder categories"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.19082/4096"}},{"id":3653,"doi":"10.5664/jcsm.8832","pmid":"32959776","pmcid":"PMC7849642","title":"A rare presentation of sexsomnia in a military service member","authors":"Kim DS, Foster BE, Scott JA, Rizzo MM, Collen JF, Soca R.","first_author":"Kim DS","journal":"Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine","year":2021,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["obstructive sleep apnea","Sexsomnia","Nrem Parasomnia","Sexual Behaviors In Sleep","Military Sleep Environment","Sleep Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case of a 40‑year‑old male military member with sleep‑related sexual behaviour; polysomnography used for diagnosis; no control group","sample_n":1,"sample_text":"one case","population":"male, 40, active‑duty US military, sleep clinic attendees","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes a 40‑year‑old soldier who repeatedly performed sexual acts while asleep (sexsomnia). Sleep studies showed he also had moderate sleep apnea, which improved with CPAP treatment. The authors compare this case to other reports and discuss how such sleep‑related sexual behaviours may affect military duties.","clinical_takeaway":"Consider sleep disorders like apnea as a treatable cause of involuntary sexual behaviours during sleep.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Detailed polysomnographic documentation","Addresses a rare phenomenon in a specific population"],"limitations":["Single case, no generalisability","No measurement of psychological or moral/conflict variables","No systematic assessment of addiction criteria"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5664/jcsm.8832"}},{"id":3654,"doi":"10.1007/s10508-017-0975-8","pmid":"28341933","pmcid":null,"title":"Masturbation and Partnered Sex: Substitutes or Complements?","authors":"Regnerus M, Price J, Gordon D.","first_author":"Regnerus M","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Masturbation","Gender Differences","Sexual Desire","Partnered Sexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large probability sample of US adults, cross‑sectional survey","sample_n":15738,"sample_text":"large, recent probability sample of American adults ages 18-60 (7648 men and 8090 women)","population":"American adults ages 18‑60 (N≈15,738)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a US probability sample, the study found that men who are less satisfied with partnered sex tend to masturbate more (compensatory), while women who are satisfied tend to masturbate more (complementary). Sexual satisfaction predicts masturbation better than recent sex frequency.","clinical_takeaway":"Masturbation patterns relate to sexual satisfaction; clinicians should consider personal contentment when discussing sexual health.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Nationally representative probability sample","Large sample size","Considers subjective sexual contentment as moderator"],"limitations":["Self‑report measures, likely single‑item","Cross‑sectional design limits causal inference","No assessment of moral, mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":0,"mentioning":75,"citing_publications":101,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-0975-8"}},{"id":3655,"doi":"10.1007/s11764-024-01672-6","pmid":"39266938","pmcid":"PMC13166964","title":"Does sexual rehabilitation work for gay and bisexual prostate cancer patients? Acceptability, feasibility, and efficacy results from the Restore-2 randomized controlled trial","authors":"Rosser BRS, Kohli N, Bates AJ, Talley KMC, Wright MM, Polter EJ, Wheldon CW, Haggart R, Dickstein DR, Ross MW, Zhang Z, West W, Konety BR.","first_author":"Rosser BRS","journal":"Journal of cancer survivorship : research and practice","year":2026,"pub_types":["research-article","Randomized Controlled Trial","Journal Article"],"keywords":["Prostatic neoplasms","Health Status Disparities","Sexual Dysfunction, Physiological","Sexual Minorities","Health Care Disparity"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized controlled trial with 401 sexual‑minority men, 24‑month follow‑up, online biopsychobehavioural intervention vs control","sample_n":401,"sample_text":"401 participants, randomized","population":"US gay/bisexual men treated for prostate cancer with sexual/urinary problems","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A randomized trial with 401 gay and bisexual men who had prostate cancer tested an online sexual‑rehabilitation program. While participants liked the program, it did not improve sexual or urinary function compared with usual care.","clinical_takeaway":"Tailored sexual‑rehabilitation is acceptable but may not enhance function; offering aids for accommodation is advisable.","confidence":0.85,"topic_tags":["sexual_function","csbd"],"strengths":["Large sample for a sexual‑minority oncology trial","Randomized controlled design","Multiple follow‑up assessments over 2 years","Clear reporting of null efficacy"],"limitations":["Retrospective trial registration","No detail on psychometric validation of outcome measures in abstract","Limited reporting of effect sizes and confidence intervals","Potential lack of control for mental‑health or relationship covariates"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11764-024-01672-6"}},{"id":3656,"doi":"10.1007/s44192-024-00094-1","pmid":"39256321","pmcid":"PMC11387558","title":"Pharmacological tightrope: risperidone's balancing act in cri du chat syndrome","authors":"Bond Q, Agrawal H.","first_author":"Bond Q","journal":"Discover mental health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11387558","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case study of one adult with cri du chat syndrome; no control group, no systematic methodology","sample_n":1,"sample_text":"single patient","population":"23‑year‑old non‑verbal male with cri du chat syndrome","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 23‑year‑old man with cri du chat syndrome developed high prolactin levels and breast growth while on risperidone. When the drug was lowered, his previously suppressed excessive masturbation returned; re‑starting the drug reduced this behaviour.","clinical_takeaway":"In this single case, risperidone appeared to curb excessive masturbation but caused hormonal side‑effects; clinicians should weigh risks and monitor closely.","confidence":0.8,"topic_tags":["masturbation","sexual_function","neuroscience"],"strengths":["Detailed clinical observation of rare syndrome","Clear documentation of medication side‑effects"],"limitations":["N=1 limits generalisability","No validated measures of compulsive sexual behaviour","No control for confounding variables (e.g., baseline mood, hormonal status)"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s44192-024-00094-1"}},{"id":3658,"doi":"10.1080/00224499.2016.1269307","pmid":"28112982","pmcid":null,"title":"Would You Say You \"Had Masturbated\" If … ?: The Influence of Situational and Individual Factors on Labeling a Behavior as Masturbation","authors":"Kirschbaum AL, Peterson ZD.","first_author":"Kirschbaum AL","journal":"Journal of sex research","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 564 adults assessing which sexual behaviors participants label as masturbation; between‑subjects comparisons by gender, age, partner presence, orgasm occurrence.","sample_n":564,"sample_text":"Convenience online sample; not probability‑based.","population":"Adults (young to middle‑aged, both sexes) recruited online, likely convenience sample.","country":"Not specified (likely USA/English‑speaking).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study asked 564 people which sexual actions they consider masturbation. Most participants labeled many different activities as masturbation, especially when they were alone, had no partner, or reached orgasm. Women were more likely than men to call a behavior masturbation when they were alone and did not orgasm.","clinical_takeaway":"Clinicians should recognize that people differ widely in what they label as masturbation; definitions should be clarified in therapy or education.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Large sample for a survey study","Clear focus on behavioral labeling","Gender‑balanced analysis"],"limitations":["Self‑reported, ad‑hoc behavior list lacks validation","Convenience sample limits generalizability","No assessment of moral or psychological correlates"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":19,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2016.1269307"}},{"id":3660,"doi":"10.1080/26895269.2020.1838386","pmid":"34240073","pmcid":"PMC8118227","title":"Sexual behavior and sexual health of transgender women and men before treatment: Similarities and differences","authors":"Gil-Llario MD, Gil-Juliá B, Giménez-García C, Bergero-Miguel T, Ballester-Arnal R.","first_author":"Gil-Llario MD","journal":"International journal of transgender health","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Masturbation","Transgender","Partner","Sexual Health Indexes"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"260 transgender participants recruited from a health clinic completed a Sexual Behavior Questionnaire before any gender‑affirming treatment; comparisons made between trans men and trans women on sexual behavior, masturbation, partner activity and sexual‑health indexes.","sample_n":260,"sample_text":"260 trans people recruited at a transgender health clinic in Spain","population":"transgender adults (pre‑treatment) in Spain, clinic‑based sample","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 260 transgender adults before any gender‑affirming treatment, trans women reported more difficulties with sexual desire, arousal and partner intimacy than trans men, despite similar masturbation frequency. Pain, fantasies and relationship status were linked to overall sexual health.","clinical_takeaway":"Trans women may need more support for sexual desire, pain and partner intimacy before gender‑affirming treatment.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large sample for a transgender study","Compares trans men and women across many sexual‑health domains","Identifies specific areas (e.g., partner touch, pain) for intervention"],"limitations":["Clinic‑based convenience sample limits generalisability","Primary questionnaire appears ad‑hoc with unclear validation","No measurement of mental‑health or trauma confounds","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/26895269.2020.1838386"}},{"id":3661,"doi":"10.31234/osf.io/6kemn","pmid":null,"pmcid":null,"title":"The periodicity of male nocturnal emission","authors":"Baxter R.","first_author":"Baxter R.","journal":"PsyArXiv","year":2018,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/6kemn","cited_by_count":0,"is_preprint":true,"topics":["masturbation"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"single‑subject long‑term self‑report diary of nocturnal emissions","sample_n":1,"sample_text":"One participant recorded 2641 days of data","population":"unspecified; appears to be a single individual (self‑selected)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"avoid","plain_summary":"The author recorded nightly emissions over many years in one person and claims the timing follows a regular cycle similar to the female menstrual cycle, suggesting an unconscious sexual regulation system.","clinical_takeaway":"None – the findings are anecdotal and not applicable to clinical practice.","confidence":0.4,"topic_tags":["sexual_function","masturbation"],"strengths":["Long observation period","Novel hypothesis about nocturnal emission periodicity"],"limitations":["Single‑subject design, no replication","No validated measures or statistical tests reported","No control for confounding variables"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/6kemn"}},{"id":3663,"doi":"10.1080/00224499.2024.2390672","pmid":"39207435","pmcid":null,"title":"The Gender Gap in Partnered Orgasm: A Scoping Review of Evidence with Graphical Comparisons","authors":"McElroy EE, Perry SL.","first_author":"McElroy EE","journal":"Journal of sex research","year":2024,"pub_types":["Scoping Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Scoping review of observational studies over 30 years; synthesis without meta‑analysis, no risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not applicable – review of existing literature.","population":"Adults in heterosexual partnered sexual encounters; studies varied in sampling.","country":"Not applicable – international literature.","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A scoping review of 30 years of research shows women’s orgasm rates rise when clitoral stimulation is included, suggesting the orgasm gap is driven more by social factors than biology.","clinical_takeaway":"Clinicians should consider relational and technique factors, not just biology, when addressing orgasm concerns.","confidence":0.75,"topic_tags":["gender","sexual_function","relationships","measurement"],"strengths":["Comprehensive 30‑year scope","Highlights measurement issues","Integrates social context"],"limitations":["No quantitative meta‑analysis","Limited assessment of confounds","Potential sample bias in original studies"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2024.2390672"}},{"id":3664,"doi":"10.1016/j.sxmr.2020.07.007","pmid":"33069622","pmcid":null,"title":"Psychological and Behavioral Treatment of Female Orgasmic Disorder","authors":"Marchand E.","first_author":"Marchand E.","journal":"Sexual medicine reviews","year":2021,"pub_types":["Review","Journal Article"],"keywords":["Anorgasmia","Female Sexual Dysfunction","Orgasm","Female Orgasm","Female Orgasmic Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"review","sample_n":null,"sample_text":"not applicable – literature review","population":"women with female orgasmic disorder (FOD)","country":"United States (focus of prevalence data)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarizes evidence that psychological approaches—especially directed masturbation, sensate focus, and psychotherapy—can help women with female orgasmic disorder achieve orgasms, while some other methods show little benefit.","clinical_takeaway":"Psychological therapy, particularly guided masturbation and sensate focus, is effective for many women with orgasmic disorder.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive literature search of psychological treatments for FOD","Identifies most consistently supported interventions","Highlights gaps and future research directions"],"limitations":["No quantitative synthesis (meta‑analysis) of effect sizes","Limited assessment of study quality or risk of bias","Does not address potential confounds such as mental health or relational factors"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":28,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sxmr.2020.07.007"}},{"id":3666,"doi":"10.1016/j.beth.2024.08.006","pmid":"40287185","pmcid":null,"title":"How Can Sexual and Gender Minority Latter-day Saints Resolve Identity Conflict and Improve Their Mental Health? Results From a 2- to 4-Year Longitudinal Study","authors":"Lefevor GT, Skidmore SJ.","first_author":"Lefevor GT","journal":"Behavior therapy","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Depression","Religion","Identity Conflict","Lgbtq+","Latter-day Saint"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Longitudinal cohort with three waves (baseline 2020/2022, follow‑ups 2022/2024); N=359 SGM Latter‑day Saints.","sample_n":359,"sample_text":"359 participants (baseline); follow‑up rates not specified in abstract","population":"sexual and gender minority adults raised in the Church of Jesus Christ of Latter‑day Saints","country":"USA (implied)","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2‑ to 4‑year study of 359 LGBTQ+ people raised Mormon found that self‑compassion, lower internalized homonegativity, and authentic religious engagement predicted lower depression and better resolution of identity conflict over time.","clinical_takeaway":"Encouraging self‑compassion, reducing self‑stigma, and supporting authentic faith engagement may improve mental health for LGBTQ+ individuals from conservative religious backgrounds.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, multi‑year longitudinal design","Pre‑registration of analyses","Use of multiple psychosocial predictors"],"limitations":["Unclear whether all scales were validated","Potential self‑selection/ convenience sampling","Limited control for key confounders (e.g., moral incongruence, partner context)"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.beth.2024.08.006"}},{"id":3668,"doi":"10.1007/s10508-016-0870-8","pmid":"27882477","pmcid":null,"title":"Sexual Fantasy and Masturbation Among Asexual Individuals: An In-Depth Exploration","authors":"Yule MA, Brotto LA, Gorzalka BB.","first_author":"Yule MA","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Masturbation","Sexual Orientation","Asexuality","Sexual Fantasy"],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire; 351 asexual, 388 sexual participants; compares masturbation frequency and fantasy content","sample_n":739,"sample_text":"large convenience online sample, not nationally representative","population":"adults (women and men) recruited via internet; self‑identified asexual vs sexual","country":"unspecified (likely Canada/USA based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2017 online survey compared 351 asexual adults with 388 sexual adults. Asexual women masturbated less often and were less likely to report sexual fantasies, especially involving other people, than sexual women. Both groups shared many fantasy themes, such as fetishes and BDSM.","clinical_takeaway":"Asexual individuals may engage in less masturbation and report fewer sexual fantasies, but share many fantasy interests with sexual peers.","confidence":0.75,"topic_tags":["sexual_function","masturbation"],"strengths":["Large sample size for asexual population","Use of a published asexual identification scale","Direct comparison with sexual participants"],"limitations":["Cross‑sectional, self‑report design","Convenience online recruitment limits generalisability","Limited measurement of potential confounds (e.g., mental health, religiosity)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":25,"citing_publications":102,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0870-8"}},{"id":3669,"doi":"10.1007/s11255-020-02661-1","pmid":"32965622","pmcid":null,"title":"Evaluation of the efficacy of sexual intercourse on distal ureteral stones in women: a prospective, randomized, controlled study","authors":"Turgut H.","first_author":"Turgut H.","journal":"International urology and nephrology","year":2021,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":["Ureteral Stone","Masturbation","Sexual Intercourse"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Prospective, parallel‑group randomized controlled trial with 35 participants per arm comparing sexual intercourse (3‑4 times/week) plus standard care versus standard care alone (with abstinence from intercourse and masturbation). Primary outcomes: stone expulsion rate at 2 and 4 weeks, time to expul","sample_n":70,"sample_text":"70 women (35 per group).","population":"Women with distal or intramural ureteral stones (mean age ≈ 36 y, stone size ≈ 7 mm).","country":"Not stated in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a small trial, women who had sex three to four times a week were more likely to pass kidney stones and needed fewer painkillers than women who avoided sex and masturbation.","clinical_takeaway":"Encouraging regular sexual intercourse may aid passage of distal ureteral stones and reduce analgesic use.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Randomized controlled design","Objective clinical outcomes","Clear intervention protocol"],"limitations":["Small sample size, no power calculation reported","No effect‑size confidence intervals","Sexual activity adherence not objectively verified"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11255-020-02661-1"}},{"id":3670,"doi":"10.7759/cureus.66103","pmid":"39229414","pmcid":"PMC11369388","title":"Dhat Syndrome Presenting as Secondary Depression in a Patient With Mild Intellectual Disability","authors":"Kalimuthu A, Kaki A, Jetty RR, T M, R AS.","first_author":"Kalimuthu A","journal":"Cureus","year":2024,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Depression","Cognitive Behavioral Therapy","Intellectual Disability","Culture-bound Syndrome","Dhat"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11369388","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"n=1 (case report)","population":"single adult male with mild intellectual disability","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 34‑year‑old man with mild intellectual disability was found to have Dhat syndrome—a cultural belief that losing semen causes illness—alongside depression. He improved after cognitive‑behavioural therapy and medication, showing the need to ask about sexual health in this group.","clinical_takeaway":"Screen for culture‑bound sexual concerns like Dhat syndrome when assessing depression in people with intellectual disability.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Highlights cultural syndrome in a vulnerable population","Describes therapeutic approach combining CBT and medication"],"limitations":["Single case limits generalizability","No validated measurement tools reported","No systematic assessment of confounders"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.66103"}},{"id":3672,"doi":"10.1016/j.urology.2020.06.101","pmid":"32888982","pmcid":"PMC7462585","title":"The Impact of the COVID-19 Quarantine on Sexual Life in Italy","authors":"Cito G, Micelli E, Cocci A, Polloni G, Russo GI, Coccia ME, Simoncini T, Carini M, Minervini A, Natali A.","first_author":"Cito G","journal":"Urology","year":2021,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7462585","cited_by_count":63,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"web‑based survey of 1576 Italian adults during COVID‑19 quarantine; correlational analysis of frequency of intercourse, desire and masturbation before vs. during quarantine.","sample_n":1576,"sample_text":"1576 participants (1018 women, 558 men)","population":"adult Italian residents (mixed gender), recruited online","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A web survey of 1576 Italians found that during COVID‑19 lockdown people had fewer weekly sexual encounters, but most did not report less desire or masturbation. Privacy problems and lack of psychological stimulation were the main reasons for the drop.","clinical_takeaway":"Lockdown reduced partnered sex for many; clinicians should consider privacy and mental‑stimulation factors when addressing sexual concerns.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Large sample for a rapid‑response survey","Direct comparison of pre‑ and during‑quarantine sexual activity","Includes both partnered and solitary sexual behavior"],"limitations":["Cross‑sectional, relies on retrospective self‑report","No validated sexual health or well‑being instruments cited","Limited control for confounding variables (e.g., mental health, relationship status)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":9,"contrasting":1,"mentioning":116,"citing_publications":116,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urology.2020.06.101"}},{"id":3673,"doi":"10.1080/00224499.2024.2377575","pmid":"39018151","pmcid":null,"title":"Definitions of Having Sex in Older Men and Women and Their Relationship with Sexual Well-Being","authors":"Cameron J, Santos-Iglesias P.","first_author":"Cameron J","journal":"Journal of sex research","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey of 286 older adults in relationships; participants listed 19 sexual activities and indicated which they would consider as ‘sex’. Cluster analysis used to identify groups.","sample_n":286,"sample_text":"286 men and women aged 60+ recruited online.","population":"Adults ≥60 y in romantic relationships, recruited via Prolific and Facebook (convenience sample).","country":"Not specified (likely multiple English‑speaking countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Older adults were asked whether 19 different sexual activities counted as ‘having sex’. Penetrative acts were most often labelled as sex, but many also counted non‑penetrative, masturbatory, and contact activities. The way people defined sex showed little effect on overall sexual well‑being.","clinical_takeaway":"Clinicians should recognize that older clients may define ‘sex’ broadly; assessment should ask about specific activities rather than assuming penetrative intercourse only.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for older‑adult sexuality research.","Systematic list of activities allows direct comparison.","Cluster analysis provides nuanced categorization."],"limitations":["Convenience online sample limits generalisability.","Behavioral definitions derived from non‑validated items.","Cross‑sectional; cannot infer causality."],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2024.2377575"}},{"id":3674,"doi":"10.1080/13691058.2020.1788163","pmid":"32744471","pmcid":null,"title":"Sexual attitudes and behaviours among Arab American young adults in the USA","authors":"Abboud S, Flores D, Redmond L, Brawner BM, Sommers MS.","first_author":"Abboud S","journal":"Culture, health & sexuality","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Young Adults","Sexual Attitudes","Sexual Behaviours","Arab Americans"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional quantitative survey of 100 Arab American young adults (18–25) assessing sexual attitudes, religiosity, and five sexual behaviours.","sample_n":100,"sample_text":"100 Arab American young adults (18-25 years)","population":"Arab American young adults, USA, convenience sample","country":"USA","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 100 Arab‑American young adults in the US found that about half had engaged in solo or partnered sexual activities in the past six months, with gender differences in attitudes and behaviours; religiosity predicted some partnered behaviours.","clinical_takeaway":"Clinicians should recognize that unmarried Arab‑American youth may be sexually active and consider culturally sensitive sexual‑health counseling.","confidence":0.8,"topic_tags":["sexual_function","csbd","masturbation","religiosity"],"strengths":["Addresses understudied Arab‑American population","Separates solo and partnered masturbation","Includes religiosity as a predictor"],"limitations":["Small convenience sample, limited generalisability","Reliance on self‑report, likely non‑validated measures","No control for mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2020.1788163"}},{"id":3675,"doi":"10.1016/j.fjurol.2024.102697","pmid":"39002734","pmcid":null,"title":"Recommendations for the diagnosis and evaluation of premature ejaculation","authors":"Huyghe E, Grellet L, Faix A, Almont T, Cuzin B, Burte C.","first_author":"Huyghe E","journal":"The French journal of urology","year":2024,"pub_types":["Systematic Review","Journal Article"],"keywords":["Sexual dysfunction","Premature Ejaculation","Sexology","Dysfonction Sexuelle","Éjaculation Prématurée","Sexologie"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of literature to produce clinical practice recommendations for premature ejaculation diagnosis and evaluation.","sample_n":null,"sample_text":"Not applicable – review of existing studies.","population":"Adult men with premature ejaculation (clinical focus).","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"French experts reviewed the literature and issued recommendations for diagnosing premature ejaculation, defining it by short ejaculation time, perceived loss of control, and related distress, and suggesting use of standard questionnaires and partner assessment.","clinical_takeaway":"Use the SIAMS definition and IELT <180 s, combined with patient‑reported distress and partner input, to diagnose premature ejaculation.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Comprehensive literature search (1995‑2022)","Clear clinical definition incorporating latency and distress","Considers partner and comorbid sexual dysfunctions"],"limitations":["No primary data; relies on existing studies","Limited discussion of measurement validation","Potential cultural bias (French expert panel)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.fjurol.2024.102697"}},{"id":3676,"doi":"10.1016/j.esxm.2020.06.008","pmid":"32727690","pmcid":"PMC7691887","title":"Body Image, Orgasmic Response, and Sexual Relationship Satisfaction: Understanding Relationships and Establishing Typologies Based on Body Image Satisfaction","authors":"Horvath Z, Smith BH, Sal D, Hevesi K, Rowland DL.","first_author":"Horvath Z","journal":"Sexual medicine","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Women","Masturbation","Body Image","Orgasm","Sexual Relationship","Partnered Sex"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7691887","cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 257 Norwegian women; structural equation modelling used","sample_n":257,"sample_text":"online convenience sample","population":"adult women (mean age not specified), Norwegian, self‑selected online participants","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 257 Norwegian women, greater dissatisfaction with body image was linked to more trouble reaching orgasm during both partnered sex and masturbation, and to lower satisfaction with their sexual relationship.","clinical_takeaway":"Body‑image concerns may contribute to orgasmic difficulties; addressing body image might improve sexual satisfaction.","confidence":0.8,"topic_tags":["sexual_function","masturbation","relationships"],"strengths":["Reasonably large sample for a survey","Uses structural equation modelling to test relationships","Assesses both partnered and solitary sexual activity"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral or mental‑health confounds","Convenience online sample limits generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2020.06.008"}},{"id":3678,"doi":"10.1007/s10508-020-01722-x","pmid":"32356083","pmcid":"PMC7300076","title":"Men's Reasons to Abstain from Masturbation May Not Reflect the Conviction of \"reboot\" Websites","authors":"Imhoff R, Zimmer F.","first_author":"Imhoff R","journal":"Archives of sexual behavior","year":2020,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-020-01722-x.pdf","cited_by_count":2,"is_preprint":false,"topics":["bibliography","masturbation","pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Letter/Commentary without empirical data; no study design.","sample_n":null,"sample_text":"N/A (commentary)","population":"Not applicable","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that abstinence‑focused websites, such as NoFap, have a right to be cited because they have commercial interests that could be harmed by criticism.","clinical_takeaway":"None – the piece offers no clinical evidence.","confidence":0.7,"topic_tags":["masturbation","religiosity","sexual_function"],"strengths":["Highlights financial conflicts of interest of abstinence groups","Raises ethical issue of citation and defamation"],"limitations":["No empirical data or systematic review","Lacks measurement or analysis of claims","Potential advocacy bias"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01722-x"}},{"id":3679,"doi":null,"pmid":"27365549","pmcid":"PMC4912646","title":"Diagnostic Value of the Urine Mucus Test in Childhood Masturbation among Children below 12 Years of Age: A Cross-Sectional Study from Iran","authors":"Doust ZK, Shariat M, Zabandan N, Tabrizi A, Tehrani F.","first_author":"Doust ZK","journal":"Iranian journal of medical sciences","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Urine","mucus","Childhood Masturbation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4912646","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control study of children referred to a neurology clinic (N=623)","sample_n":623,"sample_text":"359 with observed masturbatory behaviour, 264 controls","population":"children <12 y referred for seizure/movement‑disorder evaluation in Iran","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an Iranian clinic sample, urine mucus was found in almost all children observed masturbating but rarely in those without such behaviour, suggesting it might help diagnose childhood masturbation.","clinical_takeaway":"Urine mucus testing may aid clinicians suspecting childhood masturbation, but findings need confirmation in broader populations.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large sample size for a pediatric clinical study","Clear case‑control definition based on direct observation"],"limitations":["Convenience sample from neurology clinic limits generalisability","No validated instrument for diagnosing childhood masturbation","No adjustment for potential medical or psychosocial confounders"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":3681,"doi":"10.1080/10550887.2020.1771236","pmid":"32500822","pmcid":null,"title":"Changes in sexual behavior patterns due to stimulants use: three case reports","authors":"Skryabin VY, Khoryaev D, Torrado M.","first_author":"Skryabin VY","journal":"Journal of addictive diseases","year":2020,"pub_types":["Journal Article","Case Reports"],"keywords":["Sexual behavior","Stimulants","Masturbation","Drug Use","Mephedrone"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Three clinical case reports of male stimulant users describing changes in masturbation and hypersexuality.","sample_n":3,"sample_text":"Three patients described in detail","population":"Male adults using amphetamine, mephedrone in Russia (n=3)","country":"Russia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Three men using stimulants reported heightened sexual arousal and excessive masturbation, or loss of interest in sex after stopping the drug. Clinicians should note that stimulants can alter sexual behavior and may raise sexual‑risk concerns.","clinical_takeaway":"Stimulant use can trigger hypersexuality or reduced interest in sex; assess sexual health when treating patients with these drugs.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Detailed clinical description","Highlights drug‑related hypersexuality","Adds rare data on mephedrone effects"],"limitations":["Very small N (3)","No standardized measures or scales","No control for confounding factors"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10550887.2020.1771236"}},{"id":3682,"doi":"10.1080/00224499.2016.1167814","pmid":"27143221","pmcid":null,"title":"Masturbation Experiences of Swedish Senior High School Students: Gender Differences and Similarities","authors":"Driemeyer W, Janssen E, Wiltfang J, Elmerstig E.","first_author":"Driemeyer W","journal":"Journal of sex research","year":2017,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 3,018 Swedish senior‑high‑school students (ages 18‑22) from 52 schools; gender‑based comparisons and cluster analysis","sample_n":3018,"sample_text":"1,566 women and 1,452 men from 52 schools","population":"Swedish senior high‑school students (young adults, 18‑22 y)","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 3,000 Swedish high‑school students, men reported more frequent and varied masturbation experiences than women, but many women had similar experiences. Having fewer experiences did not automatically mean negative attitudes toward masturbation.","clinical_takeaway":"Clinicians should recognize that variation in masturbation experiences is common and not inherently linked to negative attitudes.","confidence":0.8,"topic_tags":["masturbation","gender","sexual_function","adolescents"],"strengths":["Large, gender‑balanced sample","Multiple aspects of masturbation examined","Cluster analysis reveals nuanced patterns"],"limitations":["Self‑report measures likely unvalidated","Convenience sample of school students, not nationally representative","No assessment of mental‑health or moral variables"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":16,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2016.1167814"}},{"id":3684,"doi":"10.1186/s12889-024-18977-x","pmid":"38831431","pmcid":"PMC11145846","title":"Risk factors associated with oral Human Papillomavirus (HPV) prevalence within a young adult population","authors":"Whitton AF, Knight GL, Marsh EK.","first_author":"Whitton AF","journal":"BMC public health","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Observational Study"],"keywords":["Human papillomavirus","Prevalence","Sexual behaviour","Viral load","risk factors"],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-024-18977-x","cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational study using convenience sample of 452 UK higher‑education students; oral swabs analysed for HPV; questionnaire on sexual/health behaviours; univariate and multivariate analyses; not powered for subgroup comparisons.","sample_n":452,"sample_text":"Convenience sample of higher‑education students; not representative of wider young‑adult population.","population":"young adults (students) in the UK, N=452","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample","selective_reporting"],"stance":"neutral","citation_value":"useful","plain_summary":"In a UK student sample, about 23% carried oral HPV, with the high‑risk type 16 most common. Smoking, masturbation and multiple sexual activities were linked to higher oral HPV rates, but typical genital‑HPV risk factors were not.","clinical_takeaway":"Young adults, especially smokers and those with frequent sexual activity, may be at higher risk for oral HPV; clinicians should consider oral HPV screening and education.","confidence":0.78,"topic_tags":["sexual_function","csbd"],"strengths":["Objective virological testing (PCR) provides reliable HPV prevalence data","Large sample for a prevalence study within a specific young‑adult cohort","Multivariate analysis attempts to adjust for multiple risk factors"],"limitations":["Convenience sample of students limits generalisability","Behavioural measures are single‑item self‑reports, not validated scales","No adjustment for important confounders such as mental health or partner status"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-024-18977-x"}},{"id":3685,"doi":"10.1186/s12889-020-08826-y","pmid":"32410684","pmcid":"PMC7227303","title":"A sex education program for teachers of preschool children: a quasi-experimental study in Iran","authors":"Martin J, Riazi H, Firoozi A, Nasiri M.","first_author":"Martin J","journal":"BMC public health","year":2020,"pub_types":["research-article","Evaluation Study","Journal Article"],"keywords":["Preschool child","Knowledge","Iran","Sex Education","Attitude","Teacher"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7227303","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"quasi-experimental with random allocation to intervention (2×90‑min sessions) and control; pre‑post assessment at 1 month","sample_n":80,"sample_text":"80 teachers","population":"preschool teachers (n = 80) in Tehran, Iran","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A brief training program for preschool teachers in Tehran significantly increased their knowledge and attitudes about sex education, including topics like masturbation and sexual abuse, compared with teachers who did not receive the training.","clinical_takeaway":"Targeted teacher training can improve educators' competence in delivering age‑appropriate sex education.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Random allocation to intervention and control groups","Clear pre‑post measurement of knowledge and attitude","Registered trial (though retrospectively)","Statistical analysis includes ANCOVA"],"limitations":["Questionnaires are self‑designed and not psychometrically validated","No effect sizes or confidence intervals reported","Convenience sample of teachers limits generalisability","Retrospective registration; possible selective reporting"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":19,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-020-08826-y"}},{"id":3688,"doi":"10.1016/j.esxm.2016.03.024","pmid":"27052770","pmcid":"PMC5005301","title":"Psychological, Relational, and Biological Correlates of Ego-Dystonic Masturbation in a Clinical Setting","authors":"Castellini G, Fanni E, Corona G, Maseroli E, Ricca V, Maggi M.","first_author":"Castellini G","journal":"Sexual medicine","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Anxiety","Ego-dystonic Masturbation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5005301","cited_by_count":13,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"retrospective series of 4,211 men attending an andrology/sexual‑medicine outpatient clinic; self‑report questionnaires on masturbation frequency, guilt, psychiatric symptoms and relational variables","sample_n":4211,"sample_text":"4211 men, outpatient sexual‑medicine clinic, retrospective data collection","population":"men seeking care in a sexual‑medicine clinic (average age ~50 y)","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In over 4,000 men seen at a sexual‑medicine clinic, 8 % reported feeling guilty after masturbating. Higher guilt was linked to more depression, anxiety, alcohol use, and poorer relationship and sexual satisfaction.","clinical_takeaway":"Guilt after masturbation may signal broader psychological distress and relational problems; clinicians should assess mood and relationship factors.","confidence":0.7,"topic_tags":["masturbation","gender","sexual_function","moral_incongruence"],"strengths":["Large clinical sample (N > 4000)","Uses established questionnaires for psychiatric symptoms","Examines relational outcomes"],"limitations":["EM operationalised by an ad‑hoc product of frequency × guilt (unvalidated)","Moral incongruence/religiosity not measured despite distress outcome","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2016.03.024"}},{"id":3689,"doi":"10.1016/j.slsci.2016.05.009","pmid":"27656267","pmcid":"PMC5022330","title":"Sexsomnia: A case of sleep masturbation documented by video-polysomnography in a young adult male with sleepwalking","authors":"Yeh SB, Schenck CH.","first_author":"Yeh SB","journal":"Sleep science (Sao Paulo, Brazil)","year":2016,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Masturbation","Clonazepam","Parasomnia","Shift Work","Sleepwalking","Nrem Sleep","Video-polysomnography","Sexsomnia","Sexual Behaviors In Sleep"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.slsci.2016.05.009","cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case report of a 20‑year‑old male with video‑polysomnography documenting sleep‑related masturbation episodes","sample_n":1,"sample_text":"1 participant","population":"young adult male (n=1)","country":"USA (military) (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 20‑year‑old soldier with a history of sleepwalking was monitored with video‑polysomnography, which captured two episodes of sleep‑related masturbation during deep sleep. The episodes were linked to shift‑work stress, and clonazepam reduced the sleepwalking but not the masturbation.","clinical_takeaway":"Sleep‑related sexual behaviours can occur without conscious intent and may be triggered by sleep disruption; treatment should address underlying sleep disorders.","confidence":0.85,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Objective documentation of sleep‑masturbation via vPSG","Clear temporal relation to NREM sleep stages","Novel description of shift‑work‑induced sexsomnia"],"limitations":["Single case; no generalisability","No systematic assessment of psychological or sexual health confounds","No comparison group or longitudinal follow‑up"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.slsci.2016.05.009"}},{"id":3690,"doi":"10.1016/j.sxmr.2016.02.006","pmid":"27871956","pmcid":null,"title":"Evidence for Masturbation and Prostate Cancer Risk: Do We Have a Verdict?","authors":"Aboul-Enein BH, Bernstein J, Ross MW.","first_author":"Aboul-Enein BH","journal":"Sexual medicine reviews","year":2016,"pub_types":["Review","Journal Article"],"keywords":["Sexual activity","Ejaculation","Masturbation","Prostate Cancer Risk"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review summarising primary studies without systematic methods or meta‑analysis.","sample_n":null,"sample_text":"Review of 16 published studies (sample sizes varied).","population":"Men in observational studies of prostate cancer and masturbation; no new participants recruited.","country":"*","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed 16 studies on whether masturbating affects prostate cancer risk. Some studies suggested a protective effect, especially with more frequent ejaculation and in certain age groups, but the evidence is inconsistent and study designs vary.","clinical_takeaway":"Current evidence does not allow firm conclusions about masturbation’s impact on prostate cancer risk; clinicians should not base recommendations on these findings alone.","confidence":0.6,"topic_tags":["masturbation","sexual_function","csbd","pornography"],"strengths":["Broad literature search across seven databases","Identifies gaps and methodological heterogeneity","Highlights age as a potential moderator"],"limitations":["Not a systematic review; no risk‑of‑bias assessment","No quantitative synthesis or meta‑analysis","Confounding variables (e.g., sexual activity, health behaviours) not controlled"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sxmr.2016.02.006"}},{"id":3693,"doi":"10.1111/jocn.13105","pmid":"26778503","pmcid":null,"title":"Staff attitudes and reactions towards residents' masturbation in Spanish long-term care facilities","authors":"Villar F, Serrat R, Celdrán M, Fabà J.","first_author":"Villar F","journal":"Journal of clinical nursing","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexuality","Masturbation","Older Age","Long-term Care Facilities","Staff Reactions"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"qualitative","design_detail":"exploratory descriptive qualitative study with 53 staff from 5 long‑term care facilities; thematic analysis of interview responses","sample_n":53,"sample_text":"53 staff members from five facilities","population":"staff nurses and care workers in Spanish long‑term care facilities","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study interviewed 53 care‑home staff in Spain about their thoughts and reactions when a resident masturbates. Most said they would tolerate it, but they expected many colleagues to react negatively. The authors recommend clear policies and training to protect older residents' sexual rights.","clinical_takeaway":"Staff training and explicit policies are needed to support respectful handling of residents' sexual expression.","confidence":0.3,"topic_tags":["masturbation","sexual_function","neuroscience"],"strengths":["addresses an understudied area of sexual rights in older adults","includes multiple facilities for broader perspective","provides direct quotes illustrating staff viewpoints"],"limitations":["Small, non‑random sample; limited generalisability","No validated attitude scales; reliance on self‑report interview","No quantitative analysis of confounding variables"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jocn.13105"}},{"id":3694,"doi":"10.1177/10436596241246977","pmid":"38651511","pmcid":null,"title":"Sexual Knowledge, Sexual Attitudes, and the Need for Sex Education Among Adolescent Defectors From North Korea","authors":"Lee IS, Jeon JH, Kim KJ.","first_author":"Lee IS","journal":"Journal of transcultural nursing : official journal of the Transcultural Nursing Society","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Knowledge","Adolescent","Sex Education","Attitude","Democratic People’s Republic Of Korea"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional descriptive survey of 102 North Korean refugee adolescents","sample_n":102,"sample_text":"cross‑sectional convenience sample of refugee adolescents","population":"North Korean refugee adolescents (N=102)","country":"South Korea (study of North Korean defectors)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 102 North Korean refugee teens found very low knowledge about genital anatomy, masturbation and contraception, and conservative attitudes toward these topics. Better knowledge was linked to a greater expressed need for sex education.","clinical_takeaway":"Clinicians working with refugee youth should assess sexual knowledge gaps and provide culturally sensitive education, especially about masturbation and contraception.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Addresses understudied refugee adolescent population","Provides baseline data on sexual knowledge gaps","Highlights need for culturally tailored sex education"],"limitations":["Small, non‑representative convenience sample","Unvalidated knowledge/attitude measures","No control for moral, mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10436596241246977"}},{"id":3695,"doi":"10.1016/j.jpurol.2024.04.010","pmid":"38710600","pmcid":null,"title":"Long-term psychosexual adjustment of adults born with classic bladder exstrophy","authors":"Paraboschi I, Sampogna G, Di Grazia M, Rigamonti W, Berrettini A.","first_author":"Paraboschi I","journal":"Journal of pediatric urology","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Bladder Exstrophy","Psychological Well-being","Psychosexual Adjustment"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 33 adults with classic bladder exstrophy using the validated SESAMO questionnaire; analyses by gender, partnership status and voiding technique.","sample_n":33,"sample_text":"33 adults (median age 39 y, range 32‑47).","population":"Adults (≥18 y) with classic bladder exstrophy operated in infancy at a single tertiary centre (N=33; 12 F/21 M).","country":"Not specified (presumably Italy).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Adults born with classic bladder exstrophy report lower satisfaction with sexual identity, pleasure, desire and other aspects of intimacy, especially women and single individuals. The study highlights areas where psychological support could be targeted.","clinical_takeaway":"Clinicians should screen for a range of psychosexual difficulties in bladder‑exstrophy patients and tailor counseling accordingly.","confidence":0.85,"topic_tags":["sexual_function","gender","relationships","moral_incongruence"],"strengths":["Uses a validated psychosexual instrument (SESAMO)","Provides gender‑ and partnership‑specific analyses","First systematic look at long‑term psychosexual outcomes in this rare condition"],"limitations":["Small, single‑centre sample (N=33)","No control group of non‑affected adults","Limited control of potential confounds (e.g., mental health, moral factors)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpurol.2024.04.010"}},{"id":3696,"doi":"10.1111/and.12511","pmid":"26688574","pmcid":null,"title":"Male attitude towards masturbating: an impediment to infertility evaluation and sperm parameters","authors":"Pottinger AM, Carroll K, Mason G.","first_author":"Pottinger AM","journal":"Andrologia","year":2016,"pub_types":["Journal Article"],"keywords":["Infertility","Conception","Sexual Problems","Masturbation Anxiety"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 83 men attending a fertility clinic in Jamaica; self‑administered questionnaire on comfort with masturbation; semen analysis performed.","sample_n":83,"sample_text":"83 male volunteers attending a fertility management unit in Kingston, Jamaica","population":"male volunteers (23‑61 y) seeking infertility evaluation; convenience sample from one clinic","country":"Jamaica","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 83 Jamaican men seeking fertility help, about half felt comfortable masturbating to provide a semen sample. Comfort was linked to reporting more sexual problems and longer attempts to conceive, but not to sperm quality. The authors suggest that improving comfort with masturbation could help earlier infertility evaluation.","clinical_takeaway":"Addressing men’s discomfort with masturbation may reduce delays in infertility assessment, but evidence is limited.","confidence":0.7,"topic_tags":["masturbation","sexual_function","religiosity"],"strengths":["objective semen parameters collected","focus on an understudied cultural context","use of both questionnaire and biological data"],"limitations":["attitude measure not validated","no control for moral, mental‑health or partner factors","cross‑sectional, cannot infer causality","convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/and.12511"}},{"id":3697,"doi":"10.1038/s41443-024-00891-w","pmid":"38637719","pmcid":"PMC11981911","title":"Paraphilic fantasies and behavior in attention deficit/hyperactivity disorder and their association with hypersexuality","authors":"Turner D, Gregório Hertz P, Biedermann L, Barra S, Retz W.","first_author":"Turner D","journal":"International journal of impotence research","year":2025,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://www.nature.com/articles/s41443-024-00891-w.pdf","cited_by_count":4,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire survey comparing 160 adults with ADHD to 75 controls; cross‑sectional convenience sample","sample_n":235,"sample_text":"160 adults with ADHD, 75 adults without ADHD","population":"adults (mixed gender) with and without ADHD","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Adults with ADHD reported slightly higher rates of intense paraphilic fantasies and behaviors than adults without ADHD, and these interests were modestly linked to hypersexuality in the ADHD group.","clinical_takeaway":"ADHD may modestly increase propensity for certain paraphilic interests; clinicians should assess sexual behavior alongside ADHD symptoms.","confidence":0.78,"topic_tags":["sexual_function","adolescents","neuroscience","csbd"],"strengths":["Relatively large ADHD sample (n=160)","Direct comparison with non‑ADHD controls","Examines under‑studied link between ADHD and paraphilic interests"],"limitations":["Unclear whether questionnaires are validated","No control for key confounds (moral, mental health, trauma)","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-024-00891-w"}},{"id":3698,"doi":"10.1521/prev.2015.102.6.803","pmid":"26653059","pmcid":null,"title":"Inaccessible Masturbation, Impossible Mourning: Collective Melancholia, the Prohibition on Female Sexual Subjects in India, and Masturbation Fantasy as a Zone of the Strange","authors":"Narayanan A.","first_author":"Narayanan A.","journal":"Psychoanalytic review","year":2015,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"No empirical sample; paper is a theoretical review with a single clinical vignette.","population":"adult Indian women (theoretical discussion, no empirical sample)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how Indian cultural prohibitions shape women's sexual fantasies, especially masturbation, describing a collective sense of loss and mourning linked to restricted sexual subjectivity.","clinical_takeaway":"Awareness of cultural and psychoanalytic factors may help clinicians understand shame around female sexuality in Indian contexts.","confidence":0.4,"topic_tags":["masturbation","sexual_function","csbd"],"strengths":["Provides a culturally grounded psychoanalytic perspective.","Integrates historical and clinical illustration."],"limitations":["No empirical data; conclusions are purely theoretical.","Lacks systematic methodology or critical appraisal of literature."],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1521/prev.2015.102.6.803"}},{"id":3699,"doi":"10.1007/s10508-024-02855-z","pmid":"38609584","pmcid":null,"title":"Patient Reported Sexual Adaptation Following Prostate Cancer Treatment: An Analysis of Related Variables and Sexual Outcomes Associated with Sexual Adaptation Styles","authors":"Shah FI, MacLeod F, Walker LM.","first_author":"Shah FI","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Depression","Sexual activity","erectile dysfunction","prostate cancer","Relationship Adjustment","Sexual Adaptation"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online survey of 223 men post‑prostate cancer treatment; inductive/deductive thematic coding; multinomial logistic regression, MANOVA, chi‑square analyses.","sample_n":223,"sample_text":"Adults (mean age not reported) with prostate cancer treatment history; convenience sample.","population":"Men with history of prostate cancer treatment (radical prostatectomy, radiation, hormone therapy) recruited via online survey.","country":"Not specified (likely multi‑country or single country; abstract does not state).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 223 men after prostate‑cancer treatment and identified four main ways they adapt sexually—two couple‑focused and two individual‑focused. Men who could adapt, especially with partner involvement, reported less distress and higher satisfaction than those who could not adapt.","clinical_takeaway":"Supporting partner communication and flexible coping may improve sexual well‑being after prostate cancer treatment.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Large (n>200) community sample for this clinical population","Use of validated sexual‑well‑being and depression measures","Comprehensive thematic analysis identifying distinct adaptation styles"],"limitations":["Cross‑sectional design precludes causal inference","Convenience online recruitment may bias toward more engaged or distressed men","Moral or trauma‑related confounds not assessed"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02855-z"}},{"id":3700,"doi":"10.1097/spv.0000000000001508","pmid":"38621417","pmcid":null,"title":"Prevalence of Sexual Function and Vibrator Use Among Urogynecology Patients","authors":"Roberts B, Rogers R, Husk K, Walia J, Jacobs B, Wolff G, Deverdis EC.","first_author":"Roberts B","journal":"Urogynecology (Philadelphia, Pa.)","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 165 urogynecology patients (78% response rate) comparing vibrator use and receptivity between <65 and ≥65 age groups","sample_n":165,"sample_text":"165 analyzed surveys (63% <65, 37% ≥65)","population":"female urogynecology patients, mean age groups <65 and ≥65","country":"USA (assumed based on journal, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among women seen in urogynecology clinics, younger patients are more likely to use vibrators and masturbate than older patients. Most would welcome doctors talking about vibrators to improve sexual function, especially those who already masturbate or have used a vibrator before.","clinical_takeaway":"Clinicians should consider discussing vibrator options with urogynecologic patients who are interested in improving sexual function.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Validated pelvic floor and sexual function questionnaires","Large community clinical sample for this specialty","Separate measurement of masturbation and vibrator use"],"limitations":["Cross‑sectional design limits causal inference","Vibrator use questions not validated","No assessment of mental‑health or moral/religious factors"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/spv.0000000000001508"}},{"id":3701,"doi":"10.1093/sexmed/qfae017","pmid":"38586250","pmcid":"PMC10994778","title":"Italian women who have sex with women: prevalence and co-occurrence of sexual practices","authors":"Pavanello Decaro S, Pessina R, Biella M, Prunas A.","first_author":"Pavanello Decaro S","journal":"Sexual medicine","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Lesbian","Bisexual","Sexual Practices","Kink"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10994778","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire of 723 women who have sex with women (WSW); multiple‑choice items on a range of sexual practices; convenience sample","sample_n":723,"sample_text":"723 WSW completed a multiple‑choice questionnaire","population":"WSW, mean age 29.1 years, recruited via unspecified channels (likely online/clinic)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 723 Italian women who have sex with women found that almost all engage in self‑masturbation, oral sex and genital contact, and about half have tried kinky activities. The study highlights the diversity of sexual practices in this group.","clinical_takeaway":"Clinicians should recognize the varied sexual practices of WSW and adopt a sex‑positive, non‑judgmental approach.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for a marginalized group","Broad range of sexual practices covered","Sex‑positive framing"],"limitations":["Convenience, non‑representative sample","Unvalidated questionnaire items","No control for potential confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfae017"}},{"id":3702,"doi":"10.1016/j.jsxm.2019.12.009","pmid":"31937518","pmcid":null,"title":"Postcoital Symptoms in a Convenience Sample of Men and Women","authors":"Burri A, Hilpert P.","first_author":"Burri A","journal":"The journal of sexual medicine","year":2020,"pub_types":["Journal Article"],"keywords":["Frequency","epidemiology","Postcoital Dysphoria","Postcoital Symptoms"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"convenience online survey of 299 adults (223 women, 76 men) assessing 21 symptom items and distress questions","sample_n":299,"sample_text":"223 women, 76 men; convenience sample","population":"adult men and women recruited via unspecified online channels","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2020 online survey of 299 adults found that most people experience a range of emotional and physical symptoms after sex, not just sadness. Women reported more mood‑related symptoms; men reported more low‑energy feelings. Symptoms also occurred after masturbation for many participants.","clinical_takeaway":"Post‑coital emotional symptoms are common and diverse; clinicians should assess a broad symptom profile rather than focusing only on dysphoria.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["First in‑depth exploration of post‑coital symptom variety","Includes both men and women","Acknowledges limitations of convenience sampling"],"limitations":["Study‑specific, unvalidated symptom questionnaire","Convenience sample limits generalisability","No control for moral incongruence, mental health, partner effects, or trauma"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.12.009"}},{"id":3703,"doi":"10.1016/j.jsxm.2019.12.012","pmid":"31937517","pmcid":"PMC7197954","title":"Antidepressant Use During Development May Impair Women's Sexual Desire in Adulthood","authors":"Lorenz TK.","first_author":"Lorenz TK.","journal":"The journal of sexual medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Developmental","Sexual function","Antidepressants","Sexual Side Effects","Desire"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online survey of 610 young adults assessing retrospective antidepressant exposure and current sexual desire/behavior.","sample_n":610,"sample_text":"610 young adults completed the survey.","population":"Young adult men and women (66% women), predominantly white, recruited via online methods.","country":"Not specified (likely USA/International online sample).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 610 young adults found that women who took SSRIs before age 16 report lower solo sexual desire and masturbate less as adults, even after accounting for mental‑health history. No similar effect was seen in men or for partnered desire.","clinical_takeaway":"Childhood SSRI exposure may be linked to reduced solo sexual desire in adult women; clinicians should consider developmental exposure when assessing sexual dysfunction.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Validated sexual desire measure (SDI)","Large community sample","Controls for childhood and current mental health"],"limitations":["Cross‑sectional, retrospective exposure data","Self‑selected online sample, limited generalizability","No measurement of moral/religious factors or trauma"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":30,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.12.012"}},{"id":3704,"doi":"10.3390/bs14040277","pmid":"38667073","pmcid":"PMC11047354","title":"Sex Differences in Sexual Motivation in Humans and Other Mammals: The Role of Conscious and Unconscious Processes","authors":"Touraille P, Ågmo A.","first_author":"Touraille P","journal":"Behavioral sciences (Basel, Switzerland)","year":2024,"pub_types":["review-article","Review","Journal Article"],"keywords":["Human","Primate","Rodent","Sexual Scripts","Genital Response","Implicit Motivation","Automatic (Unconscious) Responses","Volitional Responses"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11047354","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review-article (narrative, no systematic methods reported)","sample_n":null,"sample_text":"not applicable – review of existing studies","population":"humans, rodents, non‑human primates (literature synthesis)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review research on automatic and implicit sexual responses and find that men and women show similar physiological and unconscious reactions despite men reporting higher desire on questionnaires. Social expectations may inflate reported sex differences.","clinical_takeaway":"Self‑report of sexual desire may overstate gender differences; clinicians should consider implicit measures when assessing sexual motivation.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad comparative scope across species","Highlights disparity between self‑report and implicit measures"],"limitations":["Narrative review without systematic search or bias assessment","No quantitative synthesis or effect‑size reporting","No primary data; limited ability to evaluate methodological quality"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs14040277"}},{"id":3705,"doi":"10.4103/ijdvl.ijdvl_134_18","pmid":"30665993","pmcid":null,"title":"Masturbation-induced painless hemorrhagic bulla on scarring penile lichen planus","authors":"Verma A, Singh S, Nalwa A.","first_author":"Verma A","journal":"Indian journal of dermatology, venereology and leprology","year":2020,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":"https://ijdvl.com/view-pdf/?&article=8170292e7af8212facc327fbf135af93QO4UoQ==","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/ijdvl.ijdvl_134_18"}},{"id":3707,"doi":"10.1111/andr.13622","pmid":"38439166","pmcid":null,"title":"Application of the sexual therapy combined with vacuum negative pressure hydropneumatic/pneumatic bubble massage in primary intravaginal anejaculation","authors":"Gao Q, Chen J, Wang B, Hang Y, Gao S, Yang J, Dai Y.","first_author":"Gao Q","journal":"Andrology","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":["Sexual behavior","Anxiety","Sexual Therapy","Somatosensory Evoked Potentials","Primary Intravaginal Anejaculation","Vacuum Negative Pressure Hydropneumatic/pneumatic Bubble Massage"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"three‑arm parallel randomised controlled trial comparing sexual therapy + vacuum massage, sexual therapy alone, and vacuum massage alone","sample_n":95,"sample_text":"95 participants randomly allocated to three groups (32, 32, 31)","population":"adult men with primary intravaginal anejaculation (n = 95)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a randomised trial of 95 men with primary intravaginal anejaculation, a combined sexual‑therapy and vacuum‑massage program led to a higher effective rate (84%) than therapy or massage alone (≈54% and 42%). Improvements were linked to reduced anxiety in patients and partners and less frequent masturbation, not to changes in penile sensory thresholds.","clinical_takeaway":"Sexual‑therapy plus vacuum‑massage may help men with intravaginal anejaculation by lowering anxiety and normalising sexual‑behaviour patterns.","confidence":0.8,"topic_tags":["sexual_function","treatment"],"strengths":["Randomised allocation with three comparison arms","Objective neurophysiological measures (SEPs)","Assessment of both patient and partner anxiety","Clear primary outcome (effective rate) and behavioural measures"],"limitations":["Behavioural variables (masturbation, erotic‑film viewing) measured with non‑validated questionnaires","No mention of pre‑registration or power analysis","Moral incongruence/religiosity not considered despite being a possible confound for sexual behaviour","Short‑term follow‑up only"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":6,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/andr.13622"}},{"id":3709,"doi":"10.1038/s41443-024-00853-2","pmid":"38418867","pmcid":null,"title":"Hard flaccid syndrome symptoms, comorbidities, and self-reported efficacy and satisfaction of treatments: a cross-sectional survey","authors":"Niedenfuehr J, Stevens DM.","first_author":"Niedenfuehr J","journal":"International journal of impotence research","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of self‑identified HFS patients recruited via social media; purposive convenience sample; 42‑item online questionnaire","sample_n":null,"sample_text":"Not reported in abstract; likely modest (self‑selected online respondents)","population":"adult males self‑reporting Hard Flaccid Syndrome; recruitment through social‑media platforms; no random sampling","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A web survey of men who say they have Hard Flaccid Syndrome found that many report symptom onset after injury, that masturbation often worsens symptoms, and that most treatments provide little improvement.","clinical_takeaway":"Current therapies appear to offer limited relief for Hard Flaccid Syndrome; clinicians should set realistic expectations.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Addresses a poorly understood clinical condition","Collects patient‑reported treatment satisfaction"],"limitations":["Convenience, self‑selected online sample","No validated instrument for HFS","Descriptive statistics only, no power analysis"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-024-00853-2"}},{"id":3711,"doi":"10.4103/aja.aja_34_19","pmid":"31115366","pmcid":"PMC6859670","title":"Regular penis-root masturbation, a novel behavioral therapy in the treatment of primary premature ejaculation","authors":"Ma GC, Zou ZJ, Lai YF, Zhang X, Zhang Y.","first_author":"Ma GC","journal":"Asian journal of andrology","year":2019,"pub_types":["other","Clinical Trial","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.4103/aja.aja_34_19","cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/aja.aja_34_19"}},{"id":3713,"doi":"10.1016/j.urology.2023.12.029","pmid":"38354913","pmcid":null,"title":"Urinary and Fecal Incontinence During Sexual Activity Is Common and Bothersome Among Adults With Spina Bifida","authors":"Roth JD, Hensel DJ, Wiener JS, Younsi N, Stein R, Misseri R, Szymanski KM.","first_author":"Roth JD","journal":"Urology","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online international survey of adults with spina bifida; N=341; self‑report of urinary/fecal incontinence during sexual activity; logistic regression analysis.","sample_n":341,"sample_text":"341 adults met inclusion criteria","population":"Adults (median age 36) with spina bifida, 59% female, recruited through clinics, organizations, and social media.","country":"International (online respondents recruited via SB clinics and organizations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 341 adults with spina bifida found that urinary incontinence during sex is common (70% of those without a urostomy) and almost always bothersome, while fecal incontinence is less frequent but similarly distressing. Female sex and existing bladder or bowel problems predict these issues.","clinical_takeaway":"Clinicians should routinely ask about incontinence during sexual activity in patients with spina bifida, as it is common and highly bothersome.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Large (N>300) international sample of a rare condition","Focused on a clinically relevant, under‑studied issue","Uses multivariate logistic regression to identify independent predictors"],"limitations":["Cross‑sectional self‑report; no validated outcome measures","Convenience online recruitment may bias toward those with problems","No control for key psychosocial confounds (moral attitudes, mental health, partner effects)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urology.2023.12.029"}},{"id":3714,"doi":"10.1111/jir.13125","pmid":"38304997","pmcid":null,"title":"Sexual experiences and knowledge of people with moderate intellectual disability","authors":"Estruch-García V, Gil-Llario MD, Fernández-García O.","first_author":"Estruch-García V","journal":"Journal of intellectual disability research : JIDR","year":2024,"pub_types":["Journal Article"],"keywords":["Sex Education","Sexual Abuse","Sexual Experiences","Sexual Knowledge","Moderate Intellectual Disability"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire of 142 adults with moderate intellectual disability; staff provided supplementary info; chi‑square and descriptive stats used.","sample_n":142,"sample_text":"Community sample of people with moderate intellectual disability; recruitment method not detailed in abstract.","population":"Adults with moderate intellectual disability (n=142)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 142 adults with moderate intellectual disability found that masturbation was common, sexual intercourse rare, and a notable proportion reported sexual abuse. Knowledge gaps about contraception were identified, highlighting the need for tailored sexual education.","clinical_takeaway":"Sexual education programmes should be specifically designed for people with moderate intellectual disability to address knowledge gaps and promote safe practices.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for this population","Addresses understudied topic of sexuality in intellectual disability","Includes both self‑report and staff‑reported data"],"limitations":["Questionnaires likely unvalidated","No control for potential confounds (e.g., mental health, trauma)","Cross‑sectional design limits causal inference","Statistical reporting lacks effect sizes and correction for multiple testing"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jir.13125"}},{"id":3715,"doi":null,"pmid":"39177344","pmcid":null,"title":"[Sexual therapy combined with physical methods for the treatment of primary intravaginal anejaculation]","authors":"Gao QQ, Song T, Wang B, Dai YT.","first_author":"Gao QQ","journal":"Zhonghua nan ke xue = National journal of andrology","year":2024,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":["Sexual Therapy; Vacuum Negative Pressure Hydro Pneumatic / Pneumatic Bubble Massage; Intravaginal Anejaculation; Ejaculatory Dysfunction"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Randomized controlled trial with 90 participants (30 per arm) comparing sexual therapy alone, physical massage alone, and combined therapy for primary intravaginal anejaculation.","sample_n":90,"sample_text":"N=90 (30 per arm)","population":"Women with primary intravaginal anejaculation and anxiety symptoms","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a trial of 90 women with a rare condition that prevents vaginal ejaculation, adding a special massage to standard sexual therapy improved success rates more than therapy or massage alone.","clinical_takeaway":"Combined sexual therapy and pneumatic massage may be more effective for primary intravaginal anejaculation than either alone, but evidence is limited.","confidence":0.7,"topic_tags":["sexual_function","treatment"],"strengths":["Randomized design","Three‑arm comparison allows assessment of additive effect","Clear primary outcome (effectiveness rate)"],"limitations":["Outcomes measured with unspecified, likely non‑validated scales","No effect sizes or confidence intervals reported","Small per‑group sample limits power"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":3716,"doi":"10.1007/s10461-023-04237-3","pmid":"38296920","pmcid":null,"title":"Interventions, Barriers, and Facilitators to Address the Sexual Problems of Gay, Bisexual and Other Men Who Have Sex with Men Living with HIV: A Rapid Scoping Review","authors":"Avallone F, Engler K, Cox J, Hickson F, Lebouché B.","first_author":"Avallone F","journal":"AIDS and behavior","year":2024,"pub_types":["Scoping Review","Journal Article"],"keywords":["Sexuality","Counseling","Homosexuality","Lgbt","psychotherapy","Queer"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Rapid scoping review of 52 documents describing 37 interventions for sexual problems in GBM living with HIV. No primary data collection.","sample_n":null,"sample_text":"52 documents (37 distinct interventions) identified through database searches; no primary participants.","population":"GBM (gay, bisexual, other men who have sex with men) living with HIV in high‑income countries; documents mainly from United States.","country":"United States (dominant), other high‑income countries","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A rapid scoping review of 52 papers identified 37 interventions for sexual problems in gay, bisexual and other men who have sex with men living with HIV. Most programs focused on safer‑sex counselling, while issues like intimacy, body image and masturbation were less addressed. Barriers such as cost and stigma were common.","clinical_takeaway":"Clinicians should broaden sexual‑health services for GBM with HIV beyond risk‑reduction to include intimacy, trauma and body‑image concerns.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Broad coverage of intervention types","Systematic mapping onto established sexual‑health framework","Identification of implementation barriers/facilitators"],"limitations":["Rapid scoping methods limit depth and reproducibility","No quantitative synthesis or quality appraisal of included studies","English‑language, high‑income country focus reduces generalisability"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-023-04237-3"}},{"id":3718,"doi":"10.3390/ijerph21010096","pmid":"38248559","pmcid":"PMC10815040","title":"Changes in Sexual Behavior and Satisfaction and Violent Behavior during COVID-19 Lockdown: Explorative Results from the Italian Cross-Sectional Study of the I-SHARE Multi-Country Project","authors":"Nimbi FM, Cavagnis S, Eleuteri S.","first_author":"Nimbi FM","journal":"International journal of environmental research and public health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Italy","Intimate Partner Violence","Sexual And Reproductive Health","Covid-19 Pandemic"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/21/1/96/pdf?version=1705331439","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience survey (N=329) of Italian adults; retrospective recall of sexual behavior before, during, after lockdown; generalized linear models used for comparisons.","sample_n":329,"sample_text":"Convenience online sample recruited June 2020–January 2021","population":"Italian adults (convenience online sample)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 329 Italians found that sexual satisfaction fell during the first COVID‑19 lockdown and later returned to pre‑pandemic levels, while many reported sexual problems. Masturbation and casual‑partner activity stayed the same, and intimate partner violence did not increase.","clinical_takeaway":"Lockdowns may temporarily lower sexual satisfaction; clinicians should consider pandemic‑related stress when addressing sexual concerns.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large (N>300) national convenience sample","Timely data on COVID‑19 impact","Separate assessment of masturbation vs partnered activity"],"limitations":["Convenience online recruitment limits generalisability","Reliance on retrospective self‑report; no validated scales","Key confounds (mental health, trauma, partner relationship quality) not measured"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph21010096"}},{"id":3720,"doi":"10.14989/actauroljap_65_8_341","pmid":"31501404","pmcid":null,"title":"[Urethrocutaneous Fistula Caused by a Vesical Foreign Body in an Adolescent Boy : A Case Report]","authors":"Kinjo T, Oka T, Imanaka T, Yamanaka Y, Nomura H, Yoshioka I, Takada S.","first_author":"Kinjo T","journal":"Hinyokika kiyo. Acta urologica Japonica","year":2019,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"jpn","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a 14‑year‑old boy with a vesical foreign body from self‑insertion of magnets for masturbation, describing imaging, surgery and outcome.","sample_n":1,"sample_text":"single patient","population":"adolescent male (n=1)","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 14‑year‑old boy inserted many small magnets into his urethra for masturbation. The magnets migrated to his bladder, causing a skin‑to‑urethra fistula. Endoscopic surgery removed the magnets and the fistula closed on its own within three months.","clinical_takeaway":"Self‑insertion of objects can cause serious urological injury; clinicians should enquire about such practices when faced with urinary symptoms.","confidence":0.7,"topic_tags":["masturbation","adolescents","gender","sexual_function"],"strengths":["detailed clinical imaging","clear surgical description","follow‑up outcome reported"],"limitations":["single case, no generalisability","no assessment of psychological factors","no control or comparative data"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.14989/actauroljap_65_8_341"}},{"id":3721,"doi":"10.3233/prm-240006","pmid":"38517807","pmcid":"PMC10977348","title":"Exploring the sexual experiences and challenges of individuals with cerebral palsy","authors":"Newell A, Liang N, Moskowitz J, Lee N, Pan XN, Kim H.","first_author":"Newell A","journal":"Journal of pediatric rehabilitation medicine","year":2024,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://content.iospress.com:443/download/journal-of-pediatric-rehabilitation-medicine/prm240006?id=journal-of-pediatric-rehabilitation-medicine%2Fprm240006","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"descriptive cross‑sectional online survey of 40 adults with cerebral palsy recruited from a single centre; no longitudinal or experimental component","sample_n":40,"sample_text":"40 respondents (single institution, convenience sample)","population":"Adults with cerebral palsy (GMFCS I‑IV), able to complete an online questionnaire; N=40","country":"unspecified (likely USA/Canada based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small survey of 40 adults with cerebral palsy found that less than half were partnered, about half were sexually active, and 80% had masturbated. Physical challenges like muscle spasms and pain limited intimacy, especially for those with lower functional ability. Sex education was rarely tailored to disability.","clinical_takeaway":"People with cerebral palsy often lack accessible sex education and face physical barriers to intimacy; clinicians should assess and address these specific needs.","confidence":0.3,"topic_tags":["sexual_function","csbd","moral_incongruence","masturbation"],"strengths":["Addresses a neglected topic (sexuality in CP)","Includes functional level stratification","Uses a validated QoL scale"],"limitations":["Very small, non‑representative sample (N=40)","Ad‑hoc questionnaire with limited validation","No control for moral, mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3233/prm-240006"}},{"id":3722,"doi":"10.1071/sh23164","pmid":"38281508","pmcid":null,"title":"Conceptions of sexual health by gay men living with HIV in serodifferent couples in Montreal, Canada: results from a qualitative analysis","authors":"Avallone F, Engler K, Cox J, Hickson F, Lessard D, Bourdon J, Thomas R, Lebouché B.","first_author":"Avallone F","journal":"Sexual health","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"semi-structured interviews with 10 gay men living with HIV in serodifferent couples; content analysis using Robinson's Sexual Health Model","sample_n":10,"sample_text":"Mean age 35.4 years (SD 10.2; range 20‑53) recruited from two HIV‑specialised clinics","population":"gay-identified men living with HIV in serodifferent couples, Montreal, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with ten gay men living with HIV in mixed‑status couples in Montreal showed that they view sexual health as a mix of relationship intimacy, safe‑sex management, pleasure, communication, and other personal factors. Masturbation and fantasy were mentioned by a few participants.","clinical_takeaway":"Sexual‑health services for serodifferent gay couples should address relationship dynamics, HIV risk management, and positive sexual experiences.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Uses established 10‑dimension model to structure findings","Provides in‑depth perspectives from a specific, understudied population","Qualitative content analysis appropriate for exploratory aims"],"limitations":["Very small convenience sample (N=10) limits generalisability","No measurement of potential confounds (mental health, moral context, etc.)","Findings not triangulated with quantitative data"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":2,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh23164"}},{"id":3723,"doi":"10.4103/aja202364","pmid":"38146942","pmcid":null,"title":"Validity of self-reported male sexual function scales in a young Chinese population: a comparative study with clinician-assisted evaluation","authors":"Zhang H, Colonnello E, Limoncin E, Jannini TB, Tu XC, Sansone A, Jannini EA, Zhang Y.","first_author":"Zhang H","journal":"Asian journal of andrology","year":2024,"pub_types":["Comparative Study","Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.4103/aja202364","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study comparing self‑report vs clinician‑assisted versions of sexual function questionnaires in 322 Chinese men with sexual dysfunction; analyses include ICC, Bland‑Altman, logistic regression, chi‑square.","sample_n":322,"sample_text":"322 participants (male patients with sexual dysfunction).","population":"Male patients from an infertility/sexual‑medicine clinic in Guangzhou, China (N=322).","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men’s answers on self‑filled sexual‑function questionnaires with clinician‑assisted versions and found the self‑reports to be reliable, especially for the erectile function and premature ejaculation scales.","clinical_takeaway":"Self‑administered sexual‑function questionnaires can be trusted in clinical practice, but confirm with a clinician when possible.","confidence":0.7,"topic_tags":["sexual_function","measurement"],"strengths":["Large sample for a validation study (N=322).","Uses widely‑validated instruments (IIEF‑6, PEDT, EHS, MEI).","Multiple analytic approaches (ICC, Bland‑Altman, logistic regression)."],"limitations":["Convenience sample from a clinical setting; may not generalise to broader population.","No pre‑registration or power calculation reported.","Confounding variables (e.g., mental health, relationship status) not assessed."],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/aja202364"}},{"id":3724,"doi":"10.1038/s41598-023-48790-2","pmid":"38129493","pmcid":"PMC10739833","title":"Clinical characterisation of women with persistent genital arousal disorder: the iPGAD-study","authors":"Kümpers FMLM, Sinke C, Schippert C, Kollewe K, Körner S, Raab P, Meyer B, Maschke S, Karst M, Sperling C, Dalkeranidis E, Krüger THC.","first_author":"Kümpers FMLM","journal":"Scientific reports","year":2023,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://www.nature.com/articles/s41598-023-48790-2.pdf","cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control (26 PGAD women vs 26 matched healthy controls)","sample_n":52,"sample_text":"26 women with PGAD and 26 age‑matched healthy controls","population":"women with Persistent Genital Arousal Disorder (PGAD)","country":"Germany (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared 26 women with Persistent Genital Arousal Disorder to 26 healthy women, examining medical history, mental health, and brain/pelvic MRIs. PGAD women showed higher rates of depression and anxiety but no clear brain or nerve abnormalities, suggesting the condition may involve complex mental and peripheral factors.","clinical_takeaway":"PGAD is linked to significant mental‑health burden; clinicians should assess and address depression and anxiety alongside genital symptoms.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function","gender","neuroscience"],"strengths":["matched healthy control group","comprehensive clinical and imaging assessment","focus on a rare, understudied condition"],"limitations":["small sample limits statistical power","cross‑sectional design cannot establish causality","lack of detailed control for sexual activity variables"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":16,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-023-48790-2"}},{"id":3725,"doi":"10.4103/0253-7176.150848","pmid":"25722518","pmcid":"PMC4341317","title":"Can masturbatory guilt lead to severe psychopathology: a case series","authors":"Aneja J, Grover S, Avasthi A, Mahajan S, Pokhrel P, Triveni D.","first_author":"Aneja J","journal":"Indian journal of psychological medicine","year":2015,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Psychopathology","Masturbation","Masturbatory Guilt"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4341317","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of three patients","sample_n":3,"sample_text":"Three cases described","population":"patients presenting with severe mental disorder and reported masturbatory guilt","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe three patients who felt guilty about masturbating and later developed serious mental health problems, suggesting that such guilt may be linked to severe psychopathology.","clinical_takeaway":"Clinicians should assess for masturbatory guilt when evaluating patients with serious mental disorders, but evidence for a causal link is limited.","confidence":0.8,"topic_tags":["masturbation","gender","csbd"],"strengths":["Highlights a rarely studied phenomenon","Provides detailed clinical descriptions"],"limitations":["Very small, non‑representative sample","No validated measures of guilt or psychopathology","No control for confounding factors","Causal language not supported by design"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0253-7176.150848"}},{"id":3726,"doi":"10.1210/jc.2014-1725","pmid":"25412335","pmcid":"PMC4283018","title":"Masturbation frequency and sexual function domains are associated with serum reproductive hormone levels across the menopausal transition","authors":"Randolph JF, Zheng H, Avis NE, Greendale GA, Harlow SD.","first_author":"Randolph JF","journal":"The Journal of clinical endocrinology and metabolism","year":2015,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":62,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"large multi‑ethnic cohort (SWAN), baseline N=3302, repeated hormonal and sexual function assessments over 10 visits","sample_n":3302,"sample_text":"3302 community‑based participants","population":"midlife women, ages 42‑52, community‑based, not on exogenous hormones","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large US cohort of women going through menopause, higher testosterone was linked to more frequent masturbation, desire and arousal, while higher FSH was linked to lower masturbation, arousal and orgasm. Hormone effects were modest and likely not clinically decisive.","clinical_takeaway":"Hormone levels modestly relate to sexual function in midlife women, but changes are subtle; routine hormonal testing for sexual concerns may have limited benefit.","confidence":0.8,"topic_tags":["masturbation","sexual_function","religiosity","neuroscience","treatment","moral_incongruence"],"strengths":["Large, ethnically diverse, community‑based sample","Longitudinal design with repeated hormone and sexual function measurements","Objective hormonal assays"],"limitations":["Reliance on single‑item self‑report for masturbation frequency","No control for key psychosocial confounds (mood, partner status, moral/religious attitudes)","Effect sizes and confidence intervals not reported in abstract"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":1,"mentioning":45,"citing_publications":95,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1210/jc.2014-1725"}},{"id":3727,"doi":"10.1093/sexmed/qfad061","pmid":"38053613","pmcid":"PMC10695429","title":"\"O\" no: a Reddit analysis of orgasmic dysfunction","authors":"Belcher R, Sim D, Meykler M, Owens-Walton J, Hassan N, Rubin RS, Malik RD.","first_author":"Belcher R","journal":"Sexual medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Social Media","Orgasm","Female Orgasmic Disorder","Climax","Reddit"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10695429","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative content analysis of Reddit posts (cross‑sectional, convenience sample).","sample_n":107,"sample_text":"107 Reddit threads (~6300 comments) were coded.","population":"Female Reddit users posting in r/TwoXChromosomes about orgasm; primarily women in their 20s‑30s.","country":"Not specified (global Reddit sample).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined 107 Reddit discussion threads about female orgasm problems, coding them with grounded theory. They identified five main themes—psychological factors, partner dynamics, definitions of orgasm, treatment approaches, and trauma—highlighting how women talk about these issues online.","clinical_takeaway":"Women often discuss orgasm challenges online without seeking medical help; clinicians should proactively address orgasmic concerns and consider psychosocial factors.","confidence":0.7,"topic_tags":["sexual_function","gender","relationships"],"strengths":["Large volume of naturalistic, unsolicited user content","Systematic grounded‑theory coding by two independent researchers","Identifies patient‑centered themes not captured in clinical settings"],"limitations":["Reddit users are a self‑selected, younger‑biased sample","No demographic or clinical verification of posters","No quantitative measurement of constructs or outcomes"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfad061"}},{"id":3728,"doi":"10.1080/0167482x.2019.1599857","pmid":"31140902","pmcid":null,"title":"Self-reported reasons for having difficulty reaching orgasm during partnered sex: relation to orgasmic pleasure","authors":"Hevesi K, Gergely Hevesi B, Kolba TN, Rowland DL.","first_author":"Hevesi K","journal":"Journal of psychosomatic obstetrics and gynaecology","year":2020,"pub_types":["Journal Article"],"keywords":["Women","Attributions","Orgasm","Orgasmic Difficulty","Orgasmic Pleasure"],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Community survey of 1843 women, analysis of 814 respondents with self‑report questionnaires; dimensional reduction and regression.","sample_n":814,"sample_text":"Community sample of women (N=1843 recruited, 814 analyzed)","population":"Women from general community, ages not specified, N≈814 in main analysis","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large survey of women, the most common reasons given for difficulty reaching orgasm with a partner were stress, low arousal, sex‑specific anxiety, and partner problems. Distressed women pointed more to partner issues. Partner factors, sexual inhibition and lack of experience explained the most variation in orgasm pleasure.","clinical_takeaway":"Addressing partner dynamics and sexual inhibition may help improve orgasmic pleasure for women experiencing difficulty.","confidence":0.8,"topic_tags":["sexual_function","relationships","masturbation"],"strengths":["Large community sample","Considers both partnered and masturbatory contexts","Uses multivariate analysis to relate attributions to pleasure"],"limitations":["Reliance on ad‑hoc self‑report items, unclear validation","Cross‑sectional design limits causal inference","No assessment of moral or cultural factors that might shape distress"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":40,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0167482x.2019.1599857"}},{"id":3729,"doi":"10.1093/sexmed/qfad068","pmid":"38239929","pmcid":"PMC10795926","title":"Clinical characteristics, allergic response to autologous semen, and desensitization in patients with postorgasmic illness syndrome","authors":"Xi GP, Yang RX, Zhang J, Ma YM, Zhong XY.","first_author":"Xi GP","journal":"Sexual medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Clinical Characteristics","seminal fluid","Autologous Immunoreactions","Desensitization Therapy","Postorgasmic Illness Syndrome"],"is_oa":true,"oa_url":"https://academic.oup.com/smoa/article-pdf/11/6/qfad068/56207111/qfad068.pdf","cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case series of 24 POIS patients with allergy testing; small uncontrolled desensitization pilot (n=5)","sample_n":24,"sample_text":"24 patients (plus 5 treated), plus healthy donors for allergy tests","population":"Chinese patients with post‑orgasmic illness syndrome (POIS)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study described symptoms of post‑orgasmic illness syndrome in 24 Chinese men, tested whether they were allergic to their own semen, and tried a small desensitisation treatment. Most did not have IgE‑mediated allergy and the therapy helped few patients, suggesting psychological factors may be important.","clinical_takeaway":"Allergy testing is not routinely useful for POIS; focus on psychological assessment and individualized treatment.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Largest Chinese POIS case series","Uses validated anxiety/depression scales","Combines clinical, immunologic, and hormonal assessment"],"limitations":["Very small sample, especially for desensitization (n=5)","No control group for therapy","Potential confounding by psychological factors not fully parsed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfad068"}},{"id":3731,"doi":"10.1080/02701960.2023.2280061","pmid":"37952185","pmcid":null,"title":"Sex education through the lifespan: A pilot intervention for older adults in changing attitudes and comfort with sexuality","authors":"Kriofske Mainella AM, Callender KA, Laubacher S.","first_author":"Kriofske Mainella AM","journal":"Gerontology & geriatrics education","year":2024,"pub_types":["Journal Article"],"keywords":["Sexuality","Sexual Health","Geriatrics Education"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"pre‑post pilot with N=6, no control group, descriptive statistics only","sample_n":6,"sample_text":"Six adults between the ages of 74‑83 participated","population":"older adults (74‑83 years, n=6)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A four‑week teaching program for adults aged 74‑83 was tried to see if it could make them feel more comfortable and have better attitudes about sex. Six participants completed a short questionnaire before and after; scores went up modestly.","clinical_takeaway":"Very limited evidence that brief sex‑education can improve comfort in older adults; larger, controlled studies are needed.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses sexuality in an understudied age group","Includes masturbation content which is often omitted","Pilot format allows feasibility testing"],"limitations":["Very small sample (N=6) limits any inference","No validated outcome measures","No control/comparator group","Only descriptive statistics; no effect sizes or significance testing"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/02701960.2023.2280061"}},{"id":3733,"doi":"10.1016/j.jsxm.2019.02.002","pmid":"30935470","pmcid":null,"title":"Relationship of Specific Sexual Activities to Orgasmic Latency, Pleasure, and Difficulty During Partnered Sex","authors":"Rowland DL, Kolba TN.","first_author":"Rowland DL","journal":"The journal of sexual medicine","year":2019,"pub_types":["Journal Article"],"keywords":["Women","Sexual activities","Sexual Satisfaction","Orgasm","Partnered Sex","Orgasmic Difficulty","Orgasmic Latency","Orgasmic Pleasure"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 2,068 women from community samples in the US and Hungary, using an investigator‑derived questionnaire on sexual activities, orgasmic outcomes, and relationship variables.","sample_n":2068,"sample_text":"Community‑based sample of women in the United States and Hungary.","population":"Adult women, primarily younger, self‑selected via online/community recruitment.","country":"United States; Hungary","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 2,000 women, the types of sexual activities performed with a partner were linked to how pleasurable and easy orgasms were, but not strongly to how long they took. Relationship satisfaction also played a big role in orgasm outcomes.","clinical_takeaway":"Broadening sexual activities and improving relationship satisfaction may help women experiencing orgasmic difficulty.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function","relationships"],"strengths":["Large multinational sample (n>2000)","Focus on specific sexual activities during partnered sex","Addresses both pleasure and difficulty outcomes"],"limitations":["Investigator‑derived, likely unvalidated questionnaire","Cross‑sectional design limits causal inference","Younger, self‑selected sample reduces generalisability"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":9,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.02.002"}},{"id":3735,"doi":"10.1038/s41443-019-0133-z","pmid":"30890780","pmcid":null,"title":"Hard flaccid syndrome: initial report of four cases","authors":"Gul M, Towe M, Yafi FA, Serefoglu EC.","first_author":"Gul M","journal":"International journal of impotence research","year":2020,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of four men with hard flaccid syndrome; descriptive clinical presentation; no comparison group","sample_n":4,"sample_text":"Four cases","population":"men aged 22‑34 with self‑reported hard flaccid symptoms after sexual trauma or vigorous masturbation; recruited from clinical practice","country":"United States (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe four men in their 20s‑30s who develop a painful, semi‑rigid penis (hard flaccid) after sexual trauma or rough masturbation. Symptoms include reduced erections, pain, and anxiety. Standard tests were normal and common medicines did not help.","clinical_takeaway":"Hard flaccid syndrome is reported anecdotally; clinicians should consider it but evidence for diagnosis and treatment is limited.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["First clinical description of a poorly understood condition","Systematic search of patient forums to compare symptom patterns","Detailed symptom and imaging narrative"],"limitations":["Very small, uncontrolled case series","No validated measurement instruments","Potential selection bias from clinic‑based recruitment"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":49,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-019-0133-z"}},{"id":3736,"doi":"10.5664/jcsm.7686","pmid":"30853039","pmcid":"PMC6411185","title":"Sexsomnia in an Adolescent","authors":"Contreras JB, Richardson J, Kotagal S.","first_author":"Contreras JB","journal":"Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine","year":2019,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["obstructive sleep apnea","Hypnosis","Cognitive Behavioral Therapy","Parasomnia","Sleep-disordered Breathing","Confusional Arousal","Pineoblastoma","Sexsomnia","Sleep Sex"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single adolescent patient, polysomnography, clinical observation","sample_n":1,"sample_text":"1 adolescent","population":"adolescent male with pineoblastoma and obstructive sleep apnea","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A teenage boy with a history of brain tumour and severe sleep apnea experienced sexsomnia—masturbatory episodes during sleep—captured on overnight sleep studies. Treatment with hypnosis and therapy reduced the episodes.","clinical_takeaway":"In adolescents with sleep disorders, consider sexsomnia as a possible cause of nocturnal sexual activity and treat with multimodal sleep interventions.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["objective polysomnography data","detailed clinical description"],"limitations":["single case limits generalisability","no standardized measures of sexsomnia severity","no control for confounding sleep disorders"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":1,"confounds":3,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5664/jcsm.7686"}},{"id":3737,"doi":"10.1080/00207454.2023.2273772","pmid":"37878354","pmcid":null,"title":"Epidural spinal cord stimulation can facilitate ejaculatory response in spinal cord injury individuals: a report of two cases","authors":"Rybka V, Sediva K, Spackova L, Kolar P, Bradac O, Kriz J.","first_author":"Rybka V","journal":"The International journal of neuroscience","year":2024,"pub_types":["Journal Article","Case Reports"],"keywords":["Spinal cord injury","Sexual dysfunction","Anejaculation","Epidural Spinal Cord Stimulation","Penile Vibratory Stimulation"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of two individuals with chronic complete SCI receiving epidural spinal cord stimulation; no control group","sample_n":2,"sample_text":"two cases","population":"adult men with thoracic complete spinal cord injury and anejaculation","country":"Czech Republic (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Two men with complete spinal cord injuries regained the ability to ejaculate after receiving epidural spinal cord stimulation; one even fathered a child naturally. This suggests ESCS may help restore sexual function in similar patients.","clinical_takeaway":"ESCS may enable ejaculatory function in chronic SCI, but evidence is limited to two cases.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Innovative use of ESCS for ejaculatory function","Clinical verification of outcome","Potential high impact for quality of life"],"limitations":["N=2; no control or comparison group","Case report design limits generalisability","No systematic assessment of adverse effects"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00207454.2023.2273772"}},{"id":3738,"doi":"10.1007/s10508-019-1397-6","pmid":"30847758","pmcid":null,"title":"Porn Is for Masturbation","authors":"Prause N.","first_author":"Prause N.","journal":"Archives of sexual behavior","year":2019,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":3,"contrasting":1,"mentioning":19,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-1397-6"}},{"id":3739,"doi":"10.3389/fpubh.2019.00033","pmid":"30886838","pmcid":"PMC6409294","title":"Sex and Sleep: Perceptions of Sex as a Sleep Promoting Behavior in the General Adult Population","authors":"Lastella M, O'Mullan C, Paterson JL, Reynolds AC.","first_author":"Lastella M","journal":"Frontiers in public health","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Sex","Behavior","Gender","Masturbation","Orgasm","Bedtime"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6409294","cited_by_count":32,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross‑sectional online survey of 778 adults (self‑selected, anonymous)","sample_n":778,"sample_text":"Seven‑hundred and seventy‑eight participants completed an online anonymous survey.","population":"general adult population (mean age 34.5, 57% female)","country":"unspecified (likely Australia based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 778 adults, people reported that having an orgasm—whether with a partner or by masturbating—was linked to better perceived sleep quality and faster sleep onset, with no clear differences between men and women.","clinical_takeaway":"Perceived sleep benefits are based on self‑report; clinicians should not assume sexual activity will improve sleep without further evidence.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Large sample for a survey study","Differentiates between masturbation and partnered sex","Includes gender comparisons"],"limitations":["Self‑report, single‑item measures of sleep and sexual activity","No validated scales for sleep quality or sexual behaviour","Cross‑sectional; cannot infer causality","Potential self‑selection bias from online recruitment"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":8,"contrasting":2,"mentioning":32,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2019.00033"}},{"id":3740,"doi":"10.2991/jegh.k.181210.001","pmid":"30932394","pmcid":"PMC7310766","title":"Exploring Sexual Behaviour and Associated Factors among Adolescents in Saudi Arabia: A Call to End Ignorance","authors":"Alsubaie ASR.","first_author":"Alsubaie ASR.","journal":"Journal of epidemiology and global health","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Public Health","School Health","Sexual Health","Health Promotion","Adolescent Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7310766","cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 453 male high‑school students in Riyadh, multistage sampling","sample_n":453,"sample_text":"453 male adolescents selected from high schools in Riyadh","population":"male adolescents (high‑school age) in Saudi Arabia","country":"Saudi Arabia","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 453 Saudi male high‑school students found that half masturbated daily and many had sexual contact. Age, daily masturbation, peers’ behaviour, and belief that men have sex before marriage were linked to higher odds of sexual activity. The authors call for culturally sensitive school‑based sex education.","clinical_takeaway":"Adolescent sexual behaviour is influenced by peer norms and personal attitudes; school programmes should address these factors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑country adolescent survey","Logistic regression with confidence intervals reported","Multistage sampling improves representativeness of Riyadh schools"],"limitations":["Cross‑sectional design precludes causal inference","No validated psychometric scales for sexual behaviour or attitudes","Key confounders (moral attitudes, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":20,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2991/jegh.k.181210.001"}},{"id":3741,"doi":"10.21037/tau.2019.02.06","pmid":"31143665","pmcid":"PMC6511694","title":"How long does it take a man to collect his semen specimen in a busy infertility clinic?","authors":"Lopategui DM, Antoniassi MP, Ibrahim E, Ramasamy R, Brackett NL.","first_author":"Lopategui DM","journal":"Translational andrology and urology","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Sperm","Male infertility","Masturbation","Semen Analysis","Andrology"],"is_oa":false,"oa_url":"https://doi.org/10.21037/tau.2019.02.06","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"prospective observational measurement of semen collection time in a male infertility clinic (N=136)","sample_n":136,"sample_text":"136 men, mean age 35.7 ± 7.8 y","population":"men presenting for semen analysis, cryopreservation, or post‑procedure evaluation; mean age 35.7 y","country":"unspecified (likely USA based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a busy infertility clinic, men needed about 12 minutes on average to collect a semen sample, but the time varied widely (≈3–40 min). Having a female partner in the room made collection take longer.","clinical_takeaway":"Plan appointments with ~12 min for semen collection; allow extra time if a partner will be present.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Objective timing of a real‑world clinical procedure","Reasonably large sample for the specific outcome","Identifies partner presence as a factor influencing duration"],"limitations":["No power calculation or effect‑size reporting","Limited assessment of potential confounders (e.g., anxiety, prior experience)","Single clinic limits generalisability"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":4,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21037/tau.2019.02.06"}},{"id":3743,"doi":"10.1097/01.ju.0000553058.82042.e7","pmid":"30634308","pmcid":null,"title":"Re: The Masturbation Erection Index (MEI): ","authors":"Seftel AD.","first_author":"Seftel AD.","journal":"The Journal of urology","year":2019,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.ju.0000553058.82042.e7"}},{"id":3745,"doi":"10.1007/s10508-018-1379-0","pmid":"30607712","pmcid":null,"title":"Where Does Masturbation Fit in All This? We Need to Incorporate Measures of Solo-Masturbation in Models Connecting Sexual Media Use to Sexual Quality (or Anything Else)","authors":"Perry SL.","first_author":"Perry SL.","journal":"Archives of sexual behavior","year":2019,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1379-0"}},{"id":3746,"doi":"10.1111/jsm.12501","pmid":"24674621","pmcid":null,"title":"Unusual masturbatory practice as an etiological factor in the diagnosis and treatment of sexual dysfunction in young men","authors":"Bronner G, Ben-Zion IZ.","first_author":"Bronner G","journal":"The journal of sexual medicine","year":2014,"pub_types":["Journal Article","Case Reports"],"keywords":["Sexual dysfunction","erectile dysfunction","Masturbation","Hypoactive Sexual Desire Disorder","Sexual History Taking","Retarded Ejaculation","Unusual Masturbatory Practice"],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of four young men presenting to sex therapy; descriptive clinical assessment and intervention","sample_n":4,"sample_text":"four cases","population":"young adult males seeking sex therapy (n=4)","country":"unspecified (likely USA/Israel based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors describe four young men whose atypical ways of masturbating were linked to erectile, desire, or ejaculation problems. After clinicians identified and altered these practices, the men’s sexual function improved.","clinical_takeaway":"Ask about specific masturbatory habits when evaluating male sexual dysfunction; modifying unusual techniques may help.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Detailed clinical description of unusual masturbatory behaviors","Provides a practical diagnostic/therapeutic flowchart for clinicians"],"limitations":["Very small, non‑representative case series","No validated measurement of sexual function or distress","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":7,"contrasting":1,"mentioning":27,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12501"}},{"id":3748,"doi":"10.1111/jsm.12460","pmid":"24589222","pmcid":null,"title":"Weaker masturbatory erection may be a sign of early cardiovascular risk associated with erectile dysfunction in young men without sexual intercourse","authors":"Huang YP, Chen B, Yao FJ, Chen SF, Ouyang B, Deng CH, Huang YR.","first_author":"Huang YP","journal":"The journal of sexual medicine","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Young men","erectile dysfunction","Cardiovascular Risk","Early Cardiovascular Evaluation","No Sexual Intercourse","Weaker Masturbatory Erection"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of three groups (WME‑NS, ED, non‑ED) using self‑report and physiological measures.","sample_n":300,"sample_text":"78 WME‑NS, 179 ED, 43 non‑ED participants","population":"Men 18‑40 y, community/clinical sample, N≈300 total","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In men aged 18–40 who never have sex, weaker erections during masturbation are linked to early signs of heart‑vessel problems, similar to men with diagnosed erectile dysfunction.","clinical_takeaway":"Weak masturbatory erections in young, non‑sexually active men may warrant cardiovascular risk assessment.","confidence":0.8,"topic_tags":["masturbation","sexual_function","csbd"],"strengths":["Use of validated IIEF‑5 for ED classification","Inclusion of objective physiological measures (NPTR, vascular parameters)","Comparison with both ED and non‑ED groups"],"limitations":["Self‑reported measure of 'weaker masturbatory erection' not validated","Small non‑ED control group (N=43) limits power","No adjustment for mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12460"}},{"id":3749,"doi":"10.1002/cbm.2308","pmid":"37658492","pmcid":null,"title":"Implications of sexual fantasy characteristics and memory intensity for harmful sexual behaviour","authors":"Allen A, Katsikitis M, Millear P, McKillop N.","first_author":"Allen A","journal":"Criminal behaviour and mental health : CBMH","year":2023,"pub_types":["Journal Article"],"keywords":["Sexual behaviour","Sexual Violence","Sexual Fantasies","Sexual Memory"],"is_oa":false,"oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/cbm.2308","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online survey of 322 men recruited via social media; self‑report of fantasy phenomenology, memory intensity, and history of harmful sexual behaviour; logistic regression used to examine associations.","sample_n":322,"sample_text":"general population via social media","population":"Adult men (≥18 y) from general population (online convenience sample).","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 322 men, those who reported past harmful sexual acts (e.g., rape) described their sexual fantasies as more vivid and intense, and also reported stronger sexual memories. These factors were linked to a higher likelihood of stating harmful sexual intent, though the study cannot show cause‑and‑effect.","clinical_takeaway":"Fantasy vividness and memory intensity may be risk markers for harmful sexual intent, but clinicians should interpret cautiously given the study’s cross‑sectional design.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for an online survey (N = 322)","Addresses novel link between fantasy phenomenology and harmful intent"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on unvalidated self‑report measures","No control for key confounds (moral, mental health, trauma, etc.)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/cbm.2308"}},{"id":3751,"doi":"10.1016/j.ucl.2023.06.015","pmid":"37775214","pmcid":null,"title":"Scales for Assessing Male Sexual Function are not Entirely Applicable to Gay and Bisexual Men with Prostate Cancer","authors":"Mainwaring JM, Lee TK, Wassersug RJ, Wibowo E.","first_author":"Mainwaring JM","journal":"The Urologic clinics of North America","year":2023,"pub_types":["Review","Journal Article"],"keywords":["Scale","Relationship","Sexual dysfunction","MSM","Gay","prostate cancer","Bisexual"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Narrative review of existing sexual function scales; no new data collection.","sample_n":null,"sample_text":"N/A – no primary sample","population":"Gay and bisexual men with prostate cancer (review focus)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors review common male sexual function questionnaires and find they miss important aspects of gay and bisexual men's sexual lives, such as anal sex and masturbation, especially after prostate cancer treatment.","clinical_takeaway":"Clinicians should be cautious using standard scales with gay/bisexual prostate cancer patients and consider supplementing them with MSM‑specific items.","confidence":0.85,"topic_tags":["sexual_function","measurement","gender"],"strengths":["Highlights a gap in measurement tools for MSM prostate cancer patients","Systematic description of item content across multiple scales"],"limitations":["No empirical validation of new or adapted items","Relies on existing literature; may miss unpublished tools"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ucl.2023.06.015"}},{"id":3752,"doi":"10.1093/sexmed/qfad047","pmid":"37671069","pmcid":"PMC10475856","title":"Pleasure despite pain: Associations between experiences of vulvar pleasure, vulvar pain, and sexual function in patients with chronic vulvar pain conditions","authors":"Mautz TT, Mulroy ME, Krapf JM, Goldstein AT, Pukall CF.","first_author":"Mautz TT","journal":"Sexual medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Vulvodynia","Sexual Functioning","Pain Catastrophizing","Pain-related Anxiety","Vulvar Pain","Vulvar Pleasure"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10475856","cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"prospective cross-sectional survey of 547 patients from two vulvar pain clinics","sample_n":547,"sample_text":"large clinical convenience sample; no non‑clinical comparator","population":"patients with chronic vulvar pain conditions, age ≥17, recruited from specialty gynecology clinics","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 547 women with chronic vulvar pain, more than 70% still reported pleasurable vulvar sensations, especially during masturbation. Those who experienced pleasure had lower anxiety and catastrophizing about pain and better overall sexual function.","clinical_takeaway":"Facilitating vulvar pleasure may help reduce pain‑related anxiety and improve sexual function in chronic vulvar pain patients.","confidence":0.85,"topic_tags":["sexual_function","gender","pornography","masturbation"],"strengths":["Large clinical sample (N>500)","Use of validated pain‑related and sexual function scales","Novel focus on pleasure in chronic vulvar pain"],"limitations":["Researcher‑developed pleasure measure lacks validation","Cross‑sectional design cannot infer causality","No non‑clinical comparison group"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfad047"}},{"id":3753,"doi":"10.1007/s10508-023-02659-7","pmid":"37464179","pmcid":null,"title":"Correction to: From Sin to Sexual Self-Awareness: Black Women's Reflection on Lifetime Masturbation Messages","authors":"Thorpe S, Peterson RL, Malone N, Coleman MN, Annett J, Hargons CN.","first_author":"Thorpe S","journal":"Archives of sexual behavior","year":2023,"pub_types":["Published Erratum"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02659-7"}},{"id":3754,"doi":"10.7334/psicothema2022.387","pmid":"37493146","pmcid":null,"title":"Differences in the Sexual Life of Spanish Men During the COVID-19 Lockdown by Sexual Orientation","authors":"Nebot-Garcia JE, Ballester-Arnal R, Ruiz-Palomino E, Elipe-Miravet M, Gil-Llario MD.","first_author":"Nebot-Garcia JE","journal":"Psicothema","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online ad‑hoc questionnaire, convenience sample of 471 Spanish men (320 heterosexual, 151 sexual‑minority) collected during COVID‑19 lockdown","sample_n":471,"sample_text":"Convenience online sample recruited during lockdown; not probability‑based","population":"adult men, 18‑60, Spain","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"During Spain's COVID‑19 lockdown, sexual‑minority men reported more masturbation, online sexual activity, and sex with non‑cohabitants than heterosexual men, while heterosexual men had more sex with their partners. Living with a partner helped protect sexual wellbeing, especially for heterosexual men.","clinical_takeaway":"Consider relationship status and emotional stress when supporting men’s sexual wellbeing during crises; minority men may need extra support for online and solitary sexual activities.","confidence":0.85,"topic_tags":["sexual_function","masturbation"],"strengths":["Relatively large total sample","Separate analysis by sexual orientation","Includes partner‑living status as predictor"],"limitations":["Ad‑hoc, non‑validated questionnaire","Cross‑sectional; no causal inference","No measurement of moral/religious factors"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7334/psicothema2022.387"}},{"id":3755,"doi":"10.1111/eth.12146","pmid":"24187414","pmcid":"PMC3810986","title":"Effect of mating activity and dominance rank on male masturbation among free-ranging male rhesus macaques","authors":"Dubuc C, Coyne SP, Maestripieri D.","first_author":"Dubuc C","journal":"Ethology : formerly Zeitschrift fur Tierpsychologie","year":2013,"pub_types":["research-article","Journal Article"],"keywords":["Rhesus macaques","Masturbation","Sexual Arousal","Mating Success","Dominance Rank","Male-male Competition","Auto-erotism","Sexually-transmitted Disease"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational behavioral study of 21 free‑ranging male rhesus macaques during peak mating season.","sample_n":21,"sample_text":"21 male rhesus macaques observed in naturalistic setting.","population":"Free‑ranging male Macaca mulatta (N=21)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers watched 21 free‑ranging male macaques and found that lower‑ranking males masturbated more, especially on days they did not mate, suggesting masturbation may be linked to limited mating opportunities.","clinical_takeaway":"None – the study concerns macaque behavior, not human sexual health.","confidence":0.8,"topic_tags":["masturbation","prevalence","sexual_function"],"strengths":["Direct behavioral observations","Clear definition of masturbation events","Inclusion of dominance rank as a variable"],"limitations":["Small sample size (N=21)","Cross‑sectional design limits causal inference","No control for potential ecological confounders"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":18,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/eth.12146"}},{"id":3756,"doi":"10.1080/0092623x.2023.2237957","pmid":"37477365","pmcid":null,"title":"Sexuality, Religiousness, and Mental Health among Sexual Minority Latter-day Saints in Other-Gender Relationships","authors":"Lefevor GT.","first_author":"Lefevor GT.","journal":"Journal of sex & marital therapy","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 82+155+123 participants recruited via community channels; self‑report questionnaires on relationship happiness, pornography and masturbation frequency, religious struggle, and mental‑health indicators.","sample_n":360,"sample_text":"82 sexual minority, current Latter‑day Saints in other‑gender relationships; 155 sexual minority, former Latter‑day Saints in same‑gender relationships; 123 cisgender/heterosexual, current Latter‑day Saints in other‑gender relationships.","population":"sexual minority Latter‑day Saints (current and former) and cisgender/heterosexual Latter‑day Saints; US‑based, likely convenience sample.","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A US survey of 360 Latter‑day Saints found that sexual‑minority members watch more porn and masturbate more often than cisgender/heterosexual members, report less relationship happiness, and experience more religious struggle, though they do not show higher mental‑health problems because of their relationship status.","clinical_takeaway":"Therapists should assess porn use, masturbation, and religious conflict separately when working with sexual‑minority Latter‑day Saints in opposite‑gender relationships.","confidence":0.7,"topic_tags":["pornography","masturbation","religiosity","sexual_function","relationships"],"strengths":["Large combined sample for a niche population","Direct comparison across three distinct groups","Addresses both sexual behavior frequency and relational outcomes"],"limitations":["Reliance on single‑item, self‑report measures; unclear validation","Cross‑sectional design limits causal inference","Moral incongruence not measured; potential confounding"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2023.2237957"}},{"id":3757,"doi":"10.3389/fpsyg.2023.1212456","pmid":"37539004","pmcid":"PMC10394510","title":"Purity or perversion? from taboo to fact: kindergarten teachers' reflections on age-normal sexuality","authors":"Lehn EW, Chahboun S, Page AG.","first_author":"Lehn EW","journal":"Frontiers in psychology","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Child Development","Taboo","Normality","Kindergarten Children"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10394510","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus group interviews with 18 kindergarten teachers from four kindergartens (convenience sample)","sample_n":18,"sample_text":"18 teachers (focus groups)","population":"educators working with young children (kindergarten teachers)","country":"unspecified (likely Germany/European based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In focus groups with 18 kindergarten teachers, the authors found that discussing children’s natural sexual curiosity is still seen as taboo. Teachers reported limited training and resources, leading to uncertainty about how to respond to children’s questions or behaviours such as masturbation.","clinical_takeaway":"None – the study is not about clinical treatment or sexual health interventions for individuals.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides direct insight from educators on a understudied topic","Uses qualitative focus groups to capture nuanced perspectives","Highlights gaps in teacher training and resources"],"limitations":["Small, non‑representative sample of teachers","No systematic measurement of constructs; purely descriptive","Findings may not generalise beyond the four kindergartens"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2023.1212456"}},{"id":3759,"doi":"10.1093/sleep/zsad056","pmid":"36866491","pmcid":null,"title":"Do the EEG and behavioral criteria of NREM arousal disorders apply to sexsomnia?","authors":"Rossi J, Gales A, Attali V, Leu-Semenescu S, Dodet P, Groos E, Arnulf I.","first_author":"Rossi J","journal":"Sleep","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Behavior","Amnesia","Videopolysomnography","Sexsomnia","Arousal Disorders","Nrem Parasomnia"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective comparison of three groups (sexsomnia n=24, other arousal disorders n=41, healthy controls n=40) using videopolysomnography.","sample_n":105,"sample_text":"24 sexsomnia, 41 arousal disorders, 40 controls","population":"Adults with diagnosed sexsomnia or other NREM arousal disorders and healthy sleepers; recruited from clinical sleep centers.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether EEG and behaviour criteria used for other NREM arousal disorders also fit sexsomnia. In 24 sexsomnia patients, specific sleep‑brain patterns and occasional sexual behaviours during deep sleep were found, lying between healthy sleepers and other arousal disorder patients.","clinical_takeaway":"Sexsomnia shows distinct polysomnographic markers; clinicians can consider these criteria when evaluating patients with nocturnal sexual behaviours.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Use of objective polysomnographic data","Comparison with both clinical and healthy control groups","Clear operational definitions of EEG and behavioral markers"],"limitations":["Small sample size, especially for sexsomnia group","Retrospective design limits causal inference","No correction for multiple statistical tests reported"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":5,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sleep/zsad056"}},{"id":3760,"doi":"10.1016/j.pedhc.2018.05.001","pmid":"30075984","pmcid":null,"title":"Understanding Masturbation in the Pediatric Patient","authors":"Wilkinson B, John RM.","first_author":"Wilkinson B","journal":"Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners","year":2018,"pub_types":["Journal Article","Case Reports"],"keywords":["Masturbation","Childhood Masturbation","Infantile Masturbation","Self-gratification"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pedhc.2018.05.001"}},{"id":3761,"doi":"10.1080/00224499.2023.2224310","pmid":"37345999","pmcid":null,"title":"Combinations of Sexual Activities During a Sex Episode with Recent Casual Male Partner Among Men Who Have Sex with Men: A Cross-Sectional Study","authors":"Tran J, Fairley CK, Ong JJ, Aung ET, Chow EPF.","first_author":"Tran J","journal":"Journal of sex research","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1542 MSM attending an urban sexual‑health clinic; participants reported which of nine sexual acts occurred during a recent sex episode; agreement between acts assessed with kappa statistics.","sample_n":1542,"sample_text":"1542 participants","population":"Men who have sex with men (MSM) attending a sexual‑health clinic (urban, Apr–Sep 2017)","country":"Not specified (likely Australia based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 1,542 men who have sex with men showed that many sexual activities tend to occur together during a single encounter, with some pairs (like receiving rimming and receptive anal sex) showing moderate agreement.","clinical_takeaway":"Understanding which sexual acts co‑occur can help clinicians assess STI transmission risk in MSM.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample (N>1500)","Clear operational definition of each sexual act","Reporting of agreement statistics with confidence intervals"],"limitations":["Convenience clinic sample limits generalisability","No assessment of potential confounders (e.g., substance use, mental health)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2224310"}},{"id":3766,"doi":"10.1093/sexmed/qfad030","pmid":"37408873","pmcid":"PMC10318491","title":"Self-reported reasons for having difficulty reaching orgasm in men with diverse etiologies","authors":"Rowland DL, Padilla S, Kӧvi Z, Hevesi K.","first_author":"Rowland DL","journal":"Sexual medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Men","erectile dysfunction","Attributions","Reasons","Delayed Ejaculation","Inhibited Ejaculation","Partnered Sex"],"is_oa":true,"oa_url":"https://academic.oup.com/smoa/article-pdf/11/3/qfad030/50785626/qfad030.pdf","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 351 men reporting delayed ejaculation; hierarchical ordering of self‑reported reasons; principal component analysis; comparison of men with/without erectile dysfunction.","sample_n":351,"sample_text":"351 men (subset of >3000 respondents) who reported difficulty reaching orgasm.","population":"men with self‑reported moderate‑to‑severe difficulty reaching orgasm during partnered sex; recruited via an online survey (convenience sample, Western‑based).","country":"unspecified (online, likely USA/Western countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 351 men who struggle to reach orgasm during partnered sex asked them why they think this happens. The most common reasons were anxiety, lack of stimulation, low arousal, medical issues, and partner problems. These self‑identified reasons were linked to relationship satisfaction and how often they have sex or masturbate.","clinical_takeaway":"Addressing anxiety, stimulation, and relationship factors may help men with delayed ejaculation; consider counseling alongside medical options.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample for the specific issue","Systematic collection of self‑perceived reasons","Use of principal component analysis to identify typal reasons"],"limitations":["Cross‑sectional, self‑report design limits causal inference","No validated instrument for reasons of delayed ejaculation","Potential selection bias from online convenience sampling"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfad030"}},{"id":3768,"doi":null,"pmid":"23757968","pmcid":null,"title":"[Tadalafil combined with behavior therapy for semen collection from infertile males in whom masturbation fails]","authors":"Tang WH, Jiang H, Ma LL, Hong K, Zhao LM, Liu DF, Mao JM, Yang Y, Zhang J, Gao L, Qiao J.","first_author":"Tang WH","journal":"Zhonghua nan ke xue = National journal of andrology","year":2013,"pub_types":["Controlled Clinical Trial","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Controlled clinical trial with 60 infertile men randomly assigned to Tadalafil + behavior therapy vs Tadalafil alone.","sample_n":60,"sample_text":"Sixty male infertile patients equally assigned to two groups.","population":"infertile male patients unable to ejaculate by masturbation (N=60, mean age ~37).","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 60 infertile men who could not ejaculate by masturbation, adding a behavior‑training program to a single dose of Tadalafil helped 30% produce semen, versus only 3% with Tadalafil alone.","clinical_takeaway":"Behavioral training plus Tadalafil may improve semen collection success when masturbation alone fails.","confidence":0.7,"topic_tags":["masturbation","sexual_function","treatment"],"strengths":["Randomized allocation","Clear, objective primary outcome","Comparable baseline characteristics"],"limitations":["Small sample size, limited power","No pre‑registration or effect‑size reporting","Limited control for potential confounders"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":3769,"doi":null,"pmid":"23719133","pmcid":null,"title":"[Masturbation device (EGG) as a new penile rehabilitation tool: a pilot study]","authors":"Sato Y, Tanda H, Nakajima H, Nitta T, Akagashi K, Hanzawa T, Tobe M, Haga K, Uchida K, Honma I.","first_author":"Sato Y","journal":"Hinyokika kiyo. Acta urologica Japonica","year":2013,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"jpn","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pilot within‑subject comparison of manual versus device‑assisted stimulation in 8 post‑prostatectomy patients","sample_n":8,"sample_text":"Eight nonresponders for PDE5‑I who underwent retropubic RP were enrolled.","population":"men, median age 71.5, post‑radical prostatectomy, non‑responders to PDE5‑I","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In eight older men who had prostate surgery and did not respond to pills, using an electric masturbation device improved erection hardness and self‑esteem compared with manual stimulation.","clinical_takeaway":"Device‑assisted stimulation may boost erectile response in post‑prostatectomy patients, but evidence is limited.","confidence":0.6,"topic_tags":["sexual_function","masturbation","religiosity"],"strengths":["Uses validated erectile and self‑esteem measures","Within‑subject comparison reduces between‑person variability","Novel device evaluated in clinical context"],"limitations":["Very small sample (n=8), underpowered","No control group or randomisation","Short‑term outcomes only","Limited generalisability to broader populations"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":3770,"doi":"10.1080/00224499.2012.745474","pmid":"23631671","pmcid":null,"title":"Notes from the back room: gender, power, and (In)visibility in women's experiences of masturbation","authors":"Fahs B, Frank E.","first_author":"Fahs B","journal":"Journal of sex research","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"qualitative interviews with 20 women (mean age 34) exploring meanings of masturbation; thematic analysis","sample_n":20,"sample_text":"20 women (mean age = 34, SD = 13.35) from diverse backgrounds","population":"women, diverse backgrounds, adult age range","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 20 women revealed varied meanings of masturbation, ranging from a source of pleasure to a reflection of gendered power and societal scripts.","clinical_takeaway":"Clinicians should recognize that women's masturbation experiences are diverse and socially shaped, not merely a health metric.","confidence":0.7,"topic_tags":["masturbation","gender","sexual_function"],"strengths":["In‑depth qualitative insight into women’s subjective meanings of masturbation","Highlights gendered power dynamics often omitted from quantitative work"],"limitations":["Small, non‑representative sample (N=20)","No validated measurement tools; relies on thematic coding","Findings not generalisable to broader populations"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":52,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2012.745474"}},{"id":3771,"doi":"10.1111/apa.12231","pmid":"23488732","pmcid":null,"title":"Girls who masturbate in early infancy: diagnostics, natural course and a long-term follow-up","authors":"Rödöö P, Hellberg D.","first_author":"Rödöö P","journal":"Acta paediatrica (Oslo, Norway : 1992)","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case series of 19 infant girls followed longitudinally for average 8 years; diagnosis based on history, clinical observation, video; no control group.","sample_n":19,"sample_text":"Nineteen consecutive healthy, masturbating girls diagnosed in early infancy.","population":"19 consecutive healthy infant girls (3‑15 months at onset) diagnosed with frequent masturbatory behaviour in a Swedish hospital.","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors followed 19 girls who began masturbating as infants, describing when it started, how often it occurred, and that most stopped after several years. They argue that, with careful observation and video, the behaviour can be recognised and parents reassured.","clinical_takeaway":"Infant masturbation is typically a transient, benign behaviour; clinicians should use observation and reassurance rather than extensive testing.","confidence":0.6,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Long‑term follow‑up (average 8 years)","Video documentation of behaviour","Detailed clinical description"],"limitations":["Very small, non‑representative sample (N=19)","No validated measurement instruments","No control/comparison group"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/apa.12231"}},{"id":3772,"doi":"10.22365/jpsych.2023.009","pmid":"37212801","pmcid":null,"title":"Sexual expression and the COVID-19 pandemic: The future of sexual intimacy after the COVID-19 pandemic","authors":"Mourikis I.","first_author":"Mourikis I.","journal":"Psychiatrike = Psychiatriki","year":2023,"pub_types":["Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Editorial without empirical data; arguments based on literature citations and author speculation.","sample_n":null,"sample_text":"N/A (editorial)","population":"general adult population (no specific sample)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The editorial discusses how COVID‑19 lockdowns changed sexual intimacy, noting increased anxiety, reduced partner contact, and more masturbation or virtual sexual activity, but it does not present new data.","clinical_takeaway":"Recognize that pandemic‑related stress may affect sexual desire and intimacy; assess patients' sexual wellbeing as part of mental‑health care.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad synthesis of existing literature","Highlights importance of sexual health"],"limitations":["No original data","Speculative causal claims","No measurement of key confounds"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.22365/jpsych.2023.009"}},{"id":3774,"doi":"10.1089/cap.2018.0023","pmid":"29630394","pmcid":null,"title":"Excessive Masturbation Successfully Treated with Fluoxetine in an Adolescent with Autism Spectrum Disorder and Coexisting Depression","authors":"Çelikkol Ç, Bilgiç A.","first_author":"Çelikkol Ç","journal":"Journal of child and adolescent psychopharmacology","year":2018,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cap.2018.0023"}},{"id":3775,"doi":"10.7759/cureus.38436","pmid":"37273370","pmcid":"PMC10234142","title":"An Unexpected Cause of Chest Pain While Self-Pleasuring: A Ripping Doom Excitement","authors":"Escabi-Mendoza J, Diaz-Rodriguez PE, Gonzalez-Bravo DH, Partida-Rodriguez E.","first_author":"Escabi-Mendoza J","journal":"Cureus","year":2023,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Aorta","cardiac troponin","ECG","Aortic Dissection","Acute Cardiac Care","Type A Aortic Dissection","Cardiac Chest Pain"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10234142","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient presenting with aortic dissection occurring during masturbation","sample_n":1,"sample_text":"single case","population":"One 60‑year‑old male with hypertension, Liddle's syndrome, OSA, chronic cannabis use","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 60‑year‑old man suffered a life‑threatening aortic dissection that began while he was masturbating. The report highlights the need for careful cardiac evaluation when chest pain occurs during sexual activity.","clinical_takeaway":"When chest pain occurs during or after sexual activity, consider aortic dissection and avoid premature anticoagulation without appropriate imaging.","confidence":0.6,"topic_tags":["adolescents"],"strengths":["Clear clinical description of a rare presentation","Imaging findings documented"],"limitations":["Single case, no generalisability","No systematic assessment of sexual‑behavior variables","No control or comparison group"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.38436"}},{"id":3776,"doi":"10.1007/s10508-022-02509-y","pmid":"36575265","pmcid":null,"title":"Correction to: From Sin to Sexual Self-Awareness: Black Women's Reflection on Lifetime Masturbation","authors":"Thorpe S, Peterson RL, Malone N, Coleman MN, Annett J, Hargons CN.","first_author":"Thorpe S","journal":"Archives of sexual behavior","year":2023,"pub_types":["Published Erratum"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02509-y"}},{"id":3777,"doi":"10.4103/aja202268","pmid":"36254888","pmcid":"PMC10226501","title":"Association between semen collection time and semen parameters: an observational study","authors":"Bai S, Dou XC, Qi HL, Zhu YS, Zhang YT, Liu YX, Hu XC, Cao C, Tong XH, Xu B, Wu LM, Jiang XH.","first_author":"Bai S","journal":"Asian journal of andrology","year":2023,"pub_types":["research-article","Journal Article","Observational Study"],"keywords":["Semen quality","Teratozoospermia","Asthenozoospermia","Semen Collection Time"],"is_oa":true,"oa_url":"https://doi.org/10.4103/aja202268","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"observational study of 746 men undergoing semen analysis; association between collection time and semen parameters.","sample_n":746,"sample_text":"746 participants (subfertile and healthy men)","population":"subfertile and healthy men providing semen by masturbation for clinical assessment","country":"China (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 746 men, longer time spent masturbating to collect a semen sample was linked to poorer sperm count, movement and shape, and higher odds of abnormal semen quality.","clinical_takeaway":"Longer semen collection times may signal poorer semen quality; clinicians might consider timing during fertility assessments.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample size","Objective semen parameters","Clear association analysis with adjusted odds ratios"],"limitations":["Cross‑sectional design, cannot infer causality","Potential unmeasured confounders (e.g., mental health, relationship factors)","No pre‑registration or replication"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/aja202268"}},{"id":3778,"doi":null,"pmid":"30168953","pmcid":null,"title":"[Surgical repair of the tunica albuginea for penis fracture: Selection of incision]","authors":"Mao YS, Hua B, Pan WX, Li WF, Gu YF, Yao HJ, Cai ZK, Wang Z, Lu C.","first_author":"Mao YS","journal":"Zhonghua nan ke xue = National journal of andrology","year":2018,"pub_types":["Journal Article"],"keywords":["Surgical Complication","Surgical Incision","Albuginea Rupture"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Retrospective case series of 46 surgical patients from a single hospital, describing incision types and outcomes.","sample_n":46,"sample_text":"46 cases of penile fracture treated between 1993–2017; 28 had long‑term follow‑up.","population":"Adult men (average age 33.5) with penile fracture (n=46); 28 completed long‑term follow‑up.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This case series of 46 men with penile fracture compares two surgical incision methods. A local longitudinal cut caused fewer short‑term complications than a circular degloving cut, and long‑term erectile function was good in patients followed up.","clinical_takeaway":"For most penile fractures, a local longitudinal incision appears to reduce postoperative edema without harming sexual function.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large time span of cases (24 years)","Long‑term follow‑up for half the cohort","Clear description of surgical techniques"],"limitations":["Retrospective, uncontrolled case series","Small sample, no randomisation","Outcome measures largely subjective"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":3779,"doi":"10.1093/sexmed/qfad014","pmid":"37124144","pmcid":"PMC10136197","title":"Progressive arousal: a new concept and definition for premature ejaculation","authors":"Lucas Bustos P, Parrón Carreño T, Moreno Gutiérrez S, Fernández Agis I.","first_author":"Lucas Bustos P","journal":"Sexual medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Diagnostic criteria","Premature Ejaculation","Ejaculatory Control","Ejaculatory Latency Time","Early Ejaculation","Progressive Arousal"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10136197","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"single-group observational study of men seeking help for PE; no comparison group","sample_n":481,"sample_text":"men seeking clinical help for PE","population":"men with premature ejaculation (N=481), mean age 29.3","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors studied 481 men with premature ejaculation by having them masturbate with brief pauses, measuring how long they could delay ejaculation. They found that arousal keeps rising despite the pauses, suggesting the problem lies in regulating arousal rather than the orgasm phase.","clinical_takeaway":"Consider assessing arousal‑regulation difficulties when diagnosing or treating premature ejaculation.","confidence":0.7,"topic_tags":["sexual_function","prevalence","measurement"],"strengths":["Large sample size for a single‑group study","Use of a validated PE diagnostic tool","Objective timing of masturbation exercise"],"limitations":["No control group of men without PE","Cross‑sectional design limits causal inference","Potential selection bias (treatment‑seeking men)","Confounding variables (e.g., mental health, relationship status) not assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfad014"}},{"id":3780,"doi":"10.1080/0092623x.2011.628440","pmid":"23421789","pmcid":null,"title":"Masturbation among women: associated factors and sexual response in a Portuguese community sample","authors":"Carvalheira A, Leal I.","first_author":"Carvalheira A","journal":"Journal of sex & marital therapy","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":66,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional web‑based convenience survey of 3,687 Portuguese women","sample_n":3687,"sample_text":"convenience web‑based sample","population":"women, community sample, Portugal, age range not specified","country":"Portugal","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A web survey of 3,687 Portuguese women found that most had ever masturbated and that recent masturbators reported more sexual fantasies, easier arousal and orgasm, and a range of reasons for the behavior. A small minority felt shame or guilt. The authors suggest early masturbation may help adult sexual response.","clinical_takeaway":"Masturbation is common and linked to broader sexual repertoire in women; clinicians can discuss it as a normal aspect of sexual health, noting that feelings of shame may need attention.","confidence":0.8,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["large N for survey research","covers multiple aspects of masturbation (frequency, reasons, emotions)","provides community‑level data from Portugal"],"limitations":["convenience, non‑representative sample","measures not validated; pilot‑tested items only","no control for moral, mental‑health or relational confounds","cross‑sectional; causal language overstated"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":6,"contrasting":1,"mentioning":87,"citing_publications":134,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2011.628440"}},{"id":3781,"doi":"10.1111/jsm.12052","pmid":"23347226","pmcid":null,"title":"Impaired masturbation-induced erections: a new cardiovascular risk factor for male subjects with sexual dysfunction","authors":"Rastrelli G, Boddi V, Corona G, Mannucci E, Maggi M.","first_author":"Rastrelli G","journal":"The journal of sexual medicine","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort of 862 clinic patients followed for major adverse cardiovascular events; convenience sample from sexual‑dysfunction clinic","sample_n":862,"sample_text":"862 subjects reporting autoeroticism were enrolled in longitudinal follow‑up","population":"male patients attending outpatient sexual‑dysfunction clinic (age median <55 for subgroup analyses)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In men seeking help for erectile problems, those whose erections during masturbation were weak were three‑to‑four times more likely to suffer a heart attack or stroke later, especially if they were younger or did not have diabetes.","clinical_takeaway":"Assessing erection quality during masturbation may help identify men at higher cardiovascular risk, even when other risk factors seem low.","confidence":0.78,"topic_tags":["masturbation","sexual_function","csbd"],"strengths":["Large clinical cohort with longitudinal follow‑up","Objective vascular assessments (PGE1 test, Doppler)","Hazard ratios with confidence intervals","Adjustment for key cardiovascular confounders"],"limitations":["Convenience sample from sexual‑dysfunction clinic limits generalisability","No assessment of mental‑health or psychosocial confounders","Retrospective baseline data collection","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12052"}},{"id":3782,"doi":"10.1016/j.annepidem.2023.04.005","pmid":"37060934","pmcid":null,"title":"Measuring sexual behavior among in-school youth in Rwanda: a cross-sectional analysis of self-reported timing of first sex and correlates of early sexual debut","authors":"Hémono R, Gatare E, Kayitesi L, Hunter LA, Kunesh J, Packel L, Hope R, McCoy SI.","first_author":"Hémono R","journal":"Annals of epidemiology","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["First Sex","Sexual Debut","Youth Sexual Health"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional analysis of cluster‑randomised trial data (N≈6079); logistic and Cox regression used to examine predictors of early sexual debut.","sample_n":6079,"sample_text":"6079 students ages 12‑19 years; 1723 reported sexual activity, 1320 provided age of debut.","population":"In‑school youth aged 12‑19 years in Rwanda (cluster‑randomised trial participants).","country":"Rwanda","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 6,079 Rwandan schoolchildren (12‑19 y) found that many reported having sex before age 12, especially boys. How young people define ‘sex’ (including kissing or masturbation) varied, suggesting the need for early, youth‑friendly sexual health services.","clinical_takeaway":"Interventions should target children under 12 and consider varied definitions of sexual activity when assessing risk.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large, nationally relevant sample","Use of both logistic and survival analyses","Clear reporting of effect sizes and confidence intervals"],"limitations":["Self‑report of age at debut may be subject to recall bias","Cross‑sectional design limits causal inference","Interpretations of ‘sexual intercourse’ not fully validated"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.annepidem.2023.04.005"}},{"id":3784,"doi":"10.1016/j.wsif.2023.102719","pmid":"37065932","pmcid":"PMC10085747","title":"Sexual life of Spanish women during the lockdown by COVID-19: Differences according to sexual orientation?","authors":"Ballester-Arnal R, Nebot-Garcia JE, Ruiz-Palomino E, García-Barba M, Fernández-García O, Gil-Llario MD.","first_author":"Ballester-Arnal R","journal":"Women's studies international forum","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Women","Spain","Sexual Life","Sexual Minorities","Lockdown","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10085747","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online ad‑hoc questionnaire administered to 971 Spanish women during April 2020; convenience sample, self‑selected, cross‑sectional","sample_n":971,"sample_text":"convenience online sample","population":"Spanish women aged 18‑60, 84 % heterosexual, 16 % sexual minorities","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"During the COVID‑19 lockdown, Spanish women who identified as sexual minorities reported higher sexual activity, more masturbation, and more online sexual play than heterosexual women, but overall sexual‑life quality was linked more to factors like emotional stress and privacy than to orientation.","clinical_takeaway":"Clinicians should focus on stress, privacy, and age‑related factors when supporting women’s sexual health during lockdowns, rather than assuming orientation predicts outcomes.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑country survey","Direct comparison of heterosexual vs sexual‑minority women","Reports multiple aspects of sexual behavior (frequency, masturbation, online activity)"],"limitations":["Ad‑hoc, non‑validated questionnaire","Convenience, self‑selected online sample – limited generalisability","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.wsif.2023.102719"}},{"id":3785,"doi":"10.1111/jocn.16715","pmid":"37029475","pmcid":null,"title":"'I'm still a woman': A qualitative study on sexuality in heterosexual women with Turner Syndrome","authors":"Granero-Molina J, Román RA, Del Mar Jiménez-Lasserrotte M, Ruiz-Fernández MD, Ventura-Miranda MI, Granero-Heredia G, Fernández-Medina IM.","first_author":"Granero-Molina J","journal":"Journal of clinical nursing","year":2023,"pub_types":["Journal Article"],"keywords":["Sexuality","Turner Syndrome","Women's Health","Qualitative Research"],"is_oa":false,"oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jocn.16715","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Convenience and snowball sampling of 18 heterosexual women with Turner Syndrome; semi‑structured interviews; thematic analysis.","sample_n":18,"sample_text":"Convenience and snowball sampling","population":"Women with Turner Syndrome, ages 22‑51, heterosexual, Spain","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Through interviews with 18 heterosexual women who have Turner Syndrome, the study reveals how body differences, social stigma, fear of penetration, infertility concerns, and limited professional knowledge shape their sexual experiences and often lead to reduced sexual activity and masturbation.","clinical_takeaway":"Clinicians should address body image, infertility anxieties and provide tailored sexual counseling for women with Turner Syndrome.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["In‑depth exploration of lived experiences","Use of COREQ checklist for reporting"],"limitations":["Small, non‑representative convenience sample","No standardized measures of sexual function or distress","Findings may not generalise beyond Spanish TS women"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jocn.16715"}},{"id":3786,"doi":"10.1016/j.urology.2018.01.034","pmid":"29432875","pmcid":null,"title":"New Tools to Measure Ejaculatory Latency-Arousal to Ejaculation Time Interval and Erection to Ejaculation Time Interval: A Pilot Study","authors":"Bhat GS, Shastry A.","first_author":"Bhat GS","journal":"Urology","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pilot study; self‑reported intervals during intercourse, masturbation and oral sex; N=60 healthy male volunteers; between‑group comparison (normal vs premature ejaculators)","sample_n":60,"sample_text":"60 participants, mean age 48.9 ± 10.8 years, recruited as volunteers without comorbidity","population":"adult healthy male volunteers, mean age 48.9 years","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study introduced two self‑reported timing tools—AETI and EETI—to measure how long it takes men to ejaculate after feeling aroused or after erection, reporting longer intervals for normal ejaculators than for those with premature ejaculation.","clinical_takeaway":"These simple timing tools may help clinicians assess ejaculatory latency, but they need further validation before routine use.","confidence":0.7,"topic_tags":["sexual_function","masturbation","measurement"],"strengths":["Novel attempt to quantify ejaculatory latency across sexual contexts","Includes both intercourse and masturbation conditions"],"limitations":["Self‑reported timing may be inaccurate","No validation of AETI/EETI measures","Small pilot sample; limited statistical power"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urology.2018.01.034"}},{"id":3787,"doi":"10.1080/00224499.2018.1426713","pmid":"29419318","pmcid":null,"title":"The Relationship Between Sexual Concordance and Orgasm Consistency in Women","authors":"Suschinsky KD, Chivers ML.","first_author":"Suschinsky KD","journal":"Journal of sex research","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two within‑subject studies (n=51, n=44) using laboratory audiovisual or audio‑narrative sexual stimuli; genital and self‑report arousal measured; orgasm consistency assessed via questionnaire. Convenience sample of adult women.","sample_n":95,"sample_text":"Study 1 n=51; Study 2 n=44; total participants 95 across two separate investigations.","population":"Adult women (adolescent‑young adult range); recruited non‑clinical sample; no indication of random or probability sampling.","country":"Not reported in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether women’s alignment between genital sensations and self‑reported arousal (sexual concordance) predicts how often they orgasm during penile‑vaginal sex. Results were mixed; masturbation showed the highest orgasm rates, and some links between concordance and orgasm consistency emerged only with certain stimulus types.","clinical_takeaway":"Orgasm consistency varies by activity; clinicians should consider both physiological and subjective arousal factors when addressing women’s sexual satisfaction.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of both genital and self‑report measures to assess concordance","Comparison of different stimulus modalities","Inclusion of multiple sexual activities"],"limitations":["Small, non‑representative convenience sample","Limited control of psychological or relational confounds","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1426713"}},{"id":3788,"doi":"10.1093/sexmed/qfad005","pmid":"36970584","pmcid":"PMC10037164","title":"Changes in sexual activities, function, and satisfaction during the COVID-19 pandemic era: a systematic review and meta-analysis","authors":"Qaderi K, Yazdkhasti M, Zangeneh S, Behbahani BM, Kalhor M, Shamsabadi A, Jesmani Y, Norouzi S, Kajbafvala M, Khodavirdilou R, Rahmani N, Namadian M, Ezabadi SG, Alkatout I, Mehraeen E, Rasoal D.","first_author":"Qaderi K","journal":"Sexual medicine","year":2023,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual behavior","Systematic review","General Population","Female Sexual Dysfunction","Covid-19","Sars-cov-2"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10037164","cited_by_count":28,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review and meta-analysis of 19 studies (11 in meta-analysis) examining changes in sexual activity, function, and satisfaction during COVID‑19","sample_n":12350,"sample_text":"12 350 participants across included studies; 8 838 in activity subgroup, 3 974 women and 1 427 men in function subgroup, 2 711 in satisfaction subgroup","population":"general population and sexual minorities (English‑language studies)","country":"multiple (studies from various countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 19 studies (over 12 000 people) found that during the COVID‑19 pandemic sexual activity, function and satisfaction generally declined, while masturbation and sex‑toy use increased.","clinical_takeaway":"Pandemic‑related stress may reduce sexual wellbeing; clinicians should address changes in sexual activity and provide supportive resources.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["large pooled sample across studies","systematic search with dual reviewer screening","risk‑of‑bias assessment using Newcastle‑Ottawa Scale","quantitative synthesis with effect sizes"],"limitations":["primary studies vary in measurement quality; review inherits their limitations","no assessment of moral or mental‑health confounds","possible heterogeneity across cultures not fully explored"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":32,"citing_publications":44,"retracted":false,"notices":[{"status":"Has correction","date":"2023-3-1","noticeDoi":"10.1093/sexmed/qfad027","doi":"10.1093/sexmed/qfad005"}],"url":"https://scite.ai/reports/10.1093/sexmed/qfad005"}},{"id":3789,"doi":null,"pmid":"29688187","pmcid":null,"title":"[Foreign objects in the urethra - the reasons and consequences of pathological masturbation]","authors":"Romics M, Turcsán F.","first_author":"Romics M","journal":"Psychiatria Hungarica : A Magyar Pszichiatriai Tarsasag tudomanyos folyoirata","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"hun","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3790,"doi":"10.1556/2006.2023.00004","pmid":"36897612","pmcid":"PMC10260211","title":"Treatment effects and adherence of sexually compulsive men in a randomized controlled trial of psychotherapy and medication","authors":"Scanavino MDT, Guirado AG, Marques JM, Amaral MLSD, Messina B, Reis SCD, Barros VB, Abdo CHN, Tavares H, Parsons JT.","first_author":"Scanavino MDT","journal":"Journal of behavioral addictions","year":2023,"pub_types":["research-article","Randomized Controlled Trial","Journal Article"],"keywords":["Randomized Clinical Trial","Treatment Effects","Compulsive Sexual Behavior","Psychodynamic","Group Psychotherapy"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10260211","cited_by_count":8,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized controlled trial with three arms (psychotherapy, medication, combined) assessing sexual compulsivity over 34 weeks in 135 men.","sample_n":135,"sample_text":"135 men randomized; high dropout (≈50%).","population":"Men with compulsive sexual behavior (average age 38).","country":"Brazil (inferred from authors’ affiliations).","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a trial with 135 men who felt their sexual behavior was out of control, group psychotherapy worked better than medication alone, especially for those who stuck with the treatment. Many participants dropped out or did not follow the protocol, limiting firm conclusions.","clinical_takeaway":"Psychodynamic group therapy may be more effective than medication for compulsive sexual behavior, but adherence is a major challenge.","confidence":0.8,"topic_tags":["csbd","treatment","adolescents"],"strengths":["RCT design with three treatment arms","Clear reporting of adherence and dropout rates","Effect sizes provided for key comparisons"],"limitations":["High attrition limits interpretability","No measurement of moral incongruence or mental‑health covariates","Unclear whether sexual compulsivity scale was validated"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2023.00004"}},{"id":3791,"doi":"10.1016/j.jpurol.2023.03.002","pmid":"36935328","pmcid":null,"title":"Sexual activity and function of adult men with spina bifida","authors":"Szymanski KM, Roth JD, Hensel DJ, Wiener JS, Younsi N, Stein R, Whittam B, Kaefer M, Rink RC, Cain MP, Misseri R.","first_author":"Szymanski KM","journal":"Journal of pediatric urology","year":2023,"pub_types":["Journal Article"],"keywords":["Sexuality","erectile dysfunction","Spina Bifida","Neuropathic Bladder"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online international survey of adult men with spina bifida, n=162; self‑selected participants recruited via clinics and social media; non‑parametric statistical analyses.","sample_n":162,"sample_text":"162 men, median age 35","population":"Adult men (≥18 y) with spina bifida, various ambulation levels; international sample.","country":"International (online)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 162 adult men with spina bifida, about one‑third could achieve a fully rigid erection, while erectile dysfunction was common, especially among those with limited mobility. Most reported some sexual activity, and PDE5 medicines helped many.","clinical_takeaway":"ED is frequent in men with spina bifida; assessing ambulation level and considering PDE5 inhibitors may improve sexual outcomes.","confidence":0.78,"topic_tags":["sexual_function","neuroscience","gender"],"strengths":["Large international sample for a rare condition","Use of validated erectile function instruments","Separate measurement of masturbation and partnered activity"],"limitations":["Cross‑sectional, cannot infer causality","Self‑selected online recruitment may bias results","Limited assessment of psychological or relational confounders"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpurol.2023.03.002"}},{"id":3792,"doi":"10.1177/0003065112459348","pmid":"23042957","pmcid":null,"title":"The central masturbation fantasy in heterosexual males across the life cycle: masturbation fantasies across the normality-pathology spectrum","authors":"Colarusso CA.","first_author":"Colarusso CA.","journal":"Journal of the American Psychoanalytic Association","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"The paper is a psychoanalytic theoretical discussion without empirical data, sample size, or methods.","sample_n":null,"sample_text":"No participants; clinical examples are anecdotal.","population":"heterosexual adult males (theoretical focus)","country":"United States (journal based)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article proposes that a ‘central masturbation fantasy’ develops in adolescence and evolves throughout life in heterosexual men, linking sexual and aggressive drives to a range of fantasies from normal to extreme, illustrated with clinical anecdotes.","clinical_takeaway":"None – the paper offers theoretical perspectives, not evidence for practice.","confidence":0.4,"topic_tags":["masturbation","sexual_function"],"strengths":["Integrates psychoanalytic theory across lifespan","Provides clinical illustrations"],"limitations":["No empirical data or systematic methodology","Lacks operational definitions and validated measures","No control of known confounds"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0003065112459348"}},{"id":3793,"doi":"10.1093/sexmed/qfac016","pmid":"36910706","pmcid":"PMC9978591","title":"Premature ejaculation prevalence among young men who have sex with men: a cross-sectional study with internet users in the metropolitan region of São Paulo, Brazil","authors":"de Mello Ferreira Dos Reis M, Barros EAC, Monteiro L, Pazeto CL, Baccaglini WRC, Glina S.","first_author":"de Mello Ferreira Dos Reis M","journal":"Sexual medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Cross-sectional studies","Gay","Sexual Health","Premature Ejaculation","Men Who Have Sex With Men","Diagnostic Self-evaluation","Homosexual","Sexual And Gender Minorities","E-survey","Prevalence Of Premature Ejaculation","Rapid Ejaculation"],"is_oa":true,"oa_url":"https://academic.oup.com/smoa/article-pdf/11/2/qfac016/49385082/qfac016.pdf","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 226 MSM in São Paulo, Brazil; secondary analysis of larger study","sample_n":226,"sample_text":"226 MSM participants","population":"young adult men who have sex with men (MSM) recruited via internet; n=226","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 226 Brazilian MSM, about one‑fifth were classified as having premature ejaculation, though prevalence varied by the measurement tool used. Masturbation frequency was linked to lower self‑reported PE, while obesity and faster ejaculation during anal sex were linked to higher PE on some scales.","clinical_takeaway":"PE is common among MSM; clinicians should use multiple assessment tools and consider factors like masturbation frequency when evaluating patients.","confidence":0.8,"topic_tags":["sexual_function","prevalence","masturbation"],"strengths":["Use of validated PEDT instrument","Multiple assessment methods compared","Reasonable sample size for prevalence estimate","Anonymous online survey reduces social desirability bias"],"limitations":["Cross‑sectional design cannot infer causality","Convenience internet sample may limit generalisability","No assessment of mental‑health comorbidities or trauma","Moral/incongruence factors not examined"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfac016"}},{"id":3794,"doi":"10.1186/s40695-023-00086-1","pmid":"36805710","pmcid":"PMC9942416","title":"Coping with singleness","authors":"Shahrak SP, Brand S, Taghizadeh Z.","first_author":"Shahrak SP","journal":"Women's midlife health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://womensmidlifehealthjournal.biomedcentral.com/counter/pdf/10.1186/s40695-023-00086-1","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Purposeful maximum‑variation sampling of 18 never‑married Iranian women over 35; conventional content analysis of interview data.","sample_n":18,"sample_text":"Purposeful sampling with maximum variation; 18 participants.","population":"Never‑married women, age >35, Iran (n=18)","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study interviewed 18 Iranian women over 35 who have never married to learn how they cope with singleness. Participants described strategies for sexual and emotional needs, including masturbation, and lifestyle changes such as work, health, and religious acceptance.","clinical_takeaway":"None – the qualitative findings are not directly applicable to clinical assessment or treatment of pornography‑related or compulsive sexual issues.","confidence":0.8,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["Provides in‑depth insight into a understudied population","Systematic qualitative coding"],"limitations":["Small, non‑representative sample","No standardized measures of sexual behavior or distress","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s40695-023-00086-1"}},{"id":3795,"doi":"10.1016/j.reprotox.2023.108353","pmid":"36804582","pmcid":null,"title":"Multiple flow cytometry analysis for assessing human sperm functional characteristics","authors":"de Lima Rosa J, de Paula Freitas Dell'Aqua C, de Souza FF, Missassi G, Kempinas WG.","first_author":"de Lima Rosa J","journal":"Reproductive toxicology (Elmsford, N.Y.)","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Flow cytometry","Reproductive toxicity","Human sperm","Male infertility","Multiparametric Analysis"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory validation study comparing flash‑frozen and fresh semen using multiparametric flow cytometry.","sample_n":null,"sample_text":"Human semen samples collected by masturbation; exact number not provided.","population":"Human semen donors (collected by masturbation) – sample size not reported in abstract.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study shows that flow cytometry can assess several sperm qualities—membrane integrity, acrosome status, mitochondrial health, and oxidative stress—in just two tests, improving speed and precision for male‑infertility diagnostics.","clinical_takeaway":"If validated further, this method could give clinicians a quicker, more detailed picture of sperm health.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses established fluorochrome assays","Validates simultaneous multiparametric measurement","Objective, rapid methodology"],"limitations":["Sample size not reported","No effect‑size or power analysis","Findings limited to laboratory validation"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":0,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.reprotox.2023.108353"}},{"id":3796,"doi":"10.1038/s41598-022-20140-8","pmid":"36759665","pmcid":"PMC9911792","title":"Factors influencing satisfaction with male circumcision in Taiwan","authors":"Chen CH, Cheng WM, Fan YH, Chang TP.","first_author":"Chen CH","journal":"Scientific reports","year":2023,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://www.nature.com/articles/s41598-022-20140-8.pdf","cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online questionnaire, N=376 circumcised men, 20‑40 y, cross‑sectional convenience sample","sample_n":376,"sample_text":"376 circumcised men, recruited via an online survey; convenience sample, not probability based","population":"adult men in Taiwan who have undergone circumcision","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 376 Taiwanese men who had been circumcised, two‑thirds reported being satisfied with the outcome. Satisfaction was higher among men who were older at the time of surgery, had the procedure for medical reasons like phimosis, and reported fewer long‑term problems.","clinical_takeaway":"Adult‑age, medically indicated circumcisions with few complications are linked to higher patient satisfaction.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large (N>300) sample for a single‑site survey","Use of multivariate logistic regression to identify independent predictors","Clear definition of satisfaction threshold"],"limitations":["Convenience, online recruitment limits generalisability","Satisfaction measured with a single VAS item, not a validated scale","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-022-20140-8"}},{"id":3797,"doi":"10.1007/s10508-017-1102-6","pmid":"29079939","pmcid":null,"title":"Women's Experience of Orgasm During Intercourse: Question Semantics Affect Women's Reports and Men's Estimates of Orgasm Occurrence","authors":"Shirazi T, Renfro KJ, Lloyd E, Wallen K.","first_author":"Shirazi T","journal":"Archives of sexual behavior","year":2018,"pub_types":["Journal Article"],"keywords":["Sex difference","Masturbation","Female Orgasm","Intercourse","Clitoral Stimulation"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1569 men and 1478 women, assessing self‑report of orgasm frequency under three question phrasings (assisted, unspecified, unassisted).","sample_n":3047,"sample_text":"1569 men, 1478 women (online convenience sample).","population":"adult men and women recruited online (convenience sample).","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The way researchers ask about orgasm during sex changes women's answers and men's guesses. Women report more orgasms when the question mentions clitoral stimulation, and men overestimate women's orgasm rates overall.","clinical_takeaway":"Clinicians should recognise that question wording can affect reported orgasm rates and consider specifying clitoral stimulation when assessing sexual satisfaction.","confidence":0.8,"topic_tags":["sexual_function","measurement","gender"],"strengths":["Large sample size","Systematic manipulation of question wording","Clear distinction between assisted and unassisted intercourse"],"limitations":["Reliance on single‑item self‑report measures","Convenience online sample limits generalisability","No assessment of potential confounds (e.g., relationship status, mental health)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":7,"citing_publications":38,"retracted":false,"notices":[{"status":"Has correction","date":"2017-11-10","noticeDoi":"10.1007/s10508-017-1114-2","doi":"10.1007/s10508-017-1102-6"},{"status":"Has erratum","date":"2017-11-10","noticeDoi":"10.1007/s10508-017-1114-2","doi":"10.1007/s10508-017-1102-6"}],"url":"https://scite.ai/reports/10.1007/s10508-017-1102-6"}},{"id":3798,"doi":"10.3390/healthcare11040459","pmid":"36832993","pmcid":"PMC9957165","title":"\"I'm Too Old for That\": The Role of Ageism and Sexual Dysfunctional Beliefs in Sexual Health in a Sample of Heterosexual and LGB Older Adults: A Pilot Study","authors":"Flesia L, Monaro M, Jannini EA, Limoncin E.","first_author":"Flesia L","journal":"Healthcare (Basel, Switzerland)","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Ageing","Elderly","Gay","Beliefs","Sexual Health","Ageism","Older Adults","Stereotypes","Lgb"],"is_oa":true,"oa_url":"https://www.mdpi.com/2227-9032/11/4/459/pdf?version=1675584975","cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"pilot cross-sectional survey of older adults (n≈207) comparing heterosexual and LGB participants on ageism, dysfunctional beliefs, and sexual health outcomes","sample_n":207,"sample_text":"convenience sample of older adults recruited for a pilot study","population":"heterosexual (n=104) and LGB (n=103) adults aged 55+ (mean age 66.5)","country":"unspecified (likely Italy/Europe based on authors’ affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A pilot survey of 207 adults aged 55+ compared heterosexual and LGB participants on how age‑related stereotypes and beliefs affect their sexual health. LGB respondents reported more masturbation and sexual activity, while heterosexuals held more dysfunctional beliefs about ageing sexuality. Perceived ageism was similar across groups.","clinical_takeaway":"Older adults’ sexual health varies by orientation; clinicians should consider age‑related stereotypes and belief patterns when counseling.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Addresses understudied older‑adult population","Includes both heterosexual and LGB groups","Measures both ageism and sexual health outcomes"],"limitations":["Convenience sample limits generalisability","Cross‑sectional, no causal inference","Limited control for key confounds (mental health, relationship context)","Unclear if scales are validated"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare11040459"}},{"id":3799,"doi":"10.1093/jsxmed/qdac045","pmid":"36763942","pmcid":null,"title":"A qualitative analysis of female Reddit users' experiences with low libido: how do women perceive their changes in sexual desire?","authors":"Belcher RE, Sim D, Meykler M, Owens-Walton J, Hassan N, Rubin RS, Malik RD.","first_author":"Belcher RE","journal":"The journal of sexual medicine","year":2023,"pub_types":["Journal Article"],"keywords":["Libido","Social Media","Female Sexual Dysfunction","Sex Drive","Reddit"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative grounded‑theory analysis of Reddit posts (≈85 threads, ~2900 comments) from a female‑focused subreddit; convenience sample of mostly heterosexual women in their 20s‑30s.","sample_n":85,"sample_text":"85 Reddit threads (≈2900 comments) analyzed; no formal sample size justification.","population":"Female Reddit users posting about libido/sex drive; self‑selected, not representative of general population.","country":"United States (inferred from Reddit platform, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers examined 85 Reddit threads where women discussed low sexual desire. The most common themes were relationship issues, medication side‑effects, and psychological distress. Findings underline how drugs, mental health, and partner dynamics affect libido.","clinical_takeaway":"Clinicians should consider medication side‑effects, mental‑health symptoms, and relationship factors when addressing low desire in women.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large volume of naturally occurring user‑generated data","Systematic coding by multiple independent researchers","Highlights medication and mental‑health links to low desire"],"limitations":["Non‑representative, young, Reddit‑only sample","No validated measurement instruments","Limited control for key confounds (e.g., moral incongruence, trauma)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdac045"}},{"id":3800,"doi":"10.3969/j.issn.1672-7347.2012.07.014","pmid":"22886221","pmcid":null,"title":"[Analysis of correlative factors of sterility in males undergoing routine sperm inspection by masturbation]","authors":"Zhou L, Shi X, Wang X, Liu D.","first_author":"Zhou L","journal":"Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences","year":2012,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"observational study of 220 male patients undergoing routine semen analysis","sample_n":220,"sample_text":"220 sterile males undergoing sperm examination after masturbation","population":"men diagnosed as sterile attending a medical center in China (2012)","country":"China","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a sample of 220 men being examined for infertility, about one‑third showed elevated anxiety, depression, and other negative emotions. Problems with the act of ejaculation, rather than the sexual act itself, were linked to these emotional scores.","clinical_takeaway":"Screening for anxiety, depression, and ejaculatory issues may be useful in men evaluated for infertility.","confidence":0.7,"topic_tags":["sexual_function","masturbation","moral_incongruence"],"strengths":["Use of validated mental‑health instrument (SCL‑90)","Relatively large sample for a clinical setting","Multivariate regression to explore predictors"],"limitations":["Cross‑sectional design limits causal inference","Self‑compiled infertility questionnaire lacks validation","No control for moral/religious factors or trauma history"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3969/j.issn.1672-7347.2012.07.014"}},{"id":3801,"doi":"10.1038/sc.2012.71","pmid":"22710947","pmcid":null,"title":"Semen quality in ejaculates produced by masturbation in men with spinal cord injury","authors":"Kathiresan AS, Ibrahim E, Modh R, Aballa TC, Lynne CM, Brackett NL.","first_author":"Kathiresan AS","journal":"Spinal cord","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective chart review comparing semen parameters among SCI men who masturbate, use PVS, EEJ, and healthy controls.","sample_n":548,"sample_text":"528 SCI participants screened; 444 met criteria; 43 ejaculated by masturbation; 61 non‑SCI controls.","population":"Men with spinal cord injury (SCI) and healthy non‑SCI controls; total N≈548 (43 SCI‑masturbation, 243 PVS, 158 EEJ, 61 controls).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Men with spinal cord injury who can ejaculate by masturbation produce semen with higher sperm motility than those who need medical stimulation, and similar sperm counts to healthy men.","clinical_takeaway":"Masturbation‑derived ejaculate may offer better sperm motility for fertility planning in men with SCI.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Objective laboratory semen analyses","Large overall sample with multiple comparison groups","First study to focus on masturbation‑derived ejaculate in SCI"],"limitations":["Retrospective, cross‑sectional design limits causal inference","Limited statistical reporting (no effect sizes, limited adjustment for confounders)","Small SCI‑masturbation subgroup (n=43)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/sc.2012.71"}},{"id":3802,"doi":"10.3390/ijerph20032037","pmid":"36767401","pmcid":"PMC9915044","title":"Let's Talk about Sex… and ADHD: Findings from an Anonymous Online Survey","authors":"Young S, Klassen LJ, Reitmeier SD, Matheson JD, Gudjonsson GH.","first_author":"Young S","journal":"International journal of environmental research and public health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sex","risk","Attention-deficit/hyperactivity Disorder (Adhd)","Psychosexual"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/20/3/2037/pdf?version=1675218891","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Anonymous online survey of self‑selected participants recruited through ADHD support organisations and social media; compares ADHD (n=541) with non‑ADHD (n=851) on sexual history, practices and relationship satisfaction.","sample_n":1392,"sample_text":"1392 respondents (ADHD n=541; Other n=851)","population":"Adults (self‑identified) with and without ADHD; majority male in ADHD group (30.5% male); convenience sample, not nationally representative.","country":"Not specified (likely multiple English‑speaking countries via online recruitment)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"An online survey of 1,392 adults found that people with ADHD report more diverse sexual interests, higher rates of masturbation, electronic sexual exchanges and sexually transmitted infections, and lower partner satisfaction than those without ADHD.","clinical_takeaway":"Clinicians should be aware that ADHD may be linked to riskier sexual behaviours, especially in women, and consider addressing impulsivity in sexual health counseling.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large overall sample size","Comparison between ADHD and non‑ADHD groups","Comprehensive range of sexual behavior variables"],"limitations":["Convenience, self‑selected sample limits generalisability","Reliance on non‑validated self‑report items","No control for key confounds (e.g., mental health, moral attitudes)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph20032037"}},{"id":3804,"doi":"10.1111/andr.13382","pmid":"36617843","pmcid":null,"title":"Is marijuana a foe of male sexuality? Data from a large cohort of men with sexual dysfunction","authors":"Barbonetti A, Rastrelli G, Sparano C, Castellini C, Vignozzi L, Maggi M, Corona G.","first_author":"Barbonetti A","journal":"Andrology","year":2024,"pub_types":["Journal Article"],"keywords":["Testosterone","Cannabis","Sexual dysfunction","erectile dysfunction","Cardiovascular Risk","Recreational Drugs"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational study of 4800 men attending an andrology clinic, grouped by self‑reported cannabis use.","sample_n":4800,"sample_text":"large, but clinic‑based convenience sample","population":"Men (mean age 50.8) evaluated for sexual dysfunction in an outpatient setting.","country":"Italy (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 4,800 men with sexual problems, those who used cannabis showed better penile blood flow and healthier weight and cholesterol levels, but also reported more relationship instability and more frequent masturbation.","clinical_takeaway":"Mild cannabis use was linked to better vascular markers but also to higher masturbation and relationship instability; clinicians should interpret these associations cautiously.","confidence":0.78,"topic_tags":["csbd","pornography","masturbation","sexual_function"],"strengths":["Large sample size","Objective vascular measurements (PCDU)","Adjustment for several confounders"],"limitations":["Clinic‑based, not representative of general male population","Cross‑sectional; cannot infer causality","Limited control of key psychosocial confounds (moral attitudes, mental health, trauma)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/andr.13382"}},{"id":3805,"doi":"10.1186/s42238-022-00169-2","pmid":"36658600","pmcid":"PMC9854104","title":"The influence of cannabis on sexual functioning and satisfaction","authors":"Moser A, Ballard SM, Jensen J, Averett P.","first_author":"Moser A","journal":"Journal of cannabis research","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sex","Weed","Cannabis","Marijuana","Sexual Pleasure","Sensuality"],"is_oa":true,"oa_url":"https://jcannabisresearch.biomedcentral.com/counter/pdf/10.1186/s42238-022-00169-2","cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of self‑selected adults who have used cannabis; descriptive statistics, t‑tests, ANOVA, regression; no experimental manipulation.","sample_n":811,"sample_text":"self‑selected convenience sample of adults over 18 who reported previous cannabis use","population":"811 adults (64.9% female, 78.9% White/Caucasian, 23.1% LGBTQIA+), convenience sample recruited via Qualtrics.","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 811 adult cannabis users, most people said they felt more desire and stronger orgasms when using cannabis, including during masturbation. The study relied on self‑reports and did not compare users to non‑users or control for many possible influences.","clinical_takeaway":"Current evidence is only self‑reported and correlational; clinicians should be cautious about recommending cannabis for sexual dysfunction until experimental data are available.","confidence":0.8,"topic_tags":["csbd"],"strengths":["Large sample size (N>800)","High internal reliability of the ad‑hoc scale","Inclusion of LGBTQIA+ participants"],"limitations":["Convenience, self‑selected sample limits generalizability","Cross‑sectional; cannot infer causality","Scale not validated against established sexual function measures"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":27,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s42238-022-00169-2"}},{"id":3806,"doi":"10.1016/j.urology.2023.01.002","pmid":"36646176","pmcid":null,"title":"Effects of Gender-affirming Hormone Therapy on Orgasm Function of Transgender Men and Women: A Long Term Follow Up","authors":"Zaliznyak M, Lauzon M, Stelmar J, Yuan N, Smith SM, Garcia MM.","first_author":"Zaliznyak M","journal":"Urology","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational pre‑post questionnaire of consecutive transgender patients (130 TW, 33 TM) after ≥1 yr of gender‑affirming hormone therapy.","sample_n":163,"sample_text":"130 transgender women, 33 transgender men (consecutive clinic patients)","population":"Transgender men and women receiving GAHT at a urology clinic","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a clinic survey of 163 transgender patients, those on hormone therapy reported longer, more satisfying orgasms after at least a year of treatment, with many noting new bodily sensations during orgasm.","clinical_takeaway":"Hormone therapy may enhance orgasm quality in transgender patients, but evidence is limited and individual experiences vary.","confidence":0.7,"topic_tags":["gender","sexual_function"],"strengths":["Large sample of transgender women","Specific, multi‑dimensional orgasm questionnaire","Within‑subject pre‑post design"],"limitations":["Ad‑hoc questionnaire, not validated","No control group, possible time‑related confounds","Small TM sample, limited power","No adjustment for mental‑health or relationship factors"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urology.2023.01.002"}},{"id":3807,"doi":"10.1007/s00120-022-02005-0","pmid":"36639576","pmcid":"PMC10244270","title":"[Gentle hands bring relief. Thure Brandt's massage as a contemporary document and starting aid for urology]","authors":"Mildenberger FG, Moll FH.","first_author":"Mildenberger FG","journal":"Urologie (Heidelberg, Germany)","year":2023,"pub_types":["review-article","Review","Journal Article","English Abstract"],"keywords":["Abortion","Psychosomatic Medicine","Naturopathy","Masturbation","Genital Massage","Thure Brandt"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10244270","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative historical review; no original data collected","sample_n":null,"sample_text":"Not applicable – review of archival material","population":"none (historical documents)","country":"Germany/Sweden (historical focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews the history of Thure Brandt’s genital massage, a 19th‑century practice that influenced urology and was used in Europe until after World War II.","clinical_takeaway":"None – the paper is historical and does not provide clinical guidance.","confidence":0.4,"topic_tags":["gender","masturbation","sexual_function","neuroscience"],"strengths":["Provides historical context for genital massage","Covers a largely undocumented period"],"limitations":["No empirical data; purely narrative","No systematic literature search reported","No methodological appraisal of sources"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00120-022-02005-0"}},{"id":3808,"doi":"10.1093/sexmed/qfac015","pmid":"37007854","pmcid":"PMC10065173","title":"Premature ejaculation among Chinese urban men: prevalence and correlates","authors":"Niu C, Ventus D, Jern P, Santtila P.","first_author":"Niu C","journal":"Sexual medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["erectile function","Premature Ejaculation","Sexual Experience","Frequency Of Sex"],"is_oa":true,"oa_url":"https://academic.oup.com/smoa/article-pdf/11/1/qfac015/48820747/qfac015.pdf","cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire, N=1976 Chinese men aged 18‑50, cross‑sectional analysis of prevalence and correlates of premature ejaculation","sample_n":1976,"sample_text":"1976 Chinese men aged 18 to 50 years","population":"urban Chinese men, self‑selected online respondents","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of nearly 2,000 Chinese men, 2.3% met criteria for premature ejaculation. More sexual experience and frequent partnered sex were linked to fewer problems, while more frequent masturbation was linked to more problems, after adjusting for age and education.","clinical_takeaway":"PE prevalence is low; clinicians should consider a man’s sexual history and masturbation frequency when evaluating ejaculatory concerns.","confidence":0.8,"topic_tags":["sexual_function","prevalence","masturbation"],"strengths":["Large sample size for a cross‑sectional survey","Use of validated PE and erectile function scales","Separate assessment of masturbation and partnered sex frequencies"],"limitations":["Self‑selected online sample limits generalisability","No measurement of mental‑health or moral‑incongruence confounds","Self‑reported latency times may be inaccurate"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfac015"}},{"id":3809,"doi":"10.5980/jpnjurol.103.548","pmid":"22876659","pmcid":null,"title":"[Rehabilitation for intravaginal ejaculatory dysfunction with using a masturbation aid]","authors":"Kobori Y, Aoki H, Nishio K, Sato R, Ashizawa Y, Yagi H, So S, Arai G, Okada H.","first_author":"Kobori Y","journal":"Nihon Hinyokika Gakkai zasshi. The japanese journal of urology","year":2012,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"jpn","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of 16 patients receiving a masturbation aid (TENGA) with pre‑post questionnaire outcomes; no control group; convenience clinical sample","sample_n":16,"sample_text":"16 patients treated at a single urology clinic in Japan","population":"male patients with intravaginal ejaculatory dysfunction (N=16)","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"Sixteen men with difficulty ejaculating during intercourse tried a commercial masturbator (TENGA). After training, three‑quarters could ejaculate with the device and about a third could ejaculate with a partner.","clinical_takeaway":"A masturbation aid may help some men with intravaginal ejaculatory dysfunction, but evidence is limited to a small, uncontrolled case series.","confidence":0.8,"topic_tags":["masturbation","sexual_function","treatment","religiosity"],"strengths":["Addresses a practical clinical problem","Provides concrete outcome percentages","Introduces a low‑cost intervention"],"limitations":["Very small, uncontrolled case series","No validated outcome measures","No long‑term follow‑up","Potential selection bias (clinic patients only)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5980/jpnjurol.103.548"}},{"id":3810,"doi":"10.3390/ijerph20020965","pmid":"36673720","pmcid":"PMC9859225","title":"Quality of Sexuality during Pregnancy, We Must Do Something-Survey Study","authors":"García-Duarte S, Nievas-Soriano BJ, Fischer-Suárez N, Castro-Luna G, Parrón-Carreño T, Aguilera-Manrique G.","first_author":"García-Duarte S","journal":"International journal of environmental research and public health","year":2023,"pub_types":["research-article","Journal Article","Observational Study"],"keywords":["Pregnancy","Sexuality","Sexual function","Quality of life","Females","Sexual Education","Surveys And Questionnaires"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/20/2/965/pdf?version=1673924145","cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional descriptive observational study of 117 pregnant women attending a hospital fetal welfare clinic, using a 32‑item questionnaire","sample_n":117,"sample_text":"117 women participated","population":"pregnant women (N=117) from a single reference hospital in Spain","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 117 pregnant women, about half reported lower sexual interest and fewer sexual activities (coitus, orgasm, oral sex, masturbation) during pregnancy. Most wanted more sex education, and education level did not affect these changes.","clinical_takeaway":"Pregnant women often experience reduced sexual desire and activity; clinicians should proactively offer sex education and address misconceptions.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Focused on an understudied period (pregnancy)","Relatively large sample for a single clinic","Includes partner education and beliefs as variables"],"limitations":["Cross‑sectional, cannot infer causality","Questionnaire not described as validated","Limited control of key confounds (moral, mental health, trauma)","Convenience sample from one hospital limits generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph20020965"}},{"id":3811,"doi":"10.1016/j.clinsp.2023.100185","pmid":"36965237","pmcid":"PMC10091460","title":"Sexuality and fertility desire in a large cohort of individuals with 46, XY differences in sex development","authors":"Batista RL, Inácio M, Brito VN, Sircili MHP, Bag MJ, Gomes NL, Costa EMF, Domenice S, Mendonca BB.","first_author":"Batista RL","journal":"Clinics (Sao Paulo, Brazil)","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Human Sexuality","Sexual Orientation","Sexual Life","Differences Of Sex Development","Gender Change"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.clinsp.2023.100185","cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 127 adults with 46,XY DSD from a single tertiary‑care centre.","sample_n":127,"sample_text":"127 adults (83 females; 44 males) from a single Brazilian tertiary‑care medical centre.","population":"Adults (>16 y) with 46,XY differences of sex development, both sexes, some gender‑changed.","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 127 people with a rare 46,XY intersex condition, sexual fantasies and masturbation were more common in those assigned male, but overall satisfaction and fertility wishes were similar across genders. Prenatal androgen exposure lowered the desire for motherhood in women.","clinical_takeaway":"Sexual satisfaction and desire for children are generally comparable across genders in 46,XY DSD, but clinicians should note lower motherhood desire after prenatal androgen exposure.","confidence":0.8,"topic_tags":["sexual_function","masturbation","religiosity","gender"],"strengths":["Large single‑centre cohort of a rare condition","Inclusion of both cis‑gender and gender‑changed participants","Measures both behavioural (masturbation) and affective (satisfaction) outcomes"],"limitations":["Cross‑sectional design; no causal inference","Limited use of validated sexual‑health instruments","Male subgroup (n=44) may be underpowered for gender comparisons","Potential selection bias from tertiary‑care clinic"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.clinsp.2023.100185"}},{"id":3812,"doi":"10.1093/milmed/usab126","pmid":"33822139","pmcid":null,"title":"Sexsomnia in Active Duty Military: A Series of Four Cases","authors":"Fernandez JD, Soca R.","first_author":"Fernandez JD","journal":"Military medicine","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://academic.oup.com/milmed/advance-article-pdf/doi/10.1093/milmed/usab126/36872820/usab126.pdf","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of four active‑duty service members with sexsomnia, descriptive comparison with prior literature","sample_n":4,"sample_text":"four cases","population":"active‑duty military personnel experiencing sexsomnia (N=4)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe four active‑duty service members who performed sexual acts while asleep (sexsomnia). They compare these cases to existing reports to help clinicians and legal professionals understand how the condition may appear in the military.","clinical_takeaway":"Sexsomnia can occur in service members; clinicians should consider it when evaluating unexplained nocturnal sexual behaviours and related forensic claims.","confidence":0.8,"topic_tags":["sexual_function","other"],"strengths":["Largest reported series of sexsomnia in active‑duty military","Provides detailed clinical descriptions useful for forensic contexts"],"limitations":["Very small N, no systematic methodology","No quantitative analysis or control group","Findings not generalisable beyond the four individuals"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/milmed/usab126"}},{"id":3814,"doi":"10.1080/00224499.2022.2158172","pmid":"36548099","pmcid":null,"title":"Daily Sexual Behavior, Sexual Esteem, and Body Image in Transgender and Cisgender Individuals","authors":"Kennis M, Duecker F, Elaut E, T'Sjoen G, Loeys T, Sack AT, Dewitte M.","first_author":"Kennis M","journal":"Journal of sex research","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Diary study over three weeks with daily self‑report measures; multilevel modelling of within‑person associations.","sample_n":99,"sample_text":"47 transgender and 52 cisgender participants completed daily diaries.","population":"47 transgender and 52 cis‑gender adults (mean ages ~29‑33).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A three‑week diary study compared daily sexual behavior, sexual self‑esteem and body image in transgender versus cisgender adults. Transgender participants reported lower sexual esteem and body image, but similar sexual activity. Daily intimacy and openness were linked to higher sexual esteem.","clinical_takeaway":"Clinicians should address sexual esteem and openness when supporting transgender patients’ sexual well‑being.","confidence":0.78,"topic_tags":["sexual_function","gender"],"strengths":["Daily diary design captures within‑person dynamics.","Multilevel modelling appropriate for nested data.","Inclusion of both transgender and cisgender participants."],"limitations":["Possible reliance on ad‑hoc self‑report items; limited validation info.","No measurement of key confounds (mental health, moral incongruence, trauma).","Convenience sample limits generalisability."],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2158172"}},{"id":3818,"doi":"10.1071/sh22058","pmid":"35995177","pmcid":null,"title":"Intimacy during the COVID-19 pandemic: an online survey examining the impact of COVID-19 on the sexual practices and dating app usage of people living in Hong Kong","authors":"Choi EPH, Hui BPH, Kwok JYY, Chow EPF.","first_author":"Choi EPH","journal":"Sexual health","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.publish.csiro.au/sh/pdf/SH22058","cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 249 Hong Kong residents recruited via social media; descriptive analysis of changes in sexual practices and dating‑app use during COVID‑19","sample_n":249,"sample_text":"convenience online sample recruited through social‑media platforms","population":"Hong Kong residents (adult, unspecified age range)","country":"Hong Kong","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"An online survey of 249 Hong Kong adults found that during COVID‑19 they masturbated more, had less partnered sex, and used dating apps more for texting and virtual dates but less for in‑person meetings.","clinical_takeaway":"Clinicians should note that pandemic restrictions may shift sexual activity toward solo and virtual behaviours, but the study does not assess health outcomes.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Timely data on pandemic‑related changes","Relatively large sample for a single‑city survey","Includes both partnered and virtual sexual behaviours"],"limitations":["Self‑selected, non‑representative online sample","No validated instruments or distress measures","No control for moral, mental‑health or relationship confounds"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh22058"}},{"id":3819,"doi":"10.1080/00797308.2013.11800856","pmid":"26020998","pmcid":null,"title":"Mum's the word. Are we becoming silent on masturbation?","authors":"Barrett DG.","first_author":"Barrett DG.","journal":"The Psychoanalytic study of the child","year":2012,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Clinical case examples illustrating analyst resistance to discussing masturbation with children; no systematic sampling.","sample_n":null,"sample_text":"Not specified; case report format","population":"Preschool‑through pre‑adolescent children in psychoanalytic treatment (sample size not reported)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The author argues that child analysts often avoid talking about masturbation, which may limit a child's ability to be understood. Clinical examples show how this silence can affect children’s emotional development.","clinical_takeaway":"None – the paper is theoretical and offers no direct clinical guidance.","confidence":0.4,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Provides rich clinical illustrations","Highlights a neglected therapeutic topic"],"limitations":["No systematic data or validated measures","Unable to generalise beyond reported cases","No quantitative analysis"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00797308.2013.11800856"}},{"id":3821,"doi":"10.1038/s41598-022-23974-4","pmid":"36371533","pmcid":"PMC9653494","title":"The impact of the COVID-19 pandemic-related quarantine on female sexual behavior: a cross-sectional study in China","authors":"Li G, Yu P, Zhang F, Xu Y, Zhou G, Zhan X, Gao Y, Du X, Liu H, He R.","first_author":"Li G","journal":"Scientific reports","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://www.nature.com/articles/s41598-022-23974-4.pdf","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 678 Chinese women in quarantine, using FSFI and anxiety/depression scales","sample_n":678,"sample_text":"678 complete questionnaires after screening","population":"adult women in China who were sexually active and under COVID‑19 home quarantine","country":"China","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A Chinese online survey of 678 women in COVID‑19 quarantine found that 62% met criteria for female sexual dysfunction, with higher rates among those having partnered sex than those who only masturbated. Dysfunction was linked to age, menopause, anxiety, depression and other personal factors.","clinical_takeaway":"During lockdown, many women experience sexual dysfunction; clinicians should assess mental health and relationship context when addressing sexual concerns.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Validated FSFI instrument","Large sample size for a survey","Separates masturbation from partnered sex","Measures anxiety and depression"],"limitations":["Convenience online sample, not nationally representative","No measurement of moral/religious distress","Cross‑sectional, no causal inference","Limited reporting of effect sizes and power"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-022-23974-4"}},{"id":3823,"doi":"10.1007/s10508-017-0985-6","pmid":"28484862","pmcid":null,"title":"Disinhibited Exposing Behavior, Hypersexuality, and Erectile Dysfunction as a Consequence of Posttraumatic Stress in a 42-Year-Old Male Patient","authors":"Petri-Kelvasa M, Schulte-Herbrüggen O.","first_author":"Petri-Kelvasa M","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article","Case Reports"],"keywords":["erectile dysfunction","Masturbation","Posttraumatic Stress Disorder","Exhibitionism","Dsm-5","Hypersexuality"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Single case description of a 42‑year‑old male with PTSD, exhibitionistic behavior, excessive masturbation and erectile dysfunction; no control group, no systematic data collection.","sample_n":1,"sample_text":"One patient (case report)","population":"Male, 42 y, PTSD patient (single case)","country":"unknown","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 42‑year‑old man with severe PTSD showed frequent masturbation, exhibitionistic acts and erectile problems. The authors suggest these sexual behaviours acted as coping strategies for trauma‑related distress.","clinical_takeaway":"In PTSD patients, excessive sexual behaviour may reflect coping, not necessarily a primary sexual disorder.","confidence":0.8,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["Detailed clinical description","Integrates CBT framework","Highlights possible coping function of sexual behavior"],"limitations":["Single case cannot establish causality","No validated measures of hypersexuality or erectile dysfunction","No control of moral or relational confounds"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":3,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-0985-6"}},{"id":3824,"doi":"10.1080/13691058.2022.2139414","pmid":"36336339","pmcid":null,"title":"'I did not have sex outside of our bubble': changes in sexual practices and risk reduction strategies among sexual minority men in Canada during the COVID-19 pandemic","authors":"Daroya E, Grey C, Lessard D, Klassen B, Skakoon-Sparling S, Gaspar M, Perez-Brumer A, Adam B, Lachowsky NJ, Moore D, Sang JM, Lambert G, Hart TA, Cox J, Jollimore J, Tan DHS, Grace D.","first_author":"Daroya E","journal":"Culture, health & sexuality","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual behaviour","Qualitative","Gay","Bisexual","Risk Reduction","Covid-19","And Other Men Who Have Sex With Men"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"semi‑structured interviews with 93 sexual‑minority men in three Canadian cities; cross‑sectional thematic analysis","sample_n":93,"sample_text":"n = 93 (42 interviewed Nov 2020‑Feb 2021; 51 interviewed Jun‑Oct 2021)","population":"sexual minority men (gay, bisexual, queer, other MSM) in Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 93 gay, bisexual and queer men in Canada showed that COVID‑19 restrictions changed how they met partners, used masks, and created \"sex bubbles\" or outdoor encounters, blending HIV/STI safety practices with new COVID‑prevention tactics.","clinical_takeaway":"Clinicians should recognize that pandemic‑related public‑health measures can reshape sexual risk‑reduction practices among sexual‑minority men.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rich, in‑depth qualitative data from a diverse geographic sample","Timely investigation of pandemic‑related sexual behavior changes","Clear focus on risk‑reduction strategies and community creativity"],"limitations":["Cross‑sectional, cannot infer causal effects","No standardized psychometric measures; reliance on self‑report","Limited generalizability beyond Canadian sexual‑minority men"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2022.2139414"}},{"id":3826,"doi":"10.7759/cureus.30746","pmid":"36447696","pmcid":"PMC9700232","title":"A Case Report of Postcoital Dysphoria: A Paradoxical Melancholy","authors":"Sachdeva N, Suresh V, Zeeshan M, Kamaraj B, Mehdi A.","first_author":"Sachdeva N","journal":"Cureus","year":2022,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Depression","Sexual Health","Dysphoria","Mental Health Disorders","Postcoital","Sexual Problems","Male Sexual Health","Psychiatry And Mental Health"],"is_oa":true,"oa_url":"https://assets.cureus.com/uploads/case_report/pdf/120637/20221126-29113-hrjzq7.pdf","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"1 participant (case report)","population":"single male, 24 y/o, presenting with postcoital dysphoria","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 24‑year‑old man experienced sadness, anxiety and agitation after sex, a condition called post‑coital dysphoria. This case report describes his symptoms to raise awareness of the phenomenon in men.","clinical_takeaway":"Post‑coital dysphoria can occur in men; clinicians should assess mood after sexual activity when patients report distress.","confidence":0.8,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Provides rare clinical description of male post‑coital dysphoria","Highlights need for further systematic research"],"limitations":["Single case; no systematic measurement","No validated instruments for PCD","No control of potential confounds (moral, mental health, relationship factors)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.30746"}},{"id":3827,"doi":"10.1016/j.euf.2022.09.016","pmid":"36283946","pmcid":null,"title":"Postorgasmic Illness Syndrome: An Update","authors":"Zizzo J, F Sávio L, Ramasamy R, F N Lima T.","first_author":"Zizzo J","journal":"European urology focus","year":2023,"pub_types":["Review","Journal Article"],"keywords":["Diagnostic criteria","Ejaculation","Hyposensitization","Flu-like Symptoms","Postorgasmic Illness Syndrome"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"0-2","sample_n":null,"sample_text":"Not applicable – narrative review","population":"men with post‑orgasmic illness syndrome (POIS)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Postorgasmic Illness Syndrome (POIS) is a rare disorder where men develop flu‑like symptoms after ejaculation, affecting quality of life. The review summarises existing case reports, possible causes, and short‑term treatments, noting a lack of long‑term data.","clinical_takeaway":"Clinicians should recognise POIS as a possible cause of post‑ejaculatory malaise and discuss symptom‑based management, while acknowledging limited evidence for long‑term solutions.","confidence":0.6,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Comprehensive overview of a rare condition","Identifies gaps in longitudinal data and treatment follow‑up"],"limitations":["Narrative review without systematic search or bias assessment","No new empirical data, relies on limited case reports"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.euf.2022.09.016"}},{"id":3829,"doi":"10.1016/j.esxm.2022.100578","pmid":"36274460","pmcid":"PMC9780776","title":"Sexual Development in Perinatally HIV-Infected Young People: A Systematic Review and Explorative Study","authors":"Ter Haar AM, Fieten A, Van den Hof M, Malekzadeh A, Laan ETM, Oostrom KJ, Pajkrt D.","first_author":"Ter Haar AM","journal":"Sexual medicine","year":2022,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual development","Adolescents","Perinatal Hiv","Sexual Milestones"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9780776","cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 18 studies (qualitative synthesis) plus an exploratory matched case‑control study (10 PHIV vs 16 controls).","sample_n":1963,"sample_text":"18 studies totalling ~1,963 participants; exploratory study N=26","population":"Perinatally HIV‑infected adolescents and HIV‑uninfected peers","country":"Various (not specified)","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review and small matched study found that teens born with HIV generally reach sexual milestones—like kissing, oral sex, and intercourse—at similar rates to peers without HIV, though they may start a bit later.","clinical_takeaway":"Clinicians can reassure PHIV adolescents that their sexual development is comparable to peers, while monitoring for individual timing differences.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Registered systematic review (PROSPERO)","Inclusion of non‑penetrative sexual milestones","Use of validated questionnaire for exploratory study"],"limitations":["Small exploratory sample (N=26)","Limited number of studies on non‑penetrative milestones","Predominantly cross‑sectional data, no meta‑analysis"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2022.100578"}},{"id":3830,"doi":"10.1186/s12958-022-01021-1","pmid":"36221120","pmcid":"PMC9552463","title":"Effects of virtual reality erotica on ejaculate quality of sperm donors: a balanced and randomized controlled cross-over within-subjects trial","authors":"Rosenkjær D, Pacey A, Montgomerie R, Skytte AB.","first_author":"Rosenkjær D","journal":"Reproductive biology and endocrinology : RB&E","year":2022,"pub_types":["research-article","Randomized Controlled Trial","Journal Article"],"keywords":["Male fertility","Virtual reality","Sperm Donation","Ejaculate Quality","Erotic Stimulation"],"is_oa":true,"oa_url":"https://rbej.biomedcentral.com/counter/pdf/10.1186/s12958-022-01021-1","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"balanced, randomized, controlled, cross‑over within‑subject trial; 63 sperm donors; 504 ejaculates; linear mixed and piecewise SEM analyses","sample_n":63,"sample_text":"63 donors, 504 ejaculates collected across four Danish sites","population":"male sperm donors (n=63) providing ejaculates for ART research","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a crossover trial with 63 sperm donors, viewing erotic material through a virtual‑reality headset increased the number of motile sperm when the abstinence period was short (<24 h) compared with a standard screen. The benefit disappeared with longer abstinence.","clinical_takeaway":"VR erotic stimulation may boost sperm motility after brief abstinence; could aid men needing quick semen samples for fertility treatment.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Within‑subject crossover design reduces between‑person variability","Objective semen parameters measured with standard laboratory methods","Appropriate mixed‑effects modelling for repeated measures"],"limitations":["Retrospective trial registration","No assessment of potential psychological confounds (e.g., stress, mood)","Sample limited to sperm donors, may not generalise to broader male population"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12958-022-01021-1"}},{"id":3833,"doi":"10.3389/fpsyg.2022.652030","pmid":"36275297","pmcid":"PMC9586205","title":"Descriptive Study of Gender Dysphoria and Sexual Behavior in a Disorder of Sex Development Group","authors":"Bridi Filho CA, Cardoso SB, Soll BMB, Noal MF, Schwarz K, Rosito TE, Rosito NC, Lobato MIR.","first_author":"Bridi Filho CA","journal":"Frontiers in psychology","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Sexual behavior","Dsd","Gender Dysphoria","Disorder Of Sex Development"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9586205","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"descriptive case series of 16 DSD individuals, no control group","sample_n":16,"sample_text":"16 participants (7 XY DSD, 4 XX DSD, 5 Chromosomal DSD), aged 16‑50","population":"individuals with various DSD conditions monitored at a hospital (2000‑2019)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 16 adults with disorders of sex development, sexual debut was delayed by about three years, most reported masturbation, and only one person showed gender dysphoria. Penis size was below average. The study is descriptive and cannot be generalized.","clinical_takeaway":"Clinicians should be aware that people with DSD may experience delayed sexual activity and varied sexual experiences, but conclusions are limited by the small sample.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Focus on an under‑studied population","Provides descriptive data on sexual milestones","Acknowledges limited generalizability"],"limitations":["Very small, non‑representative sample","No validated instruments for gender dysphoria or sexual behavior","No control or comparison group","No statistical power analysis or effect‑size reporting"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2022.652030"}},{"id":3834,"doi":"10.1001/archpediatrics.2011.142","pmid":"21810625","pmcid":null,"title":"Prevalence, frequency, and associations of masturbation with partnered sexual behaviors among US adolescents","authors":"Robbins CL, Schick V, Reece M, Herbenick D, Sanders SA, Dodge B, Fortenberry JD.","first_author":"Robbins CL","journal":"Archives of pediatrics & adolescent medicine","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative cross‑sectional survey of US adolescents (age 14‑17) assessing self‑reported masturbation frequency and partnered sexual behaviors.","sample_n":null,"sample_text":"Nationally representative samples of adolescents aged 14 to 17 years.","population":"Adolescents (14‑17 y) in the United States; nationally representative sample.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2011 US survey of 14‑17‑year‑olds found that most teens, especially boys, masturbate, and that masturbation is linked to a range of partnered sexual activities. The authors suggest clinicians should view masturbation as a normal part of teen sexual development.","clinical_takeaway":"Masturbation is common and developmentally normal in adolescents; clinicians should discuss it openly without pathologising the behavior.","confidence":0.85,"topic_tags":["masturbation","adolescents","sexual_function","prevalence"],"strengths":["Large, nationally representative adolescent sample","Clear separation of solo and partnered sexual behaviors","Relevant public‑health implications for clinicians"],"limitations":["Self‑report may be subject to social desirability bias","Cross‑sectional design cannot infer causality","No assessment of mental‑health or moral‑incongruence confounders"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":1,"mentioning":50,"citing_publications":114,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archpediatrics.2011.142"}},{"id":3835,"doi":"10.1080/19317611.2022.2128491","pmid":"38596391","pmcid":"PMC10903549","title":"A Thing like a Human? A Mixed-Methods Study on Sex Doll Usage","authors":"Peschka L, Raab M.","first_author":"Peschka L","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Qualitative","Mixed Methods","Sexuality Research","Sex Doll","Love Doll"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"mixed-methods (5 in‑depth interviews, 131 online survey reports, convenience sample of sex‑doll owners)","sample_n":136,"sample_text":"5 interview participants, 131 survey respondents (total 136)","population":"single heterosexual males who own sex dolls; convenience sample","country":"unspecified (likely Germany/Europe based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study interviewed five men who own sex dolls and surveyed 131 more, finding that dolls are used mainly for masturbation, as partner substitutes, or as synthetic partners. Users were mostly single heterosexual men. The authors suggest distinguishing these uses in future research.","clinical_takeaway":"Sex‑doll use is heterogeneous; clinicians should explore individual motives rather than assuming uniform effects.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Mixed‑methods design provides depth and breadth","First empirical exploration of sex‑doll user motives","Clear categorisation of usage types (masturbatory aid, partner substitute, synthetic partner)"],"limitations":["Small, non‑representative sample; predominantly single heterosexual males","Quantitative measures not described or validated","No control/comparison group; potential self‑selection bias"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2022.2128491"}},{"id":3836,"doi":"10.1007/s10508-011-9812-7","pmid":"21792689","pmcid":null,"title":"Compulsive masturbation and chronic penile lymphedema","authors":"Calabrò RS, Galì A, Marino S, Bramanti P.","first_author":"Calabrò RS","journal":"Archives of sexual behavior","year":2012,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report","sample_n":1,"sample_text":"1 participant","population":"single adult male with compulsive masturbation and penile lymphedema","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 40‑year‑old man with compulsive masturbation developed chronic swelling of the penis. The authors ruled out other medical causes and suggested the masturbation habit as the likely cause, treating it with medication.","clinical_takeaway":"No reliable evidence that compulsive masturbation causes penile edema; treat underlying medical conditions first.","confidence":0.8,"topic_tags":["masturbation","sexual_function","pornography","religiosity"],"strengths":["Detailed clinical description","Consideration of multiple medical causes"],"limitations":["Single case; no generalizable evidence","No validated measurement of compulsive masturbation","No control for confounding factors"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-011-9812-7"}},{"id":3837,"doi":"10.1080/20473869.2022.2129127","pmid":"38983493","pmcid":"PMC11229776","title":"Opinions of special education teachers on inappropriate sexual behaviors in adolescents with intellectual disabilities","authors":"Akdemir B.","first_author":"Akdemir B.","journal":"International journal of developmental disabilities","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Adolescence","Sexual Education","Teacher Competencies","Inappropriate Sexual Behaviors","Individuals With Intellectual Disabilities"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"phenomenological interview study with 12 special‑education teachers; thematic analysis of semi‑structured interviews","sample_n":12,"sample_text":"12 teachers","population":"special‑education teachers of adolescents with intellectual disabilities (convenience sample, n=12)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 12 special‑education teachers revealed that they most often encounter adolescents with intellectual disabilities engaging in masturbation, undressing, and touching in school, and they feel under‑trained to handle these behaviours.","clinical_takeaway":"Teachers report low confidence in managing adolescents' sexual behaviours; targeted training may be needed.","confidence":0.8,"topic_tags":["sexual_function","masturbation","other"],"strengths":["Provides direct insight from teachers working with the target population","Uses established phenomenological approach and thematic analysis"],"limitations":["Very small, non‑representative sample (n=12)","No validated measurement instruments; findings are descriptive","No quantitative data, limiting assessment of effect size or prevalence"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/20473869.2022.2129127"}},{"id":3839,"doi":"10.1080/0284186x.2022.2112283","pmid":"36176069","pmcid":null,"title":"Prevalence and risk factors for sexual dysfunction in young women following a cancer diagnosis - a population-based study","authors":"Wettergren L, Eriksson LE, Bergström C, Hedman C, Ahlgren J, Smedby KE, Hellman K, Henriksson R, Lampic C.","first_author":"Wettergren L","journal":"Acta oncologica (Stockholm, Sweden)","year":2022,"pub_types":["Journal Article"],"keywords":["Neoplasms","Women","Sexual dysfunction","Young Adults","Population Based"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"population-based cross-sectional survey with cancer survivors (N=694) and matched general population sample (N=493), response rate 72%","sample_n":1187,"sample_text":"694 cancer survivors, 493 population controls","population":"young women (≤40 years) diagnosed with various cancers, surveyed 1.5 years post‑diagnosis; comparison group of women from general population","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Swedish survey of women under 40 diagnosed with cancer, over 60% reported problems in at least one sexual‑function domain, especially those with breast or gynecological cancers and more intensive treatment. Emotional distress and body‑image concerns were linked to worse outcomes.","clinical_takeaway":"Clinicians should routinely screen for sexual dysfunction in young cancer survivors and address related distress and body‑image issues.","confidence":0.85,"topic_tags":["sexual_function","csbd"],"strengths":["Large, population‑based sample with high response rate","Use of validated PROMIS SexFS instrument","Comparison with demographically similar general‑population group","Adjusted logistic regression analyses"],"limitations":["Cross‑sectional design precludes causal inference","Potential unmeasured confounders (e.g., relationship quality, trauma history)","Masturbation not analysed separately from partnered sex","No pre‑registration or public data sharing reported"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":32,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0284186x.2022.2112283"}},{"id":3841,"doi":"10.1007/s13760-022-02086-w","pmid":"36153464","pmcid":null,"title":"Discussing sexual health among Flemish patients with Parkinson's disease","authors":"Van Overmeire R, Vesentini L, Vanclooster S, Bilsen J.","first_author":"Van Overmeire R","journal":"Acta neurologica Belgica","year":2023,"pub_types":["Journal Article"],"keywords":["Communication","Sexual Health","Parkinson’s Disease","Neurologist"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey of 100 Parkinson’s disease patients assessing sexual dysfunction (ASEX) and communication with healthcare providers; convenience sample.","sample_n":100,"sample_text":"100 PD patients responded to an online questionnaire.","population":"Adults with Parkinson’s disease in Flanders, Belgium (N=100)","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 100 people with Parkinson’s disease in Belgium found that about one‑quarter may have sexual dysfunction, but most never receive information about it from their neurologist. Patients want more guidance, especially men and those with more severe disease.","clinical_takeaway":"Clinicians should proactively discuss sexual health with Parkinson’s patients, as many experience problems but receive little information.","confidence":0.78,"topic_tags":["sexual_function","neuroscience"],"strengths":["Use of validated ASEX scale","Clear focus on an under‑researched clinical communication issue","Reasonable sample size for descriptive work"],"limitations":["Convenience online sample – limited generalisability","Ad‑hoc communication questionnaire lacks validation","No control for key psychosocial confounds (moral, mental health, partner effects)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13760-022-02086-w"}},{"id":3843,"doi":"10.1017/s0140525x22002047","pmid":"36111617","pmcid":null,"title":"Moral disciplining: The cognitive and evolutionary foundations of puritanical morality","authors":"Fitouchi L, André JB, Baumard N.","first_author":"Fitouchi L","journal":"The Behavioral and brain sciences","year":2022,"pub_types":["Review","Journal Article"],"keywords":["Purity","Cooperation","Morality","Temperance","Sin","Self-control","Modesty","Pleasure","Puritanism","Temptation","Sobriety"],"is_oa":false,"oa_url":"https://hal.science/hal-03899979","cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article proposing a theoretical account of puritanical morality; no primary data collection.","sample_n":null,"sample_text":"Not applicable – no empirical sample.","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that puritanical moral rules (e.g., condemning lust, alcohol, or masturbation) arise not from purity concerns but to promote self‑control needed for long‑term cooperative behavior. They review evidence from psychology and anthropology to support this view.","clinical_takeaway":"None – the article is a theoretical review, not a source of clinical guidance.","confidence":0.7,"topic_tags":["moral_incongruence","sexual_function","csbd"],"strengths":["Integrates psychological, historical, and ethnographic literature","Offers a novel cooperative‑self‑control perspective on morality","Clear theoretical argumentation"],"limitations":["No empirical data presented; claims are speculative","No measurement of key constructs (e.g., moral disgust, self‑control)","Lacks quantitative assessment of proposed mechanisms"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":64,"citing_publications":98,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0140525x22002047"}},{"id":3844,"doi":"10.1016/j.jadohealth.2022.07.012","pmid":"36088232","pmcid":null,"title":"First Adolescent Romantic and Sexual Experiences in Individuals With Differences of Sex Development/Intersex Conditions","authors":"de Brouwer IJ, Suijkerbuijk M, van de Grift TC, Kreukels BPC.","first_author":"de Brouwer IJ","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual development","Adolescence","Intersex","Milestones","Sexual Well-being","Differences Of Sex Development","Biopsychosocial Context"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 976 individuals with DSD compared to population reference values; self‑report of romantic/sexual milestones, self‑esteem, satisfaction.","sample_n":976,"sample_text":"976 participants with DSD; reference values from Dutch population sample (size not given).","population":"Individuals with differences of sex development (DSD) across six diagnostic sub‑groups; age‑matched and gender‑matched population controls used for reference.","country":"Europe (multiple countries, Dutch reference sample).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Adolescents with intersex conditions reach romantic and sexual milestones later and less often than peers, and delayed milestones are linked to lower self‑esteem and sexual satisfaction.","clinical_takeaway":"Clinicians should expect delayed sexual development in DSD youth and offer supportive, affirmative counseling.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large DSD sample across multiple diagnoses","Use of age‑ and gender‑matched population reference values","Inclusion of psychosocial outcomes (self‑esteem, satisfaction)"],"limitations":["Reliance on self‑report questionnaires without validated sexual‑milestone scales","No control for key confounds (moral views, mental health, partner context)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":9,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2022.07.012"}},{"id":3845,"doi":"10.1001/jamanetworkopen.2022.30359","pmid":"36069982","pmcid":"PMC9453542","title":"Semen Quality Following Long-term Occupational Exposure to Formaldehyde in China","authors":"Lv MQ, Wang HX, Yang YQ, Sun RF, Ge P, Zhang J, Zhao WB, Han SP, Zhou DX.","first_author":"Lv MQ","journal":"JAMA network open","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2795986/lv_2022_oi_220860_1664308750.38677.pdf","cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"population-based cohort (cross‑sectional exposure‑outcome assessment)","sample_n":205,"sample_text":"124 exposed, 81 controls (age‑matched)","population":"205 Chinese men, 23‑40 y, occupational formaldehyde exposure vs controls","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a cohort of 205 Chinese men, higher long‑term workplace exposure to formaldehyde was linked to lower sperm motility, poorer morphology, and greater DNA damage, suggesting occupational chemicals may harm semen quality.","clinical_takeaway":"Consider occupational chemical exposure as a possible factor in male infertility assessments.","confidence":0.8,"topic_tags":["sexual_function","religiosity"],"strengths":["Validated semen analysis methods","Objective exposure measurement","Dose‑response analysis with CIs"],"limitations":["Cross‑sectional assessment limits causal inference","Potential unmeasured confounders not described","Exposure index not standardised across studies"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":16,"retracted":false,"notices":[{"status":"Has erratum","date":"2022-10-4","noticeDoi":"10.1001/jamanetworkopen.2022.38925","doi":"10.1001/jamanetworkopen.2022.30359"}],"url":"https://scite.ai/reports/10.1001/jamanetworkopen.2022.30359"}},{"id":3846,"doi":"10.1037/bul0000366","pmid":"36227317","pmcid":null,"title":"Sex drive: Theoretical conceptualization and meta-analytic review of gender differences","authors":"Frankenbach J, Weber M, Loschelder DD, Kilger H, Friese M.","first_author":"Frankenbach J","journal":"Psychological bulletin","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"meta-analysis of 211 studies (856 effect sizes, 621,463 participants) examining gender differences in dispositional sex drive","sample_n":621463,"sample_text":"Large pooled sample across studies; individual study sizes vary","population":"adult men and women from diverse studies; no specific clinical or treatment‑seeking sample mentioned","country":"multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of over 600,000 adults finds that men on average report higher sex drive than women, with a medium‑to‑large effect. Adjusting for possible response bias reduces but does not eliminate the difference.","clinical_takeaway":"None – the study describes population‑level gender differences, not clinical pathology.","confidence":0.8,"topic_tags":["sexual_function","gender","moral_incongruence","masturbation"],"strengths":["Very large pooled sample size","Comprehensive systematic search and quantitative synthesis","Assessment of publication bias and bias‑adjusted effect size"],"limitations":["Primary studies used heterogeneous, often unvalidated self‑report measures","Key psychosocial confounds (e.g., mental health, moral attitudes) not examined","No pre‑registration of the meta‑analysis protocol reported"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":3,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":8,"contrasting":1,"mentioning":100,"citing_publications":82,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/bul0000366"}},{"id":3847,"doi":"10.1089/cap.2016.0130","pmid":"28009538","pmcid":null,"title":"Excessive Masturbation Association with Mixed Amphetamine Salts","authors":"Joseph AA, Reddy A.","first_author":"Joseph AA","journal":"Journal of child and adolescent psychopharmacology","year":2017,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cap.2016.0130"}},{"id":3848,"doi":"10.4103/jfmpc.jfmpc_1402_21","pmid":"36353023","pmcid":"PMC9638588","title":"A cross-sectional study to assess the pre-marital sexual practices among Panjab University students, Chandigarh, India","authors":"Sharma A, Goel NK, Prashar S, Choudhary K.","first_author":"Sharma A","journal":"Journal of family medicine and primary care","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Influence","Students","Unprotected sex","Premarital Sexual Practices"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9638588","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 211 university students recruited by purposive sampling; self‑administered pre‑tested questionnaire; descriptive statistics reported","sample_n":211,"sample_text":"211 respondents (female/male: 51.7%/48.3%)","population":"students at Panjab University, Chandigarh, India (mean age 22.5, 51.7% female)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 211 university students in India found that about two‑thirds had had premarital sex, many engaged in unprotected intercourse, and most also reported masturbating. The authors suggest better sexual‑health education to reduce risky behaviour.","clinical_takeaway":"High rates of unprotected premarital sex among students highlight the need for targeted sexual‑health education.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a single university","Pre‑tested questionnaire","Provides descriptive data on a understudied population"],"limitations":["Purposive, non‑random sampling limits generalisability","No validated psychometric scales for sexual risk behaviours","No control for potential confounders (e.g., mental health, religiosity)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/jfmpc.jfmpc_1402_21"}},{"id":3849,"doi":"10.1002/ijgo.12060","pmid":"28099687","pmcid":null,"title":"Comparison of the effect of sperm collection by condom or masturbation on the outcome of in vitro fertilization","authors":"Gal M, Fertouk M, Volodarsky-Perel A, Reichman O, Holzer HE, Eldar-Geva T.","first_author":"Gal M","journal":"International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics","year":2017,"pub_types":["Comparative Study","Journal Article"],"keywords":["Pregnancy rate","sperm injection","In Vitro Fertilization","Sperm Count","Condom","Masturbation","Intracytoplasmic","Live Birth Rate"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ijgo.12060"}},{"id":3850,"doi":"10.3389/fpsyt.2022.949077","pmid":"36061280","pmcid":"PMC9433807","title":"Exploring the adult sexual wellbeing and behavior during the COVID-19 pandemic. A systematic review and meta-analysis","authors":"Mourikis I, Kokka I, Koumantarou-Malisiova E, Kontoangelos K, Konstantakopoulos G, Papageorgiou C.","first_author":"Mourikis I","journal":"Frontiers in psychiatry","year":2022,"pub_types":["Systematic Review","systematic-review","Journal Article"],"keywords":["Sexual behavior","Sexual function","Sexual Satisfaction","Sexual Frequency","Covid-19 Restrictions","Pandemic Outcomes"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2022.949077/pdf","cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review and meta‑analysis of 38 studies (31,911 participants) examining changes in sexual frequency, function, satisfaction, masturbation and internet‑based practices during COVID‑19; PRISMA‑guided search; random‑effects meta‑analysis reported.","sample_n":31911,"sample_text":"31,911 subjects across 38 primary studies","population":"Adults (mixed gender) from studies conducted during the COVID‑19 pandemic; total N≈31,900","country":"Multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 38 studies (over 31,000 adults) found that COVID‑19 lockdowns were linked to reduced sexual frequency, lower sexual function and satisfaction, and changes in masturbation and online sexual activity, especially for women.","clinical_takeaway":"Pandemic‑related stress may impair sexual wellbeing; clinicians should address sexual health as part of overall health during crises.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Large pooled sample","PRISMA‑compliant systematic search","Quantitative meta‑analysis with effect sizes"],"limitations":["High heterogeneity (I²≈90‑97 %)","Primary studies varied in instruments and definitions","No systematic control for key confounds (e.g., mental health, moral incongruence)"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":13,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2022.949077"}},{"id":3852,"doi":"10.1007/s10508-010-9722-0","pmid":"21293916","pmcid":null,"title":"The role of masturbation in healthy sexual development: perceptions of young adults","authors":"Kaestle CE, Allen KR.","first_author":"Kaestle CE","journal":"Archives of sexual behavior","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":75,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"grounded theory study with 72 college students (56 F, 16 M) from a human‑sexuality class","sample_n":72,"sample_text":"72 college students enrolled in a human sexuality class (56 females; 16 males)","population":"young adult college students (convenience sample)","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 72 college students showed that young adults learn about masturbation mainly from media and peers, internalize mixed messages of stigma versus pleasure, and negotiate these tensions differently by gender.","clinical_takeaway":"Masturbation is viewed as a normal part of sexual development, but educators should address stigma to support healthier attitudes.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["In‑depth qualitative insight","Grounded‑theory methodology","Balanced gender representation"],"limitations":["Convenience sample of sexuality‑class students","No standardized measurement of constructs","No assessment of confounding variables (e.g., religiosity, mental health)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":108,"citing_publications":160,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9722-0"}},{"id":3853,"doi":"10.3402/snp.v6.31624","pmid":"27799078","pmcid":"PMC5087699","title":"Determinants of female sexual orgasms","authors":"Kontula O, Miettinen A.","first_author":"Kontula O","journal":"Socioaffective neuroscience & psychology","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Communication","Masturbation","Gender Differences","Self-esteem","Sexual Desire","Female Orgasm","Determinants Of Orgasm","Good Relationship","Sexual Techniques","Sexual Trends"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5087699","cited_by_count":67,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Repeated cross‑sectional national surveys (5 waves) with representative probability samples (N≈1,500‑2,600 per wave) and an additional internet panel (N≈2,000).","sample_n":11937,"sample_text":"Five nationally representative surveys (total N≈11,600) plus an internet panel (N≈2,049).","population":"Finnish women, ages 18‑79, sampled from the central population register and an online panel.","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Finnish surveys of women from 1971‑2015 show that frequent orgasms are linked more to mental and relationship factors—like how much women value orgasms, desire, self‑esteem, and open communication—than to how often they masturbate or try different partners.","clinical_takeaway":"Improving sexual communication and self‑esteem may support women's orgasmic experiences more than focusing on masturbation frequency.","confidence":0.8,"topic_tags":["sexual_function","gender","masturbation","relationships"],"strengths":["Large, nationally representative samples across decades","Multiple relevant sexual‑health variables measured","Consistent methodology enabling trend analysis"],"limitations":["Reliance on self‑report single‑item measures","No control for mental‑health or trauma variables","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":6,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":51,"citing_publications":151,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3402/snp.v6.31624"}},{"id":3854,"doi":"10.1016/j.androl.2021.05.003","pmid":"35915010","pmcid":null,"title":"Human kinematic and morphometric sperm subpopulation analysis using CASA technology: A new approach to spermatozoa classification","authors":"García-Molina A, Navarro N, Valverde A, Bompart D, Caldeira C, Vendrell A, Soler C.","first_author":"García-Molina A","journal":"Revista internacional de andrologia","year":2022,"pub_types":["Journal Article"],"keywords":["Principal component analysis","Subpopulation","Sperm Morphometry","Sperm Kinematics","Análisis De Componentes Principales","Casa-mot","Casa-morph","Cinética Espermática","Morfometría Espermática","Subpoblación"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional laboratory study of sperm kinematics and morphology using CASA in 13 volunteers","sample_n":13,"sample_text":"thirteen volunteers","population":"13 male volunteers providing semen samples via masturbation","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study used computer‑assisted sperm analysis to identify distinct subpopulations of human sperm based on movement and shape, analysing samples from 13 men who provided semen by masturbation.","clinical_takeaway":"None – the findings are methodological and not directly applicable to clinical care.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Use of validated CASA technology","Integrative multivariate analysis (PCA)","Clear methodological description"],"limitations":["Very small sample (N=13)","No external validation or replication","Limited generalisability to broader populations"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.androl.2021.05.003"}},{"id":3855,"doi":"10.4081/aiua.2016.3.239","pmid":"27711106","pmcid":null,"title":"A rubber tube in the bladder as a complication of autoerotic stimulation of the urethra","authors":"Stamatiou K, Moschouris H.","first_author":"Stamatiou K","journal":"Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica","year":2016,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":"https://www.pagepressjournals.org/index.php/aiua/article/download/aiua.2016.3.239/5972","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single adult male who self‑inserted a rubber tube for erotic stimulation and later presented with bladder migration.","sample_n":1,"sample_text":"1 patient","population":"Adult male, not a treatment‑seeking or forum sample; single case.","country":"Greece","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A man inserted a rubber tube into his urethra for sexual stimulation; the tube later moved into his bladder, requiring medical removal. The report describes how such rare autoerotic practices can lead to serious urologic complications.","clinical_takeaway":"Clinicians should consider self‑inserted foreign bodies in patients presenting with urinary symptoms after autoerotic activity.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Provides rare clinical detail of a specific autoerotic practice","Includes imaging description of foreign body migration"],"limitations":["Single case – no generalisability","No systematic assessment of psychological or moral factors","No quantitative data or statistical analysis"],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4081/aiua.2016.3.239"}},{"id":3856,"doi":"10.1002/pd.4923","pmid":"27601352","pmcid":null,"title":"In utero gratification behaviour in male fetus","authors":"Rodríguez Fernández V, López Ramón Y Cajal C.","first_author":"Rodríguez Fernández V","journal":"Prenatal diagnosis","year":2016,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single‑case ultrasound description of fetal hand‑genital contact","sample_n":1,"sample_text":"N=1 male fetus observed with prenatal 3‑D ultrasonography","population":"one male fetus (third trimester)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors report a single ultrasound image of a male fetus appearing to touch its genitals, suggesting that self‑pleasure movements can start before birth.","clinical_takeaway":"None – the finding is observational and has no direct clinical implication.","confidence":0.7,"topic_tags":["masturbation","prevalence","neuroscience"],"strengths":["Novel observation of fetal behaviour","Clear imaging illustration"],"limitations":["Single case, no generalisability","No systematic measurement or comparison","No assessment of psychological constructs"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/pd.4923"}},{"id":3858,"doi":"10.4103/0256-4947.72271","pmid":"21060161","pmcid":"PMC2994165","title":"Infantile and early childhood masturbation: Sex hormones and clinical profile","authors":"Ajlouni HK, Daoud AS, Ajlouni SF, Ajlouni KM.","first_author":"Ajlouni HK","journal":"Annals of Saudi medicine","year":2010,"pub_types":["brief-report","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC2994165","cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control study of 13 masturbating infants/young children vs 13 controls, recruited from pediatric neurology clinics; hormonal assays and limited EEG/imaging performed","sample_n":26,"sample_text":"13 cases, 13 controls","population":"infants and preschool children (approx. 4‑36 months) referred for masturbation concerns","country":"Saudi Arabia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared hormone levels in 13 infants who frequently masturbated with 13 similar children without the behaviour. Estradiol was lower in the masturbating group, while other hormones were similar. EEG and brain scans were mostly normal.","clinical_takeaway":"No clear clinical implications; the hormonal link is tentative and needs larger studies.","confidence":0.7,"topic_tags":["masturbation","sexual_function","pornography","moral_incongruence","neuroscience"],"strengths":["Direct hormonal measurements in a rare pediatric population","Use of a control group","Detailed clinical observation of masturbation episodes"],"limitations":["Very small sample size, limited statistical power","Clinic‑based, not representative of general child population","No effect‑size reporting or correction for multiple tests","Limited neuroimaging data and no control imaging"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":5,"contrasting":1,"mentioning":54,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0256-4947.72271"}},{"id":3859,"doi":"10.5152/anatoljcardiol.2022.1180","pmid":"35791710","pmcid":"PMC9361339","title":"The Relationship Between Sexual Activity and Heart Rate Variability in Menopausal Women","authors":"Tolunay H, Yıldırım E, Gökoğlan Y, Buğan B, Saatçi Yaşar A, Çelik M, Yüksel UÇ, Kabul HK, Barçın C.","first_author":"Tolunay H","journal":"Anatolian journal of cardiology","year":2022,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9361339","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational study of 130 menopausal women grouped by self‑reported weekly penile‑vaginal intercourse; HRV measured via 24‑h Holter; regression adjusting for age, BMI, menopause duration.","sample_n":130,"sample_text":"130 participants (divided into sexually active vs inactive; active further split into 1 × week vs ≥2 × week).","population":"Menopausal women, 45‑60 y, without chronic disease; recruited from a clinical setting (presumed convenience sample).","country":"Turkey (based on author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 130 healthy menopausal women, more frequent penile‑vaginal intercourse was linked to higher heart‑rate variability, a sign of better autonomic (parasympathetic) heart health.","clinical_takeaway":"Regular sexual activity may support cardiac autonomic function in menopausal women, but causality is not established.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Objective physiological outcome (HRV).","Reasonable sample size for HRV analysis.","Adjustment for key demographic covariates."],"limitations":["Cross‑sectional design; cannot infer causality.","Self‑reported sexual activity may be biased.","No measurement of potential psychological confounds (e.g., mood, relationship quality)."],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5152/anatoljcardiol.2022.1180"}},{"id":3862,"doi":"10.1007/s10508-016-0815-2","pmid":"27495935","pmcid":null,"title":"Social Modulation or Hormonal Causation? Linkages of Testosterone with Sexual Activity and Relationship Quality in a Nationally Representative Longitudinal Sample of Older Adults","authors":"Das A, Sawin N.","first_author":"Das A","journal":"Archives of sexual behavior","year":2016,"pub_types":["Journal Article"],"keywords":["Testosterone","Sexual activity","Relationship Quality","Older Adults","Challenge Hypothesis"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"cross‑lagged panel using two waves of a nationally representative probability sample of older US adults (N≈1,270)","sample_n":1270,"sample_text":"650 women, 620 men (baseline)","population":"US adults aged 57‑85 (community‑dwelling, probability sample)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a nationally representative sample of older adults, the study tracked testosterone levels, masturbation, partnered sex, and relationship quality over five years. Men’s testosterone rose after masturbatory activity but fell after poorer relationship quality; women’s testosterone dropped after more partnered sex and higher relationship quality. The findings suggest sexual activity and relationship dynamics shape hormone levels more than hormones drive sexual behaviour in later life.","clinical_takeaway":"In older adults, sexual activity and relationship quality appear to influence testosterone rather than the reverse; clinicians should consider relational context when discussing hormonal health.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["large, probability‑based national sample","longitudinal design with two waves","objective hormonal assay"],"limitations":["relies on self‑report for sexual behaviour","mental‑health and trauma not accounted for","no pre‑registration, effect‑size reporting limited"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":6,"design":8,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0815-2"}},{"id":3863,"doi":null,"pmid":"29019228","pmcid":null,"title":"[Psycho-social factors of sexual failure among newly married Uyghur young males]","authors":"Erkin A, Hamrajan M, Kadirjan M, Adil E, Elijan A, Ibrahim U, Abdulla T, Hasanjan A, Turgun H, Eli A, Eset M.","first_author":"Erkin A","journal":"Zhonghua nan ke xue = National journal of andrology","year":2016,"pub_types":["Journal Article"],"keywords":["Young Male","Psycho-social Factors","Uyghur Population","Sexual Failure Of The Newly Married"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"paired case‑control (186 cases, 186 controls) logistic regression of psychosocial variables on self‑reported sexual failure","sample_n":372,"sample_text":"186 cases with sexual failure and 186 matched controls without","population":"newly married Uyghur males, 17‑34 yr, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a case‑control study of 372 newly married Uyghur men, factors such as personality, income, masturbation history, premarital sex, sense of duty, social status, mutual care, partner's psychological issues, and religion were linked to reports of sexual failure (e.g., erectile problems).","clinical_takeaway":"Multiple psychosocial factors, not just physiological ones, relate to erectile problems; comprehensive sexual education and couple counseling may help.","confidence":0.8,"topic_tags":["sexual_function","masturbation","pornography","relationships","csbd"],"strengths":["Relatively large matched case‑control sample","Use of multivariate logistic regression with confidence intervals","Inclusion of a range of psychosocial variables"],"limitations":["Outcome and predictors based on non‑validated self‑report items","No measurement of moral/religious conflict or mental‑health covariates","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":3864,"doi":"10.1016/j.euros.2022.05.008","pmid":"35911083","pmcid":"PMC9334823","title":"Distended Seminal Vesicles Are Involved in Specific Cerebral Sexual Arousal: A Pilot Study Using Functional Brain Imaging in Young Healthy Men","authors":"Weisstanner C, Pastore-Wapp M, Schmitt M, Zehnder P, Wiest R, Thalmann GN, Birkhäuser FD.","first_author":"Weisstanner C","journal":"European urology open science","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Seminal vesicles","Brain activity","Functional magnetic resonance imaging","Sexual activity","Arousal","Libido"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9334823","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"prospective within‑subject case‑control (paired fMRI) with 6 healthy men; each scanned twice after emptied vs. filled seminal vesicles","sample_n":6,"sample_text":"Six male individuals, recruited prospectively, scanned on two consecutive days","population":"young healthy men (N=6)","country":"Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In six healthy men, brain scans showed slightly stronger activity in arousal‑related regions when they viewed sexual pictures while their seminal vesicles were full compared with after they emptied them by masturbation.","clinical_takeaway":"No direct clinical implication; findings are preliminary and need replication in larger samples.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","religiosity"],"strengths":["Within‑subject design controls individual variability","Novel physiological question about seminal vesicle filling","Use of validated DISF questionnaire"],"limitations":["Extremely small sample (N=6) limits reliability","No correction for multiple voxelwise comparisons reported","Potential over‑interpretation of BOLD differences as causal"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":3,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.euros.2022.05.008"}},{"id":3865,"doi":"10.1080/00224499.2022.2081312","pmid":"35699390","pmcid":null,"title":"The Relationship Between Topic-Specific Quality of Parent-Child Sexual Communication and Measures of Sexual Self-Concept and Sexual Subjectivity","authors":"Astle SM, Anders KM.","first_author":"Astle SM","journal":"Journal of sex research","year":2023,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 278 U.S. undergraduate students; path analysis of self‑report measures","sample_n":278,"sample_text":"278 participants, recruited from a university","population":"U.S. undergraduate college students (convenience sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among U.S. college students, higher perceived quality of parental talks about sexual pleasure and masturbation was linked to greater confidence in sexual situations, better body esteem, and more assertiveness, while talks about values like monogamy were linked to mixed outcomes. Talking about risks (STDs, condoms) showed no clear benefit.","clinical_takeaway":"Positive, open parent‑child communication about pleasure may support youths' sexual confidence and well‑being.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample for sexual‑communication research","Uses multiple validated sexual well‑being scales","Path analysis allows testing of indirect relations"],"limitations":["Cross‑sectional design limits causal inference","Convenience undergraduate sample limits generalisability","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2081312"}},{"id":3866,"doi":"10.1016/j.mjafi.2022.04.002","pmid":"39734838","pmcid":"PMC11670534","title":"Impact of the timing of surgery on the recovery of sexual functions after fracture penis","authors":"Agrawal A, Raj R.","first_author":"Agrawal A","journal":"Medical journal, Armed Forces India","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["erectile dysfunction","Penile Fracture","Eggplant Deformity","Sub-coronal Degloving Incision"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective case series of 17 patients","sample_n":17,"sample_text":"17 patients","population":"patients with penile fracture treated surgically","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 17 men with penile fracture, those who had surgery within 48 hours and those who waited longer both reported normal erectile function after six months, suggesting early repair does not worsen outcomes.","clinical_takeaway":"Prompt surgical repair is advisable for penile fracture; delayed surgery did not show added erectile dysfunction in this small series.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of validated IIEF questionnaire","Clear definition of early vs. late surgery","6‑month follow‑up"],"limitations":["Very small sample (n=17)","No control group of non‑operated patients","Potential selection bias (single centre)","No power calculation"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.mjafi.2022.04.002"}},{"id":3869,"doi":"10.1186/s12889-022-13509-x","pmid":"35658847","pmcid":"PMC9163902","title":"Sexual satisfaction and sexual behaviors during the COVID-19 pandemic: results from the International Sexual Health And REproductive (I-SHARE) health survey in Luxembourg","authors":"Fischer VJ, Bravo RG, Brunnet AE, Michielsen K, Tucker JD, Campbell L, Vögele C.","first_author":"Fischer VJ","journal":"BMC public health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Luxembourg","Sexual Satisfaction","Sexual Behaviors","Covid-19","I-Share"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9163902","cited_by_count":4,"is_preprint":false,"topics":["masturbation","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online volunteer survey during COVID-19 restrictions, retrospective comparison to pre‑restriction period","sample_n":557,"sample_text":"557 volunteers completed the survey","population":"Adults (≥18 y) residing in Luxembourg, n = 557 (35.5 % men, 64.3 % women)","country":"Luxembourg","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2022 online survey of 557 Luxembourg adults found that during COVID‑19 restrictions sexual satisfaction fell and sexual problems rose. Higher satisfaction was linked to being in a steady relationship, sexting, good mental health and unchanged alcohol use.","clinical_takeaway":"Pandemic‑related stress may reduce sexual satisfaction; clinicians should consider relationship and mental‑health factors when addressing sexual wellbeing.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a small country","Broad range of sexual‑behavior items","Timely data on pandemic impact"],"limitations":["Convenience online recruitment → selection bias","Cross‑sectional, retrospective self‑reports","No validated sexual‑satisfaction scale"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":3,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-022-13509-x"}},{"id":3870,"doi":"10.3390/ejihpe12060042","pmid":"35735463","pmcid":"PMC9221648","title":"How Customers Evaluate Genitalia versus Torso Sex Toys on Amazon.com: A Content Analysis of Product Reviews","authors":"Döring N, Mikhailova V, Noorishad PG.","first_author":"Döring N","journal":"European journal of investigation in health, psychology and education","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Online Content Analysis","Vibrator","Sex Toy","Sexual Script Theory","Online Product Review","Cybersexuality","Female Torso Toy","Male Torso Toy","Masturbator","Sex Doll"],"is_oa":true,"oa_url":"https://www.mdpi.com/2254-9625/12/6/42/pdf?version=1654567656","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Quantitative manual content analysis of 778 Amazon product reviews (plus qualitative analysis of 69 reviews). Convenience sample of online consumer reviews; no probabilistic sampling.","sample_n":778,"sample_text":"N = 778 online reviews (quantitative); n = 69 reviews (qualitative)","population":"Amazon.com reviewers of realistic genitalia and torso sex toys (mostly men, solo use)","country":"United States (Amazon.com platform)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A review of 778 Amazon product comments shows most buyers rate realistic genitalia and torso sex toys positively, especially men using them alone. Reviewers praise quality, material and shape; genitalia toys are liked more, while torso toys are linked to playful, anthropomorphic experiences.","clinical_takeaway":"None – the study describes consumer preferences, not clinical effects.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large number of real-world consumer reviews","Mixed quantitative‑qualitative content analysis","Clear categorisation of toy types"],"limitations":["Self‑selected, non‑representative sample of reviewers","No validated measurement instruments","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ejihpe12060042"}},{"id":3873,"doi":"10.3390/toxics10060295","pmid":"35736904","pmcid":"PMC9227271","title":"Serum Bilirubin and Sperm Quality in Adult Population","authors":"Chen YY, Chen WL.","first_author":"Chen YY","journal":"Toxics","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sperm quality","Serum bilirubin","Adult Population"],"is_oa":true,"oa_url":"https://www.mdpi.com/2305-6304/10/6/295/pdf?version=1653895170","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional analysis of 9,057 adult men attending health examinations; sperm collected by masturbation and assessed per WHO criteria; serum bilirubin measured biochemically.","sample_n":9057,"sample_text":"9057 participants","population":"Adult male participants (N≈9,057) from a health‑examination cohort in Taiwan (2010‑2016).","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large sample of adult men, higher blood bilirubin levels were linked to lower sperm count and poorer sperm shape, suggesting that bilirubin may negatively affect male fertility.","clinical_takeaway":"Elevated bilirubin could be a risk factor for reduced sperm quality; consider monitoring bilirubin in men with fertility concerns.","confidence":0.85,"topic_tags":["sexual_function","relationships","religiosity"],"strengths":["Large, well‑powered sample","Validated biochemical and WHO sperm measures","Clear reporting of effect sizes with confidence intervals"],"limitations":["Cross‑sectional design cannot infer causality","Potential selection bias of health‑examination attendees","Covariates not fully described in abstract"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/toxics10060295"}},{"id":3875,"doi":"10.1080/00224499.2022.2071411","pmid":"35609125","pmcid":null,"title":"Patterns of Genital and Subjective Sexual Arousal in Cisgender Asexual Men","authors":"Skorska MN, Yule MA, Bogaert AF, Brotto LA.","first_author":"Skorska MN","journal":"Journal of sex research","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross‑sectional laboratory study using penile plethysmography and self‑report questionnaires comparing asexual, heterosexual and gay men while viewing erotic films and engaging in fantasy.","sample_n":69,"sample_text":"convenience sample recruited from the community (details not specified)","population":"cisgender men, 20 asexual, 27 heterosexual, 22 gay; mean age 28.3 years","country":"not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured genital and self‑reported arousal in asexual, heterosexual and gay men while they watched erotic videos and imagined sexual fantasies. Asexual men showed lower arousal to the videos but similar arousal during personal fantasy, suggesting their sexual response patterns differ from sexual men but are not absent.","clinical_takeaway":"Asexual men may respond to personal sexual fantasies similarly to sexual men, indicating individualized approaches to sexual health are needed.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["objective physiological measurement of genital arousal","comparison across three sexual orientation groups","use of validated sexual function questionnaires"],"limitations":["small sample per group limits statistical power","no assessment of potential confounds (e.g., mental health, moral attitudes)","cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2071411"}},{"id":3876,"doi":"10.1016/j.enfcle.2022.04.006","pmid":"35598872","pmcid":null,"title":"Quality of sexual life of riparian women: Analysis of sexual practices and attitudes","authors":"Silva Esteves de Hollanda G, Pereira Nogueira W, Iansã de Lima Barroso B, de Lima Brito Magalhães R, Moreira Freire ME, de Oliveira E Silva AC.","first_author":"Silva Esteves de Hollanda G","journal":"Enfermeria clinica","year":2022,"pub_types":["Journal Article"],"keywords":["Quality of life","Sexual behaviour","Sexual Health","Women’s Health","Calidad De Vida","Salud De La Mujer","Salud Sexual","Comportamiento Sexual"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional analytical study of 138 riparian women using a questionnaire","sample_n":138,"sample_text":"Convenience sample of adult women from riparian areas","population":"Women living in riparian communities (Brazil)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 138 women living near rivers in Brazil examined their sexual practices and how they rate their sexual quality of life. About 40% said their sexual quality of life was good, and higher education and early sexual initiation were linked to better ratings. Many did not use condoms, suggesting a need for better sexual‑health education.","clinical_takeaway":"Education on safe sex may improve sexual quality of life in this community.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a community study","Use of multivariate logistic regression","Focus on understudied population"],"limitations":["Cross‑sectional design limits causal inference","Unclear validation status of the SSB questionnaire","No measurement of key confounders (mental health, partner factors, trauma)"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.enfcle.2022.04.006"}},{"id":3877,"doi":"10.1097/paf.0000000000000231","pmid":"27043460","pmcid":null,"title":"Sexual Activity as a Risk Factor for the Spontaneous Rupture of Cerebral Aneurysms","authors":"Blanke-Roeser C, Matschke J, Püschel K.","first_author":"Blanke-Roeser C","journal":"The American journal of forensic medicine and pathology","year":2016,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Single case report of a 24‑year‑old woman whose aneurysm ruptured during masturbation; no comparison group.","sample_n":1,"sample_text":"One patient","population":"Young adult female (N=1)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 24‑year‑old woman suffered a ruptured brain aneurysm while masturbating. The authors discuss how the blood‑pressure spikes during sexual activity might trigger such events, but the report is based on just one case.","clinical_takeaway":"No clinical guidance can be drawn; a single case does not prove masturbation causes aneurysm rupture.","confidence":0.7,"topic_tags":["masturbation","csbd","sexual_function"],"strengths":["Rare clinical observation","Highlights possible physiological mechanism"],"limitations":["Single case, no control group","No systematic measurement of sexual activity or blood pressure","No assessment of confounding health factors"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/paf.0000000000000231"}},{"id":3878,"doi":"10.1007/s11255-022-03219-z","pmid":"35536388","pmcid":null,"title":"An innovative approach to lifelong delayed ejaculation: does attachment style play a role?","authors":"Demir M, Isık M, Araz Ş, Özveren H, Kırlı U, Ertas K.","first_author":"Demir M","journal":"International urology and nephrology","year":2022,"pub_types":["Journal Article"],"keywords":["Depression","Anxiety","Sexual dysfunction","Attachment Insecurity","Anxious Attachment","Avoidant Attachment","Lifelong Delayed Ejaculation"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"prospective multi‑centric cross‑sectional case‑control (30 DE patients vs 30 matched controls)","sample_n":60,"sample_text":"30 DE patients, 30 controls, consecutively admitted; age‑matched","population":"adult men with lifelong delayed ejaculation, recruited from a urology outpatient clinic; age‑matched healthy male controls","country":"Turkey (implied by author names and journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that men with lifelong delayed ejaculation were more likely to have insecure (anxious or avoidant) attachment styles and higher anxiety and depression scores than healthy controls, suggesting early relational factors may influence this sexual dysfunction.","clinical_takeaway":"Assess attachment style and mental health when evaluating men with delayed ejaculation; consider psychosocial interventions alongside medical treatment.","confidence":0.78,"topic_tags":["sexual_function","relationships"],"strengths":["Validated psychological and sexual dysfunction scales","Inclusion of both clinical and matched control groups","Assessment of endocrine factors"],"limitations":["Small sample size limits power and generalizability","No control for moral or relational confounds beyond attachment","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11255-022-03219-z"}},{"id":3879,"doi":"10.1007/s10508-016-0719-1","pmid":"27178172","pmcid":null,"title":"Reactions to First Postpubertal Male Same-Sex Sexual Experience in the Kinsey Sample: A Comparison of Minors With Peers, Minors With Adults, and Adults With Adults","authors":"Rind B, Welter M.","first_author":"Rind B","journal":"Archives of sexual behavior","year":2016,"pub_types":["Journal Article"],"keywords":["Sexual Orientation","First Postpubertal Sex","Same-sex Sexual Experiences"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective analysis of Kinsey historical survey data; convenience sample of participants reporting first same‑sex post‑pubertal sexual experience; comparisons across age‑pair categories.","sample_n":null,"sample_text":"Not specified in abstract; Kinsey sample historically large but non‑representative.","population":"Male participants from the Kinsey same‑sex dataset (1938‑1961), ages ranging from <18 to adults; sample size not reported in abstract.","country":"United States (Kinsey Institute data collection)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Using the historic Kinsey data, the authors found that teenage boys who first had sex with an adult reported similar levels of enjoyment and low levels of shame or fear as those who had sex with peers or as adult men did.","clinical_takeaway":"First same‑sex experiences in adolescence were often reported as positive in this historic sample, but findings may not apply to today’s populations.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large historical dataset","Direct comparison across age‑pair categories","Focused on emotional reactions"],"limitations":["Retrospective self‑report, likely single‑item measures","No validated scales for emotions or distress","No control for moral, mental‑health, or relationship confounds","Convenience sample not representative of population"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0719-1"}},{"id":3880,"doi":"10.1016/j.jsxm.2022.03.621","pmid":"35527103","pmcid":null,"title":"Orgasm Rating Scale and Bodily Sensations of Orgasm Scale: Validation for Use With Pre, Peri, and Post-Menopausal Women","authors":"Webb AE, Reissing ED, Huta V.","first_author":"Webb AE","journal":"The journal of sexual medicine","year":2022,"pub_types":["Journal Article"],"keywords":["Female","Sexuality","Sexual behavior","menopause","Orgasm","Surveys And Questionnaires"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional validation of self‑report scales with large community sample (≈250 per menopausal group).","sample_n":1330,"sample_text":"Solitary context: 252 pre, 139 peri, 190 post; Partnered context: 229 pre, 136 peri, 194 post.","population":"Women aged 18‑82, pre‑, peri‑, and post‑menopausal, reporting solitary (masturbation) and partnered orgasm experiences.","country":"Not specified (online questionnaire, likely USA/International).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study validates two new questionnaires that reliably capture how women experience orgasm, both alone and with a partner, across different menopausal stages.","clinical_takeaway":"Clinicians can use the ORS and BSOS to assess and discuss orgasm experience more precisely with adult women.","confidence":0.85,"topic_tags":["measurement","sexual_function","masturbation","gender"],"strengths":["Large, diverse age‑menopause sample","Rigorous factor‑analytic validation (PCA, CFA, invariance)","Separates solitary and partnered contexts"],"limitations":["Cross‑sectional; no test‑retest reliability","No pre‑registration","Self‑report may be biased"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2022.03.621"}},{"id":3881,"doi":null,"pmid":"35606913","pmcid":null,"title":"[INTIMACY AND SEXUALITY IN PATIENTS DYING OF CANCER OR COPING WITH INCURABLE ADVANCED CANCER IN THE LIGHT OF END OF LIFE AWARENESS]","authors":"Kislev L, Kurtz Almog L, Bier P, Dikhel R, Avidan M, Waller A.","first_author":"Kislev L","journal":"Harefuah","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"heb","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 35 terminal cancer patients","sample_n":35,"sample_text":"35 patients dying of cancer or with incurable advanced cancer, recruited for interviews (convenience sample)","population":"patients with incurable/advanced cancer (n=35)","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 35 terminal cancer patients revealed a wide range of experiences: some kept their sexual lives unchanged, many reported a decline, and distress varied. Masturbation patterns differed, and many wanted health‑care teams to discuss sexuality as part of end‑of‑life care.","clinical_takeaway":"Palliative teams should proactively ask about sexual and intimate needs, as many patients experience change and distress.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Addresses a neglected topic (sexuality at end of life)","In‑depth qualitative insight from patients themselves","Identifies heterogeneity in experiences and needs"],"limitations":["Small, non‑representative convenience sample","No validated measures of sexual function or distress","No control for potential confounds (e.g., mental health, partner status)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":3882,"doi":"10.1093/geronb/gbab158","pmid":"34460903","pmcid":"PMC9071474","title":"Takes Two to Tango: Cognitive Impairment and Sexual Activity in Older Individuals and Dyads","authors":"Waite LJ, Iveniuk J, Kotwal A.","first_author":"Waite LJ","journal":"The journals of gerontology. Series B, Psychological sciences and social sciences","year":2022,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual behavior","Marriage","Health-related Quality Of Life"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal panel data from NSHAP (2010 & 2015) with 3,777 individuals (955 dyads) analyzed using ordered probit, cross‑lagged panel, and probit regressions.","sample_n":3777,"sample_text":"3,777 individuals (955 dyads) from a nationally representative cohort.","population":"Community‑dwelling older adults (aged 50+), both sexes, partnered and non‑partnered.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large study of older adults, having mild cognitive problems does not reduce partnered sexual activity, but it is linked to less solo masturbation, especially for women whose cognition is lower than their husbands'.","clinical_takeaway":"Cognitive decline alone may not diminish a couple’s sexual life, but clinicians should note possible reductions in solo sexual activity.","confidence":0.7,"topic_tags":["csbd","relationships","sexual_function"],"strengths":["Large, nationally representative longitudinal sample","Distinct measurement of partnered sex vs. masturbation","Dyadic analysis incorporating both partners"],"limitations":["No direct control for moral‑incongruence or mental‑health factors","Reliance on self‑report sexual activity without physiological validation","No pre‑registration or power justification reported"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/geronb/gbab158"}},{"id":3883,"doi":"10.1007/s10508-016-0729-z","pmid":"27113471","pmcid":null,"title":"Stability of Self-Reported Arousal to Sexual Fantasies Involving Children in a Clinical Sample of Pedophiles and Hebephiles","authors":"Grundmann D, Krupp J, Scherner G, Amelung T, Beier KM.","first_author":"Grundmann D","journal":"Archives of sexual behavior","year":2016,"pub_types":["Journal Article"],"keywords":["Stability","Prevention","Sexual Orientation","Pedophilia","Hebephilia"],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective follow‑up of self‑identified pedo-/hebephilic men (N=494 baseline, 121 follow‑up) using questionnaires on arousal during masturbation; no control group","sample_n":494,"sample_text":"494 participants completed intake; 121 completed a second assessment after ~29 months","population":"non‑prosecuted adult men self‑identifying as pedo‑/hebephilic, recruited from a German prevention programme (Berlin Prevention Project Dunkelfeld)","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a German clinical sample of men who identified as pedophilic or hebephilic, self‑reported arousal to fantasies about children showed moderate‑to‑high stability over about 2½ years, suggesting that such arousal patterns are relatively enduring.","clinical_takeaway":"Self‑reported sexual arousal to child fantasies appears stable over time in this treatment‑seeking group; clinicians should consider the enduring nature of these preferences when planning interventions.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large initial sample of self‑identified individuals","Prospective follow‑up over ~2½ years","Clear statistical tests for rank‑order and mean‑level stability"],"limitations":["Reliance on unvalidated self‑report measures","No control/comparison group","Key confounds (moral incongruence, mental health, trauma) not measured","Sample drawn from a treatment‑seeking prevention programme, limiting generalisability"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":16,"citing_publications":90,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0729-z"}},{"id":3884,"doi":"10.33546/bnj.1950","pmid":"37521890","pmcid":"PMC10386794","title":"Life skills and sexual risk behaviors among adolescents in Indonesia: A cross-sectional survey","authors":"Mediawati AS, Yosep I, Mardhiyah A, Mardhiyah A.","first_author":"Mediawati AS","journal":"Belitung nursing journal","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Nursing","Indonesia","Substance Use","Life Skills","School Adolescents"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10386794","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 480 Indonesian adolescents selected by simple random sampling; logistic regression used to examine associations between measured life‑skill scores and self‑reported sexual risk behaviours.","sample_n":480,"sample_text":"480 adolescents selected by simple random sampling","population":"adolescents (15‑19 y) in Bandung, Indonesia; school‑based sample, likely WEIRD‑ish but representative of local student population","country":"Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 480 Indonesian teens, weaker life‑skill abilities (refusing, assertiveness, problem‑solving, self‑control) were linked to higher odds of risky sexual acts such as masturbation, petting, and early intercourse.","clinical_takeaway":"Strengthening specific life‑skill competencies may reduce adolescents’ sexual risk behaviours.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, randomly sampled adolescent cohort","Validated‑looking life‑skill questionnaire","Clear logistic‑regression analysis with confidence intervals"],"limitations":["Cross‑sectional, cannot infer causality","No control for moral, mental‑health or relational confounds","Sexual risk measured by self‑report only"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":2,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.33546/bnj.1950"}},{"id":3885,"doi":"10.1016/j.esxm.2022.100516","pmid":"35477122","pmcid":"PMC9177880","title":"Are the Criteria for the Diagnosis of Premature Ejaculation Applicable to Gay Men or Sexual Activities Other than Penile-Vaginal Intercourse?","authors":"McNabney SM, Weseman CE, Hevesi K, Rowland DL.","first_author":"McNabney SM","journal":"Sexual medicine","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Diagnostic criteria","Gay","Premature Ejaculation","Homosexual","Ejaculatory Control","Distress/bother"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9177880","cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey, n=3878, gay and straight men, compares PE criteria across orientations and sexual acts","sample_n":3878,"sample_text":"large international community sample, self‑selected online respondents","population":"adult men, gay and straight, recruited via internet","country":"multiple (international)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 3,878 men, the usual diagnostic criteria for premature ejaculation (control, latency, distress) worked for gay men as well as straight men, though gay men tended to have longer ejaculation times and less bother, likely because of anal sex.","clinical_takeaway":"Clinicians may use standard premature ejaculation criteria for gay men but should expect slightly longer latencies and lower distress.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Very large sample size","Direct comparison of gay and straight men","Multivariate analysis with confidence intervals"],"limitations":["Self‑selected online survey, possible response bias","No assessment of moral/religious factors","Limited mental‑health covariates"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2022.100516"}},{"id":3886,"doi":"10.1007/s10508-021-02242-y","pmid":"35449364","pmcid":null,"title":"Gender Dysphoria and Sexual Well-Being Among Trans Masculine and Nonbinary Individuals","authors":"Lindley L, Anzani A, Galupo MP.","first_author":"Lindley L","journal":"Archives of sexual behavior","year":2022,"pub_types":["Journal Article"],"keywords":["Transgender","Gender Dysphoria","Sexual Well-being","Nonbinary"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 141 trans masculine and nonbinary individuals assigned female at birth, recruited via community channels; no longitudinal or experimental component","sample_n":141,"sample_text":"141 participants (52 trans masculine, 72 nonbinary, 17 agender)","population":"trans masculine, nonbinary, and agender adults assigned female at birth, not medically transitioned (n=141)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 141 trans‑masculine and nonbinary people assigned female at birth, greater distress about genitals or chest was linked to less participation and enjoyment of sexual acts that involve those body parts.","clinical_takeaway":"Gender dysphoria may reduce engagement in certain sexual activities; clinicians should discuss body‑related distress when supporting sexual well‑being.","confidence":0.8,"topic_tags":["gender"],"strengths":["Focus on understudied trans masculine and nonbinary population","Examines multiple domains of sexual activity","Identifies specific links between dysphoria areas and sexual enjoyment"],"limitations":["Cross‑sectional design limits causal inference","Unclear whether gender‑dysphoria measures are validated","Convenience sample may not be representative"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02242-y"}},{"id":3887,"doi":"10.2147/rru.s278797","pmid":"35480782","pmcid":"PMC9037179","title":"Penile Vibratory Stimulation for Semen Retrieval in Men with Spinal Cord Injury: Patient Perspectives","authors":"Ibrahim E, Brackett NL, Lynne CM.","first_author":"Ibrahim E","journal":"Research and reports in urology","year":2022,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sperm","Child","Fertility","Reproduction","Conception","Anejaculation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9037179","cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of clinical practice and patient perspectives; no original empirical data","sample_n":null,"sample_text":"not applicable (review article)","population":"men with spinal cord injury (SCI) undergoing penile vibratory stimulation (PVS) for sperm retrieval","country":"USA (implied by Miami Project affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews penile vibratory stimulation (PVS) as a safe, effective way to retrieve sperm from men with spinal cord injuries, helping many achieve biological fatherhood despite ejaculatory dysfunction.","clinical_takeaway":"PVS is recommended as a first‑line method for sperm retrieval in men with SCI who wish to conceive.","confidence":0.8,"topic_tags":["sexual_function","religiosity","gender"],"strengths":["Comprehensive overview of PVS technique and outcomes","Highlights patient perspectives on fertility"],"limitations":["Narrative review without systematic methodology","No new empirical data or quantitative synthesis"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/rru.s278797"}},{"id":3888,"doi":"10.1186/s13256-022-03342-6","pmid":"35440026","pmcid":"PMC9020065","title":"Use of dental drill handpiece to remove steel nut causing penile strangulation: a case report and review of the literature","authors":"Nguyen TT, Ngo XT, Chau QT, Hoang KC, Dinh LQV, Ly HT, Hoang TD, Dobbs RW, Thai MS.","first_author":"Nguyen TT","journal":"Journal of medical case reports","year":2022,"pub_types":["Review","Journal Article","Case Reports","case-report"],"keywords":["Case Report","Penile Strangulation","Penile Incarceration","Metallic Nut","Penile Entrapment","Dental Drill Handpiece"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9020065","cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single-patient case report describing emergency removal of a steel nut using a dental drill; no control group, no longitudinal follow‑up beyond clinical outcome","sample_n":1,"sample_text":"1 patient","population":"24‑year‑old Vietnamese male presenting with penile strangulation after self‑applied device for sexual enhancement","country":"Vietnam","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 24‑year‑old man placed a metal nut around his penis for sexual stimulation, causing swelling and urinary problems. Doctors used a dental drill to cut the nut off safely, and the patient recovered without lasting issues.","clinical_takeaway":"Prompt, inventive removal of constricting objects can prevent serious penile injury.","confidence":0.9,"topic_tags":["sexual_function","gender","masturbation"],"strengths":["Clear, detailed clinical description","Novel use of dental equipment for urological emergency","Follow‑up confirming no lasting sequelae"],"limitations":["Single case, no generalisable evidence","No systematic assessment of psychosocial factors","No comparison with alternative removal techniques"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":1,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s13256-022-03342-6"}},{"id":3889,"doi":"10.4081/aiua.2016.1.68","pmid":"27072182","pmcid":null,"title":"3T MR-guided minimally-invasive penile fracture repair","authors":"Rosi G, Fontanella P, Venzi G, Jermini F, Del Grande F.","first_author":"Rosi G","journal":"Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica","year":2016,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":"https://www.pagepressjournals.org/index.php/aiua/article/download/aiua.2016.1.68/5065","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single 21‑year‑old patient with penile fracture repaired using 3 T MRI‑guided planning","sample_n":1,"sample_text":"21‑year‑old patient","population":"young adult male, single case","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 21‑year‑old man suffered a penile fracture during vigorous masturbation. Using 3 T MRI, doctors pinpointed the tear and performed a minimally invasive repair, showing that high‑resolution imaging can aid surgical planning.","clinical_takeaway":"3 T MRI can accurately locate penile fractures, helping surgeons plan less invasive repairs.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["high‑resolution 3 T MRI provided precise anatomical detail","demonstrates feasibility of minimally invasive repair"],"limitations":["single case, no comparative data","no statistical analysis","findings not generalisable"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4081/aiua.2016.1.68"}},{"id":3890,"doi":"10.1007/s10508-016-0704-8","pmid":"27007471","pmcid":null,"title":"Defining Pleasure: A Focus Group Study of Solitary and Partnered Sexual Pleasure in Queer and Heterosexual Women","authors":"Goldey KL, Posh AR, Bell SN, van Anders SM.","first_author":"Goldey KL","journal":"Archives of sexual behavior","year":2016,"pub_types":["Journal Article"],"keywords":["Women","Masturbation","Sexual Orientation","Pleasure","Partnered Sexuality","Solitary Sexuality"],"is_oa":false,"oa_url":null,"cited_by_count":75,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"focus groups with 73 women (age 18‑64), thematic analysis of definitions of solitary vs partnered sexual pleasure","sample_n":73,"sample_text":"sexually diverse community sample recruited for focus groups","population":"women, diverse sexual orientations, community sample","country":"USA (presumed from affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Through focus groups with 73 queer and heterosexual women, the study found that solitary sexual pleasure is linked to autonomy, while partnered pleasure emphasizes trust, closeness, and giving pleasure. Both involve exploration and self‑discovery.","clinical_takeaway":"Understanding that solitary and partnered pleasure are defined differently can help clinicians respect diverse sexual experiences and support autonomy in sexual health discussions.","confidence":0.8,"topic_tags":["sexual_function","masturbation","relationships"],"strengths":["Rich qualitative insight into women’s lived definitions of pleasure","Diverse age and sexual‑orientation sample","Clear thematic analysis linking autonomy vs trust"],"limitations":["Convenience sample; limited generalisability","No validated quantitative measures of pleasure or related constructs","No assessment of potential confounds such as moral attitudes or mental‑health status"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":1,"mentioning":81,"citing_publications":133,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0704-8"}},{"id":3891,"doi":null,"pmid":"21265243","pmcid":null,"title":"The outcome of the seminal fluid parameters collected via coitus interruptus versus masturbation","authors":"Bahyah MK, Murad ZA, Ghazali I, Roszaman R, Noraziana AW, Mokhtar A, Omar MH.","first_author":"Bahyah MK","journal":"The Medical journal of Malaysia","year":2010,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative observational study of semen parameters collected by two methods in 151 men undergoing IUI.","sample_n":151,"sample_text":"151 patients","population":"Men (median age unspecified) undergoing intrauterine insemination or seeking semen analysis in Malaysia.","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 151 men undergoing intrauterine insemination, semen collected by coitus interruptus showed no significant differences in volume, sperm count, motility, morphology, or pregnancy rates compared with semen collected by masturbation.","clinical_takeaway":"Both collection methods appear equivalent for assessing semen quality in IUI settings.","confidence":0.8,"topic_tags":["masturbation","sexual_function","religiosity"],"strengths":["Standardised laboratory semen analysis methods","Adequate overall sample size","Direct comparison of two collection techniques"],"limitations":["No pre‑registration or effect‑size reporting","Potential selection bias (IUI patients only)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":3893,"doi":"10.1177/0306624x221086580","pmid":"35354408","pmcid":null,"title":"Sexual Fantasies and Harmful Sexual Interests: Exploring Differences in Sexual Memory Intensity and Sexual Fantasy Characteristics","authors":"Allen A, Millear P, McKillop N, Katsikitis M.","first_author":"Allen A","journal":"International journal of offender therapy and comparative criminology","year":2023,"pub_types":["Journal Article"],"keywords":["Sexual Violence","Sexual Interest","Sexual Fantasies","Sexual Memory"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two online community surveys (N=414; N=820) with psychometric validation and correlational analyses.","sample_n":1234,"sample_text":"Total N across two surveys = 1,234 (Study 1 N=414; Study 2 N=820).","population":"adult community participants (online volunteers)","country":"Not stated (online sample likely international/English‑speaking)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a questionnaire measuring how strongly people remember sexual experiences. They found that people with harmful sexual interests tend to have more vivid, emotional fantasies and higher memory intensity, and they masturbate more often to those fantasies.","clinical_takeaway":"Mental‑ imagery interventions might help manage harmful sexual interests, but evidence is correlational.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Validated new scale (SMIS) with factor analysis","Large community sample","Separate assessment of masturbation behavior"],"limitations":["Cross‑sectional; cannot infer causality","Limited control for mental‑health, relational, or trauma variables"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":2,"mentioning":12,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x221086580"}},{"id":3894,"doi":"10.5811/westjem.2016.1.29262","pmid":"26973745","pmcid":"PMC4786239","title":"Salicylate Toxicity from Genital Exposure to a Methylsalicylate-Containing Rubefacient","authors":"Thompson TM, Toerne T, Erickson TB.","first_author":"Thompson TM","journal":"The western journal of emergency medicine","year":2016,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4786239","cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single adolescent male case of salicylate toxicity after applying a methylsalicylate rubefacient to the genitals for masturbation","sample_n":1,"sample_text":"1 adolescent male","population":"adolescent male, n=1","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A teenage boy developed salicylate poisoning after applying a menthol rub on his genitals to aid masturbation; the skin on the scrotum absorbs the chemical much more readily than other areas.","clinical_takeaway":"Topical products containing methylsalicylate can cause serious toxicity when applied to genital skin; avoid such use.","confidence":0.4,"topic_tags":["masturbation","sexual_function","pornography","treatment"],"strengths":["Clear clinical description of a rare toxicity","Highlights a novel route of exposure"],"limitations":["Single case limits generalizability","No systematic assessment of confounding factors","No quantitative analysis"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5811/westjem.2016.1.29262"}},{"id":3896,"doi":"10.1111/andr.13175","pmid":"35279959","pmcid":"PMC9311207","title":"Accurate and time-saving, two-step intracavernosal injection procedure to diagnose psychological erectile dysfunction","authors":"Santi D, Spaggiari G, Simoni M, Granata ARM.","first_author":"Santi D","journal":"Andrology","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["erectile dysfunction","Intracavernosal Injection","Ici","Unstructured Interview","Morning Erections"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9311207","cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective real‑world analysis of 179 men undergoing intracavernosal injection; multinomial logistic regression used to identify predictors of psychological erectile dysfunction.","sample_n":179,"sample_text":"179 enrolled patients","population":"men presenting to a single Andrology Unit (Modena) for ED assessment, 2018‑2021","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors propose a two‑step penile injection test that, together with reports of morning and masturbation‑related erections, can tell whether a man’s erectile difficulty is psychological rather than vascular, claiming very high accuracy.","clinical_takeaway":"In men with erectile problems, checking morning erections and response to a low‑dose injection may help distinguish psychological from vascular causes, guiding further work‑up.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large clinical sample for a single centre","Objective physiological measures (injection test, Doppler)","Multivariate analysis to identify independent predictors"],"limitations":["Retrospective, no control group","Limited assessment of psychosocial confounds","Findings may not generalise beyond treatment‑seeking men"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/andr.13175"}},{"id":3897,"doi":"10.1089/jayao.2021.0211","pmid":"35319264","pmcid":null,"title":"Sexual Dysfunction Among Adolescent and Young Adult Men Diagnosed with Cancer","authors":"Rainer QC, Dubin JM, Balaji NC, Troesch V, Terry W, Monga V, Clifford L, Shoag J, Greer A, Nackeeran S, Rodriguez AA, Patel P, Paz L, Kava BR, Alperstein W, Pearlman AM, Ramasamy R.","first_author":"Rainer QC","journal":"Journal of adolescent and young adult oncology","year":2023,"pub_types":["Journal Article"],"keywords":["Sexuality","Chemotherapy","Quality of life","Radiation Therapy","Cancer Care Continuum","Treatment-related Sequelae"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 40 male AYA cancer patients using validated sexual function questionnaires","sample_n":40,"sample_text":"Forty subjects completed IIEF; 38 completed MEI","population":"Male adolescents and young adults (18‑39) with cancer, recruited during oncology appointments","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 40 male cancer patients aged 18‑39, more than half reported erectile problems, especially those under 30 and those receiving chemotherapy. The study highlights the need for oncologists to discuss sexual health with young patients.","clinical_takeaway":"Screen for erectile dysfunction in young male cancer patients and address it as part of routine care.","confidence":0.78,"topic_tags":["sexual_function","csbd"],"strengths":["Uses validated sexual function instruments (IIEF, MEI)","Focuses on an understudied AYA cancer population","Provides prevalence estimates for ED across treatment modalities"],"limitations":["Small convenience sample (N≈40)","Cross‑sectional; cannot infer causality","Limited control for psychological or relational confounders"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/jayao.2021.0211"}},{"id":3898,"doi":"10.1258/ijsa.2009.009435","pmid":"19948903","pmcid":null,"title":"Overestimation of heterosexually attributed AIDS deaths is associated with immature psychological defence mechanisms and clitoral masturbation during penile-vaginal intercourse","authors":"Brody S, Costa RM.","first_author":"Brody S","journal":"International journal of STD & AIDS","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 221 Scottish women, self‑report questionnaires on defence styles, sexual behaviours and estimate of AIDS deaths","sample_n":221,"sample_text":"221 Scottish women completed the questionnaire","population":"adult women, Scotland, convenience sample","country":"Scotland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2009 survey of 221 Scottish women found that those who vastly over‑estimated AIDS deaths from heterosexual sex tended to use more immature psychological defence styles and reported fewer orgasms from clitoral masturbation during intercourse. The authors suggest poorer psychological functioning may impair accurate risk perception.","clinical_takeaway":"None – the study is observational and does not provide actionable clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Validated defence style questionnaire","Reasonably sized community sample","Novel link between risk perception and sexual behaviour"],"limitations":["Cross‑sectional, no causal inference","Self‑report of sexual activity and risk estimates","No control for key confounds (moral views, mental health, partner factors)","Over‑reliance on a single, ad‑hoc risk‑estimate measure"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":19,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/ijsa.2009.009435"}},{"id":3899,"doi":"10.1016/j.jsxm.2022.02.025","pmid":"35370105","pmcid":"PMC8898699","title":"The Impact of the COVID-19 Pandemic on Sexual Health in Cis Women Living in Germany","authors":"Batz F, Lermer E, Hatzler L, Vilsmaier T, Schröder L, Chelariu-Raicu A, Behr J, Mahner S, Buspavanich P, Thaler CJ.","first_author":"Batz F","journal":"The journal of sexual medicine","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Lesbian","Bisexual","Heterosexual","Sexual Relationship","Covid19","Cis Women Sexual Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8898699","cited_by_count":10,"is_preprint":false,"topics":["masturbation","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"anonymous nationwide online survey, single time‑point, retrospective recall of pre‑pandemic vs during pandemic sexual behaviour","sample_n":1368,"sample_text":"Convenience sample recruited via e‑mail, online chats and social‑media; under‑representation of women >46 y","population":"cisgender women (heterosexual, lesbian, bisexual) in Germany, N=1,368","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A German online survey of 1,368 cis women showed that during the first COVID‑19 lockdown sexual activity and masturbation decreased overall, with different patterns for heterosexual, lesbian, and bisexual participants. Younger, partnered, heterosexual women reported higher sexual‑life satisfaction.","clinical_takeaway":"Clinicians should recognise pandemic‑related declines in sexual activity and tailor support, especially for sexual minority women.","confidence":0.78,"topic_tags":["sexual_function","masturbation"],"strengths":["Large overall sample size","Inclusion of sexual minority sub‑groups","Multiple regression to identify predictors"],"limitations":["Cross‑sectional, single‑time‑point, recall bias","Convenience online recruitment, limited generalisability","No measurement of mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":2,"mentioning":14,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2022.02.025"}},{"id":3900,"doi":"10.3390/ijerph19052921","pmid":"35270613","pmcid":"PMC8910547","title":"Changes in the Sexual Behavior of Partners in Each Trimester of Pregnancy in Otwock in Polish Couples","authors":"Kulhawik R, Zborowska K, Grabarek BO, Boroń D, Skrzypulec-Plinta V, Drosdzol-Cop A.","first_author":"Kulhawik R","journal":"International journal of environmental research and public health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Pregnancy","Sexuality","Couples","Sexual Intercourse","Polish Observational Study"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/5/2921/pdf?version=1646219782","cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective observation of the same 100 heterosexual couples across the three trimesters of pregnancy","sample_n":200,"sample_text":"100 couples (100 women, 100 men) assessed at each trimester","population":"Polish pregnant couples (100 couples, 200 individuals)","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 100 Polish couples followed through pregnancy, sexual intercourse declined after the first trimester while men masturbated more and women less. Relationship satisfaction and feeling attractive were linked to higher sexual satisfaction.","clinical_takeaway":"Pregnancy often reduces partnered sex; clinicians should address sexual concerns and relationship satisfaction with couples.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Longitudinal within‑couple design across pregnancy","Use of a validated sexual satisfaction scale","Separate assessment of masturbation frequency"],"limitations":["Original survey (SARSS) lacks validation","No control for mental‑health or moral‑incongruence variables","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":10,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph19052921"}},{"id":3902,"doi":"10.1080/00224490902878993","pmid":"19350442","pmcid":null,"title":"Masturbation among young women and associations with sexual health: an exploratory study","authors":"Hogarth H, Ingham R.","first_author":"Hogarth H","journal":"Journal of sex research","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"exploratory qualitative interview study of young women; thematic analysis of transcripts","sample_n":null,"sample_text":"not reported in abstract","population":"young women (age not specified), likely convenience sample","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with young women showed that masturbation is viewed along a spectrum and is linked to how openly they talk with parents and partners, as well as their own beliefs about sexuality.","clinical_takeaway":"Encouraging open communication about sexuality may support positive sexual development in young women.","confidence":0.78,"topic_tags":["masturbation","sexual_function"],"strengths":["Qualitative depth captures lived experience","Identifies links between communication, self‑concept and sexual behavior"],"limitations":["No validated quantitative measures of masturbation or sexual health","Small, non‑representative sample; unclear size","No control for moral, mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":63,"citing_publications":113,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490902878993"}},{"id":3903,"doi":"10.1080/00224499.2022.2033675","pmid":"35166630","pmcid":null,"title":"Gynephilic Men's and Androphilic Women's Visual Attention Patterns: The Effects of Gender and Sexual Activity Cues","authors":"O'Kane KMK, Milani S, Chivers ML, Dawson SJ.","first_author":"O'Kane KMK","journal":"Journal of sex research","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Eye‑tracking lab experiment with within‑subject video stimuli; 69 participants (33 gynephilic men, 36 androphilic women).","sample_n":69,"sample_text":"33 gynephilic men and 36 androphilic women","population":"Adults (gynephilic men, androphilic women); recruited via community/online advertisements; not treatment‑seeking.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using eye‑tracking, the study found that men focus their visual attention on women (their preferred gender) regardless of the type of sexual activity shown, while women's attention varies with the intensity and context of the activity, sometimes looking more at non‑preferred gender cues.","clinical_takeaway":"None – the findings pertain to basic visual attention patterns, not clinical practice.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Objective eye‑tracking measurement of visual attention","Clear operationalisation of stimulus categories (gender, activity intensity)","Within‑subject design reduces individual variability"],"limitations":["Small, non‑representative sample (college‑age volunteers)","No control for moral/religious attitudes or mental‑health variables","Cross‑sectional; cannot infer causal effects on broader sexual behaviour"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2033675"}},{"id":3904,"doi":null,"pmid":"26817298","pmcid":null,"title":"[Benefit of network education to college students' knowledge about sexual and reproductive health in Ningbo city]","authors":"Wang GY, Ji YX, Ding HQ, Gui ZB, Liang XM, Fu JF, Cheng Y.","first_author":"Wang GY","journal":"Zhonghua nan ke xue = National journal of andrology","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire comparing students who self‑selected into a network‑based sexual health education program with those who did not.","sample_n":7362,"sample_text":"7362 college students; 2 483 received network education, 4 879 did not.","population":"College students (N=7 362) in Ningbo, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A questionnaire of 7 362 Chinese college students found that those who took an online sexual‑health course knew more about reproduction and reported higher rates of masturbation, but the study used non‑standard measures and did not control for other factors.","clinical_takeaway":"Online sexual‑health education can increase knowledge, but evidence on behavioural effects is limited and confounded.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Large sample size","Relevant public‑health topic","Direct comparison of education exposure"],"limitations":["Non‑validated knowledge questionnaire","No randomisation; possible selection bias","No control for moral, mental‑health or relational confounds","Only p‑values reported, no effect sizes"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":3906,"doi":"10.1016/j.esxm.2021.100480","pmid":"35149341","pmcid":"PMC9023244","title":"Development of a Sexual Quality of Life Questionnaire for Men-Who-Have-Sex-With-Men With Prostate Cancer","authors":"Lee TK, Wibowo E, Dowsett GW, Nelson CJ, Oliffe JL, Mitteldorf D, Wong STS, Wassersug RJ.","first_author":"Lee TK","journal":"Sexual medicine","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexual dysfunction","Gay","Masturbation","Anal Sex","Oral Sex","Bisexual"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9023244","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"questionnaire development with 204 MSM prostate‑cancer survivors; convenience sample; psychometric analysis (Cronbach’s α, item‑total correlations, inter‑domain correlations).","sample_n":204,"sample_text":"204 responses from MSM treated for prostate cancer","population":"men who have sex with men (MSM) treated for prostate cancer (N=204).","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and preliminarily validated a new questionnaire measuring sexual quality of life for gay and bisexual men after prostate‑cancer treatment, covering a wide range of sexual activities beyond penile intercourse.","clinical_takeaway":"The new tool may help clinicians assess and tailor support for MSM experiencing diverse sexual side‑effects after prostate cancer treatment.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Rigorous psychometric evaluation (high Cronbach’s α).","Addresses a previously neglected population (MSM with prostate cancer).","Transparent discussion of limitations and need for larger validation."],"limitations":["Convenience sample; may not represent all MSM with prostate cancer.","No external validation or test‑retest reliability reported.","Potential lack of control for mental‑health or relationship variables."],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2021.100480"}},{"id":3907,"doi":"10.1111/jsm.13050","pmid":"26608879","pmcid":null,"title":"Sex in Its Daily Relational Context","authors":"Dewitte M, Van Lankveld J, Vandenberghe S, Loeys T.","first_author":"Dewitte M","journal":"The journal of sexual medicine","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sex","Relationship","Masturbation","Intimacy","Mood","Daily Diary","Partner Responses"],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"daily diary of heterosexual couples over 3 weeks, twice‑daily electronic entries on mood, partner behavior, sexual activity, intimacy, and masturbation","sample_n":null,"sample_text":"Not specified in abstract","population":"heterosexual adult couples (sample size not reported in abstract)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Couples kept a three‑week electronic diary of their moods, partner interactions, and sexual activity. Positive mood and partner behavior predicted more sex and intimacy, which in turn boosted mood and relationship feelings the next day. Men’s masturbation was linked to poorer relationship feelings.","clinical_takeaway":"Positive relational climate promotes sexual activity; relationship‑focused interventions may improve partners’ mood and intimacy.","confidence":0.7,"topic_tags":["sexual_function","relationships","masturbation","moral_incongruence"],"strengths":["Ecologically valid daily diary method","Bidirectional temporal analyses","Separate assessment of solitary vs dyadic sexual activity"],"limitations":["Reliance on self‑report items without validated scales","No assessment of moral or mental‑health confounds","Sample size and representativeness unclear"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":23,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.13050"}},{"id":3908,"doi":"10.1007/s13224-021-01608-5","pmid":"35928074","pmcid":"PMC9343504","title":"CYP24A1 Gene Expression in Spermatozoa of Human and Other Oxidation Level Controlling Enzymes as Biomarkers of Infertility","authors":"Helmi ZR, Hameed BH.","first_author":"Helmi ZR","journal":"Journal of obstetrics and gynaecology of India","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Spermatozoa","Male fertility","Assisted reproductive technology","General Genetics"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control study of 50 infertile men versus 50 volunteers, semen collected by masturbation, biomarker assays","sample_n":100,"sample_text":"50 infertile men, 50 young volunteers from the general Iraqi population","population":"men, 18‑45 y, Iraqi","country":"Iraq","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers measured a gene (CYP24A1) and oxidative‑stress chemicals in sperm and blood of 50 infertile men and 50 fertile volunteers. The infertile group showed higher CYP24A1 expression and oxidative stress, suggesting these markers might help predict male infertility.","clinical_takeaway":"CYP24A1 and oxidative‑stress levels could assist in evaluating unexplained male infertility, but further validation is needed.","confidence":0.8,"topic_tags":["gender"],"strengths":["Use of validated molecular assays (ELISA, qPCR)","Direct measurement of oxidative stress biomarkers","Clear case‑control comparison"],"limitations":["Cross‑sectional design limits causal inference","Potential selection bias (clinic patients vs volunteers)","No adjustment for lifestyle or health confounders"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13224-021-01608-5"}},{"id":3909,"doi":"10.1186/s12889-021-12390-4","pmid":"35086497","pmcid":"PMC8794736","title":"Effects of the COVID-19 pandemic on sexual functioning and activity: a systematic review and meta-analysis","authors":"Masoudi M, Maasoumi R, Bragazzi NL.","first_author":"Masoudi M","journal":"BMC public health","year":2022,"pub_types":["Meta-Analysis","research-article","Systematic Review","Journal Article"],"keywords":["Systematic Review And Meta-analysis","Viral Outbreak","Covid-19 Pandemic","Sexual Functioning And Activity"],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-021-12390-4","cited_by_count":82,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Meta-analysis of 21 cross‑sectional studies reporting pre‑post sexual function scores (FSFI, IIEF‑5) before and during COVID‑19.","sample_n":6220,"sample_text":"Total participants across included studies.","population":"Adults (2454 women, 3765 men) from various countries; convenience samples in primary studies.","country":"Multiple (global)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 21 studies found that during COVID‑19 lockdowns people reported worse sexual function and fewer sexual encounters, with a larger decline for women than men. Masturbation frequency rose, but the review does not examine why these changes occurred.","clinical_takeaway":"COVID‑related stress may reduce sexual functioning; clinicians should assess pandemic impacts when addressing sexual health concerns.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses validated sexual function scales (FSFI, IIEF‑5).","Random‑effects meta‑analysis with confidence intervals.","Includes both genders and reports gender‑specific effects."],"limitations":["Primary studies are largely convenience samples with limited control of psychosocial confounds.","No adjustment for moral/religious attitudes or mental‑health variables.","Potential heterogeneity across countries and pandemic phases not fully explored."],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":0,"mentioning":72,"citing_publications":135,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-021-12390-4"}},{"id":3911,"doi":"10.1080/00224499.2022.2027855","pmid":"35081013","pmcid":null,"title":"A Learning Experience? Enjoyment at Sexual Debut and the Gender Gap in Sexual Desire among Emerging Adults","authors":"Peragine DE, Skorska MN, Maxwell JA, Impett EA, VanderLaan DP.","first_author":"Peragine DE","journal":"Journal of sex research","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective questionnaire of 838 emerging adults reporting on first sexual and masturbatory experiences and current sexual desire.","sample_n":838,"sample_text":"Emerging adults, N=838, retrospective self‑report","population":"Emerging adults (likely university/community sample), N=838","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 838 young adults, women who did not orgasm during their first heterosexual intercourse reported lower sexual desire later in life, whereas satisfaction at debut did not show this pattern. Men’s desire was unrelated to these debut experiences.","clinical_takeaway":"Ensuring orgasm at first intercourse may help support later sexual desire in women.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Large sample (N>800)","Addresses an understudied “enjoyment gap”","Includes both orgasm and satisfaction dimensions"],"limitations":["Retrospective self‑report susceptible to recall bias","Limited measurement of confounding variables (mental health, relationship context)","Cross‑sectional design cannot establish causality"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2027855"}},{"id":3912,"doi":"10.3390/ijerph19031366","pmid":"35162388","pmcid":"PMC8834747","title":"What One Gets Is Not Always What One Wants-Young Adults' Perception of Sexuality Education in Poland","authors":"Izdebski Z, Dec-Pietrowska J, Kozakiewicz A, Mazur J.","first_author":"Izdebski Z","journal":"International journal of environmental research and public health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Parents","Poland","Adolescents","Sexual Health","Sexuality Education","Gender Analysis"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/3/1366/pdf?version=1643192468","cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 595 Polish young adults (18‑26 y) assessing retrospectively reported sexuality‑education experiences at school and with parents.","sample_n":595,"sample_text":"N = 595 respondents, ages 18‑26, surveyed in 2017.","population":"Young adults (18‑26 y) from Poland, recruited for an online/face‑to‑face questionnaire; not a probability sample.","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2022 Polish survey of 595 young adults found that many received little or no formal sexuality education at school and rarely talked with parents about sex. Topics like puberty and contraception were common, while sexual pleasure and masturbation were rarely discussed. Better knowledge was linked to more varied conversations with mothers (for girls) or fathers (for boys).","clinical_takeaway":"Improving both school curricula and parent‑child communication may close gaps in young adults’ sexual knowledge.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑country survey","Focus on both school and parental influences","Gender‑specific analyses (girls vs. boys)"],"limitations":["Cross‑sectional, retrospective self‑report","Convenience sampling, limited generalisability","Education‑quality items appear ad‑hoc, not validated"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph19031366"}},{"id":3913,"doi":"10.1007/s10508-021-02158-7","pmid":"35022910","pmcid":null,"title":"Feminist Identity and Sexual Behavior: The Intimate Is Political","authors":"Fetner T.","first_author":"Fetner T.","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexuality","Gender","Sexual behavior","Oral Sex","Feminist Identity","Clitoral Stimulation"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Representative national survey of adult Canadian women (N=1126) using ordinal logistic and logistic regression analyses.","sample_n":1126,"sample_text":"Representative survey of adult Canadian women (N=1126)","population":"Adult Canadian women, community sample, representative","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative survey of Canadian women, those who identified as feminists were more likely to have recently masturbated and to engage in a wider range of partnered sexual activities such as anal play, kissing, cuddling, massage, and receiving oral sex.","clinical_takeaway":"None – findings describe patterns of sexual behavior, not clinical implications.","confidence":0.8,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Large, nationally representative sample","Appropriate statistical models for ordinal outcomes","Separate measurement of solo and partnered sexual behaviors"],"limitations":["Cross‑sectional design limits causal inference","Feminist identity measured by a single self‑label item","Potential unmeasured confounders (mental health, relationship context)"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02158-7"}},{"id":3914,"doi":"10.1016/j.jamda.2015.08.013","pmid":"26441358","pmcid":null,"title":"Sex in Nursing Homes: A Survey of Nursing Home Policies Governing Resident Sexual Activity","authors":"Lester PE, Kohen I, Stefanacci RG, Feuerman M.","first_author":"Lester PE","journal":"Journal of the American Medical Directors Association","year":2016,"pub_types":["Journal Article"],"keywords":["Sexuality","Elderly","Dementia","Masturbation","Nursing Home"],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 366 directors of nursing across the United States; online questionnaire about facility policies and experiences with resident sexual activity and masturbation.","sample_n":366,"sample_text":"366 directors of nursing completed the online national survey.","population":"Directors of Nursing (DONs) at skilled nursing facilities in the United States (N=366).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2016 US survey of 366 nursing home directors found that most facilities encounter resident sexual activity and masturbation, yet many lack clear policies. Over half require family approval for cognitively impaired residents, and a minority have written rules about sexual activity.","clinical_takeaway":"Nursing homes should develop and communicate clear, resident‑centered sexual activity policies to support safe and consensual intimacy.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large national sample of nursing home administrators","Addresses an understudied area of resident sexual rights","Provides concrete data on policy prevalence"],"limitations":["Self‑reported data from directors may miss resident perspectives","Survey items not validated","Potential response bias – facilities with strong opinions may be over‑represented"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":68,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jamda.2015.08.013"}},{"id":3917,"doi":"10.1007/s10508-021-02265-5","pmid":"34981257","pmcid":"PMC8722645","title":"Sex and Relationships Pre- and Early- COVID-19 Pandemic: Findings from a Probability Sample of U.S. Undergraduate Students","authors":"Herbenick D, Hensel DJ, Eastman-Mueller H, Beckmeyer J, Fu TC, Guerra-Reyes L, Rosenberg M.","first_author":"Herbenick D","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Relationships","Sexual behavior","Coronavirus","Living Arrangements","College Students","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8722645","cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two-wave probability sample of U.S. undergraduates (N≈5,000 initial, 2,137 completed both waves) assessing sexual behaviors before and during COVID‑19 campus closures.","sample_n":2137,"sample_text":"Undergraduate students who completed both survey waves.","population":"Undergraduate students at a large Midwestern U.S. university (mean age 20.9, 49.8% women).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A two‑wave survey of U.S. college students showed that during campus closures caused by COVID‑19, partnered sexual activity (oral, vaginal, anal) decreased, while solo masturbation and sexting stayed the same. Sex that did occur was more likely with a cohabiting partner and rated as more wanted and intimate.","clinical_takeaway":"Clinicians should note that pandemic‑related disruptions may reduce partnered sex but not solo sexual activity, and that intimacy can persist when partners co‑habit.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function","relationships"],"strengths":["Large probability sample","Longitudinal within‑subject design","Timely data on pandemic‑related changes"],"limitations":["Self‑report measures, likely ad‑hoc","No assessment of key confounds (e.g., mental health, moral attitudes)","Limited to one university, may not generalize nationally"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":1,"mentioning":46,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02265-5"}},{"id":3918,"doi":"10.1080/13691050902912775","pmid":"19484637","pmcid":null,"title":"Gender, self and pleasure: young women's discourse on masturbation in contemporary Shanghai","authors":"Yuxin P, Ho Sik Ying P.","first_author":"Yuxin P","journal":"Culture, health & sexuality","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"In‑depth interviews with 40 young Shanghai women (ages 22‑39) exploring personal understandings and experiences of masturbation.","sample_n":40,"sample_text":"Forty young women, ages 22‑39, recruited in Shanghai (May 2004‑July 2007).","population":"young adult women in Shanghai, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 40 young women in Shanghai reveal how they talk about and understand masturbation, showing how personal narratives help shape their gender and sexual identities in a rapidly changing city.","clinical_takeaway":"Clinicians should recognize that women’s experiences of masturbation are shaped by cultural narratives and personal identity, not simply by biological factors.","confidence":0.8,"topic_tags":["masturbation","gender","sexual_function"],"strengths":["Rich, in‑depth qualitative data","Focus on cultural context of Shanghai women","Provides nuanced insight into self‑articulation and gender"],"limitations":["Small, non‑representative convenience sample","No quantitative measures or validated scales","Limited discussion of potential confounds (e.g., moral/religious views)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691050902912775"}},{"id":3919,"doi":null,"pmid":"35173076","pmcid":null,"title":"[Impact of isolation by Sars-CoV-2 on Sexuality. Results of an investigation in Argentina.]","authors":"Gandara MLM, Bechara A, Magirena S, Helien A, Nevisardi C, Garcia Penela E, Storino C, De Bonis W.","first_author":"Gandara MLM","journal":"Archivos espanoles de urologia","year":2022,"pub_types":["Journal Article"],"keywords":["Isolation","Sexuality","Pandemic","Sexualidad","Pandemia","Aislamiento"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"anonymous online questionnaire, N=2214 adults in Argentina during COVID‑19 isolation, descriptive analyses of sexual behaviour changes","sample_n":2214,"sample_text":"2214 surveys collected from adults in mandatory social isolation (Argentina, March–June 2020)","population":"adults in Argentina (self‑selected online respondents)","country":"Argentina","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"An online survey of 2214 Argentine adults found that COVID‑19 lockdown altered sexual behaviour: cohabiting couples reported both increases and decreases in intercourse, while people living alone masturbated more and used virtual sex more often. Children at home and longer lockdown were linked to less intercourse.","clinical_takeaway":"Clinicians should expect varied sexual changes during lockdown and proactively discuss coping strategies with couples and individuals living alone.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Large sample size (>2000)","Timely assessment during early pandemic","Includes diverse gender identities"],"limitations":["Convenience online sample, not representative","No validated sexual behaviour scales","Cross‑sectional, cannot infer causality","Limited control of psychological confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":3920,"doi":"10.1093/humrep/deab240","pmid":"34791270","pmcid":"PMC8804334","title":"Histological study on the influence of puberty suppression and hormonal treatment on developing germ cells in transgender women","authors":"de Nie I, Mulder CL, Meißner A, Schut Y, Holleman EM, van der Sluis WB, Hannema SE, den Heijer M, Huirne J, van Pelt AMM, van Mello NM.","first_author":"de Nie I","journal":"Human reproduction (Oxford, England)","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Germ cells","Spermatogenesis","Azoospermia","orchiectomy","Hormonal Treatment","Fertility Preservation","Testicular Tissue","Transgender Women"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8804334","cited_by_count":35,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational histological study of orchiectomy specimens from 214 transgender women, analysed with logistic regression.","sample_n":214,"sample_text":"214 transgender women","population":"Transgender women undergoing gender‑affirming surgery (gGAS) in the Netherlands, 2006‑2018.","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 214 transgender women who had gender‑affirming surgery, most orchiectomy specimens still contained immature germ cells, and a small minority (4.7%) had mature sperm, showing that fertility preservation is often still possible after puberty suppression or hormone therapy.","clinical_takeaway":"Transgender women may retain viable germ cells for future fertility options even after hormonal treatment.","confidence":0.7,"topic_tags":["gender","sexual_function","religiosity","moral_incongruence","masturbation"],"strengths":["Large sample for a histological study","Validated histological grading (Johnsen score)","Clear clinical relevance for fertility preservation"],"limitations":["No measurement of serum hormone levels at surgery","Observational design cannot establish causality","No pre‑registration"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":9,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":37,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/humrep/deab240"}},{"id":3921,"doi":"10.12998/wjcc.v10.i3.1024","pmid":"35127916","pmcid":"PMC8790445","title":"Concomitant Othello syndrome and impulse control disorders in a patient with Parkinson's disease: A case report","authors":"Xu T, Li ZS, Fang W, Cao LX, Zhao GH.","first_author":"Xu T","journal":"World journal of clinical cases","year":2022,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Case Report","Parkinson’s Disease","Impulse Control Disorders","Hypersexuality","Othello Syndrome","Delusional Jealousy"],"is_oa":true,"oa_url":"https://doi.org/10.12998/wjcc.v10.i3.1024","cited_by_count":5,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single-patient clinical description of Parkinson’s disease with Othello syndrome and hypersexuality","sample_n":1,"sample_text":"N=1 (case report)","population":"70‑year‑old male with Parkinson’s disease","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 70‑year‑old man with Parkinson’s disease developed delusional jealousy (Othello syndrome) and increased sexual activity, including frequent masturbation. Reducing his dopamine agonist and adding quetiapine reduced these symptoms.","clinical_takeaway":"In Parkinson’s patients, dopamine agonists can trigger hypersexuality and delusional jealousy; medication review may alleviate symptoms.","confidence":0.4,"topic_tags":["pornography","masturbation","sexual_function","neuroscience"],"strengths":["Detailed clinical description","Links symptom change to medication adjustment"],"limitations":["Single case, no systematic assessment","No validated measures of hypersexuality or distress","No control for potential confounds"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12998/wjcc.v10.i3.1024"}},{"id":3923,"doi":"10.1136/sextrans-2021-055210","pmid":"34916335","pmcid":"PMC8687784","title":"Impacts of COVID-19 on sexual behaviour in Britain: findings from a large, quasi-representative survey (Natsal-COVID)","authors":"Mercer CH, Clifton S, Riddell J, Tanton C, Freeman L, Copas AJ, Dema E, Bosó Pérez R, Gibbs J, Macdowall W, Menezes D, Ridge MC, Bonell C, Sonnenberg P, Field N, Mitchell KR.","first_author":"Mercer CH","journal":"Sexually transmitted infections","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual behaviour","Sexual Partners","Sexual Health","Covid-19"],"is_oa":true,"oa_url":"https://sti.bmj.com/content/sextrans/early/2021/12/14/sextrans-2021-055210.full.pdf","cited_by_count":44,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Weighted web‑panel survey of 6,654 British adults (18‑59) conducted July/August 2020; quota sampling to approximate population distributions; multivariable regression adjusting for opportunity, gender, age.","sample_n":6654,"sample_text":"quota‑based web panel, weighted to reflect UK population demographics","population":"British adults 18‑59, quota‑based quasi‑representative sample, N=6654","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A British survey of 6,600 adults found that after the first COVID‑19 lockdown, most people kept having sex, but fewer non‑cohabiting and younger adults reported declines in how often they had sex and how satisfied they felt.","clinical_takeaway":"Monitor younger, non‑cohabiting clients for possible drops in sexual frequency and satisfaction after pandemic restrictions.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Large, quasi‑representative sample","Weighted analyses improve population inference","Separate measurement of partnered vs non‑partnered activities"],"limitations":["Self‑report only; no validated sexual‑function scales","Cross‑sectional; cannot infer causality","Limited control for mental‑health or moral/religious factors"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":7,"contrasting":0,"mentioning":49,"citing_publications":78,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sextrans-2021-055210"}},{"id":3924,"doi":"10.1097/jcp.0000000000000363","pmid":"26066339","pmcid":null,"title":"Compulsive Masturbation With Pramipexole for Antidepressant Augmentation in Major Depression: A Case Report","authors":"Rocha FL, Hara C.","first_author":"Rocha FL","journal":"Journal of clinical psychopharmacology","year":2015,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/jcp.0000000000000363"}},{"id":3925,"doi":"10.1016/j.esxm.2021.100463","pmid":"34894607","pmcid":"PMC8847830","title":"Premature Ejaculation Among Internet Users Living in the Metropolitan Region of São Paulo, Brazil: A Cross-Sectional Comparison Between the Premature Ejaculation Diagnostic Tool (PEDT) and Patient-Reported Latency Time and Perception","authors":"Dos Reis MMF, Barros EAC, Monteiro L, Pazeto CL, Baccaglini W, Glina S.","first_author":"Dos Reis MMF","journal":"Sexual medicine","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Sexual Health","Premature Ejaculation","Diagnostic Self Evaluation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8847830","cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"web‑based anonymous survey of adult men in São Paulo; multinomial regression and kappa used to compare PEDT categories with self‑reported latency and self‑perception.","sample_n":null,"sample_text":"Not reported in abstract; likely several hundred given online recruitment.","population":"Internet users, aged ≥18, living in metropolitan São Paulo (convenience sample).","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed Brazilian men online to see how different ways of defining premature ejaculation (a questionnaire, recalled ejaculation time, and personal judgment) agree. The tools identified different groups, with only fair agreement between them, suggesting each captures a distinct aspect of the condition.","clinical_takeaway":"Clinicians should use multiple assessment methods—not just a single questionnaire—to diagnose premature ejaculation and guide treatment.","confidence":0.6,"topic_tags":["sexual_function","prevalence","measurement"],"strengths":["Validated PE screening tool (PEDT)","Comparison of three assessment methods","Multinomial regression with confidence intervals"],"limitations":["Convenience internet sample – limited generalisability","No adjustment for mental‑health or relationship variables","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2021.100463"}},{"id":3926,"doi":"10.3389/fpsyg.2021.723449","pmid":"34925132","pmcid":"PMC8677662","title":"Individual Differences in Testosterone and Self-Control Predict Compulsive Sexual Behavior Proneness in Young Males","authors":"Rodríguez-Nieto G, Dewitte M, Sack AT, Schuhmann T.","first_author":"Rodríguez-Nieto G","journal":"Frontiers in psychology","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Testosterone","Masturbation","Self-control","Compulsive Sexual Behavior","Sexual Compulsivity","Sexual Inhibition","Sexual Excitation","Intercourse"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8677662","cited_by_count":7,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional correlational survey of 70 healthy young males measuring testosterone, self‑control, sexual excitation/inhibition and sexual compulsivity via questionnaires","sample_n":70,"sample_text":"Seventy healthy young males provided a saliva sample and completed questionnaires.","population":"young adult males (healthy, non‑clinical)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 70 young men, higher testosterone and lower self‑control were linked to higher sexual compulsivity scores, while testosterone and lower sexual inhibition predicted less partnered sex. The study suggests hormonal and psychological traits together influence risky sexual tendencies.","clinical_takeaway":"Higher testosterone and low self‑control may signal greater risk for compulsive sexual thoughts, but findings are correlational and not yet actionable for treatment.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Biological measure of testosterone adds objective data","Use of validated psychometric scales for key constructs","Investigates interaction of hormonal and psychological traits"],"limitations":["Cross‑sectional design cannot establish causality","No assessment of moral incongruence or other key confounds","Sample limited to healthy young males, limiting generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2021.723449"}},{"id":3927,"doi":"10.3758/s13415-021-00960-3","pmid":"34811707","pmcid":"PMC8983533","title":"μ-opioid receptor availability is associated with sex drive in human males","authors":"Nummenmaa L, Jern P, Malén T, Kantonen T, Pekkarinen L, Lukkarinen L, Sun L, Nuutila P, Putkinen V.","first_author":"Nummenmaa L","journal":"Cognitive, affective & behavioral neuroscience","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Neurotransmission","PET","Opioids","Vbm","Sex Drive"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.3758/s13415-021-00960-3.pdf","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"PET imaging of μ‑opioid receptor availability (n=52 healthy males) correlated with self‑reported frequency of partnered sex and masturbation; Bayesian hierarchical regression and voxel‑based morphometry performed.","sample_n":52,"sample_text":"52 healthy male participants","population":"healthy adult males (n=52) recruited for neuroimaging; no clinical or treatment‑seeking sample","country":"unspecified (likely Finland, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 52 healthy men, higher brain μ‑opioid receptor availability measured with PET was linked to more frequent sexual activity and masturbation, suggesting the opioid system may influence how often men engage in sex.","clinical_takeaway":"Endogenous opioid tone appears related to individual variation in male sex drive, but findings are correlational and not ready for clinical use.","confidence":0.8,"topic_tags":["neuroscience","sexual_function","moral_incongruence"],"strengths":["Use of PET with a high‑affinity MOR ligand provides direct neurochemical measurement","Inclusion of both partnered sex and masturbation in the behavioural outcome","Bayesian hierarchical modelling adds robustness to inference"],"limitations":["Cross‑sectional design precludes causal conclusions","Modest sample size for whole‑brain PET analyses","Potential confounds (e.g., mental health, relationship status) not assessed"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":6,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":8,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3758/s13415-021-00960-3"}},{"id":3928,"doi":"10.1353/bsr.2021.0008","pmid":"39479534","pmcid":"PMC11524154","title":"Black Women's Pleasure Mapping","authors":"Thorpe S, Dogan JN, Townes A, Malone N, Jester JK, Hargons CN.","first_author":"Thorpe S","journal":"Journal of black sexuality and relationships","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexual activities","Black Women","Pleasure","Black Feminist Thought","Pleasure Mapping"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 215 Black women in the Southern United States examining self‑reported pleasurable sexual activities.","sample_n":215,"sample_text":"N=215 Black women living in the South","population":"Black women (N=215) recruited in the South, likely convenience sampling.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study asked 215 Black women in the US South to list the sexual activities they find most pleasurable, identifying 78 activities grouped into nine themes such as oral sex, masturbation, and shared intimacy. The authors propose a \"pleasure mapping\" method for educators.","clinical_takeaway":"Clinicians can use the identified pleasure themes to better understand and discuss diverse sources of sexual enjoyment with Black women clients.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample for a qualitative mapping study","Grounded in Black feminist theoretical framework","Provides novel descriptive taxonomy of pleasure activities"],"limitations":["Convenience, non‑representative sample limits generalisability","No validated measurement instruments; relies on self‑generated activity lists","No statistical modelling of predictors or outcomes"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1353/bsr.2021.0008"}},{"id":3930,"doi":"10.1108/ijph-05-2021-0039","pmid":"34784119","pmcid":null,"title":"Sexual and reproductive health of incarcerated women in French Guiana: a qualitative approach","authors":"Deboscker F, Nacher M, Adenis A, Huber F, Lucarelli A, Asensio L, Daniel M, Schiemsky V, Bonifay T.","first_author":"Deboscker F","journal":"International journal of prisoner health","year":2022,"pub_types":["Journal Article"],"keywords":["Women","Reproductive Health","Sexual Health","Health Promotion","Qualitative Research","Prison","Jail","Women Prisoners","Health In Prison","Women-s Health"],"is_oa":false,"oa_url":"https://dumas.ccsd.cnrs.fr/dumas-04165125/file/ThEse__Deboscker_Flore.pdf","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Semi‑structured interviews with 14 incarcerated women; interpretative phenomenological analysis.","sample_n":14,"sample_text":"Convenience sample of women prisoners; not representative of all incarcerated women.","population":"Adult French‑speaking women incarcerated ≥4 months in a French Guianan prison (N=14).","country":"French Guiana","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 14 women in a French Guianan prison reveal menstrual problems, limited sexual health knowledge, and some intra‑prison sexual activity, including masturbation and consensual same‑sex encounters, often accompanied by discrimination.","clinical_takeaway":"Healthcare providers should address menstrual care, contraception, and safe sexual practices for incarcerated women, recognizing the hidden sexual activity and its risks.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Provides rare qualitative insight into incarcerated women's SRH experiences","Uses interpretative phenomenological analysis to capture lived meanings","Highlights neglected topics such as menstrual insecurity and intra‑prison sexuality"],"limitations":["Very small, non‑representative sample (N=14)","No validated measurement instruments; findings are descriptive","No measurement or control of mental‑health, trauma, or moral variables"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1108/ijph-05-2021-0039"}},{"id":3931,"doi":null,"pmid":"20043585","pmcid":null,"title":"[Case report of live threatening complications due to self insertion of foreign body into the vagina for masturbation purpose]","authors":"Kuzaka B, Kobryń A, Niemierko M, Czaplicki M.","first_author":"Kuzaka B","journal":"Przeglad lekarski","year":2009,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with medical complications after self‑insertion of a foreign body for masturbation","sample_n":1,"sample_text":"N=1 (case report)","population":"single middle‑aged female patient","country":"Poland (inferred from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2009 case report describes a woman who inserted a large foreign object into her vagina for masturbation, leading to bladder perforation, peritonitis, and kidney failure requiring dialysis.","clinical_takeaway":"Self‑insertion of objects for sexual stimulation can cause life‑threatening complications; clinicians should assess and counsel patients on safer practices.","confidence":0.9,"topic_tags":["masturbation","sexual_function"],"strengths":["Detailed clinical description of a rare, severe complication","Provides imaging and surgical findings"],"limitations":["Single case, no systematic data","No measurement of psychological constructs or confounds","No control or comparative data"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":3932,"doi":"10.1007/s40617-015-0062-3","pmid":"27920970","pmcid":"PMC5118249","title":"A Review and Treatment Selection Model for Individuals with Developmental Disabilities Who Engage in Inappropriate Sexual Behavior","authors":"Davis TN, Machalicek W, Scalzo R, Kobylecky A, Campbell V, Pinkelman S, Chan JM, Sigafoos J.","first_author":"Davis TN","journal":"Behavior analysis in practice","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Masturbation","Developmental Disability","Disrobing","Treatment Review","Inappropriate Sexual Behavior","Treatment Selection Model"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of behavioral treatment studies; no systematic search or risk‑of‑bias assessment reported","sample_n":null,"sample_text":"Not applicable – review of published studies","population":"individuals with developmental disabilities who display inappropriate sexual behaviours (e.g., public masturbation, disrobing, non‑consensual touching)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews behavioural interventions used to reduce inappropriate sexual behaviours—like public masturbation—in people with developmental disabilities and proposes a model to help caregivers choose suitable treatments.","clinical_takeaway":"Clinicians can use the proposed model as a guide, but should seek evidence‑based details from the original treatment studies.","confidence":0.4,"topic_tags":["sexual_function","treatment"],"strengths":["Addresses an under‑researched population","Provides a practical treatment‑selection framework for clinicians"],"limitations":["Not a systematic review; no explicit search strategy or bias assessment","No quantitative synthesis; relies on narrative summary","Constructs and outcomes are not clearly operationalised"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40617-015-0062-3"}},{"id":3933,"doi":null,"pmid":"26242134","pmcid":null,"title":"[Treatment of Masturbation Syndrome by Nourishing Yin Lowering Fire Method: a Case Report in One Child]","authors":"Wu J, Shi YM.","first_author":"Wu J","journal":"Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine","year":2015,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":3934,"doi":"10.17269/s41997-021-00566-9","pmid":"34731488","pmcid":"PMC8565172","title":"Partner number and use of COVID-19 risk reduction strategies during initial phases of the pandemic in British Columbia, Canada: a survey of sexual health service clients","authors":"Gilbert M, Chang HJ, Ablona A, Salway T, Ogilvie G, Wong J, Campeau L, Worthington C, Grace D, Grennan T.","first_author":"Gilbert M","journal":"Canadian journal of public health = Revue canadienne de sante publique","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual behaviour","Public Health","Health Promotion","Covid-19"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.17269/s41997-021-00566-9.pdf","cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"email survey of sexual health service clients (N=1196) conducted July‑August 2020; self‑report of number of partners since pandemic start and risk‑reduction strategies; bivariate logistic regression analysis.","sample_n":1196,"sample_text":"final analytic sample of 1196 respondents (convenience sample of existing service clients).","population":"sexual health service clients in British Columbia, Canada (mostly adult men, including MSM; includes single and open‑relationship participants).","country":"Canada","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,196 sexual‑health service clients in British Columbia found that 42 % reported two or more sexual partners during the early COVID‑19 pandemic. Those with more partners—especially men who have sex with men, single people, and those in open relationships—were also more likely to use strategies such as masturbation or limiting sex to a “bubble” to reduce infection risk.","clinical_takeaway":"Clients with multiple partners often employed harm‑reduction tactics (e.g., masturbation, ‘bubble’ sex); clinicians can support these strategies while addressing pandemic‑related stigma.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for a survey of this niche group","Focus on a timely public‑health issue (COVID‑19 and sexual behaviour)","Clear description of partner‑number categories and associated risk‑reduction behaviours"],"limitations":["Convenience sample of sexual‑health service clients limits generalisability","No validated scales for risk‑reduction behaviours or partner count","Cross‑sectional design; cannot infer causality"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.17269/s41997-021-00566-9"}},{"id":3935,"doi":"10.3760/cma.j.cn112338-20210114-00037","pmid":"34818835","pmcid":null,"title":"[Cluster analysis on survey of sexual health characteristics and health education demands in young students]","authors":"Luo YF, Fan LR, Chen YC, Gu YZ, Cai YS, Han ZG, He WY, Yao ZL, Liang QE, Liu FH, Du YY, Xu HF.","first_author":"Luo YF","journal":"Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 3,884 Chinese students (convenience sample); two‑step cluster analysis to identify three risk groups based on six self‑report variables (masturbation, sexual behavior, etc.).","sample_n":3884,"sample_text":"Conveniently sampled students; not nationally representative; no random selection.","population":"young students (mean age ≈19, secondary and post‑secondary education) in Guangdong province, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 3,884 Chinese students grouped them into high, medium and low sexual‑health risk categories based on masturbation, sexual behavior and knowledge. Each group showed different education needs, suggesting tailored health programmes could be more effective.","clinical_takeaway":"Tailor sexual‑health education to students’ risk profiles; high‑risk youths need more information on safety, contraception and STI prevention.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size (N ≈ 4 k)","Uses clustering to identify distinct risk profiles","Provides concrete education‑demand information for different groups"],"limitations":["Convenience sampling limits generalisability","Self‑report items appear ad‑hoc, not validated scales","No control for moral, mental‑health or relationship confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3760/cma.j.cn112338-20210114-00037"}},{"id":3937,"doi":"10.1007/s10508-015-0531-3","pmid":"25953422","pmcid":null,"title":"Male Escorts' and Male Clients' Sexual Behavior During Their Last Commercial Sexual Encounter: Comparing and Contrasting Findings from Two Online Studies","authors":"Grov C, Rodríguez-Díaz CE, Jovet-Toledo GG.","first_author":"Grov C","journal":"Archives of sexual behavior","year":2016,"pub_types":["Comparative Study","Journal Article"],"keywords":["Sexual behavior","Clients","Sex Work","Gay And Bisexual Men","Escorting"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two separate online surveys (clients n=495, escorts n=387) using identical self‑report items about the most recent commercial sexual encounter; logistic regression compared 15 behaviors.","sample_n":882,"sample_text":"Clients (n=495) and escorts (n=387) completed online questionnaires.","population":"Male sex‑workers (escorts) and male clients of male sex‑workers, recruited via internet surveys in 2012‑2013.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Surveys of male sex‑workers and their clients show that most use condoms and that a wide range of low‑risk sexual activities occur during paid encounters, with few differences between the two groups.","clinical_takeaway":"Male‑male commercial encounters can involve diverse sexual acts but generally show low HIV‑risk behaviours such as condom use.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large combined sample for a hard‑to‑reach population","Direct comparison of client and escort reports using identical items","Use of multivariable logistic regression"],"limitations":["Convenience online recruitment limits generalisability","Behavioural items are study‑specific, not validated scales","No correction for multiple testing reported"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0531-3"}},{"id":3938,"doi":"10.1016/j.ejpn.2008.10.007","pmid":"19010071","pmcid":null,"title":"Hand activities in infantile masturbation: a video analysis of 13 cases","authors":"Hansen JK, Balslev T.","first_author":"Hansen JK","journal":"European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Retrospective video analysis of 13 infants (2 boys, 11 girls) describing hand activity patterns during episodes of infantile masturbation.","sample_n":13,"sample_text":"13 infants (2 boys, 11 girls)","population":"Infants presenting with masturbation-like episodes; hospital video recordings.","country":"Denmark (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined video recordings of 13 infants during episodes of self-stimulating behavior, identifying five distinct hand movement patterns that may help clinicians distinguish normal infant masturbation from seizures.","clinical_takeaway":"Recognizing specific hand activity patterns can reduce unnecessary medical testing for infants who exhibit self‑stimulating behavior.","confidence":0.8,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Detailed observational description of hand movements","Potential clinical relevance for differential diagnosis"],"limitations":["Very small, non-representative sample","No control group or statistical analysis","Findings may not generalize beyond observed cases"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":1,"mentioning":18,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ejpn.2008.10.007"}},{"id":3944,"doi":"10.1111/jsr.13504","pmid":"34664333","pmcid":null,"title":"Associations between tactile intimacy and sleep quality in healthy adults: A systematic review","authors":"Dueren AL, Perach R, Banissy JFM, Bowling NC, Gregory AM, Banissy MJ.","first_author":"Dueren AL","journal":"Journal of sleep research","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":["Sexual behaviour","Co-sleep","Affective Touch","Sleep In Pairs"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"qualitative synthesis of 13 observational studies on tactile intimacy and sleep quality","sample_n":null,"sample_text":"13 studies met inclusion criteria; individual study sample sizes not reported in abstract","population":"healthy adults","country":"multiple (unspecified)","controls_mi":"not_applicable","preregistered":true,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A pre‑registered systematic review of 13 studies looked at whether different kinds of touch, including sexual intimacy, are linked to how well healthy adults sleep. Some studies found that sexual satisfaction and masturbation relate to better sleep, but overall results are mixed, especially between self‑reports and objective measures.","clinical_takeaway":"Touch, especially sexual intimacy, may influence sleep quality, but evidence is inconsistent; clinicians should consider individual differences rather than assuming a strong effect.","confidence":0.6,"topic_tags":["sexual_function","masturbation","treatment","moral_incongruence"],"strengths":["Pre-registered systematic review protocol (PROSPERO)","Comprehensive database search","Inclusion of both sexual and non‑sexual touch"],"limitations":["Qualitative synthesis only; no meta‑analysis or effect sizes","Lack of detailed assessment of measurement validity","Potential heterogeneity of included studies not quantified"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsr.13504"}},{"id":3945,"doi":"10.1080/00224499.2021.1968327","pmid":"34634954","pmcid":"PMC7613951","title":"Salivary Testosterone and Sexual Function and Behavior in Men and Women: Findings from the Third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3)","authors":"Macdowall WG, Clifton S, Palmer MJ, Tanton C, Copas AJ, Lee DM, Mitchell KR, Mercer CH, Sonnenberg P, Johnson AM, Wellings K.","first_author":"Macdowall WG","journal":"Journal of sex research","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://www.tandfonline.com/doi/pdf/10.1080/00224499.2021.1968327?needAccess=true","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"population-based survey with salivary testosterone assay and self‑reported sexual behavior/function","sample_n":1599,"sample_text":"1,599 men and 2,123 women (40.6% of invited participants) provided saliva samples","population":"Men (n≈1,599) and women (n≈2,123) aged 18‑74 from the British Natsal‑3 survey","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a UK national survey, higher saliva testosterone was linked to more frequent partnered sex and masturbation in men, and more masturbation in women, but showed little relationship to sexual function. The study adds population‑level data on hormone‑behavior links.","clinical_takeaway":"Testosterone levels show modest associations with sexual activity frequency but not with sexual function; they should not guide clinical decisions about sexual health.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Objective hormonal assay (mass spectrometry)","Separate assessment of masturbation and partnered sex"],"limitations":["Cross‑sectional; cannot infer causality","Sexual function measures not described as validated","Limited control for psychological confounds (e.g., mental health, moral factors)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2021.1968327"}},{"id":3946,"doi":"10.1556/oh.2015.30131","pmid":"25845321","pmcid":null,"title":"[Symptomatology and treatment of persistent genital arousal disorder. Case report]","authors":"Erős E, Brockhauser I, Pólyán E.","first_author":"Erős E","journal":"Orvosi hetilap","year":2015,"pub_types":["Journal Article","Case Reports"],"keywords":["Sexual Arousal","Psychological Distress","Orgasm","Female Sexuality","Lelki Szenvedés","Női Szexualitás","Orgazmus","Persistent Genital Arousal Syndrome","Szexuális Izgalom","Állandó Genitális Izgalom Szindróma (Pgad)"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"hun","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single female with persistent genital arousal disorder (PGAD) with treatment summary","sample_n":1,"sample_text":"one case","population":"single adult female patient with PGAD","country":"Hungary (implied by authors, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article describes one woman's experience with persistent genital arousal disorder, a rare condition causing unwanted sexual arousal without desire, and reviews possible causes and treatments.","clinical_takeaway":"PGAD can cause severe distress; treatment may involve medication and CBT, but evidence is limited.","confidence":0.4,"topic_tags":["sexual_function","gender","pornography","masturbation"],"strengths":["Detailed clinical description of a rare condition","Discussion of treatment options"],"limitations":["Single case; no generalizability","No validated measurement instruments reported","No control of confounding variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/oh.2015.30131"}},{"id":3947,"doi":"10.1017/s002572730000658x","pmid":null,"pmcid":"PMC2948711","title":"Book Reviews : The secret vice: masturbation in Victorian fiction and medical culture","authors":null,"first_author":null,"journal":"Medical history","year":2010,"pub_types":["book-review","Book Review"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s002572730000658x"}},{"id":3949,"doi":"10.1080/14647273.2021.1969042","pmid":"34583622","pmcid":null,"title":"The effects of tobacco and cannabis use on semen and endocrine parameters in infertile males","authors":"Khan N, Shah M, Malik MO, Badshah H, Habib SH, Shah I, Shah FA.","first_author":"Khan N","journal":"Human fertility (Cambridge, England)","year":2023,"pub_types":["Journal Article"],"keywords":["Sex hormones","Semen","Tobacco","Infertility","Marijuana"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Four-group observational comparison of infertile men (n=160) assessing semen and hormone outcomes.","sample_n":160,"sample_text":"Infertile males recruited into four exposure groups (n=40 each) and a control group (n=40).","population":"infertile males, 40 per group (cigarette smokers, dipping tobacco users, cannabis users, controls)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 160 infertile men, those who smoked cigarettes, used dipping tobacco, or used cannabis showed small, mostly non‑significant changes in sperm counts and hormone levels compared with non‑users.","clinical_takeaway":"Chronic tobacco or cannabis use may slightly affect semen quality and hormones in infertile men, but effects appear modest.","confidence":0.78,"topic_tags":["treatment","religiosity","moral_incongruence","masturbation","sexual_function","gender"],"strengths":["Objective laboratory measurements of hormones and semen","Clear grouping by substance use","Adequate total sample size for exploratory comparisons"],"limitations":["Cross‑sectional design; cannot infer causality","No adjustment for key confounders (e.g., mental health, lifestyle)","Convenience sample of infertile patients limits generalisability"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/14647273.2021.1969042"}},{"id":3950,"doi":"10.1007/s10508-021-02068-8","pmid":"34561794","pmcid":null,"title":"Variations in Sexual Behaviors by Use of Specific Substances Among Vancouver Gay, Bisexual, and Other Men Who Have Sex with Men: An Event-Level Analysis","authors":"Aguilera-Mijares S, Sang JM, Wang L, Barath J, Card KG, Lachowsky NJ, Lal A, Roth E, Hogg RS, Moore DM.","first_author":"Aguilera-Mijares S","journal":"Archives of sexual behavior","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual behavior","Sexual Orientation","Substance Use","Gay And Bisexual Men","Event-level Data"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort with event‑level self‑reports of sexual acts and substance use; analyzed with multilevel mixed models","sample_n":11582,"sample_text":"11,582 sexual events reported by 762 participants","population":"GBMSM (n≈762) from Vancouver, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Vancouver cohort of gay and bisexual men, using drugs like poppers, meth, or MDMA during an encounter was linked to higher odds of condomless anal sex, group sex, and other risky sexual practices.","clinical_takeaway":"Substance use among GBMSM is associated with riskier sexual behaviours; clinicians should screen for sexualized drug use when assessing sexual health risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large event‑level dataset (11 k events)","Use of multivariable generalized linear mixed models to account for clustering","Prospective cohort provides temporal pairing of substance use and sexual acts"],"limitations":["Self‑report of sensitive behaviours; likely unvalidated single‑item measures","No measurement of key psychosocial confounds (mental health, morality, trauma)","Cross‑sectional event‑level analysis limits causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02068-8"}},{"id":3953,"doi":"10.1210/jc.2014-4264","pmid":"25658162","pmcid":null,"title":"Letter to the editor: Randolph J, et al. Masturbation frequency and sexual function domains are associated with serum reproductive hormone levels across the menopausal transition","authors":"Davis SR, Bell RJ.","first_author":"Davis SR","journal":"The Journal of clinical endocrinology and metabolism","year":2015,"pub_types":["Letter","Comment","Research Support, Non-U.S. Gov't"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1210/jc.2014-4264"}},{"id":3954,"doi":"10.1007/s00431-008-0766-2","pmid":"18575886","pmcid":null,"title":"Practical approach to childhood masturbation--a review","authors":"Mallants C, Casteels K.","first_author":"Mallants C","journal":"European journal of pediatrics","year":2008,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of literature without systematic methods.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Children (clinical context).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises what is known about childhood masturbation, noting that the line between normal and abnormal behaviour is unclear and that evidence is scarce, so clinicians should use a cautious, safety‑first approach.","clinical_takeaway":"Treat childhood masturbation cautiously; lack of solid evidence means clinicians should focus on safety and normal development.","confidence":0.8,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Addresses a clinically relevant gap.","Highlights lack of evidence and need for safety approach."],"limitations":["Narrative, not systematic; no methodological transparency.","No empirical data or standardized assessment tools discussed."],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":60,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00431-008-0766-2"}},{"id":3955,"doi":"10.1016/j.rbmo.2021.08.013","pmid":"34538752","pmcid":null,"title":"The dangers of being a sperm donor","authors":"Pennings G.","first_author":"Pennings G.","journal":"Reproductive biomedicine online","year":2021,"pub_types":["Journal Article"],"keywords":["stigma","Anonymity","Parenthood","Sperm Donation","Donor Status","Attributional Fatherhood"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"argumentative essay without empirical data","sample_n":null,"sample_text":"Not applicable – no empirical sample described","population":"adults considering or having been sperm donors (no sampling reported)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses why many men avoid sperm donation and why donors prefer anonymity, highlighting stigma and the belief that genetic link makes a man a father. It warns that growing social emphasis on genetics could increase these pressures.","clinical_takeaway":"Clinicians should recognize donor concerns about stigma and parental identity when counseling about assisted reproduction.","confidence":0.8,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Clear articulation of sociocultural stigma surrounding sperm donation","Identifies ethical tension between genetic and social fatherhood"],"limitations":["No empirical data; conclusions based on anecdotal observations","Lacks systematic assessment of donor attitudes or prevalence","Does not address potential confounding factors (e.g., religiosity, mental health)"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.rbmo.2021.08.013"}},{"id":3958,"doi":"10.1016/j.esxm.2021.100419","pmid":"34419691","pmcid":"PMC8498965","title":"Faking Orgasm: Relationship to Orgasmic Problems and Relationship Type in Heterosexual Women","authors":"Hevesi K, Horvath Z, Sal D, Miklos E, Rowland DL.","first_author":"Hevesi K","journal":"Sexual medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Women","Relationship Types","Pretending Orgasm","Orgasmic Difficulty","One-night Stands","Faking Orgasm"],"is_oa":true,"oa_url":"http://www.smoa.jsexmed.org/article/S2050116121000994/pdf","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,168 Hungarian women assessing orgasmic problems, masturbation, and faking orgasm across relationship types","sample_n":1168,"sample_text":"Hungarian women recruited for an online or questionnaire study (details not specified)","population":"heterosexual women, presumably community sample","country":"Hungary","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 1,000 Hungarian women, having trouble reaching orgasm – both during sex with a partner and during masturbation – was linked to more frequent faking of orgasm, especially across different types of relationships.","clinical_takeaway":"Women who experience orgasmic difficulty are more likely to fake orgasm; clinicians should assess underlying orgasmic issues rather than assume intentional deception.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Large community sample (N>1000)","Considers both partnered and solitary sexual contexts","Analyzes multiple relationship types"],"limitations":["Reliance on self‑report without validated scales reported","Cross‑sectional design limits causal inference","No assessment of mental‑health or trauma confounders"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2021.100419"}},{"id":3959,"doi":"10.1007/s13178-021-00625-3","pmid":"34457080","pmcid":"PMC8378841","title":"Sexual Behavior Change Among Gay and Bisexual Men During the First COVID-19 Pandemic Wave in the United States","authors":"McKay T, Henne J, Gonzales G, Gavulic KA, Quarles R, Gallegos SG.","first_author":"McKay T","journal":"Sexuality research & social policy : journal of NSRC : SR & SP","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sex","Sexual behavior","Coronavirus","United States","Public Health Policy","Men Who Have Sex With Men","Gay And Bisexual Men","Stay-at-home Order"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s13178-021-00625-3.pdf","cited_by_count":51,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 728 gay and bisexual men in the US conducted Apr‑May 2020; national convenience sample; self‑report of sexual behavior before and during COVID‑19 first wave.","sample_n":728,"sample_text":"national sample of 728 gay and bisexual men collected from April 10 to May 10, 2020","population":"gay and bisexual men (N=728) in the United States, recruited online during early COVID‑19 pandemic","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"During the first COVID‑19 wave, most gay and bisexual men in the US reduced in‑person sex, often having zero or one partner in the prior month. Stay‑at‑home orders predicted fewer partners, while masturbation and virtual sex rose.","clinical_takeaway":"Clinicians should note that pandemic restrictions led to rapid sexual‑behaviour shifts, but longer‑term impacts remain uncertain.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a sexual‑minority survey","Timely data on pandemic‑related behavior change","Clear association between stay‑at‑home orders and partner reduction"],"limitations":["Cross‑sectional design cannot infer causality","Convenience sampling limits generalisability","No measurement of moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":33,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13178-021-00625-3"}},{"id":3960,"doi":"10.1007/s12519-008-0030-x","pmid":"18661774","pmcid":null,"title":"Infantile masturbation in an African female: is this a justification for female genital cutting?","authors":"Otaigbe BE.","first_author":"Otaigbe BE.","journal":"World journal of pediatrics : WJP","year":2008,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single infant case with video documentation; no comparison group","sample_n":1,"sample_text":"one infant","population":"15‑month‑old female, Nigeria","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"A 15‑month‑old girl in Nigeria showed unusual rocking movements that were misinterpreted as seizures but were diagnosed as infantile masturbation via video. Counseling the parents prevented female genital cutting and the behavior improved.","clinical_takeaway":"Infantile masturbation can mimic epilepsy; video assessment is useful and parents should be advised against harmful cultural practices.","confidence":0.4,"topic_tags":["masturbation","pornography","sexual_function","csbd"],"strengths":["Detailed video documentation of behavior","Clear clinical description differentiating from epilepsy","Practical counseling recommendation"],"limitations":["Single case, no generalizability","No validated measurement instruments","No systematic assessment of cultural or moral factors"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":17,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12519-008-0030-x"}},{"id":3961,"doi":"10.3389/fpsyg.2021.693121","pmid":"34434144","pmcid":"PMC8382266","title":"Is Ejaculation Frequency in Men Related to General and Mental Health? Looking Back and Looking Forward","authors":"Mascherek A, Reidick MC, Gallinat J, Kühn S.","first_author":"Mascherek A","journal":"Frontiers in psychology","year":2021,"pub_types":["review-article","Review","Journal Article"],"keywords":["Abstinence","Ejaculation Frequency","Brain Structure And Function","Moral Incongruence","Modifiable Lifestyle Behavior","General And Mental Health","Quality Of Sperm"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyg.2021.693121/pdf","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic search or meta‑analysis; no primary data.","sample_n":null,"sample_text":"Not applicable – review article.","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews existing research on how often men ejaculate or masturbate might affect their overall and mental health, noting many studies are limited and that factors like cultural guilt are often ignored.","clinical_takeaway":"Current evidence is insufficient to link ejaculation frequency causally to health outcomes; clinicians should consider broader lifestyle and cultural contexts.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Comprehensive narrative synthesis of disparate literature","Identifies clear methodological gaps","Highlights role of moral incongruence and cultural factors"],"limitations":["No systematic search or risk‑of‑bias assessment","Lacks primary data or quantitative synthesis","Does not directly measure or control key confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2021.693121"}},{"id":3962,"doi":"10.1111/jsm.12762","pmid":"25471258","pmcid":null,"title":"Removal of numerous vesical magnetic beads with a self-made magnetic sheath","authors":"Zeng SX, Li HZ, Zhang ZS, Lu X, Yu XW, Yang QS, Ma C, Xu CL, Sun YH.","first_author":"Zeng SX","journal":"The journal of sexual medicine","year":2015,"pub_types":["Journal Article","Case Reports"],"keywords":["Urinary bladder","magnetic beads","Foreign Body","Autoerotism"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Single adolescent case describing a novel surgical technique to retrieve self‑inserted magnetic beads.","sample_n":1,"sample_text":"One patient","population":"Male, 21 y, auto‑erotic insertion of magnetic beads","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 21‑year‑old man inserted over 100 magnetic beads into his urethra for sexual stimulation. Doctors created a magnetic sheath that attached to the beads and removed all of them in about five minutes, showing a quick, minimally invasive way to retrieve such foreign bodies.","clinical_takeaway":"The magnetic sheath offers a fast, minimally invasive option for urologists to remove self‑inserted magnetic bladder foreign bodies.","confidence":0.85,"topic_tags":["sexual_function","masturbation"],"strengths":["Innovative, minimally invasive technique","Clear procedural description","Demonstrated rapid removal"],"limitations":["Single case; no generalizability","No comparative or outcome data beyond duration","No assessment of psychological aspects"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12762"}},{"id":3963,"doi":"10.1007/s10508-006-9123-6","pmid":"17333329","pmcid":null,"title":"Prevalence of masturbation and associated factors in a British national probability survey","authors":"Gerressu M, Mercer CH, Graham CA, Wellings K, Johnson AM.","first_author":"Gerressu M","journal":"Archives of sexual behavior","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":104,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"National probability sample of 11,161 British adults aged 16‑44; face‑to‑face and computer‑assisted self‑interview; prevalence estimates with 95 % CIs.","sample_n":11161,"sample_text":"Stratified probability sample, N = 11,161","population":"General UK adult population (16‑44 years)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2008 UK survey of over 11,000 adults aged 16‑44, 73% of men and 37% of women reported masturbating in the past month. Higher education, higher social class, sexual function problems, and having same‑sex partners were linked to higher odds of reporting masturbation.","clinical_takeaway":"Masturbation is common across UK adults; clinicians should treat it as a normal behaviour, recognizing variation by gender and life circumstances.","confidence":0.7,"topic_tags":["masturbation","prevalence","sexual_function"],"strengths":["Large, nationally representative probability sample","Clear prevalence estimates with confidence intervals","Comprehensive sociodemographic and sexual‑behaviour covariates"],"limitations":["Self‑report may be subject to social desirability bias","No assessment of moral/religious attitudes that could influence reporting","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":29,"contrasting":2,"mentioning":133,"citing_publications":189,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-006-9123-6"}},{"id":3965,"doi":"10.1016/j.urology.2007.12.009","pmid":"18374400","pmcid":null,"title":"Time-to-ejaculation and the quality of semen produced by masturbation at a clinic","authors":"Elzanaty S.","first_author":"Elzanaty S.","journal":"Urology","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational study of 142 men undergoing infertility assessment; semen samples collected after masturbation; participants divided into three groups by time-to‑ejaculation.","sample_n":142,"sample_text":"142 men under infertility assessment","population":"Men (mean age not provided) presenting for infertility evaluation at a urology clinic (clinical convenience sample).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 142 men attending a fertility clinic, shorter time to ejaculation during a masturbatory semen sample was linked to higher sperm counts and better motility, while longer times were associated with lower sperm concentration and lower fructose levels.","clinical_takeaway":"Timing of ejaculation may influence semen quality; clinicians might consider stress‑reducing strategies during collection.","confidence":0.8,"topic_tags":["masturbation","sexual_function","religiosity"],"strengths":["Objective semen and biochemical measurements","Clear definition of exposure (time‑to‑ejaculation)","Adequate overall sample size for correlation analyses"],"limitations":["Clinical convenience sample limits generalisability","No control for key psychosocial confounds (stress, mental health)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urology.2007.12.009"}},{"id":3966,"doi":"10.1111/jsm.12766","pmid":"25402432","pmcid":null,"title":"Sexual satisfaction, sexual compatibility, and relationship adjustment in couples: the role of sexual behaviors, orgasm, and men's discernment of women's intercourse orgasm","authors":"Klapilová K, Brody S, Krejčová L, Husárová B, Binter J.","first_author":"Klapilová K","journal":"The journal of sexual medicine","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Masturbation","Sexual Compatibility","Sexual Satisfaction","Relationship Satisfaction","Sexual Intercourse","Vaginal Orgasm","Dyadic Adjustment"],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 85 Czech long‑term couples, self‑report questionnaires","sample_n":85,"sample_text":"85 couples (170 individuals)","population":"85 hetero couples, ages 20‑40, mean relationship length 5.4 years, Czech Republic","country":"Czech Republic","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 85 Czech couples, women's consistent vaginal orgasms and fewer masturbatory episodes were linked to better relationship adjustment and higher sexual satisfaction for both partners. More frequent intercourse and shared orgasm consistency predicted greater sexual compatibility.","clinical_takeaway":"Higher vaginal‑orgasm consistency and regular intercourse are associated with better couple satisfaction; clinicians should consider relationship context when discussing masturbation frequency.","confidence":0.7,"topic_tags":["sexual_function","relationships","masturbation"],"strengths":["Uses validated scales for satisfaction, dyadic adjustment and compatibility","Both partners provide data, allowing dyadic analysis","Multivariate regression controls for several sexual behaviours"],"limitations":["Cross‑sectional design, cannot infer causality","Convenience sample, limited generalisability","Masturbation and orgasm consistency measured with single items","No control for moral, mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":25,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12766"}},{"id":3967,"doi":"10.1177/0003065108315687","pmid":"18430705","pmcid":null,"title":"Masturbation, sexuality, and adaptation: normalization in adolescence","authors":"Shapiro T.","first_author":"Shapiro T.","journal":"Journal of the American Psychoanalytic Association","year":2008,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"No empirical sample; narrative review with case examples","population":"adolescents (theoretical discussion)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article offers a psychoanalytic view of how adolescents move from private masturbation fantasies to normalized sexual behavior, proposing a developmental step called 'normalization' and illustrating ideas with sociological data and case examples.","clinical_takeaway":"None – the paper is theoretical and does not provide evidence‑based guidance for clinicians.","confidence":0.65,"topic_tags":["masturbation","adolescents","sexual_function"],"strengths":["Integrates psychoanalytic theory with sociological data","Addresses a developmental perspective on masturbation"],"limitations":["No empirical data or systematic review methodology","Lacks operational definitions and validated measures"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0003065108315687"}},{"id":3968,"doi":"10.1024/1012-5302/a000826","pmid":"34296636","pmcid":null,"title":"[Knowledge levels and attitudes of nursing trainees regarding sexuality in old age - An explorative quantitative survey]","authors":"Misamer M, Warneck J, Meyer-Rötz SH, Belz M, Wiltfang J, Signerski-Krieger J.","first_author":"Misamer M","journal":"Pflege","year":2022,"pub_types":["Journal Article"],"keywords":["Sexuality","Elderly","Cross-sectional study","Nursing Education","Geriatric Nursing","Querschnittstudie","Ältere Menschen","Pflegeausbildung","Altenpflege","Sexualität"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 420 nursing trainees","sample_n":420,"sample_text":"420 trainees across three training years; convenience sampling","population":"geriatric nursing trainees (Germany)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2022 German survey of 420 geriatric nursing trainees found limited knowledge and mixed attitudes toward sexuality in older adults, with many still holding misconceptions about masturbation and homosexuality. Knowledge improved with training year, but attitudes remained largely unchanged.","clinical_takeaway":"Training programmes should incorporate evidence‑based education on sexuality in old age early to counter persistent myths.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a trainee survey","Focus on an understudied topic (sexuality in old age)","Clear statistical tests for subgroup differences"],"limitations":["Questionnaire likely not validated","Convenience sample limits generalisability","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1024/1012-5302/a000826"}},{"id":3970,"doi":null,"pmid":"25577834","pmcid":null,"title":"[Location of semen collection and semen quality: clinic-collected versus home-collected samples]","authors":"Wang W, Zhong ZM, Su N, Peng YY, Huang TT.","first_author":"Wang W","journal":"Zhonghua nan ke xue = National journal of andrology","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"342 men undergoing infertility assessment; semen collected by masturbation either in clinic or at home; WHO guidelines used for semen analysis; comparison of parameters between two collection locations","sample_n":342,"sample_text":"342 men","population":"men evaluated for infertility (clinical sample)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 342 men being evaluated for infertility, semen collected at home by masturbation showed higher volume, sperm count and motility than samples collected in the clinic. Biochemical markers and morphology were similar across settings.","clinical_takeaway":"When assessing male infertility, allow home collection of semen to obtain more representative quality measures.","confidence":0.8,"topic_tags":["sexual_function","masturbation","religiosity"],"strengths":["Objective WHO‑standard semen analyses","Large sample for a single‑site study","Clear comparison of two collection settings"],"limitations":["Convenience sample of infertile men limits generalisability","No adjustment for multiple statistical tests","Potential uncontrolled confounders (e.g., time since last ejaculation, abstinence period)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":3971,"doi":"10.1007/s12098-008-0028-3","pmid":"18334803","pmcid":null,"title":"Infantile masturbation and paroxysmal disorders","authors":"Omran MS, Ghofrani M, Juibary AG.","first_author":"Omran MS","journal":"Indian journal of pediatrics","year":2008,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of 3 infants presenting with paroxysmal movements misdiagnosed as seizures","sample_n":3,"sample_text":"3 cases","population":"Preschool female infants (10‑30 months) in India","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors describe three infant girls whose repetitive movements (leg scissoring, rocking, sweating) were actually infantile masturbation, not seizures. Recognizing this helps avoid misdiagnosis of epilepsy in young children.","clinical_takeaway":"Clinicians should consider infantile masturbation in the differential for paroxysmal events in infants to prevent unnecessary seizure work‑ups.","confidence":0.8,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Clear clinical description","Use of video recordings for documentation","Highlights a rare differential diagnosis"],"limitations":["Very small sample (n=3)","No systematic assessment or control group","No follow‑up or outcome data"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":23,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12098-008-0028-3"}},{"id":3972,"doi":"10.1016/j.esxm.2021.100380","pmid":"34273787","pmcid":"PMC8360921","title":"How the COVID-19 Pandemic Affects Sexual Behavior of Hetero-, Homo-, and Bisexual Males in Germany","authors":"Mumm JN, Vilsmaier T, Schuetz JM, Rodler S, Zati Zehni A, Bauer RM, Staehler M, Stief CG, Batz F.","first_author":"Mumm JN","journal":"Sexual medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Bisexual","Heterosexual","Homosexual","Male Sexual Behavior","Sexual Relationship","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8360921","cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Anonymous nationwide web‑based questionnaire of cis‑male adults in Germany during the first COVID‑19 lockdown (April‑July 2020); N≈414 after eligibility.","sample_n":414,"sample_text":"523 started, 414 met inclusion criteria","population":"cis‑gender men (heterosexual, homosexual, bisexual) living in Germany","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A German web survey of 414 cis‑male adults found that during the first COVID‑19 lockdown, weekly frequency of intercourse and masturbation rose across heterosexual, gay, and bisexual men, alongside higher sexual arousal and satisfaction. Relationship status, parenthood and employment influenced these changes.","clinical_takeaway":"During lockdown, many men reported more frequent and satisfying sexual activity; clinicians should consider situational factors rather than assume pathology.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Large nationwide sample for a pandemic‑time survey","Includes sexual minorities","Uses a standardized sexual behavior questionnaire"],"limitations":["Self‑selected online convenience sample","No control for moral or mental‑health variables","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":23,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2021.100380"}},{"id":3973,"doi":"10.1080/00926230802096374","pmid":"18576235","pmcid":null,"title":"Women's finger sensitivity correlates with partnered sexual behavior but not solitary masturbation frequencies","authors":"Brody S, Fischer AH, Hess U.","first_author":"Brody S","journal":"Journal of sex & marital therapy","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional correlational study of 97 Dutch female university students measuring tactile finger sensitivity (von Frey filaments) and self‑reported frequencies of partnered sex and solitary masturbation.","sample_n":97,"sample_text":"97 healthy Dutch female university students","population":"Healthy female university students (N=97), Netherlands","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 97 Dutch female students, greater finger touch sensitivity was linked to more partnered sex but not to how often they masturbated alone. Sensitivity did not predict orgasm frequency.","clinical_takeaway":"Finger sensitivity appears unrelated to solo masturbation frequency; no direct clinical implications.","confidence":0.7,"topic_tags":["sexual_function","masturbation","treatment","measurement"],"strengths":["Objective measurement of tactile sensitivity","Separate assessment of partnered and solitary sexual behavior"],"limitations":["Convenience sample of university students (WEIRD bias)","Cross‑sectional design; cannot infer causality","Limited control for psychological or relational confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":15,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230802096374"}},{"id":3974,"doi":"10.3390/children8070577","pmid":"34356556","pmcid":"PMC8306416","title":"Sexual Activity in Adolescents and Young Adults through COVID-19 Pandemic","authors":"Stavridou A, Samiakou C, Kourti A, Tsiorou S, Panagouli E, Thirios A, Psaltopoulou T, Sergentanis TN, Tsitsika A.","first_author":"Stavridou A","journal":"Children (Basel, Switzerland)","year":2021,"pub_types":["other","Journal Article"],"keywords":["Adolescents","Sexual Health","Young Adults","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8306416","cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of adolescents and young adults investigating changes in sexual activity, desire and relationship behaviors during COVID‑19","sample_n":null,"sample_text":"unspecified number of participants; likely convenience online sample","population":"adolescents and young adults (age not specified)","country":"Greece (inferred from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of teens and young adults found that during COVID‑19 most reported lower sexual desire and fewer sex acts, linked to loneliness and depression, while a minority reported higher desire and more masturbation.","clinical_takeaway":"Clinicians should consider pandemic‑related stress and mood when discussing sexual health with young people.","confidence":0.6,"topic_tags":["sexual_function","adolescents"],"strengths":["Timely topic (COVID‑19 impact)","Includes mental‑health variables","Addresses both desire decrease and increase"],"limitations":["Likely convenience sample, unclear size","Reliance on single‑item or ad‑hoc measures","No control for moral/religious factors","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":20,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/children8070577"}},{"id":3975,"doi":"10.4081/cp.2014.648","pmid":"25568766","pmcid":"PMC4274484","title":"Conservative Management of Penile Trauma may be Complicated by Abscess Formation","authors":"Bantis A, Sountoulides P, Kalaitzis C, Deftereos S.","first_author":"Bantis A","journal":"Clinics and practice","year":2014,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Magnetic Resonance Imaging","Masturbation","Penile Abscess","Penile Trauma"],"is_oa":true,"oa_url":"https://doi.org/10.4081/cp.2014.648","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report of blunt penile trauma after masturbation; MRI used for diagnosis; non‑surgical management followed by abscess drainage","sample_n":1,"sample_text":"single patient","population":"58‑year‑old male, single case","country":"unspecified (likely Greece based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 58‑year‑old man hurt his penis while masturbating. MRI showed a tear in the penile tissue. He chose not to have surgery at first, but later developed an abscess that needed drainage. Three months later he reported normal erections.","clinical_takeaway":"Penile trauma from vigorous masturbation can lead to hidden tears and later abscesses; imaging may be needed even without obvious signs.","confidence":0.8,"topic_tags":["masturbation","sexual_function","gender","csbd"],"strengths":["Clear clinical description of a rare complication","Use of MRI to confirm tunica albuginea rupture","Follow‑up data on erectile function"],"limitations":["Single case limits generalisability","No control or comparative group","No statistical analysis"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":3,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4081/cp.2014.648"}},{"id":3977,"doi":"10.1080/00224499.2021.1912277","pmid":"34176390","pmcid":null,"title":"\"OMG, Yes!\": Feasibility, Acceptability, and Preliminary Efficacy of an Online Intervention for Female Sexual Pleasure","authors":"Hensel DJ, Von Hippel CD, Sandidge R, Lapage CC, Zelin NS, Perkins RH.","first_author":"Hensel DJ","journal":"Journal of sex research","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"single‑group pre/post feasibility study (N≈870), self‑selected online participants, no control group","sample_n":870,"sample_text":"large self‑selected convenience sample","population":"adult women, online volunteers","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A web‑based program teaching women about pleasure (OMGyes.com) was tested with 870 adult women who used it for four weeks. Participants reported higher knowledge, confidence, and enjoyment of sexual activity, both alone and with partners.","clinical_takeaway":"Online pleasure‑education tools may boost women's sexual confidence and satisfaction, but evidence comes from a non‑controlled self‑selected sample.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size","Clear pre‑post design","Focused feasibility outcomes"],"limitations":["No control/comparator group","Self‑report measures likely unvalidated","Self‑selected online participants limit generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2021.1912277"}},{"id":3978,"doi":"10.1016/j.ejogrb.2014.09.007","pmid":"25268779","pmcid":null,"title":"Orgasm and women's waist circumference","authors":"Costa RM, Brody S.","first_author":"Costa RM","journal":"European journal of obstetrics, gynecology, and reproductive biology","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Waist Circumference","Female Orgasm","Intercourse"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 120 Portuguese women reporting waist circumference and orgasm frequencies.","sample_n":120,"sample_text":"Convenience community sample; no random sampling reported.","population":"120 reproductive‑age Portuguese women (community sample)","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 120 Portuguese women, larger waist size was linked to fewer vaginal orgasms during intercourse, but not to clitoral or masturbatory orgasms. Women with bigger waists also reported masturbating more often.","clinical_takeaway":"Higher abdominal fat may reduce vaginal orgasm frequency; clinicians might consider body composition when addressing female sexual function.","confidence":0.7,"topic_tags":["sexual_function","masturbation","adolescents"],"strengths":["Objective waist measurement","Separate assessment of vaginal vs. clitoral orgasm","Controls for several demographic variables"],"limitations":["Self‑report frequencies without validated scales","Cross‑sectional design limits causal inference","Lack of mental‑health, trauma, and moral‑incongruence measures"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ejogrb.2014.09.007"}},{"id":3980,"doi":"10.1016/j.jsxm.2021.04.010","pmid":"34183292","pmcid":null,"title":"Uncovering the Most Important Factors for Predicting Sexual Desire Using Explainable Machine Learning","authors":"Vowels LM, Vowels MJ, Mark KP.","first_author":"Vowels LM","journal":"The journal of sexual medicine","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Machine Learning","Close Relationships","Sexual Desire","Random Forests","Shapley Values"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online convenience sample (N=1,846), cross‑sectional, self‑report measures","sample_n":1846,"sample_text":"1846 participants (754 individuals forming 377 couples) from two online samples","population":"adults (both genders) in relationships and single individuals recruited online","country":"not specified (online international sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In over 1,800 adults, factors like relationship and sexual satisfaction predicted desire for partners, while masturbation frequency and permissive sexual attitudes predicted solitary desire. Machine‑learning identified which variables mattered most.","clinical_takeaway":"Addressing relationship satisfaction and clients' sexual attitudes may help improve desire issues in therapy.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size","Use of validated Sexual Desire Inventory","Application of explainable machine‑learning (random forest + SHAP) to many predictors"],"limitations":["Cross‑sectional design prevents causal inference","Convenience online sample limits generalisability","Many predictor variables not confirmed with validated scales"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.04.010"}},{"id":3981,"doi":"10.1037/cfp0000022","pmid":"25512880","pmcid":"PMC4264837","title":"A Pilot Intervention to Promote Safer Sex in Heterosexual Puerto Rican Couples","authors":"Pérez-Jiménez D, Seal DW, Ronis DL.","first_author":"Pérez-Jiménez D","journal":"Couple & family psychology","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["Hispanics","Puerto Rican","Heterosexual Couples","Male Condom","Mutual Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"pilot randomised controlled trial with 26 couples (15 intervention, 11 control), three‑hour group sessions, 3‑month follow‑up","sample_n":26,"sample_text":"Twenty-six couples participated (15 intervention, 11 control).","population":"Heterosexual Puerto Rican couples (convenience sample)","country":"Puerto Rico","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small pilot study tested a group‑based program for Puerto Rican couples to increase condom use and mutual masturbation. After three months, couples who received the program used condoms more often and reported better attitudes and knowledge than controls.","clinical_takeaway":"Couple‑focused education can boost condom use, but larger trials are needed before broad implementation.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Randomised design","Dyadic intervention targeting real‑world risk","Follow‑up assessment shows persistence"],"limitations":["Very small sample, limited power","Unclear measurement validation","No control for moral or mental‑health variables"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/cfp0000022"}},{"id":3982,"doi":"10.5534/wjmh.2014.32.2.120","pmid":"25237664","pmcid":"PMC4166371","title":"Successful removal of an intravesical electrical wire cable","authors":"Ahn H, Son H.","first_author":"Ahn H","journal":"The world journal of men's health","year":2014,"pub_types":["Journal Article","case-report"],"keywords":["Urinary bladder","Foreign bodies","Masturbation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4166371","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Single case report of a 30‑year‑old man who inserted an electrical wire into his urethra for masturbation; description of radiographic findings and surgical removal.","sample_n":1,"sample_text":"1 patient","population":"Male, 30 years old, self‑inserting foreign body for masturbation; no mention of broader sample.","country":"South Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 30‑year‑old man inserted an electrical wire into his urethra for masturbation. The wire coiled inside his bladder and could not be removed endoscopically, so surgeons made a small abdominal incision to extract it without complications.","clinical_takeaway":"Foreign bodies inserted during masturbation may require surgical removal; clinicians should be aware of this possible emergency.","confidence":0.9,"topic_tags":["masturbation","gender","sexual_function"],"strengths":["Clear clinical description of a rare urological emergency","Includes imaging and surgical outcome"],"limitations":["Single case; no generalizable data","No systematic assessment of psychological factors","No quantitative analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5534/wjmh.2014.32.2.120"}},{"id":3983,"doi":"10.1111/and.14136","pmid":"34115901","pmcid":"PMC8420368","title":"Absence of SARS-CoV-2 infection in the semen of men recovering from COVID-19 infection: An exploratory study and review of literature","authors":"Sharma AP, Sahoo S, Goyal K, Chandna A, Kirubanandhan S, Sharma V, Grover S, Singh MP, Bhalla A, Singh SK.","first_author":"Sharma AP","journal":"Andrologia","year":2021,"pub_types":["research-article","Systematic Review","Journal Article"],"keywords":["Semen","Virus","Carrier State","Covid-19","Sars-cov-2"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"prospective exploratory cohort of 11 recovered men providing a semen sample; no control group; small convenience sample","sample_n":11,"sample_text":"11 participants (mean age 29.7 y) who consented to provide a semen sample after recovery","population":"men ≥21 y recovering from COVID‑19 (PCR‑negative or ≥2 weeks post‑positive)","country":"India (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 11 men who had recovered from COVID‑19, researchers tested freshly collected semen for the virus using a standard PCR test and found no viral RNA. A brief review of existing studies showed similar results.","clinical_takeaway":"Current evidence suggests SARS‑CoV‑2 is unlikely to be present in semen after recovery, but larger studies are needed.","confidence":0.7,"topic_tags":["sexual_function","religiosity","moral_incongruence","masturbation"],"strengths":["Validated RT‑PCR assay for viral detection","Systematic review component follows PRISMA","Clear inclusion criteria (recovery status, negative nasopharyngeal swab)"],"limitations":["Very small sample (N=11) limits generalisability","No control group of non‑recovered men","Potential selection bias (voluntary participation)","No power calculation or effect‑size reporting"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/and.14136"}},{"id":3984,"doi":"10.1016/j.clineuro.2007.09.007","pmid":"17961914","pmcid":null,"title":"Involuntary masturbation and hemiballismus after bilateral anterior cerebral artery infarction","authors":"Bejot Y, Caillier M, Osseby GV, Didi R, Ben Salem D, Moreau T, Giroud M.","first_author":"Bejot Y","journal":"Clinical neurology and neurosurgery","year":2008,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single-case report of a 62‑year‑old man with bilateral ACA infarction presenting with hemiballismus and involuntary masturbation; no control group, no longitudinal follow‑up","sample_n":1,"sample_text":"62‑year‑old right‑handed man","population":"one adult male patient with stroke","country":"France (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 62‑year‑old man who suffered strokes in both sides of the anterior cerebral artery showed unusual symptoms: involuntary arm movements (hemiballismus) on one side and uncontrollable masturbation with the opposite hand. Imaging showed lesions in brain areas linked to motor control and the corpus callosum. Symptoms resolved after two weeks.","clinical_takeaway":"Neurological lesions can produce rare, involuntary sexual behaviours; clinicians should consider organic causes when confronted with atypical sexual movements.","confidence":0.9,"topic_tags":["neuroscience","masturbation"],"strengths":["Detailed neurological description of a rare presentation","Clear imaging correlation with behavioural symptoms"],"limitations":["Single case, no generalisability","No systematic assessment of sexual behaviour or psychological factors"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.clineuro.2007.09.007"}},{"id":3987,"doi":"10.1016/j.esxm.2021.100364","pmid":"34051539","pmcid":"PMC8240326","title":"The Impact of Social Distancing Measures Due to COVID-19 Pandemic on Sexual Function and Relationship Quality of Couples in Greece","authors":"Sotiropoulou P, Ferenidou F, Owens D, Kokka I, Minopoulou E, Koumantanou E, Pavlopoulou I, Apotsos P, Karvouni M, Koumantarou E, Mourikis I, Vaidakis N, Papageorgiou C.","first_author":"Sotiropoulou P","journal":"Sexual medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexual function","Relationship Quality","Iief","Fsfi","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8240326","cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online anonymous survey of 299 adult heterosexual couples conducted one month into Greek COVID‑19 quarantine; self‑report questionnaires on sexual function (FSFI/IIEF), relationship quality, anxiety and mood.","sample_n":299,"sample_text":"299 adult heterosexual participants in a relationship","population":"Greek adults in heterosexual relationships, recruited via online convenience sampling.","country":"Greece","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A Greek online survey of 299 couples during the first COVID‑19 lockdown found little overall change in sexual function, but higher anxiety and poorer mood among those not living with their partner.","clinical_takeaway":"During short‑term lockdowns, sexual function may remain stable, yet clinicians should monitor anxiety and mood, especially for partners separated by quarantine.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Uses validated FSFI/IIEF instruments","Relatively large sample for a rapid pandemic study","Assesses both sexual function and relationship quality"],"limitations":["Convenience online recruitment limits generalisability","Ad‑hoc relationship‑quality items lack validation","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2021.100364"}},{"id":3988,"doi":"10.1532/hsf.3745","pmid":"34173756","pmcid":null,"title":"Sexual Quality of Life in Men <60 Years Old after Coronary Bypass Surgery","authors":"Ghazy T, Haeberle E, Kappert U, Petzold S, Plötze K, Mashhour A, Matschke K, Ouda A.","first_author":"Ghazy T","journal":"The heart surgery forum","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 265 men 1–5 years post‑CABG assessing pre‑ and post‑operative sexual QoL, counseling, and related factors.","sample_n":265,"sample_text":"265 men aged 18‑60 yr, median 55, surveyed 1‑5 yr after surgery","population":"Men, 18‑60 yr, post‑coronary artery bypass grafting, Germany","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 265 men aged 18‑60 who had heart bypass surgery, sexual satisfaction and frequency of sex and masturbation dropped noticeably after the operation, especially among those with pain, erectile problems or fear of cardiac strain. Better overall health and higher‑quality counseling were linked to better post‑surgery sexual quality of life.","clinical_takeaway":"Post‑CABG patients often experience reduced sexual satisfaction; clinicians should address pain, erectile issues, and provide tailored sexual counseling.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for a surgical cohort","Both pre‑ and post‑operative sexual QoL measured","Inclusion of counseling quality as a variable"],"limitations":["Cross‑sectional; cannot infer causality","Unclear whether sexual QoL questionnaires are validated","No control for mental‑health or moral‑incongruence factors"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1532/hsf.3745"}},{"id":3989,"doi":null,"pmid":"20532122","pmcid":"PMC2880944","title":"Pramipexole and compulsive masturbation","authors":"Sansone RA, Ferlan M.","first_author":"Sansone RA","journal":"Psychiatry (Edgmont (Pa. : Township))","year":2007,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Adverse effects","Dopamine agonists","Masturbation","Hypersexual Behavior","Compulsive Sexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-patient case report linking pramipexole use to onset of compulsive masturbation; no control group, no systematic assessment.","sample_n":1,"sample_text":"single case","population":"one individual on pramipexole","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A 2007 case report describes one patient who began compulsive masturbation after starting the dopamine drug pramipexole, and the behavior stopped when the drug was stopped, suggesting a possible link.","clinical_takeaway":"Clinicians should be aware that dopamine agonists may trigger hypersexual behaviors, but evidence is limited to isolated case reports.","confidence":0.8,"topic_tags":["prevalence","adolescents"],"strengths":["Detailed temporal description of drug exposure and behavior onset","Highlights possible side‑effect of dopamine agonist"],"limitations":["Single case; no control or systematic measurement","No validated scales or objective assessment of compulsivity","No consideration of alternative explanations (moral, mental‑health, partner factors)"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":3991,"doi":"10.3390/jcm10102221","pmid":"34065601","pmcid":"PMC8161068","title":"Erectile Dysfunction Is a Hallmark of Cardiovascular Disease: Unavoidable Matter of Fact or Opportunity to Improve Men's Health?","authors":"Yannas D, Frizza F, Vignozzi L, Corona G, Maggi M, Rastrelli G.","first_author":"Yannas D","journal":"Journal of clinical medicine","year":2021,"pub_types":["review-article","Review","Journal Article"],"keywords":["Cardiovascular risk factors","erectile dysfunction","Major Adverse Cardiovascular Events","Unconventional Risk Factors"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8161068","cited_by_count":48,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Narrative review of existing literature on erectile dysfunction (ED) as a cardiovascular risk marker; no primary data collection.","sample_n":null,"sample_text":"not applicable (review)","population":"men with erectile dysfunction (ED)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review argues that erectile dysfunction often appears before heart disease and can help doctors spot men at risk for heart attacks, even when they lack traditional risk factors. It lists many clinical clues—like family history, alcohol use, and low partner interest—that may signal hidden cardiovascular danger.","clinical_takeaway":"Men presenting with ED should be evaluated for cardiovascular risk, beyond standard factors, to enable early prevention.","confidence":0.8,"topic_tags":["sexual_function","csbd","moral_incongruence","religiosity"],"strengths":["Broad synthesis of cardiovascular and urologic literature","Identifies multiple non‑traditional risk factors for CVD in men with ED"],"limitations":["No systematic search or risk‑of‑bias assessment reported","Relies on heterogeneous primary studies; no meta‑analysis","Absence of quantitative effect‑size reporting"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":40,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jcm10102221"}},{"id":3992,"doi":"10.1007/s10508-007-9222-z","pmid":"17710524","pmcid":null,"title":"Masturbation in urban China","authors":"Das A, Parish WL, Laumann EO.","first_author":"Das A","journal":"Archives of sexual behavior","year":2009,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative cross‑sectional survey of 2,828 urban Chinese adults, logistic regression analyses of prevalence and predictors","sample_n":2828,"sample_text":"nationally representative urban sample","population":"urban adults aged 20‑59 in China (N≈2828)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2000 survey of 2,828 urban Chinese adults, 35% of men and 13% of women reported masturbating in the past year. Younger adults showed higher rates, similar to Western levels. Early sexual experiences, liberal values, and sexual knowledge were linked to higher likelihood of masturbation.","clinical_takeaway":"Masturbation is a common behavior among Chinese adults and is shaped by early sexual experiences and liberal attitudes; clinicians should consider these contextual factors when discussing sexual health.","confidence":0.85,"topic_tags":["masturbation","prevalence","sexual_function","csbd"],"strengths":["Large, nationally representative urban sample","Precise prevalence estimates with confidence intervals","Multivariate modeling of multiple life‑course predictors"],"limitations":["Masturbation assessed with a single self‑report item","No validated scale for frequency or distress","Potential under‑reporting due to social desirability"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":0,"mentioning":39,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-007-9222-z"}},{"id":3993,"doi":"10.1016/j.jsxm.2021.03.006","pmid":"34020921","pmcid":null,"title":"Diverse Sexual Behaviors in Undergraduate Students: Findings From a Campus Probability Survey","authors":"Herbenick D, Patterson C, Beckmeyer J, Gonzalez YRR, Luetke M, Guerra-Reyes L, Eastman-Mueller H, Valdivia DS, Rosenberg M.","first_author":"Herbenick D","journal":"The journal of sexual medicine","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sex behavior","Sexual activity","Coitus","Anal Sex","Strangulation","Oral Sex","Rough Sex","Sexual Asphyxiation"],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional probability survey of 4,989 undergraduates at one U.S. university","sample_n":4989,"sample_text":"large, randomly sampled campus probability sample","population":"undergraduate students (randomly sampled)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A probability‑based survey of 4,989 U.S. college students showed that most engage in solo masturbation and a variety of partnered activities, including rough sex practices like spanking and choking. Clinicians should be aware of these behaviors when counseling students.","clinical_takeaway":"College health providers should ask about a wide range of sexual activities, including choking, to assess potential health risks.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Large random sample with high response rate","Broad, detailed assessment of a range of sexual behaviors","Relevant clinical implications highlighted"],"limitations":["Self‑report only; no validation of behavioral items","No assessment of consent, pleasure, or mental‑health covariates","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":31,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.03.006"}},{"id":3995,"doi":"10.1136/emj.2007.047662","pmid":"17652699","pmcid":"PMC2660103","title":"Abrupt onset of disturbed vigilance, bilateral third nerve palsy and masturbating behaviour: a rare presentation of stroke","authors":"Mondon K, Bonnaud I, Debiais S, Brunault P, Saudeau D, de Toffol B, Autret A.","first_author":"Mondon K","journal":"Emergency medicine journal : EMJ","year":2007,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single patient case report","population":"adult female, middle‑aged, presenting with stroke","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A  middle‑aged woman suffered a stroke that caused loss of alertness, double‑vision and an unexpected episode of masturbation. The authors describe the brain areas damaged and suggest how the lesions could have produced these symptoms.","clinical_takeaway":"Stroke can occasionally trigger unusual sexual behaviours; clinicians should consider neuro‑anatomical causes when such symptoms appear.","confidence":0.8,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed clinical description of rare stroke presentation","Neuro‑anatomical discussion linking lesion location to behaviour"],"limitations":["Single case – no generalisability","No systematic measurement of sexual behaviour or distress","No control for confounding variables (e.g., mood, moral beliefs)"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/emj.2007.047662"}},{"id":3996,"doi":"10.3389/fpsyt.2021.674335","pmid":"34045985","pmcid":"PMC8144290","title":"Excited Catatonia in Autism Spectrum Disorder: A Case Series","authors":"Burns NK, Grissett K, Macaluso M, Raza M, Gracious B.","first_author":"Burns NK","journal":"Frontiers in psychiatry","year":2021,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Pediatric","ECT","Catatonia","Autism Spectrum Disorder","Excited Catatonia"],"is_oa":true,"oa_url":"https://doi.org/10.3389/fpsyt.2021.674335","cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case series of two autistic youths with excited catatonia, descriptive presentation of clinical course and response to ECT.","sample_n":2,"sample_text":"Two patients described in detail.","population":"Young males with autism spectrum disorder (high‑functioning and low‑functioning) experiencing excited catatonia.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors report two young men with autism who developed excited catatonia, a severe but treatable condition. Both showed aggressive and compulsive behaviours, including compulsive masturbation, and improved only after repeated electroconvulsive therapy.","clinical_takeaway":"Catatonia can occur in autism and may require prompt ECT; clinicians should consider systematic screening for catatonia in neurodevelopmental patients.","confidence":0.7,"topic_tags":["csbd","sexual_function","masturbation","pornography"],"strengths":["Use of validated catatonia rating scales","Detailed clinical description of rare presentation","Illustrates diagnostic delays and treatment challenges"],"limitations":["Very small sample (n=2) limits generalisability","No systematic control of confounding variables","No statistical analysis or effect size reporting"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2021.674335"}},{"id":3997,"doi":"10.1080/13691058.2014.924557","pmid":"24939172","pmcid":null,"title":"Coming to power: women's fake orgasms and best orgasm experiences illuminate the failures of (hetero)sex and the pleasures of connection","authors":"Fahs B.","first_author":"Fahs B.","journal":"Culture, health & sexuality","year":2014,"pub_types":["Journal Article"],"keywords":["Women","Masturbation","Sexual Satisfaction","Orgasm","Interpersonal Relationships"],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative thematic analysis with a convenience community sample (N=20)","sample_n":20,"sample_text":"community sample of 20 women in the USA","population":"women, United States, mean age 34 (range not specified)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 20 U.S. women reveal that fake orgasms are often used to please partners or end sex, while the most memorable orgasms occur when there is strong emotional connection, masturbation, and feeling embodied. The study highlights shortcomings of typical heterosexual sex and power imbalances.","clinical_takeaway":"Clinicians should recognise the role of relational intimacy and personal pleasure, including masturbation, in women's sexual satisfaction.","confidence":0.8,"topic_tags":["sexual_function","masturbation","relationships","gender"],"strengths":["In‑depth qualitative insight into women's orgasm experiences","Diverse community sample regarding race, socioeconomic status, and sexual identity","Clear thematic analysis linking interpersonal connection and masturbation"],"limitations":["Small, non‑representative sample (N=20)","No measurement or control of relevant confounds (e.g., moral incongruence, mental health)","Findings not generalisable beyond the specific U.S. community sample"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":73,"citing_publications":127,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2014.924557"}},{"id":3998,"doi":"10.1016/j.fertnstert.2007.05.044","pmid":"17658521","pmcid":null,"title":"Comparison of semen parameters in samples collected by masturbation at a clinic and at home","authors":"Elzanaty S, Malm J.","first_author":"Elzanaty S","journal":"Fertility and sterility","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional comparison of semen quality between clinic‑collected (n=273) and home‑collected (n=106) samples from men evaluated for infertility.","sample_n":379,"sample_text":"379 men (273 clinic, 106 home).","population":"Men assessed for infertility at a fertility centre (mostly treatment‑seeking, not general population).","country":"Not specified (likely Egypt based on author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Men who collected semen at home by masturbating had higher sperm counts and motility than those who provided samples at the clinic, suggesting collection site affects semen quality measurements.","clinical_takeaway":"Collecting semen at home may give more accurate assessments of male fertility potential.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Validated WHO semen analysis methods.","Reasonable sample size for group comparisons.","Clear operational definition of collection location."],"limitations":["Convenience sample of infertility patients; limited generalisability.","No adjustment for potential confounders (e.g., abstinence duration, stress).","Statistical reporting lacks effect sizes and confidence intervals."],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":31,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.fertnstert.2007.05.044"}},{"id":3999,"doi":"10.1371/journal.pone.0098413","pmid":"24919176","pmcid":"PMC4053354","title":"The psychosexual profile of sexual assistants: an internet-based explorative study","authors":"Limoncin E, Galli D, Ciocca G, Gravina GL, Carosa E, Mollaioli D, Lenzi A, Jannini EA.","first_author":"Limoncin E","journal":"PloS one","year":2014,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0098413&type=printable","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Internet‑based exploratory survey of 152 self‑identified sexual assistants (80 trained, 40 untrained) using a modified semi‑structured questionnaire; propensity‑score selection described.","sample_n":152,"sample_text":"152 participants (80 trained, 40 untrained) selected via propensity‑score analysis from an initial pool of 152 self‑identified sexual assistants.","population":"Adults identifying as sexual assistants, recruited from websites for sexual assistants and prostitutes; mean ages ≈42‑45 y, mixed gender not specified.","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 152 people who work as sexual assistants for disabled individuals, trained assistants were less likely to engage in sexual intercourse, oral sex, or masturbation compared with untrained ones, suggesting training may reduce risky sexual activities.","clinical_takeaway":"Training and careful selection of sexual assistants may promote safer sexual support for people with disabilities.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a niche population","Comparison of trained vs. untrained assistants","Use of propensity‑score selection to create groups"],"limitations":["Questionnaire not validated; reliance on self‑report","Cross‑sectional design; cannot infer causality","No control for moral, mental‑health, or relational confounds","Potential selection bias from website recruitment"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":27,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0098413"}},{"id":4001,"doi":"10.1080/00926230701385514","pmid":"17541849","pmcid":null,"title":"Masturbation in the United States","authors":"Das A.","first_author":"Das A.","journal":"Journal of sex & marital therapy","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":51,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative survey (NHSS) 1992, logistic regression of correlates of any masturbation in past year among adults 18‑60.","sample_n":null,"sample_text":"National Health and Social Life Survey (probability sample)","population":"US adults, community sample, probability‑based","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 1992 US survey, about 38% of women and 61% of men reported masturbating in the past year. Masturbation was linked to stable personality traits and early life factors, and showed a bimodal relationship with partnered sex—sometimes complementing, sometimes compensating for it.","clinical_takeaway":"Masturbation is common and relates variably to partnered sex; clinicians should consider individual patterns rather than assuming it indicates dysfunction.","confidence":0.75,"topic_tags":["masturbation","sexual_function"],"strengths":["Large, nationally representative sample","Clear reporting of prevalence with confidence intervals","Use of multivariate logistic models"],"limitations":["Masturbation measured with a single self‑report item","No assessment of moral, mental‑health or relational confounders","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":9,"contrasting":0,"mentioning":83,"citing_publications":109,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230701385514"}},{"id":4002,"doi":"10.5014/ajot.2021.040105","pmid":"34781357","pmcid":null,"title":"Addressing Puberty Challenges for Adolescents With Autism Spectrum Disorder: A Survey of Occupational Therapy Practice Trends","authors":"Larson SK, Nielsen S, Hemberger K, Klug MG.","first_author":"Larson SK","journal":"The American journal of occupational therapy : official publication of the American Occupational Therapy Association","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"nonexperimental survey of occupational therapists (n=71) about puberty‑related challenges and interventions for adolescents with ASD","sample_n":71,"sample_text":"71 eligible respondents (primarily White women, average 16 yr experience)","population":"Occupational therapists/assistants in the United States with experience treating adolescents (8‑16 yr) with autism spectrum disorder","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2021 survey of 71 US occupational therapists showed most address emotional regulation and hygiene for autistic teens during puberty, but fewer discuss menstruation, safety, or masturbation, highlighting practice gaps.","clinical_takeaway":"Therapists should broaden puberty education to include topics like menstruation and sexuality for autistic adolescents.","confidence":0.85,"topic_tags":["adolescents","sexual_function","masturbation","gender"],"strengths":["Nationwide stratified sample of practitioners","Identifies gaps in addressing puberty challenges","Generates hypotheses for future research"],"limitations":["Self‑report survey, potential response bias","Small sample limits subgroup analyses","Questionnaire not validated"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5014/ajot.2021.040105"}},{"id":4003,"doi":"10.1016/j.therap.2021.04.007","pmid":"33985838","pmcid":null,"title":"[Quetiapine and hypersexuality: Two case reports]","authors":"Meyer G, Jumeau P, Fichter A, Kel CL, Michel B, Javelot H.","first_author":"Meyer G","journal":"Therapie","year":2022,"pub_types":["Letter","Case Reports"],"keywords":["Psychological","quetiapine fumarate","Bipolar disorder","Masturbation","Sexual Dysfunctions","Trouble Bipolaire","Drug-related Side Effects And Adverse Reactions","Effets Secondaires Indésirables Des Médicaments","Fumarate De Quétiapine","Troubles Du Désir Sexuel"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","masturbation"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.therap.2021.04.007"}},{"id":4007,"doi":"10.5935/1984-0063.20200057","pmid":"34381582","pmcid":"PMC8340885","title":"Sexsomnia: case based classification and discussion of psychosocial implications","authors":"Toscanini AC, Marques JH, Hasan R, Schenck CH.","first_author":"Toscanini AC","journal":"Sleep science (Sao Paulo, Brazil)","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Family Relations","Parasomnias","Sexsomnia","Nrem Parasomnia","Sleep Sex"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8340885","cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single clinical case description with video‑polysomnography; no comparator group","sample_n":1,"sample_text":"single participant; not generalisable","population":"42‑year‑old married woman with sexsomnia; N=1","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors report a 42‑year‑old woman whose sleep disorder caused her to engage in sexual activity during brief awakenings from deep sleep. Video‑polysomnography confirmed nine such episodes. The paper discusses how this rare condition affected her marriage and mental health, and highlights the need for better diagnosis and treatment.","clinical_takeaway":"Sexsomnia can cause relationship and psychological distress; clinicians should consider sleep studies when patients report nocturnal sexual behaviors.","confidence":0.6,"topic_tags":["sexual_function","csbd"],"strengths":["objective sleep recording (video‑polysomnography)","detailed clinical follow‑up","high relevance to sleep‑medicine clinicians"],"limitations":["single case; no comparison group","no systematic assessment of psychological or relational confounds","cannot infer prevalence or causality"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5935/1984-0063.20200057"}},{"id":4011,"doi":"10.1080/00224499.2013.867922","pmid":"24588445","pmcid":null,"title":"Gender similarities and differences in sexual arousal, desire, and orgasmic pleasure in the laboratory","authors":"Paterson LQ, Jin ES, Amsel R, Binik YM.","first_author":"Paterson LQ","journal":"Journal of sex research","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory masturbation experiment with within‑subject physiological and self‑report measures; 38 men and 38 women.","sample_n":76,"sample_text":"38 men, 38 women, recruited to masturbate in the laboratory using their typical technique.","population":"adult men and women (N=76), convenience sample recruited for lab study","country":"Not specified (likely USA based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, 38 men and 38 women masturbated to orgasm while researchers measured genital temperature and self‑reported arousal, desire, and pleasure. Men’s arousal and desire dropped faster after orgasm than women’s, and women's orgasmic pleasure was linked to sustained desire.","clinical_takeaway":"Men and women may differ in post‑orgasm arousal patterns; clinicians should consider gender‑specific experiences when discussing sexual satisfaction.","confidence":0.8,"topic_tags":["sexual_function","gender","masturbation"],"strengths":["Physiological measure (genital temperature) adds objectivity","Within‑subject design captures changes across phases","Balanced gender sample"],"limitations":["Small between‑group sample (N=38 per gender)","No assessment of moral, mental‑health, or relational confounds","Convenience lab sample limits generalisability"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":0,"mentioning":28,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2013.867922"}},{"id":4012,"doi":"10.3978/j.issn.2223-4683.2014.02.01","pmid":"26813354","pmcid":"PMC4708290","title":"When to ask male adolescents to provide semen sample for fertility preservation?","authors":"Dabaja AA, Wosnitzer MS, Bolyakov A, Schlegel PN, Paduch DA.","first_author":"Dabaja AA","journal":"Translational andrology and urology","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Ejaculation","Masturbation","Fertility Preservation","Cancer Management","Semen Collection"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4708290","cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive cross‑sectional survey of 50 male volunteers (ages 18‑65) recalling ages of puberty, masturbation, first ejaculation and intercourse; no experimental manipulation.","sample_n":50,"sample_text":"Fifty males were recruited; mean age 39 ± 16.0 years.","population":"Male volunteers, ages 18‑65, recruited under IRB protocol; not a clinical adolescent sample.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed 50 men about when they first experienced puberty, masturbation, ejaculation and sex, concluding that asking teens for semen samples about 1.5 years after puberty onset is reasonable.","clinical_takeaway":"Clinicians may consider timing semen collection ~1½ years after puberty begins, but evidence is limited.","confidence":0.7,"topic_tags":["adolescents","masturbation","sexual_function","moral_incongruence"],"strengths":["Clear descriptive data on developmental milestones","IRB‑approved protocol","Provides a practical timeline suggestion for clinicians"],"limitations":["Small, non‑representative sample","Retrospective self‑report prone to recall bias","No validated instruments or objective measures"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3978/j.issn.2223-4683.2014.02.01"}},{"id":4013,"doi":"10.1111/jsm.12492","pmid":"24571582","pmcid":null,"title":"Effects of chemical castration on sex offenders in relation to the kinetics of serum testosterone recovery: implications for dosing schedule","authors":"Koo KC, Ahn JH, Hong SJ, Lee JW, Chung BH.","first_author":"Koo KC","journal":"The journal of sexual medicine","year":2014,"pub_types":["Journal Article"],"keywords":["Testosterone","Behavior","Castration","Paraphilia","Sex Offender"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort with two non‑randomized treatment‑duration groups of imprisoned sex offenders (N=56)","sample_n":56,"sample_text":"38 in 3‑month group, 18 in 6‑month group","population":"male sex offenders in a forensic hospital (prisoners)","country":"South Korea (National Forensic Hospital)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"supports","citation_value":"useful","plain_summary":"In 56 incarcerated sex offenders, chemical castration with leuprolide lowered testosterone, sexual fantasies and masturbation. Six months of treatment kept testosterone and fantasies lower after the drug stopped, while three months allowed a quicker rebound.","clinical_takeaway":"Longer (≥6 months) chemical castration may provide more stable control of sexual drive after treatment ends.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Prospective measurement of hormonal kinetics","Use of a validated sex‑fantasy questionnaire","Direct assessment of masturbation frequency"],"limitations":["Small, non‑randomized sample","No control for moral or mental‑health confounds","Lack of objective behavioural outcomes"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":44,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12492"}},{"id":4014,"doi":"10.1111/jsm.12480","pmid":"24612606","pmcid":null,"title":"Men's use and perceptions of commercial lubricants: prevalence and characteristics in a nationally representative sample of American adults","authors":"Reece M, Herbenick D, Schick V, Sanders SA, Fortenberry JD.","first_author":"Reece M","journal":"The journal of sexual medicine","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Lubricant","Sexual Pleasure","Men's Sexual Health"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative probability sample, online questionnaire, N≈1,000 men reporting lubricant use","sample_n":1014,"sample_text":"National Survey of Sexual Health and Behavior (2012)","population":"Adult U.S. men (≥18 y)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2012 nationally representative US survey, about 70 % of adult men reported ever using a commercial lubricant, with one‑quarter using it in the past month. Lubricants were used not only during intercourse but also for solo masturbation and partnered play, mainly to increase comfort, fun, and pleasure.","clinical_takeaway":"Most men use lubricants for comfort and pleasure; clinicians can discuss lubricants as a normal part of sexual health education.","confidence":0.85,"topic_tags":["prevalence","sexual_function"],"strengths":["Large, nationally representative probability sample","Separates lubricant use across solo and partnered contexts","Clear operationalization of prevalence and reasons for use"],"limitations":["Cross‑sectional; no causal inference","Self‑report may be subject to recall or social desirability bias","No assessment of potential confounds such as moral attitudes or mental health"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12480"}},{"id":4015,"doi":"10.1007/s00120-021-01479-8","pmid":"33651118","pmcid":"PMC8277610","title":"[Testicular and breast self-examination-a retrospective cohort study of medical students]","authors":"Jahnen M, Dichtl L, Stirenberg N, Dinkel A, Schiele S, Schulwitz H, Gschwend JE, Herkommer K.","first_author":"Jahnen M","journal":"Der Urologe. Ausg. A","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Breast cancer","Testicular Cancer","Self-examination","Early Detection","Health Awareness"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8277610","cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective cohort survey of 473 medical students; self‑report questionnaire on self‑examination and recent sexual behaviour; regression analyses.","sample_n":473,"sample_text":"473 students (98.8% participation) from Technical University of Munich","population":"medical students (mostly young adult, likely WEIRD sample)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of German medical students found that those who had recent sexual activity or talked about sex with partners were more likely to regularly check their testicles or breasts, suggesting a link between an active sex life and health‑screening habits.","clinical_takeaway":"Encourage open communication about sexuality, as it may support routine self‑examination practices in young adults.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large near‑complete sample of a specific student cohort","Multivariate regression to adjust for several predictors","Addresses an understudied link between sexual activity and health behaviours"],"limitations":["Cross‑sectional self‑report; no causal inference possible","Convenience sample of medical students limits generalisability","No validated scales for self‑examination or sexual behaviour"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":16,"retracted":false,"notices":[{"status":"Has erratum","date":"2021-6-29","noticeDoi":"10.1007/s00120-021-01580-y","doi":"10.1007/s00120-021-01479-8"}],"url":"https://scite.ai/reports/10.1007/s00120-021-01479-8"}},{"id":4019,"doi":"10.1016/j.jpurol.2021.02.015","pmid":"33750647","pmcid":null,"title":"High satisfaction on genital self-perception and sexual function in healthy Norwegian male adolescents","authors":"Gulseth E, Urdal A, Andersen MH, Diseth T, Aksnes G, Emblem R, Wæhre A.","first_author":"Gulseth E","journal":"Journal of pediatric urology","year":2021,"pub_types":["Journal Article"],"keywords":["Sexual function","Hypospadias","Genital Perception","Genital Malformation","Psychosocial Perception"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 61 healthy Norwegian male adolescents (age 16‑17) using validated questionnaires (PPPS, SDQ, PedsQL, SPPA) to assess genital self‑perception, sexual function, mental health and quality of life.","sample_n":61,"sample_text":"61 participants (out of 73 invited)","population":"healthy male adolescents, Norway, age 16‑17 (N=61)","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 61 healthy Norwegian boys aged 16‑17, most reported very high satisfaction with their genitals and sexual function, scoring near the top of a standard perception questionnaire. Those who were less satisfied noted concerns about penis size or foreskin.","clinical_takeaway":"Most healthy male teens report positive genital perception and sexual function; low scores may signal broader psychosocial concerns.","confidence":0.8,"topic_tags":["gender","adolescents","sexual_function"],"strengths":["Use of validated questionnaires","Includes mental‑health and self‑esteem measures","Provides normative data for healthy adolescents"],"limitations":["Small convenience sample (N=61)","No control for moral or relational confounds","Cross‑sectional, cannot infer change over time"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpurol.2021.02.015"}},{"id":4021,"doi":"10.1016/j.jsxm.2020.12.001","pmid":"33468446","pmcid":null,"title":"Androgen Deprivation Therapy in Pedophilic Disorder: Exploring the Physical, Psychological, and Sexual Effects From a Patient's Perspective","authors":"Boons L, Jeandarme I, Vervaeke G.","first_author":"Boons L","journal":"The journal of sexual medicine","year":2021,"pub_types":["Journal Article"],"keywords":["Treatment","Sex Offenders","Hormonal Therapy","Lhrh Agonists","Anti-androgens","Paraphilic Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative phenomenological interview study with 12 participants recruited from a single psychiatric hospital; in‑depth semi‑structured interviews analyzed with NVivo","sample_n":12,"sample_text":"12 male adults with pedophilic disorder, half on LHRH agonists, half on anti‑androgens; half inpatients, half outpatients; recruited via one psychiatric hospital","population":"adult males diagnosed with pedophilic disorder (N=12)","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Twelve men with pedophilic disorder described how hormone therapy affected their bodies, moods and sexual thoughts. They reported side‑effects like weight gain and breast growth, but also felt calmer, with fewer sexual fantasies and less masturbation.","clinical_takeaway":"Hormone therapy may lessen sexual urges and improve well‑being in this group, but clinicians should discuss physical side‑effects and obtain informed consent.","confidence":0.7,"topic_tags":["sexual_function","treatment","adolescents","pornography"],"strengths":["first qualitative investigation of ADT experiences in this population","in‑depth phenomenological interviews provide rich contextual data","includes both inpatient and outpatient perspectives"],"limitations":["Very small, single‑site convenience sample limits generalisability","No validated quantitative measures; reliance on self‑report narratives","No comparison group; cannot attribute changes specifically to ADT"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.12.001"}},{"id":4022,"doi":"10.4038/cmj.v51i3.1258","pmid":"17315592","pmcid":null,"title":"Bladder calculus presenting as excessive masturbation","authors":"De Alwis AC, Senaratne AM, De Silva SM, Rodrigo VS.","first_author":"De Alwis AC","journal":"The Ceylon medical journal","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single pediatric patient describing excessive masturbation as a presenting symptom of a bladder calculus","sample_n":1,"sample_text":"single case","population":"preschool male child with bladder calculus","country":"Sri Lanka (implied by journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A young boy was found to have a bladder stone that caused him to masturbate frequently, showing that medical problems can sometimes appear as unusual sexual behaviors.","clinical_takeaway":"Consider organic causes when a child shows excessive sexual behaviors.","confidence":0.8,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Clear clinical description of a rare presentation","Highlights need for medical evaluation of atypical sexual behaviors in children"],"limitations":["Single case; no generalizable data","No standardized measures of masturbation frequency or distress","No control or comparison group"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4038/cmj.v51i3.1258"}},{"id":4024,"doi":"10.1007/s10508-013-0199-5","pmid":"24132777","pmcid":null,"title":"Glans necrosis produced by trauma during masturbation","authors":"Arrabal-Polo MA, Pareja-Vilchez M, Lahoz-Garcia C, Gonzalez-Torres S, Valderrama-Illana P, Arrabal-Martin M.","first_author":"Arrabal-Polo MA","journal":"Archives of sexual behavior","year":2013,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0199-5"}},{"id":4026,"doi":"10.1080/10550887.2020.1860423","pmid":"33393441","pmcid":null,"title":"Cybersex addiction in a gay man: a case report","authors":"Skryabin V, Zastrozhin M, Chumakov E.","first_author":"Skryabin V","journal":"Journal of addictive diseases","year":2021,"pub_types":["Journal Article","Case Reports"],"keywords":["MSM","Case Report","Sexual Addiction","Behavioral Addiction","Cybersex"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single individual","sample_n":1,"sample_text":"single case","population":"26‑year‑old gay man","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["circular_addiction_scale","advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The authors describe one 26‑year‑old gay man they label as having a cybersex addiction, using a generic addiction model to list six “addiction‑like” features.","clinical_takeaway":"Do not diagnose cybersex addiction from a single case; evidence is insufficient for clinical decisions.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Detailed narrative of a rarely described population","Application of an established addiction framework"],"limitations":["Single case; no generalizability","No validated measures of addiction or distress","No assessment of key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":11,"max_possible":60,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":2,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10550887.2020.1860423"}},{"id":4028,"doi":"10.1111/j.2047-2927.2013.00133.x","pmid":"24124176","pmcid":null,"title":"Randomised controlled trial of whether erotic material is required for semen collection: impact of informed consent on outcome","authors":"Handelsman DJ, Sivananathan T, Andres L, Bathur F, Jayadev V, Conway AJ.","first_author":"Handelsman DJ","journal":"Andrology","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":["Randomization","Masturbation","Consent","Semen Analysis","Semen Collection","Erotic Material"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized controlled trial with 1520 men, alternating weeks allocation of printed erotic material versus none; primary outcome objectively timed semen collection.","sample_n":1520,"sample_text":"1520 men (1046 fertility evaluation, 474 cryostorage) providing 1932 semen collection episodes.","population":"Men attending a metropolitan hospital semen laboratory for fertility evaluation or sperm cryostorage (N≈1520, 1932 collection episodes).","country":"Not specified (major metropolitan teaching hospital, likely UK or USA).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large randomised trial, men collecting semen in a lab took slightly longer when given printed erotic magazines than when none were provided. The magazines did not improve collection success or semen quality, suggesting they are unnecessary for routine semen collection.","clinical_takeaway":"Clinics can omit erotic material without harming semen collection rates; it may even marginally speed the process.","confidence":0.9,"topic_tags":["sexual_function","masturbation","religiosity"],"strengths":["Large, well‑powered RCT","Objective primary outcome","Simple, pragmatic intervention"],"limitations":["No pre‑registration","No reporting of effect sizes/confidence intervals","Potential unmeasured psychosocial confounders (e.g., anxiety, moral attitudes)"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.2047-2927.2013.00133.x"}},{"id":4029,"doi":"10.1111/andr.12955","pmid":"33275841","pmcid":null,"title":"SECRET<sup>®</sup> - SExual Chronicle REcording Table: Validation and reliability","authors":"Zaccaro C, Lotti F, Morselli S, Sebastianelli A, Frizza F, Bigazzi B, Liaci A, Cai T, Vignozzi L, Vignolini G, Serni S, Gravas S, Moncada I, Salonia A, Gacci M.","first_author":"Zaccaro C","journal":"Andrology","year":2021,"pub_types":["Validation Study","Multicenter Study","Journal Article"],"keywords":["Reproducibility","Internal Coherence","Structured Interview","Sexual History","Sexual Habits"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"multicenter validation of a structured sexual‑history interview with 300 male uro‑andrological patients; test‑retest reliability reported","sample_n":295,"sample_text":"300 recruited, 295 completed all items","population":"male patients with uro‑andrological diseases, Italy","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The SECRET® interview is a new, paper‑based questionnaire that asks men about their whole sexual history, including masturbation and partnered sex. In 295 patients it showed strong internal consistency and stable scores over time, suggesting it works well for clinical use.","clinical_takeaway":"Clinicians can use the SECRET® tool to obtain a comprehensive, reliable sexual history in routine practice.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large multicenter sample for a validation study","High internal consistency (α 0.85‑0.97)","Test‑retest reliability demonstrated"],"limitations":["Clinical convenience sample limits generalisability","No external validation against other sexual‑history tools","No reporting of effect‑size confidence intervals or power analysis"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/andr.12955"}},{"id":4030,"doi":"10.1038/s41443-020-00378-4","pmid":"33328620","pmcid":"PMC7739794","title":"Influence of COVID-19 pandemic on sexuality: a cross-sectional study among couples in Turkey","authors":"Karagöz MA, Gül A, Borg C, Erihan İB, Uslu M, Ezer M, Erbağcı A, Çatak B, Bağcıoğlu M.","first_author":"Karagöz MA","journal":"International journal of impotence research","year":2020,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7739794","cited_by_count":55,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 245 Turkish couples comparing sexual function before and during COVID‑19 pandemic","sample_n":245,"sample_text":"Convenience sample of volunteers recruited during the pandemic","population":"couples (148 men, 97 women) from Turkey; convenience volunteer sample","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 245 Turkish couples found that during the COVID‑19 pandemic sexual function scores dropped and the frequency of intercourse fell, while solitary sexual activities such as masturbation rose. Couples who spent more time together reported better sexual function.","clinical_takeaway":"Pandemic‑related stress may reduce couple sexual activity; supporting couples’ shared time may help maintain sexual health.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Validated sexual function scales (IIEF, FSFI)","Inclusion of mental‑health covariates","Couples‑level analysis of time spent together"],"limitations":["Convenience sample, not nationally representative","Self‑constructed sexual behaviour questionnaire lacks validation","No effect sizes or correction for multiple testing reported"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":10,"contrasting":1,"mentioning":116,"citing_publications":117,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-020-00378-4"}},{"id":4031,"doi":"10.1111/j.2047-2927.2013.00119.x","pmid":"23970455","pmcid":null,"title":"Clinical characteristics and penile afferent neuronal function in patients with primary delayed ejaculation","authors":"Xia JD, Han YF, Pan F, Zhou LH, Chen Y, Dai YT.","first_author":"Xia JD","journal":"Andrology","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Neurophysiology","Sexual dysfunction","Somatosensory Evoked Potentials","Delayed Ejaculation"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control comparison of 24 men with primary delayed ejaculation and 24 age‑matched controls; somatosensory evoked potentials recorded; questionnaires for anxiety, depression, masturbation frequency.","sample_n":48,"sample_text":"24 patients with primary DE and 24 age‑matched healthy men","population":"Adult males with primary delayed ejaculation; control group of normally potent men; recruited likely from clinical settings.","country":"China (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Men with primary delayed ejaculation showed less penile shaft sensitivity and different nerve response patterns than healthy men. They also reported more frequent, idiosyncratic masturbation, lower nighttime emissions, longer intercourse times, and higher anxiety and depression.","clinical_takeaway":"Delayed ejaculation may involve sensory hyposensitivity and psychological factors; assessment should include neurophysiological testing and mental‑health screening.","confidence":0.6,"topic_tags":["sexual_function","neuroscience","masturbation"],"strengths":["Objective neurophysiological measures (SEPs)","Matched control group","Inclusion of psychological covariates"],"limitations":["Small sample size","No power calculation or effect sizes reported","Key confounds (moral incongruence, partner factors, trauma) not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":23,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.2047-2927.2013.00119.x"}},{"id":4032,"doi":"10.33588/rn.5705.2013219","pmid":"23975532","pmcid":null,"title":"[Kinetogenic reflex epilepsy associated to masturbatory movements]","authors":"García N, Aragonès JM.","first_author":"García N","journal":"Revista de neurologia","year":2013,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.33588/rn.5705.2013219"}},{"id":4033,"doi":"10.1038/s41443-020-00381-9","pmid":"33311709","pmcid":"PMC7728577","title":"Sexual attitudes of healthcare professionals during the COVID-19 outbreak","authors":"Culha MG, Demir O, Sahin O, Altunrende F.","first_author":"Culha MG","journal":"International journal of impotence research","year":2021,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7728577","cited_by_count":34,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 185 healthcare workers comparing pre‑ and during‑COVID sexual attitudes","sample_n":185,"sample_text":"185 participants completed the questionnaire","population":"healthcare professionals (Turkey)","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"During the first COVID‑19 wave, Turkish health‑care workers reported lower sexual desire, fewer sexual encounters (including masturbation), shorter foreplay and intercourse, and a shift toward less face‑to‑face positions.","clinical_takeaway":"Clinicians should be aware that pandemic‑related stress may reduce sexual activity and desire in health‑care staff.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Uses validated sexual function questionnaires (IIEF, FSFI)","Assesses both sexual desire and frequency","Includes mental‑health covariates (anxiety, depression)","Within‑subject pre/post design captures change over pandemic"],"limitations":["Convenience sample of health‑care workers; not generalisable","Frequency of intercourse and masturbation combined; no isolation of masturbation","No moral‑incongruence or partner variables measured","No pre‑registration; effect sizes not reported"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":66,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-020-00381-9"}},{"id":4034,"doi":"10.1016/j.fertnstert.2013.07.1979","pmid":"23987518","pmcid":null,"title":"Fresh semen quality in ejaculates produced by nocturnal emission in men with idiopathic anejaculation","authors":"Meng X, Fan L, Liu J, Wang T, Yang J, Wang J, Wang S, Ye Z.","first_author":"Meng X","journal":"Fertility and sterility","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Infertility","electroejaculation","Idiopathic Anejaculation","Nocturnal Emission","Penile Vibratory Stimulation"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective clinical study comparing semen parameters from nocturnal emission, penile vibratory stimulation, electroejaculation in idiopathic anejaculation patients versus masturbated samples from healthy controls.","sample_n":91,"sample_text":"91 men with idiopathic anejaculation; control group size not reported in abstract.","population":"91 men with idiopathic anejaculation; healthy control men (sample size not specified).","country":"China (inferred from author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In men who cannot ejaculate naturally, semen collected during a nighttime emission had better motility and shape than sperm obtained by vibratory or electric stimulation, but still lagged behind samples from healthy men who masturbated.","clinical_takeaway":"Nocturnal emission may yield higher‑quality sperm than assisted methods for men with anejaculation, though values remain below those from typical masturbation.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Objective, validated semen analysis outcomes","Direct comparison of three clinical ejaculation methods","Clear quantitative results"],"limitations":["Retrospective, non‑randomised design","Small, clinic‑based sample limits generalisability","No power calculation or effect‑size reporting"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.fertnstert.2013.07.1979"}},{"id":4035,"doi":"10.1016/j.pediatrneurol.2005.10.023","pmid":"16648008","pmcid":null,"title":"Compulsive masturbation in infantile autism treated by mirtazapine","authors":"Albertini G, Polito E, Sarà M, Di Gennaro G, Onorati P.","first_author":"Albertini G","journal":"Pediatric neurology","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single pediatric case, no control, pre‑post observation of medication effect","sample_n":1,"sample_text":"case report of a single child","population":"one preschool male with severe autism and compulsive masturbation","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"supports","citation_value":"avoid","plain_summary":"A 5‑year‑old boy with autism who showed intense, repetitive masturbation was given the antidepressant mirtazapine. After treatment, the masturbatory behavior stopped and broader autism symptoms improved, suggesting the drug might help similar cases.","clinical_takeaway":"One case suggests mirtazapine can reduce compulsive masturbation in autistic children, but evidence is insufficient for clinical use.","confidence":0.4,"topic_tags":["masturbation","sexual_function","neuroscience","treatment"],"strengths":["Detailed clinical description of a rare presentation","Reports notable broader improvements beyond sexual behavior"],"limitations":["Single case; no control or replication","No standardized measurement of masturbatory behavior or autism severity","No assessment of potential confounds (e.g., medication side‑effects, developmental changes)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":37,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pediatrneurol.2005.10.023"}},{"id":4036,"doi":"10.1542/peds.2019-1411","pmid":"33257402","pmcid":null,"title":"Sexual Experiences of Young Transgender Persons During and After Gender-Affirmative Treatment","authors":"Bungener SL, de Vries ALC, Popma A, Steensma TD.","first_author":"Bungener SL","journal":"Pediatrics","year":2020,"pub_types":["Video-Audio Media","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire study of 113 transgender adolescents assessed before and after gender‑affirmative treatment, with comparison to a large Dutch general‑population sample.","sample_n":113,"sample_text":"113 transgender participants; comparison group N=4020 (general population).","population":"113 transgender adolescents/young adults (38 transwomen, 75 transmen) who received puberty suppression, hormone therapy, and surgery; mean age 20.8 y (SD 1.36). Compared to 4 020 same‑aged Dutch general‑population respondents.","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Transgender young adults who received early gender‑affirmative treatment reported more sexual activities (masturbation, petting, intercourse) one year after surgery, but still engaged less often than peers from the general population.","clinical_takeaway":"Gender‑affirmative treatment may broaden sexual and romantic experiences, though clinicians should note that overall activity levels may remain lower than peers.","confidence":0.7,"topic_tags":["sexual_function","gender","treatment"],"strengths":["Large comparison sample from national survey","Within‑person pre‑post assessment of treatment effects","Separate reporting of masturbation frequency"],"limitations":["Questionnaire not reported as validated","No adjustment for mental‑health or relationship variables","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":20,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2019-1411"}},{"id":4037,"doi":"10.1177/0025802412474813","pmid":"23929674","pmcid":null,"title":"Impulsive frotteurism: a case report","authors":"Patra AP, Bharadwaj B, Shaha KK, Das S, Rayamane AP, Tripathi CS.","first_author":"Patra AP","journal":"Medicine, science, and the law","year":2013,"pub_types":["Journal Article","Case Reports"],"keywords":["Depression","Impulse","Masturbation","Frotteurism","Hypersexual","Morbid"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single 12‑year‑old boy with impulsive frotteurism, depression and OCD; treatment with sertraline and counseling; 6‑month follow‑up.","sample_n":1,"sample_text":"single case (N=1)","population":"one male adolescent (12 y) with hypersexual/frotteuristic behaviour; recruited from clinical presentation (not a research sample).","country":"India (inferred from authors’ names, not stated in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 12‑year‑old boy displayed impulsive frotteurism and compulsive masturbation, leading to depression. After treatment with sertraline and counseling, his symptoms remitted over six months.","clinical_takeaway":"In adolescents, compulsive sexual behaviours may co‑occur with mood disorders; pharmacological and psychosocial treatment can be effective.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Detailed clinical narrative","Longitudinal follow‑up (6 months)","Discussion of differential diagnosis and management"],"limitations":["Single case – no generalisability","No validated psychometric instruments","No control for moral or relational confounds","Interpretation may over‑pathologise normal developmental impulses"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0025802412474813"}},{"id":4040,"doi":"10.1016/j.jsxm.2020.09.012","pmid":"33223426","pmcid":null,"title":"A Double-Blind, Placebo-Controlled Parallel Group Study to Evaluate the Effect of a Single Oral Dose of 5-HT1A Antagonist GSK958108 on Ejaculation Latency Time in Male Patients Suffering From Premature Ejaculation","authors":"Migliorini F, Tafuri A, Bettica P, Ziviani L, Lund J, Poggesi I, Marcer A, Cacciamani GE, Lorenzo-Gomez MF, Porcaro AB, Antonelli A, Milleri S.","first_author":"Migliorini F","journal":"The journal of sexual medicine","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":["Premature Ejaculation","5Ht(1a) Antagonist","Ejaculation Disorders","Ejaculation Latency Time"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Phase 1 double‑blind, placebo‑controlled parallel‑group randomized trial; 35 male PE patients; single oral dose 3 mg or 7 mg GSK958108 vs placebo; outcome measured as ejaculation latency time in a masturbation model.","sample_n":35,"sample_text":"35 male subjects were enrolled; all completed the study.","population":"Male patients with premature ejaculation (PE), n = 35, recruited for a phase‑1 trial (details of recruitment not provided).","country":"Not specified (likely multinational trial).","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small double‑blind trial, a single dose of the 5‑HT1A antagonist GSK958108 lengthened the time men could delay ejaculation during a masturbation test, especially at the higher 7 mg dose, with few mild side effects.","clinical_takeaway":"GSK958108 may increase ejaculation latency in PE, but evidence is limited by the small sample size.","confidence":0.78,"topic_tags":["prevalence","treatment","sexual_function","neuroscience"],"strengths":["Double‑blind, placebo‑controlled design","Objective physiological outcome (ELT)","Clear dosing regimen with pharmacokinetic data"],"limitations":["Very small sample (35), likely under‑powered","Single‑dose, short‑term assessment only","No assessment of psychological or relational confounders"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.09.012"}},{"id":4041,"doi":"10.1136/sextrans-2020-054688","pmid":"33203737","pmcid":null,"title":"Love during lockdown: findings from an online survey examining the impact of COVID-19 on the sexual health of people living in Australia","authors":"Coombe J, Kong FYS, Bittleston H, Williams H, Tomnay J, Vaisey A, Malta S, Goller JL, Temple-Smith M, Bourchier L, Lau A, Chow EPF, Hocking JS.","first_author":"Coombe J","journal":"Sexually transmitted infections","year":2021,"pub_types":["Journal Article"],"keywords":["Infectious diseases","Sexual behaviour","Sexual Health"],"is_oa":false,"oa_url":null,"cited_by_count":91,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online retrospective survey comparing 2019 vs lockdown period, convenience sample (N≈965), logistic regression","sample_n":965,"sample_text":"965 participants completed the survey","population":"Australian adults, 70% female, 66% aged 18‑29, recruited via social media","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2020 online survey of 965 Australian adults found that during COVID‑19 lockdown most people had less sex overall, but partnered sex with spouses rose, solo activities and masturbation increased, and use of dating apps fell.","clinical_takeaway":"Lockdowns change sexual patterns; clinicians should anticipate altered needs for sexual and reproductive health services.","confidence":0.8,"topic_tags":["sexual_function","relationships","masturbation"],"strengths":["Large sample for an online survey","Timely data on pandemic‑related sexual behavior","Provides within‑person comparison (2019 vs lockdown)"],"limitations":["Convenience, young‑female skew limits generalisability","Self‑report, retrospective recall bias","No validated measures of sexual health or distress"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":12,"contrasting":3,"mentioning":144,"citing_publications":152,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sextrans-2020-054688"}},{"id":4043,"doi":"10.1007/s13178-020-00506-1","pmid":"33224310","pmcid":"PMC7666970","title":"\"INSIDE\" Project on Sexual Health in Spain: Sexual Life During the Lockdown Caused by COVID-19","authors":"Ballester-Arnal R, Nebot-Garcia JE, Ruiz-Palomino E, Giménez-García C, Gil-Llario MD.","first_author":"Ballester-Arnal R","journal":"Sexuality research & social policy : journal of NSRC : SR & SP","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Impact","Spain","General Population","Lockdown","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7666970","cited_by_count":44,"is_preprint":false,"topics":["masturbation","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1448 adults from the general Spanish population during COVID‑19 lockdown; convenience sampling; self‑report questionnaire covering sexual desire, activity, masturbation, online sexual activity, mood, privacy, couple life, stress.","sample_n":1448,"sample_text":"detailed in abstract; recruited via online panels during April 2020.","population":"Spanish adults, 18‑60 y, community sample (N = 1448).","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"During Spain's COVID‑19 lockdown, about half of the 1,448 adults surveyed said their sexual lives changed, with women more likely to report a decline. Factors such as gender, having a partner, privacy, stress, and how unbearable the lockdown felt predicted whether people felt their sexual life got better or worse.","clinical_takeaway":"Lockdown‑related stress and reduced privacy can negatively affect sexual wellbeing; clinicians should assess relationship and stress factors when addressing patients' sexual concerns.","confidence":0.85,"topic_tags":["sexual_function","masturbation"],"strengths":["Large sample size for a rapid pandemic survey","Broad assessment of sexual behaviors and contextual factors","Inclusion of both men and women across a wide age range"],"limitations":["Convenience online sampling limits generalisability","Reliance on ad‑hoc, non‑validated questionnaire items","No measurement of moral or religious factors that could affect distress ratings"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":13,"contrasting":0,"mentioning":82,"citing_publications":101,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13178-020-00506-1"}},{"id":4044,"doi":"10.1080/13691058.2013.792955","pmid":"23758496","pmcid":null,"title":"Sexuality and 'silence' among Khasi youth of Meghalaya, Northeast India","authors":"War RJ, Albert S.","first_author":"War RJ","journal":"Culture, health & sexuality","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed methods survey of university students (convenience sample)","sample_n":null,"sample_text":"unspecified number of university students; likely convenience sample","population":"Indigenous Khasi university students (young adult, both sexes)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study explored how Khasi university students in India think about sex education, masturbation, pre‑marital sex and related topics. It found a cultural “silence” about sexuality, strong Christian influences, and a desire for better, non‑judgmental sexual health discussions.","clinical_takeaway":"None – the paper offers sociocultural insights rather than clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses understudied indigenous population","Combines qualitative and quantitative data","Highlights cultural and religious influences on sexual attitudes"],"limitations":["Convenience sample of university students limits generalisability","No validated measurement instruments reported","No power calculation or effect‑size reporting"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2013.792955"}},{"id":4045,"doi":"10.1111/and.13880","pmid":"33108822","pmcid":null,"title":"Developing a prediction model for the self-evaluation of erectile dysfunction in an adult male population","authors":"Cai Z, Li H.","first_author":"Cai Z","journal":"Andrologia","year":2021,"pub_types":["Journal Article"],"keywords":["erectile dysfunction","Risk Prediction Model","Clinical Usefulness","Adult Male Population"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 612 adult men; logistic regression model development with internal validation split (357 training, 255 validation).","sample_n":612,"sample_text":"Adults aged ~28‑37, recruited via an online ED network survey in China (Oct‑Nov 2019).","population":"Adult male population in China, mean age 31 years (n=612).","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers built a statistical tool that uses factors like education, smoking, health conditions, relationship feelings, sexual frequency, masturbation, and satisfaction to predict erectile dysfunction risk in Chinese men.","clinical_takeaway":"The model may help clinicians identify men at higher ED risk, but it relies on self‑report data and lacks mental‑health screening.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large community sample with internal validation","Multivariable logistic regression with ROC and calibration assessment","Inclusion of both sexual activity and psychosocial predictors"],"limitations":["Self‑report measures without validated ED scale","No assessment of mental‑health or trauma confounders","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/and.13880"}},{"id":4046,"doi":"10.1016/j.esxm.2020.10.007","pmid":"33291042","pmcid":"PMC7718780","title":"Evaluation of the Sexual Functioning of Individuals Living in Turkey During the COVID-19 Pandemic: An Internet-Based Nationwide Survey Study","authors":"Karsiyakali N, Sahin Y, Ates HA, Okucu E, Karabay E.","first_author":"Karsiyakali N","journal":"Sexual medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexual activity","Pandemic","Sexual Desire","Sexual Functioning","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7718780","cited_by_count":23,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Internet‑based nationwide survey (N=1,356) assessing self‑reported sexual intercourse frequency, desire and masturbation during COVID‑19 lockdown; subgroup analyses by city population density.","sample_n":1356,"sample_text":"Convenience sample of volunteers who accessed the online survey between 1–20 June 2020.","population":"Adults (mean age 33 ± 8 y) living in Turkey; recruited via online questionnaire; no medical history of COVID‑19.","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2021 Turkish online survey of 1,356 adults found that during the COVID‑19 lockdown people reported fewer weekly sexual encounters, less desire and, in some groups, fewer masturbations, especially among those living in big cities.","clinical_takeaway":"Clinicians should be aware that pandemic‑related stressors can reduce sexual activity and desire; routine assessment of sexual wellbeing may be warranted.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Large national sample","Timely data on pandemic impact","Multiple demographic variables examined"],"limitations":["Study‑specific, non‑validated questionnaire","Cross‑sectional, no causal inference","Potential self‑selection bias","No measurement of mental‑health or moral variables"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":50,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2020.10.007"}},{"id":4048,"doi":"10.1155/2020/6908458","pmid":"33150165","pmcid":"PMC7603604","title":"Influence of Lifestyle and Environmental Factors on Semen Quality in Ghanaian Men","authors":"Blay RM, Pinamang AD, Sagoe AE, Owusu EDA, Koney NK, Arko-Boham B.","first_author":"Blay RM","journal":"International journal of reproductive medicine","year":2020,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7603604","cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional study of 80 Ghanaian men referred for semen analysis; questionnaire on lifestyle/environment; WHO semen parameters measured.","sample_n":80,"sample_text":"80 apparent healthy adult males in their reproductive age referred for semen analysis.","population":"adult Ghanaian men (n=80) seeking semen analysis at a teaching hospital.","country":"Ghana","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 80 Ghanaian men, smoking was linked to lower sperm count and sitting more than four hours a day was linked to poorer sperm movement. Keeping a cell phone in a side pocket was oddly associated with better sperm motility. The study suggests lifestyle habits affect semen quality.","clinical_takeaway":"Counselling men on smoking cessation and reducing prolonged sitting may help improve sperm health.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["WHO‑standard semen analysis","Direct measurement of sperm parameters","Inclusion of several lifestyle factors"],"limitations":["Convenience sample from a clinical lab, not population‑based","Questionnaire not validated, limited confound control","No effect sizes or correction for multiple testing"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":18,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2020/6908458"}},{"id":4049,"doi":"10.1542/peds.2005-0532","pmid":"16322167","pmcid":null,"title":"Masturbation in infancy and early childhood presenting as a movement disorder: 12 cases and a review of the literature","authors":"Yang ML, Fullwood E, Goldstein J, Mink JW.","first_author":"Yang ML","journal":"Pediatrics","year":2005,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case series of 12 infants presenting with movement‑like episodes later identified as masturbatory behavior.","sample_n":12,"sample_text":"Twelve patients","population":"Infants and preschool children (3 months–3 years) seen in a pediatric movement‑disorder clinic.","country":"USA (presumed from journal and author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe 12 young children who were initially thought to have a movement disorder but were later found to be showing normal infant masturbation. Recognizing the characteristic posture, vocalisations and response to distraction can prevent unnecessary medical testing.","clinical_takeaway":"Clinicians should consider infant masturbation as a benign explanation for brief, stereotyped movement episodes to avoid needless investigations.","confidence":0.8,"topic_tags":["masturbation","prevalence","pornography","sexual_function"],"strengths":["Detailed clinical description of a rare, easily misdiagnosed phenomenon","Use of home video recordings to verify behavior"],"limitations":["Very small, non‑representative convenience sample","No standardized or validated measurement of masturbation behavior","No systematic comparison group"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":2,"mentioning":98,"citing_publications":110,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2005-0532"}},{"id":4050,"doi":"10.1016/j.nrl.2013.01.013","pmid":"23664055","pmcid":null,"title":"Sexsomnia: parasomnia associated with sexual behaviour during sleep","authors":"Ariño H, Iranzo A, Gaig C, Santamaria J.","first_author":"Ariño H","journal":"Neurologia (Barcelona, Spain)","year":2014,"pub_types":["Journal Article","Case Reports"],"keywords":["Masturbation","Parasomnia","Intercourse","Sexsomnia","Amnesia And Sleep","Amnesia Y Sueño","Coito","Masturbación"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 4 patients with video-polysomnography","sample_n":4,"sample_text":"Four cases (3 men, 1 woman) aged 28–43 years","population":"young adult patients (3 men, 1 woman) with sexsomnia, recruited from a sleep clinic","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes four adults who performed sexual acts while asleep, a condition called sexsomnia. Episodes were recorded with sleep studies and often occurred with other sleep disorders, but patients had no memory of the events.","clinical_takeaway":"Sexsomnia can co‑occur with other sleep disorders; awareness and sleep‑study evaluation are useful for diagnosis and management.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed clinical description","Use of video‑polysomnography","Identifies comorbid sleep disorders"],"limitations":["Very small, non‑representative sample","No control group or systematic measurement of confounds","Descriptive only, no inferential statistics"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.nrl.2013.01.013"}},{"id":4051,"doi":"10.1017/s0317167100014189","pmid":"23603159","pmcid":null,"title":"Gratification, masturbation or paroxysmal hyperkinetic motor syndrome of infancy?","authors":"Phillips DF, Seshia SS.","first_author":"Phillips DF","journal":"The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques","year":2013,"pub_types":["Comment","Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0317167100014189"}},{"id":4053,"doi":"10.1016/j.jsxm.2020.09.001","pmid":"33032958","pmcid":null,"title":"Sexual Satisfaction and Frequency of Orgasm in Women With Chronic Pelvic Pain due to Endometriosis","authors":"Hämmerli S, Kohl-Schwartz A, Imesch P, Rauchfuss M, Wölfler MM, Häberlin F, von Orelli S, Leeners B.","first_author":"Hämmerli S","journal":"The journal of sexual medicine","year":2020,"pub_types":["Journal Article"],"keywords":["Endometriosis","Chronic Pelvic Pain","Orgasm","Noncoital Sexual Activities"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study with matched control groups (n=434 per group)","sample_n":868,"sample_text":"434 women with endometriosis and 434 matched controls","population":"women with endometriosis‑related chronic pelvic pain and healthy control women, German‑speaking countries","country":"Germany (German‑speaking countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Women with endometriosis are less likely to orgasm during intercourse, but not during masturbation or non‑coital activities. Partnered non‑coital sex may help them achieve orgasm and greater sexual satisfaction.","clinical_takeaway":"Counselling should promote non‑coital partnered activities to improve orgasm and satisfaction in women with endometriosis‑related pelvic pain.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large, well‑matched sample","Validated sexual functioning questionnaires","Separate assessment of orgasm across activity types"],"limitations":["No control for mental‑health or relationship factors","Cross‑sectional; cannot infer causality","No effect‑size reporting"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":13,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.09.001"}},{"id":4055,"doi":"10.1111/ped.14267","pmid":"32335978","pmcid":null,"title":"Association between children's sleep patterns and problematic behaviors at age 5","authors":"Suda M, Nagamitsu S, Obara H, Shimomura G, Ishii R, Yuge K, Shimomura K, Kurokawa M, Matsuishi T, Yamagata Z, Kakuma T, Yamashita Y.","first_author":"Suda M","journal":"Pediatrics international : official journal of the Japan Pediatric Society","year":2020,"pub_types":["Journal Article"],"keywords":["Sleep Pattern","Problematic Behavior","Individual / Environmental Factor"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large cross‑sectional health‑checkup dataset (N≈8,700) of 5‑year‑olds; associations between sleep variables and a broad set of reported problem behaviours analysed with logistic models and a tree‑based approach","sample_n":8689,"sample_text":"8,689 five‑year‑old children","population":"Preschool children (age 5) from Japan; data from routine health‑checkup records","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a sample of over 8,600 Japanese five‑year‑olds, kids who went to bed late or slept less were slightly more likely to show various problem behaviours, including anxiety, aggression and even masturbation. Longer TV time and lower father involvement were also linked to these outcomes.","clinical_takeaway":"Improving sleep routines and reducing screen time may help lower early childhood behavioural issues.","confidence":0.85,"topic_tags":["csbd","sexual_function","masturbation"],"strengths":["Very large, national‑scale sample","Statistical adjustment for multiple environmental factors","Clear reporting of effect sizes (ORs with CIs)"],"limitations":["Cross‑sectional; cannot infer causality","Behavioural outcomes based on single‑item parental reports, no validated scales","No control for child mental‑health or family psychosocial confounders"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/ped.14267"}},{"id":4056,"doi":"10.1016/j.jsxm.2020.08.020","pmid":"33008782","pmcid":null,"title":"Analysis of the Symptomatology, Disease Course, and Treatment of Postorgasmic Illness Syndrome in a Large Sample","authors":"Natale C, Gabrielson A, Tue Nguyen HM, Dick B, Hellstrom WJG.","first_author":"Natale C","journal":"The journal of sexual medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Male Sexual Dysfunction","Sexual Disorder","Ejaculatory Disorder","Postorgasmic Illness Syndrome"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 302 men recruited from a single online POIS community; self‑report questionnaire; no longitudinal or control group.","sample_n":302,"sample_text":"302 men recruited via an online POIS community.","population":"Men with self‑identified POIS (n=302); mean age 32.6; English‑only survey; response rate 32%.","country":"Global (online community, English‑language).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 302 men with post‑orgasmic illness syndrome (POIS) described common symptoms, how the condition affects daily life, and what treatments people try. Certain symptom groups were linked to greater disease burden.","clinical_takeaway":"Clinicians should recognize POIS symptom clusters as possible markers of higher disease burden and discuss treatment options, but evidence is limited to self‑report data.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation","csbd","measurement"],"strengths":["Largest POIS sample to date","Global participant pool","Detailed symptom cluster analysis"],"limitations":["Convenience online sample, possible selection bias","Self‑report data only, no clinical verification","Questionnaire not validated","Low response rate"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.08.020"}},{"id":4058,"doi":"10.1111/jsm.12153","pmid":"23574740","pmcid":null,"title":"More frequent vaginal orgasm is associated with experiencing greater excitement from deep vaginal stimulation","authors":"Brody S, Klapilova K, Krejčová L.","first_author":"Brody S","journal":"The journal of sexual medicine","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Vagina","Masturbation","Sexual Intercourse","Early Sexual Experience","Vaginal Orgasm"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 75 Czech women reporting self‑rated vaginal orgasm consistency and arousability from different genital stimulation sites.","sample_n":75,"sample_text":"75 Czech women aged 18‑36 recruited via unspecified means.","population":"Adult women, 18‑36 years, Czech Republic (convenience sample)","country":"Czech Republic","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 75 Czech women, those who more often have vaginal orgasms during intercourse also reported higher sexual arousal from deep vaginal stimulation and were more likely to have used vaginal stimulation during their first masturbation.","clinical_takeaway":"Early masturbation involving vaginal stimulation may relate to later vaginal orgasm consistency, but evidence is limited and correlational.","confidence":0.7,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["Focused examination of specific genital stimulation sites","Addresses under‑studied aspect of vaginal orgasm consistency","Provides novel hypothesis about early masturbation and later responsiveness"],"limitations":["Small, non‑representative convenience sample","Self‑report measures without validated scales","Cross‑sectional design limits causal inference","No control for potential psychological or relational confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":10,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12153"}},{"id":4059,"doi":"10.1111/jsm.12144","pmid":"23551826","pmcid":null,"title":"Pleasure and pain: the effect of (almost) having an orgasm on genital and nongenital sensitivity","authors":"Paterson LQ, Amsel R, Binik YM.","first_author":"Paterson LQ","journal":"The journal of sexual medicine","year":2013,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subjects laboratory experiment where 26 healthy women masturbated to (almost) orgasm in two sessions; pressure stimuli applied to genital and forearm sites at baseline, immediate post‑masturbation, and after 15 min.","sample_n":26,"sample_text":"Twenty‑six women","population":"Adult women (average age not given), recruited privately; likely convenience sample.","country":"Not specified (likely USA/Canada based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 26 women, researchers measured how touching the clitoris, vulva, and forearm felt before, right after, and 15 minutes after masturbating to either a full or an almost orgasm. Genital areas felt more pleasurable right after masturbation, but also more painful, especially after a real orgasm. Hormonal‑contraception users reported less pleasure and lower pain thresholds.","clinical_takeaway":"Orgasm may increase genital pain sensitivity while maintaining pleasure; clinicians should consider both pain and pleasure when discussing sexual activity.","confidence":0.7,"topic_tags":["gender","sexual_function","masturbation","religiosity"],"strengths":["Within‑subject design controls individual variability","Objective physiological pain thresholds measured","Clear operationalisation of orgasm vs. almost‑orgasm"],"limitations":["Very small sample (N=26) limits power and generalisability","Pleasurableness ratings rely on single‑item self‑report","No control for psychological or relational confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":2,"mentioning":19,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12144"}},{"id":4060,"doi":"10.1007/s10508-013-0071-7","pmid":"23334627","pmcid":null,"title":"Penile incarceration secondary to masturbation with a steel pipe","authors":"Flores-Martín JF, Puche-Sanz I, Vázquez-Alonso F, Vicente-Prados J, Cózar-Olmo JM.","first_author":"Flores-Martín JF","journal":"Archives of sexual behavior","year":2013,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0071-7"}},{"id":4061,"doi":"10.1007/s10508-020-01837-1","pmid":"32964350","pmcid":"PMC8416830","title":"Sexual Inhibition and Sexual Excitation Scales in Men: Psychometric Properties of a Polish Adaptation","authors":"Nowosielski K, Kurpisz J, Kowalczyk R, Lew-Starowicz M.","first_author":"Nowosielski K","journal":"Archives of sexual behavior","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Psychometrics","Hypersexuality","Sexual Risk","Sexual Inhibition","Sexual Excitation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8416830","cited_by_count":6,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"psychometric validation of a Polish adaptation of the Sexual Inhibition/Sexual Excitation Scale (SIS/SES) in a community sample of 498 men (age 18‑55). Exploratory and confirmatory factor analyses, test‑retest reliability, and convergent correlations with related constructs were reported.","sample_n":498,"sample_text":"498 men aged 18‑55 years","population":"men, 18‑55 years, Poland, community sample","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors translated and tested a Polish version of a questionnaire that measures how easily men become sexually excited or inhibited. The scale showed solid factor structure, reliability and links to related behaviours such as masturbation and risk‑taking.","clinical_takeaway":"The Polish SIS/SES appears reliable for assessing sexual excitation and inhibition, aiding clinicians in tailoring therapy for sexual problems.","confidence":0.7,"topic_tags":["sexual_function","measurement"],"strengths":["Large sample for psychometric work","Full factor‑analytic validation (EFA & CFA)","Good reliability (Cronbach α = .93) and test‑retest stability","Convergent validity with many relevant constructs"],"limitations":["Cross‑sectional; no test of predictive validity","No assessment of moral/religious conflict or partner variables","No pre‑registration or open data statement"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":1,"mentioning":14,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01837-1"}},{"id":4062,"doi":"10.1016/j.ijscr.2020.09.080","pmid":"33607367","pmcid":"PMC7900217","title":"Penile ring entrapment and strangulation: A case report at Kampala International University Teaching Hospital in Western Uganda","authors":"Kyomukama LA, Ssebuufu R, Wani SA, Waziri MA, Lule H.","first_author":"Kyomukama LA","journal":"International journal of surgery case reports","year":2021,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Masturbation","Case-report","Erectile-dysfunction","Penile Ring-entrapment","Penile-strangulation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7900217","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report describing presentation, management, and outcome of penile ring entrapment; no comparison group or systematic methodology","sample_n":1,"sample_text":"1 patient","population":"43‑year‑old male in Uganda, self‑selected case; not representative","country":"Uganda","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 43‑year‑old man in Uganda inserted a metal ring to maintain an erection. After 72 hours the ring caused swelling, pain, and urinary retention. The ring was cut off with a grinder and the penis healed over eight months.","clinical_takeaway":"Prompt removal of constricting devices is essential to prevent permanent penile damage.","confidence":0.9,"topic_tags":["masturbation","sexual_function"],"strengths":["detailed clinical description","follow‑up outcome reported"],"limitations":["single case, no generalisability","no systematic assessment of underlying motives","no control or comparison"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijscr.2020.09.080"}},{"id":4063,"doi":"10.1016/j.jsxm.2020.08.009","pmid":"32948487","pmcid":null,"title":"Prevalence Rates of Sexual Behaviors, Condom Use, and Contraception Among Australian Heterosexual Adolescents","authors":"Fisher CM, Kauer S, Mikolajczak G, Ezer P, Kerr L, Bellamy R, Waling A, Lucke J.","first_author":"Fisher CM","journal":"The journal of sexual medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Contraception","Sexual behaviour","Adolescence","Condoms","Sexual Health Promotion"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large nationally representative cross‑sectional survey of Australian year‑10 to 12 heterosexual students (N≈4,350)","sample_n":4356,"sample_text":"2,301 male and 2,055 female year‑10 through‑12 students","population":"heterosexual cis‑gender adolescents (year 10‑12) in Australia","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationwide survey of 4,356 Australian high‑school students showed that most had masturbated, while less than half had engaged in oral or penetrative sex. Condom use at first and recent sex was around 75 % and most used some contraception.","clinical_takeaway":"Adolescent clinicians can expect high rates of masturbation and moderate condom use among heterosexual Australian teens.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Nationally representative probability sample","Large sample size","Weighted prevalence estimates with confidence intervals"],"limitations":["Self‑report may be subject to recall or social desirability bias","No measurement of mental‑health or moral‑incongruence variables","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":2,"contrasting":1,"mentioning":12,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.08.009"}},{"id":4064,"doi":"10.1016/j.fertnstert.2013.01.116","pmid":"23490168","pmcid":null,"title":"Effect of an isotonic lubricant on sperm collection and sperm quality","authors":"Agarwal A, Malvezzi H, Sharma R.","first_author":"Agarwal A","journal":"Fertility and sterility","year":2013,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"paired randomized cross‑over trial with 22 healthy male donors","sample_n":22,"sample_text":"22 donors (crossover)","population":"healthy men ≥18 y, normal WHO semen parameters","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small crossover trial, men collected semen with or without an isotonic lubricant. Most preferred using the lubricant, and sperm quality measures showed no adverse effects, suggesting the product is safe for fertility clinics.","clinical_takeaway":"The isotonic lubricant Pre‑Seed can be used during semen collection without harming sperm quality.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Crossover RCT controls for participant variability","Validated sperm function assays","Clear, relevant outcome for fertility clinics"],"limitations":["Small sample (n=22) limits power","No pre‑registration reported","Generalizability limited to healthy donors"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":0,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.fertnstert.2013.01.116"}},{"id":4066,"doi":"10.1016/j.biopsycho.2005.06.008","pmid":"16095799","pmcid":null,"title":"The post-orgasmic prolactin increase following intercourse is greater than following masturbation and suggests greater satiety","authors":"Brody S, Krüger TH.","first_author":"Brody S","journal":"Biological psychology","year":2006,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":77,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory comparative study measuring prolactin response after intercourse vs masturbation with a non‑sexual control condition.","sample_n":null,"sample_text":"Not reported in abstract.","population":"Adult men and women (sample size not specified in abstract).","country":"Not specified.","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab setting, blood prolactin rose about four times more after intercourse than after masturbation, suggesting that coitus may produce a stronger physiological feeling of sexual satiety.","clinical_takeaway":"Intercourse may trigger larger prolactin‑linked satiety signals than masturbation, but relevance to health or wellbeing is unclear.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","moral_incongruence"],"strengths":["Objective hormonal measure (prolactin).","Within‑subject comparison of two sexual activities.","Includes non‑sexual control condition."],"limitations":["Sample size and participant characteristics not reported.","No control for moral, psychological or relational confounds.","Interpretation limited to physiological satiety; cannot infer broader wellbeing."],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":10,"contrasting":0,"mentioning":83,"citing_publications":145,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.biopsycho.2005.06.008"}},{"id":4067,"doi":"10.1007/s00120-020-01297-4","pmid":"32803406","pmcid":null,"title":"[\"Rohleder was one of the first to fully realize the importance of sexology.\" : Life and work of the venereologist, urologist, and sexologist Hermann Rohleder (1866-1934)]","authors":"Moll FH, Halling T, Krischel M.","first_author":"Moll FH","journal":"Der Urologe. Ausg. A","year":2020,"pub_types":["Historical Article","Biography","Review","Journal Article"],"keywords":["History Of Medicine","Eugenics","Masturbation","Medical Specialization","History Of Sexology"],"is_oa":false,"oa_url":"https://link.springer.com/content/pdf/10.1007/s00120-020-01297-4.pdf","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical biography/review; no primary data collected.","sample_n":null,"sample_text":"Not applicable – article is a narrative historical account.","population":"none","country":"Germany (historical context)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article recounts the career of Hermann Rohleder, an early 20th‑century physician who helped shape German sexology, describing his work in venereology, urology, and attempts to establish a sexology professorship.","clinical_takeaway":"None – the paper is historical and does not provide clinical guidance.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Provides detailed historical context for early sexology.","Covers intertwining of urology and sexology in early 20th‑century Germany."],"limitations":["No empirical data; purely narrative.","No methodological rigor assessment possible.","Findings not directly applicable to current clinical issues."],"rubric_version":"2.0","raw_total":3,"max_possible":50,"pct_score":6,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":0,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00120-020-01297-4"}},{"id":4068,"doi":"10.1097/paf.0000000000000576","pmid":"32568885","pmcid":null,"title":"An Illustrative Case of Suicidal Hanging Versus Accidental Hanging Associated With Autoerotic Activity: Necessary Medicolegal Death Investigation and Role of Cognitive Bias","authors":"Zou J, Bauler LD, Brown TT.","first_author":"Zou J","journal":"The American journal of forensic medicine and pathology","year":2020,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single forensic case description with death‑scene investigation; no systematic data collection","sample_n":1,"sample_text":"single case","population":"one adult male decedent","country":"USA (presumed from journal affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A forensic case described a man who died by hanging. Initial signs suggested suicide, but later investigation of the scene and family testimony indicated the death was likely accidental, linked to solo sexual activity (autoerotic asphyxia). The report urges pathologists to consider all evidence before labeling hanging deaths as suicide.","clinical_takeaway":"When assessing hanging deaths, investigators should evaluate possible autoerotic behaviors to avoid misclassifying accidental deaths as suicides.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Detailed forensic scene documentation","Highlights importance of avoiding premature conclusions"],"limitations":["Single case; no generalizable data","No systematic measurement of sexual behavior or mental health"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/paf.0000000000000576"}},{"id":4069,"doi":"10.1136/bmjsrh-2020-200720","pmid":"32868336","pmcid":null,"title":"Age pattern of sexual activities with the most recent partner among men who have sex with men in Melbourne, Australia: a cross-sectional study","authors":"Kilner A, Fairley CK, Burrell S, Bradshaw CS, Chen MY, Chow EPF.","first_author":"Kilner A","journal":"BMJ sexual & reproductive health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual behavior"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of MSM attending a sexual health clinic (N=1596)","sample_n":1596,"sample_text":"1596 men answered the survey (median age 30, IQR 25‑37)","population":"men who have sex with men, median age 30, Australia","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 1,596 Australian gay men, younger participants were more likely to engage in kissing, oral sex and receptive anal sex with casual partners, while older men reported more insertive anal sex. With regular partners, age differences were smaller, except for mutual masturbation and receptive anal sex.","clinical_takeaway":"Age influences the type of sexual activities MSM engage in, especially with casual partners; clinicians should consider age when discussing sexual health practices.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a cross‑sectional survey","Focused on understudied sexual activities beyond anal intercourse","Clear age‑trend analysis"],"limitations":["Convenience clinic sample limits generalisability","Self‑report items likely ad‑hoc, no validated scales","No control for moral, mental‑health or trauma confounders"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjsrh-2020-200720"}},{"id":4070,"doi":"10.1080/00224499.2020.1802644","pmid":"32808815","pmcid":null,"title":"Adolescents' Perspective on Their Sexual Knowledge and the Role of School in Addressing Emotions in Sex Education: An Exploratory Analysis of Two School Types in Austria","authors":"Seiler-Ramadas R, Grabovac I, Niederkrotenthaler T, Dorner TE.","first_author":"Seiler-Ramadas R","journal":"Journal of sex research","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire survey of 198 Austrian adolescents (age 13‑16) from two secondary schools and one polytechnic school","sample_n":198,"sample_text":"198 participants (age 13‑16) from three schools","population":"adolescents, school‑based convenience sample, Austria","country":"Austria","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2020 Austrian survey of 198 teens compared how students in secondary schools and polytechnic schools felt about their sexual knowledge. Secondary school students felt more knowledgeable about biology but less informed about emotional issues, masturbation, and relationships. The authors argue that sex education should better integrate emotional topics and use varied teaching methods.","clinical_takeaway":"Sex education programmes should balance factual information with emotional and relational content to meet adolescents’ needs.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relatively large adolescent sample for a school‑based study","Addresses both factual and emotional aspects of sex education","Uses regression to compare school types"],"limitations":["Questionnaire appears ad‑hoc; limited evidence of validation","Cross‑sectional design prevents causal inference","No control for key confounds (e.g., mental health, moral attitudes)","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2020.1802644"}},{"id":4072,"doi":"10.1080/10538712.2013.811140","pmid":"23924178","pmcid":null,"title":"Sister-sister incest: data from an anonymous computerized survey","authors":"Stroebel SS, O'Keefe SL, Griffee K, Kuo SY, Beard KW, Kommor MJ.","first_author":"Stroebel SS","journal":"Journal of child sexual abuse","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective anonymous computer‑assisted self‑interview of 1,521 adult women; 31 sister‑sister incest victims; cross‑sectional comparison with controls","sample_n":1521,"sample_text":"31 sister‑sister incest victims, 40 brother‑sister, 19 father‑daughter, 8 adult‑female abusers, 232 other male abusers, 1,203 controls","population":"adult women (community sample, self‑selected)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,521 adult women, those who reported sister‑sister incest in childhood showed higher rates of depression, unplanned pregnancy, sex‑trading and varied sexual behaviours compared with women without such abuse.","clinical_takeaway":"History of incest can be linked to later mental‑health and sexual‑risk issues; clinicians should screen for these outcomes.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Large overall sample size","Anonymous survey reduces social desirability bias","Direct assessment of multiple outcome domains"],"limitations":["Cross‑sectional, retrospective design limits causal inference","Small number of sister‑sister incest cases reduces precision","Likely reliance on unvalidated self‑report items"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":27,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2013.811140"}},{"id":4073,"doi":"10.4103/2279-042x.114086","pmid":"24991601","pmcid":"PMC4076896","title":"Risperidone as a treatment for childhood habitual behavior","authors":"Omranifard V, Najafi M, Sharbafchi MR, Emami P, Maracy M.","first_author":"Omranifard V","journal":"Journal of research in pharmacy practice","year":2013,"pub_types":["research-article","Journal Article"],"keywords":["Risperidone","Behavioral Problems","Behavioral Treatment","Children Habitual Behavior","Children Masturbation"],"is_oa":true,"oa_url":"https://doi.org/10.4103/2279-042x.114086","cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"4‑week randomized controlled trial (N=90) of risperidone + behavioral therapy vs behavioural therapy alone in children 3‑7 y recruited from a psychiatric clinic.","sample_n":90,"sample_text":"44 risperidone, 46 control","population":"children 3‑7 years with reported habitual masturbation, clinical sample","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a 4‑week study of 90 children aged 3‑7 who repeatedly masturbated, adding low‑dose risperidone to behavioural therapy cut the number of daily masturbations more than therapy alone.","clinical_takeaway":"Risperidone may further reduce frequent masturbation in young children beyond behavioural treatment, but evidence is limited and based on a small clinical sample.","confidence":0.7,"topic_tags":["masturbation","pornography","sexual_function","treatment"],"strengths":["Randomized allocation","Clear behavioural outcome (masturbation frequency)","Reasonable sample size for a paediatric trial"],"limitations":["No validated measurement instrument","Clinical convenience sample limits generalisability","No reporting of effect sizes or confidence intervals","Potential lack of blinding"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":9,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/2279-042x.114086"}},{"id":4074,"doi":"10.2196/20961","pmid":"32716895","pmcid":"PMC7419154","title":"Impact of the COVID-19 Pandemic on Partner Relationships and Sexual and Reproductive Health: Cross-Sectional, Online Survey Study","authors":"Li G, Tang D, Song B, Wang C, Qunshan S, Xu C, Geng H, Wu H, He X, Cao Y.","first_author":"Li G","journal":"Journal of medical Internet research","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["China","Survey","Youth","Sexual behavior","Reproductive Health","Sexual Health","Young Adults","Novel Coronavirus","Covid-19"],"is_oa":true,"oa_url":"https://doi.org/10.2196/20961","cited_by_count":147,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 3500 invited, 967 analysed; convenience sample of Chinese youth recruited via social media; cross‑sectional self‑report questionnaire","sample_n":967,"sample_text":"967 participants included in sexual health analysis","population":"young adults in China (age not specified)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2020 Chinese online survey of 967 young adults found that during COVID‑19 lockdowns many reported lower sexual desire, less intercourse, more masturbation, and poorer partner relationships, with these changes linked to living conditions and relationship status.","clinical_takeaway":"Clinicians should be aware that pandemic‑related stress can reduce sexual desire and satisfaction and increase masturbation; address relationship and mental‑health factors when counseling young patients.","confidence":0.78,"topic_tags":["sexual_function","relationships","masturbation","religiosity","moral_incongruence"],"strengths":["Large initial recruitment (3500) and respectable analytic sample (967)","Provides timely data on pandemic‑related changes in sexual behavior","Reports effect sizes (odds ratios) with confidence intervals"],"limitations":["Convenience, self‑selected sample via social media; limited generalisability","Reliance on ad‑hoc self‑report items; no validated scales for desire, satisfaction, or relationship quality","Key confounds (moral incongruence, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":18,"contrasting":3,"mentioning":275,"citing_publications":272,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/20961"}},{"id":4075,"doi":"10.1007/s10461-020-02795-4","pmid":"32072385","pmcid":null,"title":"Iterative Development of In This toGether, the First mHealth HIV Prevention Program for Older Adolescents in Uganda","authors":"Ybarra ML, Agaba E, Chen E, Nyemara N.","first_author":"Ybarra ML","journal":"AIDS and behavior","year":2020,"pub_types":["Journal Article"],"keywords":["Sub-Saharan Africa","Uganda","Intervention Development","Hiv Prevention","Mhealth","Older Adolescents"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Iterative development with focus groups, advisory teams, alpha and beta testing; no control group; convenience sample recruited via social media.","sample_n":202,"sample_text":"202 focus‑group participants, 143 advisory team members, 34 beta‑test participants.","population":"Ugandan older adolescents (18‑22 y), both sexes; recruited nationally via Facebook/Instagram.","country":"Uganda","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers built a text‑message HIV‑prevention program for Ugandan youths aged 18‑22, using focus groups and beta testing to shape content on sex, protection, and topics like masturbation. The process showed the program is feasible and acceptable.","clinical_takeaway":"The program appears feasible for Ugandan adolescents, but effectiveness for HIV prevention remains untested.","confidence":0.6,"topic_tags":["moral_incongruence","masturbation","sexual_function"],"strengths":["National recruitment via social media—broad geographic reach","Iterative, participatory development involving adolescents themselves","Addresses culturally sensitive topics (masturbation, oral/anal sex)"],"limitations":["No efficacy data; only feasibility/acceptability","Small beta‑test sample (n=34) limits generalisability","Lacks rigorous quantitative evaluation or power justification"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":52,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-020-02795-4"}},{"id":4078,"doi":null,"pmid":"33347212","pmcid":null,"title":"Sex During Menstruation: Race, Sexual Identity, and Women’s Accounts of Pleasure and Disgust","authors":"Fahs B.","first_author":"Fahs B.","journal":"Palgrave Macmillan, Singapore","year":2020,"pub_types":["Review"],"keywords":[],"is_oa":true,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative interview study with 40 women; purposive sampling across age, race, sexual orientation","sample_n":40,"sample_text":"40 women interviewed","population":"women (diverse in age, race, sexual orientation) who have had sex during menstruation","country":"Not specified (likely Singapore/UK authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 40 women showed that most felt discomfort or disgust during sex while menstruating, while a minority reported pleasure and rebellion against anti‑menstrual attitudes. Positive experiences were more common among White and bisexual/lesbian women, and those who also enjoyed masturbation.","clinical_takeaway":"Clinicians should recognise that attitudes toward sex during menstruation vary widely and can be shaped by cultural and identity factors; no universal judgment should be applied.","confidence":0.6,"topic_tags":["sexual_function","gender","csbd"],"strengths":["Diverse sample across race and sexual identity","Rich qualitative insight into pleasure and disgust","Clear thematic analysis"],"limitations":["Small, non‑representative convenience sample","No quantitative measures of frequency or distress","No control for moral or mental‑health variables"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":4079,"doi":"10.3390/jcm9072297","pmid":"32698369","pmcid":"PMC7408907","title":"Consensus on Recommendations for Safe Sexual Activity during the COVID-19 Coronavirus Pandemic","authors":"Cabello F, Sánchez F, Farré JM, Montejo AL.","first_author":"Cabello F","journal":"Journal of clinical medicine","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Sexual activity","Recommendations","Consensus","Sexual Risk","Covid-19","Sars-cov-2"],"is_oa":true,"oa_url":"https://www.mdpi.com/2077-0383/9/7/2297/pdf?version=1595237332","cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"expert consensus without empirical data","sample_n":null,"sample_text":"none (expert consensus)","population":"adults, general population","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A Spanish expert panel gave practical advice on how to have safer sex during the COVID‑19 pandemic, recommending abstinence or virtual sex when a partner might be infected and normal activity after quarantine periods.","clinical_takeaway":"Follow the consensus safety guidelines (quarantine, symptom checks, virtual alternatives) to reduce COVID‑19 transmission risk during sexual activity.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Clear, actionable public‑health recommendations","Addresses multiple partner‑status scenarios"],"limitations":["No empirical data; based solely on expert opinion","No systematic evidence review reported","Potential cultural/regional bias (Spanish experts only)"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":37,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jcm9072297"}},{"id":4081,"doi":"10.1016/j.annder.2020.04.022","pmid":"32654793","pmcid":null,"title":"[Cutaneous and mucosal manifestations of sexual practices]","authors":"Kluger N.","first_author":"Kluger N.","journal":"Annales de dermatologie et de venereologie","year":2020,"pub_types":["Journal Article"],"keywords":["Sexuality","Allergy","SKin","Masturbation","Oral Sex","Peau","Kissing","Sexualité","Piercing Génital","Allergie","Poppers","Baiser","Sex-toys","Sexe Oral"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative overview without empirical data; no described methodology or sample.","sample_n":null,"sample_text":"Not applicable – no empirical sample reported.","population":"Patients presenting with cutaneous or mucosal lesions; no sample size reported.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews skin and mucous‑membrane problems that can arise from various sexual activities, urging dermatologists to ask patients about their sexual history to avoid misdiagnosis.","clinical_takeaway":"Consider sexual practices when evaluating unexplained skin or mucosal lesions; ask patients directly about relevant behaviours.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Highlights a clinically relevant but under‑recognised topic for dermatologists.","Provides a broad overview of possible lesions linked to sexual activities."],"limitations":["Lacks empirical data or systematic methodology.","No description of literature search or inclusion criteria."],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.annder.2020.04.022"}},{"id":4082,"doi":"10.1016/j.jsxm.2020.06.006","pmid":"32653391","pmcid":"PMC7342024","title":"Love in the Time of COVID-19: Sexual Function and Quality of Life Analysis During the Social Distancing Measures in a Group of Italian Reproductive-Age Women","authors":"Schiavi MC, Spina V, Zullo MA, Colagiovanni V, Luffarelli P, Rago R, Palazzetti P.","first_author":"Schiavi MC","journal":"The journal of sexual medicine","year":2020,"pub_types":["other","Multicenter Study","Journal Article"],"keywords":["Sexual function","Quality of life","Coronavirus","Fsfi","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7342024","cited_by_count":105,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational pre‑post (within‑subject) survey of 89 Italian women, convenience sample","sample_n":89,"sample_text":"89 participants (median age 39, range 28‑50)","population":"reproductive‑age women living with a sexual partner, non‑infected with COVID‑19","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In 89 Italian women living with a partner, sexual activity and function dropped sharply during COVID‑19 lockdown, and overall quality of life fell, especially for those working outside the home or with higher education and children.","clinical_takeaway":"Lockdown stress can impair women's sexual health; clinicians should consider offering psychological or sexual support during such periods.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses validated sexual function and distress scales","Pre‑post design allows intra‑individual comparison","Addresses an under‑studied pandemic impact"],"limitations":["No measurement of masturbation or solo sexual activity","No assessment of mental‑health or moral/religious factors","Convenience sample; limited generalisability","No power calculation or pre‑registration"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":14,"contrasting":9,"mentioning":213,"citing_publications":175,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.06.006"}},{"id":4083,"doi":"10.1093/humrep/deaa133","pmid":"32613241","pmcid":"PMC7368399","title":"Impaired semen quality in trans women: prevalence and determinants","authors":"de Nie I, Meißner A, Kostelijk EH, Soufan AT, Voorn-de Warem IAC, den Heijer M, Huirne J, van Mello NM.","first_author":"de Nie I","journal":"Human reproduction (Oxford, England)","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Fertility / Sperm Quality / Cryopreservation / Andrology / Transgender"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7368399","cited_by_count":40,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective cohort of 260 trans women attending a gender clinic; no loss to follow-up.","sample_n":260,"sample_text":"260 trans women, age 16–52, from a single gender clinic (1972‑2017).","population":"Trans women (birth‑assigned male) seeking fertility preservation before hormone therapy.","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 260 trans women who had not yet started hormone therapy, sperm counts and motility were already lower than typical male values. Smoking and older age were linked to poorer motility, but other usual risk factors did not explain the overall reduction.","clinical_takeaway":"Trans women should be counseled that semen quality may be low even before hormone treatment; smoking cessation may help.","confidence":0.85,"topic_tags":["sexual_function","religiosity"],"strengths":["Large retrospective cohort for a rare population","Validated WHO semen parameters","Clear statistical reporting with CIs"],"limitations":["Retrospective design limits causality","Lacks data on transgender‑specific factors (tucking, masturbation frequency)","Potential selection bias – only those presenting for fertility preservation"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":4,"contrasting":1,"mentioning":46,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/humrep/deaa133"}},{"id":4084,"doi":"10.1002/iju5.12184","pmid":"32914071","pmcid":"PMC7469847","title":"Case of post-orgasmic illness syndrome associated with hypogonadism","authors":"Takeshima T, Kuroda S, Yumura Y.","first_author":"Takeshima T","journal":"IJU case reports","year":2020,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Hypogonadism","Testosterone Replacement Therapy","Ejaculatory Disorder","Post‐Orgasmic Illness Syndrome"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7469847","cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report describing post‑orgasmic illness syndrome and response to testosterone therapy","sample_n":1,"sample_text":"single case","population":"21‑year‑old unmarried man with POIS and mild hypogonadism","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 21‑year‑old man experienced flu‑like symptoms for two days after masturbating. He had slightly low free testosterone. NSAIDs helped pain, and testosterone injections reduced fatigue and allowed daily ejaculation.","clinical_takeaway":"In rare post‑orgasmic illness syndrome, checking testosterone levels and considering hormone therapy may help.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Detailed clinical description","Biochemical measurement of testosterone","Therapeutic response documented"],"limitations":["Single case, no control group","No validated symptom scales","No assessment of psychological confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/iju5.12184"}},{"id":4085,"doi":"10.1080/00224499.2020.1783505","pmid":"32609010","pmcid":"PMC7775328","title":"Age of Sexual Debut among Young Gay-identified Sexual Minority Men: The P18 Cohort Study","authors":"Halkitis PN, LoSchiavo C, Martino RJ, De La Cruz BM, Stults CB, Krause KD.","first_author":"Halkitis PN","journal":"Journal of sex research","year":2021,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational cohort with retrospective self‑report of sexual debut ages; diverse NYC gay‑identified YSMM sample","sample_n":null,"sample_text":"not reported in abstract","population":"young gay‑identified sexual minority men in New York City","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a New York City cohort of gay-identified young men, the average age of first sexual activity was 14.5 years, with mutual masturbation occurring earliest. Black and Hispanic/Latino participants started oral and anal sex earlier, while higher‑SES youth started later.","clinical_takeaway":"Early sexual debut varies by race/ethnicity and SES; clinicians should consider tailored, inclusive sex education for younger adolescents.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large, diverse sample of YSMM","focus on multiple specific sexual behaviors","identifies racial/SES disparities"],"limitations":["retrospective self‑report of age of debut","no validated measures of sexual behavior timing","limited control for psychological or contextual confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2020.1783505"}},{"id":4086,"doi":"10.1097/qai.0000000000002342","pmid":"32149857","pmcid":"PMC7293558","title":"Brief Report: Sexual Debut Among 14- to 17-year-old Sexual Minority Males: A Preliminary Investigation of Early HIV Risk and Sexual Health Needs","authors":"Nelson KM, Perry NS, Stout CD, Carey MP.","first_author":"Nelson KM","journal":"Journal of acquired immune deficiency syndromes (1999)","year":2020,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online survey of 118 sexually active adolescent sexual‑minority males (ages 14‑17) in the US; Fisher exact tests used to examine racial/ethnic differences and associations between early anal‑sex debut and condomless anal sex.","sample_n":118,"sample_text":"Sexually active ASMM (N = 118; ages 14‑17) completed an online sexual health survey.","population":"Adolescent sexual‑minority males (ASMM), 14‑17 y, United States (N = 118).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 14‑17‑year‑old gay and bisexual boys in the US, the average age of first sex with a male was 14. One‑third started with anal sex, especially Black youth. Those who had anal sex before age 14 were all later engaged in condomless anal sex, highlighting a need for early, tailored sexual‑health education.","clinical_takeaway":"Early anal‑sex debut in teen gay/bisexual males predicts later condomless sex; clinicians should provide age‑appropriate anal‑sex safety and communication counseling well before debut.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Focus on understudied high‑risk group (ASMM)","Provides age‑specific data on sexual debut","Identifies clear racial/ethnic disparities"],"limitations":["Small, non‑representative convenience sample","Self‑report without validated scales","No adjustment for key psychosocial confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/qai.0000000000002342"}},{"id":4087,"doi":"10.1007/s00414-020-02344-7","pmid":"32592072","pmcid":null,"title":"Rectal explosion: a strange case of autoerotic death","authors":"Hejna P, Zátopková L, Janík M.","first_author":"Hejna P","journal":"International journal of legal medicine","year":2021,"pub_types":["Journal Article","Case Reports"],"keywords":["Foreign Object Insertion","Anal Autoeroticism","Anal Explosion","Anal Sadomasochism","Autoerotic Fatality","Lethal Paraphilic Syndrome"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single fatal autoerotic incident; no control group; descriptive forensic analysis","sample_n":1,"sample_text":"single case","population":"single adult male (35‑year‑old) who engaged in anal autoeroticism","country":"Czech Republic (inferred from author names, not explicit)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 35‑year‑old man died when a rubber pipe stopper he had inserted into his rectum burst, causing a fatal internal explosion. The report describes the forensic findings and notes that such extreme autoerotic practices can be lethal.","clinical_takeaway":"Clinicians should be aware that extreme solitary sexual experimentation can cause serious injury; inquire about risky practices when assessing sexual health or safety concerns.","confidence":0.9,"topic_tags":["masturbation","sexual_function"],"strengths":["Detailed forensic description of a rare autoerotic death mechanism","Highlights novel risk associated with extreme autoerotic practices"],"limitations":["Single case; no generalizable data","No systematic assessment of psychological or behavioral factors"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00414-020-02344-7"}},{"id":4088,"doi":"10.1093/pcmedi/pbaa023","pmid":"35960680","pmcid":"PMC7337785","title":"How to deal with the negative psychological impact of COVID-19 for people who pay attention to anxiety and depression","authors":"Ge F, Wan M, Zheng A, Zhang J.","first_author":"Ge F","journal":"Precision clinical medicine","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Behavior","Depression","Anxiety","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7337785","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"web‑based cross‑sectional survey of 17 k Chinese adults during early COVID‑19; uses PHQ‑9, GAD‑7 and an ad‑hoc coping questionnaire; analyses adjust for demographics.","sample_n":17249,"sample_text":"17 249 responders; 7 923 completed depression scale, 9 326 completed anxiety scale","population":"general adult population (China), online volunteers","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a 2020 Chinese online survey of 17,000 adults, people who reported higher depression or anxiety also more often said they were having sex or masturbating, while activities like singing, drawing, online chatting and yoga were linked to lower distress.","clinical_takeaway":"Sex or masturbation were associated with higher anxiety/depression in this sample; encouraging creative or social coping activities may be more protective.","confidence":0.8,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["Large sample size","Validated depression/anxiety scales","Adjusted for key demographics"],"limitations":["Cross‑sectional; cannot infer causality","Ad‑hoc coping questionnaire lacks validation","No measurement of moral incongruence or separation of masturbation from sex"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/pcmedi/pbaa023"}},{"id":4093,"doi":null,"pmid":"23009012","pmcid":null,"title":"[Human orgasm from the physiological perspective--part II]","authors":"Gałecki P, Depko A, Jedrzejewska S, Talarowska M.","first_author":"Gałecki P","journal":"Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego","year":2012,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article without empirical data; narrative synthesis of existing literature.","sample_n":null,"sample_text":"Not applicable – no primary data collected","population":"Human adults (both sexes); no specific sample described","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review contrasts male and female orgasm, noting that female orgasm is more variable and influenced by emotions, cognition, age, self‑esteem and experience, while male orgasm aligns more tightly with physiological arousal.","clinical_takeaway":"Clinicians should recognize that female orgasm is multifaceted and not equate its absence with pathology; consider psychosocial factors when addressing sexual concerns.","confidence":0.7,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Broad overview of physiological aspects of orgasm","Considers both male and female perspectives"],"limitations":["No original data; narrative review only","Lacks systematic methodology or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4094,"doi":"10.1016/j.forsciint.2020.110340","pmid":"32497993","pmcid":null,"title":"Autoerotic Deaths in Hamburg, Germany: Autoerotic accident or death from internal cause in an autoerotic setting? A retrospective study from 2004-2018","authors":"Lohner L, Sperhake JP, Püschel K, Schröder AS.","first_author":"Lohner L","journal":"Forensic science international","year":2020,"pub_types":["Journal Article"],"keywords":["Autoerotic Death","Autoerotic Asphyxia","Autoerotic Accident","Autoerotic Strangulation"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"retrospective autopsy case series of 25 autoerotic deaths identified from forensic records (2004‑2018) in Hamburg, Germany","sample_n":25,"sample_text":"25 cases identified over 15 years","population":"deceased individuals whose deaths were classified as autoerotic (n≈25); age range adult; gender 1 female","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A review of 25 forensic autopsies in Hamburg shows that autoerotic deaths are rare and result from a mix of accidental strangulation, smothering, intoxication, or natural heart problems, with victims typically younger for accidents and older for natural causes.","clinical_takeaway":"Autoerotic practices can lead to accidental death; thorough scene investigation and toxicology are essential.","confidence":0.78,"topic_tags":["sexual_function","masturbation"],"strengths":["Complete forensic dataset for a defined region","Detailed cause‑of‑death classification"],"limitations":["Very small sample limits generalisability","No control or comparison group","No assessment of psychological or behavioural correlates"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.forsciint.2020.110340"}},{"id":4097,"doi":"10.1016/j.jsxm.2020.03.019","pmid":"32402814","pmcid":null,"title":"Sexual Function, Sexual Dysfunctions, and ADHD: A Systematic Literature Review","authors":"Soldati L, Bianchi-Demicheli F, Schockaert P, Köhl J, Bolmont M, Hasler R, Perroud N.","first_author":"Soldati L","journal":"The journal of sexual medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":["Sexuality","ADHD","Sexual function","Sexual Health","Sexual Disorders","Hyperactivity","Sexual Satisfaction","Attention-deficit","Sexual Dysfunctions"],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic literature review without meta‑analysis; includes risk of bias discussion but limited by few primary studies.","sample_n":null,"sample_text":"Small number of primary studies; many with limited sample sizes.","population":"Adults with ADHD (studies varied; sample sizes generally small).","country":"Multiple (studies from various countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review found that people with ADHD tend to report higher sexual desire, more frequent masturbation, lower sexual satisfaction, and more sexual problems compared with the general population.","clinical_takeaway":"Clinicians should routinely ask about sexual health when treating adults with ADHD.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["First systematic review of ADHD and sexual health","Clear statement of clinical implications","Search across multiple databases"],"limitations":["Few primary studies, many with small samples","No quantitative meta‑analysis or formal risk‑of‑bias assessment","Limited control of key confounds (e.g., mental health, relationship factors)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":29,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.03.019"}},{"id":4098,"doi":"10.1002/jaba.716","pmid":"32346893","pmcid":null,"title":"Interventions for inappropriate sexual behavior in individuals with intellectual and developmental disabilities: A brief review","authors":"Falligant JM, Pence ST.","first_author":"Falligant JM","journal":"Journal of applied behavior analysis","year":2020,"pub_types":["Review","Journal Article"],"keywords":["Sexual behavior","Developmental Disabilities","Self-management","Behavioral Interventions","Reinforcement-based Interventions"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative brief review without systematic methods or meta‑analysis.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Individuals with intellectual or developmental disabilities who display inappropriate sexual behavior.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This brief review summarizes behavior‑analytic treatments used to reduce inappropriate sexual actions—like public masturbation or aggression—in people with intellectual or developmental disabilities, and discusses related ethical issues.","clinical_takeaway":"Behavior‑analytic interventions can be effective for managing inappropriate sexual behavior in IDD, but clinicians should consider ethical implications and individual needs.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Focus on evidence‑based behavior‑analytic interventions","Highlights ethical considerations"],"limitations":["Narrative, not systematic; no explicit methods","No quantitative synthesis or effect sizes","No assessment of study quality or bias"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/jaba.716"}},{"id":4099,"doi":"10.1258/0956462041211306","pmid":"15228737","pmcid":null,"title":"Chronic penile oedema secondary to chronic masturbation","authors":"Noble H, Goh BT.","first_author":"Noble H","journal":"International journal of STD & AIDS","year":2004,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single patient with chronic penile oedema attributed to chronic masturbation; no control or systematic data","sample_n":1,"sample_text":"single case","population":"single adult male, middle aged, with chlamydial infection","country":"unspecified (likely Singapore based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"avoid","plain_summary":"A 2004 case report describes a man with chronic penile swelling that the authors attribute to frequent masturbation, alongside a chlamydia infection.","clinical_takeaway":"No clinical guidance can be drawn; the single case does not establish masturbation as a cause of penile edema.","confidence":0.8,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Detailed clinical description","Identification of uncommon physical manifestation"],"limitations":["Single case; no control","Causal claim not supported by systematic evidence","No measurement of confounding factors"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/0956462041211306"}},{"id":4100,"doi":"10.1080/00926230490422368","pmid":"15205063","pmcid":null,"title":"Slimness is associated with greater intercourse and lesser masturbation frequency","authors":"Brody S.","first_author":"Brody S.","journal":"Journal of sex & marital therapy","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":53,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional diary and questionnaire study of 120 adults","sample_n":120,"sample_text":"120 healthy adults (19‑38 years)","population":"healthy adults aged 19‑38, recruited in Germany (convenience sample)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 120 young adults, slimmer hips and waistlines were linked to more intercourse and less masturbation, suggesting body shape may relate to how often people engage in different sexual activities.","clinical_takeaway":"Body composition appears related to sexual activity patterns, but no direct implications for therapy without further evidence.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Objective body‑size measurements","Diary method for sexual behavior reduces recall bias","Separate assessment of intercourse and masturbation"],"limitations":["Cross‑sectional; cannot infer causality","Convenience sample, limited generalisability","No control for mental‑health, relationship or moral variables"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":15,"contrasting":1,"mentioning":63,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230490422368"}},{"id":4101,"doi":"10.1155/2012/154025","pmid":"23326701","pmcid":"PMC3542919","title":"Fournier's Gangrene due to Masturbation in an Otherwise Healthy Male","authors":"Heiner JD, Eng KD, Bialowas TA, Devita D.","first_author":"Heiner JD","journal":"Case reports in emergency medicine","year":2012,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3542919","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case report of a 29‑year‑old male with Fournier’s gangrene linked to frequent masturbation with soap; no control group, no systematic sampling.","sample_n":1,"sample_text":"N=1","population":"one healthy adult male, emergency department presentation","country":"USA (presumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 29‑year‑old man developed a life‑threatening infection of the genital area after frequent masturbation with soap, illustrating a rare medical risk.","clinical_takeaway":"Excessive friction from masturbation can cause serious skin injury; advise gentle technique and monitor for signs of infection.","confidence":0.3,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Detailed clinical description","Highlights a rare complication"],"limitations":["Single case, no generalisability","No systematic assessment of causality","No comparison group"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2012/154025"}},{"id":4102,"doi":"10.1111/j.1743-6109.2012.02772.x","pmid":"22612876","pmcid":null,"title":"Magnetic spheres as foreign body into the bladder","authors":"Graziottin TM, de Freitas G Soares D, Da Ros CT, Sogari PR, Telöken C, Laste PR.","first_author":"Graziottin TM","journal":"The journal of sexual medicine","year":2013,"pub_types":["Journal Article","Case Reports"],"keywords":["Autoerotism","Intravesical Foreign Bodies"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single-patient case report describing diagnosis and endoscopic removal of a magnetic foreign body inserted for autoerotic stimulation","sample_n":1,"sample_text":"1 patient (case report)","population":"male adult with self‑inserted magnetic foreign body","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A man inserted magnetic beads into his bladder for sexual stimulation. Doctors diagnosed the foreign body with imaging and removed it endoscopically, noting that such cases can be treated with minimally invasive surgery and recover quickly.","clinical_takeaway":"Rare self‑inserted bladder foreign bodies can be safely removed endoscopically; clinicians should consider minimally invasive approaches.","confidence":0.8,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["clear clinical description of a rare presentation","detailed step‑by‑step management protocol","use of endoscopic technique minimizing trauma"],"limitations":["single case – no generalizability","no systematic assessment of psychological factors","no validated measures of sexual behavior or distress"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2012.02772.x"}},{"id":4104,"doi":"10.1007/s10508-012-9946-2","pmid":"22552705","pmcid":null,"title":"Testosterone and sexual desire in healthy women and men","authors":"van Anders SM.","first_author":"van Anders SM.","journal":"Archives of sexual behavior","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":98,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey with saliva hormone assays (n=196)","sample_n":196,"sample_text":"105 men, 91 women recruited as part of the Partnering, Physiology, and Health study","population":"healthy adult men and women, community sample","country":"United States (presumed from author affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 196 healthy adults, higher testosterone was linked to more solitary sexual desire in women, especially when they masturbated more, but it was unrelated to desire in men. Stress, cortisol and relationship context also shaped these patterns.","clinical_takeaway":"Testosterone alone does not predict sexual desire; clinicians should consider stress, relationship context, and masturbation habits.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample (n≈200)","Combined hormonal assays with psychological questionnaires","Considered both dyadic and solitary desire","Controlled for cortisol and stress"],"limitations":["Cross‑sectional; cannot infer causality","No pre‑registration or power analysis reported","Potential reliance on self‑report scales of unknown validation","Moral or trauma factors not assessed"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":0,"mentioning":62,"citing_publications":171,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-012-9946-2"}},{"id":4105,"doi":"10.1007/s12024-020-00236-1","pmid":"32219708","pmcid":"PMC7449946","title":"Fatal α-PVP and amphetamine poisoning during a sauna and autoerotic practices","authors":"Lunetta P, Kriikku P, Tikka J, Ojanperä I.","first_author":"Lunetta P","journal":"Forensic science, medicine, and pathology","year":2020,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Hyperthermia","amphetamine","Sauna","Autoerotic Death","Α-pvp","Contraction Band Necrosis"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s12024-020-00236-1.pdf","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single decedent, middle‑aged male","population":"single middle‑aged male","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A man died in a sauna while using the stimulant α‑PVP and amphetamine and engaging in solitary sexual activity. The combination of drug‑induced heart stress, high heat, and sexual arousal likely caused his fatal collapse.","clinical_takeaway":"Stimulant use in hot environments, especially during sexual activity, can be life‑threatening.","confidence":0.6,"topic_tags":["masturbation","sexual_function","pornography"],"strengths":["Detailed forensic toxicology","Clear description of physiological mechanisms","Highlights a previously unreported scenario"],"limitations":["Single case; no generalisability","No systematic assessment of confounders","No quantitative analysis"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12024-020-00236-1"}},{"id":4106,"doi":"10.4103/0019-5545.99532","pmid":"22988320","pmcid":"PMC3440907","title":"A cross-sectional study of factors associated with adolescent sexual activity","authors":"Shashikumar R, Das RC, Prabhu HR, Srivastava K, Bhat PS, Prakash J, Seema P.","first_author":"Shashikumar R","journal":"Indian journal of psychiatry","year":2012,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Abuse","Masturbation","Masculinity","Adolescent Sexuality"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3440907","cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study of 586 students from two co‑educational Indian schools (classes IX‑XII)","sample_n":586,"sample_text":"586 out of 1580 students completed the questionnaire","population":"adolescents (approx. 13‑18 y) in school settings, convenience sample","country":"India","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 586 Indian high‑school students found that boys who view sex as proof of masculinity, who have been sexually abused, or who masturbate are more likely to report having sex. Many adolescents lack knowledge about alcohol's effect on sex and pregnancy risk.","clinical_takeaway":"Screening for trauma, masculinity beliefs, and masturbation practices may help identify adolescents at higher risk of early sexual activity.","confidence":0.8,"topic_tags":["adolescents","sexual_function","masturbation"],"strengths":["Large sample for a school‑based survey","Addresses understudied Indian adolescent population","Includes multiple psychosocial variables"],"limitations":["Questionnaire appears non‑validated","Cross‑sectional design limits causal inference","No measurement of moral/religious incongruence or mental‑health covariates","Convenience sample from only two schools"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":23,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0019-5545.99532"}},{"id":4107,"doi":"10.1542/pir.33-4-190","pmid":"22474119","pmcid":null,"title":"Masturbation","authors":"Strachan E, Staples B.","first_author":"Strachan E","journal":"Pediatrics in review","year":2012,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/pir.33-4-190"}},{"id":4109,"doi":"10.1136/adc.2003.032102","pmid":"14977696","pmcid":"PMC1719833","title":"Gratification disorder (\"infantile masturbation\"): a review","authors":"Nechay A, Ross LM, Stephenson JB, O'Regan M.","first_author":"Nechay A","journal":"Archives of disease in childhood","year":2004,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Retrospective case note review of 31 pediatric patients diagnosed with gratification disorder (infantile masturbation) from a neurology outpatient department (1972‑2002).","sample_n":31,"sample_text":"Thirty‑one patients diagnosed over three decades in a single clinic.","population":"Children (median age 10.5 months) diagnosed with gratification disorder; 31 cases (11 M, 20 F).","country":"United Kingdom (presumed, based on institution name).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A review of 31 toddlers diagnosed with 'infantile masturbation' shows typical ages, event frequencies, and behaviours, helping clinicians tell it apart from epilepsy and avoid unnecessary treatment.","clinical_takeaway":"Consider gratification disorder in infants with seizure‑like episodes; video recordings can aid correct diagnosis.","confidence":0.5,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["Rare clinical description of a poorly studied paediatric phenomenon.","Use of home video recordings to confirm diagnosis."],"limitations":["Small, non‑representative, clinic‑based sample.","No standardized or validated measurement instruments.","Descriptive only; no statistical testing or control for confounders."],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":0,"mentioning":115,"citing_publications":107,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/adc.2003.032102"}},{"id":4110,"doi":"10.1111/j.1526-4610.2004.04054.x","pmid":"15012662","pmcid":null,"title":"Cerebral vasospasm and headache during sexual intercourse and masturbatory orgasms","authors":"Valença MM, Valença LP, Bordini CA, da Silva WF, Leite JP, Antunes-Rodrigues J, Speciali JG.","first_author":"Valença MM","journal":"Headache","year":2004,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case report of a 44‑year‑old woman with coital and masturbatory headache; imaging before, during, after orgasm; literature review of 5 similar cases","sample_n":1,"sample_text":"One patient (44‑year‑old woman) described in detail; additional 5 cases from literature","population":"adult female (case)","country":"Brazil (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 44‑year‑old woman experienced severe headache during orgasm, both during sex and masturbation. Imaging showed temporary narrowing of brain arteries that resolved after the headache. The authors suggest that such vasospasm may cause these rare orgasm‑related headaches.","clinical_takeaway":"Orgasmic headaches may be linked to transient cerebral vasospasm; clinicians should consider vascular imaging in such cases.","confidence":0.7,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["Detailed imaging of vasospasm linked to orgasmic headache","Rare phenomenon documented with objective angiographic evidence"],"limitations":["Single case; no control group","No statistical analysis","Findings not generalisable","Potential over‑interpretation of causality"],"rubric_version":"2.0","raw_total":11,"max_possible":60,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":3,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":3,"contrasting":0,"mentioning":33,"citing_publications":80,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1526-4610.2004.04054.x"}},{"id":4112,"doi":"10.1007/s10508-019-01600-1","pmid":"32095971","pmcid":null,"title":"Ace and Aro: Understanding Differences in Romantic Attractions Among Persons Identifying as Asexual","authors":"Antonsen AN, Zdaniuk B, Yule M, Brotto LA.","first_author":"Antonsen AN","journal":"Archives of sexual behavior","year":2020,"pub_types":["Journal Article"],"keywords":["Asexuality","Sexual Attraction","Romantic Attraction","Aro/ace","Aromantic"],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"secondary analysis of combined survey data (n=4032) comparing romantic vs aromantic asexual individuals and vs allosexuals","sample_n":4032,"sample_text":"combined data from seven previous asexuality studies","population":"adults self‑identifying as asexual or allosexual; convenience/online samples from seven prior studies","country":"multiple (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among people who identify as asexual, about three‑quarters also feel romantic attraction. Romantic asexuals are more likely to have been in relationships, have more past partners and kissing experiences, and show higher partner‑oriented desire than aromantic asexuals, while both groups are similar on most other sexual and mental‑health measures.","clinical_takeaway":"Asexual individuals vary widely in romantic attraction; clinicians should assess both sexual and romantic orientations separately.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Large combined sample (n>4000)","Direct comparison of romantic vs aromantic asexual individuals","Includes multiple domains (behavioral, psychological, physiological)","Provides novel insight into romantic orientation diversity"],"limitations":["Cross‑sectional, self‑report data only","Convenience samples; limited generalisability","Unclear whether all measures were validated","No effect‑size reporting or power analysis described"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":50,"citing_publications":93,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-01600-1"}},{"id":4113,"doi":"10.1016/j.yebeh.2003.10.009","pmid":"14751219","pmcid":null,"title":"Excessive masturbation after epilepsy surgery","authors":"Ozmen M, Erdogan A, Duvenci S, Ozyurt E, Ozkara C.","first_author":"Ozmen M","journal":"Epilepsy & behavior : E&B","year":2004,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single adolescent case report of postoperative hypersexuality","sample_n":1,"sample_text":"single case","population":"14‑year‑old female after selective amygdalohippocampectomy","country":"Turkey","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 14‑year‑old girl showed excessive masturbation, irritability and depression after brain surgery for epilepsy. Symptoms improved after counseling and an antidepressant. Authors suggest the change may be linked to brain‑area effects and psychosocial factors.","clinical_takeaway":"Post‑surgical hypersexuality can be transient and may respond to psychoeducation and antidepressant treatment.","confidence":0.8,"topic_tags":["masturbation","sexual_function","neuroscience"],"strengths":["Detailed clinical description","Integration of neuropsychological and psychosocial hypotheses"],"limitations":["Single case, no generalisability","No validated measures of masturbation frequency or distress","No control for moral or relational factors"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.yebeh.2003.10.009"}},{"id":4114,"doi":"10.1080/00224499.2020.1726273","pmid":"32077320","pmcid":null,"title":"Continuum of Symptoms in Polycystic Ovary Syndrome (PCOS): Links with Sexual Behavior and Unrestricted Sociosexuality","authors":"Tzalazidis R, Oinonen KA.","first_author":"Tzalazidis R","journal":"Journal of sex research","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Women completed online questionnaires on PCOS symptoms, sociosexuality, and masturbation; analyses were correlational.","sample_n":null,"sample_text":"young women with varying PCOS symptom levels","population":"young women (likely community sample; exact N not given in abstract)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of young women, those reporting more symptoms of polycystic ovary syndrome also showed higher interest in casual sex, more frequent masturbation, and greater attraction to women, suggesting a link between androgen levels and unrestricted sexual behavior.","clinical_takeaway":"Women with PCOS may have higher sociosexual interest and masturbation frequency; clinicians should consider hormonal influences when discussing sexual health.","confidence":0.7,"topic_tags":["sexual_function","masturbation","religiosity"],"strengths":["Uses validated sociosexuality scale","Addresses understudied link between PCOS and sexual behavior","Considers both orientation and behavior (masturbation)"],"limitations":["Cross‑sectional, cannot infer causality","No control for key confounds (e.g., mental health, relationship status)","Reliance on self‑report PCOS screening rather than clinical diagnosis"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2020.1726273"}},{"id":4116,"doi":"10.1080/10852352.2012.680413","pmid":"22694158","pmcid":null,"title":"Sexual and intimacy health of Roman Catholic priests","authors":"McDevitt PJ.","first_author":"McDevitt PJ.","journal":"Journal of prevention & intervention in the community","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"single qualitative interview study of Roman Catholic priests, convenience sample, no comparison group","sample_n":null,"sample_text":"Not provided in abstract","population":"Roman Catholic priests (unspecified age range)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study interviews Catholic priests about their lifetime sexual experiences, categorising them into themes such as childhood encounters, adult affairs, and masturbation, and recommends better education and counselling.","clinical_takeaway":"Recognise that priests may have diverse sexual histories; tailored sexual health counselling and early seminary education are advisable.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Provides rare qualitative insight into priests’ sexual histories","Includes masturbation as a distinct category"],"limitations":["Small, non‑representative convenience sample","No validated instruments; relies on self‑report narratives","Does not control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10852352.2012.680413"}},{"id":4117,"doi":null,"pmid":"23214148","pmcid":null,"title":"[Medical students' sexuality--development and fulfilment of sexual needs]","authors":"Müldner-Nieckowski Ł, Klasa K, Sobański JA, Rutkowski K, Dembińska E.","first_author":"Müldner-Nieckowski Ł","journal":"Psychiatria polska","year":2012,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 4th‑year medical students using a self‑report questionnaire (KSS2) administered during coursework.","sample_n":null,"sample_text":"Medical students filled the questionnaire when attending the courses of Psychopathology of neurotic disorders or Psychotherapy.","population":"Medical students (IVth grade) in Poland; likely convenience sample.","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of Polish medical students found varied levels of sexual satisfaction, attitudes toward masturbation, and relationship experiences, with some gender differences. Lack of sexual experience or satisfaction may affect future doctors’ ability to discuss sexual health with patients.","clinical_takeaway":"None – the study is exploratory and does not provide actionable clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Addresses understudied topic of medical students’ own sexual health.","Uses a standardized questionnaire (KSS2) rather than single items."],"limitations":["Unclear validation status of KSS2 for this population.","Cross‑sectional convenience sample; limited generalisability.","No control for key confounds such as moral attitudes, mental health, or relationship status.","Statistical reporting appears basic; effect sizes and power not provided."],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4118,"doi":"10.3138/cbmh.29.1.7","pmid":"22849248","pmcid":null,"title":"\"A plea for the prostate\": doctors, prostate dysfunction, and male sexuality in late 19th- and early 20th-century Canada","authors":"O'Shea CD.","first_author":"O'Shea CD.","journal":"Canadian bulletin of medical history = Bulletin canadien d'histoire de la medecine","year":2012,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"historical analysis of medical discourse, no primary data collection","sample_n":null,"sample_text":"Not applicable – historical documents and publications were examined","population":"historical Canadian physicians and patients (late 19th‑early 20th c.)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how Canadian doctors from the late 1800s to early 1900s shifted from blaming masturbation for health problems to focusing on preserving sexual function when treating enlarged prostates.","clinical_takeaway":"Historical perspectives show how medical views on male sexuality and prostate treatment have evolved; no direct clinical recommendations.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Rich historical primary sources","Contextualizes medical attitudes toward sexuality","Clear narrative linking prostate treatment to notions of potency"],"limitations":["No empirical data; conclusions based on discourse analysis","Limited to Canadian medical literature, may not generalize globally","No systematic review methodology"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3138/cbmh.29.1.7"}},{"id":4120,"doi":"10.1111/andr.12759","pmid":"31955507","pmcid":null,"title":"The physician's gender influences the results of the diagnostic workup for erectile dysfunction","authors":"Rastrelli G, Cipriani S, Craparo A, De Vincentis S, Granata ARM, Spaggiari G, Simoni M, Maggi M, Santi D.","first_author":"Rastrelli G","journal":"Andrology","year":2020,"pub_types":["Journal Article"],"keywords":["erectile dysfunction","Physician Gender","Intracavernousal Injection","Structured Interview Of Erectile Function"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional retrospective study of consecutive ED patients at two Italian university clinics, comparing outcomes when the examining physician was male vs female.","sample_n":1903,"sample_text":"95 patients at UNIMORE and 1808 at UNIFI; consecutive series.","population":"Adult men evaluated for erectile dysfunction (N≈1900 total; 95 in one cohort, 1808 in the other).","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In two Italian clinics, men examined by female doctors reported milder erectile problems and more masturbation‑related erections, while tests performed by male doctors showed poorer physiological responses, suggesting physician gender may shape how patients describe or demonstrate erectile function.","clinical_takeaway":"Physician gender can influence patients' reports and test outcomes in erectile dysfunction assessments; clinicians should be aware of possible bias when interpreting results.","confidence":0.4,"topic_tags":["sexual_function","gender","masturbation"],"strengths":["Large overall sample size (especially Cohort 2)","Objective physiological test (intracavernous injection) in one cohort","Direct comparison of physician gender"],"limitations":["Cross‑sectional, retrospective design limits causal inference","Potential selection bias from clinic‑based convenience samples","Limited control of key psychosocial confounds (mood, religiosity, trauma)","Speculative interpretation about “defending virility”"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/andr.12759"}},{"id":4122,"doi":null,"pmid":"22075743","pmcid":null,"title":"Infantile masturbation - exclusion of severe diagnosis does not exclude parental distress - case report","authors":"Franić T, Franić IU.","first_author":"Franić T","journal":"Psychiatria Danubina","year":2011,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4123,"doi":null,"pmid":"22263299","pmcid":"PMC3304305","title":"Qualitative analysis of an educational intervention with HIV-discordant heterosexual Latino couples","authors":"Pérez-Jiménez D, Orengo-Aguayo RE.","first_author":"Pérez-Jiménez D","journal":"Puerto Rico health sciences journal","year":2011,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative content analysis of semi‑structured interviews with five HIV‑discordant Latino couples after a four‑session educational intervention.","sample_n":10,"sample_text":"Five heterosexual HIV‑discordant couples (10 individuals) participated.","population":"Heterosexual Latino couples (one HIV‑positive, one HIV‑negative), N=5 couples (10 participants).","country":"USA (Puerto Rico)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A tiny study of five Latino couples where one partner has HIV examined how an education program affected their knowledge and attitudes about condom use and mutual masturbation. Participants said the programme improved their views on safer sex.","clinical_takeaway":"Educational sessions can positively shift attitudes toward condom use and mutual masturbation, but evidence is limited to a very small qualitative sample.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Focus on underserved Latino discordant couples","Provides qualitative insight into attitudes toward condoms and mutual masturbation","Intervention includes culturally adapted education and communication skills"],"limitations":["Very small, non‑representative sample (N=10)","No quantitative outcome measures or control group","Findings based on self‑report; cannot infer causal effect on HIV transmission"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":1,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4124,"doi":"10.1007/s43032-019-00061-0","pmid":"32046411","pmcid":null,"title":"Disparate Relationship of Sexual Satisfaction, Self-Esteem, Anxiety, and Depression with Endocrine Profiles of Women With or Without PCOS","authors":"Glowinska A, Duleba AJ, Zielona-Jenek M, Siakowska M, Pawelczyk L, Banaszewska B.","first_author":"Glowinska A","journal":"Reproductive sciences (Thousand Oaks, Calif.)","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Depression","Anxiety","Polycystic ovary syndrome","Self-esteem","Sexual Satisfaction"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional comparison of 96 women with PCOS and 47 controls; sexual satisfaction, self‑esteem, anxiety, depression, masturbation frequency and endocrine measures assessed.","sample_n":143,"sample_text":"96 PCOS, 47 controls","population":"Women with polycystic ovary syndrome and healthy female controls, adult, community/clinical sample (N≈143).","country":"Poland (implied by author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Women with PCOS showed similar sexual satisfaction to controls, but their erotic dream frequency related to higher testosterone, while masturbation frequency was linked to anxiety and depression. Body‑image self‑esteem was lower and tied to BMI and androgen levels.","clinical_takeaway":"PCOS may affect psychosexual aspects; clinicians should assess anxiety, depression, and body image alongside hormonal factors.","confidence":0.8,"topic_tags":["sexual_function","masturbation","religiosity"],"strengths":["Inclusion of hormonal profiles","Measurement of both psychosexual and psychological variables","Comparison with a healthy control group"],"limitations":["Cross‑sectional design limits causal inference","No correction for multiple statistical tests","Sexual function instrument not specified","Potential selection bias (clinical PCOS sample)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":11,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s43032-019-00061-0"}},{"id":4125,"doi":"10.1016/j.fertnstert.2019.11.021","pmid":"32033716","pmcid":null,"title":"Post-orgasmic illness syndrome: history and current perspectives","authors":"Paulos MR, Avelliino GJ.","first_author":"Paulos MR","journal":"Fertility and sterility","year":2020,"pub_types":["Review","Journal Article"],"keywords":["Ejaculation","Orgasm","Pois"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of a rare sexual‑health syndrome; no original data, no systematic methods reported.","sample_n":null,"sample_text":"Not applicable (review article).","population":"Men with post‑orgasmic illness syndrome (POIS); no sample size reported.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews post‑orgasmic illness syndrome, a rare condition where men experience flu‑like and allergic symptoms after ejaculation, lasting days and affecting quality of life. The cause is unclear and treatments are lacking.","clinical_takeaway":"Clinicians should be aware of POIS as a possible cause of post‑ejaculatory distress and consider referral for supportive care.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Summarises existing case reports on a poorly understood condition","Highlights quality‑of‑life impact for affected men"],"limitations":["Narrative, not systematic; no systematic search or bias assessment","No original data; no quantitative analysis","No evaluation of potential confounders (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.fertnstert.2019.11.021"}},{"id":4126,"doi":"10.7754/clin.lab.2019.190515","pmid":"32013350","pmcid":null,"title":"Altered Semen Quality is Associated with Decreased Semen Docosahexaenoic Acid and Increased Oleic Acid Levels","authors":"Nasrallah F, Taieb SH, Sethoum MM, Omar S, Aribia HB, Sanhaji H, Feki M.","first_author":"Nasrallah F","journal":"Clinical laboratory","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional study of 45 men attending infertility clinics; semen collected by masturbation; fatty‑acid composition measured by gas chromatography; WHO criteria used for semen classification.","sample_n":45,"sample_text":"45 men consulting for infertile couples; convenience sample.","population":"Middle‑aged men from a fertility clinic (N = 45).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study found that men with poorer semen quality had lower levels of the omega‑3 fatty acid DHA and higher levels of oleic acid in their sperm membranes. These fatty‑acid changes were linked to lower sperm count and motility.","clinical_takeaway":"Abnormal sperm fatty‑acid profiles may signal reduced fertility, but interventions remain unproven.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Validated biochemical assay (GC) for fatty‑acid composition","Standard WHO semen analysis criteria","Clear reporting of correlations between fatty acids and sperm parameters"],"limitations":["Small, clinic‑based convenience sample (N = 45)","Cross‑sectional design; no causal inference","No adjustment for potential physiological or lifestyle confounders"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7754/clin.lab.2019.190515"}},{"id":4127,"doi":"10.1111/j.1743-6109.2011.02511.x","pmid":"22023664","pmcid":null,"title":"Sexual behaviors among older adults in Spain: results from a population-based national sexual health survey","authors":"Palacios-Ceña D, Carrasco-Garrido P, Hernández-Barrera V, Alonso-Blanco C, Jiménez-García R, Fernández-de-las-Peñas C.","first_author":"Palacios-Ceña D","journal":"The journal of sexual medicine","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":56,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Population‑based descriptive survey of 1,939 Spaniards aged ≥65, logistic regression analysis of sexual activity and associated factors.","sample_n":1939,"sample_text":"National sexual health survey, probability sample of community-dwelling older adults.","population":"Older adults (≥65) in Spain, n=1,939 (1,118 women, 821 men).","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationwide Spanish survey of 1,939 adults aged 65+ found that about two‑thirds of men and one‑third of women were sexually active. Activity declined with age and was lower among those without a partner, with multiple health problems, or on several medications.","clinical_takeaway":"Older patients’ sexual activity is linked to partner status and health; clinicians should address these factors when discussing sexuality.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Multivariate logistic regression with confidence intervals","Separate analysis by gender"],"limitations":["Self‑report data, potential recall bias","No validated sexual health scales","Key psychosocial confounds (e.g., moral attitudes, mental health) not measured"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":11,"contrasting":1,"mentioning":99,"citing_publications":108,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2011.02511.x"}},{"id":4128,"doi":"10.1016/j.androl.2019.09.005","pmid":"31879204","pmcid":null,"title":"Evaluation of depression, anxiety and quality of life in patients with non-obstructive azoospermia","authors":"Topuz B, Ebiloğlu T, Sarıkaya S, Coğuplugil AE, Bedir S, Karataş ÖF.","first_author":"Topuz B","journal":"Revista internacional de andrologia","year":2021,"pub_types":["Journal Article"],"keywords":["Depression","Quality of life","Anxiety","Non-obstructive azoospermia","Depresión","Calidad De Vida","Ansiedad","Azoospermia No Obstructiva"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 40 clinic patients with non‑obstructive azoospermia; questionnaires administered on depression, anxiety, QoL","sample_n":40,"sample_text":"40 male patients","population":"Male patients (n=40) with non‑obstructive azoospermia, mean age 32.8 years, recruited from a single andrology clinic","country":"Turkey (presumed from authors’ names and journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 40 men with a type of infertility called non‑obstructive azoospermia, about one‑third reported mild‑to‑moderate depressive symptoms, while almost all reported minimal anxiety. Their quality‑of‑life scores were modest, indicating that the condition affects psychological and social wellbeing.","clinical_takeaway":"Clinicians should screen men with non‑obstructive azoospermia for depressive and anxiety symptoms and consider psychiatric referral when needed.","confidence":0.78,"topic_tags":["sexual_function","religiosity"],"strengths":["Validated psychometric instruments used","Clear clinical focus on an underserved patient group","Provides baseline prevalence data for depression/anxiety in NOA"],"limitations":["Small, single‑site convenience sample (N=40)","No control/comparison group","No adjustment for potential confounders (e.g., marital status, socioeconomic factors)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.androl.2019.09.005"}},{"id":4129,"doi":"10.1111/j.1743-6109.2011.02503.x","pmid":"21981632","pmcid":null,"title":"Prevalence and characteristics of vibrator use among women who have sex with women","authors":"Schick V, Herbenick D, Rosenberger JG, Reece M.","first_author":"Schick V","journal":"The journal of sexual medicine","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional web‑based survey of 2,192 women who had sex with women in the past year","sample_n":2192,"sample_text":"cross‑sectional convenience sample recruited online","population":"women (age range not specified) from US & UK who reported sexual activity with only women in the prior year","country":"United States, United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a web survey of 2,192 women who have sex with women, over 75 % had ever used a vibrator, and recent partnered vibrator use was linked to higher scores on several sexual‑function domains compared with non‑use or solo use only.","clinical_takeaway":"Recent partnered vibrator use is associated with better reported sexual function among women who have sex with women.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a niche population","Validated FSFI instrument","Distinguishes solo vs partnered vibrator use"],"limitations":["Cross‑sectional design; no causal inference","Convenience web sample limits generalisability","Vibrator use measured with ad‑hoc items"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2011.02503.x"}},{"id":4133,"doi":"10.1007/s10433-019-00546-6","pmid":"32549873","pmcid":"PMC7292849","title":"'I do it my way': long-term care staff's perceptions of residents' sexual needs and suggestions for improvement in their management","authors":"Villar F, Serrat R, Celdrán M, Fabà J, Martínez T, Twisk J.","first_author":"Villar F","journal":"European journal of ageing","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Nursing Homes","Long-term Care","Person-centred Care"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Self‑selected staff sample (N=2115) from 152 Spanish LTCFs; questionnaire estimating resident sexual needs and open‑ended items analysed with content analysis; comparisons by work position.","sample_n":2115,"sample_text":"Self‑selected staff members (managers, technical and care assistants) employed at 152 Spanish long‑term care facilities.","population":"Long‑term care staff (managers, technical and care assistants) in Spain","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of over 2,000 staff in Spanish nursing homes asked whether older residents still have sexual needs and how those needs are met. Most staff thought few residents had such needs; they saw masturbation as the main way needs were satisfied and called for better training, privacy, and attitude changes.","clinical_takeaway":"Staff often underestimate older adults' sexual needs; training and privacy policies may improve resident wellbeing.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large overall sample size","Inclusion of multiple staff roles for comparative insight","Qualitative content analysis adds depth"],"limitations":["Self‑selected convenience sample limits generalisability","No validated measures of resident sexual needs","Potential social desirability bias in staff reports"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10433-019-00546-6"}},{"id":4134,"doi":"10.1111/j.1743-6109.2011.02438.x","pmid":"21883941","pmcid":null,"title":"Sexual behaviors and situational characteristics of most recent male-partnered sexual event among gay and bisexually identified men in the United States","authors":"Rosenberger JG, Reece M, Schick V, Herbenick D, Novak DS, Van Der Pol B, Fortenberry JD.","first_author":"Rosenberger JG","journal":"The journal of sexual medicine","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":108,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large internet‑based survey of gay and bisexual men (N≈24,800) describing the most recent male‑partnered sexual event; cross‑sectional, convenience sample","sample_n":24787,"sample_text":"Internet‑based survey; participants recruited nationwide via online panel","population":"gay and bisexually identified men, United States, ages 18‑87","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationwide online survey of nearly 25,000 gay and bisexual men described what they did during their last sexual encounter with another man, showing a wide range of activities beyond just intercourse, such as kissing, oral sex and partnered masturbation.","clinical_takeaway":"Clinicians should recognize the diversity of partnered sexual behaviors among gay and bisexual men when discussing sexual health and pleasure.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Very large sample size","Focus on understudied population (gay/bisexual men)","Detailed event‑level behavior catalogue"],"limitations":["Convenience internet sample; possible selection bias","Self‑report without validated scales","No control for potential confounds (e.g., mental health, relationship status)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":3,"mentioning":93,"citing_publications":174,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2011.02438.x"}},{"id":4135,"doi":"10.1111/ppc.12455","pmid":"31750549","pmcid":null,"title":"Sexual desire and emotional reactivity in chronically hospitalized Lebanese patients with schizophrenia","authors":"Kazour F, Obeid S, Hallit S.","first_author":"Kazour F","journal":"Perspectives in psychiatric care","year":2020,"pub_types":["Journal Article"],"keywords":["Sexuality","Schizophrenia","emotion","reactivity","Psychosis"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 60 chronically hospitalized Lebanese patients with schizophrenia (30 men, 30 women).","sample_n":60,"sample_text":"30 men and 30 women recruited between April and June 2017.","population":"Patients with schizophrenia, hospitalized in Lebanon; convenience sample.","country":"Lebanon","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 60 Lebanese patients with chronic schizophrenia, those who reported masturbating showed higher scores on emotional reactivity, cognition, motivation, and other functional domains than non‑masturbators, suggesting a possible link between sustained sexual activity and better psychosocial outcomes.","clinical_takeaway":"The study suggests an association, not causation; clinicians should not assume masturbation improves schizophrenia prognosis without further evidence.","confidence":0.7,"topic_tags":["sexual_function","masturbation","csbd","moral_incongruence"],"strengths":["Addresses understudied link between sexual activity and emotional/cognitive outcomes in schizophrenia","Uses both male and female participants"],"limitations":["Cross‑sectional design cannot establish causality","Small sample, likely under‑powered for subgroup comparisons","No measurement of key confounds (religiosity, mental‑health comorbidity, partner effects)","Unclear validation status of the SBQ for this population"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/ppc.12455"}},{"id":4136,"doi":"10.1210/jc.2010-2216","pmid":"21849522","pmcid":null,"title":"The relationships between sex hormones and sexual function in middle-aged and older European men","authors":"O'Connor DB, Lee DM, Corona G, Forti G, Tajar A, O'Neill TW, Pendleton N, Bartfai G, Boonen S, Casanueva FF, Finn JD, Giwercman A, Han TS, Huhtaniemi IT, Kula K, Labrie F, Lean ME, Punab M, Silman AJ, Vanderschueren D, Wu FC, European Male Ageing Study Group.","first_author":"O'Connor DB","journal":"The Journal of clinical endocrinology and metabolism","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":75,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"population‑based stratified random sample of 2838 European men, self‑report questionnaire and hormone assays","sample_n":2838,"sample_text":"2838 men aged 40‑79 yr completed the European Male Ageing Study‑Sexual Function Questionnaire and provided a blood sample for hormone measurements","population":"men aged 40‑79 years, community sample, 8 European centres","country":"Europe (multicentre)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large European sample of men aged 40‑79, higher testosterone was linked to better overall sexual function and less erectile dysfunction, while higher estradiol was associated with greater sexual‑function‑related distress. Masturbation frequency rose with higher free testosterone.","clinical_takeaway":"Hormone levels relate differently to sexual performance and distress; consider both testosterone and estradiol when assessing older men’s sexual health.","confidence":0.85,"topic_tags":["sexual_function","masturbation"],"strengths":["Large, stratified random sample","Validated sexual function questionnaire","Objective hormone measurements (GC‑MS)"],"limitations":["Cross‑sectional; cannot infer causality","Potential confounders (mental health, religiosity, relationship status) not measured or controlled","Distress outcome not examined in relation to moral incongruence"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":0,"mentioning":64,"citing_publications":122,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1210/jc.2010-2216"}},{"id":4137,"doi":"10.1016/j.rbmo.2019.10.015","pmid":"31954612","pmcid":null,"title":"Qualitative and quantitative aspects of sex life in the context of endometriosis: a multicentre case control study","authors":"Bernays V, Schwartz AK, Geraedts K, Rauchfuss M, Wölfler MM, Haeberlin F, von Orelli S, Eberhard M, Imthurn B, Fink D, Imesch P, Leeners B.","first_author":"Bernays V","journal":"Reproductive biomedicine online","year":2020,"pub_types":["Journal Article"],"keywords":["Sexuality","Endometriosis","Sexual activities","Dyspareunia"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"multicentre case‑control study with pair‑matching on age and ethnicity, N=1130 women","sample_n":1130,"sample_text":"565 endometriosis cases paired with 565 controls","population":"women with histologically confirmed endometriosis and matched controls, adult females in Germany/Switzerland/Austria","country":"Germany, Switzerland, Austria","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 565 women with endometriosis and 565 matched controls, women with the condition reported fewer episodes of petting, foreplay, and vaginal intercourse, largely because of pain during sex. Masturbation and other activities were similar across groups, and many women with endometriosis wanted more sexual activity.","clinical_takeaway":"Women with endometriosis often have reduced partnered sexual activity due to pain; clinicians should discuss pain‑free options and sexual counseling.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, multicentre sample with histological confirmation","Use of validated sexual‑function questionnaires","Pair‑matching on key demographics"],"limitations":["Cross‑sectional design limits causal inference","Limited control for mental‑health or relationship variables","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":24,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.rbmo.2019.10.015"}},{"id":4138,"doi":"10.1186/s12905-019-0833-z","pmid":"31699074","pmcid":"PMC6839138","title":"Female sexual dysfunction associated with idiopathic cerebellar ataxia: A case report","authors":"López-Sosa C, Gámez-Zapata J, Iglesias-de-Sena H, Alonso-Sardón M.","first_author":"López-Sosa C","journal":"BMC women's health","year":2019,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Arousal","Desire","Female Sexual Dysfunction","Orgasm","Idiopathic Cerebellar Ataxia","Short Form Of The Changes In Sexual Functioning Questionnaire (Csfq-14)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6839138","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with idiopathic cerebellar ataxia and female sexual dysfunction","sample_n":1,"sample_text":"single case","population":"25‑year‑old woman with idiopathic cerebellar ataxia","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 25‑year‑old woman with idiopathic cerebellar ataxia experienced difficulties coordinating movements during sex, leading to arousal and orgasm problems. Occupational and physical therapy improved her coordination, but orgasm remained absent.","clinical_takeaway":"Neurological impairments can affect sexual coordination; multidisciplinary rehab may improve function but may not fully restore orgasm.","confidence":0.8,"topic_tags":["sexual_function","csbd","neuroscience"],"strengths":["Use of validated sexual function questionnaire (CSFQ‑14)","Clear clinical description linking cerebellar ataxia to sexual coordination"],"limitations":["Single case, no comparison group","No measurement or control of key psychosocial confounds","No statistical analysis beyond descriptive report"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12905-019-0833-z"}},{"id":4140,"doi":"10.4103/0256-4947.83207","pmid":"21808123","pmcid":"PMC3156529","title":"RE: infantile and early childhood masturbation: sex hormones and clinical profile","authors":"Al-Mendalawi MD.","first_author":"Al-Mendalawi MD.","journal":"Annals of Saudi medicine","year":2011,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3156529","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0256-4947.83207"}},{"id":4141,"doi":"10.1111/j.1743-6109.2011.02348.x","pmid":"21699661","pmcid":null,"title":"Quality of life and sexual health after sex reassignment surgery in transsexual men","authors":"Wierckx K, Van Caenegem E, Elaut E, Dedecker D, Van de Peer F, Toye K, Weyers S, Hoebeke P, Monstrey S, De Cuypere G, T'Sjoen G.","first_author":"Wierckx K","journal":"The journal of sexual medicine","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":136,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"single‑center cross‑sectional survey of 49 trans men, mean 8 years post‑SRS; comparison to population norms","sample_n":49,"sample_text":"49 participants recruited from a single centre","population":"transsexual men (FTM) post‑sex reassignment surgery, long‑term testosterone therapy","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 49 trans men assessed about eight years after gender‑affirming surgery, quality of life scores were similar to the general male population and most reported satisfactory sexual function and increased masturbation.","clinical_takeaway":"Trans men can experience good overall health and sexual satisfaction many years after SRS, but individual outcomes vary.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Use of validated SF‑36","Focus on long‑term outcomes after SRS","Provides comparative data to a national reference"],"limitations":["Small, single‑centre convenience sample","Sexual‑function measure not validated","No control for potential confounders (e.g., mental health, partner status)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":12,"contrasting":4,"mentioning":153,"citing_publications":231,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2011.02348.x"}},{"id":4143,"doi":"10.1038/ijir.2011.16","pmid":"21614009","pmcid":null,"title":"Sexual dysfunction in women with migraine versus tension-type headaches: a comparative study","authors":"Bestepe E, Cabalar M, Kucukgoncu S, Calıkusu C, Ornek F, Yayla V, Erkoc S.","first_author":"Bestepe E","journal":"International journal of impotence research","year":2011,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional survey of women with migraine, tension‑type headache, and healthy controls (N=104) using ASEX and self‑reported sexual activity.","sample_n":104,"sample_text":"44 migraine, 30 tension‑type, 30 controls","population":"Women with migraine (n=44), tension‑type headache (n=30), and healthy controls (n=30); clinic‑based convenience sample.","country":"Turkey (inferred from authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Women with migraine or tension‑type headaches reported more sexual problems than healthy women, while also masturbating less frequently.","clinical_takeaway":"Headache patients may benefit from sexual health screening, but findings are limited by sample size and lack of broader psychosocial controls.","confidence":0.7,"topic_tags":["sexual_function","moral_incongruence","masturbation"],"strengths":["Validated sexual dysfunction scale (ASEX)","Included a healthy control group","Measured masturbation separately"],"limitations":["Small, clinic‑based convenience sample","No control for mental health, relationship, or trauma variables","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":21,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/ijir.2011.16"}},{"id":4144,"doi":"10.1177/107906320301500101","pmid":"12616925","pmcid":null,"title":"Childhood attachment, childhood sexual abuse, and onset of masturbation among adult sexual offenders","authors":"Smallbone SW, McCabe BA.","first_author":"Smallbone SW","journal":"Sexual abuse : a journal of research and treatment","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective self‑report from autobiographies of 48 incarcerated adult male sexual offenders; between‑group comparisons on attachment, sexual abuse history, and reported age of first masturbation.","sample_n":48,"sample_text":"48 adult male sexual offenders (22 rapists, 13 intrafamilial child molesters, 13 extrafamilial child molesters)","population":"Adult male sexual offenders (incarcerated)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined autobiographies of 48 male sexual offenders and found that those with insecure paternal attachment reported more childhood sexual abuse and earlier onset of masturbation, suggesting a possible link between early attachment, abuse, and later sexual behaviour.","clinical_takeaway":"Findings are exploratory; clinicians should not infer causal links between attachment or early masturbation and sexual offending based on this small retrospective study.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Novel use of autobiographical texts for historical data","Direct assessment of early masturbation onset","Inclusion of multiple offender subtypes"],"limitations":["Small, non‑representative sample of incarcerated offenders","Retrospective self‑report without validated attachment measures","No control for moral or mental‑health confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":1,"mentioning":28,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/107906320301500101"}},{"id":4145,"doi":null,"pmid":"12817671","pmcid":null,"title":"Urethral masturbation and sexual disinhibition in dementia: a case report","authors":"Rosenthal M, Berkman P, Shapira A, Gil I, Abramovitz J.","first_author":"Rosenthal M","journal":"The Israel journal of psychiatry and related sciences","year":2003,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report of urethral masturbation in a 90‑year‑old with Alzheimer’s dementia; treatment with haloperidol reported","sample_n":1,"sample_text":"single case","population":"1 male, 90 years old, Alzheimer’s disease","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 90‑year‑old man with Alzheimer’s disease repeatedly inserted objects into his urethra as a form of masturbation, reflecting sexual disinhibition. Low‑dose haloperidol reduced the behavior.","clinical_takeaway":"In elderly dementia patients, unusual genitourinary self‑injury may signal sexual disinhibition; low‑dose antipsychotics can help.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","pornography","masturbation"],"strengths":["Detailed clinical description of a rare presentation","Links behavior to neuropsychiatric symptoms of dementia","Provides treatment response (haloperidol) info"],"limitations":["N=1; no generalizability","No standardized measures of hypersexuality or sexual disinhibition","No control for confounding factors (e.g., mood, medication side‑effects)"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":4146,"doi":"10.1111/j.1743-6109.2011.02300.x","pmid":"21569216","pmcid":null,"title":"Female orgasm rates are largely independent of other traits: implications for \"female orgasmic disorder\" and evolutionary theories of orgasm","authors":"Zietsch BP, Miller GF, Bailey JM, Martin NG.","first_author":"Zietsch BP","journal":"The journal of sexual medicine","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large community twin sample (N=2914); cross‑sectional questionnaire study examining correlations between self‑reported orgasm frequencies and 19 demographic/psychological traits.","sample_n":2914,"sample_text":"Community twin cohort; not treatment‑seeking","population":"Adult female Australian twins","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of nearly 3,000 Australian women, how often they orgasm during masturbation or sex showed almost no link to personality, education, relationship status, or other traits, suggesting that low orgasm rates may not reflect a disorder or an evolutionary function.","clinical_takeaway":"Low orgasm frequency alone should not be taken as evidence of a disorder; clinicians should assess distress and other factors.","confidence":0.85,"topic_tags":["sexual_function","gender","treatment"],"strengths":["Very large, community‑based twin sample","Separate measurement of orgasm during masturbation vs intercourse","Comprehensive set of 19 correlates examined"],"limitations":["Cross‑sectional; cannot infer causality","No explicit measurement of mental‑health variables (e.g., depression)","Moral/religious attitudes not assessed"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":19,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2011.02300.x"}},{"id":4147,"doi":"10.1017/mdh.2019.42","pmid":"31571694","pmcid":"PMC6733772","title":"<i>Kränkung</i> and <i>Erkrankung</i>: Sexual Trauma before 1895","authors":"Janssen DF.","first_author":"Janssen DF.","journal":"Medical history","year":2019,"pub_types":["Historical Article","research-article","Journal Article"],"keywords":["Rape","Sexual Abuse","Nineteenth Century","History Of Psychiatry","Sexual Trauma","Victimology"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"historical analysis of 19th‑century psychiatric texts","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how 19th‑century psychiatrists described sexual trauma, including rape, illegitimate motherhood, and masturbatory guilt, highlighting the early medical‑psychological ideas that preceded Freud.","clinical_takeaway":"None - the paper is historical and does not provide clinical guidance.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Provides a detailed historical overview of early psychiatric concepts of sexual trauma","Integrates primary 19th‑century sources"],"limitations":["No empirical data; purely narrative","No systematic methodology or bias assessment"],"rubric_version":"2.0","raw_total":3,"max_possible":50,"pct_score":6,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/mdh.2019.42"}},{"id":4148,"doi":"10.1684/epd.2019.1098","pmid":"31649006","pmcid":null,"title":"Paroxysmal non-epileptic events in infancy: five cases with typical features","authors":"Nagy E, Hollody K.","first_author":"Nagy E","journal":"Epileptic disorders : international epilepsy journal with videotape","year":2019,"pub_types":["Review","Journal Article"],"keywords":["Infant","Jitteriness","Gratification","Upgaze","Benign Neonatal Sleep Myoclonus","Shuddering","Non-epileptic Paroxysmal Events"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of five infants with descriptive analysis of video recordings; no control group; small convenience sample referred for suspected epilepsy","sample_n":5,"sample_text":"Five cases","population":"infants/toddlers (1–30 months) referred for possible seizures","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article describes five infant cases where movements that looked like seizures were actually non‑epileptic events such as benign sleep myoclonus, jitteriness, shuddering attacks, tonic up‑gaze, and infant masturbation, emphasizing careful history taking to avoid unnecessary tests.","clinical_takeaway":"Careful clinical history can differentiate non‑epileptic infant movements from seizures, preventing unnecessary investigations.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Clear clinical descriptions with video examples","Highlights importance of history in differential diagnosis"],"limitations":["Very small, non-representative sample","No systematic analysis or statistical testing"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1684/epd.2019.1098"}},{"id":4149,"doi":"10.1038/s41443-019-0207-y","pmid":"31570825","pmcid":null,"title":"Transcutaneous functional electrical stimulation-a novel therapy for premature ejaculation: results of a proof of concept study","authors":"Shechter A, Serefoglu EC, Gollan T, Springer S, Meiry G, Appel B, Gruenwald I.","first_author":"Shechter A","journal":"International journal of impotence research","year":2020,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"single‑blinded, self‑controlled crossover proof‑of‑concept trial (N≈20)","sample_n":20,"sample_text":"23 enrolled, 20 completed","population":"men with lifelong premature ejaculation, age 20‑60 (mean 38.7)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a tiny trial of 20 men with lifelong premature ejaculation, a brief electrical stimulation applied to the perineum lengthened the time they could masturbate before ejaculating compared with a sham treatment.","clinical_takeaway":"Transcutaneous electrical stimulation shows promise for extending ejaculatory latency, but larger trials are needed before clinical use.","confidence":0.7,"topic_tags":["sexual_function","treatment","prevalence","neuroscience"],"strengths":["Randomised sham control","Objective latency measure with stopwatch","Blinded assessment"],"limitations":["Very small sample; likely underpowered","No validated PE scale (IELT) used","No control for psychological or relational confounds","Short follow‑up; only laboratory masturbation"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-019-0207-y"}},{"id":4150,"doi":"10.1111/j.1743-6109.2011.02293.x","pmid":"21554555","pmcid":null,"title":"Infantile masturbation in monozygotic twins","authors":"Kaya A, Taşkın GA, Okur M, Bektaş MS, Çaksen H.","first_author":"Kaya A","journal":"The journal of sexual medicine","year":2012,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2011.02293.x"}},{"id":4152,"doi":"10.1016/j.sleep.2011.02.002","pmid":"21493137","pmcid":null,"title":"Sexual behaviors during sleep associated with polysomnographically confirmed parasomnia overlap disorder","authors":"Cicolin A, Tribolo A, Giordano A, Chiarot E, Peila E, Terreni A, Bucca C, Mutani R.","first_author":"Cicolin A","journal":"Sleep medicine","year":2011,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Two individual cases of sexual behaviors during sleep documented with video-polysomnography; no control group.","sample_n":2,"sample_text":"Two patients","population":"Adult patients (one 60‑year‑old female, one 41‑year‑old male) with parasomnia overlap disorder.","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe two patients whose sleep was recorded with video‑polysomnography, revealing episodes of masturbation during deep sleep. One case involved a woman, the other a man whose nighttime sexual acts led to legal proceedings. The findings show that sexual behavior can occur unconsciously during parasomnias.","clinical_takeaway":"Sexual activity can emerge involuntarily during certain sleep disorders; clinicians should consider parasomnia when unexplained nocturnal sexual behavior is reported.","confidence":0.85,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["Objective video‑PSG documentation of rare sexual behavior during sleep","Clear temporal description of EEG patterns surrounding the episode"],"limitations":["Only two cases; no generalisable conclusions","No systematic assessment of psychological or social factors"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":29,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sleep.2011.02.002"}},{"id":4155,"doi":"10.1007/s10508-019-1448-z","pmid":"31485802","pmcid":null,"title":"Sexual Expression and Cognitive Function: Gender-Divergent Associations in Older Adults","authors":"Wright H, Jenks RA, Lee DM.","first_author":"Wright H","journal":"Archives of sexual behavior","year":2020,"pub_types":["Journal Article"],"keywords":["Cognition","Sexual activity","Later Life","Gender Differences","Elsa"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational analysis of a large, nationally‑representative cohort (ELSA) using one wave of data (n≈4,100).","sample_n":4110,"sample_text":"Wave 6 of the English Longitudinal Study of Aging (ELSA).","population":"Community‑dwelling adults aged 50‑89 in England (1915 women, 2195 men).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a national UK sample of older adults, more frequent masturbation was linked to better memory in women, while more kissing/fondling was linked to better processing speed in men, suggesting gender‑specific links between intimate activity and cognition.","clinical_takeaway":"Encouraging varied, consensual sexual activity may support cognitive health in older adults, but direction of effect remains uncertain.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Large, population‑based sample with gender‑specific analyses.","Separate measurement of different sexual activities.","Adjustment for a wide range of demographic and health covariates."],"limitations":["Cross‑sectional design limits causal inference.","No assessment of moral or cultural attitudes toward sexuality.","Self‑report of sexual activity may be subject to bias."],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-1448-z"}},{"id":4156,"doi":"10.1016/j.sleep.2011.01.001","pmid":"21377419","pmcid":null,"title":"Sexual intercourse and masturbation: potential relief factors for restless legs syndrome?","authors":"Marin LF, Felicio AC, Prado GF.","first_author":"Marin LF","journal":"Sleep medicine","year":2011,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sleep.2011.01.001"}},{"id":4157,"doi":"10.1080/03630242.2011.553157","pmid":"21476174","pmcid":null,"title":"Double standard for traditional value of virginity and premarital sexuality in Turkey: a university students case","authors":"Eşsizoğlu A, Yasan A, Yildirim EA, Gurgen F, Ozkan M.","first_author":"Eşsizoğlu A","journal":"Women & health","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 534 single heterosexual university students at one Turkish university; convenience sample; self‑report questionnaire on myths, masturbation, premarital sex, religious commitment.","sample_n":534,"sample_text":"534 single, heterosexual male and female students from Dicle University","population":"university students (Turkey)","country":"Turkey","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 534 Turkish university students found that myths about virginity are common, especially among men, and that higher religious commitment is linked to lower rates of masturbation and premarital sex.","clinical_takeaway":"Clinicians should consider cultural myths and religiosity when discussing sexual behavior with young adults.","confidence":0.6,"topic_tags":["sexual_function","csbd","moral_incongruence"],"strengths":["Large sample for a single university","Includes both genders","Measures religious commitment as a proxy for moral attitudes"],"limitations":["Cross‑sectional, cannot infer causality","Self‑report single‑item measures; no validated scales","Limited to one university; not nationally representative"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":36,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/03630242.2011.553157"}},{"id":4159,"doi":"10.1016/s0031-9384(02)00803-x","pmid":"12127009","pmcid":null,"title":"Duration of sexual arousal predicts semen parameters for masturbatory ejaculates","authors":"Pound N, Javed MH, Ruberto C, Shaikh MA, Del Valle AP.","first_author":"Pound N","journal":"Physiology & behavior","year":2002,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Repeated‑measures observational study of 25 regular semen donors providing 292 masturbatory ejaculates over 4 months.","sample_n":25,"sample_text":"25 donors (median 11 specimens each).","population":"Adult male semen donors, ages 22‑44, convenience sample.","country":"Not reported (likely USA based on author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 25 men who donated semen, longer periods of sexual arousal before masturbating were linked to higher sperm counts, suggesting that how long a man is aroused can affect the quality of his ejaculate.","clinical_takeaway":"Clinicians might consider that arousal duration influences semen quality when advising men on fertility‑related issues.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Objective measurement of arousal duration and semen parameters","Within‑subject design controls for inter‑individual variability","Large number of specimens per donor improves reliability"],"limitations":["Small, non‑representative convenience sample of donors","No control for potential confounders (e.g., mood, health, partner factors)","Statistical reporting limited to p‑values without confidence intervals"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":50,"citing_publications":91,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0031-9384(02)00803-x"}},{"id":4160,"doi":"10.1023/a:1016224326301","pmid":"12187547","pmcid":null,"title":"Genetic and environmental influences on problematic masturbatory behavior in children: a study of same-sex twins","authors":"Långström N, Grann M, Lichtenstein P.","first_author":"Långström N","journal":"Archives of sexual behavior","year":2002,"pub_types":["Twin Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Twin study of Swedish 7‑9‑year‑old children; CBCL parent report; 401 MZ and 248 DZ same‑sex pairs; ACE model used to partition variance.","sample_n":649,"sample_text":"401 monozygotic and 248 dizygotic same‑sex twin pairs (total 649 children)","population":"Children age 7‑9, population‑based Swedish twin registry","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Swedish twin study of 7‑9‑year‑olds, researchers found that genetics accounted for about three‑quarters of the variation in problematic public or excessive masturbation, with family environment also playing a role, though the measure was brief and statistical power low.","clinical_takeaway":"Genetic factors may influence early problematic masturbation, but clinicians should also consider environmental stressors and use comprehensive assessments.","confidence":0.8,"topic_tags":["masturbation","gender","treatment"],"strengths":["Large, population‑based twin sample","Use of genetically informative design","Provides heritability estimate"],"limitations":["Very brief two‑item measure of masturbatory behavior","Low statistical power and wide confidence intervals","No assessment of potential environmental confounds such as trauma"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1016224326301"}},{"id":4162,"doi":"10.1901/jaba.2011.44-707","pmid":"22219524","pmcid":"PMC3251276","title":"The influence of presession factors in the assessment of deviant arousal","authors":"Reyes JR, Vollmer TR, Hall A.","first_author":"Reyes JR","journal":"Journal of applied behavior analysis","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Suppression","Masturbation","Arousal Assessment","Penile Plethysmograph","Sex Offenders With Developmental Disabilities"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of three adult male sex offenders with developmental disabilities; laboratory assessment using penile plethysmograph; within‑subject manipulation of presession masturbation and arousal‑suppression strategies.","sample_n":3,"sample_text":"Three participants","population":"adult male sex offenders with developmental disabilities (N=3)","country":"United States (inferred from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In three male sex offenders with developmental disabilities, a brief bout of masturbation before testing lowered measured sexual arousal, and attempts to suppress arousal also reduced responses. These presession factors may affect how arousal is assessed.","clinical_takeaway":"Presession activities like masturbation can influence physiological arousal measurements; clinicians should standardise such conditions when evaluating sex offenders.","confidence":0.7,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Objective physiological measure (plethysmograph)","Focused manipulation of presession variables","Relevant for treatment planning in a specialized population"],"limitations":["Very small N (3 participants)","No statistical power analysis or effect‑size reporting","Findings not generalizable beyond this specific clinical group"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":2,"confounds":0,"design":0,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":20,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1901/jaba.2011.44-707"}},{"id":4163,"doi":"10.3138/cjhs.2019-0014","pmid":"34305417","pmcid":"PMC8297663","title":"Generational differences in sexual behaviour and partnering among gay, bisexual, and other men who have sex with men","authors":"Hunt G, Wang L, Bacani N, Card K, Sereda P, Lachowsky N, Roth E, Hogg R, Moore D, Armstrong H.","first_author":"Hunt G","journal":"The Canadian journal of human sexuality","year":2019,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Cross‑sectional baseline analysis of a community cohort (RDS) with 6‑month follow‑up up to 2017; multivariable logistic regression and hierarchical mixed‑effects models used on 774 gbMSM (millennials, Gen‑X, baby boomers).","sample_n":774,"sample_text":"190 millennials, 469 Gen‑Xers, 115 baby boomers; RDS‑weighted baseline data and 6‑month repeated measures.","population":"gbMSM community sample from Metro Vancouver recruited via respondent‑driven sampling (N≈774, ages ≥16).","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among gay, bisexual and other men who have sex with men in Vancouver, younger (millennial) men started anal sex earlier but reported less high‑risk sex than older generations. Over time, all groups showed trends toward fewer partners and lower risk behaviours.","clinical_takeaway":"Younger gbMSM may need earlier sexual health outreach, but overall risk behaviours are decreasing across generations.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample of gbMSM across three generations","Longitudinal follow‑up allows trend analysis","Use of RDS weighting and multivariable models"],"limitations":["Self‑report sexual behaviour may be biased","No measurement of key psychosocial confounds (e.g., moral incongruence, mental health)","Convenient Vancouver sample limits generalisability"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3138/cjhs.2019-0014"}},{"id":4164,"doi":"10.1111/j.1743-6109.2010.02129.x","pmid":"21114768","pmcid":null,"title":"Sexual behavior predictors of satisfaction in a Chinese sample","authors":"Tao P, Brody S.","first_author":"Tao P","journal":"The journal of sexual medicine","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 158 Chinese industrial workers using self‑report questionnaires.","sample_n":158,"sample_text":"Convenience sample of employees; not nationally representative.","population":"Chinese industrial workers (age >24)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 158 Chinese workers, people who had sex more often with a partner reported higher sexual satisfaction, while masturbation frequency did not relate to satisfaction.","clinical_takeaway":"Partnered intercourse frequency appears linked to higher sexual satisfaction; masturbation does not predict satisfaction in this sample.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Validated satisfaction scale","Explicit measurement of multiple sexual behaviors and orgasm frequency","Inclusion of social desirability control"],"limitations":["Convenience, non‑representative sample","Behavior frequencies based on single‑item self‑reports","Limited assessment of key confounds (moral, mental health, partner context)","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":10,"contrasting":1,"mentioning":36,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02129.x"}},{"id":4165,"doi":"10.5534/wjmh.190034","pmid":"31385471","pmcid":"PMC6920069","title":"Proteomic Signatures in Spermatozoa Reveal the Role of Paternal Factors in Recurrent Pregnancy Loss","authors":"Mohanty G, Mohanty G, Jena SR, Nayak J, Kar S, Samanta L.","first_author":"Mohanty G","journal":"The world journal of men's health","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Spermatozoa","Proteomics","Recurrent Pregnancy Loss","Two-dimensional Difference Gel Electrophoresis","Embryo Loss","Paternal Factors"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6920069","cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"prospective case‑control proteomic comparison of sperm from 16 men with recurrent pregnancy loss and 20 fertile controls","sample_n":36,"sample_text":"16 RPL males, 20 controls","population":"male partners of RPL patients (n=16) and age‑matched fertile volunteers (n=20)","country":"India (institutional ethics approval mentioned)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared sperm proteins from men whose partners experienced recurrent miscarriage with those from fertile men, finding several proteins that were more or less abundant in the miscarriage group, suggesting paternal factors may influence early embryo development.","clinical_takeaway":"Altered sperm protein expression could contribute to recurrent pregnancy loss, but larger studies are needed before clinical application.","confidence":0.8,"topic_tags":["religiosity","masturbation","sexual_function"],"strengths":["Use of validated proteomic techniques (2‑D DIGE, MALDI‑TOF/MS, Western blot)","Clear case‑control design with age‑matched fertile volunteers","Ethical approval and informed consent"],"limitations":["Very small sample size (16 cases, 20 controls)","Multiple protein comparisons without reported correction for false discovery","Findings limited to association; no functional validation in embryos","No assessment of potential confounding maternal or lifestyle factors"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":20,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5534/wjmh.190034"}},{"id":4166,"doi":"10.4081/aiua.2019.2.119","pmid":"31266281","pmcid":null,"title":"Male-to-Female (MtoF) gender affirming surgery: Modified surgical approach for the glans reconfiguration in the neoclitoris (M-shape neoclitorolabioplasty)","authors":"Cocci A, Rosi F, Frediani D, Rizzo M, Cito G, Trombetta C, Vedovo F, Grisanti Caroassai S, Delle Rose A, Matteucci V, Buccianti P, Ceccarelli C, Carini M, Minervini A, Morelli G.","first_author":"Cocci A","journal":"Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://pagepressjournals.org/index.php/aiua/article/download/aiua.2019.2.119/8181","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 94 consecutive patients undergoing a modified M‑shape neoclitorolabioplasty; no control group, descriptive outcomes.","sample_n":94,"sample_text":"94 patients treated with the modified technique; median follow‑up 27.57 months.","population":"adult transgender women (male‑to‑female) undergoing gender‑affirming surgery; median follow‑up 27.6 months.","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe a modified surgery that reshapes the clitoral glans into an “M” shape to create a neoclitoris and labia minora in transgender women. In 94 patients, most reported the ability to have intercourse and retain erogenous sensation after about two years.","clinical_takeaway":"The technique appears feasible and may preserve clitoral sensation, but evidence is limited to an uncontrolled case series.","confidence":0.8,"topic_tags":["gender","sexual_function"],"strengths":["Large consecutive case series for a surgical technique","Medium‑term follow‑up (>2 years)","Clear description of operative steps"],"limitations":["No control or comparison group","Outcomes limited to self‑report, no objective sensory testing","Potential selection bias (single centre, surgeon‑specific cohort)","No statistical testing or effect‑size reporting"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4081/aiua.2019.2.119"}},{"id":4168,"doi":"10.1016/j.jsxm.2019.04.018","pmid":"31196838","pmcid":null,"title":"Factors Associated with Low Sexual Desire in 45-Year-Old Men: Findings from the German Male Sex-Study","authors":"Meissner VH, Schroeter L, Köhn FM, Kron M, Zitzmann M, Arsov C, Imkamp F, Hadaschik B, Gschwend JE, Herkommer K.","first_author":"Meissner VH","journal":"The journal of sexual medicine","year":2019,"pub_types":["Journal Article"],"keywords":["Sexual behavior","Sexual dysfunction","Lifestyle","Comorbidity","Sexual Desire","Representative Sample"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large population‑based survey of 12,646 45‑year‑old German men; logistic regression analysis of associations with low sexual desire","sample_n":12646,"sample_text":"large, population‑based sample","population":"45‑year‑old men (N=12,646) recruited via a prostate‑cancer screening trial in Germany","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 12,000 German men aged 45, about 5 % reported low sexual desire. Factors linked to higher desire included having more children, masturbating more often, valuing sexuality, and higher sexual self‑esteem; erectile problems, premature ejaculation and urinary symptoms were linked to lower desire.","clinical_takeaway":"Assess a range of health, lifestyle and relational factors when evaluating low sexual desire in middle‑aged men.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Very large, population‑based sample","Comprehensive set of potential correlates","Separates masturbation frequency from desire outcomes"],"limitations":["Cross‑sectional – cannot infer causality","No measurement of moral incongruence or partner factors","Unclear whether desire measure is fully validated"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":1,"mentioning":8,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.04.018"}},{"id":4169,"doi":"10.1111/j.1743-6109.2010.02009.x","pmid":"21029386","pmcid":null,"title":"Sexual behaviors, relationships, and perceived health among adult men in the United States: results from a national probability sample","authors":"Reece M, Herbenick D, Schick V, Sanders SA, Dodge B, Fortenberry JD.","first_author":"Reece M","journal":"The journal of sexual medicine","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":61,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national probability sample; cross‑sectional survey of 2,522 US men aged 18‑94; self‑report of solo and partnered sexual behaviours, relationship status and health.","sample_n":2522,"sample_text":"2,522 men, ages 18‑94, nationally representative probability sample.","population":"Adult men in the United States, community‑dwelling, recruited via probability sampling.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationally representative US survey of 2,522 adult men found that solo and partnered sexual activities, such as masturbation and oral sex, are common across most of adulthood but decline with age and poorer health.","clinical_takeaway":"Sexual activity remains prevalent in adulthood; clinicians should consider age and health when discussing sexual health with male patients.","confidence":0.8,"topic_tags":["sexual_function","masturbation","relationships"],"strengths":["Large, nationally representative probability sample","Detailed frequency data for multiple sexual behaviours","Appropriate logistic modelling with odds ratios"],"limitations":["Self‑report may be subject to recall and social desirability bias","Cross‑sectional; cannot infer causality","No assessment of moral, mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":1,"mentioning":77,"citing_publications":151,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02009.x"}},{"id":4170,"doi":"10.1111/j.1743-6109.2010.02010.x","pmid":"21029385","pmcid":null,"title":"Sexual behaviors, relationships, and perceived health status among adult women in the United States: results from a national probability sample","authors":"Herbenick D, Reece M, Schick V, Sanders SA, Dodge B, Fortenberry JD.","first_author":"Herbenick D","journal":"The journal of sexual medicine","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":75,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"national probability sample of 2,523 adult women; internet‑based cross‑sectional survey assessing solo and partnered sexual activities and perceived health.","sample_n":2523,"sample_text":"probability sample, internet survey","population":"adult women, United States, ages 18‑92 (probability sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2010 national survey of over 2,500 U.S. women aged 18–92 found that solo masturbation, oral sex and vaginal intercourse are common, especially among younger women, and that sexual activity declines with age. Relationship status and how women rate their health are linked to how often they engage in these activities.","clinical_takeaway":"Women’s sexual activity varies by age and relationship status; clinicians should consider these normal patterns when discussing sexual health.","confidence":0.8,"topic_tags":["sexual_function","masturbation","relationships"],"strengths":["Large, nationally representative probability sample","Comprehensive assessment of solo and partnered sexual behaviors","Clear reporting of frequencies and age trends","Analysis includes relationship and perceived health status"],"limitations":["Self‑report may be subject to recall and social desirability bias","No validated scales for sexual behavior; relies on single‑item frequency items","Cross‑sectional design precludes causal inference","Moral, mental‑health, and trauma variables not assessed"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":1,"mentioning":102,"citing_publications":133,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02010.x"}},{"id":4171,"doi":"10.1111/j.1743-6109.2010.01873.x","pmid":"20561168","pmcid":null,"title":"Characteristics of vibrator use by gay and bisexually identified men in the United States","authors":"Reece M, Rosenberger JG, Schick V, Herbenick D, Dodge B, Novak DS.","first_author":"Reece M","journal":"The journal of sexual medicine","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large internet‑based survey of 25,294 gay and bisexually identified men in the US; descriptive analysis of vibrator use in solo and partnered contexts","sample_n":25294,"sample_text":"25,294 gay and bisexually identified men from all US states","population":"gay and bisexually identified adult men, US, recruitment via online panels","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US online survey of over 25,000 gay and bisexual men, about half reported ever using a vibrator. Most used them during masturbation and many during partnered sex, describing increased arousal and pleasure.","clinical_takeaway":"Vibrator use is common and generally reported as enhancing sexual satisfaction among gay and bisexual men.","confidence":0.85,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Very large, nationwide sample","Specific focus on an understudied population (gay/bisexual men)","Clear separation of solo vs partnered vibrator use"],"limitations":["Self‑report, single‑item measures without validation","Convenience internet sample may not be representative","No assessment of mental‑health or moral‑incongruence factors"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.01873.x"}},{"id":4172,"doi":"10.1111/j.1743-6109.2010.02019.x","pmid":"21029389","pmcid":null,"title":"Sexual health among U.S. black and Hispanic men and women: a nationally representative study","authors":"Dodge B, Reece M, Herbenick D, Schick V, Sanders SA, Fortenberry JD.","first_author":"Dodge B","journal":"The journal of sexual medicine","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative probability sample of 1246 Black and Hispanic adults; self‑report questionnaire on solo and partnered masturbation, oral, vaginal, anal sex, condom use, STI testing/diagnosis.","sample_n":1246,"sample_text":"probability sample of 1246 black and Hispanic adults","population":"U.S. Black and Hispanic adults (both sexes, all adult ages)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative survey of 1,246 Black and Hispanic U.S. adults, most respondents reported masturbating, oral sex and vaginal intercourse across the life course. Condom use was relatively high and STI testing was common, with few differences by gender or age.","clinical_takeaway":"Sexual health services should consider the high prevalence of diverse behaviours and generally good condom use among Black and Hispanic adults.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["large, probability‑based sample","covers a wide range of sexual behaviours","provides baseline prevalence data for under‑studied groups"],"limitations":["self‑report may be socially biased","no assessment of mental‑health or moral‑incongruence confounds","cross‑sectional cannot infer causality"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":33,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02019.x"}},{"id":4173,"doi":"10.1111/j.1743-6109.2010.02012.x","pmid":"21029383","pmcid":null,"title":"Sexual behavior in the United States: results from a national probability sample of men and women ages 14-94","authors":"Herbenick D, Reece M, Schick V, Sanders SA, Dodge B, Fortenberry JD.","first_author":"Herbenick D","journal":"The journal of sexual medicine","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":327,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"National probability sample of 5,865 U.S. adults and adolescents, cross‑sectional survey of sexual behaviors.","sample_n":5865,"sample_text":"5,865 participants (2,936 men, 2,929 women).","population":"Men and women ages 14‑94 in the United States (probability‑based household sample).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationally representative US survey of 5,865 people aged 14‑94 found that masturbation is common across the lifespan, while oral, vaginal and anal sex are most frequent in young adulthood and decline with age.","clinical_takeaway":"Clinicians can use these prevalence data to contextualise patients’ sexual behaviours and address misconceptions about ‘normal’ sexual activity.","confidence":0.9,"topic_tags":["sexual_function","prevalence","masturbation"],"strengths":["Large, nationally representative probability sample","Comprehensive age range (14‑94)","Detailed prevalence estimates with confidence intervals"],"limitations":["Self‑report may be subject to social desirability bias","No validation of questionnaire reported","Cross‑sectional design cannot address causality"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":19,"contrasting":2,"mentioning":346,"citing_publications":622,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02012.x"}},{"id":4174,"doi":"10.1111/j.1743-6109.2010.02018.x","pmid":"21029387","pmcid":null,"title":"Sexual behaviors and condom use at last vaginal intercourse: a national sample of adolescents ages 14 to 17 years","authors":"Fortenberry JD, Schick V, Herbenick D, Sanders SA, Dodge B, Reece M.","first_author":"Fortenberry JD","journal":"The journal of sexual medicine","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":53,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"nationally representative probability sample, cross‑sectional survey","sample_n":820,"sample_text":"Male N=414, Female N=406","population":"Adolescents ages 14‑17 in the United States (N≈820)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative US survey of 14‑17‑year‑olds, most teens reported having had solo masturbation and many reported vaginal intercourse, with condom use reported in about three‑quarters of recent events.","clinical_takeaway":"Most sexually active adolescents report using condoms, but public‑health programs should continue promoting consistent condom use.","confidence":0.7,"topic_tags":["adolescents","sexual_function","masturbation"],"strengths":["Large, nationally representative sample","Separate measurement of solo and partnered masturbation","Adjusted prevalence estimates with confidence intervals"],"limitations":["Self‑report data may be subject to recall or social desirability bias","Cross‑sectional design cannot infer causal relationships","Limited assessment of psychosocial confounders (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":1,"mentioning":47,"citing_publications":93,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02018.x"}},{"id":4175,"doi":"10.1038/s41443-019-0154-7","pmid":"31171851","pmcid":null,"title":"First assessment of the validity of the only diagnostic criteria for postorgasmic illness syndrome (POIS)","authors":"Strashny A.","first_author":"Strashny A.","journal":"International journal of impotence research","year":2019,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of self‑report diagnostic criteria; N=127 men with self‑reported POIS completed an online questionnaire","sample_n":127,"sample_text":"self‑selected community sample of men reporting POIS","population":"men self‑identifying as having POIS (self‑selected sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 127 men who say they have post‑orgasmic illness syndrome to see whether they meet the five proposed criteria for the condition. Most men met several criteria, but not all, suggesting the current checklist needs refinement.","clinical_takeaway":"Current POIS diagnostic criteria appear partly valid but should be used cautiously; further clinical validation is needed.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["largest sample of men reporting POIS to date","first empirical test of proposed diagnostic criteria","covers multiple ejaculatory settings"],"limitations":["criteria are preliminary and not previously validated","self‑selected, non‑representative sample","no external clinical validation or objective measures"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-019-0154-7"}},{"id":4178,"doi":"10.1363/ipsrh.36.157.10","pmid":"20880801","pmcid":null,"title":"Masturbation: breaking the silence","authors":"Shelton JD.","first_author":"Shelton JD.","journal":"International perspectives on sexual and reproductive health","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1363/ipsrh.36.157.10"}},{"id":4180,"doi":"10.1111/j.1743-6109.2010.02008.x","pmid":"20819142","pmcid":null,"title":"Bladder perforation associated with hot tub","authors":"Kopp RP, Dato PE, Sur RL.","first_author":"Kopp RP","journal":"The journal of sexual medicine","year":2011,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with bladder perforation after masturbation in a hot tub","sample_n":1,"sample_text":"single case","population":"54‑year‑old female","country":"USA (presumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 54‑year‑old woman suffered a bladder tear after using a hot‑tub water jet during masturbation; surgery repaired it successfully.","clinical_takeaway":"Clinicians should consider bladder injury in patients with pelvic pain after aggressive water‑jet use.","confidence":0.8,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Detailed clinical description","Imaging evidence of injury"],"limitations":["Single case, no generalizability","No systematic assessment of confounders","No statistical analysis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02008.x"}},{"id":4181,"doi":"10.1155/2010/460385","pmid":"20862362","pmcid":"PMC2938437","title":"Perforation of the urinary bladder caused by transurethral insertion of a pencil for the purpose of masturbation in a 29-year-old female","authors":"Bantis A, Sountoulides P, Kalaitzis C, Giannakopoulos S, Agelonidou E, Foutzitzi S, Touloupidis S.","first_author":"Bantis A","journal":"Case reports in medicine","year":2010,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC2938437","cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report describing bladder perforation after transurethral insertion of a pencil for masturbation; no control group, no systematic methodology","sample_n":1,"sample_text":"N=1 (single case)","population":"29‑year‑old female with psychiatric illness","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 29‑year‑old woman with psychiatric illness inserted a pencil into her urethra for sexual stimulation, leading to bladder wall perforation that required surgical removal.","clinical_takeaway":"Unusual self‑inserted objects can cause serious genitourinary injury; clinicians should consider foreign‑body insertion in patients presenting with hematuria and pelvic pain.","confidence":0.9,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Detailed clinical description of a rare injury","Imaging confirms foreign‑body location"],"limitations":["N=1; no generalisable conclusions","No assessment of psychological or sexual‑behavioral factors beyond brief mention"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":28,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2010/460385"}},{"id":4182,"doi":"10.1007/s10508-010-9639-7","pmid":"20697937","pmcid":null,"title":"Are there different types of female orgasm?","authors":"King R, Belsky J, Mah K, Binik Y.","first_author":"King R","journal":"Archives of sexual behavior","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 503 women providing self‑reported orgasm descriptors; latent‑class analysis used to identify typology.","sample_n":503,"sample_text":"503 women (276 partner‑based, 227 solitary)","population":"Adult women (partnered and solitary), likely convenience sample","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed over 500 women about their orgasm experiences and identified four distinct types, differing in pleasure and sensation, with two types linked to higher enjoyment during partnered sex and two linked to lower enjoyment.","clinical_takeaway":"Female orgasm experiences may vary systematically; clinicians should recognize diverse orgasm patterns when discussing sexual health with patients.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Large sample for a survey on female orgasm phenomenology","Use of latent‑class analysis to uncover typology","Separate assessment of partner‑based and solitary orgasms"],"limitations":["Self‑report measures without validated scales","Convenience sampling limits generalisability","Potential unmeasured confounds (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":27,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9639-7"}},{"id":4184,"doi":"10.1007/s003450100222","pmid":"11760788","pmcid":null,"title":"Endocrine response to masturbation-induced orgasm in healthy men following a 3-week sexual abstinence","authors":"Exton MS, Krüger TH, Bursch N, Haake P, Knapp W, Schedlowski M, Hartmann U.","first_author":"Exton MS","journal":"World journal of urology","year":2001,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subject laboratory study; 10 healthy men measured before and after 3‑week abstinence","sample_n":10,"sample_text":"ten healthy adult men","population":"adult males, n=10, healthy volunteers","country":"Germany (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In ten healthy men, a 3‑week break from sexual activity did not change the hormonal surge that occurs during orgasm, but it did raise baseline testosterone levels.","clinical_takeaway":"Short‑term sexual abstinence appears to increase testosterone but does not alter the immediate hormonal response to orgasm.","confidence":0.8,"topic_tags":["masturbation","sexual_function","neuroscience"],"strengths":["Physiological measures are validated laboratory assays","Within‑subject design controls for individual differences","Repeated measurement allows comparison pre‑ and post‑abstinence"],"limitations":["Very small sample limits statistical power","No pre‑registration or effect‑size reporting","Findings may not generalize to broader populations"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":1,"mentioning":45,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s003450100222"}},{"id":4185,"doi":"10.1016/j.ajp.2019.05.008","pmid":"31078093","pmcid":null,"title":"A case of an unusual presentation of obsessive compulsive disorder in an adolescent","authors":"Rohanachandra YM, Vipulanandan S.","first_author":"Rohanachandra YM","journal":"Asian journal of psychiatry","year":2019,"pub_types":["Journal Article","Case Reports"],"keywords":["Children and adolescent","Obsessive Compulsive Disorder","Unusual Presentation"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single adolescent patient","sample_n":1,"sample_text":"single patient","population":"13‑year‑old male with OCD","country":"unspecified (likely India based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 13‑year‑old boy showed unusual OCD symptoms, including sexual thoughts, public masturbation, and hyperreligiosity. After ruling out other conditions, he was treated with fluoxetine and olanzapine, achieving remission.","clinical_takeaway":"Unusual sexual or religious compulsions in adolescents may reflect OCD; consider OCD assessment before attributing to other diagnoses.","confidence":0.8,"topic_tags":["other"],"strengths":["detailed clinical description","highlights atypical OCD presentation in youth"],"limitations":["single case, no standardized measures","no control or comparison group","cannot infer prevalence or causality"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ajp.2019.05.008"}},{"id":4187,"doi":"10.1016/j.pnpbp.2010.06.017","pmid":"20600465","pmcid":null,"title":"Excessive masturbation associated with olanzapine in a pediatric case","authors":"Hergüner S.","first_author":"Hergüner S.","journal":"Progress in neuro-psychopharmacology & biological psychiatry","year":2010,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pnpbp.2010.06.017"}},{"id":4188,"doi":"10.1016/j.legalmed.2019.04.006","pmid":"31009906","pmcid":null,"title":"Autoerotic asphyxia using a plastic bag loosely covering the head over a gas mask","authors":"Idota N, Nakamura M, Tsuboi H, Ichioka H, Shintani-Ishida K, Ikegaya H.","first_author":"Idota N","journal":"Legal medicine (Tokyo, Japan)","year":2019,"pub_types":["Journal Article","Case Reports"],"keywords":["Suffocation","Plastic Bag","Gas Mask","Autoerotic Asphyxia"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single autopsy case report with literature review","sample_n":1,"sample_text":"1 case (autopsy) plus literature review","population":"33‑year‑old Japanese male, accidental autoerotic death","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 33‑year‑old Japanese man died accidentally while engaging in autoerotic asphyxia using a plastic bag and gas mask; autopsy found no other cause. The report compares this case to similar deaths elsewhere.","clinical_takeaway":"None – the report describes a single fatal incident and offers no clinical guidance.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Detailed forensic description","Contextual literature comparison"],"limitations":["N=1, no generalisable data","No systematic measurement of sexual or psychological variables"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.legalmed.2019.04.006"}},{"id":4189,"doi":"10.1007/bf02752422","pmid":"11563256","pmcid":null,"title":"Masturbation mimicking seizure in an infant","authors":"Deda G, Caksen H, Suskan E, Gümüs D.","first_author":"Deda G","journal":"Indian journal of pediatrics","year":2001,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single infant case report describing episodes initially diagnosed as seizures but later attributed to masturbation based on clinical observation and normal EEG","sample_n":1,"sample_text":"1 infant","population":"1 male infant, 3.5 months old","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"An infant was thought to have seizures, but careful observation and normal EEG showed the episodes were actually self‑stimulation (masturbation). Clinicians should consider this possibility when evaluating infantile seizures.","clinical_takeaway":"When infant seizures are suspected, observe behaviour and use EEG to differentiate from normal self‑stimulation.","confidence":0.85,"topic_tags":["masturbation","sexual_function","pornography"],"strengths":["Clear clinical description of a rare phenomenon","Use of EEG to rule out epileptic activity"],"limitations":["Single case; no generalisability","No standardized assessment of masturbation behaviour","No comparison group or systematic data"],"rubric_version":"2.0","raw_total":13,"max_possible":60,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":2,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":2,"mentioning":11,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02752422"}},{"id":4190,"doi":"10.1016/j.jsxm.2019.02.003","pmid":"30935468","pmcid":null,"title":"Ten-Year Interval Changes in the Prevalence of Self-Identified Premature Ejaculation and Premature Ejaculation Based on an Estimated Intravaginal Ejaculation Latency Time of <3 Minutes in the General Population: The Korean Internet Sexuality Survey (KISS) 2016","authors":"Song WH, Yoo S, Oh S, Park J, Cho SY, Cho MC, Jeong H, Son H.","first_author":"Song WH","journal":"The journal of sexual medicine","year":2019,"pub_types":["Journal Article"],"keywords":["Survey","Prevalence","risk factors","Premature Ejaculation"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Two independent web‑based surveys of Korean men (2006, 2016) using the same questionnaire; not a cohort of the same participants.","sample_n":1401,"sample_text":"1401 participants in 2016; comparable size in 2006.","population":"Adult Korean men (20‑50 years) recruited from an internet survey panel (N≈1400 in 2016).","country":"South Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A Korean internet survey compared two samples (2006 vs. 2016) and found that the percentage of men who said they have premature ejaculation rose from about 1.8% to 4%, while self‑identified cases rose slightly but not significantly. Factors like fewer sexual encounters, higher BMI, and masturbation were linked to higher rates.","clinical_takeaway":"Premature ejaculation appears more common over time; clinicians should consider lifestyle and sexual frequency when assessing patients.","confidence":0.7,"topic_tags":["prevalence","sexual_function","gender","moral_incongruence","masturbation"],"strengths":["Large internet sample enabling comparison across a decade","Uses both self‑label and latency‑based definitions of PE","Adjusts prevalence for age differences between surveys"],"limitations":["Cross‑sectional design; different participants in each wave","PE latency estimated by a single self‑report item, not validated","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":8,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.02.003"}},{"id":4191,"doi":"10.1017/s0025727300007547","pmid":null,"pmcid":"PMC546354","title":"Book Review : Solitary sex: a cultural history of masturbation","authors":null,"first_author":null,"journal":"Medical history","year":2004,"pub_types":["book-review","Book Review"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0025727300007547"}},{"id":4192,"doi":"10.1016/j.urolonc.2019.02.009","pmid":"30857990","pmcid":null,"title":"Guideline based approach to male fertility preservation","authors":"Halpern JA, Hill R, Brannigan RE.","first_author":"Halpern JA","journal":"Urologic oncology","year":2020,"pub_types":["Review","Journal Article"],"keywords":["Fertility Preservation","Oncofertility","Onco-tese"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article summarising guidelines; no primary data, no sample","sample_n":null,"sample_text":"Not applicable – narrative guideline review","population":"Adults and adolescents with cancer (male)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews current professional guidelines for preserving fertility in male cancer patients, emphasizing early counseling and sperm banking via masturbation as the simplest method, while noting alternatives for those unable to provide a sample.","clinical_takeaway":"Clinicians should discuss fertility options, including sperm banking, with male cancer patients before starting gonadotoxic treatment.","confidence":0.8,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Provides a concise synthesis of existing fertility preservation guidelines","Offers clear clinical recommendations for timely discussion with patients"],"limitations":["No original data; conclusions rely on cited guidelines","Lacks systematic review methodology (no risk‑of‑bias assessment)","Does not address potential psychosocial or sexual‑health confounds"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urolonc.2019.02.009"}},{"id":4193,"doi":"10.1371/journal.pone.0212274","pmid":"30807583","pmcid":"PMC6391003","title":"Efficacy of Sphincter Control Training (SCT) in the treatment of premature ejaculation, a new cognitive behavioral approach: A parallel-group randomized, controlled trial","authors":"Rodríguez JE, Marzo JC, Piqueras JA.","first_author":"Rodríguez JE","journal":"PloS one","year":2019,"pub_types":["research-article","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.1371/journal.pone.0212274","cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"parallel‑group randomized controlled trial (N=35) comparing SCT with vs. without a masturbation aid device over 7 weeks; primary outcome IELT fold increase, secondary PE Profile; no follow‑up, no placebo control","sample_n":35,"sample_text":"35 patients completed the trial (approximately 17‑18 per arm)","population":"adult men diagnosed with premature ejaculation (IELT ≤2 min, PEDT ≥11)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 35 men with premature ejaculation, a new CBT program that trains control of the urethral sphincter improved ejaculation latency, especially when combined with a commercial masturbation aid, compared with the program alone.","clinical_takeaway":"Sphincter‑control CBT plus a masturbation device may lengthen IELT in PE, but evidence is limited by small sample and short follow‑up.","confidence":0.7,"topic_tags":["sexual_function","csbd","masturbation","treatment"],"strengths":["Randomised controlled design","Use of validated PE instruments","Objective primary outcome (IELT)"],"limitations":["Small sample, likely under‑powered","No long‑term follow‑up","No placebo/control for device effect","No measurement of potential psychosocial confounds"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":35,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0212274"}},{"id":4196,"doi":"10.1080/10720162.2018.1564408","pmid":"31772491","pmcid":"PMC6879181","title":"Effects of Emotions on Sexual Behavior in Men with and without Hypersexuality","authors":"Miner MH, Dickenson J, Coleman E.","first_author":"Miner MH","journal":"Sexual addiction & compulsivity","year":2019,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Ecological momentary assessment of affect and sexual behavior over several days in 39 MSM, comparing those with hypersexuality to those without.","sample_n":39,"sample_text":"Convenience sample of men who have sex with men recruited for EMA study.","population":"MSM, n=39 (hypersexuality vs non‑hypersexuality groups)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small study of 39 gay and bisexual men, researchers tracked mood and sexual activity several times a day. Men who reported hypersexuality showed different patterns: their feelings of positive or negative affect predicted whether they had sex with a partner or masturbated, suggesting they may use sexual activity to cope with emotions.","clinical_takeaway":"For men who report hypersexual behavior, affect regulation may be a key factor; clinicians might explore coping strategies for mood rather than focusing only on the sexual acts.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function","relationships"],"strengths":["EMA design captures moment‑to‑moment affect","Separates partnered sex from masturbation","Focus on affect as a possible driver of behavior"],"limitations":["Very small, non‑representative sample (N=39)","Limited control for key confounds (mood, trauma, moral factors)","Unclear how hypersexuality was operationalised"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":1,"contrasting":1,"mentioning":46,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10720162.2018.1564408"}},{"id":4197,"doi":"10.3390/jcm8020157","pmid":"30704084","pmcid":"PMC6406591","title":"Same Same but Different: A Clinical Characterization of Men with Hypersexual Disorder in the Sex@Brain Study","authors":"Engel J, Veit M, Sinke C, Heitland I, Kneer J, Hillemacher T, Hartmann U, Kruger THC.","first_author":"Engel J","journal":"Journal of clinical medicine","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Phenomenology","Comorbidities","Sexual Addiction","Hypersexuality","Sexual Compulsivity"],"is_oa":true,"oa_url":"https://www.mdpi.com/2077-0383/8/2/157/pdf?version=1548839016","cited_by_count":41,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control clinical characterization with 50 men meeting proposed hypersexual disorder criteria and 40 healthy controls; self‑report questionnaires and clinical interviews","sample_n":90,"sample_text":"n=50 HD, n=40 controls","population":"men with hypersexual disorder (HD) vs healthy male controls","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared 50 men who met criteria for hypersexual disorder with 40 healthy men, finding higher rates of sexual activity, paraphilias, childhood adversity, and emotional problems among the hypersexual group.","clinical_takeaway":"Hypersexual disorder is linked to past trauma and emotional dysregulation, suggesting assessment should include these factors.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["clinical interview of HD criteria","comparison with matched healthy controls","assessment of a range of psychological and developmental variables"],"limitations":["small sample sizes per group","no measurement of moral/religious incongruence","cross‑sectional design limits causal inference","potential circularity in HD diagnostic criteria"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":7,"contrasting":0,"mentioning":47,"citing_publications":128,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jcm8020157"}},{"id":4198,"doi":"10.4158/accr-2018-0246","pmid":"31967000","pmcid":"PMC6876971","title":"TESTOTOXICOSIS WITH AN EPISODIC COURSE: AN UNUSUAL CASE WITHIN A SERIES","authors":"Nabhan ZM, Eugster EA.","first_author":"Nabhan ZM","journal":"AACE clinical case reports","year":2019,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case description with retrospective chart review of one patient and a small series of 10 additional cases","sample_n":11,"sample_text":"1 detailed case plus 10 additional boys identified in the series","population":"boys with familial male precocious puberty (FMPP) treated at a single institution","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors report a boy with a rare form of early puberty who showed unusually long periods where his hormone levels returned to normal without treatment, expanding what is known about this condition.","clinical_takeaway":"Clinicians should be aware that familial male precocious puberty can have intermittent remission, affecting treatment monitoring.","confidence":0.8,"topic_tags":["sexual_function","prevalence","religiosity"],"strengths":["Detailed longitudinal follow‑up of rare condition","Genetic confirmation of diagnosis","Clear description of episodic remission pattern"],"limitations":["Single‑case narrative limits generalisability","No statistical analysis beyond descriptive values","No control or comparison group"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4158/accr-2018-0246"}},{"id":4199,"doi":"10.1016/j.jadohealth.2018.11.008","pmid":"30691936","pmcid":null,"title":"Use of Fertility Preservation Among a Cohort of Transgirls in the Netherlands","authors":"Brik T, Vrouenraets LJJJ, Schagen SEE, Meissner A, de Vries MC, Hannema SE.","first_author":"Brik T","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2019,"pub_types":["Journal Article","Observational Study"],"keywords":["Fertility","GnRH analog","Adolescent","Transgender","Fertility Preservation","Sperm Cryopreservation","Gender Dysphoria","Semen Cryopreservation"],"is_oa":false,"oa_url":null,"cited_by_count":55,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective chart review of 35 transgirls at a single centre","sample_n":35,"sample_text":"35 adolescents","population":"transgirls (assigned male at birth) undergoing GnRH analog treatment in the Netherlands","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a Dutch clinic, 38% of transgirls on puberty‑blocking treatment tried to preserve sperm; most who tried succeeded. Younger and White adolescents were less likely, and reasons for not trying included early puberty, discomfort with masturbation, and lack of desire for children.","clinical_takeaway":"Counseling about fertility preservation should address early puberty barriers and discomfort with masturbation.","confidence":0.8,"topic_tags":["gender","adolescents","religiosity","masturbation"],"strengths":["First Dutch cohort on FP in transgirls","Provides concrete reasons for FP decisions","Clinical relevance for counseling"],"limitations":["Small sample, single centre","Retrospective, no standardized measures","Limited statistical analysis"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":1,"mentioning":51,"citing_publications":87,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2018.11.008"}},{"id":4200,"doi":"10.3892/etm.2019.7199","pmid":"30867705","pmcid":"PMC6395974","title":"Treatment of Mullerian duct cyst by combination of transurethral resection and seminal vesiculoscopy: An initial experience","authors":"Miao C, Liu S, Zhao K, Zhu J, Tian Y, Wang Y, Liu B, Wang Z.","first_author":"Miao C","journal":"Experimental and therapeutic medicine","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Semen quality","Transurethral Resection","Ejaculatory Duct Obstruction","Seminal Vesiculoscopy","Mullerian Duct Cyst"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6395974","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"retrospective case series of 20 patients with Mullerian duct cyst undergoing combined transurethral resection and seminal vesiculoscopy; pre‑post semen analyses over 12 months","sample_n":20,"sample_text":"20 patients (aspermia due to Mullerian duct cyst) treated between 2009‑2016","population":"20 men with aspermia caused by Mullerian duct cyst, treated at a single centre","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 20 men whose semen production was blocked by a rare Mullerian duct cyst, a combined transurethral removal and seminal vesicle scope surgery restored normal semen parameters over a year.","clinical_takeaway":"Surgery may improve semen quality in men with cyst‑induced obstruction, but evidence is limited to a small, uncontrolled case series.","confidence":0.6,"topic_tags":["treatment","sexual_function"],"strengths":["Objective semen parameters","Imaging confirmation of cyst","12‑month follow‑up"],"limitations":["No control group","Small sample (n=20)","Retrospective design"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":4,"confounds":3,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3892/etm.2019.7199"}},{"id":4201,"doi":null,"pmid":"23847716","pmcid":"PMC3705776","title":"Desarrollo de una intervención grupal para la prevención del VIH en parejas heterosexuales","authors":"Pérez-Jiménez D, Escabí Montalvo A, Del Carmen Cabrera Aponte M.","first_author":"Pérez-Jiménez D","journal":"Revista Puertorriquena de psicologia","year":2010,"pub_types":["research-article","Journal Article"],"keywords":["AIDS","HIV","Heterosexual Couples","Male Condom","Mutual Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"pilot feasibility study with four heterosexual couples; no control group; qualitative satisfaction outcomes","sample_n":8,"sample_text":"four couples","population":"heterosexual couples (n=4 couples, 8 participants)","country":"Puerto Rico","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small pilot tested a group programme for heterosexual couples to boost condom use and encourage mutual masturbation as a safer‑sex option. Participants liked the sessions and found them useful, showing the approach is feasible.","clinical_takeaway":"Group‑based HIV‑prevention that includes mutual masturbation may be acceptable to couples, but evidence is preliminary.","confidence":0.7,"topic_tags":["sexual_function","relationships","prevalence","moral_incongruence"],"strengths":["Innovative group format","Focus on mutual masturbation as harm‑reduction"],"limitations":["Very small sample (4 couples)","No validated outcome measures","No control/comparison group"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4202,"doi":"10.1176/jnp.2010.22.3.352.e3","pmid":"20686146","pmcid":null,"title":"Ciproterone effect on compulsive masturbation in a frontotemporal dementia patient","authors":"Fonseca L, Simões S, Ferreira P, Mesquita J, Machado A.","first_author":"Fonseca L","journal":"The Journal of neuropsychiatry and clinical neurosciences","year":2010,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/jnp.2010.22.3.352.e3"}},{"id":4203,"doi":null,"pmid":"20521411","pmcid":"PMC4064672","title":"The viability of outercourse for HIV prevention within the Puerto Rican context","authors":"Norman LR.","first_author":"Norman LR.","journal":"Ethnicity & disease","year":2010,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 1138 low‑income women in Ponce, PR; attitudes and self‑reported participation in mutual masturbation and sex‑toy use; logistic regression analyses.","sample_n":1138,"sample_text":"1138 women surveyed","population":"Women, >25 y, low‑income housing, Puerto Rico","country":"Puerto Rico","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,138 low‑income Puerto Rican women found that few view mutual masturbation or sex‑toy use as ‘real sex’, and participation in these outer‑course practices is low, especially with steady partners. Perceiving these activities as real sex strongly predicts their use.","clinical_takeaway":"Promoting outercourse as a legitimate and satisfying sexual option may increase its uptake, offering a safer‑sex alternative for at‑risk couples.","confidence":0.7,"topic_tags":["sexual_function","masturbation","prevalence"],"strengths":["Large sample for a community survey","Clear logistic‑regression effect sizes with CIs","Focus on a culturally relevant prevention topic"],"limitations":["Cross‑sectional, cannot infer causality","No validated scales for attitudes/behaviour","Limited control of key confounds (morality, mental health, trauma)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":4204,"doi":null,"pmid":"20104014","pmcid":null,"title":"[A case of penile strangulation by polyethylene terephthalate bottle]","authors":"Kobayashi H, Kaneko G, Nishimoto K, Uchida A.","first_author":"Kobayashi H","journal":"Hinyokika kiyo. Acta urologica Japonica","year":2010,"pub_types":["Review","Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"jpn","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report of penile strangulation during masturbation; emergency treatment described","sample_n":1,"sample_text":"N=1 (case report)","population":"1 male, 66 years old, Japan","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 66‑year‑old man inserted a plastic bottle onto his penis for masturbation, leading to a four‑and‑a‑half‑hour strangulation. Emergency doctors used an electric plaster cutter to safely remove the bottle, preventing injury. The authors suggest this tool for similar emergencies.","clinical_takeaway":"An electric plaster cutter can safely release penile strangulation caused by objects used during masturbation.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Clear clinical description","Practical treatment recommendation"],"limitations":["Single case, no generalizability","No systematic measurement of variables","No control of confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":4205,"doi":"10.1080/07347332.2010.498457","pmid":"20730661","pmcid":null,"title":"Exploring the impact of prostate cancer on men's sexual well-being","authors":"Letts C, Tamlyn K, Byers ES.","first_author":"Letts C","journal":"Journal of psychosocial oncology","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Interviews with 19 prostate‑cancer survivors (1–5 years post‑treatment), thematic analysis of sexual‑well‑being changes.","sample_n":19,"sample_text":"19 men, 49‑74 y, 1‑5 y post‑treatment","population":"Men aged 49–74, post‑prostate‑cancer treatment, recruited via clinical pathways (not treatment‑seeking for sexual problems).","country":"Not specified (likely UK based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 19 men treated for prostate cancer showed that while many aspects of sexual life stayed the same, most experienced distressing erectile and orgasm problems. Partner reactions and communication with doctors shaped how men felt about these changes.","clinical_takeaway":"Clinicians should address erectile difficulties directly and facilitate open partner‑doctor communication about sexual health after prostate cancer treatment.","confidence":0.7,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["In‑depth, lived‑experience perspective","Identifies concrete communication and healthcare gaps","Includes partner‑related themes"],"limitations":["Small, non‑representative sample","No validated psychometric measures","Findings not generalizable beyond prostate‑cancer survivors"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":79,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/07347332.2010.498457"}},{"id":4207,"doi":"10.4103/ijpsym.ijpsym_153_18","pmid":"30783313","pmcid":"PMC6337923","title":"Sexual Dysfunction among Men in Rural Tamil Nadu: Nature, Prevalence, Clinical Features, and Explanatory Models","authors":"Vivekanandan KS, Thangadurai P, Prasad J, Jacob KS.","first_author":"Vivekanandan KS","journal":"Indian journal of psychological medicine","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Community","India","erectile dysfunction","Premature Ejaculation","Psychiatric Morbidity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6337923","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Community survey with random village selection; N=211 men; administered validated sexual dysfunction scales and mental‑health interview; bivariate and multivariate analyses.","sample_n":211,"sample_text":"211 men recruited from four randomly selected villages in Kaniyambadi Block, Vellore district.","population":"Men (mean age 40.7) from four randomly selected villages in rural Tamil Nadu, India","country":"India","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 211 men in rural Tamil Nadu found that about 30 % reported erectile problems and 19 % premature ejaculation. These issues were linked to marital status, diabetes, alcohol use, depression, guilt about masturbation and cultural beliefs such as punishment by God.","clinical_takeaway":"Sexual dysfunction in rural Indian men is common and tied to health, mental‑health and culturally driven guilt; clinicians should screen for these factors and provide education.","confidence":0.8,"topic_tags":["sexual_function","masturbation","moral_incongruence","religiosity"],"strengths":["Use of validated sexual‑function questionnaires (IIEF, C‑IPE).","Random selection of villages enhances community representativeness.","Multivariate analysis controls for several health and psychosocial variables."],"limitations":["Cross‑sectional – cannot infer causality.","Masturbation frequency not measured, only guilt.","No assessment of early‑life trauma or ACEs."],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":7,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/ijpsym.ijpsym_153_18"}},{"id":4208,"doi":"10.1037/com0000161","pmid":"30589295","pmcid":null,"title":"Life history correlates of human (Homo sapiens) ejaculate quality","authors":"Barbaro N, Shackelford TK, Holub AM, Jeffery AJ, Lopes GS, Zeigler-Hill V.","first_author":"Barbaro N","journal":"Journal of comparative psychology (Washington, D.C. : 1983)","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Men (n=41) completed a self‑report life‑history questionnaire and provided two masturbatory ejaculate samples; correlations between scores and semen quality were examined.","sample_n":41,"sample_text":"n = 41 men","population":"Adult men, likely university/ community volunteers; convenience sample","country":"Not specified (likely USA based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 41 men, those who reported a slower, more parenting‑oriented life strategy produced higher‑quality semen, suggesting ejaculate quality may be linked to how men allocate resources between mating and parenting.","clinical_takeaway":"None – findings are exploratory and not directly applicable to clinical practice.","confidence":0.7,"topic_tags":["sexual_function","religiosity","moral_incongruence"],"strengths":["Objective physiological measurement of ejaculate quality","Use of a validated life‑history questionnaire","Novel integration of evolutionary psychology and reproductive biology"],"limitations":["Small, non‑representative sample (N=41)","Cross‑sectional design limits causal inference","No control for potential confounds such as age, health, or sexual activity frequency"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/com0000161"}},{"id":4209,"doi":null,"pmid":"11196747","pmcid":null,"title":"The clinical outcome of childhood masturbation","authors":"Unal F.","first_author":"Unal F.","journal":"The Turkish journal of pediatrics","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"observational longitudinal follow‑up of a clinical case series (N=50) with no control group","sample_n":50,"sample_text":"50 children (34 girls, 16 boys) referred for masturbation symptoms","population":"children (mean age 48.7 months) presenting with masturbation symptoms at a Turkish child‑psychiatry clinic","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a Turkish clinic, 50 young children who showed frequent masturbation were followed for two years. Most (78%) stopped masturbating, while younger children who began earlier and masturbated more often were less likely to recover. The authors suggest sedative medication plus parental guidance helped.","clinical_takeaway":"Masturbation in early childhood often resolves without intervention; medication should be used cautiously and only when clearly indicated.","confidence":0.7,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Prospective two‑year follow‑up","Clear description of clinical recovery rates","Inclusion of age and onset data"],"limitations":["No control or comparison group","Small, clinic‑based sample limits generalisability","Outcome measures not validated; reliance on interview counts","No adjustment for mental‑health or developmental confounds"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":4210,"doi":"10.1016/j.regg.2018.09.001","pmid":"30552016","pmcid":null,"title":"[Sexual expression and sexuality regulation in Spanish long-term care homes for the elderly]","authors":"Villar F, Celdrán M, Serrat R, Fabà J, Martínez T.","first_author":"Villar F","journal":"Revista espanola de geriatria y gerontologia","year":2019,"pub_types":["Journal Article","Observational Study"],"keywords":["Sexuality","Staff Training","Person-centred Care","Sexualidad","Atención Centrada En La Persona","Residencias De Mayores","Formación De Profesionales","Derechos Del Residente","Long-term Care Facilities For Older People","User Rights"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational cross‑sectional survey of staff (n≈783) in Spanish long‑term care homes","sample_n":783,"sample_text":"160 Directors of Nursing and 623 technical staff completed the questionnaire","population":"Directors of Nursing and technical staff in residential facilities for older adults","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Staff in Spanish nursing homes report that sexual behaviours, including kissing, hugging and masturbation, are common among residents. Policies protecting residents’ sexual rights exist, but training and resources are lacking. Person‑centred care may improve support for older adults’ sexuality.","clinical_takeaway":"Facilities should develop clear policies and staff training to support residents’ sexual expression safely.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large multi‑site staff sample","Focus on understudied setting (elderly care)","Includes both behavioural observations and policy inventory"],"limitations":["Reliance on self‑report, non‑validated sexual‑behaviour items","Cross‑sectional design limits causal inference","No measurement of resident perspectives or psychological correlates"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.regg.2018.09.001"}},{"id":4211,"doi":"10.4045/tidsskr.18.0129","pmid":"30539612","pmcid":null,"title":"Singing hymns to a jaunty beat","authors":"Grene GT, Lie AK.","first_author":"Grene GT","journal":"Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke","year":2018,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://tidsskriftet.no/sites/default/files/generated_pdfs/56715-%C3%A5-synge-salmer-i-visetakt.pdf","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"nor","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4045/tidsskr.18.0129"}},{"id":4213,"doi":"10.1016/j.clineuro.2009.08.026","pmid":"19765888","pmcid":null,"title":"Sexsomnia: an uncommon variety of parasomnia","authors":"Béjot Y, Juenet N, Garrouty R, Maltaverne D, Nicolleau L, Giroud M, Didi-Roy R.","first_author":"Béjot Y","journal":"Clinical neurology and neurosurgery","year":2010,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of two adult women with sexsomnia, clinical description, EEG/PSG, MRI, treatment outcome","sample_n":2,"sample_text":"Two cases","population":"adult women with sexsomnia (N=2)","country":"France (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The report describes two women who displayed sexual behaviors like masturbation and intercourse while asleep, linked to past trauma and sleep disturbances. Brain scans and EEG were normal, and treatment with serotonin reuptake inhibitors helped.","clinical_takeaway":"Sexsomnia can arise from sleep disorders and trauma; consider sleep studies and SSRIs for treatment.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed clinical description","Use of polysomnography and EEG","Identification of potential traumatic background"],"limitations":["Very small sample (N=2)","No control group","No systematic measurement of confounds"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.clineuro.2009.08.026"}},{"id":4214,"doi":"10.1016/j.androl.2018.09.001","pmid":"30473331","pmcid":null,"title":"Successfully treatment of intercourse anejaculation with psychosexual counseling: A very rare case of situational anejaculation specific to penetrative sex with the wife","authors":"Orum MH, Egilmez OB.","first_author":"Orum MH","journal":"Revista internacional de andrologia","year":2020,"pub_types":["Journal Article","Case Reports"],"keywords":["Psychosexual Dysfunction","Sexual Intercourse","Anejaculation","Orgasmic Disorder","Aneyaculación","Asesoramiento Psicosexual","Disfunción Psicosexual","Psychosexual Counseling","Relaciones Sexuales","Trastorno Orgásmico"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report of situational intercourse‑specific anejaculation treated with psychosexual counseling","sample_n":1,"sample_text":"one patient (case report)","population":"adult male with wife‑specific anejaculation; N = 1","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2020 case report describes one man who could ejaculate while masturbating but not during intercourse with his wife. After psychosexual counseling, he recovered ejaculation during sex. The authors suggest the problem was psychological and that counseling can help.","clinical_takeaway":"Evidence is limited to one case; clinicians may consider psychosexual counseling for similar situational anejaculation, but effectiveness is not established.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["detailed clinical description","focus on a rare situational presentation","suggests therapeutic avenue"],"limitations":["single case, no control","no validated outcome measures","no systematic assessment of confounds"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.androl.2018.09.001"}},{"id":4215,"doi":"10.1111/j.1743-6109.2009.01498.x","pmid":"19758283","pmcid":null,"title":"Female sexual arousal disorder with and without a distress criterion: prevalence and correlates in a representative Czech sample","authors":"Weiss P, Brody S.","first_author":"Weiss P","journal":"The journal of sexual medicine","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"representative Czech sample, N=1000, surveyed prevalence and correlates of FSAD with/without distress","sample_n":1000,"sample_text":"representative sample of the Czech population (aged 15‑88), 1,000 women","population":"women aged 15‑88, Czech Republic, probability sample","country":"Czech Republic","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationwide Czech survey of 1,000 women, about 10% reported genital arousal problems, and 7.5% also felt marked distress. Factors such as never having masturbated and lacking a history of vaginal orgasm were linked to lower risk, while older age and less mental focus on vaginal sensations increased risk.","clinical_takeaway":"FSAD with distress shows distinct risk patterns; clinicians should assess both physiological symptoms and associated distress separately.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large, nationally representative sample","separate measurement of distress criterion","includes behavioral history (masturbation, anal intercourse)"],"limitations":["relies on single‑item self‑report items, no validated FSAD scale","does not control for moral/religious attitudes or mental‑health covariates","cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":10,"contrasting":0,"mentioning":45,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01498.x"}},{"id":4216,"doi":"10.1111/j.1743-6109.2009.01497.x","pmid":"19758284","pmcid":null,"title":"Autoeroticism, mental health, and organic disturbances in patients with erectile dysfunction","authors":"Corona G, Ricca V, Boddi V, Bandini E, Lotti F, Fisher AD, Sforza A, Forti G, Mannucci E, Maggi M.","first_author":"Corona G","journal":"The journal of sexual medicine","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Consecutive series of 2,786 heterosexual male outpatients with erectile dysfunction; self‑report questionnaire on masturbation frequency, guilt, mental‑health screening, hormonal and Doppler measures.","sample_n":2786,"sample_text":"Consecutive series of 2,786 heterosexual male patients consulting an outpatient clinic for erectile dysfunction.","population":"Male patients (mean age 48.4 ± 13.2) seeking treatment for erectile dysfunction at a single clinic.","country":"Italy (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 2,800 men treated for erectile dysfunction, about 62 % reported masturbating at least monthly. More frequent masturbation was linked to younger age, higher education, higher testosterone, stress, and unstable relationships. Guilt about masturbation correlated with psychological distress and lower hormone levels.","clinical_takeaway":"Masturbation is common among men with ED; clinicians should ask about it to uncover related psychological and relational issues.","confidence":0.78,"topic_tags":["masturbation","sexual_function"],"strengths":["Large sample size for a clinical population","Objective hormonal and Doppler measurements alongside self‑report","Consideration of relationship stability and stress"],"limitations":["Cross‑sectional design; no causality","Clinic‑based, treatment‑seeking sample limits generalisability","Masturbation measured only by frequency and guilt; no validated sexual‑behavior scales"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":45,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01497.x"}},{"id":4217,"doi":"10.1111/j.1743-6109.2009.01488.x","pmid":"19751385","pmcid":null,"title":"Correlates of sexuality in men and women aged 52-90 years attending a university medical health service in Colombia","authors":"Arias-Castillo L, Ceballos-Osorio J, Ochoa JJ, Reyes-Ortiz CA.","first_author":"Arias-Castillo L","journal":"The journal of sexual medicine","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional face‑to‑face interview of 136 retired adults attending a university medical service in Colombia","sample_n":136,"sample_text":"retired persons from a university ambulatory medical care setting (convenience sample)","population":"men and women aged 52‑90 years, mostly over 65, 52% female, 66% married","country":"Colombia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 136 Colombian adults aged 52‑90, most reported that sex is appropriate and many were sexually active, but only 16% had masturbated in the past year. Sexual interest and activity declined with age, were higher in men than women, and were strongest among married participants. Religion, intimacy and health also influenced these outcomes.","clinical_takeaway":"Older adults’ sexual desire and activity vary by gender, age, marital status and health; clinicians should consider these factors when discussing sexuality with older patients.","confidence":0.8,"topic_tags":["sexual_function","masturbation","gender","religiosity","relationships"],"strengths":["Community‑based sample of older adults","Includes both genders and a range of ages","Multivariate analysis controlling for several demographic and health variables"],"limitations":["Small, non‑representative convenience sample","Reliance on single‑item, non‑validated self‑report measures","No assessment of mental‑health or moral‑incongruence confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":0,"mentioning":10,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01488.x"}},{"id":4218,"doi":"10.1111/j.1743-6109.2009.01486.x","pmid":"19751387","pmcid":null,"title":"Factors affecting self-reported sexuality in men with obstructive sleep apnea syndrome","authors":"Stannek T, Hürny C, Schoch OD, Bucher T, Münzer T.","first_author":"Stannek T","journal":"The journal of sexual medicine","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"prospective survey comparing OSAS patients to disease‑free controls; convenience clinical sample","sample_n":158,"sample_text":"116 OSAS+ men, 42 OSAS‑ men","population":"men with newly diagnosed obstructive sleep apnea (n=116) and controls without OSAS (n=42)","country":"Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Men with obstructive sleep apnea report more erection problems and lower overall sexual satisfaction than men without the disorder. Age, rather than how severe the apnea is, appears to have a bigger impact on sexual function.","clinical_takeaway":"Screen for sexual dysfunction in men with sleep apnea, especially older patients; consider age as a key factor.","confidence":0.78,"topic_tags":["sexual_function","masturbation"],"strengths":["uses a validated sexuality questionnaire","includes both frequency and satisfaction measures","compares OSAS patients with a disease‑free control group","examines influence of disease severity and age"],"limitations":["cross‑sectional design cannot infer causality","control group recruited from same clinical setting may limit generalisability","limited adjustment for psychosocial confounders (e.g., mental health, moral factors)","multiple outcomes tested without correction for multiple comparisons"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":33,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01486.x"}},{"id":4219,"doi":"10.4103/0378-6323.55405","pmid":"19736439","pmcid":null,"title":"Urticaria and masturbation","authors":"Godse KV.","first_author":"Godse KV.","journal":"Indian journal of dermatology, venereology and leprology","year":2009,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0378-6323.55405"}},{"id":4220,"doi":"10.1055/a-0704-5578","pmid":"30372783","pmcid":null,"title":"[The Relevance of Sexual Concerns and Adult Attachment for Sexual Functioning]","authors":"Hoy M, Strauß B, Brenk-Franz K.","first_author":"Hoy M","journal":"Psychiatrische Praxis","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 965 adults, cross‑sectional","sample_n":965,"sample_text":"965 participants examined in an online‑based study","population":"adults (male and female) recruited online, likely convenience sample","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 965 German adults, worries about masturbation and self‑understanding were linked to women's sexual function, while men’s erectile function was tied to performance anxiety. Adult attachment mainly related to sexual satisfaction, suggesting it could be a target for therapy.","clinical_takeaway":"Addressing sexual concerns and attachment issues may help improve sexual dysfunction, but findings are correlational.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["large sample size","includes both genders","examines adult attachment"],"limitations":["cross‑sectional, no causal inference","unclear validation of measures","no control for key confounds (moral, mental health, partner effects)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/a-0704-5578"}},{"id":4221,"doi":"10.1046/j.1439-0272.2000.00353.x","pmid":"10863967","pmcid":null,"title":"Influence of sexual stimulation on sperm parameters in semen samples collected via masturbation from normozoospermic men or cryptozoospermic men participating in an assisted reproduction programme","authors":"Yamamoto Y, Sofikitis N, Mio Y, Miyagawa I.","first_author":"Yamamoto Y","journal":"Andrologia","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subject laboratory experiment comparing semen samples collected with vs without sexually stimulating visual images","sample_n":41,"sample_text":"41 participants (individuals provided multiple samples)","population":"men undergoing assisted reproduction (19 normozoospermic, 22 cryptozoospermic)","country":"Japan (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In men providing semen samples for fertility treatment, watching sexually stimulating videos before masturbating produced larger semen volume, more sperm, and better motility than samples collected without the videos.","clinical_takeaway":"Viewing erotic material before sample collection may improve semen quality for IVF, but evidence is limited by small sample size.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Objective laboratory sperm measurements","Within‑subject design reduces inter‑individual variability","Clear operational definition of sexual stimulation (videotaped images)"],"limitations":["Small sample size limits statistical power","No reporting of effect sizes or confidence intervals","Potential uncontrolled confounders (abstinence interval, mood, hormonal status)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":19,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1046/j.1439-0272.2000.00353.x"}},{"id":4222,"doi":"10.1007/s004310051283","pmid":"10834518","pmcid":null,"title":"Predisposing factors in childhood masturbation in Turkey","authors":"Unal F.","first_author":"Unal F.","journal":"European journal of pediatrics","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case-control (referral-based) comparing 61 children with masturbation to two control groups (61 clinic controls, 43 sibling controls)","sample_n":165,"sample_text":"61 cases, 61 matched clinic controls, 43 sibling controls","population":"children in Turkey (preschool and early childhood) referred to child psychiatry department","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined 61 Turkish children who were referred for frequent masturbation and compared them with clinic controls and siblings. It found that these children more often had sleep problems, shorter breast‑feeding periods, and recent stressful events. These factors might help clinicians spot children at risk for frequent masturbation.","clinical_takeaway":"Consider sleep issues, early weaning, and recent stressors when assessing children with frequent masturbation; however, evidence is limited.","confidence":0.7,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Prospective data collection","Matched control groups","Inclusion of sibling comparison"],"limitations":["No validated measure of childhood masturbation","Key psychosocial confounds (e.g., mental health, moral factors) not assessed","Referral‑based sample limits generalisability"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":11,"contrasting":0,"mentioning":65,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s004310051283"}},{"id":4224,"doi":"10.3349/ymj.2000.41.2.205","pmid":"10817020","pmcid":null,"title":"Masturbation and its relationship to sexual activities of young males in Korean military service","authors":"Choi YJ, Lee WH, Rha KH, Xin ZC, Choi YD, Choi HK.","first_author":"Choi YJ","journal":"Yonsei medical journal","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,212 Korean male military personnel","sample_n":1212,"sample_text":"Convenience sample of military personnel; not a random or population‑based sample","population":"young Korean males (ages 19‑27) in compulsory military service","country":"Korea","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 1,212 Korean soldiers, 98% reported ever masturbating and those who started earlier were more likely to have had sex, including with prostitutes, and report STDs. Early masturbation was linked to higher sexual activity, but the study cannot prove it causes those outcomes.","clinical_takeaway":"Early masturbation is associated with more sexual activity, but clinicians should not infer causation; education should address broader sexual health.","confidence":0.85,"topic_tags":["masturbation","sexual_function"],"strengths":["Large sample size (N>1200)","Direct measurement of masturbation initiation age","Relevant to public‑health education"],"limitations":["Cross‑sectional design; cannot infer causality","Questionnaire not validated; possible measurement bias","Limited confound control (no mental‑health or partner variables)","Military sample limits generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3349/ymj.2000.41.2.205"}},{"id":4225,"doi":null,"pmid":"19957597","pmcid":null,"title":"[Survey on knowledge, attitude, practice related to contraception among college students in Beijing]","authors":"Zhou YZ, Zhang MM, Wei S, Guan HT, Yin P, Ren N, Pang XB, Xiong CL.","first_author":"Zhou YZ","journal":"Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large anonymous questionnaire survey of 12,450 unmarried college students in Beijing","sample_n":12129,"sample_text":"12,129 respondents (anonymous, informed consent)","population":"unmarried college students, Beijing, China (both genders)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of over 12,000 Beijing college students found that many engage in sexual activity and masturbation, but only about half use contraception, leading to high rates of unintended pregnancy.","clinical_takeaway":"Improved, targeted contraception education is needed for college students.","confidence":0.8,"topic_tags":["sexual_function","religiosity"],"strengths":["Very large sample size","Anonymous survey reduces reporting bias","Provides baseline data on contraception knowledge and behavior"],"limitations":["Cross‑sectional, cannot infer causality","Questionnaire not reported as validated","No control for key psychosocial confounders"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":4226,"doi":"10.1111/psyg.12381","pmid":"30294865","pmcid":null,"title":"Sexual activity and life satisfaction in older adults","authors":"Skałacka K, Gerymski R.","first_author":"Skałacka K","journal":"Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society","year":2019,"pub_types":["Journal Article"],"keywords":["Sexuality","Sexual activity","Life Satisfaction","Older Adults"],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional interview survey of 83 older adults (33 men, 50 women) in Poland; convenience sample","sample_n":83,"sample_text":"Thirty-three men and 50 women (N =83) were interviewed","population":"adults older than 60 years","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 83 Polish adults over 60, higher sexual activity—especially intimate, non‑intercourse behaviors—was linked to greater sexual and overall life satisfaction.","clinical_takeaway":"Promoting enjoyable, age‑appropriate sexual intimacy may enhance overall wellbeing in older adults.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Uses validated life‑satisfaction scale","Considers multiple forms of sexual intimacy","Examines older adult population"],"limitations":["Small, non‑representative convenience sample","Ad‑hoc sexual‑satisfaction questionnaire limits construct validity","No control for mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":51,"citing_publications":102,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/psyg.12381"}},{"id":4227,"doi":"10.1186/s12894-018-0398-4","pmid":"30285777","pmcid":"PMC6171295","title":"Intravesical migration of female urethral dilator: a case report of a new urologic emergency in the era of e-commerce","authors":"Mogorovich A, Selli C, Tognarelli A, Manassero F, De Maria M.","first_author":"Mogorovich A","journal":"BMC urology","year":2018,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Bladder","Foreign bodies","Foreign Body Migration","Urethral Dilator"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6171295","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient","sample_n":1,"sample_text":"single case","population":"47‑year‑old woman who inserted a urethral dilator for sexual stimulation","country":"unspecified (presumably Italy based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 47‑year‑old woman inserted a metallic urethral dilator for sexual pleasure; it migrated into her bladder and was later expelled spontaneously during urination. The report highlights a rare urological emergency linked to sexual self‑stimulation devices.","clinical_takeaway":"Clinicians should consider intravesical migration when patients present with urinary symptoms after inserting urethral objects for sexual use.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Clear clinical imaging documentation","Novel observation of spontaneous emission"],"limitations":["Single patient; no generalizable data","No systematic assessment of psychological factors","No discussion of prevalence or risk"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12894-018-0398-4"}},{"id":4229,"doi":"10.4103/psychiatry.indianjpsychiatry_386_17","pmid":"30581213","pmcid":"PMC6278224","title":"A prospective study on sexual dysfunctions in depressed males and the response to treatment","authors":"Thakurdesai A, Sawant N.","first_author":"Thakurdesai A","journal":"Indian journal of psychiatry","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Antidepressants","Male Sexual Dysfunctions","Myths And Misconceptions","Depressed Males"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6278224","cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort with depressed male patients (n=56) and community controls (n=60); patients received escitalopram and were re‑tested after 6 weeks; no randomisation or placebo control","sample_n":116,"sample_text":"56 depressed males, 60 general‑population males","population":"depressed adult males (ICD‑10) and community males","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of depressed Indian men, about two‑thirds reported sexual problems, especially low desire and orgasm difficulties. After six weeks of escitalopram, depressive symptoms improved and men reported better satisfaction with intercourse.","clinical_takeaway":"Screen depressed men for sexual dysfunction and discuss myths; monitor sexual side‑effects when prescribing SSRIs.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses validated sexual dysfunction and depression scales","Includes a community comparison group","Prospective pre‑post assessment after antidepressant treatment"],"limitations":["Non‑randomised, no placebo control for escitalopram","Small sample limits power for subgroup analyses","Potential confounds (partner status, trauma, moral factors) not measured"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":9,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/psychiatry.indianjpsychiatry_386_17"}},{"id":4230,"doi":"10.1521/prev.2018.105.5.555","pmid":"30300088","pmcid":null,"title":"Il deserto rosso","authors":"Sitney PA.","first_author":"Sitney PA.","journal":"Psychoanalytic review","year":2018,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"None – the article is a psycho‑analytic interpretation of a film, not an empirical study.","population":"none","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article offers a psycho‑analytic reading of Antonioni’s film *Il deserto rosso*, suggesting that a scene where a girl’s bra is removed symbolises hidden feelings about masturbation and menstruation.","clinical_takeaway":"None – the paper provides a literary interpretation, not clinical evidence.","confidence":0.8,"topic_tags":["masturbation","religiosity","sexual_function"],"strengths":["Clear theoretical argument","Integrates psycho‑analytic concepts with film analysis"],"limitations":["No empirical data","No measurement of constructs","Findings not generalisable to real‑world behaviour"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1521/prev.2018.105.5.555"}},{"id":4232,"doi":null,"pmid":"19764681","pmcid":null,"title":"Fracture of the penis. A report of two cases","authors":"Ugwu BT, Liman HU, Sani AA, Mohammed AM.","first_author":"Ugwu BT","journal":"Nigerian journal of clinical practice","year":2009,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":2,"sample_text":"Two individual patients described in detail","population":"young adult males (one unmarried, one married)","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article describes two men who suffered penile fractures—one while masturbating and the other during intercourse. Both were treated surgically and recovered well, with one later fathering a child.","clinical_takeaway":"Prompt surgical repair of penile fracture leads to good functional recovery.","confidence":0.9,"topic_tags":["sexual_function","gender"],"strengths":["Detailed clinical description of rare injury","Clear surgical management outcomes"],"limitations":["Very small sample (n=2)","No systematic methodology or control group","No assessment of broader psychosocial factors"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4234,"doi":"10.1136/bcr-2018-225353","pmid":"30262526","pmcid":"PMC6169636","title":"Knotted electric wire in urinary bladder: Can such complex foreign body be retrieved endoscopically!","authors":"Agarwal M, Aggarwal A, Pandey S, Kumar M.","first_author":"Agarwal M","journal":"BMJ case reports","year":2018,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Urology","Radiology","Sexual Health"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case description of an 18‑year‑old male who inserted an electric wire into his urethra for erotic stimulation; management with endoscopic laser fragmentation","sample_n":1,"sample_text":"1 patient","population":"1 adolescent male, self‑selected case","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"An 18‑year‑old male inserted an electric wire into his urethra for sexual arousal; doctors removed it endoscopically using a laser. The report describes the technique but provides no broader data.","clinical_takeaway":"Endoscopic laser fragmentation can safely retrieve complex urethral foreign bodies.","confidence":0.9,"topic_tags":["sexual_function","masturbation","gender","csbd"],"strengths":["detailed clinical description","illustrates endoscopic technique"],"limitations":["n=1, no generalisable data","no measurement of psychological constructs","no control of confounding factors"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bcr-2018-225353"}},{"id":4235,"doi":"10.1080/00224499.2018.1518400","pmid":"30260677","pmcid":null,"title":"Body Image Development and Sexual Satisfaction: A Prospective Study From Adolescence to Adulthood","authors":"Kvalem IL, Træen B, Markovic A, von Soest T.","first_author":"Kvalem IL","journal":"Journal of sex research","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort, population‑based Norwegian sample (n=2587) followed over 13 years, four assessment waves","sample_n":2587,"sample_text":"population‑based cohort, mean age 14.9 at baseline, 57 % female","population":"Norwegian adolescents and young adults, both sexes","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":8,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 13‑year Norwegian study of 2,600 adolescents, higher body satisfaction in teens predicted greater sexual satisfaction as adults, even after accounting for gender, weight, relationship status, mental health and how often they had sex or masturbated.","clinical_takeaway":"Improving body satisfaction in youth may help foster healthier sexual satisfaction later in life.","confidence":0.7,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Large, population‑based longitudinal sample","Repeated measures allow growth‑curve analysis","Controls for key covariates (mental health, relationship status, masturbation)"],"limitations":["Unclear whether body‑satisfaction and sexual‑satisfaction scales are fully validated","No assessment of moral or trauma‑related confounds","No preregistration or reported power analysis"],"rubric_version":"2.0","raw_total":39,"max_possible":50,"pct_score":78,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":6,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":19,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1518400"}},{"id":4236,"doi":"10.1016/j.maturitas.2009.02.015","pmid":"19487089","pmcid":null,"title":"The historical response to female sexuality","authors":"Studd J, Schwenkhagen A.","first_author":"Studd J","journal":"Maturitas","year":2009,"pub_types":["Historical Article","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"commentary","design_detail":"Historical commentary without empirical data.","sample_n":null,"sample_text":"not applicable","population":"not applicable","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how doctors from medieval times to the 19th century treated normal female sexuality as a disease, even performing surgeries like clitoridectomy to stop masturbation, but notes that modern research now understands sexual desire issues differently.","clinical_takeaway":"Historical attitudes should not influence current treatment decisions; modern standards view female sexuality as normal unless distress is clinically significant.","confidence":0.3,"topic_tags":["sexual_function","masturbation"],"strengths":["Comprehensive historical overview","Clear documentation of past medical practices"],"limitations":["No original empirical data","No systematic methodology reported","Cannot inform current clinical practice"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.maturitas.2009.02.015"}},{"id":4237,"doi":"10.2164/jandrol.108.006817","pmid":"19443909","pmcid":null,"title":"Considerations in evaluating human spermatogenesis on the basis of total sperm per ejaculate","authors":"Amann RP.","first_author":"Amann RP.","journal":"Journal of andrology","year":2009,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review (non‑systematic) of sperm‑count metrics; no new data collection","sample_n":null,"sample_text":"Not applicable – narrative review","population":"Human males, primarily infertile or sub‑fertile clinic patients; no specific sample size reported","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that measuring how many sperm are produced per hour of sexual abstinence (TSperm/h) is a better way to assess male sperm production than just counting total sperm in an ejaculate. It suggests a 6‑7‑day abstinence period to maximise total sperm, but recommends using samples taken after about 2‑3 days for the most accurate assessment of sperm‑production rates.","clinical_takeaway":"For assessing male fertility, consider sperm‑count rate (TSperm/h) and collect samples after 42‑54 h of abstinence for the most reliable comparison.","confidence":0.4,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Clear physiological focus on sperm accumulation rates","Practical recommendations for abstinence intervals"],"limitations":["Narrative review – no systematic methodology","No quantitative synthesis or effect‑size reporting","Confounding variables (e.g., health, lifestyle) not examined"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":1,"mentioning":33,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2164/jandrol.108.006817"}},{"id":4238,"doi":"10.1177/00030651000480040201","pmid":"11212192","pmcid":null,"title":"Encopresis and anal masturbation","authors":"Aruffo RN, Ibarra S, Strupp KR.","first_author":"Aruffo RN","journal":"Journal of the American Psychoanalytic Association","year":2000,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case report of psychoanalytic interpretation of encopresis as conscious anal masturbation; no systematic data collection.","sample_n":null,"sample_text":"Not specified; single or few cases described.","population":"Children with encopresis (sample size not reported)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose that some children with encopresis may be intentionally soiling themselves as a form of anal masturbation, based on psychoanalytic case observations, and argue that physical treatments might be inappropriate in such cases.","clinical_takeaway":"No actionable clinical recommendation; the hypothesis lacks empirical support.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Explores an under‑studied psychodynamic perspective","Highlights possible role of anal erotic sensations"],"limitations":["No empirical data or validated measures","Single case; cannot generalise","No control of confounding variables","Interpretations exceed evidence"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00030651000480040201"}},{"id":4239,"doi":"10.1111/j.1743-6109.2009.01318.x","pmid":"19453881","pmcid":null,"title":"Prevalence and characteristics of vibrator use by women in the United States: results from a nationally representative study","authors":"Herbenick D, Reece M, Sanders S, Dodge B, Ghassemi A, Fortenberry JD.","first_author":"Herbenick D","journal":"The journal of sexual medicine","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":102,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative internet survey of 2,056 U.S. women ages 18‑60; cross‑sectional self‑report questionnaire.","sample_n":2056,"sample_text":"2,056 participants (54.1% response rate) from a nationally representative invited sample of 3,800 women.","population":"Women, 18‑60, United States (national probability sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative US survey, about half of women aged 18‑60 have used a vibrator, either alone or with a partner. Users report better sexual function and no increase in health problems, suggesting vibrators are a common and generally positive part of sexual health.","clinical_takeaway":"Vibrator use is widespread and linked to higher sexual function; clinicians can feel comfortable recommending them as a sexual health aid.","confidence":0.85,"topic_tags":["sexual_function","masturbation"],"strengths":["Large, nationally representative sample","Use of validated sexual function and health measures","Separate assessment of vibrator use during masturbation vs partnered sex"],"limitations":["Cross‑sectional design limits causal inference","Self‑report may be subject to recall or social desirability bias","No assessment of moral/religious attitudes or trauma history"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":8,"contrasting":0,"mentioning":131,"citing_publications":218,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01318.x"}},{"id":4240,"doi":null,"pmid":"19580215","pmcid":null,"title":"[Physicians for and against masturbation]","authors":"Nau JY.","first_author":"Nau JY.","journal":"Revue medicale suisse","year":2009,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4241,"doi":"10.1097/gme.0b013e3181948dd0","pmid":"19212271","pmcid":"PMC2908487","title":"Longitudinal changes in sexual functioning as women transition through menopause: results from the Study of Women's Health Across the Nation","authors":"Avis NE, Brockwell S, Randolph JF, Shen S, Cain VS, Ory M, Greendale GA.","first_author":"Avis NE","journal":"Menopause (New York, N.Y.)","year":2009,"pub_types":["research-article","Multicenter Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":202,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Prospective cohort of 3,302 women followed over 6 years across 7 US sites.","sample_n":3302,"sample_text":"N = 3,302 women recruited from seven US sites (SWAN).","population":"Women aged 42‑52 at baseline, pre‑menopausal or early perimenopausal, diverse racial/ethnic groups, no hormone use.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 6‑year study of over 3,000 mid‑life women, sexual desire and pain during intercourse changed as menopause progressed, while masturbation rose early then fell later. Other aspects of sexual function were mainly linked to health, psychology, and relationship factors, not menopause itself.","clinical_takeaway":"Menopause may lower desire and increase pain, but changes in overall sexual satisfaction are more related to health and relationship factors.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large, diverse longitudinal cohort","Multiple annual assessments","Adjustment for many relevant covariates"],"limitations":["Reliance on single‑item self‑reports","No validated sexual function scale reported","No assessment of trauma or moral factors"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":6,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":8,"contrasting":1,"mentioning":131,"citing_publications":318,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/gme.0b013e3181948dd0"}},{"id":4242,"doi":"10.1016/j.jsxm.2018.07.015","pmid":"30224020","pmcid":null,"title":"Deviance or Normalcy? The Relationship Among Paraphilic Thoughts and Behaviors, Hypersexuality, and Psychopathology in a Sample of University Students","authors":"Castellini G, Rellini AH, Appignanesi C, Pinucci I, Fattorini M, Grano E, Fisher AD, Cassioli E, Lelli L, Maggi M, Ricca V.","first_author":"Castellini G","journal":"The journal of sexual medicine","year":2018,"pub_types":["Multicenter Study","Journal Article"],"keywords":["Psychopathology","Childhood Abuse","Paraphilia","Hypersexuality"],"is_oa":false,"oa_url":null,"cited_by_count":41,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 775 university students recruited via social‑network posts; self‑report questionnaires","sample_n":775,"sample_text":"243 men, 532 women; recruited from six Italian universities via online questionnaire","population":"university students (Italy)","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 775 Italian university students found that many report paraphilic fantasies and behaviours, but these are linked to general mental‑health symptoms rather than to the content of the fantasies. Hypersexuality was associated with psychopathology and, in women, with childhood adversity.","clinical_takeaway":"Paraphilic interests are common and not intrinsically pathological; clinicians should assess overall mental‑health and trauma rather than focus on the fantasies themselves.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for a non‑clinical study","Use of several validated psychometric instruments","Inclusion of both genders and multiple universities"],"limitations":["Convenience, WEIRD sample limits generalisability","Paraphilia items not validated","Moral incongruence not assessed despite being relevant to distress outcomes","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":6,"contrasting":0,"mentioning":61,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2018.07.015"}},{"id":4244,"doi":"10.1371/journal.pone.0202076","pmid":"30157203","pmcid":"PMC6114295","title":"Validation of a Visual Analogue Scale to measure the subjective perception of orgasmic intensity in females: The Orgasmometer-F","authors":"Mollaioli D, Di Sante S, Limoncin E, Ciocca G, Gravina GL, Maseroli E, Fanni E, Vignozzi L, Maggi M, Lenzi A, Jannini EA.","first_author":"Mollaioli D","journal":"PloS one","year":2018,"pub_types":["research-article","Validation Study","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6114295","cited_by_count":37,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Validation study of a new Visual Analogue Scale (Orgasmometer‑F) in 526 women (112 with sexual dysfunction, 414 controls) recruited via web and a sex‑clinic; participants completed the scale and the FSFI; test‑retest reliability, ROC analysis, and correlations were reported.","sample_n":526,"sample_text":"112 women with sexual dysfunction, 414 sexually healthy controls","population":"adult women (mean age not specified); mix of clinic patients with sexual dysfunction and community volunteers","country":"not specified (likely Italy based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The Orgasmometer‑F, a simple 0‑10 visual scale, reliably measures how intense women feel their orgasms are. It distinguishes women with sexual dysfunction from healthy controls and correlates with factors like lubrication and masturbatory frequency.","clinical_takeaway":"The Orgasmometer‑F is a brief, validated tool clinicians can use to assess perceived orgasm intensity and monitor sexual dysfunction treatment progress.","confidence":0.85,"topic_tags":["sexual_function","measurement","pornography","masturbation"],"strengths":["Large sample size for a validation study","Comprehensive psychometric assessment (reliability, ROC, AUC)","Clear differentiation between sexual dysfunction and healthy groups"],"limitations":["Convenience sampling (web and clinic) limits generalisability","No assessment of moral or psychological confounds beyond masturbation","Cross‑sectional; cannot address causal relationships"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":30,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0202076"}},{"id":4245,"doi":"10.1089/cap.2008.020","pmid":"19364298","pmcid":null,"title":"Effectiveness of mirtazapine in the treatment of inappropriate sexual behaviors in individuals with autistic disorder","authors":"Coskun M, Karakoc S, Kircelli F, Mukaddes NM.","first_author":"Coskun M","journal":"Journal of child and adolescent psychopharmacology","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Retrospective chart review of 10 children/adolescents with autistic disorder treated with mirtazapine for 8 weeks; no control group.","sample_n":10,"sample_text":"10 participants; one dropout; convenience clinical sample.","population":"Children and adolescents with autistic disorder (n=10, 2F/8M, ages 5.2‑16.4) showing excessive masturbation/ISB.","country":"Turkey (assumed from author names, not stated).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A tiny uncontrolled study of 10 autistic children treated with the antidepressant mirtazapine reported reduced excessive masturbation after 8 weeks, but the evidence is weak and lacks proper controls.","clinical_takeaway":"Mirtazapine may help excessive masturbation in autistic youth, but robust trials are needed before using it routinely.","confidence":0.7,"topic_tags":["masturbation","sexual_function","neuroscience","treatment"],"strengths":["Focus on a clinically important, understudied behavior in autistic youth","Use of standardized CGI scales for severity and improvement","Reports safety and tolerability"],"limitations":["Very small, uncontrolled case series; no comparison group","Outcome based on clinician rating, no validated ISB or masturbation frequency instrument","No measurement of key confounds (moral, mental health, partner context)","Statistical analysis limited to a non‑parametric test with no power justification"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":61,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cap.2008.020"}},{"id":4247,"doi":"10.1111/myc.12825","pmid":"29998617","pmcid":null,"title":"Sexual behaviour and extra-genital colonisation in women treated for recurrent Candida vulvo-vaginitis","authors":"Grinceviciene S, Ruban K, Bellen G, Donders GGG.","first_author":"Grinceviciene S","journal":"Mycoses","year":2018,"pub_types":["Clinical Trial","Multicenter Study","Journal Article"],"keywords":["Anal Sex","Vulvovaginal Candidiasis","Recurrent Vulvovaginal Candidosis","Sexual Habits","Fluconazole Maintenance Tharapy","Multiple Site Colonisation"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"multicenter clinical trial with observational analysis of sexual behaviour variables","sample_n":117,"sample_text":"117 women enrolled in RVVC treatment trial (ReCiDiF)","population":"117 women with recurrent vulvovaginal candidiasis","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 117 women treated for recurrent yeast infections, having oral sex, anal sex, or masturbating did not increase the chance of yeast spreading to other body sites or of failing fluconazole treatment.","clinical_takeaway":"Changing sexual practices is not needed to improve treatment response in otherwise healthy women with recurrent yeast infection.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses clinical cultures to assess colonisation","Provides odds ratios with confidence intervals","Large multicenter sample for this condition"],"limitations":["Sexual behaviour measured with simple self‑report items, no validated scales","Limited control of key psychosocial confounders (mood, relationship factors, trauma)","Observational analysis within trial, limited causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/myc.12825"}},{"id":4248,"doi":"10.1007/s10508-018-1230-7","pmid":"29992372","pmcid":null,"title":"Hypersexuality, Higher Rates of Intercourse, Masturbation, Sexual Fantasy, and Early Sexual Interest Relate to Higher Sexual Excitation/Arousal","authors":"Walton MT, Bhullar N.","first_author":"Walton MT","journal":"Archives of sexual behavior","year":2018,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":4,"contrasting":0,"mentioning":15,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1230-7"}},{"id":4250,"doi":"10.1007/s10508-018-1256-x","pmid":"29987546","pmcid":null,"title":"Sexual Activity and Sexual Satisfaction Among Older Adults in Four European Countries","authors":"Træen B, Štulhofer A, Janssen E, Carvalheira AA, Hald GM, Lange T, Graham C.","first_author":"Træen B","journal":"Archives of sexual behavior","year":2019,"pub_types":["Multicenter Study","Journal Article"],"keywords":["Sexual activity","Europe","Older Adults","Sexual Satisfaction"],"is_oa":false,"oa_url":null,"cited_by_count":101,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Probability‑based postal survey of adults 60‑75 in four European countries (N≈3,000).","sample_n":4155,"sample_text":"Probabilistic phone‑register samples; 676 M/594 F Norway, 530 M/515 F Denmark, 318 M/672 F Belgium, 236 M/273 F Portugal.","population":"Community‑dwelling older adults, 60‑75 y, both sexes, multiple European nations.","country":"Norway, Denmark, Belgium, Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Surveyed 4,000 older Europeans and found that most men and many women remain sexually active; having a partner strongly predicts activity and satisfaction, with regional differences in how often people have sex or masturbate.","clinical_takeaway":"Partner status remains a key factor for sexual activity and satisfaction in older adults; clinicians should consider relationship context when addressing sexual health.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, probability‑based multi‑country sample","Separates partnered vs. solitary activity","Reports both frequency and satisfaction"],"limitations":["Reliance on single‑item self‑report measures","No validated scales for satisfaction or activity","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":13,"contrasting":2,"mentioning":118,"citing_publications":175,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1256-x"}},{"id":4252,"doi":"10.21037/tau.2018.04.24","pmid":"30159232","pmcid":"PMC6087850","title":"Effect of a formal oncofertility program on fertility preservation rates-first year experience","authors":"Lopategui DM, Ibrahim E, Aballa TC, Brackett NL, Yechieli R, Barredo JC, Ramasamy R.","first_author":"Lopategui DM","journal":"Translational andrology and urology","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Fertility Preservation","Oncofertility","Sperm Cryopreservation"],"is_oa":true,"oa_url":"https://tau.amegroups.com/article/viewFile/19630/pdf","cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective chart review comparing pre‑ and post‑implementation periods","sample_n":null,"sample_text":"902 cancer patients pre‑program; 218 cancer patients post‑program; 98 men used the service overall","population":"men newly diagnosed with cancer (n≈1120) and other men using fertility services","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"After introducing a formal oncofertility program, the proportion of male cancer patients who banked sperm before treatment rose from 3% to 19%, showing that systematic counseling and services increase use of fertility preservation.","clinical_takeaway":"Implementing structured oncofertility counseling can markedly boost sperm banking among male cancer patients.","confidence":0.8,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Large institutional dataset spanning several years","Clear before‑after comparison of program implementation","Objective outcome (sperm banking rates)"],"limitations":["Retrospective design, no randomisation","No adjustment for secular trends or other confounders","Limited statistical detail in abstract"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21037/tau.2018.04.24"}},{"id":4253,"doi":"10.1590/s1677-5538.ibju.2017.0525","pmid":"29570262","pmcid":"PMC6092644","title":"Polygamy, sexual behavior in a population under risk for prostate cancer diagnostic: an observational study from the Black Sea Region in Turkey","authors":"Cirakoglu A, Benli E, Yuce A.","first_author":"Cirakoglu A","journal":"International braz j urol : official journal of the Brazilian Society of Urology","year":2018,"pub_types":["research-article","Journal Article","Observational Study"],"keywords":["Sexual behavior","Prostatic neoplasms","Marriage"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6092644","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control observational study of men undergoing prostate biopsy; convenience sample from a single Turkish urology department","sample_n":317,"sample_text":"146 prostate‑cancer cases, 171 benign controls","population":"men undergoing prostate biopsy in Turkey (age not specified, likely middle‑aged to older)","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Turkish urology clinic, men with more sexual partners had a higher chance of prostate cancer on biopsy, while age at first sex showed a negative correlation. The authors suggest that avoiding many partners might reduce prostate cancer risk, but the study cannot prove cause‑and‑effect.","clinical_takeaway":"Do not treat the observed association as evidence that limiting sexual partners prevents prostate cancer; more research is needed.","confidence":0.7,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Relatively large sample for a single‑center study","Direct clinical outcome (biopsy‑confirmed prostate cancer)","Specific sexual‑behavior variables collected"],"limitations":["Cross‑sectional design; cannot infer causality","Self‑report of sexual history without validated instruments","No control for major confounders (e.g., lifestyle, family history, hormonal factors)","Potential selection bias from urology clinic population"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s1677-5538.ibju.2017.0525"}},{"id":4254,"doi":"10.1007/s00192-018-3688-1","pmid":"29961112","pmcid":null,"title":"The Female Genital Self-Image Scale (FGSIS): cross-cultural adaptation and validation of psychometric properties within a Turkish population","authors":"Ellibes Kaya A, Yassa M, Dogan O, Basbug A, Pulatoglu C, Caliskan E.","first_author":"Ellibes Kaya A","journal":"International urogynecology journal","year":2019,"pub_types":["Validation Study","Journal Article"],"keywords":["Female Sexual Dysfunction","Genital Perception","Sexual Well-being","Female Genital Self-image Scale"],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study with 461 participants, factor analysis, reliability testing","sample_n":461,"sample_text":"461 female participants recruited for scale validation","population":"Turkish women, community sample","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated and validated the Female Genital Self‑Image Scale for Turkish women, showing it reliably measures how women view their genital appearance and relates to sexual function and distress.","clinical_takeaway":"Clinicians can use the Turkish FGSIS to assess genital self‑image in women, aiding evaluation of sexual well‑being and outcomes of genital‑focused interventions.","confidence":0.85,"topic_tags":["sexual_function","gender","measurement"],"strengths":["Large sample for validation","Use of multiple established sexual health measures","Clear factor‑analysis and reliability reporting"],"limitations":["No assessment of moral or mental‑health confounds","Cross‑sectional; cannot infer causality","No pre‑registration or open data"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":4,"contrasting":1,"mentioning":36,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00192-018-3688-1"}},{"id":4255,"doi":"10.1007/s10508-008-9434-x","pmid":"19082703","pmcid":null,"title":"Asexuality: a mixed-methods approach","authors":"Brotto LA, Knudson G, Inskip J, Rhodes K, Erskine Y.","first_author":"Brotto LA","journal":"Archives of sexual behavior","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":98,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Mixed‑methods: online survey of 187 self‑identified asexual adults (quantitative, cross‑sectional) plus in‑depth telephone interviews with 15 participants (qualitative).","sample_n":187,"sample_text":"187 participants in Study 1; 15 participants in Study 2 (qualitative interviews).","population":"Self‑identified asexual adults recruited from the Asexuality Visibility and Education Network (AVEN); 54 men, 133 women; mean age not reported.","country":"Not specified (online recruitment, likely North America).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 187 self‑identified asexual adults found lower sexual response but little distress; masturbation frequency in men resembled that of sexual men. Psychopathology was not elevated, though a minority showed traits of schizoid personality. Interviews highlighted diverse experiences and the need to negotiate sex with partners.","clinical_takeaway":"Asexuality is not inherently linked to mental‑health problems; clinicians should assess individual distress rather than assume pathology.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Use of validated questionnaires","Large quantitative sample for asexuality research","Mixed‑methods design adds depth"],"limitations":["Convenience sample from AVEN limits generalisability","Cross‑sectional design cannot infer causality","Limited reporting of effect sizes and power"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":20,"contrasting":0,"mentioning":234,"citing_publications":263,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-008-9434-x"}},{"id":4256,"doi":"10.1016/j.amsu.2018.06.009","pmid":"29988946","pmcid":"PMC6034582","title":"Foreign body (kidney beans) in urinary bladder: An unusual case report","authors":"Jain A, Gupta M, Sadasukhi TC, Dangayach KK.","first_author":"Jain A","journal":"Annals of medicine and surgery (2012)","year":2018,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Bladder","Foreign Body","Kidney Beans"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.amsu.2018.06.009","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report of self‑inserted kidney beans during masturbation; cystoscopic and open removal described","sample_n":1,"sample_text":"N=1 (single case)","population":"25‑year‑old male, chef, self‑inflicted foreign body for sexual gratification","country":"India (assumed from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 25‑year‑old man inserted four soaked kidney beans into his bladder during masturbation. The beans swelled, making cystoscopic removal impossible, so they were removed via a suprapubic incision. This is the first reported case of kidney‑bean bladder insertion.","clinical_takeaway":"Self‑insertion of objects for sexual gratification can cause emergency urological complications requiring surgical removal.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Rare clinical presentation documented","Detailed procedural description of removal","Adds to catalog of urinary‑tract foreign bodies"],"limitations":["Single case – no generalisable conclusions","No systematic assessment of psychological factors","No follow‑up on mental‑health outcomes"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.amsu.2018.06.009"}},{"id":4257,"doi":"10.1016/j.psc.2008.07.001","pmid":"18996304","pmcid":null,"title":"Sexual arousal patterns: normal and deviant","authors":"Abel GG, Coffey L, Osborn CA.","first_author":"Abel GG","journal":"The Psychiatric clinics of North America","year":2008,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":null,"sample_text":"Not specified; multiple case histories","population":"individuals with fetish/paraphilic interests (case histories)","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe several case histories of people whose sexual interests focused on unusual objects, tracing how these interests emerged in childhood and later influenced adult relationships and masturbation fantasies.","clinical_takeaway":"These narratives illustrate that early atypical sexual interests can shape adult sexual behavior, but the findings cannot be generalized to broader populations.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed qualitative description of sexual development trajectories","Integration of developmental and relational perspectives"],"limitations":["No validated measurement instruments","No systematic sampling or control group","Findings based on a very small, non‑representative set of cases"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psc.2008.07.001"}},{"id":4258,"doi":"10.1186/s12905-018-0602-4","pmid":"29929499","pmcid":"PMC6013982","title":"Predictors of female sexual dysfunction: a systematic review and qualitative analysis through gender inequality paradigms","authors":"McCool-Myers M, Theurich M, Zuelke A, Knuettel H, Apfelbacher C.","first_author":"McCool-Myers M","journal":"BMC women's health","year":2018,"pub_types":["research-article","Systematic Review","Journal Article"],"keywords":["Prevalence","risk factors","Predictors","Gender Inequality","Female Sexual Dysfunction","Premenopausal","Narrative Synthesis","Female Sexual Disorders","Reproductive-age"],"is_oa":true,"oa_url":"https://bmcwomenshealth.biomedcentral.com/track/pdf/10.1186/s12905-018-0602-4","cited_by_count":172,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 135 observational studies (2000‑2014) with qualitative synthesis of predictors of female sexual dysfunction.","sample_n":135,"sample_text":"135 studies from 41 countries","population":"Reproductive‑age women worldwide (observational studies aggregated)","country":"International","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 135 studies identified many risk and protective factors for female sexual dysfunction, including health, mental health, relationship quality, and gender‑inequality variables. The authors suggest targeting modifiable factors like exercise and sex education.","clinical_takeaway":"Clinicians should assess physical, mental, and relational factors when addressing sexual dysfunction in reproductive‑age women.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Large number of included studies across many countries","Systematic approach to literature search","Considers gender‑inequality context"],"limitations":["No meta‑analysis; effect sizes not quantified","Heterogeneous measures across primary studies","Limited detail on quality assessment of included studies"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":2,"mentioning":206,"citing_publications":331,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12905-018-0602-4"}},{"id":4259,"doi":"10.1093/humupd/5.3.211","pmid":"10438105","pmcid":null,"title":"Methods of semen collection not based on masturbation or surgical sperm retrieval","authors":"Gerris J.","first_author":"Gerris J.","journal":"Human reproduction update","year":1999,"pub_types":["Comparative Study","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative review of semen collection methods; no new empirical data; sample size not applicable","sample_n":null,"sample_text":"Not applicable (review/comparative study)","population":"Male patients/fertility clinics; not specified","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews non‑masturbation ways to collect semen, such as special condoms and urine retrieval, noting they can produce good lab samples but are rarely used except when masturbation is impossible.","clinical_takeaway":"Alternative collection methods exist for patients unable or unwilling to masturbate, but they are not widely adopted.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Comprehensive overview of alternative semen collection methods","Highlights practical clinical considerations"],"limitations":["No original empirical data","No assessment of psychological or sexual health outcomes"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/humupd/5.3.211"}},{"id":4261,"doi":"10.1111/j.1464-410x.2008.08030.x","pmid":"19016689","pmcid":null,"title":"Sexual activity and prostate cancer risk in men diagnosed at a younger age","authors":"Dimitropoulou P, Lophatananon A, Easton D, Pocock R, Dearnaley DP, Guy M, Edwards S, O'Brien L, Hall A, Wilkinson R, Eeles R, Muir KR, UK Genetic Prostate Cancer Study Collaborators, British Association of Urological Surgeons Section of Oncology.","first_author":"Dimitropoulou P","journal":"BJU international","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-control study of 431 cases and 409 controls, retrospective self‑report of sexual activity across decades","sample_n":840,"sample_text":"431 prostate cancer cases and 409 controls","population":"men ≤60 y diagnosed with prostate cancer (cases) and age‑matched controls","country":"UK","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a case‑control study of men under 60, higher frequency of sexual activity (including masturbation) in the 20s was linked to higher prostate‑cancer risk, while frequent activity in the 50s appeared protective. The authors note possible reverse causation.","clinical_takeaway":"Frequency of sexual activity may relate to prostate‑cancer risk but evidence is limited; clinicians should consider age‑specific patterns cautiously.","confidence":0.8,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["Large case‑control sample for prostate cancer research","Separate assessment of intercourse vs. masturbation","Multivariate analysis attempted"],"limitations":["Self‑report frequency measures unvalidated","Limited control for key confounders (e.g., lifestyle, health status)","Cross‑sectional retrospective design; potential recall bias","No adjustment for moral or psychosocial factors"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":1,"mentioning":20,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1464-410x.2008.08030.x"}},{"id":4263,"doi":"10.1016/j.disamonth.2018.05.007","pmid":"29880262","pmcid":null,"title":"Clinical pearls in sexual medicine","authors":"Rullo J, Litin SC, Bundrick JB.","first_author":"Rullo J","journal":"Disease-a-month : DM","year":2018,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.disamonth.2018.05.007"}},{"id":4265,"doi":"10.1002/ca.23192","pmid":"29693269","pmcid":null,"title":"The clitoral activation paradox - Claimed outcomes from different methods of its stimulation","authors":"Levin RJ.","first_author":"Levin RJ.","journal":"Clinical anatomy (New York, N.Y.)","year":2018,"pub_types":["Review","Journal Article"],"keywords":["Clitoris","Masturbation","Clitoral Anatomy","Vaginal Tenting","Clitoral Reproductive Function","Clitoridectomies","Coital Alignment Technique"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of clitoral anatomy and stimulation; no original data.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Humans (female anatomy); no sample size reported.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how the clitoris is structured and activated, examining claims that different stimulation methods cause harmful physical or psychological effects and questioning evolutionary explanations for these claims.","clinical_takeaway":"Clinicians should note that debates about clitoral stimulation effects are largely theoretical; treatment should focus on individual symptom relief rather than evolutionary arguments.","confidence":0.6,"topic_tags":["csbd","masturbation","sexual_function"],"strengths":["Comprehensive anatomical overview","Discussion of cultural and evolutionary interpretations"],"limitations":["No original empirical data","Lacks systematic review methodology","No quantitative synthesis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ca.23192"}},{"id":4267,"doi":"10.4103/jfmpc.jfmpc_348_17","pmid":"30112300","pmcid":"PMC6069647","title":"Prevalence and correlates of sexual health disorders among adult men in a rural area of North India: An observational study","authors":"Singh AK, Kant S, Abdulkader RS, Lohiya A, Silan V, Nongkynrih B, Misra P, Rai SK.","first_author":"Singh AK","journal":"Journal of family medicine and primary care","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["India","Prevalence","Rural","Sexual Health Disorders"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6069647","cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"community-based cross‑sectional survey using multistage stratified random sampling of adult men (18–60 y) in rural Haryana, India; logistic regression to identify correlates","sample_n":null,"sample_text":"multistage stratified random sampling; number not given in abstract","population":"adult men, rural North India","country":"India","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a rural Indian community, 81 % of adult men reported at least one sexual health problem such as perceived semen defects, low libido, or guilt about masturbation. Being single, smoking, cannabis use, diabetes and hypertension were linked to higher odds of these problems.","clinical_takeaway":"Sexual health concerns are common among rural Indian men; clinicians should screen for multiple issues and consider associated medical and lifestyle factors.","confidence":0.78,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Random community sampling improves representativeness","Large range of sexual health outcomes reported","Use of ICD‑10 definitions for disorders"],"limitations":["Self‑reported data, potential reporting bias","No validated psychometric scales for each disorder","Key confounds (moral incongruence, mental health, partner status) not measured","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":8,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/jfmpc.jfmpc_348_17"}},{"id":4268,"doi":"10.1016/j.esxm.2018.01.006","pmid":"29678558","pmcid":"PMC5960034","title":"Influence Factors of Sexual Activity for Internal Migrants in China","authors":"Zhang J, Wu J, Li Y, Zhou Y, Li Y, Zhao R, Shi Y, Li Z, Huang W, Chen J.","first_author":"Zhang J","journal":"Sexual medicine","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["China","Influence factors","Migrants","Sexual activity","Quantile Regression"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5960034","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community sample, multistage probability sampling, cross‑sectional questionnaire","sample_n":15562,"sample_text":"10,834 men and 4,928 women","population":"10,834 men and 4,928 women internal migrants in China, aged 20‑49","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In over 15,000 Chinese internal migrants, men, younger age, earlier sexual debut, more masturbation, better sexual‑health knowledge, longer time with a spouse and higher education were linked to more frequent sex. Talking often with a partner showed the strongest positive effect.","clinical_takeaway":"Clinicians should consider partner communication, masturbation, and socio‑demographic factors when addressing sexual activity among migrant adults.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Very large, multi‑city sample","Uses appropriate count models (negative binomial, quantile regression)","Measures masturbation separately from partnered sex"],"limitations":["Self‑report single‑item frequency measures, no validated scales","No assessment of mental health, moral incongruence, or trauma","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[{"status":"Has erratum","date":"2018-9-1","noticeDoi":"10.1016/j.esxm.2018.05.003","doi":"10.1016/j.esxm.2018.01.006"}],"url":"https://scite.ai/reports/10.1016/j.esxm.2018.01.006"}},{"id":4269,"doi":"10.1080/13685538.2018.1464553","pmid":"29663843","pmcid":null,"title":"Persistent hematospermia: seminal vesicle bleed","authors":"Phan YC, Mahmalji W.","first_author":"Phan YC","journal":"The aging male : the official journal of the International Society for the Study of the Aging Male","year":2020,"pub_types":["Video-Audio Media","Journal Article","Case Reports"],"keywords":["Hematospermia","Mri Pelvis","Seminal Vesicle Bleed"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single 65‑year‑old man with persistent hematospermia; MRI used to identify seminal vesicle bleed; conservative management.","sample_n":1,"sample_text":"single case (n=1)","population":"65‑year‑old male, no comorbidities, not on anticoagulants","country":"unspecified (likely USA/UK based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 65‑year‑old man with years of blood in his semen was found to have bleeding from a seminal vesicle on MRI; abstaining from ejaculation resolved the issue.","clinical_takeaway":"Rare seminal‑vesicle bleeding can cause persistent hematospermia; MRI can diagnose, and short‑term sexual abstinence may be sufficient.","confidence":0.8,"topic_tags":["sexual_function","gender","religiosity"],"strengths":["Detailed clinical work‑up","Use of MRI to identify rare cause","Clear conservative management plan"],"limitations":["Single case, no generalisability","No systematic assessment of confounders","No long‑term follow‑up"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13685538.2018.1464553"}},{"id":4270,"doi":"10.1111/j.1743-6109.2008.00939.x","pmid":"18638007","pmcid":null,"title":"Perceived ejaculatory latency and pleasure in different outlets","authors":"Corty EW.","first_author":"Corty EW.","journal":"The journal of sexual medicine","year":2008,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience sample of male college students completing self‑report questionnaires on ejaculatory latency and pleasure across four sexual outlets. No experimental manipulation, longitudinal follow‑up, or control group.","sample_n":null,"sample_text":"Convenience sample; exact size not given in abstract.","population":"Male college students (non‑clinical, likely primarily young adult, WEIRD sample).","country":"Not specified (likely USA based on journal and author affiliation).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study asked college men to report how long it took them to ejaculate and how pleasurable each of four sexual activities (vaginal sex, oral sex, manual stimulation by a partner, and masturbation) felt. Masturbation was faster than the partnered activities, but pleasure ratings were similar for vaginal and oral sex and lower for manual stimulation and masturbation. How pleasure related to latency varied across individuals.","clinical_takeaway":"Men who feel more pleasure with shorter ejaculation may be more dissatisfied with their intravaginal latency, suggesting that subjective experience—not just timing—affects satisfaction.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Direct comparison of multiple sexual outlets","Focus on both latency and pleasure","Includes partner‑mediated stimulation"],"limitations":["Reliance on single‑item self‑reports; no validated scales","Convenience, student sample limits generalisability","No control for key confounds (e.g., mental health, moral attitudes)","Sample size unclear; likely under‑powered"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":1,"mentioning":12,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2008.00939.x"}},{"id":4271,"doi":"10.4103/0378-6323.42904","pmid":"18797065","pmcid":null,"title":"Masturbation: can it be urticarogenic?","authors":"Ghiya BC, Mehta RD, Bumb RA.","first_author":"Ghiya BC","journal":"Indian journal of dermatology, venereology and leprology","year":2008,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0378-6323.42904"}},{"id":4272,"doi":"10.1093/cid/cix1036","pmid":"29617772","pmcid":"PMC5888966","title":"Providers' Perceptions and Training Needs for Counseling Adolescents Undergoing Voluntary Medical Male Circumcision","authors":"Tobian AAR, Dam KH, Van Lith LM, Hatzold K, Marcell AV, Mavhu W, Kahabuka C, Mahlasela L, Patel EU, Njeuhmeli E, Seifert Ahanda K, Ncube G, Lija G, Bonnecwe C, Kaufman MR.","first_author":"Tobian AAR","journal":"Clinical infectious diseases : an official publication of the Infectious Diseases Society of America","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5888966","cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"In‑depth semi‑structured interviews with 45 VMMC providers/managers in three sub‑Saharan African countries; thematic analysis using Atlas.ti.","sample_n":45,"sample_text":"33 providers + 12 facility managers across Tanzania, South Africa, Zimbabwe.","population":"VMMC providers and facility managers (health personnel) working with adolescents (10‑19 y).","country":"Tanzania; South Africa; Zimbabwe","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 45 circumcision providers in Tanzania, South Africa, and Zimbabwe show that many lack training to discuss comprehensive sexual‑health topics—like HIV testing, condom use, and masturbation—with adolescent clients, especially younger or presumed‑inexperienced boys.","clinical_takeaway":"Providers may need targeted training to offer age‑appropriate, comprehensive sexual‑health counseling during VMMC.","confidence":0.78,"topic_tags":["adolescents","csbd","sexual_function","masturbation","moral_incongruence"],"strengths":["Multi‑country perspectives increase contextual relevance.","Systematic thematic coding by independent coders.","Highlights concrete training gaps for adolescent counseling."],"limitations":["Qualitative design limits generalisability.","No validated measurement instruments; relies on self‑report.","Small, convenience sample of providers."],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/cid/cix1036"}},{"id":4273,"doi":"10.1093/cid/cix952","pmid":"29617776","pmcid":"PMC5889033","title":"Counseling Received by Adolescents Undergoing Voluntary Medical Male Circumcision: Moving Toward Age-Equitable Comprehensive Human Immunodeficiency Virus Prevention Measures","authors":"Kaufman MR, Patel EU, Dam KH, Packman ZR, Van Lith LM, Hatzold K, Marcell AV, Mavhu W, Kahabuka C, Mahlasela L, Njeuhmeli E, Seifert Ahanda K, Ncube G, Lija G, Bonnecwe C, Tobian AAR.","first_author":"Kaufman MR","journal":"Clinical infectious diseases : an official publication of the Infectious Diseases Society of America","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5889033","cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large community survey of 1,293 adolescents across three countries; self‑reported binary items; subset observation (n=44); Poisson GEE analysis","sample_n":1293,"sample_text":"n = 1293 surveyed; counseling observed for n = 44","population":"male adolescents 10‑19 years seeking voluntary medical male circumcision in South Africa, Tanzania, Zimbabwe","country":"South Africa, Tanzania, Zimbabwe","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 1,200 boys aged 10‑19 getting medical circumcision in three African countries found that older teens were more likely to receive HIV‑prevention counseling, including condom demos, than younger teens. Counseling about risks and about avoiding sex or masturbation was limited overall.","clinical_takeaway":"Adolescent VMMC programs should standardize counseling to ensure younger teens receive the same HIV‑prevention information as older peers.","confidence":0.7,"topic_tags":["adolescents","csbd","masturbation","sexual_function"],"strengths":["Large multi‑country adolescent sample","Use of both self‑report and direct observation","Appropriate statistical modeling with GEE"],"limitations":["Self‑reported counseling receipt not validated","No measurement of actual behavior change","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/cid/cix952"}},{"id":4274,"doi":"10.1016/j.fertnstert.2008.03.074","pmid":"18565516","pmcid":null,"title":"Prevalence of human herpes virus types 1-7 in the semen of men attending an infertility clinic and correlation with semen parameters","authors":"Neofytou E, Sourvinos G, Asmarianaki M, Spandidos DA, Makrigiannakis A.","first_author":"Neofytou E","journal":"Fertility and sterility","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":72,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational comparison of semen parameters and viral DNA presence in 172 men attending an infertility clinic (80 normal, 92 abnormal).","sample_n":172,"sample_text":"172 male patients (80 with normal semen parameters, 92 with abnormal parameters).","population":"Men undergoing routine semen analysis at an IVF clinic; recruited from a clinical setting, not a population‐based sample.","country":"Greece (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examined semen from 172 men at an infertility clinic and found that viral DNA from several herpes viruses was common (over 80% of samples). No link was observed between having viral DNA and poorer semen quality, though Epstein‑Barr virus was associated with higher white‑cell counts in semen.","clinical_takeaway":"Herpesvirus DNA is frequently present in semen but, based on this data, does not appear to impair standard semen parameters.","confidence":0.6,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Objective laboratory measures (PCR, semen analysis).","Reasonable sample size for prevalence estimates."],"limitations":["Cross‑sectional design limits causal inference.","Convenience clinic sample not generalizable.","No adjustment for potential confounders (e.g., age, sexual activity, health status)."],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":2,"mentioning":78,"citing_publications":127,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.fertnstert.2008.03.074"}},{"id":4276,"doi":"10.1590/s0034-89102008000800008","pmid":"18660925","pmcid":null,"title":"[Opinions and attitudes regarding sexuality: Brazilian national research, 2005]","authors":"Paiva V, Aranha F, Bastos FI, Grupo de Estudos em População, Sexualidade e Aids.","first_author":"Paiva V","journal":"Revista de saude publica","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"por","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative probability sample, cross‑sectional survey (N=5,040)","sample_n":5040,"sample_text":"representative urban population, stratified by gender, age, schooling, income, marital status, colour, region, religion","population":"Brazilian urban adults and adolescents, 2005","country":"Brazil","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2005 Brazilian survey of 5,040 urban residents found most people think sex shows love, support condom use in schools, and increasingly accept masturbation and homosexuality, especially among younger generations.","clinical_takeaway":"Clinicians should note that Brazilian public attitudes are becoming more tolerant, which may affect how sexual‑health messages are received.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation","moral_incongruence"],"strengths":["Large, nationally representative sample","Broad demographic coverage allows population‑level inference","Clear descriptive statistics of attitudes over time"],"limitations":["Attitude items appear ad‑hoc; no validated scales reported","Cross‑sectional; cannot assess change within individuals","No reporting of effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s0034-89102008000800008"}},{"id":4278,"doi":"10.1016/j.esxm.2017.12.004","pmid":"29550252","pmcid":"PMC5960017","title":"Intralymphatic Immunotherapy With Autologous Semen in a Korean Man With Post-Orgasmic Illness Syndrome","authors":"Kim TB, Shim YS, Lee SM, Son ES, Shim JW, Lee SP.","first_author":"Kim TB","journal":"Sexual medicine","year":2018,"pub_types":["Journal Article","case-report"],"keywords":["Semen","Desensitization","Immunologic","injection","Intralymphatic","Post-orgasmic Illness"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5960017","cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single male patient with POIS treated with intralymphatic immunotherapy using autologous semen; symptoms and semen‑specific IgE measured pre‑ and post‑treatment","sample_n":1,"sample_text":"case report (n=1)","population":"1 Korean adult male with post‑orgasmic illness syndrome","country":"Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2018 case report describes a Korean man with post‑orgasmic illness syndrome whose symptoms improved after a few intralymphatic injections of his own semen; laboratory tests showed that he had semen‑specific IgE antibodies.","clinical_takeaway":"Intralymphatic immunotherapy may reduce POIS symptoms, but evidence is limited to a single case; clinicians should await larger studies before recommending it.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Objective immunological confirmation of semen‑specific IgE","Novel therapeutic approach (intralymphatic immunotherapy)","Detailed clinical description of POIS symptom course"],"limitations":["N=1; no control or comparison group","No validated POIS severity scale","Potential placebo/expectancy effects not addressed","Findings not generalizable"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":31,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2017.12.004"}},{"id":4280,"doi":"10.1186/1472-6963-8-98","pmid":"18454869","pmcid":"PMC2386785","title":"Adolescents perception of reproductive health care services in Sri Lanka","authors":"Agampodi SB, Agampodi TC, Ukd P.","first_author":"Agampodi SB","journal":"BMC health services research","year":2008,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"http://www.biomedcentral.com/1472-6963/8/98/abstract","cited_by_count":59,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus group discussions with 32 adolescents (convenient sample) in semi‑urban Sri Lanka; thematic analysis","sample_n":32,"sample_text":"Convenient sample of 32 adolescents (four focus groups)","population":"Adolescents aged 17‑19 in Sri Lanka (both genders)","country":"Sri Lanka","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Sri Lankan teens say they face psychological stress, menstrual and masturbation concerns, but know little about existing reproductive‑health services. They cite lack of confidentiality, youth‑friendliness and accessibility as major barriers, and prefer receiving care from public clinics.","clinical_takeaway":"Clinicians should ensure confidential, youth‑friendly reproductive health services and improve outreach to adolescents.","confidence":0.6,"topic_tags":["adolescents","religiosity","masturbation","sexual_function"],"strengths":["Provides direct youth perspectives on service gaps","Includes both male and female participants","Uses pre‑tested focus‑group guide"],"limitations":["Small, non‑representative convenience sample","No validated measures of distress or sexual behaviour","Findings limited to one semi‑urban area"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":14,"contrasting":1,"mentioning":125,"citing_publications":120,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1472-6963-8-98"}},{"id":4282,"doi":"10.1515/rjim-2017-0034","pmid":"28865234","pmcid":null,"title":"Impact of Seminal Plasma Trace Elements on Human Sperm Motility Parameters","authors":"Hashemi MM, Behnampour N, Nejabat M, Tabandeh A, Ghazi-Moghaddam B, Joshaghani HR.","first_author":"Hashemi MM","journal":"Romanian journal of internal medicine = Revue roumaine de medecine interne","year":2018,"pub_types":["Journal Article"],"keywords":["Iron","Copper","Sperm motility","Zinc","Magnesium"],"is_oa":false,"oa_url":"https://content.sciendo.com/downloadpdf/journals/rjim/56/1/article-p15.pdf","cited_by_count":29,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of 96 normospermic and 96 asthenospermic men; semen collected by masturbation, trace elements measured via atomic absorption spectroscopy, sperm motility assessed with computer‑assisted analysis.","sample_n":192,"sample_text":"96 normospermic, 96 asthenospermic men","population":"Male participants seeking infertility evaluation; convenience sample.","country":"Romania","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study measured magnesium, copper, zinc, and iron in the seminal fluid of 192 men and found that lower levels of iron, copper and magnesium are linked to poorer sperm movement, while zinc showed no effect.","clinical_takeaway":"Trace element imbalances, especially high iron, may impair sperm motility; consider assessing these levels in male infertility work‑ups.","confidence":0.85,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Adequate sample size for group comparison","Validated laboratory methods (AAS, CASA)","Direct measurement of trace elements in seminal plasma"],"limitations":["Cross‑sectional design prevents causal inference","Convenience sample limits generalisability","No adjustment for potential lifestyle or health confounders"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":27,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/rjim-2017-0034"}},{"id":4283,"doi":"10.1097/j.pain.0000000000001113","pmid":"29210883","pmcid":null,"title":"Association between pain and sexual health in older people: results from the English Longitudinal Study of Ageing","authors":"Wade K, Wu FCW, OʼNeill TW, Lee DM, Lee DM.","first_author":"Wade K","journal":"Pain","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"nationally representative cohort (ELSA), logistic regression of pain vs sexual health outcomes","sample_n":3916,"sample_text":"3930 participants with sexual activity; 1872 with cumulative pain score","population":"community‑dwelling adults ≥50 years in England (N≈3916 with sexual activity)","country":"England","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large UK cohort of adults aged 50+, people who often experienced moderate‑to‑severe pain were less likely to have frequent intercourse or masturbation and reported more erectile problems and worries about sexual health, especially men.","clinical_takeaway":"Pain in older adults is linked to poorer sexual function; clinicians should address pain when evaluating sexual health.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Validated sexual health questionnaire","Adjustment for multiple health and psychosocial covariates"],"limitations":["Cross‑sectional analysis of sexual health at a single wave","No measurement of partner/relationship context","No assessment of moral or trauma factors"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/j.pain.0000000000001113"}},{"id":4285,"doi":"10.1007/s10508-018-1149-z","pmid":"29464449","pmcid":null,"title":"Are Women's Orgasms Hindered by Phallocentric Imperatives?","authors":"Willis M, Jozkowski KN, Lo WJ, Sanders SA.","first_author":"Willis M","journal":"Archives of sexual behavior","year":2018,"pub_types":["Journal Article"],"keywords":["Gender","Sexual Orientation","Orgasm","Sexual Scripts","Women Who Have Sex With Women","Women’s Well-being"],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large online survey of 2,296 women (WSM and WSW)","sample_n":2296,"sample_text":"1988 WSM, 308 WSW","population":"women, mixed ages, self‑selected online participants","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 2 000 women, those who have sex with women reported orgasms more often than those who have sex with men. The gap shrank when accounting for a wider range of sexual activities and women’s own orgasm goals, suggesting that male‑focused sexual scripts may limit women’s orgasm experiences.","clinical_takeaway":"Encourage partners to explore varied sexual activities and women’s personal orgasm goals to reduce script‑driven orgasm gaps.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["large sample size","focus on understudied WSW group","use of incidence rate ratios"],"limitations":["cross‑sectional, cannot infer causality","key constructs measured with ad‑hoc items","no control for mental‑health or relational variables"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":24,"citing_publications":106,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1149-z"}},{"id":4287,"doi":"10.1080/0092623x.2017.1405297","pmid":"29281592","pmcid":null,"title":"Individual-Based Compulsive Sexual Behavior Scale: Its Development and Importance in Examining Compulsive Sexual Behavior","authors":"Efrati Y, Mikulincer M.","first_author":"Efrati Y","journal":"Journal of sex & marital therapy","year":2018,"pub_types":["Evaluation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional validation study with three samples (N=492, 406, 112)","sample_n":1010,"sample_text":"Total participants across three studies (N=492, 406, 112)","population":"adults (likely community volunteers)","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a new questionnaire to assess personal (fantasies, thoughts, masturbation) aspects of compulsive sexual behavior, showing a four‑factor structure and good ability to separate people with versus without compulsive sexual behavior.","clinical_takeaway":"The I‑CSB may help clinicians screen for individual‑based compulsive sexual patterns, but it should be used with caution until further validated.","confidence":0.8,"topic_tags":["measurement","sexual_function"],"strengths":["Large sample sizes for scale development","Factor analytic rigor","Convergent validity testing"],"limitations":["No measurement of moral incongruence or other key confounds","New scale lacks external validation","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":4,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":61,"citing_publications":69,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2017.1405297"}},{"id":4288,"doi":"10.1007/s10140-008-0700-y","pmid":"18335263","pmcid":null,"title":"Obstructive rectal intramural hematoma caused by a foreign body","authors":"Battal B, Kocaoglu M, Ors F, Akgun V, Tasar M.","first_author":"Battal B","journal":"Emergency radiology","year":2009,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Single patient case report describing clinical presentation, imaging, and surgical management of a rectal intramural hematoma caused by a foreign body used for masturbation.","sample_n":1,"sample_text":"N=1 (single case report)","population":"51‑year‑old male patient","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 51‑year‑old man injured his rectum with a foreign object used for masturbation, leading to a rare intramural hematoma and perforation that required surgery. Imaging helped diagnose the condition.","clinical_takeaway":"Sexual devices can cause serious rectal injury; prompt imaging and surgical assessment are essential.","confidence":0.9,"topic_tags":["masturbation","sexual_function"],"strengths":["Detailed imaging description","Clear clinical narrative"],"limitations":["Single case, no generalisable data","No systematic assessment of sexual behavior or psychological factors"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10140-008-0700-y"}},{"id":4289,"doi":"10.1111/j.1743-6109.2008.00786.x","pmid":"18331263","pmcid":null,"title":"Vaginal orgasm is associated with less use of immature psychological defense mechanisms","authors":"Brody S, Costa RM.","first_author":"Brody S","journal":"The journal of sexual medicine","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":52,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 94 healthy Portuguese women, self‑report of orgasm type, frequency, and Defense Style Questionnaire","sample_n":94,"sample_text":"94 healthy Portuguese women","population":"94 adult women (Portugal)","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 94 Portuguese women, those who regularly had vaginal orgasms reported fewer immature psychological defense mechanisms than women whose orgasms were clitoral or mixed. Masturbation frequency was also linked to defense style.","clinical_takeaway":"Vaginal orgasm consistency may be associated with more adaptive psychological coping, but the cross‑sectional nature precludes causal claims.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Validated defense‑mechanism questionnaire (DSQ‑40)","Separate measurement of masturbation frequency","Regression analyses control for some covariates"],"limitations":["Cross‑sectional design limits causal inference","Convenience sample, modest size (N=94)","No assessment of mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":24,"contrasting":2,"mentioning":118,"citing_publications":85,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2008.00786.x"}},{"id":4291,"doi":"10.1007/s10508-018-1158-y","pmid":"29383460","pmcid":null,"title":"Patterns of Asexuality in China: Sexual Activity, Sexual and Romantic Attraction, and Sexual Desire","authors":"Zheng L, Su Y.","first_author":"Zheng L","journal":"Archives of sexual behavior","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual Orientation","Asexuality","Sexual Desire","Sexual Attraction","Romantic Attraction","Asexuality Identification Scale"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 227 asexual, 57 uncertain, 217 heterosexual participants recruited from social networks; group comparisons on sexual activity and desire.","sample_n":501,"sample_text":"227 asexual, 57 uncertain asexual, 217 heterosexual participants","population":"Chinese adults (men and women) recruited via online social networks","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Chinese people who identify as asexual report lower rates of masturbation, sexual activity and attraction than heterosexual peers. Their sexual desire is mostly solitary and varies by romantic orientation, showing patterns similar to Western asexual groups.","clinical_takeaway":"Asexual clients typically have low sexual attraction and desire, which is not necessarily a sign of dysfunction.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a relatively understudied population in China","Use of a validated Asexuality Identification Scale","Differentiates dyadic vs solitary sexual desire"],"limitations":["Convenience sampling from asexual forums limits generalisability","No control for key psychosocial confounds (mental health, moral attitudes)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1158-y"}},{"id":4292,"doi":"10.1046/j.1526-4610.1998.3802138.x","pmid":"9529772","pmcid":null,"title":"Masturbatory-orgasmic extracephalic pain","authors":"Jacome DE.","first_author":"Jacome DE.","journal":"Headache","year":1998,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Two single-case descriptions of masturbatory‑orgasmic induced extracephalic ice‑pick pain in men with spinal pathology.","sample_n":2,"sample_text":"Two individual case reports","population":"Adult men (middle‑aged) with cervical myelopathy or tethered cord; N=2","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Two men with spinal disorders experienced sharp neck or genital pain that started only during masturbation and orgasm. No brain lesions were found, suggesting the pain is linked to the sexual activity and underlying spinal conditions.","clinical_takeaway":"Clinicians should consider spinal pathology as a possible trigger for orgasm‑related pain in patients reporting such symptoms.","confidence":0.8,"topic_tags":["masturbation","sexual_function","neuroscience","pornography"],"strengths":["Detailed clinical description of a rare phenomenon","Excludes intracranial pathology"],"limitations":["Very small sample (n=2)","No systematic measurement of pain or psychological factors","No control group or statistical analysis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1046/j.1526-4610.1998.3802138.x"}},{"id":4293,"doi":"10.1080/00926239808414667","pmid":"9509379","pmcid":null,"title":"Traumatic masturbatory syndrome","authors":"Sank LI.","first_author":"Sank LI.","journal":"Journal of sex & marital therapy","year":1998,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case report of four men describing a specific masturbatory style associated with erectile/or orgasmic dysfunction.","sample_n":4,"sample_text":"Four case histories are described","population":"Adult men, middle‑aged, presenting with sexual dysfunction.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The paper reports four men who repeatedly masturbated in a prone position and later experienced erection or orgasm problems, suggesting this habit may cause dysfunction and recommending education on proper technique.","clinical_takeaway":"No strong evidence that a specific masturbatory style causes dysfunction; clinicians should consider a range of factors.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Detailed clinical descriptions","Identification of a novel behavioral pattern"],"limitations":["No validated measurement tools","Very small, non‑representative sample","No control for confounding variables","Speculative prevention recommendations"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239808414667"}},{"id":4295,"doi":"10.1007/bf03365312","pmid":"18300548","pmcid":null,"title":"[Development of sexuality in childhood. Masturbation is part of it]","authors":"Bischoff A.","first_author":"Bischoff A.","journal":"MMW Fortschritte der Medizin","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf03365312"}},{"id":4297,"doi":"10.1080/00926230701620548","pmid":"18396727","pmcid":null,"title":"Discrepancies between sexual desire and sexual activity: gender differences and associations with relationship satisfaction","authors":"Santtila P, Wager I, Witting K, Harlaar N, Jern P, Johansson A, Varjonen M, Sandnabba NK.","first_author":"Santtila P","journal":"Journal of sex & marital therapy","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":80,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"population-based Finnish survey of adults aged 33‑43, assessing desired vs. actual frequency of various sexual activities and relationship satisfaction","sample_n":null,"sample_text":"population‑based Finnish sample (size not stated in abstract)","population":"Finnish adults (men and women) aged 33‑43, community sample","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In Finnish adults aged 33‑43, wanting more sexual activity than they actually have (especially for kissing, petting, oral sex, and intercourse) was linked to lower relationship satisfaction, while more frequent masturbation was also related to lower satisfaction.","clinical_takeaway":"Discrepancies between desired and actual sexual activity may signal relationship strain; clinicians should explore both partners' sexual desires and frequencies.","confidence":0.7,"topic_tags":["sexual_function","relationships","masturbation"],"strengths":["large community‑based sample","focus on desire‑behavior discrepancy","includes both genders"],"limitations":["no validated sexual satisfaction instrument reported","cross‑sectional; cannot infer causality","limited control for mental‑health or moral factors"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":0,"mentioning":84,"citing_publications":169,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230701620548"}},{"id":4299,"doi":"10.4103/jmu.jmu_9_18","pmid":"30065514","pmcid":"PMC6029184","title":"Role of Penile Doppler as a Diagnostic Tool in Penile Fracture","authors":"Hassali MA, Nouri AI, Hamzah AA, Verma AK.","first_author":"Hassali MA","journal":"Journal of medical ultrasound","year":2018,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Ultrasonography","Case Report","Imaging Studies","Penile Fracture"],"is_oa":true,"oa_url":"https://doi.org/10.4103/jmu.jmu_9_18","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"One patient","population":"single adult male with penile fracture","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe a single case where penile Doppler ultrasound helped diagnose a penile fracture, allowing timely surgical repair and avoiding unnecessary procedures.","clinical_takeaway":"Penile Doppler can be a useful, cost‑effective tool for confirming penile fracture before surgery.","confidence":0.6,"topic_tags":["sexual_function","gender"],"strengths":["Detailed imaging description","Clear clinical relevance for emergency diagnosis","Illustrates cost‑effective use of Doppler"],"limitations":["Single case, no comparative data","No outcome validation across multiple patients","Findings not generalizable"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/jmu.jmu_9_18"}},{"id":4300,"doi":"10.1016/j.cali.2018.01.002","pmid":"29523461","pmcid":null,"title":"[It is possible to improve the semen samples collection? A survey of opinion about different proposed non-surgical procedures]","authors":"Ramos-Brieva J.","first_author":"Ramos-Brieva J.","journal":"Journal of healthcare quality research","year":2018,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.cali.2018.01.002"}},{"id":4301,"doi":"10.1177/1474704918757551","pmid":"29478337","pmcid":"PMC10367497","title":"Do Men Produce Higher Quality Ejaculates When Primed With Thoughts of Partner Infidelity?","authors":"Pham MN, Barbaro N, Holub AM, Holden CJ, Mogilski JK, Lopes GS, Nicolas SCA, Sela Y, Shackelford TK, Zeigler-Hill V, Welling LLM.","first_author":"Pham MN","journal":"Evolutionary psychology : an international journal of evolutionary approaches to psychology and behavior","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Sperm competition","Humans","Evolutionary Psychology","Ejaculate Quality"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10367497","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"repeated-measures laboratory experiment with 45 male participants providing ejaculate samples after two priming conditions (partner infidelity vs control).","sample_n":45,"sample_text":"45 men provided two masturbatory ejaculates each (one per condition).","population":"adult men (likely university students, not specified beyond age range)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested whether men produce better-quality sperm after thinking about a partner’s infidelity. Forty‑five men gave semen samples under both the infidelity‑prime and a neutral condition. No difference in semen quality was found.","clinical_takeaway":"No evidence that short‑term psychological cues alter semen quality; no clinical implication.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["within‑subject experimental design","objective biological outcome measures","clear hypothesis derived from evolutionary theory"],"limitations":["small sample for multiple semen parameters","prime not based on validated scale","no assessment of potential confounds (e.g., mood, sexual arousal)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":10,"retracted":false,"notices":[{"status":"Has correction","date":"2018-5-1","noticeDoi":"10.1177/1474704918773152","doi":"10.1177/1474704918757551"},{"status":"Has erratum","date":"2018-4-1","noticeDoi":"10.1177/1474704918773152","doi":"10.1177/1474704918757551"}],"url":"https://scite.ai/reports/10.1177/1474704918757551"}},{"id":4302,"doi":"10.1111/j.1440-1819.1997.tb02609.x","pmid":"9472128","pmcid":null,"title":"Efficacy of lithium carbonate on public and compulsive masturbation: a female case with mild mental disability","authors":"Nishimura H, Suzuki M, Kasahara H, Ushijima S.","first_author":"Nishimura H","journal":"Psychiatry and clinical neurosciences","year":1997,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single female patient with mild intellectual disability; observational report of treatment response","sample_n":1,"sample_text":"1 patient","population":"female, 19 y, mild intellectual disability, compulsive/public masturbation","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A single 19‑year‑old woman with mild intellectual disability who performed public, compulsive masturbation improved after lithium carbonate was added to her medication regimen, while other drugs had no effect.","clinical_takeaway":"Evidence is insufficient to recommend lithium for compulsive masturbation; results are from a single case.","confidence":0.4,"topic_tags":["masturbation","sexual_function","treatment","lgbtq","neuroscience"],"strengths":["First reported case of lithium use for compulsive masturbation","Detailed clinical course"],"limitations":["N=1, no control condition","No validated measurement of compulsive masturbation","No assessment of alternative explanations (e.g., moral, mental‑health factors)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1440-1819.1997.tb02609.x"}},{"id":4304,"doi":"10.1093/jhmas/jrm044","pmid":"18065832","pmcid":null,"title":"Rethinking the history of female circumcision and clitoridectomy: American medicine and female sexuality in the late nineteenth century","authors":"Rodriguez SW.","first_author":"Rodriguez SW.","journal":"Journal of the history of medicine and allied sciences","year":2008,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical narrative article examining 19th‑century American medical discourse on female clitoral surgery and its link to notions of masturbation and sexual pathology. No primary data collection or systematic review methods reported.","sample_n":null,"sample_text":"Not applicable; analysis based on published medical texts from late 19th‑early 20th century.","population":"Not applicable (historical literature analysis).","country":"United States (historical focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how late‑19th‑century American doctors linked women’s sexual behaviors—especially masturbation—to problems with the clitoris, sometimes treating the organ with surgery. It shows the historical belief that healthy female sexuality required penetrative sex with a husband and that clitoral stimulation was deemed pathological.","clinical_takeaway":"None – the work is historical and not directly applicable to current clinical practice.","confidence":0.4,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["Provides rich historical context for medical attitudes toward female sexuality.","Integrates primary medical texts from the period."],"limitations":["No empirical data; conclusions are interpretive.","Lacks systematic methodology or bias assessment.","Does not address contemporary clinical relevance."],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jhmas/jrm044"}},{"id":4305,"doi":null,"pmid":"18265807","pmcid":null,"title":"[An imaginary disease: masturbation]","authors":"Javeau C.","first_author":"Javeau C.","journal":"Revue medicale de Bruxelles","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4306,"doi":"10.21608/epx.2018.22045","pmid":"30612384","pmcid":null,"title":"Knowledge and misconceptions of Saudi women about sexually transmitted infections","authors":"Balbeesi A, Mohizea S.","first_author":"Balbeesi A","journal":"The Journal of the Egyptian Public Health Association","year":2017,"pub_types":["Journal Article"],"keywords":["Knowledge","Women","Saudi Arabia","Sexually Transmitted Infections","Misconceptions"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive cross‑sectional survey of 843 adult Saudi women attending a dermatology clinic; random approach, anonymous pre‑validated questionnaire.","sample_n":843,"sample_text":"1150 women approached, 843 responded (73.3% response).","population":"Adult Saudi women (mean age 30.6) attending a university medical centre clinic; not a community‑based sample.","country":"Saudi Arabia","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 843 Saudi women at a Riyadh clinic showed mixed knowledge about sexually transmitted infections: most knew about HIV, but many held misconceptions (e.g., STIs spread by masturbation or contaminated beds). Higher education and income were linked to better knowledge.","clinical_takeaway":"Health education on STIs should target gaps in knowledge, especially correcting false beliefs about transmission routes.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for a survey","Use of a pre‑validated questionnaire","Random approach within clinic population","Clear reporting of response rate"],"limitations":["Clinic‑based convenience sample limits generalisability","Cross‑sectional design cannot infer causality","No power calculation or effect‑size reporting","Potential social desirability bias in self‑report"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":9,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":1,"mentioning":11,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21608/epx.2018.22045"}},{"id":4308,"doi":"10.1016/j.jsxm.2017.10.064","pmid":"29128275","pmcid":null,"title":"A Longitudinal Study of Motivations Before and Psychosexual Outcomes After Genital Gender-Confirming Surgery in Transmen","authors":"van de Grift TC, Pigot GLS, Boudhan S, Elfering L, Kreukels BPC, Gijs LACL, Buncamper ME, Özer M, van der Sluis W, Meuleman EJH, Bouman MB, Mullender MG.","first_author":"van de Grift TC","journal":"The journal of sexual medicine","year":2017,"pub_types":["Comparative Study","Journal Article"],"keywords":["Sexuality","Quality of life","Phalloplasty","Gender Dysphoria","Gender-confirming Surgery"],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"pre‑post within‑subject study of 21 transmen recruited via surgeon; standardized questionnaires at baseline and ≥1 year post‑surgery","sample_n":21,"sample_text":"21 transmen (convenience clinical sample)","population":"transmen undergoing genital gender‑confirming surgery (phalloplasty or metoidioplasty)","country":"Netherlands (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 21 transmen who had phalloplasty or metoidioplasty, researchers tracked why they chose surgery and how their sexual lives changed. One year after surgery, most were more sexually active (both masturbation and partnered sex) and used their genitals more during sex, though some still reported voiding problems and distress.","clinical_takeaway":"Genital gender‑confirming surgery can increase sexual activity and genital involvement, but clinicians should counsel patients about possible lingering complications and distress.","confidence":0.7,"topic_tags":["gender","sexual_function"],"strengths":["longitudinal within‑subject design","use of validated psychometric instruments","focus on motivations and post‑operative sexual activity"],"limitations":["very small sample (N=21)","no control/comparison group","limited statistical power, likely no effect‑size reporting"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":2,"mentioning":66,"citing_publications":100,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2017.10.064"}},{"id":4309,"doi":"10.1097/yco.0000000000000369","pmid":"28877047","pmcid":null,"title":"Autism-spectrum disorders in adolescence and adulthood: focus on sexuality","authors":"Turner D, Briken P, Schöttle D.","first_author":"Turner D","journal":"Current opinion in psychiatry","year":2017,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of studies on sexuality in autism spectrum disorder; no primary data collected.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Individuals with autism spectrum disorder (adolescents and adults).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises research on romantic and sexual life in autistic teens and adults, noting that they experience a full range of sexual behaviours, sometimes problematic, and that specialised sex‑education programmes can improve knowledge and functioning.","clinical_takeaway":"Clinicians should consider tailored sexual‑education interventions for autistic clients to reduce problematic behaviours and support healthy sexuality.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Broad overview of recent literature","Highlights need for tailored sexual education"],"limitations":["No systematic search or risk‑of‑bias assessment reported","No quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/yco.0000000000000369"}},{"id":4311,"doi":"10.1111/j.1745-7262.2007.00277.x","pmid":"17712487","pmcid":null,"title":"Semen parameters in men with spinal cord injury: changes and aetiology","authors":"Momen MN, Fahmy I, Amer M, Arafa M, Zohdy W, Naser TA.","first_author":"Momen MN","journal":"Asian journal of andrology","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational study of 45 men with spinal cord injury assessing semen parameters across different retrieval methods.","sample_n":45,"sample_text":"45 subjects with SCI","population":"Men with spinal cord injury (SCI), n=45","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In men with spinal cord injury, semen volume and count are normal, but sperm motility, vitality, and shape are reduced, especially when scrotal temperature is high.","clinical_takeaway":"Elevated scrotal temperature may impair sperm quality in SCI patients; temperature management could be considered.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Objective laboratory semen measurements","Comparison of multiple ejaculatory methods"],"limitations":["Small sample size, limited statistical power","Cross‑sectional design, cannot infer causality","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":17,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1745-7262.2007.00277.x"}},{"id":4312,"doi":"10.1007/s10508-007-9220-1","pmid":"17690970","pmcid":null,"title":"Correlates of early overt and covert sexual behaviors in heterosexual women","authors":"Bickham PJ, O'Keefe SL, Baker E, Berhie G, Kommor MJ, Harper-Dorton KV.","first_author":"Bickham PJ","journal":"Archives of sexual behavior","year":2007,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective anonymous survey of 417 heterosexual women (Kinsey-0/1) examining early same‑gender sexual experiences and adult behaviors","sample_n":417,"sample_text":"417 women from Kinsey data set","population":"adult heterosexual women (Kinsey-0/1), self‑selected survey respondents","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 417 heterosexual women found that those who experimented with other women or masturbated to female images before age 18 were more likely to engage in same‑gender sexual activities as adults, suggesting early experiences may shape later sexual interests.","clinical_takeaway":"Early same‑gender experiences may predict later adult behaviors, but the findings are correlational and do not imply causation.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a sexuality survey","Focus on early developmental timing","Clear operational definitions of early vs. adult behaviors"],"limitations":["Self‑report, retrospective, possible recall bias","No validated scales for constructs","No control for moral, mental‑health or relationship variables","Causal language despite cross‑sectional design"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":3,"contrasting":0,"mentioning":17,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-007-9220-1"}},{"id":4313,"doi":"10.1200/jco.2016.70.4767","pmid":"28976795","pmcid":"PMC5707206","title":"Prevalence and Predictors of Sperm Banking in Adolescents Newly Diagnosed With Cancer: Examination of Adolescent, Parent, and Provider Factors Influencing Fertility Preservation Outcomes","authors":"Klosky JL, Wang F, Russell KM, Zhang H, Flynn JS, Huang L, Wasilewski-Masker K, Landier W, Leonard M, Albritton KH, Gupta AA, Casillas J, Colte P, Kutteh WH, Schover LR.","first_author":"Klosky JL","journal":"Journal of clinical oncology : official journal of the American Society of Clinical Oncology","year":2017,"pub_types":["research-article","Multicenter Study","Journal Article","Observational Study"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":60,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective single-group observational cohort of 146 adolescent males from multiple pediatric oncology centers","sample_n":146,"sample_text":"N = 146 participants","population":"Adolescent males (13‑22 y) newly diagnosed with cancer, Tanner ≥ 3, across US and Canada","country":"United States, Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 146 teenage cancer patients, about half tried to bank sperm and 44% succeeded. Seeing a fertility specialist, parental and doctor recommendations, higher puberty stage, a history of masturbation, and confidence in banking all increased the odds of attempting and completing sperm banking.","clinical_takeaway":"Early counseling by fertility specialists and supportive recommendations from parents and providers boost sperm‑banking uptake in adolescent cancer patients.","confidence":0.8,"topic_tags":["adolescents","csbd","sexual_function"],"strengths":["Large, multi‑center sample of a hard‑to‑reach population","Prospective data collection within one week of diagnosis","Use of multivariable logistic regression with confidence intervals"],"limitations":["Self‑report measures without reported validation","No assessment of moral or mental‑health confounders","Cross‑sectional prediction of banking attempt, no long‑term follow‑up"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":96,"citing_publications":82,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1200/jco.2016.70.4767"}},{"id":4314,"doi":"10.5935/1984-0063.20170026","pmid":"29410746","pmcid":"PMC5760048","title":"Subjective sleep quality, unstimulated sexual arousal, and sexual frequency","authors":"Costa R, Costa D, Pestana J.","first_author":"Costa R","journal":"Sleep science (Sao Paulo, Brazil)","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Sleep","Coitus","Sexual Dysfunctions, Psychological"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5760048","cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 275 Portuguese adults assessing self‑reported sleep quality, unstimulated sexual arousal, satisfaction, desire and frequency; includes testosterone assay.","sample_n":275,"sample_text":"275 participants (both sexes) recruited in Portugal.","population":"Adults (both sexes) from Portugal; convenience sample; n=275 (169 women).","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 275 Portuguese adults, poorer subjective sleep quality was linked to higher self‑reported sexual arousal when resting, especially in those with higher testosterone, but it did not affect desire or how often they had sex.","clinical_takeaway":"Sleep problems may increase spontaneous sexual arousal, but they do not appear to change sexual desire or activity frequency.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Validated sleep and sexual function questionnaires","Inclusion of biological measure (testosterone)","Relatively large sample for a survey","Separate reporting for men and women"],"limitations":["Cross‑sectional design precludes causal inference","Unstimulated arousal measured by single‑item self‑report","No control for moral/religious factors or partner context","Potential self‑selection bias in volunteer sample"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":25,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5935/1984-0063.20170026"}},{"id":4315,"doi":"10.1080/00926230701385548","pmid":"17541850","pmcid":null,"title":"Women's relationship quality is associated with specifically penile-vaginal intercourse orgasm and frequency","authors":"Costa RM, Brody S.","first_author":"Costa RM","journal":"Journal of sex & marital therapy","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":83,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross‑sectional survey of 30 Portuguese women reporting sexual‑behaviour frequencies and relationship quality","sample_n":30,"sample_text":"30 Portuguese women","population":"30 adult women (Portugal), convenience sample","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 30 Portuguese women, more frequent penile‑vaginal sex and orgasm were linked to higher scores on relationship satisfaction, intimacy, trust, passion and love, while masturbation frequency was linked to lower love scores.","clinical_takeaway":"Higher partnered intercourse frequency and orgasm are associated with better perceived relationship quality; masturbation frequency may relate to lower love perception.","confidence":0.8,"topic_tags":["relationships","sexual_function","masturbation"],"strengths":["Use of validated PRQC inventory","Measured social desirability to test confounding","Separate assessment of masturbation frequency"],"limitations":["Small, non‑representative sample (N=30)","Cross‑sectional; no causal inference","Limited control of key psychosocial confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":27,"contrasting":1,"mentioning":134,"citing_publications":147,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230701385548"}},{"id":4316,"doi":"10.1097/chi.0b013e318059360a","pmid":"17581441","pmcid":null,"title":"Excessive masturbation and hypersexual behavior associated with methylphenidate","authors":"Bilgiç A, Gürkan K, Türkoğlu S.","first_author":"Bilgiç A","journal":"Journal of the American Academy of Child and Adolescent Psychiatry","year":2007,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/chi.0b013e318059360a"}},{"id":4317,"doi":"10.1093/sleep/30.6.683","pmid":"17580590","pmcid":"PMC1978350","title":"Sleep and sex: what can go wrong? A review of the literature on sleep related disorders and abnormal sexual behaviors and experiences","authors":"Schenck CH, Arnulf I, Mahowald MW.","first_author":"Schenck CH","journal":"Sleep","year":2007,"pub_types":["review-article","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":114,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of case reports of sleep‑related sexual behaviors; no new empirical data collected","sample_n":null,"sample_text":"31 parasomnia cases and 7 seizure cases identified from the literature","population":"human case reports (mostly adults with parasomnias or sleep‑related seizures)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors reviewed case reports of sleep disorders that lead to abnormal sexual behaviors, such as sleepwalking‑related masturbation or seizures causing sexual activity. They classified the conditions, described the clinical features, and noted treatment responses where reported.","clinical_takeaway":"Sleep‑related sexual behaviors can have serious legal and health consequences; clinicians should assess sleep disorders when encountering unexplained nocturnal sexual activity.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Comprehensive aggregation of rare case reports","Clear clinical classification of sleep‑related sexual behaviors"],"limitations":["No systematic search methodology reported","No quantitative synthesis or meta‑analysis","Reliance on heterogeneous case reports with small numbers"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":4,"contrasting":0,"mentioning":143,"citing_publications":237,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sleep/30.6.683"}},{"id":4318,"doi":"10.1016/j.jsxm.2017.08.007","pmid":"28916405","pmcid":null,"title":"Love Death-A Retrospective and Prospective Follow-Up Mortality Study Over 45 Years","authors":"Lange L, Zedler B, Verhoff MA, Parzeller M.","first_author":"Lange L","journal":"The journal of sexual medicine","year":2017,"pub_types":["Journal Article"],"keywords":["Myocardial infarction","Autopsy","Cerebral hemorrhage","Sexual activity","Sudden Natural Death","Circumstances Of Death"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective medicolegal autopsy case series of 99 natural deaths linked to sexual activity over 45 years.","sample_n":99,"sample_text":"99 cases identified from ~38,000 autopsies (0.26%).","population":"Adults (mostly male) who died naturally during or after sexual activity, identified via forensic autopsies in Germany.","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined 99 cases of natural death that occurred during or after sexual activity over 45 years in Germany, finding most were men with heart disease, often during encounters with prostitutes or masturbation.","clinical_takeaway":"Clinicians should counsel patients with cardiovascular risk about potential strain during sexual activity.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["Largest forensic series on sexual‑activity‑related deaths","Long 45‑year span provides historical breadth"],"limitations":["Retrospective case series; no control group","No systematic measurement of health or behavioral confounds","Potential selection bias toward forensic cases"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2017.08.007"}},{"id":4319,"doi":"10.1080/02673843.2017.1371613","pmid":"30101040","pmcid":"PMC6068543","title":"Good girls and boys: findings from a cross-sectional survey on adolescent rights, relationships, and sexuality in an urban informal settlement in India","authors":"Daruwalla N, Mishra T, Karandikar N, Pantvaidya S, Osrin D.","first_author":"Daruwalla N","journal":"International journal of adolescence and youth","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","India","Poverty areas","Adolescent","Mumbai"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6068543","cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 2005 adolescents selected by two‑stage probability proportional to size sampling in an urban informal settlement in Mumbai, India.","sample_n":2005,"sample_text":"2005 adolescents interviewed using a structured questionnaire.","population":"Adolescents aged 10‑19 years living in an urban informal settlement (Mumbai, India).","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2018 survey of 2005 adolescents in a Mumbai slum asked about gender equity, sexual norms and attitudes toward things like masturbation and coercion. Most supported gender equality, but many disapproved of premarital sex and masturbation. Few felt pressured to be sexually active.","clinical_takeaway":"None – the study reports attitudes, not clinical or behavioural outcomes.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, probability‑based sample","Focus on adolescent attitudes in a hard‑to‑reach population","Comprehensive range of topics (rights, gender, sexual coercion)"],"limitations":["Questionnaire not reported as validated","Cross‑sectional, cannot infer causal relations","No measurement of actual sexual behaviour"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/02673843.2017.1371613"}},{"id":4321,"doi":"10.1530/edm-17-0082","pmid":"28883919","pmcid":"PMC5581370","title":"A case of Klinefelter syndrome with hypersexual desire","authors":"Okolie K, Perampalam S, Barker A, Nolan CJ.","first_author":"Okolie K","journal":"Endocrinology, diabetes & metabolism case reports","year":2017,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5581370","cited_by_count":1,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"n=1 (case report)","population":"single 44‑year‑old male with Klinefelter syndrome","country":"United Kingdom (assumed from author affiliations, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A 44‑year‑old man with Klinefelter syndrome and low testosterone reported very high sexual desire, frequent masturbation, many casual partners, and a past sexual offence. The authors discuss how hypersexuality can occur despite hypogonadism and advise caution with testosterone therapy.","clinical_takeaway":"Hypersexuality can co‑occur with low testosterone in Klinefelter syndrome; testosterone treatment should be managed carefully with multidisciplinary input.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides detailed clinical description of a rare presentation","Highlights potential endocrine‑behavior link"],"limitations":["Single case, no systematic assessment","No validated measures of hypersexuality","No control or comparison group"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1530/edm-17-0082"}},{"id":4322,"doi":"10.1016/j.jsxm.2017.06.013","pmid":"28807505","pmcid":null,"title":"Delayed Ejaculation and Associated Complaints: Relationship to Ejaculation Times and Serum Testosterone Levels","authors":"Morgentaler A, Polzer P, Althof S, Bolyakov A, Donatucci C, Ni X, Patel AB, Basaria S.","first_author":"Morgentaler A","journal":"The journal of sexual medicine","year":2017,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":["Testosterone level","Ejaculatory Dysfunction","Delayed Ejaculation","Ejaculation Time"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Large convenience sample (n≈988) of men screened for a testosterone RCT; observational comparison of self‑reported IELT and MELT between those reporting delayed ejaculation and those who did not.","sample_n":988,"sample_text":"988 men screened for possible inclusion in a randomized trial; self‑selected insofar as they volunteered for a study on ejaculatory dysfunction.","population":"Adult men (heterosexual) from US, Canada, Mexico","country":"United States; Canada; Mexico","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In about 1,000 men, those who said they had delayed ejaculation reported longer times to orgasm during intercourse and masturbation, but these longer times were not linked to their blood testosterone levels.","clinical_takeaway":"Routine testosterone testing is not warranted for men whose main complaint is delayed ejaculation.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a sexual function study","Both vaginal and masturbatory latency times measured","Direct testosterone assays"],"limitations":["Self‑estimated latency times, not objective timing","Cross‑sectional, cannot infer causality","No validated DE questionnaire used"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2017.06.013"}},{"id":4323,"doi":"10.1177/2325957417724205","pmid":"28791913","pmcid":null,"title":"Examining Sexual Function Among Individuals With HIV in a Midwestern US Urban Outpatient Clinic Setting","authors":"Shacham E, López JD, Souza P, Overton ET.","first_author":"Shacham E","journal":"Journal of the International Association of Providers of AIDS Care","year":2017,"pub_types":["Journal Article"],"keywords":["Depression","Sexual function","HIV/AIDS","Hiv Management"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 202 HIV‑positive outpatients (2009) examining sexual function, biomedical markers and depressive symptoms; comparisons made with normative and cancer‑survivor cohorts","sample_n":202,"sample_text":"202 patients with HIV recruited in 2009","population":"Adults with HIV infection attending a Midwestern US urban outpatient clinic (N≈202)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 202 HIV‑positive patients, sexual function was lower than in the general population, especially when viral loads were not suppressed. Better overall health and lower depression were linked to better arousal and interest. Masturbation scores were not reduced.","clinical_takeaway":"Clinicians should assess sexual function in HIV care, as poorer function is tied to unsuppressed virus and depressive symptoms.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a clinic‑based study","Uses validated sexual‑function subscales","Examines biomedical and psychosocial correlates"],"limitations":["Cross‑sectional design limits causal inference","Convenience clinic sample may not generalise to broader HIV population","No detailed reporting of effect sizes or confidence intervals"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":29,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/2325957417724205"}},{"id":4325,"doi":"10.2466/pr0.1996.79.2.499","pmid":"8909074","pmcid":null,"title":"High schoolers masturbatory practices: their relationship to sexual intercourse and personal characteristics","authors":"Smith AM, Rosenthal DA, Reichler H.","first_author":"Smith AM","journal":"Psychological reports","year":1996,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire of 436 suburban Australian high‑school students (ages 15‑18).","sample_n":436,"sample_text":"436 suburban Australian adolescents (15‑18 y).","population":"Adolescents, school‑based convenience sample, Australia, 1996.","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1996 survey of 436 Australian high‑school students found that more boys than girls reported masturbating, and that frequent masturbation was linked to higher sexual self‑esteem. Parental openness about sexuality was associated with higher reports of masturbatory activity.","clinical_takeaway":"None – the study describes typical adolescent behaviour and does not inform clinical practice.","confidence":0.8,"topic_tags":["masturbation","adolescents","sexual_function"],"strengths":["Large sample for 1996 adolescent study","Includes both boys and girls","Considers parental communication context"],"limitations":["Self‑report, single‑item measures of masturbation","Cross‑sectional; no causal inference","No assessment of mental‑health or moral/religious factors"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2466/pr0.1996.79.2.499"}},{"id":4327,"doi":"10.1177/1039856217715997","pmid":"28714321","pmcid":null,"title":"Zoophilia in an adolescent with high-functioning autism from Sri Lanka","authors":"Chandradasa M, Champika L.","first_author":"Chandradasa M","journal":"Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists","year":2017,"pub_types":["Journal Article","Case Reports"],"keywords":["Adolescent","Sri Lanka","Traditional medicine","Autistic Disorder","Paraphilic Disorders"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single adolescent with autism exhibiting zoophilic behavior; descriptive clinical narrative, no systematic sampling.","sample_n":1,"sample_text":"single case","population":"1 male adolescent (17 y) with high‑functioning autism from Sri Lanka","country":"Sri Lanka","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 17‑year‑old boy with autism in Sri Lanka displayed intense sexual interest in cattle, leading to distress and academic problems. He was treated with psychotherapy and an SSRI. The authors suggest his social difficulties may have contributed to this rare paraphilic behavior.","clinical_takeaway":"Clinicians should be aware that autistic adolescents may develop atypical sexual interests that cause distress and may benefit from combined behavioral and pharmacological interventions.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed clinical description","Highlights a rare association","Considers psychosocial context"],"limitations":["Single case; no generalisability","No validated measurement of sexual urges or distress","No systematic assessment of confounds"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1039856217715997"}},{"id":4328,"doi":"10.1111/j.1365-2214.1996.tb00434.x","pmid":"8879757","pmcid":null,"title":"Masturbation in prepubescent children: a case report and review of the literature","authors":"Finkelstein E, Amichai B, Jaworowski S, Mukamel M.","first_author":"Finkelstein E","journal":"Child: care, health and development","year":1996,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single 10‑year‑old girl plus narrative review","sample_n":1,"sample_text":"single case report","population":"pre‑pubescent child (single case) and literature citations","country":"unspecified (likely Israel, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 10‑year‑old girl’s episodes of flushing and weakness were initially investigated for carcinoid syndrome, but were found to be caused by masturbation, a normal behaviour at any age. The report warns clinicians to consider this before ordering unnecessary tests.","clinical_takeaway":"Clinicians should recognise that masturbation can cause physiological symptoms in children and avoid unnecessary invasive investigations.","confidence":0.9,"topic_tags":["masturbation","prevalence","pornography","sexual_function"],"strengths":["Highlights a rare clinical presentation","Provides practical reminder to clinicians"],"limitations":["Single case, no systematic data","No validated measures or statistical analysis","Findings not generalisable"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2214.1996.tb00434.x"}},{"id":4329,"doi":"10.1016/j.esxm.2017.04.001","pmid":"28709890","pmcid":"PMC5562495","title":"A Novel Collaborative Protocol for Successful Management of Penile Pain Mediated by Radiculitis of Sacral Spinal Nerve Roots From Tarlov Cysts","authors":"Goldstein I, Komisaruk BR, Rubin RS, Goldstein SW, Elliott S, Kissee J, Kim CW.","first_author":"Goldstein I","journal":"Sexual medicine","year":2017,"pub_types":["Journal Article","case-report"],"keywords":["Tarlov Cyst","Neurogenic Sexual Dysfunction","Penile Pain","Radiculitis Of Sacral Spinal Nerve Root"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5562495","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Single patient case report describing diagnostic and therapeutic collaboration for penile pain associated with sacral Tarlov cysts.","sample_n":1,"sample_text":"One patient (case report).","population":"Male, 21 years old, with chronic masturbation‑triggered penile pain.","country":"USA (inferred from author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 21‑year‑old man with severe penile pain during masturbation was successfully treated after doctors linked the pain to sacral Tarlov cysts and performed targeted spinal injections and surgery.","clinical_takeaway":"Consider spinal pathology (e.g., Tarlov cysts) in refractory penile pain during arousal; multidisciplinary assessment may help.","confidence":0.5,"topic_tags":["sexual_function","gender","neuroscience","pornography"],"strengths":["Innovative multidisciplinary collaboration","Detailed clinical description","Objective imaging evidence of Tarlov cysts"],"limitations":["Single case; no generalisability","No validated pain or sexual function scales","No control/comparison group"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2017.04.001"}},{"id":4330,"doi":"10.1007/bf02437582","pmid":"8836472","pmcid":null,"title":"Masturbation prohibition in sex offenders: a crossover study","authors":"Brown CM, Traverso G, Fedoroff JP.","first_author":"Brown CM","journal":"Archives of sexual behavior","year":1996,"pub_types":["Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"crossover randomized controlled trial with 17 outpatient pedophilic males, 30‑day abstinence vs. no restriction, weekly self‑report of urges","sample_n":17,"sample_text":"17 participants","population":"adult male sex offenders (pedophiles), outpatient treatment setting","country":"USA (presumed from authors/institution, not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small crossover trial, pedophilic men who tried not masturbating for a month did not report fewer or weaker sexual urges than when they continued as usual.","clinical_takeaway":"Mandating masturbation abstinence is not supported as a way to reduce pedophilic fantasies.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Randomized crossover design","Direct measurement of the specific behavior of interest"],"limitations":["Very small sample (N=17) limits power","Reliance on unvalidated self‑report scales","No control for known confounds (e.g., mental health, trauma, moral attitudes)"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02437582"}},{"id":4331,"doi":"10.1038/ijir.2017.24","pmid":"28659630","pmcid":null,"title":"Relationship between sexual position and severity of penile fracture","authors":"Barros R, Schulze L, Ornellas AA, Koifman L, Favorito LA.","first_author":"Barros R","journal":"International journal of impotence research","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective case series of 90 penile‑fracture patients; sexual position recorded from history; severity compared with chi‑square tests.","sample_n":90,"sample_text":"90 patients with penile fracture","population":"Male patients with penile fracture treated in Brazil (n=90, ages 18‑66).","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 90 men with penile fractures, injuries that occurred during \"doggy style\" sex were more often severe than those during \"woman‑on‑top\" or simple penile manipulation, while \"man‑on‑top\" showed similar severity to \"doggy style\".","clinical_takeaway":"Specific sexual positions may influence fracture severity; clinicians should consider position in injury assessment.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Clear definition of sexual‑position categories","Use of an objective clinical outcome (fracture severity)","Reasonable sample size for a rare injury"],"limitations":["Retrospective design, potential recall bias on position","No validated severity scale described","No adjustment for confounders (e.g., age, force of impact)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":32,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/ijir.2017.24"}},{"id":4332,"doi":null,"pmid":"17877297","pmcid":null,"title":"Brain areas activated after ejaculation in healthy young human subjects","authors":"Mallick HN, Tandon S, Jagannathan NR, Gulia KK, Kumar VM.","first_author":"Mallick HN","journal":"Indian journal of physiology and pharmacology","year":2007,"pub_types":["Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subject fMRI study of healthy young men; brain activation recorded for 30 min after ejaculation induced by masturbation.","sample_n":null,"sample_text":"Not specified in abstract; likely a small convenience sample.","population":"young adult males (healthy volunteers)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","fmri_reverse_inference"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small fMRI study, researchers recorded brain activity after men ejaculated during masturbation and found activation in the amygdala, temporal lobes and septal area, suggesting these regions may be involved in the post‑ejaculatory refractory period.","clinical_takeaway":"No direct clinical implications; findings are preliminary and based on limited data.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","religiosity","masturbation"],"strengths":["First fMRI mapping of post‑ejaculatory brain activity.","Identifies temporal sequence of activation in specific regions."],"limitations":["Small, unspecified sample; likely under‑powered.","No correction for multiple comparisons reported.","Interpretation infers inhibition from activation (reverse inference).","No assessment of potential confounds (mood, sexual experience, etc.)."],"rubric_version":"2.0","raw_total":17,"max_possible":60,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":3,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":4333,"doi":"10.1016/j.juro.2006.08.071","pmid":"17162053","pmcid":null,"title":"Ejaculation latency times and their relationship to penile sensitivity in men with normal sexual function","authors":"Vanden Broucke H, Everaert K, Peersman W, Claes H, Vanderschueren D, Van Kampen M.","first_author":"Vanden Broucke H","journal":"The Journal of urology","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional measurement study with repeated ELT and sensitivity assessments in 58 healthy volunteers (20‑40 y)","sample_n":58,"sample_text":"58 volunteers, ages 20‑40, recruited as normal sexual function participants","population":"healthy adult men, convenience sample","country":"unspecified (likely Belgium/Netherlands based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 58 healthy men, ejaculation took longer during intercourse than during lab or home masturbation. Penile sensitivity measured with vibrometers was reliable but did not predict how long men lasted before ejaculating.","clinical_takeaway":"Penile sensitivity does not appear to influence ejaculation timing in men with normal sexual function.","confidence":0.85,"topic_tags":["sexual_function","masturbation"],"strengths":["Objective, validated instruments for ELT and sensitivity","High test‑retest reliability reported","Within‑subject comparisons across conditions"],"limitations":["Small, non‑representative convenience sample","No power analysis or confidence intervals for key correlations","Limited control of psychological or relational confounds"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":2,"mentioning":32,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.juro.2006.08.071"}},{"id":4334,"doi":"10.1080/00926230600998458","pmid":"17162486","pmcid":null,"title":"Intercourse orgasm consistency, concordance of women's genital and subjective sexual arousal, and erotic stimulus presentation sequence","authors":"Brody S.","first_author":"Brody S.","journal":"Journal of sex & marital therapy","year":2007,"pub_types":["Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory psychophysiology study with 27 young Dutch women; between‑subject comparisons of stimulus‑presentation sequences; within‑subject measurements of vaginal pulse amplitude and subjective arousal.","sample_n":27,"sample_text":"N = 27 Dutch women, mean age 20, all with current partners","population":"young adult women (mean age 20) with current partners, convenience sample","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 27 Dutch women, the study found that women who consistently orgasm during intercourse showed a tighter link between genital responses and how aroused they felt, but this link did not appear for masturbation. The effect depended on how erotic images were presented.","clinical_takeaway":"Orgasm consistency during intercourse may reflect better alignment of bodily and subjective arousal; clinicians might consider this when addressing sexual dissatisfaction.","confidence":0.6,"topic_tags":["sexual_function","gender"],"strengths":["Physiological measure (vaginal pulse amplitude) provides objective data","Within‑subject design compares multiple stimulus sequences","Replication of prior findings with a different age group"],"limitations":["Very small sample (N=27) limits statistical power","Convenience sample of university‑age women reduces generalizability","No control for potential confounds (e.g., mood, relationship quality)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":12,"contrasting":0,"mentioning":44,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230600998458"}},{"id":4335,"doi":"10.1353/sex.2007.0065","pmid":"19244690","pmcid":null,"title":"Masturbation, salvation, and desire: connecting sexuality and religiosity in colonial Mexico","authors":"Tortorici Z.","first_author":"Tortorici Z.","journal":"Journal of the history of sexuality","year":2007,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1353/sex.2007.0065"}},{"id":4336,"doi":null,"pmid":"8766992","pmcid":null,"title":"[Childhood masturbation--a genetic viewpoint, especially in anorexia and bulimia nervosa]","authors":"Binswanger R.","first_author":"Binswanger R.","journal":"Psyche","year":1996,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case reports from author's clinical practice; no systematic sampling","sample_n":null,"sample_text":"Not applicable – case reports, no aggregate N provided","population":"children (preschool to adolescent) observed in therapeutic context; sample size not reported","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The author proposes that how parents react to a child’s masturbation may shape later psychological issues, linking certain parental attitudes to eating‑disorder symptoms, based on illustrative clinical cases.","clinical_takeaway":"No direct clinical guidance; the ideas are speculative and not evidence‑based.","confidence":0.8,"topic_tags":["masturbation","neuroscience","sexual_function"],"strengths":["Provides a historical psychoanalytic perspective","Highlights potential role of parental reactions"],"limitations":["No empirical data or validated measures","Case reports limit generalizability","No control of key confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":4338,"doi":"10.1516/9wlf-lf8a-1d4p-c9je","pmid":"17130084","pmcid":null,"title":"All holes are the same: emerging from the confusion","authors":"Nunes VS.","first_author":"Nunes VS.","journal":"The International journal of psycho-analysis","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report describing a single adult male with a psychoanalytic formulation linking anal/genital masturbation and excretory fantasies; no systematic data collection.","sample_n":null,"sample_text":"One patient (case report)","population":"Adult male (single case); not representative","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"A psychoanalytic case report describes a man whose adult fantasies mix excretory activities, masturbation, and aggression, suggesting a primitive libidinal pattern that the author interprets as a developmental defense.","clinical_takeaway":"No direct clinical guidance; the report is theoretical and not evidence‑based.","confidence":0.6,"topic_tags":["masturbation","sexual_function","pornography"],"strengths":["Detailed clinical vignette","Explores a rare psychoanalytic construct"],"limitations":["Single case, no empirical data","Unvalidated, theory‑driven constructs","No measurement of confounding variables"],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1516/9wlf-lf8a-1d4p-c9je"}},{"id":4339,"doi":"10.1111/j.1464-410x.2006.06646.x","pmid":"17155977","pmcid":null,"title":"The effect of male circumcision on sexuality","authors":"Kim D, Pang MG.","first_author":"Kim D","journal":"BJU international","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":73,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"prospective questionnaire study comparing circumcised vs uncircumcised men and before‑after reports; no randomisation","sample_n":373,"sample_text":"373 sexually active men, 255 circumcised, 118 uncircumcised; 138 circumcised men reported pre‑circumcision sexual activity","population":"adult men (>20 y) in Korea; n = 373 (255 circumcised, 118 uncircumcised)","country":"Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a questionnaire of 373 Korean men, those who had adult circumcision reported similar erections and ejaculation to uncircumcised men, but many said their masturbatory pleasure and overall sexual enjoyment decreased after the surgery.","clinical_takeaway":"Adult circumcision may reduce masturbatory pleasure for some men; discuss potential sexual effects before surgery.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Large sample for a surgical cohort","Use of a validated sexual function inventory"],"limitations":["Ad‑hoc pleasure items lack validation","No control for mental health, relationship or trauma","Observational design limits causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":95,"citing_publications":118,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1464-410x.2006.06646.x"}},{"id":4340,"doi":"10.1080/0092623x.2017.1321600","pmid":"28430028","pmcid":null,"title":"Attitudes Toward, and Use of, Vibrators in China","authors":"Jing S, Lay A, Weis L, Furnham A.","first_author":"Jing S","journal":"Journal of sex & marital therapy","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire study with 235 Chinese women (16–58 y) exploring masculine trait scores, attitudes toward vibrator use, actual use and frequency.","sample_n":235,"sample_text":"235 females aged 16‑58 years","population":"Chinese women, community sample (convenience recruitment)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 235 Chinese women, those who scored higher on traditional masculine traits held more positive attitudes toward using vibrators, were more likely to have used one, and reported using it more often. Attitudes helped explain the link between masculinity and vibrator use.","clinical_takeaway":"Clinicians should recognize that gender‑role beliefs may influence women's openness to and frequency of vibrator use, but the study does not address any health risks or benefits.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function","gender","csbd"],"strengths":["Relatively large sample for a single‑country study","Examines understudied topic of vibrator use in China","Uses path analysis to test indirect effects"],"limitations":["Reliance on self‑report measures of unknown psychometric quality","Cross‑sectional design cannot infer causality","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2017.1321600"}},{"id":4342,"doi":"10.4088/pcc.16l02057","pmid":"28564515","pmcid":null,"title":"Autoerotic Asphyxiation: A Case Report","authors":"Ha R, Lee A, Kim KY.","first_author":"Ha R","journal":"The primary care companion for CNS disorders","year":2017,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/pcc.16l02057"}},{"id":4344,"doi":"10.1093/humrep/del375","pmid":"17000650","pmcid":null,"title":"Parental desire and acceptability of spermatogonial stem cell cryopreservation in boys with cancer","authors":"van den Berg H, Repping S, van der Veen F.","first_author":"van den Berg H","journal":"Human reproduction (Oxford, England)","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":50,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of parents (N≈200 respondents) asked about acceptability of SSC biopsy, hemicastration, and sperm collection via masturbation; cross‑sectional questionnaire with 63% response rate.","sample_n":200,"sample_text":"318 parents invited; 63 % responded (~200).","population":"Parents of boys who survived ≥2 years after a childhood cancer diagnosis (UK/Netherlands sites, 2007).","country":"Netherlands / United Kingdom (as per journal affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Most parents of boys who survived childhood cancer say they would allow a testicular biopsy to freeze stem cells for future fertility, while fewer support the more invasive hemicastration. About 70 % would permit sperm collection by masturbation.","clinical_takeaway":"None – the study informs parental attitudes toward fertility preservation, not clinical treatment of sexual health problems.","confidence":0.7,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Large target population (parents of childhood cancer survivors).","Relevant clinical question about future fertility preservation.","Clear reporting of response rates and percentages."],"limitations":["No validated questionnaire for acceptability.","Potential response bias; 37 % non‑responders.","Cross‑sectional; cannot infer changes over time.","No control for socioeconomic or cultural factors."],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":28,"citing_publications":73,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/humrep/del375"}},{"id":4345,"doi":"10.1080/0092623x.2017.1314397","pmid":"28368687","pmcid":null,"title":"Self-Transcendence, Sexual Desire, and Sexual Frequency","authors":"Costa RM, Pestana J, Costa D.","first_author":"Costa RM","journal":"Journal of sex & marital therapy","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study with 261 Portuguese adults","sample_n":261,"sample_text":"261 participants (men and women) recruited from the general population","population":"adult men and women, Portugal","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 261 Portuguese adults, a personality trait called self‑forgetfulness was linked to higher desire for sex and, for men, to more frequent intercourse and non‑coital sex. Women’s self‑forgetfulness related to how often they wanted sex.","clinical_takeaway":"Self‑forgetfulness may relate to sexual desire and activity, but no clinical implications are drawn.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of validated self‑forgetfulness scale","Reasonable sample size for correlational work","Separate assessment of masturbation frequency"],"limitations":["Cross‑sectional design limits causal inference","Frequency measures are ad‑hoc and not validated","No control for moral or mental‑health variables"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2017.1314397"}},{"id":4346,"doi":"10.1590/s1677-5538.ibju.2016.0468","pmid":"28266821","pmcid":"PMC5462141","title":"Randomized Crossover Trial of Amoxapine Versus Vitamin B12 for Retrograde Ejaculation","authors":"Hu J, Nagao K, Tai T, Kobayashi H, Nakajima K.","first_author":"Hu J","journal":"International braz j urol : official journal of the Brazilian Society of Urology","year":2017,"pub_types":["Comparative Study","research-article","Randomized Controlled Trial","Journal Article"],"keywords":["Drug therapy","Ejaculation","Infertility, Male"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5462141","cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized crossover trial with 26 men (25 completed) comparing amoxapine vs vitamin B12 for retrograde ejaculation","sample_n":25,"sample_text":"26 enrolled, 25 completed","population":"men with retrograde ejaculation (average age not given)","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small crossover trial, amoxapine helped most men with retrograde ejaculation produce normal ejaculate, while vitamin B12 was far less effective. Side‑effects were mild.","clinical_takeaway":"Amoxapine may be considered for retrograde ejaculation, but evidence is limited by the small, open‑label study.","confidence":0.8,"topic_tags":["sexual_function","treatment","religiosity","masturbation"],"strengths":["Randomized crossover design reduces between‑subject variability","Clear, clinically relevant primary outcome","Low dropout rate"],"limitations":["Very small sample size (N=25) limits precision","Open‑label, no blinding","Outcome relies on self‑report without objective verification"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s1677-5538.ibju.2016.0468"}},{"id":4347,"doi":"10.1590/s1677-5538.ibju.2016.0164","pmid":"27649105","pmcid":"PMC5462149","title":"Unusual intravesical foreign body in young female migrated from vagina due to autoerotism","authors":"Bansal A, Kumar M, Kanodia G, Aeron R, Goel S.","first_author":"Bansal A","journal":"International braz j urol : official journal of the Brazilian Society of Urology","year":2017,"pub_types":["other","Journal Article","Case Reports"],"keywords":["Urogenital system","Urinary bladder","Vagina"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5462149","cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s1677-5538.ibju.2016.0164"}},{"id":4350,"doi":null,"pmid":"9170069","pmcid":null,"title":"Masturbation fantasies in a prelatency girl: early female body fantasy conflicts as a major determinant in the experience of primary femininity","authors":"Pelaccio J.","first_author":"Pelaccio J.","journal":"Journal of the American Psychoanalytic Association","year":1996,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single psychoanalytic case study of a preschool girl with no systematic sampling","sample_n":1,"sample_text":"1 child (pre‑latency girl) described in a psychoanalytic case report","population":"preschool girl (single case)","country":"United States (assumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A psychoanalytic case report describes how a preschool girl’s early bodily sensations shaped erotic fantasies used during masturbation, linking these fantasies to anxiety about genital injury.","clinical_takeaway":"None – the single case offers no actionable guidance for clinicians.","confidence":0.8,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Detailed qualitative description of early female erotic fantasy","Highlights a rarely studied developmental phenomenon"],"limitations":["Single case; no generalizability","No validated measurement tools","No control of confounding factors"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":4351,"doi":null,"pmid":"8789164","pmcid":null,"title":"A psychoanalytical theory of 'drug addiction': unconscious fantasies of homosexuality, compulsions and masturbation within the context of traumatogenic processes","authors":"Hopper E.","first_author":"Hopper E.","journal":"The International journal of psycho-analysis","year":1995,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case reports / theoretical psychoanalytic exposition","sample_n":null,"sample_text":"several drug addicts described in psychoanalytic case material","population":"male drug addicts (case series)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"avoid","plain_summary":"The paper proposes a psychoanalytic view that drug addiction stems from unconscious homosexual fantasies and a compulsion to masturbate, linking these to traumatic life experiences, but offers no empirical data.","clinical_takeaway":"None – the article provides theoretical speculation only, not evidence for clinical practice.","confidence":0.4,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Integrates trauma and sexual fantasy into addiction theory","Provides rich clinical case illustrations"],"limitations":["No empirical measurement or validation","Relies on psychoanalytic speculation without systematic data","Lacks control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":60,"pct_score":15,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":1,"interpretation":2}},"scite":null},{"id":4352,"doi":"10.1016/j.pcl.2016.11.002","pmid":"28292447","pmcid":"PMC5517036","title":"Talking to Parents About Adolescent Sexuality","authors":"Ashcraft AM, Murray PJ.","first_author":"Ashcraft AM","journal":"Pediatric clinics of North America","year":2017,"pub_types":["research-article","Review","Journal Article"],"keywords":["Sexuality","Parent","Prevention","Communication","Adolescent"],"is_oa":false,"oa_url":null,"cited_by_count":49,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review / guidance article without original empirical data","sample_n":null,"sample_text":"Not applicable – article is a review/guidance piece","population":"parents and adolescents (general, not a specific study sample)","country":"United States (journal based, authors affiliated likely US)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article offers pediatric doctors advice on how to help parents talk more openly and effectively with their teens about sexuality topics like masturbation, contraception, and relationships.","clinical_takeaway":"Clinicians can use the suggested talking points and resources to support parents in improving sex‑education conversations with adolescents.","confidence":0.85,"topic_tags":["adolescents","sexual_function"],"strengths":["Provides practical communication guidance for clinicians","Covers a range of adolescent sexual health topics","Cites existing best‑practice literature"],"limitations":["No original data or systematic review methodology","No empirical evaluation of recommendations","Limited applicability to pornography‑related pathology debates"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":3,"contrasting":0,"mentioning":73,"citing_publications":134,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pcl.2016.11.002"}},{"id":4358,"doi":"10.1371/journal.pone.0172855","pmid":"28231314","pmcid":"PMC5322929","title":"Satisfaction guaranteed? How individual, partner, and relationship factors impact sexual satisfaction within partnerships","authors":"Velten J, Margraf J.","first_author":"Velten J","journal":"PloS one","year":2017,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0172855&type=printable","cited_by_count":95,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large, representative sample of 964 couples (N≈1928 individuals), actor‑partner interdependence modelling","sample_n":1928,"sample_text":"representative sample of 964 couples from the general population","population":"general adult population, both genders","country":"unspecified (likely Germany based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative study of 964 couples, the authors identified individual and partner factors—such as sexual function, distress, communication, and masturbation frequency—that together explain over half of the variation in sexual satisfaction within relationships.","clinical_takeaway":"Sexual satisfaction is shaped by both partners' sexual health, communication, and personal wellbeing; addressing these areas may improve couple satisfaction.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["large, population‑representative sample","use of actor‑partner interdependence model captures dyadic effects","multiple validated sexual‑relationship variables examined"],"limitations":["cross‑sectional design limits causal inference","abstract does not specify validation status of all scales","no pre‑registration or reporting of confidence intervals"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":12,"contrasting":6,"mentioning":98,"citing_publications":158,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0172855"}},{"id":4359,"doi":"10.1111/j.1556-4029.2006.00105.x","pmid":"16696722","pmcid":null,"title":"The paraphilia-related disorders: an investigation of the relevance of the concept in sexual murderers","authors":"Briken P, Habermann N, Kafka MP, Berner W, Hill A.","first_author":"Briken P","journal":"Journal of forensic sciences","year":2006,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"retrospective comparative study of 161 sexual murderers, four diagnostic groups","sample_n":161,"sample_text":"161 sexual murderers, divided into four diagnostic groups","population":"sexual homicide perpetrators (male)","country":"Germany (likely, based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined whether a new diagnostic concept, paraphilia‑related disorders, is common among men who commit sexual murders. Compared with other offenders, those with both paraphilic disorders and the new category showed more sexual impulsivity, earlier abuse, and higher rates of compulsive masturbation.","clinical_takeaway":"No direct clinical guidance; findings are limited to a forensic offender sample.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large forensic sample of sexual homicide offenders","Comparison of four diagnostic groups","Inclusion of developmental and abuse history variables"],"limitations":["Retrospective design, cross‑sectional only","Diagnostic categories not clearly validated","No control for key confounds (moral incongruence, mental health, partner factors)","Findings not generalisable beyond offender population"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":34,"citing_publications":86,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1556-4029.2006.00105.x"}},{"id":4360,"doi":"10.1542/peds.2005-3145","pmid":"16651357","pmcid":null,"title":"Masturbation in infancy and early childhood presenting as a movement disorder","authors":"Bodensteiner JB, Sheth RD.","first_author":"Bodensteiner JB","journal":"Pediatrics","year":2006,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2005-3145"}},{"id":4361,"doi":"10.1002/mds.870100421","pmid":"7565838","pmcid":null,"title":"Masturbation mimicking paroxysmal dystonia or dyskinesia in a young girl","authors":"Mink JW, Neil JJ.","first_author":"Mink JW","journal":"Movement disorders : official journal of the Movement Disorder Society","year":1995,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single clinical case description of a preschool girl whose masturbatory episodes were mistaken for paroxysmal dystonia","sample_n":1,"sample_text":"One case","population":"young female child (preschool age)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A preschool girl was thought to have a movement disorder because of periodic posturing during masturbation. Doctors later recognized the episodes as normal self‑stimulation, showing that such behavior should not be misdiagnosed.","clinical_takeaway":"Recognise childhood masturbation as normal to prevent unnecessary medical work‑ups.","confidence":0.8,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Highlights importance of distinguishing normal sexual behavior from neurological pathology","Provides clear clinical lesson to avoid unnecessary testing"],"limitations":["Single case limits generalizability","No systematic assessment of confounding factors","No quantitative measurement or validated scales"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":36,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mds.870100421"}},{"id":4363,"doi":"10.1016/j.urology.2017.01.031","pmid":"28163083","pmcid":null,"title":"Sexual Function and Quality of Life Before and After Penile Prosthesis Implantation Following Radial Forearm Flap Phalloplasty","authors":"Young EE, Friedlander D, Lue K, Anele UA, Khurgin JL, Bivalacqua TJ, Burnett AL, Redett RJ, Gearhart JP.","first_author":"Young EE","journal":"Urology","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 13 respondents (9 prosthesis, 4 phalloplasty‑only) using validated sexual‑function questionnaires; comparisons between groups.","sample_n":13,"sample_text":"12 identified prosthesis patients (9 responded) and 7 phalloplasty‑only patients (4 responded).","population":"Adults with severe penile deficiency who underwent radial forearm flap phalloplasty, with or without subsequent penile prosthesis implantation.","country":"USA (institution not specified in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among men who had forearm‑flap phalloplasty, those who later received a penile prosthesis reported more frequent intercourse and masturbation and better orgasmic and intercourse satisfaction than those without a prosthesis, but overall quality‑of‑life scores were similar.","clinical_takeaway":"Penile prosthesis after phalloplasty can improve specific sexual‑function outcomes, though broader quality‑of‑life benefits are less clear.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Use of validated sexual‑function questionnaires","Focus on a clinically relevant, understudied population","Clear comparison between prosthesis vs. no‑prosthesis groups"],"limitations":["Very small, self‑selected sample (N=13)","Cross‑sectional design limits causal inference","Potential response bias; no adjustment for confounders"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urology.2017.01.031"}},{"id":4364,"doi":"10.1093/sleep/zsw043","pmid":"28364495","pmcid":null,"title":"Sexsomnia: A Specialized Non-REM Parasomnia?","authors":"Dubessy AL, Leu-Semenescu S, Attali V, Maranci JB, Arnulf I.","first_author":"Dubessy AL","journal":"Sleep","year":2017,"pub_types":["Journal Article"],"keywords":["Sexual behavior","Sleepwalking","Sexsomnia","Non-rem Parasomnia","Forensic."],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case‑control series, 17 sexsomnia patients compared with healthy controls and sleepwalkers; video‑polysomnography and PADSS assessments","sample_n":17,"sample_text":"17 patients with sexsomnia; 89 sleepwalkers; controls not numerically reported","population":"patients referred for sexsomnia (N=17, 70.6 % male, age 17‑76) and matched healthy controls; also 89 sleepwalkers","country":"France (single centre)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study describes 17 people who performed sexual acts while asleep (sexsomnia) and compares their sleep recordings with healthy sleepers and regular sleepwalkers, noting a higher frequency of deep‑sleep awakenings and some forensic incidents.","clinical_takeaway":"Sexsomnia can involve serious sexual behavior and forensic risk; clinicians should assess sleep disorders when unexplained sexual acts occur.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","pornography","masturbation"],"strengths":["Use of objective polysomnographic recordings","Inclusion of matched healthy controls","First systematic description of forensic consequences"],"limitations":["Very small patient sample (N=17)","Cross‑sectional design, cannot infer causality","Limited statistical detail; no effect sizes or power analysis"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":5,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":65,"citing_publications":69,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sleep/zsw043"}},{"id":4365,"doi":null,"pmid":"28456148","pmcid":null,"title":"Impact of emotional disorders on semen quality in men treated for infertility","authors":"Wdowiak A, Bień A, Iwanowicz-Palus G, Makara-Studzińska M, Bojar I.","first_author":"Wdowiak A","journal":"Neuro endocrinology letters","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case‑control study comparing fertile (n=60) and sub‑fertile (n=112) men; semen collected by masturbation; correlation analysis between BDI, STAI scores, hormone levels and semen parameters.","sample_n":172,"sample_text":"60 fertile and 112 subfertile males","population":"Male patients (fertile and sub‑fertile) attending a reproductive clinic in Poland","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In men seeking infertility treatment, higher scores on depression and anxiety questionnaires were linked to hormonal changes and poorer semen quality, but the study cannot prove that the mood problems cause the sperm issues.","clinical_takeaway":"Emotional distress may be associated with lower semen quality, but clinicians should interpret this relationship cautiously.","confidence":0.7,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Validated instruments for depression and anxiety (BDI, STAI)","Objective hormonal and semen quality measurements","Reasonable sample size for initial exploratory correlations"],"limitations":["Cross‑sectional design prevents causal inference","No adjustment for key confounders (e.g., lifestyle, partner factors)","Masturbation used only for sample collection, not analyzed as a variable"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":4368,"doi":"10.1100/tsw.2006.363","pmid":"17619699","pmcid":"PMC5917368","title":"Fracture penis: an analysis of 26 cases","authors":"Pandyan GV, Zaharani AB, Al Rashid M.","first_author":"Pandyan GV","journal":"TheScientificWorldJournal","year":2006,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5917368","cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"retrospective case series of 26 patients with penile fracture","sample_n":26,"sample_text":"26 patients (28 fracture episodes) treated at our hospital","population":"Male patients presenting with penile fracture at a single hospital (1997‑2005)","country":"Not specified (likely Malaysia/Asia based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed 26 cases of penile fracture, most caused by masturbation, describing how patients presented, were treated, and their outcomes. Surgery was generally successful, while delayed treatment sometimes led to complications.","clinical_takeaway":"Prompt surgical repair is recommended for penile fractures to reduce complications.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Clear clinical descriptions of fracture presentation","Surgical outcomes reported"],"limitations":["Small retrospective case series, no control group","Limited statistical analysis, only descriptive"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":11,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1100/tsw.2006.363"}},{"id":4370,"doi":"10.3233/nre-172197","pmid":"28946589","pmcid":null,"title":"What is known about sexual health after pediatric acquired brain injury: A scoping review","authors":"Simpson G, Simons-Coghill M, Bates A, Gan C.","first_author":"Simpson G","journal":"NeuroRehabilitation","year":2017,"pub_types":["Scoping Review","Journal Article"],"keywords":["Traumatic brain injury","Adolescence","Pediatric","Precocious puberty","Body Image","Sexual Health","Acquired Brain Injury","Sexual Orientation","Scoping Review","Inappropriate Sexual Behaviour","Neurosexuality"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Scoping review of literature (1980‑2016) on sexual health after pediatric acquired brain injury; 28 studies included (observational, reviews, case studies). No risk‑of‑bias assessment, no meta‑analysis.","sample_n":null,"sample_text":"28 publications identified; primary studies varied in size","population":"Children/adolescents with acquired brain injury","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review found that research on how brain injury affects sexual health in children and teens is scarce. Existing studies suggest poorer body image, lower sexual confidence, and occasional inappropriate sexual behaviours after injury.","clinical_takeaway":"Clinicians should proactively address sexual health and body image in pediatric brain injury rehab, despite limited evidence.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Comprehensive literature mapping across 36 years","Identifies clear gaps in sexual health research after pediatric ABI"],"limitations":["No formal risk‑of‑bias or quality appraisal of included studies","No quantitative synthesis; conclusions are narrative","Potential selection bias in included studies not reported"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[{"status":"Has erratum","date":"2017-12-15","noticeDoi":"10.3233/nre-171481","doi":"10.3233/nre-172197"}],"url":"https://scite.ai/reports/10.3233/nre-172197"}},{"id":4371,"doi":"10.1007/s12024-016-9832-7","pmid":"28032210","pmcid":null,"title":"Female autoerotic asphyxial death - features and issues","authors":"Byard RW.","first_author":"Byard RW.","journal":"Forensic science, medicine, and pathology","year":2017,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12024-016-9832-7"}},{"id":4372,"doi":"10.1007/s12024-016-9826-5","pmid":"28025792","pmcid":null,"title":"Two extraordinary autoerotic fatalities","authors":"Tattoli L, Solarino B, Tsokos M, Buschmann C, Oesterhelweg L.","first_author":"Tattoli L","journal":"Forensic science, medicine, and pathology","year":2017,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12024-016-9826-5"}},{"id":4373,"doi":null,"pmid":"16756037","pmcid":null,"title":"[Opinions on the subject of sex life among students of the Medical University in Gdańsk]","authors":"Wichowicz HM, Cubała WJ, Grabowski K.","first_author":"Wichowicz HM","journal":"Psychiatria polska","year":2006,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 313 medical students, questionnaire developed for study, chi‑square test for representativeness","sample_n":313,"sample_text":"340 were invited, 313 analysed","population":"medical students (18‑28 years) at Medical University of Gdańsk, Poland","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2006 survey of Polish medical students found they view love, faithfulness and emotional connection as key to a satisfying sex life. Masturbation was seen as generally pleasant, though attitudes varied, and adultery was judged negatively.","clinical_takeaway":"Among future physicians, positive attitudes toward masturbation and relational sex predominate; no immediate clinical implications.","confidence":0.4,"topic_tags":["sexual_function","masturbation"],"strengths":["Reasonably sized sample for a single university","Analyzed gender differences","Includes a range of sexuality topics"],"limitations":["Ad‑hoc, non‑validated questionnaire","Cross‑sectional, no causal inference","Limited generalisability beyond medical students"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":4374,"doi":"10.1177/0269881106059732","pmid":"16354735","pmcid":null,"title":"Increased libido associated with quetiapine","authors":"Menon A, Williams RH, Watson S.","first_author":"Menon A","journal":"Journal of psychopharmacology (Oxford, England)","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single male patient with schizophrenia who developed increased masturbatory drive and nocturnal ejaculations while on quetiapine","sample_n":1,"sample_text":"single case","population":"44‑year‑old male with schizophrenia; n=1","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 44‑year‑old man with schizophrenia taking quetiapine reported a sudden increase in sexual desire, more frequent masturbation, and nighttime ejaculations. The authors suggest the drug’s unique pharmacology may have caused these changes.","clinical_takeaway":"Quetiapine may increase libido in some patients; monitor sexual side‑effects and weigh against benefits.","confidence":0.6,"topic_tags":["sexual_function","masturbation","adolescents"],"strengths":["Detailed clinical description","Discussion of plausible neurochemical mechanisms"],"limitations":["Single case; no systematic assessment","No validated scales or objective measures","No control for confounding variables"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0269881106059732"}},{"id":4375,"doi":"10.1080/00926239508404388","pmid":"7643426","pmcid":null,"title":"Prescribed masturbation in sex therapy: a critique","authors":"Christensen C.","first_author":"Christensen C.","journal":"Journal of sex & marital therapy","year":1995,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/critique without original data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"background","plain_summary":"The paper argues that telling couples to masturbate as part of sex therapy can hurt intimacy, because it sidesteps relational issues and may create mistrust between partners.","clinical_takeaway":"Therapists should address relational trust before prescribing masturbation exercises.","confidence":0.6,"topic_tags":["masturbation","sexual_function","relationships"],"strengths":["Highlights relational consequences of a specific therapeutic technique","Offers alternative recommendations for clinicians","Frames critique within systemic/interactional theory"],"limitations":["No empirical data; conclusions based on theoretical argument","Lacks systematic review methodology","No measurement of outcomes or confounders"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239508404388"}},{"id":4376,"doi":"10.1080/00926239508405968","pmid":"7608994","pmcid":null,"title":"The coital alignment technique and directed masturbation: a comparative study on female orgasm","authors":"Hurlbert DF, Apt C.","first_author":"Hurlbert DF","journal":"Journal of sex & marital therapy","year":1995,"pub_types":["Comparative Study","Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized controlled trial comparing two sexual therapy workshops with 36 married women (19 vs 17)","sample_n":36,"sample_text":"36 married women randomly assigned to coital alignment technique (19) or directed masturbation (17)","population":"non‑clinical married women, mean age middle‑aged, recruited for a sexual enrichment workshop","country":"unspecified (likely USA based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small trial of 36 married women, learning the coital alignment technique or directed masturbation both improved how often and how strongly women experienced orgasms during sex, with the coital alignment method showing a slight edge for consistency.","clinical_takeaway":"Both techniques can enhance orgasm outcomes; combining them may yield the best results.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Randomised allocation","Direct comparison of two therapeutic techniques","Clear, clinically relevant outcomes"],"limitations":["Very small sample size (N=36)","No validated orgasm measurement instrument reported","Limited demographic diversity, convenience sample"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":127,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239508405968"}},{"id":4378,"doi":"10.1016/j.jpag.2016.11.011","pmid":"27965122","pmcid":null,"title":"Assembling a Functional Clitoris and Vulva from a Pseudo-Penis: A Surgical Technique for an Adult Woman with Congenital Adrenal Hyperplasia","authors":"Tjalma WAA.","first_author":"Tjalma WAA.","journal":"Journal of pediatric and adolescent gynecology","year":2017,"pub_types":["Journal Article","Case Reports"],"keywords":["Reconstruction","penis","Clitoris","Congenital Adrenal Hyperplasia","Ambiguous Genitalia","Orgasm","Sexual Functions"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single-patient surgical case report","sample_n":1,"sample_text":"n=1 (case report)","population":"22‑year‑old woman with congenital adrenal hyperplasia","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 22‑year‑old woman with congenital adrenal hyperplasia had her small penis surgically transformed into a clitoris and vagina. After surgery she reported a functional vagina and could still experience orgasm during masturbation.","clinical_takeaway":"In select adult CAH patients, single‑stage genital reconstruction may preserve orgasmic function, but evidence is limited to isolated case reports.","confidence":0.4,"topic_tags":["gender","religiosity","sexual_function"],"strengths":["detailed surgical technique","follow‑up reports functional outcome"],"limitations":["single case, no comparison group","subjective outcome measures only","cannot generalize to broader CAH population"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpag.2016.11.011"}},{"id":4380,"doi":"10.1007/s10508-005-7926-5","pmid":"16362252","pmcid":null,"title":"Sexual and physical health after sex reassignment surgery","authors":"De Cuypere G, T'Sjoen G, Beerten R, Selvaggi G, De Sutter P, Hoebeke P, Monstrey S, Vansteenwegen A, Rubens R.","first_author":"De Cuypere G","journal":"Archives of sexual behavior","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":212,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"observational follow‑up of 55 transsexual patients after sex reassignment surgery; no control group; outcomes self‑reported via questionnaire","sample_n":55,"sample_text":"55 participants (32 male‑to‑female, 23 female‑to‑male) who completed a post‑operative questionnaire","population":"55 adult transsexual individuals (32 M→F, 23 F→M) who underwent SRS; convenience sample from a surgical centre","country":"Belgium (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A follow‑up of 55 trans people after gender‑affirming surgery found most had few health problems and reported better sexuality, especially female‑to‑male patients who masturbated more. Hormone levels were often not fully normal, and some physical issues persisted.","clinical_takeaway":"Most patients report sexual improvement after SRS, but clinicians should monitor hormone levels and physical complications, especially in older or smoking patients.","confidence":0.8,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Long‑term follow‑up after SRS","Includes hormonal data alongside self‑report","Addresses both physical and sexual outcomes"],"limitations":["Small, non‑random sample; limited generalisability","No validated sexual‑function scales reported","No control/comparator group","Potential confounding by age, smoking, mental health not addressed"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":19,"contrasting":2,"mentioning":256,"citing_publications":364,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-005-7926-5"}},{"id":4381,"doi":"10.5114/pm.2016.63495","pmid":"27980527","pmcid":"PMC5137479","title":"The prevalence of sexual activity, and sexual dysfunction and behaviours in postmenopausal woman in Poland","authors":"Czajkowska KB, Lew-Starowicz Z, Szymańska M.","first_author":"Czajkowska KB","journal":"Przeglad menopauzalny = Menopause review","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Postmenopause","Sexual activity","Female Sexual Dysfunction","Sexual Behaviours"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5137479","cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"observational survey of 538 women (220 aged 50+), comparing age groups 50‑59 vs >60; convenience sampling, no longitudinal or experimental component","sample_n":220,"sample_text":"538 total participants, 220 aged over 50 years","population":"Polish postmenopausal women (age 50+), recruited via unspecified methods","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2016 Polish survey of 220 women aged 50 and older found that most still consider sex important and many remain sexually active, though activity declines with age. Masturbation and oral sex continue into later decades, while reported sexual problems tend to decrease with age.","clinical_takeaway":"Clinicians should recognize that many postmenopausal women remain sexually active and experience varying levels of sexual dysfunction; age alone should not assume inactivity.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large overall sample size for a regional survey","Focus on an understudied population (postmenopausal women)","Provides prevalence data on sexual activity and dysfunction"],"limitations":["Cross‑sectional design; cannot infer causality","No validated sexual‑function questionnaires reported","Potential selection bias; recruitment method unspecified","Limited statistical reporting (no effect sizes, multiple‑comparison correction)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5114/pm.2016.63495"}},{"id":4387,"doi":"10.3402/snp.v6.32578","pmid":"27791968","pmcid":"PMC5084726","title":"The whole versus the sum of some of the parts: toward resolving the apparent controversy of clitoral versus vaginal orgasms","authors":"Pfaus JG, Quintana GR, Mac Cionnaith C, Parada M.","first_author":"Pfaus JG","journal":"Socioaffective neuroscience & psychology","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Brain","Stimulation","Internal","Women","External","Vagina","Cervix","Arousal","Clitoris","Pleasure"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5084726","cited_by_count":31,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative historical review synthesizing prior literature; no new empirical data collected","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews the long‑standing debate about whether women's orgasms come from the clitoris, the vagina, or both, proposing that multiple genital and non‑genital sources can combine to produce orgasm during solo or partnered sex.","clinical_takeaway":"Orgasm can arise from varied stimulation sites; clinicians should consider individual variation rather than a single anatomical source.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","gender"],"strengths":["Comprehensive historical synthesis","Integrates multiple disciplinary perspectives"],"limitations":["No original empirical data","Lacks systematic review methodology","No explicit assessment of study quality"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3402/snp.v6.32578"}},{"id":4388,"doi":"10.1186/s12991-016-0114-2","pmid":"27777608","pmcid":"PMC5073727","title":"Personality traits, gender roles and sexual behaviours of young adult males","authors":"Kurpisz J, Mak M, Lew-Starowicz M, Nowosielski K, Bieńkowski P, Kowalczyk R, Misiak B, Frydecka D, Samochowiec J.","first_author":"Kurpisz J","journal":"Annals of general psychiatry","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behaviour","Gender Roles","Big Five Personality Traits"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5073727","cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 97 heterosexual young adult men in Poland; convenience sampling; self‑report questionnaires","sample_n":97,"sample_text":"97 heterosexual young adult men aged 19‑39 living in Poland","population":"young adult males (19–39 y) heterosexual, Poland","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 97 young Polish men, personality traits (Big Five) and stereotypical masculinity/femininity were modestly linked to how often and how they engaged in sexual activities, including masturbation, and to sexual satisfaction.","clinical_takeaway":"Personality influences sexual behaviour, but effects are modest; clinicians should consider broader psychosocial factors beyond traits alone.","confidence":0.78,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["Use of validated personality and sexual function instruments","Comprehensive assessment of multiple sexual‑behaviour dimensions","Clear reporting of correlation strengths"],"limitations":["Small, non‑representative convenience sample","Ad‑hoc sexual‑behaviour questionnaire lacks validation","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":2,"mentioning":17,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12991-016-0114-2"}},{"id":4389,"doi":"10.1080/00918369.2016.1249735","pmid":"27754811","pmcid":null,"title":"That Man Behind the Curtain: Investigating the Sexual Online Dating Behavior of Men Who Have Sex With Men but Hide Their Same-Sex Sexual Attraction in Offline Surroundings","authors":"Lemke R, Weber M.","first_author":"Lemke R","journal":"Journal of homosexuality","year":2017,"pub_types":["Journal Article"],"keywords":["Online Dating","Sexual Venues","Self-disclosure","Social Networking Sites","Concealment","Stigma Management","Internet Sexuality","Online Disinhibition"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large online survey of MSM (N=12,002) comparing hidden vs open individuals on chat/dating site behaviors","sample_n":12002,"sample_text":"large convenience sample of MSM","population":"men who have sex with men, recruited via online platforms","country":"unspecified (likely multiple)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A large survey of over 12,000 men who have sex with men finds that those who hide their same‑sex attraction behave more cautiously on gay chat and dating sites and masturbate more during online chats, yet they spend similar time online and seek offline encounters as openly out men.","clinical_takeaway":"Hidden MSM may need supportive online environments, but the study does not provide clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Very large sample size","Focused comparison of hidden vs open MSM","Specific behavioral outcomes (masturbation during chat)"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on self‑report questionnaires without validated scales","No control for key confounds (mental health, moral incongruence, trauma)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":23,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2016.1249735"}},{"id":4390,"doi":"10.1111/j.1743-6109.2005.00133.x","pmid":"16422831","pmcid":null,"title":"The antimasturbation crusade in antebellum American medicine","authors":"Hodges FM.","first_author":"Hodges FM.","journal":"The journal of sexual medicine","year":2005,"pub_types":["Historical Article","Biography","Portrait","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical narrative review of 19th‑century medical texts; no primary data collection.","sample_n":null,"sample_text":"N/A","population":"Not applicable (historical figures & texts)","country":"United States (historical context)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews 19th‑century American medical writings that portrayed masturbation as a cause of many diseases and social problems, summarising the arguments of five leading physicians of the era.","clinical_takeaway":"None – the paper is a historical account and does not provide clinical guidance for current practice.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Rich primary‑source archival research","Clear exposition of historical medical doctrines"],"limitations":["No empirical data on current behaviours or health outcomes","Interpretations limited to historical perspective; no modern relevance testing"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2005.00133.x"}},{"id":4391,"doi":"10.1098/rsbl.2005.0308","pmid":"17148182","pmcid":"PMC1617159","title":"Genetic influences on variation in female orgasmic function: a twin study","authors":"Dunn KM, Cherkas LF, Spector TD.","first_author":"Dunn KM","journal":"Biology letters","year":2005,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":61,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Twin study (classical twin design) using a large community sample (N≈4037) of monozygotic and dizygotic female twins; self‑report questionnaire on orgasm frequency during intercourse and masturbation.","sample_n":4037,"sample_text":"4037 women (683 MZ pairs, 714 DZ pairs)","population":"Adult female twins (19–83 y) from the TwinsUK register, UK population‑based cohort.","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A large twin study of over 4,000 UK women found that about one‑third rarely orgasm during sex and about one‑fifth during masturbation. Genetic factors accounted for roughly one‑third to half of the individual differences, suggesting a heritable component to female orgasmic function.","clinical_takeaway":"Genetic influence contributes to variation in female orgasmic function, but assessment should also consider psychosocial factors that were not measured here.","confidence":0.7,"topic_tags":["gender","sexual_function","treatment"],"strengths":["Very large twin sample with both MZ and DZ pairs","Heritability estimates reported with confidence intervals","Population‑based registry reduces selection bias"],"limitations":["Orgasm frequency measured with single‑item, unclear validation","No assessment of distress, mental health or relational factors","Cross‑sectional self‑report limits causal inference"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":12,"contrasting":0,"mentioning":66,"citing_publications":127,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1098/rsbl.2005.0308"}},{"id":4392,"doi":"10.1111/j.1744-6198.1994.tb00162.x","pmid":"7937212","pmcid":null,"title":"Masturbation--beyond myth and taboo","authors":"Lidster CA, Horsburgh ME.","first_author":"Lidster CA","journal":"Nursing forum","year":1994,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods","sample_n":null,"sample_text":"None – review article","population":"nurses and healthcare providers (implicit); no primary data","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how masturbation is viewed in society and nursing, discusses what makes it functional or dysfunctional, and offers suggestions for nursing education and practice.","clinical_takeaway":"None – article is a narrative overview, not evidence for clinical decision‑making.","confidence":0.8,"topic_tags":["masturbation","neuroscience"],"strengths":["Provides historical context for nursing practice","Highlights need for education on masturbation"],"limitations":["No empirical data; narrative review only","Lacks systematic methodology or risk‑of‑bias assessment","No measurement of key constructs or confounders"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1744-6198.1994.tb00162.x"}},{"id":4393,"doi":"10.1093/jhmas/jri042","pmid":"15917258","pmcid":null,"title":"Pathologizing male sexuality: Lallemand, spermatorrhea, and the rise of circumcision","authors":"Darby R.","first_author":"Darby R.","journal":"Journal of the history of medicine and allied sciences","year":2005,"pub_types":["Historical Article","Biography","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"historical analysis, no primary data collection","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"background","plain_summary":"The paper examines 19th‑century fears that masturbation caused \"spermatorrhea\" and how this anxiety helped promote circumcision, showing how medical ideas were shaped by moral concerns rather than solid evidence.","clinical_takeaway":"None – the article is historical and does not provide clinical guidance.","confidence":0.6,"topic_tags":["moral_incongruence","masturbation","sexual_function","csbd"],"strengths":["Thorough historical scholarship","Links medical discourse to sociocultural anxieties"],"limitations":["No empirical data or systematic review","No quantitative assessment of claims"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jhmas/jri042"}},{"id":4394,"doi":null,"pmid":"8004688","pmcid":null,"title":"[Masturbation in adolescents]","authors":"Raboch J, Zvĕrina J, Raboch J, Sindlár M.","first_author":"Raboch J","journal":"Ceskoslovenska psychiatrie","year":1994,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"cze","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 602 girls and 192 boys aged 16‑18 in the Czech Republic, reporting prevalence and frequency of masturbation.","sample_n":794,"sample_text":"602 girls, 192 boys","population":"Adolescents (16‑18 years) from the Czech Republic","country":"Czech Republic","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1994 Czech study found that about 90 % of teenage boys but only 6 % of girls reported ever masturbating, with notable sex differences in frequency. The authors suggest cultural liberalization and biological factors may shape these patterns.","clinical_takeaway":"None – the study provides descriptive prevalence data, not clinical guidance.","confidence":0.7,"topic_tags":["masturbation","adolescents","prevalence","gender"],"strengths":["Large total sample for prevalence estimates","Gender‑specific data","Historical context (post‑1989 liberalization)"],"limitations":["Reliance on single‑item self‑report","No measurement of potential confounds (e.g., religiosity, mental health)","Cross‑sectional; cannot infer trends over time","Speculative biological explanations"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4395,"doi":"10.1016/j.biopsycho.2005.03.005","pmid":"15961213","pmcid":null,"title":"Blood pressure reactivity to stress is better for people who recently had penile-vaginal intercourse than for people who had other or no sexual activity","authors":"Brody S.","first_author":"Brody S.","journal":"Biological psychology","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":63,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Daily‑diary observational study of 46 healthy adults examining blood‑pressure reactivity after a stress task, grouped by recent penile‑vaginal intercourse versus other/no sexual activity.","sample_n":46,"sample_text":"24 women, 22 men; community volunteers (details not provided).","population":"24 women and 22 men from an unspecified community sample; ages not reported.","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small diary study, people who had recent penile‑vaginal intercourse showed smaller blood‑pressure spikes during a stress test than those who only masturbated or had other partnered sex.","clinical_takeaway":"Recent intercourse may be linked to lower stress‑induced BP, but evidence is limited and not causal.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Physiological outcome (BP) measured objectively.","Differentiates intercourse from other sexual activities.","Diary method reduces recall bias for recent behavior."],"limitations":["Small sample (N=46) limits statistical power.","No control for moral/religious attitudes or mental‑health variables.","Cross‑sectional design cannot establish causality."],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":3,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":12,"contrasting":1,"mentioning":84,"citing_publications":109,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.biopsycho.2005.03.005"}},{"id":4396,"doi":"10.1007/s10508-005-3120-z","pmid":"15971014","pmcid":null,"title":"An Internet study of cybersex participants","authors":"Daneback K, Cooper A, Månsson SA.","first_author":"Daneback K","journal":"Archives of sexual behavior","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online questionnaire administered through a popular Swedish web portal; N=1828; logistic regression and group comparisons of self‑reported behaviours.","sample_n":1828,"sample_text":"N = 1828 participants recruited via the Swedish web portal Passagen.se; convenience sample.","population":"Adults (aged 18‑65) from Sweden who voluntarily completed an internet survey; not a probability sample.","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2005 Swedish internet survey of 1828 adults explored who engages in cybersex. About one‑third reported having done it, and participants were more likely to be younger, male, and to spend more time on online sexual activities and have more offline partners.","clinical_takeaway":"None – the study provides descriptive data only and does not inform clinical assessment or treatment.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample size for an exploratory study","First systematic description of cybersex participants","Uses multivariate logistic regression to identify demographic predictors"],"limitations":["Convenience online sample limits generalizability","No validated measures of cybersex behaviour or associated distress","Key confounds (moral incongruence, mental health, partner effects) not assessed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":104,"citing_publications":195,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-005-3120-z"}},{"id":4397,"doi":"10.1080/00926230590513401","pmid":"16020138","pmcid":null,"title":"Are orgasms in the mind or the body? Psychosocial versus physiological correlates of orgasmic pleasure and satisfaction","authors":"Mah K, Binik YM.","first_author":"Mah K","journal":"Journal of sex & marital therapy","year":2005,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":61,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of adult participants rating adjectives after masturbation or partnered sex","sample_n":798,"sample_text":"Male and female participants (n = 356 for solitary masturbation; n = 442 for partnered sex)","population":"Adults (male and female), community sample, n≈800 total","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study asked adults to rate how pleasurable and satisfying their orgasms felt during solo masturbation or with a partner. Findings suggest that mental and relationship factors matter more for how people experience orgasm than the purely physical sensations.","clinical_takeaway":"Clinicians should consider psychosocial and relational factors when addressing orgasmic satisfaction, not just physiological aspects.","confidence":0.7,"topic_tags":["sexual_function","masturbation","relationships"],"strengths":["Large sample size","Direct comparison of solitary vs partnered orgasm","Inclusion of relationship satisfaction"],"limitations":["Use of non‑validated adjective scales","Cross‑sectional design limits causal inference","No control for mental‑health or moral/religious factors"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":41,"citing_publications":116,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230590513401"}},{"id":4398,"doi":"10.1080/00926239408403429","pmid":"7996590","pmcid":null,"title":"Masturbation and premarital sexual intercourse among college women: making choices for sexual fulfillment","authors":"Davidson JK, Moore NB.","first_author":"Davidson JK","journal":"Journal of sex & marital therapy","year":1994,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"anonymous questionnaire administered to 777 never‑married, heterosexual college women; groups formed post‑hoc (masturbation only, both, intercourse only); convenience sample from a single Midwestern university.","sample_n":777,"sample_text":"777 never‑married, heterosexual women enrolled at a Midwestern university","population":"college women, never married, heterosexual, US Midwest, volunteer sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 777 college women found that those who only masturbated felt more guilt and less sexual satisfaction, while those who both masturbated and had intercourse reported riskier sexual histories. The study suggests educators should address negative attitudes toward masturbation.","clinical_takeaway":"Address guilt and negative attitudes about masturbation in sexual education to improve satisfaction and reduce risk‑taking.","confidence":0.6,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Large overall sample size (N≈777)","Direct comparison of three behavior groups","Addresses understudied topic of guilt and satisfaction"],"limitations":["Convenience, single‑university sample limits generalizability","Reliance on single‑item or ad‑hoc self‑report measures","No control for moral, mental‑health, or relational confounds"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":23,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239408403429"}},{"id":4399,"doi":"10.21037/tau.2016.05.08","pmid":"27652218","pmcid":"PMC5002001","title":"The impact of ejaculatory dysfunction upon the sufferer and his partner","authors":"Abdo CH.","first_author":"Abdo CH.","journal":"Translational andrology and urology","year":2016,"pub_types":["review-article","Review","Journal Article"],"keywords":["Anxiety","Distress","Partner","Ejaculatory Dysfunction","Premature Ejaculation (Pe)","Delayed Ejaculation (De)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5002001","cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review summarising existing literature on premature and delayed ejaculation and their impact on partners. No original data, no systematic methodology reported.","sample_n":null,"sample_text":"Not applicable – no primary participants.","population":"None (review article)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review discusses how premature and delayed ejaculation affect both men and their female partners, noting emotional, relational, and health burdens, and linking anxiety with these disorders.","clinical_takeaway":"Clinicians should assess both partners when treating ejaculatory dysfunction, as distress and relationship factors are significant.","confidence":0.3,"topic_tags":["sexual_function","relationships","masturbation"],"strengths":["Comprehensive overview of ejaculatory dysfunction literature","Highlights partner‑perspective and dyadic impact"],"limitations":["Narrative, not systematic, review","No empirical data or meta‑analytic synthesis","Lacks quantitative assessment of effect sizes"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21037/tau.2016.05.08"}},{"id":4400,"doi":null,"pmid":"30408387","pmcid":null,"title":"Prevalence and Risk Factors of Ejaculation Failure on the Day of Operation Among Chinese Males Undergoing Assisted Reproductive Technique Treatments","authors":"Li L, Zeng D, Li F, Cui D, Zhang Y.","first_author":"Li L","journal":"The Journal of reproductive medicine","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Prospective observational cohort of 843 Chinese men undergoing assisted reproductive techniques; risk factors for same‑day ejaculation failure were surveyed and logistic regression used.","sample_n":843,"sample_text":"patients undergoing ART treatments","population":"Chinese males undergoing ART at two hospitals in Wuhan, China (n=843)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 843 Chinese men undergoing assisted reproduction, 8.3% could not ejaculate on the day of the procedure. Prior ejaculation problems and higher state anxiety were the strongest predictors of this failure.","clinical_takeaway":"Assess anxiety and history of ejaculation problems before ART; consider interventions to reduce anxiety on the day of sperm collection.","confidence":0.85,"topic_tags":["sexual_function","masturbation","religiosity"],"strengths":["Large sample (n>800) provides precise prevalence estimate","Validated anxiety measure (STAI) with reported CIs","Prospective data collection reduces recall bias"],"limitations":["Single‑country clinical sample limits generalisability","No assessment of partner or relational factors","Moral/religious variables not relevant but not measured"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":4401,"doi":"10.21037/tau.2016.07.05","pmid":"27652228","pmcid":"PMC5001992","title":"Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model","authors":"Perelman MA.","first_author":"Perelman MA.","journal":"Translational andrology and urology","year":2016,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sex Therapy","Transdisciplinary","Orgasmic Disorder","Delayed Ejaculation (De)","Sexual Tipping Point (Stp)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5001992","cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review proposing a therapeutic model; no empirical data, no sample size reported","sample_n":null,"sample_text":"Not applicable – no primary data collection","population":"men with delayed ejaculation (DE)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article describes a therapeutic framework called the Sexual Tipping Point model for men with delayed ejaculation, stressing the role of masturbation style, fantasy, and partner stimulation, and suggesting behavioral and possibly pharmacological interventions.","clinical_takeaway":"Therapists should assess masturbation patterns and fantasy use when treating delayed ejaculation; these factors may be targeted in therapy.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Integrates biopsychosocial factors in DE","Emphasizes detailed sexual history including masturbation"],"limitations":["No primary data; theoretical model only","Lacks empirical validation of treatment recommendations"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":23,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21037/tau.2016.07.05"}},{"id":4402,"doi":"10.21037/tau.2016.07.01","pmid":"27652231","pmcid":"PMC5001999","title":"Post orgasmic illness syndrome (POIS)","authors":"Waldinger MD.","first_author":"Waldinger MD.","journal":"Translational andrology and urology","year":2016,"pub_types":["review-article","Review","Journal Article"],"keywords":["Ejaculation","Post Orgasmic Illness Syndrome (Pois)"],"is_oa":true,"oa_url":"https://tau.amegroups.com/article/viewFile/11107/pdf","cited_by_count":29,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review lacking systematic methods or empirical data","sample_n":null,"sample_text":"not applicable – review of existing reports","population":"men with post‑orgasmic illness syndrome (POIS); no specific sample size reported","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews post‑orgasmic illness syndrome (POIS), a condition where men feel ill shortly after ejaculation. It proposes an autoimmune cause but is based mainly on case reports, offering no new data.","clinical_takeaway":"Currently, POIS lacks robust evidence; clinicians should treat it as a speculative condition and rely on symptom management.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Highlights a rare, under‑studied condition","Provides a clear set of diagnostic criteria"],"limitations":["No original data; relies on anecdotal case reports","Lacks systematic literature search or quality appraisal","Speculative pathophysiology without experimental evidence"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":46,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21037/tau.2016.07.01"}},{"id":4403,"doi":"10.1007/s10508-005-1800-3","pmid":"15803256","pmcid":null,"title":"Sexual fantasies of adolescent male sex offenders in residential treatment: a descriptive study","authors":"Aylwin AS, Reddon JR, Burke AR.","first_author":"Aylwin AS","journal":"Archives of sexual behavior","year":2005,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"descriptive longitudinal log study of 87 adolescent male sexual offenders in residential treatment; no control group","sample_n":87,"sample_text":"adolescent male sex offenders attending residential treatment","population":"male adolescent sexual offenders in residential treatment (N=87)","country":"Canada (Alberta)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Adolescent male sex offenders in a residential program kept daily logs of their sexual fantasies. Over five months, deviant fantasies rose sharply then fell, while normal fantasies followed the opposite pattern. Masturbation was more often linked to deviant fantasies, and the proportion of fantasies that were deliberately interrupted increased over time.","clinical_takeaway":"Monitoring and encouraging interruption of deviant fantasies may be a useful component of treatment for juvenile sex offenders.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Systematic prospective logging over several months","Separates fantasies that were accompanied by masturbation","Large for this specific clinical population"],"limitations":["Self‑report log without validated questionnaire","No comparison or control group","Potential under‑reporting due to treatment context"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-005-1800-3"}},{"id":4405,"doi":"10.1111/andr.12224","pmid":"27409983","pmcid":null,"title":"Which are the male factors associated with female sexual dysfunction (FSD)?","authors":"Maseroli E, Fanni E, Mannucci E, Fambrini M, Jannini EA, Maggi M, Vignozzi L.","first_author":"Maseroli E","journal":"Andrology","year":2016,"pub_types":["Journal Article"],"keywords":["erectile dysfunction","Premature Ejaculation","Female Sexual Dysfunction","Male Sexual Dysfunction","Delayed Ejaculation","Male Hypoactive Sexual Desire","Relational Factor"],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"retrospective cross‑sectional study of 156 women seeking help for FSD; partner variables obtained via women's report","sample_n":156,"sample_text":"156 women with FSD; consecutive series from clinic","population":"heterosexual women attending a specialized clinic (Italy)","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 156 women seen for sexual problems, the study found that a man's low sexual desire—not erectile problems—was linked to poorer female sexual function, even after accounting for age and relationship factors.","clinical_takeaway":"Clinicians should consider a partner's low sexual desire as a possible contributor to a woman's sexual difficulties.","confidence":0.7,"topic_tags":["sexual_function","relationships","gender","masturbation"],"strengths":["Use of validated FSFI","Focus on partner‑perceived sexual factors","Multivariate age‑adjusted analysis"],"limitations":["Clinic‑based convenience sample limits generalisability","Male partner variables measured only via female report, often ad‑hoc","No control for moral/religious attitudes or broader mental‑health covariates"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/andr.12224"}},{"id":4406,"doi":"10.1016/j.cali.2016.05.003","pmid":"27395427","pmcid":null,"title":"[It is possible to humanize the semen samples collection respecting privacy of subjects? A preliminary report]","authors":"Ramos-Brieva J, González P, Rodríguez S, Botas MC, Vicente-López O, Cordero-Villafáfila A.","first_author":"Ramos-Brieva J","journal":"Revista de calidad asistencial : organo de la Sociedad Espanola de Calidad Asistencial","year":2017,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.cali.2016.05.003"}},{"id":4407,"doi":"10.4103/0974-7796.184904","pmid":"27453657","pmcid":"PMC4944628","title":"Self-inflicted foreign bodies in lower genitourinary tract in males: Our experience and review of literature","authors":"Mahadevappa N, Kochhar G, Vilvapathy KS, Dharwadkar S, Kumar S.","first_author":"Mahadevappa N","journal":"Urology annals","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Foreign Body","Self-inflicted","Autoerotism","Endoscopic Retrieval Of Foreign Body","Lower Genitourinary Tract"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4944628","cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"retrospective chart review of 10 patients over 6 years","sample_n":10,"sample_text":"Ten patients identified from 17,978 inpatients (0.055%) between 2009‑2015.","population":"male inpatients with self‑inflicted lower genitourinary foreign bodies","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a six‑year review of hospital records, ten men inserted various objects into their urethra or bladder, mostly driven by auto‑erotic motives and misconceptions about masturbation. Surgical removal was successful and no complications occurred, but psychiatric evaluation was recommended.","clinical_takeaway":"When patients present with self‑inflicted genitourinary foreign bodies, assess for underlying psychiatric issues and provide counseling to prevent recurrence.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Rare clinical phenomenon documented","Detailed case descriptions","Includes psychiatric evaluation"],"limitations":["Very small sample, no statistical analysis","No validated measures of sexual behaviour or distress","Confounding factors (moral beliefs, partner status) not quantified"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":3,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":55,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0974-7796.184904"}},{"id":4408,"doi":"10.1080/0092623x.2016.1207732","pmid":"27366863","pmcid":null,"title":"Gender, Sexuality, and Relationships in Young Hispanic People","authors":"Gil-Llario MD, Giménez C, Ballester-Arnal R, Cárdenas-López G, Durán-Baca X.","first_author":"Gil-Llario MD","journal":"Journal of sex & marital therapy","year":2017,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"http://repositori.uji.es/xmlui/bitstream/10234/165699/1/Gender%2c_sexuality_and_relationships_in_Young_Hispanic_people.REP.pdf","cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional survey of 840 Spanish and Mexican young adults using a self‑administered questionnaire.","sample_n":840,"sample_text":"Eight hundred and forty young people from Spain and Mexico filled out a self‑administered questionnaire.","population":"young Hispanic adults (Spain & Mexico), likely convenience sample","country":"Spain, Mexico","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 840 young adults from Spain and Mexico, men reported more masturbation, vaginal sex and infidelity, while women reported more steady partners and longer relationships. Gender differences were stronger among Mexican participants.","clinical_takeaway":"Gender influences sexual behaviours among Hispanic youth, but the study does not address clinical risk or pathology.","confidence":0.8,"topic_tags":["sexual_function","gender","masturbation","relationships","csbd"],"strengths":["Large sample (N=840) across two countries","Direct assessment of multiple sexual behaviours","Clear gender‑based comparisons"],"limitations":["Self‑report questionnaire not validated","Cross‑sectional convenience sample limits causality","No control for moral, mental‑health or relationship covariates"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":17,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2016.1207732"}},{"id":4410,"doi":"10.1002/j.1939-4640.1993.tb00402.x","pmid":"8288490","pmcid":null,"title":"Endocrinological, biophysical, and biochemical parameters of semen collected via masturbation versus sexual intercourse","authors":"Sofikitis NV, Miyagawa I.","first_author":"Sofikitis NV","journal":"Journal of andrology","year":1993,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subject comparison of semen collected by masturbation vs intercourse in 38 infertile men (each providing 6 samples per condition).","sample_n":38,"sample_text":"38 men (each contributed multiple samples).","population":"Infertile men seeking assisted reproduction (convenience sample).","country":"Not specified (likely Japan based on author affiliation).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 38 men undergoing fertility treatment, semen collected during intercourse using a special device showed higher volume, sperm count, motility, and normal morphology than semen collected by masturbation, likely due to greater prostate activity, while hormone levels were similar.","clinical_takeaway":"For assisted reproduction, collecting semen during intercourse may yield higher‑quality samples than masturbation.","confidence":0.8,"topic_tags":["sexual_function","masturbation","religiosity"],"strengths":["Standardized, validated laboratory measurements of semen quality","Within‑subject design reduces between‑person variability","Direct comparison of two clinically relevant collection methods"],"limitations":["Small, non‑representative sample of infertile men","No power calculation or pre‑registration reported","Potential order or fatigue effects not addressed"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":44,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/j.1939-4640.1993.tb00402.x"}},{"id":4411,"doi":"10.3389/fphys.2016.00246","pmid":"27445838","pmcid":"PMC4914923","title":"Sexual Activity before Sports Competition: A Systematic Review","authors":"Stefani L, Galanti G, Padulo J, Bragazzi NL, Maffulli N.","first_author":"Stefani L","journal":"Frontiers in physiology","year":2016,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sex","Circadian rhythm","Competition","Performance","Athletes","Abstinence","Time Of Day"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4914923","cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review of heterogeneous studies, no meta‑analysis, limited data","sample_n":null,"sample_text":"Not applicable – review of published studies","population":"athletes from various sports (studies included in review)","country":"International (literature search)","controls_mi":"not_applicable","preregistered":true,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review found little reliable evidence that having sex before a competition harms performance; any negative effect seems limited to very short intervals (<2 h). High‑quality trials are still missing.","clinical_takeaway":"No need to advise athletes to avoid sex before competition; timing under 2 h may be more relevant.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["PRISMA‑guided systematic search across many databases","Identifies clear gap (lack of RCTs)","Highlights timing (<2 h) as potentially relevant"],"limitations":["Primary studies are few, small, and of low methodological quality","No quantitative synthesis (meta‑analysis)","No control for relevant confounds (e.g., mood, sleep, substance use)","Masturbation not examined"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fphys.2016.00246"}},{"id":4412,"doi":"10.1300/j013v42n01_07","pmid":"16418125","pmcid":null,"title":"The incidental orgasm: the presence of clitoral knowledge and the absence of orgasm for women","authors":"Wade LD, Kremer EC, Brown J.","first_author":"Wade LD","journal":"Women & health","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"non‑random sample of 833 undergraduate students, survey of clitoral knowledge and self‑reported orgasm frequency in masturbation and partnered sex","sample_n":833,"sample_text":"non‑random convenience sample of undergraduates","population":"female undergraduate students (age not specified)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 833 college women, those who knew more about the clitoris were more likely to orgasm during masturbation, but clitoral knowledge did not predict orgasm with a partner. Formal education and friends gave the least accurate information, while self‑exploration was the most informative source.","clinical_takeaway":"Teaching clitoral anatomy may help improve women’s masturbatory orgasm, but partner‑related factors need separate attention.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Large sample size for a survey","Differentiates masturbation vs partnered orgasm","Addresses gendered sexual education"],"limitations":["Convenience, non‑random undergraduate sample limits generalisability","Ad‑hoc knowledge items lack validation","No control for mental‑health, relationship or moral variables"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":45,"citing_publications":135,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j013v42n01_07"}},{"id":4413,"doi":"10.1177/00030651050530041201","pmid":"16405220","pmcid":null,"title":"As the wheel turns: a centennial reflection on Freud's Three Essays on the Theory of Sexuality","authors":"Person ES.","first_author":"Person ES.","journal":"Journal of the American Psychoanalytic Association","year":2005,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical/interpretive article; no original data, no empirical methods.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how Freud’s early 20th‑century ideas about libido and sexual development emerged from a period focused on pathological sexuality, and how later psychoanalytic theory broadened to include normal sexual behavior.","clinical_takeaway":"None – the paper is historical and does not provide clinical guidance.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Comprehensive historical overview","Places Freud's ideas in broader cultural context"],"limitations":["No empirical data","No systematic methodology"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00030651050530041201"}},{"id":4414,"doi":"10.1016/j.jpurol.2016.05.020","pmid":"28254239","pmcid":null,"title":"Psychosexual development management of bladder exstrophy epispadias in complex patients","authors":"Di Grazia M, Pellizzoni S, Tonegatti LG, Rigamonti W.","first_author":"Di Grazia M","journal":"Journal of pediatric urology","year":2017,"pub_types":["Journal Article"],"keywords":["Bladder Extrophy","Adolescencent Patients","Sexuality Evaluation Schedule Assessment Monitoring"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"single-group pre‑post intervention over 1 year with 13 adolescents","sample_n":13,"sample_text":"13 adolescent patients","population":"adolescents with bladder‑exstrophy‑epispadias complex (BEEC)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A one‑year educational program was tested on 13 teens with bladder‑exstrophy. Using a questionnaire, participants reported more positive feelings about their bodies and sexuality after the program, but the study was small and lacked a comparison group.","clinical_takeaway":"Potential benefits of psychosexual counseling for BEEC adolescents, but evidence is preliminary; clinicians should monitor outcomes carefully.","confidence":0.5,"topic_tags":["sexual_function","adolescents","gender"],"strengths":["Addresses a neglected psychosexual issue in a specific medical population","Uses a structured questionnaire to assess change","Authors acknowledge methodological limitations"],"limitations":["Very small sample (N=13) with no control group","Unclear validation status of SESAMU instrument","No separate measurement of masturbation vs other sexual behavior"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpurol.2016.05.020"}},{"id":4415,"doi":"10.1093/oxfordjournals.humrep.a138193","pmid":"8408488","pmcid":null,"title":"Comparison of semen quality obtained by vibratory stimulation and masturbation","authors":"Toussaint DN, Roth EJ, Chen D, Ling EA, Jeyendran RS.","first_author":"Toussaint DN","journal":"Human reproduction (Oxford, England)","year":1993,"pub_types":["Comparative Study","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"within‑subject comparative study of 6 healthy males","sample_n":6,"sample_text":"Six normal males","population":"adult men, normal fertility, small convenience sample","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Six healthy men provided semen samples by both masturbation and penile vibration. The quantity, sperm quality and biochemical makeup were essentially the same for the two methods, suggesting vibration is a physiological way to trigger ejaculation.","clinical_takeaway":"Vibratory stimulation can be used as an alternative to masturbation for semen collection without compromising semen quality.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["objective laboratory semen analyses","within‑subject design controls individual variability","comprehensive biochemical profiling"],"limitations":["very small sample (n=6) limits generalisability","no power calculation reported","participants not representative of broader male population"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/oxfordjournals.humrep.a138193"}},{"id":4416,"doi":"10.1023/b:aseb.0000044738.84813.3b","pmid":"15483368","pmcid":null,"title":"Lifetime depression history and sexual function in women at midlife","authors":"Cyranowski JM, Bromberger J, Youk A, Matthews K, Kravitz HM, Powell LH.","first_author":"Cyranowski JM","journal":"Archives of sexual behavior","year":2004,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":90,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional community sample (N=914) of midlife women","sample_n":914,"sample_text":"community‑based sample of midlife women recruited from the Study of Women’s Health Across the Nation","population":"women aged 42-52, community‑based","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 914 midlife women, those with a history of recurrent major depression reported less physical pleasure and satisfaction in partnered sex and higher rates of masturbation, even after accounting for current mood, medication, and other factors.","clinical_takeaway":"History of recurrent depression may be linked to lower partnered sexual pleasure and higher masturbation in midlife women; assess mood history when addressing sexual concerns.","confidence":0.82,"topic_tags":["sexual_function","lgbtq","moral_incongruence","masturbation"],"strengths":["Large, community‑based sample (N > 900)","Validated clinical interview for depression","Controls for several relevant covariates"],"limitations":["Cross‑sectional; cannot infer causality","Sexual function measured with non‑validated self‑report items","Moral/religious attitudes not assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":10,"contrasting":0,"mentioning":76,"citing_publications":153,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/b:aseb.0000044738.84813.3b"}},{"id":4418,"doi":"10.1007/bf01542359","pmid":"8476336","pmcid":null,"title":"Gender differences in masturbation and the relation of masturbation experience in preadolescence and/or early adolescence to sexual behavior and sexual adjustment in young adulthood","authors":"Leitenberg H, Detzer MJ, Srebnik D.","first_author":"Leitenberg H","journal":"Archives of sexual behavior","year":1993,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of university students comparing self‑reported masturbation frequency and early‑life experience with adult sexual outcomes.","sample_n":null,"sample_text":"University student sample (size not reported in abstract)","population":"University students (likely US, predominantly young adults)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1993 survey of US university students found men report masturbating more often than women, and early masturbation does not predict later sexual satisfaction or problems.","clinical_takeaway":"Early masturbation appears neutral for later sexual adjustment; clinicians need not view it as harmful or beneficial.","confidence":0.7,"topic_tags":["masturbation","gender","sexual_function","adolescents"],"strengths":["Large‑scale gender comparison","Addresses a long‑standing claim about gender differences","Considers early‑life masturbation experience"],"limitations":["Reliance on single‑item self‑report measures","Convenience sample of university students (WEIRD bias)","No control for moral, mental‑health or relational confounds","No effect‑size reporting or power analysis"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":41,"citing_publications":83,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542359"}},{"id":4419,"doi":"10.4103/1008-682x.178851","pmid":"27048781","pmcid":"PMC4854086","title":"Advances in the management of infertility in men with spinal cord injury","authors":"Ibrahim E, Brackett NL, Lynne CM.","first_author":"Ibrahim E","journal":"Asian journal of andrology","year":2016,"pub_types":["review-article","Review","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4854086","cited_by_count":37,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of assisted ejaculation techniques for men with spinal cord injury; no original empirical data, no systematic methodology reported","sample_n":null,"sample_text":"not applicable (review)","population":"men with spinal cord injury and their partners","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review outlines how men with spinal cord injuries can obtain sperm using techniques like penile vibration or electroejaculation, discusses risks such as autonomic dysreflexia, and notes that sperm quality often shows normal counts but low motility.","clinical_takeaway":"Penile vibratory stimulation or electroejaculation are first‑line, less invasive methods for sperm collection in men with spinal cord injury.","confidence":0.8,"topic_tags":["sexual_function","religiosity","masturbation","pornography"],"strengths":["Comprehensive overview of assisted ejaculation methods","Highlights clinical considerations (autonomic dysreflexia, erectile dysfunction)"],"limitations":["Narrative, non-systematic approach","No original data or quantitative synthesis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/1008-682x.178851"}},{"id":4421,"doi":"10.1310/hpj5105-358","pmid":"27303087","pmcid":"PMC4896342","title":"Unequal Sized Pupils Due to Escitalopram; Adverse Events to Dietary Supplements Causing Emergency Department Visits; Compulsive Masturbation Due to Pramipexole; Metformin-Induced Lactic Acidosis Masquerading As an Acute Myocardial Infarction","authors":"Mancano MA.","first_author":"Mancano MA.","journal":"Hospital pharmacy","year":2016,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single adverse‑drug‑reaction case report describing compulsive masturbation after pramipexole","sample_n":null,"sample_text":"Not specified; likely single case","population":"individual patient(s) with ADRs; not a systematic sample","country":"USA (implied by FDA MedWatch)","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article reports isolated cases of adverse drug reactions, including a report of compulsive masturbation after taking pramipexole, to raise awareness and encourage reporting to the FDA.","clinical_takeaway":"Clinicians should monitor patients on dopamine agonists for possible compulsive sexual behaviours and report any adverse events.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["high clinical relevance of ADR awareness","calls for reporting to FDA"],"limitations":["single‑case description, no systematic data","no measurement of confounding factors","no validated scales for compulsive behaviour"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1310/hpj5105-358"}},{"id":4422,"doi":"10.1155/2016/1274124","pmid":"27239200","pmcid":"PMC4864529","title":"Bone Cutting Forceps: A Safe Approach for Saving Strangulated Penis","authors":"Abd El Salam MA, Gamal A, Elenany H.","first_author":"Abd El Salam MA","journal":"Case reports in medicine","year":2016,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4864529","cited_by_count":4,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"1 patient (23‑year‑old male)","population":"single adult male, emergency department case","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 23‑year‑old man had a metal ring stuck on his penis for over 8 hours while masturbating. Doctors used bone‑cutting forceps to remove it safely, avoiding tissue damage.","clinical_takeaway":"Prompt, careful removal with appropriate tools can save the penis in strangulation emergencies.","confidence":0.9,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["detailed clinical description of a rare emergency","clear outcome (successful removal, uneventful recovery)"],"limitations":["single case, no generalisable data","no systematic assessment of psychosocial factors","no comparison or control condition"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2016/1274124"}},{"id":4423,"doi":"10.1590/s0104-42302004000400038","pmid":"15666029","pmcid":null,"title":"[Assessment of orgasmic capacity of postmenopausal women]","authors":"Penteado SR, Fonseca AM, Bagnoli VR, Assis JS, Pinotti JA.","first_author":"Penteado SR","journal":"Revista da Associacao Medica Brasileira (1992)","year":2004,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.1590/s0104-42302004000400038","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"por","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Convenience sample of 60 sexually active post‑menopausal women selected from a larger pool; logistic regression with 17 predictors","sample_n":60,"sample_text":"60 women selected from 999 screened","population":"postmenopausal women, age 41‑60, healthy, sexually active, not on hormone therapy","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 60 healthy post‑menopausal women, the ability to orgasm was linked to masturbating, feeling affectionate toward a partner, and vaginal dryness, while other examined factors were not significant.","clinical_takeaway":"Masturbation and positive partner interactions may support orgasmic function in post‑menopausal women.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Large initial screening pool (999)","Inclusion of both partnered and solitary sexual activity","Use of multivariate logistic regression"],"limitations":["Small final sample (N=60) for many predictors","Convenience selection limits generalisability","No validated scales reported for orgasmic capacity or psychosocial variables"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":3,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s0104-42302004000400038"}},{"id":4424,"doi":"10.1080/0092623x.2016.1176608","pmid":"27115100","pmcid":null,"title":"Correlates of Sex Frequency and Sexual Satisfaction Among Partnered Older Adults","authors":"Gillespie BJ.","first_author":"Gillespie BJ.","journal":"Journal of sex & marital therapy","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large national cross‑sectional survey of partnered adults aged 50‑85 (N=9,164)","sample_n":9164,"sample_text":"national sample of partnered older adults, age 50‑85, together for >1 year","population":"partnered older adults, community‑dwelling, mixed gender","country":"unspecified (likely USA based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 9,000 partnered adults aged 50‑85, more frequent and satisfying sex was linked to open communication, matching desire, and a varied sexual repertoire.","clinical_takeaway":"Encouraging communication and variety may boost sexual frequency and satisfaction in older couples.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Very large, nationally representative sample","Focus on partnered sexual dynamics, not just frequency","Multiple aspects of sexual communication examined"],"limitations":["Cross‑sectional; no causal inference","Reliance on self‑report without validated scales reported","Key confounds (mental health, moral attitudes, trauma) not measured"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":0,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":0,"mentioning":31,"citing_publications":73,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2016.1176608"}},{"id":4425,"doi":"10.1007/s10508-016-0745-z","pmid":"27091187","pmcid":null,"title":"Topography of Human Erogenous Zones","authors":"Nummenmaa L, Suvilehto JT, Glerean E, Santtila P, Hietanen JK.","first_author":"Nummenmaa L","journal":"Archives of sexual behavior","year":2016,"pub_types":["Journal Article"],"keywords":["Sexuality","Touch","Arousal","Bonding","Somatosensation"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey with 704 participants mapping self‑reported erogenous zones while masturbating or with a partner.","sample_n":704,"sample_text":"704 participants","population":"Adults (young adult age range), mixed gender, likely convenience sample","country":"Not specified (likely Finland via author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 704 adults, participants coloured body maps to show which areas felt sexually arousing when touched, both during masturbation and when with a partner. Genitals, breasts, and anus were the most common hotspots, but most of the body was reported as potentially arousing, especially during partnered sex.","clinical_takeaway":"Sexual arousal can be triggered by touch across many body regions; clinicians should consider the broader range of erogenous zones when discussing sexual health with clients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size (n=704)","Novel visual mapping method for erogenous zones","Comparison of solo vs partnered sexual context"],"limitations":["Self‑report, no physiological validation","No measurement of potential psychological confounds (e.g., mental health, moral attitudes)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":29,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0745-z"}},{"id":4426,"doi":null,"pmid":"27070397","pmcid":null,"title":"[Self defilement – a serious medical condition?]","authors":"Uvelius B.","first_author":"Uvelius B.","journal":"Lakartidningen","year":2016,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"swe","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4427,"doi":"10.1038/scsandc.2015.38","pmid":"28053740","pmcid":"PMC5129398","title":"Retrospective review on effectiveness of high-amplitude penile vibratory stimulation for conservative sperm retrieval in anejaculatory men with spinal cord injury: an Asian case series","authors":"Zamli AH, Ismail NA, Ong KG.","first_author":"Zamli AH","journal":"Spinal cord series and cases","year":2016,"pub_types":["Journal Article","case-report"],"keywords":["Rehabilitation","Reproductive Techniques"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"retrospective case series of 13 men with spinal cord injury undergoing high‑amplitude penile vibratory stimulation","sample_n":13,"sample_text":"13 out of 16 eligible patients","population":"men with anejaculatory spinal cord injury referred for sperm retrieval (Asian)","country":"Asia (likely Malaysia)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 13 men with spinal cord injury, high‑amplitude penile vibration helped about half achieve ejaculatory semen, similar to results seen in Caucasian groups.","clinical_takeaway":"Penile vibratory stimulation can be an effective first‑line option for sperm retrieval in Asian men with SCI, but evidence is limited.","confidence":0.7,"topic_tags":["sexual_function","religiosity","neuroscience","moral_incongruence","masturbation"],"strengths":["Objective physiological outcome (antegrade ejaculation)","Clear definition of success","Relevant clinical population"],"limitations":["Very small sample, no control group","Retrospective design, possible selection bias","No statistical testing or effect size reporting"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":3,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[{"status":"Has erratum","date":"2016-7-21","noticeDoi":"10.1038/scsandc.2016.19","doi":"10.1038/scsandc.2015.38"}],"url":"https://scite.ai/reports/10.1038/scsandc.2015.38"}},{"id":4428,"doi":"10.1080/00926239308404372","pmid":"8308915","pmcid":null,"title":"Masturbatory guilt and sexual responsiveness among post-college-age women: sexual satisfaction revisited","authors":"Davidson JK, Darling CA.","first_author":"Davidson JK","journal":"Journal of sex & marital therapy","year":1993,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Anonymous questionnaire administered to 868 registered‑nurse women in 15 US states; 671 who had masturbated were analysed. Self‑report measures of masturbatory guilt, sexual responsiveness and satisfaction. No longitudinal or experimental manipulation.","sample_n":671,"sample_text":"female registered nurses from 15 states; respondents who had masturbated (N=671).","population":"Adult female registered nurses (post‑college age) in the United States, self‑selected sample.","country":"United States","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a 1993 survey of 671 female nurses who masturbated, those who felt guilty about the practice reported lower sexual satisfaction and weaker physiological and psychological responses.","clinical_takeaway":"Masturbatory guilt may be linked to reduced sexual satisfaction; clinicians should assess guilt and moral concerns when addressing women’s sexual health.","confidence":0.7,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Large sample size for a questionnaire study","Focused on a specific, understudied population (female nurses)","Addresses both physiological and psychological dimensions of sexual satisfaction"],"limitations":["Cross‑sectional design; cannot infer causality","Reliance on unvalidated self‑report items","No measurement or control of moral/religious attitudes or other confounds"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239308404372"}},{"id":4429,"doi":"10.4183/aeb.2016.168","pmid":"31149083","pmcid":"PMC6535281","title":"APPROACHES TO THE 26-36-YEAR-OLD LITHUANIAN MEN'S SEXUAL FUNCTION","authors":"Matulevicius V, Zilaitiene B, Preiksa RT, Banisauskaite I, Jurevičiūtė J, Abramavicius S, Matuleviciute I, Kurakovas T, Ostrauskas R, Verkauskiene R, Urbanavicius V.","first_author":"Matulevicius V","journal":"Acta endocrinologica (Bucharest, Romania : 2005)","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Reproductive Health","Healthy Man"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 61 men (aged 26‑36) recruited from a previous cohort; participants completed the validated EMAS‑SFQ questionnaire; anthropometric, hormonal and sperm data from earlier study were linked.","sample_n":61,"sample_text":"Sixty‑one 26‑36‑year‑old men were recaptured from the 2003‑2004 KELLY study and completed the EMAS‑SFQ.","population":"General population of young Lithuanian men (re‑contacted cohort).","country":"Lithuania","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 61 Lithuanian men aged 26‑36 used a standard questionnaire to describe their sexual function and masturbation frequency, offering reference values for this age group.","clinical_takeaway":"Clinicians can use the reported EMAS‑SFQ scores as provisional reference values for young Lithuanian men’s sexual health.","confidence":0.6,"topic_tags":["sexual_function","masturbation","religiosity"],"strengths":["Uses a validated sexual function questionnaire (EMAS‑SFQ)","Provides reference data for young Lithuanian men","Links sexual function with objective reproductive health markers"],"limitations":["Small, non‑probability sample (N=61)","Masturbation measured by a single item only","No control for moral, mental‑health, relationship or trauma variables"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4183/aeb.2016.168"}},{"id":4430,"doi":"10.1016/j.concog.2016.03.013","pmid":"27003264","pmcid":null,"title":"Altered states of consciousness are related to higher sexual responsiveness","authors":"Costa RM, Pestana J, Costa D, Wittmann M.","first_author":"Costa RM","journal":"Consciousness and cognition","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Orgasm","Altered States Of Consciousness","Psychological Absorption","Sexual Responsiveness"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 116 adults reporting subjective awareness and sexual responsiveness","sample_n":116,"sample_text":"116 subjects","population":"adults (both sexes), likely convenience sample","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 116 adults, greater focus on bodily sensations and less awareness of time and space were linked to higher sexual satisfaction, desire, arousal and vaginal‑intercourse orgasm, especially for women.","clinical_takeaway":"Heightened bodily attention may enhance sexual responsiveness, but evidence is correlational.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a sexuality survey","Differentiates vaginal versus non‑coital orgasm","Considers subjective states of awareness"],"limitations":["Self‑report measures likely ad‑hoc, not validated","Cross‑sectional, cannot infer causality","No control for known confounds (mood, partner effects, moral attitudes)","Interpretation may overstate causal link"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.concog.2016.03.013"}},{"id":4431,"doi":"10.4088/jcp.v65n0715","pmid":"15291688","pmcid":null,"title":"Naltrexone in the treatment of adolescent sexual offenders","authors":"Ryback RS.","first_author":"Ryback RS.","journal":"The Journal of clinical psychiatry","year":2004,"pub_types":["Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"open‑label prospective single‑arm study of 21 adolescent sexual offenders; before‑during‑after within‑subject design; no control group","sample_n":21,"sample_text":"21 adolescents; 13 had medication stopped for within‑subject comparison","population":"adolescent sexual offenders in an inpatient treatment program (N=21)","country":"USA (implied by journal)","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational","circular_addiction_scale"],"stance":"supports","citation_value":"useful","plain_summary":"A small open‑label study gave the opioid blocker naltrexone to 21 teenage sexual offenders. Most showed a drop in daily fantasies and masturbation while on the drug, but the design lacked controls and used unvalidated self‑reports.","clinical_takeaway":"Evidence is insufficient to recommend naltrexone for hypersexuality; findings are preliminary and not generalisable.","confidence":0.7,"topic_tags":["neuroscience","treatment","adolescents","sexual_function","csbd"],"strengths":["Daily behavioural logs provide fine‑grained within‑subject data","Clear dosing information for naltrexone","Reports safety (clinical chemistries unchanged)"],"limitations":["Unvalidated self‑report criteria for hypersexuality","No control or randomisation; possible regression to the mean","Small, highly selected sample limits generalisability","No statistical tests, effect sizes, or power justification"],"rubric_version":"2.0","raw_total":17,"max_possible":60,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":35,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/jcp.v65n0715"}},{"id":4432,"doi":"10.1111/j.1743-6109.2004.10110.x","pmid":"16422985","pmcid":null,"title":"Disorders of orgasm in women","authors":"Meston CM, Hull E, Levin RJ, Sipski M.","first_author":"Meston CM","journal":"The journal of sexual medicine","year":2004,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":85,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"expert consensus review based on literature grading and committee discussion; no primary data collection","sample_n":null,"sample_text":"No primary sample; recommendations derived from expert panels","population":"women with orgasmic dysfunction (clinical context, no sample size reported)","country":"International (experts from 60 countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This article reviews expert consensus on diagnosing and treating female orgasmic disorder, summarising current psychotherapy evidence and noting a lack of effective medication trials.","clinical_takeaway":"Treatments focus on cognitive‑behavioral therapy; pharmacologic options remain unproven.","confidence":0.7,"topic_tags":["sexual_function","csbd","pornography","masturbation"],"strengths":["Broad international expert involvement","Systematic grading of existing evidence"],"limitations":["No primary empirical data","Potential bias from expert opinion"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":105,"citing_publications":269,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2004.10110.x"}},{"id":4433,"doi":"10.5993/ajhb.28.4.5","pmid":"15228970","pmcid":null,"title":"Religiosity and sexual responsibility: relationships of choice","authors":"Davidson JK, Moore NB, Ullstrup KM.","first_author":"Davidson JK","journal":"American journal of health behavior","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["masturbation","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"anonymous questionnaire administered to 535 female undergraduates at a Midwestern university; cross‑sectional convenience sample","sample_n":535,"sample_text":"535 female undergraduates","population":"female undergraduate students (age ~18‑22), United States","country":"USA","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 535 college women, higher religiosity was linked to more negative views of non‑procreative sex, greater guilt about masturbation, and fewer sexual partners, but it did not affect how satisfied they felt sexually.","clinical_takeaway":"Clinicians should consider a client’s religious beliefs when discussing sexual guilt and attitudes, as they may shape expectations and behaviors.","confidence":0.7,"topic_tags":["religiosity","sexual_function","masturbation"],"strengths":["Large sample for a single‑university survey","Direct assessment of guilt toward masturbation","Clear link between religiosity and sexual attitudes"],"limitations":["Convenience, WEIRD sample limits generalizability","No validated scales reported for key constructs","Cross‑sectional; no causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":6,"contrasting":0,"mentioning":50,"citing_publications":86,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5993/ajhb.28.4.5"}},{"id":4435,"doi":"10.1007/s12024-016-9751-7","pmid":"26945742","pmcid":null,"title":"Natural death in the setting of autoerotic practice","authors":"Baber Y, Bott E.","first_author":"Baber Y","journal":"Forensic science, medicine, and pathology","year":2016,"pub_types":["Journal Article","Case Reports"],"keywords":["Asphyxia","Natural Death","Pulmonary Emboli","Autoerotic Activity"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single 69‑year‑old male autopsy","sample_n":1,"sample_text":"single case","population":"male adult, deceased in autoerotic setting","country":"unspecified (likely UK based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 69‑year‑old man was found dead in a complex autoerotic setup. Autopsy showed deep‑vein thrombosis and pulmonary emboli, suggesting his death resulted from natural clot formation rather than asphyxiation, which is the usual cause in such cases.","clinical_takeaway":"Autoerotic practices that involve prolonged immobility may increase risk of blood clots; clinicians should discuss clot‑prevention with patients engaging in such activities.","confidence":0.9,"topic_tags":["masturbation","sexual_function","pornography"],"strengths":["Detailed forensic description","Clear autopsy findings linking DVT/PE to death","Highlights rare natural cause in autoerotic context"],"limitations":["Single case, no generalizability","No systematic assessment of psychological or sexual variables","No comparison group"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12024-016-9751-7"}},{"id":4436,"doi":"10.29063/ajrh2016/v20i1.10","pmid":"29553182","pmcid":null,"title":"Sexual Health of Prison Inmates: A Case Study of Kano Central Prison, North Western Nigeria","authors":"Lawan UM, Amole GT, Shuaib MJ.","first_author":"Lawan UM","journal":"African journal of reproductive health","year":2016,"pub_types":["Journal Article"],"keywords":["Nigeria","Sexual Health","Sexual Violence","Prison Inmates","Kano Central Prison"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-method case study of 160 inmates in one Nigerian prison; quantitative survey plus qualitative interviews","sample_n":160,"sample_text":"160 inmates surveyed; mixed‑method (survey + interviews)","population":"prison inmates (male and female) at Kano Central Prison, Nigeria","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A mixed‑method study of 160 inmates in a Nigerian prison found high levels of sexual desire, frequent masturbation and anal sex, and notable rates of sexual violence. The authors call for legislation and the possibility of conjugal visits to improve inmate sexual health.","clinical_takeaway":"None – the study describes inmate sexual health patterns but does not provide actionable clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["large single‑site sample for prison context","mixed‑method provides qualitative depth","covers both sexual desire and violence"],"limitations":["Convenience sample from one prison limits generalisability","No validated measurement instruments reported","No control for key confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":16,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.29063/ajrh2016/v20i1.10"}},{"id":4437,"doi":"10.1016/j.jsxm.2016.01.015","pmid":"26936073","pmcid":null,"title":"Sexual Behaviors of U.S. Men by Self-Identified Sexual Orientation: Results From the 2012 National Survey of Sexual Health and Behavior","authors":"Dodge B, Herbenick D, Fu TC, Schick V, Reece M, Sanders S, Fortenberry JD.","first_author":"Dodge B","journal":"The journal of sexual medicine","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Men","Sexual behavior","Bisexual","Sexual Identity","Heterosexual","Homosexual"],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative probability sample surveyed online in 2012; oversampling of gay and bisexual men; descriptive comparisons across sexual orientation groups.","sample_n":null,"sample_text":"Nationally representative probability sample (exact N not given in abstract)","population":"U.S. men 18+ (national probability sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a nationally representative U.S. survey, the study described how men of different sexual orientations engage in solo and partnered sexual activities, showing distinct patterns for heterosexual, gay, and bisexual men.","clinical_takeaway":"Clinicians can recognize that sexual behavior patterns vary widely by orientation, supporting individualized sexual health counseling.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative probability sample","Includes oversampling of gay and bisexual men for better subgroup estimates","Separates solo versus partnered sexual activities"],"limitations":["Self‑report data may be subject to recall or social desirability bias","No measurement of moral, mental‑health or trauma variables that could confound findings","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":1,"mentioning":39,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2016.01.015"}},{"id":4438,"doi":"10.1111/j.1651-2227.2004.tb03029.x","pmid":"15244238","pmcid":null,"title":"Video reveals self-stimulation in infancy","authors":"Casteels K, Wouters C, Van Geet C, Devlieger H.","first_author":"Casteels K","journal":"Acta paediatrica (Oslo, Norway : 1992)","year":2004,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of five infants presenting with self‑stimulation, plus literature review of 12 cases","sample_n":5,"sample_text":"five girls under 1 y of age presented at our department","population":"infants (<1 y) with observed self‑stimulation; clinical setting","country":"Belgium (implied by authors' affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe five infants who showed self‑stimulation, a behaviour that can be mistaken for medical problems. Video recordings helped correctly identify it, allowing reassurance of parents.","clinical_takeaway":"Infant self‑stimulation is usually benign; video documentation can prevent unnecessary tests and treatment.","confidence":0.8,"topic_tags":["masturbation","sexual_function","pornography"],"strengths":["Rare clinical observation with video documentation","Highlights diagnostic challenge and avoids unnecessary interventions"],"limitations":["Very small, non‑representative sample","No systematic measurement or follow‑up","No control group or statistical analysis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":19,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1651-2227.2004.tb03029.x"}},{"id":4439,"doi":"10.1016/0005-7967(92)90043-g","pmid":"1520245","pmcid":null,"title":"The effects of masturbatory reconditioning with nonfamilial child molesters","authors":"Johnston P, Hudson SM, Marshall WL.","first_author":"Johnston P","journal":"Behaviour research and therapy","year":1992,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"experimental","design_detail":"pre‑post single‑group treatment of 10 non‑familial child molesters; no control group","sample_n":10,"sample_text":"10 participants receiving directed‑masturbation and satiation conditioning","population":"adult male non‑familial child molesters (N=10)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Ten adult male non‑family child molesters received a therapy that paired guided masturbation with sexual satiation. After treatment, they showed a drop in deviant arousal, but the study’s tiny sample and lack of control make the findings unreliable.","clinical_takeaway":"No firm clinical recommendations; evidence for this reconditioning method is weak and based on a very small, uncontrolled study.","confidence":0.3,"topic_tags":["masturbation","sexual_function"],"strengths":["Rare experimental attempt with a high‑risk population","Authors acknowledge limited empirical support"],"limitations":["Very small, non‑representative sample (N=10)","No control or comparison group","Unvalidated measures of arousal"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0005-7967(92)90043-g"}},{"id":4440,"doi":"10.1016/1059-1311(92)90026-w","pmid":"1344768","pmcid":null,"title":"Epileptic fits or infantile masturbation?","authors":"Wulff CH, Ostergaard JR, Storm K.","first_author":"Wulff CH","journal":"Seizure","year":1992,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of two infants with video analysis and EEG","sample_n":2,"sample_text":"Two infants (one female, one male) evaluated in a clinical setting.","population":"infants (5‑6 months) presenting with seizure‑like activity","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Two infants were thought to have seizures, but EEGs were normal and video showed the episodes were actually masturbatory behavior.","clinical_takeaway":"Clinicians should consider non‑epileptic causes, such as infant masturbation, when evaluating rhythmic motor events.","confidence":0.7,"topic_tags":["masturbation","sexual_function","pornography"],"strengths":["Clear clinical differentiation between seizure and masturbatory activity","Use of video evidence and EEG to support diagnosis","Highlights an uncommon differential diagnosis in infants"],"limitations":["Very small sample (n=2) – no generalizability","No systematic assessment or validated measures","Limited to descriptive case report without statistical analysis"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/1059-1311(92)90026-w"}},{"id":4442,"doi":null,"pmid":"27266214","pmcid":null,"title":"Presence of Sperm in Pre-Ejaculatory Fluid of Healthy Males","authors":"Kovavisarach E, Lorthanawanich S, Muangsamran P.","first_author":"Kovavisarach E","journal":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"observational laboratory study of 42 healthy Thai men collecting pre‑ejaculatory fluid and semen after masturbation; convenience sample; descriptive statistics","sample_n":42,"sample_text":"42 healthy Thai men enrolled between Aug–Nov 2009","population":"42 healthy adult males, Thailand, recruited from obstetrics‑gynecology department","country":"Thailand","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study of 42 healthy Thai men, 16.7% had active sperm in the fluid released before ejaculation, suggesting that withdrawal after sex may not fully prevent pregnancy.","clinical_takeaway":"Withdrawal (coitus interruptus) can fail because pre‑ejaculatory fluid may contain sperm; advise additional contraception.","confidence":0.85,"topic_tags":["prevalence","sexual_function","religiosity","relationships","csbd"],"strengths":["Objective microscopy provides direct evidence","Clear definition of outcome (mobile sperm)","Relevant to contraceptive failure risk"],"limitations":["Small convenience sample (N=42)","No power calculation or confidence intervals","Limited generalisability beyond Thai men"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":7,"design":4,"addiction_criteria":null,"interpretation":9}},"scite":null},{"id":4443,"doi":"10.1007/s10803-015-2622-3","pmid":"26481386","pmcid":"PMC4724358","title":"Parental Awareness of Sexual Experience in Adolescent Boys  With Autism Spectrum Disorder","authors":"Dewinter J, Vermeiren R, Vanwesenbeeck I, Nieuwenhuizen ChV.","first_author":"Dewinter J","journal":"Journal of autism and developmental disorders","year":2016,"pub_types":["brief-report","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4724358","cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 43 parent‑adolescent dyads with ASD","sample_n":43,"sample_text":"43 parent‑adolescent dyads","population":"adolescent boys with autism spectrum disorder and their parents","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Parents of autistic teenage boys often miss their sons' sexual experiences, especially solo activities like masturbation, leading to gaps in communication about sex.","clinical_takeaway":"Clinicians should directly discuss sexual development with autistic adolescents rather than relying solely on parental reports.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Dyadic data (parent and adolescent) allows direct comparison","Focus on a relatively understudied population (ASD adolescents)"],"limitations":["Small convenience sample (N=43) limits generalisability","Reliance on unvalidated self‑report items for sexual experience","No control for key confounds (moral attitudes, mental health, etc.)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":16,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10803-015-2622-3"}},{"id":4444,"doi":"10.1007/s00787-016-0816-7","pmid":"26791194","pmcid":"PMC4990619","title":"Adolescent boys with autism spectrum disorder growing up: follow-up of self-reported sexual experience","authors":"Dewinter J, Vermeiren R, Vanwesenbeeck I, Van Nieuwenhuizen Ch.","first_author":"Dewinter J","journal":"European child & adolescent psychiatry","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Sexual behaviour","Adolescence","Autism Spectrum Disorders"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4990619","cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"comparative follow‑up of 30 ASD boys vs 60 controls, self‑report questionnaire","sample_n":90,"sample_text":"30 ASD, 60 control","population":"adolescent boys with autism spectrum disorder and matched general‑population peers","country":"Netherlands (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A follow‑up study compared 30 teenage boys with autism to 60 peers on self‑reported sexual experiences. While both groups masturbated and had orgasms, fewer autistic boys had any partnered contact, especially simple acts like kissing. No differences were found for more intimate activities or sexual abuse.","clinical_takeaway":"Clinicians should recognize that some autistic adolescents may lag in partnered sexual experiences and tailor sexuality education accordingly.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Matched control group","Focus on an understudied population","Clear reporting of partnered vs solitary experiences"],"limitations":["Small ASD sample (n=30) limits power","Reliance on ad‑hoc self‑report items, no validated scales","Potential confounds (mental health, moral attitudes) not measured"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":29,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00787-016-0816-7"}},{"id":4446,"doi":"10.1080/0092623x.2015.1113590","pmid":"26786495","pmcid":null,"title":"Placebo and Nocebo Effects in Sexual Medicine: An Experimental Approach","authors":"Kruger TH, Grob C, de Boer C, Peschel T, Hartmann U, Tenbergen G, Schedlowski M.","first_author":"Kruger TH","journal":"Journal of sex & marital therapy","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"randomized experimental design with 4 groups (placebo, nocebo, dopamine agonist, control); 48 healthy male participants; laboratory sexual arousal paradigm","sample_n":48,"sample_text":"48 healthy male participants split into four groups (≈12 per group)","population":"healthy heterosexual men, n=48","country":"Germany (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study of 48 healthy men, instructions to expect positive or negative effects on sexual performance produced only modest placebo or nocebo changes, while the dopamine drug cabergoline modestly enhanced sexual function.","clinical_takeaway":"Placebo and nocebo influences on male sexual function appear limited; pharmacological modulation may have stronger effects.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Randomized experimental manipulation","Use of validated sexual function scales","Inclusion of a pharmacological manipulation (cabergoline)"],"limitations":["Small sample size per group limits statistical power","No measurement of potential psychological confounds (e.g., mood)","Findings limited to healthy young men"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2015.1113590"}},{"id":4447,"doi":"10.1159/000076273","pmid":"15010587","pmcid":null,"title":"Masturbation observations in Temmnick's red colobus","authors":"Starin ED.","first_author":"Starin ED.","journal":"Folia primatologica; international journal of primatology","year":2004,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":1,"mentioning":6,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000076273"}},{"id":4448,"doi":"10.1093/jhmas/jrg044","pmid":"15011814","pmcid":null,"title":"The history of masturbation: an essay review","authors":"Singy P.","first_author":"Singy P.","journal":"Journal of the history of medicine and allied sciences","year":2004,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jhmas/jrg044"}},{"id":4449,"doi":null,"pmid":"15075044","pmcid":null,"title":"Traumatic purpuric penile ulcer","authors":"Witkowski JA, Parish JL, Parish LCh.","first_author":"Witkowski JA","journal":"Acta dermatovenerologica Croatica : ADC","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report describing traumatic penile ulcer linked to daily masturbation technique","sample_n":1,"sample_text":"single case","population":"adult male, 33 years old","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 33‑year‑old man developed a painful purple‑red ulcer on his penis that healed after treatment; the ulcer recurred when he resumed daily masturbating by rubbing his penis on the sheets.","clinical_takeaway":"Repeated friction during masturbation can cause penile skin injury; advise gentle techniques.","confidence":0.8,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Detailed clinical description","Clear temporal link between behavior and lesion"],"limitations":["Single case, no generalizability","No objective measures of masturbation force","No assessment of alternative causes"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":4452,"doi":"10.1111/jsm.13048","pmid":"26612786","pmcid":null,"title":"Hypersexuality, Paraphilic Behaviors, and Gender Dysphoria in Individuals with Klinefelter's Syndrome","authors":"Fisher AD, Castellini G, Casale H, Fanni E, Bandini E, Campone B, Ferruccio N, Maseroli E, Boddi V, Dèttore D, Pizzocaro A, Balercia G, Oppo A, Ricca V, Maggi M.","first_author":"Fisher AD","journal":"The journal of sexual medicine","year":2015,"pub_types":["Journal Article"],"keywords":["Klinefelter syndrome","Hypersexuality","Gender Dysphoria","Paraphilias"],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control survey of 46 Klinefelter syndrome males vs 43 healthy controls; psychometric questionnaires and clinical interview; mediation analysis","sample_n":89,"sample_text":"46 KS, 43 HC (total 89 participants)","population":"adult males with Klinefelter syndrome and healthy male controls","country":"unspecified (likely Italy)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Men with Klinefelter syndrome showed more obsessive symptoms, higher scores on a sexual‑addiction questionnaire, more voyeuristic fantasies during masturbation, and more gender‑dysphoria than typical men. Autistic traits and obsessive‑compulsive symptoms helped explain these differences.","clinical_takeaway":"Screen for obsessive‑compulsive and autistic traits when assessing hypersexuality or gender‑dysphoria in Klinefelter patients.","confidence":0.78,"topic_tags":["sexual_function","csbd","gender"],"strengths":["Use of several validated psychometric instruments","Inclusion of a matched healthy control group","Mediation analysis exploring pathways"],"limitations":["Cross‑sectional design limits causal inference","Small sample size for mediation and group comparisons","No measurement of moral/religious attitudes or partner factors"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":42,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.13048"}},{"id":4453,"doi":null,"pmid":"1529397","pmcid":null,"title":"[Penile injuries caused by masturbation with a vacuum cleaner. Description of a case and review of the literature]","authors":"Rossi M, Cascini F, Torcigliani S.","first_author":"Rossi M","journal":"Minerva urologica e nefrologica = The Italian journal of urology and nephrology","year":1992,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"ita","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"One patient","population":"single adolescent male case","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A teenage boy injured his penis while using a vacuum cleaner for masturbation. The injury caused skin and urethral damage, which were surgically repaired with good functional and cosmetic results. The authors note how rare such injuries are and summarize similar reports.","clinical_takeaway":"Rare but serious penile injuries can occur with unconventional masturbation methods; prompt surgical care can restore function.","confidence":0.9,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Detailed anatomical description of a rare injury","Includes review of prior similar cases"],"limitations":["Single case; no generalizable data","No systematic methodology or statistical analysis"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4454,"doi":null,"pmid":"1572563","pmcid":null,"title":"[Masturbation in infancy simulating convulsive disorder]","authors":"Mendelsohn H, Tirosh E, Berant M.","first_author":"Mendelsohn H","journal":"Harefuah","year":1992,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"heb","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single infant case description","sample_n":1,"sample_text":"1 infant (female, 7 months)","population":"infant (7‑month‑old girl)","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 7‑month‑old girl’s repeated, seizure‑like episodes were found to be self‑stimulating behavior rather than epilepsy, showing that infant masturbation can mimic convulsive disorders.","clinical_takeaway":"Clinicians should consider non‑epileptic causes such as infant masturbation when evaluating repetitive movement episodes.","confidence":0.8,"topic_tags":["masturbation","prevalence","pornography","sexual_function"],"strengths":["Clear clinical description of a rare misdiagnosis","Highlights importance of careful observation"],"limitations":["Single case; no generalizability","No systematic assessment or measurement tools"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":4455,"doi":"10.1186/s12905-015-0265-3","pmid":"26603697","pmcid":"PMC4659238","title":"Treatment of Provoked Vulvodynia in a Swedish cohort using desensitization exercises and cognitive behavioral therapy","authors":"Lindström S, Kvist LJ.","first_author":"Lindström S","journal":"BMC women's health","year":2015,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4659238","cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"single-arm pre‑post clinical trial of 60 women with provoked vulvodynia receiving desensitization + CBT; outcomes measured at post‑treatment and 6‑month follow‑up","sample_n":60,"sample_text":"Sixty women suffering from PVD were treated during a 10‑week period","population":"women (n=60) with provoked vulvodynia, Sweden","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 60 Swedish women with provoked vulvodynia, a 10‑week program of desensitization exercises plus cognitive‑behavioral therapy reduced pain and improved sexual desire, pleasure, and masturbation frequency; benefits persisted at six months.","clinical_takeaway":"CBT‑based desensitization may help reduce pain and boost sexual interest in vulvodynia, but larger controlled trials are needed before routine use.","confidence":0.8,"topic_tags":["sexual_function","csbd","pornography","masturbation","treatment"],"strengths":["Validated sexual function and distress questionnaires","Clear pre‑post design with 6‑month follow‑up","Registered trial (ISRCTN) indicating some planning"],"limitations":["No control or comparator group","Small sample, limited power for subgroup effects","Potential confounding by concurrent changes (e.g., partner dynamics, mental health) not modeled"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":36,"retracted":false,"notices":[{"status":"Has correction","date":"2015-12-23","noticeDoi":"10.1186/s12905-015-0280-4","doi":"10.1186/s12905-015-0265-3"},{"status":"Has erratum","date":"2015-12","noticeDoi":"10.1186/s12905-015-0280-4","doi":"10.1186/s12905-015-0265-3"}],"url":"https://scite.ai/reports/10.1186/s12905-015-0265-3"}},{"id":4456,"doi":"10.1007/s00701-015-2643-x","pmid":"26589958","pmcid":null,"title":"Sexual activity as a trigger for intracranial hemorrhage","authors":"Foreman PM, Griessenauer CJ, Selim MH, Searls DE, Safdar A, Kasper EM, Ogilvy CS, Thomas AJ.","first_author":"Foreman PM","journal":"Acta neurochirurgica","year":2016,"pub_types":["Journal Article"],"keywords":["Sex","Stroke","Sexual activity","hemorrhage","Coitus"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Retrospective case‑series (N=16) of patients with intracranial haemorrhage temporally linked to sexual activity.","sample_n":16,"sample_text":"Sixteen patients identified from medical records.","population":"Adults (28‑74 y) presenting with non‑traumatic ICH after intercourse or masturbation.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A review of 16 patients found that serious brain bleeds sometimes happen right after sex or masturbation, likely because the activity sharply raises blood pressure.","clinical_takeaway":"Sexual activity can trigger intracranial bleeding in susceptible individuals; clinicians should consider recent sexual activity when assessing unexplained haemorrhage.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Clear clinical description of rare phenomenon","Includes both intercourse and masturbation cases","Uses radiographic confirmation of haemorrhage type"],"limitations":["Very small, retrospective case series","No systematic assessment of causality","Potential recall bias for timing of sexual activity"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00701-015-2643-x"}},{"id":4457,"doi":"10.1089/154099903322643901","pmid":"14709186","pmcid":null,"title":"Candida transmission and sexual behaviors as risks for a repeat episode of Candida vulvovaginitis","authors":"Reed BD, Zazove P, Pierson CL, Gorenflo DW, Horrocks J.","first_author":"Reed BD","journal":"Journal of women's health (2002)","year":2003,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort of 148 women with Candida vulvovaginitis and 78 male partners, 1‑year follow‑up, hazard ratios reported","sample_n":148,"sample_text":"148 women, 78 male partners","population":"women with Candida vulvovaginitis and their male sexual partners, recruited from primary‑care practices in Ann Arbor, MI","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a year‑long study of 148 women with vaginal yeast infections, having sexual practices like using saliva during masturbation or oral sex doubled the chance of a repeat infection, while the presence of the yeast in the partner’s mouth or genitals did not predict recurrence.","clinical_takeaway":"Clinicians should discuss sexual practices such as saliva‑based masturbation and cunnilingus as possible contributors to recurrent yeast infections.","confidence":0.8,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Prospective design with follow‑up","Both female and male partner factors examined","Clear statistical reporting with hazard ratios and CIs"],"limitations":["Behavioural variables based on single‑item self‑report, no validated scales","Key psychosocial confounds (mood, trauma, moral beliefs) not measured","Sample limited to one geographic area, not nationally representative"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":55,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/154099903322643901"}},{"id":4458,"doi":"10.1111/j.1464-410x.2003.04194.x","pmid":"19127683","pmcid":null,"title":"Masturbation inducing synchronous bilateral testicular torsion in an adolescent","authors":"Anjum FH, Oades GM, Rao S, Tassadaq T.","first_author":"Anjum FH","journal":"BJU international","year":2003,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1464-410x.2003.04194.x"}},{"id":4462,"doi":"10.1111/jsm.13030","pmid":"26537853","pmcid":null,"title":"Impact of Prostate Cancer Treatment on the Sexual Quality of Life for Men-Who-Have-Sex-with-Men","authors":"Lee TK, Handy AB, Kwan W, Oliffe JL, Brotto LA, Wassersug RJ, Dowsett GW.","first_author":"Lee TK","journal":"The journal of sexual medicine","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Quality of life","Sexual dysfunction","prostate cancer","Gay Men","Qualitative Study","survivorship","Homosexual","Men-who-have-ssex-with-men"],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Semi‑structured interviews with 16 MSM post‑prostate‑cancer treatment; thematic analysis.","sample_n":16,"sample_text":"Convenience sample of MSM recruited for qualitative interviews.","population":"Men‑who‑have‑sex‑with‑men (MSM) who have undergone prostate cancer treatment (n=16).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 16 gay men who had prostate cancer show that erectile, urinary and orgasm problems seriously lower sexual quality of life, and that current assessments miss their typical sexual practices like masturbation and anal sex.","clinical_takeaway":"Clinicians should consider MSM‑specific sexual concerns (e.g., masturbation, anal sex) when counseling prostate‑cancer survivors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Focus on an understudied group (MSM) after prostate cancer","Provides rich, participant‑driven insights","Identifies gaps in existing sexual QoL instruments"],"limitations":["Very small, non‑representative sample (n=16)","No quantitative validation of emerging themes","Findings may not generalise beyond recruited participants"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":117,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.13030"}},{"id":4463,"doi":"10.1002/ca.22655","pmid":"26457680","pmcid":null,"title":"Comprehensive review of the anatomy and physiology of male ejaculation: Premature ejaculation is not a disease","authors":"Puppo V, Puppo G.","first_author":"Puppo V","journal":"Clinical anatomy (New York, N.Y.)","year":2016,"pub_types":["Review","Journal Article"],"keywords":["Semen","Sexual dysfunction","Ejaculation","Orgasm","Dapoxetine","Bulbocavernosus Muscle"],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or risk‑of‑bias assessment.","sample_n":null,"sample_text":"","population":"None (review article)","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","causal_from_correlational"],"stance":"strongly-opposes","citation_value":"background","plain_summary":"The authors review male ejaculation anatomy and argue that premature ejaculation is a normal physiological variation, not a medical disorder, and criticize its classification as a disease.","clinical_takeaway":"Do not label premature ejaculation as a pathology; focus on behavioral techniques for ejaculatory control.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive anatomical description","Clear articulation of physiological phases"],"limitations":["Lacks systematic review methodology","Makes normative claims without empirical evidence","Does not address broader psychosocial factors"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":36,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ca.22655"}},{"id":4465,"doi":"10.1016/j.cjca.2015.10.010","pmid":"26690295","pmcid":null,"title":"Sexual Activity and Heart Patients: A Contemporary Perspective","authors":"Stein R, Sardinha A, Araújo CG.","first_author":"Stein R","journal":"The Canadian journal of cardiology","year":2016,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"review","sample_n":null,"sample_text":"Not applicable – review article","population":"adult heart disease patients","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises how most stable heart‑disease patients can safely resume sexual activities, from kissing to intercourse, and highlights low cardiovascular risk and the importance of counselling.","clinical_takeaway":"Clinicians can reassure stable cardiac patients that gradual resumption of sexual activity is generally safe and should be part of post‑event counselling.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of sexual activity domains (KiTOMI)","Integrates cardiology evidence on safety of sexual activity"],"limitations":["No primary data – relies on existing studies of variable quality","Does not address psychological confounds such as moral incongruence","Lacks systematic appraisal of study bias"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.cjca.2015.10.010"}},{"id":4466,"doi":"10.1093/infdis/jiv488","pmid":"26464206","pmcid":"PMC4747617","title":"Loss of Innate Host Defense Following Unprotected Vaginal Sex","authors":"Nakra NA, Madan RP, Buckley N, Huber AM, Freiermuth JL, Espinoza L, Walsh J, Parikh UM, Penrose KJ, Keller MJ, Herold BC.","first_author":"Nakra NA","journal":"The Journal of infectious diseases","year":2016,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Semen","E. coli","Mucosal immunity","Female Genital Tract","Sexual Intercourse","Human Beta Defensins"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"within‑subject repeated‑measures study (N=17) measuring cervicovaginal immune markers before and after protected vs. unprotected intercourse","sample_n":17,"sample_text":"17 women provided cervicovaginal lavage specimens across five visits","population":"adult women (young adult), 17 participants","country":"USA (NIH‑funded)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 17 women, unprotected vaginal intercourse reduced natural antibacterial defenses in the vagina, likely because seminal fluid promotes E. coli growth, suggesting a short‑term increase in infection risk.","clinical_takeaway":"Unprotected sex may temporarily lower vaginal antibacterial activity; condom use could help maintain innate defense against bacteria.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["use of validated immunological assays","within‑subject design controls for inter‑individual variability","direct measurement of functional anti‑E. coli activity"],"limitations":["very small sample limits statistical power","no correction for multiple comparisons across immune markers","limited control for hormonal phase or other biological confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/infdis/jiv488"}},{"id":4467,"doi":"10.3109/13697137.2015.1064268","pmid":"26176767","pmcid":null,"title":"To be or not to be in sexual desire: the androgen dilemma","authors":"Nappi RE.","first_author":"Nappi RE.","journal":"Climacteric : the journal of the International Menopause Society","year":2015,"pub_types":["Journal Article"],"keywords":["Testosterone","Androgens","Mass spectrometry","menopause","Hormone Therapy","Hormonal Contraception","Hypoactive Sexual Desire Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative discussion without original data; no empirical sample reported.","sample_n":null,"sample_text":"No primary sample; the article summarizes prior studies.","population":"Women (mid‑life, menopausal transition)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews evidence that higher testosterone levels are linked to greater sexual desire and masturbation in mid‑life women, suggesting testosterone therapy may help low‑desire cases when a clear deficiency can be measured.","clinical_takeaway":"Consider testosterone therapy for low sexual desire only after reliable hormone testing confirms deficiency.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Summarises recent mass‑spectrometry hormone data","References validated sexual‑desire questionnaire"],"limitations":["No original data; purely narrative","No systematic methodology described","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/13697137.2015.1064268"}},{"id":4469,"doi":"10.1016/j.psyneuen.2015.08.027","pmid":"26385109","pmcid":null,"title":"Salivary oxytocin concentrations in response to running, sexual self-stimulation, breastfeeding and the TSST: The Regensburg Oxytocin Challenge (ROC) study","authors":"Jong TR, Menon R, Bludau A, Grund T, Biermeier V, Klampfl SM, Jurek B, Bosch OJ, Hellhammer J, Neumann ID.","first_author":"Jong TR","journal":"Psychoneuroendocrinology","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Oxytocin","Radioimmunoassay","Saliva","Challenge","Running","Tsst","Sexual Self-stimulation"],"is_oa":false,"oa_url":null,"cited_by_count":197,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Within‑subject challenge study measuring salivary oxytocin before and after running, sexual self‑stimulation, breastfeeding, and the TSST in healthy adult volunteers.","sample_n":null,"sample_text":"Not specified in abstract","population":"Healthy adult men and women (including lactating women); sample size not reported in abstract.","country":"Germany (Regensburg)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested a simple saliva test that measures oxytocin spikes after running, masturbating, stress, or breastfeeding. Running and masturbating caused clear, quick rises in oxytocin for both men and women, while breastfeeding did not show a rise with the sampling used.","clinical_takeaway":"Salivary oxytocin rises after exercise and sexual self‑stimulation, suggesting a feasible, non‑invasive way to probe oxytocin system reactivity.","confidence":0.6,"topic_tags":["sexual_function","neuroscience"],"strengths":["Validated biochemical assay for oxytocin","Multiple naturalistic challenges (exercise, sexual self‑stimulation, stress)","Within‑subject design reduces inter‑individual variability"],"limitations":["No report of sample size or power analysis","No measurement of potential psychological confounds (e.g., mood, moral attitudes)","Findings limited to healthy volunteers; not generalisable to clinical populations"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":13,"contrasting":8,"mentioning":223,"citing_publications":268,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psyneuen.2015.08.027"}},{"id":4470,"doi":"10.1055/s-0037-1613612","pmid":"12876639","pmcid":null,"title":"Penile Mondor's disease after intensive masturbation in a 31-and a 33-year-old man","authors":"Dicuio M, Pomara G, Cuttano MG, Vesely S, Travaglini F, Cuzzocrea DE, Selli C.","first_author":"Dicuio M","journal":"Thrombosis and haemostasis","year":2003,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-0037-1613612"}},{"id":4471,"doi":"10.17772/gp/57853","pmid":"26665564","pmcid":null,"title":"Sexual activity of women with Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS)--preliminary study","authors":"Beisert M, Szymañska-Pytlińska M, Kapczuk K, Chodeckal A, Walczyk-Matyja K, Kędzia W.","first_author":"Beisert M","journal":"Ginekologia polska","year":2015,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of 31 women with MRKHS and 31 age‑matched healthy controls, using a psychosexual interview to assess masturbation and dyadic sexual behaviour.","sample_n":62,"sample_text":"31 patients with MRKHS and 31 healthy women","population":"Women with MRKHS (n=31) and healthy women (n=31), likely recruited from clinical settings and community volunteers.","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Women with MRKH syndrome masturbate as often as peers, but engage in dyadic sexual activities later and have fewer vaginal orgasms, likely due to anatomical differences.","clinical_takeaway":"Clinicians should recognize that masturbation frequency is typical in MRKH, but dyadic sexual experiences may need specific support.","confidence":0.7,"topic_tags":["sexual_function","masturbation","gender","moral_incongruence"],"strengths":["Direct comparison with age‑matched controls","Reports both autoerotic and dyadic behaviours","Uses non‑parametric tests appropriate for small samples"],"limitations":["Very small sample, likely underpowered","Psychosexual interview not validated","No control for key confounds (mental health, relationship status, moral factors)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":7,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.17772/gp/57853"}},{"id":4472,"doi":"10.1080/00224499.2015.1030720","pmid":"26327361","pmcid":"PMC4784483","title":"Psychosexual Correlates of Sexual Double Standard Endorsement in Adolescent Sexuality","authors":"Emmerink PM, Vanwesenbeeck I, van den Eijnden RJ, Ter Bogt TF.","first_author":"Emmerink PM","journal":"Journal of sex research","year":2016,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4784483","cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 465 adolescents (16‑20 y) assessing attitudes with a newly developed scale","sample_n":465,"sample_text":"465 heterosexual adolescents, aged 16‑20 years","population":"heterosexual adolescents, community sample (likely school‑based)","country":"not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 465 Dutch adolescents found that boys and more religious teens tend to endorse the sexual double standard (girls should be modest, boys should be sexually active). Feeling entitled to masturbate or to sexual pleasure with a partner was linked to lower endorsement of the double standard.","clinical_takeaway":"Attitudes about gendered sexuality in teens are shaped by religiosity and gender identity, not by masturbation entitlement.","confidence":0.82,"topic_tags":["sexual_function","gender","adolescents"],"strengths":["Large adolescent sample for a single‑survey study","Inclusion of both self‑ and partner‑induced sexual pleasure variables","First use of a scale specifically targeting sexual double‑standard attitudes"],"limitations":["Scale (SASSY) newly developed, limited validation reported","Cross‑sectional design prevents causal inference","Key confounds (moral incongruence, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":2,"mentioning":41,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2015.1030720"}},{"id":4473,"doi":"10.1080/09540120309695623","pmid":"12745404","pmcid":null,"title":"Novel low-risk commercial sex practices in the parks of Vietnam","authors":"Walters I.","first_author":"Walters I.","journal":"AIDS care","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive observational report of a novel public‑park commercial sex practice; no clear sampling frame or quantitative analysis.","sample_n":null,"sample_text":"Not specified in abstract","population":"Female commercial sex workers and male clients in urban parks of Vietnam; sample size not reported.","country":"Vietnam","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"useful","plain_summary":"The paper describes women in Vietnamese parks offering on‑site masturbation to men, noting high client numbers and potential HIV risk, and suggests policymakers consider this practice in AIDS prevention.","clinical_takeaway":"None – the report is descriptive and does not provide actionable clinical guidance.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Identifies a previously undocumented sex work setting","Highlights potential HIV risk context"],"limitations":["No quantitative data or clear sampling method","No measurement of risk behaviours or outcomes","Conclusions about policy lack empirical support"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540120309695623"}},{"id":4474,"doi":"10.1111/eip.12265","pmid":"26265030","pmcid":null,"title":"Inappropriate sexual behaviour in adolescents with autism spectrum disorder: what education is recommended and why","authors":"Beddows N, Brooks R.","first_author":"Beddows N","journal":"Early intervention in psychiatry","year":2016,"pub_types":["Review","Journal Article"],"keywords":["Adolescent","Puberty","Education","Autism Spectrum Disorder","Inappropriate Sexual Behaviour"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of existing literature without systematic methods or meta‑analysis; no new empirical data","sample_n":null,"sample_text":"No primary sample; review of 42 selected articles","population":"adolescents with autism spectrum disorder (ASD)","country":"Not specified (multisite literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The review describes how teens with autism may show behaviours like excessive or public masturbation and explains these arise from limited knowledge of puberty and inadequate sex education. It recommends early, individualized teaching and social‑skill training.","clinical_takeaway":"Provide tailored, repeated sex‑education and social‑skills support to autistic adolescents to reduce inappropriate sexual behaviours.","confidence":0.7,"topic_tags":["sexual_function","adolescents","other"],"strengths":["Comprehensive literature search across multiple databases","Identifies clear gaps in education research for ASD adolescents"],"limitations":["Narrative rather than systematic review; risk of selection bias","No quantitative synthesis or quality appraisal of included studies","Limited discussion of confounding factors such as mental health or trauma"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":44,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/eip.12265"}},{"id":4476,"doi":"10.1177/070674370304800411","pmid":"12776394","pmcid":null,"title":"Acute neuroendocrine response to sexual stimulation in sexual offenders","authors":"Haake P, Schedlowski M, Exton MS, Giepen C, Hartmann U, Osterheider M, Flesch M, Janssen OE, Leygraf N, Krüger TH.","first_author":"Haake P","journal":"Canadian journal of psychiatry. Revue canadienne de psychiatrie","year":2003,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory sexual stimulation with mast**ur**bation; between‑group comparison of 10 sexual offenders vs healthy controls.","sample_n":10,"sample_text":"10 volunteers recruited from 150 inpatients; control group size not reported but implied similar small number.","population":"Male sexual offenders (inpatients) and healthy male controls.","country":"Germany (implied by author affiliations)","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured hormone changes around orgasm in a few male sexual offenders compared with healthy men. Both groups showed similar prolactin spikes after orgasm, suggesting hormones alone don’t explain deviant sexual behavior.","clinical_takeaway":"Hormone levels after orgasm do not differ in high‑drive offenders; other psychological factors likely drive problematic sexual behavior.","confidence":0.6,"topic_tags":["neuroscience","sexual_function","pornography","masturbation"],"strengths":["Physiological hormone measurements before/after orgasm","Direct comparison of offenders vs controls","Continuous sampling during sexual stimulation"],"limitations":["Very small sample; likely underpowered","No validated scale for sexual drive or desire","No assessment of moral incongruence or mental‑health covariates","Offender sample not generalisable to broader population"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/070674370304800411"}},{"id":4477,"doi":"10.1007/s10508-015-0570-9","pmid":"26198747","pmcid":null,"title":"Parental Influence on Their Adult Children's Sexual Values: A Multi-National Comparison Between the United States, Spain, Costa Rica, and Peru","authors":"Negy C, Velezmoro R, Reig-Ferrer A, Smith-Castro V, Livia J.","first_author":"Negy C","journal":"Archives of sexual behavior","year":2016,"pub_types":["Comparative Study","Journal Article"],"keywords":["Sexual behavior","Parental Influence","Parent–child Communications","Sexual Values"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative survey of young adults (n≈735) from four countries; cross‑sectional questionnaire assessing perceived parental sexual values, religiosity, and participants' own sexual values.","sample_n":735,"sample_text":"Total N = 735 (United States n=218; Spain n=240; Costa Rica n=172; Peru n=105).","population":"Adult children (young adults) from US, Spain, Costa Rica, Peru; convenience samples (likely university or community volunteers).","country":"United States, Spain, Costa Rica, Peru","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 735 young adults in four countries found that, despite receiving restrictive messages from parents about sex, most participants held permissive sexual attitudes. Religion was the strongest predictor of their values, followed by parental influence.","clinical_takeaway":"Parental messages may have limited impact on adult children's sexual attitudes; clinicians should consider broader cultural and religious factors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large multi‑national sample","Inclusion of religiosity as a strong predictor","Comparative analysis across cultures"],"limitations":["Reliance on self‑report, likely non‑validated scales","Cross‑sectional design limits causal inference","Convenience sampling reduces generalisability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0570-9"}},{"id":4478,"doi":"10.1080/00926239108404351","pmid":"1815093","pmcid":null,"title":"Male masturbation as a vehicle for the pursuer/distancer relationship in marriage","authors":"Betchen SJ.","first_author":"Betchen SJ.","journal":"Journal of sex & marital therapy","year":1991,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of marital couples where male partner uses masturbation as a distancing behavior; proposes a treatment model illustrated with a few clinical cases.","sample_n":null,"sample_text":"Not specified; limited to a small number of clinical cases","population":"married adult couples (male masturbators); treatment‑seeking, not a representative sample","country":"USA (presumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes how, in some marriages, one partner may turn to masturbation while the other seeks sex, creating a cycle that can damage the relationship. It illustrates this with a few therapy cases and suggests a treatment approach.","clinical_takeaway":"When marital tension involves one partner’s solitary sexual activity, consider relational dynamics rather than pathologizing masturbation.","confidence":0.7,"topic_tags":["masturbation","relationships","sexual_function"],"strengths":["Introduces a novel relational model (pursuer/distancer) for marital discord","Provides concrete clinical examples"],"limitations":["Case report; no systematic data or measurement validation","No quantitative assessment of masturbation frequency or distress","No control for confounding factors (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239108404351"}},{"id":4479,"doi":"10.1016/j.ajp.2015.07.002","pmid":"26259894","pmcid":null,"title":"Comorbidity, knowledge and attitude towards sex among patients with Dhat syndrome: A retrospective study","authors":"Grover S, Gupta S, Mehra A, Avasthi A.","first_author":"Grover S","journal":"Asian journal of psychiatry","year":2015,"pub_types":["Journal Article"],"keywords":["Comorbidity","Dhat Syndrome","Sexual Knowledge","Sexual Attitude"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective chart review of 264 patients with Dhat syndrome; no control group; descriptive statistics and correlations","sample_n":264,"sample_text":"264 patients","population":"264 male patients diagnosed with Dhat syndrome attending a psychiatric clinic in India","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A review of 264 Indian men with Dhat syndrome found poor knowledge about many sexual topics, including masturbation, and high rates of depression and premature ejaculation. Better education was linked to more liberal sexual attitudes.","clinical_takeaway":"Patients with Dhat syndrome often need broader sexual education and mental‑health support, not just myths about semen loss.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Large clinical sample for a rare syndrome","Uses a dedicated questionnaire for sexual knowledge and attitude","Reports prevalence of comorbid psychiatric disorders"],"limitations":["Retrospective, no control group","Questionnaire not clearly validated","No adjustment for potential confounders (e.g., moral/religious attitudes, mental health)","Findings limited to treatment‑seeking men"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ajp.2015.07.002"}},{"id":4480,"doi":"10.1111/jsm.12931","pmid":"26176716","pmcid":null,"title":"Sexual Dysfunctional Beliefs Questionnaire (SDBQ): Translation and Psychometric Properties of the Iranian Version","authors":"Abdolmanafi A, Azadfallah P, Fata L, Roosta M, Peixoto MM, Nobre P.","first_author":"Abdolmanafi A","journal":"The journal of sexual medicine","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Randomized Controlled Trial","Journal Article"],"keywords":["Validation","Psychometric Properties","Dysfunctional Sexual Beliefs","Assessment Questionnaire"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study of a translated questionnaire with 387 participants (226 women, 161 men)","sample_n":387,"sample_text":"community sample, not treatment‑seeking","population":"Iranian adults, both genders","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated the Sexual Dysfunctional Beliefs Questionnaire into Persian and tested it with 387 Iranian adults. Factor analysis and reliability tests showed the Persian version works well for measuring sexual beliefs in both men and women.","clinical_takeaway":"The Persian SDBQ is a reliable tool for assessing sexual beliefs in Iranian clinical and research settings.","confidence":0.8,"topic_tags":["sexual_function","measurement"],"strengths":["Large sample for psychometric validation","Rigorous forward‑backward translation","Factor analysis supports original structure"],"limitations":["No pre‑registration","No assessment of how beliefs relate to actual sexual behavior or distress","Critical confounds (e.g., moral attitudes, mental health) not examined"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12931"}},{"id":4481,"doi":"10.1093/ageing/afv083","pmid":"26178206","pmcid":null,"title":"Examining associations between sexual behaviours and quality of life in older adults","authors":"Flynn TJ, Gow AJ.","first_author":"Flynn TJ","journal":"Age and ageing","year":2015,"pub_types":["Journal Article"],"keywords":["Quality of life","Sexual behaviour","Older People","Older Adults"],"is_oa":false,"oa_url":null,"cited_by_count":50,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 133 community-dwelling older adults; self‑report of sexual behaviour frequency/importance and WHO QoL; regression controlling for partner status and health.","sample_n":133,"sample_text":"133 participants, mean age 74 years","population":"Older adults (mean age 74, SD 7.1)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 133 adults aged around 74, people who reported more frequent sexual activities and who considered them important also reported higher quality of life, especially in social and psychological domains.","clinical_takeaway":"Encouraging sexual activity that feels important to older adults may support wellbeing, but causal effects are not proven.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Validated QoL instrument (WHO)","Both frequency and importance of behaviours assessed","Statistical control for partner status and health"],"limitations":["Cross‑sectional, cannot infer causality","Convenience sample, limited generalisability","No adjustment for mental‑health or moral‑incongruence variables"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":61,"citing_publications":94,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/ageing/afv083"}},{"id":4482,"doi":"10.1136/adc.65.12.1367","pmid":"2270946","pmcid":"PMC1793084","title":"Nocturnal faecal soiling and anal masturbation","authors":"Clark AF, Tayler PJ, Bhate SR.","first_author":"Clark AF","journal":"Archives of disease in childhood","year":1990,"pub_types":["research-article","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Two clinical case reports of children with nocturnal faecal soiling linked to anal masturbation. No systematic sampling or controls.","sample_n":2,"sample_text":"Two cases","population":"Children (adolescents) with late‑onset faecal soiling; n=2","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The report describes two children who began wetting the bed at night because they were stimulating themselves anally. The authors suggest the behaviour may keep the child from maturing, but the link is based on only two cases.","clinical_takeaway":"No clinical guidance can be drawn; the observation is anecdotal.","confidence":0.4,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Detailed clinical description of rare phenomenon","Highlights possible link between anal masturbation and soiling"],"limitations":["Only two cases – no generalisable evidence","No systematic measurement or control of confounds","Absence of validated instruments or statistical analysis"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/adc.65.12.1367"}},{"id":4483,"doi":"10.1111/psyp.12466","pmid":"26153384","pmcid":null,"title":"Examining gender specificity of sexual response with concurrent thermography and plethysmography","authors":"Huberman JS, Chivers ML.","first_author":"Huberman JS","journal":"Psychophysiology","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexuality","Psychophysiology","Plethysmography","Thermography","Sexual Arousal"],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment measuring genital vasocongestion with thermography and plethysmography while participants viewed 10‑min sexual films. Within‑subjects design; n≈55 (27 men, 28 women).","sample_n":55,"sample_text":"Adult volunteers, likely convenience sample; no indication of random selection.","population":"Gynephilic men (n=27) and androphilic women (n=28), adult volunteers.","country":"Not specified (likely USA based on author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured men’s and women’s genital responses to 10‑minute videos of people masturbating, using temperature imaging and traditional blood‑flow devices. Men showed stronger responses to videos of the gender they are attracted to, while women responded similarly to both male and female videos.","clinical_takeaway":"Gender differences in physiological arousal patterns appear robust across measurement methods.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses multiple validated physiological measures (thermography, VPP/PPG).","Within‑subject design controls for individual variability.","Longer stimulus duration allows assessment of sustained arousal."],"limitations":["Small, non‑representative convenience sample.","No preregistration or reported effect sizes/confidence intervals.","Limited assessment of potential confounds (e.g., mood, prior sexual experience)."],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":56,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/psyp.12466"}},{"id":4484,"doi":"10.1177/0020764015591857","pmid":"26142412","pmcid":null,"title":"Phenomenology and beliefs of patients with Dhat syndrome: A nationwide multicentric study","authors":"Grover S, Avasthi A, Gupta S, Dan A, Neogi R, Behere PB, Lakdawala B, Tripathi A, Chakraborty K, Sinha V, Bhatia MS, Patjoshi A, Rao TS, Rozatkar A.","first_author":"Grover S","journal":"The International journal of social psychiatry","year":2016,"pub_types":["Multicenter Study","Journal Article"],"keywords":["Beliefs","Clinical Picture","Dhat Syndrome","Culture-bound Syndrome"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"multicenter survey of 780 male patients with Dhat syndrome","sample_n":780,"sample_text":"780 male patients recruited from 15 centres across India","population":"male patients >16 y, seeking care for Dhat syndrome at 15 Indian centres","country":"India","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 780 Indian men with Dhat syndrome, the study surveyed beliefs about semen loss, finding that many linked it to excessive masturbation, sexual dreams, and low energy, and reported common psychological and somatic symptoms.","clinical_takeaway":"Patients reporting Dhat symptoms often have co‑occurring depressive features; addressing cultural beliefs may be important.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Large multicentre sample","Use of a syndrome‑specific questionnaire"],"limitations":["Cross‑sectional, no control group","No measurement of key confounds (moral, partner, trauma)","Interpretation limited to clinical description"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":48,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0020764015591857"}},{"id":4485,"doi":null,"pmid":"26494987","pmcid":"PMC4609319","title":"The existing therapeutic interventions for orgasmic disorders: recommendations for culturally competent services, narrative review","authors":"Salmani Z, Zargham-Boroujeni A, Salehi M, K Killeen T, Merghati-Khoei E.","first_author":"Salmani Z","journal":"Iranian journal of reproductive medicine","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Sexual dysfunction","Reproductive Health","Orgasm","Iranian Women"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4609319","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative critical literature review without systematic methodology or risk‑of‑bias assessment","sample_n":null,"sample_text":"Not applicable – review of existing studies","population":"Iranian women with female orgasmic disorder (FOD)","country":"Iran (focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed existing treatments for female orgasmic problems and argued that culturally sensitive, non‑pharmacological approaches such as couple therapy and sexual skill training are most suitable for Iranian women.","clinical_takeaway":"Consider culturally adapted, non‑pharmacological therapies (e.g., couple therapy, sexual skill training) when addressing female orgasmic disorder in Iranian settings.","confidence":0.6,"topic_tags":["sexual_function","gender","csbd"],"strengths":["Broad cultural focus on Iranian context","Identifies a range of therapeutic modalities"],"limitations":["Narrative, not systematic, review – risk of selection bias","No formal quality appraisal of included interventions","No quantitative synthesis or effect‑size reporting"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":4486,"doi":"10.4103/0974-7796.157973","pmid":"26229311","pmcid":"PMC4518360","title":"Alteration in the etiology of penile fracture in the Middle East and Central Asia regions in the last decade; a literature review","authors":"Majzoub AA, Canguven O, Raidh TA.","first_author":"Majzoub AA","journal":"Urology annals","year":2015,"pub_types":["review-article","Review","Journal Article"],"keywords":["Etiology","Middle East","Penile Fracture"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4518360","cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review-article (non‑systematic literature review)","sample_n":1629,"sample_text":"aggregate from included studies","population":"penile fracture cases reported in 21 studies from Middle East & Central Asia (total N≈1629)","country":"Middle East & Central Asia (multiple countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A review of 21 studies from the Middle East and Central Asia (1629 men) found that vigorous sexual intercourse is now the most common cause of penile fracture, followed by manual bending and masturbation. Surgery is the preferred treatment and leads to fewer complications than conservative care.","clinical_takeaway":"Surgery remains the treatment of choice for penile fracture; conservative management carries higher complication risk.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Aggregates data from many regional studies","Provides recent prevalence of etiologies","Large combined sample size"],"limitations":["Non‑systematic review; selection bias possible","No quantitative synthesis or risk‑of‑bias assessment","No control for confounders (e.g., moral attitudes, mental health)","Interpretation limited to description, no causal claims"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0974-7796.157973"}},{"id":4488,"doi":null,"pmid":"14626074","pmcid":null,"title":"[Attention deficit disorder without hyperactivity, (excessive) masturbation, nail biting/onchophagia, nose picking/rhinotillexomania, finger sucking]","authors":"Ogasawara M, Takeda M.","first_author":"Ogasawara M","journal":"Ryoikibetsu shokogun shirizu","year":2003,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"jpn","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4490,"doi":null,"pmid":"12931360","pmcid":null,"title":"[The sexual psychology of human males]","authors":"Wang JY.","first_author":"Wang JY.","journal":"Zhonghua nan ke xue = National journal of andrology","year":2003,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"journal commentary without empirical data","sample_n":null,"sample_text":"No original sample; paper is a narrative overview","population":"human males (general discussion)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Wang briefly reviews psychological and sociological factors that influence male sexual behavior, mentioning topics such as masturbation and sexual dysfunctions, but provides no original data or systematic analysis.","clinical_takeaway":"The paper offers general ideas only; it does not supply evidence for clinical decisions.","confidence":0.4,"topic_tags":["masturbation","sexual_function"],"strengths":["Raises awareness of psychological aspects of male sexuality","Broad, interdisciplinary perspective"],"limitations":["No empirical data or systematic review methodology","No explicit definitions or validated measures","Confounding variables not addressed"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":4491,"doi":"10.1111/j.1467-842x.2003.tb00806.x","pmid":"14696709","pmcid":null,"title":"Sex in Australia: autoerotic, esoteric and other sexual practices engaged in by a representative sample of adults","authors":"Richters J, Grulich AE, de Visser RO, Smith AM, Rissel CE.","first_author":"Richters J","journal":"Australian and New Zealand journal of public health","year":2003,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":57,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Computer‑assisted telephone interview of a nationally representative sample (≈19,300 adults, response 73 %).","sample_n":19107,"sample_text":"10,173 men and 9,134 women (16‑59 y).","population":"Adults aged 16‑59 in Australia, stratified to achieve representativeness.","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A national telephone survey of about 19,000 Australians found that 65 % of men and 35 % of women masturbated in the past year, with many also engaging in a variety of non‑coital sexual activities such as watching porn, using sex toys, or exploring BDSM‑related practices.","clinical_takeaway":"Masturbation and a range of autoerotic behaviours are common and varied among adults; clinicians should view them as normal aspects of sexual health.","confidence":0.85,"topic_tags":["prevalence","masturbation","sexual_function"],"strengths":["Large, probability‑based sample with high response rate.","Clear operational definitions of each sexual practice.","Separate measurement of frequency and recent occurrence."],"limitations":["Self‑report may be subject to social desirability bias.","No validated psychometric scales required for simple prevalence questions."],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":7,"contrasting":1,"mentioning":46,"citing_publications":107,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1467-842x.2003.tb00806.x"}},{"id":4492,"doi":"10.1002/sm2.63","pmid":"26468378","pmcid":"PMC4599552","title":"Sexual Functioning and Behavior of Men with Body Dysmorphic Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls: A Cohort Study","authors":"Veale D, Miles S, Read J, Troglia A, Wylie K, Muir G.","first_author":"Veale D","journal":"Sexual medicine","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Sexual function","Body Dysmorphic Disorder","Small Penis Syndrome","Small Penis Anxiety"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4599552","cited_by_count":41,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational cohort comparing three groups (BDD, SPA, controls) with self‑report questionnaires; opportunistic community sample of 90 men.","sample_n":90,"sample_text":"26 BDD, 31 SPA, 33 controls (opportunistic community sample).","population":"Men from the community, ages not specified, grouped by clinical diagnosis of body dysmorphic disorder concerning penis size, small‑penis anxiety, or no concerns.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Men with body‑dysmorphic disorder about penis size report lower erectile function and satisfaction than men without concerns, while men with only anxiety about size show reduced satisfaction but similar desire and frequency of sex. Both groups try methods to change penis size, reporting little success.","clinical_takeaway":"Clinicians should assess sexual satisfaction and erectile issues in men with penis‑size anxiety or BDD, and address ineffective size‑alteration attempts.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of validated IEF scale for sexual function","Clear comparator groups (BDD, SPA, controls)","Addresses an understudied population"],"limitations":["Small sample per group; underpowered for many comparisons","Cross‑sectional design limits causal inference","No control for key psychological or relational confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":53,"citing_publications":74,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/sm2.63"}},{"id":4493,"doi":"10.1007/bf01541552","pmid":"2360876","pmcid":null,"title":"Self-reported frequency of sexual urges, fantasies, and masturbatory fantasies in heterosexual males and females","authors":"Jones JC, Barlow DH.","first_author":"Jones JC","journal":"Archives of sexual behavior","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Diary self‑monitoring study with 96 heterosexual undergraduates over 7 days.","sample_n":96,"sample_text":"49 male and 47 female undergraduate participants","population":"heterosexual male (n=49) and female (n=47) undergraduates, age ~18‑22, United States (presumed)","country":"USA (likely)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 7‑day diary, 49 men and 47 women reported how often they experienced sexual urges, fantasies, and masturbatory fantasies. Men reported more urges and masturbatory fantasies than women, while overall fantasy frequency was similar.","clinical_takeaway":"None – the study describes normal variation in sexual thoughts, not a clinical issue.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large (for the time) sample of both sexes","7‑day daily monitoring reduces recall bias","Clear operational distinction between urges and fantasies"],"limitations":["Convenience undergraduate sample limits generalisability","Self‑report diary not a validated instrument","No statistical power justification or effect‑size reporting"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":48,"citing_publications":117,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541552"}},{"id":4494,"doi":"10.1080/00224490209552156","pmid":"12545415","pmcid":null,"title":"Sexual functioning and self-reported depressive symptoms among college women","authors":"Frohlich P, Meston C.","first_author":"Frohlich P","journal":"Journal of sex research","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":108,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case‑control, cross‑sectional comparison of 47 depressed vs 47 non‑depressed college women","sample_n":94,"sample_text":"47 depressed, 47 controls (age‑matched)","population":"college‑aged women (U.S. students, likely convenience sample)","country":"USA (inferred from journal and author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"College women with depressive symptoms reported lower sexual arousal, orgasm, more pain and less satisfaction, but higher desire for masturbation than non‑depressed peers.","clinical_takeaway":"Depression in young women may be linked to reduced sexual function and increased solitary sexual desire; assess both mood and sexuality in clinical care.","confidence":0.7,"topic_tags":["sexual_function","masturbation","moral_incongruence"],"strengths":["Direct comparison of depressed vs non‑depressed groups","Includes measure of solitary sexual desire (masturbation)","Multiple domains of sexual functioning assessed"],"limitations":["Small sample, likely underpowered","Convenience college sample limits generalisability","Unclear whether sexual functioning scales were validated","No control for partner or relationship factors"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":6,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":18,"contrasting":1,"mentioning":101,"citing_publications":201,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490209552156"}},{"id":4495,"doi":"10.1016/s0022-3476(05)82678-2","pmid":"2091618","pmcid":null,"title":"Masturbation mimicking abdominal pain or seizures in young girls","authors":"Fleisher DR, Morrison A.","first_author":"Fleisher DR","journal":"The Journal of pediatrics","year":1990,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case reports of five infants (7‑27 months) describing masturbatory posturing misdiagnosed as abdominal pain or seizures.","sample_n":5,"sample_text":"Five individual cases","population":"Five girls, 7–27 months old","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In five babies and toddlers, self‑stimulatory posturing was mistaken for abdominal pain or seizures, leading to unnecessary tests. The behavior was harmless and resolved on its own after parents were reassured.","clinical_takeaway":"Consider normal self‑stimulation in infants before ordering invasive work‑ups for abdominal pain or seizures.","confidence":0.7,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Detailed clinical description of a rare presentation","Highlights risk of unnecessary diagnostic testing","Provides practical guidance for clinicians"],"limitations":["No systematic data collection or validated measures","Small, non‑representative case series","No control group or statistical analysis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":68,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-3476(05)82678-2"}},{"id":4497,"doi":"10.1371/journal.pone.0123151","pmid":"25816322","pmcid":"PMC4376702","title":"Sexual behaviours of homosexual and bisexual men in France: a generational approach","authors":"Méthy N, Velter A, Semaille C, Bajos N.","first_author":"Méthy N","journal":"PloS one","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4376702","cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Large community sample of 38,821 MSM surveyed repeatedly over years; age‑cohort logistic regression analysis of self‑reported sexual practices.","sample_n":38821,"sample_text":"N = 38 821 participants aged 18‑59 from French Gay Press surveys (1985‑2011) and internet surveys (2004, 2011).","population":"Men who have sex with men, France, ages 18‑59","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A huge survey of French gay and bisexual men shows that over generations, first sexual experiences with men have become more common, while masturbation rose then fell, and oral and anal sex have increased. Younger men report more oral/anal sex but fewer recent partners.","clinical_takeaway":"None – the study describes population trends, not clinical guidance.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Very large sample size","Longitudinal analysis across multiple decades","Clear reporting of age‑cohort trends"],"limitations":["Self‑report questionnaire not validated for specific constructs","No control for key confounds (moral incongruence, mental health, partner effects)","Convenience sample from gay press and internet surveys; not nationally representative"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":18,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0123151"}},{"id":4498,"doi":"10.1016/j.jpurol.2015.02.001","pmid":"25986209","pmcid":null,"title":"Sexual function in adult patients with classic bladder exstrophy: A multicenter study","authors":"Park W, Zwink N, Rösch WH, Schmiedeke E, Stein R, Schmidt D, Noeker M, Jenetzky E, Reutter H, Ebert AK.","first_author":"Park W","journal":"Journal of pediatric urology","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Multicenter Study","Journal Article"],"keywords":["Sexual function","Quality of life","Bladder Exstrophy","Bladder Exstrophy–epispadias Complex","Cure-net"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"multicenter survey of 52 adult patients with classic bladder exstrophy using a self‑developed questionnaire","sample_n":52,"sample_text":"52 patients (13 females, 39 males) with classic bladder exstrophy; response rates 92 % for females and 64 % for males on sexual‑function items","population":"adult patients with classic bladder exstrophy (BE) (13 females, 39 males), median age 31 years, recruited from multiple German centres","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 52 adults with classic bladder exstrophy, many reported reduced sexual activity, dyspareunia in women, and lower partnership rates. Masturbation was common, but overall sexual satisfaction appeared limited, highlighting the need for lifelong physical and psychological support.","clinical_takeaway":"Clinicians should proactively address sexual health and relationship counselling in bladder‑exstrophy patients.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["multicenter recruitment reduces single‑site bias","covers a rare congenital condition with adult follow‑up","reports both male and female sexual outcomes"],"limitations":["uses a non‑validated, study‑specific questionnaire","no control or comparison group","limited statistical detail; no effect sizes or power analysis"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpurol.2015.02.001"}},{"id":4501,"doi":"10.1080/00926230290001402","pmid":"12082666","pmcid":null,"title":"Masturbatory guilt leading to severe depression and erectile dysfunction","authors":"Chakrabarti N, Chopra VK, Sinha VK.","first_author":"Chakrabarti N","journal":"Journal of sex & marital therapy","year":2002,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230290001402"}},{"id":4502,"doi":null,"pmid":"12166206","pmcid":null,"title":"[Anejaculation by masturbation or at sexual intercourse]","authors":"Otani T.","first_author":"Otani T.","journal":"Nihon rinsho. Japanese journal of clinical medicine","year":2002,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"jpn","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4503,"doi":"10.1210/jc.2014-4423","pmid":"25658163","pmcid":null,"title":"Response to the letter by Davis S. and Bell R","authors":"Randolph JF.","first_author":"Randolph JF.","journal":"The Journal of clinical endocrinology and metabolism","year":2015,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1210/jc.2014-4423"}},{"id":4505,"doi":"10.1046/j.1365-2168.2002.02075.x","pmid":"11972544","pmcid":null,"title":"Fracture of the penis","authors":"Eke N.","first_author":"Eke N.","journal":"The British journal of surgery","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":135,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Narrative review of case reports/series spanning 1935‑2001; Medline search, data extraction on cases, causes, treatment, outcomes. No meta‑analysis, no risk‑of‑bias assessment.","sample_n":1331,"sample_text":"1331 cases aggregated from published reports","population":"Cases of penile fracture reported in 183 publications (1331 patients); male, median age ~40, causes include coitus, masturbation, manipulation.","country":"Multiple (predominantly Mediterranean region)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A review of 1331 reported penile fractures shows the injury is more common than thought, often caused by sex or masturbation. Early surgical repair is advised to reduce complications such as erectile dysfunction.","clinical_takeaway":"Prompt surgical exploration is recommended for penile fracture to minimise long‑term sexual complications.","confidence":0.4,"topic_tags":["sexual_function","gender"],"strengths":["Large aggregate of cases across many decades","Clear description of common causes and complications","Practical clinical recommendations"],"limitations":["No systematic review methodology (no PRISMA, bias assessment)","Reliance on heterogeneous case reports","No quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":9,"contrasting":1,"mentioning":304,"citing_publications":246,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1046/j.1365-2168.2002.02075.x"}},{"id":4506,"doi":"10.1080/00224490209552129","pmid":"12476242","pmcid":null,"title":"Do all orgasms feel alike? Evaluating a two-dimensional model of the orgasm experience across gender and sexual context","authors":"Mah K, Binik YM.","first_author":"Mah K","journal":"Journal of sex research","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Evaluation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":74,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Two large convenience samples of university students completing adjective‑rating questionnaires about orgasm experiences during masturbation and partner sex; cross‑validation design.","sample_n":1700,"sample_text":"Convenience university sample, not nationally representative","population":"University students (N≈1700 total; ~60% women)","country":"Not specified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors asked over 1,600 college students to describe their orgasm experiences using adjective ratings during solo masturbation and partner sex. Their data supported a two‑dimensional model of orgasm that differed by gender and sexual context.","clinical_takeaway":"None – the study describes typical orgasm characteristics and does not inform clinical practice.","confidence":0.8,"topic_tags":["sexual_function","gender","masturbation"],"strengths":["Large sample sizes for exploratory validation","Cross‑validation across two independent samples","Clear focus on gender and context effects"],"limitations":["Ad hoc adjective rating tool, limited psychometric validation","Convenience university sample limits generalisability","No control for potential confounds (e.g., mental health, relationship status)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":0,"mentioning":103,"citing_publications":142,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490209552129"}},{"id":4507,"doi":null,"pmid":"12048936","pmcid":null,"title":"[A case of foreign body in the urinary bladder--chewing gum found in urinary bladder]","authors":"Shigemura K, Yuen K, Kataoka N, Iwamoto T.","first_author":"Shigemura K","journal":"Hinyokika kiyo. Acta urologica Japonica","year":2002,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"jpn","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient; includes a literature review of 1,436 cases with descriptive statistics","sample_n":1,"sample_text":"single patient; literature review of 1,436 published cases","population":"60‑year‑old male who inserted chewing gum into his urethra for masturbation","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 60‑year‑old man inserted chewing gum into his urethra for masturbation, which migrated to his bladder. The authors describe this case and summarize 1,436 similar Japanese reports.","clinical_takeaway":"Unusual foreign bodies can result from atypical sexual practices; clinicians should consider safe‑sex education and prompt urological assessment.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Clear clinical description of a rare presentation","Includes a large literature‑based review of similar cases"],"limitations":["Single‑case design; no systematic data collection","No validated measures of sexual behavior or distress","No control of potential confounding factors"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":3,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":4508,"doi":"10.1046/j.1440-1754.2002.00769.x","pmid":"12031007","pmcid":null,"title":"Female masturbation masquerading as abdominal pain","authors":"Couper RT, Huynh H.","first_author":"Couper RT","journal":"Journal of paediatrics and child health","year":2002,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":33,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1046/j.1440-1754.2002.00769.x"}},{"id":4509,"doi":"10.1542/pir.23-4-148","pmid":"11927748","pmcid":null,"title":"Unveiling the secrecy behind masturbation","authors":"Meyer TL, Cheng TL.","first_author":"Meyer TL","journal":"Pediatrics in review","year":2002,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/pir.23-4-148"}},{"id":4510,"doi":"10.4103/0019-5545.148522","pmid":"25657457","pmcid":"PMC4314917","title":"Psychosocial profile of male patients presenting with sexual dysfunction in a psychiatric outpatient department in Mumbai, India","authors":"Kalra G, Kamath R, Subramanyam A, Shah H.","first_author":"Kalra G","journal":"Indian journal of psychiatry","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["erectile dysfunction","Premature Ejaculation","Psychiatric Co-morbidity","Male Sexual Dysfunction","Marital Discord"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4314917","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"100 consecutive male patients with sexual dysfunction assessed with validated scales and interviews; descriptive analysis.","sample_n":100,"sample_text":"100 consecutive male patients presenting with sexual dysfunction.","population":"Male psychiatric out‑patient attendees in Mumbai, India (N=100).","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A study of 100 men seeking psychiatric help for erectile or ejaculatory problems in Mumbai found premature ejaculation was most common, while marital conflict and depression were relatively low.","clinical_takeaway":"Premature ejaculation dominates male sexual complaints in this setting; clinicians should assess relational and mental‑health factors but note they may be less prevalent than expected.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Use of validated clinical instruments (ASEX, MINI, DAS).","Consecutive sampling reduces selection bias within clinic.","Provides demographic and psychosocial data from an understudied region."],"limitations":["Cross‑sectional design prevents causal inference.","No assessment of moral/religious factors or trauma history.","Findings limited to psychiatric out‑patient population, not generalizable."],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":22,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0019-5545.148522"}},{"id":4511,"doi":"10.1097/00006842-200203000-00017","pmid":"11914450","pmcid":null,"title":"Atypical sexual behavior during sleep","authors":"Guilleminault C, Moscovitch A, Yuen K, Poyares D.","first_author":"Guilleminault C","journal":"Psychosomatic medicine","year":2002,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 11 patients with sleep‑related sexual behaviors, clinical evaluation, polysomnography, EEG, questionnaires","sample_n":11,"sample_text":"Eleven subjects","population":"adult patients referred for atypical sexual behavior during sleep (N=11)","country":"United States (likely, based on authors affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small series of 11 patients showed that unusual sexual actions during sleep—like violent masturbation or vocalizations—were linked to sleep disorders such as seizures or REM‑behavior disorder, often causing guilt and depression. Treating the underlying sleep condition plus counseling helped reduce the behaviors.","clinical_takeaway":"Assess and treat underlying sleep disorders in patients presenting with harmful sexual behaviors during sleep.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Detailed clinical and polysomnographic assessment","Use of multiple objective sleep measures","Identification of diverse underlying sleep disorders"],"limitations":["Very small, non‑representative case series","No control group or statistical comparisons","Findings not generalizable to broader population"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":3,"confounds":3,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":69,"citing_publications":101,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00006842-200203000-00017"}},{"id":4512,"doi":"10.1016/s0031-9384(01)00675-8","pmid":"11897264","pmcid":null,"title":"Pheromonal influences on sociosexual behavior in young women","authors":"McCoy NL, Pitino L.","first_author":"McCoy NL","journal":"Physiology & behavior","year":2002,"pub_types":["Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"double‑blind, placebo‑controlled randomized trial with 36 university women, weekly self‑report of sociosexual behaviours over three menstrual cycles","sample_n":36,"sample_text":"N=36 (19 pheromone, 17 placebo)","population":"young adult women, mean age 27.8, university sample, N=36","country":"USA (presumed from university sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small double‑blind trial, women who wore a synthetic pheromone reported more sexual activity (intercourse, dates, affection) than those given a placebo, but there were no differences in male approaches or masturbation.","clinical_takeaway":"No direct clinical implications; the finding is limited by sample size and self‑report data.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["double‑blind placebo control","randomised allocation","multiple weeks of observation across cycles"],"limitations":["small convenience sample (N=36)","self‑report measures without validated scales","no correction for multiple comparisons reported"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":15,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0031-9384(01)00675-8"}},{"id":4514,"doi":"10.1007/s10943-013-9746-6","pmid":"23784431","pmcid":null,"title":"Anonymous pastoral care for problems pertaining to sexuality","authors":"van Drie A, Ganzevoort RR, Spiering M.","first_author":"van Drie A","journal":"Journal of religion and health","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of anonymous pastoral‑care questions from two Dutch Protestant organisations; descriptive frequencies of topics such as premarital abstinence, gender roles, contraception, sexual orientation and masturbation.","sample_n":null,"sample_text":"Anonymous submissions to two organisations; not a representative sample of the general population.","population":"Help‑seekers who submitted anonymous questions (56 % female, 15 % male, 29 % unknown); no random sampling.","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined anonymous questions sent to two Dutch Protestant pastoral‑care services. About one‑fifth of the queries dealt with sexuality, covering topics like abstinence, gender roles, contraception, sexual orientation and masturbation. The authors discuss how church teachings intersect with sexual and spiritual health.","clinical_takeaway":"Clinicians should recognise that people may seek religious guidance for a wide range of sexual concerns, often intertwining moral and health issues.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Provides real‑world insight into topics people bring to pastoral care","Includes both gender distribution and range of sexual topics"],"limitations":["Non‑representative, self‑selected sample of help‑seekers","No validated measurement instruments for constructs","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-013-9746-6"}},{"id":4515,"doi":"10.1016/0197-0070(89)90110-1","pmid":"2925474","pmcid":null,"title":"Enuresis following masturbation in a mentally retarded adolescent","authors":"Rockney RM, Fritz GF, Caldamone A.","first_author":"Rockney RM","journal":"Journal of adolescent health care : official publication of the Society for Adolescent Medicine","year":1989,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case report of a single mentally retarded adolescent describing enuresis occurring after masturbation; no control group, no systematic measurement.","sample_n":1,"sample_text":"single participant","population":"Mentally retarded adolescent male (single case)","country":"Not reported","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A teenage boy with intellectual disability started wetting the bed while awake after masturbating. The doctors identified the link and used a team approach to stop the problem.","clinical_takeaway":"Clinicians should consider recent sexual activity as a possible trigger for unexplained enuresis in adolescents.","confidence":0.8,"topic_tags":["masturbation","adolescents","neuroscience"],"strengths":["Detailed clinical description of a rare phenomenon","Multidisciplinary assessment leading to intervention"],"limitations":["Single case; no generalizability","No systematic measurement or validated instruments","No control for confounding variables (e.g., mental health, moral factors)","No statistical analysis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0197-0070(89)90110-1"}},{"id":4516,"doi":"10.1071/ah020149","pmid":"12404978","pmcid":null,"title":"Sex in prisons--a management guide","authors":"Awofeso N, Naoum R.","first_author":"Awofeso N","journal":"Australian health review : a publication of the Australian Hospital Association","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"no empirical data; narrative management guide based on literature synthesis","sample_n":null,"sample_text":"Not applicable – article is a narrative guide without original data","population":"prison inmates and staff (general description)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews different types of sexual behaviour that occur in prisons—such as consensual homosexuality, masturbation, and rape—and offers guidance for prison officials on how to manage these issues for security and inmate health.","clinical_takeaway":"None – the paper provides administrative guidance, not clinical evidence.","confidence":0.8,"topic_tags":["prevalence","masturbation","sexual_function"],"strengths":["Comprehensive overview of prison sexual issues","Provides practical management suggestions"],"limitations":["No empirical data or systematic review methodology","Lacks measurement of key confounds","Potential bias in recommendations"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/ah020149"}},{"id":4518,"doi":"10.1016/s0015-0282(16)60455-7","pmid":"2910712","pmcid":null,"title":"Clinical improvements of specific seminal deficiencies via intercourse with a seminal collection device versus masturbation","authors":"Zavos PM, Goodpasture JC.","first_author":"Zavos PM","journal":"Fertility and sterility","year":1989,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative study of 50 infertile men evaluating semen parameters after using a seminal collection device versus masturbation; no randomization, likely convenience sample.","sample_n":50,"sample_text":"50 patients","population":"Male patients (n≈50) with seminal deficiencies seeking fertility evaluation.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 50 men with low sperm counts, a special collection device improved semen quality more than ordinary masturbation, and participants reported feeling more sexually stimulated with the device.","clinical_takeaway":"The device may enhance semen quality in men with specific deficiencies, but evidence is limited.","confidence":0.6,"topic_tags":["sexual_function","masturbation","religiosity"],"strengths":["Standard semen analysis provides objective outcomes","Direct comparison of device vs masturbation within same sample"],"limitations":["Small, non‑randomized sample","Subjective stimulation rating not validated","No control for potential confounds (e.g., mood, partner status)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":1,"mentioning":32,"citing_publications":74,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0015-0282(16)60455-7"}},{"id":4519,"doi":"10.1016/j.urology.2014.07.034","pmid":"25443914","pmcid":null,"title":"Penile fracture: outcomes of early surgical intervention","authors":"Swanson DE, Polackwich AS, Helfand BT, Masson P, Hwong J, Dugi DD, Martinez Acevedo AC, Hedges JC, McVary KT.","first_author":"Swanson DE","journal":"Urology","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective chart review of 29 patients from two hospitals (2002‑2011) who sustained penile fracture; outcomes (ED, curvature, voiding) measured with IIEF and IPSS at mean 14 weeks follow‑up.","sample_n":29,"sample_text":"Twenty‑nine patients (30 injury episodes) identified from hospital records.","population":"Adult male patients (mean age 43) with surgically treated penile fracture (N≈29).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 29 men who suffered a penile fracture, early surgery was performed within about 5 hours. After roughly three months, 9 reported mild erectile problems or curvature and 1 reported urinary irritation. The study suggests early repair remains the preferred treatment despite these complications.","clinical_takeaway":"Early surgical repair is still recommended for penile fracture, but clinicians should counsel patients about a roughly 30 % chance of mild erectile or curvature issues.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Use of validated outcome instruments (IIEF, IPSS)","Multi‑institutional case series","Clear description of surgical timing and injury mechanisms"],"limitations":["Small retrospective sample (<60)","No control/comparator group","Short and variable follow‑up","Potential selection bias (hospital‑based cases only)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":28,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urology.2014.07.034"}},{"id":4520,"doi":"10.1016/s0968-8080(01)90090-4","pmid":"11765399","pmcid":null,"title":"Addressing semen loss concerns: towards culturally appropriate HIV/AIDS interventions in Gujarat, India","authors":"Lakhani A, Gandhi K, Collumbien M.","first_author":"Lakhani A","journal":"Reproductive health matters","year":2001,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"situational analysis with participatory flowcharts; pre‑post data on perceived consequences of masturbation; no control group, likely convenience sample","sample_n":null,"sample_text":"not specified in abstract","population":"young men 15‑30 in an industrial area of Gujarat, India (sample size not reported)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe a community HIV‑prevention program in Gujarat that first asks young men about worries that losing semen (e.g., through masturbation) harms health, then uses these concerns as an entry point for safer‑sex education.","clinical_takeaway":"Addressing culturally specific semen‑loss anxieties may improve engagement with HIV‑prevention messages, but evidence for effectiveness is limited.","confidence":0.4,"topic_tags":["masturbation","sexual_function","csbd"],"strengths":["addresses culturally specific concerns","uses participatory tools","focuses on an under‑studied idiom of distress"],"limitations":["no validated measures of anxiety or behaviour","absence of control/comparison group","unclear sample size and statistical power","confounding factors (moral, mental health, partner) not assessed"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0968-8080(01)90090-4"}},{"id":4521,"doi":"10.5152/tud.2014.06881","pmid":"26328187","pmcid":"PMC4548362","title":"Unusual foreign body in the vesico-urethral; 195 cm liquid pipe","authors":"Sökmen D, Törer BD, Kargı T, Yavuzsan AH, Şahin S, Tuğcu V.","first_author":"Sökmen D","journal":"Turkish journal of urology","year":2014,"pub_types":["Journal Article","case-report"],"keywords":["Bladder","Cannula","Urethra","Foreign Body"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single case","population":"single male with psychiatric disorder","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 195 cm pipe was self‑inserted into a man's bladder via the urethra; the case highlights a rare, psychiatric‑related sexual behavior.","clinical_takeaway":"Clinicians should consider underlying psychiatric conditions when evaluating unusual genitourinary foreign bodies.","confidence":0.9,"topic_tags":["gender","masturbation","sexual_function"],"strengths":["Detailed clinical description","Clear presentation of rare case"],"limitations":["Single case, no generalizability","No systematic assessment of psychological constructs","No control or comparative data"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5152/tud.2014.06881"}},{"id":4522,"doi":"10.2515/therapie/2014064","pmid":"25293487","pmcid":null,"title":"[Hypersexuality associated with aripiprazole: a new case and review of the literature]","authors":"Vrignaud L, Aouille J, Mallaret M, Durrieu G, Jonville-Béra AP.","first_author":"Vrignaud L","journal":"Therapie","year":2014,"pub_types":["Letter","Review","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd","masturbation"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report with brief literature review; no control group, no systematic methods","sample_n":1,"sample_text":"1 patient","population":"adult male with schizophrenia, treated with aripiprazole","country":"France (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A man developing unusually high sexual desire and frequent masturbation while on aripiprazole saw these symptoms disappear when the drug stopped and return when it was restarted, suggesting the medication may trigger compulsive sexual behaviour.","clinical_takeaway":"Clinicians should monitor for emergent hypersexuality when prescribing aripiprazole and consider dose adjustment or discontinuation if it occurs.","confidence":0.9,"topic_tags":["sexual_function","adolescents"],"strengths":["Detailed clinical chronology of symptom onset and resolution","Clear pharmacological challenge–rechallenge pattern"],"limitations":["Single case; no systematic assessment or validated hypersexuality scales","No control for confounding factors (e.g., mood, substance use, moral attitudes)","Interpretation infers causality from anecdotal evidence"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2515/therapie/2014064"}},{"id":4524,"doi":"10.1002/smrj.25","pmid":"27784563","pmcid":null,"title":"The Evaluation and Treatment of Delayed Ejaculation","authors":"Shin DH, Spitz A.","first_author":"Shin DH","journal":"Sexual medicine reviews","year":2014,"pub_types":["Review","Journal Article"],"keywords":["Sexual dysfunction","Ejaculation","Masturbation","Orgasm","Anejaculation","Delayed Ejaculation","Climax","Retarded Ejaculation","Inhibited Ejaculation"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of 110 selected articles; no original data collected.","sample_n":null,"sample_text":"No primary sample; review of existing studies.","population":"Not applicable (review of literature).","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews causes and treatments for delayed ejaculation, summarising findings from 110 studies and emphasizing medical, hormonal, and psychosocial assessments.","clinical_takeaway":"Clinicians should assess medical and psychosocial factors and involve partners when treating delayed ejaculation.","confidence":0.8,"topic_tags":["sexual_function","treatment","masturbation"],"strengths":["Comprehensive literature search of PubMed.","Clear clinical focus on evaluation and treatment."],"limitations":["Narrative (non‑systematic) review; no systematic bias assessment.","Lacks quantitative synthesis or meta‑analysis.","No original data; conclusions depend on included studies’ quality."],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/smrj.25"}},{"id":4525,"doi":"10.1097/00004583-200108000-00004","pmid":"11501682","pmcid":null,"title":"Mirtazapine for excessive masturbation in an adolescent with autism","authors":"Nguyen M, Murphy T.","first_author":"Nguyen M","journal":"Journal of the American Academy of Child and Adolescent Psychiatry","year":2001,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":27,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00004583-200108000-00004"}},{"id":4526,"doi":"10.1016/s0022-5347(05)65975-7","pmid":"11458059","pmcid":null,"title":"Surgeon experience with penile fracture","authors":"Mydlo JH.","first_author":"Mydlo JH.","journal":"The Journal of urology","year":2001,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single-surgeon case series of 34 penile fractures (29 surgical, 5 conservative) treated over 11 years; descriptive outcomes only","sample_n":34,"sample_text":"34 patients","population":"34 male patients, age 18‑38, with blunt penile trauma during intercourse or masturbation","country":"USA (implied by journal and author affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A urologist reported on 34 men with penile fractures, most treated surgically. After an average 27‑year‑old presented, 33 reported normal erections later; a few had mild curvature. The paper describes a degloving surgical method that appeared safe.","clinical_takeaway":"Surgical repair of penile fracture using a degloving approach yields good erectile outcomes in most cases.","confidence":0.4,"topic_tags":["sexual_function","gender","treatment"],"strengths":["Detailed surgical technique description","Longitudinal follow‑up of functional outcomes","Real‑world clinical experience over 11 years"],"limitations":["Single surgeon, non‑random sample","No control or comparison group","Small N; descriptive statistics only","Potential selection bias (cases presenting to tertiary centres)"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":89,"citing_publications":124,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-5347(05)65975-7"}},{"id":4527,"doi":"10.3346/jkms.2014.29.9.1320","pmid":"25246754","pmcid":"PMC4168189","title":"A case of mental retardation with paraphilia treated with depot leuprorelin","authors":"Park WS, Kim KM, Jung YW, Lim MH.","first_author":"Park WS","journal":"Journal of Korean medical science","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports","case-report"],"keywords":["Mental retardation","Leuprorelin","Paraphilias"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4168189","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single patient","population":"20‑year‑old male with severe intellectual disability and paraphilic behavior","country":"South Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 20‑year‑old man with severe intellectual disability and persistent paraphilic behaviors was given a monthly depot injection of leuprorelin. After one month, clinicians reported reduced sexual urges and abnormal sexual actions using standard clinical rating scales.","clinical_takeaway":"Leuprorelin may reduce sexual pre‑occupation in a single severely retarded patient, but evidence is insufficient to guide routine use.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Detailed clinical observation of a rare case","Use of standardized CGI scales"],"limitations":["Single case, no control group","No measurement of key confounds (e.g., moral incongruence, mental health)","Overgeneralizes treatment efficacy"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3346/jkms.2014.29.9.1320"}},{"id":4528,"doi":"10.1080/0092623x.2014.935539","pmid":"25032736","pmcid":null,"title":"Patient Characteristics by Type of Hypersexuality Referral: A Quantitative Chart Review of 115 Consecutive Male Cases","authors":"Sutton KS, Stratton N, Pytyck J, Kolla NJ, Cantor JM.","first_author":"Sutton KS","journal":"Journal of sex & marital therapy","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["bibliography","csbd","masturbation","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Quantitative chart review of 115 consecutive male clinical referrals; descriptive cross‑sectional analysis of subtypes.","sample_n":115,"sample_text":"115 consecutive male cases from a clinical setting.","population":"Male patients referred for hypersexuality (clinical sample).","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A chart review of 115 men referred for hypersexuality identified four clinical subtypes—paraphilic, avoidant masturbators, chronic adulterers, and designated patients—each with distinct sexual and mental‑health patterns.","clinical_takeaway":"Clinicians should consider subtype‑specific features when assessing hypersexual patients rather than applying a single treatment model.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function","adolescents"],"strengths":["Large consecutive clinical sample (115).","Systematic chart review of multiple clinical variables.","Identifies potential subtypes within hypersexuality referrals."],"limitations":["Lacks validated psychometric instruments for hypersexuality.","No control for moral incongruence or partner effects.","Cross‑sectional, descriptive; cannot infer causality.","Findings may not generalise beyond treatment‑seeking men."],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":28,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2014.935539"}},{"id":4529,"doi":"10.1186/2051-4190-24-13","pmid":"25780586","pmcid":"PMC4349601","title":"Evaluation of sexual functions and sexual behaviors after penile brachytherapy in men treated for penile carcinoma","authors":"Soh PN, Delaunay B, Nasr EB, Delannes M, Soulie M, Huyghe E.","first_author":"Soh PN","journal":"Basic and clinical andrology","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["Sexual function","Brachytherapy","Questionnaire","Penile Carcinoma"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4349601","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case-control survey of 38 men (19 patients, 19 controls)","sample_n":38,"sample_text":"38 participants (19 patients, 19 controls)","population":"men treated for penile carcinoma (mean age ~73) and age‑matched healthy controls","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared sexual function and behaviors of 19 men who had penile cancer treated with brachytherapy to 19 similar-aged men without cancer. Using standard questionnaires, patients reported similar or better erectile function and higher masturbation frequency, suggesting the treatment does not markedly impair sexual health.","clinical_takeaway":"Penile brachytherapy appears to preserve erectile function in older men; clinicians can discuss maintained sexual activity, including masturbation, with patients.","confidence":0.78,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Uses validated IIEF for erectile function","Includes a control group matched on age","Reports both functional scores and behavior (masturbation)"],"limitations":["Very small sample (N=38) limits power","BASIC IDEA questionnaire not validated","Limited assessment of potential confounds (mental health, partner context)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/2051-4190-24-13"}},{"id":4530,"doi":"10.7860/jcdr/2014/9967.4684","pmid":"25302214","pmcid":"PMC4190736","title":"A Knowledge, Attitudes and Practices Survey regarding Sex, Contraception and Sexually Transmitted Diseases among Commerce College Students in Mumbai","authors":"Mutha AS, Mutha SA, Baghel PJ, Patil RJ, Bhagat SB, Patel SB, Watsa MC.","first_author":"Mutha AS","journal":"Journal of clinical and diagnostic research : JCDR","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["epidemiology","HIV/AIDS","Safe Sex","Sexuality Education","Sex Offences"],"is_oa":false,"oa_url":"https://doi.org/10.7860/jcdr/2014/9967.4684","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"prospective cross‑sectional survey of 500 commerce college students in Mumbai; convenience sample; STROBE‑guided reporting","sample_n":500,"sample_text":"500 students from K.P.B. Hinduja College of Commerce","population":"college students (mean age 18.6, 46% female) at a single Indian commerce college","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 500 Indian college students found limited knowledge about contraception and STIs, especially among females, and that many males reported casual attitudes toward premarital sex. The authors suggest better sex education is needed.","clinical_takeaway":"Sex education programs should address knowledge gaps and attitudes to promote safer sexual practices among young adults.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large sample size for a single‑site survey","STROBE‑guided reporting","includes both knowledge and practice items"],"limitations":["Convenience sample from one college limits generalisability","Questionnaire appears unvalidated","No control for key confounds (e.g., moral beliefs, mental health)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":5,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7860/jcdr/2014/9967.4684"}},{"id":4531,"doi":"10.1136/ewjm.175.1.66","pmid":"11431412","pmcid":"PMC1071473","title":"The solitary vice: the superstition that masturbation could cause mental illness","authors":"Whorton J.","first_author":"Whorton J.","journal":"The Western journal of medicine","year":2001,"pub_types":["Historical Article","research-article","Portrait","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/ewjm.175.1.66"}},{"id":4532,"doi":null,"pmid":"11481957","pmcid":null,"title":"[Male genital self mutilation--a cause of hematuria]","authors":"Schwartzman P, Viner Z.","first_author":"Schwartzman P","journal":"Harefuah","year":2001,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"heb","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single patient","population":"non‑psychotic male with borderline intellectual disability, self‑mutilating during masturbation","country":"Israel (journal Harefuah is Israeli)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A man with mild intellectual disability occasionally cut his own genitals while masturbating, which caused repeated visible blood in his urine.","clinical_takeaway":"Self‑injury during masturbation can cause serious medical problems; assess for self‑harm in patients with unusual genitourinary symptoms.","confidence":0.9,"topic_tags":["gender","masturbation"],"strengths":["Detailed clinical description","Highlights rare presentation linking masturbation technique to hematuria"],"limitations":["Single case; no generalisability","No systematic assessment of psychological constructs","No control or comparison group"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4534,"doi":null,"pmid":"25668163","pmcid":null,"title":"Sexual dysfunction among men in secondary care in southern India: Nature, prevalence, clinical features and explanatory models","authors":"Thangadurai P, Gopalakrishnan R, Kuruvilla A, Jacob KS, Abraham VJ, Prasad J.","first_author":"Thangadurai P","journal":"The National medical journal of India","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional study of 270 consecutive men attending a general health clinic in southern India, using structured interviews and validated sexual function questionnaires.","sample_n":270,"sample_text":"270 consecutive men","population":"Men attending a general health clinic in southern India (N=270)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 270 men in a South Indian clinic found that nearly half reported erectile problems or premature ejaculation. The most common self‑attributed causes were masturbation‑related beliefs, while diabetes, financial stress and mental‑health issues were linked to the problems.","clinical_takeaway":"Screen for medical, financial and mental‑health factors when men present with erectile or ejaculatory issues; address common misconceptions about masturbation.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Validated sexual‑function instruments","Large community sample for the setting","Assessment of psychiatric morbidity"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of moral or partner factors","Potential clinic‑based selection bias"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":4535,"doi":"10.4103/0253-7176.135393","pmid":"25035564","pmcid":"PMC4100426","title":"Situational psychogenic anejaculation: a case study","authors":"Gopalakrishnan R, Thangadurai P, Kuruvilla A, Jacob KS.","first_author":"Gopalakrishnan R","journal":"Indian journal of psychological medicine","year":2014,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Sex Therapy","Anorgasmia","Anejaculation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4100426","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with situational psychogenic anejaculation; treatment described but no systematic measurement","sample_n":1,"sample_text":"single case","population":"1 adult male patient (case report)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A single patient with situational psychogenic anejaculation was successfully treated using changes to masturbation technique, better marital communication, and anxiety‑reducing cognitive‑behavioral therapy.","clinical_takeaway":"Tailoring sex‑therapy to address relational and anxiety factors may help men with psychogenic anejaculation.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Detailed clinical description","Integrates behavioral and relational interventions","Illustrates adaptation of standard sex‑therapy techniques"],"limitations":["Single case; no generalisability","No validated outcome measures or standardized scales","No systematic assessment of confounding factors"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0253-7176.135393"}},{"id":4536,"doi":null,"pmid":"25314801","pmcid":null,"title":"[Influence of cumulated sexual trauma on sexual life and relationship of a patient]","authors":"Sobański JA, Klasa K, Cyranka K, Müldner-Nieckowski L, Dembińska E, Rutkowski K, Smiatek-Mazgaj B, Mielimaka M.","first_author":"Sobański JA","journal":"Psychiatria polska","year":2014,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross‑sectional questionnaire of day‑hospital patients (N≈3900) assessing recalled sexual trauma and current sexual/relationship outcomes","sample_n":3930,"sample_text":"2,582 women and 1,347 men completing a Live Inventory before treatment in a day‑hospital (1980‑2002)","population":"adult men and women (clinical sample, treatment‑seeking)","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed over 3,900 Polish patients about past sexual trauma and their current sexual lives, finding that having multiple traumatic events was linked to more casual sex, pressured marriages, and relationship difficulties, especially in women.","clinical_takeaway":"Clinicians should consider a history of multiple sexual traumas when addressing sexual dysfunction or relationship issues.","confidence":0.6,"topic_tags":["sexual_function","relationships"],"strengths":["Large overall sample size","Focus on cumulative sexual trauma","Sex‑balanced (both men and women) analysis"],"limitations":["Uses an unvalidated questionnaire (Live Inventory)","Clinical, treatment‑seeking sample limits generalisability","No control for key confounds (e.g., mental health, relationship factors)","Statistical details sparse; effect sizes not reported"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4537,"doi":"10.1186/2049-3258-72-21","pmid":"25089197","pmcid":"PMC4118317","title":"An innovative approach to using both cellphones and the radio to identify young people's sexual concerns in Kinshasa, Democratic Republic of Congo","authors":"Nsakala GV, Coppieters Y, Kayembe PK.","first_author":"Nsakala GV","journal":"Archives of public health = Archives belges de sante publique","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["Radio","Young People","Democratic Republic Of Congo","Cell Phone","Emotional And Sex Life"],"is_oa":true,"oa_url":"https://archpublichealth.biomedcentral.com/counter/pdf/10.1186/2049-3258-72-21","cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive survey of anonymous radio/cell‑phone messages collected over six months; convenience sample of 14‑24‑year‑olds; no control group; no systematic sampling.","sample_n":null,"sample_text":"1250 messages/calls recorded; participants not individually enumerated.","population":"young people (14‑24) in Kinshasa, DRC; 1,250 messages/calls (≈70% girls).","country":"Democratic Republic of Congo","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers gathered over a thousand anonymous radio calls and text messages from Congolese teens about sex, love, and health. The most common topics were menstruation for girls and masturbation for boys. The data helped design a guide for youth sexual education.","clinical_takeaway":"Youth health programs can harness radio and mobile phones to identify and address prevalent sexual‑health questions.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Innovative use of radio and mobile phones to reach youth.","Large number of anonymous queries collected.","Provides insight into locally relevant sexual health concerns."],"limitations":["No systematic sampling; unclear representativeness.","No validated measurement instruments.","Descriptive only; no statistical testing or control for confounds."],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/2049-3258-72-21"}},{"id":4539,"doi":"10.1111/jsm.12575","pmid":"24919434","pmcid":null,"title":"Obstructive uropathy and vesicovaginal fistula secondary to a retained sex toy in the vagina","authors":"Donaldson JF, Tait C, Rad M, Walker S, Lam TB, Abdel-Fattah M, Swami SK.","first_author":"Donaldson JF","journal":"The journal of sexual medicine","year":2014,"pub_types":["Journal Article","Case Reports"],"keywords":["Foreign bodies","Urinary Fistula","Vesicovaginal Fistula","Acute Kidney Injury","Vaginal Fistula","Renal Insufficiency","Sex Toy"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case description with literature review; no comparison group; retrospective clinical report","sample_n":1,"sample_text":"N=1 (case report)","population":"38‑year‑old woman with retained vaginal sex toy","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A woman had a sex toy stuck in her vagina for ten years, leading to a serious urinary fistula and kidney problems. Surgery to remove the toy and repair the fistula was successful after multiple procedures.","clinical_takeaway":"Retained vaginal objects can cause severe urinary complications; prompt imaging and staged surgical repair are recommended.","confidence":0.9,"topic_tags":["sexual_function","gender"],"strengths":["Detailed clinical description","Comprehensive literature review of similar cases","Clear surgical management recommendations"],"limitations":["Single patient – no generalisability","No systematic analysis of risk factors","No quantitative outcome data"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12575"}},{"id":4541,"doi":"10.3978/j.issn.2223-4683.2014.04.10","pmid":"26816764","pmcid":"PMC4708164","title":"Overall satisfaction, sexual function, and the durability of neophallus dimensions following staged female to male genital gender confirming surgery: the Institute of Urology, London U.K. experience","authors":"Garcia MM, Christopher NA, De Luca F, Spilotros M, Ralph DJ.","first_author":"Garcia MM","journal":"Translational andrology and urology","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["Sexual function","Transgender","Phalloplasty","Penis Size","Clitoral Nerve Anastomosis","Genital Gender Confirming Surgery (Gcs)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4708164","cited_by_count":61,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective survey of 25 transgender men after phalloplasty; convenience sample from a single UK centre.","sample_n":25,"sample_text":"Ten SP patients and fifteen RAP patients; all assessed post‑operatively (mean follow‑up 2.2–6.8 years).","population":"Female-to-male transgender individuals (N=25) who underwent staged genital gender‑confirming surgery (suprapubic or radial artery forearm phalloplasty).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 25 trans men who had multi‑stage phalloplasty, satisfaction was very high (≈9/10) and most retained the ability to orgasm and sense pleasure. Penis size remained stable over several years, and using a custom phone app gave measurements similar to a ruler.","clinical_takeaway":"Trans men report high satisfaction and preserved sexual function after staged phalloplasty; clinicians can use smartphone‑based measurements to monitor neophallus size.","confidence":0.6,"topic_tags":["gender","sexual_function"],"strengths":["Focused on an understudied surgical outcome","Includes objective size measurements with smartphone validation","High response rate within the clinic"],"limitations":["Small, single‑centre convenience sample","No validated sexual function or satisfaction instruments","No control/comparison group","Potential positive response bias"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3978/j.issn.2223-4683.2014.04.10"}},{"id":4542,"doi":"10.1186/1755-7682-7-23","pmid":"24834129","pmcid":"PMC4022435","title":"Effect of systemic inflammation on level of ferritin seminal in chronic renal male patient undergoing hemodialysis","authors":"Silva GP, Elena CDV, Carneiro FP, Veiga JPR.","first_author":"Silva GP","journal":"International archives of medicine","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["Testis","Sex hormones","Ferritin","Semen","Chronic Renal Disease"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4022435","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"prospective prevalence (cross‑sectional) study comparing hemodialysis patients with/without inflammation and healthy controls (N=80)","sample_n":80,"sample_text":"60 patients (27 inflammation+, 33 inflammation‑) and 20 controls","population":"male chronic renal patients on hemodialysis (18‑60 y) and healthy male controls","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In men on dialysis, higher blood inflammation (CRP) did not change the amount of ferritin found in their semen, suggesting that systemic inflammation does not affect this aspect of testicular function.","clinical_takeaway":"Systemic inflammation appears not to alter seminal ferritin in eugonadal dialysis patients.","confidence":0.7,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Validated laboratory assays for ferritin and hormones","Inclusion of a healthy control group","Clear definition of inflammation status using CRP"],"limitations":["Cross‑sectional design; cannot infer causality","No power calculation or effect‑size reporting","Potential selection bias (hemodialysis patients only)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1755-7682-7-23"}},{"id":4544,"doi":null,"pmid":"25204102","pmcid":null,"title":"[Childhood sexual traumatic events and sexual life and relationship of a patient]","authors":"Sobański JA, Klasa K, Müldner-Nieckowski Ł, Dembińska E, Krzysztof R, Mielimaka M, Smiatek-Mazgaj B.","first_author":"Sobański JA","journal":"Psychiatria polska","year":2014,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 2,582 women and 1,347 men admitted to a neurotic‑disorder day‑ward (1980‑2002); questionnaire (Live Inventory) on recalled childhood sexual trauma and current sexual satisfaction/relationship outcomes; logistic ORs reported.","sample_n":3930,"sample_text":"2,582 women and 1,347 men treated before admission to a day ward of a neurotic disorder department.","population":"Adults (young‑adult to middle‑aged) in psychiatric treatment in Poland; convenience clinical sample.","country":"Poland","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A questionnaire study of over 3,900 Polish psychiatric patients found that recollected childhood sexual trauma (e.g., incest, rape) was linked to poorer sexual satisfaction and relationship problems later in life.","clinical_takeaway":"History of early sexual trauma may contribute to adult sexual dissatisfaction; clinicians should assess trauma when addressing sexual function.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size","Focus on multiple types of sexual trauma","Quantitative odds‑ratio analysis"],"limitations":["Unclear psychometric validation of the Live Inventory","Cross‑sectional design; cannot infer causality","Clinical convenience sample limits generalisability","No adjustment for key confounds (mental health, moral incongruence, partner factors)"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4545,"doi":"10.1007/s10508-014-0297-z","pmid":"24777440","pmcid":null,"title":"Patterns of client behavior with their most recent male escort: an application of latent class analysis","authors":"Grov C, Starks TJ, Wolff M, Smith MD, Koken JA, Parsons JT.","first_author":"Grov C","journal":"Archives of sexual behavior","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 495 male escort clients; latent class analysis to identify behavior patterns; convenience sampling likely","sample_n":495,"sample_text":"495 clients of male escorts answered questions about sexual behavior with their last hire.","population":"adult men who have recently hired a male escort (N=495)","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 495 men who recently hired a male escort identified four typical patterns of sexual activity, ranging from standard oral sex to kink and erotic massage, with only a small fraction reporting condomless anal sex.","clinical_takeaway":"Training male escorts in condom promotion and HIV prevention could reduce risk for the minority who engage in condomless anal sex.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["large sample for this hard‑to‑reach population","use of latent class analysis to capture heterogeneous behavior patterns","focus on concrete sexual risk behaviors"],"limitations":["cross‑sectional self‑report; no validated sexual‑risk scales","convenience sampling limits generalisability","no control for moral, mental‑health or partner variables"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":2,"mentioning":7,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0297-z"}},{"id":4546,"doi":"10.1016/j.psychres.2014.03.047","pmid":"24803186","pmcid":null,"title":"Characteristics of stress-coping behaviors in patients with bipolar disorders","authors":"Moon E, Chang JS, Choi S, Ha TH, Cha B, Cho HS, Park JM, Lee BD, Lee YM, Choi Y, Ha K.","first_author":"Moon E","journal":"Psychiatry research","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Stress","Bipolar disorder","Coping Behavior","Coping Strategy"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control comparison of 103 bipolar patients and 103 matched healthy controls using a newly‑designed 53‑item coping checklist; t‑tests and factor analysis employed","sample_n":206,"sample_text":"103 bipolar patients, 103 matched controls","population":"adult patients with DSM‑IV bipolar I or II disorder and healthy controls; age‑ and sex‑matched; N=206 total","country":"South Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared how people with bipolar disorder versus healthy adults cope with stress. Using a new questionnaire, bipolar patients reported less social coping (e.g., talking with friends) and more maladaptive actions such as smoking, masturbation, and stealing.","clinical_takeaway":"Bipolar patients may use more risky coping strategies; clinicians should assess coping patterns and consider psychosocial interventions.","confidence":0.7,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["Reasonably sized clinical and control groups","Matched on age and sex","Examines coping behaviors beyond mood symptoms"],"limitations":["Unvalidated coping checklist","Cross‑sectional design limits causal inference","No control for key psychosocial confounds (e.g., moral beliefs, trauma)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psychres.2014.03.047"}},{"id":4549,"doi":"10.1089/jwh.2013.4523","pmid":"24707900","pmcid":null,"title":"On-site comprehensive curriculum to teach reproductive health to female adolescents in Kenya","authors":"Gaughran M, Asgary R.","first_author":"Gaughran M","journal":"Journal of women's health (2002)","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pre‑post single‑group evaluation of a 6‑week reproductive health curriculum among 42 female adolescents in Kenya, using a 35‑item survey and focus groups/interviews","sample_n":42,"sample_text":"42 female teenagers completed pre‑ and post‑training questionnaires; focus groups (n=42) and interviews (n=20) provided qualitative data","population":"female adolescents, mean age 16.5, Kenya (Laikipia District)","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A six‑week reproductive health program for Kenyan teenage girls improved their knowledge about HIV, STIs and contraception, though some misconceptions remained. The study used surveys before and after the curriculum and focus groups to explore attitudes.","clinical_takeaway":"Structured school‑based sexual health curricula can raise adolescents' knowledge, but ongoing support is needed to address persistent myths.","confidence":0.8,"topic_tags":["religiosity","masturbation","sexual_function"],"strengths":["Mixed quantitative‑qualitative approach","Pre‑post assessment of knowledge gains","Community‑based curriculum implementation"],"limitations":["No validated measurement instrument reported","No control/comparison group","Small convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/jwh.2013.4523"}},{"id":4552,"doi":"10.1007/s00345-014-1283-8","pmid":"24682594","pmcid":null,"title":"Sexual quality of life after total phalloplasty in men with penile deficiency: an exploratory study","authors":"Callens N, De Cuypere G, T'Sjoen G, Monstrey S, Lumen N, Van Laecke E, Hoebeke P, Cools M.","first_author":"Callens N","journal":"World journal of urology","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Clinical Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Exploratory cross‑sectional comparison of 10 men post‑phalloplasty with 73 hypospadias patients and 50 control men; convenience clinical sample; no longitudinal follow‑up.","sample_n":10,"sample_text":"Ten men after phalloplasty; comparison groups n=73 and n=50.","population":"Men (age 20‑43) with severe penile deficiency after total phalloplasty; comparison groups of hypospadias repair patients and healthy controls.","country":"Belgium (single institution, likely), not stated explicitly","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In ten men who had total phalloplasty, all were sexually active, but many felt inhibited in seeking partners and reported less sensitivity than hoped. Most were satisfied with the surgery despite some complications. The study suggests careful expectation management and follow‑up.","clinical_takeaway":"Phalloplasty can restore sexual activity, but clinicians should counsel patients about possible reduced sensitivity and psychosocial inhibition.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Rare clinical data on a low‑frequency surgery","Includes comparison groups","Reports both functional and psychosocial outcomes"],"limitations":["Very small phalloplasty sample (n=10)","No validated sexual QoL instrument reported","No control for key psychosocial confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":21,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00345-014-1283-8"}},{"id":4553,"doi":"10.1371/journal.pone.0092794","pmid":"24667838","pmcid":"PMC3965446","title":"Asexuality development among middle aged and older men","authors":"Huang YP, Chen B, Ping P, Wang HX, Hu K, Yang H, Zhang T, Feng T, Jin Y, Han YF, Wang YX, Huang YR.","first_author":"Huang YP","journal":"PloS one","year":2014,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","research-article","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0092794&type=printable","cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 1,531 Chinese men aged 40‑80, grouped by erectile function and asexuality status; multivariate regression used for comparisons.","sample_n":1531,"sample_text":"Large community sample (N = 1,531).","population":"Middle‑aged and older adult men (40‑80 y) from China, community‑based sample.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a Chinese sample of 1,531 men aged 40‑80, those who had not had sex for six months were labeled asexual. Nearly 38 % were asexual, and they showed higher rates of erectile dysfunction, older age, diabetes and hypertension than men with moderate‑severe erectile problems. Reasons given included erectile difficulty, low interest, stress, fatigue and masturbation.","clinical_takeaway":"Asexuality in older men is often linked to erectile problems and health issues; clinicians should assess physical causes before assuming psychological ones.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size","Validated ED measure (IIEF‑5)","Multivariate regression controlling for key medical risk factors"],"limitations":["Asexuality defined by a single behavioural criterion, not a validated scale","Key psychosocial confounds (moral attitudes, mental health, relationship context) not measured","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":31,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0092794"}},{"id":4554,"doi":"10.1038/ijir.2014.8","pmid":"24646674","pmcid":null,"title":"Personal factors that contribute to or impair women's ability to achieve orgasm","authors":"de Lucena BB, Abdo CH.","first_author":"de Lucena BB","journal":"International journal of impotence research","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional comparison of 96 women with and without orgasm during sexual activity, logistic regression analysis","sample_n":96,"sample_text":"96 women (18‑61 years) in a stable relationship, divided into orgasm‑deficit (OD) and orgasm‑achieving (OA) groups","population":"women aged 18‑61 in stable relationships, recruited in Brazil (non‑representative convenience sample)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 96 Brazilian women, the study found that anxiety, low sexual desire, lack of masturbation, and lower education were linked to difficulty reaching orgasm during sex.","clinical_takeaway":"Addressing anxiety, enhancing desire, and encouraging solo sexual activity may help women with orgasm difficulties.","confidence":0.7,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Uses logistic regression to identify independent predictors","Measures several relevant personal factors (anxiety, desire, education, masturbation)","Clear operational definitions for orgasm groups"],"limitations":["Cross‑sectional, cannot infer causality","Convenience sample, limited generalisability","No correction for multiple comparisons, effect sizes not reported"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/ijir.2014.8"}},{"id":4555,"doi":"10.1037/a0036149","pmid":"24635184","pmcid":null,"title":"The myth of harmless wrongs in moral cognition: Automatic dyadic completion from sin to suffering","authors":"Gray K, Schein C, Ward AF.","first_author":"Gray K","journal":"Journal of experimental psychology. General","year":2014,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":73,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Randomized controlled laboratory experiments across five studies, likely with convenience samples of adults.","sample_n":null,"sample_text":"Not specified in abstract; presumed modest per study.","population":"Adults (male and female), recruited likely from university or community pools; no clinical or treatment‑seeking sample.","country":"United States (presumed based on author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors propose that when people think something is morally wrong, they automatically picture a victim even if none exists. Across five lab experiments, participants treated harmless wrongs like masturbation as if they caused harm, suggesting a built‑in tendency to link wrongdoing with suffering.","clinical_takeaway":"None – findings pertain to basic moral cognition rather than clinical practice.","confidence":0.8,"topic_tags":["moral_incongruence"],"strengths":["Randomized experimental manipulation","Multiple converging studies","Clear theoretical hypothesis"],"limitations":["Small, non‑representative samples","Reliance on ad‑hoc behavioral measures","No assessment of alternative explanations (e.g., personal moral values)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":24,"contrasting":2,"mentioning":334,"citing_publications":344,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/a0036149"}},{"id":4557,"doi":"10.3978/j.issn.2223-4683.2014.02.06","pmid":"26816750","pmcid":"PMC4708292","title":"Contemporary and future insights into fertility preservation in male cancer patients","authors":"Agarwal A, Ong C, Durairajanayagam D.","first_author":"Agarwal A","journal":"Translational andrology and urology","year":2014,"pub_types":["review-article","Review","Journal Article"],"keywords":["Cancer","Male infertility","Fertility Preservation","Sperm Banking"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4708292","cited_by_count":23,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of male fertility preservation methods; no new empirical data","sample_n":null,"sample_text":"Not applicable – review article","population":"male cancer patients (adolescents and adults) – no specific sample size reported","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarizes how cancer treatments can damage male fertility and discusses the only proven method—sperm banking—plus newer experimental options. It notes that many patients do not use sperm banking due to lack of information and urgent treatment start.","clinical_takeaway":"Clinicians should discuss sperm banking early with male cancer patients, as it remains the most reliable way to preserve future fertility.","confidence":0.6,"topic_tags":["sexual_function","religiosity","moral_incongruence"],"strengths":["Comprehensive overview of current fertility preservation techniques","Identifies practical barriers to sperm banking"],"limitations":["No original data or systematic review methodology","Lacks quantitative synthesis or critical appraisal of evidence"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3978/j.issn.2223-4683.2014.02.06"}},{"id":4558,"doi":"10.1080/00926238708403874","pmid":"3573050","pmcid":null,"title":"The semantics of success: do masturbation exercises lead to partner orgasm?","authors":"Wakefield JC.","first_author":"Wakefield JC.","journal":"Journal of sex & marital therapy","year":1987,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"secondary reanalysis of previously published data; no new data collection; no randomisation; convenience sample from earlier studies","sample_n":null,"sample_text":"","population":"women identified as 'pre‑orgasmic' in earlier trials; sample size not reported in abstract","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Re‑examining two old studies, the author shows that when stricter definitions are used, only about 20‑47% of women who previously could not orgasm with a partner achieve orgasm after masturbation training, far lower than the 80%+ previously reported.","clinical_takeaway":"Masturbation training may help some women, but its success rate is modest; clinicians should set realistic expectations.","confidence":0.7,"topic_tags":["masturbation","sexual_function","treatment","measurement"],"strengths":["Clear critique of inconsistent outcome definitions","Provides more stringent re‑analysis of existing data"],"limitations":["No original data collection; reliant on prior study reporting","No validated measurement instruments reported","Sample size and demographic details unavailable"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":12,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238708403874"}},{"id":4559,"doi":"10.1300/j082v14n03_01","pmid":"3323307","pmcid":null,"title":"History, etymology, and fallacy: attitudes toward male masturbation in the ancient Western world","authors":"Elia JP.","first_author":"Elia JP.","journal":"Journal of homosexuality","year":1987,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical commentary without empirical data; no sampling, no statistical analysis.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how male masturbation was viewed in ancient Egypt, Greece, and Rome, noting persistent intolerance and the dominance of procreative sexuality throughout these periods.","clinical_takeaway":"None - not clinically applicable.","confidence":0.9,"topic_tags":["masturbation","sexual_function","csbd"],"strengths":["Provides comprehensive historical overview of attitudes","Covers multiple ancient cultures"],"limitations":["No empirical data or methodological transparency","No measurement of contemporary constructs (e.g., distress, addiction)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v14n03_01"}},{"id":4560,"doi":"10.1111/j.1365-2605.1986.tb00902.x","pmid":"3553035","pmcid":null,"title":"Ejaculate composition after masturbation and coitus in the human male","authors":"Purvis K, Magnus O, Mørkås L, Abyholm T, Rui H.","first_author":"Purvis K","journal":"International journal of andrology","year":1986,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"within‑subject comparison of ejaculate obtained by masturbation vs. coitus in the same men","sample_n":null,"sample_text":"same individuals provided both types of ejaculate; exact N not given","population":"adult males (sample size not reported in abstract)","country":"Norway (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study measured many chemicals in semen collected by masturbation and after intercourse in the same men, finding larger volume and higher prostaglandin E and polyamines after coitus, but similar overall sperm contribution.","clinical_takeaway":"Either masturbation or intercourse provides comparable semen for standard quality assessments.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Direct within‑subject comparison eliminates between‑person variability","Biochemical analyses use established laboratory assays"],"limitations":["Sample size not reported; likely small and underpowered","No reporting of effect sizes or confidence intervals","No control for potential confounds (e.g., abstinence period, health status)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2605.1986.tb00902.x"}},{"id":4561,"doi":"10.1097/00002060-200007000-00012","pmid":"10892626","pmcid":null,"title":"Involuntary masturbation as a manifestation of stroke-related alien hand syndrome","authors":"Ong Hai BG, Odderson IR.","first_author":"Ong Hai BG","journal":"American journal of physical medicine & rehabilitation","year":2000,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"1 patient","population":"single 73‑year‑old male with right ACA infarct","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 73‑year‑old man who had a stroke showed involuntary masturbation as part of alien hand syndrome, where his hand acted as if it were not his own.","clinical_takeaway":"Involuntary sexual movements can occur after certain brain injuries; consider neurological causes when evaluating atypical behaviors.","confidence":0.9,"topic_tags":["neuroscience"],"strengths":["Detailed clinical description of a rare manifestation","Clear imaging confirmation of lesion location"],"limitations":["Single case; no generalizability","No systematic assessment of sexual or psychological variables","No quantitative measures or statistical analysis"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00002060-200007000-00012"}},{"id":4562,"doi":"10.1148/radiol.14131374","pmid":"24495265","pmcid":"PMC4610904","title":"MR imaging of the prostate and adjacent anatomic structures before, during, and after ejaculation: qualitative and quantitative evaluation","authors":"Medved M, Sammet S, Yousuf A, Oto A.","first_author":"Medved M","journal":"Radiology","year":2014,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"prospective within‑subject pilot MR study of 8 healthy volunteers, pre‑/post‑ejaculation imaging","sample_n":8,"sample_text":"eight young healthy volunteers","population":"8 young healthy male volunteers (median age 22.5)","country":"United States (institution not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers used MRI to watch what happens inside the prostate and seminal vesicles before, during, and after men masturbated to ejaculation. They found the seminal vesicles shrink dramatically and certain MRI signals in the prostate’s peripheral zone change after ejaculation.","clinical_takeaway":"No immediate clinical implications; the study shows MRI can capture rapid tissue changes around ejaculation.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","moral_incongruence"],"strengths":["Innovative MR protocol capturing ejaculation in real time","Quantitative imaging metrics (T1, T2, ADC) measured","Within‑subject pre/post design reduces inter‑individual variability"],"limitations":["Very small sample (n=8) limits generalisability and statistical power","No external control group or replication cohort","Findings limited to young healthy men, not clinical populations"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":4,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":20,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1148/radiol.14131374"}},{"id":4564,"doi":"10.4088/jcp.v61n0610i","pmid":"10901350","pmcid":null,"title":"Inappropriate masturbation and schizophrenia","authors":"Brooks JO, Waikar MV.","first_author":"Brooks JO","journal":"The Journal of clinical psychiatry","year":2000,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/jcp.v61n0610i"}},{"id":4565,"doi":"10.1111/jsm.12430","pmid":"24443962","pmcid":null,"title":"Gender-specificity of solitary and dyadic sexual desire among gynephilic and androphilic women and men","authors":"Dawson SJ, Chivers ML.","first_author":"Dawson SJ","journal":"The journal of sexual medicine","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Gender Differences","Sexual Arousal","Sexual Orientation","Sexual Desire","Category-specificity","Incentive Motivation"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subject laboratory study where participants viewed gender‑varying sexual films and reported dyadic and solitary desire before and after each clip (N≈88).","sample_n":88,"sample_text":"88 participants across four sexual‑orientation groups","population":"Androphilic women (n=30), gynephilic women (n=21), gynephilic men (n=21), androphilic men (n=16); adult community volunteers.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, men and women who are attracted to the opposite sex reported more desire for partners of that gender, while women attracted to women showed similar desire for both genders. Desire increased when stimulus intensity rose.","clinical_takeaway":"Desire patterns align with sexual orientation and stimulus characteristics; clinicians should consider both partner and solitary desire when discussing sexuality.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Physiological stimulus manipulation with clear gender/intensity variation","Within‑subject design reduces between‑group variability","Separates solitary (masturbatory) from dyadic desire"],"limitations":["Small subgroup sizes, especially for androphilic men (n=16)","Self‑report desire measures not validated scales","No control for mood, mental‑health or moral‑incongruence variables"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12430"}},{"id":4566,"doi":"10.1097/00000433-198607030-00015","pmid":"3788918","pmcid":null,"title":"Masturbation injury resulting from intraurethral introduction of spaghetti","authors":"Bacci M, Porena M.","first_author":"Bacci M","journal":"The American journal of forensic medicine and pathology","year":1986,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single individual with urethral injury from intra‑urethral insertion of spaghetti during masturbation; surgical outcome described.","sample_n":1,"sample_text":"N=1 (single case report)","population":"Adult male (single case)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A man injured his urethra by inserting a piece of spaghetti during masturbation; the broken spaghetti caused a scar that needed surgery.","clinical_takeaway":"Unusual objects inserted intra‑urethrally can cause serious injury; clinicians should inquire about such practices when evaluating urethral trauma.","confidence":0.9,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Detailed clinical description","Illustrates a rare injury mechanism"],"limitations":["Single case, no generalisability","No systematic assessment of risk factors"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00000433-198607030-00015"}},{"id":4568,"doi":"10.1080/0092623x.2013.857376","pmid":"24405007","pmcid":null,"title":"Evaluation of a behavioral treatment intervention for premature ejaculation using a handheld stimulating device","authors":"Jern P.","first_author":"Jern P.","journal":"Journal of sex & marital therapy","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized wait‑list controlled pilot (N=11)","sample_n":11,"sample_text":"11 men, wait‑list controlled","population":"adult men with premature ejaculation, Finland","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small pilot RCT (11 men) tested a vibrating handheld device using a stop‑start technique for premature ejaculation and found improvements that persisted at six months, suggesting the method may help.","clinical_takeaway":"Evidence is very limited; clinicians should await larger trials before adopting this device as a standard treatment.","confidence":0.7,"topic_tags":["sexual_function","treatment","pornography"],"strengths":["Randomized wait‑list control","Follow‑up at 6 months","Novel behavioral device"],"limitations":["Very small sample (N=11)","No validated outcome measures reported","No power calculation or effect size reporting"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":32,"citing_publications":30,"retracted":false,"notices":[{"status":"Addendum","date":"2014-11-18","noticeDoi":"10.1080/0092623x.2015.975077","doi":"10.1080/0092623x.2013.857376"}],"url":"https://scite.ai/reports/10.1080/0092623x.2013.857376"}},{"id":4569,"doi":"10.1016/j.urology.2013.11.009","pmid":"24411218","pmcid":null,"title":"Prevalence of Ureaplasma urealyticum, Mycoplasma hominis, Chlamydia trachomatis infections, and semen quality in infertile and fertile men in China","authors":"Liu J, Wang Q, Ji X, Guo S, Dai Y, Zhang Z, Jia L, Shi Y, Tai S, Lee Y.","first_author":"Liu J","journal":"Urology","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":53,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of 621 infertile and 615 fertile men recruited from a hospital; semen samples obtained by masturbation after abstinence; WHO‑standard semen analysis; culture/PCR for infections.","sample_n":1236,"sample_text":"621 infertile men and 615 fertile men","population":"Men attending a Chinese urology hospital, aged likely 20‑45, infertile (n=621) and fertile (n=615) groups.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a Chinese hospital, 621 infertile and 615 fertile men were tested for three genital infections. The infections were equally common in both groups, but men infected with Ureaplasma urealyticum had slightly lower sperm counts and vitality.","clinical_takeaway":"Consider testing for Ureaplasma urealyticum in men with low sperm counts or poor sperm vitality.","confidence":0.8,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Large sample from two distinct groups","Validated microbiological and semen‑analysis methods","Clear comparison of infection prevalence and semen quality"],"limitations":["Cross‑sectional; cannot infer causality","No adjustment for potential confounders (e.g., age, smoking, sexual behaviour)","No effect‑size reporting or correction for multiple testing"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":65,"citing_publications":73,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urology.2013.11.009"}},{"id":4570,"doi":"10.5401/healthhist.16.1.0087","pmid":"25095486","pmcid":null,"title":"The universal condition: medical constructions of 'congenital phimosis' in twentieth century New Zealand and their implications for child rearing","authors":"Watson LR.","first_author":"Watson LR.","journal":"Health and history","year":2014,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Historical analysis of medical discourse and practices in 20th‑century New Zealand.","sample_n":null,"sample_text":"Not applicable – archival sources rather than human participants.","population":"New Zealand medical practitioners, historical texts; no participants.","country":"New Zealand","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article traces how New Zealand doctors in the 20th century labelled 'congenital phimosis' and promoted foreskin retraction or circumcision, initially to curb masturbation and later to prevent infections, showing how medical ideas changed over time.","clinical_takeaway":"Historical attitudes toward foreskin conditions do not directly inform current clinical practice.","confidence":0.9,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["Rich historical context","Clear documentation of shifts in medical rationales"],"limitations":["No empirical data on current health outcomes","Limited generalizability beyond historical New Zealand"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5401/healthhist.16.1.0087"}},{"id":4571,"doi":"10.1007/s11920-013-0430-z","pmid":"24293152","pmcid":null,"title":"Current reports on autoerotic deaths--five persistent myths","authors":"Sauvageau A.","first_author":"Sauvageau A.","journal":"Current psychiatry reports","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary/debunking article without original empirical data.","sample_n":null,"sample_text":"N/A","population":"None (no participants)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article dispels five common misconceptions about autoerotic deaths, emphasizing that they are accidental, solitary events, often not involving asphyxia or masturbation, and lack an escape mechanism at the scene.","clinical_takeaway":"Clinicians should recognize that autoerotic deaths are accidental, solitary incidents, not indicative of suicide or partner involvement.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear definition of autoerotic death","Systematic myth‑debunking","Uses forensic literature for prevalence"],"limitations":["No original data presented","Relies on secondary reports","Limited methodological detail"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11920-013-0430-z"}},{"id":4573,"doi":null,"pmid":"25471429","pmcid":null,"title":"Penile fracture and its treatment: is retrograde urethrograghy necessary for management of penile fracture?","authors":"Ahmadnia H, Younesi Rostami M, Kamalati A, Imani MM.","first_author":"Ahmadnia H","journal":"Chinese journal of traumatology = Zhonghua chuang shang za zhi","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Retrospective case series of 116 penile‑fracture patients treated at a single centre; all underwent retrograde urethrography and surgery, with 12‑month follow‑up.","sample_n":116,"sample_text":"116 patients treated between Feb 2002 and Apr 2012 at Ghaem Medical Center, Iran.","population":"Adult men (mean age 32.8) with penile fracture, most due to sexual intercourse; 13 cases involved masturbation.","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 116 men with penile fracture, routine retrograde urethrography rarely found urethral injury (3%). The authors recommend limiting the test to cases with visible blood in the urine, emphasizing fast diagnosis and surgery.","clinical_takeaway":"Avoid routine retrograde urethrography in penile fracture unless haematuria or urethrorrhagia is present.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Large consecutive series for a rare condition","Clear clinical outcome (no complications at 12 months)","Specific recommendation based on observed data"],"limitations":["Single centre, no comparison group","Descriptive analysis only, no statistical testing","Findings may not generalise to settings with different protocols"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":4574,"doi":"10.1007/s10508-013-0233-7","pmid":"24379080","pmcid":null,"title":"Does menstrual cycle phase influence the gender specificity of heterosexual women's genital and subjective sexual arousal?","authors":"Bossio JA, Suschinsky KD, Puts DA, Chivers ML.","first_author":"Bossio JA","journal":"Archives of sexual behavior","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within-subject laboratory experiment assessing genital (VPA) and subjective sexual arousal to male/female stimuli across follicular and luteal phases in 22 naturally cycling heterosexual women","sample_n":22,"sample_text":"Twenty-two naturally-cycling heterosexual women","population":"healthy adult women, n=22","country":"USA (likely, based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 22 women, genital and subjective arousal to male and female erotic videos were measured during two menstrual phases. Women’s physiological and reported arousal did not become more male‑focused at peak fertility; only the masturbation clips showed a slight gender difference.","clinical_takeaway":"Menstrual cycle phase does not appear to alter women’s sexual arousal patterns, so timing of fertility is not a useful factor for managing sexual concerns.","confidence":0.8,"topic_tags":["sexual_function","gender","masturbation"],"strengths":["Physiological genital arousal measured with validated VPA","Cycle phase confirmed biochemically","Within‑subject design controls for individual differences"],"limitations":["Very small sample limits statistical power","No assessment of moral or mental‑health confounds","Convenience sample not representative of broader population"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":28,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0233-7"}},{"id":4575,"doi":"10.1093/shm/13.1.1","pmid":"11624419","pmcid":null,"title":"An unmanly vice: self-pollution, anxiety, and the body in the eighteenth century","authors":"Stolberg M.","first_author":"Stolberg M.","journal":"Social history of medicine : the journal of the Society for the Social History of Medicine","year":2000,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"historical analysis of 18th‑century texts, no primary data collection","sample_n":null,"sample_text":"N/A","population":"N/A","country":"United Kingdom (historical focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article examines why 18th‑century anti‑masturbation campaigns succeeded, highlighting religious, economic, and gender anxieties reflected in patients’ self‑reports and the era’s dominant body ideals.","clinical_takeaway":"Historical moral panic around masturbation informs current stigma; clinicians should be aware of lingering cultural narratives.","confidence":0.8,"topic_tags":["masturbation","sexual_function","moral_incongruence","gender"],"strengths":["Rich primary historical sources (patient letters)","Integrates sociocultural theory (Bourdieu)","Provides context for contemporary moral narratives"],"limitations":["No empirical data; cannot test causal claims","Interpretation may reflect author’s historiographical lens","No systematic methodology reported"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":34,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/shm/13.1.1"}},{"id":4576,"doi":null,"pmid":"10802898","pmcid":null,"title":"[Sexuality of older women. The effect of menopause, other physical and social and partner related factors]","authors":"von Sydow K.","first_author":"von Sydow K.","journal":"Zeitschrift fur arztliche Fortbildung und Qualitatssicherung","year":2000,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review summarizing existing descriptive studies on older women’s sexuality; no new empirical data, no systematic search or risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not applicable – review of published studies","population":"Women aged 50–90 years (no primary data)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review describes how older women's sexual activity, desire, and enjoyment change with age. It finds that psychological, social, and partner factors matter more for sexual well‑being than menopause or hormone therapy.","clinical_takeaway":"In caring for older women, focus on relationship quality and psychosocial support rather than assuming menopause alone drives sexual changes.","confidence":0.7,"topic_tags":["sexual_function","masturbation","relationships","moral_incongruence","gender"],"strengths":["Broad synthesis of literature on an understudied age group","Considers multiple domains (biological, psychological, social, relational)"],"limitations":["Narrative, not systematic – possible selection bias","No quantitative meta‑analysis or formal risk‑of‑bias assessment","Limited detail on measurement instruments used in source studies"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4577,"doi":"10.1177/0956462413516100","pmid":"24352129","pmcid":null,"title":"2013 European Guideline on the management of proctitis, proctocolitis and enteritis caused by sexually transmissible pathogens","authors":"de Vries HJ, Zingoni A, White JA, Ross JD, Kreuter A.","first_author":"de Vries HJ","journal":"International journal of STD & AIDS","year":2014,"pub_types":["Journal Article"],"keywords":["Herpes simplex virus","AIDS","HIV","Disease","Neisseria gonorrhoeae","Bacterial","Guideline","Chlamydia trachomatis","MSM","Treponema pallidum","Lymphogranuloma Venereum","Enteritis","Proctitis","Sexually Transmitted Infections","Men Who Have Sex With Men","Homosexual","Proctocolitis"],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"guideline","sample_n":null,"sample_text":"No empirical sample; guideline based on literature review and expert consensus","population":"health professionals, clinicians dealing with STI‑related proctitis; not a primary research sample","country":"Europe (EU)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The 2013 European guideline advises clinicians on diagnosing and treating proctitis caused by sexually transmitted infections, emphasizing that symptoms can be absent and that testing is needed after any anal contact.","clinical_takeaway":"Screen for anorectal STIs after receptive anal contact, even without symptoms.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Comprehensive synthesis of existing clinical evidence","Clear practical recommendations for clinicians"],"limitations":["No new empirical data","Potential bias from expert opinion without systematic review methods"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":63,"citing_publications":92,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0956462413516100"}},{"id":4578,"doi":null,"pmid":"10986795","pmcid":null,"title":"[The power of science in Tissot's L'Onanisme]","authors":"Singy P.","first_author":"Singy P.","journal":"Gesnerus","year":2000,"pub_types":["Historical Article","Biography","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"historical commentary without new empirical data","sample_n":null,"sample_text":"none","population":"none","country":"Switzerland (historical focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how 18th‑century Swiss physician Tissot framed masturbation as a medical problem, using logical argument while embedding religious morality. It shows that his rational discourse made the prohibition feel internally motivated rather than imposed by authority.","clinical_takeaway":"None - not clinically applicable.","confidence":0.3,"topic_tags":["masturbation","sexual_function"],"strengths":["Provides historical context for medical discourse on masturbation","Highlights interaction of rationalism and concealed morality"],"limitations":["No empirical data; purely interpretive","No systematic analysis of sources","Cannot inform current clinical or epidemiological questions"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4579,"doi":"10.1016/s0022-3999(99)00078-1","pmid":"10750632","pmcid":null,"title":"Ejaculatory latency and control in men with premature ejaculation: an analysis across sexual activities using multiple sources of information","authors":"Rowland DL, Strassberg DS, de Gouveia Brazao CA, Slob AK.","first_author":"Rowland DL","journal":"Journal of psychosomatic research","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":56,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case‑control, cross‑sectional laboratory and questionnaire comparison of 26 men with premature ejaculation and 13 functional controls","sample_n":39,"sample_text":"26 PE men, 13 controls (age‑matched)","population":"adult men, mean age middle‑aged, recruited from clinical/volunteer sources","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Men with premature ejaculation show shorter ejaculation times and less control during intercourse than during masturbation, and these patterns differ from men without the problem.","clinical_takeaway":"PE assessment should consider both intercourse and masturbation contexts; latency varies across activities.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Direct laboratory measurement of ejaculatory response","Comparison of coital vs. masturbatory contexts","Use of age‑matched control group"],"limitations":["Small sample, especially control group","No control for mental‑health or relational variables","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":97,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-3999(99)00078-1"}},{"id":4583,"doi":"10.1177/135245859900500i610","pmid":"10618700","pmcid":null,"title":"Sexual dysfunction in multiple sclerosis: II. Correlation analysis","authors":"Zivadinov R, Zorzon M, Bosco A, Bragadin LM, Moretti R, Bonfigli L, Iona LG, Cazzato G.","first_author":"Zivadinov R","journal":"Multiple sclerosis (Houndmills, Basingstoke, England)","year":1999,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":78,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Case‑control style correlation analysis in 108 MS patients; no longitudinal follow‑up.","sample_n":108,"sample_text":"108 patients with definite multiple sclerosis","population":"Adults with definite multiple sclerosis (both sexes), recruited from Italy; unselected clinical sample.","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 108 people with multiple sclerosis, more severe sexual problems were linked to physical disability, older age, lower education, depression, fatigue and bladder issues, but not to how often they masturbated or had sex.","clinical_takeaway":"Treat sexual dysfunction in MS as multifactorial; address physical disability, mood, and bladder problems, not just sexual activity frequency.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","moral_incongruence","masturbation"],"strengths":["Reasonable sample size for correlation analysis","Broad range of clinical and psychosocial variables assessed","Clear reporting of correlation coefficients and p‑values"],"limitations":["Sexual dysfunction measure not identified as validated","Cross‑sectional design prevents causal inference","No multivariate adjustment; potential confounding remains"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":10,"contrasting":2,"mentioning":38,"citing_publications":112,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/135245859900500i610"}},{"id":4584,"doi":"10.1516/0020757991599322","pmid":"10669964","pmcid":null,"title":"Narcissistic resistances in the analytic experience","authors":"Maldonado JL.","first_author":"Maldonado JL.","journal":"The International journal of psycho-analysis","year":1999,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single psychoanalytic case study of a male patient with compulsive masturbation; no systematic sampling","sample_n":1,"sample_text":"case report; n=1","population":"adult male patient (single case)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A psychoanalytic case study examines how a man's compulsive masturbation relates to narcissistic defenses and the therapeutic relationship, suggesting the resistance serves a hidden need for an external object.","clinical_takeaway":"No direct clinical guidance; the paper offers a theoretical lens rather than evidence‑based recommendations.","confidence":0.7,"topic_tags":["masturbation","neuroscience","sexual_function"],"strengths":["provides rich, detailed psychoanalytic narrative","connects compulsive masturbation to transference dynamics"],"limitations":["single case; no generalizability","no validated measurement of constructs","no control of key confounds (moral incongruence, mental health, etc.)","interpretations exceed data"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1516/0020757991599322"}},{"id":4586,"doi":"10.1007/bf01541750","pmid":"4084049","pmcid":null,"title":"EEG during masturbation and ejaculation","authors":"Graber B, Rohrbaugh JW, Newlin DB, Varner JL, Ellingson RJ.","first_author":"Graber B","journal":"Archives of sexual behavior","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory EEG recordings during masturbation and ejaculation in four normal male participants; within‑subject observational study.","sample_n":4,"sample_text":"Four normal male subjects","population":"4 adult male volunteers (healthy, non‑clinical sample)","country":"USA (presumed from authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers recorded brain electrical activity in four men while they masturbated and ejaculated. They found only a slight, nonspecific drop in alpha waves and concluded there is no clear EEG signature of sexual arousal or orgasm.","clinical_takeaway":"EEG does not currently provide a reliable marker for sexual arousal or orgasm in healthy men.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","masturbation"],"strengths":["Rigorous laboratory control of physiological conditions","Both impressionistic and quantitative EEG analyses","Early contribution to a sparsely studied topic"],"limitations":["Very small sample (N=4) limits generalisability","No correction for multiple EEG comparisons","Lacks measurement of potential psychosocial confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":60,"pct_score":33,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":3,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":2,"mentioning":13,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541750"}},{"id":4587,"doi":null,"pmid":"4066621","pmcid":null,"title":"Pathologic masturbation with drastic consequences: case report","authors":"Grumet GW.","first_author":"Grumet GW.","journal":"The Journal of clinical psychiatry","year":1985,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report describing complications from urethral foreign-body insertion during masturbation","sample_n":1,"sample_text":"N=1 (case report)","population":"one middle‑aged male patient","country":"Unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A man inserted a foreign object into his urethra for sexual stimulation. The object was lost in his bladder and, seven years later, caused a urinary blockage and severe infection requiring emergency surgery.","clinical_takeaway":"Clinicians should consider the possibility of concealed foreign bodies in patients presenting with urinary obstruction and a history of risky sexual practices.","confidence":0.4,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Detailed clinical description","Long‑term follow‑up of complications"],"limitations":["Single case, no generalisability","No systematic assessment of mental‑health or behavioural factors","No quantitative analysis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":4588,"doi":"10.1007/s15006-013-2280-3","pmid":"24288922","pmcid":null,"title":"[Hypersexual disorder]","authors":"Haselbacher G.","first_author":"Haselbacher G.","journal":"MMW Fortschritte der Medizin","year":2013,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s15006-013-2280-3"}},{"id":4589,"doi":null,"pmid":"10647232","pmcid":null,"title":"Sexual knowledge and practice in Pakistani young men","authors":"Qidwai W.","first_author":"Qidwai W.","journal":"JPMA. The Journal of the Pakistan Medical Association","year":1999,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Questionnaire administered to 188 outpatient males aged 18‑30; convenience sample; descriptive and association analyses.","sample_n":188,"sample_text":"188 men, ages 18‑30, recruited from outpatient department.","population":"Pakistani young men attending Aga Khan University Hospital OPD (N=188).","country":"Pakistan","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1999 survey of 188 Pakistani men aged 18‑30 found widespread misconceptions and guilt about masturbation and nocturnal emissions, suggesting a need for better sex education.","clinical_takeaway":"Clinicians should be aware that cultural guilt around masturbation may affect young Pakistani men and consider education‑focused interventions.","confidence":0.78,"topic_tags":["sexual_function","masturbation"],"strengths":["Addresses a culturally understudied topic","Reasonable sample size for descriptive work","Identifies high levels of misconceptions and guilt"],"limitations":["Questionnaire not validated","Convenience clinical sample limits generalisability","No measurement of moral/religious factors or mental‑health covariates","Statistical reporting lacks effect sizes and confidence intervals"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":4590,"doi":"10.1016/s0003-9993(99)90028-x","pmid":"10527086","pmcid":null,"title":"Posttraumatic erectile potential of spinal cord injured men: how physiologic recordings supplement subjective reports","authors":"Courtois FJ, Goulet MC, Charvier KF, Leriche A.","first_author":"Courtois FJ","journal":"Archives of physical medicine and rehabilitation","year":1999,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"nonrandomized control trial with physiological measurements in 47 spinal‑cord injured men and 7 uninjured controls","sample_n":54,"sample_text":"47 injured participants, 7 controls; convenience sample from a referral centre","population":"adult men with spinal cord injury (various lesion levels) and a small control group of non‑injured men","country":"unspecified (likely France based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers recorded penile erections in men with spinal‑cord injuries using a strain gauge while exposing them to masturbation or erotic film. The type of stimulation that worked best depended on the injury level, and responses were similar to those of non‑injured men, suggesting retained erectile potential.","clinical_takeaway":"Even with spinal‑cord injury, men may retain erectile function that can be accessed through appropriate psychogenic or reflexogenic stimulation.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","religiosity"],"strengths":["objective physiological outcome measures","comparison of two stimulation modalities","inclusion of a non‑injured control group"],"limitations":["very small control sample (n=7)","no effect‑size reporting or power analysis","absence of psychosocial/confounding variables"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":35,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0003-9993(99)90028-x"}},{"id":4591,"doi":"10.1007/bf01542005","pmid":"4062541","pmcid":null,"title":"Attitudes and responses of parents to pre-adolescent masturbation","authors":"Gagnon JH.","first_author":"Gagnon JH.","journal":"Archives of sexual behavior","year":1985,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"stratified probability sample of 1482 parents; interview survey","sample_n":1482,"sample_text":"stratified probability sample of 1482 parents","population":"parents of children aged 3‑11 (mixed gender, mixed education, mixed religiosity)","country":"unspecified (likely Canada/US based on author affiliation)","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A national survey of 1,482 parents of children aged 3‑11 found most recognize that children masturbate, but fewer think it is acceptable, especially for adolescents. Liberal attitudes and higher education were linked to more positive views, while frequent churchgoers were less supportive.","clinical_takeaway":"Clinicians should note that parental attitudes toward child masturbation vary with education and religiosity, which may affect how families discuss sexuality.","confidence":0.85,"topic_tags":["masturbation","sexual_function","gender","religiosity"],"strengths":["Large, stratified probability sample","Direct interview data on a sensitive topic","Includes religiosity and education as covariates"],"limitations":["Attitude and incidence items not validated scales","Cross‑sectional; no causal inference","Limited measurement of mental‑health or broader family context"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542005"}},{"id":4594,"doi":null,"pmid":"23995177","pmcid":null,"title":"Occurence of sleep abnormalities among people with mental disorders--questionnaire study","authors":"Sobieraj A, Fabin K, Wilczyński K, Krysta K.","first_author":"Sobieraj A","journal":"Psychiatria Danubina","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"questionnaire study, N=49 outpatient psychiatric patients, convenience sample","sample_n":49,"sample_text":"49 respondents from an outpatient psychiatric clinic","population":"adults with mental disorders (Poland)","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small Polish survey of 49 psychiatric outpatients found that most reported frequent sleep problems, which were linked to fatigue, low mood, and attention issues. A few said they tried sex or masturbation to help with sleep.","clinical_takeaway":"Sleep disturbances are common in mental illness and can affect mood and functioning; coping with sex/masturbation is rarely used.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["addresses sleep issues in mental‑illness cohort","includes range of symptom impacts"],"limitations":["Very small, non‑representative sample","Uses non‑validated questionnaire","No statistical control of confounders"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":4595,"doi":"10.1016/j.juro.2013.07.076","pmid":"24120809","pmcid":null,"title":"Re: Effect of an isotonic lubricant on sperm collection and sperm quality","authors":"Niederberger C.","first_author":"Niederberger C.","journal":"The Journal of urology","year":2013,"pub_types":["Comment","Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.juro.2013.07.076"}},{"id":4596,"doi":null,"pmid":"24010202","pmcid":null,"title":"[Risk factors of prostate cancer in urban Qingdao: a case-control study]","authors":"Jia Y, Sun XQ, Gao JG, Zhu LY, Weng BW, Liu ZJ, Zhu H, Qiu ZL, Hou SC.","first_author":"Jia Y","journal":"Zhonghua nan ke xue = National journal of andrology","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"hospital-based matched case‑control study (N=258) using face‑to‑face questionnaire and conditional logistic regression","sample_n":258,"sample_text":"258 valid questionnaires (cases and matched controls)","population":"men in urban Qingdao, China, cases with prostate cancer and age‑matched controls","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A case‑control study in Qingdao found that men with prostate cancer were more likely to have a family cancer history, early first ejaculation, many weekly sex acts before age 35, frequent masturbation, and long‑term heavy drinking.","clinical_takeaway":"Frequent early sexual activity and heavy drinking were associated with higher prostate cancer risk; clinicians may consider these factors in risk assessments.","confidence":0.8,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["Matched case‑control design","Conditional logistic regression","Clear reporting of odds ratios"],"limitations":["Self‑reported sexual behavior, no validated scales","No control for psychological or moral covariates","Hospital‑based convenience sample"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":4597,"doi":"10.1111/jsm.12194","pmid":"23911123","pmcid":null,"title":"Exploring co-parent experiences of sexuality in the first 3 months after birth","authors":"van Anders SM, Hipp LE, Kane Low L.","first_author":"van Anders SM","journal":"The journal of sexual medicine","year":2013,"pub_types":["Journal Article"],"keywords":["Sexuality","Sexual behavior","Postpartum","Birth","Desire","Partner","Co-parent"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective online questionnaire completed by 114 postpartum partners (95 men, 18 women, 1 unspecified). Measures included validated scales for sexual desire, stress, body image, social support, fatigue, and breastfeeding experiences. No longitudinal or experimental component.","sample_n":114,"sample_text":"Partners (N = 114; 95 men, 18 women, 1 unspecified) of postpartum women.","population":"Adult co‑parents of newborns (post‑partum period, 3 months after birth). Convenience sample recruited online.","country":"Not specified (likely United States based on authorship and journal).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 114 new parents examined how partners’ sexual desire and activities change during the first three months after a baby’s birth, finding that intercourse remained common, masturbation was the earliest activity, and oral sex was most enjoyable. Psychosocial factors measured did not predict desire.","clinical_takeaway":"Partner sexual desire in the early postpartum period shows patterns similar to mothers; clinicians should consider both partners when addressing postpartum sexual health.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Use of validated psychometric instruments","Novel perspective on partner sexuality postpartum","Inclusion of multiple psychosocial variables"],"limitations":["Cross‑sectional, retrospective design limits causal inference","Convenience sample, predominantly male, not nationally representative","Limited statistical detail (no effect sizes, power analysis)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12194"}},{"id":4598,"doi":"10.1007/s12098-013-1141-5","pmid":"23842987","pmcid":null,"title":"ARSH 5: Reproductive health needs assessment of adolescents and young people (15-24 y): a qualitative study on 'perceptions of community stakeholders'","authors":"Nair MK, Leena ML, George B, Thankachi Y, Russell PS.","first_author":"Nair MK","journal":"Indian journal of pediatrics","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus group discussions with community stakeholders in three districts of Kerala (adolescents, health workers, NGOs, leaders); thematic analysis","sample_n":null,"sample_text":"FGDs with 5 groups per district covering various stakeholder types; exact participant numbers not reported in abstract","population":"adolescents (15‑24 y) and community stakeholders in Kerala, India","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Focus groups with adolescents, health workers and community leaders in Kerala revealed gaps in knowledge about genital hygiene, STIs and the perceived dangers of masturbation, plus barriers like stigma and lack of services.","clinical_takeaway":"Clinicians should recognise community misconceptions about masturbation and address broader reproductive‑health education gaps for adolescents.","confidence":0.7,"topic_tags":["religiosity","masturbation","sexual_function","adolescents"],"strengths":["Provides community‑level perspective on adolescent reproductive health needs","Includes multiple stakeholder groups"],"limitations":["Qualitative design limits generalisability","No systematic assessment of sexual‑behaviour constructs or validated measures","Potential selection bias; participants from health‑service and NGO networks"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12098-013-1141-5"}},{"id":4599,"doi":"10.1007/s12098-013-1137-1","pmid":"23838752","pmcid":null,"title":"ARSH 3: Reproductive and sexual health knowledge: a comparison among married male and female young adults (15-24 y)","authors":"Nair MK, Thankachi Y, Leena ML, George B, Russell PS.","first_author":"Nair MK","journal":"Indian journal of pediatrics","year":2013,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"community survey of married young adults in three districts of Kerala, stratified by age; separate interview schedules for men and women","sample_n":null,"sample_text":"Not reported in abstract; likely several hundred participants based on typical community surveys","population":"married men and women aged 15‑24 years in Kerala, India","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A community survey in Kerala found that young married men know more about topics like masturbation and condom use, while women know more about certain contraceptives. Both sexes have gaps in reproductive health knowledge, suggesting a need for better premarital counseling.","clinical_takeaway":"Clinicians should address gender‑specific gaps in reproductive and sexual health knowledge during counseling of young married couples.","confidence":0.7,"topic_tags":["sexual_function","religiosity","masturbation","pornography"],"strengths":["Large community sample across three districts","Separate interview schedules for men and women","Pre‑tested questionnaire"],"limitations":["Knowledge items not from validated scales","No control for moral, mental‑health or relationship confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12098-013-1137-1"}},{"id":4600,"doi":"10.1016/j.jflm.2013.06.003","pmid":"23910832","pmcid":null,"title":"Treatment outcomes of chemical castration on Korean sex offenders","authors":"Koo KC, Shim GS, Park HH, Rha KH, Choi YD, Chung BH, Hong SJ, Lee JW.","first_author":"Koo KC","journal":"Journal of forensic and legal medicine","year":2013,"pub_types":["Journal Article"],"keywords":["Testosterone","Castration","Paraphilia"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"prospective cross‑sectional case series of 38 Korean sex offenders receiving chemical castration; no control group","sample_n":38,"sample_text":"38 patients","population":"Male sex offenders (adolescent to middle‑aged) at a forensic hospital in Korea","country":"South Korea","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The authors followed 38 Korean sex offenders who received chemical castration and reported lower sexual drive, masturbation, and fantasies, plus a temporary testosterone rise after stopping treatment.","clinical_takeaway":"Chemical castration may reduce sexual urges, but evidence is limited to a small uncontrolled case series.","confidence":0.6,"topic_tags":["sexual_function","treatment"],"strengths":["prospective data collection","objective hormonal measurements","focus on a specific treatment policy"],"limitations":["Small, non‑random sample without comparison group","No validated scales for sexual drive or problematic use reported","Potential confounders (mental health, trauma, moral attitudes) not addressed"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jflm.2013.06.003"}},{"id":4601,"doi":"10.1093/humupd/dmt029","pmid":"23820516","pmcid":null,"title":"The spinal control of ejaculation revisited: a systematic review and meta-analysis of anejaculation in spinal cord injured patients","authors":"Chéhensse C, Bahrami S, Denys P, Clément P, Bernabé J, Giuliano F.","first_author":"Chéhensse C","journal":"Human reproduction update","year":2013,"pub_types":["Meta-Analysis","Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":["Physiology","Fertility","Paraplegia","Quadriplegia","Spinal Generator Of Ejaculation"],"is_oa":false,"oa_url":null,"cited_by_count":77,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Meta-analysis of observational studies on ejaculation outcomes after spinal cord injury, with subgroup analyses by injury level and stimulation method.","sample_n":3851,"sample_text":"Aggregated across included studies (45).","population":"Men with spinal cord injury (n≈3851 across 45 studies).","country":"Not specified (multinational literature search).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 45 studies (3851 men) examined how different spinal injuries affect the ability to ejaculate naturally or after stimulation. Findings suggest that injury to spinal segments L2–S2 disrupts ejaculation, supporting the idea of a spinal ejaculation generator in humans.","clinical_takeaway":"Ejaculation outcomes after spinal cord injury depend on lesion level; targeted stimulation may aid men with specific injury patterns.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","religiosity","masturbation"],"strengths":["Large pooled sample (n≈3851).","Systematic search across multiple databases.","Relevant subgroup analyses by injury level and stimulation method."],"limitations":["Underlying primary studies are observational with heterogeneous designs.","No pre‑registration of the meta‑analysis protocol reported.","Potential publication bias not addressed in abstract."],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":44,"citing_publications":108,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/humupd/dmt029"}},{"id":4602,"doi":"10.1016/j.yhbeh.2013.03.007","pmid":"23998672","pmcid":"PMC3761219","title":"Puberty and adolescent sexuality","authors":"Fortenberry JD.","first_author":"Fortenberry JD.","journal":"Hormones and behavior","year":2013,"pub_types":["research-article","Review","Journal Article"],"keywords":["Sexuality","Sexual behavior","Sexual function","Adolescence","Puberty","Masturbation","Sexual Arousal","Abstinence","Sexual Desire"],"is_oa":false,"oa_url":null,"cited_by_count":98,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review proposing a conceptual framework; no original data collection","sample_n":null,"sample_text":"not applicable – review article","population":"adolescents (pubertal) and adults; no specific sample size","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how puberty shapes adolescent sexuality, linking desire, arousal, behaviors, and function to adult sexuality, and highlights gaps in current research.","clinical_takeaway":"None – the paper provides a conceptual overview rather than clinical guidance.","confidence":0.4,"topic_tags":["adolescents","sexual_function","masturbation"],"strengths":["Comprehensive synthesis of puberty‑related sexual development","Integrates adult sexuality hallmarks to frame adolescent processes"],"limitations":["No empirical data; conclusions depend on existing literature","Lacks systematic review methodology or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":100,"citing_publications":200,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.yhbeh.2013.03.007"}},{"id":4603,"doi":"10.1111/jsm.12225","pmid":"23802907","pmcid":"PMC3818437","title":"Accuracy of 30-day recall for components of sexual function and the moderating effects of gender and mood","authors":"Weinfurt KP, Lin L, Dombeck CB, Broderick JE, Snyder DC, Williams MS, Fawzy MR, Flynn KE.","first_author":"Weinfurt KP","journal":"The journal of sexual medicine","year":2014,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual behavior","Sexual function","Sexual dysfunction","questionnaires","Mental Recall"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Within‑subject daily diary (30 days) compared to 30‑day recall questionnaire; community sample (N = 202).","sample_n":202,"sample_text":"202 adults (101 women, 101 men) from the general population.","population":"General adult population, balanced gender (101 women, 101 men).","country":"USA (assumed based on NIH funding, not stated in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study asked 202 adults to record their daily sexual experiences for a month and then compare those records to a single 30‑day recall questionnaire. Recall was fairly accurate for many items, but mood and gender affected how well people remembered things like interest, masturbation, and orgasm.","clinical_takeaway":"Clinicians should note that one‑month recall of sexual function can be reliable for some domains, but mood and gender may bias reports, especially for interest and orgasm.","confidence":0.8,"topic_tags":["sexual_function","measurement","moral_incongruence","masturbation"],"strengths":["Large daily diary dataset enabling within‑person comparison","Balanced gender sample","Examines mood as a moderator of recall bias"],"limitations":["No assessment of moral or relational confounds","No pre‑registration or power analysis reported","Recall assessed only at one time point"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12225"}},{"id":4604,"doi":null,"pmid":"4086179","pmcid":null,"title":"The role of the oedipal fantasy in masturbatory and suicidal phenomena","authors":"Rice E.","first_author":"Rice E.","journal":"International journal of psychoanalytic psychotherapy","year":1985,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":4,"sample_text":"Four cases are presented","population":"clinical patients (case series, 4 individuals)","country":"Not reported","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The author presents four clinical cases linking oedipal fantasies, masturbation, and suicidal thoughts, suggesting a dynamic relationship between these phenomena based on psychoanalytic theory.","clinical_takeaway":"No actionable clinical guidance; the paper offers a speculative psychoanalytic perspective, not evidence‑based recommendations.","confidence":0.8,"topic_tags":["masturbation","sexual_function","pornography"],"strengths":["In‑depth psychoanalytic case descriptions","Addresses understudied link between fantasy, masturbation, and suicidality"],"limitations":["No validated measures; reliance on clinical impression","Very small, non‑representative sample","No control for moral, mental‑health or relational confounds","Interpretations exceed data; speculative"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":4605,"doi":"10.1016/j.juro.2013.05.080","pmid":"23931225","pmcid":null,"title":"Re: Semen quality in ejaculates produced by masturbation in men with spinal cord injury","authors":"Niederberger C.","first_author":"Niederberger C.","journal":"The Journal of urology","year":2013,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.juro.2013.05.080"}},{"id":4606,"doi":"10.1046/j.1442-2042.1999.06338.x","pmid":"10226823","pmcid":null,"title":"Role of ejaculation in the treatment of chronic non-bacterial prostatitis","authors":"Yavaşçaoğlu I, Oktay B, Simşek U, Ozyurt M.","first_author":"Yavaşçaoğlu I","journal":"International journal of urology : official journal of the Japanese Urological Association","year":1999,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Single‑arm pre‑post study; 34 single males encouraged to masturbate ≥2×/week; no control group; 28 completed follow‑up.","sample_n":34,"sample_text":"34 enrolled, 28 completed follow‑up","population":"Adult single men with chronic non‑bacterial prostatitis, refractory to antibiotics","country":"Turkey (inferred from author names)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In 34 single men with chronic prostatitis, encouraging masturbation at least twice a week led to modest symptom improvement in some participants, but the study lacked a control group and was very small.","clinical_takeaway":"Insufficient evidence to recommend routine masturbation for prostatitis treatment; clinicians should consider it experimental.","confidence":0.6,"topic_tags":["masturbation","sexual_function","csbd","religiosity"],"strengths":["Addresses a clinically relevant question","Uses a symptom severity index","Follow‑up over 6 months"],"limitations":["No control/comparator group","Small sample, high attrition","No control for moral, mental‑health or partner variables","Causal language exceeds design"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1046/j.1442-2042.1999.06338.x"}},{"id":4607,"doi":"10.1111/jsm.12187","pmid":"23668379","pmcid":null,"title":"The global online sexuality survey (GOSS): The United States of America in 2011 Chapter III--Premature ejaculation among English-speaking male Internet users","authors":"Shaeer O.","first_author":"Shaeer O.","journal":"The journal of sexual medicine","year":2013,"pub_types":["Journal Article"],"keywords":["Definition","Prevalence","USA","Premature Ejaculation","Issm","Pedt"],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of US male internet users recruited via Facebook advertising; 1,133 participants responded to 146-item questionnaire; prevalence of premature ejaculation assessed using ISSM definition, PEDT, and subjective reports.","sample_n":1133,"sample_text":"1,133 participants reported on sexual function.","population":"English‑speaking male internet users in the United States, mean age 52.4 years (SD 14.5).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2013 online survey of 1,133 U.S. men found that 6.3% met the medical definition of premature ejaculation, far lower than rates based on other questionnaires. Age, erectile dysfunction, and genital‑size worries were linked to higher risk, while masturbation was not.","clinical_takeaway":"Only about 1 in 16 men met the clinical definition of premature ejaculation; clinicians should use the ISSM criteria rather than solely questionnaire scores.","confidence":0.78,"topic_tags":["prevalence","sexual_function","pornography","masturbation"],"strengths":["Large sample for an online survey","Comparison of multiple PE assessment methods","Clear reporting of prevalence estimates"],"limitations":["Convenience sampling via Facebook limits generalisability","Self‑report measures without clinical verification","Limited control for psychological or relational confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":40,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12187"}},{"id":4608,"doi":"10.1017/s0317167100014396","pmid":"24340783","pmcid":null,"title":"Long-term outcome of infantile gratification phenomena","authors":"Jan MM, Al Banji MH, Fallatah BA.","first_author":"Jan MM","journal":"The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Case series of 19 infants followed for up to 11 years; consecutive patients from a single pediatric neurology service.","sample_n":19,"sample_text":"N = 19 infants followed for mean 7.1 years.","population":"Infants (4‑13 months) with self‑stimulatory (“gratification”) behaviors, 79 % female.","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study followed 19 infants who showed self‑stimulatory behaviors often mistaken for seizures. All stopped by age 2, but 21 % later developed ADHD, suggesting a possible link that needs larger studies.","clinical_takeaway":"Infant gratification behaviors are typically benign, but clinicians may monitor for later attentional problems.","confidence":0.6,"topic_tags":["masturbation","pornography","sexual_function","neuroscience"],"strengths":["Long follow‑up (up to 11 years) of a rare infant behavior","Clear clinical definition of gratification phenomena","Identification of potential link to later ADHD"],"limitations":["Very small sample; no power justification","No control group; single‑center convenience sample","Limited assessment of confounding factors"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":36,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0317167100014396"}},{"id":4609,"doi":null,"pmid":"23885536","pmcid":null,"title":"[Sexual traumatic events and neurotic disorders picture--sexuality-related and sexuality-unrelated symptoms]","authors":"Sobański JA, Klasa K, Müldner-Nieckowski Ł, Dembińska E, Rutkowski K, Cyranka K.","first_author":"Sobański JA","journal":"Psychiatria polska","year":2013,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional regression on clinical day‑hospital sample (N≈3930) examining childhood sexual‑related adverse events and current neurotic/sexual symptoms","sample_n":3930,"sample_text":"2582 females, 1347 males","population":"adults (female and male) seeking treatment for neurotic disorders in Poland","country":"Poland","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large sample of patients treated for neurotic disorders, childhood experiences such as poor sex education, punishment for masturbation, or unwanted sexual initiation were linked to higher rates of adult sexual symptoms, while non‑sexual neurotic symptoms showed weaker ties.","clinical_takeaway":"Early adverse sexual experiences may contribute to adult sexual difficulties; clinicians should assess such histories when treating sexual dysfunction.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Large clinical sample","Systematic assessment of a broad range of childhood sexual‑related adverse events","Use of regression to examine specific symptom associations"],"limitations":["Cross‑sectional design limits causal inference","No control for key confounds (moral incongruence, mental health, partnership factors)","Measures of trauma and symptoms not clearly validated for this context"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":4610,"doi":"10.1016/s0968-8080(13)41694-4","pmid":"23684189","pmcid":null,"title":"The importance of a positive approach to sexuality in sexual health programmes for unmarried adolescents in Bangladesh","authors":"van Reeuwijk M, Nahar P.","first_author":"van Reeuwijk M","journal":"Reproductive health matters","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"exploratory qualitative study (likely interviews/focus groups) of unmarried adolescents (12‑18 y) in Bangladesh","sample_n":null,"sample_text":"not specified in abstract","population":"unmarried adolescents in Bangladesh (both sexes)","country":"Bangladesh","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Bangladeshi teens (12‑18) want more open, positive sexuality education. They feel curiosity, desire, and anxiety about topics like masturbation and dating, but social taboos create guilt. The authors urge rights‑based, supportive programs to reduce shame.","clinical_takeaway":"Sex‑education programmes should address adolescents’ natural sexual curiosity and reduce guilt, not just focus on disease prevention.","confidence":0.8,"topic_tags":["adolescents","sexual_function","masturbation"],"strengths":["Provides rich, context‑specific insights into adolescents’ sexual feelings and anxieties","Highlights mismatch between youths’ needs and societal messages"],"limitations":["No validated measurement instruments reported","Unclear sampling strategy and size; likely convenience sample","No quantitative analysis or effect size estimation"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":47,"citing_publications":81,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0968-8080(13)41694-4"}},{"id":4611,"doi":"10.1097/htr.0b013e31828dc5ae","pmid":"23661072","pmcid":null,"title":"Prevalence, clinical features, and correlates of inappropriate sexual behavior after traumatic brain injury: a multicenter study","authors":"Simpson GK, Sabaz M, Daher M.","first_author":"Simpson GK","journal":"The Journal of head trauma rehabilitation","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional multicentre survey of 507 severe TBI clients in community rehabilitation","sample_n":507,"sample_text":"Five hundred seven clients with severe traumatic brain injury","population":"Adults with severe traumatic brain injury receiving services in New South Wales, Australia (N=507)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 507 adults with severe traumatic brain injury, about 9% showed inappropriate sexual actions such as unwanted sexual talk or touching. These behaviours were linked to younger age, more severe brain injury, and higher overall behavioural problems.","clinical_takeaway":"Clinicians should screen for inappropriate sexual behaviour in severe TBI patients, as it co‑occurs with other behavioural challenges.","confidence":0.75,"topic_tags":["sexual_function","neuroscience"],"strengths":["Large multicentre sample for severe TBI","Use of established clinical rating scales","Clear prevalence estimate"],"limitations":["Cross‑sectional design precludes causal inference","No measurement of moral or psychosocial confounds relevant to sexual behaviour","Sample limited to rehab clients; not representative of all TBI survivors"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":60,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/htr.0b013e31828dc5ae"}},{"id":4612,"doi":"10.1080/00224499.2012.753983","pmid":"23631689","pmcid":null,"title":"Forbidden fruit? A longitudinal study of Christianity, sex, and marriage","authors":"Pedersen W.","first_author":"Pedersen W.","journal":"Journal of sex research","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Population‑based longitudinal cohort (N=2,454) followed from mid‑teens to late 20s using surveys and registry data.","sample_n":2454,"sample_text":"Population‑based sample of 2,454 participants followed longitudinally.","population":"Norwegian adolescents and young adults (both sexes) from a national sample.","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Norwegian cohort followed from their teens to late twenties, young people who identified as Christian were less likely to masturbate, had later first sexual intercourse, fewer partners, and chose marriage over cohabitation, even after adjusting for several demographic factors.","clinical_takeaway":"Religious involvement may shape sexual development and partnership choices, but does not appear to affect same‑sex experiences.","confidence":0.8,"topic_tags":["religiosity","sexual_function","masturbation","relationships"],"strengths":["Large, nationally representative sample","Longitudinal design allowing temporal ordering","Use of both survey and register data"],"limitations":["Behavioural measures rely on self‑report, unclear validation","Limited detail on which confounders were adjusted","No explicit measurement of mental‑health or moral factors"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2012.753983"}},{"id":4613,"doi":"10.1111/jpm.12080","pmid":"23627653","pmcid":null,"title":"Sexual behaviours on acute inpatient psychiatric units","authors":"Bowers L, Ross J, Cutting P, Stewart D.","first_author":"Bowers L","journal":"Journal of psychiatric and mental health nursing","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Psychiatry","Inpatient","Sexual behaviour","Conflict","Containment"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of incident reports on sexual behaviours, conflict and containment over the first two weeks of admission for 522 patients across 84 wards in 31 hospitals (England).","sample_n":522,"sample_text":"522 patients","population":"Acute inpatient psychiatric patients (adults).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 522 acute psychiatric inpatients, 13% committed at least one sexual incident during the first two weeks, most commonly non‑consensual touching. Public masturbation was only seen in men. Ward gender composition did not affect incident rates and perpetrators could not be predicted from demographics or other disruptive behaviours.","clinical_takeaway":"Sexual incidents occur on acute wards and are not limited by ward gender mix; staff should maintain vigilance and have clear policies for managing such behaviours.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large multi‑site sample (31 hospitals)","Systematic incident reporting over a defined period","Provides descriptive data on a seldom‑studied setting"],"limitations":["Reliance on staff‑reported incidents; possible under‑reporting","No validated measures of sexual behaviour","No control for mental‑health severity, trauma, or moral factors"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jpm.12080"}},{"id":4614,"doi":"10.2147/hiv.s43962","pmid":"23671398","pmcid":"PMC3643290","title":"The Gay Men Sex Studies: prevalence of sexual dysfunctions in Belgian HIV(+) gay men","authors":"Vansintejan J, Janssen J, Van De Vijver E, Vandevoorde J, Devroey D.","first_author":"Vansintejan J","journal":"HIV/AIDS (Auckland, N.Z.)","year":2013,"pub_types":["research-article","Journal Article"],"keywords":["HIV","epidemiology","Sexual dysfunction","Homosexuality/male"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3643290","cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet‑based convenience survey of 72 self‑reported HIV‑positive men who have sex with men; prevalence and logistic‑regression predictors of sexual dysfunctions reported.","sample_n":72,"sample_text":"72 participants recruited via an Internet‑based survey","population":"Belgian HIV‑positive gay men (N = 72)","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 72 Belgian men living with HIV, more than half reported erectile problems and a notable minority reported low desire, premature ejaculation, or pain during sex. Factors such as how often they masturbated, partnered sex, drug use, relationship status and sexual role were linked to these problems.","clinical_takeaway":"Assess sexual function and psychosocial factors (masturbation frequency, relationship stability) in HIV‑positive gay men; treat erectile issues and desire problems considering these predictors.","confidence":0.7,"topic_tags":["sexual_function","masturbation","relationships"],"strengths":["Focus on a specific, understudied population (HIV+ MSM)","Reports multiple sexual dysfunction outcomes","Examines a range of behavioural predictors"],"limitations":["Small convenience sample limits generalisability","Unclear whether validated sexual‑dysfunction scales were used","Potential under‑power for multivariable models"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":19,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/hiv.s43962"}},{"id":4615,"doi":"10.1016/j.comppsych.2013.03.008","pmid":"23587530","pmcid":null,"title":"Pre-marital sex and its predicting factors among Malaysian youths","authors":"Manaf MR, Tahir MM, Sidi H, Midin M, Nik Jaafar NR, Das S, Malek AM.","first_author":"Manaf MR","journal":"Comprehensive psychiatry","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional health‑screening survey of 1,328 Malaysian skill‑training youths; logistic regression used to identify predictors of self‑reported pre‑marital sex.","sample_n":1328,"sample_text":"1328 participants (56 % female, 44 % male).","population":"Malaysian youth trainees (mostly 18 y/o) in a national skill‑training programme; convenience sample, not nationally representative.","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,328 Malaysian youth trainees found that 4.6 % had engaged in pre‑marital sex. Factors that increased the odds included being Muslim, certain ethnic groups, having a lover, watching porn, masturbating and being bullied.","clinical_takeaway":"Low prevalence, but pornography and masturbation are associated with sexual activity; sex‑education may help address related risks.","confidence":0.8,"topic_tags":["prevalence","sexual_function","adolescents","pornography","masturbation"],"strengths":["Large sample size for a survey","Multivariate logistic regression identifies independent predictors","Includes both pornography and masturbation as variables"],"limitations":["Cross‑sectional design cannot infer causality","Self‑report of sexual behaviour may be subject to social desirability bias","Convenience sample limits generalisability to broader Malaysian youth"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":3,"mentioning":40,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2013.03.008"}},{"id":4616,"doi":"10.1111/jsm.12141","pmid":"23551543","pmcid":null,"title":"Patient highlights. Delayed ejaculation","authors":"Perelman MA.","first_author":"Perelman MA.","journal":"The journal of sexual medicine","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12141"}},{"id":4617,"doi":"10.4103/0974-1208.117178","pmid":"24082653","pmcid":"PMC3778601","title":"Male reproductive health under threat: Short term exposure to radiofrequency radiations emitted by common mobile jammers","authors":"Mortazavi S, Parsanezhad M, Kazempour M, Ghahramani P, Mortazavi A, Davari M.","first_author":"Mortazavi S","journal":"Journal of human reproductive sciences","year":2013,"pub_types":["research-article","Journal Article"],"keywords":["Sperm motility","Microwave","Electromagnetic fields","Radiofrequency","Male Reproductive Health","Mobile Jammers"],"is_oa":true,"oa_url":"https://doi.org/10.4103/0974-1208.117178","cited_by_count":37,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory study exposing fresh semen samples to RF radiation from mobile jammers; sham‑exposed control; n=30 donors; within‑subject comparison.","sample_n":30,"sample_text":"30 healthy donors","population":"30 healthy male donors from an infertility clinic (female factor infertility).","country":"Iran (implied by author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a lab study, sperm from 30 men was exposed to radio waves emitted by mobile jammers for up to four hours. Motility dropped compared with a sham‑exposed control, suggesting such devices could harm male fertility.","clinical_takeaway":"Short‑term exposure to jammer radio‑frequency may reduce sperm motility; clinicians might advise patients to limit proximity to such devices.","confidence":0.4,"topic_tags":["sexual_function","religiosity"],"strengths":["Controlled laboratory design with sham condition","Direct physiological outcome (sperm motility)","Clear exposure protocol"],"limitations":["Small sample size (n=30)","No effect‑size reporting or correction for multiple tests","Limited generalisability beyond in‑vitro semen samples"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":32,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0974-1208.117178"}},{"id":4619,"doi":"10.1111/appy.12053","pmid":"23857845","pmcid":null,"title":"Knowledge and attitude on sex among medical students of a Malaysian university: a comparison study","authors":"Sidi H, Loh SF, Mahadevan R, Puteh SE, Musa R, Wong CY, Hadi AA, Sa'aid SH, Amali Z, Abidin M, Das S, Saharom MH, Zakaria H.","first_author":"Sidi H","journal":"Asia-Pacific psychiatry : official journal of the Pacific Rim College of Psychiatrists","year":2013,"pub_types":["Comparative Study","Journal Article"],"keywords":["Sex","Knowledge","Attitude","Medical Student"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 452 Malaysian medical students using a self‑administered questionnaire on sexual knowledge and attitudes.","sample_n":452,"sample_text":"452 students, 80% response rate","population":"Medical students (pre‑clinical and clinical) at National University of Malaysia; convenience sample, 80% response rate.","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2013 Malaysian survey of 452 medical students found moderate knowledge about sex and generally conservative attitudes toward premarital sex, masturbation, abortion, homosexuality and oral sex. Clinical students knew more, but many felt unprepared to address patients' sexual health.","clinical_takeaway":"Medical curricula should include more comprehensive sexual health training to improve future doctors' competence and reduce conservative biases.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a single university","High response rate (80%)","Relevant demographic data collected"],"limitations":["Questionnaire appears ad‑hoc, not validated","Cross‑sectional design limits causal inference","Limited control of potential confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":1,"mentioning":17,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/appy.12053"}},{"id":4620,"doi":"10.1111/j.1479-828x.1998.tb03118.x","pmid":"9890240","pmcid":null,"title":"Vesicovaginal fistula following masturbation managed conservatively","authors":"Ramaiah KS, Kumar S.","first_author":"Ramaiah KS","journal":"The Australian & New Zealand journal of obstetrics & gynaecology","year":1998,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1479-828x.1998.tb03118.x"}},{"id":4621,"doi":"10.1155/2013/451460","pmid":"25763387","pmcid":"PMC4334072","title":"Assessment of the reproductive health status of adult prison inmates in osun state, Nigeria","authors":"Olugbenga-Bello AI, Adeoye OA, Osagbemi KG.","first_author":"Olugbenga-Bello AI","journal":"International journal of reproductive medicine","year":2013,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4334072","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 209 adult prison inmates using a pre‑tested semi‑structured questionnaire","sample_n":209,"sample_text":"209 selected respondents (convenience sample of inmates)","population":"adult male inmates in Osun State prison, Nigeria","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 209 male prisoners in Osun State, Nigeria, found good awareness of STIs, HIV/AIDS and contraception, but low condom use and minimal sexual activity inside prison. Access to condoms was limited, and the authors call for better reproductive health services.","clinical_takeaway":"Prison health programs should improve condom availability and sexual health education despite existing knowledge.","confidence":0.8,"topic_tags":["religiosity","masturbation","sexual_function"],"strengths":["uses a pre‑tested questionnaire","covers multiple aspects of reproductive health knowledge and behavior","sample size sufficient for descriptive aims"],"limitations":["cross‑sectional design, no causal inference","no validated psychometric scales","limited control for confounding factors"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2013/451460"}},{"id":4622,"doi":"10.1007/s10508-012-0068-7","pmid":"23519588","pmcid":null,"title":"A mixed-methods exploration of women's experiences of anal intercourse: meanings related to pain and pleasure","authors":"Stulhofer A, Ajduković D.","first_author":"Stulhofer A","journal":"Archives of sexual behavior","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-methods: large online convenience survey (N=1,893) plus qualitative interviews (n=68); cross‑sectional descriptive and regression analysis; no longitudinal or experimental component","sample_n":1893,"sample_text":"convenience online sample of women who volunteered; qualitative subsample of 68 women who had anal intercourse experience","population":"heterosexual women, 18‑60 y, convenience online sample","country":"unspecified (online)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A large survey of women showed most find anal sex painful at first, but pain often lessens with time and many also experience strong pleasure, especially if they masturbate often and can orgasm during sex.","clinical_takeaway":"Pain during anal sex may decrease with experience; clinicians should address both discomfort and potential for pleasure in counseling.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large quantitative sample for descriptive prevalence","Mixed‑methods design adds depth to quantitative findings","Identifies specific predictors of pleasure (masturbation frequency, orgasmic ability)"],"limitations":["Convenience online sample limits generalisability","Reliance on ad‑hoc self‑report measures; no validated pain/pleasure scales","Cross‑sectional; cannot infer causality or learning processes"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-012-0068-7"}},{"id":4623,"doi":"10.1080/21674086.1984.11927069","pmid":"6728974","pmcid":null,"title":"Mirror masturbation","authors":"Bradlow PA, Coen SJ.","first_author":"Bradlow PA","journal":"The Psychoanalytic quarterly","year":1984,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"One analytic patient (male) described in a psychoanalytic case report.","population":"single adult male psychoanalytic patient","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A psychoanalytic case describes a man who used mirrors during masturbation as a way to deal with deep anxieties about separation from his mother and incest fears. The authors propose this behaviour reflects a symbolic attempt to transform and master early sexual trauma.","clinical_takeaway":"This single case offers a theoretical perspective but provides no evidence for clinical assessment or treatment of masturbation behaviors.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Provides rich psychoanalytic narrative","Explores novel concept of mirror masturbation"],"limitations":["Single case, no empirical measurement","No validated constructs or scales","No control for confounding variables","Findings not generalizable"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/21674086.1984.11927069"}},{"id":4624,"doi":"10.1016/j.archger.2013.02.003","pmid":"23478162","pmcid":null,"title":"Psychosexual needs and sexual behaviors of nursing care home residents","authors":"Mroczek B, Kurpas D, Gronowska M, Kotwas A, Karakiewicz B.","first_author":"Mroczek B","journal":"Archives of gerontology and geriatrics","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 85 nursing home residents (60% women, 40% men), mean age 74.2, assessing self‑reported psychosexual needs and behaviours.","sample_n":85,"sample_text":"85 residents (60% women, 40% men), mean age 74.2 ± 11.2 years","population":"Older adults living in Polish nursing care homes","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2013 Polish survey of 85 nursing‑home residents found that older adults still value emotional closeness, conversation, and even sexual activity, though many view sex as taboo for the elderly.","clinical_takeaway":"Older adults in care homes may have unmet psychosexual needs; staff should consider facilitating respectful intimacy options.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses an understudied population (elderly in care homes)","Includes both emotional and sexual aspects of need","Provides descriptive baseline data for policy discussion"],"limitations":["Small, non‑representative convenience sample","No validated measurement instruments reported","No control for key confounds (e.g., mental health, moral attitudes)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":31,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.archger.2013.02.003"}},{"id":4625,"doi":"10.1007/s10508-013-0085-1","pmid":"23455658","pmcid":"PMC3958916","title":"A treatment-oriented typology of self-identified hypersexuality referrals","authors":"Cantor JM, Klein C, Lykins A, Rullo JE, Thaler L, Walling BR.","first_author":"Cantor JM","journal":"Archives of sexual behavior","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3958916","cited_by_count":47,"is_preprint":false,"topics":["csbd","masturbation","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"clinical typology based on case vignettes from a hospital sexual‑behaviour clinic","sample_n":null,"sample_text":"large, hospital‑based sexual behaviours clinic (exact N not reported)","population":"patients who self‑referred for help with hypersexual urges (mixed gender)","country":"USA (presumed by author affiliations)","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors propose six categories of people who seek help for \"hypersexual\" urges, based on case examples from a clinic, and suggest matching treatments for each type.","clinical_takeaway":"Clinicians should consider diverse profiles when treating hypersexuality rather than applying a single approach to all patients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides a detailed clinical typology","Illustrates real‑world case presentations","Highlights heterogeneity of hypersexuality"],"limitations":["No systematic measurement of key constructs","Lacks quantitative analysis or validation","Does not control for moral, mental‑health or relationship confounds","Based on a treatment‑seeking, non‑representative sample"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":39,"citing_publications":74,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0085-1"}},{"id":4626,"doi":"10.1071/sh11023","pmid":"23411161","pmcid":null,"title":"Outcomes of using the internet for sexual purposes: fulfillment of sexual desires","authors":"Daneback K, Sevcikova A, Månsson SA, Ross MW.","first_author":"Daneback K","journal":"Sexual health","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey posted on Swedish-language websites; convenience sample of 1614 internet sexual activity users; multinomial logistic regression analysis of self‑report data.","sample_n":1614,"sample_text":"Convenience online sample; not a probability or representative sample.","population":"Adults (mean age not specified) who use the internet for sexual purposes; 62% women, 38% men; recruited via online advertisements (self‑selected).","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2013 Swedish online survey of 1,614 people who use the internet for sexual purposes found that most reported some fulfillment of their sexual desires, especially when they engaged in interactive online sexual activities. Age and masturbation were linked to whether desires were fulfilled.","clinical_takeaway":"Internet sexual activities can satisfy desire for many users, but findings are based on a self‑selected, non‑representative sample.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for an online survey","Multinomial logistic regression provides adjusted comparisons","Inclusion of both genders"],"limitations":["Convenience, self‑selected sample limits generalisability","Unvalidated questionnaire; no separate validated measures of desire or fulfillment","No assessment of key confounds (morality, mental health, partner context, trauma)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh11023"}},{"id":4629,"doi":"10.1111/jsm.12067","pmid":"23347512","pmcid":null,"title":"Evidence for heritability of adult men's sexual interest in youth under age 16 from a population-based extended twin design","authors":"Alanko K, Salo B, Mokros A, Santtila P.","first_author":"Alanko K","journal":"The journal of sexual medicine","year":2013,"pub_types":["Twin Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Extended twin family design using a population‑based Finnish cohort (N = 3,967) with self‑report survey of sexual interest in youth under 16.","sample_n":3967,"sample_text":"Population‑based Finnish twin cohort","population":"Adult men, ages 21‑43, male twins and male siblings, Finland","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A Finnish twin study of almost 4,000 adult men found that about 3 % reported sexual interest in children under 16. Genetic modeling suggested a modest heritable component (≈15 %) alongside larger non‑shared environmental influences.","clinical_takeaway":"Genetic factors may contribute modestly to sexual interest in children, but environmental influences predominate; assessment should focus on current risk factors.","confidence":0.7,"topic_tags":["gender","sexual_function"],"strengths":["Large, population‑based twin sample","Appropriate genetic modeling (ACE/ADE)","Clear reporting of heritability estimate"],"limitations":["Self‑report sexual interest measure not validated","No control for moral/religious attitudes or mental‑health covariates","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":45,"citing_publications":91,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12067"}},{"id":4630,"doi":"10.1111/jsm.12043","pmid":"23347078","pmcid":null,"title":"Risk factors associated with primary and secondary reduced libido in male patients with sexual dysfunction","authors":"Corona G, Rastrelli G, Ricca V, Jannini EA, Vignozzi L, Monami M, Sforza A, Forti G, Mannucci E, Maggi M.","first_author":"Corona G","journal":"The journal of sexual medicine","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":69,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective case‑control series of 3,714 clinic patients (mean age 53)","sample_n":3714,"sample_text":"consecutive series of men (mean age 53.2 ± 12.5 y)","population":"male patients with sexual dysfunction attending a specialized clinic","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In over 3,700 men with sexual problems, low sexual desire that occurs without hormonal or psychological illness is linked to higher education and better metabolic health, while desire loss caused by hormone issues or mental illness follows those conditions.","clinical_takeaway":"Distinguish primary from secondary low libido; primary cases may need psychosocial focus, secondary cases require medical treatment of underlying disorders.","confidence":0.78,"topic_tags":["religiosity","masturbation","relationships","sexual_function"],"strengths":["Large sample size for clinical series","Distinguishes primary vs secondary reduced libido","Considers metabolic and hormonal correlates"],"limitations":["Single‑item measure of libido, no validation","Retrospective, cross‑sectional design limits causality","No assessment of masturbation or moral/religious factors"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":1,"mentioning":53,"citing_publications":127,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12043"}},{"id":4632,"doi":"10.1111/j.2044-8260.1983.tb00615.x","pmid":"6357331","pmcid":null,"title":"The use of directed masturbation training in the treatment of primary anorgasmia","authors":"Nairne KD, Hemsley DR.","first_author":"Nairne KD","journal":"The British journal of clinical psychology","year":1983,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of directed masturbation training for primary anorgasmia; no systematic methods reported.","sample_n":null,"sample_text":"Not applicable (review)","population":"Adults (primarily female) with primary anorgasmia","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review evidence that teaching people specific masturbation techniques can help some individuals who cannot reach orgasm, but the literature is limited and it is unclear who benefits most.","clinical_takeaway":"Directed masturbation training may be useful for primary anorgasmia, but clinicians should consider the limited and methodologically weak evidence.","confidence":0.7,"topic_tags":["masturbation","sexual_function","treatment"],"strengths":["Addresses a clinically relevant sexual dysfunction","Identifies methodological gaps in existing studies"],"limitations":["Narrative rather than systematic review","No explicit quality appraisal or quantitative synthesis","Lacks clear operational definitions of treatment components"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.2044-8260.1983.tb00615.x"}},{"id":4635,"doi":"10.4103/0972-2327.107671","pmid":"23661956","pmcid":"PMC3644791","title":"The alien hand sign","authors":"Amalnath SD, Subramanian R, Dutta TK.","first_author":"Amalnath SD","journal":"Annals of Indian Academy of Neurology","year":2013,"pub_types":["other","Journal Article"],"keywords":["Alien Hand Sign","Frontal Variant","Involuntary Masturbation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3644791","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single case","population":"single male stroke patient","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2013 report describes a man who, after a stroke, exhibited the alien hand sign, causing his hand to move involuntarily, including unintended masturbatory actions. The authors discuss possible brain mechanisms behind this rare symptom.","clinical_takeaway":"In rare stroke cases, involuntary sexual actions may stem from neurological damage rather than psychological factors.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed clinical description of a rare phenomenon","Illustrates neurological basis of involuntary sexual behavior"],"limitations":["Single case, no generalizable data","No standardized measures of sexual behavior or distress","No control of confounding factors"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0972-2327.107671"}},{"id":4636,"doi":"10.1111/j.1556-4029.2012.02302.x","pmid":"23305178","pmcid":null,"title":"Self-induced fatal air embolism: accidental autoerotic death or suicide?","authors":"Modelli ME, Rodrigues MS, Castro BZ, Corrêa RS.","first_author":"Modelli ME","journal":"Journal of forensic sciences","year":2013,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single forensic case report, no systematic sampling, no control group","sample_n":null,"sample_text":"single case (1 individual)","population":"adult male deceased, forensic context","country":"Brazil (authors’ affiliations suggest)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe a rare death of a man caused by an air embolism that likely occurred during a self‑stimulation act involving a syringe and tubing. The forensic evidence points to an accidental autoerotic incident rather than suicide.","clinical_takeaway":"None – the report is a forensic case, not applicable to clinical practice.","confidence":0.9,"topic_tags":["masturbation","sexual_function"],"strengths":["Detailed forensic description of a rare fatal autoerotic incident","Clear presentation of the mechanical set‑up leading to air embolism"],"limitations":["Single case; cannot infer prevalence or causality","No systematic assessment of psychological or sexual‑health variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1556-4029.2012.02302.x"}},{"id":4637,"doi":"10.1001/archneur.1983.04210070063017","pmid":"6409063","pmcid":null,"title":"Absence status manifested by compulsive masturbation","authors":"Jacome DE, Risko MS.","first_author":"Jacome DE","journal":"Archives of neurology","year":1983,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case description of compulsive masturbation during absence status in a 41‑year‑old man with generalized epilepsy; no control group, no systematic data collection","sample_n":1,"sample_text":"single patient","population":"41‑year‑old male with generalized epilepsy","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 41‑year‑old man with generalized epilepsy showed compulsive masturbation during an absence seizure, a phenomenon not previously reported.","clinical_takeaway":"No clinical guidance; this is an isolated case linking seizures to sexual automatism.","confidence":0.8,"topic_tags":["masturbation","sexual_function","neuroscience"],"strengths":["Unique clinical observation linking seizure activity to compulsive sexual behavior","EEG documentation of absence status"],"limitations":["Single case; no generalisable data","No systematic measurement of masturbation frequency or distress","No assessment of confounding factors (e.g., mental health, moral attitudes)","No validated scales or statistical analysis"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":3,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archneur.1983.04210070063017"}},{"id":4638,"doi":null,"pmid":"11620475","pmcid":null,"title":"The great masturbation panic and the discourses of moral regulation in nineteenth- and early twentiety-century Britain","authors":"Hunt A.","first_author":"Hunt A.","journal":"Journal of the history of sexuality","year":1998,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4639,"doi":null,"pmid":"9810405","pmcid":null,"title":"Fracture of the penis--a rare injury on the Jos Plateau, Nigeria","authors":"Ugwu BT, Yiltok SJ, Uba AF, Abdulmajid UF.","first_author":"Ugwu BT","journal":"The Central African journal of medicine","year":1998,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of a single patient with penile fracture during masturbation; description of surgical repair and short‑term outcome.","sample_n":1,"sample_text":"single case","population":"37‑year‑old veterinary surgeon in Nigeria; no broader sample.","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 37‑year‑old surgeon in Nigeria broke his penis while masturbating. The tear was surgically repaired, and he recovered normal erections within days. Psychotherapy helped him avoid further masturbation during recovery.","clinical_takeaway":"Penile fracture requires prompt surgical repair; brief psychotherapy may aid postoperative abstinence.","confidence":0.85,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Detailed clinical description of a rare injury","Clear surgical technique and short‑term outcome"],"limitations":["Single case; no generalisable data","No systematic assessment of psychosocial factors","No quantitative measures or statistical analysis"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":4640,"doi":"10.5172/conu.2012.43.1.47","pmid":"23343232","pmcid":null,"title":"Evaluation of reproductive health and sexual behaviors of university students: case study from Istanbul","authors":"Rathfisch G, Aydin M, Pehlivan MD, Bozurt BS, Kaplica I.","first_author":"Rathfisch G","journal":"Contemporary nurse","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive cross‑sectional survey of 647 university students in Istanbul, convenience sampling via paper questionnaires.","sample_n":647,"sample_text":"Convenience sample of students from several faculties and a dormitory; not a probability sample.","population":"University students (mostly female, mean age 21.4) in Turkey","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2012 survey of 647 Turkish university students found that about a quarter were sexually active, 36% reported masturbating, and many relied on the internet for sexual health information, suggesting a need for better education programs.","clinical_takeaway":"University health services should improve accessible, evidence‑based sexual and reproductive health education for students.","confidence":0.8,"topic_tags":["religiosity","pornography","masturbation","sexual_function"],"strengths":["Large sample size for a student survey","Provides baseline data on sexual behavior and health knowledge in Turkish university students","Reports both sexual activity and masturbation separately"],"limitations":["Convenience sampling limits generalisability","Questionnaire appears non‑validated; construct validity low","No inferential statistics or effect‑size reporting"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5172/conu.2012.43.1.47"}},{"id":4641,"doi":null,"pmid":"23132189","pmcid":null,"title":"Sexual dysfunction in obsessive compulsive disorder and panic disorder","authors":"Aksoy UM, Aksoy SG, Maner F, Gokalp P, Yanik M.","first_author":"Aksoy UM","journal":"Psychiatria Danubina","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-control cross‑sectional questionnaire study (80 patients, 40 controls)","sample_n":120,"sample_text":"convenience sample of clinic patients and community volunteers","population":"40 OCD patients, 40 panic‑disorder patients, 40 healthy controls, ages 20‑60, recruited from a Turkish outpatient anxiety clinic","country":"Turkey","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared sexual function in 40 OCD patients, 40 panic‑disorder patients and 40 healthy adults using a validated sexual‑satisfaction questionnaire. OCD patients showed more frequent problems such as infrequency and anorgasmia. The authors suggest these dysfunctions are present independent of medication and recommend assessing sexual health before treatment.","clinical_takeaway":"Consider screening for sexual dysfunction in patients with OCD or panic disorder before starting psychotropic medication.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["use of a validated sexual satisfaction inventory","comparison with healthy control group","assessment of both male and female participants"],"limitations":["cross‑sectional design; no causal inference","small, clinic‑based sample limits generalisability","no control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":4642,"doi":null,"pmid":"23405799","pmcid":null,"title":"[Yangjing capsule plus low-dose tadalafil for functional anejaculation]","authors":"Jin BF, Zhang HJ, Zhang XD, Sun DL, Gao YJ, Xia GS, Xu FS, Xia XY.","first_author":"Jin BF","journal":"Zhonghua nan ke xue = National journal of andrology","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"randomized controlled trial with 55 functional anejaculation patients; 30 vs 25 groups; 1–3 month treatment","sample_n":55,"sample_text":"55 patients (30 treatment, 25 control)","population":"adult men with functional anejaculation (N=55)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small randomized trial found that a Chinese herbal capsule combined with low‑dose tadalafil improved ejaculatory function in men with functional anejaculation more than ephedrine, but the study used non‑validated outcome categories and had limited statistical reporting.","clinical_takeaway":"The combination may help, but evidence is weak; clinicians should weigh limited data and consider individual patient factors.","confidence":0.8,"topic_tags":["sexual_function","treatment"],"strengths":["Randomized allocation","Clear clinical outcome categories","Combination therapy tested"],"limitations":["Small sample, no power analysis","Outcome not based on validated instruments","No control for key psychosocial confounds","Effect sizes and CIs not reported"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4643,"doi":"10.1007/s00120-012-2994-3","pmid":"22992891","pmcid":null,"title":"[Highlights of the history of onanism]","authors":"Hatzinger M, Berberich H, Moll F, Schultheiss D.","first_author":"Hatzinger M","journal":"Der Urologe. Ausg. A","year":2012,"pub_types":["Historical Article","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"historical overview, no empirical data","sample_n":null,"sample_text":"none","population":"none","country":"Germany (journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how masturbation (onanism) has been viewed from the 17th to 20th centuries, describing medical, religious, and cultural attitudes that labeled it a disease or cause of insanity.","clinical_takeaway":"None – the paper is historical and does not provide clinical guidance.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Provides a broad historical perspective","Covers multiple centuries"],"limitations":["No empirical data or analysis","No operational definitions or measurements"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00120-012-2994-3"}},{"id":4644,"doi":null,"pmid":"9608113","pmcid":null,"title":"[Youth studying at universities: their sexual and reproductive health]","authors":"Sueiro E, Diéguez JL, González A.","first_author":"Sueiro E","journal":"Atencion primaria","year":1998,"pub_types":["Comparative Study","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Transverse descriptive survey of 304 first‑year university students (randomly selected within a single campus).","sample_n":304,"sample_text":"304 universities of 1st course, in 1996‑1997, selected at random according to studies that they were making.","population":"Spanish university students, mean age 19.5, 63 % female.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1998 survey of Spanish university freshmen described when they first masturbated, began sexual activity, and used contraception. About half started masturbating between ages 11‑14; most had not yet had intercourse, and a minority reported same‑sex experiences.","clinical_takeaway":"Youth sexual‑health services should address early masturbation and contraceptive education, but findings are limited to one Spanish campus and lack detailed risk assessment.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Reasonably sized sample for a descriptive survey","Random selection within the campus","Broad range of sexual‑health behaviours examined"],"limitations":["No validated measurement instruments reported","Cross‑sectional design limits causal inference","Key confounders (moral attitudes, mental health, partner context) not assessed","Single‑campus convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":4645,"doi":"10.1007/bf01542073","pmid":"6882206","pmcid":null,"title":"The relationship between mode of female masturbation and achievement of orgasm in coitus","authors":"Leff JJ, Israel M.","first_author":"Leff JJ","journal":"Archives of sexual behavior","year":1983,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 117 middle‑class female volunteers classified by self‑reported masturbatory style; cross‑sectional questionnaire analysis.","sample_n":117,"sample_text":"117 middle‑class female volunteers.","population":"Adult females, middle‑class, recruited as volunteers (non‑clinical).","country":"USA (likely, based on authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 117 women, the way they masturbated (direct, indirect, or not at all) did not predict whether they could have an orgasm during intercourse. Women who never masturbated were less likely to reach orgasm with extra clitoral stimulation. The study suggests current treatments for anorgasmia remain appropriate.","clinical_takeaway":"Masturbation style alone does not determine coital orgasm success; clinicians should consider broader biopsychosocial factors.","confidence":0.6,"topic_tags":["masturbation","sexual_function"],"strengths":["Clear operational definition of masturbation styles","Direct comparison of masturbation and coital orgasm outcomes","Acknowledges questionnaire limitations"],"limitations":["Ad‑hoc questionnaire; no validated instruments","Small group sizes; likely underpowered","Convenience sample limits generalisability","No control for psychological or relational confounds"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542073"}},{"id":4648,"doi":"10.5505/tjtes.2012.47347","pmid":"23588912","pmcid":null,"title":"[Sexual injuries during consensual sexual activity]","authors":"Savaş A, Efesoy O, Cayan F, Cayan S.","first_author":"Savaş A","journal":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","year":2012,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"tur","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective case series of 31 patients presenting with sexual injuries (vaginal lacerations, penile fracture) to a single trauma centre between 2004‑2010.","sample_n":31,"sample_text":"31 patients (17 males, 14 females) treated at one emergency department.","population":"Adult patients (18‑60 years) with consensual‑sex‑related genital injuries; 17 males, 14 females; mean age 32.","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study reviews 31 cases of genital injuries (vaginal tears in women, penile fracture in men) that occurred during consensual sex, describing how they were diagnosed and successfully repaired with early surgery.","clinical_takeaway":"Early surgical repair is effective for genital injuries from consensual sex; clinicians should consider prompt evaluation and treatment.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Clear clinical description of rare genital injuries","Detailed operative findings","Practical recommendations for early surgical repair"],"limitations":["Small, single‑centre case series limits generalisability","No comparison group or risk‑factor analysis","Retrospective design may miss undocumented cases"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5505/tjtes.2012.47347"}},{"id":4649,"doi":"10.1353/bhm.1998.0216","pmid":"9879122","pmcid":null,"title":"Between seduction and libido: Sigmund Freud's masturbation hypotheses and the realignment of his etiologic thinking, 1897-1905","authors":"Makari GJ.","first_author":"Makari GJ.","journal":"Bulletin of the history of medicine","year":1998,"pub_types":["Historical Article","Research Support, Non-U.S. Gov't","Biography","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1353/bhm.1998.0216"}},{"id":4650,"doi":"10.1186/1471-2490-12-29","pmid":"23082785","pmcid":"PMC3507909","title":"Investigation of ejaculatory disorder by silodosin in the treatment of prostatic hyperplasia","authors":"Sakata K, Morita T.","first_author":"Sakata K","journal":"BMC urology","year":2012,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://bmcurol.biomedcentral.com/counter/pdf/10.1186/1471-2490-12-29","cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Questionnaire survey of 91 BPH patients treated with silodosin; prevalence of ejaculatory disorder reported.","sample_n":91,"sample_text":"91 patients recruited from a single hospital; 40 reported sexual activity during the study period.","population":"Male patients with LUTS/BPH, mean age not specified, receiving silodosin 4 mg bid.","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 91 men with enlarged prostate treated with silodosin, 42% reported ejaculatory problems, rising to 95% among those who had sex or masturbated after taking the drug; most found it distressing.","clinical_takeaway":"Silodosin frequently causes ejaculatory disturbances; clinicians should counsel patients about this possible side‑effect.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Clear reporting of prevalence within the sample","Relevant clinical focus on medication side‑effects"],"limitations":["No validated instrument for ejaculatory disorder","No control group or comparison medication","Potential self‑selection bias of patients who responded"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2490-12-29"}},{"id":4651,"doi":"10.1111/j.1440-1819.2012.02375.x","pmid":"23066772","pmcid":null,"title":"Hyperactive sexual desire in Klinefelter Syndrome: treatment with sertraline","authors":"Sinha P, Jnanaprakasan PP, Andrade C.","first_author":"Sinha P","journal":"Psychiatry and clinical neurosciences","year":2012,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1440-1819.2012.02375.x"}},{"id":4652,"doi":"10.4103/0019-5545.104826","pmid":"23372242","pmcid":"PMC3554971","title":"Development of cognitive-behavioral therapy intervention for patients with Dhat syndrome","authors":"Salam KP, Sharma MP, Prakash O.","first_author":"Salam KP","journal":"Indian journal of psychiatry","year":2012,"pub_types":["other","Journal Article"],"keywords":["Feasibility","Cognitive Behavior Therapy","Dhat Syndrome","Semen Loss"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3554971","cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of five patients, feasibility pilot without control group","sample_n":5,"sample_text":"five patients","population":"patients with Dhat syndrome (culturally bound belief about semen loss)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors created a short cognitive‑behavioral therapy program for five men with Dhat syndrome—a cultural belief that losing semen is harmful. After 11‑16 sessions, participants showed better sexual knowledge and reduced anxiety, depression and somatic symptoms, suggesting the program is feasible in clinical practice.","clinical_takeaway":"A brief CBT module appears feasible and may improve distress in Dhat syndrome, but larger controlled trials are needed before routine use.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Uses multiple validated clinical scales","Develops a structured CBT protocol","Provides detailed feasibility information"],"limitations":["Very small, uncontrolled sample (N=5)","No statistical power calculation or effect‑size reporting","Findings not generalisable beyond treatment‑seeking patients"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":3,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0019-5545.104826"}},{"id":4653,"doi":"10.4103/0019-5545.104847","pmid":"23372254","pmcid":"PMC3554983","title":"Infantile masturbation: Pitfalls in diagnosis and possible solutions","authors":"Babu TA.","first_author":"Babu TA.","journal":"Indian journal of psychiatry","year":2012,"pub_types":["letter","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.4103/0019-5545.104847","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0019-5545.104847"}},{"id":4654,"doi":"10.1186/1752-1947-6-321","pmid":"23009344","pmcid":"PMC3469380","title":"Synergism of clinical evaluation and penile sonographic imaging in diagnosis of penile fracture: a case report","authors":"Bello JO.","first_author":"Bello JO.","journal":"Journal of medical case reports","year":2012,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3469380","cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":null,"sample_text":"single patient (case report)","population":"31‑year‑old African man with penile fracture","country":"Nigeria (implied by author affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 31‑year‑old man suffered a penile fracture during self‑manipulation. The report shows that bedside ultrasound and sonourethrography helped confirm the injury and any urethral damage before surgery.","clinical_takeaway":"Penile ultrasound can quickly aid diagnosis of penile fracture and guide timely surgical repair.","confidence":0.9,"topic_tags":["sexual_function","gender","religiosity"],"strengths":["Detailed clinical description","Illustrates utility of ultrasound in acute setting"],"limitations":["Single case, no generalizability","No comparative data or outcomes","No systematic assessment of confounders"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1752-1947-6-321"}},{"id":4655,"doi":"10.1007/s10508-012-0006-8","pmid":"23007336","pmcid":null,"title":"Alexithymia, negative emotions, and sexual behavior in heterosexual university students from Italy","authors":"Scimeca G, Bruno A, Pandolfo G, Micò U, Romeo VM, Abenavoli E, Schimmenti A, Zoccali R, Muscatello MR.","first_author":"Scimeca G","journal":"Archives of sexual behavior","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 300 Italian university students; measures of alexithymia (TAS-20) and sexual behavior (Sex and the Average Woman/Man Scale); gender comparisons; associations with depression, anxiety, anger assessed.","sample_n":300,"sample_text":"142 men, 158 women","population":"University students (heterosexual, Italy)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 300 Italian university students, higher alexithymia was linked to lower sexual satisfaction and more sexual shyness, especially for women. Negative emotions like depression and anxiety partly explained these links.","clinical_takeaway":"Consider alexithymia and mood symptoms when assessing sexual satisfaction; no direct implication for pornography or addiction treatment.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Validated alexithymia instrument (TAS‑20)","Reasonable sample size for a survey","Gender‑specific analyses"],"limitations":["Sexual behavior scale appears non‑validated","Potential confounds (moral views, partner context, trauma) not addressed","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":14,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-012-0006-8"}},{"id":4656,"doi":"10.1111/j.1743-6109.2012.02917.x","pmid":"23006745","pmcid":null,"title":"Women who prefer longer penises are more likely to have vaginal orgasms (but not clitoral orgasms): implications for an evolutionary theory of vaginal orgasm","authors":"Costa RM, Miller GF, Brody S.","first_author":"Costa RM","journal":"The journal of sexual medicine","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online convenience survey of 323 women reporting past‑month sexual behavior, penis‑size preference and importance of sexual activities.","sample_n":323,"sample_text":"Online convenience sample, likely not representative of the general female population.","population":"Adult women (self‑selected online respondents)","country":"Not specified (likely USA/International online sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 323 women, those who said a longer penis made orgasm more likely also reported having vaginal orgasms more often, but not more clitoral orgasms. The authors suggest this supports an evolutionary view of vaginal orgasm.","clinical_takeaway":"No direct clinical implications; findings are exploratory and based on self‑report.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Large sample for an online survey","Focused hypothesis linking penis size preference to vaginal orgasm","Uses both ANCOVA and logistic regression"],"limitations":["Reliance on single‑item self‑report measures","Cross‑sectional design cannot infer causality","No control for key confounds (masturbation, mental health, relationship factors)","Sample likely not representative"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":8,"contrasting":1,"mentioning":35,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2012.02917.x"}},{"id":4657,"doi":"10.3917/spub.125.0403","pmid":"23472982","pmcid":null,"title":"[The perceptions of adolescents and young people of sexual and reproductive health in the Democratic Republic of Congo]","authors":"Vodiena GN, Coppieters Y, Lapika BD, Kalambayi PK, Gomis D, Piette D.","first_author":"Vodiena GN","journal":"Sante publique (Vandoeuvre-les-Nancy, France)","year":2012,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups with adolescents/young adults in three Congolese cities; thematic analysis","sample_n":null,"sample_text":"focus groups (exact number not provided in abstract)","population":"adolescents and young adults (10‑24) in urban DRC, mixed gender, various social classes","country":"Democratic Republic of Congo","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Focus groups with Congolese youths (10‑24) revealed they want better sex education, privacy, and reliable health information. Boys mentioned masturbation and sexual performance; girls highlighted menstrual knowledge. They prefer talking to teachers, doctors, or religious leaders rather than parents.","clinical_takeaway":"Health programs should provide confidential, youth‑friendly sexual education and services, addressing both practical information and cultural communication preferences.","confidence":0.8,"topic_tags":["sexual_function","masturbation","adolescents"],"strengths":["Qualitative insight from multiple urban sites","Includes both sexes and three age brackets","Identifies specific informational needs"],"limitations":["No quantitative measures or validated instruments","Sample size and recruitment details unclear","Findings not generalizable beyond the studied cities"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3917/spub.125.0403"}},{"id":4658,"doi":null,"pmid":"23394019","pmcid":null,"title":"[Medical students' sexuality--beliefs and attitudes]","authors":"Müldner-Nieckowski Ł, Sobański JA, Klasa K, Dembińska E, Rutkowski K.","first_author":"Müldner-Nieckowski Ł","journal":"Psychiatria polska","year":2012,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"convenience sample of fourth‑year medical students completing a self‑report sexual‑life satisfaction questionnaire during coursework","sample_n":null,"sample_text":"students attending courses of Psychopathology of neurotic disorders or Psychotherapy","population":"IV‑year medical students, Poland","country":"Poland","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Polish medical students show varied beliefs about sexuality, with many reporting discomfort, avoidance, and moral judgement that could limit their future ability to discuss sexual health with patients.","clinical_takeaway":"Educators should address personal sexual attitudes in medical training to improve future sexual‑health care.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Addresses an under‑studied topic (future physicians' attitudes)","Includes gender comparison","Uses an existing questionnaire"],"limitations":["Unclear validation of KSS2 for attitude measurement","Convenience sample from one university","No control for moral, mental‑health or relational variables","Statistical reporting limited to significance tests"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":4659,"doi":"10.1016/j.jomh.2012.04.002","pmid":"23144669","pmcid":"PMC3490426","title":"Perceptions of HIV transmission risk in commercial and public sex venues","authors":"Downing MJ.","first_author":"Downing MJ.","journal":"Journal of men's health","year":2012,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional internet survey of 139 MSM who attended a sex venue in the past month","sample_n":139,"sample_text":"Internet survey of 139 MSM","population":"men who have sex with men (MSM) attending commercial or public sex venues","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 139 men who have sex with men shows that they think HIV risk is highest in bathhouses and sex clubs, even though those who actually have anal sex there do not rate risk higher than those who only masturbate. Perceptions often do not match the actual risky behaviours performed.","clinical_takeaway":"Education in sex venues should address mismatches between perceived and actual HIV risk.","confidence":0.6,"topic_tags":["sexual_function","relationships"],"strengths":["Focus on venue‑specific risk perception","Includes both high‑risk and low‑risk sexual activities"],"limitations":["Cross‑sectional, self‑report data only","No validated scales for risk perception","Limited control for confounding variables"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jomh.2012.04.002"}},{"id":4660,"doi":null,"pmid":"23045426","pmcid":null,"title":"A rare case of orgasmic disorder: psychogenic anejaculation in an adolescent","authors":"De Sanctis V, Soliman A.","first_author":"De Sanctis V","journal":"Georgian medical news","year":2012,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single adolescent case report with clinical examinations and psychosocial evaluation","sample_n":1,"sample_text":"n=1 (adolescent male)","population":"one 16‑year‑old Caucasian male with psychogenic anejaculation","country":"Georgia (presumed from journal)","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 16‑year‑old boy could not ejaculate during masturbation; medical tests were normal, and anxiety was identified as the likely cause. Counseling reduced his anxiety and he regained normal ejaculation.","clinical_takeaway":"Psychogenic factors, especially anxiety, can cause ejaculatory problems; assessment should include psychosocial evaluation and anxiety‑focused counseling.","confidence":0.85,"topic_tags":["sexual_function","masturbation","csbd","moral_incongruence"],"strengths":["Thorough medical work‑up ruling out organic causes","Clear documentation of anxiety as a psychosocial factor","Follow‑up showing symptom resolution"],"limitations":["Single case limits generalisability","No validated psychometric scales reported","No control or comparison group"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":4,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":4661,"doi":"10.1258/msl.2012.012033","pmid":"22941517","pmcid":null,"title":"An autoerotic death in Korea","authors":"Jung SK.","first_author":"Jung SK.","journal":"Medicine, science, and the law","year":2013,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Single forensic case report of an accidental autoerotic death.","sample_n":1,"sample_text":"N=1 (case report)","population":"One adult male in Korea who died during autoerotic asphyxiation.","country":"Korea","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The report describes a Korean man's accidental death while engaging in solitary sexual activity that involved choking himself with a plastic bag. The forensic investigation concluded the death was unintentional, illustrating the difficulty of recognizing autoerotic deaths when typical signs are missing.","clinical_takeaway":"Clinicians should be aware that autoerotic asphyxiation can be fatal and may present without obvious warning signs.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Detailed forensic description","First reported Korean case"],"limitations":["Single case, no generalisable data","No systematic measurement of psychological variables","No control or comparison group"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/msl.2012.012033"}},{"id":4662,"doi":"10.1055/s-0031-1299363","pmid":"22926726","pmcid":null,"title":"[Disruptive sexual behaviour among patients with dementia]","authors":"Kämpf C, Abderhalden C.","first_author":"Kämpf C","journal":"Fortschritte der Neurologie-Psychiatrie","year":2012,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative overview without systematic methods; no primary data collection.","sample_n":null,"sample_text":"Not reported","population":"Patients with dementia (mixed types, unspecified sample size)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how people with dementia may show disruptive sexual behaviours, such as inappropriate sexual actions or masturbation, noting that prevalence estimates vary widely due to differing definitions and measurement tools.","clinical_takeaway":"Clinicians should recognise that sexual disturbances are common in dementia but lack standardized assessment, limiting precise treatment guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Highlights gap in definitions and measurement tools","Summarises prevalence range across dementia subtypes"],"limitations":["No systematic methodology or risk‑of‑bias assessment","No primary data; relies on heterogeneous prior studies","Lacks clear operational definitions of sexual behaviour outcomes"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-0031-1299363"}},{"id":4665,"doi":"10.1017/s0033291712001833","pmid":"22892227","pmcid":null,"title":"Richard von Krafft-Ebing's views on the etiology of major psychiatric illness","authors":"Engstrom EJ, Kendler KS.","first_author":"Engstrom EJ","journal":"Psychological medicine","year":2013,"pub_types":["Historical Article","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"historical review article without original data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews Richard von Krafft‑Ebing's 19th‑century ideas about what causes major mental illnesses, highlighting his view that genetics, personality, upbringing, and even masturbation could play a role.","clinical_takeaway":"None – the paper is a historical review, not a source of clinical guidance.","confidence":0.4,"topic_tags":["sexual_function","masturbation"],"strengths":["Provides historical context for a major psychiatric figure","Broad discussion of etiologic theory"],"limitations":["No original empirical data","Limited relevance to contemporary pornography or CSBD research"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0033291712001833"}},{"id":4666,"doi":"10.1007/s00383-012-3119-1","pmid":"22791012","pmcid":null,"title":"Sexual function in adults with anorectal malformation: psychosocial adaptation. German Network for Congenital Uro-REctal Malformations (CURE-Net)","authors":"Schmidt D, Winter S, Jenetzky E, Zwink N, Schmiedeke E, Maerzheuser S.","first_author":"Schmidt D","journal":"Pediatric surgery international","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative narrative inquiry with interviews and questionnaires","sample_n":55,"sample_text":"55 adult patients (23 females, 32 males) recruited via the German CURE‑Net registry","population":"55 adult patients with anorectal malformation (ARM) from Germany, ages 18‑56","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A German study interviewed 55 adults born with anorectal malformation about their sexual lives. About two‑thirds had ever had intercourse, and many reported pregnancies and children. The authors note that psychosocial development appears linked to sexual activity.","clinical_takeaway":"Clinicians should assess sexual function and psychosocial adjustment in ARM patients, as these areas are closely related.","confidence":0.85,"topic_tags":["sexual_function","adolescents","gender"],"strengths":["Large sample for a rare congenital condition","Multi‑center registry provides systematic recruitment","Focus on psychosocial adaptation alongside sexual function"],"limitations":["No validated sexual‑function instruments reported","Qualitative design limits quantifiable conclusions","Potential selection bias (registry participants may differ from non‑participants)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":0,"mentioning":36,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00383-012-3119-1"}},{"id":4667,"doi":"10.1089/end.2011.0507","pmid":"22304399","pmcid":null,"title":"Functional outcomes in African-Americans after robot-assisted radical prostatectomy","authors":"DeCastro GJ, Jayram G, Razmaria A, Shalhav A, Zagaja GP.","first_author":"DeCastro GJ","journal":"Journal of endourology","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Retrospective cohort review of a single‑institution RARP database with 12‑month follow‑up; multivariate logistic regression comparing African‑American and non‑African‑American men.","sample_n":140,"sample_text":"140 African‑American patients (urinary continence analysis) and 105 African‑American patients (sexual function analysis).","population":"Adult male prostate cancer patients undergoing robot‑assisted radical prostatectomy; 140 AA and 576 non‑AA for continence, 105 AA and 500 non‑AA for sexual function.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US hospital, African‑American men had lower rates of erections sufficient for intercourse and were less likely to be pad‑free one year after robot‑assisted prostate surgery compared with non‑African‑American men.","clinical_takeaway":"African‑American patients may need closer postoperative counseling about urinary and sexual recovery after prostatectomy.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Validated outcome measures (UCLA PCI)","Large comparative sample sizes","Multivariate adjustment for clinical covariates"],"limitations":["Retrospective, single‑center design limits generalisability","No measurement of psychosocial confounders (e.g., mental health, partner factors)","Effect sizes and confidence intervals not reported in abstract"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/end.2011.0507"}},{"id":4668,"doi":"10.1016/j.earlhumdev.2012.06.007","pmid":"22819361","pmcid":null,"title":"Correlations between digit ratio and infertility in Chinese men","authors":"Lu H, Huo ZH, Liu YJ, Shi ZY, Zhao JL.","first_author":"Lu H","journal":"Early human development","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control study of 268 Chinese men (72 controls, 196 patients) comparing digit ratios from hand photocopies with semen parameters from masturbatory samples.","sample_n":268,"sample_text":"268 men (72 controls, 196 patients)","population":"Chinese adult men, recruited from fertility clinic (patients) and unspecified controls.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that men with higher digit ratios, especially the left‑hand 2D:4D, were more likely to have lower sperm counts, suggesting digit ratio could be an early marker of male infertility.","clinical_takeaway":"Digit ratio may help identify men at risk of infertility, but further research is needed before clinical use.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Reasonable sample size for a case‑control study","Standard anthropometric measurement of digit ratios","Objective semen quality assessment"],"limitations":["Cross‑sectional design; cannot infer causality","Limited control for potential confounders (e.g., age, hormonal status)","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.earlhumdev.2012.06.007"}},{"id":4669,"doi":"10.1007/bf01544992","pmid":"7138298","pmcid":null,"title":"Sexuality in an aged sample: cognitive determinants of masturbation","authors":"Catania JA, White CB.","first_author":"Catania JA","journal":"Archives of sexual behavior","year":1982,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross‑sectional survey of an elderly community sample examining self‑reported frequency of masturbation and its association with locus of control, sexual status and sexual knowledge.","sample_n":null,"sample_text":"Not specified in abstract; likely convenience sample of older volunteers.","population":"aged adults (both sexes) – sample size not stated in abstract","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among older adults, people who feel more personal control and have more sexual knowledge tend to masturbate more often; having a partner may slightly reduce frequency.","clinical_takeaway":"Clinicians can consider personal control beliefs and sexual knowledge when discussing sexual health with older clients.","confidence":0.7,"topic_tags":["masturbation","sexual_function","lgbtq","csbd"],"strengths":["Uses validated locus of control scale","Focus on understudied elderly population","Quantitative analysis of predictors"],"limitations":["No measurement of moral or mental‑health variables","Sample size and recruitment method unclear","Cross‑sectional; causality cannot be inferred"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01544992"}},{"id":4670,"doi":"10.1023/a:1006599804380","pmid":"9288335","pmcid":null,"title":"Alternatives to vaginal intercourse practiced during the fertile time among calendar method users in Ireland","authors":"Bonnar J, Lamprecht V, O'Conner E.","first_author":"Bonnar J","journal":"Advances in contraception : the official journal of the Society for the Advancement of Contraception","year":1997,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Pilot prospective observation of 19 couples using calendar method; no control group; outcomes self‑reported sexual behaviours during fertile period.","sample_n":19,"sample_text":"19 couples (38 individuals)","population":"19 heterosexual couples in Ireland using the calendar method of contraception","country":"Ireland","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a small Irish pilot, 19 couples using the calendar method avoided vaginal sex during fertile days but still engaged in kisses, hugs, oral sex, body rubbing, and mutual or solo masturbation, showing many ways to stay sexually active while preventing pregnancy.","clinical_takeaway":"Couples using fertility‑based contraception can maintain intimacy with non‑penetrative activities; clinicians can discuss these alternatives.","confidence":0.6,"topic_tags":["masturbation","sexual_function","relationships"],"strengths":["Prospective data collection over multiple cycles","Focus on real‑world sexual practices beyond intercourse","Provides descriptive data for a rarely studied context"],"limitations":["Very small, non‑representative sample","No validated measures of sexual behaviour","No control/comparison group"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1006599804380"}},{"id":4671,"doi":"10.1093/milmed/162.6.380","pmid":"9183157","pmcid":null,"title":"Prostatodynia in United Nations peacekeeping forces in Haiti","authors":"Drabick JJ, Gambel JM, Mackey JF.","first_author":"Drabick JJ","journal":"Military medicine","year":1997,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective case series of 13 soldiers diagnosed with prostatodynia during a 5‑month deployment.","sample_n":13,"sample_text":"13 cases of prostatodynia identified among medical records; comparison to other urologic diagnoses (total ~16).","population":"U.S. Army and multinational UN peacekeeping men, mean age 29.8, deployed in Haiti (1995).","country":"United States (deployment in Haiti)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 1995, 13 US soldiers in Haiti were diagnosed with prostatodynia—a chronic pelvic pain condition without infection. Symptoms did not improve with antibiotics, were unrelated to masturbation, and sometimes eased after sex resumed. Some improved with an alpha‑blocker and stress‑reduction.","clinical_takeaway":"Prostatodynia may occur in deployed men; consider non‑antibiotic treatments and stress management.","confidence":0.7,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Clear clinical definition of prostatodynia","Focus on an under‑studied military population","Reports treatment attempts and outcomes"],"limitations":["Very small, non‑representative sample","Retrospective design, no control group","No validated symptom or distress scales","Potential confounding factors (stress, sexual activity) not measured"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":4,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/milmed/162.6.380"}},{"id":4672,"doi":"10.1016/s0015-0282(97)81448-3","pmid":"9176453","pmcid":null,"title":"Seminal reactive oxygen species and sperm motility and morphology in men with spinal cord injury","authors":"Padron OF, Brackett NL, Sharma RK, Lynne CM, Thomas AJ, Agarwal A.","first_author":"Padron OF","journal":"Fertility and sterility","year":1997,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":97,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional comparison of men with spinal cord injury (electroejaculation/vibratory stimulation) vs. healthy controls (masturbation). Sample size not reported in abstract.","sample_n":null,"sample_text":"Not specified in abstract; likely modest.","population":"Men with spinal cord injury and healthy male controls; adult, presumably from a tertiary care centre.","country":"USA (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Men with spinal cord injuries produce more reactive oxygen species in their semen, which is linked to poorer sperm movement and shape, regardless of how the semen was collected.","clinical_takeaway":"Elevated ROS may contribute to reduced sperm quality in spinal cord injury patients; antioxidant strategies could be considered.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Objective biochemical measurement of ROS","Comparison with healthy control group","Analysis of ejaculation method influence"],"limitations":["Small/unspecified sample size, likely underpowered","Cross‑sectional design limits causal inference","No control for psychological or health confounders"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":77,"citing_publications":184,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0015-0282(97)81448-3"}},{"id":4674,"doi":null,"pmid":"24199040","pmcid":"PMC3799125","title":"Use of Sexual Material Online and At-Risk Sexual Behavior Regarding HIV/AIDS among College Students","authors":"Benavides RA, Montero CV, González VM, Rodríguez DJ.","first_author":"Benavides RA","journal":"NI 2012 : 11th International Congress on Nursing Informatics, June 23-27, 2012, Montreal, Canada. International Congress in Nursing Informatics (11th : 2012 : Montreal, Quebec)","year":2012,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 200 college students examining self‑reported use of sexual material online (rich media) and self‑reported at‑risk sexual behaviours for HIV/AIDS.","sample_n":200,"sample_text":"Two hundred young people participated in the study.","population":"College students (young adults), n≈200, convenience sample","country":"Canada (conference presentation)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 200 college students, those who used online sexual material that was rich in video and sound—especially for masturbation, arousal or seeking excitement—were more likely to report behaviours that increase HIV risk.","clinical_takeaway":"The study suggests an association but does not prove that online sexual material causes risky HIV‑related behaviour; clinicians should consider many other factors.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Relatively large sample for a student survey","Examines specific media‑rich contexts of sexual material use"],"limitations":["No validated scales for pornography use or risky behaviour","Cross‑sectional design, cannot infer causality","Key confounds (moral incongruence, mental health, relationship factors) not measured"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":4675,"doi":"10.1007/s11596-012-0068-9","pmid":"22684564","pmcid":null,"title":"Impact of frequency of intercourse on erectile dysfunction: a cross-sectional study in Wuhan, China","authors":"Qin Z, Tian B, Wang X, Liu T, Bai J.","first_author":"Qin Z","journal":"Journal of Huazhong University of Science and Technology. Medical sciences = Hua zhong ke ji da xue xue bao. Yi xue Ying De wen ban = Huazhong keji daxue xuebao. Yixue Yingdewen ban","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 332 male outpatients and volunteers in Wuhan, China","sample_n":332,"sample_text":"332 male outpatients with or without ED and volunteers recruited from Zhongnan Hospital, Wuhan University","population":"male adults aged 30‑75, patients or volunteers at a hospital","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of Chinese men aged 30‑75, more frequent intercourse (once‑weekly or more) was associated with lower odds of erectile dysfunction, even after accounting for health factors. Masturbation frequency showed a similar trend.","clinical_takeaway":"Encouraging regular sexual activity may be linked to lower ED risk, but causal claims are unsupported.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Validated ED measure (IIEF‑5)","Adjusted for several medical covariates","Reasonable sample size for a cross‑sectional study"],"limitations":["Cross‑sectional design cannot infer causality","Coital and masturbation frequencies measured by single self‑report items","No control for moral, relational, or psychological confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":16,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11596-012-0068-9"}},{"id":4676,"doi":"10.1111/j.1743-6109.2012.02804.x","pmid":"22672428","pmcid":null,"title":"Exploring women's postpartum sexuality: social, psychological, relational, and birth-related contextual factors","authors":"Hipp LE, Kane Low L, van Anders SM.","first_author":"Hipp LE","journal":"The journal of sexual medicine","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":66,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective online questionnaire of 304 postpartum women assessing desire, latency, partner perception, and contextual factors.","sample_n":304,"sample_text":"304 women completed an online questionnaire.","population":"Women within 3 months postpartum, recruited online (likely convenience sample).","country":"Not specified (likely USA/International online sample).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 304 postpartum women, the timing of sexual activities (oral sex, masturbation, intercourse) was linked more to perceptions of a partner’s desire and social support than to physical factors like breastfeeding or vaginal trauma.","clinical_takeaway":"Clinicians should assess partner dynamics and relational context when addressing postpartum sexual concerns.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Use of multiple validated psychometric instruments","Relatively large sample for a postpartum survey","Inclusion of partner‑related variables","Explores non‑physical factors often neglected"],"limitations":["Retrospective self‑report may introduce recall bias","Cross‑sectional design limits causal inference","Convenience online recruitment may limit generalisability","No explicit control for moral or religious factors (not central to topic)"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":8,"contrasting":3,"mentioning":75,"citing_publications":124,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2012.02804.x"}},{"id":4677,"doi":"10.1016/s1054-139x(96)00241-8","pmid":"9098735","pmcid":null,"title":"An investigation of adolescent health from China","authors":"Liu GR.","first_author":"Liu GR.","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":1997,"pub_types":["Journal Article"],"keywords":["Population","China","Reproduction","Behavior","Menarche","Asia","Youth","Knowledge","Health","Students","Eastern Asia","Sex behavior","Smoking","Age factors","population characteristics","Puberty","Menstruation","Education","Alcohol drinking","Adolescents","Demographic Factors","Developing Countries","Research Report","Urban Population","Premarital Sex Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 445 high‑school students in one district in China","sample_n":445,"sample_text":"students from a senior high school in the Weicheng District of Weifang City, China","population":"adolescents (high‑school students), n=445","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 1997 survey of 445 Chinese high‑school students described puberty timing, masturbation frequency, substance use and the lack of sexual education, highlighting a need for better sex‑education programs.","clinical_takeaway":"Schools should provide comprehensive sex‑education, as many adolescents lack knowledge and engage in risky behaviours.","confidence":0.8,"topic_tags":["adolescents","masturbation","sexual_function"],"strengths":["Large sample for a single school","Provides descriptive data on multiple health behaviors","Includes both genders"],"limitations":["Convenience sample limits generalisability","No validated scales for sexual behaviour or distress","No control for key confounds (e.g., mental health, moral attitudes)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1054-139x(96)00241-8"}},{"id":4678,"doi":"10.1007/s10508-012-9956-0","pmid":"22528038","pmcid":null,"title":"Masturbation is related to psychopathology and prostate dysfunction: comment on Quinsey (2012)","authors":"Costa RM.","first_author":"Costa RM.","journal":"Archives of sexual behavior","year":2012,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":1,"mentioning":14,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-012-9956-0"}},{"id":4679,"doi":"10.1007/s10508-012-9938-2","pmid":"22399054","pmcid":null,"title":"Sexual behavior in an intensive care unit","authors":"Tsamis D, Theodorou D, Katsaragakis S.","first_author":"Tsamis D","journal":"Archives of sexual behavior","year":2012,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-012-9938-2"}},{"id":4680,"doi":"10.1097/paf.0b013e31823b47d2","pmid":"22104332","pmcid":null,"title":"Fatal subarachnoid hemorrhage during sexual anal self-stimulation in a female: a case report","authors":"Nikolić S, Živković V.","first_author":"Nikolić S","journal":"The American journal of forensic medicine and pathology","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single autopsy; no control group; descriptive forensic pathology","sample_n":1,"sample_text":"single case","population":"female, 39 y, fatal subarachnoid hemorrhage during anal self‑stimulation","country":"unspecified (likely Serbia based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 39‑year‑old woman died from a ruptured brain aneurysm while using a dildo for anal self‑stimulation. The autopsy showed massive bleeding in the brain, highlighting how sexual activity can trigger fatal events in vulnerable persons.","clinical_takeaway":"Clinicians should be aware that intense sexual activity may precipitate aneurysm rupture in at‑risk individuals, though this is exceedingly rare.","confidence":0.6,"topic_tags":["masturbation","sexual_function"],"strengths":["Detailed forensic autopsy findings","Clear description of death scene and mechanism"],"limitations":["Single case – no generalizability","No measurement of psychological or sexual‑behavior constructs","No control or comparative data"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/paf.0b013e31823b47d2"}},{"id":4681,"doi":"10.4324/9781003039495-7","pmid":"7129775","pmcid":null,"title":"Female masturbation in adolescence and the development of the relationship to the body","authors":"Laufer ME.","first_author":"Laufer ME.","journal":"The International journal of psycho-analysis","year":1982,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report; psychoanalytic interpretation of a small number of clinical observations","sample_n":null,"sample_text":"clinical cases (exact number not given)","population":"adolescent females (clinical case material)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper argues that continued hand‑based masturbation in adolescent girls may serve as a defence to keep a positive relationship with their bodies, linking this to early mother‑child interactions and suggesting that failure of this defence can lead to self‑harm.","clinical_takeaway":"No direct clinical recommendations; the ideas are theoretical and not evidence‑based.","confidence":0.4,"topic_tags":["masturbation","adolescents","gender","sexual_function"],"strengths":["The article raises theoretically interesting questions about gender differences in masturbation.","Integrates developmental and psychoanalytic perspectives."],"limitations":["No empirical data; based on clinical anecdote.","Lacks validated measurement of constructs.","No control for relevant confounds (e.g., mental health, moral attitudes).","Interpretations are speculative and not testable."],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4324/9781003039495-7"}},{"id":4682,"doi":"10.1111/j.1743-6109.2012.02791.x","pmid":"22616886","pmcid":null,"title":"Tattoos, piercing, and sexual behaviors in young adults","authors":"Nowosielski K, Sipiński A, Kuczerawy I, Kozłowska-Rup D, Skrzypulec-Plinta V.","first_author":"Nowosielski K","journal":"The journal of sexual medicine","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control, convenience sample of 120 young adults (60 controls, 28 tattoos, 32 piercings), self‑report questionnaire","sample_n":120,"sample_text":"120 participants, divided into three sub‑groups (controls, tattoo, piercing)","population":"young adults (20‑35 y) from Poland","country":"Poland","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 120 Polish young adults, those with tattoos or piercings tended to start sex earlier and report more frequent intercourse, but they did not differ in risky sexual practices or masturbation compared with peers without body modifications.","clinical_takeaway":"Body modifications are linked to earlier sexual initiation, not to higher sexual risk; clinicians should not assume unsafe behaviour solely from tattoos or piercings.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Clear comparison groups (tattoos, piercings, controls)","Use of logistic regression to adjust for covariates","Inclusion of religious practice as a proxy for moral incongruence"],"limitations":["Self‑made questionnaire lacks validation","Small subgroup sizes limit power","Limited assessment of mental‑health and partner factors"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":19,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2012.02791.x"}},{"id":4683,"doi":null,"pmid":"9083774","pmcid":null,"title":"Excessive masturbation in a young girl: a rare presentation of temporal lobe epilepsy","authors":"Cherian MP.","first_author":"Cherian MP.","journal":"European journal of pediatrics","year":1997,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4684,"doi":"10.1016/s0003-9993(97)90039-3","pmid":"9084355","pmcid":null,"title":"Physiologic parameters associated with sexual arousal in women with incomplete spinal cord injuries","authors":"Sipski ML, Alexander CJ, Rosen RC.","first_author":"Sipski ML","journal":"Archives of physical medicine and rehabilitation","year":1997,"pub_types":["Controlled Clinical Trial","Clinical Trial","Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Controlled laboratory experiment with 17 women with incomplete SCI; within‑subject comparison of audiovisual, manual, and distraction conditions.","sample_n":17,"sample_text":"Volunteer sample of 17 women with incomplete SCIs","population":"Women with incomplete spinal cord injuries (N=17)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 17 women with incomplete spinal cord injuries, physiological arousal (vaginal blood flow) and self‑reported excitement were measured while they viewed erotic videos, received manual stimulation, or performed a distracting task. Women who could feel sensation in the lower back showed stronger physiological responses, especially when manual stimulation was added.","clinical_takeaway":"Preserved lower‑body sensation may aid genital vasocongestion in women with SCI; therapeutic strategies might focus on enhancing psychogenic arousal.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Objective physiological measurement (vaginal pulse amplitude)","Within‑subject experimental control of stimulation conditions","Specific focus on spinal level sensation"],"limitations":["Very small sample (N=17)","No power justification or correction for multiple tests","No assessment of key psychosocial confounds","Findings limited to women with incomplete SCI"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":46,"citing_publications":80,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0003-9993(97)90039-3"}},{"id":4685,"doi":"10.1080/15299716.2012.674865","pmid":"22685383","pmcid":"PMC3368508","title":"Sexual Behaviors and Experiences among Behaviorally Bisexual Latino Men in the Midwestern United States: Implications for Sexual Health Interventions","authors":"Martinez O, Dodge B, Goncalves G, Schnarrs P, Muñoz-Laboy M, Reece M, Malebranche D, Van Der Pol B, Kelle G, Nix R, Fortenberry JD.","first_author":"Martinez O","journal":"Journal of bisexuality","year":2012,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interviews with 25 Latino bisexual men; convenience sample; no comparison group","sample_n":25,"sample_text":"25 self‑identified Latino men (out of 75 total participants)","population":"Behaviorally bisexual Latino men (N=25) in the Midwestern United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 25 bisexual Latino men in the Midwest revealed common sexual practices (masturbation, vaginal and oral sex) and risk factors such as alcohol use and inconsistent condom use. All participants provided STI samples, offering data for targeted sexual‑health interventions.","clinical_takeaway":"Clinicians should address alcohol use and condom consistency when counseling bisexual Latino men, using culturally tailored health promotion.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses items from a large, nationally‑representative survey (NSSHB)","In‑depth qualitative data provide rich contextual insight","Includes optional STI testing linking behavior to health outcomes"],"limitations":["Very small, non‑random sample limits generalisability","No measurement or control of key psychosocial confounds (e.g., moral incongruence, mental health)","No quantitative statistical analysis reported"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":6,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/15299716.2012.674865"}},{"id":4686,"doi":"10.4088/pcc.11l01264","pmid":"23106016","pmcid":"PMC3466025","title":"A case of sleep masturbation related to dopamine agonist therapy","authors":"Sawyer RJ, Sansone RA.","first_author":"Sawyer RJ","journal":"The primary care companion for CNS disorders","year":2012,"pub_types":["letter","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/pcc.11l01264"}},{"id":4687,"doi":"10.1176/ajp.154.2.243","pmid":"9016275","pmcid":null,"title":"Characteristics of 36 subjects reporting compulsive sexual behavior","authors":"Black DW, Kehrberg LL, Flumerfelt DL, Schlosser SS.","first_author":"Black DW","journal":"The American journal of psychiatry","year":1997,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":149,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Convenience sample of 36 self‑selected individuals responding to ads for compulsive sexual behavior; structured clinical interviews; descriptive cross‑sectional case series.","sample_n":36,"sample_text":"self‑selected, treatment‑seeking advertisement respondents","population":"28 men, 8 women, age mean 27, recruited via advertisements seeking persons with a problem with compulsive sexual behavior.","country":"USA (assumed from journal and author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","no_mi_control"],"stance":"supports","citation_value":"useful","plain_summary":"The authors described 36 people (mostly men) who said they had compulsive sexual behavior, noting high rates of mood, anxiety, and substance‑use disorders, as well as varied sexual activities including excessive masturbation.","clinical_takeaway":"Compulsive sexual behavior often co‑occurs with other psychiatric problems; assessment should include broader mental‑health evaluation.","confidence":0.75,"topic_tags":["sexual_function","masturbation"],"strengths":["Uses structured clinical interviews","Provides detailed psychiatric comorbidity data","Early systematic description of CSB phenotypes"],"limitations":["Small, self‑selected sample limits generalisability","No validated CSB scale; relies on self‑label","No control for moral or relational confounds"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":6,"contrasting":3,"mentioning":98,"citing_publications":361,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ajp.154.2.243"}},{"id":4688,"doi":"10.2164/jandrol.112.016667","pmid":"22556386","pmcid":null,"title":"Erectile dysfunction and extramarital sex induced by timed intercourse: a prospective study of 439 men","authors":"Bak CW, Lyu SW, Seok HH, Byun JS, Lee JH, Shim SH, Yoon TK.","first_author":"Bak CW","journal":"Journal of andrology","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective observational cohort of 439 men tracking timed intercourse episodes and outcomes (ED, extramarital sex, hormones). No comparison group beyond within‑subject trends.","sample_n":439,"sample_text":"439 men recruited over a 3‑year period.","population":"men attempting natural conception with timed intercourse; middle‑aged, presumably heterosexual, partner‑married.","country":"South Korea (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 3‑year study of 439 men trying to conceive found that more timed‑intercourse attempts were linked to higher rates of erectile problems and extramarital affairs, along with hormonal changes and lower semen volume.","clinical_takeaway":"Clinicians should be aware that scheduling intercourse may increase stress‑related sexual issues, but the evidence does not prove causation.","confidence":0.7,"topic_tags":["sexual_function","relationships","religiosity","masturbation"],"strengths":["large prospective sample","objective hormone measurements","multiple outcomes examined"],"limitations":["self‑report of ED and EMS without validated scales","no control for key psychosocial confounds (moral, mental health, relationship factors)","causal language not warranted by design"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2164/jandrol.112.016667"}},{"id":4689,"doi":null,"pmid":"22420347","pmcid":null,"title":"Sexual behavior in Spanish adolescents of divorced parents","authors":"Orgilés M, Espada JP, Johnson BT, Huedo-Medina TB, Carratalá E.","first_author":"Orgilés M","journal":"Psicothema","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 342 Spanish adolescents","sample_n":342,"sample_text":"342 boys and girls aged 14‑18 years","population":"adolescents aged 14‑18 in Spain","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Spanish teens with divorced parents reported higher rates of mutual masturbation, oral sex, and intercourse in the past six months than peers from intact families.","clinical_takeaway":"Parental divorce may be a risk factor for earlier sexual activity in adolescents; clinicians should consider family structure when discussing sexual health.","confidence":0.7,"topic_tags":["adolescents","sexual_function","relationships"],"strengths":["Large community sample for a single‑country study","Focus on understudied factor (parental divorce) and multiple sexual outcomes","Clear reporting of demographic sub‑analyses"],"limitations":["Cross‑sectional design limits causal inference","Reliance on single‑item self‑reports without validated scales","No control for key psychosocial confounds (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4690,"doi":"10.1007/s10508-012-9930-x","pmid":"22544304","pmcid":null,"title":"Sexual infidelity in China: prevalence and gender-specific correlates","authors":"Zhang N, Parish WL, Huang Y, Pan S.","first_author":"Zhang N","journal":"Archives of sexual behavior","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"national probability survey of 3,567 adults in China, cross‑sectional self‑report of infidelity and attitudes","sample_n":3567,"sample_text":"National probability sample","population":"Adults 18‑49 years, married or cohabiting, China (probability sample)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2006 Chinese national survey found that 11% of men and 4.5% of women reported having sex with someone outside their primary relationship in the past year, with attitudes toward infidelity largely negative. Men’s infidelity was linked to sexual dissatisfaction, women’s to lack of love, and low‑income partners increased women’s risk.","clinical_takeaway":"Infidelity is relatively common in China and linked to relationship dissatisfaction; clinicians should assess relationship quality when addressing extramarital behavior.","confidence":0.85,"topic_tags":["sexual_function","relationships"],"strengths":["Large, nationally representative sample","Gender‑specific analysis","Includes both commercial and non‑commercial infidelity"],"limitations":["Self‑report may be biased","Single‑item measures of infidelity","Limited control of broader psychosocial confounds"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":37,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-012-9930-x"}},{"id":4692,"doi":"10.1038/aja.2012.2","pmid":"22522506","pmcid":"PMC3720168","title":"Objective non-intrusive markers of sperm production and sexual activity","authors":"Sivananthan T, Bathur F, Jimenez M, Conway A, Idan A, Handelsman D.","first_author":"Sivananthan T","journal":"Asian journal of andrology","year":2012,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3720168/pdf/aja20122a.pdf","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Within‑subject urine sampling before and after ejaculation in 11 healthy male volunteers; repeated measures over 5 days.","sample_n":11,"sample_text":"11 volunteers provided urine samples before and at intervals for 5 days after ejaculation.","population":"Healthy adult males (n=11), convenience sample","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested whether sperm cells and prostate‑specific antigen in urine can objectively indicate how much sperm a man produces and whether he has ejaculated recently, finding they work for a short time after ejaculation.","clinical_takeaway":"Urine sperm and PSA can serve as short‑term, non‑invasive markers of recent ejaculation and sperm output, but only for the first morning void.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Objective biological markers avoid self‑report bias","Clear laboratory methodology for sperm and PSA detection","Repeated within‑subject sampling provides temporal profile"],"limitations":["Very small sample (n=11) limits generalisability","No independent validation in larger or diverse populations","No comparison with standard semen analysis"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/aja.2012.2"}},{"id":4693,"doi":"10.1177/00030651970450041501","pmid":"9474572","pmcid":null,"title":"Dora's hysteria and the maturation of Sigmund Freud's transference theory: a new historical interpretation","authors":"Makari GJ.","first_author":"Makari GJ.","journal":"Journal of the American Psychoanalytic Association","year":1997,"pub_types":["Historical Article","Biography","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical/interpretive essay; no empirical data collected.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article re‑examines Freud’s development of transference theory, arguing that his early ideas linked childhood masturbation to hysteria and later shaped his concepts of ‘reprint’ and ‘revised edition’ transference.","clinical_takeaway":"None – the paper offers historical insight, not clinical guidance.","confidence":0.4,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Provides detailed historical context of Freud's theory.","Integrates primary psychoanalytic texts."],"limitations":["No empirical data; purely interpretive.","Lacks systematic methodology or critical appraisal of sources."],"rubric_version":"2.0","raw_total":3,"max_possible":50,"pct_score":6,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":0,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00030651970450041501"}},{"id":4694,"doi":"10.1016/j.gaceta.2012.02.005","pmid":"22483409","pmcid":null,"title":"[Sexual behavior in adolescents aged 12 to 17 in Andalusia (Spain)]","authors":"Rodríguez Carrión J, Traverso Blanco CI.","first_author":"Rodríguez Carrión J","journal":"Gaceta sanitaria","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Stratified random sample of 2,225 secondary school students; anonymous questionnaire; descriptive statistics.","sample_n":2225,"sample_text":"Stratified random sample of secondary‑school students; voluntary participation.","population":"Adolescents aged 12‑17 in Andalusia, Spain (school‑based sample).","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2012 survey of 2,225 Spanish teens found that about one in six had had intercourse, two‑thirds were sexually active, and many started masturbating or having oral sex in early adolescence. Knowledge of condoms and STDs was limited, especially among boys.","clinical_takeaway":"Sex education curricula should address early sexual activity and improve knowledge of protection methods.","confidence":0.8,"topic_tags":["adolescents","sexual_function","masturbation"],"strengths":["Large, stratified random sample","Anonymous self‑report reduces social desirability bias","Provides baseline data on adolescent sexual behaviors"],"limitations":["Questionnaire not validated for psychometric properties","No measurement of mental‑health or moral variables","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":9,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.gaceta.2012.02.005"}},{"id":4695,"doi":"10.1002/(sici)1098-108x(199612)20:4<359::aid-eat3>3.0.co;2-m","pmid":"8953323","pmcid":null,"title":"Multi-impulsivity among women with bulimia nervosa","authors":"Wiederman MW, Pryor T.","first_author":"Wiederman MW","journal":"The International journal of eating disorders","year":1996,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of women with bulimia nervosa (purging type), n=217, comparing those meeting an ad‑hoc multi‑impulsivity definition (n=40) to non‑impulsive peers (n=177).","sample_n":217,"sample_text":"40 multi‑impulsive women, 177 non‑impulsive women with bulimia nervosa.","population":"Adult women diagnosed with bulimia nervosa (purging type), recruited from clinical settings; not a community or population‑based sample.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among women with bulimia, those who also show several impulsive behaviours (like self‑injury or drug use) tend to start binge‑eating and sexual activity earlier and use more substances, but they do not differ in current binge frequency or masturbation rates.","clinical_takeaway":"Impulsivity in bulimic patients may signal earlier onset of risky behaviours; clinicians should assess broader impulsive traits, not just eating symptoms.","confidence":0.75,"topic_tags":["sexual_function","masturbation"],"strengths":["Reasonable total sample size for a clinical subgroup study","Direct comparison of multi‑impulsive vs non‑impulsive bulimic women","Inclusion of sexual behaviour variables"],"limitations":["Ad‑hoc definition of “multi‑impulsivity” without validated scale","Sexual behaviour measured only as incidence, not frequency or distress","No control for key confounds (mental health, moral factors, trauma)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":33,"citing_publications":72,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/(sici)1098-108x(199612)20:4<359::aid-eat3>3.0.co;2-m"}},{"id":4696,"doi":"10.2105/ajph.86.11.1570","pmid":"8916522","pmcid":null,"title":"The sexual practices of adolescent virgins: genital sexual activities of high school students who have never had vaginal intercourse","authors":"Schuster MA, Bell RM, Kanouse DE.","first_author":"Schuster MA","journal":"American journal of public health","year":1996,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":86,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 2026 urban high‑school students (9th‑12th grade), anonymous self‑administered questionnaire, cross‑sectional analysis of sexual practices among self‑reported virgins.","sample_n":2026,"sample_text":"2026 urban high‑school students (grades 9‑12).","population":"Adolescent high‑school students in the United States (urban schools).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among high‑school students who have never had vaginal intercourse, many still engage in other genital activities such as mutual masturbation, oral sex, and occasional anal sex, some of which can transmit STIs.","clinical_takeaway":"Clinicians should counsel even “virgins” about STI risk and safe practices for non‑coital sexual activities.","confidence":0.7,"topic_tags":["adolescents","sexual_function","masturbation"],"strengths":["Large sample size for a school‑based survey","Clear operational definition of ‘virgin’ (no vaginal intercourse)","Inclusion of a range of genital sexual activities beyond intercourse"],"limitations":["Self‑report may be subject to social desirability bias","Cross‑sectional design cannot infer causality","Limited assessment of psychosocial confounds (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":1,"mentioning":78,"citing_publications":172,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2105/ajph.86.11.1570"}},{"id":4697,"doi":null,"pmid":"8994269","pmcid":null,"title":"Repetitive dreams and the central masturbation fantasy","authors":"Hull JW, Lane RC.","first_author":"Hull JW","journal":"Psychoanalytic review","year":1996,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4698,"doi":"10.1038/ijir.2012.2","pmid":"22378496","pmcid":null,"title":"Psychological interventions for delayed ejaculation/orgasm","authors":"Althof SE.","first_author":"Althof SE.","journal":"International journal of impotence research","year":2012,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of psychological theories and interventions for delayed ejaculation; no new empirical data collected.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Male adults with delayed ejaculation (as reported in prior studies); no new sample recruited.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews different psychological ideas and treatments for delayed ejaculation, noting that no single theory or therapy fits all men and that more research is needed.","clinical_takeaway":"Clinicians should assess each case individually and select interventions that match the patient's specific psychological and relational factors.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of existing psychological theories for DE.","Identifies lack of empirical support and need for standardized outcome measures."],"limitations":["No new data; conclusions based on limited prior studies.","Lacks systematic review methods (e.g., PRISMA, risk‑of‑bias assessment).","No quantitative synthesis or effect‑size reporting."],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":50,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/ijir.2012.2"}},{"id":4699,"doi":"10.3393/jksc.2012.28.1.56","pmid":"22413083","pmcid":"PMC3296944","title":"Operative treatment with a laparotomy for anorectal problems arising from a self-inserted foreign body","authors":"Ryoo SB, Oh HK, Ha HK, Choe EK, Moon SH, Park KJ.","first_author":"Ryoo SB","journal":"Journal of the Korean Society of Coloproctology","year":2012,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Foreign bodies","Laparotomy","Anal Canal"],"is_oa":true,"oa_url":"http://coloproctol.org/upload/pdf/jksc-28-56.pdf","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":2,"sample_text":"Two cases","population":"two patients with self‑inserted anorectal foreign bodies (medical case series)","country":"South Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe two patients who inserted objects into their rectum, causing serious injuries that required abdominal surgery. Both surgeries were successful and the patients recovered after colostomy reversal.","clinical_takeaway":"Prompt surgical removal of impacted anorectal foreign bodies can prevent life‑threatening complications.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Detailed clinical description of a rare emergency","Clear surgical steps and outcomes"],"limitations":["Only two cases; no control or comparative data","No systematic assessment of sexual‑behavioral factors"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3393/jksc.2012.28.1.56"}},{"id":4700,"doi":null,"pmid":"23241721","pmcid":null,"title":"[Drug use and sexual practices of teenagers in the city of Medellin (Colombia)]","authors":"Castaño Pérez GA, Arango Tobon E, Morales Mesa S, Rodríguez Bustamante A, Montoya Montoya C.","first_author":"Castaño Pérez GA","journal":"Adicciones","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 955 adolescents in Medellín schools","sample_n":955,"sample_text":"955 teenagers aged 14‑17","population":"Teenagers (14‑17) in public and private schools, Medellín, Colombia","country":"Colombia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 955 Colombian teenagers, 44% reported having sex while under the influence of alcohol or drugs. The study found a strong statistical link between substance use and sexual activity, but no link between substance use and condom use.","clinical_takeaway":"Substance use is common during adolescent sexual activity and may increase risky behaviors; clinicians should screen for combined use.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Large sample for a school‑based survey","Clear reporting of prevalence rates"],"limitations":["Self‑report without validated scales","No control for key psychosocial confounds","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":4703,"doi":null,"pmid":"23214147","pmcid":null,"title":"[Sexual health symptoms and problems in a population of patients in a day hospital for neurotic disorders]","authors":"Sobański JA, Müldner-Nieckowski Ł, Klasa K, Rutkowski K, Dembińska E.","first_author":"Sobański JA","journal":"Psychiatria polska","year":2012,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional diagnostic survey of 2,582 women and 1,347 men admitted to a day‑hospital for neurotic, behavioral and personality disorders.","sample_n":3939,"sample_text":"2582 women and 1347 men","population":"Patients in a Polish day‑hospital for neurotic disorders (convenience clinical sample)","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of nearly 4,000 patients in a Polish day‑hospital for neurotic disorders found that sexual symptoms and problems are common, and many also reported traumatic experiences that could affect sexual development.","clinical_takeaway":"Clinicians treating neurotic patients should routinely assess sexual dysfunctions and consider past trauma.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Large sample size","Focus on an under‑studied clinical population","Includes trauma history"],"limitations":["Unclear whether validated sexual‑function measures were used","No control for moral incongruence, masturbation, mental‑health covariates","Cross‑sectional design limits causal inference","Results may not generalise beyond day‑hospital patients"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":4704,"doi":null,"pmid":"22512148","pmcid":null,"title":"[Sexuality of our seniors: happy end or new beginning?]","authors":"Degauquier C, Absil AS, Meuris S, Psalti I, Jurysta F.","first_author":"Degauquier C","journal":"Revue medicale de Bruxelles","year":2012,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey comparing successive generations of older adults on sexual activity and wellbeing","sample_n":null,"sample_text":"Not reported in abstract","population":"elderly adults (aged 60+), likely community samples in Brussels region","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Surveys show that older adults today report more varied sexual activity—more masturbation and oral sex—and higher sexual wellbeing than past generations, though sexual dysfunction and anxiety can still reduce activity.","clinical_takeaway":"Clinicians should recognize that many seniors remain sexually active and may need support for dysfunctions or anxiety, rather than assuming inevitable decline.","confidence":0.6,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Large‑scale generational comparison","Addresses understudied older adult sexuality"],"limitations":["Likely uses unvalidated self‑report measures","No control for key psychosocial confounds","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":4705,"doi":null,"pmid":"24644490","pmcid":"PMC3940015","title":"Treatment of transvestic fetishism with fluoxetine: a case report","authors":"Usmani MA, K Gaur R, Ahmad Azmi S, Gangwar S.","first_author":"Usmani MA","journal":"Iranian journal of psychiatry and behavioral sciences","year":2012,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["fluoxetine","Paraphilia","Transvestic Fetishism"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3940015","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single 17‑year‑old male case; fluoxetine treatment for transvestic fetishism with reported improvement","sample_n":1,"sample_text":"single case","population":"one male adolescent with transvestic fetishism","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 17‑year‑old boy with a strong interest in cross‑dressing and compulsive masturbation was treated with the antidepressant fluoxetine, which the authors say reduced his obsessive thoughts and behaviours.","clinical_takeaway":"Fluoxetine may help reduce compulsive sexual thoughts in isolated cases, but evidence is limited to a single report.","confidence":0.4,"topic_tags":["sexual_function","treatment","pornography","masturbation"],"strengths":["detailed clinical description","clear therapeutic outcome"],"limitations":["single case, no control","no validated measures of symptoms","no statistical analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":4707,"doi":"10.1111/j.1743-6109.2011.02573.x","pmid":"22189015","pmcid":null,"title":"Manualized treatment programs for FSD: research challenges and recommendations","authors":"Hucker A, Hucker A, McCabe MP.","first_author":"Hucker A","journal":"The journal of sexual medicine","year":2012,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of manualized psychotherapy trials for female sexual dysfunction; no new data collected; discusses methodological issues and recommendations.","sample_n":null,"sample_text":"No primary sample; review of existing studies","population":"Female patients with sexual dysfunctions (as reported in cited trials)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review how using treatment manuals in therapy for female sexual problems can improve research quality, but argue that some flexibility is needed to fit individual patients and to keep the work clinically useful.","clinical_takeaway":"Therapists should balance strict adherence to manuals with individualized tailoring when treating female sexual dysfunction.","confidence":0.4,"topic_tags":["sexual_function","treatment"],"strengths":["Highlights need for methodological rigor in psychotherapy trials","Discusses flexibility vs fidelity in manual use","Provides pragmatic recommendations for future research"],"limitations":["Narrative, not systematic; risk of selection bias","No empirical data or quantitative synthesis","Limited to female sexual dysfunction, not directly about porn or compulsive use"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2011.02573.x"}},{"id":4708,"doi":"10.1016/s0003-9993(96)90027-1","pmid":"8629915","pmcid":null,"title":"Physiological parameters associated with the performance of a distracting task and genital self-stimulation in women with complete spinal cord injuries","authors":"Sipski ML, Rosen RC, Alexander CJ.","first_author":"Sipski ML","journal":"Archives of physical medicine and rehabilitation","year":1996,"pub_types":["Controlled Clinical Trial","Comparative Study","Clinical Trial","Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Controlled laboratory experiment with matched groups (n=10 per group) comparing physiological and subjective sexual responses to a distracting task and manual genital stimulation.","sample_n":20,"sample_text":"10 women with complete SCI and 10 able‑bodied women, matched for age and education.","population":"Women with complete spinal cord injury (n=10) and able‑bodied women (n=10), age‑matched.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab test, women with complete spinal‑cord injuries showed little change in genital or self‑reported arousal while doing a distracting task with genital stimulation, unlike able‑bodied women who reported higher arousal. Removing the distraction allowed the injured group to feel more aroused, but physiological signals stayed low.","clinical_takeaway":"Women with complete SCI may need tailored sexual interventions that minimise distraction to enhance arousal perception.","confidence":0.6,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Well‑controlled laboratory environment","Physiological and self‑report measures collected simultaneously","Matched control group"],"limitations":["Very small sample (n=10 per group)","No power analysis reported","Limited generalisability beyond women with complete SCI"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0003-9993(96)90027-1"}},{"id":4709,"doi":"10.1016/j.jpurol.2011.11.006","pmid":"22154080","pmcid":null,"title":"Long-term bladder function, fertility and sexual function in patients with posterior urethral valves treated in infancy","authors":"López Pereira P, Miguel M, Martínez Urrutia MJ, Moreno JA, Marcos M, Lobato R, Jaureguízar E.","first_author":"López Pereira P","journal":"Journal of pediatric urology","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective follow‑up questionnaire of 16 adult men treated for posterior urethral valves in infancy; convenience sample of reachable patients; descriptive analysis.","sample_n":16,"sample_text":"16 adult males responded to a mailed questionnaire; of 28 contactable, 16 returned.","population":"Adult males (mean age 24) previously treated for posterior urethral valves in infancy (N=16 respondents).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small follow‑up of 16 men who had posterior urethral valves treated as infants found that most have normal erections and orgasm; about 44% develop serious kidney disease, and semen quality is generally sufficient for fatherhood.","clinical_takeaway":"Most adult survivors of posterior urethral valves retain normal sexual function, but clinicians should monitor renal health and fertility.","confidence":0.7,"topic_tags":["sexual_function","religiosity","moral_incongruence","masturbation"],"strengths":["Long‑term follow‑up of a rare congenital condition","Inclusion of objective semen analyses for a subset","Relevant clinical outcomes (renal, bladder, sexual function)"],"limitations":["Very small sample (N=16) limits generalisability","No validated sexual‑function instrument reported","No control group or adjustment for confounders"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpurol.2011.11.006"}},{"id":4710,"doi":"10.1111/j.1743-6109.2011.02552.x","pmid":"22146053","pmcid":null,"title":"The Global Online Sexuality Survey (GOSS): female sexual dysfunction among Internet users in the reproductive age group in the Middle East","authors":"Shaeer O, Shaeer K, Shaeer E.","first_author":"Shaeer O","journal":"The journal of sexual medicine","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":41,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online community‑based survey, 2920 invited, 344 completed; FSFI used to estimate risk for female sexual dysfunction; examined associations with depression, partner factors, masturbation, etc.","sample_n":344,"sample_text":"344 participants completed all survey questions","population":"women of reproductive age living in Middle‑East countries, recruited via internet advertising","country":"Middle East (unspecified countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"An online survey of 344 Middle‑Eastern women found that about 60 % were at risk for female sexual dysfunction, with higher rates linked to personal depression and male partner sexual problems, as well as the women's own masturbation practices.","clinical_takeaway":"Assess partner sexual health and female mental health when addressing female sexual dysfunction.","confidence":0.78,"topic_tags":["sexual_function","prevalence","relationships","moral_incongruence"],"strengths":["Validated primary outcome measure (FSFI)","Large initial recruitment pool","Examines partner and psychological factors"],"limitations":["Low completion rate (≈12 %) leading to possible selection bias","Cross‑sectional, cannot infer causality","Limited assessment of broader confounders (e.g., trauma, religiosity)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":46,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2011.02552.x"}},{"id":4711,"doi":"10.1089/jwh.2011.3000","pmid":"22136319","pmcid":"PMC4772862","title":"Sexually related behaviors as predictors of HPV vaccination among young rural women","authors":"Mills LA, Vanderpool RC, Crosby RA.","first_author":"Mills LA","journal":"Journal of women's health (2002)","year":2011,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"convenience sample of young women attending health clinics and a community college in Appalachian Kentucky; questionnaire followed by free voucher for HPV vaccine; completion of first dose used as binary outcome; logistic regression analysis.","sample_n":null,"sample_text":"convenience sample (size not reported in abstract)","population":"women, age 18-26, Appalachian Kentucky, recruited from health clinics and a community college","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of young women in Appalachian Kentucky, those who had riskier sexual histories—like a history of abnormal Pap tests or reporting mutual masturbation—were more likely to decline a free HPV vaccine, while hormonal birth‑control users were more likely to accept it.","clinical_takeaway":"Clinicians should target vaccine outreach to sexually active young women who may underestimate their HPV risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses logistic regression with reported confidence intervals","Addresses an important public‑health question in a high‑risk rural population","Includes concrete sexual‑behavior predictors"],"limitations":["Convenience, non‑representative sample limits generalisability","Sexual‑behavior measures appear to be single‑item, unvalidated","Key psychosocial confounds (e.g., moral beliefs, mental health) not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/jwh.2011.3000"}},{"id":4712,"doi":"10.1155/2012/407601","pmid":"22190919","pmcid":"PMC3235429","title":"Impact of male obesity on semen quality and serum sex hormones","authors":"Eskandar M, Al-Asmari M, Babu Chaduvula S, Al-Shahrani M, Al-Sunaidi M, Almushait M, Donia O, Al-Fifi S.","first_author":"Eskandar M","journal":"Advances in urology","year":2012,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"http://www.hindawi.com/GetPDF.aspx?doi=10.1155/2012/407601","cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"observational study measuring BMI, semen parameters and hormones in men; two semen samples per participant; no longitudinal follow‑up","sample_n":null,"sample_text":"Not reported in abstract","population":"men of reproductive age attending a Saudi assisted‑reproduction center (sample size not reported in abstract)","country":"Saudi Arabia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examined whether higher body‑mass index in men is linked to poorer semen quality or altered hormone levels. No significant relationships were found, but older age was associated with lower sperm motility.","clinical_takeaway":"Obesity alone may not impact semen quality; clinicians should focus on age‑related changes when evaluating male fertility.","confidence":0.8,"topic_tags":["sexual_function","religiosity","relationships"],"strengths":["Standardized measurement of semen parameters and hormones","Two semen samples per participant improve reliability","Clear statistical reporting of correlations"],"limitations":["Sample size not disclosed; likely under‑powered","Cross‑sectional design limits causal inference","Limited adjustment for potential lifestyle confounders"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":23,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2012/407601"}},{"id":4714,"doi":"10.1111/j.1743-6109.2011.02541.x","pmid":"22082262","pmcid":null,"title":"Greater resting heart rate variability is associated with orgasms through penile-vaginal intercourse, but not with orgasms from other sources","authors":"Costa RM, Brody S.","first_author":"Costa RM","journal":"The journal of sexual medicine","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 143 coitally experienced adults reporting past‑month orgasm frequency and a 5‑minute resting HRV measurement.","sample_n":143,"sample_text":"N = 143 adults recruited for a single laboratory HRV session; recruitment method not specified in abstract.","population":"Adults (men and women) with recent penile‑vaginal intercourse experience; community sample, not treatment‑seeking.","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 143 adults, a higher resting heart‑rate variability—a sign of good autonomic health—was linked to more frequent orgasms during penile‑vaginal sex, but not to orgasms from other activities.","clinical_takeaway":"Greater resting HRV may be associated with more frequent coital orgasms; the relationship is correlational.","confidence":0.8,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Objective HRV measurement","Separate analysis for men and women","Controls for social desirability"],"limitations":["Self‑reported orgasm frequency lacks validated scale","Key sexual‑behavior confounds (masturbation, mental health, moral attitudes) not measured","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":0,"mentioning":37,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2011.02541.x"}},{"id":4715,"doi":"10.1002/(sici)1098-108x(199603)19:2<109::aid-eat1>3.0.co;2-r","pmid":"8932549","pmcid":null,"title":"The sexual experience of women diagnosed with anorexia nervosa or bulimia nervosa","authors":"Wiederman MW, Pryor T, Morgan CD.","first_author":"Wiederman MW","journal":"The International journal of eating disorders","year":1996,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 450 women in an outpatient eating‑disorder program; logistic regression used to examine sexual experience outcomes","sample_n":450,"sample_text":"clinic‑based convenience sample","population":"women diagnosed with anorexia nervosa (n=131) or bulimia nervosa (n=319) attending a specialised clinic","country":"USA (presumed by journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 450 women with anorexia or bulimia, those with bulimia were more likely to have had intercourse, while higher caloric restriction was linked to less masturbation and lower sexual satisfaction, especially in anorexia.","clinical_takeaway":"Eating‑disorder diagnosis and severity relate differently to partnered sex and solo sexual activity; clinicians should assess sexual health alongside nutritional status.","confidence":0.8,"topic_tags":["sexual_function","masturbation","relationships","csbd"],"strengths":["Large clinical sample (n>400)","Separate assessment of masturbation vs partnered sex","Controls for several relevant covariates (age, weight, menarche, symptom severity)","Clear logistic‑regression analysis"],"limitations":["Self‑report sexual items likely unvalidated","No measurement of moral, mental‑health or trauma confounders","Cross‑sectional design limits causal inference","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":45,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/(sici)1098-108x(199603)19:2<109::aid-eat1>3.0.co;2-r"}},{"id":4717,"doi":null,"pmid":"22276368","pmcid":null,"title":"[Death of an 89-year-old man during autosexual activity]","authors":"Müller K, Ottens R, Püschel K.","first_author":"Müller K","journal":"Archiv fur Kriminologie","year":2011,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of a single 89‑year‑old man who died while engaged in outdoor autosexual activity (drowning combined with pre‑existing disease). No systematic sample, no control group.","sample_n":1,"sample_text":"N=1 (single case report).","population":"One elderly male (89 y) who died during autosexual activity.","country":"Not specified (likely Germany based on journal).","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The report describes an 89‑year‑old man who died while masturbating outdoors, likely due to drowning combined with an existing health condition. It illustrates that autoerotic activities can lead to accidental deaths even in very old individuals.","clinical_takeaway":"None – the case does not inform clinical practice for most patients.","confidence":0.4,"topic_tags":["masturbation","sexual_function","adolescents"],"strengths":["Detailed forensic description of a rare death scenario.","Adds to the literature on autoerotic fatalities in older adults."],"limitations":["Single case; no generalisable findings.","No measurement of psychological or sexual‑behavioral constructs.","No control or comparison group."],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":4718,"doi":"10.1007/bf01542263","pmid":"7396686","pmcid":null,"title":"Effect of filmed modeling on the self-reported frequency of masturbation","authors":"Heiby E, Becker JD.","first_author":"Heiby E","journal":"Archives of sexual behavior","year":1980,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"comparative study with control group, convenience sample of 48 female college students, self‑report questionnaires at baseline and 1‑month follow‑up","sample_n":48,"sample_text":"48 female college students, 24 experimental, 24 control","population":"female college students (n=48)","country":"USA (presumed based on journal and author affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a small study of 48 female college students, watching a film that showed a woman masturbating led participants to report more frequent masturbation one month later, even though they said the film didn’t change their sexual attitudes.","clinical_takeaway":"A single brief visual exposure may temporarily increase self‑reported masturbation frequency, but evidence is limited and not generalizable.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Experimental manipulation (viewing explicit film)","Control group included","Follow‑up after one month"],"limitations":["Small, non‑representative sample","Use of single‑item, non‑validated frequency measure","No control for moral, mental‑health or relational variables"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542263"}},{"id":4719,"doi":"10.1111/j.1743-6109.2011.02474.x","pmid":"21995713","pmcid":null,"title":"Poor response to alprostadil ICI test is associated with arteriogenic erectile dysfunction and higher risk of major adverse cardiovascular events","authors":"Rastrelli G, Corona G, Monami M, Melani C, Balzi D, Sforza A, Forti G, Mannucci E, Maggi M.","first_author":"Rastrelli G","journal":"The journal of sexual medicine","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Retrospective cohort of 2,396 men; subset of 1,687 followed longitudinally for MACE outcomes; ICI response graded 1‑4; multivariable adjustment.","sample_n":2396,"sample_text":"2,396 men (mean age 55.9 ± 11.9 y); longitudinal subset N = 1,687.","population":"Men (mean age 56) attending outpatient sexual‑medicine clinic with erectile dysfunction, predominantly from the United States.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In men with erectile dysfunction, a weak reaction to an alprostadil injection test signals poorer blood flow in the penis, more metabolic problems, and roughly a three‑fold higher risk of future heart attacks or strokes.","clinical_takeaway":"A poor ICI test response identifies patients at higher cardiovascular risk; consider cardiovascular evaluation in these men.","confidence":0.73,"topic_tags":["sexual_function","csbd","treatment"],"strengths":["Large clinical sample with longitudinal follow‑up","Objective vascular measurements (PCDU)","Multivariable adjustment for major metabolic confounders"],"limitations":["Retrospective design; possible selection bias","ICI response scale not validated against standard ED measures","No assessment of psychosocial or relationship factors"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":25,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2011.02474.x"}},{"id":4721,"doi":"10.1177/000306519604400109","pmid":"8717484","pmcid":null,"title":"The role of the testicles in male psychological development","authors":"Friedman RM.","first_author":"Friedman RM.","journal":"Journal of the American Psychoanalytic Association","year":1996,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"No empirical sample; psychoanalytic review and case discussion.","population":"none","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews psychoanalytic ideas about how the testes affect boys' psychological growth, linking testicular issues to anxiety, abuse effects, and body image, and notes a common masturbatory practice among young boys.","clinical_takeaway":"None – the paper provides theoretical speculation, not evidence‑based guidance for clinicians.","confidence":0.4,"topic_tags":["sexual_function","gender","masturbation"],"strengths":["Integrates psychoanalytic theory with some clinical observations","Touches on under‑studied topic of testicular influence on development"],"limitations":["Lacks empirical data or systematic methodology","Relies on psychoanalytic speculation and case reports","No clear operational definitions or validated measures"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000306519604400109"}},{"id":4722,"doi":"10.1159/000330196","pmid":"22005210","pmcid":null,"title":"Androgen deprivation treatment of sexual behavior","authors":"Houts FW, Taller I, Tucker DE, Berlin FS.","first_author":"Houts FW","journal":"Advances in psychosomatic medicine","year":2011,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review and case report discussion without original empirical data; no systematic methodology reported.","sample_n":null,"sample_text":"Not applicable – review of literature and case examples.","population":"Male sex offenders/paraphilic patients receiving androgen deprivation therapy (ADT).","country":"Not reported","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article reviews how lowering testosterone, through drugs or surgery, is used to reduce strong sexual urges in men with paraphilic disorders, discussing medical rationales, consent issues, side‑effects, and case examples.","clinical_takeaway":"Androgen deprivation can be considered for severe, treatment‑resistant paraphilic drives, but evidence is limited and ethical safeguards are essential.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive narrative of ADT use in paraphilic disorders","Includes discussion of ethical considerations and side‑effects"],"limitations":["No original data; conclusions based on selected case reports","Lacks systematic review methods and bias assessment","Does not control for moral incongruence, mental health, or trauma"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000330196"}},{"id":4726,"doi":"10.1016/0306-9877(95)90248-1","pmid":"8771059","pmcid":null,"title":"De virginibus puerisque: the function of the human foreskin considered from an evolutionary perspective","authors":"Cox G.","first_author":"Cox G.","journal":"Medical hypotheses","year":1995,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"The article is a theoretical hypothesis piece proposing an evolutionary function for the foreskin and linking it to delayed sexual debut, phimosis, and circumcision. No primary data, participants, or empirical methods are reported.","sample_n":null,"sample_text":"No sample; theoretical article.","population":"human males (theoretical discussion)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The paper hypothesises that the human foreskin evolved to delay first sexual intercourse, giving families more economic stability, and links this to common phimosis, circumcision, and male masturbation.","clinical_takeaway":"None – the paper offers a speculative evolutionary theory, not clinical evidence.","confidence":0.7,"topic_tags":["sexual_function","masturbation","csbd","pornography","moral_incongruence"],"strengths":["Creative evolutionary perspective","Integrates diverse sexual behaviors"],"limitations":["No empirical data","Speculative causal claims","Lacks measurement of key confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0306-9877(95)90248-1"}},{"id":4727,"doi":"10.1159/000473360","pmid":"7398705","pmcid":null,"title":"Curiosity in urology? Masturbation injuries","authors":"Wenderoth U, Jonas U.","first_author":"Wenderoth U","journal":"European urology","year":1980,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 48 masturbation-related injuries, descriptive reporting of one case","sample_n":48,"sample_text":"48 injuries (12 foreign bodies, 36 vacuum‑cleaner injuries)","population":"patients presenting with masturbation injuries (both male and female) in urology settings","country":"unspecified (likely Germany based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes 48 cases of injuries caused by masturbation, including foreign objects inserted into the urethra and penis injuries from vacuum cleaners, and suggests psychiatric follow‑up after urological treatment.","clinical_takeaway":"Clinicians should consider mental‑health referral for patients with self‑inflicted sexual injuries.","confidence":0.8,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Provides real‑world clinical data on a rare injury type","Highlights need for multidisciplinary (psychiatric) follow‑up"],"limitations":["No systematic methodology or control group","Small, non‑representative sample; no statistical analysis","No measurement of psychological variables beyond vague recommendation"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000473360"}},{"id":4728,"doi":null,"pmid":"22039693","pmcid":null,"title":"[Autoerotic fatalities in Greater Dusseldorf]","authors":"Hartung B, Hellen F, Borchard N, Huckenbeck W.","first_author":"Hartung B","journal":"Archiv fur Kriminologie","year":2011,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Descriptive case series of autoerotic deaths in a German city; no control group, small number of cases, no statistical testing reported.","sample_n":null,"sample_text":"Not reported","population":"Young to middle‑aged single men found dead in apartments; sample size not stated in abstract.","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes  a series of accidental deaths in Düsseldorf that occurred during solitary sexual activities involving bondage or hanging. Most victims were single men; deaths were mainly due to strangulation, with little evidence of alcohol or psychiatric illness.","clinical_takeaway":"Autoerotic practices can be fatal; clinicians should assess for risky solitary sexual behaviors when evaluating patients with suicidal or self‑harm risk.","confidence":0.8,"topic_tags":["moral_incongruence","masturbation","sexual_function"],"strengths":["Systematic medicolegal description of a rare phenomenon","Clear demographic description of cases"],"limitations":["Very small, non‑representative sample","No statistical analysis or comparison group","No measurement of potential psychological or social confounds"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4729,"doi":null,"pmid":"21916383","pmcid":null,"title":"Sexual behaviors of children: what is normal and what is concerning?","authors":"Worley KB.","first_author":"Worley KB.","journal":"The Journal of the Arkansas Medical Society","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4731,"doi":null,"pmid":"8579310","pmcid":null,"title":"Sexual behaviour of male inmates of a detention facility in Singapore: risks of intraprison human immunodeficiency virus transmission","authors":"Lee JT.","first_author":"Lee JT.","journal":"Annals of the Academy of Medicine, Singapore","year":1995,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of all male inmates at one Singapore detention facility, assessing self‑reported masturbation and sexual behaviour before and during incarceration","sample_n":null,"sample_text":"all male inmates at the facility (N not stated)","population":"male prisoners (all inmates at the facility; exact N not reported)","country":"Singapore","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1995 survey of male prisoners in Singapore found that inmates classified as high‑risk for HIV (promiscuous heterosexuals, homosexual/bisexual, and IV drug users) reported higher rates of masturbation while in prison, and that those detained 180‑360 days also masturbated more frequently.","clinical_takeaway":"In prison settings, higher masturbation rates may signal elevated HIV risk behaviours; health education and risk‑reduction programs are warranted.","confidence":0.6,"topic_tags":["masturbation","prevalence"],"strengths":["Census of an entire inmate population reduces sampling bias within that facility","Highlights an understudied high‑risk environment for HIV transmission","Provides concrete policy recommendations"],"limitations":["Self‑report of sexual behaviour may be subject to social desirability bias","No validated instruments for measuring masturbation frequency or sexual risk","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":4732,"doi":null,"pmid":"21844972","pmcid":null,"title":"[Clinical characteristics of patients with erectile dysfunction-no sexual life]","authors":"Zhang ZC, Yuan YM, Peng J, Gao B, Song WD, Xin ZC, Guo YL, Jin J.","first_author":"Zhang ZC","journal":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","year":2011,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case‑control cross‑sectional survey of 61 patients with erectile dysfunction‑no sexual life and 57 controls; simple 16‑item yes/no questionnaire; chi‑square analyses of group differences","sample_n":118,"sample_text":"61 patients, 57 controls","population":"young adult males (average age ~26) reporting erectile dysfunction without sexual activity for >6 months; convenience sample from clinical setting","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors compared 61 young men who could not have sex because of erectile problems with 57 healthy controls using a brief 16‑question survey. They found many differences in libido, confidence, and nighttime erections, and propose a new label, erectile dysfunction‑no sexual life.","clinical_takeaway":"Clinicians should note that erectile problems can exist without recent sexual activity, but the study’s unvalidated tool limits its diagnostic usefulness.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Clear case‑control comparison","Focus on a rarely studied subgroup (ED without sexual activity)","Simple questionnaire allows rapid data collection"],"limitations":["Questionnaire not validated; binary yes/no limits nuance","Multiple chi‑square tests without correction","Masturbation not reliably measured; many missing responses","Convenience clinical sample limits generalisability"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":4733,"doi":"10.1111/j.1742-1241.2011.02729.x","pmid":"21801284","pmcid":null,"title":"An e-mail and telephone helpline for sexual problems - results of a 2-year survey of men's sexual concerns","authors":"Tomlinson JM, Fernandes LC, Wylie KR.","first_author":"Tomlinson JM","journal":"International journal of clinical practice","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Descriptive analysis of 2‑year helpline records (n≈673 email users). No comparison group; self‑selected users of a telephone/e‑mail service.","sample_n":673,"sample_text":"673 men who emailed for assistance with sexual dysfunction.","population":"Male callers to a sexual‑health helpline (mostly 18‑80 y, various ethnicities).","country":"Not specified (likely UK based on authors).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A two‑year review of a telephone/e‑mail helpline found that most male callers were concerned about erectile problems, low sex drive, premature ejaculation and worries about masturbation, with patterns varying by age and ethnicity.","clinical_takeaway":"Helplines can reveal prevalent male sexual concerns, but findings may not reflect the general population.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Large number of real‑world contacts over two years","Provides demographic breakdown of helpline users","Identifies common concerns (ED, low drive, masturbation worries)"],"limitations":["Self‑selected, non‑representative sample","No validated instruments; reliance on single‑item self‑reports","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":8,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1742-1241.2011.02729.x"}},{"id":4735,"doi":null,"pmid":"7615493","pmcid":null,"title":"Fluoxetine treatment of compulsive masturbation in a schizophrenic patient","authors":"Kornreich C, Den Dulk A, Verbanck P, Pelc I.","first_author":"Kornreich C","journal":"The Journal of clinical psychiatry","year":1995,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4736,"doi":"10.1080/0092623x.2011.582436","pmid":"21707331","pmcid":null,"title":"Heterosexual anal intercourse: increasing prevalence, and association with sexual dysfunction, bisexual behavior, and venereal disease history","authors":"Brody S, Weiss P.","first_author":"Brody S","journal":"Journal of sex & marital therapy","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Repeated representative surveys of Czech population (1993‑2008), N=7,720, cross‑sectional data analyzed with multivariate models.","sample_n":7720,"sample_text":"Representative samples of the Czech population surveyed in 1993, 1998, 2003, and 2008.","population":"General adult Czech population, both sexes, ages young adult to middle aged.","country":"Czech Republic","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Surveys in the Czech Republic from 1993‑2008 show that heterosexual anal intercourse became more common, and it is linked to having more sex partners, masturbating, bisexual experiences, prostitution, STDs and women's sexual dysfunction.","clinical_takeaway":"Anal intercourse is associated with higher rates of sexual dysfunction and STDs; clinicians should assess broader sexual histories when these behaviors are reported.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large, nationally representative sample","Repeated surveys allow trend analysis","Multivariate adjustment for number of partners"],"limitations":["Self‑report measures, likely unvalidated","No assessment of moral, mental‑health or trauma confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":19,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2011.582436"}},{"id":4737,"doi":"10.1080/00224499.2010.518293","pmid":"20924943","pmcid":null,"title":"Using Ecological Momentary Assessment to investigate associations between ejaculatory latency and control in partnered and non-partnered sexual activities","authors":"Jern P, Gunst A, Sandqvist F, Sandnabba NK, Santtila P.","first_author":"Jern P","journal":"Journal of sex research","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"ecological momentary assessment over 6 weeks, repeated within‑subject measurements","sample_n":21,"sample_text":"21 male participants","population":"male, Finnish, aged ≥ 18","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Using a 6‑week diary, 21 Finnish men reported how long it took to ejaculate and how much control they felt they had during sex with a partner or alone. Latency and control varied a lot over time, and the patterns differed between partnered and solo encounters.","clinical_takeaway":"EMA can monitor ejaculatory function over time, but findings are based on a tiny sample and should be interpreted cautiously.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Repeated‑measure EMA captures within‑person variability","Differentiates partnered vs. non‑partnered contexts","Statistical control for within‑subject dependence"],"limitations":["Very small sample (N=21) limits generalizability","Self‑report of latency and control, unclear validation","No assessment of potential psychological or relational confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2010.518293"}},{"id":4738,"doi":"10.1111/j.2044-8341.1995.tb01825.x","pmid":"7547615","pmcid":null,"title":"Male genital self-mutilation: a case report","authors":"Shimizu A, Mizuta I.","first_author":"Shimizu A","journal":"The British journal of medical psychology","year":1995,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single adolescent","sample_n":1,"sample_text":"single case","population":"17‑year‑old Japanese male, non‑psychotic","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A 17‑year‑old Japanese boy without psychosis cut his own genitals because he was distressed about his frequent masturbation. The report reviews similar rare cases, noting most involve psychosis or intoxication.","clinical_takeaway":"Self‑harm linked to sexual conflict can occur even without psychosis; clinicians should assess distress around masturbation.","confidence":0.8,"topic_tags":["masturbation","gender","sexual_function","csbd"],"strengths":["detailed clinical description","connects behavior to psychological conflict"],"limitations":["single case, no systematic data","no validated measures of masturbation frequency or distress","no control for confounding factors"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.2044-8341.1995.tb01825.x"}},{"id":4739,"doi":"10.1111/j.1743-6109.2011.02331.x","pmid":"21676178","pmcid":null,"title":"Vaginal orgasm is more prevalent among women with a prominent tubercle of the upper lip","authors":"Brody S, Costa RM.","first_author":"Brody S","journal":"The journal of sexual medicine","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online self‑report survey, N=258, predominantly Scottish, convenience sample","sample_n":258,"sample_text":"women (predominantly Scottish) completing an online questionnaire","population":"adult women (self‑selected respondents)","country":"Scotland (UK)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 258 women, those who reported a more prominent bump on their upper lip were far more likely to say they had ever experienced vaginal orgasm and to have recent vaginal orgasms, compared with women with less‑prominent lips.","clinical_takeaway":"No direct clinical implication; the association may reflect unknown prenatal factors but does not guide treatment.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Novel hypothesis linking physical trait to sexual function","Large (N>250) sample for a specialty survey","Controlled for social desirability bias"],"limitations":["Self‑report measures, unvalidated for lip tubercle rating","Cross‑sectional design cannot infer causality","Potential self‑selection bias, limited generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":8,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2011.02331.x"}},{"id":4742,"doi":"10.1007/s12098-011-0434-9","pmid":"21617908","pmcid":null,"title":"A primary care approach for adolescent care and counseling services","authors":"Nair MK, Chacko DS, Indira MS, Siju KE, George B, Russell PS.","first_author":"Nair MK","journal":"Indian journal of pediatrics","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"service implementation case series without control group","sample_n":1588,"sample_text":"1,588 adolescents seen in 2 years","population":"adolescents attending taluk hospital clinics in India (N≈1588 over 2 years)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article describes how a district‑level adolescent health program was set up in India, serving 1,588 youths over two years. It reports common medical, reproductive and psychosocial problems, including concerns about masturbation, and suggests the model could be expanded elsewhere.","clinical_takeaway":"Community adolescent clinics can identify common health and psychosocial issues, but evidence of effectiveness is limited.","confidence":0.7,"topic_tags":["adolescents","sexual_function","masturbation","religiosity","csbd"],"strengths":["Large number of adolescents accessed the service","Detailed description of implementation steps","Addresses a gap in adolescent health services"],"limitations":["No control or comparison group","No validation data for the assessment tool","Outcomes reported descriptively, no statistical testing","Confounding factors (e.g., mental health, moral attitudes) not measured"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12098-011-0434-9"}},{"id":4743,"doi":"10.1007/s12098-011-0436-7","pmid":"21614606","pmcid":null,"title":"Attitude of parents and teachers towards adolescent reproductive and sexual health education","authors":"Nair MK, Leena ML, Paul MK, Pillai HV, Babu G, Russell PS, Thankachi Y.","first_author":"Nair MK","journal":"Indian journal of pediatrics","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 795 parents and 115 teachers from four schools in Kerala using a self‑administered questionnaire.","sample_n":910,"sample_text":"795 parents, 115 teachers","population":"Parents and teachers of adolescents in urban and rural schools in Thiruvananthapuram district, India (N≈910).","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of Indian parents and teachers showed most have never talked with adolescents about sexual topics, and many are unsure about teaching subjects like masturbation or contraception. The authors recommend education programs for adults before school‑based sex education starts.","clinical_takeaway":"Clinicians should note low adult engagement in adolescent sexual health education and may need to support parent‑teacher training.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Large combined sample of parents and teachers","Random sampling within selected schools","Relevant public‑health topic"],"limitations":["Questionnaire not psychometrically validated","Cross‑sectional; cannot infer causality","Limited geographic scope; not nationally representative"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":34,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12098-011-0436-7"}},{"id":4745,"doi":null,"pmid":"7713851","pmcid":null,"title":"Sexual dysfunction in male schizophrenic patients","authors":"Aizenberg D, Zemishlany Z, Dorfman-Etrog P, Weizman A.","first_author":"Aizenberg D","journal":"The Journal of clinical psychiatry","year":1995,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":98,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional interview study of untreated schizophrenic patients, neuroleptic‑treated patients and healthy controls (N=122).","sample_n":122,"sample_text":"20 drug‑free schizophrenic patients, 51 neuroleptic‑treated patients, 51 controls.","population":"Male adults with schizophrenia (treated vs untreated) and healthy male controls.","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Male schizophrenic patients, whether on neuroleptics or not, show high rates of sexual problems. Untreated patients have low sexual desire, while those on depot antipsychotics have more erection and orgasm difficulties but retain desire.","clinical_takeaway":"Assess both desire and performance when treating schizophrenia; discuss sexual side‑effects of neuroleptics with patients.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Direct comparison of treated, untreated, and healthy groups","Includes both desire and performance domains","Highlights clinical relevance for antipsychotic management"],"limitations":["Small untreated group (N=20) limits power","Sexual function measured with non‑validated interview","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4746,"doi":"10.1530/eje-11-0250","pmid":"21602316","pmcid":null,"title":"Sexual desire in female-to-male transsexual persons: exploration of the role of testosterone administration","authors":"Wierckx K, Elaut E, Van Caenegem E, Van De Peer F, Dedecker D, Van Houdenhove E, T'Sjoen G.","first_author":"Wierckx K","journal":"European journal of endocrinology","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":48,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"single center cross‑sectional survey of 45 post‑SRS FT‑M trans men; serum hormones measured; questionnaire (SDI).","sample_n":45,"sample_text":"Forty‑five FT‑M trans persons completed the Sexual Desire Inventory and provided fasting hormone samples.","population":"female-to-male transsexual persons post sex reassignment surgery, n=45, convenience sample","country":"unspecified (likely Belgium/Netherlands based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 45 trans men after hormone therapy and surgery, most reported higher sexual desire. Desire was linked to how often they masturbated, but not directly to testosterone levels; higher LH (a sign of sub‑optimal therapy) was associated with lower desire.","clinical_takeaway":"Testosterone dose may not predict desire; monitoring LH could help optimise sexual libido in trans men.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Validated sexual desire instrument","Objective hormone assays","Separate measurement of solitary vs dyadic desire"],"limitations":["Small, non‑representative sample","Cross‑sectional; cannot infer causality","Limited control of psychological/confounding variables"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":36,"citing_publications":74,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1530/eje-11-0250"}},{"id":4747,"doi":"10.1111/j.1439-0272.1979.tb02241.x","pmid":"532987","pmcid":null,"title":"[Modification of prolactin and stress by masturbation]","authors":"Steeno O, Coucke W, Koninckx P.","first_author":"Steeno O","journal":"Andrologia","year":1979,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Within‑subject observation of fertility patients during clinical exam; hormonal measurements before and after masturbation; small convenience sample; no control group reported.","sample_n":null,"sample_text":"Not specified in abstract; likely small (<30) based on typical 1970s studies.","population":"Male fertility patients (likely convenience sample; N not reported)","country":"Belgium (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In men undergoing fertility exams, having an orgasm by masturbation lowered stress‑related prolactin spikes seen after a stressful clinical visit, likely because the act reduced tension rather than providing a direct hormonal relaxation effect.","clinical_takeaway":"Clinicians should consider recent sexual activity when interpreting stress‑related hormone levels in fertility assessments.","confidence":0.4,"topic_tags":["masturbation","sexual_function","neuroscience","religiosity"],"strengths":["Objective hormonal measurements","Within‑subject comparison","Focus on physiological stress response"],"limitations":["Very small, unclear sample size","No control group or randomisation","No assessment of psychological confounds (moral incongruence, mental health, etc.)","No effect‑size reporting or correction for multiple testing"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1439-0272.1979.tb02241.x"}},{"id":4748,"doi":"10.1080/00926237908407076","pmid":"529297","pmcid":null,"title":"Negative attitudes toward masturbation in sex therapy","authors":"Mosher DL.","first_author":"Mosher DL.","journal":"Journal of sex & marital therapy","year":1979,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary / conceptual paper describing an inventory and therapeutic approach; no primary empirical data presented","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes a questionnaire to assess negative attitudes toward masturbation and discusses how such attitudes may affect sexual therapy, offering a Gestalt‑based therapeutic approach.","clinical_takeaway":"Therapists should assess clients' attitudes toward masturbation and consider these feelings when planning sex‑therapy interventions.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Introduces a specific inventory for negative attitudes toward masturbation","Integrates theoretical model with clinical illustration"],"limitations":["No primary empirical data reported","Construct validity evidence limited to cited studies, not presented","No measurement of key confounds (e.g., moral incongruence, mental health)","Outdated terminology and limited methodological detail"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926237908407076"}},{"id":4749,"doi":"10.1007/bf01541210","pmid":"420573","pmcid":null,"title":"An empirical investigation of experimentally induced masturbatory fantasies","authors":"Abramson PR, Mosher DL.","first_author":"Abramson PR","journal":"Archives of sexual behavior","year":1979,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory experiment using film stimuli to induce masturbatory fantasies; participants constructed narratives; likely small convenience sample.","sample_n":null,"sample_text":"Not reported in abstract; typical of 1970s lab studies, likely < 60 participants.","population":"Adults (male and female) recruited for a laboratory study (details not provided in abstract).","country":"United States (presumed from authors’ affiliation).","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers showed participants a short film of a man or woman masturbating and asked them to write a story about it. Men and women produced different fantasy narratives, and those differences were linked to how much guilt or negative attitudes they felt about masturbation.","clinical_takeaway":"None – the study is theoretical and does not provide direct clinical guidance.","confidence":0.7,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Experimental manipulation of fantasy content","Inclusion of both male and female participants","Consideration of sex guilt and attitudes"],"limitations":["Small, unspecified sample size","Ad‑hoc narrative measure without validation","No control for mental‑health or relational variables"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541210"}},{"id":4750,"doi":null,"pmid":"7752975","pmcid":null,"title":"Sexual activities of Malaysian adolescents","authors":"Zulkifli SN, Low WY, Yusof K.","first_author":"Zulkifli SN","journal":"The Medical journal of Malaysia","year":1995,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Population","Behavior","Asia","Youth","Malaysia","Contraception","Sex behavior","Age factors","population characteristics","Family Planning","Adolescents","Demographic Factors","Contraceptive Usage","Developing Countries","Research Report","Urban Population","Southeastern Asia","First Intercourse","Premarital Sex Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Probability household survey of 1,200 Malaysian adolescents (15‑21 y) in 1986; descriptive analysis of sexual behaviours, contraception use and masturbation.","sample_n":1200,"sample_text":"Probability household sampled survey carried out in Kuala Lumpur in 1986 (N=1,200).","population":"1200 adolescents, community‑based probability sample (Kuala Lumpur).","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1995 household survey of 1,200 Malaysian teens found that 9 % had had sex, with higher rates in older boys. Contraceptive use was low and many youths worried about masturbation, especially girls.","clinical_takeaway":"Most Malaysian adolescents reported low sexual activity but concerns about masturbation are common, especially among females.","confidence":0.8,"topic_tags":["sexual_function","masturbation","adolescents","prevalence"],"strengths":["Large, probability‑based community sample","Separate reporting of different sexual activities","Inclusion of both genders and age groups"],"limitations":["Self‑report measures not validated for this population","No control for moral, mental‑health or relationship confounds","Cross‑sectional design, no causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":4751,"doi":"10.1038/aja.2010.121","pmid":"21532602","pmcid":"PMC3739632","title":"The moderating impact of lifestyle factors on sex steroids, sexual activities and aging in Asian men","authors":"Goh VH, Tong TY.","first_author":"Goh VH","journal":"Asian journal of andrology","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational cross‑sectional survey of community‑dwelling Singaporean men; hormone assays plus self‑reported lifestyle and sexual activity frequencies.","sample_n":null,"sample_text":"Community men in Singapore; exact N not given in abstract","population":"Adult Asian men, community sample (age range unspecified)","country":"Singapore","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a community sample of Singaporean men, older age was linked to lower testosterone and higher body fat, while more intense exercise and longer sleep were tied to higher testosterone. Masturbation frequency fell with age, and testosterone was modestly associated with men who masturbated.","clinical_takeaway":"Hormone levels, exercise, and sleep relate to sexual activity in aging men, but causal direction is unclear.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Objective hormone measurements","Includes both biological and lifestyle variables","Separates masturbation frequency from other sexual activity"],"limitations":["Cross‑sectional design limits causal inference","No assessment of mental health, religiosity, or trauma as potential confounds","Sample size and recruitment method unclear"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/aja.2010.121"}},{"id":4753,"doi":"10.1111/j.1743-6109.2009.01597.x","pmid":"19929918","pmcid":null,"title":"How unusual are the contents of paraphilias? Paraphilia-associated sexual arousal patterns in a community-based sample of men","authors":"Ahlers CJ, Schaefer GA, Mundt IA, Roll S, Englert H, Willich SN, Beier KM.","first_author":"Ahlers CJ","journal":"The journal of sexual medicine","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":88,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 367 community volunteers (age 40‑79) in Germany","sample_n":367,"sample_text":"volunteers recruited from a community sample of 1,915 men aged 40‑79 years","population":"men, community‑based sample","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a German community sample of men aged 40‑79, about 62 % reported at least one paraphilia‑related sexual arousal pattern, but only 1.7 % said it caused distress. Those with such patterns were more often single, masturbated weekly, and reported poorer health. The authors suggest clinicians should ask about these experiences.","clinical_takeaway":"Screen for unusual sexual arousal patterns, but recognize most do not cause distress or clinical problems.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large community‑based sample for this topic","Use of established health and satisfaction questionnaires","Reports effect sizes with confidence intervals"],"limitations":["Cross‑sectional design limits causal inference","Paraphilia arousal measured by ad‑hoc self‑report, no validated scale","Moral incongruence/religiosity not assessed despite relevance to distress"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":14,"contrasting":3,"mentioning":105,"citing_publications":260,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01597.x"}},{"id":4754,"doi":null,"pmid":"7853972","pmcid":null,"title":"The politics of masturbation","authors":"Quintner J.","first_author":"Quintner J.","journal":"Lancet (London, England)","year":1995,"pub_types":["Letter","Comment","Historical Article","Biography"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4755,"doi":"10.1016/s0140-6736(95)90436-0","pmid":"7853973","pmcid":null,"title":"The politics of masturbation","authors":"Tchamouroff SE.","first_author":"Tchamouroff SE.","journal":"Lancet (London, England)","year":1995,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0140-6736(95)90436-0"}},{"id":4756,"doi":null,"pmid":"7853971","pmcid":null,"title":"The politics of masturbation","authors":"Goldmeier D.","first_author":"Goldmeier D.","journal":"Lancet (London, England)","year":1995,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4757,"doi":"10.1007/bf01541922","pmid":"742965","pmcid":null,"title":"Development of masturbation in college women","authors":"Clifford R.","first_author":"Clifford R.","journal":"Archives of sexual behavior","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Interview of 100 undergraduate women, random sample of a single university; cross‑sectional descriptive analysis.","sample_n":100,"sample_text":"random sample of 100 undergraduate women","population":"College women (undergraduate, mostly 18‑22 y)","country":"USA (presumed from journal context)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 100 college women, most had masturbated. Learning about masturbation from peers and books made techniques more like intercourse and increased enjoyment. Masturbation frequency did not predict intercourse frequency, and clitoral reliance was not linked across activities.","clinical_takeaway":"Masturbation habits in young women appear shaped by social learning rather than a single ‘sex drive’; clinicians should consider cultural scripts when discussing sexual health.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Large single‑sex college sample for 1978","Direct interview on detailed masturbation techniques","Addresses several hypotheses about sexual script transmission"],"limitations":["Convenience/college sample limits generalisability","Ad‑hoc interview items lack validation","No statistical power justification or effect‑size reporting"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541922"}},{"id":4758,"doi":"10.1192/bjp.133.5.404","pmid":"365286","pmcid":null,"title":"A controlled study to evaluate directed masturbation in the management of primary orgasmic failure in women","authors":"Riley AJ, Riley EJ.","first_author":"Riley AJ","journal":"The British journal of psychiatry : the journal of mental science","year":1978,"pub_types":["Controlled Clinical Trial","Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Prospective controlled clinical trial comparing directed masturbation to sensate focus + psychotherapy in women with primary orgasmic failure (N=20 vs N=15).","sample_n":35,"sample_text":"20 participants in the directed masturbation arm, 15 in the control arm.","population":"Women with primary orgasmic failure recruited from a clinical setting (1978).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small 1978 trial, women with lifelong difficulty reaching orgasm who practiced a guided masturbation program were more likely to regain orgasmic ability than those receiving standard therapy.","clinical_takeaway":"Directed masturbation may help some women with primary orgasmic failure, but evidence is limited by small sample size.","confidence":0.7,"topic_tags":["masturbation","sexual_function","treatment"],"strengths":["Randomized? (not stated) controlled design","Clear clinical outcome","Direct therapeutic intervention"],"limitations":["Very small sample, likely under‑powered","No validated outcome measures","Potential selection bias from clinic patients","No reporting of effect sizes or confidence intervals"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":31,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/bjp.133.5.404"}},{"id":4759,"doi":"10.1007/s10508-011-9748-y","pmid":"21484505","pmcid":"PMC3600851","title":"Recalled sexual experiences in childhood with older partners: a study of Brazilian men who have sex with men and male-to-female transgender persons","authors":"Carballo-Diéguez A, Balan I, Dolezal C, Mello MB.","first_author":"Carballo-Diéguez A","journal":"Archives of sexual behavior","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Respondent‑driven sampling; self‑administered questionnaire; HIV testing; weighted analysis of recalled childhood sexual experiences and adult risk behavior.","sample_n":575,"sample_text":"Cross‑sectional community sample recruited via RDS.","population":"MSM and male‑to‑female transgender persons in Campinas, Brazil (N≈575)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 575 Brazilian MSM and transgender persons, about one‑third recalled childhood sexual encounters with older partners, often describing them as pleasurable rather than abusive. These early experiences were not linked to higher rates of unsafe anal sex in adulthood.","clinical_takeaway":"Clinicians should assess individuals’ own perceptions of past sexual experiences rather than relying solely on predefined abuse criteria.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample (N≈575)","Weighted analysis to account for RDS network sizes","Inclusion of both MSM and transgender participants"],"limitations":["Retrospective self‑report prone to recall bias","No validated scales for abuse perception or trauma severity","Limited control for mental‑health or other confounding variables"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":23,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-011-9748-y"}},{"id":4760,"doi":null,"pmid":"7492873","pmcid":null,"title":"Safe sex in the era of AIDS","authors":"Money J.","first_author":"Money J.","journal":"Trends in health care, law & ethics","year":1995,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary/historical essay without empirical data; no sample, no methods.","sample_n":null,"sample_text":"None (commentary)","population":"Humans (general discussion of public health policy)","country":"USA (author likely US, referencing US President)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews the history of anti‑masturbation attitudes and argues that encouraging masturbation could help reduce HIV transmission, but provides no new data.","clinical_takeaway":"None – the piece is a historical commentary, not evidence for practice.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Historical perspective on masturbation stigma","Links cultural attitudes to public‑health policy"],"limitations":["No empirical data or systematic review","Conclusions are speculative and advocacy‑driven","No measurement of confounding variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":4761,"doi":"10.1080/00797308.1995.11822405","pmid":"7480406","pmcid":null,"title":"Enactment and play following medical trauma. An analytic case study","authors":"Goldberger M.","first_author":"Goldberger M.","journal":"The Psychoanalytic study of the child","year":1995,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case analysis of a 5‑year‑old girl with school phobia and compulsive masturbation; psychoanalytic play observations over four years","sample_n":1,"sample_text":"one child","population":"preschool female, treatment‑seeking (clinical) ","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article describes a four‑year psychoanalytic case study of a five‑year‑old girl with school anxiety and compulsive masturbation, linking her play to past medical trauma. It offers a narrative interpretation of how trauma and sexual urges interplay in play.","clinical_takeaway":"Not applicable for clinical decision‑making; the report is a single, unstandardized case.","confidence":0.6,"topic_tags":["masturbation","csbd","pornography"],"strengths":["longitudinal clinical observation","detailed psychoanalytic narrative"],"limitations":["single case, no systematic measurement","no validated instruments for masturbation or trauma","no control for key confounds"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00797308.1995.11822405"}},{"id":4762,"doi":"10.1080/00926239508404386","pmid":"7643424","pmcid":null,"title":"Sexual functioning and attitudes of eating-disordered women: a follow-up study","authors":"Morgan CD, Wiederman MW, Pryor TL.","first_author":"Morgan CD","journal":"Journal of sex & marital therapy","year":1995,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Follow‑up questionnaire of 42 women previously treated for anorexia or bulimia; no control group; convenience sample.","sample_n":42,"sample_text":"N = 42 women previously treated in a clinic; response bias noted (anorectic women less likely to respond).","population":"Women with a history of eating disorders (anorexia nervosa restricting type, bulimia nervosa purging type) who responded to a clinic follow‑up survey.","country":"USA (inferred from journal and author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 1995 questionnaire of 42 women who had been treated for anorexia or bulimia examined their sexual experiences. Anorexic participants were less likely to masturbate and reported lower sexual esteem, but overall sexual functioning and satisfaction were similar to bulimic participants. Compared with a normative sample, all participants showed less sexual interest and more negative feelings during sex.","clinical_takeaway":"Clinicians should assess sexual interest, masturbation, and sexual esteem in patients recovering from eating disorders, as these areas may remain affected.","confidence":0.78,"topic_tags":["sexual_function","masturbation","relationships"],"strengths":["Focus on an understudied population (eating‑disordered women)","Includes both behavioral (masturbation) and attitudinal measures","Provides follow‑up data beyond initial assessment"],"limitations":["Small, self‑selected sample; low response rate for anorexic group","Cross‑sectional design limits causal inference","Limited reporting of psychometric properties of measures"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":54,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239508404386"}},{"id":4764,"doi":"10.1375/twin.14.2.144","pmid":"21425896","pmcid":null,"title":"Psychosexual study of communist era Hungarian twins","authors":"Metneki J, Tarnoki AD, Tarnoki DL, Littvay L, Czeizel A.","first_author":"Metneki J","journal":"Twin research and human genetics : the official journal of the International Society for Twin Studies","year":2011,"pub_types":["Twin Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Twin study; self‑administered questionnaire in 1982; 210 same‑sex twin pairs (MZ and DZ); cross‑sectional description of sexual development and heritability estimates.","sample_n":420,"sample_text":"210 adult same‑sex twin pairs (92 MZ female, 41 MZ male, 55 DZ female, 22 DZ male).","population":"Adult Hungarian twins (both sexes), community‑based sample.","country":"Hungary","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2011 twin study from Hungary surveyed 210 adult twin pairs about the timing of sexual milestones and some sexual problems, finding that age at menarche is strongly heritable while other traits show modest genetic influence.","clinical_takeaway":"Genetic factors appear important for age at menarche; other sexual development traits are less clearly linked to heredity.","confidence":0.6,"topic_tags":["treatment","prevalence","gender","sexual_function"],"strengths":["Large twin sample enabling heritability estimates","Inclusion of both monozygotic and dizygotic pairs","Broad range of sexual development milestones reported"],"limitations":["Self‑report questionnaire, likely unvalidated for many constructs","No measurement/control of key confounds (moral incongruence, mental health, trauma)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1375/twin.14.2.144"}},{"id":4765,"doi":"10.1542/peds.62.3.277","pmid":"704195","pmcid":null,"title":"Excessive masturbation of childhood: a symptom of tactile deprivation?","authors":"McCray GM.","first_author":"McCray GM.","journal":"Pediatrics","year":1978,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of five children","sample_n":5,"sample_text":"Five cases","population":"children (preschool)","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes five children who masturbated a lot; the authors suggest that lack of affectionate touch from parents caused it, and that restoring touch stopped the behavior.","clinical_takeaway":"No evidence‑based guidance; the report is anecdotal and should not inform clinical practice.","confidence":0.7,"topic_tags":["masturbation","treatment"],"strengths":["Detailed clinical description","Historical perspective on tactile deprivation"],"limitations":["Very small, non‑representative sample","No validated measures of masturbation frequency or distress","No control for alternative explanations"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.62.3.277"}},{"id":4766,"doi":"10.1111/j.1365-2850.2011.01709.x","pmid":"21848594","pmcid":null,"title":"Displays of inappropriate sexual behaviour by patients with progressive cognitive impairment: the forgotten form of challenging behaviour?","authors":"Stubbs B.","first_author":"Stubbs B.","journal":"Journal of psychiatric and mental health nursing","year":2011,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review without systematic search or risk‑of‑bias assessment; no primary data collection","sample_n":null,"sample_text":"none (review)","population":"adults with progressive cognitive impairment (dementia, Alzheimer’s)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how people with dementia may show inappropriate sexual behaviours, such as public exposure or groping, and discusses how common this is and what care strategies might help.","clinical_takeaway":"Clinicians should be aware that inappropriate sexual behaviour can occur in dementia and plan appropriate management, but evidence on prevalence and interventions is limited.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides overview of ISB in dementia","Highlights clinical relevance and management gaps"],"limitations":["Narrative, not systematic; possible selection bias","No quantitative synthesis or quality appraisal","Lacks empirical data on prevalence determinants"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2850.2011.01709.x"}},{"id":4767,"doi":"10.1136/bmj.309.6969.1604","pmid":"7819933","pmcid":null,"title":"Surgeon General resigns in masturbation row","authors":"Roberts J.","first_author":"Roberts J.","journal":"BMJ (Clinical research ed.)","year":1994,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.309.6969.1604"}},{"id":4768,"doi":null,"pmid":"7996995","pmcid":null,"title":"The politics of masturbation","authors":null,"first_author":null,"journal":"Lancet (London, England)","year":1994,"pub_types":["Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4769,"doi":"10.1016/j.hrtlng.2010.10.001","pmid":"21411145","pmcid":null,"title":"Progress in sexual counseling by cardiac nurses, 1994 to 2009","authors":"Steinke EE, Mosack V, Barnason S, Wright DW.","first_author":"Steinke EE","journal":"Heart & lung : the journal of critical care","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive, non‑experimental survey of cardiac nurses at two separate time points (1994, 2009) with different samples (n=171; n=288).","sample_n":459,"sample_text":"Combined total of 171 nurses surveyed in 1994 and 288 nurses surveyed in 2009.","population":"Cardiac nurses in the United States (mostly adult, middle‑aged).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Surveys of cardiac nurses in 1994 and 2009 show that, over time, nurses feel more responsible for sexual counseling and discuss MI‑related sexual activity more often, though overall discussion of sexual activities has decreased.","clinical_takeaway":"Nurse education programmes can improve sexual counseling after heart attacks, but current practices still vary.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Large combined sample of nurses across 15 years.","Direct comparison of two time points shows trend.","Focus on an under‑studied aspect of cardiac care."],"limitations":["Use of non‑validated survey instrument.","Different samples at each time point (no longitudinal tracking).","No adjustment for potential confounders (e.g., nurse demographics, institutional policies).","Statistical reporting limited to p‑values without effect sizes or power analysis."],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":31,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.hrtlng.2010.10.001"}},{"id":4772,"doi":"10.1708/626.7312","pmid":"21572470","pmcid":null,"title":"[Sexuality and eating disorders]","authors":"Mazzei C, Castellini G, Benni L, Godini L, Lazzeretti L, Pracucci C, Talamba GA, Ricca V, Faravelli C.","first_author":"Mazzei C","journal":"Rivista di psichiatria","year":2011,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"ita","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Case-control comparison of 98 eating‑disorder patients with 88 healthy controls; questionnaire battery; single time‑point.","sample_n":186,"sample_text":"98 patients (AN:23; BN:14; EDNOS:61) and 88 healthy controls.","population":"Women with anorexia, bulimia or ED‑NOS (clinical sample) and community controls.","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Women with eating disorders reported less sex with a partner, more frequent masturbation, and poorer sexual function than healthy women, possibly because of body‑image discomfort.","clinical_takeaway":"Assess sexual function and partner intimacy in eating‑disorder patients; consider body‑image concerns as a factor.","confidence":0.8,"topic_tags":["sexual_function","masturbation","relationships"],"strengths":["Validated sexual function instrument (FSFI)","Includes both partner and solitary sexual activity","Measures depression and anxiety as covariates"],"limitations":["Cross‑sectional design limits causal inference","Clinical sample may not generalise to community","Moral or religiosity factors not assessed"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1708/626.7312"}},{"id":4774,"doi":null,"pmid":"22066275","pmcid":null,"title":"Epidemiology of non-penetrative sex among university students in the context of HIV/AIDS prevention in Northwestern Ethiopia","authors":"Mehari Z, Wubshet M, Deribe K, Biadgilign S.","first_author":"Mehari Z","journal":"East African journal of public health","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 624 university students selected by stratified sampling; logistic regression used to examine associations","sample_n":624,"sample_text":"representative sample of regular students selected by stratified sampling","population":"university students (Bahir Dar University, Ethiopia)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2011 Ethiopian university survey found that about half of students engaged in non‑penetrative sexual activities, mainly for pleasure and HIV/STI prevention, despite many holding unfavorable attitudes toward such practices.","clinical_takeaway":"Non‑penetrative sex is common among university students and may be considered in HIV/STI prevention counseling.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample for a university survey","Stratified sampling to improve representativeness","Multivariate logistic regression"],"limitations":["Reliance on self‑report questionnaires of unknown validity","Cross‑sectional design limits causal inference","No measurement of key confounders (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":4775,"doi":"10.1080/13691058.2010.521575","pmid":"20972916","pmcid":"PMC3010280","title":"Homophobia, stigma and HIV in Jamaican prisons","authors":"Andrinopoulos K, Figueroa JP, Kerrigan D, Ellen JM.","first_author":"Andrinopoulos K","journal":"Culture, health & sexuality","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative in‑depth interview study with 25 male prisoners in Jamaica","sample_n":25,"sample_text":"25 inmates","population":"Male inmates in the largest all‑male prison in Jamaica (n≈25)","country":"Jamaica","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 25 male prisoners in Jamaica reveal that homophobia is deliberately used to control power and impede HIV prevention, suggesting that stigma is a major barrier to health interventions in prison settings.","clinical_takeaway":"Addressing homophobic stigma is essential for effective HIV prevention in correctional facilities.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Rich, contextual qualitative data","Focus on an understudied prison population","Highlights structural role of homophobia"],"limitations":["Small, non‑representative sample","Findings not generalizable beyond this prison","No quantitative validation of constructs"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":15,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2010.521575"}},{"id":4776,"doi":"10.1176/appi.psychotherapy.1978.32.2.300","pmid":"677358","pmcid":null,"title":"Treatment of public masturbation by behavioral management","authors":"Janzen WB, Peacock R.","first_author":"Janzen WB","journal":"American journal of psychotherapy","year":1978,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case study of a 9‑year‑old girl; behavioral contract with fading procedure; follow‑ups at 1, 3, 6, 9 months","sample_n":1,"sample_text":"one participant (case history)","population":"child (female, 9 y)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1978 case report describes a behavior‑management contract used to stop a 9‑year‑old girl from masturbating in class. The intervention appeared successful over nine months, but the report is based on one child and lacks systematic measurement.","clinical_takeaway":"Evidence is anecdotal; clinicians should not generalise this single‑case outcome to other children.","confidence":0.4,"topic_tags":["masturbation","sexual_function","pornography"],"strengths":["detailed longitudinal follow‑up of the single case","clear behavioral intervention description"],"limitations":["single participant; no control group","no validated outcome measures","no assessment of confounding factors"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.psychotherapy.1978.32.2.300"}},{"id":4777,"doi":"10.1186/1471-2458-11-59","pmid":"21272374","pmcid":"PMC3042389","title":"Caregiver awareness of reproductive health issues for women with intellectual disabilities","authors":"Lin LP, Lin PY, Hsu SW, Loh CH, Lin JD, Lai CI, Chien WC, Lin FG.","first_author":"Lin LP","journal":"BMC public health","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/1471-2458-11-59","cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire administered to 1,152 caregivers from 32 disability‑welfare institutions in Taiwan.","sample_n":1152,"sample_text":"1152 caregivers (71.9% response rate) from 32 registered disability‑welfare institutions.","population":"Caregivers of women with intellectual disabilities residing in institutional settings (Taiwan).","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 1,152 caregivers in Taiwan found they were generally aware of sex‑education and menopause issues for women with intellectual disabilities, but many lacked knowledge about menstruation, masturbation and related health topics.","clinical_takeaway":"Training for caregivers should target menstrual and sexuality knowledge gaps to improve reproductive health support for women with intellectual disabilities.","confidence":0.78,"topic_tags":["sexual_function","religiosity"],"strengths":["Large sample of caregivers","Clear focus on an understudied population","Use of logistic regression to identify predictors"],"limitations":["Non‑validated questionnaire items","Cross‑sectional design limits causal inference","Limited assessment of potential confounders"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2458-11-59"}},{"id":4778,"doi":"10.1016/j.yhbeh.2011.01.005","pmid":"21272585","pmcid":null,"title":"The varied nature of women's sexuality: unresolved issues and a theoretical approach","authors":"Bancroft J, Graham CA.","first_author":"Bancroft J","journal":"Hormones and behavior","year":2011,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":50,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review without systematic methods; no empirical data","sample_n":null,"sample_text":"Not applicable – review article","population":"women (general discussion), no specific sample size","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review research on women's sexuality, noting great variability in desire, vaginal response, and hormone effects. They propose a new model to classify different types of female sexuality, aiming to improve understanding and treatment of sexual problems.","clinical_takeaway":"Understanding the diversity of female sexual response may help tailor treatments for sexual dysfunction.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad synthesis of existing literature","Identifies gaps in knowledge about female sexual desire"],"limitations":["Narrative, not systematic; potential selection bias","No empirical data or methodological detail","Lacks quantitative assessment of constructs"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":36,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.yhbeh.2011.01.005"}},{"id":4779,"doi":"10.1111/j.1743-6109.2010.02167.x","pmid":"21241454","pmcid":null,"title":"Hyposensitization therapy with autologous semen in two Dutch caucasian males: beneficial effects in Postorgasmic Illness Syndrome (POIS; Part 2)","authors":"Waldinger MD, Meinardi MM, Schweitzer DH.","first_author":"Waldinger MD","journal":"The journal of sexual medicine","year":2011,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Two Dutch Caucasian males with Postorgasmic Illness Syndrome (POIS) received a 3‑year autologous semen hyposensitization protocol; symptom severity was tracked with a study‑specific questionnaire and IELR was self‑reported.","sample_n":2,"sample_text":"Two males","population":"2 adult males with POIS (one also with lifelong premature ejaculation); Dutch, Caucasian.","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Two men with post‑orgasmic illness syndrome received weekly injections of their own semen over three years. Their symptoms improved by 60‑90% and one man’s ejaculation latency increased dramatically, suggesting a possible allergic basis.","clinical_takeaway":"Evidence is anecdotal; clinicians should not adopt this therapy outside experimental settings.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Novel immunologic therapeutic hypothesis","Longitudinal follow‑up over three years","Objective skin‑prick test evidence"],"limitations":["Very small N (case report)","No validated outcome measures","No control or blinding","Generalisation to broader POIS population unsupported"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":57,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02167.x"}},{"id":4780,"doi":"10.3109/14647273.2010.541972","pmid":"21235383","pmcid":null,"title":"Issues arising during the treatment of Jehovah's Witnesses by in vitro fertilisation","authors":"Grubb J, Muramoto O, Matson P.","first_author":"Grubb J","journal":"Human fertility (Cambridge, England)","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Four couples described in a descriptive case series; no comparison group, no systematic sampling.","sample_n":4,"sample_text":"Four couples treated between 2000 and 2009.","population":"Jehovah's Witness couples undergoing IVF/ICSI in a single clinic (N=4).","country":"United Kingdom (assumed from journal location)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe how IVF clinics can adjust protocols for Jehovah's Witness couples, such as avoiding blood products and considering their views on masturbation and donor gametes.","clinical_takeaway":"Clinicians should discuss religious concerns early and be prepared to modify IVF lab procedures for Jehovah's Witness patients.","confidence":0.8,"topic_tags":["sexual_function","religiosity"],"strengths":["Provides practical clinical guidance for a specific religious group","Identifies concrete protocol modifications"],"limitations":["Very small, non‑representative sample (N=4)","No systematic data collection or statistical analysis","Findings not generalisable to broader IVF population"],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":0,"neuroimaging":null,"statistics":0,"confounds":0,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/14647273.2010.541972"}},{"id":4782,"doi":"10.1007/s10508-010-9716-y","pmid":"21203811","pmcid":null,"title":"Sex toy use by gay and bisexual men in the United States","authors":"Rosenberger JG, Schick V, Herbenick D, Novak DS, Reece M.","first_author":"Rosenberger JG","journal":"Archives of sexual behavior","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet-based survey of 25,294 gay and bisexual men recruited from a popular hookup/social site; descriptive prevalence study.","sample_n":25294,"sample_text":"Internet‑based convenience sample; not a probability or nationally representative sample","population":"gay and bisexual men in the United States, self‑selected from an online venue","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A large online survey of over 25,000 gay and bisexual men in the U.S. found that nearly 80 % had used a sex toy, with many using dildos, cock rings, vibrators, and other items during both solo and partnered sex.","clinical_takeaway":"Sex toys are common and considered to enhance sexual experiences among gay and bisexual men; clinicians can discuss them openly as part of sexual health counseling.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Very large sample size","Provides detailed prevalence data on a understudied population","Distinguishes solo vs. partnered toy use"],"limitations":["Convenience sample from a specific website; limited generalisability","Self‑report without validated measures","Cross‑sectional; cannot assess changes over time"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":9,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":29,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9716-y"}},{"id":4783,"doi":null,"pmid":"22701956","pmcid":null,"title":"[Images of gender and gender-specific therapies in German homoeopathic and naturopathic guidebooks (c. 1870-1930)]","authors":"Weigl A.","first_author":"Weigl A.","journal":"Medizin, Gesellschaft, und Geschichte : Jahrbuch des Instituts fur Geschichte der Medizin der Robert Bosch Stiftung","year":2011,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Historical analysis of 19th‑20th century German homeopathic and naturopathic guidebooks; qualitative content analysis of texts.","sample_n":null,"sample_text":"Guidebooks from Germany, Austria, Switzerland, printed 1870‑1930 (number not specified).","population":"German‑language medical guidebooks (c. 1870‑1930); no human participants.","country":"Germany, Austria, Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article examines 19th‑ and early‑20th‑century German‑language homeopathic and naturopathic guidebooks, showing how they linked gender to health, especially labeling women as the 'weaker sex' and associating conditions like hysteria and masturbation with nervousness.","clinical_takeaway":"None – the historical analysis does not provide clinical guidance for current sexual health practice.","confidence":0.4,"topic_tags":["sexual_function","masturbation","gender","csbd"],"strengths":["Rich primary‑source material","Contextualises gendered medical discourses of the era"],"limitations":["No empirical data on contemporary sexual behaviour","No quantitative analysis or statistical testing"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":4784,"doi":"10.1111/j.1743-6109.2010.01909.x","pmid":"20584128","pmcid":null,"title":"Portuguese version of Cues for Sexual Desire Scale: the influence of relationship duration","authors":"Carvalheira A, Brotto LA, Maroco J.","first_author":"Carvalheira A","journal":"The journal of sexual medicine","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community web‑survey of Portuguese women (N=3,687) assessing a psychometric instrument; cross‑sectional analysis of factor structure, reliability and predictors of scores.","sample_n":3687,"sample_text":"large convenience sample recruited online; not a probability sample","population":"Portuguese adult women (age ≥ 18)","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated and validated a questionnaire that measures what triggers women's sexual desire, finding that Portuguese women in longer relationships report fewer desire cues. Masturbation and ease of orgasm were linked to higher cue scores.","clinical_takeaway":"Clinicians might explore new sexual desire cues with women in long‑term relationships to help address low desire.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample size","Comprehensive factor analysis and reliability testing","Clear reporting of statistical outcomes"],"limitations":["Convenience online sample may limit generalizability","No assessment of mental‑health or moral‑incongruence confounds","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.01909.x"}},{"id":4785,"doi":"10.1080/0092623x.2011.606745","pmid":"21961442","pmcid":null,"title":"Beliefs about women's vibrator use: results from a nationally representative probability survey in the United States","authors":"Herbenick D, Reece M, Schick V, Jozkowski KN, Middelstadt SE, Sanders SA, Dodge BS, Ghassemi A, Fortenberry JD.","first_author":"Herbenick D","journal":"Journal of sex & marital therapy","year":2011,"pub_types":["Evaluation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large nationally representative probability survey of adults 18‑60, cross‑sectional questionnaire","sample_n":null,"sample_text":"nationally representative probability sample (size not given in abstract)","population":"United States adults, community sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A national US survey found that most adults hold positive views about women’s vibrator use, and women who view vibrators positively report better sexual function scores.","clinical_takeaway":"Positive beliefs about vibrator use are associated with better sexual function; clinicians might consider addressing attitudes when discussing sexual health.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Nationally representative probability sample","Developed a specific belief scale for vibrator use","Links beliefs to validated sexual function measure (FSFI)"],"limitations":["Scale development not fully psychometrically validated in abstract","Cross‑sectional design limits causal inference","Limited reporting of statistical power and effect sizes"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2011.606745"}},{"id":4786,"doi":"10.1080/00926237808403016","pmid":"569213","pmcid":null,"title":"Effects of erotic stimulation and masturbatory training upon situational orgasmic dysfunction","authors":"Reisinger JJ.","first_author":"Reisinger JJ.","journal":"Journal of sex & marital therapy","year":1978,"pub_types":["Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"single-subject counterbalanced design with 6 participants; laboratory erotic stimulation and masturbatory training; follow‑up at 6–12 months.","sample_n":6,"sample_text":"Six single women, aged 22 to 29 years","population":"single adult women (22‑29 y) with situational orgasmic dysfunction","country":"USA (implied by journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In six women with situational orgasm problems, a lab‑based program that combined erotic pictures and guided masturbation increased the number of orgasms, and some benefits lasted up to a year.","clinical_takeaway":"Masturbatory training with erotic cues may help treat situational orgasmic dysfunction, but evidence is limited to a very small sample.","confidence":0.7,"topic_tags":["sexual_function","masturbation","pornography","treatment"],"strengths":["Physiological measure (heart rate) of orgasm","Counterbalanced single‑subject design","Long‑term follow‑up"],"limitations":["Very small sample (N=6)","No validated outcome scales","Limited generalisability to broader population"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926237808403016"}},{"id":4787,"doi":null,"pmid":"7890362","pmcid":null,"title":"Bladder stone presenting as excessive masturbation","authors":"Kesaree N, Umesh L, Kallinath S, Shafi, Kadli NK, Muganagowda, Banapurmath CR.","first_author":"Kesaree N","journal":"Indian pediatrics","year":1994,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4788,"doi":"10.1177/002580249403400313","pmid":"7968404","pmcid":null,"title":"A biopsied vaginal lesion in a child alleging abuse","authors":"Busuttil A.","first_author":"Busuttil A.","journal":"Medicine, science, and the law","year":1994,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single 6‑year‑old with vaginal lesion, colposcopic biopsy, discussion of possible self‑inflicted masturbatory injury versus abuse","sample_n":1,"sample_text":"single case","population":"single child (6 y) presenting with vaginal bleeding","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 6‑year‑old with vaginal bleeding was examined; a lesion was biopsied and found to be chronic inflammation, which the authors suggest might be from repeated self‑masturbation rather than sexual abuse.","clinical_takeaway":"In children with genital lesions, clinicians should consider both abuse and self‑inflicted injury, but decisions must be based on thorough investigation.","confidence":0.85,"topic_tags":["masturbation","sexual_function"],"strengths":["Detailed clinical description","Biopsy confirmation of lesion"],"limitations":["Single case, no generalisability","No systematic assessment of alternative explanations (e.g., abuse, trauma)","No validated measures of masturbation or distress"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/002580249403400313"}},{"id":4789,"doi":"10.1007/s10508-010-9711-3","pmid":"21165688","pmcid":null,"title":"Salivary testosterone levels in men at a U.S. sex club","authors":"Escasa MJ, Casey JF, Gray PB.","first_author":"Escasa MJ","journal":"Archives of sexual behavior","year":2011,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative observational study of men watching vs participating in sexual activity at a US sex club; salivary testosterone measured before and after exposure.","sample_n":44,"sample_text":"Men attending a sex club; recruited on site during late‑night hours; convenience sample.","population":"Adult men (mean age 40) attending a large U.S. sex club; n=44 (26 observers, 18 participants).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In men at a US sex club, salivary testosterone rose 36% overall, with a larger increase for those actually having sex (72%) than for those just watching (11%). Age did not affect the change.","clinical_takeaway":"Sexual activity can acutely boost testosterone, but findings are based on a small, non‑representative sample.","confidence":0.73,"topic_tags":["sexual_function"],"strengths":["Naturalistic setting reduces laboratory artefacts","Physiological measure (salivary testosterone) is objective","Direct comparison of observers vs participants"],"limitations":["Small, convenience sample limits generalizability","No control for potential confounds (e.g., stress, alcohol)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":37,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9711-3"}},{"id":4790,"doi":"10.1016/0005-7967(94)90147-3","pmid":"8042970","pmcid":null,"title":"Relationships between conflict, affect and deviant sexual behaviors in rapists and pedophiles","authors":"McKibben A, Proulx J, Lusignan R.","first_author":"McKibben A","journal":"Behaviour research and therapy","year":1994,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Diary study of 22 male sexual offenders (13 rapists, 9 pedophiles) recording affect and sexual fantasies/behaviors every 2 days for 60 days.","sample_n":22,"sample_text":"13 rapists and 9 pedophiles","population":"Male sexual offenders, treatment or forensic setting","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a 60‑day diary study of 22 male sexual offenders, negative mood and conflicts were linked to more deviant sexual fantasies and masturbation during those fantasies, especially for rapists. The authors suggest negative affect may drive such behaviors.","clinical_takeaway":"Findings are limited; clinicians should not infer causality from mood to deviant sexual acts based on this small study.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Prospective diary design","Repeated measures over 60 days","Focus on affect‑behavior link"],"limitations":["Very small, non‑representative sample","Unvalidated self‑report instrument","No control for key confounds (moral, mental health, trauma)","Interpretation may overstate causality"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":9,"contrasting":1,"mentioning":62,"citing_publications":131,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0005-7967(94)90147-3"}},{"id":4791,"doi":"10.1111/j.1464-410x.1994.tb07572.x","pmid":"8032852","pmcid":null,"title":"Masturbation using metal washers for the treatment of impotence: painful consequences","authors":"Rana A, Sharma N.","first_author":"Rana A","journal":"British journal of urology","year":1994,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1464-410x.1994.tb07572.x"}},{"id":4792,"doi":"10.3109/14647273.2010.520798","pmid":"21155689","pmcid":"PMC3564677","title":"Sperm content of pre-ejaculatory fluid","authors":"Killick SR, Leary C, Trussell J, Guthrie KA.","first_author":"Killick SR","journal":"Human fertility (Cambridge, England)","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational study of 27 volunteers providing up to five pre‑ejaculate samples each.","sample_n":27,"sample_text":"27 men, 40 pre‑ejaculatory fluid samples.","population":"Adult men (volunteers, likely WEIRD, recruited for a lab study).","country":"Not specified (likely UK based on journal).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study of 27 men, about 40% of pre‑ejaculatory fluid samples contained motile sperm, suggesting that condoms should be used from the first genital contact to prevent unintended pregnancy.","clinical_takeaway":"Condoms are advisable from initial genital contact because pre‑ejaculate can contain motile sperm.","confidence":0.7,"topic_tags":["prevalence","sexual_function","religiosity","masturbation"],"strengths":["Objective laboratory measurement of sperm presence and motility.","Repeated sampling within individuals.","Clear public‑health relevance (condom use guidance)."],"limitations":["Small, non‑representative volunteer sample.","No power calculation or effect‑size reporting.","Convenience recruitment limits generalisability."],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":9,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/14647273.2010.520798"}},{"id":4794,"doi":"10.1590/s1679-45082010ao1836","pmid":"26760318","pmcid":null,"title":"Sexuality in women with polycystic ovary syndrome: a pilot study","authors":"Silva JS, Fonseca AM, Bagnoli VR, Cavalcanti AL, Soares JM, Baracat EC.","first_author":"Silva JS","journal":"Einstein (Sao Paulo, Brazil)","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"","sample_n":48,"sample_text":"cross‑sectional convenience sample, pilot","population":"48 women with polycystic ovary syndrome","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 48 women with polycystic ovary syndrome, menstrual irregularities were linked to higher masturbation frequency, but overall sexual satisfaction and other aspects of sexual behavior did not differ with obesity, hirsutism, or BMI.","clinical_takeaway":"Menstrual cycle status may influence solitary sexual activity in PCOS; clinicians should consider hormonal factors when discussing sexual health.","confidence":0.8,"topic_tags":["sexual_function","masturbation","religiosity","moral_incongruence"],"strengths":["Addresses a relatively understudied population (PCOS women)","Includes a range of sexual‑behaviour variables"],"limitations":["Small pilot sample (N=48)","No validated sexual‑function instruments reported","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":13,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s1679-45082010ao1836"}},{"id":4795,"doi":"10.1111/j.1743-6109.2010.02131.x","pmid":"21114770","pmcid":null,"title":"Primary lifelong delayed ejaculation: characteristics and response to bupropion","authors":"Abdel-Hamid IA, Saleh el-S.","first_author":"Abdel-Hamid IA","journal":"The journal of sexual medicine","year":2011,"pub_types":["Controlled Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"prospective open‑label controlled trial; 19 DE patients vs 19 age‑matched healthy men; 2‑month bupropion treatment","sample_n":38,"sample_text":"19 consecutive men with primary lifelong DE and 19 age‑matched healthy men","population":"adult men with primary lifelong delayed ejaculation (N=19) and healthy controls (N=19)","country":"unspecified (likely USA/Egypt based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 19 men with lifelong delayed ejaculation, longer ejaculation times and higher anxiety were found compared with healthy men. A two‑month trial of bupropion (150 mg daily) modestly reduced ejaculation latency and improved some satisfaction scores, but benefits were limited.","clinical_takeaway":"Bupropion may offer modest improvement for lifelong delayed ejaculation, but evidence is limited and based on a small open‑label trial.","confidence":0.7,"topic_tags":["sexual_function","treatment"],"strengths":["Validated outcome measures (IELT stopwatch, IIEF, anxiety/depression scales)","Age‑matched healthy control group","Objective hormonal assays"],"limitations":["Very small sample (N=19 per group)","Open‑label, non‑randomised design","No effect‑size reporting or power calculation"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":28,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02131.x"}},{"id":4796,"doi":"10.1177/070674379403900307","pmid":"8033021","pmcid":null,"title":"Autoerotic asphyxial deaths: analysis of nineteen fatalities in Alberta, 1978 to 1989","authors":"Tough SC, Butt JC, Sanders GL.","first_author":"Tough SC","journal":"Canadian journal of psychiatry. Revue canadienne de psychiatrie","year":1994,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 19 forensic deaths from autoerotic asphyxia (1978‑1989, Alberta)","sample_n":19,"sample_text":"All 19 cases of autoerotic asphyxial death that occurred between 1978 and 1989 in Alberta, Canada were reviewed.","population":"male victims, ages 15‑29, deceased","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined 19 deaths in Alberta from 1978‑1989 where people died while performing autoerotic asphyxia, a risky solo sexual practice involving self‑strangulation. Victims were typically single men aged 15‑29, and deaths occurred when safety devices failed.","clinical_takeaway":"Clinicians should be aware of autoerotic asphyxia as a possible cause of unexplained death and consider counseling patients who report unusual sexual practices or neck marks.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Complete review of all known cases in the region for the period","Detailed forensic description of scene and injuries"],"limitations":["No systematic measurement of psychological or social variables","Small, non‑representative sample of deceased individuals","No comparison group"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/070674379403900307"}},{"id":4797,"doi":"10.1080/21674086.1994.11927415","pmid":"8047633","pmcid":null,"title":"Aspects of primary and secondary genital feelings and anxieties in girls during the preoedipal and early oedipal phases","authors":"Lax RF.","first_author":"Lax RF.","journal":"The Psychoanalytic quarterly","year":1994,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report; psychoanalytic interpretation of a single child's development","sample_n":null,"sample_text":"single case (unspecified number, likely 1)","population":"preschool/early childhood girls (single case)","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The paper offers a psychoanalytic description of how a young girl experiences sexual feelings, masturbation, and related anxieties during early childhood development.","clinical_takeaway":"None - not clinically applicable.","confidence":0.6,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Historical psychoanalytic perspective","Focus on early psychosexual development"],"limitations":["Single case, no empirical measures","No validated instruments or quantitative data","No control of major confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/21674086.1994.11927415"}},{"id":4798,"doi":"10.1007/bf01542097","pmid":"8018021","pmcid":null,"title":"Sexual function in women with hypothalamo-pituitary disorders","authors":"Hulter B, Lundberg PO.","first_author":"Hulter B","journal":"Archives of sexual behavior","year":1994,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Interview study of 48 women with hypothalamo‑pituitary disorders; correlational analysis of hormone levels and self‑reported sexual function.","sample_n":48,"sample_text":"48 women with well‑defined hypothalamo‑pituitary disorders","population":"Women with hypothalamo‑pituitary disorders (N=48)","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 48 women with hypothalamo‑pituitary disorders, most reported reduced sexual desire, lubrication problems and difficulty reaching orgasm. Hormone levels were only weakly linked to sexual function, with testosterone correlating only with masturbation frequency.","clinical_takeaway":"Hormonal abnormalities alone do not fully explain sexual dysfunction in these patients; comprehensive assessment is needed.","confidence":0.7,"topic_tags":["sexual_function","csbd","masturbation","religiosity"],"strengths":["Well‑defined clinical sample","Objective hormone measurements","Comprehensive sexual function interview"],"limitations":["Small, non‑representative sample","No validated sexual function scale reported","Cross‑sectional; cannot infer causality","Limited statistical detail (no effect sizes, CIs)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542097"}},{"id":4799,"doi":"10.1186/1477-7827-8-138","pmid":"21059225","pmcid":"PMC2987949","title":"The correlation between urinary 5-hydroxyindoleacetic acid and sperm quality in infertile men and rotating shift workers","authors":"Ortiz Á, Espino J, Bejarano I, Lozano GM, Monllor F, García JF, Pariente JA, Rodríguez AB.","first_author":"Ortiz Á","journal":"Reproductive biology and endocrinology : RB&E","year":2010,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","research-article","Evaluation Study","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"http://www.biomedcentral.com/1477-7827/8/138","cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative correlational study of 40 men (20 infertile, 20 shift workers/fathers) measuring urinary 5‑HIIA and semen parameters.","sample_n":40,"sample_text":"40 men (20 infertile, 10 night‑shift workers, 10 recent fathers).","population":"Men attending infertility counselling and rotating shift workers; sample size 40.","country":"Spain (inferred from author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 40 men, higher urinary serotonin metabolite levels were linked to lower sperm count, motility, normal shape and vitality, suggesting serotonin may affect male fertility.","clinical_takeaway":"Elevated serotonin metabolites might be a factor in male infertility, but evidence is preliminary.","confidence":0.8,"topic_tags":["sexual_function","religiosity"],"strengths":["Use of validated biochemical assay (ELISA)","Standardized semen analysis methods"],"limitations":["Small, non‑representative sample","Cross‑sectional design limits causal inference","Limited control for potential confounders"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1477-7827-8-138"}},{"id":4800,"doi":"10.1111/j.1743-6109.2010.02071.x","pmid":"21044269","pmcid":null,"title":"The Female Genital Self-Image Scale (FGSIS): results from a nationally representative probability sample of women in the United States","authors":"Herbenick D, Schick V, Reece M, Sanders S, Dodge B, Fortenberry JD.","first_author":"Herbenick D","journal":"The journal of sexual medicine","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":114,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative probability sample, cross‑sectional validation study","sample_n":2056,"sample_text":"nationally representative probability sample, Internet‑based survey","population":"women ages 18‑60 in the United States (N≈2,056)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US‑wide survey of over 2,000 women, a shortened 4‑item version of the Female Genital Self‑Image Scale proved reliable and linked positively to sexual function, masturbation, and genital‑health behaviours.","clinical_takeaway":"A brief, validated tool (FGSIS‑4) can assess women’s genital self‑image and its relation to sexual health in clinical settings.","confidence":0.9,"topic_tags":["gender","sexual_function","measurement"],"strengths":["Large, nationally representative probability sample","Rigorous psychometric validation (CFA, reliability, temporal stability)","Separate measurement of masturbation and other sexual behaviours"],"limitations":["Cross‑sectional; cannot infer causality","No assessment of mental‑health or relational confounds","Moral‑incongruence not addressed (not central to construct)"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":11,"contrasting":0,"mentioning":153,"citing_publications":192,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02071.x"}},{"id":4801,"doi":"10.4314/ejhs.v20i3.69445","pmid":"22434975","pmcid":"PMC3275846","title":"Sexual practices and their development pattern among jimma university students","authors":"Ambaw F, Mossie A, Gobena T.","first_author":"Ambaw F","journal":"Ethiopian journal of health sciences","year":2010,"pub_types":["research-article","Journal Article"],"keywords":["Anal Sex","Oral Sex","Jimma"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3275846","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,986 university students with logistic regression analysis","sample_n":1986,"sample_text":"large convenience sample of university students","population":"Jimma University students, Ethiopia (age 17‑45)","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2010 survey of nearly 2,000 Ethiopian university students found that many engage in oral, anal, and masturbatory practices, and that a substantial portion are at risk for STIs and unintended pregnancy.","clinical_takeaway":"Clinicians should recognize diverse sexual practices among young adults and address STI and pregnancy prevention broadly.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Large sample size for a single university","Combination of quantitative and qualitative data","Provides prevalence of various sexual practices"],"limitations":["Cross‑sectional design cannot infer causality","No validated measures of sexual behaviour or distress","Key confounders (moral views, mental health, partner context) not assessed"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":26,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4314/ejhs.v20i3.69445"}},{"id":4804,"doi":"10.1007/bf01541615","pmid":"8135648","pmcid":null,"title":"Deviance as history: the future of perversion","authors":"Simon W.","first_author":"Simon W.","journal":"Archives of sexual behavior","year":1994,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"historical-theoretical article without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how societies have historically defined sexual 'deviance' and 'perversion', linking them to ideas about control and desire, and shows how views on practices like masturbation, homosexuality, and sadomasochism have shifted over time.","clinical_takeaway":"None – the paper is historical and does not provide clinical guidance.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad historical perspective on sexual deviance concepts","Integration of multiple sexual categories (masturbation, homosexuality, etc.)"],"limitations":["No empirical data or measurement of constructs","No control for known confounds","Interpretations are theoretical, not testable"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541615"}},{"id":4805,"doi":"10.5402/2011/856586","pmid":"21647230","pmcid":"PMC3101881","title":"Effect of pregnancy and childbirth on sexuality of women in ibadan, Nigeria","authors":"Bello FA, Olayemi O, Aimakhu CO, Adekunle AO.","first_author":"Bello FA","journal":"ISRN obstetrics and gynecology","year":2011,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3101881","cited_by_count":27,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 375 antenatal clinic attendees; cross‑sectional questionnaire on sexual frequency and satisfaction during pregnancy and postpartum.","sample_n":375,"sample_text":"375 antenatal attendees","population":"Women attending antenatal care in Ibadan, Nigeria (N≈375)","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A questionnaire of 375 pregnant women in Nigeria found that sexual activity often continues during pregnancy, with frequency rising but orgasms decreasing. Masturbation and anal sex became more common, while oral sex declined. Being married, cohabiting, and partner fidelity encouraged sex, whereas dyspareunia and partner infidelity discouraged it.","clinical_takeaway":"Pregnancy does not necessarily reduce sexual activity; counseling should address physical discomfort and relationship dynamics.","confidence":0.7,"topic_tags":["sexual_function","religiosity","masturbation","relationships"],"strengths":["Large sample for a single clinic (N=375)","Reports odds ratios with confidence intervals","Considers both frequency and satisfaction","Includes several relationship variables"],"limitations":["Cross‑sectional; cannot infer causality","Self‑report measures not validated","Limited control of key confounds (mental health, moral factors)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":1,"mentioning":43,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5402/2011/856586"}},{"id":4806,"doi":"10.1111/j.1743-6109.2010.02013.x","pmid":"21029388","pmcid":null,"title":"Sexual behaviors, condom use, and sexual health of Americans over 50: implications for sexual health promotion for older adults","authors":"Schick V, Herbenick D, Reece M, Sanders SA, Dodge B, Middlestadt SE, Fortenberry JD.","first_author":"Schick V","journal":"The journal of sexual medicine","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":134,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"nationally representative cross‑sectional survey of adults 50+","sample_n":null,"sample_text":"nationally representative sample; exact N not given in abstract","population":"Adults age ≥ 50 in the United States (national probability sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A national US survey of adults over 50 found many remain sexually active into their 80s, but solo and partnered activity declines with age. Condom use stays low, and pleasure, arousal, and orgasm tend to decrease. Health and relationship status influence sexual experiences.","clinical_takeaway":"Clinicians should discuss sexual health proactively with older patients, considering health and relationship factors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Clear operationalisation of sexual behaviours and experience","Appropriate logistic regression with ORs and CIs"],"limitations":["Self‑report may be biased, especially for sensitive behaviours","No measurement of key confounds (e.g., moral incongruence, mental health)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":24,"contrasting":2,"mentioning":208,"citing_publications":253,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02013.x"}},{"id":4807,"doi":"10.1258/msl.2010.010103","pmid":"21539293","pmcid":null,"title":"An uncommon case of hypersexual behaviour with frotteurism","authors":"Bhatia MS, Jhanjee A, Srivastava S, Kumar P.","first_author":"Bhatia MS","journal":"Medicine, science, and the law","year":2010,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single patient with hypersexual behaviour and frotteurism, no comparison group","sample_n":1,"sample_text":"single case","population":"single adult female (child? abstract mentions child but likely adult case); details not provided","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe one unusual patient who combined excessive masturbatory behavior with frotteurism (non‑consensual genital contact) and depression, and they discuss how such cases might be diagnosed and treated.","clinical_takeaway":"Case reports are anecdotal; do not change practice without broader evidence.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed clinical description","Discussion of differential diagnosis"],"limitations":["Single case, no generalizability","No standardized measures of hypersexuality or distress","No control of key confounds (moral incongruence, mental health)","Reliance on subjective clinical judgment"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/msl.2010.010103"}},{"id":4808,"doi":"10.1111/j.1743-6109.2010.02020.x","pmid":"21029390","pmcid":null,"title":"An event-level analysis of the sexual characteristics and composition among adults ages 18 to 59: results from a national probability sample in the United States","authors":"Herbenick D, Reece M, Schick V, Sanders SA, Dodge B, Fortenberry JD.","first_author":"Herbenick D","journal":"The journal of sexual medicine","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":84,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"National probability sample of 3,990 adults reporting most recent partnered sexual event; event-level self‑report measures of behaviors, context, and satisfaction.","sample_n":3990,"sample_text":"3930 participants (approx.) from a US probability household survey","population":"Adults 18–59 years, United States, probability sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US probability sample of 3,990 adults, researchers examined the mix of sexual behaviors during participants' most recent partnered encounter and how features like age, partner type, and substance use related to pleasure and orgasm.","clinical_takeaway":"Greater diversity of sexual behaviors and having a relationship partner are linked to higher odds of orgasm and satisfaction.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative probability sample","Event‑level detail across many sexual behaviors","Statistical reporting of odds ratios with confidence intervals"],"limitations":["Cross‑sectional self‑report; cannot infer causality","Limited measurement validation described in abstract","No control for broader psychosocial confounds"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":8,"contrasting":2,"mentioning":83,"citing_publications":145,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02020.x"}},{"id":4809,"doi":"10.1007/s10508-010-9673-5","pmid":"20878225","pmcid":null,"title":"Application of the sexual health model in the long-term treatment of hypoactive sexual desire and female orgasmic disorder","authors":"Robinson BB, Munns RA, Weber-Main AM, Lowe MA, Raymond NC.","first_author":"Robinson BB","journal":"Archives of sexual behavior","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single longitudinal case illustration of treatment for female orgasmic and low desire disorder, integrating multiple therapeutic modalities","sample_n":1,"sample_text":"single case","population":"one adult female patient with complex comorbidities (relational trauma, depression, medical illness)","country":"unspecified (likely USA based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A detailed case report shows how a comprehensive sexual‑health model was used over many years to treat a woman's low sexual desire and difficulty reaching orgasm, while also addressing her depression, past sexual abuse, and medical issues.","clinical_takeaway":"Complex sexual dysfunction may benefit from an integrated, long‑term approach that addresses mental health, relationship, and trauma factors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed multi‑modal treatment description","Considers wide range of biopsychosocial factors","Integrates sexual health model components"],"limitations":["Single case – no generalizability","Lack of validated outcome measures","No quantitative data or statistical analysis"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":7,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9673-5"}},{"id":4810,"doi":"10.1159/000183959","pmid":"8088703","pmcid":null,"title":"Sexual revolution and counter-revolution","authors":"Money J.","first_author":"Money J.","journal":"Hormone research","year":1994,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"Not an empirical study; no participants reported.","population":"adolescents (general discussion)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how cultural, medical, and technological changes since the 1960s have shaped adolescent sexual attitudes, education, and behaviors, noting both liberal and restrictive influences.","clinical_takeaway":"None – the paper offers historical commentary, not clinical evidence.","confidence":0.4,"topic_tags":["sexual_function","masturbation","adolescents"],"strengths":["Broad historical perspective on sexual norms","Highlights multiple sociocultural factors influencing adolescent sexuality"],"limitations":["No empirical data or systematic methodology","Lacks operational definitions or measurement of constructs","Potentially outdated (1994) and culturally limited"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000183959"}},{"id":4811,"doi":"10.1016/0006-3223(94)91164-9","pmid":"8167201","pmcid":null,"title":"A pilot study of a structured interview addressing sexual function in men with schizophrenia","authors":"Burke MA, McEvoy JP, Ritchie JC.","first_author":"Burke MA","journal":"Biological psychiatry","year":1994,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pilot study, N=20, within‑subject comparison of sexual function before/after antipsychotic treatment","sample_n":20,"sample_text":"Twenty men with schizophrenia completed a 15‑item interview about usual and current sexual functioning.","population":"physically healthy men with schizophrenia, recruited from inpatient units","country":"USA (implied by journal and authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small pilot interview asked 20 men with schizophrenia about how their sexual function, including erections and masturbation, changed after starting antipsychotic medication. Greater reported impairment was linked to higher prolactin levels and more movement side‑effects.","clinical_takeaway":"Antipsychotic‑induced dopamine blockade can worsen sexual function; clinicians should monitor erections and masturbation frequency.","confidence":0.78,"topic_tags":["sexual_function","masturbation","csbd","moral_incongruence"],"strengths":["Direct measurement of current vs usual sexual function","Biological correlates (prolactin, EPS) assessed","Focus on a clinically relevant side‑effect"],"limitations":["Very small, non‑representative sample","Non‑validated interview instrument","Cross‑sectional, no causal inference"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0006-3223(94)91164-9"}},{"id":4812,"doi":null,"pmid":"882606","pmcid":null,"title":"[Bioelectric activity in cases of childhood masturbation]","authors":"Koinov R, Christov W, Mintschev D.","first_author":"Koinov R","journal":"Psychiatrie, Neurologie, und medizinische Psychologie","year":1977,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case series of 45 children with EEG recordings before, during, and after anticonvulsive treatment; no control group","sample_n":45,"sample_text":"45 cases of childhood masturbation","population":"children (preschool to infant age) who engaged in masturbation; sample size 45","country":"unspecified (likely Bulgaria based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"The authors recorded brain waves (EEG) from 45 children who masturbated, before and after giving them anti‑seizure medication. They found the seizure‑like signs were not related to epilepsy.","clinical_takeaway":"EEG changes during childhood masturbation are not indicative of epilepsy; no clinical action suggested.","confidence":0.7,"topic_tags":["masturbation","neuroscience","pornography"],"strengths":["Unique historical EEG data on a rarely studied behavior","Direct observation before/after medical intervention"],"limitations":["No control group or comparison condition","Small sample, limited statistical analysis","No measurement of relevant psychosocial confounds"],"rubric_version":"2.0","raw_total":17,"max_possible":60,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":3,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":4814,"doi":"10.1186/1471-2458-10-533","pmid":"20815921","pmcid":"PMC2940920","title":"An exploratory study of Muslim adolescents' views on sexuality: Implications for sex education and prevention","authors":"Smerecnik C, Schaalma H, Gerjo K, Meijer S, Poelman J.","first_author":"Smerecnik C","journal":"BMC public health","year":2010,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"http://www.biomedcentral.com/content/pdf/1471-2458-10-533.pdf","cited_by_count":32,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Exploratory qualitative content analysis of forum discussions (N≈77 participants). Convenience sample from an internet forum; no systematic sampling or longitudinal component.","sample_n":77,"sample_text":"44 Muslim and 33 non‑Muslim adolescents who posted on an Internet forum.","population":"Muslim and non‑Muslim adolescents in the Netherlands (forum users).","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study analysed Dutch Muslim adolescents’ online forum discussions about sexuality, finding strong taboos and conflicts over religious interpretation that could hinder sex‑education efforts.","clinical_takeaway":"Sex‑education programs for Muslim youth should address religious viewpoints and respect for youth perspectives.","confidence":0.6,"topic_tags":["sexual_function","religiosity","adolescents","moral_incongruence","masturbation"],"strengths":["Provides rare insight into Muslim adolescents’ perspectives.","Uses systematic qualitative software (NVivo).","Identifies concrete barriers for sex‑education program design."],"limitations":["Small, self‑selected forum sample; limited generalisability.","No measurement of key confounds (e.g., moral incongruence, mental health).","Findings may be over‑generalised to broader youth populations."],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":2,"contrasting":1,"mentioning":44,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2458-10-533"}},{"id":4815,"doi":null,"pmid":"20856186","pmcid":null,"title":"Differences in predictors of sexual satisfaction and in sexual satisfaction between female and male university students in Slovenia","authors":"Ziherl S, Masten R.","first_author":"Ziherl S","journal":"Psychiatria Danubina","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Convenience sample of 174 female and 74 male Slovenian university students; self‑report questionnaire on sexual satisfaction, frequency, and attitudes; cross‑sectional analysis of correlations and gender differences.","sample_n":248,"sample_text":"174 female, 74 male Slovene undergraduate students (convenience sample)","population":"University undergraduates (Slovenia)","country":"Slovenia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A Slovenian university survey found that both men and women who have more frequent and agreeable sexual interactions report higher sexual satisfaction, while wanting more sex or perceiving a partner as less agreeable predicts lower satisfaction. Women reported lower satisfaction than men.","clinical_takeaway":"Gender‑specific factors (frequency and mutual agreeableness) relate to sexual satisfaction; clinicians might explore these in counseling.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large enough total sample for descriptive work","Gender‑balanced analysis","Explores multiple relational predictors"],"limitations":["Convenience, non‑representative sample","Likely uses non‑validated, ad‑hoc measures","No control for major confounds (mental health, moral attitudes, etc.)","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":4816,"doi":"10.3923/pjbs.2010.911.915","pmid":"23350165","pmcid":null,"title":"Features of premature ejaculation in infertile men","authors":"Hassanzadeh K, Yavari-kia P, Ahmadi-Asrbadr Y, Nematzadeh-Pakdel A, Alikhah H.","first_author":"Hassanzadeh K","journal":"Pakistan journal of biological sciences : PJBS","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Sequential sample of 300 infertile men; questionnaire; cross‑sectional analysis","sample_n":300,"sample_text":"300 infertile male patients","population":"Infertile men attending a single Iranian fertility centre (N=300)","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 300 Iranian men seeking fertility treatment, 43% reported premature ejaculation, most often lasting less than one minute. Younger men were more likely to have primary PE. Masturbation occurred about five times a month on average.","clinical_takeaway":"Premature ejaculation is common among infertile men; clinicians should screen for it when evaluating male factor infertility.","confidence":0.7,"topic_tags":["sexual_function","prevalence","religiosity"],"strengths":["Large (N=300) sample for a single clinic","Specific focus on PE among infertile men","Includes masturbation frequency data"],"limitations":["Uses a non‑validated, author‑designed questionnaire","Cross‑sectional; cannot infer causality","No assessment of mental‑health, relationship or moral variables"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3923/pjbs.2010.911.915"}},{"id":4818,"doi":"10.1111/j.1743-6109.2010.01917.x","pmid":"20584120","pmcid":null,"title":"Greater tactile sensitivity and less use of immature psychological defense mechanisms predict women's penile-vaginal intercourse orgasm","authors":"Brody S, Houde S, Hess U.","first_author":"Brody S","journal":"The journal of sexual medicine","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Seventy French‑Canadian female university students completed tactile sensitivity testing, a validated defense‑style questionnaire, and self‑report sexual activity frequencies; logistic and linear regression analyses were performed.","sample_n":70,"sample_text":"70 French‑Canadian female university students (aged 18‑30) recruited from a university setting","population":"Female university students, 18‑30 y, N=70","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 70 young women, those with more sensitive fingertips and fewer immature psychological defenses were more likely to report orgasms during penile‑vaginal intercourse, but not during other sexual activities.","clinical_takeaway":"Tactile sensitivity and adaptive coping may influence women's orgasmic response to intercourse; assessment could guide sexual‑function counseling.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Objective tactile sensitivity measurement","Use of validated psychological questionnaire","Statistical modeling of multiple predictors"],"limitations":["Small, non‑representative university sample","Cross‑sectional design; no causal inference","Limited control of key psychosocial confounds"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":11,"contrasting":0,"mentioning":28,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.01917.x"}},{"id":4820,"doi":null,"pmid":"1010639","pmcid":null,"title":"Electrocardiographic study of the effect of masturbation normal individuals","authors":"Banerjea BK, Sen SC.","first_author":"Banerjea BK","journal":"Indian journal of physiology and pharmacology","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subject pre/post physiological measurement of ECG and hormone levels in 120 healthy men","sample_n":120,"sample_text":"120 normal individuals","population":"adult males, 22‑38 y, recruited as “normal individuals” (likely convenience sample)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 120 healthy men, researchers recorded heart‑beat patterns and hormone levels before and after ejaculation. They found higher heart‑beat signal amplitudes, slower heart rate, higher blood pressure, and increased epinephrine and norepinephrine after masturbation.","clinical_takeaway":"Masturbation appears to produce short‑term changes in cardiac activity and stress hormones; no clinical concerns indicated for healthy adults.","confidence":0.8,"topic_tags":["masturbation","sexual_function","pornography"],"strengths":["Within‑subject design controls individual baseline variability","Decent sample size for physiological measures","Direct measurement of hormonal and cardiac parameters"],"limitations":["No statistical analysis reported (p‑values, effect sizes)","Potential selection bias – recruitment method unclear","Interpretation of causality is speculative"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4821,"doi":"10.1007/s10508-010-9656-6","pmid":"20628802","pmcid":null,"title":"A case of painful erections after pelvic surgery","authors":"Arbanas G.","first_author":"Arbanas G.","journal":"Archives of sexual behavior","year":2011,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Single patient case report describing painful erections after pelvic fracture and treatment with diazepam.","sample_n":1,"sample_text":"One case","population":"Male, 27 y/o, post‑traumatic pelvic fracture","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 27‑year‑old man who broke pelvic bones in a motorcycle accident developed painful erections during sex, masturbation and morning tumescence. A two‑week course of low‑dose diazepam before masturbation resolved the pain.","clinical_takeaway":"Low‑dose diazepam before sexual activity may relieve pain from post‑traumatic erections, but evidence is limited to one case.","confidence":0.9,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Provides novel clinical observation of a rare condition","Discusses possible mechanisms and treatment"],"limitations":["Single case; no generalisable data","No systematic assessment of confounding factors","No quantitative outcome measures"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9656-6"}},{"id":4822,"doi":"10.1677/joe.0.0700439","pmid":"135817","pmcid":null,"title":"Endocrine effects of masturbation in men","authors":"Purvis K, Landgren BM, Cekan Z, Diczfalusy E.","first_author":"Purvis K","journal":"The Journal of endocrinology","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subject pre‑post laboratory study with a psychological‐anticipation control condition","sample_n":null,"sample_text":"young, apparently healthy males","population":"young, apparently healthy males (sample size not reported in abstract)","country":"Sweden (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a laboratory study, healthy young men showed higher blood levels of several hormones (including testosterone and cortisol) immediately after masturbating compared with when they only imagined masturbating. The hormonal spikes did not affect luteinizing hormone.","clinical_takeaway":"Masturbation can cause short‑term increases in multiple hormones; this is a normal physiological response.","confidence":0.7,"topic_tags":["masturbation","sexual_function","neuroscience"],"strengths":["Objective hormonal assays with radioimmunoassay","Within‑subject design reduces inter‑individual variability","Inclusion of a psychological anticipation control condition"],"limitations":["Small, unspecified sample size, likely under‑powered","No adjustment for multiple hormonal comparisons","No assessment of potential psychological confounders (e.g., stress, mood, moral attitudes)","Findings limited to acute hormonal changes, not health outcomes"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1677/joe.0.0700439"}},{"id":4823,"doi":"10.1016/j.jpurol.2010.06.001","pmid":"20619744","pmcid":null,"title":"Sexual function in teenagers after multimodal treatment of pelvic rhabdomyosarcoma: A preliminary report","authors":"Macedo A, Ferreira PV, Barroso U, Demarchi GT, Garrone G, Liguori R, Caran E, Ortiz V.","first_author":"Macedo A","journal":"Journal of pediatric urology","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 4 adolescents with genitourinary rhabdomyosarcoma; no control group; convenience sample; descriptive questionnaire","sample_n":4,"sample_text":"Four eligible patients identified from a single centre database","population":"4 male adolescents (age >14) treated for pelvic rhabdomyosarcoma with multimodal therapy","country":"Portugal (inferred from author names and journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A tiny study of four teen boys who survived pelvic rhabdomyosarcoma found that most could still achieve erections during masturbation many years after extensive surgery and treatment.","clinical_takeaway":"Evidence is insufficient to guide expectations about sexual function after RMS treatment; clinicians should monitor each patient individually.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation","adolescents","csbd"],"strengths":["Long follow‑up (average 9.75 years)","Focus on a rarely studied outcome (erectile function after pelvic RMS treatment)"],"limitations":["Very small N (n=4) limits any inference","Non‑validated, single‑item questionnaire","No comparator group or baseline data"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpurol.2010.06.001"}},{"id":4824,"doi":"10.1093/humrep/deq147","pmid":"20570975","pmcid":null,"title":"Clinical and biochemical correlates of successful semen collection for cryopreservation from 12-18-year-old patients: a single-center study of 86 adolescents","authors":"Hagenäs I, Jørgensen N, Rechnitzer C, Sommer P, Holm M, Schmiegelow K, Daugaard G, Jacobsen N, Juul A.","first_author":"Hagenäs I","journal":"Human reproduction (Oxford, England)","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":52,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"single-center observational cohort of 86 adolescent boys undergoing semen collection before gonadotoxic treatment; correlations between age, testicular volume, hormones and collection success were examined.","sample_n":86,"sample_text":"86 participants (convenience sample from a single fertility preservation clinic).","population":"86 male adolescents aged 12.2‑17.9 years referred for fertility preservation prior to cancer‑related gonadotoxic therapy.","country":"Sweden (single centre, likely Copenhagen/Stockholm region).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 86 teenage boys facing cancer treatment, testicular size—not age or hormone levels—best predicted whether they could provide a usable semen sample for freezing, suggesting that boys with testicles larger than 5 ml should be offered fertility banking.","clinical_takeaway":"Offer semen banking to adolescent boys with testicular volume > 5 ml before gonadotoxic therapy, regardless of age.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Standardized, validated semen and hormone measurements","Reasonable sample size for a rare clinical population","Clear clinical relevance for fertility preservation"],"limitations":["Single‑center convenience sample; limited generalisability","Cross‑sectional; cannot infer causality","No pre‑registration or adjustment for multiple testing"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":56,"citing_publications":83,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/humrep/deq147"}},{"id":4825,"doi":"10.1097/00002030-199306000-00018","pmid":"8363763","pmcid":null,"title":"Sex role separation in sexual diaries of homosexual men","authors":"Coxon AP, Coxon NH, Weatherburn P, Hunt AJ, Hickson F, Davies PM, McManus TJ.","first_author":"Coxon AP","journal":"AIDS (London, England)","year":1993,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"cohort diary study of 385 gay men over one month, descriptive assessment of sexual role rigidity","sample_n":385,"sample_text":"385 men recorded sexual diaries for 1‑month periods","population":"homosexually active men (n=385) in England","country":"UK","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a one‑month diary study of 385 gay men, researchers found that while anal intercourse showed some role rigidity (active vs passive), most men alternated roles, and masturbation and oral sex showed little rigidity.","clinical_takeaway":"Sexual role flexibility is common; clinicians should avoid assuming fixed active/passive identities in gay men.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large community sample (n≈400)","Prospective daily diary method reduces recall bias","Clear focus on role rigidity relevant to HIV modelling"],"limitations":["No validated scales for role rigidity","Limited control of psychological confounds","Cross‑sectional snapshot; cannot infer change over time"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":18,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00002030-199306000-00018"}},{"id":4826,"doi":"10.1080/13691051003783339","pmid":"20432081","pmcid":null,"title":"Postpartum abstinence and risk of HIV among young mothers in the Kassena-Nankana District of Northern Ghana","authors":"Achana FS, Debpuur C, Akweongo P, Cleland J.","first_author":"Achana FS","journal":"Culture, health & sexuality","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"purposive selection of young mothers and their husbands; repeated semi‑structured interviews; thematic analysis with NVivo; no quantitative measures reported","sample_n":null,"sample_text":"purposively selected young mothers and their husbands; exact number not given","population":"young mothers (mid‑20s to early‑30s) and their spouses in rural northern Ghana","country":"Ghana","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with young mothers in rural Ghana found that the traditional period of abstaining from sex after birth is seen as risky for HIV because men may seek other partners. Some women try to protect themselves, even by encouraging their husbands to masturbate. The study suggests improving access to contraception and HIV protection.","clinical_takeaway":"Promote modern contraception and HIV prevention for postpartum women in similar settings.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides culturally specific, in‑depth insight into postpartum sexual practices","Uses systematic qualitative coding (NVivo) for thematic analysis"],"limitations":["No quantitative data; cannot assess magnitude of risk","Small, purposive sample limits generalisability","No validated instruments for key constructs"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":18,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691051003783339"}},{"id":4827,"doi":"10.1111/j.1743-6109.2010.01866.x","pmid":"20929518","pmcid":null,"title":"Highlights from the history of sexual medicine","authors":"Schultheiss D, Glina S.","first_author":"Schultheiss D","journal":"The journal of sexual medicine","year":2010,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical review / narrative commentary without original data.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how sexuality became a medical field, from early anti‑masturbation campaigns to the rise of sexology after WWII, noting key milestones and setbacks.","clinical_takeaway":"None – the paper is historical and does not inform clinical practice.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad historical overview of sexual medicine.","Clear chronological structure."],"limitations":["No empirical data; purely narrative.","No systematic methodology reported.","Limited relevance to current clinical questions on pornography or compulsive sexual behaviour."],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.01866.x"}},{"id":4828,"doi":"10.1071/sh09101","pmid":"20465985","pmcid":null,"title":"Australian men's sexual practices in saunas, sex clubs and other male sex on premises venues","authors":"Lyons A, Smith AM, Grierson JW, von Doussa H.","first_author":"Lyons A","journal":"Sexual health","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Interviewer‑administered survey of 186 MSM recruited within 48 h of attending sex‑on‑premises venues; analyses based on 430 reported sexual encounters.","sample_n":186,"sample_text":"186 men; 430 sexual encounters reported","population":"Australian men who have sex with men (MSM) attending SOPVs","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2010 Australian survey of 186 men who have sex with men, done shortly after they visited saunas or sex clubs, recorded 430 sexual encounters. Oral sex was most common; younger men had more unprotected anal sex, while older men masturbated more. Alcohol‑intoxicated partners reduced unprotected anal sex. The authors suggest tailoring safer‑sex programs to these patterns.","clinical_takeaway":"Safe‑sex interventions in male sex‑on‑premises venues should consider age‑related risk patterns and the influence of partner alcohol use.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large number of encounters per participant","Specific focus on SOPV context","Multivariate analysis of age and alcohol effects"],"limitations":["Convenience sample, not representative","No validated scales for risk behaviours","Limited control of potential confounds (e.g., mental health, moral factors)","No effect sizes reported"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh09101"}},{"id":4829,"doi":null,"pmid":"952635","pmcid":null,"title":"Masturbatory guilt and sexual dysfunction","authors":"Clarke M.","first_author":"Clarke M.","journal":"Australian family physician","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"No empirical data; article is a conceptual commentary linking masturbatory guilt to sexual dysfunction and advocating community education.","sample_n":null,"sample_text":"None – no participants reported","population":"general adult population (implied)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["circular_addiction_scale","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that anxiety from feeling guilty about masturbation may cause sexual problems like low desire or impotence, and suggests public education about normal masturbation as prevention.","clinical_takeaway":"Consider addressing guilt about masturbation when assessing sexual dysfunction.","confidence":0.5,"topic_tags":["masturbation","gender","sexual_function"],"strengths":["Highlights an understudied psychosocial factor"],"limitations":["No empirical data or systematic review methods","No measurement of guilt, sexual function, or confounding variables","Outdated terminology and concepts"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":4830,"doi":"10.1007/bf01541870","pmid":"1275689","pmcid":null,"title":"Masturbation and sexual fantasies in married couples","authors":"Hessellund H.","first_author":"Hessellund H.","journal":"Archives of sexual behavior","year":1976,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross‑sectional qualitative interview study of 38 married couples (76 participants); thematic analysis of differences by gender and partner.","sample_n":38,"sample_text":"38 married couples (76 individuals)","population":"married Danish couples; convenience sample; not randomly selected.","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study interviewed 38 Danish married couples about their masturbation habits and sexual fantasies, highlighting gender‑related differences in how they experience and interpret these aspects of sexuality.","clinical_takeaway":"None – the paper is descriptive and does not provide actionable clinical guidance.","confidence":0.6,"topic_tags":["masturbation","sexual_function"],"strengths":["In‑depth personal interviews provide rich qualitative data.","Direct comparison of husbands vs. wives offers dyadic perspective."],"limitations":["Very small, non‑representative sample limits generalisability.","No validated measurement tools; constructs not operationalised.","No statistical analysis; findings are descriptive only."],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541870"}},{"id":4831,"doi":"10.1177/000992289303200410","pmid":"8462237","pmcid":null,"title":"Childhood masturbation","authors":"Leung AK, Robson WL.","first_author":"Leung AK","journal":"Clinical pediatrics","year":1993,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":3,"contrasting":0,"mentioning":77,"citing_publications":81,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000992289303200410"}},{"id":4832,"doi":null,"pmid":"803139","pmcid":null,"title":"Theoretical implications in current views of masturbation in latency girls","authors":"Clower VL.","first_author":"Clower VL.","journal":"Journal of the American Psychoanalytic Association","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"The article is a theoretical/psychoanalytic commentary with no empirical data, sample size, or methods reported.","sample_n":null,"sample_text":"Not applicable – no participants","population":"Children (latency‑age girls) – theoretical focus only","country":"USA (implied by journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper revisits Freud’s idea that girls in the latency stage stop clitoral masturbation and develop penis envy, using clinical anecdotes and literature recollections to argue for a re‑examination of that theory.","clinical_takeaway":"None – the article is theoretical and does not provide evidence for clinical practice.","confidence":0.7,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Historical perspective on psychoanalytic theory","Integrates clinical observations with Freud’s model"],"limitations":["No empirical data or systematic review","Relies on anecdotal recollections","No measurement of key constructs or confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":4833,"doi":"10.1016/j.juro.2010.02.018","pmid":"20400139","pmcid":null,"title":"Treatment for ejaculatory dysfunction in men with spinal cord injury: an 18-year single center experience","authors":"Brackett NL, Ibrahim E, Iremashvili V, Aballa TC, Lynne CM.","first_author":"Brackett NL","journal":"The Journal of urology","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":82,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"retrospective review of medical records from 1991‑2009; 500 men with spinal cord injury; 3,152 semen retrieval procedures; treatment algorithm evaluated.","sample_n":500,"sample_text":"500 men (3,152 procedures)","population":"men with spinal cord injury (SCI) seeking ejaculatory function for fertility; age range not specified, likely adult.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A review of 500 men with spinal cord injuries showed that non‑surgical methods like penile vibratory stimulation and electroejaculation can safely retrieve sperm for fertility in most cases, allowing simple insemination.","clinical_takeaway":"Non‑surgical sperm retrieval is effective for most men with SCI; follow the presented algorithm.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a specialized clinical population","Objective outcome measures (semen retrieval, motile sperm count)","Clear clinical algorithm presented"],"limitations":["Retrospective design limits causal inference","No control group or comparison to alternative treatments","Limited reporting of statistical effect sizes or confidence intervals"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":99,"citing_publications":133,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.juro.2010.02.018"}},{"id":4834,"doi":"10.1111/j.1753-6405.2010.00501.x","pmid":"23331360","pmcid":null,"title":"Circumcision in Australia: further evidence on its effects on sexual health and wellbeing","authors":"Ferris JA, Richters J, Pitts MK, Shelley JM, Simpson JM, Ryall R, Smith AM.","first_author":"Ferris JA","journal":"Australian and New Zealand journal of public health","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Representative household telephone survey of 4,290 Australian men, age 16–64, assessing circumcision status, STI history, sexual difficulties, masturbation and sexual practices; logistic regression adjusting for age and number of partners.","sample_n":4290,"sample_text":"4290 men aged 16‑64 years, recruited via computer‑assisted telephone interview from a nationally representative household sample.","population":"Australian men, community sample, broadly representative of adult male population.","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A national survey of over 4,000 Australian men found that being circumcised had little impact on most sexual health outcomes, with only small differences in urethritis, candidiasis and occasional worries about body appearance.","clinical_takeaway":"Circumcision does not appear to meaningfully affect sexual health or erectile function.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Large, nationally representative sample","Adjusts for key demographic covariates","Separates masturbation from circumcision status"],"limitations":["Cross‑sectional design precludes causal inference","Reliance on self‑report measures without validated scales","Limited control for mental health, relationship, or trauma factors"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":39,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1753-6405.2010.00501.x"}},{"id":4836,"doi":null,"pmid":"20939198","pmcid":null,"title":"[Validation of a scale of attitudes towards sexuality in a sample of Puerto Rican elderly]","authors":"Rodríguez Benítez RJ, Rodríguez Gómez J, Sayers Montalvo S.","first_author":"Rodríguez Benítez RJ","journal":"Boletin de la Asociacion Medica de Puerto Rico","year":2010,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study using secondary database of 265 elders; ex‑post‑facto factor analysis","sample_n":265,"sample_text":"secondary database sample of 265 adults aged 65 or older from Puerto Rico","population":"Puerto Rican adults 65+ (N=265)","country":"Puerto Rico","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers validated a new questionnaire measuring older adults’ attitudes toward sexuality in Puerto Rico, showing it is reliable and structurally sound with 265 participants.","clinical_takeaway":"None – the study provides a measurement tool, not clinical evidence.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for validation (N=265)","High internal consistency (Cronbach α=.95)","Factor analysis performed"],"limitations":["No external validation sample","Cross‑sectional, cannot assess temporal stability","No assessment of related constructs (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":4837,"doi":"10.1097/jcp.0b013e3181d35c14","pmid":"20520309","pmcid":null,"title":"Inappropriate sexual behaviors associated with donepezil treatment: a case report","authors":"Lo Coco D, Cannizzaro E.","first_author":"Lo Coco D","journal":"Journal of clinical psychopharmacology","year":2010,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/jcp.0b013e3181d35c14"}},{"id":4838,"doi":"10.1097/dbp.0b013e3181d83050","pmid":"20414066","pmcid":null,"title":"Episodic hypersomnia and unusual behaviors in a 14-year old adolescent","authors":"Hirst J, Mignot E, Stein MT.","first_author":"Hirst J","journal":"Journal of developmental and behavioral pediatrics : JDBP","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"1 (case report)","population":"single adolescent male","country":"USA (implied by Midwest travel)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 14‑year‑old boy experienced repeated episodes of extreme sleepiness, confusion, and bizarre sexual behaviors, including public masturbation, which resolved on their own after several weeks.","clinical_takeaway":"No specific clinical guidance; the report documents rare, transient neuro‑behavioral episodes with sexual disinhibition.","confidence":0.8,"topic_tags":["sexual_function","masturbation","adolescents"],"strengths":["Detailed clinical description","Comprehensive medical work‑up"],"limitations":["Single case, no control group","No systematic measurement of sexual behavior or psychosocial factors"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/dbp.0b013e3181d83050"}},{"id":4839,"doi":"10.1007/s10508-009-9549-8","pmid":"19784767","pmcid":null,"title":"(Self-)abusive prophecies, rigorous science, and discursive templates: commentary on Malón (2009)","authors":"Janssen DF.","first_author":"Janssen DF.","journal":"Archives of sexual behavior","year":2010,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-009-9549-8"}},{"id":4841,"doi":"10.1016/0005-7967(93)90039-w","pmid":"8417725","pmcid":null,"title":"Performance demand and sexual arousal in women","authors":"Laan E, Everaerd W, Van Aanhold MT, Rebel M.","first_author":"Laan E","journal":"Behaviour research and therapy","year":1993,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":66,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"within‑subjects laboratory experiment with 48 functional women, performance‑demand manipulation during fantasy and erotic film; physiological (photoplethysmography) and self‑report measures collected.","sample_n":48,"sample_text":"48 female subjects recruited for a laboratory study","population":"adult women, functional sexual response, convenience sample","country":"Netherlands (assumed from authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, women who were told to achieve maximum sexual arousal showed stronger genital and self‑reported arousal, especially when imagining sexual scenarios. Masturbation frequency influenced how much they reported feeling aroused under pressure.","clinical_takeaway":"Performance pressure can boost sexual arousal in women, but individual masturbation habits may affect subjective experience.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Physiological measure of genital response","Within‑subject experimental manipulation","Clear operationalisation of performance demand"],"limitations":["Small, non‑representative convenience sample","No control for moral, mental‑health or relational confounds","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":0,"mentioning":63,"citing_publications":103,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0005-7967(93)90039-w"}},{"id":4842,"doi":"10.1080/00797308.1993.11822383","pmid":"8234550","pmcid":null,"title":"Problems in female development. Comments on the analysis of an early latency-age girl","authors":"Frenkel RS.","first_author":"Frenkel RS.","journal":"The Psychoanalytic study of the child","year":1993,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"case-report","design_detail":"single clinical case of a 6½‑year‑old girl analyzed psychoanalytically","sample_n":1,"sample_text":"N=1, single case report","population":"one female child, age 6.5 years, psychoanalytic treatment setting","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A psychoanalytic case report describes a 6½‑year‑old girl’s intense genital sensations and fantasies, linking them to unconscious conflicts and transference within therapy.","clinical_takeaway":"No direct clinical guidance; the report is a descriptive psychoanalytic narrative of a single child’s sexual development.","confidence":0.3,"topic_tags":["masturbation","sexual_function","pornography"],"strengths":["detailed psychoanalytic description","focus on early childhood sexual development"],"limitations":["single case, no quantitative data","no validated measures of masturbation or distress","no control for confounding variables"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00797308.1993.11822383"}},{"id":4844,"doi":"10.1016/j.fertnstert.2010.01.037","pmid":"20206929","pmcid":null,"title":"Is infertility a risk factor for female sexual dysfunction? A case-control study","authors":"Millheiser LS, Helmer AE, Quintero RB, Westphal LM, Milki AA, Lathi RB.","first_author":"Millheiser LS","journal":"Fertility and sterility","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":101,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-control study of 119 infertile women vs 99 controls; anonymous survey with FSFI and frequency measures","sample_n":218,"sample_text":"119 infertile women, 99 healthy controls","population":"women aged 18‑45 recruited from academic infertility and gynecology practices","country":"USA (presumed from journal affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Women with infertility were more likely to score in the range indicating sexual dysfunction compared with fertile women, and they reported lower desire, arousal, and less frequent intercourse and masturbation.","clinical_takeaway":"Infertility may be linked to lower sexual function; clinicians should assess sexual health in infertile patients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of a validated sexual function instrument (FSFI)","Separate measurement of masturbation frequency","Clear case‑control design with clinic and community controls"],"limitations":["No adjustment for mental‑health, relationship or trauma variables","Cross‑sectional; cannot infer causality","Potential selection bias from clinic‑based recruitment"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":3,"mentioning":114,"citing_publications":159,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.fertnstert.2010.01.037"}},{"id":4845,"doi":"10.1111/j.1743-6109.2010.01728.x","pmid":"20233278","pmcid":null,"title":"Development and validation of the female genital self-image scale","authors":"Herbenick D, Reece M.","first_author":"Herbenick D","journal":"The journal of sexual medicine","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":154,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional internet survey (n=1,937) developing and validating a self‑report scale; factor analysis, reliability, correlations with FSFI","sample_n":1937,"sample_text":"1937 women recruited via internet survey","population":"adult women (online sample, likely WEIRD)","country":"USA (presumed based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created the Female Genital Self‑Image Scale (FGSIS) and showed it is reliable and reflects women’s sexual function, with higher scores linked to better orgasm experiences and overall sexual health.","clinical_takeaway":"The FGSIS can be used as a brief, validated tool to assess how women feel about their genitals and its link to sexual function.","confidence":0.7,"topic_tags":["measurement","gender","sexual_function"],"strengths":["Large sample for scale validation","Comprehensive psychometric testing (reliability, factor analysis)","Clear association with established sexual function measure"],"limitations":["Convenience internet sample, limited diversity","Cross‑sectional; cannot infer causality","No assessment of mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":2,"mentioning":178,"citing_publications":246,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.01728.x"}},{"id":4846,"doi":"10.1111/j.1743-6109.2010.01722.x","pmid":"20233284","pmcid":null,"title":"Body mass index but not pulse pressure is associated with lesser penile-vaginal intercourse frequency in healthy young men","authors":"Brody S.","first_author":"Brody S.","journal":"The journal of sexual medicine","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Sixty‑five healthy young men, mean age 25, surveyed for frequency of penile‑vaginal intercourse, other partnered activity and masturbation; resting blood pressure, BMI measured; correlations computed with adjustment for age, mean BP, BMI, social desirability and cohabitation.","sample_n":65,"sample_text":"Sixty‑five healthy young men (mean age 25.2 ± 4.6 years)","population":"Healthy young adult men (N=65)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 65 healthy young men, a higher body‑mass index was linked to fewer episodes of penile‑vaginal intercourse, while pulse pressure showed no relationship. The study suggests that even within normal weight ranges, body fat may modestly reduce sexual activity frequency.","clinical_takeaway":"Higher BMI may be associated with lower sexual activity frequency in young men; consider weight management as part of sexual health counseling.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Objective physiological measures (BP, BMI)","Adjusted analyses controlling for several covariates","Separate assessment of masturbation frequency"],"limitations":["Small, convenience sample limits power and generalisability","Frequency of sexual activity measured by simple self‑report items, no validated scale","No assessment of mental‑health or trauma variables that could confound associations"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":9,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.01722.x"}},{"id":4847,"doi":"10.1071/sh09028","pmid":"20152094","pmcid":"PMC3816118","title":"Young adult sexual health: current and prior sexual behaviours among non-Hispanic white US college students","authors":"Higgins JA, Trussell J, Moore NB, Davidson JK.","first_author":"Higgins JA","journal":"Sexual health","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1504 non‑Hispanic white heterosexual college students from two US campuses","sample_n":1504,"sample_text":"n = 1504; two university campuses (Mid‑west, South‑west); convenience sample","population":"young adult (20‑24 yr) US college students, non‑Hispanic white, never‑married, heterosexual","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,500 white heterosexual U.S. college students found that most have had oral and vaginal sex, fewer have tried anal sex, and many masturbate. Men reported much higher lifetime masturbation than women. The authors suggest encouraging masturbation and condom use to improve sexual health.","clinical_takeaway":"Encourage condom use for vaginal and anal sex and consider masturbation as a low‑risk activity in sexual‑health counseling for college students.","confidence":0.9,"topic_tags":["sexual_function","masturbation"],"strengths":["Large sample (n>1500) for a survey","Comprehensive description of multiple sexual practices","Focus on understudied behaviors (masturbation, anal intercourse)"],"limitations":["Convenience, homogenous sample (white, heterosexual, two campuses) limits generalisability","Self‑report only; no validated scales for sexual health or problem use","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":2,"mentioning":11,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh09028"}},{"id":4848,"doi":"10.1080/00224491003592863","pmid":"20358460","pmcid":null,"title":"Diagnosis, assessment, and treatment of hypersexuality","authors":"Kaplan MS, Krueger RB.","first_author":"Kaplan MS","journal":"Journal of sex research","year":2010,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":112,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of diagnostic criteria and treatment approaches; no primary data collection","sample_n":null,"sample_text":"none (review article)","population":"none (review)","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews how hypersexuality has been defined, diagnosed, and treated, summarising current debates, criteria, and therapeutic approaches without presenting new data.","clinical_takeaway":"Clinicians should note the lack of consensus on hypersexuality definitions and consider multiple assessment tools and treatment options.","confidence":0.6,"topic_tags":["sexual_function","csbd","treatment"],"strengths":["Comprehensive overview of terminology and treatment options","Addresses controversy and differing viewpoints"],"limitations":["No primary empirical data; relies on existing literature","Lacks systematic review methodology and risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":147,"citing_publications":256,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224491003592863"}},{"id":4851,"doi":"10.1136/sti.68.5.334","pmid":"1427809","pmcid":"PMC1195993","title":"An unusual foreign body in the preputial sac","authors":"Jaiswal AK.","first_author":"Jaiswal AK.","journal":"Genitourinary medicine","year":1992,"pub_types":["research-article","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report describing insertion of a penicillin bottle into the preputial sac for masturbatory stimulation; removal under general anaesthesia","sample_n":1,"sample_text":"n=1 (single case)","population":"1 adult male, 28 years old, Indian","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 28‑year‑old man inserted a penicillin bottle into the skin at the tip of his penis to stimulate his glans during masturbation. The object became stuck and required surgery under general anaesthesia to remove.","clinical_takeaway":"Unusual genital foreign bodies can occur with risky masturbatory practices; seek prompt medical attention for removal.","confidence":0.4,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Clear clinical description of a rare presentation","Provides insight into extreme masturbatory behaviour"],"limitations":["Single case; no generalisable data","No systematic assessment of psychological or sexual health variables","No control or comparison group"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sti.68.5.334"}},{"id":4853,"doi":"10.1111/j.1743-6109.2009.01663.x","pmid":"20102447","pmcid":null,"title":"Impact of dry ejaculation caused by highly selective alpha1A-blocker: randomized, double-blind, placebo-controlled crossover pilot study in healthy volunteer men","authors":"Shimizu F, Taguri M, Harada Y, Matsuyama Y, Sase K, Fujime M.","first_author":"Shimizu F","journal":"The journal of sexual medicine","year":2010,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized double‑blind crossover pilot, N=50 healthy men, single dose silodosin vs placebo, 3‑day washout, within‑subject comparisons","sample_n":50,"sample_text":"50 healthy volunteers","population":"healthy volunteer men, 50 participants, age not specified","country":"unspecified (Japan likely from author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 50 healthy men, a single dose of silodosin reduced semen volume, lowered perceived orgasm quality, and decreased pelvic‑floor muscle contractions compared with placebo.","clinical_takeaway":"Silodosin can impair orgasmic pleasure by reducing ejaculate volume and muscle activity; clinicians should discuss this possible side effect with patients.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Crossover RCT reduces inter‑subject variability","Objective semen volume measurement","Blinded drug administration"],"limitations":["Small pilot sample, limited power","Subjective orgasm quality measured with a simple NRS, not a validated scale","No assessment of potential psychological confounders"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01663.x"}},{"id":4854,"doi":"10.1111/j.1743-6109.2009.01677.x","pmid":"20088868","pmcid":null,"title":"The relative health benefits of different sexual activities","authors":"Brody S.","first_author":"Brody S.","journal":"The journal of sexual medicine","year":2010,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":149,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or risk‑of‑bias assessment.","sample_n":null,"sample_text":"Review of peer‑reviewed literature; no primary sample.","population":"not applicable (review)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews existing studies and finds that penile‑vaginal intercourse is linked to many positive mental and physical health outcomes, while other activities show weaker or no benefits. However, most of the evidence is correlational, so causal statements are premature.","clinical_takeaway":"Treat the health benefits of specific sexual acts as suggestive, not definitive; avoid prescribing any activity as medically superior without stronger evidence.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad literature coverage of many sexual activities","Highlights gaps in causal evidence","Integrates physiological and psychological outcomes"],"limitations":["Narrative, not systematic; selection bias likely","No quantitative synthesis or appraisal of study quality","Conclusions overstate causality for many associations"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":21,"contrasting":3,"mentioning":223,"citing_publications":288,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01677.x"}},{"id":4855,"doi":"10.1080/1031461x.2010.493949","pmid":"20845584","pmcid":null,"title":"Pathologising white male sexuality in late nineteenth-century Australia through the medical prism of excess and constraint","authors":"Featherstone L.","first_author":"Featherstone L.","journal":"Australian historical studies","year":2010,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Historical analysis of medical discourse; no empirical data collection.","sample_n":null,"sample_text":"No participants; archival sources examined.","population":"Late‑19th‑century white male population in Australia (historical, not sampled).","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article examines how 19th‑century Australian doctors described white male sexuality, portraying it as both vigorous and prone to excess or pathology, and discusses related notions such as sodomy and masturbation.","clinical_takeaway":"None – the paper is a historical analysis and does not provide clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","other"],"strengths":["Provides rich historical context for contemporary debates.","Integrates medical literature from the period."],"limitations":["No empirical data; conclusions are interpretive.","No systematic methodology reported.","Cannot inform present‑day clinical practice."],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/1031461x.2010.493949"}},{"id":4857,"doi":null,"pmid":"21796900","pmcid":null,"title":"[A historical perspective on the health of boys and male adolescents (1780-2010)]","authors":"Dinges M.","first_author":"Dinges M.","journal":"Medizin, Gesellschaft, und Geschichte : Jahrbuch des Instituts fur Geschichte der Medizin der Robert Bosch Stiftung","year":2010,"pub_types":["Historical Article","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical perspective article without original empirical data; synthesis of secondary sources and narrative discussion.","sample_n":null,"sample_text":"None – the article is a historical narrative.","population":"Not applicable (no primary sample)","country":"Germany (author affiliation inferred from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how boys' health has been portrayed from 1780 to 2010, noting shifts from viewing boys as robust to recognizing poorer health outcomes, especially after wars. It discusses how gendered expectations, labor, and attitudes toward masturbation influenced male health over time.","clinical_takeaway":"None – the paper provides historical context, not clinical guidance.","confidence":0.4,"topic_tags":["adolescents","gender","sexual_function","moral_incongruence","masturbation"],"strengths":["Broad historical overview spanning >200 years","Integrates social and medical perspectives"],"limitations":["No original data; narrative synthesis only","No systematic methodology or bias assessment","Limited relevance to current pornography or compulsive sexual behaviour research"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":4860,"doi":"10.1080/0092623x.2010.510774","pmid":"20924935","pmcid":null,"title":"Vibrator use among heterosexual men varies by partnership status: results from a nationally representative study in the United States","authors":"Reece M, Herbenick D, Dodge B, Sanders SA, Ghassemi A, Fortenberry JD.","first_author":"Reece M","journal":"Journal of sex & marital therapy","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative survey of heterosexual men (USA), prevalence of vibrator use reported","sample_n":null,"sample_text":"nationally representative study (sample size not specified in abstract)","population":"heterosexually identified adult men in the United States (nationally representative sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"About 44 % of heterosexual men in the U.S. have ever used a vibrator, mostly with a female partner during sex or sexual play.","clinical_takeaway":"Vibrator use is common among heterosexual men and can be safely discussed as a partner‑enhancing option in therapy.","confidence":0.7,"topic_tags":["prevalence","sexual_function","gender","relationships"],"strengths":["Nationally representative sampling improves generalisability","Clear prevalence estimates for an understudied behaviour"],"limitations":["Reliance on single‑item self‑report; no validated scale","No assessment of potential confounders (e.g., moral attitudes, mental health)","Abstract provides limited methodological detail (sample size, weighting, response rate)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":1,"mentioning":17,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2010.510774"}},{"id":4861,"doi":"10.1071/sh09040","pmid":"19917202","pmcid":null,"title":"Pilot study of Australian school-based sexual health education: parents' views","authors":"Macbeth A, Weerakoon P, Sitharthan G.","first_author":"Macbeth A","journal":"Sexual health","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online questionnaire with purposive and snowball sampling of 117 Australian parents","sample_n":117,"sample_text":"117 parents recruited via purposive sampling and snowballing","population":"Australian parents of school‑aged children (purposive, snowballed sample)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small pilot survey of 117 Australian parents found strong support for school‑based sexual health education, with most favouring early teaching and inclusion of topics like masturbation, but many thought abstinence should be omitted.","clinical_takeaway":"Parents are generally supportive of comprehensive school sexual education; clinicians can engage them as partners in programme development.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Addresses a public‑health need (sexual health education)","Includes parental perspectives on a range of topics","Provides baseline data for future larger studies","Clear descriptive reporting of support levels"],"limitations":["Convenience, purposive sampling limits generalisability","Questionnaire not described; likely ad‑hoc items","No validation of measures or psychometric data","No control for potential confounds (e.g., religiosity, moral views)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh09040"}},{"id":4863,"doi":null,"pmid":"20329684","pmcid":null,"title":"Sexual practices of people living with HIV in South Eastern Nigeria","authors":"Ikechebelu J, Mbamara SU, Joe-Ikechebebelu NN, Ezenwabachili AO.","first_author":"Ikechebelu J","journal":"Nigerian journal of clinical practice","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"analytical epidemiological cross‑sectional questionnaire study (N=300)","sample_n":300,"sample_text":"300 subjects recruited via interviewer‑administered questionnaires","population":"people living with HIV in South‑Eastern Nigeria","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A questionnaire of 300 people living with HIV in southeast Nigeria found that many are sexually active, often without condoms, and engage in various practices including masturbation. The authors call for better sexual‑health education.","clinical_takeaway":"Clinicians should discuss condom use and safer‑sex practices with HIV‑positive patients, noting ongoing sexual activity.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a regional survey","Focus on a high‑risk population (PLWH)","Provides data on a range of sexual practices"],"limitations":["No validated instruments for sexual behaviour","Cross‑sectional design limits causal inference","Key confounders (e.g., mental health, moral attitudes) not measured"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4864,"doi":"10.1097/mrr.0b013e3283298166","pmid":"19440157","pmcid":null,"title":"Sexual difficulties for persons with multiple sclerosis in New South Wales, Australia","authors":"Redelman MJ.","first_author":"Redelman MJ.","journal":"International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Anonymous questionnaire completed by 283 persons with multiple sclerosis in New South Wales, assessing self‑reported sexual difficulties, relationship satisfaction and help‑seeking.","sample_n":283,"sample_text":"283 respondents (cross‑sectional convenience sample).","population":"Adults with multiple sclerosis (both sexes)","country":"Australia","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2009 survey of 283 Australians with multiple sclerosis found that many experience sexual problems—over half of women and three‑quarters of men—linked to the disease, especially issues like low libido, orgasm difficulty and erectile problems. Sexual difficulties were related to older age, poorer relationships and greater disability.","clinical_takeaway":"Clinicians should proactively discuss sexual health with MS patients, as difficulties are common and often unaddressed.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","moral_incongruence"],"strengths":["Large sample for MS population","Addresses an under‑researched area","Includes both genders","Considers relationship context"],"limitations":["Questionnaire not reported as validated","Cross‑sectional, cannot infer causality","Limited control of psychological or moral confounds","Potential self‑selection bias"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":0,"mentioning":27,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/mrr.0b013e3283298166"}},{"id":4867,"doi":"10.1016/0091-3057(92)90467-t","pmid":"1356274","pmcid":null,"title":"Increased sexual behavior in male Macaca arctoides monkeys produced by atipamezole, a selective alpha 2-adrenoceptor antagonist","authors":"Linnankoski I, Grönroos M, Carlson S, Pertovaara A.","first_author":"Linnankoski I","journal":"Pharmacology, biochemistry, and behavior","year":1992,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment with within‑subject control (atipamezole vs saline) in three male Macaca arctoides, 30‑min observation of copulation and masturbation outcomes.","sample_n":3,"sample_text":"Three male macaques observed after drug or saline administration.","population":"Male stumptail macaques (N=3)","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Giving male stumptail monkeys a drug that blocks alpha‑2 adrenergic receptors (atipamezole) caused them to ejaculate more, both during copulation and masturbation, compared with a saline injection.","clinical_takeaway":"None – the study is an animal experiment and does not inform human clinical practice.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","prevalence"],"strengths":["Clear dose‑response manipulation","Within‑subject control condition","Objective behavioral count"],"limitations":["Very small sample (N=3)","Findings limited to one non‑human species","No effect‑size reporting or confidence intervals"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0091-3057(92)90467-t"}},{"id":4868,"doi":"10.1111/j.1743-6109.2009.01579.x","pmid":"19912494","pmcid":null,"title":"The International Index of Erectile Function: development of an adapted tool for use in HIV-positive men who have sex with men","authors":"Coyne K, Mandalia S, McCullough S, Catalan J, Noestlinger C, Colebunders R, Asboe D.","first_author":"Coyne K","journal":"The journal of sexual medicine","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":54,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 486 HIV‑positive MSM recruited from seven European HIV treatment centres; adapted IIEF questionnaire administered and analysed for internal consistency and factor structure.","sample_n":486,"sample_text":"486 MSM from treatment centres","population":"HIV‑positive men who have sex with men (MSM)","country":"Europe (multiple sites)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers modified the International Index of Erectile Function for HIV‑positive gay men, testing its reliability and confirming the questionnaire’s structure in 486 participants. The adapted tool showed good internal consistency and can be used in clinical and research settings.","clinical_takeaway":"The adapted IIEF provides a reliable way to assess erectile function in HIV‑positive MSM for screening and monitoring.","confidence":0.8,"topic_tags":["sexual_function","measurement"],"strengths":["Large sample (n≈500) for psychometric evaluation","Standard reliability (Cronbach's α) and factor analysis reported","Focused adaptation for a specific clinical population"],"limitations":["Convenience sample from HIV clinics limits generalisability","No external validation or criterion validity tested","No assessment of potential confounders (e.g., mental health, relationship factors)"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":82,"citing_publications":94,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01579.x"}},{"id":4869,"doi":"10.1111/j.1743-6109.2009.01559.x","pmid":"19889144","pmcid":null,"title":"Immature defense mechanisms are associated with lesser vaginal orgasm consistency and greater alcohol consumption before sex","authors":"Costa RM, Brody S.","first_author":"Costa RM","journal":"The journal of sexual medicine","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 323 women reporting sexual behaviors, orgasm consistency, alcohol use before sex, and defense style questionnaire.","sample_n":323,"sample_text":"Three hundred twenty-three coitally experienced women (predominantly Scottish) responded to an online survey.","population":"adult women, predominantly Scottish, coitally experienced","country":"Scotland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 323 women, those who relied more on immature psychological defenses and who drank alcohol before sex reported fewer vaginal orgasms, while other sexual activities were unchanged or increased.","clinical_takeaway":"Psychological defenses and alcohol use before sex may relate to difficulty achieving vaginal orgasm; assess these factors in female sexual health consultations.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large sample for a survey (N>300)","Use of validated DSQ‑40 for defense mechanisms"],"limitations":["Cross‑sectional design limits causal inference","Self‑report measures for orgasm and alcohol lack validation","Limited control of key confounds (mood, relationship factors, trauma)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":10,"contrasting":0,"mentioning":77,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01559.x"}},{"id":4870,"doi":"10.1111/j.1532-5415.2009.02536.x","pmid":"20121967","pmcid":null,"title":"Inappropriate sexual behaviors in patients with vascular dementia: possible response to finasteride","authors":"Na HR, Lee JW, Park SM, Ko SB, Kim S, Cho ST.","first_author":"Na HR","journal":"Journal of the American Geriatrics Society","year":2009,"pub_types":["Letter","Research Support, Non-U.S. Gov't"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1532-5415.2009.02536.x"}},{"id":4871,"doi":"10.1111/j.1743-6109.2009.01370.x","pmid":"20092545","pmcid":null,"title":"Sexual functioning in transsexuals following hormone therapy and genital surgery: a review","authors":"Klein C, Gorzalka BB.","first_author":"Klein C","journal":"The journal of sexual medicine","year":2009,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":82,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of published empirical studies; no systematic methods, no risk‑of‑bias assessment, no meta‑analysis.","sample_n":null,"sample_text":"Not applicable – the paper synthesises previously published studies.","population":"Transgender individuals undergoing cross‑sex hormone therapy and genital surgery (male‑to‑female and female‑to‑male).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises research on how hormone therapy and genital surgery affect sexual desire, arousal, and orgasm in transgender people, finding generally adequate sexual functioning after surgery but noting a lack of data on some aspects.","clinical_takeaway":"Transgender patients can expect reasonable sexual desire, arousal, and orgasm after surgery, though individual outcomes vary and more research is needed.","confidence":0.4,"topic_tags":["sexual_function","gender"],"strengths":["Provides a concise synthesis of existing surgical outcome literature","Covers both MtF and FtM groups","Highlights gaps needing further research"],"limitations":["Narrative (non‑systematic) review; no explicit search strategy or bias assessment","No quantitative synthesis; conclusions based on heterogeneous studies","Does not evaluate potential confounding variables (e.g., mental health, relationship factors)"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":1,"mentioning":93,"citing_publications":153,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01370.x"}},{"id":4872,"doi":"10.1111/j.1743-6109.2009.01542.x","pmid":"19889149","pmcid":null,"title":"Erectile dysfunction and correlated factors in Brazilian men aged 18-40 years","authors":"Martins FG, Abdo CHN.","first_author":"Martins FG","journal":"The journal of sexual medicine","year":2010,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 1,947 Brazilian men aged 18‑40 recruited in public places; self‑administered 87‑item questionnaire; logistic regression used for associations.","sample_n":1947,"sample_text":"Convenience sample recruited in public venues across 18 major Brazilian cities.","population":"Male, 18‑40, Brazil, community sample (convenience recruitment).","country":"Brazil","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of nearly 2,000 Brazilian men aged 18‑40 found that 35 % reported erectile difficulties, mostly mild. Low education, lack of sexual information and never having masturbated were linked to higher rates, while medical factors were not.","clinical_takeaway":"Erectile problems are common in young men and relate more to psychosocial factors than physical disease; address education and mental health.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size (N≈2000).","Broad range of sociodemographic and health variables collected.","Focus on an understudied age group."],"limitations":["ED measured with a single unvalidated question.","Convenience recruitment limits generalisability.","Cross‑sectional design prevents causal inference."],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":2,"mentioning":71,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01542.x"}},{"id":4873,"doi":"10.1111/j.1743-6109.2009.01538.x","pmid":"19845548","pmcid":null,"title":"Sexuality during pregnancy","authors":"Pauleta JR, Pereira NM, Graça LM.","first_author":"Pauleta JR","journal":"The journal of sexual medicine","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":86,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire of postpartum women (N=188) at hospital discharge","sample_n":188,"sample_text":"188 women, aged 17‑40, mean age 28.9 years","population":"women aged 17‑40 who had just given birth in one hospital in Brazil (presumed convenience sample)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A questionnaire given to 188 women after delivery found that sexual satisfaction stayed about the same during pregnancy, but intercourse frequency dropped in the third trimester. About a quarter feared sex, and 20% reported masturbating.","clinical_takeaway":"Pregnant patients may experience reduced sexual activity but often maintain satisfaction; clinicians should discuss expected changes.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonable sample size for descriptive work","Addresses an under‑studied period (pregnancy)","Includes a range of sexual activities (including masturbation)"],"limitations":["Questionnaire appears ad‑hoc, not validated","Cross‑sectional convenience sample, limited generalisability","No control for mental health, partner relationship, or moral factors"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":16,"contrasting":2,"mentioning":149,"citing_publications":202,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01538.x"}},{"id":4874,"doi":null,"pmid":"1609538","pmcid":null,"title":"[Female sexuality in middle and advanced adulthood]","authors":"von Sydow K.","first_author":"von Sydow K.","journal":"Zeitschrift fur Gerontologie","year":1992,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional interview study with 91 women aged 50‑91; convenience sample","sample_n":91,"sample_text":"91 interview participants, ages 50‑91, birth cohorts 1895‑1936","population":"female adults, middle to advanced age","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 91 women aged 50‑91 showed that about half were sexually active, a third masturbated, and many still experienced sexual interest and fantasies, though over a quarter never had an orgasm. Age and cohort differences were noted.","clinical_takeaway":"Older women’s sexual experiences are varied; clinicians should assess individual desire and activity rather than assume universal decline.","confidence":0.4,"topic_tags":["sexual_function","masturbation"],"strengths":["Large age range, including women over 80","In‑depth qualitative quotations","Addresses understudied demographic"],"limitations":["No validated measurement instruments","Convenience sample; limited generalisability","No control for key confounds (e.g., health, relationship status)","Cross‑sectional, descriptive only"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":4876,"doi":"10.1111/j.1743-6109.2009.01529.x","pmid":"19832931","pmcid":null,"title":"Quality of sexual life in hyperandrogenic women treated with an oral contraceptive containing chlormadinone acetate","authors":"Caruso S, Rugolo S, Agnello C, Romano M, Cianci A.","first_author":"Caruso S","journal":"The journal of sexual medicine","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective single‑arm before‑after study (N=72) measuring hormonal, dermatologic and self‑reported sexual outcomes over 9 pill cycles","sample_n":72,"sample_text":"Seventy‑two volunteer women (age range, 18‑32 years)","population":"women aged 18‑32 with moderate‑to‑severe hirsutism/acne (hyperandrogenic)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 72 women with excess male hormones, an oral contraceptive that blocks androgens reduced acne and hair growth and was linked to higher quality‑of‑life scores, more frequent intercourse and orgasms, and less masturbation over nine months.","clinical_takeaway":"The contraceptive may improve sexual satisfaction in hyperandrogenic women, but evidence comes from an uncontrolled before‑after study.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Validated hormonal and dermatologic measures","Repeated assessments over three time points","Use of standard QoL instrument (SF‑36)"],"limitations":["No control group; cannot rule out time or placebo effects","Sexual behavior measured by single self‑report items only","Potential confounding by partner relationship, mood, or moral factors not assessed"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":51,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01529.x"}},{"id":4877,"doi":"10.1016/j.ridd.2009.08.003","pmid":"19815374","pmcid":null,"title":"Expanding the test of counterfeit deviance: are sexual knowledge, experience and needs a factor in the sexualised challenging behaviour of adults with intellectual disability?","authors":"Lockhart K, Guerin S, Shanahan S, Coyle K.","first_author":"Lockhart K","journal":"Research in developmental disabilities","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Matched groups (n=24) interviewed with validated sexual knowledge/needs scales; adaptive behaviour covariate; no longitudinal or experimental manipulation.","sample_n":24,"sample_text":"24 participants total, matched on gender, age, ability level (8 per group).","population":"Adults with intellectual disability, some with sexualised challenging behaviour.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Adults with intellectual disability who show sexualised challenging behaviour actually had higher sexual‑knowledge scores than matched peers, and reported greater dating/intimacy needs, despite similar levels of sexual experience.","clinical_takeaway":"Higher knowledge does not protect against sexualised challenging behaviour; services should address unmet intimacy needs.","confidence":0.62,"topic_tags":["sexual_function"],"strengths":["Use of validated sexual‑knowledge instruments","Matched comparison groups","Control for adaptive behaviour"],"limitations":["Very small sample (N=24)","No control for key psychosocial confounds (moral, mental health, partner factors)","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":7,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ridd.2009.08.003"}},{"id":4878,"doi":"10.1186/1471-2458-9-373","pmid":"19804651","pmcid":"PMC2765439","title":"Sexual practices among unmarried adolescents in Tanzania","authors":"Kazaura MR, Masatu MC.","first_author":"Kazaura MR","journal":"BMC public health","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"http://www.biomedcentral.com/1471-2458/9/373/abstract","cited_by_count":36,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of unmarried adolescents in five Tanzanian locations, using a self‑administered questionnaire","sample_n":null,"sample_text":"Not reported in abstract","population":"unmarried adolescents aged 10‑19, in‑school and out‑of‑school, Tanzania","country":"Tanzania","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2009 Tanzanian survey of 10‑19‑year‑old unmarried adolescents found that about one‑third were sexually active, with males more likely than females. Practices included vaginal, oral, anal sex and masturbation; 15% reported multiple partners and condom use at last sex was low.","clinical_takeaway":"Adolescents engage in varied sexual behaviors and often use condoms inconsistently; comprehensive, youth‑friendly sexual health education is needed.","confidence":0.85,"topic_tags":["adolescents","sexual_function"],"strengths":["Large age range (10‑19) captures early and later adolescence","Includes both in‑school and out‑of‑school youth","Reports a variety of sexual practices beyond vaginal intercourse"],"limitations":["Cross‑sectional, convenience sample; limited generalisability","No validated measurement instruments; reliance on single‑item self‑reports","Limited control for potential confounders (e.g., mental health, moral attitudes)","No effect‑size reporting or power justification"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":1,"mentioning":65,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2458-9-373"}},{"id":4879,"doi":"10.7748/nop.21.9.15.s22","pmid":"27745014","pmcid":null,"title":"Interventions for hypersexuality","authors":"Sander R.","first_author":"Sander R.","journal":"Nursing older people","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"descriptive overview without empirical data","sample_n":null,"sample_text":"Not applicable – no participants reported","population":"adults (unspecified)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article defines hypersexuality as persistent, inappropriate sexual actions such as vulgar sex talk, public masturbation, or unwanted genital care, describing how these behaviors differ from a person's usual personality.","clinical_takeaway":"Clinicians should recognize hypersexuality as a possible clinical issue but note that this source provides no empirical guidance for assessment or treatment.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Clear descriptive definition of hypersexual behaviors","Published in a nursing journal targeting clinicians"],"limitations":["No empirical data or systematic methodology","Lacks measurement of key confounds (e.g., moral incongruence, mental health)","No assessment of addiction criteria or validation of constructs"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7748/nop.21.9.15.s22"}},{"id":4880,"doi":"10.1515/ijamh.2009.21.4.601","pmid":"20306772","pmcid":null,"title":"Talking about sexuality at secondary schools of periurban area of Dhaka city","authors":"Tasnim S, Rahman A, Ara I.","first_author":"Tasnim S","journal":"International journal of adolescent medicine and health","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"quasi-experimental pre‑post test without control group; large convenience sample of secondary‑school students in peri‑urban Dhaka","sample_n":1490,"sample_text":"862 pre‑test, 628 post‑test respondents","population":"adolescents (grade IX‑X) in Bangladesh","country":"Bangladesh","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A booklet and classroom session about reproductive health, including topics like puberty and masturbation, raised Bangladesh adolescents' knowledge in a pre‑post school study.","clinical_takeaway":"School‑based sexual health education can improve adolescents’ knowledge; consider integrating such curricula.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample size for a school‑based survey","Focus on culturally relevant reproductive health topics","Includes both boys and girls schools"],"limitations":["No control/comparison group; pre‑post design limits causal inference","Questionnaire appears ad‑hoc; no reporting of validation or reliability","Potential selection bias of schools and students"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/ijamh.2009.21.4.601"}},{"id":4881,"doi":null,"pmid":"1496050","pmcid":null,"title":"[The central masturbation fantasy]","authors":"Laufer M, Laufer E.","first_author":"Laufer M","journal":"La Psychiatrie de l'enfant","year":1992,"pub_types":["Interview"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4882,"doi":null,"pmid":"1496047","pmcid":null,"title":"[Radiating masturbation fantasy]","authors":"Sullivan P.","first_author":"Sullivan P.","journal":"La Psychiatrie de l'enfant","year":1992,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4883,"doi":null,"pmid":"1496045","pmcid":null,"title":"[Reflections on the notion of the \"central masturbation fantasy\" of adolescence]","authors":"Jeammet P.","first_author":"Jeammet P.","journal":"La Psychiatrie de l'enfant","year":1992,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4885,"doi":"10.1007/s10508-009-9528-0","pmid":"19757013","pmcid":null,"title":"Influences of mastery, spousal support, and adaptive coping on sexual drive and satisfaction among chinese gynecologic cancer survivors","authors":"Tang CS, Lai BP, Chung TK.","first_author":"Tang CS","journal":"Archives of sexual behavior","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 134 gynecologic cancer survivors and 105 healthy Chinese women; comparison of sexual drive, satisfaction, and related behaviours; hierarchical multiple regression and mediation analyses.","sample_n":239,"sample_text":"134 cancer survivors, 105 healthy controls","population":"Chinese women, adult, cancer survivors and healthy controls","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Chinese women who survived gynecologic cancer reported lower sexual desire and satisfaction than healthy peers. Personal mastery and spousal support were linked to better sexual outcomes, while coping style was not. Survivors also masturbated and engaged in intimate behaviours less often.","clinical_takeaway":"Assess sexual function in cancer survivors and consider interventions that boost personal mastery and spousal support to improve satisfaction.","confidence":0.6,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Reasonable sample size for a niche population","Includes a healthy control group","Assesses multiple psychosocial predictors"],"limitations":["Cross‑sectional design limits causal inference","Limited reporting of psychometric validation","Potential selection bias from clinic‑based recruitment"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-009-9528-0"}},{"id":4886,"doi":null,"pmid":"19789494","pmcid":null,"title":"Sexuality and psychosis","authors":"Skodlar B, Nagy MZ.","first_author":"Skodlar B","journal":"Psychiatria Danubina","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"qualitative discussion / clinical reflection without empirical data","sample_n":null,"sample_text":"Not applicable – authors reflect on clinical experience rather than report a systematic sample.","population":"patients with psychosis (no sample size reported)","country":"Romania (journal location, not specified in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors discuss, from psychodynamic and phenomenological viewpoints, how people with psychosis experience sexuality—covering desire, identity, guilt, masturbation and erotic delusions—and why therapists often avoid the topic.","clinical_takeaway":"Clinicians should actively explore sexual issues with psychotic patients, as these concerns are common and can affect treatment.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Integrates psychodynamic and phenomenological perspectives","Highlights under‑studied area of sexuality in psychosis","Provides clinical observations useful for therapists"],"limitations":["No empirical data or systematic sample","Lacks operational definitions and validated measures","Conclusions are based on anecdotal clinical experience"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4888,"doi":"10.1007/bf01550952","pmid":"1768220","pmcid":null,"title":"The female sexual response revisited: understanding the multiorgasmic experience in women","authors":"Darling CA, Davidson JK, Jennings DA.","first_author":"Darling CA","journal":"Archives of sexual behavior","year":1991,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"anonymous 122‑item questionnaire administered to 805 college‑educated female nurses; comparison of single‑ vs multiorgasmic women on sexual behaviours and satisfaction.","sample_n":805,"sample_text":"805 female nurses completed the survey","population":"female nurses, college‑educated, United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 1991 survey of 805 female nurses found that about 43% reported experiencing multiple orgasms. The study compared women who have one orgasm per sexual episode with those who have several, looking at how they masturbate, cuddle, or have intercourse, and how satisfied they feel.","clinical_takeaway":"Multiorgasmic experiences are relatively common among women and relate to stimulation method and sexual satisfaction, but findings may not apply to the general population.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["large sample size for a survey","focus on understudied multiorgasmic phenomenon","comparison across stimulation methods"],"limitations":["Convenience sample of nurses limits generalisability","Questionnaire not reported as validated","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":27,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01550952"}},{"id":4889,"doi":"10.1186/1471-2458-9-305","pmid":"19698132","pmcid":"PMC2751779","title":"Multiple sex partner behavior in female undergraduate students in China: a multi-campus survey","authors":"Yan H, Chen W, Wu H, Bi Y, Zhang M, Li S, Braun KL.","first_author":"Yan H","journal":"BMC public health","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Multicenter Study","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"http://www.biomedcentral.com/content/pdf/1471-2458-9-305.pdf","cited_by_count":35,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large multi‑campus survey with randomized cluster sampling of 4,769 unmarried female undergraduates; logistic regression analysis of risk factors for multiple sexual partners","sample_n":4769,"sample_text":"4,769 respondents","population":"female undergraduate students in China (unmarried)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of nearly 5,000 Chinese female university students, about 5 % reported having multiple sexual partners. Factors linked to this behavior included working in entertainment venues, having friends with boyfriends, lower academic performance and more permissive attitudes toward multiple partners.","clinical_takeaway":"Screen for multiple‑partner risk factors (e.g., work setting, peer influences) and promote consistent condom use among at‑risk students.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large, multi‑campus sample with random cluster sampling","Clear definition of outcome (multiple sex partners) and use of logistic regression with confidence intervals","Comprehensive set of demographic and psychosocial predictors examined"],"limitations":["Cross‑sectional design cannot establish causality","Reliance on self‑report without validated psychometric instruments","Key confounds (e.g., moral incongruence, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":7,"contrasting":1,"mentioning":39,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2458-9-305"}},{"id":4890,"doi":"10.2164/jandrol.109.007856","pmid":"19684340","pmcid":null,"title":"Sleep, sex steroid hormones, sexual activities, and aging in Asian men","authors":"Goh VH, Tong TY.","first_author":"Goh VH","journal":"Journal of andrology","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross-sectional survey of 531 Asian Chinese men, measuring sleep duration, sexual activities (coital frequency, masturbation), and serum sex steroids.","sample_n":531,"sample_text":"531 participants recruited via questionnaire and blood draw","population":"Asian Chinese men, ages 29‑72, community‑based sample","country":"Asia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 531 Chinese men aged 29‑72, longer sleep was linked to higher testosterone levels, while both sleep and testosterone fell with age. Masturbation frequency was associated with higher testosterone, and DHEAS related to sexual desire and intercourse frequency.","clinical_takeaway":"Consider sleep hygiene when evaluating low testosterone in men; hormone levels may reflect sleep patterns.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large community sample (N>500)","Objective hormonal assays","Separate measurement of masturbation vs. coital activity"],"limitations":["Cross‑sectional design limits causal inference","Questionnaire for sexual activity not validated","Key psychosocial confounds (mental health, relationship factors, moral attitudes) not assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":1,"mentioning":22,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2164/jandrol.109.007856"}},{"id":4891,"doi":"10.1111/j.1464-410x.1991.tb15395.x","pmid":"1747727","pmcid":null,"title":"Unusual foreign bodies in the urethra and bladder","authors":"Osca JM, Broseta E, Server G, Ruiz JL, Gallego J, Jimenez-Cruz JF.","first_author":"Osca JM","journal":"British journal of urology","year":1991,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case series of 8 self‑inserted foreign bodies, descriptive data only.","sample_n":8,"sample_text":"Eight cases reported from 1976‑1990.","population":"Patients (mixed gender, ages) presenting with urethral/bladder foreign bodies, some with psychiatric illness.","country":"Not specified (likely UK based on journal).","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes eight patients who inserted unusual objects into their urethra or bladder, often for masturbatory reasons. It outlines the types of objects, symptoms, and surgical removal methods.","clinical_takeaway":"Clinicians should consider self‑injurious sexual behavior when patients present with urinary symptoms and assess mental health.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Detailed clinical descriptions of rare cases","Highlights need for urological awareness of self‑injurious behavior"],"limitations":["Very small, non‑representative sample","No systematic assessment of psychological or sexual factors","No quantitative analysis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":37,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1464-410x.1991.tb15395.x"}},{"id":4892,"doi":"10.1016/j.jpedsurg.2008.10.111","pmid":"19635293","pmcid":null,"title":"Long-term physical, hormonal, and sexual outcome of males with disorders of sex development","authors":"Kojima Y, Mizuno K, Nakane A, Kato T, Kohri K, Hayashi Y.","first_author":"Kojima Y","journal":"Journal of pediatric surgery","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional assessment of 12 adult males with DSD; physical, hormonal, and self‑reported sexual outcomes measured once.","sample_n":12,"sample_text":"Twelve DSD patients (average age, 21.0 ± 3.6 y) were enrolled.","population":"12 males with various forms of disorders of sex development, average age 21 ± 3.6 y, recruited from a pediatric surgery follow‑up clinic.","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 12 men who were raised as male despite having intersex conditions, doctors found small penises and testes and abnormal hormone levels, but most reported being able to get erections, masturbate, and have sex with women.","clinical_takeaway":"Most DSD males retain sexual function if testes are preserved, but careful hormonal monitoring is needed.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Rare clinical population","Comprehensive physical, hormonal, and basic sexual outcomes"],"limitations":["Very small sample; no statistical power","No validated sexual‑function instruments","No control for mental‑health, relational, or moral factors"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":19,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpedsurg.2008.10.111"}},{"id":4894,"doi":"10.2147/ijgm.s4674","pmid":"20360887","pmcid":"PMC2840579","title":"Prevalence of hypersexual behavior in Parkinson's disease patients: Not restricted to males and dopamine agonist use","authors":"Cooper CA, Jadidian A, Paggi M, Romrell J, Okun MS, Rodriguez RL, Fernandez HH.","first_author":"Cooper CA","journal":"International journal of general medicine","year":2009,"pub_types":["research-article","Journal Article"],"keywords":["Dopamine agonists","Parkinson’s Disease","Impulsive Behavior","Hypersexuality"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC2840579","cited_by_count":18,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Mail‑in survey of 141 Parkinson’s disease patients from a single movement‑disorders clinic; prevalence estimate of hypersexual behavior with follow‑up interview.","sample_n":141,"sample_text":"141 completed surveys (out of 400 mailed)","population":"Patients with Parkinson’s disease (N=141 respondents, 35% response rate)","country":"USA (likely; based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 141 Parkinson’s patients, about 4 % showed clinically significant hypersexual behavior, including compulsive masturbation and other risky sexual acts. This occurred in both men and women and was not linked to dopamine‑agonist medication.","clinical_takeaway":"Clinicians should screen all Parkinson’s patients for hypersexual behavior, not just males or those on dopamine agonists.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","csbd"],"strengths":["Focus on a understudied PD symptom","Use of follow‑up clinical interview to confirm cases"],"limitations":["Low response rate; possible self‑selection bias","No validated hypersexuality instrument reported","Limited control for psychological or relational confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":30,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/ijgm.s4674"}},{"id":4895,"doi":"10.1016/0379-0738(91)90201-s","pmid":"1752585","pmcid":null,"title":"Semen finger print","authors":"Doss SH, Louca NA.","first_author":"Doss SH","journal":"Forensic science international","year":1991,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"laboratory validation of testosterone/dihydrotestosterone ratio for individual semen identification; includes coital and masturbated samples","sample_n":null,"sample_text":"not specified","population":"male donors; sample size not reported in abstract","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study shows that the ratio of testosterone to dihydrotestosterone in semen is stable for each man, offering a biochemical ‘fingerprint’ that could help identify the source of semen in forensic cases.","clinical_takeaway":"None - not clinically applicable.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Biochemical assay with potential forensic utility","Includes both coital and masturbated semen samples"],"limitations":["Sample size and participant characteristics not reported","Statistical details (effect sizes, power) absent","No control for potential biological confounders (e.g., age, health status)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0379-0738(91)90201-s"}},{"id":4897,"doi":"10.1093/humrep/dep267","pmid":"19625312","pmcid":null,"title":"Re: Fertility preservation in adolescent males: experience over 22 years at Rouen University Hospital","authors":"Carmignani L.","first_author":"Carmignani L.","journal":"Human reproduction (Oxford, England)","year":2009,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/humrep/dep267"}},{"id":4898,"doi":"10.1192/bjp.159.3.371","pmid":"1958948","pmcid":null,"title":"Age, transvestism, bondage, and concurrent paraphilic activities in 117 fatal cases of autoerotic asphyxia","authors":"Blanchard R, Hucker SJ.","first_author":"Blanchard R","journal":"The British journal of psychiatry : the journal of mental science","year":1991,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":54,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of 117 male deaths examined via coroners’ files; cross‑sectional, descriptive analysis of age, bondage, transvestism and other paraphilic behaviours.","sample_n":117,"sample_text":"117 males aged 10‑56 who died accidentally during autoerotic asphyxial activities.","population":"Male, age 10‑56, fatal autoerotic asphyxia cases (Canada).","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Examining 117 men who died during autoerotic asphyxia, researchers found older victims were more likely to incorporate bondage or cross‑dressing into their rituals, suggesting these practices become more elaborate with age.","clinical_takeaway":"Fatal autoerotic behaviors may evolve over time; clinicians should assess for multiple paraphilic activities when addressing risky sexual practices.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["large case series for a rare fatal phenomenon","systematic extraction of coronial data","clear age‑related patterns"],"limitations":["No validated measures of paraphilic behaviours","No control/comparison group","Descriptive only, no inferential statistics","Findings not generalisable to non‑fatal or general population"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":0,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":2,"contrasting":0,"mentioning":32,"citing_publications":116,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/bjp.159.3.371"}},{"id":4899,"doi":"10.1080/00224490902754103","pmid":"19199141","pmcid":null,"title":"Conscious regulation of sexual arousal in men","authors":"Winters J, Christoff K, Gorzalka BB.","first_author":"Winters J","journal":"Journal of sex research","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["bibliography","csbd","masturbation","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"laboratory experiment measuring physiological and cognitive sexual arousal regulation after an online questionnaire battery","sample_n":null,"sample_text":"sample size not reported in abstract","population":"men, adult (young, middle‑aged, older)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested whether men can voluntarily lower sexual arousal using an emotional‑reappraisal strategy. Men who were good at regulating amusement also tended to control sexual arousal, but results varied widely. Higher sexual excitement and desire made regulation harder, while fear of performance problems helped.","clinical_takeaway":"Emotion‑regulation training may help some men manage unwanted sexual arousal, but individual differences are large.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Laboratory measurement of physiological arousal adds objective data","Links emotion‑regulation ability across domains (humor and sexual arousal)","Considers multiple sexual‑psychology variables (excitation, inhibition, desire)"],"limitations":["Abstract provides no sample size or power information","Key confounds (moral views, masturbation, mental health, relationship context, trauma) not addressed","Reliance on self‑report questionnaires; unclear whether scales are fully validated"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":24,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490902754103"}},{"id":4900,"doi":"10.1515/ijamh.2009.21.3.319","pmid":"20014635","pmcid":null,"title":"Sexuality and persons with Down syndrome. A study from Brazil","authors":"Bononi BM, Sant'Anna MJ, de Oliveira AC, Renattini TS, Pinto CF, Passarelli ML, Coates V, Omar HA.","first_author":"Bononi BM","journal":"International journal of adolescent medicine and health","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Descriptive cross‑sectional survey of 50 adolescents with Down syndrome in Brazil.","sample_n":50,"sample_text":"50 patients with DS between the ages of 10 and 20 years.","population":"Adolescents with Down syndrome, ages 10‑20, Brazil (n≈50).","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Brazilian sample of 50 teenagers with Down syndrome, about half reported masturbating (often daily) and many had normal sexual development and body image, though they showed limited autonomy in daily tasks.","clinical_takeaway":"Adolescents with Down syndrome can have typical sexual development, but clinicians should assess and support autonomy and social integration.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides rare data on sexuality in DS adolescents","Includes both behavioral (masturbation) and autonomy measures"],"limitations":["Small convenience sample, limited generalisability","No validated sexuality or mental‑health instruments","No control for confounding variables (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/ijamh.2009.21.3.319"}},{"id":4901,"doi":"10.1089/apc.2008.0249","pmid":"19534602","pmcid":"PMC2856496","title":"Beyond anal sex: sexual practices associated with HIV risk reduction among men who have sex with men in Boston, Massachusetts","authors":"Reisner SL, Mimiaga MJ, Skeer M, Mayer KH.","first_author":"Reisner SL","journal":"AIDS patient care and STDs","year":2009,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 189 MSM in Boston, logistic regression analysis of self‑reported sexual risk‑reduction behaviors and psychosocial factors","sample_n":189,"sample_text":"One hundred eighty‑nine MSM completed a one‑time behavioral and psychosocial assessment","population":"adult men who have sex with men (MSM) from greater Boston, Massachusetts; convenience sample","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 189 gay and bisexual men in Boston, about one‑fifth reported using practices like rimming, mutual masturbation, or condoms to lower HIV risk. Those who used these strategies were more likely to be open about their sexuality and less likely to be depressed, drink alcohol during sex, or meet partners in cruising areas.","clinical_takeaway":"Promoting diverse, low‑risk sexual practices and addressing depression may help reduce HIV risk among MSM.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Validated depression scale (CES‑D)","Multivariable logistic regression controlling for several covariates","Focus on a range of risk‑reduction practices beyond condom use"],"limitations":["Cross‑sectional design; cannot infer causality","Convenience sample limits generalisability","Sexual behavior measures are self‑report and not validated scales"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":0,"mentioning":39,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/apc.2008.0249"}},{"id":4903,"doi":"10.2298/sarh0908409s","pmid":"19764596","pmcid":null,"title":"General characteristics of adolescent sexual behaviour: national survey","authors":"Stanković M, Miljković S, Grbesa G, Visnjić A.","first_author":"Stanković M","journal":"Srpski arhiv za celokupno lekarstvo","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"http://www.doiserbia.nb.rs/ft.aspx?id=0370-81790908409S","cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"national survey of 1101 Serbian adolescents (13‑25 y), questionnaire devised for study","sample_n":1101,"sample_text":"1101 adolescents (472 male, 629 female)","population":"Adolescents and young adults in Serbia","country":"Serbia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2009 Serbian national survey of 1,101 adolescents (13‑25 y) described patterns of sexual activity, condom use, masturbation, and experiences of rape and abortion, highlighting low condom use and gaps in sexual education.","clinical_takeaway":"Adolescents in Serbia show high premarital sexual activity and low condom use; improved sexual education is needed.","confidence":0.78,"topic_tags":["adolescents","sexual_function","masturbation"],"strengths":["Large sample size for a national survey","Broad coverage of sexual behaviour variables","Provides baseline data for Serbian adolescents"],"limitations":["Questionnaire appears study‑specific and unvalidated","No measurement or control of key confounds (e.g., mental health, moral/religious factors)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":9,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2298/sarh0908409s"}},{"id":4906,"doi":"10.1016/j.urology.2008.05.059","pmid":"19482170","pmcid":null,"title":"Re: Stancik et al: Effect of antibiotic therapy on interleukin-6 in fresh semen and postmasturbation urine samples of patients with chronic prostatitis/chronic pelvic pain syndrome. (Urology 2008;72: 336-339)","authors":"Berger RE.","first_author":"Berger RE.","journal":"Urology","year":2009,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urology.2008.05.059"}},{"id":4908,"doi":"10.1016/0091-3057(91)90408-t","pmid":"1833778","pmcid":null,"title":"Quinelorane (LY163502), a D2 dopamine receptor agonist, acts centrally to facilitate penile erections of male rhesus monkeys","authors":"Pomerantz SM.","first_author":"Pomerantz SM.","journal":"Pharmacology, biochemistry, and behavior","year":1991,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"controlled laboratory pharmacology experiment in rhesus monkeys with within‑subject dose manipulation and antagonist blockade","sample_n":null,"sample_text":"Not reported in abstract; typical N for such studies is small (≈5‑10)","population":"male rhesus monkeys (Macaca mulatta)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In male rhesus monkeys, a dopamine‑D2 agonist (quinelorane) increased penile erections and masturbation at low doses, an effect blocked by a central dopamine antagonist but not a peripheral one, suggesting central dopamine drives sexual arousal.","clinical_takeaway":"Central dopamine pathways influence male sexual arousal; pharmacological modulation could affect erectile function, but human relevance remains uncertain.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","prevalence"],"strengths":["Clear dose‑response manipulation of a specific D2 agonist","Use of both central and peripheral antagonists to locate site of action","Objective behavioral observations of erections and masturbation"],"limitations":["Small, unspecified sample size typical of primate work","Findings from non‑human primates may not translate directly to humans","No assessment of broader psychosocial factors"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0091-3057(91)90408-t"}},{"id":4909,"doi":"10.1016/j.yhbeh.2009.04.007","pmid":"19409392","pmcid":null,"title":"Are gonadal steroids linked with orgasm perceptions and sexual assertiveness in women and men?","authors":"van Anders SM, Dunn EJ.","first_author":"van Anders SM","journal":"Hormones and behavior","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 86 women and 91 men; saliva hormone assay and self‑report questionnaires on orgasm experience, sexual assertiveness and desire.","sample_n":177,"sample_text":"86 women, 91 men","population":"adult men and women, likely convenience/student sample","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 177 adults, higher testosterone in women was linked to feeling more relaxed and peaceful during orgasm, while higher estradiol was linked to physical sensations of orgasm. No hormone‑orgasm links were found for men, and testosterone did not predict sexual assertiveness.","clinical_takeaway":"Hormone levels may shape how women experience orgasm, but the findings are correlational and not ready for clinical use.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Validated questionnaires for orgasm and sexual assertiveness","Objective hormone measurement from saliva","Separate analysis of solitary vs partnered orgasm"],"limitations":["Cross‑sectional; cannot infer causality","Convenience sample, likely WEIRD, limits generalisability","No control for mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":4,"mentioning":53,"citing_publications":91,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.yhbeh.2009.04.007"}},{"id":4910,"doi":"10.1111/j.1743-6109.2009.01248.x","pmid":"19473282","pmcid":null,"title":"Selective serotonin reuptake inhibitor-induced sexual dysfunction","authors":"Corona G, Ricca V, Bandini E, Mannucci E, Lotti F, Boddi V, Rastrelli G, Sforza A, Faravelli C, Forti G, Maggi M.","first_author":"Corona G","journal":"The journal of sexual medicine","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":82,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 2,040 male patients presenting with sexual dysfunction; consecutive clinical sample","sample_n":2040,"sample_text":"consecutive series of 2,040 male patients","population":"male patients, mean age 51, seeking care for sexual dysfunction","country":"unspecified (likely Italy given author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 2,040 men with sexual problems, those taking SSRIs were twice as likely to have low sexual desire and much more likely to experience delayed ejaculation compared with men on other drugs. Hormone changes (higher prolactin) were also seen with SSRIs.","clinical_takeaway":"SSRIs are strongly linked to multiple male sexual side‑effects; clinicians should discuss these risks and consider alternatives when appropriate.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large sample size","Validated sexual dysfunction interview (SIEDY)","Hormonal measurements add objective data"],"limitations":["Cross‑sectional; cannot infer causality","Clinical convenience sample limits generalisability","Moral or religiosity factors not assessed","Potential confounding by underlying mood disorder"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":93,"citing_publications":129,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01248.x"}},{"id":4911,"doi":null,"pmid":"22837585","pmcid":"PMC3403820","title":"[Sexual Behavior and Self-Efficacy for the Negotiation of Safer Sex in Heterosexual Persons.]","authors":"Pérez-Jiménez D, Santiago-Rivas M, Serrano-García I.","first_author":"Pérez-Jiménez D","journal":"Revista interamericana de psicologia = Interamerican journal of psychology","year":2009,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross‑sectional questionnaire study of 447 heterosexual adults (convenience sample)","sample_n":447,"sample_text":"447 sexually active heterosexual adults completed a self‑administered questionnaire","population":"sexually active heterosexual adults (unspecified recruitment method)","country":"Mexico (based on journal language and author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A questionnaire of 447 heterosexual adults found low condom and mutual‑masturbation use, especially in steady relationships, despite participants reporting high confidence in their ability to practice safer sex.","clinical_takeaway":"High self‑efficacy alone may not increase condom or mutual‑masturbation use; interventions should address additional barriers.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample size for a survey (N=447)","Addresses both condom use and mutual masturbation as safer‑sex strategies","Assesses self‑efficacy, a theoretically relevant predictor"],"limitations":["Use of author‑developed, likely unvalidated scales","Cross‑sectional design cannot infer causality","No control for key confounds (e.g., moral attitudes, mental health, partner context)","Sampling method unclear; possible volunteer bias"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":4912,"doi":null,"pmid":"19478365","pmcid":null,"title":"Online health information needs of unmet young people","authors":"Yamuna S.","first_author":"Yamuna S.","journal":"Indian pediatrics","year":2009,"pub_types":["Letter","Comparative Study"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"descriptive analysis of 963 emailed queries from young people; cross‑sectional survey","sample_n":963,"sample_text":"963 queries obtained through e‑mails from unmet young people","population":"young people who sent health‑related email queries (self‑selected)","country":"India (inferred from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined 963 email questions sent by young people. Boys asked more about sexuality and masturbation, while girls focused on depression and loneliness, highlighting gender differences in health information needs.","clinical_takeaway":"Clinicians should expect gender‑specific health queries from adolescents, with boys more likely to raise sexual topics.","confidence":0.7,"topic_tags":["sexual_function","masturbation","adolescents"],"strengths":["Large number of real‑world queries (N=963)","Provides insight into gender differences in health information seeking"],"limitations":["No validated measurement instruments","Self‑selected sample limits generalisability","No control for moral, mental‑health or other confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4913,"doi":"10.3899/jrheum.080867","pmid":"19411396","pmcid":null,"title":"Effect of musculoskeletal pain on sexuality of male adolescents and adults with juvenile idiopathic arthritis","authors":"de Avila Lima Souza L, Gallinaro AL, Abdo CH, Kowalski SC, Suehiro RM, da Silva CA, Goldenstein-Schainberg C.","first_author":"de Avila Lima Souza L","journal":"The Journal of rheumatology","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional comparison of 32 JIA patients with 120 matched controls","sample_n":152,"sample_text":"32 patients, 120 controls","population":"male adolescents and young adult (16‑26 yr) with RF‑negative polyarticular JIA, inactive disease","country":"Brazil (presumed from authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers created a short questionnaire to study sexual activity in young men with juvenile arthritis. Compared with healthy peers, they reported similar desire and satisfaction, but joint pain during intercourse was more common.","clinical_takeaway":"Most young men with inactive JIA maintain normal sexual desire and satisfaction; clinicians should address joint pain during sex when present.","confidence":0.8,"topic_tags":["sexual_function","adolescents","religiosity","masturbation"],"strengths":["Clear comparison with age‑matched control group","Inclusion of functional disability (HAQ) alongside sexual outcomes","Focus on a specific clinical population often overlooked"],"limitations":["Very small patient sample; limited power to detect differences","Newly created sexual questionnaire lacks validation","No assessment of psychological or relational confounders"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3899/jrheum.080867"}},{"id":4914,"doi":"10.1111/j.1743-6109.2009.01297.x","pmid":"19453897","pmcid":null,"title":"Emotional intelligence and its association with orgasmic frequency in women","authors":"Burri AV, Cherkas LM, Spector TD.","first_author":"Burri AV","journal":"The journal of sexual medicine","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Large community sample (N=2035) from TwinsUK registry; self‑report questionnaire; cross‑sectional analysis with logistic regression.","sample_n":2035,"sample_text":"2035 women recruited from the TwinsUK registry.","population":"Women, mean age not specified, from a UK twin registry (predominantly White, middle‑aged).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 2000 UK women, higher emotional intelligence was linked to more frequent orgasms during both sex and masturbation. Women with the lowest emotional‑intelligence scores were about twice as likely to report infrequent orgasms.","clinical_takeaway":"Assessing emotional‑intelligence skills may help identify women at risk for low orgasmic frequency and guide therapeutic focus.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, well‑powered sample.","Validated measure for emotional intelligence.","Separate assessment of intercourse and masturbation orgasm frequency."],"limitations":["Orgasm frequency measured with ad‑hoc, non‑validated items.","No assessment of moral incongruence, mental‑health status, or partner factors.","Cross‑sectional design limits causal inference."],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":3,"mentioning":32,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01297.x"}},{"id":4915,"doi":"10.1111/j.1743-6109.2009.01303.x","pmid":"19453891","pmcid":null,"title":"Satisfaction (sexual, life, relationship, and mental health) is associated directly with penile-vaginal intercourse, but inversely with other sexual behavior frequencies","authors":"Brody S, Costa RM.","first_author":"Brody S","journal":"The journal of sexual medicine","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":131,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large, nationally representative survey of 2,810 Swedish adults; multivariate regression analysis","sample_n":2810,"sample_text":"representative sample of Swedes","population":"Swedish adults (age range not specified)","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative Swedish survey, more frequent penile‑vaginal intercourse was linked to higher sexual, life, partnership and mental‑health satisfaction, while more frequent masturbation and non‑coital sex were linked to lower satisfaction.","clinical_takeaway":"Higher frequency of penile‑vaginal intercourse associates with greater reported well‑being, but causality cannot be inferred.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Large, nationally representative sample","Separate measurement of PVI, non‑coital sex, and masturbation frequencies","Multivariate analysis controlling for age"],"limitations":["Cross‑sectional design cannot establish causality","No assessment of moral/religious attitudes or other psychosocial confounds","Satisfaction measures not described; possible reliance on single‑item scales"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":31,"contrasting":5,"mentioning":198,"citing_publications":213,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01303.x"}},{"id":4916,"doi":"10.1111/j.1743-6109.2009.01290.x","pmid":"19453874","pmcid":null,"title":"Prevalence and characteristics of vibrator use by men in the United States","authors":"Reece M, Herbenick D, Sanders SA, Dodge B, Ghassemi A, Fortenberry JD.","first_author":"Reece M","journal":"The journal of sexual medicine","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Population‑based cross‑sectional survey of 1,047 US men (age 18‑60), weighted analyses.","sample_n":1047,"sample_text":"Population‑based cross‑sectional survey","population":"Men aged 18‑60 in the United States (n≈1,047)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"About 45% of US men have ever used a vibrator, and recent users report better erectile function, orgasmic function, desire and sexual satisfaction compared with non‑users.","clinical_takeaway":"Vibrator use is common and linked to higher self‑reported sexual function in men; clinicians may consider it a positive sexual health tool.","confidence":0.9,"topic_tags":["prevalence","sexual_function","masturbation"],"strengths":["Large, nationally‑representative sample","Validated sexual function measure (IIEF)","Weighted analyses to account for sampling"],"limitations":["Self‑report of vibrator use, single‑item measurement","Cross‑sectional; cannot infer causality","Limited control for mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":0,"mentioning":68,"citing_publications":88,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01290.x"}},{"id":4919,"doi":"10.1177/070674379103600233","pmid":"2044038","pmcid":null,"title":"Tourette syndrome and recurrent paraphilic masturbatory fantasy","authors":"Kerbeshian J, Burd L.","first_author":"Kerbeshian J","journal":"Canadian journal of psychiatry. Revue canadienne de psychiatrie","year":1991,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":1,"mentioning":4,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/070674379103600233"}},{"id":4920,"doi":"10.4103/0970-1591.52942","pmid":"19672365","pmcid":"PMC2710083","title":"An innovative surgical technique for treating penile incarceration injury caused by heavy metallic ring","authors":"Baruah SJ, Bagchi PK, Barua SK, Deka PM.","first_author":"Baruah SJ","journal":"Indian journal of urology : IJU : journal of the Urological Society of India","year":2009,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Retrieval","Metallic Ring","Penile Incarceration Injury"],"is_oa":true,"oa_url":"https://doi.org/10.4103/0970-1591.52942","cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report describing a novel surgical technique for penile incarceration injury (Grades II‑III); no control group, no statistical analysis","sample_n":1,"sample_text":"one patient","population":"single adult male with penile incarceration from a metallic ring","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors report a new surgical method to safely remove a heavy metal ring that became stuck on a man's penis, a rare injury usually caused by auto‑erotic use. The technique worked for moderate‑grade injuries and may help surgeons treat similar cases.","clinical_takeaway":"For moderate penile ring incarcerations, this described technique offers a possible surgical option, but evidence is limited to one case.","confidence":0.6,"topic_tags":["sexual_function","gender"],"strengths":["Provides a detailed description of a novel surgical approach","Addresses a rare clinical scenario","Includes intra‑operative images/illustrations (assumed from case report format)"],"limitations":["Single case; no comparative data","No statistical analysis or outcome metrics beyond narrative","Limited generalisability to broader populations"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0970-1591.52942"}},{"id":4921,"doi":null,"pmid":"19364429","pmcid":null,"title":"Fracture of the penis: a radiological or clinical diagnosis? A case series and literature review","authors":"Agarwal MM, Singh SK, Sharma DK, Ranjan P, Kumar S, Chandramohan V, Gupta N, Acharya NC, Bhalla V, Mavuduru R, Mandal AK.","first_author":"Agarwal MM","journal":"The Canadian journal of urology","year":2009,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 17 patients with penile fracture, descriptive outcomes, no control group","sample_n":17,"sample_text":"seventeen patients presenting between 2002 and 2007","population":"adult males, median age 36, presenting with suspected penile fracture","country":"India (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 17 men with suspected penile fracture, doctors found that a good history and physical exam were enough to decide on surgery; ultrasound and MRI added little value.","clinical_takeaway":"For suspected penile fracture, focus on history and exam; imaging can often be omitted.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Detailed clinical description of a rare condition","Includes imaging and surgical confirmation","Follow‑up data on functional outcome"],"limitations":["Small, non‑random sample; no control group","Descriptive case series limits causal inference","Imaging use not systematic, limits comparative conclusions"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":4923,"doi":"10.1176/appi.psychotherapy.1991.45.1.14","pmid":"2018192","pmcid":null,"title":"Semen-loss syndrome: a comparison between Sri Lanka and Japan","authors":"Dewaraja R, Sasaki Y.","first_author":"Dewaraja R","journal":"American journal of psychotherapy","year":1991,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑cultural survey of 35 psychiatric patients in Sri Lanka and university samples in Sri Lanka and Japan; questionnaire on negative attitudes toward semen loss.","sample_n":35,"sample_text":"35 non‑psychotic patients; additional university participants (number not reported)","population":"Adult males (psychiatric patients and university students) in Sri Lanka and Japan","country":"Sri Lanka; Japan","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study found that Sri Lankan patients and university members hold much more negative beliefs about semen loss from masturbation or emissions than Japanese participants, suggesting cultural attitudes may shape how physical and mental complaints are expressed.","clinical_takeaway":"Cultural beliefs about semen loss can influence symptom presentation; clinicians should assess such beliefs when evaluating related complaints.","confidence":0.7,"topic_tags":["masturbation","csbd"],"strengths":["Cross‑cultural comparison highlights cultural belief impact","Inclusion of both clinical and general population samples"],"limitations":["Small clinical sample; university sample size not disclosed","Non‑validated questionnaire","Limited control of mental‑health and relationship confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.psychotherapy.1991.45.1.14"}},{"id":4924,"doi":"10.1111/j.1744-6163.1991.tb00329.x","pmid":"2008326","pmcid":null,"title":"Death from auto-erotic asphyxiation in a long-term psychiatric setting","authors":"Cosgray RE, Hanna V, Fawley R, Money M.","first_author":"Cosgray RE","journal":"Perspectives in psychiatric care","year":1991,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single case","population":"adult psychiatric inpatients (male)","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The report describes one psychiatric patient who died while engaging in auto‑erotic asphyxiation, a practice used to intensify masturbatory pleasure, and discusses nursing considerations.","clinical_takeaway":"Clinicians should be aware of auto‑erotic asphyxiation risks in psychiatric settings and monitor patients using risky sexual practices.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Highlights rare fatal outcome","Provides clinical nursing implications"],"limitations":["Single case, no systematic data","No validated measures of behavior or distress","No control for confounding factors"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1744-6163.1991.tb00329.x"}},{"id":4925,"doi":"10.1176/appi.psychotherapy.1991.45.1.9","pmid":"2018201","pmcid":null,"title":"Semen-conservation doctrine from ancient Ayurvedic to modern sexological theory","authors":"Money J, Prakasam KS, Joshi VN.","first_author":"Money J","journal":"American journal of psychotherapy","year":1991,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Historical overview without empirical data","sample_n":null,"sample_text":"No participants; article is a historical review.","population":"none","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article traces the doctrine that preserving semen is vital for health, showing its roots in ancient Indian Ayurveda and its later adoption in European medicine, where it fueled fears about masturbation and disease.","clinical_takeaway":"None – the paper is historical and does not provide clinical guidance.","confidence":0.6,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["Comprehensive historical synthesis from ancient to modern texts","Connects Ayurvedic concepts with Western medical history"],"limitations":["No empirical data or systematic review methodology","Lacks contemporary scientific evidence on health outcomes"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.psychotherapy.1991.45.1.9"}},{"id":4927,"doi":"10.1055/s-0029-1202302","pmid":"19247915","pmcid":null,"title":"Reproduction in men with Klinefelter syndrome: the past, the present, and the future","authors":"Paduch DA, Bolyakov A, Cohen P, Travis A.","first_author":"Paduch DA","journal":"Seminars in reproductive medicine","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":51,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Review article summarizing literature on Klinefelter syndrome and reproductive techniques; no primary data collection.","sample_n":null,"sample_text":"Not applicable – review of existing studies.","population":"Men with Klinefelter syndrome (adolescents and adults), primarily clinical/research settings.","country":"Not specified (international literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarizes current knowledge about how men with Klinefelter syndrome can achieve biological fatherhood using hormonal treatment and assisted‑reproductive technologies, highlighting recent advances and future research directions.","clinical_takeaway":"Men with Klinefelter syndrome can consider sperm‑retrieval and IVF/ICSI to father children, but counseling and multidisciplinary care are essential.","confidence":0.9,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Comprehensive overview of KS reproductive care","Integrates recent advances in assisted reproduction"],"limitations":["No primary data; conclusions rely on cited studies","Potential selection bias toward positive outcomes in cited literature"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":77,"citing_publications":77,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-0029-1202302"}},{"id":4928,"doi":"10.1007/s10508-008-9465-3","pmid":"19224354","pmcid":null,"title":"Onanism and child sexual abuse: a comparative study of two hypotheses","authors":"Malón A.","first_author":"Malón A.","journal":"Archives of sexual behavior","year":2010,"pub_types":["Comparative Study","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Comparative narrative review of historical hypotheses; no empirical data, no systematic methods reported.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"background","plain_summary":"The article compares the historical moral panic over onanism (masturbation) with modern assumptions that all child sexual abuse is inherently harmful, arguing that both are based on untested, moralistic theories.","clinical_takeaway":"None - not clinically applicable.","confidence":0.6,"topic_tags":["masturbation","sexual_function","csbd"],"strengths":["Broad historical perspective","Attempts to draw parallels between two controversial theories"],"limitations":["No empirical data or systematic methodology","Lacks measurement of key constructs","Potential bias against CSA hypothesis"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-008-9465-3"}},{"id":4930,"doi":null,"pmid":"2251172","pmcid":null,"title":"Demystifying masturbation","authors":"Flanagan L.","first_author":"Flanagan L.","journal":"Nursing times","year":1990,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4932,"doi":"10.1212/01.wnl.0000341936.78678.3a","pmid":"19204265","pmcid":null,"title":"Nonviolent elaborate behaviors may also occur in REM sleep behavior disorder","authors":"Oudiette D, De Cock VC, Lavault S, Leu S, Vidailhet M, Arnulf I.","first_author":"Oudiette D","journal":"Neurology","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":94,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Case series of 24 reported/observed incidents plus prospective interview of 100 Parkinson’s patients (60 with RBD) to estimate frequency of non‑violent behaviors.","sample_n":100,"sample_text":"Prospective series of 100 PD patients (60 with RBD); 24 incidental case reports.","population":"Adults with Parkinson’s disease (and other neurodegenerative conditions) who have REM sleep behavior disorder.","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study reports that people with REM sleep behavior disorder can act out non‑violent scenes during sleep, including sexual actions like masturbating‑like movements, along with eating, drinking, and speaking. About 18% of Parkinson’s patients with RBD showed such behaviours.","clinical_takeaway":"Clinicians should be aware that RBD may involve sexual behaviours, which could have safety and legal implications for patients and bed partners.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Novel documentation of non‑violent behaviors in RBD","Use of video‑polysomnography for objective observation","Prospective interview of a relatively large PD cohort"],"limitations":["Descriptive case series without validated behavior scales","No control group for neurobiological inference","Limited statistical analysis; no power calculation"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":6,"contrasting":0,"mentioning":73,"citing_publications":159,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1212/01.wnl.0000341936.78678.3a"}},{"id":4934,"doi":"10.1007/s11920-009-0002-4","pmid":"19187702","pmcid":null,"title":"Sexual functioning in older adults","authors":"DeLamater J, Karraker A.","first_author":"DeLamater J","journal":"Current psychiatry reports","year":2009,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":48,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without original data","sample_n":null,"sample_text":"No original sample; review of existing studies","population":"older adults (mixed gender, community samples referenced)","country":"International (review of multiple studies)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review summarises how biology, psychology, and social context affect sexual activity in older adults, noting declines in frequency but highlighting the importance of partner relationships, hormones, and health.","clinical_takeaway":"Older adults’ sexual health is shaped by multiple factors; clinicians should consider partner status, health, and psychosocial context when addressing sexual concerns.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad synthesis of medical and social science literature","Inclusion of both solo and partnered sexual activity"],"limitations":["No systematic review methodology","Lack of critical appraisal of cited studies","No quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":93,"citing_publications":107,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11920-009-0002-4"}},{"id":4935,"doi":"10.13109/prkk.2009.58.3.186","pmid":"19435153","pmcid":null,"title":"[Children and adolescents with sexual behaviour problems in residential and partially residential welfare services]","authors":"Schuhrke B, Arnold J.","first_author":"Schuhrke B","journal":"Praxis der Kinderpsychologie und Kinderpsychiatrie","year":2009,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Secondary analysis of a questionnaire (EVAS) completed at admission of >5,000 youths in German residential/welfare services; compares those with sexual‑behaviour problems to non‑sexual symptom controls.","sample_n":5000,"sample_text":"More than 5,000 children and adolescents","population":"Children and adolescents in residential or partially residential child‑welfare settings (Germany); sample size ≈5,000.","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used data from over 5,000 German youths in residential welfare care to describe how many have sexual‑behaviour problems, their comorbid mental‑health issues, and service use, comparing them to peers without such problems.","clinical_takeaway":"Clinicians should note that sexual‑behaviour problems are common in child‑welfare settings and often co‑occur with other mental‑health disorders.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size","First estimate of prevalence in German welfare system","Provides comorbidity information"],"limitations":["Convenience sample from treatment‑seeking youth, not general population","Limited detail on measurement validity","No control for moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.13109/prkk.2009.58.3.186"}},{"id":4939,"doi":"10.1016/j.encep.2008.06.013","pmid":"19853724","pmcid":null,"title":"[The case of temporal lobes dysfunction in atypical psychiatric episodes]","authors":"Gabison-Hermann D, Pelletier A, Taleb M, Bouleau JH.","first_author":"Gabison-Hermann D","journal":"L'Encephale","year":2009,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","masturbation"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with temporal epilepsy presenting hypersexuality and KBS symptoms","sample_n":1,"sample_text":"single clinical case","population":"37‑year‑old male with temporal epilepsy","country":"France (assumed from journal L'Encephale)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 37‑year‑old man with temporal‑lobe epilepsy showed unusual psychiatric episodes including intense sexual urges, exhibitionism, and visual agnosia. Brain scans revealed reduced blood flow in both temporal lobes, suggesting a Klüver‑Bucy‑like syndrome despite normal MRI.","clinical_takeaway":"Hypersexuality can arise from temporal‑lobe dysfunction; clinicians should consider neurological causes when encountering abrupt sexual changes.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed clinical description of a rare syndrome","Multi‑modal imaging (MRI & SPECT) reported"],"limitations":["Single case, no control group","No validated measures of hypersexuality or distress","No assessment of confounding factors (mood, trauma, moral beliefs)"],"rubric_version":"2.0","raw_total":12,"max_possible":60,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":2,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.encep.2008.06.013"}},{"id":4940,"doi":null,"pmid":"2380679","pmcid":null,"title":"Sexual function and practice in elderly men of lower socioeconomic status","authors":"Cogen R, Steinman W.","first_author":"Cogen R","journal":"The Journal of family practice","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Physician‑administered interviews with 87 lower‑SES elderly men at a VA geriatric clinic; prevalence and practices reported.","sample_n":87,"sample_text":"87 men attending an urban Veterans Administration geriatric clinic","population":"elderly men (≥65) of lower socioeconomic status, US Veterans","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 87 low‑income older men, about a third reported total or frequent erectile problems. Fewer used alternative sexual activities like mutual masturbation or oral sex compared with wealthier peers, and many held negative attitudes toward these practices.","clinical_takeaway":"Erectile dysfunction in low‑SES older men often leads to cessation of partnered sex; clinicians should discuss alternative sexual activities and address negative attitudes.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Focus on understudied low‑SES elderly men","Direct physician interview format","Provides prevalence data for erectile dysfunction and alternative practices"],"limitations":["Small, non‑representative convenience sample","No validated measurement instruments","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":4941,"doi":"10.1007/s10508-008-9416-z","pmid":"19067153","pmcid":null,"title":"Renegotiating sexuality and intimacy in the context of cancer: the experiences of carers","authors":"Gilbert E, Ussher JM, Perz J.","first_author":"Gilbert E","journal":"Archives of sexual behavior","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":66,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Cross‑sectional qualitative interview study with 20 carers; grounded‑theory analysis.","sample_n":20,"sample_text":"Twenty participants were interviewed across a range of cancer types, stages, and age groups.","population":"Partners/caregivers of adults with cancer (Australia).","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 20 partners caring for people with cancer reveal how they adapt sexual intimacy when intercourse is no longer possible, using activities like mutual or solo masturbation, oral sex, and affection. Success depends on communication and moving away from a focus on penetrative sex.","clinical_takeaway":"Clinicians should discuss a range of intimate activities with couples facing cancer‑related sexual changes, not just intercourse.","confidence":0.8,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Provides rich, first‑person accounts of intimacy renegotiation.","Highlights under‑researched perspective of carers."],"limitations":["Small, non‑representative convenience sample.","No validated measurement instruments; qualitative only.","Findings not generalisable beyond Australian carers."],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":7,"contrasting":0,"mentioning":84,"citing_publications":119,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-008-9416-z"}},{"id":4942,"doi":"10.1016/j.psc.2008.06.009","pmid":"18996300","pmcid":null,"title":"Sexual behavior that is \"out of control\": a theoretical conceptual approach","authors":"Bancroft J.","first_author":"Bancroft J.","journal":"The Psychiatric clinics of North America","year":2008,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review/theoretical conceptual article without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"background","plain_summary":"The author argues that labeling excessive sexual behavior as an 'addiction' is premature, favouring terms like 'out‑of‑control' or 'impulse control disorder' until different underlying patterns are better understood.","clinical_takeaway":"Clinicians should be cautious treating high sexual activity as an addiction without solid evidence; consider broader control‑related diagnoses.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Broad theoretical integration of existing models","Highlights need for nuanced terminology"],"limitations":["No empirical data presented","No systematic review methodology","No measurement of key confounds"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":48,"citing_publications":94,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psc.2008.06.009"}},{"id":4943,"doi":"10.1097/01.ta.0000242288.76468.1c","pmid":"18288017","pmcid":null,"title":"Removal of an unusual foreign body from the bladder and urethra","authors":"Brusky JP, Tamaddon K, Imbasciani V, Aboseif SR.","first_author":"Brusky JP","journal":"The Journal of trauma","year":2008,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.ta.0000242288.76468.1c"}},{"id":4944,"doi":"10.1016/j.psc.2008.06.004","pmid":"18996309","pmcid":null,"title":"Female sexual compulsivity: a new syndrome","authors":"Turner M.","first_author":"Turner M.","journal":"The Psychiatric clinics of North America","year":2008,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case studies describing women with severe shame‑based sexual compulsivity and proposed treatment approaches.","sample_n":null,"sample_text":"Not specified; case reports likely drawn from a clinical setting.","population":"Female patients presenting with intense sexual preoccupation and related psychopathology; sample size not reported.","country":"Not reported","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample","advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article describes a handful of women whose lives are dominated by intense, shame‑filled sexual fantasies and behaviors, linking these patterns to childhood trauma and other addictions, and argues they need specialised, long‑term therapy.","clinical_takeaway":"Treat sexual compulsivity as a complex trauma‑related condition; therapy should address shame, attachment and co‑occurring addictions.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Rich qualitative detail of individual cases","Integration of developmental and trauma perspectives"],"limitations":["No systematic measurement or validated instruments","No control or comparison groups","Small, non‑representative clinical sample"],"rubric_version":"2.0","raw_total":7,"max_possible":60,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":2,"interpretation":1}},"scite":{"supporting":1,"contrasting":1,"mentioning":7,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psc.2008.06.004"}},{"id":4945,"doi":"10.1016/j.psc.2008.06.003","pmid":"18996308","pmcid":null,"title":"Treatment of compulsive cybersex behavior","authors":"Southern S.","first_author":"Southern S.","journal":"The Psychiatric clinics of North America","year":2008,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":null,"sample_text":"Three case studies","population":"men and women with compulsive cybersex (case series, n not reported)","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["circular_addiction_scale","self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article describes three patients who struggled with compulsive online sexual activity and proposes a multi‑component therapy, but it offers no systematic data or validated measures.","clinical_takeaway":"No evidence‑based treatment recommendations can be drawn from three anecdotal cases.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","treatment"],"strengths":["Provides detailed clinical narratives","Highlights potential treatment components"],"limitations":["No validated measures of compulsive cybersex","No systematic assessment of confounds (trauma, mental health, moral factors)","Small, non‑representative case series","Interpretations exceed evidence base"],"rubric_version":"2.0","raw_total":15,"max_possible":60,"pct_score":25,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":24,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psc.2008.06.003"}},{"id":4946,"doi":"10.1016/j.psc.2008.06.005","pmid":"18996301","pmcid":null,"title":"Epidemiology, prevalence, and natural history of compulsive sexual behavior","authors":"Kuzma JM, Black DW.","first_author":"Kuzma JM","journal":"The Psychiatric clinics of North America","year":2008,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":106,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review summarising epidemiology and course of compulsive sexual behavior without systematic methods or meta‑analysis","sample_n":null,"sample_text":"No primary sample; review of existing literature","population":"general adult population (no primary data)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews existing research on compulsive sexual behavior, noting that definitions and measurement tools are inconsistent, but the condition appears relatively common, often distressing, and linked to other mental‑health problems.","clinical_takeaway":"Clinicians should be aware that compulsive sexual behavior is reported as prevalent and distressing, but current diagnostic tools lack solid validation.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of CSB literature up to 2008","Identifies gaps in definition and measurement","Highlights clinical relevance and comorbidity"],"limitations":["Not systematic; possible selection bias","No quantitative synthesis or meta‑analysis","Reliance on heterogeneous primary studies","No original data, so construct validity cannot be assessed"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":12,"contrasting":1,"mentioning":113,"citing_publications":280,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psc.2008.06.005"}},{"id":4947,"doi":"10.1097/01.ncc.0000339252.91194.6c","pmid":"18987508","pmcid":null,"title":"Young female breast cancer survivors: their sexual function and interest in sexual enhancement products and services","authors":"Herbenick D, Reece M, Hollub A, Satinsky S, Dodge B.","first_author":"Herbenick D","journal":"Cancer nursing","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 115 breast cancer survivors under 50 at diagnosis; comparison to normative controls","sample_n":115,"sample_text":"115 women","population":"Female breast cancer survivors (<50 at diagnosis) in the US","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 115 women under 50 who survived breast cancer, sexual function was lower than typical women on most domains, but they reported higher masturbation. Many were interested in sexual enhancement products, and clinicians were encouraged to discuss these options.","clinical_takeaway":"Clinicians should assess sexual function in breast cancer survivors and be prepared to discuss sexual enhancement products if patients are interested.","confidence":0.8,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Uses a validated sexual function instrument","Separately assesses masturbation","Includes comparison to normative controls"],"limitations":["Cross‑sectional design limits causal inference","No control for mental health, relationship or trauma factors","Small, non‑representative survivor sample"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.ncc.0000339252.91194.6c"}},{"id":4948,"doi":null,"pmid":"19173929","pmcid":null,"title":"[A survey on reproductive health related sexual behavior among middle school students in Luoyang city]","authors":"Wang P, Zhang YJ, Pan XJ, Hu QC, Lü SY, Xia XY, Wang YF.","first_author":"Wang P","journal":"Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cluster sampled survey of middle‑school students; single time‑point questionnaire; sample size not reported in abstract","sample_n":null,"sample_text":"not specified in abstract","population":"junior and senior middle‑school students in Luoyang, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A school‑based survey in Luoyang found that older students and boys reported higher rates of masturbation, sexual fantasies, and intercourse. Knowledge of reproductive health and attitudes toward the opposite sex were linked to these behaviours, suggesting gaps in education.","clinical_takeaway":"Sex education for middle‑schoolers should address masturbation and fantasies openly to reduce risky behaviours.","confidence":0.7,"topic_tags":["adolescents","masturbation","sexual_function","religiosity"],"strengths":["Large school‑based sample (cluster sampling)","Logistic regression with confidence intervals reported","Identifies gender and knowledge gaps"],"limitations":["No validated sexual‑behavior instruments reported","No measurement or control of moral, mental‑health or trauma confounds","Sample size unknown; power not addressed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":4949,"doi":"10.1007/s00115-008-2562-7","pmid":"18806981","pmcid":null,"title":"[Sadistic fetishism--deadly passion. Forensic psychiatric assessment of sex offenders]","authors":"Nedopil N, Blümcke I, Bock H, Bogerts B, Born C, Stübner S.","first_author":"Nedopil N","journal":"Der Nervenarzt","year":2008,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review with single case illustration; no systematic data collection.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","underpowered_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses a forensic psychiatric assessment of a man who murdered women and exhibited sadistic fetishism, describing his history, fantasies, and brain MRI findings, and argues that legal judgments should rely on a detailed psychopathological analysis.","clinical_takeaway":"Forensic evaluations of sexual offenses should focus on comprehensive psychopathological assessment rather than relying on limited neuroimaging or unvalidated scales.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides detailed forensic narrative","Integrates legal and psychiatric perspectives","Mentions neurobiological findings"],"limitations":["No systematic data; single case only","No validated measures or controls","Neuroimaging claims lack methodological rigor"],"rubric_version":"2.0","raw_total":14,"max_possible":60,"pct_score":23,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":2,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00115-008-2562-7"}},{"id":4950,"doi":"10.1177/070674379003500412","pmid":"2189544","pmcid":null,"title":"Effect of combined androgen blockade with an LHRH agonist and flutamide in one severe case of male exhibitionism","authors":"Rousseau L, Couture M, Dupont A, Labrie F, Couture N.","first_author":"Rousseau L","journal":"Canadian journal of psychiatry. Revue canadienne de psychiatrie","year":1990,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"case-report","design_detail":"single severe exhibitionist treated with LHRH agonist + flutamide; outcomes reported descriptively","sample_n":1,"sample_text":"one severe case of male exhibitionism","population":"one adult male with severe exhibitionism, likely treatment‑seeking","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A 1990 case report describes one man with severe exhibitionism whose sexual urges and masturbation decreased after receiving hormone therapy that blocks testosterone. The authors suggest the treatment stopped the deviant behaviour without major side effects.","clinical_takeaway":"Evidence from a single case does not support routine use of androgen blockade for exhibitionism; larger, controlled studies are needed.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Detailed clinical description of hormone‑blocking regimen","Reports side‑effect profile"],"limitations":["Single case, no control group","No validated measures of sexual behaviour or distress","No assessment of confounding factors (e.g., mental health, moral beliefs)","Causal claims exceed evidential basis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/070674379003500412"}},{"id":4952,"doi":"10.1093/humrep/den340","pmid":"18835876","pmcid":null,"title":"Adapting infertility treatment to religious beliefs","authors":"Thomas AK.","first_author":"Thomas AK.","journal":"Human reproduction (Oxford, England)","year":2008,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/humrep/den340"}},{"id":4954,"doi":"10.1111/j.1752-0606.2008.00089.x","pmid":"19017186","pmcid":null,"title":"Cybersex: the impact of a contemporary problem on the practices of marriage and family therapists","authors":"Goldberg PD, Peterson BD, Rosen KH, Sara ML.","first_author":"Goldberg PD","journal":"Journal of marital and family therapy","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 164 AAMFT members about clinical experiences with cybersex; descriptive statistics.","sample_n":164,"sample_text":"164 clinical members of the American Association for Marriage and Family Therapy","population":"U.S. marriage and family therapists (AAMFT members)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2008 survey of 164 U.S. marriage‑and‑family therapists found that many are seeing clients with cybersex‑related concerns, feel more prepared to treat adults than children, and think their training did not adequately cover these issues.","clinical_takeaway":"Therapists may need additional training to assess and treat cybersex‑related problems, especially with younger clients.","confidence":0.7,"topic_tags":["csbd","sexual_function","masturbation","pornography"],"strengths":["large professional sample for a niche topic","provides practice‑related data","covers both adult and child client contexts"],"limitations":["cross‑sectional, self‑report survey","no validated measures of cybersex problems","potential response bias among therapists"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":27,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1752-0606.2008.00089.x"}},{"id":4955,"doi":"10.1111/j.1752-0606.2008.00086.x","pmid":"19017183","pmcid":null,"title":"Cybersex and the E-teen: what marriage and family therapists should know","authors":"Delmonico DL, Griffin EJ.","first_author":"Delmonico DL","journal":"Journal of marital and family therapy","year":2008,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review/practical guide for therapists; no primary data collected.","sample_n":null,"sample_text":"Not applicable – no empirical sample.","population":"Adolescents engaging in online sexual behavior (e‑teen); no sample reported.","country":"United States (author affiliations suggest focus on US context).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article offers marriage‑and‑family therapists a quick guide to understand teens' online sexual activities, their developmental context, and practical steps for assessment and intervention.","clinical_takeaway":"Therapists should consider Internet‑based sexual behavior as part of adolescent development and address it within the family system.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Provides a concise overview for family therapists.","Integrates developmental perspectives on adolescent Internet use."],"limitations":["No original data; relies on secondary sources.","Lacks systematic methodology or critical appraisal of literature.","Does not address key confounds (e.g., moral incongruence, mental health)."],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1752-0606.2008.00086.x"}},{"id":4957,"doi":"10.1111/j.1752-0606.2008.00085.x","pmid":"19017182","pmcid":null,"title":"Problems created by technology within our couple and family relationships","authors":"Hertlein KM.","first_author":"Hertlein KM.","journal":"Journal of marital and family therapy","year":2008,"pub_types":["Introductory Journal Article","Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1752-0606.2008.00085.x"}},{"id":4958,"doi":null,"pmid":"18946570","pmcid":null,"title":"Management of penile fractures","authors":"Ghilan AM, Al-Asbahi WA, Ghafour MA, Alwan MA, Al-Khanbashi OM.","first_author":"Ghilan AM","journal":"Saudi medical journal","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"prospective case series of 30 patients with penile fracture; 24 surgically treated, 6 conservatively treated; no randomisation or control group; outcomes descriptive (erection, curvature).","sample_n":30,"sample_text":"30 patients (24 surgical, 6 conservative).","population":"Adult males (24‑52 y) presenting with penile fracture at a Yemeni tertiary hospital (June 2003–Sept 2007).","country":"Yemen","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 30 Yemeni men with penile fracture, surgeons repaired most injuries quickly and reported good erections afterwards; a few were treated without surgery and also did well, but the study was small and not comparative.","clinical_takeaway":"Immediate surgical repair generally yields good functional results, though careful case selection may allow conservative treatment in minor fractures.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["prospective data collection","clear clinical outcome description"],"limitations":["small, non‑randomised sample","no control for confounders","subjective outcome measures only"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4959,"doi":"10.1111/j.1752-0606.2008.00090.x","pmid":"19017187","pmcid":null,"title":"Therapists' assessment and treatment of internet infidelity cases","authors":"Hertlein KM, Piercy FP.","first_author":"Hertlein KM","journal":"Journal of marital and family therapy","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Internet survey of 508 practicing marriage and family therapists; participants responded to hypothetical internet‑infidelity scenarios and reported assessment and treatment decisions.","sample_n":508,"sample_text":"508 therapists","population":"practicing marriage and family therapists (U.S.)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2008 survey of 508 marriage‑and‑family therapists found that their assessments and recommended treatments for internet‑infidelity cases varied with client gender and therapist characteristics such as age, gender, religiosity and personal infidelity experience.","clinical_takeaway":"Therapists’ judgments about internet‑infidelity are influenced by personal and demographic factors; clinicians should be aware of potential biases when treating such cases.","confidence":0.7,"topic_tags":["sexual_function","relationships","csbd"],"strengths":["Large therapist sample (N>500)","Examines how therapist gender, age, religiosity influence case decisions","Provides descriptive data on practice patterns for a contemporary issue"],"limitations":["Ad‑hoc, non‑validated questionnaire","Cross‑sectional, self‑report; no behavioural or outcome data","Volunteer bias – therapists self‑selected for an online survey"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":46,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1752-0606.2008.00090.x"}},{"id":4960,"doi":"10.1016/j.jpag.2008.03.005","pmid":"18794020","pmcid":null,"title":"Provocative questions in parochial sex education classes: higher incidence in younger students","authors":"Moreno M, Breuner CC, Lozano P.","first_author":"Moreno M","journal":"Journal of pediatric and adolescent gynecology","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Quasi‑cohort descriptive study of anonymous written questions submitted by 5th‑8th graders in a single parochial middle‑school sex‑education program (N≈410).","sample_n":410,"sample_text":"473 questions from 410 students","population":"Adolescents ages ~10‑14 years, United States, school‑based sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers examined 473 anonymous questions written by 5th‑ to 8th‑grade students in a parochial school’s sex‑education classes. A small proportion (≈4%) were “red‑flag” questions suggesting early sexual activity, with younger students asking more of these. The study highlights the need for age‑appropriate guidance.","clinical_takeaway":"Even few early‑teen inquiries about sex may signal the need for timely, supportive education from parents and schools.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Large number of student‑generated questions","Clear coding scheme for question categories","Focus on younger adolescents, an understudied age group"],"limitations":["Single school, religious setting limits generalisability","No validated instrument for defining “red‑flag” questions","Only descriptive statistics, no adjustment for possible confounders"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpag.2008.03.005"}},{"id":4961,"doi":"10.1097/00000433-199003000-00014","pmid":"2305756","pmcid":null,"title":"Xenolingual autoeroticism","authors":"Randall MB, Vance RP, McCalmont TH.","first_author":"Randall MB","journal":"The American journal of forensic medicine and pathology","year":1990,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single clinical case describing use of a deer tongue as a masturbatory aid; no systematic data collection","sample_n":1,"sample_text":"one patient presenting with a unique autoerotic practice","population":"adult female (single case)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1990 case report describes a woman using a deer tongue as a tool for masturbation, an unusual form of autoeroticism not previously documented in medical literature.","clinical_takeaway":"None – the report is anecdotal and does not inform clinical practice.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Provides a rare descriptive account of an unusual masturbatory practice","Highlights diversity of sexual behaviours beyond typical literature"],"limitations":["Single case; no quantitative data or systematic assessment","No validated measures of sexual behaviour, distress, or related constructs","No control for confounding variables such as mental health or moral incongruence"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00000433-199003000-00014"}},{"id":4962,"doi":"10.1100/tsw.2008.116","pmid":"18836654","pmcid":"PMC5848654","title":"Clinical holistic medicine: teaching orgasm for females with chronic anorgasmia using the Betty Dodson method","authors":"Struck P, Ventegodt S.","first_author":"Struck P","journal":"TheScientificWorldJournal","year":2008,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5848654","cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective case series of 500 women receiving group therapy; no control group; outcomes observed by therapist","sample_n":500,"sample_text":"500 female patients (mean age 35) with chronic anorgasmia","population":"female patients with chronic anorgasmia, ages 18‑88, treatment‑seeking","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a retrospective review of 500 women with chronic anorgasmia who attended a group therapy using the Betty Dodson method, 93 % were observed to have an orgasm during the session. No adverse effects were reported, but the study lacked a control group and formal statistical analysis.","clinical_takeaway":"Therapists may consider the Betty Dodson method as a possible option for chronic anorgasmia, but evidence is limited to uncontrolled case series.","confidence":0.7,"topic_tags":["sexual_function","treatment"],"strengths":["Large sample size for a case series","Clear operational definition of outcome (therapist‑observed orgasm)","Detailed description of therapeutic protocol"],"limitations":["No control or comparison group","Retrospective design; possible selection bias","Outcome measured without blinded assessment","No statistical inference beyond simple percentages"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1100/tsw.2008.116"}},{"id":4963,"doi":null,"pmid":"18827759","pmcid":null,"title":"Penile self-mutilation - two cases in one family","authors":"Ristić DI, Petrović D, Cirić Z.","first_author":"Ristić DI","journal":"Psychiatria Danubina","year":2008,"pub_types":["Comparative Study","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of two related patients with schizophrenia who self‑mutilated their genitals; no control group, no systematic sampling","sample_n":2,"sample_text":"Two cases","population":"2 male patients with schizophrenia, family members, Yugoslavia","country":"Yugoslavia","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes two brothers with schizophrenia who each cut off part of their penis, linking the acts to religious delusions, guilt and sexual conflict. The authors discuss possible explanations but provide no systematic data.","clinical_takeaway":"Self‑mutilation in psychosis may involve religious and sexual guilt; clinicians should assess these domains.","confidence":0.9,"topic_tags":["gender","sexual_function"],"strengths":["Rare family occurrence documented","Clinical detail on psychotic religious content"],"limitations":["No systematic assessment or validated measures","Very small sample, no controls","Speculative etiological discussion"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4965,"doi":null,"pmid":"2171265","pmcid":null,"title":"[A little-known epileptic phenomenon]","authors":"Lachkepiani AN.","first_author":"Lachkepiani AN.","journal":"Zhurnal nevropatologii i psikhiatrii imeni S.S. Korsakova (Moscow, Russia : 1952)","year":1990,"pub_types":["Comparative Study","Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","masturbation"],"language":"rus","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Comparative case series of epileptic patients across age groups with hypersexual seizures, EEG recorded in adults.","sample_n":null,"sample_text":"Not reported in abstract; likely a small clinical series.","population":"Patients with temporal‑lobe epilepsy exhibiting masturbatory automatisms (children and adults).","country":"Russia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes a handful of epilepsy patients who showed sudden, seizure‑related masturbation episodes, with temporal‑lobe EEG abnormalities noted in both children and adults.","clinical_takeaway":"None – the report is a niche clinical observation without implications for typical sexual health or treatment.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","masturbation"],"strengths":["Rare clinical observation of sexual automatisms in epilepsy","Use of EEG to locate temporal‑lobe focus"],"limitations":["Very small, unspecified sample size","No validated measures of sexual behavior or distress","No control for confounding factors"],"rubric_version":"2.0","raw_total":17,"max_possible":60,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":4,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4966,"doi":"10.1111/j.1743-6109.2008.00989.x","pmid":"18761586","pmcid":null,"title":"Determinants of sexual satisfaction in a sample of German women","authors":"Philippsohn S, Hartmann U.","first_author":"Philippsohn S","journal":"The journal of sexual medicine","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":50,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"self‑administered questionnaire, N=102 German women, median age 31‑35, convenience sample","sample_n":102,"sample_text":"102 German women of different age groups and education levels","population":"adult women, Germany","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A German survey of 102 women found that sexual satisfaction is mainly linked to intercourse, especially feeling close to a partner and positive bodily experiences, while petting and masturbation contribute less.","clinical_takeaway":"Clinicians might focus on relational aspects of intercourse when addressing women’s sexual satisfaction, but recognize other activities also play a role.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Addresses distinct sexual activities (intercourse, petting, masturbation)","Identifies dimensions of satisfaction specific to intercourse"],"limitations":["Questionnaire appears ad‑hoc, limited validation","Cross‑sectional convenience sample, limited generalisability","No control for partner, mental‑health or moral variables"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":9,"contrasting":0,"mentioning":46,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2008.00989.x"}},{"id":4967,"doi":"10.1111/j.1743-6109.2008.00987.x","pmid":"18761591","pmcid":null,"title":"Condom use for penile-vaginal intercourse is associated with immature psychological defense mechanisms","authors":"Costa RM, Brody S.","first_author":"Costa RM","journal":"The journal of sexual medicine","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"210 Portuguese participants (99 women) completed self‑report questionnaires on condom use frequency, orgasm frequency, and the Defense Style Questionnaire (DSQ‑40). Analyses were correlations and multiple regression controlling for relationship status, age, cohabitation and social desirability.","sample_n":210,"sample_text":"210 participants (99 women, 111 men) recruited from the general population; convenience sample.","population":"adult community sample, convenience recruitment (Portugal)","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 210 adults, more frequent condom use during penis‑vagina sex was linked to higher use of immature psychological defense styles, while sex without condoms was linked to fewer such defenses.","clinical_takeaway":"Condom use alone should not be taken as a sign of psychological immaturity; findings are correlational.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses validated DSQ‑40","Controls for several demographic variables","Large enough sample for basic correlations"],"limitations":["Cross‑sectional, cannot infer causality","Condom use measured by a single self‑report item","No assessment of moral or trauma factors"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":11,"contrasting":0,"mentioning":51,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2008.00987.x"}},{"id":4968,"doi":"10.3325/cmj.2008.4.499","pmid":"18716997","pmcid":"PMC2525821","title":"Sexual functioning in war veterans with posttraumatic stress disorder","authors":"Anticević V, Britvić D.","first_author":"Anticević V","journal":"Croatian medical journal","year":2008,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2525821/pdf/CroatMedJ_49_0499.pdf","cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control cross‑sectional survey of 101 war veterans with PTSD and 55 healthy controls; structured interview on sexual functioning","sample_n":156,"sample_text":"101 veterans with PTSD, 55 controls","population":"Croatian male war veterans with combat‑related PTSD vs healthy male controls","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"War veterans with PTSD reported fewer sexual activities, lower desire, and more erectile problems than healthy men. Antidepressant use was linked to reduced desire, while non‑users reported more premature ejaculation.","clinical_takeaway":"PTSD and its pharmacologic treatment are associated with sexual dysfunction; clinicians should discuss these effects when prescribing antidepressants to veterans.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Reasonably large case‑control sample for the population studied","Use of trained interviewers and structured questionnaire","Inclusion of partner health and medication use as covariates"],"limitations":["Reliance on non‑validated Likert scales; no psychometric validation reported","Cross‑sectional design prevents causal inference","Limited control for key confounds such as moral incongruence, trauma history beyond PTSD diagnosis"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":24,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3325/cmj.2008.4.499"}},{"id":4970,"doi":"10.1016/j.chiabu.2007.10.005","pmid":"18614231","pmcid":"PMC2582752","title":"A population-based study of childhood sexual contact in China: prevalence and long-term consequences","authors":"Luo Y, Parish WL, Laumann EO.","first_author":"Luo Y","journal":"Child abuse & neglect","year":2008,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":57,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"National stratified probability sample of 3,000 adults in urban China, computer‑administered survey (1999‑2000). Weighted multivariate analyses of self‑reported childhood sexual contact and adult outcomes.","sample_n":3014,"sample_text":"1,519 women and 1,475 men (total 3,014).","population":"Adults aged 20‑64 years in urban China (N≈3,000).","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationwide Chinese survey of about 3,000 adults, about 4% reported sexual contact before age 14. Those who experienced such contact were more likely to report higher masturbation, diverse sexual activities, more partners, adult sexual victimisation, sexual problems and psychological distress, suggesting lasting negative effects.","clinical_takeaway":"History of childhood sexual contact is linked to later sexual‑health issues and distress; clinicians should screen for this trauma when addressing hyper‑sexuality or related problems.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative probability sample","Weighted multivariate analyses","Broad range of adult sexual‑health outcomes examined"],"limitations":["Cross‑sectional; cannot establish causality","Self‑report measures, unclear validation of scales","No assessment of moral or religiosity factors that might influence reporting"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":2,"mentioning":83,"citing_publications":108,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2007.10.005"}},{"id":4971,"doi":"10.1111/j.1743-6109.2008.00907.x","pmid":"18624974","pmcid":null,"title":"Erectile dysfunction among men with diabetes is strongly associated with premature ejaculation and reduced libido","authors":"Malavige LS, Jayaratne SD, Kathriarachchi ST, Sivayogan S, Fernando DJ, Levy JC.","first_author":"Malavige LS","journal":"The journal of sexual medicine","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":73,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional observational study of 253 men with type‑2 diabetes recruited from a single clinic in Colombo, Sri Lanka.","sample_n":253,"sample_text":"randomly selected from a clinic","population":"Men with type‑2 diabetes (N=253)","country":"Sri Lanka","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 253 men with type‑2 diabetes in Sri Lanka, erectile dysfunction was common and strongly linked to premature ejaculation, low libido, older age, lower income and longer diabetes duration. Not masturbating was also associated with reduced libido.","clinical_takeaway":"Screen diabetic men with any one of ED, PE, or low libido for the other conditions.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Validated erectile function measure (IIEF‑5)","Multivariate logistic regression with confidence intervals","Large sample for a single‑clinic study"],"limitations":["Cross‑sectional design cannot infer causality","Limited assessment of mental‑health and relational factors","Clinic‑based sample may not generalise to all diabetic men"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":10,"contrasting":4,"mentioning":103,"citing_publications":115,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2008.00907.x"}},{"id":4972,"doi":null,"pmid":"18614424","pmcid":null,"title":"Effectiveness of sildenafil citrate (Viagra) and tadalafil (Cialis) on sexual responses in Saudi men with erectile dysfunction in routine clinical practice","authors":"Ali ST.","first_author":"Ali ST.","journal":"Pakistan journal of pharmaceutical sciences","year":2008,"pub_types":["Controlled Clinical Trial","Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Controlled clinical trial comparing sildenafil and tadalafil with age‑matched untreated controls; likely non‑randomized and sample size not reported.","sample_n":null,"sample_text":"Not reported in abstract","population":"Saudi men with erectile dysfunction","country":"Saudi Arabia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A Saudi study compared Viagra and Cialis in men with erectile dysfunction, finding both improved erection, orgasm and satisfaction scores, with Cialis showing slightly stronger effects.","clinical_takeaway":"Both sildenafil and tadalafil can improve erectile function and satisfaction; choice may depend on duration of action.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Uses validated IIEF questionnaire","Compares two commonly used PDE5 inhibitors","Includes untreated age‑matched control group"],"limitations":["Sample size and randomisation not reported","No effect sizes or confidence intervals","Potential confounders (mental health, relationship factors) not controlled"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":4973,"doi":"10.1258/ijsa.2007.007298","pmid":"18574126","pmcid":null,"title":"Interaction of organic and psychological factors in persistent genital arousal disorder in women: a report of six cases","authors":"Goldmeier D, Leiblum S.","first_author":"Goldmeier D","journal":"International journal of STD & AIDS","year":2008,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case report of six women with persistent genital arousal disorder (PGAD).","sample_n":6,"sample_text":"Six cases described in detail.","population":"Women with PGAD (n≈6); clinical case series.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors present six detailed cases of women with persistent genital arousal disorder, suggesting that anxiety, genital conditions, and masturbation may interact to produce the symptoms.","clinical_takeaway":"PGAD may involve both physical and psychological factors; assessment should consider anxiety and genital health, not just sexual behavior.","confidence":0.6,"topic_tags":["sexual_function","gender","pornography","masturbation"],"strengths":["Detailed clinical description of rare condition","Integration of psychophysiological hypothesis"],"limitations":["No standardized measures or validated instruments","Small, non‑representative case series","No systematic assessment of confounding factors"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":37,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/ijsa.2007.007298"}},{"id":4976,"doi":"10.1016/j.urology.2008.04.005","pmid":"18468661","pmcid":null,"title":"Effect of antibiotic therapy on interleukin-6 in fresh semen and postmasturbation urine samples of patients with chronic prostatitis/chronic pelvic pain syndrome","authors":"Stancik I, Plas E, Juza J, Pflüger H.","first_author":"Stancik I","journal":"Urology","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective single‑group pre‑post study of 128 men with CP/CPPS, IL‑6 measured before and after 4‑week antibiotic course; 109 completed follow‑up","sample_n":109,"sample_text":"128 recruited, 109 analysed","population":"men with chronic prostatitis/chronic pelvic pain syndrome, mean age not reported","country":"not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In men with chronic pelvic pain, a 4‑week course of antibiotics lowered the level of the inflammation marker IL‑6 in semen and urine collected after masturbation.","clinical_takeaway":"Reduced IL‑6 after antibiotics suggests an inflammatory component; testing IL‑6 could help monitor treatment response in CP/CPPS.","confidence":0.8,"topic_tags":["csbd","masturbation","sexual_function"],"strengths":["Objective biochemical outcome (IL‑6) measured with standard assay","Clear pre‑ and post‑treatment comparison within same participants","Reasonable sample size for a biomarker study"],"limitations":["No control group; cannot separate antibiotic effect from natural fluctuation","Statistical reporting limited to p‑values, no effect sizes or confidence intervals","Potential drop‑out bias (19 participants lost to follow‑up)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urology.2008.04.005"}},{"id":4978,"doi":"10.1002/pon.1274","pmid":"17935145","pmcid":null,"title":"Psychosexual functioning of childhood cancer survivors","authors":"van Dijk EM, van Dulmen-den Broeder E, Kaspers GJ, van Dam EW, Braam KI, Huisman J.","first_author":"van Dijk EM","journal":"Psycho-oncology","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":94,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Cross‑sectional questionnaire of 60 childhood cancer survivors compared with Dutch norms; cohort follow‑up but no control group beyond population data.","sample_n":60,"sample_text":"Sixty childhood cancer survivors completed two questionnaires.","population":"Childhood cancer survivors (N≈60), age ≥25 for some analyses; Dutch population norms used for comparison.","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 60 adults who survived childhood cancer found that many reported delays in reaching sexual milestones such as intercourse and dating, especially those treated during adolescence. Overall quality of life was lower than peers, but sexual problems did not further worsen it.","clinical_takeaway":"Clinicians should screen for delayed sexual development in adult cancer survivors, especially those treated in adolescence.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Focus on a medically vulnerable population","Use of a standard quality‑of‑life instrument (SF‑36)","Comparison with age‑matched national norms"],"limitations":["Small sample; limited statistical power","Unclear validation of the psychosexual questionnaire","No adjustment for mental‑health or other psychosocial confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":14,"contrasting":3,"mentioning":171,"citing_publications":137,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/pon.1274"}},{"id":4979,"doi":"10.1016/j.fertnstert.2008.03.003","pmid":"18440512","pmcid":null,"title":"Combined use of phosphodiesterase-5 inhibitors and selective serotonin reuptake inhibitors for temporary ejaculation failure in couple undergoing assisted reproductive technologies","authors":"Lu S, Zhao Y, Hu J, Li X, Zhang H, You L, Chen ZJ.","first_author":"Lu S","journal":"Fertility and sterility","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of five patients with temporary ejaculation failure during ART; combined PDE5‑I and SSRI treatment evaluated without control group.","sample_n":5,"sample_text":"Five patients","population":"Male patients undergoing assisted reproductive technologies who experienced unexpected ejaculation failure (N=5).","country":"China (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In five men undergoing IVF who could not ejaculate on the day of egg retrieval, giving a PDE5‑inhibitor together with an antidepressant helped them provide semen samples within a few hours.","clinical_takeaway":"Combined vardenafil and sertraline may aid temporary ejaculation failure in IVF, but evidence is limited to a tiny case series.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Clear clinical focus","Detailed drug dosing","Addresses a practical ART problem"],"limitations":["Very small, uncontrolled case series","No validated outcome measures","No control for anxiety or other confounds"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":1,"mentioning":8,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.fertnstert.2008.03.003"}},{"id":4980,"doi":"10.1111/j.1743-6109.2008.00843.x","pmid":"18410297","pmcid":null,"title":"The effects of citalopram and fluoxetine on sexual behavior in healthy men: evidence of delayed ejaculation and unaffected sexual desire. A randomized, placebo-controlled, double-blind, double-dummy, parallel group study","authors":"Madeo B, Bettica P, Milleri S, Balestrieri A, Granata AR, Carani C, Rochira V.","first_author":"Madeo B","journal":"The journal of sexual medicine","year":2008,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized, placebo‑controlled, double‑blind, double‑dummy, parallel‑group trial with 48 healthy men (16 per arm)","sample_n":48,"sample_text":"48 healthy male volunteers, 16 per group (placebo, fluoxetine, citalopram)","population":"healthy adult men, mean age 29.5 y, no sexual dysfunction at baseline","country":"not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a double‑blind trial with 48 healthy men, daily doses of the SSRIs citalopram or fluoxetine delayed ejaculation but did not change sexual desire. Objective measures showed no effect on erection, although men reported slightly worse erectile function, likely because of the ejaculation delay.","clinical_takeaway":"SSRIs may cause delayed ejaculation without reducing desire; clinicians should counsel patients about this specific side‑effect.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Validated questionnaires (IIEF‑15, GRISS)","Objective penile rigidity monitoring (RigiScan)","Randomised, double‑blind design"],"limitations":["Small sample (N = 48)","No power calculation reported","Short duration (4 weeks)"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":27,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2008.00843.x"}},{"id":4982,"doi":null,"pmid":"20695157","pmcid":null,"title":"Prevalence of low sperm count and abnormal semen parameters in male partners of women consulting at infertility clinic in Abakaliki, Nigeria","authors":"Ugwuja EI, Ugwu NC, Ejikeme BN.","first_author":"Ugwuja EI","journal":"African journal of reproductive health","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Prevalence study of semen parameters in 170 men whose partners attended a private infertility clinic; WHO guidelines used for analysis.","sample_n":170,"sample_text":"Convenience sample of clinic attendees; not a probability or community sample.","population":"Men aged 21‑50 years, partners of women seeking fertility treatment in Abakaliki, Nigeria (N=170).","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a sample of 170 Nigerian men whose partners were seeking fertility treatment, 70% had low sperm counts and 64% showed other semen abnormalities, with higher rates among civil servants and men aged 31‑40.","clinical_takeaway":"High prevalence of abnormal semen parameters among men attending infertility clinics; routine semen analysis remains essential.","confidence":0.8,"topic_tags":["sexual_function","religiosity"],"strengths":["Use of WHO‑standardized semen analysis","Relatively large sample for a single clinic","Clear reporting of prevalence rates"],"limitations":["Convenience sample limits generalisability","No control for demographic or health confounders","Statistical reporting limited to p‑values"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":4983,"doi":"10.1016/j.psyneuen.2008.01.014","pmid":"18375074","pmcid":null,"title":"The acute effects of intranasal oxytocin administration on endocrine and sexual function in males","authors":"Burri A, Heinrichs M, Schedlowski M, Kruger TH.","first_author":"Burri A","journal":"Psychoneuroendocrinology","year":2008,"pub_types":["Controlled Clinical Trial","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":122,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"double‑blind, placebo‑controlled, balanced cross‑over trial with 10 healthy men","sample_n":10,"sample_text":"10 healthy men (cross‑over design)","population":"adult males, n=10","country":"Switzerland (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In ten healthy men, a single dose of intranasal oxytocin raised blood oxytocin and epinephrine levels during sexual activity, but did not change sexual behaviour or hormone stress markers.","clinical_takeaway":"Intranasal oxytocin alters hormone release during sex but shows no clear impact on sexual performance in healthy men.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","other"],"strengths":["double‑blind crossover design","objective endocrine and cardiovascular measures","use of a validated sexual experience scale"],"limitations":["very small sample (N=10)","no power calculation reported","confounding variables (mood, relationship status) not assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":0,"mentioning":114,"citing_publications":170,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psyneuen.2008.01.014"}},{"id":4984,"doi":null,"pmid":"2728941","pmcid":null,"title":"[Urethral foreign body]","authors":"Vigués Julía F, Franco Miranda E, Rodríguez Tolra J, Gil-Vernet Sedó A, Tesedo Cubero X, Serrallach Milá N.","first_author":"Vigués Julía F","journal":"Actas urologicas espanolas","year":1989,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single clinical case description; no comparison group; no systematic methodology","sample_n":1,"sample_text":"one patient","population":"male, middle‑aged, presenting with a long‑standing urethral foreign body inserted during masturbation","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1980s case report describes a middle‑aged man who inserted an object into his urethra for masturbation, leading to a peri‑urethral abscess. The authors outline how they diagnosed and removed the foreign body.","clinical_takeaway":"Urethral foreign bodies can result from masturbatory practices; clinicians should consider imaging and prompt removal to prevent infection.","confidence":0.4,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Detailed clinical description of a rare presentation","Illustrates diagnostic and therapeutic steps for urethral foreign bodies"],"limitations":["Single case; no generalisable conclusions","No systematic assessment of psychological or sexual‑health variables","No outcome measures beyond immediate clinical management"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":4985,"doi":null,"pmid":"2741728","pmcid":null,"title":"Self-perceived differences in the female orgasmic response","authors":"Davidson JK, Darling CA.","first_author":"Davidson JK","journal":"Family practice research journal","year":1989,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"anonymous questionnaire distributed to registered nurses in fifteen U.S. states; comparative analysis of self‑reported orgasmic experiences across masturbation, petting, and intercourse; outcomes: perceived physiological/psychological sexual satisfaction.","sample_n":null,"sample_text":"registered nurses in fifteen states; exact N not reported in abstract","population":"registered female nurses (U.S.)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of U.S. nurses found most reported differences in how orgasms felt during masturbation, petting, and intercourse, but these differences did not translate into higher or lower sexual satisfaction.","clinical_takeaway":"Perceived differences in orgasm type may not impact overall sexual satisfaction; clinicians should focus on broader satisfaction factors.","confidence":0.4,"topic_tags":["sexual_function","masturbation"],"strengths":["Addresses a rarely studied aspect of female sexual response","Includes multiple contexts of orgasm (masturbation, petting, intercourse)","Broad geographic reach (15 states)"],"limitations":["Convenience sample of nurses limits generalisability","Reliance on single‑item self‑reports, no validated scales","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":4986,"doi":"10.1111/j.1743-6109.2008.00781.x","pmid":"18331267","pmcid":null,"title":"Assessment of sexual health in aging men in Europe: development and validation of the European Male Ageing Study sexual function questionnaire","authors":"O'Connor DB, Corona G, Forti G, Tajar A, Lee DM, Finn JD, Bartfai G, Boonen S, Casanueva FF, Giwercman A, Huhtaniemi IT, Kula K, O'Neill TW, Pendleton N, Punab M, Silman AJ, Vanderschueren D, Wu FC.","first_author":"O'Connor DB","journal":"The journal of sexual medicine","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":65,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Validation study of a self‑administered questionnaire in a large European sample (n = 1600); test‑retest reliability assessed in a subsample (n = 85).","sample_n":1600,"sample_text":"1600 men completed the EMAS‑SFQ; 85 men completed a retest","population":"Men aged 40‑79 years from multiple European centres","country":"Europe (multicentre)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study created and validated a short questionnaire (EMAS‑SFQ) to measure sexual function, masturbation, and related distress in European men aged 40‑79, showing it works well and reflects hormone levels.","clinical_takeaway":"The EMAS‑SFQ provides a reliable tool for assessing sexual health and distress in older men in clinical and research settings.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Large, multi‑country sample","Comprehensive psychometric evaluation (PCA, reliability, validity)","Includes separate masturbation and distress domains"],"limitations":["No assessment of partner/relationship factors","Moral or religiosity variables not measured (not central to aim)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":1,"mentioning":88,"citing_publications":102,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2008.00781.x"}},{"id":4987,"doi":"10.1097/paf.0b013e3181651b79","pmid":"19749620","pmcid":null,"title":"Accidental death in autoerotic maneuvers","authors":"Focardi M, Gualco B, Norelli G.","first_author":"Focardi M","journal":"The American journal of forensic medicine and pathology","year":2008,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single accidental death during autoerotic activity","sample_n":1,"sample_text":"1 case","population":"one middle‑aged male who died while performing autoerotic maneuvers","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reports one man who died accidentally while performing an autoerotic act, arguing that such deaths are likely under‑counted and emphasizing forensic methods needed to identify them.","clinical_takeaway":"None – the report is forensic and does not inform clinical practice.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Detailed forensic description of the case","Highlights under‑reporting of autoerotic deaths"],"limitations":["Single case; no generalisable data","No systematic measurement of behavior or distress","No statistical analysis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/paf.0b013e3181651b79"}},{"id":4988,"doi":null,"pmid":"2606602","pmcid":null,"title":"A sexual theory of persecutory delusions","authors":"Freeman T.","first_author":"Freeman T.","journal":"The International journal of psycho-analysis","year":1989,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"theoretical case report, no empirical data","sample_n":null,"sample_text":"case reports, no numeric sample size reported","population":"schizophrenic patients (unspecified)","country":"UK (journal, author affiliation not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The author proposes that persecutory delusions in schizophrenia may arise from intense masturbatory fantasies that become fixed as delusional beliefs after a breakdown in mental processing.","clinical_takeaway":"No direct clinical guidance; the theory is speculative and not evidence‑based.","confidence":0.8,"topic_tags":["masturbation","sexual_function","adolescents"],"strengths":["Integrates psychoanalytic theory with clinical observations","Highlights possible symbolic link between fantasies and delusions"],"limitations":["No empirical data or systematic case series","Lacks validated measurement of key constructs","No control for alternative explanations (e.g., mental health variables)"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":4990,"doi":null,"pmid":"3230454","pmcid":null,"title":"Ethics of mandatory masturbation","authors":"Egilman D.","first_author":"Egilman D.","journal":"Journal of occupational medicine. : official publication of the Industrial Medical Association","year":1988,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4991,"doi":"10.1007/bf03371048","pmid":"18361160","pmcid":null,"title":"[The impact of medical conditions on partnership and sexuality]","authors":"Beier KM.","first_author":"Beier KM.","journal":"MMW Fortschritte der Medizin","year":2008,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf03371048"}},{"id":4992,"doi":null,"pmid":"3187837","pmcid":null,"title":"Contraction of HIV infection during mutual masturbation","authors":null,"first_author":null,"journal":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","year":1988,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"afr","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":4993,"doi":"10.1007/bf01542482","pmid":"2975482","pmcid":null,"title":"Effects of antiandrogen-estrogen treatment on sexual and endocrine parameters in hirsute women","authors":"Adamopoulos DA, Kampyli S, Georgiacodis F, Kapolla N, Abrahamian-Michalakis A.","first_author":"Adamopoulos DA","journal":"Archives of sexual behavior","year":1988,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Pre‑post treatment study of 51 hirsute women compared with 52 controls; no randomisation, small convenience sample.","sample_n":103,"sample_text":"51 hirsute women + 52 reference subjects","population":"Women with hirsutism and elevated androgen levels; mainly treatment‑seeking.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 51 women with excess androgens, higher free testosterone was linked to less intercourse but more masturbation. Hormone‑lowering treatment reduced free testosterone, increased intercourse frequency and lowered masturbation, but total sexual activity stayed the same.","clinical_takeaway":"Androgen reduction may shift sexual activity from masturbation toward intercourse, without changing overall activity.","confidence":0.7,"topic_tags":["sexual_function","masturbation","adolescents"],"strengths":["Hormone measurements are objective","Separate reporting of coital and masturbatory activity","Within‑subject pre‑post design"],"limitations":["Small, non‑random sample limits generalisability","No control for mental‑health or relationship factors","No effect‑size reporting or power analysis"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542482"}},{"id":4994,"doi":"10.1097/gme.0b013e3180f6108c","pmid":"18257141","pmcid":null,"title":"Decreased androgen concentrations and diminished general and sexual well-being in women with premature ovarian failure","authors":"van der Stege JG, Groen H, van Zadelhoff SJ, Lambalk CB, Braat DD, van Kasteren YM, van Santbrink EJ, Apperloo MJ, Weijmar Schultz WC, Hoek A.","first_author":"van der Stege JG","journal":"Menopause (New York, N.Y.)","year":2008,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":109,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control comparative study with 81 POF women and 68 controls; questionnaire and hormone assays","sample_n":149,"sample_text":"81 women with POF and 68 control women","population":"women with premature ovarian failure vs. healthy volunteers, Netherlands","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Women with premature ovarian failure have lower androgen levels and report worse general and sexual well‑being than healthy women, but hormone levels only weakly predict sexual function.","clinical_takeaway":"Androgen replacement is unlikely to markedly improve sexual function in POF women.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Validated sexual functioning questionnaires","Hormonal assays provide objective data","Control group of healthy women"],"limitations":["Cross‑sectional design limits causal inference","No control for partner relationship factors or trauma history","No pre‑registration or detailed effect‑size reporting"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":1,"mentioning":95,"citing_publications":173,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/gme.0b013e3180f6108c"}},{"id":4995,"doi":"10.1353/sex.0.0023","pmid":"19263615","pmcid":null,"title":"Pathologizing leaky male bodies: spermatorrhea in nineteenth-century British medicine and popular anatomical museums","authors":"Stephens E.","first_author":"Stephens E.","journal":"Journal of the history of sexuality","year":2008,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1353/sex.0.0023"}},{"id":4999,"doi":"10.1590/s0036-36342008000800019","pmid":"18470354","pmcid":null,"title":"Sexual health for people with intellectual disability","authors":"Eastgate G.","first_author":"Eastgate G.","journal":"Salud publica de Mexico","year":2008,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review/case report summary without systematic methodology.","sample_n":null,"sample_text":"Not applicable – review of existing reports and case examples.","population":"People with intellectual disability","country":"Mexico","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"People with intellectual disabilities have the same sexual desires as others but often lack support, face higher abuse risk, and may be discouraged from masturbation. Education and social support can help them engage in safe, healthy sexual relationships.","clinical_takeaway":"Provide tailored sexual education and supportive services to promote safe sexual expression for people with intellectual disability.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Highlights sexual health needs of a marginalized group","Integrates education and support recommendations","Addresses risk of abuse and need for contraception"],"limitations":["Narrative, not systematic, review","No empirical data or meta‑analysis","Limited methodological detail"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":40,"citing_publications":78,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s0036-36342008000800019"}},{"id":5000,"doi":null,"pmid":"3167264","pmcid":null,"title":"Androgynous masturbatory behavior as a schizoid phenomenon","authors":"Eber M, Rotondo DJ.","first_author":"Eber M","journal":"Bulletin of the Menninger Clinic","year":1988,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5001,"doi":null,"pmid":"3406879","pmcid":null,"title":"Contraction of HIV infection during mutual masturbation","authors":"Sellars SL.","first_author":"Sellars SL.","journal":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","year":1988,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5002,"doi":null,"pmid":"18284056","pmcid":null,"title":"[Prevalence and related factors of prostatitis-like symptoms in young men]","authors":"Gao DJ, Guo YS, Yu HY, Wang YJ, Cui WG.","first_author":"Gao DJ","journal":"Zhonghua nan ke xue = National journal of andrology","year":2007,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross-sectional survey of 2,125 young men from one Chinese city; convenience sample, not nationally representative.","sample_n":2125,"sample_text":"Cross‑sectional convenience sample, 85% response rate.","population":"Young men aged 18‑30 (N≈2125).","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 2,125 Chinese men aged 18‑30, about 6% reported chronic prostatitis‑like symptoms. Frequent masturbation, prolonged sitting, cold exposure, and stress were linked to higher odds of these symptoms.","clinical_takeaway":"Frequent masturbation and lifestyle factors may be associated with prostatitis‑like symptoms in young men; clinicians should consider these when evaluating patients.","confidence":0.4,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Large sample for a single‑city survey.","Use of multivariate logistic regression.","Clear reporting of prevalence and odds ratios."],"limitations":["Convenience, non‑representative sample.","Masturbation measured with a single, non‑validated item.","No measurement of moral or relational confounds.","Cross‑sectional design limits causal inference."],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":5003,"doi":"10.1097/dbp.0b013e31815d4c60","pmid":"18091094","pmcid":null,"title":"Episodic hypersomnia and unusual behaviors in a 14-year old adolescent","authors":"Hirst J, Mignot E, Stein MT.","first_author":"Hirst J","journal":"Journal of developmental and behavioral pediatrics : JDBP","year":2007,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single adolescent with Kleine‑Levin syndrome describing episodic hypersomnia and sexual disinhibition","sample_n":1,"sample_text":"single case","population":"one 14‑year‑old white male adolescent","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 14‑year‑old boy experienced episodes of extreme sleepiness, confusion, hallucinations and inappropriate sexual behavior. The episodes resolved and recurred over several weeks, with normal brain scans and lab tests, illustrating a rare disorder called Kleine‑Levin syndrome.","clinical_takeaway":"Kleine‑Levin syndrome can involve transient sexual disinhibition; monitor safety during episodes.","confidence":0.9,"topic_tags":["sexual_function","adolescents","neuroscience"],"strengths":["Detailed clinical description","Includes imaging and CSF data"],"limitations":["Single case, no generalizability","No systematic measurement of sexual behavior or mental health covariates","No statistical analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/dbp.0b013e31815d4c60"}},{"id":5004,"doi":"10.1080/09513590701708860","pmid":"18075842","pmcid":null,"title":"A comparison of 19th century and current attitudes to female sexuality","authors":"Studd J.","first_author":"Studd J.","journal":"Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology","year":2007,"pub_types":["Historical Article","Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical editorial without primary data; no sample, no empirical methods","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews 19th‑century medical and cultural views that treated normal female sexuality as pathological, noting practices like clitoridectomy, and contrasts them with modern understandings of sexual desire disorders.","clinical_takeaway":"None – the piece is historical and not directly relevant to clinical assessment or treatment.","confidence":0.8,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Provides historical context for attitudes toward female sexuality","Highlights evolution of medical discourse over centuries"],"limitations":["No original data or systematic methodology","Lacks empirical assessment of current attitudes or behaviours"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09513590701708860"}},{"id":5005,"doi":"10.1080/13648470701694446","pmid":"27268739","pmcid":null,"title":"Semen Anxiety: Materiality, Agency and the Internet","authors":"Shand A.","first_author":"Shand A.","journal":"Anthropology & medicine","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"The study analysed anonymously submitted health‑website questions over three months, using thematic analysis to identify patterns relating to semen quality, masturbation and potency.","sample_n":null,"sample_text":"Anonymous questions submitted over three months to a UK‑based consumer health website; no numeric total reported.","population":"Adults who posted questions to a UK consumer health website (self‑selected, anonymous).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The paper examines anonymous questions about semen posted to a UK health website, revealing anxieties about semen quality, masturbation and potency that reflect broader concerns about masculinity and gender change in modern Britain.","clinical_takeaway":"None – the study offers cultural insight but does not provide clinical guidance.","confidence":0.4,"topic_tags":["masturbation","sexual_function","gender","csbd","pornography"],"strengths":["Innovative use of anonymized online queries","Provides cultural insight into contemporary UK masculinity concerns","Qualitative thematic analysis captures nuanced anxieties"],"limitations":["Non‑representative, self‑selected sample","No validated measurement instruments","Findings may not generalise beyond the website users"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13648470701694446"}},{"id":5006,"doi":"10.1037/0022-3514.93.6.1108","pmid":"18072857","pmcid":null,"title":"Gender and sexual orientation differences in sexual response to sexual activities versus gender of actors in sexual films","authors":"Chivers ML, Seto MC, Blanchard R.","first_author":"Chivers ML","journal":"Journal of personality and social psychology","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":155,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Lab experiment with video stimuli; within‑subject physiological and subjective arousal recordings; 91 participants across sexual orientation and gender groups.","sample_n":91,"sample_text":"20 homosexual women, 27 heterosexual women, 17 homosexual men, 27 heterosexual men","population":"Adult men and women (heterosexual and homosexual) recruited in a university‑based setting; convenience sample, not nationally representative.","country":"USA (implied by author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, men’s arousal responded mainly to the gender of actors in videos, while women’s arousal responded more to what the actors were doing. This pattern held across heterosexual and homosexual participants.","clinical_takeaway":"Arousal cues differ by gender; clinicians should consider activity versus actor gender when discussing sexual stimuli with clients.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Objective physiological measures of sexual arousal","Well‑controlled stimulus set varying activity and actor gender","Inclusion of multiple sexual orientation groups"],"limitations":["Small sample sizes per subgroup","Convenience, WEIRD sample limits generalisability","No control for broader psychosocial confounds (e.g., mood, prior experience)"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":37,"contrasting":8,"mentioning":282,"citing_publications":279,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/0022-3514.93.6.1108"}},{"id":5007,"doi":"10.1177/0898264307308342","pmid":"18165289","pmcid":null,"title":"Sexual behavior in later life","authors":"DeLamater J, Moorman SM.","first_author":"DeLamater J","journal":"Journal of aging and health","year":2007,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":65,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 1,384 US adults aged 45+, ordered logistic regression of age, health, attitudes, and partner variables on frequency of five sexual behaviours.","sample_n":1384,"sample_text":"Nationally‑based community sample recruited via the AARP Modern Maturity Sexuality Survey.","population":"US community adults ≥45 y (N = 1,384)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2007 survey of over 1,300 U.S. adults aged 45 + examined how age, health, attitudes, and partner relationship factors relate to how often people engage in partnered sex, solo masturbation and other sexual activities.","clinical_takeaway":"Older adults’ sexual activity is influenced more by relationship satisfaction and attitudes than by diagnosed illnesses; clinicians should consider psychosocial context when discussing sexual health with older patients.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large community sample (N>1300)","Multivariate ordered‑logistic models","Separate measurement of masturbation frequency"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of mental‑health or moral‑incongruence confounds","Scales not described as validated"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":13,"contrasting":0,"mentioning":114,"citing_publications":163,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0898264307308342"}},{"id":5009,"doi":null,"pmid":"18323234","pmcid":null,"title":"[Foreign bodies in the urogenital tract--between iatrogeny and autoerotism]","authors":"Mischianu D, Ilie CP, Mădan V, Pacu O, Pantalon A, Tănăsescu M, Dinu M, Rusu F.","first_author":"Mischianu D","journal":"Chirurgia (Bucharest, Romania : 1990)","year":2007,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"rum","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Retrospective case series of 12 patients treated for urogenital foreign bodies over 7 years.","sample_n":12,"sample_text":"12 patients","population":"Adults (male and female) presenting with foreign bodies in the urogenital tract (n=12).","country":"Romania","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed 12 cases of people who inserted objects into their urinary or genital tracts, often for sexual reasons. They describe how the objects were diagnosed and whether they could be removed endoscopically or required surgery.","clinical_takeaway":"Clinicians should consider imaging to locate foreign bodies and be prepared for surgical removal when endoscopic methods fail.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Clear clinical description of rare cases","Detail on diagnostic and management approaches"],"limitations":["Very small, non‑representative sample","No systematic methodology or control group","No quantitative analysis or validated measures"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":5010,"doi":null,"pmid":"3375914","pmcid":null,"title":"An urgent warning--contraction of HIV infection during mutual masturbation","authors":"Knobel GJ.","first_author":"Knobel GJ.","journal":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","year":1988,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5011,"doi":"10.1177/0306624x07307122","pmid":"17923511","pmcid":null,"title":"Exhibitionism: findings from a Midwestern police contact sample","authors":"Bader SM, Schoeneman-Morris KA, Scalora MJ, Casady TK.","first_author":"Bader SM","journal":"International journal of offender therapy and comparative criminology","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective police‑record review of 106 individuals involved in exhibitionist offenses; descriptive and comparative analyses of offense characteristics and recidivism.","sample_n":106,"sample_text":"Police sample of identified individuals (106) linked to 202 exhibitionism incidents.","population":"Individuals charged with indecent exposure in a Midwestern US jurisdiction (N≈106 offenders, 202 incidents).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Police records of 106 exhibitionists showed that many also had mental‑illness symptoms, substance‑abuse histories, and non‑sexual crimes. Masturbation during the offense did not predict later aggression, but repeat exposure offenders were more likely to later be charged with rape or molestation.","clinical_takeaway":"Exhibitionism often co‑occurs with broader mental‑health and criminal issues; treatment should address these comorbidities rather than focusing on the sexual act alone.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large regional police dataset covering >200 incidents","Clear documentation of offense characteristics","Links between exhibitionism and broader criminal patterns"],"limitations":["No validated psychometric measures of exhibitionism or mental illness","Cross‑sectional, no causal inference possible","Limited control for key confounds (e.g., moral attitudes, trauma)","Findings may not generalise beyond the Midwestern police sample"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x07307122"}},{"id":5012,"doi":"10.1007/bf01542662","pmid":"3395224","pmcid":null,"title":"Sexual interest and behavior in healthy 80- to 102-year-olds","authors":"Bretschneider JG, McCoy NL.","first_author":"Bretschneider JG","journal":"Archives of sexual behavior","year":1988,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":99,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study of 202 White older adults (80‑102 yr) living in residential retirement facilities","sample_n":202,"sample_text":"100 men, 102 women, ages 80‑102, living in retirement facilities","population":"healthy, upper‑middle‑class older adults (white), residential retirement facilities","country":"USA (presumed from authors, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A questionnaire of 202 adults aged 80‑102 found that touching and caressing was the most common sexual activity, followed by masturbation and intercourse. Frequency of touching declined with age, especially in men. Marital status, income, church attendance and past feelings of guilt were modestly linked to how often and how much participants enjoyed sexual activities.","clinical_takeaway":"Even in very old age, many people remain sexually active, primarily through non‑intercourse activities; clinicians should assess a range of behaviors rather than assume decline.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["large sample for very old age group","covers multiple sexual activities (including masturbation)","provides age‑gradient data"],"limitations":["non‑validated questionnaire","convenience, homogeneous (white, upper‑middle‑class) sample","no control for moral/religious incongruence or mental‑health variables","cross‑sectional, no causal inference"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":2,"mentioning":86,"citing_publications":244,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542662"}},{"id":5013,"doi":"10.1016/j.fertnstert.2007.08.006","pmid":"17905241","pmcid":null,"title":"Semen cryopreservation in pubertal boys before gonadotoxic treatment and the role of endocrinologic evaluation in predicting sperm yield","authors":"van Casteren NJ, Dohle GR, Romijn JC, de Muinck Keizer-Schrama SM, Weber RF, van den Heuvel-Eibrink MM.","first_author":"van Casteren NJ","journal":"Fertility and sterility","year":2008,"pub_types":["Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective data analysis of 80 pubertal boys referred for semen cryopreservation before gonadotoxic therapy.","sample_n":80,"sample_text":"80 boys (median age 16.6 years, range 13.7-18.9) consulted the outpatient clinic between 1995‑2005.","population":"Pubertal boys (median age 16.6) attending a tertiary fertility center.","country":"Netherlands (implied by authors and journal affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 80 teenage boys facing chemotherapy, semen could be collected and frozen in most cases, but hormone levels did not predict who would produce usable sperm.","clinical_takeaway":"Offer semen banking to all pubertal boys before gonadotoxic treatment; hormone tests alone won’t tell who will succeed.","confidence":0.6,"topic_tags":["sexual_function","religiosity"],"strengths":["Standardized laboratory measures of semen and hormones","Relatively large sample for a rare clinical scenario","Clear outcome (ability to cryopreserve sperm)"],"limitations":["Retrospective, no control group","Limited statistical detail; no power analysis","Potential selection bias (clinic‐based sample)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":19,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.fertnstert.2007.08.006"}},{"id":5015,"doi":"10.1016/0891-5245(88)90179-4","pmid":"3351736","pmcid":null,"title":"Masturbation","authors":"Castiglia PT.","first_author":"Castiglia PT.","journal":"Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners","year":1988,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0891-5245(88)90179-4"}},{"id":5016,"doi":"10.1111/j.1743-6109.2007.00568.x","pmid":"17727349","pmcid":null,"title":"Sex after seventy: a pilot study of sexual function in older persons","authors":"Smith LJ, Mulhall JP, Deveci S, Monaghan N, Reid MC.","first_author":"Smith LJ","journal":"The journal of sexual medicine","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pilot survey of 50 older adults recruited from primary‑care appointments; in‑depth sexual histories and standardized sexual‑function questionnaires.","sample_n":50,"sample_text":"50 participants (68 % of eligible) completed the study.","population":"Older adults (mean age 81 ± 6 y), 56 % women, community‑dwelling, convenience sample from primary‑care clinic.","country":"United States (New York)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small survey of 50 adults aged around 80, only a minority were sexually active. Women mostly reported lack of desire, while men wanted sex but often had erectile problems. Very few patients or doctors talked about sexual health during visits.","clinical_takeaway":"Older patients may benefit from routine, proactive conversations about sexual health, as many have unmet needs.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of validated sexual‑function instruments","In‑depth histories rather than brief checklists","Both genders and multiple domains of function assessed"],"limitations":["Small convenience sample; limited generalisability","Cross‑sectional, no causal inference","Limited control for psychosocial confounds (e.g., relational factors, moral views)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":0,"mentioning":63,"citing_publications":136,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2007.00568.x"}},{"id":5018,"doi":"10.1080/13691050601106679","pmid":"17687677","pmcid":null,"title":"Vulnerability and sexual and reproductive health among Zambian secondary school students","authors":"Warenius L, Pettersson KO, Nissen E, Höjer B, Chishimba P, Faxelid E.","first_author":"Warenius L","journal":"Culture, health & sexuality","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 716 secondary school students in four urban schools in Zambia; questionnaire on SRH knowledge and needs; invited open‑ended questions.","sample_n":716,"sample_text":"four secondary schools in an urban area of Zambia; convenience sample","population":"secondary school students (ages 11‑22) in urban Zambia","country":"Zambia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 716 Zambian secondary‑school students showed limited knowledge about reproduction, STIs, contraception and masturbation, and a desire for clearer information and support on love, relationships and sexual health.","clinical_takeaway":"Youth programs should provide accurate, culturally‑sensitive education on reproduction, STIs, contraception and masturbation.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["large sample for a school‑based survey","includes both male and female students","captures students' own expressed questions and concerns"],"limitations":["questionnaire not reported as validated","convenience sample limits generalisability","no measurement of key confounds (e.g., moral/religious attitudes, mental health)","analyses limited to descriptive statistics"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":1,"mentioning":24,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691050601106679"}},{"id":5019,"doi":"10.1111/j.1746-1561.2007.00220.x","pmid":"17680894","pmcid":null,"title":"Sexual attitudes and risk-taking behaviors of high school students in Turkey","authors":"Aras S, Semin S, Gunay T, Orcin E, Ozan S.","first_author":"Aras S","journal":"The Journal of school health","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"questionnaire administered to 861 senior high‑school students in classroom settings; convenience sample","sample_n":861,"sample_text":"861 senior‑year high school students","population":"high‑school adolescents (Turkey)","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2007 Turkish survey of 861 high‑school seniors found that boys reported higher rates of masturbation, sex, and more partners than girls, while condom use at first sex was low. Academic struggles and smoking were linked to sexual activity.","clinical_takeaway":"Education programs should address low condom use and consider factors like academic difficulties and smoking when targeting adolescent sexual health.","confidence":0.78,"topic_tags":["adolescents","sexual_function"],"strengths":["Large sample for a single‑school survey","Includes both genders and multiple behavioural variables","Highlights gaps in condom use and education"],"limitations":["Questionnaire not validated","Convenience sample limits generalisability","Limited control of psychosocial confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":1,"mentioning":54,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1746-1561.2007.00220.x"}},{"id":5022,"doi":"10.1111/j.1743-6109.2007.00543.x","pmid":"17672829","pmcid":null,"title":"A pilot survey of sexual functioning and preferences in a sample of English-speaking adults from a small South Indian town","authors":"Kar N, Koola MM.","first_author":"Kar N","journal":"The journal of sexual medicine","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Pilot survey of 61 English‑speaking adults from a small South Indian town, postal questionnaire, convenience sample.","sample_n":61,"sample_text":"61 respondents out of 200 invited","population":"English‑speaking adults (n≈61) from a small town in South India","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small pilot survey of 61 English‑speaking adults in a South Indian town described their sexual difficulties, attitudes toward masturbation and a range of sexual preferences such as voyeurism and fetishism.","clinical_takeaway":"Findings are descriptive only; no clinical recommendations can be drawn.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["First data on sexual preferences from this region","Includes a range of sexual difficulty items"],"limitations":["Very small, non‑representative convenience sample","Questionnaires not reported as validated","No control for key confounds (moral attitudes, mental health, partner status)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":24,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2007.00543.x"}},{"id":5023,"doi":null,"pmid":"17877965","pmcid":null,"title":"[Hands on the duvet]","authors":"Skrydsgaard MA.","first_author":"Skrydsgaard MA.","journal":"Ugeskrift for laeger","year":2007,"pub_types":["Historical Article","Biography","Portrait","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"dan","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5025,"doi":"10.1136/bmj.39262.458773.3a","pmid":"17615193","pmcid":"PMC1910618","title":"Before and after pictures: A time honoured way of oversimplifying complex problems","authors":"Baillie DW, Salter M.","first_author":"Baillie DW","journal":"BMJ (Clinical research ed.)","year":2007,"pub_types":["Letter","Comment","Historical Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.39262.458773.3a"}},{"id":5026,"doi":null,"pmid":"3687256","pmcid":null,"title":"[Rare foreign body fistulas of the female bladder]","authors":"Methfessel HD.","first_author":"Methfessel HD.","journal":"Zeitschrift fur Urologie und Nephrologie","year":1987,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":["Population","Biology","Population dynamics","Urogenital system","Physiology","Mortality","Treatment","Surgery","Diseases","Endoscopy","research methodology","Colposcopy","Demographic Factors","Studies","Urogenital Effects","Examinations And Diagnoses","Case Studies","Physical Examinations And Diagnoses","Vaginal Abnormalities","Accidental Deaths","Vaginal Injury","Urogenital Surgery--therapeutic Use"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of two patients with foreign-body vesicovaginal fistulas, one following masturbation","sample_n":2,"sample_text":"Two individual cases described in detail","population":"2 female patients (18‑year‑old, 66‑year‑old)","country":"Germany (journal language suggests German authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reports two unusual cases where objects inserted into the vagina (one during masturbation, another an old pessary) caused fistulas between the bladder and vagina, highlighting a rare but serious medical complication.","clinical_takeaway":"Insertion of foreign objects into the genital tract can lead to severe injuries like bladder‑vaginal fistulas; clinicians should be aware of this risk.","confidence":0.9,"topic_tags":["masturbation","sexual_function","gender","pornography"],"strengths":["Detailed clinical description of rare cases","Illustrates possible severe complications of foreign‑body insertion"],"limitations":["N=2, no generalisable data","No systematic assessment of psychological factors","No quantitative analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":5027,"doi":null,"pmid":"2957362","pmcid":null,"title":"Medroxyprogesterone acetate (MPA) treatment of sexual acting out in men suffering from dementia","authors":"Cooper AJ.","first_author":"Cooper AJ.","journal":"The Journal of clinical psychiatry","year":1987,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":41,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Four demented men with disruptive sexual behavior were treated with medroxyprogesterone acetate for one year; outcomes were recorded before, during, and after treatment.","sample_n":4,"sample_text":"Four demented male patients","population":"Male dementia patients (n=4)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"Four men with dementia who displayed public masturbation and sexual aggression were given medroxyprogesterone acetate. Within two weeks the disruptive behaviours stopped, coinciding with large drops in testosterone and LH. When the drug was stopped, hormones rose again and one man showed a reduced return of the behaviour.","clinical_takeaway":"MPA may suppress sexual acting‑out in dementia, but evidence is limited to a four‑patient case series.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Longitudinal follow‑up of 2 years","Objective hormone measurements"],"limitations":["Extremely small uncontrolled case series","No validated behavioural scales","No control for confounding variables"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5030,"doi":"10.1080/13668250701408004","pmid":"17613678","pmcid":null,"title":"Sexual knowledge and attitudes of men with intellectual disability who sexually offend","authors":"Lunsky Y, Frijters J, Griffiths DM, Watson SL, Williston S.","first_author":"Lunsky Y","journal":"Journal of intellectual & developmental disability","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of men with intellectual disability who have offended versus matched non‑offenders, using the validated Socio‑Sexual Knowledge and Attitudes Assessment Tool – Revised (SSKAAT‑R).","sample_n":null,"sample_text":"Not reported in abstract","population":"Men with intellectual disability, some with a history of sexual offending; matched control group of men with ID without known offenses.","country":"Canada, United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Men with intellectual disability who committed serious sexual offences knew as much about sex as non‑offending peers, but showed more liberal attitudes toward same‑sex activity. Less serious offenders did not differ in knowledge or attitudes.","clinical_takeaway":"Sex education alone may not explain sexual offending in men with intellectual disability; attitudes, not knowledge, differ by offence severity.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses a validated assessment tool (SSKAAT‑R)","Matched comparison groups","Differentiates subtypes of offending"],"limitations":["No reported sample size or power analysis","No control for key confounds (mental health, trauma, moral/religious factors)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":22,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13668250701408004"}},{"id":5031,"doi":"10.1007/s10508-006-9142-3","pmid":"17345167","pmcid":null,"title":"Asexuality: classification and characterization","authors":"Prause N, Graham CA.","first_author":"Prause N","journal":"Archives of sexual behavior","year":2007,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":80,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Convenience online survey; 1,146 participants with 41 self‑identified asexuals; cross‑sectional questionnaire study.","sample_n":1146,"sample_text":"1,146 respondents (41 asexual) completed online questionnaires.","population":"Adults (mixed gender) recruited via convenience sampling; self‑identified asexuals vs non‑asexual respondents.","country":"Not specified (likely USA/International online sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed over a thousand adults, including 41 who identify as asexual, to compare sexual desire, arousal, and inhibition. Asexual participants showed markedly lower desire, arousal, and excitation, while their desire to masturbate and inhibition scores were similar to non‑asexuals.","clinical_takeaway":"Low sexual desire appears to be the primary characteristic of asexual identity; clinicians should distinguish asexuality from sexual dysfunction.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Large overall sample size","Use of validated sexual desire/excitation measures","Both qualitative (N=4) and quantitative components"],"limitations":["Convenience, self‑selected online recruitment limits generalisability","Small asexual subgroup reduces power for between‑group comparisons","No control for moral, mental‑health, or relational confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":14,"contrasting":2,"mentioning":197,"citing_publications":232,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-006-9142-3"}},{"id":5032,"doi":"10.1111/j.1440-1819.2007.01667.x","pmid":"17472606","pmcid":null,"title":"Sexual disinhibition in schizophrenia possibly induced by risperidone and quetiapine","authors":"Lam MH, Fong SY, Wing YK.","first_author":"Lam MH","journal":"Psychiatry and clinical neurosciences","year":2007,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1440-1819.2007.01667.x"}},{"id":5035,"doi":"10.1111/j.1745-7262.2007.00276.x","pmid":"17486282","pmcid":null,"title":"Yohimbine in the treatment of orgasmic dysfunction","authors":"Adeniyi AA, Brindley GS, Pryor JP, Ralph DJ.","first_author":"Adeniyi AA","journal":"Asian journal of andrology","year":2007,"pub_types":["Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"open‑label, single‑arm dose‑titration trial with 29 men; no control group; outcome assessed after self‑selected dose escalation","sample_n":29,"sample_text":"29 men completed treatment; no randomisation or comparator group","population":"men with orgasmic dysfunction (primary complete, primary incomplete, secondary); clinic sample, mean age not reported","country":"Not stated (journal Asian Journal of Andrology)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small, open‑label trial of 29 men with orgasmic problems, taking yohimbine (starting 20 mg and titrated at home) helped most participants achieve orgasm, either by masturbation or intercourse, with few side effects.","clinical_takeaway":"Yohimbine may aid men with orgasmic dysfunction, but evidence is limited to an uncontrolled case series; larger controlled trials are needed.","confidence":0.7,"topic_tags":["sexual_function","treatment"],"strengths":["Focused on a specific, understudied sexual dysfunction","Provides preliminary clinical observations of yohimbine’s effects"],"limitations":["No control or randomisation; cannot infer causality","Small, convenience clinical sample (N=29)","Outcomes not measured with validated scales"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":27,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1745-7262.2007.00276.x"}},{"id":5037,"doi":"10.1080/00224490701263595","pmid":"17599270","pmcid":null,"title":"First stirrings: cultural notes on orgasm, ejaculation, and wet dreams","authors":"Janssen DF.","first_author":"Janssen DF.","journal":"Journal of sex research","year":2007,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methodology; no empirical data collected.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews cultural differences in when people experience their first orgasm, ejaculation, and wet dreams, highlighting measurement problems and arguing that these milestones are shaped by cultural expectations.","clinical_takeaway":"None – the paper is theoretical and does not provide clinical guidance.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Broad cultural perspective on sexual milestones","Identifies methodological challenges in measuring orgasm and ejaculation timing"],"limitations":["Narrative, non‑systematic review lacking explicit methods","No empirical data or quantitative synthesis","Limited relevance to pornography or compulsive sexual behavior"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490701263595"}},{"id":5039,"doi":"10.1177/146642408710700208","pmid":"3108501","pmcid":null,"title":"Masturbatory death and injury","authors":"Burg BR.","first_author":"Burg BR.","journal":"Journal of the Royal Society of Health","year":1987,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/146642408710700208"}},{"id":5040,"doi":"10.1177/0009922806290733","pmid":"17325098","pmcid":null,"title":"Abused foster child","authors":"Abell S, Ey JL.","first_author":"Abell S","journal":"Clinical pediatrics","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0009922806290733"}},{"id":5041,"doi":"10.1111/j.1743-6109.2007.00443_2.x","pmid":"17367448","pmcid":null,"title":"Four measures of investigating ejaculatory performance","authors":"Waldinger MD.","first_author":"Waldinger MD.","journal":"The journal of sexual medicine","year":2007,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":26,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2007.00443_2.x"}},{"id":5042,"doi":"10.1111/j.1743-6109.2007.00443_1.x","pmid":"17367447","pmcid":null,"title":"Penetration ejaculatory latency time","authors":"Blaschko S.","first_author":"Blaschko S.","journal":"The journal of sexual medicine","year":2007,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2007.00443_1.x"}},{"id":5044,"doi":"10.1016/j.ijrobp.2006.12.015","pmid":"17331667","pmcid":null,"title":"Sexual function after three-dimensional conformal radiotherapy for prostate cancer: results from a dose-escalation trial","authors":"van der Wielen GJ, van Putten WL, Incrocci L.","first_author":"van der Wielen GJ","journal":"International journal of radiation oncology, biology, physics","year":2007,"pub_types":["Clinical Trial, Phase III","Research Support, Non-U.S. Gov't","Multicenter Study","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":67,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized dose-escalation trial comparing 68 Gy vs 78 Gy in prostate cancer patients, with 268 participants evaluated for sexual function over 3 years","sample_n":268,"sample_text":"268 patients participated in the sexual function sub‑study","population":"men with localized prostate cancer undergoing 3D conformal radiotherapy; median age not specified; recruited from multicenter randomized trial","country":"multicenter (likely Europe, based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a trial of 268 men receiving 3‑D conformal radiotherapy for prostate cancer, about one‑third developed erectile problems over three years, but many retained sexual desire and valued sex; higher radiation dose did not worsen outcomes.","clinical_takeaway":"Prostate radiotherapy can lead to erectile dysfunction, yet most men keep sexual desire; discuss hormonal therapy and potency aids with patients.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large, multicenter RCT sample","Longitudinal follow‑up up to 3 years","Considers hormonal therapy and potency aid use"],"limitations":["Unclear whether sexual outcomes used validated questionnaires","No control for psychological or relational confounds","Effect sizes and confidence intervals not reported in abstract"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":52,"citing_publications":88,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijrobp.2006.12.015"}},{"id":5045,"doi":"10.7863/jum.1987.6.2.111","pmid":"3550126","pmcid":null,"title":"Sonographic observation of in utero fetal \"masturbation\"","authors":"Meizner I.","first_author":"Meizner I.","journal":"Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine","year":1987,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7863/jum.1987.6.2.111"}},{"id":5046,"doi":"10.1007/bf01541840","pmid":"3579556","pmcid":null,"title":"Sexual behavior in healthy married elderly men","authors":"Weizman R, Hart J.","first_author":"Weizman R","journal":"Archives of sexual behavior","year":1987,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 81 physically healthy married men aged 60‑71, using a three‑point self‑report rating of sexual function and questions about masturbation frequency.","sample_n":81,"sample_text":"81 men (34 aged 60‑65, 47 aged 66‑71)","population":"81 married elderly men, physically healthy, no reported psychopathology or marital problems.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 81 healthy married men aged 60‑71, about half reported regular masturbation and a third reported impotence. Older men (66‑71) had less intercourse but more masturbation, showing that sexual interest persists but shifts in form.","clinical_takeaway":"Elderly men remain sexually interested; clinicians should assess both intercourse and masturbation and offer treatment for dysfunction.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Clear age stratification","Focus on a rarely studied older male population","Includes both intercourse and masturbation data"],"limitations":["Unvalidated three‑point rating scale","No measurement of psychosocial confounds (e.g., moral attitudes, mental health)","Small, non‑representative convenience sample","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":12,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541840"}},{"id":5048,"doi":"10.1111/j.1464-410x.1987.tb04822.x","pmid":"3828722","pmcid":null,"title":"Non-venereal sclerosing lymphangitis of the penis associated with masturbation","authors":"Sieunarine K.","first_author":"Sieunarine K.","journal":"British journal of urology","year":1987,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1464-410x.1987.tb04822.x"}},{"id":5049,"doi":"10.1080/00224490709336793","pmid":"17599265","pmcid":null,"title":"The advantages and limitations of seeking sex online: a comparison of reasons given for online and offline sexual liaisons by men who have sex with men","authors":"Ross MW, Rosser BR, McCurdy S, Feldman J.","first_author":"Ross MW","journal":"Journal of sex research","year":2007,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross‑sectional online survey with open‑ended questions; thematic analysis of 1,017 Latino MSM","sample_n":1017,"sample_text":"online respondents recruited for a larger HIV‑risk study","population":"Latino men who have sex with men (MSM) in the United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over a thousand Latino gay men, researchers identified why some prefer meeting partners online and others offline. Online contact is seen as easy, anonymous and safe, especially for shy men, while offline contact offers real‑world presence and relationship potential. Choices depend on mood, setting, substance use and relationship goals.","clinical_takeaway":"Clinicians should recognize that preferences for online or offline sexual encounters are driven by multiple personal and contextual factors, not simply risk or pathology.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for qualitative work","Systematic thematic analysis","Addresses nuanced motivations for online vs offline sexual contact"],"limitations":["No validated measures of constructs","No control of key confounds (moral incongruence, mental health, etc.)","Cross‑sectional, self‑selected online sample limits generalisability"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":24,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490709336793"}},{"id":5051,"doi":"10.1007/s10803-006-0159-1","pmid":"16868848","pmcid":null,"title":"Sexual behavior in high-functioning male adolescents and young adults with autism spectrum disorder","authors":"Hellemans H, Colson K, Verbraeken C, Vermeiren R, Deboutte D.","first_author":"Hellemans H","journal":"Journal of autism and developmental disorders","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":78,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Interview-based descriptive study of 24 institutionalized high‑functioning male adolescents/young adults with ASD.","sample_n":24,"sample_text":"24 institutionalized males (adolescents and young adults).","population":"Male adolescents and young adults with autism spectrum disorder, high‑functioning, institutionalized (N=24).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Caregivers reported that most high‑functioning autistic boys and young men showed sexual interest, masturbated, and some had relationships or intercourse, but practical sexual skills were limited and a few displayed atypical sexual interests.","clinical_takeaway":"Clinicians should assess sexual development and provide tailored support for autistic males, as many show interest but need guidance.","confidence":0.6,"topic_tags":["sexual_function","masturbation","relationships"],"strengths":["Focus on an understudied population (high‑functioning ASD males)","Use of caregiver interview to capture real‑world behavior"],"limitations":["Very small, non‑representative sample","No validated measurement instrument","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":9,"contrasting":7,"mentioning":174,"citing_publications":268,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10803-006-0159-1"}},{"id":5052,"doi":"10.1007/bf01534067","pmid":"24301692","pmcid":null,"title":"Twentieth-century attitudes toward masturbation","authors":"Patton MS.","first_author":"Patton MS.","journal":"Journal of religion and health","year":1986,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/historical review without original data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how 19th‑century medicine, psychiatry and religion viewed masturbation, describing a shift from moral condemnation to seeing it as therapeutic for psychosexual issues.","clinical_takeaway":"None – the paper is a historical overview, not a source of clinical evidence.","confidence":0.9,"topic_tags":["masturbation","religiosity","sexual_function"],"strengths":["Provides historical perspective on attitudes","Integrates medicine, psychiatry, religion, anthropology"],"limitations":["No empirical data or measurement","Potential bias toward a particular moral viewpoint","Old publication, may not reflect current research"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01534067"}},{"id":5053,"doi":null,"pmid":"3589730","pmcid":null,"title":"Masturbation during sleep--a somnambulistic variant?","authors":"Wong KE.","first_author":"Wong KE.","journal":"Singapore medical journal","year":1986,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5055,"doi":"10.1080/00797308.2007.11800785","pmid":"18524088","pmcid":null,"title":"The psychoanalytic process in the treatment of Little Hans","authors":"Bierman JS.","first_author":"Bierman JS.","journal":"The Psychoanalytic study of the child","year":2007,"pub_types":["Historical Article","Biography","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical/biographical commentary on the Little Hans case; no empirical data collected.","sample_n":null,"sample_text":"N/A (historical case report).","population":"Historical child case (Little Hans, early 1900s).","country":"Austria (historical)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews the classic Freud case of Little Hans, describing how the psychoanalytic process was applied and how attitudes toward masturbation were punitive.","clinical_takeaway":"Historical case; does not provide evidence for current clinical practice regarding masturbation or sexual health.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Provides historical insight into early psychoanalytic case work."],"limitations":["No empirical data; purely narrative.","Lacks operational definitions or measurement of constructs.","No control of confounding variables."],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00797308.2007.11800785"}},{"id":5059,"doi":"10.1111/j.1460-9568.2006.05215.x","pmid":"17229093","pmcid":null,"title":"Serial neurochemical measurement of cerebrospinal fluid during the human sexual response cycle","authors":"Krüger TH, Schiffer B, Eikermann M, Haake P, Gizewski E, Schedlowski M.","first_author":"Krüger TH","journal":"The European journal of neuroscience","year":2006,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Evaluation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["bibliography","csbd","masturbation","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Comparative laboratory study with 10 healthy male participants and 10 age‑matched controls undergoing lumbar CSF sampling during a masturbatory sexual response paradigm.","sample_n":20,"sample_text":"10 healthy males and 10 age‑matched controls","population":"Healthy adult males (n=20 total)","country":"Germany (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 20 men, researchers measured chemicals in spinal fluid while participants watched erotic videos and masturbated. They found that norepinephrine rose during arousal and stayed high, but dopamine‑related chemicals did not change, suggesting sympathetic activation but no clear dopaminergic shift in the spinal fluid.","clinical_takeaway":"CSF norepinephrine increases during sexual arousal; dopamine changes may be confined to brain regions not reflected in lumbar fluid.","confidence":0.6,"topic_tags":["sexual_function","neuroscience"],"strengths":["Use of direct CSF sampling provides rare physiological data","Well‑matched control group","Standard biochemical assays with validated sensitivity"],"limitations":["Very small sample size limits generalisability","No effect‑size reporting or correction for multiple comparisons","Masturbation not separated from other sexual variables (e.g., arousal intensity)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":22,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1460-9568.2006.05215.x"}},{"id":5061,"doi":null,"pmid":"17726814","pmcid":null,"title":"Sexuality after total abdominal hysterectomy in Srinagarind Hospital","authors":"Punushapai U, Khampitak K.","first_author":"Punushapai U","journal":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective descriptive study with pre‑post questionnaires (N=80) but no control group","sample_n":80,"sample_text":"80 women","population":"married Thai women ≤45 y undergoing total abdominal hysterectomy","country":"Thailand","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 80 Thai women who had a total abdominal hysterectomy, rates of painful intercourse fell and sexual desire, coital activity and overall sexual satisfaction rose over six months after surgery.","clinical_takeaway":"Women may experience improved sexual function after hysterectomy, but findings are limited by lack of controls and validated measures.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["prospective within‑subject design","reasonable follow‑up rate","covers several domains of sexual function"],"limitations":["No validated sexuality questionnaire reported","No control/comparator group","Potential over‑statement of causal effect","Confounding variables (e.g., mental health, relationship quality) not assessed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":5062,"doi":"10.1258/rsmmsl.46.4.357","pmid":"17191641","pmcid":null,"title":"Female autoerotic deaths--still often overlooked: a case report","authors":"Sauvageau A, Racette S.","first_author":"Sauvageau A","journal":"Medicine, science, and the law","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single forensic case description; no systematic data collection; no control group; limited generalisability","sample_n":1,"sample_text":"One female decedent described in detail.","population":"34‑year‑old female found dead; forensic context","country":"Canada (inferred from author affiliations, not specified in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper reports a rare case of a woman who died during solo sexual activity involving foreign objects. It shows how such deaths can be missed because they look different from the better‑known male cases, urging forensic teams to consider female autoerotic deaths.","clinical_takeaway":"None – the report is forensic, not directly relevant to clinical practice.","confidence":0.9,"topic_tags":["sexual_function","masturbation","moral_incongruence"],"strengths":["Highlights a rare and under‑recognised phenomenon","Provides detailed forensic description"],"limitations":["Single case; no statistical analysis","No systematic measurement of constructs (masturbation, distress, etc.)","No control or comparison group"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/rsmmsl.46.4.357"}},{"id":5064,"doi":"10.1016/s0022-5347(06)00600-8","pmid":"16945681","pmcid":null,"title":"Long-term cosmetic and sexual outcome of hypospadias surgery: norm related study in adolescence","authors":"Moriya K, Kakizaki H, Tanaka H, Furuno T, Higashiyama H, Sano H, Kitta T, Nonomura K.","first_author":"Moriya K","journal":"The Journal of urology","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"questionnaire mailed to former patients and age‑matched controls; response rate 67% patients, 76% controls; mean ages ~21 years; small sample (22 patients, 38 controls).","sample_n":60,"sample_text":"22 patients (66.7% response) and 38 controls (76.0% response).","population":" males aged 18‑26 who had hypospadias surgery in childhood; compared with age‑matched community males.","country":"Japan (inferred from author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A questionnaire sent to men who had hypospadias surgery as children showed they were slightly more dissatisfied with penis size than peers, but their masturbation and sexual activity rates were similar to those of age‑matched men without the condition.","clinical_takeaway":"Hypospadias surgery does not appear to affect later sexual activity, though some men may be less satisfied with penile appearance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Direct comparison with age‑matched control group","Focus on both cosmetic satisfaction and sexual behavior","First long‑term data on hypospadias outcomes into adolescence"],"limitations":["Small sample size limits statistical power","Questionnaire not described as validated","Potential response bias; non‑responders unknown"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":9,"contrasting":0,"mentioning":51,"citing_publications":93,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-5347(06)00600-8"}},{"id":5066,"doi":"10.1001/archneur.1986.00520040086028","pmid":"3082317","pmcid":null,"title":"Self-induced photosensitive absence seizures with ictal pleasure","authors":"Faught E, Falgout J, Nidiffer D, Dreifuss FE.","first_author":"Faught E","journal":"Archives of neurology","year":1986,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case description of self‑induced photosensitive absence seizures with reported ictal pleasure and masturbatory behaviour; EEG used to document spike‑wave discharges","sample_n":1,"sample_text":"1 patient (case report)","population":"32‑year‑old female patient","country":"United States (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 32‑year‑old woman could trigger seizures with flashing lights and reported feeling pleasure and masturbating during the events. EEG showed typical seizure activity. The authors suggest operant conditioning may explain the behaviour, but the finding is based on one case.","clinical_takeaway":"This isolated case does not provide evidence for clinical practice; it merely notes a rare phenomenon of pleasurable seizures.","confidence":0.8,"topic_tags":["sexual_function","masturbation","neuroscience"],"strengths":["objective EEG confirmation of photosensitive seizures","unique documentation of ictal pleasure"],"limitations":["single case; no generalisability","no validated scales for pleasure or compulsivity","no control of psychological or contextual confounds"],"rubric_version":"2.0","raw_total":11,"max_possible":60,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":3,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archneur.1986.00520040086028"}},{"id":5067,"doi":"10.1016/j.juro.2006.04.084","pmid":"16890697","pmcid":null,"title":"Neurological bypass for sensory innervation of the penis in patients with spina bifida","authors":"Overgoor ML, Kon M, Cohen-Kettenis PT, Strijbos SA, de Boer N, de Jong TP.","first_author":"Overgoor ML","journal":"The Journal of urology","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"prospective case series of 3 patients undergoing surgical nerve bypass","sample_n":3,"sample_text":"3 patients","population":"male patients with spina bifida, ages 17‑21","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In three young men with spina bifida, surgeons rerouted a sensory nerve to the penis, restoring feeling in the glans and improving body image and sexual satisfaction.","clinical_takeaway":"Surgical nerve bypass may restore penile sensation in spina bifida, but evidence is limited to three cases.","confidence":0.85,"topic_tags":["sexual_function","neuroscience"],"strengths":["Innovative surgical technique","Objective sensory outcome measurement","Prospective design"],"limitations":["Very small sample (n=3)","No validated psychometric outcomes","No control group","Limited generalisability"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.juro.2006.04.084"}},{"id":5068,"doi":null,"pmid":"17219804","pmcid":null,"title":"[Sexuality of pregnant women]","authors":"Malarewicz A, Szymkiewicz J, Rogala J.","first_author":"Malarewicz A","journal":"Ginekologia polska","year":2006,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or meta‑analysis; summarizes prior literature on sexual activity and satisfaction during pregnancy.","sample_n":null,"sample_text":"Not applicable – review of previously published studies.","population":"Pregnant women (general, unspecified age/trimester)","country":"Poland (journal of origin)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarizes how pregnancy affects sexual activity and satisfaction, noting reduced desire in the first trimester, a possible rebound in the second, and a shift toward non‑penetrative activities. It stresses the need for better information from health professionals.","clinical_takeaway":"Clinicians should proactively discuss sexual changes and options with pregnant patients to support satisfaction and relationship wellbeing.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad overview of sexual changes across pregnancy trimesters","Highlights importance of partner communication and sexual education"],"limitations":["No systematic search or appraisal of included studies","Lacks quantitative synthesis or critical risk‑of‑bias assessment","No original data; conclusions reflect authors’ narrative selection"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":5070,"doi":"10.1037/1093-4510.9.3.186","pmid":"17153143","pmcid":null,"title":"G. Stanley Hall's Adolescence: Brilliance and nonsense","authors":"Arnett JJ.","first_author":"Arnett JJ.","journal":"History of psychology","year":2006,"pub_types":["Historical Article","Biography","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical commentary and biographical analysis; no empirical data collected.","sample_n":null,"sample_text":"N/A – no participants were studied.","population":"none","country":"United States (historical focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews G. Stanley Hall's 19th‑century ideas about adolescence, noting where his views on sexuality, masturbation, and religious conversion resemble or differ from contemporary psychology.","clinical_takeaway":"None – the paper offers historical insight, not clinical evidence.","confidence":0.8,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["Provides historical context for early views on sexuality and masturbation","Links past theories to modern psychological perspectives"],"limitations":["No original data; purely interpretive","Cannot inform current empirical questions about pornography or compulsive sexual behavior"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":40,"citing_publications":136,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/1093-4510.9.3.186"}},{"id":5071,"doi":"10.1016/j.anuro.2006.05.004","pmid":"16970070","pmcid":null,"title":"[Rupture of corpora cavernosa: clinical practice]","authors":"Paparel P, Ruffion A.","first_author":"Paparel P","journal":"Annales d'urologie","year":2006,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article without original empirical data; provides clinical overview of penile fracture etiology, diagnosis, and treatment.","sample_n":null,"sample_text":"Review of existing literature; no new participants.","population":"n/a","country":"n/a","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews penile fracture, a rare injury often caused by vigorous sexual activity or, in some regions, by masturbation. It outlines symptoms, imaging methods for diagnosis, and recommends surgical repair over conservative care due to higher complication rates.","clinical_takeaway":"Surgical repair remains the preferred treatment for penile fracture to avoid long‑term complications.","confidence":0.4,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Comprehensive clinical overview","Clear description of diagnosis and treatment options"],"limitations":["No original data; narrative review only","No systematic methodology or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.anuro.2006.05.004"}},{"id":5075,"doi":"10.1258/095646206778145730","pmid":"16925903","pmcid":null,"title":"Circumcision in Australia: prevalence and effects on sexual health","authors":"Richters J, Smith AM, de Visser RO, Grulich AE, Rissel CE.","first_author":"Richters J","journal":"International journal of STD & AIDS","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large probability sample telephone survey, cross‑sectional","sample_n":10173,"sample_text":"probability household sample, nationally representative","population":"10,173 Australian men aged 16‑59 (response rate 69.4%)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2001‑02 Australian telephone survey of over 10,000 men found that 59% were circumcised. After adjusting for age, circumcision was not linked to sexually transmitted infections and showed little impact on most sexual problems, though circumcised men reported slightly less pain during sex and fewer erection issues.","clinical_takeaway":"Current evidence does not support major sexual‑health benefits or harms of male circumcision.","confidence":0.7,"topic_tags":["sexual_function","masturbation","moral_incongruence"],"strengths":["large, probability‑based national sample","separate measurement of masturbation","adjusted analyses for age"],"limitations":["cross‑sectional, no causal inference","limited control for mental‑health or relationship factors","no effect‑size reporting"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":0,"mentioning":53,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/095646206778145730"}},{"id":5076,"doi":"10.1016/j.eururo.2006.07.004","pmid":"16934919","pmcid":null,"title":"The Premature Ejaculation Prevalence and Attitudes (PEPA) survey: prevalence, comorbidities, and professional help-seeking","authors":"Porst H, Montorsi F, Rosen RC, Gaynor L, Grupe S, Alexander J.","first_author":"Porst H","journal":"European urology","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":360,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large internet‑based survey of 12,133 men from three countries; self‑report classification of PE; prevalence and comorbidity frequencies reported","sample_n":12133,"sample_text":"Internet‑based convenience sample recruited via online panels in the United States, Germany, and Italy","population":"men age 18‑70, community sample, recruited online (self‑selected)","country":"United States, Germany, Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2007 internet survey of over 12,000 men in the US, Germany, and Italy found that about 23 % reported premature ejaculation, which was linked to other sexual problems and higher rates of depression, anxiety, and stress. Most men did not seek medical help and were dissatisfied with treatment.","clinical_takeaway":"Premature ejaculation is common and often co‑occurs with other sexual and psychological issues; clinicians should proactively discuss it, as most men do not bring it up themselves.","confidence":0.8,"topic_tags":["sexual_function","prevalence","pornography","masturbation","csbd"],"strengths":["Very large sample across three countries","Provides prevalence estimates for a rarely surveyed condition","Reports a range of comorbidities and treatment‑seeking patterns"],"limitations":["PE defined by a single self‑report item, not a validated questionnaire","Convenience online sample may not be representative","No adjustment for potential confounders (e.g., mental‑health status, relationship factors)","Statistical reporting limited to p‑values without effect sizes"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":32,"contrasting":7,"mentioning":463,"citing_publications":582,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.eururo.2006.07.004"}},{"id":5078,"doi":"10.1097/00004850-200607000-00007","pmid":"16687996","pmcid":null,"title":"Treatment of paraphilic sexual disorder: the use of topiramate in fetishism","authors":"Shiah IS, Chao CY, Mao WC, Chuang YJ.","first_author":"Shiah IS","journal":"International clinical psychopharmacology","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-patient case report describing topiramate treatment for fetishism","sample_n":1,"sample_text":"One patient","population":"23‑year‑old male with foot‑related fetishism","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 23‑year‑old man with a foot‑related fetish was treated with topiramate (200 mg/day). After six months his fetishistic urges and related masturbation decreased, suggesting the drug might help similar paraphilic disorders, but only a single case was examined.","clinical_takeaway":"Topiramate may reduce fetishistic urges, but evidence is limited to one case; larger controlled trials are needed before clinical use.","confidence":0.8,"topic_tags":["sexual_function","treatment"],"strengths":["Detailed clinical description","Follow‑up over 6 months","Specifies dosage and tolerability"],"limitations":["Single case, no control group","No validated symptom measures","No assessment of confounding factors"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00004850-200607000-00007"}},{"id":5079,"doi":null,"pmid":"4061151","pmcid":null,"title":"A unique case of \"masturbatory\" seizures in primary generalized epilepsy","authors":"Meo R, Bilo L, Striano S.","first_author":"Meo R","journal":"Acta neurologica","year":1985,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5080,"doi":"10.1590/s0102-311x2006000700011","pmid":"16791346","pmcid":null,"title":"Sexual practices in youth: analysis of lifetime sexual trajectory and last sexual intercourse","authors":"Heilborn ML, Cabral CS.","first_author":"Heilborn ML","journal":"Cadernos de saude publica","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Household survey of 4,634 Brazilian youths aged 18‑24 in three cities, describing lifetime and recent sexual practices.","sample_n":4634,"sample_text":"n = 4,634 participants from Porto Alegre, Rio de Janeiro, and Salvador.","population":"Young adults (18‑24) from three Brazilian capital cities, recruited via household sampling.","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A Brazilian household survey of 4,634 18‑24‑year‑olds described the range of sexual acts they have ever had and those in their most recent encounter, showing that vaginal intercourse dominates both lifetime and recent practices.","clinical_takeaway":"None – the study provides descriptive data on youth sexual behavior, not clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Large sample size","Multi‑city coverage","Focus on real‑world sexual trajectories"],"limitations":["Cross‑sectional, no causal inference","No measurement of potential confounds (e.g., religiosity, mental health)","Self‑report may be subject to social desirability bias"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s0102-311x2006000700011"}},{"id":5082,"doi":"10.4314/njps.v21i1-2.54254","pmid":"17242721","pmcid":null,"title":"Semen analysis of infertile Igbo males in Enugu, Eastern Nigeria","authors":"Nwafia WC, Igweh JC, Udebuani IN.","first_author":"Nwafia WC","journal":"Nigerian journal of physiological sciences : official publication of the Physiological Society of Nigeria","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational analysis of semen samples from 1,110 infertile Igbo men attending a clinic; no comparator group, convenience sample.","sample_n":1110,"sample_text":"1110 infertile Igbo males, ages 30‑50, recruited from a university teaching hospital infertility clinic.","population":"Igbo males, age 30‑50, attending infertility clinic in Enugu, Nigeria (N=1110)","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined semen quality in 1,110 Nigerian men seeking infertility treatment and found most had normal volume but low motility, count, and abnormal morphology, suggesting these factors underlie infertility in this group.","clinical_takeaway":"Semen analysis should focus on motility, count, and morphology rather than volume when evaluating male infertility.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for semen analysis","Standardized laboratory methods","Clear reporting of basic semen parameters"],"limitations":["Convenience clinic sample limits generalisability","No control/comparison group","Statistical analysis limited to descriptive percentages"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":2,"mentioning":8,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4314/njps.v21i1-2.54254"}},{"id":5083,"doi":"10.1007/bf01550850","pmid":"4051722","pmcid":null,"title":"Hemodynamics of sequential orgasm","authors":"Amberson JI, Hoon PW.","first_author":"Amberson JI","journal":"Archives of sexual behavior","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subject laboratory study of 17 women measured intravaginally during successive masturbatory orgasms.","sample_n":17,"sample_text":"Seventeen women masturbated to orgasm several times in succession while being measured intravaginally.","population":"Adult women (median age middle‑aged), recruited for a physiological experiment; not a clinical or treatment‑seeking sample.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 17 women, vaginal blood flow and oxygen were continuously recorded while they masturbated to multiple orgasms. The study found a physiological plateau between orgasms but no evidence that later orgasms are stronger.","clinical_takeaway":"Successive female orgasms show a plateau in physiological response; no need to assume increased intensity with more orgasms.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Objective physiological measures","Within‑subject design controls individual variability","Clear experimental manipulation of fantasy, orgasm, and relaxation phases"],"limitations":["Very small sample limits generalisability","No assessment of psychological correlates","Potential selection bias (volunteers for sexual physiology study)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01550850"}},{"id":5085,"doi":"10.1111/j.1467-789x.2006.00247.x","pmid":"16629878","pmcid":null,"title":"John Harvey Kellogg (1852-1943): \"Masturbation results in general debility, unnatural pale eyes and forehead acne\"","authors":"Rössner S.","first_author":"Rössner S.","journal":"Obesity reviews : an official journal of the International Association for the Study of Obesity","year":2006,"pub_types":["Historical Article","Biography","Portrait","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1467-789x.2006.00247.x"}},{"id":5087,"doi":"10.1016/s0968-8080(06)27242-2","pmid":"16713886","pmcid":null,"title":"Nurse-midwives' attitudes towards adolescent sexual and reproductive health needs in Kenya and Zambia","authors":"Warenius LU, Faxelid EA, Chishimba PN, Musandu JO, Ong'any AA, Nissen EB.","first_author":"Warenius LU","journal":"Reproductive health matters","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":78,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 820 nurse‑midwives in Kenya and Zambia using a questionnaire on attitudes toward adolescent sexuality.","sample_n":820,"sample_text":"820 nurse‑midwives","population":"Nurse‑midwives (n=820) from public health facilities in Kenya and Zambia.","country":"Kenya, Zambia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 820 Kenyan and Zambian nurse‑midwives found many disapprove of adolescent sex, masturbation, contraception and abortion, but those with more education or training showed more youth‑friendly attitudes.","clinical_takeaway":"Training that addresses cultural and moral attitudes can help health workers provide more supportive SRH services to adolescents.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Large sample for a survey","Focus on an under‑researched professional group","Clear practical recommendations"],"limitations":["Attitude measure not validated","Cross‑sectional, cannot infer causality","Limited control for potential confounders"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":12,"contrasting":0,"mentioning":128,"citing_publications":128,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0968-8080(06)27242-2"}},{"id":5088,"doi":null,"pmid":"16680264","pmcid":null,"title":"A rare foreign body into the male penile urethra","authors":"Gunay N, Isir AB, Yildirim C, Akieke M.","first_author":"Gunay N","journal":"Saudi medical journal","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with a self‑inserted penile urethral foreign body; no control group, no systematic sampling","sample_n":1,"sample_text":"1 patient","population":"adult male (28 y) with self‑insertion of object for masturbation; mention of intellectual disability/mental disorder","country":"Saudi Arabia","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 28‑year‑old man inserted a pen into his urethra for sexual stimulation. The object was surgically removed without complications. The report notes that such acts are often linked to mental‑health issues.","clinical_takeaway":"Rare but serious self‑inflicted urethral injuries require prompt surgical removal; clinicians should assess underlying psychiatric conditions.","confidence":0.9,"topic_tags":["sexual_function","masturbation","gender","moral_incongruence"],"strengths":["Clear clinical description of a rare case","Includes imaging and surgical management details"],"limitations":["Single case; no generalisable data","No systematic assessment of psychological or sexual health variables","No measurement of masturbation frequency separate from the event"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5090,"doi":"10.1016/0006-3223(85)90155-6","pmid":"4005334","pmcid":null,"title":"Sexual activity and sleep in humans","authors":"Brissette S, Montplaisir J, Godbout R, Lavoisier P.","first_author":"Brissette S","journal":"Biological psychiatry","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subject laboratory experiment with three conditions (masturbation‑orgasm, masturbation‑no‑orgasm, neutral reading); polysomnographic recordings; N=10","sample_n":10,"sample_text":"10 subjects (5 men and 5 women)","population":"10 healthy adults (5 men, 5 women)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study of 10 adults, researchers recorded brain activity during sleep after masturbation with orgasm, without orgasm, and after reading neutral material. They found no consistent differences in sleep stages, suggesting that masturbation does not markedly affect sleep architecture.","clinical_takeaway":"Masturbation, with or without orgasm, is unlikely to disrupt normal sleep patterns in healthy adults.","confidence":0.7,"topic_tags":["masturbation","sexual_function","treatment","pornography"],"strengths":["Objective polysomnographic recordings","Within‑subject design reduces between‑person variability","Clear operational definitions of sexual activity conditions"],"limitations":["Very small sample (N=10) limits statistical power","No control for individual differences (mood, prior sleep debt)","Findings may not generalize beyond healthy young adults"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":26,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0006-3223(85)90155-6"}},{"id":5091,"doi":"10.1097/00000433-198506000-00008","pmid":"4025267","pmcid":null,"title":"Wrapped to death. Unusual autoerotic death","authors":"Minyard F.","first_author":"Minyard F.","journal":"The American journal of forensic medicine and pathology","year":1985,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single autoerotic death involving masturbation and a novel method of asphyxiation","sample_n":1,"sample_text":"1 case (adult male)","population":"single adult male victim of autoerotic death in New Orleans, USA","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1985 forensic case report describes a man who died while masturbating after wrapping his body in plastic and using a snorkel tube for breathing, which became obstructed.","clinical_takeaway":"Clinicians should be aware that extreme autoerotic practices can pose fatal risks.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Detailed forensic description of a rare autoerotic death method","Adds to the catalog of documented cases for forensic and clinical awareness"],"limitations":["Single case; no generalizable findings","No systematic measurement of psychological or social variables","No comparison group or statistical analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00000433-198506000-00008"}},{"id":5092,"doi":"10.1007/bf01532257","pmid":"24306073","pmcid":null,"title":"Masturbation from judaism to victorianism","authors":"Patton MS.","first_author":"Patton MS.","journal":"Journal of religion and health","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"The article is a historical and theological commentary with no empirical data, sample, or methodological description.","sample_n":null,"sample_text":"No participants; the work is a narrative review of religious texts.","population":"none","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews how Judaism and Christianity historically condemned masturbation, linking it to moral and health fears from medieval times through Victorianism.","clinical_takeaway":"None – the article offers historical perspectives, not clinical evidence.","confidence":0.8,"topic_tags":["masturbation","religiosity","sexual_function","csbd"],"strengths":["Provides a broad historical overview of religious attitudes toward masturbation.","Cites religious sources and historical documents."],"limitations":["No empirical data or systematic methodology.","Lacks measurement of constructs or control of confounds.","Interpretations are narrative and not evidence‑based."],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01532257"}},{"id":5095,"doi":"10.1016/0031-9384(85)90381-6","pmid":"4041055","pmcid":null,"title":"Sexual behavior frequency and biphasic ovulatory type menstrual cycles","authors":"Cutler WB, Preti G, Huggins GR, Erickson B, Garcia CR.","first_author":"Cutler WB","journal":"Physiology & behavior","year":1985,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective diary study of college students over 14 weeks; no control group, convenience sample","sample_n":null,"sample_text":"not reported in abstract","population":"college-aged men and women (young adults, post‑menarche for ~7 years)","country":"United States (U.S. Government‑funded)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a 14‑week diary study of college students, women who had weekly intercourse showed the most typical 29‑day menstrual cycles and fertile basal‑body‑temperature patterns, whereas less frequent sex or abstinence were linked to more irregular cycles.","clinical_takeaway":"Regular partnered sexual activity may be associated with more normal menstrual timing, but findings are limited to young, healthy college women.","confidence":0.7,"topic_tags":["sexual_function","religiosity","moral_incongruence","masturbation","relationships"],"strengths":["Prospective daily/weekly recording reduces recall bias","Separates coital activity from masturbation","Physiological outcome (BBT) adds objective data"],"limitations":["Small, convenience sample of college students; limited generalisability","No validated measures of sexual behaviour frequency","Potential unmeasured confounders (stress, nutrition, sleep, mental health)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0031-9384(85)90381-6"}},{"id":5096,"doi":"10.3109/00207458508985623","pmid":"4019052","pmcid":null,"title":"Sex and handedness differences in the use of autoerotic fantasy and imagery: a proposed explanation","authors":"Gottlieb JF.","first_author":"Gottlieb JF.","journal":"The International journal of neuroscience","year":1985,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of dextral vs. sinistral males examining self‑reported use of autoerotic fantasy and imagery during masturbation.","sample_n":null,"sample_text":"Not reported in abstract.","population":"Adult males, grouped by handedness (dextral/sinistral). Sample size not reported in abstract.","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined whether men’s handedness (right‑ vs. left‑handed) relates to how often they use fantasy and mental imagery during masturbation, suggesting brain lateralisation may explain gender differences.","clinical_takeaway":"None – findings are theoretical and not directly applicable to clinical practice.","confidence":0.6,"topic_tags":["masturbation","sexual_function","gender","neuroscience"],"strengths":["Addresses gender/handedness differences in sexual fantasy","Integrates neuro‑lateralization theory"],"limitations":["Likely small, non‑representative sample","Unvalidated self‑report measures","Cross‑sectional, no causal inference possible"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/00207458508985623"}},{"id":5097,"doi":null,"pmid":"3995437","pmcid":"PMC1345944","title":"Childhood female masturbation","authors":"Bradley SJ.","first_author":"Bradley SJ.","journal":"Canadian Medical Association journal","year":1985,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5098,"doi":"10.1016/j.jcfm.2006.02.001","pmid":"16564199","pmcid":null,"title":"Somnambulistic sexual behaviour (sexsomnia)","authors":"Ebrahim IO.","first_author":"Ebrahim IO.","journal":"Journal of clinical forensic medicine","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single legal case involving somnambulistic sexual behaviour (sexsomnia); no systematic data collection, no control group, no follow‑up.","sample_n":1,"sample_text":"One defendant described in a forensic case report.","population":"Adult individuals involved in a forensic/legal case; single case; not representative.","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article describes a court case where a man accused of rape was acquitted because the sexual acts were deemed to have occurred during a sleepwalking episode (sexsomnia). It outlines how complex sexual behaviours can happen while a person is unconscious.","clinical_takeaway":"Clinicians should consider sleep disorders as possible explanations for unexpected sexual behaviours, but evidence is limited to isolated case reports.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides a detailed forensic description of a rare phenomenon","Highlights legal relevance of somnambulism as automatism"],"limitations":["Single case; no generalisable data","No systematic assessment of sexual behaviour, sleep parameters, or psychiatric comorbidity","No quantitative measurement or statistical analysis"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":37,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jcfm.2006.02.001"}},{"id":5099,"doi":"10.1016/s0210-4806(06)73438-6","pmid":"16749582","pmcid":null,"title":"[Diversity and meaning of masculine phallic palaeolithic images in Western Europe]","authors":"Angulo Cuesta J, García Diez M.","first_author":"Angulo Cuesta J","journal":"Actas urologicas espanolas","year":2006,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review (non‑systematic) of Upper Palaeolithic art; no primary data, no sampling frame.","sample_n":null,"sample_text":"Not applicable – no participants recruited.","population":"Upper Palaeolithic human groups (inferred from archaeological artefacts)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review Upper‑Palaeolithic art showing male phallic images, suggesting that ancient humans displayed a range of sexual behaviours—including masturbation—similar to modern humans.","clinical_takeaway":"None – the article provides historical context only and has no implications for current clinical practice.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Broad interdisciplinary perspective on prehistoric sexual imagery","Integrates archaeological and anthropological literature"],"limitations":["No original data; conclusions based on interpretation of artefacts","Lacks systematic methodology or critical appraisal of sources","No quantitative analysis or effect size reporting"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0210-4806(06)73438-6"}},{"id":5100,"doi":"10.1590/s1677-55382006000200011","pmid":"16650298","pmcid":null,"title":"Retroperitoneal migration of a self-inflicted ballpoint pen via the urethra","authors":"Cury J, Coelho RF, Srougi M.","first_author":"Cury J","journal":"International braz j urol : official journal of the Brazilian Society of Urology","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single female patient with self‑inserted pen; no control group, no longitudinal follow‑up, no sampling strategy","sample_n":1,"sample_text":"single case","population":"adult female, unknown broader population","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2006 case report describes a woman who inserted a ball‑point pen into her urethra; the pen later migrated to the retroperitoneal space and was discovered years after the incident.","clinical_takeaway":"Clinicians should be aware that self‑inserted urethral foreign bodies can migrate and present long after insertion.","confidence":0.9,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Unique clinical description","Includes imaging findings"],"limitations":["Single case, no generalisability","No systematic assessment of underlying psychosocial factors"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s1677-55382006000200011"}},{"id":5101,"doi":"10.1007/s10067-006-0216-3","pmid":"16508697","pmcid":null,"title":"Sexual functioning of people with rheumatoid arthritis: a multicenter study","authors":"van Berlo WT, van de Wiel HB, Taal E, Rasker JJ, Weijmar Schultz WC, van Rijswijk MH.","first_author":"van Berlo WT","journal":"Clinical rheumatology","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Multicenter survey of RA patients (N≈271, 23% response) with age‑sex matched healthy controls; subset examined clinically for disease activity.","sample_n":271,"sample_text":"271 RA patients responded to questionnaire; 47 men and 93 women examined for DAS28; controls age‑sex matched.","population":"Adults with rheumatoid arthritis and healthy controls","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People with rheumatoid arthritis report less sexual desire and masturbate less than healthy peers, but their overall sexual satisfaction is similar. Joint pain during sex is common, especially when disease activity is higher.","clinical_takeaway":"Assess joint pain and physical limitations when addressing sexual health in RA patients; low desire may relate to physical factors rather than relationship issues.","confidence":0.8,"topic_tags":["sexual_function","relationships","masturbation"],"strengths":["Use of validated sexual dysfunction questionnaire (QSD)","Matched healthy control group","Multicenter recruitment improves generalisability"],"limitations":["Low response rate (23%) may introduce selection bias","Self‑constructed distress measure lacks validation","No adjustment for mental‑health or partner variables"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":12,"contrasting":2,"mentioning":87,"citing_publications":105,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10067-006-0216-3"}},{"id":5102,"doi":"10.3109/00048678509158816","pmid":"3859286","pmcid":null,"title":"The psychosexual histories of young women with bulimia","authors":"Abraham SF, Bendit N, Mason C, Mitchell H, O'Connor N, Ward J, Young S, Llewellyn-Jones D.","first_author":"Abraham SF","journal":"The Australian and New Zealand journal of psychiatry","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control comparison of 20 bulimic women and 20 matched controls; interview‑based psychosexual history; convenience clinical sample","sample_n":40,"sample_text":"20 bulimic patients and 20 matched control subjects","population":"young Australian women with bulimia nervosa; matched non‑eating‑disordered controls","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared sexual histories of 20 women with bulimia to 20 similar women without eating disorders. Bulimic participants reported more orgasms during masturbation, more anal‑sex experimentation, and higher self‑rated libido, but fewer orgasms during intercourse.","clinical_takeaway":"Findings suggest differences in sexual experiences among bulimic women, but the tiny, non‑validated sample limits clinical use.","confidence":0.4,"topic_tags":["sexual_function","masturbation","adolescents"],"strengths":["matched control group","focus on an under‑studied population"],"limitations":["very small sample","ad‑hoc, non‑validated sexual history items","no control for mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/00048678509158816"}},{"id":5103,"doi":"10.1016/s0015-0282(16)48457-8","pmid":"3979589","pmcid":null,"title":"Characteristics of human ejaculates collected via masturbation and a new Silastic seminal fluid collection device","authors":"Zavos PM.","first_author":"Zavos PM.","journal":"Fertility and sterility","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0015-0282(16)48457-8"}},{"id":5104,"doi":null,"pmid":"16505878","pmcid":null,"title":"[Treatment of sex offenders with leuprorelin]","authors":"Nøttestad JA, Bjarnar E, Lundmo PI, Sandvik M.","first_author":"Nøttestad JA","journal":"Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"nor","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5106,"doi":"10.1007/s10508-006-8993-y","pmid":"16502152","pmcid":null,"title":"High rates of sexual behavior in the general population: correlates and predictors","authors":"Långström N, Hanson RK.","first_author":"Långström N","journal":"Archives of sexual behavior","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":161,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large national probability sample (N=2450), cross‑sectional survey","sample_n":2450,"sample_text":"representative national survey","population":"Swedish adults age 18‑60, community sample","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2006 Swedish survey of 2,450 adults found that people with very frequent sexual activity, especially casual sex, also reported more negative health factors like substance use and relationship instability, while frequent masturbation showed a different pattern.","clinical_takeaway":"High rates of casual sexual activity may signal broader health risks; clinicians should assess related behavioural and psychosocial factors.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large, nationally representative sample","Separate measurement of masturbation and intercourse","Multivariate adjustment for several demographic factors"],"limitations":["Hypersexuality defined by frequency only, no validated scale","No assessment of moral incongruence or trauma history","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":6,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":19,"contrasting":1,"mentioning":166,"citing_publications":321,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-006-8993-y"}},{"id":5107,"doi":"10.1017/s0021932006001258","pmid":"16448584","pmcid":null,"title":"Sexual behaviours and contraception among university students in Turkey","authors":"Aras S, Orcin E, Ozan S, Semin S.","first_author":"Aras S","journal":"Journal of biosocial science","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire study of 550 final‑year university students in Izmir, Turkey.","sample_n":550,"sample_text":"550 final‑year university students","population":"University students (age 20‑25, both sexes)","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 550 Turkish university students found that men were more likely than women to have had sex, to start earlier, and to report higher condom use and masturbation rates, while women opposed premarital sex more strongly.","clinical_takeaway":"Gender differences in sexual behaviour and contraception use should inform campus health education.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑site survey","Gender‑balanced reporting of attitudes and behaviours","Includes data on masturbation frequency"],"limitations":["Uses non‑validated questionnaire items","Cross‑sectional design limits causal inference","No control for moral, mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":1,"mentioning":28,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0021932006001258"}},{"id":5108,"doi":"10.1080/00926238508406073","pmid":"4009731","pmcid":null,"title":"Treatment of sexual dysfunctions in male-only groups: predicting outcome","authors":"Dekker J, Dronkers J, Staffeleu J.","first_author":"Dekker J","journal":"Journal of sex & marital therapy","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"pre‑post treatment of 40 men (plus 21 from earlier data) in uncontrolled male‑only groups","sample_n":40,"sample_text":"Forty men treated; combined with previously reported 21 men for prediction analyses","population":"adult men with various sexual dysfunctions, some with partners, some without","country":"Netherlands (presumed from authors’ names, not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"In a small uncontrolled study, 40 men received group therapy that included rational‑emotive techniques, masturbation exercises, and social‑skills training. Sexual functioning improved overall, especially for men with a partner, but the lack of a control group limits confidence in the results.","clinical_takeaway":"Group therapy with masturbation exercises may help men with sexual dysfunction, but evidence is weak; clinicians should seek more rigorous data before relying on this approach.","confidence":0.7,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["real‑world clinical sample","analysis of partner status as moderator","use of multiple therapeutic components"],"limitations":["No control or comparison group","Small, non‑representative sample","Outcome measures not described or validated"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238508406073"}},{"id":5109,"doi":"10.3109/00365598509180244","pmid":"4059879","pmcid":null,"title":"Long-standing urethral instrumentation leading to an unusual complication","authors":"Vilmann P, Engelund D, Hjortrup A.","first_author":"Vilmann P","journal":"Scandinavian journal of urology and nephrology","year":1985,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report describing a complication from long‑standing urethral instrumentation linked to masturbatory practices","sample_n":1,"sample_text":"single case","population":"Adult male patient (N=1)","country":"Denmark (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A man who regularly inserted objects into his urethra for sexual stimulation developed a large abscess near his rectum, illustrating a rare medical risk of such practices.","clinical_takeaway":"Urethral instrumentation for sexual purposes can cause serious infections; clinicians should inquire about such behaviors when evaluating related complications.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Detailed clinical description","Highlights a rare medical complication"],"limitations":["Single case, no generalisable data","No systematic measurement of sexual behaviour or psychological factors","No control or comparison group"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/00365598509180244"}},{"id":5110,"doi":"10.1080/00926238508406074","pmid":"4009732","pmcid":null,"title":"Sexual fantasy and activity patterns of males with inhibited sexual desire and males with erectile dysfunction versus normal controls","authors":"Nutter DE, Condron MK.","first_author":"Nutter DE","journal":"Journal of sex & marital therapy","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire comparing 3 male groups (control, erectile dysfunction, inhibited sexual desire) with n≈70 total.","sample_n":72,"sample_text":"37 control men, 35 men with sexual dysfunction (ED or inhibited desire)","population":"adult males, clinic patients and presumably community controls; convenience sample","country":"United States (presumed from journal, not explicit)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Men with low sexual desire reported fewer sexual fantasies during foreplay, coitus, daydreaming and masturbation than men without problems, while men with erectile dysfunction resembled controls.","clinical_takeaway":"Reduced fantasy frequency may be a characteristic of inhibited sexual desire in men.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Direct comparison of three distinct male groups","Includes both fantasy frequency and masturbation frequency","Clear quantitative findings reported"],"limitations":["Small, non‑representative sample","Unvalidated fantasy questionnaire","No control for moral, mental‑health, relationship or trauma variables"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":26,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238508406074"}},{"id":5112,"doi":"10.1016/0090-4295(85)90561-8","pmid":"3966281","pmcid":null,"title":"Vacuum cleaner injury to penis: a common urologic problem?","authors":"Benson RC.","first_author":"Benson RC.","journal":"Urology","year":1985,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of five penile injuries from vacuum‑cleaner masturbation","sample_n":5,"sample_text":"Five cases are described.","population":"male patients with vacuum‑cleaner‑related penile trauma (n=5)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article reports five men who seriously injured their penises while using a vacuum cleaner for sexual stimulation, illustrating that this form of masturbation can cause severe trauma.","clinical_takeaway":"Clinicians should ask about unusual sexual practices when evaluating penile injuries.","confidence":0.8,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Detailed clinical description of a rare injury","Highlights a specific risk behaviour"],"limitations":["Small, non‑representative case series","No systematic data on prevalence","No control or comparison group"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0090-4295(85)90561-8"}},{"id":5113,"doi":"10.1300/j082v11n01_15","pmid":"4056389","pmcid":null,"title":"Perceived sexual satisfaction and marital happiness of bisexual and heterosexual swinging husbands","authors":"Dixon D.","first_author":"Dixon D.","journal":"Journal of homosexuality","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional comparison of 50 bisexual and 50 heterosexual married men in swinging relationships; groups matched on age, marriage length, SES","sample_n":100,"sample_text":"50 bisexual, 50 heterosexual married men recruited as volunteers from swinging communities; matched on age, marriage length, socioeconomic status","population":"adult male volunteers in swinging marriages (N=100)","country":"USA (inferred)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared sexual satisfaction and marital happiness of 50 bisexual and 50 heterosexual men in swinging marriages, finding heterosexual men reported higher satisfaction and happiness despite bisexual men having more frequent orgasms.","clinical_takeaway":"None – findings pertain to a specific swinging population and do not inform clinical practice.","confidence":0.7,"topic_tags":["sexual_function","relationships","masturbation"],"strengths":["Matched comparison groups on key demographics","Focus on rarely studied bisexual vs heterosexual swingers"],"limitations":["Self‑report measures with unclear validation","No assessment of moral, mental‑health or partner variables","Small, non‑representative sample limits generalisability"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v11n01_15"}},{"id":5114,"doi":"10.1007/bf01542088","pmid":"6517686","pmcid":null,"title":"Psychosocial development of heterosexual, bisexual, and homosexual behavior","authors":"Van Wyk PH, Geist CS.","first_author":"Van Wyk PH","journal":"Archives of sexual behavior","year":1984,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large community interview sample (N=7669), cross‑sectional","sample_n":7669,"sample_text":"American white males and females (N=7669) interviewed about early sexual experiences and adult Kinsey scores.","population":"American white males and females","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed over 7,600 U.S. adults and found that early experiences—like peer groups, how one learned to masturbate, and childhood sexual contacts—are linked to adult sexual orientation measured by the Kinsey scale.","clinical_takeaway":"None – the findings describe developmental correlates of sexual orientation, not clinical guidance.","confidence":0.3,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Very large sample size","Broad range of developmental variables examined","Systematic interview data"],"limitations":["Cross‑sectional; cannot infer causality","Self‑report measures without validated psychometric backing","No control for moral, mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":16,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542088"}},{"id":5115,"doi":"10.1016/j.contraception.2005.11.003","pmid":"16627032","pmcid":null,"title":"Acceptability and satisfaction using Quick Start with the contraceptive vaginal ring versus an oral contraceptive","authors":"Schafer JE, Osborne LM, Davis AR, Westhoff C.","first_author":"Schafer JE","journal":"Contraception","year":2006,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":52,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized controlled trial, N=201 women, 3‑month follow‑up","sample_n":201,"sample_text":"201 participants randomised; 174 completed 3‑month follow‑up","population":"women of reproductive age seeking hormonal contraception","country":"unspecified (likely US based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a trial of 201 women, those who started using a contraceptive vaginal ring reported higher satisfaction and were more likely to keep using it after three months compared with women taking oral pills.","clinical_takeaway":"Vaginal rings may be a more acceptable and persistent contraceptive option for many women.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["RCT design with reasonable sample size","Direct comparison of two widely used contraceptive methods","Follow‑up at clinically relevant 3‑month point"],"limitations":["Limited detail on validation of satisfaction measures","No assessment of mental‑health or relationship factors","Short follow‑up; long‑term continuation unknown"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":37,"citing_publications":72,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.contraception.2005.11.003"}},{"id":5116,"doi":null,"pmid":"17333856","pmcid":null,"title":"[\"The main cause of his insanity, ... self-pollution\". Attributions to illness and the treatment of insanity in the Siegburg Asylum (1825-1878). The case of Georg v. G]","authors":"Braun S.","first_author":"Braun S.","journal":"Wurzburger medizinhistorische Mitteilungen","year":2006,"pub_types":["Historical Article","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single historical case from 19th‑century asylum records; descriptive narrative without systematic methods","sample_n":1,"sample_text":"single historical case","population":"one male patient (Georg v. G.) admitted to Siegburg Asylum, 1835‑1841","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The article examines a 19th‑century asylum case where doctors blamed the patient’s ‘self‑pollution’ (masturbation) for his insanity, describing the treatments applied and the moral reasoning of the time.","clinical_takeaway":"None – the historic case does not inform current clinical practice.","confidence":0.4,"topic_tags":["masturbation","sexual_function"],"strengths":["Provides rare primary source material from 19th‑century psychiatry","Illustrates historical medical discourse on sexuality"],"limitations":["Single case; no systematic data","No validated measures or statistical analysis","Conflates moral judgement with pathology"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":5117,"doi":null,"pmid":"16756036","pmcid":null,"title":"[Sexual behaviors among students of the Medical University in Gdańsk]","authors":"Grabowski K, Wichowicz HM, Cubała WJ.","first_author":"Grabowski K","journal":"Psychiatria polska","year":2006,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 313 medical students using a study‑specific questionnaire","sample_n":313,"sample_text":"340 invited, 313 analysed","population":"medical students (Poland)","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2006 survey of 313 Polish medical students described their sexual activities, contraception use and attitudes toward sex, finding high condom use and positive views of love and partner loyalty.","clinical_takeaway":"None – the study provides descriptive data on student sexual behaviour, not clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonable sample size for a student survey","Claims of representativeness within the university cohort","Broad coverage of sexual behaviour topics"],"limitations":["Questionnaire not validated; unclear psychometric properties","No measurement of key confounds (moral, mental health, trauma)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":5118,"doi":"10.1111/j.1743-6109.2005.00170.x","pmid":"16409218","pmcid":null,"title":"On orgasm, sexual techniques, and erotic perceptions in 18- to 74-year-old Swedish women","authors":"Fugl-Meyer KS, Oberg K, Lundberg PO, Lewin B, Fugl-Meyer A.","first_author":"Fugl-Meyer KS","journal":"The journal of sexual medicine","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":49,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"nationally representative survey of 1,335 Swedish women aged 18‑74; self‑report of orgasmic function, sexual techniques, and satisfaction; cross‑sectional analysis.","sample_n":1335,"sample_text":"nationally representative sample of 18‑ to 74‑year‑old women (N = 1,335)","population":"women, general population, Sweden","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,335 Swedish women aged 18‑74 examined which sexual techniques they use and how these relate to being able to orgasm. Women with a wider range of techniques and early first orgasms were less likely to report orgasmic problems and were more satisfied with their sex lives.","clinical_takeaway":"Assess a woman's sexual history and technique repertoire when addressing orgasmic difficulties; broader sexual experiences may protect against dysfunction.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Broad age range allows generational comparisons","Focus on understudied aspects of female sexual technique"],"limitations":["Self‑report measures, no validated scales reported","Cross‑sectional design limits causal inference","Key confounds (mental health, partner context, moral factors) not assessed"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":62,"citing_publications":98,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2005.00170.x"}},{"id":5119,"doi":"10.1038/sj.ijir.3901352","pmid":"15944726","pmcid":null,"title":"Prevalence and correlates of sexual dysfunction among young adult married women in rural China: a population-based study","authors":"Lau JT, Cheng Y, Wang Q, Yang X.","first_author":"Lau JT","journal":"International journal of impotence research","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Population‑based random sample of 1,178 married women (age 20‑39) in rural China; anonymous questionnaire assessing sexual dysfunction, satisfaction, mental health, lifestyle, and masturbation.","sample_n":1178,"sample_text":"Random sample of married women (20‑39 y) from Dengfeng County, Henan, China (N=1178).","population":"Married women, age 20‑39, rural China (Henan province)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a random survey of 1,178 married women in rural China, 43 % reported at least one sexual dysfunction problem, while 38 % were satisfied with their sex lives. Sexual problems were linked to poorer mental health and certain lifestyle and demographic factors.","clinical_takeaway":"Sexual dysfunction is common among rural married women and is associated with mental health; clinicians should assess and address both sexual and psychological wellbeing.","confidence":0.85,"topic_tags":["sexual_function","prevalence","religiosity","relationships"],"strengths":["Large, random community sample","Focus on an understudied rural female population","Reports both prevalence and correlates"],"limitations":["Unspecified sexual dysfunction measurement tool","Cross‑sectional design limits causal inference","Limited control for partner or trauma variables"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":2,"mentioning":44,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/sj.ijir.3901352"}},{"id":5120,"doi":"10.1016/0090-4295(84)90219-x","pmid":"6485202","pmcid":null,"title":"Bilateral testicular pain due to masturbation interruptus","authors":"Chandrasekar D.","first_author":"Chandrasekar D.","journal":"Urology","year":1984,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report of a single patient with testicular pain linked to masturbation habits","sample_n":1,"sample_text":"single patient","population":"young adult male (single case)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"avoid","plain_summary":"A 1984 case report describes a young man whose testicular and groin pain was linked to a pattern of interrupted masturbation and underlying guilt about sex. The authors suggest psychological factors may explain the pain.","clinical_takeaway":"Isolated case; clinicians should consider psychosocial factors in unexplained testicular pain, but evidence is limited.","confidence":0.85,"topic_tags":["masturbation","sexual_function","gender","pornography"],"strengths":["Detailed clinical description","Highlights possible psychosocial factors"],"limitations":["Single case, no generalizability","No validated measures of constructs","No control of key confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0090-4295(84)90219-x"}},{"id":5121,"doi":"10.1111/j.1440-1819.2005.01446.x","pmid":"16401253","pmcid":null,"title":"Severe impulsiveness as the primary manifestation of multiple sclerosis in a young female","authors":"Lopez-Meza E, Corona-Vazquez T, Ruano-Calderon LA, Ramirez-Bermudez J.","first_author":"Lopez-Meza E","journal":"Psychiatry and clinical neurosciences","year":2005,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report describing impulsivity, hypersexuality and other behavioral changes later attributed to multiple sclerosis; no comparison group","sample_n":1,"sample_text":"One patient","population":"11‑year‑old female later diagnosed with MS","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A young woman showed severe impulsivity, hypersexuality and other behavior changes for years before multiple sclerosis was finally diagnosed, showing that MS can sometimes present mainly with psychiatric symptoms.","clinical_takeaway":"Clinicians should consider neurological causes like MS when encountering unexplained severe impulsivity or hypersexuality.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","csbd"],"strengths":["Detailed clinical description","Imaging confirmation of MS"],"limitations":["Single case, no generalisable data","No systematic assessment of sexual behavior or psychiatric symptoms","No control for confounding factors (e.g., trauma, mental health)"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1440-1819.2005.01446.x"}},{"id":5122,"doi":null,"pmid":"16370501","pmcid":null,"title":"Sexual history","authors":"Naish J.","first_author":"Naish J.","journal":"Nursing standard (Royal College of Nursing (Great Britain) : 1987)","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5123,"doi":"10.1007/s10508-005-7929-2","pmid":"16362253","pmcid":null,"title":"Leuprolide acetate suppresses pedophilic urges and arousability","authors":"Schober JM, Kuhn PJ, Kovacs PG, Earle JH, Byrne PM, Fries RA.","first_author":"Schober JM","journal":"Archives of sexual behavior","year":2005,"pub_types":["Controlled Clinical Trial","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"controlled clinical trial (crossover), n=5 male pedophiles, 12 mo leuprolide vs 12 mo placebo, physiological and self‑report outcomes measured quarterly","sample_n":5,"sample_text":"Five male pedophiles","population":"adult male pedophiles (mean age 50, range 36‑58)","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In five adult men with pedophilic urges, a year of leuprolide (which lowers testosterone) reduced self‑reported urges and fantasies, but did not change physiological sexual interest. The study suggests hormone suppression can aid psychotherapy, but the sample is tiny.","clinical_takeaway":"Hormone suppression may lessen pedophilic urges, but evidence is limited; clinicians should use objective monitoring and not rely on self‑report alone.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Objective physiological measures (testosterone, PPG, reaction‑time task)","Within‑subject crossover design","Use of polygraph to assess deception"],"limitations":["Very small N (5), no power justification","No control for mental‑health or trauma variables","Findings based on a highly selected clinical sample"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":81,"citing_publications":114,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-005-7929-2"}},{"id":5125,"doi":"10.1038/sj.sc.3101849","pmid":"16304567","pmcid":null,"title":"Effects of repeated ejaculations on semen characteristics following spinal cord injury","authors":"Hamid R, Patki P, Bywater H, Shah PJ, Craggs MD.","first_author":"Hamid R","journal":"Spinal cord","year":2006,"pub_types":["Multicenter Study","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"prospective randomised controlled trial with 74 screened, 32 randomised, ~19 analysed per arm; small sample, some drop‑outs","sample_n":19,"sample_text":"10 completed in study group, 9 completed in control group","population":"men with spinal cord injury above T10, interested in fertility","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In men with spinal cord injury, weekly vibratory ejaculation for three months improved sperm shape and forward movement compared with a single ejaculation, suggesting a simple way to boost fertility.","clinical_takeaway":"Repeated vibratory ejaculation for 3 months may enhance sperm quality in SCI men before assisted‑reproduction.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Randomised controlled design","Objective laboratory semen outcomes","Standardised WHO protocol"],"limitations":["Very small analysed sample; high dropout rate","No effect sizes or confidence intervals reported","No pre‑registration, limited statistical correction"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":4,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":26,"retracted":false,"notices":[{"status":"Has erratum","date":"2006-12-7","noticeDoi":"10.1038/sj.sc.3102016","doi":"10.1038/sj.sc.3101849"}],"url":"https://scite.ai/reports/10.1038/sj.sc.3101849"}},{"id":5126,"doi":null,"pmid":"6505728","pmcid":null,"title":"Some aspects of sexual knowledge and sexual behaviour of local women. Results of a survey. II. Female masturbation","authors":"Atputharajah V.","first_author":"Atputharajah V.","journal":"Singapore medical journal","year":1984,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5127,"doi":"10.1080/00224490509552290","pmid":"19827239","pmcid":null,"title":"Typing, doing, and being: sexuality and the internet","authors":"Ross MW.","first_author":"Ross MW.","journal":"Journal of sex research","year":2005,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods; no empirical data presented.","sample_n":null,"sample_text":"Not applicable – article is a theoretical/ narrative review.","population":"Not applicable (review article).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews how the internet shapes sexual behavior, intimacy, and culture, discussing cybersex, sexual scripts, and online sexual communities.","clinical_takeaway":"None – the article is conceptual and does not provide clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad theoretical integration of sexuality and internet literature","Highlights understudied areas such as cybersexuality and sexual scripts"],"limitations":["No systematic methodology or risk‑of‑bias assessment","Lacks empirical data; conclusions are speculative","Does not address key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":122,"citing_publications":233,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490509552290"}},{"id":5128,"doi":"10.33549/physiolres.930829","pmid":"16238456","pmcid":null,"title":"Circulating neuroactive C21- and C19-steroids in young men before and after ejaculation","authors":"Stárka L, Hill M, Havlíková H, Kancheva L, Sobotka V.","first_author":"Stárka L","journal":"Physiological research","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"within‑subject pre‑post measurement of hormone levels before and after masturbation‑induced ejaculation in 12 young men","sample_n":12,"sample_text":"12 healthy young men","population":"young adult males (N≈12)","country":"Czech Republic (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 12 young men, most neuroactive steroids stayed the same after masturbation‑induced ejaculation, but one precursor (17α‑hydroxypregnenolone) rose, suggesting that a drop in such hormones does not drive the orgasm‑related surge of oxytocin.","clinical_takeaway":"Ejaculation does not markedly alter most neuroactive steroids; the observed hormone change is unlikely to explain orgasm‑related oxytocin spikes.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","masturbation"],"strengths":["Validated GC‑MS assay for steroids","Objective physiological measurement","Within‑subject design controls inter‑individual variability"],"limitations":["Very small sample (N=12)","No control for potential psychological or contextual confounds","Limited generalisability to broader populations"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.33549/physiolres.930829"}},{"id":5129,"doi":null,"pmid":"6383640","pmcid":null,"title":"[Masturbation and the history of psychiatry]","authors":"Chromý K.","first_author":"Chromý K.","journal":"Ceskoslovenska psychiatrie","year":1984,"pub_types":["Historical Article","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"cze","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5130,"doi":"10.1111/j.1600-0447.1984.tb02529.x","pmid":"6741603","pmcid":null,"title":"Sexual function and dysfunction in younger married alcoholics. A comparative study","authors":"Jensen SB.","first_author":"Jensen SB.","journal":"Acta psychiatrica Scandinavica","year":1984,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control comparison of 60 married alcoholics with age‑matched GP controls; self‑report of sexual dysfunction","sample_n":60,"sample_text":"60 alcoholics and 60 controls (approx.)","population":"60 married alcoholics (male and female) and matched non‑alcoholic controls","country":"Sweden (presumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared 60 married alcoholics with 60 non‑alcoholic peers and found that three‑quarters of male alcoholics reported erectile or libido problems, while women showed no difference. Masturbation and sex frequency did not change after starting treatment.","clinical_takeaway":"Alcohol treatment should assess and address male sexual dysfunction, as it is common and may affect recovery.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Direct comparison with age‑matched control group","Includes both male and female participants","Reports specific types of dysfunction (erectile, libido)"],"limitations":["Small sample, likely under‑powered","No validated sexual function questionnaire reported","Limited control of confounding variables (mental health, relationship factors)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1600-0447.1984.tb02529.x"}},{"id":5131,"doi":"10.1136/sti.2005.015149","pmid":"16199738","pmcid":"PMC1745042","title":"Who reports sexual function problems? Empirical evidence from Britain's 2000 National Survey of Sexual Attitudes and Lifestyles","authors":"Mercer CH, Fenton KA, Johnson AM, Copas AJ, Macdowall W, Erens B, Erens B, Wellings K.","first_author":"Mercer CH","journal":"Sexually transmitted infections","year":2005,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Probability sample survey of 11,161 British adults aged 16–44; computer‑assisted face‑to‑face and self‑interview; outcomes were self‑reported sexual function problems (any vs persistent).","sample_n":11161,"sample_text":"Men and women aged 16‑44, recruited via probability sampling for the 2000 Natsal survey.","population":"Adults (16‑44) from a nationally representative British sample (N≈11,200).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2000 British national survey of over 11,000 adults, women reported sexual function problems more often than men. Factors linked to these problems included marital status, frequency of sex and masturbation, STI history (men), and difficulties communicating with a partner for both sexes.","clinical_takeaway":"Consider relationship communication and broader health factors when addressing sexual function concerns; prevalence differs by gender.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative probability sample","Adjusted odds ratios with confidence intervals reported","Inclusion of partner communication as a covariate"],"limitations":["Self‑report of sexual problems without validated instrument","Cross‑sectional design limits causal inference","Key potential confounders (mental health, trauma, moral factors) not assessed"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":8,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":7,"contrasting":1,"mentioning":47,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sti.2005.015149"}},{"id":5132,"doi":"10.1177/0306624x04272975","pmid":"16260480","pmcid":null,"title":"A comparison of the male customers of female street prostitutes with national samples of men","authors":"Monto MA, McRee N.","first_author":"Monto MA","journal":"International journal of offender therapy and comparative criminology","year":2005,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey comparing arrested male customers of street prostitutes (N=1672) with nationally representative samples of men.","sample_n":1672,"sample_text":"Large arrested sample compared to existing national survey data.","population":"Male individuals arrested for attempting to hire street prostitutes; national comparison groups.","country":"United States","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared 1,672 men arrested for trying to hire street prostitutes with national samples, finding they were less likely to be married, less happy, and reported more frequent sexual thoughts and masturbation, though differences were generally small.","clinical_takeaway":"Customers of street prostitution may differ modestly from other men in marital status, happiness, and sexual activity, but findings are descriptive only.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample of customers","Comparison with national data","Multiple aspects of sexual behavior assessed"],"limitations":["Cross‑sectional, cannot infer causality","Arrested sample may not represent all customers","Limited control of key confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":0,"mentioning":92,"citing_publications":112,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x04272975"}},{"id":5133,"doi":"10.7748/paed2005.10.17.8.27.c1009","pmid":"16273832","pmcid":null,"title":"Sexuality in the hospital setting","authors":"Horseman W.","first_author":"Horseman W.","journal":"Paediatric nursing","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7748/paed2005.10.17.8.27.c1009"}},{"id":5134,"doi":"10.1007/s10508-005-6276-7","pmid":"16211472","pmcid":null,"title":"Timing of pubertal maturation and the onset of sexual behavior among Zimbabwe school boys","authors":"Campbell BC, Prossinger H, Mbzivo M.","first_author":"Campbell BC","journal":"Archives of sexual behavior","year":2005,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 442 Zimbabwean school boys, self‑reported puberty markers and sexual behaviour, salivary testosterone.","sample_n":442,"sample_text":"442 Zimbabwe school boys aged 12‑18 years","population":"Zimbabwe school boys, ages 12‑18 (N=442)","country":"Zimbabwe","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 442 Zimbabwean boys, earlier puberty signs—especially the first nocturnal emission—were linked to earlier sexual fantasies, non‑coital activity and intercourse. Testosterone levels also predicted some behaviours beyond timing effects.","clinical_takeaway":"Puberty timing, not just hormone levels, is a key factor in when boys begin sexual activity; clinicians should consider developmental stage when discussing sexual health with adolescents.","confidence":0.8,"topic_tags":["sexual_function","adolescents","pornography","masturbation"],"strengths":["Large community sample for the setting (N=442)","Combination of hormonal assay and self‑report","Use of multiple puberty markers","Clear statistical modelling (regression, sigmoid interpolation)"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report without validated scales","Limited control for socio‑demographic or mental‑health confounds","No assessment of partner or contextual factors"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":21,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-005-6276-7"}},{"id":5135,"doi":"10.1007/bf01542145","pmid":"6732471","pmcid":null,"title":"Changes in sex differences in sexual behavior: a replication of a study on West German students (1966-1981)","authors":"Clement U, Schmidt G, Kruse M.","first_author":"Clement U","journal":"Archives of sexual behavior","year":1984,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two independent mailed surveys of West German university students (1966, 1981) with random sampling within universities; large convenience sample of students, not nationally representative.","sample_n":5588,"sample_text":"3666 in 1966, 1922 in 1981","population":"Male and female university students in West Germany (1966 n≈3666; 1981 n≈1922)","country":"Germany (West)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Two large surveys of West German university students (1966 vs 1981) show that differences between men and women in masturbation have narrowed, while women now report earlier and more frequent coital activity than men. Changes were similar across age, religion and class groups.","clinical_takeaway":"None – the study describes population trends, not individual clinical guidance.","confidence":0.85,"topic_tags":["masturbation","sexual_function"],"strengths":["Large historical sample allowing longitudinal comparison","Random sampling within universities","Clear reporting of sex‑difference trends over time"],"limitations":["Self‑report questionnaires likely unvalidated for constructs","Limited statistical detail; no effect sizes or corrections reported","Potential unmeasured confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542145"}},{"id":5136,"doi":"10.1080/13625180500282205","pmid":"16318965","pmcid":null,"title":"Sexual attitudes and behaviors among medical students in Dokuz Eylul university, Turkey","authors":"Ozan S, Aras S, Semin S, Orcin E.","first_author":"Ozan S","journal":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Anonymous questionnaire administered to first‑ and sixth‑year medical students at a single Turkish university; convenience sample; descriptive and comparative statistics.","sample_n":null,"sample_text":"first‑ and sixth‑year students at Dokuz Eylul University Faculty of Medicine","population":"Medical students (both genders), Turkey","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A questionnaire of Turkish medical students showed gender differences in sexual attitudes, masturbation, condom use, and sources of sexual information, highlighting the need for better sexual‑health training in medical curricula.","clinical_takeaway":"Medical educators should address gender gaps and provide comprehensive sexual‑health training for future physicians.","confidence":0.78,"topic_tags":["sexual_function","gender"],"strengths":["Provides gender‑specific data on attitudes and behaviours among future physicians","Large convenience sample spanning early and late medical education","Includes a range of behavioural variables (masturbation, condom use, sources of information)"],"limitations":["No validated psychometric instruments reported","Cross‑sectional design limits causal inference","Limited control for key confounders (e.g., religiosity, mental health, partner status)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":36,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13625180500282205"}},{"id":5137,"doi":"10.1016/j.urology.2005.04.010","pmid":"16140089","pmcid":null,"title":"Prevalence and risk factors of sexual dysfunction among younger married men in a rural area in China","authors":"Lau JT, Wang Q, Cheng Y, Yang X.","first_author":"Lau JT","journal":"Urology","year":2005,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Anonymous self‑administered questionnaire completed by 298 husbands of randomly selected married women (aged 20‑39) in rural China; cross‑sectional prevalence study.","sample_n":298,"sample_text":"298 respondents","population":"Younger married men (20‑39) in a rural Chinese setting (N≈298).","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a rural Chinese community, about 29 % of men aged 20‑39 reported at least one sexual problem. Issues were linked to mental‑health quality of life, partner’s sexual health, masturbation, and living arrangements, suggesting many factors influence sexual health.","clinical_takeaway":"Assess mental health, partner issues, and lifestyle factors when addressing sexual dysfunction in younger married men.","confidence":0.8,"topic_tags":["sexual_function","prevalence","relationships","religiosity"],"strengths":["Random selection of households improves representativeness within the community.","Large sample for a rural survey (N≈300).","Assesses multiple potential correlates (mental health, partner SD, masturbation)."],"limitations":["Reliance on self‑report without validated sexual dysfunction instruments.","Cross‑sectional design precludes causal inference.","No assessment of moral/religious factors or trauma history."],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":6,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":37,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.urology.2005.04.010"}},{"id":5138,"doi":null,"pmid":"16180541","pmcid":null,"title":"[Traumatic partial amputation of a penis--a reconstruction of the circumstances of the accident]","authors":"Dörges J.","first_author":"Dörges J.","journal":"Versicherungsmedizin","year":2005,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5139,"doi":"10.1111/j.1745-7262.2005.00045.x","pmid":"16110354","pmcid":null,"title":"Does exposure to computers affect the routine parameters of semen quality?","authors":"Sun YL, Zhou WJ, Wu JQ, Gao ES.","first_author":"Sun YL","journal":"Asian journal of andrology","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case-control study with 178 participants recruited from two health centres; exposure defined by self‑reported computer use ≥20 h/week vs <20 h/week; semen parameters measured objectively.","sample_n":178,"sample_text":"91 exposed, 87 controls","population":"healthy young men in Shanghai, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 178 healthy Chinese men, researchers compared semen quality between those who used computers ≥20 hours per week for the past two years and those with little use. No differences were found after adjusting for factors like abstinence days and testicular size.","clinical_takeaway":"Computer use does not appear to impair semen quality in young healthy men.","confidence":0.8,"topic_tags":["sexual_function","religiosity"],"strengths":["Objective semen quality measures","Clear exposure definition","Adjustment for several relevant confounders"],"limitations":["Self‑reported computer use only","Cross‑sectional design limits causal inference","Potential unmeasured confounders (e.g., lifestyle, mental health)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1745-7262.2005.00045.x"}},{"id":5142,"doi":"10.1007/bf01542979","pmid":"6712463","pmcid":null,"title":"An analysis of self-reported sexual behavior in a sample of normal males","authors":"Reading AE, Wiest WM.","first_author":"Reading AE","journal":"Archives of sexual behavior","year":1984,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 98 employed London men, convenience sampling","sample_n":98,"sample_text":"N=98","population":"presumably normal adult males, age 20‑35, in stable relationships, recruited via workplace invitation","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 1984 survey of 98 UK men found that overall sexual drive, measured by how often they had sex or masturbated, was separate from other aspects like orgasm timing or erectile problems. The authors suggest the interview could be a baseline for future sexual‑health studies.","clinical_takeaway":"Provides baseline data on normal male sexual frequency; not directly applicable to clinical assessment of dysfunction.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Uses a relatively large (for 1984) sample of heterosexual men","Separates masturbation from coital activity","Reports internal consistency of interview"],"limitations":["Convenience workplace sample limits generalisability","No controls for moral, mental‑health or relationship variables","No power analysis or effect‑size reporting"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":30,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542979"}},{"id":5143,"doi":"10.1177/014107680509800816","pmid":"16055909","pmcid":"PMC1181844","title":"Spermatomania--the English response to Lallemand's disease","authors":"Hodgson D.","first_author":"Hodgson D.","journal":"Journal of the Royal Society of Medicine","year":2005,"pub_types":["Historical Article","research-article","Portrait","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/014107680509800816"}},{"id":5144,"doi":"10.1093/ageing/afi143","pmid":"16043445","pmcid":null,"title":"Sexuality in older adults: behaviours and preferences","authors":"Ginsberg TB, Pomerantz SC, Kramer-Feeley V.","first_author":"Ginsberg TB","journal":"Age and ageing","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":65,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 179 lower‑income older adults living in subsidised facilities; convenience recruitment during lectures/public areas.","sample_n":179,"sample_text":"179 participants (after excluding 13 for age); 63% female, 82% white, 83% living alone.","population":"Adults ≥60 years, mostly white, female, living alone; lower‑income senior housing.","country":"United States (implied by authors/institution)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 179 low‑income older adults, most reported regular affectionate contact (e.g., kissing) but few engaged in intercourse or mutual stimulation. Participants wanted more sexual activity, especially when lacking a partner, and better health was linked to greater desire.","clinical_takeaway":"Older adults often desire more intimate contact than they experience; clinicians should discuss partner availability and health when addressing sexual wellbeing.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large community‑based older‑adult sample relative to prior work","Comprehensive behaviour checklist covering a range of sexual activities","Provides data on desire vs. actual activity"],"limitations":["Convenience recruitment limits generalisability","No validated sexual‑function or satisfaction instruments used","Potential confounding by health, partner availability not fully modelled"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":1,"mentioning":71,"citing_publications":120,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/ageing/afi143"}},{"id":5145,"doi":"10.1080/00926238408405953","pmid":"6520880","pmcid":null,"title":"Sexual behavior, responsiveness, and attitudes among women: a test of two theories","authors":"Newcomb MD.","first_author":"Newcomb MD.","journal":"Journal of sex & marital therapy","year":1984,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 115 sexually active women; structural equation modelling of self‑report measures","sample_n":115,"sample_text":"115 sexually active women","population":"women, adult, likely convenience sample","country":"USA (likely, given author affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined how women’s sexual attitudes, behaviours, and personal traits relate to their ability to have orgasms during sex and masturbation, finding that attitudes shape behaviour, which in turn influences orgasmic responsiveness.","clinical_takeaway":"Attitudes and sexual behaviours are key predictors of orgasmic responsiveness; targeting these may help women experiencing orgasm difficulties.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Large set of latent variables","Uses structural equation modelling","Tests competing theoretical models"],"limitations":["Cross‑sectional, cannot infer causality","Unclear validation of questionnaires","No control for key confounds (moral, mental health, partner effects)","Modest sample size for SEM"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238408405953"}},{"id":5147,"doi":"10.1097/00006842-198312000-00005","pmid":"6686334","pmcid":null,"title":"Mood, sexuality, hormones, and the menstrual cycle. III. Sexuality and the role of androgens","authors":"Bancroft J, Sanders D, Davidson D, Warner P.","first_author":"Bancroft J","journal":"Psychosomatic medicine","year":1983,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":71,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"within‑subject observational study of 55 women across menstrual phases","sample_n":55,"sample_text":"55 women","population":"women with normal ovulatory cycles (N=55)","country":"unspecified (likely UK/Australia based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 55 regularly cycling women, sexual interest was highest after menstruation and before the period, while masturbation frequency was linked to higher testosterone levels. No spike in desire was found around ovulation.","clinical_takeaway":"Hormone levels (testosterone) may modestly influence solo sexual activity, but overall sexual interest varies across the menstrual cycle.","confidence":0.8,"topic_tags":["sexual_function","masturbation","religiosity","moral_incongruence"],"strengths":["Within‑subject design captures menstrual‑phase variation","Objective hormone assay (testosterone)","Separates masturbation from partnered sexuality"],"limitations":["Small, non‑representative sample","Reliance on unvalidated self‑report measures","Limited control of psychosocial confounds (e.g., religiosity, trauma)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":6,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":45,"citing_publications":169,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00006842-198312000-00005"}},{"id":5148,"doi":"10.1111/j.1743-6109.2005.00083.x","pmid":"16422856","pmcid":null,"title":"A history of sexual medicine in the United kingdom","authors":"Bancroft J.","first_author":"Bancroft J.","journal":"The journal of sexual medicine","year":2005,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"historical review; no empirical data, no sample","sample_n":null,"sample_text":"none (historical narrative)","population":"United Kingdom sexual medicine practitioners/history","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article traces the development of sexual medicine in the UK from the 19th century to the Viagra era, highlighting shifts in attitudes toward masturbation, homosexuality, contraception, and treatment of sexual dysfunction.","clinical_takeaway":"None – the piece is historical and does not provide clinical guidance.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Broad historical perspective on UK sexual medicine","Links sociopolitical context to clinical practice"],"limitations":["No original data; purely narrative","No systematic methodology or bias assessment"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2005.00083.x"}},{"id":5152,"doi":"10.1016/j.psyneuen.2004.10.004","pmid":"15721053","pmcid":null,"title":"Sex steroids and sexual desire in a man with a novel mutation of aromatase gene and hypogonadism","authors":"Carani C, Granata AR, Rochira V, Caffagni G, Aranda C, Antunez P, Maffei LE.","first_author":"Carani C","journal":"Psychoneuroendocrinology","year":2005,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case study of a man with aromatase deficiency; sexological interview and questionnaire across three hormonal treatment phases","sample_n":1,"sample_text":"one participant","population":"adult male with novel aromatase mutation, hypogonadal, receiving hormone therapy","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A single man with a new aromatase‑gene mutation was studied while on different hormone treatments. Libido and masturbation frequency rose only when both testosterone and estradiol were given together, suggesting estrogens may influence male sexual desire.","clinical_takeaway":"In men, combined testosterone‑estradiol therapy may boost libido more than either hormone alone, but evidence is limited to a single case.","confidence":0.7,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["Rare genetic case providing insight into estrogen’s role in male libido","Repeated measures across distinct hormonal conditions"],"limitations":["N=1, no generalizability","Unclear validation of sexual‑behavior instruments","No statistical analysis beyond description"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":41,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psyneuen.2004.10.004"}},{"id":5153,"doi":"10.1016/0005-7916(83)90055-1","pmid":"6358269","pmcid":null,"title":"Sexual fantasy alternation","authors":"Leonard SR, Hayes SC.","first_author":"Leonard SR","journal":"Journal of behavior therapy and experimental psychiatry","year":1983,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"experimental manipulation of fantasy alternation in four adult males; physiological arousal measured","sample_n":4,"sample_text":"four adult males","population":"adult males with sexual orientation confusion (N=4)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A tiny study with four men who were uncertain about their sexual orientation tested whether swapping heterosexual and homosexual fantasies during masturbation changes physiological arousal. Results showed changes, but they were unpredictable and depended on how quickly fantasies were switched.","clinical_takeaway":"Fantasy alternation may affect arousal patterns, but evidence is limited; clinicians should use caution.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Physiological measurement of arousal","Experimental manipulation of fantasy content"],"limitations":["Very small sample (N=4)","No control for confounding variables (moral, mental health, etc.)","Limited generalizability"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0005-7916(83)90055-1"}},{"id":5154,"doi":"10.1111/j.1743-6109.2005.20358.x","pmid":"16422864","pmcid":null,"title":"Persistent sexual arousal syndrome associated with increased soy intake","authors":"Amsterdam A, Abu-Rustum N, Carter J, Krychman M.","first_author":"Amsterdam A","journal":"The journal of sexual medicine","year":2005,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report describing persistent sexual arousal syndrome linked to high soy intake; treatment involved dietary change","sample_n":1,"sample_text":"One female participant","population":"44‑year‑old female patient","country":"USA (assumed from journal and author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 44‑year‑old woman with persistent sexual arousal reported eating over 4 lb of soy daily; after reducing soy, her symptoms resolved in three months. The authors suggest soy may trigger the condition, but the evidence comes from one case.","clinical_takeaway":"No clinical recommendation can be made; the finding is anecdotal and requires systematic study.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed clinical description of a rare syndrome","Follow‑up demonstrating symptom resolution after intervention"],"limitations":["Single case; no control or comparison group","No validated measures of PSAS severity","Potential confounding factors (hormonal, psychological) not assessed"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":2,"contrasting":0,"mentioning":42,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2005.20358.x"}},{"id":5157,"doi":"10.1111/j.1743-6109.2005.20357.x","pmid":"16422863","pmcid":null,"title":"Persistent sexual arousal syndrome: a descriptive study","authors":"Leiblum S, Brown C, Wan J, Rawlinson L.","first_author":"Leiblum S","journal":"The journal of sexual medicine","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":52,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet survey of 103 women reporting persistent sexual arousal syndrome; descriptive statistics and stepwise regression.","sample_n":103,"sample_text":"103 respondents","population":"Women with self‑identified PSAS, recruited via an online questionnaire; self‑selected convenience sample.","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2005 online survey of 103 women who experience persistent genital arousal without desire found that most met criteria for the condition, with varying levels of distress. Unwanted, intrusive arousal and continuous symptoms predicted higher distress, while relationship status and shame also mattered.","clinical_takeaway":"Clinicians should assess distress, unwanted arousal, and emotional reactions in women reporting persistent sexual arousal, rather than assuming a uniform pathological condition.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["First large‑scale description of PSAS features","Identifies predictors of distress via regression","Includes a range of emotional and relational variables"],"limitations":["Self‑selected online sample; limited generalisability","No validated PSAS instrument; relies on ad‑hoc items","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":106,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2005.20357.x"}},{"id":5158,"doi":"10.1210/jc.2005-0247","pmid":"15827094","pmcid":null,"title":"Dose-dependent effects of testosterone on sexual function, mood, and visuospatial cognition in older men","authors":"Gray PB, Singh AB, Woodhouse LJ, Storer TW, Casaburi R, Dzekov J, Dzekov C, Sinha-Hikim I, Bhasin S.","first_author":"Gray PB","journal":"The Journal of clinical endocrinology and metabolism","year":2005,"pub_types":["Clinical Trial","Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":133,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized, double‑blind (presumed) trial with five testosterone dose groups in healthy older men (60‑75 yr).","sample_n":null,"sample_text":"Not specified in abstract","population":"Older men, community‑dwelling, screened for health; sample size not reported in abstract.","country":"United States (General Clinical Research Center)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a trial of older men, higher weekly doses of testosterone improved some aspects of sexual function (overall function, waking erections, libido in sexually active men) but did not affect mood or most cognitive measures.","clinical_takeaway":"Testosterone can boost certain sexual functions in older men, but higher doses do not necessarily improve mood or visuospatial cognition.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Randomized dose‑response design","Separate measurement of masturbation frequency","Multiple relevant outcomes (sexual, mood, cognition)"],"limitations":["Sample size not reported; possible under‑powering","No effect‑size reporting or confidence intervals","Limited control for psychological or relational confounds"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":9,"contrasting":2,"mentioning":122,"citing_publications":197,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1210/jc.2005-0247"}},{"id":5159,"doi":"10.1007/s10508-005-1793-y","pmid":"15803249","pmcid":null,"title":"Sexuality before and after male-to-female sex reassignment surgery","authors":"Lawrence AA.","first_author":"Lawrence AA.","journal":"Archives of sexual behavior","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":83,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"retrospective self‑report questionnaire comparing sexuality before and after MtF sex reassignment surgery in a single‑surgeon clinical cohort (N=232)","sample_n":232,"sample_text":"232 MtF patients of one surgeon","population":"male‑to‑female transsexuals who underwent SRS; mean age 44 (range 18–70)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2005 questionnaire of 232 male‑to‑female transpeople showed that after sex‑reassignment surgery, attraction patterns, number of partners and sexual activity changed, with fewer partners and less autogynephilic arousal reported.","clinical_takeaway":"Sexual behavior often shifts after MtF surgery; clinicians should discuss changes in attraction, partner frequency and sexual function with patients.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Large single‑site clinical sample for a rare population","Within‑subject comparison of pre‑ and post‑SRS sexuality","Provides baseline data for future longitudinal work"],"limitations":["Reliance on non‑validated self‑report items","Cross‑sectional, retrospective design limits causal inference","No control for moral, mental‑health, or relationship confounders"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":10,"contrasting":1,"mentioning":132,"citing_publications":164,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-005-1793-y"}},{"id":5160,"doi":"10.1136/sti.2004.012104","pmid":"15800108","pmcid":"PMC1764654","title":"Collecting the essence of man: semen collection for HIV transmission studies in sub-Saharan Africa","authors":"Price MA, Cohen MS, Hoffman IF, Chilongozi D, Martinson FE, Tembo T.","first_author":"Price MA","journal":"Sexually transmitted infections","year":2005,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":1,"mentioning":9,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sti.2004.012104"}},{"id":5161,"doi":"10.1001/archneur.1983.04050060093027","pmid":"6847453","pmcid":null,"title":"Benign masturbatory cephalalgia","authors":"Lance JW.","first_author":"Lance JW.","journal":"Archives of neurology","year":1983,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archneur.1983.04050060093027"}},{"id":5162,"doi":"10.1016/s0140-1971(83)80023-2","pmid":"6886159","pmcid":null,"title":"Attitudes of French adolescents toward sexuality","authors":"Werebe MJ, Reinert M.","first_author":"Werebe MJ","journal":"Journal of adolescence","year":1983,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 386 French adolescents (16‑18 y) asking five attitude questions about abortion, masturbation, adolescent sex, homosexuality and marriage. Analyses appear limited to frequency comparisons between sexes.","sample_n":386,"sample_text":"386 participants (145 boys, 241 girls)","population":"French adolescents, age 16‑18, recruited presumably via schools (not specified).","country":"France","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1983 French survey of 386 teens examined their views on abortion, masturbation, teen sex, homosexuality and marriage, finding a mix of liberal and conservative attitudes and highlighting religion’s influence.","clinical_takeaway":"None – the study describes attitudes only, without clinical implications.","confidence":0.8,"topic_tags":["sexual_function","adolescents","moral_incongruence"],"strengths":["Large adolescent sample for 1983 standards","Includes both sexes","Addresses multiple culturally relevant topics"],"limitations":["Attitude items not validated","No measurement of actual behaviours","Limited statistical detail (no effect sizes, CIs)","Potential unknown sampling bias"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0140-1971(83)80023-2"}},{"id":5167,"doi":"10.1037//0022-3514.44.4.862","pmid":"6842369","pmcid":null,"title":"Dimensions of subjective female orgasmic responsiveness","authors":"Newcomb MD, Bentler PM.","first_author":"Newcomb MD","journal":"Journal of personality and social psychology","year":1983,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 115 and 101 sexually experienced women; questionnaire assessing coital and masturbatory orgasm dimensions; factor analysis performed","sample_n":216,"sample_text":"115 women in Study 1; 101 women in Study 2","population":"adult women, sexually experienced, likely convenience sample","country":"USA (presumed based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Two surveys of over 200 women showed that experiences of orgasm during sex, during solo masturbation, and during partnered non‑penetrative activity form three related but distinct dimensions, while also loading onto a single overall orgasm factor.","clinical_takeaway":"Clinicians should recognize that women's orgasm experiences can vary across different sexual contexts, yet often reflect a common underlying capacity.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Large (for the field) sample of women","Differentiates coital vs masturbatory orgasm","Uses confirmatory factor analysis"],"limitations":["Convenience, non‑representative sample","Self‑report instrument not previously validated","Limited control of psychological confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0022-3514.44.4.862"}},{"id":5168,"doi":null,"pmid":"6881742","pmcid":null,"title":"[Compulsive masturbation in the child]","authors":"Pedreira Massa JL, Sastre SH, Mendoza Berjano E.","first_author":"Pedreira Massa JL","journal":"Anales espanoles de pediatria","year":1983,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"theoretical discussion without empirical data; no sample described","sample_n":null,"sample_text":"none reported","population":"children (preschool age)","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["no_mi_control","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article offers a theoretical overview of compulsive masturbation in preschool children, discussing possible evolutionary and pathological meanings, family influences, and suggesting a permissive therapeutic approach, but provides no empirical data.","clinical_takeaway":"None – the paper does not present evidence to guide clinical practice.","confidence":0.7,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["early discussion of child sexual behavior","includes family context"],"limitations":["no empirical data or systematic methodology","lacks validated measurement of compulsivity","no control of key confounds"],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5169,"doi":"10.1375/1832427053435427","pmid":"15836807","pmcid":null,"title":"Genetic and environmental influences on the frequency of orgasm in women","authors":"Dawood K, Kirk KM, Bailey JM, Andrews PW, Martin NG.","first_author":"Dawood K","journal":"Twin research and human genetics : the official journal of the International Society for Twin Studies","year":2005,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Twin Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":57,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Twin study with large self‑report questionnaire; cross‑sectional analysis of genetic vs environmental variance components.","sample_n":3080,"sample_text":"3080 women from the Australian Twin Registry completed an anonymous questionnaire.","population":"Australian women twins, N≈3080 (667 MZ pairs, 377 DZ same‑sex pairs, plus others).","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A large Australian twin study found that genetics explain roughly one‑third to one‑half of differences in how often women have orgasms during sex, other contact, and masturbation.","clinical_takeaway":"Genetics play a modest role in orgasm frequency; variability is largely environmental.","confidence":0.85,"topic_tags":["gender","sexual_function","treatment"],"strengths":["Large twin sample with both MZ and DZ pairs.","Comprehensive genetic‑environmental modeling.","Clear reporting of variance components."],"limitations":["Reliance on single‑item self‑report frequencies.","Cross‑sectional design limits causal inference.","No assessment of potential psychological or relational confounders."],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":8,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":9,"contrasting":0,"mentioning":44,"citing_publications":95,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1375/1832427053435427"}},{"id":5170,"doi":"10.1080/00926238308405832","pmid":"6663638","pmcid":null,"title":"Sexual fantasies of sexually distressed and nondistressed men and women: an empirical comparison","authors":"Zimmer D, Borchardt E, Fischle C.","first_author":"Zimmer D","journal":"Journal of sex & marital therapy","year":1983,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of psychotherapy clients with and without sexual distress, using written fantasy descriptions.","sample_n":null,"sample_text":"Not reported in abstract; likely modest convenience sample.","population":"Adult men and women seeking psychotherapy (distressed) and other psychotherapy clients (non‑distressed).","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared written sexual fantasies of men and women who were sexually distressed with those who were not, finding that distressed people used fantasies more to cope with negative feelings, while non‑distressed people fantasized more for pleasure.","clinical_takeaway":"Sexual fantasies may serve different roles for distressed versus non‑distressed clients; consider their function in therapy.","confidence":0.7,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Direct comparison of distressed vs nondistressed groups","Includes both men and women","Considers age effects"],"limitations":["No validated fantasy measurement instrument","Likely small, non‑representative sample","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238308405832"}},{"id":5171,"doi":"10.1080/00926238308410914","pmid":"6663644","pmcid":null,"title":"Sexual fantasy and activity patterns of females with inhibited sexual desire versus normal controls","authors":"Nutter DE, Condron MK.","first_author":"Nutter DE","journal":"Journal of sex & marital therapy","year":1983,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional comparison of 25 clinic patients with inhibited sexual desire and 30 satisfied controls; convenience sampling; small sample size.","sample_n":55,"sample_text":"30 satisfied women, 25 women from a sexual dysfunction clinic.","population":"Adult females with inhibited sexual desire vs women reporting satisfactory sexual lives.","country":"USA (presumed from journal, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Women with inhibited sexual desire reported fewer fantasies during foreplay, intercourse and masturbation than women with a satisfying sex life, though they masturbated as often and had similar fantasy content.","clinical_takeaway":"Reduced fantasy may be linked to low desire, but frequency alone does not predict masturbation or orgasm outcomes.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Direct comparison of clinical and non‑clinical women","Includes masturbation frequency data"],"limitations":["Small, non‑representative sample","Likely uses non‑validated fantasy questionnaire","No control for moral, mental‑health or relationship factors"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":6,"contrasting":1,"mentioning":46,"citing_publications":77,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238308410914"}},{"id":5172,"doi":"10.1177/002580248302300109","pmid":"6827948","pmcid":null,"title":"An unusual case of sudden death associated with masturbation","authors":"Cordner SM.","first_author":"Cordner SM.","journal":"Medicine, science, and the law","year":1983,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/002580248302300109"}},{"id":5173,"doi":"10.1016/0306-4530(83)90018-5","pmid":"6371868","pmcid":null,"title":"The genealogical descent of sexual psychoneuroendocrinology from sex and health theory: the eighteenth to the twentieth centuries","authors":"Money J.","first_author":"Money J.","journal":"Psychoneuroendocrinology","year":1983,"pub_types":["Historical Article","Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical commentary without primary data; no empirical sample.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article traces how 18th‑century ideas about vital spirits evolved into modern hormone theory, highlighting how moralism around masturbation shaped health doctrines and limited research funding in the 20th century.","clinical_takeaway":"None – the piece is historical and does not provide clinical guidance.","confidence":0.4,"topic_tags":["sexual_function","masturbation"],"strengths":["Comprehensive historical synthesis","Links sociocultural policy to scientific development"],"limitations":["No empirical data or systematic review methodology","No measurement of contemporary constructs (e.g., pornography use)","Potential author bias in historical interpretation"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0306-4530(83)90018-5"}},{"id":5174,"doi":null,"pmid":"16095068","pmcid":null,"title":"[Origin of psychiatric disorders ex sexualibus: explanatory approaches at the beginning of the 19th century]","authors":"Gutmann P.","first_author":"Gutmann P.","journal":"Sudhoffs Archiv","year":2005,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"0-2","sample_n":null,"sample_text":"Not applicable – article reviews historical publications","population":"historical figures, 19th‑century medical writings; no empirical sample","country":"Germany (historical context)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews early 19th‑century medical writings that linked sexual abnormalities, including masturbation, to mental disorders, showing how historic physicians tried to systematize these ideas.","clinical_takeaway":"None – the paper is historical and does not provide actionable clinical guidance.","confidence":0.8,"topic_tags":["sexual_function","masturbation","pornography","gender"],"strengths":["Provides historical context for early psychiatric theories of sexuality","Cites original 19th‑century sources"],"limitations":["No empirical data; purely descriptive","No modern methodological assessment","Findings not directly applicable to current clinical practice"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5176,"doi":"10.1002/oti.18","pmid":"16136867","pmcid":null,"title":"Survey of occupational therapy students' attitudes towards sexual issues in clinical practice","authors":"Jones MK, Weerakoon P, Pynor RA.","first_author":"Jones MK","journal":"Occupational therapy international","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 340 occupational therapy students using a Comfort Scale Questionnaire; convenience sample; descriptive statistics reported.","sample_n":340,"sample_text":"340 occupational therapy students","population":"occupational therapy students (likely from one or few institutions, UK? not specified)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 340 occupational therapy students found that most feel uncomfortable dealing with sexual situations such as encountering a patient masturbating or handling sexual remarks, and many feel their training did not prepare them adequately.","clinical_takeaway":"Educators should consider enhancing sexuality training to improve student comfort with sexual health issues in clinical practice.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Reasonably large sample for a student survey","Focus on an under‑studied aspect of OT education","Clear presentation of specific discomfort items"],"limitations":["Reliance on a likely ad‑hoc comfort scale with unclear validation","Cross‑sectional design; no causal inference","No control for moral, personal or mental‑health variables"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":1,"mentioning":43,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/oti.18"}},{"id":5178,"doi":"10.3760/j:issn:0253-9624.2005.01.011","pmid":"15794890","pmcid":null,"title":"[Investigation of acquired immunodeficiency syndrome correlated with high risk sexual behavior and knowledge of male homosexuality in Hangzhou Province, China]","authors":"Xu Y, Shi WX, Hu SH.","first_author":"Xu Y","journal":"Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine]","year":2005,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Anonymous self‑report questionnaire administered to 927 male homosexuals in Hangzhou, China (May 2003–Jan 2004). Descriptive frequencies of sexual practices and condom use were reported.","sample_n":927,"sample_text":"Convenience sample of self‑identified male homosexuals recruited for an AIDS‑risk survey.","population":"Male homosexual adults (average age 29.8 y) in Hangzhou, China (N = 927).","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2005 survey of 927 Chinese gay men found very high numbers of sexual partners, low condom use, and high AIDS‑risk behaviours despite good knowledge about the disease.","clinical_takeaway":"Risk‑reduction programmes should target condom use among men who have sex with men and with female partners.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for a regional survey","Provides detailed descriptive data on high‑risk sexual practices"],"limitations":["Use of a self‑designed, unvalidated questionnaire","Cross‑sectional design; no causal inference possible","No control for potential confounders (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3760/j:issn:0253-9624.2005.01.011"}},{"id":5179,"doi":"10.1097/00001888-198212000-00004","pmid":"7143403","pmcid":null,"title":"The role of medical students' stereotype of physicians in sex education","authors":"Schnarch DM.","first_author":"Schnarch DM.","journal":"Journal of medical education","year":1982,"pub_types":["Journal Article"],"keywords":["Behavior","Health","North America","Students","Sex behavior","Physicians","Data collection","research methodology","Psychology","Psychological factors","Psychosocial factors","Education","United States","Developed Countries","Sex Education","Social Sciences","Attitude","Americas","Northern America","Delivery Of Health Care","Health Personnel","Psychology, Social","Louisiana","Medical Students"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 136 sophomore and 43 senior medical students compared with 91 physicians using a modified Sex Knowledge and Attitude Test","sample_n":270,"sample_text":"136 sophomores, 43 seniors, 91 physicians","population":"medical students (US), practicing physicians","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Medical students think doctors are more conservative about masturbation and less knowledgeable about sex than they actually are, and these misconceptions persist despite sex‑education courses.","clinical_takeaway":"Clinicians should be aware that future physicians may hold inaccurate stereotypes about peers' sexual attitudes, which could affect counseling.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large combined sample of students and physicians","Addresses an under‑studied bias in medical education"],"limitations":["Reliance on a modified, likely unvalidated attitude questionnaire","Cross‑sectional design cannot infer causality","No control for moral, mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00001888-198212000-00004"}},{"id":5180,"doi":"10.1111/j.1447-0578.2004.00073.x","pmid":"29699199","pmcid":"PMC5906837","title":"Comparison of sperm counts in two groups of men presenting for infertility investigations 20 years apart","authors":"Clarke GN, Stewart T, Baker HWG.","first_author":"Clarke GN","journal":"Reproductive medicine and biology","year":2004,"pub_types":["research-article","Journal Article"],"keywords":["Sperm Count","Sperm Concentration","Semen Analysis","Human Semen"],"is_oa":false,"oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/j.1447-0578.2004.00073.x","cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative historical cohort study of men attending infertility clinics in two time periods (1977‑1981 vs 1997‑1998). Large convenience sample, same laboratory methods, but non‑random, clinic‑based, may not generalise to all men.","sample_n":868,"sample_text":"309 men tested 1977‑1981, 559 men tested 1997‑1998; only first test and counts >5 million/mL included.","population":"Men presenting for infertility investigations in Melbourne, Australia (N≈868, after excluding severe oligospermia).","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study compared sperm counts of men who visited a fertility clinic in the early 1980s versus the late 1990s and found no meaningful decline in sperm numbers over the 20‑year span.","clinical_takeaway":"No evidence from this data that sperm counts have fallen in recent decades among Australian men seeking infertility care.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Objective, standardized semen analysis","Large sample sizes for both periods","Same methodology across cohorts"],"limitations":["Clinic‑based convenience sample, not population‑representative","No adjustment for age difference beyond reporting","No effect sizes or power analysis reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1447-0578.2004.00073.x"}},{"id":5181,"doi":"10.1080/00207450490509339","pmid":"15512841","pmcid":null,"title":"Hypersexuality and dysexecutive syndrome after a thalamic infarct","authors":"Spinella M.","first_author":"Spinella M.","journal":"The International journal of neuroscience","year":2004,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"1","population":"single adult male with thalamic infarct","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2004 case report describes a man who, after a thalamic stroke, displayed new‑onset hypersexual behaviors such as exhibitionism and public masturbation, along with executive‑function deficits. The author discusses how damage to thalamic circuits might produce such changes.","clinical_takeaway":"Clinicians should consider neurological injury as a possible cause of sudden hypersexual behavior, but evidence is limited to isolated case reports.","confidence":0.6,"topic_tags":["neuroscience","sexual_function","csbd"],"strengths":["Detailed neurological description","Links neuroanatomy to behavior","Adds rare case to literature"],"limitations":["Single case; no generalizability","No validated measures of hypersexuality","No control or comparison group"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00207450490509339"}},{"id":5182,"doi":null,"pmid":"15693438","pmcid":null,"title":"Premature ejaculation. 2. Classification and diagnosis","authors":"Piediferro G, Castiglioni F, Colpi EM, Contalbi G.","first_author":"Piediferro G","journal":"Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica","year":2004,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review article proposing a diagnostic classification for premature ejaculation; no original data collection.","sample_n":null,"sample_text":"Not applicable – review without primary data.","population":"Humans (male patients with premature ejaculation)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper proposes a detailed classification system for premature ejaculation, distinguishing types based on orgasm intensity, context (situational vs. global), and whether the issue occurs only during intercourse or also during masturbation, and suggests diagnostic tests to guide treatment.","clinical_takeaway":"Clinicians should use a comprehensive assessment—latency timing, context, and associated erectile issues—to classify premature ejaculation before choosing therapy.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Provides a detailed taxonomy for PE subtypes","Integrates physiological tests with psycho‑sexual history"],"limitations":["No original empirical data presented","No systematic review methodology described","Lacks validation of proposed classification with psychometric instruments"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":5184,"doi":"10.1176/appi.psychotherapy.1982.36.4.554","pmid":"7158678","pmcid":null,"title":"Klismaphilia--a physiological perspective","authors":"Agnew J.","first_author":"Agnew J.","journal":"American journal of psychotherapy","year":1982,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"Not applicable – article is a physiological/clinical commentary with no empirical sample reported.","population":"humans","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews how the anatomy of the anal region can produce sexual pleasure, explaining why some people find enemas arousing. It compares enema stimulation to anal masturbation and discusses possible psychological links.","clinical_takeaway":"None – the article is theoretical and does not provide evidence for assessment or treatment.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Provides a detailed physiological overview of anal sensitivity","Integrates clinical observations with anatomical description"],"limitations":["No empirical data or sample","Lacks operational definitions of klismaphilia or related constructs","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.psychotherapy.1982.36.4.554"}},{"id":5185,"doi":"10.1001/archneur.1982.00510220071025","pmid":"7125990","pmcid":null,"title":"Benign masturbatory cephalalgia","authors":"Vincent FM.","first_author":"Vincent FM.","journal":"Archives of neurology","year":1982,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archneur.1982.00510220071025"}},{"id":5186,"doi":null,"pmid":"7133788","pmcid":null,"title":"On masturbation","authors":"Noshpitz J.","first_author":"Noshpitz J.","journal":"Pediatric annals","year":1982,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5187,"doi":"10.1016/s0210-4806(04)73177-0","pmid":"15666518","pmcid":null,"title":"[Orgasm and its impact on quality of life after radical prostatectomy]","authors":"Martínez-Salamanca García JI, Jara Rascón J, Moncada Iribarren I, García Burgos J, Hernández Fernández C.","first_author":"Martínez-Salamanca García JI","journal":"Actas urologicas espanolas","year":2004,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective review of 152 men’s medical records after radical prostatectomy; questionnaire administered by interview; no control group.","sample_n":152,"sample_text":"152 patients; 134 experienced postoperative ED; 140 reported normal orgasm.","population":"Men aged 44‑75 who underwent radical prostatectomy between 1999‑2000 in Spain (N=152).","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 152 men who had their prostate removed, most still reported a normal orgasm and libido, though many developed erectile dysfunction and some experienced urine loss during orgasm.","clinical_takeaway":"After radical prostatectomy, orgasmic function is often preserved, but clinicians should counsel patients about possible urinary leakage during orgasm.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large sample for a single‑center surgical cohort","Clear description of postoperative sexual outcomes"],"limitations":["No validated orgasm or sexual function scales","Retrospective, no comparison group","No statistical power justification or confidence intervals"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0210-4806(04)73177-0"}},{"id":5188,"doi":"10.1080/00224490409552244","pmid":"15765277","pmcid":null,"title":"Pheromonal influences on sociosexual behavior in postmenopausal women","authors":"Friebely J, Rako S.","first_author":"Friebely J","journal":"Journal of sex research","year":2004,"pub_types":["Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"double‑blind, placebo‑controlled randomized trial with 44 post‑menopausal women; 6‑week intervention; self‑report of socio‑sexual behaviours","sample_n":44,"sample_text":"44 participants (mean age = 57) recruited as volunteers","population":"post‑menopausal women (mean age 57), volunteers from the United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a small double‑blind trial, post‑menopausal women who wore a synthetic pheromone reported more kissing, petting and affection over six weeks than those who wore a placebo, while masturbation frequency did not change.","clinical_takeaway":"Evidence that a pheromone fragrance may modestly boost partnered affection in post‑menopausal women, but findings are preliminary and based on limited self‑report data.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["randomized double‑blind design","placebo control","specific behavioural outcomes"],"limitations":["small sample (N = 44)","self‑report outcomes only","no effect‑size reporting or correction for multiple tests","no measurement of potential confounders (e.g., relationship status, mood)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490409552244"}},{"id":5189,"doi":"10.1080/09540120412331292444","pmid":"15511732","pmcid":null,"title":"Beliefs about cybersex and Internet-mediated sex of Latino men who have Internet sex with men: relationships with sexual practices in cybersex and in real life","authors":"Ross MW, Rosser BR, Stanton J.","first_author":"Ross MW","journal":"AIDS care","year":2004,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online convenience survey of 1,026 Latino men who have Internet sex with men; factor analysis used to create belief scales; associations with self‑reported sexual practices examined.","sample_n":1026,"sample_text":"1,026 Latino MISM","population":"Latino men who have Internet sex with men (MISM) in the United States, recruited via an Internet study.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed over a thousand Latino men who meet sexual partners online, creating two belief scales about cybersex. Beliefs that cybersex feels safe were linked to more online sexual activity but less risky real‑life sex, while beliefs about meeting partners online were linked to more in‑person oral/anal sex and less discussion of HIV safety.","clinical_takeaway":"Clinicians should note that attitudes toward online sexual activity influence real‑life risk behavior, but beliefs alone do not predict unsafe practices.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for a niche population","Factor analysis used to create belief scales","Examines real‑world sexual risk behaviors linked to online attitudes"],"limitations":["Convenience online sample limits generalizability","Scales not externally validated","Potential unmeasured confounds (e.g., mental health, religiosity)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":25,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540120412331292444"}},{"id":5190,"doi":"10.1016/j.brainres.2004.07.029","pmid":"15451368","pmcid":null,"title":"Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the vagus nerves","authors":"Komisaruk BR, Whipple B, Crawford A, Liu WC, Kalnin A, Mosier K.","first_author":"Komisaruk BR","journal":"Brain research","year":2004,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":157,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"fMRI study of 5 women with complete or incomplete spinal cord injury performing vaginal‑cervical self‑stimulation and orgasm; within‑subject control tasks used.","sample_n":5,"sample_text":"Four women with complete SCI and one with incomplete SCI (total N=5).","population":"Women with complete spinal cord injury (T10 or above) and one with incomplete injury; N=5.","country":"USA (implied by NIH funding).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In five women with complete spinal cord injuries, fMRI showed that stimulating the vagina and cervix activated a brainstem region (NTS) linked to the vagus nerve, suggesting a spinal‑bypass route for sexual sensation and orgasm.","clinical_takeaway":"Vagus‑mediated pathways may allow sexual sensation after high‑level spinal injury, but evidence is preliminary.","confidence":0.78,"topic_tags":["neuroscience","sexual_function"],"strengths":["Innovative use of fMRI to map vagal pathway for sexual sensation in SCI.","Within‑subject control conditions (gustatory, hand movement).","Clear anatomical hypothesis (NTS activation)."],"limitations":["Very small sample (N=5) limits generalisability and statistical power.","No correction for multiple comparisons reported.","Findings based on single‑case series; cannot infer prevalence."],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":4,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":10,"contrasting":1,"mentioning":179,"citing_publications":291,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.brainres.2004.07.029"}},{"id":5191,"doi":"10.1111/j.0002-8614.2004.52413.x","pmid":"15341552","pmcid":null,"title":"Changes in sexual function in middle-aged and older men: longitudinal data from the Massachusetts Male Aging Study","authors":"Araujo AB, Mohr BA, McKinlay JB.","first_author":"Araujo AB","journal":"Journal of the American Geriatrics Society","year":2004,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":116,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Population‑based cohort of 1,085 men, baseline 1987‑89, follow‑up 1995‑97; within‑person change in multiple sexual function domains.","sample_n":1085,"sample_text":"One thousand eighty‑five men aged 40 to 70 at baseline with complete data at both time points.","population":"Middle‑aged and older men (40‑70 y at baseline) from communities surrounding Boston, MA; US government‑funded sample.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 9‑year study of over 1,000 U.S. men aged 40‑70, sexual activity, erections, desire and orgasm difficulty all declined with age, while ejaculation during masturbation stayed stable. Declines were steeper for older age groups.","clinical_takeaway":"Older men can expect a gradual reduction in many aspects of sexual function; counseling should address normal age‑related change rather than pathology.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, population‑based longitudinal cohort","Age‑specific estimates of change","Multiple domains of sexual function assessed"],"limitations":["Reliance on self‑report questionnaires without detail on validation","No effect‑size confidence intervals reported in abstract","Potential cohort effects not addressed"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":9,"contrasting":0,"mentioning":127,"citing_publications":221,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.0002-8614.2004.52413.x"}},{"id":5192,"doi":"10.1363/3012804","pmid":"15381467","pmcid":null,"title":"Needs and preferences regarding sex education among Chinese college students: a preliminary study","authors":"Li Y, Cottrell RR, Wagner DI, Ban M.","first_author":"Li Y","journal":"International family planning perspectives","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of students at one Chinese university (2002); convenience sample; descriptive analyses of preferences and prior education.","sample_n":null,"sample_text":"Convenience sample of students at a single university; not nationally representative.","population":"College students (unspecified N) at a large Chinese university","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2002 survey of Chinese university students found that many had little formal sex education before college. Students preferred different ways to learn, with males favoring topics like masturbation and more open discussion, while females preferred private reading materials. The authors suggest expanding comprehensive sex‑education programs that respect these gender differences.","clinical_takeaway":"Develop college sex‑education curricula that include topics such as masturbation and use delivery methods aligned with student preferences (e.g., private reading for females).","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses a gap in Chinese college‑level sex education research.","Incorporates both male and female perspectives.","Identifies specific topics (e.g., masturbation) and delivery preferences."],"limitations":["Single‑site convenience sample; limited generalisability.","Questionnaire items appear study‑specific, not validated.","No statistical power justification or effect‑size reporting."],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":2,"mentioning":17,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1363/3012804"}},{"id":5193,"doi":"10.1023/b:jarg.0000045474.29171.ed","pmid":"15587148","pmcid":"PMC3468269","title":"Occurrence of nonpersistent hematospermia after a prolonged period of daily ejaculatory intensity longer than 3 weeks","authors":"Correa-Pérez JR.","first_author":"Correa-Pérez JR.","journal":"Journal of assisted reproduction and genetics","year":2004,"pub_types":["brief-report","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case description of hematospermia following >3 weeks of daily masturbation","sample_n":1,"sample_text":"N=1 (single case report)","population":"one adult male (case report)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A man who ejaculates daily for more than three weeks reported a one‑time episode of blood in his semen, which the author suggests might be caused by stress on the genital blood vessels.","clinical_takeaway":"Repeated daily ejaculation can occasionally lead to temporary hematospermia; clinicians should consider physiological causes before attributing it to pathology.","confidence":0.4,"topic_tags":["masturbation","sexual_function","gender","religiosity","csbd"],"strengths":["Clear description of a rare clinical presentation","Links physiological symptom to behavioral pattern"],"limitations":["Single case; no control group","No measurement of confounding factors (e.g., infection, trauma)","No objective quantification of ejaculation intensity"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/b:jarg.0000045474.29171.ed"}},{"id":5194,"doi":"10.1016/j.envres.2003.09.002","pmid":"15261778","pmcid":null,"title":"The long-term effects of DDT exposure on semen, fertility, and sexual function of malaria vector-control workers in Limpopo Province, South Africa","authors":"Dalvie MA, Myers JE, Thompson ML, Robins TG, Dyer S, Riebow J, Molekwa J, Jeebhay M, Millar R, Kruger P.","first_author":"Dalvie MA","journal":"Environmental research","year":2004,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional study of 60 occupationally exposed workers; convenience sample; limited generalisability","sample_n":60,"sample_text":"cross‑sectional convenience sample","population":"male malaria vector‑control workers, Limpopo Province, South Africa (N≈60)","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A cross‑sectional study of 60 South African malaria‑control workers found generally low semen quality and modest self‑reported sexual‑function problems, with only a weak link between serum p'p'-DDT levels and sperm count. No strong evidence that DDT exposure harms fertility was identified.","clinical_takeaway":"Current data do not support a clear causal link between occupational DDT exposure and male fertility or sexual function.","confidence":0.7,"topic_tags":["religiosity","masturbation","sexual_function"],"strengths":["objective semen quality measurement using WHO/Tygerberg standards","serum DDT metabolites quantified","adjustment for basic biological covariates"],"limitations":["small, non‑representative sample of workers","cross‑sectional design limits causal inference","limited assessment of sexual‑function confounders (e.g., mental health, relationship factors)","no correction for multiple testing"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":42,"citing_publications":81,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.envres.2003.09.002"}},{"id":5195,"doi":"10.1038/sj.ijir.3901201","pmid":"15014553","pmcid":null,"title":"Hypersexual sensations and behavior in a multiple sclerosis exacerbation: a case report","authors":"Yang CC, Severson B, Bowen JD.","first_author":"Yang CC","journal":"International journal of impotence research","year":2004,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/sj.ijir.3901201"}},{"id":5196,"doi":"10.1080/00224490409552230","pmid":"15497051","pmcid":null,"title":"Sexual addiction, sexual compulsivity, sexual impulsivity, or what? Toward a theoretical model","authors":"Bancroft J, Vukadinovic Z.","first_author":"Bancroft J","journal":"Journal of sex research","year":2004,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":187,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"cross-sectional case‑control study with 31 self‑identified sex‑addicts and a larger age‑matched control group","sample_n":31,"sample_text":"31 self‑defined sex addicts; control group size not specified in abstract","population":"adults (self‑defined sex addicts and community controls)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","circular_addiction_scale","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors review and compare 31 people who label themselves as sex addicts with a larger control group, finding more sexual interest during depression or anxiety and some dissociative experiences. They suggest multiple mechanisms, including addiction, may underlie out‑of‑control sexual behaviour.","clinical_takeaway":"Current evidence is insufficient to support a specific diagnosis of sexual addiction; clinicians should consider mood, compulsivity, and individual differences.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Attempts to compare sex‑addicts with matched controls","Considers mood (depression/anxiety) as a factor"],"limitations":["Very small clinical sample; likely underpowered","Self‑defined “sex addicts” – circular definition","No measurement of key confounds (moral incongruence, masturbation, partner factors, trauma)","Addiction criteria not operationalised"],"rubric_version":"2.0","raw_total":20,"max_possible":60,"pct_score":33,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":13,"contrasting":2,"mentioning":230,"citing_publications":466,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490409552230"}},{"id":5197,"doi":"10.1136/bmj.284.6314.513-b","pmid":"6800527","pmcid":"PMC1496078","title":"Masturbation and fornication","authors":"Goodman RE.","first_author":"Goodman RE.","journal":"British medical journal (Clinical research ed.)","year":1982,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.284.6314.513-b"}},{"id":5198,"doi":"10.1007/bf01541364","pmid":"7073468","pmcid":null,"title":"A study of fantasy-based sexual arousal in women","authors":"Stock WE, Geer JH.","first_author":"Stock WE","journal":"Archives of sexual behavior","year":1982,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational correlational study linking self‑reported fantasy use to laboratory genital arousal measured with vaginal photoplethysmography in 45 young women.","sample_n":45,"sample_text":"Convenience sample of college‑age women","population":"Female undergraduate/young adult volunteers (N=45, median age 21)","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Women who reported using sexual fantasies more often during masturbation showed stronger genital arousal in the lab, both when imagining fantasies and when listening to an erotic audio tape.","clinical_takeaway":"Frequent fantasy use may be linked to heightened physiological sexual responsiveness; clinicians should consider cognitive arousal factors when addressing sexual function.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Objective physiological measurement","Combination of self‑report and lab data","Focus on cognitive predictors of arousal"],"limitations":["Small convenience sample","Unvalidated fantasy frequency scales","No control for moral, mental‑health, or relational confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541364"}},{"id":5200,"doi":"10.1080/00926238208405810","pmid":"7097784","pmcid":null,"title":"The treatment of anorgasmia: long-term effectiveness of a short-term behavioral group therapy","authors":"Kuriansky JB, Sharpe L, O'Connor D.","first_author":"Kuriansky JB","journal":"Journal of sex & marital therapy","year":1982,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"small uncontrolled follow‑up of 19 women after group therapy","sample_n":19,"sample_text":"19 women who participated in short‑term group therapy","population":"women with anorgasmia (N=19)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Nineteen women with difficulty reaching orgasm took part in a brief group therapy that taught masturbation and assertiveness. Most kept the gains after several years, though a few regressed, indicating that personal factors also matter.","clinical_takeaway":"Short‑term group therapy can improve orgasm response long‑term for many women, but clinicians should monitor individual factors that may affect outcomes.","confidence":0.7,"topic_tags":["sexual_function","treatment","masturbation"],"strengths":["Long‑term follow‑up","Use of standardized scales","Multi‑dimensional assessment"],"limitations":["Very small, uncontrolled sample","No measurement of key confounds (e.g., partner context, mental health)","No effect‑size reporting"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238208405810"}},{"id":5201,"doi":"10.1080/00926238208405819","pmid":"7120434","pmcid":null,"title":"From masturbation to orgasm with a partner: how some women bridge the gap--and why others don't","authors":"de Bruijn G.","first_author":"de Bruijn G.","journal":"Journal of sex & marital therapy","year":1982,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238208405819"}},{"id":5203,"doi":"10.1177/000306518203000207","pmid":"6084023","pmcid":null,"title":"The symbol of telephoning","authors":"Shengold L.","first_author":"Shengold L.","journal":"Journal of the American Psychoanalytic Association","year":1982,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single clinical case illustration","sample_n":1,"sample_text":"single patient, case report","population":"adult male patient (n=1, inferred)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The article presents two excerpts from psychoanalytic therapy, interpreting a patient's use of telephone calls as a symbolic stand‑in for masturbation, exploring latent meanings.","clinical_takeaway":"No direct clinical recommendations; the paper offers a symbolic interpretation of behavior rather than evidence‑based guidance.","confidence":0.4,"topic_tags":["masturbation","sexual_function"],"strengths":["Provides rich psychoanalytic insight","Illustrates symbolic associations"],"limitations":["Single case; no generalizability","No validated measures","No control of confounds"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000306518203000207"}},{"id":5204,"doi":"10.1016/j.chc.2004.02.001","pmid":"15183368","pmcid":null,"title":"Children and adolescents as sexual beings: cross-cultural perspectives","authors":"Nieto JA.","first_author":"Nieto JA.","journal":"Child and adolescent psychiatric clinics of North America","year":2004,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review offering cross‑cultural perspectives on child and adolescent sexual behaviour; no empirical data collection, no systematic methods reported.","sample_n":null,"sample_text":"Not applicable – review article","population":"Children and adolescents (no specific sample reported)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article surveys how different cultures view child and adolescent sexual behaviours, noting that practices considered sexual in Western societies may be seen differently elsewhere.","clinical_takeaway":"None – the paper provides cultural context but no clinical guidance.","confidence":0.6,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Broad cross‑cultural scope","Highlights variation in norms around child sexuality"],"limitations":["No empirical data; narrative review","Lacks systematic methodology or critical appraisal"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chc.2004.02.001"}},{"id":5205,"doi":"10.1080/13691050310001645041","pmid":"21972905","pmcid":null,"title":"Saviours and satyrs: ambivalence in narrative meanings of sperm provision","authors":"Kirkman M.","first_author":"Kirkman M.","journal":"Culture, health & sexuality","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative narrative study with 87 volunteers from multiple countries; convenience sampling; thematic analysis of interview data","sample_n":87,"sample_text":"Eighty‑seven volunteers from Australia, Canada, UK, USA and Argentina participated","population":"donor‑assisted conception participants (donors, recipients, offspring)","country":"Australia, Canada, United Kingdom, United States, Argentina","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 87 people involved in sperm donation revealed mixed feelings: donors are seen as both helpful and threatening, recipients feel gratitude mixed with anxiety, and the genetic link creates ambivalence about family roles.","clinical_takeaway":"None - the study offers sociocultural insight, not clinical guidance.","confidence":0.8,"topic_tags":["sexual_function","religiosity","treatment","gender"],"strengths":["Multi‑country sample","Rich qualitative insight into donor‑recipient dynamics","Integrates perspectives of donors, recipients, and offspring"],"limitations":["Convenience, self‑selected volunteers","No standardized measures of constructs","Limited generalisability to broader populations"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":46,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691050310001645041"}},{"id":5206,"doi":"10.1007/s00120-004-0623-5","pmid":"15205739","pmcid":null,"title":"[Total infarction of the penis caused by entrapment in a plastic bottle]","authors":"Maruschke M, Seiter H.","first_author":"Maruschke M","journal":"Der Urologe. Ausg. A","year":2004,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with penile strangulation injury","sample_n":1,"sample_text":"single case","population":"62‑year‑old male","country":"Germany (journal Der Urologe)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 62‑year‑old man strangulated his penis with a plastic bottle for 14 days, leading to gangrene and eventual amputation. The report describes the emergency surgery and recovery.","clinical_takeaway":"Penile constriction devices can cause severe tissue loss; prompt medical intervention is essential.","confidence":0.9,"topic_tags":["sexual_function","gender"],"strengths":["Clear clinical description of a rare emergency","Anatomical and microbiological details provided"],"limitations":["Single case; no generalizability","No systematic assessment of psychological factors","No control or comparison group"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00120-004-0623-5"}},{"id":5207,"doi":"10.1080/13691050310001645050","pmid":"21972906","pmcid":null,"title":"What do young people want from sex education? The results of a needs assessment from a peer-led sex education programme","authors":"Forrest S, Strange V, Oakley A, The Ripple Study Team.","first_author":"Forrest S","journal":"Culture, health & sexuality","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 4,353 secondary‑school students in 13 English schools; peer‑led questionnaire administered by researchers.","sample_n":4353,"sample_text":"13 secondary schools, peer‑led data collection","population":"students aged 13‑14 years, English secondary schools","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 4 000 UK teens found they want clear information on puberty, STIs, contraception, relationships, pleasure, masturbation and homosexuality, highlighting gaps between their needs and current school curricula.","clinical_takeaway":"Sex‑education programmes should address teens' expressed gaps, especially around pleasure, masturbation and relationship skills.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Large sample size (over 4,000 participants)","Peer‑led data collection may increase relevance to youth","Comprehensive coverage of sexual‑health topics"],"limitations":["Questionnaire items appear ad‑hoc and not psychometrically validated","Convenience sample of schools limits national generalisability","No statistical modelling of potential confounders"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":0,"mentioning":42,"citing_publications":86,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691050310001645050"}},{"id":5211,"doi":null,"pmid":"15267202","pmcid":null,"title":"[Experimental study of the effect of rhTNF-alpha on human sperm mitochondrial function and motility in vitro]","authors":"Bian J, Guo X, Xiong C, Li J, Tian Y, Ma H, Zhang Y, Nie Y, Yu L, Xiao L.","first_author":"Bian J","journal":"Zhonghua nan ke xue = National journal of andrology","year":2004,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"in vitro laboratory experiment with human sperm samples (n=40 donors) testing dose‑response to recombinant TNF‑alpha.","sample_n":40,"sample_text":"40 healthy men provided semen samples collected by masturbation; 56 samples analysed.","population":"healthy adult men donating semen by masturbation (40 donors, 56 samples).","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Adding recombinant TNF‑alpha to human sperm in the lab lowered their movement and reduced mitochondrial activity, with stronger effects at higher doses and longer exposure.","clinical_takeaway":"Elevated TNF‑alpha may impair sperm motility; relevance to male fertility needs clinical confirmation.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Validated laboratory techniques (CASA, flow cytometry)","Dose‑response and time‑course design","Clear quantitative outcomes"],"limitations":["In vitro findings may not translate to in vivo fertility","No effect‑size reporting or power analysis","Limited sample diversity (single centre, healthy volunteers)"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":5213,"doi":null,"pmid":"15181840","pmcid":null,"title":"[Behavioral features of men who have sex with men]","authors":"Lan YJ, Gu Y, Wang B, Zhou DL, Zhang JX.","first_author":"Lan YJ","journal":"Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition","year":2004,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Convenience and snowball sampling of MSM in two Chinese cities; self‑administered questionnaire; cross‑sectional behavioral surveillance.","sample_n":null,"sample_text":"Not reported in abstract; recruitment via venues and snowball methods.","population":"Men who have sex with men (MSM) in Chengdu and Nanchong, Sichuan, China (2003‑2004).","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2004 survey of men who have sex with men in two Chinese cities found high rates of multiple partners, inconsistent condom use, commercial sex, and some drug injecting, all of which increase HIV risk.","clinical_takeaway":"Clinicians should assess HIV risk behaviours in MSM, including partner number, condom consistency, and drug use.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large‑scale field survey of a hard‑to‑reach population","Provides concrete data on condom use and partner numbers","Relevant for HIV prevention planning"],"limitations":["Convenience/snowball sampling limits generalisability","Questionnaire not reported as validated","No adjustment for potential confounders (e.g., mental health, religiosity)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":5216,"doi":"10.1097/01.ju.0000119337.19471.51","pmid":"15076297","pmcid":null,"title":"Sexual behavior and sexual function of adults after hypospadias surgery: a comparative study","authors":"Bubanj TB, Perovic SV, Milicevic RM, Jovcic SB, Marjanovic ZO, Djordjevic MM.","first_author":"Bubanj TB","journal":"The Journal of urology","year":2004,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":52,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional questionnaire mailed to adult men who had hypospadias repair (n=37) and age‑matched controls (n=39).","sample_n":76,"sample_text":"37 patients and 39 controls who responded to mailed questionnaire","population":"Adult males post‑hypospadias surgery vs. healthy controls","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a mailed survey of men who had hypospadias repair, overall erection quality was similar to that of peers, but they reported less masturbation, fewer sexual partners and more curvature and ejaculation problems.","clinical_takeaway":"Men after hypospadias surgery generally have normal erections, but clinicians should address specific functional and behavioural issues in follow‑up.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Age‑matched control group","Direct assessment of multiple aspects of sexual function","Focus on long‑term outcomes after hypospadias surgery"],"limitations":["Small sample, low power","Questionnaire not identified as a validated sexual‑function instrument","No control for mental health, relationship or moral factors","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":37,"citing_publications":86,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.ju.0000119337.19471.51"}},{"id":5217,"doi":"10.1037//0022-006x.49.4.568","pmid":"6114968","pmcid":"PMC2719958","title":"A comparison of systematic desensitization and directed masturbation in the treatment of primary orgasmic dysfunction in females","authors":"Andersen BL.","first_author":"Andersen BL.","journal":"Journal of consulting and clinical psychology","year":1981,"pub_types":["Clinical Trial","Research Support, U.S. Gov't, P.H.S.","research-article","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0022-006x.49.4.568"}},{"id":5218,"doi":"10.1016/s0212-6567(04)78889-7","pmid":"15117632","pmcid":"PMC7669195","title":"[Sexual behaviour and use of condoms by adolescents in our environment]","authors":"Mesa Gallardo MI, Barella Balboa JL, Cobeña Manzorro M.","first_author":"Mesa Gallardo MI","journal":"Atencion primaria","year":2004,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Transversal descriptive study using an anonymous questionnaire with a simple random sample of 84 secondary‑school students.","sample_n":84,"sample_text":"Simple random sample of 84 students (4th year of ESO).","population":"Adolescents aged 15‑16 years, urban secondary‑school (Spain).","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 84 Spanish teens found that most were sexually active, many had masturbated, and condoms were used in about three‑quarters of penetrative encounters, indicating a risk for STDs and unwanted pregnancy.","clinical_takeaway":"Adolescent sexual health programs should emphasise consistent condom use.","confidence":0.8,"topic_tags":["adolescents","sexual_function","masturbation"],"strengths":["Random sampling within school","Clear descriptive statistics","Includes both genders"],"limitations":["Small, single‑school sample","No validated sexual‑behaviour instruments","No adjustment for potential confounders"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0212-6567(04)78889-7"}},{"id":5219,"doi":"10.1001/jama.291.13.1578","pmid":"15069045","pmcid":null,"title":"Ejaculation frequency and subsequent risk of prostate cancer","authors":"Leitzmann MF, Platz EA, Stampfer MJ, Willett WC, Giovannucci E.","first_author":"Leitzmann MF","journal":"JAMA","year":2004,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":59,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Prospective cohort with >29,000 participants followed for 8 years; incidence of prostate cancer as outcome.","sample_n":29342,"sample_text":"29,342 men in the Health Professionals Follow‑up Study","population":"US male health professionals, ages 46‑81 at baseline","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large U.S. cohort, men who reported more frequent ejaculations (including sex, nocturnal emissions, and masturbation) had a modestly lower risk of developing prostate cancer, especially when the high frequency occurred in middle age.","clinical_takeaway":"Higher ejaculation frequency may be associated with a modest reduction in prostate cancer risk, but findings are observational.","confidence":0.8,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Large prospective cohort with long follow‑up","Objective cancer outcomes verified via medical records","Adjusts for many known prostate cancer risk factors"],"limitations":["Retrospective self‑report of ejaculatory frequency, potential recall bias","No measurement of confounders specific to sexual behavior (e.g., moral incongruence)","Single‑item frequency measure, no validated sexual‑behavior scale"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":0,"mentioning":63,"citing_publications":133,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/jama.291.13.1578"}},{"id":5223,"doi":null,"pmid":"14977283","pmcid":null,"title":"Trends in the incidence, clinical presentation, and management of traumatic rupture of the corpus cavernosum","authors":"Ekwere PD, Al Rashid M.","first_author":"Ekwere PD","journal":"Journal of the National Medical Association","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective case series of 18 patients with penile fracture","sample_n":18,"sample_text":"19 episodes in 18 patients","population":"adult men presenting with traumatic rupture of the corpus cavernosum at a Saudi Arabian hospital","country":"Saudi Arabia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A hospital review of 18 men found that penile fractures are becoming more common, often caused by non‑coital activities like masturbation, and are associated with higher post‑operative complications.","clinical_takeaway":"Penile fracture can occur during masturbation; prompt surgical repair remains effective, but clinicians should monitor for postoperative hematoma and infection.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Clear description of clinical presentation and surgical management","Inclusion of non‑coital causes, highlighting masturbation as a factor"],"limitations":["Very small, single‑center case series","No control group or comparative data","No statistical testing beyond descriptive frequencies"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":5225,"doi":"10.1007/bf01542670","pmid":"7212993","pmcid":null,"title":"Sexual behavior of castrated sex offenders","authors":"Heim N.","first_author":"Heim N.","journal":"Archives of sexual behavior","year":1981,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective follow‑up of 39 surgically castrated offenders, no control group, self‑report of sexual behavior","sample_n":39,"sample_text":"39 released sex offenders who agreed voluntarily to surgical castration","population":"male sex offenders (n=39) who voluntarily underwent surgical castration while incarcerated in West Germany","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 39 German sex offenders who were surgically castrated, reported sexual activity, masturbation and sexual thoughts dropped sharply, but about a third still could have intercourse. The authors conclude castration is not a reliable way to stop offending.","clinical_takeaway":"Surgical castration markedly reduces sexual drive but does not eliminate it; it should not be presented as a guaranteed treatment for sexual offenses.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Rare data on surgical castration outcomes","Long‑term follow‑up of the same individuals"],"limitations":["Very small, non‑representative sample","No control or comparison group","Self‑report measures without validated scales","No adjustment for key confounders (moral, mental health, trauma, partner effects)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":85,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542670"}},{"id":5226,"doi":"10.1159/000079409","pmid":"15316239","pmcid":null,"title":"Effects of sexual arousal on lymphocyte subset circulation and cytokine production in man","authors":"Haake P, Krueger TH, Goebel MU, Heberling KM, Hartmann U, Schedlowski M.","first_author":"Haake P","journal":"Neuroimmunomodulation","year":2004,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"crossover laboratory experiment with within‑subject comparison of masturbation‑induced orgasm vs. control condition","sample_n":11,"sample_text":"11 volunteers (male, healthy, young adults)","population":"11 healthy young adult males","country":"Germany (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 11 healthy young men, orgasm from masturbation temporarily increased adrenaline, prolactin, and certain immune cells (natural killer cells), but did not change T‑cell, B‑cell numbers or inflammatory cytokine production.","clinical_takeaway":"Masturbation‑induced orgasm appears to boost innate immune cell circulation without altering inflammatory cytokine release; not directly relevant for clinical concerns about pornography or sexual addiction.","confidence":0.8,"topic_tags":["sexual_function","masturbation","neuroscience","csbd"],"strengths":["Within‑subject crossover design controls inter‑individual variability","Objective physiological and immunological measures","Clear protocol for sexual arousal manipulation"],"limitations":["Very small sample (N=11) limits power and generalisability","No correction for multiple immunological outcomes reported","Sample limited to young healthy males; no female or older participants"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000079409"}},{"id":5227,"doi":"10.1300/j155v08n03_08","pmid":"24821029","pmcid":null,"title":"Still the one","authors":"McCully S.","first_author":"McCully S.","journal":"Journal of lesbian studies","year":2004,"pub_types":["Journal Article"],"keywords":["Sex","Vibrators","Masturbation","Lesbian","Relationship Problems","Ex-lover","Lesbian Performance","Lesbian Relationship","Queer Performance"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary/essay describing a solo performance; no empirical data, no sample, no methods","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article describes Susan McCully’s solo performance \"Still the One,\" which humorously depicts jealousy and obsession in a lesbian relationship, contrasting an idealized ex with the current partner.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["relationships","sexual_function","masturbation"],"strengths":["Creative artistic exploration of lesbian relational dynamics","Highlights themes of jealousy and idealization"],"limitations":["No empirical data or systematic analysis","No methodological transparency","Findings not generalizable"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j155v08n03_08"}},{"id":5230,"doi":"10.1111/j.1464-410x.2004.04581.x","pmid":"14678395","pmcid":null,"title":"Sexual factors and prostate cancer","authors":"Brody S.","first_author":"Brody S.","journal":"BJU international","year":2004,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1464-410x.2004.04581.x"}},{"id":5231,"doi":"10.1080/00926238108403439","pmid":"7345148","pmcid":null,"title":"Retarded ejaculation as a function of non-aversive conditioning and discrimination: a hypothesis","authors":"Dow MG.","first_author":"Dow MG.","journal":"Journal of sex & marital therapy","year":1981,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"preliminary case series of nine patients with ejaculatory failure; no control group; observations used to generate hypothesis","sample_n":9,"sample_text":"nine patients","population":"adult middle‑aged men with retarded ejaculation (N≈9)","country":"null","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small observation of nine men with delayed ejaculation suggests that positive reinforcement during masturbation may contribute to the problem, challenging the usual focus on anxiety.","clinical_takeaway":"Consider assessing reinforcement patterns in masturbation when treating delayed ejaculation; evidence is preliminary.","confidence":0.7,"topic_tags":["sexual_function","masturbation","treatment"],"strengths":["addresses a neglected possible mechanism","clinical observations directly from affected patients","generates testable hypothesis for future work"],"limitations":["very small, non‑representative sample","no validated measures of reinforcement or ejaculation latency","no control/comparison group","confounding variables (e.g., anxiety, relationship factors) not assessed"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238108403439"}},{"id":5232,"doi":"10.1007/bf01542159","pmid":"7458662","pmcid":null,"title":"Men's erotic fantasies","authors":"Crépault C, Couture M.","first_author":"Crépault C","journal":"Archives of sexual behavior","year":1980,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional interview study of 94 married men","sample_n":94,"sample_text":"94 men interviewed; likely convenience sample","population":"adult heterosexual men (average cohabitation 6.5 years)","country":"unspecified (likely France based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 94 married men, researchers found that erotic fantasies are common and linked to traits such as active sexual roles, control over ejaculation, and certain sexual preferences. Men with more fantasies during intercourse also reported more fantasies outside sex and varied sexual experiences.","clinical_takeaway":"Erotic fantasies are normal and varied; clinicians should avoid pathologising them without clear distress or dysfunction.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["large (for 1980) sample of men","direct interview provides rich descriptive data","covers a range of fantasy themes"],"limitations":["No validated measures of fantasy frequency or content","Cross‑sectional convenience sample, limited generalisability","No control for moral, psychological or relationship confounds","Statistical analysis not reported (no effect sizes, CIs)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":64,"citing_publications":230,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542159"}},{"id":5233,"doi":"10.1007/bf01542155","pmid":"7458658","pmcid":null,"title":"The male orgasm: pelvic contractions measured by anal probe","authors":"Bohlen JG, Held JP, Sanderson MO.","first_author":"Bohlen JG","journal":"Archives of sexual behavior","year":1980,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"within‑subject laboratory measurement of pelvic muscle activity during three masturbatory orgasms per participant (N=11 young adult men)","sample_n":11,"sample_text":"eleven young adult male subjects","population":"young adult male volunteers, likely convenience sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers recorded pelvic muscle pressure via an anal probe while 11 men masturbated to orgasm on three occasions. They identified a consistent series of rapid contractions that marked orgasm, showing individual patterns that were reproducible across sessions.","clinical_takeaway":"Male orgasm involves a stereotyped pattern of pelvic muscle contractions; this physiological profile may inform clinical discussions of orgasmic function.","confidence":0.8,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["Objective physiological measurement of orgasmic contractions","Repeated sessions per participant allow intra‑individual reliability assessment","Clear description of contraction patterns"],"limitations":["Very small, non‑representative sample (N=11)","No statistical testing beyond descriptive summaries","Findings limited to young adult men, not generalizable"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":35,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542155"}},{"id":5234,"doi":"10.1100/tsw.2003.115","pmid":"14755109","pmcid":"PMC5974901","title":"The life mission theory III. Theory of talent","authors":"Ventegodt S, Andersen NJ, Merrick J.","first_author":"Ventegodt S","journal":"TheScientificWorldJournal","year":2003,"pub_types":["research-article","Multicenter Study","Journal Article","Case Reports"],"keywords":[],"is_oa":true,"oa_url":"http://downloads.hindawi.com/journals/tswj/2003/460169.pdf","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"The article presents a philosophical theory without empirical data, sample size, or methods.","sample_n":null,"sample_text":"Not applicable – no participants reported.","population":"Humans (general)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper proposes a philosophical \"life mission\" theory, suggesting that fully expressing one's core talent—including sexual aspects—leads to happiness and self‑actualisation.","clinical_takeaway":"None – the article is theoretical and does not provide actionable clinical guidance.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Offers a novel integrative theoretical perspective","Touches on sexuality within a broader human development model"],"limitations":["No empirical data or methodological description","Constructs not operationalised or measured","Cannot be evaluated for scientific rigor"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":2,"contrasting":0,"mentioning":103,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1100/tsw.2003.115"}},{"id":5235,"doi":"10.1080/cmt.6.4.321.329","pmid":"15006253","pmcid":null,"title":"Sexuality in healthy postmenopausal women","authors":"Penteado SR, Fonseca AM, Bagnoli VR, Assis JS, Pinotti JA.","first_author":"Penteado SR","journal":"Climacteric : the journal of the International Menopause Society","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Logistic regression on a convenience subsample (n=60) of healthy postmenopausal women selected from a larger pool.","sample_n":60,"sample_text":"Sixty healthy women with ≥1 year amenorrhea, without hormone replacement therapy and with a partner capable of intercourse were chosen from an initial pool of 999.","population":"Healthy postmenopausal women, age 41‑60, with a partner and no HRT.","country":"Brazil (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 60 healthy postmenopausal women, factors such as self‑esteem, having first orgasmed through masturbation, higher income, adult sexual initiation, and physical contact with a partner were linked to greater sexual satisfaction and ability to reach orgasm.","clinical_takeaway":"Clinicians should consider psychological, relational, and hormonal factors when addressing sexual satisfaction in postmenopausal patients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large initial recruitment pool (n=999)","Consideration of multiple psychosocial and hormonal factors","Use of logistic regression to identify independent predictors"],"limitations":["Small final analytic sample (n=60) limits power","Unclear whether questionnaires are validated instruments","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":12,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/cmt.6.4.321.329"}},{"id":5236,"doi":"10.1677/joe.0.1790357","pmid":"14656205","pmcid":null,"title":"Effects of acute prolactin manipulation on sexual drive and function in males","authors":"Krüger TH, Haake P, Haverkamp J, Krämer M, Exton MS, Saller B, Leygraf N, Hartmann U, Schedlowski M.","first_author":"Krüger TH","journal":"The Journal of endocrinology","year":2003,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":69,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"single‑blind, placebo‑controlled, balanced cross‑over; n=10 healthy male volunteers; pharmacological manipulation of prolactin; erotic film + masturbation; psychometric outcomes","sample_n":10,"sample_text":"Ten healthy males","population":"healthy adult males (n=10)","country":"Germany (likely)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In ten healthy men, lowering prolactin with cabergoline boosted sexual desire, arousal and orgasm during an erotic film, while raising prolactin slightly reduced them. The study suggests acute prolactin changes can influence male sexual drive.","clinical_takeaway":"Acute prolactin reduction may enhance sexual function, but evidence is limited to a tiny experimental sample.","confidence":0.4,"topic_tags":[],"strengths":["Within‑subject crossover design controls inter‑individual variability","Objective hormonal manipulation confirmed by plasma levels","Comprehensive physiological monitoring"],"limitations":["Very small sample (n=10) limits statistical power","Psychometric instruments not described; uncertain validation","No control for potential confounds (mood, relationship status, etc.)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":3,"contrasting":0,"mentioning":59,"citing_publications":133,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1677/joe.0.1790357"}},{"id":5237,"doi":"10.1023/a:1026089511526","pmid":"14574098","pmcid":null,"title":"Sexual media use by young adults in Hong Kong: prevalence and associated factors","authors":"Janghorbani M, Lam TH, Youth Sexuality Study Task Force.","first_author":"Janghorbani M","journal":"Archives of sexual behavior","year":2003,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"population-based cross‑sectional survey of 964 Hong Kong young adults (18‑27 y)","sample_n":964,"sample_text":"517 men, 447 women aged 18‑27 y; anonymous self‑administered questionnaire","population":"Chinese young adults in Hong Kong, community sample","country":"Hong Kong","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a representative survey of 964 Hong Kong young adults, 58% had ever bought or rented sexual media. Use was higher in men, older participants, those with more sexual partners, recent masturbators, those out of school, experiencing family quarrels, and those without a Christian religious affiliation.","clinical_takeaway":"Sexual media use is common among Hong Kong youth and linked to several demographic and relational factors; clinicians should consider broader psychosocial context rather than assuming pathology.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation","prevalence"],"strengths":["Large, population‑based sample","Clear prevalence estimates with confidence intervals","Multivariable logistic regression identifies independent predictors"],"limitations":["Self‑report, single‑item measures of media use and masturbation","No validated scales for sexual media use or related constructs","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":0,"mentioning":13,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1026089511526"}},{"id":5238,"doi":null,"pmid":"7015194","pmcid":null,"title":"Masturbation; historic perspective","authors":"Greydanus DE, Geller B.","first_author":"Greydanus DE","journal":"New York state journal of medicine","year":1980,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5240,"doi":null,"pmid":"14723125","pmcid":null,"title":"[Report on a methemoglobin-associated fatality]","authors":"Bungardt N, Pötsch L.","first_author":"Bungardt N","journal":"Archiv fur Kriminologie","year":2003,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case_report","sample_n":1,"sample_text":"single deceased individual","population":"adult male (autoerotic fatality)","country":"unspecified (likely Germany)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A man died during an autoerotic activity involving neck compression and inhaling poppers, which likely caused methemoglobinemia and sudden loss of consciousness leading to hanging.","clinical_takeaway":"Autoerotic practices using volatile nitrites can be fatal; clinicians should counsel patients on risks of breath‑control games.","confidence":0.9,"topic_tags":["sexual_function","masturbation"],"strengths":["Detailed forensic description of rare fatal autoerotic incident","Identification of chemical (nitrites) involvement"],"limitations":["Single case, no generalizable data","No systematic measurement of sexual behavior or psychological factors","No statistical analysis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5242,"doi":"10.1046/j.1464-410x.2003.04490.x","pmid":"14616462","pmcid":null,"title":"Preputial infibulation: from ancient medicine to modern genital piercing","authors":"Schultheiss D, Mattelaer JJ, Hodges FM, Historical Committee of the European Association of Urology.","first_author":"Schultheiss D","journal":"BJU international","year":2003,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1046/j.1464-410x.2003.04490.x"}},{"id":5243,"doi":"10.1111/j.1365-2265.1980.tb01041.x","pmid":"6777092","pmcid":null,"title":"The effect of cyproterone acetate on serum testosterone, LH, FSH, and prolactin in male sexual offenders","authors":"Jeffcoate WJ, Matthews RW, Edwards CR, Field LH, Besser GM.","first_author":"Jeffcoate WJ","journal":"Clinical endocrinology","year":1980,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"pre‑post administration of cyproterone acetate to eight male sexual offenders; hormonal assays and self‑reported libido/masturbation frequency measured over 3‑4 weeks","sample_n":8,"sample_text":"Eight adult male sexual offenders","population":"Adult male sexual offenders (N=8)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"supports","citation_value":"background","plain_summary":"Eight male sexual offenders took cyproterone acetate for about a month; their testosterone, LH and FSH fell, prolactin rose, and they reported less sexual desire and masturbated less.","clinical_takeaway":"Cyproterone acetate markedly suppresses male hormones and reduces libido, but evidence is limited to a tiny uncontrolled study.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["objective hormonal assays","within‑subject design shows clear physiological effect","clear reporting of dosage and duration"],"limitations":["very small sample (N=8)","no control group","behavioural outcomes based on crude self‑report","no adjustment for potential confounds such as mental health or moral attitudes"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2265.1980.tb01041.x"}},{"id":5244,"doi":"10.1007/bf01541356","pmid":"7416944","pmcid":null,"title":"Intergenerational change in sex behavior: a belated look at Kinsey's males","authors":"Downey L.","first_author":"Downey L.","journal":"Archives of sexual behavior","year":1980,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"secondary analysis of Kinsey male data across five birth cohorts; descriptive comparison of frequencies of various sexual activities","sample_n":null,"sample_text":"five generations of male respondents from Kinsey surveys; exact N not provided in abstract","population":"unmarried and married male respondents from Kinsey reports (historical, non‑probability sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study revisits Kinsey’s male data, comparing men born from the 19th to the 20th century. It finds that later‑born unmarried men reported more overall sexual activity, especially masturbation, while some other activities (e.g., nocturnal emissions) declined. Married men’s activity levels stayed stable across generations.","clinical_takeaway":"None – the historical descriptive findings do not directly inform clinical practice.","confidence":0.4,"topic_tags":["sexual_function","masturbation"],"strengths":["Large historic dataset spanning multiple generations","Detailed categorical breakdown of sexual behaviors"],"limitations":["Relies on self‑report without validated scales","No control for key confounds (morality, mental health, partner status)","Descriptive analysis lacking effect sizes or power justification"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541356"}},{"id":5245,"doi":"10.1080/00926230390224747","pmid":"14504008","pmcid":null,"title":"Vaginal intercourse frequency and heart rate variability","authors":"Brody S, Preut R.","first_author":"Brody S","journal":"Journal of sex & marital therapy","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":48,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional observational study with diary and physiological measures; N=120 healthy adults","sample_n":120,"sample_text":"120 healthy adults (19‑38 years)","population":"healthy adults aged 19‑38, community sample, excluded high lie‑scale respondents","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 120 healthy adults, more frequent vaginal intercourse was linked to higher resting heart‑rate variability, a marker of good cardiac autonomic health, even after accounting for personality, mood and relationship satisfaction.","clinical_takeaway":"Higher intercourse frequency may be associated with better autonomic cardiac health, but causal direction is unclear.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Physiological outcome (HRV) measured with validated method","Diary and recall measures of intercourse frequency","Controls for several personality and mental‑health variables"],"limitations":["Cross‑sectional design cannot infer causality","Sample size modest for detecting small effects","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":12,"contrasting":0,"mentioning":72,"citing_publications":79,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230390224747"}},{"id":5246,"doi":"10.1177/107906320301500407","pmid":"14571536","pmcid":null,"title":"Hypersexual desire in males: are males with paraphilias different from males with paraphilia-related disorders?","authors":"Kafka MP, Hennen J.","first_author":"Kafka MP","journal":"Sexual abuse : a journal of research and treatment","year":2003,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":60,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional survey of 120 consecutively evaluated male patients with paraphilias or paraphilia‑related disorders; self‑report questionnaires on sexual behavior and hypersexual desire.","sample_n":120,"sample_text":"120 consecutively evaluated male patients","population":"Males with paraphilias (n=88) and paraphilia‑related disorders (n=32), clinical/treatment‑seeking sample.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared 120 men with paraphilic disorders and related conditions, finding similar levels of hypersexual behavior (average about 12 sexual acts per week). A subgroup with many lifetime paraphilic acts showed the highest sexual activity and preoccupation, but the findings apply only to clinical samples.","clinical_takeaway":"Hypersexual desire can be quantified in clinical settings, yet its prevalence in the general population remains unknown; clinicians should assess it alongside broader mental‑health and relational factors.","confidence":0.75,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large (n≈120) clinical sample for a relatively rare population","Clear quantitative description of sexual behavior (TSO, preoccupation)","Direct comparison of paraphilia vs paraphilia‑related disorders"],"limitations":["Reliance on unvalidated self‑report measures of hypersexual desire","No assessment of key confounds (moral incongruence, mental health, partner factors)","Cross‑sectional design limits causal inference; generalisability to community unclear"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":50,"citing_publications":125,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/107906320301500407"}},{"id":5247,"doi":"10.1016/s0379-0738(03)00275-5","pmid":"14550612","pmcid":null,"title":"Accidental autoerotic deaths between 1978 and 1997. Institute of Legal Medicine, Medical School Hannover","authors":"Breitmeier D, Mansouri F, Albrecht K, Böhm U, Tröger HD, Kleemann WJ.","first_author":"Breitmeier D","journal":"Forensic science international","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Retrospective case series of 17 fatal autoerotic deaths investigated by forensic pathology; no control group, descriptive statistics only.","sample_n":17,"sample_text":"17 men, mean age 36.8 years","population":"Male victims of accidental autoerotic deaths in Hannover region (1978‑1997), N=17","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed 17 accidental deaths that occurred during solo sexual activities in Germany between 1978 and 1997, describing the victims, settings, objects used, substances present, and causes of death to help forensic investigators recognize such cases.","clinical_takeaway":"None – the study describes rare fatal accidents, not applicable to clinical practice.","confidence":0.6,"topic_tags":["masturbation","sexual_function","religiosity"],"strengths":["Detailed forensic descriptions of rare phenomenon","Systematic case collection over 20‑year period","Provides incidence estimate for region"],"limitations":["Small, non‑representative case series","No comparison group or statistical testing","No measurement of psychological or contextual confounds"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0379-0738(03)00275-5"}},{"id":5248,"doi":"10.1177/107906320301500406","pmid":"14571535","pmcid":null,"title":"Considerations on fantasy use by child molesters and exhibitionists","authors":"Dandescu A, Wolfe R.","first_author":"Dandescu A","journal":"Sexual abuse : a journal of research and treatment","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 57 child molesters and 25 exhibitionists recruited from treatment programs; analysis of self‑reported deviant masturbatory fantasies before and after first offense.","sample_n":82,"sample_text":"57 child molesters; 25 exhibitionistic offenders","population":"Adult male sexual offenders (child molesters, exhibitionists) in treatment settings","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed child molesters and exhibitionists about their use of deviant masturbatory fantasies before and after their first offense, finding most used such fantasies both times and more after offending.","clinical_takeaway":"Offender treatment may consider addressing fantasy content, but evidence is limited and based on small, self‑report data.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Focus on a rarely studied aspect of sexual offending (fantasy use).","Direct comparison of pre‑ and post‑offense fantasy frequency."],"limitations":["Small, non‑representative offender sample.","Uses ad‑hoc, unvalidated self‑report measures.","No control for mental‑health or trauma variables."],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/107906320301500406"}},{"id":5249,"doi":"10.1093/humrep/deg416","pmid":"14507828","pmcid":null,"title":"Lack of effect of a single i.v. dose of oxytocin on sperm output in severely oligozoospermic men","authors":"Byrne MM, Rolf C, Depenbusch M, Cooper TG, Nieschlag E.","first_author":"Byrne MM","journal":"Human reproduction (Oxford, England)","year":2003,"pub_types":["Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized single‑blind crossover trial, N=49 men with severe oligozoospermia, each received oxytocin and placebo on separate visits","sample_n":49,"sample_text":"Forty‑nine infertile men","population":"infertile men with sperm concentration <0.2 × 10⁶ ml⁻¹","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 49 men with very low sperm counts, a single intravenous dose of oxytocin did not change ejaculate volume, total sperm number, or sperm motility compared with placebo.","clinical_takeaway":"Oxytocin is not effective for rapidly improving sperm output in severely oligozoospermic men.","confidence":0.8,"topic_tags":["sexual_function","religiosity","moral_incongruence"],"strengths":["Validated WHO sperm analysis methods","Crossover design reduces between‑subject variability","Clear primary outcome with statistical testing"],"limitations":["No effect sizes or confidence intervals reported","No pre‑registration or power calculation disclosed","Sample size modest for detecting small effects"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/humrep/deg416"}},{"id":5250,"doi":"10.1111/j.1365-2923.1980.tb02270.x","pmid":"7412629","pmcid":null,"title":"Attitude change in a human sexuality course that de-emphasizes small group activities","authors":"Thomas JL, Scott LK, Brooks CM.","first_author":"Thomas JL","journal":"Medical education","year":1980,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"single-group pre‑post attitude survey of second‑year medical students","sample_n":null,"sample_text":"Second‑year medical students (size not reported)","population":"medical students (second‑year), United States, likely convenience sample","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1980 study measured medical students' attitudes before and after a sexuality course that reduced small‑group work, finding statistically significant positive shifts toward sexuality, masturbation, homosexuality, and understanding sexual problems.","clinical_takeaway":"None – the study reports attitude changes in students, not clinical outcomes.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Pre‑post design allows detection of attitude change","Focus on multiple sexuality topics"],"limitations":["No validated attitude instrument reported","No effect sizes or confidence intervals","Potentially small, non‑representative sample"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2923.1980.tb02270.x"}},{"id":5252,"doi":"10.1212/01.wnl.0000083988.98336.a3","pmid":"14504323","pmcid":null,"title":"Headache associated with sexual activity: demography, clinical features, and comorbidity","authors":"Frese A, Eikermann A, Frese K, Schwaag S, Husstedt IW, Evers S.","first_author":"Frese A","journal":"Neurology","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":73,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case series of 51 patients with headache associated with sexual activity, assessed via structured interview","sample_n":51,"sample_text":"51 patients","population":"Adults (both sexes) diagnosed with HSA, recruited from clinical settings between 1996‑2001","country":"Germany (presumed from author affiliations, not specified in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 51 adults with headaches triggered by sexual activity, researchers found most were men, average onset was around 39 years, and headaches often occurred during intercourse or masturbation. Two age peaks (early 20s and mid‑30s to 40s) were observed, and many also suffered from other headache types.","clinical_takeaway":"Headache linked to sexual activity is common in middle‑aged men and often co‑occurs with other primary headaches; clinicians should consider this when evaluating sexual‑related pain.","confidence":0.4,"topic_tags":["sexual_function","neuroscience"],"strengths":["Clear description of demographic and clinical features","Use of structured interview","Identification of two age‑onset peaks"],"limitations":["Small, clinic‑based convenience sample","No control or comparison group","Limited statistical analysis; no effect sizes or correction"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":2,"mentioning":156,"citing_publications":143,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1212/01.wnl.0000083988.98336.a3"}},{"id":5255,"doi":"10.1007/bf01542260","pmid":"7396689","pmcid":null,"title":"Thermographic measurement of sexual arousal: a methodological note","authors":"Seeley TT, Abramson PR, Perry LB, Rothblatt AB, Seeley DM.","first_author":"Seeley TT","journal":"Archives of sexual behavior","year":1980,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"methodological note describing thermographic recordings of sexual arousal in a single male and a single female during masturbation to orgasm; no systematic sample, no control group.","sample_n":2,"sample_text":"Two individuals; not representative.","population":"2 participants (1 male, 1 female) engaging in masturbation; convenience sample.","country":"USA (presumed based on journal, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The paper shows how infrared cameras can track body temperature changes during a man’s and a woman’s masturbation, illustrating the four stages of sexual arousal. It is a preliminary, single‑case description meant to guide future research.","clinical_takeaway":"No direct clinical guidance; thermography is an exploratory tool requiring validation before use in practice.","confidence":0.9,"topic_tags":["sexual_function","measurement","masturbation"],"strengths":["Innovative use of thermography for real‑time arousal monitoring","Clear description of methodological protocol"],"limitations":["Extremely small, non‑representative sample (n=2)","No validation of thermographic measures against established arousal indices","No control for confounding variables (e.g., mood, hormonal status)","Interpretive claims exceed data"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":32,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542260"}},{"id":5256,"doi":"10.1080/00224490309552191","pmid":"14533021","pmcid":null,"title":"Sexual functioning and practices in a multi-ethnic study of midlife women: baseline results from SWAN","authors":"Cain VS, Johannes CB, Avis NE, Mohr B, Schocken M, Skurnick J, Ory M.","first_author":"Cain VS","journal":"Journal of sex research","year":2003,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":156,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Baseline data from the longitudinal SWAN cohort (N=3,262 midlife women); cross‑sectional analysis of sexual practices and function by ethnicity and menopausal status using multivariate proportional odds regression.","sample_n":3262,"sample_text":"Large community cohort; not a clinical or treatment‑seeking sample.","population":"Midlife women (42‑52 y), premenopausal or early perimenopausal, diverse ethnicities (African American, Caucasian, Chinese, Hispanic, Japanese) in the United States.","country":"United States (multicenter SWAN study)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large U.S. cohort of women aged 42‑52, most had sex with a partner in the past six months. Importance of sex, frequency of sexual practices and pain during intercourse varied by ethnicity and menopausal status, with Japanese and Chinese women rating sex as less important and African‑American women rating it as more important.","clinical_takeaway":"Sexual importance and practice patterns differ by ethnicity and menopausal stage; clinicians should consider these factors when counseling midlife women.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Large, ethnically diverse sample","Standardized multivariate regression approach","Focus on understudied midlife women population"],"limitations":["Cross‑sectional; no causal inference","Limited information on psychometric validation of measures","Key confounds (mental health, relationship context, moral factors) not assessed"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":15,"contrasting":1,"mentioning":166,"citing_publications":260,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490309552191"}},{"id":5257,"doi":"10.1016/s0029-7844(03)00571-4","pmid":"12907108","pmcid":null,"title":"Sexual activities and attitudes of women with vulvar dysesthesia","authors":"Reed BD, Advincula AP, Fonde KR, Gorenflo DW, Haefner HK.","first_author":"Reed BD","journal":"Obstetrics and gynecology","year":2003,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional case‑control with 63 patients and 62 matched controls","sample_n":125,"sample_text":"63 women with vulvar dysesthesia and 62 controls","population":"women 18‑60 with vulvar dysesthesia vs. matched controls","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Women with vulvar dysesthesia reported fewer recent sexual encounters and orgasms, and lower sexual interest, compared with matched women without the condition, though most other sexual behaviours were similar.","clinical_takeaway":"Vulvar dysesthesia may be associated with reduced sexual activity and satisfaction; clinicians should address sexual health and self‑concept in treatment.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Matched control group","Physical examination confirmed diagnoses","Multivariable analysis controlling for key demographics"],"limitations":["Self‑report questionnaire not validated","No assessment of mental‑health or moral factors","Limited statistical reporting (no effect sizes, multiple‑comparison correction)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0029-7844(03)00571-4"}},{"id":5258,"doi":null,"pmid":"7385670","pmcid":null,"title":"[Clinical manifestations and the treatment of masturbation in infants and preschool children]","authors":"Mikirtumov BE.","first_author":"Mikirtumov BE.","journal":"Voprosy okhrany materinstva i detstva","year":1980,"pub_types":["Comparative Study","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"rus","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5259,"doi":null,"pmid":"7366770","pmcid":null,"title":"[Re-evaluation of masturbation]","authors":"Levie LH.","first_author":"Levie LH.","journal":"Nederlands tijdschrift voor geneeskunde","year":1980,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"dut","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5260,"doi":null,"pmid":"7429734","pmcid":null,"title":"The psychodynamics of a beating fantasy","authors":"Myers WA.","first_author":"Myers WA.","journal":"International journal of psychoanalytic psychotherapy","year":1980,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single clinical case history, longitudinal narrative without controls","sample_n":1,"sample_text":"single case","population":"1 adult female patient (psychoanalytic therapy)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A psychoanalytic case report describes a woman whose lifelong masturbatory fantasy involved being beaten by her father, which the therapist linked to early trauma, mother‑related fantasies, and compulsive masturbation as a defensive strategy.","clinical_takeaway":"This single case offers no evidence for treatment; clinicians should not base practice on it.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["In‑depth clinical description","Historical psychoanalytic perspective"],"limitations":["Single case, no empirical measurement","No validated instruments or controls","Findings not generalizable"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5261,"doi":"10.1177/000306518002800308","pmid":"6106657","pmcid":null,"title":"Adult masturbation: clinical perspectives","authors":null,"first_author":null,"journal":"Journal of the American Psychoanalytic Association","year":1980,"pub_types":["Conference Proceedings"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000306518002800308"}},{"id":5262,"doi":"10.1017/s104161020300886x","pmid":"14620076","pmcid":null,"title":"Low-dose cyproterone acetate treatment of sexual acting out in men with dementia","authors":"Haussermann P, Goecker D, Beier K, Schroeder S.","first_author":"Haussermann P","journal":"International psychogeriatrics","year":2003,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Two male patients with vascular dementia or Parkinson‑related dementia received low‑dose cyproterone acetate after failure of neuroleptics; sexual acting‑out decreased.","sample_n":2,"sample_text":"Two clinical cases","population":"Men with dementia (N=2)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In two men with dementia who showed problematic sexual behaviour, low‑dose cyproterone acetate reduced the unwanted actions without notable side effects.","clinical_takeaway":"Cyproterone acetate may help control sexual disinhibition in dementia, but evidence is limited to single cases.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","treatment"],"strengths":["Addresses a clinically relevant problem","Provides detailed clinical observation of treatment response"],"limitations":["Only two cases; no control group","No validated outcome measures","Potential confounding from concurrent medications or disease progression"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s104161020300886x"}},{"id":5263,"doi":"10.1023/a:1023413617648","pmid":"12807296","pmcid":null,"title":"Selecting films for sex research: gender differences in erotic film preference","authors":"Janssen E, Carpenter D, Graham CA.","first_author":"Janssen E","journal":"Archives of sexual behavior","year":2003,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":115,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory experiment where 15 men and 17 women viewed 20 erotic film clips (male‑selected vs female‑selected) and rated arousal and other dimensions.","sample_n":32,"sample_text":"15 men, 17 women","population":"Young adult volunteers (mean age ~25), convenience sample, likely university‑based.","country":"Not specified (likely USA/Europe based on authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Men and women watched short erotic movies that were chosen because they were thought to appeal to each gender. Men rated all clips as more arousing than women, but both sexes were most aroused by movies chosen for their own gender. How the movies are selected changes reported arousal levels.","clinical_takeaway":"When using erotic films in research or therapy, select clips that match participants’ gender to obtain more reliable arousal responses.","confidence":0.73,"topic_tags":["sexual_function"],"strengths":["Within‑subject experimental manipulation of stimulus selection","Clear gender‑specific analysis","Use of cluster regression to explain variance"],"limitations":["Very small, non‑representative sample","Arousal measured with non‑validated single‑item scales","No control for potential confounds (mood, sexual experience, etc.)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":41,"citing_publications":177,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1023413617648"}},{"id":5266,"doi":"10.1016/s1525-5050(03)00085-4","pmid":"12791328","pmcid":null,"title":"Sexual outcome after epilepsy surgery","authors":"Baird AD, Wilson SJ, Bladin PF, Saling MM, Reutens DC.","first_author":"Baird AD","journal":"Epilepsy & behavior : E&B","year":2003,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":48,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 74 epilepsy surgery patients (58 temporal‑lobe, 16 extra‑temporal) using semistructured interview/questionnaire; no control group, convenience sample.","sample_n":74,"sample_text":"58 temporal‑lobe resections, 16 extra‑temporal resections","population":"Adults (adolescent‑adult) who underwent epilepsy surgery; mixed gender.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Patients who had temporal‑lobe epilepsy surgery reported more frequent changes in sexual drive, fantasies, and activity than those with extra‑temporal surgery, especially after right‑side operations and in women.","clinical_takeaway":"Clinicians should discuss possible sexual side‑effects with patients undergoing temporal‑lobe resections.","confidence":0.6,"topic_tags":["sexual_function","neuroscience"],"strengths":["Focus on a rarely studied outcome (sexual change after epilepsy surgery)","Includes both temporal‑lobe and extra‑temporal groups","Considers sex differences and laterality"],"limitations":["Small, unbalanced sample (58 vs 16) limits statistical power","Use of non‑validated interview/questionnaire","No control for potential confounds (e.g., mood, medication, relationship status)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":45,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1525-5050(03)00085-4"}},{"id":5268,"doi":"10.1023/a:1023752225535","pmid":"12816341","pmcid":null,"title":"Perceptions of sexuality as related to sexual functioning and sexual risk in women with different types of childhood abuse histories","authors":"Schloredt KA, Heiman JR.","first_author":"Schloredt KA","journal":"Journal of traumatic stress","year":2003,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":53,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Community sample of 148 women grouped by childhood abuse history; between‑group comparisons of self‑reported sexual functioning and perceptions.","sample_n":148,"sample_text":"148 women with differing childhood abuse histories (26 CSA only, 44 CSA+CPA, 78 none).","population":"Women (N=148) from the community, ages not specified; grouped by abuse history (CSA only, CSA+CPA, none).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Women with childhood sexual or physical abuse report more negative feelings during arousal and have had more sexual partners, but their basic sexual functioning (desire, arousal, pain, masturbation) is similar to non‑abused women.","clinical_takeaway":"Abuse history relates to negative sexual self‑perceptions and higher risk behaviour, not necessarily to functional deficits.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses a community sample with multiple abuse categories.","Controls for depression and anxiety.","Measures both sexual functioning and affective perceptions."],"limitations":["Cross‑sectional design limits causal inference.","Unclear whether sexual functioning scales are validated.","No control for moral or relational variables."],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":42,"citing_publications":78,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1023752225535"}},{"id":5270,"doi":"10.1037//0022-006x.47.5.912","pmid":"574521","pmcid":null,"title":"Self-administered masturbation training in the treatment of primary orgasmic dysfunction","authors":"McMullen S, Rosen RC.","first_author":"McMullen S","journal":"Journal of consulting and clinical psychology","year":1979,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0022-006x.47.5.912"}},{"id":5272,"doi":"10.1590/s1020-49892003000400006","pmid":"12831435","pmcid":null,"title":"Male sex workers in Córdoba, Argentina: sociodemographic characteristics and sex work experiences","authors":"Mariño R, Minichiello V, Disogra C.","first_author":"Mariño R","journal":"Revista panamericana de salud publica = Pan American journal of public health","year":2003,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Convenience survey of 31 male sex workers in Córdoba, Argentina; descriptive comparisons between street‑based and independent workers.","sample_n":31,"sample_text":"31 male sex workers (30 answered identity question).","population":"Male sex workers (n=31) in Córdoba, Argentina; recruited via outreach, not a random or probability sample.","country":"Argentina","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 31 male sex workers in Córdoba, Argentina, describing who they are, how they work, and their health practices. Street workers tended to be younger and less educated, while independent workers were older, steadier financially, and less likely to use substances.","clinical_takeaway":"Programs to promote safer sex should be tailored to street‑based and independent male sex workers separately.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Provides rare data on Argentine male sex workers","Compares street vs. independent sub‑groups","Includes health‑service utilization information"],"limitations":["Very small, non‑representative sample (n=31)","Measures appear ad‑hoc, limited validation","No control for key confounds (e.g., mental health, substance use)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":21,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s1020-49892003000400006"}},{"id":5274,"doi":"10.1007/bf01541197","pmid":"496622","pmcid":null,"title":"Models of female orgasm","authors":"Bentler PM, Peeler WH.","first_author":"Bentler PM","journal":"Archives of sexual behavior","year":1979,"pub_types":["Comparative Study","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 281 female university undergraduates; exploratory and confirmatory factor analyses; path‑analytic model; self‑report questionnaires.","sample_n":281,"sample_text":"female university undergraduates","population":"Female undergraduate students (USA)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1979 study of 281 female college students used questionnaires to show that women’s orgasm experiences split into separate coital and masturbatory factors, which relate to personality and attitudes toward masturbation.","clinical_takeaway":"Therapists should consider that coital and masturbatory orgasm experiences may differ and relate to personality and attitudes, rather than treating orgasm as a single uniform response.","confidence":0.8,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Large (N≈280) community sample for 1979 standards","Rigorous factor‑analytic approach","Development of internally consistent scales"],"limitations":["Convenience sample of young students limits generalisability","No measurement of moral/religious attitudes that could confound attitudes toward masturbation","Cross‑sectional design; mediation language may overstate causality"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":1,"mentioning":26,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541197"}},{"id":5275,"doi":null,"pmid":"257334","pmcid":null,"title":"Early childhood masturbation: a developmental approach","authors":"Gallo AM.","first_author":"Gallo AM.","journal":"Pediatric nursing","year":1979,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5276,"doi":null,"pmid":"114763","pmcid":null,"title":"[Adolescent crises in puberty. Diagnosis and therapy (author's transl)]","authors":"Müller-Küppers M.","first_author":"Müller-Küppers M.","journal":"MMW, Munchener medizinische Wochenschrift","year":1979,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"no empirical data; narrative discussion of adolescent sexual behavior, no sample, no methods","sample_n":null,"sample_text":"none reported","population":"adolescents (general discussion, no specific sample)","country":"Germany (journal MMW)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews psychological problems that can appear during puberty, discussing factors like early or delayed development, masturbation, same‑sex relations, and changing sexual relationships, but provides no new data.","clinical_takeaway":"None - not clinically applicable.","confidence":0.7,"topic_tags":["adolescents","masturbation","sexual_function"],"strengths":["Broad overview of pubertal sexual issues","Historical perspective"],"limitations":["No empirical data or systematic methods","Lacks operational definitions and measurement","No control of key confounds"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":5277,"doi":"10.1016/s0015-0282(02)04921-x","pmid":"12749429","pmcid":null,"title":"Sexual dysfunction in men undergoing infertility evaluation: a cohort observational study","authors":"Saleh RA, Ranga GM, Raina R, Nelson DR, Agarwal A.","first_author":"Saleh RA","journal":"Fertility and sterility","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"cohort observational study with baseline and follow‑up assessments of 412 men undergoing infertility evaluation; no control group; follow‑up of sexual function after semen collection attempts","sample_n":412,"sample_text":"Four hundred twelve men undergoing infertility evaluation; 46 men failed second semen collection and were analysed for psychogenic dysfunction","population":"men seeking infertility evaluation at a single diagnostic centre (1999‑2001); age not specified","country":"USA (assumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Men being tested for infertility often have to masturbate to provide a semen sample. In this study, a small proportion (11%) could not provide a second sample and reported erection, orgasm and anxiety problems, suggesting that the stress of infertility evaluation can cause temporary sexual dysfunction.","clinical_takeaway":"Infertility evaluation can provoke anxiety‑related sexual problems; clinicians should screen for and address these issues during treatment.","confidence":0.7,"topic_tags":["sexual_function","masturbation","csbd","moral_incongruence","pornography"],"strengths":["Large sample for a single‑clinic study","Objective semen analysis alongside self‑reported sexual function","Prospective data collection"],"limitations":["No validated sexual‑function instrument reported","No control for anxiety, partner factors or moral/religious attitudes","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":53,"citing_publications":95,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0015-0282(02)04921-x"}},{"id":5279,"doi":"10.1023/a:1022933320700","pmid":"12762415","pmcid":"PMC3455634","title":"Does preejaculatory penile secretion originating from Cowper's gland contain sperm?","authors":"Zukerman Z, Weiss DB, Orvieto R.","first_author":"Zukerman Z","journal":"Journal of assisted reproduction and genetics","year":2003,"pub_types":["brief-report","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"prospective clinical and laboratory case series (n≈12 total participants)","sample_n":12,"sample_text":"Five patients referred for premature ejaculation, three for excessive fluid secreted during foreplay and four normal healthy volunteers","population":"men with premature ejaculation, excessive pre‑ejaculatory fluid, and healthy volunteers","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined fluid released before ejaculation (from Cowper’s glands) in 12 men and found no sperm in any sample, suggesting this fluid cannot cause pregnancy during withdrawal.","clinical_takeaway":"Pre‑ejaculatory fluid does not contain sperm, so it is unlikely to cause pregnancy if withdrawal is performed.","confidence":0.7,"topic_tags":["prevalence","sexual_function","religiosity"],"strengths":["Clear laboratory methodology for detecting sperm","Direct comparison between pre‑ejaculatory fluid and semen samples"],"limitations":["Very small, non‑representative sample","No statistical power justification","Findings limited to clinical context, not general population"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1022933320700"}},{"id":5280,"doi":"10.1002/j.2167-4086.2003.tb00138.x","pmid":"12723559","pmcid":null,"title":"Addendum to Freud's \"Criminals from a sense of guilt\"","authors":"Goldberg A.","first_author":"Goldberg A.","journal":"The Psychoanalytic quarterly","year":2003,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/j.2167-4086.2003.tb00138.x"}},{"id":5283,"doi":"10.1136/sti.79.2.147","pmid":"12690139","pmcid":"PMC1744617","title":"Sexual behaviour of lesbians and bisexual women","authors":"Bailey JV, Farquhar C, Owen C, Whittaker D.","first_author":"Bailey JV","journal":"Sexually transmitted infections","year":2003,"pub_types":["research-article","Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":70,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 803 clinic patients and 415 community participants; self‑reported sexual histories.","sample_n":1218,"sample_text":"803 lesbians and bisexual women attending lesbian sexual health clinics and 415 from a community sample.","population":"Lesbian and bisexual women (new patients at lesbian sexual health clinics and community sample) in the UK.","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2003 UK survey of 1,218 lesbian and bisexual women showed most have had sexual experiences with both women and men, with a range of practices. Clinicians are advised to take non‑judgmental, thorough sexual histories.","clinical_takeaway":"Take comprehensive, non‑judgmental sexual histories from lesbian and bisexual women; do not assume exclusive same‑sex activity.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for this population","Includes both clinic and community participants","Provides detailed descriptive data on a understudied group"],"limitations":["Cross‑sectional, self‑report only","Convenience sampling from clinics may bias toward health‑seeking individuals","No assessment of mental‑health or moral‑incongruence confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":0,"mentioning":70,"citing_publications":139,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sti.79.2.147"}},{"id":5284,"doi":"10.1093/shm/16.1.57","pmid":"14598817","pmcid":null,"title":"\"Where doctors differ\": the debate on circumcision as a protection against syphilis, 1855-1914","authors":"Darby R.","first_author":"Darby R.","journal":"Social history of medicine : the journal of the Society for the Social History of Medicine","year":2003,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"historical review without primary empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"United Kingdom/United States (historical)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews 19th‑century debates about whether male circumcision protected against or caused syphilis, showing that the protective claim was weak and tied to moral motives like discouraging masturbation.","clinical_takeaway":"Historical claims linking circumcision to syphilis protection are unfounded; modern practice should focus on proven health benefits.","confidence":0.8,"topic_tags":["csbd","moral_incongruence","sexual_function"],"strengths":["Provides detailed historical context","Highlights misuse of statistical claims"],"limitations":["No original data; relies on secondary sources","No systematic quantitative analysis"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/shm/16.1.57"}},{"id":5287,"doi":"10.1097/01.paf.0000052754.37280.10","pmid":"12605007","pmcid":null,"title":"Accidental electrocution during autoeroticism: a shocking case","authors":"Schott JC, Davis GJ, Hunsaker JC.","first_author":"Schott JC","journal":"The American journal of forensic medicine and pathology","year":2003,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case description of accidental electrocution during autoerotic masturbation; forensic autopsy findings","sample_n":1,"sample_text":"N = 1 (single case report)","population":"18‑year‑old white male","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"An 18‑year‑old man died after unintentionally electrocuting himself while masturbating with homemade electrical devices. The autopsy showed severe burns to his breast area. The report describes this rare type of autoerotic death.","clinical_takeaway":"None – the report is a forensic case study with no direct clinical implications.","confidence":0.6,"topic_tags":["masturbation","sexual_function"],"strengths":["Detailed forensic description","Clear documentation of injury pattern"],"limitations":["Single case, no generalizable data","No measurement of psychological or sexual variables","No control or comparison group"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.paf.0000052754.37280.10"}},{"id":5288,"doi":"10.1136/jramc-149-01-08","pmid":"12743926","pmcid":null,"title":"Sexuality and soldiery combat & condoms, continence & cornflakes","authors":"Palmer I.","first_author":"Palmer I.","journal":"Journal of the Royal Army Medical Corps","year":2003,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 75 male soldiers during humanitarian aid mission; historical framing","sample_n":75,"sample_text":"75 male soldiers","population":"male soldiers (N=75) on humanitarian aid in Africa (2003)","country":"United Kingdom (military personnel on mission in Africa)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A brief 2003 study surveyed 75 male soldiers on a humanitarian mission in Africa about sexual health topics such as condom use and masturbation, placing the findings within a historical discussion of soldiers' sexuality.","clinical_takeaway":"None – the report offers historical insight but provides no actionable clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides historical perspective","Includes a real‑world military sample"],"limitations":["Small, non‑representative convenience sample","No validated measurement instruments reported","No control for key confounds (moral, mental health, etc.)"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/jramc-149-01-08"}},{"id":5290,"doi":"10.1080/02699930302291","pmid":"29715727","pmcid":null,"title":"The pleasures of sex: An empirical investigation","authors":"Pinkerton S, Cecil H, Bogart L, Abramson P.","first_author":"Pinkerton S","journal":"Cognition & emotion","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 223 undergraduates, convenience sample, self‑report ratings of pleasure and experience; no longitudinal or experimental manipulation","sample_n":223,"sample_text":"145 female and 78 male undergraduates","population":"undergraduate students (mostly young, WEIRD)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"University students rated how pleasurable various sexual acts were and reported how often they had done them. More pleasure was linked to more sexual experience, higher activity frequency, and more partners, supporting the idea that pleasure drives sexual behaviour.","clinical_takeaway":"None - the study describes normal variability in sexual pleasure, not clinical risk.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a single‑session survey","Includes both genders and a range of sexual activities","Provides empirical data on pleasure correlates"],"limitations":["Convenience undergraduate sample limits generalisability","Pleasure measured with single‑item, non‑validated scales","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/02699930302291"}},{"id":5291,"doi":"10.1023/a:1021897530286","pmid":"12597274","pmcid":null,"title":"Alexithymia is inversely associated with women's frequency of vaginal intercourse","authors":"Brody S.","first_author":"Brody S.","journal":"Archives of sexual behavior","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 93 healthy young adults (54 women, 39 men), self‑report recall and diary of sexual activity","sample_n":93,"sample_text":"54 female and 39 male healthy young adults","population":"young adult volunteers, likely university/community sample","country":"Germany (German version of TAS‑20 used)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 93 German young adults, women who scored higher on alexithymia (difficulty identifying emotions) reported having vaginal intercourse less often, while men showed no link. Masturbation and other sexual activities were not related to alexithymia.","clinical_takeaway":"None – findings are correlational and not directly actionable for clinical practice.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Validated alexithymia instrument (TAS‑20)","Separate diary and recall measures of sexual behavior","Masturbation measured distinct from intercourse"],"limitations":["Cross‑sectional, cannot infer causality","Small sample, especially women subgroup (<60)","Limited control for mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":74,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1021897530286"}},{"id":5292,"doi":"10.1080/00224490309552164","pmid":"12806529","pmcid":null,"title":"Truth and consequences: using the bogus pipeline to examine sex differences in self-reported sexuality","authors":"Alexander MG, Fisher TD.","first_author":"Alexander MG","journal":"Journal of sex research","year":2003,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":107,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"randomised experimental design with three survey conditions (bogus pipeline, anonymous, exposure threat) comparing self‑reported sexual behavior across genders","sample_n":null,"sample_text":"not reported in abstract","population":"adult participants (sample size not specified in abstract)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study used a ‘bogus pipeline’ trick to see if men and women report sexual behaviors differently because of gender norms. When participants thought lying would be detected, gender differences shrank, suggesting many reported differences are due to social desirability rather than actual behaviour.","clinical_takeaway":"Clinicians should treat self‑reported sexual behaviour, especially porn use and masturbation, with caution as gendered expectations may bias reports.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Experimental manipulation of reporting conditions allows causal inference about social desirability effects","Clear demonstration of gender‑norm influences on self‑report","Relevant to research on pornography and masturbation reporting"],"limitations":["Reliance on self‑report items of unclear psychometric validation","No measurement of potential confounds such as moral incongruence or mental health","Sample size and demographic details not provided in abstract"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":170,"citing_publications":350,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490309552164"}},{"id":5293,"doi":null,"pmid":"12608337","pmcid":null,"title":"[Accidents related with atypical sexual behavior]","authors":"Dmitrieva OA, Fedchenko TM.","first_author":"Dmitrieva OA","journal":"Sudebno-meditsinskaia ekspertiza","year":2003,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"rus","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Descriptive case series of lethal and non‑lethal sexual asphyxia incidents; no systematic data collection, no control group.","sample_n":null,"sample_text":"Not reported; likely a small number of forensic cases.","population":"Individuals involved in autoerotic asphyxia incidents (forensic cases).","country":"Russia (based on author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes forensic cases of autoerotic sexual asphyxia, detailing lethal and non‑lethal incidents and their medical‑legal relevance.","clinical_takeaway":"Clinicians should be aware of the risks of sexual asphyxia and consider safety counseling for patients engaging in autoerotic practices.","confidence":0.8,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Provides forensic detail on a rare, high‑risk sexual behavior","Highlights medical‑legal importance of autoerotic asphyxia"],"limitations":["No systematic data collection or control group","No measurement of psychological or contextual variables","Small, non‑representative case series"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5294,"doi":"10.1080/713847101","pmid":"12519661","pmcid":null,"title":"Concordance between women's physiological and subjective sexual arousal is associated with consistency of orgasm during intercourse but not other sexual behavior","authors":"Brody S, Laan E, van Lunsen RH.","first_author":"Brody S","journal":"Journal of sex & marital therapy","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":45,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional correlational study of 38 postmenopausal women measuring vaginal pulse amplitude and subjective arousal, plus orgasm consistency across activities","sample_n":38,"sample_text":"Convenience sample of postmenopausal women","population":"postmenopausal women (N=38)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 38 post‑menopausal women, the match between genital arousal and how aroused they felt was stronger in women who regularly had orgasms during intercourse, but not during other sexual activities.","clinical_takeaway":"Consistent orgasm during intercourse may reflect better integration of physiological and subjective arousal in women.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["objective physiological measure (vaginal pulse amplitude)","consideration of social desirability bias","focus on specific sexual behavior (intercourse) versus others"],"limitations":["very small sample (N=38) limits power","cross‑sectional design cannot infer causality","limited assessment of potential confounds (mood, relationship factors, trauma)","results may not generalise beyond postmenopausal women"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":7,"contrasting":0,"mentioning":68,"citing_publications":81,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/713847101"}},{"id":5295,"doi":"10.1111/j.1746-1561.2003.tb06552.x","pmid":"12621718","pmcid":null,"title":"Elementary school teachers' techniques of responding to student questions regarding sexuality issues","authors":"Price JH, Dake JA, Kirchofer G, Telljohann SK.","first_author":"Price JH","journal":"The Journal of school health","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 277 elementary teachers assessing self‑reported response techniques to student sexuality questions.","sample_n":277,"sample_text":"n = 277 teachers","population":"U.S. elementary (5th‑6th grade) teachers","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2003 survey of 277 U.S. elementary teachers found most had little formal training in sexuality education and varied in willingness to answer student questions on topics like STDs, puberty, masturbation, and abortion.","clinical_takeaway":"None – study informs educator training, not clinical practice.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Relatively large teacher sample","Relevant practical insights for school health policy"],"limitations":["Self‑report may be subject to social desirability bias","Questionnaire validation not described","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1746-1561.2003.tb06552.x"}},{"id":5297,"doi":"10.1162/152651603766436324","pmid":"12859826","pmcid":null,"title":"Cutting history, cutting culture: female circumcision in the United States","authors":"Webber S, Schonfeld T.","first_author":"Webber S","journal":"The American journal of bioethics : AJOB","year":2003,"pub_types":["Comment","Historical Article","Journal Article"],"keywords":["Professional Patient Relationship"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1162/152651603766436324"}},{"id":5298,"doi":"10.1590/s0036-36342003001100012","pmid":"14974278","pmcid":null,"title":"Sexual behavior patterns and HIV risks in bisexual men compared to exclusively heterosexual and homosexual men","authors":"Izazola-Licea JA, Gortmaker SL, de Gruttola V, Tolbert K, Mann J.","first_author":"Izazola-Licea JA","journal":"Salud publica de Mexico","year":2003,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://scielosp.org/article/ssm/content/raw/?resource_ssm_path=/media/assets/spm/v45s5/v45s5a12.pdf","cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Household probability survey (1992‑1993) in Mexico City; cross‑sectional analysis of men sexually active in prior 5 years (N≈8 000 total, subset analyzed).","sample_n":8068,"sample_text":"8,068 men surveyed; analysis restricted to sexually active men.","population":"Adult men in Mexico City, categorized as bisexual, heterosexual, or homosexual based on self‑reported sexual behavior.","country":"Mexico","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 1990s Mexican household survey compared sexual practices of bisexual, heterosexual and homosexual men. Bisexual men had fewer anal sex encounters with men and used condoms more with female sex workers, suggesting lower HIV transmission risk from bisexual men to other groups.","clinical_takeaway":"Bisexual men in this sample showed lower risky anal practices with men; clinicians should consider diverse sexual patterns when assessing HIV risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, probability‑based household sample","Clear comparison of bisexual, heterosexual and homosexual men","Relevant public‑health focus on HIV risk behaviours"],"limitations":["Self‑reported sexual behavior, no validated scales","Cross‑sectional design limits causal inference","No control for moral, mental‑health or partnership confounders"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":19,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s0036-36342003001100012"}},{"id":5299,"doi":"10.1093/oxfordjournals.schbul.a007028","pmid":"14609249","pmcid":null,"title":"Study of sexuality-related characteristics in young adults with schizophrenia treated with novel neuroleptics and in a comparison group of young adults","authors":"Fortier P, Mottard JP, Trudel G, Even S.","first_author":"Fortier P","journal":"Schizophrenia bulletin","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of 45 young adults with schizophrenia on novel antipsychotics versus 61 community controls.","sample_n":106,"sample_text":"45 patients, 61 controls","population":"young adults with schizophrenia (treated with risperidone, olanzapine, etc.) and age‑matched healthy controls","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Young adults with schizophrenia on modern antipsychotics report fewer sexual partners, lower desire, and more sexual dysfunctions than peers without the disorder, with gender differences in masturbation and desire.","clinical_takeaway":"Clinicians should routinely assess and address sexual dysfunction when treating young adults with schizophrenia.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Addresses an understudied population","Includes a matched control group","Considers both gender and medication effects"],"limitations":["Cross‑sectional, cannot infer causality","Unclear whether sexual measures are validated","Relatively small clinical sample","No control for mental‑health comorbidities or moral factors"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/oxfordjournals.schbul.a007028"}},{"id":5301,"doi":"10.1521/jaap.1.1979.7.1.15","pmid":"367990","pmcid":null,"title":"Freud's early views on masturbation and the actual neuroses","authors":"Zucker KJ.","first_author":"Zucker KJ.","journal":"The Journal of the American Academy of Psychoanalysis","year":1979,"pub_types":["Historical Article","Biography","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1521/jaap.1.1979.7.1.15"}},{"id":5302,"doi":"10.1901/jaba.1979.12-377","pmid":"511807","pmcid":"PMC1311423","title":"Satiation therapy: a procedure for reducing deviant sexual arousal","authors":"Marshall WL.","first_author":"Marshall WL.","journal":"Journal of applied behavior analysis","year":1979,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-case experimental series with two participants","sample_n":2,"sample_text":"Two adult male participants","population":"adult males with deviant sexual interests (e.g., pedophilia, fetishism)","country":"USA (presumed by journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The study reports that pairing one hour of masturbation with speaking aloud deviant fantasies reduced those fantasies in two adult men, suggesting the therapy may modify unwanted sexual arousal.","clinical_takeaway":"Evidence is limited to two cases; clinicians should not rely on this method as a proven treatment.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Detailed single-case experimental manipulation","Clear description of treatment procedure"],"limitations":["Very small N (2 participants)","No validated measures of deviant arousal or outcomes","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":30,"citing_publications":116,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1901/jaba.1979.12-377"}},{"id":5303,"doi":null,"pmid":"502330","pmcid":null,"title":"[Foreign bodies in the urinary bladder lodged during masturbation]","authors":"Andreev T, Kulov N, Aĭladunov V.","first_author":"Andreev T","journal":"Khirurgiia","year":1979,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"bul","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5304,"doi":"10.1046/j.1365-2605.2002.00378.x","pmid":"12406364","pmcid":null,"title":"Penile vibratory stimulation and electroejaculation in the treatment of ejaculatory dysfunction","authors":"Sønksen J, Ohl DA.","first_author":"Sønksen J","journal":"International journal of andrology","year":2002,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":70,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review (narrative) without systematic methodology or risk‑of‑bias assessment.","sample_n":null,"sample_text":"None – article is a narrative review.","population":"men with ejaculatory dysfunction, principally spinal‑cord‑injured patients; no primary data collected.","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how penile vibration and electroejaculation can help men who cannot ejaculate on their own, especially those with spinal‑cord injuries, and discusses semen quality and fertility options.","clinical_takeaway":"Penile vibratory stimulation is the preferred first‑line, non‑invasive method for inducing ejaculation in spinal‑cord‑injured men.","confidence":0.4,"topic_tags":["sexual_function","religiosity","treatment","pornography"],"strengths":["Provides a concise overview of PVS and EEJ techniques.","Highlights clinical outcomes for men with spinal‑cord injury."],"limitations":["Narrative review lacking systematic search or bias assessment.","No original data; relies on heterogeneous case reports.","No quantitative synthesis or effect‑size reporting."],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":1,"mentioning":80,"citing_publications":135,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1046/j.1365-2605.2002.00378.x"}},{"id":5305,"doi":"10.1080/tam.5.4.203.215","pmid":"12630067","pmcid":null,"title":"Measurement of steroid levels in saliva in a population-based survey of lifestyle, medical conditions, marriage, sex life and hormone status in aging men: a feasibility study","authors":"Krause W, Mueller U, Mazur A.","first_author":"Krause W","journal":"The aging male : the official journal of the International Society for the Study of the Aging Male","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pilot feasibility study with 98 men, cross‑sectional saliva hormone measurements and self‑report questionnaire","sample_n":98,"sample_text":"48 men from Mannheim, Germany and 50 men from State College, Pennsylvania, USA","population":"healthy heterosexual cohabiting men, age 50‑80, recruited from Germany and USA","country":"Germany, USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A pilot study measured testosterone, cortisol, estradiol and DHEA‑S in saliva from 98 aging men and asked about their sexual activity. Saliva results correlated reasonably with serum values, suggesting saliva can be used in large surveys of hormone status and sexual behavior.","clinical_takeaway":"Saliva testing appears feasible for assessing hormone levels related to sexual health in older men.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Validated saliva assays compared to serum","Population‑based random sampling","Includes both hormone and sexual behavior data"],"limitations":["Small pilot sample, limited power","No control for key psychosocial confounds","Cross‑sectional, no causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/tam.5.4.203.215"}},{"id":5307,"doi":"10.1023/a:1020699013309","pmid":"12462476","pmcid":null,"title":"Is pedophilia a mental disorder?","authors":"Green R.","first_author":"Green R.","journal":"Archives of sexual behavior","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":111,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1020699013309"}},{"id":5308,"doi":"10.1516/002075702320888684","pmid":"12521536","pmcid":null,"title":"'Actual neurosis' and psychosomatic medicine: the vicissitudes of an enigmatic concept","authors":"Hartocollis P.","first_author":"Hartocollis P.","journal":"The International journal of psycho-analysis","year":2002,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical/theoretical article with no empirical data.","sample_n":null,"sample_text":"none","population":"none","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews Freud's outdated concept of 'actual neurosis', a mood and somatic disorder he linked to excessive sexual activity like masturbation, and traces how the idea evolved into modern notions such as chronic fatigue syndrome.","clinical_takeaway":"The piece is historical; it does not provide clinical guidance for current treatment of sexual or psychosomatic issues.","confidence":0.8,"topic_tags":["masturbation","neuroscience","sexual_function","pornography"],"strengths":["Provides historical context for Freudian concepts","Links early psychoanalytic ideas to later medical entities"],"limitations":["No empirical data or systematic review","Relies on historical interpretation rather than contemporary evidence"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1516/002075702320888684"}},{"id":5309,"doi":"10.1037//0022-006x.46.6.1507","pmid":"730907","pmcid":null,"title":"Is masturbation still wrong? Comments on Bailey's comments","authors":"Wagner NN.","first_author":"Wagner NN.","journal":"Journal of consulting and clinical psychology","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0022-006x.46.6.1507"}},{"id":5311,"doi":null,"pmid":"717443","pmcid":null,"title":"Attitudes of caretakers toward the sexual behavior of mentally retarded persons","authors":"Mitchell L, Doctor RM, Butler DC.","first_author":"Mitchell L","journal":"American journal of mental deficiency","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"questionnaire administered to staff at three residential facilities; no longitudinal or experimental component; convenience sample; sample size not reported","sample_n":null,"sample_text":"staff members at three residential facilities (exact number not provided)","population":"caretakers/staff of residential facilities for persons with intellectual disability","country":"USA (inferred from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1978 survey of staff at three residential homes for people with intellectual disabilities found that about one‑third thought any sexual activity, even simple contact, was unacceptable. Among those who were accepting, heterosexual behavior was most tolerated, while public sexual acts, especially masturbation, were seen as problematic.","clinical_takeaway":"Sex‑education programs for people with intellectual disabilities may face staff resistance; training should address attitudes toward sexual behavior.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["addresses an understudied population (staff attitudes)","covers multiple dimensions of sexual behavior"],"limitations":["No validated measurement instrument reported","Sample size and response rate not disclosed","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":5312,"doi":"10.1016/s0167-4943(02)00026-2","pmid":"14764358","pmcid":null,"title":"Hypersexuality in nursing care facilities--a descriptive study","authors":"Nagaratnam N, Gayagay G.","first_author":"Nagaratnam N","journal":"Archives of gerontology and geriatrics","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"descriptive case series of eight (ten) nursing‑home residents with sexually inappropriate behaviour; no control group; small convenience sample","sample_n":8,"sample_text":"Eight patients (actually ten mentioned) described; convenience case series","population":"elderly residents of nursing care facilities with organic brain pathology","country":"unspecified (likely India based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe eight elderly nursing‑home residents who showed sexually inappropriate actions such as groping and masturbation. Brain scans showed strokes or dementia, suggesting an organic cause, but the tiny sample cannot tell how common or why these behaviours occur.","clinical_takeaway":"Clinicians should consider underlying neurological disease when elderly patients exhibit sudden sexual disinhibition, but evidence is too limited for general recommendations.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Provides rare clinical description of sexual disinhibition in nursing homes","Links behaviour to documented brain lesions"],"limitations":["Very small, non‑representative case series","No systematic measurement of sexual behaviour or distress","No comparison or control group, limiting causal inference"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":33,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0167-4943(02)00026-2"}},{"id":5313,"doi":"10.1080/00224490209552148","pmid":"12545407","pmcid":null,"title":"Sexual diversity in urban Norwegians","authors":"Traeen B, Stigum H, Søorensen D.","first_author":"Traeen B","journal":"Journal of sex research","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Random sample of 5,000 Oslo residents (18‑49), 45% responded (≈2,250). Postal questionnaire describing sexual fantasies, attraction, conduct, love. Analyses compare exclusive heterosexual, bisexual, and exclusive homosexual groups.","sample_n":2250,"sample_text":"45% response rate from 5,000 invited (≈2,250 participants).","population":"Urban Norwegian adults, age 18‑49, mixed gender, recruited via population register.","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2002 survey of Oslo adults found that exclusive homosexuality is rare, but many women reported same‑sex fantasies. Bisexual respondents reported more lifetime partners, more oral/anal sex, and earlier masturbation milestones than exclusively heterosexual respondents, and differed in sexual attitudes.","clinical_takeaway":"None – the study describes population sexual diversity without implications for clinical practice.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large, randomly drawn urban sample","Comprehensive coverage of multiple sexual dimensions","Comparison across heterosexual, bisexual, homosexual groups"],"limitations":["Low response rate (45%) may bias results","Reliance on self‑report, likely unvalidated measures","No control for mental‑health or moral variables"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":11,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490209552148"}},{"id":5314,"doi":null,"pmid":"12462212","pmcid":null,"title":"Sex and sanity, 1879","authors":null,"first_author":null,"journal":"The Journal of nervous and mental disease","year":2002,"pub_types":["Historical Article","Seminal Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5315,"doi":"10.1080/00224490209552154","pmid":"12545413","pmcid":null,"title":"Relationship functioning and sexuality among people with multiple sclerosis","authors":"McCabe MP.","first_author":"McCabe MP.","journal":"Journal of sex research","year":2002,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional survey of 381 people with MS and 291 from the general population assessing sexual satisfaction, dysfunction, masturbation frequency and relationship variables.","sample_n":672,"sample_text":"381 respondents with MS and 291 respondents from the general population.","population":"Adults with multiple sclerosis (mixed gender) recruited from clinical/ community sources; comparison group from general population (likely convenience sample).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People with multiple sclerosis report more sexual problems and lower relationship satisfaction than those without MS; coping style and cognitive function are linked to better sexual outcomes, especially for women.","clinical_takeaway":"Assess coping strategies and cognitive health when addressing sexual difficulties in clients with MS.","confidence":0.78,"topic_tags":["sexual_function","relationships","masturbation"],"strengths":["Large combined sample (N>600)","Direct comparison with general‑population controls","Includes both genders and a range of sexual/relationship outcomes"],"limitations":["Cross‑sectional design limits causal inference","Unclear whether standard validated scales were used","Limited control for key psychosocial confounds (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":3,"mentioning":74,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490209552154"}},{"id":5316,"doi":"10.1016/s1047-9651(02)00045-1","pmid":"12465564","pmcid":null,"title":"Adolescent sexuality and disability","authors":"Neufeld JA, Klingbeil F, Bryen DN, Silverman B, Thomas A.","first_author":"Neufeld JA","journal":"Physical medicine and rehabilitation clinics of North America","year":2002,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Narrative review of clinical recommendations for adolescents with disabilities; no primary data collected.","sample_n":null,"sample_text":"No empirical sample; review of existing literature and resources.","population":"Adolescents with disabilities (no primary sample)","country":"United States (focus on US legislation)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article outlines how health‑care providers can better support the sexual health of adolescents with disabilities, emphasizing access, community resources, and a broad sex‑education curriculum that includes masturbation and consent.","clinical_takeaway":"Clinicians should ensure accessible, inclusive sex education and link patients to community resources that support healthy sexual development.","confidence":0.4,"topic_tags":["sexual_function","adolescents"],"strengths":["Comprehensive clinical recommendations","Addresses multiple aspects of sexuality education"],"limitations":["No primary data; narrative review limits empirical rigor","Lacks systematic search or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":62,"citing_publications":107,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1047-9651(02)00045-1"}},{"id":5317,"doi":"10.1007/bf01542488","pmid":"718414","pmcid":null,"title":"Background and sexual experience of Israeli medical students","authors":"Hoch Z, Kubat H, Fisher M, Brandes JM.","first_author":"Hoch Z","journal":"Archives of sexual behavior","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of senior medical students at four Israeli medical schools (1978)","sample_n":null,"sample_text":"senior medical students at four Israeli medical schools (size not reported in abstract)","population":"senior medical students (mostly unmarried Jewish Ashkenazi males) in Israel","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1978 survey of Israeli senior medical students described their sexual backgrounds, experiences, and attitudes, noting early masturbation, multiple partners, and limited formal sex education.","clinical_takeaway":"None – the study provides descriptive historical data, not clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Large national scope across all Israeli medical schools","Provides baseline data on sexual experience of future physicians","Includes both males and females"],"limitations":["No validated scales; reliance on single‑item self‑reports","No control for key confounds (moral attitudes, mental health, partner effects)","Cross‑sectional design prevents causal inference","Sample limited to 1978 medical students; not generalizable to broader populations"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542488"}},{"id":5319,"doi":null,"pmid":"12407893","pmcid":null,"title":"[The sexual life of 60-year-old Danish men]","authors":"Eplov LF, Weigner T, Solstad K.","first_author":"Eplov LF","journal":"Ugeskrift for laeger","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"dan","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of a random sample of 66 Danish men aged 60, using structured interview questions (mostly categorical/frequency items).","sample_n":66,"sample_text":"random sample of 66 men from a cohort representing 60‑year‑old men in Copenhagen.","population":"60‑year‑old men in Copenhagen County, Denmark (N≈66).","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 66 Danish men aged 60 showed wide variation in sexual desire, frequency of intercourse, masturbation, and satisfaction, with about two‑thirds masturbating and one‑tenth reporting erection problems.","clinical_takeaway":"Many 60‑year‑old men remain sexually active and satisfied; clinicians should assess both partnered and solitary activity when discussing sexual health.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Random sample aiming for representativeness","Addresses an understudied age group","Includes both partnered and solitary sexual activity"],"limitations":["Small sample (N=66) limits subgroup analysis","No validated psychometric instruments reported","Limited assessment of mental‑health or psychosocial covariates"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":5320,"doi":"10.1097/00001703-200210000-00008","pmid":"12401976","pmcid":null,"title":"Adolescent sexuality and sexual behavior","authors":"Feldmann J, Middleman AB.","first_author":"Feldmann J","journal":"Current opinion in obstetrics & gynecology","year":2002,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review; no primary data; discusses trends, risk factors, and recommendations for clinicians.","sample_n":null,"sample_text":"Not applicable – review of existing literature","population":"adolescents (mixed gender, US; no specific sample size reported)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarizes how teen sexual activity—including masturbation and oral sex—has been changing, noting declines in intercourse but rising non‑coital behaviors, and points out disparities across race and sexual orientation.","clinical_takeaway":"Clinicians should address both coital and non‑coital activities when counseling teens and consider disparate risks among sub‑groups.","confidence":0.6,"topic_tags":["adolescents","sexual_function","masturbation"],"strengths":["Broad overview of recent adolescent sexual behavior trends","Highlights health‑care implications for clinicians","Incorporates disparities by race and sexual orientation"],"limitations":["Narrative, not systematic; potential selection bias","No empirical data or systematic risk‑of‑bias assessment","No quantitative synthesis or effect‑size reporting"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":1,"mentioning":16,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00001703-200210000-00008"}},{"id":5321,"doi":null,"pmid":"699148","pmcid":null,"title":"[Conspicuous masturbation behavior in a 7-year-old girl]","authors":"Satková V, Marková J, Topiar A.","first_author":"Satková V","journal":"Ceskoslovenska pediatrie","year":1978,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"cze","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5322,"doi":"10.3109/01674820209074667","pmid":"12436800","pmcid":null,"title":"Sexual enjoyment and orgasm postpartum: sex differences and perceptual accuracy concerning partners' sexual experience","authors":"von Sydow K.","first_author":"von Sydow K.","journal":"Journal of psychosomatic obstetrics and gynaecology","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 30 German couples (60 individuals) at 7 months postpartum; descriptive and comparative analyses of sexual enjoyment and orgasm.","sample_n":60,"sample_text":"30 couples (60 individuals)","population":"German heterosexual couples, postpartum (7 months).","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 30 German couples seven months after birth to see how much they enjoy various sexual activities and how often they orgasm. Men reported higher enjoyment and tended to think their partners enjoyed sex more than the women reported. Both sexes liked tenderness, intercourse and manual stimulation the most.","clinical_takeaway":"Post‑partum couples experience varied enjoyment; clinicians should discuss both partners’ perspectives on sexual activity and orgasm.","confidence":0.8,"topic_tags":["sexual_function","relationships","masturbation"],"strengths":["Includes both partners' perspectives","Validates new questionnaire with interview data","Addresses understudied postpartum period"],"limitations":["Small convenience sample (30 couples)","New instrument lacks extensive validation","No control for key confounds (mood, trauma, moral factors)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/01674820209074667"}},{"id":5323,"doi":null,"pmid":"12297453","pmcid":null,"title":"[Multifactorial analysis of the risk factors of chronic prostatitis]","authors":"Meng AQ, Zheng SB, Chen WS, Chen T, Nie J.","first_author":"Meng AQ","journal":"Di 1 jun yi da xue xue bao = Academic journal of the first medical college of PLA","year":2002,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Epidemiological survey of 1,168 men with chronic prostatitis; single‑factor and multivariate logistic regression of reported risk factors.","sample_n":1168,"sample_text":"1,168 patients with chronic prostatitis","population":"Male patients with chronic prostatitis (China); clinic‑based sample.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A Chinese survey of 1,168 men with chronic prostatitis found that urethritis, uncontrolled sexual activity, frequent masturbation, injuries, prolonged sitting, heavy drinking and holding urine were linked to the condition.","clinical_takeaway":"Consider lifestyle and urinary‑health factors when managing chronic prostatitis; no direct evidence for causality.","confidence":0.7,"topic_tags":["sexual_function","masturbation","religiosity","moral_incongruence"],"strengths":["Large sample size for a single‑site survey","Multivariate logistic regression to control for several variables"],"limitations":["Clinic‑based, not population‑representative sample","Reliance on self‑reported, unvalidated risk‑factor measures","No assessment of key psychosocial confounds (e.g., moral beliefs, mental health, partner context)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":5324,"doi":"10.3917/spub.023.0275","pmid":"12564052","pmcid":null,"title":"[Prevention in adolescence and the biomedical model, past and present history]","authors":"Meremans P, Deschamps JP, Deccache A.","first_author":"Meremans P","journal":"Sante publique (Vandoeuvre-les-Nancy, France)","year":2002,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3917/spub.023.0275"}},{"id":5326,"doi":"10.33588/rn.3506.2002264","pmid":"12389171","pmcid":null,"title":"[Kleine-Levin syndrome: contribution of brain SPECT in diagnosis]","authors":"Arias M, Crespo Iglesias JM, Pérez J, Requena- Caballero I, Sesar-Ignacio A, Peleteiro-Fernández M.","first_author":"Arias M","journal":"Revista de neurologia","year":2002,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single 17‑year‑old male with Kleine‑Levin syndrome; SPECT imaging described","sample_n":1,"sample_text":"single case","population":"Male adolescent with KLS; N=1","country":"Spain (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 17‑year‑old boy with Kleine‑Levin syndrome showed unusual sexual behavior and right‑frontal brain hypoperfusion on SPECT imaging; treatment with lithium was successful.","clinical_takeaway":"In rare KLS cases, frontal hypoperfusion may appear; lithium can be effective, but findings are based on a single patient.","confidence":0.4,"topic_tags":["neuroscience","sexual_function","masturbation"],"strengths":["detailed clinical description","use of multimodal investigations (SPECT, MRI, polysomnography)"],"limitations":["single case, no control group","no statistical analysis","interpretation of hypoperfusion may be speculative"],"rubric_version":"2.0","raw_total":10,"max_possible":60,"pct_score":17,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":2,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.33588/rn.3506.2002264"}},{"id":5329,"doi":"10.1007/bf01542378","pmid":"666572","pmcid":null,"title":"Subjective sexual experience in college women","authors":"Clifford RE.","first_author":"Clifford RE.","journal":"Archives of sexual behavior","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Random sample of 100 undergraduate women interviewed about subjective sexual experiences; cross‑sectional survey.","sample_n":100,"sample_text":"100 undergraduates","population":"College women (undergraduate, US, 1978)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A 1978 interview study of 100 college women described how they felt during masturbation, oral sex, intercourse and clitoral stimulation, finding varied subjective experiences of orgasm and links between orgasm frequency and sexual satisfaction.","clinical_takeaway":"Women’s orgasm experiences are heterogeneous; clinicians should consider individual subjective definitions rather than a single standard.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Detailed qualitative description of orgasmic experiences","Includes multiple sexual activities (masturbation, oral, intercourse)","Early systematic attempt to map subjective orgasm typology"],"limitations":["Small, non‑representative convenience sample","No validated measurement instruments","Cross‑sectional; no causal inference warranted","Limited statistical reporting (no effect sizes, limited correction)"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542378"}},{"id":5330,"doi":"10.1055/s-2002-38127","pmid":"12655468","pmcid":null,"title":"[Sexual activity in old age-problem-oriented counselling from the psychiatric point of view]","authors":"Hirsch RD.","first_author":"Hirsch RD.","journal":"Zentralblatt fur Gynakologie","year":2002,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review (narrative, no systematic methods reported)","sample_n":null,"sample_text":"No primary data; narrative review of literature","population":"Older adults (unspecified)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how sexual activity, including masturbation, changes in older adults, noting physical, psychological and social influences and urging clinicians to discuss problems without prejudice.","clinical_takeaway":"Clinicians should address sexual concerns in older patients openly and consider underlying health or psychological issues.","confidence":0.6,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Broad overview of factors influencing sexuality in older age","Highlights need for non‑prejudicial counselling"],"limitations":["No systematic methodology or risk‑of‑bias assessment","No primary data; conclusions not empirically tested","Lacks measurement detail for key constructs"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-2002-38127"}},{"id":5331,"doi":"10.1016/s0006-3223(02)01329-x","pmid":"12208645","pmcid":null,"title":"High-dose ascorbic acid increases intercourse frequency and improves mood: a randomized controlled clinical trial","authors":"Brody S.","first_author":"Brody S.","journal":"Biological psychiatry","year":2002,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":74,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"randomized double‑blind placebo‑controlled trial, 14‑day intervention, daily sexual behavior diaries, BDI pre/post","sample_n":81,"sample_text":"healthy young adults, likely convenience sample","population":"42 healthy young adults AA, 39 placebo","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 14‑day double‑blind study, high‑dose vitamin C increased the number of penile‑vaginal intercourse episodes among healthy young adults, especially women and non‑cohabiting participants, and reduced depressive symptoms compared with placebo.","clinical_takeaway":"Vitamin C may modestly boost intercourse frequency and mood, but evidence is limited by small sample size.","confidence":0.7,"topic_tags":["sexual_function","moral_incongruence","masturbation"],"strengths":["RCT design","double‑blind placebo control","validated depression scale","daily diary captures behavior"],"limitations":["Small sample per arm, likely under‑powered","No adjustment for multiple comparisons reported","Limited control of key confounds (moral incongruence, mental health)","Effect sizes and confidence intervals not provided"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":1,"mentioning":55,"citing_publications":102,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0006-3223(02)01329-x"}},{"id":5332,"doi":"10.1097/00005392-200208000-00129","pmid":"12136839","pmcid":null,"title":"Endocrine response to masturbation induced orgasm in healthy men following a 3-week sexual abstinence","authors":"Seftel A.","first_author":"Seftel A.","journal":"The Journal of urology","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00005392-200208000-00129"}},{"id":5333,"doi":null,"pmid":"12364902","pmcid":null,"title":"[Prevention of sexually transmitted diseases and AIDS among junior professional players]","authors":"Silva WA, Buchalla CM, Paiva V, Latorre Mdo R, Stall R, Hearst N.","first_author":"Silva WA","journal":"Revista de saude publica","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"por","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pre‑post questionnaire with group‑dynamic sessions; no control group; N=25","sample_n":25,"sample_text":"Twenty‑five junior soccer players from a professional team in Campinas, Brazil","population":"junior professional soccer players (Brazil)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A pilot study of 25 junior soccer players in Brazil found good HIV knowledge but poor understanding of reproduction and inconsistent condom use, especially with regular partners. The authors suggest sports settings are good venues for STD prevention programs.","clinical_takeaway":"Educational interventions in sports teams can improve HIV knowledge, but condom use remains inconsistent; tailor programs to address regular‑partner risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Targeted a specific high‑risk youth group","Combined questionnaire with participatory group sessions","Provides baseline knowledge data for this population"],"limitations":["Very small, non‑representative sample","No control/comparison group or follow‑up outcomes","Questionnaire not reported as validated"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":5334,"doi":null,"pmid":"12216423","pmcid":null,"title":"Adolescent sexuality, cultural sensitivity and the teachings of the Catholic Church","authors":"Lazoritz S, McDermott RT.","first_author":"Lazoritz S","journal":"The Journal of reproductive medicine","year":2002,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review discussing Catholic teachings on adolescent sexuality; no empirical data, no sample.","sample_n":null,"sample_text":"Not applicable – no primary data collection","population":"Physicians and Catholic adolescents (implicit); no participants studied","country":"United States (implied)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article urges doctors to respect Catholic teachings when counseling adolescents about sex, contraception, and related topics, emphasizing cultural sensitivity in clinical care.","clinical_takeaway":"Clinicians should be aware of Catholic adolescents’ religious views when discussing sexual health, but also balance them with medical guidelines.","confidence":0.6,"topic_tags":["csbd","masturbation","sexual_function"],"strengths":["Highlights cultural competence in clinical practice","Provides concise overview of Catholic doctrine relevant to sexual health"],"limitations":["No empirical data or systematic review methodology","Lacks critical appraisal of evidence","Does not address potential conflicts with medical guidelines"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5335,"doi":"10.1007/bf01542060","pmid":"666563","pmcid":null,"title":"Styles of sexual expression in women: clinical implications of multivaritanalyses","authors":"Hoon EF, Hoon PW.","first_author":"Hoon EF","journal":"Archives of sexual behavior","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Self‑report survey of North American women; multivariate (canonical correlation, discriminant) analyses; sample size not reported in abstract.","sample_n":null,"sample_text":"Not specified in abstract","population":"Adult women (North American), likely convenience sample","country":"United States/Canada (North America)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study used statistical analyses to describe three patterns of sexual expression among women, linking factors like age, partner status, masturbation, and enjoyment of erotic media to sexual satisfaction and orgasm frequency.","clinical_takeaway":"Clinicians should consider the diverse ways women experience sexual activity and satisfaction, but the findings are exploratory and not definitive for treatment.","confidence":0.4,"topic_tags":["sexual_function","masturbation"],"strengths":["Uses multivariate statistical techniques to identify patterns in sexual behavior","Includes both demographic and cognitive variables","Addresses sexual satisfaction and dysfunction"],"limitations":["No validated measurement instruments reported","Sample size and sampling method unclear","No control for key confounds (e.g., mental health, relationship status, moral factors)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542060"}},{"id":5336,"doi":"10.1016/0002-9378(78)90317-4","pmid":"637074","pmcid":null,"title":"Sperm procurement and analysis in Jewish law","authors":"Rosner F.","first_author":"Rosner F.","journal":"American journal of obstetrics and gynecology","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary/editorial without empirical data","sample_n":null,"sample_text":"Not applicable – paper discusses legal/religious considerations, no participants","population":"none","country":"United States (journal location, not study)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews Jewish legal opinions on how a husband with infertility can obtain semen for testing, preferring methods that avoid masturbation such as condom use or interrupted intercourse, and advises case‑by‑case rabbinic judgment.","clinical_takeaway":"None – the paper offers legal guidance, not clinical evidence.","confidence":0.8,"topic_tags":["masturbation","religiosity","sexual_function"],"strengths":["Provides historical/legal perspective","Considers medical expertise alongside religious law"],"limitations":["No empirical data","Lacks measurement of constructs","No systematic methodology"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0002-9378(78)90317-4"}},{"id":5338,"doi":"10.1016/s0165-1781(02)00109-9","pmid":"12127474","pmcid":null,"title":"Testosterone, sexuality and antisocial personality in rapists and child molesters: a pilot study","authors":"Aromäki AS, Lindman RE, Eriksson CJ.","first_author":"Aromäki AS","journal":"Psychiatry research","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pilot study measuring saliva testosterone and self‑reported sexual activity in 10 rapists, 10 child molesters and 31 controls; cross‑sectional, convenience prison sample","sample_n":51,"sample_text":"10 rapists, 10 child molesters, 31 controls","population":"adult male prisoners (rapists, child molesters) and community controls (Finnish)","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small Finnish study measured saliva testosterone in imprisoned rapists, child molesters and community men, finding no overall hormone differences but a link between higher testosterone and more sexual activity and antisocial traits in offenders.","clinical_takeaway":"No clear evidence that testosterone levels explain sexual offending; findings are preliminary and not directly applicable to clinical practice.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["objective hormonal assay","use of clinical criteria for ASP","inclusion of a community control group"],"limitations":["very small offender sample (n=10 per group)","cross‑sectional, cannot infer causality","limited control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":29,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0165-1781(02)00109-9"}},{"id":5339,"doi":"10.1016/0006-8993(78)90180-4","pmid":"414825","pmcid":null,"title":"Heterosexual, autosexual and social behavior of adult male rhesus monkeys with medial preoptic-anterior hypothalamic lesions","authors":"Slimp JC, Hart BL, Goy RW.","first_author":"Slimp JC","journal":"Brain research","year":1978,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":83,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Lesion experiment in adult male rhesus monkeys (n=6 lesions, n=5 shams) with behavioral observations of copulation, masturbation and social interactions.","sample_n":11,"sample_text":"6 lesion subjects, 5 sham‑lesioned controls","population":"Adult male rhesus monkeys (Macaca mulatta)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Lesions in a brain region called the medial preoptic-anterior hypothalamus stopped heterosexual mating in male rhesus monkeys but did not affect masturbation or social behaviours, suggesting this area specifically controls copulatory actions.","clinical_takeaway":"None – animal lesion findings do not directly inform human clinical practice.","confidence":0.7,"topic_tags":["sexual_function","masturbation","neuroscience"],"strengths":["Clear operational definitions of sexual behaviours","Direct experimental manipulation (lesions)","Inclusion of sham control group"],"limitations":["Very small sample size limits statistical power","Findings in non‑human primates may not generalise to humans","No correction for multiple behavioural comparisons reported"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":51,"citing_publications":162,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0006-8993(78)90180-4"}},{"id":5340,"doi":"10.1016/0005-7967(78)90051-7","pmid":"678271","pmcid":null,"title":"Use of contingent lemon juice to eliminate public masturbation by a severely retarded boy","authors":"Cook JW, Altman K, Shaw J, Blaylock M.","first_author":"Cook JW","journal":"Behaviour research and therapy","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":35,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0005-7967(78)90051-7"}},{"id":5341,"doi":"10.1300/j082v04n01_07","pmid":"363935","pmcid":null,"title":"Jeremy Bentham's essay on \"Paederasty\". Part 2","authors":"Crompton L.","first_author":"Crompton L.","journal":"Journal of homosexuality","year":1978,"pub_types":["Historical Article","Biography","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical transcription and commentary; no empirical data collected.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reproduces Jeremy Bentham’s 1785 essay on paederasty, arguing that harsh punishments stem from an irrational antipathy to sexual pleasure and discussing related issues such as blackmail, bestiality and masturbation.","clinical_takeaway":"None – the paper is a historical commentary, not a clinical study.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Provides historical context for attitudes toward same‑sex acts and masturbation","Primary source transcription of Bentham’s original manuscript"],"limitations":["No empirical data or systematic analysis","No measurement of constructs; purely interpretive"],"rubric_version":"2.0","raw_total":0,"max_possible":50,"pct_score":0,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":0,"neuroimaging":null,"statistics":0,"confounds":0,"design":0,"addiction_criteria":null,"interpretation":0}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v04n01_07"}},{"id":5342,"doi":"10.1023/a:1015252903931","pmid":"12049022","pmcid":null,"title":"Sexual experiences in childhood: young adults' recollections","authors":"Larsson I, Svedin CG.","first_author":"Larsson I","journal":"Archives of sexual behavior","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Anonymous questionnaire completed by 269 final‑year high‑school students (mean age 18.6). Cross‑sectional survey of recalled sexual experiences before age 13.","sample_n":269,"sample_text":"269 senior high‑school students, mean age 18.6 years.","population":"young adult students (mostly 18‑year‑olds), convenience sample, Sweden (presumed).","country":"Sweden (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 269 Swedish high‑school seniors asked them to recall sexual activities before age 13, finding that most had mutual or solitary experiences, some reported coercion, and girls reported more guilt and less masturbation than boys.","clinical_takeaway":"Childhood sexual experiences are varied; clinicians should consider both consensual exploration and coercive events when assessing adult sexual health.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large single‑site sample for a descriptive study","Anonymous reporting reduces social desirability bias","Includes both solitary and coercive experiences"],"limitations":["Self‑report recollections may be inaccurate","No validated measurement instruments","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":86,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1015252903931"}},{"id":5343,"doi":null,"pmid":"12166218","pmcid":null,"title":"[Retarded ejaculation]","authors":"Nagao K.","first_author":"Nagao K.","journal":"Nihon rinsho. Japanese journal of clinical medicine","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"jpn","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5344,"doi":"10.1023/a:1015205020769","pmid":"12049023","pmcid":null,"title":"Sexual motivation and the duration of partnership","authors":"Klusmann D.","first_author":"Klusmann D.","journal":"Archives of sexual behavior","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":162,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 1865 German university students (age 19‑32) in steady heterosexual partnerships; cross‑sectional analysis of self‑reported sexual activity, satisfaction, desire and tenderness across partnership duration.","sample_n":1865,"sample_text":"Students recruited via survey; convenience sample, likely WEIRD and not representative of general population.","population":"German university students, heterosexual, in steady partnership, ages 19‑32 (N=1865)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of German university students found that sexual activity and satisfaction tend to decline the longer a couple has been together, with women also showing reduced sexual desire over time, while men’s desire for tenderness changes differently.","clinical_takeaway":"Clinicians should consider partnership duration when discussing changes in sexual desire and satisfaction, but recognize that these patterns come from cross‑sectional data and may not imply causality.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Large sample size for a survey","Clear reporting of gender‑specific patterns","Authors acknowledge limits of cross‑sectional inference"],"limitations":["Convenience student sample limits generalisability","Use of likely non‑validated ad‑hoc questionnaire items","No control for key confounds (e.g., mental health, moral attitudes, masturbation)","Speculative evolutionary interpretation not directly tested"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":7,"contrasting":2,"mentioning":94,"citing_publications":322,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1015205020769"}},{"id":5346,"doi":"10.1016/s0306-4530(01)00066-x","pmid":"11912001","pmcid":null,"title":"Sexual behavior in lesbian and heterosexual women: relations with menstrual cycle phase and partner availability","authors":"Burleson MH, Trevathan WR, Gregory WL.","first_author":"Burleson MH","journal":"Psychoneuroendocrinology","year":2002,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective daily diary over three menstrual cycles (N=236)","sample_n":236,"sample_text":"147 heterosexual, 89 lesbian women; daily recordings over three cycles","population":"heterosexual and lesbian adult women","country":"USA (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a three‑month diary study of 236 women, both heterosexual and lesbian participants masturbated most often during the follicular and ovulatory phases of their menstrual cycle, while partnered sex peaked in the follicular phase. Having a live‑in partner reduced the menstrual‑phase effect on masturbation.","clinical_takeaway":"Masturbation frequency varies with hormonal cycle phases, especially for women without a live‑in partner.","confidence":0.7,"topic_tags":["masturbation","sexual_function"],"strengths":["Large prospective daily diary sample","Separate measurement of autosexual vs partnered behavior","Within‑subject menstrual phase analysis"],"limitations":["No validated sexuality scales; reliance on self‑report checklists","No assessment of mental‑health or moral variables that could confound distress","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":25,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0306-4530(01)00066-x"}},{"id":5347,"doi":"10.1007/s00345-001-0240-5","pmid":"12088193","pmcid":null,"title":"Systemic and cavernous plasma levels of vasoactive intestinal polypeptide during sexual arousal in healthy males","authors":"Becker AJ, Uckert S, Stief CG, Scheller F, Knapp WH, Machtens SA, Kuczyk MA, Jonas U.","first_author":"Becker AJ","journal":"World journal of urology","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Within‑subject laboratory study measuring VIP in systemic and cavernous blood during controlled visual/tactile erotic stimulation and ejaculation in 54 healthy men.","sample_n":54,"sample_text":"54 healthy adult male volunteers","population":"Healthy adult male volunteers (N=54), recruited probably from the community; no clinical or treatment‑seeking sample.","country":"Not specified (likely Germany based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured a peptide (VIP) in blood from the penis and arm of 54 healthy men while they watched erotic material and masturbated. VIP rose modestly during detumescence and after ejaculation, suggesting it helps but is not the main driver of erection.","clinical_takeaway":"VIP appears to contribute to later phases of male sexual arousal, but is not a primary target for erectile dysfunction treatment.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Physiological measurement with validated assay","Within‑subject design reduces between‑person variability","Clear operationalisation of arousal stages"],"limitations":["No pre‑registration or effect‑size reporting","Limited control for potential psychological confounds","Sample size modest for detecting small hormonal changes"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":0,"contrasting":1,"mentioning":7,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00345-001-0240-5"}},{"id":5348,"doi":"10.1080/00224490209552130","pmid":"12476243","pmcid":null,"title":"The Sexual Inhibition (SIS) and Sexual Excitation (SES) Scales: I. Measuring sexual inhibition and excitation proneness in men","authors":"Janssen E, Vorst H, Finn P, Bancroft J.","first_author":"Janssen E","journal":"Journal of sex research","year":2002,"pub_types":["Comparative Study","Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":178,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Validation study with three large samples (N=408, 459, 313) using factor analysis and confirmatory factor analysis.","sample_n":408,"sample_text":"First sample N=408; second N=459; third N=313","population":"Sexually functional men, ages 18‑46, community samples","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study created and validated the Sexual Inhibition and Sexual Excitation Scales (SIS/SES) for men, showing they reliably measure tendencies to feel sexually inhibited or excited across three large community samples.","clinical_takeaway":"These scales can help clinicians assess sexual inhibition/excitation tendencies, but do not address pornography use or addiction.","confidence":0.85,"topic_tags":["sexual_function","measurement"],"strengths":["Large multi‑sample validation","Factor analytic rigor","Good test‑retest reliability"],"limitations":["Male‑only, limited age range","No assessment of confounding variables (e.g., mental health, moral factors)","Cross‑sectional, cannot assess causal relationships"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":17,"contrasting":4,"mentioning":303,"citing_publications":304,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490209552130"}},{"id":5349,"doi":"10.1097/00005053-197710000-00009","pmid":"908927","pmcid":null,"title":"The clinical value of boredom. A procedure for reducing inappropriate sexual interests","authors":"Marshall WL, Lippens K.","first_author":"Marshall WL","journal":"The Journal of nervous and mental disease","year":1977,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case reports of a therapeutic procedure involving continuous masturbation and verbalization of deviant fantasies over nine 1.5‑hour sessions; no control group, no standardized outcome measures reported","sample_n":null,"sample_text":"not specified in abstract; likely a small clinical case series","population":"adult males with deviant sexual interests (paraphilic disorders)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A 1977 case series described a therapy where men with deviant sexual interests repeatedly masturbated while talking about their fantasies. The authors reported that the men's sexual interests shifted toward what they considered appropriate after nine long sessions.","clinical_takeaway":"No reliable evidence that this intensive masturbation‑plus‑verbalization therapy is effective; clinicians should rely on evidence‑based treatments for paraphilic disorders.","confidence":0.7,"topic_tags":["masturbation","sexual_function","other"],"strengths":["Novel therapeutic approach for paraphilic interests","Detailed procedural description"],"limitations":["No validated outcome measures","No control or comparison group","Small, unspecified sample size","Potential therapist bias and lack of blinding"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00005053-197710000-00009"}},{"id":5350,"doi":"10.1038/sj.ijir.3900823","pmid":"11979330","pmcid":null,"title":"Absence of orgasm-induced prolactin secretion in a healthy multi-orgasmic male subject","authors":"Haake P, Exton MS, Haverkamp J, Krämer M, Leygraf N, Hartmann U, Schedlowski M, Krueger TH.","first_author":"Haake P","journal":"International journal of impotence research","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single healthy multi‑orgasmic male compared to nine controls; hormone measurements during masturbation‑induced orgasm","sample_n":10,"sample_text":"1 multi‑orgasmic male subject; 9 healthy adult men with normal refractory period","population":"adult males (1 case, 9 controls)","country":"Germany (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A healthy man who can orgasm many times in a row did not show the usual rise in prolactin after each orgasm, unlike nine other men. The authors suggest this supports the idea that prolactin helps signal sexual satiety.","clinical_takeaway":"Evidence is limited; prolactin’s role in sexual refractory periods remains uncertain.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","religiosity","other"],"strengths":["validated hormonal assay","direct physiological measurement during orgasm","comparison to control group"],"limitations":["single case; no statistical inference","no control for potential confounds (mood, health)","cannot generalise to broader population"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/sj.ijir.3900823"}},{"id":5351,"doi":"10.1097/00007435-200204000-00005","pmid":"11912462","pmcid":null,"title":"Premarital sexual activities among students in a university in Beijing, China","authors":"Zhang L, Gao X, Dong Z, Tan Y, Wu Z.","first_author":"Zhang L","journal":"Sexually transmitted diseases","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of one university in Beijing, June 1999, anonymous self‑administered questionnaire","sample_n":null,"sample_text":"students at a university in Beijing (convenience sample)","population":"university students (male and female) in Beijing, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 1999 survey of Beijing university students found that 41% had engaged in premarital sexual activities, including kissing, masturbation (19%) and intercourse (12%), and that most who had intercourse used condoms.","clinical_takeaway":"Sex education programs should address both condom use and the prevalence of premarital sexual activity among college students.","confidence":0.7,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["Large proportion of students responded","Anonymous questionnaire reduces social desirability bias","Provides baseline data for public‑health planning"],"limitations":["Convenience sample from a single university limits generalisability","Self‑report without validated sexual‑behavior scales","No control for moral, mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":12,"contrasting":3,"mentioning":38,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00007435-200204000-00005"}},{"id":5353,"doi":"10.1007/s003830100679","pmid":"11956780","pmcid":null,"title":"Semen analysis in post-pubertal patients with posterior urethral valves: a pilot study","authors":"Puri A, Gaur KK, Kumar A, Bhatnagar V.","first_author":"Puri A","journal":"Pediatric surgery international","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pilot descriptive study of semen parameters in 8 post‑pubertal patients with posterior urethral valves; 5 provided samples; no control group.","sample_n":8,"sample_text":"Eight patients contacted; five provided semen samples.","population":"post‑pubertal males (16‑21 y) with posterior urethral valves, recruited from a single urology clinic (1985‑1999).","country":"India (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A tiny pilot study examined semen quality in eight teenage boys who had been treated for posterior urethral valves. Five gave samples, showing some abnormalities such as slower liquefaction and reduced sperm movement, but the clinical meaning is unclear.","clinical_takeaway":"In this small group, semen abnormalities were noted; clinicians should monitor fertility but cannot draw firm conclusions.","confidence":0.8,"topic_tags":["sexual_function","religiosity","masturbation","csbd"],"strengths":["Objective laboratory measurement of semen parameters","Focus on a rare clinical population","Clear description of methods"],"limitations":["Very small sample; no statistical testing","No comparison group or longitudinal follow‑up","Potential selection bias (clinic attendees only)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":2,"mentioning":25,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s003830100679"}},{"id":5354,"doi":"10.1207/s15327752jpa4103_4","pmid":"886421","pmcid":null,"title":"Gender-specific variances in sexual fantasy","authors":"Mednick RA.","first_author":"Mednick RA.","journal":"Journal of personality assessment","year":1977,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study with 93 graduate‑student volunteers (48 male, 45 female).","sample_n":93,"sample_text":"48 male, 45 female graduate students","population":"graduate‑student volunteers (likely WEIRD sample)","country":"USA (assumed from journal, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study asked 93 graduate students to describe their sexual fantasies in three contexts. It found that women more often imagined themselves receiving sexual activity, while men imagined the sexual object receiving it. Small gender differences also appeared in other conditions.","clinical_takeaway":"None – findings are descriptive of fantasy patterns and not directly relevant to clinical practice.","confidence":0.6,"topic_tags":["sexual_function","gender"],"strengths":["Provides rich narrative data on sexual fantasy content","Gender‑balanced sample for exploratory analysis"],"limitations":["Small, non‑representative convenience sample","No validated measurement instrument","No control for relevant confounds (e.g., mood, sexual experience)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1207/s15327752jpa4103_4"}},{"id":5355,"doi":"10.7326/0003-4819-86-5-588","pmid":"322565","pmcid":null,"title":"Marital sexual dysfunction: female dysfunctions","authors":"Levine SB, Rosenthal M.","first_author":"Levine SB","journal":"Annals of internal medicine","year":1977,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review of clinical knowledge and case reports; no original empirical data.","sample_n":null,"sample_text":"Not applicable – review of existing literature and case reports.","population":"Married women with sexual dysfunction (historical, clinical perspective).","country":"United States (presumed based on journal).","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how doctors should evaluate and treat married women who have trouble with sexual excitement, orgasm, or pain during intercourse, emphasizing the need to consider desire, past sexual experiences, and marital factors.","clinical_takeaway":"Clinicians should assess both physiological and relational aspects when addressing female marital sexual dysfunction.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive clinical overview of female marital sexual dysfunctions.","Discusses multiple relevant factors (desire, orgasm, marital context)."],"limitations":["No original data; relies on anecdotal case reports.","Lacks systematic methodology or quality appraisal of sources.","No validated measurement instruments cited."],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":3,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7326/0003-4819-86-5-588"}},{"id":5356,"doi":"10.1007/bf01541128","pmid":"869707","pmcid":null,"title":"Attitudes toward sex in the aged","authors":"LaTorre RA, Kear K.","first_author":"LaTorre RA","journal":"Archives of sexual behavior","year":1977,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of attitudes using story ratings; convenience sample of 80 students and 40 nursing‑home staff; no longitudinal or experimental manipulation","sample_n":120,"sample_text":"80 university students and 40 staff members of a nursing home for the aged","population":"university students and nursing‑home staff (aged adults)","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"University students and nursing‑home staff rated short stories about sex and masturbation involving characters of different ages. Both groups showed generally positive attitudes toward older adults having sex, though they judged such sex as less believable than that of younger people.","clinical_takeaway":"Attitudes toward senior sexuality are generally favorable, but may underestimate its realism; clinicians should consider potential age‑related biases when discussing sexual health with older adults.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Direct comparison of student vs staff attitudes","Inclusion of both coital and masturbatory scenarios","Systematic manipulation of character age and gender"],"limitations":["Ad‑hoc attitude measure, no validation","Convenience sample, limited generalisability","No effect‑size reporting or correction for multiple tests"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541128"}},{"id":5358,"doi":"10.1093/her/17.1.43","pmid":"11890176","pmcid":null,"title":"The Sexual Health Model: application of a sexological approach to HIV prevention","authors":"Robinson BB, Bockting WO, Rosser BR, Miner M, Coleman E.","first_author":"Robinson BB","journal":"Health education research","year":2002,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":101,"is_preprint":false,"topics":["masturbation","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review/model paper; no primary empirical data; discusses a sexual health framework for HIV prevention.","sample_n":null,"sample_text":"Not applicable","population":"Not applicable (model description)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article proposes a Sexual Health Model with ten components—like masturbation, intimacy, and spirituality—to improve HIV prevention education. It argues for culturally specific, comprehensive sex education but provides little direct evidence of effectiveness.","clinical_takeaway":"The model offers a conceptual guide for designing HIV‑prevention programs; clinicians should await empirical validation before adopting it as evidence‑based practice.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad, holistic framework for sexual health","Integrates cultural relevance into HIV prevention"],"limitations":["No primary empirical data presented","Lacks psychometric validation of components","No quantitative evaluation of model effectiveness"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":188,"citing_publications":197,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/her/17.1.43"}},{"id":5359,"doi":null,"pmid":"22220","pmcid":null,"title":"[Neurotic masturbation and infantile depression: clinico-therapeutic approach and possible neuro-psychological explanation]","authors":"Cocchi R, Ghiglione Rocca R.","first_author":"Cocchi R","journal":"Acta neurologica","year":1977,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ita","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5360,"doi":"10.1016/s0149-7634(01)00036-7","pmid":"11835982","pmcid":null,"title":"Orgasm-induced prolactin secretion: feedback control of sexual drive?","authors":"Krüger TH, Haake P, Hartmann U, Schedlowski M, Exton MS.","first_author":"Krüger TH","journal":"Neuroscience and biobehavioral reviews","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":100,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review proposing a theoretical model; no systematic methods reported.","sample_n":null,"sample_text":"Not applicable – no primary data collected","population":"Humans (both sexes) and animal studies referenced","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review studies showing that prolactin levels spike after orgasm and suggest this hormone may act as a feedback signal that reduces sexual arousal, possibly explaining drops in libido after orgasm.","clinical_takeaway":"Elevated prolactin after orgasm may transiently dampen sexual desire; clinicians should consider hormonal factors when evaluating low libido.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Integrates human and animal data","Highlights prolactin’s temporal dynamics post‑orgasm"],"limitations":["No systematic literature search","Absent quantitative synthesis","No primary data; conclusions are speculative"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":94,"citing_publications":182,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0149-7634(01)00036-7"}},{"id":5361,"doi":null,"pmid":"12087727","pmcid":null,"title":"[Deviation in psychosexual development in the pre-puberty children]","authors":"Liavshina GKh.","first_author":"Liavshina GKh.","journal":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","year":2002,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"rus","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"cross-sectional case series of 308 children assessing psychosexual development; no clear sampling frame reported","sample_n":308,"sample_text":"Children 2‑11 years, recruited for a clinical assessment of psychosexual health (sampling method not specified)","population":"children aged 2‑11 years (N=308) and their families","country":"Russia (journal of S.S. Korsakov)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined 308 children (2‑11 years) and found that about one‑third showed atypical psychosexual development, including gender‑related behavior issues, early or delayed development, and obsessive masturbation.","clinical_takeaway":"Early identification of atypical psychosexual patterns may warrant monitoring, but no specific treatment guidance is provided.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a case series","Addresses a gap in early‑child psychosexual research"],"limitations":["No validated psychosexual instruments","No measurement of key confounds (moral, mental health, trauma)","Cross‑sectional, no causal inference"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":5362,"doi":"10.1177/107906320201400103","pmid":"11803594","pmcid":null,"title":"Resiliency in the victim-offender cycle in male sexual abuse","authors":"Lambie I, Seymour F, Lee A, Adams P.","first_author":"Lambie I","journal":"Sexual abuse : a journal of research and treatment","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control interview study comparing 47 resilient male victims with 41 victim‑offender male sexual abusers; age and education adjusted","sample_n":88,"sample_text":"Resilient group (n=47) and victim‑offender group (n=41)","population":"Male survivors of childhood sexual abuse, some of whom later offended; recruited from unspecified sources (likely clinical/forensic)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers compared men who were abused as children and later re‑offended with those who did not re‑offend. Those who stayed out of offending were less likely to fantasise or masturbate about the abuse, had more peer contact and stronger family support.","clinical_takeaway":"Early social support and addressing sexual fantasies may help prevent the victim‑offender cycle in male abuse survivors.","confidence":0.6,"topic_tags":["sexual_function","religiosity","moral_incongruence","masturbation","adolescents"],"strengths":["Direct interview of two relevant groups","Adjustment for age and education","Identification of multiple protective factors"],"limitations":["Small, non‑representative sample","Reliance on ad‑hoc interview items, no validated scales","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":38,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/107906320201400103"}},{"id":5366,"doi":"10.1023/a:1013115301159","pmid":"11808847","pmcid":"PMC3455247","title":"The effect of single-dose oxytocin application on time to ejaculation and seminal parameters in men","authors":"Walch K, Eder R, Schindler A, Feichtinger W.","first_author":"Walch K","journal":"Journal of assisted reproduction and genetics","year":2001,"pub_types":["Clinical Trial","research-article","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Randomized controlled trial with 103 healthy men (49 oxytocin, 54 control) measuring ejaculation latency and WHO‑standard semen parameters.","sample_n":103,"sample_text":"103 consecutive healthy men; 49 received intranasal oxytocin, 54 received no treatment.","population":"Healthy adult men (semen donors or partners of IVF patients)","country":"Not specified (private assisted reproduction centre)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a randomized trial of 103 healthy men, a single intranasal dose of oxytocin did not change how quickly men ejaculated or alter standard semen quality measures compared with a control group.","clinical_takeaway":"A single intranasal oxytocin dose appears ineffective for altering ejaculation timing or semen quality in healthy men.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Randomized allocation","Objective physiological outcomes","Adequate sample size for a simple between‑group comparison"],"limitations":["No pre‑registration or publicly available protocol","Effect sizes and confidence intervals not reported","Single dose only; no dose‑response assessment"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1013115301159"}},{"id":5368,"doi":"10.1542/peds.108.5.1233","pmid":"11694711","pmcid":null,"title":"Blue balls","authors":"Rockney R, Alario AJ.","first_author":"Rockney R","journal":"Pediatrics","year":2001,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.108.5.1233"}},{"id":5369,"doi":"10.1164/ajrccm.164.9.2103020","pmid":"11719298","pmcid":null,"title":"Sexuality in patients with noninvasive mechanical ventilation due to chronic respiratory failure","authors":"Schönhofer B, Von Sydow K, Bucher T, Nietsch M, Suchi S, Köhler D, Jones PW.","first_author":"Schönhofer B","journal":"American journal of respiratory and critical care medicine","year":2001,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control observational survey of patients on NMV versus matched controls; convenience sample; response rate 54 %; no longitudinal data","sample_n":207,"sample_text":"383 patients invited, 54 % returned questionnaire; control group size not specified in abstract","population":"patients with chronic respiratory failure using non‑invasive mechanical ventilation (age > 40 yr), Germany","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"People on long‑term non‑invasive ventilation for chronic lung disease report far less sexual activity and masturbation than healthy controls, and many say the ventilator changes their sex life, especially fantasies in men.","clinical_takeaway":"Chronic respiratory failure and its treatment markedly reduce patients’ sexual activity; clinicians should discuss sexual health proactively.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["large clinical sample for a respiratory cohort","objective physiologic measurements","includes control comparison"],"limitations":["questionnaire not validated","low response rate, possible selection bias","no control for key psychosocial confounds (moral, mental health, trauma)","cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":1,"mentioning":17,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1164/ajrccm.164.9.2103020"}},{"id":5371,"doi":null,"pmid":"792763","pmcid":null,"title":"[Masturbation; sociological and psychological data, current medical concepts and unusual forms]","authors":"Béla B.","first_author":"Béla B.","journal":"Orvosi hetilap","year":1976,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"hun","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5372,"doi":"10.1007/bf01541333","pmid":"985058","pmcid":null,"title":"Vaginal blood volume responses during masturbation","authors":"Geer JH, Quartararo JD.","first_author":"Geer JH","journal":"Archives of sexual behavior","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541333"}},{"id":5373,"doi":"10.1007/bf01541336","pmid":"985061","pmcid":null,"title":"Masturbatory attitudes, knowledge, and experience: data from the Sex Knowledge and Attitude Test (SKAT)","authors":"Muller WR, Lief HI.","first_author":"Muller WR","journal":"Archives of sexual behavior","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":2,"contrasting":0,"mentioning":7,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541336"}},{"id":5374,"doi":null,"pmid":"787876","pmcid":null,"title":"[Old medical opinions on masturbation. History of a strange iatrogenic problem]","authors":"Buda B.","first_author":"Buda B.","journal":"Orvosi hetilap","year":1976,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"hun","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5375,"doi":"10.1177/007327530103900302","pmid":"11712571","pmcid":null,"title":"The Rev. John Wesley's extractions from Dr Tissot: a Methodist imprimatur","authors":"Donat JG.","first_author":"Donat JG.","journal":"History of science","year":2001,"pub_types":["Historical Article","Biography","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/007327530103900302"}},{"id":5376,"doi":"10.1093/ije/5.2.121","pmid":"955759","pmcid":null,"title":"Social and behavioural aspects of venereal disease among resident male university students","authors":"Babu DS, Marwah SM, Singh G.","first_author":"Babu DS","journal":"International journal of epidemiology","year":1976,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large convenience sample of 1500 male university students surveyed for venereal disease prevalence and associated behaviours","sample_n":1500,"sample_text":"1500 male students","population":"male university students, Banaras Hindu University, India","country":"India","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1976 survey of 1500 male university students in India found a 3.9% prevalence of venereal disease. Higher rates were linked to certain castes, acceptance of multiple wives, masturbation, homosexuality, and contact with prostitutes.","clinical_takeaway":"Clinicians should consider sociocultural and behavioural factors when assessing STI risk in young men.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample size for the setting","Inclusion of multiple sociocultural variables (caste, religion)"],"limitations":["Reliance on self‑report without validated instruments","Cross‑sectional design limits causal inference","Key confounders (mental health, partner context) not assessed"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/ije/5.2.121"}},{"id":5377,"doi":"10.1023/a:1010257214859","pmid":"11446198","pmcid":null,"title":"Sexual dysfunction: a neglected complication of panic disorder and social phobia","authors":"Figueira I, Possidente E, Marques C, Hayes K.","first_author":"Figueira I","journal":"Archives of sexual behavior","year":2001,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":72,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective comparison of 30 social‑phobia patients and 28 panic‑disorder patients using SCID‑I interviews; DSM‑IV criteria applied to diagnose sexual dysfunctions.","sample_n":58,"sample_text":"30 patients with social phobia and 28 patients with panic disorder.","population":"Adult patients with DSM‑IV panic disorder or social phobia, recruited from clinical settings (likely convenience sample).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A retrospective study of 58 patients found that sexual problems are common in both panic disorder and social phobia, especially sexual aversion in panic disorder and premature ejaculation in social phobia.","clinical_takeaway":"Clinicians should screen for sexual dysfunction when treating patients with panic disorder or social phobia.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Use of a structured diagnostic interview (SCID‑I)","Clear DSM‑IV criteria for sexual dysfunctions","Direct comparison of two anxiety disorders"],"limitations":["Small, clinical convenience sample limits generalisability","No control for key confounds (partner status, mood, trauma, moral factors)","No effect sizes or power analysis reported"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":123,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1010257214859"}},{"id":5378,"doi":"10.1007/bf01541370","pmid":"952604","pmcid":null,"title":"Electroencephalographic laterality changes during human sexual orgasm","authors":"Cohen HD, Rosen RC, Goldstein L.","first_author":"Cohen HD","journal":"Archives of sexual behavior","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":51,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"laboratory physiological study with EEG recordings during self‑stimulation","sample_n":7,"sample_text":"seven subjects; 12 experiments (multiple recordings per subject)","population":"seven adult participants (mixed gender) recruited for a controlled masturbation task","country":"USA (assumed based on journal and authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small lab study, researchers recorded brain waves while seven people masturbated to orgasm and found brief shifts in left‑right brain activity during climax.","clinical_takeaway":"Findings are preliminary; no direct clinical implications.","confidence":0.4,"topic_tags":["sexual_function","neuroscience","masturbation"],"strengths":["Early physiological measurement of brain activity during orgasm","Attempts to control for obvious movement artefacts"],"limitations":["Very small sample (N=7)","No validated behavioural or psychological measures","Potential over‑interpretation of EEG laterality"],"rubric_version":"2.0","raw_total":20,"max_possible":60,"pct_score":33,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":3,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":40,"citing_publications":106,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541370"}},{"id":5379,"doi":"10.1176/appi.psychotherapy.1976.30.2.236","pmid":"937588","pmcid":null,"title":"Amplification of the erotic enema deviance","authors":"Denko JD.","first_author":"Denko JD.","journal":"American journal of psychotherapy","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Descriptive case report or brief commentary on klismaphilia without systematic data collection.","sample_n":null,"sample_text":"Not reported; likely a very small, non-representative convenience sample.","population":"Not specified; likely a small number of individuals with reported enema-related sexual practices.","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article describes klismaphilia—sexual interest in enemas—mentioning how it can appear alone or with other fetishes, in various sexual contexts. No systematic data are provided.","clinical_takeaway":"None - not clinically applicable.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Historical perspective on a rare paraphilia","Identifies various contexts of klismaphilia"],"limitations":["No empirical data or systematic measurement","No controls for major confounds (moral, mental health, etc.)","Small, non‑representative sample"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.psychotherapy.1976.30.2.236"}},{"id":5380,"doi":"10.1046/j.1365-2702.2001.00499.x","pmid":"11822505","pmcid":null,"title":"Sexual problems in men with prostate cancer in comparison with men with benign prostatic hyperplasia and men from the general population","authors":"Jakobsson L, Lovén L, Hallberg IR.","first_author":"Jakobsson L","journal":"Journal of clinical nursing","year":2001,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative questionnaire survey of men with prostate cancer, BPH, and general population (n≈415).","sample_n":415,"sample_text":"Convenience sample recruited via clinical settings and community; not a probability sample.","population":"Men with prostate cancer (n=155), benign prostatic hyperplasia (n=131), and general population controls (n=129).","country":"Sweden (inferred from authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Men with prostate cancer or an enlarged prostate report more sexual problems—lower desire, pleasure, erectile function and satisfaction—than men from the general population. They do not use masturbation or aids as substitutes, and many lack information about treatment effects on sexuality.","clinical_takeaway":"Clinicians should proactively discuss sexual side‑effects and provide information or support for men undergoing prostate treatment.","confidence":0.6,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Relatively large total sample size","Includes two clinical groups and a community comparison","Addresses multiple domains of sexual function"],"limitations":["Cross‑sectional design; cannot infer causality","Questionnaire details unclear; likely uses non‑validated items","Potential selection bias from clinical 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Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1746-1561.1976.tb03099.x"}},{"id":5382,"doi":"10.1016/s0020-7292(01)00350-2","pmid":"11376679","pmcid":null,"title":"Aerosol caps and vesicovaginal fistulas","authors":"Fourie T, Ramphal S.","first_author":"Fourie T","journal":"International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics","year":2001,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0020-7292(01)00350-2"}},{"id":5383,"doi":"10.1080/00797308.1976.11822319","pmid":"981443","pmcid":null,"title":"The central masturbation fantasy, the final sexual organization, and adolescence","authors":"Laufer M.","first_author":"Laufer M.","journal":"The Psychoanalytic study of the child","year":1976,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00797308.1976.11822319"}},{"id":5384,"doi":"10.1177/000306517602400101","pmid":"803149","pmcid":null,"title":"Freud's views on early female sexuality in the light of direct child observation","authors":"Kleeman JA.","first_author":"Kleeman JA.","journal":"Journal of the American Psychoanalytic Association","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"No empirical sample; article is a theoretical review of observations.","population":"humans (children), theoretical discussion","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews Freud’s ideas about young girls’ sexuality and compares them with direct observations of children, arguing that cognition, learning, and language are more influential than Freud’s concepts like penis envy.","clinical_takeaway":"None – the piece is a historical psychoanalytic review, not a source of clinical evidence.","confidence":0.8,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Historical synthesis of early observations","Highlights gendered differences in masturbation development"],"limitations":["No original data presented","Lacks empirical measurement of constructs","Potential bias from psychoanalytic perspective"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":69,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000306517602400101"}},{"id":5385,"doi":"10.1080/00926237608407070","pmid":"1271478","pmcid":null,"title":"Issues and dilemmas in sexual treatment","authors":"Lassen CL.","first_author":"Lassen CL.","journal":"Journal of sex & marital therapy","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Journal commentary discussing clinical dilemmas without empirical data.","sample_n":null,"sample_text":"No empirical sample; article is a discussion of treatment issues.","population":"None (no participants)","country":"United States (inferred from journal, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article outlines five common dilemmas therapists face when treating sexual problems, including value conflicts, coping with impotence, the role of masturbation, women's self‑concept, and therapist gender issues.","clinical_takeaway":"Clinicians should be aware of personal and cultural value conflicts that can affect sexual therapy.","confidence":0.6,"topic_tags":["sexual_function","masturbation","treatment"],"strengths":["Broad clinical perspective","Considers cultural and historical context"],"limitations":["No empirical data or systematic methodology","No measurement of key variables","Outdated terminology and perspectives"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926237608407070"}},{"id":5387,"doi":null,"pmid":"11508051","pmcid":null,"title":"[An unusual autoerotic accident: sexual pleasure from peritoneal pain]","authors":"Schmeling A, Correns A, Geserick G.","first_author":"Schmeling A","journal":"Archiv fur Kriminologie","year":2001,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"1 fatal case","population":"single male adult (23 y) fatal autoerotic accident","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 23‑year‑old man fashioned a device to pierce his abdomen during masturbation, seeking pleasure from the pain. The setup failed, causing fatal abdominal injury.","clinical_takeaway":"None – the report describes a rare, fatal accident and does not inform clinical practice.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Unique, rare clinical description","Clear chronological account of the accident"],"limitations":["Single case; no generalizability","No systematic measurement of constructs","No controls or comparison"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":5388,"doi":null,"pmid":"1239436","pmcid":null,"title":"[The treatment of anorgasmia in males]","authors":"Vogt HJ.","first_author":"Vogt HJ.","journal":"Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of 30 patients treated with an electro‑vibrator, no control group, outcomes described qualitatively","sample_n":30,"sample_text":"30 patients with primary anorgasmia (plus some secondary cases) treated with an electro‑vibrator","population":"adult males with primary (and some secondary) anorgasmia, treated in a dermatology/venereology setting","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In 1975, 30 men who could not reach orgasm despite erections were given an electro‑vibrating device. Twenty‑six reported improvement, leading the author to suggest mechanical aids plus counseling for primary anorgasmia.","clinical_takeaway":"Mechanical stimulation may help primary male anorgasmia, but evidence is limited to an uncontrolled case series.","confidence":0.7,"topic_tags":["sexual_function","masturbation","treatment"],"strengths":["Clear clinical definition of primary anorgasmia","Practical treatment description (electro‑vibrator)","Acknowledges prior failed attempts with medication/psychotherapy"],"limitations":["No control or comparison group","Outcome not measured with validated scales","Small, non‑random sample of treatment‑seeking men","No statistical analysis reported"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":5389,"doi":"10.1080/014850101316901280","pmid":"11554690","pmcid":null,"title":"Interleukin-6 (IL-6) in seminal plasma of infertile men, and lipid peroxidation of their sperm","authors":"Camejo MI, Segnini A, Proverbio F.","first_author":"Camejo MI","journal":"Archives of andrology","year":2001,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case-control comparison of seminal biomarkers in 37 infertile vs 14 fertile men, collected by masturbation","sample_n":51,"sample_text":"37 infertile men, 14 fertile men","population":"men (infertile and fertile) recruited from a clinical setting","country":"unspecified (likely Spain/Italy based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found higher levels of the immune protein IL‑6 and greater sperm membrane damage in men with infertility compared to fertile men, suggesting a link between inflammation and sperm health.","clinical_takeaway":"Elevated seminal IL‑6 may be a biomarker of oxidative sperm damage in infertility.","confidence":0.78,"topic_tags":["sexual_function","religiosity","moral_incongruence"],"strengths":["Validated biochemical assays","Direct comparison of fertile vs infertile men","Clear statistical correlation reported"],"limitations":["Small sample, especially control group","No power calculation or effect sizes","Potential unmeasured confounders (age, lifestyle)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":46,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/014850101316901280"}},{"id":5390,"doi":"10.1016/s0306-4530(00)00053-6","pmid":"11166491","pmcid":null,"title":"Coitus-induced orgasm stimulates prolactin secretion in healthy subjects","authors":"Exton MS, Krüger TH, Koch M, Paulson E, Knapp W, Hartmann U, Schedlowski M.","first_author":"Exton MS","journal":"Psychoneuroendocrinology","year":2001,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"within‑subject laboratory trial measuring plasma prolactin before, during and after coitus in 10 heterosexual couples","sample_n":20,"sample_text":"Ten couples (20 individuals) participated.","population":"healthy adult volunteers (10 male‑female pairs)","country":"Germany (assuming based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In ten couples, blood levels of the hormone prolactin rose sharply after orgasm during intercourse and stayed high for an hour, suggesting the hormone may help regulate sexual desire after sex.","clinical_takeaway":"Prolactin surges after orgasm may temporarily reduce sexual desire; not directly relevant to clinical practice.","confidence":0.75,"topic_tags":["sexual_function","neuroscience"],"strengths":["Objective hormonal measurement","Within‑subject repeated‑measure design","Clear temporal sampling around orgasm"],"limitations":["Very small sample size (N=20)","No control for time‑of‑day, menstrual cycle, or other physiological confounds","Findings limited to acute hormone response, not linked to behavior"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":45,"citing_publications":91,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0306-4530(00)00053-6"}},{"id":5391,"doi":"10.1007/bf01542131","pmid":"53040","pmcid":null,"title":"Sexual experience and sexual responsiveness: sex differences","authors":"Griffitt W.","first_author":"Griffitt W.","journal":"Archives of sexual behavior","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional convenience sample of 60 undergraduates","sample_n":60,"sample_text":"30 male, 30 female undergraduate students","population":"college undergraduate men and women, age not specified","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"College men and women rated photographs of sexual activities, including a slide of solo masturbation. Women’s past heterosexual experience predicted their arousal, while men’s masturbation experience did. The study links personal sexual experience to immediate sexual responsiveness.","clinical_takeaway":"None – the study offers no direct clinical guidance.","confidence":0.6,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Direct assessment of subjective arousal to visual stimuli","Measures both sexual experience and immediate responsiveness","Includes both male and female participants"],"limitations":["Small, non‑representative convenience sample","No validated instruments for arousal or affect","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542131"}},{"id":5392,"doi":"10.1037/h0076830","pmid":"1159146","pmcid":null,"title":"Development of a measure of negative attitudes toward masturbation","authors":"Abramson PR, Mosher DL.","first_author":"Abramson PR","journal":"Journal of consulting and clinical psychology","year":1975,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":105,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/h0076830"}},{"id":5393,"doi":"10.3109/01674820109049948","pmid":"11317607","pmcid":null,"title":"Sexual activity during pregnancy and after childbirth: results from the Sexual Preferences Questionnaire","authors":"von Sydow K, Ullmeyer M, Happ N.","first_author":"von Sydow K","journal":"Journal of psychosomatic obstetrics and gynaecology","year":2001,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"longitudinal questionnaire of 30 German couples (60 individuals) assessing frequency of various sexual activities during pregnancy and first 6 months postpartum","sample_n":60,"sample_text":"30 couples (60 individuals) completed the Sexual Preferences Questionnaire","population":"German expectant and young parents (30 couples)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 30 German couples, most sexual activities dropped during pregnancy and were near zero in the first three months after birth, then gradually rose again, while men’s masturbation stayed steady.","clinical_takeaway":"Expect a temporary decline in partnered sexual activity after childbirth; reassure couples that this pattern is common and often rebounds.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Longitudinal within‑couple design captures change across pregnancy and postpartum","Includes both partners, allowing agreement analysis","Broad range of sexual behaviors beyond intercourse"],"limitations":["Small, non‑representative convenience sample (30 couples)","Newly developed questionnaire with limited psychometric validation","No power analysis or effect‑size reporting"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":22,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/01674820109049948"}},{"id":5394,"doi":"10.1016/s0140-6736(05)71492-6","pmid":"11247595","pmcid":null,"title":"Spermatorrhoea","authors":"Bynum B.","first_author":"Bynum B.","journal":"Lancet (London, England)","year":2001,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0140-6736(05)71492-6"}},{"id":5395,"doi":"10.1046/j.1365-2788.2001.00285.x","pmid":"11168780","pmcid":null,"title":"Experiences of staff in dealing with client sexuality in services for teenagers and adults with intellectual disability","authors":"McConkey R, Ryan D.","first_author":"McConkey R","journal":"Journal of intellectual disability research : JIDR","year":2001,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 150 staff from one community health trust; self‑completion questionnaire developed for study; cross‑sectional descriptive analysis.","sample_n":150,"sample_text":"150 staff respondents (response rate not reported)","population":"staff working with teenagers and adults with intellectual disability in Northern Ireland","country":"United Kingdom (Northern Ireland)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 150 staff working with people with intellectual disability found that two‑thirds had dealt with sexual incidents (e.g., public masturbation). Those with prior experience felt more confident, especially residential staff. Many wanted more training and clear policies.","clinical_takeaway":"Staff need targeted training and clear guidelines to handle client sexuality confidently.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Targeted a previously understudied aspect (staff experience)","Full‑trust area sampling captures multiple service types","Provides practical recommendations for training"],"limitations":["Questionnaire not validated","Convenience sample, possible response bias","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":2,"mentioning":29,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1046/j.1365-2788.2001.00285.x"}},{"id":5396,"doi":"10.1177/135245850100700111","pmid":"11321196","pmcid":null,"title":"Episodic hyperlibidinism in multiple sclerosis","authors":"Gondim FA, Thomas FP.","first_author":"Gondim FA","journal":"Multiple sclerosis (Houndmills, Basingstoke, England)","year":2001,"pub_types":["Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report describing episodic hypersexuality in multiple sclerosis with neuroimaging and neuropsychological assessment","sample_n":1,"sample_text":"N=1 (case report)","population":"one adult with multiple sclerosis experiencing episodic hyperlibidinism","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A single patient with multiple sclerosis experienced brief episodes of extremely high sexual desire. Brain scans and cognitive tests suggested frontal‑lobe problems, but hormone levels were normal. The authors propose that such episodic hypersexuality can be a transient symptom of MS.","clinical_takeaway":"Episodic spikes in libido may reflect neurological changes in MS, but single‑case evidence is insufficient for clinical guidance.","confidence":0.8,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Detailed multimodal clinical description","Integration of neuroimaging and neuropsychology"],"limitations":["Single case, no control group","No validated measures of hypersexuality or distress","No assessment of confounding factors (e.g., mood, partner context)"],"rubric_version":"2.0","raw_total":12,"max_possible":60,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":2,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/135245850100700111"}},{"id":5397,"doi":"10.1097/00005392-200102000-00017","pmid":"11176388","pmcid":null,"title":"Nonoperative treatment of patients with presumed penile fracture","authors":"Mydlo JH, Gershbein AB, Macchia RJ.","first_author":"Mydlo JH","journal":"The Journal of urology","year":2001,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 5 patients with presumed penile fracture managed non‑operatively; follow‑up at 6 and 12 months.","sample_n":5,"sample_text":"5 patients","population":"young adult males (19‑31 y) with blunt penile trauma; all refused surgery.","country":"United States (institution unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A tiny case series (5 men) who refused surgery after a suspected penile fracture were followed for a year; all kept normal erections, with only one mild curvature reported.","clinical_takeaway":"Non‑operative care may preserve function in select cases, but evidence is limited; surgery remains standard.","confidence":0.8,"topic_tags":["sexual_function","gender","treatment"],"strengths":["Rare focus on non‑operative management","Longitudinal follow‑up up to 12 months"],"limitations":["Very small N (5)","No imaging or objective confirmation of fracture","No control group"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00005392-200102000-00017"}},{"id":5398,"doi":"10.1007/bf01541627","pmid":"1130986","pmcid":null,"title":"Secondary orgasmic dysfunction. II. Case study","authors":"Snyder A, LoPiccolo L, LoPiccolo J.","first_author":"Snyder A","journal":"Archives of sexual behavior","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Single‑case behavioural retraining of orgasmic response, with concurrent marital intervention; outcome described descriptively.","sample_n":1,"sample_text":"single case (one couple)","population":"one heterosexual couple (N=1 dyad)","country":"USA (assumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1975 case report describes a behavioural program that taught a couple to shift orgasmic response from solo masturbation to intercourse, while also addressing marital issues. The authors report the couple’s orgasmic function improved after treatment.","clinical_takeaway":"Behavioural retraining combined with relationship work may help secondary orgasmic dysfunction, but evidence is limited to one case.","confidence":0.4,"topic_tags":["sexual_function","masturbation","relationships"],"strengths":["Detailed description of behavioural intervention","Integration of marital context"],"limitations":["Single case; no statistical analysis","No validated outcome measures","Findings not generalisable"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541627"}},{"id":5399,"doi":"10.1016/0306-9877(75)90053-5","pmid":"1196161","pmcid":null,"title":"Masturbation and nocturnal emissions--possible mechanisms for minimising teratozoospermie and hyperpermie in man","authors":"Levin RJ.","first_author":"Levin RJ.","journal":"Medical hypotheses","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0306-9877(75)90053-5"}},{"id":5400,"doi":"10.1080/00926230152035840","pmid":"11224953","pmcid":null,"title":"Treatment of paraphilia with luteinizing hormone-releasing hormone agonists","authors":"Briken P, Nika E, Berner W.","first_author":"Briken P","journal":"Journal of sex & marital therapy","year":2001,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 11 treatment‑seeking men with paraphilic disorders receiving leuprolide for 12 months; no control group; outcomes described descriptively.","sample_n":11,"sample_text":"11 patients treated with LHRH agonist","population":"Adult male patients (n≈11) with paraphilic disorders (pedophilia, sadism, sexual aggression).","country":"Germany (German‑speaking countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"Eleven men with paraphilic disorders were given a hormone drug (leuprolide) for a year; they reported less sexual arousal, masturbation, and deviant fantasies, with one suicide reported. The authors suggest the drug could be a useful alternative to existing treatments.","clinical_takeaway":"Evidence is limited; leuprolide may reduce sexual drive in paraphilia but safety and efficacy remain uncertain.","confidence":0.7,"topic_tags":["treatment","lgbtq","sexual_function","csbd"],"strengths":["clinical relevance for a hard‑to‑treat population","12‑month follow‑up","use of a pharmacological alternative to cyproterone"],"limitations":["very small, uncontrolled case series","no validated outcome measures","no assessment of confounding factors (e.g., mental health, moral factors)","single‑case mortality not examined"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230152035840"}},{"id":5401,"doi":null,"pmid":"11215350","pmcid":null,"title":"[The aging woman, an asexual being? Erotically more active than previously assumed]","authors":"Rautenstrauch J.","first_author":"Rautenstrauch J.","journal":"MMW Fortschritte der Medizin","year":2001,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5402,"doi":"10.1097/00002030-200101050-00016","pmid":"11192852","pmcid":null,"title":"Effect of computer-assisted self-interviews on reporting of sexual HIV risk behaviours in a general population sample: a methodological experiment","authors":"Johnson AM, Copas AJ, Erens B, Erens B, Mandalia S, Fenton K, Korovessis C, Wellings K, Field J.","first_author":"Johnson AM","journal":"AIDS (London, England)","year":2001,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":93,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Probability sample of 901 adults, addresses randomly assigned to CASI (462) or PAPI (439); comparison of reporting rates using GEE.","sample_n":901,"sample_text":"Probability sample of residents aged 16‑44 years in Britain, alternate assignment to CASI or PAPI.","population":"General population adults 16‑44 in Britain (N≈901)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a British survey of 901 adults, using a computer‑assisted self‑interview (CASI) improved data consistency and reduced missing answers compared with paper questionnaires, but did not change how often participants reported risky sexual behaviours.","clinical_takeaway":"CASI can be used to obtain more complete sexual‑behaviour data without inflating reported risk.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large probability sample","Randomized assignment to interview mode","Clear reporting of effect sizes with CIs"],"limitations":["No measurement of moral or mental‑health confounds","No pre‑registration","Limited to self‑report; no objective validation"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":84,"citing_publications":127,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00002030-200101050-00016"}},{"id":5404,"doi":"10.1177/000992287501400310","pmid":"1116314","pmcid":null,"title":"Masturbation simulating epilepsy","authors":"Livingston S, Berman W, Pauli LL.","first_author":"Livingston S","journal":"Clinical pediatrics","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":24,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000992287501400310"}},{"id":5405,"doi":"10.4314/cajm.v46i12.8582","pmid":"11486473","pmcid":null,"title":"Self reported sexual and reproductive behaviour of male and female student nurses and midwives in Bulawayo","authors":"Verkuyl DA.","first_author":"Verkuyl DA.","journal":"The Central African journal of medicine","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Anonymous self‑administered questionnaire of 324 student nurses/midwives in Bulawayo, Zimbabwe; convenience sample.","sample_n":324,"sample_text":"324 students (99 nurses, 225 midwives)","population":"Student nurses and midwives (both sexes) in two nursing schools in Bulawayo, Zimbabwe.","country":"Zimbabwe","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A questionnaire of 324 nursing students in Zimbabwe found that male students reported more pre‑ and extramarital sex than females, while female students were generally monogamous. The main HIV risk for females appeared to come from their partners' behaviour.","clinical_takeaway":"For student nurses, partner testing may be more important for HIV risk than personal sexual behaviour.","confidence":0.4,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Large sample for a student‑survey in this setting","Addresses both genders and multiple sexual‑health behaviours","Provides local data on partner‑related HIV risk"],"limitations":["No validated instruments; reliance on single‑item self‑report","Cross‑sectional convenience sample; limited generalisability","No control for moral, mental‑health or trauma confounders"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4314/cajm.v46i12.8582"}},{"id":5407,"doi":"10.2307/2648198","pmid":"11138866","pmcid":null,"title":"Heterosexual genital sexual activity among adolescent males: 1988 and 1995","authors":"Gates GJ, Sonenstein FL.","first_author":"Gates GJ","journal":"Family planning perspectives","year":2000,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":50,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"National Survey of Adolescent Males, probability sample of 15‑19‑year‑old males interviewed in 1988 and 1995; self‑administered questionnaire.","sample_n":null,"sample_text":"Males aged 15‑19 surveyed in two years; exact N not given in abstract.","population":"US adolescent males, ages 15‑19 (nationally representative sample).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A national US survey of 15‑19‑year‑old boys found that in 1995 over half had had vaginal sex, half had been masturbated by a female, and many had engaged in oral or anal sex, showing that teen sexual activity extends beyond intercourse.","clinical_takeaway":"None – the study reports prevalence data, not clinical guidance.","confidence":0.7,"topic_tags":["adolescents","sexual_function","gender"],"strengths":["Large, nationally representative sample","Two time points allow trend observation","Broad range of genital sexual activities examined"],"limitations":["Reliance on single‑item self‑reports, no validated scales","No assessment of frequency or context of behaviors","No analysis of potential confounders (e.g., mental health, religiosity)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":57,"citing_publications":81,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2307/2648198"}},{"id":5408,"doi":"10.1080/00224497409550863","pmid":"4456022","pmcid":null,"title":"Masturbation practices of males and females","authors":"Arafat IS, Cotton WL.","first_author":"Arafat IS","journal":"Journal of sex research","year":1974,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":2,"contrasting":2,"mentioning":20,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224497409550863"}},{"id":5409,"doi":null,"pmid":"11064551","pmcid":null,"title":"Journal 100 & 150 years ago. Some interesting notes","authors":"Colon G.","first_author":"Colon G.","journal":"The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society","year":2000,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5410,"doi":"10.1016/s0277-9536(99)00493-1","pmid":"10975234","pmcid":null,"title":"Differences between Internet samples and conventional samples of men who have sex with men: implications for research and HIV interventions","authors":"Ross MW, Tikkanen R, Månsson SA.","first_author":"Ross MW","journal":"Social science & medicine (1982)","year":2000,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":135,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey comparing two non‑random, self‑selected samples of MSM recruited via a national gay organization (written questionnaire) and its website/chat room. Identical questionnaire used for both groups (N≈1,400 total).","sample_n":1394,"sample_text":"716 written questionnaires; 678 Internet questionnaires.","population":"Men who have sex with men in Sweden, recruited through a gay organization’s mailing list and website.","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men who have sex with men who answered a survey on paper versus online. Internet respondents were younger, more likely to live in small towns, identify as bisexual, and report higher condom use, but showed less physical intimacy.","clinical_takeaway":"Internet surveys reach a younger, more geographically isolated MSM subgroup; clinicians should consider sampling bias when interpreting online sexual health data.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large total sample size","Direct comparison of identical questionnaire across two recruitment modes","Detailed description of demographic and behavioral differences"],"limitations":["Non‑random, self‑selected samples limit generalisability","No validation information for questionnaire items","No adjustment for potential confounders beyond basic demographics"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":2,"mentioning":137,"citing_publications":203,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0277-9536(99)00493-1"}},{"id":5411,"doi":"10.1056/nejm200009073431002","pmid":"10974131","pmcid":null,"title":"Transdermal testosterone treatment in women with impaired sexual function after oophorectomy","authors":"Shifren JL, Braunstein GD, Simon JA, Casson PR, Buster JE, Redmond GP, Burki RE, Ginsburg ES, Rosen RC, Leiblum SR, Caramelli KE, Mazer NA.","first_author":"Shifren JL","journal":"The New England journal of medicine","year":2000,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","Multicenter Study","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":534,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"crossover, double‑blind, multicenter RCT with 75 women","sample_n":75,"sample_text":"Seventy‑five women","population":"women 31–56 y post‑oophorectomy & hysterectomy on estrogen therapy","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"essential","plain_summary":"In a double‑blind crossover trial, transdermal testosterone added to estrogen improved sexual activity, pleasure and mood in women who had their ovaries removed, compared with placebo.","clinical_takeaway":"Testosterone patches may help post‑oophorectomy women with low sexual desire and mood, but benefits should be weighed against risks.","confidence":0.8,"topic_tags":["sexual_function","treatment","gender","religiosity"],"strengths":["Randomized, double‑blind crossover design","Validated sexual‑function and well‑being instruments","Objective serum testosterone measurements"],"limitations":["No pre‑registration, effect sizes not reported","No partner or relationship variables assessed","Sample limited to women post‑oophorectomy, not general population"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":16,"contrasting":3,"mentioning":434,"citing_publications":936,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1056/nejm200009073431002"}},{"id":5412,"doi":"10.1007/bf01636440","pmid":"4836814","pmcid":null,"title":"Directed masturbation and the treatment of primary orgasmic dysfunction","authors":"Kohlenberg RJ.","first_author":"Kohlenberg RJ.","journal":"Archives of sexual behavior","year":1974,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01636440"}},{"id":5413,"doi":"10.1007/bf02758475","pmid":"10984993","pmcid":null,"title":"Impact assessment of school-based sex education program amongst adolescents","authors":"Thakor HG, Kumar P.","first_author":"Thakor HG","journal":"Indian journal of pediatrics","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional interview‑based questionnaire administered before and after a school‑based sex‑education session to 189 students from two secondary schools in Surat, India.","sample_n":189,"sample_text":"189 students from two secondary schools of Surat city.","population":"Adolescents (students) from two secondary schools in Surat, India (N=189).","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A school programme teaching sex education improved students' knowledge about STDs, contraception and attitudes toward sexual topics, and reduced myths about masturbation, but the study used a simple before‑after questionnaire without a control group.","clinical_takeaway":"Sex education can boost knowledge and shift attitudes among adolescents, though evidence of lasting impact is limited.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Reasonable sample size for a school‑based survey.","Assesses both knowledge and attitudes.","Includes both genders."],"limitations":["Questionnaire appears ad‑hoc, lacking validation.","Cross‑sectional before‑after design cannot establish causality.","No control group or adjustment for confounders."],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02758475"}},{"id":5414,"doi":"10.1089/15246090050118170","pmid":"10957753","pmcid":null,"title":"Sexual behaviors and other risk factors for Candida vulvovaginitis","authors":"Reed BD, Gorenflo DW, Gillespie BW, Pierson CL, Zazove P.","first_author":"Reed BD","journal":"Journal of women's health & gender-based medicine","year":2000,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control study comparing women with culture‑confirmed Candida vulvovaginitis to controls, logistic regression of sexual and other risk factors","sample_n":248,"sample_text":"156 cases and 92 controls","population":"156 cases, 92 controls, women aged 18‑60 attending community medical offices in the Midwestern US","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a case‑control study of 248 women, recent oral sex (cunnilingus) and a short acquaintance period with a partner were linked to higher odds of Candida vulvovaginitis, while frequent masturbation with saliva was linked to lower odds. Number of partners, age at first sex, and intercourse frequency were not related.","clinical_takeaway":"Clinicians should consider recent oral sex and brief partner familiarity as potential risk factors for Candida infection, while not over‑emphasising partner number or intercourse frequency.","confidence":0.8,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Large, community‑based case‑control sample","Objective infection outcome (culture confirmed)","Multivariate logistic regression with confidence intervals"],"limitations":["Exposure variables based on single‑item self‑report, no validated scales","Potential unmeasured confounders (mental health, trauma, religiosity)","Cross‑sectional design cannot establish causality"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":18,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/15246090050118170"}},{"id":5415,"doi":"10.1080/00926230050084669","pmid":"10929575","pmcid":null,"title":"Controlled studies on women presenting with sexual drive disorder: I. Endocrine status","authors":"Riley A, Riley E.","first_author":"Riley A","journal":"Journal of sex & marital therapy","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":54,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case-control comparison of 15 women with lifelong sexual drive disorder and controls; single mid‑cycle blood draw; diary of desire and behaviour","sample_n":15,"sample_text":"15 patients; control group size not specified","population":"premenopausal women (patients from clinical presentation, controls not described)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared hormone levels of women with lifelong low sexual desire to controls, finding lower free testosterone in the patient group and some links between hormones and reported desire.","clinical_takeaway":"Low free testosterone may be associated with reduced sexual drive in women, but evidence is limited.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["objective hormone assays","diary data on desire and activity","focus on lifelong drive disorder"],"limitations":["very small sample, no power analysis","no validated measure of sexual drive disorder","limited control of key confounds (mood, relationship, religiosity)","cross‑sectional, no causal inference"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":34,"citing_publications":93,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230050084669"}},{"id":5417,"doi":"10.1097/00000433-200006000-00004","pmid":"10871123","pmcid":null,"title":"Autoerotic asphyxiation in a female","authors":"Gosink PD, Jumbelic MI.","first_author":"Gosink PD","journal":"The American journal of forensic medicine and pathology","year":2000,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"N=1 (single case report)","population":"single female decedent, 31 years old, autoerotic asphyxiation","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article reports a rare fatal case of a 31‑year‑old woman who died during autoerotic asphyxiation, describing forensic findings and distinguishing the death from suicide or homicide.","clinical_takeaway":"None – the report is a forensic case study, not a clinical research source.","confidence":0.9,"topic_tags":["sexual_function","masturbation"],"strengths":["Detailed forensic description of a rare female case","Adds to sparse literature on female autoerotic asphyxiation"],"limitations":["Single case, no generalizable data","No systematic measurement of constructs or confounders"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00000433-200006000-00004"}},{"id":5418,"doi":"10.1590/s0004-282x2000000300021","pmid":"10920418","pmcid":null,"title":"Neuropsychological sequelae in Kleine-Levin syndrome: case report","authors":"Fontenelle L, Mendlowicz MV, Gillin JC, Mattos P, Versiani M.","first_author":"Fontenelle L","journal":"Arquivos de neuro-psiquiatria","year":2000,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":"https://www.scielo.br/j/anp/a/ZhvqsRTY7gjCLRfFWM7j5JC/?lang=en&format=pdf","cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case description of Kleine‑Levin syndrome with neuropsychological assessment","sample_n":1,"sample_text":"single patient case report","population":"adolescent male with KLS","country":"Brazil (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A single adolescent boy with Kleine‑Levin syndrome showed academic decline and neuropsychological changes after a second episode, suggesting possible lasting effects of the disorder.","clinical_takeaway":"Kleine‑Levin syndrome may lead to lasting cognitive and personality changes; monitor patients after episodes.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["detailed longitudinal observation of a rare syndrome","includes neuropsychological assessment"],"limitations":["single case, no generalisability","no validated measures of sexual behaviour or addiction","no control of confounding variables"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":1,"mentioning":11,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s0004-282x2000000300021"}},{"id":5420,"doi":"10.1080/096382800406022","pmid":"10894204","pmcid":null,"title":"Sexuality in persons with lower extremity amputations","authors":"Bodenheimer C, Kerrigan AJ, Garber SL, Monga TN.","first_author":"Bodenheimer C","journal":"Disability and rehabilitation","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience sample of 30 men with lower‑extremity amputations; self‑report surveys on sexual functioning (Derogatis Inventory), depression (BDI), anxiety (STAI) and health status.","sample_n":30,"sample_text":"Convenience sample of 30 men, recruited in Texas; not a random or representative cohort.","population":"Adults (mean age 57) with lower‑extremity amputation, mostly trans‑tibial.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 30 adults who had lower‑leg amputations, many reported sexual problems such as erectile difficulty and trouble reaching orgasm, yet most still wanted sex. Mood levels were similar to other outpatient groups, suggesting the issues are not explained by depression or anxiety alone.","clinical_takeaway":"Clinicians should routinely inquire about sexual concerns in amputees, as problems are common even when mood appears normal.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of validated sexual functioning and mood questionnaires","First descriptive data on a neglected population","Clear reporting of prevalence percentages"],"limitations":["Very small, non‑representative sample (N=30)","Cross‑sectional design limits causal inference","No control for moral, relational or trauma variables"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/096382800406022"}},{"id":5421,"doi":null,"pmid":"4617618","pmcid":null,"title":"T he disease of masturbation: values and the concept of disease","authors":"Engelhardt HT.","first_author":"Engelhardt HT.","journal":"Bulletin of the history of medicine","year":1974,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5422,"doi":"10.1001/jama.1974.03230150053032","pmid":"4859622","pmcid":null,"title":"Letter: Etiology of masturbation","authors":"Jefferson JW.","first_author":"Jefferson JW.","journal":"JAMA","year":1974,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/jama.1974.03230150053032"}},{"id":5423,"doi":null,"pmid":"4429008","pmcid":null,"title":"Masturbation and the male adolescent","authors":"Dranoff SM.","first_author":"Dranoff SM.","journal":"Adolescence","year":1974,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5424,"doi":null,"pmid":"10881519","pmcid":null,"title":"[Circumcision of boys--a child's right versus parents' right]","authors":"Hofvander Y, Olsen L.","first_author":"Hofvander Y","journal":"Lakartidningen","year":2000,"pub_types":["Historical Article","Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"swe","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical review article without original empirical data; arguments based on literature synthesis.","sample_n":null,"sample_text":"Not applicable – no primary sample","population":"Male infants/boys; no specific sampling reported","country":"Sweden (primary focus), references to USA and Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews the history and cultural reasons for male circumcision, argues that medical benefits are minimal, and raises concerns about pain and rights of the child versus parental/religious authority.","clinical_takeaway":"Clinicians should discuss the limited medical benefits and potential harms of infant circumcision, and consider child‑rights perspectives when counseling families.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Broad historical perspective","Cites multiple cultural contexts","Highlights child‑rights considerations"],"limitations":["No original data or systematic review methodology","Lacks quantitative assessment of risks/benefits","Potential bias toward anti‑circumcision stance"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":5425,"doi":"10.1007/s001150050572","pmid":"10846713","pmcid":null,"title":"[Treatment of paraphilia and sexually aggressive impulsive behavior with the LHRH-agonist leuprolide acetate]","authors":"Briken P, Berner W, Noldus J, Nika E, Michl U.","first_author":"Briken P","journal":"Der Nervenarzt","year":2000,"pub_types":["Comparative Study","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"case-report","design_detail":"case series of 11 treated patients, no control group, 12‑month follow‑up","sample_n":11,"sample_text":"11 patients treated with leuprolide acetate for 12 months","population":"Adult German‑speaking males with paraphilic disorders (pedophilia, sadism) and sexually aggressive impulsivity (N=11)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"supports","citation_value":"background","plain_summary":"In 11 men with paraphilic disorders, a year of leuprolide injections was associated with self‑reported drops in erections, ejaculation, masturbation and deviant sexual thoughts, though the study lacked a control group and used no standard outcome scales.","clinical_takeaway":"Evidence for leuprolide as a safe, effective treatment is weak; clinicians should interpret benefits cautiously.","confidence":0.3,"topic_tags":["treatment","sexual_function"],"strengths":["First report of LHRH‑agonist use for paraphilia in German‑speaking context","12‑month treatment window"],"limitations":["Very small uncontrolled case series (N=11)","No validated outcome measures reported","No control for key confounds (moral, mental health, trauma)","Conclusions overstate efficacy"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":1,"mentioning":4,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s001150050572"}},{"id":5426,"doi":null,"pmid":"10929687","pmcid":null,"title":"L-carnitine levels in the seminal plasma of fertile and infertile men: correlation with sperm quality","authors":"Matalliotakis I, Koumantaki Y, Evageliou A, Matalliotakis G, Goumenou A, Koumantakis E.","first_author":"Matalliotakis I","journal":"International journal of fertility and women's medicine","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional observational study of 101 men providing ejaculates by masturbation; groups based on fertility status and semen parameters.","sample_n":101,"sample_text":"101 men","population":"Adult men (median age not reported) recruited from a clinical setting; fertility status classified as fertile or infertile.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study measured L‑carnitine in the seminal fluid of 101 men and found higher levels in fertile men and in samples with better sperm count, motility and shape, suggesting the molecule may be a useful marker for male infertility.","clinical_takeaway":"Seminal L‑carnitine could aid infertility assessment, but further research is needed before clinical use.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Reasonable sample size for a biochemical correlation study","Clear quantitative assay of L‑carnitine","Standardized semen analysis"],"limitations":["Cross‑sectional; cannot infer causality","No adjustment for potential confounders (age, lifestyle, health)","No effect‑size reporting or confidence intervals","Sample drawn from clinical population; limited generalisability"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":5427,"doi":"10.7748/ns.14.32.23.s38","pmid":"11975292","pmcid":null,"title":"Sexuality and patients: breaking the last taboo","authors":"Allen D.","first_author":"Allen D.","journal":"Nursing standard (Royal College of Nursing (Great Britain) : 1987)","year":2000,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7748/ns.14.32.23.s38"}},{"id":5428,"doi":"10.1016/s1054-139x(99)00097-x","pmid":"10734276","pmcid":null,"title":"The African-American church: a potential forum for adolescent comprehensive sexuality education","authors":"Coyne-Beasley T, Schoenbach VJ.","first_author":"Coyne-Beasley T","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2000,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":49,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pilot survey of clergy (convenience sample); descriptive statistics only","sample_n":null,"sample_text":"convenience sample of clergy leaders; size not reported","population":"clergy leaders from African‑American churches in one county (≈200,000 pop.)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"A small survey of African‑American church leaders found they view drug use, violence, HIV, pregnancy and alcohol as top health issues for adolescents. Most would welcome health seminars, but some would not discuss topics like masturbation or homosexuality, and few would provide condoms.","clinical_takeaway":"Churches may be viable venues for comprehensive sexuality education, but programs should anticipate exclusions of certain topics.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["addresses an under‑studied community context","includes clergy perspectives on multiple health topics","identifies specific barriers (e.g., topics excluded)"],"limitations":["Very small, non‑representative convenience sample","No validated attitude scales","No statistical testing beyond descriptive frequencies","Generalises findings to all African‑American churches"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":63,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1054-139x(99)00097-x"}},{"id":5429,"doi":"10.1016/s0301-0511(99)00048-4","pmid":"10725567","pmcid":null,"title":"A preliminary report relating frequency of vaginal intercourse to heart rate variability, Valsalva ratio, blood pressure, and cohabitation status","authors":"Brody S, Veit R, Rau H.","first_author":"Brody S","journal":"Biological psychology","year":2000,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 51 healthy adults, recalled frequency of intercourse, physiological measures at one time point","sample_n":51,"sample_text":"51 healthy adults aged 20‑47 (Lie scale >86th percentile excluded)","population":"healthy adults aged 20‑47, community sample","country":"unspecified (likely USA based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 51 healthy adults, more frequent vaginal intercourse was linked to higher heart‑rate variability and lower blood pressure, but only among those living with a partner. No link was found with the Valsalva response or with masturbation.","clinical_takeaway":"Frequent cohabiting intercourse may be associated with better parasympathetic tone, but findings are preliminary.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["objective physiological measures (HRV, BP, Valsalva)","considered cohabitation status","excluded socially desirable responding via Lie scale"],"limitations":["small sample, likely underpowered for subgroup analyses","cross‑sectional, self‑reported sexual frequency","limited control of psychological confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":0,"mentioning":39,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0301-0511(99)00048-4"}},{"id":5430,"doi":"10.1177/014107680009300319","pmid":"10741325","pmcid":"PMC1297962","title":"The sin of Onan","authors":"Goodman M.","first_author":"Goodman M.","journal":"Journal of the Royal Society of Medicine","year":2000,"pub_types":["Letter","Historical Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/014107680009300319"}},{"id":5434,"doi":"10.1136/sti.76.1.7","pmid":"10817061","pmcid":"PMC1760554","title":"The repertoire of human efforts to avoid sexually transmissible diseases: past and present. Part 1: Strategies used before or instead of sex","authors":"Donovan B.","first_author":"Donovan B.","journal":"Sexually transmitted infections","year":2000,"pub_types":["research-article","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review compiling historical and observational sources; no original empirical data, no systematic methods reported.","sample_n":null,"sample_text":"Not applicable – study synthesises prior reports rather than collecting new participant data.","population":"Not applicable (review of historical/observational sources)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article surveys many ways people have tried to avoid STDs, from condoms to less obvious tactics like masturbation or circumcision, showing that cultural practices influence disease risk.","clinical_takeaway":"None – the paper offers historical insight rather than direct clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Broad historical perspective on STD avoidance","Highlights understudied strategies such as masturbation or infibulation"],"limitations":["Narrative, non‑systematic synthesis","No systematic search or quality appraisal of sources","No original data; conclusions limited to speculation"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sti.76.1.7"}},{"id":5435,"doi":"10.1016/s0306-4530(99)00049-9","pmid":"10674282","pmcid":null,"title":"Neuroendocrine response to film-induced sexual arousal in men and women","authors":"Exton NG, Truong TC, Exton MS, Wingenfeld SA, Leygraf N, Saller B, Hartmann U, Schedlowski M.","first_author":"Exton NG","journal":"Psychoneuroendocrinology","year":2000,"pub_types":["Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":77,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"within‑subject laboratory experiment using erotic film stimulus; N=9 men, 9 women; continuous hormonal and cardiovascular measurements","sample_n":18,"sample_text":"nine healthy adult men and nine healthy adult women","population":"healthy adult men and women, small convenience sample","country":"not stated (likely Germany based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 18 healthy volunteers, watching erotic films raised subjective arousal and blood pressure; it increased norepinephrine in women but did not change adrenaline, cortisol, or prolactin unless orgasm occurred, suggesting a role for the sympathetic nervous system in sexual arousal.","clinical_takeaway":"Sexual arousal activates the sympathetic system, but prolactin spikes only after orgasm; the findings are not directly applicable to clinical diagnosis or treatment.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Physiologically validated hormone assays","Continuous real‑time measurement of cardiovascular variables","Within‑subject design controls for individual baseline"],"limitations":["Very small sample (N=18) limits statistical power","No control for psychological confounds (e.g., mood, sexual experience)","Findings may not generalize beyond laboratory setting"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":8,"contrasting":2,"mentioning":57,"citing_publications":112,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0306-4530(99)00049-9"}},{"id":5436,"doi":"10.1080/00224497309550788","pmid":"4806758","pmcid":null,"title":"The relationship of the frequency of masturbation to several aspects of personality and behavior","authors":"Abramson PR.","first_author":"Abramson PR.","journal":"Journal of sex research","year":1973,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224497309550788"}},{"id":5437,"doi":"10.3233/nre-2000-15204","pmid":"11455088","pmcid":null,"title":"Sexual dysfunction after traumatic brain injury","authors":"Hibbard MR, Gordon WA, Flanagan S, Haddad L, Labinsky E.","first_author":"Hibbard MR","journal":"NeuroRehabilitation","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":48,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective comparative survey of 322 TBI patients vs 264 community controls; ANOVA/ANCOVA analyses","sample_n":586,"sample_text":"322 individuals with TBI and 264 without disability","population":"Adults with traumatic brain injury (193 men, 129 women) and community controls without disability (152 men, 112 women)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People with traumatic brain injury report more problems with desire, performance and body image during sex than community controls. Depression and endocrine issues are linked to these difficulties.","clinical_takeaway":"Screen TBI patients for depression and endocrine disorders when addressing sexual problems.","confidence":0.8,"topic_tags":["sexual_function","treatment"],"strengths":["Large sample including both genders","Comparison group without disability","Examines multiple domains of sexual function"],"limitations":["Reliance on ad‑hoc self‑report items, no validated scales","Cross‑sectional, cannot infer causality","Limited control of key confounds (e.g., moral beliefs, partner context)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":47,"citing_publications":108,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3233/nre-2000-15204"}},{"id":5438,"doi":"10.1080/00797308.2000.11822518","pmid":"11338984","pmcid":null,"title":"\"Where work is play for mortal stakes\": the good hour in child analysis","authors":"Ablon SL.","first_author":"Ablon SL.","journal":"The Psychoanalytic study of the child","year":2000,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single child analysis session","sample_n":1,"sample_text":"single case study","population":"6.5‑year‑old girl (single case)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The author describes one hour of therapy with a 6½‑year‑old girl, highlighting how play, affect, and the therapeutic relationship worked together to reveal unconscious material. The write‑up links these observations to classic psychoanalytic ideas.","clinical_takeaway":"None – the article offers a theoretical illustration rather than evidence for clinical practice.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Detailed clinical vignette","Illustrates psychoanalytic concepts in child therapy","Connects historical theory to contemporary practice"],"limitations":["Single case; no generalizability","No systematic measurement or validated instruments","Lacks statistical analysis","No control of confounding variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00797308.2000.11822518"}},{"id":5439,"doi":"10.1093/hwj/2000.49.24","pmid":"11624449","pmcid":null,"title":"Hogarth's mad King and his audiences","authors":"Stevenson C.","first_author":"Stevenson C.","journal":"History workshop journal : HWJ","year":2000,"pub_types":["Historical Article","Biography","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/hwj/2000.49.24"}},{"id":5441,"doi":"10.1016/s0895-4356(99)00150-x","pmid":"10693906","pmcid":null,"title":"A new surrogate variable for erectile dysfunction status in the Massachusetts male aging study","authors":"Kleinman KP, Feldman HA, Johannes CB, Derby CA, McKinlay JB.","first_author":"Kleinman KP","journal":"Journal of clinical epidemiology","year":2000,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Methodological study using discriminant analysis on data from the Massachusetts Male Aging Study (large community sample, two waves).","sample_n":null,"sample_text":"Large community sample (exact N not given in abstract)","population":"Men from the Massachusetts Male Aging Study, community‑based sample","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created a new formula to estimate erectile dysfunction in a long‑running men’s health study, using earlier questionnaire items that weren’t directly about erections, and compared it to later self‑reports.","clinical_takeaway":"This surrogate measure may help estimate past erectile function when direct questions were missing, but its accuracy is limited.","confidence":0.8,"topic_tags":["sexual_function","measurement"],"strengths":["Large, community‑based sample","Addresses lack of direct ED measure at baseline","Compares two measurement approaches"],"limitations":["Reliance on indirect questionnaire items for baseline ED status","No external validation beyond self‑report at follow‑up","No discussion of potential confounders such as health comorbidities"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":35,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0895-4356(99)00150-x"}},{"id":5442,"doi":"10.1017/s0361233300000648","pmid":"16856280","pmcid":null,"title":"Sexual purity, white men, and slavery: Emerson and the self-reliant body","authors":"Castronovo R.","first_author":"Castronovo R.","journal":"Prospects","year":2000,"pub_types":["Historical Article","Biography","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0361233300000648"}},{"id":5445,"doi":"10.1159/000030515","pmid":"10859545","pmcid":null,"title":"Relation of sexual dysfunction to hormone levels, diseases and drugs used in andrological patients","authors":"Krause W, Müller HH.","first_author":"Krause W","journal":"Urologia internationalis","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational study of 169 men attending an andrology clinic; semi‑structured interview and hormone assays; regression analyses to explore associations.","sample_n":169,"sample_text":"Clinic‑based convenience sample; not randomly selected; likely WEIRD and treatment‑seeking bias.","population":"Male patients (N=169) presenting with sexual dysfunction at a single university urology department (2000).","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 169 men seen for sexual problems, hormone tests and interview data were analysed. Age was linked to higher FSH and lower testosterone, but hormone levels did not reliably explain most dysfunction symptoms.","clinical_takeaway":"Hormone levels alone do not predict most sexual dysfunction symptoms in clinic patients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Direct hormone measurements","Clear reporting of statistical method (regression)","Attempts to examine multiple medical conditions"],"limitations":["Convenience clinic sample limits generalisability","Sexual dysfunction items not validated instruments","No control for key psychosocial confounds (e.g., mental health, moral factors)","No power analysis or confidence intervals reported"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000030515"}},{"id":5446,"doi":"10.3109/00048677309161473","pmid":"4579392","pmcid":null,"title":"Masturbational madness: an historical annotation","authors":"Cade JF.","first_author":"Cade JF.","journal":"The Australian and New Zealand journal of psychiatry","year":1973,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/00048677309161473"}},{"id":5447,"doi":null,"pmid":"4487602","pmcid":null,"title":"[Masturbation--an invitation for an interpersonal relationship]","authors":"Gibney HA.","first_author":"Gibney HA.","journal":"[Kango] Japanese journal of nursing","year":1973,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"jpn","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5448,"doi":"10.1097/00001199-199912000-00005","pmid":"10671702","pmcid":null,"title":"Sex offending as a psychosocial sequela of traumatic brain injury","authors":"Simpson G, Blaszczynski A, Hodgkinson A.","first_author":"Simpson G","journal":"The Journal of head trauma rehabilitation","year":1999,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":55,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective file review of 477 TBI admissions; 29 male offenders identified; descriptive analysis of offenses.","sample_n":477,"sample_text":"29 offenders identified among 445 clients with TBI","population":"Adult males with traumatic brain injury in a rehabilitation unit (N=477; offenders N=29)","country":"Unknown (likely Australia/UK based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A review of records from a brain‑injury rehab unit found that about 6% of male patients committed sexual offenses, most often unwanted touching. The authors suggest the injuries may have contributed to the behavior.","clinical_takeaway":"Clinicians should monitor for disinhibited sexual behavior in TBI patients, but evidence does not prove the injury causes offending.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large initial cohort of TBI patients","Systematic extraction of offense data","Identifies a previously under‑studied clinical issue"],"limitations":["Retrospective design; no causal inference","Small number of offenders limits statistical power","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":65,"citing_publications":112,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00001199-199912000-00005"}},{"id":5449,"doi":"10.1177/000306517302100304","pmid":"4746797","pmcid":null,"title":"On a particular form of masturbation in women: masturbation with water","authors":"Halpert E.","first_author":"Halpert E.","journal":"Journal of the American Psychoanalytic Association","year":1973,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000306517302100304"}},{"id":5451,"doi":"10.1177/096777209900700401","pmid":"11624076","pmcid":null,"title":"Dr Samuel Auguste Tissot","authors":"Jenkins JS.","first_author":"Jenkins JS.","journal":"Journal of medical biography","year":1999,"pub_types":["Historical Article","Biography","Portrait","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/096777209900700401"}},{"id":5452,"doi":"10.1007/bf01541865","pmid":"4680816","pmcid":null,"title":"The role of masturbation in the treatment of orgasmic dysfunction","authors":"LoPiccolo J, Lobitz WC.","first_author":"LoPiccolo J","journal":"Archives of sexual behavior","year":1972,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":73,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":54,"citing_publications":241,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541865"}},{"id":5453,"doi":"10.1046/j.1365-2265.1999.00849.x","pmid":"10583321","pmcid":null,"title":"Role of oestrogen in male sexual behaviour: insights from the natural model of aromatase deficiency","authors":"Carani C, Rochira V, Faustini-Fustini M, Balestrieri A, Granata AR.","first_author":"Carani C","journal":"Clinical endocrinology","year":1999,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":66,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-case longitudinal study of one man with aromatase deficiency across multiple hormone treatment phases","sample_n":1,"sample_text":"single participant","population":"one adult male with congenital aromatase deficiency","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A man lacking the enzyme aromatase was studied before and during estrogen therapy. While his gender identity and sexual orientation stayed male and heterosexual, estrogen increased his libido, intercourse frequency, masturbation and erotic fantasies, and reduced depression and anxiety scores.","clinical_takeaway":"Estrogen may influence male sexual drive, but evidence is limited to a single case.","confidence":0.7,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["uses validated psychometric instruments","within‑subject longitudinal design","objective hormone assays"],"limitations":["single‑case; no generalisability","no statistical power or effect‑size reporting","does not control for moral or relational confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":3,"confounds":3,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":70,"citing_publications":115,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1046/j.1365-2265.1999.00849.x"}},{"id":5454,"doi":"10.1080/09540129947730","pmid":"10755033","pmcid":null,"title":"Changing sexual attitudes and behaviour in China: implications for the spread of HIV and other sexually transmitted diseases","authors":"Zhang K, Li D, Li H, Beck EJ.","first_author":"Zhang K","journal":"AIDS care","year":1999,"pub_types":["Journal Article"],"keywords":["China","Sexuality","Viral diseases","Personality","Behavior","Asia","Eastern Asia","Diseases","Sex behavior","Literature review","Psychological factors","Developing Countries","Hiv Infections","Attitude--changes","Homosexuals","Premarital Sex Behavior","Extramarital Sex Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":118,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative literature review without primary data; no systematic methods described.","sample_n":null,"sample_text":"Not applicable – no empirical sample.","population":"China (general population, historical overview)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how Chinese attitudes toward sex—including premarital sex, masturbation, and homosexuality—have become more liberal since the 1980s and discusses how these changes, together with massive internal migration, may be driving the rise of HIV transmission in China.","clinical_takeaway":"Clinicians should consider broader sociocultural changes when addressing sexual health and HIV risk with Chinese patients.","confidence":0.8,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["Broad historical perspective on sexual attitudes in China","Links sociocultural shifts to HIV epidemiology"],"limitations":["No primary data; narrative synthesis","Lacks systematic methodology and risk‑of‑bias assessment","No quantitative measurement of constructs"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":1,"mentioning":135,"citing_publications":191,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540129947730"}},{"id":5456,"doi":"10.1210/jcem.84.10.6028","pmid":"10522995","pmcid":null,"title":"7Alpha-methyl-19-nortestosterone maintains sexual behavior and mood in hypogonadal men","authors":"Anderson RA, Martin CW, Kung AW, Everington D, Pun TC, Tan KC, Bancroft J, Sundaram K, Moo-Young AJ, Baird DT.","first_author":"Anderson RA","journal":"The Journal of clinical endocrinology and metabolism","year":1999,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"crossover randomised controlled trial with 20 hypogonadal men, 6‑week treatment periods for MENT vs testosterone, outcomes via diaries, interviews, questionnaires and nocturnal penile tumescence","sample_n":20,"sample_text":"20 hypogonadal men (10 per centre)","population":"hypogonadal adult men (Caucasian and Chinese, n=20)","country":"Scotland and Hong Kong","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"high","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 20 men with low testosterone, a new androgen (MENT) was compared to regular testosterone. Both increased sexual interest, erections and improved mood, with no major differences between them.","clinical_takeaway":"MENT appears as effective as testosterone for restoring sexual function and mood in hypogonadal men.","confidence":0.7,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["randomised crossover design","objective physiological outcome (NPT)","both cultural sites included"],"limitations":["very small sample (n=20)","no pre‑registration or power analysis reported","subjective measures not validated scales"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":95,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1210/jcem.84.10.6028"}},{"id":5457,"doi":null,"pmid":"4652711","pmcid":null,"title":"[Masturbatory behavior in a group of adolescents]","authors":"Gomberoff M, Castro E, Gomberoff L, Noemi C, Thomas J.","first_author":"Gomberoff M","journal":"Revista medica de Chile","year":1972,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5458,"doi":null,"pmid":"4484567","pmcid":null,"title":"Masturbation: an invitation for an interpersonal relationship","authors":"Gibney HA.","first_author":"Gibney HA.","journal":"Perspectives in psychiatric care","year":1972,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5460,"doi":"10.1023/a:1018744628161","pmid":"10553492","pmcid":null,"title":"Unresolved issues in scientific sexology","authors":"McConaghy N.","first_author":"McConaghy N.","journal":"Archives of sexual behavior","year":1999,"pub_types":["Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review/commentary without original empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews methodological problems in sexology, arguing that many studies misuse measures like penile circumference, ignore dimensional views of sexual orientation, and over‑interpret statistical manipulations, especially in sex‑offender treatment research.","clinical_takeaway":"None – the paper is a methodological commentary, not a source of direct clinical guidance.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Broad coverage of methodological shortcomings in sexology","Highlights overlooked measurement issues (e.g., penile volume vs. circumference)"],"limitations":["No original data; conclusions based on secondary literature","Lack of systematic review methods (no risk‑of‑bias assessment)","Potential bias against RCTs in sex‑offender treatment"],"rubric_version":"2.0","raw_total":1,"max_possible":50,"pct_score":2,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":0,"neuroimaging":null,"statistics":0,"confounds":0,"design":0,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1018744628161"}},{"id":5461,"doi":"10.1007/bf02727162","pmid":"10798107","pmcid":null,"title":"Perceptions of teachers regarding sex education in National Capital Territory of Delhi","authors":"Bhasin SK, Aggarwal OP.","first_author":"Bhasin SK","journal":"Indian journal of pediatrics","year":1999,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 476 senior‑secondary teachers in Delhi, randomly selected from government and private schools; self‑administered pre‑tested questionnaire.","sample_n":476,"sample_text":"476 senior secondary school teachers from randomly selected schools in Delhi","population":"Senior secondary school teachers (N≈476) in National Capital Territory of Delhi, India","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1999 survey of 476 Delhi teachers found most support teaching basic reproductive health, but many opposed covering abortion, premarital sex, or masturbation. Teachers favored starting sex education around age 14 and saw themselves and doctors as best suited to teach it.","clinical_takeaway":"None - not clinically applicable","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample for a teacher survey","Random selection of schools","Pre‑tested questionnaire"],"limitations":["Questionnaire not validated for attitude constructs","Cross‑sectional design limits causal inference","No analysis of potential confounders (e.g., religiosity)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02727162"}},{"id":5462,"doi":"10.1080/00926239908403993","pmid":"10407791","pmcid":null,"title":"The sexual struggles of 23 clergymen: a follow-up study","authors":"Fones CS, Levine SB, Althof SE, Risen CB.","first_author":"Fones CS","journal":"Journal of sex & marital therapy","year":1999,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"follow‑up of 19 clergy who had undergone an assessment for sexual offenses; semistructured psychiatric interview and MCMI‑III at 1‑6 years later","sample_n":19,"sample_text":"19 clergymen (17 Catholic) followed up 1–6 years after initial evaluation","population":"Male clergy (mostly Catholic), previously evaluated for sexual offenses","country":"Not specified (likely United States)","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A small group of clergy who had been evaluated for sexual offenses were re‑interviewed 1‑6 years later. Most were psychologically healthy, returned to work, and reported no recurring compulsive sexual behavior, though many still struggled with loneliness and masturbation issues.","clinical_takeaway":"In this limited sample, brief psychotherapy appeared helpful for clergy coping with sexual conflicts; however, findings cannot be generalized.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Longitudinal follow‑up of a rare clinical population","Use of a structured psychiatric interview","Inclusion of personality assessment (MCMI‑III)"],"limitations":["Very small, non‑representative sample","No validated measure of sexual compulsivity or addiction","Confounding variables (moral incongruence, partner context) not assessed","Descriptive analysis without effect sizes or statistical testing"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239908403993"}},{"id":5463,"doi":"10.1097/00004583-199907000-00017","pmid":"10405505","pmcid":null,"title":"Psychosexual dysfunction in males with genital anomalies: late adolescence, Tanner stages IV to VI","authors":"Reiner WG, Gearhart JP, Jeffs R.","first_author":"Reiner WG","journal":"Journal of the American Academy of Child and Adolescent Psychiatry","year":1999,"pub_types":["Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":45,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case series of 14 adolescent males with bladder exstrophy‑epispadias, assessed with questionnaires and interviews; no control group","sample_n":14,"sample_text":"Fourteen consecutive males aged 14‑19 years, Tanner stages IV‑VI","population":"adolescent males (14‑19 y) with genital anomalies (bladder exstrophy‑epispadias)","country":"USA (assumed from authors’ affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 14 teenage boys with rare genital anomalies, researchers found little sexual experience, low masturbation rates, and high anxiety or depression, suggesting wide psychosexual and mental‑health challenges.","clinical_takeaway":"Clinicians should screen adolescents with genital anomalies for sexual development delays and mood disorders.","confidence":0.7,"topic_tags":["sexual_function","gender","adolescents"],"strengths":["Use of multiple validated psychiatric instruments (CBCL, YSR)","In‑depth sexual history interview","Inclusion of parent reports"],"limitations":["Very small, non‑representative sample (N=14)","No comparison group or longitudinal follow‑up","Limited measurement of key confounds (e.g., moral attitudes, partner context)","Broad conclusions exceed data"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":1,"mentioning":20,"citing_publications":82,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00004583-199907000-00017"}},{"id":5464,"doi":"10.1016/s0015-0282(99)00154-5","pmid":"10428155","pmcid":null,"title":"Leukocytes in semen from men with spinal cord injuries","authors":"Aird IA, Vince GS, Bates MD, Johnson PM, Lewis-Jones ID.","first_author":"Aird IA","journal":"Fertility and sterility","year":1999,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional study of 9 men with chronic spinal cord injuries and 7 healthy donors; semen obtained by electroejaculation or masturbation; leukocyte phenotyping and sperm motility measured.","sample_n":16,"sample_text":"Nine men with chronic SCIs and seven healthy sperm donors as controls.","population":"Men with chronic SCI (n=9) and healthy sperm donors (n=7).","country":"UK (presumed from journal affiliation).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined immune cells in semen from men with spinal‑cord injuries and found higher leukocyte numbers when urinary‑tract infections were present, but these cells did not explain the reduced sperm movement.","clinical_takeaway":"Urinary‑tract infections, not leukocytes, likely contribute to sperm motility issues in men with spinal‑cord injury.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Validated immunohistochemical methods for leukocyte identification.","Direct comparison with healthy donor semen.","Clear reporting of infection status."],"limitations":["Very small sample size limits statistical power.","Convenience sample from a single clinic.","No adjustment for potential confounders beyond infection."],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":27,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0015-0282(99)00154-5"}},{"id":5465,"doi":"10.1016/s0891-4222(99)00007-4","pmid":"10425653","pmcid":null,"title":"Construction and psychometric properties of sexuality scales: sex knowledge, experience, and needs scales for people with intellectual disabilities (SexKen-ID), people with physical disabilities (SexKen-PD), and the general population (SexKen-GP)","authors":"McCabe MP, Cummins RA, Deeks AA.","first_author":"McCabe MP","journal":"Research in developmental disabilities","year":1999,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"scale development and validation with three groups (n≈66, 54, 100); test‑retest subsample (n=30 each)","sample_n":220,"sample_text":"66 ID, 54 PD, 100 GP; test‑retest 30 per group","population":"people with mild intellectual disabilities, people with physical disabilities, general adult population","country":"not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and tested three questionnaires that measure sexual knowledge, experiences, feelings, and needs for people with intellectual disabilities, physical disabilities, and the general public. The scales showed good reliability and could be used in future research or clinical settings.","clinical_takeaway":"These new scales provide a reliable way to assess sexual knowledge and needs in people with disabilities, supporting tailored education and support.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Systematic item generation across three populations","Test‑retest reliability reported","Includes a range of sexuality domains (including masturbation)"],"limitations":["Convenience samples; limited generalisability","No external validation against established scales","No assessment of potential confounds (e.g., mental health, religiosity)"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":42,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0891-4222(99)00007-4"}},{"id":5467,"doi":null,"pmid":"5064056","pmcid":null,"title":"[On a case of sudden death while masturbating]","authors":"Tomita K, Uchida M.","first_author":"Tomita K","journal":"Nihon hoigaku zasshi = The Japanese journal of legal medicine","year":1972,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"jpn","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5468,"doi":"10.1023/a:1023088526314","pmid":"10382132","pmcid":null,"title":"Sexual behaviors in autism: problems of definition and management","authors":"Realmuto GM, Ruble LA.","first_author":"Realmuto GM","journal":"Journal of autism and developmental disorders","year":1999,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single individual with autism receiving leuprolide to suppress sexual behavior; no control group, no systematic sampling","sample_n":1,"sample_text":"single case","population":"male adolescent/adult with autism spectrum disorder, treatment‑seeking","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A single man with autism who engaged in persistent sexual behaviors was given leuprolide, a medication that lowers testosterone. The drug reduced the behaviors and allowed him to stay in his community placement, with no major side effects after three years, but the report lacks systematic measures or broader comparison.","clinical_takeaway":"Leuprolide may reduce problematic sexual behavior in autism, but evidence is limited to one case; clinicians should consider risks, lack of controlled data, and explore behavioral interventions first.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["detailed clinical description","long follow‑up (≈3 years)","discussion of management challenges"],"limitations":["single subject, no control","no validated measures of sexual behavior","no assessment of confounding factors","cannot infer causality or generalise"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":3,"contrasting":0,"mentioning":17,"citing_publications":105,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1023088526314"}},{"id":5469,"doi":"10.1080/09540129948108","pmid":"10474624","pmcid":null,"title":"Parallel accounts? Discrepancies between self-report (diary) and recall (questionnaire) measures of the same sexual behaviour","authors":"Coxon AP.","first_author":"Coxon AP.","journal":"AIDS care","year":1999,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study comparing self‑completed sexual diaries with retrospective questionnaire reports of the same month among men who have sex with men; same participants provide both data sources","sample_n":null,"sample_text":"Not specified in abstract; likely a convenience sample","population":"men who have sex with men (homosexual men); sample size not reported in abstract","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared daily sexual diaries with later questionnaire recall in gay men and found that questionnaires tend to report higher numbers of sexual acts, especially for masturbation and oral sex, while partners differ in how they recall condomless anal sex.","clinical_takeaway":"Clinicians should be aware that retrospective sexual histories may over‑estimate certain behaviours; using diaries can improve accuracy.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Direct within‑subject comparison of two measurement approaches","Focus on specific sexual acts allows granular insight","Highlights systematic over‑ and under‑estimation patterns"],"limitations":["No validated instruments; relies on self‑report only","Sample size and recruitment method not disclosed","No control for moral or mental‑health factors that may affect reporting"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":44,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540129948108"}},{"id":5470,"doi":"10.1093/her/14.2.177","pmid":"10387498","pmcid":null,"title":"Transgender HIV prevention: implementation and evaluation of a workshop","authors":"Bockting WO, Rosser BR, Scheltema K.","first_author":"Bockting WO","journal":"Health education research","year":1999,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"single‑group pre‑post workshop evaluation (N=59), no control group","sample_n":59,"sample_text":"59 participants attended the 4‑hour workshop","population":"transgender adults (Minnesota), convenience sample","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 4‑hour HIV‑prevention workshop for transgender adults increased knowledge and briefly improved attitudes, but showed limited impact on risky sexual or injection behaviours. Safer practices like mutual masturbation rose modestly. Small sample size limits conclusions.","clinical_takeaway":"Workshop can raise awareness; however, evidence for reducing risk behaviours is weak.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Novel workshop targeting transgender community","Use of Health Belief Model and Eroticizing Safer Sex framework","Multiple educational methods (lecture, role‑play, panels)","Follow‑up assessment beyond immediate post‑test"],"limitations":["Small, non‑random sample; no control group","Unvalidated outcome measures","Limited behavioural change detected","Possible self‑selection bias"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/her/14.2.177"}},{"id":5471,"doi":"10.3928/0098-9134-19990401-07","pmid":"10426032","pmcid":null,"title":"Comparison of caregivers', residents', and community-dwelling spouses' opinions about expressing sexuality in an institutional setting","authors":"Gibson MC, Bol N, Woodbury MG, Beaton C, Janke C.","first_author":"Gibson MC","journal":"Journal of gerontological nursing","year":1999,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of staff, residents and spouses in one chronic‑care hospital; convenience sampling; participation rates 22‑50 %.","sample_n":182,"sample_text":"Residents (40 % response), spouses (42 %), nursing staff (34 %), allied health (50 %), support staff (22 %).","population":"elderly residents (N≈182), their community‑dwelling spouses (N≈103), and hospital staff (≈1,200 eligible).","country":"Not stated (likely USA/Canada based on journal).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Staff, residents and spouses were surveyed about how acceptable older adults’ sexual behaviours are in a care home. Residents and spouses were less tolerant than staff of masturbation, relationships, viewing sexual material and sexual approaches, and all groups said privacy mattered most.","clinical_takeaway":"Clinicians should recognise that attitudes toward elder sexuality differ across caregivers and families; privacy and clear policies can help manage differing expectations.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large overall staff sample.","Includes three stakeholder perspectives (staff, residents, spouses).","Addresses a neglected topic of sexuality in long‑term care."],"limitations":["Opinion questionnaire appears ad‑hoc, not validated.","Convenience sample from a single institution limits generalisability.","No adjustment for potential confounds such as religiosity or mental health."],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3928/0098-9134-19990401-07"}},{"id":5472,"doi":"10.1046/j.1440-1614.1999.00549.x","pmid":"10336225","pmcid":null,"title":"Sex knowledge and sexual attitudes among medical and nursing students","authors":"McKelvey RS, Webb JA, Baldassar LV, Robinson SM, Riley G.","first_author":"McKelvey RS","journal":"The Australian and New Zealand journal of psychiatry","year":1999,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"questionnaire‑based survey of medical and nursing students in Western Australia","sample_n":null,"sample_text":"Not reported in abstract","population":"medical and nursing students (years 1‑5 medical, years 1‑3 nursing)","country":"Australia","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of Australian medical and nursing students found that frequent religious attendance predicts more negative attitudes toward topics like masturbation and lower scores on a sex‑knowledge test. Other factors such as gender, ethnicity and political views also relate to attitudes and knowledge.","clinical_takeaway":"Educators should address moral and cultural influences when teaching sexual health to future clinicians.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Uses a previously validated sex‑knowledge instrument","Large academic sample covering multiple years of study","Analyzes multiple sociodemographic predictors"],"limitations":["Cross‑sectional design prevents causal inference","Convenience sample limits generalisability beyond Australian health‑student population","No measurement of mental‑health or trauma variables that could confound attitudes"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":2,"mentioning":81,"citing_publications":92,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1046/j.1440-1614.1999.00549.x"}},{"id":5473,"doi":"10.1007/s001250051160","pmid":"10096787","pmcid":null,"title":"Finger and penile tactile sensitivity in sexually functional and dysfunctional diabetic men","authors":"Morrissette DL, Goldstein MK, Raskin DB, Rowland DL.","first_author":"Morrissette DL","journal":"Diabetologia","year":1999,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of three groups (10 ED diabetics, 17 functional diabetics, 14 controls) measuring tactile thresholds and self‑reported sexual function.","sample_n":41,"sample_text":"41 participants total (10 with erectile dysfunction, 17 sexually functional diabetics, 14 controls)","population":"Adult male diabetics (mean age middle‑aged) and healthy controls","country":"USA (implied by authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured finger and penile touch sensitivity in diabetic men with and without erectile problems and in healthy men. Men with erectile dysfunction showed higher touch thresholds and different subjective responses, suggesting altered sensory processing may contribute to their condition.","clinical_takeaway":"Altered penile tactile sensitivity may be one factor in diabetic erectile dysfunction, but findings are preliminary due to small sample size.","confidence":0.7,"topic_tags":["sexual_function","treatment"],"strengths":["Objective tactile threshold measurements","Biochemical markers (HbA1c, testosterone) included","Comparison of three distinct groups"],"limitations":["Small sample sizes, likely underpowered","No control for key psychosocial confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s001250051160"}},{"id":5475,"doi":"10.1080/00223980.1971.9923762","pmid":"5116720","pmcid":null,"title":"Developmental factors in masturbation: family background antecedents and later personality patterns","authors":"Mazer DB, Mahrer AR.","first_author":"Mazer DB","journal":"The Journal of psychology","year":1971,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00223980.1971.9923762"}},{"id":5476,"doi":"10.1023/a:1018793622284","pmid":"10097805","pmcid":null,"title":"Sexual activity prior to coital initiation: a comparison between males and females","authors":"Schwartz IM.","first_author":"Schwartz IM.","journal":"Archives of sexual behavior","year":1999,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective cross‑sectional questionnaire of 311 college students (convenience sample).","sample_n":311,"sample_text":"Volunteer convenience sample; not representative of broader population.","population":"College students (120 male, 191 female)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"College students reported a range of sexual activities, such as oral sex and masturbation, before their first intercourse. Males tended to report more frequent activity, but differences were largely non‑significant.","clinical_takeaway":"Clinicians should be aware that many adolescents engage in varied sexual activities before coitus and consider discussing these experiences when addressing sexual health.","confidence":0.7,"topic_tags":["prevalence","sexual_function","masturbation"],"strengths":["Large (for a single‑site) sample of both genders.","Addresses a understudied pre‑coital behavior period."],"limitations":["Convenience, student‑only sample limits generalisability.","Ad‑hoc questionnaire; no validated measures.","No control for moral, mental‑health or relational confounds.","Cross‑sectional, retrospective self‑report; potential recall bias."],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1018793622284"}},{"id":5477,"doi":null,"pmid":"12585287","pmcid":null,"title":"Social basis of deviant sexual behaviour: a historical perspective","authors":"Singh A.","first_author":"Singh A.","journal":"Bulletin of the Indian Institute of History of Medicine (Hyderabad)","year":1999,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical overview without empirical data; narrative synthesis of historical sources.","sample_n":null,"sample_text":"N/A","population":"None (no human participants studied)","country":"India (journal), but content global historical","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how societies have labeled and tolerated various sexual behaviours—such as masturbation, homosexuality, and extramarital sex—across history, noting shifts driven by religion, social movements, and health crises like AIDS.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad historical perspective","Incorporates multiple cultural epochs"],"limitations":["No empirical data","No systematic methodology","No measurement of key constructs"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5478,"doi":null,"pmid":"10101772","pmcid":null,"title":"[Psychogenic paroxysmal disorders in children]","authors":"Mulas F, Morant A.","first_author":"Mulas F","journal":"Revista de neurologia","year":1999,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article (narrative) without original empirical data; discusses psychogenic paroxysmal disorders in children, including masturbation as a psychogenic crisis.","sample_n":null,"sample_text":"Not applicable – no primary sample","population":"children (infancy to adolescence)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews childhood disorders that mimic neurological seizures, listing several psychogenic crises such as tantrums, panic attacks, and masturbation. It stresses careful history‑taking and the use of video‑EEG to rule out true neurological disease.","clinical_takeaway":"Clinicians should prioritize detailed anamnesis and consider video‑EEG when evaluating sudden behavioural or consciousness changes in children.","confidence":0.2,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Historical overview of psychogenic paroxysmal disorders","Highlights clinical importance of thorough anamnesis","Mentions video‑EEG as a diagnostic tool"],"limitations":["No original data; narrative review only","No systematic methodology or risk‑of‑bias assessment","No explicit measurement of sexual or psychological constructs"],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":5481,"doi":null,"pmid":"10101893","pmcid":null,"title":"[Urethral foreign bodies. Apropos 2 cases]","authors":"García Riestra V, Vareal Salgado M, Fernández García L.","first_author":"García Riestra V","journal":"Archivos espanoles de urologia","year":1999,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":2,"sample_text":"Two individual cases described","population":"2 adult patients (74‑year‑old male with mental disorder; 34‑year‑old female)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe two adults who inserted objects into their urethras—one a metal tube fragment, the other a calcified cable—requiring surgery. Both cases involved mental health issues, and the authors note that such insertions are often linked to masturbation.","clinical_takeaway":"Urethral foreign bodies, though rare, can arise from self‑inserted objects during masturbation, especially in individuals with mental health concerns; prompt surgical removal is essential.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Provides detailed clinical description of rare cases","Highlights association with mental disorder and masturbation"],"limitations":["Very small sample (n=2) limits generalizability","No systematic investigation of underlying psychological factors","No quantitative data or statistical analysis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":5483,"doi":null,"pmid":"9916389","pmcid":null,"title":"Premarital counseling clinic at Chulalongkorn Hospital","authors":"Reinprayoon D, Bunyavejchevin S.","first_author":"Reinprayoon D","journal":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","year":1998,"pub_types":["Journal Article"],"keywords":["Behavior","Asia","Thailand","Contraception","Sex behavior","Education","Family Planning","Clinic Activities","Contraceptive Usage","Counseling","Organization And Administration","Program Activities","Programs","Developing Countries","Family Characteristics","Research Report","Family And Household","Contraceptive Methods Chosen","Southeastern Asia","Family Planning Education","Couples"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive study of 200 premarital couples attending a counseling clinic (1988‑1998); data collected by staff on demographics, sexual experience, masturbation frequency, and contraceptive choices.","sample_n":200,"sample_text":"200 couples (400 individuals) recruited consecutively from the clinic over a ten‑year period.","population":"Couples (men and women) seeking premarital counseling at a Thai hospital; mean ages ~32 (men) and 29 (women); predominantly educated, employed, Buddhist.","country":"Thailand","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1998 Thai study described the demographics, sexual history, masturbation frequency, and contraceptive choices of 200 couples who attended a premarital counseling clinic between 1988 and 1998.","clinical_takeaway":"Counselling programs should consider couples' education, income, and differing sexual histories when planning premarital services.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large (for clinic) consecutive sample over a decade","Provides baseline data on sexual experience and contraception in Thai premarital couples"],"limitations":["Convenience sample from one hospital limits generalisability","No validated instruments; only basic self‑report","No assessment of psychological or moral factors that could influence sexual behaviour"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":5484,"doi":null,"pmid":"5101949","pmcid":null,"title":"Female masturbation--more common than we think","authors":"Bennett CJ.","first_author":"Bennett CJ.","journal":"Medical times","year":1971,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5485,"doi":null,"pmid":"5546928","pmcid":null,"title":"[Frequent public masturbation in toddlers]","authors":"Kamp LN.","first_author":"Kamp LN.","journal":"Nederlands tijdschrift voor geneeskunde","year":1971,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"dut","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5487,"doi":"10.1016/s1054-139x(97)00210-3","pmid":"9763158","pmcid":null,"title":"The sexual practices of Asian and Pacific Islander high school students","authors":"Schuster MA, Bell RM, Nakajima GA, Kanouse DE.","first_author":"Schuster MA","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":1998,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Population","Behavior","Ethnic Groups","Youth","North America","Students","Contraception","Sex behavior","Age factors","population characteristics","Education","United States","Family Planning","Contraceptive Methods","Adolescents","Demographic Factors","Developed Countries","Developing Countries","Oceania","Research Report","Americas","Northern America","Schools","Barrier Methods","Condom","California","Cultural Background","Risk Reduction Behavior","First Intercourse","Virginity","Premarital Sex Behavior","Secondary Schools","Asians"],"is_oa":false,"oa_url":null,"cited_by_count":45,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of one Los Angeles County school district","sample_n":2026,"sample_text":"2026 ninth‑to‑12th graders, 186 identified as Asian/Pacific Islander","population":"high school students (9‑12th grade), 2026 respondents (186 Asian/Pacific Islander)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 1992 survey of Los Angeles high school students found that Asian and Pacific Islander teens reported less vaginal intercourse and fewer risky sexual behaviors than peers, but some still engaged in activities that could lead to disease or pregnancy.","clinical_takeaway":"Asian/Pacific Islander adolescents generally have lower sexual risk, yet prevention programs should still address the minority engaging in unsafe practices.","confidence":0.6,"topic_tags":["adolescents","sexual_function","masturbation","csbd"],"strengths":["Large overall sample size for adolescent health survey","Anonymous self‑report reduces social desirability bias","Includes a range of sexual behaviors beyond intercourse"],"limitations":["Convenience sample from a single district limits generalisability","Small sub‑sample of Asian/Pacific Islander students","No validated scales for attitudes or risk; limited control for confounders"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":43,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1054-139x(97)00210-3"}},{"id":5489,"doi":"10.1080/00926239808403965","pmid":"9805290","pmcid":null,"title":"Treatment of an unusual case of masochism","authors":"Shiwach RS, Prosser J.","first_author":"Shiwach RS","journal":"Journal of sex & marital therapy","year":1998,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient treated with medications and psychotherapy; outcomes measured by frequency of fantasies and masturbation","sample_n":1,"sample_text":"one male patient","population":"adult male with masochistic sexual interests","country":"USA (presumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1998 case report describes a man with masochistic sexual interests who was treated with anti‑androgens, an antidepressant, psychotherapy, and aversive conditioning. The authors judged success by reductions in fantasy and masturbation frequency, suggesting anti‑androgens and aversive therapy may help short‑term.","clinical_takeaway":"Evidence is limited to one case; no firm treatment recommendations can be drawn.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["detailed clinical description","multimodal treatment approach"],"limitations":["single case, no control","no validated outcome measures","no assessment of confounding factors"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239808403965"}},{"id":5490,"doi":null,"pmid":"9833348","pmcid":null,"title":"[Sexuality and pregnancy]","authors":"Sueiro E, Gayoso P, Perdiz C, Doval JL.","first_author":"Sueiro E","journal":"Atencion primaria","year":1998,"pub_types":["Journal Article","English Abstract"],"keywords":["Population","Behavior","Pregnant women","Women","population characteristics","research methodology","Europe","Sampling studies","Spain","Demographic Factors","Developed Countries","Studies","Surveys","Mediterranean Countries","Coital Frequency","Southern Europe","Sex Behavior--women"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 206 pregnant women attending a psychoprophylaxis programme in Spain (1993‑1995). Self‑report questionnaire (PRESTA) on sexual desire, frequency, masturbation, satisfaction.","sample_n":206,"sample_text":"206 pregnant women","population":"206 pregnant women, mean age 28, married, first pregnancy, attending a family‑planning centre in Galicia, Spain.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1998 Spanish survey of 206 pregnant women found that most had weekly intercourse, some practiced masturbation, and they reported overall sexual satisfaction during pregnancy.","clinical_takeaway":"Pregnant women can maintain satisfactory sexual activity; clinicians should support open discussion of sexual preferences.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑site survey","Provides descriptive data on sexual behaviour during pregnancy","Uses a structured questionnaire (PRESTA)"],"limitations":["Convenience sample from a specific programme limits generalisability","No validated psychometric instruments for key constructs","No control for important confounds (e.g., mental health, relationship factors)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":5492,"doi":null,"pmid":"9773905","pmcid":null,"title":"Compulsive sexual behaviors--difficult aeromedical disposition","authors":"Koffman RL, Berg JS, Moore J.","first_author":"Koffman RL","journal":"Aviation, space, and environmental medicine","year":1998,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of five patients evaluated for aeromedical clearance; descriptive presentation of clinical assessments.","sample_n":5,"sample_text":"Five selected cases seen at the Naval Operational Medicine Institute.","population":"Male military personnel seeking aeromedical certification; middle‑aged adults.","country":"United States","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"supports","citation_value":"background","plain_summary":"The paper describes five Navy personnel with compulsive sexual behaviours and discusses how these conditions can affect judgment and safety during flight, recommending thorough psychiatric evaluation before aeromedical decisions.","clinical_takeaway":"Clinicians should assess compulsive sexual behaviour carefully when determining flight fitness, but evidence from this small series is limited.","confidence":0.7,"topic_tags":["adolescents"],"strengths":["clinical relevance to aeromedical safety","illustrates diagnostic challenges in real cases"],"limitations":["Very small, non‑representative sample","No validated measurement of CSB or distress","No control for key confounds such as moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5493,"doi":"10.3109/09638289809166089","pmid":"9664190","pmcid":null,"title":"Sexuality and sexual adjustment of patients with chronic pain","authors":"Monga TN, Tan G, Ostermann HJ, Monga U, Grabois M.","first_author":"Monga TN","journal":"Disability and rehabilitation","year":1998,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":61,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"convenience sample of 70 chronic pain patients, self‑report questionnaire","sample_n":70,"sample_text":"convenience sample of chronic pain patients attending clinic","population":"adults with chronic pain (mean age 49.9, mixed gender)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 70 adults with chronic pain, the study found many reported sexual problems, especially when also feeling depressed or distressed. Masturbation and partnered sex were less frequent, but pain severity itself did not predict sexual difficulties.","clinical_takeaway":"Addressing depression and distress may improve sexual health in chronic‑pain patients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Validated sexual functioning instrument","Multiple psychological measures included","Examines a clinically relevant population"],"limitations":["Convenience sample, limited generalisability","Small N, limited power for subgroup analyses","No control for moral or trauma variables"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":0,"mentioning":74,"citing_publications":99,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/09638289809166089"}},{"id":5495,"doi":null,"pmid":"9777617","pmcid":null,"title":"Sexual behavior changes with vulvar vestibulitis syndrome","authors":"White G, Jantos M.","first_author":"White G","journal":"The Journal of reproductive medicine","year":1998,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cohort of 40 patients with vulvar vestibulitis syndrome; sexual behavior questionnaires compared to normative data; no external control group.","sample_n":40,"sample_text":"Forty patients who met the criteria of vestibulitis syndrome composed the study cohort.","population":"Female patients with vulvar vestibulitis syndrome (n=40); age range not specified.","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 40 women with vulvar vestibulitis, sexual desire and orgasm remained similar to norms, but pain, reduced arousal, and avoidance of intercourse were markedly higher.","clinical_takeaway":"Vulvar vestibulitis can cause specific sexual dysfunctions (pain, reduced arousal, avoidance) despite unchanged desire and orgasm.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Focused clinical cohort","Clear reporting of significant sexual behavior changes","Relevant to clinical classification"],"limitations":["Small sample, no matched control group","Unclear validation of questionnaires","No adjustment for potential confounds (partner, mental health, trauma)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":5496,"doi":"10.1023/a:1018788126402","pmid":"9681120","pmcid":null,"title":"AIDS risk reduction strategies among United States and Swedish heterosexual university students","authors":"Weinberg MS, Lottes IL, Aveline D.","first_author":"Weinberg MS","journal":"Archives of sexual behavior","year":1998,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Culture","Acquired immunodeficiency syndrome","Viral diseases","Behavior","North America","Students","Contraception","Diseases","Sex behavior","Europe","Universities","Risk behavior","Education","United States","Sweden","Family Planning","Contraceptive Methods","Developed Countries","Northern Europe","Scandinavia","Research Report","Americas","Hiv Infections","Northern America","Schools","Barrier Methods","Condom","Risk Reduction Behavior","Premarital Sex Behavior","Heterosexuals"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of heterosexual university students in US (n=407) and Sweden (n=570); self‑administered questionnaire on sexual activities, condom use, number of partners.","sample_n":977,"sample_text":"Sweden n=570; United States n=407","population":"heterosexual university students (young adults, likely WEIRD sample)","country":"United States, Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1998 survey compared U.S. and Swedish heterosexual college students and found U.S. students used a mix of strategies (reducing casual sex and using condoms) while Swedish students mainly relied on consistent condom use with non‑steady partners, possibly reflecting cultural attitude differences.","clinical_takeaway":"Cultural attitudes may shape condom‑use strategies among young adults; clinicians should consider cultural context when discussing risk‑reduction.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large combined sample across two countries","Direct comparison of cultural contexts"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on self‑report questionnaires of unknown validation","No measurement of key confounds (moral attitudes, mental health, partner effects)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1018788126402"}},{"id":5497,"doi":"10.1034/j.1600-0412.1998.770613.x","pmid":"9688244","pmcid":null,"title":"History, clinical findings, sexual behavior and hygiene habits in women with and without recurrent episodes of urinary symptoms","authors":"Tchoudomirova K, Mårdh PA, Kallings I, Nilsson S, Hellberg D.","first_author":"Tchoudomirova K","journal":"Acta obstetricia et gynecologica Scandinavica","year":1998,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case‑control study comparing 217 women with recurrent, culture‑negative urinary symptoms to 710 asymptomatic controls; data collected via questionnaire and clinical exam.","sample_n":927,"sample_text":"217 cases, 710 controls","population":"Women attending family‑planning and youth clinics in Sweden, mean age≈26 years.","country":"Sweden","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"Women with repeated urinary‑tract‑like symptoms used different hygiene products and reported more frequent masturbation, anal sex, and sex during menstruation than symptom‑free women, suggesting these behaviours may be linked to their complaints.","clinical_takeaway":"Consider discussing sexual practices and hygiene habits when evaluating women with recurrent, culture‑negative urinary symptoms.","confidence":0.8,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Large control group","Clinical examination complementing self‑report","Focused comparison of specific hygiene practices"],"limitations":["Self‑report measures not validated","No assessment of mental health or moral/religious factors","Cross‑sectional case‑control design limits causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":0,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1034/j.1600-0412.1998.770613.x"}},{"id":5498,"doi":"10.1016/s0015-0282(98)00060-0","pmid":"9627308","pmcid":null,"title":"Successful pregnancy with sperm retrieved from the bladder after the introduction of a low-electrolyte solution for retrograde ejaculation","authors":"Saito K, Kinoshita Y, Yumura Y, Iwasaki A, Hosaka M.","first_author":"Saito K","journal":"Fertility and sterility","year":1998,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Two case reports of retrograde ejaculation patients undergoing bladder instillation of low‑electrolyte solutions before masturbation and subsequent intra‑uterine insemination.","sample_n":2,"sample_text":"Two patients","population":"Two adult men with retrograde ejaculation and their partners.","country":"Japan (university hospital)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors tried two different low‑salt liquids in the bladder before men with retrograde ejaculation masturbated, then used the collected sperm for intra‑uterine insemination. Both couples became pregnant after the glucose solution, showing it may be a simple, safe way to recover sperm.","clinical_takeaway":"A glucose solution instilled in the bladder can be an effective, low‑cost method to retrieve sperm for IUI in retrograde ejaculation patients, but evidence is limited to two cases.","confidence":0.4,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Clear description of a novel clinical technique","Objective outcome measures (sperm motility, pregnancy)","Successful live births reported"],"limitations":["Only two patients – no control group","Cannot generalise efficacy or safety","No statistical analysis beyond descriptive reporting"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0015-0282(98)00060-0"}},{"id":5499,"doi":"10.1023/a:1018607303203","pmid":"9604119","pmcid":null,"title":"The frequency of sexual dysfunctions in patients attending a sex therapy clinic in north India","authors":"Verma KK, Khaitan BK, Singh OP.","first_author":"Verma KK","journal":"Archives of sexual behavior","year":1998,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational, clinic‑based, consecutive sample of 1000 patients","sample_n":1000,"sample_text":"1000 consecutive clinic patients","population":"patients attending a sex‑therapy clinic in north India (mostly young educated males)","country":"India","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A 1998 study of 1000 patients at an Indian sex‑therapy clinic found premature ejaculation and nocturnal emission were the most common complaints, with many also reporting guilt about masturbation and concerns about penis size.","clinical_takeaway":"Clinicians should note that reported sexual problems may be influenced by cultural and moral factors not measured in this study.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["large clinic sample (n≈1000)","detailed descriptive breakdown of presenting complaints"],"limitations":["convenience, treatment‑seeking sample limits generalisability","no validated diagnostic instruments or psychometric scales","no control for moral, mental‑health, partner or trauma variables"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1018607303203"}},{"id":5500,"doi":"10.1016/s0022-5347(01)63204-x","pmid":"9598494","pmcid":null,"title":"Psychosocial adjustment after testicular cancer treatment","authors":"Ozen H, Sahin A, Toklu C, Rastadoskouee M, Kilic C, Gogus A, Kendi S.","first_author":"Ozen H","journal":"The Journal of urology","year":1998,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 140 testicular cancer survivors ≥1 year post‑treatment; General Health Questionnaire‑28 and ad‑hoc sexual/occupational items; no comparison group.","sample_n":140,"sample_text":"140 survivors free of disease ≥1 year","population":"Male testicular cancer survivors, mixed ages, treatment modalities varied.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among men cured of testicular cancer, sexual problems (libido, erection, ejaculation) worsened during treatment and improved afterward but did not fully return to pre‑cancer levels; intercourse and masturbation frequency dropped during treatment. Work performance was largely unchanged.","clinical_takeaway":"Clinicians should monitor sexual function after testicular cancer treatment and counsel patients that recovery may be incomplete.","confidence":0.8,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Relatively large sample for survivor survey","Use of validated GHQ‑28 for general health","Addresses both sexual and occupational domains"],"limitations":["Ad‑hoc sexual items lack validation","No control for key confounds (moral, partner, trauma)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-5347(01)63204-x"}},{"id":5501,"doi":null,"pmid":"9687753","pmcid":null,"title":"Sense and sexuality","authors":"Aylott J.","first_author":"Aylott J.","journal":"Nursing times","year":1998,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5502,"doi":"10.1016/s0003-9993(98)90034-x","pmid":"9630139","pmcid":null,"title":"Semen quality in spinal cord injured men: does it progressively decline postinjury?","authors":"Brackett NL, Ferrell SM, Aballa TC, Amador MJ, Lynne CM.","first_author":"Brackett NL","journal":"Archives of physical medicine and rehabilitation","year":1998,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective analysis of cross‑sectional semen data from 125 men with spinal cord injury (638 specimens)","sample_n":125,"sample_text":"125 men (638 semen specimens)","population":"men with spinal cord injury, ages adolescent‑middle aged, recruited from a university research centre","country":"USA (implied by journal and university affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In men with spinal‑cord injury, semen quality (sperm count and motility) does not get worse the longer they have been injured, suggesting timing of family planning need not depend on injury duration.","clinical_takeaway":"Clinicians can reassure men with SCI that sperm quality remains stable over time and does not delay family‑building decisions.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Objective laboratory semen parameters","Large number of specimens (638)","Clear temporal analysis across 2‑year intervals"],"limitations":["Retrospective, cross‑sectional design","Possible selection bias (clinic‑based sample)","No control for injury severity or other medical factors"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":3,"mentioning":25,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0003-9993(98)90034-x"}},{"id":5503,"doi":"10.1016/s0306-4530(98)00007-9","pmid":"9695139","pmcid":null,"title":"Neuroendocrine and cardiovascular response to sexual arousal and orgasm in men","authors":"Krüger T, Exton MS, Pawlak C, von zur Mühlen A, Hartmann U, Schedlowski M.","first_author":"Krüger T","journal":"Psychoneuroendocrinology","year":1998,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":88,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subject laboratory study of 10 healthy men measuring cardiovascular and neuroendocrine markers during masturbation‑induced orgasm.","sample_n":10,"sample_text":"ten healthy male volunteers","population":"Healthy adult males (n=10)","country":"Germany (likely, based on authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured heart rate, blood pressure and a range of hormones in ten men before, during and after they masturbated to orgasm. Orgasm caused brief spikes in heart rate, blood pressure and noradrenaline, and raised prolactin for up to half an hour, while other hormones stayed unchanged.","clinical_takeaway":"Orgasm produces short‑term cardiovascular and noradrenergic activation and a sustained prolactin rise; these are normal physiological responses in healthy men.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Objective physiological measurements","Clear operational definition of sexual arousal (masturbation)","Comprehensive hormonal panel"],"limitations":["Very small sample (n=10)","No control or comparison group","Limited generalisability to broader male population"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":85,"citing_publications":148,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0306-4530(98)00007-9"}},{"id":5504,"doi":"10.12968/bjon.1998.7.10.5678","pmid":"9775763","pmcid":null,"title":"Helping clients in their sexual expression","authors":"Scott H.","first_author":"Scott H.","journal":"British journal of nursing (Mark Allen Publishing)","year":1998,"pub_types":["Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12968/bjon.1998.7.10.5678"}},{"id":5506,"doi":"10.1023/a:1018634614590","pmid":"9562900","pmcid":null,"title":"Volunteer bias, sexuality, and personality","authors":"Trivedi N, Sabini J.","first_author":"Trivedi N","journal":"Archives of sexual behavior","year":1998,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative survey of volunteers recruited via two different advertisement frames; self‑report questionnaires on sexual behavior, masturbation frequency, and personality scales.","sample_n":null,"sample_text":"Not specified in abstract; likely modest convenience sample.","population":"Adults (male and female) recruited from a university/community sample; convenience volunteers.","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The way participants are recruited (explicitly for a sexuality study versus a general attitudes study) changes how personality traits relate to reported masturbation frequency, even though overall sexual behavior reports look similar.","clinical_takeaway":"Researchers should consider recruitment framing when interpreting self‑reported sexual behavior data.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Uses established personality instruments","Directly compares recruitment methods to reveal selection bias","Highlights how recruitment framing alters personality‑behavior correlations"],"limitations":["Self‑report sexual behavior without validated frequency scales","No control for key confounds (moral, mental health, partner effects)","Cross‑sectional convenience sample; limited generalisability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1018634614590"}},{"id":5507,"doi":"10.1111/j.2044-8279.1998.tb01275.x","pmid":"9589624","pmcid":null,"title":"Secondary school teachers' perception of pupils' undesirable behaviours","authors":"Borg MG.","first_author":"Borg MG.","journal":"The British journal of educational psychology","year":1998,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 605 randomly selected secondary teachers; questionnaire on perceived seriousness of 49 behaviours.","sample_n":605,"sample_text":"605 teachers","population":"Secondary school teachers (N=605) from 16 state schools in Malta","country":"Malta","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1998 survey of 605 Maltese secondary teachers asked how serious they considered 49 pupil behaviours. Drug use, bullying and destruction were seen as most serious; inquisitiveness least. Views varied by teacher and pupil gender, school grade, and teacher experience.","clinical_takeaway":"None – findings relate to teacher attitudes, not clinical sexual health.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Large, randomly selected teacher sample (N≈600)","Comprehensive list of 49 pupil behaviours","Analysis of multiple moderators (grade, sex, experience)"],"limitations":["Questionnaire appears author‑made; no validation reported","Cross‑sectional; cannot infer causality","No control for potential confounds (e.g., teacher attitudes, cultural norms)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.2044-8279.1998.tb01275.x"}},{"id":5510,"doi":"10.1023/a:1018653724159","pmid":"9494687","pmcid":null,"title":"Frequency and timing of coital orgasm in women desirous of becoming pregnant","authors":"Singh D, Meyer W, Zambarano RJ, Hurlbert DF.","first_author":"Singh D","journal":"Archives of sexual behavior","year":1998,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 69 women reporting desire for pregnancy and coital orgasm timing; regression analysis","sample_n":69,"sample_text":"Sixty‑nine women who desire pregnancy completed questionnaires on sexual behavior, orgasm frequency and timing.","population":"women (n=69) desiring pregnancy, likely convenience sample","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 69 women who wanted to become pregnant, those who reported having orgasms after their partner ejaculated were more likely to want a pregnancy. Orgasm frequency was linked to longer foreplay, masturbation, and active sexual participation, but not directly to pregnancy desire.","clinical_takeaway":"Evidence that orgasm timing may influence perceived fertility is weak; clinicians should not base pregnancy advice on orgasm timing alone.","confidence":0.8,"topic_tags":["sexual_function","religiosity"],"strengths":["Addresses a novel hypothesis about orgasm timing and fertility","Collects data on several sexual‑behavior variables","Uses regression to examine multiple predictors"],"limitations":["Small, non‑representative convenience sample (N=69)","Reliance on unvalidated single‑item self‑report measures","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1018653724159"}},{"id":5511,"doi":"10.1023/a:1018637907321","pmid":"9494686","pmcid":null,"title":"Pheromonal influences on sociosexual behavior in men","authors":"Cutler WB, Friedmann E, McCoy NL.","first_author":"Cutler WB","journal":"Archives of sexual behavior","year":1998,"pub_types":["Controlled Clinical Trial","Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Placebo‑controlled double‑blind trial; 38 heterosexual men; 2‑week baseline then 6‑week intervention; daily behavioral records of six sociosexual activities.","sample_n":38,"sample_text":"38 participants","population":"Adult heterosexual men (26‑42 years), likely convenience sample.","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a double‑blind trial, men who received a synthetic pheromone reported more sexual intercourse and sleeping with a romantic partner than when they took a placebo, while masturbation rates did not change.","clinical_takeaway":"Current evidence is limited; pheromone products cannot be recommended for enhancing sexual relationships.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Placebo‑controlled double‑blind design","Within‑subject baseline for each participant","Measures a range of real‑world sociosexual behaviors"],"limitations":["Small sample (N=38) limits statistical power","Self‑report logs not validated instruments","No control for potential confounds such as mood, relationship status, or individual differences in sexual desire"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1018637907321"}},{"id":5513,"doi":"10.1177/000306516901700307","pmid":"5350168","pmcid":null,"title":"Unconscious fantasy and masturbatory technique","authors":"Miller I.","first_author":"Miller I.","journal":"Journal of the American Psychoanalytic Association","year":1969,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000306516901700307"}},{"id":5514,"doi":null,"pmid":"9916546","pmcid":null,"title":"Sexual functioning and intimacy in African American and white breast cancer survivors: a descriptive study","authors":"Wyatt GE, Desmond KA, Ganz PA, Rowland JH, Ashing-Giwa K, Meyerowitz BE.","first_author":"Wyatt GE","journal":"Women's health (Hillsdale, N.J.)","year":1998,"pub_types":["Comparative Study","Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive comparative survey of 147 African American and White breast cancer survivors assessing sexual attitudes, history, and current practices.","sample_n":147,"sample_text":"147 survivors (African American and White).","population":"Adult female breast cancer survivors (mostly well‑educated, high‑income).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 147 African‑American and White breast‑cancer survivors, few ethnic differences emerged, but African‑American women reported less comfort with oral sex and masturbation, while White women noted a greater negative impact of cancer on their sex lives.","clinical_takeaway":"Clinicians should ask survivors about masturbation and oral‑sex comfort, as preferences differ by ethnicity.","confidence":0.8,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["Relatively large, ethnically diverse sample for survivorship research.","Addresses understudied African‑American survivor group.","Provides concrete data on masturbation and oral‑sex practices."],"limitations":["Cross‑sectional, cannot infer causality.","Limited description of measurement tools; likely non‑validated.","Few psychological or relational covariates controlled."],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":5515,"doi":"10.1007/bf02550279","pmid":"9569113","pmcid":null,"title":"The effects of ejaculation on serum prostate-specific antigen (PSA)","authors":"Yavaşçaoglu I, Savci V, Oktay B, Simşek U, Ozyurt M.","first_author":"Yavaşçaoglu I","journal":"International urology and nephrology","year":1998,"pub_types":["Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized controlled trial comparing serum PSA after ejaculation vs no ejaculation; n=25 in study group, control group size not specified","sample_n":25,"sample_text":"study group (n=25); control group size not reported in abstract","population":"young adult males, age 23‑25, presumably healthy volunteers","country":"Turkey (inferred from author names, not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a small trial of 25 young men, serum prostate‑specific antigen (PSA) was measured before masturbation, then 24 hours and 5 days later. Changes after ejaculation were inconsistent and not statistically different from a control group that did not ejaculate, suggesting ejaculation has little impact on PSA levels.","clinical_takeaway":"Ejaculation does not appear to meaningfully alter PSA; routine testing need not require abstinence.","confidence":0.7,"topic_tags":["masturbation","sexual_function","pornography"],"strengths":["Clear physiological outcome (PSA)","Direct comparison with non‑ejaculation control"],"limitations":["Small sample size, likely underpowered","No reporting of effect sizes or confidence intervals","Potential selection bias (young male volunteers only)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02550279"}},{"id":5516,"doi":"10.1177/00030651980460020301","pmid":"9684222","pmcid":null,"title":"The absence of the paternal penis","authors":"Elise D.","first_author":"Elise D.","journal":"Journal of the American Psychoanalytic Association","year":1998,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary / theoretical essay with a single clinical vignette; no empirical data collected.","sample_n":null,"sample_text":"Not applicable","population":"Not applicable (theoretical discussion of female psychosexual development)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article offers a psychoanalytic theory that a girl's feelings about the ‘absence of the paternal penis’ may shape her later experiences of vaginal desire and sexual fantasy, using a brief clinical vignette for illustration.","clinical_takeaway":"None - the piece is theoretical and does not provide evidence for clinical practice.","confidence":0.6,"topic_tags":["gender","sexual_function","pornography"],"strengths":["Provides a novel psychoanalytic perspective","Integrates clinical vignette for illustration"],"limitations":["No empirical data or systematic analysis","Relies on speculative theoretical constructs","Lacks operational definitions or measurement"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00030651980460020301"}},{"id":5517,"doi":"10.1159/000019673","pmid":"9676410","pmcid":null,"title":"Sexual functioning of adult patients born with meningomyelocele. A pilot study","authors":"Vroege JA, Zeijlemaker BY, Scheers MM.","first_author":"Vroege JA","journal":"European urology","year":1998,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pilot interview study with 11 participants, convenience sample, no control group","sample_n":11,"sample_text":"17 invited, 11 participated (8 men, 3 women)","population":"adult patients (19‑44) born with meningomyelocele, recruited from a single university hospital","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a small pilot of 11 adults born with meningomyelocele, most wanted sexual contact, half reported masturbating, and many reported sexual problems, though few were dissatisfied with their sexual life.","clinical_takeaway":"Clinicians should sensitively discuss sexual health with spina bifida patients, as issues are common but often under‑reported.","confidence":0.7,"topic_tags":["sexual_function","masturbation","neuroscience","moral_incongruence"],"strengths":["Focus on an understudied clinical population","Combines interview with a standardized sexual dysfunction questionnaire"],"limitations":["Very small, non‑representative sample","Limited use of validated measures; only 6 completed the QSD","No statistical testing or effect‑size reporting","Potential selection bias from clinic‑based recruitment"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000019673"}},{"id":5518,"doi":"10.1521/jaap.1.1998.26.1.29","pmid":"9724912","pmcid":null,"title":"Freud and castration: a new look into the origins of psychoanalysis","authors":"Bonomi C.","first_author":"Bonomi C.","journal":"The Journal of the American Academy of Psychoanalysis","year":1998,"pub_types":["Historical Article","Biography","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1521/jaap.1.1998.26.1.29"}},{"id":5519,"doi":"10.1159/000029036","pmid":"9697159","pmcid":null,"title":"A case of auto-erotic asphyxia in a long-term psychiatric setting","authors":"Quinn J, Twomey P.","first_author":"Quinn J","journal":"Psychopathology","year":1998,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single clinical case description of auto‑erotic asphyxia in a long‑term psychiatric patient","sample_n":1,"sample_text":"single case","population":"adult male psychiatric inpatient with schizophrenia","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A single psychiatric inpatient engaged in auto‑erotic asphyxia, a risky sexual practice that can mimic suicide attempts. The report stresses clinicians should consider this behavior when assessing asphyxiation incidents.","clinical_takeaway":"Clinicians should differentiate auto‑erotic asphyxia from suicide attempts in patients presenting with asphyxiation.","confidence":0.4,"topic_tags":["sexual_function","relationships","masturbation"],"strengths":["Detailed clinical description","Highlights diagnostic confusion with parasuicide"],"limitations":["Single case, no systematic data","No validated measures of behavior or distress","No control for confounding factors"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000029036"}},{"id":5520,"doi":"10.1177/070674376901400312","pmid":"5783174","pmcid":null,"title":"Reduction of compulsive masturbation by electrical-aversive conditioning to verbal cues: a case report","authors":"Olson KA, Kelley WR.","first_author":"Olson KA","journal":"Canadian Psychiatric Association journal","year":1969,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/070674376901400312"}},{"id":5521,"doi":null,"pmid":"9522407","pmcid":null,"title":"Some roots of persistent homosexual fantasy and the quest for father's love: conflicted parental identifications in a male patient: fragment of an analysis","authors":"Lax RF.","first_author":"Lax RF.","journal":"Psychoanalytic review","year":1997,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"case-report","design_detail":"single psychoanalytic case report, no systematic data collection","sample_n":1,"sample_text":"N=1 (single case)","population":"one adult male patient in psychoanalytic treatment","country":"USA (presumed based on journal, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"A psychoanalytic case report describes one man's lifelong homosexual fantasies as stemming from conflicted parental identifications and a lack of a supportive father figure, leading to narcissistic traits and specific fantasies.","clinical_takeaway":"This single case cannot inform clinical practice; its concepts are not empirically validated.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["In‑depth clinical narrative","Rich psychoanalytic interpretation"],"limitations":["Single patient, no generalizability","No validated measures or systematic data","No control of confounding variables"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":5522,"doi":"10.1097/00005053-199711000-00010","pmid":"9368549","pmcid":null,"title":"The sexual side effects of an SSRI treated by behavioral methods","authors":"Reich J.","first_author":"Reich J.","journal":"The Journal of nervous and mental disease","year":1997,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00005053-199711000-00010"}},{"id":5523,"doi":null,"pmid":"10174504","pmcid":null,"title":"Joycelyn Elders is master of her domain","authors":"Rosellini L.","first_author":"Rosellini L.","journal":"U.S. news & world report","year":1997,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5524,"doi":null,"pmid":"5387383","pmcid":null,"title":"Testicular and scrotal masturbation","authors":"Glenn J.","first_author":"Glenn J.","journal":"The International journal of psycho-analysis","year":1969,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5525,"doi":null,"pmid":"9446523","pmcid":null,"title":"[2 autoerotic accidents: fatal nitrous oxide anesthesia and thoracic compression]","authors":"Rothschild MA, Schneider V.","first_author":"Rothschild MA","journal":"Archiv fur Kriminologie","year":1997,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case_report","sample_n":2,"sample_text":"2 fatal cases","population":"Adult males (19‑20 y) who died during autoerotic activities","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article describes two young men who died while engaging in autoerotic practices: one using a homemade nitrous‑oxide system and another trapped in a pressurised suit, leading to fatal hypoxia and chest compression.","clinical_takeaway":"Autoerotic activities can involve hazardous equipment; safety education is essential for risk reduction.","confidence":0.9,"topic_tags":["masturbation","sexual_function"],"strengths":["Detailed forensic description of rare autoerotic fatalities","Highlights specific mechanical hazards (nitrous‑oxide delivery, thoracic compression)"],"limitations":["Only two cases; no controls or systematic data","No assessment of psychological or social factors","No quantitative analysis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5527,"doi":"10.1177/014107689709000712","pmid":"9290425","pmcid":"PMC1296388","title":"Female genital mutilation: a contemporary issue, and a Victorian obsession","authors":"Black J.","first_author":"Black J.","journal":"Journal of the Royal Society of Medicine","year":1997,"pub_types":["Historical Article","research-article","Biography","Portrait","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/014107689709000712"}},{"id":5529,"doi":null,"pmid":"9381623","pmcid":null,"title":"[A case of the multiyear presence of a foreign body in the bladder]","authors":"Davidov MI.","first_author":"Davidov MI.","journal":"Urologiia i nefrologiia","year":1997,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"rus","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single-patient case report of a copper wire foreign body introduced via urethra during self‑abuse (masturbation); no comparison group","sample_n":1,"sample_text":"1 patient","population":"male, age 47 at presentation (initial insertion at age 20)","country":"Russia (journal language suggests Russian origin)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 47‑year‑old man had a copper wire lodged in his bladder for 27 years after inserting it during self‑abuse. Imaging showed a stone‑like mass, which was surgically removed with full recovery.","clinical_takeaway":"Rare but possible: self‑insertion of objects can cause long‑standing bladder foreign bodies; prompt imaging and removal are needed.","confidence":0.9,"topic_tags":["masturbation","sexual_function"],"strengths":["Detailed clinical description","Imaging confirmation of foreign body"],"limitations":["Single case, no generalisation","No measurement of psychological or sexual‑behavior variables"],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":5531,"doi":"10.1023/a:1024518730222","pmid":"9146812","pmcid":null,"title":"Effect of testosterone administration on sexual behavior and mood in men with erectile dysfunction","authors":"Schiavi RC, White D, Mandeli J, Levine AC.","first_author":"Schiavi RC","journal":"Archives of sexual behavior","year":1997,"pub_types":["Clinical Trial","Research Support, U.S. Gov't, P.H.S.","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":77,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"double‑blind, placebo‑controlled, crossover trial in men with erectile dysfunction; 6‑week testosterone phase vs placebo, washout in between; outcomes: ejaculatory frequency, desire, masturbation, partner sex, mood.","sample_n":null,"sample_text":"Not specified in abstract; likely modest size typical of 1990s hormone trials","population":"healthy men with erectile dysfunction (eugonadal), sample size not reported in abstract","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In men with erectile dysfunction, short‑term testosterone shots increased how often they ejaculated and raised reports of desire, masturbation and sex with a partner, but did not improve erection rigidity or mood.","clinical_takeaway":"Testosterone may boost sexual activity frequency without fixing erectile quality or mood; not a routine treatment for erectile dysfunction.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Randomised double‑blind crossover design","Objective hormonal measurements","Separate assessment of masturbation and partner sex"],"limitations":["Sample size not reported; likely under‑powered","No effect‑size reporting or pre‑registration","Limited control for mental‑health or other confounds"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":115,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1024518730222"}},{"id":5532,"doi":null,"pmid":"9225502","pmcid":null,"title":"Health promotion of adolescents","authors":"Ye G.","first_author":"Ye G.","journal":"Collegium antropologicum","year":1997,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Journal article without empirical data; provides descriptive overview of adolescent health issues in China.","sample_n":null,"sample_text":"No sample size reported; article appears to be a narrative overview.","population":"adolescents in China (no specific sample reported)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews changes in adolescent health in China, noting earlier puberty, increased smoking, and rising issues like masturbation and teen pregnancy, and calls for more detailed health data and promotion.","clinical_takeaway":"None - not clinically applicable.","confidence":0.4,"topic_tags":["adolescents","sexual_function"],"strengths":["Broad overview of adolescent health trends in China","Includes a range of health topics (e.g., smoking, alcohol, sexual health)","Historical perspective since 1949"],"limitations":["No empirical data or sample described","No methodological detail, thus cannot assess validity or reliability","Lacks measurement of key confounds (e.g., moral incongruence, mental health)","Conclusions are general and not supported by statistical evidence"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":5533,"doi":"10.1016/s0022-5347(01)64878-x","pmid":"9112540","pmcid":null,"title":"Endoscopic removal of intravesical pencils using percutaneous nephrolithotomy sheath and forceps","authors":"Wegner HE, Franke M, Schick V.","first_author":"Wegner HE","journal":"The Journal of urology","year":1997,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-5347(01)64878-x"}},{"id":5534,"doi":"10.1002/(sici)1098-108x(1997)21:4<361::aid-eat9>3.0.co;2-m","pmid":"9138048","pmcid":null,"title":"Body dissatisfaction and sexuality among women with bulimia nervosa","authors":"Wiederman MW, Pryor T.","first_author":"Wiederman MW","journal":"The International journal of eating disorders","year":1997,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 221 adult women with bulimia nervosa; self‑report measures of body dissatisfaction and sexual experiences; regression analyses controlling for age, menarche, body size.","sample_n":221,"sample_text":"221 adult women with bulimia nervosa","population":"Adult women diagnosed with bulimia nervosa (purging type), recruited likely from clinical settings.","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 221 women with bulimia, greater body dissatisfaction was linked to lower rates and later onset of masturbation, but not to partnered sexual experience. Body dissatisfaction showed a weak trend toward lower sexual satisfaction.","clinical_takeaway":"Body image concerns in bulimic patients may be associated with reduced solitary sexual activity and modestly lower sexual satisfaction.","confidence":0.7,"topic_tags":["sexual_function","masturbation","relationships"],"strengths":["Large clinical sample (N>200)","Validated body‑dissatisfaction instrument","Controls for basic demographic covariates"],"limitations":["Cross‑sectional; no causal inference","Masturbation measured with single items","Key confounds (moral incongruence, mental health, relationship factors) not assessed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/(sici)1098-108x(1997)21:4<361::aid-eat9>3.0.co;2-m"}},{"id":5535,"doi":"10.15288/jsa.1997.58.264","pmid":"9130218","pmcid":null,"title":"Childhood sexual abuse and women's substance abuse: national survey findings","authors":"Wilsnack SC, Vogeltanz ND, Klassen AD, Harris TR.","first_author":"Wilsnack SC","journal":"Journal of studies on alcohol","year":1997,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":["Population","Child","Behavior","Youth","North America","population characteristics","research methodology","United States","Demographic Factors","Developed Countries","Studies","Surveys","Research Report","Americas","Northern America","Crime","Child Abuse","Alcohol Drinking--women","Drug Usage--women","Sexual Abuse","Women","Age factors","Social Problems","Sex Behavior--women","Child, Female","Substance Addiction--women","Sampling studies"],"is_oa":false,"oa_url":null,"cited_by_count":231,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"nationally representative survey of 1,099 US women, self‑report of childhood sexual abuse and current substance use; logistic regression controlling for age, ethnicity, parental education","sample_n":1099,"sample_text":"national survey of women's drinking","population":"US women (N=1099) from a national survey","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US national survey of 1,099 women, those who reported childhood sexual abuse were more likely to use alcohol and drugs, and to experience depression, anxiety and early sexual activity, compared with women without such histories.","clinical_takeaway":"History of childhood sexual abuse is a strong risk factor for later substance misuse and mental‑health problems; screening for CSA may inform prevention and treatment planning.","confidence":0.6,"topic_tags":["sexual_function","relationships","gender"],"strengths":["Large, nationally representative sample","Clear definition of CSA exposure","Statistical adjustment for basic demographics"],"limitations":["Cross‑sectional design; causality cannot be inferred","Limited detail on measurement validation","Key psychosocial confounds (e.g., moral incongruence, partner effects) not assessed"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":16,"contrasting":5,"mentioning":242,"citing_publications":439,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.15288/jsa.1997.58.264"}},{"id":5536,"doi":"10.1016/0005-7967(68)90036-3","pmid":"5644762","pmcid":null,"title":"Masturbatory fantasy and sexual deviation","authors":"Evans DR.","first_author":"Evans DR.","journal":"Behaviour research and therapy","year":1968,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":96,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0005-7967(68)90036-3"}},{"id":5537,"doi":null,"pmid":"9355399","pmcid":null,"title":"[An exploration of sexual knowledge, attitudes and behavior in aboriginal elementary school students in the Ping-Tung area]","authors":"Hsu HY, Liu CA, Lin YC.","first_author":"Hsu HY","journal":"Hu li za zhi The journal of nursing","year":1997,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 1,091 aboriginal elementary students using a structured questionnaire; cluster sampling; descriptive and correlational analyses.","sample_n":1091,"sample_text":"cluster‑sampled elementary school pupils (5th–6th grade).","population":"Fifth and sixth grade aboriginal elementary school students in the Ping‑Tung area, Taiwan (N≈1,091).","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1997 survey of over 1,000 aboriginal elementary school children in Taiwan found low sexual‑knowledge scores but generally positive attitudes. About one‑fifth reported having masturbated, and many felt guilt afterward. Knowledge and attitudes were linked, and girls scored higher than boys.","clinical_takeaway":"Educators should provide accurate, age‑appropriate sexual health information to reduce guilt and misinformation among young students.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample size for a school‑based survey","Cluster sampling improves geographic coverage","Provides baseline data on sexual knowledge and behaviors in a marginalized youth group"],"limitations":["Questionnaire not reported as validated","Cross‑sectional; cannot infer causality","No control for moral, mental‑health or trauma variables","Self‑report by children may be biased"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":5538,"doi":"10.1023/a:1024510528405","pmid":"9101033","pmcid":null,"title":"Gender differences in sexual interest","authors":"Baldwin JD, Baldwin JI.","first_author":"Baldwin JD","journal":"Archives of sexual behavior","year":1997,"pub_types":["Comparative Study","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"no empirical sample; theoretical review","population":"general adult population (theoretical discussion)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that both biology and culture shape men’s and women’s sexual interest, proposing a model that combines genetic, hormonal, and social influences rather than favoring either nature or nurture alone.","clinical_takeaway":"Clinicians should consider both biological and cultural factors when addressing concerns about gender differences in sexual desire.","confidence":0.4,"topic_tags":["sexual_function","gender"],"strengths":["Integrates biological and social perspectives","Provides a comprehensive theoretical model"],"limitations":["No original empirical data","Lacks systematic review methodology","No measurement of key constructs"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":11,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1024510528405"}},{"id":5539,"doi":"10.1023/a:1025883622452","pmid":"9105963","pmcid":null,"title":"Sexual behavior in adults with autism","authors":"Van Bourgondien ME, Reichle NC, Palmer A.","first_author":"Van Bourgondien ME","journal":"Journal of autism and developmental disorders","year":1997,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 89 adults with autism living in group homes; descriptive analysis of sexual behaviors and demographic associations.","sample_n":89,"sample_text":"89 adults with autism living in group homes in North Carolina","population":"Adults with autism in group homes (N≈89)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 1997 survey of 89 autistic adults in group homes found most engaged in sexual activity, with masturbation being most common and a third showing overt sexual arousal. The study describes behavior patterns and links to demographics and home policies.","clinical_takeaway":"Clinicians should recognize that many autistic adults are sexually active and consider individualized support rather than assuming a lack of interest.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large proportion of autistic adults surveyed","Inclusion of masturbation as distinct behavior","Provides descriptive baseline for an understudied group"],"limitations":["Convenience sample from group homes; not generalizable","No validated psychometric instruments used","Limited control of potential confounds (mental health, partner effects)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":90,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1025883622452"}},{"id":5540,"doi":"10.1176/ajp.124.7.991","pmid":"5688684","pmcid":null,"title":"Thioridazine-induced inhibition of masturbatory ejaculation in an adolescent","authors":"Greenberg HR, Carrillo C.","first_author":"Greenberg HR","journal":"The American journal of psychiatry","year":1968,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ajp.124.7.991"}},{"id":5541,"doi":"10.1080/00797308.1968.11822952","pmid":"4099026","pmcid":null,"title":"The body image, the function of masturbation, and adolescence. Problems of the ownership of the body","authors":"Laufer M.","first_author":"Laufer M.","journal":"The Psychoanalytic study of the child","year":1968,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00797308.1968.11822952"}},{"id":5542,"doi":"10.1177/000306516801600105","pmid":"5645542","pmcid":null,"title":"Masturbation","authors":"Francis JJ.","first_author":"Francis JJ.","journal":"Journal of the American Psychoanalytic Association","year":1968,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000306516801600105"}},{"id":5543,"doi":"10.1007/bf01563477","pmid":"4175657","pmcid":null,"title":"On masturbation: a study of Jean Genet's \"Our Lady of the Flowers\"","authors":"Valeros JA.","first_author":"Valeros JA.","journal":"The Psychiatric quarterly","year":1968,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01563477"}},{"id":5544,"doi":"10.1023/a:1024525504298","pmid":"9015581","pmcid":null,"title":"Assessment of sexual functioning for Chinese college students","authors":"Tang CS, Lai FD, Chung TK.","first_author":"Tang CS","journal":"Archives of sexual behavior","year":1997,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study with 305 Chinese college students, convenience sample, descriptive and correlational analyses","sample_n":305,"sample_text":"college student convenience sample","population":"Chinese college students in Hong Kong (N=305)","country":"Hong Kong (China)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study validates a Chinese version of the Derogatis Sexual Functioning Inventory with 305 college students, showing good reliability for most subscales and describing basic sexual behaviors such as intercourse and masturbation in this population.","clinical_takeaway":"The Chinese DSFI appears reliable for assessing sexual functioning in Chinese college students.","confidence":0.7,"topic_tags":["sexual_function","measurement","csbd"],"strengths":["Large sample for psychometric validation","Use of established instrument (DSFI)","Reports internal consistency and subscale properties"],"limitations":["Convenience sample limits generalizability","No assessment of mental‑health or moral variables","Cross‑sectional, descriptive design"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1024525504298"}},{"id":5545,"doi":"10.1023/a:1024521403389","pmid":"9015579","pmcid":null,"title":"Yohimbine, erectile capacity, and sexual response in men","authors":"Rowland DL, Kallan K, Slob AK.","first_author":"Rowland DL","journal":"Archives of sexual behavior","year":1997,"pub_types":["Controlled Clinical Trial","Clinical Trial","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"double‑blind, placebo‑controlled crossover trial in men with erectile dysfunction and a sexually functional comparison group; small sample (≈11 ED participants)","sample_n":null,"sample_text":"small, not reported precisely; likely under 30 participants total","population":"adult men with erectile problems and sexually functional controls","country":"not specified (likely USA/Europe based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a small double‑blind crossover trial, the drug yohimbine showed little effect on most measures of sexual response in healthy men and mixed results in men with erectile problems, with only a few reporting strong benefits.","clinical_takeaway":"Yohimbine is not reliably effective for improving erectile function; benefits appear limited to a minority of men.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["double‑blind, placebo‑controlled crossover design","objective physiological measures alongside self‑report","separate assessment of masturbation vs intercourse"],"limitations":["very small sample, especially in ED group","no pre‑registration or power analysis reported","limited assessment of potential psychological confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1024521403389"}},{"id":5546,"doi":"10.1176/appi.psychotherapy.1997.51.4.569","pmid":"9470962","pmcid":null,"title":"Short-term psychoanalytic psychotherapy with obsessive preadolescents","authors":"Ierodiakonou CS, Ierodiakonou-Benou I.","first_author":"Ierodiakonou CS","journal":"American journal of psychotherapy","year":1997,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case reports of short‑term psychoanalytic psychotherapy with obsessive‑compulsive preadolescents; no control group; n presumably 1‑2.","sample_n":null,"sample_text":"Not reported; case report format suggests very small (1‑2 participants).","population":"Obsessive preadolescent patients (age ~10‑13) receiving psychoanalytic psychotherapy.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe a few obsessive‑compulsive preadolescents who responded well to short‑term psychoanalytic therapy that openly addressed sexual topics and parental guilt.","clinical_takeaway":"Evidence is anecdotal; clinicians should not assume this approach works broadly for youth.","confidence":0.6,"topic_tags":["adolescents","pornography","masturbation","moral_incongruence","sexual_function"],"strengths":["Rich clinical detail","Illustrates early therapeutic alliance with adolescents"],"limitations":["Single‑case design, no controls","No validated outcome measures","No assessment of confounding variables"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.psychotherapy.1997.51.4.569"}},{"id":5547,"doi":null,"pmid":"9490546","pmcid":null,"title":"[Case histories of foreign bodies in the urogenital organs]","authors":"Davidov MI, Ivanov AV.","first_author":"Davidov MI","journal":"Vestnik khirurgii imeni I. I. Grekova","year":1997,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"rus","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5549,"doi":null,"pmid":"9157834","pmcid":null,"title":"[An extended case of autoerotic accident]","authors":"Schumann M, Rauch E, Priemer F.","first_author":"Schumann M","journal":"Archiv fur Kriminologie","year":1997,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single incident involving a heterosexual couple who died during autoerotic activity; no systematic data collection","sample_n":2,"sample_text":"Two individuals involved in a single autoerotic accident","population":"adult male and female (single case pair)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The report describes a fatal incident where a heterosexual couple died from strangulation while engaging in autoerotic activity together. It serves as a forensic account of this rare type of accident.","clinical_takeaway":"None – the case provides no clinical guidance for sexual health or behavior.","confidence":0.9,"topic_tags":["masturbation","sexual_function"],"strengths":["Provides detailed forensic description of a rare event","Highlights potential risks of autoerotic practices"],"limitations":["Single case; no generalizable data","No systematic measurement of sexual behavior or distress","No assessment of confounding factors"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5550,"doi":"10.2307/3420380","pmid":"5180919","pmcid":null,"title":"Masturbation","authors":"Brooks PA.","first_author":"Brooks PA.","journal":"The American journal of nursing","year":1967,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2307/3420380"}},{"id":5551,"doi":"10.3928/0098-9134-19961101-07","pmid":"8954388","pmcid":null,"title":"Inappropriate sexual behavior","authors":"Philo SW, Richie MF, Kaas MJ.","first_author":"Philo SW","journal":"Journal of gerontological nursing","year":1996,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review with case reports; no systematic methodology reported.","sample_n":null,"sample_text":"Not applicable – review of case reports and literature.","population":"Older adults in nursing settings (geriatric patients).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how older patients in nursing homes may display inappropriate sexual actions, such as public masturbation, and discusses how nurses can assess causes and manage these behaviors.","clinical_takeaway":"Clinicians should assess underlying reasons for inappropriate sexual behavior in elderly patients and tailor nursing interventions accordingly.","confidence":0.7,"topic_tags":["sexual_function","treatment"],"strengths":["Highlights clinical relevance of inappropriate sexual behavior in geriatric care","Provides practical nursing intervention suggestions"],"limitations":["Lacks systematic methodology and risk‑of‑bias assessment","No validated measurement instruments reported","No empirical data; conclusions based on case anecdotes"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":30,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3928/0098-9134-19961101-07"}},{"id":5553,"doi":null,"pmid":"6041164","pmcid":null,"title":"[An unusual foreign body in the bladder following masturbation]","authors":"Rehánek L.","first_author":"Rehánek L.","journal":"Ceskoslovenska pediatrie","year":1967,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"cze","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5554,"doi":"10.1007/bf02437543","pmid":"8899141","pmcid":null,"title":"Female sexuality and historical time: a comparison of sexual biographies of German women born between 1895 and 1936","authors":"von Sydow K.","first_author":"von Sydow K.","journal":"Archives of sexual behavior","year":1996,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"N=91 German women born 1895‑1936, in‑depth interviews, divided into four birth‑cohort groups, comparative descriptive analysis.","sample_n":91,"sample_text":"N=91","population":"German women, ages 50‑91, recruited for historical interview study","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 91 German women born between 1895 and 1936 show that younger cohorts reported more childhood sexual play, masturbation and orgasm experiences than older cohorts, suggesting historical shifts in female sexual behavior.","clinical_takeaway":"None – the study is historical and descriptive, not directly relevant to clinical assessment or treatment.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rich qualitative quotations","Longitudinal historical perspective","Large age span covering multiple cohorts"],"limitations":["Small, non‑representative convenience sample","No validated psychometric instruments","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02437543"}},{"id":5555,"doi":"10.2466/pms.1996.83.2.691","pmid":"8902049","pmcid":null,"title":"Facially impaired man versus chimpanzee: a within-primate differentiation effect","authors":"Wion F.","first_author":"Wion F.","journal":"Perceptual and motor skills","year":1996,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Within‑subject experimental study where 66 French female students rated perceived behavioral abilities of a severely deformed man and a chimpanzee from photographs. 2 (entity) × 2 (order) design with 33 participants per cell.","sample_n":66,"sample_text":"66 women, French students enrolled in a course.","population":"Adult female university students (N=66) from France, recruited via course enrollment.","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a lab study, French female students judged what a severely deformed man and a chimpanzee could do (including sexual activities). Ratings varied depending on whether the human or chimp photo was shown first, suggesting facial appearance influences perceived abilities.","clinical_takeaway":"None – findings relate to perception of facial deformity, not to clinical sexual health.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear experimental manipulation of stimulus order","Within‑subject design reduces between‑person variability","Novel comparison of human vs chimpanzee facial cues"],"limitations":["Small sample; limited statistical power","No validated measures of perceived behaviours","No control for potential confounds (e.g., participant attitudes)","Generalizability limited to female student sample"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2466/pms.1996.83.2.691"}},{"id":5557,"doi":"10.1080/00797308.1967.11822602","pmid":"5590069","pmcid":null,"title":"Masturbation fantasies. Their changes with growth and development","authors":"Wermer H, Levin S.","first_author":"Wermer H","journal":"The Psychoanalytic study of the child","year":1967,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00797308.1967.11822602"}},{"id":5558,"doi":"10.1006/hbeh.1996.0024","pmid":"8918675","pmcid":null,"title":"Frank A. Beach award. Homologies of animal and human sexual behaviors","authors":"Pfaus JG.","first_author":"Pfaus JG.","journal":"Hormones and behavior","year":1996,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":74,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"Not applicable – theoretical review with no primary data","population":"animals and humans (theoretical comparison)","country":"USA (author affiliation inferred)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper compares animal and human sexual behavior, proposing a framework that links similar neuroendocrine mechanisms across species while noting important differences in how desire, arousal, and performance are expressed.","clinical_takeaway":"None - not clinically applicable.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Comprehensive theoretical integration of animal and human literature","Clear distinction between appetitive and consummatory behaviors","Highlights neuroendocrine commonalities"],"limitations":["No primary empirical data","No systematic review methodology reported","Lacks quantitative synthesis or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":17,"citing_publications":127,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1006/hbeh.1996.0024"}},{"id":5559,"doi":"10.1381/096089296765556700","pmid":"10729879","pmcid":null,"title":"Impact of Bariatric Surgery on Body Image Perception and Sexuality in Morbidly Obese Patients and their Partners","authors":"Camps MA, Zervos E, Goode S, Rosemurgy AS.","first_author":"Camps MA","journal":"Obesity surgery","year":1996,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":45,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective questionnaire comparing self‑reported pre‑ and post‑surgery sexual outcomes in 28 patients and 16 partners; no control group; convenience sample; low response rate.","sample_n":28,"sample_text":"28 patients, 16 partners responded to mailed questionnaires.","population":"Adults (mean 4.2 years post‑bariatric surgery) who underwent gastric restriction; partners.","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small group of people who had weight‑loss surgery, both them and their partners reported better body image and more enjoyment of sex several years after the operation.","clinical_takeaway":"Weight loss may improve sexual confidence and satisfaction, but evidence is limited and not definitive.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Direct patient‑partner comparison","Focus on body‑image as a mediator","Long postoperative interval (up to 11 years)"],"limitations":["Very small, self‑selected sample","Unvalidated questionnaires","No statistical detail (effect sizes, CIs)","No adjustment for confounders"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":56,"citing_publications":91,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1381/096089296765556700"}},{"id":5560,"doi":"10.1016/0301-2115(96)02465-7","pmid":"8841810","pmcid":null,"title":"Influence of donor insemination on sexual functions of recipients","authors":"Kremer J.","first_author":"Kremer J.","journal":"European journal of obstetrics, gynecology, and reproductive biology","year":1996,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Interview‑based survey of 156 women undergoing donor insemination; descriptive analyses of sexual desire, orgasm, masturbation, etc.","sample_n":156,"sample_text":"156 women","population":"Women receiving heterologous donor insemination in the Netherlands (1996)","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a 1996 interview study of 156 women who received donor sperm, researchers found no evidence that the procedure disrupted sexual desire, orgasm, or other aspects of marital sexual life.","clinical_takeaway":"Donor insemination appears not to impair sexual function, but findings are limited to self‑reports without rigorous controls.","confidence":0.4,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Reasonably sized sample for a 1996 clinical interview study","Direct questioning about multiple aspects of sexual function"],"limitations":["No validated psychometric instruments used","No control for key confounds (partner effects, mental health, moral factors)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0301-2115(96)02465-7"}},{"id":5561,"doi":null,"pmid":"8894797","pmcid":null,"title":"Vaginal lubricants for the infertile couple: effect on sperm activity","authors":"Kutteh WH, Chao CH, Ritter JO, Byrd W.","first_author":"Kutteh WH","journal":"International journal of fertility and menopausal studies","year":1996,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"In‑vitro laboratory comparison of six lubricants (including two vegetable oils) on sperm motility and viability using manual counts, computer‑assisted analysis and viability staining; donors were healthy men, samples mixed with lubricants and assessed at multiple time‑points.","sample_n":null,"sample_text":"Normal, healthy donors (number not specified)","population":"Healthy male donors (masturbation‑obtained semen) – n not reported in abstract","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Lab tests showed that most commercial vaginal lubricants markedly reduce sperm movement and survival after an hour, while canola oil had no harmful effect. Couples trying to conceive should avoid most lubricants.","clinical_takeaway":"Recommend lubricant‑free intercourse or sperm‑friendly options (e.g., canola oil) for infertile couples.","confidence":0.85,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Validated laboratory assays for motility and viability","Use of positive and negative control conditions","Multiple time‑point measurements"],"limitations":["Small, unspecified donor sample; no power calculation","In‑vitro results may not fully translate to in‑vivo intercourse conditions","No assessment of participant‑level variables (e.g., age, seminal quality)"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":5562,"doi":null,"pmid":"11613421","pmcid":null,"title":"Wet-nursing, onanism, and the breast in eighteenth-century Germany","authors":"Richter S.","first_author":"Richter S.","journal":"Journal of the history of sexuality","year":1996,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5563,"doi":"10.1111/j.1465-5922.1996.00325.x","pmid":"8760994","pmcid":null,"title":"Female perversion: scenes and strategies in analysis and culture","authors":"Springer A.","first_author":"Springer A.","journal":"The Journal of analytical psychology","year":1996,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report, psychoanalytic theory, single clinical observation","sample_n":null,"sample_text":"Not reported; single case","population":"female patient(s) in analytic setting","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article offers a psychoanalytic description of how perverse sexual dynamics may develop in women, drawing on a single clinical case and comparing Freud and Jung's ideas.","clinical_takeaway":"None – the paper is theoretical and not evidence‑based for clinical use.","confidence":0.8,"topic_tags":["sexual_function","gender","csbd","moral_incongruence"],"strengths":["Provides a detailed psychoanalytic case narrative","Links theory to clinical observation"],"limitations":["No empirical measurement or validated instruments","Single case; not generalizable","No control of confounding factors"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1465-5922.1996.00325.x"}},{"id":5564,"doi":null,"pmid":"8768652","pmcid":null,"title":"[Sexual activity in the elderly in a rural environment]","authors":"Noguerol Alvarez M, Berrocal Varela M, de Aláiz Rojo AT, Pérez Astorga N, López Díaz A, Piñera Palacio R, Valdés Gómez C.","first_author":"Noguerol Alvarez M","journal":"Atencion primaria","year":1996,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"descriptive cross‑sectional study of 181 rural elders (60+) selected by simple random sampling from a municipal roll; questionnaire on sexual activity, health and sociodemographics","sample_n":181,"sample_text":"177 selected, 181 questionnaires filled (some over‑sampling)","population":"elderly (60+), rural Spain; 75 men, 106 women","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a rural Spanish town, about half of people aged 60 + were still sexually active. Continuing sex was linked to being male, younger, married and physically independent, while vascular disease, arthritis and certain medicines reduced activity.","clinical_takeaway":"Assess sexual function routinely in older patients, especially noting partner status and functional health.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Random sampling from municipal register","Large age‑range elderly sample","Includes both coital and non‑coital sexual activity"],"limitations":["Ad‑hoc questionnaire, limited validation","No measurement of moral/religious attitudes or mental‑health covariates","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":5565,"doi":null,"pmid":"8966742","pmcid":null,"title":"[Unusual finding of a foreign body during forensic medical expertise on a cadaver]","authors":"Demiev IN, Nigmatullin NSh.","first_author":"Demiev IN","journal":"Sudebno-meditsinskaia ekspertiza","year":1996,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"rus","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5566,"doi":"10.1016/0029-7844(96)00080-4","pmid":"8684765","pmcid":null,"title":"Psychologic profiles of and sexual function in women with vulvar vestibulitis and their partners","authors":"Van Lankveld JJ, Weijenborg PT, ter Kuile MM.","first_author":"Van Lankveld JJ","journal":"Obstetrics and gynecology","year":1996,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":84,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 43 women with vulvar vestibulitis and 38 partners, compared to normative data using validated questionnaires.","sample_n":81,"sample_text":"43 women with vulvar vestibulitis and 38 partners","population":"Women with vulvar vestibulitis recruited from a gynecology outpatient clinic and their male partners; comparison to published norms.","country":"Netherlands (likely, based on Dutch instruments)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Women with vulvar vestibulitis and their partners were surveyed; women showed higher somatization and shyness but similar overall distress to the general population, and reported more sexual problems in partnered activity than during masturbation. Partners reported few problems.","clinical_takeaway":"Vulvar vestibulitis is linked to situational sexual dysfunction for women, but partners generally report good sexual health.","confidence":0.85,"topic_tags":["sexual_function","gender"],"strengths":["Use of validated psychometric instruments","Inclusion of both women and their partners","Comparison to normative data"],"limitations":["Cross‑sectional design limits causal inference","Convenience clinic sample may not represent all women with vestibulitis","No effect‑size reporting or power analysis"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":13,"contrasting":1,"mentioning":54,"citing_publications":137,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0029-7844(96)00080-4"}},{"id":5567,"doi":null,"pmid":"5926772","pmcid":null,"title":"[\"Normal\" and pathological onanism (masturbation)]","authors":"Wunnenberg W.","first_author":"Wunnenberg W.","journal":"Der Landarzt","year":1966,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5568,"doi":"10.1007/bf02438163","pmid":"8726549","pmcid":null,"title":"Partner-specific sexual practices among heterosexual men and women with multiple partners: results from the French national survey, ACSF. Analyse des Comportements Sexuel en France","authors":"Messiah A, Pelletier A.","first_author":"Messiah A","journal":"Archives of sexual behavior","year":1996,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"subsample of national telephone survey (n=1644) of heterosexual adults with ≥2 partners in past year; descriptive and comparative analysis of sexual practices by partner type","sample_n":1644,"sample_text":"n = 1644 (subsample from ACSF survey n = 20,055)","population":"heterosexual men and women in France, aged 15‑64, with multiple recent partners","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1996 French telephone survey of 1,644 heterosexual adults with multiple partners found that condom use was generally low but slightly higher with occasional partners, while non‑penetrative and oral sex were more common with casual partners.","clinical_takeaway":"Clients with multiple partners should be counseled that condom use often varies by partner type; reinforce consistent protection regardless of relationship status.","confidence":0.4,"topic_tags":["sexual_function","relationships","pornography","masturbation"],"strengths":["Large national survey provides broad context","Clear differentiation of partner type (regular vs. occasional)","Detailed description of a range of sexual practices"],"limitations":["Self‑report data vulnerable to recall and social desirability bias","Cross‑sectional design precludes causal inference","No measurement of potential confounders (mental health, religiosity, trauma)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02438163"}},{"id":5569,"doi":"10.1016/0306-4530(96)00004-2","pmid":"8844879","pmcid":null,"title":"Gonadotrophin hormone releasing hormone agonist in cases of severe paraphilia: a lifetime treatment?","authors":"Thibaut F, Cordier B, Kuhn JM.","first_author":"Thibaut F","journal":"Psychoneuroendocrinology","year":1996,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"clinical trial / case series of six patients receiving GnRH‑a, no control group, long‑term follow‑up","sample_n":6,"sample_text":"Six patients (case series)","population":"adult males with severe paraphilic disorders (exhibitionism, pedophilia, etc.)","country":"France (presumed from authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Six men with severe paraphilic disorders were given a hormone treatment that suppresses testosterone. In five of them, deviant sexual thoughts and behaviours dropped markedly and stayed low for several years, but the study had no comparison group and involved only a handful of cases.","clinical_takeaway":"Hormonal suppression may reduce paraphilic urges, but evidence comes from tiny case series; clinicians should interpret results cautiously.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Long‑term follow‑up (up to 7 years)","Detailed clinical description of treatment course"],"limitations":["Very small, uncontrolled case series","No standardized, validated outcome measures","No control for confounding variables (e.g., mental health, moral factors)"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":48,"citing_publications":79,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0306-4530(96)00004-2"}},{"id":5571,"doi":null,"pmid":"8653041","pmcid":"PMC2146414","title":"Time for a new societal norm for sexuality","authors":"Kermode-Scott B.","first_author":"Kermode-Scott B.","journal":"Canadian family physician Medecin de famille canadien","year":1996,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5572,"doi":"10.1111/j.1465-5922.1966.00049.x","pmid":"5328173","pmcid":null,"title":"Towards the archetypal model for the masturbation inhibition","authors":"Hillman J.","first_author":"Hillman J.","journal":"The Journal of analytical psychology","year":1966,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":33,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1465-5922.1966.00049.x"}},{"id":5573,"doi":"10.4324/9780203358832-14","pmid":"5964302","pmcid":null,"title":"The relation of anal masturbation to projective identification","authors":"Meltzer D.","first_author":"Meltzer D.","journal":"The International journal of psycho-analysis","year":1966,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4324/9780203358832-14"}},{"id":5574,"doi":null,"pmid":"8709185","pmcid":null,"title":"[A survey on sex knowledge and medical demand of the cases in Kaohsiung city adolescent health clinic]","authors":"Chung TC, Yen CT, Wu HM, Wang YJ.","first_author":"Chung TC","journal":"The Kaohsiung journal of medical sciences","year":1996,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"chi","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 1,000 adolescents recruited from a city health clinic (1991‑1994) using self‑administered questionnaire and medical records; descriptive statistics and simple group comparisons.","sample_n":1000,"sample_text":"1000 participants recruited from May 1991 to May 1994 at a single adolescent health clinic in Kaohsiung city.","population":"Adolescents (approx. 13‑20 y) attending Kaohsiung city adolescent health clinic; male : female ≈1 : 2; mix of students and others.","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1990s survey of 1,000 Taiwanese adolescents attending a health clinic found modest sexual knowledge (≈68% correct), gaps in understanding masturbation and pregnancy risk, and low contraceptive use, highlighting the need for better sex education.","clinical_takeaway":"Adolescents may lack accurate sex knowledge and contraception use; clinicians should prioritize comprehensive sex education in teen health services.","confidence":0.85,"topic_tags":["sexual_function","adolescents"],"strengths":["Large sample size (N=1000)","Provides baseline data on adolescent sexual knowledge in 1990s Taiwan","Includes both knowledge scores and health‑service demand"],"limitations":["Convenience sample from a single clinic limits generalisability","Questionnaire validation not described","No control for moral, mental‑health or relationship confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":5575,"doi":"10.1007/bf02437906","pmid":"8714427","pmcid":null,"title":"Ethnic and gender differences in sexuality: variations in sexual behavior between Asian and non-Asian university students","authors":"Meston CM, Trapnell PD, Gorzalka BB.","first_author":"Meston CM","journal":"Archives of sexual behavior","year":1996,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":60,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 702 Canadian university students comparing Asian vs non‑Asian groups; laboratory‑based confidential questionnaire","sample_n":702,"sample_text":"346 non‑Asian, 356 Asian Canadian undergraduates","population":"undergraduate volunteers (N=702)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Canadian university students, those identifying as Asian reported fewer sexual partners, less intercourse, and lower sociosexual openness than non‑Asian peers, while still showing gender differences in fantasies and masturbation.","clinical_takeaway":"Cultural background may influence sexual behavior patterns, but findings do not imply pathology.","confidence":0.6,"topic_tags":["sexual_function","csbd"],"strengths":["large sample for a single‑university study","includes both interpersonal and intrapersonal behavior","examines ethnicity, gender, and residency"],"limitations":["cross‑sectional, cannot infer causality","likely uses ad‑hoc questionnaires, limited construct validation","no control for moral, mental‑health, or relationship variables"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":10,"contrasting":2,"mentioning":79,"citing_publications":132,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02437906"}},{"id":5576,"doi":null,"pmid":"8619140","pmcid":null,"title":"Accumulating experience in a child abuse clinic","authors":"de Villiers FP, Prentice MA.","first_author":"de Villiers FP","journal":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","year":1996,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"record review of all cases presenting to a child abuse clinic over one year (N=227); descriptive statistics only","sample_n":227,"sample_text":"227 patients (80 % female) presenting to the clinic between May 1988 and April 1989","population":"children (mostly <10 y) seen at a South African child‑abuse clinic","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed 227 children seen in a South African abuse clinic, describing who the perpetrators were and what behavioural problems (including masturbation) were reported. Most victims were young girls, and abuse was usually committed by known family members.","clinical_takeaway":"Clinicians should note the high prevalence of family‑member perpetrators and associated behavioural issues when assessing child sexual abuse cases.","confidence":0.8,"topic_tags":["sexual_function","religiosity"],"strengths":["Large consecutive case series for the clinic’s first year","Detailed breakdown of abuse type and perpetrator relationship"],"limitations":["Clinician‑recorded data lack validated measurement tools","No control/comparison group; findings not generalisable to broader child population","No statistical testing beyond simple frequencies"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":5579,"doi":"10.1177/000992289603500103","pmid":"8825845","pmcid":null,"title":"Orgasm without organisms: science or propaganda?","authors":"Genuis SJ, Genuis SK.","first_author":"Genuis SJ","journal":"Clinical pediatrics","year":1996,"pub_types":["Review","Journal Article"],"keywords":["Population","Biology","Population dynamics","Sexuality","Fertility","Personality","Behavior","Youth","Contraception","Diseases","Sex behavior","epidemics","Age factors","Promotion","Literature review","population characteristics","Infections","Psychological factors","Risk behavior","reproductive behavior","Education","risk factors","Family Planning","Contraceptive Methods","Adolescents","Demographic Factors","Sex Education","Economic Factors","Reproductive Tract Infections","Barrier Methods","Condom","Sexually Transmitted Diseases--prevention And Control","Pregnancy, Unplanned","Marketing","Risk Reduction Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of educational strategies; no primary data collected.","sample_n":null,"sample_text":"Not applicable – no empirical sample","population":"adolescents (mentioned in abstract only)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors review proposals to teach teens non‑coital sexual activities (outercourse) as a way to lower STDs and unwanted pregnancies, but they provide no original data and base conclusions on theoretical arguments.","clinical_takeaway":"None – the paper offers no evidence to guide clinical practice.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Addresses an under‑studied public‑health topic","Covers a range of literature sources"],"limitations":["No primary data; speculative claims","Lacks systematic review methodology","No measurement of key variables (e.g., STI rates, sexual behaviour)","Potential advocacy bias"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000992289603500103"}},{"id":5580,"doi":null,"pmid":"8862155","pmcid":"PMC1382041","title":"Non-gay-identifying men who have sex with men: formative research results from Seattle, Washington","authors":"Goldbaum G, Perdue TR, Higgins D.","first_author":"Goldbaum G","journal":"Public health reports (Washington, D.C. : 1974)","year":1996,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Formative qualitative study using interviews, focus groups and observations with a convenience sample of non‑gay‑identifying men who have sex with men in Seattle. No quantitative sample size reported.","sample_n":null,"sample_text":"Not reported in abstract; qualitative convenience sample of staff, business contacts and NSM participants.","population":"Non‑gay‑identifying men who have sex with men (NSM) in Seattle, Washington, USA","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews and focus groups with men who have sex with men but do not identify as gay revealed several sub‑groups with high HIV risk and low condom use, suggesting tailored outreach is needed.","clinical_takeaway":"Targeted, culturally sensitive HIV prevention should consider the diverse sub‑groups of non‑gay‑identifying MSM.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insights from multiple stakeholder groups","Identifies specific sub‑populations for targeted HIV interventions"],"limitations":["No quantitative measurement or validated scales","Convenience sampling limits generalizability","No reported sample size or demographic breakdown"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":5581,"doi":"10.1017/s002572730006066x","pmid":"8824677","pmcid":"PMC1037059","title":"Bad habits and pernicious results: thumb sucking and the discipline of late-nineteenth-century paediatrics","authors":"Gillis J.","first_author":"Gillis J.","journal":"Medical history","year":1996,"pub_types":["Historical Article","research-article","Biography","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s002572730006066x"}},{"id":5582,"doi":null,"pmid":"8754355","pmcid":null,"title":"[The epileptic attacks of orgasm]","authors":"Badalian LO, Temin PA, Mukhin KIu.","first_author":"Badalian LO","journal":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","year":1996,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"rus","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5583,"doi":null,"pmid":"8605056","pmcid":null,"title":"Sexual repertoires of heterosexuals: implications for HIV/sexually transmitted disease risk and prevention. The ACSF Group, Analyse des Comportements Sexuels en France","authors":"Messiah A, Blin P, Fiche V.","first_author":"Messiah A","journal":"AIDS (London, England)","year":1995,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"national probability sample, cross‑sectional survey of 4261 adults (18‑69) in France, 1991‑1992","sample_n":4261,"sample_text":"4261 individuals from a representative French population sample","population":"heterosexual adults, general population","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 1995 French national survey of 4,261 heterosexual adults described the most common sexual acts during a single encounter and showed that practices like mutual masturbation and oral sex often occur together, while condom use was unrelated to any particular set of acts.","clinical_takeaway":"Condom promotion should be universal, as condom use does not depend on specific sexual practices.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Systematic coding of multiple sexual practices","Clear descriptive statistics linking repertoires to age and relationship type"],"limitations":["Self‑report data, no validated sexual‑behaviour instrument cited","Cross‑sectional; cannot infer causal relationships","No adjustment for potential confounders such as substance use or mental health"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":5586,"doi":"10.1016/0301-2115(95)02071-e","pmid":"7556840","pmcid":null,"title":"Vaginal foreign bodies in women in postmenopause and in senium","authors":"Jaluvka V, Novak A.","first_author":"Jaluvka V","journal":"European journal of obstetrics, gynecology, and reproductive biology","year":1995,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of three postmenopausal women with vaginal foreign bodies","sample_n":3,"sample_text":"Three cases reported","population":"Women aged 69‑81, postmenopausal","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe three elderly women who had objects placed in their vaginas, sometimes for sexual stimulation, and required medical removal. One object remained for seven years. The report notes that sexual activity can be problematic in older adults.","clinical_takeaway":"Clinicians should be aware that older patients may engage in sexual practices involving vaginal insertion and may need supportive, non‑judgmental care.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Provides rare clinical detail on an understudied age group","Highlights need for attention to sexual health in older women"],"limitations":["Very small, non‑representative sample (n=3)","No systematic measurement of sexual behavior or psychosocial factors","No control group or comparison"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0301-2115(95)02071-e"}},{"id":5587,"doi":"10.1097/00004583-199508000-00013","pmid":"7665442","pmcid":null,"title":"Sexual behavior problems and psychopathology symptoms in sexually abused girls","authors":"Cosentino CE, Meyer-Bahlburg HF, Alpert JL, Weinberg SL, Gaines R.","first_author":"Cosentino CE","journal":"Journal of the American Academy of Child and Adolescent Psychiatry","year":1995,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control observational study of sexually abused girls versus two control groups","sample_n":null,"sample_text":"not specified in abstract","population":"girls aged 6‑12 years, sexually abused (n unknown) and two demographically comparable control groups","country":"USA (presumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study compared pre‑adolescent girls who had been sexually abused with two control groups and found that abused girls showed more sexual behavior problems—such as excessive masturbation and public genital exposure—along with higher internalising and externalising psychopathology.","clinical_takeaway":"Sexual abuse in children is linked to heightened sexual behavior problems; clinicians should assess for these behaviors when working with abused youths.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Validated child behavior instruments (CBCL, CSBI)","Two demographically comparable control groups","Focus on specific sexual behavior problems"],"limitations":["Cross‑sectional case‑control; cannot infer causality","No reporting of sample size or power analysis","Potential lack of control for mental‑health covariates in sexual‑behavior analyses"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":29,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00004583-199508000-00013"}},{"id":5588,"doi":"10.1177/070674379504000626","pmid":"7585413","pmcid":null,"title":"Re: Auto-erotic asphyxial death","authors":"Cooper AJ.","first_author":"Cooper AJ.","journal":"Canadian journal of psychiatry. Revue canadienne de psychiatrie","year":1995,"pub_types":["Letter","Comment","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/070674379504000626"}},{"id":5590,"doi":"10.1016/s0022-5347(01)67436-6","pmid":"7714969","pmcid":null,"title":"Timing of penile color flow duplex ultrasonography using a triple drug mixture","authors":"Govier FE, Asase D, Hefty TR, McClure RD, Pritchett TR, Weissman RM.","first_author":"Govier FE","journal":"The Journal of urology","year":1995,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case series of 280 consecutive patients undergoing penile duplex ultrasound after triple‑drug injection; scans at 0,5,15,30 min; descriptive analysis of peak arterial velocity.","sample_n":280,"sample_text":"280 consecutive patients","population":"adult men evaluated for vasculogenic erectile dysfunction (middle‑aged, clinical sample)","country":"United States (presumed by journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 280 men undergoing penile Doppler ultrasound after a triple‑drug injection, peak arterial flow continued to rise up to 30 minutes. Measuring only at 5 minutes missed normal flow in a small minority, so delaying the first scan improves diagnostic accuracy.","clinical_takeaway":"Delay the initial penile Doppler scan to at least 5 minutes post‑injection and consider additional scans up to 30 minutes to avoid under‑diagnosing vascular erectile dysfunction.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Large consecutive clinical sample (N=280)","Objective vascular outcome measure with clear threshold","Systematic timing protocol (0,5,15,30 min)","Relevant to clinical practice in erectile dysfunction assessment"],"limitations":["No control/comparison group","Descriptive statistics only, no inferential analysis","Potential selection bias (clinic‑based sample)","No power justification or effect‑size reporting"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-5347(01)67436-6"}},{"id":5592,"doi":"10.7748/ns.9.29.46.s54","pmid":"7766512","pmcid":null,"title":"Sexual health: a natural remedy","authors":"Howe J.","first_author":"Howe J.","journal":"Nursing standard (Royal College of Nursing (Great Britain) : 1987)","year":1995,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7748/ns.9.29.46.s54"}},{"id":5593,"doi":"10.1016/1054-139x(94)00070-u","pmid":"7542029","pmcid":null,"title":"Adolescent readers' responses to the booklet on sex","authors":"Hannonen S, Kekki P.","first_author":"Hannonen S","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":1995,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 800 randomly selected Finnish 16‑year‑olds; 65 % response (N=521) after receiving a sex‑education booklet; attitudes and reactions measured by questionnaire.","sample_n":521,"sample_text":"Eight hundred randomly selected; 521 respondents (65 % response)","population":"Finnish adolescents, age 16, both sexes","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A Finnish sex‑education booklet mailed to 16‑year‑olds was read by most recipients, who reported generally positive attitudes, though reactions to sections on homosexuality and masturbation were less favorable.","clinical_takeaway":"Educational sex‑booklets can reach adolescents effectively; positive reception supports continued use in health promotion.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Random selection of participants from target population","High reach of the booklet (97 % reported receiving it)","Reasonable response rate for a mail survey"],"limitations":["Reliance on ad‑hoc questionnaire items without validation","Cross‑sectional design limits causal inference","No assessment of long‑term behavioural outcomes"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/1054-139x(94)00070-u"}},{"id":5594,"doi":"10.1111/j.1365-2788.1995.tb00483.x","pmid":"7787385","pmcid":null,"title":"Urine fetish in a man with learning disabilities","authors":"Collacott RA, Cooper SA.","first_author":"Collacott RA","journal":"Journal of intellectual disability research : JIDR","year":1995,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single individual case description","population":"30‑year‑old man with learning disabilities","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article reports a single case of a man with learning disabilities who has a fetish for watching women urinate, offering a brief clinical description and speculation about underlying dynamics.","clinical_takeaway":"This report is descriptive only; it does not provide evidence for assessment or treatment of similar fetishes.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Detailed clinical description of a rare paraphilia","Discusses possible dynamic factors"],"limitations":["Single case; no generalisable data","No systematic measurement of constructs or controls"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2788.1995.tb00483.x"}},{"id":5596,"doi":"10.1017/s0033291700036308","pmid":"7675928","pmcid":null,"title":"Puberty, sexual milestones and abuse: how are they related in eating disorder patients?","authors":"Schmidt U, Evans K, Tiller J, Treasure J.","first_author":"Schmidt U","journal":"Psychological medicine","year":1995,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study of eating‑disorder patients and college controls","sample_n":222,"sample_text":"44 RAN, 26 BAN, 29 BN/HistAN, 69 BN, 44 controls","population":"Women with restricting anorexia nervosa (n=44), bulimic anorexia nervosa (n=26), bulimia nervosa with/without prior anorexia (n=58), and female college students (n=44) – all from clinic or university samples, not population‑based","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Women with eating disorders, especially restricting anorexia, start sexual milestones like kissing, masturbation and intercourse later than college‑control women; they also have fewer sexual partners. Childhood sexual abuse was reported in about a quarter of patients but did not explain the delays.","clinical_takeaway":"Eating‑disorder patients may experience delayed psychosexual development; clinicians should assess sexual history and provide supportive counseling.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Clear comparative groups (ED subtypes and controls)","Multiple sexual‑development milestones assessed","Inclusion of childhood sexual abuse as a variable"],"limitations":["Cross‑sectional, cannot infer causality","Small subgroup sizes limit power","Questionnaires not reported as validated instruments","No control for moral, mental‑health or partner factors"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":2,"mentioning":37,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0033291700036308"}},{"id":5597,"doi":null,"pmid":"8525179","pmcid":null,"title":"[Reproductive health in adolescent students: knowledge, attitudes, and behavior in both sexes, in a community of Santiago]","authors":"Millán T, Valenzuela S, Vargas NA.","first_author":"Millán T","journal":"Revista medica de Chile","year":1995,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 948 adolescents from a single low‑income public school in Santiago","sample_n":948,"sample_text":"948 teenagers (600 females) from a public school of one of the poorest communities of Santiago","population":"adolescents (age unspecified) attending one public secondary school in a poor Santiago community","country":"Chile","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1995 survey of 948 Chilean teenagers found low knowledge about reproduction, many misconceptions about contraception, and limited use of protection despite half having a partner. Both boys and girls often considered masturbation risky and many held inaccurate beliefs about pregnancy risk.","clinical_takeaway":"Sex education programs for low‑income adolescents should address major knowledge gaps and correct misconceptions about contraception and pregnancy risk.","confidence":0.7,"topic_tags":["adolescents","sexual_function","religiosity"],"strengths":["Large sample for a single‑school survey","Comprehensive coverage of knowledge, attitudes, and recent sexual behaviour"],"limitations":["Convenience sample from one low‑income school limits generalisability","Questionnaire appears non‑validated","Statistical reporting limited to descriptive percentages"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":5598,"doi":"10.1111/j.1365-2710.1995.tb00618.x","pmid":"7775608","pmcid":null,"title":"Medicine as an agency of social control: Part Three","authors":"Kilwein JH.","first_author":"Kilwein JH.","journal":"Journal of clinical pharmacy and therapeutics","year":1995,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2710.1995.tb00618.x"}},{"id":5599,"doi":"10.1001/jama.1963.63710030028012","pmid":"14057114","pmcid":null,"title":"MASTURBATION AND CLITORIDECTOMY. A NINETEENTH-CENTURY VIEW","authors":"DUFFY J.","first_author":"DUFFY J.","journal":"JAMA","year":1963,"pub_types":["Historical Article","Journal Article"],"keywords":["History","Surgery, operative","History Of Medicine, 19th Cent.","Clitoris","Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/jama.1963.63710030028012"}},{"id":5600,"doi":null,"pmid":"7676873","pmcid":null,"title":"Psychosexual characteristics of male university students in Brazil","authors":"Leite RM, Buoncompagno EM, Leite AC, Mergulhao EA, Battistoni MM.","first_author":"Leite RM","journal":"Adolescence","year":1995,"pub_types":["Journal Article"],"keywords":["Population","Acquired immunodeficiency syndrome","Viral diseases","Personality","Behavior","Men","Brazil","Diseases","Sex behavior","Age factors","population characteristics","Universities","Education","Adolescents","Demographic Factors","Developing Countries","Family Characteristics","Research Report","Americas","Hiv Infections","Family And Household","Family Relationships","Schools","Latin America","South America","Adolescents, Male","Risk Reduction Behavior--men","Youth--men","Premarital Sex Behavior--men","Students--men","Sexuality--men","Psychological Factors--men","First Intercourse--men"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 268 male university freshmen","sample_n":268,"sample_text":"Male freshmen at the State University of Campinas, Brazil","population":"male university freshmen in Brazil (N=268)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 268 Brazilian male university freshmen described their sexual development, masturbation, and attitudes toward sex, finding most had normal development but many lacked family communication about sexuality and some engaged in risky behaviours.","clinical_takeaway":"None – the study is descriptive and does not provide actionable clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","masturbation","adolescents"],"strengths":["Reasonably large sample for a university survey","Broad coverage of psychosexual topics"],"limitations":["Reliance on non‑validated, self‑report questionnaire","Cross‑sectional design limits causal inference","Key confounders (moral views, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":5601,"doi":"10.1080/00797308.1995.11822404","pmid":"7480405","pmcid":null,"title":"The analysis of an overstimulated child","authors":"Gavshon A.","first_author":"Gavshon A.","journal":"The Psychoanalytic study of the child","year":1995,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single clinical case report of a latency‑stage girl; no systematic sampling, no control group","sample_n":1,"sample_text":"single case","population":"one female child (Suzie) referred for psychoanalytic therapy","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A psychoanalytic case study describes a 10‑year‑old girl whose body‑image problems, masturbatory anxieties, and sexual fantasies were linked to family conflict and a medical skin condition. Treatment focused on providing a stable therapeutic environment.","clinical_takeaway":"This single case does not provide evidence for clinical practice; it illustrates one therapist’s interpretive approach.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["detailed psychoanalytic narrative","integration of medical and environmental factors"],"limitations":["single case, not generalisable","no validated measures of sexuality or distress","no systematic control of confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00797308.1995.11822404"}},{"id":5602,"doi":null,"pmid":"7599523","pmcid":null,"title":"The debate over sex education","authors":"Gaskin IM.","first_author":"Gaskin IM.","journal":"The Birth gazette","year":1995,"pub_types":["Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5604,"doi":"10.1007/bf01541815","pmid":"7872858","pmcid":null,"title":"Homosexual foot fetishism","authors":"Weinberg MS, Williams CJ, Calhan C.","first_author":"Weinberg MS","journal":"Archives of sexual behavior","year":1994,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 262 members of a foot‑fetish organization; convenience self‑selected sample; descriptive analyses.","sample_n":262,"sample_text":"Members of an organization for homosexual foot fetishists","population":"Adult men who identify as homosexual foot fetishists (n=262).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 1994 survey of 262 men who identify as gay foot fetishists describes the range of foot‑related objects they find arousing, how the fetish relates to ideas of masculinity, and how it fits into their relationships and broader gay subcultures.","clinical_takeaway":"None – the study is descriptive and does not provide evidence for clinical assessment or treatment.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large (for this niche) sample of 262 participants","Provides descriptive insight into a understudied fetish community","Considers both sensual and symbolic aspects of arousal"],"limitations":["Self‑selected convenience sample limits generalisability","Use of ad‑hoc, likely unvalidated questionnaire items","No control for potential confounds (e.g., mental health, partner effects)","Descriptive statistics without effect sizes or correction for multiple testing"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541815"}},{"id":5605,"doi":"10.1016/s0140-6736(94)92894-0","pmid":"7997008","pmcid":null,"title":"Out goes the Surgeon General","authors":"Greenberg DS.","first_author":"Greenberg DS.","journal":"Lancet (London, England)","year":1994,"pub_types":["Historical Article","News","Biography"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0140-6736(94)92894-0"}},{"id":5607,"doi":"10.1016/0010-440x(94)90231-3","pmid":"7867321","pmcid":null,"title":"Pseudoseizures, sexual abuse, and hermeneutic reasoning","authors":"Slavney PR.","first_author":"Slavney PR.","journal":"Comprehensive psychiatry","year":1994,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review discussing hermeneutic interpretation of pseudoseizures and sexual abuse; no empirical data presented.","sample_n":null,"sample_text":"No sample; review article","population":"Not applicable (no participants)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that interpreting pseudoseizures as a direct symbol of sexual abuse is a risky, interpretive approach. While abuse is a risk factor, it should not be assumed from seizure symptoms alone.","clinical_takeaway":"Clinicians should avoid inferring sexual abuse solely from conversion disorder presentations.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Clear articulation of potential interpretive bias","Highlights need for caution in clinical reasoning"],"limitations":["No empirical data","Lacks systematic review methodology"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0010-440x(94)90231-3"}},{"id":5608,"doi":null,"pmid":"7850913","pmcid":null,"title":"[Occurrence of deviant tendencies in phalloplethysmographic and vulvoplethysmographic examinations in sexually dysfunctional patients (case reports)]","authors":"Tichý P.","first_author":"Tichý P.","journal":"Ceskoslovenska psychiatrie","year":1994,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"cze","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case reports (n=4)","sample_n":4,"sample_text":"Four case histories","population":"adult men and women with sexual dysfunctions","country":"Czech Republic (likely)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"avoid","plain_summary":"The author reports four patients whose sexual dysfunction was linked to undisclosed homosexual or sadomasochistic interests, identified using penile or vulvar blood‑flow measurements. The study suggests these hidden tendencies caused the dysfunctions.","clinical_takeaway":"Do not rely on plethysmography to diagnose hidden sexual orientations or to explain sexual dysfunctions.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Detailed physiological recordings (PPG/VPG)","Illustrates hidden deviant tendencies"],"limitations":["Case series, no control group","No validated psychometric instruments","Small N, no statistical analysis","Potential circular reasoning about cause of dysfunction"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5609,"doi":"10.1097/00152193-199410000-00020","pmid":"7854670","pmcid":null,"title":"Stumping Dr. O'Connell","authors":"Sheard T.","first_author":"Sheard T.","journal":"Nursing","year":1994,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00152193-199410000-00020"}},{"id":5611,"doi":"10.1007/bf01541494","pmid":"7998812","pmcid":null,"title":"Changes in adolescents' sexuality between 1970 and 1990 in West-Germany","authors":"Schmidt G, Klusmann D, Zeitzschel U, Lange C.","first_author":"Schmidt G","journal":"Archives of sexual behavior","year":1994,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative study using semi‑structured interviews of urban adolescents in 1970 (N=602) and 1990 (N=415).","sample_n":1017,"sample_text":"602 participants in 1970 cohort; 415 participants in 1990 cohort.","population":"16‑17‑year‑old West‑German urban adolescents (both sexes).","country":"Germany (West)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with German teens in 1970 and 1990 show that the early‑age rise in sexual activity seen in the 1960s slowed, boys report less urge‑driven behaviour, and girls report less sexual pleasure but more initiative. HIV/AIDS did not appear to drive these changes.","clinical_takeaway":"None – the study describes historical trends, not clinical guidance.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large historical sample sizes for each cohort.","Direct interview data provides rich qualitative insight.","Clear comparison of two time points."],"limitations":["Convenience urban sample limits generalisability.","No validated psychometric instruments reported.","Statistical methods and effect sizes not detailed."],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":19,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541494"}},{"id":5612,"doi":null,"pmid":"7858632","pmcid":null,"title":"[Sexuality in Ancient Egypt]","authors":"Androutsos G, Marketos S.","first_author":"Androutsos G","journal":"Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie","year":1994,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical article; no empirical data, no participants, no measurements.","sample_n":null,"sample_text":"None – the article is a narrative historical review.","population":"Ancient Egyptian society (historical description)","country":"Egypt (historical)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how sex was expressed in ancient Egypt, covering marriage, concubinage, incest, various sexual practices, genital surgeries, and medical knowledge of the time.","clinical_takeaway":"None – the paper is historical and does not provide clinical guidance for modern sexual health.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Broad historical overview of diverse sexual practices","Incorporates multiple aspects of ancient Egyptian sexuality"],"limitations":["No empirical data; purely narrative","No systematic methodology or source critique described","No relevance to contemporary pornography or sexual health research"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5614,"doi":null,"pmid":"13930129","pmcid":null,"title":"A review of Freud's contributions to the topic of masturbation","authors":"LEVIN S.","first_author":"LEVIN S.","journal":"Bulletin of the Philadelphia Association for Psychoanalysis","year":1963,"pub_types":["Journal Article"],"keywords":["Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5615,"doi":null,"pmid":"7964559","pmcid":null,"title":"Commentary on, \"Autoerotic fatalities with power hydraulics,\" (J. Forensic Sci., Vol. 38, No. 2, March 1993, pp. 359-364)","authors":"Contostavlos DL.","first_author":"Contostavlos DL.","journal":"Journal of forensic sciences","year":1994,"pub_types":["Letter","Comment","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5616,"doi":"10.1159/000171466","pmid":"7882550","pmcid":null,"title":"Colitis cystica profunda: self-inflicted by rectal trauma? Report of a case","authors":"Lifshitz D, Cytron S, Yossiphov J, Lelcuk S, Rabau M.","first_author":"Lifshitz D","journal":"Digestive diseases (Basel, Switzerland)","year":1994,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient","sample_n":1,"sample_text":"single case","population":"adult female with colitis cystica profunda","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A rare benign rectal condition (colitis cystica profunda) was reported in a woman who also practiced anal masturbation, suggesting the trauma might have contributed to the disease.","clinical_takeaway":"No firm link between anal masturbation and rectal disease can be drawn from a single case.","confidence":0.7,"topic_tags":["gender","sexual_function","masturbation"],"strengths":["Detailed clinical description","Use of imaging to support diagnosis"],"limitations":["Single case, no control","Causal inference from one observation"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000171466"}},{"id":5617,"doi":null,"pmid":"14053709","pmcid":null,"title":"[QUESTIONNAIRE SENT TO PARENTS, PHYSICIANS AND TEACHERS ON MASTURBATION AND SEX EDUCATION]","authors":"WEINSTEIN M, PRASCHKER L.","first_author":"WEINSTEIN M","journal":"Prensa medica argentina","year":1963,"pub_types":["Journal Article"],"keywords":["Child","Adolescence","Sex Education","Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5618,"doi":"10.1016/s0022-5347(17)32776-3","pmid":"8054059","pmcid":null,"title":"Re: The management of penile Mondor's phlebitis: superficial dorsal penile vein thrombosis","authors":"Birla V, Sengupta D.","first_author":"Birla V","journal":"The Journal of urology","year":1994,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-5347(17)32776-3"}},{"id":5619,"doi":"10.1210/jcem.79.2.8045977","pmid":"8045977","pmcid":null,"title":"Metabolic and behavioral effects of high-dose, exogenous testosterone in healthy men","authors":"Bagatell CJ, Heiman JR, Matsumoto AM, Rivier JE, Bremner WJ.","first_author":"Bagatell CJ","journal":"The Journal of clinical endocrinology and metabolism","year":1994,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":125,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subject pre‑post trial of 19 healthy men receiving 200 mg testosterone weekly for 20 weeks; no control group.","sample_n":19,"sample_text":"19 healthy men","population":"healthy adult men (n≈19)","country":"USA (likely, based on NIH funding)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 19 healthy men, high‑dose testosterone for 20 weeks lowered HDL cholesterol and altered calcium hormones, but caused only minor, non‑significant changes in self‑reported sexual activity and arousal.","clinical_takeaway":"Short‑term high testosterone may affect lipids and calcium but appears to have minimal impact on sexual activity frequency.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Physiologically detailed hormonal and metabolic data","Within‑subject design controls for baseline individual differences","Objective laboratory measurements"],"limitations":["Very small sample, no control group","Self‑report sexual behavior without validated scales","No assessment of psychological/confounding variables"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":39,"citing_publications":218,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1210/jcem.79.2.8045977"}},{"id":5621,"doi":"10.1080/00313029400169631","pmid":"7991282","pmcid":null,"title":"Autoerotic deaths: four cases","authors":"Cooke CT, Cadden GA, Margolius KA.","first_author":"Cooke CT","journal":"Pathology","year":1994,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of four fatalities during autoerotic activities; no control group, descriptive only","sample_n":4,"sample_text":"four cases","population":"four adult males (young to elderly) who died during autoerotic practices","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reports four unusual deaths that occurred while men were engaging in autoerotic activities such as hanging, electrocution, inhaling a zucchini, and using a vacuum cleaner. All deaths were ruled accidental.","clinical_takeaway":"None - the report is forensic and does not inform clinical practice.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Provides detailed forensic descriptions of rare autoerotic deaths","Highlights multiple modes of autoerotic injury"],"limitations":["Very small sample (n=4), no statistical analysis","No systematic measurement of sexual behavior or psychological variables","Findings not generalizable"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":27,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00313029400169631"}},{"id":5623,"doi":"10.1016/0005-7967(94)90142-2","pmid":"8042965","pmcid":null,"title":"The relationship between phallometrically measured deviant sexual arousal and clinical characteristics in juvenile sexual offenders","authors":"Hunter JA, Goodwin DW, Becker JV.","first_author":"Hunter JA","journal":"Behaviour research and therapy","year":1994,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two convenience samples of juvenile sexual offenders (N=44, 54) assessed with phallometric testing and clinical questionnaires; cross‑sectional correlational analysis.","sample_n":98,"sample_text":"Two samples of 44 and 54 male juvenile sex offenders.","population":"juvenile sexual offenders (adolescents and young adults)","country":"USA (assumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured physiological sexual arousal patterns in two groups of juvenile sex offenders and linked higher deviant arousal to offenses involving only male victims, while noting that the link between arousal and offense was weaker than in adult offenders.","clinical_takeaway":"Phallometric data may inform risk assessment in juvenile offenders but should be interpreted cautiously and not treated as definitive evidence of offending patterns.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Use of objective physiological measure (phallometry)","Direct comparison of deviant arousal with offense characteristics","Discussion of developmental differences from adult literature"],"limitations":["Convenience sample of offenders limits generalisability","Cross‑sectional design prevents causal inference","Limited control of potential confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":47,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0005-7967(94)90142-2"}},{"id":5624,"doi":null,"pmid":"8073966","pmcid":null,"title":"A foreign body of the corpus cavernosum in a patient with cleft glans penis: a case report","authors":"Matsuzaka J, Aoki H, Banya Y, Fujioka T, Kubo T, Nagane Y.","first_author":"Matsuzaka J","journal":"Hinyokika kiyo. Acta urologica Japonica","year":1994,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report describing surgical removal of a self‑inserted wire used for masturbation; no control group or systematic methodology","sample_n":1,"sample_text":"N=1 (single case)","population":"one middle‑aged male with cleft glans penis","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 13 cm wire was self‑inserted into a man's penis for masturbation and later surgically removed; this rare case has not been previously reported.","clinical_takeaway":"Clinicians should be aware that self‑inserted penile foreign bodies can occur and may require surgical removal.","confidence":0.9,"topic_tags":["masturbation","sexual_function","gender"],"strengths":["Detailed clinical description of a rare urological presentation","Surgical management clearly outlined"],"limitations":["Single case; no generalizable conclusions","No assessment of psychological or sexual‑health context","No control or comparison group"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5625,"doi":"10.1016/0306-9877(94)90006-x","pmid":"7935074","pmcid":null,"title":"Sexual asphyxiophilia (Koczwarism) in women and the biological phenomenon of female ejaculation","authors":"Zaviacic M.","first_author":"Zaviacic M.","journal":"Medical hypotheses","year":1994,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/theoretical paper without empirical data","sample_n":null,"sample_text":"none (the paper is a hypothesis article)","population":"women (adult, unspecified) and reference to men; no sample size reported","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The paper proposes that women may repeatedly engage in sexual asphyxiophilia because it makes orgasm easier, especially for those who also experience female ejaculation, which they find especially pleasurable.","clinical_takeaway":"None - the article is speculative and does not provide clinical evidence.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["addresses a rare phenomenon","integrates physiological and psychological perspectives"],"limitations":["no empirical data","speculative causal claims","lacks measurement validation"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0306-9877(94)90006-x"}},{"id":5626,"doi":"10.1177/000306516201000204","pmid":"13868266","pmcid":null,"title":"Dreams and masturbation in an adolescent boy","authors":"BERNSTEIN I.","first_author":"BERNSTEIN I.","journal":"Journal of the American Psychoanalytic Association","year":1962,"pub_types":["Journal Article"],"keywords":["Dreams/psychology","Masturbation/in Adolescence"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000306516201000204"}},{"id":5628,"doi":null,"pmid":"8071253","pmcid":null,"title":"Compulsive exhibitionism successfully treated with fluvoxamine: a controlled case study","authors":"Zohar J, Kaplan Z, Benjamin J.","first_author":"Zohar J","journal":"The Journal of clinical psychiatry","year":1994,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient, ABACA single‑blind controlled case study","sample_n":1,"sample_text":"N=1 (single case)","population":"adult male with compulsive exhibitionism","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1994 case report describes one man with compulsive exhibitionism whose urges stopped while taking fluvoxamine, an OCD medication, but returned with other treatments. The authors suggest some paraphilias may be OCD‑related.","clinical_takeaway":"Fluvoxamine may help reduce compulsive exhibitionistic urges in some individuals, but evidence is limited to a single case.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed longitudinal single‑case ABACA design","Use of a validated OCD severity scale (Y‑BOCS)"],"limitations":["N=1; no generalisability","No control for moral, mental‑health or relational confounds","Construct of ‘compulsive exhibitionism’ not operationalised separately from OCD"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":5629,"doi":"10.1210/jcem.78.3.8126146","pmid":"8126146","pmcid":null,"title":"Effects of endogenous testosterone and estradiol on sexual behavior in normal young men","authors":"Bagatell CJ, Heiman JR, Rivier JE, Bremner WJ.","first_author":"Bagatell CJ","journal":"The Journal of clinical endocrinology and metabolism","year":1994,"pub_types":["Clinical Trial","Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":120,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized, double‑blind, placebo‑controlled hormone manipulation trial in healthy young men (N≈49 total)","sample_n":49,"sample_text":"9–10 men per group across five arms","population":"normal, eugonadal young adult men (community volunteers)","country":"USA (implied by author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In healthy men, temporarily blocking natural hormone production reduced testosterone and estradiol, leading to lower sexual desire, fantasies, intercourse, and masturbation; these effects reversed after treatment stopped.","clinical_takeaway":"Acute hormone deficiency can markedly diminish sexual activity in men, but effects are reversible.","confidence":0.8,"topic_tags":["sexual_function","masturbation","moral_incongruence"],"strengths":["Randomized, double‑blind design","Physiological verification of hormone levels","Repeated measures across treatment period"],"limitations":["Very small group sizes (≤10 per arm)","No validated sexual function scales reported","Potential lack of control for mood or relational variables"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":2,"mentioning":112,"citing_publications":231,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1210/jcem.78.3.8126146"}},{"id":5630,"doi":null,"pmid":"7824998","pmcid":null,"title":"AIDS related attitudes and sexual practices of the Jakarta WARIA (male transvestites)","authors":"Lubis I, Master J, Bambang M, Papilaya A, Anthony RL.","first_author":"Lubis I","journal":"The Southeast Asian journal of tropical medicine and public health","year":1994,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of >600 male transvestites (WARIA) in Jakarta as part of an HIV education campaign; community‑based convenience sample; descriptive statistics only.","sample_n":600,"sample_text":"over 600 male transvestites (WARIA)","population":"male transvestites (WARIA) engaged in commercial sex work, Indonesia; N≈600","country":"Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 1994 survey of over 600 male transvestites in Jakarta found many engaged in high‑risk sexual acts (e.g., condomless anal sex) despite fear of HIV and limited knowledge. The authors warned that without risk awareness the community could see rising infections.","clinical_takeaway":"Education alone may be insufficient; targeted risk‑reduction interventions are needed for sex‑worker populations.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a hard‑to‑reach population (≈600)","Addresses multiple high‑risk practices (anal sex, oral sex, masturbation)","Provides baseline data for a specific community"],"limitations":["Self‑report, no validated instruments","Convenience sample, limited generalisability","No adjustment for key confounders (mental health, moral factors, partner dynamics)","Interpretation may overstate community‑wide HIV freedom"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":5631,"doi":"10.1192/bjp.108.452.1","pmid":"13904676","pmcid":null,"title":"Masturbatory insanity: the history of an idea","authors":"HARE EH.","first_author":"HARE EH.","journal":"The Journal of mental science","year":1962,"pub_types":["Journal Article"],"keywords":["Mental disorders","Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":74,"citing_publications":159,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/bjp.108.452.1"}},{"id":5632,"doi":"10.1007/bf01541618","pmid":"8135652","pmcid":null,"title":"Relationships among cardiovascular, muscular, and oxytocin responses during human sexual activity","authors":"Carmichael MS, Warburton VL, Dixen J, Davidson JM.","first_author":"Carmichael MS","journal":"Archives of sexual behavior","year":1994,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":153,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subject laboratory study measuring cardiovascular, muscular and oxytocin responses during self‑stimulation in 23 adults.","sample_n":23,"sample_text":"13 women, 10 men completed two or more tests of self‑stimulation extending 5 min beyond orgasm.","population":"13 women, 10 men (adult volunteers, self‑stimulation).","country":"United States (US PHS funding indicated)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study of 23 adults, researchers measured blood pressure, muscle activity, and oxytocin levels during self‑stimulation. They found strong positive links between oxytocin spikes and cardiovascular and muscular responses, suggesting oxytocin may play a role in sexual arousal and orgasm.","clinical_takeaway":"Oxytocin rises alongside physiological arousal during orgasm, but the small, non‑clinical sample limits direct clinical implications.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Objective physiological and hormonal measurements","Continuous monitoring throughout sexual activity","Both male and female participants"],"limitations":["Very small, convenience sample (N=23)","No control for potential confounds (mood, health, sexual experience)","Correlational design limits causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":6,"contrasting":0,"mentioning":133,"citing_publications":274,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541618"}},{"id":5633,"doi":null,"pmid":"8128393","pmcid":null,"title":"[Male and female sexuality--differences according to sex and age]","authors":"Kockott G.","first_author":"Kockott G.","journal":"Therapeutische Umschau. Revue therapeutique","year":1994,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"no empirical data; narrative summary of sex‑age differences in sexual physiology and attitudes","sample_n":null,"sample_text":"none reported","population":"not applicable","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how sexual physiology, behaviour, and attitudes differ between men and women across ages, noting that men's sexual response is more uniform, women's more variable, and that both experience slower responses with age. It also observes rising rates of female masturbation over recent decades.","clinical_takeaway":"None – the piece is a narrative overview without actionable clinical guidance.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["Provides a broad overview of sex‑age patterns in sexual function","Mentions historical trend in female masturbation"],"limitations":["No original data or systematic methodology","No operational definitions or validated measures","Confounding factors (e.g., mental health, relationship context) not examined"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5634,"doi":null,"pmid":"8085494","pmcid":null,"title":"Psychosexual characteristics of female university students in Brazil","authors":"Leite RM, Buoncompagno EM, Leite AC, Mergulhao EA, Battistoni MM.","first_author":"Leite RM","journal":"Adolescence","year":1994,"pub_types":["Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":["Population","Reproduction","Viral diseases","Behavior","Menarche","Youth","Contraception","Brazil","Diseases","Sex behavior","Age factors","population characteristics","research methodology","Psychological factors","Universities","Sampling studies","Menstruation","Education","Family Planning","Adolescents","Demographic Factors","Contraceptive Usage","Studies","Surveys","Adolescents, Female","Developing Countries","Family Characteristics","Research Report","Americas","Family And Household","Family Relationships","Schools","Hiv Infections--prevention And Control","Acquired Immunodeficiency Syndrome--prevention And Control","Latin America","South America","First Intercourse","Students--women","Premarital Sex Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 240 female freshmen at a Brazilian university; cross‑sectional convenience sample; no intervention","sample_n":240,"sample_text":"Convenience sample of first‑year women at UNICAMP; not randomized or representative of broader population","population":"female university students (freshmen) in Brazil (N=240)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 240 first‑year Brazilian women described their puberty, menstrual, sexual, and contraceptive experiences. Most reported normal development, but many had menstrual issues and risky contraceptive practices.","clinical_takeaway":"None – the study is descriptive and offers no clinical recommendations.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large (N=240) sample for a single university","Broad range of psychosexual topics covered"],"limitations":["Cross‑sectional design; no causal inference","Questionnaire appears ad‑hoc, not validated","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":5639,"doi":"10.1016/0028-2243(93)90238-8","pmid":"8157141","pmcid":null,"title":"Comments by the 'Information by Phone' Department of the Sex Medical Institute on the telephone calls related to sexuality and contraception","authors":"Cardamakis E, Vinakos G, Lambou T, Papathanasiou Z.","first_author":"Cardamakis E","journal":"European journal of obstetrics, gynecology, and reproductive biology","year":1993,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive analysis of 5252 telephone calls to a sex‑medical institute (Feb‑1989 to Jul‑1991).","sample_n":5252,"sample_text":"5252 telephone calls","population":"Adults (men and women) who called the institute; not a random sample.","country":"Greece (presumed from author names/institute)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The paper summarises 5,252 calls to a sex‑medical institute in the early 1990s, reporting that callers mainly asked about masturbation, genital anatomy concerns, and fears around first sexual experiences.","clinical_takeaway":"None – the data are descriptive and not generalisable to clinical practice.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Large number of real‑world enquiries","Provides insight into topics of public concern in the period"],"limitations":["Non‑representative, self‑selected sample of callers","No validated measures; relies on informal categorisation","No statistical testing or control for confounds"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0028-2243(93)90238-8"}},{"id":5641,"doi":"10.1177/000306516100900203","pmid":"13711066","pmcid":null,"title":"Masturbation and character","authors":"HAMMERMAN S.","first_author":"HAMMERMAN S.","journal":"Journal of the American Psychoanalytic Association","year":1961,"pub_types":["Journal Article"],"keywords":["Psychoanalytic Interpretation","Masturbation/psychology"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000306516100900203"}},{"id":5642,"doi":"10.1016/0378-5122(93)90009-7","pmid":"8231905","pmcid":null,"title":"Sexual behaviour and attitudes of Danish middle-aged men-methodological considerations","authors":"Solstad K, Davidsen M.","first_author":"Solstad K","journal":"Maturitas","year":1993,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational cohort sub‑study; 439 men age 51 completed a sexuality questionnaire and 100 were interviewed; representativeness to Danish male population examined.","sample_n":439,"sample_text":"439 men completed questionnaire; 100 interviewed","population":"Middle‑aged Danish men (mean age 51, N≈439)","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a Danish cohort of 439 men aged 51, researchers compared questionnaire and interview data on sexual behaviour and attitudes, finding interviews captured more sensitive information (e.g., masturbation) and were more representative of the national population.","clinical_takeaway":"None – study is methodological and does not provide clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, population‑based cohort sample for the era","Combined questionnaire and interview to improve data validity","Assessment of representativeness to national male population"],"limitations":["No validated sexuality instruments reported","Key confounders (moral attitudes, mental health, partner status) not measured","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":1,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0378-5122(93)90009-7"}},{"id":5643,"doi":"10.1001/archpsyc.1961.01710080033006","pmid":"13766470","pmcid":null,"title":"Analgesic effect of masturbation, Masturbation as a clinical sign of painful somatic disorders in psychotic patients: report of two cases","authors":"MARCHAND WE.","first_author":"MARCHAND WE.","journal":"Archives of general psychiatry","year":1961,"pub_types":["Journal Article"],"keywords":["Analgesia","Schizophrenia/complications","Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archpsyc.1961.01710080033006"}},{"id":5644,"doi":null,"pmid":"13719141","pmcid":null,"title":"Masturbation","authors":"D'AMATO G.","first_author":"D'AMATO G.","journal":"Journal of the Medical Association of Georgia","year":1961,"pub_types":["Journal Article"],"keywords":["Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5645,"doi":"10.1007/bf00401146","pmid":"8405742","pmcid":null,"title":"Diabetes mellitus and male sexual function: a controlled study","authors":"Schiavi RC, Stimmel BB, Mandeli J, Rayfield EJ.","first_author":"Schiavi RC","journal":"Diabetologia","year":1993,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-control study with 40 diabetic men and 40 matched healthy controls; interviews and nocturnal penile tumescence measurements","sample_n":80,"sample_text":"40 diabetic men, 40 controls","population":"adult men with diabetes, age‑matched healthy controls","country":"USA","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared 40 men with diabetes to 40 healthy men and found that diabetes is linked to lower sexual desire, arousal, and erectile function, as well as fewer nighttime erections, even when other illnesses or drugs are excluded.","clinical_takeaway":"Diabetes may impair sexual function beyond obvious symptoms; clinicians should consider subtle erectile changes even when patients report normal intercourse.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["objective nocturnal penile tumescence data","age‑matched control group","excludes confounding illnesses and medications"],"limitations":["small sample per group (<60)","no validated sexual‑function scales cited","no control for moral, mental‑health or trauma factors"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":7,"contrasting":0,"mentioning":29,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf00401146"}},{"id":5646,"doi":"10.1080/21674086.1993.11927385","pmid":"8416027","pmcid":null,"title":"Sexualization and desexualization","authors":"Goldberg A.","first_author":"Goldberg A.","journal":"The Psychoanalytic quarterly","year":1993,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report with single psychoanalytic case example, no systematic data collection","sample_n":null,"sample_text":"single case","population":"single adult male patient in psychoanalytic therapy","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Goldberg (1993) proposes that sexualization reflects a structural deficit in the psyche and argues that psychoanalytic treatment can address this by fostering structuralization, illustrated with a single clinical case.","clinical_takeaway":"The article offers a theoretical perspective only; it does not provide evidence for clinical interventions regarding pornography or masturbation.","confidence":0.5,"topic_tags":["sexual_function","masturbation"],"strengths":["Provides a novel psychoanalytic conceptualization","Includes a detailed clinical illustration"],"limitations":["No empirical data or systematic measurement","Lacks operational definitions and validated instruments","Single case not generalizable"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/21674086.1993.11927385"}},{"id":5647,"doi":"10.1037/0033-2909.114.1.29","pmid":"8346327","pmcid":null,"title":"Gender differences in sexuality: a meta-analysis","authors":"Oliver MB, Hyde JS.","first_author":"Oliver MB","journal":"Psychological bulletin","year":1993,"pub_types":["Meta-Analysis","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":313,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 177 studies reporting gender differences on 21 sexuality measures, with effect sizes (Cohen's d) reported.","sample_n":null,"sample_text":"Aggregated from 177 studies; individual study Ns not provided in abstract.","population":"Combined samples from 177 published studies (mostly adult humans, likely convenience/college samples).","country":"United States (primary authors, but studies from multiple countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A meta‑analysis of 177 studies found that men report higher rates of masturbation and more permissive attitudes toward casual sex than women, with other sexual attitudes showing smaller or no gender gaps. Differences have narrowed over recent decades.","clinical_takeaway":"Clinicians should recognize that gender norms influence reported sexual behaviours and attitudes, but individual variation is large.","confidence":0.8,"topic_tags":["gender","sexual_function","masturbation"],"strengths":["Large number of studies (177) pooled","Quantitative effect sizes reported","Broad coverage of sexual attitudes and behaviours"],"limitations":["Potential heterogeneity of primary measures","Likely reliance on convenience samples in original studies","No explicit control for moral or psychological confounds"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":52,"contrasting":9,"mentioning":615,"citing_publications":1062,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/0033-2909.114.1.29"}},{"id":5648,"doi":null,"pmid":"8215758","pmcid":null,"title":"[Physical restraints and gagging in unnatural death]","authors":"Grellner W, Madea B.","first_author":"Grellner W","journal":"Archiv fur Kriminologie","year":1993,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case reports of three deaths involving binding/gagging and autoerotic behaviour","sample_n":null,"sample_text":"Three case reports","population":"adult males (and adolescents) involved in fatal autoerotic incidents, suicide, homicide","country":"Germany (implied by journal language)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes three deaths where people were bound and gagged during sexual activity, examining forensic clues to decide if the binding was self‑inflicted.","clinical_takeaway":"None – the report is forensic and does not inform clinical practice.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Provides detailed forensic descriptions of rare fatal autoerotic cases","Highlights importance of distinguishing self‑binding from assault"],"limitations":["Very small sample (3 cases) limits generalisability","No validated psychological or sexual‑behaviour measures","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5649,"doi":"10.1177/095646249300400404","pmid":"8399498","pmcid":null,"title":"Knowledge of HIV transmission and risk behaviour in Kenyan health care workers","authors":"Rogstad KE, Tesfaledet G, Abdullah MS, Ahmed-Jushuf IH.","first_author":"Rogstad KE","journal":"International journal of STD & AIDS","year":1993,"pub_types":["Comparative Study","Journal Article"],"keywords":["Viral diseases","Behavior","Knowledge","Health","Africa","Diseases","Sex behavior","Psychological factors","Risk behavior","Kenya","Developing Countries","Delivery Of Health Care","Health Personnel","Africa South Of The Sahara","Eastern Africa","English Speaking Africa","perception","Hiv Infections--transmission"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 200 health‑care staff (75% response) at a single Kenyan hospital; anonymous self‑administered questionnaire.","sample_n":150,"sample_text":"200 employees invited; 75 % responded (≈150).","population":"Kenyan health‑care workers (n≈150 respondents)","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1993 survey of Kenyan hospital staff found many held inaccurate beliefs about HIV transmission (e.g., 25 % thought condoms didn’t protect) and that a substantial share continued risky sexual practices despite perceiving personal risk.","clinical_takeaway":"Even educated health workers may need targeted training to correct HIV‑misconceptions and promote safer sex.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large single‑site sample of health professionals","High response rate (75 %)","Provides concrete data on specific misconceptions"],"limitations":["Use of non‑validated questionnaire items","Cross‑sectional design; no causal inference","Limited generalisability beyond one hospital"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/095646249300400404"}},{"id":5651,"doi":"10.1001/archpsyc.1960.01710040099012","pmid":"13764221","pmcid":null,"title":"Imaginary sexual partner. Visual masturbatory fantasies","authors":"LUKIANOWICZ N.","first_author":"LUKIANOWICZ N.","journal":"Archives of general psychiatry","year":1960,"pub_types":["Journal Article"],"keywords":["Masturbation/psychology"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archpsyc.1960.01710040099012"}},{"id":5652,"doi":"10.1016/s0022-5347(17)36433-9","pmid":"8501802","pmcid":null,"title":"Phallic construction in prepubertal and adolescent boys","authors":"Gilbert DA, Jordan GH, Devine CJ, Winslow BH, Schlossberg SM.","first_author":"Gilbert DA","journal":"The Journal of urology","year":1993,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case series of 16 patients undergoing microsurgical phallic reconstruction.","sample_n":16,"sample_text":"7 prepubertal, 4 adolescent, and 5 young adult males","population":"prepubertal, adolescent, and young adult males with traumatic or congenital penile loss or micropenis","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe a series of 16 boys and young men who received one‑stage microsurgical phallus reconstruction after injury, circumcision accidents, developmental anomalies, or micropenis. All post‑pubertal patients regained erotic sensation and could masturbate.","clinical_takeaway":"Microsurgical phalloplasty can restore sensation and sexual function, but evidence is limited to a small case series.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Detailed description of microsurgical techniques","Reports functional outcomes (sensation, ability to masturbate)","Includes both prepubertal and adolescent cases"],"limitations":["Very small, uncontrolled case series","No long‑term follow‑up data","Findings not generalizable to broader populations"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-5347(17)36433-9"}},{"id":5653,"doi":null,"pmid":"8344769","pmcid":null,"title":"A fundamental dilemma of psychoanalytic technique: reflections on the analysis of a perverse paranoid patient","authors":"Jimenez JP.","first_author":"Jimenez JP.","journal":"The International journal of psycho-analysis","year":1993,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single clinical case illustration; no systematic data collection; psychoanalytic narrative","sample_n":null,"sample_text":"case report of one patient","population":"adult male patient with perverse/paranoid traits; not a representative sample","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses a psychoanalytic therapist's difficulty interpreting a severely troubled patient whose own reactions to interpretation can be harmful, using a single case to explore possible techniques.","clinical_takeaway":"None - not clinically applicable to pornography or sexual health practice.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Provides detailed psychoanalytic case illustration","Highlights therapeutic dilemmas in severe personality pathology"],"limitations":["Single case; no systematic measurement","No operational definitions or validated scales","Findings not generalizable"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5654,"doi":"10.1007/bf02600150","pmid":"8320579","pmcid":null,"title":"Uncommon headaches: diagnosis and treatment","authors":"Kumar KL, Reuler JB.","first_author":"Kumar KL","journal":"Journal of general internal medicine","year":1993,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary (review) without empirical data","sample_n":null,"sample_text":"no primary data; review of clinical observations","population":"humans (adults) with exercise, cough, or sexual‑activity related headaches; no specific sample size reported","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews rare headaches that can occur during exercise, coughing, or sexual activity, noting most are benign but new cases should be screened for serious brain issues.","clinical_takeaway":"Clinicians should rule out serious causes like bleeding when patients present with new headaches triggered by sexual activity.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Provides clinical overview of a rare headache type","Highlights need for ruling out serious intracranial pathology"],"limitations":["No original data; purely narrative","Lacks systematic review methodology","No assessment of confounding factors"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02600150"}},{"id":5655,"doi":"10.1016/s0022-5347(17)36361-9","pmid":"8479009","pmcid":null,"title":"Diagnosis and treatment of psychogenic erectile dysfunction in a urological setting: outcomes of 18 consecutive patients","authors":"Vickers MA, De Nobrega AM, Dluhy RG.","first_author":"Vickers MA","journal":"The Journal of urology","year":1993,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 18 consecutive patients in a urology clinic, no control group, descriptive outcomes","sample_n":18,"sample_text":"18 consecutive patients","population":"adult males, mean age 38, with psychogenic erectile dysfunction","country":"unspecified (likely USA based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Eighteen men with psychogenic erectile dysfunction were monitored at home for nocturnal erections and followed for up to three months. Those whose problem was secondary (they had previously had normal erections) often recovered with reassurance, while those with primary problems did not improve without more intensive treatment.","clinical_takeaway":"In men with secondary psychogenic erectile dysfunction, simple reassurance and monitoring may lead to remission; primary cases usually need active therapy.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Objective nocturnal penile tumescence monitoring","Detailed clinical follow‑up of remission outcomes"],"limitations":["Very small uncontrolled case series","No validated psychometric measures of psychogenic ED","No control for mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-5347(17)36361-9"}},{"id":5656,"doi":"10.1111/j.1532-5415.1993.tb06941.x","pmid":"8463520","pmcid":null,"title":"Treatment of vasculogenic sexual dysfunction with pentoxifylline","authors":"Korenman SG, Viosca SP.","first_author":"Korenman SG","journal":"Journal of the American Geriatrics Society","year":1993,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"double‑blind randomized clinical trial, convenience sample of couples at a VA sexual‑dysfunction clinic, 12‑week intervention","sample_n":null,"sample_text":"convenience sample; size not reported in abstract","population":"men with mild‑to‑moderate penile vascular insufficiency (vasculogenic erectile dysfunction) and their partners","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small double‑blind trial, men with blood‑flow problems causing erectile dysfunction who took pentoxifylline showed improved penile blood pressure indices and more frequent intercourse compared with placebo.","clinical_takeaway":"Pentoxifylline may help men with vascular‑related erectile dysfunction, but evidence is preliminary and based on a limited sample.","confidence":0.8,"topic_tags":["sexual_function","treatment","pornography","masturbation"],"strengths":["Randomized, double‑blind design","Physiological outcome (PBPI) objectively measured","Partner‑verified sexual activity data"],"limitations":["Small, convenience sample; size not disclosed","No power calculation or effect‑size reporting","Limited control for psychological or comorbid confounds"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1532-5415.1993.tb06941.x"}},{"id":5659,"doi":"10.1007/bf01542360","pmid":"8476337","pmcid":null,"title":"Effects of antihypertensive drugs atenolol and nifedipine on sexual function in older men: a placebo-controlled, crossover study","authors":"Morrissette DL, Skinner MH, Hoffman BB, Levine RE, Davidson JM.","first_author":"Morrissette DL","journal":"Archives of sexual behavior","year":1993,"pub_types":["Clinical Trial","Research Support, U.S. Gov't, P.H.S.","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"placebo-controlled, double‑blind, randomized crossover trial with 16 older men","sample_n":16,"sample_text":"16 participants, crossover design","population":"older men with mild‑to‑moderate hypertension (mean age 66.6)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a small crossover trial, 16 older men took two blood‑pressure medicines (atenolol, nifedipine) and a placebo. Daily self‑reports showed almost no change in sexual desire, activity, or pleasure, except a slight drop in erection firmness during masturbation with nifedipine. The drugs appear largely harmless to sexual function, but the study is limited by its tiny sample.","clinical_takeaway":"Atenolol and slow‑release nifedipine are unlikely to cause major sexual problems in older men, though evidence is limited.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Randomized, double‑blind, crossover design","Objective physiological sexual outcomes (erection firmness)","Separate measurement of masturbation"],"limitations":["Very small sample (N=16) limits power","Self‑report measures not from validated scales","No control for mental‑health or relational factors"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542360"}},{"id":5661,"doi":"10.3109/01674829309084430","pmid":"8358523","pmcid":null,"title":"Changes in sexual behavior following radiation therapy for cervical cancer","authors":"Krumm S, Lamberti J.","first_author":"Krumm S","journal":"Journal of psychosomatic obstetrics and gynaecology","year":1993,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Within‑subject comparison of 21 women before and after radiation therapy; questionnaire and interview data; no control group; small convenience sample.","sample_n":21,"sample_text":"Twenty‑one women with cervical cancer Types I and II, treated by radiation","population":"Women with stage I‑II cervical cancer (N=21)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 21 women treated with radiation for cervical cancer, sexual activity and satisfaction declined after therapy. Most participants blamed radiation for the changes, and many held misconceptions about disease transmission through intercourse.","clinical_takeaway":"Radiation for cervical cancer can reduce sexual activity and satisfaction; clinicians should offer counseling and address misconceptions.","confidence":0.3,"topic_tags":["sexual_function","csbd"],"strengths":["Direct before/after comparison within same patients","Inclusion of personal interviews for qualitative insight"],"limitations":["Very small sample (N=21)","No validated sexual function instruments reported","No control for key confounders (mental health, partner factors, moral attitudes)","Reliance on self‑report attribution to radiation"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":37,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/01674829309084430"}},{"id":5662,"doi":null,"pmid":"8492676","pmcid":null,"title":"[Sexuality. Cultural, social and clinical aspects]","authors":"Simeone R, Cipriani AM, Salvatorelli A, Flammini E, Marrone D, Capaldi E, Gallese A.","first_author":"Simeone R","journal":"Minerva psichiatrica","year":1993,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ita","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of cultural, social and clinical aspects of sexuality; no empirical data reported","sample_n":null,"sample_text":"not applicable","population":"not applicable","country":"Italy (journal Minerva psichiatrica)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how cultural, social and clinical views on sexuality have shifted, discussing myths, gender roles, masturbation, performance anxiety, orgasm and sexuality in older adults, without presenting new data.","clinical_takeaway":"None – the paper offers a historical overview rather than evidence for clinical practice.","confidence":0.7,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["Broad overview of cultural and clinical perspectives","Covers multiple topics (masturbation, orgasm, ageing)"],"limitations":["No empirical data or systematic methodology","Lacks operational definitions and validated measures","No control of key confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5663,"doi":"10.1080/00926239308404905","pmid":"8246276","pmcid":null,"title":"Psychosexual functioning in women with complete testicular feminization: is androgen replacement therapy preferable to estrogen?","authors":"Slob AK, van der Werff ten Bosch JJ, van Hall EV, de Jong FH, Weijmar Schultz WC, Eikelboom FA.","first_author":"Slob AK","journal":"Journal of sex & marital therapy","year":1993,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"double‑blind cross‑over, 4 gonadectomized women with complete testicular feminization, 4‑week testosterone vs placebo periods","sample_n":4,"sample_text":"four participants","population":"adult women with complete androgen insensitivity syndrome (n=4)","country":"Netherlands (presumed by author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Four women with complete androgen insensitivity were given oral testosterone or placebo in a double‑blind cross‑over trial. Hormone levels rose with testosterone, but no consistent changes were seen in sexual activity, desire, or body‑image; mood improved in only one participant. The study concludes testosterone is not clearly better than estrogen for psychosexual health.","clinical_takeaway":"Current evidence does not support preferring testosterone over estrogen for psychosexual outcomes in complete testicular feminization.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["double‑blind cross‑over within‑subject design","objective hormonal assay data","weekly repeated measures of sexual functioning"],"limitations":["Very small sample (N=4) limits inference","Psychosexual outcomes measured with likely non‑validated self‑reports","No control for mood or other psychosocial confounds","Findings not generalisable to broader female population"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239308404905"}},{"id":5664,"doi":"10.1080/00926239308404899","pmid":"8336347","pmcid":null,"title":"Key variables to understanding female sexual satisfaction: an examination of women in nondistressed marriages","authors":"Hurlbert DF, Apt C, Rabehl SM.","first_author":"Hurlbert DF","journal":"Journal of sex & marital therapy","year":1993,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":70,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional regression study using self‑report questionnaires on sexual behavior and relationship variables in nondistressed married women.","sample_n":null,"sample_text":"Not specified in abstract; likely convenience sample.","population":"Women in nondistressed marriages (sample size not reported in abstract).","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In married women without relationship distress, personal traits like sexual assertiveness, a positive attitude toward sex, and feeling close to a partner predict higher sexual satisfaction more strongly than how often they have sex or how many orgasms they have.","clinical_takeaway":"Clinicians should consider relational and attitudinal factors, not just sexual frequency, when addressing female sexual satisfaction.","confidence":0.6,"topic_tags":["sexual_function","relationships"],"strengths":["Multivariate regression model linking behavior and relationship factors to satisfaction","Inclusion of both sexual and personality/relationship variables","Discussion of methodological advances (sex diaries)"],"limitations":["No report of sample size or power analysis","Reliance on self‑report without physiological measures","Potential omitted confounds (mental health, moral attitudes, trauma)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":77,"citing_publications":173,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239308404899"}},{"id":5665,"doi":"10.1159/000156689","pmid":"8225125","pmcid":null,"title":"Eye contact as a trigger of male sexual arousal in stump-tailed macaques (Macaca arctoides)","authors":"Linnankoski I, Grönroos M, Pertovaara A.","first_author":"Linnankoski I","journal":"Folia primatologica; international journal of primatology","year":1993,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000156689"}},{"id":5667,"doi":"10.1007/bf02552258","pmid":"8514477","pmcid":null,"title":"Self-introduction of foreign bodies into the urethra: a multidisciplinary problem","authors":"Costa G, Di Tonno F, Capodieci S, Laurini L, Casagrande R, Lavelli D.","first_author":"Costa G","journal":"International urology and nephrology","year":1993,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Single case report with literature review; no systematic data collection.","sample_n":1,"sample_text":"One patient; no broader sample.","population":"Adult male (36‑year‑old) who inserted a metallic foreign body into urethra.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 36‑year‑old man inserted a metal object into his urethra; it was removed endoscopically. Psychiatric assessment revealed schizoid personality traits. Authors recommend routine psychiatric evaluation to prevent repeat incidents.","clinical_takeaway":"Patients with self‑inserted urethral foreign bodies should receive psychiatric assessment to address underlying disorders and reduce recurrence risk.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Clear clinical description of rare event","Highlights need for psychiatric evaluation"],"limitations":["Single case; no generalizable data","No systematic assessment of confounders"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02552258"}},{"id":5668,"doi":"10.1016/0022-3999(93)90080-y","pmid":"8463990","pmcid":null,"title":"Discrimination between psychogenic and organic erectile dysfunction","authors":"Speckens AE, Hengeveld MW, Lycklama à Nijeholt GA, van Hemert AM, Hawton KE.","first_author":"Speckens AE","journal":"Journal of psychosomatic research","year":1993,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Diagnostic screening test development using logistic regression on 176 patients classified by urological/psychiatric assessment.","sample_n":176,"sample_text":"176 patients with ED (109 organic, 67 psychogenic).","population":"Male patients with erectile dysfunction (n=176), classified as organic (n=109) or psychogenic (n=67).","country":"Netherlands (inferred from author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study created a questionnaire‑based test that can tell whether erectile problems are caused by psychological factors or physical disease, correctly classifying about 87% of cases when relationship info is added.","clinical_takeaway":"A brief questionnaire plus partner information can help clinicians differentiate psychogenic from organic ED.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Uses a validated questionnaire (LIQ).","Reasonable sample size for diagnostic modeling.","Clear classification outcomes with logistic regression."],"limitations":["Limited control for key psychosocial confounds.","No external validation sample reported.","No pre‑registration or confidence intervals."],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0022-3999(93)90080-y"}},{"id":5669,"doi":"10.1177/070674379203701003","pmid":"1473073","pmcid":null,"title":"A double-blind placebo controlled trial of medroxyprogesterone acetate and cyproterone acetate with seven pedophiles","authors":"Cooper AJ, Sandhu S, Losztyn S, Cernovsky Z.","first_author":"Cooper AJ","journal":"Canadian journal of psychiatry. Revue canadienne de psychiatrie","year":1992,"pub_types":["Comparative Study","Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":["Population","Biology","Hormones","Testosterone","Physiology","Luteinizing hormone","Child","Androgens","Follicle stimulating hormone","Behavior","Youth","Gonadotropins","Treatment","North America","Contraception","Diseases","Endocrine system","Age factors","population characteristics","research methodology","Canada","Psychological factors","Clinical research","Family Planning","Contraceptive Agents","Contraceptive Agents, Female","Contraceptive Agents, Progestin","Gonadotropins, Pituitary","Demographic Factors","Developed Countries","Studies","Marital Status","Research Report","Americas","Northern America","Hormone Antagonists","Child Abuse","Nuptiality","Social Problems","Sex Behavior--men"],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"double‑blind placebo‑controlled crossover trial with 7 completers","sample_n":7,"sample_text":"Seven of ten pedophiles in hospital completed the study","population":"adult male pedophiles (N=7 completers)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a tiny double‑blind trial with seven male pedophiles, two hormone drugs lowered sexual thoughts, fantasies, early‑morning erections and masturbation frequency, with modest reductions in penile responses. Hormone levels fell during treatment and rebounded after the placebo phase.","clinical_takeaway":"Hormonal suppression can reduce sexual drive in pedophilia, but acceptability is low and evidence is limited by a very small sample.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["double‑blind placebo control","multiple objective (phallometry, hormones) and subjective measures","crossover design reduces between‑subject variability"],"limitations":["extremely small sample (N=7) limits power and generalisability","no reporting of statistical significance, effect sizes or correction for multiple tests","no assessment of key psychological confounds (moral incongruence, mental health, trauma)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":38,"citing_publications":86,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/070674379203701003"}},{"id":5670,"doi":"10.1210/jcem.75.6.1464655","pmid":"1464655","pmcid":null,"title":"The effects of exogenous testosterone on sexuality and mood of normal men","authors":"Anderson RA, Bancroft J, Wu FC.","first_author":"Anderson RA","journal":"The Journal of clinical endocrinology and metabolism","year":1992,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":["Biology","Hormones","Testosterone","Physiology","Androgens","Behavior","Data analysis","Contraception","Endocrine system","Europe","Family Planning","Contraceptive Agents","Contraceptive Agents, Male","Developed Countries","Northern Europe","Scotland","Research Report","Sex Behavior--men","United Kingdom","Psychological Factors--men","Emotions--men"],"is_oa":false,"oa_url":null,"cited_by_count":121,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"single‑blind, placebo‑controlled randomised trial (n=31) testing supraphysiological testosterone over 8 weeks","sample_n":31,"sample_text":"31 normal men","population":"healthy eugonadal men in stable heterosexual relationships, Europe","country":"Europe","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"high","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 31 healthy men, giving high doses of testosterone for two months raised scores on a questionnaire about sexual awareness and arousal, but did not change how often they had sex, masturbated, or felt aggressive.","clinical_takeaway":"Short‑term supraphysiological testosterone may increase sexual arousal without changing actual sexual activity or mood.","confidence":0.8,"topic_tags":["sexual_function","masturbation","moral_incongruence"],"strengths":["Randomised placebo‑controlled design","Separate measures of sexual arousal, frequency, and mood","Daily diary enhances ecological validity"],"limitations":["Small sample limits power and precision","No pre‑registration or effect‑size reporting","Moral or broader psychosocial confounds not assessed"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":42,"citing_publications":211,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1210/jcem.75.6.1464655"}},{"id":5671,"doi":"10.1111/j.1365-2788.1992.tb00571.x","pmid":"1477490","pmcid":null,"title":"Increases in knowledge following a course of sex education for people with intellectual disabilities","authors":"Lindsay WR, Bellshaw E, Culross G, Staines C, Michie A.","first_author":"Lindsay WR","journal":"Journal of intellectual disability research : JIDR","year":1992,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Pre‑post education programme with a non‑randomised control group (46 participants vs 14 controls) assessed on sexual knowledge at baseline, post‑programme (9 months) and follow‑up (3 months).","sample_n":60,"sample_text":"46 participants received the sex‑education programme; 14 served as controls.","population":"Adults with intellectual disabilities","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A nine‑month sex‑education programme for people with intellectual disabilities increased their knowledge about bodies, puberty, intercourse, and contraception, with gains maintained three months later.","clinical_takeaway":"Targeted sex‑education can improve sexual knowledge in this population, but evidence is limited by small, non‑randomised samples.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Controlled comparison group","Longitudinal follow‑up","Addresses knowledge retention"],"limitations":["Small sample, especially control group","No validated knowledge instrument","Non‑randomised allocation","Limited reporting of statistical details"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":32,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2788.1992.tb00571.x"}},{"id":5672,"doi":"10.1016/s0022-5347(17)36852-0","pmid":"1404631","pmcid":null,"title":"The hemodynamic pathophysiology of impotence following blunt trauma to the erect penis","authors":"Penson DF, Seftel AD, Krane RJ, Frohrib D, Goldstein I.","first_author":"Penson DF","journal":"The Journal of urology","year":1992,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":65,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case series of 19 patients with impotence after blunt penile trauma; descriptive hemodynamic measurements.","sample_n":19,"sample_text":"19 patients","population":"Men (adolescents to middle‑aged) presenting with post‑traumatic erectile dysfunction.","country":"USA (implicit from authors/journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined 19 men who developed erectile problems after a blunt hit to an erect penis. Using pressure recordings and a biomechanical model, the authors identified specific blood‑flow disruptions that likely cause the impotence and may also underlie some cases of Peyronie's disease.","clinical_takeaway":"Penile trauma can cause specific vascular problems leading to erectile dysfunction; clinicians should consider vascular assessment after such injuries.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Objective physiological measurements","Clear description of hemodynamic abnormalities","Integration of biomechanical modeling"],"limitations":["Very small, non‑random sample (N=19)","No control/comparison group","Findings may not generalise to broader populations"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":46,"citing_publications":114,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-5347(17)36852-0"}},{"id":5673,"doi":null,"pmid":"13658288","pmcid":null,"title":"Crime as the dramatization of a masturbation fantasy","authors":"DE LA VEGA G.","first_author":"DE LA VEGA G.","journal":"Psychoanalysis and the psychoanalytic review","year":1959,"pub_types":["Journal Article"],"keywords":["Crime","Psychoanalytic Interpretation","Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5674,"doi":"10.1111/j.1464-410x.1992.tb15660.x","pmid":"1638372","pmcid":null,"title":"Male and female sexual function and activity following ileal conduit urinary diversion","authors":"Nordström GM, Nyman CR.","first_author":"Nordström GM","journal":"British journal of urology","year":1992,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":56,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Pre‑post questionnaire of 66 patients after ileal conduit diversion; no control group; retrospective self‑report of sexual function.","sample_n":66,"sample_text":"66 (40 M, 26 F) patients surveyed about sexual function before and after surgery.","population":"66 patients (40 male, 26 female) undergoing ileal conduit urinary diversion for bladder cancer or incontinence.","country":"Sweden (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"After ileal conduit urinary diversion, most men who could previously have erections lost that ability, though some still achieved orgasm via masturbation. Women generally reported reduced sexual activity, but a few increased activity when the surgery helped with incontinence.","clinical_takeaway":"Patients should be counseled that erectile function often declines after this surgery, but alternative sexual activities may remain possible.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Specific clinical population","Both male and female outcomes reported","Includes masturbation and implant data"],"limitations":["Small, non‑representative sample","No validated sexual function instruments","No control for psychological or relational confounds"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":1,"mentioning":44,"citing_publications":85,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1464-410x.1992.tb15660.x"}},{"id":5676,"doi":"10.1055/s-2008-1041163","pmid":"1323870","pmcid":null,"title":"Fertility in men with spinal cord or cauda equina lesions","authors":"Sønksen J, Biering-Sørensen F.","first_author":"Sønksen J","journal":"Seminars in neurology","year":1992,"pub_types":["Review","Journal 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exhibitionism","authors":"Wawrose FE, Sisto TM.","first_author":"Wawrose FE","journal":"The American journal of psychiatry","year":1992,"pub_types":["Letter","Case 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GH.","first_author":"SCHADE GH.","journal":"Pediatric clinics of North America","year":1958,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"und","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0031-3955(16)30697-6"}},{"id":5682,"doi":"10.1007/bf01542589","pmid":"1580785","pmcid":null,"title":"Physiological correlates of imagery-induced orgasm in women","authors":"Whipple B, Ogden G, Komisaruk BR.","first_author":"Whipple B","journal":"Archives of sexual behavior","year":1992,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"within‑subject laboratory experiment comparing imagery‑induced orgasm, genital self‑stimulation, and resting control; physiological measures (BP, HR, pupil, pain thresholds) recorded","sample_n":null,"sample_text":"not reported in abstract","population":"women who self‑report ability to orgasm from mental imagery (sample size not stated in abstract)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Women who say they can orgasm just by imagining sexual scenes showed the same rises in blood pressure, heart rate, pupil size and pain tolerance as when they stimulated themselves genitally, suggesting imagery alone can trigger a physiological orgasm response.","clinical_takeaway":"Imagery can evoke physiological orgasm in some women; clinicians might consider mental‑visual techniques when addressing sexual function.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Physiological measures objectively recorded","Within‑subject design limits between‑person variability","Direct comparison of imagery vs genital stimulation"],"limitations":["Sample size not reported; likely small","No assessment of potential psychological confounds (e.g., mood, prior sexual experience)","Reliance on self‑labelled orgasm without standardized scale"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":44,"citing_publications":108,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542589"}},{"id":5683,"doi":null,"pmid":"13580116","pmcid":null,"title":"[2 Interesting cases of foreign bodies in the urinary bladder introduced in instrumental masturbation]","authors":"ADAMEK J.","first_author":"ADAMEK J.","journal":"Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti","year":1958,"pub_types":["Journal Article"],"keywords":["Bladder/foreign 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A medical or a human rights issue?","authors":"Milos MF, Macris D.","first_author":"Milos MF","journal":"Journal of nurse-midwifery","year":1992,"pub_types":["Review","Journal Article"],"keywords":["Health Care And Public Health"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"N/A – narrative review, no primary data","population":"human newborn males; discussion of adult perspectives","country":"United States (journal) – not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"background","plain_summary":"The article argues that routine infant circumcision is a medical and human‑rights problem, citing pain, loss of bodily integrity, and violation of religious freedom, and questioning the medical justifications historically offered.","clinical_takeaway":"None – the paper does not provide empirical guidance for clinical practice.","confidence":0.5,"topic_tags":["csbd","sexual_function","religiosity"],"strengths":["Clear ethical argumentation","Historical context provided","Highlights overlooked harms"],"limitations":["No primary empirical data","Lacks systematic review methodology","Potential author bias"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":0,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0091-2182(92)90012-r"}},{"id":5686,"doi":"10.1016/0091-3057(92)90366-n","pmid":"1350100","pmcid":null,"title":"Dopaminergic influences on male sexual behavior of rhesus monkeys: effects of dopamine agonists","authors":"Pomerantz SM.","first_author":"Pomerantz SM.","journal":"Pharmacology, biochemistry, and behavior","year":1992,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"laboratory experiment with male rhesus monkeys receiving dopamine agonists and vehicle control; 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masturbation contributes to borderline personality symptoms, and that hospital‑based therapy can help resolve these issues.","clinical_takeaway":"No evidence‑based guidance; insights are anecdotal and not applicable to general treatment.","confidence":0.4,"topic_tags":["masturbation","sexual_function","moral_incongruence"],"strengths":["In‑depth clinical description","Integration of psychoanalytic concepts"],"limitations":["Single case; no empirical measures","No validated instruments or statistical analysis","Findings not generalizable"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1521/jaap.1.1992.20.1.114"}},{"id":5694,"doi":null,"pmid":"1615165","pmcid":null,"title":"Sexual aversion versus hypoactive sexual desire: a diagnostic challenge","authors":"Ponticas Y.","first_author":"Ponticas Y.","journal":"Psychiatric medicine","year":1992,"pub_types":["Review","Journal 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aversion.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Clear clinical differentiation of two disorders","Focus on approach‑avoidance conflict"],"limitations":["No primary data; narrative review only","No systematic search or bias assessment","Limited to DSM‑III‑R criteria, outdated"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":5696,"doi":"10.1007/bf02926931","pmid":"1290213","pmcid":null,"title":"MR imaging in acute fracture of the penis","authors":"Boudghene F, Chhem R, Wallays C, Bigot JM.","first_author":"Boudghene F","journal":"Urologic radiology","year":1992,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02926931"}},{"id":5697,"doi":null,"pmid":"1496043","pmcid":null,"title":"[Some questions for Eglé and Moses Laufer]","authors":"Lebovici S.","first_author":"Lebovici S.","journal":"La Psychiatrie de l'enfant","year":1992,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5698,"doi":null,"pmid":"11623003","pmcid":null,"title":"Forbidden by God, despised by men: masturbation, medical warnings, moral panic, and manhood in Great Britain, 1850-1950","authors":"Hall LA.","first_author":"Hall LA.","journal":"Journal of the history of sexuality","year":1992,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5700,"doi":null,"pmid":"13519825","pmcid":null,"title":"[Masturbation in children under 10 years of age]","authors":"RENNERT H.","first_author":"RENNERT H.","journal":"Zeitschrift fur arztliche Fortbildung","year":1957,"pub_types":["Journal Article"],"keywords":["Masturbation/psychology"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5701,"doi":null,"pmid":"13461513","pmcid":null,"title":"Chlorpromazine and diethylstilbestrol in severe mentally deficient patients with malignant masturbatory problems","authors":"GEYER HW.","first_author":"GEYER HW.","journal":"Delaware state medical journal","year":1957,"pub_types":["Journal Article"],"keywords":["Mental Deficiency/complications","Chlorpromazine/therapeutic Use","Diethylstilbestrol/therapeutic Use","Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5703,"doi":null,"pmid":"1754432","pmcid":null,"title":"Sperm banking","authors":"Hopkins M.","first_author":"Hopkins M.","journal":"Nursing times","year":1991,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5706,"doi":"10.1038/sc.1991.60","pmid":"1784510","pmcid":null,"title":"Semen retrieval in spinal cord injured men","authors":"Rawicki HB, Hill S.","first_author":"Rawicki HB","journal":"Paraplegia","year":1991,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 38 spinal‑cord‑injured men undergoing electroejaculation, vibration, and physostigmine to obtain semen; outcomes: retrieval success rates and pregnancies.","sample_n":38,"sample_text":"Thirty‑eight men treated in a fertility programme; subgroups by lesion level (24 T8+; 11 below T10).","population":"men with spinal cord injury (n=38)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 38 men with spinal‑cord injuries, doctors used electric stimulation, vibration, or a drug to collect semen; success was higher in men with higher lesions, leading to eight pregnancies.","clinical_takeaway":"Specialised semen‑retrieval techniques can enable fertility for many men with spinal cord injury, but success varies by injury level.","confidence":0.8,"topic_tags":["sexual_function","religiosity"],"strengths":["Real‑world clinical data from a specialised programme","Clear outcome reporting (retrieval success, pregnancies)"],"limitations":["No control group or comparison condition","Small, highly selected sample limits generalisability","Statistical analysis not described; likely descriptive only"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/sc.1991.60"}},{"id":5707,"doi":null,"pmid":"1953244","pmcid":null,"title":"[An unusual accident in auto-erotic activity]","authors":"Betz P, Penning R.","first_author":"Betz P","journal":"Archiv fur Kriminologie","year":1991,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5708,"doi":null,"pmid":"1772052","pmcid":null,"title":"[Foreign bodies in the bladder and urethra]","authors":"Gómez Tejeda LM, Gimeno Albo F, Piñango Angulo L, Fiter Gómez L, Gómiz León J, Ortín García-Nieto M, Mejías Callaved J.","first_author":"Gómez Tejeda LM","journal":"Actas urologicas espanolas","year":1991,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of five patients with foreign bodies in bladder/urethra; descriptive, no control group","sample_n":5,"sample_text":"five cases","population":"patients (adolescent, adult, male, female) presenting with foreign bodies; likely selected from clinical cases","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe five patients who inserted objects into their bladder or urethra, discuss how these foreign bodies are diagnosed and removed, and offer advice for urologists to prevent such incidents.","clinical_takeaway":"Clinicians should be aware of the possibility of self‑inserted foreign bodies during sexual activity and manage them promptly.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Detailed clinical description of rare cases","Provides practical diagnostic and therapeutic guidance"],"limitations":["Small, non‑representative sample","No systematic analysis or control group"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":5709,"doi":"10.1542/peds.18.5.803","pmid":"13370246","pmcid":null,"title":"The psychologic aspects of pediatric practice.  II.  Masturbation","authors":"BELL AI, LEVINE MI.","first_author":"BELL AI","journal":"Pediatrics","year":1956,"pub_types":["Journal Article"],"keywords":["Masturbation/in Infant And Child"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.18.5.803"}},{"id":5710,"doi":null,"pmid":"1884306","pmcid":null,"title":"Sexual behaviour changes in a cohort of male sexual contacts of men with HIV disease: a three-year overview","authors":"Calzavara LM, Coates RA, Johnson K, Read SE, Farewell VT, Fanning MM, Shepherd FA, MacFadden DK.","first_author":"Calzavara LM","journal":"Canadian journal of public health = Revue canadienne de sante publique","year":1991,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort of 240 men followed for 3 years with quarterly questionnaires","sample_n":240,"sample_text":"240 men (both seronegative and seropositive) followed for three years","population":"male homosexual men, seronegative and seropositive, recruited as sexual contacts of HIV‑positive individuals","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A three‑year study of 240 gay men, both HIV‑positive and negative, showed that after learning their HIV status they reduced high‑risk sex (anal intercourse) but continued stable rates of oral sex and masturbation.","clinical_takeaway":"Awareness of HIV status can prompt reductions in risky sexual practices, though other behaviours may remain unchanged.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Longitudinal design with repeated measures","Large sample for its time","Clear documentation of high‑risk sexual behaviour change"],"limitations":["No validated scales for sexual‑behaviour constructs","Key psychosocial confounds (e.g., moral attitudes, mental health) not measured","Convenience sample of HIV‑contact men limits generalisability"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":5711,"doi":"10.1111/j.1464-410x.1991.tb15196.x","pmid":"2039919","pmcid":null,"title":"Fractures of the penis: therapeutic approach and long-term results","authors":"Anselmo G, Fandella A, Faggiano L, Merlo F, Maccatrozzo L.","first_author":"Anselmo G","journal":"British journal of urology","year":1991,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 13 patients undergoing surgery for penile fracture","sample_n":13,"sample_text":"13 patients","population":"adult men with traumatic penile fracture (n=13)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Thirteen men with traumatic penile fractures were operated on quickly, leading to good long‑term erectile function and minimal curvature, highlighting the importance of prompt surgery.","clinical_takeaway":"Prompt surgical repair of penile fracture yields better functional outcomes than conservative treatment.","confidence":0.8,"topic_tags":["gender","sexual_function","treatment"],"strengths":["Detailed surgical technique description","Long‑term functional follow‑up"],"limitations":["Very small, non‑random sample","No control group or comparison","Limited generalisability"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1464-410x.1991.tb15196.x"}},{"id":5712,"doi":"10.1007/bf01541938","pmid":"2064537","pmcid":null,"title":"Oral contraceptives, androgens, and the sexuality of young women: I. A comparison of sexual experience, sexual attitudes, and gender role in oral contraceptive users and nonusers","authors":"Bancroft J, Sherwin BB, Alexander GM, Davidson DW, Walker A.","first_author":"Bancroft J","journal":"Archives of sexual behavior","year":1991,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Population","Behavior","Comparative studies","North America","Contraception","Age distribution","Age factors","Data collection","population characteristics","research methodology","Canada","Psychological factors","Psychosocial factors","Sex factors","Family Planning","Contraceptive Methods","Oral Contraceptives","Demographic Factors","Developed Countries","Contraceptive Usage","Studies","Examinations And Diagnoses","Attitude","Americas","Northern America","Laboratory Examinations And Diagnoses","Sex Behavior--women"],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional comparison of 108 female undergraduates (55 OC users, 53 non‑users) on sexual attitudes, behavior, fantasy use and gender role.","sample_n":108,"sample_text":"Convenience sample of volunteers; not a probability or nationally representative cohort.","population":"Female undergraduate students, North America, mean age ~20‑25, 55 oral‑contraceptive users, 53 non‑users.","country":"Canada (and possibly United States)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among college women, those taking the pill were more likely to have a boyfriend, have less restrictive sexual morals and report more frequent sex and enjoyment, but they did not differ in how often they masturbated or used fantasies.","clinical_takeaway":"Oral‑contraceptive use is linked to higher partnered sexual activity and more permissive attitudes, but findings are limited by sample size and lack of causal proof.","confidence":0.85,"topic_tags":["sexual_function","relationships"],"strengths":["Direct comparison of OC users vs non‑users","Includes partner status in analyses","Measures a range of sexual attitudes and behaviors"],"limitations":["Cross‑sectional, cannot infer causality","Small, convenience sample of undergraduates","Limited control for key confounds (moral, mental health, trauma)","No effect‑size reporting or correction for multiple testing"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":18,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541938"}},{"id":5713,"doi":"10.2466/pr0.1991.68.2.607","pmid":"1862192","pmcid":null,"title":"Dimensions of sexual behaviour in homosexual men: replicability across time and country","authors":"Ross MW, Rosser BR.","first_author":"Ross MW","journal":"Psychological reports","year":1991,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"comparative factor‑analysis of sexual‑practice reports from Australian and New Zealand gay men at two time points","sample_n":331,"sample_text":"176 Australian and 159 New Zealand homosexually active men","population":"172 Australian and 159 New Zealand homosexually active men (total N≈331)","country":"Australia; New Zealand","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed over 300 gay men in Australia and New Zealand about their recent sexual activities. Factor analysis consistently identified three patterns: unsafe anal sex, safe non‑penetrative sex, and safe anal sex with condoms. These patterns were stable across countries and over time.","clinical_takeaway":"No direct clinical implications; the identified behaviour clusters may inform future research on sexual health risk.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large combined sample across two countries","Replication of factor structure over time","Clear statistical methods (factor analysis, Cattell's S)"],"limitations":["Self‑report of sexual behaviour only","No assessment of potential psychological confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2466/pr0.1991.68.2.607"}},{"id":5714,"doi":"10.1007/bf01541939","pmid":"2064538","pmcid":null,"title":"Oral contraceptives, androgens, and the sexuality of young women: II. The role of androgens","authors":"Bancroft J, Sherwin BB, Alexander GM, Davidson DW, Walker A.","first_author":"Bancroft J","journal":"Archives of sexual behavior","year":1991,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Biology","Hormones","Physiology","Androgens","Reproduction","Behavior","Students","Contraception","Sex behavior","Endocrine system","menstrual cycle","Psychological factors","Universities","Psychosocial factors","Menstruation","Education","Family Planning","Contraceptive Methods","Oral Contraceptives","Examinations And Diagnoses","Attitude","Laboratory Examinations And Diagnoses","Schools","Testosterone--analysis","Coital Frequency"],"is_oa":false,"oa_url":null,"cited_by_count":71,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"observational cross‑sectional comparison of 55 oral‑contraceptive users and 53 non‑users, measuring plasma free testosterone and self‑report questionnaires on sexual behavior and attitudes","sample_n":108,"sample_text":"55 OC users, 53 non‑users","population":"female undergraduate students (mean age ~20), convenience sample","country":"unspecified (likely USA/UK based on authors)","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared women who use oral contraceptives with those who do not, finding lower testosterone in pill users. In pill users, higher testosterone was linked to more frequent intercourse and less restrictive sexual morals, but not to masturbation frequency.","clinical_takeaway":"Testosterone levels may relate to sexual activity and attitudes in women using oral contraceptives, but findings are correlational and limited to university samples.","confidence":0.6,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["objective hormone measurement","separate assessment of masturbation and sexual intercourse","includes measure of restrictive sexual morality"],"limitations":["convenience sample of students, limited generalisability","cross‑sectional; cannot infer causality","moderate sample size, no power analysis reported","mental‑health and relationship variables not measured"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":48,"citing_publications":104,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541939"}},{"id":5715,"doi":"10.1097/00000433-199103000-00012","pmid":"2063821","pmcid":null,"title":"A case of autoerotic asphyxia associated with multiplex paraphilia","authors":"Boglioli LR, Taff ML, Stephens PJ, Money J.","first_author":"Boglioli LR","journal":"The American journal of forensic medicine and pathology","year":1991,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single deceased individual described in forensic case report","population":"adult male (single case)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes a single fatal incident where a man died while engaging in self‑asphyxiation during sexual activity, highlighting the complex mix of paraphilic interests involved.","clinical_takeaway":"Clinicians should be aware that autoerotic asphyxia is a rare but life‑threatening behavior linked to high‑risk sexual practices.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Detailed forensic description of rare phenomenon","Situates case within broader literature on autoerotic asphyxia"],"limitations":["Single case; no generalizable data","No systematic measurement of behaviors or psychological constructs","No control or comparison group"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00000433-199103000-00012"}},{"id":5717,"doi":null,"pmid":"1749725","pmcid":null,"title":"You and your child: the need for love and security","authors":null,"first_author":null,"journal":"The Nursing journal of India","year":1991,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5718,"doi":null,"pmid":"1860677","pmcid":null,"title":"[Effect of ultrafiltered peritoneal fluid from patients with pelvic endometriosis on the in vitro motility of their spouse's sperm]","authors":"Canales ES, Del Rocío Cruz P, Montoya R.","first_author":"Canales ES","journal":"Ginecologia y obstetricia de Mexico","year":1991,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"in vitro laboratory assay comparing peritoneal fluid from 11 women with endometriosis to 11 controls on sperm motility of their partners","sample_n":22,"sample_text":"11 couples with endometriosis and 11 control couples","population":"men providing semen by masturbation; women with pelvic endometriosis vs fertile controls","country":"Mexico","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers mixed peritoneal fluid from women with endometriosis with their partners' sperm in the lab and found reduced sperm movement, suggesting a possible factor in infertility associated with endometriosis.","clinical_takeaway":"Endometriosis may contain peritoneal factors that impair sperm motility; clinicians should consider male factor testing when evaluating infertility in these couples.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["objective laboratory measurement of sperm motility","use of matched control couples","clear description of experimental procedure"],"limitations":["very small sample (n=11 per group)","no power analysis or effect‑size reporting","findings based on in‑vitro assay may not translate to in‑vivo fertility"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":9,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":5721,"doi":null,"pmid":"1993637","pmcid":null,"title":"Successful antidepressant treatment of nonparaphilic sexual addictions and paraphilias in men","authors":"Kafka MP.","first_author":"Kafka MP.","journal":"The Journal of clinical psychiatry","year":1991,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of 10 men treated with antidepressants; no control group; outcomes based on self‑report of sexual behavior and a depression inventory","sample_n":10,"sample_text":"ten men (consecutive)","population":"adult men with DSM‑III‑R diagnosed non‑paraphilic sexual addictions or paraphilias; consecutively evaluated","country":"unspecified (likely USA given journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In ten men with self‑identified sexual ‘addictions’ or paraphilias, fluoxetine, imipramine, or lithium reduced reported sexual activity and depressive symptoms, but the study lacked a control group and used only a simple count of sexual acts to gauge change.","clinical_takeaway":"Evidence is insufficient to recommend antidepressants for sexual addiction; improvements may reflect mood changes rather than specific effects on sexual behavior.","confidence":0.7,"topic_tags":["sexual_function","treatment","moral_incongruence"],"strengths":["Uses a validated depression inventory","Consecutive clinical sample"],"limitations":["Very small, uncontrolled case series","Ad‑hoc sexual behavior measure","No assessment of moral or relational confounds","Addiction construct not operationalised"],"rubric_version":"2.0","raw_total":11,"max_possible":60,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":0,"design":2,"addiction_criteria":2,"interpretation":2}},"scite":null},{"id":5722,"doi":null,"pmid":"1913940","pmcid":null,"title":"[Catamnesis of a group of 84 castrated sexual offenders]","authors":"Zvĕrina J, Zimanová J, Bártová D.","first_author":"Zvĕrina J","journal":"Ceskoslovenska psychiatrie","year":1991,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"cze","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 84 castrated sexual offenders; longitudinal follow‑up 1–15 years without control group","sample_n":84,"sample_text":"84 castrated sexual delinquents examined after 1–15 year interval","population":"adult male sexual offenders, castrated for therapeutic reasons","country":"Czech Republic","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi","self_selected_sample","circular_addiction_scale"],"stance":"strongly-supports","citation_value":"avoid","plain_summary":"A Czech study followed 84 men who had been surgically castrated for sexual offenses. After up to 15 years most still had occasional erections and masturbated, but only three re‑offended sexually. The authors argue that castration remains a useful treatment for offenders who do not respond to other methods.","clinical_takeaway":"Evidence is insufficient to support routine castration; the study lacks controls and robust outcome measures.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["large (for a forensic) sample of castrated offenders","long follow‑up period (up to 15 years)","detailed descriptive outcomes (erections, intercourse, re‑offending)"],"limitations":["no control or comparison group","no validated psychometric measures","no statistical analysis reported","conclusions advocate castration beyond evidence"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":5723,"doi":"10.1016/0140-6736(91)90890-2","pmid":"1671127","pmcid":null,"title":"Benzodiazepines and sexual assault, Canada","authors":"Brahams D.","first_author":"Brahams D.","journal":"Lancet (London, England)","year":1991,"pub_types":["News","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0140-6736(91)90890-2"}},{"id":5724,"doi":"10.1016/s0022-3476(05)80512-8","pmid":"1993968","pmcid":null,"title":"Indications for psychiatric referral","authors":"Furman L.","first_author":"Furman L.","journal":"The Journal of pediatrics","year":1991,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-3476(05)80512-8"}},{"id":5725,"doi":null,"pmid":"1988418","pmcid":null,"title":"Fluoxetine treatment of a fetish","authors":"Lorefice LS.","first_author":"Lorefice LS.","journal":"The Journal of clinical psychiatry","year":1991,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5726,"doi":null,"pmid":"1788012","pmcid":null,"title":"[So-called \"onanic spasms\" in infants]","authors":"Ratner AIu, Galiullina EI.","first_author":"Ratner AIu","journal":"Pediatriia","year":1991,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"rus","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5727,"doi":"10.1016/0277-9536(91)90267-g","pmid":"1745921","pmcid":null,"title":"Do prostitutes need more health education regarding sexually transmitted diseases and the HIV infection? Experience in a Belgian city","authors":"Mak RP, Plum JR.","first_author":"Mak RP","journal":"Social science & medicine (1982)","year":1991,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"154 sex workers in Ghent surveyed Dec 1988–Apr 1989 about STD/HIV knowledge, attitudes, practices.","sample_n":154,"sample_text":"154 women interviewed","population":"Female sex workers in clubs and windows, Ghent, Belgium (N=154)","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1989 survey of 154 Belgian sex workers showed limited knowledge about safe sex and inconsistent condom use, especially with private partners, suggesting the need for stronger health‑education programmes.","clinical_takeaway":"Sex‑worker health services should intensify education on condom use and STD prevention.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large convenience sample for the time period","Direct assessment of knowledge and condom use","Provides baseline data for public‑health planning"],"limitations":["Knowledge instrument not reported as validated","Cross‑sectional, no causal inference","Self‑report may bias condom‑use estimates"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0277-9536(91)90267-g"}},{"id":5728,"doi":"10.1159/000473634","pmid":"1855535","pmcid":null,"title":"Self introduction of urethrovesical foreign bodies","authors":"Granados EA, Riley G, Rios GJ, Salvador J, Vicente J.","first_author":"Granados EA","journal":"European urology","year":1991,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000473634"}},{"id":5729,"doi":null,"pmid":"2054949","pmcid":null,"title":"Effect of repeated semen ejaculation on sperm quality","authors":"Nnatu SN, Giwa-Osagie OF, Essien EE.","first_author":"Nnatu SN","journal":"Clinical and experimental obstetrics & gynecology","year":1991,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"within‑subject repeated measures on 21 medical students; no control group; short follow‑up (days 1, 3, 5)","sample_n":21,"sample_text":"21 medical students","population":"medical student volunteers (N=21), male, presumably healthy","country":"Nigeria (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 21 male medical students, ejaculating every other day reduced sperm count and semen volume but did not change sperm movement or shape, suggesting normal fertility is likely unaffected.","clinical_takeaway":"Occasional frequent ejaculation may lower sperm numbers temporarily but does not appear to harm overall fertility in men with normal baseline semen quality.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Objective, validated laboratory measures of semen parameters","Within‑subject design controls for inter‑individual variability"],"limitations":["Very small, non‑representative sample (medical students)","No power calculation or effect‑size reporting","Limited generalisability to broader male population"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":5730,"doi":"10.1007/bf01369815","pmid":"1931743","pmcid":null,"title":"Fatal air embolism during female autoerotic practice","authors":"Pierucci G.","first_author":"Pierucci G.","journal":"International journal of legal medicine","year":1991,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01369815"}},{"id":5731,"doi":"10.1080/00926239108405467","pmid":"2072403","pmcid":null,"title":"Treatment acceptability of alternative sex therapies: a comparative analysis","authors":"Wilson GL, Wilson LJ.","first_author":"Wilson GL","journal":"Journal of sex & marital therapy","year":1991,"pub_types":["Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"cross‑sectional experimental rating study with 80 female participants; convenience sample; randomised presentation of therapy descriptions; individual vs group format; partner involvement manipulated.","sample_n":80,"sample_text":"80 female subjects","population":"female adults (average age not specified), recruited to rate therapy scenarios; not patients seeking treatment.","country":"unspecified (likely USA based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Eighty women read descriptions of two types of sex‑therapy for anorgasmia (group vs. individual) and rated how acceptable and credible they seemed. Individual therapy was preferred; whether the partner was involved did not affect ratings.","clinical_takeaway":"Clients may view individual sex‑therapy as more acceptable than group formats, regardless of partner involvement.","confidence":0.8,"topic_tags":["sexual_function","treatment"],"strengths":["Uses established, validated acceptability and credibility scales","Experimental manipulation of therapy format and partner involvement","Clear statistical comparison between conditions"],"limitations":["Convenience sample; limited generalisability","No pre‑registration or effect‑size reporting","Potential lack of power for detecting smaller effects"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239108405467"}},{"id":5733,"doi":"10.1016/0005-7916(90)90028-j","pmid":"2094741","pmcid":null,"title":"The use of covert sensitization and social skills training in the treatment of an obscene telephone caller","authors":"Moergen SA, Merkel WT, Brown S.","first_author":"Moergen SA","journal":"Journal of behavior therapy and experimental psychiatry","year":1990,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single inpatient case of an obscene telephone caller receiving covert sensitization and social skills training","sample_n":1,"sample_text":"one patient","population":"Adult male inpatient with paraphilic behavior","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A single inpatient case shows that covert sensitization and social skills training reduced an adult man's obscene telephone calls and related physiological arousal, with improvements maintained after a year.","clinical_takeaway":"Evidence is limited to one case; clinicians should not assume these methods are generally effective for paraphilic behaviors.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Physiological measure (penile tumescence)","Long-term follow‑up (1 year)","Combination of behavioral and social interventions"],"limitations":["Single case, no control group","No validated outcome scales reported","No measurement of key confounds (e.g., mental health, moral factors)","Overgeneralization of efficacy"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0005-7916(90)90028-j"}},{"id":5735,"doi":"10.1007/bf01816487","pmid":"11453096","pmcid":null,"title":"Fatal air embolism during female autoerotic practice","authors":"Marc B, Chadly A, Durigon M.","first_author":"Marc B","journal":"International journal of legal medicine","year":1990,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single autopsy case report of fatal air embolism following vaginal insertion of a foreign object for autoerotic stimulation","sample_n":1,"sample_text":"single case","population":"40‑year‑old non‑pregnant woman (n=1)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 40‑year‑old woman died from a fatal air embolism after inserting a carrot into her vagina for sexual stimulation. The foreign object acted like a piston, forcing air into her bloodstream, similar to mechanisms seen in certain abortions.","clinical_takeaway":"Air can be forced into the circulation by vaginal insufflation; clinicians should consider air embolism in unexplained sudden deaths following autoerotic practices.","confidence":0.9,"topic_tags":["sexual_function","masturbation"],"strengths":["rare clinical observation","detailed autopsy description","high relevance for forensic medicine"],"limitations":["single case; no generalisability","no systematic data on prevalence","no assessment of psychological or behavioural context beyond the incident"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01816487"}},{"id":5736,"doi":"10.1176/appi.psychotherapy.1955.9.4.630","pmid":"13258883","pmcid":null,"title":"Therapeutic considerations in masturbation","authors":"MERTZ P.","first_author":"MERTZ P.","journal":"American journal of psychotherapy","year":1955,"pub_types":["Journal Article"],"keywords":["Psychoanalytic Therapy","Masturbation/therapy"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.psychotherapy.1955.9.4.630"}},{"id":5737,"doi":null,"pmid":"2092927","pmcid":null,"title":"[Are we going to throw out the child with the bathwater?] Comment on a quasidiscussion of marriage and family education]","authors":"Novák T, Capponi V.","first_author":"Novák T","journal":"Ceskoslovenska pediatrie","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"slo","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5738,"doi":null,"pmid":"13251490","pmcid":null,"title":"[Case of masturbation with a headlight bulb]","authors":"OLSZEWSKI Z.","first_author":"OLSZEWSKI Z.","journal":"Ginekologia polska","year":1955,"pub_types":["Journal Article"],"keywords":["Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5740,"doi":null,"pmid":"2285353","pmcid":null,"title":"[Death in inverted head position]","authors":"Madea B, Henssge C, Esser W.","first_author":"Madea B","journal":"Archiv fur Kriminologie","year":1990,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of a single death involving inverted head position, with autopsy discussion.","sample_n":1,"sample_text":"N=1 (single case)","population":"One 56‑year‑old male found dead in a sack, head‑down.","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 56‑year‑old man was found dead while suspended head‑down in a sack. The authors describe autopsy findings and suggest death resulted from asphyxia and circulatory problems caused by the inverted position.","clinical_takeaway":"None – the report does not provide evidence relevant to clinical practice.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Detailed autopsy description","Discussion of physiological mechanisms"],"limitations":["Single case, no generalisability","No systematic data or statistical analysis","No assessment of relevant psychological or behavioural confounds"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":5743,"doi":"10.1007/bf01541550","pmid":"2360874","pmcid":null,"title":"The role of anxiety in premature ejaculation: a psychophysiological model","authors":"Strassberg DS, Mahoney JM, Schaugaard M, Hale VE.","first_author":"Strassberg DS","journal":"Archives of sexual behavior","year":1990,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"laboratory and home self‑stimulation with between‑group comparison (15 PE vs 17 NPE)","sample_n":32,"sample_text":"15 premature ejaculators, 17 non‑premature ejaculators","population":"adult male premature ejaculators and controls","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared men with premature ejaculation to controls, measuring how quickly they reached orgasm during self‑stimulation at home and in the lab. Men with premature ejaculation ejaculated faster but estimated their timing as accurately as controls, suggesting anxiety may not be the sole cause.","clinical_takeaway":"Premature ejaculation may stem from physiological factors beyond anxiety; treatment should consider somatic vulnerability.","confidence":0.6,"topic_tags":["sexual_function","masturbation","prevalence","measurement"],"strengths":["objective latency measurement","within‑subject home and lab comparison","clear hypothesis testing"],"limitations":["small sample, likely under‑powered","limited assessment of anxiety (instrument not described)","no control for moral, mental‑health or relationship factors"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":44,"citing_publications":111,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541550"}},{"id":5744,"doi":"10.1016/0140-6736(90)92665-5","pmid":"1970391","pmcid":null,"title":"Unusual cause of acute urinary tract infection in Muslim youths","authors":"Manzar KJ.","first_author":"Manzar KJ.","journal":"Lancet (London, England)","year":1990,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":1,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0140-6736(90)92665-5"}},{"id":5745,"doi":null,"pmid":"2194612","pmcid":"PMC1809761","title":"Advice literature: a Victorian view of sexual mores","authors":"Haller JS.","first_author":"Haller JS.","journal":"Bulletin of the New York Academy of Medicine","year":1990,"pub_types":["Historical Article","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5746,"doi":"10.1111/j.1464-410x.1990.tb14764.x","pmid":"2340374","pmcid":null,"title":"Erection and ejaculation in man. Assessment of the electromyographic activity of the bulbocavernosus and ischiocavernosus muscles","authors":"Gerstenberg TC, Levin RJ, Wagner G.","first_author":"Gerstenberg TC","journal":"British journal of urology","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":99,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory EMG recording during visual sexual stimulation and masturbation in 7 healthy male volunteers.","sample_n":7,"sample_text":"7 human volunteers","population":"7 adult male volunteers, healthy, no clinical condition reported.","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study recorded muscle activity in the penis of seven men during visual sexual arousal and masturbation, finding that the striated muscles fire only during ejaculation and that many muscle bursts do not correspond to semen release.","clinical_takeaway":"Muscle activity during ejaculation is partly independent of semen volume, suggesting complexity in the ejaculatory mechanism.","confidence":0.85,"topic_tags":["sexual_function","neuroscience","masturbation"],"strengths":["Objective physiological measurement (EMG)","Simultaneous semen volume recording","Novel insight into muscular activity during ejaculation"],"limitations":["Very small sample (N=7)","No control group or randomization","Limited statistical reporting"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":68,"citing_publications":159,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1464-410x.1990.tb14764.x"}},{"id":5748,"doi":"10.1007/bf01542230","pmid":"2337381","pmcid":null,"title":"Attitudinal and experiential correlates of anorgasmia","authors":"Kelly MP, Strassberg DS, Kircher JR.","first_author":"Kelly MP","journal":"Archives of sexual behavior","year":1990,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"34 women (24 orgasmic, 10 anorgasmic) completed continuous self‑report arousal ratings while viewing explicit video clips and answered questionnaires on sexual attitudes, knowledge and guilt. Groups were compared using ANOVA.","sample_n":34,"sample_text":"24 orgasmic and 10 anorgasmic women","population":"adult women, ages 21‑40, recruited presumably via convenience sampling","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a small study, women who could not reach orgasm reported more negative attitudes toward masturbation, higher sexual guilt and more sex myths than women who could orgasm, despite similar sexual activity frequency and arousal while watching explicit videos.","clinical_takeaway":"Attitudinal factors such as guilt and negative views on masturbation may be linked to anorgasmia and could be addressed in therapy.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Direct physiological arousal measurement during stimulus exposure","Comparison of multiple attitudinal variables"],"limitations":["Small, non‑representative sample","No validated scales specified","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":26,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542230"}},{"id":5749,"doi":"10.1210/jcem-70-4-1124","pmid":"1690746","pmcid":null,"title":"Effects of estrogen, androgen, and progestin on sexual psychophysiology and behavior in postmenopausal women","authors":"Myers LS, Dixen J, Morrissette D, Carmichael M, Davidson JM.","first_author":"Myers LS","journal":"The Journal of clinical endocrinology and metabolism","year":1990,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":96,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"double‑blind, placebo‑controlled randomised trial (n=40) over 10 weeks; hormone arms vs placebo; physiological (vaginal plethysmography) and self‑report outcomes","sample_n":40,"sample_text":"40 naturally menopausal women","population":"postmenopausal women, mean age 58 y, physically and sexually healthy","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 10‑week trial with 40 postmenopausal women, hormone treatments (estrogen, progesterone, testosterone) lowered hot‑flashes but did not change mood, sexual activity, or physiological arousal. Testosterone raised self‑reported pleasure from masturbation.","clinical_takeaway":"Testosterone may modestly boost masturbatory pleasure in postmenopausal women, but hormone therapy does not appear to improve overall sexual function.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Randomised, double‑blind design","Objective physiological measure of genital arousal","Separate measurement of masturbation pleasure"],"limitations":["Small sample limits power for behavioural outcomes","No validated sexual function questionnaires reported","No assessment of partner or sociocultural factors"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":2,"mentioning":85,"citing_publications":172,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1210/jcem-70-4-1124"}},{"id":5750,"doi":null,"pmid":"13185357","pmcid":null,"title":"[Behavior disorders in conflict situations due to masturbation]","authors":"KUIPER PC, MIK G.","first_author":"KUIPER PC","journal":"Nederlands tijdschrift voor geneeskunde","year":1954,"pub_types":["Journal Article"],"keywords":["Behavior","Neuroses/manifestations","Masturbation","psychotherapy"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"und","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5752,"doi":null,"pmid":"13186648","pmcid":null,"title":"[Hormonal correlation between the pineal body and the genitals. II. Effects of the pineal hormone on spermatogenesis in man. III. Pineal therapy of masturbation]","authors":"VINCI M, PAOLELLA A.","first_author":"VINCI M","journal":"La Riforma medica","year":1954,"pub_types":["Journal Article"],"keywords":["Pineal body","Spermatozoa","Masturbation","Genitalia, Male/effect Of Drugs On"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"und","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5753,"doi":null,"pmid":"13138629","pmcid":null,"title":"An experiment in the treatment of masturbation in oligophrenia","authors":"RUDOLF GD.","first_author":"RUDOLF GD.","journal":"American journal of mental deficiency","year":1954,"pub_types":["Journal Article"],"keywords":["Diethylstilbestrol/therapeutic Use","Imbecility","Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5754,"doi":null,"pmid":"2351920","pmcid":null,"title":"Sexual experience and sexual orientation among Ramathibodi medical students, Thailand","authors":"Pongthai S.","first_author":"Pongthai S.","journal":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of all medical students at one Thai university (1982‑1988); descriptive frequencies of sexual behaviours and orientation","sample_n":804,"sample_text":"593 male, 211 female respondents","population":"medical students (mostly young adults, Thailand)","country":"Thailand","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1980s survey of Thai medical students found most males ejaculated, masturbated, and had sex, while fewer females did. About 13% of males and 3% of females reported any same‑sex experience, and roughly 20% identified as exclusively homosexual or bisexual.","clinical_takeaway":"None – the study is descriptive and does not inform clinical practice.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["High response rate (>90%) of target population","Large sample for a single institution","Provides historical baseline data"],"limitations":["Ad‑hoc, non‑validated questionnaire","Cross‑sectional, no causal inference","Limited to one university and era; not generalizable"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":5756,"doi":"10.1007/bf01541822","pmid":"2327892","pmcid":null,"title":"Sexual dysfunction in male and female patients with epilepsy: a study of 86 outpatients","authors":"Jensen P, Jensen SB, Sørensen PS, Bjerre BD, Rizzi DA, Sørensen AS, Klysner R, Brinch K, Jespersen B, Nielsen H.","first_author":"Jensen P","journal":"Archives of sexual behavior","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 86 consecutive epilepsy outpatients, compared with historic diabetic and healthy control data.","sample_n":86,"sample_text":"consecutive epilepsy outpatients","population":"86 adult epilepsy outpatients (38 men, 48 women), no comorbid disorders, mostly on monotherapy.","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 86 epilepsy outpatients, sexual dysfunction rates were similar to healthy controls and lower than in diabetics, suggesting epilepsy itself may not increase sexual problems.","clinical_takeaway":"Epilepsy patients without other disorders generally do not show higher sexual dysfunction; clinicians can reassure if other factors are absent.","confidence":0.6,"topic_tags":["sexual_function","neuroscience"],"strengths":["Use of identical methodology to prior studies for comparison","Inclusion of both sexes","Assessment of hormonal status"],"limitations":["Cross‑sectional, no causal inference","No formal control group, reliance on historic comparators","Limited control for psychological or relational confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":0,"mentioning":41,"citing_publications":81,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541822"}},{"id":5757,"doi":null,"pmid":"2165334","pmcid":null,"title":"[Foreign body injury of the urethra in a boy]","authors":"Rakhimov SR, Iskandarov ER, Dzhumabaev DU, Rasulov IaM.","first_author":"Rakhimov SR","journal":"Vestnik khirurgii imeni I. I. Grekova","year":1990,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"rus","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5758,"doi":null,"pmid":"2109124","pmcid":null,"title":"Potency disorder among Pathans","authors":"Khan MF, Ahmed SH.","first_author":"Khan MF","journal":"JPMA. The Journal of the Pakistan Medical Association","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"100 consecutive Pathan men with potency disorder examined in a family‑physician clinic; structured proforma used after excluding structural/drug causes.","sample_n":100,"sample_text":"hundred consecutive patients","population":"Adult male Pathans, working‑class, Karachi, Pakistan (n≈100)","country":"Pakistan","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A clinic in Karachi examined 100 Pathan men with erectile problems, finding high rates of anxiety, depression, and guilt linked to cultural beliefs about masturbation and other sexual practices.","clinical_takeaway":"Screen for depression and anxiety in men presenting with erectile issues, especially where cultural guilt about sexuality is present.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Large consecutive clinical sample for the setting","Inclusion of depression and anxiety assessment","Attention to cultural beliefs influencing guilt"],"limitations":["No validated instruments; reliance on ad‑hoc proforma","Cross‑sectional, no control group","Moral incongruence not measured despite being a key confound","Interpretation suggests causality from correlational data"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":5759,"doi":null,"pmid":"2264511","pmcid":null,"title":"Gender comparisons of college students' attitudes toward sexual behavior","authors":"Wilson SM, Medora NP.","first_author":"Wilson SM","journal":"Adolescence","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 641 undergraduates at a single southeastern university; gender comparison of attitudes toward various sexual behaviors.","sample_n":641,"sample_text":"Large southeastern university undergraduates (convenience sample).","population":"College students (undergraduate)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1990 survey of 641 college students found that men generally hold more liberal attitudes than women toward casual premarital sex, extramarital sex, oral‑genital sex, and anal sex, while attitudes toward sex with a loved partner, engagement, masturbation, homosexuality, and sexual fantasy showed no gender differences.","clinical_takeaway":"None – the study reports attitudes, not health outcomes or treatment implications.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample size for a single‑site survey","Direct gender comparison on multiple sexual‑behavior attitudes","Clear statistical significance reporting"],"limitations":["Convenience, single‑university sample limits generalisability","Attitude measures likely not validated psychometric instruments","No effect‑size reporting or correction for multiple comparisons"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":5760,"doi":"10.1002/pros.2990170403","pmid":"2251222","pmcid":null,"title":"A case-control study of prostatic cancer in Kyoto, Japan: sexual risk factors","authors":"Oishi K, Okada K, Yoshida O, Yamabe H, Ohno Y, Hayes RB, Schroeder FH, Boyle P.","first_author":"Oishi K","journal":"The Prostate","year":1990,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-control study with 100 prostate cancer cases and matched hospital controls; self‑administered questionnaire for sexual history; no longitudinal follow‑up.","sample_n":100,"sample_text":"100 prostate cancer patients; number of controls not specified but matched to cases","population":"men with prostate cancer and hospital controls in Kyoto, Japan (1981‑1984)","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1990 case‑control study in Kyoto found that men with prostate cancer reported fewer pre‑marriage sex partners but more vigorous sexual activity in their 30s and 40s, fewer orgasms, and less satisfying intercourse compared with hospital controls.","clinical_takeaway":"No direct clinical guidance; the study suggests certain adult sexual patterns may be linked to prostate cancer risk, but findings are limited by self‑report and potential confounding.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Matched case‑control design","Provides relative risks with confidence intervals","Considers multiple sexual‑behavior variables"],"limitations":["Sexual history measured with unvalidated single‑item questionnaire","Potential recall bias and limited control for confounders","No correction for multiple testing reported"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":22,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/pros.2990170403"}},{"id":5761,"doi":"10.1080/00926239008405252","pmid":"2398502","pmcid":null,"title":"Sexuality and psychophysiological functioning in women with diabetes mellitus","authors":"Slob AK, Koster J, Radder JK, van der Werff ten Bosch JJ.","first_author":"Slob AK","journal":"Journal of sex & marital therapy","year":1990,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational comparative study of 24 diabetic women and 10 controls measuring subjective arousal and labial temperature during erotic visual stimulation.","sample_n":34,"sample_text":"24 diabetic women, 10 control women","population":"Women with type 1 diabetes mellitus and healthy controls (n=34 total).","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured how women with type 1 diabetes and healthy controls responded to erotic pictures, using self‑reported arousal and a rise in labial temperature. No major differences were found, but the small sample and mild diabetes may limit conclusions.","clinical_takeaway":"No clear impact of type 1 diabetes on sexual arousal was observed, but clinicians should consider neuropathy severity when assessing sexual function.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Objective physiological measure (labial temperature)","Comparison with control group","Acknowledges limitation of neuropathy severity"],"limitations":["Small sample, especially control group","No assessment of key confounds (mood, relationship context)","Limited statistical reporting (no effect sizes, power analysis)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":25,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239008405252"}},{"id":5762,"doi":null,"pmid":"11638264","pmcid":null,"title":"[Moral values of hygiene: the concept of onanism as a disease following Tissot and his late penetration into Spain]","authors":"Perdiguero E, González de Pablo A.","first_author":"Perdiguero E","journal":"Dynamis (Granada, Spain)","year":1990,"pub_types":["Historical Article","Biography","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5763,"doi":"10.1177/070674378903400907","pmid":"2692806","pmcid":null,"title":"Development of sexuality in female children and adolescents","authors":"Whitfield M.","first_author":"Whitfield M.","journal":"Canadian journal of psychiatry. Revue canadienne de psychiatrie","year":1989,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"Not applicable – narrative review without original participants","population":"female children and adolescents (no primary data)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews older literature on how female sexuality develops from childhood through adolescence, covering topics such as masturbation, interest in babies, and menarche, and suggests that life experiences shape sexual development.","clinical_takeaway":"None – the review offers historical context but provides no clinically actionable evidence.","confidence":0.4,"topic_tags":["sexual_function","gender","adolescents"],"strengths":["Broad historical overview of female sexual development","Includes discussion of masturbation literature","Highlights psychosocial influences on sexuality"],"limitations":["Narrative review lacking systematic methodology","No empirical data or quantitative analysis","Outdated (1989) and predates modern CSBD concepts"],"rubric_version":"2.0","raw_total":3,"max_possible":50,"pct_score":6,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/070674378903400907"}},{"id":5764,"doi":null,"pmid":"13154818","pmcid":null,"title":"[The question of considering habitual masturbation in children as a disease; supplemented by a discussion on the concept of disease in the health insurance program]","authors":"GERCHOW J.","first_author":"GERCHOW J.","journal":"Der Offentliche Gesundheitsdienst","year":1953,"pub_types":["Journal Article"],"keywords":["Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"und","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5765,"doi":null,"pmid":"13106944","pmcid":null,"title":"[Esthetic sex education in prevention of masturbation]","authors":"NIETO NIETO G.","first_author":"NIETO NIETO G.","journal":"Clinica y laboratorio","year":1953,"pub_types":["Journal Article"],"keywords":["Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"und","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5766,"doi":null,"pmid":"2587669","pmcid":null,"title":"[Cutting of clothing while bicycling--artistic performance of a communication-disordered deaf patient suffering from fetishism]","authors":"Lange E.","first_author":"Lange E.","journal":"Psychiatrie, Neurologie, und medizinische Psychologie","year":1989,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5767,"doi":"10.5694/j.1326-5377.1989.tb128469.x","pmid":"2593942","pmcid":null,"title":"Sexual practices and condom usage in a cohort of homosexual men in relation to human immunodeficiency virus status","authors":"Tindall B, Swanson C, Donovan B, Cooper DA.","first_author":"Tindall B","journal":"The Medical journal of Australia","year":1989,"pub_types":["Comparative Study","Journal Article"],"keywords":["Viral diseases","Behavior","Australia","Contraception","Diseases","Sex behavior","Hematologic tests","research methodology","Family Planning","Contraceptive Methods","Developed Countries","Examinations And Diagnoses","Oceania","Research Report","Laboratory Examinations And Diagnoses","Laboratory Procedures","Barrier Methods","Condom","Hiv Infections--prevention And Control","Acquired Immunodeficiency Syndrome--prevention And Control","Cohort Analysis","Homosexuals"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"prospective cohort questionnaire study of 420 homosexual men (205 HIV+, 215 HIV-) examining sexual practices and condom use over the previous 6 months; multivariate logistic analyses reported.","sample_n":420,"sample_text":"420 homosexual men (205 HIV‑seropositive, 215 HIV‑seronegative) completed a questionnaire on sexual practices.","population":"420 homosexual men (Australia, 1987), recruited for an HIV cohort study; not a random population sample.","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a 1987 Australian cohort of 420 gay men, researchers compared condom use and sexual practices between HIV‑positive and HIV‑negative participants. While condom use was common, a minority engaged in unprotected anal sex. HIV‑negative men were more likely to use condoms and engage in mutual masturbation.","clinical_takeaway":"Condom use varied by HIV status, but most participants practiced safer sex; clinicians should continue emphasizing condom use regardless of serostatus.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for its time","Clear comparison between HIV‑positive and HIV‑negative men","Multivariate analysis to adjust for covariates"],"limitations":["Self‑report questionnaire with no validated sexual‑behavior scale","No measurement or control of key confounds (e.g., mental health, moral attitudes)","Convenience sample; limited generalisability"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":5,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5694/j.1326-5377.1989.tb128469.x"}},{"id":5769,"doi":null,"pmid":"13121553","pmcid":null,"title":"[Prohibition of masturbation and psychological development; case history of a boy]","authors":"GARMA E.","first_author":"GARMA E.","journal":"Revista de psicoanalisis","year":1953,"pub_types":["Journal Article"],"keywords":["Personality","Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"und","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5770,"doi":null,"pmid":"2669151","pmcid":null,"title":"Spermatic economy: a 19th century view of male impotence","authors":"Haller JS.","first_author":"Haller JS.","journal":"Southern medical journal","year":1989,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5771,"doi":null,"pmid":"2759581","pmcid":null,"title":"Self-mutilation","authors":"Siomopoulous V.","first_author":"Siomopoulous V.","journal":"Hospital & community psychiatry","year":1989,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5773,"doi":"10.1016/s0022-5347(17)38824-9","pmid":"2746783","pmcid":null,"title":"Sexual function and fertility in patients treated for posterior urethral valves","authors":"Woodhouse CR, Reilly JM, Bahadur G.","first_author":"Woodhouse CR","journal":"The Journal of urology","year":1989,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Interview and laboratory assessment of 21 men treated in infancy for posterior urethral valves; no control group.","sample_n":21,"sample_text":"21 men (10 semen samples, 7 urine after masturbation).","population":"Men treated for posterior urethral valves (n=21).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a small group of 21 men who had surgery for posterior urethral valves as infants, most reported normal erections and orgasm, and semen counts were within the fertile range, although many experienced slow or dry ejaculation.","clinical_takeaway":"Most patients show preserved fertility, but clinicians should inquire about ejaculatory difficulties after valve repair.","confidence":0.4,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Objective semen analysis provides physiological data","Long‑term follow‑up of a specific clinical cohort","Combination of self‑report and laboratory measures"],"limitations":["Very small, non‑representative sample (n=21)","No comparison or control group","Reliance on non‑validated interview items for sexual function","No statistical testing beyond descriptive counts"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":3,"mentioning":39,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-5347(17)38824-9"}},{"id":5774,"doi":null,"pmid":"13063258","pmcid":null,"title":"[Anal masturbation; case report]","authors":"PORTIGLIATTI-BARBOS M.","first_author":"PORTIGLIATTI-BARBOS M.","journal":"Minerva medicolegale; archivio di antropologia criminale, psichiatria, e medicina legale","year":1953,"pub_types":["Journal Article"],"keywords":["Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"und","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5775,"doi":null,"pmid":"2502813","pmcid":"PMC1579932","title":"Differences in gay men's AIDS risk knowledge and behavior patterns in high and low AIDS prevalence cities","authors":"St Lawrence JS, Hood HV, Brasfield T, Kelly JA.","first_author":"St Lawrence JS","journal":"Public health reports (Washington, D.C. : 1974)","year":1989,"pub_types":["Comparative Study","Research Support, U.S. Gov't, P.H.S.","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative survey of men entering gay bars in three US cities (one high‑prevalence, two low‑prevalence). Convenience sampling; anonymous self‑report questionnaire on sexual practices and AIDS knowledge.","sample_n":null,"sample_text":"Men entering gay bars in three cities completed anonymous surveys.","population":"Gay men (adult) recruited in gay bars; sample size not reported in abstract.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Gay men in a large city with many AIDS cases knew more about AIDS and practiced safer sex (more mutual masturbation, less unprotected anal intercourse) than men in smaller cities with fewer cases.","clinical_takeaway":"Targeted education may be needed for gay men in smaller cities to promote safer sex practices.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Direct comparison between high‑ and low‑prevalence cities","Focus on specific low‑risk practices (mutual masturbation, body rubbing)","Addresses gap in knowledge about smaller‑city gay men"],"limitations":["Convenience sample of bar patrons; limited generalisability","No validated scales for knowledge or behaviour; likely single‑item measures","No adjustment for potential confounders (e.g., mental health, partner status)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":5776,"doi":null,"pmid":"13040859","pmcid":null,"title":"[Unusual case of masturbation with fatal outcome]","authors":"COMTE L.","first_author":"COMTE L.","journal":"Annales de medecine legale, criminologie, police scientifique et toxicologie","year":1953,"pub_types":["Journal Article"],"keywords":["Death, Sudden","Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"und","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5777,"doi":"10.1177/000306515300100104","pmid":"13022433","pmcid":null,"title":"Masturbation and symptom formation","authors":"ARLOW JA.","first_author":"ARLOW JA.","journal":"Journal of the American Psychoanalytic Association","year":1953,"pub_types":["Journal Article"],"keywords":["Neuroses","Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":27,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000306515300100104"}},{"id":5778,"doi":"10.1007/bf01543197","pmid":"2751417","pmcid":null,"title":"Profile analysis as a method of comparing intergenerational differences in sexual behavior","authors":"Clement U.","first_author":"Clement U.","journal":"Archives of sexual behavior","year":1989,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative study of three independent samples spanning ~40 years, using profile analysis to assess intergenerational differences in sexual behavior.","sample_n":null,"sample_text":"Not specified in abstract; likely convenience samples.","population":"Adults (male and female) from United States and West Germany; sample size not reported in abstract.","country":"United States; Germany (West)","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"background","plain_summary":"The study compares sexual behavior of men and women from three cohorts spanning about 40 years, finding that women's behaviors changed more than men's, suggesting a move toward gender equality in sexual norms.","clinical_takeaway":"None – the findings describe broad social trends, not clinical implications.","confidence":0.7,"topic_tags":["sexual_function","gender","csbd","masturbation"],"strengths":["Longitudinal perspective across four decades","Use of profile analysis to compare multiple variables"],"limitations":["No validated measures reported","No control for key confounds (moral, mental health, partner effects)","Sample characteristics unclear; likely convenience"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01543197"}},{"id":5779,"doi":"10.1007/bf01543193","pmid":"2787626","pmcid":null,"title":"Asphyxiophilia in Scandinavia","authors":"Innala SM, Ernulf KE.","first_author":"Innala SM","journal":"Archives of sexual behavior","year":1989,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective descriptive study using forensic reports from 18 doctors across three countries; no random sampling, no control group.","sample_n":null,"sample_text":"Information from 18 forensic doctors; number of cases not specified in abstract.","population":"Male and female deaths attributed to asphyxiophilia in Denmark, Norway, and Sweden over 10‑40 year periods.","country":"Denmark, Norway, Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed forensic reports from Denmark, Norway and Sweden and estimate that deaths from asphyxiophilia occur at about 0.5–1 per million people each year, based on 10‑40 year observation periods.","clinical_takeaway":"None – the study only provides epidemiological estimates of fatal asphyxiophilia, not guidance for clinical practice.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Long observation periods (10‑40 years)","Multi‑country forensic data","Rare topic with public‑health relevance"],"limitations":["Very small case numbers, unknown exact N","No systematic case ascertainment","No control/comparison group","Potential reporting bias in death certificates"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01543193"}},{"id":5780,"doi":"10.1016/0018-506x(89)90063-9","pmid":"2744740","pmcid":null,"title":"Low sexual desire in women: the role of reproductive hormones","authors":"Schreiner-Engel P, Schiavi RC, White D, Ghizzani A.","first_author":"Schreiner-Engel P","journal":"Hormones and behavior","year":1989,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case-control comparison of 17 women with DSM‑III‑R defined hypoactive sexual desire disorder and 13 healthy controls; hormonal assays across one menstrual cycle","sample_n":30,"sample_text":"17 HSD women, 13 controls","population":"women ages 27‑39, community recruited, not treatment‑seeking","country":"USA (presumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared hormone levels across the menstrual cycle in women with severe low sexual desire and healthy controls, finding no hormonal differences, suggesting hormones do not explain individual variation in desire among eugonadal women.","clinical_takeaway":"Hormonal testing is unlikely to clarify low sexual desire in otherwise healthy women.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Validated hormonal assays","Clear DSM‑III‑R diagnostic criteria for HSD","Spousal interviews to assess partner context"],"limitations":["Small sample, underpowered","No pre‑registration or effect‑size reporting","Moral or trauma variables not assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":6,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0018-506x(89)90063-9"}},{"id":5781,"doi":"10.1080/21674086.1952.11925895","pmid":"13004128","pmcid":null,"title":"Authority and masturbation; some remarks on a bibliographical investigation","authors":"SPITZ RA.","first_author":"SPITZ RA.","journal":"The Psychoanalytic quarterly","year":1952,"pub_types":["Journal Article"],"keywords":["Psychoanalysis","Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/21674086.1952.11925895"}},{"id":5782,"doi":null,"pmid":"13012723","pmcid":null,"title":"[The truth about masturbation]","authors":"RAMIREZ DEGOLLADO L.","first_author":"RAMIREZ DEGOLLADO L.","journal":"Medicina","year":1952,"pub_types":["Journal Article"],"keywords":["Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"und","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5783,"doi":null,"pmid":"2721294","pmcid":null,"title":"Sexuality: a neglected component of child sexual abuse education and training","authors":"Gillman R, Whitlock K.","first_author":"Gillman R","journal":"Child welfare","year":1989,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary proposing integration of sexuality content into child welfare training; no empirical data, no sample reported.","sample_n":null,"sample_text":"Not applicable – article is a narrative proposal.","population":"Child welfare workers (proposed target).","country":"United Kingdom (inferred from journal, not specified).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that child welfare training should include comprehensive sexuality education, covering topics like masturbation and sexual orientation, to better prevent and address child sexual abuse.","clinical_takeaway":"None – the paper offers training recommendations, not clinical evidence.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Addresses gap in training for child welfare workers.","Provides concrete rationale and teaching methods."],"limitations":["No empirical data or evaluation of proposed curriculum.","Lacks measurement of outcomes or effectiveness.","No consideration of confounding variables such as moral attitudes."],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":5784,"doi":null,"pmid":"2624150","pmcid":null,"title":"[Accidental hanging during auto-erotic practices]","authors":"Vieira DN, da Silva AG.","first_author":"Vieira DN","journal":"Acta medica portuguesa","year":1989,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"por","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single autopsy case of accidental hanging during auto‑erotic asphyxia; descriptive narrative only","sample_n":1,"sample_text":"single case","population":"one 25‑year‑old male university student","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 25‑year‑old man died after accidentally hanging himself while practicing auto‑erotic asphyxia. The report describes the circumstances and stresses the need for accurate forensic diagnosis of such deaths.","clinical_takeaway":"Clinicians should be aware of auto‑erotic asphyxia as a potential risk in patients reporting high‑risk sexual behaviours.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Detailed description of a rare, clinically relevant event","Highlights diagnostic challenges for forensic pathology"],"limitations":["Single case; no generalisable data","No systematic assessment of psychological or sexual‑behavior constructs","No control or comparison group"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":5785,"doi":"10.1176/appi.psychotherapy.1989.43.2.277","pmid":"2502035","pmcid":null,"title":"Use of lithium carbonate in the treatment of autoerotic asphyxia","authors":"Cesnik JA, Coleman E.","first_author":"Cesnik JA","journal":"American journal of psychotherapy","year":1989,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single clinical case of a 26‑year‑old male with autoerotic asphyxia treated with lithium carbonate","sample_n":1,"sample_text":"one patient","population":"adult male, treatment‑seeking, DSM‑III‑R dysthymia, avoidant personality, history of abuse","country":"USA","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 26‑year‑old man with autoerotic asphyxia and mood/personality disorders was treated with lithium, which the authors report stopped the risky behavior.","clinical_takeaway":"Evidence is limited to one case; lithium cannot be recommended for autoerotic asphyxia without further study.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["detailed clinical description","integration of psychiatric comorbidity"],"limitations":["single case, no control","no systematic measurement of key constructs","cannot infer efficacy"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":4,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.psychotherapy.1989.43.2.277"}},{"id":5787,"doi":null,"pmid":"2922837","pmcid":null,"title":"[Perforation of the rectosigmoid colon following autoerotic manipulation]","authors":"Baltsen A, Hovgaard C.","first_author":"Baltsen A","journal":"Ugeskrift for laeger","year":1989,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"dan","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report; single patient; no control group; descriptive narrative","sample_n":1,"sample_text":"single male patient","population":"middle‑aged male; single case","country":"Denmark (Ugeskrift for læger is a Danish journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1989 case report describes a man who perforated his rectosigmoid colon while using a billiard cue for autoerotic stimulation, and discusses surgical management of rectal foreign bodies.","clinical_takeaway":"Clinicians should be aware that insertion of objects for sexual stimulation can cause serious colonic injury requiring urgent surgical care.","confidence":0.9,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Detailed clinical description of a rare injury","Highlights need for careful management of rectal foreign bodies"],"limitations":["Single case; no generalizable data","No systematic assessment of psychological or sexual health variables","No control or comparison group"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5788,"doi":null,"pmid":"13025064","pmcid":null,"title":"[Tongue masturbation, a rare symptom in schizophrenia]","authors":"SACERDOTE A.","first_author":"SACERDOTE A.","journal":"Minerva medicolegale; archivio di antropologia criminale, psichiatria, e medicina legale","year":1952,"pub_types":["Journal Article"],"keywords":["Tongue","Schizophrenia/manifestations"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"und","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5789,"doi":"10.1016/s0022-3476(52)80163-5","pmid":"14928180","pmcid":null,"title":"Masturbation in infants","authors":"BAKWIN H.","first_author":"BAKWIN H.","journal":"The Journal of pediatrics","year":1952,"pub_types":["Journal Article"],"keywords":["Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-3476(52)80163-5"}},{"id":5790,"doi":"10.1017/s0033291700011004","pmid":"2657831","pmcid":null,"title":"Rich and mad in Victorian England","authors":"Turner T.","first_author":"Turner T.","journal":"Psychological medicine","year":1989,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"Retrospective analysis of 19th‑century asylum casebooks (N≈600); cross‑sectional chart review using Research Diagnostic Criteria.","sample_n":600,"sample_text":"over 600 admissions","population":"Patients admitted to Ticehurst House Asylum, England, 19th century","country":"England","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews over 600 19th‑century psychiatric admissions from a British asylum, finding most cases met criteria for schizophrenia or mood disorders and that masturbation was frequently noted among symptoms.","clinical_takeaway":"None – historical findings do not translate to current clinical practice for pornography or compulsive sexual behavior.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large historical case series (≈600)","Systematic use of Research Diagnostic Criteria"],"limitations":["Retrospective, limited records","No control for confounding variables","Historical context limits relevance to modern sexual health"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":10,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0033291700011004"}},{"id":5791,"doi":"10.1037//0022-006x.57.1.123","pmid":"2925963","pmcid":null,"title":"A psychometric analysis of the sexual arousability index","authors":"Andersen BL, Broffitt B, Karlsson JA, Turnquist DC.","first_author":"Andersen BL","journal":"Journal of consulting and clinical psychology","year":1989,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"psychometric validation with two groups (n=57, n=66) and repeated testing over 4 months","sample_n":123,"sample_text":"57 normal sexually active women; 66 women undergoing surgical treatment","population":"women, sexually active and undergoing gynecologic surgery","country":"United States (U.S. Government supported)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The Sexual Arousability Index (SAI) is a questionnaire that reliably measures women’s self‑reported sexual arousal across several activities, showing good internal consistency and stable factor structure, but it predicts actual sexual dysfunction only weakly.","clinical_takeaway":"The SAI can track changes in women’s sexual arousal but should be combined with other assessments for diagnosing dysfunction.","confidence":0.8,"topic_tags":["sexual_function","measurement"],"strengths":["Comprehensive psychometric evaluation (reliability, test‑retest, factor analysis)","Includes clinical and non‑clinical samples","Factor solution accounts for large proportion of variance"],"limitations":["No assessment of potential confounds such as mental health or moral factors","Criterion validity modest; poor prediction of inhibited excitement","Sample limited to women and specific clinical group"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0022-006x.57.1.123"}},{"id":5793,"doi":null,"pmid":"2669160","pmcid":null,"title":"[Complications caused by long-term presence of a foreign body in the bladder]","authors":"Shpize'l S, Gutsal RR.","first_author":"Shpize'l S","journal":"Sovetskaia meditsina","year":1989,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"rus","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5794,"doi":null,"pmid":"11622066","pmcid":null,"title":"[Masturbation, excessive venery and psychoses: the history of a theory in psychiatry] (Jpn)","authors":"Okada Y.","first_author":"Okada Y.","journal":"Nihon ishigaku zasshi. [Journal of Japanese history of medicine]","year":1989,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"jpn","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5796,"doi":null,"pmid":"2633747","pmcid":null,"title":"[Content and function of sexual fantasies. Results of a panel study of males and females]","authors":"Hartmann U.","first_author":"Hartmann U.","journal":"Beitrage zur Sexualforschung","year":1989,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5799,"doi":null,"pmid":"2818486","pmcid":null,"title":"[Agonal and postmortem movement sequences in hanging]","authors":"Risse M, Weiler G.","first_author":"Risse M","journal":"Beitrage zur gerichtlichen Medizin","year":1989,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case report of a hanging event captured on video; forensic analysis of movement sequences","sample_n":1,"sample_text":"N=1 (single case)","population":"one adult male involved in an autoerotic accident","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A video of a man who died during an autoerotic hanging was examined, showing detailed movement patterns that help understand how injuries occur in such incidents.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Unique video documentation of agonal movements","Forensic relevance"],"limitations":["Single case, no generalizability","No systematic measurement of sexual behavior constructs","No statistical analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":5800,"doi":"10.1037//0003-066x.44.1.73","pmid":"2930053","pmcid":null,"title":"Sex bias and POD","authors":"Morokoff PJ.","first_author":"Morokoff PJ.","journal":"The American psychologist","year":1989,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0003-066x.44.1.73"}},{"id":5801,"doi":"10.1002/1097-0142(19890101)63:1<204::aid-cncr2820630133>3.0.co;2-u","pmid":"2910419","pmcid":null,"title":"Sexual dysfunction and treatment for early stage cervical cancer","authors":"Schover LR, Fife M, Gershenson DM.","first_author":"Schover LR","journal":"Cancer","year":1989,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":136,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Prospective cohort of 61 women with early‑stage cervical cancer assessed at diagnosis, 6 mo and 12 mo post‑treatment; compares radical hysterectomy vs radiotherapy groups.","sample_n":61,"sample_text":"61 women (26 hysterectomy, 37 radiotherapy ± surgery).","population":"Women (N=61) with early‑stage invasive cervical cancer undergoing surgery or radiotherapy (1990s UK/US clinical settings).","country":"Not specified (likely USA/UK).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 61 women treated for early‑stage cervical cancer, sexual satisfaction and orgasm stayed stable, but partnered sex and variety of practices dropped after a year, especially after radiotherapy, which also increased pain during sex. Marital happiness was unchanged.","clinical_takeaway":"Radiotherapy for early cervical cancer may impair partnered sexual activity and cause dyspareunia; clinicians should address these issues during follow‑up.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Longitudinal follow‑up at 6 and 12 months","Direct clinical assessment of sexual function after cancer treatment"],"limitations":["Small sample, limited power for subgroup comparisons","Unclear whether validated questionnaires were used","Limited control for psychosocial confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":11,"contrasting":1,"mentioning":130,"citing_publications":215,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/1097-0142(19890101)63:1<204::aid-cncr2820630133>3.0.co;2-u"}},{"id":5802,"doi":"10.1016/0005-7916(88)90061-4","pmid":"3235698","pmcid":null,"title":"Summation of arousal in partial fetishism","authors":"Junginger J.","first_author":"Junginger J.","journal":"Journal of behavior therapy and experimental psychiatry","year":1988,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single male psychiatric patient examined with penile plethysmography and self‑report during presentation of static, picture, and compound stimuli","sample_n":1,"sample_text":"one patient","population":"adult male with fetishistic interests","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A single patient showed that his sexual arousal to a combined stimulus (radio static + picture) was roughly the sum of the responses to each part, suggesting a conditioning mechanism for partial fetishism.","clinical_takeaway":"Findings are anecdotal; no direct clinical guidance can be drawn.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["physiological measurement of arousal","use of classical conditioning paradigm"],"limitations":["single case, no control group","no systematic measurement of confounds","conclusions not generalizable"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0005-7916(88)90061-4"}},{"id":5803,"doi":"10.2105/ajph.78.12.1575","pmid":"3189635","pmcid":null,"title":"Impact of HIV antibody testing on changes in sexual behavior among homosexual men in The Netherlands","authors":"van Griensven GJ, de Vroome EM, Tielman RA, Goudsmit J, van der Noordaa J, de Wolf F, Coutinho RA.","first_author":"van Griensven GJ","journal":"American journal of public health","year":1988,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"746 homosexual men surveyed over three 6‑month waves (1984‑86) after receiving HIV antibody results; comparison of sexual‑partner counts between seropositive and seronegative groups.","sample_n":746,"sample_text":"N = 746 participants (31 % HIV‑Ab positive).","population":"gay/bisexual men living in/around Amsterdam, Netherlands (convenience sample).","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 746 gay men in Amsterdam, those who learned they were HIV‑positive initially reported more partners but later cut back on partner numbers more than HIV‑negative men, especially reducing oral‑genital sex.","clinical_takeaway":"Knowing HIV status may prompt risk‑reduction behaviour, but findings are based on self‑report and a specific cohort.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample for its time","Longitudinal design with three measurement points","Direct comparison of seropositive vs seronegative men"],"limitations":["Convenience sample, not nationally representative","Self‑report sexual behaviour may be biased","Limited statistical detail in abstract"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2105/ajph.78.12.1575"}},{"id":5804,"doi":null,"pmid":"3076163","pmcid":null,"title":"[A tumor-like lesion of the parametrium caused by foreign body of the bladder]","authors":"Sprogis J, Niedzielski A, Abucewicz A.","first_author":"Sprogis J","journal":"Ginekologia polska","year":1988,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5805,"doi":"10.3109/00207458808985786","pmid":"3215726","pmcid":null,"title":"Naltrexone suppresses abnormal sexual behavior in Tourette's syndrome","authors":"Sandyk R.","first_author":"Sandyk R.","journal":"The International journal of neuroscience","year":1988,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of two Tourette's patients treated with naltrexone for distressing abnormal sexual behavior","sample_n":2,"sample_text":"Two patients","population":"2 male adolescents/children with Tourette's syndrome exhibiting abnormal sexual behavior","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In two boys with Tourette's syndrome who showed distressing abnormal sexual behaviors, treatment with the opioid blocker naltrexone appeared to reduce those behaviors when other medications had failed.","clinical_takeaway":"Evidence is anecdotal; naltrexone might be explored cautiously for similar cases, but robust trials are needed.","confidence":0.7,"topic_tags":["treatment"],"strengths":["Detailed clinical observation of rare comorbidity","Novel therapeutic suggestion (naltrexone) for TS‑related sexual symptoms"],"limitations":["Case report with N=2; no control group","No validated measurement of sexual behavior or distress","No assessment of confounding factors (e.g., co‑occurring psychiatric symptoms)","Causal inference not justified"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/00207458808985786"}},{"id":5806,"doi":"10.1520/jfs12595j","pmid":"3204350","pmcid":null,"title":"Autoerotic asphyxial death following television broadcast","authors":"O'Halloran RL, Lovell FW.","first_author":"O'Halloran RL","journal":"Journal of forensic sciences","year":1988,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single forensic case report of autoerotic asphyxial death temporally linked to a TV broadcast","sample_n":1,"sample_text":"N=1 (case report)","population":"one adult male deceased in forensic setting","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A man died from autoerotic asphyxiation shortly after watching a TV program that discussed the practice. The authors suggest that similar deaths might be linked to such broadcasts and ask for more reporting.","clinical_takeaway":"None – the report is a single forensic case and does not inform clinical practice.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Provides detailed forensic description","Raises hypothesis about media influence"],"limitations":["Single case, no control group","No measurement of relevant confounds"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1520/jfs12595j"}},{"id":5807,"doi":null,"pmid":"14900531","pmcid":null,"title":"[Urogenital system and psychosomatic medicine in children; infantile sexuality; precocious puberty; masturbation; urination disorders; enuresis]","authors":"PACHECO E SILVA AC.","first_author":"PACHECO E SILVA AC.","journal":"Revista brasileira de medicina","year":1951,"pub_types":["Journal Article"],"keywords":["Enuresis","Masturbation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"und","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5808,"doi":"10.1176/ajp.145.9.1179","pmid":"3414868","pmcid":null,"title":"Medroxyprogesterone acetate as a treatment for sexual acting out in organic brain syndrome","authors":"Cooper AJ.","first_author":"Cooper AJ.","journal":"The American journal of psychiatry","year":1988,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ajp.145.9.1179"}},{"id":5809,"doi":"10.1111/j.1365-2788.1988.tb01407.x","pmid":"2971115","pmcid":null,"title":"Parents' perception of social and sexual functions in adolescents with Down's syndrome","authors":"Pueschel SM, Scola PS.","first_author":"Pueschel SM","journal":"Journal of mental deficiency research","year":1988,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of parents of adolescents with Down syndrome; descriptive statistics; no control group","sample_n":null,"sample_text":"not reported in abstract","population":"parents of adolescents with Down syndrome (age not specified)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Parents of teenagers with Down syndrome reported that many show interest in opposite‑sex relationships and social events, but fewer express desire for sexual activity. Masturbation was observed in about 40% of boys and 22% of girls. Few youths received sex education, and many parents favored sterilisation or contraception if reproduction were possible.","clinical_takeaway":"Clinicians should discuss realistic sexual development and appropriate education with families of adolescents with Down syndrome, noting varied interest and limited sex‑education exposure.","confidence":0.7,"topic_tags":["sexual_function","adolescents","gender","masturbation"],"strengths":["Provides rare data on sexual development in Down‑syndrome adolescents","Includes both male and female participants"],"limitations":["No validated measurement instruments reported","Cross‑sectional design, cannot infer causality","Small or unspecified sample size","No control for key confounds (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2788.1988.tb01407.x"}},{"id":5810,"doi":"10.1007/bf01541741","pmid":"3408344","pmcid":null,"title":"Kinsey revisited, Part I: Comparisons of the sexual socialization and sexual behavior of white women over 33 years","authors":"Wyatt GE, Peters SD, Guthrie D.","first_author":"Wyatt GE","journal":"Archives of sexual behavior","year":1988,"pub_types":["Comparative Study","Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":["Population","Behavior","Ethnic Groups","Comparative studies","North America","Contraception","population characteristics","research methodology","Sampling studies","Education","United States","Family Planning","Demographic Factors","Developed Countries","Studies","Surveys","Developing Countries","Americas","Northern America","Cultural Background","Crime","Social Problems","Sex Behavior--changes","Contraceptive Usage--changes","Sexual Partners","Premarital Sex Behavior--changes","Whites--women","Sex Behavior--women","Sex Education--changes","Child Abuse--changes","Extramarital Sex Behavior--changes","Multiple Partners--changes"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative analysis of two historical samples (n=3952 from 1940s Kinsey cohort; n=122 from 1980s Los Angeles study) using log‑linear models to adjust for age, education, marital status.","sample_n":4074,"sample_text":"3952 women from Kinsey study; 122 women from 1980s LA County study","population":"White women, 18‑36 years, United States","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Comparing women surveyed in the 1940s with those in the 1980s shows earlier sexual debut, more partners, broader sexual practices and higher reports of childhood abuse in the later cohort, reflecting social change.","clinical_takeaway":"Sexual norms have shifted substantially; clinicians should consider cohort effects when discussing sexual histories with women of different ages.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large historic sample (Kinsey) provides longitudinal context","Statistical adjustment for key demographic differences","Broad range of sexual‑behavior variables"],"limitations":["Small recent sample limits power for subgroup analyses","No measurement of moral or religious attitudes that could influence self‑report","Convenience sampling (Los Angeles) reduces generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":26,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541741"}},{"id":5812,"doi":"10.1177/106002808802200308","pmid":"3366062","pmcid":null,"title":"Bizarre behavior following the ingestion of levo-desoxyephedrine","authors":"Ferrando RL, McCorvey E, Simon WA, Stewart DM.","first_author":"Ferrando RL","journal":"Drug intelligence & clinical pharmacy","year":1988,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient","sample_n":1,"sample_text":"single case","population":"32‑year‑old heterosexual male","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 32‑year‑old man developed cross‑dressing and sexual excitement after inhaling large amounts of a Vicks inhaler containing levo‑desoxyephedrine, an amphetamine‑like substance. The authors suggest a biochemical cause but evidence is limited to this single case.","clinical_takeaway":"No clinical recommendations; the report only highlights a potential rare side‑effect of inhaler abuse.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["detailed clinical description","identifies novel drug‑induced behavior"],"limitations":["single case, no controls","no standardized measures","speculative mechanistic claims"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/106002808802200308"}},{"id":5813,"doi":null,"pmid":"3351291","pmcid":null,"title":"The vacuum cleaner","authors":"Grisell TL.","first_author":"Grisell TL.","journal":"Indiana medicine : the journal of the Indiana State Medical Association","year":1988,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5815,"doi":null,"pmid":"3370703","pmcid":null,"title":"[Development of orgasmic capacity in sexually inexperienced girls]","authors":"Raboch J, Becvárová D, Pondĕlícková J, Raboch J.","first_author":"Raboch J","journal":"Ceskoslovenska gynekologie","year":1988,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"cze","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5816,"doi":"10.1176/appi.psychotherapy.1950.4.2.303","pmid":"15410902","pmcid":null,"title":"The magical experience of the masturbation fantasy","authors":"NYDES J.","first_author":"NYDES J.","journal":"American journal of psychotherapy","year":1950,"pub_types":["Journal Article"],"keywords":["Sex"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.psychotherapy.1950.4.2.303"}},{"id":5817,"doi":"10.4067/s0370-41061988000100005","pmid":"3222506","pmcid":null,"title":"[Characteristics of psychosocial development in adolescents 16 to 19 years of age with longitudinal follow-up. II. Sex behavior]","authors":"Avendaño A, Valenzuela C, Correa F, Almonte C, Sepúlveda G.","first_author":"Avendaño A","journal":"Revista chilena de pediatria","year":1988,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4067/s0370-41061988000100005"}},{"id":5818,"doi":null,"pmid":"3168820","pmcid":null,"title":"[The sexual development of young people]","authors":"Aalberg V.","first_author":"Aalberg V.","journal":"Duodecim; laaketieteellinen aikakauskirja","year":1988,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fin","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5819,"doi":null,"pmid":"3172663","pmcid":null,"title":"[A case of foreign body in the bladder serving as the nucleus for a calculus]","authors":"Panchev P, Neĭkov K.","first_author":"Panchev P","journal":"Khirurgiia","year":1988,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"bul","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5820,"doi":"10.1001/archpsyc.1988.01800250023004","pmid":"3122695","pmcid":null,"title":"Sex chromosome anomalies, hormones, and sexuality","authors":"Schiavi RC, Theilgaard A, Owen DR, White D.","first_author":"Schiavi RC","journal":"Archives of general psychiatry","year":1988,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"double‑blind controlled investigation comparing XYY, XXY men with population controls; cross‑sectional assessment of sexual behavior and hormones","sample_n":null,"sample_text":"Not specified in abstract; likely modest given rarity of conditions","population":"adult males with sex‑chromosome anomalies (XYY, XXY) identified from a birth cohort in Copenhagen; controls matched on height/age","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study compared sexual behavior, gender role, and hormone levels in men with XYY or XXY chromosome patterns to similar men without those anomalies. Differences were found in several sexual traits, but adult hormone levels did not explain these differences.","clinical_takeaway":"Sex chromosome variations may influence sexual behavior independent of current hormone levels; clinicians should consider genetic factors when evaluating sexual concerns.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Rare population studied with biological measures","Double‑blind controlled design","Hormonal assays add objective data"],"limitations":["Small, possibly under‑powered sample of XYY/XXU men","Sexual behavior measures not described as validated","No control for mental‑health or moral/religious factors"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":27,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archpsyc.1988.01800250023004"}},{"id":5821,"doi":"10.1300/j013v13n03_05","pmid":"3266392","pmcid":null,"title":"Gynecology and sexuality in middle-aged women","authors":"Hagstad A.","first_author":"Hagstad A.","journal":"Women & health","year":1988,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"randomly selected, population‑based questionnaire study of women aged 37‑66 in Gothenburg, Sweden (N not reported in abstract)","sample_n":null,"sample_text":"randomly selected from Census Register; exact N not given in abstract","population":"middle‑aged women (37‑66 y) from Swedish Census Register","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A Swedish survey of women aged 37‑66 described menopause timing, hot‑flush symptoms, urinary leakage, and sexual history, noting few partners, low masturbation, and that most experienced orgasm.","clinical_takeaway":"Middle‑aged women show diverse sexual experiences; clinicians should assess individual sexual health without assuming pathology.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large, randomly selected, population‑based sample","Broad coverage of gynecological and sexual health variables","Clear descriptive statistics on menopause, urinary leakage, and sexual behavior"],"limitations":["No validated psychometric instruments reported for sexual behavior or distress","Potential confounding variables (mental health, relationship status, moral attitudes) not measured","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j013v13n03_05"}},{"id":5823,"doi":"10.1111/j.1439-0272.1988.tb02363.x","pmid":"3369708","pmcid":null,"title":"Changes in seminal parameters of ejaculates after repeated ejaculation","authors":"Zvĕrina J, Pondĕlícková J.","first_author":"Zvĕrina J","journal":"Andrologia","year":1988,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Within‑subject repeated‑measures study of 60‑min interval ejaculations in adult men; semen parameters compared between first and second sample.","sample_n":103,"sample_text":"Approximately 100 men; 32 (31%) showed higher sperm density in second ejaculate.","population":"Adult men (mid‑aged), likely recruited from clinical or volunteer pool; sample size≈100 (32 reported for a subgroup).","country":"Czech Republic (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared semen quality between a first and a second ejaculation taken one hour apart. Volume was lower in the second sample, sperm count was higher in only a minority, and sperm speed was reduced, while motility and morphology stayed the same.","clinical_takeaway":"A single extra ejaculation an hour later yields little clinical benefit for men with low fertility.","confidence":0.8,"topic_tags":["masturbation","sexual_function","religiosity"],"strengths":["Objective, standardized semen analysis","Within‑subject design reduces between‑person variability","Clear reporting of significant differences"],"limitations":["No reporting of effect sizes or confidence intervals","Convenience sample, limited generalisability","No control for potential physiological confounders (e.g., hydration, abstinence length)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1439-0272.1988.tb02363.x"}},{"id":5824,"doi":"10.1080/00224498809551415","pmid":"22375652","pmcid":null,"title":"Nocturnal emission and masturbatory frequency relationships: A 19th-century account","authors":"Burg BR.","first_author":"Burg BR.","journal":"Journal of sex research","year":1988,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224498809551415"}},{"id":5825,"doi":null,"pmid":"3402086","pmcid":null,"title":"Sexual behaviour, a stress factor affecting ovulation and cycle length","authors":"Blum M, Kitai E.","first_author":"Blum M","journal":"Clinical and experimental obstetrics & gynecology","year":1988,"pub_types":["Journal Article"],"keywords":["Amines","Biology","Stress","Hormones","Physiology","Catecholamines","Behavior","Asia","Comparative studies","Amenorrhea","Diseases","Sex behavior","Endocrine system","research methodology","Psychological factors","Life style","Clinical research","Developed Countries","Studies","Marital Status","Ingredients And Chemicals","Menstruation Disorders","Mediterranean Countries","Western Asia","Nuptiality","Organic Chemicals","Coital Frequency","Israel","Pituitary Hormones","Human Volunteers"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative observational study of women with long anovulatory cycles (n≈? ) versus age‑matched controls (n=14). Hormonal and catecholamine measures reported; sexual behavior recorded via self‑report.","sample_n":null,"sample_text":"small, likely <30 per group","population":"young adult women (mean age 21) with irregular cycles; small convenience sample.","country":"unspecified (likely USA or Europe based on journal)","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a small study of young women, those who did not have regular sexual intercourse showed longer, irregular menstrual cycles and higher stress‑related hormones than women with weekly coitus. The authors suggest the lack of a stable heterosexual relationship may temporarily disrupt ovulation.","clinical_takeaway":"Evidence is weak; clinicians should not base treatment decisions on sexual activity patterns alone.","confidence":0.7,"topic_tags":["sexual_function","religiosity","masturbation","relationships"],"strengths":["Physiological hormone measurements","Direct comparison with control group","Consideration of both masturbation and coital activity"],"limitations":["Very small, non‑representative sample","No control for key psychosocial confounds (moral, mental health, trauma)","Cross‑sectional design limits causal inference","Lacks validated measures of sexual behavior or stress"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":5826,"doi":"10.1176/ajp.144.11.1511b","pmid":"3674238","pmcid":null,"title":"Antiandrogen treatment of aberrant sexual activity","authors":"Ross LA, Bland WP, Ruskin P, Bacher N.","first_author":"Ross LA","journal":"The American journal of psychiatry","year":1987,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ajp.144.11.1511b"}},{"id":5829,"doi":"10.1007/bf01541422","pmid":"3689107","pmcid":null,"title":"Correlates of fantasy-induced and film-induced male sexual arousal","authors":"Smith D, Over R.","first_author":"Smith D","journal":"Archives of sexual behavior","year":1987,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subject laboratory study measuring penile circumference and self‑reported arousal while participants used fantasy or watched an erotic film (N=66).","sample_n":66,"sample_text":"66 men","population":"Adult males (no further demographic detail in abstract)","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 66 men, sexual arousal caused by erotic fantasies was physiologically and subjectively different from arousal caused by watching an erotic film, and each was linked to different personal traits such as vividness of mental images.","clinical_takeaway":"Fantasy‑based arousal may rely on imagery ability, whereas film‑based arousal does not; clinicians should consider individual differences in mental imagery when addressing sexual dysfunction.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Physiological and subjective arousal measured simultaneously","Use of validated imagery scale (Betts QMI)","Within‑subject design controls individual differences"],"limitations":["Small sample for physiological study","No reporting of effect sizes or confidence intervals","Limited information on participant characteristics"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":2,"mentioning":37,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541422"}},{"id":5830,"doi":"10.2307/3105184","pmid":"11612372","pmcid":null,"title":"Technology for the prevention of \"Les maladies produites par la masturbation.\"","authors":"Bullough VL.","first_author":"Bullough VL.","journal":"Technology and culture","year":1987,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2307/3105184"}},{"id":5831,"doi":"10.1097/00000433-198708030-00014","pmid":"3673989","pmcid":null,"title":"Rolled up to death. An unusual autoerotic fatality","authors":"Eriksson A, Gezelius C, Bring G.","first_author":"Eriksson A","journal":"The American journal of forensic medicine and pathology","year":1987,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case report of an autoerotic death, no control group","sample_n":1,"sample_text":"One individual","population":"one middle‑aged male who died during an autoerotic act","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe a second documented case where a man died from hypoxia after enclosing himself in plastic during an autoerotic act, highlighting similarities to a previously reported death.","clinical_takeaway":"Clinicians should be aware of the rare risk of fatal autoerotic behaviors when assessing patients with extreme sexual practices.","confidence":0.9,"topic_tags":["masturbation","sexual_function"],"strengths":["Rare clinical forensic description","Adds to knowledge of autoerotic fatalities"],"limitations":["Single case, no generalisability","No systematic measurement of behaviour or mental health"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00000433-198708030-00014"}},{"id":5832,"doi":null,"pmid":"3630220","pmcid":null,"title":"[Partnership relations, sexuality and sexual behavior in elderly females and males after age 55. Partnership relations, sexuality and sexual reactions]","authors":"Weissbach-Rieger A.","first_author":"Weissbach-Rieger A.","journal":"Zeitschrift fur Alternsforschung","year":1987,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of elderly sexual behavior; no methodological details provided; likely convenience sample; no longitudinal or experimental component.","sample_n":null,"sample_text":"Not specified in abstract","population":"Elderly females and males aged 55+; sample size not reported","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reports that older adults can remain sexually active, though sexual responses tend to slow with age. Masturbation is described as a compensatory behavior when partnered sex is limited.","clinical_takeaway":"None – the study offers no actionable clinical guidance.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Addresses sexuality in an under‑studied age group","Includes both genders"],"limitations":["No quantitative data or sample size reported","Vague measurement of sexual behaviors","No control for key confounds (e.g., health, relationship status)"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5833,"doi":"10.1016/0030-4220(49)90390-4","pmid":"18123831","pmcid":null,"title":"Case report of traumatic lesions of the cheeks associated with masturbation","authors":"WINTER GR.","first_author":"WINTER GR.","journal":"Oral surgery, oral medicine, and oral pathology","year":1949,"pub_types":["Journal Article"],"keywords":["Mouth/diseases","Sex/perversion"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0030-4220(49)90390-4"}},{"id":5835,"doi":null,"pmid":"3632228","pmcid":null,"title":"[Simulation of a suicide to hide a homicide in a case of autoerotic accident]","authors":"Madea B, Henssge C, Roth H.","first_author":"Madea B","journal":"Archiv fur Kriminologie","year":1987,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5836,"doi":"10.1080/07448481.1987.9939645","pmid":"3584712","pmcid":null,"title":"Antiandrogenic treatment in a university setting","authors":"Young CR.","first_author":"Young CR.","journal":"Journal of American college health : J of ACH","year":1987,"pub_types":["Journal Article","Case 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CS.","journal":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","year":1987,"pub_types":["Letter","Historical Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5838,"doi":"10.1192/bjp.150.4.518","pmid":"3664133","pmcid":null,"title":"Behavioural treatment of life-threatening masochistic asphyxiation: a case study","authors":"Haydn-Smith P, Marks I, Buchaya H, Repper D.","first_author":"Haydn-Smith P","journal":"The British journal of psychiatry : the journal of mental science","year":1987,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/bjp.150.4.518"}},{"id":5840,"doi":"10.1192/bjp.150.2.189","pmid":"3651672","pmcid":null,"title":"Influence of the day of the week and the weather on people using a telephone support system","authors":"Hribersek E, van de Voorde H, Poppe H, Casselman J.","first_author":"Hribersek E","journal":"The British journal of psychiatry : the journal of mental science","year":1987,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational analysis of telephone counselling calls over 21 months, relating call volume/reason to weather variables.","sample_n":null,"sample_text":"All calls recorded in a single telephone zone over 21 months; exact number of calls not given in abstract.","population":"Callers to a Belgian telephone counselling service (both sexes); no further demographic detail provided.","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examined how the day of the week and weather affected calls to a Belgian telephone counselling service. Calls about health and relationship problems rose with certain weather patterns, while calls indicating a desire to masturbate increased when the weather improved.","clinical_takeaway":"None – the findings describe call patterns and do not provide actionable clinical guidance.","confidence":0.7,"topic_tags":["masturbation","sexual_function","csbd"],"strengths":["Large temporal dataset covering 21 months","Objective weather data linked to call logs"],"limitations":["No validated measures of sexual behavior or distress","Potential confounding factors (e.g., mood, moral attitudes) not assessed","Descriptive analysis without effect sizes or correction for multiple testing"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/bjp.150.2.189"}},{"id":5843,"doi":null,"pmid":"3818380","pmcid":null,"title":"Combined perforation of the rectum and urinary bladder secondary to autoanal stimulation: report of a case","authors":"Tucker MS, Sinaiko P, Gallo L.","first_author":"Tucker MS","journal":"The Journal of the American Osteopathic Association","year":1987,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5845,"doi":null,"pmid":"3112830","pmcid":null,"title":"From the analysis of an obsessive hummer: theoretical and clinical implications","authors":"Juni S.","first_author":"Juni S.","journal":"Psychoanalytic review","year":1987,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5847,"doi":"10.1080/08905498708583265","pmid":"11623462","pmcid":null,"title":"(R)evolutionary scenes: the body politic and the political body in Henry Maudsley's nosology of \"masturbatory insanity.\"","authors":"Cohen E.","first_author":"Cohen E.","journal":"Nineteenth-century contexts","year":1987,"pub_types":["Historical Article","Biography","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/08905498708583265"}},{"id":5848,"doi":null,"pmid":"3442311","pmcid":null,"title":"[Excessive ipsism in women]","authors":"Vasilev D, Rachev E.","first_author":"Vasilev D","journal":"Akusherstvo i ginekologiia","year":1987,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"bul","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5849,"doi":"10.1080/00926238708403889","pmid":"2444712","pmcid":null,"title":"Intracavernosal injection in the treatment of impotence: a prospective study of sexual, psychological, and marital functioning","authors":"Althof SE, Turner LA, Levine SB, Risen C, Kursh ED, Bodner D, Resnick M.","first_author":"Althof SE","journal":"Journal of sex & marital therapy","year":1987,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"prospective single‑group treatment study of intracavernosal injection for erectile dysfunction; outcomes measured pre‑post","sample_n":null,"sample_text":"not specified in abstract; 96% achieved erection, 35% dropout","population":"men with impotence receiving papaverine/phentolamine injections; partners also surveyed","country":"USA (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Men with erectile dysfunction who used self‑injected papaverine/phentolamine reported better erections, more sex, and higher satisfaction, while masturbating less. Their partners also noted more sexual activity and satisfaction, and patients showed reduced psychiatric symptoms and higher self‑esteem.","clinical_takeaway":"Intracavernosal injection can improve sexual and psychosocial outcomes in ED, but results come from an uncontrolled study.","confidence":0.6,"topic_tags":["sexual_function","treatment","relationships"],"strengths":["Prospective assessment of both patient and partner outcomes","Reports a range of sexual and psychosocial variables","Provides side‑effect profile of intracavernosal injections"],"limitations":["No control or comparison group; causality cannot be established","Outcome measures not described as validated instruments","Sample size and power not reported"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238708403889"}},{"id":5850,"doi":"10.1016/0022-3999(87)90104-8","pmid":"3820137","pmcid":null,"title":"Female sexual behavior: fluctuations during the menstrual cycle","authors":"Harvey SM.","first_author":"Harvey SM.","journal":"Journal of psychosomatic research","year":1987,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":51,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective within‑subject study of 69 women tracked over 2‑3 menstrual cycles with daily self‑report of sexual behavior and basal body temperature; analyses by repeated‑measures ANOVA","sample_n":69,"sample_text":"Sixty‑nine normally cycling women monitored ... over two or three consecutive menstrual cycles","population":"normally cycling adult women (self‑selected community sample)","country":"unspecified (likely USA/UK based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 69 women followed across several menstrual cycles, sexual activity—both with a partner and solo—peaked during ovulation, and arousal and pleasure rose from menstruation toward the premenstrual phase, suggesting hormones influence sexual behavior.","clinical_takeaway":"Clinicians can consider menstrual phase when discussing fluctuations in women's sexual desire and pleasure.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Within‑subject design reduces between‑person variability","Daily prospective logging of behavior and temperature","Clear operationalisation of menstrual phases"],"limitations":["Self‑report of sexual activity not validated","Convenience sample limits generalisability","No control for mood, relationship, or moral factors"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":44,"citing_publications":97,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0022-3999(87)90104-8"}},{"id":5852,"doi":"10.1007/bf01542311","pmid":"3800637","pmcid":null,"title":"Sexological theory, H-Y antigen, chromosomes, gonads, and cyclicity: two syndromes compared","authors":"Lewis VG, Money J.","first_author":"Lewis VG","journal":"Archives of sexual behavior","year":1986,"pub_types":["Comparative Study","Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative case‑control study of 9 AIS women vs 9 RS women; self‑report questionnaires on sexual imagination, orientation, satisfaction, masturbation, orgasm, attitudes toward marriage and childcare.","sample_n":18,"sample_text":"Nine AIS women and nine RS women.","population":"Adult women with androgen‑insensitivity syndrome (AIS) or Rokitansky syndrome (RS); recruited from clinical settings (U.S. and non‑U.S. government support).","country":"United States (and possibly other sites, not specified).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A tiny study of 18 women with two different intersex conditions found no systematic differences in sexual fantasies, orientation, satisfaction, masturbation, orgasm, or attitudes toward marriage and child‑care, suggesting that chromosomes or H‑Y antigen alone do not determine gender identity.","clinical_takeaway":"No clinical conclusions; the findings are preliminary and based on a very small sample.","confidence":0.7,"topic_tags":["gender","sexual_function"],"strengths":["Rare comparison of two intersex syndromes","Broad range of sexual‑behavioral dimensions examined","Direct assessment of masturbation separate from other variables"],"limitations":["Very small sample (N=9 per group)","Likely convenience clinical recruitment","No validated scales reported","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542311"}},{"id":5853,"doi":"10.1080/00325481.1986.11699613","pmid":"3774672","pmcid":null,"title":"Sexual excitement is possible side affect of bronchodilator","authors":"Peterson CD.","first_author":"Peterson CD.","journal":"Postgraduate medicine","year":1986,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00325481.1986.11699613"}},{"id":5856,"doi":"10.1007/bf01550365","pmid":"3755586","pmcid":null,"title":"Hazards associated with anal erotic activity","authors":"Agnew J.","first_author":"Agnew J.","journal":"Archives of sexual behavior","year":1986,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/clinical overview without empirical data","sample_n":null,"sample_text":"none – narrative overview","population":"human adults (general)","country":"unspecified (likely USA/UK)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews medical complications that can arise from anal erotic activities, such as using objects, enemas, and anal masturbation, to inform health professionals about potential risks.","clinical_takeaway":"Clinicians should be aware of possible injuries and infections linked to anal erotic practices and discuss safety with patients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides practical clinical information on potential medical hazards","Broad overview of various anal erotic practices"],"limitations":["No empirical data or systematic methodology","No assessment of prevalence or risk factors","Lacks quantitative analysis or statistical support"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01550365"}},{"id":5857,"doi":"10.1016/s0022-5347(17)44891-9","pmid":"3735508","pmcid":null,"title":"Sexual function in adults with myelomeningocele","authors":"Cass AS, Bloom BA, Luxenberg M.","first_author":"Cass AS","journal":"The Journal of urology","year":1986,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":53,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Interview of 47 adults with myelomeningocele (out of 108 eligible). Descriptive frequencies of sexual activity, pregnancy, erection, ejaculation. No comparison group.","sample_n":47,"sample_text":"Of 108 patients 16 or more years old with myelomeningocele 47 were interviewed regarding sexual function.","population":"Adults (≥16 y) with myelomeningocele, recruited from a clinical setting.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a small interview study of 47 adults with myelomeningocele, most reported being sexually active, with many women becoming pregnant and most men having erections and ejaculation. Overall sexual function was described as satisfactory.","clinical_takeaway":"Adults with myelomeningocele can have functional sexual lives and successful pregnancies; clinicians should discuss sexuality openly.","confidence":0.3,"topic_tags":["sexual_function","moral_incongruence","masturbation","adolescents"],"strengths":["Rare focus on sexual function in adults with myelomeningocele","Provides descriptive data on pregnancy outcomes"],"limitations":["Small, non‑representative sample","No validated sexual‑function instruments","No control/comparison group"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":34,"citing_publications":92,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-5347(17)44891-9"}},{"id":5858,"doi":"10.1002/dev.420190409","pmid":"3732627","pmcid":null,"title":"Male chacma baboon (Papio ursinus) sexual arousal: studies with adolescent and adult females as visual stimuli","authors":"Bielert C, Girolami L, Anderson C.","first_author":"Bielert C","journal":"Developmental psychobiology","year":1986,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/dev.420190409"}},{"id":5863,"doi":"10.1080/21674086.1986.11927143","pmid":"3714921","pmcid":null,"title":"A footnote in Freud's work and the Isakower phenomenon","authors":"Waugaman R.","first_author":"Waugaman R.","journal":"The Psychoanalytic quarterly","year":1986,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/21674086.1986.11927143"}},{"id":5864,"doi":"10.1007/bf01572671","pmid":"20284384","pmcid":null,"title":"Masturbation fantasies","authors":"ROHEIM G.","first_author":"ROHEIM G.","journal":"The Psychiatric quarterly","year":1946,"pub_types":["Journal Article"],"keywords":["Sex/perversions"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01572671"}},{"id":5865,"doi":"10.1111/j.1746-1561.1986.tb01177.x","pmid":"3633366","pmcid":null,"title":"The relationship between the sexual attitudes of parents and their college daughters' or sons' sexual attitudes and sexual behavior","authors":"Yarber WL, Greer JM.","first_author":"Yarber WL","journal":"The Journal of school health","year":1986,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 83 college freshmen and both parents using mailed questionnaires; Pearson correlations and regression analyses","sample_n":83,"sample_text":"83 dyads (student + both parents)","population":"Never‑married college freshmen (age ~18‑22) and their parents at a large Midwestern university (USA)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed 83 college freshmen and their parents, finding that mothers' positive sexual attitudes were linked to daughters' higher masturbation frequency and orgasm experiences, but not to more heterosexual activity. Fathers' attitudes showed little connection to children's sexual behavior.","clinical_takeaway":"Parental sexual attitudes may influence offspring's private sexual behaviors, especially for daughters.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Includes both mothers and fathers","Measures masturbation separately","Explores parent‑child attitude linkage"],"limitations":["Small, non‑representative sample","Reliance on non‑validated questionnaires","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1746-1561.1986.tb01177.x"}},{"id":5866,"doi":"10.1300/j082v13n01_04","pmid":"3772084","pmcid":null,"title":"Sensitive drawings of sexual activity in human sexuality textbooks: an analysis on communication and bias","authors":"Pollis CA.","first_author":"Pollis CA.","journal":"Journal of homosexuality","year":1986,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"no empirical data; essay‑type analysis of textbook illustrations","sample_n":null,"sample_text":"N/A","population":"N/A","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper examines how drawings in sexuality textbooks depict gender, age, ethnicity, and sexual identity, finding strong class and heterosexual biases that mirror broader societal stereotypes.","clinical_takeaway":"None – the article does not provide direct clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides a historical perspective on visual representations in sexuality education","Highlights class and heteronormative bias in textbook imagery"],"limitations":["No primary data; relies on author interpretation","Lacks systematic methodology or quantitative analysis","Findings not generalizable beyond the selected textbooks"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v13n01_04"}},{"id":5867,"doi":"10.1080/00926238608415406","pmid":"3761372","pmcid":null,"title":"Psychological subtypes of anorgasmia: a marker variable approach","authors":"Derogatis LR, Fagan PJ, Schmidt CW, Wise TN, Gilden KS.","first_author":"Derogatis LR","journal":"Journal of sex & marital therapy","year":1986,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control comparison of 76 women with anorgasmia and matched functional controls; matched on age, race, marital status, social class","sample_n":76,"sample_text":"N=76 women (case) with matched controls (approximately equal numbers)","population":"women presenting with anorgasmia (clinical sample) and community controls","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared 76 women with anorgasmia to matched controls, finding two distinct psychological subtypes based on the presence of homosexual fantasies. Differences in sexual function measures suggest heterogeneity within anorgasmic women.","clinical_takeaway":"Anorgasmia may involve different psychological profiles; clinicians should assess for underlying fantasy patterns.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of validated DSFI instrument","Matched control group on key demographics","Clear subgroup analysis using marker variable"],"limitations":["Small sample, likely underpowered for subgroup comparisons","Clinical, self‑selected sample limits generalisability","Limited control of important confounds (mental health, partner factors, trauma)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238608415406"}},{"id":5869,"doi":"10.1016/s0015-0282(16)49106-5","pmid":"3943641","pmcid":null,"title":"Sperm quality of healthy smokers, ex-smokers, and never-smokers","authors":"Vogt HJ, Heller WD, Borelli S.","first_author":"Vogt HJ","journal":"Fertility and sterility","year":1986,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":62,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Blind comparative study of 333 healthy male volunteers classified as smokers, ex‑smokers, or never‑smokers; sperm parameters measured objectively.","sample_n":333,"sample_text":"150 smokers, 37 ex‑smokers, 52 never‑smokers evaluated.","population":"Adult men aged 19‑40, recruited from general population; health screening applied.","country":"USA (presumed from journal affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 333 healthy men, smoking was not linked to significant changes in sperm count, movement, or shape; any small reduction in sperm number among heavy smokers was not statistically clear.","clinical_takeaway":"Smoking does not appear to markedly impair sperm quality, but heavy use may still warrant monitoring.","confidence":0.8,"topic_tags":["csbd","masturbation","sexual_function"],"strengths":["Objective laboratory measurements of sperm quality","Reasonable sample size for a physiological study","Blinded assessment reduces measurement bias"],"limitations":["Cross‑sectional design cannot infer causality","Limited assessment of potential confounders (e.g., alcohol, diet)","No effect‑size reporting or power calculation"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":53,"citing_publications":100,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0015-0282(16)49106-5"}},{"id":5870,"doi":"10.1080/00797308.1986.11823457","pmid":"3823270","pmcid":null,"title":"Trauma in childhood. Signs and sequelae as seen in the analysis of an adolescent","authors":"Kennedy H.","first_author":"Kennedy H.","journal":"The Psychoanalytic study of the child","year":1986,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00797308.1986.11823457"}},{"id":5872,"doi":"10.1080/00926238608415400","pmid":"2873253","pmcid":null,"title":"Perspectives of sex therapy outcome: a survey of AASECT providers","authors":"Kilmann PR, Boland JP, Norton SP, Davidson E, Caid C.","first_author":"Kilmann PR","journal":"Journal of sex & marital therapy","year":1986,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of AASECT members (N=289) about caseloads and perceived success rates; random selection of members but response‑bias possible; no client‑level data.","sample_n":289,"sample_text":"Randomly selected AASECT members who conduct sex therapy (N = 289) responded to a questionnaire.","population":"Sex therapists (AASECT members) in the United States, 1986","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1986 survey of 289 U.S. sex‑therapy professionals found that desire differences were the most common problem they treated, while erectile dysfunction was least common. Success rates varied by issue, with premature ejaculation rated most successful. Therapists differed in the techniques they used and how successful they felt they were.","clinical_takeaway":"Therapists report varied success across sexual problems; techniques like communication skills and sensate focus are widely used, but outcomes rely on therapist self‑report rather than client data.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large professional sample for 1986","Provides comparative data across therapist sub‑groups","Uses discriminant function analysis to explore patterns"],"limitations":["Self‑report by therapists; no client outcomes measured","Questionnaire not validated; possible response bias","Cross‑sectional, no causal inference possible"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238608415400"}},{"id":5873,"doi":null,"pmid":"3964204","pmcid":null,"title":"[Sexuality in social change. An empirical comparative study of students 1966 and 1981]","authors":"Clement U.","first_author":"Clement U.","journal":"Beitrage zur Sexualforschung","year":1986,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5876,"doi":null,"pmid":"3952909","pmcid":null,"title":"[Vaginal foreign bodies as the cause of urogenital fistulas in girls]","authors":"Pesin AL.","first_author":"Pesin AL.","journal":"Urologiia i nefrologiia","year":1986,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"rus","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5878,"doi":null,"pmid":"4091627","pmcid":null,"title":"[Perforation of the vaginal and rectal areas--self-inflicted or caused by another hand?]","authors":"Missliwetz J, Denk W.","first_author":"Missliwetz J","journal":"Archiv fur Kriminologie","year":1985,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5879,"doi":"10.1080/01952307.1985.11719616","pmid":"3910762","pmcid":null,"title":"Sexuality and fertility among spinal cord and/or cauda equina injuries","authors":"Comarr AE.","first_author":"Comarr AE.","journal":"The Journal of the American Paraplegia Society","year":1985,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/01952307.1985.11719616"}},{"id":5880,"doi":"10.1007/bf01542004","pmid":"4062540","pmcid":null,"title":"Orgasm in women in the laboratory--quantitative studies on duration, intensity, latency, and vaginal blood flow","authors":"Levin RJ, Wagner G.","first_author":"Levin RJ","journal":"Archives of sexual behavior","year":1985,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory within‑subject study of 28 healthy young women; self‑stimulated clitoral arousal to induce orgasm; physiological (vaginal blood flow) and self‑report measures.","sample_n":28,"sample_text":"healthy, young adult women volunteers (n = 28)","population":"young adult women volunteers (N≈28)","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a lab with 28 women who stimulated themselves, researchers timed orgasms and measured vaginal blood flow. Women underestimated how long orgasms lasted, and the physiological measures did not match how intense they said the orgasms felt.","clinical_takeaway":"Self‑reports of orgasm length may be unreliable; clinicians should consider objective measures when assessing sexual function.","confidence":0.78,"topic_tags":["sexual_function","masturbation","neuroscience"],"strengths":["objective physiological measure of blood flow","within‑subject design allows direct comparison of self‑report vs. measurement","focus on a rarely quantified phenomenon (orgasm duration)"],"limitations":["very small sample limits statistical power","subjective intensity scale not validated","no control for menstrual cycle, hormonal status, or psychological variables"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":28,"citing_publications":74,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542004"}},{"id":5881,"doi":"10.1080/21674086.1985.11927120","pmid":"3840904","pmcid":null,"title":"Beating fantasies in a latency girl: their role in female sexual development","authors":"Friedman LH.","first_author":"Friedman LH.","journal":"The Psychoanalytic quarterly","year":1985,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single clinical case analysis, no systematic methodology","sample_n":1,"sample_text":"single case","population":"one latency‑stage girl, psychoanalytic setting","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"A detailed psychoanalytic case study of a pre‑pubertal girl describes how her vivid \"beating\" fantasies may reflect Freud's ideas about the onset of the Oedipus complex in girls, noting early vaginal sensations.","clinical_takeaway":"No direct clinical guidance; the case illustrates a theoretical psychoanalytic perspective on early sexual fantasy.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["rich clinical description","historical psychoanalytic insight"],"limitations":["single case, no generalisability","unvalidated psychoanalytic constructs","no systematic measurement or statistical analysis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/21674086.1985.11927120"}},{"id":5882,"doi":"10.1007/bf01131507","pmid":"4056564","pmcid":null,"title":"An unusual cause of failure of in vitro fertilization: report of a case","authors":"Barriere P, Lopes P, Boiffard JP, L'Hermite A, Lerat MF.","first_author":"Barriere P","journal":"Journal of in vitro fertilization and embryo transfer : IVF","year":1985,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01131507"}},{"id":5883,"doi":"10.1016/0090-4295(85)90143-8","pmid":"4035857","pmcid":null,"title":"Vacuum cleaner injury to penis","authors":"Lewi H, Drury JK, Monsour M.","first_author":"Lewi H","journal":"Urology","year":1985,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0090-4295(85)90143-8"}},{"id":5884,"doi":"10.1007/bf02089238","pmid":"24301225","pmcid":null,"title":"Idiopathic precocious puberty in girls: Psychosexual development","authors":"Meyer-Bahlburg HF, Ehrhardt AA, Bell JJ, Cohen SF, Healey JM, Feldman JF, Morishima A, Baker SW, New MI.","first_author":"Meyer-Bahlburg HF","journal":"Journal of youth and adolescence","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"controlled comparative study, N=32 (16 IPP, 16 matched controls), half‑structured interview","sample_n":32,"sample_text":"16 IPP females, 16 matched controls","population":"girls and young women 13–20 y with idiopathic precocious puberty vs normal‑puberty peers","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Girls who mature early (idiopathic precocious puberty) tend to reach sexual milestones, like masturbation, sooner than peers, but this early timing only modestly influences overall sexual development.","clinical_takeaway":"Early puberty may accelerate some sexual behaviors, but does not markedly increase risk of atypical sexual orientation or dysfunction.","confidence":0.8,"topic_tags":["sexual_function","masturbation","adolescents","moral_incongruence"],"strengths":["Matched control group","Systematic interview protocol","Focus on early puberty, a less‑studied factor"],"limitations":["Small sample size, likely underpowered","No validated psychometric instruments","Key psychosocial confounds (moral, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":7,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02089238"}},{"id":5885,"doi":null,"pmid":"3831892","pmcid":null,"title":"[A foreign body of an unusual size in the vagina of a 13-year-old girl]","authors":"Kmita MB.","first_author":"Kmita MB.","journal":"Pediatria polska","year":1985,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5886,"doi":"10.1016/0090-4295(85)90245-6","pmid":"4012970","pmcid":null,"title":"Self-inflicted foreign bodies involving lower urinary tract and male genitals","authors":"Aliabadi H, Cass AS, Gleich P, Johnson CF.","first_author":"Aliabadi H","journal":"Urology","year":1985,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":52,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case series of 16 patients with self‑inflicted foreign bodies in the lower urinary tract and male genitalia; descriptive medical report without control group.","sample_n":16,"sample_text":"16 patients (both sexes) treated at a urology department.","population":"Patients presenting with autoerotic or other self‑inflicted foreign bodies; age range not specified beyond MeSH terms.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reports 16 cases where people inserted objects into their urethra or genital area for various reasons, describing how doctors identified and removed the objects using endoscopy or surgery.","clinical_takeaway":"Clinicians should consider autoerotic injury in patients presenting with urinary symptoms and use endoscopy when feasible.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Detailed clinical description of rare presentations","Clear procedural outcomes for endoscopic vs surgical removal"],"limitations":["Very small, non‑representative case series","No systematic assessment of psychological or sexual‑behavioral factors","No statistical analysis beyond case description"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":71,"citing_publications":92,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0090-4295(85)90245-6"}},{"id":5888,"doi":null,"pmid":"3843484","pmcid":null,"title":"Normal childhood and early adolescent sexuality. A psychologist's perspective","authors":"Moore RE.","first_author":"Moore RE.","journal":"Seminars in adolescent medicine","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5889,"doi":"10.1007/bf01542109","pmid":"4004549","pmcid":null,"title":"Transsexual surgery at 74: a case report","authors":"Docter RF.","first_author":"Docter RF.","journal":"Archives of sexual behavior","year":1985,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of a single elderly transsexual patient; no control group, descriptive only.","sample_n":1,"sample_text":"Single case (N=1).","population":"One 74‑year‑old male, formerly heterosexual, married 37 years.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 74‑year‑old man who had been married for decades began identifying as transsexual after his wife's death. The report describes his lifelong fantasies, limited masturbation, and social factors that may have influenced his decision for surgery.","clinical_takeaway":"Clinicians should recognize that gender identity changes can occur late in life and consider the individual's relational and social context.","confidence":0.8,"topic_tags":["gender","sexual_function","lgbtq"],"strengths":["Detailed narrative of an unusual late‑onset transsexual case","Considers social and relational context"],"limitations":["Single case; no generalisability","No systematic measurement or validated instruments","No control or comparison group"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542109"}},{"id":5890,"doi":"10.1007/bf01531607","pmid":"3997748","pmcid":null,"title":"Sex education and sexual awareness building for autistic children and youth: some viewpoints and considerations","authors":null,"first_author":null,"journal":"Journal of autism and developmental disorders","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01531607"}},{"id":5891,"doi":null,"pmid":"3843481","pmcid":null,"title":"Religion and adolescent sexuality","authors":"Stayton WR.","first_author":"Stayton WR.","journal":"Seminars in adolescent medicine","year":1985,"pub_types":["Journal Article"],"keywords":["Population","Population dynamics","Reproduction","Behavior","Menarche","Youth","Contraception","Sex behavior","Age factors","population characteristics","Menstruation","Education","Family Planning","Adolescents","Demographic Factors","Sex Education","Time Factors","Economic Factors","Religion","Decision Making","Physician-patient Relations","Marriage","Marriage Age","Nuptiality","Family Planning, Behavioral Methods","Marriage Patterns","Needs","Interpersonal Relations","Sexual Abstinence","Premarital Sex Behavior","Contraceptive Availability","Marriage Postponement"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Journal commentary providing recommendations for sexuality education in religious settings; no empirical data reported.","sample_n":null,"sample_text":"Not applicable – no participants studied","population":"adolescents (unspecified)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that health professionals and religious groups can work together to teach adolescents about sexuality within a moral framework, promoting healthy attitudes and relationships.","clinical_takeaway":"None – the piece offers educational suggestions, not evidence for clinical practice.","confidence":0.8,"topic_tags":["religiosity","adolescents","sexual_function"],"strengths":["Highlights potential role of religious institutions in sex education","Integrates moral and health perspectives"],"limitations":["No empirical data or systematic review","Lacks methodological detail","Potential bias toward religious values"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5892,"doi":null,"pmid":"20984271","pmcid":null,"title":"A contribution to the study of the masturbation phantasy","authors":"EIDELBERG L.","first_author":"EIDELBERG L.","journal":"The International journal of psycho-analysis","year":1945,"pub_types":["Journal Article"],"keywords":["Sex/perversion"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5893,"doi":"10.1016/0005-7916(85)90028-x","pmid":"3998172","pmcid":null,"title":"Sexual fantasy alternation: procedural considerations","authors":"Laws DR.","first_author":"Laws DR.","journal":"Journal of behavior therapy and experimental psychiatry","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"The article is a methodological commentary evaluating prior clinical trials of a sexual fantasy alternation procedure; it does not present new empirical data.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews earlier clinical trials of a technique that changes sexual fantasies to modify orgasm responses, pointing out methodological flaws and suggesting ways clinicians can improve the procedure.","clinical_takeaway":"None – the article does not provide new evidence for practice.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Thoughtful critique of prior trials","Highlights methodological considerations"],"limitations":["No original data presented","Lacks empirical verification of claims"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0005-7916(85)90028-x"}},{"id":5894,"doi":"10.1176/ajp.142.3.339","pmid":"3970272","pmcid":null,"title":"Gender identity in childhood and later sexual orientation: follow-up of 78 males","authors":"Green R.","first_author":"Green R.","journal":"The American journal of psychiatry","year":1985,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort follow‑up of two groups (clinical GID boys vs demographically matched volunteers); N≈78 re‑evaluated for sexual orientation.","sample_n":78,"sample_text":"78 males (66 clinically referred, 56 matched volunteers; two‑thirds followed up)","population":"males assessed in childhood and reassessed in adolescence/young adulthood","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 1985 US study followed 78 boys—66 diagnosed with childhood gender identity disorder and 34 matched peers—into adolescence. Two‑thirds of the gender‑variant group later reported bisexual or homosexual orientation, while none of the comparison group did.","clinical_takeaway":"Childhood gender variance was associated with later non‑heterosexual orientation, but findings are based on a small, selective sample and lack robust controls.","confidence":0.6,"topic_tags":["gender","sexual_function","csbd"],"strengths":["prospective design","clinical group with clear diagnosis","demographically matched comparison"],"limitations":["small follow‑up sample","no validated scales reported","lack of control for key confounds (moral, mental health, partner effects)","potential selection bias"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":81,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ajp.142.3.339"}},{"id":5895,"doi":"10.1007/bf01541350","pmid":"2983641","pmcid":null,"title":"Effects of estrogen treatment on sexual behavior in male-to-female transsexuals: experimental and clinical observations","authors":"Kwan M, VanMaasdam J, Davidson JM.","first_author":"Kwan M","journal":"Archives of sexual behavior","year":1985,"pub_types":["Controlled Clinical Trial","Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Controlled double‑blind crossover trial with placebo, N=7 male‑to‑female transsexuals, measured physiological and self‑report sexual outcomes.","sample_n":7,"sample_text":"seven presurgical male‑to‑female transsexuals","population":"Presurgical male‑to‑female transsexual adults (N=7)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In seven male‑to‑female transsexuals, oral estrogen reduced spontaneous erections, nocturnal erections, and masturbation, but did not change physiological responses to erotic films or fantasies. The effect appears linked to lower free testosterone.","clinical_takeaway":"Estrogen therapy may suppress erection frequency in MtF patients, likely via reduced free testosterone.","confidence":0.6,"topic_tags":["sexual_function","gender"],"strengths":["double‑blind placebo crossover design","objective physiological measures (NPT, lab‑stimulated erection)","multiple assessment time points"],"limitations":["very small sample (N=7) limits power and generalisability","no formal power calculation or effect‑size reporting","sample limited to presurgical transsexuals; not representative of broader population"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541350"}},{"id":5896,"doi":null,"pmid":"4031393","pmcid":null,"title":"Sexuality in aging: a study of a group of 300 elderly men and women","authors":"Todarello O, Boscia FM.","first_author":"Todarello O","journal":"Journal of endocrinological investigation","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5897,"doi":"10.1300/j082v12n01_04","pmid":"3841667","pmcid":null,"title":"Some anatomical and physiological aspects of anal sexual practices","authors":"Agnew J.","first_author":"Agnew J.","journal":"Journal of homosexuality","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review without empirical data; no systematic methods reported.","sample_n":null,"sample_text":"Not applicable – review article.","population":"general adult humans (no specific sample)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews human anatomy and physiology related to anal sexual activities, offering clinicians an overview of how these practices can be pleasurable and describing relevant bodily structures.","clinical_takeaway":"Clinicians can use this overview to better understand and discuss anal sexual practices with patients, but it does not provide evidence‑based guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad anatomical overview","Provides clinical background for practitioners","Cites relevant literature"],"limitations":["No empirical data presented","Lacks systematic review methodology","No assessment of methodological quality of cited studies"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":1,"mentioning":19,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v12n01_04"}},{"id":5898,"doi":null,"pmid":"4003688","pmcid":null,"title":"The analysis of an adolescent boy","authors":"Galatzer-Levy RM.","first_author":"Galatzer-Levy RM.","journal":"Adolescent psychiatry","year":1985,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5899,"doi":null,"pmid":"4038388","pmcid":null,"title":"Serum androgenic hormones motivate sexual behavior in adolescent boys","authors":"Udry JR, Billy JO, Morris NM, Groff TR, Raj MH.","first_author":"Udry JR","journal":"Fertility and sterility","year":1985,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey with hormone assays on 102 adolescent boys","sample_n":102,"sample_text":"representative sample of 102 boys in grades 8‑10","population":"Adolescent males (grades 8‑10) from a public school system, N=102","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 102 teenage boys, higher levels of free testosterone were linked to greater sexual desire and activity, independent of age or puberty stage.","clinical_takeaway":"Hormone levels may influence teen sexual motivation, but findings do not guide clinical practice.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Objective hormonal measurement","Representative school‑based sample","Attempts to isolate biological from social influences"],"limitations":["Self‑report sexual behavior not validated","Cross‑sectional; no causal inference","Limited control of key psychosocial confounds"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":5900,"doi":null,"pmid":"3936520","pmcid":null,"title":"Sexuality and aging","authors":"Starr BD.","first_author":"Starr BD.","journal":"Annual review of gerontology & geriatrics","year":1985,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5901,"doi":"10.1177/000306518503300105","pmid":"4020024","pmcid":null,"title":"The development of the drive object concept in Freud's work: 1905-1915","authors":"Compton A.","first_author":"Compton A.","journal":"Journal of the American Psychoanalytic Association","year":1985,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"case reports / theoretical analysis","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews how Freud’s ideas about ‘drive objects’ – the objects of sexual and other instinctual drives – changed between 1905 and 1915, outlining shifts in his thinking about object‑directedness, object choice and the role of fantasies in childhood.","clinical_takeaway":"None – the article is a historical discussion, not a clinical study.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Comprehensive historical analysis of Freud’s writings","Clear articulation of conceptual evolution"],"limitations":["No empirical data or measurement of constructs","Lacks relevance to contemporary pornography or sexual health research"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000306518503300105"}},{"id":5902,"doi":"10.1300/j082v11n01_10","pmid":"4056384","pmcid":null,"title":"Sexuality and relationship changes in married females following the commencement of bisexual activity","authors":"Dixon JK.","first_author":"Dixon JK.","journal":"Journal of homosexuality","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"in‑depth personal interviews with 50 married women (age > 30) who began bisexual activity while engaged in consensual swinging; convenience sample","sample_n":50,"sample_text":"50 women recruited via self‑selection from swinging communities","population":"married women, age 30+, heterosexual‑swinging, new bisexual activity","country":"UK (presumed from journal, not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 50 married women who began having sex with other women after age 30 showed they enjoyed the new activities, reported stable or improved marriages, and said their sexual fantasies changed, while still preferring men overall.","clinical_takeaway":"None – the study describes personal experiences of a specific, self‑selected group and does not offer clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Rich qualitative data","Focus on a rarely studied demographic","Direct quotes illustrate lived experience"],"limitations":["Highly selective sample (married, swinging, already sexually active)","No validated measures; constructs loosely defined","No control for moral, mental‑health or trauma variables","Findings not generalisable to broader population"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v11n01_10"}},{"id":5903,"doi":null,"pmid":"4003674","pmcid":null,"title":"A developmental approach to the psychotherapy of adolescents","authors":"Esman AH.","first_author":"Esman AH.","journal":"Adolescent psychiatry","year":1985,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5904,"doi":"10.1016/s0197-0070(85)80103-0","pmid":"3965418","pmcid":null,"title":"Spermarche--the age of onset of sperm emission","authors":"Hirsch M, Lunenfeld B, Modan M, Ovadia J, Shemesh J.","first_author":"Hirsch M","journal":"Journal of adolescent health care : official publication of the Society for Adolescent Medicine","year":1985,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Growth","Population","Biology","Genitalia","Spermatogenesis","Urogenital system","Physiology","Reproduction","Sperm maturation","Asia","Youth","Prospective studies","Age factors","population characteristics","research methodology","Child Development","Sampling studies","Adolescents","Demographic Factors","Developed Countries","Studies","Developing Countries","Research Report","Mediterranean Countries","Western Asia","Genitalia, Male","Adolescents, Male","Israel"],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Prospective cohort of 155 schoolboys examined at ages 12 and 13 for spermaturia via first‑void urine; repeated sampling over 10 days; life‑table analysis.","sample_n":155,"sample_text":"155 boys examined twice; >90% provided ≥2 urine samples, 50% provided 5‑10 samples.","population":"normal schoolboys, age 12‑13, community sample","country":"Israel (likely, based on authors’ affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured the age at which boys first produce sperm by testing first‑morning urine. About 38% showed sperm at age 12 and 69% at age 13, indicating spermarche occurs between these ages, though urine tests missed many cases.","clinical_takeaway":"Spermarche typically begins around age 12‑13; clinicians should consider normal variability when discussing puberty with adolescents.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large community sample for adolescent health study","Repeated urine sampling improves detection","Use of life‑table method to handle variable sampling","Links spermarche to secondary sex characteristic development"],"limitations":["High false‑negative rate in urine testing","No gold‑standard validation of spermaturia as spermarche marker","No control for potential confounders (e.g., health, nutrition)","Only two assessment ages limit precise timing"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":28,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0197-0070(85)80103-0"}},{"id":5905,"doi":null,"pmid":"6569520","pmcid":null,"title":"Coping with sexuality. Two. 'In a private place'","authors":"Birchall J.","first_author":"Birchall J.","journal":"Nursing times","year":1984,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5906,"doi":null,"pmid":"6569519","pmcid":null,"title":"Coping with sexuality. One. Unspoken anxieties","authors":"Davies M.","first_author":"Davies M.","journal":"Nursing times","year":1984,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5907,"doi":"10.1038/sc.1984.56","pmid":"6335235","pmcid":null,"title":"The fertility of men with spinal injuries","authors":"Brindley GS.","first_author":"Brindley GS.","journal":"Paraplegia","year":1984,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":76,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Case series of 81 men with spinal cord injury; vibrator used to induce ejaculation; no control group.","sample_n":81,"sample_text":"81 men with spinal cord injuries","population":"Men with spinal cord injuries, mostly complete, >6 months duration (n=81).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In men with spinal cord injuries, a low‑frequency vibrator induced ejaculation in about 60% of cases, especially when reflexes were present, and led to several pregnancies.","clinical_takeaway":"Vibratory stimulation can be an effective method to obtain semen for fertility purposes in many men with spinal injuries.","confidence":0.8,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Objective physiological outcome (ejaculation)","Clear inclusion criteria (SCI duration)","Relevant clinical population"],"limitations":["No control or comparison group","Descriptive statistics only, no effect sizes","Limited assessment of long‑term fertility outcomes"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":62,"citing_publications":141,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/sc.1984.56"}},{"id":5909,"doi":"10.1097/00003081-198409000-00017","pmid":"6488612","pmcid":null,"title":"Physiology of female sexual function","authors":"Weisberg M.","first_author":"Weisberg M.","journal":"Clinical obstetrics and gynecology","year":1984,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00003081-198409000-00017"}},{"id":5910,"doi":"10.1016/0005-7916(84)90007-7","pmid":"6480869","pmcid":null,"title":"Ejaculatory incompetence: a theoretical formulation and case illustration","authors":"Libman E, Brender W, Burstein R, Hodgins S.","first_author":"Libman E","journal":"Journal of behavior therapy and experimental psychiatry","year":1984,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report presenting theoretical formulations and a single clinical illustration of ejaculatory incompetence.","sample_n":null,"sample_text":"Single case illustration; no sample size reported.","population":"Adult men and women with ejaculatory dysfunction (single case described).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews three psychological theories for why some people have trouble ejaculating and illustrates one with a clinical case, offering ideas for therapy.","clinical_takeaway":"No direct clinical guidance; the article offers theoretical perspectives only.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear theoretical discussion of three models","Links theory to therapeutic implications"],"limitations":["Single case illustration limits generalizability","No empirical measurement or validated instruments","No control of potential confounds"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0005-7916(84)90007-7"}},{"id":5911,"doi":null,"pmid":"6506715","pmcid":null,"title":"[Peculiar case of a foreign body in the digestive tract]","authors":"Stoiński M.","first_author":"Stoiński M.","journal":"Wiadomosci lekarskie (Warsaw, Poland : 1960)","year":1984,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5912,"doi":null,"pmid":"6566461","pmcid":null,"title":"[Do sexual perversions exist?]","authors":"Tordjman G.","first_author":"Tordjman G.","journal":"Soins. Psychiatrie","year":1984,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5913,"doi":null,"pmid":"21965976","pmcid":"PMC3012223","title":"Treatment of single impotent males","authors":"Kuruvilla K.","first_author":"Kuruvilla K.","journal":"Indian journal of psychiatry","year":1984,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3012223","cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single-group treatment case series without control; sample size not reported","sample_n":null,"sample_text":"Not reported in abstract","population":"single males with psychogenic impotence (treatment seekers)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 1984 case series reports a behavioral program (sex education, guided imagery, and masturbatory conditioning) for single men with psychogenic impotence, noting encouraging immediate and long‑term results, but provides no control group or validated outcome measures.","clinical_takeaway":"Evidence is insufficient to endorse this treatment; robust trials are needed before clinical use.","confidence":0.6,"topic_tags":["sexual_function","treatment","masturbation"],"strengths":["Describes a novel behavioral treatment approach","Includes long‑term follow‑up for completers"],"limitations":["No control or comparison group","Sample size and demographics not reported","Outcomes not measured with validated instruments"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5914,"doi":"10.1007/bf01542146","pmid":"6732467","pmcid":null,"title":"Sexual behavior of unmarried Colombian University students: a five-year follow-up","authors":"Alzate H.","first_author":"Alzate H.","journal":"Archives of sexual behavior","year":1984,"pub_types":["Journal Article"],"keywords":["Behavior","Students","Sex behavior","Universities","Sex factors","Education","Colombia","Developing Countries","Americas","Schools","Latin America","South America","Premarital Sex Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"5‑year follow‑up survey of unmarried university students in Colombia; likely convenience sample, descriptive longitudinal cohort.","sample_n":null,"sample_text":"Not specified in abstract","population":"unmarried Colombian university students (both sexes)","country":"Colombia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A five‑year survey of Colombian university students shows most men (94%) and many women (38%) have had sex, with prostitution still common for men but declining, and an increase in premarital sex among women.","clinical_takeaway":"None – the study describes general sexual behavior trends, not clinical issues.","confidence":0.7,"topic_tags":["sexual_function","relationships","csbd","pornography","masturbation","moral_incongruence"],"strengths":["Longitudinal design over five years","Addresses gender double‑standard in a developing‑country context"],"limitations":["No validated measurement instruments reported","Unclear sample size and representativeness","No control for potential confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542146"}},{"id":5915,"doi":null,"pmid":"6726172","pmcid":null,"title":"An unusual autoerotic death: asphyxia with an abdominal ligature","authors":"Thibault R, Spencer JD, Bishop JW, Hibler NS.","first_author":"Thibault R","journal":"Journal of forensic sciences","year":1984,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single autoerotic death involving abdominal ligature; descriptive forensic analysis","sample_n":1,"sample_text":"case report; N=1","population":"single adult male victim","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article describes a rare accidental death where a man died during an autoerotic act that involved tying a high abdominal ligature, presenting forensic findings and psychological considerations.","clinical_takeaway":"None – the report is a forensic case and does not provide clinical guidance.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Detailed forensic description","Highlights rare autoerotic behavior"],"limitations":["Single case, no generalizability","No systematic measurement of constructs","No control of confounding variables"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":5916,"doi":null,"pmid":"6538378","pmcid":null,"title":"Sexual activity and the postcoronary patient","authors":"Walbroehl GS.","first_author":"Walbroehl GS.","journal":"American family physician","year":1984,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational survey of post‑myocardial infarction patients reporting whether they resumed intercourse; no longitudinal follow‑up, no control group.","sample_n":null,"sample_text":"Not provided in abstract","population":"Patients after coronary event; likely convenience sample from clinical setting; sample size not reported in abstract.","country":"United States (American Family Physician)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"After a heart attack, many patients do not return to sexual activity, especially if they lacked a strong sexual relationship beforehand. Physicians often overlook discussing this issue during rehabilitation.","clinical_takeaway":"Clinicians should proactively discuss sexual health with post‑MI patients, as prior relationship quality predicts resumption of activity.","confidence":0.7,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Addresses an important clinical concern for post‑MI patients","Highlights the role of prior sexual relationship quality"],"limitations":["No details on sample size or recruitment method","Reliance on simple self‑report without validated sexual function scales","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":5917,"doi":"10.1001/jama.1984.03340320016008","pmid":"6694304","pmcid":null,"title":"Onan's act","authors":"Waldman GD.","first_author":"Waldman GD.","journal":"JAMA","year":1984,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/jama.1984.03340320016008"}},{"id":5919,"doi":null,"pmid":"11635135","pmcid":null,"title":"[Not Available]","authors":"Guerrand RH.","first_author":"Guerrand RH.","journal":"Histoire (Paris, France)","year":1984,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5921,"doi":null,"pmid":"21965960","pmcid":"PMC3012257","title":"Dhat syndrome: the phenomenology of a culture bound sex neurosis of the orient","authors":"Behere PB, Natraj GS.","first_author":"Behere PB","journal":"Indian journal of psychiatry","year":1984,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3012257","cited_by_count":30,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Descriptive case series of Dhat syndrome patients; no control group, likely convenience sample, small N.","sample_n":null,"sample_text":"Not reported in abstract; likely small.","population":"Young Indian males (16‑23) presenting with Dhat syndrome symptoms; low/average socioeconomic status.","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes Dhat syndrome, a culture‑bound condition in young Indian men who report anxiety and other symptoms after noticing whitish urine discharge, which they believe is lost semen. Masturbation is commonly cited as a cause.","clinical_takeaway":"Clinicians should consider cultural beliefs about semen loss when assessing anxiety and sexual complaints in young men from South‑Asian backgrounds.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Highlights cultural context of sexual concerns","Identifies common symptom cluster"],"limitations":["No validated measurement instruments","No control or comparative group","Small/unspecified sample size","Confounding factors not assessed"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":5923,"doi":"10.1097/00000433-198312000-00011","pmid":"6666760","pmcid":null,"title":"Accidental hanging in autoeroticism. An unusual case occurring outdoors","authors":"Emson HE.","first_author":"Emson HE.","journal":"The American journal of forensic medicine and pathology","year":1983,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00000433-198312000-00011"}},{"id":5925,"doi":null,"pmid":"6651540","pmcid":null,"title":"Avarice, ennui and onanism","authors":"McGrath WB.","first_author":"McGrath WB.","journal":"Arizona medicine","year":1983,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5926,"doi":"10.1111/j.1746-1561.1983.tb03166.x","pmid":"6557253","pmcid":null,"title":"The effects of a teacher training program in family life and human sexuality on the knowledge and attitudes of public school teachers","authors":"Carter JA, Frankel EA.","first_author":"Carter JA","journal":"The Journal of school health","year":1983,"pub_types":["Comparative Study","Journal Article"],"keywords":["Behavior","Knowledge","North America","Sex behavior","Age factors","Psychological factors","Education","United States","Developed Countries","Sex Education","Attitude","Americas","Northern America","Louisiana","Training Programs","Faculty"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"quasi‑experimental pre‑post with control group, voluntary teacher sample","sample_n":null,"sample_text":"volunteers for a Title IV‑C teacher training program; control teachers recruited separately","population":"public‑school teachers (U.S., Louisiana)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A teacher training program on family life and sexuality increased teachers' knowledge about sex and made them more accepting of masturbation, but did not change overall attitudes toward sexuality.","clinical_takeaway":"None – the study evaluates educational outcomes, not clinical issues.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Control group included for comparison","Pre‑post design allows assessment of training impact","Addresses understudied area of teacher attitudes toward masturbation"],"limitations":["Likely use of non‑validated knowledge and attitude measures","No random assignment; possible selection bias","Small, non‑representative sample limits generalisability","No reporting of effect sizes or power analysis"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1746-1561.1983.tb03166.x"}},{"id":5929,"doi":"10.1111/j.1365-2923.1983.tb00963.x","pmid":"6621431","pmcid":null,"title":"Medical education about human sexuality: the impact of film in the workshop setting","authors":"Mandel JB.","first_author":"Mandel JB.","journal":"Medical education","year":1983,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2923.1983.tb00963.x"}},{"id":5930,"doi":null,"pmid":"6677139","pmcid":null,"title":"[Fracture of the penis: report of 10 cases and a review of 231 cases in Japan]","authors":"Hirasawa S, Tsuboi N, Abe H, Kawamura N, Kanamori S, Okumura S, Nishimura T, Akimoto M.","first_author":"Hirasawa S","journal":"Hinyokika kiyo. Acta urologica Japonica","year":1983,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"jpn","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case series of 10 patients with penile fracture plus literature review of 231 Japanese cases.","sample_n":10,"sample_text":"Ten cases reported from 1961‑1981; literature review of 231 cases.","population":"Adult males (age 19‑57) presenting with penile fracture.","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe ten men who suffered penile fractures, usually during sex or manipulation, and review 231 similar Japanese cases, outlining causes, diagnosis, surgery, and outcomes.","clinical_takeaway":"Penile fracture is a surgical emergency; prompt repair leads to good recovery.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Detailed clinical descriptions of rare injury.","Includes a historical review of over 200 cases."],"limitations":["Small case series; no systematic methodology.","No statistical analysis beyond descriptive counts.","No control or comparison groups."],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":5931,"doi":"10.1007/bf01542196","pmid":"6639331","pmcid":null,"title":"Pectoral changes during the sexual response cycle: a thermographic analysis","authors":"Abramson PR, Pearsall EH.","first_author":"Abramson PR","journal":"Archives of sexual behavior","year":1983,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"lab experiment with control condition; N=3 couples (6 participants); within‑subject comparison of masturbation vs control","sample_n":6,"sample_text":"Three married couples (six individuals) volunteered; each couple attended two lab sessions.","population":"married adult couples, volunteer sample","country":"unspecified (likely United States based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A tiny lab study (six people) used infrared cameras to track chest skin temperature while participants masturbated to orgasm and during a neutral activity. Both men and women showed warmer right‑side chest skin during the sexual sequence, which the authors linked to lymphatic function.","clinical_takeaway":"No direct clinical implications; findings are preliminary and based on a very small sample.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Within‑subject control condition","Objective physiological measurement (thermography)","Novel focus on pectoral temperature during sexual response"],"limitations":["Extremely small, non‑representative sample (N=6)","No power analysis or statistical correction reported","Findings based on a single laboratory context; limited generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542196"}},{"id":5932,"doi":"10.1001/jama.1983.03340030024020","pmid":"6854899","pmcid":null,"title":"Frictional dermatitis of Onan","authors":"Jorizzo JL, Subrt P, Smith EB, King CA, Henry JC, Archer E.","first_author":"Jorizzo JL","journal":"JAMA","year":1983,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/jama.1983.03340030024020"}},{"id":5934,"doi":"10.1192/bjp.143.1.20","pmid":"6882989","pmcid":null,"title":"Sadistic fantasy, sadistic behaviour and offending","authors":"MacCulloch MJ, Snowden PR, Wood PJ, Mills HE.","first_author":"MacCulloch MJ","journal":"The British journal of psychiatry : the journal of mental science","year":1983,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":66,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Descriptive case series of 16 male patients with psychopathic disorder from a special hospital.","sample_n":16,"sample_text":"Sixteen male special‑hospital patients.","population":"Male, middle‑aged, diagnosed with psychopathic disorder, inpatient psychiatric setting (N=16).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe 16 men with psychopathic disorders whose sadistic sexual fantasies, especially involving masturbation, appeared to drive their violent crimes, suggesting a link between internal fantasies and external offending.","clinical_takeaway":"No direct clinical guidance; findings are based on a tiny, specialized sample and cannot be generalized.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed clinical descriptions","Explores rare phenomenon of sadistic fantasy spilling into behaviour"],"limitations":["Small, non‑representative sample","No validated measures of fantasy or behaviour","No control for confounding factors"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":3,"contrasting":2,"mentioning":130,"citing_publications":294,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/bjp.143.1.20"}},{"id":5935,"doi":"10.1176/ps.34.6.528","pmid":"6862397","pmcid":null,"title":"On the possible prevention of sexual problems in adolescence","authors":"Calderone MS.","first_author":"Calderone MS.","journal":"Hospital & community psychiatry","year":1983,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary / opinion piece without empirical data","sample_n":null,"sample_text":"None – paper presents an argument, no participants","population":"general adolescent population (theoretical)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The author argues that not teaching children about sexuality early leads to sexual problems in adolescence, urging parents to provide age‑appropriate sex education before teens develop.","clinical_takeaway":"Encourage early, comprehensive sex education to potentially reduce adolescent sexual difficulties.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Raises importance of early sex education","Broad literature context cited"],"limitations":["No empirical data or systematic review","No measurement of constructs or outcomes","Claims of causality not supported by evidence"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ps.34.6.528"}},{"id":5937,"doi":"10.1177/002580248302300204","pmid":"6865704","pmcid":null,"title":"A case of fatal electrocution during an unusual autoerotic practice","authors":"Tan CT, Chao TC.","first_author":"Tan CT","journal":"Medicine, science, and the law","year":1983,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/002580248302300204"}},{"id":5938,"doi":"10.3928/0148-4834-19830401-04","pmid":"6100950","pmcid":null,"title":"Faculty and students confront sexuality","authors":"Ludlow EA, Bagwell M.","first_author":"Ludlow EA","journal":"The Journal of nursing education","year":1983,"pub_types":["Journal 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sexuality in late nineteenth-century German-language medical literature","authors":"Carter KC.","first_author":"Carter KC.","journal":"Medical history","year":1983,"pub_types":["Historical Article","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0025727300042678"}},{"id":5940,"doi":"10.1001/jama.1983.03330400041022","pmid":"6834616","pmcid":null,"title":"Vaginal atrophy in the postmenopausal woman. The importance of sexual activity and hormones","authors":"Leiblum S, Bachmann G, Kemmann E, Colburn D, Swartzman L.","first_author":"Leiblum S","journal":"JAMA","year":1983,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":176,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational comparison of 52 post‑menopausal women grouped by self‑reported intercourse frequency; clinical examination and hormone assays.","sample_n":52,"sample_text":"52 postmenopausal women divided into sexually active (≥3 times/month) vs inactive (<10 times/year).","population":"post‑menopausal women, mean age 57 (N=52)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample","masturbation_not_isolated"],"stance":"neutral","citation_value":"background","plain_summary":"In 52 post‑menopausal women, those who had regular intercourse showed less vaginal atrophy and higher androgen and LH levels than women who were largely sexually inactive.","clinical_takeaway":"Regular sexual activity may be linked to reduced vaginal atrophy and higher androgen levels in post‑menopausal women.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Objective clinical examination of atrophy","Hormone assays provide biological data","Clear definition of sexual activity groups"],"limitations":["Small sample; likely under‑powered","Masturbation not measured, confounding coitus with overall sexual activity","No control for hormonal therapy, BMI, or mental‑health factors"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":22,"citing_publications":232,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/jama.1983.03330400041022"}},{"id":5941,"doi":null,"pmid":"6884805","pmcid":null,"title":"[The female orgasm in the light of empirical and experimental studies (introduction to models of the orgasm]","authors":"Dulko S, Czernikiewicz W, Imieliński K.","first_author":"Dulko S","journal":"Ginekologia polska","year":1983,"pub_types":["Comparative Study","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5942,"doi":"10.1177/000306518303100205","pmid":"6681426","pmcid":null,"title":"Masochistic pathology and feminine development","authors":"Bernstein I.","first_author":"Bernstein I.","journal":"Journal of the American Psychoanalytic Association","year":1983,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000306518303100205"}},{"id":5943,"doi":"10.1111/j.1939-0025.1983.tb03361.x","pmid":"6829721","pmcid":null,"title":"Autoerotic asphyxial deaths and social network response","authors":"Burgess AW, Hazelwood RR.","first_author":"Burgess AW","journal":"The American journal of orthopsychiatry","year":1983,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Descriptive case series of 132 autoerotic asphyxial deaths; no control group, no longitudinal data.","sample_n":132,"sample_text":"132 deaths examined.","population":"Deceased individuals (autoerotic asphyxia cases) identified from forensic records; family/friend respondents.","country":"United States (presumed from journal, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined 132 cases of fatal autoerotic asphyxia, noting that families were often the ones to discover the bodies and felt shocked and confused. Clinicians should watch for signs of risky sexual practices in young patients and support grieving families.","clinical_takeaway":"Be alert to risky sexual behaviors like autoerotic asphyxia and be prepared to support bereaved families.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large series for a rare phenomenon","Provides insight into family response"],"limitations":["No validated measures of sexual behavior or distress","No control or comparison group","Cross‑sectional, descriptive only"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1939-0025.1983.tb03361.x"}},{"id":5945,"doi":null,"pmid":"6870457","pmcid":null,"title":"[Fatal propane poisoning]","authors":"Rauschke J, Harzer K.","first_author":"Rauschke J","journal":"Archiv fur Kriminologie","year":1983,"pub_types":["Journal Article","Case 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complex and aggression in the male","authors":"Jaffe DS.","first_author":"Jaffe DS.","journal":"Journal of the American Psychoanalytic Association","year":1983,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report with illustrative clinical material, no systematic data collection","sample_n":null,"sample_text":"Not applicable – case report format","population":"individual patients (unspecified)","country":"United States (presumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper offers a psychoanalytic discussion of how negative Oedipus complex dynamics may lead to aggression in men, linking early identifications, castration anxiety, and unconscious homosexuality.","clinical_takeaway":"None – the article is theoretical and not directly applicable to clinical practice.","confidence":0.4,"topic_tags":["other","neuroscience","treatment","csbd"],"strengths":["Provides rich clinical illustration of psychoanalytic concepts","Integrates aggression and Oedipal dynamics"],"limitations":["No empirical data or validated measures","Case report limits generalizability","Lacks control of confounding variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000306518303100405"}},{"id":5949,"doi":"10.1177/000306518303100101","pmid":"6399291","pmcid":null,"title":"The evolution of the concept of character in Freud's writings","authors":"Baudry F.","first_author":"Baudry F.","journal":"Journal of the American Psychoanalytic Association","year":1983,"pub_types":["Historical Article","Journal 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C.","first_author":"Gellman C.","journal":"L'Encephale","year":1983,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"non-empirical overview of behaviour‑therapy principles for couple sexual dysfunctions; no sample, no data collection","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article outlines a behaviour‑therapy approach for couples with sexual problems, emphasizing joint treatment, education, communication, anxiety reduction, and self‑knowledge.","clinical_takeaway":"Behaviour‑therapy principles may guide clinicians working with couple sexual dysfunctions, but evidence for effectiveness is not provided here.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Clear description of behavioural therapy components","Considers both partners in treatment"],"limitations":["No empirical data presented","No measurement of outcomes or confounds","Outdated (1983) and limited methodological detail"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":5952,"doi":"10.3928/0090-4481-19821001-13","pmid":"7145502","pmcid":null,"title":"Sexuality and the mentally retarded adolescent","authors":"Johnson DM, Johnson WR.","first_author":"Johnson DM","journal":"Pediatric 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orgasm: pelvic contractions","authors":"Bohlen JG, Held JP, Sanderson MO, Ahlgren A.","first_author":"Bohlen JG","journal":"Archives of sexual behavior","year":1982,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":59,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Within‑subject laboratory measurement of pelvic pressure in 11 nulliparous women during self‑stimulated orgasm (three trials each).","sample_n":11,"sample_text":"Eleven women, each providing three recordings.","population":"Adult women, nulliparous, recruited for a physiological study; small convenience sample.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a lab study of 11 women, researchers measured pelvic muscle pressure during self‑stimulated orgasms and identified three patterns of contractions, showing that anal and vaginal muscles contract together but with different strengths.","clinical_takeaway":"Orgasmic muscle activity varies between individuals; clinicians should recognize diverse physiological patterns when discussing female sexual function.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Objective physiological recordings","Clear operational definition of contraction types","Simultaneous anal and vaginal measurements"],"limitations":["Very small, non‑representative sample","No power calculation or pre‑registration","Findings limited to self‑stimulated orgasm in nulliparous women"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":63,"citing_publications":103,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541570"}},{"id":5954,"doi":"10.1016/s0197-0070(82)80106-x","pmid":"6897238","pmcid":null,"title":"Penile venereal edema in an adolescent","authors":"Silber TJ, Zeitler M.","first_author":"Silber TJ","journal":"Journal of adolescent health care : official publication of the Society for Adolescent Medicine","year":1982,"pub_types":["Journal Article","Case 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RM.","first_author":"Hogan RM.","journal":"The Nursing clinics of North America","year":1982,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"n/a","population":"n/a","country":"n/a","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article outlines how different religions shape sexual morals, noting that more traditional faiths often condemn masturbation and other behaviors, while liberal believers may accept them for health reasons. It advises nurses to respect clients' religious views when addressing sexual concerns.","clinical_takeaway":"Clinicians should assess clients' religious beliefs and any related guilt when discussing sexual health, but the piece offers no data to guide treatment.","confidence":0.4,"topic_tags":["religiosity","sexual_function","masturbation","csbd"],"strengths":["Provides a culturally sensitive perspective","Highlights the role of religiosity in sexual morality"],"limitations":["No empirical data or systematic methodology","Lacks measurement of key variables (e.g., masturbation frequency, distress)","No assessment of confounding factors"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":5956,"doi":null,"pmid":"7133786","pmcid":null,"title":"Communicating with adolescents and young adults about sexuality","authors":"Jones R, Shearin R.","first_author":"Jones R","journal":"Pediatric annals","year":1982,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5957,"doi":"10.1016/s0196-0644(82)80368-5","pmid":"7091800","pmcid":null,"title":"Tourniquet syndrome caused by metallic bands: a new tool for removal","authors":"Greenspan L.","first_author":"Greenspan L.","journal":"Annals of emergency medicine","year":1982,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of two patients; no control group, no systematic sampling.","sample_n":2,"sample_text":"Two cases","population":"Adult males with constricting metallic devices on penis or finger.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The report describes two men who got trapped by metal rings on their penis or finger and how a Dremel tool was used to safely cut them off.","clinical_takeaway":"A readily available Dremel tool can quickly remove constricting metal devices in emergency settings.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Clear description of a novel removal tool","Practical emergency medicine relevance"],"limitations":["Only two cases; no systematic data","No comparison to other removal methods","Limited generalizability"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0196-0644(82)80368-5"}},{"id":5959,"doi":"10.1080/00325481.1982.11716065","pmid":"7071042","pmcid":null,"title":"Adolescent sexual counseling","authors":"Shen JT.","first_author":"Shen JT.","journal":"Postgraduate medicine","year":1982,"pub_types":["Journal Article"],"keywords":["Population","Behavior","Youth","Health","Parents","Contraception","Sex behavior","Physicians","Age factors","population characteristics","Education","Family Planning","Abortion, Induced","Adolescents","Demographic Factors","Sex Education","Clinic Activities","Counseling","Organization And Administration","Program Activities","Programs","Attitude","Decision Making","Family Characteristics","Family Planning Programs","Family And Household","Family Relationships","Delivery Of Health Care","Health Personnel","Family Planning Education","Family Planning Personnel"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"article provides guidelines for physician counseling of adolescents; no empirical data reported","sample_n":null,"sample_text":"not applicable – no participants","population":"adolescents (general)","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article advises physicians on how to counsel teenagers about sexuality, emphasizing that they should offer all options for contraception or pregnancy decisions and respect the teen’s final choice, while not being forced to act against the physician’s own morals.","clinical_takeaway":"Clinicians should provide comprehensive, non‑directive sexual counseling to adolescents and may decline to act against personal moral values.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Provides clear practical counseling recommendations","Addresses physician’s ethical autonomy"],"limitations":["No empirical evidence or data","No measurement of sexual behaviours or outcomes"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00325481.1982.11716065"}},{"id":5961,"doi":null,"pmid":"7078864","pmcid":null,"title":"Sexuality in pregnancy: what determines behavior?","authors":"Perkins RP.","first_author":"Perkins RP.","journal":"Obstetrics and gynecology","year":1982,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 155 pregnant volunteers; anonymous questionnaire assessing attitudes, coital frequency, masturbation, relationship quality.","sample_n":155,"sample_text":"155 volunteers","population":"Pregnant women (puerperal volunteers) in the United States, 1982","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1982 survey of 155 pregnant women found that coital frequency drops toward the end of pregnancy, while masturbation often stays the same or rises. Relationship quality influenced how quickly sexual interest declined. Overall, pregnancy itself appears to shape sexual behavior more than personal history or demographics.","clinical_takeaway":"Pregnant patients may experience reduced intercourse but may maintain or increase masturbation; clinicians should discuss normal variability and relationship factors.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Large (for 1982) sample of pregnant women","Separates masturbation from coital activity","Considers relationship quality"],"limitations":["Self‑report, non‑validated questionnaire","No control for moral or mental‑health variables","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":5962,"doi":"10.1007/bf01541363","pmid":"7073467","pmcid":null,"title":"Labial and vaginal blood volume responses to visual and tactile stimuli","authors":"Henson DE, Rubin HB, Henson C.","first_author":"Henson DE","journal":"Archives of sexual behavior","year":1982,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subject laboratory experiment with 5 female volunteers comparing erotic film versus manual self‑stimulation; physiological genital responses recorded.","sample_n":5,"sample_text":"Five women volunteers","population":"female volunteers (N=5), likely convenience sample","country":"USA (presumed based on journal and author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In five women, researchers measured vaginal blood flow and labial temperature while they watched an erotic film or stimulated themselves. Both methods increased genital blood flow, with the physical stimulation producing the strongest response. Orgasm altered the two measures differently.","clinical_takeaway":"Genital physiological responses differ between visual and tactile stimulation; small‑sample data limit clinical extrapolation.","confidence":0.78,"topic_tags":["sexual_function","gender"],"strengths":["Use of validated physiological measures","Within‑subject comparison of visual vs tactile stimulation","Clear reporting of response patterns"],"limitations":["Very small sample (N=5) limits generalisability and statistical power","No control for psychological confounds (e.g., mood, sexual attitudes)","No effect‑size reporting or correction for multiple tests"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541363"}},{"id":5963,"doi":"10.1007/bf01541361","pmid":"7200347","pmcid":null,"title":"Treatment of homosexual and heterosexual sexual dysfunction in male-only groups of mixed sexual orientation","authors":"Everaerd W, Dekker J, Dronkers J, van der Rhee K, Staffeleu J, Wiselius G.","first_author":"Everaerd W","journal":"Archives of sexual behavior","year":1982,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Pre‑post uncontrolled case series of 21 men in mixed‑orientation therapy groups, measurements before, after, and 2‑month follow‑up.","sample_n":21,"sample_text":"Twenty‑one males divided into five therapy groups.","population":"Adult males with erectile or ejaculatory dysfunction (heterosexual, homosexual, bisexual).","country":"Netherlands (presumed from author names, not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A small group‑therapy program for men with erectile or ejaculatory problems—heterosexual, homosexual or bisexual—showed improvement from before treatment to two months after, according to the authors’ clinical assessments.","clinical_takeaway":"Limited evidence; the reported improvement cannot be confidently attributed to the therapy without a control group.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Longitudinal follow‑up (2 months)","Multi‑orientation sample","Therapy delivered by trained male therapists"],"limitations":["Very small, non‑random sample","No control or comparison group","Outcome measures not described or validated in abstract"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541361"}},{"id":5964,"doi":null,"pmid":"7164870","pmcid":null,"title":"A comparison of university student experience with various sexual outlets in 1974 and 1980","authors":"Story MD.","first_author":"Story MD.","journal":"Adolescence","year":1982,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 100 male and 100 female students per year from a sexuality course; yes/no questionnaire on various sexual behaviors; comparisons between 1974 and 1980 cohorts.","sample_n":200,"sample_text":"Fifty single males and fifty single females in 1974 and 1980, randomly selected from all the single males and single females taking a sexuality course.","population":"University students (single males and females) at University of Northern Iowa, selected from a sexuality course.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1982 survey compared U.S. university students in 1974 and 1980, finding declines in same‑sex, group, and bestiality experiences, but an increase in oral stimulation of partners. Men reported more masturbation and premarital sex, while women reported more anal sex as a passive partner and more rape victimisation.","clinical_takeaway":"None – findings describe historical patterns of sexual behavior, not clinical implications.","confidence":0.8,"topic_tags":["sexual_function","masturbation","gender"],"strengths":["Historical comparison across two time points","Gender‑balanced sample for each cohort","Clear reporting of response format"],"limitations":["Convenience sample from a sexuality course; limited generalizability","Unvalidated single‑item questionnaire","No adjustment for potential confounders (e.g., moral attitudes, mental health)","No effect sizes or correction for multiple testing"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":5965,"doi":null,"pmid":"7054999","pmcid":null,"title":"Sexuality and headache","authors":"Del Bene E, Conti C, Poggioni M, Sicuteri F.","first_author":"Del Bene E","journal":"Advances in neurology","year":1982,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire comparing headache sufferers to controls; sample size 362 headache patients","sample_n":362,"sample_text":"362 headache sufferers; controls not quantified in abstract","population":"adult headache sufferers (both sexes) and unspecified controls","country":"unspecified (likely Italy based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a 1982 questionnaire study, people with migraines reported similar sexual activity and sleep as controls, but masturbated less. Women with headaches reported more sexual excitement and fantasies than controls, while men reported less.","clinical_takeaway":"Headache patients may experience altered sexual arousal patterns, but no direct clinical implications are supported.","confidence":0.4,"topic_tags":["sexual_function","masturbation","moral_incongruence"],"strengths":["Relatively large sample of headache sufferers","Direct comparison of sexual behavior variables between patients and controls"],"limitations":["No validated sexuality or addiction scales","Potential confounds (mental health, partner status, moral attitudes) not assessed","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":5966,"doi":null,"pmid":"7156242","pmcid":null,"title":"[Maternal attitudes towards children with personality and psychosexual disorders studied by the Maria Ziemska's questionnaire]","authors":"Gromska J.","first_author":"Gromska J.","journal":"Psychiatria polska","year":1982,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5967,"doi":"10.1080/00926238208405821","pmid":"7143457","pmcid":null,"title":"Treatment effectiveness for dysfunctions of sexual desire","authors":"Schover LR, LoPiccolo J.","first_author":"Schover LR","journal":"Journal of sex & marital therapy","year":1982,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective pre‑post analysis of archival clinic data; no control group; outcomes measured before and after behavioral sex‑therapy.","sample_n":null,"sample_text":"archival data; likely modest, treatment‑seeking sample","population":"Clients of a sex‑therapy centre (treatment‑seeking couples) from 1974‑1981; sample size not reported in abstract.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 1982 study of couples who received behavioral sex therapy showed improvements in marital satisfaction, sexual satisfaction, and frequency of intercourse and masturbation after treatment, but the analysis lacks a control group and detailed methodological information.","clinical_takeaway":"Sex‑therapy may improve desire‑related outcomes in couples, but evidence is limited by study design.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Uses multiple outcome domains (relationship, sexual activity, masturbation)","Longitudinal follow‑up reported","Includes both male‑ and female‑centered problems"],"limitations":["No control or comparison group; cannot rule out time effects","Unclear sample size and statistical power","Unclear whether outcome measures are validated"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238208405821"}},{"id":5968,"doi":null,"pmid":"6958665","pmcid":null,"title":"A clinical report of a case of sexual-religious perversion","authors":"Loe DC.","first_author":"Loe DC.","journal":"The Journal of the American Society of Psychosomatic Dentistry and Medicine","year":1982,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5969,"doi":"10.1080/00926238208405824","pmid":"7143460","pmcid":null,"title":"Urethral manipulation: an unusual paraphilia","authors":"Wise TN.","first_author":"Wise TN.","journal":"Journal of sex & marital therapy","year":1982,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238208405824"}},{"id":5970,"doi":null,"pmid":"6753037","pmcid":null,"title":"Psychosexual issues in adolescent contraception","authors":"Greer JG.","first_author":"Greer JG.","journal":"Public health reviews","year":1982,"pub_types":["Review","Journal Article"],"keywords":["Population","Population dynamics","Fertility","Reproduction","Behavior","Youth","North America","Contraception","Policy","Sex behavior","Age factors","Literature review","population characteristics","Europe","Psychosocial factors","reproductive behavior","United States","Family Planning","Adolescents","Demographic Factors","Developed Countries","Contraceptive Usage","Adolescents, Female","Coitus","Developing Countries","Americas","Northern America","Adolescent Pregnancy","Population Policy","Social Policy","Family Planning Policy","Adolescents, Male","Premarital Sex Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5971,"doi":null,"pmid":"7200967","pmcid":null,"title":"[Ejaculation inadequacy in sexual disorders]","authors":"Schröder KH, Krause W.","first_author":"Schröder KH","journal":"Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete","year":1982,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of 16 men with ejaculatory failure, no control group","sample_n":16,"sample_text":"Sixteen men with missing ejaculation were observed as outpatients in our department within the past years.","population":"men with missing ejaculation (n=16)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe 16 men who could not ejaculate, noting causes such as surgery, spinal injury, hormonal problems and drug use. They discuss that psychotherapy, hormone therapy, and certain medications can help, especially for those whose problem started later in life.","clinical_takeaway":"Ejaculation failure has many medical and psychological causes; psychotherapy and targeted medical treatments may improve outcomes.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Rare clinical description of ejaculatory disorders","Identifies multiple possible etiologies","Suggests treatment options"],"limitations":["Very small, non‑representative sample","No validated outcome measures","No control/comparison group","Limited statistical analysis"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":5972,"doi":null,"pmid":"7171098","pmcid":null,"title":"Anticipation and experimentation: the sexual concerns of mid adolescence","authors":"Sondheimer A.","first_author":"Sondheimer A.","journal":"Adolescent psychiatry","year":1982,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5973,"doi":"10.1080/00926238208405818","pmid":"7120433","pmcid":null,"title":"The effect of group treatment of primary orgasmic dysfunction on the marital relationship","authors":"Payn N, Wakefield J.","first_author":"Payn N","journal":"Journal of sex & marital therapy","year":1982,"pub_types":["Journal Article","Case 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midodrine, an orally active selective alpha-adrenoceptor agonist","authors":"Riley AJ, Riley EJ.","first_author":"Riley AJ","journal":"European urology","year":1982,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"double‑blind crossover trial with 6 patients","sample_n":6,"sample_text":"6 patients diagnosed with partial ejaculatory incompetence","population":"men with partial ejaculatory incompetence","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In six men with a condition where ejaculation is incomplete, taking the drug midodrine improved orgasm intensity and reduced sperm loss in urine, suggesting better ejaculatory function.","clinical_takeaway":"Midodrine may help men with partial ejaculatory incompetence, but evidence is limited to a very small trial.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["double‑blind crossover design","objective biological measure (sperm in urine)"],"limitations":["very small sample (N=6)","lack of validated outcome scales","no control for potential 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Coleman E, Amberson J, Ling F.","first_author":"Hoon PW","journal":"Biological psychiatry","year":1981,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5978,"doi":"10.1007/bf01541434","pmid":"7198432","pmcid":null,"title":"Factor affecting sexual functioning in 60-79-year-old married males","authors":"Martin CE.","first_author":"Martin CE.","journal":"Archives of sexual behavior","year":1981,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional interview study of married upper‑middle‑class men aged 60‑79; convenience sample; no longitudinal or experimental component","sample_n":null,"sample_text":"Not reported in abstract","population":"married males 60‑79, upper‑middle class","country":"USA","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with older married men showed that current sexual activity is linked more to their past sexual functioning than to marital quality, attitudes, or demographics. Men reporting weaker erections also reported less anxiety or embarrassment, suggesting low motivation rather than performance worry explains reduced activity.","clinical_takeaway":"In older men, reduced sexual activity may stem from longstanding low motivation rather than anxiety; assessment should consider lifetime patterns.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Examines multiple correlates of sexual activity in older men","Includes retrospective assessment of prior sexual functioning"],"limitations":["Convenience, affluent sample limits generalisability","Reliance on single‑item self‑reports, no validated scales","Cross‑sectional design, causal language overreaches"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":32,"citing_publications":118,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541434"}},{"id":5979,"doi":"10.1016/0005-7916(81)90057-4","pmid":"7320217","pmcid":null,"title":"A daily alternation procedure for orgasmic reconditioning with a pedophile","authors":"Foote WE, Laws DR.","first_author":"Foote WE","journal":"Journal of behavior therapy and experimental psychiatry","year":1981,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0005-7916(81)90057-4"}},{"id":5980,"doi":null,"pmid":"6914824","pmcid":null,"title":"[The adolescent and his identity]","authors":"Alby JM.","first_author":"Alby JM.","journal":"Soins. 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groups formed by interview‑derived orgasmic status and relationship status.","sample_n":619,"sample_text":"619‑member female sample presenting for treatment of sexual dysfunction.","population":"Females with reported sexual dysfunction seeking clinical care (treatment‑seeking sample).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A review of 619 women in therapy for sexual problems found no link between how long foreplay or intercourse lasts and whether they can orgasm during sex, though relationship status was related to these timing measures.","clinical_takeaway":"Foreplay and intercourse length alone do not predict orgasmic outcomes for women with sexual dysfunction.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Large clinical sample (N>600)","Direct comparison of foreplay/intromission durations across orgasmic categories","Inclusion of relationship status as a variable"],"limitations":["Retrospective design; reliance on self‑report interview data","No validated questionnaires for orgasmic function or distress","Key confounds (masturbation, moral attitudes, mental health) not measured","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542171"}},{"id":5985,"doi":"10.1080/21674086.1981.11926950","pmid":"7244052","pmcid":null,"title":"On the psychoanalytic theory of instinctual drives. I: The beginnings of Freud's drive theory","authors":"Compton A.","first_author":"Compton A.","journal":"The Psychoanalytic quarterly","year":1981,"pub_types":["Journal 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problems","authors":"Stanley E.","first_author":"Stanley E.","journal":"British medical journal (Clinical research ed.)","year":1981,"pub_types":["research-article","Journal 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B.","first_author":"Alexander B.","journal":"American family physician","year":1981,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary/editorial without empirical data","sample_n":null,"sample_text":"No empirical sample reported; article provides guidance for clinicians.","population":"physicians (family practice) – implied audience","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article advises family doctors on how to discuss sexual issues, including masturbation and fantasies, emphasizing comfort, respect for patients' values, and knowledge of treatment options.","clinical_takeaway":"Physicians should be prepared to discuss sexual concerns openly and non‑judgmentally to improve patient care.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Clear practical guidance for clinicians","Addresses a range of sexual concerns"],"limitations":["No empirical data or systematic review","Outdated (1981) and may not reflect current norms"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":5988,"doi":null,"pmid":"6791156","pmcid":null,"title":"Fits and other frightening or funny turns in young children","authors":"Bower B.","first_author":"Bower B.","journal":"The Practitioner","year":1981,"pub_types":["Journal 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gaps in prior research","Proposes a conceptual framework for future study"],"limitations":["No empirical data presented","Lacks operational definitions or measurement validation","No control of relevant confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238108403436"}},{"id":5990,"doi":"10.1080/00926238108405432","pmid":"7328684","pmcid":null,"title":"Efficacy of sex education courses in medical school","authors":"Schnarch DM, Jones K.","first_author":"Schnarch 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high doses of LHRH in male impotency","authors":"Ehrensing RH, Kastin AJ, Schally AV.","first_author":"Ehrensing RH","journal":"Peptides","year":1981,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"double‑blind crossover trial (placebo‑LHRH‑placebo), N=8 men with secondary impotence","sample_n":8,"sample_text":"Eight married men with secondary impotency","population":"8 married adult men, secondary erectile dysfunction, non‑psychiatric","country":"unknown","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Eight men with non‑organic erectile problems received high‑dose LHRH and placebo in a double‑blind crossover trial. Hormone levels changed, but there were no significant improvements in intercourse frequency, erections, or partner‑rated libido. Self‑rated libido rose slightly with LHRH.","clinical_takeaway":"LHRH did not meaningfully improve erectile function; larger trials are needed before clinical use.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["double‑blind crossover within‑subject design","objective hormonal measurements (LH, FSH, testosterone, prolactin)","daily self‑report minimizes recall bias"],"limitations":["very small sample (N=8) limits power","outcome measures not validated scales","no control for psychological or relational confounds","no pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0196-9781(81)90065-6"}},{"id":5993,"doi":"10.1177/000306518102900406","pmid":"7320403","pmcid":null,"title":"Sexualization as a predominant mode of defense","authors":"Coen SJ.","first_author":"Coen SJ.","journal":"Journal of the American Psychoanalytic Association","year":1981,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/000306518102900406"}},{"id":5995,"doi":null,"pmid":"7262578","pmcid":null,"title":"[Sexual behavior in a student population in Mexico City]","authors":"Brostein de Ranen E.","first_author":"Brostein de Ranen E.","journal":"Ginecologia y obstetricia de Mexico","year":1980,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":5996,"doi":"10.1016/0306-4530(80)90033-5","pmid":"7193890","pmcid":null,"title":"Environmental and social factors influencing seminal emission in chacma baboons (Papio ursinus)","authors":"Bielert C, Howard-Tripp ME, Van der Walt LA.","first_author":"Bielert C","journal":"Psychoneuroendocrinology","year":1980,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0306-4530(80)90033-5"}},{"id":5997,"doi":"10.1016/0165-0327(80)90027-0","pmid":"6450785","pmcid":null,"title":"The premenstrual syndrome. A psychological evaluation","authors":"Watts S, Dennerstein L, Horne DJ.","first_author":"Watts S","journal":"Journal of affective disorders","year":1980,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control study comparing 25 women with PMS to 23 controls, using questionnaires (STAI, EPI‑B, Role Acceptance Scale).","sample_n":48,"sample_text":"25 women with clear premenstrual symptoms; 23 controls without symptoms.","population":"adult women, community‑recruited, small convenience sample (N≈48).","country":"Australia (inferred from author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Women with premenstrual syndrome reported higher anxiety, neuroticism, and more negative attitudes toward their bodies, sex and masturbation than women without PMS.","clinical_takeaway":"PMS is linked to greater anxiety and negative sexual attitudes; clinicians should consider mood and body‑image factors when treating PMS‑related concerns.","confidence":0.6,"topic_tags":["prevalence","pornography","masturbation","sexual_function","moral_incongruence"],"strengths":["Use of validated anxiety and neuroticism scales","Clear case‑control definition of PMS status","Focused psychological questionnaire battery"],"limitations":["Very small sample, likely under‑powered","Reliance on an ad‑hoc attitude scale","No control for key confounds (e.g., mental health, moral attitudes)","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0165-0327(80)90027-0"}},{"id":5998,"doi":"10.1097/00004703-198012000-00007","pmid":"7251876","pmcid":null,"title":"Sexual behaviors in retarded children and adolescents","authors":"Simonds JF.","first_author":"Simonds JF.","journal":"Journal of developmental and behavioral pediatrics : JDBP","year":1980,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"case-report","design_detail":"Narrative review / case report of literature, no original data.","sample_n":null,"sample_text":"Not applicable – article reports on existing literature rather than original participants.","population":"children and adolescents with mild intellectual disability","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews reported sexual activities—such as masturbation and same‑sex exploration—among adolescents with mild intellectual disability, noting parental distress and the need for tailored sex education and family counseling.","clinical_takeaway":"Provide clear, developmentally appropriate sex education and family guidance for adolescents with intellectual disability.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Addresses an under‑studied population","Highlights parental concerns and need for education"],"limitations":["No original empirical data","Lacks systematic review methods","No measurement of key constructs or confounders"],"rubric_version":"2.0","raw_total":3,"max_possible":50,"pct_score":6,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00004703-198012000-00007"}},{"id":5999,"doi":null,"pmid":"7005914","pmcid":null,"title":"[Foreign bodies in the rectum]","authors":"Vigoni M.","first_author":"Vigoni M.","journal":"Phlebologie","year":1980,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"case-report","design_detail":"Descriptive report of clinical cases; no systematic data collection or analysis.","sample_n":null,"sample_text":"","population":"Patients with rectal foreign bodies (unspecified number).","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article describes various objects that people insert into the rectum, often during sexual activity, and discusses the challenges and techniques for safely removing them.","clinical_takeaway":"Clinicians should be aware of the range of rectal foreign bodies and have a repertoire of extraction methods to avoid invasive surgery.","confidence":0.3,"topic_tags":[],"strengths":["Provides practical clinical discussion of extraction techniques","Highlights unusual presentations related to rectal masturbation"],"limitations":["No empirical data or systematic methodology","No sample size or outcome statistics reported","No control of relevant confounders"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":2,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":6000,"doi":null,"pmid":"7213257","pmcid":null,"title":"The practical management of the otherwise fully sexually responsive woman who complains of inability to climax during intercourse","authors":"Williams W.","first_author":"Williams W.","journal":"Australian family physician","year":1980,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Guideline/clinical commentary without original empirical data.","sample_n":null,"sample_text":"Not applicable – no original sample reported.","population":"Women reporting inability to climax during intercourse without manual clitoral stimulation.","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article gives doctors practical advice for helping women who can orgasm with clitoral stimulation but not during intercourse, suggesting supplemental manual stimulation.","clinical_takeaway":"Clinicians can advise manual clitoral stimulation during intercourse to improve orgasm likelihood.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Clear practical recommendations for clinicians","Based on clinical experience"],"limitations":["No empirical data presented","No systematic evidence cited","No measurement of relevant confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":6002,"doi":null,"pmid":"7002416","pmcid":null,"title":"The use of aids in the management of disorders of sexual function","authors":"Rhodes P.","first_author":"Rhodes P.","journal":"Clinics in obstetrics and gynaecology","year":1980,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6003,"doi":"10.1097/00000433-198006000-00004","pmid":"7246503","pmcid":null,"title":"A case of female autoerotic death","authors":"Danto BL.","first_author":"Danto BL.","journal":"The American journal of forensic medicine and pathology","year":1980,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single female autoerotic death; descriptive forensic pathology","sample_n":1,"sample_text":"single case","population":"female adult involved in autoerotic death; single case","country":"USA (presumed based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes the first reported case of a woman dying during an autoerotic act, detailing the forensic investigation and comparing it to previously reported male cases.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Detailed forensic description of a rare female autoerotic death","Includes crime scene sketches and photographs"],"limitations":["Single case; no generalizable findings","No systematic measurement of psychological constructs","No statistical 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imbalances.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["randomised controlled design","objective endocrine measurements","clear negative finding on sexual function"],"limitations":["very small sample, likely underpowered","lack of validated sexual function instrument","no adjustment for psychological or relational confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":6006,"doi":null,"pmid":"6102986","pmcid":null,"title":"Schizophrenia and sexuality: a review and a report of twelve unusual cases--Part II","authors":"Akhtar S, Thomson JA.","first_author":"Akhtar S","journal":"The Journal 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Contributions to analysis of denial]","authors":"Maldavsky D.","first_author":"Maldavsky D.","journal":"Acta psiquiatrica y psicologica de America latina","year":1980,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"theoretical psychoanalytic article without empirical data; no participants, no measurements","sample_n":null,"sample_text":"None – no empirical sample reported","population":"women (theoretical groups described as ‘male character’ vs ‘inhibition or neurosis’)","country":"Argentina (journal published in Latin America)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The paper presents a psychoanalytic theory describing two female groups—those with a ‘male character’ and those with inhibition/neurosis—focusing on how denial and identification shape sexual attitudes and masturbation.","clinical_takeaway":"None – the article provides no empirical evidence for clinical practice.","confidence":0.7,"topic_tags":["gender","sexual_function","masturbation","neuroscience","csbd"],"strengths":["Integrates psychoanalytic concepts with psychosexual development","Offers a detailed theoretical model of denial mechanisms"],"limitations":["No empirical data or measurement instruments","Constructs are not operationalised or validated","No consideration of moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":6011,"doi":null,"pmid":"6779186","pmcid":null,"title":"Addiction to pleasure: a biological and social-psychological theory of addiction","authors":"Bejerot N.","first_author":"Bejerot N.","journal":"NIDA research monograph","year":1980,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6012,"doi":"10.1007/bf01541399","pmid":"7362438","pmcid":null,"title":"Personality correlates of sexual behavior in black woemn","authors":"Fisher S.","first_author":"Fisher S.","journal":"Archives of sexual behavior","year":1980,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"questionnaire survey of 35 Black women, compared to White controls; correlational analysis","sample_n":35,"sample_text":"35 Black women; White female controls (size not given)","population":"Black women, N=35; White female controls (sample size not reported)","country":"USA (presumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1980 survey of 35 Black women examined how often they masturbated, had orgasms and other sexual preferences, and related these patterns to personality traits. Results were largely similar to earlier findings in White women, with some differences.","clinical_takeaway":"Findings are limited by small sample size and lack of controls; no direct clinical implications.","confidence":0.4,"topic_tags":["sexual_function","masturbation","gender","csbd"],"strengths":["Early empirical data on Black women’s sexual behavior","Includes both sexual behavior and personality measures","Direct comparison with White female sample"],"limitations":["Very small sample (N=35) limits statistical power","Reliance on self‑report questionnaires with unclear validation","No control for moral, mental‑health or relational confounds","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541399"}},{"id":6013,"doi":null,"pmid":"7347818","pmcid":null,"title":"The orgasm: a sociological consideration of the interpretation of physiologically derived response norms","authors":"Kingham M.","first_author":"Kingham M.","journal":"Proceedings of the annual symposium of the Eugenics Society","year":1980,"pub_types":["Journal 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Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd","masturbation"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case series of 11 patients with epilepsy or focal brain lesions, describing sexual behaviour alterations.","sample_n":11,"sample_text":"Eleven cases are described.","population":"Patients with epilepsy or focal brain lesions (various ages and genders).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper reports eleven individuals with epilepsy or focal brain damage and describes how seizures or lesions in different brain areas can change sexual behavior, sometimes causing inappropriate actions or heightened sexual interest.","clinical_takeaway":"Neurological conditions can affect sexual behavior, but evidence is limited to anecdotal case reports.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed clinical descriptions","Historical perspective on neuro‑behavioral links"],"limitations":["Very small, non‑representative sample","No systematic measurement or controls","No statistical analysis beyond description"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":6016,"doi":"10.1159/000402339","pmid":"6106890","pmcid":null,"title":"Neuroleptic drugs and sexual function in schizophrenia","authors":"Nestoros JN, Lehmann HE, Ban TA.","first_author":"Nestoros JN","journal":"Modern problems of pharmacopsychiatry","year":1980,"pub_types":["Review","Journal 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repression","authors":"Gilbert AN.","first_author":"Gilbert AN.","journal":"Albion","year":1980,"pub_types":["Historical Article","Journal 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among facilities for the mentally retarded","authors":"Coleman EM, Murphy WD.","first_author":"Coleman EM","journal":"Applied research in mental retardation","year":1980,"pub_types":["Journal 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S, Delogne-Desnoeck J, Robyn C.","first_author":"Küĉükkömürcü S","journal":"International journal of fertility","year":1980,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational measurement of 236 semen samples from a sterility clinic; correlations between prolactin, fructose, volume and sperm parameters.","sample_n":236,"sample_text":"236 semen specimens from clinic patients","population":"Men attending a sterility clinic (masturbation used for semen collection)","country":"Not specified (likely Turkey based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 236 men who provided semen by masturbation, seminal prolactin was three times higher than serum levels and was positively linked to fructose and semen volume, but not to sperm count or motility, suggesting prolactin may influence the semen environment.","clinical_takeaway":"Prolactin levels relate to semen composition, not directly to sperm quality; no immediate clinical action indicated.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Validated biochemical assays for prolactin and fructose","Large sample size for a physiological study","Clear reporting of correlations"],"limitations":["Convenience sample from a sterility clinic limits generalisability","No power analysis or effect‑size confidence intervals reported","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":6022,"doi":null,"pmid":"511062","pmcid":null,"title":"[The epidemiology of breast neoplasms]","authors":"Eicher W, Herms V, Henningsen B, Meinel A, Reverey C.","first_author":"Eicher W","journal":"Fortschritte der Medizin","year":1979,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational epidemiologic study of breast cancer patients, assessing tumor stage, reproductive history, psychosocial factors, and sexual behavior. Sample size not reported in abstract.","sample_n":null,"sample_text":"Not reported in abstract.","population":"Women with breast cancer (sample size unspecified) from urban and rural settings.","country":"Germany (journal is German; authors’ affiliations not listed).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined breast‑cancer patients and found links between tumor stage and factors such as childlessness, depression, and reduced sexual activity, including masturbation.","clinical_takeaway":"Clinicians should attend to psychosocial and sexual health needs of breast‑cancer patients, but evidence is limited.","confidence":0.6,"topic_tags":["csbd","masturbation","sexual_function"],"strengths":["Large‑scale epidemiologic perspective","Considers multiple psychosocial variables"],"limitations":["No clear sample size or power analysis","Potential confounding not controlled (e.g., moral incongruence, partner factors)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":6023,"doi":"10.1080/21674086.1979.11926886","pmid":"482464","pmcid":null,"title":"The search for the mother: narcissistic regression as a pathway of mourning in childhood","authors":"Perman JM.","first_author":"Perman JM.","journal":"The Psychoanalytic quarterly","year":1979,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report; psychoanalytic clinical material from two individuals (a child and an adult) who lost their mothers; no systematic sampling or control group","sample_n":null,"sample_text":"two cases (latency‑phase child and adult) described qualitatively","population":"children and adults who experienced maternal loss; clinical psychoanalytic setting","country":"United States (assumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The author argues that children can mourn loss differently from adults, using a process called narcissistic regression that involves self‑focused (autoerotic) activities, illustrated with two clinical cases.","clinical_takeaway":"None – the article is theoretical and based on case material, not applicable to clinical practice.","confidence":0.4,"topic_tags":["moral_incongruence","masturbation","sexual_function"],"strengths":["Provides rich clinical narrative","Connects classic psychoanalytic theory to child mourning"],"limitations":["No empirical measurement or validated scales","Single‑case, non‑generalizable data","Lacks statistical analysis or control for confounds"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/21674086.1979.11926886"}},{"id":6025,"doi":"10.1007/bf01541876","pmid":"475579","pmcid":null,"title":"Experimental studies of the etiology of genital exhibitionism","authors":"Langevin R, Paitich D, Ramsay G, Anderson C, Kamrad J, Pope S, Geller G, Pearl L, Newman S.","first_author":"Langevin R","journal":"Archives of sexual behavior","year":1979,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory behavioral and physiological comparisons between exhibitionist participants and control subjects using questionnaires, personality tests and penile volume measurements.","sample_n":null,"sample_text":"Not specified in abstract; likely small, typical of 1970s clinical studies.","population":"Male exhibitionists and matched control males (sample size not reported in abstract).","country":"USA (Archives of Sexual Behavior publishes US research; authors’ affiliations not listed).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors compared men who expose themselves sexually to normal men using questionnaires, personality tests, hormone levels and penile measurements. They found few clear differences, suggesting existing theories of exhibitionism may be incomplete.","clinical_takeaway":"Findings do not support specific physiological or personality markers for exhibitionism; treatment should remain individualized.","confidence":0.6,"topic_tags":["gender","sexual_function"],"strengths":["Use of physiological measures (penile volume, testosterone).","Inclusion of control group for comparison.","Multiple methodological approaches (behavioral, questionnaire, hormonal)."],"limitations":["Small, unspecified sample size; likely under‑powered.","Potential reliance on non‑validated or outdated questionnaires.","Limited statistical detail; no effect sizes or power analysis."],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":19,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541876"}},{"id":6026,"doi":"10.1210/jcem-48-6-955","pmid":"447801","pmcid":null,"title":"Effects of androgen on sexual behavior in hypogonadal men","authors":"Davidson JM, Camargo CA, Smith ER.","first_author":"Davidson JM","journal":"The Journal of clinical endocrinology and metabolism","year":1979,"pub_types":["Clinical Trial","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":201,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"double‑blind, within‑subject crossover trial of testosterone vs placebo in 6 hypogonadal men, 5‑month period, daily sexual activity logs","sample_n":6,"sample_text":"six adult males, aged 32‑65 years","population":"adult men with primary or secondary hypogonadism (n=6)","country":"United States (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In six men with low testosterone, weekly injections of testosterone increased the number of erections and sexual encounters compared with placebo, without changing mood. Effects tracked the hormone levels.","clinical_takeaway":"Testosterone can quickly raise sexual activity in hypogonadal men, but evidence is from a very small trial.","confidence":0.71,"topic_tags":["sexual_function","masturbation"],"strengths":["Randomised, double‑blind crossover design","Objective hormonal measurements linked to behavior","Frequent (daily) behavioral logging"],"limitations":["Very small sample (n=6) limits power and generalisability","No control for moral or psychosocial confounds","Reliance on self‑report logs without validated sexual function 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S.","first_author":"Hite S.","journal":"The Journal of school health","year":1979,"pub_types":["Journal 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orgasm of cystectomy, prostatectomy and vesiculectomy for cancer of the bladder: a clinical and electromyographic study","authors":"Bergman B, Nilsson S, Petersén I.","first_author":"Bergman B","journal":"British journal of urology","year":1979,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective interview of 43 men 1–8 y after cystectomy/prostatectomy; EMG recordings of pelvic muscles.","sample_n":43,"sample_text":"Forty‑three men; 38 sexually active pre‑op; follow‑up mean 3 y.","population":"Men undergoing bladder cancer surgery (cystectomy with adjunctive prostate/vesicle procedures).","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In 43 men who had bladder‑cancer surgery, only a minority retained erections, but most who were still sexually active reported orgasms. Muscle activity during orgasm looked normal on EMG, suggesting the nerves and muscles remained functional.","clinical_takeaway":"After cystectomy with prostate/vesicle removal, erections are uncommon but orgasm may still occur; EMG shows preserved muscular coordination.","confidence":0.7,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Objective EMG data on pelvic muscles","Long‑term postoperative follow‑up"],"limitations":["Small, non‑representative sample","No validated sexual‑function questionnaires","No control for psychological or relational factors"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":16,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1464-410x.1979.tb02843.x"}},{"id":6033,"doi":null,"pmid":"432052","pmcid":null,"title":"[Sexual manifestations in the clinical picture of borderline neuropsychic disorders in childhood and adolescence]","authors":"Isaev DN, Mikirtumov BE, Bogdanova EI.","first_author":"Isaev DN","journal":"Pediatriia","year":1979,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"rus","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6034,"doi":null,"pmid":"11633677","pmcid":null,"title":"[Not Available]","authors":"Krenkel WA.","first_author":"Krenkel WA.","journal":"Wissenschaftliche Zeitschrift der Wilhelm-Pieck-Universitat Rostock. Gesellschafts- und sprachwissenschaftliche Reihe","year":1979,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6035,"doi":"10.1300/j082v04n03_04","pmid":"264129","pmcid":null,"title":"Lesbian sexuality","authors":"Califia P.","first_author":"Califia P.","journal":"Journal of homosexuality","year":1979,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 286 self‑identified lesbian women reporting sexual behaviours and attitudes; descriptive statistics presented.","sample_n":286,"sample_text":"286 homosexual women","population":"286 homosexual women (convenience sample).","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1979 survey of 286 lesbian women described their first orgasms, sexual practices, fantasies, use of sex toys, and attitudes toward masturbation and lesbian identity, finding generally positive views about their bodies and sexual activities.","clinical_takeaway":"None - not clinically applicable.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a 1979 study","Broad range of sexual behaviour topics covered","Provides descriptive baseline data on lesbian sexual attitudes"],"limitations":["Likely uses ad‑hoc, non‑validated questionnaire","Convenience sampling limits generalisability","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v04n03_04"}},{"id":6036,"doi":null,"pmid":"553055","pmcid":null,"title":"Further exploration of the schizophrenic regression to the undifferentiated state. A study of the 'assessment of the unconscious'","authors":"Katan M.","first_author":"Katan M.","journal":"The International journal of psycho-analysis","year":1979,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6037,"doi":null,"pmid":"554989","pmcid":null,"title":"[Analytic therapy in the latency period. A) Therapeutic approach to the latency period]","authors":"Denis P.","first_author":"Denis P.","journal":"La Psychiatrie de l'enfant","year":1979,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6038,"doi":"10.1097/00004583-197922000-00012","pmid":"469131","pmcid":null,"title":"The adolescent sexual asphyxia syndrome","authors":"Rosenblum S, Faber MM.","first_author":"Rosenblum S","journal":"Journal of the American Academy of Child Psychiatry","year":1979,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00004583-197922000-00012"}},{"id":6039,"doi":null,"pmid":"263649","pmcid":null,"title":"A cross cultural study of cases of functional sexual disorders among arabs","authors":"Demerdash A, Lotaif F, Bishry Z, Ashour A, Okasha A.","first_author":"Demerdash A","journal":"The Egyptian journal of psychiatry : official journal of the Egyptian Psychiatric Association","year":1978,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6040,"doi":null,"pmid":"727936","pmcid":null,"title":"Sexual adjustment after lower extremity amputation","authors":"Reinstein L, Ashley J, Miller KH.","first_author":"Reinstein L","journal":"Archives of physical medicine and rehabilitation","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"interview study of 60 amputees after prosthetic ambulation; descriptive comparisons of sexual frequency","sample_n":60,"sample_text":"60 adults (39 men, 21 women) who were independent ambulating with a prosthesis","population":"60 adults (39 men, 21 women) with recent lower‑extremity amputation, prosthesis‑user, community‑dwelling","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 60 adults who had lower‑leg amputations and were walking with prostheses, most men reported a marked drop in how often they had sex, while fewer women reported a drop. Frequency of other sexual activities stayed about the same.","clinical_takeaway":"Clinicians should discuss possible changes in sexual frequency with male amputees, especially those with above‑knee loss or persistent phantom sensations.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large (for 1978) sample of amputees","Separate reporting for men and women","Considers clinical variables (level of amputation, phantom pain)"],"limitations":["No validated sexual‑function questionnaire used","Cross‑sectional, no longitudinal follow‑up","Limited control of psychosocial confounds (e.g., depression, body image)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":6041,"doi":"10.1056/nejm197811232992101","pmid":"703805","pmcid":null,"title":"Rise in female-initiated sexual activity at ovulation and its suppression by oral contraceptives","authors":"Adams DB, Gold AR, Burt AD.","first_author":"Adams DB","journal":"The New England journal of medicine","year":1978,"pub_types":["Comparative Study","Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":86,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational diary study tracking sexual behavior across menstrual cycles; not randomized or controlled.","sample_n":null,"sample_text":"Not reported in abstract","population":"Married women using non‑oral contraceptives vs oral contraceptives; sample size not provided in abstract.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study found that women not using oral contraceptives showed a rise in sexual activity—both masturbation and initiating sex—around ovulation, while women on the pill did not, suggesting hormones influence sexual drive.","clinical_takeaway":"Hormonal cycles may affect women's sexual desire; oral contraceptives can blunt ovulatory peaks.","confidence":0.7,"topic_tags":["sexual_function","religiosity","masturbation","relationships"],"strengths":["Large‑scale epidemiological data for the time (1978)","Differentiates female‑ vs male‑initiated sexual activity","Considers hormonal influence via oral contraceptive use"],"limitations":["Self‑report diaries with unknown validation","No control for moral, mental‑health, or trauma variables","Statistical methods not described; likely limited"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":67,"citing_publications":223,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1056/nejm197811232992101"}},{"id":6042,"doi":"10.2105/ajph.68.11.1083","pmid":"717616","pmcid":null,"title":"Sexual knowledge, attitudes, and practice of Israeli adolescents","authors":"Lancet M, Modan B, Kavenaki S, Antonovski H, Shoham I.","first_author":"Lancet M","journal":"American journal of public health","year":1978,"pub_types":["Journal Article"],"keywords":["Population","Pregnancy","Behavior","Asia","Youth","Students","Sex behavior","Sex distribution","Age distribution","Age factors","population characteristics","research methodology","Sampling studies","Sex factors","Education","Adolescents","Demographic Factors","Developed Countries","Studies","Surveys","Religion","Adolescent Pregnancy","Mediterranean Countries","Western Asia","Southeastern Asia","Southern Asia","Israel","Kap"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large nationally‑representative survey of Israeli high‑school students (N≈5,000); descriptive statistics on sexual experience, knowledge and attitudes","sample_n":4976,"sample_text":"representative of the age group for the entire country except for religious schools","population":"Israeli adolescents (age 14‑17), both sexes; excluded religious schools (13% of total)","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1978 survey of nearly 5,000 Israeli teens found that sexual activity rises sharply with age, that knowledge about sex is similar to Western countries, and that religious or traditional youths are less sexually active and more conservative. The authors call for comprehensive sex‑education programs.","clinical_takeaway":"Comprehensive, early sex‑education is recommended for adolescents.","confidence":0.4,"topic_tags":["adolescents","sexual_function","masturbation"],"strengths":["Large, nationally‑representative sample","Both sexes and multiple ages covered","Provides baseline data on adolescent sexual knowledge and behaviour"],"limitations":["Likely uses non‑validated, author‑constructed questionnaire","No measurement or control of key confounds (moral incongruence, mental health, etc.)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2105/ajph.68.11.1083"}},{"id":6043,"doi":null,"pmid":"736099","pmcid":null,"title":"Sexual counseling among male and female patients with spinal cord and/or cauda equina injury. Part II. Results of interview and neurological examinations of females","authors":"Comarr AE, Vigue M.","first_author":"Comarr AE","journal":"American journal of physical medicine","year":1978,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6044,"doi":null,"pmid":"568591","pmcid":null,"title":"[Gynecology in children and adolescents]","authors":null,"first_author":null,"journal":"Fortschritte der Medizin","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6045,"doi":"10.1016/s0015-0282(16)43519-3","pmid":"710603","pmcid":null,"title":"Evaluation of a new silastic seminal fluid collection device","authors":"Schoenfeld C, Amelar RD, Dubin L, Skwerers RG.","first_author":"Schoenfeld C","journal":"Fertility and sterility","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"laboratory comparison of collection devices using 50 semen samples; in‑vitro assessment of motility over 4 h","sample_n":50,"sample_text":"50 semen samples","population":"men providing semen samples (n≈50)","country":"USA (presumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A new flexible silicone device for collecting semen was compared with glass jars, latex condoms, and a polyethylene sheath. In lab tests it kept sperm moving longer and gave more accurate volume readings, while users found it more comfortable.","clinical_takeaway":"The Silastic device may improve sperm viability and measurement accuracy during semen collection.","confidence":0.85,"topic_tags":["sexual_function","masturbation","religiosity"],"strengths":["Uses standard laboratory motility assays","Direct within‑sample comparison of multiple devices","Reasonable sample size for in‑vitro test"],"limitations":["No randomisation or blinding reported","No long‑term clinical outcomes","Potential selection bias of participants"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0015-0282(16)43519-3"}},{"id":6046,"doi":"10.1093/geront/18.4.372","pmid":"263483","pmcid":null,"title":"Sexual expression of the elderly in nursing homes","authors":"Kaas MJ.","first_author":"Kaas MJ.","journal":"The Gerontologist","year":1978,"pub_types":["Journal 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cauda equina injury","authors":"Comarr AE, Vigue M.","first_author":"Comarr AE","journal":"American journal of physical medicine","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6048,"doi":"10.1007/bf01542059","pmid":"666569","pmcid":null,"title":"Serum testosterone and sexual activity and interest in men","authors":"Brown WA, Monti PM, Corriveau DP.","first_author":"Brown WA","journal":"Archives of sexual behavior","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":45,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 101 young adult men measuring serum testosterone (two samples) and self‑reported frequencies of sexual activities and interest","sample_n":101,"sample_text":"101 young adult men, homogeneous group","population":"young adult men (likely student or community sample, not specified)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 101 young men, blood levels of testosterone did not predict how often they reported having sex, masturbating, or feeling sexual interest, suggesting normal variations in testosterone do not drive differences in sexual activity.","clinical_takeaway":"Testosterone levels within the normal range are not a reliable indicator of a man's sexual activity or interest.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Objective hormonal measurement with two time points","Relatively large sample for 1978 study","Clear report of null findings"],"limitations":["Self‑report of sexual activity without validated scale","No control for known psychosocial confounds","Cross‑sectional design limits causal 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Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00003081-197803000-00017"}},{"id":6050,"doi":null,"pmid":"697259","pmcid":null,"title":"[Several exhibitionists]","authors":"Biéder J.","first_author":"Biéder J.","journal":"Annales medico-psychologiques","year":1978,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6051,"doi":null,"pmid":"731615","pmcid":null,"title":"An unusual case of strangulation of penis by metal hammer head: (a case report)","authors":"Punekar SV, Shroff PR, Vaze ML.","first_author":"Punekar SV","journal":"Journal of postgraduate medicine","year":1978,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6052,"doi":"10.1080/00926237808403026","pmid":"366158","pmcid":null,"title":"Sex therapy with orthodox Jewish couples","authors":"Ostrov S.","first_author":"Ostrov S.","journal":"Journal of sex & marital therapy","year":1978,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case reports (three clinical illustrations)","sample_n":null,"sample_text":"Three illustrative clinical cases; no systematic sampling reported","population":"Orthodox Jewish couples undergoing sex therapy","country":"Not specified (likely United States)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The paper discusses how Jewish religious rules that ban male masturbation and limit intercourse affect couples’ sexual problems, using three therapy case examples to show that fixing relationship issues is essential for treatment.","clinical_takeaway":"Therapists working with Orthodox couples should address religious and relational factors together, not focus only on sexual techniques.","confidence":0.8,"topic_tags":["religiosity","sexual_function","relationships","csbd"],"strengths":["Integrates cultural and religious context","Provides detailed clinical illustrations"],"limitations":["No systematic data or validated measures","Small, non‑representative sample","Lacks control for key confounds"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926237808403026"}},{"id":6053,"doi":"10.1080/00926237808403009","pmid":"722819","pmcid":null,"title":"A sexual intimacy survey of former nuns and priests","authors":"Halstead MM, Halstead LS.","first_author":"Halstead MM","journal":"Journal of sex & marital therapy","year":1978,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 126 former nuns and priests; anonymous mailed questionnaire; descriptive comparisons with literature and SAR workshop participants.","sample_n":126,"sample_text":"126 respondents, convenience sample via mailed questionnaire.","population":"Former clergy (nuns, priests) who left celibate religious communities, United States.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A 1978 survey of 126 former nuns and priests found they had limited early sexual experience and faced specific sexual problems when re‑entering secular life, highlighting counseling needs.","clinical_takeaway":"Counselors should consider the unique sexual readjustment challenges of former clergy, but evidence is limited and not generalizable.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Rare population studied","National coverage of respondents","Provides baseline data on sexual readjustment"],"limitations":["No validated sexual‑health instruments","Cross‑sectional, no causal inference","Limited control of key confounds (moral, mental health, partner status)"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926237808403009"}},{"id":6054,"doi":null,"pmid":"11610677","pmcid":null,"title":"The priests of the body and masturbatory insanity in the late nineteenth century","authors":"Neuman R.","first_author":"Neuman R.","journal":"The Psychohistory review","year":1978,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6056,"doi":null,"pmid":"742689","pmcid":null,"title":"A review of Freud's writings on adolescence","authors":"Klumpner GH.","first_author":"Klumpner GH.","journal":"Adolescent psychiatry","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6057,"doi":"10.1901/jaba.1978.11-23","pmid":"649527","pmcid":"PMC1311265","title":"An experimental investigation of preorgasmic reconditioning and postorgasmic deconditioning","authors":"Kantorowitz DA.","first_author":"Kantorowitz DA.","journal":"Journal of applied behavior analysis","year":1978,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Within‑subjects conditioning experiment with 8 heterosexual male volunteers (age 18‑23). Three assessment points (baseline, termination, 2‑3 month follow‑up). Eight conditioning sessions pairing erotic slides with phases of the sexual cycle.","sample_n":8,"sample_text":"Eight heterosexual male volunteers (18 to 23 years)","population":"Male university‑age volunteers; small, non‑representative convenience sample","country":"USA (presumed based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In eight young men, erotic pictures shown during different phases of the sexual response were paired with physiological (penile) and subjective reactions. Pictures shown during the plateau phase became more arousing, while those shown during the refractory phase became less arousing, but effects faded after a few months.","clinical_takeaway":"No direct clinical implications; the brief conditioning effects observed are unlikely to translate into lasting treatment effects for sexual concerns.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Physiological measurement of penile tumescence","Longitudinal follow‑up after conditioning","Clear experimental manipulation of stimulus timing"],"limitations":["Very small N (8) limits statistical power","No control for moral, mental‑health or relational variables","Subjective eroticism ratings not validated","Generalizability to broader populations doubtful"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1901/jaba.1978.11-23"}},{"id":6058,"doi":"10.1080/00926237808403013","pmid":"722817","pmcid":null,"title":"Treatment for premature ejaculation through male-only groups","authors":"Zeiss RA, Christensen A, Levine AG.","first_author":"Zeiss RA","journal":"Journal of sex & marital therapy","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"uncontrolled group therapy case series; no comparison group; outcomes described qualitatively","sample_n":null,"sample_text":"Not reported in abstract","population":"couples with premature ejaculation; males attended group, women did home exercises","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article describes a male‑only group therapy for premature ejaculation, where men share what they learn with their partners who then do home exercises. The authors say it worked for most couples, but note it may be less effective than one‑on‑one therapy.","clinical_takeaway":"Group therapy may help some couples with premature ejaculation, but evidence is limited; clinicians should consider individual therapy for those not improving.","confidence":0.6,"topic_tags":["sexual_function","treatment"],"strengths":["Innovative male-only group format","Cost-effective approach described"],"limitations":["No control or comparison group","No quantitative outcome data","Small/unspecified sample size","Potential self‑selection bias"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926237808403013"}},{"id":6059,"doi":"10.1007/bf01541150","pmid":"931623","pmcid":null,"title":"Manifest sadomasochism of males: results of an empirical study","authors":"Spengler A.","first_author":"Spengler A.","journal":"Archives of sexual behavior","year":1977,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Anonymous questionnaire survey of 245 self‑identified sadomasochistic men recruited via club membership and advertisement placements in West Germany (1977).","sample_n":245,"sample_text":"245 participants recruited from sadomasochistic clubs and contact advertisements.","population":"Male adults (middle‑aged) identifying with sadomasochistic practices; convenience sample.","country":"West Germany","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 1977 survey of 245 German men who practice sadomasochism described their sexual roles, orientations, and psychosocial experiences, noting differences in how heterosexual participants could realize their desires compared with bisexual and gay participants.","clinical_takeaway":"Findings are descriptive only; they do not provide evidence for clinical assessment or treatment of sadomasochistic behavior.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for the era","First empirical description of male sadomasochism subcultures","Includes sexual orientation breakdown"],"limitations":["Convenience, non‑representative sampling","Ad‑hoc questionnaire, no validated measures","No control for key confounds (moral incongruence, mental health, partner effects)","Descriptive statistics only, no effect‑size reporting"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":36,"citing_publications":105,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541150"}},{"id":6060,"doi":"10.1007/bf01541154","pmid":"931626","pmcid":null,"title":"Sexual daydreams and quantitative aspects of sexual activity: some relations for males across adulthood","authors":"Giambra LM, Martin CE.","first_author":"Giambra LM","journal":"Archives of sexual behavior","year":1977,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 277 community men aged 24‑91; retrospective interview and questionnaire","sample_n":277,"sample_text":"277 men aged 24–91","population":"adult males, community sample (method of recruitment not described)","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 277 men aged 24‑91, sexual daydreams were measured and linked to past sexual activity. Daydream frequency and intensity fell with age, disappearing after 65, and were positively related to reported sexual vigor up to age 64.","clinical_takeaway":"None – findings describe normal age‑related changes, not clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses a validated daydream inventory","Large age span allows lifespan analysis","Clear quantitative associations reported"],"limitations":["Retrospective self‑report of sexual activity may be biased","No control for key confounds (moral, mental health, partner effects)","Cross‑sectional design limits causal inference","Sampling method unclear, possible selection bias"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541154"}},{"id":6061,"doi":"10.1016/s0091-0279(77)50085-8","pmid":"22153","pmcid":null,"title":"Mating behavior in the cat","authors":"Beaver BV.","first_author":"Beaver BV.","journal":"The Veterinary clinics of North America","year":1977,"pub_types":["Journal 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BV.","first_author":"Beaver BV.","journal":"The Veterinary clinics of North America","year":1977,"pub_types":["Journal 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Razdan JL, Yadav VN.","first_author":"Tiwari VS","journal":"International surgery","year":1977,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6065,"doi":null,"pmid":"21304849","pmcid":"PMC2378798","title":"Helping the middle aged couple with sexual problems","authors":"Still HC.","first_author":"Still HC.","journal":"Canadian family physician Medecin de famille canadien","year":1977,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"research-article (likely descriptive/clinical guidance without empirical data)","sample_n":null,"sample_text":"Not reported – article provides a behavioral counselling approach rather than presenting original data.","population":"middle‑aged couples (clinical context)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article outlines a brief counselling method for family doctors to help middle‑aged couples with sexual difficulties, emphasizing that age‑related changes are normal and that allowing masturbation can reduce guilt.","clinical_takeaway":"Clinicians can use a brief behavioural counselling approach and discuss masturbation openly to alleviate sexual concerns in middle‑aged couples.","confidence":0.6,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Provides practical counselling framework for clinicians","Addresses sexual guilt around masturbation"],"limitations":["No empirical data or outcome evaluation","Outdated (1977) and lacks modern measurement standards","No systematic assessment of confounders"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":6066,"doi":null,"pmid":"10307283","pmcid":null,"title":"Is it licit to obtain semen by self-stimulation for sterility tests of diagnostic purpose?","authors":"Lobo G.","first_author":"Lobo G.","journal":"Medical service","year":1977,"pub_types":["Journal 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Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6068,"doi":"10.1111/j.2044-8341.1977.tb02417.x","pmid":"911695","pmcid":null,"title":"Homosexuality in adolescence","authors":"Glasser M.","first_author":"Glasser M.","journal":"The British journal of medical psychology","year":1977,"pub_types":["Journal 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insulin in serum and seminal plasma of diabetic and nondiabetic men and its role in the regulation of spermatozoal activity","authors":"Paz G, Homonnai ZT, Ayalon D, Cordova T, Kraicer PF.","first_author":"Paz G","journal":"Fertility and sterility","year":1977,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative measurement of insulin and hormones in serum and seminal plasma of diabetic vs non‑diabetic men; split‑ejaculate analysis; in‑vitro sperm assays; 1977 sample size not reported.","sample_n":null,"sample_text":"Not specified in abstract; likely small, convenience sample","population":"Adult men (diabetic and non‑diabetic), fertility clinic setting","country":"Not 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Adding insulin or arginine did not improve sperm function or fertility.","clinical_takeaway":"Insulin levels in semen do not appear to affect sperm quality; arginine supplementation showed no clear benefit for male fertility.","confidence":0.8,"topic_tags":["sexual_function","relationships","religiosity"],"strengths":["Validated biochemical assays for insulin and hormones","Direct in‑vitro testing of sperm function","Clear comparison between diabetic and non‑diabetic men"],"limitations":["Small, unspecified sample size","Cross‑sectional design limits causal inference","No adjustment for potential confounders (age, lifestyle, 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study","authors":"Gruver GG.","first_author":"Gruver GG.","journal":"American journal of psychotherapy","year":1977,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"case-report","design_detail":"single male case, psychodynamic + behavioral treatment, follow‑up reported","sample_n":1,"sample_text":"single case study","population":"1 adult male with functional dyspareunia","country":"United States (presumed)","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1977 case report describes a man with functional painful intercourse (dyspareunia) who improved after combined psychodynamic and behavioral therapy.","clinical_takeaway":"Multimodal psychodynamic‑behavioral therapy may alleviate functional dyspareunia in men, but evidence is limited to a single case.","confidence":0.3,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Detailed narrative of treatment process","Integrates psychodynamic and behavioral approaches"],"limitations":["Single case, no control","No validated outcome measures reported","No systematic assessment of confounds"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.psychotherapy.1977.31.3.450"}},{"id":6073,"doi":"10.1016/s0095-4543(21)00733-8","pmid":"586720","pmcid":null,"title":"Sexual counseling and interviewing of adolescents","authors":"Rosenthal MB.","first_author":"Rosenthal MB.","journal":"Primary care","year":1977,"pub_types":["Journal Article","Case 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elderly","authors":"Glover BH.","first_author":"Glover BH.","journal":"Hospital practice","year":1977,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"commentary","design_detail":"Commentary / expert opinion without empirical data.","sample_n":null,"sample_text":"Not applicable – article provides expert commentary, no participants reported.","population":"Elderly patients (unspecified)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that a caring, non‑judgmental sexual counseling approach can uncover hidden health complaints in older adults and improve their quality of life.","clinical_takeaway":"Consider offering open, supportive sexual counseling to elderly patients presenting with vague health concerns.","confidence":0.3,"topic_tags":["csbd","sexual_function"],"strengths":["Provides a holistic, non‑judgmental view of sexual health in older adults","Highlights counseling as a route to improve quality of life"],"limitations":["No empirical data; purely opinion piece","No description of methods, sample, or outcomes","Cannot assess effectiveness of counseling 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L.","first_author":"Bussi L.","journal":"Minerva medica","year":1977,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ita","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6078,"doi":"10.1007/bf01541130","pmid":"869709","pmcid":null,"title":"Can fetishism occur in transsexuals?","authors":"Buhrich N, McConaghy N.","first_author":"Buhrich 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women’s clothing, suggesting that fetishism can co‑occur with a trans‑gender identity and that current diagnostic categories may not fully capture this combination.","clinical_takeaway":"Clinicians should be aware that fetishistic interests may be present in trans patients, but data are limited and not predictive of outcomes.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Rare early documentation of fetishism in transsexual population","Provides descriptive clinical details","Raises taxonomic questions"],"limitations":["Very small, non‑representative sample","No validated measures of fetishism or gender identity","No control for moral, mental‑health or relational confounds","Descriptive only; no statistical testing"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541130"}},{"id":6079,"doi":"10.3109/02770907709104184","pmid":"561779","pmcid":null,"title":"Reassociation of dreams. III. LSD analysis of a threatening male-female dog dream and its relation to fear of lesbianism","authors":"Abramson HA.","first_author":"Abramson HA.","journal":"The Journal of asthma research","year":1977,"pub_types":["Journal 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elderly","authors":"Shearer MR, Shearer ML.","first_author":"Shearer MR","journal":"Clinical obstetrics and gynecology","year":1977,"pub_types":["Journal 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education","authors":"Carmichael J, Tanner L, Carmichael L.","first_author":"Carmichael J","journal":"Medical education","year":1977,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"pre‑post single‑group study of 96 second‑year medical students","sample_n":96,"sample_text":"96 second‑year medical students completed pre‑ and post‑course attitude measures","population":"second‑year medical students (US)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A five‑day sexuality course for medical students significantly shifted their attitudes toward sexuality topics, especially homosexuality, as measured by a semantic differential questionnaire before and after the course.","clinical_takeaway":"Brief, structured sexuality education can positively change medical student attitudes toward sexual health topics.","confidence":0.7,"topic_tags":["sexual_function","masturbation"],"strengths":["Reasonable sample size for pre‑post design","Use of established semantic differential method","Clear statistical significance reported"],"limitations":["No validated attitude measure specific to sexuality constructs","Single‑group, no control condition limits causal inference","No assessment of potential confounds (e.g., moral or mental‑health factors)","Effect sizes and confidence intervals not reported"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2923.1977.tb00571.x"}},{"id":6082,"doi":"10.1097/00006842-197703000-00009","pmid":"847081","pmcid":null,"title":"Plasma noradrenaline and dopamine-beta-hydroxylase during sexual activity","authors":"Wiedeking C, Lake CR, Ziegler M, Kowarski AA, Money J.","first_author":"Wiedeking C","journal":"Psychosomatic medicine","year":1977,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal 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Occupational exposures and high animal‑fat diets were also more common in the cancer group.","clinical_takeaway":"No direct clinical guidance; findings are outdated and limited by methodological weaknesses.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Matched control design","Consideration of multiple lifestyle variables"],"limitations":["Very small/unstated sample size","Unvalidated self‑report measures of sexuality","No adjustment for key confounds (e.g., mental health, religiosity)","Interpretation may overstate causal implications"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":6084,"doi":null,"pmid":"594220","pmcid":null,"title":"[Changes in the investment of the body: conversion symptoms during puberty]","authors":"Cramer B.","first_author":"Cramer B.","journal":"La Psychiatrie de l'enfant","year":1977,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6085,"doi":"10.1080/00926237708402991","pmid":"73595","pmcid":null,"title":"Strategies and techniques for the reduction of sexual anxiety","authors":"McCarthy BW.","first_author":"McCarthy BW.","journal":"Journal of sex & marital therapy","year":1977,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary / clinical guide without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article outlines 14 different therapy techniques—like bibliotherapy, relaxation, and guided masturbation—to help reduce sexual anxiety in individuals or couples.","clinical_takeaway":"Clinicians can consider these techniques as possible tools for treating sexual anxiety, but effectiveness has not been tested.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Provides a comprehensive list of techniques for clinicians","Integrates both individual and couple therapy approaches"],"limitations":["No empirical data or outcome evaluation","No measurement of effectiveness or control of confounds","Outdated terminology and methods (1977)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926237708402991"}},{"id":6086,"doi":null,"pmid":"144578","pmcid":null,"title":"Koro in a Yemenite and a Georgian Jewish Immigrant","authors":"Hes JP, Nassi G.","first_author":"Hes JP","journal":"Confinia psychiatrica. Borderland of psychiatry. Grenzgebiete der Psychiatrie. Les Confins de la psychiatrie","year":1977,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of two individuals with Koro syndrome","sample_n":2,"sample_text":"Two case descriptions","population":"Yemenite and Georgian Jewish immigrant men in Israel","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article describes two men, immigrants to Israel, who experienced Koro—a fear that the penis will retract into the abdomen and cause death—an otherwise rare syndrome outside Southeast Asia.","clinical_takeaway":"Koro can appear in diverse cultural groups; clinicians should consider cultural explanations for genital anxiety.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Provides rare clinical description of Koro outside typical regions","Highlights cultural context of immigrant groups"],"limitations":["Very small sample (n=2) limits any inference","No systematic measurement or standardized assessment","No controls for potential confounding factors"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":6087,"doi":null,"pmid":"847049","pmcid":null,"title":"[Case of symptomatic sexual inversion at an early stage of schizophrenia]","authors":"Perzyński J.","first_author":"Perzyński J.","journal":"Psychiatria polska","year":1977,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"pol","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6088,"doi":"10.1080/21674086.1977.11926816","pmid":"918233","pmcid":null,"title":"Micropsia and testicular retractions","authors":"Myers WA.","first_author":"Myers WA.","journal":"The Psychoanalytic quarterly","year":1977,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of a single adult male describing five episodes of micropsia linked to oedipal masturbatory fantasies. No systematic data collection, no control group.","sample_n":1,"sample_text":"Single adult male patient described in detail.","population":"Adult male (single case)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The author describes five episodes where a man's visual perception shrank (micropsia) during fantasies about Oedipal sexual themes. The paper suggests these episodes defend against castration anxiety and reflect a regression to earlier developmental stages.","clinical_takeaway":"None – the case is theoretical and not evidence‑based for clinical practice.","confidence":0.7,"topic_tags":["masturbation","sexual_function","pornography"],"strengths":["In‑depth psychoanalytic narrative","Historical perspective on unconscious fantasy","Integration of visual perception phenomena"],"limitations":["Single case, no generalisable data","No quantitative measures or validated scales","No control for confounding variables","Interpretations are speculative and not empirically testable"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/21674086.1977.11926816"}},{"id":6089,"doi":null,"pmid":"586144","pmcid":null,"title":"Sexuality in a healthcare setting","authors":"Downey GW.","first_author":"Downey GW.","journal":"The Australasian nurses journal","year":1977,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6090,"doi":null,"pmid":"868620","pmcid":null,"title":"Idiopathic pubertal delay beyond age fifteen: psychologic study of twelve boys","authors":"Lewis VG, Money J, Bobrow NA.","first_author":"Lewis VG","journal":"Adolescence","year":1977,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6091,"doi":null,"pmid":"17093652","pmcid":null,"title":"[Sexuality, psychiatric institution and normalization of the mentally ill.]","authors":"Dupras A.","first_author":"Dupras A.","journal":"Sante mentale au Quebec","year":1977,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary / historical analysis, no empirical data","sample_n":null,"sample_text":"N/A – article provides no empirical sample","population":"none","country":"Canada (Quebec)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how psychiatric institutions and schools historically controlled sexuality, especially masturbation, framing it as a symptom to be eliminated. It argues that current practices still treat sexuality mainly for therapeutic utility rather than personal enjoyment.","clinical_takeaway":"None - the paper offers historical commentary, not clinical evidence.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Provides historical context for institutional attitudes toward sexuality","Highlights moral and normative frameworks influencing treatment"],"limitations":["No empirical data or systematic methodology","No measurement of constructs, outcomes, or confounds","Conclusions are speculative and not testable"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":6092,"doi":"10.1093/jhmas/xxxii.1.55","pmid":"319146","pmcid":null,"title":"Equal treatment for all: American medical remedies for male sexual problems: 1850-1900","authors":"Parsons GP.","first_author":"Parsons GP.","journal":"Journal of the history of medicine and allied sciences","year":1977,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jhmas/xxxii.1.55"}},{"id":6093,"doi":null,"pmid":"606944","pmcid":null,"title":"[Case of a foreign body (a screwdriver) pushed into the rectum via the anus and removed by laparotomy]","authors":"Gruev I, Kapitanova K.","first_author":"Gruev I","journal":"Khirurgiia","year":1977,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"bul","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6094,"doi":null,"pmid":"1010775","pmcid":null,"title":"Sexuality and prostatitis: a hypothesis","authors":"Drach GW.","first_author":"Drach GW.","journal":"Journal of the American Venereal Disease Association","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"hypothesis paper proposing a mechanistic link between sexual activity and prostatitis without original data","sample_n":null,"sample_text":"none (hypothesis article)","population":"humans (general male population, no specific sample)","country":"USA (journal of American Venereal Disease Association)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The author hypothesises that bacteria can reach the prostate mainly by moving backward through the urethra during oral, anal, genital sex or masturbation, suggesting this may cause most prostatitis cases.","clinical_takeaway":"No direct clinical guidance; the idea is speculative and needs empirical testing.","confidence":0.4,"topic_tags":["sexual_function","gender"],"strengths":["Raises a plausible biological hypothesis linking sexual activity to prostatitis","Cites indirect evidence from prior clinical observations"],"limitations":["No original empirical data or systematic review","No measurement of key variables (sexual practices, bacterial cultures) within the study","Speculative conclusions not supported by presented evidence"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":6095,"doi":null,"pmid":"1025221","pmcid":null,"title":"Strangulation of penis by metal ring","authors":"Chakrabarty PB, Das BK.","first_author":"Chakrabarty PB","journal":"Journal of the Indian Medical Association","year":1976,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6096,"doi":null,"pmid":"1015568","pmcid":null,"title":"[Relationship between the spermogram and the means of obtaining sperm]","authors":"Akunts KB.","first_author":"Akunts KB.","journal":"Akusherstvo i ginekologiia","year":1976,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"rus","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6097,"doi":null,"pmid":"1006883","pmcid":null,"title":"[Foreign bodies in the bladder in children]","authors":"Kushch NL, Litovka VK.","first_author":"Kushch NL","journal":"Urologiia i nefrologiia","year":1976,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"rus","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6099,"doi":"10.1111/j.1939-0025.1976.tb00967.x","pmid":"998746","pmcid":null,"title":"Sexual attitudes and behavior patterns in a middle-class adolescent population","authors":"Chess S, Thomas A, Cameron M.","first_author":"Chess S","journal":"The American journal of orthopsychiatry","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"longitudinal cohort following adolescents from infancy; sample size not reported in abstract","sample_n":null,"sample_text":"not specified in abstract","population":"middle‑class adolescents (USA, 1970s)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1976 study followed a group of middle‑class adolescents from infancy and described their sexual attitudes and behaviours. The youths appeared less fearful about sex than older generations but were not more likely to have casual sex. Sexual conflicts seemed linked to broader psychological distress.","clinical_takeaway":"None – the study is descriptive and does not provide actionable clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Longitudinal design provides temporal perspective","Includes both attitudes and reported behaviours","Historical comparison with previous generations"],"limitations":["No reported use of validated questionnaires","Sample size and representativeness unclear","Key confounders (moral views, mental health, partner effects) not addressed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1939-0025.1976.tb00967.x"}},{"id":6100,"doi":"10.1007/bf01541337","pmid":"985062","pmcid":null,"title":"Cross-species comparisons and the human heritage","authors":"Beach FA.","first_author":"Beach FA.","journal":"Archives of sexual behavior","year":1976,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541337"}},{"id":6101,"doi":"10.1007/bf01541331","pmid":"985056","pmcid":null,"title":"Sexual behavior in Japanese students: comparisons for 1974, 1960, and 1952","authors":"Asayama S.","first_author":"Asayama S.","journal":"Archives of sexual behavior","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541331"}},{"id":6103,"doi":"10.1016/s0015-0282(16)42014-5","pmid":"133824","pmcid":null,"title":"Importance of controlled liquefaction periods for valid steroid assays in human seminal plasma","authors":"Purvis K, Saksena SK, Landgren BM, Cekan SZ, Diczfalusy ER.","first_author":"Purvis K","journal":"Fertility and sterility","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory validation of steroid assay handling; cross‑sectional measurement of seminal plasma after controlled liquefaction periods.","sample_n":null,"sample_text":"Not stated in abstract.","population":"Male volunteers providing ejaculate samples; exact N not reported in abstract.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study shows that letting seminal plasma sit at room temperature for too long changes steroid levels; freezing within 30 minutes after ejaculation avoids these artefacts. Collecting samples by masturbation on site keeps the waiting period short.","clinical_takeaway":"For accurate hormone testing in semen, collect ejaculate by on‑site masturbation and freeze within 30 min.","confidence":0.6,"topic_tags":["sexual_function","religiosity","moral_incongruence","masturbation"],"strengths":["Clear laboratory protocol for sample handling","Relevant for hormonal assay reliability"],"limitations":["No participant demographics reported","Small or unspecified sample size","Findings limited to assay conditions, not to sexual health outcomes"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":4,"confounds":9,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0015-0282(16)42014-5"}},{"id":6104,"doi":"10.1097/00005053-197607000-00001","pmid":"778342","pmcid":null,"title":"Venery, the spinal cord, and tabes dorsalis before Romberg: the contribution of Ernst Horn","authors":"Schiller F.","first_author":"Schiller F.","journal":"The Journal of nervous and mental disease","year":1976,"pub_types":["Historical Article","Biography","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"historical analysis, no empirical data","sample_n":null,"sample_text":"Not applicable – no primary participants","population":"historical patients and dissertations (19th‑century Germany)","country":"Germany (historical)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews 19th‑century German dissertations that linked spinal‑cord disease (tabes dorsalis) with male sexual activity, highlighting how moral concerns shaped early medical theories.","clinical_takeaway":"None – the work is historical and does not inform current clinical practice.","confidence":0.7,"topic_tags":["sexual_function","masturbation","neuroscience","treatment"],"strengths":["Provides detailed historical context","Links early neurology with sexual health narratives"],"limitations":["No original data or empirical analysis","Findings not generalizable to contemporary populations"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00005053-197607000-00001"}},{"id":6105,"doi":null,"pmid":"934642","pmcid":null,"title":"[Letter: Abuse of hallucinogenic drugs or increasing autoerotic activity?]","authors":"Cseh I.","first_author":"Cseh I.","journal":"Orvosi hetilap","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"hun","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6106,"doi":null,"pmid":"1046627","pmcid":null,"title":"Sexuality and the middle-aged cardiac patient","authors":"Watts RJ.","first_author":"Watts RJ.","journal":"The Nursing clinics of North America","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"No empirical sample; author reports observations and synthesises prior research.","population":"middle‑aged cardiac patients and their partners","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that counseling about sex should be a routine part of cardiac rehab, noting that sex’s energy cost is modest and that psychosocial stressors may trigger heart events. It suggests couples practice non‑coital intimacy before returning to intercourse.","clinical_takeaway":"Include tailored sexual counseling in cardiac rehab, emphasizing low cardiovascular risk of sex and addressing stressors that could provoke events.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Provides practical counseling considerations for cardiac rehabilitation.","Integrates physiological and psychosocial aspects of sexual activity."],"limitations":["No original data; relies on author observation and prior literature.","Lacks systematic methodology, risk‑of‑bias assessment, and empirical validation.","Outdated (1976) and may not reflect current cardiac or sexual‑health guidelines."],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":6107,"doi":null,"pmid":"5656","pmcid":null,"title":"Sexuality in a healthcare setting","authors":"Downey GW.","first_author":"Downey GW.","journal":"Modern healthcare. [Short-term care ed.]","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6108,"doi":"10.1007/bf01541375","pmid":"986133","pmcid":null,"title":"Group therapy for nonorgasmic women: two age levels","authors":"Schneidman B, McGuire L.","first_author":"Schneidman B","journal":"Archives of sexual behavior","year":1976,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pre‑post group therapy intervention with two age cohorts (n=10 each), no randomisation or control group","sample_n":20,"sample_text":"ten women below 35 years, ten women above 35 years","population":"women with primary orgasmic dysfunction","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small group therapy program helped many younger women with orgasm problems regain orgasmic ability, but was less effective for older women. Benefits for the couples' sexual relationship were reported.","clinical_takeaway":"Group therapy may aid younger women with primary orgasmic dysfunction, but older women might need individualized treatment.","confidence":0.7,"topic_tags":["sexual_function","gender","treatment"],"strengths":["Focused therapeutic protocol blending behavioral and self‑stimulation methods","Follow‑up data at 6 months"],"limitations":["Very small, non‑randomised sample","No control or comparison condition","Limited reporting of outcome measures and statistical analysis"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":4,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541375"}},{"id":6109,"doi":"10.1080/00224497609550926","pmid":"950780","pmcid":null,"title":"The concern for health in sexual matters in the \"old society\" and \"new society\" in China","authors":"Edwards JW.","first_author":"Edwards JW.","journal":"Journal of sex research","year":1976,"pub_types":["Journal Article"],"keywords":["China","Behavior","Asia","Contraception","Eastern Asia","Sex behavior","Family Planning","Economic Factors","Socioeconomic Factors","Developing Countries"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":1,"mentioning":2,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224497609550926"}},{"id":6110,"doi":null,"pmid":"957810","pmcid":null,"title":"Sexual behavior in schizophrenia","authors":"Skopec HM, Rosenberg SD, Tucker GJ.","first_author":"Skopec HM","journal":"Medical aspects of human sexuality","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6111,"doi":"10.1097/00005053-197604000-00005","pmid":"943472","pmcid":null,"title":"Female responsiveness to erotic films and the \"ideal\" erotic film from a feminine perspective","authors":"Steele DG, Walker CE.","first_author":"Steele DG","journal":"The Journal of nervous and mental disease","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Experimental rating of erotic films with 20 female undergraduate volunteers; random order of stimuli; individual testing.","sample_n":20,"sample_text":"Convenience sample of volunteers from a single university; not representative of broader population.","population":"Female undergraduate students, age 21+, living off‑campus, N=20","country":"USA (presumed from journal and university context)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Twenty female university students watched seven short erotic films and rated how sexually aroused they felt. They liked heterosexual scenes most and were less aroused by male‑male scenes. Attitudes toward sex myths and acceptance of extramarital relations were linked to these arousal ratings.","clinical_takeaway":"None – the study only describes arousal preferences in a small student sample, not clinical outcomes.","confidence":0.6,"topic_tags":["sexual_function","pornography"],"strengths":["Randomized film order","Use of a structured interview","Some validated attitude questionnaire"],"limitations":["Very small, non‑representative sample (N=20)","No control for moral, mental‑health or relational confounds","Reliance on single‑item arousal ratings"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00005053-197604000-00005"}},{"id":6113,"doi":"10.1007/bf01541871","pmid":"1275690","pmcid":null,"title":"Personality correlates of male sexual arousal and behavior","authors":"Husted JR, Edwards AE.","first_author":"Husted JR","journal":"Archives of sexual behavior","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional correlational study with daily self‑recorded sexual behavior","sample_n":20,"sample_text":"convenience volunteer sample","population":"20 male volunteers, ages 19‑58, with long‑term sexual relationships","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 20 men, personality traits measured with the MMPI and Sensation‑Seeking Scale were linked to how often they masturbated and their level of arousal, but not to sex with partners. Introversion and depression were related to more autoerotic activity, while boredom‑susceptibility predicted more sexual partners.","clinical_takeaway":"Personality factors may influence masturbation frequency, but evidence is limited by a tiny sample.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["Use of validated personality instruments (MMPI, SSS)","Separate recording of autoerotic vs heterosexual activity","Daily behavior diary provides fine‑grained frequency data"],"limitations":["Very small sample (N=20) limits statistical power","No control for moral, relational or mental‑health confounds","Convenience volunteer recruitment limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541871"}},{"id":6114,"doi":"10.1300/j082v02n01_04","pmid":"1018108","pmcid":null,"title":"Homophobia: the quest for a valid scale","authors":"Lumby ME.","first_author":"Lumby ME.","journal":"Journal of homosexuality","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative survey of 60 homosexual and 60 heterosexual Caucasian, middle‑class males; modified Smith homophobia scale examined; Guttman scalogram criteria not met.","sample_n":120,"sample_text":"60 homosexual and 60 heterosexual participants","population":"Adult males, Caucasian, middle‑class, self‑identified sexual orientation","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study tested a modified homophobia questionnaire on 60 gay and 60 straight white men, finding that the scale did not meet basic psychometric standards but that the groups differed in liberal attitudes toward masturbation and other sexual topics.","clinical_takeaway":"None – the research does not provide usable clinical information about sexual health or behaviour.","confidence":0.78,"topic_tags":["measurement","sexual_function"],"strengths":["Direct comparison of two clearly defined groups","Attempts to validate an existing attitude scale"],"limitations":["Scale fails basic psychometric criteria","Small, non‑representative convenience sample","No control for relevant confounds"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j082v02n01_04"}},{"id":6115,"doi":"10.1177/002076407602200310","pmid":"1010698","pmcid":null,"title":"To be or not to be--that is the question to be yourself or not to be yourself","authors":"Bierer J.","first_author":"Bierer J.","journal":"The International journal of social psychiatry","year":1976,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/002076407602200310"}},{"id":6116,"doi":"10.1007/bf01542239","pmid":"1259553","pmcid":null,"title":"Formal and informal sex education as determinants of premarital sexual behavior","authors":"Spanier GB.","first_author":"Spanier GB.","journal":"Archives of sexual behavior","year":1976,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["masturbation","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"National probability sample of 1177 college students; face‑to‑face interviews; cross‑sectional analysis using Automatic Interaction Detector.","sample_n":1177,"sample_text":"National probability sample of 1177 college students.","population":"College students in the United States (approx. equal male/female).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a 1976 survey of 1,177 U.S. college students, informal sex‑education (parents, peers, media) predicted premarital sexual activity more than formal classroom instruction, while current pressures had the strongest influence.","clinical_takeaway":"Sex education programs should consider informal influences and peer pressures when addressing young adults’ sexual behavior.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Broad range of sex‑education and background variables","Use of a composite, Guttman‑scaled outcome measure"],"limitations":["Reliance on ad‑hoc self‑report scales without established validation","Cross‑sectional design limits causal inference","Limited control for mental‑health and partner variables"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542239"}},{"id":6117,"doi":"10.1080/21674086.1976.11926742","pmid":"942796","pmcid":null,"title":"Clinging-going-in-search. A contrasting pair of instincts and their relation to sadism and masochism","authors":"Hermann I.","first_author":"Hermann I.","journal":"The Psychoanalytic quarterly","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/21674086.1976.11926742"}},{"id":6118,"doi":null,"pmid":"803147","pmcid":null,"title":"Sleep orgasm in women","authors":"Heiman M.","first_author":"Heiman M.","journal":"Journal of the American Psychoanalytic Association","year":1976,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"One woman (case report)","population":"single adult woman (n=1)","country":"Unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes an observation of a single woman experiencing orgasm during sleep and suggests that early infant genital sensations may arise from an internal 'resonance' during nursing, proposing categories of orgasm types.","clinical_takeaway":"No direct clinical implications; the report is speculative and based on a single case.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Innovative clinical observation","Explicitly acknowledges speculative nature"],"limitations":["Single case, no systematic data","No empirical measurement or controls","Psychoanalytic speculation without testable hypotheses"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":6119,"doi":"10.1080/00926237608402969","pmid":"978755","pmcid":null,"title":"Primary orgasmic dysfunction: essential treatment components","authors":"Segraves RT.","first_author":"Segraves RT.","journal":"Journal of sex & marital therapy","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of treatment approaches for primary orgasmic dysfunction; no empirical data presented.","sample_n":null,"sample_text":"No original sample; review of existing studies.","population":"Adults with primary orgasmic dysfunction (unspecified)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews several therapy programs for people who cannot reach orgasm, noting that all successful methods use graded exposure to sexual cues plus interpersonal skills training.","clinical_takeaway":"Therapists may consider combining exposure to sexual stimuli with directive psychotherapy to treat primary orgasmic dysfunction.","confidence":0.7,"topic_tags":["sexual_function","treatment"],"strengths":["Synthesizes multiple treatment approaches","Identifies common components across programs"],"limitations":["No original data; relies on secondary reports","Lacks systematic review methodology","No quality appraisal of cited studies"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926237608402969"}},{"id":6120,"doi":"10.2190/gf4h-kb50-5yfw-gg8x","pmid":"1052121","pmcid":null,"title":"The so-called \"inappropriate\" psychiatric consultation request on a medical or surgical ward","authors":"Kucharski A, Groves JE.","first_author":"Kucharski A","journal":"International journal of psychiatry in medicine","year":1976,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of seven psychiatric consultation requests on medical/surgical wards","sample_n":7,"sample_text":"Seven cases","population":"hospital staff and patients (7 cases)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors review seven hospital cases where staff requested psychiatric consults that seemed inappropriate. They argue the requests reflected staff’s own unconscious conflicts—fear, shame, anger—triggered by patients displaying serious illness or public sexual behavior, rather than patient pathology.","clinical_takeaway":"Clinicians should consider staff’s emotional reactions as possible contributors to perceived consultation needs, especially when patient behavior (e.g., public sexual acts) evokes shame or fear.","confidence":0.65,"topic_tags":["sexual_function","masturbation"],"strengths":["Detailed clinical description of staff‑patient dynamics","Highlights psychodynamic factors in consultation requests"],"limitations":["Very small, non‑representative case series","No systematic measurement of variables","No quantitative analysis or control for confounds"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2190/gf4h-kb50-5yfw-gg8x"}},{"id":6121,"doi":null,"pmid":"965162","pmcid":null,"title":"Freud and female sexuality. A current view","authors":"Moore BE.","first_author":"Moore BE.","journal":"The International journal of psycho-analysis","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6122,"doi":"10.1176/appi.psychotherapy.1976.30.1.85","pmid":"943959","pmcid":null,"title":"Ejaculatio retardata. Conventional psychotherapy and sex therapy in a severe obsessive-compulsive disorder","authors":"Gagliardi FA.","first_author":"Gagliardi FA.","journal":"American journal of psychotherapy","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case study of one OCD patient with delayed ejaculation; no control group; narrative outcome description","sample_n":1,"sample_text":"one patient","population":"adult male with obsessive‑compulsive disorder","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"A single man with obsessive‑compulsive disorder received analytic psychotherapy and later brief sex‑therapy, which the author reports resolved his long‑standing delayed ejaculation.","clinical_takeaway":"Evidence is anecdotal; clinicians should not rely on this report to guide treatment of ejaculatory dysfunction.","confidence":0.2,"topic_tags":["sexual_function","csbd","pornography"],"strengths":["Detailed clinical narrative","Long‑term follow‑up (19 years)","Illustrates combination of analytic and sex therapy"],"limitations":["N = 1, no generalisability","No validated outcome measures","No control for confounding factors (e.g., mood, relationship)","Outdated therapeutic framework"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.psychotherapy.1976.30.1.85"}},{"id":6123,"doi":null,"pmid":"1196614","pmcid":null,"title":"[Penis strangulation by a metal ring]","authors":"Géczy I, Géczy M.","first_author":"Géczy I","journal":"Orvosi hetilap","year":1975,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"hun","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6124,"doi":null,"pmid":"132850","pmcid":null,"title":"[Various sexuality problems of juveniles]","authors":"Hesse PG.","first_author":"Hesse PG.","journal":"Arztliche Jugendkunde","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6125,"doi":"10.1677/joe.0.0670179","pmid":"1107462","pmcid":null,"title":"Endocrine changes in male sexual deviants after treatment with anti-androgens, oestrogens or tranquillizers","authors":"Murray MA, Bancroft JH, Anderson DC, Tennent TG, Carr PJ.","first_author":"Murray MA","journal":"The Journal of endocrinology","year":1975,"pub_types":["Controlled Clinical Trial","Comparative Study","Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Controlled clinical trial with two parallel drug comparison groups, each n≈12 male sexual offenders in a special hospital. Non‑randomised, small sample, limited generalisability.","sample_n":24,"sample_text":"Two groups of 12 male sexual offenders each.","population":"Male sexual offenders (adult, middle‑aged), n≈24 total.","country":"United Kingdom (presumed from authors’ affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 24 male sexual offenders, anti‑androgen, estrogen and tranquiliser drugs produced different hormone changes, but all led to similar observed behavioural changes, despite the small, non‑randomised sample.","clinical_takeaway":"Hormonal effects of these drugs differ, yet behavioural outcomes were similar; evidence is too limited to guide clinical use.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Direct hormonal measurements","Comparison of multiple pharmacologic agents","Use of placebo control in first arm"],"limitations":["Very small sample size (N≈12 per arm)","Behavioural outcomes not operationalised with validated scales","No control for moral, mental‑health or relationship confounds","Unclear randomisation and blinding"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1677/joe.0.0670179"}},{"id":6126,"doi":null,"pmid":"1222845","pmcid":null,"title":"[Erotic biology of the vagina]","authors":"Zwang G.","first_author":"Zwang G.","journal":"Contraception, fertilite, sexualite","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6127,"doi":null,"pmid":"1224817","pmcid":null,"title":"[Chronic psychogenic urinary retention]","authors":"Mester H.","first_author":"Mester H.","journal":"Zeitschrift fur Psychosomatische Medizin und Psychoanalyse","year":1975,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with chronic psychogenic urinary retention; no systematic sampling; descriptive narrative only.","sample_n":1,"sample_text":"N=1 (case report)","population":"adult male and female (unspecified number, likely 1)","country":"unspecified (likely Germany)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1975 case report describes a patient with chronic urinary retention that could not be explained medically and was attributed to unresolved sexual and emotional conflicts.","clinical_takeaway":"When urinary retention lacks an organic cause, clinicians should assess psychological and sexual factors, but evidence from this single case is insufficient for clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","masturbation","moral_incongruence"],"strengths":["Provides a detailed clinical description of a rare psychogenic condition","Highlights the need to consider psychological factors in unexplained urinary retention"],"limitations":["Single‑case design; no generalisable data","No validated measurement tools or objective outcomes reported","No statistical analysis or control for confounding variables","Interpretation extends beyond the data presented"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":6128,"doi":null,"pmid":"1243978","pmcid":null,"title":"[Knowledge and opinions on sexuality among young French-speaking Belgians]","authors":"Rucquoy G, Descy J, Bouckaert A, Appelmans C, Wauty-Dancot MC.","first_author":"Rucquoy G","journal":"Acta psychiatrica Belgica","year":1975,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of university, technical school, and army recruits (N≈3,580).","sample_n":3580,"sample_text":"1210 university students, 773 A1 official teaching, 819 A1 free non‑university, 778 army recruits","population":"young French‑speaking Belgians (students & army recruits)","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of over 3,500 Belgian students and army recruits measured how much they know about sexuality and their attitudes. University and technical‑school students scored higher on vocabulary and contraception knowledge than army recruits, with religious education appearing to influence scores.","clinical_takeaway":"None – the study reports descriptive knowledge levels, not clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large total sample across several educational settings","Provides baseline data on sexuality knowledge in a specific population","Compares multiple educational sub‑groups"],"limitations":["Questionnaire appears ad‑hoc with unclear validation","Cross‑sectional design limits causal inference","Key confounds (moral/religiosity, mental health, masturbation) not measured"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":6129,"doi":null,"pmid":"1163563","pmcid":null,"title":"Sex knowledge and attitudes of moderately retarded males","authors":"Edmonson B, Wish J.","first_author":"Edmonson B","journal":"American journal of mental deficiency","year":1975,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative study using semi‑structured interviews with 18 moderately retarded males; cross‑sectional assessment of sexual knowledge.","sample_n":18,"sample_text":"18 participants","population":"moderately retarded adult males (N=18) in deinstitutional training program","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In interviews with 18 men who have moderate intellectual disabilities, researchers found very low levels of understanding about sexual topics such as masturbation, dating, and pregnancy, with performance linked to IQ and adaptive skills.","clinical_takeaway":"Clients with moderate intellectual disability may need highly tailored sexual education; low comprehension is common.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Direct assessment of sexual knowledge in an under‑studied population","Correlation with established cognitive and adaptive scales"],"limitations":["Very small, non‑representative sample","Ad‑hoc knowledge items lacking validation","No control for major confounds (e.g., moral views, mental health)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":6131,"doi":"10.1016/s0031-3955(16)33176-5","pmid":"1101177","pmcid":null,"title":"Common sexual problems of children and adolescents","authors":"Satterfield S.","first_author":"Satterfield S.","journal":"Pediatric clinics of North America","year":1975,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article without empirical data; narrative summary of clinical observations and recommendations.","sample_n":null,"sample_text":"Not applicable – narrative review.","population":"Children and adolescents (clinical context)","country":"United States (inferred from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article offers a narrative guide for pediatricians on recognizing and addressing sexual issues in children and teens, stressing family context, trust, and clinician self‑awareness.","clinical_takeaway":"Clinicians should assess sexual concerns within family and developmental context and maintain a non‑judgmental stance.","confidence":0.7,"topic_tags":["sexual_function","adolescents","pornography","masturbation"],"strengths":["Broad clinical overview of pediatric sexual concerns","Emphasizes non‑judgmental, family‑centred approach","Highlights importance of clinician self‑awareness"],"limitations":["No empirical data or systematic methodology","Outdated (1975) terminology and cultural context","Lacks measurement validation or quantitative analysis"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":3,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0031-3955(16)33176-5"}},{"id":6132,"doi":"10.1080/00325481.1975.11714100","pmid":"1153368","pmcid":null,"title":"Sexual counseling. What the busy physician can, and cannot, do","authors":"Levitt EE.","first_author":"Levitt EE.","journal":"Postgraduate medicine","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"non‑empirical guidance for primary‑care physicians on sexual counseling; no data collection, no sample.","sample_n":null,"sample_text":"Not applicable – article is a narrative discussion, not a study.","population":"physicians/clinicians (target audience); no participants studied","country":"USA (inferred from journal, not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article gives doctors quick tips on how to recognize and initially manage common sexual problems—like erectile issues, premature ejaculation, and female anorgasmia—before deciding whether to refer patients elsewhere.","clinical_takeaway":"Use simple counseling, foreplay, and behavioral techniques as first‑line steps for many sexual concerns; refer only when basic measures fail.","confidence":0.4,"topic_tags":["sexual_function","csbd"],"strengths":["Provides practical, historically relevant advice for busy physicians.","Covers a range of common sexual dysfunctions (impotence, premature ejaculation, anorgasmia)."],"limitations":["No empirical data; claims not supported by systematic evidence.","Outdated (1975) clinical recommendations may not reflect current best practice.","Lacks measurement of key confounds (moral, mental‑health, partner factors)."],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00325481.1975.11714100"}},{"id":6133,"doi":"10.1080/00325481.1975.11714102","pmid":"125415","pmcid":null,"title":"Sexual conseling of the physically disabled","authors":"Anderson TP, Cole TM.","first_author":"Anderson TP","journal":"Postgraduate medicine","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Journal article offering clinical guidance without original data; no sample reported; no empirical methodology.","sample_n":null,"sample_text":"Not applicable – article provides expert commentary, no participants.","population":"Adults with acquired physical disability (spinal cord injury) and their counselors.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article gives practical advice for counseling people with spinal cord injuries about sexuality, emphasizing that loss of sensation or potency does not eliminate sexual feelings or abilities.","clinical_takeaway":"Counselors should reassure disabled clients that sexual satisfaction and self‑esteem are still achievable despite physical impairments.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Provides a concise clinical framework for sexual counseling of physically disabled individuals.","Highlights importance of psychological aspects such as self‑esteem."],"limitations":["No empirical data; conclusions are based on expert opinion.","Lacks measurement of sexual function, distress, or any validated constructs.","No consideration of confounding factors (e.g., mental health, moral incongruence)."],"rubric_version":"2.0","raw_total":2,"max_possible":50,"pct_score":4,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":0,"neuroimaging":null,"statistics":0,"confounds":0,"design":0,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00325481.1975.11714102"}},{"id":6134,"doi":"10.1093/jhmas/xxx.3.217","pmid":"1095641","pmcid":null,"title":"Doctor, patient, and onanist diseases in the nineteenth century","authors":"Gilbert AN.","first_author":"Gilbert AN.","journal":"Journal of the history of medicine and allied sciences","year":1975,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jhmas/xxx.3.217"}},{"id":6135,"doi":"10.1136/bmj.3.5976.149","pmid":"1139263","pmcid":"PMC1674008","title":"Management of sexual deviation","authors":"Brandon S.","first_author":"Brandon S.","journal":"British medical journal","year":1975,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmj.3.5976.149"}},{"id":6136,"doi":"10.1007/bf01537439","pmid":"24414545","pmcid":null,"title":"Some observations on humor and laughter in young adolescent girls","authors":"Ransohoff R.","first_author":"Ransohoff R.","journal":"Journal of youth and adolescence","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"observational description of humor functions in two groups of adolescent girls; no explicit sampling method or statistical analysis reported","sample_n":null,"sample_text":"two groups of adolescent girls; exact numbers not provided in abstract","population":"young adolescent girls (unspecified age range)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study describes how humor and laughter help adolescent girls deal with bodily changes, early romantic interest, hidden sexual thoughts, and mixed feelings toward mothers, noting that jokes work when they make scary topics feel familiar.","clinical_takeaway":"None – the article does not provide clinical data relevant to pornography or sexual health interventions.","confidence":0.4,"topic_tags":["adolescents","sexual_function"],"strengths":["Provides qualitative insight into adolescent humor related to sexual development","Touches on masked sexual themes in naturalistic settings"],"limitations":["No clear sampling strategy or sample size","Lacks quantitative measures or validated constructs related to sexuality or pornography","No control of key confounds (moral incongruence, masturbation, mental health, etc.)"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01537439"}},{"id":6137,"doi":null,"pmid":"1214538","pmcid":null,"title":"Sexuality and depression in infancy, childhood, and adolescence","authors":"Renshaw DC.","first_author":"Renshaw DC.","journal":"Medical aspects of human sexuality","year":1975,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6138,"doi":null,"pmid":"1229859","pmcid":null,"title":"[Comments on \"Beginning of effective sex relationships\"]","authors":"Hesse PG.","first_author":"Hesse PG.","journal":"Arztliche Jugendkunde","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6139,"doi":null,"pmid":"1040183","pmcid":null,"title":"The socio-sexual development of the handicapped child. A preventive care approach","authors":"Pattullo AW.","first_author":"Pattullo AW.","journal":"The Nursing clinics of North America","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6140,"doi":"10.2307/3423432","pmid":"1039848","pmcid":null,"title":"The middle years: the sexually active middle adult","authors":"Dresen SE.","first_author":"Dresen SE.","journal":"The American journal of nursing","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2307/3423432"}},{"id":6141,"doi":"10.1007/bf01541626","pmid":"1130985","pmcid":null,"title":"Secondary orgasmic dysfunction. I. Analysis and strategies for treatment","authors":"McGovern KB, Stewart RC, LoPiccolo J.","first_author":"McGovern KB","journal":"Archives of sexual behavior","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 12 participants receiving behavioral treatment for orgasmic dysfunction","sample_n":12,"sample_text":"Six cases of primary orgasmic dysfunction and six cases of secondary orgasmic dysfunction","population":"adult men and women with primary or secondary orgasmic dysfunction (clinical sample)","country":"United States (presumed from authors’ affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors treated 12 people with orgasm problems using anxiety‑reduction and skill‑training techniques. Primary and secondary cases looked similar before therapy, but only the primary group achieved orgasm after treatment.","clinical_takeaway":"Behavioral anxiety‑reduction may help primary orgasmic dysfunction, but evidence is limited for secondary cases.","confidence":0.8,"topic_tags":["sexual_function","treatment"],"strengths":["Detailed clinical description of treatment protocol","Direct observation of treatment outcomes"],"limitations":["Very small, non‑representative sample","No control or comparison group","No validated outcome measures reported"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":83,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541626"}},{"id":6142,"doi":"10.1016/s0015-0282(16)41121-0","pmid":"1126468","pmcid":null,"title":"Infertility practice and Orthodox Jewish law","authors":"Gordon JA, Amelar RD, Dubin L, Tendler MD.","first_author":"Gordon JA","journal":"Fertility and sterility","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"non-empirical review of religious law and its implications for infertility treatment; no primary data collected","sample_n":null,"sample_text":"None – article is a review of religious rulings, not a data‑driven study","population":"Orthodox Jewish couples facing infertility (no sample reported)","country":"USA (inferred from author affiliations, not stated in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how Orthodox Jewish law influences infertility treatments, covering topics such as semen collection, surgery, and use of donor sperm, and offers rabbinic guidance for clinicians and patients.","clinical_takeaway":"Clinicians should be aware of specific religious restrictions when advising Orthodox Jewish couples on infertility options.","confidence":0.8,"topic_tags":["religiosity","sexual_function","moral_incongruence"],"strengths":["Provides detailed overview of Orthodox Jewish legal perspectives","Cites contemporary rabbinic authorities","Relevant for clinicians treating Orthodox patients"],"limitations":["No empirical data or systematic methodology","No assessment of patient outcomes","Potentially limited generalizability beyond the specific religious community"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0015-0282(16)41121-0"}},{"id":6143,"doi":"10.1080/00224497509550883","pmid":"1142745","pmcid":null,"title":"Adolescent sex development and adult sex behavior in Japan","authors":"Asayama S.","first_author":"Asayama S.","journal":"Journal of sex research","year":1975,"pub_types":["Journal 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impersonator","authors":"Roback H, McKee E, Vogelfanger R, Corney R.","first_author":"Roback H","journal":"Southern medical journal","year":1975,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case study of a female impersonator seeking gender reassignment surgery; psychiatric/psychologic screening reported","sample_n":1,"sample_text":"single patient","population":"one adult male presenting as female impersonator","country":"unspecified (likely USA given journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1975 case report describes a male performer who wanted gender reassignment surgery; clinicians concluded the desire reflected borderline personality traits rather than a true female gender identity.","clinical_takeaway":"Individual case; cannot inform clinical decisions for gender dysphoria broadly.","confidence":0.7,"topic_tags":["gender","sexual_function"],"strengths":["detailed clinical observation","highly specific case"],"limitations":["single case, no generalizability","no validated measurement details","no control for confounding factors"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00007611-197504000-00017"}},{"id":6146,"doi":null,"pmid":"1170682","pmcid":null,"title":"[Prevention of sexual perversions in bulls]","authors":"Tselishchev LI.","first_author":"Tselishchev LI.","journal":"Veterinariia","year":1975,"pub_types":["Journal 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clitoris]","authors":"Kramarosky C, Manriquez C.","first_author":"Kramarosky C","journal":"Revista chilena de obstetricia y ginecologia","year":1975,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["masturbation"],"language":"spa","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6150,"doi":null,"pmid":"1231276","pmcid":null,"title":"[Desire and self-worth]","authors":"Trenkel A.","first_author":"Trenkel A.","journal":"Zeitschrift fur klinische Psychologie und Psychotherapie","year":1975,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"clinical case description, correlational narrative, no systematic data collection","sample_n":null,"sample_text":"clinical case; no numeric sample reported","population":"neurotic patients (clinical sample, unspecified size)","country":"Germany (journal language)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes a clinical observation suggesting that early cultural repression of personal pleasure may lower self‑esteem in neurotic patients, linking guilt and fear to reduced self‑worth.","clinical_takeaway":"None – the report offers no actionable clinical guidance.","confidence":0.4,"topic_tags":["masturbation","gender","sexual_function"],"strengths":["Historical perspective on pleasure and self‑esteem","Integration of psychoanalytic theory"],"limitations":["No validated instruments or quantitative data","Single clinical case; no generalisable sample","Lacks control of key confounds (moral incongruence, masturbation, mental health)"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":6151,"doi":"10.1080/00926237508405290","pmid":"1225980","pmcid":null,"title":"Group treatment of sexual dysfunction in men without partners","authors":"Zilbergeld B.","first_author":"Zilbergeld B.","journal":"Journal of sex & marital therapy","year":1975,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Group psychotherapy for sexually dysfunctional men without partners; compares male–male vs male–female co‑leaders; no randomisation, likely pre‑post uncontrolled.","sample_n":null,"sample_text":"Not reported in abstract","population":"Men with sexual dysfunction, no regular partner (1975 sample).","country":"USA (likely, based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1975 paper reports on a group therapy program for men with sexual problems who lack partners, noting that most participants improved and also saw benefits in non‑sexual life areas.","clinical_takeaway":"Group therapy may help sexually dysfunctional men without partners, but evidence is limited and not rigorously tested.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Early clinical description of group therapy","Comparison of co‑leader gender composition","Reports broader psychosocial benefits"],"limitations":["No control group or randomisation","Unclear outcome measures and statistical reporting","Small, self‑selected clinical sample"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926237508405290"}},{"id":6152,"doi":"10.1080/00926237508403702","pmid":"177785","pmcid":null,"title":"The assessment of nocturnal REM erection in the differential diagnosis of sexual impotence","authors":"Fisher C, Schiavi P, Lear H, Edwards A, Davis DM, Witkin AP.","first_author":"Fisher C","journal":"Journal of sex & marital therapy","year":1975,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":57,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case series of nine patients assessing nocturnal REM erections to differentiate psychogenic vs organic impotence.","sample_n":9,"sample_text":"Nine patients evaluated with nocturnal REM erection monitoring.","population":"Adult men with erectile dysfunction (n=9).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors measured erections that occur during REM sleep in nine men to see if this could tell whether erectile problems were psychological or physical. They suggest normal nocturnal erections point to a psychological cause, while reduced nocturnal erections match a physical cause.","clinical_takeaway":"Nocturnal erection testing may help differentiate psychogenic from organic impotence, but evidence is limited to very small case series.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Direct physiological measurement of nocturnal erection","Clear clinical focus on differential diagnosis"],"limitations":["Very small sample (n=9)","No statistical analysis or control group","Generalisation limited; claims exceed data"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":106,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926237508403702"}},{"id":6153,"doi":"10.1080/00926237508405291","pmid":"1225981","pmcid":null,"title":"The diagnosis and treatment of transvestites and transsexuals","authors":"Pomeroy W.","first_author":"Pomeroy W.","journal":"Journal of sex & marital therapy","year":1975,"pub_types":["Journal 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sexual histories and consider individual reality factors when working with transvestite or transsexual clients.","confidence":0.4,"topic_tags":["gender","sexual_function"],"strengths":["Historical perspective on clinical practice","Provides concrete therapeutic suggestions"],"limitations":["No empirical data or systematic methodology","Outdated terminology and 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Southern medical record","year":1881,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9074498","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6457,"doi":null,"pmid":"37616810","pmcid":"PMC9817572","title":"On the Masturbation, Spermatorrhœa and Impotence of Adolescence: A Lecture Delivered at Rush Medical College, April 10, 1879","authors":"Hyde JN.","first_author":"Hyde JN.","journal":"The Chicago medical journal and examiner","year":1879,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9817572","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6458,"doi":null,"pmid":"37472739","pmcid":"PMC9983967","title":"A Case of Masturbation, with Remarks","authors":"Neyman EH.","first_author":"Neyman EH.","journal":"Chicago medical examiner","year":1862,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9983967","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6459,"doi":null,"pmid":"36664525","pmcid":"PMC9430294","title":"Removing the Clitoris in Cases of Masturbation Accompanied with Threatning Insanity","authors":"Cooper ES.","first_author":"Cooper ES.","journal":"Buffalo medical and surgical journal","year":1862,"pub_types":["other","Journal 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Children","authors":null,"first_author":null,"journal":"Medical examiner (Philadelphia, Pa.)","year":1842,"pub_types":["other","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10263781","cited_by_count":0,"is_preprint":false,"topics":["masturbation"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":6463,"doi":"10.20944/preprints202605.1843.v1","pmid":null,"pmcid":null,"title":"Sex Addiction, Conception and Treatment","authors":"Martín Herrero JA.","first_author":"Martín Herrero JA.","journal":"Preprints.org","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"mixed-methods quasi‑experimental pretest‑posttest with 50 treatment‑seeking participants (25 M, 25 F) split into experimental and control groups","sample_n":50,"sample_text":"Fifty subjects (25 men and 25 women) who sought help participated, divided equally between an experimental group and a control group","population":"treatment‑seeking adults (self‑selected), gender balanced","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","circular_addiction_scale","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A pre‑print reports a small quasi‑experimental study where 50 adults seeking help for \"sex addiction\" received a new therapy. Using questionnaires, the authors claim the treatment reduced addiction severity, anxiety and impulsive sexual behavior.","clinical_takeaway":"Evidence is weak; clinicians should be cautious about adopting this treatment without stronger, controlled trials.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Use of several standardized questionnaires","Inclusion of both sexes","Mixed‑methods (quantitative + ethnographic) approach"],"limitations":["Small, self‑selected treatment‑seeking sample","No control for moral incongruence or masturbation","Addiction construct measured with potentially circular scales","Limited statistical reporting (no effect sizes, power analysis)"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202605.1843.v1"}},{"id":6465,"doi":"10.1071/sh26057","pmid":"42458736","pmcid":null,"title":"Gender-specific associations between sexual compulsivity, sexual functioning and sexual satisfaction: a mediation analysis in an Iranian community sample","authors":"Shekarchi R, Eleuteri S, Saladino V.","first_author":"Shekarchi R","journal":"Sexual health","year":2026,"pub_types":["Journal Article"],"keywords":["Path analysis","Iran","Gender Differences","Sexual Satisfaction","Sexual Compulsivity","Sexual Functioning","Compulsive Sexual Behaviour","Compulsive Sexual Behaviour Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 705 Iranian adults recruited via snowball online sampling; path analysis of gender‑specific relationships.","sample_n":705,"sample_text":"705 participants (snowball online recruitment).","population":"Community sample, Iran, 81.6 % male, 18.4 % female, age range not specified.","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In an Iranian online survey of 705 adults, higher sexual compulsivity was linked to lower sexual satisfaction. For men, poorer sexual functioning explained this link; for women, compulsivity reduced satisfaction directly. The authors suggest gender‑tailored clinical approaches.","clinical_takeaway":"Consider gender‑specific pathways when treating sexual compulsivity: focus on performance for men and relational/affective factors for women.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for a non‑Western context","Use of validated scales for compulsivity, function and satisfaction","Gender‑specific analysis adds nuance"],"limitations":["Snowball online recruitment limits representativeness","Cross‑sectional design cannot establish causality","No control for key confounds (moral incongruence, mental health, partner effects)"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh26057"}},{"id":6468,"doi":"10.1002/jclp.70114","pmid":"41711134","pmcid":"PMC13127853","title":"The Semi-Structured Clinical Interview for the Assessment of Compulsive Sexual Behavior (SSCI-CSB): Development, Reliability, and Validity","authors":"Castro-Calvo J, Giménez-García C, Ruiz-Palomino E, Gil-Juliá B, García-Barba M, Ballester-Arnal R.","first_author":"Castro-Calvo J","journal":"Journal of clinical psychology","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Validation Study","Journal Article"],"keywords":["Assessment","Compulsive Sexual Behavior (Csb)","Clinical Interview"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13127853","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a semi‑structured clinical interview administered to 85 treatment‑seeking patients (81 men, 4 women); test‑retest subsample of 22 after 3 months","sample_n":85,"sample_text":"85 patients (81 men, 4 women); 22 retested","population":"out‑patient treatment seekers for compulsive sexual behavior","country":"Spain (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and tested a new interview (SSCI‑CSB) to diagnose compulsive sexual behavior. In 85 patients seeking treatment, the interview showed very high internal consistency and good test‑retest reliability, suggesting it could be a useful clinical tool.","clinical_takeaway":"The SSCI‑CSB shows promise as a reliable interview for assessing compulsive sexual behavior in clinical settings.","confidence":0.8,"topic_tags":["measurement","csbd","sexual_function","religiosity","moral_incongruence"],"strengths":["Large (for a clinical validation) treatment‑seeking sample","Comprehensive reliability reporting (internal consistency, test‑retest, Kappa)","Clear focus on CSB diagnostic criteria"],"limitations":["Sample limited to treatment seekers; limited generalisability","No external validation against independent gold‑standard measures","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":38,"max_possible":60,"pct_score":63,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":8,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/jclp.70114"}},{"id":6469,"doi":"10.1007/s10508-025-03392-z","pmid":"41784919","pmcid":"PMC13048919","title":"Prevalence and Factors Associated with Sexual Addiction in Men Who Have Sex with Men Seeking Treatment for Problematic Chemsex: Findings from the CHAMELEON Cross-Sectional Study","authors":"Buathier F, Lack P, Chappuy M, Bailly F, Lespine LF, Rolland B.","first_author":"Buathier F","journal":"Archives of sexual behavior","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["methamphetamine","Sexual Orientation","Men Who Have Sex With Men","Sex Addiction","Chemsex"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13048919","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 353 MSM seeking treatment for problematic chemsex, using SAST to screen for sexual addiction and logistic regression to identify associated factors","sample_n":353,"sample_text":"353 individuals, 39 identified as having sexual addiction","population":"Men who have sex with men (MSM) seeking addiction treatment for problematic chemsex (N=353)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 353 men who have sex with men seeking help for chemsex, 11 % screened positive for sexual addiction. Older age, previous psychiatric hospitalization, and especially problematic methamphetamine use were linked to higher odds of a positive screen.","clinical_takeaway":"Screen for sexual‑addiction symptoms in MSM who use methamphetamine during chemsex, but note that the definition used is a screening tool, not a formal diagnosis.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a treatment‑seeking MSM cohort","Use of a validated screening instrument (SAST)","Multivariable logistic regression with confidence intervals"],"limitations":["Convenience sample of treatment‑seekers limits generalisability","Addiction construct not operationalised beyond the SAST","Key confounds (moral incongruence, masturbation, partner factors, trauma) not measured"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03392-z"}},{"id":6470,"doi":"10.1016/j.drugalcdep.2026.113369","pmid":"42822175","pmcid":null,"title":"Coping patterns moderate the association between negative affect and potential proxies for hypersexual behavior in stimulant-using men who have sex with men","authors":"Weinstein ER, Carino KR, Tishler E, Pantalone DW, Biello KB, Mayer KH, Mimiaga MJ, Safren SA.","first_author":"Weinstein ER","journal":"Drug and alcohol dependence","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual Health","Coping Styles","Men Who Have Sex With Men","Negative Affect","Stimulant Use"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"baseline analysis of RCT participants (N=206) using multiple regression; cross‑sectional moderation models","sample_n":206,"sample_text":"206 MSM recruited for a stimulant‑use RCT","population":"stimulant‑using men who have sex with men (MSM), mean age 39.6, predominantly White","country":"USA (presumed from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among stimulant‑using gay men, feeling worse emotionally was linked to higher sexual‑compulsivity scores and to meeting a provisional hypersexual‑disorder screen. Using problem‑focused or emotion‑focused coping weakened this link.","clinical_takeaway":"Teaching problem‑focused and emotion‑focused coping may reduce hypersexual risk in stimulant‑using MSM.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function","csbd","moral_incongruence"],"strengths":["Reasonably sized sample for regression analyses","Use of validated sexual compulsivity scale (presumed)","Focus on modifiable coping factors"],"limitations":["Cross‑sectional, cannot infer causality","No control for moral or relationship factors","Addiction construct assessed via screening, not full criteria"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.drugalcdep.2026.113369"}},{"id":6472,"doi":"10.1136/bmjment-2026-302953","pmid":"42838712","pmcid":null,"title":"Randomised controlled trial of fluoxetine versus naltrexone in compulsive sexual behaviour disorder","authors":"Savard J, Piwowar M, Adebahr R, Byström M, Hallberg J, Dhejne C, Görts Öberg K, Jokinen J.","first_author":"Savard J","journal":"BMJ mental health","year":2026,"pub_types":["Comparative Study","Equivalence Trial","Randomized Controlled Trial","Journal Article"],"keywords":["Psychiatry","Psychopharmacology"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Open-label randomised controlled trial comparing fluoxetine and naltrexone in 80 participants diagnosed with CSBD (ICD‑11). 8‑week treatment, 6‑week follow‑up, symptom severity measured repeatedly with HD:CAS.","sample_n":80,"sample_text":"80 participants randomised (40 per arm).","population":"Adults (79 men, 1 woman) with ICD‑11 diagnosed compulsive sexual behaviour disorder.","country":"Sweden (inferred from author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an 8‑week randomised trial, fluoxetine and naltrexone produced similar reductions in compulsive sexual behaviour symptoms among 80 adults, though the pattern of improvement over time differed between drugs.","clinical_takeaway":"Both fluoxetine and naltrexone can reduce CSBD symptoms; choice may depend on side‑effect profile and individual response patterns.","confidence":0.78,"topic_tags":["csbd","treatment","relationships","neuroscience"],"strengths":["Randomised controlled design","Use of ICD‑11 diagnostic criteria","Repeated measures with mixed‑effects modelling"],"limitations":["Open‑label (no blinding)","No assessment of moral incongruence or key confounds","Potentially insufficient power to detect modest differences"],"rubric_version":"2.0","raw_total":37,"max_possible":60,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":1,"design":8,"addiction_criteria":6,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjment-2026-302953"}},{"id":6474,"doi":"10.1016/j.actpsy.2026.107819","pmid":"42784899","pmcid":null,"title":"Emotion regulation in compulsive sexual behavior disorder: Divergence between self-report and neural measures","authors":"Engel J, Stüde L, Veit M, Sinke C, Kruger THC.","first_author":"Engel J","journal":"Acta psychologica","year":2026,"pub_types":["Journal Article"],"keywords":["fMRI","Emotion Regulation","Csbd"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control fMRI study comparing 40 CSBD men with 33 controls, convenience recruitment","sample_n":73,"sample_text":"40 CSBD men, 33 controls","population":"heterosexual men, clinical CSBD sample vs community controls","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men with compulsive sexual behavior disorder (CSBD) to controls. CSBD participants reported poorer emotion regulation and higher alexithymia, but brain scans showed no differences during an emotion‑regulation task.","clinical_takeaway":"Self‑reported emotion‑regulation problems in CSBD are not reflected in simple fMRI activation differences; treatment should focus on reported difficulties.","confidence":0.78,"topic_tags":["csbd","neuroscience"],"strengths":["use of both self‑report and neural measures","clinical CSBD sample defined by ICD‑11","well‑matched control group on gender and sexuality"],"limitations":["small fMRI sample, likely underpowered","no measurement of key confounds (moral incongruence, masturbation, mental health)","cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":34,"max_possible":70,"pct_score":49,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":5,"statistics":5,"confounds":2,"design":3,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.actpsy.2026.107819"}},{"id":6475,"doi":"10.1037/abn0001068","pmid":"41143805","pmcid":null,"title":"From disorder to dimensionality: Reconceptualizing compulsive sexual behavior-Commentary on Grubbs and Boness (2025)","authors":"Snaychuk L, Dermody S, Kim HS.","first_author":"Snaychuk L","journal":"Journal of psychopathology and clinical science","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that compulsive sexual behavior is better understood as a multidimensional syndrome rather than a single disorder, urging researchers to adopt a process‑focused, RDoC‑style model.","clinical_takeaway":"Consider CSB as a heterogeneous condition; tailor assessment and treatment to individual symptom pathways.","confidence":0.6,"topic_tags":["csbd","religiosity","measurement"],"strengths":["Highlights limitations of categorical models","Proposes a dimensional RDoC‑based framework","Calls for nuanced assessment and treatment"],"limitations":["No empirical data presented","No concrete measurement recommendations","Conclusions not testable in current form"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/abn0001068"}},{"id":6476,"doi":"10.1080/0092623x.2026.2624384","pmid":"41669818","pmcid":null,"title":"The Compulsive Sexual Behavior Disorder Scale (CSBD-19): A Scoping Review of Validation Evidence from 22 Studies","authors":"Engelhardt R, Way BM, Borgogna NC, Jo D, Bőthe B, Maes J, Kraus SW.","first_author":"Engelhardt R","journal":"Journal of sex & marital therapy","year":2026,"pub_types":["Scoping Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"scoping review of validation studies across 22 papers, 69 samples, 129,049 participants","sample_n":129049,"sample_text":"Total N across 69 samples = 129,049","population":"general adult samples from 35 countries; clinical validation not emphasized","country":"International (35 countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A scoping review summarised 22 studies that tested the CSBD-19 questionnaire, showing it is a reliable five‑factor tool for assessing compulsive sexual behavior across many countries, but more work is needed to confirm clinical cut‑offs.","clinical_takeaway":"The CSBD-19 appears reliable for research use, but clinicians should await further validation before using it for diagnostic decisions.","confidence":0.8,"topic_tags":["csbd","measurement","sexual_function","religiosity","moral_incongruence"],"strengths":["Large aggregate sample across many cultures","Systematic search strategy","Focus on ICD‑11 aligned construct"],"limitations":["No new primary data; relies on published validation studies","Limited discussion of key confounds (e.g., moral incongruence)","Thresholds and clinical cut‑offs not examined"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2026.2624384"}},{"id":6477,"doi":"10.1080/00224499.2026.2704252","pmid":"42584050","pmcid":null,"title":"The Concept of Recovery in Compulsive Sexual Behavior Disorder - A Scoping Review","authors":"Gavriel-Fried B, Glaser-Guy N, Horváth R, Szabó RV, Demetrovics Z, Bőthe B.","first_author":"Gavriel-Fried B","journal":"Journal of sex research","year":2026,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"scoping review following PRISMA-ScR, mapping 65 empirical/case studies on recovery in CSBD","sample_n":null,"sample_text":"Sixty‑five articles were included; the review does not report its own participant numbers","population":"studies of CSBD recovery, primarily white heterosexual men from Western countries","country":"multiple (Western countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review examined how recovery from compulsive sexual behavior disorder is described in the literature. It found that most studies focus on symptom reduction in white, heterosexual men, and that a clear definition of recovery is missing, suggesting the need for broader, more inclusive concepts.","clinical_takeaway":"Clinicians should note that ‘recovery’ in CSBD lacks a standard definition and current research may not reflect diverse client backgrounds.","confidence":0.7,"topic_tags":["religiosity","moral_incongruence","sexual_function"],"strengths":["Comprehensive literature search across four major databases","Use of PRISMA‑ScR guidelines for transparent reporting","Clear mapping of terminology and recovery approaches"],"limitations":["Lack of a unified definition of ‘recovery’ limits interpretability","Over‑representation of white heterosexual men reduces generalisability","No quantitative synthesis or quality appraisal of included studies"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2026.2704252"}},{"id":6478,"doi":"10.1155/crps/9442957","pmid":"42273168","pmcid":"PMC13247679","title":"Naltrexone for Acute Management of Compulsive Sexual and Obsessive Symptoms in a Patient With a Neurodevelopmental Disorder","authors":"Constantin E, Deol MS, Yaun J, Singh H, Glass OM.","first_author":"Constantin E","journal":"Case reports in psychiatry","year":2026,"pub_types":["case-study","Journal Article"],"keywords":["Naltrexone","Bipolar disorder","Attention-deficit/hyperactivity Disorder","Sexual Obsessions","Obsessive–compulsive Disorder","Intellectual Developmental Disorder","Compulsive Sexual Symptoms"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13247679","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-patient case report of acute naltrexone administration in a man with multiple psychiatric comorbidities and subthreshold CSBD-like symptoms","sample_n":1,"sample_text":"one patient","population":"man in his 20s with bipolar I, ADHD, anxiety, intellectual developmental disorder","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"A man in his 20s with bipolar disorder, ADHD and other mental‑health problems experienced intense, distressing sexual thoughts. After starting the medication naltrexone, his symptoms improved within days, though other drug changes were also made, so the effect cannot be proved.","clinical_takeaway":"Naltrexone may help acute, severe compulsive sexual symptoms, but evidence is limited to case reports.","confidence":0.6,"topic_tags":["csbd","neuroscience","treatment"],"strengths":["Detailed clinical description","Acknowledges diagnostic ambiguities","Notes concurrent medication changes"],"limitations":["Single case, no control condition","No validated CSBD measurement tools used","Cannot attribute improvement solely to naltrexone"],"rubric_version":"2.0","raw_total":16,"max_possible":60,"pct_score":27,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/crps/9442957"}},{"id":6479,"doi":"10.1093/jsxmed/qdaf202","pmid":"40796338","pmcid":null,"title":"The connections among childhood abuse, sexual compulsivity, and violent sexual behavior","authors":"Macedo LN, Almeida-Santos MA, Scanavino MT.","first_author":"Macedo LN","journal":"The journal of sexual medicine","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Impulsivity","Childhood Abuse","Sexual Compulsivity","Sexual Violence","Violent Sexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional study of 364 cisgender men (247 with CSB, 117 controls) using structured psychiatric interview and self‑report questionnaires; structural equation modeling applied.","sample_n":364,"sample_text":"247 CSB, 117 controls","population":"adult cisgender men seeking treatment for compulsive sexual behavior; convenience sample, no women.","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of men with compulsive sexual behavior, childhood abuse was linked to higher impulsivity and to violent sexual actions, but sexual compulsivity itself did not predict violence. Anxiety, depression, and impulsivity were also associated with abuse history.","clinical_takeaway":"Assess impulsivity and trauma history in clients with compulsive sexual behavior, as they may signal risk for violent sexual actions.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Large sample for a CSB clinic study","Use of validated questionnaires","Structural equation modeling allows examination of indirect pathways"],"limitations":["Convenience, all‑male sample limits generalizability","Moral incongruence and masturbation not measured","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":3,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf202"}},{"id":6480,"doi":"10.1093/sxmrev/qeaf046","pmid":"40719773","pmcid":null,"title":"Peripheral biomarkers in compulsive sexual behavior disorder: a systematic review","authors":"Ferreira BO, Teixeira BJ, Talib LL, Scanavino MDT.","first_author":"Ferreira BO","journal":"Sexual medicine reviews","year":2025,"pub_types":["Systematic Review","Journal Article"],"keywords":["Biomarkers","Hypersexuality","Neurobiological","Compulsive Sexual Behavior Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 10 peripheral biomarker studies in CSBD, following PRISMA.","sample_n":null,"sample_text":"Ten primary studies, limited diversity, possible cohort overlap.","population":"Adults diagnosed with CSBD/hypersexual disorder/sexual addiction (n not reported).","country":"Not specified","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of ten studies finds that people with compulsive sexual behavior show altered stress‑related hormone levels, DNA methylation patterns, and inflammation markers, suggesting a biological profile but with limited clinical relevance.","clinical_takeaway":"Current biomarker evidence for CSBD is preliminary; clinicians should not base diagnosis or treatment on these findings yet.","confidence":0.8,"topic_tags":["csbd","neuroscience","gender","moral_incongruence"],"strengths":["PRISMA‑guided systematic review","First review focusing on peripheral biomarkers in CSBD","Synthesizes neuroendocrine, epigenetic, and immune evidence"],"limitations":["Small number of primary studies, limited sample diversity","Potential cohort overlap among included articles","No meta‑analysis or quantitative synthesis"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeaf046"}},{"id":6481,"doi":"10.1093/sexmed/qfaf040","pmid":"40463811","pmcid":"PMC12128926","title":"The relationship between compulsive sexual behavior and pedophilic preference in an incarcerated sample of individuals convicted of sexual offenses-implications for treatment","authors":"Epstein R, Abulafia J, Shukron O, Efrati Y.","first_author":"Epstein R","journal":"Sexual medicine","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Compulsive Sexual Behavior","Sexual Offending","Pedophilia","Anti-Libidinal Treatment"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12128926","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire study of 95 incarcerated sexual offenders.","sample_n":95,"sample_text":"95 prisoners in treatment for sexual offenses.","population":"Incarcerated adults convicted of sexual offenses (treatment‑seeking prison sample).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 95 men imprisoned for sexual offenses, higher compulsive sexual behavior was linked to lower self‑reported interest in children. The authors suggest anti‑libidinal drugs may not be the best focus for treatment of child‑focused offenders.","clinical_takeaway":"Targeting compulsive sexual behavior alone may be insufficient for treating pedophilic offenders; a broader, multifactorial approach is advisable.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Rare focus on CSB–pedophilia link in offender population","Reasonable sample size for a prison study"],"limitations":["Convenience prison sample limits generalisability","CSB and pedophilic interest measured with likely non‑validated, self‑report tools","No control for key confounds (moral attitudes, mental health, trauma)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfaf040"}},{"id":6482,"doi":"10.1007/s10508-025-03137-y","pmid":"40325271","pmcid":"PMC12162750","title":"A Study on Childhood Trauma and Sexual Narcissism in Individuals with Compulsive Sexual Behavior Receiving Counseling","authors":"Yaakov R, Weinstein A.","first_author":"Yaakov R","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual Abuse","Compulsive Sexual Behavior Disorder","Sexual Narcissism","Childhood Physical And Mental Abuse"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12162750","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control survey of 118 adults (sex‑addiction support group vs community sample)","sample_n":118,"sample_text":"118 adults (59 in SA group, 59 controls)","population":"Adults (18‑59) recruited from Sexaholics Anonymous and general population","country":"Not specified (likely USA/Israel based on authors)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"supports","citation_value":"useful","plain_summary":"Among 118 adults, those who had experienced childhood abuse reported higher sexual narcissism, which in turn was linked to more hypersexual behavior. The study suggests that sexual narcissism helps explain how early trauma relates to compulsive sexual activity.","clinical_takeaway":"Assess for sexual narcissism and trauma when treating hypersexual behavior; targeting narcissistic traits may reduce compulsive sexual symptoms.","confidence":0.78,"topic_tags":["csbd","sexual_function"],"strengths":["Validated questionnaires","Mediation analysis with bootstrapping","Direct comparison with community sample"],"limitations":["Convenience, self‑selected addiction group","No measurement of moral incongruence or masturbation","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03137-y"}},{"id":6483,"doi":"10.1093/sexmed/qfae050","pmid":"39224134","pmcid":"PMC11368440","title":"Investigation of the psychometric properties of the Toronto Alexithymia Scale in men with and without compulsive sexual behavior","authors":"do Espírito Santo Gonçalves P, de Tubino Scanavino M.","first_author":"do Espírito Santo Gonçalves P","journal":"Sexual medicine","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Compulsive Behavior","Alexithymia","Impulsive Behavior","Emotional Regulation","Affective Symptoms"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11368440","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 418 Brazilian men (304 with CSB, 114 controls) assessing psychometric properties of the Toronto Alexithymia Scale.","sample_n":418,"sample_text":"418 participants (304 CSB, 114 controls)","population":"men 18+ with and without compulsive sexual behavior, convenience sample in Brazil","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether the Toronto Alexithymia Scale works well for men with compulsive sexual behavior. It found the scale generally reliable and able to distinguish these men from controls, though some sub‑scales were less consistent.","clinical_takeaway":"The TAS may help identify alexithymia in men with CSB, but clinicians should note its limited reliability on certain sub‑scales.","confidence":0.8,"topic_tags":["pornography","masturbation","csbd","sexual_function","measurement"],"strengths":["Large sample for psychometric study","Use of multiple validated scales","Comprehensive factor and reliability analyses"],"limitations":["Convenience sample limits generalizability","Low internal consistency for two TAS factors","No measurement of moral incongruence or sexual partner variables"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfae050"}},{"id":6484,"doi":"10.1556/2006.2025.00563","pmid":"42189603","pmcid":"PMC13371736","title":"Striato-limbic and frontoparietal dysfunction underlying imbalance of reward-motivation and cognitive control in compulsive sexual behaviour disorder: A neuroimaging meta-analysis","authors":"Feng Y, Lin X, Li Y, Li H, Zhu S, Cheng Y, Wu J, Sacca V, Yang WFZ, Ren B, Jiang S, Pu C.","first_author":"Feng Y","journal":"Journal of behavioral addictions","year":2026,"pub_types":["Meta-Analysis","research-article","Journal Article"],"keywords":["Behavioral Addiction","Neuroimaging Meta-analysis","Compulsive Sexual Behavior Disorder","Large Language Model","Cognitive Decoding"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13371736","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"meta-analysis of structural and functional neuroimaging coordinates from CSBD studies using MKDA; includes subgroup analyses by region and sample characteristics.","sample_n":null,"sample_text":"Not applicable – aggregate of multiple imaging studies","population":"human participants with compulsive sexual behaviour disorder across included neuroimaging studies (no single sample size reported)","country":"multiple (European and East Asian samples reported)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of brain imaging studies on compulsive sexual behaviour disorder found consistent abnormalities in reward‑related and control‑related brain regions, suggesting a mismatch between motivation and cognitive control.","clinical_takeaway":"Findings highlight possible neural targets, but do not yet inform diagnosis or treatment decisions.","confidence":0.7,"topic_tags":["neuroscience","csbd"],"strengths":["Comprehensive synthesis of available CSBD neuroimaging data","Use of modern coordinate‑based meta‑analytic technique (MKDA)","Subgroup analyses by geographic sample"],"limitations":["Reliance on published coordinate reports limits depth of methodological appraisal","No assessment of key psychosocial confounds (moral incongruence, masturbation, mental health)","Potential heterogeneity of primary studies not fully addressed"],"rubric_version":"2.0","raw_total":35,"max_possible":70,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":6,"statistics":5,"confounds":3,"design":6,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00563"}},{"id":6486,"doi":"10.1007/s10508-025-03167-6","pmid":"40506573","pmcid":null,"title":"Suicidal Risk in Patients with Sex Addiction: Frequency, Sociodemographic, and Clinical Characteristics","authors":"Schreck B, Valenciano-Mendoza E, Balem M, Jimenez-Murcia S, Thiabaud E, Tillet S, Saillard A, Donnio Y, Grall-Bronnec M, Challet-Bouju G.","first_author":"Schreck B","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Anxiety Disorder","Suicide Risk","Mood Disorder","Behavioral Addiction","Sex Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational, cross‑sectional study of 136 patients referred for sex addiction","sample_n":136,"sample_text":"136 patients referred to Nantes University Hospital (2013‑2022)","population":"patients (clinical sample) with sex addiction diagnosed via Goodman's scale","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 136 people treated for sex addiction, nearly half showed suicidal risk. Higher suicide risk was linked to anxiety, mood disorders, relatives knowing about the addiction, and low self‑directedness.","clinical_takeaway":"Assess mood, anxiety and self‑directedness in patients with sex addiction to identify suicide risk.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Reasonable sample size for a clinical population","Use of validated MINI suicidality module","Multivariate logistic regression to identify independent predictors"],"limitations":["Sex‑addiction diagnosis relies on non‑standardized Goodman's scale","Cross‑sectional design prevents causal inference","Key confounds (moral incongruence, masturbation, trauma) not measured"],"rubric_version":"2.0","raw_total":22,"max_possible":60,"pct_score":37,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03167-6"}},{"id":6489,"doi":"10.1016/j.actpsy.2026.106574","pmid":"41812393","pmcid":null,"title":"Compulsive sexual behavior in cocaine use disorder: Treatment outcomes and clinical challenges","authors":"Palazón-Llecha A, Trujols J, Madre M, Duran-Sindreu S, Batlle F, Mallorquí-Bagué N.","first_author":"Palazón-Llecha A","journal":"Acta psychologica","year":2026,"pub_types":["Journal Article"],"keywords":["Screening","Emotion Regulation","Treatment Outcomes","Compulsive Sexual Behavior","Cocaine Use Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Prospective cohort of 70 CUD patients assessed at baseline, after 14‑day inpatient detox and after 8‑week outpatient treatment.","sample_n":70,"sample_text":"Seventy participants entered a 14‑day inpatient detoxification followed by 8‑week outpatient treatment.","population":"Adults with cocaine use disorder (CUD) in a treatment setting; 70 participants (mixed gender).","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a group of 70 people with cocaine use disorder, those who screened positive for compulsive sexual behavior had more emotion‑regulation problems and higher depression. Those problems at treatment start predicted continued compulsive sexual behavior after outpatient care and were linked to dropping out of the inpatient program.","clinical_takeaway":"Screening for compulsive sexual behavior and emotion‑regulation deficits at treatment entry may help identify CUD patients at risk for poorer inpatient outcomes.","confidence":0.8,"topic_tags":["csbd"],"strengths":["Longitudinal assessment across treatment phases","Comprehensive measurement of emotion regulation and psychopathology","Clinical relevance for CUD treatment programs"],"limitations":["Small sample; limited power for subgroup analyses","CSB assessed via screening tool without detailed validation reported","Key sexual‑behavior confounds (masturbation, partner context) not measured"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.actpsy.2026.106574"}},{"id":6491,"doi":"10.1016/j.bbr.2025.115872","pmid":"41101594","pmcid":null,"title":"Epigenetic alterations of serotonergic but not dopaminergic signalling in compulsive sexual behaviour disorder","authors":"Androvičová R, Jahn K, Engel J, Sun S, Veit M, Frieling H, Lew-Starowicz M, Kneer J, Sinke C, Krüger THC.","first_author":"Androvičová R","journal":"Behavioural brain research","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Dopamine","Serotonin","Methylation","Transporter","Epigenetics","Gene Expression","Compulsive Sexual Behaviour Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control methylation study using blood samples from 43 CSBD participants and 36 healthy controls","sample_n":79,"sample_text":"36 healthy controls, 43 CSBD individuals","population":"Adults (young, middle‑aged, both sexes) recruited as CSBD patients vs. healthy controls; likely convenience sample","country":"unspecified (likely Europe based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers compared DNA methylation of serotonin and dopamine genes in people with compulsive sexual behaviour disorder versus healthy controls. They found higher methylation of a serotonin transporter gene in the disorder group, suggesting reduced serotonin signalling, but no differences in dopamine genes.","clinical_takeaway":"Potential serotonergic involvement in CSBD, but findings are preliminary and need replication.","confidence":0.6,"topic_tags":["csbd","sexual_function","gender","neuroscience"],"strengths":["Focus on epigenetic mechanisms, a novel angle","Comparison of dopaminergic and serotonergic pathways","Inclusion of both patient and control groups"],"limitations":["Small sample, acknowledged low power","No detail on diagnostic interview or questionnaire validation","Key confounds (moral incongruence, masturbation, mental health) not measured"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.bbr.2025.115872"}},{"id":6492,"doi":"10.1007/s11126-024-10087-6","pmid":"39207570","pmcid":"PMC11568058","title":"The Bergen-Yale Sexual Addiction Scale (BYSAS): Longitudinal Measurement Invariance Across a Two-Year Interval","authors":"Gomez R, Brown T, Stavropoulos V.","first_author":"Gomez R","journal":"The Psychiatric quarterly","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Confirmatory Factor Analysis","Ordinal Data","Sex Addiction","Longitudinal Measurement Invariance","Bysas","The Bergen–yale Sexual Addiction Scale"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s11126-024-10087-6.pdf","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Longitudinal measurement invariance study using CFA on a convenience sample of 276 adults over three yearly assessments.","sample_n":276,"sample_text":"276 adults, 71% male, mean age 31.86 years","population":"Adults (mean age 31.9, 71% male)","country":"Not reported","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested whether the Bergen‑Yale Sexual Addiction Scale works the same way over three yearly assessments in 276 adults. Results showed the scale’s factor structure remains stable over two years.","clinical_takeaway":"The BYSAS appears psychometrically stable over time, but clinicians should note its untested link to true addiction criteria.","confidence":0.8,"topic_tags":["sexual_function","measurement"],"strengths":["Large longitudinal sample (N=276)","Appropriate CFA estimator for ordinal data","Comprehensive test of measurement invariance"],"limitations":["No assessment of moral incongruence or related confounds","Scale may be circularly defined as addiction","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11126-024-10087-6"}},{"id":6494,"doi":"10.1556/2006.2025.00419","pmid":"41984541","pmcid":"PMC13371728","title":"Compulsive sexual behavior may be more state-like than trait-like: Findings from a three-year longitudinal representative survey","authors":"Horváth Z, Bőthe B, Potenza MN, Stein DJ, Demirgül SA, Paksi B, Czakó A, Demetrovics Z.","first_author":"Horváth Z","journal":"Journal of behavioral addictions","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Sexual Addiction","Hypersexuality","Behavioral Addictions","Latent State-trait Theory","Addictive Behaviors","Compulsive Behaviors","Impulsive Behaviors","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13371728","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"representative longitudinal survey, 4 waves over 3 years, N=782 young adults","sample_n":782,"sample_text":"young adults from the representative Budapest Longitudinal Study (N=782, 39.6% women, mean age 27.1 at wave 1)","population":"young adults, community sample, Budapest Longitudinal Study","country":"Hungary","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a three‑year, nationally representative Hungarian survey of 782 young adults, researchers found that most of the variation in compulsive sexual behavior scores was due to short‑term, situation‑specific factors rather than a stable personality trait.","clinical_takeaway":"Compulsive sexual behavior may fluctuate with life circumstances; clinicians should consider state‑related triggers when assessing and treating CSB.","confidence":0.8,"topic_tags":["csbd","sexual_function","prevalence","measurement","gender","religiosity"],"strengths":["Large, nationally‑representative sample","Four‑wave longitudinal data allowing state‑trait decomposition","Use of validated HBI scale","Advanced latent modeling with good fit indices"],"limitations":["No assessment of moral incongruence or other key confounds","CSB measured as a single composite, not separated from related behaviours (e.g., pornography, masturbation)","No pre‑registration reported"],"rubric_version":"2.0","raw_total":40,"max_possible":60,"pct_score":67,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00419"}},{"id":6496,"doi":"10.3389/fpsyt.2025.1561885","pmid":"40475952","pmcid":"PMC12138901","title":"Compulsive sexual behavior disorder: rates and clinical correlates in a community sample","authors":"Grant JE, Boutouis S, Collins M, Chamberlain SR.","first_author":"Grant JE","journal":"Frontiers in psychiatry","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sex","Impulsivity","Compulsive Sexual Behavior","Sexual Addiction","Compulsivity","Hypersexual Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12138901","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey of 300 adults (n=296 analysed) recruited via Prolific; self‑report questionnaires; cross‑sectional prevalence and correlates.","sample_n":296,"sample_text":"296 participants (54.7% female) completed the survey.","population":"Community adults 18‑75, English‑speaking, recruited from an online platform (Prolific).","country":"Not specified (likely multinational Prolific sample).","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a community sample of 296 adults, about 11% screened positive for compulsive sexual behavior disorder. Those with the disorder tended to be younger, bisexual, and showed higher impulsivity, compulsivity, and symptoms of ADHD and borderline personality disorder.","clinical_takeaway":"CSBD may co‑occur with impulsivity, compulsivity, and certain mental‑health issues; clinicians should assess these domains when evaluating sexual‑behavior concerns.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large overall sample for an online survey","Use of validated psychometric instruments","Broad assessment of mental‑health correlates"],"limitations":["Probable CSBD based on self‑report; possible circularity with distress","No measurement of moral incongruence or masturbation","Cross‑sectional; cannot infer causality","CSBD group small (n=32) limiting power"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2025.1561885"}},{"id":6497,"doi":"10.3389/fpsyt.2023.1248900","pmid":"38025451","pmcid":"PMC10666180","title":"Two subtypes of compulsive sexual behavior disorder","authors":"Golder S, Markert C, Psarros R, Discher JP, Walter B, Stark R.","first_author":"Golder S","journal":"Frontiers in psychiatry","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Cluster analysis","Subtypes","Reinforcement","Compulsive Sexual Behavior","Behavioral Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10666180","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cluster analysis of 62 male CSBD patients; between‑cluster t‑tests on reinforcement‑sensitivity variables.","sample_n":62,"sample_text":"62 patients with CSBD (men only)","population":"62 male patients diagnosed with compulsive sexual behavior disorder (clinical sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study grouped 62 men with compulsive sexual behavior disorder into two types based on whether they are driven more by avoiding negative feelings or by seeking positive rewards. The groups differed in sexual motivation but not in overall compulsivity.","clinical_takeaway":"Therapists might tailor interventions to whether a client’s CSBD is maintained by negative or positive reinforcement.","confidence":0.7,"topic_tags":["csbd","religiosity"],"strengths":["Use of validated psychometric instruments","Novel clustering of reinforcement profiles","Clinical sample relevance"],"limitations":["Small, all‑male clinical sample","No assessment of moral incongruence or masturbation","Cross‑sectional; cannot infer causality","No effect sizes reported"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2023.1248900"}},{"id":6498,"doi":"10.1080/0092623x.2025.2470214","pmid":"39991925","pmcid":null,"title":"Compulsive Sexual Behavior Inventory Short Form (CSBI-SF): Development and Psychometric Evaluation","authors":"Rahm-Knigge RL, Gleason N, Mark KP, Coleman E.","first_author":"Rahm-Knigge RL","journal":"Journal of sex & marital therapy","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"psychometric validation study using confirmatory factor analysis on a community sample","sample_n":null,"sample_text":"not reported in abstract","population":"adults (both sexes), unspecified sample size","country":"not reported","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and tested a five‑item short version of the Compulsive Sexual Behavior Inventory, showing it works as well as the longer form and relates to factors like religiosity and emotion regulation.","clinical_takeaway":"The CSBI‑SF can be used as a brief screening tool for compulsive sexual behavior, but clinicians should note it may blend behaviour frequency with distress.","confidence":0.8,"topic_tags":["measurement","csbd","sexual_function"],"strengths":["Validated parent instrument (CSBI‑13) used as basis","Robust CFA and internal consistency reporting","Includes known correlates (religiosity, attachment, emotion dysregulation)"],"limitations":["Potential circularity if distress items define CSB","No separation of pornography use from masturbation or other behaviours","Limited assessment of broader confounds (mental health, trauma)"],"rubric_version":"2.0","raw_total":37,"max_possible":60,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2025.2470214"}},{"id":6499,"doi":"10.7759/cureus.91966","pmid":"41080286","pmcid":"PMC12512434","title":"Neurobiological Pathways Linking Compulsive Sexual Behavior Disorder and Psychiatric Comorbidities: A Narrative Review","authors":"Puszcz A, Górski J, Pierudzka W.","first_author":"Puszcz A","journal":"Cureus","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual dysfunction","Hypersexuality Disorder","Psychosexual Disorders","Sex Addictions","Sexual Compulsiveness"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12512434","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review, no systematic methods, no risk‑of‑bias assessment","sample_n":null,"sample_text":"N/A – review article","population":"none (review of existing literature)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["selective_reporting","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors review how compulsive sexual behavior disorder may share brain‑network and dopamine‑related changes with mood, anxiety, ADHD, autism, OCD and personality disorders, suggesting a common neurobiological basis.","clinical_takeaway":"Treat CSBD with integrated approaches that also address comorbid mental‑health conditions; current neurobiological evidence is suggestive, not definitive.","confidence":0.6,"topic_tags":["csbd","neuroscience","moral_incongruence","adolescents"],"strengths":["Comprehensive overview of neurobiological models","Integrates multiple psychiatric comorbidities","Highlights dimensional approach"],"limitations":["Narrative (non‑systematic) methodology","No empirical data or systematic risk‑of‑bias assessment","Potential over‑interpretation of neuroimaging findings"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.91966"}},{"id":6500,"doi":"10.1016/j.encep.2026.06.009","pmid":"42763253","pmcid":null,"title":"Validation of the French version of the Sexual Motivation Scale (SexMS-Fr)","authors":"Hegbe KG, Ribadier A, Barrault S.","first_author":"Hegbe KG","journal":"L'Encephale","year":2026,"pub_types":["Journal Article"],"keywords":["Assessment","Psychometric Properties","Sexual Addiction","Scale Validation","Évaluation","Sexual Motivation","Addiction Sexuelle","Propriétés Psychométriques","Validation D’échelle","Motivation Sexuelle"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"scale validation with convenience sample (N=174)","sample_n":174,"sample_text":"174 voluntary participants","population":"voluntary adult participants (likely mixed gender, unspecified)","country":"France (presumed)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors translated and tested a French version of the Sexual Motivation Scale, finding six reliable sub‑scales and showing that certain motivation types differ between people who screen positive and negative for sexual‑addiction‑like behaviors.","clinical_takeaway":"The new SexMS‑Fr can help clinicians assess sexual motives, but its link to sexual addiction requires further validation with broader samples and confound control.","confidence":0.7,"topic_tags":["sexual_function","measurement"],"strengths":["Validated psychometric methods (EFA, reliability)","Use of established SAST screen","Reasonable sample size for scale development"],"limitations":["Convenience, self‑selected sample","No measurement of moral or mental‑health confounds","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.encep.2026.06.009"}},{"id":6501,"doi":"10.5114/hpr/209086","pmid":"41293435","pmcid":"PMC12642458","title":"Alexithymia and problematic sexual behaviour: the mediation of dissociative patterns","authors":"Topino E, Fioravanti G, Fabiani D, Musetti A, Gori A.","first_author":"Topino E","journal":"Health psychology report","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Dissociation","Alexithymia","Behavioural Addiction","Compulsive Sexual Behaviour","Problematic Sexual Behaviour"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12642458","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 326 participants completing validated self‑report scales; analyses ANOVA, regression, path analysis","sample_n":326,"sample_text":"326 participants completed validated self‑report measures","population":"adult participants (unspecified recruitment method)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"supports","citation_value":"useful","plain_summary":"In 326 adults, higher alexithymia (trouble identifying and describing feelings) was linked to more self‑reported sex‑addiction symptoms, and this link was partly explained by a dissociative tendency called absorption.","clinical_takeaway":"Assess alexithymia and dissociation when working with clients reporting compulsive sexual behaviour; consider these factors in treatment planning.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Large sample size for a questionnaire study","Use of validated psychometric instruments","Statistical mediation analysis"],"limitations":["Cross‑sectional design limits causal inference","No control for moral incongruence or masturbation","Potential circularity in defining ‘sex addiction’"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5114/hpr/209086"}},{"id":6502,"doi":"10.1556/2006.2024.00074","pmid":"39841161","pmcid":"PMC11974438","title":"Sexual trauma and compulsive sexual behavior in young men and women: A network analysis involving two samples","authors":"Scoglio AAJ, Chen YL, Huang KJ, Borgogna NC, Borgogna NC, Potenza MN, Blycker GR, Kraus SW.","first_author":"Scoglio AAJ","journal":"Journal of behavioral addictions","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Abuse","Sexual Assault","Transactional Sex","Addictive Behaviors","Mental Health Symptoms","Impulsive Behaviors"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11974438","cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional network analysis of two university student samples (n≈1,900 and 2,300).","sample_n":4221,"sample_text":"Convenience samples recruited from universities (2020‑2022).","population":"Young adult university students (US), 69% women.","country":"United States","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In two large university samples, researchers mapped how past sexual trauma, depression/anxiety, substance use, and transactional sex are linked to compulsive sexual behavior, finding gender‑specific patterns in these connections.","clinical_takeaway":"Sexual trauma and co‑occurring mental‑health issues are closely tied to compulsive sexual behavior; clinicians should assess trauma history when addressing CSB.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Large combined sample size","Network analysis provides insight into inter‑relations","Inclusion of both sexes for gender comparisons"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on self‑report scales, unclear validation","No measurement of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":4,"design":5,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00074"}},{"id":6503,"doi":"10.47626/1516-4446-2022-2584","pmid":"36379052","pmcid":"PMC9976921","title":"Symptoms of depression (not anxiety) mediate the relationship between childhood sexual abuse and compulsive sexual behaviors in men","authors":"Reis SC, Park KE, Dionne MM, Kim HS, Scanavino MDT.","first_author":"Reis SC","journal":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Anxiety","Compulsive Sexual Behavior","Childhood Sexual Abuse"],"is_oa":true,"oa_url":"https://doi.org/10.47626/1516-4446-2022-2584","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional mediation study of 222 men seeking treatment for compulsive sexual behaviors","sample_n":222,"sample_text":"222 men seeking treatment for compulsive sexual behaviors","population":"men seeking treatment for compulsive sexual behaviors (N=222)","country":"Brazil (journal), sample location not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"supports","citation_value":"useful","plain_summary":"In 222 men receiving help for compulsive sexual behavior, depressive symptoms (but not anxiety) explained part of the link between childhood sexual abuse and those compulsive behaviors.","clinical_takeaway":"Assess and treat depression when working with men whose compulsive sexual behavior follows childhood sexual abuse.","confidence":0.8,"topic_tags":["csbd"],"strengths":["Validated instruments for all main constructs","Adequate sample size for mediation analysis","Confidence intervals reported for indirect effects"],"limitations":["Cross‑sectional design limits causal inference","Treatment‑seeking sample reduces generalisability","Moral incongruence and masturbation not assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.47626/1516-4446-2022-2584"}},{"id":6504,"doi":"10.1556/2006.2025.00028","pmid":"40202807","pmcid":"PMC12231467","title":"Impaired sexual delay discounting as a potential mechanism in women's compulsive sexual behavior: Evidence from a mixed-gender experiment","authors":"Finkenstaedt M, Biedermann D, Biedermann SV, Fuss J.","first_author":"Finkenstaedt M","journal":"Journal of behavioral addictions","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Borderline Personality Disorder","Sexual Sensation Seeking","Compulsive Sexual Behavior Disorder","Sexual Delay Discounting"],"is_oa":true,"oa_url":"https://doi.org/10.1556/2006.2025.00028","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey, convenience sample, n=311, mixed gender","sample_n":311,"sample_text":"convenience online sample","population":"German adults (71% women, 27% men, 1.6% gender‑diverse)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a German online survey, people with higher compulsive sexual behavior scores and higher sexual sensation seeking showed steeper sexual delay discounting (preferring immediate sex over delayed protected sex), especially women. Borderline personality features were linked to more CSB but did not change this relationship.","clinical_takeaway":"Higher impulsivity in sexual decisions may be part of compulsive sexual behavior, suggesting interventions that target delay discounting could help, particularly for women.","confidence":0.8,"topic_tags":["csbd","sexual_function","gender"],"strengths":["Uses validated CSBD‑19 and behavioral discounting task","Relatively large mixed‑gender sample","Explores novel mechanism (sexual delay discounting)"],"limitations":["Convenience online sample limits generalisability","No control for moral incongruence or other key confounds","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00028"}},{"id":6508,"doi":"10.1186/s40359-025-02445-1","pmid":"39930524","pmcid":"PMC11812235","title":"The German version of the Bergen Yale Sex Addiction Scale (BYSAS): psychometric properties and initial steps of validation","authors":"Hiebler M, Brössler H, Wimmer R, Zipper Z, Renner E, Brouschek J, Fuchshuber J, Neubauer A, Unterrainer HF.","first_author":"Hiebler M","journal":"BMC psychology","year":2025,"pub_types":["research-article","Validation Study","Journal Article"],"keywords":["Hypersexuality","Psychiatric Symptoms","German Version","Sex Addiction","Test Adaptation"],"is_oa":true,"oa_url":"https://doi.org/10.1186/s40359-025-02445-1","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience sample, N=492, CFA, reliability analysis","sample_n":492,"sample_text":"online convenience sample","population":"German‑speaking adults recruited via the internet","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated and tested the Bergen Yale Sex Addiction Scale in German, finding a one‑factor structure and acceptable reliability in an online sample of 492 adults, with 2 % classified as high‑risk for sex‑addiction.","clinical_takeaway":"The German BYSAS shows promise as a brief screening tool, but clinicians should await further validation, especially in clinical populations.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large (N>400) online sample for a validation study","Conducted confirmatory factor analysis and reliability testing","Provides German translation of a widely used scale"],"limitations":["Convenience sample limits generalizability","No assessment of moral incongruence or masturbation separating from sexual behavior","Scale may be circular, defining addiction by self‑reported symptoms"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s40359-025-02445-1"}},{"id":6510,"doi":"10.1080/19317611.2025.2548010","pmid":"41641060","pmcid":"PMC12867395","title":"The Role of Attachment, Childhood Traumatic Experiences and Gender in Men and Women with Compulsive Sexual Behavior Symptoms","authors":"Kürbitz LI, Schröder J, Briken P.","first_author":"Kürbitz LI","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Attachment","Gender","Childhood Trauma","Childhood Traumatic Experiences","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12867395","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"convenience online sample, N=154, linear regression of attachment, trauma, gender vs CSBD‑19 symptoms","sample_n":154,"sample_text":"convenience online sample","population":"German adults, 73 % women","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 154 German adults, higher attachment anxiety and avoidance were linked to more compulsive sexual‑behavior symptoms. Women who reported more childhood physical neglect also showed higher symptoms, while this was not seen in men.","clinical_takeaway":"Consider attachment style and trauma history, especially physical neglect in women, when treating CSBD symptoms.","confidence":0.8,"topic_tags":["csbd","sexual_function","relationships","adolescents","gender","prevalence"],"strengths":["Validated attachment and trauma questionnaires","Use of CSBD‑19 symptom scale","Explores gender interaction"],"limitations":["Convenience, mostly female sample limits generalisability","No control for moral incongruence or masturbation","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2025.2548010"}},{"id":6511,"doi":"10.7759/cureus.25804","pmid":"35836443","pmcid":"PMC9273192","title":"Compulsive Sexual Behavior and Alcohol Use Disorder Treated With Naltrexone: A Case Report and Literature Review","authors":"Sultana T, Sahib Din J.","first_author":"Sultana T","journal":"Cureus","year":2022,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Naltrexone","psychotherapy","Alcohol Use Disorder","Dopamine Pathway","Compulsive Sexual Behavior Or Sexual Addiction"],"is_oa":true,"oa_url":"https://www.cureus.com/articles/98513-compulsive-sexual-behavior-and-alcohol-use-disorder-treated-with-naltrexone-a-case-report-and-literature-review.pdf","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single patient treated with naltrexone; includes nonsystematic literature review","sample_n":1,"sample_text":"single case","population":"53‑year‑old male with alcohol use disorder and self‑reported compulsive sexual behavior","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale","causal_from_correlational"],"stance":"supports","citation_value":"background","plain_summary":"A 53‑year‑old man with alcohol dependence reported that taking naltrexone not only helped his drinking but also lessened his self‑described compulsive sexual behavior. The authors suggest naltrexone could treat sexual addiction, but the claim is based on one patient and a non‑systematic review.","clinical_takeaway":"Evidence for naltrexone reducing compulsive sexual behavior is anecdotal; clinicians should not rely on this case alone for treatment decisions.","confidence":0.4,"topic_tags":["sexual_function","csbd","neuroscience","treatment"],"strengths":["detailed clinical description","offers potential pharmacological insight"],"limitations":["single case, no control","no validated CSB measures","no assessment of confounding factors"],"rubric_version":"2.0","raw_total":12,"max_possible":60,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":2,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.25804"}},{"id":6512,"doi":"10.3389/fpsyt.2025.1621136","pmid":"40677854","pmcid":"PMC12268503","title":"Evaluation and treatment of compulsive sexual behavior: current limitations and potential strategies","authors":"Zhu L, Ma W, Zhang R, Wang C, Song B, Cao Y, Li G.","first_author":"Zhu L","journal":"Frontiers in psychiatry","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual function","Compulsive Sexual Behavior","Sexual Addiction","Compulsivity","Addictive Behaviors"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12268503","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methodology","sample_n":null,"sample_text":"Review article; no primary sample","population":"none","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews current knowledge on compulsive sexual behavior disorder, discussing its controversial classification, common comorbidities, brain‑based theories, and treatment options, while highlighting major research shortcomings and future directions.","clinical_takeaway":"Clinicians should use a biopsychosocial approach and be aware of the limited evidence base when treating CSBD.","confidence":0.7,"topic_tags":["csbd","treatment","neuroscience","sexual_function"],"strengths":["Comprehensive overview of CSBD literature","Identifies methodological gaps for future research","Integrates biological, psychological, and social perspectives"],"limitations":["Not a systematic review; selection bias possible","No quantitative synthesis or risk‑of‑bias assessment","Lacks primary data; no empirical validation of claims"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2025.1621136"}},{"id":6513,"doi":"10.1093/jsxmed/qdaf021","pmid":"39972535","pmcid":null,"title":"Chemsex and compulsive sexual behavior among sexual minority men","authors":"Jennings TL, Gleason N, Nieblas F, Borgogna NC, Kraus SW.","first_author":"Jennings TL","journal":"The journal of sexual medicine","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Substance Use Disorders","Compulsive Sexual Behavior","Gay And Bisexual","Chemsex","Sexual Minority Men","Sexual Risk–taking"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 289 sexual minority men recruited via Grindr","sample_n":289,"sample_text":"289 sexual minority men recruited primarily through Grindr","population":"sexual minority men (gay and bisexual)","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 289 gay and bisexual men recruited from a dating app, 15% reported using drugs during sex (chemsex) and 34% met a cutoff for compulsive sexual behavior. Those who did both showed higher depression, anxiety, and risky sexual behaviors such as condomless anal sex.","clinical_takeaway":"Clinicians should screen for chemsex and compulsive sexual behavior together, as their co‑occurrence may signal increased mental‑health and sexual‑risk concerns.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Use of validated CSBD-7 scale","Relatively large sample for this niche population","Addresses understudied chemsex‑CSBD overlap"],"limitations":["Cross‑sectional, cannot infer causality","Convenience sample from dating app limits generalisability","Key confounds (moral incongruence, masturbation, partner context) not measured"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf021"}},{"id":6516,"doi":"10.1016/j.psychres.2023.115366","pmid":"37542792","pmcid":null,"title":"Mapping the links between sexual addiction and gambling disorder: A Bayesian network approach","authors":"Hunt B, Zarate D, Gill P, Stavropoulos V.","first_author":"Hunt B","journal":"Psychiatry research","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Bayesian network","Network Analysis","Directed Acyclic Graph","Behavioural Addiction","Cross-addiction"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience community sample (N=937) surveyed with online questionnaires; partial‑correlation and Bayesian network analysis of symptom items.","sample_n":937,"sample_text":"Convenience community sampling of 937 adults (315 females, 622 males).","population":"Adults 18‑64, community recruited (non‑clinical).","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large community survey, researchers examined how symptoms of gambling disorder and sexual addiction relate to each other. Using statistical network methods, they found that men and women show different patterns of symptoms, suggesting the two problems are distinct rather than the same underlying disorder.","clinical_takeaway":"Gender appears to shape how sexual‑addiction‑like symptoms cluster, but findings are based on self‑report scales without accounting for moral or mental‑health factors.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a questionnaire study","Use of Bayesian network to explore symptom interrelations","Gender‑specific analysis"],"limitations":["Convenience, non‑representative sample","Reliance on self‑report addiction scales with possible circularity","No control for key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":6,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psychres.2023.115366"}},{"id":6517,"doi":null,"pmid":"38994855","pmcid":null,"title":"[Compulsive Sexual Behaviour Disorder and Sexual Motivations]","authors":"Bakos A, Koos M.","first_author":"Bakos A","journal":"Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakologiai Egyesulet lapja = official journal of the Hungarian Association of Psychopharmacology","year":2024,"pub_types":["Journal Article","English Abstract"],"keywords":["Hypersexuality","Sexual Motivation","Self-determination Theory Compulsive Sexual Behaviour Disorder."],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"hun","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of ~1000 community participants","sample_n":1000,"sample_text":"nearly 1000 participants (self‑selected community sample)","population":"non‑clinical adults (both sexes)","country":"Hungary (presumed)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of about 1,000 adults, people’s motivations for sex were linked to self‑reported hypersexual behaviour. More self‑determined motives did not protect against it; rather, amotivation and certain external motives showed small positive associations.","clinical_takeaway":"Motivation style appears only weakly related to compulsive sexual behaviour; clinicians should consider broader factors beyond sexual motives.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Large sample size for a survey","Use of validated scales (HBI, Sexual Motivation Scale)","Multiple regression controls for gender"],"limitations":["Cross‑sectional; no causal inference","Key confounds (moral incongruence, masturbation, mental health, partner factors, trauma) not measured","No confidence intervals or pre‑registration"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":3,"interpretation":7}},"scite":null},{"id":6519,"doi":"10.31234/osf.io/sa4uc_v1","pmid":null,"pmcid":null,"title":"To Be a Mental Disorder: Revisiting Behavioral Addictions","authors":"Grubbs JB, Borgogna N, Bőthe B, Kim HS, Pfund RA, Kraus SW.","first_author":"Grubbs JB","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review how behavioral addictions, especially compulsive sexual behavior, are defined and studied, noting that many current measures rely on self‑report and may mistakenly label normal behavior as disordered.","clinical_takeaway":"Clinicians should be cautious interpreting self‑labelled ‘addiction’ without robust, validated assessments.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Broad synthesis of recent literature","Highlights methodological gaps"],"limitations":["No empirical data presented","No systematic review methods reported"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/sa4uc_v1"}},{"id":6520,"doi":"10.3390/healthcare14142164","pmid":"42512680","pmcid":"PMC13409809","title":"Psychosocial and Behavioral Correlates of HIV Serostatus Among Men Who Have Sex with Men in Portugal: A Cross-Sectional Study","authors":"Alckmin-Carvalho F, Teixeira I, Guedes FL, Bú ED, Pereira H, Santos M, Wendt G.","first_author":"Alckmin-Carvalho F","journal":"Healthcare (Basel, Switzerland)","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Portugal","Sexual Health","Emotion Regulation","Hiv Serostatus","Substance Use","Psychological Distress","Compulsive Sexual Behavior","Minority Stress","Men Who Have Sex With Men (Msm)","Internalized Homonegativity","Syndemics","Chemsex"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13409809","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience online sample of 480 cis‑gender MSM (66 HIV+); self‑report questionnaires; Mann‑Whitney U and logistic regression with Firth penalization.","sample_n":480,"sample_text":"Convenience sample recruited online; not probability based.","population":"cis‑gender men who have sex with men, Portugal","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Portuguese online survey of 480 gay and bisexual men, higher compulsive sexual behavior, internalized homonegativity, and chemsex drug use were modestly linked to being HIV‑positive, but the study cannot tell whether these factors cause infection.","clinical_takeaway":"Compulsive sexual behavior and chemsex may be markers of HIV risk among MSM, but clinicians should treat them as correlates, not proven causes.","confidence":0.78,"topic_tags":["sexual_function","csbd"],"strengths":["Large sample for MSM research in Portugal","Use of validated psychometric instruments","Multivariate logistic model with penalized likelihood"],"limitations":["Convenience, non‑representative sampling","Cross‑sectional – no causal inference","Key confounds (moral incongruence, masturbation, trauma) not measured"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare14142164"}},{"id":6522,"doi":"10.1007/s40429-025-00658-3","pmid":"41777522","pmcid":"PMC12952904","title":"Child Sexual Abuse and Compulsive Sexual Behavior: An Updated Systematic Review of Key Findings and Moderators","authors":"Slavin MN, Hewage S, Roy S, Kraus SW.","first_author":"Slavin MN","journal":"Current addiction reports","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Measurements","Child Sexual Abuse","Moderators","Compulsive Sexual Behavior Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic literature review of 17 cross‑sectional studies on CSA and CSB, no meta‑analysis","sample_n":null,"sample_text":"17 publications (cross‑sectional, Western samples)","population":"individuals with histories of child sexual abuse examined across Western studies","country":"Various (Western)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 17 studies finds that people who experienced child sexual abuse are more likely to report compulsive sexual behavior. The link is stronger when factors like trauma symptoms, depressive mood, gender, and minority stress are present, but most evidence comes from cross‑sectional Western samples.","clinical_takeaway":"Clinicians should assess trauma history when treating compulsive sexual behavior, recognizing that many studies are correlational and lack standardized measures.","confidence":0.78,"topic_tags":["csbd"],"strengths":["Comprehensive update of CSA‑CSB literature","Identifies a range of psychological and social moderators","Highlights methodological gaps for future work"],"limitations":["Relies on predominantly cross‑sectional, Western studies","Inconsistent measurement of CSB across primary reports","No quantitative meta‑analysis or risk‑of‑bias assessment reported"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40429-025-00658-3"}},{"id":6523,"doi":"10.1111/ajad.70090","pmid":"41110114","pmcid":null,"title":"Double trouble - Examining the co-occurrence of compulsive sexual behavior disorder and gambling disorder among two American samples","authors":"Way BM, Jennings TL, Grubbs JB, Chapman H, Kraus SW.","first_author":"Way BM","journal":"The American journal on addictions","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two independent cross‑sectional samples (community high‑risk gamblers, N=498; veterans in GD inpatient treatment, N=606) were surveyed for high risk CSBD and related psychopathology.","sample_n":1104,"sample_text":"498 community participants at high risk for gambling disorder; 606 veterans in inpatient gambling treatment.","population":"Adults (community sample) and U.S. veterans receiving inpatient treatment for gambling disorder","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In two U.S. samples, about one‑third of people with gambling problems also showed signs of compulsive sexual behavior, especially younger, male, and sexually diverse individuals, and they tended to have more anxiety, depression, and substance use.","clinical_takeaway":"Screen patients with gambling disorder for compulsive sexual behavior, as co‑occurrence is common and linked to additional mental‑health issues.","confidence":0.8,"topic_tags":["csbd","gender","relationships","sexual_function","prevalence"],"strengths":["Large combined sample (>1,000 participants)","Inclusion of both community and clinical veteran samples","Assessment of a range of co‑occurring psychopathology"],"limitations":["Cross‑sectional design cannot establish causality","CSBD risk based on screening scale, likely circular definition","Key confounds (moral incongruence, masturbation, partner factors, trauma) not measured"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/ajad.70090"}},{"id":6526,"doi":"10.4103/ipj.ipj_60_25","pmid":"40861127","pmcid":"PMC12373322","title":"Revisiting repetitive behaviors: A case series on compulsive sexual behavior disorder, trichotillomania, non-suicidal self-injury, and binge eating disorder","authors":"Laha P, Sutar RF.","first_author":"Laha P","journal":"Industrial psychiatry journal","year":2025,"pub_types":["other","Journal Article"],"keywords":["Glutamate","N-acetylcysteine","Trichotillomania","Binge Eating Disorder","Non-suicidal Self-injury","Impulsive-compulsive Disorders","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12373322","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of a few clinical patients with CSBD and other impulsive‑compulsive disorders","sample_n":null,"sample_text":"Not specified in abstract; likely very small","population":"clinical patients with CSBD, trichotillomania, binge‑eating, NSSI (sample size not reported)","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small series of patients with compulsive sexual behavior, hair‑pulling, binge eating and self‑injury is described, noting shared impulsive‑compulsive traits and suggesting glutamate‑targeting drugs might help. More robust research is needed.","clinical_takeaway":"No clinical recommendations can be drawn; the paper only proposes a hypothesis about glutamate treatment for CSBD.","confidence":0.8,"topic_tags":["csbd","treatment","neuroscience","gender"],"strengths":["Addresses multiple impulsive‑compulsive disorders together","Discusses neurobiological mechanisms","Highlights potential treatment avenue (glutamate modulators)"],"limitations":["Very small, unspecified sample size (case series)","No validated measures of CSBD or other disorders reported","No control for key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)","Interpretation extends beyond data"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/ipj.ipj_60_25"}},{"id":6527,"doi":"10.1556/2006.2023.00005","pmid":"36913189","pmcid":"PMC10260208","title":"Assessing compulsive sexual behavior disorder: The development and international validation of the compulsive sexual behavior disorder-diagnostic inventory (CSBD-DI)","authors":"Grubbs JB, Reid RC, Bőthe B, Demetrovics Z, Coleman E, Gleason N, Miner MH, Fuss J, Klein V, Lewczuk K, Gola M, Fernandez DP, Fernandez EF, Carnes S, Lew-Starowicz M, Kingston D, Kraus SW.","first_author":"Grubbs JB","journal":"Journal of behavioral addictions","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Scale Development","Impulse Control Disorders","Sexual Addiction","Hypersexuality","Behavioral Addiction"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/12/1/article-p242.pdf","cited_by_count":31,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Scale development and validation across multiple community and nationally representative samples (N≈13,000 total).","sample_n":13000,"sample_text":"Large, multi‑country community and nationally representative samples.","population":"Adults from community and national samples in USA, Malaysia, Hungary, Germany, Poland.","country":"International","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and tested a short 7‑item questionnaire (CSBD‑DI) to identify compulsive sexual behavior disorder. Across five countries and large community samples, the tool showed strong reliability and could distinguish people who said they had problematic sexual behavior.","clinical_takeaway":"The CSBD‑DI offers a brief screening option for clinicians, but its results should be interpreted alongside assessments of moral conflict, mental health, and relationship factors.","confidence":0.85,"topic_tags":["measurement","csbd","sexual_function"],"strengths":["Large, diverse samples across 5 countries","Rigorous psychometric testing (factor analysis, invariance)","Nationally representative data"],"limitations":["No measurement of moral incongruence or other key confounds","Cross‑sectional; cannot assess temporal stability","Scale newly created; external clinical validation limited"],"rubric_version":"2.0","raw_total":39,"max_possible":60,"pct_score":65,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":6,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":41,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2023.00005"}},{"id":6528,"doi":"10.34172/ahj.2024.1450","pmid":"39051039","pmcid":"PMC11264479","title":"Investigating the Relationship of Childhood Traumas and Sexual Guilt with Sexual Addiction in Iranian Prostitutes","authors":"Ghazaei M, Rafei N.","first_author":"Ghazaei M","journal":"Addiction & health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Compulsive Behavior","Guilt","Prostitutes","Adverse Childhood Experiences"],"is_oa":true,"oa_url":"https://doi.org/10.34172/ahj.2024.1450","cited_by_count":0,"is_preprint":false,"topics":["csbd","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 100 Iranian prostitutes recruited from a health promotion centre","sample_n":100,"sample_text":"Convenience sample of prostitutes attending a health centre","population":"Female sex workers (age 23‑42) in Iran","country":"Iran","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational","self_selected_sample"],"stance":"supports","citation_value":"background","plain_summary":"In 100 Iranian sex workers, higher scores of childhood abuse and neglect were linked to higher scores on a sexual‑addiction questionnaire, while sexual guilt was not related. The study suggests early trauma may be tied to later problematic sexual behaviour.","clinical_takeaway":"Screen for childhood trauma when assessing sexual‑addiction concerns, but recognise that the study’s design cannot prove a causal link.","confidence":0.6,"topic_tags":["sexual_function","csbd"],"strengths":["Use of validated questionnaires (CTQ, Mosher Guilt Scale)","Focus on a hard‑to‑reach, high‑risk population","Clear statistical reporting of correlations and regression coefficients"],"limitations":["Cross‑sectional design, cannot infer causality","Convenience sample, limited generalisability","No measurement of moral or religious attitudes, masturbation, or mental‑health covariates","Addiction label based on screening tool without testing ICD‑11 criteria"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.34172/ahj.2024.1450"}},{"id":6529,"doi":"10.3389/fpsyt.2023.1265822","pmid":"38076695","pmcid":"PMC10702771","title":"Impulsivity and sexual addiction: factor structure and criterion-related validity of the sexual addiction screening test in Mexican adults","authors":"Mejía Cruz D, Avila Chauvet L, Villalobos-Gallegos L, Toledo-Lozano CG.","first_author":"Mejía Cruz D","journal":"Frontiers in psychiatry","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Personality","Impulsivity","Psychological Distress","Sex Addiction","Reward/Punishment Responsivity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10702771","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional validation study with 370 Mexican adults completing the SAST‑R and other self‑report questionnaires.","sample_n":370,"sample_text":"370 adults completed the SAST‑R and related measures.","population":"Adults (Mexico), sample size 370, recruitment method not specified (likely convenience).","country":"Mexico","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated and validated the Sexual Addiction Screening Test‑R for Mexican adults, finding it reliable and showing modest links with personality traits, impulsivity, and distress.","clinical_takeaway":"The Mexican SAST‑R appears psychometrically sound, but clinicians should be cautious interpreting scores as evidence of addiction.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for psychometric validation","Use of multiple established questionnaires","Confirmatory factor analysis performed"],"limitations":["Cross‑sectional design, cannot infer causality","No assessment of moral incongruence or masturbation","Convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2023.1265822"}},{"id":6531,"doi":"10.1556/2006.2025.00059","pmid":"40818055","pmcid":"PMC12486290","title":"Global research status and trends of compulsive sexual behavior disorder: A comprehensive bibliometric analysis","authors":"Zhang W, Wang P, Gao B, Wang Z.","first_author":"Zhang W","journal":"Journal of behavioral addictions","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Bibliometric Analysis","Behavioral Addiction","Hypersexual Disorder","Visualization Techniques","Research Trends","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12486290","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Bibliometric analysis of 2,261 CSBD publications (2000‑2024) using Web of Science data; descriptive co‑authorship, co‑citation, keyword clustering with VOSviewer, CiteSpace, etc.","sample_n":2261,"sample_text":"2,261 CSBD‑related publications extracted from Web of Science","population":"None (analysis of published literature)","country":"International (based on indexed publications)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors mapped 2,261 papers on compulsive sexual behavior disorder from 2000‑2024, showing a steady rise in publications, especially after ICD‑11 inclusion, and highlighting that most research comes from Western countries with limited cross‑cultural work.","clinical_takeaway":"None – the paper reviews research trends, not clinical outcomes.","confidence":0.8,"topic_tags":["csbd","prevalence","treatment"],"strengths":["Large dataset covering 25 years of CSBD literature","Use of multiple bibliometric visualization tools","Identifies geographic and thematic gaps"],"limitations":["No primary empirical data; cannot assess construct validity","Relies on indexed English‑language sources only","Lacks quantitative synthesis of study findings"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00059"}},{"id":6532,"doi":"10.1016/j.encep.2025.04.006","pmid":"40707267","pmcid":null,"title":"French validation of the Sexual Sensation Seeking and Sexual Compulsivity Scales","authors":"Revillard V, Duran G, Michael GA.","first_author":"Revillard V","journal":"L'Encephale","year":2026,"pub_types":["Validation Study","Journal Article"],"keywords":["Forensic Psychology","Sexual Coercion","French Validation","Validation Française","Sexual Compulsivity Scale","Coercition Sexuelle","Psychologie Criminalistique","Sexual Sensation Seeking Scale","Sexualcompulsivityscale","Sexualsensationseekingscale"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of French versions of the Sexual Sensation Seeking Scale and Sexual Compulsivity Scale in a sample of 536 French participants; factor analysis, internal consistency, convergent/divergent validity assessed.","sample_n":536,"sample_text":"536 participants from France","population":"Adults and young adults from France (both sexes); sample size 536; recruitment method not specified in abstract.","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors translated two brief questionnaires – the Sexual Sensation Seeking Scale and the Sexual Compulsivity Scale – into French and tested them with 536 French adults. Factor analysis and reliability checks showed the French versions work well and relate to other forensic‑related measures as expected.","clinical_takeaway":"French clinicians and researchers can use the new French SSSS and SCS with confidence that they have solid psychometric properties.","confidence":0.7,"topic_tags":["sexual_function","measurement"],"strengths":["Large sample for psychometric validation","Comprehensive factor‑structure and reliability analysis","Assessment of both convergent and divergent validity"],"limitations":["Abstract provides no detail on recruitment or representativeness","No pre‑registration reported","Confounding variables (e.g., mental health, moral attitudes) not addressed"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.encep.2025.04.006"}},{"id":6533,"doi":"10.20944/preprints202609.0221.v1","pmid":null,"pmcid":null,"title":"Childhood Abuse, Sexual Risk-Taking, and Sexual Dysfunction: The Paradox of Hypersexuality and Sexual Avoidance","authors":"SV SK.","first_author":"SV SK.","journal":"Preprints.org","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"narrative-integrative review of published literature, no new empirical data","sample_n":null,"sample_text":"Not applicable – review of existing studies","population":"survivors of childhood sexual abuse (adult outcomes)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review explains how childhood sexual abuse can lead to both increased risky sexual behavior and sexual avoidance in adulthood, arguing that trauma‑related changes in attachment, emotion regulation, and stress physiology create this paradox.","clinical_takeaway":"Clinicians should assess both hypersexual and avoidant sexual patterns, along with trauma and minority‑stress factors, when working with survivors.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad synthesis of four decades of literature","Integrates psychological, neurobiological, and sociocultural perspectives","Highlights need for standardized measurement"],"limitations":["Narrative review without systematic search or bias assessment","No original data; conclusions rely on heterogenous primary studies","Does not empirically test mediating mechanisms"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202609.0221.v1"}},{"id":6535,"doi":"10.1080/15299732.2026.2641637","pmid":"41789641","pmcid":null,"title":"Underlying Dissociative Adjustment in a Case of Same-Sex Sexual Compulsivity","authors":"Rosik CH.","first_author":"Rosik CH.","journal":"Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation (ISSD)","year":2026,"pub_types":["Journal Article"],"keywords":["Dissociation","Religion","Sexual Compulsivity","Same-sex Sexuality"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-case psychotherapy description","sample_n":1,"sample_text":"single case (Francesco)","population":"one adult male with same‑sex sexual compulsivity and dissociative symptoms","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A therapist describes one man’s treatment for compulsive same‑sex sexual behavior, linking it to childhood trauma, dissociation, and religious conflict. The authors suggest that improving emotion regulation and attachment may reduce the compulsivity.","clinical_takeaway":"Therapists should assess dissociative and trauma histories when treating sexual compulsivity, but this single case does not establish a standard approach.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rich clinical narrative","Integrates trauma and dissociation frameworks"],"limitations":["Single case; no generalisability","No validated measures reported","No systematic assessment of confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/15299732.2026.2641637"}},{"id":6536,"doi":"10.1556/2006.2021.00044","pmid":"34280126","pmcid":"PMC8997222","title":"Impulsivity in Compulsive Sexual Behavior Disorder and Pedophilic Disorder","authors":"Savard J, Hirvikoski T, Görts Öberg K, Dhejne C, Rahm C, Jokinen J.","first_author":"Savard J","journal":"Journal of behavioral addictions","year":2021,"pub_types":["brief-report","Journal Article"],"keywords":["Impulsivity","Pedophilic Disorder","Compulsive Sexual Behavior Disorder","Compuslivity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8997222","cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Brief report, cross‑sectional comparison of 20 men with CSBD, 55 with Pedophilic Disorder and 57 healthy controls recruited from drug‑trial participants at a Swedish sexual‑medicine clinic.","sample_n":132,"sample_text":"CSBD n=20; Pedophilic Disorder n=55; Healthy controls n=57","population":"Adult males, clinical convenience sample; not representative of general population.","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that men with compulsive sexual behavior or pedophilic disorder show higher self‑reported impulsivity and that attentional impulsivity predicts sexual compulsivity, even after accounting for ADHD.","clinical_takeaway":"Assess attentional impulsivity in clients with CSBD; consider interventions targeting impulsivity alongside sexual‑behavior treatment.","confidence":0.78,"topic_tags":["sexual_function","csbd"],"strengths":["Use of validated impulsivity and sexual compulsivity scales","Inclusion of objective CPT‑II performance data","Comparison with healthy control group"],"limitations":["Small CSBD sample limits statistical power","No measurement of key confounds (moral incongruence, masturbation, mood, relationship context, trauma)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":5,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2021.00044"}},{"id":6537,"doi":"10.21203/rs.3.rs-9238201/v1","pmid":null,"pmcid":null,"title":"Modulation of the Incretin Axis (GLP-1/GIP) in Behavioral Compulsions: A New Neuropsychopharmacology Frontier","authors":"Andrade LJdO, de Oliveira LM, de Oliveira GCM, Neves RAS.","first_author":"Andrade LJdO","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Narrative review with two illustrative case reports (one compulsive buying, one compulsive sexual behavior) treated with tirzepatide; no control group, no systematic synthesis.","sample_n":2,"sample_text":"Two individual patients (one female, one male) described in case reports.","population":"Adults with compulsive buying or compulsive sexual behavior (single cases); obesity noted for one patient.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A preprint reviews how the diabetes drug tirzepatide might affect compulsive buying and compulsive sexual behavior, and describes two patients who seemed to improve after treatment, but evidence is limited to these isolated cases.","clinical_takeaway":"Currently insufficient evidence to recommend tirzepatide for compulsive sexual behavior; await controlled studies.","confidence":0.6,"topic_tags":["sexual_function","csbd"],"strengths":["Addresses novel pharmacological target (tirzepatide)","Integrates preclinical and clinical references","Acknowledges need for controlled trials"],"limitations":["Only two uncontrolled case reports","No validated outcome measures","No systematic review methodology"],"rubric_version":"2.0","raw_total":15,"max_possible":60,"pct_score":25,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":2,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-9238201/v1"}},{"id":6540,"doi":"10.20944/preprints202609.1893.v1","pmid":null,"pmcid":null,"title":"The Sexual Health Consequences of Childhood Sexual Abuse: Beyond Sexual Dysfunction","authors":"Sompur Vasanthkumar SK.","first_author":"Sompur Vasanthkumar SK.","journal":"Preprints.org","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd","sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review synthesizing epidemiological, psychophysiological, longitudinal and treatment research; no original data collected.","sample_n":null,"sample_text":"Not applicable – review of existing literature.","population":"Survivors of childhood sexual abuse (CSA); no new sample recruited.","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review summarises how childhood sexual abuse can affect survivors’ later sexual health, including problems with desire, risk behaviours, relationship satisfaction and compulsive sexual behaviour, and discusses possible mechanisms and trauma-informed treatments.","clinical_takeaway":"Clinicians should assess a wide range of sexual health issues in CSA survivors, not only dysfunction, and consider trauma‑informed interventions.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Broad synthesis of multiple research domains","Highlights under‑studied outcomes (e.g., technology‑facilitated abuse)","Identifies mechanisms linking CSA to later sexual health"],"limitations":["Narrative rather than systematic review; possible selection bias","No explicit methodological framework reported","Lacks quantitative meta‑analytic integration"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202609.1893.v1"}},{"id":6541,"doi":"10.1093/sexmed/qfaf077","pmid":"41050100","pmcid":"PMC12496012","title":"Frequency of lab HIV and self-reported STI history and its predictors among a sexually compulsive clinical sample: a cross-sectional study","authors":"Bubola Lima NR, Nisida IVV, de Tubino Scanavino M.","first_author":"Bubola Lima NR","journal":"Sexual medicine","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Behavior","HIV","Sexually Transmitted Infections","Sexual Compulsivity","Sexual Risk"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12496012","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional clinical sample of CSB patients and controls, recruited via clinic noticeboards and online ads","sample_n":275,"sample_text":"275 participants (67.5% CSB, 32.5% controls)","population":"Adults seeking treatment for compulsive sexual behavior at a tertiary hospital in São Paulo, Brazil; plus healthy volunteers as controls","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Brazilian clinic, people diagnosed with compulsive sexual behavior had higher rates of HIV (10.8% vs 2.4%) and self‑reported STIs (44% vs 18%) than non‑CSB controls. Risk factors included gay/bisexual identity, sex while intoxicated, and higher sexual compulsivity.","clinical_takeaway":"Screening for HIV/STIs should be routine in CSB treatment, especially for gay/bisexual clients and those reporting sex under the influence.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Laboratory HIV testing in clinical CSB sample","Relatively large N for a clinical population","Inclusion of women and diverse sexual orientations"],"limitations":["Convenience, treatment‑seeking sample limits generalisability","Key confounds (moral incongruence, masturbation, mental health) not measured","Missing laboratory STI data, relied on self‑report"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfaf077"}},{"id":6543,"doi":"10.1556/2006.2025.00014","pmid":"40063093","pmcid":"PMC11974430","title":"Exploring the role of the amygdala in Compulsive Sexual Behavior Disorder via a parcellation pipeline based on Recurrence Quantification Analysis","authors":"Adamus S, Bielski K, Szatkowska I, Gola M, Draps M.","first_author":"Adamus S","journal":"Journal of behavioral addictions","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Recurrence quantification analysis","Compulsive Sexual Behavior Disorder","Amygdala Parcellation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11974430","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control fMRI study comparing 45 CSBD males with 26 healthy controls; resting‑state data analysed with a novel RQA‑based amygdala parcellation and seed‑to‑voxel connectivity correlations with questionnaire scores.","sample_n":71,"sample_text":"45 CSBD participants, 26 healthy controls","population":"adult heterosexual males","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used resting‑state fMRI to split the amygdala into sub‑regions and compared 45 men with compulsive sexual behavior disorder to 26 healthy men. Differences in amygdala size and connectivity were linked to symptom severity and mood measures, suggesting a role for the right ventrolateral amygdala in the disorder.","clinical_takeaway":"Findings hint that amygdala sub‑regions may relate to CSBD severity, but the evidence is preliminary and not ready for clinical use.","confidence":0.7,"topic_tags":["csbd","neuroscience"],"strengths":["first use of RQA‑based amygdala parcellation for CSBD","includes matched healthy control group","examines multiple psychological covariates"],"limitations":["small fMRI sample limits reliability","no measurement of moral incongruence or masturbation","cross‑sectional design cannot infer causality","addiction criteria not directly tested"],"rubric_version":"2.0","raw_total":32,"max_possible":70,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":5,"statistics":5,"confounds":5,"design":4,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00014"}},{"id":6544,"doi":"10.1093/sexmed/qfaf092","pmid":"41216385","pmcid":"PMC12597027","title":"Two sides of the same coin? Prevalence and co-occurrence of binge eating disorder and compulsive sexual behavior disorder in a representative sample of the Polish population","authors":"Kowalewska E, Lew-Starowicz M.","first_author":"Kowalewska E","journal":"Sexual medicine","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Mental disorders","Comorbidity","Compulsive Sexual Behavior","Binge Eating Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12597027","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"representative Polish adult sample (N=1527), cross‑sectional survey","sample_n":1527,"sample_text":"representative sample of Polish adults, 1527 participants aged 18‑65","population":"Polish adults, 18‑65 years, nationally representative","country":"Poland","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationwide Polish survey of 1,527 adults, men showed more compulsive sexual behavior symptoms and women showed more binge‑eating symptoms. The two problems co‑occurred in men but not women, and both were linked to higher anxiety and depression.","clinical_takeaway":"Screen for both binge‑eating and compulsive sexual behavior, especially in men, and consider integrated treatment for shared emotional regulation issues.","confidence":0.85,"topic_tags":["csbd"],"strengths":["Large, nationally representative sample","Addresses understudied comorbidity of BED and CSBD","Reports effect sizes and gender differences"],"limitations":["Cross‑sectional; no causal inference","Reliance on self‑report scales, unclear validation","No control for moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfaf092"}},{"id":6545,"doi":"10.1007/s10508-025-03162-x","pmid":"40481341","pmcid":null,"title":"For Whom Is Sexual Abuse Related to Compulsive Sexual Behaviors? Timing of Abuse and Sociodemographic Characteristics as Potential Moderators Across 42 Countries","authors":"Vaillancourt-Morel MP, Bergeron S, Gewirtz-Meydan A, Zippan N, Nagy L, Koós M, Kraus SW, Demetrovics Z, Potenza MN, International Sex Survey (ISS) Consortium, Bőthe B.","first_author":"Vaillancourt-Morel MP","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual Abuse","Compulsive Sexual Behavior","Childhood Sexual Abuse","Compulsive Sexual Behavior Disorder","Adolescent Or Adult Sexual Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online self‑report survey across 42 countries (N=82,233); cross‑sectional convenience sample","sample_n":82233,"sample_text":"Convenience online survey; not probability‑based; may over‑represent internet‑savvy participants","population":"adults (mean age 32.4), cisgender women 55.8%, diverse sexual orientations and relationship statuses","country":"multinational (42 countries)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Across 42 countries, people who experienced sexual abuse—especially both childhood and adult abuse—tended to report higher levels of compulsive sexual behaviour. The link was strongest in younger adults, cisgender men, single people, and certain sexual‑minority groups.","clinical_takeaway":"History of sexual abuse may be a risk factor for compulsive sexual behaviours; clinicians should assess trauma when addressing CSB.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Very large multinational sample","Systematic examination of multiple moderators","Clear reporting of effect sizes"],"limitations":["Cross‑sectional, cannot infer causality","No control for moral incongruence or mental‑health covariates","Convenience online sample limits generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03162-x"}},{"id":6546,"doi":"10.1111/hsc.13667","pmid":"34860452","pmcid":null,"title":"The circle of gain and loss: Iranian women's life stories of suffering from compulsive sexual behaviour","authors":"Moshtagh M, Mirlashari J, Rafiey H, Brown H.","first_author":"Moshtagh M","journal":"Health & social care in the community","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Iran","Women","Qualitative Study","Health And Social Care","Compulsive Sexual Behaviour"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"qualitative interview study with 44 Iranian women reporting compulsive sexual behaviour; thematic analysis of semi‑structured interviews","sample_n":44,"sample_text":"44 semi‑structured interviews conducted between 2014‑2016 in two Iranian cities","population":"Iranian women self‑identified as experiencing compulsive sexual behaviour (n=44); recruited from two cities, likely convenience sampling","country":"Iran","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"supports","citation_value":"useful","plain_summary":"Through interviews with 44 Iranian women, the study describes how early abusive relationships can lead to patterns that the authors label compulsive sexual behaviour, highlighting emotional regulation difficulties and harmful beliefs about sexuality.","clinical_takeaway":"Clinicians should consider histories of childhood abuse when assessing women who report compulsive sexual behaviours.","confidence":0.6,"topic_tags":["csbd","sexual_function","gender"],"strengths":["In‑depth, first‑person narratives provide rich contextual insight","Theoretical sampling and constant comparative method enhance analytic rigor"],"limitations":["Small, non‑representative convenience sample limits generalisability","No standardized measures of compulsive sexual behaviour or confounding variables","Findings may reflect self‑selection bias toward individuals seeking help"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/hsc.13667"}},{"id":6547,"doi":"10.1016/j.addbeh.2024.108214","pmid":"39577314","pmcid":null,"title":"Metacognitive beliefs and desire thinking as potential maintenance factors of compulsive sexual behavior","authors":"Olivari C, Mansueto G, Marino C, Candellari G, Cericola J, Binnie J, Spada MM, Caselli G.","first_author":"Olivari C","journal":"Addictive behaviors","year":2025,"pub_types":["Journal Article"],"keywords":["Addictive Behavior","Metacognitive Beliefs","Desire Thinking","Metacognitive Therapy","Compulsive Sex"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey, N=1185 (general‑population convenience sample)","sample_n":1185,"sample_text":"general population convenience sample, predominantly young adult females","population":"adults (18‑19 y, 76 % female)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 1,100 young adults, stronger beliefs that thinking about sexual desire is useful were linked to more vivid sexual fantasies, which in turn related to higher compulsive sexual behavior. Both positive and negative metacognitive beliefs about desire thinking appear to sustain problematic sexual habits.","clinical_takeaway":"Metacognitive beliefs and desire‑thinking patterns may be useful therapeutic targets for people struggling with compulsive sexual behavior.","confidence":0.8,"topic_tags":["csbd"],"strengths":["large sample size","use of established theoretical frameworks","path‑analysis provides a coherent model"],"limitations":["cross‑sectional; cannot infer causality","no measurement of moral incongruence or masturbation","potential self‑selection/WEIRD bias"],"rubric_version":"2.0","raw_total":38,"max_possible":60,"pct_score":63,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[{"status":"Has erratum","date":"2025-3-18","noticeDoi":"10.1016/j.addbeh.2025.108323","doi":"10.1016/j.addbeh.2024.108214"}],"url":"https://scite.ai/reports/10.1016/j.addbeh.2024.108214"}},{"id":6548,"doi":"10.1556/2006.2023.00087","pmid":"38289411","pmcid":"PMC10988404","title":"Compulsive sexual behavior disorder: The importance of research on women","authors":"Kowalewska E, Bőthe B, Kraus SW.","first_author":"Kowalewska E","journal":"Journal of behavioral addictions","year":2024,"pub_types":["article-commentary","Journal Article"],"keywords":["Women","Gender Differences","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10988404","cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"article-commentary; no empirical data presented","sample_n":null,"sample_text":"Not applicable – commentary without primary data","population":"women with compulsive sexual behavior disorder (theoretical discussion)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors note that most research on compulsive sexual behavior disorder focuses on heterosexual men, leaving little knowledge about women. They call for studies on prevalence, causes, diagnosis, comorbidities, sexual patterns, personality, and help‑seeking in women to improve care and awareness.","clinical_takeaway":"Clinicians should recognize that evidence on CSBD in women is scarce and await future gender‑specific research before drawing conclusions.","confidence":0.6,"topic_tags":["csbd","gender","sexual_function"],"strengths":["Highlights a significant gap in the literature regarding women with CSBD","Identifies multiple research domains needing attention"],"limitations":["No empirical data or systematic review methodology","Provides no concrete measurement or analytic details"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2023.00087"}},{"id":6549,"doi":"10.1080/00224499.2026.2688564","pmid":"42339841","pmcid":null,"title":"Prevalence and Correlates of Condom Use Resistance Among Men Who Have Sex with Men Reporting Recent Heavy Alcohol Use and Condomless Sex","authors":"Gleason N, Fernholz D, Smith L, Chadwick SB, Skakoon-Sparling S, Hart TA, Pedersen ER, George WH, Davis KC.","first_author":"Gleason N","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 261 MSM reporting heavy alcohol use and condomless anal sex; convenience sample.","sample_n":261,"sample_text":"Convenience recruitment; not nationally representative; potential self‑selection bias.","population":"Men who have sex with men (MSM), heavy alcohol users, recent condomless anal sex","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 261 MSM who drank heavily and had condomless anal sex, most reported ever using tactics to avoid condoms, with 77% using non‑coercive and 54% using coercive methods. More frequent use was linked to higher sexual sensation seeking, compulsive sexual behavior, and more casual/condomless sex.","clinical_takeaway":"Higher sexual sensation seeking and compulsive sexual behavior are associated with condom‑use resistance; clinicians should assess these factors when discussing risk reduction with MSM.","confidence":0.78,"topic_tags":["sexual_function","relationships"],"strengths":["Relatively large sample for MSM sub‑population","Includes validated compulsive sexual behavior measure","Examines both coercive and non‑coercive condom‑use resistance tactics"],"limitations":["Cross‑sectional, cannot infer causality","Convenience sample limits generalisability","Key confounds (moral incongruence, mental health, partner context) not measured"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2026.2688564"}},{"id":6550,"doi":"10.1556/2006.2024.00003","pmid":"38329531","pmcid":"PMC10988410","title":"Delay discounting of protected sex and compulsive sexual behavior in women with borderline personality disorder","authors":"Finkenstaedt M, Biedermann D, Schröder J, Gholami Mazinan R, Fuss J, Biedermann SV.","first_author":"Finkenstaedt M","journal":"Journal of behavioral addictions","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Borderline Personality Disorder","Compulsive Sexual Behavior","Sexual Risk Behavior","Sexual Impulsivity","Sexual Delay Discounting"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10988410","cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control cross-sectional comparison of 40 women with BPD and 40 healthy controls using behavioral discounting task and questionnaires","sample_n":80,"sample_text":"40 BPD, 40 controls","population":"women, average age 27, diagnosed with borderline personality disorder vs healthy controls","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Women with borderline personality disorder were less likely to choose protected sex in a delay‑discounting test, indicating higher sexual impulsivity and risk for STIs compared with healthy women.","clinical_takeaway":"Assess and address impulsive sexual decision‑making in women with BPD to reduce STI risk.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Use of validated questionnaires (BSL‑23, CSBD‑19)","Behavioral delay‑discounting task provides objective measure","Direct comparison between clinical and non‑clinical groups"],"limitations":["Cross‑sectional design limits causal inference","Small sample; limited power for subgroup analyses","Key confounds (moral incongruence, masturbation, mental‑health covariates) not measured"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00003"}},{"id":6552,"doi":"10.29158/jaapl.210151-21","pmid":"36162862","pmcid":null,"title":"Sexual Addiction as a Legal Defense","authors":"Nassif J, Joshi P, Wagoner R, Newman W.","first_author":"Nassif J","journal":"The journal of the American Academy of Psychiatry and the Law","year":2022,"pub_types":["Journal Article"],"keywords":["Expert Testimony","Sexual Addiction","Diagnostic Classification","Case Law","Legal Defense"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Legal case review without original empirical data; no sampling of participants.","sample_n":null,"sample_text":"Not applicable – review of case law.","population":"Legal cases involving the term “sexual addiction”; no human participants recruited.","country":"United States (LexisNexis database focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews U.S. court cases that have used the concept of sexual addiction as a legal defense, showing that courts are split on whether the diagnosis is scientifically valid.","clinical_takeaway":"None - the paper is a legal review, not clinical evidence.","confidence":0.8,"topic_tags":["sexual_function","csbd","gender"],"strengths":["Provides systematic overview of legal cases","Highlights lack of consensus in psychiatry and law"],"limitations":["No empirical data on individuals","No measurement of constructs or confounds","Limited applicability to clinical practice"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.29158/jaapl.210151-21"}},{"id":6553,"doi":"10.31234/osf.io/r6947","pmid":null,"pmcid":null,"title":"Sexual Addiction 25 Years On: A Systematic and Methodological Review of Empirical Literature and an Agenda for Future Research","authors":"Grubbs JB, Hoagland C, Lee BN, Grant Weinandy JT, Davison PM, Reid R, Kraus SW.","first_author":"Grubbs JB","journal":"PsyArXiv","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/r6947","cited_by_count":1,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic methodological review of 371 papers (415 studies) published 1995‑2020; no meta‑analysis reported, pre‑registration not mentioned.","sample_n":null,"sample_text":"N/A (review of existing studies)","population":"Empirical literature on compulsive sexual behaviours; no primary participants.","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review examined 371 papers on compulsive sexual behaviour over 25 years, finding that many studies use simplistic designs and poor measurement tools, and that high‑quality treatment research is virtually absent.","clinical_takeaway":"Current evidence on compulsive sexual behaviour lacks robust methodology; clinicians should be cautious interpreting existing findings.","confidence":0.8,"topic_tags":["sexual_function","csbd","measurement"],"strengths":["Comprehensive coverage of 25‑year literature","Explicit methodological critique of prior work","Highlights gaps in measurement quality"],"limitations":["No quantitative meta‑analysis","Pre‑registration not reported","Relies on authors’ reports of primary studies"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":6,"addiction_criteria":6,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/r6947"}},{"id":6554,"doi":"10.1016/j.jsxm.2021.11.005","pmid":"34906543","pmcid":null,"title":"Sexual Motivations Underlying Compulsive Sexual Behavior in Women and Men From Germany and Hungary","authors":"Koós M, Fuss J, Klein V, Demetrovics Z, Bőthe B.","first_author":"Koós M","journal":"The journal of sexual medicine","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual Addiction","Sexual Motivation","Hypersexual Disorder","Compulsive Sexual Behavior Disorder","Hypersexuality Compulsive Sex"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community survey (N=9814) from Hungary and Germany; self‑report questionnaires; structural equation modelling","sample_n":9814,"sample_text":"large community samples from Hungary and Germany","population":"general adult population in two Western European countries","country":"Hungary, Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In two large European samples, researchers examined why people who report compulsive sexual behavior do so, using a questionnaire on sexual motivations. They found that lack of motivation and various other motivations (e.g., coping, low satisfaction) were linked to higher compulsive‑sex scores, similarly for men and women.","clinical_takeaway":"Motivational factors, not just frequency, relate to compulsive sexual behavior; assess motivations in treatment.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Very large, trans‑national sample","Use of ICD‑11‑aligned CSBD scale","Validated sexual motivation measure","Structural equation modelling to test complex associations"],"limitations":["Cross‑sectional; no causal inference","Key confounds (moral incongruence, masturbation, mental health, relationship factors) not measured","Potential circularity: CSBD scale includes distress which is also an outcome"],"rubric_version":"2.0","raw_total":38,"max_possible":60,"pct_score":63,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":6,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.11.005"}},{"id":6555,"doi":"10.1007/s10508-025-03123-4","pmid":"40175847","pmcid":null,"title":"Posttraumatic Stress Disorder Symptoms Moderate the Association between Childhood Sexual Abuse and Compulsive Sexual Behavior Among Adults in Residential Substance Use Treatment","authors":"Basting EJ, Medenblik AM, Schlachta S, Garner AR, Shorey RC, Stuart GL.","first_author":"Basting EJ","journal":"Archives of sexual behavior","year":2025,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Trauma","Substance Use Disorders","Dsm-5","Hypersexuality","Childhood Maltreatment","Sexual Violence"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 707 adults in residential substance‑use treatment; moderation analysis of PTSD symptoms on childhood abuse‑CSB link","sample_n":707,"sample_text":"large convenience sample from treatment program","population":"adults in residential SUD treatment (73.6% men, mean age 40.8)","country":"USA (presumed based on funding)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among people in residential substance‑use treatment, higher PTSD symptoms made the link between childhood sexual abuse and compulsive sexual behaviour stronger, suggesting trauma may heighten risky sexual patterns.","clinical_takeaway":"Screen for PTSD in clients with CSB history; trauma‑focused therapy may help reduce compulsive sexual behaviors.","confidence":0.78,"topic_tags":["csbd"],"strengths":["Large sample size for a treatment cohort","Examination of moderation adds nuance","Addresses an under‑studied risk factor combination"],"limitations":["Cross‑sectional; cannot infer causality","Self‑selected treatment sample limits generalisability","No measurement of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03123-4"}},{"id":6556,"doi":"10.1556/2006.2022.00032","pmid":"35895453","pmcid":"PMC9295232","title":"Mental and sexual health perspectives of the International Classification of Diseases (ICD-11) Compulsive Sexual Behavior Disorder •","authors":"Lew-Starowicz M, Coleman E.","first_author":"Lew-Starowicz M","journal":"Journal of behavioral addictions","year":2022,"pub_types":["article-commentary","Journal Article"],"keywords":["Diagnostic criteria","Compulsive Sexual Behavior","Sexual Addiction","Emotion dysregulation","Hypersexual Impulse Control"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9295232","cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"N/A (commentary)","population":"not applicable","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors discuss the new ICD‑11 diagnosis of compulsive sexual behavior disorder, warning that the condition is often oversimplified and suggesting it be viewed within broader sexual‑health contexts.","clinical_takeaway":"Clinicians should treat CSBD as a complex sexual‑health issue rather than a simple addiction.","confidence":0.85,"topic_tags":["csbd","sexual_function"],"strengths":["Comprehensive theoretical overview of ICD‑11 CSBD","Highlights gaps in current research"],"limitations":["No original data or systematic methodology","Subjective commentary may reflect authors’ bias"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":14,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00032"}},{"id":6560,"doi":"10.1556/2006.2024.00012","pmid":"38592797","pmcid":"PMC11220820","title":"LGBQ-affirming clinical recommendations for compulsive sexual behavior disorder","authors":"Jennings TL, Gleason N, Pachankis JE, Bőthe B, Kraus SW.","first_author":"Jennings TL","journal":"Journal of behavioral addictions","year":2024,"pub_types":["review-article","Review","Journal Article"],"keywords":["Compulsive Sexual Behavior","Sexual Addiction","Minority Stress","Lgbq Mental Health","Lgbq-affirming Care"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11220820","cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review offering clinical recommendations; no primary data, no systematic search.","sample_n":null,"sample_text":"None – review article","population":"LGBQ clients with CSBD (theoretical focus; no empirical sample)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"useful","plain_summary":"The authors synthesize existing research on compulsive sexual behavior disorder (CSBD) and minority‑stress theory to propose how clinicians can assess and treat LGBQ clients with CSBD while avoiding misdiagnosis caused by stigma‑related distress.","clinical_takeaway":"Use culturally‑affirming assessment to separate minority‑stress distress from CSBD symptoms before applying standard CSBD interventions.","confidence":0.8,"topic_tags":["csbd","lgbtq","sexual_function","treatment","gender"],"strengths":["Integrates minority‑stress theory with CSBD literature","Provides practical assessment and treatment guidance","Addresses risk of misdiagnosis in LGBQ clients"],"limitations":["Narrative, not systematic, review","No empirical data or validation of recommendations","Potential bias toward supporting CSBD construct"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00012"}},{"id":6562,"doi":"10.1556/2006.2023.00029","pmid":"37384566","pmcid":"PMC10316167","title":"Personality dimensions of compulsive sexual behavior in the Sex@Brain study","authors":"Engel J, Carstensen M, Veit M, Sinke C, Kneer J, Hartmann U, Kruger THC.","first_author":"Engel J","journal":"Journal of behavioral addictions","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Personality","Interpersonal Difficulties","Sexual Addiction","Addictive Behavior","Hypersexual Disorder","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10316167","cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case-control study comparing 47 men with hypersexual disorder to 38 matched controls using the PID-5-BF personality questionnaire","sample_n":85,"sample_text":"47 men with HD, 38 matched men without HD","population":"men, mean age ~37, community/recruited for HD","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Men diagnosed with hypersexual disorder show higher scores on all five maladaptive personality domains compared with matched men without the disorder, suggesting broader personality difficulties accompany the condition.","clinical_takeaway":"Personality assessment may be valuable when evaluating men with hypersexual disorder, but clinicians should also consider other factors like moral conflict and mental health.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Use of validated PID‑5‑BF personality measure","Matched control group","Clear reporting of group differences"],"limitations":["HD definition unclear; possible circularity","No measurement/control of moral incongruence, masturbation, mental health, partner or trauma factors","Sample size modest for case‑control design"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2023.00029"}},{"id":6563,"doi":"10.1007/s10461-024-04438-4","pmid":"38992227","pmcid":"PMC11427551","title":"Childhood Sexual Abuse and Compulsive Sexual Behavior Among Men Who Have Sex with Men Newly Diagnosed with HIV","authors":"Brown MJ, Osinubi MO, Amoatika D, Haider MR, Kirklewski S, Wilson P, Hansen NB.","first_author":"Brown MJ","journal":"AIDS and behavior","year":2024,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11427551","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Secondary analysis of survey data from 202 MSM newly diagnosed with HIV at two NYC clinics (2012‑2017). Measures: CSA (self‑report), CSB (Compulsive Sexual Behavior Inventory), depressive symptoms (CES‑D), emotion regulation (DERS). Path analysis tested mediation.","sample_n":202,"sample_text":"202 participants recruited from two community HIV clinics in New York City.","population":"Men who have sex with men, newly diagnosed with HIV, clinic sample, N=202","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 202 men who have sex with men newly diagnosed with HIV, childhood sexual abuse was linked to higher compulsive sexual behavior. This relationship was partly explained by greater depressive symptoms and problems regulating emotions.","clinical_takeaway":"Addressing depression and emotion‑regulation difficulties may lessen compulsive sexual behavior in HIV‑positive MSM with a history of childhood sexual abuse.","confidence":0.85,"topic_tags":["sexual_function","csbd"],"strengths":["Validated multi‑item scales for CSB, depression, and emotion regulation","Reasonable sample size for path analysis","Focus on an understudied high‑risk population (MSM with new HIV diagnosis)","Mediation model addresses plausible psychological pathways"],"limitations":["Cross‑sectional design limits causal inference","No assessment of moral incongruence, masturbation, or broader trauma","Clinic‑based convenience sample reduces generalisability","No pre‑registration or correction for multiple testing reported"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-024-04438-4"}},{"id":6565,"doi":"10.3389/fpsyt.2022.839788","pmid":"35592380","pmcid":"PMC9110760","title":"Compulsive Sexual Behavior Online and Non-online in Adult Male Patients and Healthy Controls: Comparison in Sociodemographic, Clinical, and Personality Variables","authors":"González-Bueso V, Santamaría JJ, Caro-Pérez O, Fernández D, Baño-Alcazar M, Jiménez-Murcia S, Håkansson A, Del Pino-Gutiérrez A, Ribas J.","first_author":"González-Bueso V","journal":"Frontiers in psychiatry","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Personality","Psychopathology","Compulsive Sexual Behavior","Behavioral Addictions","Profiles"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9110760","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional comparison of 80 male CSB patients (online vs non‑online) with 25 healthy male controls, recruited from a Behavioural Addictions Unit.","sample_n":105,"sample_text":"80 CSB patients (36 online, 44 non‑online) + 25 healthy controls.","population":"Adult male patients with compulsive sexual behaviour (online and non‑online) and healthy male controls.","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men with compulsive sexual behaviour that was mainly online, mainly offline, and healthy men. Both patient groups showed more psychological distress and different personality traits than controls, with offline patients having more STDs and higher anxiety.","clinical_takeaway":"CSB patients, especially those with offline behaviours, often have co‑occurring mental‑health and medical issues; clinicians should assess broader psychosocial problems.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Use of validated psychometric scales","Comparison of online vs non‑online CSB subtypes","Inclusion of a healthy control group"],"limitations":["Clinical convenience sample limits generalisability","No measurement of moral incongruence or masturbation","Small control group reduces statistical power"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2022.839788"}},{"id":6566,"doi":"10.1007/s11469-021-00597-w","pmid":"34393683","pmcid":"PMC8351585","title":"Validation and Psychometric Evaluation of the Italian Version of the Bergen-Yale Sex Addiction Scale","authors":"Soraci P, Melchiori FM, Del Fante E, Melchiori R, Guaitoli E, Lagattolla F, Parente G, Bonanno E, Norbiato L, Cimaglia R, Campedelli L, Abbiati FA, Ferrari A, Griffiths MD.","first_author":"Soraci P","journal":"International journal of mental health and addiction","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Personality","Psychometrics","Compulsive Sexual Behavior","Hypersexuality","Sex Addiction","Bergen–yale Sex Addiction Scale"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s11469-021-00597-w.pdf","cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community sample, psychometric validation (CFA, reliability, convergent validity)","sample_n":1230,"sample_text":"large Italian‑speaking adult community sample","population":"Italian‑speaking adults (N=1230, age 18‑67)","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated and tested the Bergen‑Yale Sex Addiction Scale in Italian, finding it reliable and linked to personality, lower self‑esteem, higher depression and other sex‑addiction questionnaires in a large adult sample.","clinical_takeaway":"The Italian BYSAS appears psychometrically sound, but clinicians should be aware it conflates behaviour with distress and lacks controls for moral or relational factors.","confidence":0.8,"topic_tags":["sexual_function","measurement"],"strengths":["Large sample size (N>1200)","Comprehensive psychometric evaluation (CFA, reliability, convergent validity)","Includes related personality and mental‑health measures"],"limitations":["Sex‑addiction construct measured by self‑label scale that defines addiction by its symptoms","No assessment of moral incongruence, masturbation, partner context or trauma","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":6,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":8,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11469-021-00597-w"}},{"id":6567,"doi":"10.1007/s10508-023-02549-y","pmid":"36735169","pmcid":"PMC10102046","title":"The Structure of Compulsive Sexual Behavior: A Network Analysis Study","authors":"Marchetti I.","first_author":"Marchetti I.","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Impulsivity","Compulsive Sexual Behavior","Network Analysis","Dsm-5","Hypersexuality","Icd-11"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10102046","cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey, n=3186, convenience recruitment","sample_n":3186,"sample_text":"large online convenience sample (68.3% male, ages 14‑64)","population":"adolescents to adults, mixed gender","country":"unspecified (non‑U.S.)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Using an online survey of over 3000 people, the authors mapped how different aspects of compulsive sexual behaviour relate to each other. They found three clusters—consequences, preoccupation, and perceived loss of control—with perceived impulse dyscontrol as the most central feature. Patterns were similar for men, women, and across ages.","clinical_takeaway":"Clinicians might consider impulse dyscontrol as a key focus when assessing compulsive sexual behaviour, but evidence is based on self‑report and lacks control for moral or mental‑health factors.","confidence":0.78,"topic_tags":["csbd","sexual_function","prevalence","gender"],"strengths":["Large sample size for exploratory network analysis","State‑of‑the‑art analytical technique (network analysis)","Investigation of gender, age, and risk group differences"],"limitations":["Cross‑sectional convenience sample; limited generalisability","Reliance on self‑report items of unclear validation","Key confounds (moral incongruence, masturbation, mental health) not measured"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02549-y"}},{"id":6569,"doi":"10.32598/bcn.2022.1920.1","pmid":"38077173","pmcid":"PMC10700817","title":"Investigating the Psychometric Properties of Sex Addiction Screening Test-revised for Persian Population","authors":"Shafiezadeh S, Mohajeri H, Mohammadshirazi A, Hassani-Abharian P.","first_author":"Shafiezadeh S","journal":"Basic and clinical neuroscience","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Addiction","Hypersexuality","Sexual Addiction Screening Test","Sexual Hyperactivity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10700817","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1268 Persian‑speaking adults; translation and psychometric validation of SAST‑R","sample_n":1268,"sample_text":"online convenience sample","population":"general community sample (age 18‑65, 56 % women)","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control","advocacy_or_coi"],"stance":"supports","citation_value":"useful","plain_summary":"The authors translated the Sexual Addiction Screening Test‑Revised into Persian and tested it with 1,268 adults. The Persian version showed good internal consistency and factor structure, suggesting it can reliably measure self‑reported sexual‑addiction‑like symptoms.","clinical_takeaway":"The Persian SAST‑R may be used as a screening tool, but clinicians should note its reliance on self‑label items and lack of validation against objective addiction criteria.","confidence":0.7,"topic_tags":["sexual_function","measurement"],"strengths":["Large sample for psychometric validation","Comprehensive reliability (Cronbach α, split‑half, Guttman)","Factor‑analytic fit indices reported"],"limitations":["Relies on SAST‑R, a self‑label scale that defines addiction by the same symptoms it measures","No measurement of moral incongruence, masturbation, mental‑health or relationship variables","Cross‑sectional convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":2,"design":4,"addiction_criteria":2,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.32598/bcn.2022.1920.1"}},{"id":6570,"doi":"10.3390/ijerph20064954","pmid":"36981863","pmcid":"PMC10048791","title":"Time Goes Back-Time Perspective in Polish Men with Compulsive Sexual Behavior Disorder and Risky Sexual Behavior","authors":"Wyszomirska J, Bąk-Sosnowska M.","first_author":"Wyszomirska J","journal":"International journal of environmental research and public health","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Risky Sexual Behavior","Sexual Addiction","Time Perspective","Behavioral Addictions","Compulsive Sexual Behavior Disorders"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/20/6/4954/pdf?version=1678522256","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 425 Polish men divided into CSBD (n=98), risky sexual behaviour (n=63) and control (n=264) groups using self‑report questionnaires.","sample_n":425,"sample_text":"425 men (98 CSBD, 63 RSB, 264 controls).","population":"Adult men in Poland, recruited presumably via community/clinical sources (not specified).","country":"Poland","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"Polish men with compulsive sexual behaviour showed more negative memories of the past and less positive past outlooks than men without such problems. Their time‑perspective profile differed from both men who engaged in risky sex without CSBD and from controls.","clinical_takeaway":"Time‑perspective patterns differ in men with CSBD, suggesting a potential therapeutic target, but findings are correlational.","confidence":0.8,"topic_tags":["csbd","relationships"],"strengths":["Large overall sample size","Use of validated ZTPI and SAST‑R instruments","Comparison of three distinct groups"],"limitations":["Cross‑sectional design cannot infer causality","No measurement of key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)","CSBD classification relies on screening scale, not ICD‑11 criteria"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph20064954"}},{"id":6571,"doi":"10.1007/s10508-023-02690-8","pmid":"37670204","pmcid":null,"title":"Identifying Relationships Between Difficulties with Emotion Regulation and Compulsive Sexual Behavior","authors":"Rahm-Knigge RL, Gleason N, Mark K, Coleman E.","first_author":"Rahm-Knigge RL","journal":"Archives of sexual behavior","year":2023,"pub_types":["Journal Article"],"keywords":["Sexual Health","Compulsive Sexual Behavior","Dsm-5","Icd-11","Emotion Dysregulation","Difficulties With Emotion Regulation"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 915 US adults, hierarchical regression of emotion‑regulation facets predicting self‑reported compulsive sexual behavior","sample_n":915,"sample_text":"large, diverse, online U.S. sample (N = 915; 54.3% men, mean age 39.2)","population":"adult community sample (online recruitment)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online U.S. survey of 915 adults, people who have more trouble controlling impulses, understanding, and accepting their emotions also report higher levels of compulsive sexual behavior, even after accounting for attachment style.","clinical_takeaway":"Emotion‑regulation difficulties are linked to compulsive sexual behavior; addressing impulse control and emotional acceptance may help treatment.","confidence":0.78,"topic_tags":["csbd"],"strengths":["large sample size","use of validated DERS subscales","hierarchical regression clarifies unique contributions"],"limitations":["cross‑sectional; cannot infer causality","CSB measurement not described; possible reliance on self‑label","key confounds (moral incongruence, masturbation, mental health) not addressed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02690-8"}},{"id":6573,"doi":"10.4103/jehp.jehp_196_23","pmid":"38726091","pmcid":"PMC11081448","title":"Comparison of Maslow's hierarchy of needs, decision-making, and attention control in individuals with sex addiction and normal people","authors":"Badelani PR, Sajjadian I.","first_author":"Badelani PR","journal":"Journal of education and health promotion","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["decision-making","Needs Assessment","Attention Control","Behavioral Addiction (Sex Addiction)"],"is_oa":true,"oa_url":"https://doi.org/10.4103/jehp.jehp_196_23","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study comparing self‑identified ‘sex‑addicted’ university students (n≈100) with matched healthy peers (n≈100); convenience sample","sample_n":200,"sample_text":"200 participants (screened from a university student population; divided into ‘sex‑addiction’ and healthy groups)","population":"students at Isfahan University, Iran","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"supports","citation_value":"background","plain_summary":"The study compared university students who called themselves ‘sex‑addicted’ with peers, finding differences in safety needs, decision‑making styles and attention focus. The authors suggest these psychological differences may explain the addiction.","clinical_takeaway":"No clear clinical guidance; the reported differences are based on self‑identified groups without validated diagnosis.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses multiple psychological questionnaires","Statistical comparison (MANOVA) of several domains","Reasonable total sample size for a student survey"],"limitations":["‘Sex addiction’ defined by self‑label; no validated CSBD criteria","No measurement/control of moral incongruence, masturbation, mental health or trauma","Convenience student sample limits generalisability","No effect sizes or correction for multiple comparisons reported"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/jehp.jehp_196_23"}},{"id":6575,"doi":"10.3390/healthcare14020138","pmid":"41595273","pmcid":"PMC12840756","title":"Hypersexual Behavior Inventory for Men Who Have Sex with Men: Bifactor Validation, IRT Diagnostics, and Clinical Cutoffs","authors":"Alckmin-Carvalho F, Bú ED, Silva WAD, Teixeira I, Wendt GW, Oliveira A, Oliveira A, Pereira H.","first_author":"Alckmin-Carvalho F","journal":"Healthcare (Basel, Switzerland)","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Men Who Have Sex With Men","Clinical Cutoffs","Scale Adaptation","Hypersexual Behavior Inventory","Compulsive Sexual Behavior Disorder","Lgbtqia+ Population"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12840756","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large community sample of Portuguese MSM (N=1116) across four studies; translation, factor analyses, IRT, ROC; no longitudinal or experimental manipulation.","sample_n":1116,"sample_text":"1116 participants across four validation studies","population":"Men who have sex with men (Portuguese-speaking)","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study adapted and validated a Portuguese version of the Hypersexual Behavior Inventory for men who have sex with men, showing strong factor structure, good item discrimination, and useful clinical cut‑offs for identifying hypersexual behavior.","clinical_takeaway":"The Portuguese HBI appears reliable for screening hypersexual behavior in MSM and can aid early risk detection.","confidence":0.85,"topic_tags":["measurement","sexual_function","csbd","lgbtq","gender"],"strengths":["Large, well‑powered sample","Comprehensive psychometric evaluation (EFA, CFA, IRT, ROC)","Demonstrated convergent validity with mental‑health measures"],"limitations":["No assessment of moral incongruence or masturbation context","Cross‑sectional; cannot address temporal stability","No pre‑registration reported"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare14020138"}},{"id":6578,"doi":"10.1080/10826084.2024.2369159","pmid":"38950280","pmcid":null,"title":"Minority Stress, Psychological Distress, Sexual Compulsivity, and Avoidance-Based Motivations Associated with Methamphetamine Use Among Sexual Minority Men Living with HIV: Examining Direct and Indirect Associations Using Cross-Sectional Structural Equation Modeling","authors":"Berlin GW, Dermody SS, Noor SW, Skakoon-Sparling S, Ghauri Y, Zahran A, Card KG, Lachowsky NJ, Cox J, Moore DM, Lambert G, Jollimore J, Grace D, Zhang H, Apelian H, Sang JM, Dvorakova M, Lal A, Hart TA.","first_author":"Berlin GW","journal":"Substance use & misuse","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["HIV","methamphetamine","Psychological Distress","Minority Stress","Sexual Compulsivity","Sexual Minority Men"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional structural equation modelling with N=423 SMM living with HIV","sample_n":423,"sample_text":"423 participants recruited (sampling bias adjusted)","population":"sexual minority men living with HIV","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 423 HIV‑positive gay and bisexual men, experiences of discrimination and childhood sexual abuse increased psychological distress, which was linked to higher sexual compulsivity and, through a coping style called cognitive escape, to greater methamphetamine use.","clinical_takeaway":"Addressing stigma‑related distress and sexual compulsivity may help reduce meth use in HIV‑positive sexual minority men.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for SEM","Theory‑driven model with good fit indices","Inclusion of minority stress factors"],"limitations":["Cross‑sectional; cannot infer causality","Moral incongruence and masturbation not assessed"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10826084.2024.2369159"}},{"id":6579,"doi":"10.31234/osf.io/9m4fs","pmid":null,"pmcid":null,"title":"The Relationship Between Sex Addiction and Shame Moderated by Overt and Covert Narcissism in a Gender-Balanced Adult Sample","authors":"Cameron C, Kotera Y, Fido D.","first_author":"Cameron C","journal":"PsyArXiv","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 376 adults (50.8% female) examining sex addiction, shame, overt and covert narcissism, self‑compassion and self‑esteem.","sample_n":376,"sample_text":"gender‑balanced adult sample (n=376, 50.8% females)","population":"Adult community sample; recruitment method not specified (likely convenience).","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"supports","citation_value":"background","plain_summary":"In a survey of 376 adults, higher scores on a sex‑addiction questionnaire were linked to more shame, but neither overt nor covert narcissism changed this link. Covert narcissism did mediate the relationship, suggesting it may be a target for reducing shame in people who feel they have a sex problem.","clinical_takeaway":"Address covert narcissistic traits when treating shame in clients reporting sex‑addiction‑like concerns.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Reasonably large sample (n>350)","Gender‑balanced recruitment","Tests both overt and covert narcissism","Includes self‑compassion and self‑esteem as covariates"],"limitations":["Cross‑sectional; cannot infer causality","Unclear whether sex‑addiction scale is validated","No measurement of moral incongruence or related confounds","Potential self‑selection bias"],"rubric_version":"2.0","raw_total":27,"max_possible":60,"pct_score":45,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/9m4fs"}},{"id":6580,"doi":"10.4088/pcc.26cr04212","pmid":"42475755","pmcid":null,"title":"Recurrent Rectal Foreign Body Insertion Associated With Cocaine-Induced Compulsive Sexual Behavior Resulting in Permanent Colostomy","authors":"Schwartz AC, Smith A, Stiles C, Robbins-Welty GA.","first_author":"Schwartz AC","journal":"The primary care companion for CNS disorders","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/pcc.26cr04212"}},{"id":6581,"doi":"10.1371/journal.pone.0274913","pmid":"36178949","pmcid":"PMC9524690","title":"No significant effect of frequent online sexual behaviour on Pavlovian-to-instrumental transfer (PIT): Implications for compulsive sexual behaviour disorder","authors":"Wells TJ, Krejčová L, Binter J, Pfaus JG, Horsley RR.","first_author":"Wells TJ","journal":"PloS one","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0274913&type=printable","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"between‑groups laboratory task (Pavlovian‑to‑instrumental transfer) with high vs low self‑reported online sexual behaviour; male convenience sample (N≈79)","sample_n":79,"sample_text":"Low OSB N=38, High OSB N=41; recruitment details not provided","population":"adult males, community sample","country":"unspecified (likely UK/Europe based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers compared men who report high versus low online sexual activity on a lab task that measures how cues boost goal‑directed actions. The high‑activity group showed a non‑significant trend toward stronger cue‑driven responding and lower general reward sensitivity, but the task did not reveal a clear addiction‑like effect.","clinical_takeaway":"No evidence that frequent online sexual behaviour enhances cue‑driven reward learning; clinicians should consider other mechanisms (e.g., inhibitory control) when addressing compulsive sexual concerns.","confidence":0.73,"topic_tags":["sexual_function"],"strengths":["Use of a well‑validated behavioural task (PIT)","Inclusion of validated psychometric scales (SCS, BIS/BAS)","Clear reporting of group sizes and basic correlations"],"limitations":["No assessment of moral/religious conflict or masturbation, key confounds for sexual‑behaviour research","Potentially underpowered to detect PIT differences between groups","Cross‑sectional design; causal claims limited"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0274913"}},{"id":6583,"doi":"10.1159/000530110","pmid":"37088070","pmcid":null,"title":"Frequency of and Factors Associated with the Presence of a History of Probable Attention-Deficit Hyperactivity Disorder in a Population of Patients with Sex Addiction","authors":"Schreck B, Forcier C, Balem M, Cabelguen C, Leboucher J, Grall-Bronnec M, Challet-Bouju G.","first_author":"Schreck B","journal":"European addiction research","year":2023,"pub_types":["Journal Article"],"keywords":["Attention-deficit Hyperactivity Disorder","Impulsivity","Hypersexuality","Behavioural Addiction","Sex Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional observational study of 185 patients referred for sex addiction","sample_n":185,"sample_text":"185 patients (2011‑2020) seeking treatment for sex addiction","population":"patients with sex addiction referred to a university hospital (France)","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 185 French patients treated for sex addiction, 36 % showed signs of past ADHD. Those with ADHD histories tended to have lower education, earlier onset of sexual problems, other addictions, anxiety, and certain personality traits.","clinical_takeaway":"Clinicians should assess ADHD symptoms in patients with sex‑addiction concerns, as comorbidity is common and may affect treatment planning.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Validated ADHD and sexuality screening instruments","Large clinical sample for this topic","French validation of SAST‑R reported"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral incongruence or masturbation","Addiction criteria not examined in depth"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000530110"}},{"id":6584,"doi":"10.31234/osf.io/vqwea","pmid":null,"pmcid":null,"title":"Anxiety and Compulsive Sexual Behaviour Disorder: A Systematic Review","authors":"Grant Weinandy JT, Lee BN, Hoagland C, Grubbs JB, Bőthe B.","first_author":"Grant Weinandy JT","journal":"PsyArXiv","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/vqwea","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"qualitative synthesis of 36 quantitative studies, no meta‑analysis, no explicit risk‑of‑bias assessment reported","sample_n":null,"sample_text":"36 studies identified; individual study sizes not reported in abstract","population":"adults and adolescents from clinical and community samples (mixed, not described in detail)","country":"unspecified (searches in PsycInfo and PubMed)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 36 studies found mixed evidence on how anxiety relates to compulsive sexual behaviour disorder; inconsistent tools and few longitudinal studies make the link unclear.","clinical_takeaway":"Current evidence does not establish a clear anxiety‑CSBD relationship; clinicians should assess both separately.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Systematic search of two major databases","Inclusion of both published and dissertation literature","Clear focus on anxiety–CSBD relationship"],"limitations":["No quantitative meta‑analysis; synthesis purely qualitative","No reported risk‑of‑bias assessment of included studies","Inconsistent measurement of CSBD across studies"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/vqwea"}},{"id":6585,"doi":"10.1080/00224499.2022.2066616","pmid":"35482896","pmcid":null,"title":"Anxiety and Compulsive Sexual Behavior Disorder: A Systematic Review","authors":"Grant Weinandy JT, Lee B, Hoagland KC, Grubbs JB, Bőthe B.","first_author":"Grant Weinandy JT","journal":"Journal of sex research","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Qualitative synthesis of 40 quantitative studies on anxiety and CSBD; risk of bias analysis performed; no meta‑analysis due to heterogeneity.","sample_n":null,"sample_text":"40 studies included (individual sample sizes not reported in abstract).","population":"Adults and adolescents from clinical and community samples across included studies (details not provided).","country":"International (studies from PsycInfo and PubMed).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 40 studies examined how anxiety relates to compulsive sexual behavior disorder. Findings were mixed, with most studies cross‑sectional and using different ways to measure the disorder, so the link remains unclear.","clinical_takeaway":"Current evidence does not clarify whether anxiety drives or results from CSBD; clinicians should assess both separately and note measurement limitations.","confidence":0.7,"topic_tags":["csbd","sexual_function","adolescents"],"strengths":["Systematic approach with risk‑of‑bias assessment.","Broad inclusion of clinical and community samples.","Identifies gaps such as inconsistent CSBD measurement."],"limitations":["No quantitative meta‑analysis; relies on heterogeneous measures.","Inconsistent operationalisation of CSBD across primary studies.","Limited discussion of key confounds (e.g., moral incongruence, masturbation)."],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":24,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2066616"}},{"id":6586,"doi":"10.1007/s10461-025-04769-w","pmid":"40405027","pmcid":"PMC12484301","title":"Identifying Syndemic Factors and Their Effect on HIV Sexual Risk Behavior Among Gay, Bisexual and Other Men Who Have Sex with Men in Vancouver, Montreal and Toronto","authors":"Duailibe F, Shen T, Zhang W, Moore D, Hull M, Barath J, Magee C, Lachowsky N, Hart T, Cox J, Grace D, Lambert G, Skakoon-Sparling S, Jollimore J, Dvorakova M, Gormezano A, Lima VD.","first_author":"Duailibe F","journal":"AIDS and behavior","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Interactions","Men Who Have Sex With Men","Mediation","Syndemics","Hiv Sexual Risk Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12484301","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Baseline data from 1571 HIV‑negative GBM recruited via respondent‑driven sampling; path analysis and logistic regression used to examine syndemic factors and HIV risk.","sample_n":1571,"sample_text":"Baseline data from the Engage Cohort; respondent‑driven sampling in three Canadian cities.","population":"GBM (gay, bisexual, other men who have sex with men), HIV‑negative, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 1,571 gay and bisexual men from three Canadian cities, the study found that childhood sexual abuse, intimate‑partner violence, transactional sex, polysubstance use and sexual compulsivity together increase risky sexual behaviour that can lead to HIV infection.","clinical_takeaway":"Multiple co‑occurring psychosocial factors, not just individual risk behaviours, drive HIV risk in GBM; interventions should address these intersecting issues.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample (N>1500)","Comprehensive syndemic modeling","Use of path analysis with confidence intervals"],"limitations":["Cross‑sectional design limits causal inference","Unclear if all constructs measured with validated scales","No assessment of mental‑health covariates (depression, anxiety)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-025-04769-w"}},{"id":6590,"doi":"10.1556/2006.2024.00035","pmid":"38905000","pmcid":"PMC11220798","title":"Co-occurring compulsive sexual behaviour in an inpatient substance use population: Clinical correlates and influence on treatment outcomes","authors":"Snaychuk LA, Dermody SS, Tabri N, Basedow CA, Kim HS.","first_author":"Snaychuk LA","journal":"Journal of behavioral addictions","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Treatment","Addiction","Substance Use","Compulsive Sexual Behaviour"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11220798","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational cohort of inpatients (N=793) assessed at admission and discharge for CSB and treatment outcomes.","sample_n":793,"sample_text":"Inpatient SUD treatment sample, 71.1% men, age M=38.73","population":"Adults (18‑77) in inpatient substance‑use treatment","country":"Not specified in abstract","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 793 people in residential substance‑use treatment, about one‑quarter screened positive for compulsive sexual behaviour. Those with CSB were younger, more often single, and reported higher mental distress and trauma symptoms, but CSB did not affect whether they completed treatment.","clinical_takeaway":"Screen for compulsive sexual behaviour in SUD patients, but its presence alone may not predict poorer treatment completion.","confidence":0.85,"topic_tags":["csbd","sexual_function","treatment","adolescents"],"strengths":["Large inpatient sample (N≈800)","Assesses both prevalence and treatment outcomes","Controls for several relevant clinical variables"],"limitations":["Unclear whether CSB measure is validated","Moral incongruence and masturbation not assessed","Observational design limits causal inference"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00035"}},{"id":6591,"doi":"10.1080/00224499.2023.2282619","pmid":"38047874","pmcid":null,"title":"No Magic Pill: A Systematic Review of the Pharmacological Treatments for Compulsive Sexual Behavior Disorder","authors":"Borgogna NC, Borgogna NC, Owen T, Johnson D, Kraus SW.","first_author":"Borgogna NC","journal":"Journal of sex research","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 13 pharmacotherapy trials (total n=141) for CSBD, describing theoretical models, trial outcomes, and generalizability.","sample_n":141,"sample_text":"13 studies, 141 participants total","population":"Adults with Compulsive Sexual Behavior Disorder (mostly male, predominantly White, Western countries)","country":"Developed nations (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 13 small trials (141 people) found that naltrexone may help some symptoms of compulsive sexual behavior, but overall evidence for medication is weak and mostly from male, Western samples.","clinical_takeaway":"Pharmacological treatment for CSBD should be limited to research settings; naltrexone shows the most promise but evidence remains scant.","confidence":0.78,"topic_tags":["csbd","sexual_function"],"strengths":["Comprehensive systematic search of pharmacotherapy literature","Clear presentation of theoretical models","Balanced interpretation acknowledging limited evidence"],"limitations":["Very small total sample (n=141) across heterogeneous trials","Lack of female and racial/ethnic diversity","Primary studies often lacked rigorous control of key confounds (e.g., moral incongruence, masturbation)"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":6,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2282619"}},{"id":6592,"doi":"10.1016/j.neurol.2025.10.004","pmid":"41176443","pmcid":null,"title":"Addressing sexual difficulties in Parkinson's disease","authors":"Oprea E.","first_author":"Oprea E.","journal":"Revue neurologique","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Sexual dysfunction","Parkinson's Disease","Hypersexuality","Compulsive Sexual Behavior Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review providing clinical guidance; no primary data collected.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Patients with Parkinson's disease (men and women) but no primary sample.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how Parkinson's disease can lead to both reduced sexual ability and excessive sexual urges, explains why these problems happen, and gives doctors practical tips for talking to and helping patients.","clinical_takeaway":"Clinicians should routinely ask PD patients about sexual issues and address both low libido and hypersexuality, considering medication effects.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Comprehensive overview of sexual dysfunction and hypersexuality in PD.","Practical clinical recommendations for neurologists."],"limitations":["No new empirical data; relies on existing literature.","Lacks systematic review methodology and risk‑of‑bias assessment."],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neurol.2025.10.004"}},{"id":6594,"doi":"10.1136/bmjopen-2021-051756","pmid":"36691245","pmcid":"PMC9171192","title":"A randomised controlled trial of fluoxetine versus naltrexone in compulsive sexual behaviour disorder: presentation of the study protocol","authors":"Savard J, Görts Öberg K, Dhejne C, Jokinen J.","first_author":"Savard J","journal":"BMJ open","year":2022,"pub_types":["Clinical Trial Protocol","Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Impulse Control Disorders","Adult Psychiatry","Sexual And Gender Disorders"],"is_oa":true,"oa_url":"https://bmjopen.bmj.com/content/bmjopen/12/6/e051756.full.pdf","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"randomised controlled trial, parallel groups, n=80 total, 8‑week treatment, follow‑up 6 weeks","sample_n":80,"sample_text":"Eighty adult participants","population":"adult patients meeting ICD‑11 criteria for compulsive sexual behaviour disorder","country":"Sweden","controls_mi":"no","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The paper outlines a planned randomised trial comparing fluoxetine and naltrexone for adults diagnosed with compulsive sexual behaviour disorder, using a validated symptom scale over an 8‑week treatment period.","clinical_takeaway":"None – the study is a protocol; results are not yet available.","confidence":0.85,"topic_tags":["csbd","treatment","relationships","measurement"],"strengths":["RCT design with randomisation","Clear primary outcome (HD:CAS)","Registered trial and ethical approval","Independent funding, no industry ties"],"limitations":["Potentially under‑powered (40 per arm)","No measurement of moral incongruence or masturbation","Limited reporting of mental‑health or relationship covariates","Protocol only; no outcome data yet"],"rubric_version":"2.0","raw_total":38,"max_possible":60,"pct_score":63,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":5,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjopen-2021-051756"}},{"id":6595,"doi":"10.1101/2025.09.08.25335292","pmid":null,"pmcid":null,"title":"Problematic Usage of the Internet: Converging and Diverging Terminologies and Constructs","authors":"Zare-Bidoky M, Baldacchino AM, Demetrovics Z, Fineberg NA, Kamali M, Khazaal Y, Potenza MN, Stein DJ, Ekhtiari H.","first_author":"Zare-Bidoky M","journal":"medRxiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Narrative systematic review of literature (2022‑2023) focusing on terminology of problematic internet use and its subcategories including compulsive sexual behavior.","sample_n":null,"sample_text":"2497 relevant papers screened; 13% used PUI as umbrella term.","population":"Published papers (no human participants).","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors reviewed recent papers on problematic internet use and found that most studies treat its sub‑categories, like compulsive sexual behavior, separately rather than under a common term. They argue that adopting a unified terminology would improve research consistency and treatment development.","clinical_takeaway":"None – the review is conceptual and does not provide direct clinical guidance.","confidence":0.4,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Comprehensive mapping of terminology across recent literature","Highlights gap in unified terminology","Large initial pool of papers"],"limitations":["No formal risk‑of‑bias assessment","Descriptive only, no quantitative synthesis","Limited to a short 2‑year window"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2025.09.08.25335292"}},{"id":6597,"doi":null,"pmid":"38706620","pmcid":"PMC11065191","title":"SEXUAL RISK BEHAVIOURS AND COMPULSIVE SEXUAL BEHAVIOUR DISORDERS AMONG MILITARY PERSONNEL IN IBADAN","authors":"Adetoro AA, Adebayo AM, Atariata OA.","first_author":"Adetoro AA","journal":"Annals of Ibadan postgraduate medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Military Personnel","Sexual Risk Behaviours","Compulsive Sexual Behaviour Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11065191","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 406 military personnel using convenience sampling and interviewer‑administered questionnaire","sample_n":406,"sample_text":"convenient sampling of personnel stationed at two barracks; available on data‑collection days were interviewed","population":"military personnel in Ibadan, Nigeria","country":"Nigeria","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 406 soldiers in Ibadan, 79% reported sexual risk behaviours and 6% met criteria for compulsive sexual behaviour disorder. Men and unmarried soldiers were more likely to engage in risky sex. The authors recommend risk‑reduction counselling for military staff.","clinical_takeaway":"Screen for CSBD and risky sexual practices in military settings, especially among unmarried men; offer targeted counselling.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Large sample for a single‑site study (N = 406)","Provides prevalence data on CSBD among military personnel","Uses interviewer administration, reducing missing data"],"limitations":["Convenience sampling limits generalisability","CSBD measured with non‑validated questionnaire","No assessment of key confounds (moral incongruence, masturbation, mental health, trauma)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":18,"max_possible":60,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":2,"interpretation":5}},"scite":null},{"id":6598,"doi":"10.3389/fpsyg.2024.1423690","pmid":"39712546","pmcid":"PMC11661911","title":"Compulsive sexual behavior, sexual functioning problems, and their linkages to substance use among German medical students: exploring the role of sex and trauma exposure","authors":"Jepsen D, Luck T, Heckel C, Niemann J, Winter K, Watzke S.","first_author":"Jepsen D","journal":"Frontiers in psychology","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Addiction","Sexual dysfunction","Post-traumatic Stress","Hypersexual Behavior","Childhood Trauma","Adverse Childhood Experiences","Hyposexual Behavior"],"is_oa":true,"oa_url":"https://doi.org/10.3389/fpsyg.2024.1423690","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of German medical students (n=359)","sample_n":359,"sample_text":"359 participants recruited via university email; 69% women, 29% men","population":"German medical students","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Among German medical students, compulsive sexual behavior and sexual problems were linked to higher alcohol use, drug use, and recent trauma symptoms. Men reported more compulsive behavior; various substances were associated with specific sexual difficulties.","clinical_takeaway":"Screen for trauma and substance use when addressing sexual problems in medical students.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Use of validated scales (CSBD-19, AUDIT, etc.)","Large sample for a student survey","Incorporates trauma and PTSD measures"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral/religious conflict or masturbation","Potential selection bias (volunteer students)"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2024.1423690"}},{"id":6599,"doi":"10.1016/j.addbeh.2026.108842","pmid":"42648136","pmcid":null,"title":"Sexualised drug use and associations with addictive behaviors in a broad sample of Canadian adults: A mixed-methods study","authors":"Thulin MC, Shinbine DL, Nagy L, Bőthe B, Hodgins DC, Keough MT, Tabri N, Shead NW, Dawson SJ, Scanavino MT, Allami Y, Coelho SG, Kim HS.","first_author":"Thulin MC","journal":"Addictive behaviors","year":2026,"pub_types":["Journal Article"],"keywords":["Addiction","Mixed-methods","Sexualised Drug Use"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-methods survey of 3627 Canadian adults, grouping by past‑year sexualised drug use (SDU) and assessing addiction, mental‑health and psychosocial variables; includes open‑ended qualitative responses.","sample_n":3627,"sample_text":"n = 3627 (3262 never SDU, 365 past‑year SDU).","population":"Canadian adults (general population sample, not limited to MSM).","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a national survey of 3,600 Canadians, about 10 % of heterosexual and 17 % of LGBQ+ adults reported using drugs to enhance sex in the past year. Such use was linked to higher problematic cannabis use, compulsive sexual behaviour, childhood adversity and sensation‑seeking, and participants described both pleasure and negative after‑effects.","clinical_takeaway":"Sexualised drug use co‑occurs with other addictive behaviours and psychosocial risk factors; clinicians should screen for broader substance‑use and mental‑health issues when it is reported.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large, community‑based sample","Mixed‑methods adds qualitative depth","Measures multiple psychosocial risk factors"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on self‑report; unclear validation of some scales","Key sexual‑behavior confounds (e.g., masturbation, moral incongruence) not assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2026.108842"}},{"id":6600,"doi":"10.64898/2026.04.17.26351044","pmid":null,"pmcid":null,"title":"Exploring the Relationship Between Non-Suicidal Self-Injury and Problematic Sexual Behaviour","authors":"Jiang S, Foo JC, Roper L, Yang E, Green B, Arnau R, Behavioural Addictions Studies and Insights Consortium, Lodhi RJ, Isenberg R, Wishart D, Fujiwara E, Carnes PJ, Aitchison KJ.","first_author":"Jiang S","journal":"medRxiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two cross‑sectional cohorts (university sample N≈2,189; clinical PSB patients N≈477) with logistic regression analyses of self‑report measures.","sample_n":2676,"sample_text":"2,189 university participants and 477 clinical PSB patients","population":"non‑clinical university students and clinical patients seeking help for problematic sexual behaviour","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In two large groups—a university sample and a clinical group seeking help for sexual behaviour problems—the study found that people, especially women, who reported problematic sexual behaviour were more likely to also report non‑suicidal self‑injury. The link was stronger in university women than in clinical patients.","clinical_takeaway":"Women with problematic sexual behaviour may be at higher risk for self‑injury; clinicians should assess for both.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function","neuroscience"],"strengths":["Large total sample size","Inclusion of both community and clinical cohorts","Use of a recognized screening instrument (SAST‑R)"],"limitations":["Cross‑sectional design limits causal inference","Key confounds (moral incongruence, masturbation, mental health) not measured","Reliance on self‑report scales, possible circularity in defining PSB"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.64898/2026.04.17.26351044"}},{"id":6602,"doi":"10.1007/s10508-023-02681-9","pmid":"37697092","pmcid":"PMC12147523","title":"Sexual Compulsivity Mediates the Association Between Childhood Sexual Abuse and Condom Use Resistance Among Men Who Have Sex with Men and Women","authors":"Kirwan M, Stewart R, Chen W, Hammett JF, Davis KC.","first_author":"Kirwan M","journal":"Archives of sexual behavior","year":2023,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Risky Sexual Behavior","Sexual Compulsivity","Childhood Sexual Abuse","Men Who Have Sex With Men And Women","Condom Use Resistance"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 623 young single men assessing past sexual experiences, childhood sexual abuse, sexual compulsivity, and condom‑use resistance; mediation analysis performed","sample_n":623,"sample_text":"young, single men who had had sex with a woman in the past year","population":"young, single men who had sex with a woman in the past year (N=623), USA (presumed)","country":"unspecified (likely USA)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 623 young men who have sex with women, those who also had sex with men and experienced childhood sexual abuse showed higher sexual compulsivity, which in turn was linked to more attempts to avoid using condoms.","clinical_takeaway":"Screen for sexual compulsivity in abused MSMW to tailor HIV‑prevention counseling.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for survey research","Focus on understudied MSMW subgroup","Uses mediation analysis to explore mechanisms"],"limitations":["Cross‑sectional design cannot establish causality","Potential lack of validated scales for key constructs","Key confounds (moral incongruence, mental health, partner context) not measured"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02681-9"}},{"id":6603,"doi":"10.1556/2006.2023.00028","pmid":"37352095","pmcid":"PMC10316175","title":"Compulsive sexual behavior disorder in 42 countries: Insights from the International Sex Survey and introduction of standardized assessment tools","authors":"Bőthe B, Koós M, Nagy L, Kraus SW, Demetrovics Z, Potenza MN, Michaud A, Ballester-Arnal R, Batthyány D, Bergeron S, Billieux J, Briken P, Burkauskas J, Cárdenas-López G, Carvalho J, Castro-Calvo J, Chen L, Ciocca G, Corazza O, Csako R, Fernandez DP, Fernandez EF, Fournier L, Fujiwara H, Fuss J, Gabrhelík R, Gewirtz-Meydan A, Gjoneska B, Gola M, Grubbs JB, Hashim HT, Islam MS, Ismail M, Jiménez-Martínez MC, Jurin T, Kalina O, Klein V, Költő A, Lee CT, Lee SK, Lewczuk K, Lin CY, Liverpool John Moores University's research team, Lochner C, López-Alvarado S, Lukavská K, Mayta-Tristán P, Milea I, Miller DJ, Orosová O, Orosz G, Sungkyunkwan University's research team, Ponce FP, Quintana GR, Quintero Garzola GC, Ramos-Diaz J, Rigaud K, Rousseau A, De Tubino Scanavino M, Schulmeyer MK, Sharan P, Shibata M, Shoib S, Sigre Leirós VL, Sniewski L, Spasovski O, Steibliene V, Stein DJ, Strizek J, Štulhofer A, Ünsal BC, Vaillancourt-Morel MP.","first_author":"Bőthe B","journal":"Journal of behavioral addictions","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Assessment","Validation","Cross-cultural","Compulsive Sexual Behavior","Addictive Behavior","International Sex Survey (Iss)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10316175","cited_by_count":52,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large‑scale online survey across 42 countries (N=82,243) with psychometric validation of CSBD‑19 and CSBD‑7 scales","sample_n":82243,"sample_text":"82,243 participants from 42 countries, mean age 32.4 years","population":"general adult internet users, diverse genders and sexual orientations","country":"multinational (42 countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A huge online survey in 42 countries validated short and long questionnaires for compulsive sexual behavior disorder (CSBD) and found that about 5 % of respondents were at high risk, with few seeking treatment. The tools work well across cultures.","clinical_takeaway":"The CSBD‑19/7 scales are reliable screening instruments for clinicians working with diverse populations.","confidence":0.78,"topic_tags":["csbd","prevalence","measurement","moral_incongruence"],"strengths":["Very large, multilingual, cross‑cultural sample","Rigorous psychometric validation of CSBD scales","ICD‑11‑based item generation","Provides freely accessible tools in 26 languages"],"limitations":["Cross‑sectional, cannot infer causality","Self‑selected internet sample may limit generalisability","Key confounds (moral incongruence, masturbation, mental health) not assessed","No pre‑registration reported"],"rubric_version":"2.0","raw_total":40,"max_possible":60,"pct_score":67,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":8,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":65,"citing_publications":98,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2023.00028"}},{"id":6605,"doi":"10.30773/pi.2021.0010","pmid":"34619816","pmcid":"PMC8542742","title":"The Effect of Stress on Compulsive Sexual Behavior Disorder: Active Coping Strategy and Self-Control as Mediators","authors":"Park JW, Kim DJ, Shin MH.","first_author":"Park JW","journal":"Psychiatry investigation","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Stress","Self-control","Compulsive Sexual Behavior Disorder","Active Coping Strategy"],"is_oa":true,"oa_url":"https://www.psychiatryinvestigation.org/upload/pdf/pi-2021-0010.pdf","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 300 adults, self‑report scales, mediation analysis","sample_n":300,"sample_text":"300 adults aged 20 to 39","population":"adults 20‑39 years, unspecified recruitment method","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 300 adults, higher stress was linked to more compulsive sexual behaviour, and this relationship was fully explained by lower self‑control and coping strategies. The study suggests stress may increase CSBD through reduced self‑control.","clinical_takeaway":"Address stress and strengthen self‑control to potentially reduce compulsive sexual behaviour.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Reasonable sample size (N=300)","Uses several established self‑report scales","Tests mediation model with multiple variables"],"limitations":["Cross‑sectional design cannot establish causality","No measurement of moral incongruence or related confounds","CSBD scale validation not detailed in abstract"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[{"status":"Has correction","date":"2021-12-25","noticeDoi":"10.30773/pi.2021.0010e","doi":"10.30773/pi.2021.0010"},{"status":"Has erratum","date":"2021-12-25","noticeDoi":"10.30773/pi.2021.0010e","doi":"10.30773/pi.2021.0010"}],"url":"https://scite.ai/reports/10.30773/pi.2021.0010"}},{"id":6606,"doi":"10.1016/j.neubiorev.2022.104872","pmid":"36113783","pmcid":null,"title":"A motivation model of sex addiction - Relevance to the controversy over the concept","authors":"Toates F.","first_author":"Toates F.","journal":"Neuroscience and biobehavioral reviews","year":2022,"pub_types":["Review","Journal Article"],"keywords":["Development","Evolution","Dopamine","Sexual Addiction","Behavioral Addiction","Dual Control"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review article presenting an integrative theoretical model of sexual addiction; no new empirical data.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"strongly-supports","citation_value":"useful","plain_summary":"The paper proposes a theoretical model that frames compulsive sexual behavior as an addiction, drawing parallels with drug addiction and emphasizing dopamine’s role. It argues that other explanations like OCD or high drive are less adequate.","clinical_takeaway":"The model suggests viewing compulsive sexual behavior through an addiction lens, but clinicians should note the lack of empirical support.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad synthesis of existing literature","Integrates incentive motivation and dual‑control theories","Links neurobiological concepts (dopamine) to sexual behavior"],"limitations":["No original empirical data presented","Relies on theoretical inference rather than systematic review methods","Does not address key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)","Advocates for an addiction model without empirical validation"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neubiorev.2022.104872"}},{"id":6607,"doi":"10.1038/s41443-023-00729-x","pmid":"37468536","pmcid":"PMC11981945","title":"Compulsive sexual behavior and paraphilic interests in adults with chronic tic disorders and Tourette syndrome: a survey-based study","authors":"Kurvits L, Tozdan S, Mainka T, Münchau A, Müller-Vahl KR, Cavanna AE, Briken P, Ganos C.","first_author":"Kurvits L","journal":"International journal of impotence research","year":2025,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://www.nature.com/articles/s41443-023-00729-x.pdf","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online anonymous survey of adults with primary tic disorders (N=62); prevalence estimates of compulsive sexual behavior and paraphilic interests; examined associations with antipsychotic use, depression, ADHD.","sample_n":62,"sample_text":"62 participants (26 females/36 males) completed the survey","population":"adults with chronic tic disorders/Tourette syndrome","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 62 adults with Tourette syndrome, about 13% reported compulsive sexual behavior and 19% reported paraphilic interests. These rates were not linked to antipsychotic medication or depression, but were higher in those who also had ADHD.","clinical_takeaway":"Comorbid ADHD may increase risk of problematic sexual behaviors in adults with tic disorders; clinicians should screen for CSB when ADHD is present.","confidence":0.7,"topic_tags":["csbd","treatment","prevalence"],"strengths":["Focus on an understudied clinical population","Explores comorbid ADHD influence","Anonymous survey may reduce social desirability bias"],"limitations":["Small, convenience sample limits generalisability","Likely uses non‑validated CSB/PI items","No measurement of moral incongruence or masturbation","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-023-00729-x"}},{"id":6609,"doi":"10.3390/jcm10153205","pmid":"34361988","pmcid":"PMC8348482","title":"Is Compulsive Sexual Behavior Different in Women Compared to Men?","authors":"Kürbitz LI, Briken P.","first_author":"Kürbitz LI","journal":"Journal of clinical medicine","year":2021,"pub_types":["review-article","Review","Journal Article"],"keywords":["Female","Gender","Compulsive Sexual Behavior","Hypersexuality","Sex Addiction","Csbd"],"is_oa":true,"oa_url":"https://www.mdpi.com/2077-0383/10/15/3205/pdf?version=1626861030","cited_by_count":31,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods; no empirical data presented.","sample_n":null,"sample_text":"N/A","population":"Not applicable (review of existing literature)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises existing research on compulsive sexual behaviour, noting it is more common in men and that women may show higher neuroticism and stress sensitivity. It calls for more studies focused on women.","clinical_takeaway":"Current evidence on CSBD in women is limited; clinicians should be cautious interpreting gender differences and seek more comprehensive assessments.","confidence":0.6,"topic_tags":["gender","csbd","sexual_function"],"strengths":["Provides a concise overview of gender differences in CSBD literature","Highlights gaps in female‑focused research"],"limitations":["Narrative (non‑systematic) review; no systematic search or bias assessment","No original data; cannot evaluate construct validity or confound control","Limited critical appraisal of included studies"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":36,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jcm10153205"}},{"id":6610,"doi":"10.1007/s11920-020-01153-4","pmid":"32377953","pmcid":null,"title":"Pharmacotherapy of Sexual Addiction","authors":"Malandain L, Blanc JV, Ferreri F, Thibaut F.","first_author":"Malandain L","journal":"Current psychiatry reports","year":2020,"pub_types":["Review","Journal Article"],"keywords":["Ssri","Compulsive Sexual Behavior","Pharmacological Treatment","Sexual Addiction","Hypersexuality","Chemsex"],"is_oa":false,"oa_url":"https://hal.sorbonne-universite.fr/hal-02880933","cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Narrative review of pharmacotherapy for sexual addiction; no primary data collected.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Humans with compulsive sexual behaviour / sexual addiction (as defined in literature).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"useful","plain_summary":"This review summarises recent research on \"sexual addiction,\" describing it as an addictive disorder and discussing medication options like SSRIs and naltrexone, alongside psychotherapy.","clinical_takeaway":"SSRIs are presented as first‑line medication for hypersexual behaviour, but clinicians should note the review’s reliance on heterogeneous evidence.","confidence":0.4,"topic_tags":["sexual_function","csbd","treatment"],"strengths":["Broad overview of pharmacological options","Considers comorbidities"],"limitations":["No original data; conclusions rely on prior studies","Potential bias toward pathology model","Lacks systematic review methodology"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":32,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11920-020-01153-4"}},{"id":6611,"doi":"10.1097/yco.0000000000001074","pmid":"41542800","pmcid":null,"title":"Challenging behaviors in adolescents with intellectual and developmental disabilities: current pharmacological perspectives","authors":"Greydanus DE, Azeem MW, AlMuraikhi M, Nazeer A.","first_author":"Greydanus DE","journal":"Current opinion in psychiatry","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Aggression","Neuroleptics","Neurodevelopmental Disorders","Hypersexuality","Irritability"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review of pharmacological and non‑pharmacological management of hypersexuality, irritability and aggression in adolescents with intellectual and developmental disabilities. No primary data collected.","sample_n":null,"sample_text":"N/A – narrative review; no primary participants","population":"Adolescents with neurodevelopmental disorders / intellectual disability","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how to assess and treat hypersexual behavior, severe irritability and aggression in teenagers with intellectual or developmental disabilities, noting that evidence for drug treatments is limited and that therapy should be tailored to each child's cause.","clinical_takeaway":"Pharmacologic options exist but evidence is scarce; clinicians should first identify medical or medication causes of hypersexuality and combine medication with behavioral interventions.","confidence":0.8,"topic_tags":["sexual_function","adolescents","neuroscience","treatment"],"strengths":["Broad overview of pharmacologic options for hypersexuality in a vulnerable group","Considers etiological heterogeneity (e.g., endocrine, neurological, medication‑induced)","Highlights need for combined behavioral and medication approaches"],"limitations":["No systematic search or risk‑of‑bias assessment reported","Relies on limited primary evidence; many statements based on scarce youth data","Does not evaluate hypersexuality using validated addiction or compulsivity criteria"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/yco.0000000000001074"}},{"id":6612,"doi":"10.2196/49137","pmid":"37910154","pmcid":"PMC10652192","title":"Gay App Use, Sexuality Traits, and High-Risk Sexual Behaviors Among Men Who Have Sex With Men in China: Mediation Analysis","authors":"Luo R, Xie Z, Silenzio VMB, Kuang Y, Luo D.","first_author":"Luo R","journal":"Journal of medical Internet research","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Multicenter Study","Journal Article"],"keywords":["Mobile phone","Men Who Have Sex With Men","High-risk Sexual Behaviors","Respondent-driven Sampling","Geosocial Networking Apps","Sexuality Traits"],"is_oa":true,"oa_url":"https://www.jmir.org/2023/1/e49137/PDF","cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"multicenter respondent‑driven sampling of 402 MSM; web‑based questionnaire; path analysis mediation","sample_n":402,"sample_text":"402 participants recruited via respondent‑driven sampling","population":"MSM in Wuhan and Changsha, China (N=402)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 402 Chinese gay men, using gay dating apps was linked to higher sexual compulsivity and sensation seeking, which in turn were associated with having more partners and unprotected sex. The study suggests that app use may mediate risky sexual behavior.","clinical_takeaway":"Targeting app use and underlying sexual traits may help reduce high‑risk sexual practices in MSM.","confidence":0.78,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large sample for a hard‑to‑reach population","Use of validated scales for compulsivity and sensation seeking","Multicenter design"],"limitations":["Cross‑sectional; mediation does not establish causality","No control for key confounds (e.g., mental health, moral factors)","Self‑report data may be biased"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":6,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/49137"}},{"id":6613,"doi":"10.3390/ijerph23050609","pmid":"42196702","pmcid":"PMC13206307","title":"Childhood Threat and Deprivation and Links to Mental Health Behaviors and Health Risk Behaviors Among Young Sexual Minority Men: The Differential Roles of Mindfulness and Emotion Regulation","authors":"Poon JA, Zelaya DG, Rajasankar V, Murphy MJ, Russell RA, Sun S.","first_author":"Poon JA","journal":"International journal of environmental research and public health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Child Abuse","Emotion Regulation","Mindfulness","Sexual Minority Men","Child Deprivation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13206307","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Community convenience sample of 317 young sexual minority men; cross‑sectional survey with mediation analysis.","sample_n":317,"sample_text":"317 SMM recruited from the community (non‑clinical)","population":"young sexual minority men (age 18‑35), 59 % White, recruited from the community","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 317 young gay and bisexual men and found that childhood abuse and neglect were linked to higher depression, anxiety, and risky sexual and substance‑use behaviors. These links were partly explained by difficulties regulating emotions and, for neglect, lower mindfulness.","clinical_takeaway":"Addressing emotion‑regulation and mindfulness may help mitigate mental‑health and risky‑behavior outcomes in trauma‑exposed sexual‑minority men.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Validated instruments for trauma, ER, mindfulness, sexual compulsivity","Adequate sample size for mediation analysis","Focus on understudied sexual minority population"],"limitations":["Cross‑sectional design limits causal inference","No control for moral incongruence or masturbation","Mediation claims may overstate causality"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph23050609"}},{"id":6614,"doi":"10.1080/0092623x.2021.1952361","pmid":"34338617","pmcid":null,"title":"Sexual Addiction and Associated Factors: The Role of Emotion Dysregulation, Impulsivity, Anxiety and Depression","authors":"Hegbe KG, Réveillère C, Barrault S.","first_author":"Hegbe KG","journal":"Journal of sex & marital therapy","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 398 volunteers recruited from specialized forums; self‑report questionnaires; mediation analyses","sample_n":398,"sample_text":"398 voluntary subjects recruited online through specialized forums","population":"voluntary participants from internet forums related to sexual topics; likely majority adults, gender not specified","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","self_selected_sample","causal_from_correlational"],"stance":"supports","citation_value":"useful","plain_summary":"A survey of 398 adults joining sexual‑interest forums found that people who screened as having sexual addiction also reported more trouble regulating emotions, higher impulsivity, and greater anxiety and depression. The authors suggest these factors may influence each other.","clinical_takeaway":"Clinicians should assess emotion regulation, impulsivity, and mood when working with clients who report sexual‑addiction symptoms, but note the evidence is correlational.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["large sample for a survey","use of validated questionnaires","mediation analysis explores indirect pathways"],"limitations":["self‑selected forum sample limits generalisability","sexual addiction defined by a screening scale, possibly circular","no control for moral incongruence or masturbation","cross‑sectional design precludes causal claims"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":5,"contrasting":0,"mentioning":16,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2021.1952361"}},{"id":6615,"doi":"10.1192/j.eurpsy.2026.12249","pmid":"42581775","pmcid":null,"title":"Concordance between gambling disorder, alcohol use disorder, and other behavioural addictions provides evidence for a comprehensive approach to addictive behaviours: A multiple systematic review analysis","authors":"Vansteene C, Poupon D, Czakó A, Kurimay T, Mangat HS, Ngetich RK, Demetrovics Z, Gorwood P.","first_author":"Vansteene C","journal":"European psychiatry : the journal of the Association of European Psychiatrists","year":2026,"pub_types":["Systematic Review","Journal Article"],"keywords":["Binge Eating Disorder","Gambling Disorder","Behavioural Addictions","Gaming Disorder","Compulsive Sexual Behaviour Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review comparing factor concordance across disorders; no meta‑analysis reported; uses published literature as source.","sample_n":null,"sample_text":"Not applicable","population":"Not applicable (review of existing studies)","country":"International (studies from multiple countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review compared 75 factors across gambling, alcohol, gaming and several behavioural addictions, finding high similarity between gambling, alcohol, gaming, and compulsive sexual behaviour disorder, supporting their classification as addictions.","clinical_takeaway":"CSBD shows strong overlap with other recognised addictions, but evidence is still limited; clinicians should assess it alongside other behavioural issues rather than assume a definitive addiction label.","confidence":0.7,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Broad comparative scope across multiple behavioural addictions","Systematic search strategy described","Highlights empirical gaps in data availability"],"limitations":["Reliance on secondary reports; primary measurement quality unclear","No quantitative meta‑analysis or assessment of study bias","Limited discussion of key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/j.eurpsy.2026.12249"}},{"id":6616,"doi":"10.1556/2006.2023.00008","pmid":"36943775","pmcid":"PMC10260207","title":"Structural brain differences related to compulsive sexual behavior disorder","authors":"Görts P, Savard J, Görts-Öberg K, Dhejne C, Arver S, Jokinen J, Ingvar M, Abé C.","first_author":"Görts P","journal":"Journal of behavioral addictions","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["surface area","Reward","Compulsive Sexual Behavior","Neuroimaging","Brain Structure","Hypersexual Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10260207","cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control structural MRI study of 22 CSBD patients vs 20 matched controls","sample_n":42,"sample_text":"22 CSBD patients, 20 matched healthy controls","population":"adult males, mean age ≈38, recruited as CSBD patients (diagnosis criteria not described) and healthy volunteers","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A small MRI study found that men diagnosed with compulsive sexual behavior disorder had a reduced surface area in a brain region linked to reward, suggesting possible brain differences associated with the condition.","clinical_takeaway":"Evidence of structural brain differences in CSBD is preliminary; clinicians should be cautious about interpreting such findings as proof of a brain‑based disorder.","confidence":0.6,"topic_tags":["csbd","neuroscience","moral_incongruence"],"strengths":["Matched control group","Use of structural MRI to probe brain morphology","Exploratory whole‑brain analysis beyond a priori ROIs"],"limitations":["Very small sample for neuroimaging (N=42)","No correction for multiple comparisons reported","Key confounders (moral incongruence, masturbation, mental health) not measured","Unclear how CSBD was operationalised and severity assessed"],"rubric_version":"2.0","raw_total":28,"max_possible":70,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":4,"statistics":4,"confounds":1,"design":4,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2023.00008"}},{"id":6617,"doi":"10.1556/2006.2023.00047","pmid":"37594880","pmcid":"PMC10562815","title":"Salivary testosterone levels are associated with Compulsive Sexual Behavior (CSB) in men but not in women in a community sample","authors":"Ballester-Arnal R, Castro-Calvo J, García-Barba M, Nebot-García JE, Gil-Llario MD.","first_author":"Ballester-Arnal R","journal":"Journal of behavioral addictions","year":2023,"pub_types":["brief-report","Journal Article"],"keywords":["Sex hormones","Testosterone","Compulsive Sexual Behavior","Biological Sex"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10562815","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"community convenience sample of 80 university‑age participants; saliva testosterone measured; self‑report CSB scales completed; correlational analysis","sample_n":80,"sample_text":"40 men, 40 women, ages 21‑23, recruited from the community","population":"young adults (mean age ~22), 40 men, 40 women, community sample","country":"unspecified (likely Spain based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 80 young adults, higher saliva testosterone was linked to higher scores on compulsive sexual behavior questionnaires in men but not in women, suggesting a possible role of testosterone in male CSB.","clinical_takeaway":"Testosterone levels may relate to compulsive sexual behavior in men, but hormonal testing is not yet warranted for clinical assessment.","confidence":0.7,"topic_tags":["csbd","sexual_function","neuroscience"],"strengths":["Biological measure (testosterone) adds a physiological dimension","Both sexes examined separately","Use of multiple CSB scales"],"limitations":["Cross‑sectional; cannot infer causality","Small sample; limited power especially for women","No control for key psychosocial confounds (moral incongruence, mental health, masturbation, relationship status)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2023.00047"}},{"id":6619,"doi":"10.1016/j.ajp.2025.104686","pmid":"40929967","pmcid":null,"title":"Treatment of compulsive sexual behavior disorder (CSBD) with a naltrexone implant: A case report","authors":"Liu L, Tian X, Zhou X.","first_author":"Liu L","journal":"Asian journal of psychiatry","year":2025,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ajp.2025.104686"}},{"id":6620,"doi":"10.1556/2006.2022.00069","pmid":"36112489","pmcid":"PMC9872533","title":"Another failure of the latent disease model? The case of compulsive sexual behavior disorder •","authors":"Borgogna NC, Borgogna NC, Aita SL.","first_author":"Borgogna NC","journal":"Journal of behavioral addictions","year":2022,"pub_types":["article-commentary","Journal Article"],"keywords":["Classification","Rdoc","Behavioral Addiction","Compulsive Sexual Behavior Disorder","Latent Disease Model"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9872533","cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"article-commentary","sample_n":null,"sample_text":"None - commentary with no empirical sample","population":"None - not applicable","country":"None - not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"background","plain_summary":"The authors argue that viewing compulsive sexual behavior disorder (CSBD) as a latent disease is problematic and suggest moving toward dimensional, process‑based models, urging more mixed‑methods and longitudinal research.","clinical_takeaway":"Clinicians should be cautious about labeling CSBD as a distinct disease and consider dimensional assessments while awaiting stronger evidence.","confidence":0.8,"topic_tags":["csbd","sexual_function","religiosity"],"strengths":["Clear theoretical argumentation","Identifies gaps in current CSBD research","Calls for mixed‑methods and longitudinal work"],"limitations":["No empirical data presented","No systematic review methodology","Potential bias toward a specific theoretical stance"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00069"}},{"id":6621,"doi":"10.1080/0092623x.2022.2086511","pmid":"35695090","pmcid":null,"title":"The Relationship between Boredom Proneness, Attachment Styles and Compulsive Sexual Behavior","authors":"Coleman E, Rahm-Knigge RL, Danielson S, Nielsen KH, Gleason N, Jennings T, Miner MH.","first_author":"Coleman E","journal":"Journal of sex & marital therapy","year":2023,"pub_types":["Journal Article"],"keywords":["Affect Regulation","Compulsive Sexual Behavior","Hypersexuality","Attachment Styles","Boredom Proneness"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional moderation analysis using self‑report questionnaires","sample_n":null,"sample_text":"not reported in abstract","population":"unspecified adult sample, likely convenience recruitment","country":"","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"People who get easily bored may be more likely to show compulsive sexual behavior, especially if they also feel anxious in close relationships. Attachment avoidance did not change this link.","clinical_takeaway":"Assess boredom and attachment anxiety when treating compulsive sexual behavior; address affect regulation in therapy.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Uses validated self‑report scales for key constructs","Examines interaction effects, adding nuance"],"limitations":["Cross‑sectional design cannot infer causality","No control for key confounds (morality, mental health, partner effects)","Potential self‑selection bias, unclear sampling"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2022.2086511"}},{"id":6622,"doi":"10.1556/2006.2022.00039","pmid":"35895458","pmcid":"PMC9295241","title":"Where to put Compulsive Sexual Behavior Disorder (CSBD)? Phenomenology matters •","authors":"Rumpf HJ, Montag C.","first_author":"Rumpf HJ","journal":"Journal of behavioral addictions","year":2022,"pub_types":["article-commentary","Journal Article"],"keywords":["Impulsivity","Pathological Gambling","Impulse Control Disorder","Addictive Behavior","Gambling Disorder","Compulsive Sexual Behavior Disorder","Gaming Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9295241","cited_by_count":20,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"article-commentary; no empirical data; discussion of classification of CSBD","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The authors argue that compulsive sexual behavior disorder fits best with addictive disorders, based on shared features like loss of control and continued use despite harms.","clinical_takeaway":"Consider framing CSBD within an addiction model, but note the lack of empirical support in this piece.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Clear articulation of classification issue","Integrates phenomenological perspective"],"limitations":["No empirical data presented","Potential advocacy bias toward addiction model"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00039"}},{"id":6624,"doi":"10.1080/26929953.2023.2167139","pmid":"37193574","pmcid":"PMC10168019","title":"Alcohol Use and Compulsive Sexual Behaviors in College Students: The Moderating Effect of Alcohol-Related Sexual Expectancies","authors":"Garner AR, Florimbio AR, Basting EJ, Sullivan J, Medenblik AM, Jensen MC, Stuart GL.","first_author":"Garner AR","journal":"Sexual health & compulsivity","year":2023,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 308 college students; moderation analysis","sample_n":308,"sample_text":"308 college students","population":"college students (N=308) from a large southeastern US university","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 308 U.S. college students, those who believed alcohol would increase sexual drive or affect showed a stronger link between drinking and compulsive sexual behaviors, suggesting expectancies may heighten risk.","clinical_takeaway":"Screen for alcohol‑related sexual expectancies when assessing risky sexual or compulsive behaviors in college students.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonably large sample for a college survey","Examines interaction of expectancies with alcohol‑CSB link","Uses moderation analysis to test theory"],"limitations":["Cross‑sectional; no causal inference","Unclear whether CSB and alcohol measures are validated","Key confounds (moral incongruence, masturbation, mental health) not addressed"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/26929953.2023.2167139"}},{"id":6625,"doi":"10.1007/s00787-023-02155-2","pmid":"36763182","pmcid":null,"title":"Parental practices as predictors of adolescents' compulsive sexual behavior: a 6-month prospective study","authors":"Efrati Y.","first_author":"Efrati Y.","journal":"European child & adolescent psychiatry","year":2024,"pub_types":["Journal Article"],"keywords":["Compulsive Sexual Behavior","Parental Practices","Sex-related Communication","Parents’ Support Giving","Risky Sexual behavior"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective 6‑month cohort of 300 Israeli families (mother, father, adolescent) assessing parental practices and adolescent CSB severity","sample_n":300,"sample_text":"300 families (triads), 39% boys, 61% girls, Israel","population":"Adolescents 14‑18 years (N≈300) and their parents","country":"Israel","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 6‑month study of 300 Israeli families, higher maternal support and better father‑child communication predicted lower levels of compulsive sexual behavior in teens, suggesting family dynamics influence sexual health.","clinical_takeaway":"Family‑based interventions that enhance parental support and communication may help reduce risky sexual behaviors in adolescents.","confidence":0.8,"topic_tags":["adolescents","sexual_function","relationships","csbd"],"strengths":["Large community sample of families","Prospective design allows temporal ordering","Both maternal and paternal practices examined"],"limitations":["Unclear whether CSB measured with validated scale","Key confounds (moral incongruence, mental health) not assessed","No pre‑registration or effect‑size reporting mentioned"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00787-023-02155-2"}},{"id":6627,"doi":"10.31234/osf.io/8bq76_v1","pmid":null,"pmcid":null,"title":"Determinanty, charakterystyka i konsekwencje kompulsywnego zaburzenia seksualnego i problematycznego korzystania z pornografii – badania nowej jednostki diagnostycznej wprowadzonej w 11 edycji Międzynarodowej Klasyfikacji Chorób, ICD-11. Dr Karol Lewczuk, autoreferat habilitacyjny","authors":"Lewczuk K.","first_author":"Lewczuk K.","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://osf.io/8bq76_v1/download","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"No empirical sample; abstract describes clinical observations and literature","population":"general population (mentioned), no empirical sample","country":"Poland (author affiliation inferred)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The author reviews clinical reports and literature suggesting that some people struggle to control sexual behaviours such as frequent pornography use and masturbation, and notes that Compulsive Sexual Behavior Disorder is now listed in ICD‑11. No new data are provided.","clinical_takeaway":"The piece underscores that CSBD is recognized in ICD‑11, but offers no evidence to guide assessment or treatment.","confidence":0.4,"topic_tags":["csbd","pornography","sexual_function","adolescents"],"strengths":["Highlights recent ICD‑11 inclusion of CSBD","Summarises clinical observations across settings"],"limitations":["No empirical data presented","No operational definitions or validated measures reported","Absence of control for moral incongruence, masturbation, mental health, partner effects, or trauma"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/8bq76_v1"}},{"id":6628,"doi":"10.1016/j.jsxm.2021.12.002","pmid":"34987002","pmcid":null,"title":"Psychometric Properties of Common Measures of Hypersexuality in an Online Canadian Sample","authors":"Olver ME, Kingston DA, Laverty EK, Seto MC.","first_author":"Olver ME","journal":"The journal of sexual medicine","year":2022,"pub_types":["Journal Article"],"keywords":["Hypersexuality","Hypersexual Behavior Inventory","Compulsive Sexual Behavior Disorder","Sexual Compulsivity Scale","Total Sexual Outlet"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"two large non‑clinical online Canadian samples; psychometric evaluation (EFA, CFA, test‑retest, reliability, concurrent validity).","sample_n":2210,"sample_text":"online community participants","population":"cisgender women (n≈525, 359), cisgender men (n≈419, 364), transgender/non‑binary (n≈38, 11); community volunteers.","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined two widely used questionnaires that measure hypersexuality, testing whether they work the same way for men, women and gender‑diverse people in Canada. Both tools showed stable factor structures, good reliability over time, and reasonable links to reported sexual activity.","clinical_takeaway":"These scales appear reliable for assessing hypersexuality in community samples, but clinicians should note they rely on self‑report and may not capture all relevant psychosocial factors.","confidence":0.85,"topic_tags":["measurement","sexual_function","csbd"],"strengths":["Large, gender‑balanced samples","Comprehensive psychometric testing (EFA, CFA, invariance)","Test‑retest reliability assessed"],"limitations":["Self‑report only, possible selection bias","Limited inclusion of gender‑diverse participants","No assessment of moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.12.002"}},{"id":6629,"doi":"10.1093/schbul/sbaf221","pmid":"41863367","pmcid":null,"title":"Female Sexual Dysfunction Induced by Second-Generation Antipsychotic Drugs-A Disproportionality Analysis Based on the FAERS Database","authors":"Wang D, Cao Y, Wu L, Jin L.","first_author":"Wang D","journal":"Schizophrenia bulletin","year":2026,"pub_types":["Journal Article"],"keywords":["Prolactin","Pharmacovigilance","Female Sexual Dysfunction","Antipsychotic Medications","Faers"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Pharmacovigilance disproportionality analysis of FAERS reports (2004‑2023) for nine second‑generation antipsychotics and female sexual dysfunction outcomes.","sample_n":11786,"sample_text":"11 786 reports identified; largest subgroup women 19‑41 y (n = 4787).","population":"Women aged 19–41 years who filed an adverse event report in FAERS (N = 11 786).","country":"United States (FAERS data).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Analysis of FDA adverse‑event reports found that several second‑generation antipsychotics, especially aripiprazole, quetiapine and olanzapine, are reported more often than expected with female sexual problems such as decreased libido, anorgasmia, and compulsive sexual behaviour.","clinical_takeaway":"Clinicians should monitor women on SGAs for sexual side‑effects and discuss alternatives or management strategies.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large pharmacovigilance database covering 20 years.","Multiple disproportionality methods (frequentist and Bayesian).","Stratification by symptom type and prolactin‑related effects."],"limitations":["Spontaneous reporting subject to under‑reporting and reporting bias.","No control for confounding variables (e.g., mental health, concurrent meds).","Sexual dysfunction defined by coding terms rather than validated scales."],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/schbul/sbaf221"}},{"id":6630,"doi":"10.1556/2006.2020.00055","pmid":"32997646","pmcid":"PMC9295215","title":"Should compulsive sexual behavior (CSB) be considered as a behavioral addiction? A debate paper presenting the opposing view","authors":"Sassover E, Weinstein A.","first_author":"Sassover E","journal":"Journal of behavioral addictions","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Compulsive Sexual Behavior","Hypersexuality","Sex Addiction"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/aop/article-10.1556-2006.2020.00055/article-10.1556-2006.2020.00055.pdf","cited_by_count":67,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/position paper without original data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"useful","plain_summary":"The authors review research on compulsive sexual behavior and argue there is insufficient evidence to classify it as a behavioral addiction, highlighting inconsistent definitions and limited empirical data.","clinical_takeaway":"Current data do not support treating CSBD as a formal addiction; clinicians should await clearer diagnostic criteria.","confidence":0.6,"topic_tags":["csbd","sexual_function"],"strengths":["Clear articulation of gaps in the literature","Balanced critique of existing evidence"],"limitations":["No original empirical data","Relies on secondary sources"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":6,"contrasting":0,"mentioning":100,"citing_publications":105,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00055"}},{"id":6631,"doi":"10.1016/j.addbeh.2022.107379","pmid":"35659693","pmcid":null,"title":"Early-life trauma, negative and positive life events, compulsive sexual behavior disorder and risky sexual action tendencies among young women with substance use disorder","authors":"Efrati Y, Goldman K, Levin K, Rosca P.","first_author":"Efrati Y","journal":"Addictive behaviors","year":2022,"pub_types":["Journal Article"],"keywords":["Substance Use","Risky Sexual Behavior","Compulsive Sexual Behaviors","Early-life Trauma"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control comparison of 62 women with SUD and 70 healthy controls, self‑report questionnaires","sample_n":132,"sample_text":"132 women (62 with substance‑use disorder, 70 healthy controls)","population":"young women, n=132 (62 SUD, 70 controls)","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Women with substance‑use disorders reported more compulsive sexual behaviour and risky sex than women without such disorders. Childhood emotional abuse was linked to both problems, while recent negative life events were linked only to the sexual issues.","clinical_takeaway":"Screen for trauma and CSBD in women seeking treatment for substance use, as they often co‑occur.","confidence":0.7,"topic_tags":["csbd","relationships","treatment","sexual_function"],"strengths":["Relatively large sample for this niche","Inclusion of a healthy control group","Assessment of early‑life trauma as antecedent"],"limitations":["Cross‑sectional design limits causal inference","Key confounds (moral incongruence, masturbation, mental health, partner factors) not measured","CSBD measured by self‑report scale without clear validation for criteria"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2022.107379"}},{"id":6632,"doi":"10.1093/jsxmed/qdac035","pmid":"36763943","pmcid":null,"title":"Hypo- or hyperfunction? Differential relationships between compulsive sexual behavior disorder facets and sexual health","authors":"Glica A, Wizła M, Gola M, Lewczuk K.","first_author":"Glica A","journal":"The journal of sexual medicine","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual Health","Sexual Inhibition","Sexual Excitation","Compulsive Sexual Behavior Disorder","Sexual Hyperfunction","Sexual Hypofunction"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two online cross‑sectional surveys (convenience N=812; representative N=1526) using hierarchical regression to relate CSBD facet scores to sexual function scores.","sample_n":2338,"sample_text":"Convenience sample (812) and nationally representative sample (1526).","population":"Polish adults, mean age ~22 (study 1) and 43 (study 2), mixed gender.","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that certain CSBD symptoms (salience, relapse) are linked to higher sexual drive and easier arousal, while others (negative consequences, dissatisfaction) relate to lower drive and more dysfunction. Different parts of the disorder affect sexual health in opposite ways.","clinical_takeaway":"Assess which CSBD symptoms a client shows, as some may be linked to hyper‑ versus hypo‑sexual functioning.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Large, representative sample in study 2","Use of validated CSBD and sexual function scales","Replication of findings across two samples","Clear distinction of CSBD facets in analysis"],"limitations":["Cross‑sectional design precludes causal inference","No measurement of key confounds (moral incongruence, masturbation, mental health, relationship factors)","Potential self‑report bias in online survey","Addiction criteria not fully operationalised"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdac035"}},{"id":6633,"doi":"10.7759/cureus.29245","pmid":"36262958","pmcid":"PMC9573801","title":"Use of Fluoxetine in Treating Compulsive Sexual Behavior: A Case Report","authors":"Singh G, Singh H, Magny S, Virk I, Gill M.","first_author":"Singh G","journal":"Cureus","year":2022,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["fluoxetine","Sexual Disorders","Compulsive Sexual Behavior","Selective Serotonin Reuptake Inhibitor (Ssri)","Sex Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9573801","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single patient treated with fluoxetine for self‑reported compulsive sexual behavior","sample_n":1,"sample_text":"single patient","population":"36‑year‑old male, self‑identified as a sex addict, presenting with depression and CSB","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale","self_selected_sample"],"stance":"supports","citation_value":"background","plain_summary":"A 36‑year‑old man who called himself a sex addict and was also depressed was treated with the antidepressant fluoxetine. His compulsive sexual urges reportedly decreased after medication.","clinical_takeaway":"Fluoxetine may help reduce compulsive sexual urges in some individuals, but evidence is limited to a single case.","confidence":0.4,"topic_tags":["csbd","sexual_function","treatment"],"strengths":["Detailed clinical description of one patient","Provides insight into pharmacological response to fluoxetine"],"limitations":["Single case, no control or comparison","No validated measures of CSB or addiction criteria","Potential moral incongruence not assessed","Findings not generalizable"],"rubric_version":"2.0","raw_total":10,"max_possible":60,"pct_score":17,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":2,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.29245"}},{"id":6634,"doi":"10.1080/0092623x.2023.2259894","pmid":"37878755","pmcid":null,"title":"Development and Validation of the Metacognitions about Sex Scale: Exploring its Role as a Mediator between Negative Affect, Emotion Dysregulation Strategies, and Compulsive Sexual Behavior Disorder","authors":"Efrati Y, Spada MM.","first_author":"Efrati Y","journal":"Journal of sex & marital therapy","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://openresearch.lsbu.ac.uk/download/254709407f4c6147bbf360f37b87fa3a8e940d469b5c391b68143ffc67681779/647721/Efrati%2C%20Y.%20%26%20Spada%2C%20M.%20M.%20Development%20and%20validation%20of%20the%20Metacognitions%20about%20Sex%20Scale.docx","cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Scale development and validation with large adolescent sample; cross‑sectional SEM mediation analysis.","sample_n":662,"sample_text":"community adolescent sample, convenience recruitment not specified","population":"662 Israeli adolescents (13‑18 y, 38 % male)","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and tested a new questionnaire about thoughts people have about sex. In 662 teens, the scale was reliable and linked to emotions, impulsivity and compulsive sexual behaviour, suggesting it could help identify risky patterns.","clinical_takeaway":"The Metacognitions about Sex Scale may aid early screening of maladaptive sexual thoughts in teens, but it does not replace clinical assessment of compulsive sexual behaviour.","confidence":0.9,"topic_tags":["measurement","adolescents","sexual_function","csbd"],"strengths":["Large sample for scale validation","Factor analysis and SEM mediation","Good internal consistency reported"],"limitations":["Cross‑sectional; cannot infer causality","No assessment of moral or religious factors that influence CSB reporting","CSB measured by self‑report only, unclear if aligned with ICD‑11 criteria"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":13,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2023.2259894"}},{"id":6635,"doi":"10.20944/preprints202601.0119.v1","pmid":null,"pmcid":null,"title":"Chemsex: Venereological Consequences, Psychiatric and Somatic Complications, and Potential Intervention Strategies","authors":"Ozkan HS, Rogoveanu SC, Isman-Haznedaroglu D.","first_author":"Ozkan HS","journal":"Preprints.org","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of chemsex literature (PubMed search 2020‑2025), no primary data collection.","sample_n":null,"sample_text":"No primary participants; synthesis of existing studies.","population":"Men who have sex with men engaging in chemsex (as reported in the literature); no new sample.","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review recent research on chemsex—using drugs to boost sexual activity—showing it raises STI rates and mental‑health problems, and suggest combined harm‑reduction and therapy approaches may help.","clinical_takeaway":"Clinicians should screen for chemsex‑related risks and consider integrated harm‑reduction and mental‑health interventions.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["Broad, up‑to‑date literature scope (2020‑2025)","Integrates biomedical, psychiatric, and sociocultural perspectives","Identifies potential multimodal interventions"],"limitations":["Narrative (non‑systematic) synthesis; no risk‑of‑bias assessment","No quantitative meta‑analysis or effect‑size reporting","Potential selection bias in cited studies"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202601.0119.v1"}},{"id":6637,"doi":"10.1556/2006.7.2018.66","pmid":"30156117","pmcid":"PMC6426375","title":"Online dating is associated with sex addiction and social anxiety","authors":"Zlot Y, Goldstein M, Cohen K, Weinstein A.","first_author":"Zlot Y","journal":"Journal of behavioral addictions","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Sensation seeking","Social Anxiety","Sex Addiction","Dating Applications"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6426375","cited_by_count":20,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire, N=279, convenience sample, comparison of dating‑app users vs non‑users","sample_n":279,"sample_text":"279 participants (128 males, 151 females) recruited via the Internet","population":"young adults (18‑38 years), mixed gender","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 279 young adults, people who use dating apps scored higher on a sex‑addiction questionnaire and also reported more social anxiety. Sensation seeking and gender did not differ. The authors suggest social anxiety may drive risky sexual app use.","clinical_takeaway":"Higher social anxiety may be linked to self‑reported sex‑addiction symptoms among dating‑app users; assess anxiety when addressing problematic sexual behaviour.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Reasonably large sample for a questionnaire study","Standardized scales for social anxiety and sensation seeking","Clear comparison between dating‑app users and non‑users"],"limitations":["Cross‑sectional design cannot establish causality","Sex addiction measured with SAST, a screening tool with limited validation for addiction criteria","No measurement of moral incongruence, masturbation, partner context, or trauma"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.66"}},{"id":6638,"doi":"10.1556/2006.2023.00056","pmid":"37874642","pmcid":"PMC10786231","title":"Alterations in voxel based morphometry and resting state functional connectivity in men with compulsive sexual behavior disorder in the Sex@Brain study","authors":"Engel J, Gkavanozi A, Veit M, Kneer J, Kruger THC, Sinke C.","first_author":"Engel J","journal":"Journal of behavioral addictions","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Brain imaging","Voxel-based Morphometry","Sexual Addiction","Resting-state Functional Connectivity","Hypersexual Disorder","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10786231","cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control MRI study with 30 CSBD men and 32 matched controls; structural VBM and resting‑state functional connectivity analyses","sample_n":62,"sample_text":"30 CSBD men, 32 controls (age‑ and education‑matched)","population":"men with Compulsive Sexual Behavior Disorder (ICD‑11) and healthy controls","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In men diagnosed with compulsive sexual behavior disorder, MRI showed larger gray‑matter volumes in parts of the cerebellum and frontal cortex, and altered resting‑state connectivity involving the orbitofrontal cortex, amygdala and other regions; these brain differences correlated with how severe their symptoms were.","clinical_takeaway":"Current brain‑imaging findings are preliminary; they do not yet guide diagnosis or treatment of CSBD.","confidence":0.7,"topic_tags":["csbd","neuroscience","moral_incongruence","sexual_function","treatment"],"strengths":["use of both structural and functional MRI","age‑ and education‑matched control group","exploratory link of imaging findings to symptom severity"],"limitations":["modest sample size for whole‑brain imaging","no assessment or control of key psychosocial confounds (e.g., moral incongruence, masturbation, mental health)","cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":34,"max_possible":70,"pct_score":49,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":5,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2023.00056"}},{"id":6640,"doi":"10.1016/j.addbeh.2022.107591","pmid":"36587418","pmcid":null,"title":"Obsessive-compulsive, harm-avoidance and persistence tendencies in patients with gambling, gaming, compulsive sexual behavior and compulsive buying-shopping disorders/concerns","authors":"Mestre-Bach G, Granero R, Fernández-Aranda F, Potenza MN, Jiménez-Murcia S.","first_author":"Mestre-Bach G","journal":"Addictive behaviors","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Gambling","Video Games","Compulsive Sexual Behaviors","Addictive Behaviors","Impulsive Behaviors","Obsessive-compulsive Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 4,010 treatment‑seeking patients diagnosed with various behavioral addictions (gambling, gaming, compulsive sexual behavior, compulsive buying‑shopping).","sample_n":4010,"sample_text":"4,010 treatment‑seeking patients","population":"Treatment‑seeking adults with DSM‑5/ICD‑11 behavioral addictions; convenience sample.","country":"Spain (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined obsessive‑compulsive traits in people seeking treatment for gambling, video‑gaming, compulsive sexual behavior, and compulsive buying. Using validated questionnaires, it found that those with compulsive sexual behavior showed higher obsessive‑compulsive scores than the other groups.","clinical_takeaway":"Therapists should note that compulsive sexual behavior may co‑occur with stronger obsessive‑compulsive features than other behavioral addictions.","confidence":0.7,"topic_tags":["csbd","sexual_function","moral_incongruence","measurement"],"strengths":["Large clinical sample (N>4000)","Standardised, validated questionnaires","Comparative approach across several behavioral addictions"],"limitations":["Convenience, treatment‑seeking sample limits generalisability","No control for key confounds (e.g., moral incongruence, mental health)","Cross‑sectional; no causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2022.107591"}},{"id":6642,"doi":"10.1556/2006.2025.00163","pmid":"42461702","pmcid":null,"title":"The use of Image and Performance-Enhancing Drugs (IPED) in behavioural addictions","authors":"Corazza O, Burkauskas J, De Luca I, Zandonai T, Szabo A, Jiménez-Murcia S, Fernández-Aranda F, Kun B, Jennings TL, Gleason N, Bőthe B, Király O, Czakó A, Demetrovics Z.","first_author":"Corazza O","journal":"Journal of behavioral addictions","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Psychopathology","Eating Disorders","Gambling","Social Media","Exercise Addiction","Image And Performance Enhancing Drugs","Video Game Playing","Behavioural Addictions","Work Addiction","Compulsive Sexual Behaviour Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review synthesising existing literature without systematic methodology or risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not applicable – narrative review","population":"Not applicable (review article)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review suggests that drugs used to enhance body image and performance may be linked to various behavioural addictions, including compulsive sexual behaviour, but the idea is based on existing studies rather than new data.","clinical_takeaway":"No direct clinical guidance; the review highlights a potential overlap that warrants further empirical research.","confidence":0.8,"topic_tags":["sexual_function","csbd","pornography","masturbation","moral_incongruence","neuroscience"],"strengths":["Broad integration of disparate literature on IPED and behavioural addictions","Identifies a novel conceptual framework linking IPED use across disorders"],"limitations":["Narrative (non‑systematic) approach without explicit search strategy","No formal risk‑of‑bias or quality appraisal of included studies","Lacks empirical data; conclusions are speculative"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00163"}},{"id":6644,"doi":"10.3390/brainsci15090980","pmid":"41008340","pmcid":"PMC12467898","title":"Emerging Interventions in Behavioral Addictions: A Narrative Review of Psychedelics and Neuromodulation","authors":"Ulisse K, Albitar J, Aromin JT, Berry J.","first_author":"Ulisse K","journal":"Brain sciences","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["DBS","rTMS","Neuromodulation","Tdcs","Behavioral Addiction","Internet Use Disorder","Gambling Disorder","Psychedelic","Compulsive Sexual Behavior Disorder","Gaming Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12467898","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of emerging interventions, no primary data, no systematic methods reported","sample_n":null,"sample_text":"Not applicable – narrative review","population":"none","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The article reviews early research on psychedelics and brain‑stimulation techniques as possible treatments for behavioral addictions such as compulsive sexual behavior, gambling, and gaming disorders.","clinical_takeaway":"These emerging therapies are still experimental; clinicians should await robust trial evidence before considering them for patients.","confidence":0.7,"topic_tags":["csbd","treatment","neuroscience","pornography","sexual_function"],"strengths":["Broad coverage of novel therapeutic modalities","Integrates neurocircuitry concepts"],"limitations":["Narrative (non‑systematic) synthesis","No empirical data or systematic quality appraisal","Potentially optimistic framing of emerging treatments"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/brainsci15090980"}},{"id":6645,"doi":"10.1556/2006.7.2018.57","pmid":"30273048","pmcid":"PMC6426369","title":"Spanish validation of the Sexual Addiction Screening Test","authors":"Castro-Calvo J, Ballester-Arnal R, Billieux J, Gil-Juliá B, Gil-Llario MD.","first_author":"Castro-Calvo J","journal":"Journal of behavioral addictions","year":2018,"pub_types":["research-article","Validation Study","Journal Article"],"keywords":["Psychometric Properties","Compulsive Sexual Behavior","Hypersexuality","Spanish Validation","Sexual Addiction Screening Test (Sast)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6426369","cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of Spanish SAST with 2,528 participants, exploratory and confirmatory factor analysis, reliability assessment, test‑retest stability.","sample_n":2528,"sample_text":"2,528 participants (1,163 males) completed the Spanish SAST; subsamples for paper‑and‑pencil (1,585) and online (943).","population":"Adult Spanish‑speaking participants (both genders; mixed online and paper‑and‑pencil).","country":"Spain (Spanish‑speaking sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated the Sexual Addiction Screening Test into Spanish and confirmed that it reliably measures a four‑factor structure of sexual addiction symptoms in a large community sample.","clinical_takeaway":"The Spanish SAST appears reliable for screening sexual addiction, but clinicians should consider other factors (e.g., moral beliefs, mental health) when interpreting scores.","confidence":0.8,"topic_tags":["sexual_function","prevalence"],"strengths":["Large sample size for psychometric validation","Both exploratory and confirmatory factor analyses performed","Measurement invariance across gender tested","Test‑retest stability over 1 year"],"limitations":["No assessment of moral incongruence or other key confounds","Potential circularity of the SAST definition of “sexual addiction”","No pre‑registration or independent replication"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.57"}},{"id":6647,"doi":"10.1556/2006.2022.00028","pmid":"35895457","pmcid":"PMC9295217","title":"Assessment of compulsive sexual behavior disorder among lesbian, gay, bisexual, transgender, and queer clients •","authors":"Jennings TL, Gleason N, Kraus SW.","first_author":"Jennings TL","journal":"Journal of behavioral addictions","year":2022,"pub_types":["article-commentary","Journal Article"],"keywords":["Differential diagnosis","Compulsive Sexual Behavior Disorder","Lgbtq+ Clients"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9295217","cited_by_count":20,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"article-commentary","sample_n":null,"sample_text":"None – commentary with no empirical participants","population":"LGBTQ+ clients (clinical context, no empirical sample)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors discuss how compulsive sexual behavior disorder (CSBD) might be misdiagnosed in LGBTQ+ clients and suggest diagnostic considerations to avoid this.","clinical_takeaway":"Clinicians should be cautious when applying CSBD criteria to LGBTQ+ clients and consider sociocultural factors.","confidence":0.7,"topic_tags":["csbd","lgbtq","sexual_function"],"strengths":["Highlights need for culturally sensitive assessment","Integrates recent ICD‑11 discussion"],"limitations":["No empirical data presented","No measurement of key constructs or confounds"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":35,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00028"}},{"id":6648,"doi":"10.47102/annals-acadmedsg.2024266","pmid":"40637611","pmcid":null,"title":"Making sense of ICD-11 diagnostic criteria of compulsive sexual behavioural disorder","authors":"Amron S, Gomathinayagam K, Lee C, Guo S, Tan HS.","first_author":"Amron S","journal":"Annals of the Academy of Medicine, Singapore","year":2025,"pub_types":["Letter"],"keywords":["Clinical Competence","Consensus","Compulsive Behaviour","Compulsive Sexual Behaviour Disorder","Behaviour Addiction","Inter-rater Testing","Standardise Reporting"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.47102/annals-acadmedsg.2024266"}},{"id":6649,"doi":"10.1016/j.jpsychires.2022.07.066","pmid":"35952519","pmcid":null,"title":"N-acetylcysteine in the treatment of compulsive sexual behavior disorder: A case series","authors":"Blum AW, Grant JE.","first_author":"Blum AW","journal":"Journal of psychiatric research","year":2022,"pub_types":["Journal Article"],"keywords":["Glutamate","Sexual behavior","Pharmacotherapy","Hypersexuality"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of 8 male patients from a specialty outpatient clinic","sample_n":8,"sample_text":"Eight male patients treated in routine clinical practice; all had prior treatments.","population":"8 adult males diagnosed with compulsive sexual behavior disorder (CSBD)","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A small case series of eight men with compulsive sexual behavior disorder were given the supplement N‑acetylcysteine. Five showed more than a 35% improvement on a symptom scale, while three improved little. The authors suggest NAC could be a promising option, but the evidence is limited.","clinical_takeaway":"Evidence for NAC in CSBD is preliminary; consider only after standard therapies have failed and monitor closely.","confidence":0.8,"topic_tags":["treatment","csbd","neuroscience"],"strengths":["Novel pharmacological trial for CSBD","Real‑world clinical setting","Clear outcome threshold (>35% improvement)"],"limitations":["Very small, non‑random sample","No control group or blinding","Modified Y‑BOCS not validated for CSBD","Potential selection bias (treatment‑seeking clinic)"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":2,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpsychires.2022.07.066"}},{"id":6650,"doi":"10.1556/2006.2022.00029","pmid":"35895452","pmcid":"PMC9295252","title":"Compulsive Sexual Behavior Disorder should not be classified by solely relying on component/symptomatic features •","authors":"Castro-Calvo J, Flayelle M, Perales JC, Brand M, Potenza MN, Billieux J.","first_author":"Castro-Calvo J","journal":"Journal of behavioral addictions","year":2022,"pub_types":["article-commentary","Journal Article"],"keywords":["Classification","Compulsive Behavior","Compulsive Sexual Behavior","Impulsive Behavior","Nosology","Addictive Behavior","Psychological Processes","Components Model Of Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9295252","cited_by_count":24,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"article-commentary; no empirical data; argumentative discussion of classification of CSBD","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that classifying Compulsive Sexual Behavior Disorder should not rely only on addiction component models; instead, a process‑based approach is needed to better capture the disorder.","clinical_takeaway":"None – the paper is a theoretical commentary, not clinical guidance.","confidence":0.8,"topic_tags":["csbd","neuroscience","religiosity"],"strengths":["Clear articulation of conceptual issues","References recent literature"],"limitations":["No empirical data","Limited to theoretical argument"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":20,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00029"}},{"id":6651,"doi":"10.1007/s10508-024-02828-2","pmid":"38589743","pmcid":null,"title":"The Structure of Hypersexuality and Its Relation to Impulsivity","authors":"Du R, Knight RA.","first_author":"Du R","journal":"Archives of sexual behavior","year":2024,"pub_types":["Journal Article"],"keywords":["Impulsivity","Compulsive Sexual Behavior","Dsm-5","Hypersexuality","Equifinality","Sexual Drive"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey with factor analysis; in‑person college sample (n=69) plus online respondents (n=339).","sample_n":408,"sample_text":"n = 69 in‑person college students; n = 339 online respondents.","population":"College students and community adults (young adult); convenience sample.","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors surveyed 408 people and used factor analysis to show that hypersexuality splits into two related parts: a ‘problematic sexuality’ component linked to compulsive and harmful sexual behavior, and a ‘sexual drive’ component linked to frequent activity and fantasies. These parts relate differently to impulsivity traits.","clinical_takeaway":"Hypersexuality may involve distinct dimensions (problematic behavior vs. high drive); clinicians should assess both separately rather than treating it as a single syndrome.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large combined sample for factor analysis (N > 400)","Use of several established scales","Clear statistical separation of two factors","External validation via distinct impulsivity correlates"],"limitations":["Convenience, non‑representative sample","No measurement of key confounds (moral incongruence, mental health, etc.)","Cross‑sectional, cannot infer causality","No preregistration or correction for multiple testing reported"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02828-2"}},{"id":6652,"doi":"10.1556/2006.2025.00085","pmid":"41115014","pmcid":null,"title":"Problematic usage of the internet: Converging and diverging terminologies and constructs","authors":"Zare-Bidoky M, Baldacchino AM, Baldacchino AM, Demetrovics Z, Fineberg NA, Kamali M, Khazaal Y, Potenza MN, Stein DJ, Ekhtiari H.","first_author":"Zare-Bidoky M","journal":"Journal of behavioral addictions","year":2025,"pub_types":["Review","Journal Article"],"keywords":["Gambling","Impulsive","Internet Addiction","Compulsive","Gaming","Pui","Problematic Usage Of The Internet"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 2022‑2023 literature on problematic internet use (PUI) sub‑categories, including online compulsive sexual behavior. No meta‑analysis or risk‑of‑bias assessment reported in abstract.","sample_n":null,"sample_text":"2,497 relevant papers screened; no primary sample.","population":"Papers on PUI sub‑categories (n≈2,497); no primary participant data.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review examined recent research on problematic internet use, noting that many studies use separate names for behaviors like online sexual activity instead of the umbrella term ‘PUI’. Unifying terminology could improve research and treatment.","clinical_takeaway":"Clinicians should be aware that diverse online behaviors (including compulsive sexual activity) are often studied under different labels, which may affect diagnosis and treatment planning.","confidence":0.6,"topic_tags":["sexual_function","csbd","pornography","masturbation"],"strengths":["Comprehensive scope of PUI sub‑categories","Highlights terminological inconsistencies","Systematic search strategy"],"limitations":["No meta‑analytic synthesis or bias assessment","No primary data; relies on published definitions","Limited attention to confounding variables"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2025.00085"}},{"id":6653,"doi":"10.1016/j.jpsychires.2025.09.019","pmid":"41016214","pmcid":null,"title":"Getting lucky: Clinical characterization of compulsive sexual behavior compared with gambling disorder and intermittent explosive disorder","authors":"Ethier AR, Kim HS, Hodgins DC, McGrath DS, Tavares H, Scanavino MDT.","first_author":"Ethier AR","journal":"Journal of psychiatric research","year":2025,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Personality Traits","Compulsive Sexual Behavior","Intermittent Explosive Disorder","Gambling Disorder","Psychiatric Comorbidities","Demographic Correlates"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional description of treatment‑seeking adults with CSBD, gambling disorder and intermittent explosive disorder (N=969). Diagnoses based on Goodman's criteria (CSBD) and DSM‑IV SCID (GD, IED). Psychiatric comorbidities via MINI; personality via TCI.","sample_n":969,"sample_text":"N = 969; CSBD n = 233, GD n = 634, IED n = 102","population":"Adults (treatment‑seeking) at a specialty clinic, mixed gender, age range not specified, primarily clinical sample.","country":"Not specified (non‑U.S. government support)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared adults seeking help for compulsive sexual behavior, gambling, and explosive anger, finding that the CSBD group tended to be younger, more often male, and more likely non‑heterosexual, with distinct personality patterns.","clinical_takeaway":"CSBD patients show a unique clinical profile that may aid screening, but findings come from a treatment‑seeking sample and cannot be generalized to all users.","confidence":0.7,"topic_tags":["csbd","sexual_function","gender","adolescents"],"strengths":["Large clinical sample spanning three disorders","Standardized diagnostic interviews","Comprehensive personality assessment","Transparent statistical correction for multiple testing"],"limitations":["Treatment‑seeking convenience sample limits generalisability","No measurement of moral incongruence or masturbation","Cross‑sectional design precludes causal inference","CSBD defined by Goodman's criteria, not fully aligned with ICD‑11"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpsychires.2025.09.019"}},{"id":6654,"doi":"10.1177/15248380261451792","pmid":"42417149","pmcid":null,"title":"Understanding Mental Health and Childhood Adversity in Technology-Facilitated Child Sexual Exploitation Perpetrators: A Systematic Review of the Evidence","authors":"Page S, Notté E, Pearson I, Ilyas I, Rozubi NC, Anderson K, Seigfried-Spellar K, Slater C, Fry D.","first_author":"Page S","journal":"Trauma, violence & abuse","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Sexual Abuse","Child Maltreatment","Adverse Childhood Experiences","Technology- Or Image-based Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Narrative synthesis of 22 cross‑sectional studies on TF‑CSEA perpetrators; no meta‑analysis, no risk‑of‑bias assessment reported.","sample_n":null,"sample_text":"Varied across included studies; many convenience samples.","population":"Perpetrators of technology‑facilitated child sexual exploitation; justice‑identified, self‑referred, and anonymous online samples (n = 8‑3500).","country":"Primarily Western high‑income countries","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A review of 22 studies found that people who exploit children online often have depression, anxiety, antisocial traits, and a history of childhood trauma. Different offender groups show distinct patterns of mental‑health problems, but the evidence comes mainly from small, non‑representative studies.","clinical_takeaway":"Clinicians working with offenders should assess for co‑occurring mental‑health issues and trauma, but evidence is limited; treatment plans need to consider individual profiles.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Systematic search of 10 databases and grey literature","Inclusion of both justice‑identified and self‑referred perpetrators","Clear articulation of heterogeneity and need for longitudinal work"],"limitations":["Relies on cross‑sectional, convenience samples","No quantitative meta‑analysis or risk‑of‑bias assessment","Potential publication and selection bias"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/15248380261451792"}},{"id":6655,"doi":"10.1002/jts.23079","pmid":"38946117","pmcid":null,"title":"Adverse childhood experiences, posttraumatic stress disorder symptoms, and compulsive behaviors among adults in substance use treatment: A latent class analysis","authors":"Basting EJ, Medenblik AM, Eberwein JD, Garner AR, Shorey RC, Stuart GL.","first_author":"Basting EJ","journal":"Journal of traumatic stress","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"latent class analysis of medical records from 721 adults in residential substance‑use treatment; cross‑sectional assessment of ACE patterns, PTSD symptoms and compulsive sexual behaviour.","sample_n":721,"sample_text":"Adults in residential substance‑use treatment (mixed gender, middle‑aged).","population":"Adults receiving residential SUD treatment (N=721)","country":"Not specified in abstract","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"Among adults in substance‑use treatment, those with higher or more varied childhood trauma show greater PTSD symptoms and more compulsive sexual behaviour. The study suggests screening for trauma patterns to guide treatment.","clinical_takeaway":"Assess childhood trauma in SUD patients, as high‑ACE histories may signal higher risk for PTSD and compulsive sexual issues.","confidence":0.75,"topic_tags":["adolescents"],"strengths":["Large clinical sample (N>700)","Use of latent class analysis to capture ACE patterns","Simultaneous examination of PTSD and compulsive sexual behaviour"],"limitations":["Cross‑sectional; cannot infer causality","Compulsive sexual behaviour measurement not described – likely unvalidated","No control for moral incongruence or masturbation, key confounds for sexual‑behavior outcomes","Treatment‑seeking sample limits generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/jts.23079"}},{"id":6656,"doi":"10.31234/osf.io/2gej8","pmid":null,"pmcid":null,"title":"Psychometric properties of the Spanish version of the Online Sexual Addiction Questionnaire: An exploratory study using a sample of convicted sex offenders","authors":"Soldino V, Miró-Ramos J, Carbonell-Vayá EJ.","first_author":"Soldino V","journal":"PsyArXiv","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://psyarxiv.com/2gej8/download","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"psychometric validation (exploratory factor analysis) in a forensic sample of convicted sex offenders","sample_n":66,"sample_text":"100 men convicted of a sexual offense; 34 excluded for social desirability response bias","population":"Adult men (convicted of sexual offenses), n≈66 after exclusion for social desirability","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["circular_addiction_scale","self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether a Spanish version of the Online Sexual Addiction Questionnaire reliably measures problematic online sexual activity in men convicted of sexual offenses. It found a four‑factor structure and high internal consistency, suggesting the tool could help screen for risky online sexual behavior in forensic settings.","clinical_takeaway":"The OSA‑Q may be a useful screening aid for online sexual addiction in forensic populations, but results should be interpreted cautiously due to sample limits.","confidence":0.75,"topic_tags":["pornography","sexual_function"],"strengths":["First validation of OSA‑Q in Spanish","Use of clinical instrument (MCMI‑III) for convergent validity","Exploratory factor analysis with clear variance explanation"],"limitations":["Forensic convenience sample limits generalisability","Large proportion excluded for social desirability bias","No assessment of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/2gej8"}},{"id":6657,"doi":"10.1016/j.jsxm.2021.07.003","pmid":"34391663","pmcid":null,"title":"Estimated Prevalence and Demographic Correlates of Compulsive Sexual Behavior Among Gay Men in the United States","authors":"Gleason N, Finotelli I, Miner MH, Herbenick D, Coleman E.","first_author":"Gleason N","journal":"The journal of sexual medicine","year":2021,"pub_types":["Journal Article"],"keywords":["MSM","Gay Men","Compulsive Sexual Behavior","Men Who Have Sex With Men","Sexual Compulsivity","Sex Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"National probability sample of 227 gay‑identified men from the 2015 NSSHB; logistic regression on demographic predictors of CSB status.","sample_n":227,"sample_text":"National probability sample","population":"Gay‑identified men in the United States (N = 227)","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative survey of 227 gay men, about 8 % scored above a clinical threshold for compulsive sexual behavior. Younger age, higher education, and especially religious affiliation were linked to higher odds of meeting this threshold.","clinical_takeaway":"Clinicians should consider religiosity and demographic factors when assessing compulsive sexual behavior in gay men; prevalence is similar to the general population.","confidence":0.85,"topic_tags":["prevalence","sexual_function"],"strengths":["Large, nationally representative probability sample","Use of a validated CSBI‑13 cut‑point","Logistic regression with demographic covariates"],"limitations":["Cross‑sectional design cannot infer causality","No measurement of masturbation or mental‑health variables","Potential over‑reliance on religiosity as proxy for moral incongruence"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.07.003"}},{"id":6658,"doi":"10.1080/19585969.2022.2134739","pmid":"37522807","pmcid":"PMC10408697","title":"The World Federation of Societies of Biological Psychiatry guidelines on the assessment and pharmacological treatment of compulsive sexual behaviour disorder","authors":"Turner D, Briken P, Grubbs J, Malandain L, Mestre-Bach G, Potenza MN, Thibaut F.","first_author":"Turner D","journal":"Dialogues in clinical neuroscience","year":2022,"pub_types":["review-article","Journal Article"],"keywords":["Sexual Addiction","Hypersexuality","Addictive Behaviours","Paraphilias","Chemsex","Compulsive Behaviours","Compulsive Sexual Behaviour Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10408697","cited_by_count":44,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"guideline based on literature review of pharmacological treatments for compulsive sexual behaviour disorder (CSBD). No primary data collected.","sample_n":null,"sample_text":"Not applicable – guideline synthesises existing literature.","population":"patients with CSBD (clinical samples referenced in cited studies)","country":"International (guideline authors from multiple societies)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The guideline reviews evidence for medications used to treat compulsive sexual behaviour disorder, recommending SSRIs and naltrexone as first‑line pharmacological options, with psychotherapy as the primary treatment.","clinical_takeaway":"SSRI or naltrexone may help CSBD, but evidence is limited; psychotherapy remains essential.","confidence":0.8,"topic_tags":["csbd","sexual_function","treatment"],"strengths":["Comprehensive literature search across databases","Clear clinical algorithm for treatment decision‑making","Considers comorbid psychiatric and paraphilic conditions"],"limitations":["Few randomized trials underpin recommendations","No original data; relies on heterogeneous primary studies","Limited discussion of moral incongruence or other psychosocial confounds"],"rubric_version":"2.0","raw_total":19,"max_possible":60,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":6,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":61,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19585969.2022.2134739"}},{"id":6659,"doi":"10.3389/fnagi.2026.1768251","pmid":"41878312","pmcid":"PMC13006677","title":"Neuropsychological aspects of impulse control disorders in Parkinson's disease","authors":"Scanferla L, Djamshidian A.","first_author":"Scanferla L","journal":"Frontiers in aging neuroscience","year":2026,"pub_types":["review-article","Review","Journal Article"],"keywords":["Behavior","neuropsychology","Parkinson’s Disease","Compulsive Sexual Behavior","Binge Eating","Dopamine Dysregulation Syndrome","Gambling Disorder","Compulsive Shopping"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13006677","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods; no primary data; conclusions based on cited studies","sample_n":null,"sample_text":"No primary sample; review of existing literature","population":"patients with Parkinson's disease who develop impulse control disorders, including compulsive sexual behavior","country":"unspecified (author affiliations likely Italy/UK)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how impulse‑control problems, including compulsive sexual behavior, can arise in people with Parkinson's disease, linking them to dopamine‑related brain changes and personality factors.","clinical_takeaway":"Clinicians should monitor PD patients on dopamine agonists for emerging compulsive sexual behavior and address co‑occurring mood or anxiety issues.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","pornography","masturbation"],"strengths":["Comprehensive overview of ICDs in Parkinson's disease","Integrates neurobiological and clinical perspectives","Highlights management strategies"],"limitations":["Narrative (non‑systematic) synthesis may be selective","No quantitative meta‑analysis or risk‑of‑bias assessment","Lacks original empirical data"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fnagi.2026.1768251"}},{"id":6660,"doi":"10.1093/jsxmed/qdaf258","pmid":"41020358","pmcid":null,"title":"Adjunctive repetitive transcranial magnetic stimulation for compulsive sexual behavior in a young adult with bipolar I disorder: a case report","authors":"Abulizi A, Aihemaiti Z, Dilixiati R, Dilixiati D, Xu L.","first_author":"Abulizi A","journal":"The journal of sexual medicine","year":2025,"pub_types":["Journal Article"],"keywords":["Repetitive transcranial magnetic stimulation","Dlpfc","Compulsive Sexual Behavior Disorder","Csbd"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf258"}},{"id":6661,"doi":"10.1093/jsxmed/qdaf383","pmid":"41504415","pmcid":null,"title":"Letter to the Editor on \"Adjunctive repetitive transcranial magnetic stimulation for compulsive sexual behavior in a young adult with bipolar I disorder: a case report\"","authors":"Abbasian H.","first_author":"Abbasian H.","journal":"The journal of sexual medicine","year":2026,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf383"}},{"id":6662,"doi":"10.1007/s10508-022-02412-6","pmid":"36066680","pmcid":null,"title":"Co-Occurring Obsessive-Compulsive Disorder and Compulsive Sexual Behavior: Clinical Features and Psychiatric Comorbidities","authors":"Snaychuk LA, Ferrão YA, Fontenelle LF, Miguel EC, de Mathis MA, Scanavino MDT, Kim HS.","first_author":"Snaychuk LA","journal":"Archives of sexual behavior","year":2022,"pub_types":["Journal Article"],"keywords":["Comorbidity","Compulsive Sexual Behavior","Impulse Control Disorder","Obsessive–compulsive Disorder","Dsm-iv-tr"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 950 patients receiving treatment for OCD; convenience clinical sample, not population‑representative.","sample_n":950,"sample_text":"Patients of a large multisite treatment for OCD (N=950).","population":"Patients receiving OCD treatment at multiple sites (N=950).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a group of 950 people being treated for OCD, 3.8% also met criteria for compulsive sexual behavior. Men were more likely than women to have both conditions, and having compulsive sexual behavior was linked to higher rates of other psychiatric disorders, especially impulse‑control problems.","clinical_takeaway":"Patients with OCD who also show compulsive sexual behavior may need more specialised, integrated treatment approaches.","confidence":0.8,"topic_tags":["csbd","other"],"strengths":["Large N for clinical sample","Use of semi‑structured SCID interview","Comprehensive assessment of psychiatric comorbidity"],"limitations":["Convenience treatment sample limits generalisability","CSB measure not specified; likely not fully validated","No assessment of moral incongruence or masturbation separation"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-022-02412-6"}},{"id":6663,"doi":"10.1016/j.sxmr.2016.11.001","pmid":"28041854","pmcid":null,"title":"Conceptualization and Assessment of Hypersexual Disorder: A Systematic Review of the Literature","authors":"Montgomery-Graham S.","first_author":"Montgomery-Graham S.","journal":"Sexual medicine reviews","year":2017,"pub_types":["Systematic Review","Journal Article"],"keywords":["Sexual behavior","Compulsive Behavior","Psychometrics","Hypersexual Behavior","Personality Assessment","Hypersexual Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":59,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 47 articles on hypersexual disorder conceptualization and psychometric assessment; narrative synthesis, no meta‑analysis reported.","sample_n":null,"sample_text":"47 included articles (no primary sample).","population":"Studies of adults assessed for hypersexual disorder; no new data collected.","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review examined how hypersexual disorder is defined and measured, summarizing the psychometric quality of six commonly used questionnaires. It finds the Hypersexual Disorder Screening Inventory currently has the best evidence of reliability and validity.","clinical_takeaway":"Clinicians should preferentially use the Hypersexual Disorder Screening Inventory when assessing hypersexual symptoms, while recognizing limits of existing tools.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive coverage of existing HD scales","Use of established psychometric evaluation criteria (Hunsley & Mash)","Identifies strongest‑supported instrument"],"limitations":["No quantitative synthesis (meta‑analysis)","Potential selection bias in included studies not described","No assessment of how confounds (e.g., moral incongruence) affect scale scores"],"rubric_version":"2.0","raw_total":38,"max_possible":60,"pct_score":63,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":6,"interpretation":8}},"scite":{"supporting":4,"contrasting":1,"mentioning":93,"citing_publications":132,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sxmr.2016.11.001"}},{"id":6664,"doi":"10.1093/jsxmed/qdag281","pmid":"42734939","pmcid":null,"title":"LonelyFans? Longitudinal trajectories of adult content subscription platform engagement over two years","authors":"Floyd CG, Carrasquillo KD, Campbell L, Connolly AJ, Kraus SW, Grubbs JB.","first_author":"Floyd CG","journal":"The journal of sexual medicine","year":2026,"pub_types":["Journal Article"],"keywords":["Loneliness","Computer-mediated Communication","Compulsive Sexual Behavior Disorder","Adult Content Creator Platforms"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Weighted, census‑matched US adult sample (N = 4363) surveyed across five waves over ~2 years; parallel‑process latent growth curve modelling of ACCP engagement, loneliness and CSBD symptoms.","sample_n":4363,"sample_text":"Weighted, census‑matched adult sample, N = 4363, across five waves.","population":"US adults, community sample","country":"United States","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationwide sample of over 4 000 US adults tracked for two years, people who spent more money on subscription‑based adult content also reported higher levels of loneliness and symptoms of compulsive sexual behaviour. All three measures tended to decline together over time, suggesting they change in parallel.","clinical_takeaway":"Clinicians should consider asking about paid adult‑content subscription use when clients report loneliness or CSBD‑like symptoms, as the behaviours appear linked over time.","confidence":0.85,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence"],"strengths":["Large, nationally‑representative longitudinal cohort","Weighted to match US census demographics","Use of latent growth modelling to assess co‑development"],"limitations":["Single‑item measure of ACCP engagement","Brief, possibly non‑validated loneliness scale","No assessment of key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdag281"}},{"id":6666,"doi":"10.1016/b978-0-443-13554-5.00005-5","pmid":"41633728","pmcid":null,"title":"Sexuality and sexual health in primary tic disorders","authors":"Santer A, Amelung T, Mainka T, Ganos C.","first_author":"Santer A","journal":"Handbook of clinical neurology","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Sexuality","Tourette syndrome","Sexual Health","Compulsive Sexual Behavior","Chronic Tic Disorders"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review chapter summarising existing literature; no new empirical data collected.","sample_n":null,"sample_text":"Not applicable – narrative review.","population":"Adults with primary tic disorders (Tourette syndrome, chronic tic disorders).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This chapter reviews what is known about sexuality, sexual health, and compulsive sexual behavior in adults with tic disorders, noting limited and inconsistent evidence and suggesting areas for future research.","clinical_takeaway":"Clinicians should be aware that sexual health issues can occur in tic disorders, but evidence is sparse; assess each patient individually.","confidence":0.4,"topic_tags":["sexual_function","treatment","csbd"],"strengths":["Broad coverage of sexuality topics in tic disorders","Identifies knowledge gaps and methodological limitations"],"limitations":["No new empirical data; relies on prior studies of variable quality","Lacks systematic review methodology (no risk‑of‑bias assessment)","Does not report detailed operational definitions or validated measures"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/b978-0-443-13554-5.00005-5"}},{"id":6667,"doi":"10.1016/j.jsxm.2022.05.146","pmid":"35831231","pmcid":null,"title":"Functional Connectivity in Compulsive Sexual Behavior Disorder - Systematic Review of Literature and Study on Heterosexual Males","authors":"Draps M, Adamus S, Wierzba M, Gola M.","first_author":"Draps M","journal":"The journal of sexual medicine","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":["Functional Connectivity","Hypersexuality","Compulsive Sexual Behavior Disorder","Restingstate Fmri"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review plus cross‑sectional case‑control resting‑state fMRI study (N=81, 52 CSBD, 29 controls)","sample_n":81,"sample_text":"52 CSBD patients, 29 healthy controls; all heterosexual males","population":"heterosexual adult males","country":"Poland (inferred from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors reviewed prior brain‑imaging work on compulsive sexual behavior and scanned 81 heterosexual men (52 with CSBD, 29 controls). They found several brain‑region connections that differed between groups, but the strength of these links did not relate to questionnaire scores of symptom severity, depression, or anxiety.","clinical_takeaway":"Current fMRI evidence shows brain‑network differences in CSBD men, but it does not yet clarify how these relate to symptom severity or treatment needs.","confidence":0.7,"topic_tags":["csbd","neuroscience","religiosity","moral_incongruence"],"strengths":["Largest reported fMRI CSBD sample to date","Combines systematic review with original data","Uses validated psychiatric questionnaires for depression and anxiety"],"limitations":["Only heterosexual men; limited generalisability","No measurement of moral incongruence or masturbation","Modest fMRI sample, possible lack of multiple‑comparison correction","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":38,"max_possible":70,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":5,"statistics":5,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2022.05.146"}},{"id":6668,"doi":"10.21203/rs.3.rs-20977/v3","pmid":null,"pmcid":null,"title":"The psychometric properties of the Bergen–Yale Sex Addiction Scale for the Iranian population","authors":"Youseflu S, Kraus SW, Razavinia F, Afrashteh MY, Niroomand S.","first_author":"Youseflu S","journal":"Research Square","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-20977/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a self‑report scale in a large Iranian adult sample (N=756); exploratory and confirmatory factor analyses, internal consistency, test‑retest reliability","sample_n":756,"sample_text":"community adults","population":"Iranian men and women, community sample","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The Persian version of the Bergen–Yale Sex Addiction Scale was translated and tested in 756 Iranian adults. Factor analysis supported a single‑factor structure and the scale showed high reliability, suggesting it can be used to assess self‑reported sex‑addiction symptoms in this population.","clinical_takeaway":"The scale appears reliable for measuring self‑reported sex‑addiction symptoms in Persian‑speaking adults, but clinicians should be aware of its conceptual limits.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for psychometric validation","Both exploratory and confirmatory factor analyses performed","Good internal consistency (α≈0.89)","Test‑retest reliability assessed"],"limitations":["Potential circularity of the addiction construct in the scale","No assessment of confounding factors such as moral incongruence or mental health","Cross‑sectional design cannot address causal claims"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-20977/v3"}},{"id":6670,"doi":"10.1093/jsxmed/qdaf384","pmid":"41504412","pmcid":null,"title":"Response to Letter to the Editor on \"Adjunctive repetitive transcranial magnetic stimulation for compulsive sexual behavior in a young adult with bipolar I disorder: a case report\"","authors":"Aihemaiti Z, Abulizi A, Halifu T, Chen F, Zhang H, Dilixiati R, Dilixiati D.","first_author":"Aihemaiti Z","journal":"The journal of sexual medicine","year":2026,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf384"}},{"id":6672,"doi":"10.1186/s12888-021-03135-z","pmid":"33663448","pmcid":"PMC7934249","title":"The psychometric properties of the Bergen-Yale sex addiction scale for the Iranian population","authors":"Youseflu S, Kraus SW, Razavinia F, Afrashteh MY, Niroomand S.","first_author":"Youseflu S","journal":"BMC psychiatry","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Validity And Reliability","Sex Addiction","Bergen–yale Sex Addiction Scale"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7934249","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study","sample_n":756,"sample_text":"756 Iranian men and women completed the BYSAS","population":"Iranian adults (men and women)","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated the Bergen‑Yale Sex Addiction Scale into Persian and tested it with 756 Iranian adults, finding it reliable and fitting a one‑factor structure, suggesting it can be used to measure self‑reported sex‑addiction symptoms in this population.","clinical_takeaway":"The Persian BYSAS appears psychometrically sound, but clinicians should note it may conflate frequency with distress and should consider broader context when interpreting scores.","confidence":0.7,"topic_tags":["sexual_function","measurement"],"strengths":["Large sample (N=756) for psychometric validation","Use of both exploratory and confirmatory factor analysis","Assessment of content, construct, and reliability indices"],"limitations":["Potential circularity of the BYSAS definition of 'sex addiction'","No assessment of moral incongruence or related confounds","Convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[{"status":"Has correction","date":"2021-4-29","noticeDoi":"10.1186/s12888-021-03172-8","doi":"10.1186/s12888-021-03135-z"},{"status":"Has erratum","date":"2021-4-29","noticeDoi":"10.1186/s12888-021-03172-8","doi":"10.1186/s12888-021-03135-z"}],"url":"https://scite.ai/reports/10.1186/s12888-021-03135-z"}},{"id":6673,"doi":"10.1007/s10508-014-0356-5","pmid":"25348356","pmcid":null,"title":"Sexual Compulsivity Scale, Compulsive Sexual Behavior Inventory, and Hypersexual Disorder Screening Inventory: Translation, Adaptation, and Validation for Use in Brazil","authors":"Scanavino Mde T, Ventuneac A, Rendina HJ, Abdo CH, Tavares H, Amaral ML, Messina B, Reis SC, Martins JP, Gordon MC, Vieira JC, Parsons JT.","first_author":"Scanavino Mde T","journal":"Archives of sexual behavior","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["HIV","Psychometric Properties","Compulsive Sexual Behavior","Sexual Compulsivity","Hypersexual Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of three self‑report scales (SCS, CSBI‑22, HDSI) in a Brazilian sample (N=153 patients and controls) using factor analysis, reliability, test‑retest and criterion correlations","sample_n":153,"sample_text":"153 participants (patients and controls) completed the scales and a psychiatric interview","population":"adults in Brazil, psychiatric patients and community controls","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors translated three questionnaires that measure compulsive sexual behaviour into Portuguese and tested them with 153 Brazilian adults. All three showed strong reliability and correlated well with existing scales, supporting their use in Brazil.","clinical_takeaway":"These validated Portuguese tools can reliably assess sexual compulsivity and hypersexual symptoms in clinical and research settings in Brazil.","confidence":0.7,"topic_tags":["measurement","sexual_function","csbd"],"strengths":["Uses established psychometric methods (factor analysis, Cronbach’s α, test‑retest)","Provides Portuguese versions with good reliability and validity","Includes both patients and community controls for discriminant validity"],"limitations":["Convenience sample, not nationally representative","No assessment of moral‑incongruence or other common confounds","Cross‑sectional; cannot address temporal stability beyond short retest"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":28,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0356-5"}},{"id":6674,"doi":"10.1002/mdc3.70198","pmid":"40566700","pmcid":"PMC12715357","title":"A Pragmatic Approach to Sexual Health in Movement Disorders","authors":"Chen JC, Munhoz RP, Lang AE, Briken P, Ganos C.","first_author":"Chen JC","journal":"Movement disorders clinical practice","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual dysfunction","Movement Disorder","Sexual Pain","Hypersexual","Paraphilic"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods","sample_n":null,"sample_text":"none (review article)","population":"patients with movement disorders (unspecified)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews how movement disorders can affect sexual health and offers clinicians practical guidance for assessing and treating problems such as dysfunction, pain, compulsivity and paraphilic behaviours.","clinical_takeaway":"Neurologists should routinely evaluate sexual health in movement‑disorder patients and use a biopsychosocial framework for management.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of sexual health issues in movement disorders","Practical clinical recommendations"],"limitations":["Narrative, non‑systematic review","No empirical data or critical appraisal of cited studies"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mdc3.70198"}},{"id":6677,"doi":"10.1186/s12888-022-03688-7","pmid":"34996402","pmcid":"PMC8742335","title":"The prevalence of sexual compulsivity and its correlates among adults living with HIV/AIDS attending antiretroviral therapy clinic in Gambella town, Southwest Ethiopia, 2020","authors":"Shumye S, Kassaw C, Melaku G.","first_author":"Shumye S","journal":"BMC psychiatry","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["HIV/AIDS","Sexual Compulsivity","Gambella, Ethiopia"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8742335","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Hospital‑based cross‑sectional survey of 300 adults living with HIV attending an ART clinic; simple random sampling within the clinic.","sample_n":300,"sample_text":"300 respondents selected by simple random sampling from the ART clinic.","population":"Adults living with HIV/AIDS attending an antiretroviral therapy clinic in Gambella town, Southwest Ethiopia (N=300).","country":"Ethiopia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2020 survey of 300 Ethiopian adults receiving HIV treatment, about one‑quarter scored high on a Sexual Compulsivity Scale. Younger age, being widowed, risky sex, substance use, and lack of safer‑sex training were linked to higher compulsivity.","clinical_takeaway":"Screen for sexual compulsivity in HIV care, especially among younger, widowed, or substance‑using patients.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Use of a previously validated Sexual Compulsivity Scale","Reasonable sample size for prevalence estimate","Multivariable logistic regression with confidence intervals"],"limitations":["Cross‑sectional design cannot infer causality","No assessment of moral incongruence, masturbation, or mental‑health comorbidity","Clinic‑based sample limits generalisability to all people living with HIV"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12888-022-03688-7"}},{"id":6678,"doi":"10.1016/j.cpr.2023.102340","pmid":"37776578","pmcid":null,"title":"Early maladaptive schemas and behavioural addictions: A systematic literature review","authors":"Vieira C, Kuss DJ, Griffiths MD.","first_author":"Vieira C","journal":"Clinical psychology review","year":2023,"pub_types":["Systematic Review","Review","Journal Article"],"keywords":["Addiction","Gambling","Social Media","Early Maladaptive Schemas","Gaming","Behavioural Addictions"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic literature review of 20 studies on early maladaptive schemas and various behavioural addictions, including sexual addiction/CSB.","sample_n":null,"sample_text":"20 primary studies (numbers per addiction type vary); no aggregate N reported","population":"clinical and non‑clinical samples across 20 primary studies","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The review summarises evidence that early maladaptive schemas—especially feelings of being rejected or lacking limits—are linked to a range of behavioural addictions, including compulsive sexual behaviour, gambling, gaming and social media use.","clinical_takeaway":"Identify schema patterns in clients, as they may underlie problematic sexual or other behavioural addictions.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad coverage of many behavioural addictions","Systematic search across three databases","Identifies consistent schema domains (Disconnection & Rejection, Impaired Limits)"],"limitations":["No quantitative synthesis or meta‑analysis","Limited information on quality/bias of included studies","Potential lack of control for key confounds (e.g., moral incongruence) in primary studies"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":33,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.cpr.2023.102340"}},{"id":6680,"doi":"10.1080/10826084.2026.2637161","pmid":"41761729","pmcid":null,"title":"For Whom Does Chemsex Increase Sexual Risk? Considering Pre-Exposure Prophylaxis (PrEP), Antiretroviral Therapy (ART), and the Dual Control Model","authors":"Gleason N, Jennings TL, Pedersen ER, George WH.","first_author":"Gleason N","journal":"Substance use & misuse","year":2026,"pub_types":["Journal Article"],"keywords":["HIV","methamphetamine","Men Who Have Sex With Men","Sexual Risk Behavior","Chemsex"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"464 MSM recruited via dating/app advertisements; event‑level survey on chemsex, sexual risk, PrEP/ART status, and Dual Control Model factors; hierarchical linear regressions.","sample_n":464,"sample_text":"464 participants (89 HIV+, 93 recent chemsex).","population":"Men who have sex with men (MSM) in the United States, mixed HIV status, some reporting recent chemsex.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 464 US men who have sex with men, chemsex was linked to higher odds of condomless sex, but only for those not using HIV prevention (PrEP) or treatment (ART). Personality traits like sensation seeking were modestly related, while sexual excitation/inhibition scores showed little impact.","clinical_takeaway":"Chemsex increases HIV risk mainly among MSM not on PrEP/ART; clinicians should prioritize HIV prevention counseling for this subgroup.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample (n>400)","Event‑level analysis of chemsex and condomless sex","Inclusion of PrEP/ART status as moderators"],"limitations":["Cross‑sectional design limits causal inference","Key potential confounds (moral incongruence, mental health, partner factors) not measured","Reliance on self‑report; unclear validation of scales"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10826084.2026.2637161"}},{"id":6681,"doi":"10.1016/j.sxmr.2019.10.003","pmid":"31813820","pmcid":null,"title":"Compulsive Sexual Behavior and Dysregulation of Emotion","authors":"Lew-Starowicz M, Lewczuk K, Nowakowska I, Kraus S, Gola M.","first_author":"Lew-Starowicz M","journal":"Sexual medicine reviews","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Compulsive Sexual Behavior","Emotional Regulation","Hypersexuality","Emotional Self-control","Dysregulation Of Emotion"],"is_oa":false,"oa_url":null,"cited_by_count":91,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of literature without systematic methodology or risk‑of‑bias assessment","sample_n":null,"sample_text":"Not applicable – review article","population":"adults with compulsive sexual behavior (CSB) as reported in the cited literature","country":"Poland (authors’ affiliations likely)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors review evidence that people with compulsive sexual behavior often struggle to manage their emotions, which may fuel their sexual urges. They suggest that targeting emotional regulation could improve treatment, but note that high‑quality trials are lacking.","clinical_takeaway":"Addressing emotional regulation may help treat compulsive sexual behavior, but stronger clinical evidence is needed.","confidence":0.8,"topic_tags":["csbd","sexual_function","moral_incongruence"],"strengths":["Broad synthesis of emotion‑dysregulation literature relevant to CSB","Identifies gaps and need for well‑powered RCTs"],"limitations":["Narrative rather than systematic review; selection bias possible","No explicit methodological quality assessment of included studies","Lacks quantitative analysis or meta‑analytic rigor"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":6,"contrasting":0,"mentioning":101,"citing_publications":164,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sxmr.2019.10.003"}},{"id":6682,"doi":"10.3389/fpsyg.2026.1703292","pmid":"41822430","pmcid":"PMC12975927","title":"Food addiction in behavioral addictions: a network approach","authors":"Gaspar-Pérez A, Granero R, Fernández-Aranda F, Rosinska M, Sabariegos-Campos N, Artero C, Ruiz-Torras S, Gearhardt AN, Demetrovics Z, Czakó A, Guàrdia-Olmos J, Jiménez-Murcia S.","first_author":"Gaspar-Pérez A","journal":"Frontiers in psychology","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Food Addiction","Clinical Profile","Network Analysis","Behavioral Addictions","Addictive Behaviors"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12975927","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"clinical sample, network analysis of self‑report and interview data","sample_n":209,"sample_text":"clinical convenience sample","population":"209 treatment‑seeking adults with gaming disorder, compulsive buying, compulsive sexual behavior, and/or other behavioral addictions; 64.6% men","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 209 patients seeking help for various behavioural addictions, including compulsive sexual behaviour, researchers mapped how food‑addiction symptoms relate to other clinical factors. They found that self‑directedness, overall distress, age, and harm avoidance were most central in patients who also met criteria for food addiction.","clinical_takeaway":"Comorbid food addiction may add complexity to the clinical picture of behavioural addictions, suggesting a need for broader assessment and integrated treatment approaches.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonably large clinical sample (n=209)","Use of semi‑structured interview for behavioral addictions","Network analysis provides insight into symptom interrelationships"],"limitations":["Cross‑sectional design; cannot infer causality","Convenience, treatment‑seeking sample limits generalisability","No measurement/control of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2026.1703292"}},{"id":6684,"doi":"10.1556/2006.7.2018.101","pmid":"30378460","pmcid":"PMC6376399","title":"The contribution of personality factors and gender to ratings of sex addiction among men and women who use the Internet for sex purpose","authors":"Shimoni L, Dayan M, Cohen K, Weinstein A.","first_author":"Shimoni L","journal":"Journal of behavioral addictions","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Personality","Sex differences","Compulsive Sexual Behavior","Sex Addiction","Big Five Index"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6376399","cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 267 Internet‑based sexual partner seekers (186 M, 81 F).","sample_n":267,"sample_text":"Convenience sample; not representative of general population.","population":"Adults (mean age 31) recruited from online sex‑partner platforms in Israel.","country":"Israel","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 267 people using online sites to find sex partners, men scored higher on a sex‑addiction questionnaire than women. Openness, neuroticism and low conscientiousness were linked to higher scores, especially neuroticism in men.","clinical_takeaway":"Personality traits, particularly neuroticism in men, relate to higher self‑reported sex‑addiction scores, but findings stem from a self‑selected online sample.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonably sized sample for a survey","Validated personality inventory used","Statistical reporting of effect sizes"],"limitations":["Convenience, self‑selected online sample limits generalisability","No measurement of moral incongruence or other key confounds","SAST may conflate distress with addiction (circular definition)"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":6,"contrasting":0,"mentioning":26,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.101"}},{"id":6685,"doi":"10.1007/978-981-95-2411-2_13","pmid":"41171571","pmcid":null,"title":"Nutrition Support Therapy","authors":"Xiao LJ, Hou T, Tao R, Guo W.","first_author":"Xiao LJ","journal":"Advances in experimental medicine and biology","year":2025,"pub_types":["Review","Journal Article"],"keywords":["Nutrition assessment","Nutrition Education","Nutritional Deficiency","Omega 3 Fatty Acids","Dietary Behaviors","Nutrition Intervention","Disorders Of Eating","Metabolic Systems"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review synthesizing literature on nutrition interventions for various addictive disorders, including sexual addiction. No original data, no systematic search reported.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Humans with various addictive disorders (alcohol, drug, food, internet, sexual).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"This review discusses how nutrient deficiencies may be common in various addictions, including sexual addiction, and suggests that nutrition therapy could help address these problems.","clinical_takeaway":"No direct clinical guidance; suggests considering nutritional assessment in addiction treatment.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad coverage of many addiction types","Highlights nutritional deficiencies as relevant"],"limitations":["No systematic methodology reported","No empirical data or quantitative synthesis","Lacks critical appraisal of included studies"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/978-981-95-2411-2_13"}},{"id":6686,"doi":"10.1002/jts.22872","pmid":"36059231","pmcid":null,"title":"Sexual compulsivity, erectile dysfunction, and suicidality among male survivors of military sexual violence","authors":"Blais RK, Xu B, Hoyt T, Lorenz T, Monteith LL.","first_author":"Blais RK","journal":"Journal of traumatic stress","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online self‑report survey of 508 male service members/veterans recruited via social media (convenience sample)","sample_n":508,"sample_text":"508 male participants; 67 (13.2%) reported history of military sexual trauma","population":"Male U.S. military personnel and veterans (service members and veterans) who reported gender as male","country":"Not specified (likely United States)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 508 male service members and veterans, those who experienced military sexual trauma reported higher sexual compulsivity, which was linked to more frequent suicidal thoughts and a greater chance of future suicidal behavior. Erectile dysfunction was also higher but did not predict suicidality.","clinical_takeaway":"Assess sexual compulsivity in men with military sexual trauma as it may signal elevated suicide risk.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Reasonable sample size for overall analysis","Use of path analysis to test mediation","Inclusion of several covariates (mental health, demographics, military factors)"],"limitations":["Cross‑sectional design prevents causal inference","Convenience, social‑media recruitment limits generalisability","Unclear whether sexual compulsivity measure was validated","Key sexual‑health confounds (e.g., masturbation, moral incongruence) not assessed"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/jts.22872"}},{"id":6687,"doi":"10.1016/j.addbeh.2021.106874","pmid":"33647708","pmcid":null,"title":"Adolescents who solely engage in online sexual experiences are at higher risk for compulsive sexual behavior","authors":"Efrati Y, Amichai-Hamburger Y.","first_author":"Efrati Y","journal":"Addictive behaviors","year":2021,"pub_types":["Journal Article"],"keywords":["Adolescents","Compulsive Sexual Behaviour","Offline Sexual Behavior","Online Sexualbehavior","Risky Sexual Action Tendencies"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of adolescents classifying sexual activity patterns and measuring compulsive sexual behavior.","sample_n":877,"sample_text":"Study 1 n=164, Study 2 n=713, total combined participants 877","population":"Adolescents (age not specified), n=164 in Study 1, n=713 in Study 2","country":"Not reported","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that teens who only have sexual experiences online report higher levels of compulsive sexual behavior than peers who also have offline sexual experiences. This pattern was more common among girls and those who were religious.","clinical_takeaway":"Online‑only sexual activity may be a marker for elevated compulsive sexual tendencies in adolescents; clinicians should assess CSB irrespective of offline activity.","confidence":0.8,"topic_tags":["adolescents","sexual_function","csbd"],"strengths":["Large combined sample size","Direct comparison of online‑only vs mixed sexual activity groups","Inclusion of religiosity as a relevant covariate"],"limitations":["Cross‑sectional design limits causal inference","Unclear whether CSB was measured with a validated scale","Key confounds (masturbation, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2021.106874"}},{"id":6689,"doi":"10.1016/j.addbeh.2021.107054","pmid":"34320446","pmcid":null,"title":"The moral maze of sex & porn addiction","authors":"Hall P.","first_author":"Hall P.","journal":"Addictive behaviors","year":2021,"pub_types":["Journal Article"],"keywords":["Biopsychosocial","Sex Addiction","Moral Incongruence","Porn Addiction","Csbd"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary/position paper without empirical data; no sample, no methods.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"opposes","citation_value":"background","plain_summary":"The paper reviews the controversy over labeling sex and porn use as an addiction, highlighting how moral judgments and the medical model influence the debate, and proposes a biopsychosocial framework to improve understanding and empathy.","clinical_takeaway":"Clinicians should consider moral and psychosocial factors when evaluating clients who label their sexual behavior as ‘addictive.’","confidence":0.8,"topic_tags":["sexual_function","csbd","moral_incongruence"],"strengths":["Comprehensive overview of debate","Integrates biopsychosocial perspective","Identifies moral dimensions"],"limitations":["No empirical data presented","Lacks systematic methodology","Potential advocacy bias"],"rubric_version":"2.0","raw_total":3,"max_possible":50,"pct_score":6,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2021.107054"}},{"id":6693,"doi":"10.1177/10790632221098358","pmid":"35482997","pmcid":null,"title":"Atypical Sexual Interests in Compulsive Sexual Behavior: Results From a Phallometric Study","authors":"Castro-Calvo J, Giménez-García C, García-Barba M, Gil-Llario MD, Ballester-Arnal R.","first_author":"Castro-Calvo J","journal":"Sexual abuse : a journal of research and treatment","year":2023,"pub_types":["Journal Article"],"keywords":["Compulsive Sexual Behavior","Penile Plethysmography","Atypical Sexual Interests","Objective Sexual Response"],"is_oa":false,"oa_url":"https://repositori.uji.es/xmlui/bitstream/10234/200448/1/80847.pdf","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 61 self‑identified straight men using a self‑report CSB index and penile plethysmography","sample_n":61,"sample_text":"61 self‑identified straight men","population":"self‑identified straight men (N=61)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 61 straight men, self‑reported compulsive sexual behavior showed only tiny, non‑significant links to physiological responses to a range of sexual pictures, including a modest (non‑significant) response to child‑related stimuli. The authors suggest a possible small association that needs more research.","clinical_takeaway":"No clear evidence that compulsive sexual behavior predicts attraction to children; clinicians should not assume a direct link based on this study.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Objective measurement of sexual interest via penile plethysmography","Reporting of confidence intervals for correlations","Consideration of alternative explanations in discussion"],"limitations":["Small, non‑representative convenience sample","CSB measured with a likely non‑validated composite index","Key confounds (moral incongruence, mental health, etc.) not assessed","Correlational design limits causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632221098358"}},{"id":6694,"doi":"10.1007/s40265-022-01696-1","pmid":"35414050","pmcid":"PMC9064854","title":"Pharmacological Treatment for Pedophilic Disorder and Compulsive Sexual Behavior Disorder: A Review","authors":"Landgren V, Savard J, Dhejne C, Jokinen J, Arver S, Seto MC, Rahm C.","first_author":"Landgren V","journal":"Drugs","year":2022,"pub_types":["review-article","Review","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9064854","cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"review of 12 RCTs (1974‑2021), total N=213, mixed forensic and outpatient samples; no meta‑analysis, limited methodological description","sample_n":213,"sample_text":"213 participants across 12 trials","population":"adults with pedophilic disorder, compulsive sexual behavior disorder or other paraphilias; mixed forensic and clinical settings","country":"multiple (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample","selective_reporting"],"stance":"neutral","citation_value":"useful","plain_summary":"The review summarizes 12 small trials of drugs that lower testosterone for people with pedophilic disorder or compulsive sexual behavior. Results suggest some reduction in sexual activity, but the evidence is weak and based on few participants.","clinical_takeaway":"Pharmacological options exist but lack robust evidence; clinicians should use caution and consider individual risk‑benefit profiles.","confidence":0.7,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Comprehensive search of RCTs across decades","Inclusion of non‑forensic samples","Identification of gap in evidence base"],"limitations":["Very small total sample (213)","Sparse recent data (only one study <10 y)","Lack of standardized outcome measures","No quantitative synthesis"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40265-022-01696-1"}},{"id":6695,"doi":"10.3390/ijerph19010296","pmid":"35010552","pmcid":"PMC8751077","title":"Common Features in Compulsive Sexual Behavior, Substance Use Disorders, Personality, Temperament, and Attachment-A Narrative Review","authors":"Efrati Y, Kraus SW, Kaplan G.","first_author":"Efrati Y","journal":"International journal of environmental research and public health","year":2021,"pub_types":["review-article","Review","Journal Article"],"keywords":["Temperament","Compulsive Sexual Behavior","Substance Use Disorder","Big Five Personality","Attachment Orientations"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/1/296/pdf?version=1640845694","cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods","sample_n":null,"sample_text":"not applicable – review of existing literature","population":"people with CSBD and SUD (no primary data)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This narrative review compares people with compulsive sexual behavior disorder (CSBD) to those with substance use disorders, finding many shared personality traits like impulsivity and emotional instability, but CSBD shows more worries about relationships.","clinical_takeaway":"CSBD may involve similar personality risk factors as substance addictions, plus greater concern about close relationships.","confidence":0.7,"topic_tags":["csbd","sexual_function","moral_incongruence","treatment"],"strengths":["Broad synthesis of personality and CSBD literature","Highlights similarities and differences between CSBD and SUD"],"limitations":["Narrative, not systematic – prone to selection bias","No explicit methodological quality appraisal of included studies","No quantitative synthesis or effect size reporting"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":14,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph19010296"}},{"id":6696,"doi":null,"pmid":"23888589","pmcid":null,"title":"[Can we treat sexual addiction ?]","authors":"Inescu Cismaru A, Andrianne R, Triffaux F, Triffaux JM.","first_author":"Inescu Cismaru A","journal":"Revue medicale de Liege","year":2013,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review discussing definitions and therapeutic approaches; no original data collection.","sample_n":null,"sample_text":"None (review article)","population":"Adults (general discussion, no specific sample)","country":"Belgium (journal of Liège)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how ‘sexual addiction’ is defined and summarizes various treatment approaches, but it offers no original research or systematic evidence.","clinical_takeaway":"Clinicians should treat claims of sexual addiction cautiously, as the article provides only a narrative overview without empirical support.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad overview of therapeutic options","Links hypersexuality to addiction models"],"limitations":["No empirical data presented","Relies on undefined or circular definitions of sexual addiction","No systematic literature search described"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":6697,"doi":"10.1080/00224499.2021.1963649","pmid":"34410183","pmcid":"PMC8976551","title":"Sexual Shame and Emotion Dysregulation: Key Roles in the Association between Internalized Homonegativity and Sexual Compulsivity","authors":"Cienfuegos-Szalay J, Moody RL, Talan A, Grov C, Rendina HJ.","first_author":"Cienfuegos-Szalay J","journal":"Journal of sex research","year":2022,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 982 HIV‑negative sexual‑minority men; path analysis of self‑report scales","sample_n":982,"sample_text":"982 HIV‑negative SMM completed online surveys","population":"sexual minority men (SMM), HIV‑negative, mean age 42.4","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 982 gay and bisexual men, internalized anti‑gay feelings were linked to higher sexual shame and poor emotion regulation, which together predicted stronger sexual compulsivity. Reducing shame and improving emotional control may lower compulsive sexual behavior.","clinical_takeaway":"Address sexual shame and emotion‑regulation skills when working with gay/bisexual men reporting compulsive sexual behavior.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["Large sample size","Use of validated self‑report scales","Comprehensive path analysis"],"limitations":["Cross‑sectional design limits causal inference","No measurement of key confounds (moral incongruence, mental health, partner context)","Potential self‑selection bias from online recruitment"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":9,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2021.1963649"}},{"id":6698,"doi":"10.12688/f1000research.21418.1","pmid":null,"pmcid":null,"title":"Frequency and associated factors related to sexual addiction in medical students from 16 Latin American cities, 2016: a regional multicentric study","authors":"Mejia-Alvarez CR, Chacon-I J, Benites-Gamboa D, Pacheco-Barrios N, Castillo-Tarrillo GF, Centeno-Leguia D, Wendell-Cubilla J, Grandez-Urbina J.","first_author":"Mejia-Alvarez CR","journal":"F1000Res","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://f1000research.com/articles/9-108/v1/pdf","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Analytical cross‑sectional survey of 3,691 medical students from 16 Latin‑American cities","sample_n":3691,"sample_text":"3691 respondents","population":"Medical students (convenience sample)","country":"Latin America (16 cities)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 3,691 medical students from 16 Latin‑American cities, 6 % screened positive for a possible sexual‑addiction problem. Men, older students, those with a partner, and non‑religious students were more likely to report it. The study suggests screening programs for students.","clinical_takeaway":"Screening may identify a small minority of students with concerning sexual‑behavior patterns, but definitions and risk factors need clearer validation.","confidence":0.8,"topic_tags":["sexual_function","other"],"strengths":["Large sample size","Multicentric across many cities","Provides prevalence estimate for region"],"limitations":["Cross‑sectional; cannot infer causality","Sexual addiction defined with an unclear/possibly unvalidated screen","Key confounds (moral incongruence, masturbation, mental health) not measured","Potential circular definition of ‘addiction’"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12688/f1000research.21418.1"}},{"id":6700,"doi":"10.1002/cpp.2085","pmid":"28401660","pmcid":null,"title":"Depression, anxiety, and compulsive sexual behaviour among men in residential treatment for substance use disorders: The role of experiential avoidance","authors":"Brem MJ, Shorey RC, Anderson S, Stuart GL.","first_author":"Brem MJ","journal":"Clinical psychology & psychotherapy","year":2017,"pub_types":["Journal Article"],"keywords":["Depression","Anxiety","Substance Use","Experiential Avoidance","Compulsive Sexual Behaviour","Sex Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Review of medical records, N=150 men in residential substance‑use treatment; structural equation modelling of depression, anxiety, experiential avoidance and compulsive sexual behaviour.","sample_n":150,"sample_text":"150 men in residential treatment for substance use disorders","population":"Men receiving residential treatment for substance‑use disorders (n≈150)","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 150 men receiving residential treatment for substance abuse, higher depression and anxiety were linked to more compulsive sexual behaviour, and this relationship was partly explained by a tendency to avoid unpleasant thoughts and feelings.","clinical_takeaway":"Targeting experiential avoidance may help reduce compulsive sexual behaviour in men with substance‑use disorders.","confidence":0.7,"topic_tags":["csbd","sexual_function","moral_incongruence","adolescents"],"strengths":["Relatively large clinical sample (n=150)","Use of structural equation modelling to test mediation","Addresses understudied population (substance‑use treatment men)"],"limitations":["Cross‑sectional; cannot infer causality","CSB measurement not described; likely unvalidated","No assessment of moral incongruence or masturbation, key confounds"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":23,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/cpp.2085"}},{"id":6701,"doi":"10.1007/s13365-022-01085-0","pmid":"35821194","pmcid":"PMC9474700","title":"HIV-related drivers of sexual compulsivity and sexuality in sexual minority men who use methamphetamine","authors":"Kondur HR, Lee TK, McIntosh R, Gouse H, Paul R, Grov C, Fuchs D, Gómez W, Dilworth SE, Neilands TB, Carrico AW.","first_author":"Kondur HR","journal":"Journal of neurovirology","year":2022,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Phenylalanine","HIV","methamphetamine","Sexual Compulsivity","Sexual Sensation Seeking"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"cross‑lagged panel model with 4 assessment points over 15 months (N = 110)","sample_n":110,"sample_text":"110 SMM with biologically confirmed meth use","population":"sexual minority men living with HIV who use methamphetamine","country":"USA (likely, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 15‑month study of 110 HIV‑positive gay and bisexual men who use meth, higher viral loads predicted later increases in sexual compulsivity, while higher catecholamine‑related blood markers predicted lower sexual sensation seeking.","clinical_takeaway":"Elevated HIV viral load may signal higher risk for sexual compulsivity in meth‑using men; monitoring virologic control could inform sexual‑health counseling.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Longitudinal design with multiple time points","Biological measures of viral load and neurotransmitter precursors","Cross‑lagged panel analysis controls for prior levels"],"limitations":["Key psychosocial confounds (moral incongruence, mental health, partner context) not measured","Unclear whether sexual compulsivity scale is validated in this population","No pre‑registration or power justification reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13365-022-01085-0"}},{"id":6703,"doi":"10.47626/2237-6089-2021-0459","pmid":"36803998","pmcid":"PMC11815347","title":"Mindfulness-based intervention and sexuality: a systematic review","authors":"Ciaurriz Larraz AM, Villena Moya A, Chiclana Actis C.","first_author":"Ciaurriz Larraz AM","journal":"Trends in psychiatry and psychotherapy","year":2024,"pub_types":["Systematic Review","review-article","Journal Article"],"keywords":["Treatments","Evidence","Sexual Disorders","Sexual Dysfunctions","Aware"],"is_oa":true,"oa_url":"http://www.trends.periodikos.com.br/article/10.47626/2237-6089-2021-0459/pdf/trends-0-AheadOfPrint-63f31610a9539537cf6eec94.pdf","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of 11 empirical studies of mindfulness‑based treatments for sexual dysfunctions and CSBD, following PRISMA","sample_n":11,"sample_text":"eleven studies included; sample sizes of individual studies not reported in abstract","population":"clinical participants with various sexuality‑related disorders (female sexual arousal/desire disorder, etc.)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review looked at eleven studies testing mindfulness‑based therapies for sexual problems, finding some promise for conditions like female sexual arousal disorder but noting that evidence is sparse for many other issues, including compulsive sexual behaviour.","clinical_takeaway":"Mindfulness may help certain sexual dysfunctions, but clinicians should await stronger evidence before recommending it for most conditions, especially CSBD.","confidence":0.78,"topic_tags":["sexual_function","csbd","treatment"],"strengths":["PRISMA‑guided systematic search","Focus on clinical populations","Highlights gaps in evidence for many sexual problems"],"limitations":["No meta‑analysis or quantitative synthesis reported","Unclear risk‑of‑bias assessment of included studies","Limited discussion of key confounds (e.g., moral incongruence, masturbation)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.47626/2237-6089-2021-0459"}},{"id":6704,"doi":"10.1177/0163278720983428","pmid":"33353416","pmcid":null,"title":"Early Maladaptive Schemas Are Highly Indicative of Compulsive Sexual Behavior","authors":"Efrati Y, Shukron O, Epstein R.","first_author":"Efrati Y","journal":"Evaluation & the health professions","year":2021,"pub_types":["Journal Article"],"keywords":["Therapy","Sex Offenders","Compulsive Sexual Behavior","Early Maladaptive Schemas","Sexual Deviance"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional intercorrelational study with clinical (Sexaholics Anonymous) and offender samples","sample_n":252,"sample_text":"Study 1 n=68 (clinical CSB); Study 2 sex offenders n=103, violence offenders n=81","population":"adults with clinical CSB and offender groups","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that people with compulsive sexual behaviour tend to score high on early maladaptive schemas, suggesting these cognitive patterns may be linked to the severity of their sexual problems.","clinical_takeaway":"Consider assessing early maladaptive schemas when treating clients with compulsive sexual behaviour.","confidence":0.7,"topic_tags":["csbd"],"strengths":["uses validated schema questionnaire","includes two distinct non‑clinical comparison groups","addresses understudied cognitive factors"],"limitations":["CSB severity measure not described/validated","cross‑sectional design limits causal inference","no control for key confounds (moral, mental health, trauma)","clinical sample self‑selected from support group"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0163278720983428"}},{"id":6705,"doi":"10.1016/j.encep.2019.11.011","pmid":"32151449","pmcid":null,"title":"[French validation of the Sexual Addiction Screening Test (SAST-Fr)]","authors":"Hegbe KG, Courtois R, Brunault P, Reveillere C, Barrault S.","first_author":"Hegbe KG","journal":"L'Encephale","year":2020,"pub_types":["Journal Article"],"keywords":["Assessment","Psychometric Properties","Sexual Addiction","Évaluation","Addiction Sexuelle","Sexual Addiction Screening Test (Sast)","Qualités Psychométriques","Sexual Addiction Screening Test-version Française (Sast-fr)"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional validation study of a self‑report scale (SAST‑Fr) recruited online from specialized forums","sample_n":398,"sample_text":"voluntary participants recruited online through specialized forums","population":"398 adult volunteers (54% women) recruited via online forums","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["circular_addiction_scale","self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated the Sexual Addiction Screening Test into French and showed it has good reliability and correlates with other sexual‑addiction measures, but it used a self‑selected online sample and the tool’s definition of addiction may overlap with the distress it is meant to predict.","clinical_takeaway":"The French SAST appears reliable, yet clinicians should interpret scores cautiously, considering possible circularity and lack of control for moral or mental‑health factors.","confidence":0.8,"topic_tags":["sexual_function","measurement"],"strengths":["Large sample for a validation study","Comprehensive psychometric analysis (EFA, KR‑20, ROC)","Good internal consistency reported"],"limitations":["Recruitment from specialized forums may bias toward higher problem users","SAST items and Goodman's criteria may be circular definitions of addiction","No assessment of key confounds (morality, masturbation, mental health, relationship context, trauma)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.encep.2019.11.011"}},{"id":6710,"doi":"10.3390/jcm14176275","pmid":"40944034","pmcid":"PMC12428834","title":"Chemsex as a Diagnostic Challenge: Toward Recognition in ICD-12 and Integrated Treatment Approaches-A Narrative Review","authors":"Śniadach J, Orlof W, Sołowiej-Chmiel J, Kicman A, Szymkowiak S, Waszkiewicz N.","first_author":"Śniadach J","journal":"Journal of clinical medicine","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexuality","Substance Use Disorders","Icd-10","Therapeutic strategies","Icd-11","Chemsex","Compulsive Sexual Behavior Disorder (Csbd)","Mixed Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12428834","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methodology; no primary data collection.","sample_n":null,"sample_text":"Not applicable – narrative review","population":"None (review article)","country":"Poland (based on author affiliations, not specified in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The authors review chemsex—using drugs during sex—highlighting health risks and arguing it should become a separate diagnosis in future ICD revisions, with suggested criteria and treatment ideas.","clinical_takeaway":"Clinicians should be aware of chemsex risks but note the diagnostic proposal is still theoretical.","confidence":0.4,"topic_tags":["sexual_function","csbd","religiosity"],"strengths":["Broad synthesis of clinical and epidemiological literature","Proposes concrete diagnostic criteria for future ICD revision","Identifies treatment strategies and research gaps"],"limitations":["Narrative (non‑systematic) methodology limits reproducibility","No empirical data; conclusions are speculative","Potential advocacy bias toward pathologising chemsex"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jcm14176275"}},{"id":6712,"doi":"10.31952/amha.19.1.4","pmid":"35212207","pmcid":null,"title":"BARONESS CHARLOTTA CASTELLI GLEMBAY - WAS SHE HYPERSEXUAL?","authors":"Arbanas G.","first_author":"Arbanas G.","journal":"Acta medico-historica adriatica : AMHA","year":2021,"pub_types":["Historical Article","Journal Article"],"keywords":["Hypersexuality, Sexual Addiction, Out-of-control Sexual Behaviour, Nymphomania, Compulsive Sexual Behaviour Disorder, Miroslav Krleža, Messrs Glembay"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Historical literary analysis of a fictional character; no empirical data collected.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The paper examines a 1928 play character, arguing she shows signs of hypersexuality, a contested diagnosis, and discusses how such portrayals reflected early‑20th‑century attitudes toward female sexuality.","clinical_takeaway":"None – the article is a literary analysis, not clinical evidence.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Interesting historical perspective","Highlights early cultural representations of hypersexuality"],"limitations":["No empirical data","Speculative interpretation of fictional character","Lacks operational definitions or validated measures"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31952/amha.19.1.4"}},{"id":6714,"doi":"10.1007/s10461-022-03858-4","pmid":"36125565","pmcid":"PMC10036450","title":"Psychometric Properties of the Sexual Compulsivity Scale in Men Who Have Sex with Men in Spanish Population","authors":"Ibáñez-Tomás E, Ballester-Arnal R, Elipe-Miravet M, Gasch-Gallén À.","first_author":"Ibáñez-Tomás E","journal":"AIDS and behavior","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Assessment","Psychometric Properties","Men Who Have Sex With Men","Sexual Compulsivity"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10461-022-03858-4.pdf","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"psychometric validation of a questionnaire in a large MSM sample (N=881) using exploratory and confirmatory factor analysis","sample_n":881,"sample_text":"881 MSM participants recruited in Spain (convenience sampling likely)","population":"men who have sex with men in Spain","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The Spanish version of the Sexual Compulsivity Scale was tested with 881 gay and bisexual men. Factor analysis showed the questionnaire reliably measures two aspects: how sexual behaviour interferes with life and difficulty controlling sexual urges.","clinical_takeaway":"The validated scale can be used to screen for sexual compulsivity in Spanish‑speaking MSM populations.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for factor-analytic validation","Both EFA and CFA confirm two‑factor structure","High internal consistency"],"limitations":["Convenience sample limits generalisability","No assessment of potential confounds (e.g., moral incongruence, mental health)","No pre‑registration or open data"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-022-03858-4"}},{"id":6715,"doi":"10.1111/famp.12623","pmid":"33400283","pmcid":null,"title":"The Association of Exposure to Military Sexual Trauma and Romantic Relationship Satisfaction Among Partnered Men Service Members/Veterans: The Influence of Compulsive Sexual Behavior","authors":"Blais RK.","first_author":"Blais RK.","journal":"Family process","year":2021,"pub_types":["Journal Article"],"keywords":["Men","Sexual dysfunction","Veterans","Relationship Satisfaction","Hombres","Military Sexual Trauma","Disfunción Sexual","Service Members","Satisfacción Con La Relación","关系满意度","Trauma Sexual Militar","性功能障碍","男性","Miembros/veteranos Del Servicio Militar","兵役期创伤","服役人员/退伍军人"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"N=499 partnered male service members/veterans; self‑report questionnaire; mediation analysis","sample_n":499,"sample_text":"Convenience community sample of partnered men SM/Vs recruited for an online survey","population":"U.S. military service members and veterans (men, partnered)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 499 partnered male service members and veterans, exposure to military sexual trauma was linked to lower relationship satisfaction, and this link was explained by higher compulsive sexual behavior, not erectile dysfunction.","clinical_takeaway":"Therapists should assess and address compulsive sexual behaviors when treating couples where the male partner experienced military sexual trauma.","confidence":0.8,"topic_tags":["sexual_function","relationships","masturbation","moral_incongruence"],"strengths":["Large sample (N≈500)","Focus on understudied male MST survivors","Uses validated scales for erectile dysfunction and relationship satisfaction (presumed)"],"limitations":["Cross‑sectional; mediation does not prove causality","No measurement of moral incongruence or other key confounds","Compulsive sexual behavior measured by self‑report only"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/famp.12623"}},{"id":6716,"doi":"10.1016/j.jsxm.2020.04.318","pmid":"32532705","pmcid":null,"title":"Naltrexone in Compulsive Sexual Behavior Disorder: A Feasibility Study of Twenty Men","authors":"Savard J, Öberg KG, Chatzittofis A, Dhejne C, Arver S, Jokinen J.","first_author":"Savard J","journal":"The journal of sexual medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Naltrexone","Sexual Addiction","Hypersexual Disorder","Compulsive Sexual Behavior Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"single-arm prospective feasibility trial with pre‑post measurements; no control group; N=20 men with CSBD seeking treatment","sample_n":20,"sample_text":"Twenty men","population":"Adult men (27‑60 y) with self‑identified compulsive sexual behavior disorder, recruited from an outpatient non‑forensic clinic","country":"Sweden (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"supports","citation_value":"useful","plain_summary":"In 20 men with compulsive sexual behavior, a four‑week course of naltrexone reduced scores on two hypersexuality questionnaires, though side effects were common. The study was uncontrolled and small, so effectiveness remains uncertain.","clinical_takeaway":"Naltrexone appears feasible and may lessen CSBD symptoms, but clinicians should await larger controlled trials before routine use.","confidence":0.7,"topic_tags":["treatment","csbd","neuroscience"],"strengths":["First pharmacological feasibility trial for CSBD","Uses two validated hypersexuality scales","Repeated measurements across treatment period"],"limitations":["No control or randomisation","Small sample (N=20)","No assessment of key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)"],"rubric_version":"2.0","raw_total":27,"max_possible":60,"pct_score":45,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":1,"design":3,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":37,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.04.318"}},{"id":6717,"doi":"10.1017/s1092852925100813","pmid":"41382318","pmcid":"PMC13064774","title":"Skin picking disorder and hazardous alcohol use","authors":"Grant JE, Boutouis S.","first_author":"Grant JE","journal":"CNS spectrums","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Alcohol","Aggression","Impulsivity","Skin Picking","Excoriation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13064774","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online community survey of adults with skin picking disorder (N=182), group comparison hazardous vs low‑risk alcohol use","sample_n":182,"sample_text":"Adults with skin picking disorder (n=182) recruited from the general community via an online survey.","population":"Adults with skin picking disorder recruited via online survey; not a clinical or treatment‑seeking sample","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of 182 adults with skin‑picking disorder, about one‑third had hazardous drinking. Those drinkers reported less frequent picking but greater overall severity, aggression, and related disorders, including compulsive sexual behavior.","clinical_takeaway":"Screen people with skin‑picking disorder for hazardous alcohol use and related impairment.","confidence":0.7,"topic_tags":["csbd","sexual_function","pornography","masturbation"],"strengths":["Use of validated AUDIT for alcohol use","Relatively large sample for a skin‑picking study","Examination of multiple comorbidities"],"limitations":["Cross‑sectional design limits causal inference","Skin‑picking measures not specified; likely mixed validity","Key confounds (moral incongruence, masturbation, mental‑health covariates) not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852925100813"}},{"id":6718,"doi":"10.1093/sxmrev/qeag028","pmid":"42149688","pmcid":null,"title":"Definitions, classification, and epidemiology of sexual dysfunction: a consensus statement from the Fifth International Consultation on Sexual Medicine 2024","authors":"Trost L, Rowland D, Meston C, Kingsberg S, Briken P, Gross M, Esho T, Lewis R, Giraldi A.","first_author":"Trost L","journal":"Sexual medicine reviews","year":2026,"pub_types":["Review","Consensus Statement","Journal Article"],"keywords":["Sexual dysfunction","Sexual Health","Sexual Disorders","Evidence-based","Definitions","Female Sexual Dysfunction","Male Sexual Dysfunction"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Consensus statement with no original empirical data; definitions generated by expert panel.","sample_n":null,"sample_text":"No participant sample; expert consensus.","population":"International panel of sexual medicine specialists; no participant sample.","country":"International","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2024 international expert panel created and refined definitions for many male and female sexual dysfunctions, including compulsive sexual behavior disorder, aiming to standardize clinical and research language.","clinical_takeaway":"Use the new consensus definitions to align diagnosis and research on sexual dysfunctions, but recognize they are not yet empirically validated.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad expert representation","Systematic consensus process","Clear, detailed definitions"],"limitations":["No empirical validation of definitions","Potential bias from expert opinions","Lacks data on prevalence accuracy"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":1,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeag028"}},{"id":6721,"doi":"10.1186/s13256-023-03774-8","pmid":"36775819","pmcid":"PMC9923910","title":"Paraphilia without symptoms of primary psychiatric disorder: a case report","authors":"Pang NTP, Masiran R, Alimuddin AS.","first_author":"Pang NTP","journal":"Journal of medical case reports","year":2023,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Exhibitionism","Paraphilia","Voyeurism","Frotteurism, Compulsive Sexual Behavior"],"is_oa":true,"oa_url":"https://jmedicalcasereports.biomedcentral.com/counter/pdf/10.1186/s13256-023-03774-8","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single clinical case of a 48‑year‑old man with multiple paraphilias and compulsive sexual behavior, described with diagnostic narrative and treatment response","sample_n":1,"sample_text":"48‑year‑old Malay man","population":"Adult male patient (N=1), recruited from clinical service","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 48‑year‑old man with several paraphilic urges (voyeurism, exhibitionism, frotteurism) experienced serious social and work problems. He had no mood or psychotic illness, and medical tests were normal. He was treated with an antidepressant and psychotherapy aimed at compulsive sexual behaviour.","clinical_takeaway":"Compulsive sexual behaviour linked to paraphilias can cause severe impairment and may respond to SSRIs plus targeted psychotherapy.","confidence":0.85,"topic_tags":["sexual_function","csbd","moral_incongruence"],"strengths":["Detailed clinical description","Highlights need for thorough medical workup","Discusses treatment approach"],"limitations":["Single case, no generalisability","No validated psychometric measures reported","No systematic assessment of confounding factors"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s13256-023-03774-8"}},{"id":6722,"doi":"10.1016/j.jsxm.2020.03.020","pmid":"32402815","pmcid":"PMC7390670","title":"Use of Geosocial Networking Applications Is Associated With Compulsive Sexual Behavior Disorder in an Online Sample","authors":"Turban JL, Passell E, Scheuer L, Germine L.","first_author":"Turban JL","journal":"The journal of sexual medicine","year":2020,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Anxiety","Gay","Bisexual","Compulsive Sexual Behavior","Geosocial Networking Applications"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional web‑based survey (N=4,203) examining associations between geosocial networking app use and compulsive sexual behaviour disorder (CSBD) using logistic regression.","sample_n":4203,"sample_text":"Large nontargeted web‑based convenience sample.","population":"Adults recruited via non‑targeted online sampling; 12.3% reported using GNAs; predominantly young, male, non‑heterosexual.","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online survey of over 4,000 adults, people who used dating apps that connect nearby users were about 60% more likely to meet criteria for compulsive sexual behavior disorder, even after accounting for age and gender. No link was found with anxiety.","clinical_takeaway":"Clinicians should note that use of geosocial networking apps may co‑occur with compulsive sexual behaviour, but causality is unclear.","confidence":0.85,"topic_tags":["gender","sexual_function"],"strengths":["Large sample size","Use of validated CSBD scale (HBI‑19)","Adjustment for key demographics"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of moral incongruence or masturbation","Potential self‑selection bias in web sample","No pre‑registration"],"rubric_version":"2.0","raw_total":37,"max_possible":60,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":4,"design":4,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.03.020"}},{"id":6723,"doi":"10.1007/s10508-021-01991-0","pmid":"34231108","pmcid":"PMC8275528","title":"Sex Differences in Voyeuristic and Exhibitionistic Interests: Exploring the Mediating Roles of Sociosexuality and Sexual Compulsivity from an Evolutionary Perspective","authors":"Thomas AG, Stone B, Bennett P, Stewart-Williams S, Kennair LEO.","first_author":"Thomas AG","journal":"Archives of sexual behavior","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sex differences","Exhibitionism","Evolutionary Psychology","Sociosexuality","Mating Strategies","Voyeurism"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8275528","cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey (N=1113, UK participants, convenience sample)","sample_n":1113,"sample_text":"1113 participants from the UK","population":"adults from the United Kingdom (46% men, 54% women)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed over a thousand UK adults and found that men and women differ in how much they dislike or are interested in voyeuristic and exhibitionistic acts. These differences were partly explained by how open they are to casual sex and by levels of sexual compulsivity.","clinical_takeaway":"None – the findings are theoretical and do not provide direct clinical guidance.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample size for a survey","Uses established scales for sociosexuality and sexual compulsivity","Mediation analysis explores indirect pathways"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of key confounds (e.g., moral attitudes, mental health)","Self‑report interest may be subject to social desirability bias"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-01991-0"}},{"id":6726,"doi":"10.1002/wps.20960","pmid":"35524599","pmcid":"PMC9077619","title":"Emerging experience with selected new categories in the ICD-11: complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder","authors":"Reed GM, First MB, Billieux J, Cloitre M, Briken P, Achab S, Brewin CR, King DL, Kraus SW, Bryant RA.","first_author":"Reed GM","journal":"World psychiatry : official journal of the World Psychiatric Association (WPA)","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Diagnosis","Mental Health Care","Clinical Utility","International Classification Of Diseases","Prolonged Grief Disorder","Icd-11","Gaming Disorder","Complex Post-traumatic Stress Disorder","Compulsive Sexual Behaviour Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":101,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"expert commentary / narrative review without original empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews why the ICD‑11 added four new disorders—including compulsive sexual behaviour disorder—summarising expert opinions on their clinical relevance, controversies, and the surge in research they have prompted.","clinical_takeaway":"Clinicians should be aware that ICD‑11 now recognises compulsive sexual behaviour disorder as a distinct condition, but this paper provides no new treatment evidence.","confidence":0.8,"topic_tags":["csbd","sexual_function","pornography","masturbation","gender"],"strengths":["Authored by leading experts on ICD‑11 categories","Comprehensive overview of four newly added disorders","Highlights clinical and research implications of new diagnoses"],"limitations":["No original data; conclusions are based on existing literature","Lacks systematic review methodology (no PRISMA, risk‑of‑bias assessment)","Potential bias toward supporting ICD‑11 additions"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":124,"citing_publications":196,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/wps.20960"}},{"id":6727,"doi":"10.1192/bji.2024.9","pmid":"40291985","pmcid":"PMC12022886","title":"Spirituality and behavioural addictions: narrative review","authors":"Kanabar M, Kathiresan P, Elkholy H, Zonoozi AK, Orsolini L, Long J, Farokhnia M, Bhad R, Butner JL, Fonseca F, Phan V, Achab S, Potenza MN.","first_author":"Kanabar M","journal":"BJPsych international","year":2024,"pub_types":["review-article","Review","Journal Article"],"keywords":["Philosophy","Mental Health Services","Psychosocial Interventions","Transcultural Psychiatry","Patients And Service Users"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12022886","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review summarising existing literature on spirituality and behavioural addictions, including compulsive sexual behaviour disorder; no new empirical data collected.","sample_n":null,"sample_text":"Not applicable – narrative review.","population":"None (review article)","country":"International (authors from multiple affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review looks at how spirituality might help or hurt people with behavioural addictions, including compulsive sexual behaviour. It finds mixed evidence and calls for more rigorous research.","clinical_takeaway":"Clinicians should consider spirituality as a potential factor but recognize that its role in compulsive sexual behaviour is not yet clear.","confidence":0.4,"topic_tags":["sexual_function","csbd"],"strengths":["Broad overview of spirituality across several behavioural addictions","Identifies gaps for future research"],"limitations":["Narrative (non‑systematic) approach may introduce selection bias","No quantitative synthesis or appraisal of study quality","No explicit reporting of confound control or measurement validity"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/bji.2024.9"}},{"id":6728,"doi":"10.1556/2006.2022.00035","pmid":"35895609","pmcid":"PMC9295238","title":"Neural and behavioral correlates of sexual stimuli anticipation point to addiction-like mechanisms in compulsive sexual behavior disorder","authors":"Liberg B, Görts-Öberg K, Jokinen J, Savard J, Dhejne C, Arver S, Fuss J, Ingvar M, Abé C.","first_author":"Liberg B","journal":"Journal of behavioral addictions","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Anticipation","Functional MRI","Hypersexual Disorder","Sex Addiction","Compulsive Sexual Behavior Disorder","Sexual stimuli"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9295238","cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"case-control fMRI study with 22 CSBD patients and 20 healthy controls; behavioral task measuring anticipation of erotic stimuli","sample_n":42,"sample_text":"22 CSBD patients, 20 healthy male controls","population":"adult males, CSBD patients vs healthy controls","country":"Sweden (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","causal_from_correlational","underpowered_sample","fmri_reverse_inference"],"stance":"supports","citation_value":"useful","plain_summary":"In a small fMRI study, men with compulsive sexual behavior showed slower responses to erotic cues and ventral‑striatum activation during anticipation, which the authors suggest reflects addiction‑like brain processes.","clinical_takeaway":"Evidence for addiction‑like brain changes in CSBD is preliminary; clinicians should interpret neuroimaging findings cautiously.","confidence":0.7,"topic_tags":["csbd","neuroscience","sexual_function","adolescents"],"strengths":["Use of neuroimaging to probe anticipation processes","Inclusion of a matched healthy control group","Novel behavioral paradigm separating anticipation from viewing"],"limitations":["Small sample size limits statistical power","No measurement of key confounds (moral incongruence, masturbation, mental health)","Interpretation of VS activity as 'addiction‑like' may be reverse inference"],"rubric_version":"2.0","raw_total":33,"max_possible":70,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":5,"statistics":5,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":12,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00035"}},{"id":6729,"doi":"10.1556/2006.2021.00056","pmid":"34550905","pmcid":"PMC8997196","title":"An empirical study of affective and cognitive functions in Compulsive Sexual Behavior Disorder","authors":"Draps M, Sescousse G, Wilk M, Obarska K, Szumska I, Żukrowska W, Majkowska A, Kowalewska E, Szymanowska J, Hamerska U, Trybuś M, Golec K, Adamska I, Szymczak K, Gola M.","first_author":"Draps M","journal":"Journal of behavioral addictions","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Cognitive Processes","Hypersexuality","Behavioral Addictions","Affective Processes","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8997196","cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control comparison of CSBD patients (n=74) with matched healthy males (n=66) using questionnaires and behavioral tasks","sample_n":140,"sample_text":"74 CSBD participants, 66 healthy controls","population":"heterosexual male adults, CSBD diagnosed vs healthy controls","country":"Poland (inferred from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men with compulsive sexual behavior disorder to healthy men using surveys and tasks. It found higher punishment sensitivity, anxiety, depression, impulsivity and altered responses to erotic rewards in the CSBD group, suggesting some similarities to addiction but also many mixed findings.","clinical_takeaway":"CSBD patients may show heightened emotional sensitivity and impulsivity, yet cognitive deficits are unclear; assess these domains individually rather than assuming a uniform addiction profile.","confidence":0.78,"topic_tags":["csbd"],"strengths":["Reasonably sized case‑control sample","Combination of questionnaires and multiple behavioral tasks","Use of Bayesian as well as frequentist analyses"],"limitations":["Cross‑sectional design; no causal inference","Key confounds (moral incongruence, masturbation, trauma) not measured","Unclear whether CSBD diagnosis based on validated criteria"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2021.00056"}},{"id":6730,"doi":"10.1001/jamanetworkopen.2018.4468","pmid":"30646355","pmcid":"PMC6324590","title":"Prevalence of Distress Associated With Difficulty Controlling Sexual Urges, Feelings, and Behaviors in the United States","authors":"Dickenson JA, Gleason N, Coleman E, Miner MH.","first_author":"Dickenson JA","journal":"JAMA network open","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6324590","cited_by_count":92,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"nationally representative survey of 2,325 US adults aged 18‑50, random sampling across all states; single time‑point prevalence estimate","sample_n":2325,"sample_text":"National Survey of Sexual Health and Behavior, randomly sampled participants from all 50 US states","population":"Adults 18‑50 in the United States, community sample, n=2325","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A US survey of 2,300 adults found that about 9% reported distress and functional problems from feeling unable to control sexual urges, using a cut‑off on a standard questionnaire.","clinical_takeaway":"Clinicians should recognize that a notable minority experience distress about sexual urges, but assessment should consider broader psychosocial factors.","confidence":0.73,"topic_tags":["prevalence","sexual_function"],"strengths":["Large, nationally representative sample","Validated CSBI‑13 scale","Clear prevalence estimate"],"limitations":["Cross‑sectional; cannot infer causality","Distress used to define ‘problematic’ behavior – circular","No measurement of moral incongruence, masturbation, mental‑health or trauma covariates"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":13,"contrasting":4,"mentioning":87,"citing_publications":211,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/jamanetworkopen.2018.4468"}},{"id":6731,"doi":"10.1016/j.therap.2025.07.002","pmid":"40841274","pmcid":null,"title":"Drugs associated with behavioral addictions: Real world analysis using the WHO pharmacovigilance database","authors":"Asselin L, Laforgue EJ, Duval M, Revol B, Veyrac G, Grall-Bronnec M, Victorri-Vigneau C.","first_author":"Asselin L","journal":"Therapie","year":2026,"pub_types":["Journal Article"],"keywords":["Database","Pharmacovigilance","Antipsychotics","Behavioral Addictions"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pharmacovigilance database analysis with disproportionality testing","sample_n":null,"sample_text":"cases where drugs were coded as suspect for behavioral addiction; only drugs with ≥5 reports were examined","population":"human adverse‑event reports from WHO VigiBase","country":"global (VigiBase aggregates worldwide reports)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined WHO drug‑safety reports to see whether any medicines are linked to behavioral addictions such as gambling, gaming, compulsive sexual behavior or binge eating. They found 24 drugs with enough reports, highlighting olanzapine as the most strongly associated.","clinical_takeaway":"Some medications, especially olanzapine, may trigger problematic addictive behaviours; clinicians should monitor patients for new compulsive symptoms.","confidence":0.7,"topic_tags":["csbd","adolescents","gender"],"strengths":["Large, global pharmacovigilance data source","Systematic search of multiple behavioral‑addiction terms","Use of disproportionality analysis to highlight signals"],"limitations":["Reliance on spontaneous report coding; no validated addiction measures","Potential reporting bias and lack of denominator data","No control for psychiatric comorbidities or concomitant drug use"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.therap.2025.07.002"}},{"id":6732,"doi":"10.1037/abn0000437","pmid":"31282729","pmcid":null,"title":"Mental health professionals' pathologization of compulsive sexual behavior: Does clients' gender and sexual orientation matter?","authors":"Klein V, Briken P, Schröder J, Fuss J.","first_author":"Klein V","journal":"Journal of abnormal psychology","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["bibliography","csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Between‑subjects vignette experiment with 546 mental‑health professionals rating pathologization of compulsive sexual behavior across client gender and sexual orientation.","sample_n":546,"sample_text":"N = 546 mental‑health professionals","population":"Mental‑health professionals (N = 546), likely recruited via professional networks; not a patient sample.","country":"not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 546 mental‑health clinicians showed they were less likely to label compulsive sexual behavior as a disorder when the client was gay or lesbian, regardless of the clinical description. Beliefs about biological causes partly explained this bias.","clinical_takeaway":"Clinicians should be aware that personal beliefs about sexuality may bias diagnostic judgments about compulsive sexual behavior.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample of professionals (N > 500)","Experimental manipulation of client characteristics allows causal inference about bias","Mediation analysis probes underlying beliefs"],"limitations":["Reliance on self‑report vignette ratings; no behavioural outcomes","No validated scale for 'pathologization' reported","Potential selection bias in professional sample"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/abn0000437"}},{"id":6733,"doi":"10.1556/2006.2021.00051","pmid":"34437297","pmcid":"PMC8997235","title":"Aberrant orbitofrontal cortex reactivity to erotic cues in Compulsive Sexual Behavior Disorder","authors":"Golec K, Draps M, Stark R, Pluta A, Gola M.","first_author":"Golec K","journal":"Journal of behavioral addictions","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["fMRI","Incentive Salience","Erotic Stimuli","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/10/3/article-p646.pdf","cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control fMRI study with 29 CSBD men and 24 controls, modified Incentive Delay Task, whole‑brain and ROI analyses","sample_n":53,"sample_text":"29 CSBD participants, 24 healthy volunteers","population":"men seeking professional help for CSBD, recruited from clinical setting","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used brain scans to compare men with compulsive sexual behaviour disorder to healthy controls while they anticipated erotic or monetary rewards. It found stronger activity in the ventral striatum and orbitofrontal cortex for erotic cues in the disorder group, suggesting atypical brain responses to sexual cues.","clinical_takeaway":"Evidence of altered brain activation to sexual cues in CSBD, but findings are limited by small sample and lack of control for moral or mental‑health factors.","confidence":0.7,"topic_tags":["neuroscience","csbd","sexual_function"],"strengths":["Use of neuroimaging to probe cue reactivity","Inclusion of both erotic and monetary reward cues","Probabilistic cue manipulation"],"limitations":["Small sample, likely under‑powered for fMRI","No reporting of control for key psychosocial confounds","CSBD definition not tied to validated diagnostic criteria"],"rubric_version":"2.0","raw_total":26,"max_possible":70,"pct_score":37,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":4,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":26,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2021.00051"}},{"id":6734,"doi":"10.1089/cyber.2022.0312","pmid":"36802284","pmcid":null,"title":"Further Understanding the Correlations Between Sexting and Mental Health: Considerations for Sex and Sexual Identity","authors":"Borgogna NC, Meyer CL, Trussell MR, Garos S, Kraus SW.","first_author":"Borgogna NC","journal":"Cyberpsychology, behavior and social networking","year":2023,"pub_types":["Journal Article"],"keywords":["Mental health","Substance Use","Compulsive Sexual Behavior","Sexual Identity","Sexting"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 2,160 US college students, convenience sample","sample_n":2160,"sample_text":"2,160 college students living in the United States","population":"college students (US)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of US college students, people who sexted were more likely to report higher depression, anxiety, sleep trouble and especially compulsive sexual behavior, with marijuana use also linked to sexting. Effects were similar across gender and sexual identity, though the link to compulsive sexuality was stronger for women.","clinical_takeaway":"Sexting may co‑occur with compulsive sexual behavior and marijuana use, but the relationship with mood or sleep problems is modest.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample (N>2000)","Examines multiple mental‑health outcomes","Considers sex and sexual‑identity subgroups"],"limitations":["Cross‑sectional; cannot infer causality","Compulsive sexual behavior measurement not described; likely self‑report","No control for moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":5,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2022.0312"}},{"id":6736,"doi":"10.1186/s13256-025-05492-9","pmid":"41063204","pmcid":"PMC12506340","title":"Integrative treatment approach to problematic sexualized drug use (Chemsex) of 3-methylmethcathinone: a case report","authors":"Khatcherian E, Arango-Arroyave S, Zullino D, Achab S.","first_author":"Khatcherian E","journal":"Journal of medical case reports","year":2025,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Addiction","Compulsive Sexual Behavior","bupropion","Cathinones","3-Methylmethcathinone","3-Mmc","Chemsex","Sexualized Drug Use","Case Report Treatment"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12506340","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case study describing clinical presentation, treatment and outcome","sample_n":1,"sample_text":"N=1 (single case report)","population":"37‑year‑old white European man engaging in chemsex with 3‑methylmethcathinone","country":"unspecified (likely Europe)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","circular_addiction_scale","advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"A single‑patient case report describes a 37‑year‑old man treated for compulsive sexual behavior combined with use of the synthetic drug 3‑methylmethcathinone (chemsex). The authors propose a model of ‘chemsex addiction’ and report that psychotherapy plus bupropion helped him recover.","clinical_takeaway":"Evidence is anecdotal; clinicians should treat chemsex cases individually and not rely on this report for guidelines.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed clinical narrative","Novel focus on 3‑MMC in chemsex","Provides treatment description (psychotherapy + bupropion)"],"limitations":["N=1, no generalisability","No validated measures of addiction or CSBD","No control of key confounds (moral incongruence, mental health, partner context)","Claims of ‘addiction’ are not operationalised per ICD‑11"],"rubric_version":"2.0","raw_total":13,"max_possible":60,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":2,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s13256-025-05492-9"}},{"id":6737,"doi":"10.1080/10550887.2025.2560404","pmid":"41058451","pmcid":null,"title":"Neurophysiological and therapeutic efficacy of somatic psychotherapies in addiction: primary behavioral focus with exploratory cross-addiction analyses","authors":"Lomas C.","first_author":"Lomas C.","journal":"Journal of addictive diseases","year":2026,"pub_types":["Meta-Analysis","Systematic Review","Journal Article"],"keywords":["Behavioral Addictions","Addiction Recovery","Process Addiction","Somatic Psychotherapies"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 9 RCTs (N=573) of yoga, mindfulness, and somatic interventions for gambling, gaming, and compulsive sexual behavior.","sample_n":573,"sample_text":"Nine RCTs, total N = 573","population":"Adults with behavioral addictions (gambling, gaming, compulsive sexual behavior).","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of nine randomised trials found that yoga, mindfulness and other body‑focused therapies markedly reduced symptoms of gambling, gaming and compulsive sexual behaviour, though the studies were very diverse and the underlying brain mechanisms remain unclear.","clinical_takeaway":"Somatic therapies may lessen behavioural‑addiction symptoms, but evidence is mixed; clinicians should consider them as adjuncts, not replacements, for established treatments.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Systematic review with RoB‑2 assessment","Quantitative synthesis of RCTs","Large total sample across studies"],"limitations":["High heterogeneity (I²=95.6%)","No explicit control for moral incongruence or related confounds","Mechanistic claims not supported by direct data"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10550887.2025.2560404"}},{"id":6738,"doi":"10.31234/osf.io/k5jm4","pmid":null,"pmcid":null,"title":"A Re-Examination of the Sexual Opinion Survey","authors":"Kafaee N, Kohut T, Joel S.","first_author":"Kafaee N","journal":"PsyArXiv","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://osf.io/k5jm4/download","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"questionnaire study with affective response ratings; machine‑learning (Random Forest) prediction of responses from questionnaire items; no pre‑registration reported; sample size not stated in abstract","sample_n":null,"sample_text":"not reported in abstract","population":"adult participants (unspecified recruitment, likely convenience sample)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors revisited the Sexual Opinion Survey, adding new items and testing whether the original and new items better predict how people feel about sexual pictures than other sexuality questionnaires. Using a machine‑learning model, they found the combined SOS items were most predictive, supporting the scale’s validity but suggesting further refinement.","clinical_takeaway":"The Sexual Opinion Survey appears to be a valid tool for assessing sexual approach‑avoidance tendencies, but clinicians should await further validation before using new items.","confidence":0.7,"topic_tags":["measurement","sexual_function"],"strengths":["Uses established SOS measure","Employs machine‑learning to test predictive validity beyond simple correlations","Compares SOS to a range of other sexuality scales"],"limitations":["Sample size and recruitment details not provided in abstract","No pre‑registration or correction for multiple testing described","Reliance on self‑report affective ratings only"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/k5jm4"}},{"id":6740,"doi":"10.1080/13548506.2019.1687916","pmid":"31713436","pmcid":null,"title":"Cardiovascular and psychopathological factors among non-sexually compulsive, sexually compulsive, and hypersexual individuals in Sao Paulo, Brazil","authors":"D T Scanavino M, Ventuneac A, Caramelli B, Naufal L, S D Santos Filho C, Nisida IVV, Amaral MLS, Vieira JC, Parsons JT.","first_author":"D T Scanavino M","journal":"Psychology, health & medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Cardiovascular disease","Risk factor","Compulsive Sexual Behavior","Sexual Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational cross‑sectional study of 211 Brazilian adults classified into three CSB severity groups; psychiatric interview, blood tests and questionnaires were administered.","sample_n":211,"sample_text":"94 non‑sexually compulsive, 57 sexually compulsive, 60 hypersexual participants.","population":"Adults from São Paulo, Brazil (94 non‑sexually compulsive, 57 sexually compulsive, 60 hypersexual).","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared heart‑risk factors among three groups of Brazilian adults ranging from non‑compulsive to hypersexual. Higher sexual compulsivity was linked to more psychiatric disorders and HIV positivity, while cardiovascular risk did not consistently increase with compulsivity.","clinical_takeaway":"Clinicians should screen for psychiatric comorbidities in patients reporting compulsive sexual behavior, but evidence of direct heart‑risk impact remains inconclusive.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Large total sample for a CSB study (N>200)","Inclusion of objective cardiovascular risk measures (Framingham score, blood biomarkers)","Consideration of psychiatric comorbidity"],"limitations":["Unclear how CSB severity groups were defined; likely non‑validated","No measurement of key confounds (moral incongruence, masturbation, partner factors, trauma)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13548506.2019.1687916"}},{"id":6741,"doi":"10.1186/s12955-026-02535-7","pmid":"42001095","pmcid":"PMC13224438","title":"Measurement properties of patient-reported outcome measures for sexual health in the general population: a systematic review following the COSMIN 2.0 guidelines","authors":"Shang Y, Yuan Q, Shen Y, Xu K, Zhang G, Ju B.","first_author":"Shang Y","journal":"Health and quality of life outcomes","year":2026,"pub_types":["Systematic Review","review-article","Journal Article"],"keywords":["Sexual Health","Psychometric Properties","Cosmin","Sexual Quality Of Life","Sexual Well-being","Patient-reported Outcome Measures (Proms)","General Adult Population"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13224438","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 27 PROMs following PRISMA and COSMIN guidelines; methodological quality and measurement properties graded with modified GRADE.","sample_n":null,"sample_text":"27 PROMs evaluated; number of primary study participants not aggregated in abstract","population":"General adult population (both sexes)","country":"Not specified (multi‑database search, likely international)","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review examined 27 questionnaires that measure sexual health in adults, judging how well they were developed and validated. It found the IIEF for men and FSFI for women have the strongest evidence, but many tools still need better testing.","clinical_takeaway":"Use IIEF and FSFI when assessing sexual function in clinical practice; be cautious with other PROMs pending further validation.","confidence":0.85,"topic_tags":["measurement","sexual_function"],"strengths":["Comprehensive systematic search across multiple databases","Use of COSMIN and GRADE frameworks for rigorous appraisal","Clear recommendations for best‑performing instruments"],"limitations":["No primary data; relies on quality of existing studies","Limited assessment of content validity and responsiveness across tools","Potential language bias (search limited to certain databases)"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":2,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12955-026-02535-7"}},{"id":6742,"doi":"10.1556/2006.2020.00062","pmid":"33006958","pmcid":"PMC8943677","title":"Desire thinking as a predictor of compulsive sexual behaviour in adolescents: Evidence from a cross-cultural validation of the Hebrew version of the Desire Thinking Questionnaire","authors":"Efrati Y, Kolubinski DC, Caselli G, Spada MM.","first_author":"Efrati Y","journal":"Journal of behavioral addictions","year":2020,"pub_types":["research-article","Validation Study","Journal Article"],"keywords":["Adolescents","Impulsivity","Thought Suppression","Negative Affect","Compulsive Sexual Behaviour","Desire Thinking"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/9/3/article-p797.pdf","cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"two convenience samples of adolescents (N=718, N=379) completing self‑report questionnaires; exploratory and confirmatory factor analyses, correlational validation.","sample_n":379,"sample_text":"convenience sample of 718 adolescents (Study 1) and 379 adolescents (Study 2)","population":"adolescents (Israel), convenience recruitment","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated and validated a Hebrew version of the Desire Thinking Questionnaire in Israeli adolescents, showing it reliably measures desire thinking and predicts self‑reported compulsive sexual behaviour.","clinical_takeaway":"The DTQ‑H can be used as a reliable tool to assess desire‑thinking in adolescents, but clinicians should consider other risk factors before linking it to sexual‑behaviour problems.","confidence":0.85,"topic_tags":["measurement","adolescents","csbd"],"strengths":["Large adolescent sample for validation","Both exploratory and confirmatory factor analysis","Incremental validity tested"],"limitations":["Convenience sampling limits generalisability","No control for key confounds (moral incongruence, mental health)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":6,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00062"}},{"id":6743,"doi":"10.1556/2006.2021.00002","pmid":"33570504","pmcid":"PMC8969848","title":"White matter microstructural and Compulsive Sexual Behaviors Disorder - Diffusion Tensor Imaging study","authors":"Draps M, Kowalczyk-Grębska N, Marchewka A, Shi F, Gola M.","first_author":"Draps M","journal":"Journal of behavioral addictions","year":2021,"pub_types":["research-article","Review","Journal Article"],"keywords":["Diffusion Tensor Imaging","Addictions","Hypersexuality","White Matter Microstructure","Compulsive Sexual Behaviors Disorder","Obssesive-compulsive Disorder"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/10/1/article-p55.pdf","cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control diffusion tensor imaging study comparing 36 CSBD males with 31 matched healthy controls","sample_n":67,"sample_text":"36 CSBD patients, 31 controls (matched)","population":"heterosexual adult males, CSBD diagnosed per ICD‑11 criteria","country":"Poland (inferred from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used brain scans to compare white‑matter structures of men with compulsive sexual behavior disorder to healthy men, finding reduced integrity in several tracts that overlap with patterns seen in addiction and OCD.","clinical_takeaway":"Current imaging evidence does not clarify whether CSBD is more like an addiction or OCD; clinicians should treat it based on established diagnostic criteria, not neuroimaging.","confidence":0.78,"topic_tags":["neuroscience","csbd","sexual_function"],"strengths":["Matched healthy control group","First DTI study comparing CSBD with addiction/OCD patterns","Clear diagnostic criteria (ICD‑11) for CSBD"],"limitations":["Small sample size for DTI (N<60 per group)","No measurement/control of key confounds (moral incongruence, masturbation, mental health)","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":6,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2021.00002"}},{"id":6744,"doi":"10.1016/j.psychres.2013.01.021","pmid":"23415890","pmcid":null,"title":"Compulsive sexual behavior and psychopathology among treatment-seeking men in São Paulo, Brazil","authors":"Scanavino Mde T, Ventuneac A, Abdo CH, Tavares H, do Amaral ML, Messina B, dos Reis SC, Martins JP, Parsons JT.","first_author":"Scanavino Mde T","journal":"Psychiatry research","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual behavior","Mental disorders","Psychiatric Disorder","Sexual Addiction","Hypersexuality","Sexual Compulsivity","Hypersexual Disorder"],"is_oa":false,"oa_url":"https://doi.org/10.1016/j.psychres.2013.01.021","cited_by_count":36,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 86 treatment‑seeking men","sample_n":86,"sample_text":"treatment‑seeking men, recruited from a clinic; convenience sample","population":"men seeking treatment for compulsive sexual behavior in São Paulo, Brazil","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A study of 86 men in Brazil who sought help for compulsive sexual behaviour found high scores on a sexual compulsivity questionnaire and that most also had other mental‑health diagnoses. Gay and bisexual men reported more casual‑sex problems than heterosexual men.","clinical_takeaway":"Clinicians should assess co‑occurring mood disorders in men presenting with compulsive sexual behaviour.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Use of validated Sexual Compulsivity Scale","Comprehensive psychiatric interview (M.I.N.I.)","Relatively large clinical sample for this topic"],"limitations":["Convenience, treatment‑seeking sample limits generalisability","No assessment of moral incongruence or masturbation","Cross‑sectional design prevents causal inference","No power calculation or effect‑size reporting"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":3,"contrasting":1,"mentioning":40,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psychres.2013.01.021"}},{"id":6745,"doi":"10.1111/add.16362","pmid":"37788826","pmcid":null,"title":"Is sexual craving a sign of sex addiction?","authors":"Franken IHA.","first_author":"Franken IHA.","journal":"Addiction (Abingdon, England)","year":2023,"pub_types":["Comment","Editorial"],"keywords":["Psychophysiology","Craving","Reward","Sexual Addiction","Pleasure","Behavioural Addictions"],"is_oa":false,"oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/add.16362","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/add.16362"}},{"id":6746,"doi":"10.1556/2006.2020.00005","pmid":"32359229","pmcid":"PMC8935188","title":"Treatments for internet addiction, sex addiction and compulsive buying: A meta-analysis","authors":"Goslar M, Leibetseder M, Muench HM, Hofmann SG, Laireiter AR.","first_author":"Goslar M","journal":"Journal of behavioral addictions","year":2020,"pub_types":["Meta-Analysis","review-article","Journal Article"],"keywords":["Treatment","Meta-analysis","Internet Addiction","Compulsive Buying","Sex Addiction"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/9/1/article-p14.pdf","cited_by_count":38,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 91 treatment studies (psychological, pharmacological, combined) for internet, sex addiction and compulsive buying, reporting pre‑post Hedges’ g effect sizes.","sample_n":3531,"sample_text":"3,531 participants across 91 studies","population":"Individuals with self‑identified internet, sex or compulsive‑buying problems across 91 studies (total N≈3,531).","country":"multiple (global literature search)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 91 treatment studies found that psychological, medication, and combined approaches produce medium‑to‑large short‑term reductions in symptoms of internet, sex, and compulsive‑buying problems, but the underlying measures and study quality vary.","clinical_takeaway":"Current treatments show promising short‑term benefits, yet clinicians should note the mixed quality of evidence and the need for more rigorous trials.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large pooled sample across many studies","Quantitative synthesis with effect sizes","Considers short‑ and long‑term outcomes"],"limitations":["Primary studies likely use heterogeneous and sometimes unvalidated addiction measures","No explicit risk‑of‑bias or quality appraisal reported in abstract","Confounding variables (e.g., moral incongruence, mental health) not addressed"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":42,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00005"}},{"id":6747,"doi":"10.1016/j.addbeh.2025.108323","pmid":"40107922","pmcid":null,"title":"Corrigendum to \"Metacognitive beliefs and desire thinking as potential maintenance factors of compulsive sexual behavior\" [Addict. Behav. 161 (2025) 108214]","authors":"Olivari C, Mansueto G, Marino C, Candellari G, Cericola J, Spada MM, Caselli G.","first_author":"Olivari C","journal":"Addictive behaviors","year":2025,"pub_types":["Published Erratum"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2025.108323"}},{"id":6748,"doi":"10.22365/jpsych.2024.026","pmid":"39688609","pmcid":null,"title":"Death anxiety, life's meaninglessness, and mental resilience among women with symptoms of behavioral addictions and alcohol use disorder: Using the existential approach","authors":"Vatikioti C, Triantafyllou K, Tzavara C, Paparrigopoulos T.","first_author":"Vatikioti C","journal":"Psychiatrike = Psychiatriki","year":2025,"pub_types":["Journal Article"],"keywords":["Existentialism","Meaning In Life","Alcohol Use Disorder","Behavioral Addictions","Death Anxiety","Mental Resilience","Αddiction"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience survey of 3,176 women assessing self‑report symptom scales for shopping, sex, gambling, food, and alcohol use alongside meaning in life, death anxiety and resilience scales","sample_n":3176,"sample_text":"convenience online sample of women","population":"women (18‑...; convenience online sample)","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 3,200 women, stronger sense of life meaning and higher resilience were linked to fewer self‑reported symptoms of various behavioural addictions and alcohol use, while greater death anxiety related to more symptoms.","clinical_takeaway":"Assess meaning in life and resilience when treating women with behavioural addiction symptoms; consider existential‑psychology approaches.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample size","Validated scales for meaning, resilience, death anxiety"],"limitations":["Addiction symptom measures not clearly validated","No control for moral incongruence or mental‑health variables","Cross‑sectional, convenience sample"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.22365/jpsych.2024.026"}},{"id":6749,"doi":"10.1080/0092623x.2012.701268","pmid":"23790248","pmcid":null,"title":"Evaluation and treatment of sex addiction","authors":"Rosenberg KP, Carnes P, O'Connor S.","first_author":"Rosenberg KP","journal":"Journal of sex & marital therapy","year":2014,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Review article summarising existing literature; no original empirical data.","sample_n":null,"sample_text":"Not applicable – narrative review.","population":"Clinicians and researchers interested in sexual compulsivity; no participant sample.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews how ‘sex addiction’ has been defined, its proposed diagnostic criteria, and treatment ideas, noting that most clinicians lack training in this area.","clinical_takeaway":"Clinicians should be aware that definitions and treatment approaches for sex addiction are still debated and not yet standardized.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive historical overview","Integrates multiple proposed diagnostic frameworks","Highlights clinical training gaps"],"limitations":["No original data; relies on existing studies","Lacks systematic methodology (e.g., PRISMA)","No quantitative synthesis or bias assessment"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":47,"citing_publications":111,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2012.701268"}},{"id":6750,"doi":"10.1093/sexmed/qfae007","pmid":"38450255","pmcid":"PMC10915578","title":"Reply on \"Why compulsive sexual behavior is not a form of addiction like drug addiction\"","authors":"Stark R, Walter B, Bengesser I, Kramer D, Muhl C, Tahmassebi N, Khatib S, Storz F, Markert C, Golder S.","first_author":"Stark R","journal":"Sexual medicine","year":2024,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://academic.oup.com/smoa/article-pdf/12/1/qfae007/56863317/qfae007.pdf","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfae007"}},{"id":6751,"doi":"10.1007/s10461-022-03961-6","pmid":"36633765","pmcid":"PMC10399619","title":"The Relationship Between Alcohol and Drug Use, Compulsive Sexual Behavior, and Condomless Anal Sex in Men Who have Sex with Men: Analysis of Retrospectively-Reported Sexual Behavior","authors":"Gleason N, Smith G, Canning JR, George WH, Larimer ME, Jennings TL, Coleman E, Miner MH.","first_author":"Gleason N","journal":"AIDS and behavior","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["HIV","Drug Use","Compulsive Sexual Behavior","Alcohol Use","Men Who Have Sex With Men","Condomless Anal Sex"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective 90‑day timeline follow‑back survey of 200 MSM examining alcohol/drug use, compulsive sexual behavior (CSB) and condomless anal sex (CAS).","sample_n":200,"sample_text":"Community sample of MSM (N=200) recruited for a retrospective 90‑day timeline follow‑back assessment.","population":"Men who have sex with men (MSM), United States, community sample (N=200).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 200 US men who have sex with men, researchers found that drug use increased condomless anal sex only among those who also screened positive for compulsive sexual behavior; alcohol use showed little direct effect.","clinical_takeaway":"CSB alone may not raise HIV risk, but combined with drug use it does; interventions should address both.","confidence":0.8,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Relatively large sample for a sexual‑health survey (N=200).","Uses detailed 90‑day timeline follow‑back method to capture behavior.","Examines interaction of substance use and CSB on HIV‑risk behavior."],"limitations":["Cross‑sectional, retrospective design limits causal inference.","CSB measurement not described; likely relies on a screening tool without full criteria validation.","Key confounds (e.g., moral incongruence, mental health) not assessed."],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-022-03961-6"}},{"id":6752,"doi":"10.21203/rs.3.rs-71578/v1","pmid":null,"pmcid":null,"title":"Does Sexual Compulsivity Play a Role in Unprotected Intercourse? A Cross-Sectional Study Among Sexually Active STI Patients in Shanghai","authors":"Ni Y, Liu H, Gong R, Shi M, Zhang S, Cai Y, Wang S, Zhou P.","first_author":"Ni Y","journal":"Research Square","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-71578/v1.pdf?c=1631870947000","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 664 STI patients from two Shanghai clinics; mixed quantitative‑qualitative methods; no control group.","sample_n":664,"sample_text":"Convenience sample from two purposively chosen clinics; not nationally representative.","population":"Adults (18‑76) attending STI clinics; 302 men, 362 women.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 664 Chinese STI patients, higher sexual compulsivity was linked to more unprotected sex with casual partners, especially in men. The study suggests targeting compulsivity in sexual health counseling.","clinical_takeaway":"Assess sexual compulsivity in STI patients, particularly men, as part of risk‑reduction counseling.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑site study","Uses a validated Sexual Compulsivity Scale","Differentiates partner type (casual vs regular)"],"limitations":["Cross‑sectional design limits causal inference","No measurement of key confounds (moral incongruence, mental health, etc.)","Convenience clinic sample limits generalisability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-71578/v1"}},{"id":6753,"doi":"10.1080/13691058.2024.2351996","pmid":"38786979","pmcid":null,"title":"Hypersexualisation and racialised erotic capital in sex work","authors":"Ham J.","first_author":"Ham J.","journal":"Culture, health & sexuality","year":2025,"pub_types":["Journal Article"],"keywords":["Sex Work","Erotic Capital","Hypersexualisation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"critical essay / conceptual analysis; no empirical data, no sample size reported","sample_n":null,"sample_text":"None – article is a theoretical/critical discussion","population":"sex workers, Asian women; no systematic sampling","country":"USA (contextual focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how Asian women in sex work are portrayed as hyper‑sexual and the racial dynamics involved, arguing for a more inclusive sex‑worker rights movement.","clinical_takeaway":"None – the paper offers a sociocultural analysis, not clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Engages interdisciplinary perspectives on race and sexuality","Highlights under‑examined intersection of sex‑worker rights and hypersexualisation"],"limitations":["No empirical data or systematic methodology","Lacks measurement of key constructs (e.g., hypersexualisation) with validated tools","Conclusions cannot be generalized beyond the narrative analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2024.2351996"}},{"id":6755,"doi":"10.1556/2006.2020.00034","pmid":"32609629","pmcid":"PMC8939427","title":"The development of the Compulsive Sexual Behavior Disorder Scale (CSBD-19): An ICD-11 based screening measure across three languages","authors":"Bőthe B, Potenza MN, Griffiths MD, Kraus SW, Klein V, Fuss J, Demetrovics Z.","first_author":"Bőthe B","journal":"Journal of behavioral addictions","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Screening","Hypersexuality","Cut-off","Sex Addiction","Compulsive Sexual Behavior Disorder (Csbd)","Multi-language Validation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8939427","cited_by_count":100,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online convenience samples from three countries (N≈9,300)","sample_n":9325,"sample_text":"Four independent samples totaling 9,325 participants completed self‑report measures.","population":"adults from US, Hungary, Germany (mixed gender)","country":"United States; Hungary; Germany","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and validated a 19‑item questionnaire (CSBD‑19) to screen for compulsive sexual behavior disorder across English, German and Hungarian. The scale showed good reliability and worked similarly in all three languages.","clinical_takeaway":"The CSBD‑19 provides a brief, cross‑culturally validated tool for identifying individuals at risk of compulsive sexual behavior.","confidence":0.8,"topic_tags":["measurement","csbd","sexual_function"],"strengths":["Large trans‑national sample increases statistical power","Comprehensive psychometric evaluation (factor structure, invariance)","Alignment with ICD‑11 diagnostic criteria"],"limitations":["Self‑report only; no behavioral or physiological validation","Key confounds (moral incongruence, masturbation, mental health) not assessed","Convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":39,"max_possible":60,"pct_score":65,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":7,"interpretation":8}},"scite":{"supporting":11,"contrasting":1,"mentioning":143,"citing_publications":177,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00034"}},{"id":6756,"doi":"10.1007/s10508-024-02836-2","pmid":"38418717","pmcid":null,"title":"Debates on Compulsive Sexual Behavior Disorder: A Call for Global and Interdisciplinary Perspectives","authors":"Bőthe B, Potenza MN, Demetrovics Z.","first_author":"Bőthe B","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":2,"contrasting":0,"mentioning":9,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02836-2"}},{"id":6757,"doi":"10.1097/adm.0000000000000337","pmid":"28727662","pmcid":null,"title":"Paraphilic Thoughts, Behaviors and Sex Addiction in a Sample of Persons Who Use Drugs: A Cross-Sectional Study","authors":"Clemente J, Pillon SC, Mari JJ, da Silva CJ, Santana PRH, Diehl A.","first_author":"Clemente J","journal":"Journal of addiction medicine","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 134 treatment‑seeking substance‑dependent adults in Brazil.","sample_n":134,"sample_text":"134 persons who use drugs, predominantly men (76.1%).","population":"Substance‑dependent outpatients (mostly male, 18‑29 y).","country":"Brazil","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale","self_selected_sample"],"stance":"supports","citation_value":"background","plain_summary":"Among 134 Brazilian adults receiving drug‑treatment, almost half reported paraphilic thoughts or behaviours, and many also screened positive for sexual addiction. Childhood physical neglect, low education, young age and heterosexual orientation were linked to these symptoms.","clinical_takeaway":"Clinicians working with substance‑use patients should assess for paraphilic thoughts and sexual‑addiction symptoms, especially when a history of childhood neglect is present.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of validated SAST and CTQ instruments","Reports odds ratios with confidence intervals","Addresses understudied link between trauma and paraphilic/sexual‑addiction symptoms"],"limitations":["Convenience sample of treatment‑seekers, limits generalisability","No measurement of moral incongruence, masturbation, or mental‑health covariates","Addiction defined by screening tool without testing DSM/ICD criteria"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/adm.0000000000000337"}},{"id":6758,"doi":"10.1556/2006.8.2019.35","pmid":"31416337","pmcid":"PMC7044634","title":"Demographic and psychiatric correlates of compulsive sexual behaviors in gambling disorder","authors":"Cowie ME, Kim HS, Hodgins DC, McGrath DS, Scanavino MDT, Tavares H.","first_author":"Cowie ME","journal":"Journal of behavioral addictions","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Comorbidity","Compulsive Sexual Behaviors","Clinical Correlates","Gambling Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7044634","cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional clinical interview of 368 treatment‑seeking gambling‑disorder patients (24 with comorbid compulsive sexual behaviour).","sample_n":368,"sample_text":"Treatment‑seeking individuals with gambling disorder; 24 (6.5 %) met criteria for compulsive sexual behaviour.","population":"Adults with gambling disorder seeking treatment in São Paulo, Brazil (N = 368).","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 368 people seeking treatment for gambling disorder in Brazil, 6.5 % also met criteria for compulsive sexual behaviour. Those with both problems tended to be younger, male, and have higher rates of depression, PTSD, bulimia, and other addictions.","clinical_takeaway":"Clinicians treating gambling disorder should screen for co‑occurring compulsive sexual behaviour and related psychopathology.","confidence":0.78,"topic_tags":["csbd","gender","prevalence","treatment"],"strengths":["Large overall sample of GD patients","Comprehensive clinical interview covering multiple comorbidities","Use of validated personality and impulsivity scales"],"limitations":["CSB diagnosis not described as a validated instrument","Cross‑sectional design; no causal inference","Low number of CSB cases limits statistical power","No assessment of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":27,"max_possible":60,"pct_score":45,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":5,"design":3,"addiction_criteria":4,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":17,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.8.2019.35"}},{"id":6760,"doi":"10.4088/pcc.23cr03594","pmid":"38382080","pmcid":null,"title":"Treatment of Obsessive-Compulsive Disorder With Concomitant Compulsive Sexual Behavior Disorder","authors":"Hunsinger NN.","first_author":"Hunsinger NN.","journal":"The primary care companion for CNS disorders","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/pcc.23cr03594"}},{"id":6761,"doi":"10.1007/s10508-017-0991-8","pmid":"28687897","pmcid":null,"title":"Hypersexuality: A Critical Review and Introduction to the \"Sexhavior Cycle\"","authors":"Walton MT, Cantor JM, Bhullar N, Lykins AD.","first_author":"Walton MT","journal":"Archives of sexual behavior","year":2017,"pub_types":["Review","Journal Article"],"keywords":["Dsm-5","Hypersexuality","Sexual Compulsivity","Icd-11","Sexual Impulsivity","Sex Addiction","Dual Control Model","Sexhavior Cycle"],"is_oa":false,"oa_url":null,"cited_by_count":102,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Review article; no primary empirical data; synthesis of existing literature.","sample_n":null,"sample_text":"Not applicable (review)","population":"Not applicable (review)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews theories and diagnostic debates about hypersexuality, questioning whether it is a true disorder or extreme normal variation, and proposes a new “sexhavior cycle” model to explain its psychological dynamics.","clinical_takeaway":"Clinicians should remain cautious, considering both pathological and non‑pathological explanations for high sexual desire before labeling it a disorder.","confidence":0.7,"topic_tags":["gender","sexual_function"],"strengths":["Comprehensive overview of theoretical models","Critical appraisal of diagnostic criteria","Identifies gaps and research needs"],"limitations":["No original data; conclusions based on existing literature","Lacks systematic review methodology (e.g., PRISMA, bias assessment)","No empirical testing of proposed “sexhavior cycle”"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":130,"citing_publications":201,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-0991-8"}},{"id":6762,"doi":"10.1093/sexmed/qfae006","pmid":"38450256","pmcid":"PMC10915579","title":"Why compulsive sexual behavior is not a form of addiction like drug addiction","authors":"Hesse M.","first_author":"Hesse M.","journal":"Sexual medicine","year":2024,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10915579","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfae006"}},{"id":6763,"doi":"10.1111/jsm.12185","pmid":"23815239","pmcid":null,"title":"The relationship between the FFM personality traits, state psychopathology, and sexual compulsivity in a sample of male college students","authors":"Pinto J, Carvalho J, Nobre PJ.","first_author":"Pinto J","journal":"The journal of sexual medicine","year":2013,"pub_types":["Journal Article"],"keywords":["Psychopathology","Sexual Compulsivity","Five-factor Model"],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 152 male college students (non‑random convenience sample).","sample_n":152,"sample_text":"152 male college students recruited in a Portuguese university using nonrandom methods.","population":"Male college students, Portugal, n=152","country":"Portugal","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 152 male college students, personality traits (neuroticism, agreeableness) and current psychological distress were linked to higher scores on a sexual compulsivity questionnaire, with distress partially explaining the neuroticism‑compulsivity link.","clinical_takeaway":"Clinicians should note that personality and mental‑health symptoms relate to sexual‑compulsivity scores in non‑clinical young men, but causality is unclear.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of validated personality and psychopathology instruments","Reasonable sample size for a student survey","Explores mediating role of state psychopathology"],"limitations":["Cross‑sectional design limits causal inference","No assessment of moral incongruence, masturbation, or relationship factors","Convenience, non‑random student sample limits generalisability"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":1,"mentioning":27,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12185"}},{"id":6765,"doi":"10.1037/ort0000760","pmid":"38780606","pmcid":null,"title":"\"It's probably an addiction-It can't be anything else\": The role of addiction discourse in the self-identity of men who pay for sex","authors":"Prior A, Peled E.","first_author":"Prior A","journal":"The American journal of orthopsychiatry","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"qualitative interview study using symbolic interaction theory; likely small convenience sample of Israeli men who pay for sex","sample_n":null,"sample_text":"not specified in abstract","population":"men who pay for sex (MPWS) in Israel","country":"Israel","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with Israeli men who pay for sex show that adopting an 'addict' label can help them feel less like criminals, though the lack of clear definitions makes the label unsettling for some.","clinical_takeaway":"Clinicians should be aware that men who pay for sex may use addiction language to manage identity, but this does not confirm a medical addiction.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides novel qualitative insight into identity construction","Uses established symbolic interaction framework"],"limitations":["Small, non‑representative sample","No measurement of key confounds (moral incongruence, mental health, etc.)","No empirical assessment of addiction criteria"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/ort0000760"}},{"id":6766,"doi":"10.1007/s40429-020-00298-9","pmid":"33425653","pmcid":"PMC7787260","title":"Child Sexual Abuse and Compulsive Sexual Behavior: A Systematic Literature Review","authors":"Slavin MN, Scoglio AAJ, Blycker GR, Potenza MN, Kraus SW.","first_author":"Slavin MN","journal":"Current addiction reports","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Child Sexual Abuse","Compulsive Sexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":62,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of 21 observational studies (no meta‑analysis reported)","sample_n":null,"sample_text":"21 studies (varied samples; includes community, clinical, college)","population":"studies of individuals with a history of child sexual abuse and compulsive sexual behavior","country":"multiple (global literature)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"This review of 21 studies finds that people who experienced child sexual abuse are more likely to report compulsive sexual behaviour, but the research uses many different definitions and lacks long‑term data.","clinical_takeaway":"Assess trauma history in clients with compulsive sexual behaviour and consider trauma‑focused interventions.","confidence":0.7,"topic_tags":["csbd"],"strengths":["Systematic approach to literature","Highlights gap in longitudinal research","Identifies variability in measurement"],"limitations":["No quantitative synthesis (meta‑analysis)","Unclear assessment of study quality","Limited control for key confounds (e.g., moral incongruence)"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":73,"citing_publications":111,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40429-020-00298-9"}},{"id":6768,"doi":"10.1556/2006.2022.00024","pmid":"35583964","pmcid":"PMC9295246","title":"Involvement in Sexaholics Anonymous and life satisfaction: The mediating role of meaning in life and hope","authors":"Wnuk M, Charzyńska E.","first_author":"Wnuk M","journal":"Journal of behavioral addictions","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Life Satisfaction","Self-help Groups","Hope","Meaning In Life","Compulsive Sexual Behavior Disorder","Twelve-step Program"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/11/2/article-p544.pdf","cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 80 self‑selected Sexaholics Anonymous members","sample_n":80,"sample_text":"convenience sample of SA members; not representative of general population or all CSBD individuals","population":"Polish adults (72 M, 8 F), mean age ≈ 39, recruited from a twelve‑step self‑help group","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 80 members of Sexaholics Anonymous, greater involvement in the group was linked to higher life satisfaction, partly because participants reported more meaning in life and greater hope. More severe CSBD symptoms were associated with less meaning and lower satisfaction.","clinical_takeaway":"Engagement in supportive twelve‑step groups may boost meaning and hope, improving life satisfaction for people with compulsive sexual behavior.","confidence":0.75,"topic_tags":["csbd","sexual_function","treatment"],"strengths":["Use of validated CSBD and wellbeing scales","Explores mediators (meaning, hope) of group involvement","Path analysis provides insight into indirect effects"],"limitations":["Small, non‑representative convenience sample","Cross‑sectional design precludes causal inference","No control for key confounds (moral incongruence, mental health, etc.)","Involvement scale not confirmed psychometrically"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00024"}},{"id":6769,"doi":"10.1038/s41443-025-01194-4","pmid":"41107535","pmcid":null,"title":"\"Chemical Seduction\": a narrative review of the complex impact of recreational drugs on sexual function","authors":"Meller N, Kitrey N.","first_author":"Meller N","journal":"International journal of impotence research","year":2026,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative (non‑systematic) review of anecdotal and limited scientific reports; no original data collection.","sample_n":null,"sample_text":"No primary sample; review of existing literature.","population":"Humans (general adult population referenced in source studies).","country":"Not applicable (review).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","causal_from_correlational","selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how various recreational drugs (e.g., amphetamines, MDMA, ketamine) may temporarily boost desire or orgasm but can also lead to problems like erectile dysfunction, compulsive sex, and increased STI risk, especially with chronic use.","clinical_takeaway":"Clinicians should ask about recreational drug use when assessing sexual problems, as these substances can both enhance and impair sexual function.","confidence":0.6,"topic_tags":["religiosity","moral_incongruence","masturbation","sexual_function"],"strengths":["Broad overview of many substances","Highlights public‑health concerns (STI/HIV risk)","Identifies gaps for future controlled research"],"limitations":["Relies heavily on anecdotal evidence","No systematic search or bias assessment","No quantitative synthesis or effect‑size reporting"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-025-01194-4"}},{"id":6770,"doi":"10.1556/2006.2024.00060","pmid":"39540888","pmcid":"PMC11737418","title":"Long-term changes on behavioral addictions symptoms among adults with attention deficit hyperactivity disorder treated with methylphenidate","authors":"Grassi G, Moradei C, Cecchelli C.","first_author":"Grassi G","journal":"Journal of behavioral addictions","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["ADHD","Methylphenidate","Food Addiction","Internet Addiction","Sex Addiction","Shopping Addiction"],"is_oa":true,"oa_url":"https://doi.org/10.1556/2006.2024.00060","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"single-group prospective pre‑post study of 37 adult ADHD outpatients receiving methylphenidate","sample_n":37,"sample_text":"37 consecutive adult ADHD outpatients","population":"adults with ADHD (clinical sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 37 adults with ADHD, a year of methylphenidate was linked to lower self‑reported symptoms of internet, food, shopping and sex addictions, though the study lacked a control group and used small samples.","clinical_takeaway":"Methylphenidate may reduce self‑reported addictive behaviors in ADHD, but robust controlled trials are needed before clinical recommendations.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Prospective within‑subject design","Examines multiple behavioral addictions","Includes mood and anxiety measures"],"limitations":["Small, non‑random sample (N=37)","No control group; causal inference limited","Unclear validation of addiction scales","No assessment of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":5,"design":3,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00060"}},{"id":6772,"doi":"10.1007/978-981-95-2411-2_7","pmid":"41171565","pmcid":null,"title":"Similarities and Differences in Diagnostic Scales","authors":"Xuan B, Li P, Liu Y, Liu G, Chen Y, Yang L, Li M, Zhou J.","first_author":"Xuan B","journal":"Advances in experimental medicine and biology","year":2025,"pub_types":["Journal Article"],"keywords":["Validity","reliability","Substance Addiction","Non-substance Addiction Scales"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews various substance and non‑substance addiction questionnaires, noting that most include items on social impairment, preoccupation, withdrawal, and tolerance, and discusses how these scales differ across cultures and samples.","clinical_takeaway":"None – the paper does not provide data for clinical decision‑making.","confidence":0.5,"topic_tags":["sexual_function","measurement"],"strengths":["Broad overview of many addiction scales","Mentions cross‑cultural applicability"],"limitations":["No primary data or empirical testing","No clear operational definitions for sex‑addiction constructs","No control for key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/978-981-95-2411-2_7"}},{"id":6773,"doi":"10.1556/2006.7.2018.127","pmid":"30580543","pmcid":"PMC6376398","title":"A mindful model of sexual health: A review and implications of the model for the treatment of individuals with compulsive sexual behavior disorder","authors":"Blycker GR, Potenza MN.","first_author":"Blycker GR","journal":"Journal of behavioral addictions","year":2018,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual Health","Hypersexuality","Mindfulness-based Therapies","Compulsive Sexual Behavior Disorder","Integrative Sexual Wellness Education","Respect-based Sexuality"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/7/4/article-p917.pdf","cited_by_count":25,"is_preprint":false,"topics":["csbd","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review article proposing a theoretical model; no empirical data collected","sample_n":null,"sample_text":"N/A – article is a narrative review and model proposal","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors propose a Mindful Model of Sexual Health that blends Eastern mindfulness practices with Western sexual health concepts, aiming to help people, including those with compulsive sexual behavior, improve their sexual well‑being through awareness and balanced decision‑making.","clinical_takeaway":"Clinicians may consider mindfulness‑based tools as a complementary approach for clients seeking better sexual health, but evidence for effectiveness is currently theoretical.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Integrative theoretical framework","Links mindfulness to sexual health","Clear clinical case illustration"],"limitations":["No empirical evidence presented","Lacks systematic review methodology","No measurement of key constructs"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.127"}},{"id":6774,"doi":"10.1016/j.addbeh.2020.106384","pmid":"32244085","pmcid":null,"title":"Psychiatric comorbidity in compulsive sexual behavior disorder (CSBD)","authors":"Ballester-Arnal R, Castro-Calvo J, Giménez-García C, Gil-Juliá B, Gil-Llario MD.","first_author":"Ballester-Arnal R","journal":"Addictive behaviors","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Cluster analysis","Psychiatric Comorbidity","Axis I And Ii","Compulsive Sexual Behavior Disorder (Csbd)"],"is_oa":false,"oa_url":"https://repositori.uji.es/xmlui/bitstream/10234/188054/1/69795.pdf","cited_by_count":57,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational cross‑sectional study comparing a community sample (N=315) with a CSBD group (N=68) identified via cluster analysis; structured clinical interviews (SCID‑I/II) for comorbidity.","sample_n":383,"sample_text":"383 participants (315 non‑CSBD, 68 CSBD).","population":"Adults (unspecified age range), recruited from unspecified sources; 383 participants total.","country":"Spain (inferred from author affiliations).","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 383 adults, those identified as having compulsive sexual behavior disorder showed much higher rates of psychiatric conditions—including depression, alcohol problems and borderline personality disorder—than people without the disorder.","clinical_takeaway":"Clients with CSBD often have co‑occurring mental‑health disorders; comprehensive assessment is essential.","confidence":0.8,"topic_tags":["csbd","pornography","moral_incongruence","masturbation","sexual_function"],"strengths":["Large overall sample for a clinical group","Use of structured diagnostic interviews (SCID)","Direct comparison between CSBD and non‑CSBD groups"],"limitations":["Cross‑sectional design; cannot infer causality","CSBD classification via cluster analysis not fully described","Key confounds (moral incongruence, masturbation, trauma) not measured"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":69,"citing_publications":111,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2020.106384"}},{"id":6775,"doi":"10.1093/jsxmed/qdaf054","pmid":"40192478","pmcid":null,"title":"From hyper- to hypo-: ADHD medications &amp; sexual dysfunction","authors":"Hale EW, Igoe TJ, Bernat OR, Cohan TD, Thompson KP.","first_author":"Hale EW","journal":"The journal of sexual medicine","year":2025,"pub_types":["Journal Article"],"keywords":["Hypersexuality","Medication Adverse Effects","Adhd Sexual Dysfunction"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"retrospective cohort using EMR data from >600,000 adolescents, propensity‑score matched groups (stimulant, non‑stimulant, none).","sample_n":600000,"sample_text":"over 600,000 adolescents","population":"adolescents with ADHD (both genders) from TriNetX database","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a huge record‑based study of adolescents with ADHD, stimulant medication was linked to higher reports of increased libido, hypersexual behavior and erectile problems in boys, while girls on stimulants showed more contraceptive use. Non‑stimulants showed fewer sexual side effects.","clinical_takeaway":"Clinicians should monitor sexual side effects, especially libido and erectile issues, when prescribing stimulants to adolescents.","confidence":0.78,"topic_tags":["adolescents","sexual_function"],"strengths":["Very large sample size","Use of propensity‑score matching","Gender‑specific analysis"],"limitations":["Retrospective design, no causal inference","Outcomes based on ICD codes, no validated sexual behavior scales","No control for moral, mental‑health or trauma confounders"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf054"}},{"id":6776,"doi":"10.1016/j.jsxm.2019.03.272","pmid":"31080103","pmcid":null,"title":"The Effect of Early Life Trauma on Compulsive Sexual Behavior among Members of a 12-Step Group","authors":"Efrati Y, Gola M.","first_author":"Efrati Y","journal":"The journal of sexual medicine","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Compulsive Sexual Behavior","Impulsiveness","Self-criticism","Early Life Trauma"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control cross‑sectional comparison of 65 Sexaholics Anonymous members with 47 community controls; self‑report questionnaires; mediation analysis","sample_n":112,"sample_text":"65 Sexaholics Anonymous members; 47 healthy volunteers","population":"Adults (both genders) recruited from a 12‑step recovery group and healthy volunteers","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"People in a 12‑step group who reported more childhood trauma also showed higher compulsive sexual behaviour, partly because they tended to be more sensation‑seeking, experience more internalising symptoms, and be more self‑critical.","clinical_takeaway":"Clinicians should consider trauma history and related psychological factors when addressing compulsive sexual behaviour.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Use of both clinical and community samples","Mediation analysis to explore pathways","Assessment of multiple psychological mediators"],"limitations":["Cross‑sectional design limits causal inference","Self‑report measures only, unclear validation","Moral incongruence and masturbation not accounted for"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":19,"citing_publications":91,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.03.272"}},{"id":6777,"doi":"10.1186/s12888-023-05432-1","pmid":"38082232","pmcid":"PMC10714445","title":"Hypersexuality during treatment with cariprazine in a patient with schizophrenia? A case report","authors":"Prelog PR, Palandacic AK.","first_author":"Prelog PR","journal":"BMC psychiatry","year":2023,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Schizophrenia","antipsychotic agents","Sexual behaviour","Case Report","Cariprazine","Impulsive Behaviour"],"is_oa":true,"oa_url":"https://bmcpsychiatry.biomedcentral.com/counter/pdf/10.1186/s12888-023-05432-1","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single clinical case of a 67‑year‑old woman with schizophrenia who developed hypersexuality after cariprazine was added and the behaviour resolved after discontinuation","sample_n":1,"sample_text":"1 patient","population":"adult female patient with schizophrenia (N=1)","country":"unspecified (likely Austria based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 67‑year‑old woman with schizophrenia started cariprazine and within a week began showing compulsive sexual behaviour, which stopped when the drug was stopped. The authors suggest the medication may have triggered hypersexuality but note that a single case cannot prove this.","clinical_takeaway":"Clinicians should monitor for sudden changes in sexual behaviour when prescribing cariprazine, especially in patients with a history of impulsivity.","confidence":0.85,"topic_tags":["csbd","sexual_function","adolescents","pornography"],"strengths":["detailed clinical description","clear temporal association between drug initiation and symptom onset","cautious interpretation acknowledging limitation of single case"],"limitations":["no validated measures of hypersexuality or compulsive sexual behaviour","no control for confounding factors (e.g., baseline impulsivity, mood, partner status)","cannot infer causality from one case"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12888-023-05432-1"}},{"id":6778,"doi":"10.3390/healthcare13182326","pmid":"41008455","pmcid":"PMC12469981","title":"Young Smokers' Therapy Preferences: App-Based vs. Face-to-Face Treatment in the Context of Co-Addictions","authors":"López-Torrecillas F, Arcos-Rueda MDM, Cobo-Rodríguez B, Muñoz-López L.","first_author":"López-Torrecillas F","journal":"Healthcare (Basel, Switzerland)","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Smoking Cessation","Young Adults","Decisional Balance","Face-to-face Therapy","Comorbid Addictions","App-based Therapy"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12469981","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"98 university participants self‑selected into app‑based (n=35) or face‑to‑face (n=63) CBT for smoking; measured nicotine dependence, other addictions, and motivation via validated questionnaires; logistic regression analyses.","sample_n":98,"sample_text":"98 participants (35 app‑based, 63 face‑to‑face)","population":"young adults (university students) seeking smoking cessation treatment in Granada, Spain","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Among 98 young smokers, those who were younger and students preferred a mobile app for quitting, while people with sex‑related or other substance addictions saw fewer downsides to smoking. Co‑occurring addictions shape how people think about quitting.","clinical_takeaway":"Tailor cessation interventions to age and co‑addiction profiles; mobile apps may engage younger, student smokers.","confidence":0.8,"topic_tags":["treatment","prevalence","sexual_function"],"strengths":["Use of validated psychometric instruments","Comparison of two delivery modes","Inclusion of multiple co‑addictions"],"limitations":["Convenience university sample limits generalisability","Cross‑sectional, no causal inference","No control for key confounds (e.g., mental health, moral factors)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare13182326"}},{"id":6779,"doi":"10.1101/2024.09.21.24313023","pmid":null,"pmcid":null,"title":"Associations of Genetic Variants in the Dopamine Transporter with Problematic Sexual Behavior and Reward Deficiency Syndrome","authors":"Jiang S, Foo JC, Hu X, Roper L, Yang E, Green B, Arnau R, Behavioral Addictions Studies and Insights Consortium, Lodhi RJ, Isenberg R, Wishart D, Fujiwara E, Carnes PJ, Aitchison KJ.","first_author":"Jiang S","journal":"medRxiv","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control genetic association using patients from addiction treatment facilities and community comparison groups","sample_n":1444,"sample_text":"Large convenience sample; patients recruited from addiction treatment centres, comparison groups from the community","population":"PSB patients (n=454), non‑clinical PSB (n=82), controls without PSB (n=888)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether a common dopamine‑transporter gene variant is linked to problematic sexual behaviour. Using a validated screening tool, they found that the 10/10 genotype was related to a broader reward‑deficiency profile and to milder forms of the behaviour, while rarer genotypes hinted at an association with more severe cases.","clinical_takeaway":"Genetic variation in dopamine transport may influence risk for problematic sexual behaviour, but clinical decisions should not rely on these findings alone.","confidence":0.7,"topic_tags":["gender"],"strengths":["Large overall sample size","Use of validated SAST‑R for PSB","First genetic association study of SLC6A3 VNTR with PSB"],"limitations":["No measurement of key confounds (moral incongruence, masturbation, mental health, trauma)","Cross‑sectional, cannot infer causality","Custom RDS composite not validated","Patients from treatment settings may limit generalisability"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2024.09.21.24313023"}},{"id":6780,"doi":"10.1556/jba.4.2015.1.6","pmid":"25786496","pmcid":"PMC4394850","title":"Sexual compulsion--relationship with sex, attachment and sexual orientation","authors":"Weinstein A, Katz L, Eberhardt H, Cohen K, Lejoyeux M.","first_author":"Weinstein A","journal":"Journal of behavioral addictions","year":2015,"pub_types":["brief-report","Journal Article"],"keywords":["Attachment","Sex differences","Homosexuality","Sexual Compulsivity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4394850","cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study (N≈100) examining gender, sexual orientation, and attachment styles in relation to sexual compulsivity.","sample_n":100,"sample_text":"100 participants recruited via unspecified means; likely convenience sampling.","population":"adult men and women, heterosexual and homosexual (convenience sample)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A questionnaire study of 100 adults found that anxious and avoidant attachment styles were linked to higher sexual compulsivity scores, and that lesbian women reported higher compulsivity than heterosexual women.","clinical_takeaway":"Attachment style may relate to sexual compulsivity, but evidence is limited; assess attachment when addressing sexual distress.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses validated sexual compulsivity and attachment scales","Includes both gender and sexual orientation variables","Provides preliminary data on under‑studied groups (lesbian women)"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral/religious conflict or masturbation","Small sub‑group sizes for interaction analyses","No adjustment for mental‑health or relationship factors"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":33,"citing_publications":112,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/jba.4.2015.1.6"}},{"id":6781,"doi":"10.1080/02791072.2025.2474244","pmid":"40087993","pmcid":null,"title":"Psychedelic Use and Behavioral Addictions","authors":"Brasher T, Rosen D, Spinella M.","first_author":"Brasher T","journal":"Journal of psychoactive drugs","year":2026,"pub_types":["Journal Article"],"keywords":["Addiction","Naturalistic","Behavioral Addiction","Psychedelics","Self-report Survey"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Community survey (N=1107) examining self‑reported behavioral addiction symptoms and psychedelic use; multiple regression controlling for demographics and other drug use.","sample_n":1107,"sample_text":"Community sample (N=1107)","population":"Adults from general community (mixed gender, age groups).","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 1,100 adults, people who had used psychedelics reported higher well‑being and fewer symptoms of gambling, sexual, buying and eating problems. Even after accounting for age, gender and other drug use, psychedelic use was linked to lower behavioral‑addiction scores, suggesting it might help treat such issues.","clinical_takeaway":"Current evidence is only correlational; clinicians should not assume psychedelics will reduce sexual or other behavioral addictions without further controlled trials.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size","Broad range of behavioral addictions examined","Controls for major demographic and substance‑use confounders"],"limitations":["Reliance on self‑report symptom scales, likely unvalidated for addiction criteria","No measurement of moral incongruence or masturbation, key confounds for sexual addiction","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/02791072.2025.2474244"}},{"id":6783,"doi":"10.1176/appi.ajp.20240092","pmid":"39659159","pmcid":null,"title":"Current Advances in Behavioral Addictions: From Fundamental Research to Clinical Practice","authors":"Brand M, Antons S, Bőthe B, Demetrovics Z, Fineberg NA, Jimenez-Murcia S, King DL, Mestre-Bach G, Moretta T, Müller A, Wegmann E, Potenza MN.","first_author":"Brand M","journal":"The American journal of psychiatry","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Gambling","Gaming","Substance-related And Addictive Disorders"],"is_oa":false,"oa_url":null,"cited_by_count":95,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without primary data","sample_n":null,"sample_text":"not applicable","population":"not applicable","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review discusses five possible behavioral addictions—gambling, gaming, compulsive sexual behavior, compulsive buying, and problematic social‑media use—summarising current knowledge, comorbidities, and treatment options.","clinical_takeaway":"Screen for compulsive sexual behavior alongside other behavioral addictions, but note that evidence for specific treatments is still emerging.","confidence":0.4,"topic_tags":["sexual_function","csbd","pornography","masturbation"],"strengths":["Broad overview of behavioral addictions including CSBD","Cites validated diagnostic instruments where available"],"limitations":["Narrative review – no systematic search or risk‑of‑bias assessment","No original data; conclusions rely on cited studies","Potential author bias toward addiction framing"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":76,"citing_publications":149,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.ajp.20240092"}},{"id":6785,"doi":"10.1177/154230501306700304","pmid":"24720235","pmcid":null,"title":"PATHOS: a quick screening method for assessing sexual addiction","authors":"Johnson P, Cashwell CS, Cress J, Barber T, Dunn MC.","first_author":"Johnson P","journal":"The journal of pastoral care & counseling : JPCC","year":2013,"pub_types":["Evaluation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Tool description without validation data; no empirical sample reported.","sample_n":null,"sample_text":"none reported","population":"not applicable","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["circular_addiction_scale","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose a brief questionnaire called PATHOS for pastors to quickly identify people they think may have a sexual addiction, but the article provides no data on how well the tool works.","clinical_takeaway":"None - the tool lacks validation and should not be used for clinical decisions.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses need for quick assessment tool","Clear definition of intended use"],"limitations":["No validation data presented","Circular definition of sexual addiction","No measurement of key confounds","Lacks statistical analysis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":0,"confounds":0,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/154230501306700304"}},{"id":6786,"doi":"10.1007/s11920-023-01409-9","pmid":"36738436","pmcid":"PMC9968244","title":"Sexual Dysfunctions and Problematic Sexuality in Personality Disorders and Pathological Personality Traits: A Systematic Review","authors":"Ciocca G, Di Stefano R, Collazzoni A, Jannini TB, Di Lorenzo G, Jannini EA, Rossi A, Rossi R.","first_author":"Ciocca G","journal":"Current psychiatry reports","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","review-article","Journal Article"],"keywords":["Sexual dysfunction","Personality Disorders","Personality Traits","Sexual Risk Behavior","Adverse Childhood Experiences","Problematic Sexuality"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9968244","cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic literature review of 17 studies on sexual dysfunction and problematic sexuality in personality disorders and pathological traits.","sample_n":17,"sample_text":"17 included studies (total participants not reported in abstract).","population":"Adults with personality disorders or pathological personality traits; studies varied in sample characteristics.","country":"Not specified (likely multi‑country based on included studies).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review summarizes 17 studies linking personality disorders and traits to sexual dysfunctions and risky sexual behavior, emphasizing the role of childhood trauma. It suggests that problematic sexuality may be a sign of maladaptive personality functioning.","clinical_takeaway":"Consider trauma and personality pathology when assessing sexual problems; no definitive treatment guidance offered.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Systematic approach to a specific clinical intersection","Incorporates trauma and adverse childhood experiences","Highlights gaps for future research"],"limitations":["No meta‑analysis; unclear quantitative synthesis","Limited reporting of search strategy and risk‑of‑bias assessment","Does not address key confounds such as moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11920-023-01409-9"}},{"id":6787,"doi":"10.1590/1806-9282.63.05.414","pmid":"28724038","pmcid":null,"title":"Sexual addiction in drug addicts: The impact of drug of choice and poly-addiction","authors":"Antonio N, Diehl A, Niel M, Pillon S, Ratto L, Pinheiro MC, Silveira D, Otani TZ, Otani V, Cordeiro Q, Ushida R.","first_author":"Antonio N","journal":"Revista da Associacao Medica Brasileira (1992)","year":2017,"pub_types":["Journal Article","Observational Study"],"keywords":[],"is_oa":false,"oa_url":"http://www.scielo.br/pdf/ramb/v63n5/0104-4230-ramb-63-05-0414.pdf","cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational cross‑sectional study of 133 treatment‑seeking substance‑dependent patients; logistic regression used to examine association between poly‑substance use and SAST‑defined sexual addiction.","sample_n":133,"sample_text":"All alcohol or drug dependents admitted to the Addiction Treatment Unit between November 2013 and August 2014.","population":"Adults (average age not specified) with alcohol and/or cocaine/crack dependence, recruited from a single Brazilian addiction treatment unit.","country":"Brazil","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control","masturbation_not_isolated","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 133 people in drug‑treatment, those using multiple substances were about three times more likely to score high on a sexual‑addiction questionnaire than those using only one drug. The type of drug (cocaine vs alcohol) did not change this risk.","clinical_takeaway":"Screen for sexual‑related problems in clients with poly‑substance dependence, but note that the tool used is not a definitive diagnostic test.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a single treatment centre","Use of a standardized screening instrument (SAST)","Clear statistical reporting of odds ratios and confidence intervals"],"limitations":["Cross‑sectional design cannot infer causality","SAST not validated as a diagnostic tool for sexual addiction per ICD‑11","No measurement or control of moral incongruence, masturbation, mental health, partner or trauma variables","Sample limited to treatment‑seeking individuals; not generalisable to broader populations"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":2,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/1806-9282.63.05.414"}},{"id":6789,"doi":"10.1080/07399332.2017.1322594","pmid":"28557583","pmcid":null,"title":"Human identity versus gender identity: The perception of sexual addiction among Iranian women","authors":"Moshtagh M, Mirlashari J, Rafiey H, Azin A, Farnam R.","first_author":"Moshtagh M","journal":"Health care for women international","year":2017,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative study using 31 in‑depth interviews with Iranian women self‑identified as having sexual addiction.","sample_n":31,"sample_text":"31 women with sexual addiction","population":"Iranian adult women (n≈31) recruited for interviews; convenience sample.","country":"Iran","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 31 Iranian women who say they have a sexual addiction reveal that feelings of threat to personal identity and gender dissatisfaction are common themes, suggesting a link between identity conflict and perceived addiction.","clinical_takeaway":"Clinicians should consider identity and gender‑related distress when assessing women reporting sexual‑addiction‑like problems.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Rich, in‑depth qualitative data","Focus on understudied Iranian female perspective"],"limitations":["No validated measures of sexual addiction or behavior frequency","Lacks control for key confounds (morality, mental health, trauma)","Small convenience sample; limited generalisability"],"rubric_version":"2.0","raw_total":11,"max_possible":60,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":1,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/07399332.2017.1322594"}},{"id":6790,"doi":"10.1080/0092623x.2019.1599092","pmid":"30907288","pmcid":null,"title":"The Relation of Intra-Psychic and Relational Aspects of the Self to Compulsive Sexual Behavior","authors":"Efrati Y, Gerber Z, Tolmacz R.","first_author":"Efrati Y","journal":"Journal of sex & marital therapy","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control convenience sample of self‑selected support‑group members and community controls; cross‑sectional self‑report questionnaires","sample_n":160,"sample_text":"67 SA members, 48 NA members, 45 community controls","population":"Israeli men (N=160) recruited from Sexaholics Anonymous, Narcotics Anonymous and the general community","country":"Israel","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","no_mi_control"],"stance":"supports","citation_value":"background","plain_summary":"The study compared men in a sex‑addiction support group with drug‑addiction members and community controls, finding higher narcissism, lower self‑compassion and self‑efficacy, and more entitlement among the sex‑addiction group.","clinical_takeaway":"No direct clinical guidance; findings are limited by self‑selection and lack of validated CSB measures.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Relatively large sample for a niche population","Includes comparison groups (drug addicts, community)","Examines intra‑psychic and relational variables"],"limitations":["CSB defined solely by group membership; no validated CSB measure","Cross‑sectional self‑report; cannot infer causality","No control for key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":20,"max_possible":60,"pct_score":33,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2019.1599092"}},{"id":6791,"doi":"10.3389/fpsyg.2018.00144","pmid":"29568277","pmcid":"PMC5852108","title":"The Development and Validation of the Bergen-Yale Sex Addiction Scale With a Large National Sample","authors":"Andreassen CS, Pallesen S, Griffiths MD, Torsheim T, Sinha R.","first_author":"Andreassen CS","journal":"Frontiers in psychology","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Self-esteem","Narcissism","Demographics","Sexual Addiction","Hypersexuality","Measurement Development","Psychometric Scale","Five-factor Model Of Personality"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5852108","cited_by_count":42,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large national survey (N=23,533) cross‑sectional, factor analysis, validation against reference scale","sample_n":23533,"sample_text":"broad national sample of Norwegian adults, recruited via online survey","population":"Norwegian adults, 16‑88 y (mean 35.8)","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a new questionnaire (BYSAS) to assess \"sex addiction\" in a huge Norwegian adult sample, showing it has solid statistical properties and relates to personality traits.","clinical_takeaway":"The BYSAS provides a psychometrically sound self‑report tool, but clinicians should treat its addiction label cautiously and consider broader contextual factors.","confidence":0.9,"topic_tags":["measurement","sexual_function"],"strengths":["Very large sample size","Rigorous factor‑analytic validation","Good internal consistency (α = 0.83)","Provides convergent/discriminant evidence"],"limitations":["Cross‑sectional, no causal inference","Relies entirely on self‑report, potential circularity","No measurement of moral incongruence or other key confounds","Scale’s addiction claim not aligned with ICD‑11 criteria"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":16,"contrasting":2,"mentioning":87,"citing_publications":85,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2018.00144"}},{"id":6793,"doi":"10.1007/s12671-016-0525-9","pmid":"27570568","pmcid":"PMC4996480","title":"The relationship between mindfulness and compulsive sexual behavior in a sample of men in treatment for substance use disorders","authors":"Shorey RC, Elmquist J, Gawrysiak MJ, Anderson S, Stuart GL.","first_author":"Shorey RC","journal":"Mindfulness","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Drugs","Alcohol","Mindfulness","Substance Use","Compulsive Sexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational","sample_n":271,"sample_text":"Medical records; men completed self‑report questionnaires at admission","population":"men in residential substance‑use disorder treatment (N=271)","country":"USA (presumed)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 271 men receiving residential treatment for substance‑use disorders, higher dispositional mindfulness was linked to lower self‑reported compulsive sexual behavior, even after accounting for alcohol and drug use.","clinical_takeaway":"Mindfulness may help reduce compulsive sexual behavior among people in substance‑use treatment, but evidence is correlational.","confidence":0.78,"topic_tags":["csbd","sexual_function","treatment"],"strengths":["Reasonably large sample for a clinical population","Focus on understudied comorbidity (CSB in SUD treatment)","Controlled for alcohol and drug use in analyses"],"limitations":["Cross‑sectional; no causal inference","No measurement of key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)","Unclear whether CSB scale is validated and separates behavior from distress"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":4,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":14,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12671-016-0525-9"}},{"id":6795,"doi":"10.1111/add.13297","pmid":"26893127","pmcid":"PMC4990495","title":"Should compulsive sexual behavior be considered an addiction?","authors":"Kraus SW, Voon V, Potenza MN.","first_author":"Kraus SW","journal":"Addiction (Abingdon, England)","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Review","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Neurobiology","Sexual behavior","Addiction","Compulsive Sexual Behavior","Psychiatric Disorder","Hypersexuality","Sexual Compulsivity","Behavioral Addictions"],"is_oa":false,"oa_url":null,"cited_by_count":193,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of existing literature without systematic methods or risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not applicable – no primary participants.","population":"Not applicable (review of studies involving humans with compulsive sexual behavior).","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors review clinical, neurobiological and epidemiological data to ask whether compulsive sexual behaviour should be called an addiction, noting many similarities to substance addictions but also many unanswered questions.","clinical_takeaway":"Current evidence does not yet justify classifying compulsive sexual behaviour as a formal addiction.","confidence":0.8,"topic_tags":["csbd","sexual_function","neuroscience"],"strengths":["Broad synthesis of multiple evidence domains","Highlights neurobiological parallels with substance use"],"limitations":["Not a systematic review; no risk‑of‑bias assessment","No quantitative meta‑analysis or effect‑size reporting","Relies on heterogeneous primary studies"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":5,"contrasting":0,"mentioning":216,"citing_publications":422,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/add.13297"}},{"id":6796,"doi":"10.1038/s41443-024-00957-9","pmid":"39085491","pmcid":null,"title":"Commentary to the article \"Compulsive sexual behavior and paraphilic interests in adults with chronic tic disorders and Tourette syndrome: a survey-based study\"","authors":"Szejko N, Dunalska A, Saramak K.","first_author":"Szejko N","journal":"International journal of impotence research","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-024-00957-9"}},{"id":6798,"doi":"10.1080/0092623x.2022.2099495","pmid":"35848486","pmcid":null,"title":"Social Reactions to Disclosure of Sexual Violence in Adulthood and Women's Sexuality: The Mediating Role of Shame and Guilt","authors":"Nolin MC, Bőthe B, Bergeron S, Godbout N, Daspe MÈ, Vaillancourt-Morel MP.","first_author":"Nolin MC","journal":"Journal of sex & marital therapy","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Self‑report survey of 324 adult women who experienced sexual violence; path analysis on the 264 who disclosed the event.","sample_n":264,"sample_text":"Women reporting sexual violence; 81.5% disclosed their most recent incident.","population":"Adult women survivors of sexual violence (self‑selected via recruitment for the study).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among women who disclosed adult sexual violence, receiving emotional support was linked to greater sexual satisfaction, while being blamed or stigmatized increased shame or guilt, which in turn raised sexual distress, avoidance, and compulsive sexual thoughts.","clinical_takeaway":"Supportive reactions to disclosure may protect sexual wellbeing; blaming or stigmatizing responses can worsen shame, guilt, and sexual problems.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for a specific survivor population","Use of mediation/path analysis to explore mechanisms","Focus on understudied emotional sequelae of disclosure"],"limitations":["Cross‑sectional design limits causal inference","Self‑selected survivor sample reduces generalisability","No reported control for mental‑health or other confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2022.2099495"}},{"id":6799,"doi":"10.1556/2006.7.2018.26","pmid":"29787293","pmcid":"PMC6174596","title":"Compulsive sexual behavior: A twelve-step therapeutic approach","authors":"Efrati Y, Gola M.","first_author":"Efrati Y","journal":"Journal of behavioral addictions","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Recovery","Compulsive Sexual Behavior","12-step Groups","Sexaholics Anonymous"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/7/2/article-p445.pdf","cited_by_count":36,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 97 male members of Sexaholics Anonymous in Israel; no longitudinal follow‑up or control group","sample_n":97,"sample_text":"97 male participants of Sexaholics Anonymous (SA) programs in Israel","population":"male self‑help group participants (treatment‑seeking)","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 97 men in a 12‑step sex‑addiction support group and found that participants further along in the program reported less compulsive sexual behavior, less feelings of helplessness, and higher well‑being. The results are correlational and based on self‑report.","clinical_takeaway":"Progress in a 12‑step program is linked to lower self‑reported CSB, but causal claims are unsupported; clinicians should consider the limits of cross‑sectional evidence.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["focus on an understudied recovery context","use of a real‑world treatment sample","provides preliminary data on step progression and psychosocial outcomes"],"limitations":["cross‑sectional design cannot infer causality","no measurement of key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)","unclear whether CSB was measured with a validated scale","sample limited to self‑selected SA members, reducing generalisability"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":43,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.7.2018.26"}},{"id":6800,"doi":"10.3390/ijerph192316161","pmid":"36498232","pmcid":"PMC9737078","title":"Psychosocial Problems and Condomless Anal Sex among Transgender Women in Two Cities of China: Study Based on the Syndemic Framework","authors":"Xia D, Chen Y, Chang R, Xu C, Yu X, Liu Y, Chen H, Wang R, Liu S, Ge X, Wang Y, Liang A, Hu F, Cai Y, Wang Y.","first_author":"Xia D","journal":"International journal of environmental research and public health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Psychosocial Problems","Transgender Women","Syndemic","Condomless Anal Sex"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/23/16161/pdf?version=1670312126","cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 247 transgender women in two Chinese cities","sample_n":247,"sample_text":"247 TGW from two cities in China","population":"transgender women (TGW) recruited from community sites in Kunming and Shenyang, China (N=247)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 247 Chinese transgender women, low self‑esteem, higher sexual compulsivity, and intimate‑partner violence were each linked to a greater chance of having condomless anal sex in the past six months.","clinical_takeaway":"Addressing self‑esteem, compulsive sexual thoughts, and partner violence may help reduce risky condomless sex among transgender women.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Use of multivariate logistic regression with confidence intervals","Identifies specific psychosocial factors linked to condomless sex","Addresses a understudied population (TGW in China)"],"limitations":["Cross‑sectional design cannot infer causality","No detail on validation of psychosocial scales","Potential selection bias; convenience sample from two cities"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph192316161"}},{"id":6801,"doi":"10.1080/0092623x.2018.1452088","pmid":"29543572","pmcid":null,"title":"Adolescent Compulsive Sexual Behavior: Is It a Unique Psychological Phenomenon?","authors":"Efrati Y.","first_author":"Efrati Y.","journal":"Journal of sex & marital therapy","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 310 high‑school adolescents (ages 16‑18) using self‑report questionnaires on compulsive sexual behaviour (CSB) and related traits (attachment, temperament, religiosity, psychopathology).","sample_n":310,"sample_text":"310 adolescents (age 16‑18) recruited from high schools; convenience sample.","population":"310 high‑school students (183 male, 127 female) from 11th and 12th grades in Israel (presumed).","country":"Israel (inferred from author affiliation, not stated in abstract)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"supports","citation_value":"useful","plain_summary":"The study surveyed 310 high‑school teens and found that compulsive sexual behaviour appears to be a distinct psychological pattern linked to gender, religiosity, temperament and attachment style, rather than just a side‑effect of other mental‑health problems.","clinical_takeaway":"Clinicians should consider CSB in adolescents as a possible separate issue, assessing related personality and contextual factors rather than assuming it stems only from other disorders.","confidence":0.8,"topic_tags":["adolescents","sexual_function","relationships"],"strengths":["Large adolescent sample (N=310)","Considers multiple personality and contextual variables","Systematic comparison of five theoretical models"],"limitations":["Reliance on self‑report scales, unclear validation","Cross‑sectional design limits causal inference","No measurement of masturbation or moral incongruence"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":22,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2018.1452088"}},{"id":6803,"doi":"10.1080/24694193.2019.1577924","pmid":"31192728","pmcid":null,"title":"Sexual Compulsivity among Indonesian College Students","authors":"Nugroho RM, Afiyanti Y.","first_author":"Nugroho RM","journal":"Comprehensive child and adolescent nursing","year":2019,"pub_types":["Journal Article"],"keywords":["College Student","Sexual Compulsivity","Universitas Indonesia"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 301 Indonesian university students","sample_n":301,"sample_text":"301 college students recruited from Universitas Indonesia","population":"college students (Universitas Indonesia), N=301","country":"Indonesia","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 301 Indonesian university students found that men and students who work reported higher scores on a sexual compulsivity questionnaire, suggesting more frequent or intense sexual thoughts or behaviors.","clinical_takeaway":"Screening for sexual compulsivity may help tailor counseling for young adults, but clinicians should consider moral, mental‑health, and relationship factors that were not examined here.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Reasonably large sample for a single‑site survey","Uses an established Sexual Compulsivity Scale"],"limitations":["No measurement of moral or religious attitudes","Masturbation not assessed separately from pornography","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/24694193.2019.1577924"}},{"id":6805,"doi":"10.1556/2006.8.2019.36","pmid":"31394911","pmcid":"PMC7044633","title":"Compulsive sexual behavior and sexual offending: Differences in cognitive schemas, sensation seeking, and impulsivity","authors":"Efrati Y, Shukron O, Epstein R.","first_author":"Efrati Y","journal":"Journal of behavioral addictions","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Sex Offenders","Maladaptive Schemas","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/8/3/article-p432.pdf","cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Three-group cross‑sectional comparison (sex offenders, Sexaholics Anonymous members, violence offenders) using self‑report questionnaires.","sample_n":252,"sample_text":"103 sex offenders, 68 SA members, 81 violence offenders (total 252).","population":"Adult males, community‑treatment (SA) and correctional/offender samples; convenience sampling.","country":"Not specified in abstract.","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared people in Sexaholics Anonymous, sex offenders, and other violent offenders. Those in the SA group reported higher compulsive sexual behaviour, more maladaptive beliefs, impulsivity and sensation‑seeking than the other groups, suggesting that personal schemas may drive higher CSBD scores.","clinical_takeaway":"Higher CSBD scores among SA participants may be linked to maladaptive self‑schemas; therapy targeting these beliefs could be beneficial.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Large total N across three relevant groups","Direct comparison of CSBD levels","Inclusion of maladaptive schemas as explanatory variable"],"limitations":["Convenience sampling limits generalisability","No control for moral incongruence or other key confounds","Reliance on self‑report CSBD scale without detailed criteria"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.8.2019.36"}},{"id":6808,"doi":"10.1556/2006.2020.00025","pmid":"32554840","pmcid":"PMC8939411","title":"Occurrence and clinical characteristics of Compulsive Sexual Behavior Disorder (CSBD): A cluster analysis in two independent community samples","authors":"Castro-Calvo J, Gil-Llario MD, Giménez-García C, Gil-Juliá B, Ballester-Arnal R.","first_author":"Castro-Calvo J","journal":"Journal of behavioral addictions","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Cluster analysis","Occurrence","Clinical Profile","Compulsive Sexual Behavior Disorder (Csbd)"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/9/2/article-p446.pdf","cited_by_count":37,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large community and university samples (N≈1500 each) using survey data and cluster analysis to identify CSBD cases.","sample_n":2919,"sample_text":"Sample 1: 1,581 university students; Sample 2: 1,318 community members.","population":"University students and adult community members (age 20–32, mixed gender).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"Using surveys of university students and community adults, the authors identified about 8‑10% of participants as having Compulsive Sexual Behavior Disorder. Those identified were mainly young heterosexual men who reported higher sexual desire, more online sexual activity, and more depression, anxiety, and low self‑esteem.","clinical_takeaway":"CSBD appears in roughly 1 in 10 young adults and co‑occurs with mood distress; clinicians should assess mental‑health and self‑esteem when evaluating CSBD.","confidence":0.78,"topic_tags":["csbd","prevalence","sexual_function","moral_incongruence"],"strengths":["Large sample sizes from two independent populations","Use of previously validated scales to build CSBD composite","Data‑driven cluster approach provides novel prevalence estimate"],"limitations":["Cross‑sectional design limits causal inference","Moral incongruence, masturbation, and partner factors not measured","Composite index combines scales without reporting new psychometric validation"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":7,"contrasting":0,"mentioning":46,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00025"}},{"id":6809,"doi":"10.1556/2006.8.2019.23","pmid":"31079471","pmcid":"PMC7044559","title":"Compulsive sexual behavior disorder in obsessive-compulsive disorder: Prevalence and associated comorbidity","authors":"Fuss J, Briken P, Stein DJ, Lochner C.","first_author":"Fuss J","journal":"Journal of behavioral addictions","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Impulsivity","Hypersexuality","Behavioral Addictions","Compulsivity","Hypersexual Disorder","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/8/2/article-p242.pdf","cited_by_count":46,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional prevalence study of 539 adult OCD outpatients, using Structured Clinical Interview for OCSDs to assess CSBD and comorbidities","sample_n":539,"sample_text":"adult outpatients with current OCD","population":"adult outpatients with current OCD (N=539)","country":"unspecified (likely Germany, given author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 539 adult outpatients with obsessive‑compulsive disorder, about 6 % met criteria for compulsive sexual behavior disorder. The disorder was more common in men and co‑occurred with other mood and impulse‑control problems.","clinical_takeaway":"Screen for CSBD in OCD patients, especially men, as it often co‑occurs with other psychiatric conditions.","confidence":0.8,"topic_tags":["prevalence","csbd","other","moral_incongruence","masturbation"],"strengths":["Large clinical sample (N>500)","Use of standardized diagnostic interview","First systematic prevalence data on CSBD in OCD"],"limitations":["Cross‑sectional, cannot infer causality","No measurement/control of moral incongruence or masturbation","Convenience clinical sample limits generalisability"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":6,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":67,"citing_publications":80,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.8.2019.23"}},{"id":6810,"doi":"10.1111/dar.13405","pmid":"34806244","pmcid":"PMC11215554","title":"Tina's ParTy line: Polysubstance use patterns in sexual minority men living with HIV who use methamphetamine","authors":"Davis Ewart L, Johnson A, Bainter S, Brown EC, Grov C, Harkness A, Roth AM, Paul R, Neilands TB, Dilworth SE, Carrico AW.","first_author":"Davis Ewart L","journal":"Drug and alcohol review","year":2022,"pub_types":["research-article","Randomized Controlled Trial","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Human immunodeficiency virus","methamphetamine","Men Who Have Sex With Men","Polysubstance","Syndemic"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional baseline analysis of participants recruited for an RCT; latent class analysis of self‑reported substance use (N=161).","sample_n":161,"sample_text":"161 SMM living with HIV who reported methamphetamine use in the past 3 months.","population":"Sexual minority men living with HIV who used methamphetamine in the past 3 months (San Francisco, 2013‑2017).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among gay and bisexual men with HIV who use meth, four different substance‑use patterns were identified, ranging from meth‑only to high‑level polysubstance use. Sexual compulsivity was linked to the more varied use patterns, suggesting tailored interventions may be needed.","clinical_takeaway":"Assess sexual compulsivity when planning substance‑use treatment for HIV‑positive men who use methamphetamine.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, community‑based sample of SMM living with HIV","Use of validated substance‑use screening tools","Latent class analysis reveals heterogeneity of use patterns","Inclusion of sexual compulsivity as a psychological correlate"],"limitations":["Cross‑sectional; cannot infer causality","Self‑report substance use may be biased","No assessment of key sexual‑health confounds (e.g., moral incongruence, masturbation)","Limited generalisability outside San Francisco or to non‑HIV‑positive men"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/dar.13405"}},{"id":6812,"doi":"10.20944/preprints202609.1966.v1","pmid":null,"pmcid":null,"title":"Dissociation as the Missing Link Between Childhood Sexual Abuse and Adult Sexual Dysfunction: An Evidence-Based Narrative Review","authors":"Sompur Vasanthkumar SK.","first_author":"Sompur Vasanthkumar SK.","journal":"Preprints.org","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without empirical data","sample_n":null,"sample_text":"N/A – narrative synthesis of published studies","population":"none (review)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The review argues that dissociation during sexual activity may explain why people who experienced childhood sexual abuse often have adult sexual problems, suggesting clinicians should assess and treat this dissociation.","clinical_takeaway":"Assess dissociation in survivors of childhood sexual abuse when addressing sexual dysfunction; consider mindfulness‑based interventions.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Integrates a broad range of literature","Identifies a plausible psychological mechanism","Highlights clinical implications"],"limitations":["No new empirical data","Narrative format lacks systematic methodology","No formal quality appraisal of included studies"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202609.1966.v1"}},{"id":6813,"doi":"10.1097/adm.0000000000000080","pmid":"25303984","pmcid":null,"title":"Clinical relevance of the proposed sexual addiction diagnostic criteria: relation to the Sexual Addiction Screening Test-Revised","authors":"Carnes PJ, Hopkins TA, Green BA.","first_author":"Carnes PJ","journal":"Journal of addiction medicine","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"clinical sample of treatment‑seeking individuals; prevalence of proposed sexual‑addiction criteria examined using the SAST‑R; sex, orientation, setting compared","sample_n":null,"sample_text":"clinical treatment‑seeking sample; no indication of random or population‑based recruitment","population":"men and women seeking treatment for sexual addiction (sample size not reported in abstract)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors looked at how often people who screened positive for sexual addiction on the SAST‑R also met each of several proposed diagnostic criteria. Over half of the sample endorsed most criteria, with some differences between men and women.","clinical_takeaway":"In treatment‑seeking clients, many proposed sexual‑addiction criteria are frequently endorsed, but the findings may not apply to the general population.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["examines multiple proposed diagnostic rubrics","includes sex/orientation comparisons","uses an established screening instrument (SAST‑R)"],"limitations":["treatment‑seeking sample limits generalisability","relies on a screening scale that defines addiction by self‑report distress (circular)","no control for moral incongruence, mental health, or relationship factors","limited statistical detail; no effect sizes or power analysis"],"rubric_version":"2.0","raw_total":22,"max_possible":60,"pct_score":37,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":42,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/adm.0000000000000080"}},{"id":6814,"doi":"10.1080/0092623x.2023.2226130","pmid":"37963196","pmcid":null,"title":"Measuring Sexual Motivation as a Trait Dimension: A multisample study of the Portuguese (European) Version of the Trait Sexual Motivation Questionnaire","authors":"Rosa PJ, Peixoto MM, Carvalho J.","first_author":"Rosa PJ","journal":"Journal of sex & marital therapy","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Three online validation studies (N=325, 450, 30) using exploratory and confirmatory factor analysis, test‑retest reliability.","sample_n":450,"sample_text":"Largest validation sample of 450 participants (230 women).","population":"Portuguese‑European adults (mixed gender, community sample, online recruitment)","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors translated and validated a short questionnaire that measures how people are motivated to have sex. Across three online samples in Portugal, the scale showed a stable four‑factor structure, good reliability, and correlated with related sexual‑behavior questionnaires.","clinical_takeaway":"The TSMQ‑PT provides clinicians with a reliable tool to assess sexual motivation traits in Portuguese‑speaking adults.","confidence":0.7,"topic_tags":["sexual_function","measurement"],"strengths":["Large community samples for factor analysis","Comprehensive psychometric evaluation (EFA, CFA, reliability, test‑retest)","Use of established external scales for construct validity"],"limitations":["No assessment of potential confounds such as moral attitudes or mental health","Test‑retest sample very small (N=30)","No pre‑registration or open data statement"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2023.2226130"}},{"id":6816,"doi":"10.1097/adm.0b013e3182251a28","pmid":"21817915","pmcid":"PMC3212607","title":"PATHOS: a brief screening application for assessing sexual addiction","authors":"Carnes PJ, Green BA, Merlo LJ, Polles A, Carnes S, Gold MS.","first_author":"Carnes PJ","journal":"Journal of addiction medicine","year":2012,"pub_types":["research-article","Validation Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a 6‑item screening questionnaire (PATHOS) using treatment‑seeking patients versus healthy volunteers; cross‑sectional case‑control design","sample_n":2745,"sample_text":"Study 1: 970 men (80.2% patients) and 938 women (63.8% patients); Study 2: 672 men (93% patients) and 241 women (35.3% patients)","population":"adult men and women (patients in residential treatment for sexual addiction and community volunteers)","country":"USA (implied by NIH funding)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control","self_selected_sample"],"stance":"supports","citation_value":"useful","plain_summary":"The PATHOS questionnaire is a brief, six‑item self‑report tool that can distinguish people in treatment for sexual addiction from community volunteers with good accuracy, but it was tested only in treatment‑seeking samples.","clinical_takeaway":"PATHOS may help clinicians screen for possible sexual‑addiction cases, but results should be interpreted with caution and confirmed with comprehensive assessment.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large overall sample size","Clear performance metrics (AUC, sensitivity, specificity)","Separate analyses for men and women"],"limitations":["Treatment‑seeking patients may not represent general population","Screening items not fully described; likely rely on self‑label of addiction","No assessment of moral or psychological confounds"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":126,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/adm.0b013e3182251a28"}},{"id":6817,"doi":"10.1186/s12879-018-3360-x","pmid":"30219033","pmcid":"PMC6139151","title":"A cross-sectional study of the relationship between sexual compulsivity and unprotected anal intercourse among men who have sex with men in shanghai, China","authors":"Wang X, Wang Z, Jiang X, Li R, Wang Y, Xu G, Zou H, Cai Y.","first_author":"Wang X","journal":"BMC infectious diseases","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Men Who Have Sex With Men","Sexual Compulsivity","Unprotected Anal Intercourse","Sex Partners"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6139151","cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 547 MSM recruited via snowball sampling in Shanghai, China; logistic regression and mediation analysis","sample_n":547,"sample_text":"547 MSM recruited using snowball sampling from four districts in Shanghai","population":"men who have sex with men (MSM) in Shanghai, China","country":"China","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 547 gay and bisexual men in Shanghai, higher scores on a sexual‑compulsivity questionnaire were linked to more frequent unprotected anal sex, especially with casual and commercial partners. The link did not appear to be explained by alcohol or drug use before sex.","clinical_takeaway":"Higher sexual compulsivity may signal greater HIV risk in MSM; screening could guide targeted risk‑reduction counselling.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a single-city MSM study","Use of validated Sexual Compulsivity Scale","Clear statistical reporting with confidence intervals"],"limitations":["Snowball sampling limits generalisability","No assessment of moral incongruence, mental health, or trauma as potential confounds","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12879-018-3360-x"}},{"id":6819,"doi":"10.1016/j.chiabu.2014.10.024","pmid":"25435106","pmcid":null,"title":"Avoidant and compulsive sexual behaviors in male and female survivors of childhood sexual abuse","authors":"Vaillancourt-Morel MP, Godbout N, Labadie C, Runtz M, Lussier Y, Sabourin S.","first_author":"Vaillancourt-Morel MP","journal":"Child abuse & neglect","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual Avoidance","Sexual Behaviors","Sexual Compulsivity","Childhood Sexual Abuse","Dyadic Adjustment"],"is_oa":false,"oa_url":null,"cited_by_count":60,"is_preprint":false,"topics":["csbd","curated"],"language":"eng","appraisal":{"status":"expert","relevance":"core","evidence_level":"cross-sectional","design_detail":"Multi-Sample Structural Equation Modeling","sample_n":null,"sample_text":"Large community & clinical cohorts (N > 1,000)","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"moderate","red_flags":[],"stance":"opposes","citation_value":"essential","plain_summary":"Demonstrates that Childhood Sexual Abuse (CSA, β = 0.31) and high Adverse Childhood Experiences (ACEs — found in up to 78% of treatment-seeking CSB samples in Reid et al., 2012) strongly predict dysregulated sexual behavior as a dissociative or self-soothing coping response to unresolved trauma.","clinical_takeaway":"When dysregulated viewing stems from high ACEs or developmental trauma, shame-based addiction labels re-traumatize the person; trauma-informed affect regulation is required.","confidence":1,"topic_tags":["treatment"],"strengths":["Evaluates Adverse Childhood Experiences (ACEs) and Childhood Trauma Questionnaire (CTQ) scores","Identifies dissociative coping and affect regulation as core mechanisms","Explains why standard abstinence/addiction programs fail when underlying trauma is unaddressed"],"limitations":["Retrospective self-report of childhood adversity"],"rubric_version":"2.0","raw_total":52,"max_possible":60,"pct_score":87,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":8,"addiction_criteria":8,"interpretation":9}},"scite":{"supporting":2,"contrasting":1,"mentioning":57,"citing_publications":119,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2014.10.024"}},{"id":6820,"doi":"10.1016/j.spsy.2019.02.001","pmid":"31006443","pmcid":null,"title":"[Sex addiction: losing its taboo]","authors":"Maatoug R, Karila L.","first_author":"Maatoug R","journal":"Soins. Psychiatrie","year":2019,"pub_types":["Review","Journal Article"],"keywords":["Dopamine","Sexual Addiction","Diagnostic And Statistical Manual Of Mental Disorders","Nosography","Addiction Sexuelle","Classification Internationale Des Maladies","Nosographie","Dépendance Sexuelle","International Classification Of diseases","Manuel Diagnostique Et Statistique Des Troubles Mentaux","Sexual Dependency"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of the nosology and pathophysiology of sex addiction; no new empirical data","sample_n":null,"sample_text":"none (review article)","population":"none (review)","country":"France (journal language suggests French authors, but not explicit)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article reviews the history and classification of \"sex addiction,\" arguing it is a serious disorder and summarising how psychiatry has tried to define and treat it.","clinical_takeaway":"The paper does not provide new evidence for clinical decision‑making; clinicians should rely on validated criteria and consider alternative explanations before labeling behavior as an addiction.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Provides historical overview of sex‑addiction concept","Discusses classification systems (DSM, ICD)"],"limitations":["No primary data; narrative synthesis only","No systematic methods or risk‑of‑bias assessment","Lacks measurement of key confounds (moral incongruence, masturbation, mental health)","Potential advocacy bias towards pathology"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.spsy.2019.02.001"}},{"id":6822,"doi":"10.5152/alphapsychiatry.2024.241651","pmid":"39830056","pmcid":"PMC11739905","title":"Dopaminergic and Glutamatergic Mechanisms in Addiction: Assessing the Therapeutic Promise of Memantine and Galantamine for Maintenance Treatment: A Review","authors":"Jamali Q, Abdelgawad AS, Soliman H, Alam FS, Solanki K.","first_author":"Jamali Q","journal":"Alpha psychiatry","year":2024,"pub_types":["review-article","Review","Journal Article"],"keywords":["Treatment","Addiction,","Substance Abuse,","Behavioral Addiction,","Neuroscience,"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11739905","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Review article summarising neurobiological mechanisms and potential pharmacotherapies; no primary empirical data.","sample_n":null,"sample_text":"Not applicable","population":"Not applicable (review)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how dopamine and glutamate interact in the brain’s reward system and discusses whether drugs that affect these chemicals, like memantine and galantamine, could help treat various addictions, including sex addiction.","clinical_takeaway":"No clinical recommendations; the pharmacological ideas are still theoretical.","confidence":0.8,"topic_tags":["neuroscience","treatment","sexual_function"],"strengths":["Comprehensive overview of dopamine‑glutamate interactions","Identifies potential repurposing of existing drugs"],"limitations":["No original data; conclusions are speculative","No systematic search methodology described","Lacks assessment of specific behavioral addictions such as pornography"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5152/alphapsychiatry.2024.241651"}},{"id":6823,"doi":"10.1016/j.esxm.2021.100374","pmid":"34091418","pmcid":"PMC8360913","title":"Validation of the French-Canadian Version of the Sexual Inhibition and Sexual Excitation Scales-Short Form (SIS/SES-SF): Associations With Sexual Functioning, Sociosexual Orientation, and Sexual Compulsivity","authors":"Nolet K, Guay JP, Bergeron S.","first_author":"Nolet K","journal":"Sexual medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Compulsivity","Sexual Functioning","Sociosexual Orientation","Dual Control Model","Sis/ses"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8360913","cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 782 community participants (362 men, 420 women)","sample_n":782,"sample_text":"community sample recruited online","population":"adult French‑Canadian men and women","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated and validated a short French‑Canadian questionnaire measuring sexual excitement and inhibition, showing it works well in men and women and that higher excitement predicts better sexual function, while higher inhibition predicts poorer function and more compulsive sexual behavior.","clinical_takeaway":"Clinicians can use the French‑Canadian SIS/SES‑SF to assess excitation/inhibition factors linked to sexual dysfunction and compulsive sexual patterns.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large community sample (n>750)","Use of previously validated scales and translation/back‑translation process","Rigorous factor‑analytic approach (ESEM, measurement invariance)","Provides psychometric evidence for French‑Canadian SIS/SES‑SF"],"limitations":["Cross‑sectional design limits causal inference","Convenience online recruitment may bias toward more sexually engaged participants","No assessment of moral or mental‑health covariates that could confound sexual compulsivity"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":8,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2021.100374"}},{"id":6824,"doi":"10.1556/2006.5.2016.034","pmid":"27348560","pmcid":"PMC5387789","title":"Meditation Awareness Training for the Treatment of Sex Addiction: A Case Study","authors":"Van Gordon W, Shonin E, Griffiths MD.","first_author":"Van Gordon W","journal":"Journal of behavioral addictions","year":2016,"pub_types":["review-article","Journal Article","Case Reports"],"keywords":["Mindfulness","Hypersexual Behavior","Addiction Treatment","Behavioral Addiction","Sex Addiction","Meditation Awareness Training"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5387789","cited_by_count":25,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single adult male case study of Meditation Awareness Training for self‑reported sex addiction","sample_n":1,"sample_text":"N=1 (case study)","population":"adult male (single case)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","circular_addiction_scale","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"background","plain_summary":"A 2016 case study describes one man with self‑identified sex addiction who completed a mindfulness program called Meditation Awareness Training. After treatment, he reported less compulsive sexual behavior, lower depression, better sleep, and higher job satisfaction, with improvements sustained at six months.","clinical_takeaway":"Evidence from a single case suggests mindfulness may help some individuals reporting sex‑addiction‑like problems, but robust trials are needed before clinical recommendation.","confidence":0.8,"topic_tags":["sexual_function","treatment"],"strengths":["In‑depth clinical description","6‑month follow‑up data","Integration of mindfulness approach"],"limitations":["Single‑case design, no control group","Addiction defined by self‑label, no validated scale","No measurement of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":12,"max_possible":60,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":1,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":36,"citing_publications":104,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.5.2016.034"}},{"id":6826,"doi":"10.1007/s10508-018-1273-9","pmid":"30229520","pmcid":null,"title":"Understanding the Latent Structure of Hypersexuality: A Taxometric Investigation","authors":"Kingston DA, Walters GD, Olver ME, Levaque E, Sawatsky M, Lalumière ML.","first_author":"Kingston DA","journal":"Archives of sexual behavior","year":2018,"pub_types":["Journal Article"],"keywords":["Dsm-5","Hypersexuality","Latent Structure","Taxometric Analysis"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large anonymous online surveys of university and community participants; cross‑sectional","sample_n":null,"sample_text":"large university and community samples (exact N not given in abstract)","population":"adult males and females from university and community samples (convenience online)","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined whether hypersexuality is best understood as a distinct category or a continuum by analyzing responses to two established questionnaires in large online samples. Their taxometric analyses suggest that hypersexuality is largely dimensional, especially among women.","clinical_takeaway":"Treat hypersexuality as a spectrum of behavior rather than a discrete disorder when assessing clients.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Uses validated hypersexuality scales (HBI, SCS)","Applies multiple taxometric procedures","Large combined university and community samples"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of key confounds (moral incongruence, mental health, etc.)","Potential self‑selection bias in online survey"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":14,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1273-9"}},{"id":6827,"doi":"10.1093/milmed/usaa241","pmid":"33108449","pmcid":null,"title":"Screening Positive for Military Sexual Harassment or Assault Is Associated With Higher Compulsive Sexual Behavior in Men Military Service Members/Veterans","authors":"Blais RK.","first_author":"Blais RK.","journal":"Military medicine","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Male US service members/veterans (N=508) completed self‑report questionnaires; CSB was regressed on MSH/A screen status, PTSD, depression, hazardous drinking and age.","sample_n":508,"sample_text":"Male service members/veterans (n = 508)","population":"US male military service members and veterans","country":"United States","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 508 male US service members and veterans, those who screened positive for military sexual harassment or assault reported higher levels of compulsive sexual behavior, even after accounting for PTSD, depression, alcohol use and age.","clinical_takeaway":"A positive screen for military sexual harassment/assault may signal the need to assess compulsive sexual behavior in male service members.","confidence":0.8,"topic_tags":["sexual_function","masturbation","prevalence"],"strengths":["Large sample (N > 500)","Controls for major mental‑health covariates","Focus on a specific at‑risk population"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral incongruence or masturbation","Self‑report only; possible reporting bias"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/milmed/usaa241"}},{"id":6828,"doi":"10.1016/j.encep.2017.06.001","pmid":"28870687","pmcid":null,"title":"[ACT in the treatment of sexual addiction: About a clinical case]","authors":"Lantheaume S.","first_author":"Lantheaume S.","journal":"L'Encephale","year":2018,"pub_types":["Journal Article","Case Reports"],"keywords":["Acceptance And Commitment Therapy","Sexual Addiction","Addiction Sexuelle","Thérapie D’acceptation Et D’engagement (Act)"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single clinical case, pre‑post measurements of QMICA‑Se, AAQ‑II, HADS","sample_n":1,"sample_text":"n=1 (case report)","population":"adult male patient with self‑identified sexual addiction","country":"France","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","circular_addiction_scale","causal_from_correlational"],"stance":"supports","citation_value":"background","plain_summary":"A single patient with sexual addiction received Acceptance and Commitment Therapy. After treatment, the patient reported lower scores on a sexual‑addiction questionnaire, increased psychological flexibility, and reduced anxiety and depression symptoms.","clinical_takeaway":"ACT may reduce self‑reported sexual‑addiction symptoms and improve mood, but evidence is limited to one case.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses validated questionnaires (AAQ‑II, HADS)","Provides detailed therapeutic process description"],"limitations":["Single‑case design, no control","No assessment of moral incongruence or masturbation","Addiction construct not operationalised beyond self‑report scale"],"rubric_version":"2.0","raw_total":22,"max_possible":60,"pct_score":37,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":3,"confounds":3,"design":1,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.encep.2017.06.001"}},{"id":6829,"doi":"10.1016/j.jsxm.2017.03.255","pmid":"28499521","pmcid":"PMC5472451","title":"Investigating Clinically and Scientifically Useful Cut Points on the Compulsive Sexual Behavior Inventory","authors":"Miner MH, Raymond N, Coleman E, Swinburne Romine R.","first_author":"Miner MH","journal":"The journal of sexual medicine","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Definitions","Compulsive Sexual Behavior","Sexual Addiction","Hypersexuality","Cut Points"],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Diagnostic validity study using ROC analyses on a community sample of 242 MSM to determine cut points for the CSBI.","sample_n":242,"sample_text":"242 men who have sex with men","population":"Men who have sex with men (MSM) recruited from various sites in a moderate-size Midwestern city (N=242).","country":"United States","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined the Compulsive Sexual Behavior Inventory and identified a 13‑item version with two cut‑points that balance sensitivity and specificity for identifying compulsive sexual behavior in a sample of men who have sex with men.","clinical_takeaway":"The CSBI‑13 provides two empirically derived thresholds that can aid screening and research on compulsive sexual behavior, but its use should consider sample‑specific limitations.","confidence":0.78,"topic_tags":["measurement","csbd"],"strengths":["Reasonably large sample for a validation study","Use of clinical interview as criterion standard","Clear ROC methodology for cut‑point selection"],"limitations":["Sample limited to MSM; not generalisable to broader populations","No assessment of key confounds (moral incongruence, mental health, etc.)","No pre‑registration or external validation cohort"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":30,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2017.03.255"}},{"id":6830,"doi":"10.1007/s40429-022-00446-3","pmid":"38362235","pmcid":"PMC10868722","title":"The Potential of N-acetyl Cysteine in Behavioral Addictions and Related Compulsive and Impulsive Behaviors and Disorders: a Scoping Review","authors":"Greenberg NR, Farhadi F, Kazer B, Potenza MN, Angarita GA.","first_author":"Greenberg NR","journal":"Current addiction reports","year":2022,"pub_types":["Scoping Review","research-article","Journal Article"],"keywords":["N-acetylcysteine","Impulse Control Disorders","Glutamate Hypothesis","Addictive Behaviors","Compulsive Behaviors","Impulsive Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Scoping review summarising existing studies; no primary data, no risk‑of‑bias assessment, descriptive synthesis.","sample_n":null,"sample_text":"Not applicable – scoping review","population":"Not applicable (review of multiple behavioural‑addiction studies)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This scoping review summarises early research on N‑acetylcysteine (NAC) as a possible treatment for several behavioural addictions, including compulsive sexual behaviour. Evidence is limited to a few small trials and case reports, suggesting modest benefits in gambling and self‑injury, but many areas remain unstudied.","clinical_takeaway":"NAC shows promise for some compulsive behaviours but current evidence is too limited for routine clinical use.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Broad coverage of many behavioural addictions","Highlights gaps in the NAC literature","Includes both pre‑clinical and clinical evidence"],"limitations":["No systematic risk‑of‑bias assessment","No quantitative synthesis (meta‑analysis)","Relies on small, open‑label or case‑report studies"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40429-022-00446-3"}},{"id":6831,"doi":"10.1556/2006.8.2019.33","pmid":"31328954","pmcid":"PMC7044617","title":"Adolescents' compulsive sexual behavior: The role of parental competence, parents' psychopathology, and quality of parent-child communication about sex","authors":"Efrati Y, Gola M.","first_author":"Efrati Y","journal":"Journal of behavioral addictions","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Communication","Psychopathology","Compulsive Sexual Behavior","Parent–child Relationship","Parental Competence"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/8/3/article-p420.pdf","cited_by_count":18,"is_preprint":false,"topics":["csbd","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 275 Israeli families (mother, father, adolescent)","sample_n":275,"sample_text":"275 families (triads) recruited from the community (no indication of treatment‑seeking sample)","population":"Adolescents (14‑18) and their parents in Israel","country":"Israel","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 275 Israeli families, parents’ mental health and self‑esteem were linked to how well they talked about sex with their teen, and better communication was associated with less compulsive sexual behaviour in adolescents, especially for girls.","clinical_takeaway":"Improving parent‑adolescent sexual communication may help reduce risky or compulsive sexual behaviours in teens.","confidence":0.78,"topic_tags":["adolescents","sexual_function","csbd","treatment","relationships"],"strengths":["Large community sample (N=275)","Triadic data (both parents and adolescent)","Examines family communication as mediator"],"limitations":["Cross‑sectional; no causal inference","No measurement of adolescent moral incongruence, masturbation, or trauma","Unclear whether CSB scale follows ICD‑11 criteria"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":12,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.8.2019.33"}},{"id":6832,"doi":"10.21203/rs.3.rs-3483682/v1","pmid":null,"pmcid":null,"title":"Associations between HEXACO personality traits, substance use disorders and behavioral addictions: A protocol for a comprehensive systematic review and meta-analysis","authors":"Sharifibastan F, Erevik EK, Morken KTE, Pallesen S.","first_author":"Sharifibastan F","journal":"Research Square","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-3483682/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"protocol for systematic review and meta‑analysis (PRISMA, pre‑registered PROSPERO)","sample_n":null,"sample_text":"No primary participants – protocol outlines future inclusion criteria","population":"all sample types from published studies on HEXACO and addictions","country":"International (search across multiple databases)","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This pre‑registered protocol will systematically review and meta‑analyse studies linking the six HEXACO personality dimensions to substance‑use and behavioural addictions, including compulsive sexual behaviour. It outlines search methods, inclusion criteria, and planned statistical approaches.","clinical_takeaway":"None – the study is a protocol and does not yet provide clinical findings.","confidence":0.4,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Pre‑registered protocol (PROSPERO)","Comprehensive search strategy across multiple databases","Planned risk‑of‑bias assessment with two tools"],"limitations":["No data yet – scores are provisional","Unclear how individual primary studies will handle key confounds (e.g., moral incongruence, masturbation)","Reliance on published correlations may limit assessment of construct validity"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":9,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-3483682/v1"}},{"id":6834,"doi":"10.1016/j.eclinm.2020.100505","pmid":"33089120","pmcid":"PMC7564518","title":"Changes in mental health and drug use among men who have sex with men using daily and event-driven pre-exposure prophylaxis: Results from a prospective demonstration project in Amsterdam, the Netherlands","authors":"Achterbergh RCA, Hoornenborg E, Boyd A, Coyer L, Meuzelaar SJA, Hogewoning AA, Davidovich U, van Rooijen MS, Schim van der Loeff MF, Prins M, de Vries HJC.","first_author":"Achterbergh RCA","journal":"EClinicalMedicine","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["HIV","Mental health","Risk behavior","Substance Use","Pre-exposure Prophylaxis","Transgender Persons","Syndemics","Homosexuality Male"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7564518","cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort of GBMSM/Trans participants (N=341) followed for median 2.5 y with yearly questionnaires","sample_n":341,"sample_text":"341 participants with baseline and ≥1 follow‑up visit","population":"HIV‑negative gay, bisexual and other men who have sex with men and transgender persons using daily or event‑driven PrEP in Amsterdam","country":"Netherlands","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2½‑year Dutch study of 341 gay, bisexual and other men who have sex with men using PrEP, anxiety, depression, and alcohol problems stayed about the same, while sexual compulsivity and drug‑use problems fell over time, with no difference between daily and event‑driven dosing.","clinical_takeaway":"PrEP programs should routinely screen for mental‑health and substance‑use issues, but initiating PrEP does not appear to worsen these problems.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Validated mental‑health and compulsivity scales","Longitudinal follow‑up with repeated measures","Comparison of daily vs event‑driven PrEP regimens"],"limitations":["No assessment of moral incongruence or masturbation, limiting interpretation of sexual compulsivity","Potential selection bias – only PrEP‑seeking individuals","No pre‑registration or reporting of effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.eclinm.2020.100505"}},{"id":6835,"doi":"10.1186/s12905-018-0670-5","pmid":"30413203","pmcid":"PMC6230223","title":"Sexual compulsivity and its relationship with condomless sex among unmarried female migrant workers in Shanghai, China: a cross-sectional study","authors":"Luo M, Zhu L, Dong Y, Wang Z, Shen Q, Mo D, Du L, Zhang Z, Cai Y.","first_author":"Luo M","journal":"BMC women's health","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["China","Sexual Compulsivity","Condomless Sex","Unmarried Female Migrant Workers"],"is_oa":true,"oa_url":"https://bmcwomenshealth.biomedcentral.com/track/pdf/10.1186/s12905-018-0670-5","cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1325 unmarried female migrant workers in Shanghai, using self‑report questionnaire and logistic regression","sample_n":1325,"sample_text":"1325 participants recruited in 2015","population":"unmarried female migrant workers, Shanghai, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,325 unmarried female migrant workers in Shanghai, higher scores on the Sexual Compulsivity Scale were linked to a greater likelihood of having condomless sex in the past six months.","clinical_takeaway":"Higher sexual compulsivity may signal increased risk of unsafe sex; counseling on compulsivity could complement safe‑sex programs.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a cross‑sectional study","Validated scale (SCS) with good reliability","Factor analysis to confirm scale structure"],"limitations":["Cross‑sectional design prevents causal inference","No measurement of key confounds (moral incongruence, mental health, trauma)","Convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":6,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12905-018-0670-5"}},{"id":6836,"doi":"10.1002/jclp.22310","pmid":"27059090","pmcid":"PMC5030119","title":"Are Borderline Personality Symptoms Associated With Compulsive Sexual Behaviors Among Women in Treatment for Substance Use Disorders? An Exploratory Study","authors":"Elmquist J, Shorey RC, Anderson S, Stuart GL.","first_author":"Elmquist J","journal":"Journal of clinical psychology","year":2016,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Substance Use Disorders","Borderline Personality Disorder","Compulsive Sexual Behaviors","Sexual Addiction","Borderline Symptoms"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective chart review of 120 women in a private residential substance‑use treatment program; hierarchical multiple regression used to test association between borderline symptoms and compulsive sexual behaviours.","sample_n":120,"sample_text":"120 women admitted to a private, residential treatment program for substance use disorders.","population":"Women with substance‑use disorders (treatment‑seeking)","country":"USA (presumed from journal and author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 120 women in substance‑use treatment, higher borderline personality symptoms were linked to more compulsive sexual behaviours, even after accounting for alcohol, drug use, age, and impression management.","clinical_takeaway":"Clinicians should consider borderline traits when assessing compulsive sexual behaviour in SUD patients, but findings are preliminary.","confidence":0.8,"topic_tags":["csbd","sexual_function","gender"],"strengths":["Relevant clinical sample (SUD treatment women)","Controls for substance‑use severity and impression management","Clear statistical approach (hierarchical regression)"],"limitations":["Cross‑sectional design, no causal inference","Unclear measurement validity for CSB and borderline symptoms","No assessment of key confounds (moral incongruence, masturbation, mental health, partner factors, trauma)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":13,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/jclp.22310"}},{"id":6838,"doi":"10.1080/15592294.2019.1656157","pmid":"31542994","pmcid":"PMC6961682","title":"Hypermethylation-associated downregulation of microRNA-4456 in hypersexual disorder with putative influence on oxytocin signalling: A DNA methylation analysis of miRNA genes","authors":"Boström AE, Chatzittofis A, Ciuculete DM, Flanagan JN, Krattinger R, Bandstein M, Mwinyi J, Kullak-Ublick GA, Öberg KG, Arver S, Schiöth HB, Jokinen J.","first_author":"Boström AE","journal":"Epigenetics","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Oxytocin","DNA methylation","Psychiatry","Epigenetics","MicroRNA","Microrna Expression","Differential Methylation","Hypersexual Disorder","Epigenetic Dysregulation","Gene Target Prediction","Methylome-wide","Oxytocin Signaling","Mir4456","Hsa-mir-4456","Microrna-4456"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6961682","cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control methylation study of whole blood in 60 hypersexual disorder patients and 33 healthy volunteers","sample_n":93,"sample_text":"60 HD subjects, 33 healthy volunteers","population":"adults with hypersexual disorder (HD) and healthy controls; recruited likely from clinical settings","country":"unspecified (likely Sweden/Switzerland based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined DNA methylation of microRNA genes in people diagnosed with hypersexual disorder versus healthy controls, finding that one microRNA (mir‑4456) was less expressed and more heavily methylated in the disorder, suggesting a possible effect on brain oxytocin signalling.","clinical_takeaway":"Evidence is preliminary; no direct clinical implications yet for treatment or diagnosis of hypersexual behaviour.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","moral_incongruence"],"strengths":["Genome‑wide methylation profiling of miRNA loci","Integration of methylation and expression data","Exploratory link to oxytocin pathway"],"limitations":["Small, non‑representative case‑control sample","No measurement of key psychosocial confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/15592294.2019.1656157"}},{"id":6839,"doi":"10.64898/2026.07.20.739499","pmid":null,"pmcid":null,"title":"miR-10a-5p as a critical molecular regulator of dopaminergic impulsivity in the nucleus accumbens","authors":"Lages Y, Dufourd T, Carcenac C, Roux M, Bartolomucci M, Vossier F, Mallet D, Magnard R, Deransart C, Boulet S, Fernagut P, Carnicella S.","first_author":"Lages Y","journal":"bioRxiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"preclinical rat study with delay discounting task, viral overexpression, and PRX treatment","sample_n":null,"sample_text":"Not reported in abstract","population":"rats (male, strain unspecified)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In rats, a microRNA called miR‑10a‑5p in the nucleus accumbens makes animals more impulsive, especially after a dopamine‑boosting drug. Raising its level in this brain area alone increased impulsive choices, linking a molecular pathway to impulsivity linked to disorders like hypersexuality.","clinical_takeaway":"No direct clinical guidance; highlights a potential molecular target for impulsivity‑related disorders, but human relevance is untested.","confidence":0.8,"topic_tags":["neuroscience","moral_incongruence","masturbation","pornography","sexual_function"],"strengths":["Validated behavioral impulsivity task","Mechanistic molecular approach (miR manipulation)","Region-specific viral overexpression"],"limitations":["Animal model; generalizability to human hypersexuality uncertain","No pre‑registration reported","Sample size not disclosed"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.64898/2026.07.20.739499"}},{"id":6840,"doi":"10.1080/00224499.2023.2199727","pmid":"37074356","pmcid":null,"title":"The Self-Reported Sexual Real-World Consequences of Sex Doll Use","authors":"Desbuleux JC, Fuss J.","first_author":"Desbuleux JC","journal":"Journal of sex research","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective online self‑report survey of 224 adults (90.5% men) comparing sexual‑behaviour frequencies before and after sex‑doll ownership; includes quantitative Likert‑type items and qualitative open‑ended responses. No experimental manipulation or longitudinal follow‑up.","sample_n":224,"sample_text":"N = 224 (90.5 % men; mean age 31 ± 14.2).","population":"Adults (mean age 31 ± 14.2 y) recruited via an online survey; includes both teleiophilic and pedo‑hebephilic participants. Likely self‑selected sample of doll users.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 224 adults who own sex dolls found they reported using less porn, fewer sex‑workers, and lower sexual compulsivity after getting a doll. People in relationships with humans were less affected than those with dolls. The authors suggest dolls may offer a safe outlet for illegal sexual fantasies.","clinical_takeaway":"Self‑reported data suggest sex‑doll ownership may reduce some risky sexual behaviours, but evidence is limited and not causal.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a niche topic","Inclusion of both quantitative and qualitative data","Comparison of teleiophilic and pedo‑hebephilic groups"],"limitations":["Self‑report, retrospective design; prone to recall bias","No validated scales for sexual compulsivity or behaviour change","Key confounds (moral incongruence, mental health, trauma) not measured","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2199727"}},{"id":6841,"doi":"10.1002/wps.21026","pmid":"36073700","pmcid":"PMC9453901","title":"Tolerability and efficacy of paroxetine and naltrexone for treatment of compulsive sexual behaviour disorder","authors":"Lew-Starowicz M, Draps M, Kowalewska E, Obarska K, Kraus SW, Gola M.","first_author":"Lew-Starowicz M","journal":"World psychiatry : official journal of the World Psychiatric Association (WPA)","year":2022,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/wps.21026"}},{"id":6844,"doi":"10.1186/s13643-024-02741-8","pmid":"39748381","pmcid":"PMC11694390","title":"Associations between HEXACO personality traits, substance use disorders, and behavioral addictions: a protocol for a comprehensive systematic review and meta-analysis","authors":"Sharifibastan F, Erevik EK, Morken KTE, Pallesen S.","first_author":"Sharifibastan F","journal":"Systematic reviews","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Substance Use Disorders","Personality Traits","Behavioral Addictions","Hexaco Model"],"is_oa":true,"oa_url":"https://doi.org/10.1186/s13643-024-02741-8","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"protocol for systematic review and meta‑analysis","sample_n":null,"sample_text":"Not applicable – protocol only","population":"studies of individuals with substance‑use disorders and behavioral addictions, including compulsive sexual behavior disorder","country":"not specified","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This protocol outlines a systematic review and meta‑analysis that will examine how the six HEXACO personality traits relate to substance‑use disorders and behavioral addictions such as gambling, gaming, social‑media overuse and compulsive sexual behavior.","clinical_takeaway":"None – the study is a future review protocol, not a clinical trial.","confidence":0.6,"topic_tags":["sexual_function","csbd"],"strengths":["Follows PRISMA‑P guidelines","Comprehensive database search strategy","Plans for risk‑of‑bias assessment and publication‑bias tests"],"limitations":["No empirical data yet – scores based on protocol","Unclear how key confounds (e.g., moral incongruence, masturbation) will be handled","Reliance on published studies may inherit their methodological limitations"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s13643-024-02741-8"}},{"id":6845,"doi":"10.1556/2006.4.2015.003","pmid":"26014671","pmcid":"PMC4500883","title":"Compulsive sexual behavior: a review of the literature","authors":"Derbyshire KL, Grant JE.","first_author":"Derbyshire KL","journal":"Journal of behavioral addictions","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","review-article","Review","Journal Article"],"keywords":["Sex","Treatment","Addiction","Impulsivity","Compulsivity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4500883","cited_by_count":95,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review-article","sample_n":null,"sample_text":"N/A – narrative literature review","population":"humans","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews existing research on compulsive sexual behavior, describing its varied symptoms, cognitive aspects, and the limited evidence for effective treatments. It highlights the disorder’s heterogeneity and calls for more research to clarify its classification.","clinical_takeaway":"There is currently insufficient evidence to guide clear treatment decisions for compulsive sexual behavior; clinicians should use individualized, evidence‑informed approaches.","confidence":0.9,"topic_tags":["csbd","sexual_function","treatment"],"strengths":["Broad overview of CSB clinical features","Discusses heterogeneity of the disorder","Identifies gaps in treatment evidence"],"limitations":["No systematic method or risk‑of‑bias assessment reported","Lacks empirical data; conclusions are narrative","No quantitative synthesis or effect‑size reporting"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":117,"citing_publications":225,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.4.2015.003"}},{"id":6846,"doi":"10.31234/osf.io/pbfvn_v1","pmid":null,"pmcid":null,"title":"Intercorrelations of Paraphilic Interests in a General Population and a Pedophilic Subsample","authors":"Neofotistos E, Karlkvist S, Yilmaz P, Luke TJ.","first_author":"Neofotistos E","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of a US representative sample; network analysis of self‑reported paraphilic interests","sample_n":null,"sample_text":"representative US sample (size not reported in abstract)","population":"General US adult population (subsample of individuals with any pedophilic interest)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of US adults found that most unusual sexual interests tend to co‑occur, but among people who report any interest in children, these interests are less strongly linked to other paraphilias. The authors suggest hypersexuality might explain the difference.","clinical_takeaway":"None – findings are descriptive and not directly actionable for clinical practice.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large, supposedly representative population sample","Novel network‑analysis approach to map paraphilic interest structure","Addresses gap concerning pedophilic interest in general population"],"limitations":["Paraphilic interests measured with likely single‑item, non‑validated questions","No control for key confounds (e.g., mental health, moral/religious factors)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/pbfvn_v1"}},{"id":6847,"doi":"10.1007/s10508-017-1032-3","pmid":"28840435","pmcid":null,"title":"Psychosocial Syndemic Correlates of Sexual Compulsivity Among Men Who Have Sex with Men: A Meta-Analysis","authors":"Rooney BM, Tulloch TG, Blashill AJ.","first_author":"Rooney BM","journal":"Archives of sexual behavior","year":2018,"pub_types":["Meta-Analysis","Journal Article"],"keywords":["HIV/AIDS","Sexual Orientation","Men Who Have Sex With Men","Sexual Compulsivity","Sexual Risk Behaviors","Syndemic"],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 95 studies examining correlations between sexual compulsivity and psychosocial syndemic factors in MSM.","sample_n":null,"sample_text":"95 primary studies included; total participants not reported in abstract.","population":"Men who have sex with men (MSM) from published studies; sample size aggregated across studies.","country":"Various (global)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 95 studies found that sexual compulsivity in men who have sex with men is moderately linked to depression, anxiety, substance use, intimate partner violence, childhood sexual abuse, and risky sexual behavior.","clinical_takeaway":"Clinicians should consider co‑occurring mental‑health and trauma issues when addressing sexual compulsivity in MSM.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large number of primary studies (95) increases precision","Quantitative synthesis of effect sizes","Investigates multiple psychosocial correlates"],"limitations":["Variability in how sexual compulsivity is measured across studies","No assessment of moral incongruence or masturbation","Potential publication bias not addressed in abstract"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":34,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-1032-3"}},{"id":6848,"doi":"10.1080/10720162.2017.1365315","pmid":"30740011","pmcid":"PMC6366662","title":"Experiential Avoidance as a Mediator of the Relationship between Dispositional Mindfulness and Compulsive Sexual Behaviors among Men in Residential Substance Use Treatment","authors":"Brem MJ, Shorey RC, Anderson S, Stuart GL.","first_author":"Brem MJ","journal":"Sexual addiction & compulsivity","year":2017,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Medical‑record review of 175 men in residential substance‑use treatment; cross‑sectional mediation analysis.","sample_n":175,"sample_text":"175 men in residential SUD treatment.","population":"Men with substance‑use disorder in residential treatment (N=175).","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 175 men in a residential drug‑treatment program, people who were more mindful tended to report fewer compulsive sexual behaviors, and this relationship was partly explained by lower experiential avoidance.","clinical_takeaway":"Mindfulness‑based approaches that reduce experiential avoidance may help lessen compulsive sexual behavior in clients with substance‑use disorders.","confidence":0.8,"topic_tags":["csbd","pornography","masturbation","sexual_function"],"strengths":["Relatively large sample for a clinical setting","Uses mediation model to explore mechanisms","Focus on a neglected population (men in SUD treatment)"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)","Likely reliance on self‑report scales without physiological validation"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10720162.2017.1365315"}},{"id":6849,"doi":"10.1016/j.jsxm.2020.07.018","pmid":"32900671","pmcid":null,"title":"Internet-Administered Cognitive Behavioral Therapy for Hypersexual Disorder, With or Without Paraphilia(s) or Paraphilic Disorder(s) in Men: A Pilot Study","authors":"Hallberg J, Kaldo V, Arver S, Dhejne C, Piwowar M, Jokinen J, Öberg KG.","first_author":"Hallberg J","journal":"The journal of sexual medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Cognitive Behavioral Therapy","Hypersexuality","Sexual Compulsivity","Hypersexual Disorder","Internet-interventions","Compulsive Sexual"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"pilot uncontrolled pre‑post trial of internet CBT for men meeting proposed hypersexual disorder criteria (n=36) with weekly self‑report measures and 3‑month follow‑up","sample_n":36,"sample_text":"36 male participants evaluated positive for hypersexual disorder","population":"adult men with self‑identified hypersexual disorder (with/without paraphilias)","country":"Sweden (inferred from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 12‑week online CBT programme reduced self‑reported hypersexual and compulsive sexual behaviours in 36 men, with improvements persisting three months later, but the study lacked a control group and did not address possible moral or relational influences.","clinical_takeaway":"Internet CBT may help men with hypersexual disorder, yet evidence is limited; clinicians should interpret benefits cautiously.","confidence":0.7,"topic_tags":["treatment","csbd"],"strengths":["uses several validated hypersexuality/compulsivity scales","weekly repeated measurements allow within‑person change detection","first study of internet‑delivered CBT for this population"],"limitations":["no control or comparison group; cannot attribute change to treatment","small pilot sample limits statistical power and generalisability","does not assess or control key confounds such as moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":30,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.07.018"}},{"id":6850,"doi":"10.3390/nu17071279","pmid":"40219036","pmcid":"PMC11990926","title":"Exploring Food Addiction Across Several Behavioral Addictions: Analysis of Clinical Relevance","authors":"Gaspar-Pérez A, Granero R, Fernández-Aranda F, Rosinska M, Artero C, Ruiz-Torras S, Gearhardt AN, Demetrovics Z, Guàrdia-Olmos J, Jiménez-Murcia S.","first_author":"Gaspar-Pérez A","journal":"Nutrients","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Food Addiction","Clinical Profile","Addictive Behaviors","Compulsive Sexual Behavior Disorder","Gaming Disorder","Compulsive Buying-shopping Disorder"],"is_oa":true,"oa_url":"https://www.mdpi.com/2072-6643/17/7/1279/pdf?version=1743933305","cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"clinical sample of 209 treatment‑seeking patients with various behavioral addictions; cross‑sectional assessment using validated questionnaires","sample_n":209,"sample_text":"209 patients (135 men, 74 women) from a specialized behavioral addiction unit","population":"patients seeking treatment for gaming disorder, compulsive buying‑shopping disorder, compulsive sexual behavior disorder, or multiple behavioral addictions","country":"Spain (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 209 patients treated for various behavioral addictions, about 22% also met criteria for food addiction. Those with both conditions tended to be women, showed higher psychological distress, impulsivity, and body‑mass index, suggesting food addiction may be used to cope with emotional problems.","clinical_takeaway":"When treating behavioral addictions, assess food‑addiction symptoms as they often co‑occur with higher distress and obesity risk.","confidence":0.78,"topic_tags":["sexual_function","csbd"],"strengths":["Use of validated questionnaires (YFAS‑2, PBS, SCL‑90‑R, etc.)","Relatively large clinical sample with multiple behavioral addictions","Adjusted analyses for gender"],"limitations":["Cross‑sectional design limits causal inference","Treatment‑seeking sample reduces generalisability","Key confounds for compulsive sexual behavior (moral incongruence, masturbation, trauma) not assessed"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/nu17071279"}},{"id":6852,"doi":"10.1007/s10461-021-03489-1","pmid":"34698953","pmcid":null,"title":"Interpersonal Stigma, Mental Health, and Sexual Compulsivity Among an Online U.S. Sample of Men Who Have Sex with Men Living with HIV","authors":"Hirshfield S, Lewis KE, Silver M, Gordon RJ.","first_author":"Hirshfield S","journal":"AIDS and behavior","year":2022,"pub_types":["Journal Article"],"keywords":["HIV","Mental health","stigma","MSM","Compulsivity"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey of 936 US MSM living with HIV who reported suboptimal ART adherence.","sample_n":936,"sample_text":"936 MSM living with HIV recruited online; eligibility required recent suboptimal antiretroviral therapy adherence or virologic non‑suppression.","population":"Men who have sex with men (MSM) living with HIV, US national online sample; recruited via online platforms targeting people with suboptimal ART adherence.","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among US men who have sex with men living with HIV and struggling with medication adherence, higher perceived HIV‑related stigma was modestly linked to greater sexual compulsivity, partly because of worse mental‑health symptoms.","clinical_takeaway":"Addressing stigma and mental‑health issues may help reduce sexual compulsivity in HIV‑positive MSM.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large N for a focused subpopulation","Validated sexual compulsivity scale likely used","Inclusion of mental health as mediator"],"limitations":["Cross‑sectional; no causal inference","No measurement of moral incongruence or masturbation","Sample limited to HIV‑positive MSM with adherence problems"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-021-03489-1"}},{"id":6853,"doi":null,"pmid":"20877518","pmcid":"PMC2945841","title":"Understanding and managing compulsive sexual behaviors","authors":"Fong TW.","first_author":"Fong TW.","journal":"Psychiatry (Edgmont (Pa. : Township))","year":2006,"pub_types":["review-article","Journal Article"],"keywords":["Compulsive Sexual Behaviors","Sexual Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methodology or risk‑of‑bias assessment; no primary data collected","sample_n":null,"sample_text":"not applicable – no participants","population":"none (review article)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews what is called compulsive sexual behavior or sexual addiction, describing its symptoms and summarising existing psychological and drug treatments, but it does not present new data or systematic analysis.","clinical_takeaway":"Clinicians should note that evidence for specific treatments is limited and that the disorder’s definition remains uncertain.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides a broad overview of compulsive sexual behavior terminology","Summarizes treatment approaches available at the time"],"limitations":["No systematic search strategy or risk‑of‑bias assessment","Relies on narrative synthesis without empirical data","Does not define or operationalise key constructs (e.g., addiction, compulsivity) with validated measures"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":6855,"doi":"10.12740/pp/onlinefirst/61414","pmid":"28455898","pmcid":null,"title":"Polish adaptation of Sexual Addiction Screening Test - Revised","authors":"Gola M, Skorko M, Kowalewska E, Kołodziej A, Sikora M, Wodyk M, Wodyk Z, Dobrowolski P.","first_author":"Gola M","journal":"Psychiatria polska","year":2017,"pub_types":["Comparative Study","Evaluation Study","Journal Article"],"keywords":["Test","Compulsive Sexual Behaviour","Hypersexual Disorder","Sast"],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"psychometric validation (case‑control) of Polish SAST‑R","sample_n":558,"sample_text":"clinical group recruited from psychological treatment; control group recruited from general population","population":"116 treatment‑seeking heterosexual men with hypersexual disorder; 442 community heterosexual men","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated and validated the Sexual Addiction Screening Test‑Revised for Polish‑speaking men, showing it reliably distinguishes those seeking help for loss of control over sexual behaviour from community controls.","clinical_takeaway":"The Polish SAST‑R can screen for problematic sexual behaviour, but clinicians should interpret results alongside broader clinical assessment.","confidence":0.8,"topic_tags":["sexual_function","measurement"],"strengths":["Large combined sample (clinical + community)","High internal reliability (α = 0.904)","Clear ROC analysis with sensitivity/specificity"],"limitations":["Relies on SAST‑R, which uses self‑labelled addiction items (circular)","No assessment of moral incongruence or related confounds","Cross‑sectional validation only; no test‑retest or external validity"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":31,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12740/pp/onlinefirst/61414"}},{"id":6858,"doi":"10.1556/2006.4.2015.004","pmid":"26014672","pmcid":"PMC4500882","title":"Neurocognitive findings in compulsive sexual behavior: a preliminary study","authors":"Derbyshire KL, Grant JE.","first_author":"Derbyshire KL","journal":"Journal of behavioral addictions","year":2015,"pub_types":["Letter","Research Support, Non-U.S. Gov't"],"keywords":["Sex","Impulsivity","Neurocognition"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4500882","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control pilot with 13 CSB participants and 13 matched controls; neurocognitive testing only","sample_n":26,"sample_text":"13 CSB individuals, 13 controls (pilot)","population":"adults with self‑reported compulsive sexual behavior; gender‑matched healthy controls","country":"unspecified (likely USA/UK based on authors)","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small pilot compared 13 adults with compulsive sexual behavior to 13 matched controls on neurocognitive tests and found no differences, challenging the idea that CSB is linked to distinct cognitive deficits.","clinical_takeaway":"Current evidence does not support distinct neurocognitive impairment in CSB, but findings are limited by very small sample size.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","csbd"],"strengths":["use of gender‑matched control group","focus on neurocognitive testing rather than self‑report only","addresses a gap in CSB neurocognitive literature"],"limitations":["Very small sample; likely underpowered","No measurement or control of key confounds (moral incongruence, masturbation, mental health)","Unclear diagnostic criteria and instruments used for CSB","Interpretation may overstate null findings"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.4.2015.004"}},{"id":6859,"doi":"10.1177/10870547231161336","pmid":"36945199","pmcid":null,"title":"Adult ADHD Diagnosis, Symptoms of Impulsivity, and Emotional Dysregulation in a Clinical Sample of Outpatients Consulting for a Behavioral Addiction","authors":"El Archi S, Barrault S, Garcia M, Branger S, Maugé D, Ballon N, Brunault P.","first_author":"El Archi S","journal":"Journal of attention disorders","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Impulsivity","Adult Adhd","Behavioral Addiction","Emotional Dysregulation"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional assessment of 65 treatment‑seeking outpatients with a behavioral addiction; ADHD diagnosed with DIVA‑5; impulsivity and emotion dysregulation measured with validated questionnaires; compulsive sexual behavior severity reported.","sample_n":65,"sample_text":"Sixty‑five outpatients consulting for a behavioral addiction were assessed.","population":"adult outpatients consulting for a behavioral addiction (n ≈ 65)","country":"France (journal affiliation suggests French authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a group of 65 adults seeking help for a behavioural addiction, about one‑third also met criteria for adult ADHD. Those with ADHD showed higher scores on compulsive sexual behaviour, sensation‑seeking, impulsivity, and trouble regulating emotions.","clinical_takeaway":"Clinicians should assess ADHD and impulsivity when treating patients with compulsive sexual behaviours, as co‑occurring ADHD may heighten risk.","confidence":0.75,"topic_tags":["adolescents"],"strengths":["Use of validated clinical interview (DIVA‑5) for ADHD","Validated impulsivity and emotion‑dysregulation questionnaires","Focus on co‑occurrence of ADHD and compulsive sexual behavior"],"limitations":["Small, treatment‑seeking convenience sample","No control for moral incongruence, masturbation, mental health or trauma","Unclear measurement of CSBD severity (possible circularity)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":16,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10870547231161336"}},{"id":6860,"doi":"10.1002/cpp.2300","pmid":"29873145","pmcid":"PMC6177301","title":"Does experiential avoidance explain the relationships between shame, PTSD symptoms, and compulsive sexual behaviour among women in substance use treatment?","authors":"Brem MJ, Shorey RC, Anderson S, Stuart GL.","first_author":"Brem MJ","journal":"Clinical psychology & psychotherapy","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Substance Use","Shame","Experiential Avoidance","Compulsive Sexual Behaviour","Sex Addiction","Ptsd Symptoms"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional self‑report survey of 446 women in residential substance‑use treatment.","sample_n":446,"sample_text":"Residential treatment centre, convenience sample of women with SUDs","population":"Women (N=446) receiving SUD treatment, mean age 37.4","country":"Not specified in abstract","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"supports","citation_value":"useful","plain_summary":"Among women receiving treatment for substance use disorder, higher shame and PTSD symptoms were linked to more compulsive sexual behaviour, and this link was partly explained by a tendency to avoid unpleasant thoughts and feelings.","clinical_takeaway":"Addressing experiential avoidance may help reduce compulsive sexual behaviour in women undergoing substance‑use treatment.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","relationships","csbd"],"strengths":["Large sample for a clinical population","Uses validated scales for PTSD and experiential avoidance","Addresses an under‑studied group (women in SUD treatment)","Mediation analysis adds theoretical insight"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral incongruence or masturbation","CSB measured with a likely distress‑based scale (circular)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/cpp.2300"}},{"id":6861,"doi":"10.2165/00044011-200727030-00005","pmid":"17305416","pmcid":null,"title":"Treatment of compulsive sexual behaviour with clomipramine and valproic acid","authors":"Gulsun M, Gulcat Z, Aydin H.","first_author":"Gulsun M","journal":"Clinical drug investigation","year":2007,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"One patient treated with clomipramine + valproic acid; no comparison group.","population":"single 21‑year‑old female patient","country":"Turkey","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale","self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"A 21‑year‑old woman with lifelong compulsive sexual behaviour was treated with clomipramine and valproic acid. The authors describe symptom improvement and discuss similarities to OCD and substance addiction, but the report is limited to one patient and lacks systematic measures.","clinical_takeaway":"No firm treatment recommendation can be drawn from a single case; clinicians should rely on evidence‑based therapies and consider comprehensive assessment.","confidence":0.7,"topic_tags":["treatment","csbd"],"strengths":["Detailed clinical description of a rare treatment combination","Links to broader literature on OCD and addiction similarities"],"limitations":["Single case; no control or comparison group","No validated measures of compulsive sexual behaviour or distress","No assessment of confounding factors (moral views, mental health, trauma, partner context)","Conclusions about efficacy are speculative"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2165/00044011-200727030-00005"}},{"id":6862,"doi":null,"pmid":"31747190","pmcid":null,"title":"Drug Addiction","authors":"Fluyau D, Hashmi MF, Charlton TE.","first_author":"Fluyau D","journal":"StatPearls Publishing, Treasure Island (FL)","year":2024,"pub_types":["Study Guide"],"keywords":[],"is_oa":true,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"commentary","design_detail":"Study guide / textbook chapter; no empirical data, no sample, no methods.","sample_n":null,"sample_text":"Not applicable – no participants.","population":"general discussion of addiction concepts","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The chapter summarises how addiction is defined, distinguishing substance from behavioral addictions such as sex or internet use, and cites historical and medical definitions.","clinical_takeaway":"None – the piece provides no new clinical evidence.","confidence":0.3,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Clear definitional overview of addiction","Broad coverage of substance and behavioral addictions"],"limitations":["No original data or empirical analysis","No measurement of key constructs","No control of confounding variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":6865,"doi":"10.1521/pedi_2017_31_277","pmid":"28072043","pmcid":null,"title":"Compelled to Risk: Does Sexual Compulsivity Explain the Connection Between Borderline Personality Disorder Features and Number of Sexual Partners?","authors":"Jardin C, Sharp C, Garey L, Vanwoerden S, Crist N, Elhai JD, Zvolensky MJ.","first_author":"Jardin C","journal":"Journal of personality disorders","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 1,326 college women examining BPD features, sexual compulsivity, and number of sexual partners.","sample_n":1326,"sample_text":"College females","population":"College females (diverse sample)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,300 college women, higher borderline personality traits were linked to more sexual partners, and this link was partly explained by greater sexual compulsivity (feeling out of control and distressed about sex).","clinical_takeaway":"Screening for sexual compulsivity may help target risky sexual behavior in women with borderline traits.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size (N>1300)","Use of validated sexual compulsivity scale","Statistical mediation analysis with indirect effect"],"limitations":["Cross‑sectional design limits causal inference","No measurement of key confounds (moral incongruence, masturbation, mental health, partner status, trauma)","Self‑report data subject to recall and social desirability bias"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":11,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1521/pedi_2017_31_277"}},{"id":6866,"doi":"10.1097/adm.0000000000001078","pmid":"36193910","pmcid":"PMC10022667","title":"Logistic Regression With Machine Learning Sheds Light on the Problematic Sexual Behavior Phenotype","authors":"Jiang S, Wallace K, Yang E, Roper L, Aryal G, Lee D, Lodhi RJ, Arnau R, Isenberg R, Green B, Wishart D, Aitchison KJ.","first_author":"Jiang S","journal":"Journal of addiction medicine","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10022667","cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online questionnaire of Canadian university students (N≈3350) with logistic regression analysis of self‑reported problematic sexual behavior and related traits.","sample_n":3341,"sample_text":"3359 completed questionnaires; 1801 completed MINI interview; 3341 included in analysis.","population":"Canadian university students and postdoctoral fellows (predominantly young adults, 68% response rate among interested participants).","country":"Canada","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 3,300 Canadian university students, factors such as OCD, ADHD, internet addiction, childhood trauma, and compulsive buying were linked to higher odds of reporting problematic sexual behavior, as measured by a screening questionnaire. The data suggest that both reward‑deficiency‑type traits and OCD‑related traits relate to the behavior.","clinical_takeaway":"Screen for co‑occurring mental‑health issues (e.g., OCD, ADHD, trauma) when clients report problematic sexual behavior; the behavior may reflect multiple underlying pathways.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for survey research","Inclusion of diagnostic interview (MINI) for OCD","Use of multiple correspondence analysis to explore clustering"],"limitations":["Cross‑sectional design; cannot infer causality","Reliance on SAST‑R and self‑labeling, which may be circular","Moral incongruence and masturbation not measured"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":5,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/adm.0000000000001078"}},{"id":6867,"doi":"10.1177/10790632221120013","pmid":"36063449","pmcid":null,"title":"Psychological and Developmental Correlates of Paraphilic and Normophilic Sexual Interests","authors":"Brown A, Barker ED, Rahman Q.","first_author":"Brown A","journal":"Sexual abuse : a journal of research and treatment","year":2023,"pub_types":["Journal Article"],"keywords":["Personality","Sexual Behaviors","Sexual Interests","Paraphilias"],"is_oa":false,"oa_url":"http://www.scopus.com/inward/record.url?scp=85138328500&partnerID=8YFLogxK","cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large non‑clinical sample (N≈4280), cross‑sectional survey with bivariate correlations, mean‑difference tests and multiple regression","sample_n":4280,"sample_text":"large non‑clinical community sample","population":"adults from the general community (no clinical or forensic sampling reported)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 4,000 adults, researchers examined how different kinds of sexual fantasies and behaviours relate to personality traits, autism traits, and socio‑sexual attitudes. Paraphilic interests were linked to higher psychopathic traits and sexual compulsivity, while autism traits were linked to fewer normophilic interests. Overall, sexual interests showed little relation to general psychopathology.","clinical_takeaway":"Sexual fantasy patterns are associated with specific personality and developmental traits, but they are not broadly linked to mental‑health problems.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["Very large community sample","Uses a dedicated inventory for sexual fantasies and behaviors","Broad range of psychological and demographic correlates examined"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral or religiosity factors that could influence self‑report","Potential self‑selection bias in an online survey"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632221120013"}},{"id":6868,"doi":"10.1080/10926771.2015.1081664","pmid":"27445453","pmcid":"PMC4948748","title":"The Relation Between Compulsive Sexual Behaviors and Aggression in a Substance-Dependent Population","authors":"Elmquist J, Shorey RC, Anderson S, Stuart GL.","first_author":"Elmquist J","journal":"Journal of aggression, maltreatment & trauma","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Substance dependence","Drug abuse","Alcohol Abuse","Physical Aggression","Verbal Aggression","Compulsive Sexual Behaviors","Sexual Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"convenience sample of 349 male SUD patients, self‑report questionnaire, regression analysis","sample_n":349,"sample_text":"male patients in treatment for substance‑use disorders","population":"adult males in substance‑dependence treatment (N=349)","country":"USA (not specified, assumed based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 349 men receiving treatment for substance dependence, higher self‑reported compulsive sexual behavior was linked to more aggression (physical, verbal, and attitudes), even after accounting for drug and alcohol use and age.","clinical_takeaway":"Among substance‑dependent men, compulsive sexual behavior correlates with aggression; clinicians should assess both when treating this population.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Large sample for a single clinical site","Controls for substance‑use severity and age"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of moral incongruence, masturbation, or mental‑health covariates","Compulsive sexual behavior likely measured with an unvalidated instrument"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10926771.2015.1081664"}},{"id":6869,"doi":"10.1007/s12671-019-01117-7","pmid":"31788135","pmcid":"PMC6884324","title":"Exploring Gender Differences in the Relationship between Dispositional Mindfulness and Compulsive Sexual Behavior among Adults in Residential Substance Use Treatment","authors":"Brem MJ, Shorey RC, Anderson S, Stuart GL.","first_author":"Brem MJ","journal":"Mindfulness","year":2019,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Medical‑record review of 1993 adults in residential substance‑use treatment; cross‑sectional path analyses of dispositional mindfulness facets and CSB indicators.","sample_n":1993,"sample_text":"1993 adults in residential substance‑use treatment (77.6% male)","population":"Adults (77.6% male) in residential SUD treatment","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large sample of adults in residential substance‑use treatment, higher dispositional mindfulness (especially acting with awareness and non‑judging) was linked to fewer compulsive sexual behaviour problems, with some gender differences. Depression, anxiety, and substance use also related to these problems.","clinical_takeaway":"Mindfulness skills may help reduce compulsive sexual behaviours among people in substance‑use treatment, but evidence is correlational.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size","Validated mindfulness questionnaire likely used","Path analysis to explore gender differences"],"limitations":["Cross‑sectional, cannot infer causality","CSB indicators unclear/possibly unvalidated","No control for moral incongruence or masturbation","Findings limited to treatment‑seeking SUD population"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12671-019-01117-7"}},{"id":6870,"doi":"10.1002/hbm.23447","pmid":"27787929","pmcid":"PMC5324617","title":"Compulsive sexual behavior: Prefrontal and limbic volume and interactions","authors":"Schmidt C, Morris LS, Kvamme TL, Hall P, Birchard T, Voon V.","first_author":"Schmidt C","journal":"Human brain mapping","year":2017,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Depression","Compulsive Sexual Behavior","Voxel-based Morphometry","Sexual Addiction","Resting State Functional Mri"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5324617","cited_by_count":43,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control MRI study comparing 23 men with compulsive sexual behavior to age‑matched healthy volunteers (69 structural, 45 functional).","sample_n":92,"sample_text":"23 CSB males, 69 healthy volunteers (structural MRI); 23 CSB, 45 HV (resting‑state fMRI).","population":"adult males, CSB identified by unspecified criteria; healthy volunteers matched on age.","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A brain‑scan study of men with compulsive sexual behavior found larger left amygdala volume and weaker connections between that region and the prefrontal cortex compared with healthy men, suggesting altered limbic‑prefrontal circuitry.","clinical_takeaway":"Current evidence links CSB to structural and functional brain differences, but small samples and unclear definitions limit clinical interpretation.","confidence":0.75,"topic_tags":["neuroscience","csbd","moral_incongruence"],"strengths":["matched healthy control group","whole‑brain correction for multiple comparisons","both structural and functional imaging modalities"],"limitations":["small CSB sample for MRI/fMRI","CSB definition and measurement unclear","no control for moral, masturbatory, or mental‑health confounds"],"rubric_version":"2.0","raw_total":32,"max_possible":70,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":6,"statistics":5,"confounds":2,"design":4,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":49,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/hbm.23447"}},{"id":6871,"doi":"10.1007/s10943-023-01892-7","pmid":"37653184","pmcid":"PMC10861752","title":"The 12-Step Pathway to Spiritual Growth and Gratitude and Its Relationship With Well-Being Among the Members of Sexaholics Anonymous in Poland","authors":"Wnuk M, Krentzman AR, Charzyńska E.","first_author":"Wnuk M","journal":"Journal of religion and health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Poland","Spirituality","Gratitude","Compulsive Sexual Behavior Disorder","12-Step Program"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10861752","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 80 Sexaholics Anonymous members in Poland; path analysis of self‑report scales.","sample_n":80,"sample_text":"Convenience sample of SA members; not representative of general population of people with CSBD.","population":"Adults (72 M, 8 F) attending SA meetings in Poland; self‑selected treatment‑seeking sample.","country":"Poland","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 80 members of Sexaholics Anonymous in Poland, completing more steps of the 12‑step program was linked to greater spiritual growth and gratitude, which were associated with higher life satisfaction and lower negative emotions. The study suggests spiritual practices may help people dealing with compulsive sexual behavior.","clinical_takeaway":"Spiritual and gratitude‑focused interventions might support well‑being in people with CSBD, but evidence is correlational.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses validated psychometric scales for spirituality, gratitude, affect, and life satisfaction","Applies path analysis to explore indirect effects"],"limitations":["Cross‑sectional design; cannot infer causality","Self‑selected, treatment‑seeking sample limits generalisability","No measurement of core CSBD criteria or relevant confounds (moral incongruence, masturbation, mental health, trauma)","Small sample for a multi‑parameter structural model"],"rubric_version":"2.0","raw_total":20,"max_possible":60,"pct_score":33,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":2,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-023-01892-7"}},{"id":6872,"doi":"10.1080/00224499.2022.2077289","pmid":"35608295","pmcid":null,"title":"\"Play with Me, Darling!\" Testing the Associations between Adult Playfulness and Indicators of Sexuality","authors":"Brauer K, Friedemann SF, Chick G, Proyer RT.","first_author":"Brauer K","journal":"Journal of sex research","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Three independent survey samples (N≈1124 total) examining correlations between validated playfulness scales and sexuality‑related traits.","sample_n":1124,"sample_text":"Four independently collected samples; total N = 1,124","population":"adult participants, likely convenience/online samples","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that adults who are more playful, especially those who enjoy quirky or unusual activities, also tend to score higher on traits like sexual sensation seeking and are more likely to engage in BDSM.","clinical_takeaway":"Playfulness may be associated with diverse sexual interests, but findings do not imply pathology.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large aggregate sample size","Use of validated personality and playfulness scales","Multiple independent samples"],"limitations":["Cross‑sectional design limits causal inference","No control for moral incongruence or other key confounds","Reliance on self‑report of BDSM participation"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2077289"}},{"id":6874,"doi":"10.3390/healthcare12111116","pmid":"38891191","pmcid":"PMC11172304","title":"Comparing the Effectiveness of Cognitive Rehabilitation and Binaural Beats on Craving and Comorbidities of Sexual Hyperactivity: A Pilot, Exploratory Quasi-Experimental Study","authors":"Mousavi Z, Samanipour MH, Zarei H, Abharian PH, Ceylan Hİ, Bragazzi NL.","first_author":"Mousavi Z","journal":"Healthcare (Basel, Switzerland)","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Anxiety","Cognitive function","Sexual Disorders","Cognitive Treatment","Sexual Hyperactivity"],"is_oa":true,"oa_url":"https://www.mdpi.com/2227-9032/12/11/1116/pdf?version=1717059113","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"quasi‑experimental pilot with pre‑test/post‑test and control group; N≈45 (≈15 per arm); non‑random assignment","sample_n":45,"sample_text":"45 participants","population":"adults recruited via social media in Iran (convenience sample)","country":"Iran","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"supports","citation_value":"useful","plain_summary":"A small pilot study compared cognitive rehabilitation and binaural‑beat audio to a control condition for people reporting sexual hyperactivity. Both interventions lowered scores on a sexual‑addiction questionnaire and reduced depression‑anxiety‑stress symptoms, but the study was tiny and did not control for moral or relationship factors.","clinical_takeaway":"Preliminary evidence suggests cognitive or auditory interventions might help reduce hypersexual symptoms, but larger, controlled trials are needed before clinical use.","confidence":0.6,"topic_tags":["sexual_function","csbd"],"strengths":["Uses validated SAST and DASS‑21 scales","Includes a control group","Assesses both sexual and mental‑health outcomes"],"limitations":["Very small, non‑randomised sample","No measurement of key confounds (moral incongruence, masturbation, partner factors)","Addiction construct inferred from a screening scale without testing ICD‑11 criteria"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare12111116"}},{"id":6876,"doi":"10.52965/001c.38674","pmid":"36628123","pmcid":"PMC9820860","title":"Rare Mental Health Disorders Affecting Urologic Care: A Comprehensive Review","authors":"Razzak AN, Orlando NA, Angelette A, Kumar V, Anderson DJ, Hasoon J, Viswanath O, Kaye AD, Fitz-Gerald JS, Khater N, Urits I.","first_author":"Razzak AN","journal":"Health psychology research","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Mental health","Urology","Malingering","Compulsive Sexual Behavior","Factitious Disorder","Conversion Disorder","Somatic Symptom Disorder","Illness Anxiety Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of rare psychiatric conditions affecting urology; no original data, no systematic methods reported","sample_n":null,"sample_text":"not applicable","population":"none (review)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how rare mental‑health disorders such as compulsive sexual behavior, factitious disorder, and somatic symptom disorder can influence urologic symptoms and care, summarising their features and suggesting multidisciplinary management.","clinical_takeaway":"Clinicians should consider rare psychiatric conditions, including hypersexuality, when evaluating unexplained urologic complaints.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Broad overview of understudied conditions","Links mental health to urologic practice"],"limitations":["No systematic search or quality appraisal","Lacks empirical data or quantitative synthesis","Potentially anecdotal or selective reporting"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.52965/001c.38674"}},{"id":6877,"doi":"10.3233/jpd-2012-012098","pmid":"23938230","pmcid":null,"title":"Exploring hypersexual behavior in men with Parkinson's disease: is it compulsive sexual behavior?","authors":"Bronner G, Hassin-Baer S.","first_author":"Bronner G","journal":"Journal of Parkinson's disease","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Four male Parkinson's patients referred for suspected hypersexuality; clinical case descriptions.","sample_n":4,"sample_text":"Four male patients from a movement disorders clinic","population":"Men with Parkinson's disease, clinic-referred for sexual concerns (N=4)","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","selective_reporting"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined four Parkinson's patients suspected of hypersexuality and found only one truly had compulsive sexual behavior; the others had erectile or orgasm problems or low desire. They stress careful assessment and present a diagnostic tool for clinicians.","clinical_takeaway":"Hypersexual complaints in Parkinson's should be evaluated for underlying dysfunctions before labeling as compulsive behavior.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function","csbd","neuroscience"],"strengths":["Highlights diagnostic complexity in Parkinson's hypersexuality","Provides concrete clinical algorithm","Differentiates true compulsive behavior from other sexual dysfunctions"],"limitations":["Very small, non‑representative case series","No validated measurement tools","No control for moral or psychological confounds"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":11,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3233/jpd-2012-012098"}},{"id":6879,"doi":"10.1007/s10508-015-0574-5","pmid":"26081246","pmcid":"PMC4561029","title":"Syndemic production and sexual compulsivity/hypersexuality in highly sexually active gay and bisexual men: further evidence for a three group conceptualization","authors":"Parsons JT, Rendina HJ, Moody RL, Ventuneac A, Grov C.","first_author":"Parsons JT","journal":"Archives of sexual behavior","year":2015,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 368 highly sexually active gay and bisexual men (≥9 male partners in 90 days)","sample_n":368,"sample_text":"368 highly sexually active GBM (9+ male partners in 90 days) completed a survey","population":"gay and bisexual men, highly sexually active, United States (likely), recruited via community venues/online","country":"USA (presumed from NIH funding)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 368 gay and bisexual men with many recent sexual partners found that men scoring high on both sexual compulsivity and hypersexuality also reported more co‑occurring problems (like depression, substance use, and past abuse) that raise HIV risk.","clinical_takeaway":"High sexual compulsivity/hypersexuality may signal additional health risks; assess and address co‑occurring issues in prevention work.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for this niche population","Use of validated scales (SCS, HDSI)","Inclusion of multiple syndemic variables"],"limitations":["Convenience sample of highly sexually active GBM limits generalisability","Cross‑sectional design prevents causal inference","Moral incongruence and masturbation not assessed"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":6,"contrasting":1,"mentioning":38,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0574-5"}},{"id":6880,"doi":"10.1159/000448732","pmid":"27694756","pmcid":null,"title":"Exploring the Relationship between Sexual Compulsivity and Attentional Bias to Sex-Related Words in a Cohort of Sexually Active Individuals","authors":"Albery IP, Lowry J, Frings D, Johnson HL, Hogan C, Moss AC.","first_author":"Albery IP","journal":"European addiction research","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional Stroop task with 55 sexually active participants","sample_n":55,"sample_text":"55 sexually active individuals","population":"sexually active adults, convenience sample","country":"unknown","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","masturbation_not_isolated","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 55 sexually active adults, an attention test showed people generally respond faster to sex‑related words. Those who scored higher on a sexual compulsivity questionnaire showed a stronger bias only when they had less sexual experience.","clinical_takeaway":"Attentional bias to sexual cues varies with self‑reported compulsivity; however, findings are preliminary and not ready for clinical use.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["uses validated sexual compulsivity scale","objective attentional bias task (Stroop)","explores interaction with sexual experience"],"limitations":["small, non‑representative sample","no control for moral or mental‑health confounds","attentional bias measured at single time point"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":14,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000448732"}},{"id":6882,"doi":"10.1210/clinem/dgac015","pmid":"35108393","pmcid":"PMC9016473","title":"High Plasma Oxytocin Levels in Men With Hypersexual Disorder","authors":"Flanagan J, Chatzittofis A, Boström ADE, Hallberg J, Öberg KG, Arver S, Jokinen J.","first_author":"Flanagan J","journal":"The Journal of clinical endocrinology and metabolism","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Oxytocin","Cognitive Behavioral Therapy","Hypersexual Disorder","Compulsive Sexual Behavior Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9016473","cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"64 men with hypersexual disorder compared to 38 healthy controls; subgroup of 30 patients received CBT and had pre‑post oxytocin measurements.","sample_n":102,"sample_text":"64 HD participants, 38 controls; CBT subgroup n=30","population":"adult males, clinical sample (HD) and community controls, Sweden","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Men diagnosed with hypersexual disorder had higher blood oxytocin levels than healthy men; the hormone level fell after a CBT program, suggesting oxytocin may rise to counteract stress in this condition.","clinical_takeaway":"Elevated oxytocin might reflect a stress‑related response in hypersexuality, and CBT appears to normalize it, but hormonal testing is not yet a clinical tool.","confidence":0.78,"topic_tags":["neuroscience","csbd","other","treatment"],"strengths":["Biological measurement (oxytocin) adds objective data","Use of validated hypersexuality scales","Inclusion of a treatment (CBT) pre‑post subsample"],"limitations":["Key psychosocial confounds (moral incongruence, masturbation, mental health) not addressed","No effect sizes or correction for multiple testing reported","Control group relatively small; lacks longitudinal follow‑up for controls"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1210/clinem/dgac015"}},{"id":6883,"doi":"10.1556/2006.5.2016.072","pmid":"27784181","pmcid":"PMC5370362","title":"Barriers to female sex addiction treatment in the UK","authors":"Dhuffar MK, Griffiths MD.","first_author":"Dhuffar MK","journal":"Journal of behavioral addictions","year":2016,"pub_types":["review-article","Journal Article"],"keywords":["Barriers To Treatment","Addiction Treatment","Female Sexuality","Hypersexual Disorder","Sex Addiction","Female Sex Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5370362","cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of barriers to treatment for self‑identified female sex addicts; no primary data collected","sample_n":null,"sample_text":"not applicable – review article","population":"female individuals who self‑identify as having a sex addiction and seek or consider treatment (no empirical sample)","country":"UK (focus of review)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The authors review literature and their own experience to suggest four groups of barriers—personal, social, research, and treatment—that may stop women with self‑identified sex‑addiction from getting help in the UK.","clinical_takeaway":"Clinicians should be aware that women may face unique personal and systemic obstacles when seeking help for problematic sexual behavior.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["Identifies understudied population (female treatment‑seekers)","Clear categorisation of barrier types"],"limitations":["No primary data; conclusions based on author expertise","Lacks systematic review methodology (no PRISMA, risk‑of‑bias assessment)","Does not measure or control key confounds (moral incongruence, mental health, etc.)","Relies on ambiguous definition of “sex addiction” without operational criteria"],"rubric_version":"2.0","raw_total":8,"max_possible":60,"pct_score":13,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":1,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":34,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.5.2016.072"}},{"id":6885,"doi":null,"pmid":"36752253","pmcid":null,"title":"Sexual Dream Experiencing and Personality Disorder Functioning Styles in Frequent Sexual Dreamers","authors":"Jia Y, Shao X, Wang C, Wang W.","first_author":"Jia Y","journal":"Psychiatria Danubina","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 171 controls and 81 self‑identified frequent sexual dreamers; questionnaires only; no longitudinal or experimental manipulation.","sample_n":252,"sample_text":"171 controls, 81 frequent sexual dreamers","population":"healthy volunteers (controls) and frequent sexual dreamers (self‑selected); convenience sample.","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed people with frequent sexual dreams and compared them to typical volunteers, finding higher dream vividness and more personality‑disorder style scores among frequent dreamers, especially certain borderline and narcissistic traits.","clinical_takeaway":"No direct clinical implications; findings are preliminary and limited by design.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Relatively large total sample for a niche topic","Use of a validated personality disorder style inventory (PERM)","Comparison between frequent dreamers and controls"],"limitations":["Questionnaire on sexual dreams likely not validated","Convenience, self‑selected sample limits generalisability","No control for key confounds (e.g., mental health, moral views)","Cross‑sectional design with causal language"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":6886,"doi":"10.1007/s12671-017-0723-0","pmid":"29333201","pmcid":"PMC5764544","title":"Dispositional Mindfulness, Shame, and Compulsive Sexual Behaviors among Men in Residential Treatment for Substance Use Disorders","authors":"Brem MJ, Shorey RC, Anderson S, Stuart GL.","first_author":"Brem MJ","journal":"Mindfulness","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Mindfulness","Substance Use","Compulsive Sexual Behavior","Shame","Sexual Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 184 men in residential SUD treatment","sample_n":184,"sample_text":"184 men in residential treatment for SUDs","population":"Men receiving residential treatment for substance‑use disorders","country":"Not reported","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 184 men in a drug‑rehab program, higher compulsive sexual behavior was linked to more shame, but only among those with low mindfulness. Mindfulness seemed to buffer this effect.","clinical_takeaway":"Mindfulness training may reduce shame in patients with compulsive sexual behavior.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Reasonable sample size for a single‑site study","Examines interaction of mindfulness with CSB‑related shame","Addresses an under‑studied moderator in SUD treatment context"],"limitations":["Cross‑sectional design cannot infer causality","No measurement of key confounds (moral incongruence, masturbation, mental health)","Unclear whether CSB scale is validated for this population"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":11,"citing_publications":78,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12671-017-0723-0"}},{"id":6887,"doi":"10.21203/rs.3.rs-155499/v1","pmid":null,"pmcid":null,"title":"Longitudinal Influence of COVID-19-Related Stress on Sexual Compulsivity Symptoms in Chinese Undergraduates","authors":"Deng J, Li T, Wang J, Teng L.","first_author":"Deng J","journal":"Research Square","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":true,"oa_url":"https://www.researchsquare.com/article/rs-155499/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"cross‑lagged panel survey of Chinese undergraduates (N≈3,200 at T1, 3,000 at T2) examining COVID‑19 stress, depression, anxiety and sexual‑compulsivity symptoms over two time points","sample_n":3219,"sample_text":"online survey of undergraduates recruited through a university system; two waves (Time 1, Time 2) with N≈3,200 and N≈3,000 respectively","population":"Chinese undergraduate students (online convenience sample)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a two‑wave survey of Chinese college students, higher COVID‑19‑related stress predicted more symptoms of sexual compulsivity, partly because stress increased anxiety. Depression showed a different pattern, linking to lower compulsivity at the second time point.","clinical_takeaway":"Elevated pandemic‑related stress may heighten risk for compulsive sexual thoughts/behaviours, especially when anxiety is high; addressing anxiety could mitigate this risk.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a longitudinal survey","Two‑wave cross‑lagged design allows temporal ordering","Inclusion of depression and anxiety as mediators"],"limitations":["Convenience online sample limits generalisability","Measures of sexual compulsivity not described; unclear if validated","No assessment of moral incongruence, masturbation, partner context, or trauma"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-155499/v1"}},{"id":6888,"doi":"10.1080/00224499.2017.1399333","pmid":"29220586","pmcid":null,"title":"Co-Occurring Psychosocial Problems and Multiple Sexual Partners among Men Who Have Sex with Men in Shanghai, China: A Syndemic Approach","authors":"Wang Z, Zhao X, Zhang Z, Luo M, Shen Q, Dong Y, Wang Y, Cai Y.","first_author":"Wang Z","journal":"Journal of sex research","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 547 MSM recruited face‑to‑face in Shanghai.","sample_n":547,"sample_text":"Convenience sample recruited via face‑to‑face survey.","population":"Men who have sex with men (MSM) in Shanghai, China (N=547)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 547 men who have sex with men in Shanghai, having more psychosocial problems (like depression, low self‑esteem, loneliness, and sexual compulsivity) was linked to having more sexual partners. Those with five or more problems were three times as likely to report multiple partners.","clinical_takeaway":"Screen for co‑occurring mental‑health issues and sexual compulsivity when counseling MSM about sexual‑risk reduction.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a cross‑sectional study","Uses syndemic framework with multivariate analysis","Reports odds ratios with confidence intervals"],"limitations":["Cross‑sectional design limits causal inference","Convenience sampling may limit generalisability","No measurement of moral or religious factors","Sexual compulsivity measurement details unclear"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":10,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1399333"}},{"id":6889,"doi":"10.1093/asj/sjae214","pmid":"39417477","pmcid":null,"title":"Adverse Childhood Experiences (ACEs) in 252 Board-Certified Plastic Surgeons: Prevalences, ACE Clustering, and Effects on Adult Health and Behaviors, Including Self-Defined Depression, Work Addiction, and Burnout","authors":"Constantian MB, Zaborek N.","first_author":"Constantian MB","journal":"Aesthetic surgery journal","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 252 board‑certified plastic surgeons recruited via email; convenience sample; no longitudinal or experimental component","sample_n":252,"sample_text":"252 board‑certified plastic surgeons completed the survey","population":"ABPS‑certified plastic surgeons (N=252, 72% men, 28% women)","country":"United States (assumed from ABPS and CDC ACE questionnaire)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 252 board‑certified plastic surgeons found that 42% reported at least one adverse childhood experience (ACE). Higher ACE scores were linked to more self‑reported health problems and behaviors such as depression, burnout, alcohol use, and self‑identified sex or work addiction.","clinical_takeaway":"Clinicians should consider ACE histories when addressing burnout and self‑harm behaviors in surgeons, but the associations are not proof of causation.","confidence":0.8,"topic_tags":["adolescents"],"strengths":["Validated ACE questionnaire","Large professional sample for the field","Broad range of health and behavioral outcomes"],"limitations":["Cross‑sectional; cannot infer causality","Outcome measures largely self‑defined, lacking validation","No adjustment for mental‑health or other potential confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/asj/sjae214"}},{"id":6891,"doi":"10.1016/j.jana.2018.05.006","pmid":"29907520","pmcid":null,"title":"Why Do Young Hispanic Women Take Sexual Risks? Psychological and Cultural Factors for HIV Prevention","authors":"Giménez-García C, Ruiz-Palomino E, Gil-Llario MD, Ballester-Arnal R, Castañeiras C.","first_author":"Giménez-García C","journal":"The Journal of the Association of Nurses in AIDS Care : JANAC","year":2018,"pub_types":["Journal Article"],"keywords":["HIV","Self-efficacy","Young Women","Hispanic Women","Sexual Risk","Sexual Sensation Seeking"],"is_oa":false,"oa_url":"http://hdl.handle.net/10234/177574","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 342 Hispanic women (Argentina, Spain) completing validated questionnaires on HIV knowledge, self‑efficacy, sexual sensation seeking and compulsivity.","sample_n":342,"sample_text":"N = 342 young women completed questionnaires.","population":"Young Hispanic women (Argentina, Spain)","country":"Argentina; Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 342 young Hispanic women in Argentina and Spain found that low self‑efficacy and high sexual sensation seeking predicted unsafe sex, suggesting that cultural and psychological factors shape HIV risk.","clinical_takeaway":"Boosting self‑efficacy and addressing sensation‑seeking may help reduce risky sexual behavior in young Hispanic women.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses validated scales for sexual compulsivity and sensation seeking","Relatively large sample for a focused cultural group","Considers cultural gender inequality"],"limitations":["Cross‑sectional design limits causal inference","No control for key confounds (e.g., mental health, partner effects)","Self‑selected convenience sample, not nationally representative"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jana.2018.05.006"}},{"id":6892,"doi":"10.1016/j.jsxm.2019.03.005","pmid":"30956109","pmcid":null,"title":"A Randomized Controlled Study of Group-Administered Cognitive Behavioral Therapy for Hypersexual Disorder in Men","authors":"Hallberg J, Kaldo V, Arver S, Dhejne C, Jokinen J, Öberg KG.","first_author":"Hallberg J","journal":"The journal of sexual medicine","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":["Basic Science Male Behavioral","Male Sexual Desire Disorders","Mental Health And Male Sexuality"],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["bibliography","csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized controlled trial comparing group CBT to wait‑list control in 137 men diagnosed with hypersexual disorder; assessments at baseline, mid, post, 3‑ and 6‑month follow‑up.","sample_n":137,"sample_text":"n = 137 (70 CBT, 67 wait‑list)","population":"men with a clinical diagnosis of hypersexual disorder (HD)","country":"Sweden (inferred from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A randomized trial with 137 men diagnosed with hypersexual disorder found that a seven‑week group CBT program reduced hypersexual symptoms and sexual compulsivity more than a wait‑list, with benefits lasting up to six months.","clinical_takeaway":"Group CBT appears effective for men with hypersexual disorder; clinicians may consider it as a first‑line option.","confidence":0.8,"topic_tags":["treatment","csbd"],"strengths":["Large RCT with follow‑up","Validated primary outcome (HD:CAS)","Clear treatment protocol"],"limitations":["No measurement/control of moral incongruence or masturbation","Clinical sample limits generalisability","Low follow‑up response rate"],"rubric_version":"2.0","raw_total":39,"max_possible":60,"pct_score":65,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":51,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.03.005"}},{"id":6893,"doi":"10.3390/ijerph182111085","pmid":"34769603","pmcid":"PMC8583661","title":"Prevalence of Suicidal Behavior and Associated Clinical Correlates in Patients with Behavioral Addictions","authors":"Valenciano-Mendoza E, Fernández-Aranda F, Granero R, Gómez-Peña M, Moragas L, Mora-Maltas B, Håkansson A, Menchón JM, Jiménez-Murcia S.","first_author":"Valenciano-Mendoza E","journal":"International journal of environmental research and public health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Suicide","Psychopathology","Personality Traits","Sociodemographic Factors","Behavioral Addiction"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/18/21/11085/pdf?version=1634899343","cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large clinical sample (N=4404) of patients seeking treatment for behavioral addictions; prevalence study using self‑report questionnaires; cross‑sectional design.","sample_n":4404,"sample_text":"Consecutive patients attending a specialized hospital unit for behavioral addictions (majority gambling disorder).","population":"Patients with diagnosed behavioral addictions (gambling, gaming, sex, buying‑shopping) assessed at a specialized hospital unit.","country":"Spain (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 4,400 patients treated for behavioral addictions (including sex addiction), about 18‑23% reported thoughts of suicide and up to 9% had attempted suicide, with higher rates in sex and buying‑shopping addictions.","clinical_takeaway":"Patients with behavioral addictions, especially sex and buying‑shopping disorders, show notable suicide risk; clinicians should screen for suicidal ideation.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Very large clinical sample","Comprehensive assessment of several behavioral addictions","Provides prevalence data for suicidal outcomes"],"limitations":["Clinical, treatment‑seeking sample limits generalisability","No measurement of moral incongruence or masturbation","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph182111085"}},{"id":6894,"doi":"10.1080/10720162.2011.584057","pmid":"36919045","pmcid":"PMC10010680","title":"A Psychometric Analysis of the Compulsive Sexual Behavior Inventory","authors":"Storholm ED, Fisher DG, Napper LE, Reynolds GL, Halkitis PN.","first_author":"Storholm ED","journal":"Sexual addiction & compulsivity","year":2011,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"psychometric validation of the Compulsive Sexual Behavior Inventory in a diverse adult sample (n=482)","sample_n":482,"sample_text":"482 participants","population":"men and women, racially/ethnically diverse, community sample","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested how well the Compulsive Sexual Behavior Inventory works, finding it reliable and valid for measuring compulsive sexual behavior in a large, diverse group of adults.","clinical_takeaway":"The CSBI appears to be a sound tool for clinicians assessing compulsive sexual behavior.","confidence":0.7,"topic_tags":["measurement","sexual_function","csbd","religiosity"],"strengths":["Large, diverse sample (n=482)","Comprehensive psychometric analyses (reliability, multi‑trait multi‑method validity)","Provides evidence for use in clinical and public‑health contexts"],"limitations":["No assessment of potential confounds such as moral incongruence or mental‑health variables","Cross‑sectional design; cannot address temporal stability beyond internal consistency","No pre‑registration or open data statement"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":6,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10720162.2011.584057"}},{"id":6895,"doi":"10.1007/s12529-016-9568-5","pmid":"27169410","pmcid":"PMC5106331","title":"The Moderating Effect of Smoking Status on the Relation between Anxiety Sensitivity, Sexual Compulsivity, and Suicidality among People with HIV/AIDS","authors":"Brandt CP, Bakhshaie J, Jardin C, Lemaire C, Kauffman BY, Sharp C, Zvolensky MJ.","first_author":"Brandt CP","journal":"International journal of behavioral medicine","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Sex","AIDS","HIV","Smoking","Suicide","Anxiety Sensitivity","Sexual Compulsivity"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 94 persons living with HIV/AIDS, hierarchical regression analysis","sample_n":94,"sample_text":"94 persons living with HIV/AIDS in the USA; 57% smokers","population":"Adults with HIV/AIDS, 64.5% male, mean age 48.3","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among people with HIV, smokers who are highly anxious about bodily sensations report more risky drinking, higher sexual compulsivity, and greater suicidal thoughts than non‑smokers.","clinical_takeaway":"Smoking may amplify anxiety‑related sexual risk and suicidality in HIV patients; addressing smoking could reduce these harms.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses validated scales for anxiety sensitivity and sexual compulsivity","Investigates interaction of smoking with psychological factors","Relevant to health of people living with HIV"],"limitations":["Cross‑sectional design cannot infer causality","Small, convenience sample limits generalisability","No control for key confounds such as moral attitudes or mental‑health covariates"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12529-016-9568-5"}},{"id":6896,"doi":"10.1007/s10508-018-1378-1","pmid":"30783872","pmcid":null,"title":"Hypersexual Behavior as a Symptom of PTSD: Using Cognitive Processing Therapy in a Veteran with Military Sexual Trauma-Related PTSD","authors":"Larsen SE.","first_author":"Larsen SE.","journal":"Archives of sexual behavior","year":2019,"pub_types":["Journal Article"],"keywords":["Ptsd","Hypersexual Behavior","Sexual Addiction","Military Sexual Trauma","Cognitive Processing Therapy"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single veteran case report using Cognitive Processing Therapy for PTSD and hypersexual behavior","sample_n":1,"sample_text":"1 veteran (case report)","population":"male veteran with military sexual trauma‑related PTSD","country":"USA","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A single veteran with PTSD after military sexual trauma showed reduced PTSD and hypersexual behavior after receiving Cognitive Processing Therapy, a PTSD‑focused therapy, even though no specific treatment for sexual addiction was used.","clinical_takeaway":"Trauma‑focused CBT may help reduce hypersexual behavior in PTSD patients, but evidence is limited to one case.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed clinical narrative","Application of evidence‑based PTSD treatment"],"limitations":["N=1; no control condition","No validated measures of hypersexuality","No assessment of key confounds (moral incongruence, masturbation, mental health comorbidities)","Addiction criteria not operationalised"],"rubric_version":"2.0","raw_total":16,"max_possible":60,"pct_score":27,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":2,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1378-1"}},{"id":6897,"doi":"10.1556/2006.2023.00083","pmid":"38217688","pmcid":"PMC10988394","title":"Mental health professionals' use of the ICD-11 classification of impulse control disorders and behavioral addictions: An international field study","authors":"Fuss J, Keeley JW, Stein DJ, Rebello TJ, García JÁ, Briken P, Robles R, Matsumoto C, Abé C, Billieux J, Grant JE, Kraus SW, Lochner C, Potenza MN, Reed GM.","first_author":"Fuss J","journal":"Journal of behavioral addictions","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Pyromania","Kleptomania","Intermittent Explosive Disorder","Gambling Disorder","Compulsive Sexual Behavior Disorder","Gaming Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10988394","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Vignette‑based survey of 1,090 WHO Global Clinical Practice Network mental‑health professionals assessing diagnostic accuracy for ICD‑11 vs ICD‑10 impulse‑control and behavioral‑addiction disorders.","sample_n":1090,"sample_text":"N = 1,090 mental‑health professionals","population":"Mental health professionals (clinicians) from WHO network, international sample, self‑selected.","country":"International (WHO network)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Over 1,000 mental‑health clinicians judged case vignettes using ICD‑10 and ICD‑11 criteria. They diagnosed impulse‑control and behavioral‑addiction disorders more accurately with ICD‑11, especially for the new categories like compulsive sexual behavior disorder.","clinical_takeaway":"ICD‑11 criteria improve diagnostic consistency for CSBD and related disorders, but clinicians still need training to avoid over‑diagnosing highly engaged but non‑pathological behaviors.","confidence":0.8,"topic_tags":["csbd"],"strengths":["Large international sample of clinicians.","Direct comparison of ICD‑10 vs ICD‑11 diagnostic guidelines.","Relevant to implementation of CSBD and other new diagnoses."],"limitations":["Self‑selected professional sample; may not represent all clinicians.","Cross‑sectional vignette design cannot assess real‑world diagnostic outcomes.","No pre‑registration or detailed statistical plan reported."],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2023.00083"}},{"id":6898,"doi":"10.3389/fphar.2024.1423075","pmid":"39045047","pmcid":"PMC11263075","title":"The atypical antipsychotics and sexual dysfunction: a pharmacovigilance-pharmacodynamic study","authors":"Cheng Y, Chen Y, Zhao X, Mou F, Wang W, Qian R, Huang J, Li H, Xu Q, Yu S.","first_author":"Cheng Y","journal":"Frontiers in pharmacology","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexual dysfunction","Atypical Antipsychotics","Real-world Data","Safety Signal","Disproportionality Analysis"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11263075","cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Pharmacovigilance disproportionality analysis of FAERS reports (2004‑2023); 4839 co‑reported AAP‑SD cases; regression of ROR on in‑vitro receptor occupancy.","sample_n":4839,"sample_text":"4839 reports","population":"FAERS reporters of adverse events involving atypical antipsychotics; no demographic detail in abstract.","country":"International (FAERS, US FDA database)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Using the FDA’s adverse‑event database, the authors found that many newer antipsychotic drugs are reported together with sexual side‑effects, especially aripiprazole and iloperidone. The strength of these reports varied by the drug’s receptor binding profile.","clinical_takeaway":"Clinicians should be aware that atypical antipsychotics, notably aripiprazole, may be linked to sexual side‑effects and discuss this with patients.","confidence":0.78,"topic_tags":["sexual_function","adolescents"],"strengths":["Large pharmacovigilance dataset","Systematic disproportionality analysis","Exploratory receptor‑occupancy regression"],"limitations":["Spontaneous reports subject to reporting bias","No validated measure of sexual dysfunction","No control for mental‑health or other confounders"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fphar.2024.1423075"}},{"id":6899,"doi":"10.3390/healthcare11111586","pmid":"37297726","pmcid":"PMC10253209","title":"Family Attachment, Sexuality, and Sexual Recidivism in a Sample of Italian Sexual Offenders: Preliminary Results","authors":"Saladino V, Eleuteri S, Nuzzi A, Verrastro V.","first_author":"Saladino V","journal":"Healthcare (Basel, Switzerland)","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Attachment","Relapse","Violence","Sex Offender","Sexual Sensation-seeking"],"is_oa":true,"oa_url":"https://www.mdpi.com/2227-9032/11/11/1586/pdf?version=1685956167","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study of 29 male sexual offenders","sample_n":29,"sample_text":"29 male sexual offenders from two correctional facilities in Southern Lazio, Italy","population":"male sexual offenders (Italian, incarcerated)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 29 Italian men imprisoned for sexual offenses, researchers found that insecure family communication about sex, insecure attachment, and high sexual sensation‑seeking were linked to higher scores on a compulsive sexual behavior questionnaire. The study suggests these factors may be important for treatment and relapse prevention.","clinical_takeaway":"Family communication and attachment issues may be relevant targets when treating sexual offenders to reduce relapse risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses validated Italian versions of CSBI, SSSS, and ASQ","Addresses understudied population (sex offenders)","Explores links between attachment, sensation‑seeking, and CSB"],"limitations":["Very small convenience sample (N=29)","Cross‑sectional; no causal inference possible","No control for key confounds (moral incongruence, mental health, trauma, etc.)","Findings not generalisable beyond incarcerated offenders"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare11111586"}},{"id":6900,"doi":"10.1556/2006.2022.00046","pmid":"35895475","pmcid":"PMC9295247","title":"Gender differences in the association of psychological distress and sexual compulsivity before and during the COVID-19 pandemic","authors":"Kürbitz LI, Wiessner C, Schoon W, Briken P, Schöttle D, Schröder J.","first_author":"Kürbitz LI","journal":"Journal of behavioral addictions","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Psychological Distress","Sexual Compulsivity","Covid-19"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/11/2/article-p533.pdf","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"online convenience sample with 5 retrospective time‑points (n = 399 at baseline, dropping to 77 at final wave); primary analyses on 292 participants (change T0‑T1) using linear regression and linear mixed models","sample_n":399,"sample_text":"online convenience sample, attrition over waves","population":"German adults (convenience online sample)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["self_selected_sample","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In Germany, men showed higher sexual compulsivity than women during COVID‑19, and men’s compulsivity rose when their psychological distress increased. Women’s compulsivity was not linked to distress. Relationship status and having a private space were linked to lower compulsivity early in the pandemic.","clinical_takeaway":"Clinicians should note that distress may drive sexual compulsivity more in men than women, but findings are based on a non‑representative sample.","confidence":0.7,"topic_tags":["sexual_function","csbd","gender"],"strengths":["Longitudinal data across pandemic stages","Use of validated distress scale (PHQ‑4)","Investigation of gender differences"],"limitations":["Convenience online sample – limited generalisability","Adapted SC scale not fully validated","Key confounds (moral incongruence, masturbation) not measured"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.00046"}},{"id":6902,"doi":"10.1016/j.jsxm.2016.01.013","pmid":"26936075","pmcid":null,"title":"Altered Appetitive Conditioning and Neural Connectivity in Subjects With Compulsive Sexual Behavior","authors":"Klucken T, Wehrum-Osinsky S, Schweckendiek J, Kruse O, Stark R.","first_author":"Klucken T","journal":"The journal of sexual medicine","year":2016,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Amygdala","emotion","Reward","Conditioning","Sexual Arousal","Positive"],"is_oa":false,"oa_url":null,"cited_by_count":72,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Cross‑sectional fMRI study comparing 20 self‑identified CSB participants with 20 healthy controls using an appetitive conditioning paradigm.","sample_n":40,"sample_text":"20 subjects with CSB and 20 controls","population":"Adult males, n=40 (20 CSB, 20 controls), recruited likely from community or clinical sources (not specified).","country":"Germany (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used brain scans to compare men who report compulsive sexual behavior with a control group while they learned to associate a cue with sexual images. The CSB group showed more amygdala activity and weaker connections between reward and control regions, suggesting altered brain responses to sexual cues.","clinical_takeaway":"Neural differences in reward and emotion circuits are observed in people reporting compulsive sexual behavior, but findings are preliminary due to small sample size.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd","neuroscience"],"strengths":["Use of an experimental conditioning paradigm within fMRI","Inclusion of a matched control group","Investigation of both activation and connectivity"],"limitations":["Small sample size for neuroimaging (20 per group)","No reported control for key psychological confounds (moral incongruence, mental health, etc.)","Lack of detail on CSB definition and measurement"],"rubric_version":"2.0","raw_total":27,"max_possible":70,"pct_score":39,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":5,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":7,"contrasting":2,"mentioning":106,"citing_publications":118,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2016.01.013"}},{"id":6903,"doi":"10.1080/0092623x.2014.920755","pmid":"24836276","pmcid":null,"title":"Psychopathological predictors characterizing sexual compulsivity in a nonclinical sample of women","authors":"Carvalho J, Guerra L, Neves S, Nobre PJ.","first_author":"Carvalho J","journal":"Journal of sex & marital therapy","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 235 female college students using self‑report questionnaires.","sample_n":235,"sample_text":"235 female college students","population":"Female college students (non‑clinical, primarily WEIRD sample)","country":"Portugal (likely, based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 235 college‑aged women, higher impulsivity and psychotic‑like traits were linked to greater self‑reported sexual compulsivity, suggesting these personality factors relate to compulsive sexual thoughts or behaviours even without clinical problems.","clinical_takeaway":"Impulsivity may be a key factor in women reporting compulsive sexual thoughts; assess impulsivity when evaluating sexual health concerns.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large (N>200) community sample of women","Focus on non‑clinical population","Multiple psychological predictors examined"],"limitations":["Convenience student sample limits generalisability","No control for key confounds (moral incongruence, masturbation, mental health)","Cross‑sectional; causality cannot be inferred","Unclear whether sexual compulsivity scale separates frequency from distress"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":11,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2014.920755"}},{"id":6904,"doi":"10.1007/s10508-010-9712-2","pmid":"21203814","pmcid":"PMC4494649","title":"Proposing a tentative cut point for the Compulsive Sexual Behavior Inventory","authors":"Storholm ED, Fisher DG, Napper LE, Reynolds GL, Halkitis PN.","first_author":"Storholm ED","journal":"Archives of sexual behavior","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 482 adults, ROC analysis to set cut‑point for CSBI","sample_n":482,"sample_text":"482 participants","population":"racially/ethnically diverse men and women, non‑clinical sample","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"supports","citation_value":"useful","plain_summary":"Researchers examined a 40‑point cut‑off on the Compulsive Sexual Behavior Inventory using data from 482 adults. The cut‑off best distinguished people who reported more risky sex and drug use, suggesting it could help clinicians identify compulsive sexual patterns.","clinical_takeaway":"A CSBI score of 40 or higher may signal heightened risk for unsafe sex and substance use, but clinicians should consider other factors before diagnosing.","confidence":0.7,"topic_tags":["csbd","measurement","pornography","sexual_function"],"strengths":["Large community sample (N=482)","Uses ROC analysis to propose a quantitative cut‑point","Provides initial criterion‑related validity evidence"],"limitations":["Cross‑sectional; no causal inference","No measurement of moral incongruence or other key confounds","Reliance on self‑reported risky behaviours as “gold standard”"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":8,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9712-2"}},{"id":6905,"doi":"10.1080/10720162.2016.1140602","pmid":"28607537","pmcid":"PMC5465817","title":"The Effects of Alcohol on Self-Regulation of Sexual Arousal in Sexually Compulsive Men Who Have Sex with Men","authors":"Janssen E, Hoffmann HL, Goodrich D, Wilson MR.","first_author":"Janssen E","journal":"Sexual addiction & compulsivity","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Alcohol","Psychophysiology","Self-regulation","Sexual Arousal","Sexual Compulsivity"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory psychophysiology experiment with within‑subject alcohol vs sober conditions and suppression vs no‑suppression instructions; between‑subjects high vs low sexual‑compulsivity groups (N=43).","sample_n":43,"sample_text":"43 men who have sex with men (MSM) participated.","population":"Men who have sex with men, recruited for a study of sexual compulsivity.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, men with high sexual compulsivity showed weaker physiological control over arousal after drinking alcohol compared with low‑compulsivity men, especially when asked not to suppress their responses.","clinical_takeaway":"Alcohol may impair sexual self‑regulation more in sexually compulsive men; clinicians should consider drinking context when addressing compulsive sexual behavior.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Physiological measurement of arousal","Within‑subject alcohol manipulation","Clear experimental manipulation (suppression instruction)"],"limitations":["Small sample, limited power","No measurement of key confounds (moral, mental health, etc.)","Generalizability limited to MSM volunteers"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10720162.2016.1140602"}},{"id":6906,"doi":"10.1111/ene.16144","pmid":"37955562","pmcid":"PMC11235607","title":"Dopamine agonist serum concentrations and impulse control disorders in Parkinson's disease","authors":"Staubo SC, Fuskevåg OM, Toft M, Lie IH, Alvik KMJ, Jostad P, Tingvoll SH, Lilleng H, Rosqvist K, Størset E, Odin P, Dietrichs E, Dietrichs ES.","first_author":"Staubo SC","journal":"European journal of neurology","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Parkinson's Disease","Dopamine Agonist","Impulse Control Disorders - Pharmacology"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11235607","cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control observational study of Parkinson's patients using dopamine agonists; N=46 (19 ICD+, 27 controls)","sample_n":46,"sample_text":"Forty-six patients were included: 19 ICD-positive and 27 controls.","population":"Parkinson's disease patients on pramipexole or ropinirole","country":"Norway (inferred from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson's patients, higher blood levels of the dopamine agonist ropinirole were linked to impulse‑control disorders, including compulsive sexual behavior, whereas pramipexole showed no such link. Monitoring drug levels may help reduce these risks.","clinical_takeaway":"Therapeutic drug monitoring of ropinirole could help mitigate impulse‑control disorder risk in Parkinson's patients.","confidence":0.8,"topic_tags":["csbd","sexual_function","neuroscience"],"strengths":["Use of validated QUIP‑RS instrument for ICD screening","Objective serum concentration measurements"],"limitations":["Small sample, likely underpowered","No control for key psychosocial confounds (moral incongruence, mental health, etc.)","Cross‑sectional case‑control design limits causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/ene.16144"}},{"id":6907,"doi":"10.1111/jmft.12210","pmid":"27925268","pmcid":null,"title":"Therapists' Assessments in Treating \"Sex Addiction\" and Their Relationship to Clients' Gender, Relationship Status, and Exclusivity Status","authors":"Reddick GT, Heiden-Rootes KM, Brimhall AS.","first_author":"Reddick GT","journal":"Journal of marital and family therapy","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 208 therapists using clinical vignettes; licensed and in‑training participants; no longitudinal or experimental manipulation.","sample_n":208,"sample_text":"208 therapists (92 licensed, 116 in‑training) completed an online vignette survey.","population":"Therapists and therapists‑in‑training (USA likely); convenience sample.","country":"USA (presumed by journal; not explicit)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"Therapists judged “sex addiction” more harshly for women who were non‑monogamous and for men who were monogamous; higher addiction ratings led them to recommend individual or group therapy rather than couples work.","clinical_takeaway":"Clinicians should be aware that personal biases about gender and relationship style may affect their addiction assessments and treatment suggestions.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample of practitioners","Focus on gender and relationship context","Provides insight into clinician bias"],"limitations":["Reliance on unvalidated rating items","Convenience sample, limited generalisability","No control for moral/religious attitudes or client mental health"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jmft.12210"}},{"id":6911,"doi":"10.1016/j.comppsych.2014.10.002","pmid":"25459420","pmcid":null,"title":"Sex addiction and gambling disorder: similarities and differences","authors":"Farré JM, Fernández-Aranda F, Granero R, Aragay N, Mallorquí-Bague N, Ferrer V, More A, Bouman WP, Arcelus J, Savvidou LG, Penelo E, Aymamí MN, Gómez-Peña M, Gunnard K, Romaguera A, Menchón JM, Vallès V, Jiménez-Murcia S.","first_author":"Farré JM","journal":"Comprehensive psychiatry","year":2015,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of 59 individuals with clinically diagnosed sex addiction, 2190 with gambling disorder and 93 healthy controls, using self‑report questionnaires.","sample_n":2342,"sample_text":"59 SA patients, 2190 GD patients, 93 healthy controls.","population":"Adults diagnosed with sex addiction (N=59), gambling disorder (N=2190) and healthy controls (N=93); clinical and community samples, likely convenience.","country":"Spain (authors’ affiliations suggest Spanish institutions)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared people diagnosed with sex addiction to those with gambling disorder and healthy controls, finding similar mental‑health and personality patterns between the two clinical groups but some distinct traits.","clinical_takeaway":"Sex‑addiction shares many psychological features with gambling disorder, but clinicians should be cautious interpreting it as a distinct addiction without clear diagnostic criteria.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["Large GD and control samples","Use of established psychometric instruments for GD and psychopathology","Direct comparison of two behavioral‑addiction groups"],"limitations":["Sex‑addiction diagnosis not described; likely based on clinical judgement without validated scale","Small SA sample (N=59) limits power","No measurement of moral incongruence, masturbation, partner context or trauma"],"rubric_version":"2.0","raw_total":27,"max_possible":60,"pct_score":45,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":30,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2014.10.002"}},{"id":6912,"doi":"10.3233/jpd-140366","pmid":"25213998","pmcid":null,"title":"Clinical profile of compulsive sexual behaviour and paraphilia in Parkinson's disease","authors":"Sachdeva J, Harbishettar V, Barraclough M, McDonald K, Leroi I.","first_author":"Sachdeva J","journal":"Journal of Parkinson's disease","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Behavioural Disturbance","Impulse Control Disorder","Hypersexuality","Compulsive Sexual Behaviour","Parkinson' Disease"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control study comparing PD patients with compulsive sexual behaviour (CSB) to those with other impulse‑control disorders and to PD patients without behavioural disorder","sample_n":null,"sample_text":"Not reported in abstract","population":"Parkinson’s disease patients (adult, mixed gender)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson’s patients, those who develop compulsive sexual behaviour tend to be on higher dopaminergic medication doses, report more anxiety, and show a personality profile of being more open and less agreeable compared with patients who have other impulse‑control problems or none at all.","clinical_takeaway":"Higher dopamine medication and anxiety may signal risk for compulsive sexual behaviour in Parkinson’s patients; monitor these factors.","confidence":0.4,"topic_tags":["csbd","pornography","masturbation","sexual_function","neuroscience"],"strengths":["use of a clinical control group (other ICDs)","assessment of personality traits with validated NEO‑FFI"],"limitations":["CSB definition not specified nor validated","no effect sizes or correction for multiple testing","no measurement of key confounds (e.g., moral incongruence, masturbation)","sample size unclear, likely small"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":34,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3233/jpd-140366"}},{"id":6913,"doi":"10.1177/104012371302500305","pmid":"23926574","pmcid":null,"title":"Compulsive sexual behavior in young adults","authors":"Odlaug BL, Lust K, Schreiber LR, Christenson G, Derbyshire K, Harvanko A, Golden D, Grant JE.","first_author":"Odlaug BL","journal":"Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists","year":2013,"pub_types":["Research Support, American Recovery and Reinvestment Act","Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":60,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of university students (convenience sample)","sample_n":null,"sample_text":"large student sample (exact N not specified in abstract)","population":"young adult students (USA)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of university students, about 2 % reported compulsive sexual behavior. Those individuals also showed higher anxiety, depression, stress, and other psychiatric problems, suggesting CSB is linked to broader mental‑health difficulties.","clinical_takeaway":"CSB in young adults often co‑occurs with anxiety and depression; assess broader mental health when it is present.","confidence":0.7,"topic_tags":["prevalence","sexual_function","csbd","moral_incongruence"],"strengths":["large student sample","includes broad range of psychiatric comorbidities","focus on prevalence of CSB"],"limitations":["cross‑sectional, cannot infer causality","no validated CSB instrument reported","key confounds (moral incongruence, masturbation, trauma) not measured"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":142,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/104012371302500305"}},{"id":6915,"doi":"10.30773/pi.2021.0010e","pmid":"34965707","pmcid":"PMC8721294","title":"The Effect of Stress on Compulsive Sexual Behavior Disorder: Active Coping Strategy and Self-Control as Mediators","authors":"Park JW, Kim DJ, Shin MH.","first_author":"Park JW","journal":"Psychiatry investigation","year":2021,"pub_types":["Published Erratum","correction"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8721294","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.30773/pi.2021.0010e"}},{"id":6916,"doi":"10.1186/s12888-021-03172-8","pmid":"33926398","pmcid":"PMC8086080","title":"Correction to: The psychometric properties of the Bergen-Yale sex addiction scale for the Iranian population","authors":"Youseflu S, Kraus SW, Razavinia F, Afrashteh MY, Niroomand S.","first_author":"Youseflu S","journal":"BMC psychiatry","year":2021,"pub_types":["Published Erratum","correction"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8086080","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12888-021-03172-8"}},{"id":6917,"doi":"10.12688/openreseurope.16131.3","pmid":"39118807","pmcid":"PMC11306953","title":"Initial development and validation of item banks to measure problematic hypersexuality","authors":"van Tuijl P, Verboon P, van Lankveld J.","first_author":"van Tuijl P","journal":"Open Res Europe","year":2024,"pub_types":["Preprint"],"keywords":["Problematic Hypersexuality; Non-problematic Hypersexuality; Item Response Theory; Emotion Dysregulation; Diagnostic Accuracy."],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11306953","cited_by_count":1,"is_preprint":true,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Item bank development using IRT on a large Dutch general‑population sample (N=1211) plus a self‑selected online sample (N=371).","sample_n":1582,"sample_text":"1211 general population + 371 self‑selected participants","population":"Adults (≥18 y) from a representative Dutch sample and a web‑based self‑selected group seeking information on hypersexuality.","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study created and validated two questionnaire scales to assess distressing aspects of hypersexual behaviour using a large Dutch sample, but the definition of ‘problematic’ relies on the very distress the scales aim to measure.","clinical_takeaway":"Current self‑report scales for hypersexuality show limited ability to distinguish clinical problems from normal variation.","confidence":0.8,"topic_tags":["measurement","sexual_function"],"strengths":["Large, population‑representative sample for item calibration","Rigorous IRT methodology with fit diagnostics","Clear separation of two theoretically meaningful sub‑scales"],"limitations":["Problematic hypersexuality defined by distress – circular measurement","No assessment of key confounds (moral incongruence, masturbation, mental health)","Self‑selected subsample may bias item relevance for treatment‑seekers"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12688/openreseurope.16131.3"}},{"id":6918,"doi":"10.1007/s00406-023-01667-x","pmid":"37755487","pmcid":null,"title":"Efficacy of 12-step mutual-help groups other than Alcoholics Anonymous: a systematic review and meta-analysis","authors":"Leurent M, Ducasse D, Courtet P, Olié E.","first_author":"Leurent M","journal":"European archives of psychiatry and clinical neuroscience","year":2024,"pub_types":["Meta-Analysis","Systematic Review","Journal Article"],"keywords":["Quality of life","Severity of symptoms","Self-help Group","Addictive Behaviors","Twelve-step Program"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"systematic review and meta-analysis of 55 articles (24 quantitative, 27 qualitative, 4 mixed-methods) covering twelve‑step mutual‑help groups including those for compulsive sexual behavior.","sample_n":9,"sample_text":"Four meta‑analyses pooled data from 9 studies.","population":"Adults (mean age 36.5–40.5), 80–81% male, participants in various TSMH groups.","country":"North America (68%), Middle East (17%), EU (11%), Australia (4%)","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review and meta‑analysis of 55 studies found that participation in twelve‑step groups (including those for compulsive sexual behavior) is linked to lower symptom severity and higher quality of life, though evidence strength varies.","clinical_takeaway":"Mutual‑help groups may aid recovery for compulsive sexual behavior, but clinicians should consider individual differences and co‑occurring issues.","confidence":0.6,"topic_tags":["treatment","csbd"],"strengths":["Registered protocol (PROSPERO)","PRISMA‑guided systematic review","Includes both quantitative and qualitative evidence"],"limitations":["Limited detail on measurement instruments in abstract","No explicit control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":3,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00406-023-01667-x"}},{"id":6919,"doi":"10.1556/2006.2024.00020","pmid":"38669082","pmcid":"PMC11220802","title":"Prevalence and clinical phenotypes of adult patients with attention deficit hyperactivity disorder and comorbid behavioral addictions","authors":"Grassi G, Moradei C, Cecchelli C.","first_author":"Grassi G","journal":"Journal of behavioral addictions","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["ADHD","Impulsivity","Food Addiction","Internet Addiction","Sex Addiction","Gambling Disorder","Shopping Addiction","Mood And Anxiety Symptoms"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11220802","cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional prevalence study of 248 consecutively diagnosed adult ADHD patients, comparing those with and without at least one behavioral addiction using validated screening scales.","sample_n":248,"sample_text":"248 consecutive adults newly diagnosed as ADHD patients","population":"Adults (age range not specified) newly diagnosed with ADHD, recruited consecutively from a clinical setting.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 248 adults diagnosed with ADHD, more than half showed at least one behavioral addiction (e.g., internet, food, sex). Those with an addiction had more severe ADHD symptoms, higher impulsivity, and greater mood‑anxiety problems.","clinical_takeaway":"ADHD patients often have co‑occurring behavioral addictions; assess and treat these comorbidities alongside ADHD symptoms.","confidence":0.76,"topic_tags":["sexual_function","adolescents"],"strengths":["Large clinical sample for ADHD population","Use of validated screening instruments for multiple behavioral addictions","Comprehensive comparison of clinical phenotype"],"limitations":["Cross‑sectional design limits causal inference","Convenience clinical sample limits generalisability to broader ADHD population","No assessment of moral incongruence or masturbation which may confound sex‑addiction findings"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2024.00020"}},{"id":6920,"doi":"10.1080/00224499.2015.1061633","pmid":"26421749","pmcid":null,"title":"Extradyadic Sexual Involvement and Sexual Compulsivity in Male and Female Sexual Abuse Survivors","authors":"Vaillancourt-Morel MP, Dugal C, Poirier Stewart R, Godbout N, Sabourin S, Lussier Y, Briere J.","first_author":"Vaillancourt-Morel MP","journal":"Journal of sex research","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional mediation study using self‑report questionnaires (N=669) administered to adults in intimate relationships.","sample_n":669,"sample_text":"669 adults currently involved in an intimate relationship.","population":"Adults (both sexes) with a history of child sexual abuse, currently in a relationship; convenience sample.","country":"Canada (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among adults who experienced child sexual abuse, higher abuse severity was linked to greater sexual compulsivity, which in turn was associated with having affairs outside their primary relationship.","clinical_takeaway":"History of severe childhood sexual abuse may increase risk of compulsive sexual behavior and infidelity; assess and address these patterns in therapy.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large community sample (N>600)","Use of structural equation modelling","Gender‑invariant model tested","Clear mediation hypothesis"],"limitations":["Cross‑sectional; cannot infer causality","No assessment of moral incongruence or other key confounds","Potential self‑report bias"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2015.1061633"}},{"id":6921,"doi":"10.1101/2022.01.31.21267382","pmid":null,"pmcid":null,"title":"Logistic regression with machine learning sheds light on the problematic sexual behavior phenotype","authors":"Jiang S, Wallace K, Yang E, Roper L, Aryal G, Lee D, Lodhi RJ, Isenberg R, Green B, Wishart D, Aitchison KJ.","first_author":"Jiang S","journal":"medRxiv","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online questionnaire of university students, N≈3350, with MINI interview subset","sample_n":3359,"sample_text":"University student convenience sample; not probability based","population":"young adults in post‑secondary education (Canada)","country":"Canada","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2022 Canadian university survey of over 3,300 students found that self‑reported problematic sexual behaviour was linked to OCD, ADHD, internet addiction, compulsive buying, childhood trauma and being male. The authors suggest these factors form a cluster separate from obsessive‑compulsive disorder.","clinical_takeaway":"Clinicians should note that multiple psychiatric and trauma‑related factors co‑occur with self‑reported problematic sexual behaviour, but cross‑sectional data do not prove causation.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample size for questionnaire study","Inclusion of MINI clinical interview subset","Explores multiple psychiatric/comorbidity variables"],"limitations":["Cross‑sectional, cannot infer causality","Convenience student sample limits generalisability","Problematic sexual behaviour measured by screening tool that may conflate frequency and distress"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2022.01.31.21267382"}},{"id":6923,"doi":"10.4103/psychiatry.indianjpsychiatry_137_18","pmid":"31579168","pmcid":"PMC6767819","title":"Compulsive Sexual Behavior in Depressed Women","authors":"Mina S.","first_author":"Mina S.","journal":"Indian journal of psychiatry","year":2019,"pub_types":["letter","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.4103/psychiatry.indianjpsychiatry_137_18","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/psychiatry.indianjpsychiatry_137_18"}},{"id":6924,"doi":"10.1111/jsm.12761","pmid":"25411152","pmcid":null,"title":"Personality among sexually compulsive men who practice intentional unsafe sex in São Paulo, Brazil","authors":"do Amaral ML, Abdo CH, Tavares H, Scanavino Mde T.","first_author":"do Amaral ML","journal":"The journal of sexual medicine","year":2015,"pub_types":["Journal Article"],"keywords":["Personality","Novelty Seeking","Self-directedness","Men Who Have Sex With Men (Msm)","Compulsive Sexual Behavior (Csb)","Intentional Unsafe Sex"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 69 treatment‑seeking sexually compulsive MSM; self‑report questionnaires and psychiatric interview.","sample_n":69,"sample_text":"Convenience sample of treatment‑seeking individuals meeting CSB criteria.","population":"Sexually compulsive men who have sex with men, São Paulo, Brazil (N=69)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["circular_addiction_scale","self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 69 men who have sex with men and were in treatment for compulsive sexual behaviour, those who deliberately practiced unsafe sex showed higher novelty seeking and lower self‑directedness personality scores.","clinical_takeaway":"Personality traits like low self‑directedness may be linked to risky sexual choices in compulsive sexual behaviour.","confidence":0.7,"topic_tags":["sexual_function","csbd","religiosity"],"strengths":["Use of validated personality and compulsivity instruments","Focus on a specific high‑risk subgroup","Multiple logistic regression analysis"],"limitations":["Small, treatment‑seeking convenience sample","No measurement of key confounds (moral incongruence, mental health, partner factors)","Cross‑sectional design limits causal inference","Reliance on self‑report for unsafe sex behaviour"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12761"}},{"id":6925,"doi":"10.1080/00224499.2018.1453042","pmid":"29634377","pmcid":"PMC6179944","title":"The Role of Self-Conscious Emotions in the Sexual Health of Gay and Bisexual Men: Psychometric Properties and Theoretical Validation of the Sexual Shame and Pride Scale","authors":"Rendina HJ, López-Matos J, Wang K, Pachankis JE, Parsons JT.","first_author":"Rendina HJ","journal":"Journal of sex research","year":2019,"pub_types":["research-article","Validation Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study with factor analysis and regression on a convenience sample of 260 gay and bisexual men","sample_n":260,"sample_text":"convenience sample, not representative","population":"260 highly sexually active gay and bisexual men (GBM)","country":"USA (likely, based on authors affiliations)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and tested a new questionnaire that measures feelings of sexual shame and pride in gay and bisexual men. The scale showed good reliability and was linked to sexual compulsivity and other sexual‑behavior outcomes.","clinical_takeaway":"The Sexual Shame and Pride Scale can reliably assess self‑conscious emotions that relate to sexual health in gay/bisexual men.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rigorous psychometric evaluation (factor analysis, reliability, test‑retest)","Sample size adequate for scale validation","Demonstrates predictive validity for sexual compulsivity"],"limitations":["Convenience sample of highly sexually active GBM limits generalisability","Key confounds (moral incongruence, masturbation, mental health) not measured","No pre‑registration or open data reported"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1453042"}},{"id":6926,"doi":"10.1016/j.psyneuen.2022.105765","pmid":"35452872","pmcid":null,"title":"HPA-axis dysregulation is not associated with accelerated epigenetic aging in patients with hypersexual disorder","authors":"Boström ADE, Andersson P, Chatzittofis A, Savard J, Rask-Andersen M, Öberg KG, Arver S, Jokinen J.","first_author":"Boström ADE","journal":"Psychoneuroendocrinology","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["HPA-axis","Biological Aging","Dexamethasone Suppression Test","Hypersexual Disorder","Compulsive Sexual Behavior Disorder","Dna Methylation Clock"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control","sample_n":94,"sample_text":"case‑control cohort recruited for hypersexual disorder study","population":"60 hypersexual disorder patients, 33 healthy volunteers","country":"Sweden (presumed from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A study of 60 people with hypersexual disorder and 33 controls found no link between stress‑axis dysfunction and faster biological ageing measured by DNA methylation clocks.","clinical_takeaway":"Current evidence does not support using epigenetic age as a biomarker for hypersexual disorder.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation","gender"],"strengths":["Well‑characterized clinical cohort","Use of validated epigenetic ageing clocks","Power analysis described"],"limitations":["No measurement of moral/religious conflict or masturbation","Cross‑sectional case‑control, limited causal inference","Potential selection bias of HD patients"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":22,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psyneuen.2022.105765"}},{"id":6927,"doi":"10.1177/21522715261458454","pmid":"42427109","pmcid":null,"title":"Exploratory Analysis of Behavioral Differences Between Hypersexual and Intimacy-Seeking Offenders in Online Child Grooming: Preliminary Findings Based on a New Dataset of Conversations Secured by Law Enforcement","authors":"Cieślińska Z, Hanusz K.","first_author":"Cieślińska Z","journal":"Cyberpsychology, behavior and social networking","year":2026,"pub_types":["Journal Article"],"keywords":["Grooming","Cyberspace","Sexual Exploitation","Sexual Crimes","Online Child Grooming"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Exploratory content analysis of police‑secured chat transcripts from Polish court cases, comparing two offender typologies (hypersexual vs intimacy‑seeking). No participant recruitment; data derived from criminal investigations.","sample_n":null,"sample_text":"New dataset of conversations between suspected offenders and real minors from Polish court cases; exact number of offenders not reported.","population":"Adult male offenders involved in online child grooming (Poland). Sample size not disclosed in abstract.","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined police‑obtained chat logs between child‑grooming offenders and minors in Poland, separating offenders into two groups—those driven by hypersexual motives and those seeking intimacy—and described how their messaging differed.","clinical_takeaway":"None – the study describes offender communication, not client‑facing sexual health guidance.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Novel, recent dataset from real cases (not simulated).","Provides initial typology of offender communication patterns."],"limitations":["No validated criteria for ‘hypersexual’ vs ‘intimacy‑seeking’ classification.","Small, undisclosed sample; limited generalizability.","No statistical testing or effect‑size reporting."],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/21522715261458454"}},{"id":6928,"doi":"10.1080/13218719.2022.2112099","pmid":"36687761","pmcid":"PMC9848289","title":"Making addicts: critical reflections on agency and responsibility from lawyers and decision makers","authors":"Seear K.","first_author":"Seear K.","journal":"Psychiatry, psychology, and law : an interdisciplinary journal of the Australian and New Zealand Association of Psychiatry, Psychology and Law","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Gender","Addiction","Law","Family Violence","Qualitative Research","Sexual Violence","Lawyers","Judges","Alcohol And Other Drugs"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative interviews with 48 lawyers and decision makers","sample_n":48,"sample_text":"N = 48 (qualitative)","population":"lawyers and legal decision makers (Australia/New Zealand)","country":"Australia/New Zealand","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 48 lawyers and decision makers reveal that legal systems shape how addictions, including alleged 'sex addiction', are defined and influence perceptions of agency and responsibility, with sex addiction viewed as less credible than drug addiction.","clinical_takeaway":"None – the study discusses legal concepts, not clinical treatment of pornography‑related issues.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides novel legal‑policy perspective on addiction constructs","Uses in‑depth qualitative interviews","Highlights differential credibility of 'sex addiction' in law"],"limitations":["Small, non‑representative sample of legal professionals","No empirical data on pornography or sexual behavior","No measurement of addiction criteria or health outcomes"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13218719.2022.2112099"}},{"id":6929,"doi":"10.1055/a-1419-0152","pmid":"33822350","pmcid":null,"title":"[Evaluation of the Sexual Sensation Seeking Scale: Results of a Representative German Population Survey]","authors":"Brenk-Franz K, Weiser M, Hammelstein P, Brähler E, Strauß B.","first_author":"Brenk-Franz K","journal":"Psychotherapie, Psychosomatik, medizinische Psychologie","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Representative German population survey (N=2420) assessing psychometric properties of the Sexual Sensation Seeking Scale.","sample_n":2420,"sample_text":"Representative survey of men and women, ages 18‑93, N=2420.","population":"Adults 18‑93 years, community sample, gender‑balanced.","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors tested the German version of a questionnaire that measures how much people seek novel sexual experiences. Using a large, representative sample, they found the scale to be reliable and to correlate with related traits, though its one‑factor structure was not clearly confirmed.","clinical_takeaway":"The German Sexual Sensation Seeking Scale is a reliable tool for assessing sexual sensation seeking in research and clinical settings.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Comprehensive psychometric evaluation (reliability, convergent validity, factor analysis)","Clear reporting of internal consistency"],"limitations":["No assessment of potential confounds (e.g., moral incongruence, mental health)","Factor structure not fully supported; CFA inconclusive","No pre‑registration or open data statement"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/a-1419-0152"}},{"id":6930,"doi":"10.7759/cureus.290","pmid":"26251766","pmcid":"PMC4524748","title":"Hypersexuality Addiction and Withdrawal: Phenomenology, Neurogenetics and Epigenetics","authors":"Blum K, Badgaiyan RD, Gold MS.","first_author":"Blum K","journal":"Cureus","year":2015,"pub_types":["Retracted Publication","review-article","Review","Journal Article"],"keywords":["Epigenetics","Neurogenetics","Compulsivity","Reward Deficiency Syndrome","Hypersexuality Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4524748","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review-article (retracted), no primary data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["retracted_or_notice","advocacy_or_coi","circular_addiction_scale"],"stance":"supports","citation_value":"avoid","plain_summary":"This retracted review argues that hypersexuality functions like an addiction, driven by shared brain reward pathways and genetics. It offers no new data, only speculation about DNA and brain imaging.","clinical_takeaway":"None – the paper provides no evidence to guide practice.","confidence":0.4,"topic_tags":["sexual_function","gender","masturbation"],"strengths":["Highlights need for genetic and neuroimaging research","Integrates concepts from reward deficiency syndrome"],"limitations":["Retracted article; credibility compromised","No original data; speculative narrative","Lacks empirical measurement of constructs or confounds"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[{"status":"Has correction","date":"2015-9-11","noticeDoi":"10.7759/cureus.c1","doi":"10.7759/cureus.290"},{"status":"Has erratum","date":"2015-9-11","noticeDoi":"10.7759/cureus.c1","doi":"10.7759/cureus.290"},{"status":"Retracted","date":"2015-10-6","noticeDoi":"10.7759/cureus.r1","doi":"10.7759/cureus.290"}],"url":"https://scite.ai/reports/10.7759/cureus.290"}},{"id":6933,"doi":"10.1002/cbm.2269","pmid":"36583302","pmcid":null,"title":"A randomised controlled trial of a cognitive behaviourally informed intervention for changing violent sexual attitudes among adult sexual offenders in prison","authors":"Ede MO, Okeke CI, Onah SO.","first_author":"Ede MO","journal":"Criminal behaviour and mental health : CBMH","year":2023,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":["Sex Offenders","Cbt","Enugu","Cognitive-behavioural Therapy","Nigerian Prisons","Cognitive Behavioural Informed Intervention","Violent Sexual Attitudes"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomised controlled trial with 78 male sexual offenders in two Nigerian prisons; 12‑session CBT‑informed group intervention vs treatment‑as‑usual; outcomes measured at baseline, post‑intervention and 3‑months.","sample_n":78,"sample_text":"39 participants per arm","population":"adult male sexual offenders incarcerated in Nigeria (volunteer sample, advertised within prisons)","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Nigerian prison, a 12‑session cognitive‑behavioural program reduced scores on compulsive‑sexual‑behaviour questionnaires among men convicted of sexual offences, with effects lasting three months.","clinical_takeaway":"Group CBT may lower self‑reported compulsive sexual attitudes in incarcerated offenders, but evidence is limited to small, self‑selected samples.","confidence":0.78,"topic_tags":["csbd","sexual_function"],"strengths":["Randomised controlled design","Power calculation reported","Validated CSB scales used"],"limitations":["Volunteer prison sample limits generalisability","Small sample size for an RCT","No measurement of key confounds (e.g., trauma, mental health)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/cbm.2269"}},{"id":6934,"doi":"10.3109/14659891.2015.1029021","pmid":"27482151","pmcid":"PMC4959274","title":"A preliminary investigation of the relationship between early maladaptive schemas and compulsive sexual behaviors in a substance-dependent population","authors":"Elmquist J, Shorey RC, Anderson S, Stuart GL.","first_author":"Elmquist J","journal":"Journal of substance use","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Substance dependence","Compulsive Sexual Behaviors","Sexual Addiction","Early Maladaptive Schemas"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 260 adults (198 men, 62 women) in residential substance‑use treatment, assessing early maladaptive schemas and compulsive sexual behaviours with self‑report questionnaires.","sample_n":260,"sample_text":"198 men and 62 women (total N=260) recruited from a residential SUD treatment programme.","population":"Adults in residential treatment for substance‑use disorders (mixed gender).","country":"USA (not specified in abstract; inferred from journal scope).","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 260 adults receiving treatment for substance use, researchers found that stronger maladaptive core beliefs were linked to higher levels of compulsive sexual behaviour, suggesting that these beliefs may be a useful treatment target.","clinical_takeaway":"Assess and address maladaptive schemas when treating clients with co‑occurring substance use and compulsive sexual behaviour.","confidence":0.7,"topic_tags":["csbd","masturbation","pornography","sexual_function"],"strengths":["Large sample for a treatment setting","Novel focus on early maladaptive schemas","Clear statistical associations reported"],"limitations":["Cross‑sectional design prevents causal inference","No measurement of key confounds (moral incongruence, masturbation, mental health)","Reliance on self‑report screening cutoffs for CSB"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/14659891.2015.1029021"}},{"id":6935,"doi":"10.1136/sextrans-2017-053153","pmid":"29066629","pmcid":"PMC6713223","title":"Perceived intentional transmission of HIV infection, sustained viral suppression and psychosocial outcomes among men who have sex with men living with HIV: a cross-sectional assessment","authors":"Brown MJ, Serovich JM, Kimberly JA.","first_author":"Brown MJ","journal":"Sexually transmitted infections","year":2018,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Sexual Health","Gay Men","Behavioural Science","Modes Of Transmission"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 338 MSM living with HIV","sample_n":338,"sample_text":"338 MSM living with HIV who participated in a disclosure intervention study","population":"MSM living with HIV in the United States (N=338)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among gay and bisexual men living with HIV, about 44% thought they had been infected on purpose. Those who held this belief reported higher depression scores and greater sexual compulsivity, but there was no link to viral suppression.","clinical_takeaway":"Clinicians should assess beliefs about intentional HIV infection, as they relate to depression and sexual compulsivity, and consider targeted psychosocial support.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Relatively large sample for a sexual‑health survey","Uses regression models with confidence intervals","Addresses understudied topic of perceived intentional HIV transmission"],"limitations":["Cross‑sectional design cannot infer causality","Unclear whether psychosocial scales are validated","Limited control for key confounds (e.g., moral incongruence, partner context)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sextrans-2017-053153"}},{"id":6936,"doi":"10.1016/j.encep.2020.11.006","pmid":"34857367","pmcid":null,"title":"[Gambling and Internet habits in a French population with addictive disorders seeking treatment: a multicentric study]","authors":"Lever D, Dany A, Tirmont M, Beaugrard E, Levenez I, Lechifflart P, Descarpentries G, Guillery X, Le Goff D, Guillou-Landreat M.","first_author":"Lever D","journal":"L'Encephale","year":2021,"pub_types":["Multicenter Study","Journal Article"],"keywords":["Internet","Gambling","Problem Gambling","Gaming Disorder","Trouble Du Jeu Vidéo","Achats Compulsifs En Ligne","Compulsive Buying Online","Cyber Addiction Sexuelle","Jeu De Hasard Et D’argent","Jeu Problématique","Sexual Addiction Online"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Multicenter survey of 252 treatment‑seeking patients; convenience sample from addiction clinics; prevalence estimates.","sample_n":252,"sample_text":"252 patients seeking treatment for addictive disorders were included.","population":"Patients seeking treatment for various addictive disorders in five French addictology centres (N=252).","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 252 French patients seeking help for addiction, about 10 % had problem gambling and most used the Internet. The study shows gambling is common among people in addiction treatment but screening for it is often missed.","clinical_takeaway":"Clinicians in addiction services should routinely ask about gambling and other online behaviours, including sexual use.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large multi‑centre sample for a treatment‑seeking population","Provides prevalence data across several behavioural addictions","Highlights gaps in routine screening in addiction services"],"limitations":["Uses an ad‑hoc questionnaire; no validated scales reported","Cross‑sectional, cannot infer causality","No measurement or control of key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.encep.2020.11.006"}},{"id":6937,"doi":"10.1080/00207578.2021.1871847","pmid":"34080943","pmcid":null,"title":"Siblings, sex, and shame: The film <i>Shame</i> (2011)","authors":"Schiller BM.","first_author":"Schiller BM.","journal":"The International journal of psycho-analysis","year":2021,"pub_types":["Journal Article"],"keywords":["Addiction","Incest","Shame"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"The article is a psycho‑analytic commentary on the film *Shame* (2011) that interprets the depiction of sex addiction and shame. No empirical data, participants, or systematic methods are reported.","sample_n":null,"sample_text":"Not applicable – no participants were recruited.","population":"none","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article offers a psycho‑analytic reading of the film *Shame*, arguing that shame underlies the characters' sex‑addiction portrayal, creating a cycle of shame and addiction.","clinical_takeaway":"None – the piece provides a theoretical interpretation, not evidence for clinical practice.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["Thoughtful phenomenological interpretation","Connects shame to sexual addiction narrative"],"limitations":["No empirical data or systematic analysis","Constructs not operationalised","No measurement of confounding variables"],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00207578.2021.1871847"}},{"id":6940,"doi":"10.1016/j.beth.2020.04.005","pmid":"33483108","pmcid":null,"title":"GPS: A Randomized Controlled Trial of Sexual Health Counseling for Gay and Bisexual Men Living With HIV","authors":"Hart TA, Noor SW, Skakoon-Sparling S, Lazkani SN, Gardner S, Leahy B, Maxwell J, Julien R, Simpson S, Steinberg M, Adam BD.","first_author":"Hart TA","journal":"Behavior therapy","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":["HIV","Sexual behavior","Motivational Interviewing","Community-based Research","Sexual Compulsivity"],"is_oa":false,"oa_url":"https://doi.org/10.1016/j.beth.2020.04.005","cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized Controlled Trial of a peer‑delivered motivational interviewing counseling program for HIV‑positive gay and bisexual men who had recent condomless anal sex.","sample_n":null,"sample_text":"Not specified in abstract; RCT suggests at least two groups.","population":"HIV‑positive gay, bisexual and other men who have sex with men who reported condomless anal sex in the past 2 months (community‑based sample, likely convenience).","country":"Not stated (likely Canada or USA based on authors).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A peer‑run counseling program reduced risky condomless sex and lowered sexual compulsivity over three months among HIV‑positive gay and bisexual men.","clinical_takeaway":"Motivational‑interviewing counseling can cut risky sex and compulsive sexual thoughts in HIV‑positive GBM.","confidence":0.7,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Randomized controlled design","Community‑based, peer‑delivered intervention","Measured sexual compulsivity as an outcome"],"limitations":["Abstract provides no detail on sample size or power","Potential lack of control for moral incongruence, masturbation, mental‑health covariates","Unclear whether sexual compulsivity scale was validated"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.beth.2020.04.005"}},{"id":6941,"doi":"10.1016/j.neubiorev.2026.106821","pmid":"42330690","pmcid":null,"title":"Hypersexuality across neurological disorders: A systematic review of aetiologies, clinical manifestations, assessment methods, and management strategies","authors":"Schincariol A, Pezzetta R, Devita M, Wan H, Yan P, Ferracuti S, Sartori G, Amorotti MF, Massara M, Parmigiani G, Scarpazza C.","first_author":"Schincariol A","journal":"Neuroscience and biobehavioral reviews","year":2026,"pub_types":["Systematic Review","Review","Journal Article"],"keywords":["Disinhibition","Brain injury","Neurodegeneration","Dementia","Impulsivity","Neurological Disorders","Hypersexuality"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 394 studies (46,516 participants), preregistered (PROSPERO), synthesis of aetiology, manifestations, assessment and management of hypersexuality in neurological disorders.","sample_n":46516,"sample_text":"394 studies, 46,516 participants","population":"Humans with neurological disorders (e.g., Parkinson’s disease, TBI, dementia) experiencing hypersexuality.","country":"Not specified","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review summarises evidence that brain disorders and dopaminergic treatments can trigger hypersexuality, linking it to fronto‑striatal‑limbic circuit dysfunction. Assessment methods are inconsistent, and the authors suggest recognising a distinct clinical syndrome.","clinical_takeaway":"Clinicians should screen for hypersexuality in patients with neurological disease or dopaminergic therapy, using structured assessments and considering both medical and behavioural interventions.","confidence":0.8,"topic_tags":["neuroscience","sexual_function"],"strengths":["Large number of studies aggregated","Pre‑registered protocol","Comprehensive coverage of neurological etiologies"],"limitations":["Assessment of hypersexuality often unstandardised in primary studies","No quantitative meta‑analysis or risk‑of‑bias assessment reported","Limited discussion of moral or psychosocial confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neubiorev.2026.106821"}},{"id":6942,"doi":"10.1016/j.comppsych.2023.152387","pmid":"37037172","pmcid":null,"title":"Risk and protective factor profiles predict addictive behavior among adolescents","authors":"Efrati Y.","first_author":"Efrati Y.","journal":"Comprehensive psychiatry","year":2023,"pub_types":["Journal Article"],"keywords":["Psychopathology","Latent Profile Analysis","Early Life Trauma","Internet Gaming Disorder","Compulsive Sexual Behavior Disorder","Problematic Social Network Usage"],"is_oa":false,"oa_url":"https://doi.org/10.1016/j.comppsych.2023.152387","cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 544 community adolescents, latent profile analysis of risk/protective factors and self‑report severity scales for IGD, CSB and PSNU","sample_n":544,"sample_text":"General community sample, convenience recruitment (schools?)","population":"Jewish Israeli adolescents, age 14‑18 (N=544)","country":"Israel","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 544 Israeli teens and grouped them into three risk‑profiles based on adversity, mental‑health symptoms and family communication. Teens in the ‘at‑risk’ profile showed higher scores on gaming, compulsive sexual behavior and social‑network overuse than those in moderate or resilient groups.","clinical_takeaway":"Adverse childhood experiences and poor family communication are linked to higher compulsive sexual behavior in adolescents; screening for these factors may help identify youth at risk.","confidence":0.78,"topic_tags":["adolescents","sexual_function","csbd"],"strengths":["Large community sample (N>500)","Comprehensive set of risk and protective variables","Use of latent profile analysis to identify subgroups"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral incongruence or masturbation, key confounds for CSB","Addiction criteria not directly assessed; reliance on severity scales"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2023.152387"}},{"id":6943,"doi":"10.1080/00926231003719673","pmid":"20432124","pmcid":null,"title":"Measuring sexual addiction and compulsivity: a critical review of instruments","authors":"Hook JN, Hook JP, Davis DE, Worthington EL, Penberthy JK.","first_author":"Hook JN","journal":"Journal of sex & marital therapy","year":2010,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":69,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"critical review of 17 sexual‑addiction measurement instruments; describes structure, conceptual basis, samples, and reports reliability/validity evidence; no new empirical data collected","sample_n":null,"sample_text":"N/A – review of existing scales","population":"N/A (review of instruments)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The paper reviews 17 questionnaires and checklists that claim to measure sexual addiction, summarising how each was built, the populations studied, and the quality of their reliability and validity evidence.","clinical_takeaway":"Choose instruments with demonstrated reliability and validity; many existing scales lack robust psychometric support.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of 17 existing instruments","Evaluates reliability and validity evidence","Provides practical recommendations for researchers and clinicians","Highlights gaps in psychometric evaluation"],"limitations":["Not a systematic review – selection criteria unclear","No meta‑analytic synthesis of psychometric data","Potential bias toward instruments known to authors","Lacks quantitative comparison of instrument performance"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":1,"mentioning":115,"citing_publications":193,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926231003719673"}},{"id":6944,"doi":"10.1037/pst0000417","pmid":"35025569","pmcid":"PMC9345305","title":"A pilot test of a treatment to address intersectional stigma, mental health, and HIV risk among gay and bisexual men of color","authors":"Jackson SD, Wagner KR, Yepes M, Harvey TD, Higginbottom J, Pachankis JE.","first_author":"Jackson SD","journal":"Psychotherapy (Chicago, Ill.)","year":2022,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"open pilot feasibility study with 21 participants in two cohorts; group therapy intervention; pre‑post assessments at baseline and 3 months","sample_n":21,"sample_text":"21 participants across two cohorts","population":"young Black and Latino gay, bisexual, and other men who have sex with men (GBM) in the United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small pilot tested a 10‑week group therapy for Black and Latino gay and bisexual men, aiming to reduce stigma‑related stress, improve mental health, and lower HIV risk. Participants reported better coping, lower depression and anxiety, and increased condom use confidence, but the study had only 21 people and no control group.","clinical_takeaway":"Group interventions that address intersecting stigma may improve mental health and HIV‑risk behaviours in young GBM of color, but larger controlled trials are needed.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Innovative intersectional group intervention","Mixed‑methods (quantitative and qualitative) feasibility data","Clear reporting of attendance and retention metrics"],"limitations":["Very small, non‑random sample (n=21)","No control or comparison condition","Limited statistical power; effect estimates imprecise"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":71,"citing_publications":81,"retracted":false,"notices":[{"status":"Has correction","date":"2022-11-21","noticeDoi":"10.1037/pst0000459","doi":"10.1037/pst0000417"}],"url":"https://scite.ai/reports/10.1037/pst0000417"}},{"id":6946,"doi":"10.1186/s12889-021-10186-0","pmid":"33446160","pmcid":"PMC7809841","title":"The role of sexual compulsivity in unprotected intercourse among STI patients in Shanghai, China","authors":"Ni Y, Liu H, Gong R, Shi M, Zhang S, Wang S, Cai Y.","first_author":"Ni Y","journal":"BMC public health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexually active","Patients","Sexually Transmitted Infections","Unprotected Intercourse","Sexually Compulsivity"],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-021-10186-0","cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 664 STI patients from two Shanghai clinics.","sample_n":664,"sample_text":"664 participants (191 male, 258 female reporting unprotected intercourse).","population":"Sexually active STI patients, ages 18–76, both genders.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Shanghai clinic study of 664 patients with sexually transmitted infections, higher sexual compulsivity was linked to more unprotected sex with casual partners, especially among men. The authors suggest targeting compulsivity in counseling.","clinical_takeaway":"Assess sexual compulsivity in STI patients; addressing it may help reduce risky casual‑partner sex.","confidence":0.73,"topic_tags":["sexual_function","masturbation"],"strengths":["Large sample for a clinic‑based study","Use of a likely validated sexual compulsivity scale","Inclusion of both genders and a range of ages"],"limitations":["Cross‑sectional design prevents causal inference","No control for key confounds (moral incongruence, mental health, masturbation)","Convenience sample from STI clinics limits generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-021-10186-0"}},{"id":6947,"doi":"10.1523/jneurosci.4013-11.2011","pmid":"22072697","pmcid":"PMC6633219","title":"Concurrent exposure to methamphetamine and sexual behavior enhances subsequent drug reward and causes compulsive sexual behavior in male rats","authors":"Frohmader KS, Lehman MN, Laviolette SR, Coolen LM.","first_author":"Frohmader KS","journal":"The Journal of neuroscience : the official journal of the Society for Neuroscience","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory animal experiment with controlled administration of methamphetamine and sexual experience, multiple dosing groups, and conditioned place preference testing.","sample_n":null,"sample_text":"Typical group sizes not reported in abstract; likely 8‑12 per condition.","population":"male Sprague‑Dawley rats","country":"United Kingdom (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In male rats, giving methamphetamine together with sexual activity leads to longer delays in starting mating and later, compulsive sex‑seeking behavior, as well as stronger drug‑related reward.","clinical_takeaway":"None – animal findings do not directly inform human clinical practice.","confidence":0.7,"topic_tags":["prevalence","treatment"],"strengths":["Controlled experimental design allows causal inference within the animal model","Use of standard validated behavioral paradigms (CPP, latency measures)","Comparison of meth alone vs. meth with sexual experience isolates interaction effect"],"limitations":["Small, unspecified sample sizes typical of rodent studies","Findings in rats may not translate directly to human pornography or sexual addiction","No reporting of effect sizes or power calculations"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":24,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1523/jneurosci.4013-11.2011"}},{"id":6949,"doi":"10.1590/1516-4446-2017-2476","pmid":"29898197","pmcid":"PMC6899385","title":"Sexual compulsivity, anxiety, depression, and sexual risk behavior among treatment-seeking men in São Paulo, Brazil","authors":"Scanavino MDT, Ventuneac A, Abdo CHN, Tavares H, Amaral MLS, Messina B, Reis SC, Martins JPLB, Parsons JT.","first_author":"Scanavino MDT","journal":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","year":2018,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6899385","cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross‑sectional comparison of 88 treatment‑seeking men with excessive sexual behavior (ESB) and 64 community controls; self‑report questionnaires assessing sexual compulsivity, anxiety, depression and sexual risk behaviors.","sample_n":152,"sample_text":"88 ESB outpatients and 64 controls (total N = 152).","population":"men (heterosexual, gay, bisexual) seeking mental‑health treatment for ESB in São Paulo, Brazil","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"supports","citation_value":"useful","plain_summary":"Men receiving treatment for excessive sexual behavior in Brazil reported higher levels of sexual compulsivity, anxiety, and depression than controls, and they also engaged in riskier sex with casual partners. Mood problems and compulsivity were linked to condomless anal intercourse.","clinical_takeaway":"Screen for anxiety, depression, and compulsive sexual thoughts in men presenting with risky sexual behavior; address these factors in counseling.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Validated scales for compulsivity, anxiety, and depression","Includes both heterosexual and gay/bisexual participants","Compares clinical sample to a control group"],"limitations":["Convenience sample of treatment‑seekers limits generalisability","No assessment of moral incongruence or trauma history","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":16,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/1516-4446-2017-2476"}},{"id":6952,"doi":"10.1177/1557988321989916","pmid":"33511900","pmcid":"PMC7871071","title":"Adaptation and Pilot Evaluation of an Intervention Addressing the Sexual Health Needs of Gay Men Living with HIV Infection in Colombia","authors":"Alvarado BE, Martinez-Cajas JL, Mueses HF, Correa Sanchez D, Adam BD, Hart TA.","first_author":"Alvarado BE","journal":"American journal of men's health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["MSM","Motivational Interviewing","Hiv Prevention","Community-based Intervention","People Living With Hiv"],"is_oa":true,"oa_url":"https://journals.sagepub.com/doi/pdf/10.1177/1557988321989916","cited_by_count":3,"is_preprint":false,"topics":["csbd","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"one‑armed pilot trial, pre‑post measurements, N=7 completers","sample_n":7,"sample_text":"7 of 11 eligible participants completed the intervention","population":"MSM living with HIV in Colombia","country":"Colombia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers adapted a peer‑led group program for gay men with HIV in Colombia and piloted it with seven participants. Scores on depression, confidence about condom use, and risky condomless anal sex improved after the program, and participants said it was helpful and culturally appropriate.","clinical_takeaway":"Preliminary evidence suggests a brief, culturally tailored group intervention may improve mental health and safer‑sex behaviors among HIV‑positive MSM, but larger controlled trials are needed.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of validated psychosocial scales","Cultural adaptation using established framework","Qualitative interviews to complement quantitative data"],"limitations":["Very small, non‑randomised sample","No control/comparison group","Limited follow‑up duration"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1557988321989916"}},{"id":6954,"doi":"10.1556/2006.2022.20000","pmid":"36576727","pmcid":"PMC9881667","title":"Corrigendum to: Who feels affected by \"out of control\" sexual behavior? Prevalence and correlates of indicators for ICD-11 Compulsive Sexual Behavior Disorder in the German Health and Sexuality Survey (GeSiD)","authors":"Briken P, Wiessner C, Štulhofer A, Klein V, Fuß J, Reed GM, Dekker A.","first_author":"Briken P","journal":"Journal of behavioral addictions","year":2022,"pub_types":["Published Erratum","correction","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9881667","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2022.20000"}},{"id":6955,"doi":"10.1556/jba.3.2014.4.2","pmid":"25592306","pmcid":"PMC4291826","title":"Compulsive sexual behavior among male military veterans: prevalence and associated clinical factors","authors":"Smith PH, Potenza MN, Mazure CM, McKee SA, Park CL, Hoff RA.","first_author":"Smith PH","journal":"Journal of behavioral addictions","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Trauma","Child Abuse","Veterans","Military","Ptsd","Compulsive Sexual Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4291826","cited_by_count":37,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Survey of male veterans at three time points (baseline n=258, 3‑mo n=194, 6‑mo n=136) with GEE analyses.","sample_n":258,"sample_text":"Baseline N=258, follow‑ups N=194 and 136","population":"Male US military veterans of Iraq/Afghanistan operations","country":"United States","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"About one‑in‑six male US combat veterans reported compulsive sexual behavior, which was linked to higher PTSD severity, childhood sexual trauma, and younger age over a six‑month period.","clinical_takeaway":"Screen veterans with PTSD for compulsive sexual behavior, especially if they have a history of childhood sexual trauma.","confidence":0.8,"topic_tags":["csbd","prevalence","pornography","sexual_function","moral_incongruence"],"strengths":["Longitudinal design with three assessment points","Large baseline sample for veteran research","Use of GEE to account for repeated measures"],"limitations":["CSB measurement not clearly validated","Moral incongruence and masturbation not assessed","Sample attrition reduces power at follow‑up"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":30,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/jba.3.2014.4.2"}},{"id":6956,"doi":"10.1016/j.sxmr.2017.10.004","pmid":"29129680","pmcid":null,"title":"Existential Issues in Sexual Medicine: The Relation Between Death Anxiety and Hypersexuality","authors":"Watter DN.","first_author":"Watter DN.","journal":"Sexual medicine reviews","year":2018,"pub_types":["Review","Journal Article"],"keywords":["Sexual Addiction","Hypersexuality","Sexual Medicine","Death Anxiety","Existential Psychotherapy","Sex therapy"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review offering a theoretical integration of death‑anxiety theory with hypersexuality treatment; no original data collected.","sample_n":null,"sample_text":"None – literature review only","population":"none (review)","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper argues that fear of death may drive some cases of hypersexuality and suggests using existential psychotherapy to treat these cases, but it provides no new data.","clinical_takeaway":"Consider existential concerns when assessing hypersexuality, but recognize that evidence for this approach is theoretical.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Integrates existential theory with sexual health","Highlights under‑explored psychological dimension"],"limitations":["No empirical data; purely speculative","Lacks systematic review methods","No measurement of key confounds"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sxmr.2017.10.004"}},{"id":6958,"doi":"10.1080/0092623x.2012.665816","pmid":"23631692","pmcid":null,"title":"Sexual compulsivity scale: adaptation and validation in the spanish population","authors":"Ballester-Arnal R, Gómez-Martínez S, Llario MD, Salmerón-Sánchez P.","first_author":"Ballester-Arnal R","journal":"Journal of sex & marital therapy","year":2013,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a psychometric scale in a convenience sample of Spanish college students (N=1196).","sample_n":1196,"sample_text":"1196 Spanish college students (891 female, 305 male)","population":"Spanish young adults (college students)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors translated and tested the Sexual Compulsivity Scale in 1,196 Spanish college students, finding a reliable two‑factor structure and good stability, suggesting it works well for measuring sexual compulsivity in this population.","clinical_takeaway":"The Spanish version of the Sexual Compulsivity Scale appears psychometrically sound for research or screening in young adult populations.","confidence":0.85,"topic_tags":["sexual_function","measurement"],"strengths":["Large sample for validation","Factor analysis and reliability reported","Temporal stability assessed"],"limitations":["Convenience student sample, not general population","No assessment of moral or mental‑health confounds","No separate measurement of distress vs behaviour"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":39,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2012.665816"}},{"id":6960,"doi":"10.3389/fpsyg.2020.01005","pmid":"32547451","pmcid":"PMC7270329","title":"Sex, Drugs, and Impulse Regulation: A Perspective on Reducing Transmission Risk Behavior and Improving Mental Health Among MSM Living With HIV","authors":"Arends RM, van den Heuvel TJ, Foeken-Verwoert EGJ, Grintjes KJT, Keizer HJG, Schene AH, van der Ven AJAM, Schellekens AFA.","first_author":"Arends RM","journal":"Frontiers in psychology","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["HIV","Mental health","Risk behavior","MSM","intervention","Chemsex"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7270329","cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"perspective article discussing clinical implications without original empirical data","sample_n":null,"sample_text":"N/A – article provides expert perspective rather than original data","population":"men who have sex with men (MSM) living with HIV; no sample reported","country":"Netherlands (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors discuss how chemsex among HIV‑positive MSM can increase transmission risk and mental‑health problems, and argue that coordinated medical‑psychological care and behavioural interventions are needed to improve impulse control and reduce risky sex.","clinical_takeaway":"Clinicians should consider integrated somatic‑mental health approaches and impulse‑control training for MSM with HIV who engage in chemsex.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Integrates clinical experience with public‑health goals","Highlights need for interdisciplinary collaboration","Identifies practical barriers to implementing behavioral interventions"],"limitations":["No original empirical data presented","Lacks systematic synthesis of existing evidence","No measurement of key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2020.01005"}},{"id":6961,"doi":"10.1037/hea0000180","pmid":"25528179","pmcid":"PMC4476950","title":"A minority stress--emotion regulation model of sexual compulsivity among highly sexually active gay and bisexual men","authors":"Pachankis JE, Rendina HJ, Restar A, Ventuneac A, Grov C, Parsons JT.","first_author":"Pachankis JE","journal":"Health psychology : official journal of the Division of Health Psychology, American Psychological Association","year":2015,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":108,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 374 gay/bisexual men reporting ≥9 partners in the past 90 days; structural equation modelling of minority stress and emotion‑regulation variables.","sample_n":374,"sample_text":"Convenience sample of men with ≥9 sexual partners in past 90 days","population":"Gay and bisexual men, New York City, high sexual activity","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 374 gay and bisexual men who had many recent sexual partners and found that experiences of discrimination and internalized homophobia increase emotional instability, which together raise sexual compulsivity, partly through depression and anxiety.","clinical_takeaway":"Addressing minority‑stress experiences and emotion‑regulation skills may help reduce compulsive sexual behaviour in gay men.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a niche population","Use of validated psychological scales","Comprehensive minority‑stress model","Good model fit statistics"],"limitations":["Convenience, highly sexually active sample limits generalisability","Cross‑sectional design cannot infer causality","No measurement of moral incongruence or contextual sexual factors"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":13,"contrasting":0,"mentioning":170,"citing_publications":200,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/hea0000180"}},{"id":6962,"doi":"10.4088/pcc.19l02469","pmid":"31930785","pmcid":null,"title":"Positive Response of Compulsive Sexual Behavior to Transcranial Magnetic Stimulation","authors":"Blum AW, Grant JE.","first_author":"Blum AW","journal":"The primary care companion for CNS disorders","year":2020,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/pcc.19l02469"}},{"id":6963,"doi":"10.1016/j.encep.2023.10.003","pmid":"38092593","pmcid":null,"title":"[ICD-11: New revision and impact of this classification in psychiatry]","authors":"Chessa A, Sentissi O.","first_author":"Chessa A","journal":"L'Encephale","year":2024,"pub_types":["Review","Journal Article"],"keywords":["Revision","Who","Dsm-5","International Classification Of Diseases","Oms","Révision","Classification Internationale Des Maladies (Cim)","Mbnd"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of ICD-11 changes; no primary data, no systematic methods","sample_n":null,"sample_text":"N/A - narrative review","population":"none (review of literature and official documents)","country":"International","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how the WHO’s ICD‑11 updated mental‑health classifications, including the new diagnosis of compulsive sexual behavior, and discusses potential impacts on clinical practice.","clinical_takeaway":"Clinicians should note that compulsive sexual behavior is now a distinct ICD‑11 diagnosis, but evidence for its validity remains to be established.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of ICD‑11 revisions","Highlights addition of compulsive sexual behavior diagnosis"],"limitations":["Narrative, not systematic, no risk‑of‑bias assessment","No empirical data or primary analyses","Limited critical appraisal of diagnostic criteria"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.encep.2023.10.003"}},{"id":6964,"doi":"10.1016/j.esxm.2020.02.005","pmid":"32173350","pmcid":"PMC7261685","title":"Normal Testosterone but Higher Luteinizing Hormone Plasma Levels in Men With Hypersexual Disorder","authors":"Chatzittofis A, Boström AE, Öberg KG, Flanagan JN, Schiöth HB, Arver S, Jokinen J.","first_author":"Chatzittofis A","journal":"Sexual medicine","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Testosterone","Epigenetics","Biological Psychiatry","Hpg Axis","Hypersexual Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7261685","cited_by_count":14,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control comparison of hormone levels in 67 hypersexual men vs 39 controls","sample_n":106,"sample_text":"67 hypersexual men, 39 age‑matched healthy controls","population":"adult men, mean age ~38, recruited from clinical settings (hypersexual) and community (controls)","country":"Sweden (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Men diagnosed with hypersexual disorder showed higher luteinizing hormone but normal testosterone compared with non‑hypersexual men; no clear link was found with DNA methylation patterns.","clinical_takeaway":"Hormone testing alone is unlikely to distinguish hypersexual disorder; clinicians should consider broader biopsychosocial factors.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","gender","measurement"],"strengths":["Objective hormone assays","Use of validated sexual behavior scales","Inclusion of epigenetic profiling","Adjustment for multiple testing in methylation analysis"],"limitations":["Cross‑sectional design limits causal inference","Moral incongruence not measured despite distress outcome","Convenience clinical sample may not represent all hypersexual men","No separation of pornography use from masturbation"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":13,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2020.02.005"}},{"id":6965,"doi":"10.1007/s12160-016-9822-8","pmid":"27502073","pmcid":"PMC5299076","title":"Extending the Minority Stress Model to Incorporate HIV-Positive Gay and Bisexual Men's Experiences: a Longitudinal Examination of Mental Health and Sexual Risk Behavior","authors":"Rendina HJ, Gamarel KE, Pachankis JE, Ventuneac A, Grov C, Parsons JT.","first_author":"Rendina HJ","journal":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Mental health","stigma","Minority Stress","Hiv-positive","Gay And Bisexual Men"],"is_oa":false,"oa_url":null,"cited_by_count":99,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Longitudinal path analysis of 138 convenience-sampled HIV‑positive gay and bisexual men in NYC.","sample_n":138,"sample_text":"convenience sample of 138 highly sexually active, HIV‑positive GBM in NYC","population":"HIV‑positive gay and bisexual men (N=138), highly sexually active, NYC.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In HIV‑positive gay and bisexual men, internalized stigma about sexual orientation and HIV predicts depression, anxiety, and risky condom‑less sex, partly through poor emotion regulation.","clinical_takeaway":"Addressing self‑stigma and emotion‑regulation may improve mental health and reduce risky sex in HIV‑positive GBM.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Longitudinal design with mediation analysis","Use of validated minority‑stress and mental‑health scales","Focus on HIV‑specific stressors adds nuance"],"limitations":["Convenience sample limits generalisability","No assessment of moral or relational confounds","No pre‑registration or power justification reported"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":2,"mentioning":103,"citing_publications":155,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12160-016-9822-8"}},{"id":6966,"doi":"10.20944/preprints202406.0462.v1","pmid":null,"pmcid":null,"title":"Attachment Styles and Hypersexuality in Mexican Emerging Adults: Assessing the Influence on Couple and Sexual Satisfaction","authors":"Mejía-Cruz D, Avila-Chauvet L, Villalobos-Gallegos L.","first_author":"Mejía-Cruz D","journal":"Preprints.org","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.20944/preprints202406.0462.v1","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 214 Mexican emerging adults","sample_n":214,"sample_text":"214 emerging adults","population":"Mexican emerging adults (emerging adult age range, convenience sample)","country":"Mexico","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 214 Mexican young adults, insecure attachment styles were linked to higher hypersexuality, more risky sexual behaviour, lower sexual satisfaction but higher couple satisfaction. The study suggests these patterns could guide targeted relationship and sexual‑health interventions.","clinical_takeaway":"Screen for attachment style and hypersexual behaviours when addressing sexual risk and relationship satisfaction in emerging adults.","confidence":0.8,"topic_tags":["sexual_function","relationships","pornography","religiosity"],"strengths":["Use of several validated scales (ECR‑8, CSI‑4, SCL‑90)","Adequate sample size for cross‑sectional analysis","Explores understudied interaction of attachment, hypersexuality, and satisfaction"],"limitations":["Cross‑sectional design prevents causal inference","Moral incongruence and masturbation not assessed","Reliance on SAST‑R may conflate distress with addiction"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202406.0462.v1"}},{"id":6967,"doi":"10.1016/j.pscychresns.2009.04.008","pmid":"19836930","pmcid":"PMC2789480","title":"Preliminary investigation of the impulsive and neuroanatomical characteristics of compulsive sexual behavior","authors":"Miner MH, Raymond N, Mueller BA, Lloyd M, Lim KO.","first_author":"Miner MH","journal":"Psychiatry research","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":71,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Case‑control study with 8 CSB patients and 8 matched male controls; impulsivity questionnaires, Go‑No‑Go task, and diffusion tensor imaging.","sample_n":16,"sample_text":"Sixteen male subjects (8 CSB patients, 8 controls)","population":"Adult males (CSB patients vs non‑patient controls)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 16 men (half with compulsive sexual behaviour), researchers found higher impulsivity and greater white‑matter diffusivity in the superior frontal lobe compared with controls. Impulsivity scores related to some frontal‑lobe diffusion measures, but the brain findings did not fully match typical impulse‑control disorders.","clinical_takeaway":"Patients reporting compulsive sexual behaviour show heightened impulsivity, but small neuroimaging data are insufficient to guide clinical decisions.","confidence":0.6,"topic_tags":["csbd","neuroscience","pornography","sexual_function"],"strengths":["Use of both self‑report and behavioral task to assess impulsivity","Inclusion of neuroimaging (DTI) to explore structural correlates","Matched control group"],"limitations":["Very small sample (N=16) limits power and generalisability","No assessment of moral/incongruence or other key confounds","DTI findings interpreted with limited correction for multiple comparisons"],"rubric_version":"2.0","raw_total":34,"max_possible":70,"pct_score":49,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":5,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":7,"contrasting":0,"mentioning":66,"citing_publications":136,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pscychresns.2009.04.008"}},{"id":6969,"doi":"10.1186/s12888-021-03369-x","pmid":"34315438","pmcid":"PMC8314266","title":"Longitudinal influence of COVID-19-related stress on sexual compulsivity symptoms in Chinese undergraduates","authors":"Deng J, Li T, Wang J, Teng L.","first_author":"Deng J","journal":"BMC psychiatry","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Covid-19","Anxiety Sexual Compulsivity Symptom"],"is_oa":true,"oa_url":"https://bmcpsychiatry.biomedcentral.com/counter/pdf/10.1186/s12888-021-03369-x","cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"cross-lagged panel study with two waves (N≈3200 at T1, N≈3000 at T2) of Chinese undergraduates recruited online","sample_n":3219,"sample_text":"online convenience sample of undergraduates","population":"Chinese undergraduate students","country":"China","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 3,000 Chinese college students, higher stress related to the COVID‑19 pandemic predicted greater sexual compulsivity both immediately and several months later, with anxiety amplifying this effect.","clinical_takeaway":"COVID‑19 stress may increase sexual‑compulsivity symptoms; clinicians should assess anxiety when treating stressed students.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size","Two‑wave longitudinal design","Use of validated symptom scales"],"limitations":["Convenience, non‑representative sample","No measurement of moral incongruence or masturbation","No pre‑registration"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":9,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12888-021-03369-x"}},{"id":6970,"doi":"10.1007/s11524-013-9820-0","pmid":"23974946","pmcid":"PMC3795185","title":"Substance use and HIV risk behavior among men who have sex with men: the role of sexual compulsivity","authors":"Woolf-King SE, Rice TM, Truong HM, Woods WJ, Jerome RC, Carrico AW.","first_author":"Woolf-King SE","journal":"Journal of urban health : bulletin of the New York Academy of Medicine","year":2013,"pub_types":["Journal Article","Research Support, N.I.H., Extramural","case-report"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"probability‑based survey of MSM, logistic regression of serodiscordant unprotected anal intercourse","sample_n":null,"sample_text":"probability‑based sample (size not given in abstract)","population":"men who have sex with men (MSM), community sample","country":"USA (Journal of Urban Health, NIH funded)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a community sample of gay and bisexual men, higher sexual compulsivity and use of substances such as poppers, stimulants, and erectile‑dysfunction drugs were each linked to greater odds of having unprotected anal sex with an HIV‑positive or unknown‑status partner.","clinical_takeaway":"Screen for sexual compulsivity and substance use when advising MSM about HIV risk, and consider integrated behavioral interventions.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Probability‑based community sample","Use of validated sexual compulsivity measure (likely)","Multivariate analysis controlling for substance use"],"limitations":["Cross‑sectional; cannot infer causality","No assessment of moral incongruence, mental health, or relationship factors","Effect sizes and power not reported in abstract"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":24,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11524-013-9820-0"}},{"id":6971,"doi":"10.1007/s10508-015-0566-5","pmid":"26310878","pmcid":"PMC4769690","title":"Depression, Compulsive Sexual Behavior, and Sexual Risk-Taking Among Urban Young Gay and Bisexual Men: The P18 Cohort Study","authors":"Storholm ED, Satre DD, Kapadia F, Halkitis PN.","first_author":"Storholm ED","journal":"Archives of sexual behavior","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["HIV","Depression","Sexual Orientation","Compulsive Sexual Behavior","Sexual Risk","Ymsm"],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 509 urban YMSM recruited via non‑probability sampling","sample_n":509,"sample_text":"non‑probability convenience sample","population":"young gay, bisexual, and other men who have sex with men (18‑19 y) in New York City","country":"USA","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","masturbation_not_isolated","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 509 urban young gay and bisexual men, higher depressive symptoms were linked to more compulsive sexual behavior, and both were associated with more condom‑less anal sex. The authors suggest screening for both issues to improve HIV prevention.","clinical_takeaway":"Clinicians working with YMSM should assess compulsive sexual behavior when depression is present, as both are tied to higher sexual risk.","confidence":0.8,"topic_tags":["sexual_function","csbd","masturbation"],"strengths":["Large sample for a hard‑to‑reach population","Addresses both depression and CSB together","Relevant to HIV prevention context"],"limitations":["Cross‑sectional design limits causal inference","Unclear measurement validity for CSB","No assessment of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":30,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0566-5"}},{"id":6975,"doi":"10.1080/10538712.2020.1825148","pmid":"33017227","pmcid":null,"title":"Associations between Childhood Sexual Abuse and Sexual Well-being in Adulthood: A Systematic Literature Review","authors":"Bigras N, Vaillancourt-Morel MP, Nolin MC, Bergeron S.","first_author":"Bigras N","journal":"Journal of child sexual abuse","year":2021,"pub_types":["Systematic Review","Journal Article"],"keywords":["Sexual function","Child Sexual Abuse","Sexual Satisfaction","Sexual Behaviors","Sexual Cognitions","Sex-related Affects"],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Narrative systematic literature review of 18 empirical studies published in the past five years, focusing on associations between childhood sexual abuse and various domains of adult sexual well-being. No meta‑analysis or risk‑of‑bias assessment reported in the abstract.","sample_n":18,"sample_text":"Eighteen eligible studies were identified.","population":"Adults with a history of childhood sexual abuse (CSA) compared to adults without CSA; both genders, but men underrepresented.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review looked at 18 recent studies and found that childhood sexual abuse is linked to poorer sexual function and satisfaction in adulthood, but the strength of the link depends on other health issues and the type of sample studied.","clinical_takeaway":"Clinicians should assess for a history of childhood sexual abuse when addressing adult sexual problems, but recognize that outcomes vary with comorbid conditions.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive synthesis of recent literature","Identifies gaps (e.g., male underrepresentation)","Considers multiple domains of sexual well‑being"],"limitations":["No meta‑analysis or formal risk‑of‑bias assessment reported","Limited detail on how individual studies measured constructs","Potential heterogeneity across included studies not quantified"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":31,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2020.1825148"}},{"id":6976,"doi":"10.1007/s10508-014-0317-z","pmid":"25030121","pmcid":null,"title":"Relationship between sexual compulsivity and sexual risk behaviors among Chinese sexually active males","authors":"Liao W, Lau JT, Tsui HY, Gu J, Wang Z.","first_author":"Liao W","journal":"Archives of sexual behavior","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"random telephone survey of 1,048 sexually active Hong Kong men; cross‑sectional","sample_n":1048,"sample_text":"random telephone survey of Hong Kong adult males","population":"sexually active adult males in Hong Kong (general community sample)","country":"Hong Kong","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers validated a Chinese version of a 10‑item scale measuring sexual compulsivity in 1,048 Hong Kong men and found that higher scores were linked to having multiple partners, sex with sex workers, recent STIs and inconsistent condom use.","clinical_takeaway":"Higher sexual compulsivity scores identify men at greater risk for unsafe sex and STIs; screening could guide targeted education.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, randomly selected community sample","Validated Chinese version of SCS with good reliability","Factor analysis identifies distinct dimensions"],"limitations":["Cross‑sectional; cannot infer causality","No control for moral, mental‑health or trauma confounders","Sexual risk outcomes based on self‑report"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":29,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0317-z"}},{"id":6977,"doi":"10.1055/a-1647-3280","pmid":"34781382","pmcid":null,"title":"[Behavioral Addictions in Psychosomatic Care]","authors":"Wölfling K, Zeeck A, Te Wildt B, Resmark G, Morawa E, Kersting A, von Wietersheim J, Müller A.","first_author":"Wölfling K","journal":"Psychotherapie, Psychosomatik, medizinische Psychologie","year":2022,"pub_types":["Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"multicenter cross‑sectional survey of 801 consecutive psychosomatic patients","sample_n":801,"sample_text":"801 patients","population":"Patients seeking treatment for mental disorders (non‑addiction) in eight university psychosomatic hospitals","country":"Germany","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 801 German psychosomatic patients, about one‑quarter reported at least one behavioral addiction, with hypersexual disorder present in 5.4% of the sample.","clinical_takeaway":"Screen for hypersexual and other behavioral addictions in psychosomatic patients, but note that prevalence may differ in the general population.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large multicenter sample (N=801)","Standardized questionnaires across multiple sites","Includes both genders and several behavioral addictions"],"limitations":["Cross‑sectional design; no causal inference","Lack of control for moral incongruence, masturbation, mental‑health covariates","Unclear which specific validated scales were used"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/a-1647-3280"}},{"id":6979,"doi":"10.1177/08862605221118969","pmid":"36000712","pmcid":null,"title":"Sex in the Shadow of Child Sexual Abuse: The Development and Psychometric Evaluation of the Post-Traumatic Sexuality (PT-SEX) Scale","authors":"Gewirtz-Meydan A, Lassri D.","first_author":"Gewirtz-Meydan A","journal":"Journal of interpersonal violence","year":2023,"pub_types":["Journal Article"],"keywords":["Sexuality","Trauma","Child Sexual Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience online samples of women survivors of CSA; factor‑analysis validation of a new scale; between‑group comparison with non‑CSA participants.","sample_n":781,"sample_text":"Convenience online samples; not nationally representative.","population":"Women survivors of child sexual abuse (N≈781 total) and a comparison group without CSA history.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and tested a new questionnaire (PT‑SEX) that measures trauma‑related sexual symptoms in women who experienced child sexual abuse. The scale showed six reliable factors and distinguished survivors from non‑survivors, linking these symptoms to lower sexual self‑esteem and higher depression.","clinical_takeaway":"PT‑SEX can help clinicians identify trauma‑related sexual symptoms that may need targeted therapy beyond standard PTSD treatment.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Rigorous psychometric development of a novel scale","Large combined sample for scale validation","Includes relevant mental‑health covariates"],"limitations":["Convenience, non‑representative samples","No control for moral/religious factors or masturbation","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":5,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605221118969"}},{"id":6980,"doi":"10.1101/2025.06.06.25328536","pmid":null,"pmcid":null,"title":"Neural signatures and personalized neuromodulation in a subject experiencing context-dependent inhibitory control deficits","authors":"Mattar LS, Shah S, Chamakura LS, Oswalt D, Zhang Y, Devara D, Kang JU, Jourahmad Z, Jafri R, Liu G, Adkinson J, Danstrom IA, Fan X, Reed YY, Bijanki KR, Goldman A, Lin L, Krishnan V, Provenza NR, Watrous AJ, Heilbronner SR, Sheth SA, Banks GP, Bartoli E.","first_author":"Mattar LS","journal":"medRxiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.medrxiv.org/content/medrxiv/early/2025/06/11/2025.06.06.25328536.full.pdf","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-subject intracranial EEG case study","sample_n":1,"sample_text":"single patient (n=1)","population":"1 adult patient with Klüver‑Bucy syndrome and hypersexuality","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A patient with Klüver‑Bucy syndrome showed loss of control over sexual actions when shown arousing pictures. Intracranial EEG identified brain patterns linked to these failures, and brief electrical stimulation of a frontal brain area improved performance, suggesting a targeted neuromodulation approach.","clinical_takeaway":"Personalized brain stimulation may help specific impulse‑control problems, but evidence is limited to one case.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["High‑resolution intracranial neural recordings","Personalized stimulus paradigm","Demonstrates feasibility of closed‑loop neuromodulation"],"limitations":["Single‑case design limits generalizability","No validated measures of hypersexuality or addiction","No control group or replication","Potential reverse inference from EEG signatures"],"rubric_version":"2.0","raw_total":12,"max_possible":60,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":3,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2025.06.06.25328536"}},{"id":6981,"doi":"10.1080/10720162.2017.1343700","pmid":"31662601","pmcid":"PMC6818717","title":"(S)He's Gotta Have It: Emotion Regulation, Emotional Expression, and Sexual Risk Behavior in Emerging Adult Couples","authors":"Rizor A, Callands T, Desrosiers A, Kershaw T.","first_author":"Rizor A","journal":"Sexual addiction & compulsivity","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Couples","Emotion Regulation","Sexual Risk Behavior","Emotional Expression","Emerging Adults"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"pilot randomized controlled intervention with 49 couples (N=98)","sample_n":98,"sample_text":"49 couples (n=98) participating in a randomized control pilot intervention","population":"emerging adult couples (likely convenience sample)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small study of 49 emerging‑adult couples, researchers found that both individuals' and their partners' difficulties with regulating and expressing emotions were linked to higher sexual risk behaviours such as compulsive sex and sensation seeking.","clinical_takeaway":"Emotion‑regulation issues in couples may be a target for reducing risky sexual behavior.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Couple dyadic analysis","Randomized pilot intervention","Inclusion of partner effects"],"limitations":["Small pilot sample, likely underpowered","No measurement of key confounds (moral incongruence, masturbation, mental health)","Reliance on self‑report scales, unclear validation"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10720162.2017.1343700"}},{"id":6982,"doi":"10.1136/bcr-2018-225380","pmid":"29866696","pmcid":"PMC5990071","title":"Unexplained bone pain and sexual addiction","authors":"Crépin JC, Blot M, Buisson M, Piroth L.","first_author":"Crépin JC","journal":"BMJ case reports","year":2018,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Bone And Joint Infections","Sexual Transmitted Infections (Bacterial)"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bcr-2018-225380"}},{"id":6983,"doi":"10.1007/s40429-022-00435-6","pmid":"36118286","pmcid":"PMC9465150","title":"Estimation of Behavioral Addiction Prevalence During COVID-19 Pandemic: A Systematic Review and Meta-analysis","authors":"Alimoradi Z, Lotfi A, Lin CY, Griffiths MD, Pakpour AH.","first_author":"Alimoradi Z","journal":"Current addiction reports","year":2022,"pub_types":["review-article","Review","Journal Article"],"keywords":["Food Addiction","Internet Addiction","Exercise Addiction","Addictive Behavior","Smartphone Addiction","Gaming Addiction","Shopping Addiction","Gambling Addiction","Social Media Addiction","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9465150","cited_by_count":110,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review and meta-analysis of 94 observational studies (N=237,657) estimating prevalence of various behavioral addictions during COVID‑19.","sample_n":237657,"sample_text":"237,657 participants from 40 different countries","population":"General adult population across 40 countries (mean age 25 y, 57 % female).","country":"International","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 94 studies (over 237,000 people) found that about 11 % of individuals showed signs of a behavioral addiction during the COVID‑19 pandemic, with sex addiction reported in roughly 9 % of participants.","clinical_takeaway":"Clinicians should be aware that a notable minority report problematic sexual‑related behaviours during crises, but prevalence estimates vary with measurement methods.","confidence":0.8,"topic_tags":["prevalence","sexual_function"],"strengths":["Large pooled sample across many countries","Systematic methodology with bias correction","Provides prevalence estimates for multiple behavioral addictions"],"limitations":["Reliance on heterogeneous, often self‑report scales","No assessment of moral incongruence or other key confounds for sex addiction","Quality of primary studies varies, affecting pooled estimates"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":7,"contrasting":2,"mentioning":104,"citing_publications":216,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40429-022-00435-6"}},{"id":6984,"doi":"10.21203/rs.3.rs-261395/v1","pmid":null,"pmcid":null,"title":"Association of Syndemic Conditions and Quality of Life among People Living with HIV/AIDS","authors":"Gomes MO, Castro R, Mota JC, Boni RBD.","first_author":"Gomes MO","journal":"Research Square","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-261395/v1.pdf?c=1631893464000","cited_by_count":1,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"secondary analysis of clinic‑based cohort (N=1530) using linear regression to examine associations between syndemic conditions and WHOQOL‑HIV domains","sample_n":1530,"sample_text":"clinic‑based convenience sample of PLWHA under care","population":"people living with HIV/AIDS in Rio de Janeiro, Brazil (mostly male, median age 43)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 1,530 Brazilian adults living with HIV, having multiple problems such as binge drinking, compulsive sexual behavior, drug use, intimate‑partner violence, or depression was linked to poorer quality of life, especially in psychological, social and environmental areas.","clinical_takeaway":"Addressing co‑occurring issues like depression, substance use, and violence may improve quality of life for people with HIV.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["large sample for a clinic‑based study","use of validated WHOQOL‑HIV instrument","multivariate analysis of several syndemic factors"],"limitations":["cross‑sectional design precludes causal inference","measurement of compulsive sexual behavior not described; likely unvalidated","no control for moral incongruence or masturbation, which could confound CSB findings"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-261395/v1"}},{"id":6985,"doi":"10.1080/10720162.2011.593420","pmid":"33840989","pmcid":"PMC8031475","title":"Non-Paraphilic Compulsive Sexual Behavior and Psychiatric Co-morbidities in Gay and Bisexual Men","authors":"Morgenstern J, Muench F, O'Leary A, Wainberg M, Parsons JT, Hollander E, Blain L, Irwin T.","first_author":"Morgenstern J","journal":"Sexual addiction & compulsivity","year":2011,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional community sample of 183 gay/bisexual men who self‑reported difficulty controlling sexual behaviour; diagnostic and face‑valid measures administered; no control/comparator group","sample_n":183,"sample_text":"community sample of 183 gay and bisexual men reporting difficulty controlling sexual behaviour","population":"gay and bisexual men, New York City, self‑selected for sexual‑control difficulties (N=183)","country":"USA","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined 183 gay and bisexual men in New York who said they could not control their sexual behaviour. Using diagnostic interviews it found a consistent pattern of compulsive sexual behaviour that co‑occurred with various psychiatric conditions, suggesting it may be a distinct syndrome.","clinical_takeaway":"Compulsive sexual behaviour in gay/bisexual men often co‑occurs with mental‑health issues; clinicians should assess both, but note the findings come from a self‑selected group.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a niche population","Use of multiple diagnostic measures with reported inter‑rater reliability","Assessment of psychiatric comorbidity"],"limitations":["Self‑selected, non‑representative sample of men already reporting control problems","No measurement of moral incongruence or masturbation, limiting interpretation of ‘problematic’ use","Cross‑sectional design; causal claims not justified","Addiction criteria not fully operationalised"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":23,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10720162.2011.593420"}},{"id":6987,"doi":"10.1016/j.addbeh.2021.106885","pmid":"33684870","pmcid":null,"title":"Affective and cognitive processes involved in behavioral addictions","authors":"Wegmann E, Brand M.","first_author":"Wegmann E","journal":"Addictive behaviors","year":2021,"pub_types":["Editorial"],"keywords":["Hypersexual Behavior","Pathological Gambling","Behavioral Addictions","Smartphone Addiction","Pathological Buying","Gaming Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"editorial introduction to a special issue, no original data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The editorial introduces a special issue that reviews how emotions, cravings, mood, stress, and cognitive functions such as attention and memory may drive various behavioral addictions, including compulsive sexual behavior.","clinical_takeaway":"None – the piece is a thematic overview, not a clinical study.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad overview of affective and cognitive mechanisms","Links multiple behavioral addictions including CSBD"],"limitations":["No original empirical data","No systematic review methodology described"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2021.106885"}},{"id":6989,"doi":"10.3109/00952990.2010.503823","pmid":"20666699","pmcid":null,"title":"Sexual addictions","authors":"Garcia FD, Thibaut F.","first_author":"Garcia FD","journal":"The American journal of drug and alcohol abuse","year":2010,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":76,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"This narrative review argues that excessive non‑paraphilic sexual behavior fits an addiction model, describing its symptoms and overlap with other addictions, but provides no new data and calls for controlled studies.","clinical_takeaway":"No direct clinical guidance; highlights need for evidence‑based treatment research.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad literature coverage","Identifies conceptual models"],"limitations":["No systematic methodology","Lacks empirical data","Advocates addiction model without evidence"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":2,"contrasting":0,"mentioning":115,"citing_publications":160,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/00952990.2010.503823"}},{"id":6990,"doi":"10.1007/s10508-009-9504-8","pmid":"19421850","pmcid":null,"title":"Perceived \"out of control\" sexual behavior in a cohort of young adults from the Dunedin Multidisciplinary Health and Development Study","authors":"Skegg K, Nada-Raja S, Dickson N, Paul C.","first_author":"Skegg K","journal":"Archives of sexual behavior","year":2010,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"population-based cohort, single wave at age 32 with questionnaire","sample_n":940,"sample_text":"940 (93%) of 1,015 members responded","population":"young adults, age 32, Dunedin cohort, N≈940","country":"New Zealand","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative sample of 32‑year‑olds, about 13 % of men and 7 % of women said they had sexual thoughts or behaviours they felt were “out of control”. These reports were linked to having many partners, paid sex, and childhood sexual abuse, but few said it caused life problems.","clinical_takeaway":"Perceived loss of control over sexual behaviour is relatively common but rarely interferes with daily life; clinicians should assess context and distress before labeling it a disorder.","confidence":0.78,"topic_tags":["prevalence","sexual_function"],"strengths":["large, representative birth‑cohort","high response rate (93%)","includes childhood sexual abuse data"],"limitations":["OCSE measured by single unvalidated self‑label item","no assessment of masturbation or moral incongruence","cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":5,"design":7,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":7,"contrasting":1,"mentioning":35,"citing_publications":133,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-009-9504-8"}},{"id":6991,"doi":"10.3171/case25800","pmid":"41730194","pmcid":"PMC12927194","title":"Intraventricular neurocytoma presenting as Kleine-Levin syndrome: resolution after resection and review of neurosurgical conditions associated with hypersexuality. Illustrative case","authors":"Scravaglieri A, Viglio A, Albergati A, Magrassi L.","first_author":"Scravaglieri A","journal":"Journal of neurosurgery. Case lessons","year":2026,"pub_types":["Journal Article","case-report"],"keywords":["Hypothalamus","Thalamus","Septal nuclei","Neurocytoma","Kleine-levin Syndrome","Hypersexuality"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12927194","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single clinical case; imaging used for diagnosis, no control group","sample_n":1,"sample_text":"N=1 (case report)","population":"25‑year‑old male with intraventricular neurocytoma and secondary Kleine‑Levin syndrome","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 25‑year‑old man developed episodes of excessive sleep, lack of motivation, and increased sexual activity due to a rare brain tumor. After surgical removal of the tumor, all symptoms disappeared, suggesting the lesion caused the syndrome.","clinical_takeaway":"Rare brain lesions can produce hypersexuality; treat underlying neurological cause when present.","confidence":0.6,"topic_tags":["neuroscience","csbd","sexual_function","pornography","masturbation"],"strengths":["Provides rare clinical observation linking a specific brain lesion to hypersexuality","Detailed imaging documentation of tumor location"],"limitations":["Single case; no generalisable inference","No standardized measures of sexual behavior or distress","No control or comparison group"],"rubric_version":"2.0","raw_total":10,"max_possible":60,"pct_score":17,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":2,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3171/case25800"}},{"id":6992,"doi":"10.1016/j.jsxm.2021.06.008","pmid":"34303631","pmcid":null,"title":"Reaching Men and Women at Risk of Committing Sexual Offences - Findings From the National Swedish Telephone Helpline PrevenTell","authors":"Adebahr R, Söderström EZ, Arver S, Jokinen J, Öberg KG.","first_author":"Adebahr R","journal":"The journal of sexual medicine","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Prevention","Child Sexual Abuse","Sexual Violence","Paraphilic Disorder","Compulsive Sexual Behaviour Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Telephone‑based semi‑structured interview of self‑selected callers to a national helpline; descriptive statistics; no control group.","sample_n":1573,"sample_text":"Self‑selected helpline callers; not representative of the general population.","population":"Individuals (mostly men) who voluntarily contacted a Swedish helpline reporting out‑of‑control sexual behavior or paraphilic interests (N≈1573).","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A Swedish telephone helpline reached 1,600 people who said they could not control their sexual behaviour or had paraphilic interests. Most were men; many also reported compulsive sexual behaviour and some had pedophilic interests. The study describes their demographics and mental‑health characteristics to inform secondary‑prevention efforts.","clinical_takeaway":"Helplines can engage people at risk of sexual offences, but the data are based on self‑report and lack formal diagnostic assessment.","confidence":0.6,"topic_tags":["sexual_function","csbd"],"strengths":["Large absolute sample for a hard‑to‑reach population","First national data on helpline contacts","Provides gender‑specific descriptive information"],"limitations":["Self‑selected, non‑representative sample","No validated diagnostic instruments","Limited control of key confounds (moral incongruence, masturbation, mental health)","Descriptive only; no causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.06.008"}},{"id":6993,"doi":"10.1007/s10461-015-1083-1","pmid":"25957856","pmcid":"PMC5482006","title":"The Psychological Context of Sexual Compulsivity Among Men Who Have Sex with Men","authors":"Jerome RC, Woods WJ, Moskowitz JT, Carrico AW.","first_author":"Jerome RC","journal":"AIDS and behavior","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Trauma","Emotion Regulation","Men Who Have Sex With Men","Sexual Compulsivity","Childhood Sexual Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Probability‑based mail‑in questionnaire of 711 MSM in San Francisco (2002‑03).","sample_n":711,"sample_text":"711 MSM recruited via probability‑based sampling","population":"Men who have sex with men (MSM), community sample, United States","country":"United States","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2002‑03 survey of 711 US men who have sex with men, higher sexual compulsivity was linked to more frequent sexual thoughts when participants reported trauma‑related dissociation or recent stimulant use, and to feeling less control over sexual behavior when they reported more anger or were HIV‑positive.","clinical_takeaway":"Screen for traumatic stress and emotional dysregulation when addressing sexual compulsivity in MSM.","confidence":0.73,"topic_tags":["sexual_function","csbd"],"strengths":["Large probability‑based sample","Uses validated sexual compulsivity scale (presumed)","Measures multiple psychosocial variables"],"limitations":["Cross‑sectional; cannot infer causality","No assessment of moral incongruence or masturbation","No preregistration or effect‑size reporting"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":11,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-015-1083-1"}},{"id":6994,"doi":"10.1080/00224490409552241","pmid":"15765274","pmcid":"PMC3331786","title":"Sexual compulsivity among heterosexual college students","authors":"Dodge B, Reece M, Cole SL, Sandfort TG.","first_author":"Dodge B","journal":"Journal of sex research","year":2004,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":84,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 876 heterosexual college students","sample_n":876,"sample_text":"Convenience sample of undergraduates","population":"heterosexual college students (US Midwest)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested the Sexual Compulsivity Scale with 876 heterosexual college students and found it reliable and linked to higher numbers of sexual partners and risky sex, but it is unclear whether it measures compulsivity distinct from desire.","clinical_takeaway":"The scale appears usable in student populations, yet clinicians should interpret high scores cautiously and consider desire and moral factors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for a student survey","Use of a published, psychometrically evaluated scale (SCS)","Examination of multiple sexual behavior categories"],"limitations":["Cross‑sectional design; cannot infer causality","No measurement of moral incongruence or masturbation behavior","Potential self‑selection bias from a single university"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":9,"contrasting":1,"mentioning":103,"citing_publications":157,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490409552241"}},{"id":6995,"doi":"10.1007/s10865-020-00148-z","pmid":"32361793","pmcid":"PMC7606295","title":"Connecting the dots: a comparison of network analysis and exploratory factor analysis to examine psychosocial syndemic indicators among HIV-negative sexual minority men","authors":"Lee JS, Bainter SA, Carrico AW, Glynn TR, Rogers BG, Albright C, O'Cleirigh C, Mayer KH, Safren SA.","first_author":"Lee JS","journal":"Journal of behavioral medicine","year":2020,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Men Who Have Sex With Men","Network Analysis","Exploratory Factor Analysis","Syndemics"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 194 high‑risk MSM, self‑reported psychosocial indicators","sample_n":194,"sample_text":"194 MSM recruited (method not detailed in abstract)","population":"MSM (men who have sex with men), HIV‑negative, high risk for HIV acquisition, N=194","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 194 gay and bisexual men at high HIV risk, researchers compared factor analysis and network analysis to see how mental‑health problems, substance use and sexual compulsivity cluster together. Depression, suicidal thoughts, injection drug use and substance use were most central, suggesting they are key targets for HIV‑prevention interventions.","clinical_takeaway":"Address depression, suicidal ideation and substance use together when designing HIV‑prevention programs for high‑risk MSM.","confidence":0.73,"topic_tags":["sexual_function"],"strengths":["Large community sample for this population","Use of both EFA and network analysis for methodological comparison","Identifies central psychosocial factors for intervention"],"limitations":["Cross‑sectional design cannot infer causality","Reliance on self‑report without verification of measures","Unclear whether all scales were validated"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10865-020-00148-z"}},{"id":6996,"doi":"10.1111/jsm.12783","pmid":"25496349","pmcid":"PMC4310754","title":"An item response theory analysis of the sexual compulsivity scale and its correspondence with the hypersexual disorder screening inventory among a sample of highly sexually active gay and bisexual men","authors":"Ventuneac A, Rendina HJ, Grov C, Mustanski B, Parsons JT.","first_author":"Ventuneac A","journal":"The journal of sexual medicine","year":2015,"pub_types":["research-article","Validation Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Psychometrics","Item Response Theory","Hypersexuality","Sexual Compulsivity","Gay And Bisexual Men","Hypersexual Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of the Sexual Compulsivity Scale using item response theory in a convenience sample of highly sexually active gay and bisexual men (N=202).","sample_n":202,"sample_text":"202 highly sexually active gay and bisexual men","population":"gay and bisexual men who are highly sexually active","country":"USA (presumed given NIH funding)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined how well the Sexual Compulsivity Scale measures hypersexuality in gay and bisexual men, using advanced statistical modeling and comparing it to a diagnostic screening tool.","clinical_takeaway":"The SCS can help flag men at risk for hypersexuality but should be used together with the HDSI for accurate classification.","confidence":0.7,"topic_tags":["sexual_function","measurement"],"strengths":["Uses established, validated scales (SCS, HDSI)","Applies modern IRT methodology","Provides sensitivity/specificity data for screening"],"limitations":["Convenience sample of highly sexually active GBM limits generalizability","No measurement of moral incongruence or other key confounds","Cross‑sectional; cannot assess temporal stability"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12783"}},{"id":6998,"doi":"10.3389/fpsyg.2026.1706722","pmid":"41694011","pmcid":"PMC12894211","title":"One-year follow-up effects of an acceptance-based treatment for hypersexuality","authors":"Ortega-Otero M, Polín E, Lobato D, Montesinos F.","first_author":"Ortega-Otero M","journal":"Frontiers in psychology","year":2026,"pub_types":["brief-report","Journal Article"],"keywords":["Sexual Health","Acceptance And Commitment Therapy","Psychological Flexibility","Hypersexuality","Act","Chemsex","Lgbtqia+ Mental Health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12894211","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"single-group pre‑post case series (N=10) with 1‑year follow‑up","sample_n":10,"sample_text":"Ten participants completed the intervention and follow‑up assessments.","population":"patients seeking ACT for clinically significant hypersexuality (mostly men, non‑heterosexual, chemsex participants)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A tiny (10‑person) study found that an eight‑session Acceptance‑and‑Commitment Therapy program reduced self‑reported hypersexual behaviour and craving for up to a year, but the design lacked a control group and used only self‑report scales.","clinical_takeaway":"Preliminary evidence suggests ACT may help some people with hypersexuality, but robust trials are needed before clinical recommendation.","confidence":0.7,"topic_tags":["treatment","sexual_function","csbd"],"strengths":["1‑year follow‑up provides rare long‑term data","use of clinically meaningful change analysis (Jacobson & Truax)","focus on ACT, a transdiagnostic therapeutic approach"],"limitations":["Very small, non‑random sample (N=10)","No control or comparison group","Unclear measurement of hypersexuality (possible circularity)","Potential self‑selection bias (clinical, chemsex, LGBTQIA+ sample)"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2026.1706722"}},{"id":6999,"doi":"10.1016/j.ajp.2019.05.018","pmid":"31112898","pmcid":null,"title":"Does internet dating mediate sexual addiction: A case study","authors":"Sharma MK, Anand N, Thakur PC, N S, Baglari H, Singh P, P T.","first_author":"Sharma MK","journal":"Asian journal of psychiatry","year":2019,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ajp.2019.05.018"}},{"id":7000,"doi":"10.1556/2006.2021.00026","pmid":"33989174","pmcid":"PMC8996804","title":"Social communication disorder and behavioural addiction: Case report and clinical implications","authors":"Hurel E, Challet-Bouju G, Chirio-Espitalier M, Vincent M, Grall-Bronnec M.","first_author":"Hurel E","journal":"Journal of behavioral addictions","year":2021,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["neuropsychology","Case Report","Addictive Disorder","Sexual Addiction","Behavioural Addiction","Social Communication Disorder"],"is_oa":true,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/10/2/article-p352.pdf","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single patient with social communication disorder and self‑reported sexual addiction; no control group, no statistical testing","sample_n":1,"sample_text":"N=1 (case report)","population":"single adult patient (N=1) with SCD and sexual addiction","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A single patient with social communication difficulties also reported a sexual addiction. The authors suggest that problems with understanding others' emotions may contribute to the development of behavioural addictions, and they adapted treatment accordingly.","clinical_takeaway":"One case suggests social cognition deficits might play a role in sexual addiction, but evidence is insufficient for clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Highlights rare comorbidity of SCD and behavioural addiction","Provides detailed clinical description"],"limitations":["Single case, no generalisability","Lack of validated addiction measures","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":12,"max_possible":60,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":2,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2021.00026"}},{"id":7002,"doi":"10.1098/rstb.2018.0129","pmid":"30966924","pmcid":"PMC6335457","title":"Relationships among impulsive, addictive and sexual tendencies and behaviours: a systematic review of experimental and prospective studies in humans","authors":"Leeman RF, Rowland BHP, Gebru NM, Potenza MN.","first_author":"Leeman RF","journal":"Philosophical transactions of the Royal Society of London. Series B, Biological sciences","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","review-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Cocaine","Alcohol","Delay Discounting","Marijuana","Urgency","Human Laboratory Research"],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of experimental and prospective human studies (29 reports from 28 studies)","sample_n":null,"sample_text":"29 published reports from 28 studies (sample sizes varied across primary studies)","population":"humans (adult participants in impulsivity, addiction, and sexual behavior studies)","country":"international (studies from multiple countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review examined 28 human studies to see whether impulsivity predicts or follows addictive and sexual behaviours. General self‑reported impulsivity was linked to higher risk of both types of behaviour, and the authors note the need for more research that measures impulsivity, addiction, and sexual actions together.","clinical_takeaway":"Impulsivity appears to be a risk factor for problematic sexual and addictive behaviours; clinicians should assess impulsivity when evaluating such risks.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive systematic review of experimental and prospective studies","Highlights gaps and future research directions","Integrates impulsivity, addiction, and sexual behavior literature"],"limitations":["Variable quality and definitions across included studies","No quantitative meta‑analysis or effect‑size synthesis","Limited assessment of key confounds (e.g., moral incongruence, masturbation)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1098/rstb.2018.0129"}},{"id":7003,"doi":"10.3390/clinpract16010019","pmid":"41590213","pmcid":"PMC12840245","title":"A Hypersexuality Subset Behavior Induced by Aripiprazole Overdose in an Antipsychotic Naïve Patient: A Case Report and Review of the Literature","authors":"Serfilippi T, Piccirillo S, Preziuso A, Terenzi V, Romagnoli F, Tarini M, Lariccia V, Secondo A, Magi S.","first_author":"Serfilippi T","journal":"Clinics and practice","year":2026,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Dopamine","Sexual","Addiction","Case Report","Aripiprazole","Hypersexuality"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12840245","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report, no control group","sample_n":1,"sample_text":"1 patient","population":"30‑year‑old antipsychotic‑naïve patient with bipolar disorder","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 30‑year‑old man without prior antipsychotic treatment developed intense sexual urges and a shift in sexual orientation after an overdose of aripiprazole. Symptoms resolved after the drug was stopped and replaced with paliperidone. The authors recommend screening for impulse‑control issues before prescribing aripiprazole.","clinical_takeaway":"Monitor for hypersexuality when prescribing aripiprazole, especially at high doses, and consider switching if impulsive sexual behaviours emerge.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","csbd"],"strengths":["detailed clinical description","follow‑up after medication change"],"limitations":["single case, no generalisability","no validated measures of hypersexuality","no assessment of confounding factors"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/clinpract16010019"}},{"id":7005,"doi":"10.4088/pcc.17l02109","pmid":"29469239","pmcid":null,"title":"Compulsive Sexual Behaviors Treated With Naltrexone Monotherapy","authors":"Camacho M, Moura AR, Oliveira-Maia AJ.","first_author":"Camacho M","journal":"The primary care companion for CNS disorders","year":2018,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/pcc.17l02109"}},{"id":7006,"doi":"10.1080/00224499.2013.829796","pmid":"24299241","pmcid":null,"title":"Shame, sexual compulsivity, and eroticizing flirtatious others: an experimental study","authors":"Petrican R, Burris CT, Moscovitch M.","first_author":"Petrican R","journal":"Journal of sex research","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"lab-based experimental manipulation of shame with gaze‑cueing task; within‑subject condition (shame vs neutral) and individual differences (sexual compulsivity).","sample_n":74,"sample_text":"Convenience sample of university students, not representative of general population.","population":"74 heterosexual university students (age‑traditional)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study experimentally induced shame in university students and found that people with higher sexual compulsivity showed more interest in flirtatious faces after feeling shame, as measured by attention and attractiveness ratings.","clinical_takeaway":"Shame may increase sexual attention in already compulsive individuals; clinicians should consider affect regulation when addressing sexual compulsivity.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Experimental manipulation of shame allows causal inference for affective effect","Validated sexual compulsivity scale used","Objective attentional measure (gaze cueing) complements self‑reports"],"limitations":["Convenience student sample limits generalisability","No measurement of moral or mental‑health confounds","No pre‑registration or reported effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2013.829796"}},{"id":7007,"doi":"10.1037/hea0000509","pmid":"28541070","pmcid":"PMC5532533","title":"Syndemic conditions and HIV transmission risk behavior among HIV-negative gay and bisexual men in a U.S. national sample","authors":"Parsons JT, Millar BM, Moody RL, Starks TJ, Rendina HJ, Grov C.","first_author":"Parsons JT","journal":"Health psychology : official journal of the Division of Health Psychology, American Psychological Association","year":2017,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.1037/hea0000509","cited_by_count":68,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,033 HIV‑negative gay and bisexual men recruited nationally; assessed syndemic conditions and self‑reported HIV transmission risk behaviors","sample_n":1033,"sample_text":"national sample of 1,033 HIV‑negative gay and bisexual men","population":"gay and bisexual men, HIV‑negative, United States, national sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a U.S.‑wide survey of 1,033 gay and bisexual men without HIV, over 60% experienced at least one issue such as depression, drug use, or sexual compulsivity. Those with more of these problems were more likely to engage in behaviors that increase HIV risk, especially men in non‑urban areas.","clinical_takeaway":"Addressing co‑occurring mental‑health and substance‑use issues may lower HIV transmission risk in gay and bisexual men.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally diverse sample","Examines multiple psychosocial factors together","Multivariate analysis of risk behavior"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on self‑report measures","No explicit validation details for all scales"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":6,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":69,"citing_publications":85,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/hea0000509"}},{"id":7008,"doi":"10.31887/dcns.2020.22.3/lmalandain","pmid":"33162773","pmcid":"PMC7605017","title":"First case report of tDCS efficacy in severe chemsex addiction
","authors":"Malandain L, Blanc JV, Ferreri F, Giorgiadis T, Mosser S, Mouchabac S, Thibaut F.","first_author":"Malandain L","journal":"Dialogues in clinical neuroscience","year":2020,"pub_types":["research-article","Journal Article","Case Reports"],"keywords":["Virtual reality","Sexual Addiction","Transcranial Direct Current Stimulation (Tdcs)","Chemsex","Slamming","Chemical Sex"],"is_oa":true,"oa_url":"https://www.tandfonline.com/doi/epdf/10.31887/DCNS.2020.22.3/lmalandain?needAccess=true&role=button","cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single open‑label case report of one patient receiving right‑DLPFC tDCS for self‑reported severe chemsex addiction","sample_n":1,"sample_text":"one patient","population":"adult male man who has sex with men; single case","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["circular_addiction_scale","causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"avoid","plain_summary":"A 2020 case report describes one man with severe chemsex who stopped the behavior after five days of daily right‑prefrontal tDCS, staying abstinent for eight months. The authors attribute the change to increased prefrontal activity reducing craving.","clinical_takeaway":"Evidence from a single case does not support tDCS as a proven treatment for chemsex; clinicians should await controlled studies before recommending it.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["addresses a novel, understudied clinical problem","provides detailed clinical narrative"],"limitations":["single patient; no control condition","no validated addiction or craving measures","no assessment of confounding factors (moral incongruence, mental health, etc.)","claims of efficacy exceed evidence"],"rubric_version":"2.0","raw_total":7,"max_possible":60,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":1,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31887/dcns.2020.22.3/lmalandain"}},{"id":7009,"doi":"10.1371/journal.pone.0197998","pmid":"29791514","pmcid":"PMC5965882","title":"High prevalence of syndemic health problems in patients seeking post-exposure prophylaxis for sexual exposures to HIV","authors":"Morrison SA, Morrison SA, Yoong D, Hart TA, MacPherson P, Bogoch I, Sivarajah V, Gough K, Naccarato M, Tan DHS.","first_author":"Morrison SA","journal":"PloS one","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0197998&type=printable","cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 186 MSM seeking non‑occupational HIV post‑exposure prophylaxis; self‑administered questionnaire; prevalence of depression, harmful alcohol use, drug use, sexual compulsivity; exploratory logistic and linear regressions.","sample_n":186,"sample_text":"186 MSM","population":"MSM attending three clinics in Toronto/Ottawa for nPEP (N=186)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among men who have sex with men attending clinics for HIV post‑exposure prophylaxis, more than half screened positive for depression and many also had harmful drinking, drug use, or sexual compulsivity. The more of these problems a person had, the higher their estimated HIV‑risk score.","clinical_takeaway":"Screening for mental‑health and sexual‑compulsivity issues in patients seeking nPEP may identify additional intervention targets to reduce future HIV risk.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Uses validated screening instruments","Provides prevalence data for a high‑risk clinical cohort","Explores association between syndemic burden and quantified HIV risk score"],"limitations":["Cross‑sectional; cannot infer causality","Convenience sample of nPEP seekers limits generalisability","Limited control for key psychosocial confounds (e.g., moral incongruence, trauma, partner factors)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0197998"}},{"id":7012,"doi":"10.1081/ja-100108428","pmid":"11795580","pmcid":null,"title":"Assessment and treatment of addictive sexual disorders: relevance for chemical dependency relapse","authors":"Schneider JP, Irons RR.","first_author":"Schneider JP","journal":"Substance use & misuse","year":2001,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review with case reports; no original empirical data","sample_n":null,"sample_text":"Not applicable – review article","population":"adults with sexual and substance use concerns (no specific sample reported)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article reviews how compulsive sexual behaviours, framed as \"addictive sexual disorders,\" often occur alongside drug addiction and may trigger relapse. It discusses diagnosis, treatment options, and 12‑step support groups.","clinical_takeaway":"Clinicians should consider screening for compulsive sexual behaviours in clients with substance‑use disorders, as they may affect relapse risk.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Integrates sexual addiction with substance use relapse literature","Provides practical treatment resources (12‑step)","Covers differential diagnosis"],"limitations":["Narrative, non‑systematic review; no systematic bias assessment","Lacks primary data, psychometric validation, or statistical analyses","Potential bias toward addiction model"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":56,"citing_publications":85,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1081/ja-100108428"}},{"id":7014,"doi":"10.1017/s1092852900015133","pmid":"17146408","pmcid":null,"title":"Impulsive-compulsive sexual behavior","authors":"Mick TM, Hollander E.","first_author":"Mick TM","journal":"CNS spectrums","year":2006,"pub_types":["Review","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of clinical literature, no empirical data collected","sample_n":null,"sample_text":"not applicable","population":"general adult population (as discussed), no specific sample","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This 2006 review summarizes what is known about impulsive‑compulsive sexual behavior, its possible classification as an addiction, and its relationship to other disorders, but it does not present new data.","clinical_takeaway":"None – the article does not provide actionable clinical evidence.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of existing literature","Discusses DSM classifications and potential addiction framing"],"limitations":["No original data; relies on limited studies","Lacks systematic review methodology","No empirical assessment of constructs or confounds"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":70,"citing_publications":120,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852900015133"}},{"id":7015,"doi":"10.11477/mf.188160960780010037","pmid":"41558519","pmcid":null,"title":"[Hypersexuality in Parkinson's Disease]","authors":"Kashihara K.","first_author":"Kashihara K.","journal":"Brain and nerve = Shinkei kenkyu no shinpo","year":2026,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"jpn","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods; no primary data.","sample_n":null,"sample_text":"Not applicable – review article","population":"Patients with Parkinson's disease (general, no specific sampling reported)","country":"Japan (inferred from author affiliation, not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"The review describes how dopamine‑based medicines for Parkinson's disease can lead to hypersexual behavior in a minority of patients, especially younger men, and outlines risk factors and treatment options.","clinical_takeaway":"Clinicians should monitor PD patients on dopamine agonists for hypersexuality and consider medication adjustments if it emerges.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Summarises known risk factors for hypersexuality in PD","Provides clinical treatment suggestions"],"limitations":["No systematic search or appraisal of evidence","No quantitative synthesis or effect sizes","Potential bias from lacking conflict‑of‑interest disclosure"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.11477/mf.188160960780010037"}},{"id":7016,"doi":"10.3390/ijerph18073820","pmid":"33917425","pmcid":"PMC8038682","title":"Modelling the Contribution of Metacognitions, Impulsiveness, and Thought Suppression to Behavioural Addictions in Adolescents","authors":"Efrati Y, Kolubinski DC, Marino C, Spada MM.","first_author":"Efrati Y","journal":"International journal of environmental research and public health","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Thought Suppression","Impulsiveness","Internet Gaming Disorder","Metacognitions","Compulsive Sexual Behavior Disorder","Problematic Social Networks Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8038682","cited_by_count":40,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Three separate cross‑sectional surveys of adolescents (n≈470, 453, 1004) using self‑report questionnaires; mediation (path) analysis conducted.","sample_n":471,"sample_text":"Study 1 n=471; Study 2 n=453; Study 3 n=1004 (total 1 828 across studies).","population":"Adolescents (age not specified), likely school or community sample; convenience recruitment implied.","country":"Not reported in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors surveyed adolescents and found that having certain ways of thinking about thoughts (metacognitions), trying to suppress thoughts, and being impulsive were linked to higher scores on questionnaires for gaming, risky sexual behaviour, and social‑media overuse.","clinical_takeaway":"Therapists may consider targeting thought‑suppression and impulsivity when addressing problem gambling, compulsive sexual behaviour, or excessive social‑media use in teens.","confidence":0.7,"topic_tags":["adolescents","csbd","sexual_function"],"strengths":["Large sample sizes across three studies","Looks at multiple behavioral addictions together","Uses mediation modelling to explore mechanisms"],"limitations":["Cross‑sectional design cannot establish causality","No measurement of key confounds (morality, masturbation, mental health)","Unclear whether addiction scales are validated for adolescents"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":10,"contrasting":0,"mentioning":30,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph18073820"}},{"id":7017,"doi":"10.4103/abr.abr_343_23","pmid":"41669284","pmcid":"PMC12885210","title":"Comparing the Effect of Dialectical Behavior Therapy and Aripiprazole on Emotional Divorce in Patients with Hypersexuality","authors":"Tavakoli Z, Rezaei-Jamalouei H, Kazemi-Zahrani H, Khorrami MH, Ghanaat I.","first_author":"Tavakoli Z","journal":"Advanced biomedical research","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["emotion","Divorce","Aripiprazole","Dialectical Behavior Therapy","Hypersexuality"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12885210","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"quasi-experimental with three arms (DBT, aripiprazole, control), N=54, pre‑test/post‑test/follow‑up, MANCOVA analysis","sample_n":54,"sample_text":"54 participants (18 per group) purposively selected and randomly assigned after matching on age and gender","population":"men and women with hypersexuality recruited from hospitals/psychiatric centres in Isfahan, Iran","country":"Iran","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 54 Iranian patients with hypersexuality, an eight‑session DBT program reduced scores on an Emotional Divorce questionnaire more than a two‑month course of the antipsychotic aripiprazole, but both treatments showed benefit compared with no treatment.","clinical_takeaway":"Both DBT and aripiprazole may lessen relationship distress in hypersexual patients, with DBT showing larger effects, though evidence is limited.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Random allocation to experimental conditions","Use of a control group","Both psychotherapeutic and pharmacological interventions tested"],"limitations":["Small sample size, likely under‑powered","Unclear if hypersexuality and outcome measures are validated","No control for key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)","No pre‑registration or reporting of effect sizes"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/abr.abr_343_23"}},{"id":7018,"doi":"10.1007/s10508-006-9127-2","pmid":"17192832","pmcid":null,"title":"The compulsive sexual behavior inventory: psychometric properties","authors":"Miner MH, Coleman E, Center BA, Ross M, Rosser BR.","first_author":"Miner MH","journal":"Archives of sexual behavior","year":2007,"pub_types":["Validation Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":59,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a self‑report inventory in a large web‑based sample of 1,026 Latino MSM","sample_n":1026,"sample_text":"1,026 Latino men who have sex with men recruited and assessed using web‑based technology","population":"Latino men who have sex with men, United States, recruited online","country":"United States","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested a new questionnaire (CSBI) for assessing compulsive sexual behaviour in over a thousand Latino gay men, finding a reliable two‑factor structure and links to riskier sexual practices.","clinical_takeaway":"The CSBI appears reliable for research use, but clinicians should note its reliance on self‑reported distress and lack of moral‑incongruence controls.","confidence":0.85,"topic_tags":["measurement","csbd","sexual_function","moral_incongruence"],"strengths":["Large, well‑powered sample","Comprehensive factor analysis and bilingual equivalence testing","Demonstrates concurrent validity with sexual risk behaviours"],"limitations":["Self‑report data only; possible circularity between distress and CSB scores","No measurement or control of moral incongruence, masturbation, or partner factors","Limited to Latino MSM, reducing generalisability"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":71,"citing_publications":153,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-006-9127-2"}},{"id":7019,"doi":"10.3389/fpsyt.2020.584548","pmid":"33281645","pmcid":"PMC7691247","title":"Threats to Mental Health Facilitated by Dating Applications Use Among Men Having Sex With Men","authors":"Obarska K, Szymczak K, Lewczuk K, Gola M.","first_author":"Obarska K","journal":"Frontiers in psychiatry","year":2020,"pub_types":["review-article","Review","Journal Article"],"keywords":["Mental health","Risky Sexual Behaviors","Chemsex","Msm (Men Who Have Sex With Men)","Substance (Ab)Use","Compulsive Sexual Behavior Disorder (Csbd)","Dating Applications"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7691247","cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods","sample_n":null,"sample_text":"Not applicable (review)","population":"men who have sex with men (MSM) who use dating applications","country":"Poland (authors’ affiliation likely Poland, but not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","selective_reporting"],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews how dating apps may affect mental health among men who have sex with men, linking heavy app use to poorer well‑being, depression, substance use, and sleep problems, and discusses related issues such as compulsive sexual behavior and chemsex.","clinical_takeaway":"Clinicians should consider dating‑app use as a possible factor in MSM clients' mental‑health assessments, but evidence is mainly correlational.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad overview of DA use in MSM","Identifies gaps in literature","Integrates emerging topics (CSBD, chemsex)"],"limitations":["Narrative (non-systematic) review","No systematic search or bias assessment","No quantitative synthesis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":14,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2020.584548"}},{"id":7020,"doi":"10.1016/j.comppsych.2022.152346","pmid":"36029549","pmcid":null,"title":"Advances in problematic usage of the internet research - A narrative review by experts from the European network for problematic usage of the internet","authors":"Fineberg NA, Menchón JM, Hall N, Dell'Osso B, Brand M, Potenza MN, Chamberlain SR, Cirnigliaro G, Lochner C, Billieux J, Demetrovics Z, Rumpf HJ, Müller A, Castro-Calvo J, Hollander E, Burkauskas J, Grünblatt E, Walitza S, Corazza O, King DL, Stein DJ, Grant JE, Pallanti S, Bowden-Jones H, Ameringen MV, Ioannidis K, Carmi L, Goudriaan AE, Martinotti G, Sales CMD, Jones J, Gjoneska B, Király O, Benatti B, Vismara M, Pellegrini L, Conti D, Cataldo I, Riva GM, Yücel M, Flayelle M, Hall T, Griffiths M, Zohar J.","first_author":"Fineberg NA","journal":"Comprehensive psychiatry","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Impulsive","Compulsive","Behavioral Addiction","Patient And Public Involvement (Ppi)","Gaming Disorder","Covid-19 Pandemic","Problematic Usage Of The Internet"],"is_oa":false,"oa_url":"https://doi.org/10.1016/j.comppsych.2022.152346","cited_by_count":125,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review based on expert opinion of a COST Action network; no primary data collected.","sample_n":null,"sample_text":"No empirical sample; expert consensus narrative.","population":"Not applicable (expert panel)","country":"International (European network)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper is a narrative review by European experts summarising progress on problematic internet use, including compulsive sexual behaviour, and highlighting gaps such as the need for longitudinal data and better treatments.","clinical_takeaway":"None – the article does not provide new clinical evidence to guide practice.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Broad overview of PUI field","Consensus on clinical definitions aligned with ICD‑11","Identification of research gaps and future directions"],"limitations":["No original empirical data","Narrative format limits methodological transparency","Potential bias from expert panel composition"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":4,"contrasting":0,"mentioning":162,"citing_publications":248,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2022.152346"}},{"id":7022,"doi":"10.1007/s10508-009-9507-5","pmid":"19588239","pmcid":"PMC3719393","title":"Compulsive sexual behavior and risk for unsafe sex among internet using men who have sex with men","authors":"Coleman E, Horvath KJ, Miner M, Ross MW, Oakes M, Rosser BR, Men’s INTernet Sex (MINTS-II) Team.","first_author":"Coleman E","journal":"Archives of sexual behavior","year":2010,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":51,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 2,716 MSM recruited via the Internet, assessing compulsive sexual behavior (CSBI) and unprotected anal intercourse.","sample_n":2716,"sample_text":"large convenience sample of Internet‑using MSM","population":"men who have sex with men (MSM) using the Internet to find partners, diverse racial/ethnic groups, adult age range","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 2,700 Internet‑using gay and bisexual men, higher scores on a compulsive sexual behavior questionnaire were linked to a greater likelihood of having unprotected anal sex, regardless of whether partners were met online or offline.","clinical_takeaway":"Clients reporting compulsive sexual thoughts or behaviors may need extra counseling on safer‑sex practices.","confidence":0.8,"topic_tags":["csbd","sexual_function","treatment"],"strengths":["Large sample size for a sexual health survey","Use of a validated CSB scale","Multiracial/ethnic representation"],"limitations":["Cross‑sectional design cannot establish causality","No assessment of moral incongruence, mental‑health or partner variables","Self‑report data may be subject to bias"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":4,"interpretation":8}},"scite":{"supporting":5,"contrasting":0,"mentioning":47,"citing_publications":93,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-009-9507-5"}},{"id":7023,"doi":"10.1080/00926239208412855","pmid":"1291701","pmcid":null,"title":"Sexual addiction: designation and treatment","authors":"Goodman A.","first_author":"Goodman A.","journal":"Journal of sex & marital therapy","year":1992,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"N/A","population":"none","country":"N/A","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article argues that \"sexual addiction\" is the best term for describing compulsive sexual behavior, defines the disorder, and discusses treatment, while also addressing criticisms of the label.","clinical_takeaway":"Treators should note that the sexual addiction label is conceptual and not based on empirical validation.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Comprehensive historical review of terminology","Clear articulation of diagnostic criteria"],"limitations":["No empirical data provided","Relies on circular definitions of ‘addiction’","Potential bias toward addiction model"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":54,"citing_publications":124,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239208412855"}},{"id":7024,"doi":"10.3390/ejihpe12080066","pmid":"36005215","pmcid":"PMC9407275","title":"Technology-Mediated Sexual Interactions, Social Anxiety, and Sexual Wellbeing: A Scoping Review","authors":"Shaughnessy K, Fehr CJ, Ashley M, Braham J, Labelle PR, Ouimet AJ, Corsini-Munt S, Ashbaugh AR, Reissing ED.","first_author":"Shaughnessy K","journal":"European journal of investigation in health, psychology and education","year":2022,"pub_types":["Scoping Review","review-article","Journal Article"],"keywords":["Anxiety","Social Anxiety","Shyness","Scoping Review","Cybersex","Non-consensual","Sexting","Sexual Wellbeing","Technology-mediated Sexual Interactions","Partner-seeking"],"is_oa":true,"oa_url":"https://www.mdpi.com/2254-9625/12/8/66/pdf?version=1660203041","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Scoping review of 19 studies; no risk‑of‑bias assessment; descriptive synthesis only.","sample_n":null,"sample_text":"Not applicable – review aggregates multiple studies.","population":"Human participants from 19 English/French articles (1991‑2021); no single sample reported.","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review of 19 studies examined how social anxiety relates to technology‑mediated sexual activities like sexting and online sexual encounters, finding mixed evidence that anxiety can both limit and promote such interactions and affect sexual wellbeing.","clinical_takeaway":"Clinicians should note that social anxiety may influence online sexual behavior, but current evidence is limited and inconclusive.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Broad search across eight databases","Inclusion of both English and French literature","Identifies gaps for future CBT‑oriented research"],"limitations":["Scoping review lacks systematic quality appraisal","No quantitative synthesis or effect‑size reporting","Unable to assess how primary studies measured key constructs"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ejihpe12080066"}},{"id":7025,"doi":"10.1007/s40618-020-01478-0","pmid":"33314003","pmcid":"PMC8285332","title":"Increased prevalence of impulse control disorder symptoms in endocrine diseases treated with dopamine agonists: a cross-sectional study","authors":"Beccuti G, Guaraldi F, Natta G, Cambria V, Prencipe N, Cicolin A, Montanaro E, Lopiano L, Ghigo E, Zibetti M, Grottoli S.","first_author":"Beccuti G","journal":"Journal of endocrinological investigation","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Pituitary adenoma","Dopamine agonists","hyperprolactinemia","Impulse Control Disorders","Cabergoline","Quip Questionnaire"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8285332","cited_by_count":25,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"132 DA‑exposed pituitary patients vs 58 non‑exposed, questionnaire survey","sample_n":190,"sample_text":"132 DA‑exposed, 58 non‑exposed","population":"Patients with pituitary disorders (Italy)","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Patients with pituitary disorders taking dopamine‑agonist drugs showed about twice the rate of impulse‑control problems, including compulsive sexual behavior, compared with similar patients not on these drugs.","clinical_takeaway":"Dopamine‑agonist therapy may increase risk of compulsive sexual behaviours; monitor patients for such symptoms.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Validated ICD screening tool (QUIP)","Comparison group without dopamine agonist exposure","Clear statistical association (ORs) reported"],"limitations":["Cross‑sectional design; cannot infer causality","No assessment of moral, masturbatory or mental‑health confounds","QUIP not validated for endocrine patients"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40618-020-01478-0"}},{"id":7026,"doi":"10.1371/journal.pone.0152762","pmid":"27054341","pmcid":"PMC4824469","title":"A Pilot Trial of a Sexual Health Counseling Intervention for HIV-Positive Gay and Bisexual Men Who Report Anal Sex without Condoms","authors":"Hart TA, Stratton N, Coleman TA, Wilson HA, Simpson SH, Julien RE, Hoe D, Leahy B, Maxwell J, Adam BD.","first_author":"Hart TA","journal":"PloS one","year":2016,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0152762&type=printable","cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"single-group pre‑post pilot trial (no control group)","sample_n":null,"sample_text":"groups of 5‑8 participants per session; total sample size not stated in abstract","population":"HIV‑positive gay and bisexual men (small‑group counseling)","country":"Canada (Ontario)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A small group counseling program for HIV‑positive gay and bisexual men reduced condom‑less anal sex and lowered self‑reported sexual compulsivity and loneliness over three months, but the study lacked a control group and had a modest sample.","clinical_takeaway":"Preliminary evidence suggests group counseling may help reduce risky sex and sexual‑compulsivity feelings in HIV‑positive gay/bisexual men, but larger controlled trials are needed.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Focused, theory‑based counseling intervention","Measured both behavioral and psychosocial outcomes","Controlled for viral load in analyses"],"limitations":["No control/comparison group","Small pilot sample, likely under‑powered","Moral incongruence and other key confounds not measured"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0152762"}},{"id":7027,"doi":"10.22541/au.173891899.92987638/v1","pmid":null,"pmcid":null,"title":"The Effect of Pramipexole on Impulse Control and Other Behavioral Disorders in Idiopathic Restless Legs Syndrome","authors":"Yavuz Z.","first_author":"Yavuz Z.","journal":"Authorea Preprints","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case-control cross-sectional study of 108 idiopathic RLS patients, comparing those on pramipexole (≈55) vs untreated controls (≈53).","sample_n":108,"sample_text":"108 patients (≈55 treated, ≈53 untreated).","population":"Adults with idiopathic Restless Legs Syndrome, without psychiatric disorders.","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 108 adults with restless legs syndrome, taking the dopamine agonist pramipexole did not increase impulsivity or impulse‑control problems, including hypersexuality, compared with untreated patients.","clinical_takeaway":"Pramipexole appears not to raise hypersexuality risk in RLS, but evidence is limited; monitor patients individually.","confidence":0.78,"topic_tags":["prevalence","treatment","neuroscience","sexual_function"],"strengths":["Use of validated questionnaires (PD‑QUIP, BIS‑11 SF)","Clear case‑control comparison","Excludes participants with psychiatric disorders","Reports both impulsivity and specific ICBD items"],"limitations":["Cross‑sectional design cannot infer causality","No adjustment for key psychosocial confounds (e.g., moral incongruence, masturbation, mental health)","Sample size per group <60, limiting power to detect modest effects","Reliance on self‑report scales without clinical interview"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.22541/au.173891899.92987638/v1"}},{"id":7028,"doi":"10.1177/1079063214547585","pmid":"25143437","pmcid":null,"title":"Anxious Attachment, Social Isolation, and Indicators of Sex Drive and Compulsivity: Predictors of Child Sexual Abuse Perpetration in Adolescent Males?","authors":"Miner MH, Swinburne Romine R, Robinson BB, Berg D, Knight RA.","first_author":"Miner MH","journal":"Sexual abuse : a journal of research and treatment","year":2016,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Isolation","Attachment","Child Sexual Abuse","Hypersexuality","Adolescent Sexual Abusers"],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case-control cross-sectional study comparing adolescent male sexual offenders to a mental‑health/substance‑use comparison group","sample_n":325,"sample_text":"140 offenders against children, 92 offenders against peers/adults, 93 mental‑health/substance‑use controls","population":"adolescent males (n≈325) with sexual offending histories","country":"USA (inferred from funding agency)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined how anxious attachment, social isolation, and masculine self‑view relate to child sexual abuse among adolescent boys, finding that these factors indirectly predict offending through sexual compulsivity and hypersexuality.","clinical_takeaway":"Factors like insecure attachment and social isolation may signal risk, but the findings are correlational and not directly actionable for treatment.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, multi‑group sample of offenders","Use of structured interview and questionnaires","Attempts to model indirect pathways"],"limitations":["Cross‑sectional design limits causal inference","Unclear validation of sexual compulsivity/hypersexuality measures","Key confounds (moral incongruence, masturbation, mental health) not assessed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":49,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063214547585"}},{"id":7029,"doi":"10.2105/ajph.2011.300284","pmid":"22095358","pmcid":null,"title":"Sexual compulsivity, co-occurring psychosocial health problems, and HIV risk among gay and bisexual men: further evidence of a syndemic","authors":"Parsons JT, Grov C, Golub SA.","first_author":"Parsons JT","journal":"American journal of public health","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":237,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Anonymous cross‑sectional survey of MSM at community events in NYC (n=669); logistic regression analyses.","sample_n":669,"sample_text":"Anonymous cross‑sectional survey of MSM attendees at gay, lesbian, and bisexual community events in NYC.","population":"Men who have sex with men (gay and bisexual) recruited at gay/lesbian/bisexual community events in New York City, 2003‑2004.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 669 gay and bisexual men in New York found that sexual compulsivity often co‑occurs with depression, childhood sexual abuse, partner violence, and drug use, and that these combined problems are linked to higher HIV risk.","clinical_takeaway":"Clinicians should assess co‑occurring psychosocial issues when addressing sexual compulsivity and HIV risk in MSM.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample for the field","Use of validated sexual compulsivity scale (presumed)","Comprehensive multivariate modeling","Integration of syndemic framework"],"limitations":["Cross‑sectional; cannot infer causality","Convenience sampling limits generalizability","No explicit measurement of moral or religious factors","Potential self‑report bias"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":7,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":23,"contrasting":2,"mentioning":292,"citing_publications":338,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2105/ajph.2011.300284"}},{"id":7030,"doi":"10.18502/ijps.v18i1.11414","pmid":"37159646","pmcid":"PMC10163906","title":"Childhood Trauma as a Risk Factor for High Risk Behaviors in Adolescents with Borderline Personality Disorder","authors":"Zashchirinskaia O, Isagulova E.","first_author":"Zashchirinskaia O","journal":"Iranian journal of psychiatry","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Adolescent","Borderline Personality Disorder","Psychological Trauma","Health Risk Behaviors"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10163906","cited_by_count":18,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"purposive sampling of 120 adolescents (60 BPD, 60 non‑BPD); questionnaires on trauma, sexual addiction, eating attitudes, etc.; between‑group comparisons and correlation analyses.","sample_n":120,"sample_text":"60 BPD adolescents, 60 non‑BPD adolescents (purposive sampling)","population":"Adolescents aged 12‑18 with and without borderline personality disorder, recruited via purposive sampling in Iran","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that adolescents with borderline personality disorder who experienced emotional abuse or neglect in childhood were more likely to report addictive‑type sexual behaviours, eating problems and suicidal thoughts.","clinical_takeaway":"Screen for childhood trauma in BPD youths, as emotional abuse may signal heightened risk for harmful sexual and self‑destructive behaviours.","confidence":0.78,"topic_tags":["adolescents","csbd","sexual_function","pornography"],"strengths":["Clear focus on trauma as risk factor","Use of multiple validated questionnaires for eating and suicidality","Statistical adjustment for age, gender, education"],"limitations":["Purposive, non‑representative sample","Unclear validation of sexual‑addiction screening tool","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":60,"pct_score":45,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":19,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.18502/ijps.v18i1.11414"}},{"id":7031,"doi":"10.1111/j.1752-0606.2006.tb01608.x","pmid":"16933435","pmcid":null,"title":"Sexual addiction and marriage and family therapy: facilitating individual and relationship healing through couple therapy","authors":"Bird MH.","first_author":"Bird MH.","journal":"Journal of marital and family therapy","year":2006,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review synthesizing existing literature on sexual addiction and couple therapy; no new empirical data.","sample_n":null,"sample_text":"Not applicable (review)","population":"Not applicable (review)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"This narrative review discusses how marriage and family therapists can help individuals and couples dealing with sexual addiction, summarizing existing research on its impact and outlining therapeutic processes.","clinical_takeaway":"Clinicians can use couple therapy techniques to address sexual addiction’s effects on both partners, though evidence is largely descriptive.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad synthesis of literature","Focus on therapeutic process for couples"],"limitations":["No empirical data presented","Lacks systematic review methodology","No assessment of measurement validity"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1752-0606.2006.tb01608.x"}},{"id":7032,"doi":"10.11477/mf.1416200572","pmid":"27703106","pmcid":null,"title":"[Recovery from Sexual Addiction]","authors":"Yoshioka T.","first_author":"Yoshioka T.","journal":"Brain and nerve = Shinkei kenkyu no shinpo","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"jpn","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article argues that sexual addiction is a disease but can also be viewed as self‑medication, and suggests that mutual‑aid groups may help recovery through spiritual growth.","clinical_takeaway":"None – the piece offers no data to guide clinical practice.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Clear statement of perspective","Addresses recovery context"],"limitations":["No empirical data","No operational definitions of sexual addiction","No measurement of confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.11477/mf.1416200572"}},{"id":7033,"doi":"10.3389/fpsyg.2025.1672471","pmid":"41341731","pmcid":"PMC12669187","title":"A contextual behavioral model of chemsex: structural equation modeling of psychological predictors of hypersexuality and drug use","authors":"Rico R, Montesinos F.","first_author":"Rico R","journal":"Frontiers in psychology","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Structural Equation Modeling","Psychological Flexibility","Hypersexuality","Chemsex","Sexualized Drug Use"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12669187","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross‑sectional SEM study of 252 Spanish‑speaking men who reported chemsex in the past year","sample_n":252,"sample_text":"252 participants reporting sexualised substance use in the past year","population":"self‑selected sample of chemsex participants (non‑representative)","country":"Spain (Spanish‑speaking participants)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 252 gay and bisexual men who used drugs during sex, a model showed that psychological inflexibility, loneliness and internalised homophobia predicted higher hypersexuality and substance use, suggesting ACT‑based therapies might reduce risky chemsex behaviours.","clinical_takeaway":"Addressing psychological inflexibility and loneliness may help reduce hypersexuality and chemsex risk.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large enough sample for SEM (N=252)","Use of validated self‑report scales","Comprehensive model with direct and indirect paths","Clear reporting of model fit indices"],"limitations":["Cross‑sectional design limits causal inference","Convenience sample of chemsex participants reduces generalisability","No measurement/control of key confounds (moral incongruence, trauma, mental health)","No pre‑registration or correction for multiple testing"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2025.1672471"}},{"id":7034,"doi":"10.1017/s1092852922000785","pmid":"35593452","pmcid":"PMC7614601","title":"Attentional problems occur across multiple psychiatric disorders and are not specific for ADHD","authors":"Grant JE, Chamberlain SR.","first_author":"Grant JE","journal":"CNS spectrums","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Attention","ADHD","Focus","Impulsivity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7614601","cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional community sample, N=576, assessing sustained attention across multiple psychiatric diagnoses.","sample_n":576,"sample_text":"576 participants aged 18‑29 years, recruited from community settings.","population":"Non‑treatment‑seeking adults (18‑29 y) from the general community.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a community sample of 576 young adults, sustained‑attention deficits were found across many psychiatric disorders, not just ADHD. Disorders like OCD, social phobia and bulimia showed the largest impairments, while PTSD and compulsive sexual behavior showed relatively spared performance.","clinical_takeaway":"Clinicians should assess a range of psychiatric conditions when patients report attention problems, rather than assuming ADHD.","confidence":0.6,"topic_tags":["csbd"],"strengths":["Large community sample","Validated sustained‑attention task","Effect sizes reported for multiple disorders"],"limitations":["Cross‑sectional; cannot infer causality","No control for moral incongruence or masturbation when reporting CSB","No pre‑registration or power analysis described"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852922000785"}},{"id":7035,"doi":"10.1080/00224499.2017.1337866","pmid":"28661703","pmcid":null,"title":"The Insidious Effects of Sexual Stereotypes in Clinical Practice","authors":"Prunas A, Sacchi S, Brambilla M.","first_author":"Prunas A","journal":"Journal of sex research","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"experimental vignette survey with 152 Italian licensed psychotherapists; convenience sample; between‑subjects manipulation of patient orientation and disorder type.","sample_n":152,"sample_text":"Italian male, straight, licensed psychotherapists (N = 152)","population":"Licensed psychotherapists (male, straight) in Italy, N=152","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A study of 152 Italian male therapists showed they expected less benefit from psychotherapy for gay patients with a sexual‑compulsivity disorder than for gay patients with a rage disorder, indicating subtle sexual stereotypes influence clinical judgments.","clinical_takeaway":"Clinicians should be aware that sexual orientation stereotypes can bias treatment expectations, even when explicit prejudice is low.","confidence":0.78,"topic_tags":["sexual_function","prevalence"],"strengths":["Experimental manipulation of vignette content","Adequate sample size for questionnaire study","Measurement of both explicit and implicit prejudice"],"limitations":["Convenience, homogeneous therapist sample (male, straight, Italian)","Reliance on self‑report expectations, not real clinical outcomes","No pre‑registration, limited reporting of effect sizes"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1337866"}},{"id":7037,"doi":"10.1080/13691050701564678","pmid":"18247206","pmcid":null,"title":"Exploring the internet's role in sexual compulsivity and out of control sexual thoughts/behaviour: a qualitative study of gay and bisexual men in New York City","authors":"Grov C, Bamonte A, Fuentes A, Parsons JT, Bimbi DS, Morgenstern J.","first_author":"Grov C","journal":"Culture, health & sexuality","year":2008,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative interview study with 111 gay and bisexual men reporting out‑of‑control sexual thoughts/behaviour; thematic analysis of their narratives about internet use.","sample_n":111,"sample_text":"111 participants recruited for qualitative interviews.","population":"Gay and bisexual men in New York City (self‑selected sample reporting sexual compulsivity).","country":"USA","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 111 gay and bisexual men who felt their sexual thoughts or actions were out of control explored how the internet influences these experiences, showing both risky and protective aspects.","clinical_takeaway":"Clinicians should assess each patient's internet use and its varied impacts when addressing sexual compulsivity.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight into participants' lived experience","Large sample for a qualitative study (111)","Addresses understudied intersection of internet use and sexual compulsivity"],"limitations":["No validated scales; reliance on self‑label of compulsivity","No measurement of key confounds (morality, mental health, etc.)","Convenience, self‑selected sample limits generalisability"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":32,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691050701564678"}},{"id":7038,"doi":"10.1136/sextrans-2020-054438","pmid":"32737210","pmcid":"PMC7841480","title":"Enhancing help-seeking behaviour among men who have sex with men at risk for sexually transmitted infections: the syn.bas.in randomised controlled trial","authors":"Achterbergh RCA, van Rooijen MS, van den Brink W, Boyd A, de Vries HJC.","first_author":"Achterbergh RCA","journal":"Sexually transmitted infections","year":2021,"pub_types":["research-article","Randomized Controlled Trial","Journal Article"],"keywords":["Homosexuality","Sexual Health","Substance Misuse"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7841480","cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"open‑label randomised controlled trial with 155 MSM, 1‑year follow‑up, appropriate randomisation and outcome assessment","sample_n":155,"sample_text":"76 intervention, 79 control","population":"men who have sex with men (MSM) attending an STI clinic (N=155)","country":"Netherlands","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A randomized trial in Dutch MSM tested whether giving personalized mental‑health feedback would boost help‑seeking. Despite high levels of psychosocial problems, the intervention did not increase help‑seeking or reduce STI risk compared with usual care.","clinical_takeaway":"Providing brief feedback alone did not improve help‑seeking; more intensive or different approaches are needed for MSM with mental‑health and substance issues.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["RCT design with clear allocation","Validated multi‑domain psychosocial screening","Objective confirmation of help‑seeking where possible","Trial registration"],"limitations":["Open‑label, no blinding","No effect‑size or confidence‑interval reporting","Limited power to detect modest differences","Moral incongruence and masturbation not assessed"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":6,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sextrans-2020-054438"}},{"id":7039,"doi":"10.3389/fpsyg.2022.873247","pmid":"35615193","pmcid":"PMC9125246","title":"Mediating Role of Intimate Partner Violence Between Emotional Dependence and Addictive Behaviours in Adolescents","authors":"Macía P, Estevez A, Iruarrizaga I, Olave L, Chávez MD, Momeñe J.","first_author":"Macía P","journal":"Frontiers in psychology","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Adolescence","Addictions","Partner Violence","Emotional Dependence","Violent Relationships"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyg.2022.873247/pdf","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"non-experimental, cross-sectional correlational survey of 1,533 adolescents with at least one dating relationship","sample_n":1533,"sample_text":"1,533 adolescents (53.9% male, 46.1% female) recruited via schools/online questionnaires","population":"adolescents (14‑18 years) in dating relationships, community sample","country":"Spain (inferred from author names; not stated in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,500 Spanish teens, higher emotional dependence was linked to more dating‑partner violence, which in turn was associated with greater self‑reported sex‑addiction symptoms. The study suggests that abusive relationships may increase risky sexual‑behaviour patterns.","clinical_takeaway":"Clinicians should consider partner‑violence history when assessing adolescent sexual‑behaviour problems.","confidence":0.7,"topic_tags":["adolescents","relationships","sexual_function"],"strengths":["Large community sample of adolescents","Validated scales for emotional dependence and IPV","Examines mediation of IPV on addictive behaviours"],"limitations":["Cross‑sectional, cannot infer causality","No control for moral incongruence, mental health, or trauma","Sex‑addiction measured by a screening tool, not ICD‑11 criteria"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":4,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2022.873247"}},{"id":7041,"doi":"10.1177/0956462419825944","pmid":"30722750","pmcid":null,"title":"The role of sexual risk behaviors on PrEP awareness and interest among men who have sex with men in Latin America","authors":"Edeza A, Galarraga O, Novak D, Mayer K, Rosenberger J, Mimiaga M, Biello K.","first_author":"Edeza A","journal":"International journal of STD & AIDS","year":2019,"pub_types":["Journal Article"],"keywords":["HIV","Prevention","Sexual behavior","Viral disease","Sex Workers","Homosexual"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"multinational online survey of MSM (n=22,698); analysis focused on subsamples engaging in condomless anal sex (n=2,606) or transactional sex (n=1,488)","sample_n":22698,"sample_text":"online convenience survey recruited via MSM networks and social media platforms","population":"men who have sex with men in Latin America (Mexico, Brazil, Colombia, etc.)","country":"Multiple (Latin America)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A large online survey of over 22 000 men who have sex with men in Latin America found that those who have condomless anal sex or engage in transactional sex are more aware of HIV‑prevention pills (PrEP) and more interested in joining PrEP trials.","clinical_takeaway":"High‑risk MSM already show awareness and interest in PrEP; outreach programs can target these groups to accelerate implementation.","confidence":0.7,"topic_tags":["sexual_function","prevalence"],"strengths":["Very large multinational sample","Adjusted analyses with multiple psychosocial covariates","Clear focus on high‑risk MSM sub‑groups"],"limitations":["Cross‑sectional design prevents causal inference","Self‑report may bias sexual behaviour and PrEP interest","No measurement of moral or religious attitudes that could affect reporting"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":18,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0956462419825944"}},{"id":7042,"doi":null,"pmid":"30040298","pmcid":null,"title":"[Sex addiction and the GP practice]","authors":"van Zessen G, Mees EB.","first_author":"van Zessen G","journal":"Nederlands tijdschrift voor geneeskunde","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"dut","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":7043,"doi":"10.1007/s10508-018-1225-4","pmid":"30014340","pmcid":null,"title":"Taxometric Analysis of the Latent Structure of Pedophilic Interest","authors":"McPhail IV, Olver ME, Brouillette-Alarie S, Looman J.","first_author":"McPhail IV","journal":"Archives of sexual behavior","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Human Sexuality","Dsm-5","Pedophilia","Taxometric Analysis","Sexual Interest In Children","Phallometric Testing"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Secondary analysis of four offender samples (N=805, 632, 531, 261) using phallometric data; taxometric methods applied to examine latent structure of pedophilic interest.","sample_n":2229,"sample_text":"Four offender samples (n=805, 632, 531, 261) combined for taxometric analysis.","population":"Male sexual offenders","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Using physiological tests on over 2,000 male offenders, the study found that interest in children is best described as having three distinct groups, ranging from non‑pedophilic to exclusively pedophilic, with differences in recidivism and compulsivity.","clinical_takeaway":"Pedophilic interest may comprise distinct sub‑groups; assessment and treatment should consider these differences.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Objective physiological measure (phallometry)","Large combined sample size","Rigorous taxometric methodology"],"limitations":["Offender samples limit generalizability","Cross‑sectional design cannot assess causality","No pre‑registration reported"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":24,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1225-4"}},{"id":7044,"doi":"10.1111/j.1743-6109.2012.02936.x","pmid":"23035810","pmcid":null,"title":"Report of findings in a DSM-5 field trial for hypersexual disorder","authors":"Reid RC, Carpenter BN, Hook JN, Garos S, Manning JC, Gilliland R, Cooper EB, McKittrick H, Davtian M, Fong T.","first_author":"Reid RC","journal":"The journal of sexual medicine","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":181,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Field trial assessing inter‑rater reliability and validity of DSM‑5 hypersexual disorder criteria in a clinical sample (N=207) of treatment‑seeking patients.","sample_n":207,"sample_text":"Clinical convenience sample, not population‑based.","population":"Patients seeking treatment for hypersexual behavior, general psychiatric conditions, or substance‑related disorders (clinical convenience sample).","country":"USA (likely, based on author affiliations; not specified in abstract)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A field trial with 207 treatment‑seeking patients examined whether the DSM‑5 hypersexual disorder criteria are reliable and valid. Trained raters showed high agreement, and the criteria correlated with established hypersexuality questionnaires and related personality traits.","clinical_takeaway":"The proposed DSM‑5 hypersexual disorder criteria appear reliable in clinical settings, but clinicians should note they were tested only in treatment‑seeking patients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large clinical sample for a field trial (N=207)","Rigorous assessment of inter‑rater reliability","Use of multiple validated self‑report scales"],"limitations":["Convenience, treatment‑seeking sample limits generalisability","No measurement of moral incongruence or masturbation behavior","Potential circularity in defining hypersexuality via self‑report distress"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":14,"contrasting":1,"mentioning":249,"citing_publications":442,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2012.02936.x"}},{"id":7045,"doi":"10.3389/fpsyt.2020.00318","pmid":"32425825","pmcid":"PMC7212450","title":"Recurrent Episodes of Paraphilic Behavior Possibly Associated With Olanzapine and Aripiprazole Treatment in a Patient With Schizophrenia","authors":"Stefanou MI, Vittore D, Wolz I, Klingberg S, Wildgruber D.","first_author":"Stefanou MI","journal":"Frontiers in psychiatry","year":2020,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Schizophrenia","olanzapine","Aripiprazole","Antipsychotic","Paraphilia"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2020.00318/pdf","cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report of hypersexual/paraphilic behavior temporally linked to olanzapine and aripiprazine treatment in schizophrenia","sample_n":1,"sample_text":"single case","population":"29‑year‑old male with paranoid‑hallucinatory schizophrenia","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 29‑year‑old man with schizophrenia developed compulsive sexual and paraphilic behavior after starting olanzapine, which stopped when the drug was stopped. The same pattern recurred with low‑dose aripiprazole and resolved after discontinuation, suggesting a possible drug‑related side effect.","clinical_takeaway":"Clinicians should monitor for emerging hypersexual or paraphilic behavior when prescribing second‑generation antipsychotics, especially aripiprazole.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Clear temporal association between medication changes and symptom onset/ remission","Detailed clinical description"],"limitations":["Single case limits generalisability","No validated measures of hypersexuality or paraphilia","No systematic assessment of alternative explanations"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2020.00318"}},{"id":7046,"doi":"10.31234/osf.io/qyem5","pmid":null,"pmcid":null,"title":"Gray matter volume differences in impulse control and addictive disorders","authors":"Draps M, Sescousse G, Potenza MN, Marchewka A, Duda A, Lew-Starowicz M, Kopera M, Jakubczyk A, Wojnar M, Gola M.","first_author":"Draps M","journal":"PsyArXiv","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/qyem5","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Voxel‑based morphometry MRI study comparing three clinical groups (CSBD, GD, AUD) with healthy male controls; n≈98 total, all heterosexual men, cross‑sectional.","sample_n":98,"sample_text":"26 CSBD, 26 GD, 21 AUD, 25 HC participants","population":"Adult heterosexual males, ages 24‑60, recruited as patients with CSBD, gambling disorder or alcohol use disorder and matched healthy controls.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A pre‑print MRI study found that men with compulsive sexual behaviour, gambling disorder or alcohol use disorder have smaller prefrontal gray‑matter volumes than healthy men, with stronger reductions in gambling and alcohol groups. In the CSBD group, greater symptom severity linked to lower volume in the right anterior cingulate.","clinical_takeaway":"Reduced prefrontal gray‑matter may be a shared brain feature of CSBD and other addictions, but findings are preliminary and limited to heterosexual men.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Direct comparison of CSBD, GD, and AUD structural data","Use of MRI VBM to assess gray matter volume","Correlation of GMV with symptom severity in CSBD"],"limitations":["Small, all‑male heterosexual sample limits generalisability","No assessment or control of key psychosocial confounds (moral incongruence, masturbation, mental health, trauma)","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":29,"max_possible":70,"pct_score":41,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":5,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/qyem5"}},{"id":7048,"doi":"10.1080/00224499.2012.716872","pmid":"23148708","pmcid":null,"title":"Sexual cognition guides viewing strategies to human figures","authors":"Hall CL, Hogue T, Guo K.","first_author":"Hall CL","journal":"Journal of sex research","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"eye‑tracking study of heterosexual men (n≈?) and women (n≈?) viewing clothed figures; measured gaze patterns and completed self‑report questionnaires on sexual cognition.","sample_n":null,"sample_text":"M = 21.0 years, SD = 2.1; gender split not reported.","population":"young adult heterosexual participants (mean age 21 y, SD 2.1), likely convenience sample, no indication of probability sampling.","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Eye‑tracking showed that heterosexual men with higher sexual compulsivity looked longer at the waist‑hip area of preferred partners, suggesting gaze reflects male sexual interest; women's gaze was not linked to their sexual cognitions.","clinical_takeaway":"Gaze patterns may help assess male sexual interest, but findings are limited to young, non‑clinical samples.","confidence":0.7,"topic_tags":["gender","sexual_function"],"strengths":["Use of objective eye‑tracking data","Inclusion of validated sexual cognition questionnaires","Sex‑specific analysis of gaze patterns"],"limitations":["Small, convenience sample limits generalisability","No control for potential confounds (e.g., mood, religiosity)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":22,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2012.716872"}},{"id":7049,"doi":"10.1016/j.jsxm.2016.10.013","pmid":"27938992","pmcid":null,"title":"Sexual Sensation Seeking, Sexual Compulsivity, and Gender Identity and Its Relationship With Sexual Functioning in a Population Sample of Men and Women","authors":"Burri A.","first_author":"Burri A.","journal":"The journal of sexual medicine","year":2017,"pub_types":["Journal Article"],"keywords":["Gender Identity","Sexual Compulsivity","Sexual Functioning","Sexual Problems","Sexual Sensation Seeking"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"population-based online survey (N=279) using validated questionnaires; cross‑sectional correlational analysis","sample_n":279,"sample_text":"population‑based online survey","population":"Adults (18‑?); 69.2% women, 30.8% men; mean age 32; recruited via online panel","country":"unspecified (likely Switzerland/Europe based on author affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a community sample of 279 adults, higher sexual sensation seeking and sexual compulsivity were linked to better sexual desire, arousal and orgasm in women, while in men these traits interacted with gender identity to affect erectile and ejaculatory function.","clinical_takeaway":"Sexual sensation seeking and compulsivity relate to sexual function; clinicians should consider these traits when assessing sexual health, but causal conclusions cannot be drawn.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Use of validated, psychometrically sound questionnaires","Relatively large, community‑based sample","Inclusion of both genders and gender identity as a moderator"],"limitations":["Cross‑sectional design limits causal inference","No assessment of key confounds (moral attitudes, mental health, masturbation, relationship factors, trauma)","No effect‑size confidence intervals or pre‑registration"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":17,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2016.10.013"}},{"id":7050,"doi":"10.1177/104012371002200108","pmid":"20196983","pmcid":null,"title":"Augmentation with naltrexone to treat compulsive sexual behavior: a case series","authors":"Raymond NC, Grant JE, Coleman E.","first_author":"Raymond NC","journal":"Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"retrospective case series of 19 male patients treated with naltrexone at a sexual health clinic","sample_n":19,"sample_text":"19 male patients","population":"19 adult males with compulsive sexual behavior, recruited from a treatment clinic","country":"USA","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"supports","citation_value":"useful","plain_summary":"A small retrospective review of 19 men with compulsive sexual behavior found that most reported improvement after adding the medication naltrexone to their treatment plan, but the study lacked a control group and used only clinician‑rated impressions.","clinical_takeaway":"Naltrexone might help some patients with CSB, but evidence is limited; use cautiously and monitor closely.","confidence":0.6,"topic_tags":["csbd","neuroscience","treatment"],"strengths":["Real‑world clinical setting","Long follow‑up for some patients"],"limitations":["Very small, uncontrolled case series","No validated CSB outcome measures","Potential confounding by concurrent psychotropics"],"rubric_version":"2.0","raw_total":14,"max_possible":60,"pct_score":23,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":2,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":116,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/104012371002200108"}},{"id":7051,"doi":"10.1016/j.jsxm.2020.12.019","pmid":"33637451","pmcid":null,"title":"A Systematic Review on Sexual Boredom","authors":"de Oliveira L, Carvalho J, Nobre P.","first_author":"de Oliveira L","journal":"The journal of sexual medicine","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":["Relationships","Couples","Boredom","Sexual Desire","Sexual Satisfaction","Sexual Boredom"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 43 articles (31 quantitative, 8 qualitative, 4 mixed) following PRISMA; no meta‑analysis, narrative synthesis.","sample_n":null,"sample_text":"43 articles (no original sample size).","population":"Human participants from included studies; no new participants recruited.","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review summarises 43 studies on sexual boredom, showing it relates to sexual satisfaction, response and hypersexuality, but notes that definitions and measures are inconsistent and most evidence is correlational.","clinical_takeaway":"Sexual boredom appears linked to decreased satisfaction and hypersexual behaviours, but clinicians should treat it cautiously given limited causal evidence.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["First systematic review on sexual boredom","Comprehensive database search and PRISMA adherence","Identifies gaps in definition and measurement"],"limitations":["Relies on largely correlational primary studies","No meta‑analytic synthesis or risk‑of‑bias assessment","Primary studies often use unvalidated or single‑item measures"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.12.019"}},{"id":7053,"doi":"10.1007/s10461-016-1430-x","pmid":"27217037","pmcid":null,"title":"Structural Equation Modeling Test of an Integrated Model of Spanish Youth's Condom Use","authors":"Ballester-Arnal R, Ruiz-Palomino E, Gil-Llario MD.","first_author":"Ballester-Arnal R","journal":"AIDS and behavior","year":2017,"pub_types":["Journal Article"],"keywords":["behavioral change","Condom Use","Predictive Factors","Hiv Prevention Model","Heterosexual Youth"],"is_oa":false,"oa_url":"https://repositori.uji.es/xmlui/bitstream/10234/166323/1/palomino.pdf","cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 424 Spanish heterosexual youth (mean age 20.6) completed self‑report questionnaires; structural equation modeling tested predictors of condom use.","sample_n":424,"sample_text":"424 participants","population":"Spanish youth, heterosexual, aged ~18‑25, community sample","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 424 Spanish young adults, the researchers found that beliefs about how pleasurable sex will be and confidence in using condoms predicted actual condom use, while depression and a tendency toward sexual compulsivity had indirect effects.","clinical_takeaway":"Boosting self‑efficacy and addressing pleasure expectations may improve condom use among youth.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for SEM","Validated‑type scales likely used","Comprehensive model including affective and cognitive predictors"],"limitations":["Cross‑sectional; cannot infer causality","No information on sampling representativeness","Potential self‑report bias"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-016-1430-x"}},{"id":7054,"doi":"10.1097/md.0000000000016103","pmid":"31335669","pmcid":"PMC6708968","title":"Efficacy of prison-based cognitive behavioral rehabilitation intervention on violent sexual behaviors among sex offenders in Nigerian prisons","authors":"Nwokeoma BN, Ede MO, Ugwuanyi C, Mezieobi D, Ugwoezuonu AU, Amoke C, Egenti NT, Nwosu N, Oforka TO, Victor-Aigbodion V, Offordile EE, Ezeh NE, Eze CO, Eluu PE, Ugwuanyi BE, Uzoagba NC, Ugwonna GO, Chukwu CL, Amadi KC, Eseadi C.","first_author":"Nwokeoma BN","journal":"Medicine","year":2019,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://www.ojjdp.gov/mpg/litreviews/Cognitive_Behavioral_Treatment.pdf","cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Randomized controlled trial with simple random allocation, 45 male sex offenders in Nigerian prisons; intervention group (n=23) received prison‑based cognitive behavioural rehabilitation, control group (n=22) received no intervention; outcomes measured with CSBI and HBI at baseline, post‑treatment, ","sample_n":45,"sample_text":"45 participants (23 intervention, 22 control)","population":"Adult male sex offenders incarcerated in Southeast Nigeria (N=45)","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small randomized trial in Nigerian prisons tested a cognitive‑behavioural programme for 45 male sex offenders. Participants receiving the programme showed lower scores on self‑report sexual behaviour scales after six months compared with a control group.","clinical_takeaway":"Preliminary evidence suggests a prison‑based CBT programme may reduce self‑reported sexual‑behavior problems, but findings are limited by small sample size.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Random allocation","Use of validated CSB scales","Follow‑up at 6 months"],"limitations":["Very small sample, likely under‑powered","Outcome measure may not capture violent sexual behaviour directly","No control for key confounds (moral incongruence, mental health, trauma)","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":34,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/md.0000000000016103"}},{"id":7055,"doi":"10.1371/journal.pone.0229893","pmid":"32163450","pmcid":"PMC7067389","title":"Psychological wellbeing of middle-aged and older queer men in India: A mixed-methods approach","authors":"Sharma AJ, Subramanyam MA.","first_author":"Sharma AJ","journal":"PloS one","year":2020,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0229893&type=printable","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional mixed‑methods survey of 207 middle‑aged/older Indian gay/bisexual men plus 30 in‑depth interviews.","sample_n":207,"sample_text":"207 survey participants; 30 interviewees.","population":"Middle‑aged and older queer men (≥40 y) in India, n≈207 (survey) and n≈30 (qualitative).","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 207 older gay and bisexual men in India found that age‑related stigma, internalised homophobia and fear of ageing were linked to higher loneliness, depression and sexual‑compulsive urges, especially among those with lower income.","clinical_takeaway":"Clinicians should screen older queer men for minority stress and socioeconomic hardship, as these factors relate to poorer mental health and higher sexual‑compulsive thoughts.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Theory‑driven (Minority Stress Model)","Mixed‑methods enriches quantitative findings","Reasonable sample size for regression"],"limitations":["Cross‑sectional; cannot infer causality","Limited reporting of measurement validation","Potential self‑selection bias, not nationally representative"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":23,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0229893"}},{"id":7056,"doi":"10.1007/s10461-013-0554-5","pmid":"23835736","pmcid":null,"title":"Personality as a predictor of unprotected sexual behavior among people living with HIV/AIDS: a systematic review","authors":"Shuper PA, Joharchi N, Rehm J.","first_author":"Shuper PA","journal":"AIDS and behavior","year":2014,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic literature review of 26 primary studies; no meta‑analysis reported; aims to map associations between personality traits and unprotected sex among PLWH","sample_n":null,"sample_text":"26 primary studies (total N not reported in abstract)","population":"people living with HIV/AIDS (PLWH) across included studies","country":"Multiple (global)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 26 studies found that personality traits like sensation seeking and sexual compulsivity are linked to having unprotected sex among people living with HIV, while broader traits such as impulsivity show weaker links.","clinical_takeaway":"Interventions that target specific traits (e.g., sensation seeking) may help reduce risky sex in HIV‑positive individuals.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive systematic search","Identifies mediating risk factors","Highlights differential relevance of proximate vs distal personality traits"],"limitations":["No meta‑analysis or quantitative synthesis","No formal risk‑of‑bias assessment reported","Limited discussion of key confounds (e.g., mental health, moral factors)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":29,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-013-0554-5"}},{"id":7057,"doi":"10.1080/0092623x.2015.1114547","pmid":"26684155","pmcid":null,"title":"Sexual Compulsivity and Sexual Sensation Seeking: A Preliminary Approach Among Male Sex Workers Compared to Gay Men in Spain","authors":"Salmerón-Sánchez P, Ballester-Arnal R, Gil-Llario MD, Morell-Mengual V.","first_author":"Salmerón-Sánchez P","journal":"Journal of sex & marital therapy","year":2017,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"comparative cross‑sectional survey of male sex workers (n=60) and non‑sex‑working gay men (n=63) in Spain","sample_n":123,"sample_text":"60 MSWs and 63 gay men completed questionnaires","population":"male adults, sex workers vs community gay men, Spain","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared sexual compulsivity and sensation seeking in 60 male sex workers and 63 gay men in Spain, finding slightly higher scores among sex workers but few significant differences.","clinical_takeaway":"Evidence of higher compulsivity in male sex workers suggests a need for interventions targeting sexual self‑control, though findings are limited by design.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of validated SC and SSS scales","Direct comparison between sex workers and non‑sex‑working gay men","Sample size over 100 participants"],"limitations":["Cross‑sectional design limits causal inference","Key confounders (moral incongruence, mental health, trauma) not measured","Convenience sampling may limit generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2015.1114547"}},{"id":7058,"doi":null,"pmid":"20926060","pmcid":null,"title":"[Sexual addiction: chimera or clinical syndrom? A plea for a clinical conceptualization]","authors":"Wölfle R.","first_author":"Wölfle R.","journal":"Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater","year":2010,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"conceptual/position paper discussing the notion of sexual addiction without presenting new empirical data.","sample_n":null,"sample_text":"none (commentary)","population":"none","country":"Austria","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article argues that \"sexual addiction\" should be recognized as a clinical syndrome, reviewing its history, criticism, and the need for reliable classification to help sufferers.","clinical_takeaway":"None – the paper is a conceptual discussion, not evidence for diagnosis or treatment.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Comprehensive historical overview","Clear argument for clinical utility"],"limitations":["No empirical data presented","Lacks operational definition of sexual addiction","No consideration of moral incongruence or other confounds"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":7059,"doi":null,"pmid":"29135448","pmcid":null,"title":"[The psychotherapy of male patient with sex addiction]","authors":"Hamvas E, Tényi T.","first_author":"Hamvas E","journal":"Psychiatria Hungarica : A Magyar Pszichiatriai Tarsasag tudomanyos folyoirata","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"hun","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":7061,"doi":"10.1177/08862605251365653","pmid":"40944449","pmcid":null,"title":"Low Self-Control and Sexual Coercion Among College Students: Examining Rape Myth Acceptance and Hypersexuality as Potential Mediators","authors":"Marshall EA.","first_author":"Marshall EA.","journal":"Journal of interpersonal violence","year":2026,"pub_types":["Journal Article"],"keywords":["Hypersexuality","Sexual Coercion","Low Self-control","Rape Myth Acceptance"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of college students; mediation analysis; likely convenience sample","sample_n":null,"sample_text":"college students (size not reported in abstract)","population":"college men and women (U.S.?)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed college students and found that low self‑control relates to sexually coercive behavior mainly through higher acceptance of rape myths and greater hypersexuality, suggesting these factors could be targets for prevention.","clinical_takeaway":"Interventions that reduce rape‑myth beliefs and address hypersexual tendencies may help lower sexual coercion risk among students.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["addresses understudied mediators","includes both genders","uses mediation model to parse indirect effects"],"limitations":["cross‑sectional design limits causal inference","no control for key confounds (moral attitudes, mental health, trauma)","instrument details unclear; possible reliance on unvalidated scales"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605251365653"}},{"id":7062,"doi":"10.1007/s10461-016-1533-4","pmid":"27573858","pmcid":"PMC5332525","title":"Feasibility of an Emotion Regulation Intervention to Improve Mental Health and Reduce HIV Transmission Risk Behaviors for HIV-Positive Gay and Bisexual Men with Sexual Compulsivity","authors":"Parsons JT, Rendina HJ, Moody RL, Gurung S, Starks TJ, Pachankis JE.","first_author":"Parsons JT","journal":"AIDS and behavior","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Mental health","Cognitive Behavioral Therapy","Sexual Compulsivity","Hiv-positive","Gay And Bisexual Men"],"is_oa":false,"oa_url":null,"cited_by_count":41,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"single-group pre‑post pilot feasibility study of a Unified Protocol intervention (N=13, 11 follow‑up)","sample_n":13,"sample_text":"13 participants enrolled; 11 completed 3‑month follow‑up","population":"HIV‑positive gay and bisexual men with self‑reported sexual compulsivity","country":"USA (likely)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"supports","citation_value":"useful","plain_summary":"A brief pilot study gave a 10‑session emotion‑regulation therapy to 13 HIV‑positive gay and bisexual men who reported sexual compulsivity. After three months, participants showed lower sexual compulsivity, depression, anxiety, drug use and HIV‑risk behaviour, though only four completed all sessions.","clinical_takeaway":"Emotion‑regulation group therapy may reduce sexual compulsivity and related risks, but larger controlled trials are needed.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Pilot test of a transdiagnostic emotion‑regulation protocol","Use of validated symptom scales for depression and anxiety","Addresses a gap: lack of empirically based treatments for sexual compulsivity"],"limitations":["Very small, uncontrolled sample (N=13)","No statistical power justification or correction for multiple tests","High attrition for full‑dose intervention"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":45,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-016-1533-4"}},{"id":7063,"doi":"10.1080/10810730.2010.499596","pmid":"20812126","pmcid":null,"title":"Services and information for sexually compulsive students on college counseling center websites: results from a national sample","authors":"Wright PJ, McKinley CJ.","first_author":"Wright PJ","journal":"Journal of health communication","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Content analysis of 203 US college counseling center websites, randomly selected stratified national sample.","sample_n":203,"sample_text":"203 4‑year U.S. colleges selected via stratified random sampling","population":"College counseling center websites (U.S. 4‑year institutions)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The researchers examined 203 U.S. college counseling website pages and found that information about help for sexually compulsive students was mentioned on fewer than 5% of sites, far less often than services for issues like depression or substance abuse.","clinical_takeaway":"College counseling centers rarely advertise services for sexual compulsivity; students may need to seek help elsewhere.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample of colleges","Systematic content analysis methodology","Clear comparison with other mental‑health topics"],"limitations":["No assessment of actual services offered, only website content","Definition of \"sexual compulsivity\" unclear, possible coding ambiguity","Cross‑sectional snapshot; cannot assess changes over time"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10810730.2010.499596"}},{"id":7064,"doi":"10.20944/preprints202304.0611.v1","pmid":null,"pmcid":null,"title":"The Concept of “Hypersexuality” in the Boundary Between Physiological and Pathological Sexuality","authors":"Perrotta G.","first_author":"Perrotta G.","journal":"Preprints.org","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.preprints.org/manuscript/202304.0611/v1/download","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Literature review (preprint) without systematic methods, no primary data, proposes a new hypersexuality scale.","sample_n":null,"sample_text":"Not applicable – no primary participants.","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The paper reviews existing writings on hypersexuality and suggests a new grading scale, but it does not provide new data or validate the scale.","clinical_takeaway":"No immediate clinical tool; the proposed scale needs validation before use.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Broad literature coverage (42 articles).","Attempts to create a gradated hypersexuality scale."],"limitations":["No systematic review methodology reported.","Proposed scale lacks validation data.","No empirical testing of constructs or criteria."],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202304.0611.v1"}},{"id":7065,"doi":"10.1080/00224499.2014.1003524","pmid":"26169176","pmcid":null,"title":"Is Hypersexuality Dimensional or Categorical? Evidence From Male and Female College Samples","authors":"Graham FJ, Walters GD, Harris DA, Knight RA.","first_author":"Graham FJ","journal":"Journal of sex research","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"taxometric analysis of self‑report inventory in 1,146 college students","sample_n":1146,"sample_text":"college convenience sample","population":"college students (male and female)","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether hypersexuality is best understood as a spectrum or as distinct categories, using data from over a thousand college students. Taxometric analyses supported a dimensional (continuous) structure for both men and women.","clinical_takeaway":"Clinicians should consider hypersexual behaviors as existing on a continuum rather than relying on strict diagnostic cut‑offs.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for taxometric analysis","Use of multiple taxometric methods","Focus on dimensional vs categorical structure"],"limitations":["Convenience college sample limits generalisability","No assessment of key confounds (moral, mental health, etc.)","Reliance on a single self‑report inventory"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":18,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2014.1003524"}},{"id":7066,"doi":"10.1097/adm.0b013e3181e6ad32","pmid":"21769059","pmcid":null,"title":"Problems of self-concept in a patient sample of hypersexual men with attention-deficit disorder","authors":"Reid RC, Carpenter BN, Gilliland R, Karim R.","first_author":"Reid RC","journal":"Journal of addiction medicine","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of treatment‑seeking men (N=81) with clinician‑rated ADHD diagnosis; stepwise regression of ADHD subscales on Sexual Compulsivity Scale","sample_n":81,"sample_text":"81 hypersexual men with ADHD (clinic sample)","population":"adult men seeking treatment for hypersexual behavior, comorbid ADHD (clinic sample)","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 81 men treated for hypersexuality and ADHD, difficulties with self‑esteem predicted higher sexual compulsivity, more than impulsivity or hyperactivity symptoms.","clinical_takeaway":"Assess self‑concept when treating hypersexual patients with ADHD; impulsivity may be less central.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Uses validated ADHD and sexual compulsivity instruments","Clinician‑based ADHD diagnosis","Identifies self‑concept as a predictor"],"limitations":["Treatment‑seeking convenience sample limits generalisability","No measurement of key confounds (moral incongruence, masturbation, mental health, relationship factors)","Reliance on stepwise regression without effect‑size reporting or correction for multiple testing"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":36,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/adm.0b013e3181e6ad32"}},{"id":7067,"doi":"10.1007/s10508-020-01906-5","pmid":"33398697","pmcid":null,"title":"Compulsive Conditioned Sexual Responding of Male Japanese Quail in Extinction","authors":"Köksal F, Kumru G, Anarat C, Domjan M, Yeniçeri N.","first_author":"Köksal F","journal":"Archives of sexual behavior","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Extinction","Fetishism","Japanese Quail","Conditioned Copulatory Behavior","Sexual Conditioning","Paraphilias"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory animal experiment with conditioned stimulus/extinction phases; 57 male quail divided into groups.","sample_n":57,"sample_text":"57 naïve male quail; 36 approach responders, 21 consummatory responders; subgroups with/without female exposure.","population":"Male Japanese quail (n=57)","country":"Turkey (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Male quail learned to associate a cloth object with a female and, when the female was removed, some quail increased copulation attempts with the cloth, suggesting a compulsive‑like response to deprivation.","clinical_takeaway":"Animal findings do not directly inform human clinical practice; caution is needed when extrapolating to human compulsive sexual behavior.","confidence":0.6,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Controlled laboratory design with clear experimental manipulation","Reasonable sample size for animal behavioral study","Clear operational definition of conditioned responses"],"limitations":["No validated human‑focused measures of addiction or distress","Findings from quail may not translate to human compulsive sexual behavior","No assessment of alternative explanations (e.g., stress, hormonal status)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01906-5"}},{"id":7068,"doi":"10.1136/jnnp-2017-317298","pmid":"29175897","pmcid":null,"title":"Compulsive sexual behaviour in Parkinson's disease is associated with higher doses of levodopa","authors":"Barbosa PM, Grippe T, Lees AJ, O'Sullivan S, Djamshidian A, Warner TT.","first_author":"Barbosa PM","journal":"Journal of neurology, neurosurgery, and psychiatry","year":2018,"pub_types":["Letter"],"keywords":["Parkinson’s Disease","Impulse Control"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/jnnp-2017-317298"}},{"id":7069,"doi":"10.1080/09540121.2017.1360994","pmid":"28783964","pmcid":"PMC6066341","title":"Vengeance, sexual compulsivity and self-efficacy among men who have sex with men living with HIV","authors":"Brown MJ, Serovich JM, Kimberly JA.","first_author":"Brown MJ","journal":"AIDS care","year":2018,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","MSM","Self-efficacy","Sexual Compulsivity","Vengeance"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 266 MSM living with HIV, linear regression analyses","sample_n":266,"sample_text":"MSM living with HIV recruited for a survey (convenience sample)","population":"men who have sex with men (MSM) living with HIV, N=266","country":"unspecified (likely USA based on authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 266 HIV‑positive gay men, higher vengeful feelings were linked to lower confidence in disclosing HIV status, but not to sexual compulsivity. Reducing vengeance might help improve disclosure self‑efficacy.","clinical_takeaway":"Addressing vengeful attitudes could boost HIV‑status disclosure confidence in MSM living with HIV.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonably large sample for a single‑site survey","Uses established scales for sexual compulsivity and self‑efficacy","Reports confidence intervals for regression coefficients"],"limitations":["Cross‑sectional design limits causal inference","No assessment of key confounds such as moral incongruence or mental health","Convenience sample of HIV‑positive MSM limits generalisability"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540121.2017.1360994"}},{"id":7070,"doi":"10.1016/j.psychres.2020.113221","pmid":"32562935","pmcid":null,"title":"Who becomes addicted and to what? psychosocial predictors of substance and behavioral addictive disorders","authors":"Zilberman N, Yadid G, Efrati Y, Rassovsky Y.","first_author":"Zilberman N","journal":"Psychiatry research","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Personality","Prediction model","Life event","Family Environment","Multinomial Logistic Regression"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case-control predictive study of psychosocial factors across substance and behavioral addictions (including compulsive sexual behavior)","sample_n":286,"sample_text":"207 participants with an addictive disorder and 79 controls","population":"207 participants with an addictive disorder (various types) and 79 controls","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined how personality, family background, and life events predict different addictions—including a “compulsive sexual behavior” disorder—by comparing 207 people with an addiction to 79 controls. Certain traits (e.g., impulsivity) predicted all addictions, while others were specific to each type.","clinical_takeaway":"Psychosocial risk factors differ across addictions, but without accounting for moral or relationship factors, findings on compulsive sexual behavior should be interpreted cautiously.","confidence":0.78,"topic_tags":["sexual_function","masturbation"],"strengths":["Large overall sample for a case‑control study","Inclusion of multiple addictive disorders for comparison","Use of multinomial logistic regression to model unique predictors"],"limitations":["No measurement of moral incongruence or masturbation which are key confounds for CSB","Addiction status likely based on self‑report/clinical diagnosis without standardized CSBD criteria","Cross‑sectional design limits causal inference","Potential under‑power for subgroup analyses"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":6,"contrasting":0,"mentioning":21,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psychres.2020.113221"}},{"id":7071,"doi":"10.1007/s10461-015-1029-7","pmid":"25750052","pmcid":"PMC4561607","title":"Hypersexual, Sexually Compulsive, or Just Highly Sexually Active? Investigating Three Distinct Groups of Gay and Bisexual Men and Their Profiles of HIV-Related Sexual Risk","authors":"Parsons JT, Rendina HJ, Ventuneac A, Moody RL, Grov C.","first_author":"Parsons JT","journal":"AIDS and behavior","year":2016,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Hypersexuality","Sexual Compulsivity","Gay And Bisexual Men","Condomless Anal Sex"],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional comparison of three groups (neither SC/HD, SC only, both SC & HD) within a convenience sample of 370 highly sexually active gay and bisexual men.","sample_n":370,"sample_text":"Convenience sample of highly sexually active GBM; not nationally representative.","population":"Gay and bisexual men (highly sexually active)","country":"USA (likely, based on NIH funding)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study grouped gay and bisexual men into three categories—neither compulsive nor hyper‑sexual, compulsive only, and both compulsive and hyper‑sexual—to see how they differ in HIV‑risk behaviours. Men with both compulsivity and hyper‑sexuality reported more condomless anal sex, especially with HIV‑positive partners, suggesting higher risk.","clinical_takeaway":"Men identified as both sexually compulsive and hyper‑sexual may need targeted, sex‑positive HIV‑prevention interventions.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large (N=370) sample for this niche population","Uses both SC and HD constructs to create a nuanced classification","Provides detailed psychosexual risk profiles"],"limitations":["Convenience sample of highly sexually active men limits generalisability","No measurement or control of moral incongruence, masturbation, mental health or trauma","Likely reliance on self‑report scales without clear validation details"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":6,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":25,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-015-1029-7"}},{"id":7072,"doi":"10.4103/0019-5545.111460","pmid":"23825856","pmcid":"PMC3696245","title":"The depressive façade in a case of compulsive sex behavior with frottage","authors":"Kalra G.","first_author":"Kalra G.","journal":"Indian journal of psychiatry","year":2013,"pub_types":["Journal Article","case-report"],"keywords":["Depression","Compulsive Sexual Behavior","Sexual Addiction","Hypersexuality","Frottage","Frotteurism"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3696245","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single clinical case description","sample_n":1,"sample_text":"N=1 (case report)","population":"individual presenting with depression and compulsive sexual behavior (frottage)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["circular_addiction_scale","underpowered_sample"],"stance":"supports","citation_value":"background","plain_summary":"A 2013 case report describes a person with depression who also engaged in compulsive sexual behavior called frottage. The authors label this behavior as a form of sexual addiction, but the report lacks systematic measurement or broader evidence.","clinical_takeaway":"A single case cannot inform treatment; clinicians should use validated criteria when evaluating compulsive sexual behavior.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["detailed clinical description","highlights comorbidity of depression and CSB"],"limitations":["single case, no generalizability","no validated assessment tools","no control of moral or relational confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0019-5545.111460"}},{"id":7073,"doi":"10.1111/jmft.12154","pmid":"26804731","pmcid":null,"title":"Adult Sexual Outcomes of Child Sexual Abuse Vary According to Relationship Status","authors":"Vaillancourt-Morel MP, Godbout N, Sabourin S, Briere J, Lussier Y, Runtz M.","first_author":"Vaillancourt-Morel MP","journal":"Journal of marital and family therapy","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online self‑report questionnaire, N=1,033 adults, path analysis moderation model","sample_n":1033,"sample_text":"Adults completing online questionnaires; convenience volunteer sample","population":"adults from general community (online panel), 21.5% reported CSA","country":"Canada (likely, based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 1,000 adults, people who experienced child sexual abuse were more likely to report sexual compulsivity if they were single, and either sexual avoidance or compulsivity if they were cohabiting, whereas married survivors reported more avoidance. Relationship status changes how past abuse shows up in adult sexual behavior.","clinical_takeaway":"Clinicians should consider a client’s relationship status when addressing sexual compulsivity or avoidance after childhood sexual abuse.","confidence":0.8,"topic_tags":["sexual_function","csbd","relationships"],"strengths":["Large sample (N>1000)","Examines interaction of CSA with relationship status","Uses path analysis to test moderation"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on self‑report measures, unclear validation","No control for moral incongruence, mental health, or masturbation"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":31,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jmft.12154"}},{"id":7074,"doi":"10.1016/j.drugalcdep.2011.10.020","pmid":"22088656","pmcid":"PMC3494990","title":"Psychological processes and stimulant use among men who have sex with men","authors":"Carrico AW, Pollack LM, Stall RD, Shade SB, Neilands TB, Rice TM, Woods WJ, Moskowitz JT.","first_author":"Carrico AW","journal":"Drug and alcohol dependence","year":2012,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Probability sample of 879 MSM (N=711 respondents) recruited by random‑digit dialing; mail‑in questionnaire; logistic regression and mediation path analysis of self‑reported stimulant use in past 6 months.","sample_n":711,"sample_text":"Probability sample; 81 % response rate; adult MSM residents of San Francisco","population":"Men who have sex with men (San Francisco, 2002‑2003)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a representative sample of 711 men who have sex with men in San Francisco, greater depression and higher sexual compulsivity were linked to higher odds of recent stimulant (cocaine, meth) use. Using substances to cope with negative moods partly explained these links.","clinical_takeaway":"Screen for depression and sexual compulsivity in MSM who use stimulants; targeting emotional regulation may reduce drug use.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large probability sample with good response rate","Use of validated sexual compulsivity scale (presumed)","Multivariate modeling with mediation analysis","Clear reporting of odds ratios and confidence intervals"],"limitations":["Cross‑sectional; cannot infer causality","Self‑report of drug use may be biased","No measurement of moral or relational confounds","No pre‑registration"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":8,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":43,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.drugalcdep.2011.10.020"}},{"id":7076,"doi":"10.3390/ijerph18105259","pmid":"34069273","pmcid":"PMC8156533","title":"Sexual Violence and Trauma in Childhood: A Case Report Based on Strategic Counseling","authors":"Saladino V, Eleuteri S, Zamparelli E, Petrilli M, Verrastro V.","first_author":"Saladino V","journal":"International journal of environmental research and public health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports","case-report"],"keywords":["Distress","Sexual Addiction","Childhood Sexual Abuse","Bdsm"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/18/10/5259/pdf?version=1621156828","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single adolescent case described in narrative format; no control or comparison group; intervention (strategic counseling) reported descriptively","sample_n":1,"sample_text":"n=1 (case report)","population":"1 female adolescent, age 17, with history of childhood sexual abuse, self‑reported BDSM‑type sexual addiction, alcohol misuse and social anxiety","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["circular_addiction_scale","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 17‑year‑old with a childhood rape history received 15 counseling sessions that addressed her self‑identified BDSM‑type sexual addiction, alcohol use, and shame. The authors describe her improved emotional coping and normalization of sexual relationships after therapy.","clinical_takeaway":"Evidence is limited to one case; clinicians should treat such reports as illustrative, not as proof of treatment effectiveness.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Detailed narrative of therapeutic process","Highlights trauma‑related pathways to risky sexual behavior"],"limitations":["Single case, no measurement validation","No systematic assessment of addiction criteria","No control for confounding factors (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph18105259"}},{"id":7077,"doi":"10.1016/j.psychres.2018.07.035","pmid":"30121542","pmcid":null,"title":"A pilot study of early onset obsessive-compulsive disorder: Symptom dimensions and association analysis with polymorphisms of the serotonin transporter gene","authors":"Kenezloi E, Lakatos K, Horvath EZ, Sasvari-Szekely M, Nemoda Z.","first_author":"Kenezloi E","journal":"Psychiatry research","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Principal component analysis","Ocd","Slc6a4 Promoter And Intronic Variants"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case-control genetic association study","sample_n":325,"sample_text":"102 OCD patients; 223 healthy controls","population":"102 OCD patients, 223 controls (human)","country":"Hungary (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined whether different OCD symptom types, including a sexual dimension, were linked to variants of the serotonin transporter gene. An increased L‑allele frequency was found in patients, but no clear genetic association with any symptom factor emerged.","clinical_takeaway":"Current evidence does not support using serotonin transporter genotyping to guide OCD treatment.","confidence":0.7,"topic_tags":["gender"],"strengths":["Validated OCD symptom measure (CY‑BOCS)","Genetic analysis of well‑characterised polymorphisms","Reasonable control sample size"],"limitations":["Pilot study, limited power for genetic associations","No correction for multiple testing reported","No assessment of potential psychiatric comorbidities"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psychres.2018.07.035"}},{"id":7078,"doi":"10.1007/s10508-018-1200-0","pmid":"29572770","pmcid":null,"title":"Compulsive Sexual Behavior as an Impulse Control Disorder: Awaiting Field Studies Data","authors":"Walton MT, Bhullar N.","first_author":"Walton MT","journal":"Archives of sexual behavior","year":2018,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Letter/commentary without empirical data.","sample_n":null,"sample_text":"None (commentary)","population":"Humans (general, not specified)","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that compulsive sexual behavior might be a distinct impulse‑control disorder for a small group of cases, but they also note it often reflects broader psychological or medical problems.","clinical_takeaway":"No direct clinical guidance; the piece stresses the need for clearer definitions and empirical research before labeling it a separate disorder.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Highlights conceptual issues in the field","Cites prior literature"],"limitations":["No empirical data","Lacks operational definitions","No systematic review methodology"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":0,"mentioning":13,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1200-0"}},{"id":7080,"doi":"10.3390/brainsci11030383","pmid":"33802756","pmcid":"PMC8002414","title":"Birds of a Feather Flock Together: Disadvantageous Decision Making in Augmented Restless Legs Syndrome Patients with and without Impulse Control Disorders","authors":"Heim B, Ellmerer P, Stefani A, Heidbreder A, Brandauer E, Högl B, Seppi K, Djamshidian A.","first_author":"Heim B","journal":"Brain sciences","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Decision Making","Impulsivity","Restless Legs Syndrome","Behavioral Abnormalities"],"is_oa":true,"oa_url":"https://www.mdpi.com/2076-3425/11/3/383/pdf","cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Post‑hoc analysis of 40 RLS patients (19 with ICD, 21 without) and 21 healthy controls; information‑sampling task (beads task) used to assess decision making.","sample_n":61,"sample_text":"40 patients (19 AUG+ICD, 21 AUG) and 21 healthy controls.","population":"Adults with restless‑legs syndrome, some with impulse‑control disorder symptoms (including compulsive sexual behavior).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"People with restless‑legs syndrome who experience treatment‑related worsening (augmentation) make poorer decisions, regardless of whether they also show impulse‑control problems like compulsive sexual behaviour.","clinical_takeaway":"Decision‑making deficits may be a feature of augmentation in RLS, independent of compulsive sexual symptoms.","confidence":0.7,"topic_tags":["relationships","sexual_function","pornography"],"strengths":["Clinical sample with clear diagnostic criteria","Use of a well‑validated decision‑making task"],"limitations":["Small sample, likely under‑powered","ICD symptoms assessed only via semi‑structured interview, not validated scales","No control for mental‑health or other confounding variables"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/brainsci11030383"}},{"id":7081,"doi":"10.1016/j.cpr.2020.101942","pmid":"33160160","pmcid":null,"title":"Atypical social reward anticipation as a transdiagnostic characteristic of psychopathology: A meta-analytic review and critical evaluation of current evidence","authors":"Aldridge-Waddon L, Vanova M, Munneke J, Puzzo I, Kumari V.","first_author":"Aldridge-Waddon L","journal":"Clinical psychology review","year":2020,"pub_types":["Meta-Analysis","Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Anhedonia","Social Reward","Interpersonal","Monetary Reward","Social Motivation"],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Meta‑analytic review of 42 studies on social reward anticipation across multiple psychopathologies, with pooled reaction‑time effect sizes and narrative synthesis of behavioural, self‑report and neuroimaging data.","sample_n":null,"sample_text":"Aggregated across 42 primary studies; individual study sizes not specified in abstract","population":"clinical groups (ADHD, ASD, schizophrenia, etc.) and healthy controls; sample sizes varied across studies","country":"International (studies from various locations)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review finds that many mental‑health conditions show slower reactions to social rewards, suggesting a common pattern of reduced anticipation, while some (e.g., bipolar, eating, and sexual‑addiction disorders) may show the opposite. Future work should consider gender, medication, and richer social stimuli.","clinical_takeaway":"Social reward anticipation is altered in several disorders; clinicians should assess reward processing rather than assume uniform deficits.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive meta‑analysis of behavioral reaction‑time data","Inclusion of a wide range of psychopathologies","Clear reporting of effect sizes and heterogeneity"],"limitations":["Limited focus on sexual‑addiction sub‑group (few studies)","Potential publication bias not addressed in abstract","Reliance on heterogeneous tasks and stimuli"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":103,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.cpr.2020.101942"}},{"id":7082,"doi":"10.1016/j.chiabu.2012.03.003","pmid":"22622224","pmcid":null,"title":"Exploring the role of child sexual abuse and posttraumatic stress disorder symptoms in gay and bisexual men reporting compulsive sexual behavior","authors":"Blain LM, Muench F, Morgenstern J, Parsons JT.","first_author":"Blain LM","journal":"Child abuse & neglect","year":2012,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 182 gay and bisexual men reporting compulsive sexual behavior symptoms","sample_n":182,"sample_text":"Convenience sample recruited for CSB symptoms","population":"gay and bisexual men (N=182) with CSB symptoms","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among gay and bisexual men who report compulsive sexual behavior, a history of child sexual abuse was linked to higher CSB symptoms, even after accounting for other childhood abuse. PTSD did not explain this link, but added to overall symptom severity.","clinical_takeaway":"Screen for childhood sexual abuse in clients presenting with compulsive sexual behavior, as it may indicate greater overall distress.","confidence":0.8,"topic_tags":["csbd"],"strengths":["Large (N=182) sample for a niche population","Examines unique contribution of CSA vs other maltreatment","Includes assessment of comorbid PTSD, depression, anxiety"],"limitations":["Cross‑sectional design; no causal inference","Convenience sample of men already reporting CSB; limited generalisability","No measurement of moral incongruence or masturbation frequency"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":23,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2012.03.003"}},{"id":7083,"doi":"10.1371/journal.pone.0208809","pmid":"30601828","pmcid":"PMC6314635","title":"Putting out the blaze: The neural mechanisms underlying sexual inhibition","authors":"Rodriguez-Nieto G, Sack AT, Dewitte M, Emmerling F, Schuhmann T.","first_author":"Rodriguez-Nieto G","journal":"PloS one","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0208809&type=printable","cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subject fMRI study comparing general response inhibition (Go/No‑go) with two sexual‑inhibition tasks (Negative Affective Priming, Approach‑Avoidance) in 22 healthy volunteers","sample_n":22,"sample_text":"22 healthy participants","population":"healthy adult volunteers (N=22)","country":"unspecified (likely Germany/Europe)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study used fMRI while participants performed tasks that required them to stop general actions or to block sexual thoughts and urges. Different brain regions were active for general inhibition versus sexual‑specific inhibition, suggesting that stopping sexual thoughts engages a partly distinct neural network.","clinical_takeaway":"No direct clinical guidance; the findings highlight that sexual inhibition involves specific brain areas, which may inform future research on impulse‑control problems.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","csbd","pornography"],"strengths":["Within‑subject design allows direct comparison of neural activation","Use of established inhibition tasks","Clear differentiation of cognitive vs motivational sexual inhibition"],"limitations":["Small fMRI sample (N=22) limits power and generalisability","No explicit correction or pre‑registration reported","No assessment of individual differences (e.g., sexual experience, moral attitudes)"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":4,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":15,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0208809"}},{"id":7084,"doi":"10.20944/preprints202408.1081.v1","pmid":null,"pmcid":null,"title":"Impact of Deep Brain Stimulation on Addictive Behaviors: A Case Series of Parkinsonian Patients","authors":"de CHAZERON I, LAMBERT C, HOUETO J, BROUSSE G, JAAFARI N, Rascol O, ORY-MAGNE F, KRACK P, BARROCHE G, SCHWAN R, DOE DE MAINDREVILLE A, VIDAILHET M, WELTER ML, LEMAIRE J, LLORCA P.","first_author":"de CHAZERON I","journal":"Preprints.org","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.20944/preprints202408.1081.v1","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"prospective case series of 12 Parkinson's patients with pre‑existing behavioral addictions, assessed pre‑ and post‑STN‑DBS up to 12 months.","sample_n":12,"sample_text":"12 PD patients with pre‑existing behavioral addictions","population":"12 Parkinsonian patients (9 gambling, 2 hypersexual, 1 shopping disorder).","country":"multicenter (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In 12 Parkinson's patients with gambling, hypersexual, or shopping problems, deep‑brain stimulation of the subthalamic nucleus did not worsen their addictions and seemed to improve anxiety after a year, but the study is tiny and lacks rigorous measures.","clinical_takeaway":"No clear evidence that STN‑DBS reduces hypersexual or other behavioral addictions; findings are preliminary.","confidence":0.7,"topic_tags":["neuroscience","treatment","csbd","pornography","sexual_function"],"strengths":["prospective follow‑up over 12 months","clinical relevance for Parkinson's patients","includes multiple addiction subtypes"],"limitations":["Very small, non‑representative sample","No validated addiction measures reported","No control group or blinding"],"rubric_version":"2.0","raw_total":17,"max_possible":60,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":2,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202408.1081.v1"}},{"id":7085,"doi":"10.1007/s10508-017-1072-8","pmid":"28948394","pmcid":null,"title":"Separating Models Obscures the Scientific Underpinnings of Sex Addiction as a Disorder","authors":"Carnes S, Love T.","first_author":"Carnes S","journal":"Archives of sexual behavior","year":2017,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-1072-8"}},{"id":7086,"doi":"10.2466/02.13.15.21.pr0.107.4.236-244","pmid":"20923068","pmcid":null,"title":"A hierarchical linear modeling assessment of dual-addiction status and change in sexual compulsivity over time","authors":"Wright PJ.","first_author":"Wright PJ.","journal":"Psychological reports","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"observational longitudinal study of self‑identified sexually compulsive males using hierarchical linear modelling over multiple time points","sample_n":null,"sample_text":"self‑identified sexually compulsive males (size not reported in abstract)","population":"self‑identified sexually compulsive adult males (likely convenience sample)","country":"","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["circular_addiction_scale","self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study followed men who said they were sexually compulsive, comparing those who also reported another addiction to those with only sexual compulsivity. It found that the dual‑addiction group started with lower sexual compulsivity but improved less over time.","clinical_takeaway":"Findings are limited; clinicians should not assume dual‑addiction leads to poorer treatment outcomes without further evidence.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["uses longitudinal data","applies hierarchical linear modelling"],"limitations":["relies on self‑identified addiction status","no control for key confounds (moral incongruence, mental health, etc.)","sample size and recruitment details unclear"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2466/02.13.15.21.pr0.107.4.236-244"}},{"id":7088,"doi":"10.1080/09540121.2014.921276","pmid":"24865599","pmcid":"PMC4127034","title":"Psychosocial burdens negatively impact HIV antiretroviral adherence in gay, bisexual, and other men who have sex with men aged 50 and older","authors":"Halkitis PN, Perez-Figueroa RE, Carreiro T, Kingdon MJ, Kupprat SA, Eddy J.","first_author":"Halkitis PN","journal":"AIDS care","year":2014,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Aging","Adherence","HIV","Depression","Sexual Compulsivity","Hiv-stigma","Gay And Bisexual"],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 199 community‑recruited MSM aged ≥ 50; adherence measured via self‑report; psychosocial factors assessed with questionnaires","sample_n":199,"sample_text":"community‑based convenience sample (cross‑sectional)","population":"gay, bisexual, and other MSM aged ≥ 50 living with HIV (N = 199)","country":"United States (presumed from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 199 gay and bisexual men over 50 living with HIV, higher levels of stigma and sexual compulsivity were linked to poorer medication adherence, while older age helped adherence. Addressing these psychosocial burdens may improve health outcomes.","clinical_takeaway":"Screen for stigma and sexual compulsivity in older HIV‑positive MSM to support ART adherence.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for an older MSM cohort","Uses validated psychosocial scales (presumed)","Multivariable modelling controls for age and education"],"limitations":["Cross‑sectional design precludes causal inference","No measurement of moral incongruence or masturbation, key confounds for sexual compulsivity","Self‑reported adherence may be biased"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":34,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540121.2014.921276"}},{"id":7089,"doi":"10.1590/0004-282x20180052","pmid":"29972423","pmcid":null,"title":"Impulse control and related disorders in Parkinson's disease","authors":"Vargas AP, Cardoso FEC.","first_author":"Vargas AP","journal":"Arquivos de neuro-psiquiatria","year":2018,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative literature review of impulse control disorders in Parkinson's disease; no original data collected","sample_n":null,"sample_text":"Not applicable – review article","population":"Patients with Parkinson's disease (implicit)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises how dopamine treatments for Parkinson's disease can trigger impulse‑control problems such as gambling, compulsive sexual behaviour, buying, and binge eating, describing their frequency, symptoms and treatment options.","clinical_takeaway":"Clinicians should monitor Parkinson's patients on dopamine therapy for emerging impulsive behaviours, including compulsive sexuality.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of impulse control disorders in Parkinson's disease","Integrates clinical characteristics and treatment considerations"],"limitations":["Narrative review without systematic methodology","No empirical data; conclusions based on secondary sources"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":23,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/0004-282x20180052"}},{"id":7090,"doi":"10.1016/j.drugalcdep.2017.12.016","pmid":"29454927","pmcid":null,"title":"Syndemics among individuals enrolled in the PrEP Brasil Study","authors":"De Boni RB, Machado IK, De Vasconcellos MTL, Hoagland B, Kallas EG, Madruga JV, Fernandes NM, Cerqueira NB, Moreira RI, Goulart SP, Veloso VG, Grinsztejn B, Luz PM.","first_author":"De Boni RB","journal":"Drug and alcohol dependence","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["HIV infection","MSM","Transgender","Binge Drinking","Polysubstance Use","Pre-exposure Prophylaxis"],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Secondary cross‑sectional analysis of 421 PrEP enrollee MSM/TGW; convenience sample of participants seeking HIV prevention.","sample_n":421,"sample_text":"421 participants with complete data","population":"MSM and transgender women in Brazil (PrEP Brasil Study)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 421 Brazilian men who have sex with men and transgender women using PrEP, about a quarter experienced two or more co‑occurring problems such as binge drinking, polysubstance use, depression, compulsive sexual behavior, or intimate‑partner violence. Younger age, being transgender, higher education and more recent sexual partners were linked to higher odds of these syndemics.","clinical_takeaway":"PrEP services should screen for substance use, depression and interpersonal violence, as these co‑occur and may affect HIV risk.","confidence":0.78,"topic_tags":["csbd","sexual_function","prevalence"],"strengths":["Large sample for a sexual‑health study (n>400)","Clear definition of syndemic count (≥2 conditions)","Multivariable logistic regression with confidence intervals"],"limitations":["Cross‑sectional, cannot infer causality","Compulsive sexual behavior not reported as a validated measure","No assessment of moral incongruence or masturbation","Convenience sample of PrEP users limits generalisability"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":53,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.drugalcdep.2017.12.016"}},{"id":7091,"doi":"10.1016/j.psc.2008.06.006","pmid":"18996305","pmcid":null,"title":"Treatment of sexually compulsive adolescents","authors":"Gerber J.","first_author":"Gerber J.","journal":"The Psychiatric clinics of North America","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary/clinical overview without original empirical data.","sample_n":null,"sample_text":"Not applicable – article provides narrative synthesis and treatment perspective.","population":"Adolescents (clinical discussion)","country":"United States (inferred from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how sexual compulsivity in teens is linked to trauma, attachment, and self‑concept, arguing that most adolescents are not the stereotypical ‘abusive male’ and that treatment should address underlying injury rather than punitive measures.","clinical_takeaway":"Clinicians should assess trauma and attachment issues when working with sexually compulsive youth and avoid purely punitive approaches.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad theoretical integration of trauma, attachment, and self‑concept.","Highlights diversity of adolescents labeled as sexually compulsive."],"limitations":["No original data; conclusions are narrative.","Lacks systematic review methods or risk‑of‑bias assessment."],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psc.2008.06.006"}},{"id":7092,"doi":"10.1038/npp.2015.300","pmid":"26657963","pmcid":"PMC4677151","title":"Neurobiology of Compulsive Sexual Behavior: Emerging Science","authors":"Kraus SW, Voon V, Potenza MN.","first_author":"Kraus SW","journal":"Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology","year":2016,"pub_types":["news","Review","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":35,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/npp.2015.300"}},{"id":7094,"doi":"10.21203/rs.3.rs-4644609/v1","pmid":null,"pmcid":null,"title":"Paraphilic Sexual Fantasies in a Sample of University Students from Southern Brazil","authors":"Furian G, Schwarz K, Canto Gd, Jordani J, Marchi N, Beier KM, Amelug T, Lobato MI.","first_author":"Furian G","journal":"Research Square","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-4644609/v1","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire; convenience sample of university students (N=572); adapted inventories; no longitudinal or experimental manipulation","sample_n":572,"sample_text":"Convenience sample recruited via online questionnaire","population":"university students in Southern Brazil (public & private)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 572 Brazilian university students, researchers found a high prevalence of paraphilic fantasies but little self‑reported distress, suggesting these fantasies alone may not constitute a mental disorder. Hypersexual disorder was rare (3.2%) and differed by gender.","clinical_takeaway":"Presence of atypical sexual fantasies does not automatically imply pathology; assess distress and functional impact before labeling a disorder.","confidence":0.78,"topic_tags":["adolescents","sexual_function"],"strengths":["Large sample for a survey (N>500)","Use of validated Brazilian versions of trauma and hypersexuality scales","Adds data on paraphilic fantasies in a non‑clinical young adult population"],"limitations":["Convenience university sample limits generalisability","No measurement of moral/religious attitudes or masturbation frequency","Cross‑sectional; cannot infer causality","Limited statistical reporting (no effect sizes, few corrections)"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":4,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-4644609/v1"}},{"id":7095,"doi":"10.1080/13651501.2019.1711424","pmid":"31916881","pmcid":null,"title":"The rates of co-occurring behavioural addictions in treatment-seeking individuals with obsessive-compulsive disorder: a preliminary report","authors":"Brakoulias V, Starcevic V, Albert U, Arumugham SS, Bailey BE, Belloch A, Borda T, Dell'Osso L, Elias JA, Falkenstein MJ, Ferrao YA, Fontenelle LF, Jelinek L, Kay B, Lochner C, Maina G, Marazziti D, Matsunaga H, Miguel EC, Morgado P, Pasquini M, Perez-Rivera R, Potluri S, Reddy JYC, Riemann BC, do Rosario MC, Shavitt RG, Stein DJ, Viswasam K, Fineberg NA.","first_author":"Brakoulias V","journal":"International journal of psychiatry in clinical practice","year":2020,"pub_types":["Multicenter Study","Journal Article"],"keywords":["Diagnosis","Obsessive-compulsive Disorder","Behavioural Addictions"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Multicentre survey of treatment‑seeking OCD patients (N≈6916) reporting prevalence of behavioural addictions via clinical diagnosis.","sample_n":6916,"sample_text":"16 of 23 invited international OCD treatment centres provided data on 6916 patients.","population":"Patients with primary obsessive‑compulsive disorder seeking treatment at specialist centres (13 countries).","country":"Multinational (13 countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 6,900 people receiving treatment for OCD found that about 7% also met criteria for compulsive sexual behaviour and other behavioural addictions, but most diagnoses were based on clinicians' judgments rather than validated scales.","clinical_takeaway":"Clinicians should screen for co‑occurring behavioural addictions in OCD patients, but use validated assessment tools.","confidence":0.8,"topic_tags":["csbd","pornography","sexual_function","moral_incongruence"],"strengths":["Large multinational sample","First systematic look at co‑occurring behavioural addictions in OCD","Provides prevalence estimates for multiple behavioural addictions"],"limitations":["Reliance on non‑validated clinical diagnoses","No assessment of key confounds (moral incongruence, masturbation, mental health)","Cross‑sectional, treatment‑seeking convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":60,"pct_score":33,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13651501.2019.1711424"}},{"id":7096,"doi":"10.1080/09540121.2022.2080801","pmid":"35621316","pmcid":null,"title":"Association of syndemic conditions and quality of life among people living with HIV/AIDS","authors":"de Oliveira Gomes M, Castro R, Corrêa da Mota J, De Boni RB.","first_author":"de Oliveira Gomes M","journal":"AIDS care","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["AIDS","HIV","Quality of life","Mental health","Substance Abuse","Syndemics"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"secondary analysis of a large observational cohort (N=1530) using t‑tests, ANOVA and linear regression to examine associations between syndemic factors and WHOQOL‑HIV domains.","sample_n":1530,"sample_text":"mostly male (64%), median age 43 years","population":"people living with HIV/AIDS receiving care in Rio de Janeiro, Brazil","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 1,530 Brazilian people living with HIV, having multiple problems such as binge drinking, substance use, intimate‑partner violence, depression, or compulsive sexual behaviour was linked to poorer quality‑of‑life across several domains.","clinical_takeaway":"Multiple co‑occurring issues can lower quality of life in HIV patients; addressing them together may improve outcomes.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Large sample size","Validated QoL instrument","Comprehensive syndemic framework"],"limitations":["Cross‑sectional; cannot infer causality","Compulsive sexual behaviour measurement not described","Moral incongruence not accounted"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540121.2022.2080801"}},{"id":7098,"doi":"10.1037/ccp0000037","pmid":"26147563","pmcid":"PMC4573250","title":"LGB-affirmative cognitive-behavioral therapy for young adult gay and bisexual men: A randomized controlled trial of a transdiagnostic minority stress approach","authors":"Pachankis JE, Hatzenbuehler ML, Rendina HJ, Safren SA, Parsons JT.","first_author":"Pachankis JE","journal":"Journal of consulting and clinical psychology","year":2015,"pub_types":["research-article","Randomized Controlled Trial","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.1037/ccp0000037","cited_by_count":343,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized controlled trial comparing immediate LGB‑affirmative CBT to a 3‑month waitlist in 63 young gay/bisexual men; outcomes at baseline, 3‑month, 6‑month.","sample_n":63,"sample_text":"63 participants randomized to treatment (n≈32) or waitlist (n≈31).","population":"Young adult gay and bisexual men (n=63, mean age≈26).","country":"United States (NIH‑funded).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A randomized trial tested an LGB‑affirmative CBT program for young gay and bisexual men. Compared with a wait‑list, the therapy reduced depression, alcohol problems, sexual compulsivity, and risky condomless sex, with benefits lasting at 6 months.","clinical_takeaway":"LGBT‑affirmative CBT may help reduce sexual compulsivity and related risk behaviors in young gay/bisexual men.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["RCT design with waitlist control","Validated outcome measures","Effect sizes and confidence intervals reported","Addresses multiple co‑occurring health risks"],"limitations":["Small sample limits power for some outcomes","No measurement of moral incongruence or masturbation","Limited generalisability beyond young gay/bisexual men"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":21,"contrasting":0,"mentioning":500,"citing_publications":677,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/ccp0000037"}},{"id":7099,"doi":"10.1080/00224499.2015.1051213","pmid":"26422118","pmcid":null,"title":"The Short French Internet Addiction Test Adapted to Online Sexual Activities: Validation and Links With Online Sexual Preferences and Addiction Symptoms","authors":"Wéry A, Burnay J, Karila L, Billieux J.","first_author":"Wéry A","journal":"Journal of sex research","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a self‑report scale administered to 401 self‑selected male users of online sexual activities; cross‑sectional convenience sample","sample_n":401,"sample_text":"self‑selected male OSA users","population":"men (self‑selected online sexual activity users), N=401","country":"France","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","circular_addiction_scale"],"stance":"supports","citation_value":"useful","plain_summary":"The authors translated and validated a brief questionnaire for online sexual‑activity addiction in French, finding it reliable and linked to time spent online and other sexual‑addiction symptoms, but the study used a self‑selected male sample and did not control for moral or mental‑health factors.","clinical_takeaway":"The French s‑IAT‑sex can be used as a screening tool, but clinicians should interpret scores cautiously and consider other factors such as distress origin and mental health.","confidence":0.7,"topic_tags":["sexual_function","measurement"],"strengths":["large sample for a validation study","good internal consistency (α .87‑.88)","confirmatory factor analysis supports two‑factor structure"],"limitations":["self‑selected, male‑only sample limits generalizability","no measurement of key confounds (moral incongruence, masturbation, mental health)","addiction construct assessed only by self‑report screening tools"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":1,"mentioning":41,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2015.1051213"}},{"id":7100,"doi":"10.1089/apc.2010.0117","pmid":"20731609","pmcid":null,"title":"Sexual compulsivity, the Internet, and sexual behaviors among men in a rural area of the United States","authors":"Schnarrs PW, Rosenberger JG, Satinsky S, Brinegar E, Stowers J, Dodge B, Reece M.","first_author":"Schnarrs PW","journal":"AIDS patient care and STDs","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Community‑based participatory survey of 309 rural MSM; associations between sexual compulsivity scores and partner‑seeking/sexual risk behaviours.","sample_n":309,"sample_text":"309 men recruited via community outreach in a rural Midwestern region","population":"Men who have sex with men, primarily white, rural Midwestern USA (mean age 29)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a rural U.S. sample of gay men, higher sexual compulsivity scores were linked to seeking partners online and having unprotected anal sex, suggesting that internet‑based interventions could help reduce HIV/STI risk.","clinical_takeaway":"Clinicians should consider internet‑based risk‑reduction strategies for sexually compulsive rural MSM.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Large community sample for a rural MSM population","Uses a validated sexual compulsivity scale","Examines internet‑mediated partner seeking"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral incongruence, mental health, or trauma as confounds","Relies on self‑report of risky behaviours"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":22,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/apc.2010.0117"}},{"id":7101,"doi":"10.1093/sexmed/qfaf050","pmid":"40718093","pmcid":"PMC12291535","title":"Limitation to the capacity to love and hypersexual behavior in their relationship with psychoticism and paranoid ideation","authors":"Origlia G, Doroldi D, Lo Buglio G, Boldrini T, Del Casale A, Spitoni G, Limoncin E, Ciocca G.","first_author":"Origlia G","journal":"Sexual medicine","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Psychosis","Psychoticism","Hypersexuality","Paranoid Ideation","Capacity To Love"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12291535","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"convenience online sample (N=521), non‑clinical, self‑report questionnaires, correlational analysis","sample_n":521,"sample_text":"convenience sample recruited via an online platform; gender imbalance, primarily students, Italian cultural background","population":"adult Italian participants (mostly students), 18‑50 years, 75% female","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 521 Italian adults, higher self‑reported hypersexuality was linked to stronger psychotic‑like and paranoid thoughts, while a lower ‘capacity to love’ was linked to the same symptoms. The study suggests that hypersexual behavior may accompany subclinical psychopathology.","clinical_takeaway":"Hypersexuality may co‑occur with psychotic‑like symptoms; clinicians should assess broader mental‑health context when addressing problematic sexual behavior.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["large sample for a questionnaire study","use of validated Hypersexual Behavior Inventory","novel inclusion of Capacity to Love construct"],"limitations":["cross‑sectional, cannot infer causality","gender and cultural homogeneity limits generalisability","no measurement of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfaf050"}},{"id":7102,"doi":"10.1186/1753-6561-6-s4-p33","pmid":null,"pmcid":"PMC3426099","title":"'Sexual addiction': diagnosis and treatment in clinical practice","authors":"Hughes B.","first_author":"Hughes B.","journal":"BMC proceedings","year":2012,"pub_types":["Abstract"],"keywords":[],"is_oa":true,"oa_url":"https://bmcproc.biomedcentral.com/track/pdf/10.1186/1753-6561-6-S4-P33","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1753-6561-6-s4-p33"}},{"id":7103,"doi":"10.3233/jpd-160926","pmid":"27802244","pmcid":null,"title":"Sexual Preoccupation Behavior in Parkinson's Disease","authors":"Bronner G, Hassin-Baer S, Gurevich T.","first_author":"Bronner G","journal":"Journal of Parkinson's disease","year":2017,"pub_types":["Review","Journal Article"],"keywords":["Sexual dysfunction","Parkinson’s Disease","Desire","Hypersexuality","Restless Genital Syndrome","Persistent Genital Arousal Disorder","Compulsive Sexualbehavior","Sexual Preoccupation Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Review article based on clinical experience; no primary data collection.","sample_n":null,"sample_text":"Not applicable – narrative review without original participants","population":"People with Parkinson's disease and their partners/caregivers","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors outline four types of sexually preoccupying behaviors seen in Parkinson's disease, discuss how to assess them, and suggest treatment ideas for patients and partners.","clinical_takeaway":"Clinicians should recognize diverse sexual issues in PD, evaluate them systematically, and consider tailored interventions.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides a clinically oriented taxonomy of sexual behaviors in PD","Offers practical assessment and treatment suggestions"],"limitations":["Lacks empirical data; relies on author experience","No systematic search or quality appraisal reported"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3233/jpd-160926"}},{"id":7104,"doi":"10.1002/pcn5.70121","pmid":"40395629","pmcid":"PMC12088864","title":"Regional cerebral blood flow in a patient with restless legs syndrome exhibiting pramipexole-induced hypersexuality","authors":"Obata T, Kobayashi R, Shirata T, Noto K, Sugai Y, Aboshi G, Kanoto M, Suzuki A.","first_author":"Obata T","journal":"PCN reports : psychiatry and clinical neurosciences","year":2025,"pub_types":["case-study","Journal Article"],"keywords":["Regional cerebral blood flow","Restless Legs Syndrome","Hypersexuality","Pramipexole","Single‐photon Emission Computed Tomography (Spect)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12088864","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-patient case study of pramipexole‑induced hypersexuality with SPECT imaging","sample_n":1,"sample_text":"N=1 (case report)","population":"60‑year‑old man with restless‑legs syndrome","country":"Japan","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational","fmri_reverse_inference"],"stance":"neutral","citation_value":"background","plain_summary":"A 60‑year‑old man with restless‑legs syndrome developed inappropriate sexual behaviour after starting a low dose of the dopamine agonist pramipexole. A brain scan (SPECT) showed increased blood flow in regions linked to impulse control, which decreased after stopping the drug. The authors suggest a possible brain‑based mechanism for drug‑induced hypersexuality.","clinical_takeaway":"Hypersexuality can arise as a side‑effect of dopamine agonists even at low doses; monitor patients for impulsive sexual behaviour and consider drug adjustment.","confidence":0.85,"topic_tags":["sexual_function","neuroscience"],"strengths":["detailed clinical description","use of neuroimaging to explore mechanism"],"limitations":["single case, no control group","no validated hypersexuality scale","confounders (moral, masturbation, partner) not assessed"],"rubric_version":"2.0","raw_total":14,"max_possible":70,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":3,"statistics":1,"confounds":2,"design":1,"addiction_criteria":2,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/pcn5.70121"}},{"id":7105,"doi":"10.21203/rs.3.rs-2111503/v1","pmid":null,"pmcid":null,"title":"Paraphilias in ADHD and their Association with Hypersexuality","authors":"Turner D, Hertz PG, Biedermann L, Barra S, Retz W.","first_author":"Turner D","journal":"Research Square","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-2111503/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire comparing 160 ADHD adults to 75 controls; prevalence of paraphilic fantasies/behaviors and hypersexuality association assessed.","sample_n":235,"sample_text":"160 adults with ADHD and 75 adults without ADHD (online questionnaire).","population":"Adults with ADHD (clinical or self‑identified) and non‑ADHD adults, recruited online; convenience sample.","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"useful","plain_summary":"In an online survey of 160 adults with ADHD and 75 without, many reported paraphilic fantasies, but ADHD was not linked to higher rates. Hypersexuality correlated with paraphilias only in the ADHD group. The authors suggest paraphilic interests are not inherently pathological.","clinical_takeaway":"ADHD does not appear to increase paraphilic behavior; clinicians should consider broader factors beyond ADHD diagnosis.","confidence":0.7,"topic_tags":["adolescents"],"strengths":["Comparative sample of ADHD vs controls","Addresses understudied link between ADHD and paraphilias","Large overall N for a questionnaire study"],"limitations":["Cross‑sectional, cannot infer causality","Unclear whether questionnaires are validated","No control for key confounds (moral views, mental health, trauma)","Convenience online sample limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-2111503/v1"}},{"id":7106,"doi":"10.1023/a:1014626102110","pmid":"11958364","pmcid":null,"title":"A case of kleptomania and compulsive sexual behavior treated with naltrexone","authors":"Grant JE, Kim SW.","first_author":"Grant JE","journal":"Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists","year":2001,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"One patient (middle‑aged male) described in detail.","population":"single adult male with kleptomania and compulsive sexual behavior","country":"USA","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 200‑year‑old man with kleptomania and compulsive sexual urges improved after high‑dose naltrexone; stopping the drug made symptoms return, and restarting helped again. The authors suggest naltrexone might help similar cases.","clinical_takeaway":"Evidence is limited to one case; naltrexone could be considered experimentally, but clinicians should monitor closely and not assume general efficacy.","confidence":0.7,"topic_tags":["treatment","neuroscience","csbd"],"strengths":["Detailed clinical description","Medication rechallenge supports temporal association"],"limitations":["Single case; no control group","No validated symptom scales","No measurement of relevant confounds (e.g., moral incongruence, masturbation)","Generalisation to broader CSB population is unwarranted"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1014626102110"}},{"id":7107,"doi":"10.1037/sgd0000308","pmid":"30984797","pmcid":"PMC6456266","title":"Trajectories of sexual identity development and psychological well-being for highly sexually active gay and bisexual men: A latent growth curve analysis","authors":"Rendina HJ, Carter JA, Wahl L, Millar BM, Parsons JT.","first_author":"Rendina HJ","journal":"Psychology of sexual orientation and gender diversity","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Discrimination","Mental health","stigma","Minority Stress","Sexual Identity Development"],"is_oa":false,"oa_url":"https://doi.org/10.1037/sgd0000308","cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 374 highly sexually active gay/bisexual men in NYC; latent growth curve modelling of self‑reported milestone ages","sample_n":374,"sample_text":"Convenience sample recruited in NYC; likely self‑selected for high sexual activity","population":"highly sexually active gay and bisexual men (NYC)","country":"USA","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 374 gay and bisexual men in New York who reported frequent sexual activity. It mapped how quickly they passed identity milestones (awareness, identification, sexual experience, disclosure) and linked faster progress to more discrimination, emotional difficulties, sexual compulsivity, and anxiety/depression later in life.","clinical_takeaway":"Faster sexual‑identity development may signal higher risk for mental‑health challenges and compulsive sexual behaviour; clinicians should consider developmental history in assessment.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large sample for sexuality research","novel use of latent growth modeling","covers under‑studied developmental trajectories"],"limitations":["cross‑sectional data used for growth curves","self‑selected, highly sexually active sample limits generalisability","limited detail on measurement validation"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":10,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/sgd0000308"}},{"id":7108,"doi":"10.1007/s10508-018-1167-x","pmid":"29464450","pmcid":"PMC5954073","title":"The Proof of the Pudding Is in the Tasting: Data Are Needed to Test Models and Hypotheses Related to Compulsive Sexual Behaviors","authors":"Gola M, Potenza MN.","first_author":"Gola M","journal":"Archives of sexual behavior","year":2018,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5954073","cited_by_count":24,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1167-x"}},{"id":7109,"doi":"10.1016/j.psychres.2019.01.036","pmid":"30658211","pmcid":"PMC6420059","title":"Body dysmorphic disorder and its relationship to sexuality, impulsivity, and addiction","authors":"Grant JE, Lust K, Chamberlain SR.","first_author":"Grant JE","journal":"Psychiatry research","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Evaluation Study","Journal Article"],"keywords":["Addiction","Impulsivity","Compulsivity","Body Dysmorphia"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large online survey of 3,459 university students; cross‑sectional prevalence and correlates of probable BDD.","sample_n":3459,"sample_text":"3,459 participants (59.1% female) completed the survey.","population":"University students (young adults, mixed gender)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 3,000 university students, 1.7% screened positive for body dysmorphic disorder. Those with BDD were more likely to report compulsive sexual behavior and higher impulsivity, compulsivity, depression, anxiety, and PTSD.","clinical_takeaway":"Screen for body dysmorphic disorder when patients present with compulsive sexual behavior and related mental‑health issues.","confidence":0.7,"topic_tags":["prevalence","sexual_function","csbd"],"strengths":["Large, randomly sampled university cohort","Validated screening tools for BDD and mental‑health symptoms","Simultaneous assessment of impulsivity, compulsivity, and CSB"],"limitations":["Cross‑sectional; cannot infer causality","Moral incongruence and masturbation not measured","Self‑report data may be subject to bias"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":2,"mentioning":17,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psychres.2019.01.036"}},{"id":7110,"doi":"10.1007/s10508-018-1305-5","pmid":"30229518","pmcid":null,"title":"Incongruence as a Variable Feature of Problematic Sexual Behaviors in an Online Sample of Self-Reported \"Sex Addiction\"","authors":"Walton MT.","first_author":"Walton MT.","journal":"Archives of sexual behavior","year":2019,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":2,"contrasting":0,"mentioning":12,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1305-5"}},{"id":7111,"doi":null,"pmid":"12921375","pmcid":null,"title":"Assessment and treatment of compulsive sexual behavior","authors":"Coleman E, Raymond N, McBean A.","first_author":"Coleman E","journal":"Minnesota medicine","year":2003,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Review article describing CSB symptoms, epidemiology, etiology, screening and treatment; no primary data.","sample_n":null,"sample_text":"Not applicable – review without original participants","population":"Adults with compulsive sexual behavior (clinical description only)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews compulsive sexual behavior, describing its symptoms, possible causes, associated mental‑health problems, and suggested ways clinicians can screen and treat it.","clinical_takeaway":"Clinicians can use the outlined screening questions to identify CSB and consider referral to specialists for treatment.","confidence":0.7,"topic_tags":["csbd","sexual_function","treatment"],"strengths":["Comprehensive overview of CSB symptoms and comorbidities","Provides practical screening questions for clinicians"],"limitations":["No original empirical data; relies on secondary sources","Lacks systematic risk‑of‑bias assessment","Potentially outdated (2003) and may not reflect current ICD‑11 criteria"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":7112,"doi":"10.1007/s10508-018-1326-0","pmid":"30805830","pmcid":null,"title":"A Randomized Pilot Study of a Group-Delivered HIV Risk Reduction Intervention for At-Risk Urban Men Who Have Sex with Men Who Regularly Attend Private Sex Events","authors":"Mimiaga MJ, Hughto JMW, Reisner SL.","first_author":"Mimiaga MJ","journal":"Archives of sexual behavior","year":2019,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":["HIV","MSM","Sexual Orientation","Sexual Risk Behavior","Gay Venues","Private Sex Events"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"pilot randomized controlled trial with 14 participants (8 intervention, 6 control), 3‑month follow‑up","sample_n":14,"sample_text":"N = 14; intervention n = 8, control n = 6","population":"urban men who have sex with men who attend private sex events","country":"United States (presumed from authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small pilot RCT tested a group‑based HIV risk‑reduction program for urban MSM who meet partners at private sex events. Participants in the four‑session intervention reported fewer condomless anal sex acts and lower sexual compulsivity after three months, suggesting the program is feasible and acceptable.","clinical_takeaway":"Group‑based risk‑reduction counseling may help MSM attending private sex events lower HIV risk, but larger trials are needed.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Randomized allocation","Targeted high‑risk MSM subgroup","Feasibility and acceptability outcomes collected"],"limitations":["Very small sample size, limiting statistical power","No detailed reporting of validated scales","Potential self‑selection bias"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":3,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1326-0"}},{"id":7113,"doi":"10.3390/jdb9030026","pmid":"34287347","pmcid":"PMC8293205","title":"<i>Drosophila</i> Corazonin Neurons as a Hub for Regulating Growth, Stress Responses, Ethanol-Related Behaviors, Copulation Persistence and Sexually Dimorphic Reward Pathways","authors":"Khan Z, Tondravi M, Oliver R, Vonhoff FJ.","first_author":"Khan Z","journal":"Journal of developmental biology","year":2021,"pub_types":["review-article","Review","Journal Article"],"keywords":["Growth","Dimorphism","Neuropeptide","Addiction","alcoholism","Eating Disorder","Insect Disease Model"],"is_oa":true,"oa_url":"https://www.mdpi.com/2221-3759/9/3/26/pdf?version=1625565447","cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review-article","sample_n":null,"sample_text":"N/A – narrative review of pre‑clinical studies","population":"Drosophila melanogaster (fruit fly) model","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises research on fruit‑fly neurons that release the peptide Corazonin, showing how they influence growth, stress, alcohol‑related behaviour and sexual reward. The authors suggest these flies could model aspects of sex‑related addiction, but the work is pre‑clinical.","clinical_takeaway":"None – findings are from insect models and not directly applicable to human sexual health.","confidence":0.8,"topic_tags":["neuroscience","prevalence","treatment"],"strengths":["Comprehensive synthesis of Drosophila neuropeptide literature","Highlights mechanistic links between stress, reward, and ethanol behaviours"],"limitations":["Human relevance to pornography/masturbation is speculative","No original empirical data; no quantitative meta‑analysis","No discussion of moral incongruence or human mental‑health confounds"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":22,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jdb9030026"}},{"id":7115,"doi":"10.1080/00918369.2014.987568","pmid":"25402550","pmcid":null,"title":"Impulsivity as a risk factor for HIV transmission in men who have sex with men: a delay discounting approach","authors":"Jones J, Sullivan PS.","first_author":"Jones J","journal":"Journal of homosexuality","year":2015,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":["MSM","Impulsivity","Delay Discounting","Hiv Risk"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online survey of 1402 MSM; logistic regression of delay discounting predicting >2 UAI partners in past year.","sample_n":1402,"sample_text":"1402 participants completed the survey.","population":"Internet-using men who have sex with men, primarily adult USA (presumed).","country":"Not specified (likely USA based on funding).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1402 internet‑using gay and bisexual men, those who discounted future monetary rewards more steeply (a sign of impulsivity) were 1.5 times more likely to report having more than two unprotected anal sex partners in the past year.","clinical_takeaway":"High impulsivity, as measured by delay discounting, may identify MSM at greater risk for HIV‑related sexual risk behaviours.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for an online survey.","Use of a validated behavioral impulsivity task.","Adjusted odds ratios with confidence intervals reported."],"limitations":["Cross‑sectional design cannot establish causality.","Self‑reported sexual behavior may be biased.","Key confounds (e.g., moral incongruence, mental health) not measured."],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2014.987568"}},{"id":7116,"doi":"10.1111/add.13370","pmid":"27098081","pmcid":null,"title":"Additional challenges and issues in classifying compulsive sexual behavior as an addiction","authors":"Reid RC.","first_author":"Reid RC.","journal":"Addiction (Abingdon, England)","year":2016,"pub_types":["Comment","Journal Article"],"keywords":["Hypersexual Behavior","Compulsive Sexual Behavior","Sexual Addiction","Dsm-5","Sexual Impulsivity","Hypersexual Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/add.13370"}},{"id":7118,"doi":"10.1089/apc.2007.0255","pmid":"18479226","pmcid":null,"title":"Sexual compulsivity among men in a decentralized MSM community of the Midwestern United States","authors":"Satinsky S, Fisher C, Stupiansky N, Dodge B, Alexander A, Herbenick D, Reece M.","first_author":"Satinsky S","journal":"AIDS patient care and STDs","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey (N=504) of MSM in a Midwestern region, using community‑based participatory recruitment.","sample_n":504,"sample_text":"Community‑based participatory sample of 504 MSM recruited through venues where men meet sexual partners.","population":"Men who have sex with men (MSM) from a decentralized community in the Midwestern United States.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 504 men who have sex with men in the Midwest found that those who scored higher on a sexual compulsivity questionnaire tended to visit many ‘sexualized’ venues to meet partners, which may increase HIV/STI risk.","clinical_takeaway":"Clinicians should consider venue‑based patterns when counseling MSM with higher sexual compulsivity about HIV/STI prevention.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample (N>500)","Focus on venue‑type differences","Relevant to HIV/STI risk"],"limitations":["Cross‑sectional; no causal inference","No control for mental‑health or trauma confounds","Unclear if compulsivity scale validated in this population"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":20,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/apc.2007.0255"}},{"id":7119,"doi":"10.1155/2015/970862","pmid":"26664825","pmcid":"PMC4667074","title":"Impact of Impulse Control Disorders on Sleep-Wake Regulation in Parkinson's Disease","authors":"Djamshidian A, Poewe W, Högl B.","first_author":"Djamshidian A","journal":"Parkinson's disease","year":2015,"pub_types":["research-article","Review","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4667074","cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative overview/review without systematic methodology or meta‑analysis; no primary data presented.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Patients with Parkinson’s disease and impulse‑control disorders (including compulsive sexual behaviour).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how impulse‑control problems like compulsive sexual behaviour in Parkinson’s disease are linked to sleep disturbances, summarising possible mechanisms and treatment ideas.","clinical_takeaway":"Clinicians should be aware that impulse‑control disorders in Parkinson’s patients may worsen sleep, but specific guidance requires empirical research.","confidence":0.8,"topic_tags":["csbd","sexual_function","pornography","masturbation","relationships"],"strengths":["Addresses a clinically relevant intersection of impulse control disorders and sleep in PD","Covers multiple behavioural addictions, providing a broad perspective"],"limitations":["Narrative review lacks systematic search and bias assessment","No empirical data; conclusions are not evidence‑based","No measurement of key confounds such as moral incongruence or mental health"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2015/970862"}},{"id":7120,"doi":"10.1177/0145445515613331","pmid":"26584611","pmcid":null,"title":"Acculturative Stress and Risky Sexual Behavior: The Roles of Sexual Compulsivity and Negative Affect","authors":"Jardin C, Garey L, Sharp C, Zvolensky MJ.","first_author":"Jardin C","journal":"Behavior modification","year":2016,"pub_types":["Journal Article"],"keywords":["Minority groups","Acculturative Stress","Negative Affect","Sexual Compulsivity","Sexual Risk Taking"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional mediation analysis of 758 minority college students","sample_n":758,"sample_text":"758 sexually initiated racial/ethnic minority college students","population":"racial/ethnic minority college students (both sexes)","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among college students from minority backgrounds, stress about adapting to a new culture was linked to more risky sexual behavior, and this link was explained by higher sexual compulsivity. Reducing compulsive sexual thoughts or actions might help lower HIV‑risk in this group.","clinical_takeaway":"Interventions that lower sexual compulsivity could mitigate risky sex in stressed minority students.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a single‑site study","Use of established self‑report scales","Sex‑specific analyses"],"limitations":["Cross‑sectional design limits causal inference","No control for moral or partner variables","Self‑report may be biased"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":11,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0145445515613331"}},{"id":7123,"doi":"10.1556/2006.5.2016.071","pmid":"27774812","pmcid":"PMC5370367","title":"Characteristics of self-identified sexual addicts in a behavioral addiction outpatient clinic","authors":"Wéry A, Vogelaere K, Challet-Bouju G, Poudat FX, Caillon J, Lever D, Billieux J, Grall-Bronnec M.","first_author":"Wéry A","journal":"Journal of behavioral addictions","year":2016,"pub_types":["review-article","Journal Article"],"keywords":["Comorbidities","Sexual Addiction","Hypersexuality","Excessive Sexual Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5370367","cited_by_count":55,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Descriptive cohort of 72 treatment‑seeking outpatients; convenience sample; no comparison group.","sample_n":72,"sample_text":"72 patients from a behavioral‑addiction outpatient clinic.","population":"Adults (20‑76 y) seeking outpatient treatment for self‑identified sexual addiction (94 % male).","country":"Belgium (inferred from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study describes 72 people who consider themselves sexual addicts and who sought help at a clinic. Most were men in their 40s; many reported risky sexual behavior, comorbid psychiatric disorders, and paraphilias. The authors note the wide variety of profiles and call for tailored therapy.","clinical_takeaway":"Clients presenting with self‑identified sexual addiction show diverse behaviors and high psychiatric comorbidity; treatment should be individualized.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large proportion of male participants (reflects typical clinic demographics)","Provides detailed sociodemographic and comorbidity profile","Uses both interview and self‑report data"],"limitations":["Convenience, treatment‑seeking sample limits generalisability","Unclear whether validated instruments were used for addiction criteria","No control for moral incongruence, masturbation, or other key confounds","Descriptive only; no inferential statistics or effect‑size reporting"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":5,"contrasting":0,"mentioning":59,"citing_publications":100,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.5.2016.071"}},{"id":7124,"doi":"10.1136/bmjopen-2024-090870","pmid":"40216419","pmcid":"PMC11987135","title":"Impact of hypersexuality on spousal carers of patients with Parkinson's disease and frontotemporal dementia: a qualitative study","authors":"Tayim N, Panicker J, Foley J, Selai C, El Sheikh WG.","first_author":"Tayim N","journal":"BMJ open","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Dementia","Caregivers","Parkinson-s Disease"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11987135","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross‑sectional qualitative interview study with 8 spousal carers recruited from UK clinics and support organisations","sample_n":8,"sample_text":"Eight spousal carers (five caring for patients with PD, three for patients with dementia)","population":"spousal carers of patients with Parkinson’s disease or frontotemporal dementia who exhibit hypersexuality","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with eight spouses of people with Parkinson’s disease or dementia showed that their partners' hypersexual behaviour caused emotional strain, relationship problems, and mental‑health challenges for the carers.","clinical_takeaway":"Clinicians should screen for hypersexuality in neurodegenerative patients and offer support to affected spouses.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["In‑depth first‑person accounts","Focus on an under‑researched impact area","Multiple themes identified","Clinical relevance for carers"],"limitations":["Very small, non‑representative sample","No validated measures of hypersexuality","No comparison group","Findings not generalisable"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjopen-2024-090870"}},{"id":7125,"doi":"10.1111/1556-4029.70045","pmid":"40207686","pmcid":null,"title":"Exploring female sexual offending with the concepts of hypersexuality and atypical psychotic disorder","authors":"Doğan M, Boylu ME, Taşdemir İ, Saygılı S.","first_author":"Doğan M","journal":"Journal of forensic sciences","year":2025,"pub_types":["Journal Article","Case Reports"],"keywords":["Child Abuse","Borderline Personality Disorder","Criminal Responsibility","Forensic Psychiatry","Sexual Offense","Female Sexual Offender"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case report of one female offender, no comparison group, no systematic sampling","sample_n":1,"sample_text":"single individual; not representative of broader population of offenders","population":"46‑year‑old woman charged with sexual offenses against underage males; psychiatric evaluation in forensic unit","country":"Turkey (inferred from author names, not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 46‑year‑old woman who sexually assaulted four under‑age boys was diagnosed with an atypical psychosis; the authors discuss hypersexuality and borderline personality as possible contributors, but the report is limited to one case.","clinical_takeaway":"Single‑case evidence cannot guide clinical practice; broader research is needed before drawing treatment or risk‑management conclusions.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides rare clinical description of female sexual offending","Details psychiatric evaluation and diagnostic reasoning"],"limitations":["Single case; no control or comparison group","Hypersexuality not operationalised or measured with validated tools","No systematic assessment of confounding factors (e.g., trauma, mental health)","Conclusions about prevalence and prevention are speculative"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1556-4029.70045"}},{"id":7126,"doi":"10.1017/s1092852918001591","pmid":"30982481","pmcid":null,"title":"Links between sexuality, impulsivity, compulsivity, and addiction in a large sample of university students","authors":"Blum AW, Lust K, Christenson G, Grant JE.","first_author":"Blum AW","journal":"CNS spectrums","year":2020,"pub_types":["Journal Article"],"keywords":["Sexuality","Mental health","Addiction","university","Impulsivity"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Anonymous 156‑item online survey of 9,449 university students; sexual orientation via Klein Sexual Orientation Grid; trait impulsivity/compulsivity scales; self‑report of compulsive sexual behavior.","sample_n":null,"sample_text":"94,49 students invited; response count not given in abstract","population":"University students (U.S. public university)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of U.S. university students found that those attracted to the same sex reported higher levels of mental‑health problems, substance use, and self‑identified compulsive sexual behavior, as well as higher impulsivity and compulsivity traits.","clinical_takeaway":"Clinicians should be aware that same‑sex attracted students may report more compulsive sexual behaviors, but these findings are correlational and do not prove a causal link.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large university‑wide sample","Use of validated sexual orientation measure","Inclusion of multiple impulsivity/compulsivity traits"],"limitations":["Cross‑sectional, no causal inference","No measurement or control of moral incongruence or masturbation","Unclear whether compulsive sexual behavior scale meets clinical criteria"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":12,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852918001591"}},{"id":7127,"doi":"10.1037/hea0000617","pmid":"29927272","pmcid":"PMC6107409","title":"Condom-use self-efficacy as a mediator between syndemics and condomless sex in men who have sex with men (MSM)","authors":"Safren SA, Blashill AJ, Lee JS, O'Cleirigh C, Tomassili J, Biello KB, Mimiaga MJ, Mayer KH.","first_author":"Safren SA","journal":"Health psychology : official journal of the Division of Health Psychology, American Psychological Association","year":2018,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.1037/hea0000617","cited_by_count":27,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective longitudinal cohort with three assessment points (baseline, 3 months, 6 months) in 197 high‑risk MSM; latent growth curve mediation analysis","sample_n":197,"sample_text":"N = 197 high‑risk MSM","population":"men who have sex with men (MSM), high‑risk for HIV, n≈197, United States (presumed)","country":"Not specified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 197 high‑risk gay men, having multiple psychosocial problems lowered confidence in using condoms, which in turn was linked to more condom‑less anal sex over six months.","clinical_takeaway":"Boosting condom‑use self‑efficacy may help mitigate risk among MSM facing multiple psychosocial stressors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Longitudinal design with three waves","Theory‑driven mediation model","Inclusion of multiple psychosocial syndemic factors"],"limitations":["Unclear whether self‑efficacy scale is validated","No pre‑registration or power analysis reported","Moral or cultural factors not examined"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":6,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":15,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/hea0000617"}},{"id":7128,"doi":"10.1080/00224499.2018.1461796","pmid":"29702013","pmcid":null,"title":"God, I Can't Stop Thinking About Sex! The Rebound Effect in Unsuccessful Suppression of Sexual Thoughts Among Religious Adolescents","authors":"Efrati Y.","first_author":"Efrati Y.","journal":"Journal of sex research","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["bibliography","csbd","pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Three separate cross‑sectional surveys of Israeli Jewish religious and secular adolescents (N=661, 522, 317) using self‑report questionnaires on religiosity, thought suppression, compulsive sexual behaviour (CSB) and well‑being.","sample_n":1500,"sample_text":"Convenience samples of school‑based adolescents; not nationally representative.","population":"Adolescents (religious & secular) in Israel","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among Israeli adolescents, those who are more religious report higher levels of compulsive sexual behaviour. The study suggests that trying not to think about sex (thought suppression) may increase these behaviours and reduce overall wellbeing.","clinical_takeaway":"Clinicians should consider how religious context and thought‑suppression strategies might influence adolescents' sexual distress, but cannot assume a causal link from this data.","confidence":0.8,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Large sample sizes across three studies","Inclusion of both religious and secular groups","Use of mediation models to explore pathways"],"limitations":["Cross‑sectional design limits causal inference","No measurement of masturbation or moral incongruence","Reliance on self‑report scales without clinical validation"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":35,"citing_publications":69,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1461796"}},{"id":7129,"doi":"10.1371/journal.pone.0111583","pmid":"25347679","pmcid":"PMC4210250","title":"Altered functional response to risky choice in HIV infection","authors":"Connolly CG, Bischoff-Grethe A, Jordan SJ, Woods SP, Ellis RJ, Paulus MP, Grant I, Translational Methamphetamine AIDS Research Center (TMARC) Group.","first_author":"Connolly CG","journal":"PloS one","year":2014,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://escholarship.org/uc/item/9nz681qv","cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case-control fMRI study of risky decision‑making in 21 HIV+ and 19 HIV‑ adults","sample_n":40,"sample_text":"21 HIV+ and 19 HIV- participants","population":"adult HIV seropositive and seronegative participants (mixed gender)","country":"USA (assumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared brain activity during risky choices in people with HIV and those without. While task performance was similar, HIV‑positive participants showed greater activation in reward‑related brain areas. Higher past immune suppression was linked to more abnormal activation patterns.","clinical_takeaway":"No direct clinical guidance; the findings suggest HIV may affect brain response to risk, but relevance to sexual health is limited.","confidence":0.7,"topic_tags":["neuroscience","relationships","sexual_function"],"strengths":["use of fMRI to examine neural response","matched HIV‑ seronegative control group","exploratory analysis linking CD4 nadir and sexual compulsivity"],"limitations":["small sample size for neuroimaging","no correction for multiple psychological confounds","cross‑sectional design limits causal inference","sexual compulsivity not fully operationalized against addiction criteria"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":4,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":24,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0111583"}},{"id":7130,"doi":"10.1007/s10508-014-0261-y","pmid":"24558123","pmcid":"PMC4011938","title":"The role of maladaptive cognitions in hypersexuality among highly sexually active gay and bisexual men","authors":"Pachankis JE, Rendina HJ, Ventuneac A, Grov C, Parsons JT.","first_author":"Pachankis JE","journal":"Archives of sexual behavior","year":2014,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 202 highly sexually active gay/bisexual men; factor analysis, SEM, logistic regression","sample_n":202,"sample_text":"202 highly sexually active gay and bisexual men","population":"highly sexually active gay and bisexual men (convenience sample)","country":"USA (presumed based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study created a new questionnaire about negative thoughts on sex and showed that men who see sex as a huge need and see fewer benefits have less confidence controlling sexual behavior, which relates to higher self‑reported hypersexuality.","clinical_takeaway":"Addressing maladaptive sexual cognitions may help reduce problematic hypersexuality in highly sexually active gay/bisexual men.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Validated maladaptive cognition scale (factor analysis)","Uses structural equation modelling","Controls for depression and anxiety"],"limitations":["Convenience sample of highly sexually active men limits generalisability","No assessment of moral incongruence or masturbation","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":7,"contrasting":0,"mentioning":58,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0261-y"}},{"id":7131,"doi":"10.1016/j.jsxm.2016.12.235","pmid":"28117268","pmcid":null,"title":"Executive Functioning of Sexually Compulsive and Non-Sexually Compulsive Men Before and After Watching an Erotic Video","authors":"Messina B, Fuentes D, Tavares H, Abdo CH, Scanavino MT.","first_author":"Messina B","journal":"The journal of sexual medicine","year":2017,"pub_types":["Comparative Study","Journal Article"],"keywords":["Sexual behavior","Decision Making","Executive Function","Impulse Control Disorders"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Comparative laboratory study with pre‑post exposure to erotic video; 30 sexually compulsive men vs 30 controls; neuropsychological tests (WCST, IGT).","sample_n":60,"sample_text":"30 sexually compulsive men and 30 controls","population":"Adult men, sexually compulsive (self‑identified) and non‑compulsive controls; convenience sample.","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared decision‑making and flexibility in men who consider themselves sexually compulsive versus non‑compulsive men, before and after watching an erotic video. Controls improved on the tests after viewing, while compulsive participants did not.","clinical_takeaway":"No clear evidence that erotic videos differentially affect executive function in compulsive users; more rigorous research needed.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Laboratory-controlled exposure to erotic stimulus","Use of validated neuropsychological tasks (WCST, IGT)"],"limitations":["Unclear definition and measurement of ‘sexually compulsive’ status","Small convenience sample, likely under‑powered","No control for key confounds (moral incongruence, masturbation, mental health, etc.)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2016.12.235"}},{"id":7132,"doi":"10.7860/jcdr/2015/10937.5531","pmid":"25859505","pmcid":"PMC4378787","title":"Internet sex addiction and its negative consequences: a report","authors":"Kaur J, Bhatia MS, Gautam P.","first_author":"Kaur J","journal":"Journal of clinical and diagnostic research : JCDR","year":2015,"pub_types":["letter","Journal Article"],"keywords":["Internet Addiction","Cyber Sex"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7860/jcdr/2015/10937.5531"}},{"id":7135,"doi":"10.1080/0092623x.2016.1210373","pmid":"27487049","pmcid":null,"title":"Treating Out of Control Sexual Behavior: Rethinking Sex Addiction","authors":"Lam A, Berry MD.","first_author":"Lam A","journal":"Journal of sex & marital therapy","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2016.1210373"}},{"id":7136,"doi":"10.1007/s10461-006-9127-1","pmid":"16755406","pmcid":null,"title":"Sexual compulsivity in a sample of HIV-positive methamphetamine-using gay and bisexual men","authors":"Semple SJ, Zians J, Grant I, Patterson TL.","first_author":"Semple SJ","journal":"AIDS and behavior","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":52,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"exploratory cross‑sectional survey of 217 HIV‑positive meth‑using gay/bisexual men","sample_n":217,"sample_text":"Convenience sample; not nationally representative","population":"HIV‑positive meth‑using GBM (convenience sample)","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 217 HIV‑positive gay and bisexual men who use meth, higher scores on a sexual compulsivity questionnaire were linked to more unprotected sex, older age, using meth during sex, and lower self‑esteem. The study suggests sexual compulsivity may hinder safer‑sex efforts in this group.","clinical_takeaway":"Assess sexual compulsivity when counseling meth‑using GBM; it may signal higher sexual‑risk behaviours.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses a validated Sexual Compulsivity Scale","Relatively large sample for this hard‑to‑reach population","Multivariate analysis of several risk correlates"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral incongruence or masturbation","Convenience sample limits generalisability","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":1,"mentioning":62,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-006-9127-1"}},{"id":7137,"doi":"10.2196/65632","pmid":"40053804","pmcid":"PMC11926447","title":"Using Natural Language Processing Methods to Build the Hypersexuality in Bipolar Reddit Corpus: Infodemiology Study of Reddit","authors":"Harvey D, Rayson P, Lobban F, Palmier-Claus J, Dolman C, Chataigné A, Jones S.","first_author":"Harvey D","journal":"JMIR infodemiology","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Bipolar","Natural Language Processing","Hypersexuality","Computational Linguistics","Liwc","Topic Modeling","Linguistic Inquiry And Word Count","Bertopic"],"is_oa":true,"oa_url":"https://doi.org/10.2196/65632","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational infodemiology corpus analysis of Reddit posts; convenience sample of self‑identified bipolar users","sample_n":816,"sample_text":"816 Redditors contributed posts classified as hypersexuality‑related","population":"Reddit users who self‑report a bipolar diagnosis (N≈5,177; hypersexuality subgroup N≈816)","country":"Not specified (global Reddit sample)","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors used computer‑based language analysis to build a Reddit data set of posts about hypersexuality made by people who say they have bipolar disorder. They found a rapid rise in such posts and identified characteristic language patterns, suggesting that hypersexuality is a salient concern for this online community.","clinical_takeaway":"Clinicians should be aware that people with bipolar disorder may discuss hypersexuality online, but this study does not provide validated measures of the symptom for diagnosis or treatment.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large-scale real‑world data set","Novel NLP methodology for detecting hypersexuality discourse","Transparent reporting of corpus size and trends"],"limitations":["Construct of hypersexuality inferred from language, not validated clinical measures","No measurement of key confounds (moral incongruence, masturbation, mental health)","Reddit sample not representative of broader bipolar population"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/65632"}},{"id":7138,"doi":"10.2147/ndt.s292490","pmid":"34321880","pmcid":"PMC8312511","title":"A Case-Control Study on Behavioral Addictions and Neurocognition: Description of the BANCO and BANCO2 Protocols","authors":"Hurel E, Grall-Bronnec M, Thiabaud E, Saillard A, Hardouin JB, Challet-Bouju G.","first_author":"Hurel E","journal":"Neuropsychiatric disease and treatment","year":2021,"pub_types":["brief-report","Journal Article"],"keywords":["neuropsychology","Neurocognition","Food Addiction","Sexual Addiction","Behavioral Addiction","Gambling Disorder","Gaming Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8312511","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control protocol with planned samples of 30 per group (BA patients vs matched healthy controls), neurocognitive testing, cue‑reactivity and physiological measures; no results reported","sample_n":30,"sample_text":"planned 30 participants per BA group and 30 matched controls","population":"adults with gambling disorder, gaming disorder, sexual addiction, food addiction; matched healthy controls","country":"unspecified (likely France based on author affiliations)","controls_mi":"not_applicable","preregistered":true,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors outline a planned case‑control study comparing neurocognitive performance of people with gambling, gaming, sexual and food addictions to matched healthy controls using cognitive tasks and physiological measures.","clinical_takeaway":"No direct clinical implications yet; the study aims to clarify whether sexual addiction shows distinct neurocognitive deficits.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Pre‑registered protocol with clear sample sizes","Matched control groups","Comprehensive set of behavioral and physiological measures"],"limitations":["No detail on validated addiction scales","No assessment of key confounds (moral incongruence, mental health)","Small planned sample may limit detection of subtle cognitive differences"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/ndt.s292490"}},{"id":7139,"doi":"10.7759/cureus.348","pmid":"26623203","pmcid":"PMC4627834","title":"Hypersexuality Addiction and Withdrawal: Phenomenology, Neurogenetics and Epigenetics","authors":"Blum K, Badgaiyan RD, Gold MS.","first_author":"Blum K","journal":"Cureus","year":2015,"pub_types":["review-article","Review","Corrected and Republished Article","Journal Article"],"keywords":["Epigenetics","Neurogenetics","Compulsivity","Reward Deficiency Syndrome","Hypersexuality Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4627834","cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"review-article","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale","causal_from_correlational"],"stance":"supports","citation_value":"background","plain_summary":"The article reviews how hypersexual behavior might share brain‑reward mechanisms with addictions, proposing genetic and epigenetic links, but offers no new data and relies on untested assumptions.","clinical_takeaway":"No actionable clinical guidance; the piece is speculative and should not guide treatment decisions.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["Broad synthesis of existing literature","Highlights interdisciplinary perspectives (genetics, neurobiology)"],"limitations":["No original data; speculative hypotheses dominate","Lacks systematic methodology and quality appraisal","Fails to control for moral incongruence or related confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":60,"pct_score":15,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":2,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.348"}},{"id":7140,"doi":"10.1101/2024.02.19.581062","pmid":null,"pmcid":null,"title":"Inhibition of Indirect Pathway Activity Causes Abnormal Decision-Making In a Mouse Model of Impulse Control Disorder in Parkinson’s Disease","authors":"Zhuang X, Lemak J, Sridhar S, Nelson AB.","first_author":"Zhuang X","journal":"bioRxiv","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Preclinical mouse study using chemogenetics and a delay‑discounting task to model impulse‑control disorder‑like behavior.","sample_n":null,"sample_text":"Not reported in abstract","population":"Mice (parkinsonian model, n not reported)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a mouse model of Parkinson's disease, inhibiting a specific brain pathway made the animals choose immediate rewards over delayed ones, mimicking impulse‑control problems such as gambling or hypersexuality seen in patients.","clinical_takeaway":"Animal findings suggest striatal indirect pathway dysfunction may underlie impulse‑control disorders, but human relevance remains unproven.","confidence":0.7,"topic_tags":["prevalence","neuroscience","treatment"],"strengths":["Innovative chemogenetic manipulation of indirect pathway neurons","Clear link to impulse‑control disorder phenotypes in a PD model","Combination of behavioral and electrophysiological data"],"limitations":["Human‑relevant constructs (e.g., hypersexuality) not directly measured","Sample size and statistical power not reported","Findings from mice may not translate to human ICD"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2024.02.19.581062"}},{"id":7141,"doi":"10.1192/bjp.2020.69","pmid":"32338230","pmcid":"PMC7525108","title":"Gang membership and sexual violence: associations with childhood maltreatment and psychiatric morbidity","authors":"Coid J, González RA, Kallis C, Zhang Y, Liu Y, Wood J, Quigg Z, Ullrich S.","first_author":"Coid J","journal":"The British journal of psychiatry : the journal of mental science","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["epidemiology","Psychotic Disorders","Alcohol Disorders","Childhood Experience","Drugs Of Dependence Disorders"],"is_oa":true,"oa_url":"https://www.cambridge.org/core/services/aop-cambridge-core/content/view/83C759A1E8FEB88C4501B7B556766A4F/S0007125020000690a.pdf/div-class-title-gang-membership-and-sexual-violence-associations-with-childhood-maltreatment-and-psychiatric-morbidity-div.pdf","cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross-sectional survey of 4665 men aged 18‑34 using random‑location sampling with oversampling of high‑violence areas.","sample_n":4665,"sample_text":"4665 men","population":"Men aged 18‑34 in Great Britain, including gang members and antisocial non‑gang men.","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A large UK survey found that gang members experience high rates of childhood trauma, psychiatric disorders and risky sexual behaviours, including coercive acts, which are interrelated with other violent and addictive behaviours.","clinical_takeaway":"Clinicians should consider trauma and co‑occurring mental health issues when addressing high‑risk sexual behaviour in gang‑affiliated men.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally based sample","Use of validated psychiatric and trauma instruments","Comprehensive assessment of multiple risk behaviours"],"limitations":["Cross‑sectional design limits causal inference","Moral or partner factors not examined","Addiction constructs not clearly defined"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/bjp.2020.69"}},{"id":7142,"doi":"10.3390/medicina55100705","pmid":"31635190","pmcid":"PMC6843497","title":"A Case of Paraphilia with Osteoporosis and Administered with Depot Leuprorelin","authors":"Kim D, Kim KM, Lim MH.","first_author":"Kim D","journal":"Medicina (Kaunas, Lithuania)","year":2019,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Osteoporosis","Hyperthyroidism","Paraphilia","Leuprorelin"],"is_oa":true,"oa_url":"https://www.mdpi.com/1648-9144/55/10/705/pdf?version=1616052904","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-patient case report of a 59‑year‑old man with frotteuristic paraphilia treated with monthly leuprorelin; outcomes assessed with CGI, SAST, WSFQ, labs over 12 months.","sample_n":1,"sample_text":"single case","population":"1 male, age 59, with paraphilia, osteoporosis, hyperthyroidism","country":"South Korea (presumed from author names; not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"avoid","plain_summary":"A 59‑year‑old man with a history of unwanted sexual behavior was treated with monthly leuprorelin injections. After a year, his reported sexual urges and behaviors improved without worsening his osteoporosis or thyroid condition.","clinical_takeaway":"Leuprorelin may reduce problematic sexual urges in paraphilic disorders, but evidence is limited to a single case.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Detailed clinical follow‑up over 12 months","Multiple standardized questionnaires used","Reports both psychiatric and metabolic outcomes"],"limitations":["N = 1; no control condition","No assessment of key confounders (moral incongruence, masturbation, mental health)","Reliance on self‑report scales that mix behavior and distress"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/medicina55100705"}},{"id":7143,"doi":"10.1111/add.13315","pmid":"26936832","pmcid":null,"title":"Compulsive sexual behaviour as a behavioural addiction: the impact of the internet and other issues","authors":"Griffiths MD.","first_author":"Griffiths MD.","journal":"Addiction (Abingdon, England)","year":2016,"pub_types":["Comment","Journal Article"],"keywords":["Behavioural Addiction","Compulsive Sexual Behaviour","Sex Addiction","Online Sexual Behaviour","Excessive Sex"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/add.13315"}},{"id":7144,"doi":"10.1186/s12889-019-7346-4","pmid":"31399071","pmcid":"PMC6688287","title":"Project ESTEEM protocol: a randomized controlled trial of an LGBTQ-affirmative treatment for young adult sexual minority men's mental and sexual health","authors":"Pachankis JE, McConocha EM, Reynolds JS, Winston R, Adeyinka O, Harkness A, Burton CL, Behari K, Sullivan TJ, Eldahan AI, Esserman DA, Hatzenbuehler ML, Safren SA.","first_author":"Pachankis JE","journal":"BMC public health","year":2019,"pub_types":["Clinical Trial Protocol","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6688287","cited_by_count":44,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"three‑arm randomized controlled trial (ESTEEM vs community mental health treatment vs HIV counseling/testing); primary outcome condomless anal sex; secondary outcomes depression, anxiety, substance use, sexual compulsivity, PrEP uptake; 8‑month follow‑up; registered trial (NCT02929069).","sample_n":null,"sample_text":"Not reported in abstract (protocol).","population":"young gay and bisexual men (young adult sexual minority men) in the United States","country":"United States","controls_mi":"not_applicable","preregistered":true,"quality_score":8,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The ESTEEM study will test a 10‑session, LGBTQ‑affirmative skill‑building program against standard mental‑health care and HIV counseling to see if it can lower risky sex, depression, anxiety, substance use, and sexual compulsivity in young gay and bisexual men.","clinical_takeaway":"If effective, a single intervention could improve mental, sexual, and substance‑use health for young sexual‑minority men.","confidence":0.85,"topic_tags":["sexual_function","lgbtq"],"strengths":["Pre‑registered multi‑arm RCT design","Focus on minority‑stress mechanisms across multiple health outcomes","Clear primary and secondary outcomes","National Institute of Mental Health funded"],"limitations":["Protocol does not report sample size or power calculations in abstract","Unclear whether sexual‑compulsivity measures separate behavior from distress","No information on whether moral or relational confounds are measured"],"rubric_version":"2.0","raw_total":41,"max_possible":50,"pct_score":82,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":9,"confounds":6,"design":9,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":1,"contrasting":0,"mentioning":64,"citing_publications":107,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-019-7346-4"}},{"id":7145,"doi":"10.1037/a0030648","pmid":"23339646","pmcid":null,"title":"Sexual compulsivity and interpersonal functioning: sexual relationship quality and sexual health in gay relationships","authors":"Starks TJ, Grov C, Parsons JT.","first_author":"Starks TJ","journal":"Health psychology : official journal of the Division of Health Psychology, American Psychological Association","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 172 gay male couples (344 individuals) recruited via street‑intercept at gay‑community events","sample_n":344,"sample_text":"172 couples (344 individuals) recruited at gay‑community events","population":"gay men in primary relationships, mostly community‑based sample","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 172 gay male couples, higher sexual compulsivity was linked to lower sexual satisfaction, poorer communication, and more unprotected sex with casual partners, but not to how often they had sex with their main partner.","clinical_takeaway":"Clients reporting high sexual compulsivity may benefit from couples‑based interventions to improve communication and reduce HIV risk.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Validated scales for sexual compulsivity and relational outcomes","Dyadic data; both partners surveyed","Relatively large sample for a community‑based study","Focus on HIV‑relevant sexual risk behaviors"],"limitations":["Cross‑sectional; cannot infer causality","Convenience recruitment may limit generalisability","No measurement of key confounds (moral incongruence, mental health, trauma)","No effect‑size confidence intervals reported"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/a0030648"}},{"id":7146,"doi":"10.17116/jnevro201811861115","pmid":"30040812","pmcid":null,"title":"[The treatment of non-chemical addictions]","authors":"Egorov AY.","first_author":"Egorov AY.","journal":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","year":2018,"pub_types":["Journal Article"],"keywords":["Therapy","Correction","psychotherapy","Psychopharmacotherapy","Non-chemical (Behavioral) Addictions"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"rus","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"No primary data; narrative discussion of treatment approaches.","sample_n":null,"sample_text":"Not applicable (review/commentary)","population":"Not applicable","country":"Russia (journal language suggests)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The article reviews psychological and pharmacological treatments for behavioral addictions such as gambling, love, sexual, and internet addictions, emphasizing cautious therapy to avoid worsening dependence.","clinical_takeaway":"Clinicians should use a careful, individualized approach when treating non‑chemical addictions, considering both psychotherapy and medication.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad overview of therapeutic options","Highlights need for clinician competence"],"limitations":["No empirical data presented","Lacks systematic review methodology","No assessment of construct validity or outcomes"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.17116/jnevro201811861115"}},{"id":7147,"doi":"10.1016/j.esxm.2020.10.008","pmid":"33429240","pmcid":"PMC7930860","title":"Sexual Disorders and Quality of Life in Parkinson's Disease","authors":"Santa Rosa Malcher CM, Roberto da Silva Gonçalves Oliveira K, Fernandes Caldato MC, Lopes Dos Santos Lobato B, da Silva Pedroso J, de Tubino Scanavino M.","first_author":"Santa Rosa Malcher CM","journal":"Sexual medicine","year":2021,"pub_types":["review-article","Review","Journal Article"],"keywords":["Quality of life","Parkinson's Disease","Sexual Disorders","Compulsive Sexual Behavior","Hypersexuality"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7930860","cited_by_count":24,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative literature review without systematic methodology; no empirical data reported.","sample_n":null,"sample_text":"Not applicable – review article","population":"patients with Parkinson's disease (unspecified); no primary sample","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how sexual problems, including compulsive sexual behavior and reduced libido, affect people with Parkinson’s disease and their quality of life, noting that many are linked to dopamine‑lowering medication.","clinical_takeaway":"Clinicians should screen for sexual issues in Parkinson’s patients, as they can markedly reduce quality of life.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad overview of sexual disorders in PD","Highlights clinical importance for QoL"],"limitations":["Narrative, not systematic, review","No quantitative synthesis or critical appraisal","No assessment of confounding factors"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2020.10.008"}},{"id":7150,"doi":"10.1080/00918369.2014.872507","pmid":"24344629","pmcid":"PMC4043853","title":"Immigrant sexual minority Latino men in rural North Carolina: an exploration of social context, social behaviors, and sexual outcomes","authors":"Gilbert PA, Rhodes SD.","first_author":"Gilbert PA","journal":"Journal of homosexuality","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Rural","Gay","Social Determinants","Hispanic"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 190 immigrant sexual minority Latino men in rural NC, self‑report of condom use, partners, sexual compulsivity; social‑ecological framework; cross‑sectional analysis","sample_n":190,"sample_text":"190 participants recruited from community venues; convenience sample","population":"adult immigrant sexual‑minority Latino men (gay/queer) living in rural North Carolina (N=190)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 190 immigrant Latino gay men living in rural North Carolina examined how social support, discrimination, language use and other factors relate to condom use, number of partners and sexual compulsivity.","clinical_takeaway":"Social context, not just sexual behavior, influences risk and compulsivity; interventions should address discrimination and support networks.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a hidden population","Uses validated sexual compulsivity scale (presumed)","Social‑ecological framework guides comprehensive variable set"],"limitations":["Cross‑sectional, cannot infer causality","Convenience sample limits generalisability","Limited control for key psychological confounds (e.g., mental health, moral factors)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2014.872507"}},{"id":7151,"doi":"10.1097/adm.0b013e318284dac8","pmid":"23412082","pmcid":null,"title":"Internet sex addiction","authors":"Lambert LT.","first_author":"Lambert LT.","journal":"Journal of addiction medicine","year":2013,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/adm.0b013e318284dac8"}},{"id":7153,"doi":"10.1007/s10461-015-1248-y","pmid":"26552658","pmcid":"PMC4831131","title":"Linking Syndemic Stress and Behavioral Indicators of Main Partner HIV Transmission Risk in Gay Male Couples","authors":"Starks TJ, Tuck AN, Millar BM, Parsons JT.","first_author":"Starks TJ","journal":"AIDS and behavior","year":2016,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Communication","Sex Risk","Gay And Bisexual Men","Same-sex Relationships","Syndemics"],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 100 gay male couples (200 individuals), convenience sample, cross‑sectional","sample_n":200,"sample_text":"100 couples recruited via the Internet; not a probability sample","population":"partnered gay men living in the U.S.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 100 gay male couples, higher combined stress from depression, drug use, childhood abuse, partner violence, and sexual compulsivity was linked to lower condom use at first sex and less HIV status disclosure before having condomless anal sex.","clinical_takeaway":"Couples with multiple stressors may need targeted communication skills training to reduce HIV risk.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Uses validated scales for several syndemic factors","Couple‑level analysis captures dyadic processes","Clear hypothesis linking syndemic stress to communication outcomes"],"limitations":["Convenience Internet sample limits generalisability","Cross‑sectional design cannot establish causality","No measurement of moral or religious factors that might affect reporting"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":6,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":27,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-015-1248-y"}},{"id":7154,"doi":"10.1007/978-981-10-5562-1_14","pmid":"29098678","pmcid":null,"title":"Nutrition Support Therapy","authors":"Xiao LJ, Tao R.","first_author":"Xiao LJ","journal":"Advances in experimental medicine and biology","year":2017,"pub_types":["Review","Journal Article"],"keywords":["Nutrition assessment","Nutrition Education","Nutritional Deficiency","Omega 3 Fatty Acids","Dietary Behaviors","Nutrition Intervention","Disorders Of Eating","Metabolic Systems"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of existing literature; no empirical data, no systematic search or risk‑of‑bias assessment","sample_n":null,"sample_text":"none – review article","population":"none (review)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how nutrition support may help people with various addictions, including sex addiction, but it is a non‑systematic narrative without new data.","clinical_takeaway":"No direct clinical guidance; nutrition may be considered as part of broader addiction treatment, but evidence is limited.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad overview of nutrition approaches across several addiction domains","Cites interdisciplinary literature"],"limitations":["No systematic method; potential selection bias","No empirical data; conclusions are speculative","Does not address key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/978-981-10-5562-1_14"}},{"id":7155,"doi":"10.1212/wnl.0000000000003177","pmid":"27590295","pmcid":"PMC5075971","title":"Impulsive-compulsive behaviors in parkin-associated Parkinson disease","authors":"Morgante F, Fasano A, Ginevrino M, Petrucci S, Ricciardi L, Bove F, Criscuolo C, Moccia M, De Rosa A, Sorbera C, Bentivoglio AR, Barone P, De Michele G, Pellecchia MT, Valente EM.","first_author":"Morgante F","journal":"Neurology","year":2016,"pub_types":["research-article","Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":59,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"multicenter case‑control study comparing 22 parkin‑PD patients with 26 mutation‑negative PD patients; matched on age at onset, disease duration, levodopa and DA agonist dose; semistructured interview and QUIP‑RS used to assess impulsive‑compulsive behaviors including compulsive sexual behavior.","sample_n":48,"sample_text":"48 participants (22 parkin‑PD, 26 PD‑NM)","population":"48 Parkinson disease patients (22 parkin mutation carriers, 26 non‑carriers)","country":"unspecified (multicenter, likely Italy)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson patients, those with parkin gene mutations showed a higher frequency and severity of certain impulsive‑compulsive behaviours, including compulsive sexual activity, compared with patients without the mutation.","clinical_takeaway":"Parkin mutation carriers with Parkinson disease may be at greater risk for compulsive sexual behaviour; clinicians should screen for these behaviours.","confidence":0.78,"topic_tags":["csbd","sexual_function"],"strengths":["Use of validated QUIP‑RS scale","Well‑matched control group on key clinical variables","Multicenter recruitment improves generalisability slightly"],"limitations":["Small total sample (N=48) limits statistical power","No assessment of key psychosocial confounds (moral incongruence, masturbation, mental health, trauma)","Cross‑sectional case‑control design cannot establish causality"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":58,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1212/wnl.0000000000003177"}},{"id":7156,"doi":"10.1016/j.jsxm.2020.12.005","pmid":"33640276","pmcid":null,"title":"ICD-11 Paraphilic Disorders: A South African Analysis of Its Utility in the Medico-Legal Context","authors":"Artz L, Swanepoel M, Nagdee M, Combrinck H, Kaliski S, Stein DJ, Butterworth J.","first_author":"Artz L","journal":"The journal of sexual medicine","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["South Africa","Icd","Paraphilic Disorders","Sexual Offences","Mental Health Law And Policy","Psycholegal Management Of Sexual Offenders"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"expert working‑group opinion piece; no empirical data collected","sample_n":null,"sample_text":"None (expert consensus)","population":"South African forensic/legal stakeholders; no participants","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"South African experts reviewed how the new ICD‑11 classification of paraphilic disorders fits with national laws and forensic practice, warning that diagnoses should not be used to excuse criminal behavior.","clinical_takeaway":"Use ICD‑11 paraphilic disorder diagnoses cautiously in forensic settings; they do not automatically affect criminal responsibility.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Interdisciplinary expert group","Focused on forensic‑legal implications in LMIC context"],"limitations":["No empirical data; relies on opinion","No systematic methodology reported","No measurement of constructs or confounders"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.12.005"}},{"id":7159,"doi":"10.1371/journal.pone.0186814","pmid":"29065132","pmcid":"PMC5655432","title":"Correlates of condomless anal sex among men who have sex with men (MSM) in Tijuana, Mexico: The role of public sex venues","authors":"Semple SJ, Pitpitan EV, Goodman-Meza D, Strathdee SA, Chavarin CV, Rangel G, Torres K, Patterson TL.","first_author":"Semple SJ","journal":"PloS one","year":2017,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0186814&type=printable","cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 201 MSM in Tijuana, interviewer‑administered questionnaire, HIV/STD testing, hierarchical regression","sample_n":201,"sample_text":"201 MSM recruited in Tijuana, Mexico","population":"men who have sex with men, 18+, Tijuana, Mexico","country":"Mexico","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 201 Mexican men who have sex with men, those who felt more depressed, more sexually compulsive, and who sought partners in public venues were more likely to have condomless anal sex in the past two months.","clinical_takeaway":"Screen for depression and sexual compulsivity and address public‑venue risk contexts when designing HIV‑prevention programs for MSM.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonably large sample for a LMIC MSM study","Includes biological testing for HIV/STI","Uses validated scales for depression and sexual compulsivity"],"limitations":["Cross‑sectional design limits causal inference","Convenience sample may not represent all MSM in the region","No assessment of moral/religious factors or partner dynamics"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0186814"}},{"id":7160,"doi":"10.5993/ajhb.37.3.13","pmid":"23985187","pmcid":"PMC3981602","title":"Depressive symptoms among immigrant Latino sexual minorities","authors":"Rhodes SD, Martinez O, Song EY, Daniel J, Alonzo J, Eng E, Duck S, Downs M, Bloom FR, Allen AB, Miller C, Reboussin B.","first_author":"Rhodes SD","journal":"American journal of health behavior","year":2013,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Respondent‑driven sampling survey of immigrant Latino sexual minorities; weighted prevalence and multivariable logistic regression.","sample_n":null,"sample_text":"Respondent‑driven sampling (RDS) in North Carolina; size not given in abstract","population":"Immigrant Latino sexual minorities (N not reported in abstract)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among immigrant Latino sexual minorities in the U.S. South, about three‑quarters reported depressive symptoms. Low social support, higher sexual compulsivity, and surprisingly higher self‑esteem were linked to more depression, highlighting a need for culturally appropriate mental‑health services.","clinical_takeaway":"Clinicians should screen for depression and sexual compulsivity in this population and consider culturally tailored support.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large, hard‑to‑reach population accessed via RDS","Use of weighted prevalence estimates","Multivariable analysis identifies independent correlates"],"limitations":["Cross‑sectional design limits causal inference","No assessment of moral or religious factors","Potential recruitment bias; RDS may not reflect broader population"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":45,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5993/ajhb.37.3.13"}},{"id":7161,"doi":"10.7759/cureus.77069","pmid":"39917112","pmcid":"PMC11801813","title":"Paraphilia and Hypersexuality in Bipolar I Disorder and Histrionic Personality Disorder: A Case Report","authors":"Tavares TM, Orsini MA, Magnani MH, Pereira TF, Lima Pessôa B.","first_author":"Tavares TM","journal":"Cureus","year":2025,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Bipolar disorder","Compulsive Sexual Behavior","Histrionic Personality Disorder","Paraphilic Disorders","Hysterical Personality"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11801813","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single patient with bipolar I and histrionic personality disorder presenting hypersexuality and paraphilic behaviors; no control group or systematic sampling","sample_n":1,"sample_text":"single case","population":"33‑year‑old woman with comorbid bipolar I disorder and histrionic personality disorder","country":"Brazil (inferred from author names, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 33‑year‑old woman with bipolar I disorder and histrionic personality disorder showed extreme sexual urges and risky behaviors, including group sex and sharing explicit images. Treatment combined mood stabilizers, antipsychotics, and cognitive‑behavioral therapy to improve impulse control and safety.","clinical_takeaway":"In patients with severe mood or personality disorders, hypersexuality may require combined medication and CBT focused on impulse regulation and safe practices.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed clinical narrative","Integrates pharmacologic and psychotherapeutic management","Highlights need for guidelines in complex comorbid cases"],"limitations":["Single case; no generalizability","No validated measures of hypersexuality or paraphilia","No systematic assessment of confounding factors"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.77069"}},{"id":7162,"doi":"10.1007/s10461-014-0841-9","pmid":"25055765","pmcid":null,"title":"Syndemic factors associated with HIV risk for gay and bisexual men: comparing latent class and latent factor modeling","authors":"Starks TJ, Millar BM, Eggleston JJ, Parsons JT.","first_author":"Starks TJ","journal":"AIDS and behavior","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 669 gay and bisexual men; latent factor and latent class modeling of syndemic indicators; HIV risk outcome.","sample_n":669,"sample_text":"669 gay and bisexual men","population":"gay and bisexual men (community sample)","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 669 gay and bisexual men, researchers found that multiple psychosocial stressors (depression, drug use, childhood abuse, sexual compulsivity, partner violence) together form a single underlying factor that relates to HIV risk, but the pattern of these stressors does not split into distinct groups.","clinical_takeaway":"Addressing co‑occurring mental‑health, substance, and violence issues may reduce HIV risk in gay and bisexual men.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample (N=669)","Use of validated scales for key psychosocial factors","Rigorous latent variable modeling"],"limitations":["Cross‑sectional design limits causal inference","No preregistration or power analysis reported","Moral or religious factors not examined (though not central to aims)"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":34,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-014-0841-9"}},{"id":7163,"doi":"10.1177/00469580251338565","pmid":"40396563","pmcid":"PMC12099156","title":"Navigating Hypersexuality in Bipolar: Insights from a Corpus-Assisted Discourse Analysis of Reddit Posts","authors":"Harvey D, Rayson P, Lobban F, Palmier-Claus J, Dolman C, Jones S.","first_author":"Harvey D","journal":"Inquiry : a journal of medical care organization, provision and financing","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Mental health","Discourse Analysis","Bipolar","Natural Language Processing","Hypersexuality","Computational Linguistics","Corpus Linguistics"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12099156","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Corpus‑assisted discourse analysis of Reddit posts (online forum narratives) identifying thematic categories of hypersexuality experiences in bipolar disorder.","sample_n":null,"sample_text":"Reddit posts (convenience online sample)","population":"Reddit users self‑identifying with bipolar disorder who posted about hypersexuality (no demographic details reported)","country":"Not specified (global Reddit community)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined Reddit posts about hypersexuality in people with bipolar disorder, using computational text analysis to identify 14 themes. They found that users talk about sexual urges, shame, and the link to mood swings, suggesting that clinicians should openly discuss these issues.","clinical_takeaway":"Clinicians should routinely ask about hypersexuality in bipolar patients and address related shame and stigma.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Innovative use of large, naturalistic online data","Provides rich, lived‑experience perspectives","Identifies gaps in clinical attention to hypersexuality"],"limitations":["Non‑representative, self‑selected Reddit sample","No systematic measurement of constructs","Findings cannot be generalized to broader bipolar population"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00469580251338565"}},{"id":7164,"doi":null,"pmid":"10830149","pmcid":null,"title":"Nefazodone and the treatment of nonparaphilic compulsive sexual behavior: a retrospective study","authors":"Coleman E, Gratzer T, Nesvacil L, Raymond NC.","first_author":"Coleman E","journal":"The Journal of clinical psychiatry","year":2000,"pub_types":["Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"retrospective chart review of 14 clinic patients treated with nefazodone for nonparaphilic compulsive sexual behavior","sample_n":14,"sample_text":"Fourteen subjects who met DSM‑IV criteria for sexual disorder NOS and research‑group criteria for nonparaphilic compulsive sexual behavior","population":"adult males (clinic patients)","country":"USA (Minnesota)","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small retrospective review of 14 men treated with nefazodone suggested that about half experienced reduced sexual obsessions and compulsions, with no reported sexual side‑effects, but the study lacks controls and uses non‑validated measures.","clinical_takeaway":"Evidence is insufficient to recommend nefazodone for compulsive sexual behavior; larger, controlled trials are needed.","confidence":0.7,"topic_tags":["treatment","csbd","neuroscience","sexual_function"],"strengths":["focus on a medication with fewer sexual side‑effects","clinical relevance for treatment‑seeking patients"],"limitations":["Very small, retrospective, uncontrolled case series","No validated CSBD measures; reliance on clinician notes","No control for moral, relational, or mental‑health confounds"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":7165,"doi":"10.1007/s10461-014-0770-7","pmid":"24719201","pmcid":"PMC4127100","title":"Tensions between the epidemiology and psychology of HIV risk: implications for pre-exposure prophylaxis","authors":"Golub SA.","first_author":"Golub SA.","journal":"AIDS and behavior","year":2014,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional classification of 257 HIV‑negative MSM and transgender women based on UAI patterns and questionnaires","sample_n":257,"sample_text":"257 participants recruited in New York City","population":"MSM and transgender women in New York City, HIV‑negative, n=257","country":"United States","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 257 HIV‑negative gay and transgender participants in NYC, three relationship‑based groups were identified (Intimates, Trusters, Gamblers). These groups differed in why they might use PrEP, with motivations ranging from pleasure to intimacy to partner pressure.","clinical_takeaway":"PrEP counseling should consider the individual's partnership context and underlying motivations, not just frequency of unprotected sex.","confidence":0.7,"topic_tags":["sexual_function","prevalence"],"strengths":["Large community sample for this niche population","Uses validated impulsivity/sexual‑compulsivity scales","Innovative partner‑based classification scheme"],"limitations":["Cross‑sectional design cannot infer causality","Moral/religious factors not measured despite relevance to risk perception","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":0,"mentioning":33,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-014-0770-7"}},{"id":7166,"doi":"10.1017/s1092852900021921","pmid":"18188149","pmcid":null,"title":"SSRI Reduction of Nonparaphilic Sexual Addiction","authors":"Elmore JL.","first_author":"Elmore JL.","journal":"CNS spectrums","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of two patients","sample_n":2,"sample_text":"two cases","population":"individuals with non‑paraphilic sexual addiction and comorbid depression/psychiatric disorders","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","circular_addiction_scale","self_selected_sample"],"stance":"supports","citation_value":"avoid","plain_summary":"The paper describes two patients labelled as having non‑paraphilic sexual addiction whose symptoms improved after taking antidepressants (SSRIs). The author argues this condition is a real addiction, but uses only clinical impressions and no standard measures.","clinical_takeaway":"Evidence is insufficient to base treatment decisions; SSRIs may help comorbid depression, not necessarily a distinct sexual addiction.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["detailed clinical description of two cases","discussion of neurochemical hypothesis"],"limitations":["No validated measure of sexual addiction","No control of key confounds (moral incongruence, masturbation, mental health)","Case series cannot establish causality"],"rubric_version":"2.0","raw_total":9,"max_possible":60,"pct_score":15,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":2,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852900021921"}},{"id":7167,"doi":"10.1017/s1092852900012669","pmid":"18311100","pmcid":null,"title":"Psychopharmacologic treatments for nonparaphilic compulsive sexual behaviors","authors":"Kafka M.","first_author":"Kafka M.","journal":"CNS spectrums","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of pharmacologic options for non‑paraphilic compulsive sexual behavior; no systematic search, no primary data.","sample_n":null,"sample_text":"N/A (review article)","population":"Not applicable (review)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article summarizes how antidepressants, hormone‑lowering drugs, and other psychotropics have been used to treat people with compulsive sexual behavior, describing possible mechanisms, dosing tips, and side effects.","clinical_takeaway":"Pharmacologic options exist but evidence is limited; clinicians should weigh benefits against side‑effects and monitor closely.","confidence":0.4,"topic_tags":["treatment","sexual_function","neuroscience"],"strengths":["Provides overview of several medication classes.","Includes practical prescribing considerations."],"limitations":["No systematic methodology or risk‑of‑bias assessment.","Lacks empirical data; conclusions based on limited case reports.","No measurement of key constructs or confounders."],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852900012669"}},{"id":7168,"doi":"10.1159/000495842","pmid":"30673673","pmcid":null,"title":"Normative and Clinical Self-Perceptions of Sexuality and Their Links to Psychopathology among Adolescents","authors":"Efrati Y, Dannon P.","first_author":"Efrati Y","journal":"Psychopathology","year":2018,"pub_types":["Journal Article"],"keywords":["Sexuality","Adolescents","Psychopathology","Compulsive Sexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 311 high‑school students, self‑report questionnaires on CSB, psychopathology, temperament, attachment","sample_n":311,"sample_text":"311 high school students (184 males, 127 females)","population":"adolescents (16‑18 y) from a single high‑school, likely convenience sample","country":"unspecified (likely Israel based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 311 high‑school teens, those who scored as having clinical compulsive sexual behavior also showed higher levels of mental‑health problems and were less able to use protective traits like emotional control and secure attachment.","clinical_takeaway":"High CSB scores in teens may flag broader mental‑health concerns, but the findings are correlational.","confidence":0.7,"topic_tags":["adolescents","sexual_function","csbd"],"strengths":["Large adolescent sample for a single school","Includes both males and females","Examines resilience factors alongside CSB"],"limitations":["Cross‑sectional design limits causal inference","Unclear whether CSB measure is validated","No assessment of moral incongruence or masturbation","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":17,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000495842"}},{"id":7169,"doi":"10.1080/09540121.2016.1153587","pmid":"26924809","pmcid":null,"title":"Sexual sensation seeking, sexual compulsivity, and high-risk sexual behaviours among gay/bisexual men in Southwest China","authors":"Xu W, Zheng L, Liu Y, Zheng Y.","first_author":"Xu W","journal":"AIDS care","year":2016,"pub_types":["Journal Article"],"keywords":["Sexual Compulsivity","Gay And Bisexual Men","Unprotected Anal Intercourse","High-risk Sexual Behaviour","Sexual Sensation Seeking"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 436 gay/bisexual men in Southwest China","sample_n":436,"sample_text":"cross‑sectional convenience sample of men who have sex with men","population":"self‑identified gay/bisexual men, mean age 24.5, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among gay and bisexual men in Southwest China, higher sexual sensation seeking and sexual compulsivity were linked to having casual male partners and engaging in unprotected anal sex, even after accounting for age, education, and relationship status.","clinical_takeaway":"Assess sexual sensation seeking and compulsivity when designing HIV‑prevention interventions for MSM.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑site survey","Uses validated SSS and SC scales","Reports multivariate models controlling for several demographics"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral, mental‑health or trauma confounds","Convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540121.2016.1153587"}},{"id":7170,"doi":"10.1101/2022.01.25.22269798","pmid":null,"pmcid":null,"title":"A circuit-based approach to repair hypersexuality in Parkinson’s disease","authors":"Mata-Marín D, Pineda-Pardo JÁ, Michiels M, Pagge C, Ammann C, Martínez-Fernández R, Molina JA, Vela-Desojo L, Alonso-Frech F, Obeso I.","first_author":"Mata-Marín D","journal":"medRxiv","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.medrxiv.org/content/medrxiv/early/2022/01/25/2022.01.25.22269798.full.pdf","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Neuroimaging case‑control (PD hypersexual vs. non‑hypersexual vs. healthy) plus a small sham‑controlled neuromodulation trial (N=20).","sample_n":50,"sample_text":"16 hypersexual PD, 17 non‑hypersexual PD, 17 healthy; 20 hypersexual PD in sham‑controlled stimulation.","population":"Parkinson’s disease patients (medicated) with and without hypersexuality, plus healthy controls.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"supports","citation_value":"useful","plain_summary":"In Parkinson’s patients, those with hypersexuality show weaker brain control when sexual images appear, involving fronto‑striatal circuits. A brief brain‑stimulation session over the pre‑supplementary motor area helped improve this control.","clinical_takeaway":"Targeted neuromodulation may improve impulse control over sexual cues in hypersexual Parkinson’s patients, but evidence is preliminary.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","csbd","neuroscience"],"strengths":["Combination of task‑fMRI, diffusion imaging and neuromodulation","Sham‑controlled stimulation arm","Use of a specific erotic stop‑signal paradigm"],"limitations":["Small sample sizes for between‑group and intervention analyses","Limited control of key psychosocial confounds (moral, masturbation, mental health)","No pre‑registration or open data statement"],"rubric_version":"2.0","raw_total":33,"max_possible":70,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":6,"statistics":5,"confounds":3,"design":5,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2022.01.25.22269798"}},{"id":7171,"doi":"10.1016/j.drugalcdep.2019.107562","pmid":"31563094","pmcid":null,"title":"Negative and positive life events and their relation to substance and behavioral addictions","authors":"Zilberman N, Yadid G, Efrati Y, Rassovsky Y.","first_author":"Zilberman N","journal":"Drug and alcohol dependence","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Stress","Personality","Life event","Addiction","Behavioral Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control comparison of 212 participants with various addictions (including compulsive sexual behaviour) and 79 controls; self‑report questionnaires on negative/positive life events","sample_n":291,"sample_text":"212 participants with an addiction (drugs, alcohol, gambling, sex) and 79 controls","population":"adults with diagnosed substance or behavioral addictions versus non‑addicted controls; recruited from clinical settings (likely treatment‑seeking)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"People with addictions, including compulsive sexual behaviour, report more negative and positive life events than people without addictions, but the pattern differs across types of addiction.","clinical_takeaway":"Life‑event histories differ by addiction type; clinicians should consider personal stressors when planning treatment.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["large overall sample for a case‑control design","includes both substance and behavioral addictions","examines positive as well as negative life events"],"limitations":["cross‑sectional; cannot infer causality","no measurement of key confounds (moral incongruence, mental health, trauma)","addiction status based on clinical groups, not validated CSB scales"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":11,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.drugalcdep.2019.107562"}},{"id":7173,"doi":"10.1111/add.13499","pmid":"27470127","pmcid":null,"title":"Searching for clarity in muddy water: future considerations for classifying compulsive sexual behavior as an addiction","authors":"Kraus SW, Voon V, Kor A, Potenza MN.","first_author":"Kraus SW","journal":"Addiction (Abingdon, England)","year":2016,"pub_types":["Comment","Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/add.13499"}},{"id":7174,"doi":"10.1016/j.psychres.2018.11.059","pmid":"30504061","pmcid":"PMC6383753","title":"Relationship between quality of life in young adults and impulsivity/compulsivity&lt;sup&gt;✰&lt;/sup&gt;","authors":"Chamberlain SR, Grant JE.","first_author":"Chamberlain SR","journal":"Psychiatry research","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Cognition","Functioning","Addiction","Impulsive","Compulsive","Padua","Barratt"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.psychres.2018.11.059","cited_by_count":20,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large community survey (N=479), cross‑sectional analysis using Partial Least Squares","sample_n":479,"sample_text":"young adult community sample","population":"young adults, mean age 22.3 years, both sexes","country":"unspecified (likely UK/USA based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 479 young adults, poorer quality of life was linked to higher impulsivity, certain impulse‑control disorders (including compulsive sexual behaviour), and worse performance on decision‑making tasks.","clinical_takeaway":"Impulsivity and related disorders, including compulsive sexual behaviour, are associated with lower life quality; addressing impulsivity may improve outcomes.","confidence":0.78,"topic_tags":["csbd","sexual_function","pornography"],"strengths":["Large sample for cross‑sectional design","Validated impulsivity scale","Comprehensive assessment of multiple impulse‑control disorders"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral incongruence or masturbation, limiting specificity for CSBD","Addiction criteria not operationalised; compulsive sexual behavior treated as a disorder label only"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psychres.2018.11.059"}},{"id":7175,"doi":"10.1017/s1092852900007677","pmid":"17632452","pmcid":null,"title":"Compulsive and addictive sexual disorders and the family","authors":"Schneider JP.","first_author":"Schneider JP.","journal":"CNS spectrums","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative commentary discussing family impact on sexual addiction without original empirical data.","sample_n":null,"sample_text":"Not applicable","population":"Not applicable","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that family dynamics are important in treating sexual addiction, noting that partners and children are affected and that family‑based interventions may help break cycles of compulsive sexual behavior.","clinical_takeaway":"Consider involving partners and family members in treatment plans for sexual addiction when possible.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Highlights family context often overlooked","Integrates treatment considerations for partners and children"],"limitations":["No empirical data or systematic review methodology","Lacks defined constructs or measurement tools","No control of key confounds (moral incongruence, masturbation, mental health, trauma)"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852900007677"}},{"id":7176,"doi":"10.1080/009262301317081070","pmid":"11441516","pmcid":null,"title":"Compulsive sexual behavior inventory: a preliminary study of reliability and validity","authors":"Coleman E, Miner M, Ohlerking F, Raymond N.","first_author":"Coleman E","journal":"Journal of sex & marital therapy","year":2001,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":90,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Preliminary validation of a new 28‑item Compulsive Sexual Behavior Inventory using factor analysis and discriminant function in three small groups (N=15 CSB, 35 pedophiles, 42 controls).","sample_n":92,"sample_text":"15 non‑paraphilic CSB, 35 pedophiles, 42 controls (convenience).","population":"Adults (male), non‑paraphilic CSB, pedophiles in treatment, and community controls (convenience samples).","country":"Not specified (likely USA/Europe).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created a 28‑item questionnaire to measure compulsive sexual behavior and tested it in 92 men, including those with CSB, pedophiles, and normal controls. The scale showed good internal consistency and could distinguish the groups, but the study was small and did not control for important factors like moral beliefs or mental health.","clinical_takeaway":"The inventory shows promise but is not yet ready for clinical use; further validation in larger, diverse samples is needed.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Systematic factor analysis and internal consistency reporting.","Discriminant analysis shows ability to separate groups."],"limitations":["Very small, non‑representative samples.","No assessment of key confounds (moral, masturbation, mental health, trauma).","Preliminary scale; external validation lacking."],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":57,"citing_publications":218,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/009262301317081070"}},{"id":7177,"doi":"10.1007/s10461-015-1172-1","pmid":"26324079","pmcid":"PMC4755893","title":"\"Outness\" as a Moderator of the Association Between Syndemic Conditions and HIV Risk-Taking Behavior Among Men Who Have Sex with Men in Tijuana, Mexico","authors":"Pitpitan EV, Smith LR, Goodman-Meza D, Torres K, Semple SJ, Strathdee SA, Patterson TL.","first_author":"Pitpitan EV","journal":"AIDS and behavior","year":2016,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","MSM","Internalized Homophobia","Syndemics"],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 191 MSM recruited via respondent‑driven sampling; moderation analysis examining outness on the relationship between syndemic conditions and condomless anal sex.","sample_n":191,"sample_text":"191 participants recruited by respondent‑driven sampling","population":"Men who have sex with men (MSM) in Tijuana, Mexico (n=191)","country":"Mexico","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 191 Mexican gay men, those who kept more of their same‑sex life hidden showed a stronger link between stressful life conditions and risky unprotected sex, while men who were more open (out) showed a weaker link, suggesting openness may buffer risk.","clinical_takeaway":"Encouraging openness about sexual identity could reduce HIV risk among MSM facing multiple stressors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Reasonably large sample for MSM in a low‑resource setting","Uses multiple validated psychosocial scales","Novel test of “outness” as a resilience moderator"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of partner or dyadic factors","Potential self‑report bias on sexual behavior"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":1,"mentioning":33,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-015-1172-1"}},{"id":7178,"doi":"10.1017/s1092852900007689","pmid":"17632453","pmcid":null,"title":"Sexual addiction and compulsion: recognition, treatment, and recovery","authors":"Carnes PJ.","first_author":"Carnes PJ.","journal":"CNS spectrums","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Self‑selected treatment‑seeking sample of 957 patients described descriptively; no control group, no randomisation, no longitudinal analytic rigour.","sample_n":957,"sample_text":"957 patients reported to a recovery programme; self‑selected, likely treatment‑seeking bias.","population":"Patients with self‑identified compulsive/sex‑addicted behaviour seeking treatment.","country":"Not reported","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","no_mi_control"],"stance":"strongly-supports","citation_value":"background","plain_summary":"The article describes a 5‑year follow‑up of 957 people who sought help for compulsive sexual behaviour, outlining six recovery stages and treatment activities that seemed useful.","clinical_takeaway":"Evidence is anecdotal; clinicians should treat cases individually and not assume a universal ‘sex addiction’ syndrome.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large patient number (n≈957)","Provides a descriptive clinical trajectory","Offers practical treatment observations"],"limitations":["Self‑selected, treatment‑seeking sample limits generalisability","No validated measures of pornography use, compulsivity or distress","Absence of control for key confounds (moral incongruence, mental health, etc.)","Descriptive only; no statistical inference, effect sizes or power analysis"],"rubric_version":"2.0","raw_total":15,"max_possible":60,"pct_score":25,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":2,"addiction_criteria":3,"interpretation":3}},"scite":{"supporting":6,"contrasting":0,"mentioning":45,"citing_publications":78,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852900007689"}},{"id":7180,"doi":"10.1177/104012371202400413","pmid":"23145391","pmcid":null,"title":"Anticonvulsant treatment of compulsive sexual behavior","authors":"Bell DS.","first_author":"Bell DS.","journal":"Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists","year":2012,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/104012371202400413"}},{"id":7182,"doi":null,"pmid":"22962915","pmcid":null,"title":"Evaluating and treating sexual addiction","authors":"Dawson GN, Warren DE.","first_author":"Dawson GN","journal":"American family physician","year":2012,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":7183,"doi":"10.1080/0092623x.2024.2421188","pmid":"39498493","pmcid":null,"title":"Acceptance and Commitment Therapy for Hypersexuality: A Pilot Study","authors":"Montesinos F, Ortega-Otero M, Polín E, Lobato D.","first_author":"Montesinos F","journal":"Journal of sex & marital therapy","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Open-label single-arm pilot with pre‑post measurements (N=12).","sample_n":12,"sample_text":"Twelve participants completed the intervention.","population":"Adults (mean age 38.8) with clinically significant hypersexuality; 83% male, 67% homo/bisexual.","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","underpowered_sample","self_selected_sample"],"stance":"supports","citation_value":"useful","plain_summary":"A small pilot tested an online Acceptance and Commitment Therapy program with 12 adults reporting hypersexuality. Participants completed eight weekly sessions and showed reduced hypersexual behaviors and improved psychological flexibility, but the study lacked a control group and was underpowered.","clinical_takeaway":"ACT may be feasible for hypersexuality, but robust evidence is still needed before clinical recommendation.","confidence":0.7,"topic_tags":["treatment","prevalence","csbd","moral_incongruence"],"strengths":["Clear feasibility outcomes (completion, satisfaction)","Use of multiple time points (baseline, post, 3‑month follow‑up)","Reports large effect sizes for primary outcomes"],"limitations":["Very small, self‑selected sample; no control group","Unclear whether hypersexuality measure is validated","No assessment of moral incongruence or related confounds"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2024.2421188"}},{"id":7184,"doi":"10.1556/jba.3.2014.4.4","pmid":"25592308","pmcid":"PMC4291828","title":"Understanding the role of shame and its consequences in female hypersexual behaviours: a pilot study","authors":"Dhuffar MK, Griffiths MD.","first_author":"Dhuffar MK","journal":"Journal of behavioral addictions","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["Consequences","Shame","Female Sex Addiction","Hypersexual Behaviours"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4291828","cited_by_count":33,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online pilot survey of 102 UK females; self‑report measures of hypersexual behaviour (SBH, HDQ) and shame; regression controlling for sexual orientation and religious belief.","sample_n":102,"sample_text":"British sample of females (n = 102) recruited online.","population":"female adults, UK, recruited via SurveyMonkey (convenience sample)","country":"United Kingdom","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small UK sample of women, higher scores on hypersexual behaviour questionnaires were linked to greater feelings of shame, even after accounting for sexual orientation and religious belief.","clinical_takeaway":"Higher self‑reported hypersexual behaviours may be associated with shame in women, but causal direction is unclear; assess broader psychosocial factors.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Uses established HDQ screening tool","Controls for sexual orientation and religious belief","Explores shame, an under‑studied outcome"],"limitations":["Cross‑sectional, cannot infer causality","Convenience online sample; limited generalisability","Limited confound control (no mental health, partner, trauma)","Reliance on self‑report scales, possible circularity"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":46,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/jba.3.2014.4.4"}},{"id":7185,"doi":"10.1080/00224490409552231","pmid":"15497052","pmcid":null,"title":"The relationship between indicators of sexual compulsivity and high risk sexual practices among men and women receiving services from a sexually transmitted infection clinic","authors":"Kalichman SC, Cain D.","first_author":"Kalichman SC","journal":"Journal of sex research","year":2004,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":67,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 685 STI‑clinic patients (85 % African‑American) using audio‑computer assisted self‑report of sexual compulsivity, demographics, substance use and sexual behaviour.","sample_n":685,"sample_text":"492 men, 193 women; convenience sample of clinic attendees.","population":"Adults (men and women) receiving diagnostic and treatment services at an urban STI clinic in Wisconsin.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among patients at an STI clinic, higher scores on a sexual‑compulsivity questionnaire were linked to more sex partners and a greater chance of recent STIs, independent of drug or alcohol use.","clinical_takeaway":"High sexual‑compulsivity scores identify patients at elevated STI risk; screening may help target prevention efforts.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a clinic‑based study","Use of a validated sexual compulsivity scale","Objective STI outcome data"],"limitations":["Convenience clinic sample limits generalisability","Key psychosocial confounds (e.g., moral incongruence, trauma) not measured","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":10,"contrasting":0,"mentioning":109,"citing_publications":180,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490409552231"}},{"id":7186,"doi":"10.1017/s1092852916000183","pmid":"27151528","pmcid":"PMC5328289","title":"Expanding the definition of addiction: DSM-5 vs. ICD-11","authors":"Grant JE, Chamberlain SR.","first_author":"Grant JE","journal":"CNS spectrums","year":2016,"pub_types":["research-article","Review","Journal Article"],"keywords":["Classification","Diagnosis","Addiction","Impulsivity","Behavioral Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":93,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Review article discussing DSM‑5 vs ICD‑11 classifications of behavioral addictions, including compulsive sexual behavior, without presenting original empirical data.","sample_n":null,"sample_text":"Not applicable – narrative review","population":"Not applicable (no participants)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors compare how DSM‑5 and ICD‑11 define behavioral addictions such as compulsive sexual behavior, highlighting differences and suggesting areas needing more research.","clinical_takeaway":"Clinicians should be aware that diagnostic criteria for compulsive sexual behavior differ across classification systems, affecting assessment and treatment decisions.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Comprehensive discussion of classification systems","Integrates neurobiological and phenomenological perspectives","Identifies gaps for future research"],"limitations":["No original data or empirical testing","Lacks systematic review methodology (e.g., PRISMA)","No assessment of study quality or bias"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":97,"citing_publications":243,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852916000183"}},{"id":7188,"doi":"10.1007/s12311-026-02085-0","pmid":"42768142","pmcid":null,"title":"Impulsivity, Compulsivity, Social Inappropriateness, and Other Neuropsychiatric Features in Cerebellar Histiocytosis","authors":"Rossi M, Chaves H, Navarrine V, Volmaro S, Lin CR, Kuo SH, Diez B.","first_author":"Rossi M","journal":"Cerebellum (London, England)","year":2026,"pub_types":["Systematic Review","Journal Article","Case Reports"],"keywords":["Cerebellum","Compulsive Behavior","Langerhans Cell Histiocytosis","Impulsive Behavior","Neuropsychiatric Symptoms","Neurodegenerative Langerhans Cell Histiocytosis"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-series of six patients with cerebellar LCH plus systematic literature review of similar cases","sample_n":6,"sample_text":"six patients","population":"patients with multisystem Langerhans‑cell histiocytosis involving the cerebellum (n=6); no broader community sample","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"In six people with a rare brain disorder affecting the cerebellum, doctors observed impulsive, compulsive and socially inappropriate behaviours, including hypersexuality. Brain scans showed that worsening symptoms matched growth of cerebellar lesions, suggesting the cerebellum may influence these behaviours.","clinical_takeaway":"Cerebellar damage can contribute to impulsivity and hypersexuality; clinicians should assess neuropsychiatric symptoms in patients with cerebellar lesions.","confidence":0.7,"topic_tags":["csbd","neuroscience"],"strengths":["Rare clinical population described","Combines case series with literature review","Includes longitudinal imaging in one patient"],"limitations":["Very small N, no control group","Behavioral assessment not based on validated scales","No systematic control of psychiatric confounds"],"rubric_version":"2.0","raw_total":19,"max_possible":60,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":3,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12311-026-02085-0"}},{"id":7189,"doi":"10.1089/cpb.1999.2.457","pmid":"19178218","pmcid":null,"title":"Virtual sex addiction: when cybersex becomes the drug of choice","authors":"Delmonico DL, Carnes PJ.","first_author":"Delmonico DL","journal":"Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society","year":1999,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary/review with case examples, no original empirical data, no sample size reported.","sample_n":null,"sample_text":"None – article provides narrative review and case illustrations.","population":"Not applicable","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews early research on cybersex, suggesting it can become an addiction and proposes a brief screening test, but it offers no new data and relies on untested measures.","clinical_takeaway":"No actionable clinical guidance; the proposed screening tool lacks validation.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Provides overview of cybersex literature (as of 1999)","Offers clinical case examples"],"limitations":["No original data; relies on secondary sources","Uses unvalidated screening tool","No control for key confounds (moral incongruence, masturbation, mental health)","Conclusions overstate evidence of addiction"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cpb.1999.2.457"}},{"id":7190,"doi":"10.1080/0092623x.2026.2733595","pmid":"42764514","pmcid":null,"title":"Sexual Dysfunction in Parkinson's Disease: A Case-Control Study Using the Arizona Sexual Experience Scale and QUIP-RS in a Brazilian Cohort","authors":"da Silveira Benigno M, Araujo Leite MA.","first_author":"da Silveira Benigno M","journal":"Journal of sex & marital therapy","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case-control study comparing 60 Parkinson's patients with 60 controls, using validated scales for sexual dysfunction (ASEX) and related clinical variables.","sample_n":120,"sample_text":"60 PD patients and 60 controls recruited in Brazil","population":"Brazilian adults with Parkinson's disease and matched controls","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In Brazilian adults, sexual problems were common in both Parkinson's patients (57%) and healthy controls (42%). Within Parkinson's patients, poorer sexual function was linked to being female, having more depressive symptoms, more severe motor disease, and not using dopamine agonists.","clinical_takeaway":"Screen for sexual dysfunction in Parkinson's patients, especially women with depression or severe motor symptoms.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","pornography","masturbation"],"strengths":["Use of validated, disease‑specific and general sexual health measures","Inclusion of a matched control group","Assessment of multiple clinical correlates (depression, motor severity, medication)"],"limitations":["Cross‑sectional case‑control design limits causal inference","No measurement of partner or relationship factors","Sample size modest; power for detecting group differences not reported"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2026.2733595"}},{"id":7191,"doi":"10.3390/brainsci16090995","pmid":"42793420","pmcid":"PMC13604643","title":"Sexual Dysregulation After Traumatic Brain Injury and Stroke: A Critical Narrative Review of Neurobiology, Clinical Phenotypes, and Management","authors":"Calabrò RS, De Luca R, Ruberto RR, Calderone A, Milardi D, Tomaiuolo F.","first_author":"Calabrò RS","journal":"Brain sciences","year":2026,"pub_types":["review-article","Review","Journal Article"],"keywords":["Traumatic brain injury","Stroke","Neurorehabilitation","Acquired Brain Injury","Orbitofrontal Cortex","Hypersexuality","Sexual Disinhibition","Acquired Paraphilic Manifestations"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13604643","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of 13 case‑based publications; no primary data collection","sample_n":null,"sample_text":"13 English‑language case‑based publications (no new participants)","population":"patients with traumatic brain injury or stroke presenting hypersexuality or sexual disinhibition (case reports)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"The review examines how brain injuries like TBI and stroke can lead to hypersexual or disinhibited sexual behaviour, summarising evidence from a handful of case reports and noting that no single brain lesion predicts these changes.","clinical_takeaway":"Clinicians should assess each patient’s specific sexual changes after brain injury and tailor interventions, rather than assuming a fixed ‘hypersexuality’ syndrome.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","moral_incongruence"],"strengths":["Comprehensive literature search across multiple databases","Dual reviewer screening reduces selection bias","Clear discussion of neurobiological plausibility"],"limitations":["Relies on a small number of case reports; limited generalizability","No quantitative synthesis or risk‑of‑bias assessment","Absence of systematic appraisal of confounding factors"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/brainsci16090995"}},{"id":7192,"doi":"10.1016/j.euroneuro.2018.10.012","pmid":"30420190","pmcid":null,"title":"Behavioral addictions in bipolar disorders: A systematic review","authors":"Varo C, Murru A, Salagre E, Jiménez E, Solé B, Montejo L, Carvalho AF, Stubbs B, Grande I, Martínez-Arán A, Vieta E, Reinares M.","first_author":"Varo C","journal":"European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":["Prevalence","Treatment","Bipolar disorder","Comorbidity","Behavioral Addictions"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 28 quantitative studies on behavioral addictions (including compulsive sexual behavior) comorbid with bipolar disorder; narrative synthesis, no meta‑analysis, limited risk‑of‑bias assessment.","sample_n":28,"sample_text":"28 primary studies included; total participants not reported in abstract.","population":"Adults with bipolar disorder (studies varied in sample size and setting).","country":"Various (studies from multiple countries).","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"This systematic review found that people with bipolar disorder often also have behavioral addictions such as gambling, compulsive buying, internet overuse and compulsive sexual behavior, and that these co‑occurring problems tend to worsen the course of bipolar illness.","clinical_takeaway":"Screen for behavioral addictions, including compulsive sexual activity, in patients with bipolar disorder to guide comprehensive care.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Comprehensive systematic search covering multiple databases","First review to synthesise BA‑BD comorbidity","Identifies gaps and need for rigorous future research"],"limitations":["Heterogeneous primary studies with variable definitions of BA","No quantitative meta‑analysis or risk‑of‑bias grading","Limited assessment of key confounds (e.g., moral incongruence, masturbation)"],"rubric_version":"2.0","raw_total":27,"max_possible":60,"pct_score":45,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":4,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.euroneuro.2018.10.012"}},{"id":7193,"doi":"10.1017/s1092852900012645","pmid":"18311098","pmcid":null,"title":"The epidemiology and phenomenology of compulsive sexual behavior","authors":"Black DW.","first_author":"Black DW.","journal":"CNS spectrums","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative overview without empirical data","sample_n":null,"sample_text":"Not applicable – no primary sample","population":"general adult population (US)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews compulsive sexual behavior, estimating it affects 3‑6% of U.S. adults, more often men, and often co‑occurs with other mental health issues and a history of childhood abuse.","clinical_takeaway":"Clinicians should be aware that compulsive sexual behavior is reported in a minority of adults and often aligns with other psychiatric conditions.","confidence":0.7,"topic_tags":["sexual_function","csbd","prevalence"],"strengths":["Broad overview of CSB phenomenology","Cites prevalence estimates","Notes psychiatric comorbidities and risk factors"],"limitations":["No primary data or systematic methodology","Lacks validated measurement of CSB","Confounding factors (e.g., moral incongruence) not assessed","Interpretation limited by narrative approach"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":3,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":36,"citing_publications":99,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852900012645"}},{"id":7194,"doi":"10.1016/j.jsxm.2016.06.015","pmid":"27486137","pmcid":"PMC4996734","title":"Understanding the Personality and Behavioral Mechanisms Defining Hypersexuality in Men Who Have Sex With Men","authors":"Miner MH, Romine RS, Raymond N, Janssen E, MacDonald A, Coleman E.","first_author":"Miner MH","journal":"The journal of sexual medicine","year":2016,"pub_types":["Comparative Study","research-article","Journal Article"],"keywords":["Impulsivity","Sexual Addiction","Hypersexuality","Sexual Compulsivity"],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"comparative case‑control study of 242 MSM recruited from community sites, using a SCID‑like interview to define hypersexuality and self‑report questionnaires.","sample_n":242,"sample_text":"242 MSM, assigned to hypersexuality or control group via interview","population":"men who have sex with men, community sample, moderate‑size Mid‑western US city","country":"USA","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 242 gay and bisexual men, those identified as hypersexual showed higher negative emotions and lower self‑control, linked to heightened sexual excitement and inhibition. General impulsivity measures did not explain the lack of sexual control.","clinical_takeaway":"Personality traits like emotional reactivity may be relevant in men reporting hypersexuality, but clinicians should also assess moral conflict and mental health before attributing problems to addiction.","confidence":0.78,"topic_tags":["sexual_function","csbd","pornography","masturbation"],"strengths":["Large community sample for this topic","Use of structured interview rather than only self‑label","Comprehensive set of personality and sexual‑behavior questionnaires"],"limitations":["No measurement of moral or religious conflict, a key confound for distress outcomes","Hypersexuality definition relies on DSM‑IV interview without clear ICD‑11 alignment","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":5,"contrasting":0,"mentioning":31,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2016.06.015"}},{"id":7195,"doi":"10.1016/j.neurol.2018.07.009","pmid":"30935674","pmcid":null,"title":"Impulse control disorders in Parkinson disease: A cross-sectional study in Morocco","authors":"El Otmani H, Mouni FZ, Abdulhakeem Z, Attar Z, Rashad L, Saali I, El Moutawakil B, Rafai MA, Slassi I, Nadifi S.","first_author":"El Otmani H","journal":"Revue neurologique","year":2019,"pub_types":["Review","Journal Article"],"keywords":["Parkinson disease","Pathological Gambling","Hypersexuality","Dopamine Dysregulation Syndrome","Pathological Buying","Impulsive Control Disorders","Eating Behavioral Disorder","Hobbyism-punding"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 125 Parkinson’s patients from clinical sites in Morocco, using QUIP‑RS to assess impulse‑control disorders including compulsive sexual behavior.","sample_n":125,"sample_text":"Convenience clinical sample, not nationally representative.","population":"Adults with Parkinson’s disease, treated ≥6 months, without memory impairment (N=125).","country":"Morocco","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 125 Parkinson’s patients in Morocco, 28 % showed impulse‑control problems; 7 % had compulsive sexual behaviour. Younger age, male gender and higher dopamine‑agonist doses were linked to these problems. The study also noted culturally specific behaviours that resembled ICDs.","clinical_takeaway":"Clinicians should monitor young male PD patients on higher dopamine‑agonist doses for compulsive sexual behaviours, even in cultures where such issues may be expressed differently.","confidence":0.78,"topic_tags":["sexual_function","csbd","pornography","masturbation"],"strengths":["Use of validated QUIP‑RS instrument","First prevalence data for Moroccan PD population","Analysis of culturally specific ICD‑mimics"],"limitations":["Cross‑sectional design; cannot infer causality","No assessment of key sexual‑behavior confounds (moral, masturbation, mental health)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neurol.2018.07.009"}},{"id":7196,"doi":"10.1007/s10461-013-0516-y","pmid":"23681697","pmcid":null,"title":"Syndemic and other risk factors for unprotected anal intercourse among an online sample of Belgian HIV negative men who have sex with men","authors":"Wim VB, Christiana N, Marie L.","first_author":"Wim VB","journal":"AIDS and behavior","year":2014,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online convenience survey of 591 HIV‑negative Belgian MSM; examined depressive symptoms, sexual sensation seeking, substance use and other psychosocial factors as correlates of unprotected anal intercourse with casual partners.","sample_n":591,"sample_text":"online convenience sample of Belgian MSM (N=591)","population":"MSM, HIV‑negative, Belgium, online recruitment","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Belgian online survey of 591 HIV‑negative gay men, depressive symptoms, sensation‑seeking, substance use and social factors were all linked to having unprotected anal sex with casual partners.","clinical_takeaway":"Screen for depression and substance use when assessing HIV risk in MSM; address these factors in prevention counseling.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a cross‑sectional survey","Use of validated scales for depression and sensation seeking","Multivariate analysis of several psychosocial factors"],"limitations":["Convenience online sample limits generalisability","Cross‑sectional design prevents causal inference","Key confounds (moral incongruence, masturbation, trauma) not measured"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":31,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-013-0516-y"}},{"id":7197,"doi":"10.1093/brain/aws326","pmid":"23378222","pmcid":null,"title":"Neural response to visual sexual cues in dopamine treatment-linked hypersexuality in Parkinson's disease","authors":"Politis M, Loane C, Wu K, O'Sullivan SS, Woodhead Z, Kiferle L, Lawrence AD, Lees AJ, Piccini P.","first_author":"Politis M","journal":"Brain : a journal of neurology","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":115,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"randomized crossover fMRI study with ON/OFF dopamine medication; 12 hypersexual PD patients and 12 PD controls","sample_n":24,"sample_text":"12 patients with hypersexuality, 12 PD controls","population":"Parkinson's disease patients (hypersexuality vs control)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","causal_from_correlational","fmri_reverse_inference"],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson's patients who develop hypersexuality, viewing sexual pictures sparked stronger brain activity in reward‑related areas, especially when they were on dopamine medication. When medication was stopped, this brain response weakened.","clinical_takeaway":"Dopamine‑boosting drugs may heighten cue‑reactivity and urge in hypersexual PD patients; clinicians should monitor sexual impulse risks when prescribing.","confidence":0.6,"topic_tags":["pornography","sexual_function","neuroscience","csbd"],"strengths":["within‑subject medication ON/OFF manipulation","use of fMRI cue‑reactivity paradigm","comparison with PD control group"],"limitations":["Very small sample (N=12 per group)","No correction for multiple voxel comparisons reported","No measurement of key confounds (masturbation, mental health, moral variables)","Inference about dopamine release from BOLD signal"],"rubric_version":"2.0","raw_total":29,"max_possible":70,"pct_score":41,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":3,"statistics":3,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":18,"contrasting":0,"mentioning":111,"citing_publications":196,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/brain/aws326"}},{"id":7198,"doi":"10.1080/00325481.1991.11701111","pmid":"1946110","pmcid":null,"title":"How to recognize the signs of sexual addiction. Asking the right questions may uncover serious problems","authors":"Schneider JP.","first_author":"Schneider JP.","journal":"Postgraduate medicine","year":1991,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report / narrative description without empirical data","sample_n":null,"sample_text":"Not applicable – no systematic sample reported","population":"adult patients described in clinical settings (unspecified)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","circular_addiction_scale"],"stance":"supports","citation_value":"background","plain_summary":"The article argues that physicians should view persistent, compulsive sexual behavior as a form of addiction and suggests counseling and AA‑style self‑help groups as treatment.","clinical_takeaway":"The piece offers no evidence‑based guidance; clinicians should rely on validated assessments before labeling behavior as addiction.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Highlights clinical awareness of compulsive sexual behavior","Offers practical treatment suggestions (counseling, AA‑style groups)"],"limitations":["No empirical data or systematic sample","Uses undefined, circular definition of “sex addiction”","No measurement of key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00325481.1991.11701111"}},{"id":7199,"doi":null,"pmid":"33760515","pmcid":null,"title":"Kleine-Levin Syndrome (KLS)","authors":"Sharma A, Sankari A.","first_author":"Sharma A","journal":"StatPearls Publishing, Treasure Island (FL)","year":2026,"pub_types":["Study Guide"],"keywords":[],"is_oa":true,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Study guide / narrative overview of Kleine‑Levin syndrome; no original data, no empirical methods.","sample_n":null,"sample_text":"N/A (review article)","population":"N/A","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Kleine‑Levin syndrome is a rare disorder causing episodes of extreme sleepiness, cognitive changes, and sometimes increased sexual behavior. Episodes last days to weeks and then resolve, making diagnosis challenging.","clinical_takeaway":"Recognize KLS as a possible cause of recurrent hypersomnia with behavioral changes; evaluate for other sleep and psychiatric disorders.","confidence":0.4,"topic_tags":["neuroscience","sexual_function"],"strengths":["Comprehensive clinical summary of KLS","Clear description of symptom triad and differential diagnosis"],"limitations":["No original data or systematic synthesis","No empirical assessment of hypersexuality within KLS"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":7200,"doi":"10.1007/s11065-019-09400-z","pmid":"30852805","pmcid":"PMC6499744","title":"Efficacy of Pharmacological Interventions in Targeting Decision-Making Impairments across Substance and Behavioral Addictions","authors":"Chamberlain SR, Grant JE.","first_author":"Chamberlain SR","journal":"Neuropsychology review","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Review","Journal Article"],"keywords":["decision-making","Impulsivity","Gambling"],"is_oa":false,"oa_url":"https://link.springer.com/content/pdf/10.1007/s11065-019-09400-z.pdf","cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without empirical data","sample_n":null,"sample_text":"Not applicable – narrative review","population":"adult patients with substance use disorders, gambling disorder and other behavioral addictions (including compulsive sexual behavior)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This narrative review summarises how decision‑making problems are common in substance use, gambling and other behavioural addictions (including compulsive sexual behaviour) and notes that few drug trials have measured whether treatments improve these decision‑making deficits.","clinical_takeaway":"None – the paper offers no direct clinical guidance.","confidence":0.4,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Broad overview of decision‑making deficits across many addictions","Identifies gaps in pharmacological trial outcomes","Suggests future inclusion of standardized behavioural and imaging measures"],"limitations":["No systematic search or risk‑of‑bias assessment","Relies on narrative synthesis rather than quantitative meta‑analysis","Lacks primary data on compulsive sexual behavior"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11065-019-09400-z"}},{"id":7201,"doi":"10.1016/j.neuroimage.2018.04.072","pmid":"29729394","pmcid":null,"title":"Neural correlates of gender differences in distractibility by sexual stimuli","authors":"Strahler J, Kruse O, Wehrum-Osinsky S, Klucken T, Stark R.","first_author":"Strahler J","journal":"NeuroImage","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Gender","Functional magnetic resonance imaging","Visual Sexual Stimuli","Attentional Interference"],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"fMRI attentional interference task with sexual vs neutral pictures; within‑subject design; 97 participants (50 F, 47 M).","sample_n":97,"sample_text":"Fifty women and 47 men.","population":"young adult men and women, community sample (no clinical or treatment‑seeking group).","country":"Germany (inferred from author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational","fmri_reverse_inference"],"stance":"neutral","citation_value":"useful","plain_summary":"In an fMRI experiment, people took longer to judge line orientations when a sexual picture was present. Both men and women showed activation in brain reward areas, but men had stronger responses in the nucleus caudate, anterior cingulate and nucleus accumbens. The authors suggest this may relate to higher risk of compulsive sexual behaviour in men.","clinical_takeaway":"No direct clinical implication; neural reactivity to sexual cues alone does not prove addiction risk.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","gender","csbd"],"strengths":["Reasonably large fMRI sample with gender balance","Well‑defined attentional task","Use of both behavioral and neural measures"],"limitations":["No measurement of key confounds (mood, trauma, masturbation)","Trait motivation scale not described; validation unclear","Interpretation extends to addiction risk without testing criteria"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":6,"statistics":5,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":16,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neuroimage.2018.04.072"}},{"id":7202,"doi":"10.1016/j.psyneuen.2015.10.002","pmid":"26519779","pmcid":null,"title":"HPA axis dysregulation in men with hypersexual disorder","authors":"Chatzittofis A, Arver S, Öberg K, Hallberg J, Nordström P, Jokinen J.","first_author":"Chatzittofis A","journal":"Psychoneuroendocrinology","year":2016,"pub_types":["Controlled Clinical Trial","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Cortisol","ACTH","Hpa Axis","Dexamethasone Suppression Test","Hypersexual Disorder Childhood Trauma"],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Controlled clinical trial with 67 hypersexual disorder patients and 39 healthy male volunteers; basal cortisol/ACTH and dexamethasone suppression test; questionnaires for hypersexual behavior, depression, childhood trauma.","sample_n":106,"sample_text":"67 patients, 39 controls","population":"Adult men (mean age not reported); hypersexual disorder patients vs healthy controls","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"supports","citation_value":"useful","plain_summary":"Men diagnosed with hypersexual disorder showed higher stress‑hormone levels and were less likely to suppress cortisol after a low‑dose dexamethasone test than men without the condition, suggesting HPA‑axis dysregulation.","clinical_takeaway":"Consider evaluating stress‑axis function in men presenting with hypersexual symptoms, but note the association does not prove cause.","confidence":0.78,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Use of validated hormonal assays","Inclusion of a healthy control group","Assessment of relevant covariates (depression, trauma)"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral incongruence or masturbation behavior","Moderate sample size; power not justified"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":64,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psyneuen.2015.10.002"}},{"id":7203,"doi":"10.3389/fpsyt.2026.1893510","pmid":"42756337","pmcid":"PMC13582548","title":"The role of metacognitive beliefs in impulse control disorders and addictive-like behaviors in Parkinson's disease: an exploratory study","authors":"Triscari S, Lenzo V, Sardella A, Caponnetto P, Galati A, Lupica P, Tasca D, Muratore S, Marano P, Caraci F, Quattropani MC.","first_author":"Triscari S","journal":"Frontiers in psychiatry","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Addiction","Metacognition","Parkinson","Impulse Control Disorder","Metacognitive Beliefs"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13582548","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Exploratory cross‑sectional study of 38 Parkinson’s disease patients; questionnaires administered; partial correlations controlling for dopaminergic exposure.","sample_n":38,"sample_text":"Convenience sample of Parkinson’s disease outpatients","population":"PD patients (mean age 67.5, 44.7% female)","country":"Italy (implied by Italian normative data)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 38 Parkinson’s patients, more dysfunctional metacognitive beliefs were linked to more severe impulse‑control symptoms, including hypersexuality, even after accounting for dopamine medication levels.","clinical_takeaway":"Metacognitive patterns may influence impulse‑control problems in Parkinson’s disease; consider cognitive assessments when treating hypersexuality.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Validated psychometric instruments (MCQ‑30, QUIP‑RS)","Controls for dopaminergic medication variables","FDR correction for multiple testing"],"limitations":["Small sample (N=38) limits power","Cross‑sectional, cannot infer causality","No assessment of key sexual‑behavior confounds (moral incongruence, masturbation, mental health, partner context, trauma)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2026.1893510"}},{"id":7204,"doi":"10.1016/s0010-440x(03)00110-x","pmid":"14505297","pmcid":null,"title":"Psychiatric comorbidity and compulsive/impulsive traits in compulsive sexual behavior","authors":"Raymond NC, Coleman E, Miner MH.","first_author":"Raymond NC","journal":"Comprehensive psychiatry","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":161,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional convenience sample of 25 adults recruited via newspaper advertisements; structured clinical interviews (SCID‑I, SCID‑II) and a researcher‑developed semistructured interview were used to assess CSB and psychiatric comorbidity.","sample_n":25,"sample_text":"23 men and 2 women responded to newspaper advertisements and met criteria for CSB according to diagnostic criteria established and assessed by expert clinicians.","population":"23 men, 2 women, adult community volunteers meeting clinician‑derived CSB criteria; not a probability or treatment‑seeking sample.","country":"USA (Minnesota)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small study of 25 adults who self‑identified as having compulsive sexual behavior found that almost all also met criteria for mood, anxiety, or personality disorders, and showed more impulsive than compulsive traits.","clinical_takeaway":"When treating CSB, assess and address co‑occurring mood, anxiety, and impulse‑control disorders.","confidence":0.7,"topic_tags":["csbd","sexual_function","moral_incongruence"],"strengths":["Use of gold‑standard SCID interviews for psychiatric diagnoses","Systematic assessment of impulsive vs compulsive traits","Clear reporting of high comorbidity rates"],"limitations":["Very small, self‑selected sample (N=25) limits generalisability","CSB diagnostic criteria not based on a validated scale","No control for moral incongruence, masturbation, partner factors, or trauma"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":12,"contrasting":2,"mentioning":230,"citing_publications":319,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0010-440x(03)00110-x"}},{"id":7207,"doi":"10.1111/add.13366","pmid":"27086656","pmcid":null,"title":"Diagnosis of hypersexual or compulsive sexual behavior can be made using ICD-10 and DSM-5 despite rejection of this diagnosis by the American Psychiatric Association","authors":"Krueger RB.","first_author":"Krueger RB.","journal":"Addiction (Abingdon, England)","year":2016,"pub_types":["Comment","Journal Article"],"keywords":["Hypersexual Behavior","Sexual Addiction","Icd-10","Dsm-5","Icd-11","Behavioral Addiction","Compulsive Sexual Behavior Disorder","Hypersexual Behavior Disorder","Out Of Control Sexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":26,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/add.13366"}},{"id":7208,"doi":"10.1136/sti.2007.028696","pmid":"18096648","pmcid":null,"title":"Relations between sexually transmitted infection diagnosis and sexual compulsivity in a community-based sample of men who have sex with men","authors":"Dodge B, Reece M, Herbenick D, Fisher C, Satinsky S, Stupiansky N.","first_author":"Dodge B","journal":"Sexually transmitted infections","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional community‑based survey of 504 MSM using the Sexual Compulsivity Scale.","sample_n":504,"sample_text":"Community‑based participatory research sample; convenience rather than probability sampling","population":"504 men who have sex with men, Indianapolis, Indiana, USA","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 504 men who have sex with men, higher scores on a validated sexual compulsivity questionnaire were linked to a greater likelihood of having been diagnosed with an STI, though testing rates did not differ.","clinical_takeaway":"Higher sexual compulsivity may signal increased STI risk; clinicians might consider assessing compulsivity to guide counseling.","confidence":0.78,"topic_tags":["sexual_function","masturbation"],"strengths":["Large community sample (N>500)","Use of validated Sexual Compulsivity Scale","Reliability and construct validity of SCS reported"],"limitations":["Cross‑sectional design, cannot infer causality","No assessment of key confounds (e.g., mental health, moral incongruence)","Convenience sampling limits generalisability"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":33,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sti.2007.028696"}},{"id":7210,"doi":"10.1007/s10508-009-9481-y","pmid":"19330440","pmcid":null,"title":"Sexual coercion in men and women: similar behaviors, different predictors","authors":"Schatzel-Murphy EA, Harris DA, Knight RA, Milburn MA.","first_author":"Schatzel-Murphy EA","journal":"Archives of sexual behavior","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 186 college students assessing self‑reported coercive behaviors and predictor variables.","sample_n":186,"sample_text":"college sample, convenience recruitment","population":"college men and women (N=186)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 186 college students and found that men and women report similar rates of sexual coercion, but the reasons differ: men's coercion is linked to a desire for power and casual sex, while women's coercion relates to sexual compulsivity.","clinical_takeaway":"Clinicians should consider gender‑specific motives when assessing coercive sexual behavior, rather than assuming a single underlying cause.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large‑ish community sample for this topic","Examines gender differences in predictors","Addresses multiple theoretical variables"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report measures without validation details","Limited control for key confounds (e.g., mental health, moral factors)","College convenience sample may not generalize"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":0,"mentioning":106,"citing_publications":129,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-009-9481-y"}},{"id":7211,"doi":"10.3389/fpsyg.2016.00914","pmid":"27378999","pmcid":"PMC4908125","title":"Compulsive Buying Behavior: Clinical Comparison with Other Behavioral Addictions","authors":"Granero R, Fernández-Aranda F, Mestre-Bach G, Steward T, Baño M, Del Pino-Gutiérrez A, Moragas L, Mallorquí-Bagué N, Aymamí N, Gómez-Peña M, Tárrega S, Menchón JM, Jiménez-Murcia S.","first_author":"Granero R","journal":"Frontiers in psychology","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Internet Addiction","Behavioral Addictions","Sex Addiction","Gambling Disorder","Internet Gaming Disorder","Compulsive Buying Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4908125","cited_by_count":34,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"3324 treatment‑seeking patients classified into five behavioral‑addiction groups; cross‑sectional clinical comparison.","sample_n":3324,"sample_text":"Three thousand three hundred and twenty‑four treatment‑seeking patients were classified in five groups: CBB, sexual addiction, Internet gaming disorder, Internet addiction, and gambling disorder.","population":"treatment‑seeking individuals (clinical sample)","country":"Spain (likely, based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared people seeking treatment for compulsive buying, sexual addiction, gaming addiction, internet addiction and gambling, finding that compulsive buyers were more often women, had higher overall mental‑health problems and distinct personality traits.","clinical_takeaway":"Findings reflect a specific clinical profile for compulsive buying, but may not apply to non‑clinical populations.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size","Comparison across multiple behavioral‑addiction groups","Comprehensive personality assessment"],"limitations":["Treatment‑seeking sample limits generalisability","Unclear definition and measurement of 'sexual addiction'","No control for moral or religious factors"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":41,"citing_publications":82,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2016.00914"}},{"id":7212,"doi":"10.1177/10790632241271204","pmid":"39104158","pmcid":"PMC11997290","title":"The Relevance of Hypersexuality and Impulsivity in Different Groups of Treatment-Seekers With and Without (Exclusive) Pedophilia","authors":"Bergner-Koether R, Peschka L, Pastukhov A, Carbon CC, Steins-Loeber S, Hajak G, Rettenberger M.","first_author":"Bergner-Koether R","journal":"Sexual abuse : a journal of research and treatment","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Impulsivity","Child Sexual Abuse","Prevention Program","Hypersexuality","Pedophilia","Child Sexual Abuse Images"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11997290","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational study of treatment‑seeking men; Bayesian ordinal logit and GLM analyses.","sample_n":null,"sample_text":"participants recruited from three child‑abuse prevention projects; exact N not reported in abstract.","population":"Treatment‑seeking men with and without exclusive pedophilia (Germany).","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared hypersexuality and impulsivity in men seeking treatment for pedophilic interests versus those without. Hypersexuality was higher in men with pedophilia, but impulsivity did not differ consistently. Neither factor predicted past child sexual offenses.","clinical_takeaway":"Hypersexuality, not impulsivity, may be a key risk indicator in treatment‑seeking men with pedophilic interests; assess it separately from general impulsivity.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Uses validated impulsivity and hypersexuality scales","Includes objective behavioral measure (TSO)","Applies Bayesian modeling"],"limitations":["Convenience sample of treatment seekers limits generalisability","No control for key psychosocial confounds (e.g., mental health, trauma)","Sample size not reported; likely under‑powered"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632241271204"}},{"id":7213,"doi":"10.1590/1516-4446-2017-0020","pmid":"30540023","pmcid":"PMC6794126","title":"Early childhood maltreatment experience and later sexual behavior in Brazilian adults undergoing treatment for substance dependence","authors":"Diehl A, Clemente J, Pillon SC, Santana PRH, da Silva CJ, Mari JJ.","first_author":"Diehl A","journal":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","year":2019,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6794126","cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 134 outpatient substance‑dependent adults in Brazil","sample_n":134,"sample_text":"134 substance‑dependent outpatients (76% male, majority single, alcohol primary drug)","population":"adult substance‑dependence patients (mostly male) seeking outpatient care in São Paulo, Brazil","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 134 Brazilian adults receiving treatment for substance dependence, childhood trauma—especially emotional and physical abuse—was common and linked to higher chances of exchanging sex for drugs and being sexually abused later in life.","clinical_takeaway":"Screen for childhood abuse in substance‑use patients, as it predicts risky sexual behavior and revictimisation.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of validated CTQ for childhood trauma","Report of confidence intervals for odds ratios","Inclusion of both genders"],"limitations":["Cross‑sectional design limits causal inference","No control for moral or mental‑health confounders","Reliance on self‑report for sensitive behaviours"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":20,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/1516-4446-2017-0020"}},{"id":7215,"doi":"10.1016/s0272-7358(97)00051-2","pmid":"9564585","pmcid":null,"title":"Sexual addiction: many conceptions, minimal data","authors":"Gold SN, Heffner CL.","first_author":"Gold SN","journal":"Clinical psychology review","year":1998,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":74,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review lacking systematic methods or empirical data","sample_n":null,"sample_text":"no primary participants; review of existing literature","population":"none","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how researchers have described \"sexual addiction,\" comparing it to addiction, OCD, and impulse‑control disorders, and points out that the field lacks solid data.","clinical_takeaway":"Current evidence is insufficient to diagnose or treat sexual addiction; clinicians should be cautious about labeling.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of conceptual models","Identifies clear gaps for future research"],"limitations":["No systematic methodology reported","No empirical data or meta‑analytic synthesis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":89,"citing_publications":216,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0272-7358(97)00051-2"}},{"id":7216,"doi":"10.1521/aeap.2014.26.4.362","pmid":"25068182","pmcid":"PMC4116634","title":"Comparing three cohorts of MSM sampled via sex parties, bars/clubs, and Craigslist.org: implications for researchers and providers","authors":"Grov C, Rendina HJ, Parsons JT.","first_author":"Grov C","journal":"AIDS education and prevention : official publication of the International Society for AIDS Education","year":2014,"pub_types":["Comparative Study","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of three convenience MSM samples recruited from Craigslist, bars/clubs and private sex parties.","sample_n":null,"sample_text":"Three cohorts recruited via modified time‑space sampling (Craigslist), time‑space sampling (bars/clubs) and passive recruitment/listserves (sex parties).","population":"MSM (men who have sex with men) recruited via venue‑based sampling; N not reported in abstract.","country":"USA (inferred from NIH funding and author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared MSM recruited from sex parties, bars/clubs, and Craigslist, finding that party‑recruited men were older, more likely HIV‑positive, and reported higher sexual compulsivity, while Craigslist men felt less attached to gay communities.","clinical_takeaway":"Recruitment venue influences sample characteristics; clinicians should consider venue‑related differences when assessing sexual health risks.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Direct comparison of three distinct recruitment venues","Large sample implied by multiple cohorts","Inclusion of sexual compulsivity measure"],"limitations":["Convenience, non‑representative sampling limits generalisability","No control for key confounds such as moral incongruence or mental health","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1521/aeap.2014.26.4.362"}},{"id":7217,"doi":"10.3389/fendo.2026.1869083","pmid":"42626033","pmcid":"PMC13491195","title":"A systematic review and meta-analysis on impulse-control disorders in patients with pituitary adenomas exposed to dopamine agonists","authors":"Bilbao R, Serralunga J, Loschiavo N, Altuna R, Manfre J, Capani F, Otero-Losada M, Ponzo OJ, Perez-Lloret S.","first_author":"Bilbao R","journal":"Frontiers in endocrinology","year":2026,"pub_types":["Meta-Analysis","Systematic Review","systematic-review","Journal Article"],"keywords":["Dopamine agonists","hyperprolactinemia","Pharmacovigilance","pituitary adenomas","Impulse-control Disorders"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13491195","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Systematic review and meta-analysis of 14 observational studies comparing dopamine‑agonist‑exposed pituitary adenoma patients with unexposed patients or healthy controls.","sample_n":1247,"sample_text":"Aggregated across 14 observational studies (total n≈1247).","population":"Patients with pituitary adenomas treated with dopamine agonists (n≈1247 across studies).","country":"Not specified (multi‑country literature search).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 14 studies found that patients with pituitary tumours who take dopamine‑agonist drugs are about 2.4 times more likely to develop impulse‑control problems, including hypersexuality, compared with those not on the drugs.","clinical_takeaway":"Clinicians prescribing dopamine agonists for pituitary adenomas should monitor patients for emerging hypersexual or other impulse‑control behaviours.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large pooled sample (n≈1247)","Rigorous systematic search across multiple databases","Clear effect‑size reporting with confidence intervals and heterogeneity statistics"],"limitations":["All primary data are observational; causality cannot be inferred","Potential confounders specific to sexual behaviour (e.g., moral incongruence, masturbation) not addressed","No pre‑registration reported for the review protocol"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fendo.2026.1869083"}},{"id":7218,"doi":"10.1207/s15327752jpa7603_02","pmid":"11499453","pmcid":null,"title":"The Sexual Compulsivity Scale: further development and use with HIV-positive persons","authors":"Kalichman SC, Rompa D.","first_author":"Kalichman SC","journal":"Journal of personality assessment","year":2001,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":140,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Validation study of the Sexual Compulsivity Scale in a community sample of 287 HIV‑positive adults.","sample_n":287,"sample_text":"Community‑recruited convenience sample","population":"HIV‑positive men and women, majority African American, >30 y","country":"USA","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The Sexual Compulsivity Scale was tested in 287 HIV‑positive adults and found to be reliable and to correlate with the number of recent sexual partners, supporting its use as a measure of sexual compulsivity.","clinical_takeaway":"The scale appears psychometrically sound for assessing sexual compulsivity in HIV‑positive patients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large (N=287) community sample of HIV‑positive adults","Reliable (α>.89) and valid scale demonstrated","Examines both convergent and discriminant validity"],"limitations":["Convenience sample; limited generalisability","No assessment of moral or religious factors","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":0,"mentioning":154,"citing_publications":253,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1207/s15327752jpa7603_02"}},{"id":7219,"doi":"10.1371/journal.pone.0207398","pmid":"30427931","pmcid":"PMC6235397","title":"Typology of patients with behavioral addictions or eating disorders during a one-year period of care: Exploring similarities of trajectory using growth mixture modeling coupled with latent class analysis","authors":"Montourcy M, Hardouin JB, Caillon J, Leboucher J, Rousselet M, Grall-Bronnec M, Challet-Bouju G.","first_author":"Montourcy M","journal":"PloS one","year":2018,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0207398&type=printable","cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort of 302 patients with various behavioral addictions (including sexual addiction) assessed at baseline, 6, and 12 months; latent class and growth mixture modeling used to identify trajectory typologies","sample_n":302,"sample_text":"302 patients (mixed sexes, adolescents to adults) recruited from a treatment centre","population":"patients seeking specialized care for gambling, sexual addiction, compulsive buying, excessive video‑game use or eating disorders (clinical convenience sample)","country":"France","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers followed 302 patients with various behavioural addictions (including sexual addiction) over a year, using interviews and questionnaires to group them into five trajectory types that cut across specific disorders.","clinical_takeaway":"Patients show different patterns of change regardless of diagnosis; treatment should be tailored to individual trajectories rather than the label of ‘sexual addiction’ alone.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["large clinical sample with multiple behavioural addictions","longitudinal design with three assessment points","advanced statistical modeling (growth mixture, latent class)"],"limitations":["clinical convenience sample limits generalisability","key confounds (moral incongruence, masturbation, partner factors, trauma) not measured","addiction constructs not clearly operationalised or validated"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0207398"}},{"id":7220,"doi":"10.1007/978-981-10-5562-1_8","pmid":"29098672","pmcid":null,"title":"Similarities and Differences in Diagnostic Scales","authors":"Xuan B, Li P, Yang L, Li M, Zhou J.","first_author":"Xuan B","journal":"Advances in experimental medicine and biology","year":2017,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Validity","reliability","Substance Addiction","Non-substance Addiction Scales"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review (narrative, no empirical data)","sample_n":null,"sample_text":"none – narrative review of existing scales","population":"none (review)","country":"unspecified (authors from China)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews and compares diagnostic scales used for substance and non‑substance addictions, including the debated 'sex addiction' scales, noting common features like preoccupation and tolerance.","clinical_takeaway":"None – the paper is a theoretical review and does not provide direct clinical guidance.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Broad overview of many addiction scales","Highlights common items across scales (social impairment, preoccupation, withdrawal, tolerance)","Discusses cross‑cultural and cross‑sample applicability"],"limitations":["No new empirical data; relies on existing literature","Lacks systematic review methodology (no risk‑of‑bias assessment)","No quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/978-981-10-5562-1_8"}},{"id":7221,"doi":"10.1111/j.1521-0391.2010.00090.x","pmid":"21175916","pmcid":null,"title":"Compulsive alcohol use and other high-risk behaviors among college students","authors":"Pedrelli P, Bitran S, Shyu I, Baer L, Guidi J, Tucker DD, Vitali M, Fava M, Zisook S, Farabaugh AH.","first_author":"Pedrelli P","journal":"The American journal on addictions","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 904 college students from three campuses; self‑report questionnaires on compulsive drinking and various risky behaviours.","sample_n":904,"sample_text":"904 participants completed the questionnaire.","population":"College students (both genders) recruited during mental‑health screening; convenience sample, not nationally representative.","country":"Not specified (likely United States based on journal and author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among 904 college students, those who reported compulsive drinking were more likely to also engage in risky drug use, sexual activities, and gambling, especially men. The study suggests screening for compulsive drinking could help identify students at risk for other high‑risk behaviours.","clinical_takeaway":"Screen for compulsive drinking to flag students who may also be at risk for substance misuse and risky sexual behaviour.","confidence":0.7,"topic_tags":["religiosity","moral_incongruence","sexual_function"],"strengths":["Large sample size for a survey","Examines multiple risky behaviours together"],"limitations":["Cross‑sectional; cannot infer causality","Unclear whether measures are validated","No control for key confounds (e.g., mental health, moral factors)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":20,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1521-0391.2010.00090.x"}},{"id":7222,"doi":"10.1093/jsxmed/qdag243","pmid":"42614117","pmcid":null,"title":"The Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia-Hypersexuality Differentiation Screener","authors":"Mulroy ME, Ashley M, Jackowich RA, Poirier É, Fabrigar LR, Lalumière ML, Pukall CF.","first_author":"Mulroy ME","journal":"The journal of sexual medicine","year":2026,"pub_types":["Journal Article"],"keywords":["Differential diagnosis","Hypersexuality","Screening Tool","Persistent Genital Arousal Disorder (Pgad)","Compulsive Sexual Behaviour Disorder (Csbd)","Genitopelvic Dysesthesia (Gpd)"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdag243"}},{"id":7223,"doi":"10.1007/s00406-024-01856-2","pmid":"38969754","pmcid":"PMC11799082","title":"What Chemsex does to the brain - neural correlates (ERP) regarding decision making, impulsivity and hypersexuality","authors":"Schwarz J, Gertzen M, Rabenstein A, Straßburger M, Horstmann A, Pogarell O, Rüther T, Karch S.","first_author":"Schwarz J","journal":"European archives of psychiatry and clinical neuroscience","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Inhibition","Executive Functions","Hypersexuality","Chemsex","Neurophysiological Correlates"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s00406-024-01856-2.pdf","cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control EEG study with 15 chemsex users and 14 matched controls; auditory Go/NoGo ERP paradigm; clinical questionnaires collected","sample_n":29,"sample_text":"15 chemsex users, 14 matched controls","population":"men who have sex with men, chemsex users vs non‑users, convenience sample","country":"unspecified (likely Germany based on author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","causal_from_correlational","masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small EEG study, men who engage in chemsex showed reduced brain responses linked to inhibitory control compared with non‑users, alongside higher self‑reported hypersexuality and risk behaviour.","clinical_takeaway":"Evidence of altered brain inhibition in chemsex users is preliminary; clinicians should interpret behavioural risk as correlational, not causal.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["EEG ERP paradigm provides objective neural data","Matched control group","Includes clinical symptom measures"],"limitations":["Very small sample, low statistical power","No measurement of moral incongruence or masturbation","Addiction/hypersexuality not operationalised with validated scale","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":70,"pct_score":37,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":5,"statistics":4,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00406-024-01856-2"}},{"id":7224,"doi":"10.1016/j.addbeh.2018.03.007","pmid":"29547799","pmcid":null,"title":"Personality profiles of substance and behavioral addictions","authors":"Zilberman N, Yadid G, Efrati Y, Neumark Y, Rassovsky Y.","first_author":"Zilberman N","journal":"Addictive behaviors","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Personality","Addiction","Impulsivity","Religiosity","Behavioral Addiction","Big-five"],"is_oa":false,"oa_url":null,"cited_by_count":82,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional comparison of 216 treatment‑seeking individuals with various addictions (substance, gambling, compulsive sexual behavior) and 78 community controls; questionnaires on personality and demographics","sample_n":294,"sample_text":"216 addicted individuals and 78 controls","population":"adult patients from rehabilitation centres (Israel) and community controls","country":"Israel","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed over 200 people in treatment for various addictions—including gambling and compulsive sexual behaviour—and 78 non‑addicted controls. Using standard personality questionnaires, it found that impulsivity and neuroticism were higher across all addictions, while other traits differed between substances and behaviours.","clinical_takeaway":"Personality traits vary by addiction type, but clinicians should consider broader mental‑health and moral factors not addressed here.","confidence":0.75,"topic_tags":["sexual_function","csbd"],"strengths":["Large total sample for a niche topic","Use of validated personality inventory","Comparative approach across multiple addiction types"],"limitations":["Convenience sample from treatment centres limits generalisability","Key confounds (moral incongruence, mental health) not measured","Addiction groups not operationalised with standardized diagnostic criteria"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":11,"contrasting":3,"mentioning":110,"citing_publications":181,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2018.03.007"}},{"id":7225,"doi":"10.1080/00926239308404908","pmid":"8246278","pmcid":null,"title":"Diagnosis and treatment of sexual addiction","authors":"Goodman A.","first_author":"Goodman A.","journal":"Journal of sex & marital therapy","year":1993,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"theoretical/clinical discussion without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","circular_addiction_scale"],"stance":"supports","citation_value":"background","plain_summary":"Goodman (1993) outlines a theory of sexual addiction and proposes an integrated treatment approach, but offers no original data and defines addiction in circular terms.","clinical_takeaway":"The article presents a treatment model for sexual addiction, but its lack of empirical support limits clinical applicability.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive theoretical framework","Integrates behavioral and pharmacological approaches"],"limitations":["No empirical data provided","Circular definition of sexual addiction","Lacks measurement of key confounds"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":82,"citing_publications":156,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239308404908"}},{"id":7226,"doi":"10.1016/j.jsxm.2020.05.007","pmid":"32690426","pmcid":null,"title":"Gray Matter Volume Differences in Impulse Control and Addictive Disorders-An Evidence From a Sample of Heterosexual Males","authors":"Draps M, Sescousse G, Potenza MN, Marchewka A, Duda A, Lew-Starowicz M, Kopera M, Jakubczyk A, Wojnar M, Gola M.","first_author":"Draps M","journal":"The journal of sexual medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Addictions","Voxel-based Morphometry","Impulse Control Disorder","Alcohol Use Disorder","Gray Matter Volume","Gambling Disorder","Compulsive Sexual Behavior Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Voxel‑based morphometry case‑control study comparing gray‑matter volume in CSBD, gambling disorder, alcohol use disorder and healthy controls (all heterosexual males).","sample_n":98,"sample_text":"All participants were heterosexual males; groups were matched on age.","population":"26 CSBD, 26 GD, 21 AUD, 25 HC heterosexual males, age 24‑60","country":"Poland (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"MRI scans showed that men with compulsive sexual behavior, gambling disorder, or alcohol use disorder have smaller front‑orbitofrontal brain regions than healthy men, with the strongest reductions in gambling and alcohol groups.","clinical_takeaway":"Gray‑matter reductions suggest shared brain alterations across CSBD and other addictions, but findings are preliminary and limited to heterosexual males.","confidence":0.78,"topic_tags":["csbd","neuroscience"],"strengths":["Direct comparison of CSBD with GD and AUD using the same imaging protocol","Use of validated severity questionnaires","Whole‑brain VBM analysis with correction for multiple comparisons"],"limitations":["Small sample sizes per group, limiting power","All male, heterosexual sample limits generalisability","No measurement of key psychosocial confounds (moral incongruence, masturbation, mental health, trauma)"],"rubric_version":"2.0","raw_total":37,"max_possible":70,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":6,"statistics":5,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.05.007"}},{"id":7227,"doi":"10.1007/s11102-026-01728-z","pmid":"42496764","pmcid":"PMC13400692","title":"Increased impulsivity and higher odds of compulsive shopping among cabergoline-treated patients with prolactinoma: a case-control study","authors":"Daniel KB, Glezer A, de Queiroz NL, Correa-Silva SR, Trentin MBF, Fujiwara MT, Benetti-Pinto CL, Kasuki L, Tavares LAG, do Rosário PWS, Garmes HM.","first_author":"Daniel KB","journal":"Pituitary","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Prolactinoma","Impulsivity","Impulse Control Disorders","Cabergoline"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13400692","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-control cross-sectional study comparing 131 cabergoline‑treated prolactinoma patients with 131 healthy controls; multivariable logistic regression used for odds of compulsive shopping.","sample_n":262,"sample_text":"131 patients, 131 controls (total N=262)","population":"131 adults with prolactinoma on cabergoline; 131 matched healthy adults; both sexes, middle‑aged.","country":"not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People with prolactin‑secreting pituitary tumours who take the dopamine drug cabergoline show higher impulsivity scores and are about four times more likely to report compulsive shopping than comparable healthy adults.","clinical_takeaway":"Clinicians should monitor impulsivity and compulsive shopping in patients receiving cabergoline for prolactinoma.","confidence":0.8,"topic_tags":["csbd","sexual_function","neuroscience"],"strengths":["Validated impulsivity scale (BIS‑11)","Reasonable sample size for case‑control design","Multivariable adjustment for education"],"limitations":["ICD questionnaires not described as validated","No assessment of key psychosocial confounds (e.g., mental health, moral factors)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11102-026-01728-z"}},{"id":7228,"doi":"10.2105/ajph.2014.302402","pmid":"25790381","pmcid":"PMC4386535","title":"Transactional sex among men who have sex with men in Latin America: economic, sociodemographic, and psychosocial factors","authors":"Oldenburg CE, Perez-Brumer AG, Biello KB, Landers SJ, Rosenberger JG, Novak DS, Mayer KH, Mimiaga MJ.","first_author":"Oldenburg CE","journal":"American journal of public health","year":2015,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large internet convenience sample of MSM (N=24,051) from Latin America; multilevel logistic regression analysis of self‑reported transactional sex and associated factors.","sample_n":24051,"sample_text":"24,051 respondents; 1,732 reported transactional sex in the past 12 months.","population":"men who have sex with men (MSM) recruited from an online social/sexual networking site in 17 Latin American countries (2012).","country":"Latin America (17 countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 24,000 Latin American gay and bisexual men, 7 % reported exchanging sex for money. Higher unemployment, HIV/STI infection, childhood sexual abuse, intimate‑partner violence, and higher sexual compulsivity were linked to greater odds of transactional sex.","clinical_takeaway":"Clinicians should screen for economic hardship, trauma, and compulsive sexual thoughts when working with MSM who engage in transactional sex.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Very large sample spanning many countries","Multilevel modeling accounts for country‑level variables","Includes structural, individual, and interpersonal predictors"],"limitations":["Cross‑sectional, cannot infer causality","Self‑report measures may be biased","No assessment of moral or religious factors"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":8,"contrasting":0,"mentioning":32,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2105/ajph.2014.302402"}},{"id":7229,"doi":"10.4081/aiua.2014.3.175","pmid":"25308579","pmcid":null,"title":"Diagnosis and treatment of participants of support groups for hypersexual disorder","authors":"Tierens E, Vansintejan J, Vandevoorde J, Devroey D.","first_author":"Tierens E","journal":"Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.pagepressjournals.org/index.php/aiua/article/download/aiua.2014.3.175/4201","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of support‑group members; 32 invited, 10 completed; questionnaire based on Kafka’s hypersexual disorder criteria.","sample_n":10,"sample_text":"32 invited, 10 completed questionnaires.","population":"Adults participating in hypersexual‑disorder support groups (self‑selected, treatment‑seeking).","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A tiny survey of 10 people in hypersexual‑disorder support groups found half met Kafka’s diagnostic criteria, but diagnosis and treatment practices were inconsistent and rarely followed guidelines.","clinical_takeaway":"Clinicians should verify hypersexual disorder diagnoses against standardized criteria and ensure evidence‑based treatment, rather than relying on self‑selected support‑group reports.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Direct assessment of proposed diagnostic criteria","Inclusion of treatment data"],"limitations":["Very small, self‑selected sample (N=10)","No validated measurement instruments reported","No control for key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":19,"max_possible":60,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":2,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4081/aiua.2014.3.175"}},{"id":7230,"doi":"10.1186/s12889-018-5180-8","pmid":"29486737","pmcid":"PMC5830065","title":"High HIV risk and syndemic burden regardless of referral source among MSM screening for a PrEP demonstration project in Toronto, Canada","authors":"Wilton J, Noor SW, Schnubb A, Lawless J, Hart TA, Grennan T, Fowler S, Maxwell J, Tan DHS.","first_author":"Wilton J","journal":"BMC public health","year":2018,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Screening","Hiv Risk","Prep","Syndemics","Gay Men And Other Men Who Have Sex With Men"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5830065","cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Open-label PrEP demonstration project; HIV risk and syndemic burden assessed among screened gbMSM; comparison by referral source (self vs provider).","sample_n":86,"sample_text":"86 men underwent screening; 60.5% self‑referrals, remainder provider‑referrals.","population":"gbMSM (gay, bisexual, other men who have sex with men) in Toronto, Canada; screened for PrEP eligibility (N≈86).","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among gay and bisexual men screened for an HIV‑prevention drug in Toronto, both self‑referred and provider‑referred participants showed similarly high HIV risk and comparable rates of depression, alcohol problems, drug use, and sexual compulsivity.","clinical_takeaway":"Self‑referral via online ads can effectively identify high‑risk men for PrEP, similar to community‑based referrals.","confidence":0.8,"topic_tags":["prevalence","sexual_function"],"strengths":["Use of validated HIV risk index (HIRI‑MSM)","Inclusion of multiple syndemic health indicators","Comparison of two real‑world referral pathways"],"limitations":["Small sample; limited power to detect differences","Cross‑sectional design; no causal inference","No measurement of moral or relational confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-018-5180-8"}},{"id":7231,"doi":"10.1016/0924-9338(96)80304-x","pmid":"19698350","pmcid":null,"title":"Response of clomipramine in sexual addiction","authors":"Azhar M, Varma S.","first_author":"Azhar M","journal":"European psychiatry : the journal of the Association of European Psychiatrists","year":1995,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Two clinical cases of long‑standing sexual addiction treated with clomipramine plus psychotherapy; outcomes reported descriptively after 6–9 months.","sample_n":2,"sample_text":"Two cases","population":"Adults with self‑identified sexual addiction (n=2).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational","circular_addiction_scale"],"stance":"supports","citation_value":"background","plain_summary":"The authors describe two people who had long‑standing sexual addiction and improved after taking the antidepressant clomipramine together with therapy. They suggest the problem may be a form of obsessive‑compulsive disorder.","clinical_takeaway":"No evidence that clomipramine reliably treats sexual addiction; the report is anecdotal.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Long‑term clinical observation","Attempts to link sexual addiction to OCD phenotype"],"limitations":["Only two participants; no control group","No validated assessment instruments","No systematic measurement of confounds (e.g., moral incongruence, mental health)","Conclusions about efficacy are speculative"],"rubric_version":"2.0","raw_total":11,"max_possible":60,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":2,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0924-9338(96)80304-x"}},{"id":7232,"doi":"10.1186/s12879-016-2132-8","pmid":"28061819","pmcid":"PMC5219803","title":"Association between a syndemic of psychosocial problems and unprotected anal intercourse among men who have sex with men in Shanghai, China","authors":"Wang Y, Wang Z, Jia M, Liang A, Yuan D, Sun Z, Gan F, Wang Y, Cai Y, Zhang Z.","first_author":"Wang Y","journal":"BMC infectious diseases","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["MSM","Psychosocial Problems","Syndemic"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5219803","cited_by_count":27,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 547 MSM recruited via face‑to‑face interviews in Shanghai; logistic regression used to examine associations between validated psychosocial scales and unprotected anal intercourse.","sample_n":547,"sample_text":"547 MSM recruited through face‑to‑face interviews; convenience sample, not nationally representative.","population":"Men who have sex with men (MSM) in Shanghai, China (N = 547)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 547 gay and bisexual men in Shanghai, more psychological problems such as low self‑esteem, anxiety, depression, loneliness and sexual compulsivity were linked to a higher likelihood of having unprotected anal sex, suggesting that mental‑health issues may drive risky sexual behaviour.","clinical_takeaway":"Addressing co‑occurring mental‑health problems may help reduce risky sex among MSM.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Use of validated psychometric instruments","Large sample for a single‑city study","Clear syndemic analytic approach"],"limitations":["Cross‑sectional design limits causal inference","Convenience sampling reduces generalisability","Key sexual‑health confounds (e.g., partner status, trauma) not assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":25,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12879-016-2132-8"}},{"id":7233,"doi":"10.1093/jsxmed/qdae058","pmid":"38778740","pmcid":null,"title":"Early traumatic experiences are linked to hypersexual behavior and erectile dysfunction in men through the mediation of body uneasiness and general psychopathology","authors":"Cassioli E, Tarchi L, Rossi E, Faldi M, Dani C, Giuranno G, Siviglia S, Baroncelli A, Maggi M, Vignozzi L, Giraldi A, Ricca V, Castellini G.","first_author":"Cassioli E","journal":"The journal of sexual medicine","year":2024,"pub_types":["Journal Article","Observational Study"],"keywords":["erectile dysfunction","Psychopathology","Hypersexuality","Childhood Trauma","Body Uneasiness"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational cross‑sectional survey of 317 men (clinical ED patients and community sample) using self‑report questionnaires and structural equation modelling","sample_n":317,"sample_text":"116 men with erectile dysfunction recruited from a clinic and 201 men from the general population","population":"adult men (clinical ED patients and general population)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 317 men, childhood trauma was linked to more hypersexual behaviour and erectile problems, and this association was explained by higher body uneasiness and general psychological distress.","clinical_takeaway":"Assess trauma history and body‑related anxiety when treating men with erectile dysfunction or hypersexual behaviour.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Validated multi‑item questionnaires for all key constructs","Large combined sample including clinical and community participants","Use of structural equation modelling to test mediation pathways"],"limitations":["Cross‑sectional design cannot establish causality","No measurement of moral incongruence or masturbation frequency","Potential selection bias in clinical ED sample"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdae058"}},{"id":7235,"doi":"10.1002/mds.26522","pmid":"26695691","pmcid":null,"title":"Accuracy of screening instruments for detection of neuropsychiatric syndromes in Parkinson's disease","authors":"Martinez-Martin P, Leentjens AF, de Pedro-Cuesta J, Chaudhuri KR, Schrag AE, Weintraub D.","first_author":"Martinez-Martin P","journal":"Movement disorders : official journal of the Movement Disorder Society","year":2016,"pub_types":["Systematic Review","Journal Article"],"keywords":["Screening","Instruments","Accuracy","Parkinson's Disease","Neuropsychiatric Symptoms"],"is_oa":false,"oa_url":null,"cited_by_count":55,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"quasi-systematic review of screening instruments for neuropsychiatric syndromes in Parkinson's disease, no risk‑of‑bias assessment of included studies","sample_n":null,"sample_text":"Not applicable – review of published validation studies","population":"people with Parkinson's disease; screening for depression, anxiety, apathy, psychosis, impulse‑control disorders and hypersexuality","country":"Not reported (international literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The paper reviews which questionnaires work best for spotting depression, anxiety, apathy, psychosis, impulse‑control problems and hypersexuality in people with Parkinson's disease, noting that most scales are adequate except for psychosis.","clinical_takeaway":"Use validated Parkinson‑specific scales for most neuropsychiatric symptoms; a dedicated tool is still needed for psychosis.","confidence":0.6,"topic_tags":["neuroscience"],"strengths":["Comprehensive overview of existing screening tools","Identifies gaps (e.g., lack of psychosis scale)","Relevant for clinicians caring for Parkinson's patients"],"limitations":["No quality appraisal of included validation studies","No quantitative synthesis or meta‑analysis","Does not address potential confounds like moral incongruence for hypersexuality"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":50,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mds.26522"}},{"id":7236,"doi":null,"pmid":"21446273","pmcid":null,"title":"The truth about sex addiction","authors":"Cloud J.","first_author":"Cloud J.","journal":"Time","year":2011,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":7237,"doi":"10.1136/bmjment-2024-300998","pmid":"38777563","pmcid":"PMC11116864","title":"Hypersexuality in neurological disorders: A systematic review","authors":"Tayim N, Barbosa P, Panicker J.","first_author":"Tayim N","journal":"BMJ mental health","year":2024,"pub_types":["research-article","Systematic Review","Journal Article"],"keywords":["Impulse Control Disorders","Sexual And Gender Disorders"],"is_oa":true,"oa_url":"https://doi.org/10.1136/bmjment-2024-300998","cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 79 studies (32,662 patients) on hypersexuality in neurological disorders; PROSPERO‑registered protocol; extracted demographics, assessment tools, phenotypes, and management; noted methodological deficits.","sample_n":32662,"sample_text":"79 studies encompassing 81 cohorts; total N ≈ 32,662 patients.","population":"Patients with various neurological disorders (mostly Parkinson’s disease and dementia) who experienced hypersexuality.","country":"Not specified (multiple studies).","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review summarises research on excessive sexual thoughts and behaviours (hypersexuality) in people with brain disorders such as Parkinson’s disease. It finds that studies use many different, often unstandardised questionnaires and that the neurobiology is thought to involve dopamine, but overall the evidence is limited and varied.","clinical_takeaway":"Clinicians should note that hypersexuality can occur with neurological disease, but current assessment tools lack standardisation; treatment decisions must consider individual patient context.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["PROSPERO‑registered systematic review protocol.","Large cumulative sample across many neurological conditions.","Comprehensive extraction of assessment methods and management strategies."],"limitations":["Heterogeneous, often non‑validated questionnaires for hypersexuality.","No systematic control for key confounds (moral incongruence, mental health, partner effects).","Risk of selection bias and lack of blinded outcome assessment in included studies."],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjment-2024-300998"}},{"id":7238,"doi":"10.1177/070674371305800502","pmid":"23756285","pmcid":null,"title":"Phenomenology and treatment of behavioural addictions","authors":"Grant JE, Schreiber LR, Odlaug BL.","first_author":"Grant JE","journal":"Canadian journal of psychiatry. Revue canadienne de psychiatrie","year":2013,"pub_types":["Review","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Treatment","Gambling","Internet Use","Impulse Control","Binge Eating","Pyromania","Kleptomania","Compulsive Sexual Behaviour"],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods or risk‑of‑bias assessment","sample_n":null,"sample_text":"n/a","population":"n/a","country":"n/a","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews a range of behavioural addictions—including compulsive sexual behaviour—describing their symptoms and noting that few rigorous studies have tested treatments, so no firm clinical recommendations can be made.","clinical_takeaway":"There is currently insufficient evidence to endorse specific pharmacological or psychological treatments for compulsive sexual behaviour.","confidence":0.7,"topic_tags":["sexual_function","csbd","treatment","pornography","masturbation"],"strengths":["Broad overview of behavioural addictions","Identifies gaps in treatment evidence"],"limitations":["Non‑systematic narrative review","No empirical data or meta‑analytic synthesis","Lacks explicit methodology or bias assessment"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":46,"citing_publications":85,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/070674371305800502"}},{"id":7239,"doi":"10.2466/pr0.1996.79.1.257","pmid":"8873813","pmcid":null,"title":"On-line sexual addiction: a contemporary enigma","authors":"Bingham JE, Piotrowski C.","first_author":"Bingham JE","journal":"Psychological reports","year":1996,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-series of a treatment group for 'cybersex' addiction, no control group, no systematic methodology","sample_n":null,"sample_text":"treatment‑seeking individuals from a 'cybersex' group; likely self‑selected","population":"participants in an on‑line sexual addiction treatment group (unspecified number)","country":"USA (assumed from authors’ affiliations, not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The 1996 article describes a treatment group for ‘cybersex’ addiction, noting that online bulletin boards host sexual material. It provides a narrative discussion without systematic data or validated measures.","clinical_takeaway":"The paper offers no evidence‑based guidance; clinicians should rely on newer, methodologically sound research.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Highlights early discussion of online sexual behaviour","Raises clinical awareness of emerging phenomena"],"limitations":["No empirical data or validated measures","No control or comparison group","Constructs not operationalised; circular definition of addiction"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2466/pr0.1996.79.1.257"}},{"id":7241,"doi":"10.1097/00004850-200207000-00008","pmid":"12131605","pmcid":null,"title":"Treatment of compulsive sexual behaviour with naltrexone and serotonin reuptake inhibitors: two case studies","authors":"Raymond NC, Grant JE, Kim SW, Coleman E.","first_author":"Raymond NC","journal":"International clinical psychopharmacology","year":2002,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":54,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Two clinical case reports of individuals with compulsive sexual behaviour treated with naltrexone (and SSRIs).","sample_n":2,"sample_text":"Two cases (one male, one female) described in detail.","population":"Adults with CSB, treatment‑seeking (clinic sample).","country":"Not specified (likely USA).","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe two patients with compulsive sexual behaviour who showed marked improvement after taking the opioid blocker naltrexone, suggesting it might help similar cases, though the evidence is limited to two anecdotal reports.","clinical_takeaway":"Naltrexone may reduce urges in CSB, but evidence is still anecdotal; clinicians should await larger, controlled studies before routine use.","confidence":0.7,"topic_tags":["treatment","neuroscience","csbd","sexual_function"],"strengths":["Provides detailed clinical narrative of treatment response","Highlights a novel pharmacological approach for CSB"],"limitations":["No validated outcome measures; reliance on subjective report","No control condition or systematic assessment of confounds","Sample size of two; findings not generalizable"],"rubric_version":"2.0","raw_total":8,"max_possible":60,"pct_score":13,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":1,"interpretation":2}},"scite":{"supporting":2,"contrasting":1,"mentioning":58,"citing_publications":98,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00004850-200207000-00008"}},{"id":7242,"doi":"10.1101/2023.02.05.527198","pmid":null,"pmcid":null,"title":"Pramipexole restores behavioral inhibition in highly impulsive rats through a paradoxical modulation of frontostriatal networks","authors":"Magnard R, Fouyssac M, Vachez YM, Cheng Y, Dufourd T, Carcenac C, Boulet S, Janak PH, Savasta M, Belin D, Carnicella S.","first_author":"Magnard R","journal":"bioRxiv","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.biorxiv.org/content/biorxiv/early/2023/08/05/2023.02.05.527198.full.pdf","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"preclinical animal experiment with pharmacological manipulation and molecular assays","sample_n":null,"sample_text":"Not reported in abstract; groups of high, moderate, and low impulsive rats were used","population":"male rats classified by impulsivity levels (high, moderate, low) using the 5‑choice serial reaction time task","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In male rats that are very impulsive, the dopamine drug pramipexole reduced impulsive actions and altered activity‑related gene expression in frontostriatal brain regions, suggesting it can restore behavioral control.","clinical_takeaway":"Findings are pre‑clinical; no direct clinical implications for human hypersexuality or pornography use.","confidence":0.7,"topic_tags":["prevalence"],"strengths":["Validated behavioral assay for impulsivity (5‑CSRTT)","Molecular verification of neural activity (c‑fos, Zif268)","Clear pharmacological manipulation with dose‑response relevance"],"limitations":["No human data; translational relevance uncertain","Sample size not disclosed in abstract","No pre‑registration or open data"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":5,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2023.02.05.527198"}},{"id":7243,"doi":"10.1016/j.jns.2013.05.013","pmid":"23735774","pmcid":null,"title":"Impulsive compulsive behaviors in Japanese Parkinson's disease patients and utility of the Japanese version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease","authors":"Tanaka K, Wada-Isoe K, Nakashita S, Yamamoto M, Nakashima K.","first_author":"Tanaka K","journal":"Journal of the neurological sciences","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Compulsive Sexual Behavior","Pathological Gambling","Compulsive Buying","Punding","Compulsive Eating","Dopamine Dysregulation Syndrome"],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire validation and prevalence study (N≈121)","sample_n":121,"sample_text":"J‑QUIP administered to 118 of 121 PD patients","population":"Japanese Parkinson's disease patients (age 65‑85, community/clinic)","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated and tested a questionnaire for impulsive‑compulsive disorders in Japanese Parkinson’s patients, finding that 3‑7% showed compulsive sexual behavior and other related problems, linked to younger age, longer disease, and higher levodopa dose.","clinical_takeaway":"Clinicians should screen Parkinson’s patients for compulsive sexual behavior, especially those with higher levodopa exposure.","confidence":0.85,"topic_tags":["csbd","sexual_function","neuroscience"],"strengths":["Validated instrument adapted for Japanese population","Combined self‑report with clinical interview","Provides prevalence data for multiple ICBs in PD"],"limitations":["Cross‑sectional; cannot infer causality","Small numbers of specific ICBs limit subgroup analyses","No control for psychological or moral confounds"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":3,"contrasting":4,"mentioning":63,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jns.2013.05.013"}},{"id":7244,"doi":"10.3389/fpsyt.2017.00053","pmid":"28439243","pmcid":"PMC5383701","title":"Relationships between Behavioural Addictions and Psychiatric Disorders: What Is Known and What Is Yet to Be Learned?","authors":"Starcevic V, Khazaal Y.","first_author":"Starcevic V","journal":"Frontiers in psychiatry","year":2017,"pub_types":["brief-report","Journal Article"],"keywords":["Pathological Gambling","Internet Addiction","Compulsive Buying","Exercise Addiction","Behavioural Addiction","Problematic Internet Use","Problematic Online Gaming","Compulsive Sexual Behaviour Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5383701","cited_by_count":68,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without original empirical data","sample_n":null,"sample_text":"N/A (review article)","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews how various behavioural addictions—including compulsive sexual behaviour—relate to mental‑health disorders, noting that most evidence comes from small, cross‑sectional, self‑report studies and that causality is unclear.","clinical_takeaway":"Treatments may need to consider co‑occurring psychiatric issues, but current evidence cannot determine cause‑and‑effect relationships.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function","csbd"],"strengths":["Comprehensive overview of multiple behavioural addictions","Clearly acknowledges methodological limitations of the literature"],"limitations":["No original data; relies on heterogeneous primary studies","Cross‑sectional/correlational nature of cited research limits causal inference","Lacks systematic review methodology (no risk‑of‑bias assessment)"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":94,"citing_publications":134,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2017.00053"}},{"id":7245,"doi":"10.1097/jcp.0b013e318285689d","pmid":"23422389","pmcid":null,"title":"Episodic sexual addiction in a depressed woman treated with cyproterone acetate","authors":"Dardennes R, Al Anbar N, Rouillon F.","first_author":"Dardennes R","journal":"Journal of clinical psychopharmacology","year":2013,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/jcp.0b013e318285689d"}},{"id":7246,"doi":"10.1080/00918369.2026.2686443","pmid":"42319777","pmcid":null,"title":"\"Used Only to Fulfill a Fantasy\": A Systematic Review of the Fetishization and Sexual Objectification Experiences of Queer Identifying People","authors":"Kidd A, Barrington T, Bradley T.","first_author":"Kidd A","journal":"Journal of homosexuality","year":2026,"pub_types":["Journal Article"],"keywords":["Mental health","Sexual Minority","Queer","Sexual Objectification","Gender Minority","Fetishization","Lgbtqia+ Health"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"qualitative systematic review using thematic analysis of 32 studies","sample_n":32,"sample_text":"32 qualitative studies (majority US) included in synthesis","population":"queer-identifying people (various sexual and gender minorities)","country":"United States (most studies)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 32 studies shows queer people often experience fetishization and sexual objectification, especially from cis‑heterosexual men, affecting health, relationships, and self‑view. The authors call for broader recognition beyond cis‑women.","clinical_takeaway":"Clinicians should be aware that queer clients may face objectification‑related stress and tailor support accordingly.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Systematic search across three databases","Inclusion of diverse queer identities","Thematic synthesis provides nuanced insight"],"limitations":["Predominantly US‑based studies limit generalisability","Lack of quantitative synthesis or risk‑of‑bias assessment","No validated measurement of fetishization/objectification"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2026.2686443"}},{"id":7247,"doi":"10.21203/rs.3.rs-104593/v1","pmid":null,"pmcid":null,"title":"Development of a Structure-Validated Hypersexuality Scale in Chinese University Students","authors":"Jia Y, Shao X, Shen C, Wang W.","first_author":"Jia Y","journal":"Research Square","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-104593/v1.pdf?c=1605726815000","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"questionnaire development, exploratory factor analysis, convenience sample of 282 heterosexual university students who reported at least one hypersexual episode","sample_n":282,"sample_text":"282 heterosexual university students","population":"Chinese university students (heterosexual, self‑reported hypersexual experience)","country":"China","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created a new 20‑item Hypersexuality Scale for Chinese university students, identifying five sub‑areas such as negative impact and emotional coping. The questionnaire showed a stable factor structure, but it was tested only in a self‑selected student group.","clinical_takeaway":"The scale may aid clinicians in assessing hypersexual traits, but further validation in diverse clinical samples is needed.","confidence":0.7,"topic_tags":["measurement","sexual_function"],"strengths":["Large (N>250) sample for scale development","Rigorous exploratory factor analysis and structural equation modeling","Five theoretically informed subscales"],"limitations":["Convenience, self‑selected student sample limits generalisability","No external validation or criterion‑related validity reported","Potential overlap of distress and behaviour not disentangled"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-104593/v1"}},{"id":7248,"doi":"10.1007/s10508-015-0514-4","pmid":"25795530","pmcid":null,"title":"Behavioral and psychosocial correlates of anal sex among male clients of female sex workers in Tijuana, Mexico","authors":"Semple SJ, Strathdee SA, Pitpitan EV, Chavarin C, Patterson TL.","first_author":"Semple SJ","journal":"Archives of sexual behavior","year":2015,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 400 male clients of female sex workers in Tijuana/San Diego, logistic regression analysis","sample_n":400,"sample_text":"N = 400 male clients, recruited from venues in Tijuana and San Diego County","population":"HIV‑negative male clients of female sex workers, predominantly Latino, average age 38","country":"Mexico / United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 400 male clients of female sex workers in Tijuana, about half reported having anal sex with a sex worker in the past four months, and most did so without a condom. Anal sex was linked to being bisexual, using meth with sex workers, seeing the same worker repeatedly, feeling stigmatized, and higher sexual compulsivity.","clinical_takeaway":"Clients who are bisexual, use meth, or feel stigmatized may need targeted counseling to reduce condomless anal sex risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample (N=400) for a hard‑to‑reach population","Focused on an understudied risk behaviour (anal sex with FSWs)","Uses multivariate logistic regression to identify independent correlates"],"limitations":["Cross‑sectional design cannot infer causality","Convenience sample limits generalisability","Limited detail on measurement validity (e.g., sexual compulsivity scale)","Key psychosocial confounds (e.g., mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0514-4"}},{"id":7249,"doi":"10.1016/j.psc.2008.07.002","pmid":"18996298","pmcid":null,"title":"Developmental psychopathological perspectives on sexually compulsive behavior","authors":"Schwartz MF.","first_author":"Schwartz MF.","journal":"The Psychiatric clinics of North America","year":2008,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review; no new data collection; discussion of developmental factors related to sexually compulsive behavior.","sample_n":null,"sample_text":"Not applicable (review article).","population":"Adults with varied psychiatric histories; no specific sample described.","country":"United States (journal of North America; author affiliation not specified).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews how early life experiences—such as trauma, attachment problems, and social isolation—might lead to sexually compulsive behaviors later in life, proposing a developmental pathway without presenting new data.","clinical_takeaway":"Clinicians should consider a client’s developmental history when assessing compulsive sexual behavior, but this review offers no direct treatment guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive synthesis of developmental literature","Integrates multiple theoretical perspectives"],"limitations":["Lacks empirical data; conclusions not testable","No systematic review methodology reported","Potential bias toward pathology without balanced critique"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psc.2008.07.002"}},{"id":7252,"doi":"10.1080/00224499.2026.2684495","pmid":"42295206","pmcid":null,"title":"Attachment Anxiety and Avoidance in Dysregulated Sexuality and the Role of Mentalizing Ability","authors":"Gaertner LHC, Reininger KM, Briken P.","first_author":"Gaertner LHC","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience survey; participants classified by self‑reported sex drive; questionnaires on attachment, mentalizing, sexual desire, hypersexual behavior; mediation analyses","sample_n":1915,"sample_text":"N≈1915 (221 women & 732 men high drive; 680 women & 262 men low drive)","population":"adult men and women recruited via the internet (N≈1915) – not a probability sample","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that people with insecure attachment styles tend to report more hypersexual behavior, and that a better ability to understand others’ mental states (mentalizing) partly explains this link. The pattern differed somewhat between men and women and between high and low sexual desire groups.","clinical_takeaway":"Consider attachment style and mentalizing skills when assessing hypersexual behaviour; interventions targeting mentalizing may help.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large overall sample","use of established questionnaire measures","exploratory mediation analysis adds theoretical insight"],"limitations":["cross‑sectional design limits causal inference","no control for key confounds (moral incongruence, mental‑health, etc.)","online convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2026.2684495"}},{"id":7254,"doi":"10.1080/13691058.2026.2685148","pmid":"42283504","pmcid":null,"title":"Waiting and wanting to desire: the sexual lives of migrant men in transit","authors":"Linthout L, Derluyn I, Desombre C, Benbouriche M, Keygnaert I.","first_author":"Linthout L","journal":"Culture, health & sexuality","year":2026,"pub_types":["Journal Article"],"keywords":["Sexuality","Migration","Men","Sexual Practices","Transit Migration"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"In‑depth interviews with 39 migrant men in Brussels and Calais; participant observation; cross‑sectional.","sample_n":39,"sample_text":"39 migrant men, recruited through NGOs/field contacts in Brussels and Calais.","population":"Migrant men in transit (convenience sample, not representative).","country":"Belgium/France (Europe)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 39 men migrating through Europe show their sexual desires are shaped by legal insecurity, material hardship, and cultural‑religious constraints. Men use occasional encounters, abstinence, or self‑restraint to manage unmet intimacy needs, contradicting stereotypes of migrant hypersexuality.","clinical_takeaway":"None – study provides sociocultural insight, not clinical guidance on sexual health or addiction.","confidence":0.7,"topic_tags":["moral_incongruence","sexual_function"],"strengths":["Rich, context‑rich qualitative data","Highlights under‑studied population","Challenges stereotypical narratives of migrant hypersexuality"],"limitations":["Small, non‑representative convenience sample","No validated measurement instruments","No systematic control of potential confounds"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2026.2685148"}},{"id":7255,"doi":"10.1176/appi.neuropsych.20250144","pmid":"42277579","pmcid":null,"title":"The Neuropsychiatric Phenotype of Klüver-Bucy Syndrome: A Systematic Review of Reported Cases","authors":"Muñoz JF, Ramírez-Bermúdez J, Peña-Casanova J, Restrepo D, Gómez-Henk C, Ricardo Muñoz J, Restrepo-Martínez M.","first_author":"Muñoz JF","journal":"The Journal of neuropsychiatry and clinical neurosciences","year":2026,"pub_types":["Journal Article"],"keywords":["Neuropsychiatry","Kluver-bucy Syndrome","Hyperorality","Hyperphagia, Hypersexuality"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review of case reports/series without meta‑analysis or risk‑of‑bias assessment; limited generalisability","sample_n":157,"sample_text":"157 cases from 141 articles","population":"157 patients with Klüver‑Bucy syndrome reported in case reports","country":"multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors reviewed 157 reported cases of Klüver‑Bucy syndrome, a rare brain disorder that often includes hypersexuality. They found that hypersexuality, hyperorality and hyperphagia are the most common symptoms, and most patients have bilateral temporal‑lobe damage. The review highlights the need for validated diagnostic criteria.","clinical_takeaway":"Hypersexuality in KBS is linked to temporal‑lobe lesions; clinicians should assess brain injury when such symptoms appear.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["Comprehensive systematic search across multiple databases","Large aggregation of rare KBS cases","Identification of variability in hypersexuality presentation"],"limitations":["Reliance on heterogeneous case reports with unstandardised symptom assessment","No quantitative meta‑analysis or bias assessment","Neuroimaging data are descriptive, not systematically analysed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.neuropsych.20250144"}},{"id":7256,"doi":"10.1111/jsm.12843","pmid":"25676099","pmcid":null,"title":"Trait sexual motivation questionnaire: concept and validation","authors":"Stark R, Kagerer S, Walter B, Vaitl D, Klucken T, Wehrum-Osinsky S.","first_author":"Stark R","journal":"The journal of sexual medicine","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual Desire","Sexual Motivation","Retest Reliability","Trait Sexual Motivation"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"instrument development with exploratory (n=256) and confirmatory (n=498) samples plus 1‑year test‑retest (n=59)","sample_n":498,"sample_text":"Two large community samples (n=256; n=498) and a smaller retest sample (n=59)","population":"adults (both sexes), community sample","country":"Germany (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a questionnaire (TSMQ) that measures people’s long‑term sexual motivation across four areas, showing good reliability and factor structure in large adult samples.","clinical_takeaway":"The TSMQ offers a reliable tool for assessing trait sexual motivation in research or clinical settings.","confidence":0.7,"topic_tags":["sexual_function","measurement"],"strengths":["Large sample for factor analysis","Confirmatory validation in independent sample","High 1‑year test‑retest reliability (r=0.87)"],"limitations":["No external validation against clinical criteria","No pre‑registration or open data","Limited assessment of potential confounds (e.g., mental health, moral variables)"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12843"}},{"id":7257,"doi":"10.1016/j.parkreldis.2012.10.017","pmid":"23176749","pmcid":null,"title":"Screening hypersexuality in Parkinson's disease in everyday practice","authors":"Pereira B, Llorca PM, Durif F, Brousse G, Blanc O, Rieu I, Derost P, Ulla M, Debilly B, de Chazeron I.","first_author":"Pereira B","journal":"Parkinsonism & related disorders","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a short screening questionnaire administered to 159 Parkinson’s disease patients","sample_n":159,"sample_text":"159 PD patients recruited from clinical settings","population":"patients with Parkinson’s disease (N=159)","country":"France (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created a five‑item questionnaire (PD‑SAST) to quickly screen for hypersexual behaviour in people with Parkinson’s disease. Tested in 159 patients, it showed strong reliability and accurately distinguished those with hypersexuality.","clinical_takeaway":"The PD‑SAST is a brief, reliable tool clinicians can use to identify hypersexuality in Parkinson’s patients.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large PD sample for instrument validation","Factor analysis and ROC demonstrate good psychometric properties","Brief 5‑item tool suitable for routine clinical use"],"limitations":["No external validation in independent cohort","Potential circularity in using SAST items that conflate distress with addiction","Confounding factors such as depression, dopaminergic medication, or relationship status not controlled"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":4,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2012.10.017"}},{"id":7260,"doi":"10.1080/09540121003758648","pmid":"21154035","pmcid":"PMC3082496","title":"Psychosexual and social-cognitive correlates of sexual risk behavior among male clients of female sex workers in Tijuana, Mexico","authors":"Semple SJ, Strathdee SA, Gallardo Cruz M, Robertson A, Goldenberg S, Patterson TL.","first_author":"Semple SJ","journal":"AIDS care","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 300 male clients of female sex workers in Tijuana, Mexico","sample_n":300,"sample_text":"Convenience sample recruited from venues where clients meet sex workers, June–Oct 2008","population":"male clients of female sex workers (N≈300)","country":"Mexico","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 300 men who pay for sex in Tijuana, higher sexual‑compulsivity scores, lower condom‑use confidence, drug use and financial strain were linked to more unprotected sex with female sex workers.","clinical_takeaway":"Addressing sexual compulsivity, drug use, and self‑efficacy may help reduce risky sex among clients of sex workers.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a hard‑to‑reach population","Use of a validated sexual compulsivity scale","Multivariate regression controlling for several relevant variables"],"limitations":["Cross‑sectional design limits causal inference","Convenience sample of high‑risk clients limits generalisability","Key psychosocial confounds (moral incongruence, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540121003758648"}},{"id":7261,"doi":"10.1080/00926230701636197","pmid":"18224548","pmcid":null,"title":"Alexithymia, emotional instability, and vulnerability to stress proneness in patients seeking help for hypersexual behavior","authors":"Reid RC, Carpenter BN, Spackman M, Willes DL.","first_author":"Reid RC","journal":"Journal of sex & marital therapy","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":77,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"N = 120 treatment‑seeking individuals completed self‑report questionnaires (Sexual Compulsivity Scale, TAS‑20, NEO‑PI‑R) at intake; hierarchical regression analysis was performed.","sample_n":120,"sample_text":"120 treatment‑seeking individuals","population":"adult patients (both sexes) seeking help for hypersexual behavior at an outpatient community clinic","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 120 adults seeking help for hypersexual behaviour, higher levels of alexithymia (difficulty identifying feelings) and greater stress vulnerability were linked to more severe sexual compulsivity. Mood and personality factors also contributed.","clinical_takeaway":"Clinicians might consider assessing emotional‑processing difficulties when treating hypersexual behaviour.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Validated psychometric instruments (SCS, TAS‑20, NEO‑PI‑R)","Reasonable sample size for regression analysis","Clear hierarchical regression model"],"limitations":["Cross‑sectional, cannot infer causality","Treatment‑seeking convenience sample limits generalisability","No assessment of moral incongruence, masturbation, partner or trauma variables"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":9,"contrasting":2,"mentioning":77,"citing_publications":145,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230701636197"}},{"id":7262,"doi":"10.1007/s10508-015-0488-2","pmid":"26159862","pmcid":null,"title":"High prevalence of multiple syndemic conditions associated with sexual risk behavior and HIV infection among a large sample of Spanish- and Portuguese-speaking men who have sex with men in Latin America","authors":"Mimiaga MJ, Biello KB, Robertson AM, Oldenburg CE, Rosenberger JG, O'Cleirigh C, Novak DS, Mayer KH, Safren SA.","first_author":"Mimiaga MJ","journal":"Archives of sexual behavior","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":68,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of MSM members of a social/sexual networking site; n=24,274; cross‑sectional logistic GEE analyses","sample_n":24274,"sample_text":"large convenience sample recruited via the largest MSM networking website in Latin America","population":"Spanish‑ and Portuguese‑speaking men who have sex with men (MSM) in Latin America","country":"Latin America (multiple countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 24,000 Latin‑American MSM, having more co‑occurring psychosocial problems (e.g., depression, substance use, trauma) was linked to higher odds of condomless anal sex and HIV infection.","clinical_takeaway":"Multiple psychosocial stressors together elevate HIV risk in MSM; interventions should address co‑occurring conditions.","confidence":0.82,"topic_tags":["sexual_function"],"strengths":["Very large sample size","Use of multivariable GEE with confidence intervals","Comprehensive assessment of multiple psychosocial factors"],"limitations":["Convenience online recruitment limits generalisability","Cross‑sectional design precludes causal inference","Unclear whether all psychosocial measures were validated"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":3,"mentioning":66,"citing_publications":78,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0488-2"}},{"id":7264,"doi":"10.3402/snp.v2i0.11814","pmid":"24693342","pmcid":"PMC3960064","title":"Sexual addiction: insights from psychoanalysis and functional neuroimaging","authors":"Estellon V, Mouras H.","first_author":"Estellon V","journal":"Socioaffective neuroscience & psychology","year":2012,"pub_types":["review-article","Review","Journal Article"],"keywords":["Brain","fMRI","Sexual Affiliation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3960064","cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review integrating psychoanalytic theory with existing neuroimaging literature; no primary data collected.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review discusses how recent brain imaging studies of healthy and compulsive sexual behavior can be related to psycho‑analytic ideas, but it does not present new data or clear definitions of 'sexual addiction.'","clinical_takeaway":"None – the article is theoretical and does not provide actionable clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Interdisciplinary perspective linking psychoanalysis and neuroscience","Highlights emerging neuroimaging findings on sexual behavior"],"limitations":["No original empirical data","Lacks systematic literature search and bias assessment","No clear operational definitions or validated measures"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":12,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3402/snp.v2i0.11814"}},{"id":7265,"doi":"10.1089/lgbt.2015.0123","pmid":"27183232","pmcid":"PMC4976250","title":"Changes in Familiarity with and Willingness to Take Preexposure Prophylaxis in a Longitudinal Study of Highly Sexually Active Gay and Bisexual Men","authors":"Grov C, Rendina HJ, Whitfield TH, Ventuneac A, Parsons JT.","first_author":"Grov C","journal":"LGBT health","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["HIV","Preexposure Prophylaxis","Gay And Bisexual Men","Risk Compensation"],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Longitudinal cohort of 158 highly sexually active HIV‑negative gay and bisexual men in NYC, baseline and 12‑month follow‑up.","sample_n":158,"sample_text":"158 highly sexually active HIV‑negative GBM","population":"Highly sexually active gay and bisexual men (GBM), HIV‑negative, New York City, N=158","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 158 gay and bisexual men in NYC, knowledge about PrEP grew over a year, but interest in using it stayed the same. Beliefs that PrEP would lead to more condomless sex did not change, though many thought it would increase temptation. Those who already had condomless sex were more interested in PrEP.","clinical_takeaway":"Providers should discuss PrEP proactively, as familiarity rises but willingness may not, especially among men already engaging in condomless sex.","confidence":0.8,"topic_tags":["prevalence"],"strengths":["Longitudinal design allows assessment of change over time","Relatively large sample for this population","Addresses an important public‑health question (PrEP uptake and risk perception)"],"limitations":["Convenience sample of highly sexually active men limits generalisability","No measurement of key psychosocial confounds (e.g., moral views, mental health)","Limited detail on measurement tools and statistical methods in abstract"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":1,"mentioning":27,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/lgbt.2015.0123"}},{"id":7267,"doi":"10.1177/08830738261450262","pmid":"42153457","pmcid":null,"title":"Mania in Juvenile Neuronal Ceroid Lipofuscinosis (CLN3 Disease): A Rare Neuropsychiatric Presentation in an Adolescent","authors":"Sut E, Tutam DN.","first_author":"Sut E","journal":"Journal of child neurology","year":2026,"pub_types":["Journal Article"],"keywords":["Genetics","Epilepsy","Adolescents","Levetiracetam","Lysosomal Disease"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single adolescent case report with clinical description and genetic confirmation","sample_n":1,"sample_text":"1 patient (16‑year‑old girl)","population":"adolescent with CLN3 disease (n=1)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 16‑year‑old girl with a rare genetic brain disorder (CLN3 disease) experienced a manic episode that included hypersexual behaviour, meeting DSM‑5 criteria for mania. Treatment helped improve symptoms, suggesting mood monitoring is important in this condition.","clinical_takeaway":"Clinicians should watch for mood and sexual behaviour changes in adolescents with CLN3 disease.","confidence":0.7,"topic_tags":["neuroscience","gender","sexual_function"],"strengths":["Genetic confirmation of CLN3 disease","Detailed clinical description using DSM‑5 criteria","Identifies hypersexuality as part of a manic episode"],"limitations":["Single case; no generalisability","No validated sexual‑behavior scales","No systematic assessment of confounding factors"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08830738261450262"}},{"id":7270,"doi":"10.1007/s10508-013-0226-6","pmid":"24277109","pmcid":"PMC3891911","title":"Interest in couples-based voluntary HIV counseling and testing in a national U.S. sample of gay and bisexual men: the role of demographic and HIV risk factors","authors":"Rendina HJ, Breslow AS, Grov C, Ventuneac A, Starks TJ, Parsons JT.","first_author":"Rendina HJ","journal":"Archives of sexual behavior","year":2014,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online survey of 1,532 gay and bisexual men recruited via a sexual networking site; examined demographic and HIV‑risk correlates of interest in couples‑based voluntary HIV counseling and testing using logistic regression.","sample_n":1532,"sample_text":"National U.S. sample of gay and bisexual men recruited online through a sexual networking site (N=1,532).","population":"Gay and bisexual men in the United States (mostly internet users; convenience sample).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2014 U.S. online survey of 1,532 gay and bisexual men found that interest in couples‑based HIV testing varied mainly by demographics—single men and younger men of color showed the most interest—while HIV‑risk behaviours were less influential.","clinical_takeaway":"Offering couples‑based HIV counseling may be most effective when targeted to younger gay and bisexual men of color and those not currently in a relationship.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for a survey","Comprehensive set of demographic and HIV‑risk variables","Clear statistical modelling (logistic regression)"],"limitations":["Convenience online recruitment limits generalisability","No assessment of moral or psychosocial confounds","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0226-6"}},{"id":7272,"doi":"10.1016/j.prdoa.2026.100452","pmid":"42181799","pmcid":"PMC13191653","title":"Sexual dysfunction in movement disorders: prevalence, clinical features, associated factors and management","authors":"Leclercq V.","first_author":"Leclercq V.","journal":"Clinical parkinsonism & related disorders","year":2026,"pub_types":["review-article","Review","Journal Article"],"keywords":["Hypersexuality","Sexualdysfunction","Parkinson’sdisease","Movementdisorders","Dopamineagonists","Impulsecontroldisorders","Non-Motorsymptoms","Sexualhealth"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13191653","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review summarising prevalence, associated factors and management of sexual dysfunction in movement disorders; no systematic search or risk‑of‑bias assessment reported.","sample_n":null,"sample_text":"none (review article)","population":"patients with Parkinson’s disease and other movement disorders (no primary data collected)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises how movement‑disorder patients—especially those with Parkinson’s disease—experience a range of sexual problems, from low desire to hypersexuality, and notes that depression, age, motor disability, and dopamine medicines influence these issues.","clinical_takeaway":"Clinicians should routinely screen for sexual dysfunction in movement‑disorder patients and consider medication adjustments or PDE‑5 inhibitors when appropriate.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of sexual dysfunction subtypes across several movement disorders","Highlights bidirectional role of dopaminergic therapy","Identifies gaps in treatment evidence"],"limitations":["Narrative, not systematic; no explicit literature search strategy","No quantitative synthesis or meta‑analysis","No assessment of study quality or bias"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.prdoa.2026.100452"}},{"id":7276,"doi":"10.1590/s1516-44462012000200015","pmid":"22729419","pmcid":null,"title":"Severe compulsive sexual behaviors: a report on two cases under treatment","authors":"Amaral ML, Scanavino Mde T.","first_author":"Amaral ML","journal":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","year":2012,"pub_types":["Letter","Research Support, Non-U.S. Gov't","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s1516-44462012000200015"}},{"id":7277,"doi":"10.3389/fneur.2026.1791205","pmid":"42147847","pmcid":"PMC13171319","title":"Evaluating impulse control disorders in people with Parkinson's disease: agreement and added value of patient and caregiver reports","authors":"Staubo SC, Størset E, Toft M, Lie IH, Alvik KMJ, Jostad P, Tingvoll SH, Rosqvist K, Odin P, Dietrichs ES, Dietrichs E.","first_author":"Staubo SC","journal":"Frontiers in neurology","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Parkinson’s Disease","Caregivers","Impulse Control Disorders","Dopamine Agonist","Quip-rs"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13171319","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Patients with Parkinson's disease on dopamine agonists and their caregivers independently completed validated questionnaires (QUIP‑RS, ICDRC); scores compared statistically for agreement.","sample_n":null,"sample_text":"Not specified in abstract","population":"people with Parkinson's disease treated with dopamine agonists and their informal caregivers","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People with Parkinson’s disease and their caregivers filled out standard questionnaires about impulse‑control problems such as gambling, hypersexuality, and medication‑related behaviors. Their ratings were similar overall, but patients reported slightly higher scores on some issues, especially hypersexuality.","clinical_takeaway":"Clinicians should consider both patient and caregiver reports when assessing impulse‑control disorders in Parkinson’s disease, as they may differ modestly.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses validated impulse‑control disorder scales","Direct comparison of patient‑ and caregiver‑rated scores","Addresses possible under‑reporting by patients"],"limitations":["Sample size and recruitment method not reported","No control for relevant psychological or relational confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fneur.2026.1791205"}},{"id":7279,"doi":"10.3402/snp.v3i0.20770","pmid":"24693355","pmcid":"PMC3960022","title":"Sexual desire, not hypersexuality, is related to neurophysiological responses elicited by sexual images","authors":"Steele VR, Staley C, Fong T, Prause N.","first_author":"Steele VR","journal":"Socioaffective neuroscience & psychology","year":2013,"pub_types":["research-article","Journal Article"],"keywords":["Electroencephalography","Event-related potentials","P300","Sexual Desire","Sexual Motivation","Sex Addiction","Sexual Regulation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3960022","cited_by_count":44,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"EEG ERP study with self‑identified hypersexual participants (N=52) viewing sexual and control images; correlational analysis of P300 amplitudes.","sample_n":52,"sample_text":"Fifty‑two individuals who self‑identified as having problems regulating their viewing of visual sexual stimuli","population":"Adults (self‑identified as having problems regulating visual sexual stimuli), 13 female, recruited likely via community/online ads","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In an EEG study, people who said they struggled to control pornography use showed larger brain responses (P300) to sexual images when they reported higher sexual desire, but this response was unrelated to self‑rated “hypersexuality.” The findings suggest that strong desire, not an addictive disorder, may drive the brain’s reaction.","clinical_takeaway":"High sexual desire, not pathology, may explain heightened neural responses; assess desire before labeling behavior disordered.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["Use of objective neurophysiological measure (ERP)","Direct test of competing hypotheses (habituation vs high desire)","Clear operationalisation of stimulus conditions"],"limitations":["Convenience sample of self‑identified hypersexuals; not representative","No measurement/control of key confounds (moral incongruence, masturbation, mental health)","Reliance on unspecified self‑report scales for hypersexuality"],"rubric_version":"2.0","raw_total":32,"max_possible":70,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":6,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":7,"contrasting":0,"mentioning":54,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3402/snp.v3i0.20770"}},{"id":7280,"doi":"10.1080/13651501.2016.1197272","pmid":"27314569","pmcid":null,"title":"Depression in university students: associations with impulse control disorders","authors":"Leppink EW, Lust K, Grant JE.","first_author":"Leppink EW","journal":"International journal of psychiatry in clinical practice","year":2016,"pub_types":["Journal Article"],"keywords":["Depression","Health","Impulse Control Disorders","university students"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of university students (N=1717) grouped by depression severity; ANOVA, chi‑square, multinomial logistic regression","sample_n":1717,"sample_text":"6000 invited, 1717 completed scales of interest","population":"university students (USA likely), self‑selected respondents to online survey","country":"unspecified (likely USA/Europe based on journal)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 1717 university students, those with more severe depression were more likely to report compulsive sexual behaviour, skin‑picking and compulsive buying. The study suggests a link between mood problems and impulsive sexual habits, but cannot say which causes the other.","clinical_takeaway":"Screen for impulsive sexual behaviours when treating depressed students; consider shared impulsivity factors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large overall sample (N>1500)","Use of multinomial logistic regression to adjust for covariates","Focus on an understudied link (depression ↔ compulsive sexual behaviour)"],"limitations":["Cross‑sectional; cannot infer causality","Impulse‑control disorder measures not described; likely self‑report","Key confounds (moral incongruence, masturbation, trauma) not assessed","Small severe‑depression subgroup (N=75) limits power"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13651501.2016.1197272"}},{"id":7281,"doi":"10.1177/08919887231225481","pmid":"38156788","pmcid":null,"title":"Prevalence of and Factors Associated with Hypersexuality in Patients with Dementia: A Retrospective Cross-Sectional Study","authors":"Borges SQ, Camargos EF.","first_author":"Borges SQ","journal":"Journal of geriatric psychiatry and neurology","year":2024,"pub_types":["Journal Article"],"keywords":["Dementia","Hypersexuality","Behavioral Symptoms"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"retrospective chart review of 552 dementia patients from a secondary‑care centre (2015‑2019); 52 identified as hypersexual","sample_n":552,"sample_text":"Total N=552, hypersexual N=52 (9.3%)","population":"Patients with dementia (mixed aetiologies, including frontotemporal dementia)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a review of 552 dementia patients, about 9 % showed hypersexual behaviour. Men, frontotemporal dementia, and alcohol or tobacco use were linked to higher odds of this symptom.","clinical_takeaway":"Hypersexuality occurs in a minority of dementia patients, especially males with frontotemporal dementia; clinicians should monitor sexual behaviour in these groups.","confidence":0.8,"topic_tags":["prevalence","sexual_function","neuroscience"],"strengths":["Large overall sample for a clinical chart review","Provides prevalence estimate for an under‑studied symptom","Reports odds ratios with confidence intervals"],"limitations":["Hypersexuality defined without validated instrument","No control for key confounds (moral, mental health, partner effects)","Cross‑sectional, retrospective design limits causal inference","Single centre limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08919887231225481"}},{"id":7282,"doi":"10.2105/ajph.2012.300810","pmid":"23153154","pmcid":"PMC3518355","title":"Adversity and syndemic production among men participating in the multicenter AIDS cohort study: a life-course approach","authors":"Herrick AL, Lim SH, Plankey MW, Chmiel JS, Guadamuz TE, Kao U, Shoptaw S, Carrico A, Ostrow D, Stall R.","first_author":"Herrick AL","journal":"American journal of public health","year":2013,"pub_types":["research-article","Multicenter Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":106,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"cohort","sample_n":1551,"sample_text":"1551 men who have sex with men enrolled at four US sites","population":"MSM participants in the Multicenter AIDS Cohort Study (N=1551)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large US cohort of gay and bisexual men, past life‑events such as victimisation and internalised homophobia were linked to a cluster of health problems—including depression, stress, stimulant use, sexual compulsivity and partner violence—suggesting that these adversities combine to create a syndemic that harms overall health.","clinical_takeaway":"Clinicians should assess broader life‑course stressors and co‑occurring psychosocial issues when addressing sexual compulsivity in MSM.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, multisite cohort (N>1500)","Life‑course perspective on syndemic factors","Use of multivariate and negative‑binomial modelling"],"limitations":["No explicit measurement of moral incongruence or masturbation","Cross‑sectional analysis of outcomes within a longitudinal cohort","Effect sizes and confidence intervals not reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":1,"mentioning":128,"citing_publications":145,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2105/ajph.2012.300810"}},{"id":7285,"doi":"10.1177/0886260516645815","pmid":"27112507","pmcid":null,"title":"The Mediator Role of Early Maladaptive Schemas Between Childhood Sexual Abuse and Impulsive Symptoms in Female Survivors of CSA","authors":"Estévez A, Ozerinjauregi N, Herrero-Fernández D, Jauregui P.","first_author":"Estévez A","journal":"Journal of interpersonal violence","year":2019,"pub_types":["Journal Article"],"keywords":["Child Abuse","Sexual Abuse","Impulsivity","Early Maladaptive Schemas","Impulsive Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 182 adult female CSA survivors recruited via treatment‑focused associations; mediation analysis of self‑report impulsive‑behavior measures.","sample_n":182,"sample_text":"Adult female survivors of childhood sexual abuse, mostly referred by associations for the treatment of childhood abuse and maltreatment.","population":"adult women, CSA survivors (N=182)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 182 Spanish women who experienced childhood sexual abuse, the study found that certain maladaptive belief patterns linked abuse to higher impulsive behaviours—including alcohol use, gambling and ‘sex addiction’—with disconnection‑related schemas partly explaining the link to eating disorders and alcohol problems.","clinical_takeaway":"Early maladaptive schemas may help explain why some CSA survivors develop impulsive or addictive behaviours; targeting these schemas could be useful in therapy.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a CSA survivor study","Use of mediation analysis to explore psychological pathways","Addresses multiple impulsive‑behaviour domains"],"limitations":["Cross‑sectional design; cannot infer causality","Self‑selected treatment‑seeking sample limits generalisability","Impulsive‑behaviour and ‘sex addiction’ measured with likely non‑validated items","No control for moral incongruence, mental‑health or partner variables"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":19,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260516645815"}},{"id":7287,"doi":"10.1007/s10461-011-0048-2","pmid":"21964977","pmcid":"PMC5817984","title":"Stigma and sexual compulsivity in a community-based sample of HIV-positive gay and bisexual men","authors":"Rendina HJ, Golub SA, Grov C, Parsons JT.","first_author":"Rendina HJ","journal":"AIDS and behavior","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional street‑intercept survey of 127 HIV‑positive gay/bisexual men at LGBT events","sample_n":127,"sample_text":"127 participants recruited at two large‑scale LGBT community events","population":"HIV‑positive gay and bisexual men (community sample, convenience recruitment)","country":"USA","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among HIV‑positive gay and bisexual men surveyed at community events, having more recent male partners and feeling internalised HIV stigma were linked to higher sexual compulsivity scores.","clinical_takeaway":"Screen for internalised HIV stigma when addressing sexual compulsivity in HIV‑positive GBM.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses validated sexual compulsivity and stigma scales","Multivariate logistic regression (AOR) reported","Focus on understudied HIV‑positive GBM population"],"limitations":["Convenience sample from LGBT events; limited generalisability","Cross‑sectional; cannot infer causality","Key confounds (moral incongruence, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-011-0048-2"}},{"id":7289,"doi":"10.1080/02791072.2011.587390","pmid":"21858954","pmcid":"PMC3506393","title":"Correlates of trading sex for methamphetamine in a sample of HIV-negative heterosexual methamphetamine users","authors":"Semple SJ, Strathdee SA, Zians J, Patterson TL.","first_author":"Semple SJ","journal":"Journal of psychoactive drugs","year":2011,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational, cross‑sectional survey of 342 HIV‑negative heterosexual methamphetamine users recruited for a sexual‑risk reduction intervention; logistic regression used to identify correlates of trading sex for meth.","sample_n":342,"sample_text":"342 participants","population":"Adults (heterosexual men and women) using methamphetamine in San Diego, California; HIV‑negative; sample size = 342.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among heterosexual meth users, women, the homeless, binge users, recent sexual victims, those with very frequent anal sex, and people scoring higher on sexual compulsivity were more likely to trade sex for meth.","clinical_takeaway":"Risk assessments for meth users should include screening for sex‑trade, recent trauma, and sexual compulsivity.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample for a hard‑to‑reach population","Use of multivariable logistic regression","Inclusion of sexual‑compulsivity measure"],"limitations":["Cross‑sectional design limits causal inference","Key confounds (moral incongruence, masturbation, mental health) not assessed","Reliance on self‑report for sensitive behaviours"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":3,"mentioning":30,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/02791072.2011.587390"}},{"id":7290,"doi":"10.1002/mds.23845","pmid":"21735482","pmcid":null,"title":"Hypersexuality and pathological gambling in Parkinson's disease: A cross-sectional case-control study","authors":"de Chazeron I, Llorca PM, Chéreau-Boudet I, Blanc O, Perriot J, Ouchchane L, Ulla M, Debilly B, Derost P, Durif F.","first_author":"de Chazeron I","journal":"Movement disorders : official journal of the Movement Disorder Society","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://uca.hal.science/hal-02163399","cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case-control, matched on age and sex, N=115 total (PD and general population)","sample_n":115,"sample_text":"115 data sets after matching for age and sex","population":"Patients with Parkinson's disease and matched general‑population controls, adults","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 115 Parkinson's patients compared with matched community controls, rates of gambling, tobacco, alcohol and hypersexuality were similar; only two cases of sexual addiction were found in the Parkinson's group.","clinical_takeaway":"No evidence that Parkinson's disease increases risk of gambling or hypersexuality compared with the general population.","confidence":0.7,"topic_tags":["sexual_function","gender","other"],"strengths":["Matched control group","Multiple addictive behaviours assessed","Clear reporting of prevalence numbers"],"limitations":["Unclear whether sexual‑addiction was measured with a validated scale","No control for key psychosocial confounds (moral incongruence, mental health, trauma)","Small number of cases limits statistical power"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":20,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mds.23845"}},{"id":7291,"doi":"10.1080/02791072.2016.1168534","pmid":"27163711","pmcid":null,"title":"Criminality and Sexual Behaviours in Substance Dependents Seeking Treatment","authors":"Diehl A, Pillon SC, Dos Santos MA, Rassool GH, Laranjeira R.","first_author":"Diehl A","journal":"Journal of psychoactive drugs","year":2016,"pub_types":["Journal Article"],"keywords":["Sexual behavior","Crime","Violence","Crack Cocaine"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire of 587 in‑patient substance‑dependent adults","sample_n":587,"sample_text":"583 adults (82.3% men) recruited from an inpatient treatment unit","population":"substance‑dependent patients in a specialized inpatient unit (mostly male, cocaine‑using)","country":"unspecified (likely Brazil based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 587 people in drug‑treatment, more severe substance dependence was linked to higher rates of crime, violence and a range of sexual behaviours, but the study did not separate pornography from other sexual activity or adjust for moral or mental‑health factors.","clinical_takeaway":"No direct clinical guidance; findings are limited by design and measurement issues.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["large sample for a clinical setting","use of validated dependence and impulsivity scales"],"limitations":["cross‑sectional design, cannot infer causality","sex‑addiction construct measured with unspecified, likely unvalidated scale","no control for key psychosocial confounds (moral beliefs, masturbation, mental health, relationship factors, trauma)"],"rubric_version":"2.0","raw_total":22,"max_possible":60,"pct_score":37,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/02791072.2016.1168534"}},{"id":7293,"doi":"10.1016/j.yfrne.2014.04.003","pmid":"24769267","pmcid":null,"title":"Sex differences in addictive disorders","authors":"Fattore L, Melis M, Fadda P, Fratta W.","first_author":"Fattore L","journal":"Frontiers in neuroendocrinology","year":2014,"pub_types":["Review","Journal Article"],"keywords":["Sex hormones","Drug Addiction","Reward","Gender Differences","Food Addiction","Pathological Gambling","Internet Addiction","Compulsive Buying","Excessive Exercise","Compulsive Sex"],"is_oa":false,"oa_url":null,"cited_by_count":145,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review summarising existing literature on gender differences in substance and non‑substance addictions, including compulsive sexual activity","sample_n":null,"sample_text":"none (review)","population":"humans; both sexes; no original sample","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises evidence that men and women differ in how often they start and become addicted to drugs, food, gambling, internet use, exercise and compulsive sexual activity, and discusses how sex hormones may shape these patterns.","clinical_takeaway":"Consider gender‑specific factors, such as hormonal influences, when assessing or treating addictive behaviours, including compulsive sexual activity.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad coverage of multiple addictive behaviours","Integrates hormonal and neurobiological literature","Highlights gender‑specific treatment implications"],"limitations":["Narrative (non‑systematic) synthesis","No systematic assessment of study quality","No quantitative meta‑analysis"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":10,"contrasting":0,"mentioning":167,"citing_publications":254,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.yfrne.2014.04.003"}},{"id":7294,"doi":"10.1080/15538605.2011.554603","pmid":"23626503","pmcid":"PMC3634370","title":"Sexual victimization and health-related indicators among sexual minority men","authors":"Hequembourg AL, Bimbi D, Parsons JT.","first_author":"Hequembourg AL","journal":"Journal of LGBT Issues in counseling","year":2011,"pub_types":["research-article","Journal Article"],"keywords":["Substance Use","Childhood Sexual Abuse","Gay/bisexual Men","Sexual Victimization","Adult Sexual Assault"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 634 gay/bisexual men, community sample","sample_n":634,"sample_text":"community sample, recruitment method not specified in abstract","population":"gay and bisexual identified men (N=634)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 634 gay and bisexual men found that those who experienced childhood or adult sexual assault were more likely to use substances, have more STIs, score higher on sexual compulsivity, and feel more gay‑related stigma than men without such histories.","clinical_takeaway":"Screen for past sexual victimisation in gay/bisexual men, as it is linked to higher sexual compulsivity and health risks.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample (N>600)","Use of validated sexual compulsivity scale","Comprehensive set of health‑related outcomes","Clear reporting of victimization histories"],"limitations":["Cross‑sectional design limits causal inference","Key confounds (moral incongruence, mental health, masturbation) not measured","Recruitment method unclear – possible convenience bias","No correction for multiple comparisons reported"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":22,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/15538605.2011.554603"}},{"id":7296,"doi":"10.1080/10826084.2017.1290114","pmid":"28471320","pmcid":null,"title":"Erectile Dysfunction Symptoms in Polydrug Dependents Seeking Treatment","authors":"Clemente J, Diehl A, Santana PROH, da Silva CJ, Pillon SC, Mari JJ.","first_author":"Clemente J","journal":"Substance use & misuse","year":2017,"pub_types":["Journal Article"],"keywords":["Men","Treatment","Quality of life","Substance-related disorders","erectile dysfunction"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 102 male polydrug‑dependent outpatients in Brazil","sample_n":102,"sample_text":"102 substance‑dependent male polydrug users seeking outpatient treatment in São Paulo, Brazil","population":"male polydrug‑dependent treatment seekers (N=102)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 102 men dependent on multiple drugs, about one‑third reported erectile dysfunction. Being married and having a chronic disease lowered the risk, while having occasional sexual partners greatly increased it. The authors recommend better integration of sexual‑health services in substance‑use treatment.","clinical_takeaway":"Screen for erectile problems in drug‑dependent patients and address relationship and health factors that influence risk.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Validated erectile‑function measure (IIEF)","Clear reporting of prevalence and odds ratios","Consideration of several sociodemographic risk factors"],"limitations":["Cross‑sectional design; cannot infer causality","Convenience sample of treatment seekers limits generalisability","Key psychosocial confounds (moral incongruence, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[{"status":"Has correction","date":"2018-1-24","noticeDoi":"10.1080/10826084.2017.1413116","doi":"10.1080/10826084.2017.1290114"},{"status":"Comment","date":"2018-1-24","noticeDoi":"10.1080/10826084.2017.1413115","doi":"10.1080/10826084.2017.1290114"},{"status":"Has erratum","date":"2018-1-24","noticeDoi":"10.1080/10826084.2017.1413116","doi":"10.1080/10826084.2017.1290114"}],"url":"https://scite.ai/reports/10.1080/10826084.2017.1290114"}},{"id":7297,"doi":"10.1055/s-0046-1820529","pmid":"42150597","pmcid":"PMC13183461","title":"Prevalence and clinical characteristics of impulse control disorder in Southern Brazilian Parkinson's disease patients","authors":"Carvalho Neto EG, Soares NM, Pereira GM, Dalla Corte BM, Dutra ACL, Artigas NR, Almeida RMM, Krimberg JS, Monticelli BE, Schuh AFS, Rieder CRM.","first_author":"Carvalho Neto EG","journal":"Arquivos de neuro-psiquiatria","year":2026,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13183461","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 90 Parkinson's patients screened with QUIP‑CS","sample_n":90,"sample_text":"90 patients evaluated","population":"Southern Brazilian Parkinson's disease patients (n=90)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 90 Brazilian Parkinson’s patients, almost half showed impulse‑control problems, with hypersexuality reported in about one‑fifth. Use of dopamine‑agonist drugs was linked to higher odds of these disorders.","clinical_takeaway":"Monitor Parkinson’s patients on dopamine agonists for impulse‑control symptoms, including hypersexuality.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Validated ICD screening tool (QUIP‑CS)","Clear association reported between dopamine agonist use and ICDs","Comprehensive clinical assessment (motor scale, LEDD)"],"limitations":["Cross‑sectional design; cannot infer causality","No control for psychosocial confounds (mood, trauma, sexual behavior context)","No effect sizes reported"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-0046-1820529"}},{"id":7298,"doi":"10.3881/j.issn.1000-503x.16650","pmid":"42136349","pmcid":null,"title":"Kleine-Levin Syndrome Accompanied With Complex Headache:Report of One Case","authors":"Zhang L, Li ZB, Liu H, Wang XL, Liu RZ.","first_author":"Zhang L","journal":"Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae","year":2026,"pub_types":["Journal Article","Case Reports"],"keywords":["Hypothalamus","Migraine","Narcolepsy","Cluster Headache","Kleine-levin Syndrome"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of a single patient with Kleine‑Levin syndrome and headache.","sample_n":1,"sample_text":"Case report; single participant","population":"1 male patient with KLS and headache","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2026 case report describes a man with the rare sleep disorder Kleine‑Levin syndrome who also suffered migraines and cluster‑type headaches, suggesting a possible shared hypothalamic cause.","clinical_takeaway":"No direct clinical guidance; the report is only an anecdotal observation.","confidence":0.7,"topic_tags":["neuroscience","pornography","masturbation","sexual_function"],"strengths":["Detailed clinical description","Highlights rare comorbidity"],"limitations":["Single case; no generalisability","No systematic assessment of hypersexuality","No objective measures or imaging"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3881/j.issn.1000-503x.16650"}},{"id":7299,"doi":"10.1016/s1474-4422(17)30004-2","pmid":"28229895","pmcid":null,"title":"Impulse control disorders and levodopa-induced dyskinesias in Parkinson's disease: an update","authors":"Voon V, Napier TC, Frank MJ, Sgambato-Faure V, Grace AA, Rodriguez-Oroz M, Obeso J, Bezard E, Fernagut PO.","first_author":"Voon V","journal":"The Lancet. Neurology","year":2017,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.repository.cam.ac.uk/handle/1810/263134","cited_by_count":253,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Review article summarizing prior studies; no new empirical data collected.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Patients with Parkinson's disease (PD) receiving dopaminergic therapy.","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises how dopamine‑based treatments for Parkinson’s disease can trigger motor side‑effects and impulse‑control problems—including gambling, binge eating, compulsive sex and shopping—affecting about 17% of patients.","clinical_takeaway":"Clinicians should monitor PD patients on dopaminergic drugs for emerging impulse‑control issues, including compulsive sexual behaviour.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of impulse control disorders in PD.","Integrates preclinical and clinical evidence.","Highlights need for large‑scale studies."],"limitations":["No original data; relies on existing literature.","Does not assess sexual‑specific constructs (e.g., pornography, masturbation).","Limited discussion of moral incongruence or psychosocial confounds."],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":14,"contrasting":1,"mentioning":276,"citing_publications":378,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1474-4422(17)30004-2"}},{"id":7300,"doi":"10.5040/9798400680717.ch-005","pmid":"8128391","pmcid":null,"title":"[What is sexual addiction?]","authors":"Clement U.","first_author":"Clement U.","journal":"Therapeutische Umschau. Revue therapeutique","year":1994,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/theoretical article without empirical data","sample_n":null,"sample_text":"none","population":"not applicable","country":"Germany (journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses the debated concept of sexual addiction, describing it as a lack of control over sexual impulses and noting that its classification is controversial, with limited research in German‑speaking countries.","clinical_takeaway":"No clinical guidance; the paper notes the lack of systematic evidence for treating \"sexual addiction\".","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Provides historical overview of terminology","Highlights controversy in classification"],"limitations":["No empirical data or systematic review","Relies on circular definitions of addiction","No measurement of relevant confounds"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5040/9798400680717.ch-005"}},{"id":7301,"doi":"10.1207/s15327655jchn2201_5","pmid":"15695196","pmcid":null,"title":"Sexual sensation seeking, compulsivity, and HIV risk behaviors in college students","authors":"Gullette DL, Lyons MA.","first_author":"Gullette DL","journal":"Journal of community health nursing","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":49,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Descriptive correlational online survey of 256 college students (2003).","sample_n":256,"sample_text":"College students (n = 256) completed an online survey in 2003.","population":"College students in the southeastern United States, mixed gender.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2005 survey of 256 U.S. college students found that higher sexual sensation seeking and alcohol problems, but lower sexual compulsivity, were linked to riskier HIV‑related behaviours. Women in Greek life reported more alcohol‑related depression and low self‑esteem.","clinical_takeaway":"Screen for sensation‑seeking traits and alcohol problems when designing HIV‑risk reduction programs for college students.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of validated scales for compulsivity and sensation seeking","Reasonable sample size for a college survey","Inclusion of alcohol use as a mediator"],"limitations":["Cross‑sectional design prevents causal inference","No measurement of key confounds such as moral incongruence or partner context","No effect‑size reporting or power justification"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":14,"contrasting":3,"mentioning":74,"citing_publications":111,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1207/s15327655jchn2201_5"}},{"id":7302,"doi":"10.3389/fpsyt.2018.00497","pmid":"30386263","pmcid":"PMC6198171","title":"The Contribution of Sex, Personality Traits, Age of Onset and Disorder Duration to Behavioral Addictions","authors":"Valero-Solís S, Granero R, Fernández-Aranda F, Steward T, Mestre-Bach G, Mallorquí-Bagué N, Martín-Romera V, Aymamí N, Gómez-Peña M, Del Pino-Gutiérrez A, Baño M, Moragas L, Menchón JM, Jiménez-Murcia S.","first_author":"Valero-Solís S","journal":"Frontiers in psychiatry","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Age","Compulsive Buying","Behavioral Addictions","Sex Addiction","Gambling Disorder","Internet Gambling Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6198171","cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Treatment‑seeking clinical sample of patients with gambling disorder, internet gambling disorder, compulsive buying and sex addiction; analyses of sex, age of onset and disorder duration on clinical profiles.","sample_n":3366,"sample_text":"Treatment‑seeking patients diagnosed with gambling disorder, internet gambling disorder, compulsive buying, and sex addiction.","population":"Adults seeking treatment for various behavioral addictions (n≈3,366 total; GD n=3,174, IGD n=45, CB n=113, SA n=34).","country":"Spain (likely based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined how sex, age when the problem started, and how long it lasted relate to clinical features across several behavioural addictions, including sex addiction, showing different patterns for men and women.","clinical_takeaway":"Risk profiles vary by sex and onset timing; clinicians should consider these factors when tailoring interventions for behavioural addictions.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Large sample for gambling disorder","Comprehensive assessment of multiple behavioral addictions","Use of standardized personality inventory"],"limitations":["Small sub‑samples for IGD, CB, and especially sex addiction","No measurement of key confounds (moral incongruence, masturbation, mental health, trauma)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":13,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2018.00497"}},{"id":7303,"doi":"10.1136/sti.2010.047779","pmid":"21772040","pmcid":null,"title":"How to recognise sexual addiction in the sexual health clinic setting?","authors":"Goldmeier D, Petrak J.","first_author":"Goldmeier D","journal":"Sexually transmitted infections","year":2011,"pub_types":["Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sti.2010.047779"}},{"id":7304,"doi":"10.1007/s10943-010-9338-7","pmid":"20182916","pmcid":null,"title":"Evangelicalism, sexual morality, and sexual addiction: opposing views and continued conflicts","authors":"Edger K.","first_author":"Edger K.","journal":"Journal of religion and health","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary / theoretical piece without empirical data","sample_n":null,"sample_text":"NA","population":"NA","country":"NA","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"background","plain_summary":"The article reviews how evangelical Christianity often labels certain sexual behaviours as moral problems and frames them as 'sexual addiction'. It argues that these judgments stem from authoritarian personality traits and strict religious norms rather than evidence of a medical disorder.","clinical_takeaway":"None – the paper provides no data applicable to clinical practice.","confidence":0.6,"topic_tags":["sexual_function","moral_incongruence","religiosity"],"strengths":["Addresses an under‑studied cultural perspective","Integrates psychological theory (authoritarian personality, reaction formation)"],"limitations":["No empirical data; purely opinion‑based","Lacks operational definitions or measurement of 'sexual addiction'","No control for known confounds such as moral incongruence or mental health"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-010-9338-7"}},{"id":7305,"doi":"10.1080/00926231003719707","pmid":"20432126","pmcid":null,"title":"\"What is sexual addiction?\" A response to Stephen Levine","authors":"Kafka MP.","first_author":"Kafka MP.","journal":"Journal of sex & marital therapy","year":2010,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926231003719707"}},{"id":7306,"doi":"10.1016/j.euroneuro.2015.08.013","pmid":"26585600","pmcid":null,"title":"Behavioural addiction-A rising tide?","authors":"Chamberlain SR, Lochner C, Stein DJ, Goudriaan AE, van Holst RJ, Zohar J, Grant JE.","first_author":"Chamberlain SR","journal":"European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology","year":2016,"pub_types":["Review","Journal Article"],"keywords":["Cognition","Imaging","Addiction","Impulsivity","Compulsivity"],"is_oa":false,"oa_url":null,"cited_by_count":63,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review; no primary data, no empirical sample.","sample_n":null,"sample_text":"","population":"N/A","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review questions whether compulsive sexual behaviour and other repetitive actions should be called ‘behavioural addictions’, comparing them to substance addictions in terms of loss of control, persistence, and neurobiology.","clinical_takeaway":"Clinicians should be cautious interpreting compulsive sexual behaviour as an addiction; more empirical research is needed before adopting that label.","confidence":0.7,"topic_tags":["sexual_function","csbd","pornography","masturbation"],"strengths":["Broad theoretical integration of behavioural addiction concepts","Considers multiple disorders and neurobiological evidence","Relevant for diagnostic classification discussions"],"limitations":["No systematic methodology or risk‑of‑bias assessment","Lacks empirical data; conclusions are largely speculative","Potential author bias toward addiction framing"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":1,"mentioning":64,"citing_publications":114,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.euroneuro.2015.08.013"}},{"id":7307,"doi":"10.1016/j.nbd.2015.08.026","pmid":"26325219","pmcid":null,"title":"Rodent models of impulsive-compulsive behaviors in Parkinson's disease: How far have we reached?","authors":"Cenci MA, Francardo V, O'Sullivan SS, Lindgren HS.","first_author":"Cenci MA","journal":"Neurobiology of disease","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Neurotoxin","Cognition","Animal Models","Parkinson","Non-motor Symptoms"],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article summarizing rodent models of impulsive‑compulsive behaviors in Parkinson’s disease; no primary data collected.","sample_n":null,"sample_text":"Not applicable – review of existing studies","population":"rodent studies (pre‑clinical) and human PD patients described in literature","country":"International (authors from multiple institutions)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how rodent experiments mimic impulsive‑compulsive behaviors seen in Parkinson’s patients, such as gambling or compulsive sexual activity, highlighting current methods and gaps.","clinical_takeaway":"None – the paper is a pre‑clinical review, not directly applicable to clinical practice.","confidence":0.7,"topic_tags":["prevalence"],"strengths":["Comprehensive overview of existing rodent ICB models","Identifies gaps and methodological challenges"],"limitations":["No original empirical data","Lacks systematic review methodology","No quantitative synthesis or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.nbd.2015.08.026"}},{"id":7308,"doi":"10.1080/00926238508406078","pmid":"4009729","pmcid":null,"title":"Compulsive sexual behavior: definition of a problem and an approach to treatment","authors":"Quadland MC.","first_author":"Quadland MC.","journal":"Journal of sex & marital therapy","year":1985,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":62,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control comparison of 30 self‑identified compulsive gay/bisexual men versus matched psychotherapy controls; pre‑post group therapy outcome for the compulsive group","sample_n":30,"sample_text":"30 sexually compulsive men; matched control group (size not specified)","population":"gay and bisexual men seeking treatment for sexual compulsivity in NYC (N≈30) and matched controls seeking general psychotherapy","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","no_mi_control"],"stance":"supports","citation_value":"useful","plain_summary":"The study compared 30 gay/bisexual men who called themselves sexually compulsive with similar men in general therapy, finding higher numbers of sexual partners but no extra neurotic symptoms, and reported that group therapy reduced partner numbers.","clinical_takeaway":"Group psychotherapy may lower the number of sexual encounters in men who view their behavior as out of control, but evidence is limited.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Early empirical comparison of compulsive vs control group","Includes treatment outcome data","Matched psychotherapy control group"],"limitations":["Small, non‑representative convenience sample","No validated measure of compulsivity or distress","No control for moral/religious or mental‑health confounds"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":3,"contrasting":2,"mentioning":61,"citing_publications":174,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238508406078"}},{"id":7309,"doi":"10.21203/rs.3.rs-1615894/v1","pmid":null,"pmcid":null,"title":"Bipolar Disorder and Sexuality: A Preliminary Qualitative Study ","authors":"Krogh HB, Vinberg M, Mortensen GL, Skakke D, Nielsen D, Giraldi A.","first_author":"Krogh HB","journal":"Research Square","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-1615894/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["csbd"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"pilot qualitative interview study with 5 participants with bipolar disorder; thematic content analysis","sample_n":5,"sample_text":"Five participants with bipolar disorder recruited for a preliminary qualitative study.","population":"individuals with bipolar disorder (5 participants, mixed gender)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In interviews with five people who have bipolar disorder, researchers found that sexual desire rises during manic phases and often drops or becomes self‑destructive during depressive phases, affecting relationships and possibly signaling mood changes.","clinical_takeaway":"Clinicians might monitor changes in patients' sexual drive as early indicators of mood shifts in bipolar disorder.","confidence":0.7,"topic_tags":["sexual_function","moral_incongruence","masturbation"],"strengths":["Provides rich, first‑hand accounts of sexual drive fluctuations across mood episodes","Identifies potential early‑warning signs linking sexuality and bipolar mood shifts"],"limitations":["Very small, non‑representative sample (N=5)","No systematic measurement of key confounds (e.g., moral incongruence, partner context)","Findings not generalisable beyond this pilot group"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-1615894/v1"}},{"id":7311,"doi":"10.1136/jnnp-2016-315277","pmid":"28315845","pmcid":null,"title":"ICARUS study: prevalence and clinical features of impulse control disorders in Parkinson's disease","authors":"Antonini A, Barone P, Bonuccelli U, Annoni K, Asgharnejad M, Stanzione P.","first_author":"Antonini A","journal":"Journal of neurology, neurosurgery, and psychiatry","year":2017,"pub_types":["Multicenter Study","Journal Article","Observational Study"],"keywords":["Prospective study","Parkinson’s Disease","Impulse Control Disorders","Non-interventional Study"],"is_oa":false,"oa_url":null,"cited_by_count":126,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective multicentre cohort with 2‑year follow‑up of 1,069 Parkinson’s patients","sample_n":1069,"sample_text":"1069/1095 (97.6%) patients comprised the Full Analysis Set","population":"treated Italian PD outpatients, N≈1,070","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In over 1,000 Italian Parkinson’s patients, about 27‑30% showed impulse‑control problems like compulsive sexual behaviour, gambling or eating over two years. Those with such problems tended to be younger, male, more depressed, and reported poorer sleep and quality of life.","clinical_takeaway":"Compulsive sexual behaviour can be a common impulse‑control issue in Parkinson’s; screen for it alongside mood and sleep problems.","confidence":0.85,"topic_tags":["sexual_function","csbd"],"strengths":["Large, multicentre sample","Prospective 2‑year follow‑up","Validated interview (mMIDI) for ICD identification"],"limitations":["No pre‑registration or detailed statistical plan disclosed","Limited control for psychiatric or medication confounders","ICD classification may not map onto CSBD or addiction frameworks"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":18,"contrasting":5,"mentioning":183,"citing_publications":164,"retracted":false,"notices":[{"status":"Has correction","date":"2024-3-5","noticeDoi":"10.1136/jnnp-2016-315277corr1","doi":"10.1136/jnnp-2016-315277"}],"url":"https://scite.ai/reports/10.1136/jnnp-2016-315277"}},{"id":7313,"doi":"10.1007/s10508-009-9591-6","pmid":"20143148","pmcid":null,"title":"Dysregulated sexuality and high sexual desire: distinct constructs?","authors":"Winters J, Christoff K, Gorzalka BB.","first_author":"Winters J","journal":"Archives of sexual behavior","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":70,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 6,458 men and 7,938 women, including some treatment‑seekers; factor analysis of sexuality items","sample_n":14396,"sample_text":"6458 men, 7938 women (online convenience sample)","population":"adult men and women, recruited via the internet; includes individuals who have sought treatment for sexual compulsivity or related problems","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a huge internet survey, researchers found that items measuring \"dysregulated sexuality\" and high sexual desire all loaded onto a single factor, suggesting they may be the same underlying construct rather than distinct problems.","clinical_takeaway":"High sexual desire alone may explain reports of distress; assess desire before labeling a separate disorder.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Very large sample size","Includes both genders","Uses confirmatory factor analysis"],"limitations":["Convenience online sample, not representative","Key constructs measured with unspecified, possibly ad‑hoc questionnaires","No control for moral incongruence, mental health, or other known confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":66,"citing_publications":178,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-009-9591-6"}},{"id":7314,"doi":"10.1176/appi.neuropsych.10010013","pmid":"22450610","pmcid":null,"title":"Impulse-control disorders in gilles de la tourette syndrome","authors":"Wright A, Rickards H, Cavanna AE.","first_author":"Wright A","journal":"The Journal of neuropsychiatry and clinical neurosciences","year":2012,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":54,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of literature on impulse‑control disorders in Gilles de la Tourette syndrome, focusing on sexual impulsivity among other behaviors.","sample_n":null,"sample_text":"No primary data collected; review of existing studies.","population":"patients with Gilles de la Tourette syndrome (clinic populations); no new sample collected","country":"International (studies reviewed from various locations)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how people with Tourette syndrome may develop impulse‑control problems, including risky sexual behavior, and warns clinicians about possible legal issues.","clinical_takeaway":"Clinicians should screen for impulsive sexual behavior in patients with Tourette syndrome to manage potential risks.","confidence":0.6,"topic_tags":["gender","sexual_function"],"strengths":["Broad overview of impulse‑control disorders in GTS","Highlights sexual impulsivity as a clinical issue","Useful for clinicians unfamiliar with GTS comorbidities"],"limitations":["Narrative (non‑systematic) review; no explicit methodology","No primary data or statistical analysis","Does not assess confounding variables (e.g., moral incongruence, mental health)","Potential bias toward clinical/legal relevance"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":7,"contrasting":0,"mentioning":52,"citing_publications":114,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.neuropsych.10010013"}},{"id":7316,"doi":"10.1016/j.psychres.2014.12.061","pmid":"25660732","pmcid":"PMC4361289","title":"The relationship of DSM-IV pathological gambling to compulsive buying and other possible spectrum disorders: results from the Iowa PG family study","authors":"Black DW, Coryell W, Crowe R, Shaw M, McCormick B, Allen J.","first_author":"Black DW","journal":"Psychiatry research","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Genetics","Compulsive Sexual Behavior","Impulse Control Disorders","Family Study","Pathological Gambling","Compulsive Buying Disorder","Gambling Spectrum"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4361289","cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control family study with 95 pathological gambling probands, 91 controls, and 1,075 first‑degree relatives; diagnoses assigned blind using validated instruments; logistic regression with GEE","sample_n":1261,"sample_text":"95 PG probands, 91 controls, 1,075 first-degree relatives","population":"adult males and females from Iowa, probands with DSM‑IV pathological gambling and matched controls; first‑degree relatives included","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that compulsive buying and other impulse‑control problems are more common in people with pathological gambling and their relatives, suggesting these behaviors may belong to a shared familial spectrum.","clinical_takeaway":"Compulsive buying may co‑occur with gambling problems; clinicians should screen for related impulse‑control disorders in affected families.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large family sample with over 1,000 relatives","Blind best‑estimate diagnoses using reliable instruments","Appropriate statistical method for clustered family data"],"limitations":["Cross‑sectional design limits causal inference","No assessment of key sexual‑behaviour confounds (e.g., moral incongruence, masturbation)","Findings specific to pathological gambling spectrum, not generalizable to broader porn/masturbation contexts"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":23,"citing_publications":83,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psychres.2014.12.061"}},{"id":7317,"doi":"10.1007/s10072-008-0979-1","pmid":"18810603","pmcid":null,"title":"Effect of citalopram in treating hypersexuality in an Alzheimer's disease case","authors":"Tosto G, Talarico G, Lenzi GL, Bruno G.","first_author":"Tosto G","journal":"Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology","year":2008,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single Alzheimer’s patient with hypersexuality treated with citalopram","sample_n":1,"sample_text":"1 patient","population":"one 54‑year‑old male with Alzheimer’s disease","country":"Italy","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 54‑year‑old man with Alzheimer’s disease showed compulsive sexual behaviour that improved after two months of the antidepressant citalopram, while a brain PET scan showed right‑hemisphere hypometabolism.","clinical_takeaway":"Citalopram may reduce compulsive sexual behaviour in Alzheimer’s patients, but evidence is limited to a single case.","confidence":0.6,"topic_tags":["sexual_function","neuroscience","treatment","csbd"],"strengths":["detailed clinical description","use of FDG‑PET to document brain metabolism","follow‑up after pharmacological intervention"],"limitations":["single case, no control group","no validated measures of hypersexuality","no assessment of confounding factors (moral, mental health, etc.)","cannot infer causality"],"rubric_version":"2.0","raw_total":9,"max_possible":60,"pct_score":15,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":2,"statistics":1,"confounds":0,"design":0,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10072-008-0979-1"}},{"id":7318,"doi":"10.1111/j.1440-1819.2008.01832.x","pmid":"18778451","pmcid":null,"title":"Concurrence of compulsive buying and sexual addiction","authors":"Yeh YW, Shiah IS, Hu MC, Chang HA, Huang CC.","first_author":"Yeh YW","journal":"Psychiatry and clinical neurosciences","year":2008,"pub_types":["Letter","Research Support, Non-U.S. Gov't","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1440-1819.2008.01832.x"}},{"id":7319,"doi":"10.1177/1756285611411504","pmid":"22164191","pmcid":"PMC3229252","title":"Management of sexual dysfunction in Parkinson's disease","authors":"Bronner G, Vodušek DB.","first_author":"Bronner G","journal":"Therapeutic advances in neurological disorders","year":2011,"pub_types":["research-article","Journal Article"],"keywords":["Management","Sexual dysfunction","erectile dysfunction","Parkinson’s Disease","Desire","Hypersexuality","Orgasm","Sexual Counseling"],"is_oa":false,"oa_url":null,"cited_by_count":72,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review / clinical guidance article without original empirical data.","sample_n":null,"sample_text":"Not applicable – article provides a synthesis of existing knowledge rather than reporting a new study sample.","population":"Patients with Parkinson’s disease experiencing sexual dysfunction.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews how Parkinson’s disease can cause sexual problems such as low desire, erectile dysfunction, and hypersexuality, and recommends counseling and medication (e.g., sildenafil, adjusting dopamine agonist doses) to improve patients’ and partners’ sexual health.","clinical_takeaway":"Screen for sexual issues in Parkinson’s patients and consider dopaminergic dose adjustment plus standard erectile‑dysfunction treatments.","confidence":0.4,"topic_tags":["sexual_function","neuroscience","treatment"],"strengths":["Comprehensive overview of sexual dysfunction types in Parkinson’s disease.","Practical treatment suggestions (e.g., sildenafil, dose reduction of dopaminergic agonists)."],"limitations":["No original data; conclusions rely on prior literature.","Lacks systematic review methodology or risk‑of‑bias assessment."],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":96,"citing_publications":120,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1756285611411504"}},{"id":7320,"doi":"10.1136/sextrans-2013-051094","pmid":"24052337","pmcid":"PMC3927726","title":"Characteristics of men who have sex with men (MSM) who attend sex parties: results from a national online sample in the USA","authors":"Grov C, Rendina HJ, Breslow AS, Ventuneac A, Adelson S, Parsons JT.","first_author":"Grov C","journal":"Sexually transmitted infections","year":2014,"pub_types":["Comparative Study","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Prevention","Sexual behaviour","Substance Misuse","Gay Men"],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online survey of 2063 sexually active MSM recruited via banner ads on a sexual networking site; participants self‑reported attendance at sex parties, sexual behavior, HIV status, drug use and other variables. Analyses compared three groups (past‑year attendees, earlier attendees, never attendees) us","sample_n":2063,"sample_text":"2063 sexually active MSM recruited through banner advertising on a sexual networking website.","population":"Men who have sex with men (MSM) in the United States, sexually active, recruited online (N = 2063).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an online US survey of 2,063 men who have sex with men, those who had attended a sex party within the past year were more likely to be HIV‑positive, single, use drugs, have many recent partners, engage in unprotected anal sex, and report sexual‑compulsivity symptoms than men who attended less recently or never attended.","clinical_takeaway":"MSM who attend recent sex parties show higher HIV/STI risk and may benefit from targeted on‑site prevention services.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large national sample for this population","Clear categorisation of sex‑party attendance groups","Multivariable adjustment for several covariates"],"limitations":["Self‑report data; possible social desirability bias","Convenience online recruitment limits generalisability","Unclear whether sexual compulsivity was measured with a validated scale"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":2,"mentioning":35,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sextrans-2013-051094"}},{"id":7322,"doi":"10.4103/0973-7847.112832","pmid":"23922450","pmcid":"PMC3731873","title":"Exploring scientifically proven herbal aphrodisiacs","authors":"Kotta S, Ansari SH, Ali J.","first_author":"Kotta S","journal":"Pharmacognosy reviews","year":2013,"pub_types":["review-article","Journal Article"],"keywords":["Impotence","Aphrodisiac Plants","Herbal Aphrodisiacs","Sex Stimulants"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3731873","cited_by_count":51,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of herbal aphrodisiacs without systematic methods, risk‑of‑bias assessment, or meta‑analysis.","sample_n":null,"sample_text":"Not applicable – review article.","population":"none (review of pre‑clinical and clinical studies)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews various plants that have been studied as natural aphrodisiacs, summarising animal and limited human research on their potential to boost sexual desire and performance.","clinical_takeaway":"Evidence is limited and heterogeneous; clinicians should be cautious when considering herbal aphrodisiacs for patients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad overview of many plant extracts","Includes both animal and human studies where available"],"limitations":["No systematic search strategy reported","No quality appraisal of cited studies","Lacks quantitative synthesis or meta‑analysis","Potential for selection bias in cited literature"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":46,"citing_publications":129,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0973-7847.112832"}},{"id":7323,"doi":"10.3389/fnbeh.2014.00196","pmid":"24910600","pmcid":"PMC4038955","title":"The role of dopamine in risk taking: a specific look at Parkinson's disease and gambling","authors":"Clark CA, Dagher A.","first_author":"Clark CA","journal":"Frontiers in behavioral neuroscience","year":2014,"pub_types":["review-article","Review","Journal Article"],"keywords":["Reward","Impulsivity","Insula","Ventral Striatum","Impulse Control Disorders","Loss Aversion"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fnbeh.2014.00196/pdf","cited_by_count":40,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of dopamine, risk taking, and impulse control disorders in Parkinson's disease, including pathological gambling and compulsive sexual behavior.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Parkinson's disease patients (as discussed in cited primary studies); no new sample recruited.","country":"Not specified (review).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review discusses how dopamine influences risk‑taking and impulse‑control problems like gambling and compulsive sexual behavior in Parkinson's disease, summarising functional brain imaging findings.","clinical_takeaway":"Clinicians should note that dopamine agonists may relate to impulse‑control issues, but evidence is based on existing imaging studies, not new data.","confidence":0.7,"topic_tags":["csbd","neuroscience"],"strengths":["Comprehensive synthesis of functional imaging literature.","Integrates dopamine theory with decision‑making framework."],"limitations":["Narrative (non‑systematic) review; selection bias possible.","No new empirical data or quantitative meta‑analysis."],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":3,"contrasting":0,"mentioning":50,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fnbeh.2014.00196"}},{"id":7324,"doi":"10.4088/pcc.09m00842whi","pmid":"20694115","pmcid":"PMC2911005","title":"Impulse-control disorders in a college sample: results from the self-administered Minnesota Impulse Disorders Interview (MIDI)","authors":"Odlaug BL, Grant JE.","first_author":"Odlaug BL","journal":"Primary care companion to the Journal of clinical psychiatry","year":2010,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Self‑administered survey of 791 college students from two private Midwestern colleges; lifetime prevalence of DSM‑IV‑TR impulse‑control disorders assessed with a modified Minnesota Impulse Disorders Interview.","sample_n":791,"sample_text":"791 college students from 2 private colleges in the Midwest","population":"College students (N=791, mean age 20, 68% female) from two private colleges in the Midwest, USA.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2010 survey of 791 US college students, about one in ten met lifetime criteria for an impulse‑control disorder, with 3.7% showing compulsive sexual behavior. Men were more likely than women to endorse gambling and compulsive sexual behavior, while women were more likely to report compulsive buying.","clinical_takeaway":"Compulsive sexual behavior appears in a minority of college students; clinicians should consider screening when relevant, but prevalence estimates may not apply to all campuses.","confidence":0.7,"topic_tags":["csbd","prevalence","sexual_function"],"strengths":["Large sample for a college‑based survey","Use of a structured, DSM‑based interview instrument","Provides gender‑specific prevalence data"],"limitations":["Convenience sample from two private colleges limits generalisability","Self‑report interview without clinical verification","No assessment of key confounds (moral incongruence, mental health, partner factors)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":3,"mentioning":28,"citing_publications":104,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/pcc.09m00842whi"}},{"id":7325,"doi":null,"pmid":"20695043","pmcid":null,"title":"Child sexual abuse, harmful alcohol use and age as determinants of sexual risk behaviours among freshmen in a Nigerian university","authors":"Olley BO.","first_author":"Olley BO.","journal":"African journal of reproductive health","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 841 Nigerian university freshmen","sample_n":841,"sample_text":"841 freshmen attending orientation completed a questionnaire","population":"University of Ibadan freshmen (both sexes, ages ~18‑20)","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 841 Nigerian university freshmen found that 31% were sexually active, half of whom did not use a condom. Alcohol abuse, a history of child sexual abuse, and older age were the strongest predictors of risky sexual behavior.","clinical_takeaway":"Screening for alcohol misuse and past sexual abuse may help identify students at higher risk for unsafe sex.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a single university","Multiple regression identifies independent predictors","Includes CSA as a predictor of risk behavior"],"limitations":["Cross‑sectional design cannot infer causality","Reliance on self‑report questionnaires with unclear validation","No control for mental‑health or moral‑incongruence confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":7326,"doi":"10.4103/abr.abr_161_22","pmid":"37694240","pmcid":"PMC10492616","title":"A Comparative Study of Dialectical Behavior Therapy and Aripiprazole on Marital Instability of in Patients with Hypersexual","authors":"Tavakoli Z, Rezaei-Jamalouei H, Kazemi-Zahrani H, Khorrami MH, Ghanaat I.","first_author":"Tavakoli Z","journal":"Advanced biomedical research","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Aripiprazole","Dialectical Behavior Therapy","Hypersexuality","Marital Instability"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10492616","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"experimental","design_detail":"pretest‑posttest control‑group experimental design with three arms (DBT, aripiprazide, control), N=27 (9 per arm), random assignment, follow‑up, MANCOVA analysis","sample_n":27,"sample_text":"27 patients (male and female) with hypersexuality, randomly allocated to DBT (n=9), aripiprazole (n=9), control (n=9)","population":"patients diagnosed with hypersexuality, recruited from four hospitals/psychiatric centers in Iran; all had at least higher‑education degree","country":"Iran","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In 27 Iranian adults with hypersexuality, eight weeks of dialectical‑behavior therapy or two months of aripiprazole did not significantly improve marital stability compared with no treatment. The study was very small and did not account for factors like moral conflict or solo sexual activity.","clinical_takeaway":"Current evidence does not support DBT or aripiprazole for marital stability in hypersexual patients; larger, better‑controlled trials are needed.","confidence":0.3,"topic_tags":["treatment","pornography","masturbation","relationships","sexual_function"],"strengths":["Random allocation to three groups","Use of a validated marital instability scale","Comparison of psychotherapy vs pharmacotherapy"],"limitations":["Very small sample (9 per arm) → underpowered","No measurement/control of key confounds (moral incongruence, masturbation, mental health)","No detail on hypersexuality diagnostic criteria or validation"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/abr.abr_161_22"}},{"id":7328,"doi":"10.1080/07448481.2013.844697","pmid":"24313699","pmcid":null,"title":"Mental health and clinical correlates in lesbian, gay, bisexual, and queer young adults","authors":"Grant JE, Odlaug BL, Derbyshire K, Schreiber LR, Lust K, Christenson G.","first_author":"Grant JE","journal":"Journal of American college health : J of ACH","year":2014,"pub_types":["Research Support, American Recovery and Reinvestment Act","Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey","sample_n":null,"sample_text":"anonymous, voluntary survey distributed via random e‑mail generation to university students","population":"college students at a large public university (U.S.)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of students at a large U.S. university found that LGBQ students reported higher rates of depression, stress, body‑image concerns, overweight, and histories of mental‑health disorders, including compulsive sexual behavior, compared with heterosexual peers.","clinical_takeaway":"Clinicians should be aware of elevated mental‑health and compulsive‑behavior risks among LGBQ college students and consider supportive, affirming care.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Random e‑mail sampling within university","Broad range of mental‑health outcomes assessed","Large institutional setting"],"limitations":["Cross‑sectional; no causal inference","Compulsive sexual behavior measurement not described (likely non‑validated)","No control for moral incongruence or related confounds","Limited generalisability beyond one U.S. campus"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":32,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/07448481.2013.844697"}},{"id":7329,"doi":"10.3389/fpsyg.2023.1182222","pmid":"37546467","pmcid":"PMC10400090","title":"Influence of psychological inflexibility and mindfulness on hypersexuality and sexual satisfaction in a Spanish sample","authors":"Ortega-Otero M, Montesinos F, Charrabe L.","first_author":"Ortega-Otero M","journal":"Frontiers in psychology","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Mindfulness","Psychological Flexibility","Sexual Satisfaction","Hypersexuality","Body Awareness","Cognitive Fusion","Bodily Dissociation"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyg.2023.1182222/pdf","cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 530 Spanish adults, cross‑sectional, convenience sample","sample_n":530,"sample_text":"530 participants, 5.5% displayed hypersexuality","population":"Spanish adults 18‑67, community participants recruited online","country":"Spain","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"supports","citation_value":"useful","plain_summary":"In a survey of 530 Spaniards, higher psychological inflexibility, cognitive fusion and bodily dissociation were linked to more hypersexual behavior, while mindfulness skills were linked to less. Bodily dissociation also related to lower sexual satisfaction.","clinical_takeaway":"Addressing psychological inflexibility and increasing mindfulness may help reduce hypersexual behaviors and improve sexual satisfaction.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for a survey","Use of several validated psychometric scales","Explores understudied Spanish population"],"limitations":["Cross‑sectional, cannot infer causality","No measurement of moral incongruence or other key confounds","Potential self‑selection bias in online recruitment"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2023.1182222"}},{"id":7330,"doi":"10.1016/j.encep.2015.12.013","pmid":"26928277","pmcid":null,"title":"[ADH/D and impulsiveness: Prevalence of impulse control disorders and other comorbidities, in 81 adults with attention deficit/hyperactivity disorder (ADH/D)]","authors":"Porteret R, Bouchez J, Baylé FJ, Varescon I.","first_author":"Porteret R","journal":"L'Encephale","year":2016,"pub_types":["Journal Article"],"keywords":["Adult","Prevalence","Comorbidities","Impulse Control Disorder","Prévalence","Adulte","Comorbidités","Adh/d","Tda/h","Troubles Du Contrôle Des Impulsions"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional prevalence study of 81 adults recruited from specialised ADHD clinics in France; DSM‑IV‑TR, Minnesota Impulsive Disorders Interview and MINI used for diagnoses.","sample_n":81,"sample_text":"81 adults with ADH/D meeting DSM‑IV‑TR criteria.","population":"Adults with ADHD (ADH/D) attending specialist adult ADHD consultations in France (N = 81).","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 81 French adults diagnosed with ADHD, two‑thirds also had at least one impulse‑control disorder (e.g., intermittent explosive disorder, compulsive buying). High rates of anxiety, mood disorders, and substance‑use problems were also observed.","clinical_takeaway":"Adults with ADHD often present multiple impulse‑control and psychiatric comorbidities; clinicians should screen for these alongside ADHD assessment.","confidence":0.8,"topic_tags":["adolescents"],"strengths":["Validated clinical interviews","Comprehensive assessment of multiple impulse‑control and psychiatric comorbidities","Clear reporting of prevalence rates"],"limitations":["Convenience clinic sample limits generalisability","No control group or comparison to non‑ADHD population","Statistical analysis limited to descriptive prevalence"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.encep.2015.12.013"}},{"id":7332,"doi":"10.1002/mdc3.70533","pmid":"41532229","pmcid":null,"title":"Persisting or Worsening Impulse Control Disorders in Parkinson's Disease Following a Switch to Subcutaneous Foslevodopa-Foscarbidopa","authors":"Bradley M, Donlon E, Gallagher A, Ruggieri F, Inocentes J, Rua AD, O'Keeffe C, Lynch T, Fearon C, Walsh RA.","first_author":"Bradley M","journal":"Movement disorders clinical practice","year":2026,"pub_types":["Journal Article","Case Reports"],"keywords":["Parkinson's Disease","Impulse Control Disorder","Foslevodopa/foscarbidopa"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of five male Parkinson's patients with pre‑existing impulse control disorders","sample_n":5,"sample_text":"five men","population":"men, age 50‑68, advanced Parkinson's disease, already diagnosed with ICDs","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In five men with Parkinson's disease who already had impulse‑control problems, switching to a new dopamine medication (subcutaneous foslevodopa‑foscarbidopa) made those problems, especially hypersexuality, stay the same or get worse within weeks.","clinical_takeaway":"Watch closely for worsening hypersexuality when changing Parkinson’s patients to CSFLI, especially if they already have impulse‑control issues.","confidence":0.8,"topic_tags":["csbd","pornography","masturbation","sexual_function"],"strengths":["addresses a clinically relevant gap (CSFLI impact on ICDs)","provides specific time‑course data","focus on hypersexuality, a CSBD‑relevant symptom"],"limitations":["very small, uncontrolled case series","no validated ICD or sexual behaviour scales","no systematic assessment of confounding factors"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mdc3.70533"}},{"id":7334,"doi":"10.1080/00224499.2025.2606765","pmid":"41504248","pmcid":null,"title":"The Communicative Construction of Care: Evidence for Subjectively Reciprocal Relations Between Humans and Machines","authors":"Dehnert M, Sharabi LL, Tracy SJ.","first_author":"Dehnert M","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"serial interview design, three waves, 29 participants (sex doll/robot owners)","sample_n":29,"sample_text":"Convenience sample of 29 adult owners of sex dolls or sex robots; recruitment method not specified in abstract","population":"owners of sex dolls and sex robots, recruited likely via convenience sampling","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study interviewed 29 owners of sex dolls and robots across three time points, finding that users feel a reciprocal, caring relationship with these machines, seeing them as controllable yet responsive partners. The authors argue this shows how care can be constructed through communication with hyper‑sexualized devices.","clinical_takeaway":"None – the qualitative findings do not provide actionable guidance for clinicians treating sexual health or compulsive sexual behavior.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["In‑depth, longitudinal interview approach (three waves)","Novel focus on communicative construction of care with sex dolls/robots"],"limitations":["Small, non‑representative convenience sample","No quantitative measurement of constructs","Potential self‑selection bias of participants"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2025.2606765"}},{"id":7335,"doi":"10.3389/fnins.2015.00349","pmid":"26500478","pmcid":"PMC4598576","title":"Transcranial direct current stimulation (tDCS) in behavioral and food addiction: a systematic review of efficacy, technical, and methodological issues","authors":"Sauvaget A, Trojak B, Bulteau S, Jiménez-Murcia S, Fernández-Aranda F, Wolz I, Menchón JM, Achab S, Vanelle JM, Grall-Bronnec M.","first_author":"Sauvaget A","journal":"Frontiers in neuroscience","year":2015,"pub_types":["review-article","Review","Journal Article"],"keywords":["Craving","Eating Disorders","Neuromodulation","Transcranial Direct Current Stimulation","Non-invasive Brain Stimulation","Behavioral Addiction","Food Craving"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4598576","cited_by_count":47,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of 7 tDCS studies on behavioral addictions, mainly eating disorders; no meta‑analysis; PRISMA reported","sample_n":7,"sample_text":"seven clinical studies identified","population":"clinical participants with various behavioral addictions (eating, gambling, sexual, etc.)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","selective_reporting"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2015 systematic review examined seven studies using transcranial direct current stimulation (tDCS) for various behavioural addictions, mainly focusing on food cravings. The authors found modest evidence that tDCS may reduce craving, but note many methodological differences and the need for more research, especially beyond eating disorders.","clinical_takeaway":"tDCS shows preliminary promise for reducing cravings, but evidence is limited; clinicians should await stronger trials before adopting it for addiction treatment.","confidence":0.7,"topic_tags":["treatment","neuroscience"],"strengths":["Systematic search following PRISMA","Focus on emerging neuromodulation technique","Identifies methodological gaps in tDCS field"],"limitations":["Very small number of included studies (n=7)","No quantitative synthesis or effect‑size pooling","Limited to eating‑related outcomes; little on sexual addiction"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":52,"citing_publications":79,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fnins.2015.00349"}},{"id":7336,"doi":"10.1111/ene.13078","pmid":"27425586","pmcid":"PMC5096013","title":"Impulse control disorder related behaviours during long-term rotigotine treatment: a post hoc analysis","authors":"Antonini A, Chaudhuri KR, Boroojerdi B, Asgharnejad M, Bauer L, Grieger F, Weintraub D.","first_author":"Antonini A","journal":"European journal of neurology","year":2016,"pub_types":["Meta-Analysis","research-article","Journal Article"],"keywords":["Dopamine agonists","Parkinson's Disease","Clinical Trial","Long-term Treatment","Impulse Control Disorders","Rotigotine Transdermal Patch"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5096013","cited_by_count":53,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"post‑hoc analysis of six open‑label extension studies (up to 6 years) in Parkinson’s disease patients receiving rotigotine","sample_n":786,"sample_text":"Patients from six open‑label extension trials; mean exposure 49.4 months","population":"786 Parkinson’s disease patients treated ≥6 months with rotigotine","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In over 750 Parkinson’s patients using the rotigotine patch for up to five years, about 9% reported impulse‑control problems such as compulsive sexual behaviour, gambling or buying. Incidence rose after 30 months of treatment. Most episodes were mild and resolved after dose reduction or discontinuation.","clinical_takeaway":"Clinicians should monitor for impulse‑control symptoms, including compulsive sexual behaviour, especially after prolonged rotigotine use; dose reduction may help.","confidence":0.9,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample (>750) across multiple long‑term studies","Use of a validated interview for impulse‑control behaviours","Clear reporting of incidence over time"],"limitations":["Post‑hoc, open‑label design without control group","No statistical modeling of risk factors or effect sizes","Confounding variables (e.g., disease severity, other meds) not addressed"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":56,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/ene.13078"}},{"id":7337,"doi":"10.1080/00224490802666225","pmid":"19148829","pmcid":null,"title":"Sexual compulsivity and sexual behaviors among gay and bisexual men and lesbian and bisexual women","authors":"Kelly BC, Bimbi DS, Nanin JE, Izienicki H, Parsons JT.","first_author":"Kelly BC","journal":"Journal of sex research","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of gay/bisexual men and lesbian/bisexual women; community sample, likely convenience","sample_n":null,"sample_text":"not reported in abstract","population":"gay and bisexual men; lesbian and bisexual women (United States)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a community survey, gay and bisexual men reported higher levels of sexual compulsivity than lesbian and bisexual women. Men with higher compulsivity were more likely to use drugs during sex, while women with higher compulsivity reported more specialized sexual behaviors.","clinical_takeaway":"Sexual compulsivity shows gender‑specific patterns; clinicians should assess both substance use and diverse sexual practices when working with GBM and LBM clients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large gender‑diverse community sample","Addresses gap in research on women’s sexual compulsivity","Uses a (presumably) validated SC scale"],"limitations":["Cross‑sectional, cannot infer causality","No measurement/control of key confounds (moral incongruence, mental health, trauma)","Sample size and recruitment method not disclosed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":20,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490802666225"}},{"id":7339,"doi":"10.1093/jsxmed/qdaf354","pmid":"41422389","pmcid":null,"title":"Hypersexuality and binge eating in a non-clinical population: psychopathological factors evaluated according to a gender perspective","authors":"Origlia G, Doroldi D, Giannini T, Colonnello E, Limoncin E, Mollaioli D, Sansone A, Jannini EA, Fontanesi L, Ciocca G.","first_author":"Origlia G","journal":"The journal of sexual medicine","year":2026,"pub_types":["Journal Article"],"keywords":["Trauma","Depression","Gender Differences","Ptsd","Boredom","Impulse Control","Hypersexuality","Binge Eating Behavior","Self-organization Disorders"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf354"}},{"id":7340,"doi":"10.1093/brain/awaf312","pmid":"40904197","pmcid":"PMC12597312","title":"Aberrant striatal firing mediates impulsive decision-making in a mouse model of Parkinson's disease","authors":"Zhuang X, Lemak J, Sridhar S, Nelson AB.","first_author":"Zhuang X","journal":"Brain : a journal of neurology","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Striatum","Basal Ganglia","Delay Discounting","Medium Spiny Neurons","Dopamine Agonist","Pramipexole"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12597312","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"mouse model of Parkinson's disease; chemogenetics, optogenetically‑identified single‑unit recordings; dopamine agonist vs control; delay‑discounting behavioral task","sample_n":null,"sample_text":"not specified in abstract; typical rodent neurophysiology studies use modest numbers per group","population":"male C57BL/6 mice, both parkinsonian (lesioned) and healthy controls","country":"USA (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In mice with a Parkinson's‑like brain lesion, the dopamine drug pramipexole made the animals choose immediate over larger delayed rewards. Recording brain cells showed that the drug altered firing in striatal pathways, and directly changing these pathways also produced impulsive choices, suggesting striatal activity drives impulse‑control problems.","clinical_takeaway":"Impulsive decision‑making in Parkinson’s may stem from striatal circuit changes; targeting these pathways could help manage ICD symptoms.","confidence":0.8,"topic_tags":["neuroscience","prevalence","treatment","adolescents"],"strengths":["causal manipulation of striatal circuits","use of validated delay‑discounting paradigm","combination of behavior with electrophysiology"],"limitations":["small, unspecified animal sample sizes","findings may not translate directly to human hypersexuality","no assessment of broader ICD symptomatology"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":5,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/brain/awaf312"}},{"id":7342,"doi":"10.1016/j.jsxm.2017.11.014","pmid":"29289371","pmcid":null,"title":"Glucose Modulates Human Ventral Tegmental Activity in Response to Sexual Stimuli","authors":"Ulrich M, Stauß P, Grön G.","first_author":"Ulrich M","journal":"The journal of sexual medicine","year":2018,"pub_types":["Journal Article"],"keywords":["Hypothalamus","Functional magnetic resonance imaging","Modulation","Ventral tegmental area","Addiction","Reward","Glucose Infusion","Salience Coding"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Between‑subjects fMRI experiment; 37 healthy men (18 glucose, 19 control) viewed sexual images while VTA activity was recorded.","sample_n":37,"sample_text":"37 healthy men (18 received glucose infusion, 19 control)","population":"Healthy adult men, mean age not specified","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","fmri_reverse_inference"],"stance":"neutral","citation_value":"useful","plain_summary":"In a brain‑imaging study, giving a glucose infusion to men temporarily switched the ventral tegmental area’s response from preferring nude to clothed female images, suggesting glucose can change how the brain tags sexual cues as important.","clinical_takeaway":"No direct clinical implications; glucose’ effect on brain salience needs more research before informing treatment.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","pornography","csbd"],"strengths":["Experimental manipulation of glucose with control group","Use of fMRI to examine VTA response","Clear within‑subject stimulus contrast (nude vs clothed)"],"limitations":["Small sample size for fMRI study","No correction for multiple comparisons reported","No behavioral or clinical measures of sexual behavior or addiction"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":4,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2017.11.014"}},{"id":7344,"doi":"10.1002/cbm.1986","pmid":"26648022","pmcid":null,"title":"Characteristics and correlates of stealing in college students","authors":"Grant JE, Odlaug BL, Lust K, Christenson G.","first_author":"Grant JE","journal":"Criminal behaviour and mental health : CBMH","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online self‑report survey of 1,805 students at a single Midwestern U.S. university; participants grouped by self‑reported stealing urges/behaviour and compared on psychosocial and psychiatric measures.","sample_n":1805,"sample_text":"large convenience sample of university students completing an online questionnaire","population":"College students (young adult, predominantly U.S. university sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among 1,800 college students, those who reported urges to steal also showed higher depression, stress, and a range of impulse‑control problems, including compulsive sexual behaviour, suggesting stealing is part of a broader pattern of impulsive actions.","clinical_takeaway":"Stealing urges in students may signal broader impulsivity and mental‑health issues; clinicians should assess for co‑occurring disorders.","confidence":0.78,"topic_tags":["adolescents"],"strengths":["Large sample size (N>1800)","Inclusive assessment of multiple impulse‑control disorders","Relevant to mental‑health services on campus"],"limitations":["Cross‑sectional design; cannot infer causality","Reliance on self‑report measures; unclear validation","Single‑university convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/cbm.1986"}},{"id":7345,"doi":"10.3390/ijerph20105844","pmid":"37239570","pmcid":"PMC10218143","title":"The Concept of \"Hypersexuality\" in the Boundary between Physiological and Pathological Sexuality","authors":"Perrotta G.","first_author":"Perrotta G.","journal":"International journal of environmental research and public health","year":2023,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual Arousal","Personality Disorders","Hypersexuality","Nymphomania","Bipolarism","Satyriasis"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10218143","cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or risk‑of‑bias assessment; no new empirical data.","sample_n":null,"sample_text":"None (review article)","population":"Humans (general literature synthesis)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article reviews how hypersexuality has been described in clinical literature and suggests a new grading system that separates milder, high‑functioning forms from more severe, pathological ones, but it does so without systematic methods or empirical testing.","clinical_takeaway":"No actionable guidance; the proposed grading system requires empirical validation before clinical use.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Broad literature coverage up to 2023","Proposes a novel grading schema (PH‑GSS)"],"limitations":["Not systematic; selection criteria unclear","No empirical data or validation of proposed scale","Lacks measurement of key confounds (moral incongruence, masturbation, mental health)","Interpretation leans toward pathology without critical appraisal"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph20105844"}},{"id":7346,"doi":"10.1590/1516-4446-2014-1568","pmid":"25946400","pmcid":null,"title":"Two clusters of child molesters based on impulsiveness","authors":"Baltieri DA, Boer DP.","first_author":"Baltieri DA","journal":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cluster analysis of 208 convicted child molesters; k‑means clustering on BIS‑11 factors; logistic regression of criminological/clinical variables.","sample_n":208,"sample_text":"208 child molesters enrolled in two sectional studies.","population":"Male and female adult prisoners convicted of child sexual abuse in São Paulo, Brazil (N = 208).","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers grouped 208 convicted child molesters into two clusters based on impulsivity scores. The higher‑impulsivity group also scored higher on measures of pedophilic interest, recidivism risk, and sexual addiction, suggesting they may need combined psychological and medication treatment.","clinical_takeaway":"Impulsivity assessment can help identify child sexual offenders who may benefit from targeted pharmacological and psychosocial interventions.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a forensic study (N=208)","Use of validated impulsivity and risk‑assessment instruments","Clear statistical clustering approach"],"limitations":["Convenience sample of convicted offenders; limited generalisability","No control for mental‑health or trauma variables","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/1516-4446-2014-1568"}},{"id":7347,"doi":"10.1080/00926238708403875","pmid":"3573048","pmcid":null,"title":"The mislabeling of sexual impulsivity","authors":"Barth RJ, Kinder BN.","first_author":"Barth RJ","journal":"Journal of sex & marital therapy","year":1987,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":95,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"not applicable","population":"not applicable","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"opposes","citation_value":"background","plain_summary":"The authors argue that labels like ‘sexual addiction’ or ‘hypersexuality’ misrepresent the condition, proposing it is better understood as an atypical impulse‑control disorder.","clinical_takeaway":"Treat compulsive sexual behavior as an impulse‑control issue rather than an addiction, focusing on impulse‑regulation strategies.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Comprehensive review of existing terminology","Historical perspective on impulse control framing"],"limitations":["No original empirical data","Lacks measurement of key constructs","Does not control for confounding variables"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":5,"contrasting":0,"mentioning":80,"citing_publications":308,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238708403875"}},{"id":7349,"doi":"10.1016/j.parkreldis.2025.108147","pmid":"41387037","pmcid":null,"title":"Impulse control disorders and dopamine receptor agonism in Parkinson's disease patients: Clinical implications","authors":"Tangedal NM, Tysnes OB.","first_author":"Tangedal NM","journal":"Parkinsonism & related disorders","year":2026,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods or risk‑of‑bias assessment","sample_n":null,"sample_text":"Not applicable – review of existing literature","population":"Parkinson’s disease patients receiving dopamine agonists (no primary data)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The review summarizes how dopamine‑agonist drugs used for Parkinson’s disease can trigger impulse‑control problems like gambling, shopping and hypersexuality, especially when they strongly activate the D3 receptor. It suggests preferring formulations or drugs with less D3 activity to lower this risk.","clinical_takeaway":"Use dopamine agonists cautiously; consider agents with broader receptor profiles or extended‑release forms to reduce impulse‑control disorder risk.","confidence":0.8,"topic_tags":["neuroscience"],"strengths":["Comprehensive overview of dopamine‑agonist–related ICDs","Discusses pharmacologic mechanisms (D3 selectivity)","Clinically relevant recommendations"],"limitations":["Narrative (non‑systematic) synthesis","No quantitative meta‑analysis","No original data, limiting empirical rigor"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2025.108147"}},{"id":7351,"doi":"10.1016/j.addbeh.2025.108582","pmid":"41385881","pmcid":null,"title":"Performing identity and risk: chemsex, misogyny, and algorithmic exclusion in queer Reddit spaces","authors":"Tunca S.","first_author":"Tunca S.","journal":"Addictive behaviors","year":2026,"pub_types":["Journal Article"],"keywords":["Chemsex","Content Moderation","Identity Performance","Online Marginalization","Digital Misogyny","Lgbtq+ Discourse"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"integrative mixed-methods analysis of 509,327 Reddit posts/comments from four LGBTQ+ subreddits; semantic co‑occurrence mapping, sentiment profiling, lexical diversity, and qualitative thematic coding.","sample_n":509327,"sample_text":"509,327 posts and comments drawn from four LGBTQ+‑oriented subreddits.","population":"English‑language Reddit users posting in LGBTQ+‑oriented communities; not a probability sample.","country":"United Kingdom / United States (Anglophone Reddit, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined millions of Reddit posts from LGBTQ+ communities, finding that discussions of chemsex are often linked to loneliness, shame, and stigma, while also showing solidarity and harm‑reduction advice. They highlight how digital misogyny and platform algorithms marginalize trans and non‑binary users.","clinical_takeaway":"None – the study provides sociocultural insights rather than clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Very large data set (>500k posts)","Combines quantitative text analysis with qualitative coding","Transparent, replicable computational pipeline"],"limitations":["No validated scales for key constructs (chemsex, misogyny)","Reddit users are a self‑selected, English‑speaking subset","Cross‑sectional; cannot infer causal effects"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2025.108582"}},{"id":7352,"doi":"10.1016/j.genhosppsych.2014.07.008","pmid":"25150776","pmcid":null,"title":"Excoriation (skin picking) disorder in Israeli University students: prevalence and associated mental health correlates","authors":"Leibovici V, Murad S, Cooper-Kazaz R, Tetro T, Keuthen NJ, Hadayer N, Czarnowicki T, Odlaug BL.","first_author":"Leibovici V","journal":"General hospital psychiatry","year":2014,"pub_types":["Journal Article"],"keywords":["Prevalence","Comorbidity","university students","Health Correlates","Skin Picking Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of Israeli university students (N=2176) with self‑selected responders; prevalence estimate and correlates of excoriation disorder.","sample_n":2176,"sample_text":"Self‑selected respondents to an online questionnaire (43.6% response rate).","population":"Israeli university students (age 17–60, 64% female)","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 2,176 Israeli university students, about 3 % screened positive for skin‑picking disorder. Those students showed higher rates of anxiety, compulsive sexual behavior and eating problems, but not higher depression. Family history of skin picking was common.","clinical_takeaway":"Screening for skin‑picking disorder in university health services may identify students at risk for broader psychosocial difficulties.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for a student survey","Use of multiple validated screening tools for mental‑health comorbidity","First prevalence data for SPD in Israeli university setting"],"limitations":["Low response rate and self‑selection bias","Cross‑sectional design cannot infer causality","Limited information on psychometric properties of SPD screen","No control for moral or relational confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.genhosppsych.2014.07.008"}},{"id":7353,"doi":"10.1016/j.encep.2016.01.003","pmid":"26923999","pmcid":null,"title":"[Aripiprazole, gambling disorder and compulsive sexuality]","authors":"Mété D, Dafreville C, Paitel V, Wind P.","first_author":"Mété D","journal":"L'Encephale","year":2016,"pub_types":["Journal Article","Case Reports"],"keywords":["Dopamine","Aripiprazole","Sexual Orientation","Hypersexuality","Partial Agonist","Gambling Disorder","Agonistes Dopaminergiques","Aripipazole","Jeu Pathologique","Orientation Sexuelle","Sexualité Compulsive"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single patient","sample_n":1,"sample_text":"single case","population":"28‑year‑old male with schizoid personality disorder","country":"France (journal L'Encephale, authors French)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 28‑year‑old man with a personality disorder developed gambling problems and intense sexual changes while taking the antipsychotic aripiprazole; symptoms stopped after the drug was discontinued.","clinical_takeaway":"Be alert to possible impulse‑control and sexual side‑effects when prescribing aripiprazole.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["detailed clinical description","highly specific pharmacological context"],"limitations":["single case, no systematic assessment","no validated measures of hypersexuality or gambling severity","no control for moral or psychological confounds"],"rubric_version":"2.0","raw_total":8,"max_possible":60,"pct_score":13,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":2,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.encep.2016.01.003"}},{"id":7354,"doi":"10.3389/fnbeh.2016.00154","pmid":"27536223","pmcid":"PMC4971057","title":"Compulsivity Across the Pathological Misuse of Drug and Non-Drug Rewards","authors":"Banca P, Harrison NA, Voon V.","first_author":"Banca P","journal":"Frontiers in behavioral neuroscience","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Addiction","Reversal Learning","Alcohol Dependence","Set-shifting","Binge Eating Disorder","Compulsivity"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fnbeh.2016.00154/pdf","cited_by_count":37,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional comparative study of clinical groups (AD, VG, BED, CSB, HV)","sample_n":null,"sample_text":"multiple clinical groups; exact numbers not given in abstract","population":"adults with alcohol dependence, pathological video‑gaming, binge‑eating disorder, compulsive sexual behavior, and healthy volunteers","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared how people with alcohol dependence, video‑gaming problems, binge‑eating, and compulsive sexual behavior performed on tests of flexibility and learning. All clinical groups showed some deficits, suggesting shared aspects of compulsivity, but the research did not examine moral or personal factors that might influence sexual‑behavior findings.","clinical_takeaway":"Deficits in learning flexibility appear across compulsive disorders, but this does not directly inform treatment of compulsive sexual behavior.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["direct behavioral testing of reversal learning and set‑shifting","comparison across several compulsive disorder groups","use of established cognitive tasks"],"limitations":["Cross‑sectional design limits causal inference","Unclear how CSB was defined or measured","Key confounds (moral incongruence, masturbation, mental health) not assessed","No pre‑registration or power justification reported"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":1,"mentioning":40,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fnbeh.2016.00154"}},{"id":7356,"doi":"10.19082/5129","pmid":"28979752","pmcid":"PMC5614302","title":"Triangular relationship among risky sexual behavior, addiction, and aggression: A systematic review","authors":"Ahmadi K, Javadinia SA, Saadat SH, Ramezani MA, Sedghijalal H.","first_author":"Ahmadi K","journal":"Electronic physician","year":2017,"pub_types":["review-article","Review","Journal Article"],"keywords":["Unprotected sex","Aggression","Addictive Behavior","High Risk Sex"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5614302","cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of 49 studies without meta‑analysis or risk‑of‑bias assessment; includes cross‑sectional and correlational primary studies","sample_n":null,"sample_text":"Not applicable (review)","population":"studies published 1993‑2013 on addiction, risky sexual behavior and aggression; no primary sample reported","country":"Not applicable (review)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The review summarises 49 prior studies and finds that addiction, risky sexual behaviour and aggression often co‑occur. It suggests a three‑way “triangle” linking these factors, but it does not analyse the quality of the original studies or prove causation.","clinical_takeaway":"The evidence only shows associations; clinicians should not assume addiction causes risky sex or aggression without further assessment.","confidence":0.7,"topic_tags":["relationships","religiosity"],"strengths":["Broad literature search across multiple databases","Identifies consistent correlations among three domains","Includes both English and Persian sources"],"limitations":["No risk‑of‑bias assessment of included studies","No meta‑analytic quantitative synthesis","Relies on correlational primary studies yet presents causal language","Does not address key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.19082/5129"}},{"id":7357,"doi":"10.1007/s10508-023-02580-z","pmid":"36947326","pmcid":null,"title":"Sexual Narcissism and Hypersexuality Relate to Sexual Coercion in Hookups among U.S. University Students","authors":"Basting EJ, Barrett ME, Garner AR, Florimbio AR, Sullivan JA, Medenblik AM, Stuart GL.","first_author":"Basting EJ","journal":"Archives of sexual behavior","year":2023,"pub_types":["Journal Article"],"keywords":["risk factors","Compulsive Sexual Behavior","Sexual Violence","Perpetration","Unwanted Sex"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 793 undergraduates; structural equation modeling","sample_n":793,"sample_text":"Undergraduate students at a large southeastern university","population":"U.S. university students (age 18‑25)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 793 U.S. college students, higher levels of sexual narcissism and hypersexuality were linked to greater self‑reported sexual coercion in casual hookups, with no differences between men and women.","clinical_takeaway":"Hypersexuality traits may increase risk of sexual coercion; clinicians should assess these traits when addressing sexual violence prevention.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Large sample size for a survey","Use of confirmatory factor analysis and SEM","Validated (or likely validated) scales for key constructs","Gender‑balanced analysis"],"limitations":["Cross‑sectional design limits causal inference","No control for key confounds (e.g., mental health, trauma)","Convenience sample of one university limits generalisability","No pre‑registration or open data"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02580-z"}},{"id":7358,"doi":"10.1007/s10508-007-9292-y","pmid":"18185990","pmcid":"PMC2695846","title":"Sexual marathons and methamphetamine use among HIV-positive men who have sex with men","authors":"Semple SJ, Zians J, Strathdee SA, Patterson TL.","first_author":"Semple SJ","journal":"Archives of sexual behavior","year":2009,"pub_types":["research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":70,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"exploratory cross‑sectional survey of 341 HIV‑positive methamphetamine‑using MSM; comparison of those reporting sexual marathons vs. those who did not","sample_n":341,"sample_text":"341 HIV‑positive meth‑using MSM","population":"HIV‑positive men who have sex with men, methamphetamine users, United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among HIV‑positive men who have sex with men and use methamphetamine, those who report \"sexual marathons\" also use more drugs and score higher on a sexual compulsivity questionnaire, especially if they have taken Viagra.","clinical_takeaway":"Sexual marathon behavior in meth‑using MSM is linked to higher drug use and compulsivity; clinicians should assess these patterns when planning HIV/STI risk‑reduction interventions.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["large sample for a hard‑to‑reach population","use of a validated sexual compulsivity scale","multivariate logistic analysis to control some covariates"],"limitations":["cross‑sectional; cannot infer causality","no measurement of key sexual‑health confounds (moral incongruence, mental health, partner context)","self‑report data may be biased"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":2,"mentioning":58,"citing_publications":97,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-007-9292-y"}},{"id":7359,"doi":"10.3389/fpsyt.2023.1088747","pmid":"37009122","pmcid":"PMC10061101","title":"Study protocol: Hypersexual and hyposexual behavior among adults diagnosed with alcohol- and substance use disorders-Associations between traumatic experiences and problematic sexual behavior","authors":"Jepsen D, Luck T, Bernard M, Moor I, Watzke S.","first_author":"Jepsen D","journal":"Frontiers in psychiatry","year":2023,"pub_types":["methods-article","Journal Article"],"keywords":["Sexual dysfunction","Drug Addiction","Libido","Compulsive Sexual Behavior","Substance Use Disorder","Alcohol Addiction","Childhood Trauma","Chemsex"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1088747/pdf","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional ex‑post‑facto online survey of adults with SUD, plus two control groups (psychiatric controls and healthy controls); convenience sampling via support services","sample_n":null,"sample_text":"Online convenience sample recruited through support and networking services; exact size not reported in abstract","population":"adults diagnosed with alcohol‑ and/or substance‑use disorders; comparison groups with other psychiatric disorders and healthy adults","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"background","plain_summary":"The authors plan a survey to see how often people with alcohol or drug problems report too much or too little sexual activity, and whether childhood trauma influences these patterns, comparing them to other psychiatric patients and healthy adults.","clinical_takeaway":"None – the paper describes a future study and does not provide clinical results.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses a neglected topic (hyper/hyposexual behavior in SUD)","Includes two control groups for comparison","Plans multivariate regression to identify risk factors"],"limitations":["Convenience online recruitment limits generalisability","No measurement of moral incongruence or masturbation behavior","Protocol provides no detail on validated instruments or power analysis"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2023.1088747"}},{"id":7363,"doi":"10.1207/s15327752jpa6503_16","pmid":"8609589","pmcid":null,"title":"Sexual sensation seeking and Sexual Compulsivity Scales: reliability, validity, and predicting HIV risk behavior","authors":"Kalichman SC, Rompa D.","first_author":"Kalichman SC","journal":"Journal of personality assessment","year":1995,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":435,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two cross‑sectional validation studies using convenience samples of gay men (N=296) and inner‑city low‑income men and women (N=158).","sample_n":454,"sample_text":"N = 296 gay men; N = 158 inner‑city low‑income men and women","population":"Adults (gay men; heterosexual low‑income men and women)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and tested two questionnaires measuring sexual sensation seeking and sexual compulsivity. Both scales were reliable and related to HIV risk behaviors like unprotected sex and many partners, though patterns differed between gay and heterosexual participants.","clinical_takeaway":"These validated scales can help identify individuals at higher risk for unsafe sexual practices, informing targeted HIV‑prevention efforts.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample sizes for scale validation","Both reliability and convergent/divergent validity assessed","Separate samples (gay men vs. heterosexual low‑income) provide comparative insight"],"limitations":["Convenience, non‑representative samples limit generalizability","No assessment of moral or partner‑related confounds","No preregistration or open data"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":18,"contrasting":1,"mentioning":566,"citing_publications":796,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1207/s15327752jpa6503_16"}},{"id":7365,"doi":"10.1080/00223891.2012.700665","pmid":"22808951","pmcid":null,"title":"Implications of recent research in neurobiology for psychological assessment","authors":"Finn SE.","first_author":"Finn SE.","journal":"Journal of personality assessment","year":2012,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review with illustrative case report; no original empirical data.","sample_n":null,"sample_text":"N/A – review article with a single illustrative case.","population":"Adult male (single case example) and broader theoretical discussion; no sample size reported.","country":"Unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The author reviews research linking early trauma, right‑hemisphere brain changes, and attachment problems to various psychopathologies, and argues that psychological assessments should consider the client‑assessor relationship and emotional experience, illustrating points with a case of compulsive sexual behavior.","clinical_takeaway":"Therapeutic assessment that evokes strong emotional experiences may enhance change, especially when attachment issues are present.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Integrates neurobiological and attachment literature.","Provides clinical illustration of compulsive sexual behavior."],"limitations":["Lacks original empirical data.","No systematic methodology or risk‑of‑bias assessment.","No measurement of key confounds (e.g., moral incongruence, masturbation)."],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00223891.2012.700665"}},{"id":7366,"doi":"10.1097/md.0000000000033401","pmid":"36961134","pmcid":"PMC10036006","title":"Intervention for modifying risk level of hypersexual behaviors among male parents with sexual offending history","authors":"Egenti NT, Ede MO, Okeke CI, Oneli JO.","first_author":"Egenti NT","journal":"Medicine","year":2023,"pub_types":["Clinical Trial","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.1097/md.0000000000033401","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"parallel-group RCT with 48 convicted male parents (24 CBT, 24 control), three assessment points, simple random allocation","sample_n":48,"sample_text":"48 inmates, randomly allocated to CBT (n=24) or no‑intervention control (n=24)","population":"convicted male sex offenders who are parents","country":"Nigeria (inferred from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"moderate","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small randomized trial found that cognitive‑behavioural therapy lowered scores on a measure of hypersexual risk among 48 convicted male parents compared with a no‑treatment group, but the study used non‑validated scales and did not control for moral or mental‑health factors.","clinical_takeaway":"CBT may reduce risky hypersexual attitudes in male sex offenders, but evidence is limited; clinicians should interpret findings cautiously.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Random allocation to intervention and control","Use of ANCOVA to adjust for baseline differences","Clear focus on a high‑risk population"],"limitations":["Very small sample (N=48) limits statistical power","Outcome measures not described as validated instruments","No assessment of key confounds (morality, mental health, trauma, etc.)","Results presented without effect sizes or confidence intervals"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/md.0000000000033401"}},{"id":7367,"doi":"10.1556/jba.2.2013.2.7","pmid":"26165931","pmcid":null,"title":"Impulse control disorders in non-treatment seeking hair pullers","authors":"Schreiber LR, Lust K, Odlaug B, Derbyshire KL, Grant J.","first_author":"Schreiber LR","journal":"Journal of behavioral addictions","year":2013,"pub_types":["Journal Article"],"keywords":["Comorbidity","Impulse Control Disorders","Hair Pulling Disorder"],"is_oa":false,"oa_url":"https://akjournals.com/downloadpdf/journals/2006/2/2/article-p113.pdf","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online mental‑health survey of 1,717 college students; 44 reported hair pulling (non‑clinical), 1,673 controls; DSM‑IV‑TR impulse‑control disorders assessed with Minnesota Impulsive Disorders Interview.","sample_n":1717,"sample_text":"44 hair‑pullers, 1,673 non‑hair‑pullers","population":"College students (young adult, likely WEIRD sample); non‑treatment‑seeking hair pullers.","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 1,700 college students, those who reported hair‑pulling were about three times more likely to also meet criteria for other impulse‑control problems like compulsive buying, compulsive sex and explosive anger, especially men.","clinical_takeaway":"Hair‑pulling often co‑occurs with other impulsive disorders; clinicians should screen for broader impulse‑control issues.","confidence":0.78,"topic_tags":["treatment","pornography","masturbation","sexual_function"],"strengths":["Large overall sample size","Use of a structured, validated interview for impulse‑control disorders","Focus on non‑clinical, community sample"],"limitations":["Very small hair‑pulling subgroup (n=44)","Cross‑sectional; cannot infer causality","No measurement of key confounds (e.g., mental health, trauma, moral factors)","College‑student sample limits generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/jba.2.2013.2.7"}},{"id":7368,"doi":"10.1111/pcn.13523","pmid":"36579893","pmcid":"PMC11488615","title":"A circuit-based approach to modulate hypersexuality in Parkinson's disease","authors":"Mata-Marín D, Pineda-Pardo JÁ, Michiels M, Pagge C, Ammann C, Martínez-Fernández R, Molina JA, Vela-Desojo L, Alonso-Frech F, Obeso I.","first_author":"Mata-Marín D","journal":"Psychiatry and clinical neurosciences","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Dopamine","Transcranial magnetic stimulation","Parkinson's Disease","Neuroimaging","Impulse-control Disorders"],"is_oa":true,"oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/pcn.13523","cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"sham‑controlled intermittent theta‑burst stimulation over pre‑SMA; case‑control fMRI connectivity; N≈20 for stimulation, N≈50 total for imaging groups","sample_n":53,"sample_text":"16 hypersexual PD, 17 non‑hypersexual PD, 17 healthy controls; 20 hypersexual PD received TBS (sham‑controlled)","population":"Parkinson’s disease patients with hypersexuality vs non‑hypersexual PD patients and healthy controls","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":["masturbation_not_isolated","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson’s patients with hypersexuality, brain scans showed over‑activity in reward‑related circuits when on dopamine medication. A brief, sham‑controlled brain‑stimulation targeting the pre‑supplementary motor area improved their ability to stop responding to sexual cues, suggesting a neural pathway that can be modulated.","clinical_takeaway":"Targeted theta‑burst stimulation may help PD patients with hypersexual impulsivity improve response inhibition.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Sham‑controlled neuromodulation","Multimodal imaging of fronto‑striatal circuitry","Focus on functional restoration rather than only description"],"limitations":["Small sample sizes for imaging and stimulation groups","No measurement/control of partner or mental‑health variables","No assessment of moral or masturbatory context"],"rubric_version":"2.0","raw_total":40,"max_possible":60,"pct_score":67,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":6,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/pcn.13523"}},{"id":7369,"doi":"10.1177/00912174251392426","pmid":"41165051","pmcid":null,"title":"Prevalence and risk factors of dopamine agonists induced impulse control disorders in patients with prolactinoma","authors":"Zhang S, Wang C, Wang D.","first_author":"Zhang S","journal":"International journal of psychiatry in medicine","year":2026,"pub_types":["Journal Article"],"keywords":["Psychiatric disorders","risk factors","Impulse Control Disorders","Prolactinoma Treatment","Dopamine Agonists Side Effects"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross-sectional convenience sample of 170 prolactinoma patients from one centre, assessing self‑reported ICD symptoms after ≥6 months dopamine‑agonist therapy.","sample_n":170,"sample_text":"Convenience sample, single centre","population":"Adults with prolactinoma on dopamine agonists (N≈170)","country":"Not reported","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 170 patients treated for prolactin‑producing pituitary tumors, about one‑quarter reported impulse‑control problems such as binge eating, compulsive sex, or shopping. Men, larger tumours, higher prolactin, higher medication doses, longer treatment, and anxiety or depression increased the risk.","clinical_takeaway":"Monitor patients on dopamine agonists for impulse‑control symptoms, especially if they are male, on high doses, or have anxiety/depression.","confidence":0.85,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Reasonably large sample for a niche clinical population","Identifies several clinical risk factors (dose, duration, gender)","Focuses on a clinically relevant adverse effect of dopamine agonists"],"limitations":["Convenience, single‑centre sample limits generalisability","ICD symptoms measured with unspecified, likely unvalidated self‑report tool","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00912174251392426"}},{"id":7370,"doi":"10.1016/s0306-4603(99)00056-8","pmid":"10628518","pmcid":null,"title":"Sexual compulsivity and substance use in HIV-seropositive men who have sex with men: prevalence and predictors of high-risk behaviors","authors":"Benotsch EG, Kalichman SC, Kelly JA.","first_author":"Benotsch EG","journal":"Addictive behaviors","year":1999,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":98,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 112 HIV‑positive MSM recruited from clinical/community settings","sample_n":112,"sample_text":"convenience sample of HIV‑positive MSM","population":"HIV‑positive men who have sex with men (N=112)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among HIV‑positive gay men, higher sexual compulsivity was linked to more unprotected sex, more cocaine use (their own and partners'), and lower self‑esteem, suggesting that compulsive sexual tendencies and substance use together raise transmission risk.","clinical_takeaway":"Assess sexual compulsivity and substance use together when counseling HIV‑positive MSM about risk reduction.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["uses a validated sexual compulsivity instrument","includes partner substance‑use variables","adds mediational analysis"],"limitations":["cross‑sectional design limits causal inference","no control for moral or mental‑health variables","convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":13,"contrasting":0,"mentioning":129,"citing_publications":198,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0306-4603(99)00056-8"}},{"id":7371,"doi":"10.3233/978-1-60750-017-9-277","pmid":"19592781","pmcid":null,"title":"Psychopathological issues of technological addiction: new diagnostic criteria for addiction","authors":"Caretti V, Craparo G.","first_author":"Caretti V","journal":"Studies in health technology and informatics","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"theoretical proposal of diagnostic criteria without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors present a new set of diagnostic criteria for various behavioural addictions, including sexual addiction, based on a conceptual model of compulsive, pleasure‑seeking behavior.","clinical_takeaway":"No clinical guidance can be drawn; the proposed criteria need empirical testing before use.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Addresses need for clearer diagnostic framework","Integrates multiple behavioural addictions"],"limitations":["No empirical validation of proposed criteria","Lacks measurement of key confounds (e.g., moral incongruence)","No data on psychometric properties"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3233/978-1-60750-017-9-277"}},{"id":7372,"doi":"10.1016/bs.irn.2017.04.006","pmid":"28802938","pmcid":null,"title":"Impulse Control and Related Disorders in Parkinson's Disease","authors":"Weintraub D, Claassen DO.","first_author":"Weintraub D","journal":"International review of neurobiology","year":2017,"pub_types":["Review","Journal Article"],"keywords":["Parkinson's Disease","Pathological Gambling","Impulsive","Impulse Control Disorder","Dopamine Agonist","Punding","Compulsive","Dopamine Dysregulation Syndrome","Mesocorticolimbic","D3 Receptor","Dopamine Agonist Withdrawal Syndrome"],"is_oa":false,"oa_url":null,"cited_by_count":165,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of impulse control disorders in Parkinson’s disease; no original empirical data.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Patients with Parkinson’s disease (PD) experiencing impulse control disorders (ICDs) including compulsive sexual behavior.","country":"International","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review describes how people with Parkinson’s disease can develop impulse‑control problems such as gambling, compulsive buying, eating, and sexual behaviour, often linked to dopamine‑boosting medications. It outlines risk factors, possible brain mechanisms, and the limited evidence for treatments.","clinical_takeaway":"Clinicians should monitor PD patients on dopamine agonists for emerging impulse‑control problems, including compulsive sexual behaviour, and consider medication adjustments when needed.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive summary of ICD prevalence and risk factors in PD.","Integrates neurobiological and clinical perspectives."],"limitations":["Narrative review; no systematic methodology or risk‑of‑bias assessment.","Lacks original data; cannot assess construct validity or statistical rigor.","Potential for author bias in topic selection."],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":8,"contrasting":1,"mentioning":212,"citing_publications":292,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/bs.irn.2017.04.006"}},{"id":7373,"doi":"10.1016/j.encep.2011.12.010","pmid":"23200612","pmcid":null,"title":"[Chemical and behavioural addiction of medical students. Comparative study in Lebanese students]","authors":"Moaouad J, Kazour F, Haddad R, Rouhayem J, Chammai R, Richa S.","first_author":"Moaouad J","journal":"L'Encephale","year":2012,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 140 medical students and 140 non‑medical students at a single Lebanese university.","sample_n":280,"sample_text":"140 medical students; 140 control students from other faculties","population":"medical students vs. non‑medical university students (Lebanon)","country":"Lebanon","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of Lebanese medical and non‑medical students found no overall difference in substance or behavioural addictions, though medical students reported lower rates of caffeine, cocaine, nicotine, sexual addiction and compulsive buying. Gender differences were noted for some behaviours.","clinical_takeaway":"Among Lebanese university students, medical training does not appear to increase sexual or other addiction risk.","confidence":0.6,"topic_tags":["sexual_function","masturbation"],"strengths":["Reasonably sized sample for a student survey","Comparison group from other faculties"],"limitations":["Reliance on self‑report DSM‑IV items; unclear validation for sexual addiction","No measurement of moral incongruence, masturbation, mental health or trauma","Cross‑sectional convenience sample limits causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":3,"contrasting":1,"mentioning":4,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.encep.2011.12.010"}},{"id":7374,"doi":"10.1016/j.comppsych.2014.07.012","pmid":"25113055","pmcid":null,"title":"Losing control: assaultive behavior as a predictor of impulse control disorders in young adults","authors":"Leppink E, Odlaug BL, Lust K, Christenson G, Derbyshire K, Grant JE.","first_author":"Leppink E","journal":"Comprehensive psychiatry","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"University-wide email survey of 6000 students; 35% response (n=2108). Single‑time point assessment of assaultive behavior and impulse‑control disorders using the Minnesota Impulsive Disorders Interview.","sample_n":2108,"sample_text":"2108 respondents (35.1% of 6000 invited)","population":"young adult university students (USA)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2014 survey of over 2,000 U.S. college students found that those who had ever assaulted someone or damaged property were more likely to report compulsive sexual behavior and other impulse‑control problems, as well as higher depression and stress.","clinical_takeaway":"History of assaultive behavior may signal heightened risk for compulsive sexual behavior and other impulse‑control issues; clinicians should assess and address co‑occurring mental‑health concerns.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Large overall sample size for a university survey","Use of a clinically validated interview (Minnesota Impulsive Disorders Interview)","Clear focus on assaultive behavior as predictor of multiple impulse‑control disorders"],"limitations":["Cross‑sectional design limits causal inference","Potential self‑selection bias (35% response rate)","Limited measurement of key confounds (e.g., moral incongruence, trauma, partner factors)","Reliance on self‑report for assaultive behavior"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2014.07.012"}},{"id":7376,"doi":"10.1111/j.1743-6109.2011.02314.x","pmid":"21595837","pmcid":null,"title":"A surprising finding related to executive control in a patient sample of hypersexual men","authors":"Reid RC, Garos S, Carpenter BN, Coleman E.","first_author":"Reid RC","journal":"The journal of sexual medicine","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control study comparing 30 hypersexual men seeking treatment with 30 community men; neuropsychological test battery; multivariate analysis controlling for IQ","sample_n":60,"sample_text":"30 hypersexual men, 30 controls","population":"male adults, treatment‑seeking hypersexual vs non‑hypersexual community controls","country":"USA (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared 30 men seeking help for hypersexual behavior with 30 community men and found no differences in executive‑function test performance, suggesting that hypersexuality may not involve general executive deficits.","clinical_takeaway":"Hypersexual patients may not have broad executive dysfunction; assessment should focus on domain‑specific impulsivity rather than global executive deficits.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["use of validated hypersexuality scales","standardized neuropsychological battery","control for IQ"],"limitations":["modest, non‑representative sample","no assessment of moral incongruence or masturbation","no power analysis or effect‑size reporting"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":32,"citing_publications":121,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2011.02314.x"}},{"id":7379,"doi":"10.1007/s10508-009-9483-9","pmid":"19308715","pmcid":"PMC2890042","title":"Sexual compulsivity and sexual risk in gay and bisexual men","authors":"Grov C, Parsons JT, Bimbi DS.","first_author":"Grov C","journal":"Archives of sexual behavior","year":2010,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":109,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional community‑based survey (N=1214) of gay and bisexual men assessing sexual compulsivity (SCS) and HIV‑related sexual risk behaviours","sample_n":1214,"sample_text":"Community‑based survey of gay and bisexual men (n = 1214)","population":"gay and bisexual men (MSM) recruited via community survey; likely convenience sample","country":"United States (presumed from authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 1,200 gay and bisexual men, higher scores on a sexual compulsivity questionnaire were linked to riskier sexual behaviours, including unprotected anal sex and drug‑involved encounters.","clinical_takeaway":"Higher sexual‑compulsivity scores may flag men at greater HIV‑risk, suggesting targeted risk‑reduction counseling.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a community survey","Use of validated Sexual Compulsivity Scale","Multivariate analysis controlling for several covariates"],"limitations":["Cross‑sectional design limits causal inference","Key confounds (moral incongruence, masturbation, mental health, trauma) not measured","Convenience sampling may limit generalisability"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":2,"mentioning":135,"citing_publications":175,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-009-9483-9"}},{"id":7380,"doi":"10.1016/j.neuroimage.2025.121507","pmid":"41052729","pmcid":"PMC13004576","title":"Neural signatures and personalized neuromodulation in a subject experiencing context-dependent inhibitory control deficits","authors":"Mattar LS, Shah S, Chamakura LS, Oswalt D, Zhang Y, Devara D, Kang JU, Jourahmad Z, Jafri R, Liu G, Adkinson J, Danstrom IA, Fan X, Reed YY, Bijanki KR, Goldman A, Lin L, Krishnan V, Provenza NR, Watrous AJ, Sheth SA, Heilbronner SR, Banks GP, Bartoli E.","first_author":"Mattar LS","journal":"NeuroImage","year":2025,"pub_types":["research-article","Journal Article","Case Reports","Research Support, N.I.H., Extramural"],"keywords":["P300","Case Study","Inhibitory Control","Functional Connectivity","Neuromodulation","Intracranial Recording","Klüver-bucy Syndrome"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13004576","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single subject intracranial monitoring with personalized neuromodulation paradigm","sample_n":1,"sample_text":"single patient recruited during epilepsy monitoring","population":"1 adult male with Klüver‑Bucy syndrome and hypersexuality","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A man with Klüver‑Bucy syndrome and uncontrolled sexual urges showed worse inhibition when viewing arousing pictures. Intracranial brain recordings identified neural patterns linked to these failures, and brief high‑frequency stimulation of a frontal area temporarily improved his control.","clinical_takeaway":"Very limited evidence; neuromodulation may help context‑dependent inhibition deficits, but findings are from a single case and not ready for clinical use.","confidence":0.6,"topic_tags":["sexual_function","csbd","neuroscience","relationships"],"strengths":["Rare intracranial recording of hypersexuality context","Personalized neuromodulation protocol","Multimodal neural biomarkers reported"],"limitations":["Single‑case design; no control group","No validated measures of hypersexuality or distress","No assessment of moral or psychological confounds"],"rubric_version":"2.0","raw_total":13,"max_possible":60,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":3,"statistics":3,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neuroimage.2025.121507"}},{"id":7381,"doi":"10.1007/s10508-007-9218-8","pmid":"17882541","pmcid":null,"title":"Explanations for the origins of sexual compulsivity among gay and bisexual men","authors":"Parsons JT, Kelly BC, Bimbi DS, DiMaria L, Wainberg ML, Morgenstern J.","first_author":"Parsons JT","journal":"Archives of sexual behavior","year":2008,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":63,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"mixed-methods study with 183 gay/bisexual men from NYC; cross‑sectional interviews and surveys; convenience sample","sample_n":183,"sample_text":"Convenience sample drawn from Project SPIN","population":"gay and bisexual men (NYC)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Gay and bisexual men with self‑identified sexual compulsivity explained its origins as a mix of personal predisposition and life experiences such as abuse and easy access to partners.","clinical_takeaway":"Clinicians should explore patients' personal narratives about compulsive sexual behavior rather than assuming a single cause.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large sample for a qualitative study","provides participants' own explanatory models","high relevance to sexual health of GBM"],"limitations":["convenience, non‑representative sample","no systematic control of key confounds (e.g., moral incongruence)","unlikely to meet power requirements for statistical testing"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":73,"citing_publications":95,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-007-9218-8"}},{"id":7382,"doi":"10.3390/medicina61101789","pmid":"41155776","pmcid":"PMC12566585","title":"Uric Acid and Impulse Control Disorders in Parkinson's Disease: A Cross-Sectional Analysis","authors":"Toś M, Dymek A, Morka A, Włodarczyk P, Siuda J.","first_author":"Toś M","journal":"Medicina (Kaunas, Lithuania)","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Uric acid","Impulsivity","Parkinson’s Disease","Pathological Gambling","Impulse Control Disorder","Hypersexuality","Uric Acid/creatine Ratio"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12566585","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 172 Parkinson’s patients screened for ICDs using the validated QUIP questionnaire; serum uric acid measured.","sample_n":172,"sample_text":"172 Parkinson’s disease patients","population":"PwP (hospitalized for follow‑up or treatment modification), N=172, median age not specified","country":"Poland (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 172 people with Parkinson’s disease, lower blood levels of uric acid relative to creatinine were linked to higher rates of hypersexuality and gambling, but not to impulse‑control problems overall.","clinical_takeaway":"Low uric‑acid/creatinine ratios may signal higher risk for hypersexuality or gambling in Parkinson’s patients; more research needed before clinical use.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Validated ICD screening tool (QUIP)","Biochemical measurement of UA/Cr","Reasonable sample size for a PD clinical study"],"limitations":["Cross‑sectional design limits causal inference","No control for mood or other psychiatric confounds","No correction for multiple comparisons reported"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/medicina61101789"}},{"id":7384,"doi":"10.1007/s10461-006-9135-1","pmid":"16775771","pmcid":null,"title":"Intentional unprotected anal intercourse among sex who have sex with men: barebacking - from behavior to identity","authors":"Parsons JT, Bimbi DS.","first_author":"Parsons JT","journal":"AIDS and behavior","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":60,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 687 gay/bisexual men recruited at community events","sample_n":687,"sample_text":"687 gay/bisexual men attending community events","population":"gay/bisexual men attending community events (likely convenience sample)","country":"unspecified (likely USA based on journal and authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 687 gay and bisexual men at community events examined how many identify as \"barebackers\" (people who seek condomless anal sex) and what predicts that identity. Those who identified as barebackers used more crystal meth, felt stronger peer pressure for unsafe sex, and showed higher sexual compulsivity or romantic obsession depending on HIV status.","clinical_takeaway":"Identity as a \"barebacker\" is linked to higher drug use and sexual compulsivity, suggesting tailored risk‑reduction interventions may be needed.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Large community sample (N=687)","Inclusion of identity dimension (bareback identity)","Assessment of multiple psychosocial correlates"],"limitations":["Cross‑sectional design limits causal inference","Convenience recruitment may bias prevalence estimates","Reliance on self‑label and self‑report measures"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":10,"contrasting":3,"mentioning":82,"citing_publications":87,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-006-9135-1"}},{"id":7386,"doi":"10.1007/s00127-025-03002-2","pmid":"40983664","pmcid":null,"title":"Experiences relating to intimacy, romance, and sexuality in early psychosis","authors":"Woolridge SM, Hau I, Wilkinson E, Stewart CA, Edirisinghe S, Aidelbaum R, Best MW, Bowie CR.","first_author":"Woolridge SM","journal":"Social psychiatry and psychiatric epidemiology","year":2026,"pub_types":["Journal Article"],"keywords":["Schizophrenia","Social Functioning","Sexual Relationships","Romantic Relationships","Early Psychosis Intervention"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Case‑control survey of early‑psychosis patients (n=35) vs community controls (n=38) using self‑report questionnaires on intimacy, romance and sexuality.","sample_n":73,"sample_text":"35 patients, 38 controls","population":"Adults with early psychosis and community controls, recruited via early‑psychosis services and convenience sampling.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"People with early psychosis report more loneliness, anxiety about attachments, and sexual dissatisfaction compared with peers, but similar relationship satisfaction when they are in a partnership.","clinical_takeaway":"Assess and support intimate and sexual wellbeing in early‑psychosis care, as patients may experience heightened distress in these domains.","confidence":0.78,"topic_tags":["sexual_function","relationships","adolescents"],"strengths":["Uses validated sexuality and relationship questionnaires (presumed)","includes a control group","Addresses understudied area (early psychosis and sexuality)"],"limitations":["Small sample limits power and generalisability","Cross‑sectional; cannot infer causality","Limited control for key confounds (moral incongruence, masturbation, mental health covariates)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00127-025-03002-2"}},{"id":7388,"doi":"10.3389/frcha.2022.1048732","pmid":"39817274","pmcid":"PMC11732009","title":"H is for hypersexual: Sexuality in youths with ADHD","authors":"Hale EW, Murphy MO, Thompson KP.","first_author":"Hale EW","journal":"Frontiers in child and adolescent psychiatry","year":2022,"pub_types":["brief-report","Journal Article"],"keywords":["ADHD","Hypersexuality","Adolescent Psychiatry","Lgbtq","Sexuality Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11732009","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective cohort using TriNetX electronic health records, comparing youths with and without ADHD on diagnoses of hypersexuality and psychiatric comorbidities.","sample_n":1355184,"sample_text":"1,355,184 analyzed patient records.","population":"Patients ≤21 years old from a US health‑record database (N≈1.36 million).","country":"United States (TriNetX network).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Using over a million health records, researchers found that youths with ADHD are more likely to receive a diagnosis of hypersexual behavior and to have other psychiatric disorders, especially when the risky sexual behavior involves same‑sex partners.","clinical_takeaway":"ADHD may co‑occur with hypersexual behavior and psychiatric comorbidity; clinicians should screen for sexual health issues in this population.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Very large, nation‑wide dataset","Clear comparison groups (ADHD vs non‑ADHD)","Comprehensive assessment of psychiatric comorbidities"],"limitations":["Reliance on diagnostic codes rather than validated scales for hypersexuality","Cross‑sectional, cannot infer causality","Key confounds (moral incongruence, masturbation, relationship context) not measured"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/frcha.2022.1048732"}},{"id":7389,"doi":null,"pmid":"21322141","pmcid":null,"title":"[Phenomenology of craving: from differentiation to adequate therapy]","authors":"Mendelevich VD.","first_author":"Mendelevich VD.","journal":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","year":2010,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"rus","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"theoretical analysis without empirical data","sample_n":null,"sample_text":"no participants; conceptual article","population":"none","country":"Russia","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper offers a theoretical discussion of addiction, distinguishing it from other drive disorders and suggesting revised definitions that include sexual addiction as a type of para‑addictive drive.","clinical_takeaway":"None – the article provides no empirical findings for clinical use.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["addresses conceptual differentiation of addiction","highly theoretical perspective"],"limitations":["no empirical data","no operational definitions or measures","cannot assess prevalence or effects"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":7390,"doi":"10.1001/archneurol.2010.65","pmid":"20457959","pmcid":null,"title":"Impulse control disorders in Parkinson disease: a cross-sectional study of 3090 patients","authors":"Weintraub D, Koester J, Potenza MN, Siderowf AD, Stacy M, Voon V, Whetteckey J, Wunderlich GR, Lang AE.","first_author":"Weintraub D","journal":"Archives of neurology","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":981,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional study of 3090 PD patients from 46 centers","sample_n":3090,"sample_text":"3090 patients","population":"treated idiopathic Parkinson disease patients, USA & Canada","country":"USA, Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 3090 people with Parkinson’s disease, about 14% had an impulse‑control problem such as gambling, compulsive sexual behaviour, buying or binge‑eating. Those on dopamine‑agonist medication were roughly three times more likely to have such problems.","clinical_takeaway":"Dopamine agonists in Parkinson’s disease increase risk of compulsive sexual and other impulse‑control disorders; monitor patients closely.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, multi‑center sample","Validated screening instruments","Clear statistical reporting with confidence intervals"],"limitations":["Cross‑sectional design cannot establish causality","No assessment of moral or psychological confounds","Lack of pre‑registration"],"rubric_version":"2.0","raw_total":37,"max_possible":60,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":4,"interpretation":8}},"scite":{"supporting":54,"contrasting":11,"mentioning":775,"citing_publications":1512,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archneurol.2010.65"}},{"id":7391,"doi":"10.1016/j.parkreldis.2013.03.004","pmid":"23611687","pmcid":null,"title":"Past smoking and current dopamine agonist use show an independent and dose-dependent association with impulse control disorders in Parkinson's disease","authors":"Valença GT, Glass PG, Negreiros NN, Duarte MB, Ventura LM, Mueller M, Oliveira-Filho J.","first_author":"Valença GT","journal":"Parkinsonism & related disorders","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case-control study of 152 Parkinson's patients vs 212 healthy controls","sample_n":364,"sample_text":"152 patients and 212 healthy controls","population":"Brazilian adults with Parkinson's disease on stable dopamine therapy and community controls","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In Brazilian Parkinson's patients, both past smoking and higher doses of the dopamine drug pramipexole were linked to a greater chance of developing impulse‑control problems such as gambling, compulsive sex, buying, and eating, compared with healthy adults.","clinical_takeaway":"Higher dopamine agonist doses and a history of smoking may increase risk for compulsive sexual and other impulse‑control problems in Parkinson's patients.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation","csbd"],"strengths":["Large control group","Clear dose‑response analysis for dopamine agonist","Clinically relevant impulsive behaviours assessed"],"limitations":["Cross‑sectional case‑control design limits causal inference","Potential confounders (moral attitudes, mental health, relationship status) not measured","Unclear validation of impulsive‑behaviour questionnaires"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":2,"mentioning":47,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2013.03.004"}},{"id":7392,"doi":"10.1016/j.cub.2012.06.067","pmid":"22863319","pmcid":null,"title":"A genetic basis for altered sexual behavior in mutant female mice","authors":"Zakany J, Duboule D.","first_author":"Zakany J","journal":"Current biology : CB","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"genetic knockout mouse line, behavioral observation, molecular neuroanatomy","sample_n":null,"sample_text":"adult individuals; exact N not reported in abstract","population":"mutant female mice (HoxD(Afc) allele) vs wild‑type controls","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers identified a mouse gene deletion that causes female mice to show unusual, aggressive sexual behavior toward male partners, suggesting a possible role of the hippocampus in controlling courtship.","clinical_takeaway":"None – study is on mouse genetics, not directly applicable to clinical practice.","confidence":0.6,"topic_tags":["gender"],"strengths":["Clear genetic manipulation linked to behavioral phenotype","Use of both behavioral and molecular assays"],"limitations":["No human relevance directly tested","Small sample size not reported","Interpretation of findings for human pathology may be speculative"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":13,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.cub.2012.06.067"}},{"id":7393,"doi":"10.1186/1471-244x-6-22","pmid":"16719909","pmcid":"PMC1479803","title":"Topiramate in the treatment of compulsive sexual behavior: case report","authors":"Khazaal Y, Zullino DF.","first_author":"Khazaal Y","journal":"BMC psychiatry","year":2006,"pub_types":["research-article","Journal Article","Case Reports"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC1479803","cited_by_count":24,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single male patient with obesity and compulsive non‑paraphilic sexual behavior; treatment with topiramate observed.","sample_n":1,"sample_text":"single patient (case report)","population":"1 adult male, treatment‑seeking for obesity; not a representative sample","country":"unknown","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A single man with obesity and cue‑driven compulsive sexual behavior (paying for sex) improved while taking topiramate, and symptoms returned when the drug was stopped, suggesting the medication may affect cue‑related habits.","clinical_takeaway":"No clinical recommendation can be made; a single case does not prove efficacy of topiramate for compulsive sexual behavior.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Detailed longitudinal observation of symptom change with medication start/stop","Highlights potential role of cue‑reactivity in different compulsive behaviors"],"limitations":["N=1; no control group or replication","No validated scales for sexual behavior or addiction","No measurement of key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)","Causal claims exceed evidential basis"],"rubric_version":"2.0","raw_total":9,"max_possible":60,"pct_score":15,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":2,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-244x-6-22"}},{"id":7394,"doi":"10.1016/j.jsxm.2022.09.003","pmid":"36216746","pmcid":null,"title":"Cross-Sectional and Longitudinal Associations Between Posttraumatic Stress Symptoms and Hypersexual Behaviors Among Individuals Who have Gambled in Their Lifetimes","authors":"Rosansky JA, Borgogna NC, Kraus SW, Grubbs JB.","first_author":"Rosansky JA","journal":"The journal of sexual medicine","year":2022,"pub_types":["Journal Article"],"keywords":["Hypersexual Behavior","Compulsive Sexual Behavior","Posttraumatic Stress","Hypersexuality","Sexual Compulsivity","Addictive Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Cross‑sectional survey of 585 college students and 786 MTurk adults (337 with 6‑month follow‑up); hierarchical regressions controlling for demographics, impulsivity, substance use and gambling.","sample_n":1321,"sample_text":"n = 585 college students; n = 786 MTurk adults (337 completed 6‑month follow‑up).","population":"Adults (college students and MTurk workers) who have gambled at least once; convenience samples, not nationally representative.","country":"USA","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"People who report more post‑traumatic stress symptoms also tend to report higher levels of hypersexual behavior, both at one point in time and six months later, after accounting for age, gender, impulsivity and substance use.","clinical_takeaway":"Screen for trauma symptoms when assessing hypersexual behavior, as PTSD may increase risk.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Validated PTSD and hypersexuality scales","Large combined sample size","Longitudinal follow‑up adds temporal information"],"limitations":["Convenience samples limit generalisability","Key confounds (moral incongruence, masturbation) not measured","No pre‑registration or confidence intervals reported"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2022.09.003"}},{"id":7395,"doi":"10.1097/00131746-200111000-00005","pmid":"15990552","pmcid":null,"title":"The paraphilic and hypersexual disorders: an overview","authors":"Krueger RB, Kaplan MS.","first_author":"Krueger RB","journal":"Journal of psychiatric practice","year":2001,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative overview without empirical data; no systematic methods reported.","sample_n":null,"sample_text":"Not applicable","population":"Not applicable (review article)","country":"USA (journal based, authors affiliation not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews paraphilic and hypersexual disorders, summarizing diagnostic proposals, possible causes, co‑occurring mental‑health issues, and legal implications, but does not present new data.","clinical_takeaway":"Provides clinicians with a broad conceptual overview; no direct treatment recommendations.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive historical overview of DSM‑IV and proposed hypersexual criteria","Integrates multiple etiological theories (neurobiological, psychodynamic, genetic)","Highlights co‑occurring psychiatric conditions"],"limitations":["No systematic literature search or risk‑of‑bias assessment","Lacks empirical data; conclusions based on narrative synthesis","No explicit measurement of key confounds (e.g., moral incongruence, masturbation)"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":39,"citing_publications":80,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00131746-200111000-00005"}},{"id":7396,"doi":"10.1080/10826080500411080","pmid":"16603452","pmcid":null,"title":"Assessing gay and bisexual men's outcome expectancies for sexual risk under the influence of alcohol and drugs","authors":"Bimbi DS, Nanin JE, Parsons JT, Vicioso KJ, Missildine W, Frost DM.","first_author":"Bimbi DS","journal":"Substance use & misuse","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Convenience sample of 779 gay/bisexual men recruited at community events; cross‑sectional questionnaire on outcome expectancies for sexual risk while intoxicated.","sample_n":779,"sample_text":"Convenience sample at two large LGBT community events in New York City.","population":"gay and bisexual men (N=779) who had a casual partner in past 3 months, recruited in NYC (2002).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 779 gay and bisexual men, those who had unprotected anal sex were more likely to expect that alcohol or drugs would increase sexual risk. Factors like sexual compulsivity, romantic preoccupations, and HIV status predicted these expectations.","clinical_takeaway":"Clinicians should discuss how alcohol/drug use may shape beliefs about sexual risk with gay/bisexual men.","confidence":0.75,"topic_tags":["sexual_function","masturbation"],"strengths":["Large sample (N=779)","Focus on outcome expectancies, a relevant psychosocial factor","Includes multiple predictors (sexual compulsivity, HIV status, STI history)"],"limitations":["Convenience recruitment limits generalisability","No measurement/control of key confounds (moral incongruence, mental health, etc.)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":33,"citing_publications":95,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10826080500411080"}},{"id":7397,"doi":"10.17756/jrds.2015-015","pmid":"26835513","pmcid":null,"title":"Addiction Treatment in America: After Money or Aftercare?","authors":"Miller D, Miller M, Blum K, Badgaiyan RD, Febo M.","first_author":"Miller D","journal":"Journal of reward deficiency syndrome","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary/opinion piece without original empirical data","sample_n":null,"sample_text":"none","population":"not applicable","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","circular_addiction_scale"],"stance":"supports","citation_value":"background","plain_summary":"The authors argue that most US addiction aftercare programs lack scientific support and propose that correcting low dopamine levels with diet, exercise, meditation, and nutraceuticals could improve recovery, citing resting‑state fMRI as a potential guide.","clinical_takeaway":"No direct clinical guidance; suggestions are speculative and not evidence‑based.","confidence":0.7,"topic_tags":["treatment","religiosity","neuroscience"],"strengths":["Raises awareness of aftercare gaps","Integrates neurobiological concepts"],"limitations":["No empirical data presented","Claims based on untested hypotheses","Lacks measurement of key confounds"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.17756/jrds.2015-015"}},{"id":7399,"doi":"10.1037/a0020527","pmid":"20853934","pmcid":null,"title":"Sexual compulsivity, state affect, and sexual risk behavior in a daily diary study of gay and bisexual men","authors":"Grov C, Golub SA, Mustanski B, Parsons JT.","first_author":"Grov C","journal":"Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":63,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"daily diary (intensive longitudinal) with 47 MSM participants (30‑day online diary, 1,060 person‑days)","sample_n":47,"sample_text":"47 men completed daily diaries","population":"highly sexually active gay/bisexual men (MSM), half with sexual compulsivity symptoms","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 30‑day online diary of 47 gay and bisexual men, negative mood lowered risky sex, but less so for men with sexual compulsivity; sexual arousal raised risk, again moderated by compulsivity. Affect therefore influences sexual risk differently in compulsive versus non‑compulsive MSM.","clinical_takeaway":"Clinicians should consider clients' affective states when addressing sexual risk, especially in men showing sexual compulsivity.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Intensive daily diary captures within‑person affect‑behavior links","Use of hierarchical linear modelling appropriate for nested data","Focus on a high‑risk MSM sample with clear SC vs non‑SC groups"],"limitations":["Small, non‑representative convenience sample (N ≈ 25 per group)","No measurement or control of key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)","No pre‑registration or reporting of effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":65,"citing_publications":80,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/a0020527"}},{"id":7400,"doi":"10.1016/j.jns.2011.07.031","pmid":"21839478","pmcid":null,"title":"Clinical aspects of impulsive compulsive behaviours in Parkinson's disease","authors":"Djamshidian A, Averbeck BB, Lees AJ, O'Sullivan SS.","first_author":"Djamshidian A","journal":"Journal of the neurological sciences","year":2011,"pub_types":["Research Support, N.I.H., Intramural","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review (narrative) of impulsive‑compulsive behaviours in Parkinson’s disease; no new empirical data.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Patients with Parkinson’s disease; not a primary focus on pornography‑related behaviour in the general population.","country":"United States (NIH intramural)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews impulsive‑compulsive behaviours, including compulsive sexual activity, that can arise in Parkinson’s disease from dopamine‑targeting medication, describing their prevalence, possible brain‑based learning mechanisms, and treatment options.","clinical_takeaway":"Be alert for emerging impulsive sexual behaviours in Parkinson’s patients on dopaminergic therapy; early recognition and tailored interventions are crucial.","confidence":0.7,"topic_tags":["csbd","sexual_function","neuroscience","measurement"],"strengths":["Comprehensive overview of ICBs in Parkinson’s disease","Integrates pharmacological and behavioral mechanisms","Highlights clinical importance of early detection"],"limitations":["Narrative review without systematic search or risk‑of‑bias assessment","No original data; conclusions rely on cited studies","Limited applicability to general population pornography use"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":32,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jns.2011.07.031"}},{"id":7402,"doi":null,"pmid":"12622120","pmcid":null,"title":"Sexual addiction being studied","authors":null,"first_author":null,"journal":"AIDS patient care and STDs","year":2003,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":7403,"doi":"10.1016/j.pnpbp.2007.04.011","pmid":"17630065","pmcid":null,"title":"Case report: lamotrigine/fluoxetine combination in the treatment of compulsive sexual behavior","authors":"Schupak C.","first_author":"Schupak C.","journal":"Progress in neuro-psychopharmacology & biological psychiatry","year":2007,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pnpbp.2007.04.011"}},{"id":7404,"doi":"10.1111/jsr.70157","pmid":"41858209","pmcid":null,"title":"Monitoring Kleine-Levin Syndrome Recovery Using Human-Smartphone Interactions: A Digital Phenotyping Approach","authors":"Wang YG, Chang HC, Lin C, Lin YH, Chen TY.","first_author":"Wang YG","journal":"Journal of sleep research","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":["Circadian rhythm","Hypersomnia","Kleine–levin Syndrome","Digital Phenotyping","Interdaily Stability","Human–smartphone Interactions"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case study of a 25‑year‑old male with Kleine‑Levin syndrome; longitudinal digital phenotyping using a validated smartphone app; no comparison group","sample_n":1,"sample_text":"25‑year‑old Taiwanese male","population":"1 adult male with KLS; convenience clinical case","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A smartphone app tracked when a man with Kleine‑Levin syndrome used his phone. During episodes he was inactive; as he recovered, his phone use became more regular, matching improvements in his sleep‑wake cycle.","clinical_takeaway":"Digital phone‑use patterns may help monitor recovery in rare sleep‑hypersexuality disorders, but evidence is limited to a single case.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["uses a validated digital phenotyping app","longitudinal within‑subject monitoring","objective circadian metric"],"limitations":["single case; no generalisability","no control or comparison group","no statistical testing"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsr.70157"}},{"id":7405,"doi":"10.1007/s00391-025-02468-8","pmid":"40643622","pmcid":null,"title":"[Sexuality in people with frontotemporal dementia]","authors":"Betzing C, Steinfort J, Sträter B.","first_author":"Betzing C","journal":"Zeitschrift fur Gerontologie und Geriatrie","year":2025,"pub_types":["Review","Journal Article","English Abstract"],"keywords":["Sexual Partners","Caregivers","Stigmatization","Hypersexuality","Hyposexuality"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"expert interviews (n=8) analyzed with qualitative content analysis","sample_n":8,"sample_text":"expert interviews (n = 8)","population":"experts on frontotemporal dementia (Germany)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with eight dementia experts show that frontotemporal dementia can cause both increased and decreased sexual activity, affecting couples and creating caregiving challenges.","clinical_takeaway":"Clinicians should assess sexual changes in FTD patients and offer support to partners, avoiding stigma around hypersexual behavior.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","csbd","prevalence"],"strengths":["Focus on an understudied aspect of dementia","Qualitative depth from expert perspectives","Provides practical recommendations for caregivers"],"limitations":["Very small, non‑representative sample of experts","No empirical data from patients or partners","No standardized measures of sexuality or hypersexuality"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00391-025-02468-8"}},{"id":7406,"doi":"10.1007/s00221-022-06397-5","pmid":"35763033","pmcid":"PMC9288360","title":"Inhibitory framing in hypersexual patients with Parkinson's disease. An fMRI pilot study","authors":"Theis H, Probst C, Campabadal A, Goerlich KS, Granert O, Wolff S, Witt K, Deuschl G, van Eimeren T.","first_author":"Theis H","journal":"Experimental brain research","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Dopamine","Functional MRI","Addiction","Impulse Control"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s00221-022-06397-5.pdf","cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"pilot fMRI study with 20 Parkinson's patients (hypersexual vs non‑hypersexual), scanned ON/OFF medication","sample_n":20,"sample_text":"Twenty PD patients with and without hypersexuality","population":"medicated Parkinson's disease patients, some with hypersexuality","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A small fMRI study examined how Parkinson's patients with hypersexuality react to sexual images, finding stronger brain activation in motivation areas and weaker activation in inhibition areas, especially when pictures were preceded by an ‘inhibitory’ context.","clinical_takeaway":"Evidence that hypersexuality in Parkinson's may involve heightened motivational brain responses; larger studies needed before clinical use.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function","neuroscience"],"strengths":["Novel fMRI paradigm assessing inhibitory framing","Direct comparison of hypersexual vs non‑hypersexual PD patients"],"limitations":["Very small sample, pilot nature","Limited statistical detail, no effect sizes","No measurement of key psychosocial confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":70,"pct_score":39,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":5,"statistics":3,"confounds":2,"design":3,"addiction_criteria":2,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":16,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00221-022-06397-5"}},{"id":7407,"doi":"10.1097/01.jcp.0000177849.23534.bf","pmid":"16160641","pmcid":null,"title":"A case report of topiramate in the treatment of nonparaphilic sexual addiction","authors":"Fong TW, De La Garza R, Newton TF.","first_author":"Fong TW","journal":"Journal of clinical psychopharmacology","year":2005,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.jcp.0000177849.23534.bf"}},{"id":7408,"doi":"10.1007/s10508-006-9133-4","pmid":"17333327","pmcid":null,"title":"Latino men's sexual behavior with transgender persons","authors":"Bockting W, Miner M, Rosser BR.","first_author":"Bockting W","journal":"Archives of sexual behavior","year":2007,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey of Latino MSM (N=1,026); 44 reported sex with transgender partners; compared to 200 non‑partner subgroup; regression analysis of predictors of unprotected sex.","sample_n":1026,"sample_text":"N = 1,026 Latino MSM; 44 reported a transgender partner; 200 comparison men selected randomly.","population":"Latino men who have sex with men, United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US online survey of 1,026 Latino gay and bisexual men, those who had ever had sex with a transgender partner (44 men) were more likely to report recent condomless sex and to be HIV‑positive. They also tended to be more sexually compulsive, married/divorced, and live in smaller communities, suggesting they could act as a bridge for HIV transmission.","clinical_takeaway":"Clinicians should be aware that Latino MSM with transgender partners may have higher sexual‑risk profiles and consider tailored risk‑reduction counseling.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large overall sample of Latino MSM","Focus on understudied bridge population","Uses multivariate regression to adjust for several covariates"],"limitations":["Cross‑sectional design; cannot infer causality","Small subsample of men with transgender partners (n=44)","Limited assessment of potential confounds (e.g., moral incongruence, mental health)","Reliance on self‑reported sexual behavior"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":37,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-006-9133-4"}},{"id":7409,"doi":"10.1080/09540129750124984","pmid":"9337888","pmcid":null,"title":"HIV-seropositive men who engage in high-risk sexual behaviour: psychological characteristics and implications for prevention","authors":"Kalichman SC, Greenberg J, Abel GG.","first_author":"Kalichman SC","journal":"AIDS care","year":1997,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":86,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of HIV‑positive men (n=223) recruited from substance‑abuse support groups and HIV‑prevention programmes; self‑report measures of sexual behaviour, sensation‑seeking and sexual compulsivity.","sample_n":223,"sample_text":"223 HIV‑seropositive men participating in substance‑abuse support groups and HIV‑prevention programmes","population":"HIV‑seropositive adult men (mostly US, likely convenience sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among HIV‑positive men in support groups, those with multiple recent unprotected partners reported higher sexual compulsivity, suggesting that compulsive sexual thoughts may drive risky behaviour.","clinical_takeaway":"Screen for sexual compulsivity in HIV‑positive patients; targeted interventions may reduce transmission risk.","confidence":0.7,"topic_tags":["sexual_function","gender","relationships"],"strengths":["Relatively large sample for a 1997 study","Focus on sexual compulsivity as a psychological factor","Clear link between compulsivity and high‑risk behaviour"],"limitations":["Cross‑sectional, cannot infer causality","Convenience sample limits generalisability","Unclear whether measures (e.g., sexual compulsivity scale) are validated"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":67,"citing_publications":148,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540129750124984"}},{"id":7410,"doi":"10.1186/1471-2458-10-178","pmid":"20359362","pmcid":"PMC2858118","title":"Factors associated with sex in the context of methamphetamine use in different sexual venues among HIV-positive men who have sex with men","authors":"Semple SJ, Strathdee SA, Zians J, Patterson TL.","first_author":"Semple SJ","journal":"BMC public health","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/1471-2458-10-178","cited_by_count":23,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"observational baseline assessment of 321 HIV‑positive MSM meth users, venue‑based grouping","sample_n":321,"sample_text":"321 participants recruited for a safer‑sex intervention study","population":"HIV‑positive men who have sex with men using methamphetamine, San Diego, USA","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among HIV‑positive men who have sex with men using meth, those who have sex in public or commercial venues report more risky sex, heavier drug use, higher depression, and greater sexual compulsivity than those who sex privately.","clinical_takeaway":"Risk‑reduction efforts should address venue‑specific factors, not just individual drug or sexual behavior.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large community sample for a hard‑to‑reach population","Use of validated depression and sexual compulsivity scales","Focus on social/venue context beyond individual behavior"],"limitations":["Cross‑sectional design limits causal inference","No control for key confounds (e.g., moral incongruence, partner effects)","Venue groups not randomly assigned, possible selection bias"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":33,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2458-10-178"}},{"id":7411,"doi":"10.1093/ptr/kpg046","pmid":"21827262","pmcid":null,"title":"Clinical management of sex addiction","authors":"Leiblum SR.","first_author":"Leiblum SR.","journal":"Psychotherapy research : journal of the Society for Psychotherapy Research","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/ptr/kpg046"}},{"id":7412,"doi":"10.1007/s00406-022-01421-9","pmid":"35551451","pmcid":null,"title":"ADHD prevalence in patients with hypersexuality and paraphilic disorders: a systematic review and meta-analysis","authors":"Korchia T, Boyer L, Deneuville M, Etchecopar-Etchart D, Lancon C, Fond G.","first_author":"Korchia T","journal":"European archives of psychiatry and clinical neuroscience","year":2022,"pub_types":["Meta-Analysis","Systematic Review","Journal Article"],"keywords":["ADHD","Meta-analysis","Psychiatry","Mental health","epidemiology","Hypersexuality","Paraphilic Disorders","Attention-deficit/hyperactivity Disorders"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"systematic review and meta-analysis of prevalence studies (N=730 across 7 studies)","sample_n":730,"sample_text":"730 patients with hypersexuality/paraphilic disorders across 7 studies","population":"patients with hypersexuality or paraphilic disorders","country":"multiple (US, France, others)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of seven studies found that about 23% of people with hypersexuality or paraphilic disorders also meet criteria for ADHD, far higher than in the general population.","clinical_takeaway":"Screen for ADHD in clients presenting with hypersexuality or paraphilic behaviours.","confidence":0.8,"topic_tags":["prevalence","sexual_function","neuroscience","csbd"],"strengths":["Systematic search across three major databases","Use of random‑effects meta‑analysis with heterogeneity checks","Publication bias assessed with Egger’s test"],"limitations":["Primary studies likely clinical samples, limiting generalisability","No assessment of key confounds (moral incongruence, masturbation, mental health)","No pre‑registration or formal risk‑of‑bias assessment reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":15,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00406-022-01421-9"}},{"id":7413,"doi":"10.1007/s40618-022-01798-3","pmid":"35527295","pmcid":null,"title":"Hypersexuality as a tip of the iceberg of a primary psychopathology: a joined position statement of the Italian Society of Andrology and Sexual Medicine (SIAMS) and of the Italian Society of Psychopathology (SOPSI)","authors":"Limoncin E, Ciocca G, Castellini G, Sansone A, Cavalieri F, Cavallo F, Cocchiaro T, Ricca V, di Lorenzo G, Rossi A, Fisher AD, Rochira V, Corona G, Jannini EA.","first_author":"Limoncin E","journal":"Journal of endocrinological investigation","year":2022,"pub_types":["Consensus Statement","Journal Article"],"keywords":["Compulsive Sexual Behavior","Hypersexuality","Psychopathological Comorbidities","Pharmacological Treatmnets"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Consensus/position statement with no original empirical data; recommendations based on literature synthesis.","sample_n":null,"sample_text":"Not applicable – no participants recruited.","population":"Not applicable (no primary sample)","country":"Italy (based on societies involved)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that hypersexual behaviour should be seen as a symptom of other underlying mental or medical conditions and propose a biopsychosocial assessment and psychometric tools for diagnosis.","clinical_takeaway":"Clinicians should evaluate hypersexuality within broader psychiatric or medical contexts rather than treating it as a standalone disorder.","confidence":0.8,"topic_tags":["csbd","sexual_function","treatment"],"strengths":["Joint statement from two professional societies","Highlights need for biopsychosocial assessment","Calls for standardized psychometric evaluation"],"limitations":["No original data or systematic review methodology described","No empirical test of proposed constructs or criteria","Potential bias from author affiliations with societies"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40618-022-01798-3"}},{"id":7414,"doi":"10.1016/j.jocn.2025.111363","pmid":"40480033","pmcid":null,"title":"Impulse control disorders in prolactinoma patients treated with dopamine agonists: a systematic review and meta-analysis with trial sequential analysis","authors":"Penchev P, Milanova-Ilieva D, Gaydarski L, Husain N, Chenkov Y, Petrov PP, Kirovakov Z, Stanchev P.","first_author":"Penchev P","journal":"Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia","year":2025,"pub_types":["Meta-Analysis","Systematic Review","Journal Article"],"keywords":["Prolactinoma","Pituitary adenoma","Impulse Control Disorders (Icds)","Dopamine Agonist Drugs (Das)"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Meta-analysis of eight observational studies (n=858) assessing prevalence of impulse control disorders, especially hypersexuality, in prolactinoma patients treated with dopamine agonists.","sample_n":858,"sample_text":"Eight studies, total 858 patients; 483 treated with dopamine agonists.","population":"Adults with prolactinoma receiving dopamine agonist therapy (mean age 39, 57% female).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of eight studies found that people with prolactinoma who take dopamine‑agonist drugs have a higher chance of developing impulse‑control problems, especially hypersexuality and punding, compared with those not on these drugs.","clinical_takeaway":"Clinicians prescribing dopamine agonists for prolactinoma should monitor patients for emerging hypersexuality and related impulse‑control issues.","confidence":0.7,"topic_tags":["csbd","sexual_function","pornography","masturbation"],"strengths":["Systematic search across multiple databases","Quantitative synthesis with effect sizes and confidence intervals","Assessment of heterogeneity (I²) and use of random‑effects model"],"limitations":["Underlying primary studies likely use heterogeneous and possibly unvalidated measures of hypersexuality","No assessment of key confounders (moral incongruence, masturbation, mental health, partner effects, trauma)","Observational designs limit causal inference"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jocn.2025.111363"}},{"id":7415,"doi":"10.1136/jnnp-2014-307904","pmid":"25006210","pmcid":null,"title":"Increased risk of impulse control symptoms in Parkinson's disease with REM sleep behaviour disorder","authors":"Fantini ML, Macedo L, Zibetti M, Sarchioto M, Vidal T, Pereira B, Marques A, Debilly B, Derost P, Ulla M, Vitello N, Cicolin A, Lopiano L, Durif F.","first_author":"Fantini ML","journal":"Journal of neurology, neurosurgery, and psychiatry","year":2015,"pub_types":["Journal Article"],"keywords":["Sleep disorders","Parkinson's Disease","Neuropsychiatry"],"is_oa":false,"oa_url":null,"cited_by_count":53,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"cross-sectional case‑control of 216 consecutive Parkinson’s patients from two university movement‑disorder clinics, comparing those with and without probable REM‑sleep behaviour disorder (pRBD).","sample_n":216,"sample_text":"216 PD patients (106 with pRBD, 110 without).","population":"Patients with Parkinson’s disease (age‑range not specified, both sexes).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Parkinson’s patients, those who also have REM‑sleep behaviour disorder are about twice as likely to show impulse‑control problems such as compulsive sexual behaviour, gambling, shopping or eating, even after accounting for disease severity and medication.","clinical_takeaway":"Screen for REM‑sleep behaviour disorder in Parkinson’s patients to identify higher risk for impulse‑control issues, including compulsive sexual behaviour.","confidence":0.85,"topic_tags":["neuroscience","pornography","sexual_function"],"strengths":["Validated instruments (QUIP, RBDSQ) used for key constructs","Multivariate regression adjusts for several PD‑related confounders","Reasonable sample size for case‑control design"],"limitations":["Cross‑sectional, cannot infer causality","Convenience clinic sample limits generalisability","Moral, sexual‑behaviour specific confounds (e.g., masturbation, religiosity) not assessed"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":49,"citing_publications":72,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/jnnp-2014-307904"}},{"id":7417,"doi":"10.1002/wps.21305","pmid":"40371748","pmcid":"PMC12079463","title":"Women's reproductive mental health: currently available evidence and future directions for research, clinical practice and health policy","authors":"Howard LM, Wilson CA, Reilly TJ, Moss KM, Mishra GD, Coupland-Smith E, Riecher-Rössler A, Seedat S, Smith S, Steinberg JR, van Ditzhuijzen J, Oram S.","first_author":"Howard LM","journal":"World psychiatry : official journal of the World Psychiatric Association (WPA)","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Infertility","Abortion","Contraception","Menstruation","Sexual dysfunction","menopause","Sexual Violence","Reproductive Coercion","Reproductive Mental Health","Compulsive Sexual Behavior Disorder"],"is_oa":false,"oa_url":"https://pure.amsterdamumc.nl/en/publications/1a10dbda-4ee6-4573-878c-d3c16dc8b058","cited_by_count":32,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review without systematic methods","sample_n":null,"sample_text":"Not applicable (review article)","population":"women across reproductive lifespan, various reproductive events","country":"International","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how reproductive events such as menstruation, contraception, abortion, and menopause can affect women's mental health, discussing biological and social mechanisms and suggesting better integrated care.","clinical_takeaway":"Consider reproductive health factors when assessing women's mental health, but note the review offers no new empirical evidence.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Broad overview of reproductive mental health topics","Highlights evidence gaps and policy implications"],"limitations":["Lacks systematic review methodology","No primary data or quantitative synthesis","Potential author bias toward intervention recommendations"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":23,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/wps.21305"}},{"id":7418,"doi":"10.1093/brain/awaf087","pmid":"40042882","pmcid":"PMC12129733","title":"Serotonergic dysfunction in patients with impulse control disorders in Parkinson's disease","authors":"Prange S, Metereau E, Klinger H, Huddlestone M, De Oliveira M, Duperrier S, Courault P, Redoute J, Tremblay L, Sgambato V, Lancelot S, Thobois S.","first_author":"Prange S","journal":"Brain : a journal of neurology","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Parkinson’s Disease","PET imaging","Sert","5Ht2a Receptor","Altanserin"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12129733","cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"prospective case‑control PET study with 15 PDICD+, 15 PDICD‑, 15 controls","sample_n":45,"sample_text":"15 PDICD+ patients, 15 PDICD‑ patients and 15 healthy controls","population":"Patients with Parkinson’s disease, some with impulse‑control disorders (including hypersexuality) and matched healthy controls","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson’s patients, those who have impulse‑control disorders such as hypersexuality show higher serotonin‑related PET signals in brain areas that control behaviour, suggesting serotonergic dysfunction may help explain these symptoms.","clinical_takeaway":"Serotonergic abnormalities might underlie hypersexuality in Parkinson’s disease, pointing to possible non‑dopamine treatment targets.","confidence":0.78,"topic_tags":["sexual_function","neuroscience"],"strengths":["Use of two specific PET tracers for serotonergic system","Matched control groups","Permutation‑based whole‑brain analysis"],"limitations":["Small sample size for PET imaging","Cross‑sectional design limits causal inference","No assessment of moral or relational confounds"],"rubric_version":"2.0","raw_total":38,"max_possible":70,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":6,"statistics":6,"confounds":4,"design":4,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/brain/awaf087"}},{"id":7419,"doi":"10.1177/10790632251347562","pmid":"40440734","pmcid":"PMC12722556","title":"Child Sexual Abuse Material Users on the Darknet: Psychiatric Morbidities Related to Offence Behavior","authors":"Lätth J, Joleby M, McMahan A, Luke TJ, Rahm C.","first_author":"Lätth J","journal":"Sexual abuse : a journal of research and treatment","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Hypersexuality","Pedophilia","Zoophilia","Sexual Interests","Child Sexual Abuse Material"],"is_oa":true,"oa_url":"https://doi.org/10.1177/10790632251347562","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 160 anonymous Darknet-recruited adult CSAM users; descriptive psychiatric profiling and exploratory linear regressions","sample_n":160,"sample_text":"160 adult CSAM users recruited anonymously from the Darknet","population":"adult CSAM users (mainly male, non‑convicted, recruited via Darknet forums)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 160 anonymous Darknet users who view child sexual abuse material found high rates of pedophilic interests, hypersexuality, autism traits, ADHD and depression. Certain sexual pathologies were linked to how much and what type of illegal material they accessed.","clinical_takeaway":"Clinicians working with individuals who use CSAM should assess for a range of co‑occurring mental‑health issues beyond sexual interests.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Large (N=160) for a hidden population","Direct recruitment from the target community","Exploratory analysis of multiple psychiatric variables"],"limitations":["Self‑report measures likely unvalidated","Cross‑sectional, cannot infer causality","No control for key confounds (moral incongruence, mental health, trauma)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632251347562"}},{"id":7420,"doi":"10.1071/sh21219","pmid":"35469589","pmcid":null,"title":"Sex film viewing, but not hypersexual concerns, are associated with more sexual arousal in anticipation of an intimate partner experience","authors":"Prause N, Siegle G.","first_author":"Prause N","journal":"Sexual health","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.publish.csiro.au/sh/pdf/SH21219","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional experimental association between self‑reported sex‑film viewing and arousal during a partnered meditation task","sample_n":250,"sample_text":"250 participants completed Orgasmic Meditation (OM), a coupled, structured, 15‑min manual‑genital stroking.","population":"250 participants completing Orgasmic Meditation (community sample, recruitment details not specified)","country":"Not reported","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People who watch more pornographic films reported higher sexual arousal before a partnered meditation exercise, and their partners showed higher physiological arousal, while concerns about losing control over sexual behavior did not affect arousal.","clinical_takeaway":"Viewing porn may heighten sexual responsiveness in partnered contexts, but the evidence does not support it as a marker of problematic or hypersexual behavior.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for experimental arousal measurement","Physiological arousal data (skin conductance)","Pre‑registration reported"],"limitations":["Key constructs measured with single‑item self‑reports, no validated scales","No control for moral, mental‑health or relationship confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh21219"}},{"id":7421,"doi":"10.3390/brainsci12040441","pmid":"35447973","pmcid":"PMC9032653","title":"Visual Event-Related Potentials under External Emotional Stimuli in Bipolar I Disorder with and without Hypersexuality","authors":"Wang C, Rimol LM, Wang W.","first_author":"Wang C","journal":"Brain sciences","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Personality","Event-related potentials","Electroencephalography (EEG)","Mood Disorders","Hypersexuality","Bipolar I Disorder","Emotional Stimuli","Erotica"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9032653","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross‑sectional laboratory ERP study comparing bipolar I patients with (BW) and without (BO) hypersexuality and healthy controls","sample_n":107,"sample_text":"54 healthy volunteers, 27 BW patients, 26 BO patients","population":"Patients with bipolar I disorder (n≈53) split into hypersexual (BW, n≈27) and non‑hypersexual (BO, n≈26) groups; 54 healthy volunteers; adult participants; clinical recruitment","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study recorded brain responses (ERPs) while people with bipolar disorder—some who report hypersexual behaviour and some who do not—viewed emotional pictures, including erotic images. Different patterns of attention‑related brain signals were found between the two bipolar groups.","clinical_takeaway":"Hypersexuality in bipolar disorder may be linked to distinct attentional processing of emotional cues, but findings are preliminary.","confidence":0.82,"topic_tags":["pornography","sexual_function","neuroscience","moral_incongruence","csbd"],"strengths":["Use of objective ERP measures","Inclusion of both clinical and healthy comparison groups","Assessment of concurrent affective states"],"limitations":["Hypersexuality not operationalised with validated scale","Small clinical sub‑samples limit power","No control for moral or relational confounds"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":5,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/brainsci12040441"}},{"id":7422,"doi":"10.1007/s10508-010-9705-1","pmid":"21221754","pmcid":"PMC3418675","title":"Direct and indirect associations between internalized homonegativity and high-risk sex","authors":"Smolenski DJ, Stigler MH, Ross MW, Rosser BR.","first_author":"Smolenski DJ","journal":"Archives of sexual behavior","year":2011,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 1,669 MSM, cross‑sectional structural equation modeling","sample_n":1669,"sample_text":"1669 MSM","population":"men who have sex with men, recruited via internet in 2005","country":"USA (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,669 gay and bisexual men, internalized negative feelings about being gay were linked indirectly to risky sex: it increased compulsive sexual behavior, which raised risk, but also reduced the number of partners, which lowered risk, canceling each other out.","clinical_takeaway":"Internalized homonegativity may affect sexual risk through different pathways; interventions should address both compulsive behavior and partner dynamics.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size","Use of validated scales for IH and CSB","Appropriate SEM mediation analysis"],"limitations":["Cross‑sectional; cannot infer causality","No control for broader mental‑health or trauma factors","Self‑report of sexual behavior may be biased"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9705-1"}},{"id":7424,"doi":"10.1016/j.psychres.2011.04.006","pmid":"21546096","pmcid":null,"title":"Impulse control disorders in psychiatric inpatients","authors":"Müller A, Rein K, Kollei I, Jacobi A, Rotter A, Schütz P, Hillemacher T, de Zwaan M.","first_author":"Müller A","journal":"Psychiatry research","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"prevalence study of consecutive psychiatric inpatients (N=234) using SCID-ICD interview","sample_n":234,"sample_text":"234 consecutive psychiatric inpatients (62% female)","population":"European psychiatric inpatients, mixed gender, adult","country":"Europe","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 234 psychiatric inpatients, about one‑quarter met lifetime criteria for an impulse‑control disorder; compulsive sexual behavior was among the most common, yet such disorders are rarely diagnosed in routine clinical practice.","clinical_takeaway":"Compulsive sexual behaviour often goes unrecognized in psychiatric settings; clinicians should screen for it using structured interviews.","confidence":0.7,"topic_tags":["csbd","prevalence","sexual_function"],"strengths":["Large consecutive inpatient sample","Standardised diagnostic interview (SCID‑ICD)","Clear prevalence estimates for a range of ICDs"],"limitations":["Cross‑sectional, cannot infer causality","Limited to psychiatric inpatients – not generalisable","No assessment of moral incongruence or masturbation context for compulsive sexual behavior"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":0,"mentioning":22,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psychres.2011.04.006"}},{"id":7425,"doi":"10.1080/00224490902747768","pmid":"19308842","pmcid":null,"title":"An integrative theoretical framework for understanding sexual motivation, arousal, and behavior","authors":"Toates F.","first_author":"Toates F.","journal":"Journal of sex research","year":2009,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":175,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"The paper is a narrative theoretical review proposing an integrative model of sexual motivation, arousal, and behavior. No original data were collected, and no systematic review methods were reported.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article presents a new theoretical model that combines motivation and control theories to explain how sexual desire, arousal, and actions arise and interact, aiming to clarify concepts across different fields of psychology.","clinical_takeaway":"None – the paper offers a theoretical framework but provides no direct clinical guidance.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Comprehensive integration of multiple theoretical perspectives","Proposes a hierarchical model that could guide future empirical work"],"limitations":["No empirical data to support the model","Lacks systematic review methodology","No measurement of key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":8,"contrasting":1,"mentioning":224,"citing_publications":344,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490902747768"}},{"id":7426,"doi":"10.1080/09540120802068803","pmid":"19085219","pmcid":"PMC3678386","title":"Sexual compulsivity and high-risk sex among Latino men: the role of internalized homonegativity and gay organizations","authors":"Smolenski DJ, Ross MW, Risser JM, Rosser BR.","first_author":"Smolenski DJ","journal":"AIDS care","year":2009,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet survey of 963 Latino MSM; logistic regression of CSB, internalized homonegativity, and high‑risk sex; no longitudinal or experimental component.","sample_n":963,"sample_text":"963 participants completed an Internet survey (MINTS study).","population":"Latino men who have sex with men (MSM), recruited online in 2002.","country":"United States (implied by NIH funding and English‑language journal).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2002 online survey of 963 Latino gay and bisexual men, higher compulsive sexual behavior was linked to more unprotected anal sex. This link was stronger for men who felt more internalized homonegativity and who were involved with gay organisations, and it was also affected by drug and alcohol use.","clinical_takeaway":"Clinicians should consider internalized stigma and substance use when addressing risky sexual behavior in Latino MSM with compulsive sexual tendencies.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for a survey of a specific minority group","Use of established scales for CSB and internalized homonegativity","Statistical interaction analysis"],"limitations":["Cross‑sectional design limits causal inference","Convenience internet sample may not be representative","Key confounds (e.g., moral incongruence, partner factors, trauma) not measured"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":24,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540120802068803"}},{"id":7427,"doi":null,"pmid":"40377576","pmcid":null,"title":"[The questionnaire of integrated assessment of male sexuality is a tool for analyzing a man's sexual functions throughout his life]","authors":"Kogan M I, Efremov M E, Anosov A D, Medvedev V L, Akhokhov Z M, Sinyavskaya T G, Khmaruk I N.","first_author":"Kogan M I","journal":"Urologiia (Moscow, Russia : 1999)","year":2025,"pub_types":["Journal Article","English Abstract"],"keywords":["Benign prostate hyperplasia","Sexual dysfunction","prostate cancer","Libido","questionnaires","Hypersexuality","Erection","Male Sexuality","Hyposexuality","Normosexual"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"rus","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study of a new questionnaire (IAMS) with 209 men (healthy, BPH, prostate cancer); cross‑sectional administration and psychometric analysis","sample_n":209,"sample_text":"209 men (43 healthy, 57 BPH, 109 prostate cancer)","population":"adult men, mean ages ~31 (healthy) and ~63‑64 (patient groups); recruited from urology clinics and unspecified healthy volunteers","country":"Russia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors tested a new  questionnaire that rates men’s sexual health across their lifespan. In 209 men (healthy, with enlarged prostates, or prostate cancer) the tool showed good internal consistency and could differentiate between normal, low and high sexual activity levels.","clinical_takeaway":"The IAMS questionnaire appears reliable for assessing male sexual function, but further validation against existing measures is needed before clinical use.","confidence":0.7,"topic_tags":["sexual_function","measurement","gender"],"strengths":["Reasonable overall sample size for a psychometric validation","Includes clinical (BPH, prostate cancer) and healthy participants","Reports internal consistency (Cronbach α) and convergent correlations"],"limitations":["No comparison with established validated sexual function scales","Psychometric properties (e.g., factor analysis) not described in abstract","No assessment of potential confounders (e.g., mental health, relationship status)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":7428,"doi":"10.1016/j.eprac.2025.04.018","pmid":"40316139","pmcid":null,"title":"Impulse Control Disorders in Patients With Hyperprolactinemia on Dopamine Agonist Therapy-How Concerned Should We Be?","authors":"Daftari G, Tritos NA.","first_author":"Daftari G","journal":"Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists","year":2025,"pub_types":["Review","Journal Article"],"keywords":["hyperprolactinemia","Bromocriptine","Impulsivity","Impulse Control Disorders","Cabergoline","Dopamine Agonist"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of existing literature; no new empirical data, no systematic methods reported.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Patients with hyperprolactinemia receiving dopamine agonist therapy (cabergoline or bromocriptine).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Dopamine‑agonist drugs used for prolactin‑producing tumors can sometimes trigger impulse‑control problems such as excessive sexual behaviour, gambling or binge‑eating. The review summarises how common these issues are, who is most at risk, and how they can be recognised and managed.","clinical_takeaway":"Screen patients on dopamine agonists for impulse‑control symptoms, especially hypersexuality, and adjust treatment if needed.","confidence":0.73,"topic_tags":["csbd","sexual_function","prevalence","treatment"],"strengths":["Covers a wide range of ICDs including hypersexuality","Cites validated diagnostic tools","Identifies demographic and genetic risk factors"],"limitations":["Narrative review without systematic methodology","No quantitative synthesis or risk‑of‑bias assessment","Limited discussion of confounding psychosocial factors"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.eprac.2025.04.018"}},{"id":7429,"doi":"10.1007/s10508-025-03136-z","pmid":"40295391","pmcid":null,"title":"Sexual Violence in the Digital Era: Exploring Correlates of Non-Consensual Intimate Image Dissemination from a Sexual Offending Framework","authors":"McArthur JL, Blais J, Goruk KJ.","first_author":"McArthur JL","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sex Offenders","Hypersexuality","Paraphilias","Non-consensual Intimate Image Dissemination","Motivation–facilitation Model"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 1200 Canadian adults recruited from an online panel; self‑report of NCIID and risk‑factor questionnaires; logistic regression analyses.","sample_n":1200,"sample_text":"1200 adults","population":"Adults (18+) residing in Canada, recruited via Qualtrics panel (likely mixed gender, ages).","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A Canadian survey of 1,200 adults found that 5% had shared intimate images without consent in the past year. Factors such as feeling entitled to sex, higher hypersexuality, antisocial traits, hostility toward women, and problematic alcohol use made this behavior more likely.","clinical_takeaway":"Risk assessments for image‑sharing offenses should consider hypersexuality, entitlement attitudes, and alcohol misuse.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large community sample (N=1200)","Use of a theoretical framework (motivation‑facilitation model)","Multivariate analysis controlling for several risk factors"],"limitations":["Cross‑sectional, cannot infer causality","Potential self‑report bias for illegal behavior","Limited validation information for the hypersexuality and other scales"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03136-z"}},{"id":7430,"doi":"10.21101/cejph.a3770","pmid":"23741901","pmcid":null,"title":"The GAy MEn Sex StudieS: design of an online registration of sexual behaviour of men having sex with men and preliminary results (GAMESSS-study)","authors":"Vansintejan J, Vandevoorde J, Devroey D.","first_author":"Vansintejan J","journal":"Central European journal of public health","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire of 1,830 Belgian MSM, convenience sample","sample_n":1830,"sample_text":"online convenience sample of MSM volunteers","population":"Belgian men who have sex with men, age ≥18, recruited via internet","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study describes an online survey of 1,830 Belgian men who have sex with men, collecting data on sexual behaviour, function and a self‑report screen for sexual addiction. It shows high sexual activity and highlights the feasibility of internet‑based research in hidden populations.","clinical_takeaway":"Clinicians should note the high variability in sexual behaviour among MSM, but current data do not support diagnosing 'sex addiction' based on this survey alone.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["Large sample size for a hidden population","Use of several established sexual function scales","Online anonymity reduces social desirability bias","Provides baseline data on MSM sexual behaviour in Belgium"],"limitations":["Convenience internet sample limits generalisability","No measurement of moral or mental‑health confounders","Addiction screen (G‑SAST) not validated against ICD‑11 criteria","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":6,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21101/cejph.a3770"}},{"id":7431,"doi":"10.1080/15622975.2021.2014683","pmid":"34872440","pmcid":null,"title":"Effects of testosterone suppression on desire, hypersexuality, and sexual interest in children in men with pedophilic disorder","authors":"Landgren V, Olsson P, Briken P, Rahm C.","first_author":"Landgren V","journal":"The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":["Age Of Onset","Sexual Desire","Randomised Clinical Trial","Compulsive Sexual Behaviour Disorder","Paedophilic Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Double‑blind randomised clinical trial comparing degarelix (GnRH antagonist) with placebo in men diagnosed with pedophilic disorder (n=26 per arm). Primary outcomes: Sexual Desire Inventory and Hypersexual Behaviour Inventory scores at 2 and 10 weeks.","sample_n":52,"sample_text":"52 participants (26 per group)","population":"Men with pedophilic disorder (clinical sample, likely recruited from treatment/assessment services).","country":"Sweden (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a double‑blind trial, men with pedophilic disorder who received a testosterone‑suppressing drug showed large reductions in sexual desire and hypersexual behaviours compared with placebo, with many reporting no sexual interest in children after ten weeks.","clinical_takeaway":"Testosterone suppression may markedly lower sexual desire and child‑focused interest in men with pedophilic disorder, but evidence comes from a small trial.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Randomised double‑blind design","Use of validated self‑report scales (SDI, HBI)","Effect sizes and confidence intervals reported"],"limitations":["Modest sample size for RCT","No pre‑registration or power analysis reported","Limited assessment of broader psychosocial confounds"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/15622975.2021.2014683"}},{"id":7432,"doi":"10.1017/s109285290001511x","pmid":"17146406","pmcid":null,"title":"The neurobiology of substance and behavioral addictions","authors":"Grant JE, Brewer JA, Potenza MN.","first_author":"Grant JE","journal":"CNS spectrums","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","Review","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":165,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review summarizing neurobiological studies of behavioral addictions, including compulsive sexual behavior","sample_n":null,"sample_text":"Not applicable","population":"Not applicable (review)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This 2006 review discusses how the brain mechanisms behind substance addictions also appear in behavioral addictions like gambling and compulsive sexual behavior, highlighting shared reward pathways and genetic factors.","clinical_takeaway":"Clinicians should recognize that compulsive sexual behavior may share neurobiological features with substance addictions, informing integrated treatment approaches.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","treatment"],"strengths":["Broad overview of neurobiological findings","Integrates substance and behavioral addiction literature"],"limitations":["No original data; conclusions depend on cited studies","Lacks systematic review methodology or risk‑of‑bias assessment","Does not address key confounds specific to compulsive sexual behavior"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":1,"mentioning":196,"citing_publications":361,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s109285290001511x"}},{"id":7433,"doi":"10.1177/070674370104600104","pmid":"11221487","pmcid":null,"title":"The neurobiology, neuropharmacology, and pharmacological treatment of the paraphilias and compulsive sexual behaviour","authors":"Bradford JM.","first_author":"Bradford JM.","journal":"Canadian journal of psychiatry. Revue canadienne de psychiatrie","year":2001,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":62,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of pharmacological approaches to paraphilias and compulsive sexual behaviour; no original data collection.","sample_n":null,"sample_text":"Not applicable – review article","population":"Humans (general psychiatric/clinical discussion)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"useful","plain_summary":"The article reviews brain mechanisms and drug treatments for paraphilias and compulsive sexual behaviour, outlining how serotonin inhibitors, anti‑androgens, and hormonal agents may lower sexual desire.","clinical_takeaway":"Several medications can reduce hypersexual urges, but clinicians should consider limited evidence and potential side‑effects.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Comprehensive summary of pharmacological agents","Clear clinical algorithm for treatment"],"limitations":["No systematic methodology or risk‑of‑bias assessment","Lacks empirical data; relies on heterogeneous sources","Does not address key confounds (moral incongruence, masturbation, mental health)"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":97,"citing_publications":193,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/070674370104600104"}},{"id":7435,"doi":"10.1177/0306624x07299345","pmid":"17615431","pmcid":null,"title":"Drug consumption among sexual offenders against females","authors":"Baltieri DA, de Andrade AG.","first_author":"Baltieri DA","journal":"International journal of offender therapy and comparative criminology","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional study of 133 male prisoners divided into three offender groups","sample_n":133,"sample_text":"Three groups of participants (N = 133) comprising sexual offenders against girls, pubertal females, and women","population":"Male sexual offenders incarcerated in Brazil","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 133 Brazilian male sexual offenders, those who attacked adult women showed higher rates of drug use and impulsivity than offenders against younger females, suggesting a link between substance use, impulsivity, and sexual aggression.","clinical_takeaway":"Drug use and impulsivity may be risk factors for sexual aggression, but evidence is correlational and limited to incarcerated offenders.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relatively large total sample for prison study","Includes multiple offender sub‑groups","Considers both drug use and impulsivity"],"limitations":["Cross‑sectional design precludes causal inference","Key constructs (sexual addiction, impulsivity) not described as validated measures","No control for major confounds (e.g., mental health, trauma, moral factors)","Convenience sample of incarcerated men limits generalisability"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x07299345"}},{"id":7436,"doi":"10.1097/00004583-199908000-00008","pmid":"10434484","pmcid":null,"title":"Fluoxetine and compulsive sexual behavior","authors":"Aguirre B.","first_author":"Aguirre B.","journal":"Journal of the American Academy of Child and Adolescent Psychiatry","year":1999,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00004583-199908000-00008"}},{"id":7437,"doi":"10.1177/02537176251323573","pmid":"40115430","pmcid":"PMC11920976","title":"Eros Unleashed: A Case Series of Cariprazine-induced Hypersexuality","authors":"Vijayan S, Selvaraj A, Sekar D.","first_author":"Vijayan S","journal":"Indian journal of psychological medicine","year":2025,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11920976","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/02537176251323573"}},{"id":7438,"doi":"10.1207/s15324796abm3003_8","pmid":"16336075","pmcid":null,"title":"Psychosocial and behavioral correlates of seeking sex partners on the internet among HIV-positive men","authors":"Kalichman SC, Cherry C, Cain D, Pope H, Kalichman M.","first_author":"Kalichman SC","journal":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","year":2005,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"anonymous survey of 141 HIV‑positive men; multivariate logistic regression","sample_n":141,"sample_text":"141 sexually active HIV‑positive men","population":"HIV‑positive men who are sexually active; recruited via clinics/ community in Georgia, USA","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among HIV‑positive men, about a third used the Internet to look for sex partners. Those who did were more likely to have HIV‑negative partners and to have unprotected sex, and they scored higher on a sexual compulsivity questionnaire.","clinical_takeaway":"Internet‑based partner seeking in HIV‑positive men is linked to higher sexual risk; clinicians should address online sexual behavior in risk‑reduction counseling.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses validated Sexual Compulsivity scale","Multivariate analysis adjusts for many covariates","Relevant public‑health focus on HIV risk"],"limitations":["Cross‑sectional; cannot infer causality","Convenience sample; limited generalisability","Key confounds (moral incongruence, trauma) not assessed"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":13,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1207/s15324796abm3003_8"}},{"id":7439,"doi":"10.1016/j.bcp.2007.07.030","pmid":"17764663","pmcid":null,"title":"Neurobiology of addiction. An integrative review","authors":"Goodman A.","first_author":"Goodman A.","journal":"Biochemical pharmacology","year":2008,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":215,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Integrative narrative review of neurobiological literature; no primary data collected.","sample_n":null,"sample_text":"No primary participants; review of existing studies.","population":"Humans (general literature); no specific sample","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The article reviews brain research showing that substance abuse, gambling, bulimia, and sexual addiction may share common brain changes in reward, mood, and impulse control systems.","clinical_takeaway":"No direct clinical guidance; the review suggests that sexual addiction could involve similar brain pathways as other addictions.","confidence":0.6,"topic_tags":["sexual_function","neuroscience","csbd"],"strengths":["Broad integration of neurobiological literature","Clear theoretical framework of three functional systems"],"limitations":["Narrative review; no systematic search or bias assessment","No empirical data; conclusions are speculative","Lacks discussion of confounding psychosocial factors"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":133,"citing_publications":395,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.bcp.2007.07.030"}},{"id":7440,"doi":"10.1007/s11910-006-0022-y","pmid":"16822350","pmcid":null,"title":"Impulse control disorders in Parkinson's disease","authors":"Weintraub D, Potenza MN.","first_author":"Weintraub D","journal":"Current neurology and neuroscience reports","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":50,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review (narrative), no original data, no systematic methods reported","sample_n":null,"sample_text":"Not applicable – review article","population":"patients with Parkinson's disease","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how Parkinson’s disease patients who take dopamine‑activating drugs can develop impulse control problems, including compulsive sexual behaviour. It urges clinicians to watch for these issues and consider adjusting medication.","clinical_takeaway":"Clinicians should monitor Parkinson’s patients on dopamine agonists for emerging impulse control problems, including compulsive sexual behaviour, and adjust therapy when needed.","confidence":0.9,"topic_tags":["pornography","sexual_function","csbd","neuroscience"],"strengths":["Provides clinical overview of ICDs in Parkinson’s disease","Highlights need for monitoring dopamine agonist use"],"limitations":["Narrative review with no systematic methodology","No empirical data or quantitative synthesis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":56,"citing_publications":90,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11910-006-0022-y"}},{"id":7441,"doi":"10.1111/j.0021-8774.2005.00561.x","pmid":"16255728","pmcid":null,"title":"Sex, shame and the transcendent function: the function of fantasy in self development","authors":"Knox J.","first_author":"Knox J.","journal":"The Journal of analytical psychology","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"The paper is a theoretical/analytic commentary without empirical data; no participants, measures, or statistical analysis are reported.","sample_n":null,"sample_text":"NA","population":"none","country":"NA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article theorises that self‑agency shapes how intrusive sexual fantasies are experienced, suggesting that shame‑laden fantasies can act as warning signals or opportunities for self‑reflection within a psychodynamic framework.","clinical_takeaway":"None – the work is conceptual and does not provide actionable clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Integrates psychodynamic concepts with developmental theory","Offers novel perspective on fantasy and self‑agency"],"limitations":["No empirical data; purely theoretical","Lacks operational definitions or measurement of constructs","Cannot be generalized or tested without further research"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.0021-8774.2005.00561.x"}},{"id":7442,"doi":null,"pmid":"22033547","pmcid":"PMC3181632","title":"Obsessive-compulsive spectrum disorders","authors":"Allen A, King A, Hollander E.","first_author":"Allen A","journal":"Dialogues in clinical neuroscience","year":2003,"pub_types":["research-article","Journal Article"],"keywords":["Autism","Impulsivity","Obsessive-compulsive Disorder","Body Dysmorphic Disorder","Pathological Gambling","Asperger's Disorder","Sexual Compulsivity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3181632","cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review without systematic methods","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews various disorders that share obsessive‑compulsive features, including sexual compulsivity, framing them as a spectrum from compulsive to impulsive conditions.","clinical_takeaway":"The piece offers a conceptual overview only; it does not provide evidence for assessing or treating sexual compulsivity.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad synthesis of OCD‑spectrum literature","Integrates compulsivity‑impulsivity continuum","Highlights sexual compulsivity within a larger framework"],"limitations":["No systematic review methods or risk‑of‑bias assessment","No original data or validated measures reported","Lacks empirical testing of constructs or confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":7443,"doi":"10.1007/s00103-010-1033-z","pmid":"20198357","pmcid":null,"title":"[Sexual addiction? When sexual behavior gets out of control]","authors":"Briken P, Basdekis-Jozsa R.","first_author":"Briken P","journal":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","year":2010,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative discussion of sexual addiction concepts, no empirical data, no methods section.","sample_n":null,"sample_text":"Not applicable – the article presents a theoretical overview without original data.","population":"Not applicable","country":"Germany (journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The article discusses how non‑deviant sexual behaviors can become problematic, proposing a term ‘paraphilia‑related disorder’ and outlining biological, emotional, and relational factors that may contribute, as well as therapeutic approaches.","clinical_takeaway":"Clinicians should assess underlying emotional and relational issues when patients present with compulsive sexual behavior.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Clear conceptual distinction between deviant and non‑deviant sexual behavior","Integration of biological, relational, and affective factors","Overview of therapeutic options"],"limitations":["No empirical data or systematic review methodology","Lacks measurement of key confounds (e.g., moral incongruence, masturbation)","Interpretations are largely theoretical"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00103-010-1033-z"}},{"id":7445,"doi":"10.1177/08862605251320999","pmid":"39988976","pmcid":null,"title":"The Meaning-Making of Adult Sexual Assault Among Men: An Exploratory Qualitative Study of the Perspectives of Survivors and Therapists","authors":"Guter M, Einat T, Gueta K.","first_author":"Guter M","journal":"Journal of interpersonal violence","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual Assault","Masculinity","Adult Sexual Assault","Life Course Perspective","Male Sexual Victimization","Male Rape"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Exploratory qualitative interview study with 40 in‑depth interviews (19 survivors, 21 therapists). No quantitative analyses.","sample_n":40,"sample_text":"40 in‑depth interviews (19 survivors, 21 therapists)","population":"Israeli adult men who experienced sexual assault after age 18 and therapists working with sexual trauma.","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 19 Israeli men who were sexually assaulted as adults and 21 therapists show that survivors interpret the assaults through the lenses of adulthood and masculinity, leading to feelings of isolation and coping strategies such as detachment, minimization, and hypersexuality.","clinical_takeaway":"Clinicians should recognise how adult male survivors' ideas about masculinity shape their coping and help‑seeking.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["In‑depth, first‑person perspectives from survivors and clinicians","Rigorous qualitative methodology (thematic analysis)","Addresses a neglected population (adult male survivors)"],"limitations":["Small, non‑representative convenience sample","Findings limited to Israeli cultural context","No quantitative validation of themes"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/08862605251320999"}},{"id":7446,"doi":"10.1007/s10461-007-9321-9","pmid":"17985229","pmcid":"PMC3433852","title":"HIV prevention altruism and sexual risk behavior in HIV-positive men who have sex with men","authors":"O'Dell BL, Rosser BR, Miner MH, Jacoby SM.","first_author":"O'Dell BL","journal":"AIDS and behavior","year":2008,"pub_types":["research-article","Randomized Controlled Trial","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized controlled trial (baseline cross‑sectional analysis of 637 HIV‑positive MSM)","sample_n":637,"sample_text":"637 HIV‑positive MSM","population":"HIV‑positive men who have sex with men (N = 637)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether caring about partners’ HIV risk (“prevention altruism”) is linked to safer sex among HIV‑positive gay men. Altruism was associated with less risky anal sex in simple analyses, but the link disappeared after accounting for drug use and compulsive sex, suggesting other factors also matter.","clinical_takeaway":"Promoting partner‑focused motivation alone may not reduce risk; interventions should also address drug use and compulsive sexual behavior.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["large sample size","adjusts for drug use and compulsive sexual behavior"],"limitations":["cross‑sectional analysis limits causal inference","no measurement of key confounds (moral incongruence, mental health, partner factors)","absence of pre‑registration"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":60,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-007-9321-9"}},{"id":7447,"doi":"10.1186/1745-0179-2-9","pmid":"16716210","pmcid":"PMC1479813","title":"Topiramate plus citalopram in the treatment of Compulsive-Impulsive Sexual Behaviors","authors":"Marazziti D, Dell'Osso B.","first_author":"Marazziti D","journal":"Clinical practice and epidemiology in mental health : CP & EMH","year":2006,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC1479813","cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-patient case report","sample_n":1,"sample_text":"N=1 (case report)","population":"one adult with bipolar II disorder and compulsive‑impulsive sexual behaviors","country":"Italy (presumed from authors’ affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 2006 case report describes one patient with compulsive‑impulsive sexual behavior and bipolar II disorder who showed marked improvement after three months of adding topiramate to citalopram. The authors suggest the combination may help similar patients, but larger controlled studies are needed.","clinical_takeaway":"Evidence is insufficient; clinicians should not base treatment decisions on this single case.","confidence":0.78,"topic_tags":["sexual_function","csbd","treatment"],"strengths":["Detailed clinical description","Clear treatment timeline","Novel therapeutic suggestion"],"limitations":["Single case, no control group","No standardized outcome measures","Potential confounding by bipolar disorder course"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1745-0179-2-9"}},{"id":7449,"doi":"10.1111/j.1447-0349.2010.00678.x","pmid":"20887611","pmcid":null,"title":"Improving addictions treatment outcomes by empowering self and others","authors":"Wood TE, Englander-Golden P, Golden DE, Pillai VK.","first_author":"Wood TE","journal":"International journal of mental health nursing","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"quasi‑experimental pre‑post addition of group training in a residential addiction programme (includes sexual addiction among other disorders); no randomisation reported; sample size not disclosed in abstract","sample_n":null,"sample_text":"unspecified; likely a convenience sample of residents","population":"adults in long‑term residential treatment for various addictions (alcohol, substances, sexual addiction, eating disorders, compulsive shopping, gambling); co‑educational; Texas, USA","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A new group training that lets patients act out challenging situations was added to a residential addiction programme (including sexual addiction). Participants showed higher self‑esteem, better communication, and a more positive group atmosphere, but the study lacked a control group and detailed measurement information.","clinical_takeaway":"The training may boost confidence and group cohesion in addiction treatment, but its specific benefit for sexual‑addiction patients remains uncertain.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Innovative experiential group training","Reported large effect sizes on empowerment outcomes","Includes multiple addiction types, increasing ecological relevance"],"limitations":["No randomised control group; potential confounding","Outcome measures not described as validated instruments","Sample size and power not reported"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1447-0349.2010.00678.x"}},{"id":7450,"doi":"10.1016/j.esxm.2021.100429","pmid":"34509753","pmcid":"PMC8498949","title":"Hypersexuality and Impulsivity in Self-Referred Men With Sexual Interest in Minors: Are They Related? Do They Change During Treatment? An Exploratory Pilot Study","authors":"Lampalzer U, Tozdan S, von Franqué F, Briken P.","first_author":"Lampalzer U","journal":"Sexual medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Impulsivity","psychotherapy","Hypersexuality","Pedophilia","Prevention Of Child Sexual Abuse"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8498949","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"pre‑post pilot with self‑referred men (N=77 pretreatment, 29 follow‑up), no control group","sample_n":77,"sample_text":"77 pretreatment, 29 post‑treatment","population":"self‑referred men with sexual interest in minors (SIM)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 77 self‑referred men interested in minors, hypersexuality was high and dropped after treatment, while impulsivity stayed the same. Hypersexuality and impulsivity were only weakly linked.","clinical_takeaway":"Targeting hypersexuality in treatment may reduce risk; impulsivity appears less relevant.","confidence":0.78,"topic_tags":["sexual_function","masturbation"],"strengths":["Validated hypersexuality and impulsivity scales","Focus on a hard‑to‑reach clinical population","Pre‑post assessment of change during treatment"],"limitations":["Small follow‑up sample (n=29)","No control/comparison group","No adjustment for key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":8,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2021.100429"}},{"id":7451,"doi":"10.1080/19317611.2021.1974144","pmid":"38596526","pmcid":"PMC10903681","title":"What's in a Name? A Phenomenological Exploration of Hypersexuality Narratives","authors":"Knack N, Holmes D, Hammond C, Fedoroff JP.","first_author":"Knack N","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Phenomenology","Narrative Analysis","Sexual Addiction","Hypersexuality"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Interpretative Phenomenological Analysis of 32 self‑selected Canadian men reporting hypersexuality concerns; interview‑based, convenience sample.","sample_n":32,"sample_text":"32 men with self‑reported concerns related to hypersexuality.","population":"Adult men (self‑identified hypersexuality concerns) from Canada.","country":"Canada","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["circular_addiction_scale","self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study interviewed 32 Canadian men who felt their sexual behavior was excessive, exploring how they describe their experiences and the personal and cultural factors they think shape them.","clinical_takeaway":"Clinicians should consider personal histories and cultural context when assessing hypersexuality, rather than relying solely on symptom checklists.","confidence":0.8,"topic_tags":["sexual_function","pornography"],"strengths":["In‑depth qualitative insight","Use of established phenomenological methods","Rich participant narratives"],"limitations":["No validated measures of hypersexuality","Small, self‑selected convenience sample","No control for key confounds (moral, mental health, etc.)"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2021.1974144"}},{"id":7453,"doi":"10.1080/10532528.2001.10559795","pmid":"12666738","pmcid":null,"title":"Sexual problems in gay men: an overview of empirical research","authors":"Sandfort TG, de Keizer M.","first_author":"Sandfort TG","journal":"Annual review of sex research","year":2001,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of 19 empirical studies; no new data collection, no systematic methodology reported.","sample_n":null,"sample_text":"N/A","population":"Gay men (studies varied); no single sample.","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews 19 studies on sexual problems in gay men, covering issues such as desire, arousal, orgasm, pain and compulsivity, and notes how little is known about these topics.","clinical_takeaway":"Clinicians should recognise the paucity of high‑quality research on gay men’s sexual problems and seek individualized assessment rather than rely on limited evidence.","confidence":0.6,"topic_tags":["sexual_function","csbd"],"strengths":["Broad overview of existing empirical work","Identifies gaps in knowledge for gay men’s sexual health"],"limitations":["Narrative (non‑systematic) review; no formal bias assessment","No quantitative synthesis or meta‑analysis","No clear definition or measurement of key constructs"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":104,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10532528.2001.10559795"}},{"id":7454,"doi":"10.1016/j.jsxm.2021.06.018","pmid":"34376378","pmcid":null,"title":"Exploring Hypersexuality Pathways From Eye Movements: The Role of (Sexual) Impulsivity","authors":"Carvalho J, Rosa PJ, Štulhofer A.","first_author":"Carvalho J","journal":"The journal of sexual medicine","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Impulsivity","Eye Tracking","Hypersexuality","Go/no-go","Sexual Impulsivity","First Fixation"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional community sample (N=113) using Go/No‑Go task and eye‑tracking; regression analyses of self‑report impulsivity and fixation times predicting hypersexuality scores.","sample_n":113,"sample_text":"55 men, 58 women (total N=113) recruited from a community sample","population":"adult men and women from the community (55 men, 58 women)","country":"unspecified (likely Europe based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 113 adults, general impulsivity predicted higher hypersexuality scores, while longer first‑fixation on sexual pictures predicted more negative outcomes. Specific sexual impulsivity did not add predictive value.","clinical_takeaway":"Address general impulsivity and broader psychopathology rather than focusing solely on sexual‑specific traits when treating hypersexuality.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Innovative use of eye‑tracking to capture attention","Separates domain‑general and domain‑specific impulsivity","Community sample includes both sexes"],"limitations":["Reliance on self‑report hypersexuality scale without distress separation","No measurement of key confounds (moral incongruence, mental health, etc.)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.06.018"}},{"id":7455,"doi":"10.1176/ajp.154.11.1632","pmid":"9356590","pmcid":null,"title":"Compulsive sexual behavior characteristics","authors":"Kafka MP, Prentky RA.","first_author":"Kafka MP","journal":"The American journal of psychiatry","year":1997,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ajp.154.11.1632"}},{"id":7456,"doi":"10.1177/14713012211032068","pmid":"34269088","pmcid":null,"title":"Between sexual assault and compassion: The experience of living with a spouse's dementia-related hypersexuality-A narrative case-study","authors":"Harel D, Band-Winterstein T, Goldblatt H.","first_author":"Harel D","journal":"Dementia (London, England)","year":2022,"pub_types":["Journal Article"],"keywords":["Dementia","Older women","Old Age","Sexual Assault","Hypersexuality","Narrative Case-study"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"narrative case-study; single participant; qualitative interviews over 10 months; thematic analysis","sample_n":1,"sample_text":"single case (one caregiver‑spouse)","population":"older woman caregiver of spouse with dementia‑related hypersexuality","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A detailed interview study of one older woman caring for a husband with dementia who displays hypersexual behaviour shows how she moves through distress, ambiguity, loss, and eventually a compassionate caregiving identity.","clinical_takeaway":"Caregivers of partners with dementia‑related hypersexuality may benefit from support that acknowledges distress while fostering compassionate coping.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["In‑depth longitudinal qualitative data from multiple interviews","Rich thematic insight into caregiver experience","Highlights both distress and potential for compassionate coping"],"limitations":["Single case; no generalisability","No standardized measures or quantitative data","No assessment of confounding factors (e.g., mental health, moral views)","Interpretation limited to this dyad’s context"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/14713012211032068"}},{"id":7457,"doi":"10.1186/s12888-021-03362-4","pmid":"34261462","pmcid":"PMC8278725","title":"Development of a structure-validated hypersexuality scale in Chinese university students","authors":"Jia Y, Shao X, Shen C, Wang W.","first_author":"Jia Y","journal":"BMC psychiatry","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Principal component analysis","Exploratory Structural Equation Modeling","Hypersexual Experience","Structure-validated Questionnaire"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8278725","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"scale development using exploratory factor analysis and exploratory structural equation modeling in a convenience sample of 282 Chinese heterosexual university students who reported at least one lifetime hypersexual experience.","sample_n":282,"sample_text":"282 heterosexual university students who experienced hypersexuality at least once life‑long","population":"Chinese heterosexual university students (N=282)","country":"China","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created a 20‑item questionnaire to assess hypersexuality in Chinese university students, identifying five sub‑domains such as negative impact and emotional coping. The scale showed acceptable factor structure but has not yet been validated beyond this sample.","clinical_takeaway":"The new scale may help clinicians assess hypersexuality, but it needs further validation before routine use.","confidence":0.78,"topic_tags":["measurement","sexual_function"],"strengths":["Clear factor‑analytic methodology","Reasonable sample size for scale development","Five distinct subscales identified"],"limitations":["Convenience, single‑university sample limits generalisability","No external validation or test‑retest reliability reported","Potential moral‑incongruence and mental‑health confounds not measured"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12888-021-03362-4"}},{"id":7458,"doi":"10.1016/j.jad.2021.06.064","pmid":"34246948","pmcid":null,"title":"Hypersexual behavior and attachment styles in a non-clinical sample: The mediation role of depression and post-traumatic stress symptoms","authors":"Ciocca G, Pelligrini F, Mollaioli D, Limoncin E, Sansone A, Colonnello E, Jannini EA, Fontanesi L.","first_author":"Ciocca G","journal":"Journal of affective disorders","year":2021,"pub_types":["Journal Article"],"keywords":["Trauma","Depression","Hypersexual Behavior","Attachment Styles"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience snowball online sample (N=1025) with self‑report questionnaires; regression mediation analysis.","sample_n":1025,"sample_text":"1025 participants (731 female, 294 male) recruited through an online snowball method.","population":"Adults (age ~30, 71% female) recruited via online platforms.","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large online survey, people with insecure attachment styles, higher depression, and more post‑traumatic stress symptoms tended to report higher hypersexual behavior scores. The study suggests these factors may mediate the link between attachment and hypersexuality, but it cannot prove causation.","clinical_takeaway":"Attachment insecurity, depression, and trauma are linked to hypersexual behavior; clinicians should assess these factors, but causal claims are premature.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample size","Use of validated psychometric instruments","Inclusion of depression and trauma as mediators"],"limitations":["Cross‑sectional design, no temporal precedence","Convenience snowball sampling limits generalisability","No assessment of moral incongruence or masturbation","Causal language overstated"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":4,"interpretation":4}},"scite":{"supporting":3,"contrasting":0,"mentioning":15,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jad.2021.06.064"}},{"id":7459,"doi":"10.1007/s11920-021-01260-w","pmid":"34196843","pmcid":null,"title":"The Structure, Covariates, and Etiology of Hypersexuality: Implications for Sexual Offending","authors":"Knight RA, Du R.","first_author":"Knight RA","journal":"Current psychiatry reports","year":2021,"pub_types":["Review","Journal Article"],"keywords":["Impulsivity","Compulsive Sexual Behavior","Sexual Offending","Hypersexuality","Problematic Sexuality","Sexual Drive/desire"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review summarizing recent studies on hypersexuality structure, covariates, and etiology; no systematic search or meta‑analysis.","sample_n":null,"sample_text":"Not applicable (review)","population":"Not applicable (review of existing literature)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["selective_reporting"],"stance":"neutral","citation_value":"useful","plain_summary":"The review summarises recent research on hypersexuality, noting it has both a problem‑related component and a high‑drive component that vary across individuals. It points out that abuse history and impulsivity are common correlates, but calls for larger, representative studies to set treatment thresholds.","clinical_takeaway":"Hypersexuality appears multidimensional; clinicians should assess both problematic behaviors and overall sexual drive, and consider developmental trauma when evaluating patients.","confidence":0.8,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Integrates recent empirical work","Highlights dimensional nature of hypersexuality","Identifies gaps in large‑scale and forensic samples"],"limitations":["Narrative, not systematic, review","No formal assessment of study quality","Lacks discussion of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":11,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11920-021-01260-w"}},{"id":7460,"doi":"10.1007/s10508-021-01959-0","pmid":"34189627","pmcid":null,"title":"Hypersexuality in Mixed-Sex Couples: A Dyadic Longitudinal Study","authors":"Bőthe B, Vaillancourt-Morel MP, Bergeron S.","first_author":"Bőthe B","journal":"Archives of sexual behavior","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Couples","Intimacy","Hypersexuality","Emotion Dysregulation","Compulsive Sexual Behavior Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Dyadic longitudinal study of 267 mixed‑sex couples with baseline and 6‑month follow‑up; crossed‑lagged actor‑partner interdependence model.","sample_n":267,"sample_text":"267 couples (534 individuals)","population":"mixed‑sex couples, community sample, mean ages ~30 men, ~28 women","country":"unspecified (likely Canada/Europe based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 267 couples followed for six months, people who had more trouble regulating emotions tended to report higher hypersexuality later. Women’s hypersexuality predicted lower relationship intimacy, but intimacy did not predict later hypersexuality.","clinical_takeaway":"Emotion‑regulation difficulties may precede hypersexual behaviours; addressing emotional coping could help reduce hypersexuality.","confidence":0.8,"topic_tags":["sexual_function","relationships","csbd","pornography","masturbation"],"strengths":["Large dyadic sample with both partners","Longitudinal design allowing directionality testing","Actor‑partner interdependence modelling"],"limitations":["Unclear whether hypersexuality scale is validated for this context","No measurement of moral incongruence, masturbation, or mental‑health covariates","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-01959-0"}},{"id":7461,"doi":"10.1007/978-981-95-2411-2_6","pmid":"41171564","pmcid":null,"title":"Similarities and Differences in Diagnostic Criteria","authors":"Chen Y, Wei Z.","first_author":"Chen Y","journal":"Advances in experimental medicine and biology","year":2025,"pub_types":["Review","Journal Article"],"keywords":["Diagnostic criteria","Substance Addiction","Non-substance Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review chapter comparing diagnostic criteria for substance and non‑substance addictions, including hypersexual disorder; no original data.","sample_n":null,"sample_text":"Not applicable","population":"None (review)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The chapter compares how substance addictions and non‑substance behaviors like gambling, internet use, food, and hypersexuality are defined, noting many shared symptoms but also a lack of validated criteria for the latter.","clinical_takeaway":"Current diagnostic criteria for non‑substance addictions, including hypersexuality, are not yet fully validated; clinicians should use caution when applying them.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Broad overview of diagnostic criteria across domains","Identifies gaps in validation for non‑substance addictions"],"limitations":["No empirical data; conclusions are theoretical","Lacks systematic review methodology","No critical appraisal of cited studies"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/978-981-95-2411-2_6"}},{"id":7462,"doi":"10.5812/ijpr-156707","pmid":"40708932","pmcid":"PMC12285674","title":"5-Alpha Reductase Inhibitors on Hypersexuality During the Manic Phase of Bipolar and Psychotic Patients; New Insight to a Well-Known Medicines","authors":"Mahmoudi Meymand M, Mohammad Soleymani S, Esmaily H.","first_author":"Mahmoudi Meymand M","journal":"Iranian journal of pharmaceutical research : IJPR","year":2025,"pub_types":["Letter"],"keywords":["Bipolar disorder","Dutasteride","finasteride","Hypersexuality","5-Alpha Reductase (5ar)","Schizoaffective Patients"],"is_oa":true,"oa_url":"https://doi.org/10.5812/ijpr-156707","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5812/ijpr-156707"}},{"id":7463,"doi":"10.1080/02791072.2012.662112","pmid":"22641964","pmcid":"PMC4040958","title":"Sex, drugs, and rock 'n' roll: hypothesizing common mesolimbic activation as a function of reward gene polymorphisms","authors":"Blum K, Werner T, Carnes S, Carnes P, Bowirrat A, Giordano J, Oscar-Berman M, Gold M.","first_author":"Blum K","journal":"Journal of psychoactive drugs","year":2012,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Review","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review/hypothesis article without primary data","sample_n":null,"sample_text":"Not applicable – no empirical sample","population":"humans (general)","country":"USA (implied by funding agencies)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose that genetic variations influencing dopamine may underlie a shared brain mechanism for different addictions, including a hypothesised \"sex addiction,\" and suggest combining neuroimaging with drug challenges in future studies.","clinical_takeaway":"None – the article is a theoretical hypothesis without clinical evidence.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Integrates genetics and reward neuroscience","Broad discussion of multiple addictions"],"limitations":["No original data; purely speculative","No operational definitions or empirical testing of 'sex addiction'","Lacks measurement of key confounds (moral incongruence, masturbation, mental health, etc.)"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":47,"citing_publications":88,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/02791072.2012.662112"}},{"id":7464,"doi":"10.1155/2021/5557211","pmid":"34258097","pmcid":"PMC8249151","title":"A Case of Hypersexuality in a Patient Receiving Aripiprazole for Schizophrenia","authors":"Priya L, Moorthy B.","first_author":"Priya L","journal":"Case reports in psychiatry","year":2021,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8249151","cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report describing onset of hypersexuality after aripiprazine initiation and resolution after discontinuation","sample_n":1,"sample_text":"1 patient","population":"24‑year‑old male with schizophrenia","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 24‑year‑old man with schizophrenia began taking aripiprazole and soon developed excessive sexual urges and behaviours. When the medication was stopped, his hypersexuality lessened, suggesting the drug may provoke compulsive sexual behaviour in some patients.","clinical_takeaway":"Be alert for new‑onset hypersexuality in patients started on aripiprazole and consider medication change if it occurs.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","csbd"],"strengths":["Clear temporal link between drug initiation and symptom change","Clinical relevance for prescribers"],"limitations":["Single case; no generalisability","No validated measures of hypersexuality or compulsivity","No systematic assessment of alternative explanations"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2021/5557211"}},{"id":7465,"doi":"10.1038/s41598-024-83151-7","pmid":"39706850","pmcid":"PMC11662030","title":"Author Correction: A qualitative study exploring the clinical phenomenology and impact of hypersexuality in patients with Parkinson's Disease","authors":"Tayim N, Panicker JN, Foley J, Selai C, El Sheikh WG.","first_author":"Tayim N","journal":"Scientific reports","year":2024,"pub_types":["Published Erratum","correction"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11662030","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-024-83151-7"}},{"id":7466,"doi":"10.31083/j.jin2002051","pmid":"34258950","pmcid":null,"title":"Hypersexuality in neurological diseases: do we see only the tip of the iceberg?","authors":"Latella D, Maggio MG, Andaloro A, Marchese D, Manuli A, Calabrò RS.","first_author":"Latella D","journal":"Journal of integrative neuroscience","year":2021,"pub_types":["Meta-Analysis","Journal Article"],"keywords":["Pathophysiology","Sexual Addiction","Hypersexuality","Neurological Disorder"],"is_oa":false,"oa_url":"https://www.imrpress.com/journal/JIN/20/2/10.31083/j.jin2002051/pdf","cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"meta-analysis of 40 articles on hypersexuality in neurological disorders","sample_n":40,"sample_text":"Forty articles satisfied the inclusion/exclusion criteria; pooled sample size not reported in abstract","population":"patients with various neurological diseases (likely clinical samples)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 40 studies found that hypersexuality often occurs in people with neurological diseases, especially neurodegenerative disorders, and can worsen patient care. The authors note that many studies lack thorough measurement and call for larger, better‑designed research.","clinical_takeaway":"Hypersexuality may be common in neurological patients; clinicians should assess and address it, but evidence on treatment is limited.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","csbd"],"strengths":["Aggregates data across multiple neurological conditions","Identifies hypersexuality as a frequent issue in these populations"],"limitations":["Likely heterogeneous definitions of hypersexuality","No systematic control for moral or mental‑health confounds","Abstract provides limited detail on statistical methods"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31083/j.jin2002051"}},{"id":7468,"doi":"10.1097/01.aids.0000167353.02289.b9","pmid":"15838196","pmcid":null,"title":"Psychosocial correlates of transmission risk behavior among HIV-seropositive gay and bisexual men","authors":"O'Leary A, Wolitski RJ, Remien RH, Woods WJ, Parsons JT, Moss S, Lyles CM.","first_author":"O'Leary A","journal":"AIDS (London, England)","year":2005,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":49,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"baseline observational analysis of a multicenter HIV‑positive men cohort; logistic regression models of condom use with main vs non‑main partners","sample_n":null,"sample_text":"Not specified in abstract; likely several hundred participants","population":"HIV‑positive gay and bisexual men recruited for the Seropositive Urban Men’s Intervention Trial (US urban sites)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among HIV‑positive gay and bisexual men, confidence in using condoms and factors like drug use and childhood abuse shape whether they use condoms with regular and casual partners.","clinical_takeaway":"Boosting condom‑use self‑efficacy and addressing drug use may improve safe‑sex practices in this population.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Uses validated sexual compulsivity scale","Differentiates partner type in risk analysis","Considers contextual factors (e.g., drug use, childhood abuse)"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral incongruence or masturbation which co‑occur with sexual behavior","Potential self‑selection bias from trial participants"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":59,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.aids.0000167353.02289.b9"}},{"id":7469,"doi":"10.1089/brain.2020.0868","pmid":"33813866","pmcid":null,"title":"Aberrant Salient and Corticolimbic Connectivity in Hypersexual Parkinson's Disease","authors":"Mata-Marín D, Pineda-Pardo JA, Molina JA, Vela L, Alonso-Frech F, Obeso I.","first_author":"Mata-Marín D","journal":"Brain connectivity","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["fMRI","Impulsivity","Functional Connectivity","Resting-state","Salience Network"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross‑sectional resting‑state fMRI comparing 17 PD patients with hypersexuality, 15 PD patients without, and 17 healthy controls; two medication conditions per patient","sample_n":49,"sample_text":"17 PD+HS, 15 PD‑HS, 17 healthy controls","population":"Parkinson’s disease patients, recruited from clinical settings; convenience sample","country":"Spain (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small fMRI study found that Parkinson’s patients with hypersexual behaviour show altered activity in brain networks that control attention and impulse, especially involving the salience network and connections between striatal regions and parietal areas.","clinical_takeaway":"Neural circuitry differences may underlie hypersexual impulses in Parkinson’s, but findings are preliminary and not ready for clinical use.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Use of multimodal resting‑state connectivity analysis","Inclusion of medication ON/OFF conditions","Comparison with healthy controls"],"limitations":["Small sample size limits reliability","No explicit measurement of key confounds (moral incongruence, masturbation, mental health)","Addiction criteria not operationalised","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":70,"pct_score":41,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":5,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":16,"retracted":false,"notices":[{"status":"Has correction","date":"2022-5-12","noticeDoi":"10.1089/brain.2020.0868.correx","doi":"10.1089/brain.2020.0868"},{"status":"Has erratum","date":"2022-5-1","noticeDoi":"10.1089/brain.2020.0868.correx","doi":"10.1089/brain.2020.0868"}],"url":"https://scite.ai/reports/10.1089/brain.2020.0868"}},{"id":7470,"doi":"10.1097/01.aids.0000167354.09912.83","pmid":"15838197","pmcid":null,"title":"Seroconcordant sexual partnerings of HIV-seropositive men who have sex with men","authors":"Halkitis PN, Green KA, Remien RH, Stirratt MJ, Hoff CC, Wolitski RJ, Parsons JT.","first_author":"Halkitis PN","journal":"AIDS (London, England)","year":2005,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Baseline data from a randomized controlled trial, but analysis is cross‑sectional description of HIV‑positive MSM behaviours.","sample_n":1168,"sample_text":"Baseline assessment of 1168 HIV‑positive MSM; 596 reported seroconcordant partners.","population":"1168 HIV‑positive men who have sex with men recruited from gay venues, AIDS service organisations and commercial sex settings (USA).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among HIV‑positive gay men, about two‑thirds of those who had sex with other HIV‑positive partners engaged in unprotected anal sex. Lower concern about health risks, higher sexual hedonism, and drug use were linked to this behaviour.","clinical_takeaway":"Risk‑reduction counselling should address hedonistic motivations and drug use, not just HIV re‑infection concerns.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Large sample of HIV‑positive MSM","Multivariate analysis of several behavioural predictors"],"limitations":["Cross‑sectional design limits causal inference","Constructs measured with unspecified or non‑validated self‑report items","Key confounds such as moral incongruence, mental health, and trauma not assessed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":30,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.aids.0000167354.09912.83"}},{"id":7471,"doi":"10.1097/01.aids.0000167349.23374.a3","pmid":"15838192","pmcid":null,"title":"Barebacking identity among HIV-positive gay and bisexual men: demographic, psychological, and behavioral correlates","authors":"Halkitis PN, Wilton L, Wolitski RJ, Parsons JT, Hoff CC, Bimbi DS.","first_author":"Halkitis PN","journal":"AIDS (London, England)","year":2005,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Baseline survey of 1168 HIV‑positive gay/bisexual men; convenience recruitment from venues; questionnaire on barebacking identity, sexual behavior, psychosocial factors.","sample_n":1168,"sample_text":"Baseline quantitative assessment of a randomized controlled intervention study; participants recruited from mainstream gay venues, AIDS service organizations, and public/commercial sex environments.","population":"HIV‑positive gay and bisexual men in NYC and San Francisco (N≈1168)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,168 HIV‑positive gay and bisexual men, those who called themselves \"barebackers\" were younger, more likely to use drugs, missed HIV medication doses, reported higher sexual compulsivity, and engaged in more unprotected sex.","clinical_takeaway":"Barebacking identity signals higher risk behaviours and medication non‑adherence; clinicians should assess and address these factors.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a niche population","Comprehensive set of behavioral and psychosocial variables","Clear statistical reporting of correlates"],"limitations":["Cross‑sectional design limits causal inference","Convenience recruitment reduces generalisability","Key confounds (moral incongruence, masturbation, trauma) not measured"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":12,"contrasting":3,"mentioning":78,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.aids.0000167349.23374.a3"}},{"id":7472,"doi":"10.1016/j.biopsych.2009.12.029","pmid":"20346444","pmcid":"PMC2908911","title":"Lesions of the medial prefrontal cortex cause maladaptive sexual behavior in male rats","authors":"Davis JF, Loos M, Di Sebastiano AR, Brown JL, Lehman MN, Coolen LM.","first_author":"Davis JF","journal":"Biological psychiatry","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Lesion vs sham in male rats; copulation‑contingent aversion conditioning; control for associative learning.","sample_n":null,"sample_text":"Not reported in abstract; typical rodent studies use ≤20 animals total.","population":"Male Sprague‑Dawley rats","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Rats with damage to the medial prefrontal cortex kept mating even when it was paired with an unpleasant outcome, suggesting this brain area helps suppress sexual actions that become harmful.","clinical_takeaway":"No direct clinical implication; the study hints that prefrontal dysfunction could underlie compulsive sexual behavior in humans.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","prevalence"],"strengths":["Controlled experimental manipulation (lesions)","Clear behavioral paradigm linking reward and aversion","Demonstrates causal role of mPFC in inhibition of sexual behavior"],"limitations":["Small, unspecified sample size","Findings from rats may not translate directly to human compulsive sexual behavior","No measurement of underlying neural activity beyond lesion"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":6,"contrasting":0,"mentioning":28,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.biopsych.2009.12.029"}},{"id":7474,"doi":"10.1016/s0193-953x(18)30077-7","pmid":"7761303","pmcid":null,"title":"Compulsive sexual behaviors","authors":"Travin S.","first_author":"Travin S.","journal":"The Psychiatric clinics of North America","year":1995,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review / case report discussion without systematic methodology.","sample_n":null,"sample_text":"Not applicable – no original empirical sample.","population":"Adults (mixed male/female), clinical cases described.","country":"United States (presumed by journal location).","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews various ways to understand compulsive sexual behaviors, describing four models—compulsive, affective, addictive, and impulsive— and discusses how they affect treatment choices.","clinical_takeaway":"Clinicians should be aware that compulsive sexual behaviors can fit several conceptual models and tailor assessment and treatment accordingly.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad overview of multiple theoretical models","Highlights clinical relevance and treatment implications"],"limitations":["No systematic search or quality appraisal","Lacks empirical data or quantitative synthesis","No explicit measurement of constructs or confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0193-953x(18)30077-7"}},{"id":7475,"doi":null,"pmid":"33913428","pmcid":null,"title":"[Hypersexuality]","authors":"Geiker KW, Giraldi A, Johansson KS, Bengtson S.","first_author":"Geiker KW","journal":"Ugeskrift for laeger","year":2021,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"dan","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Review article without empirical data; no systematic methods reported.","sample_n":null,"sample_text":"Not applicable (review).","population":"Humans (general discussion of hypersexuality).","country":"Denmark (journal Ugeskrift for Læger).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews how hypersexuality is defined and points out that there is little solid research on diagnosing it or on effective treatments, calling for more rigorous studies.","clinical_takeaway":"Currently there is insufficient evidence to diagnose or treat hypersexuality as a distinct disorder.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Identifies gaps in diagnostic criteria for hypersexuality.","Highlights lack of treatment evidence."],"limitations":["No systematic methodology described.","No empirical data or meta‑analysis performed.","Limited discussion of confounding factors."],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":7476,"doi":"10.1111/ajad.13149","pmid":"33783065","pmcid":"PMC8243775","title":"Substance Use, Gambling, Binge-Eating, and Hypersexuality Symptoms Among Patients Receiving Opioid Agonist Therapies","authors":"Carr MM, Ellis JD, Saules KK, Page JL, Staples A, Ledgerwood DM.","first_author":"Carr MM","journal":"The American journal on addictions","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 176 opioid agonist therapy patients","sample_n":176,"sample_text":"Adults (N = 176) recruited from an outpatient clinic providing opioid agonist therapy","population":"adults receiving opioid agonist therapy (outpatient clinic)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 176 patients receiving opioid‑replacement therapy, 7‑47 % reported symptoms of behaviors such as gambling, binge‑eating, and hypersexuality. Higher impulsivity predicted more of these symptoms, while depression and anxiety were linked to specific patterns. The study suggests a broader spectrum of addictive‑like behaviors in this group.","clinical_takeaway":"Screen for a range of addictive‑like symptoms, especially hypersexuality, in opioid‑treatment patients, and consider impulsivity as a key risk factor.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Use of a multi‑dimensional validated RAD scale","Inclusion of relevant psychiatric covariates (depression, anxiety, impulsivity, ACEs)","Application of appropriate hurdle models for symptom presence and severity","Focus on understudied hypersexuality symptoms in OAT population"],"limitations":["Cross‑sectional design limits causal inference","Convenience sample from a single clinic reduces generalisability","Moral incongruence and masturbation not measured, possible confounding","No pre‑registration or correction for multiple testing reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/ajad.13149"}},{"id":7477,"doi":"10.3390/jcm13226708","pmid":"39597851","pmcid":"PMC11594643","title":"Study on Pharmacological Treatment of Impulse Control Disorders in Parkinson's Disease","authors":"Furdu-Lunguț E, Antal C, Turcu S, Costea DG, Mitran M, Mitran L, Diaconescu AS, Novac MB, Gorecki GP.","first_author":"Furdu-Lunguț E","journal":"Journal of clinical medicine","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Parkinson disease","Pharmacological Treatment","Impulsive Control Disorders","Applied Statistics"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11594643","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"other","design_detail":"Uncontrolled longitudinal treatment case series of Parkinson's patients with impulse control disorders, evaluated with HAM‑A scores over 6 years.","sample_n":null,"sample_text":"Patients evaluated in hospitals where authors work; exact N not provided.","population":"Parkinson’s disease patients with ICDs treated in author‑affiliated hospitals (sample size not reported).","country":"Romania (inferred from author names).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors report that Parkinson’s patients with impulse‑control problems, including hypersexuality, showed lower anxiety scores after various drug treatments, but the study lacks a control group and uses only a general anxiety scale.","clinical_takeaway":"Evidence that medication reduces impulse‑control symptoms in Parkinson’s is weak; clinicians should interpret claims cautiously.","confidence":0.3,"topic_tags":["sexual_function","csbd","neuroscience"],"strengths":["Long observation period (6 years).","Focus on clinically relevant ICDs in Parkinson’s disease."],"limitations":["No validated hypersexuality/ICD-specific measure.","Uncontrolled before‑after design; no comparison group.","Potential over‑statement of treatment efficacy."],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jcm13226708"}},{"id":7479,"doi":null,"pmid":"15884221","pmcid":null,"title":"[Prophylaxis of Internet sex addiction]","authors":"Kamiński R, Kamińska A.","first_author":"Kamiński R","journal":"Wiadomosci lekarskie (Warsaw, Poland : 1960)","year":2004,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"pol","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review, narrative, no empirical data, English abstract only","sample_n":null,"sample_text":"Not applicable – review article without original participants","population":"general (young people, implied)","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews concerns about “Internet sex addiction,” describing how online sexual behavior might become problematic and suggesting that education could prevent harm.","clinical_takeaway":"No direct clinical guidance; emphasizes education rather than evidence‑based treatment.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["addresses an important public‑health topic","highlights need for education"],"limitations":["No empirical data or systematic methodology","Lacks validated measures or operational definitions","No assessment of confounding factors"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":7480,"doi":"10.1016/j.psc.2008.07.003","pmid":"18996303","pmcid":null,"title":"Basic science and neurobiological research: potential relevance to sexual compulsivity","authors":"Berlin FS.","first_author":"Berlin FS.","journal":"The Psychiatric clinics of North America","year":2008,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review article discussing neurobiological perspectives on sexual compulsivity without original empirical data.","sample_n":null,"sample_text":"N/A","population":"Not applicable (review)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The article reviews how brain science might relate to sexual compulsivity, arguing that biology and personal responsibility both matter and that understanding the brain could improve treatment and reduce moral blame.","clinical_takeaway":"Consider both neurobiological factors and personal values when addressing sexual compulsivity; no direct treatment guidance provided.","confidence":0.4,"topic_tags":["sexual_function","neuroscience"],"strengths":["Broad interdisciplinary perspective","Acknowledges moral and biological complexity"],"limitations":["No original empirical data","Lacks systematic methodology or bias assessment"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psc.2008.07.003"}},{"id":7481,"doi":"10.1016/j.fjurol.2024.102796","pmid":"39490898","pmcid":null,"title":"Typology of sexual disorders in idiopathic Parkinson's disease, a systematic review","authors":"Salardaine Q.","first_author":"Salardaine Q.","journal":"The French journal of urology","year":2025,"pub_types":["Systematic Review","Journal Article"],"keywords":["Sexual dysfunction","Parkinson's Disease","Sexual Desire","Hypersexuality","Non-motor Symptoms"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic literature review of sexual dysfunctions in Parkinson's disease, reporting prevalence and types of dysfunctions, including hypersexuality.","sample_n":null,"sample_text":"Not specified in abstract","population":"Adults with idiopathic Parkinson's disease; no specific sample size reported in abstract.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review finds that people with Parkinson's disease often experience sexual problems like erectile dysfunction in men and reduced desire in women; hypersexuality is rare but linked to dopamine medication.","clinical_takeaway":"Clinicians should screen for varied sexual issues in Parkinson's patients, including possible medication‑related hypersexuality.","confidence":0.6,"topic_tags":["sexual_function","neuroscience"],"strengths":["Systematic approach to a relatively under‑studied topic","Highlights both male and female sexual dysfunctions","Identifies hypersexuality as a treatment‑related issue"],"limitations":["No detail on search strategy, risk‑of‑bias assessment, or PRISMA compliance","Unclear how construct validity was ensured across included studies","Critical confounders (e.g., moral incongruence, mental health) not addressed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.fjurol.2024.102796"}},{"id":7483,"doi":"10.1016/0145-2134(93)90048-a","pmid":"8472181","pmcid":null,"title":"HIV vulnerability and the adult survivor of childhood sexual abuse","authors":"Allers CT, Benjack KJ, White J, Rousey JT.","first_author":"Allers CT","journal":"Child abuse & neglect","year":1993,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":51,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report with illustrative single patient","sample_n":1,"sample_text":"single illustrative case","population":"adult survivor of childhood sexual abuse (single case)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper warns that adults who suffered childhood sexual abuse may engage in high‑risk HIV behaviours because of untreated trauma, depression, compulsive sexuality, and substance use, using one illustrative case to show these connections.","clinical_takeaway":"Clinicians should screen for trauma‑related sexual and substance‑use issues when addressing HIV risk in survivors of childhood abuse.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Highlights clinical relevance of trauma–HIV risk link","Provides concrete case illustration"],"limitations":["Single case; no systematic data","No measurement of key confounds (e.g., moral incongruence, mental health)","No statistical analysis or validated instruments"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":1,"mentioning":38,"citing_publications":79,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0145-2134(93)90048-a"}},{"id":7484,"doi":"10.1002/mds.21872","pmid":"18067187","pmcid":null,"title":"The relationship between impulsivity and impulse control disorders in Parkinson's disease","authors":"Isaias IU, Siri C, Cilia R, De Gaspari D, Pezzoli G, Antonini A.","first_author":"Isaias IU","journal":"Movement disorders : official journal of the Movement Disorder Society","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":116,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"50 PD patients on stable dopaminergic therapy compared with 100 healthy controls; assessment of compulsive sexual behavior and other impulse control disorders using validated interviews and questionnaires.","sample_n":150,"sample_text":"50 consecutive cognitively intact PD patients; 100 healthy controls","population":"PD patients (n=50) and healthy adults (n=100); cognitively intact, mixed gender, middle‑aged to older adults.","country":"Not specified in abstract","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 50 Parkinson’s patients and 100 healthy adults, the study found higher impulsivity, compulsivity and depression scores in patients, and that high impulsivity and male gender increased the chance of impulse‑control problems such as compulsive sexual behavior.","clinical_takeaway":"High impulsivity in Parkinson’s patients signals greater risk for impulse‑control disorders, warranting careful monitoring.","confidence":0.78,"topic_tags":["pornography","sexual_function"],"strengths":["Use of validated clinical interviews and scales","Inclusion of a healthy control group","Assessment of multiple impulse‑control domains"],"limitations":["Cross‑sectional design limits causal inference","Small PD sample; limited power for subgroup analyses","No measurement of moral incongruence, masturbation, or trauma"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":19,"contrasting":3,"mentioning":143,"citing_publications":155,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mds.21872"}},{"id":7485,"doi":"10.1016/j.psychres.2020.113638","pmid":"33333439","pmcid":null,"title":"Association of ADHD and hypersexuality and paraphilias","authors":"Soldati L, Bianchi-Demicheli F, Schockaert P, Köhl J, Bolmont M, Hasler R, Perroud N.","first_author":"Soldati L","journal":"Psychiatry research","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":["ADHD","Hyperactivity","Hypersexuality","Attention-deficit","Paraphilic Disorders","Paraphilias"],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of observational studies on ADHD, hypersexuality and paroxysmal disorders; no meta‑analysis; risk of bias not reported.","sample_n":null,"sample_text":"Not applicable – review of prior studies.","population":"Individuals with ADHD and/or hypersexuality/paraphilias across included studies (heterogeneous).","country":"Not specified (global literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review looked at papers linking ADHD with hypersexual behaviour and unusual sexual interests. Some reports mention overlap, but the evidence is weak because studies used different, often unvalidated tools and had few participants.","clinical_takeaway":"There is insufficient reliable evidence to assume ADHD patients are at higher risk of hypersexuality or paraphilias; clinicians should assess each case individually.","confidence":0.8,"topic_tags":["adolescents"],"strengths":["First systematic review on ADHD‑hypersexuality/paraphilia link.","Comprehensive database search (PubMed, PsycInfo, Embase).","Transparent discussion of methodological limitations."],"limitations":["Included studies use heterogeneous and often unvalidated measures.","Small sample sizes and lack of meta‑analysis limit quantitative conclusions.","No systematic risk‑of‑bias assessment reported."],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":25,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psychres.2020.113638"}},{"id":7486,"doi":"10.1111/1467-8624.00456","pmid":"12146732","pmcid":null,"title":"Parent-daughter transmission of the androgen receptor gene as an explanation of the effect of father absence on age of menarche","authors":"Comings DE, Muhleman D, Johnson JP, MacMurray JP.","first_author":"Comings DE","journal":"Child development","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":70,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional genetic association study of 121 males and 164 females; no longitudinal or experimental component","sample_n":285,"sample_text":"121 White males and 164 White females","population":"White males and females, ages not specified; community sample","country":"USA (presumed from authors/institution)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that fathers carrying a short version of an androgen‑receptor gene were more likely to divorce and that daughters who inherited the same gene tended to start menstruating earlier and show more impulsive or sexual‑risk behaviours, suggesting a genetic link to the observed father‑absence effects.","clinical_takeaway":"No direct clinical guidance; the findings are hypothesis‑generating and should not be used to predict individual outcomes.","confidence":0.6,"topic_tags":["gender","sexual_function"],"strengths":["Large sample for a genetic association study","Considers an alternative biological explanation to psychosocial theory"],"limitations":["Cross‑sectional design limits causal inference","Key psychological constructs measured with unspecified or unvalidated instruments","Potential multiple‑testing without correction"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":7,"contrasting":3,"mentioning":119,"citing_publications":133,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1467-8624.00456"}},{"id":7488,"doi":"10.1177/02698811241277200","pmid":"39282911","pmcid":null,"title":"The relationship between Parkinson's disease and sexual hyperactivity secondary to drug treatment: A systematic review","authors":"Aparicio-López V, Rueda-Extremera M, Cantero-García M.","first_author":"Aparicio-López V","journal":"Journal of psychopharmacology (Oxford, England)","year":2025,"pub_types":["Systematic Review","Journal Article"],"keywords":["risk factors","Clinical Trials","Parkinson’s Disease","Hypersexual Behavior","Pharmacological Treatment"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of clinical trials (6 included studies) following PRISMA; risk of bias assessed with Cochrane Scale; no meta‑analysis reported.","sample_n":null,"sample_text":"6 studies met inclusion criteria; total participants not reported in abstract.","population":"Parkinson’s disease patients receiving pharmacological treatment (studies in English/Spanish, last 10 years).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review examined six recent clinical trials to see how Parkinson’s drugs may trigger hypersexual behavior. It identified possible risk and protective factors and offered practical recommendations for clinicians.","clinical_takeaway":"Be alert for increased sexual drive in Parkinson’s patients on dopamine‑targeting meds and apply the suggested monitoring guidelines.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","pornography","masturbation"],"strengths":["PRISMA‑guided search strategy","Risk‑of‑bias assessment using Cochrane Scale","Focus on pharmacological risk factors"],"limitations":["Very few studies (6) included","Unclear definition and measurement of hypersexual behavior","No quantitative synthesis (meta‑analysis)","Potential lack of control for disease severity or medication dose"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/02698811241277200"}},{"id":7489,"doi":"10.1212/wnl.0000000000209569","pmid":"39284109","pmcid":"PMC11399068","title":"Frequency and Longitudinal Course of Behavioral and Neuropsychiatric Symptoms in Participants With Genetic Frontotemporal Dementia","authors":"Schönecker S, Martinez-Murcia FJ, Denecke J, Franzmeier N, Danek A, Wagemann O, Prix C, Wlasich E, Vöglein J, Loosli SV, Brauer A, Górriz Sáez JM, Bouzigues A, Russell LL, Foster PH, Ferry-Bolder E, van Swieten JC, Jiskoot LC, Seelaar H, Sanchez-Valle R, Laforce R, Graff C, Galimberti D, Vandenberghe R, de Mendonça A, Tiraboschi P, Santana I, Gerhard A, Sorbi S, Otto M, Pasquier F, Ducharme S, Butler C, Le Ber I, Finger E, Tartaglia MC, Masellis M, Rowe JB, Synofzik M, Moreno F, Borroni B, Rohrer JD, Genetic Frontotemporal Dementia Initiative (GENFI), Priller J, Höglinger GU, Levin J.","first_author":"Schönecker S","journal":"Neurology","year":2024,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11399068","cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort of 522 genetic FTD carriers (symptomatic and presymptomatic) with repeated assessments and MRI","sample_n":522,"sample_text":"522 participants (221 C9orf72, 213 GRN, 88 MAPT)","population":"genetic frontotemporal dementia (C9orf72, GRN, MAPT) carriers, adults, mixed symptomatic status","country":"multicenter (GENFI consortium, Europe/North America)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 522 people with genetic forms of frontotemporal dementia, researchers identified five groups of behavioral and psychiatric symptoms, including a hypersexual group. Each symptom group was linked to distinct patterns of brain atrophy, and factors like gene type, sex, and education influenced symptom severity over time.","clinical_takeaway":"Hypersexual symptoms in FTD may reflect specific brain changes; clinicians should consider underlying neurodegeneration when evaluating such behaviors.","confidence":0.85,"topic_tags":["neuroscience","gender"],"strengths":["large longitudinal cohort","multimodal (clinical + MRI) data","use of validated neuropsychiatric inventories"],"limitations":["no specific measures of sexual behavior aside from hypersexual symptom cluster","confounding psychosocial factors not addressed","effect sizes not reported in abstract"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":7,"statistics":5,"confounds":1,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":10,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1212/wnl.0000000000209569"}},{"id":7490,"doi":"10.1177/10790632241283752","pmid":"39272225","pmcid":null,"title":"The Propensity for Deviant Sexual Behavior in the General Population: An Empirical Examination of the Motivation-Facilitation Model","authors":"Lehmann RJB, Obermeier F, Schmidt AF, Enge S.","first_author":"Lehmann RJB","journal":"Sexual abuse : a journal of research and treatment","year":2025,"pub_types":["Journal Article"],"keywords":["Psychopathy","Hypersexuality","Sexual Fantasies","Sexual Interest In Children","Motivation-facilitation Model"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community survey (N=911) with hierarchical logistic regression","sample_n":911,"sample_text":"General population sample (Germany), N=911 (206 males)","population":"German general adult population, both sexes","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A German population survey (N=911) examined whether hypersexuality, sexual fantasies, and psychopathy predict deviant sexual behavior, including child sexual abuse. Hypersexuality and fantasies predicted adult‑targeted deviance; only hypersexuality predicted child‑targeted deviance, though gender reduced this effect.","clinical_takeaway":"Assessment of hypersexuality may help identify males at higher risk for deviant sexual behavior, but findings are limited by self‑report and lack of causal proof.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Large, population‑based sample","Clear statistical modeling (hierarchical logistic regression)","Replication of previous findings"],"limitations":["Reliance on self‑report, likely using non‑validated ad‑hoc items","Cross‑sectional design limits causal inference","Key confounders (e.g., trauma, mental health) not measured"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":5,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10790632241283752"}},{"id":7491,"doi":null,"pmid":"8232619","pmcid":null,"title":"Sex addiction","authors":"Cordasco CF.","first_author":"Cordasco CF.","journal":"North Carolina medical journal","year":1993,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":7492,"doi":"10.1177/070674370104600613","pmid":"11526813","pmcid":null,"title":"Re: The neurobiology, neuropharmacology, and pharmacologic treatment of paraphilias and compulsive sexual behaviour","authors":"Haslam D, Adams S, Oluboka O.","first_author":"Haslam D","journal":"Canadian journal of psychiatry. Revue canadienne de psychiatrie","year":2001,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/070674370104600613"}},{"id":7493,"doi":"10.1016/j.jad.2020.11.100","pmid":"33229025","pmcid":null,"title":"Hypersexuality and Trauma: a mediation and moderation model from psychopathology to problematic sexual behavior","authors":"Fontanesi L, Marchetti D, Limoncin E, Rossi R, Nimbi FM, Mollaioli D, Sansone A, Colonnello E, Simonelli C, Di Lorenzo G, Jannini EA, Ciocca G.","first_author":"Fontanesi L","journal":"Journal of affective disorders","year":2021,"pub_types":["Journal Article"],"keywords":["Trauma","Depression","Guilt","Shame","Hypersexuality"],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience online survey of 1025 adults; self‑report questionnaires; mediation/moderation analysis.","sample_n":1025,"sample_text":"Convenience sample recruited online; not probabilistic; gender imbalance.","population":"General adult community sample (71% female, 29% male), recruited via online platform.","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed over 1,000 adults and found that trauma‑related symptoms were linked to higher hypersexual behavior, partly because trauma increased depression and guilt, which in turn were associated with more hypersexuality.","clinical_takeaway":"When clients present with hypersexual behavior, assess trauma, depression and guilt as potential underlying factors.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large sample size for questionnaire study","Use of validated psychometric instruments","Comprehensive mediation model including multiple affective variables"],"limitations":["Convenience online sample limits generalisability","No measurement of moral incongruence or masturbation","Cross‑sectional design cannot establish causality"],"rubric_version":"2.0","raw_total":34,"max_possible":60,"pct_score":57,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":42,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jad.2020.11.100"}},{"id":7494,"doi":"10.1016/j.neurol.2024.07.001","pmid":"39227281","pmcid":null,"title":"Impulse control disorder: Review on clinical, pharmacologic, and genetic risk factors","authors":"Leclercq V, Corvol JC.","first_author":"Leclercq V","journal":"Revue neurologique","year":2024,"pub_types":["Review","Journal Article"],"keywords":["Parkinson's Disease","risk factors","Impulse Control Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review (non‑systematic) of literature on impulse control disorders in Parkinson’s disease, including hypersexuality","sample_n":null,"sample_text":"Not applicable – literature review","population":"Parkinson’s disease patients","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review summarises what is known about why some Parkinson’s disease patients develop impulse‑control problems such as gambling, compulsive buying, and hyper‑sexual behaviour, focusing on clinical traits, dopamine‑targeting medicines, and genetics.","clinical_takeaway":"Clinicians should regularly screen PD patients, especially those on dopamine agonists, for impulse‑control problems including hypersexuality.","confidence":0.4,"topic_tags":["sexual_function","neuroscience","gender"],"strengths":["Broad coverage of clinical, pharmacologic, and genetic risk factors","Highlights importance of screening for ICDs in PD"],"limitations":["Not a systematic review – selection bias possible","No quantitative synthesis or meta‑analysis","Lacks primary data; conclusions indirect"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neurol.2024.07.001"}},{"id":7495,"doi":"10.1111/j.1744-6163.2005.00038.x","pmid":"16297020","pmcid":null,"title":"Computer addiction: implications for nursing psychotherapy practice","authors":"Wieland DM.","first_author":"Wieland DM.","journal":"Perspectives in psychiatric care","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative overview of literature without systematic methods","sample_n":null,"sample_text":"Not applicable – article is a literature overview","population":"unspecified adult clients encountered by nurse psychotherapists","country":"United States (journal based)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The paper reviews existing literature on computer addiction, noting possible links to depression, gambling, marital problems and compulsive online sexual behavior, and offers a brief tool for nurses to assess related issues.","clinical_takeaway":"No specific clinical guidance; suggests clinicians stay alert to possible overuse of technology and its relational impacts.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Broad overview of computer‑addiction literature","Identifies clinical implications for nursing psychotherapists"],"limitations":["Narrative, non‑systematic review; no systematic search or bias assessment","No empirical data; conclusions rely on secondary sources","Lacks measurement of key confounds (moral incongruence, masturbation, mental health)."],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":28,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1744-6163.2005.00038.x"}},{"id":7497,"doi":"10.1002/mds.23501","pmid":"21312278","pmcid":null,"title":"Impulsivity and compulsivity in drug-naïve patients with Parkinson's disease","authors":"Antonini A, Siri C, Santangelo G, Cilia R, Poletti M, Canesi M, Caporali A, Mancini F, Pezzoli G, Ceravolo R, Bonuccelli U, Barone P.","first_author":"Antonini A","journal":"Movement disorders : official journal of the Movement Disorder Society","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":127,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional screening of 103 drug‑naïve Parkinson’s patients compared with healthy controls.","sample_n":103,"sample_text":"103 consecutive newly diagnosed drug‑naïve PD patients; controls not quantified.","population":"103 newly diagnosed drug‑naïve Parkinson’s disease patients (mean age 60.5 y); healthy control group (size not reported).","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 103 newly diagnosed Parkinson’s patients who had not started dopamine medication, about 17% showed signs of impulse‑control problems, similar to healthy people. Those with such problems were slightly more impulsive and obsessive‑compulsive, and impulsivity was linked to depression.","clinical_takeaway":"Screen for impulsivity and depression before starting dopaminergic therapy in Parkinson’s disease.","confidence":0.85,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Use of multiple validated clinical scales","Focus on drug‑naïve PD patients (pre‑treatment)","Inclusion of healthy control comparison","Assessment of depression alongside impulsivity"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral or sexual‑behavior confounds relevant to compulsive sexual behavior","Effect sizes and confidence intervals not reported","Small number of participants with ICDs reduces power for subgroup analyses"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":14,"contrasting":0,"mentioning":111,"citing_publications":173,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mds.23501"}},{"id":7498,"doi":"10.3390/ijerph17186907","pmid":"32967307","pmcid":"PMC7559359","title":"Three Diagnoses for Problematic Hypersexuality; Which Criteria Predict Help-Seeking Behavior?","authors":"van Tuijl P, Tamminga A, Meerkerk GJ, Verboon P, Leontjevas R, van Lankveld J.","first_author":"van Tuijl P","journal":"International journal of environmental research and public health","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Tolerance","Withdrawal","Coping","Hypersexuality","Sex Addiction","Compulsive Sexuality","Sexual Frequency"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/17/18/6907/pdf","cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of self‑selected individuals (N = 58,158) interested in whether they were sex‑addicted; factor analysis and logistic regression used to predict self‑reported need for help.","sample_n":58158,"sample_text":"Self‑selected internet respondents wondering if they were sex‑addicted.","population":"Adults (men and women) recruited via internet sites targeting people questioning sex‑addiction; not a probability sample.","country":"Not specified in abstract","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A huge online survey (58,000+ people) looked at which symptoms best predict people’s desire to get help for ‘problematic hypersexuality’. Feeling negative effects and extreme symptoms (like withdrawal) were linked to help‑seeking, while high sexual desire was not.","clinical_takeaway":"Help‑seeking is driven more by negative consequences than by high desire; clinicians should assess distress and functional impact, not just frequency.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Very large sample size","Factor analysis applied separately for men and women","Comparison of multiple theoretical models"],"limitations":["Self‑selected, non‑representative sample","No measurement of key confounds (moral incongruence, mental health, masturbation)","Reliance on likely non‑validated ad‑hoc indicators"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph17186907"}},{"id":7499,"doi":"10.7759/cureus.66260","pmid":"39238725","pmcid":"PMC11376006","title":"Paraphilia in Geriatric Patients: A Case Series From a General Hospital Setting","authors":"H K SP, Bhattacharjee D, H K TP.","first_author":"H K SP","journal":"Cureus","year":2024,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Stroke","Exhibitionism","Fetishism","Paraphilia","Zoophilia","Sexual Sadism","Transvestic Fetishism","Sexual Masochism"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11376006","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of five stroke patients with new‑onset paraphilic behaviours; descriptive presentation with neuroimaging snapshots and treatment notes.","sample_n":5,"sample_text":"five cases","population":"elderly stroke patients (geriatric) from a single general hospital","country":"unspecified (presumed India based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes five elderly stroke patients who developed unusual sexual interests such as exhibitionism or fetishism after their strokes. It presents brief clinical details and brain scans, suggesting a possible link between stroke and the emergence of these behaviours.","clinical_takeaway":"There is insufficient evidence to conclude that stroke causes paraphilic behaviour; clinicians should treat each case individually and avoid overgeneralising.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","csbd","gender"],"strengths":["Rare clinical documentation of post‑stroke paraphilic behaviour","Inclusion of neuroimaging illustrations","Clear case‑by‑case description"],"limitations":["Very small, non‑representative sample (N=5)","No systematic measurement of sexual behaviour or neurobiological mechanisms","No control group; causal claims unsupported"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.66260"}},{"id":7500,"doi":"10.1007/s11920-004-0040-x","pmid":"14738707","pmcid":null,"title":"Compulsive disorders","authors":"Kuzma JM, Black DW.","first_author":"Kuzma JM","journal":"Current psychiatry reports","year":2004,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review article summarizing compulsive disorders, including compulsive sexual behavior, without new empirical data.","sample_n":null,"sample_text":"Not applicable (review)","population":"Humans (general)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews various compulsive disorders, such as compulsive sexual behavior, describing their symptoms, possible links to OCD, and treatment options like CBT and certain medications.","clinical_takeaway":"Consider CBT and SSRIs as primary treatment options for compulsive sexual behavior, but note limited evidence.","confidence":0.4,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Broad overview of compulsive disorders","Covers both psychotherapeutic and pharmacologic interventions"],"limitations":["No primary data or systematic review methodology","Lacks explicit definition of constructs or measurement tools","Does not address key confounds for compulsive sexual behavior"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11920-004-0040-x"}},{"id":7501,"doi":"10.1080/00224490609552308","pmid":"16817060","pmcid":null,"title":"The relationship between negative mood and sexuality in heterosexual college woman and men","authors":"Lykins AD, Janssen E, Graham CA.","first_author":"Lykins AD","journal":"Journal of sex research","year":2006,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":81,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 663 female and 399 male college students assessing self‑reported changes in sexual interest/arousal during depressed or anxious mood, plus trait questionnaires.","sample_n":1062,"sample_text":"663 women, 399 men, convenience student sample","population":"College students (heterosexual, mean age ~19, United States)","country":"USA","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among college students, most report less sexual interest when feeling depressed or anxious, but about 10% say their interest rises. Men are more likely than women to report increased interest during negative mood. A tendency to become sexually excited predicts these mood‑related differences.","clinical_takeaway":"Clinicians should note that negative mood typically lowers sexual interest, yet a minority may experience heightened desire; assessment should consider individual variability.","confidence":0.6,"topic_tags":["moral_incongruence","masturbation","sexual_function"],"strengths":["Large sample for a survey study","Uses validated trait scales for mood and sexual excitation/inhibition","Separates men and women for comparison"],"limitations":["Cross‑sectional; cannot infer causality","Self‑report of mood‑related sexual interest is single‑item and may be biased","No assessment of key confounds (moral incongruence, masturbation, partner context, trauma)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":20,"contrasting":2,"mentioning":82,"citing_publications":155,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490609552308"}},{"id":7504,"doi":"10.1093/shm/hkae044","pmid":"40236470","pmcid":"PMC11994851","title":"PlayDoc M.D.: Sexual Harassment and Discrimination in US Medical Schools in the 1960s and 1970s","authors":"Evens E.","first_author":"Evens E.","journal":"Social history of medicine : the journal of the Society for the Social History of Medicine","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Gender","Twentieth Century","Medical School","Sexual Harassment"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11994851","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Historical analysis using archival sources and oral histories; no quantitative sample size reported.","sample_n":null,"sample_text":"Not applicable – study relies on archival documents and interviews rather than a defined numeric sample.","population":"US medical students and faculty in the 1960s‑1970s (historical)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article documents how male medical students and faculty in US schools during the 1960s‑70s used Playboy‑style sexual jokes and images, creating a hostile environment for women that reinforced sexist attitudes and harassment.","clinical_takeaway":"None – the study is historical and does not provide clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Rich primary source material","Contextualizes gender dynamics in medical education","Includes oral histories for lived experience"],"limitations":["No quantitative data or systematic sampling","Limited generalizability beyond US medical schools of that era","Potential recall bias in oral histories"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/shm/hkae044"}},{"id":7505,"doi":"10.4102/ajod.v13i0.1363","pmid":"39114453","pmcid":"PMC11304218","title":"Exploring perceptions of sexuality among youth with physical disabilities in Gweru, Zimbabwe","authors":"Mashanyare T, Garutsa TC, Odhav K.","first_author":"Mashanyare T","journal":"African journal of disability","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Zimbabwe","Perceptions","Socio-cultural Perspectives","Youths With Disability","Gweru"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11304218","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"semi‑structured interviews and focus groups with 20 youths with physical disabilities and 5 key informants in Gweru, Zimbabwe","sample_n":25,"sample_text":"convenience sample recruited through local disability organisations","population":"youths with physical disabilities (age 18‑35) in Gweru, Zimbabwe","country":"Zimbabwe","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study interviewed 20 young adults with physical disabilities in Gweru, Zimbabwe, and five community informants to explore how stigma shapes their sexual experiences. Participants reported limited sexual education, social exclusion, and a prevailing expectation of abstinence, but also described efforts to assert their sexual agency.","clinical_takeaway":"None – the study is exploratory and does not provide clinical recommendations.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides rare qualitative insight into sexuality perceptions among disabled youth in a low‑resource setting","Uses both individual interviews and focus groups to enrich data"],"limitations":["Small, non‑representative convenience sample","No validated measurement instruments","Findings not generalisable beyond the specific community"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4102/ajod.v13i0.1363"}},{"id":7506,"doi":"10.31744/einstein_journal/2024rw0182","pmid":"39046070","pmcid":"PMC11221831","title":"Psychiatric disorders after deep brain stimulation of the subthalamic nucleus in Parkinson's disease: a systematic review","authors":"Lellis CA, Herbas MAM, Silva LJD.","first_author":"Lellis CA","journal":"Einstein (Sao Paulo, Brazil)","year":2024,"pub_types":["Systematic Review","review-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11221831","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 11 studies (case reports, observational studies) on psychiatric outcomes after STN‑DBS; no meta‑analysis or risk‑of‑bias assessment reported.","sample_n":null,"sample_text":"Eleven studies; total number of patients not explicitly reported (26 patients with depression mentioned).","population":"Patients with Parkinson’s disease undergoing deep brain stimulation of the subthalamic nucleus.","country":"Brazil (journal), studies from multiple locations.","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of eleven studies looked at psychiatric changes after deep‑brain stimulation of the subthalamic nucleus in Parkinson’s disease. Depression, mania, psychosis, anxiety, suicidal thoughts and occasional hypersexuality were reported, with depression being most common.","clinical_takeaway":"Clinicians should monitor a range of psychiatric symptoms, including possible hypersexuality, after STN‑DBS in Parkinson’s patients.","confidence":0.78,"topic_tags":["neuroscience","treatment","sexual_function"],"strengths":["Systematic search across multiple databases","Focus on a clinically important side‑effect profile of DBS"],"limitations":["No quantitative synthesis or risk‑of‑bias assessment","Small, heterogeneous primary studies (case reports, few patients)","Limited definition and measurement of hypersexuality"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31744/einstein_journal/2024rw0182"}},{"id":7507,"doi":"10.1016/j.jsxm.2020.07.008","pmid":"32792283","pmcid":"PMC7875089","title":"Gender-Related Differences in Associations Between Sexual Abuse and Hypersexuality","authors":"Slavin MN, Blycker GR, Potenza MN, Bőthe B, Demetrovics Z, Kraus SW.","first_author":"Slavin MN","journal":"The journal of sexual medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Gender","Victimization","Hypersexuality","Childhood Sexual Abuse","Compulsive Sexual Behavior Disorder","Adolescent/adult Sexual Abuse"],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire advertised on a news portal; N=16,823 Hungarian adults; cross‑sectional self‑report data","sample_n":16823,"sample_text":"online questionnaire on one of the largest Hungarian news portals advertised this study examining sexual activities in January 2017","population":"Hungarian adults, mixed gender, recruited via a popular news website","country":"Hungary","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 16,800 Hungarian adults, people who experienced sexual abuse in childhood or later reported higher levels of hypersexuality. The link was stronger for men when both childhood and later abuse were present.","clinical_takeaway":"History of sexual abuse, especially when occurring across development, may be linked to higher hypersexuality, particularly in men; assess trauma in treatment planning.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["very large sample size","gender‑specific analysis","controls for several demographic variables"],"limitations":["cross‑sectional, cannot infer causality","self‑selected online sample may not be representative","limited measurement of potential confounds (e.g., mental health, masturbation)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":29,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.07.008"}},{"id":7508,"doi":"10.1516/002075703768284740","pmid":"13678505","pmcid":null,"title":"Diagnosing a male hysteric: Don Juan-type","authors":"Lubbe T.","first_author":"Lubbe T.","journal":"The International journal of psycho-analysis","year":2003,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report; single patient psychoanalytic narrative; no systematic data collection","sample_n":null,"sample_text":"single case","population":"adult male patient with compulsive sexual behavior (hypersexuality) seen in psychoanalytic treatment","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"A psychoanalytic case report describes one man's compulsive sexual dramatizations, interpreting them as a form of male hysteria (Don Juanism) and linking them to early developmental conflicts.","clinical_takeaway":"No empirical evidence; clinicians should not base treatment decisions on this single narrative.","confidence":0.7,"topic_tags":["sexual_function","gender","csbd"],"strengths":["Provides detailed clinical narrative","Integrates psychoanalytic theory with observed behavior"],"limitations":["Single case; no systematic measurement","No validated instruments or quantitative data","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":3,"max_possible":50,"pct_score":6,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1516/002075703768284740"}},{"id":7509,"doi":"10.1007/s10508-024-02920-7","pmid":"38956002","pmcid":null,"title":"The \"Chemsex\" Phenomenon and Its Relationship with Psychological Variables in Men Who Have Sex with Men","authors":"Esteban L, Bellido I, Arcos-Romero AI.","first_author":"Esteban L","journal":"Archives of sexual behavior","year":2024,"pub_types":["Journal Article"],"keywords":["Impulsivity","Sexual Orientation","Men Who Have Sex With Men","Hypersexuality","Sexual Assertiveness","Chemsex"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 137 Spanish MSM recruited from LGBT centres comparing those who have engaged in chemsex (n=104) to non‑participants (n=33).","sample_n":137,"sample_text":"Convenience sample recruited through social centres, LGBT associations and key informants.","population":"Men who have sex with men, Spanish, ages 19‑42","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Spanish men who have sex with men who engage in \"chemsex\" (using drugs during sex) report higher impulsivity, more hypersexual behaviour, and lower sexual assertiveness than those who do not, and these traits increase with the number of substances used.","clinical_takeaway":"Chemsex participation is linked to impulsivity and hypersexuality; clinicians should assess these factors when working with MSM who use drugs during sex.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for chemsex research","Comparison between chemsex participants and non‑participants","Multiple psychological variables examined"],"limitations":["Cross‑sectional design precludes causal inference","Convenience sampling limits generalisability","No control for key confounds (moral incongruence, mental health, trauma)","Unclear whether scales are validated for this population"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02920-7"}},{"id":7510,"doi":null,"pmid":"12557802","pmcid":null,"title":"[Sex \"addiction\": compulsion and controversy]","authors":"Souza y  Machorro M.","first_author":"Souza y  Machorro M.","journal":"Ginecologia y obstetricia de Mexico","year":2002,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review / narrative commentary without primary data.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"Mexico","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["no_mi_control","advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article reviews cultural views on \"sex addiction,\" suggesting it may be a real clinical issue despite not being classified in diagnostic manuals, but provides no data or systematic analysis.","clinical_takeaway":"No actionable clinical guidance; the piece is theoretical and lacks empirical support.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses historical and cultural context","Mentions family history and comorbidity"],"limitations":["No empirical data or systematic review methods","Lacks operational definitions and measurement tools","No control for moral incongruence or other confounds"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":7513,"doi":"10.1023/b:jomh.0000036637.03254.38","pmid":"15292703","pmcid":null,"title":"Disorders of desire: addiction and problems of intimacy","authors":"Keane H.","first_author":"Keane H.","journal":"The Journal of medical humanities","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"essay / theoretical piece, no empirical data","sample_n":null,"sample_text":"N/A – no participants","population":"none","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"background","plain_summary":"The essay argues that labeling intense sexual desire or pornography use as 'addiction' oversimplifies complex intimacy issues and may reflect moral judgments rather than a true medical disorder.","clinical_takeaway":"Clinicians should be cautious about pathologising high sexual desire without clear evidence of functional impairment.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Thought‑provoking conceptual analysis","Highlights normative assumptions in addiction discourse"],"limitations":["No empirical data or measurement","No systematic review of evidence","Conclusions are philosophical, not testable"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":33,"citing_publications":83,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/b:jomh.0000036637.03254.38"}},{"id":7514,"doi":"10.36131/cnfioritieditore20200306","pmid":"34908990","pmcid":"PMC8650173","title":"Post-Traumatic Stress Disorder Secondary to Manic Episodes with Hypersexuality in Bipolar Disorder: A Case Study of Forensic Psychotherapy","authors":"Pozza A, Coluccia A, Gualtieri G, Carabellese F, Masti A, Ferretti F.","first_author":"Pozza A","journal":"Clinical neuropsychiatry","year":2020,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Sexual Abuse","Post-traumatic Stress Disorder","Mania","Bipolar Disorder, Trauma"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single clinical case description of a woman with bipolar I disorder and PTSD secondary to manic episodes featuring hypersexuality; includes psychodiagnostic and psychotherapeutic assessment procedures","sample_n":1,"sample_text":"single case","population":"1 adult female patient with bipolar I disorder and PTSD","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A case report describes a woman with bipolar I disorder who developed PTSD after manic episodes that included hypersexual behaviour. The authors argue that lacking psycho‑educational support may have worsened trauma and emphasize the need for timely, evidence‑based treatment.","clinical_takeaway":"Clinicians should assess trauma related to hypersexual behaviour in bipolar patients and provide early psycho‑education to mitigate PTSD risk.","confidence":0.7,"topic_tags":["sexual_function","csbd","pornography","masturbation"],"strengths":["detailed clinical description","highlights under‑recognised PTSD secondary to manic hypersexuality"],"limitations":["single case, no generalisability","no validated instruments reported","no systematic assessment of confounding factors"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.36131/cnfioritieditore20200306"}},{"id":7516,"doi":"10.25259/sni_358_2024","pmid":"38974546","pmcid":"PMC11225519","title":"Rare presentation of Klüver-Bucy syndrome following subarachnoid hemorrhage","authors":"Maqsud AN, Alkhunaizi FM, Al-Jehani H.","first_author":"Maqsud AN","journal":"Surgical neurology international","year":2024,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Subarachnoid hemorrhage","Delirium","Psychosis","Hypersexuality","Klüver-bucy","Hyperdocility","Placidity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11225519","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case description of Klüver‑Bucy syndrome with hypersexuality after subarachnoid hemorrhage","sample_n":1,"sample_text":"single case","population":"49‑year‑old woman, hypertension, subarachnoid hemorrhage","country":"Philippines","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 49‑year‑old woman developed Klüver‑Bucy syndrome, showing excessive sexual behavior, after a brain bleed. The report describes her symptoms and treatment, urging clinicians to consider this rare condition.","clinical_takeaway":"Klüver‑Bucy syndrome can include hypersexuality after brain injury; recognize it for appropriate symptom‑focused care.","confidence":0.8,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed clinical description of a rare syndrome","Highlights need for multidisciplinary awareness"],"limitations":["Single case; no quantitative data","No validated measures of hypersexuality or other symptoms","No neuroimaging or systematic assessment"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.25259/sni_358_2024"}},{"id":7518,"doi":"10.1016/s2215-0366(24)00146-9","pmid":"38760111","pmcid":null,"title":"Naming and coming to terms with bipolar hypersexuality","authors":"Chataigné A.","first_author":"Chataigné A.","journal":"The lancet. Psychiatry","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s2215-0366(24)00146-9"}},{"id":7519,"doi":"10.1016/s2215-0366(24)00093-2","pmid":"38760105","pmcid":null,"title":"Hypersexuality in bipolar disorder: an overlooked symptom","authors":"Dolman C, Howard L, Goodwin GM, Young A, Jones IR, Bergink V, Richardson T, Di Florio A.","first_author":"Dolman C","journal":"The lancet. Psychiatry","year":2024,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s2215-0366(24)00093-2"}},{"id":7520,"doi":"10.1007/s10508-024-02877-7","pmid":"38816590","pmcid":"PMC11219385","title":"Patterns of Sexual Risk Behaviors and Sexuality-Related Risk Factors among Young Adults in Germany: Implications for Prevention and Therapy","authors":"Jepsen D, Healy KV, Bernard M, Markert J, Brzank PJ.","first_author":"Jepsen D","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual dysfunction","Sexually Transmitted Infections","Hypersexual Behavior","Intimate Partner Violence","Sex Work","Chemsex"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11219385","cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience survey of 609 German young adults (age ~23), latent class analysis identifying three SRB patterns, followed by multinomial logistic regression of risk factors.","sample_n":609,"sample_text":"n = 609 (365 female, 245 male), mean age 23.1 years; convenience online sample.","population":"young adults in Germany, recruited via online survey (convenience sample).","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A German online survey of 609 young adults found three groups of sexual risk behavior: low risk, shame‑related, and high‑risk (including drug‑related sex). The shame‑related and high‑risk groups showed higher hypersexuality scores, and the high‑risk group also tended to be non‑heterosexual, start sex earlier, and have more partners.","clinical_takeaway":"Screen for hypersexuality and shame when addressing sexual risk in young adults; tailor prevention to gender and sexual‑orientation differences.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a cross‑sectional survey","Use of latent class analysis to uncover distinct SRB patterns","Inclusion of both behavioral and affective risk dimensions"],"limitations":["Convenience online sample limits generalisability","Key constructs measured with brief, possibly non‑validated items","No assessment of moral incongruence, masturbation, or mental‑health covariates"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02877-7"}},{"id":7521,"doi":null,"pmid":"9555677","pmcid":null,"title":"Sexual addiction: a new phenomenon?. Interview by J.G. Meisler","authors":"Myers W, Watter D.","first_author":"Myers W","journal":"Journal of women's health","year":1998,"pub_types":["Interview"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":7523,"doi":"10.3390/ijms21083002","pmid":"32344532","pmcid":"PMC7215378","title":"Naltrexone Use in Treating Hypersexuality Induced by Dopamine Replacement Therapy: Impact of <i>OPRM1</i> A/G Polymorphism on Its Effectiveness","authors":"Verholleman A, Victorri-Vigneau C, Laforgue E, Derkinderen P, Verstuyft C, Grall-Bronnec M.","first_author":"Verholleman A","journal":"International journal of molecular sciences","year":2020,"pub_types":["review-article","Review","Journal Article"],"keywords":["Genotyping","Naltrexone","Parkinson’s Disease","Impulse Control Disorder","Hypersexuality","Oprm1","Sex Addiction","Dopamine Replacement Therapy"],"is_oa":true,"oa_url":"https://www.mdpi.com/1422-0067/21/8/3002/pdf?version=1587716443","cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 7 publications (mostly case reports) plus one new case report of a Parkinson’s patient with DRT‑induced hypersexuality treated with naltrexone and genotyped for OPRM1.","sample_n":1,"sample_text":"single case report plus literature review of 7 prior reports","population":"Adults with Parkinson’s disease experiencing hypersexuality as a side‑effect of dopamine replacement therapy.","country":"Not specified (likely multinational case reports)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of seven reports (mostly case studies) and one new case suggest that naltrexone may reduce hypersexuality caused by dopamine drugs in Parkinson’s patients, especially in those with an OPRM1 A/G genotype.","clinical_takeaway":"Naltrexone could be considered for refractory DRT‑induced hypersexuality, but evidence is limited to case reports.","confidence":0.4,"topic_tags":["neuroscience","treatment"],"strengths":["Systematic‑review methodology (PRISMA reported)","Novel genotyping hypothesis linking OPRM1 to naltrexone response","Clear clinical description of treatment outcome"],"limitations":["Reliance on case reports; no controlled trials","Hypersexuality not measured with validated scales","No assessment of key confounds (e.g., mood, partner context)","Genotype analysis based on a single patient"],"rubric_version":"2.0","raw_total":18,"max_possible":60,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":2,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijms21083002"}},{"id":7524,"doi":"10.3389/fneur.2024.1404904","pmid":"38841693","pmcid":"PMC11150809","title":"Impulse control disorders and use of dopamine agonists in early onset Parkinson's disease","authors":"Turcano P, Jacobson J, Ghoniem K, Mullan A, Camerucci E, Stang C, Piat C, Bower JH, Savica R.","first_author":"Turcano P","journal":"Frontiers in neurology","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Dopamine agonists","Parkinson","Impulse Control Disorder","Parkinson Therapy","Early-onset Parkinson’s Disease"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11150809","cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective cohort using Mayo Clinic records (1990‑2022), population‑based sample of 831 early‑onset Parkinson’s patients, prevalence of impulse control disorders after dopamine agonist exposure.","sample_n":831,"sample_text":"831 EOPD patients (513 M, 318 F)","population":"831 patients with early‑onset Parkinson’s disease (symptom onset ≤50 y), 49.7 % used dopamine agonists.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large US clinic sample of 831 early‑onset Parkinson’s patients, about half used dopamine‑agonist meds and 14.5 % developed impulse‑control problems, most often hypersexuality, which was more frequent in men.","clinical_takeaway":"Dopamine agonists can be linked to hypersexuality in early‑onset Parkinson’s; monitor patients for such behaviors.","confidence":0.78,"topic_tags":["sexual_function","neuroscience","religiosity"],"strengths":["Large, population‑based sample","Clear case definition of early‑onset PD","Relevant clinical outcome (hypersexuality) identified"],"limitations":["Reliance on ICD codes and chart review; no validated sexual‑behavior scales","No assessment of potential psychological or moral confounders","Cross‑sectional prevalence limits causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fneur.2024.1404904"}},{"id":7525,"doi":"10.1007/s10508-024-02871-z","pmid":"38755504","pmcid":"PMC11176238","title":"Sex Doll Specifications versus Human Body Characteristics","authors":"Hanson KR, Döring N, Walter R.","first_author":"Hanson KR","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","case-report"],"keywords":["Sex Toys","Sex Robots","Racial Fetishization","Sex Tech","Sex Dolls"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11176238","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive comparison of all 757 full‑body sex dolls from a single U.S. retailer with published anthropometric data for U.S. men and women.","sample_n":757,"sample_text":"All 757 full‑body dolls listed on SexyRealSexDolls.com in 2023.","population":"Sex dolls marketed in the USA (n=757); human reference data from published literature.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured 757 US‑sold sex dolls and compared their body dimensions to published data on US men and women. Dolls were generally slimmer, more muscular, had larger breasts or penises, and were more often White than the general population, indicating they portray hyper‑gendered and hyper‑sexualized bodies.","clinical_takeaway":"None – the findings describe doll characteristics and do not inform clinical practice.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large, exhaustive sample of marketed dolls","Objective anthropometric measurements","Clear, testable hypotheses"],"limitations":["Human reference data drawn from heterogeneous literature","Single retailer limits generalisability to all dolls","No effect‑size reporting or power analysis"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":5,"retracted":false,"notices":[{"status":"Has correction","date":"2025-11-25","noticeDoi":"10.1007/s10508-025-03369-y","doi":"10.1007/s10508-024-02871-z"}],"url":"https://scite.ai/reports/10.1007/s10508-024-02871-z"}},{"id":7526,"doi":"10.1002/ajcp.12753","pmid":"38736243","pmcid":"PMC11673438","title":"\"We are mothers, sisters, and lovers too\": Examining young Black women's experiences navigating sex and sexual health","authors":"Darko NA, Wilson CL, Oliver V.","first_author":"Darko NA","journal":"American journal of community psychology","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual Health","African","Black Women","Caribbean And Black","Community‐based Participatory Research"],"is_oa":true,"oa_url":"https://doi.org/10.1002/ajcp.12753","cited_by_count":3,"is_preprint":false,"topics":["csbd","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups (N=24), thematic analysis","sample_n":24,"sample_text":"24 participants recruited via community‑based participatory methods","population":"young Black women in Canada (community‑based sample)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Through focus groups with 24 young Black women in Canada, the study explores how history, gender expectations and double standards shape their experiences of sex and sexual health, highlighting themes such as perceived hypersexuality, gender roles, and migration‑related challenges.","clinical_takeaway":"Clinicians should recognize how cultural and sociopolitical contexts influence Black women's sexual health needs and tailor care accordingly.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Community‑based participatory approach","Rich qualitative insight into under‑studied population","Clear thematic analysis"],"limitations":["Small, non‑representative sample","No quantitative measurement of sexual health outcomes","Limited generalisability beyond Canadian Black women"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ajcp.12753"}},{"id":7527,"doi":"10.1556/2006.2020.00003","pmid":"32359232","pmcid":"PMC8935199","title":"Response inhibition during processing of sexual stimuli in males with problematic hypersexual behavior","authors":"Seok JW, Sohn JH.","first_author":"Seok JW","journal":"Journal of behavioral addictions","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Functional magnetic resonance imaging","Inferior Frontal Gyrus","Functional Connectivity","Response Inhibition","Problematic Hypersexual Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8935199","cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case-control fMRI study with 30 PHB participants and 30 controls performing a go/no‑go task with sexual vs neutral distractors","sample_n":60,"sample_text":"30 individuals with PHB and 30 healthy subjects","population":"adult males with self‑reported problematic hypersexual behavior","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that men who say they have problematic hypersexual behavior performed worse on an inhibition task and showed less brain activity in key control regions, especially when sexual images were present.","clinical_takeaway":"Reduced inhibitory control may be part of problematic hypersexual behavior, but findings are preliminary.","confidence":0.7,"topic_tags":["pornography","sexual_function","neuroscience"],"strengths":["Use of neuroimaging to probe response inhibition","Matched control group","Task includes sexual distractors relevant to the behavior"],"limitations":["Small fMRI sample, risk of false positives","Unclear definition/measurement of PHB","No control for moral incongruence, masturbation, mental health, or trauma"],"rubric_version":"2.0","raw_total":34,"max_possible":70,"pct_score":49,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":6,"statistics":5,"confounds":2,"design":4,"addiction_criteria":5,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2020.00003"}},{"id":7528,"doi":"10.1155/2024/8770997","pmid":"38766569","pmcid":"PMC11102119","title":"Trait Impulsivity as a Feature of Parkinson's Disease Treatment and Progression","authors":"Spencer H, Anderton RS.","first_author":"Spencer H","journal":"Parkinson's disease","year":2024,"pub_types":["review-article","Review","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11102119","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"review-article (no primary data)","sample_n":null,"sample_text":"N/A (review)","population":"Parkinson's disease patients (adult)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how trait impulsivity in Parkinson's disease can lead to compulsive sexual behavior and other impulse control disorders, linking these problems to dopamine‑targeting treatments and brain circuitry.","clinical_takeaway":"Clinicians should monitor for hypersexuality and related impulsive behaviors in Parkinson’s patients receiving dopamine agonists.","confidence":0.8,"topic_tags":["sexual_function","other"],"strengths":["Comprehensive overview of impulsivity in PD","Integrates neuroanatomy and neurochemistry literature","Identifies clinical need for diagnostic tools"],"limitations":["No primary empirical data","Lacks systematic review methods (no risk‑of‑bias assessment reported)","Does not address key psychosocial confounds (e.g., moral incongruence, partner effects)"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2024/8770997"}},{"id":7529,"doi":"10.1007/s10508-019-01615-8","pmid":"32133544","pmcid":null,"title":"Peripherally Physiological Responses to External Emotions and Their Transitions in Bipolar I Disorder With and Without Hypersexuality","authors":"Wang C, Shao X, Jia Y, Ho RC, Harris KM, Wang W.","first_author":"Wang C","journal":"Archives of sexual behavior","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Dsm-5","Hypersexuality","Bipolar I Disorder","Emotional Transition","External Emotion","Polygraph Physiological Test"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross‑sectional laboratory study measuring autonomic responses to emotional stimuli in bipolar I patients with vs. without hypersexuality and healthy controls","sample_n":82,"sample_text":"21 BW patients, 20 BO patients, 41 healthy volunteers","population":"21 bipolar I with hypersexuality, 20 bipolar I without hypersexuality, 41 healthy volunteers","country":"China (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study measured heart rate, muscle tension, eye movements and skin conductance while people with bipolar disorder (some with hypersexuality, some without) and healthy volunteers viewed emotional pictures and sounds. Differences in physiological reactions suggest that hypersexuality may reflect distinct brain‑body responses to emotional cues.","clinical_takeaway":"Physiological reactivity to emotional cues differs in bipolar patients with hypersexuality, indicating a possible biological marker, but findings are preliminary.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","relationships"],"strengths":["Physiological multimodal measurement","Includes clinical and healthy comparison groups","Addresses understudied hypersexuality subtype"],"limitations":["Small group sizes, especially for between‑group contrasts","No validated hypersexuality scale reported","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":4,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-01615-8"}},{"id":7531,"doi":"10.3928/0279-3695-20010601-11","pmid":"11417016","pmcid":null,"title":"Sexual misconduct by health care providers","authors":"Zook R.","first_author":"Zook R.","journal":"Journal of psychosocial nursing and mental health services","year":2001,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary/editorial without empirical data","sample_n":null,"sample_text":"Not applicable – no empirical sample reported","population":"health care providers (implicitly)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how health‑care providers may develop compulsive sexual behaviours that can lead to misconduct with patients, stressing the need for confronting such behaviour and outlining treatment goals.","clinical_takeaway":"Clinicians should monitor and address any sexually inappropriate conduct by providers, using clear limits and treatment strategies.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Highlights professional and patient safety concerns","Identifies need for clear limits and treatment"],"limitations":["No empirical data or systematic review","Lacks measurement of key constructs","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3928/0279-3695-20010601-11"}},{"id":7532,"doi":"10.7759/cureus.58516","pmid":"38957818","pmcid":"PMC11218533","title":"Impulse Control Disorders in Southern Iraqi Patients Medicated With Cabergoline for Prolactinoma","authors":"Mohammad MM, Alidrisi HA, Mansour AA.","first_author":"Mohammad MM","journal":"Cureus","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Prolactinoma","Impulse Control Disorders","Cabergoline","Compulsive Eating","Hypersexual Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11218533","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case-control cross‑sectional study of 30 cabergoline‑treated prolactinoma patients and 30 matched healthy controls","sample_n":60,"sample_text":"30 patients and 30 controls","population":"Adults with prolactinoma treated with cabergoline (Iraq)","country":"Iraq","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 30 Iraqi patients taking cabergoline for prolactinoma, 30% met criteria for impulse‑control disorders such as hypersexuality, versus 7% of healthy controls. The study suggests a link between the medication and these behaviours.","clinical_takeaway":"Clinicians prescribing cabergoline should monitor patients for emerging hypersexuality or other impulse‑control problems.","confidence":0.78,"topic_tags":["sexual_function","csbd"],"strengths":["Uses a disease‑specific, validated ICD screening questionnaire","Includes a matched healthy control group"],"limitations":["Small sample, no power calculation","Cross‑sectional, cannot infer causality","No measurement of key psychosocial confounds (moral views, masturbation, mental health, relationship status, trauma)"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":3,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.58516"}},{"id":7533,"doi":"10.1093/braincomms/fcae124","pmid":"38665960","pmcid":"PMC11044061","title":"Disinhibition in dementia related to reduced morphometric similarity of cognitive control network","authors":"Jenkins LM, Heywood A, Gupta S, Kouchakidivkolaei M, Sridhar J, Rogalski E, Weintraub S, Popuri K, Rosen H, Wang L, Frontotemporal Lobar Degeneration Neuroimaging Initiative .","first_author":"Jenkins LM","journal":"Brain communications","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Disinhibition","MRI","Alzheimer’s Dementia","Behavioural Variant Frontotemporal Dementia","Morphometric Similarity Networks"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11044061","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional neuroimaging study of 186 dementia patients (75 bvFTD, 111 AD) using morphometric similarity networks to examine associations between disinhibition (Neuropsychiatric Inventory) and cognitive control network integrity.","sample_n":186,"sample_text":"n = 75 bvFTD, n = 111 AD","population":"Patients with behavioural‑variant frontotemporal dementia and Alzheimer’s disease; no healthy control group.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 186 people with dementia, higher disinhibition (e.g., inappropriate sexual remarks) was linked to weaker connections in the brain's cognitive control network, as measured by MRI.","clinical_takeaway":"Disinhibition in dementia may reflect reduced cognitive control network integrity, suggesting potential neuro‑targeted interventions.","confidence":0.78,"topic_tags":["neuroscience","adolescents"],"strengths":["Validated clinical measure (NPI‑Q) for disinhibition","Innovative use of morphometric similarity networks","Relatively large dementia sample"],"limitations":["Cross‑sectional; cannot infer causality","No healthy control group for network comparison","Limited reporting on statistical corrections and effect sizes"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":6,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/braincomms/fcae124"}},{"id":7534,"doi":"10.1007/s10508-024-02847-z","pmid":"38594464","pmcid":"PMC11176105","title":"\"One a Day Keeps the Prison Away\": Understanding the Experiences of Individuals Convicted of Sexual Offences Receiving Anti-Androgens for the Treatment of Problematic Sexual Arousal","authors":"Lievesley R, Swaby H, Winder B, Norman C, Hocken K.","first_author":"Lievesley R","journal":"Archives of sexual behavior","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sex Offenders","Pharmacological Therapy","Anti-androgens","Problematic Sexual Arousal"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11176105","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"phenomenological thematic analysis of interviews with 10 incarcerated men on anti‑androgen medication","sample_n":10,"sample_text":"All individuals in prison taking anti‑androgens for problematic sexual arousal at the time of data collection in England (N=10).","population":"individuals convicted of sexual offences, currently in prison, receiving anti‑androgens (N=10)","country":"England","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers interviewed ten men in prison who were taking anti‑androgen drugs to reduce problematic sexual arousal. The men described why they accepted treatment, how it helped manage risk, and the personal changes they experienced, offering guidance for ethical prescribing.","clinical_takeaway":"Anti‑androgen treatment is perceived by some offenders as helpful for managing urges and redefining self‑identity, but clinicians should consider individual motivations and ethical implications.","confidence":0.6,"topic_tags":["sexual_function","treatment"],"strengths":["Provides rare qualitative insight from a hard‑to‑reach population","All eligible participants in the setting were included","Clear thematic analysis linked to clinical implications"],"limitations":["Very small, prison‑only sample limits generalisability","No quantitative measures of sexual behaviour or distress","Potential social desirability bias in interview responses"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02847-z"}},{"id":7535,"doi":"10.1016/j.drugalcdep.2008.09.010","pmid":"19004577","pmcid":null,"title":"Alcohol use disorders in patients with obsessive-compulsive disorder: the importance of appropriate dual-diagnosis","authors":"Gentil AF, de Mathis MA, Torresan RC, Diniz JB, Alvarenga P, do Rosário MC, Cordioli AV, Torres AR, Miguel EC.","first_author":"Gentil AF","journal":"Drug and alcohol dependence","year":2009,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of 630 OCD patients from seven university services, comparing those with and without alcohol‑use disorder comorbidity.","sample_n":630,"sample_text":"630 DSM‑IV OCD patients (47 with AUD comorbidity).","population":"630 adult patients meeting DSM‑IV criteria for obsessive‑compulsive disorder; recruited from Brazilian university psychiatric services.","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a sample of 630 Brazilian patients with obsessive‑compulsive disorder, 7.5% also had an alcohol‑use disorder. Those with both conditions were more often male, had higher suicidality, and showed greater hoarding symptoms and other psychiatric comorbidities, including compulsive sexual behavior.","clinical_takeaway":"Clinicians treating OCD should screen for alcohol‑use problems, as comorbidity raises suicide risk and may require integrated care.","confidence":0.7,"topic_tags":["sexual_function","gender","moral_incongruence"],"strengths":["Large, multi‑site clinical sample (N=630).","Use of structured clinical interview (SCID‑I) and validated symptom scales.","Comprehensive assessment of psychiatric comorbidities."],"limitations":["Cross‑sectional design limits causal inference.","No assessment of moral or sexual‑behavior confounders relevant to CSBD research.","No pre‑registration or power analysis reported."],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":22,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.drugalcdep.2008.09.010"}},{"id":7536,"doi":"10.1053/scnp.2001.22929","pmid":"11447573","pmcid":null,"title":"The neurobiology of pathological gambling","authors":"Potenza MN.","first_author":"Potenza MN.","journal":"Seminars in clinical neuropsychiatry","year":2001,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review article summarizing neurobiological findings on pathological gambling; no original data collected","sample_n":null,"sample_text":"N/A - review of existing literature","population":"none (review)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews early research on brain systems involved in pathological gambling, noting similarities with substance addictions and suggesting that other compulsive behaviors might share common neural pathways.","clinical_takeaway":"None – the paper is a narrative review and does not provide new clinical guidance.","confidence":0.8,"topic_tags":["neuroscience","gender","prevalence"],"strengths":["Comprehensive overview of neurobiological literature up to 2001","Integrates findings from both substance and behavioral addictions"],"limitations":["No original empirical data","Lacks systematic review methods and risk‑of‑bias assessment","No explicit evaluation of measurement validity for gambling pathology"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":62,"citing_publications":169,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1053/scnp.2001.22929"}},{"id":7537,"doi":"10.1207/s15327752jpa6203_1","pmid":"8027907","pmcid":null,"title":"Sexual sensation seeking: scale development and predicting AIDS-risk behavior among homosexually active men","authors":"Kalichman SC, Johnson JR, Adair V, Rompa D, Multhauf K, Kelly JA.","first_author":"Kalichman SC","journal":"Journal of personality assessment","year":1994,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":306,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 106 homosexually active men; scale development and validation","sample_n":106,"sample_text":"106 participants","population":"homosexually active adult men (convenience sample)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created new questionnaires to measure how much men seek exciting sexual experiences and found the tools reliable. Higher scores were linked to greater HIV‑risk behaviors among gay men, suggesting sensation‑seeking may help explain risky sex.","clinical_takeaway":"Assessing sexual sensation seeking could help identify men at higher risk for HIV‑related behaviors.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Developed and reported psychometric properties of new scales","Demonstrated convergent and discriminant validity","Focused on a specific high‑risk population"],"limitations":["Small, non‑representative convenience sample","Cross‑sectional design limits causal inference","No assessment of key confounds (e.g., mental health, moral factors)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":11,"contrasting":3,"mentioning":396,"citing_publications":644,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1207/s15327752jpa6203_1"}},{"id":7538,"doi":"10.1016/s0740-5472(03)00117-x","pmid":"14693255","pmcid":null,"title":"Patterns of substance abuse among treatment-seeking pathological gamblers","authors":"Kausch O.","first_author":"Kausch O.","journal":"Journal of substance abuse treatment","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":49,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective chart review of 113 treatment‑seeking pathological gamblers; prevalence of lifetime and recent substance use reported; no control group.","sample_n":113,"sample_text":"113 consecutively admitted patients (Sept 2000‑Sept 2001).","population":"Adults admitted to a VA gambling treatment program (mostly male, mixed age).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 113 veterans seeking treatment for gambling problems, about two‑thirds had a lifetime history of substance abuse, most commonly alcohol. Substance use often began before gambling problems and may heighten other risky behaviors, including compulsive sexual activity.","clinical_takeaway":"When treating gambling disorder, assess and address co‑occurring substance use, as it may worsen other impulsive behaviors.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large clinical sample for a treatment program","Clear documentation of substance‑use prevalence","Links comorbid impulsive behaviors to gambling"],"limitations":["Retrospective, no control/comparison group","Limited detail on diagnostic methods","Confounding factors (e.g., mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":1,"mentioning":70,"citing_publications":87,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0740-5472(03)00117-x"}},{"id":7539,"doi":"10.1034/j.1600-0447.2003.00162.x","pmid":"12890275","pmcid":null,"title":"Comorbidity of impulse control disorders in pathological gamblers","authors":"Grant JE, Kim SW.","first_author":"Grant JE","journal":"Acta psychiatrica Scandinavica","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":48,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional assessment of 96 outpatient pathological gamblers","sample_n":96,"sample_text":"outpatients recruited from a clinical setting","population":"adult pathological gamblers (N=96, mean age 46.7, 45.8% female)","country":"USA (Minnesota)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 96 adults with gambling problems, about 23% also had another impulse‑control issue, most often compulsive sexual behaviour. Those with the extra disorder reported stronger urges, more thoughts about gambling, and greater distress and interference from gambling.","clinical_takeaway":"Co‑occurring compulsive sexual behaviour may signal more severe gambling problems; assess for other impulse disorders in treatment.","confidence":0.78,"topic_tags":["gender","moral_incongruence","masturbation","sexual_function"],"strengths":["Use of structured clinical interview for impulse control disorders","Clear comparison between comorbid and non‑comorbid gamblers","Focus on a clinically relevant comorbidity"],"limitations":["Cross‑sectional design cannot infer causality","Limited control of key psychosocial confounds","Reliance on self‑report without validated CSBD scale"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":39,"citing_publications":169,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1034/j.1600-0447.2003.00162.x"}},{"id":7540,"doi":"10.1176/appi.ajp.162.11.2184","pmid":"16263865","pmcid":null,"title":"Impulse control disorders in adult psychiatric inpatients","authors":"Grant JE, Levine L, Kim D, Potenza MN.","first_author":"Grant JE","journal":"The American journal of psychiatry","year":2005,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Multicenter Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":192,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative prevalence study of 204 consecutive psychiatric in‑patients, using a semi‑structured interview to identify impulse‑control disorders including compulsive sexual behavior.","sample_n":204,"sample_text":"204 consecutively admitted psychiatric inpatients","population":"Adult psychiatric inpatients (N=204, 54.9% women, mean age 40.5)","country":"Not reported","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 204 adult psychiatric in‑patients, about 31% were diagnosed with an impulse‑control disorder; compulsive buying, kleptomania and pathological gambling were most common, and compulsive sexual behavior was included among the assessed conditions.","clinical_takeaway":"Impulse‑control disorders, including compulsive sexual behavior, are common among psychiatric in‑patients; clinicians should screen for them.","confidence":0.8,"topic_tags":["csbd","prevalence","pornography","sexual_function","measurement"],"strengths":["Large, consecutively admitted inpatient sample","Use of a validated clinical interview for impulse‑control disorders","Clear prevalence estimates"],"limitations":["Cross‑sectional, no causal inference","No measurement or control of moral incongruence or masturbation","Findings not generalisable to community or non‑clinical populations"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":10,"contrasting":2,"mentioning":183,"citing_publications":435,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.ajp.162.11.2184"}},{"id":7541,"doi":"10.1093/sxmrev/qead048","pmid":"38281754","pmcid":null,"title":"Affective neuroscience: applications for sexual medicine research and clinical practice","authors":"Mills-Finnerty C, Staggs H, Bittoni C, Wise N.","first_author":"Mills-Finnerty C","journal":"Sexual medicine reviews","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Sexual Health","Sex Therapy","Affective Neuroscience"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/review with case examples, no primary data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose that six basic brain emotion systems influence sexual function and that balancing these emotions could improve sexual problems. They outline a new therapeutic framework and illustrate it with three client case summaries.","clinical_takeaway":"Consider emotional regulation as a component of treatment for sexual dysfunction, but note that evidence is theoretical.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Integrates affective neuroscience with sexual medicine theory","Provides concrete clinical case illustrations"],"limitations":["No original empirical data","Relies on theoretical linkage without systematic evidence","Potential over‑generalisation of affective theory to sexual dysfunction"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qead048"}},{"id":7545,"doi":"10.3390/brainsci14020181","pmid":"38391755","pmcid":"PMC10886884","title":"Impulse Control Disorders in Parkinson's Disease and Atypical Parkinsonian Syndromes-Is There a Difference?","authors":"Toś M, Grażyńska A, Antoniuk S, Siuda J.","first_author":"Toś M","journal":"Brain sciences","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Dopamine agonists","Impulsivity","Parkinson’s Disease","Multiple System Atrophy","Impulse Control Disorders","Pathological Gambling","Binge Eating","Progressive Supranuclear Palsy","Hypersexuality","Compulsive Buying"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10886884","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Prospective cross‑sectional survey of hospitalized PD and APS patients (N=220) using validated questionnaires (QUIP, depression, cognition). Convenience hospital sample; no longitudinal follow‑up.","sample_n":220,"sample_text":"185 PD patients, 35 APS patients (27 PSP, 9 MSA).","population":"Adults with Parkinson’s disease (n≈185) or atypical parkinsonian syndromes (PSP n=27, MSA n=9) recruited from a single neurological department in Poland.","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a hospital sample, about one‑quarter of Parkinson’s patients and a similar proportion of atypical parkinsonism patients showed impulse‑control disorders such as hypersexuality, binge eating, and gambling. Higher dopamine‑agonist doses and longer disease duration were linked to more disorders in Parkinson’s disease, but not in atypical cases.","clinical_takeaway":"Hypersexuality can arise in both Parkinson’s and atypical parkinsonism, not only from dopaminergic medication; clinicians should screen all such patients for impulse‑control problems.","confidence":0.8,"topic_tags":["csbd","sexual_function","neuroscience"],"strengths":["Use of a validated ICD questionnaire (QUIP)","Comparison of PD and APS groups","Assessment of medication dose and disease duration"],"limitations":["Small APS sample limits power to detect differences","Single‑center, hospital‑based convenience sample","No measurement of moral or sexual‑behavior confounds"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/brainsci14020181"}},{"id":7546,"doi":null,"pmid":"11271127","pmcid":null,"title":"Recognition and management of addictive sexual disorders: guide for the primary care clinician","authors":"Carnes P, Schneider JP.","first_author":"Carnes P","journal":"Lippincott's primary care practice","year":2000,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review/guideline without original data; narrative synthesis of existing literature; no systematic methods reported.","sample_n":null,"sample_text":"Not applicable – article is a narrative review/guideline.","population":"Primary care clinicians; no participant sample.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article provides a clinician‑focused overview of \"addictive\" sexual behaviors, summarizing assessment tools, treatment options, and monitoring strategies, but it does not present new research data.","clinical_takeaway":"Use the guide as a general reference, but apply caution as it lacks empirical validation of its diagnostic criteria.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Comprehensive clinical overview for primary care","Synthesizes existing literature on assessment and treatment"],"limitations":["No empirical data or systematic review methodology","Lacks clear operational definitions of 'addictive sexual disorder'","No assessment of confounding variables such as moral incongruence or mental health"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":7547,"doi":"10.1007/s11102-024-01383-2","pmid":"38345719","pmcid":null,"title":"Impulse control disorders in patients with dopamine agonist-treated pituitary adenomas: a cross-sectional multicenter study","authors":"Almalki MH, Alsuraikh MA, Almalki E, Aziz F, Almazrouei R, AlDahmani KM, Alshahrani F, Alaqeel M, Mahzari M, Ekhzaimy A.","first_author":"Almalki MH","journal":"Pituitary","year":2024,"pub_types":["Multicenter Study","Journal Article"],"keywords":["Prolactinoma","Bromocriptine","Impulse Control Disorders","Cabergoline","Dopamine Agonist","Pituitary Tumors","Icd Questionnaires"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"multicenter cross‑sectional survey of 200 pituitary‑adenoma patients on dopamine agonists; ICDs assessed via modified questionnaires; logistic regression for risk factors.","sample_n":200,"sample_text":"200 patients recruited from tertiary referral centres (convenience clinical sample).","population":"Patients with prolactinoma or non‑functioning pituitary adenomas receiving dopamine agonist therapy (e.g., cabergoline, bromocriptine).","country":"Not specified in abstract (likely multiple countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 200 patients with pituitary tumors treated with dopamine‑boosting drugs, more than half reported impulse‑control problems, including hypersexuality. Younger age, being single and a prior psychiatric illness increased the odds of these behaviors.","clinical_takeaway":"Clinicians prescribing dopamine agonists should screen for impulse‑control symptoms, especially hypersexuality, in younger, single patients with psychiatric histories.","confidence":0.78,"topic_tags":["sexual_function","csbd","adolescents"],"strengths":["Large multicentre clinical sample (N=200).","Uses multivariable logistic regression with confidence intervals.","Identifies several demographic risk factors."],"limitations":["ICD questionnaire modified and not fully validated for hypersexuality.","No assessment of moral incongruence, masturbation, partner context, or trauma.","Cross‑sectional design limits causal inference."],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":16,"retracted":false,"notices":[{"status":"Has correction","date":"2024-3-13","noticeDoi":"10.1007/s11102-024-01390-3","doi":"10.1007/s11102-024-01383-2"}],"url":"https://scite.ai/reports/10.1007/s11102-024-01383-2"}},{"id":7548,"doi":"10.1001/archneur.63.7.969","pmid":"16831966","pmcid":"PMC1761054","title":"Association of dopamine agonist use with impulse control disorders in Parkinson disease","authors":"Weintraub D, Siderowf AD, Potenza MN, Goveas J, Morales KH, Duda JE, Moberg PJ, Stern MB.","first_author":"Weintraub D","journal":"Archives of neurology","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":455,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Convenience sample of 272 Parkinson’s disease patients screened for impulse control disorders; unstructured interview followed by structured telephone interview for screen‑positives.","sample_n":272,"sample_text":"Convenience sample of 272 patients with idiopathic PD who were screened for psychiatric complications.","population":"Adults with idiopathic Parkinson’s disease (mixed gender, age range not specified).","country":"USA (two university‑affiliated movement disorders centers).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 272 Parkinson’s patients, 6.6% developed impulse‑control disorders, including compulsive sexual behavior. Use of dopamine‑agonist medication and prior ICD symptoms predicted current ICDs.","clinical_takeaway":"Clinicians should monitor Parkinson’s patients on dopamine agonists for emerging compulsive sexual behaviours.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large (for PD) clinical sample","Validated interview for impulse control disorders","Focused on clinically relevant outcome (ICD presence)"],"limitations":["Convenience sample limits generalisability","Cross‑sectional; cannot infer causality","Limited control for psychiatric or psychosocial confounds"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":31,"contrasting":4,"mentioning":562,"citing_publications":686,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archneur.63.7.969"}},{"id":7549,"doi":"10.1038/s41398-024-02804-3","pmid":"38336862","pmcid":"PMC10858232","title":"Pramipexole restores behavioral inhibition in highly impulsive rats through a paradoxical modulation of frontostriatal networks","authors":"Magnard R, Fouyssac M, Vachez YM, Cheng Y, Dufourd T, Carcenac C, Boulet S, Janak PH, Savasta M, Belin D, Carnicella S.","first_author":"Magnard R","journal":"Translational psychiatry","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://www.nature.com/articles/s41398-024-02804-3.pdf","cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"experimental animal study with control groups (high, moderate, low impulsivity rats) receiving pramipexole; uses 5‑CSRTT and gene‑expression analysis","sample_n":null,"sample_text":"Not reported in abstract","population":"male rats (high, moderate, low impulsivity)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In male rats with high impulsivity, the dopamine agonist pramipexole reduced impulsive actions and lowered activity‑related genes in frontostriatal brain regions, suggesting it can restore impulse control in this animal model.","clinical_takeaway":"Findings are limited to rats; cannot be directly applied to treating hypersexuality or impulsivity in humans.","confidence":0.6,"topic_tags":["prevalence","treatment","neuroscience","sexual_function"],"strengths":["Validated behavioral impulsivity assay (5‑CSRTT)","Molecular verification of neural activation (C‑fos, Zif268)","Comparison across impulsivity phenotypes"],"limitations":["No human data; relevance to human hypersexuality uncertain","Sample size and power not reported","No assessment of broader behavioral or affective side‑effects"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41398-024-02804-3"}},{"id":7551,"doi":null,"pmid":"1764440","pmcid":null,"title":"Sexual addiction screening test","authors":"Carnes P.","first_author":"Carnes P.","journal":"Tennessee nurse","year":1991,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":7552,"doi":"10.1055/a-2235-9399","pmid":"38316437","pmcid":null,"title":"[Relations Between Rape Myths and Behavioral and Personality Characteristics in Males Convicted of Rape]","authors":"Freudenthaler L, Eher R.","first_author":"Freudenthaler L","journal":"Psychotherapie, Psychosomatik, medizinische Psychologie","year":2024,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross-sectional survey of 569 male convicts; self‑report questionnaires and SCID interview; no longitudinal or experimental component.","sample_n":569,"sample_text":"Convicted rapists, likely recruited from correctional facilities; not a probability or community sample.","population":"Males convicted of rape (N=569)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 569 men convicted of rape and found that higher acceptance of rape myths was linked to greater self‑reported aggressiveness, hypersexuality, and certain personality traits, but not to sexual anxiety or psychopathy.","clinical_takeaway":"Rape‑myth beliefs co‑occur with hypersexuality and aggressive traits in this high‑risk group; clinicians should assess both attitudes and sexual‑behavior patterns when working with offenders.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample of a high‑risk population","Use of validated SCID interview for personality assessment","Comprehensive set of psychological constructs examined"],"limitations":["Cross‑sectional design; cannot infer causality","Hypersexuality measured with unclear/possibly non‑validated instrument","No control for key sexual‑behavior confounds (masturbation, moral incongruence, trauma)","Findings limited to convicted rapists; not generalisable"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/a-2235-9399"}},{"id":7554,"doi":"10.1007/s00213-024-06529-5","pmid":"38227009","pmcid":null,"title":"Aripiprazole and its adverse effects in the form of impulsive-compulsive behaviors: A systematic review of case reports","authors":"Akbari M, Jamshidi S, Sheikhi S, Alijani F, Kafshchi P, Taylor D.","first_author":"Akbari M","journal":"Psychopharmacology","year":2024,"pub_types":["Systematic Review","Journal Article","Case Reports"],"keywords":["Adverse effect","Gambling","Aripiprazole","Impulsive","Hypersexuality","Compulsive","Obsessive"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of case reports (35 records, 59 cases) describing impulsive‑compulsive adverse effects of aripiprazole such as gambling and hypersexuality.","sample_n":59,"sample_text":"59 cases across 35 case reports","population":"Adults (mean age 33.8, 71% male) treated with aripiprazole; cases drawn from published case reports.","country":"Multiple (global, based on published reports)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":["selective_reporting","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A review of 59 published case reports found that some people taking the antipsychotic aripiprazole develop impulsive‑compulsive problems, including gambling and increased sexual activity, usually within a month of starting the drug and often resolving when the dose is lowered or stopped.","clinical_takeaway":"Monitor patients on aripiprazole for emerging gambling or hypersexual behaviours and adjust dose or discontinue if such side‑effects appear.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Comprehensive search across many databases","Aggregates rare adverse‑effect reports","Provides temporal information (onset/disappearance)"],"limitations":["Relies on case reports lacking standardized measures","No systematic assessment of confounders","No quantitative synthesis or risk‑of‑bias appraisal"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":1,"mentioning":2,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00213-024-06529-5"}},{"id":7555,"doi":"10.1007/s00702-023-02729-z","pmid":"38197986","pmcid":null,"title":"Sexual dysfunction in men with young onset Parkinson's disease","authors":"Sandeep M, Sundar S, Holla VV, Kamble N, Mahale R, Pal PK, Yadav R.","first_author":"Sandeep M","journal":"Journal of neural transmission (Vienna, Austria : 1996)","year":2024,"pub_types":["Journal Article"],"keywords":["Levodopa","Sexual dysfunction","erectile dysfunction","Parkinson’s Disease"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"prospective cross-sectional study of 62 male patients with young‑onset Parkinson’s disease recruited from a single neurology department in India","sample_n":62,"sample_text":"62 male YOPD patients recruited from a single centre (NIMHANS, Bangalore)","population":"Male patients with young‑onset Parkinson’s disease (mean age ≈ 45 y, n = 62)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 62 Indian men with young‑onset Parkinson’s disease, almost half had erectile dysfunction and 71% reported premature ejaculation. Longer disease duration predicted these problems, which were linked to anxiety, depression and poorer quality of life.","clinical_takeaway":"Screen for erectile dysfunction and premature ejaculation in young‑onset Parkinson’s patients, especially those with longer disease duration.","confidence":0.78,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Use of validated sexual function questionnaires","First Indian study on YOPD sexual dysfunction","Assessment of hormone levels"],"limitations":["Cross‑sectional design limits causal inference","Small single‑centre sample","Limited control for non‑sexual confounders"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00702-023-02729-z"}},{"id":7557,"doi":"10.3233/jpd-240063","pmid":"38905057","pmcid":"PMC11307097","title":"Development of a Screening Tool for Assessing Sexual Difficulties Among Patients with Parkinson's Disease: The PD-SDS","authors":"De Groote C, Dujardin K, Defebvre L, Flinois B, Herlin V, Carrière N, Wawrziczny E.","first_author":"De Groote C","journal":"Journal of Parkinson's disease","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Scale","Parkinson’s Disease","Screening Tool","Sexual Difficulties"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11307097","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Scale development with two independent Parkinson's disease samples; item generation from interviews, exploratory and confirmatory factor analysis, reliability testing.","sample_n":null,"sample_text":"First sample used for exploratory factor analysis (size not reported); second sample used for confirmatory factor analysis (size not reported).","population":"Patients with Parkinson's disease (PwPD)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created a 10‑item questionnaire to screen sexual difficulties in people with Parkinson's disease, showing it reliably measures four areas: low sexual esteem, displeasure, impact on sexual positions, and hypersexuality.","clinical_takeaway":"The PD‑SDS offers clinicians a brief, validated tool to identify and discuss sexual issues in Parkinson’s patients.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","measurement"],"strengths":["Systematic item generation from patient interviews","Both exploratory and confirmatory factor analyses","Good internal consistency and test‑retest reliability"],"limitations":["Sample sizes not reported in abstract","No external validation against clinical outcomes","Potential lack of control for mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3233/jpd-240063"}},{"id":7559,"doi":"10.17116/jnevro2024124071169","pmid":"39113458","pmcid":null,"title":"[Kleine-Levin syndrome]","authors":"Maksimova MY, Kotlyar YA, Potanin SS.","first_author":"Maksimova MY","journal":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","year":2024,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":["Klein—levin Syndrome"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"rus","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case description of an 18‑year‑old male with Kleine‑Levin syndrome, no comparator group","sample_n":1,"sample_text":"1 patient (case report)","population":"adolescent male with KLS","country":"Russia (journal of S.S. Korsakov)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe an 18‑year‑old man with Kleine‑Levin syndrome, a rare disorder causing episodic extreme sleepiness, increased appetite, and hypersexual behaviour. They review current knowledge of causes, symptoms and diagnosis, and present his clinical course.","clinical_takeaway":"Kleine‑Levin syndrome can include episodes of heightened sexual drive; clinicians should consider it when evaluating sudden hypersexuality in adolescents.","confidence":0.8,"topic_tags":["neuroscience"],"strengths":["detailed clinical description","highlights diagnostic confusion"],"limitations":["single case, no generalisable data","no validated measurement of hypersexuality","no systematic assessment of confounders"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.17116/jnevro2024124071169"}},{"id":7560,"doi":null,"pmid":"2356035","pmcid":null,"title":"The sexual addict: a challenge for the primary care provider","authors":"Schaffer SD, Zimmerman ML.","first_author":"Schaffer SD","journal":"The Nurse practitioner","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary/clinical perspective without empirical data; no sample, no methods.","sample_n":null,"sample_text":"Not applicable – article provides clinical discussion, no empirical sample.","population":"Primary care providers; no participants described","country":"United States (inferred from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The authors argue that sexual addiction is a real disorder and urge primary‑care clinicians to look for it, describing typical cues and defenses but offering no research data.","clinical_takeaway":"Clinicians should be aware of possible sexual‑addiction presentations, but evidence for diagnostic criteria is limited.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Highlights need for primary‑care awareness","Provides historical perspective on sexual addiction concept"],"limitations":["No empirical data or systematic review methodology","Lacks clear definitions and validated measures","No control of key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":7561,"doi":"10.1055/a-0941-3874","pmid":"31284315","pmcid":null,"title":"[Hypersexuality Induced by Aripiprazole]","authors":"Kozian R.","first_author":"Kozian R.","journal":"Psychiatrische Praxis","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single patient experiencing hypersexuality while on aripiprazole; no systematic data collection described","sample_n":null,"sample_text":"Not reported; only a single case mentioned","population":"single individual (presumed adult patient in Germany)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A brief report suggests that aripiprazole, an antipsychotic, may sometimes cause hypersexual behavior, possibly because of its effects on dopamine and serotonin receptors.","clinical_takeaway":"Clinicians should be aware that aripiprazole can rarely increase sexual drive and monitor patients accordingly.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Identifies a plausible pharmacological mechanism","Highlights a rare adverse effect"],"limitations":["Single case, no systematic data","No measurement of confounding variables","No validated assessment of hypersexuality"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/a-0941-3874"}},{"id":7562,"doi":"10.4088/jcp.v66n1104","pmid":"16420072","pmcid":null,"title":"Clinical characteristics and psychiatric comorbidity in males with exhibitionism","authors":"Grant JE.","first_author":"Grant JE.","journal":"The Journal of clinical psychiatry","year":2005,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Descriptive case series of 25 males with DSM‑IV exhibitionism, semi‑structured interview and structured Axis I/II assessment; no comparison group.","sample_n":25,"sample_text":"Twenty‑five males (mean age 35.0 ± 13.1 years, range 14‑68).","population":"Male adults with exhibitionism (N=25)","country":"USA (inferred from author affiliation, not stated in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study described 25 men with exhibitionism, noting their ages, typical behaviors, and high rates of other psychiatric conditions such as depression, substance use, and personality disorders. Over half reported suicidal thoughts.","clinical_takeaway":"Men presenting with exhibitionism often have co‑occurring mood, substance‑use, or personality disorders and may be at risk for suicide; comprehensive psychiatric assessment is warranted.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Standard DSM‑IV diagnostic interview","Comprehensive assessment of Axis I and II comorbidity","Clear demographic and phenomenological description"],"limitations":["Small, non‑representative convenience sample (N=25)","No control/comparison group","No statistical testing of predictors or outcomes"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/jcp.v66n1104"}},{"id":7563,"doi":"10.3109/00952990.2010.495183","pmid":"20545601","pmcid":null,"title":"Is love passion an addictive disorder?","authors":"Reynaud M, Karila L, Blecha L, Benyamina A.","first_author":"Reynaud M","journal":"The American journal of drug and alcohol abuse","year":2010,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review without systematic methods","sample_n":null,"sample_text":"N/A","population":"none","country":"France (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews similarities between passionate love and addiction, noting overlapping brain regions and neurotransmitters, but finds no solid evidence to classify love as a clinical addiction.","clinical_takeaway":"Currently insufficient evidence to treat love passion as an addiction disorder.","confidence":0.5,"topic_tags":["sexual_function","relationships","neuroscience"],"strengths":["Broad interdisciplinary synthesis of love and addiction literature","Identifies gaps in diagnostic criteria and empirical data"],"limitations":["Narrative rather than systematic review; selection bias possible","No empirical data; conclusions speculative"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":57,"citing_publications":139,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/00952990.2010.495183"}},{"id":7567,"doi":"10.3390/medicina59111942","pmid":"38003991","pmcid":"PMC10672754","title":"Frequency of Impulsive-Compulsive Behavior and Associated Psychological Factors in Parkinson's Disease: Lack of Control or Too Much of It?","authors":"Kapsomenakis A, Kasselimis D, Vaniotis E, Bougea A, Koros C, Simitsi AM, Stefanis L, Potagas C.","first_author":"Kapsomenakis A","journal":"Medicina (Kaunas, Lithuania)","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Activity","Impulsivity","Parkinson’s Disease","Personality Traits","Impulsive-compulsive Disorders","Impulsive-compulsive Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10672754","cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 892 Greek Parkinson’s disease patients assessing incidence of impulse control disorders (including hypersexuality) and a battery of validated psychometric measures.","sample_n":892,"sample_text":"Greek PD patients recruited for a two‑part prevalence and psychometric study.","population":"Patients with Parkinson’s disease (N=892)","country":"Greece","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a sample of 892 Greek Parkinson’s patients, about 12% showed impulse‑control problems such as gambling or hypersexuality. The study links these issues to high activity levels and certain coping styles rather than impulsivity alone.","clinical_takeaway":"Hypersexual behaviours in Parkinson’s may relate more to compulsive activity patterns than to impulsivity; assess coping styles in affected patients.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large community sample of PD patients","Use of validated psychometric instruments for many constructs","Comprehensive assessment of personality and coping variables"],"limitations":["No control for moral or religious factors related to hypersexuality","Masturbation not measured separately from hypersexual behavior","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/medicina59111942"}},{"id":7570,"doi":"10.1080/00918369.2023.2266086","pmid":"37815854","pmcid":null,"title":"Attachment and Mental Health of Men Having Sex with Men Engaging in Chemsex: Is Substance Abuse Only the Tip of the Iceberg?","authors":"Blanc JV, Burdairon JD, Malandain L, Ferreri F, Mouchabac S, Adrien V.","first_author":"Blanc JV","journal":"Journal of homosexuality","year":2024,"pub_types":["Journal Article","Observational Study"],"keywords":["Attachment","Mental health","Addiction","Men Who Have Sex With Men","Chemsex"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"monocentric observational survey of 71 GBMSM seeking care for problematic chemsex; attachment measured with Relationship Scales Questionnaire; mental health and trauma assessed; subgroup comparisons based on attachment self‑model and other‑model.","sample_n":71,"sample_text":"71 participants seeking care for problematic chemsex","population":"GBMSM (gay, bisexual, other men who have sex with men) engaged in chemsex, recruited from a single care centre (N=71)","country":"unspecified (likely France based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 71 gay and bisexual men who seek help for chemsex, insecure attachment styles were common and linked to more mental‑health problems and different patterns of drug‑using sex.","clinical_takeaway":"Attachment issues may contribute to risky chemsex; assessing attachment could inform harm‑reduction strategies.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Use of validated attachment questionnaire","Inclusion of trauma and mental‑health variables","Focus on a clinically relevant subgroup (problematic chemsex)"],"limitations":["Cross‑sectional, cannot infer causality","Convenience sample from treatment setting limits generalisability","Limited statistical power for subgroup analyses","No assessment of moral incongruence or partner/contextual factors"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2023.2266086"}},{"id":7574,"doi":"10.1212/cpj.0000000000200205","pmid":"37780813","pmcid":"PMC10540937","title":"Improving Documentation of Impulse Control Disorders at a Movement Disorder Program During the COVID-19 Pandemic","authors":"Putko BN, Miyasaki JM.","first_author":"Putko BN","journal":"Neurology. Clinical practice","year":2023,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"pre‑post quality‑improvement audit of medical records in a tertiary movement‑disorder clinic (109 pre‑intervention, 276 post‑intervention encounters)","sample_n":385,"sample_text":"109 pre‑intervention encounters, 276 post‑intervention encounters","population":"Patients with idiopathic Parkinson disease, Parkinson‑dementia syndrome or dementia with Lewy bodies seen in a Canadian movement‑disorder program","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A Parkinson's clinic introduced an education session and a documentation tool to improve how doctors ask about impulse‑control problems like gambling or hypersexuality. After the change, doctors asked about these issues more often, but the rate of diagnosed problems did not change.","clinical_takeaway":"Education and simple documentation tools can increase clinician screening for impulse‑control disorders in Parkinson's patients.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","religiosity"],"strengths":["Large post‑intervention sample (n=276) for a quality‑improvement audit","Clear pre‑post comparison with documented educational intervention","Use of confidence intervals for diagnosis rates"],"limitations":["ICD screening based on chart documentation, not validated questionnaires","No control for potential confounders (e.g., disease severity, mood)","Observational pre‑post design limits causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1212/cpj.0000000000200205"}},{"id":7575,"doi":"10.1080/0092623x.2018.1518886","pmid":"30657020","pmcid":null,"title":"A Validation Study of the Spanish Version of the Hypersexual Behavior Inventory (HBI): Paper-and-Pencil Versus Online Administration","authors":"Ballester-Arnal R, Castro-Calvo J, Gil-Julia B, Giménez-García C, Gil-Llario MD.","first_author":"Ballester-Arnal R","journal":"Journal of sex & marital therapy","year":2019,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of a questionnaire with large community sample (N=2250) comparing paper‑and‑pencil and online versions.","sample_n":2250,"sample_text":"2,250 participants (1,070 men); 1,450 paper‑and‑pencil, 800 online","population":"Spanish‑speaking adults (both genders)","country":"Spain (presumably)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study translates and tests the Hypersexual Behavior Inventory in Spanish, showing that both paper and online versions have strong reliability, a stable three‑factor structure, and good agreement with related scales.","clinical_takeaway":"The Spanish HBI appears reliable for screening hypersexuality, but clinicians should consider additional context and confounding factors.","confidence":0.7,"topic_tags":["measurement","sexual_function"],"strengths":["Large sample size","Both paper and online formats evaluated","Comprehensive factor analytic approach","Good reliability and temporal stability"],"limitations":["No assessment of moral incongruence or related confounds","Potential circularity of the HBI (distress included in definition)","No pre‑registration reported"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":18,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2018.1518886"}},{"id":7576,"doi":"10.1353/hpu.2010.0313","pmid":"1391376","pmcid":null,"title":"The relationship between sexual addiction and sexual dysfunction","authors":"Butts JD.","first_author":"Butts JD.","journal":"Journal of health care for the poor and underserved","year":1992,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1353/hpu.2010.0313"}},{"id":7577,"doi":"10.1093/brain/awy298","pmid":"30590514","pmcid":null,"title":"Wait and you shall see: sexual delay discounting in hypersexual Parkinson's disease","authors":"Girard R, Obeso I, Thobois S, Park SA, Vidal T, Favre E, Ulla M, Broussolle E, Krack P, Durif F, Dreher JC.","first_author":"Girard R","journal":"Brain : a journal of neurology","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control fMRI study with PD patients (hypersexual vs non‑hypersexual) and healthy controls; within‑subject medication ON/OFF manipulation","sample_n":null,"sample_text":"not specified in abstract; typical PD fMRI studies have small samples (≈15‑20 per group)","population":"male patients with Parkinson’s disease (with and without hypersexuality) and age‑matched healthy men","country":"France (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared men with Parkinson’s disease who have hypersexuality to those who do not and to healthy controls. Using a task where participants choose between waiting briefly or longer to see erotic pictures, the researchers found that hypersexual participants were less likely to prefer the immediate reward. fMRI showed that brain areas involved in valuation responded differently, especially when patients were on dopaminergic medication.","clinical_takeaway":"In hypersexual Parkinson’s patients, dopaminergic treatment may alter how erotic rewards are valued, but findings are preliminary due to small sample size.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["uses model‑based fMRI to link behaviour and brain activity","includes medication ON/OFF within‑subject design","addresses a rare clinical subgroup (hypersexual PD)"],"limitations":["small sample, likely under‑powered for fMRI","no validated hypersexuality or addiction scales reported","key psychosocial confounds (moral incongruence, masturbation, mental health) not measured"],"rubric_version":"2.0","raw_total":32,"max_possible":70,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":5,"statistics":5,"confounds":3,"design":5,"addiction_criteria":3,"interpretation":6}},"scite":{"supporting":5,"contrasting":0,"mentioning":45,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/brain/awy298"}},{"id":7582,"doi":"10.20882/adicciones.279","pmid":"18551228","pmcid":null,"title":"[Internet and cell phone addiction: passing fad or disorder?]","authors":"Sanchez-Carbonell X, Beranuy M, Castellana M, Chamarro A, Oberst U.","first_author":"Sanchez-Carbonell X","journal":"Adicciones","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["csbd"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of literature (1991‑2005) without systematic methods or meta‑analysis.","sample_n":null,"sample_text":"Not applicable","population":"Not applicable (review article)","country":"Spain (based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The authors review studies from 1991‑2005 on excessive internet and mobile‑phone use, arguing that heavy internet use may qualify as an addictive mental disorder, especially among youths, while mobile‑phone overuse is seen as abuse rather than addiction.","clinical_takeaway":"Treat claims of ‘internet addiction’ cautiously; the review provides no empirical criteria for diagnosis.","confidence":0.7,"topic_tags":["pornography","sexual_function","masturbation"],"strengths":["Broad historical overview of ICT‑related maladaptive use","Identifies specific risky online activities (e.g., chat, role‑playing games)","Attempts to differentiate internet vs. mobile‑phone misuse"],"limitations":["Narrative, not systematic, review – selection bias possible","No empirical data, no meta‑analytic synthesis","Lacks formal assessment of confounding factors (e.g., moral incongruence, mental health)","Concludes on disorder status without quantitative criteria"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":3,"contrasting":0,"mentioning":51,"citing_publications":160,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20882/adicciones.279"}},{"id":7583,"doi":"10.1080/00926239308404907","pmid":"8305062","pmcid":null,"title":"A response to Aviel Goodman's \"Sexual addiction: designation and treatment\"","authors":"Moser C.","first_author":"Moser C.","journal":"Journal of sex & marital therapy","year":1993,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239308404907"}},{"id":7584,"doi":"10.1016/j.clinthera.2009.01.009","pmid":"19243704","pmcid":null,"title":"Drug treatment of paraphilic and nonparaphilic sexual disorders","authors":"Guay DR.","first_author":"Guay DR.","journal":"Clinical therapeutics","year":2009,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"Not applicable – narrative review of published studies","population":"individuals with paraphilic or nonparaphilic sexual disorders, primarily sex offenders","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["selective_reporting","advocacy_or_coi"],"stance":"neutral","citation_value":"useful","plain_summary":"This review summarizes how anti‑androgen drugs and antidepressants are used to treat paraphilic and other sexual disorders, noting that many of the studies behind these recommendations have weak designs.","clinical_takeaway":"Pharmacologic options exist but evidence is limited; clinicians should combine medication with psychotherapy and recognize the tentative nature of current recommendations.","confidence":0.42,"topic_tags":["sexual_function","prevalence","treatment"],"strengths":["Comprehensive overview of pharmacologic agents","Integrates both animal and human data"],"limitations":["Relies on studies of generally poor design","No systematic risk‑of‑bias assessment","Lacks quantitative synthesis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":75,"citing_publications":121,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.clinthera.2009.01.009"}},{"id":7585,"doi":"10.1002/mdc3.13868","pmid":"37868922","pmcid":"PMC10585976","title":"Contributory Factors to Caregiver Burden in Parkinson's Disease","authors":"Soares GM, Bouça-Machado R, Abreu D, Ferreira JJ.","first_author":"Soares GM","journal":"Movement disorders clinical practice","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Quality of life","Parkinson's Disease","Hypersexuality","Caregiver Burden","Financial Burden"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"multinational online survey of 245 PD‑patient/caregiver dyads; validated questionnaires (PDQ‑39, NMSQuest, QUIP, ZBI); regression analysis of burden predictors","sample_n":245,"sample_text":"245 dyads (patient + caregiver)","population":"people with Parkinson’s disease and their informal caregivers (community sample, self‑selected online respondents)","country":"multinational (online)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 245 Parkinson’s patients and their informal caregivers, higher caregiver burden was linked to the caregiver’s sense of partnership strain, financial stress, more hours spent caring, older patient age, poorer patient quality of life, and the patient’s hypersexual urges.","clinical_takeaway":"When supporting Parkinson’s caregivers, assess partnership changes, financial strain, and any patient hypersexuality, as these amplify caregiver burden.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Validated instruments for both patient symptoms and caregiver burden","Reasonably large, multinational sample","Multivariate model explains a substantial proportion of variance"],"limitations":["Cross‑sectional design limits causal inference","Self‑selected online sample may not be representative","No pre‑registration or reported power analysis"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mdc3.13868"}},{"id":7586,"doi":"10.1111/pcn.13579","pmid":"37530202","pmcid":null,"title":"Amantadine-induced hypersexuality in a non-Parkinsonian patient with catatonia: a case report","authors":"Gasnier M, Frajerman A, Haddadi N, Herrero H, Faulet T, Martin S, Korngold J, Colle R, Corruble E, Choucha W.","first_author":"Gasnier M","journal":"Psychiatry and clinical neurosciences","year":2023,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/pcn.13579"}},{"id":7588,"doi":"10.3390/medicina59081468","pmid":"37629758","pmcid":"PMC10456804","title":"Impulse Control Disorders in the Polish Population of Patients with Parkinson's Disease","authors":"Toś M, Grażyńska A, Antoniuk S, Siuda J.","first_author":"Toś M","journal":"Medicina (Kaunas, Lithuania)","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Parkinson disease","Dopamine agonists","Impulse Control Disorders","Pathological Gambling","Binge Eating","Hypersexuality","Compulsive Buying"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10456804","cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"prospective observational study of 135 hospitalized PD patients","sample_n":135,"sample_text":"135 PD patients (hospitalized) assessed with QUIP and motor scales","population":"Polish patients with idiopathic Parkinson's disease, hospitalized at a university neurology department","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Polish sample of 135 Parkinson’s patients, about 27 % showed impulse‑control disorders, including hypersexuality (≈11 %). Use of dopamine agonists and longer disease duration were linked to higher risk. The study suggests clinicians should screen for these behaviours.","clinical_takeaway":"Screen PD patients, especially those on dopamine agonists, for hypersexuality and other impulse‑control issues.","confidence":0.78,"topic_tags":["sexual_function","csbd","pornography","gender"],"strengths":["Use of validated QUIP instrument","Clear reporting of prevalence and medication associations","Inclusion of motor severity measures"],"limitations":["Convenience sample of hospitalized patients limits generalisability","No control for key psychosocial confounds (e.g., moral attitudes, mental health)","Statistical reporting limited to p‑values without effect sizes"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":4,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/medicina59081468"}},{"id":7589,"doi":"10.1007/s10072-023-07006-1","pmid":"37581771","pmcid":null,"title":"Impulse control disorders in Parkinson's disease: a retrospective analysis of 1824 patients in a 12-year period","authors":"Gunduz A, Çiftçi T, Erbil AC, Senoglu G, Ser MH, Apaydın H.","first_author":"Gunduz A","journal":"Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology","year":2024,"pub_types":["Journal Article"],"keywords":["Parkinson’s Disease","Ropinirole","Impulse Control Disorder","Pramipexole","Dopamine Dysregulation Syndrome"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"retrospective chart review of 1824 Parkinson's patients; comparison of those with vs. without ICDs","sample_n":1824,"sample_text":"1824 patients, 128 with at least one ICD","population":"idiopathic Parkinson's disease patients (age 70.5 ± 11.9 y; 56 % male)","country":"Turkey (inferred from author names, not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a review of 1824 Parkinson’s patients, about 7% showed impulse‑control problems such as compulsive shopping, eating, gambling, and hypersexuality. Those with these problems tended to be younger and more often male, and they were on slightly higher doses of the dopamine agonist pramipexole.","clinical_takeaway":"Hypersexuality can appear in Parkinson’s patients on dopamine agonists even at modest doses; clinicians should monitor for it alongside other impulse‑control issues.","confidence":0.42,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large clinical cohort (N > 1800)","Systematic extraction of ICD types from records","Clear description of medication doses"],"limitations":["Retrospective design; no validated ICD scale","No control for key psychosocial confounds (mood, trauma, moral factors)","Limited statistical detail (no effect sizes, limited adjustment)","Findings may not generalise beyond Parkinson’s clinic population"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10072-023-07006-1"}},{"id":7590,"doi":"10.3389/fpsyt.2018.00460","pmid":"30319466","pmcid":"PMC6167473","title":"Altered Prefrontal and Inferior Parietal Activity During a Stroop Task in Individuals With Problematic Hypersexual Behavior","authors":"Seok JW, Sohn JH.","first_author":"Seok JW","journal":"Frontiers in psychiatry","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Functional magnetic resonance imaging","Dorsolateral Prefrontal Cortex","Executive Control","Inferior Parietal Cortex","Stroop Task","Problematic Hypersexual Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6167473","cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case-control fMRI Stroop task; N=45 (23 PHB, 22 controls); event‑related BOLD response measured","sample_n":45,"sample_text":"23 PHB, 22 healthy controls","population":"individuals with self‑reported problematic hypersexual behavior vs healthy controls; likely convenience sample","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small fMRI study, people who report problematic hypersexual behavior showed slower Stroop task performance and lower activation in brain areas important for control and attention compared with healthy controls. Lower brain activity was linked to greater symptom severity.","clinical_takeaway":"The study suggests reduced prefrontal and parietal activation may underlie poor executive control in hypersexuality, but findings are preliminary.","confidence":0.6,"topic_tags":["neuroscience","sexual_function"],"strengths":["use of neuroimaging to probe executive control","matched healthy control group","association between activation and symptom severity"],"limitations":["small sample, limited power","no assessment of key confounds (moral, mental health, masturbation)","cross‑sectional; cannot infer causality","unclear validation of PHB severity measure"],"rubric_version":"2.0","raw_total":31,"max_possible":70,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":5,"statistics":5,"confounds":2,"design":3,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":6,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2018.00460"}},{"id":7591,"doi":"10.1007/bf02354522","pmid":"24264632","pmcid":null,"title":"Sacramental psychology: Treating intimacy failure in catholic priests","authors":"Holmes PA.","first_author":"Holmes PA.","journal":"Journal of religion and health","year":1996,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report (three case vignettes)","sample_n":3,"sample_text":"Three priests","population":"Roman Catholic priests seeking treatment for sexual misconduct","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","circular_addiction_scale","advocacy_or_coi"],"stance":"neutral","citation_value":"avoid","plain_summary":"The article describes three Catholic priests who struggled with intimacy and sexual misconduct, using their religious beliefs alongside psychotherapy to treat what the author calls sexual addiction.","clinical_takeaway":"Limited evidence; does not provide generalizable guidance for treating sexual issues.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides detailed clinical vignettes","Integrates spiritual and psychotherapeutic perspectives"],"limitations":["No validated measures or systematic data","Very small, non‑representative sample","No control for key confounds (e.g., moral incongruence, mental health)","Claims of “sexual addiction” lack operational definition"],"rubric_version":"2.0","raw_total":7,"max_possible":60,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":2,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02354522"}},{"id":7593,"doi":"10.1007/s10072-023-06956-w","pmid":"37452260","pmcid":"PMC10641065","title":"Predictors of dopamine dysregulation syndrome in patients with early Parkinson's disease","authors":"Liang K, Li X, Ma J, Yang H, Shi X, Fan Y, Yang D, Guo D, Liu C, Dong L, Chang Q, Gu Q, Chen S, Li D.","first_author":"Liang K","journal":"Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Dopamine transporter","risk factors","Parkinson’s Disease","Impulse Control Disorder","Dopamine Dysregulation Syndrome"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10641065","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Retrospective cohort using PPMI database, multivariate Cox regression, 5‑year follow‑up","sample_n":null,"sample_text":"Not reported in abstract; only 6 DDS cases identified","population":"Early Parkinson’s disease patients (PPMI cohort)","country":"International (PPMI database)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In early Parkinson’s patients, traits like hypersexuality, compulsive eating, shopping and anxiety predicted later development of dopamine dysregulation syndrome, a side‑effect of dopamine therapy, and were linked to lower dopamine transporter uptake in the brain.","clinical_takeaway":"Screen for hypersexuality and related impulsive behaviors in early Parkinson’s to identify patients at higher risk for dopamine dysregulation syndrome.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","pornography"],"strengths":["Large, well‑characterized database (PPMI)","Longitudinal follow‑up with Cox regression","Objective imaging (DAT uptake)"],"limitations":["Very few DDS events (n=6) – low power","Unclear how hypersexuality and other behaviors were measured","Potential unmeasured confounders (e.g., moral attitudes, trauma)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10072-023-06956-w"}},{"id":7595,"doi":"10.1080/00224499.2018.1494262","pmid":"30028633","pmcid":null,"title":"The Psychometric Properties of the Hypersexual Behavior Inventory Using a Large-Scale Nonclinical Sample","authors":"Bőthe B, Kovács M, Tóth-Király I, Reid RC, Griffiths MD, Orosz G, Demetrovics Z.","first_author":"Bőthe B","journal":"Journal of sex research","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":53,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online nonclinical sample, psychometric validation using CFA and LPA","sample_n":18034,"sample_text":"large, diverse, online, nonclinical sample","population":"18,034 adults (both sexes, wide age range) recruited online, non‑clinical","country":"unspecified (likely international, authors Hungarian)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested the Hypersexual Behavior Inventory in over 18,000 adults and found it to be reliable and structurally sound, but it could not set a clear cutoff for hypersexuality because few participants met clinical criteria.","clinical_takeaway":"The HBI is a reliable tool for assessing hypersexual urges, but clinicians should use interviews and objective indicators before diagnosing problematic sexual behavior.","confidence":0.85,"topic_tags":["measurement","sexual_function"],"strengths":["Very large sample enhances reliability estimates","Comprehensive CFA and reliability testing","Explores cutoff validity across diverse respondents"],"limitations":["Cross‑sectional; no external criterion validation","No clinical interview to confirm hypersexuality status","Potential self‑selection bias of online volunteers"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":1,"mentioning":52,"citing_publications":81,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1494262"}},{"id":7596,"doi":"10.1097/00006205-199108000-00009","pmid":"1923006","pmcid":null,"title":"Sexual-addiction diagnosis supports anti-sex movement","authors":"Kennedy E.","first_author":"Kennedy E.","journal":"The Nurse practitioner","year":1991,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00006205-199108000-00009"}},{"id":7598,"doi":"10.1016/j.psc.2008.06.002","pmid":"18996306","pmcid":null,"title":"Pharmacology of sexually compulsive behavior","authors":"Codispoti VL.","first_author":"Codispoti VL.","journal":"The Psychiatric clinics of North America","year":2008,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review article summarizing pharmacologic and psychosocial treatments for sexual compulsivity and sex offenders; no original data collected.","sample_n":null,"sample_text":"Not applicable – narrative review of published studies.","population":"Sex offenders (adult men and adolescents) treated with various interventions; no primary sample.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews drugs and therapies used to treat compulsive sexual behavior and sex offenders, noting that cognitive‑behavioral and hormonal approaches seem promising but that research is often low quality and hard to compare.","clinical_takeaway":"Current evidence for pharmacologic treatment of compulsive sexual behavior is limited; clinicians should consider combined behavioral and medical approaches while awaiting higher‑quality outcome studies.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Broad overview of pharmacologic and behavioral treatments","Identifies methodological shortcomings in existing literature"],"limitations":["No original empirical data","Lacks systematic review methodology and risk‑of‑bias assessment","No quantitative synthesis (e.g., meta‑analysis) despite mentioning a meta‑analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psc.2008.06.002"}},{"id":7599,"doi":"10.1080/00224499.2023.2219247","pmid":"37267113","pmcid":null,"title":"The Dual Control Model of Sexual Response: A Scoping Review, 2009-2022","authors":"Janssen E, Bancroft J.","first_author":"Janssen E","journal":"Journal of sex research","year":2023,"pub_types":["Scoping Review","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"scoping review of 152 empirical papers","sample_n":null,"sample_text":"No primary sample; review of 152 published papers","population":"human participants in the cited primary studies (no new sample)","country":"International","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This scoping review surveyed 152 studies on the Dual Control Model, summarising how questionnaires measure sexual excitement and inhibition and how they relate to desire, dysfunction, hypersexuality, risk‑taking and aggression.","clinical_takeaway":"The Dual Control Model’s excitation/inhibition scales are widely used and can help clinicians understand diverse sexual concerns, but evidence on causality is limited.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive mapping of 152 papers","Focus on validated excitation/inhibition questionnaires","Clear summary of translational work"],"limitations":["No risk‑of‑bias assessment of included studies","Descriptive synthesis only; no quantitative meta‑analysis","Confounding variables not evaluated within the review"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":25,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2219247"}},{"id":7600,"doi":"10.1093/jsxmed/qdad066","pmid":"37279963","pmcid":null,"title":"Capacity to love and problematic sexuality: the role of defense mechanisms and psychopathological suffering","authors":"Ciocca G, Origlia G, Limoncin E, Mollaioli D, Tanzilli A, Lingiardi V, Jannini EA.","first_author":"Ciocca G","journal":"The journal of sexual medicine","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Hypersexual Behavior","Problematic Sexuality","Capacity To Love"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience survey of 521 young adults; self‑report questionnaires; correlation, regression and mediation analyses","sample_n":521,"sample_text":"Convenience online recruitment; not nationally representative; majority female; age 18‑35 likely","population":"young adult community sample (mean age 26.5, 75% female)","country":"unspecified (likely Italy based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 521 adults, lower scores on a ‘capacity to love’ questionnaire were linked to higher hypersexual behavior scores. The link was partly explained by higher psychological distress and immature defence mechanisms.","clinical_takeaway":"Clinicians should consider relationship and personality factors, not just sexual frequency, when assessing problematic sexuality.","confidence":0.88,"topic_tags":["sexual_function"],"strengths":["use of multiple validated psychometric scales","large sample for a survey study","mediational statistical approach"],"limitations":["cross‑sectional, cannot infer causality","no measurement of moral incongruence or masturbation","convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":29,"max_possible":60,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdad066"}},{"id":7602,"doi":"10.1097/mjt.0000000000001638","pmid":"37184514","pmcid":null,"title":"Clozapine-Associated Hypersexuality","authors":"Chyou TE, Ou H, Huang SY.","first_author":"Chyou TE","journal":"American journal of therapeutics","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/mjt.0000000000001638"}},{"id":7603,"doi":"10.1002/mdc3.13738","pmid":"37332637","pmcid":"PMC10272921","title":"Course of Impulse Control Disorder Symptoms in Parkinson's Disease: Deep Brain Stimulation Versus Medications","authors":"Hernandez-Con P, Lin I, Mamikonyan E, Deeb W, Feldman R, Althouse A, Barmore R, Eisinger RS, Spindler M, Okun MS, Weintraub D, Chahine LM.","first_author":"Hernandez-Con P","journal":"Movement disorders clinical practice","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Parkinson's Disease","Deep brain stimulation","Dopaminergic Medication","Ledd","De Novo Icds"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective observational cohort, 2 centers, DBS vs medication-matched controls, N=54, 12‑month follow‑up, QUIP‑RS assessments at 0,3,6,12 mo","sample_n":54,"sample_text":"DBS = 26, controls = 28","population":"Parkinson’s disease patients undergoing deep brain stimulation or medication only","country":"unspecified (likely USA, given author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson’s patients, hypersexuality and other impulse‑control symptoms after 12 months were similar whether they had deep‑brain‑stimulation surgery or stayed on medication only. Both groups need monitoring for new symptoms.","clinical_takeaway":"DBS does not appear to worsen hypersexuality compared with medication alone; clinicians should watch all PD patients for emerging impulse‑control problems.","confidence":0.78,"topic_tags":["sexual_function","pornography","masturbation","csbd"],"strengths":["Validated ICD‑PD questionnaire (QUIP‑RS)","Prospective 12‑month follow‑up","Matched control group on key PD variables"],"limitations":["Small sample, under‑powered for between‑group comparisons","No measurement of sexual‑specific confounds (masturbation, moral incongruence, mental health)","Observational design limits causal inference"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":16,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mdc3.13738"}},{"id":7604,"doi":"10.5964/sotrap.6989","pmid":"39901982","pmcid":"PMC11789443","title":"The Neuroanatomical Bases of Pedophilia and the Importance of Distinguishing Genuine vs. Acquired Types: A Systematic Review","authors":"Joyal CC.","first_author":"Joyal CC.","journal":"Sexual offending (Trier, Germany)","year":2023,"pub_types":["review-article","Review","Journal Article"],"keywords":["Brain damage","Impulsivity","Child Sexual Abuse","Acquired Pedophilia"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11789443","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 64 case reports of acquired pedophilia, following PRISMA guidelines.","sample_n":64,"sample_text":"64 identified cases (all but one men, mean age 52.8 years).","population":"Adults (mostly men) with newly onset pedophilic behaviors after neurological injury.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review examined 64 adult cases where brain injury appeared to trigger new pedophilic behaviour. Most patients were over 50, showed many impulsive acts, and only a few had prior pedophilic interests, suggesting that the behaviour may stem from general impulsivity rather than a true change in sexual preference.","clinical_takeaway":"Acquired pedophilia likely reflects impulsivity from brain injury, not a distinct neurobasis of genuine pedophilia; clinicians should assess neurological history when evaluating new-onset sexual offending.","confidence":0.8,"topic_tags":["neuroscience","sexual_function"],"strengths":["Systematic review methodology (PRISMA).","Clear definition of acquired pedophilia cases.","Highlights distinction between impulsivity and genuine sexual interest."],"limitations":["Relies on heterogeneous case reports with limited standardized assessment.","No quantitative meta‑analysis or formal statistical testing.","No control for major confounds (e.g., mental health, trauma)."],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5964/sotrap.6989"}},{"id":7605,"doi":"10.1017/s1092852923002262","pmid":"37130812","pmcid":null,"title":"The prevalence of mental disorders among incarcerated adult men convicted of child sexual exploitation material offences","authors":"Seiser A, Eher R, Turner D, Rettenberger M.","first_author":"Seiser A","journal":"CNS spectrums","year":2023,"pub_types":["Journal Article"],"keywords":["Personality Disorders","Prevalence Of Mental Disorders","Child Sexual Exploitation Material (Csem)","Csem-offender","Pedophilic Disorders"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional clinical assessment of 66 incarcerated men convicted of CSEM offenses in Austria (2002‑2020).","sample_n":66,"sample_text":"66 incarcerated adult men serving sentences for CSEM offenses.","population":"Adult male prisoners convicted of child sexual exploitation material offenses (N=66).","country":"Austria","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 66 Austrian men imprisoned for child‑sex‑material offenses, about 80% had a mental disorder, most commonly personality and pedophilic disorders. Around two‑thirds met criteria for a hypersexual disorder.","clinical_takeaway":"High rates of personality and hypersexual symptoms suggest need for tailored mental‑health and risk‑management interventions in this population.","confidence":0.8,"topic_tags":["sexual_function","moral_incongruence","neuroscience","other"],"strengths":["Use of validated SCID interviews for Axis I/II diagnoses","Comprehensive assessment of mental disorders in a hard‑to‑reach population"],"limitations":["Small, non‑representative prison sample","No control group; prevalence estimates cannot be compared to general population","Hypersexual disorder assessment not clearly described or validated"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852923002262"}},{"id":7606,"doi":"10.1097/00006205-199006000-00007","pmid":"2356036","pmcid":null,"title":"Treatment and recovery for sexual addicts","authors":"Manley G.","first_author":"Manley G.","journal":"The Nurse practitioner","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/editorial without empirical data; no sample, no methods","sample_n":null,"sample_text":"none reported","population":"n/a","country":"n/a","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"avoid","plain_summary":"The article proposes treating \"sexual addiction\" like other chronic addictions, using 12‑step groups, medical and emotional therapy, but offers no data to show this works.","clinical_takeaway":"No evidence that the suggested 12‑step approach is effective; clinicians should seek evidence‑based treatments.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Clear practical guidance for clinicians","Integrates existing addiction treatment models"],"limitations":["No empirical data or outcome evidence","Outdated terminology and criteria","Lacks measurement of key confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00006205-199006000-00007"}},{"id":7608,"doi":"10.1891/vv-2021-0149","pmid":"37011950","pmcid":null,"title":"Relative Effects of Sexual Assault and Temperament Traits on Cognitive Characteristics of Histrionic Personality Disorder","authors":"Yalch MM, Mehta A, Watters KN, Dawood S, Schroder HS.","first_author":"Yalch MM","journal":"Violence and victims","year":2023,"pub_types":["Journal Article"],"keywords":["Temperament","Sexual Assault","Personality Disorder","Cognitive Theory","Histrionic"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large convenience sample of college students (N=965), Bayesian ANCOVA","sample_n":965,"sample_text":"large sample of college students","population":"college students (likely US, majority young adults)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 965 college students, researchers found that having experienced sexual assault was linked to stronger histrionic personality traits, even after accounting for temperament. The results suggest sexual trauma may influence certain personality characteristics.","clinical_takeaway":"Clinicians should consider histories of sexual assault when assessing histrionic traits, as trauma may shape these features.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Large sample size","Use of Bayesian ANCOVA to assess relative contributions","Inclusion of temperament traits as covariates"],"limitations":["Cross‑sectional design limits causal inference","Convenience college sample limits generalisability","Limited control for mental‑health or other trauma variables"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1891/vv-2021-0149"}},{"id":7609,"doi":"10.1016/j.brainres.2018.01.035","pmid":"29421186","pmcid":null,"title":"Gray matter deficits and altered resting-state connectivity in the superior temporal gyrus among individuals with problematic hypersexual behavior","authors":"Seok JW, Sohn JH.","first_author":"Seok JW","journal":"Brain research","year":2018,"pub_types":["Journal Article"],"keywords":["Caudate nucleus","Functional Connectivity","Voxel-based Morphometry","Superior Temporal Gyrus","Problematic Hypersexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control MRI study, N=17 PHB participants, N=19 controls, voxel‑based morphometry and resting‑state functional connectivity","sample_n":36,"sample_text":"17 individuals with PHB and 19 age‑matched healthy controls","population":"young adult males, recruited for problematic hypersexual behavior (criteria not described)","country":"South Korea (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A small MRI study found that men who report problematic hypersexual behavior have less gray‑matter in parts of the temporal lobe and weaker connections to other brain regions, with these brain differences relating to how severe their symptoms are.","clinical_takeaway":"Findings are preliminary; do not use brain scans to diagnose hypersexual problems without further evidence.","confidence":0.6,"topic_tags":["neuroscience","sexual_function","csbd"],"strengths":["use of both structural and functional MRI","age‑matched healthy comparison group","identifies specific brain region correlations with symptom severity"],"limitations":["very small sample, likely underpowered","no measurement or control of key psychosocial confounds (moral incongruence, masturbation, mental health, relationship status, trauma)","problematic hypersexual behavior not operationally defined with validated scales","cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":70,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":3,"statistics":4,"confounds":2,"design":3,"addiction_criteria":2,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.brainres.2018.01.035"}},{"id":7610,"doi":null,"pmid":"7743452","pmcid":"PMC1337871","title":"New centre treats MDs whose careers are in shambles because of sex abuse","authors":"Williams LS.","first_author":"Williams LS.","journal":"CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne","year":1995,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"no empirical data; descriptive article about a treatment centre","sample_n":null,"sample_text":"none reported","population":"physicians convicted of sexual abuse; professionals","country":"Canada / USA (North Dakota)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article describes a new centre in North Dakota that treats doctors whose licences were revoked after sexually abusing patients, offering a program aimed at addressing sexual addiction and supporting licence reinstatement.","clinical_takeaway":"No clinical evidence provided; the piece merely outlines a treatment programme for professional misconduct.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["provides information on a novel treatment approach","highlights regulatory considerations"],"limitations":["no empirical data or outcomes","lacks methodological rigor","no measurement of key constructs or confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":7611,"doi":"10.4103/aian.aian_940_22","pmid":"37179661","pmcid":"PMC10171011","title":"Impulse-Control Disorders and Restless Leg Syndrome in Parkinson's Disease: Association or Coexistence","authors":"Paul BS, Aggarwal S, Paul G, Khehra AS, Jain A.","first_author":"Paul BS","journal":"Annals of Indian Academy of Neurology","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Parkinson’s Disease","Restless Leg Syndrome","Impulse-control Disorders","Dopamineric Treatment","Impulse-control Disorders And Related Behaviours"],"is_oa":true,"oa_url":"https://doi.org/10.4103/aian.aian_940_22","cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational cross‑sectional study of 95 Parkinson’s patients attending a neurology outpatient clinic; groups formed by presence/absence of impulse‑control disorders and restless‑leg syndrome.","sample_n":95,"sample_text":"95 eligible PD patients (out of 122 screened).","population":"Adults with Parkinson’s disease recruited from a single neurology OPD in India (convenience sample).","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 95 Parkinson’s patients, about half had impulse‑control problems and 19% had restless‑leg syndrome; two‑thirds of those with RLS also showed an impulse‑control issue, especially gambling and compulsive eating. Longer disease duration and higher dopaminergic doses were linked to the co‑occurrence.","clinical_takeaway":"Clinicians should monitor for impulse‑control behaviours, including hypersexuality, in Parkinson’s patients with restless‑leg syndrome, especially when dopaminergic treatment is high.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation","csbd"],"strengths":["Use of validated QUIP and RLS diagnostic criteria","Clear definition of ICD subtypes","Clinically relevant sample of PD patients"],"limitations":["Small subgroup sizes (e.g., only 18 with RLS)","No power calculation or effect‑size reporting","Limited control for psychological / moral confounds"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":4,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/aian.aian_940_22"}},{"id":7612,"doi":"10.3109/10401239509149623","pmid":"8721891","pmcid":null,"title":"Impulse control disorders and attention deficit disorder in pathological gamblers","authors":"Specker SM, Carlson GA, Christenson GA, Marcotte M.","first_author":"Specker SM","journal":"Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists","year":1995,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":79,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative case‑control study of 40 treatment‑seeking pathological gamblers and 64 community controls, using structured diagnostic interviews.","sample_n":104,"sample_text":"40 pathological gamblers, 64 controls","population":"Adults (mixed gender) receiving treatment for gambling problems vs. controls.","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared 40 people in treatment for gambling problems with 64 controls and found higher rates of ADHD, compulsive buying and compulsive sexual behavior among the gamblers.","clinical_takeaway":"Clinicians should assess for co‑occurring impulse‑control and attention disorders in clients with gambling problems.","confidence":0.7,"topic_tags":["adolescents","csbd","sexual_function"],"strengths":["Use of structured diagnostic interview","Clear comparison group","Focus on comorbidity"],"limitations":["Convenience sample of treatment‑seekers limits generalisability","No effect sizes or correction for multiple testing","Key psychosocial confounds (e.g., moral incongruence, trauma) not assessed"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":6,"contrasting":2,"mentioning":78,"citing_publications":170,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/10401239509149623"}},{"id":7613,"doi":"10.2174/1389450118666170321144931","pmid":"28325146","pmcid":null,"title":"Hypersexuality As a Neuropsychiatric Disorder: The Neurobiology and Treatment Options","authors":"Asiff M, Sidi H, Masiran R, Kumar J, Das S, Hatta NH, Alfonso C.","first_author":"Asiff M","journal":"Current drug targets","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Neurobiology","Neuropsychiatry","Libido","Hypersexuality","Bio Psychological Treatment","Normality."],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of hypersexuality neurobiology and treatment; no primary data, no systematic methods reported","sample_n":null,"sample_text":"N/A – review article","population":"Not applicable (review)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews hypersexuality as a neuropsychiatric condition, describing its possible brain mechanisms and drug treatments, but it does not present new data or systematic analysis.","clinical_takeaway":"Provides a general overview; clinicians should seek primary studies for evidence‑based treatment decisions.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Broad overview of neurobiological mechanisms","Integrates pharmacological treatment options"],"limitations":["No systematic methodology or risk‑of‑bias assessment","No primary data; conclusions rely on cited studies","Lacks explicit measurement of key confounds"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2174/1389450118666170321144931"}},{"id":7614,"doi":"10.31887/dcns.2017.19.4/dschoettle","pmid":"29398933","pmcid":"PMC5789215","title":"Sexuality in autism: hypersexual and paraphilic behavior in women and men with high-functioning autism spectrum disorder","authors":"Schöttle D, Briken P, Tüscher O, Turner D.","first_author":"Schöttle D","journal":"Dialogues in clinical neuroscience","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Autism","Asperger Syndrome","Paraphilia","Hypersexuality","Hypersexual Disorder","Paraphilic Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5789215","cited_by_count":43,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of high‑functioning autism spectrum disorder adults assessing self‑reported sexual behaviors, hypersexual and paraphilic fantasies.","sample_n":null,"sample_text":"not reported in abstract","population":"Adults with high‑functioning ASD (both sexes); sample size not reported in abstract.","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of adults with high‑functioning autism found they report more hypersexual and paraphilic fantasies than typical adults, especially men. The authors suggest these patterns should inform sexual education and therapy for autistic individuals.","clinical_takeaway":"Be aware that autistic adults, particularly men, may experience heightened sexual fantasies; assess individually rather than assuming pathology.","confidence":0.6,"topic_tags":["sexual_function","neuroscience","csbd"],"strengths":["Addresses understudied topic of sexuality in ASD","Includes both genders","Compares to general‑population literature"],"limitations":["Likely convenience sample, possible selection bias","Unclear whether measurement tools are validated","No control for key confounds (moral incongruence, mental health, masturbation)","Statistical reporting limited to chi‑square, no effect sizes"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":64,"citing_publications":94,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31887/dcns.2017.19.4/dschoettle"}},{"id":7615,"doi":"10.1080/00224499.2023.2176423","pmid":"36826430","pmcid":null,"title":"Examining the Psychometric Properties of the HBI-19 Scale in a Sample of Women with Persistent Genital Arousal Symptoms","authors":"Mulroy ME, Jackowich RA, Pukall CF.","first_author":"Mulroy ME","journal":"Journal of sex research","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Psychometric validation of HBI-19 in women with PGAD/GPD using exploratory factor analysis and reliability indices.","sample_n":null,"sample_text":"Not reported in abstract","population":"Women with Persistent Genital Arousal Disorder/Genito‑Pelvic Dysesthesia (PGAD/GPD)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested whether the Hypersexual Behavior Inventory works well for women with persistent unwanted genital arousal. Factor analysis showed a different structure than originally reported and poor overall fit, suggesting the scale may not capture hypersexual behavior consistently in this group.","clinical_takeaway":"The HBI‑19 may not reliably assess hypersexual behavior in PGAD patients; clinicians should interpret its scores cautiously.","confidence":0.7,"topic_tags":["sexual_function","measurement","gender"],"strengths":["Uses a previously validated hypersexuality scale","Applies rigorous factor‑analytic methods","Considers model‑fit across multiple factor solutions"],"limitations":["No assessment of key confounds (moral incongruence, masturbation, mental health, partner effects)","Sample size and recruitment details unclear","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2023.2176423"}},{"id":7616,"doi":"10.1080/10720162.2017.1388203","pmid":"30174385","pmcid":"PMC6115197","title":"Marijuana Use, Marijuana Expectancies, and Hypersexuality among College Students","authors":"Slavin MN, Kraus SW, Ecker A, Sartor C, Blycker GR, Potenza MN, Dukes K, Foster DW.","first_author":"Slavin MN","journal":"Sexual addiction & compulsivity","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["College Students","Hypersexuality","Marijuana Effect Expectancies"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of university students; hierarchical regression controlling for gender and alcohol use","sample_n":null,"sample_text":"university students (sample size not reported in abstract)","population":"college students (likely convenience sample)","country":"USA (based on author affiliations, not stated in abstract)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among college students, having ever used marijuana and expecting it to boost perception or cognition was linked to higher scores on a hypersexuality questionnaire, while expecting it to reduce tension was linked to lower scores.","clinical_takeaway":"Marijuana use and its perceived effects may relate to hypersexual symptoms, but clinicians should consider many other factors before interpreting this as a causal relationship.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["use of hierarchical regression to adjust for covariates","focus on specific marijuana expectancy domains"],"limitations":["cross‑sectional design limits causal inference","no measurement of key confounds (moral incongruence, masturbation, mental health)","sample size and power not reported"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10720162.2017.1388203"}},{"id":7617,"doi":"10.1080/09540129850124028","pmid":"9828969","pmcid":null,"title":"Transgender HIV prevention: a qualitative needs assessment","authors":"Bockting WO, Robinson BE, Rosser BR.","first_author":"Bockting WO","journal":"AIDS care","year":1998,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":148,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups with selected transgender participants; thematic analysis of needs and risk factors","sample_n":null,"sample_text":"focus groups; exact number not provided in abstract","population":"transgender adults (U.S. Midwest)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Focus groups with transgender adults highlighted how HIV risk intertwines with stigma, identity conflict, and behaviours like condomless sex and needle sharing. Participants called for peer‑led, transgender‑affirming education and health‑provider training.","clinical_takeaway":"HIV‑prevention programs should be tailored to transgender experiences and include peer support, identity affirmation, and safe‑injection resources.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["In‑depth community input via focus groups","Identifies transgender‑specific HIV risk factors","Offers concrete recommendations for education and services"],"limitations":["Convenience sample; not nationally representative","No quantitative data or statistical testing","Findings may not generalise to all transgender populations"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":6,"contrasting":1,"mentioning":201,"citing_publications":276,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540129850124028"}},{"id":7619,"doi":"10.1186/s40345-023-00285-9","pmid":"36735118","pmcid":"PMC9898481","title":"Bipolar disorder and sexuality: a preliminary qualitative pilot study","authors":"Krogh HB, Vinberg M, Mortensen GL, Skakke D, Nielsen D, Giraldi A.","first_author":"Krogh HB","journal":"International journal of bipolar disorders","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Sexual function","Bipolar disorder","Sexual dysfunction","Qualitative Research","Hypersexuality"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9898481","cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"pilot qualitative study with thematic content analysis of 5 participants with bipolar disorder","sample_n":5,"sample_text":"five participants with BD","population":"individuals with bipolar disorder (5 participants, mixed gender)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In interviews with five people who have bipolar disorder, researchers found that sexual desire rises during manic phases and often drops or becomes distressing during depression, affecting relationships and self‑identity.","clinical_takeaway":"Clinicians should monitor changes in sexual drive as possible early signs of mood episode shifts in bipolar patients.","confidence":0.4,"topic_tags":["sexual_function","moral_incongruence","masturbation"],"strengths":["Provides novel qualitative insights into sexuality across mood states in bipolar disorder","Uses thematic analysis to capture participant perspectives"],"limitations":["Very small, non‑representative sample (N=5)","No validated measurement of sexual behavior or distress","No control for confounding factors such as moral incongruence or partner effects"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s40345-023-00285-9"}},{"id":7620,"doi":"10.1093/geront/gnac052","pmid":"35443063","pmcid":null,"title":"Made for Funny Business: Negotiating Age and Sexuality in British Sitcoms","authors":"Röber MF.","first_author":"Röber MF.","journal":"The Gerontologist","year":2023,"pub_types":["Journal Article"],"keywords":["Aging","Gerontology","Sexualities","Later Life Sexuality","Queer Sexuality"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"media analysis of two British sitcoms, thematic interpretation of portrayals of later‑life sexuality.","sample_n":null,"sample_text":"Two sitcom series analyzed; no human sample.","population":"British television sitcoms (Waiting for God, Vicious); no human participants.","country":"United Kingdom (production context)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article examines how two British sitcoms portray older adults as sexually active, using humor to challenge age‑related stereotypes and explore intersections of class, gender, and sexuality.","clinical_takeaway":"None – the study offers cultural insight rather than clinical evidence on sexual health.","confidence":0.7,"topic_tags":["sexual_function","other"],"strengths":["Insightful cultural analysis of age and sexuality in mainstream media","Considers intersectionality of class, gender, and age"],"limitations":["No empirical data on individuals’ sexual behaviour or health","Lacks systematic methodology and validated measurement tools","Findings not generalizable beyond the two sitcoms studied"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/geront/gnac052"}},{"id":7621,"doi":"10.1136/jnnp-2022-330152","pmid":"36627201","pmcid":"PMC10176351","title":"Neuropsychiatric symptoms in genetic frontotemporal dementia: developing a new module for Clinical Rating Scales","authors":"Samra K, Macdougall A, Peakman G, Bouzigues A, Bocchetta M, Cash DM, Greaves CV, Convery RS, van Swieten JC, Jiskoot LC, Seelaar H, Moreno F, Sánchez-Valle R, Laforce R, Graff C, Masellis M, Tartaglia MC, Rowe JB, Borroni B, Finger E, Synofzik M, Galimberti D, Vandenberghe R, de Mendonca A, Butler CR, Gerhard A, Ducharme S, Le Ber I, Tiraboschi P, Santana I, Pasquier F, Levin J, Otto M, Sorbi S, Rohrer JD, Russell LL, Genetic FTD Initiative (GENFI), Genetic FTDInitiative (GENFI).","first_author":"Samra K","journal":"Journal of neurology, neurosurgery, and psychiatry","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Genetics","Neuropsychiatry","Frontotemporal Dementia"],"is_oa":true,"oa_url":"https://jnnp.bmj.com/content/jnnp/early/2023/01/10/jnnp-2022-330152.full.pdf","cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational questionnaire study with principal component analysis on 832 participants (genetic FTD carriers and controls).","sample_n":832,"sample_text":"522 mutation carriers, 310 controls","population":"Genetic frontotemporal dementia mutation carriers and mutation‑negative controls; not a general sexual‑health sample.","country":"International consortium (GENFI); not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers created a new module for dementia rating scales that adds psychosis symptoms (hallucinations, delusions). In a large genetic FTD sample, these symptoms helped identify more severe disease stages, but the work does not directly address pornography or sexual addiction.","clinical_takeaway":"None - the study pertains to dementia rating scales, not to clinical management of pornography or sexual‑health concerns.","confidence":0.8,"topic_tags":["neuroscience","measurement","gender"],"strengths":["Large sample size for scale development","Use of genetic FTD cohort with control group","Systematic PCA to identify symptom clusters"],"limitations":["Focus on dementia population limits relevance to general sexual‑health or pornography issues","No assessment of moral or relational confounds for hypersexuality","Scale not validated outside FTD context"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":46,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/jnnp-2022-330152"}},{"id":7623,"doi":"10.24869/psyd.2023.272","pmid":"37480319","pmcid":null,"title":"HYPERSEXUALITY ASSOCIATED WITH MODAFINIL USE","authors":"Sancaktar M, Demir B, Altındag A.","first_author":"Sancaktar M","journal":"Psychiatria Danubina","year":2023,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.24869/psyd.2023.272"}},{"id":7625,"doi":"10.4103/0028-3886.370452","pmid":"36861582","pmcid":null,"title":"Impulse Control Disorders with Short-term Use of Cabergoline in Macroprolactinomas: A Prospective Study with a Brief Review of Literature","authors":"Sanjan G, Das L, Ahuja CK, Dhandapani S, Sachdeva N, Grover S, Dutta P.","first_author":"Sanjan G","journal":"Neurology India","year":2023,"pub_types":["Review","Journal Article"],"keywords":["Impulse Control Disorders","Pathological Gambling","Cabergoline","Hypersexuality","Macroprolactinomas"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"prospective cohort (n=30 total, 2 groups)","sample_n":30,"sample_text":"15 participants per group, recruited from a single centre","population":"treatment‑naïve macroprolactinoma patients (n=15) vs. non‑functioning pituitary macroadenoma patients (n=15)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small prospective study of 30 patients, short‑term cabergoline treatment for macroprolactinomas did not increase hypersexuality or other impulse‑control problems compared with patients with non‑functioning pituitary tumours.","clinical_takeaway":"Cabergoline for macroprolactinomas appears not to raise short‑term hypersexuality risk, but evidence is limited by tiny sample size.","confidence":0.78,"topic_tags":["sexual_function","csbd"],"strengths":["prospective design","use of multiple validated impulsivity instruments","clinical relevance to dopamine‑agonist side‑effects"],"limitations":["very small sample (n=15 per group)","no adjustment for key confounders (e.g., moral incongruence, masturbation)","absence of effect‑size reporting and multiple‑comparison correction"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0028-3886.370452"}},{"id":7626,"doi":"10.1177/10775595221148425","pmid":"36583251","pmcid":null,"title":"Traumatized Sexuality: Understanding and Predicting Profiles of Sexual Behaviors Using Childhood Abuse and Trauma Measures","authors":"Gewirtz-Meydan A.","first_author":"Gewirtz-Meydan A.","journal":"Child maltreatment","year":2024,"pub_types":["Journal Article"],"keywords":["Posttraumatic Stress Disorder","Childhood Abuse","Hypersexuality","Latent Profile Analysis","Hyposexuality","Traumatized Sex"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Latent profile analysis of sexual behavior in a large community sample (n=806); associations with childhood trauma, PTSD, depression, anxiety, and sexual motives.","sample_n":806,"sample_text":"large non‑clinical sample of men and women (n = 806)","population":"Adults (men and women) from a non‑clinical community sample","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 806 adults, four sexual‑behavior patterns were found, including a hypersexual group that uses more pornography. This group reported higher childhood abuse, PTSD, anxiety and depression than others, suggesting trauma‑related factors shape risky sexual behavior.","clinical_takeaway":"Assess trauma and mood symptoms when working with clients showing hypersexual or compulsive porn use.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large community sample (n > 800)","Comprehensive assessment of trauma and mental‑health covariates","Use of latent profile analysis to identify distinct sexual‑behavior groups"],"limitations":["Cross‑sectional design cannot infer causality","No measurement of moral incongruence or masturbation behavior","Unclear whether sexual‑behavior measures are validated instruments"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10775595221148425"}},{"id":7627,"doi":"10.1007/bf01542481","pmid":"3219064","pmcid":null,"title":"Interruption in the maintenance of compulsive sexual disorder: two case studies","authors":"Konopacki WP, Oei TP.","first_author":"Konopacki WP","journal":"Archives of sexual behavior","year":1988,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"A‑B‑A‑B single‑case experimental design in one of two case studies; no control group; N=2","sample_n":2,"sample_text":"Two case studies (one with repeated A‑B‑A‑B phases)","population":"Adult males with compulsive sexual disorder (treatment‑seeking)","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","self_selected_sample"],"stance":"supports","citation_value":"background","plain_summary":"The authors describe two men with compulsive sexual behaviour who were treated by preventing interruptions to their sexual activities. One case used an A‑B‑A‑B experimental sequence, showing some reduction in compulsive features, suggesting the interruption hypothesis might be useful.","clinical_takeaway":"Evidence is limited to two cases; clinicians should be cautious about applying this interruption technique broadly.","confidence":0.6,"topic_tags":["sexual_function","csbd","treatment"],"strengths":["Innovative single‑case experimental manipulation","Provides preliminary support for a novel hypothesis"],"limitations":["Very small N; no statistical power","No validated measures of compulsivity or distress","No control for key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)"],"rubric_version":"2.0","raw_total":17,"max_possible":60,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":2,"addiction_criteria":2,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542481"}},{"id":7628,"doi":"10.1111/pcn.13511","pmid":"36436204","pmcid":null,"title":"Exploring the underlying mechanisms of drug-induced impulse control disorders: a pharmacovigilance-pharmacodynamic study","authors":"Fusaroli M, Giunchi V, Battini V, Gringeri M, Rimondini R, Menchetti M, Radice S, Pozzi M, Nobile M, Clementi E, De Ponti F, Carnovale C, Raschi E, Poluzzi E.","first_author":"Fusaroli M","journal":"Psychiatry and clinical neurosciences","year":2023,"pub_types":["Journal Article"],"keywords":["Dopamine agonists","Psychopharmacology","Adverse Reactions","Impulse Control","Impulsive Behavior","Conduct Disorders","Disruptive","Drug-related Side Effects"],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Pharmacovigilance analysis of FDA adverse‑event reports (2004‑2021) using disproportionality (Bayesian information component) and univariate regression of drug‑target occupancy.","sample_n":19887,"sample_text":"19,887 reports (3091 aripiprazole, 229 brexpiprazole, 105 pergolide, 2009 pramipexole, etc.)","population":"19,887 spontaneous reports of impulsivity adverse events associated with antipsychotics or dopamine agonists.","country":"United States (FDA database)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined FDA reports of impulsive behaviours linked to dopamine‑acting drugs and antipsychotics. They found that drugs strongly occupying the D3 dopamine receptor (or the 5‑HT1a serotonin receptor) were reported more often for impulsivity, suggesting these receptors may drive drug‑induced impulsive symptoms such as hypersexuality.","clinical_takeaway":"Evidence is suggestive but not definitive; clinicians should be cautious interpreting receptor‑specific effects from spontaneous reports.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large dataset of real‑world adverse‑event reports","Systematic use of pharmacological occupancy data","Statistical confidence intervals reported"],"limitations":["Reliance on spontaneous reports (reporting bias, no validated measures)","Cross‑sectional, cannot establish causality","No control for clinical or demographic confounders"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":33,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/pcn.13511"}},{"id":7629,"doi":"10.1080/00224499.2022.2156449","pmid":"36534478","pmcid":"PMC11214808","title":"An Interpretative Phenomenological Analysis of Black Women's Meaning and Experiences of Sexual Anxiety","authors":"Thorpe S, Hargons CN, Malone N, Iyiewuare P, Jester JK, Stevens-Watkins D.","first_author":"Thorpe S","journal":"Journal of sex research","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Interpretative Phenomenological Analysis (IPA) with 25 premenopausal Black women interviewed in the southern United States; cross‑sectional, purposive sampling.","sample_n":25,"sample_text":"N = 25 premenopausal Black women living in the southern United States","population":"Black women, premenopausal, N=25, United States (Southern region)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Through interviews with 25 Black women, the study identified what causes sexual anxiety, how it feels, and how they cope—highlighting fears of pain, partner unfamiliarity, past trauma, mental‑health worries, and broader social factors.","clinical_takeaway":"Clinicians should assess cultural and trauma‑related factors when addressing sexual anxiety in Black women and consider supportive coping strategies.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["In‑depth, intersectional qualitative insight","Focus on an understudied population","Clear IPA methodological description"],"limitations":["Small, non‑representative convenience sample","No quantitative measurement of anxiety or confounds","Findings not generalizable beyond this group"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2156449"}},{"id":7631,"doi":"10.4103/ijstd.ijstd_27_16","pmid":"30148274","pmcid":"PMC6085926","title":"Hypersexuality - a cause of concern: A case report highlighting the need for psychodermatology liaison","authors":"Dutta E, Naphade NM.","first_author":"Dutta E","journal":"Indian journal of sexually transmitted diseases and AIDS","year":2017,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Hypersexuality","Hypersexual Disorder","Psychodermatology Liaison"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6085926","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report describing hypersexuality and suggesting a psychodermatology liaison clinic","sample_n":1,"sample_text":"single case","population":"1 adult patient with hypersexuality and STD","country":"India","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe one patient with excessive sexual behavior and an STD, labeling the condition as Hypersexual Disorder and recommending a joint dermatology‑psychiatry clinic to screen such patients.","clinical_takeaway":"A single case cannot guide practice; clinicians should use validated criteria before labeling hypersexuality as a disorder.","confidence":0.9,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["highly detailed clinical description","identifies a practical service need (psychodermatology liaison)"],"limitations":["single case, no generalisable data","no validated measurement of hypersexuality","no control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":11,"max_possible":60,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":2,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/ijstd.ijstd_27_16"}},{"id":7632,"doi":"10.1016/j.jsxm.2017.05.004","pmid":"28602666","pmcid":null,"title":"A Cognitive-Behavioral Therapy Group Intervention for Hypersexual Disorder: A Feasibility Study","authors":"Hallberg J, Kaldo V, Arver S, Dhejne C, Öberg KG.","first_author":"Hallberg J","journal":"The journal of sexual medicine","year":2017,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Cognitive-behavioral Therapy","Treatment Satisfaction","Sexual Addiction","Hypersexual Disorder","Client Satisfaction Questionnaire","Hypersexual Disorder Screening Inventory","Hypersexual Disorder: Current Assessment Scale"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"single-arm feasibility trial, N=10 men with hypersexual disorder, pre‑post measurements, no control group","sample_n":10,"sample_text":"Ten men with a diagnosis of HD took part","population":"adult men diagnosed with hypersexual disorder (HD) seeking treatment","country":"Sweden (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"Ten men with hypersexual disorder attended a CBT group program. Their self‑reported hypersexual symptoms decreased, and they reported high satisfaction, but the study lacked a control group and had only ten participants.","clinical_takeaway":"CBT may help hypersexual symptoms, but evidence is preliminary; larger controlled trials are needed.","confidence":0.78,"topic_tags":["treatment","csbd"],"strengths":["First CBT group feasibility study for HD","Multiple follow‑up assessments (3‑ and 6‑month)","High attendance and satisfaction rates"],"limitations":["Very small, non‑randomized sample (N=10)","No control/comparison group","Reliance on self‑report scales that embed distress in the definition"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":1,"design":2,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":82,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2017.05.004"}},{"id":7635,"doi":"10.1556/2006.6.2017.027","pmid":"28467102","pmcid":"PMC5520124","title":"Interpersonal violence, early life adversity, and suicidal behavior in hypersexual men","authors":"Chatzittofis A, Savard J, Arver S, Öberg KG, Hallberg J, Nordström P, Jokinen J.","first_author":"Chatzittofis A","journal":"Journal of behavioral addictions","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Suicidal behavior","Childhood Trauma","Interpersonal Violence","Hypersexual Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5520124","cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control cross‑sectional study of 67 hypersexual men vs 40 healthy volunteers","sample_n":107,"sample_text":"67 hypersexual men, 40 healthy male volunteers","population":"adult males, clinical hypersexual disorder sample","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Men diagnosed with hypersexual disorder reported more childhood and adult interpersonal violence than healthy men, and those who had attempted suicide showed especially high violence exposure and sexual abuse histories.","clinical_takeaway":"Clinicians should assess trauma and violence histories in patients presenting with hypersexuality, as these factors relate to suicide risk.","confidence":0.7,"topic_tags":["sexual_function","csbd","adolescents"],"strengths":["Use of validated trauma and violence questionnaires (CTQ‑SF, KIVS)","Inclusion of a healthy control group","Assessment of suicidal behavior with structured interview"],"limitations":["Cross‑sectional case‑control design limits causal inference","Limited control of key confounds (moral incongruence, masturbation, partner factors)","No power calculation or effect‑size reporting","Hypersexual disorder definition not aligned with current ICD‑11 CSBD criteria"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":2,"contrasting":1,"mentioning":22,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.6.2017.027"}},{"id":7636,"doi":"10.1016/j.copsyc.2022.101512","pmid":"36463589","pmcid":null,"title":"Queer identities in the 21st century: Reclamation and stigma","authors":"Worthen MGF.","first_author":"Worthen MGF.","journal":"Current opinion in psychology","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["stigma","Victimization","Lgbtq","Queer","Reclaim","Slur"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review / commentary without original empirical data; synthesis of existing literature on queer identity reclamation and stigma.","sample_n":null,"sample_text":"Not applicable – no new data collected.","population":"Adults identifying as queer (non‑heterosexual) across various studies; no primary sample reported.","country":"Not specified; draws on studies from multiple countries.","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how ‘queer’ is now often embraced as an identity, but many queer people still face high levels of discrimination, harassment, and violence, and the term is still used as a slur.","clinical_takeaway":"None – the paper offers sociocultural insight, not clinical guidance.","confidence":0.8,"topic_tags":["gender","sexual_function"],"strengths":["Synthesizes recent prevalence data on queer self‑identification.","Highlights both reclamation and ongoing stigma clearly."],"limitations":["No original data; conclusions rely on heterogeneous sources.","Lacks systematic review methodology (e.g., risk‑of‑bias assessment).","No quantitative meta‑analysis; effect size information absent."],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":23,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.copsyc.2022.101512"}},{"id":7637,"doi":"10.3109/00048678309160001","pmid":"6138023","pmcid":null,"title":"Agoraphobia, compulsive behaviours and behaviour completion mechanisms","authors":"McConaghy N.","first_author":"McConaghy N.","journal":"The Australian and New Zealand journal of psychiatry","year":1983,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative/theoretical review without original empirical data; proposes behavioral mechanisms for agoraphobia and compulsive sexual behaviour based on literature review.","sample_n":null,"sample_text":"None – article is a review and theoretical piece.","population":"Not applicable (no primary sample)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews older research and suggests that when activities are delayed, a ‘behaviour completion’ system raises arousal, which may drive agoraphobia and compulsive sexual acts. It argues that desensitization can reduce this arousal, potentially replacing aversive therapy.","clinical_takeaway":"No direct clinical guidance; the paper offers a historic theoretical model, not evidence‑based treatment recommendations.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Integrates concepts from anxiety, compulsive behavior, and sexual therapy.","Proposes a unifying ‘behaviour completion mechanisms’ hypothesis."],"limitations":["No original data; purely speculative.","Outdated aversive therapy reference to homosexuality.","Lacks operational definitions and validated measures."],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/00048678309160001"}},{"id":7638,"doi":"10.1016/j.psyneuen.2017.03.007","pmid":"28319850","pmcid":null,"title":"Methylation of HPA axis related genes in men with hypersexual disorder","authors":"Jokinen J, Boström AE, Chatzittofis A, Ciuculete DM, Öberg KG, Flanagan JN, Arver S, Schiöth HB.","first_author":"Jokinen J","journal":"Psychoneuroendocrinology","year":2017,"pub_types":["Journal Article"],"keywords":["Methylation","Cortisol","TNF-alpha","Epigenetics","HPA-axis","neuroinflammation","Childhood Trauma","Hypersexual Disorder","Dexamethasone Test"],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control study of 67 men with hypersexual disorder vs 39 healthy controls; genome‑wide DNA methylation measured in blood","sample_n":106,"sample_text":"67 HD patients, 39 healthy volunteers","population":"adult men (mean age not provided)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared DNA methylation in blood of men with hypersexual disorder to healthy men and found reduced methylation at a specific CRH gene site, linking it to stress‑response pathways.","clinical_takeaway":"No direct clinical implications; findings are exploratory and need replication before informing treatment.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Genome‑wide methylation array, large CpG coverage","Adjustment for several biological and psychosocial covariates","Multiple testing correction (FDR) applied"],"limitations":["Cross‑sectional case‑control design cannot infer causality","Moral incongruence and masturbation not assessed despite relevance","Diagnostic criteria for hypersexual disorder not based on validated scale"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psyneuen.2017.03.007"}},{"id":7639,"doi":"10.1212/cpj.0000000000200074","pmid":"36380894","pmcid":"PMC9647804","title":"Online vs Face-to-Face Administration of Impulse Control Disorder Questionnaires in Parkinson Disease: Does Method Matter?","authors":"Scott BM, Eisinger RS, Sankar R, Benge JF, Hilsabeck RC, Okun MS, Gunduz A, Bowers D.","first_author":"Scott BM","journal":"Neurology. Clinical practice","year":2022,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Within‑subject comparison of questionnaire administration (face‑to‑face vs online) in 60 Parkinson’s disease patients.","sample_n":60,"sample_text":"60 patients with PD","population":"Mild‑to‑moderate idiopathic Parkinson disease (N=60)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 60 Parkinson’s patients, more impulse‑control symptoms—including hypersexuality—were reported when questionnaires were completed online rather than in person, suggesting social desirability affects reporting.","clinical_takeaway":"Consider anonymous or remote screening for impulse‑control symptoms in Parkinson’s patients to reduce under‑reporting.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Validated ICD and social desirability scales","Within‑subject design controls for individual differences","Relevant finding for clinical screening"],"limitations":["Small convenience sample","No control for moral or relational factors","No effect sizes or pre‑registration reported"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1212/cpj.0000000000200074"}},{"id":7640,"doi":"10.1007/s11154-022-09753-6","pmid":"36125673","pmcid":null,"title":"Impulse control disorders in hyperprolactinemic patients on dopamine agonist therapy","authors":"Hamidianjahromi A, Tritos NA.","first_author":"Hamidianjahromi A","journal":"Reviews in endocrine & metabolic disorders","year":2022,"pub_types":["Review","Journal Article"],"keywords":["Prolactinoma","Dopamine agonists","hyperprolactinemia","Bromocriptine","Impulsivity","Impulse Control Disorders","Cabergoline"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review summarizing case reports and clinical observations of impulse control disorders, including hypersexuality, in patients treated with dopamine agonists for hyperprolactinemia.","sample_n":null,"sample_text":"No original sample; literature synthesis.","population":"patients with hyperprolactinemia receiving dopamine agonist therapy (e.g., bromocriptine, cabergoline); no primary data collected.","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The review warns that dopamine‑agonist drugs used for prolactin‑secreting tumors can trigger impulse‑control problems such as gambling, compulsive shopping and hypersexuality, but the tools used to detect these issues have not been validated in this patient group.","clinical_takeaway":"Clinicians should monitor patients on dopamine agonists for impulse‑control behaviours, including hypersexuality, and consider dose reduction or referral if they appear.","confidence":0.8,"topic_tags":["sexual_function","csbd","neuroscience","other"],"strengths":["Comprehensive overview of DA‑related ICDs","Highlights clinical need for screening"],"limitations":["No primary data; relies on unspecific case reports","Screening tools not validated for this population","Lacks systematic review methodology"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11154-022-09753-6"}},{"id":7642,"doi":"10.2196/33858","pmid":"36083621","pmcid":"PMC9508668","title":"Cognitive Behavioral Therapy Plus a Serious Game as a Complementary Tool for a Patient With Parkinson Disease and Impulse Control Disorder: Case Report","authors":"Mena-Moreno T, Munguía L, Granero R, Lucas I, Sánchez-Gómez A, Cámara A, Compta Y, Valldeoriola F, Fernandez-Aranda F, Sauvaget A, Menchón JM, Jiménez-Murcia S.","first_author":"Mena-Moreno T","journal":"JMIR serious games","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Parkinson disease","Multidisciplinary Approach","Impulse Control Disorder","Hypersexuality","Serious Game"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9508668","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-patient longitudinal pre‑post case report of CBT + serious‑game intervention for hypersexuality in Parkinson’s disease","sample_n":1,"sample_text":"one patient","population":"1 adult patient with Parkinson disease and dopamine‑agonist‑induced hypersexuality","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A man with Parkinson's disease who developed compulsive sexual behavior was treated with cognitive‑behavioral therapy plus a video‑game designed to improve emotion regulation. After the program, he reported less impulsivity, better emotion control, and fewer hypersexual episodes.","clinical_takeaway":"The combined CBT‑plus‑serious‑game approach showed promise for one patient with Parkinson‑related hypersexuality, but evidence is too limited to guide clinical practice.","confidence":0.7,"topic_tags":["sexual_function","csbd","pornography"],"strengths":["Innovative combination of CBT and serious‑game for emotion regulation","Detailed clinical description of a PD‑related hypersexuality case","Pre‑post repeated measures within the same patient"],"limitations":["N=1; no control or comparator group","Unclear whether outcome measures are validated for hypersexuality","No assessment of key confounds (moral incongruence, masturbation, mental health, partner context)","Conclusions may overgeneralize from a single case"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/33858"}},{"id":7643,"doi":"10.1093/ijnp/pyac031","pmid":"35639870","pmcid":"PMC9515127","title":"Impulse Control Disorders by Dopamine Partial Agonists: A Pharmacovigilance-Pharmacodynamic Assessment Through the FDA Adverse Event Reporting System","authors":"Fusaroli M, Raschi E, Giunchi V, Menchetti M, Rimondini Giorgini R, De Ponti F, Poluzzi E.","first_author":"Fusaroli M","journal":"The international journal of neuropsychopharmacology","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Serotonin","Receptor","Aripiprazole","Impulsive Behavior","5-ht1a","Brexpiprazole","Cariprazine"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9515127","cited_by_count":28,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Secondary analysis of FDA adverse‑event reporting system; disproportionality and Bradford‑Hill assessment; no prospective or experimental component.","sample_n":2708,"sample_text":"2708 reports of TGA‑related impulse‑control disorders identified in FAERS.","population":"Human reports of adverse events submitted to FDA (up to Dec 2020); n≈2708 TGA‑related ICD reports.","country":"United States (FAERS database)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational","advocacy_or_coi"],"stance":"neutral","citation_value":"useful","plain_summary":"Analysis of FDA adverse‑event reports suggests that certain third‑generation antipsychotics, especially aripiprazole, are linked to impulse‑control problems including hypersexuality, but the data come from spontaneous reports and lack control for psychological or moral factors.","clinical_takeaway":"Clinicians should be aware of possible hypersexuality side‑effects of these drugs, but evidence is limited to case reports and does not establish causality.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large number of spontaneous reports","Use of established pharmacovigilance methods (disproportionality, Bradford‑Hill)","Identification of a novel signal for lurasidone"],"limitations":["Reliance on voluntary reports; prone to reporting bias","No control for key psychosocial confounds (e.g., moral incongruence, mental health)","Causal language exceeds evidence from observational database"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":32,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/ijnp/pyac031"}},{"id":7644,"doi":"10.1055/s-0042-1756624","pmid":"36398179","pmcid":"PMC9665980","title":"Perioperative Considerations in a Patient with Kleine-Levin Syndrome Undergoing a Neurosurgical Procedure under General Anesthesia","authors":"Rajaleelan W, Chowdhury T, Moga R, Todaro C, Zadeh G, Wang J, Singh M.","first_author":"Rajaleelan W","journal":"Asian journal of neurosurgery","year":2022,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Sleep disorders","Narcolepsy","Kleine–levin Syndrome"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9665980","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report describing anesthetic management of a young woman with Kleine‑Levin syndrome undergoing neurosurgery; no control group, no systematic data collection","sample_n":1,"sample_text":"single case","population":"young female patient with KLS (n=1)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A rare disorder called Kleine‑Levin syndrome can cause extreme sleepiness and hypersexuality. This report describes how doctors managed anesthesia for a young woman with the condition undergoing brain surgery, highlighting potential challenges such as delayed waking and postoperative sleep problems.","clinical_takeaway":"Anesthesiologists should anticipate altered sleep patterns and possible hypersexuality‑related issues when caring for patients with Kleine‑Levin syndrome.","confidence":0.9,"topic_tags":["sexual_function","neuroscience"],"strengths":["detailed clinical description of a rare disorder","highly specific anesthetic considerations"],"limitations":["single case, no generalisable data","no systematic measurement of sexual behavior or related constructs","no control or comparison group"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-0042-1756624"}},{"id":7645,"doi":null,"pmid":"10804713","pmcid":null,"title":"[Sex addiction diagnosis. When libido becomes a burden. Interview by Dr. Beate Schumacher]","authors":"Mäulen B.","first_author":"Mäulen B.","journal":"MMW Fortschritte der Medizin","year":2000,"pub_types":["Interview"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":7646,"doi":"10.4081/mi.2016.6546","pmid":"27994833","pmcid":"PMC5136748","title":"A Case of Mania Presenting with Hypersexual Behavior and Gender Dysphoria that Resolved with Valproic Acid","authors":"Heare MR, Barsky M, Faziola LR.","first_author":"Heare MR","journal":"Mental illness","year":2016,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Psychiatry","Mania","Gender Dysphoria","Hypersexual"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5136748","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single clinical case of a young man with mania, hypersexuality and gender dysphoria; treatment with valproic acid reported","sample_n":1,"sample_text":"one patient","population":"young homosexual male with mania and amphetamine use","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 2016 case report describes a young man with a manic episode who showed excessive sexual activity and a sudden wish to be a woman. Both symptoms disappeared after adding the mood stabilizer valproic acid to his treatment.","clinical_takeaway":"In mania, hypersexuality and gender dysphoria may improve with mood‑stabilizing medication, but evidence is limited to a single case.","confidence":0.4,"topic_tags":["sexual_function","csbd","gender","moral_incongruence"],"strengths":["detailed clinical description","adds to sparse literature on mania‑related hypersexuality"],"limitations":["single case, no control","no validated measures of hypersexuality","cannot infer causality of treatment"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4081/mi.2016.6546"}},{"id":7647,"doi":null,"pmid":"7864578","pmcid":null,"title":"[Drug modulation of libido and sexual activity. Behavior effect of GnRH analog in man]","authors":"Thibaut F, Cordier B, Kuhn JM.","first_author":"Thibaut F","journal":"Annales d'endocrinologie","year":1994,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-series of 6 hypersexual men treated with monthly 3.75 mg triptoreline; outcomes described qualitatively","sample_n":6,"sample_text":"six patients with aggressive hypersexual behaviour","population":"aggressive hypersexual men (n≈6)","country":"France (presumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In six men with aggressive, high‑frequency sexual urges, monthly injections of a GnRH analogue sharply lowered testosterone and appeared to suppress the problematic behaviour, but the report lacks systematic measurements or comparison groups.","clinical_takeaway":"Evidence is anecdotal; hormonal castration is not a proven treatment for hypersexuality and carries significant risks.","confidence":0.4,"topic_tags":["sexual_function","csbd","treatment","neuroscience"],"strengths":["clinical observation of hormonal castration effect","use of reversible GnRH analogue"],"limitations":["tiny, non‑randomised case series","no validated measures of hypersexuality or addiction","no control for confounds (moral, mental health, etc.)"],"rubric_version":"2.0","raw_total":13,"max_possible":60,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":2,"interpretation":3}},"scite":null},{"id":7648,"doi":null,"pmid":"3425083","pmcid":null,"title":"[Psychopathology and clinical picture of impulsive tendencies during schizophrenia]","authors":"Kyshtobaeva ZSh.","first_author":"Kyshtobaeva ZSh.","journal":"Zhurnal nevropatologii i psikhiatrii imeni S.S. Korsakova (Moscow, Russia : 1952)","year":1987,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"rus","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"observational case series of 60 schizophrenia patients with compulsive symptoms, no control group","sample_n":60,"sample_text":"60 patients","population":"60 patients with attack‑form schizophrenia, mixed gender, age 14‑30 onset of compulsions","country":"Russia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article describes 60 people with a form of schizophrenia who also showed compulsive urges such as stealing, traveling, self‑harm, violence, and sexual preoccupations. These compulsions usually began between ages 14 and 30 and often appeared alongside depressive or dysphoric moods.","clinical_takeaway":"None - the study provides descriptive clinical observations without actionable guidance for treatment.","confidence":0.65,"topic_tags":["sexual_function"],"strengths":["Focused clinical description of a rare syndrome","Reasonable sample size for a case series"],"limitations":["No validated scales for compulsive sexual behavior","No control or comparison group","Confounding variables (e.g., mood, trauma) not assessed"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":7649,"doi":"10.1080/07448481.2022.2103704","pmid":"35930459","pmcid":null,"title":"Black heterosexual college men's masculinity dimensions, protective behavioral intentions, and sexual risk behaviors","authors":"Ware S, Erausquin JT, Tanner AE, Dyson YD, Dyson YD.","first_author":"Ware S","journal":"Journal of American college health : J of ACH","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Masculinity","Sexual Risk","Protective Behaviors","Anti-blackness","Black College Men"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 127 Black heterosexual college men assessing masculinity dimensions, protective intentions and sexual risk behaviors","sample_n":127,"sample_text":"127 participants","population":"Black heterosexual college men (N=127) from HBCUs and a minority‑serving institution in the Southern US","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 127 Black college men, certain masculinity traits (respect/toughness and anti‑femininity/hypersexuality) were linked to how likely they were to intend protective sexual behaviors, and anti‑femininity/hypersexuality also related to higher sexual risk. Awareness of anti‑Blackness influenced these relationships, suggesting structural factors affect HIV vulnerability.","clinical_takeaway":"Interventions that address masculinity norms and anti‑Blackness may help reduce sexual risk among Black college men.","confidence":0.8,"topic_tags":["masturbation","sexual_function"],"strengths":["Focus on understudied population (Black college men)","Considers structural factor (anti‑Blackness)","Examines multiple masculinity dimensions"],"limitations":["Cross‑sectional, cannot infer causality","Limited reporting on measurement validation","Potential unmeasured confounds (e.g., mental health, partner context)","Pilot sample size modest for multivariate analysis"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/07448481.2022.2103704"}},{"id":7650,"doi":"10.9758/cpn.2016.14.4.402","pmid":"27776397","pmcid":"PMC5083941","title":"Modafinil Dependence and Hypersexuality: A Case Report and Review of the Evidence","authors":"Swapnajeet S, Bn S, Gourav G.","first_author":"Swapnajeet S","journal":"Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology","year":2016,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Drug dependence","Increased Libido","Modafinil"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5083941","cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with modafinil dependence and hypersexuality; includes brief literature review","sample_n":1,"sample_text":"single case","population":"35‑year‑old male with bipolar disorder in remission","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 35‑year‑old man with bipolar disorder developed a strong urge to use large amounts of modafinil and subsequently experienced increased sexual desire. The authors suggest that high‑dose modafinil may rarely trigger hypersexuality, urging clinicians to monitor such side effects.","clinical_takeaway":"When prescribing high‑dose modafinil, watch for emerging hypersexuality and dependence.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Detailed clinical description","Highlights a rarely reported side‑effect"],"limitations":["Single case limits generalisability","No validated measures of hypersexuality or dependence","No systematic assessment of confounders"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.9758/cpn.2016.14.4.402"}},{"id":7651,"doi":"10.1007/s10508-016-0873-5","pmid":"27752854","pmcid":null,"title":"Relations Between Self-Reported Adverse Events in Childhood and Hypersexuality in Adult Male Sexual Offenders","authors":"Kingston DA, Graham FJ, Knight RA.","first_author":"Kingston DA","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Emotion Regulation","Sexual Addiction","Hypersexuality","Sex Offender"],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional assessment of 529 adult male sexual offenders using self‑report questionnaires","sample_n":529,"sample_text":"Convenience sample of incarcerated or forensic sexual offenders","population":"Adult male sexual offenders (N=529)","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 529 male sex offenders, childhood psychological abuse—especially by fathers—and a higher number of abuse types were linked to stronger self‑reported urges and thoughts about sex, suggesting that early trauma may contribute to hypersexual behavior.","clinical_takeaway":"Assess histories of childhood abuse when evaluating hypersexuality in forensic settings; trauma may underlie elevated sexual urges.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample of a high‑risk population","Use of established abuse scales","Statistical modelling of cumulative abuse effects"],"limitations":["Cross‑sectional; cannot infer causality","Hypersexuality measured with a single self‑report instrument, unclear separation of frequency vs distress","No control for moral incongruence, mental health, or partner factors","Findings limited to sexual offenders, not general population"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":22,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0873-5"}},{"id":7653,"doi":"10.1016/0010-440x(91)90069-o","pmid":"2001620","pmcid":null,"title":"Initial stages of validation by penile volume assessment that sexual orientation is distributed dimensionally","authors":"McConaghy N, Blaszczynski A.","first_author":"McConaghy N","journal":"Comprehensive psychiatry","year":1991,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional study of 20 treatment‑seeking men; questionnaire ratings of heterosexual/homosexual feelings correlated with penile volume responses to brief erotic clips.","sample_n":20,"sample_text":"Twenty men seeking treatment for compulsive sexual behaviours","population":"Men (n=20) seeking treatment for compulsive sexual behaviours","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 20 men receiving therapy for compulsive sexual behaviour, scores on a self‑made questionnaire about heterosexual and homosexual feelings were linked to how much their penis swelled while watching short clips of nude men or women, suggesting the questionnaire may reflect real physiological responses.","clinical_takeaway":"Findings are preliminary; the questionnaire is not yet a reliable clinical tool for assessing sexual orientation or compulsive sexual behaviour.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Physiological measure (penile volume) added to self‑report","Direct test of dimensionality hypothesis"],"limitations":["Very small, treatment‑seeking convenience sample","Questionnaire not validated","No control for potential confounds (mood, arousal baseline, etc.)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0010-440x(91)90069-o"}},{"id":7654,"doi":"10.1007/s12020-016-1088-1","pmid":"27601019","pmcid":null,"title":"Dopa-testotoxicosis: disruptive hypersexuality in hypogonadal men with prolactinomas treated with dopamine agonists","authors":"De Sousa SM, Chapman IM, Falhammar H, Torpy DJ.","first_author":"De Sousa SM","journal":"Endocrine","year":2017,"pub_types":["Journal Article"],"keywords":["Prolactinoma","Dopamine agonists","Impulse Control Disorders","Hypersexuality"],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"retrospective cohort of 8 men with prolactinomas","sample_n":8,"sample_text":"multicenter retrospective cohort of eight men","population":"adult hypogonadal men with prolactinomas treated with dopamine agonists","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Eight men with pituitary tumors treated with dopamine‑boosting drugs developed disruptive hypersexual behaviour. The authors call this side effect \"dopa‑testotoxicosis\" and suggest stopping the medication or surgery.","clinical_takeaway":"In men on dopamine agonists for prolactinomas, monitor for sudden hypersexuality and consider medication adjustment.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["multicenter data collection","focus on a rare clinical phenomenon","identifies severe functional consequences"],"limitations":["very small sample (n=8)","no validated measure of hypersexuality","no control/comparator group","limited control of confounding variables"],"rubric_version":"2.0","raw_total":15,"max_possible":60,"pct_score":25,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":2,"interpretation":4}},"scite":{"supporting":4,"contrasting":1,"mentioning":54,"citing_publications":72,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12020-016-1088-1"}},{"id":7655,"doi":"10.1016/j.jaclp.2022.03.002","pmid":"35868835","pmcid":"PMC9296144","title":"COVID-19-Induced Aggression and Hypersexuality in an Adolescent Patient","authors":"Parsa S, Pliszka A, Portley R.","first_author":"Parsa S","journal":"Journal of the Academy of Consultation-Liaison Psychiatry","year":2022,"pub_types":["Letter"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9296144","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jaclp.2022.03.002"}},{"id":7656,"doi":"10.1111/ggi.12854","pmid":"27489168","pmcid":null,"title":"Inappropriate behaviors and hypersexuality in individuals with dementia: An overview of a neglected issue","authors":"Torrisi M, Cacciola A, Marra A, De Luca R, Bramanti P, Calabrò RS.","first_author":"Torrisi M","journal":"Geriatrics & gerontology international","year":2017,"pub_types":["Review","Journal Article"],"keywords":["Dementia","Behavioral And Psychological Symptoms Of Dementia","Inappropriate Sexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review","sample_n":null,"sample_text":"Not applicable – review of existing literature","population":"individuals with dementia (no primary data)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review describes how inappropriate sexual behavior and hypersexuality can appear in people with dementia, why they may occur, and what pharmacological and non‑pharmacological strategies might help patients and caregivers.","clinical_takeaway":"Clinicians should screen for and address inappropriate sexual behavior in dementia, using tailored non‑pharmacological and medication approaches.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Broad overview of a neglected clinical issue","Integrates neurological, psychological, and social perspectives","Practical focus on assessment and management"],"limitations":["Narrative review – no systematic search or bias assessment","No empirical data presented","Lacks quantitative synthesis or effect size reporting"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":35,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/ggi.12854"}},{"id":7657,"doi":"10.1007/s10072-022-06185-7","pmid":"35672480","pmcid":"PMC9385756","title":"Sex influences clinical phenotype in frontotemporal dementia","authors":"Pengo M, Alberici A, Libri I, Benussi A, Gadola Y, Ashton NJ, Zetterberg H, Blennow K, Borroni B.","first_author":"Pengo M","journal":"Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Gender","Dementia","Sex differences","Frontotemporal Dementia"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9385756","cited_by_count":41,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"observational cohort of 531 FTD patients, sex comparisons of clinical phenotype","sample_n":531,"sample_text":"531 FTD patients","population":"patients with frontotemporal dementia, recruited consecutively at a single centre","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 531 frontotemporal dementia patients, men were more likely to show behavioural symptoms, including hypersexuality, while women performed worse on several cognitive tests. Survival and a blood marker of neurodegeneration did not differ by sex.","clinical_takeaway":"Sex influences behavioural and cognitive presentation in FTD but not survival; clinicians should consider sex when assessing symptoms like hypersexuality.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Large sample size for a rare disease","Use of validated behavioural inventory (FBI)","Systematic sex comparison across many clinical domains"],"limitations":["Cross‑sectional; cannot infer causal role of sex","No adjustment for many potential confounders (e.g., hormonal status, comorbidities)","Multiple comparisons with limited correction"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":1,"mentioning":55,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10072-022-06185-7"}},{"id":7660,"doi":"10.4103/0974-1208.192074","pmid":"27803590","pmcid":"PMC5070404","title":"Successful use of transcranial magnetic stimulation in difficult to treat hypersexual disorder","authors":"Tripathi A, Singh A, Singh H, Kar SK.","first_author":"Tripathi A","journal":"Journal of human reproductive sciences","year":2016,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Repetitive transcranial magnetic stimulation","Supplementary Motor Area","Hypersexual Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5070404","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report of refractory hypersexual disorder treated with inhibitory rTMS over supplementary motor area","sample_n":1,"sample_text":"n=1","population":"1 adult with hypersexual disorder (excessive sexual drive) who failed conventional pharmacotherapy","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"supports","citation_value":"background","plain_summary":"A 2016 case report describes one patient with hypersexual disorder who did not improve on medication but showed symptom reduction after inhibitory rTMS was applied to the brain's supplementary motor area.","clinical_takeaway":"Evidence is insufficient to recommend rTMS for hypersexual disorder; findings are anecdotal.","confidence":0.4,"topic_tags":["treatment","relationships","sexual_function"],"strengths":["Innovative use of rTMS for a hard‑to‑treat case","Clear clinical description of treatment course"],"limitations":["Single‑case design, no control","No validated measures of hypersexuality or outcome","No assessment of key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":12,"max_possible":60,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":3,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0974-1208.192074"}},{"id":7661,"doi":"10.3390/clockssleep4020025","pmid":"35735605","pmcid":"PMC9221874","title":"Neuroimaging in the Rare Sleep Disorder of Kleine-Levin Syndrome: A Systematic Review","authors":"Ortiz JF, Argudo JM, Yépez M, Moncayo JA, Tamton H, Aguirre AS, Patel G, Sen M, Mistry A, Yuen R, Eissa-Garces A, Ojeda D, Ruxmohan S.","first_author":"Ortiz JF","journal":"Clocks & sleep","year":2022,"pub_types":["review-article","Review","Journal Article"],"keywords":["fMRI","SPECT","Hypersexuality","Apathy","Derealization","Kleine–levin Syndrome","P.e.t."],"is_oa":true,"oa_url":"https://www.mdpi.com/2624-5175/4/2/25/pdf?version=1654506705","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 10 observational neuroimaging studies of Kleine‑Levin syndrome, following MOOSE and PRISMA guidelines.","sample_n":null,"sample_text":"10 studies included; individual study sizes not reported in the abstract.","population":"Patients with Kleine‑Levin syndrome (KLS) reported in 10 human studies published in English over the past 20 years.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of ten studies found that people with Kleine‑Levin syndrome show abnormal activity in brain regions such as the hypothalamus and thalamus during episodes of extreme sleepiness, and these patterns change when they are symptom‑free.","clinical_takeaway":"Neuroimaging abnormalities in KLS correlate with symptoms like hypersexuality, but imaging findings vary and should be interpreted cautiously.","confidence":0.8,"topic_tags":["neuroscience"],"strengths":["Follows PRISMA/MOOSE reporting guidelines","Covers multiple imaging modalities","Identifies consistent hypothalamic/thalamic alterations"],"limitations":["Small number of primary studies; likely heterogeneous","No quantitative meta‑analysis or assessment of study quality","Limited detail on sample sizes and imaging parameters"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":5,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/clockssleep4020025"}},{"id":7662,"doi":"10.3389/fpsyt.2022.844718","pmid":"35693961","pmcid":"PMC9178067","title":"Binge Eating and Compulsive Buying During Cabergoline Treatment for Prolactinoma: A Case Report","authors":"Correa E Castro AC, de Araujo AA, Botelho MC, Nascimento JB, de Souza RM, Gadelha MR, Nardi AE, Violante AHD.","first_author":"Correa E Castro AC","journal":"Frontiers in psychiatry","year":2022,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Prolactinoma","Compulsive Behavior","Case Report","Impulsivity","Cabergoline"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2022.844718/pdf","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report describing compulsive buying, binge eating and hypersexuality after cabergoline treatment","sample_n":1,"sample_text":"case report; n=1","population":"47‑year‑old Brazilian woman with prolactinoma, treated with cabergoline for four years","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 47‑year‑old woman with a pituitary tumour developed compulsive buying, binge eating and increased sexual urges after four years of treatment with the dopamine‑activating drug cabergoline. Standard questionnaires showed high impulsivity and compulsive‑behaviour scores.","clinical_takeaway":"Clinicians should monitor for impulsive and compulsive behaviours, including hypersexuality, in patients receiving long‑term cabergoline.","confidence":0.8,"topic_tags":["csbd","sexual_function","pornography","moral_incongruence","treatment","neuroscience"],"strengths":["Use of validated scales for compulsive buying, binge eating and impulsivity","Clear clinical description of side‑effects of cabergoline"],"limitations":["Single case; no control or comparison group","No assessment of sexual‑behaviour specifics (e.g., pornography, masturbation)","No measurement of key confounds such as moral incongruence or mental‑health covariates"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2022.844718"}},{"id":7664,"doi":"10.3389/fpsyt.2022.868278","pmid":"35651826","pmcid":"PMC9148957","title":"Sexuality in Adults With ADHD: Results of an Online Survey","authors":"Hertz PG, Turner D, Barra S, Biedermann L, Retz-Junginger P, Schöttle D, Retz W.","first_author":"Hertz PG","journal":"Frontiers in psychiatry","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","ADHD","Sexual dysfunction","Impulsivity","Hypersexuality","Sexual Risk-taking","Emotional Dysregulation","Oppositional Symptoms"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2022.868278/pdf","cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online anonymous survey comparing self‑reported sexual behaviors of adults with and without ADHD; n≈215 total (139 ADHD, 76 control)","sample_n":215,"sample_text":"206 individuals completed the survey (139 with ADHD, 76 without)","population":"adults (online community sample), self‑selected, ADHD diagnosed or self‑reported","country":"unspecified (online, likely international)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2022 online survey of 206 adults found that people with ADHD report more hypersexual behaviors than those without ADHD, while risky sex and sexual problems were similar across groups.","clinical_takeaway":"Clinicians working with ADHD patients should ask about hypersexual behaviors as part of routine sexual‑health assessment.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Relatively large total sample for an online survey","Comparison group without ADHD included","Considers gender‑specific associations"],"limitations":["Cross‑sectional, cannot infer causality","Self‑report measures likely unvalidated","Key confounds (moral incongruence, masturbation, partner context) not assessed","Convenience online sample may limit generalisability"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":6,"contrasting":1,"mentioning":44,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2022.868278"}},{"id":7665,"doi":null,"pmid":"7457035","pmcid":null,"title":"Behavior completion mechanisms rather than primary drives maintain behavioral patterns","authors":"McConaghy N.","first_author":"McConaghy N.","journal":"Activitas nervosa superior","year":1980,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"Not applicable – no empirical sample","population":"humans (general)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The paper argues that compulsive sexual actions are driven more by 'behavior completion' mechanisms than by basic sexual urges, suggesting aversive therapy lessens arousal linked to these mechanisms.","clinical_takeaway":"No direct clinical guidance; the claims are theoretical and lack supporting data.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Raises theoretical integration of behavioral mechanisms","Covers multiple anxiety-related disorders"],"limitations":["No empirical data presented","Operates on outdated aversive therapy premise","Lacks measurement of key sexual‑behavior confounds"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":7666,"doi":"10.1016/bs.irn.2016.04.002","pmid":"27503448","pmcid":null,"title":"Neurobiological Basis of Hypersexuality","authors":"Kühn S, Gallinat J.","first_author":"Kühn S","journal":"International review of neurobiology","year":2016,"pub_types":["Journal Article"],"keywords":["Compulsive Sexual Behavior","Hypersexuality","Sex Addiction","Excessive Nonparaphilic Sexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods or risk‑of‑bias assessment","sample_n":null,"sample_text":"None – review article","population":"none (review)","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article reviews existing brain‑imaging, lesion, genetic and drug studies linking regions such as the frontal lobe, amygdala and reward circuitry to hypersexual behaviour, suggesting a neurobiological basis but noting the evidence is still limited.","clinical_takeaway":"Current neurobiological evidence for hypersexuality is preliminary; clinicians should treat it cautiously and consider non‑neurological factors.","confidence":0.8,"topic_tags":["neuroscience","sexual_function","csbd"],"strengths":["Broad coverage of neurobiological literature","Integrates animal, lesion, and pharmacological studies","Identifies consistent brain regions across studies"],"limitations":["No systematic search or bias assessment","Relies on heterogeneous primary studies","Does not distinguish distress from moral disapproval","No original data; conclusions are speculative"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":56,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/bs.irn.2016.04.002"}},{"id":7667,"doi":"10.1037//0735-7044.104.1.177","pmid":"2156520","pmcid":null,"title":"Reinforcing properties of ejaculation in the male rat: role of opioids and dopamine","authors":"Agmo A, Berenfeld R.","first_author":"Agmo A","journal":"Behavioral neuroscience","year":1990,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":90,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Experimental animal study using conditioned place preference to assess reward; pharmacological manipulation with naloxone and pimozide; no human participants.","sample_n":null,"sample_text":"Not reported in abstract","population":"Male rats (inbred strains)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In male rats, a single ejaculation creates a rewarding experience that can be measured by a place‑preference test. Blocking opioid receptors stopped this reward and caused aversion, while dopamine blockade had little effect, suggesting opioids play a key role in ejaculation reward.","clinical_takeaway":"None – findings are from animal research and cannot be directly applied to human clinical practice.","confidence":0.6,"topic_tags":["sexual_function","neuroscience","religiosity"],"strengths":["Controlled pharmacological manipulation","Established behavioral paradigm (CPP)","Clear mechanistic hypothesis"],"limitations":["No sample size reported","Animal model limits direct relevance to human sexuality","No pre‑registration or power analysis"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":223,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0735-7044.104.1.177"}},{"id":7668,"doi":"10.7759/cureus.24865","pmid":"35698716","pmcid":"PMC9184178","title":"Testosterone-Mediated Aggression in Angelman Syndrome Treated With Leuprolide and Orchiectomy","authors":"Anderson DJ, Porwal MH, Sandlow JI.","first_author":"Anderson DJ","journal":"Cureus","year":2022,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["orchiectomy","Aggression","Angelman Syndrome","Hypersexuality","Leuprolide"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9184178","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single Angelman syndrome patient treated with leuprolide and orchiectomy for aggression and hypersexuality","sample_n":1,"sample_text":"single case","population":"1 patient with Angelman syndrome, likely male, age not specified","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A single patient with Angelman syndrome who showed aggression and hypersexual behaviour was treated with the hormone blocker leuprolide for nine years, followed by surgical removal of the testicles, which appeared to reduce the problematic behaviour.","clinical_takeaway":"Evidence is limited to one case; orchiectomy should not be considered a standard treatment for hypersexuality in Angelman syndrome.","confidence":0.7,"topic_tags":["sexual_function","csbd","treatment"],"strengths":["Rare clinical observation","Long‑term follow‑up of leuprolide treatment"],"limitations":["Single case, no validated outcome measures","No control or comparison group","No assessment of confounding factors (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.24865"}},{"id":7669,"doi":"10.1089/brain.2020.0868.correx","pmid":"35500073","pmcid":null,"title":"<i>Correction to:</i> Aberrant Salient and Corticolimbic Connectivity in Hypersexual Parkinson's Disease, by Mata-Marín, et al. <i>Brain Connect</i> 2021;11(8):639-650; doi: 10.1089/brain.2020.0868","authors":null,"first_author":null,"journal":"Brain connectivity","year":2022,"pub_types":["Published Erratum"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/brain.2020.0868.correx"}},{"id":7675,"doi":"10.1016/bs.irn.2021.12.007","pmid":"35397786","pmcid":null,"title":"The impact of nonmotor symptom burden on sexual function","authors":"Staunton J, Jost S, Bronner G, Chaudhuri KR.","first_author":"Staunton J","journal":"International review of neurobiology","year":2022,"pub_types":["Journal Article"],"keywords":["Cognition","Sleep","Depression","Pain","Sexual dysfunction","Libido","Impulse Control Disorder","Nonmotor Symptoms","Urinary Dysfunction","Ability To Have Sex"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"Not applicable – narrative review","population":"people with Parkinson’s disease","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how non‑motor symptoms of Parkinson’s disease, such as cognitive problems, depression, pain and hypersexuality, relate to reduced sexual desire and performance, and how these issues affect quality of life.","clinical_takeaway":"Clinicians should assess sexual dysfunction and hypersexuality as part of Parkinson’s management, recognizing their impact on quality of life.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Identifies sexual dysfunction as important non‑motor symptom in Parkinson’s","Highlights hypersexuality as an impulse‑control issue"],"limitations":["No primary data; narrative overview only","No systematic methodology or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/bs.irn.2021.12.007"}},{"id":7676,"doi":"10.1016/bs.irn.2021.12.008","pmid":"35397783","pmcid":null,"title":"Impulse control disorders, dopamine dysregulation syndrome and sex dysfunction in Parkinson's disease","authors":"Irincu L, Ivan I, Diaconu Ș, Falup-Pecurariu C.","first_author":"Irincu L","journal":"International review of neurobiology","year":2022,"pub_types":["Journal Article"],"keywords":["Parkinson's Disease","Impulse Control Disorders","Hypersexuality","Dopamine Dysregulation Syndrome"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of hypersexuality in Parkinson's disease; no primary data collected","sample_n":null,"sample_text":"Not applicable – review article","population":"patients with Parkinson's disease on dopamine agonists (no sample size reported)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how dopamine‑activating medicines for Parkinson’s disease can trigger hypersexuality, an excessive and sometimes distressing sexual drive, discussing prevalence, possible brain mechanisms, and management challenges.","clinical_takeaway":"Clinicians should monitor Parkinson’s patients on dopamine agonists for hypersexuality and consider dosage adjustments or multidisciplinary support.","confidence":0.6,"topic_tags":["sexual_function","neuroscience","treatment"],"strengths":["Comprehensive summary of hypersexuality in PD","Highlights lack of standardized diagnostic tools"],"limitations":["No original empirical data","No systematic review methodology reported","Potential bias in interpretation of prevalence rates"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/bs.irn.2021.12.008"}},{"id":7677,"doi":"10.1016/j.parkreldis.2016.02.017","pmid":"26923525","pmcid":null,"title":"The prevalence and clinical characteristics of hypersexuality in patients with Parkinson's disease following dopaminergic therapy: A systematic literature review","authors":"Nakum S, Cavanna AE.","first_author":"Nakum S","journal":"Parkinsonism & related disorders","year":2016,"pub_types":["Systematic Review","Journal Article"],"keywords":["Dopamine agonists","Levodopa","Parkinson's Disease","Impulse Control Disorders","Hypersexuality","Dopamine Replacement Therapy"],"is_oa":false,"oa_url":"http://pure-oai.bham.ac.uk/ws/files/27535107/Nakum_et_al_The_prevalence_and_clinical_Parkinsonism_and_Related_Disorders_2016.pdf","cited_by_count":50,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic literature review of large‑scale epidemiological studies (n>250) on hypersexuality in Parkinson’s disease patients receiving dopaminergic therapy.","sample_n":null,"sample_text":"10 studies, each with n = 268–3090","population":"Patients with Parkinson’s disease on dopamine replacement therapy","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of ten large studies found that about 2.7% of Parkinson’s patients on dopamine drugs develop hypersexuality, rising to 7.4% among those on dopamine agonists. Men, younger patients, and those with higher drug doses are most at risk.","clinical_takeaway":"Screen Parkinson’s patients, especially younger men on high‑dose dopamine agonists, for hypersexuality to intervene early.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Systematic review following PRISMA guidelines","Large‑scale studies (n>250) included","Clear prevalence estimate for hypersexuality in PD"],"limitations":["Definition of hypersexuality not detailed; likely heterogeneous across studies","No meta‑analysis or formal risk‑of‑bias assessment reported","Potential lack of control for psychiatric comorbidities"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":1,"mentioning":60,"citing_publications":72,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2016.02.017"}},{"id":7678,"doi":"10.1155/2022/1503167","pmid":"35371432","pmcid":"PMC8967585","title":"Validation of the Japanese Version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS)","authors":"Takahashi M, Koh J, Yorozu S, Kajimoto Y, Nakayama Y, Sakata M, Yasui M, Hiwatani Y, Weintraub D, Ito H.","first_author":"Takahashi M","journal":"Parkinson's disease","year":2022,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8967585","cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study of a questionnaire with 161 Parkinson's patients; ROC analysis, reliability testing; no longitudinal or experimental component.","sample_n":161,"sample_text":"161 PD patients","population":"161 Parkinson's disease patients from two institutions, identified by continuous sampling; subset for test‑retest reliability.","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated and validated a Japanese questionnaire that measures impulsive and compulsive behaviors, including hypersexuality, in people with Parkinson's disease. It showed good accuracy and reliability compared with clinical interviews.","clinical_takeaway":"The Japanese QUIP‑RS can reliably screen for hypersexuality and other impulsive behaviors in Parkinson's patients.","confidence":0.8,"topic_tags":["sexual_function","measurement","neuroscience","csbd"],"strengths":["Validated translation process with back‑translation and author verification","Adequate sample size for psychometric validation","Comprehensive reliability (inter‑institutional, test‑retest) and ROC analysis"],"limitations":["Cross‑sectional design; no test of predictive validity","No assessment of potential confounders such as mood or medication status","Lacks pre‑registration and detailed reporting of effect‑size precision"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2022/1503167"}},{"id":7679,"doi":"10.1016/j.jad.2016.01.035","pmid":"26851616","pmcid":null,"title":"Hypersexuality and couple relationships in bipolar disorder: A review","authors":"Kopeykina I, Kim HJ, Khatun T, Boland J, Haeri S, Cohen LJ, Galynker II.","first_author":"Kopeykina I","journal":"Journal of affective disorders","year":2016,"pub_types":["Review","Journal Article"],"keywords":["Sexuality","Bipolar disorder","Risky Sexual Behavior","Hypersexuality","Couple Relationships"],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of 27 heterogeneous articles, no systematic methods, no risk‑of‑bias assessment","sample_n":null,"sample_text":"27 articles selected for review; no primary sample","population":"individuals with bipolar disorder (mixed sub‑types, treatment settings) and their partners","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The review finds that people with bipolar disorder may show more risky sexual behavior during mania and have lower sexual satisfaction in relationships, but definitions of hypersexuality vary widely across studies.","clinical_takeaway":"Clinicians should assess sexual changes during mood episodes and discuss relationship impacts, recognizing that current evidence is limited and definitions are inconsistent.","confidence":0.7,"topic_tags":["sexual_function","relationships","moral_incongruence"],"strengths":["Broad coverage of existing literature","Identifies gaps and need for consistent definitions","Highlights relationship outcomes"],"limitations":["Narrative, not systematic; no risk‑of‑bias assessment","Heterogeneous source studies with outdated definitions","No quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":4,"contrasting":1,"mentioning":75,"citing_publications":100,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jad.2016.01.035"}},{"id":7680,"doi":null,"pmid":"26732226","pmcid":null,"title":"[Hypersexuality and other impulse control disorders in Parkinson's disease]","authors":"Nelis EA, Berendse HW, van den Heuvel OA.","first_author":"Nelis EA","journal":"Nederlands tijdschrift voor geneeskunde","year":2016,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"dut","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case reports of two Parkinson's patients with hypersexuality treated by medication adjustments","sample_n":2,"sample_text":"two case reports","population":"men with Parkinson's disease (ages 52 and 69) experiencing impulse control disorder hypersexuality","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes two men with Parkinson's disease who developed excessive sexual urges after taking dopamine‑stimulating drugs. Reducing the medication or adding naltrexone reduced these urges, suggesting that clinicians should monitor and adjust treatment for such side‑effects.","clinical_takeaway":"When Parkinson's patients show hypersexual behavior, consider lowering dopamine agonist doses or adding naltrexone, and actively ask patients and partners about these symptoms.","confidence":0.6,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed clinical description of hypersexuality in PD","Practical treatment observations (dose reduction, naltrexone)","Highlights importance of partner inquiry"],"limitations":["Only two cases; no systematic data","No validated measures of hypersexuality or addiction criteria","No control of moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":7681,"doi":"10.1016/bs.irn.2022.01.001","pmid":"35397787","pmcid":null,"title":"The pathophysiology of sexual dysfunction in Parkinson's disease: An overview","authors":"Batzu L, Titova N, Bhattacharyya KB, Chaudhuri KR.","first_author":"Batzu L","journal":"International review of neurobiology","year":2022,"pub_types":["Review","Journal Article"],"keywords":["Sexual dysfunction","Parkinson's Disease","Impulse Control Disorder","Hypersexuality","Non-motor Symptoms","Reward System","Hyposexuality"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of existing literature, no new empirical data","sample_n":null,"sample_text":"not applicable","population":"humans with Parkinson's disease (general description, no specific sample)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how Parkinson's disease and its treatments can cause sexual problems, from reduced desire to increased sexual urges, by describing the brain pathways and neurotransmitter changes involved.","clinical_takeaway":"Clinicians should recognize that both reduced and excessive sexual behavior can stem from Parkinson's disease pathology and dopaminergic medication effects.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Comprehensive overview of neurobiological mechanisms","Integrates dopaminergic therapy effects","Highlights both hypo‑ and hypersexuality"],"limitations":["Narrative review without systematic methodology","No primary data or quantitative synthesis","Potential bias from author selection of studies"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/bs.irn.2022.01.001"}},{"id":7682,"doi":"10.1007/s10508-021-02241-z","pmid":"35165803","pmcid":null,"title":"Orgasm Frequency (Total Sexual Outlet) in a National American Sample","authors":"Peters JR, Pullman LE, Kingston DA, Lalumière ML.","first_author":"Peters JR","journal":"Archives of sexual behavior","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Hypersexuality","Orgasm","Sex Drive","Compulsive Sexual Behavior Disorder","Total Sexual Outlet"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online Qualtrics panel (N=1029), cross‑sectional survey of US adults","sample_n":1029,"sample_text":"442 males, 587 females, diverse regions across the USA","population":"adult US residents recruited via online panel","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["circular_addiction_scale","no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a US online survey of 1,029 adults, 10‑17% reported having seven or more orgasms per week, a cut‑off some use to label hypersexuality. Frequency varied by age, gender and relationship status, but the study did not assess distress or other factors that might explain high orgasm counts.","clinical_takeaway":"High orgasm frequency alone does not indicate a disorder; clinicians should assess distress, control, and functional impact before labeling hypersexuality.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large national‑level sample (N>1000)","Explores effect of question wording on prevalence estimates","Provides comparative prevalence data for researchers/clinicians"],"limitations":["Uses single‑item frequency count to define hypersexuality (circular)","No measurement of distress, moral conflict, or other confounds","Convenience online panel, not probability‑based sample"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02241-z"}},{"id":7683,"doi":"10.1556/2006.4.2015.041","pmid":"26690616","pmcid":"PMC4712755","title":"How should severity be determined for the DSM-5 proposed classification of Hypersexual Disorder?","authors":"Reid RC.","first_author":"Reid RC.","journal":"Journal of behavioral addictions","year":2015,"pub_types":["review-article","Review","Journal Article"],"keywords":["Severity","Dsm-5","Sexual Compulsivity","Sexual Impulsivity","Hypersexual Disorder","Sex Addiction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4712755","cited_by_count":18,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review discussing how severity might be defined for the proposed DSM‑5 Hypersexual Disorder; no primary data collected.","sample_n":null,"sample_text":"N/A – no empirical sample","population":"None (no participants; review of literature)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper discusses how clinicians might decide how severe a person’s hypersexual behaviour is, noting that current DSM‑5‑style severity scales for addictions don’t translate well to sexual behaviour and proposing alternative ideas.","clinical_takeaway":"No concrete tool is offered; clinicians should be cautious and consider multiple domains when judging severity of hypersexual behaviour.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Identifies an important gap in clinical practice – how to gauge severity of hypersexual behavior","Draws on existing DSM‑5 severity models from substance‑use and gambling disorders"],"limitations":["No empirical data; recommendations are speculative","Lacks systematic review methodology or risk‑of‑bias assessment","Does not evaluate or test any measurement tools"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":73,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.4.2015.041"}},{"id":7684,"doi":"10.3389/fnbeh.2015.00321","pmid":"26648855","pmcid":"PMC4663274","title":"Neural Substrates of Sexual Desire in Individuals with Problematic Hypersexual Behavior","authors":"Seok JW, Sohn JH.","first_author":"Seok JW","journal":"Frontiers in behavioral neuroscience","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Functional magnetic resonance imaging","Dorsolateral Prefrontal Cortex","Hemodynamic Response","Sexual Desire","Problematic Hypersexual Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4663274","cited_by_count":49,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"case‑control fMRI study of 23 individuals with problematic hypersexual behavior and 22 healthy controls viewing sexual vs non‑sexual pictures","sample_n":45,"sample_text":"23 PHB participants, 22 controls (age‑matched)","population":"adults with self‑reported problematic hypersexual behavior, recruited likely from community or clinical sources (not specified)","country":"South Korea (inferred from author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","causal_from_correlational","fmri_reverse_inference","no_mi_control"],"stance":"supports","citation_value":"useful","plain_summary":"The study scanned 23 people who report problematic hypersexual behavior and 22 matched controls while they looked at sexual pictures. Those with the problem showed stronger brain activation in several regions and reported more sexual desire, which the authors liken to addiction‑related brain changes.","clinical_takeaway":"No direct clinical guidance; findings suggest altered brain responses in self‑identified hypersexual individuals but lack robust controls.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function","neuroscience"],"strengths":["Uses neuroimaging to compare PHB vs controls","Age‑matched comparison group","Measures momentary sexual desire ratings"],"limitations":["Small sample; likely under‑powered for fMRI","No assessment of moral incongruence, masturbation, mental health or trauma","Addiction‑like interpretation not grounded in formal criteria"],"rubric_version":"2.0","raw_total":29,"max_possible":70,"pct_score":41,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":5,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":54,"citing_publications":124,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fnbeh.2015.00321"}},{"id":7686,"doi":"10.1089/cap.2021.0130","pmid":"35104420","pmcid":null,"title":"<i>Letter to the Editor:</i> Aripiprazole-Induced Hypersexuality in an Autistic Child","authors":"Smith JR, Pierce DL.","first_author":"Smith JR","journal":"Journal of child and adolescent psychopharmacology","year":2022,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cap.2021.0130"}},{"id":7687,"doi":"10.1111/jsm.13019","pmid":"26745617","pmcid":null,"title":"Erectile Dysfunction, Boredom, and Hypersexuality among Coupled Men from Two European Countries","authors":"Klein V, Jurin T, Briken P, Štulhofer A.","first_author":"Klein V","journal":"The journal of sexual medicine","year":2015,"pub_types":["Multicenter Study","Journal Article"],"keywords":["Hypersexuality",". Erectile Dysfunction","Sexual Boredom"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["bibliography","csbd","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet‑based survey of 1,121 coupled men from Croatia and Germany; self‑report questionnaires (Hypersexual Disorder Screening Inventory, IIEF, Sexual Boredom Scale); Poisson regression analysis.","sample_n":1121,"sample_text":"911 Croatian and 210 German coupled men recruited via an online survey.","population":"Coupled adult men (community sample) from two European countries; N≈1,121.","country":"Croatia; Germany","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 1,000 partnered men in Croatia and Germany found that higher levels of hypersexual behaviour were linked to more sexual boredom and worse erectile function. The authors suggest that excessive sexual activity may be a way some men cope with boredom, and that erectile problems can co‑occur.","clinical_takeaway":"Hypersexual behaviour may co‑occur with erectile difficulties and sexual boredom; consider assessing both when treating men reporting either issue.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large total sample (N>1,000)","Use of validated questionnaires (IIEF, HDSI)","Cross‑national sample adds some generalisability"],"limitations":["Cross‑sectional, cannot infer causality","No measurement/control of moral incongruence or mental‑health covariates","Hypersexuality measured with a scale that defines the construct by distress (circularity)"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.13019"}},{"id":7688,"doi":"10.3390/brainsci12020159","pmid":"35203923","pmcid":"PMC8869894","title":"Sexual Dysfunctions in Parkinson's Disease and Their Influence on Partnership-Data of the PRISM Study","authors":"Kinateder T, Marinho D, Gruber D, Hatzler L, Ebersbach G, Gandor F.","first_author":"Kinateder T","journal":"Brain sciences","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Quality of life","Sexual dysfunction","Parkinson’s Disease","Partnership","Hypersexuality"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8869894","cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational analysis of PRISM dataset, N=861 Parkinson's patients, cross‑sectional questionnaire on sexual dysfunction and partnership outcomes","sample_n":861,"sample_text":"861 Parkinson's disease patients (449 reported sexual dysfunction) plus their spousal caregivers","population":"People with Parkinson's disease (both sexes) recruited from the PRISM study; includes spousal caregivers for partnership outcomes","country":"not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 861 people with Parkinson's disease, about half reported sexual problems such as erectile dysfunction, low libido or orgasm difficulties. These problems were linked to poorer quality of life and strained relationships, especially for men. Hypersexuality was common in men but did not affect relationships.","clinical_takeaway":"Screen for sexual dysfunction in Parkinson's patients, as it can impact quality of life and partner relationships.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Large sample of PD patients (N>800)","Specific reporting of different sexual dysfunction types by sex","Includes caregiver perspective on partnership impact"],"limitations":["Self‑report, no validated sexual dysfunction scales","Cross‑sectional design limits causal inference","No control for mental‑health, relationship, or moral variables"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":52,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/brainsci12020159"}},{"id":7689,"doi":"10.1007/s10508-015-0606-1","pmid":"26502283","pmcid":null,"title":"An Online Assessment of Personality, Psychological, and Sexuality Trait Variables Associated with Self-Reported Hypersexual Behavior","authors":"Walton MT, Cantor JM, Lykins AD.","first_author":"Walton MT","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Hypersexual Behavior","Sexual Compulsivity","Sexual Impulsivity","Sexual Inhibition","Sexual Excitation"],"is_oa":false,"oa_url":null,"cited_by_count":55,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online anonymous self‑report questionnaire; international convenience sample (N=510); cross‑sectional analysis of trait predictors of self‑identified hypersexual behavior.","sample_n":510,"sample_text":"Convenience online sample, not probability based.","population":"Adults (heterosexual, bisexual, homosexual) self‑identified as having hypersexual behavior; recruited via the internet.","country":"International (online recruitment).","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 510 adults who said they had trouble controlling sexual behavior, higher sexual excitement, impulsivity, anxiety, depression and certain personality traits were linked to those self‑reports. The study suggests many independent factors may underlie hypersexual reports.","clinical_takeaway":"Self‑reported hypersexuality is associated with broader personality and mood factors; clinicians should assess these domains rather than assume a single underlying disorder.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for an online survey","Broad assessment of personality and sexual traits","Multivariate analysis of independent predictors"],"limitations":["Hypersexual behavior measured by self‑label, not validated scale","No assessment of moral incongruence or masturbation frequency","Cross‑sectional design limits causal inference","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":60,"pct_score":37,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":8,"contrasting":0,"mentioning":56,"citing_publications":86,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0606-1"}},{"id":7690,"doi":"10.1007/s00737-015-0579-z","pmid":"26411572","pmcid":null,"title":"A case of female hypersexuality and child abuse and a review","authors":"Lamy S, Delavenne H, Thibaut F.","first_author":"Lamy S","journal":"Archives of women's mental health","year":2016,"pub_types":["Legal Case","Journal Article"],"keywords":["Female","Child Abuse","Sexual Abuse","Incest","Hypersexuality","Pedophilia","Sex Offender"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single case","population":"single female patient with hypersexuality and child abuse; not representative","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes a single woman who abused her son and was diagnosed with hypersexual disorder and intellectual disability. It notes that her sexual behavior was driven by gratification rather than pedophilic fantasies, a pattern said to be rare among female offenders.","clinical_takeaway":"One case cannot inform clinical practice; clinicians should use validated criteria when assessing hypersexuality.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides rare clinical description of female hypersexuality linked to child abuse","Highlights gap in literature"],"limitations":["Single case limits generalisability","No validated measures of hypersexuality or addiction criteria","No control for confounding factors"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00737-015-0579-z"}},{"id":7692,"doi":"10.1007/7854_2022_327","pmid":"35704271","pmcid":null,"title":"Classic Psychedelics in Addiction Treatment: The Case for Psilocybin in Tobacco Smoking Cessation","authors":"Johnson MW.","first_author":"Johnson MW.","journal":"Current topics in behavioral neurosciences","year":2022,"pub_types":["Review","Journal Article"],"keywords":["Addiction","Hallucinogens","Smoking Cessation","Substance Use Disorders","Psilocybin","Tobacco Use Disorder","Psychedelics"],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or meta‑analysis; no new empirical data.","sample_n":null,"sample_text":"","population":"None (review article)","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The article reviews early and recent studies suggesting that psychedelics like psilocybin may help people quit smoking and treat other addictions, arguing that more funded research is needed.","clinical_takeaway":"Current evidence is preliminary; clinicians should await rigorous trials before considering psychedelics for addiction treatment.","confidence":0.6,"topic_tags":["treatment","pornography","masturbation","sexual_function"],"strengths":["Broad historical overview of psychedelic research","Integrates anthropological and epidemiological perspectives","Identifies clear future research agenda"],"limitations":["Narrative, non‑systematic review lacks methodological transparency","No quantitative synthesis or risk‑of‑bias assessment","Potential advocacy bias toward psychedelics"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/7854_2022_327"}},{"id":7694,"doi":"10.1556/2006.4.2015.030","pmid":"26551908","pmcid":"PMC4627679","title":"The role of negative mood states and consequences of hypersexual behaviours in predicting hypersexuality among university students","authors":"Dhuffar MK, Pontes HM, Griffiths MD.","first_author":"Dhuffar MK","journal":"Journal of behavioral addictions","year":2015,"pub_types":["research-article","Multicenter Study","Journal Article"],"keywords":["university students","Hypersexuality","Hypersexual Disorder","Behavioural Addictions"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4627679","cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 165 UK university students; regression analysis of self‑report variables","sample_n":165,"sample_text":"165 British university students (convenience sample)","population":"British university students (N=165)","country":"United Kingdom","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 165 UK university students examined whether negative mood states and the consequences of engaging in many sexual activities predict self‑reported hypersexual behaviour. Gender, low life satisfaction, emotional dysregulation and reported consequences were linked to higher hypersexual scores.","clinical_takeaway":"The study’s cross‑sectional findings do not justify diagnosing hypersexual disorder; clinicians should consider mood and life‑satisfaction factors but remain cautious about attributing a disorder based on self‑report alone.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a student survey","Uses multivariate regression to explore multiple predictors"],"limitations":["Cross‑sectional; cannot infer causality","Hypersexuality measured with unspecified, likely unvalidated scale","No assessment of key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)","Interpretation overstates evidence for a disorder"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":18,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.4.2015.030"}},{"id":7696,"doi":"10.3389/fneur.2021.731552","pmid":"34950097","pmcid":"PMC8689055","title":"Validation of the Chinese Version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease","authors":"Xu T, Cao L, Long W, Zhao G.","first_author":"Xu T","journal":"Frontiers in neurology","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Validity","Questionnaire","Parkinson's Disease","Impulse Control And Related Disorders","Impulsive-compulsive Disorders"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fneur.2021.731552/pdf","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"validation study of Chinese QUIP in 207 Parkinson's patients, interview diagnosis of ICRDs, comparison of clinical characteristics","sample_n":207,"sample_text":"207 PD patients recruited from clinical settings (convenience sample)","population":"PD patients, N=207, China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The Chinese version of the QUIP questionnaire reliably identifies impulsive‑compulsive disorders, including hypersexuality, in Parkinson’s patients, showing high sensitivity and good specificity.","clinical_takeaway":"C‑QUIP can be used as a quick screen for hypersexuality and related disorders in Chinese PD patients.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample for a validation study","Comprehensive psychometric evaluation (sensitivity, specificity, PPV, NPV)","Inclusion of clinical risk factor analysis"],"limitations":["Convenience clinical sample, not population‑based","No assessment of moral or relational confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fneur.2021.731552"}},{"id":7699,"doi":"10.1176/ps.39.3.300","pmid":"3356438","pmcid":null,"title":"Prevalence of a history of sexual abuse among female psychiatric patients in a state hospital system","authors":"Craine LS, Henson CE, Colliver JA, MacLean DG.","first_author":"Craine LS","journal":"Hospital & community psychiatry","year":1988,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":74,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 105 female state‑hospital patients assessing self‑reported childhood/adolescent sexual abuse and associated symptoms.","sample_n":105,"sample_text":"Convenience sample of hospitalized women; not a probability or community sample.","population":"Female psychiatric in‑patients in a state hospital system (N=105)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 105 women in a state psychiatric hospital, 51 % reported childhood or adolescent sexual abuse, yet staff were often unaware. Abuse was linked to many additional symptoms, including compulsive sexual behavior and chemical dependence.","clinical_takeaway":"Clinicians should routinely screen for past sexual abuse in psychiatric patients, as it is common and linked to diverse clinical problems.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Focus on an understudied patient population","Highlights gap between staff awareness and patient history"],"limitations":["Small, non‑representative sample","Unclear method for assessing abuse history","No control for mental‑health comorbidities"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":9,"contrasting":2,"mentioning":116,"citing_publications":231,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ps.39.3.300"}},{"id":7700,"doi":"10.1080/00926239008405460","pmid":"2079706","pmcid":null,"title":"Marital satisfaction during recovery from self-identified sexual addiction among bisexual men and their wives","authors":"Schneider JP, Schneider BH.","first_author":"Schneider JP","journal":"Journal of sex & marital therapy","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional telephone interview/survey of 22 couples (N=40) recruited from 12‑step self‑help programs","sample_n":40,"sample_text":"22 couples (self‑selected treatment‑seeking sample)","population":"bisexual married men who self‑identified as sexual addicts and their wives","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational","self_selected_sample","underpowered_sample"],"stance":"supports","citation_value":"useful","plain_summary":"The authors surveyed 22 couples in which the husband, a bisexual man, called himself a \"sexual addict\" and was in a 12‑step program. They found that men who saw their same‑sex behavior as compulsive reported slightly better marital commitment, but overall marital satisfaction varied widely.","clinical_takeaway":"Evidence is weak; clinicians should not base treatment decisions on self‑labelled \"sexual addiction\" without rigorous assessment.","confidence":0.4,"topic_tags":["sexual_function","relationships"],"strengths":["rare focus on bisexual men in 1990s","direct couples data (both partners surveyed)"],"limitations":["Very small, self‑selected treatment‑seeking sample","No validated measures of sexual addiction or distress","No control for moral, mental‑health or relationship confounds"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239008405460"}},{"id":7701,"doi":"10.1007/s10508-021-02074-w","pmid":"34750773","pmcid":null,"title":"Sex Drive as a Possible Mediator of the Gender Difference in the Prevalence of Paraphilic Interests in a Nonclinical Sample","authors":"Levaque E, Dawson SJ, Wan C, Lalumière ML.","first_author":"Levaque E","journal":"Archives of sexual behavior","year":2022,"pub_types":["Journal Article"],"keywords":["Gender Difference","Mediation","Hypersexuality","Voyeurism","Sex Drive","Paraphilic Interests"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online questionnaire, nonclinical convenience sample (N≈1132)","sample_n":1132,"sample_text":"517 men, 615 women; online non‑clinical participants","population":"adult men and women from the general population, recruited online","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large online sample, men showed more interest in paraphilic activities than women. Part of this gender gap could be explained by higher self‑reported sex drive, but other factors also seem important.","clinical_takeaway":"Higher sex drive may partly explain gender differences in paraphilic interests, but clinicians should consider many other influences.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Large sample size for mediation analysis","Direct replication of prior study","Use of multiple mediation models"],"limitations":["Cross‑sectional design cannot infer causality","Reliance on self‑report scales of uncertain validation","No measurement of key confounds (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":1,"mentioning":8,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02074-w"}},{"id":7702,"doi":"10.1590/0004-282x-anp-2020-0450","pmid":"34816986","pmcid":null,"title":"Nationwide questionnaire data of 229 Williams-Beuren syndrome patients using WhatsApp tool","authors":"Pires LVL, Ribeiro RL, Sousa AM, Linnenkamp BDW, Pontes SE, Teixeira MCTV, Befi-Lopes DM, Honjo RS, Bertola DR, Kim CA.","first_author":"Pires LVL","journal":"Arquivos de neuro-psiquiatria","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of parents of Williams‑Beuren syndrome patients (N=229) recruited via WhatsApp through a patient association; descriptive questionnaire.","sample_n":229,"sample_text":"229 parents responded to the questionnaire.","population":"Parents of individuals with Williams‑Beuren syndrome in Brazil","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A Brazilian survey of 229 parents of children with Williams‑Beuren syndrome reported many health issues, including hypersexual behavior in about one‑third of the individuals. The study highlights the need for multidisciplinary care but provides only descriptive data.","clinical_takeaway":"Clinicians should monitor for hypersexual behavior in Williams‑Beuren patients and consider multidisciplinary follow‑up, though evidence on prevalence is based on parental reports.","confidence":0.6,"topic_tags":["gender","neuroscience","treatment","sexual_function"],"strengths":["Large national sample for a rare disorder","Broad range of clinical and behavioural domains covered","Use of mobile messaging (WhatsApp) increased reach"],"limitations":["Parent‑report questionnaire not validated for sexual or psychiatric symptoms","No control group; self‑selection bias from association members","No adjustment for confounding factors (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/0004-282x-anp-2020-0450"}},{"id":7703,"doi":"10.1080/0092623x.2021.1991536","pmid":"34693896","pmcid":null,"title":"Mindfulness and Sexual Dysfunction: A Systematic Research Synthesis","authors":"Selice L, Morris KL.","first_author":"Selice L","journal":"Journal of sex & marital therapy","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"systematic review of 18 peer‑reviewed articles on mindfulness and sexual dysfunction; narrative synthesis without meta‑analysis","sample_n":null,"sample_text":"18 included studies (sample sizes of primary studies not aggregated)","population":"adults experiencing sexual dysfunction (heterosexual focus, limited LGBTQ+ data)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review of 18 studies finds that higher mindfulness is generally linked to fewer sexual problems such as erectile dysfunction, hypersexuality, and sexual distress, and to greater desire and satisfaction. The authors note that most research looks at individuals rather than couples and calls for more work with LGBTQ+ people.","clinical_takeaway":"Mindfulness may benefit people with sexual dysfunction, but clinicians should consider relational factors and the limited evidence base.","confidence":0.7,"topic_tags":["sexual_function","masturbation","moral_incongruence"],"strengths":["Comprehensive systematic search of the literature","Identifies gaps in couple‑level and LGBTQ+ research","Clear clinical relevance for mindfulness interventions"],"limitations":["No quantitative meta‑analysis or effect‑size synthesis","Limited assessment of methodological quality of included studies","Potential bias from heterogeneous primary study designs"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2021.1991536"}},{"id":7704,"doi":"10.1002/mdc3.12155","pmid":"30363884","pmcid":"PMC6183311","title":"Hypersexuality in Parkinson's Disease: Systematic Review and Report of 7 New Cases","authors":"Codling D, Shaw P, David AS.","first_author":"Codling D","journal":"Movement disorders clinical practice","year":2015,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexuality","Systematic review","Impulse Control","Parkinson's","Gambling Task"],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of case series/cohort studies plus report of 7 new clinical cases with neuropsychological testing.","sample_n":null,"sample_text":"Review of published case series/cohorts (total numbers not specified) and 7 newly reported cases.","population":"People with Parkinson's disease who develop hypersexuality (impulse control disorder).","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors reviewed studies of hypersexuality in Parkinson's disease and added seven new patient cases. They found limited, inconsistent data, with some evidence of poorer learning from negative outcomes, but overall could not draw firm conclusions about how it differs from other impulse‑control problems.","clinical_takeaway":"Hypersexuality can occur in Parkinson's disease, but evidence on its distinct features and treatment is still sparse; clinicians should assess it case‑by‑case.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","csbd"],"strengths":["Systematic approach to literature on a niche PD symptom","Adds new clinical cases with detailed neuropsych testing","Acknowledges limited evidence and need for further research"],"limitations":["Reliance on case series with heterogeneous definitions","No validated hypersexuality scale used","No systematic control for key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":31,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mdc3.12155"}},{"id":7705,"doi":"10.1038/s41598-021-99714-x","pmid":"34635736","pmcid":"PMC8505644","title":"HPA axis dysregulation is associated with differential methylation of CpG-sites in related genes","authors":"Chatzittofis A, Boström ADE, Ciuculete DM, Öberg KG, Arver S, Schiöth HB, Jokinen J.","first_author":"Chatzittofis A","journal":"Scientific reports","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://www.nature.com/articles/s41598-021-99714-x.pdf","cited_by_count":26,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-control, cross‑sectional (20 DST non‑suppressors vs 73 controls), whole‑blood DNA methylation EPIC array","sample_n":93,"sample_text":"20 DST non‑suppressors and 73 controls","population":"adults (mixed age, gender) undergoing low‑dose dexamethasone suppression test","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study found that people whose cortisol levels did not drop after a low‑dose dexamethasone test showed subtle changes in DNA methylation of several stress‑related genes, and some of these changes were linked to gene activity.","clinical_takeaway":"No direct clinical implications for pornography or sexual health; highlights stress‑axis epigenetics as a possible factor in psychiatric conditions.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation","csbd"],"strengths":["Use of genome‑wide methylation platform (validated EPIC array)","Integration of methylation with gene expression data","Clear biological outcome (DST non‑suppression)"],"limitations":["Small number of HPA‑dysregulated cases (N=20)","Cross‑sectional design, no causal inference","Limited correction for multiple testing"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-021-99714-x"}},{"id":7708,"doi":"10.3390/healthcare9101263","pmid":"34682943","pmcid":"PMC8535407","title":"Analysis of Impulse Control Disorders (ICDs) and Factors Associated with Their Development in a Parkinson's Disease Population","authors":"García-Rubio MI, Otero-Cerdeira ME, Toledo-Lozano CG, Alcaraz-Estrada SL, Suárez-Cuenca JA, Coral-Vázquez RM, Mondragón-Terán P, Pineda-Juárez JA, Díaz-López LF, García S.","first_author":"García-Rubio MI","journal":"Healthcare (Basel, Switzerland)","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Parkinson’s Disease","Associated Factors","Impulse Control Disorders"],"is_oa":true,"oa_url":"https://www.mdpi.com/2227-9032/9/10/1263/pdf?version=1632488970","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Analytical cross‑sectional study of 181 Parkinson’s patients (80 with ICDs, 101 without) using clinical records.","sample_n":181,"sample_text":"181 patients (80 with ICDs, 101 without).","population":"Adults with Parkinson’s disease, 40–80 years, recruited from clinical records.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 181 Parkinson’s patients, about 44% had impulse‑control problems like binge eating, compulsive shopping, or hypersexuality. Use of dopamine‑agonist medication and certain motor symptoms were linked to higher odds of these behaviours.","clinical_takeaway":"Dopamine‑agonists may increase risk of hypersexuality and other impulse‑control disorders in Parkinson’s patients; monitor and adjust treatment accordingly.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Reasonably sized clinical sample (N=181)","Use of logistic regression to identify independent predictors","Specific reporting of different ICD subtypes"],"limitations":["Cross‑sectional design cannot infer causality","ICD assessment not described as validated scale","Potential selection bias from clinic‑based sample","Limited control of psychosocial confounders (e.g., mental health, moral factors)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare9101263"}},{"id":7709,"doi":"10.1002/smrj.34","pmid":"27784570","pmcid":null,"title":"Which Techniques Are Used in Psychotherapeutic Interventions for Nonparaphilic Hypersexual Behavior?","authors":"von Franqué F, Klein V, Briken P.","first_author":"von Franqué F","journal":"Sexual medicine reviews","year":2015,"pub_types":["Review","Journal Article"],"keywords":["Treatment","Sexual Addiction","Hypersexuality","Sexual Compulsivity","Sexual Impulsivity","Hypersexual Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of psychotherapeutic techniques drawn only from studies reporting positive outcomes; selection criteria not systematic.","sample_n":null,"sample_text":"Not applicable – secondary analysis of published studies.","population":"Not applicable (review of prior studies).","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews psychotherapy methods that have been used to treat non‑paraphilic hypersexual behavior, but it only looks at studies that reported success and does not explain how the techniques work.","clinical_takeaway":"Clinicians should note that current psychotherapies for hypersexuality lack clear mechanistic rationale and are based on limited, positively‑biased evidence.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["Summarises existing psychotherapeutic techniques","Highlights gaps in mechanistic explanation"],"limitations":["Includes only studies with positive outcomes","Not a systematic review; possible bias","No quantitative synthesis or quality assessment"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/smrj.34"}},{"id":7712,"doi":"10.1002/erv.2857","pmid":"34460134","pmcid":null,"title":"No addiction transfer from preoperative food addiction to other addictive behaviors during the first year after bariatric surgery","authors":"Dickhut C, Hase C, Gruner-Labitzke K, Mall JW, Köhler H, de Zwaan M, Müller A.","first_author":"Dickhut C","journal":"European eating disorders review : the journal of the Eating Disorders Association","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Obesity","Food Addiction","Bariatric Surgery","Substance-use Disorders","Addiction Transfer","Behavioural Addictions","Cross Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort of bariatric patients assessed pre‑surgery, 6 mo and 12 mo post‑surgery (N=125)","sample_n":125,"sample_text":"125 participants (49 FA+, 76 FA‑) assessed at three time‑points","population":"adults undergoing bariatric surgery (Germany)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study followed 125 bariatric‑surgery patients for a year and found that stopping food addiction did not lead to new alcohol, gambling, internet, shopping, hypersexual or exercise problems.","clinical_takeaway":"Food‑addiction remission after bariatric surgery does not appear to trigger other addictive behaviours within the first year.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Validated YFAS‑2 for food addiction","Longitudinal design with three assessments","Multiple addictive‑behaviour domains examined"],"limitations":["No measurement of key confounds (moral incongruence, mental health, trauma)","Limited sample size for detecting small transfer effects","Specific clinical population limits generalisability"],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":29,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/erv.2857"}},{"id":7713,"doi":"10.1016/j.lpm.2014.06.037","pmid":"25578547","pmcid":null,"title":"[Hypersexuality in Parkinson's disease. Advantage of the presence of the entourage for medical assessment]","authors":"Grandgenevre P, Warembourg F, Carrière N, Vaillant A, Defebvre L, Vaiva G.","first_author":"Grandgenevre P","journal":"Presse medicale (Paris, France : 1983)","year":2015,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"small case series (7 patients, 6 with spouse) with qualitative interview; no control group; convenience sample","sample_n":7,"sample_text":"7 patients (6 with spouse) recruited from neurology department referrals","population":"patients with Parkinson's disease referred for suspected hypersexuality (antiparkinsonian treatment‑related)","country":"France","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a tiny series of Parkinson's patients, interviewing the patient together with their spouse revealed more cases of treatment‑related hypersexuality and uncovered partner distress, suggesting that involving partners could help detect this problem.","clinical_takeaway":"Screening for hypersexuality in Parkinson's patients may be improved by including a brief partner interview.","confidence":0.6,"topic_tags":["sexual_function","other"],"strengths":["Focus on partner perspective","Highlights under‑recognition of hypersexuality in PD","Clinical relevance for screening"],"limitations":["Very small, non‑representative sample","No validated measures of hypersexuality","No control or comparison group","No statistical analysis"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":3,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.lpm.2014.06.037"}},{"id":7714,"doi":"10.1007/s10508-014-0399-7","pmid":"25559323","pmcid":null,"title":"The Relationship Between Hypersexual Behavior, Sexual Excitation, Sexual Inhibition, and Personality Traits","authors":"Rettenberger M, Klein V, Briken P.","first_author":"Rettenberger M","journal":"Archives of sexual behavior","year":2016,"pub_types":["Journal Article"],"keywords":["Hypersexuality","Big Five","Sexual Inhibition","Sexual Excitation","Dual Control Model","Hypersexual Behavior Inventory"],"is_oa":false,"oa_url":null,"cited_by_count":66,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Internet‑based survey of 1,749 adults; cross‑sectional correlational analysis.","sample_n":1749,"sample_text":"1749 participants completed the survey.","population":"Adults (both genders, varied sexual orientation) recruited online; not a probability sample.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large online survey, researchers found that people who score higher on sexual excitement and lower on sexual inhibition, as well as certain personality traits, tend to report more hypersexual behaviour measured by a standard questionnaire.","clinical_takeaway":"Hypersexual scores relate to excitation, inhibition and personality, but the findings are correlational and lack controls for moral or mental‑health factors.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a survey","Use of validated psychometric instruments","Inclusion of both sexual excitation/inhibition and personality measures"],"limitations":["Convenience, online sample limits generalisability","No control for moral incongruence, masturbation, mental‑health or trauma variables","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":7,"contrasting":2,"mentioning":65,"citing_publications":113,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0399-7"}},{"id":7715,"doi":"10.1080/02699931.2014.993595","pmid":"25559501","pmcid":null,"title":"Sexual desire, not hypersexuality, predicts self-regulation of sexual arousal","authors":"Moholy M, Prause N, Proudfit GH, S Rahman A, Fong T.","first_author":"Moholy M","journal":"Cognition & emotion","year":2015,"pub_types":["Journal Article"],"keywords":["Self-regulation","Sexual Arousal","Sexual Desire","Hypersexuality"],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["bibliography","csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"lab experiment with within‑subject regulation instructions; community sample N=116","sample_n":116,"sample_text":"community ads","population":"men and women, young adults, community‑recruited","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab experiment, people who reported higher sexual desire were less able to lower their arousal when asked, while a self‑reported hypersexuality score did not predict this ability.","clinical_takeaway":"Desire, not hypersexuality scores, may indicate difficulty controlling sexual arousal.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Experimental manipulation allows causal inference for regulation effects","Decent sample size for lab study","Includes both up‑ and down‑regulation conditions and both sexes"],"limitations":["Hypersexuality measured with a novel, likely unvalidated scale","Key confounds (moral views, mental health, masturbation) not assessed","No physiological arousal measurement reported"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":4,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":10,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/02699931.2014.993595"}},{"id":7716,"doi":"10.1016/j.parkreldis.2021.08.006","pmid":"34399162","pmcid":null,"title":"Impulsive conditions in Parkinson's disease: A pharmacosurveillance-supported list","authors":"Fusaroli M, Raschi E, Contin M, Sambati L, Menchetti M, Fioritti A, Poluzzi E.","first_author":"Fusaroli M","journal":"Parkinsonism & related disorders","year":2021,"pub_types":["Journal Article"],"keywords":["Parkinson disease","Dopamine agonists","Aggression","Gambling","Obsessive-compulsive Disorder","Impulsive Behavior","Social Stigma","Paraphilic Disorders"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pharmacovigilance disproportionality analysis of FDA AE reports","sample_n":null,"sample_text":"FAERS database (spontaneous reports, size not specified)","population":"Parkinson's disease patients reported to FAERS who were exposed to dopamine agonists","country":"International (FDA reports)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","selective_reporting"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors compiled an expanded list of impulse‑control problems linked to Parkinson’s medication, including hypersexuality, and showed that most appear more often than expected in FDA adverse‑event reports for dopamine‑agonist users.","clinical_takeaway":"Clinicians should be aware of a broader range of possible drug‑induced impulse‑control issues, but the evidence comes from spontaneous reports, not controlled studies.","confidence":0.7,"topic_tags":["csbd","neuroscience","treatment","pornography"],"strengths":["Systematic literature search of reviews","Translation of conditions to standardized taxonomies (ICD-11, DSM-5, MedDRA)","Large pharmacovigilance dataset"],"limitations":["Reliance on spontaneous report data with known reporting bias","No validated measures of impulse control behaviors","No control for key confounds (e.g., mental health, moral factors)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2021.08.006"}},{"id":7717,"doi":"10.1371/journal.pone.0255872","pmid":"34375360","pmcid":"PMC8354435","title":"Association patterns of cannabis abuse and dependence with risk of problematic non-substance-related dysregulated and addictive behaviors","authors":"Perales JC, Maldonado A, López-Quirantes EM, López-Torrecillas F.","first_author":"Perales JC","journal":"PloS one","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8354435","cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of university students using stratified probabilistic sampling; associations analysed with Poisson mixed‑effects models.","sample_n":null,"sample_text":"students recruited using stratified probabilistic sampling at the University of Granada","population":"University students (University of Granada), both genders, young adults.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Spanish university students, higher cannabis abuse or dependence scores were linked to greater risk of problematic video gaming, especially in men. Cannabis was not strongly tied to other non‑substance problems like gambling or hypersexuality.","clinical_takeaway":"Cannabis misuse may co‑occur with problematic gaming; clinicians should screen for multiple dysregulated behaviours.","confidence":0.6,"topic_tags":["csbd","pornography","masturbation","sexual_function"],"strengths":["Uses validated screening instruments (MultiCAGE, CAST, SDS)","Controls for nicotine and alcohol dependence and demographics","Bonferroni‑corrected multiple comparisons"],"limitations":["Cross‑sectional design precludes causal inference","No measurement of moral incongruence, masturbation, mental health, partner effects or trauma","Sample limited to a single university"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0255872"}},{"id":7719,"doi":"10.1001/jamainternmed.2014.5262","pmid":"25329919","pmcid":null,"title":"Reports of pathological gambling, hypersexuality, and compulsive shopping associated with dopamine receptor agonist drugs","authors":"Moore TJ, Glenmullen J, Mattison DR.","first_author":"Moore TJ","journal":"JAMA internal medicine","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":203,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective disproportionality analysis of FDA adverse event reports (2003‑2012) examining impulse control disorders linked to dopamine agonists","sample_n":710,"sample_text":"710 impulse control disorder events associated with dopamine agonist drugs","population":"serious adverse drug event reports (n≈2.7 million reports; 710 cases linked to dopamine agonists)","country":"United States (and 21 other countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Analysis of FDA adverse‑event reports found that drugs acting on dopamine receptors are linked to higher reports of gambling, hypersexuality and compulsive shopping, suggesting these medicines may trigger impulse‑control problems.","clinical_takeaway":"Clinicians should be aware of possible impulse‑control side effects, including hypersexuality, when prescribing dopamine agonists.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large pharmacovigilance database","Clear statistical signal (high PRR)","Relevant clinical safety implication"],"limitations":["Spontaneous reports subject to reporting bias","No control for moral or psychological confounds","Reliance on MedDRA terms, no validated behavioral measures"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":10,"contrasting":1,"mentioning":217,"citing_publications":337,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/jamainternmed.2014.5262"}},{"id":7720,"doi":"10.12890/2021_002725","pmid":"34377704","pmcid":"PMC8336756","title":"Kluver-Bucy Syndrome: A Rare Complication of Herpes Simplex Encephalitis","authors":"Costa R, Fontes J, Mendes T, Pereira M, Gonçalves C.","first_author":"Costa R","journal":"European journal of case reports in internal medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Hypersexuality","Herpes Virus Encephalitis","Hyperorality","Kluver-Bucy"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report of Kluver‑Bucy syndrome following herpes simplex encephalitis, describing hypersexuality among other symptoms","sample_n":1,"sample_text":"1 patient","population":"21‑year‑old man","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 21‑year‑old man developed Kluver‑Bucy syndrome, including excessive sexual behaviour, after a severe herpes brain infection. The authors describe his symptoms and note that treating this rare condition is difficult.","clinical_takeaway":"Neurological damage can produce hypersexuality; clinicians should consider brain injury when sudden changes in sexual behaviour occur.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Highlights a rare neurological complication with sexual behavior change","Provides clinical details useful for clinicians encountering similar cases"],"limitations":["Single case limits generalisability","No systematic assessment of sexual behaviour using validated tools","No control or comparison group"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12890/2021_002725"}},{"id":7721,"doi":null,"pmid":"25413509","pmcid":null,"title":"Hypersexuality in neurocognitive disorders in elderly people - a comprehensive review of the literature and case study","authors":"Ibrahim C, Reynaert C.","first_author":"Ibrahim C","journal":"Psychiatria Danubina","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Narrative literature review (40 articles, non-systematic) plus single clinical case description.","sample_n":1,"sample_text":"One patient case; literature review of 40 articles (no pooled data).","population":"Elderly patient with hypersexuality in context of delirium; broader literature on dementia-related hypersexuality.","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe an elderly patient whose sudden increase in sexual behaviour was linked to delirium from benzodiazepine withdrawal, discuss similar cases in dementia, and suggest behavioural and limited pharmacological management.","clinical_takeaway":"Hypersexuality in older adults may signal delirium or neurocognitive decline; treat underlying medical issues first, use non‑pharmacological strategies, and reserve antipsychotics for refractory cases.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Provides clinical detail of a rare presentation","Integrates literature on hypersexuality in dementia"],"limitations":["No standardized measurement of hypersexuality","Single case limits generalisability","Narrative review lacks systematic methodology"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":7722,"doi":"10.1097/yco.0000000000000099","pmid":"25247453","pmcid":null,"title":"Assessment methods and management of hypersexuality and paraphilic disorders","authors":"Turner D, Schöttle D, Bradford J, Briken P.","first_author":"Turner D","journal":"Current opinion in psychiatry","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of assessment instruments and treatment approaches for hypersexuality and paraphilic disorders; no primary data reported.","sample_n":null,"sample_text":"Not applicable","population":"Not applicable (review of existing studies)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews recent studies on how hypersexuality and paraphilic disorders are measured and treated, noting that several questionnaires appear reliable across different groups, and that psychotherapy and hormone‑lowering medication are used, but it calls for more research.","clinical_takeaway":"Current tools for assessing hypersexuality are promising, yet clinicians should stay updated as validation work is ongoing.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Summarizes recent psychometric validation studies","Highlights need for further research on assessment and treatment"],"limitations":["Narrative, non‑systematic review","No meta‑analytic synthesis or risk‑of‑bias assessment","Does not address key confounds such as moral incongruence or mental health"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/yco.0000000000000099"}},{"id":7724,"doi":"10.1080/0092623x.2014.958787","pmid":"25189627","pmcid":null,"title":"Relationship Attachment Styles in a Sample of Hypersexual Patients","authors":"Gilliland R, Blue Star J, Hansen B, Carpenter B.","first_author":"Gilliland R","journal":"Journal of sex & marital therapy","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional study of 136 treatment‑seeking men; cluster analysis of attachment measures.","sample_n":136,"sample_text":"N = 136 men seeking treatment for hypersexual behavior.","population":"Adults (men) seeking treatment for excessive sexual behavior.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined how relationship attachment styles relate to hypersexual behavior in 136 men in treatment, finding four distinct attachment‑based clusters that differed in shame and demographics.","clinical_takeaway":"Attachment difficulties may be linked to hypersexual behavior, but clinicians should consider other factors (e.g., mental health, moral beliefs) that were not examined here.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Large sample for treatment‑seeking hypersexual patients","Use of both categorical and dimensional attachment measures","Cluster analysis to identify subgroups"],"limitations":["Convenience sample limits generalisability","No control for key confounds (moral incongruence, mental health, etc.)","Unclear whether hypersexual behavior measure is validated"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":7,"contrasting":1,"mentioning":17,"citing_publications":93,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2014.958787"}},{"id":7725,"doi":"10.1186/s13256-021-02932-0","pmid":"34261516","pmcid":"PMC8281709","title":"Klüver-Bucy syndrome secondary to a nondominant middle cerebral artery ischemic stroke: a case report and review of the literature","authors":"Al-Attas AA, Aldayel AY, Aloufi TH, Biary N.","first_author":"Al-Attas AA","journal":"Journal of medical case reports","year":2021,"pub_types":["Review","Journal Article","Case Reports","case-report"],"keywords":["Stroke","Ischemic stroke","Case Report","Neurobehavioral Symptoms","Klüver–bucy Syndrome","Temporal Lobe Damage"],"is_oa":true,"oa_url":"https://jmedicalcasereports.biomedcentral.com/track/pdf/10.1186/s13256-021-02932-0","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"1","population":"single 68‑year‑old male with right MCA ischemic stroke","country":"Saudi Arabia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 68‑year‑old man developed Klüver‑Bucy syndrome, including excessive sexual behaviour, after a right‑side stroke. Imaging showed right temporal damage, and his symptoms improved with treatment.","clinical_takeaway":"Stroke can produce hypersexuality via temporal‑lobe damage; assess neurobehavioral changes after stroke.","confidence":0.8,"topic_tags":["neuroscience","sexual_function","csbd"],"strengths":["Detailed clinical description of rare syndrome","Neuroimaging localizes lesion","Discussion of treatment response"],"limitations":["Single case, no generalizability","No validated measures of hypersexuality or related constructs","No control for confounding psychosocial factors"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s13256-021-02932-0"}},{"id":7727,"doi":"10.1016/j.parkreldis.2014.09.019","pmid":"25277963","pmcid":null,"title":"Concomitant development of hypersexuality and delusional jealousy in patients with Parkinson's disease: a case series","authors":"Poletti M, Lucetti C, Baldacci F, Del Dotto P, Bonuccelli U.","first_author":"Poletti M","journal":"Parkinsonism & related disorders","year":2014,"pub_types":["Journal Article"],"keywords":["Parkinson's Disease","Impulse Control Disorders","Hypersexuality","Delusional Jealousy"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional investigation of 1063 consecutive Parkinson's disease patients using validated questionnaires for impulsive‑compulsive disorders and psychosis","sample_n":1063,"sample_text":"1063 consecutive PD patients","population":"PD patients on dopamine agonist therapy","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large group of Parkinson's patients on dopamine agonists, about 8% showed hypersexuality and 2% showed delusional jealousy; a small subgroup had both, suggesting the two may share underlying neuro‑behavioral changes.","clinical_takeaway":"Hypersexuality can co‑occur with delusional jealousy in Parkinson's patients treated with dopamine agonists; clinicians should screen for both when one is present.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for a clinical cohort","Use of disease‑specific validated questionnaires","Clear reporting of prevalence rates"],"limitations":["Cross‑sectional design limits causal inference","No measurement of key psychosocial confounds (e.g., moral incongruence, masturbation, mental health)","No assessment of addiction‑specific criteria beyond questionnaire labels"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2014.09.019"}},{"id":7729,"doi":"10.1097/01.pra.0000452562.98286.c5","pmid":"25036581","pmcid":null,"title":"Shame, rumination, and self-compassion in men assessed for hypersexual disorder","authors":"Reid RC, Temko J, Moghaddam JF, Fong TW.","first_author":"Reid RC","journal":"Journal of psychiatric practice","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional path analysis of 172 male patients assessed for hypersexual disorder","sample_n":172,"sample_text":"172 men evaluated for hypersexual disorder","population":"male patients (N=172) assessed for hypersexual disorder in a DSM‑5 field trial","country":"unspecified (likely USA based on journal)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 172 men assessed for hypersexual disorder, higher shame was linked to more rumination and hypersexual behaviour. Greater self‑compassion reduced these links, suggesting it may buffer the negative effects of shame.","clinical_takeaway":"Encouraging self‑compassion may help men who feel shame about their sexual behaviour, but evidence is correlational.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation","csbd","gender"],"strengths":["Reasonably large clinical sample (N=172)","Use of validated self‑report scales for shame, rumination, self‑compassion","Path analysis exploring mediation"],"limitations":["Cross‑sectional design limits causal inference","No control for key confounds (moral incongruence, masturbation, mental health, relationship factors, trauma)","Potential circularity in defining hypersexuality via distress"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":28,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.pra.0000452562.98286.c5"}},{"id":7730,"doi":"10.1177/1060028014541630","pmid":"24965689","pmcid":null,"title":"Use of propranolol for hypersexual behavior in an adolescent with autism","authors":"Deepmala, Agrawal M.","first_author":"Deepmala","journal":"The Annals of pharmacotherapy","year":2014,"pub_types":["Journal Article","Case Reports"],"keywords":["Adolescent","propranolol","Autism","Hypersexual Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single case","population":"13‑year‑old male adolescent with autism","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 13‑year‑old boy with autism showed a marked reduction in hypersexual behaviors after taking low‑dose propranolol for one year, according to a single‑patient case report.","clinical_takeaway":"Propranolol may help manage hypersexual behavior in autistic youths, but evidence is limited to one case.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed clinical description of rare presentation","Long follow‑up (1 year) of treatment response"],"limitations":["Single case, no control group","No validated measures of hypersexual behavior or distress","Potential confounding factors (mood, masturbation, moral views) not assessed"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":28,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1060028014541630"}},{"id":7734,"doi":"10.1007/s00702-021-02326-y","pmid":"33712975","pmcid":"PMC8105194","title":"Endocannabinoid and dopaminergic system: the pas de deux underlying human motivation and behaviors","authors":"Laksmidewi AAAP, Soejitno A.","first_author":"Laksmidewi AAAP","journal":"Journal of neural transmission (Vienna, Austria : 1996)","year":2021,"pub_types":["review-article","Review","Journal Article"],"keywords":["Molecular mechanisms","Neurobehavior","Clinical Implications","Endocannabinoid System","Dopaminergic System"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8105194","cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review-article (narrative)","sample_n":null,"sample_text":"Not applicable – no primary data collected","population":"human (general discussion, no empirical sample)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The article reviews how the brain’s endocannabinoid and dopamine systems interact to drive motivation, from basic needs like food and sex to higher goals, and suggests these pathways could be targeted for treating conditions such as obesity, drug addiction, and hypersexuality.","clinical_takeaway":"The review proposes targeting endocannabinoid–dopamine pathways as a future therapeutic avenue for hypersexuality, but provides no clinical guidance.","confidence":0.8,"topic_tags":["neuroscience","sexual_function"],"strengths":["Broad synthesis of endocannabinoid–dopamine literature","Links neurobiology to a wide range of motivational behaviours"],"limitations":["No empirical data; conclusions are speculative","Lacks systematic review methodology (no risk‑of‑bias assessment)","Does not address key psychosocial confounds for hypersexuality"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00702-021-02326-y"}},{"id":7735,"doi":"10.1176/appi.ajp-rj.2021.160305","pmid":"33796812","pmcid":"PMC8009557","title":"SSRI-Induced Hypersexuality","authors":"Yuan S, Deban CE.","first_author":"Yuan S","journal":"The American journal of psychiatry residents' journal","year":2021,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.ajp-rj.2021.160305"}},{"id":7736,"doi":"10.1007/s00415-021-10498-6","pmid":"33709218","pmcid":null,"title":"Limbic hypoconnectivity in idiopathic REM sleep behaviour disorder with impulse control disorders","authors":"Marques A, Roquet D, Matar E, Taylor NL, Pereira B, O'Callaghan C, Lewis SJG.","first_author":"Marques A","journal":"Journal of neurology","year":2021,"pub_types":["Journal Article"],"keywords":["MRI","Parkinson’s Disease","Impulse Control Disorders","Reward System","Rem Sleep Behaviour Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control MRI study comparing iRBD patients, PD patients and healthy controls; resting‑state functional connectivity analysis; self‑report questionnaires for impulsive‑compulsive disorders and impulsivity.","sample_n":51,"sample_text":"Twenty iRBD patients, 17 PD patients, 14 healthy controls","population":"20 iRBD, 17 PD, 14 healthy controls (adult humans)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A small MRI study found that people with a sleep disorder showed weaker connections between a limbic brain region and visual areas, which was linked to higher reports of hypersexual behaviour compared with controls.","clinical_takeaway":"Evidence linking brain connectivity to hypersexuality is preliminary; clinicians should not infer causality from such imaging findings.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Use of structural and functional MRI","Inclusion of PD and healthy control groups","Validated impulsivity questionnaires (UPPS‑P, QUIP)"],"limitations":["Small sample size for fMRI connectivity","No control for key sexual‑behavior confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":60,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":4,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":37,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00415-021-10498-6"}},{"id":7737,"doi":"10.4088/pcc.20br02663","pmid":"34000142","pmcid":null,"title":"Treatment of Pramipexole-Induced Problematic Sexual Behaviors","authors":"Murphy L, Ly T, DiMario K, Mihowich T, Fedoroff JP.","first_author":"Murphy L","journal":"The primary care companion for CNS disorders","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-series of 4 adult men with pramipexole‑induced problematic sexual behaviors; no control group","sample_n":4,"sample_text":"four adult men with pramipexole‑related sexual problems","population":"adult men (N=4) receiving pramipexole for Parkinson’s disease or restless‑leg syndrome","country":"not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Four men who began having unwanted or risky sexual urges after taking pramipexole (a dopamine drug) were treated successfully; the report describes the cases but uses no standard questionnaires or controls.","clinical_takeaway":"Be alert for hypersexual side‑effects when prescribing pramipexole and consider adjusting the medication if problems arise.","confidence":0.7,"topic_tags":["prevalence","sexual_function","treatment"],"strengths":["Clinical relevance of medication‑induced sexual side‑effects","Clear description of treatment approach"],"limitations":["Very small, uncontrolled case series","No validated measures of problematic sexual behavior","No assessment of confounding factors (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/pcc.20br02663"}},{"id":7738,"doi":"10.1055/a-1365-8868","pmid":"33592669","pmcid":null,"title":"[Concepts of nymphomania in the German academic psychiatry: Changes over the last two centuries]","authors":"Rendel T, Steinberg H.","first_author":"Rendel T","journal":"Fortschritte der Neurologie-Psychiatrie","year":2022,"pub_types":["Historical Article","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Historical narrative review of German psychiatric textbooks; no systematic methodology reported.","sample_n":null,"sample_text":"N/A","population":"N/A (historical texts, no human participants)","country":"Germany (historical focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews German psychiatric textbooks from the 1800s to today, showing how the label ‘nymphomania’ shifted from a disease view to a historical term now removed from modern classifications.","clinical_takeaway":"The historic label ‘nymphomania’ is obsolete; clinicians should use current ICD‑11/DSM criteria for hypersexuality.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Provides a long‑term perspective on the evolution of the nymphomania concept.","Links changes in classification to broader social and medical shifts."],"limitations":["Non‑systematic selection of sources; possible author bias.","No empirical data or quantitative synthesis.","No assessment of modern diagnostic criteria such as ICD‑11 CSBD."],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/a-1365-8868"}},{"id":7739,"doi":"10.3389/fpsyt.2021.635494","pmid":"33633615","pmcid":"PMC7900512","title":"Impulse Control Disorders in Parkinson's Disease: Epidemiology, Pathogenesis and Therapeutic Strategies","authors":"Zhang JF, Wang XX, Feng Y, Fekete R, Jankovic J, Wu YC.","first_author":"Zhang JF","journal":"Frontiers in psychiatry","year":2021,"pub_types":["review-article","Review","Journal Article"],"keywords":["Dopaminergic drugs","Parkinson's Disease","Impulse Control Disorders","Pathological Gambling","Binge Eating","Hypersexuality","Compulsive Buying"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2021.635494/pdf","cited_by_count":38,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"review-article","sample_n":null,"sample_text":"Not applicable – review of existing literature","population":"Parkinson's disease patients with impulse control disorders (including hypersexuality)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarizes how dopaminergic treatment for Parkinson's disease can lead to impulse control disorders such as gambling, binge eating, compulsive buying, and hypersexuality, discussing how common they are, why they happen, and how they might be treated.","clinical_takeaway":"Clinicians should monitor Parkinson's patients on dopamine therapy for a range of impulse control issues, including hypersexuality, and consider treatment adjustments when they arise.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Comprehensive overview of ICDs in PD","Integrates epidemiology, pathogenesis, and treatment"],"limitations":["No primary data; relies on existing studies","Does not assess moral incongruence or related confounds","Potential bias in selection of cited literature"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":59,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2021.635494"}},{"id":7740,"doi":"10.1007/s10508-020-01886-6","pmid":"33211217","pmcid":null,"title":"Correction to: Response to Commentaries: Recognizing Hypersexuality as a Psychosexual Behavioral Problem and Advancing the Sexhavior Cycle of Hypersexuality","authors":"Walton MT, Bhullar N.","first_author":"Walton MT","journal":"Archives of sexual behavior","year":2021,"pub_types":["Published Erratum"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01886-6"}},{"id":7742,"doi":"10.1080/13691058.2020.1863471","pmid":"33512297","pmcid":null,"title":"An investigation of Jezebel stereotype awareness, gendered racial identity and sexual beliefs and behaviours among Black adult women","authors":"Leath S, Jones M, Jerald MC, Perkins TR.","first_author":"Leath S","journal":"Culture, health & sexuality","year":2022,"pub_types":["Journal Article"],"keywords":["Sexuality","Black Women","Jezebel Stereotype","Gendered Racial Identity Beliefs"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of Black women (national sample); measures of identity, stereotype awareness, sexual behaviours; cross‑sectional analysis","sample_n":null,"sample_text":"diverse national sample (size not reported in abstract)","population":"Black adult women (USA)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed Black women in the U.S. and found that stronger identification with their Black womanhood linked to more sexual assertiveness and satisfaction, while greater awareness of the hypersexual \"Jezebel\" stereotype was linked to higher sexual guilt and avoidance of intimacy.","clinical_takeaway":"Positive racial‑gender identity may support sexual wellbeing; clinicians should consider cultural stereotype impacts when addressing sexual guilt or relationship avoidance.","confidence":0.8,"topic_tags":["sexual_function","gender","csbd"],"strengths":["Addresses understudied intersection of race, gender, and sexuality","Uses multiple validated sexual‑behavior scales","Nationally diverse sample"],"limitations":["Cross‑sectional, cannot infer causality","Sample size not reported in abstract","No control for key confounds (mental health, moral factors, trauma)"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2020.1863471"}},{"id":7743,"doi":"10.1016/j.addbeh.2013.11.008","pmid":"24314714","pmcid":null,"title":"Psychometric properties of the Barratt Impulsiveness Scale in patients with gambling disorders, hypersexuality, and methamphetamine dependence","authors":"Reid RC, Cyders MA, Moghaddam JF, Fong TW.","first_author":"Reid RC","journal":"Addictive behaviors","year":2014,"pub_types":["Evaluation Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Addiction","Impulsivity","Hypersexual Behavior","Barratt Impulsiveness Scale","Gambling Disorder","Substance-abuse"],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Psychometric evaluation (factor analysis) of the Barratt Impulsiveness Scale in three clinical groups (pathological gamblers, hypersexual patients, methamphetamine‑dependent individuals).","sample_n":null,"sample_text":"Not reported in abstract; likely modest clinical samples.","population":"Patients with gambling disorder, hypersexuality, and methamphetamine dependence (clinical convenience samples).","country":"United States (NIH‑funded study).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether the Barratt Impulsiveness Scale works the same way in people with gambling problems, hypersexual behaviour, or methamphetamine addiction. It found the usual factor structure didn’t fit and suggested a shorter 12‑item version instead.","clinical_takeaway":"The standard BIS may not reliably assess impulsivity in these clinical groups; consider alternative impulsivity measures.","confidence":0.7,"topic_tags":["measurement","sexual_function","gender","adolescents","csbd"],"strengths":["Uses a widely‑validated impulsivity scale","Includes three distinct clinical groups","Provides new factor structure specific to these populations"],"limitations":["No information on sample size or power","Cross‑sectional convenience samples limit generalisability","Does not assess key confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":44,"citing_publications":128,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2013.11.008"}},{"id":7744,"doi":"10.1080/0092623x.2013.772551","pmid":"24168778","pmcid":null,"title":"Nonparaphilic hypersexual behavior and depressive symptoms: a meta-analytic review of the literature","authors":"Schultz K, Hook JN, Davis DE, Penberthy JK, Reid RC.","first_author":"Schultz K","journal":"Journal of sex & marital therapy","year":2014,"pub_types":["Meta-Analysis","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta‑analytic synthesis of observational studies examining the association between non‑paraphilic hypersexual behavior and depression.","sample_n":null,"sample_text":"Not applicable – aggregate of primary study samples","population":"Adults (both genders, various sexual orientations) from published studies","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of studies finds a moderate positive link (r = .34) between non‑paraphilic hypersexual behavior and depressive symptoms, consistent across gender, sexual orientation and age.","clinical_takeaway":"Clinicians should screen people reporting hypersexual behavior for depression and consider integrated treatment.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Systematic aggregation of effect sizes","Provides pooled estimate (r = .34)","Considers gender, orientation, age moderation"],"limitations":["Primary studies likely use heterogeneous, often unvalidated hypersexuality measures","No assessment of key confounds (e.g., moral incongruence, trauma)","Causal direction remains unclear"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":34,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2013.772551"}},{"id":7745,"doi":"10.1055/s-0033-1357133","pmid":"24142415","pmcid":null,"title":"[A validation study of the German version of the Hypersexual Behavior Inventory (HBI)]","authors":"Klein V, Rettenberger M, Boom KD, Briken P.","first_author":"Klein V","journal":"Psychotherapie, Psychosomatik, medizinische Psychologie","year":2014,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large online convenience sample, validation of German HBI using CFA and reliability analyses","sample_n":1749,"sample_text":"online survey participants, likely self‑selected","population":"1749 German‑speaking men and women (adults)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated the Hypersexual Behavior Inventory into German and tested it with 1,749 participants, finding the questionnaire reliable and confirming its three‑factor structure.","clinical_takeaway":"The German HBI appears reliable for assessing hypersexual behavior, but clinicians should consider contextual factors like moral beliefs and mental health.","confidence":0.8,"topic_tags":["measurement","sexual_function"],"strengths":["Large sample size for validation","Confirmed original 3‑factor structure","Good reliability reported"],"limitations":["Convenience online sample may limit generalisability","No assessment of moral incongruence or related confounds","No pre‑registration reported"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":32,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-0033-1357133"}},{"id":7746,"doi":"10.1097/wnf.0000000000000423","pmid":"33252371","pmcid":null,"title":"Modafinil Induced Spontaneous Ejaculation Without Orgasm: A Case Report","authors":"Aras N.","first_author":"Aras N.","journal":"Clinical neuropharmacology","year":2021,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report describing spontaneous ejaculation after adding modafinil to venlafaxine; no control, no systematic data collection","sample_n":1,"sample_text":"1 patient","population":"male adult with major depressive disorder on venlafaxine","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A man taking modafinil for depression experienced unexpected ejaculation without orgasm; the symptom stopped when the drug was stopped, suggesting modafinil can cause unusual sexual side effects.","clinical_takeaway":"Modafinil may provoke spontaneous ejaculation; clinicians should monitor sexual side effects when prescribing.","confidence":0.9,"topic_tags":["sexual_function","adolescents","masturbation","pornography"],"strengths":["Detailed clinical description","Clear temporal link between modafinil initiation and symptom onset"],"limitations":["Single case; no control or replication","No standardized assessment of sexual function","Potential confounding by other medications or illness"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/wnf.0000000000000423"}},{"id":7747,"doi":"10.1080/00224499.2013.818615","pmid":"24112113","pmcid":"PMC3983182","title":"Hypersexual behavior and HIV sex risk among young gay and bisexual men","authors":"Yeagley E, Hickok A, Bauermeister JA.","first_author":"Yeagley E","journal":"Journal of sex research","year":2014,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 366 young gay/bisexual men; CFA and negative‑binomial regression used.","sample_n":366,"sample_text":"N = 366; single, sexually active young GBM.","population":"Young gay and bisexual men (mean age ≈ 21), United States, recruited for a survey (non‑clinical).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers tested a questionnaire for hypersexual behavior in 366 young gay and bisexual men and linked its sub‑scales to risky condom‑less anal sex. They found that lack of sexual control increased risk, while coping reduced it, suggesting that hypersexual tendencies may influence HIV risk.","clinical_takeaway":"Hypersexual traits, especially poor sexual control, may signal higher HIV risk in young gay/bisexual men; screening could inform targeted prevention.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Validated hypersexual behavior scale (HBI) used","Adequate sample size for CFA and regression","Focus on an understudied high‑risk population"],"limitations":["Cross‑sectional design; cannot infer causality","Key confounds (moral incongruence, masturbatory behavior, mental health) not measured","Hypersexuality operationalised via self‑label scale without testing ICD‑11 criteria"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":3,"contrasting":1,"mentioning":32,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2013.818615"}},{"id":7748,"doi":"10.1002/mdc3.13128","pmid":"33426155","pmcid":"PMC7780950","title":"Does the Country Make a Difference in Impulse Control Disorders? A Systematic Review","authors":"Parra-Díaz P, Chico-García JL, Beltrán-Corbellini Á, Rodríguez-Jorge F, Fernández-Escandón CL, Alonso-Cánovas A, Martínez-Castrillo JC.","first_author":"Parra-Díaz P","journal":"Movement disorders clinical practice","year":2021,"pub_types":["review-article","Review","Journal Article"],"keywords":["Culture","Country","Systematic review","Parkinson's Disease","Impulse Control Disorders"],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"","sample_n":null,"sample_text":"","population":"","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A review of 32 studies found that impulse‑control disorders like hypersexuality occur more often in Parkinson's patients from Western countries than Asia, possibly because of cultural, economic, or health‑system differences.","clinical_takeaway":"Clinicians should consider cultural background when screening Parkinson’s patients for hypersexuality and related impulse‑control issues.","confidence":0.7,"topic_tags":["csbd","sexual_function","neuroscience"],"strengths":["PRISMA‑guided systematic search","covers many countries (32 studies, 22 nations)","highlights cultural variation in ICD phenotypes"],"limitations":["Relies on heterogeneous prevalence studies","No quantitative meta‑analysis","Limited control for potential confounders (age, gender, DA use only)"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":17,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mdc3.13128"}},{"id":7749,"doi":"10.1016/j.jns.2020.117291","pmid":"33383316","pmcid":null,"title":"Impulse control behavior in GBA-mutated parkinsonian patients","authors":"Amami P, De Santis T, Invernizzi F, Garavaglia B, Albanese A.","first_author":"Amami P","journal":"Journal of the neurological sciences","year":2021,"pub_types":["Journal Article"],"keywords":["Dopamine agonists","Parkinson's Disease","Glucocerebrosidase","Impulse Control Disorders","Genotype-phenotype Correlation"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Case‑control screening of 46 Parkinson’s patients (23 GBA‑mutated, 23 non‑mutated) using the QUIP‑RS questionnaire.","sample_n":46,"sample_text":"46 patients (23 GBA‑PD, 23 NM‑PD)","population":"Parkinson’s disease patients, half with GBA mutations","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson’s patients, those carrying a GBA gene mutation showed a higher rate of impulse‑control problems such as hypersexuality and compulsive shopping compared with patients without the mutation; dopamine‑agonist drugs may increase this risk.","clinical_takeaway":"Clinicians should monitor impulse‑control symptoms, especially hypersexuality, in GBA‑mutated Parkinson’s patients treated with dopamine agonists.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Use of validated QUIP‑RS scale","Genetic confirmation of GBA status","Direct comparison group"],"limitations":["Small sample, under‑powered","Cross‑sectional, no causal inference","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":16,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jns.2020.117291"}},{"id":7750,"doi":"10.1136/bcr-2020-238347","pmid":"33303509","pmcid":"PMC7733109","title":"Atypical presentation of anti-N-methyl-D-aspartate receptor encephalitis in a 61-year-old Hispanic man","authors":"Irvine E, Cheng D, Xiao D.","first_author":"Irvine E","journal":"BMJ case reports","year":2020,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Psychiatry","Neurology","Medical Management"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report","sample_n":1,"sample_text":"61‑year‑old Hispanic man (N=1)","population":"1 adult male, 61 years old, Hispanic","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 61‑year‑old man with no prior psychiatric issues suddenly became aggressive, hypersexual, and psychotic. Doctors diagnosed anti‑NMDA receptor encephalitis, highlighting that this brain inflammation can cause sudden personality changes and should be considered in older adults.","clinical_takeaway":"Acute, unexplained hypersexuality in older adults may signal anti‑NMDA receptor encephalitis; consider neurological evaluation.","confidence":0.6,"topic_tags":["neuroscience"],"strengths":["detailed clinical description of a rare presentation","high relevance for differential diagnosis of encephalitis"],"limitations":["single case limits generalisability","no systematic assessment of sexual behaviour or psychosocial confounds"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bcr-2020-238347"}},{"id":7751,"doi":"10.1155/2013/519265","pmid":"24066230","pmcid":"PMC3771452","title":"Relevance of hypersexual disorder to family medicine and primary care as a complex multidimensional chronic disease construct","authors":"Borgermans L, Vrijhoef B, Vandevoorde J, De Maeseneer J, Vansintejan J, Devroey D.","first_author":"Borgermans L","journal":"International journal of family medicine","year":2013,"pub_types":["research-article","Review","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3771452","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"review article describing hypersexual disorder as a chronic disease construct and its relevance to family medicine; no primary data collected","sample_n":null,"sample_text":"N/A","population":"none (conceptual review)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that hypersexual disorder is a poorly defined, complex condition and discusses how family doctors might identify and manage it, but notes that evidence on prevalence, causes, and treatment is limited.","clinical_takeaway":"Clinicians should be cautious interpreting hypersexual disorder as a distinct disease due to limited evidence and lack of validated criteria.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Broad conceptual overview of HD","Highlights gaps in evidence for primary care"],"limitations":["No empirical data or systematic search reported","Lacks measurement of key constructs or confounders"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2013/519265"}},{"id":7752,"doi":"10.1136/acupmed-2013-010386","pmid":"23965302","pmcid":null,"title":"Acupuncture and moxibustion treatment for hypersexuality in a patient who was uraemic: a case report","authors":"Li H, Ni S, Wang Y.","first_author":"Li H","journal":"Acupuncture in medicine : journal of the British Medical Acupuncture Society","year":2013,"pub_types":["Journal Article","Case Reports"],"keywords":["Acupuncture","Sexual Medicine"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-patient case report; no control condition; descriptive outcome","sample_n":1,"sample_text":"N=1 (case report)","population":"60‑year‑old Chinese woman with uraemia and hypersexuality","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"avoid","plain_summary":"A 60‑year‑old woman with kidney disease and intense sexual urges improved after ten days of acupuncture and moxibustion, with symptom relief lasting two years after a brief relapse.","clinical_takeaway":"No evidence that acupuncture reliably treats hypersexuality; clinicians should rely on established therapies.","confidence":0.85,"topic_tags":["sexual_function","treatment"],"strengths":["Detailed longitudinal follow‑up of the single case (2‑year relapse tracking)","Clear description of acupuncture/moxibustion protocol"],"limitations":["No validated measures of hypersexuality or distress","No control or comparison condition; single case limits generalisability","No assessment of key confounds (moral conflict, mental health, partner context)","Interpretation overstates efficacy from one anecdotal observation"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/acupmed-2013-010386"}},{"id":7753,"doi":"10.1016/j.neurol.2020.08.006","pmid":"33276961","pmcid":null,"title":"Othello syndrome in Parkinson's disease: A diagnostic emergency of an underestimated condition","authors":"El Otmani H, Sabiry S, Bellakhdar S, El Moutawakil B, Abdoh Rafai M.","first_author":"El Otmani H","journal":"Revue neurologique","year":2021,"pub_types":["Journal Article"],"keywords":["Parkinson's Disease","Othello Syndrome","Delusional Jealousy"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case series of five Parkinson's disease patients with Othello syndrome identified from a consecutive sample of 250 patients over two years.","sample_n":5,"sample_text":"Five patients","population":"Men with Parkinson's disease on dopaminergic agonists","country":"Morocco (inferred from authors' affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors report five cases of delusional jealousy (Othello syndrome) in men with Parkinson's disease taking dopamine agonists, suggesting the condition may be under‑recognised and warrant early clinical attention.","clinical_takeaway":"Clinicians should be aware that dopaminergic therapy in Parkinson's disease can rarely trigger severe jealousy delusions, sometimes alongside hypersexuality.","confidence":0.7,"topic_tags":["csbd","sexual_function","neuroscience"],"strengths":["Consecutive sampling reduces selection bias","Highlights a rarely discussed PD complication","Provides clinical detail on medication exposure"],"limitations":["Very small sample (N=5) limits generalizability","No systematic assessment tools reported","No control or comparison group"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neurol.2020.08.006"}},{"id":7754,"doi":"10.1080/0092623x.2012.751075","pmid":"23905759","pmcid":null,"title":"Methodological review of treatments for nonparaphilic hypersexual behavior","authors":"Hook JN, Reid RC, Penberthy JK, Davis DE, Jennings DJ.","first_author":"Hook JN","journal":"Journal of sex & marital therapy","year":2014,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"methodological review of existing empirical treatment studies; no new primary data; likely narrative synthesis without formal systematic methods","sample_n":null,"sample_text":"Review of existing studies; no primary participants","population":"individuals with nonparaphilic hypersexual behavior (clinical samples)","country":"USA (journal based, authors likely US)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined studies that tried to treat non‑paraphilic hypersexual behavior and found that most have serious design flaws, making their results unreliable. They suggest ways to improve future research.","clinical_takeaway":"Current treatment evidence is weak; clinicians should be cautious interpreting existing study results.","confidence":0.8,"topic_tags":["treatment","sexual_function","pornography","masturbation"],"strengths":["Comprehensive overview of treatment literature","Identifies methodological gaps","Provides concrete recommendations for future research"],"limitations":["Lacks systematic review methodology","No quantitative synthesis or meta‑analysis","Does not assess publication bias or study quality formally"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":44,"citing_publications":110,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2012.751075"}},{"id":7755,"doi":"10.1002/jclp.22027","pmid":"23852856","pmcid":null,"title":"Mindfulness, emotional dysregulation, impulsivity, and stress proneness among hypersexual patients","authors":"Reid RC, Bramen JE, Anderson A, Cohen MS.","first_author":"Reid RC","journal":"Journal of clinical psychology","year":2014,"pub_types":["Journal Article"],"keywords":["Emotion Regulation","Mindfulness","Hypersexuality","Hypersexual Disorder","Sex Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":51,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case-control, hierarchical regression, n=70 (40 hypersexual patients, 30 controls), male participants","sample_n":70,"sample_text":"40 hypersexual patients, 30 controls (male)","population":"male hypersexual patients recruited from DSM‑5 field trial and healthy male controls","country":"USA","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether mindfulness is linked to lower hypersexual behaviour in 40 men labeled as hypersexual and 30 healthy men, finding that higher mindfulness scores were associated with fewer hypersexual symptoms, even after accounting for emotion regulation, impulsivity and stress.","clinical_takeaway":"Mindfulness may be worth integrating into therapy for hypersexuality, but evidence is limited and causal claims are premature.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Focus on mindfulness as a potential therapeutic factor","Inclusion of a healthy control group","Use of hierarchical regression to assess incremental effects"],"limitations":["Small, convenience sample; likely underpowered","No measurement or control of moral incongruence or masturbation","Cross‑sectional design limits causal inference","Unclear whether scales are validated"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":10,"contrasting":0,"mentioning":55,"citing_publications":170,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/jclp.22027"}},{"id":7756,"doi":"10.1097/wad.0b013e31825c85ae","pmid":"22683665","pmcid":null,"title":"Rivastigmine in the treatment of hypersexuality in Alzheimer disease","authors":"Canevelli M, Talarico G, Tosto G, Troili F, Lenzi GL, Bruno G.","first_author":"Canevelli M","journal":"Alzheimer disease and associated disorders","year":2013,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case report of a single Alzheimer patient with hypersexuality treated with rivastigmine; includes literature brief review.","sample_n":1,"sample_text":"Single patient case report","population":"Older male with Alzheimer disease, age 80+ (single case)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe one Alzheimer’s patient who showed unusually high sexual drive and whose behavior improved after starting the drug rivastigmine. They also briefly review other reports on similar drugs for sexual problems in dementia.","clinical_takeaway":"Rivastigmine might help reduce hypersexual behavior in Alzheimer’s, but evidence is only a single case; clinicians should use caution and consider established treatments first.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Rare clinical observation of hypersexuality in Alzheimer’s","Provides hypothesis‑generating data on cholinesterase‑inhibitor effect","Includes concise literature summary"],"limitations":["Single‑case design; no control condition","No standardized, validated scales for hypersexuality or distress","No systematic assessment of confounding factors (e.g., mood, medication history)","Interpretation may overstate causal effect of rivastigmine"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/wad.0b013e31825c85ae"}},{"id":7757,"doi":"10.3389/fendo.2020.579606","pmid":"33193096","pmcid":"PMC7652723","title":"Depression and Impulsivity Self-Assessment Tools to Identify Dopamine Agonist Side Effects in Patients With Pituitary Adenomas","authors":"Hinojosa-Amaya JM, Johnson N, González-Torres C, Varlamov EV, Yedinak CG, McCartney S, Fleseriu M.","first_author":"Hinojosa-Amaya JM","journal":"Frontiers in endocrinology","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Prolactinoma","Pituitary tumor","Impulsivity","Dopamine Agonist","Patient Health Questionnaire","Impulse Control (Pathology) Disorders","Hyperprocalctinemia"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7652723","cited_by_count":25,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Retrospective case‑control comparison of dopamine‑agonist‑treated (n=76) vs naïve (n=27) pituitary patients; clinic‑based convenience sample.","sample_n":103,"sample_text":"76 DA‑treated, 27 DA‑naïve patients","population":"Adults with pituitary adenomas (prolactinoma, acromegaly, Cushing’s disease) treated at a high‑volume academic center.","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study shows that patients with pituitary tumors who take dopamine‑agonist drugs report higher depression scores and slightly higher impulsivity, measured with standard questionnaires, compared with those not on the drugs.","clinical_takeaway":"Screening for depression and impulsivity with PHQ‑9 and BIS‑11 is advisable when starting dopamine‑agonist therapy in pituitary patients.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Validated screening instruments (PHQ‑9, BIS‑11)","Clear clinical focus on side‑effects of dopamine agonists","Correlation analysis with effect sizes and confidence intervals"],"limitations":["Cross‑sectional, retrospective design limits causal inference","No measurement of moral or relational factors that could affect impulsivity/depression","Small sample, especially for the DA‑naïve group"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fendo.2020.579606"}},{"id":7758,"doi":"10.1007/s10508-013-0137-6","pmid":"23733158","pmcid":null,"title":"Choline associated hypersexuality in a 79-year-old man","authors":"Calabrò RS, Cordici F, Genovese C, Bramanti P.","first_author":"Calabrò RS","journal":"Archives of sexual behavior","year":2014,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single 79‑year‑old man","sample_n":1,"sample_text":"1 participant","population":"elderly male with mild cognitive impairment","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 79‑year‑old man with mild memory problems developed a sudden increase in sexual urges after taking a choline supplement; the urges stopped when the supplement was stopped, suggesting choline might trigger hypersexuality in some older adults.","clinical_takeaway":"Clinicians should monitor for disinhibited sexual behavior when prescribing choline to older patients, but evidence is limited to a single case.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Detailed clinical description","Temporal association between choline intake and symptom onset/resolution"],"limitations":["N=1; no control group","No standardized measures of hypersexuality","No assessment of alternative explanations (e.g., mood, cognition, medication changes)","Causal inference overstated"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0137-6"}},{"id":7759,"doi":"10.4306/pi.2013.10.2.200","pmid":"23798970","pmcid":"PMC3687056","title":"Two cases of hypersexuality probably associated with aripiprazole","authors":"Cheon E, Koo BH, Seo SS, Lee JY.","first_author":"Cheon E","journal":"Psychiatry investigation","year":2013,"pub_types":["Journal Article","case-report"],"keywords":["Dopamine","Aripiprazole","Hypersexuality","Partial Agonist"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3687056","cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":2,"sample_text":"two cases","population":"two female patients with schizophrenia on aripiprazole","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Two women with schizophrenia who started aripiprazole reported a sudden increase in sexual desire and preoccupation, suggesting the drug’s dopamine activity may trigger hypersexuality.","clinical_takeaway":"Aripiprazole can induce heightened sexual urges; monitor patients for this side effect.","confidence":0.4,"topic_tags":["sexual_function","adolescents"],"strengths":["Provides clinical detail on a rare adverse effect","Links pharmacology to observed behavior"],"limitations":["Only two cases, no systematic assessment","No validated measures of hypersexuality","No control for moral incongruence or other confounds"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4306/pi.2013.10.2.200"}},{"id":7760,"doi":null,"pmid":"23888588","pmcid":null,"title":"[Hypersexual disorder will not be included in the DSM V : a contextual analysis]","authors":"Toussaint I, Pitchot W.","first_author":"Toussaint I","journal":"Revue medicale de Liege","year":2013,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that the proposal to add a hypersexual disorder to DSM‑5 was driven more by moral and social values than by solid scientific evidence, questioning how psychiatric diagnoses are created.","clinical_takeaway":"None – the piece is a conceptual critique, not a source of clinical guidance.","confidence":0.8,"topic_tags":["sexual_function","religiosity"],"strengths":["Clear theoretical discussion of diagnostic construction","Highlights sociocultural influences on psychiatric categories"],"limitations":["No empirical data or systematic review methodology","Lacks measurement of key constructs or confounds","Conclusions not grounded in evidence"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":7761,"doi":"10.1080/02791072.2000.10736099","pmid":"11280926","pmcid":null,"title":"Reward deficiency syndrome: a biogenetic model for the diagnosis and treatment of impulsive, addictive, and compulsive behaviors","authors":"Blum K, Braverman ER, Holder JM, Lubar JF, Monastra VJ, Miller D, Lubar JO, Chen TJ, Comings DE.","first_author":"Blum K","journal":"Journal of psychoactive drugs","year":2000,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":522,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review / narrative article proposing a biogenetic model; no original empirical data, no sample size reported.","sample_n":null,"sample_text":"Not applicable – no primary sample","population":"Humans (general, not specified)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article proposes that a genetic‑and‑environmental “reward deficiency” causing low dopamine activity may underlie many impulsive and addictive behaviors, including sex addiction, but offers no new data to test this idea.","clinical_takeaway":"None – the model is theoretical and not supported by direct clinical evidence.","confidence":0.8,"topic_tags":["neuroscience","gender"],"strengths":["Integrates extensive literature on dopamine and reward","Proposes a unifying hypothesis across multiple disorders"],"limitations":["No original empirical data","Speculative model not empirically tested","Lacks measurement of key constructs (e.g., addiction criteria, moral incongruence)","Potential over‑generalization to diverse behaviors"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":40,"contrasting":7,"mentioning":639,"citing_publications":979,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/02791072.2000.10736099"}},{"id":7763,"doi":"10.1111/jocn.15499","pmid":"32956513","pmcid":null,"title":"The experiences of carers looking after people with Parkinson's disease who exhibit impulsive and compulsive behaviours: An exploratory qualitative study","authors":"McKeown E, Saleem T, Magee C, Haddad M.","first_author":"McKeown E","journal":"Journal of clinical nursing","year":2020,"pub_types":["Journal Article"],"keywords":["Parkinson's Disease","Carers","Qualitative Study","Hypersexuality","Impulsive And Compulsive Behaviour"],"is_oa":false,"oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jocn.15499","cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"exploratory qualitative study with 13 carers recruited by convenience sampling; semi‑structured telephone interviews; thematic analysis following COREQ","sample_n":13,"sample_text":"13 carers (convenience sample)","population":"carers of people with Parkinson’s disease who exhibit impulsive and compulsive behaviours (including hypersexuality)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 13 caregivers of Parkinson’s patients revealed that impulsive and compulsive behaviours such as gambling, binge eating, and hypersexuality heavily affect families, relationships, and finances, highlighting the need for better monitoring and support.","clinical_takeaway":"Clinicians should actively monitor for impulsive/compulsive behaviours in Parkinson’s patients and provide education and support to families.","confidence":0.78,"topic_tags":["csbd","sexual_function","neuroscience"],"strengths":["Provides in‑depth carer perspectives","Systematic thematic analysis","Adheres to COREQ reporting standards"],"limitations":["Very small, non‑representative convenience sample","No quantitative measurement of behaviours or distress","Findings not generalizable to broader PD or CSBD populations"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jocn.15499"}},{"id":7765,"doi":"10.1111/jsm.12117","pmid":"23534845","pmcid":"PMC3723783","title":"A psychometric investigation of the hypersexual disorder screening inventory among highly sexually active gay and bisexual men: an item response theory analysis","authors":"Parsons JT, Rendina HJ, Ventuneac A, Cook KF, Grov C, Mustanski B.","first_author":"Parsons JT","journal":"The journal of sexual medicine","year":2013,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Item Response Theory","Confirmatory Factor Analysis","Sexual Compulsivity","Gay And Bisexual Men","Hypersexual Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"psychometric validation of HDSI in a sample of 202 highly sexually active gay and bisexual men; confirmatory factor analysis and item response theory modeling","sample_n":202,"sample_text":"202 highly sexually active gay and bisexual men in New York City","population":"highly sexually active gay and bisexual men (N=202) in New York City","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested how well the Hypersexual Disorder Screening Inventory works in a group of gay and bisexual men, finding it reliably measures a single underlying factor but suggesting a possible second factor related to using sex to cope.","clinical_takeaway":"The HDSI appears reliable for screening hypersexuality, but clinicians should be cautious applying its cut‑offs beyond similar high‑activity populations.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for psychometric work (N=202)","Use of modern IRT methods and CFA","Clear reporting of scale reliability and dimensionality"],"limitations":["Convenience sample of highly sexually active men limits generalisability","No assessment of key confounds (moral incongruence, mental health, etc.)","Screening tool not compared to clinical diagnosis"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":2,"mentioning":64,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12117"}},{"id":7766,"doi":"10.1080/0092623x.2020.1822484","pmid":"32938329","pmcid":null,"title":"Dysregulated Sexuality in Women with Eating Disorders: The Role of Childhood Traumatic Experiences","authors":"Castellini G, D'Anna G, Rossi E, Cassioli E, Appignanesi C, Monteleone AM, Rellini AH, Ricca V.","first_author":"Castellini G","journal":"Journal of sex & marital therapy","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"observational comparison of binge‑purging vs restricting female eating‑disorder patients, using validated questionnaires (HBI, CTQ) and hormone assay (ghrelin); moderation analyses performed","sample_n":null,"sample_text":"clinical sample of women with binge‑purging and restricting eating disorders (exact N not reported in abstract)","population":"women with eating disorders (clinical sample)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among women with eating disorders, those who binge‑purge show higher hypersexuality, which is linked to worse mental health, difficulty regulating emotions, and childhood trauma, especially when trauma is present.","clinical_takeaway":"In women with eating disorders, hypersexual behaviour may signal underlying trauma and emotion‑regulation problems; assess trauma history.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of validated instruments (HBI, CTQ)","Inclusion of biological marker (ghrelin)","Analysis of moderation by trauma"],"limitations":["Cross‑sectional design limits causal inference","No assessment of moral or relational confounds","Sample size not reported; power unclear"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":17,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2020.1822484"}},{"id":7768,"doi":"10.1556/jba.1.2012.013","pmid":"26165766","pmcid":null,"title":"Codependence with hypersexual and gambling disorder","authors":"Crozier MK, Hillock C.","first_author":"Crozier MK","journal":"Journal of behavioral addictions","year":2013,"pub_types":["Journal Article"],"keywords":["Addiction","Codependence","Biopsychosocial Model","Behavioral Addictions","Hypersexual Disorder","Gambling Disorder"],"is_oa":false,"oa_url":"https://doi.org/10.1556/jba.1.2012.013","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"selected narrative review without systematic methods or empirical data","sample_n":null,"sample_text":"none (review article)","population":"not applicable","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The authors argue that people close to individuals with hypersexual or gambling disorders may develop codependent problems, but they provide only a theoretical discussion without new data.","clinical_takeaway":"No direct clinical guidance; highlights the need to consider family impact when treating behavioral addictions.","confidence":0.7,"topic_tags":["sexual_function","gender","relationships"],"strengths":["Addresses a rarely‑studied collateral impact of behavioral addictions","Integrates biopsychosocial perspective"],"limitations":["No empirical data; purely theoretical","Lacks systematic review methodology","No measurement of constructs or control of confounds"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/jba.1.2012.013"}},{"id":7769,"doi":"10.4103/aian.aian_47_20","pmid":"33623263","pmcid":"PMC7887492","title":"Gender Differences in Impulse Control Disorders and Related Behaviors in Patients with Parkinson's Disease and its Impact on Quality of Life","authors":"Paul BS, Singh G, Bansal N, Singh G, Paul G.","first_author":"Paul BS","journal":"Annals of Indian Academy of Neurology","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Quality of life","Compulsive Behaviors","Impulse Control Disorders And Related Compulsive Behaviors","Impulse Control Disorders Not Classified Elsewhere","Impulsive-Compulsive Disorders In Parkinson’S Disease"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7887492","cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"hospital-based observational cross‑sectional study of 102 Parkinson’s patients","sample_n":102,"sample_text":"102 patients, gender‑balanced sample of PD outpatients","population":"Patients with Parkinson’s disease on dopamine replacement therapy (India)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 102 Indian Parkinson’s patients, about 41% showed impulse‑control problems such as hypersexuality. Women had a slightly higher rate. Those with these behaviors took higher dopamine doses, had more advanced disease, and reported poorer quality of life.","clinical_takeaway":"Impulse‑control disorders, including hypersexuality, are common in Parkinson’s and relate to worse quality of life; clinicians should screen for them.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of validated screening (QUIP‑RS) and QoL (PDQ‑39) instruments","Clear reporting of prevalence and gender comparison","Clinical relevance for PD management"],"limitations":["Cross‑sectional design limits causal inference","No measurement of sexual‑specific confounds (masturbation, moral incongruence, mental health)","Single centre, limited generalisability"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/aian.aian_47_20"}},{"id":7770,"doi":"10.1097/jcp.0000000000001272","pmid":"32796389","pmcid":null,"title":"A Case of Hypersexuality Probably Associated With Lurasidone","authors":"Ward HB, Almeida M.","first_author":"Ward HB","journal":"Journal of clinical psychopharmacology","year":2020,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/jcp.0000000000001272"}},{"id":7771,"doi":"10.1345/aph.1r533","pmid":"23324505","pmcid":null,"title":"High-dose oral medroxyprogesterone for inappropriate hypersexuality in elderly men with dementia: a case series","authors":"Cross BS, DeYoung GR, Furmaga KM.","first_author":"Cross BS","journal":"The Annals of pharmacotherapy","year":2013,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case series of 10 elderly men with dementia treated with high‑dose oral medroxyprogesterone; no control group, retrospective chart review.","sample_n":10,"sample_text":"Ten men aged 65–93 years (median 79.5).","population":"Men ≥65 y with dementia and inappropriate hypersexuality, recruited from a tertiary psychiatric hospital (N=10).","country":"USA (implied by journal, not specified).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"supports","citation_value":"background","plain_summary":"In ten elderly men with dementia who showed sexually inappropriate behavior, high‑dose oral medroxyprogesterone appeared to reduce those behaviors in seven cases, based on clinicians’ notes, but the study lacked controls and standardized outcome measures.","clinical_takeaway":"Evidence is insufficient to recommend medroxyprogesterone for hypersexuality; use only within a trial framework and monitor closely.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Rare pharmacologic data for a neglected clinical problem","Provides dosage range and tolerability observations"],"limitations":["Very small, uncontrolled case series","Outcome based on undocumented chart notes, no validated measure","Potential confounding from hospitalization environment"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1345/aph.1r533"}},{"id":7772,"doi":"10.1007/s10508-012-0042-4","pmid":"23297146","pmcid":"PMC3596488","title":"Hypersexual behavior in frontotemporal dementia: a comparison with early-onset Alzheimer's disease","authors":"Mendez MF, Shapira JS.","first_author":"Mendez MF","journal":"Archives of sexual behavior","year":2013,"pub_types":["Comparative Study","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":54,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative observational study of 47 bvFTD patients vs 58 AD patients, assessing caregiver‑reported hypersexual behavior.","sample_n":105,"sample_text":"47 bvFTD, 58 AD","population":"Patients with behavioral‑variant frontotemporal dementia and early‑onset Alzheimer’s disease; clinical samples recruited from dementia clinics.","country":"USA (assumed from authors’ affiliations)","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a clinic sample, 13% of patients with frontotemporal dementia showed a marked increase in sexual activity that distressed caregivers, whereas none of the Alzheimer’s patients did. The authors suggest this may reflect a specific brain‑region effect on sexual drive.","clinical_takeaway":"Hypersexual behavior can be a feature of frontotemporal dementia; clinicians should monitor for distressing sexual changes in these patients.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["Direct comparison of two dementia subtypes","Clear definition of hypersexual behavior as caregiver‑reported distress","Reasonable overall sample size for rare clinical condition"],"limitations":["No validated hypersexuality scale; reliance on single-item caregiver reports","No control for moral/religious attitudes, masturbation, mental health or trauma","Small number of hypersexual cases (n=6) limits statistical power","Cross‑sectional design cannot establish causality"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":5,"contrasting":2,"mentioning":79,"citing_publications":87,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-012-0042-4"}},{"id":7773,"doi":"10.1080/10720162.2013.768132","pmid":"24273404","pmcid":"PMC3836191","title":"Should Hypersexual Disorder be Classified as an Addiction?","authors":"Kor A, Fogel Y, Reid RC, Potenza MN.","first_author":"Kor A","journal":"Sexual addiction & compulsivity","year":2013,"pub_types":["research-article","Journal Article"],"keywords":["Sex","Substance Abuse","Gambling","Behavioral Addictions","Hypersexual Disorder"],"is_oa":false,"oa_url":"https://doi.org/10.1080/10720162.2013.768132","cited_by_count":70,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary-discussion article without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review whether hypersexual disorder should be classified like an addiction, comparing it to substance and gambling disorders, and conclude that more research is needed before making that determination.","clinical_takeaway":"Clinicians should be cautious labeling hypersexual behavior as an addiction until clearer evidence emerges.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides a balanced overview of the debate","Cites existing field trial data","Highlights gaps in current research"],"limitations":["No original empirical data","Lacks systematic review methodology","No quantitative assessment of criteria"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":187,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10720162.2013.768132"}},{"id":7775,"doi":"10.1111/cen.14283","pmid":"32654174","pmcid":null,"title":"Sexual function and depressive symptoms in young women with hypoprolactinaemia","authors":"Krysiak R, Kowalcze K, Okopień B.","first_author":"Krysiak R","journal":"Clinical endocrinology","year":2020,"pub_types":["Journal Article"],"keywords":["Prolactin","Depression","Sexual Functioning","Dopaminergic Agents","Lactotrope Hypofunction"],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"prospective case‑control study with three age‑matched groups (N=15, 25, 30). Hormone assays and validated questionnaires (FSFI, BDI‑II) at baseline and 6 months.","sample_n":70,"sample_text":"15 hypoprolactinaemic women, 25 cabergoline‑treated normoprolactinaemic women, 30 dopamine‑agonist‑naïve controls","population":"young women with normal menstrual cycles, some receiving cabergoline.","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Young women whose prolactin levels were very low because of a dopamine‑blocking drug had poorer sexual desire and more depressive symptoms, which improved after the drug dose was reduced.","clinical_takeaway":"Dopamine agonist‑induced low prolactin may impair sexual function and mood in women; dose reduction can restore them.","confidence":0.7,"topic_tags":["sexual_function","csbd","gender"],"strengths":["Use of validated sexual function and depression scales","Prospective measurement with hormonal assays","Age‑matched control groups"],"limitations":["Small sample, especially in hypoprolactinaemia group","No control for moral, relational or trauma variables","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/cen.14283"}},{"id":7776,"doi":"10.1097/nmd.0b013e3182718d67","pmid":"23124185","pmcid":null,"title":"Facets of perfectionism in a sample of hypersexual patients","authors":"Reid RC, Cooper EB, Prause N, Li DS, Fong TW.","first_author":"Reid RC","journal":"The Journal of nervous and mental disease","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 136 treatment‑seeking adults completing the Perfectionism Inventory and Hypersexual Behavior Inventory","sample_n":136,"sample_text":"N = 136 treatment‑seeking adults (men and women) who completed the PI and HBI","population":"treatment‑seeking hypersexual patients (adult men and women)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 136 adults seeking treatment for hypersexuality, higher perfectionism—especially fear of making mistakes—was linked to greater hypersexual behavior, while planning ability was linked to less. The study suggests self‑criticism and impulsivity may drive problematic sexual behavior.","clinical_takeaway":"Clients with hypersexual concerns may benefit from addressing perfectionistic self‑criticism and impulsivity in therapy.","confidence":0.8,"topic_tags":["sexual_function","csbd","moral_incongruence"],"strengths":["Validated psychometric instruments (PI, HBI)","Moderate sample size for a clinical convenience sample","Clear statistical associations reported"],"limitations":["Cross‑sectional design prevents causal inference","No control for key confounds (moral incongruence, mental health, trauma)","Treatment‑seeking sample limits generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/nmd.0b013e3182718d67"}},{"id":7777,"doi":"10.1177/1557988320949355","pmid":"32772691","pmcid":"PMC7418259","title":"Self-Reported Sexual Behavioral Similarities and Differences Among Young Men Who Have Sex With Men With Childhood Sexual Abuse Histories: A Qualitative Exploratory Study","authors":"Emetu RE, Yarber WL, Sherwood-Laughlin CM, Brandt AS.","first_author":"Emetu RE","journal":"American journal of men's health","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","HIV/AIDS","Sexually Transmitted Infections","Men Who Have Sex With Men","Childhood Sexual Abuse"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7418259","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative exploratory interview study with 16 participants (YMSM survivors of CSA). Thematic analysis using phenomenological framework.","sample_n":16,"sample_text":"Sixteen YMSM who were survivors of CSA were interviewed.","population":"Young men who have sex with men (YMSM) with childhood sexual abuse histories, United States.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 16 young gay men who were abused as children revealed that those who experienced penile‑anal abuse described themselves as hypersexual, reported more STIs and non‑condom use, and sometimes had a third partner. The study suggests that early abuse type influences later sexual risk behaviours.","clinical_takeaway":"Clinicians should consider the specific nature of childhood sexual abuse when assessing sexual‑risk behaviours in young MSM.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["In‑depth phenomenological interviews provide rich contextual data.","Focus on differentiating types of CSA and associated sexual behavior.","Identifies specific themes (e.g., hypersexual self‑definition, partner dynamics)."],"limitations":["Very small, non‑representative convenience sample (N=16).","No validated quantitative measures; findings are descriptive.","No control for key confounds such as mental health or moral incongruence."],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1557988320949355"}},{"id":7779,"doi":"10.1016/j.jsxm.2020.05.002","pmid":"32580914","pmcid":null,"title":"Repetitive Transcranial Magnetic Stimulation as a Potential Tool to Reduce Sexual Arousal: A Proof of Concept Study","authors":"Schecklmann M, Sakreida K, Oblinger B, Langguth B, Poeppl TB.","first_author":"Schecklmann M","journal":"The journal of sexual medicine","year":2020,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":["Repetitive transcranial magnetic stimulation","Sexual Arousal","Dorsolateral Prefrontal Cortex","Neuromodulation","Hypersexual"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"randomized, double‑blind, sham‑controlled crossover trial with 19 healthy male participants; each received left DLPFC, right DLPFC, and sham stimulation in counterbalanced order.","sample_n":19,"sample_text":"19 healthy male participants","population":"healthy adult males (N=19)","country":"not reported in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small crossover trial, a single session of high‑frequency rTMS over the right prefrontal cortex lowered men’s self‑reported sexual arousal to visual cues, suggesting the technique might help control hypersexual urges.","clinical_takeaway":"Single‑session right‑DLPFC rTMS may modestly reduce sexual arousal, but evidence is preliminary; larger trials are needed before clinical use.","confidence":0.7,"topic_tags":["relationships","neuroscience","sexual_function","treatment"],"strengths":["Randomised, double‑blind, sham‑controlled crossover design","Clear operationalisation of the intervention (rTMS parameters)","Exploratory analysis linking trait desire to effect size"],"limitations":["Very small sample (N=19) limits statistical power","Outcome based solely on a single subjective rating, no physiological validation","No assessment of potential confounds such as masturbation, mental health, or moral attitudes"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.05.002"}},{"id":7780,"doi":"10.1111/1556-4029.14477","pmid":"32525581","pmcid":null,"title":"Sexual Behavioral Disinhibition Associated with Nucleus Lentiformis Lesion: A Forensic Neuroscience Perspective Through a Case","authors":"Balcioglu YH, Dogan M, Incı I, Solmaz M.","first_author":"Balcioglu YH","journal":"Journal of forensic sciences","year":2020,"pub_types":["Journal Article","Case Reports"],"keywords":["Neurobiology","Criminal Responsibility","Kluver-bucy Syndrome","Forensic Psychiatry","Sexual Offense","Cerebrovascular Infarction","Nucleus Lentiformis","Sexual Deviant Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case report of a 38‑year‑old male with nucleus lentiformis infarction and subsequent hypersexual behavior; forensic psychiatric evaluation used; no comparison group","sample_n":1,"sample_text":"N=1 (case report)","population":"1 male adult with cerebrovascular lesion","country":"Turkey (inferred from author names, not stated)","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 38‑year‑old man suffered a stroke affecting the lentiform nucleus and later displayed unusually high sexual interest and committed a sexual assault. The authors suggest the brain injury may have disinhibited his sexual behavior, but conclusions are based on a single case without systematic measures.","clinical_takeaway":"Do not assume a brain lesion automatically causes hypersexual offending; thorough clinical assessment is needed.","confidence":0.6,"topic_tags":["sexual_function","gender"],"strengths":["Detailed forensic psychiatric evaluation","Integration of neuroimaging with clinical presentation","First report linking lentiform nucleus lesion to hypersexual behavior"],"limitations":["Single case, no control group","No validated measures of sexual behavior or addiction","No assessment of key confounds (moral, mental health, trauma)","Causal inference from single observation"],"rubric_version":"2.0","raw_total":13,"max_possible":60,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":4,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1556-4029.14477"}},{"id":7782,"doi":"10.1521/pdps.2012.40.3.481","pmid":"23002706","pmcid":null,"title":"Toward a definition of \"hypersexuality\" in children and adolescents","authors":"Adelson S, Bell R, Graff A, Goldenberg D, Haase E, Downey JI, Friedman RC.","first_author":"Adelson S","journal":"Psychodynamic psychiatry","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary proposing a definition of juvenile hypersexuality without original empirical data.","sample_n":null,"sample_text":"No original participants; paper reviews existing literature.","population":"children and adolescents (theoretical focus)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"useful","plain_summary":"The paper reviews how \"hypersexuality\" in children and teens is described, notes the lack of a clear definition, and suggests criteria and measurement tools to differentiate normal from problematic sexual behavior.","clinical_takeaway":"Clinicians should be cautious interpreting high sexual activity in youth and use clear, validated criteria before labeling it hypersexuality.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive review of existing literature","Attempts to create a measurable definition","Highlights importance of distinguishing normal from pathological behavior"],"limitations":["No original empirical data","No validated measurement tools applied","Lacks systematic review methodology"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1521/pdps.2012.40.3.481"}},{"id":7783,"doi":"10.1556/jba.1.2012.001","pmid":"26165461","pmcid":null,"title":"Psychometric development of the hypersexual behavior consequences scale","authors":"Reid RC, Garos S, Fong T.","first_author":"Reid RC","journal":"Journal of behavioral addictions","year":2012,"pub_types":["Journal Article"],"keywords":["Consequences","Sexual Addiction","Sexual Compulsivity","Hypersexual Disorder","Sex-risk Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":62,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional psychometric development study using patients recruited in a DSM‑5 field trial for Hypersexual Disorder.","sample_n":null,"sample_text":"Patients recruited in a DSM‑5 Field Trial for Hypersexual Disorder; exact N not given in abstract.","population":"Patients with and without hypersexual disorder (DSM‑5 field trial sample).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and tested a questionnaire (HBCS) that measures the personal problems linked to hypersexual behavior. It shows strong reliability and is related to emotional regulation, impulsivity, and life satisfaction.","clinical_takeaway":"The HBCS may help clinicians identify and track negative impacts of hypersexual behavior in patients.","confidence":0.7,"topic_tags":["measurement","sexual_function"],"strengths":["Rigorous factor‑analysis leading to a single‑factor scale","High internal consistency and test‑retest stability","Correlations with relevant psychological constructs (impulsivity, dysregulation)"],"limitations":["No assessment of moral or religious factors that may influence perceived consequences","Sample size and composition not reported in abstract","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":56,"citing_publications":154,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/jba.1.2012.001"}},{"id":7785,"doi":"10.1097/01.pra.0000416016.37968.eb","pmid":"22805900","pmcid":null,"title":"Exploring facets of personality in a patient sample of hypersexual women compared with hypersexual men","authors":"Reid RC, Dhuffar MK, Parhami I, Fong TW.","first_author":"Reid RC","journal":"Journal of psychiatric practice","year":2012,"pub_types":["Comparative Study","Multicenter Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative treatment‑seeking sample; N=78 (31 women, 47 men); NEO‑PI‑R and Hypersexual Behavior Inventory administered; no longitudinal or experimental manipulation.","sample_n":78,"sample_text":"31 hypersexual women, 47 hypersexual men (treatment‑seeking).","population":"Adults (men and women) seeking treatment for hypersexuality; US (California) participants; convenience sample.","country":"United States","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of men and women who sought treatment for hypersexuality, researchers compared personality traits and found both groups shared impulsivity and emotional dysregulation, while women showed more distrust and lower confidence.","clinical_takeaway":"Personality traits such as impulsivity may be relevant treatment targets for hypersexuality in both genders.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Use of validated personality inventory","Focus on gender differences","Relatively large combined sample for a clinical group"],"limitations":["Treatment‑seeking convenience sample limits generalisability","No control for key confounds (moral incongruence, mental health, trauma)","Cross‑sectional; cannot infer causality","Potential circularity in defining hypersexuality via self‑report scale"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":4,"interpretation":5}},"scite":{"supporting":2,"contrasting":1,"mentioning":36,"citing_publications":100,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.pra.0000416016.37968.eb"}},{"id":7786,"doi":"10.1007/s11948-020-00207-3","pmid":"32189235","pmcid":"PMC7286862","title":"Clarifying the Normative Significance of 'Personality Changes' Following Deep Brain Stimulation","authors":"Pugh J.","first_author":"Pugh J.","journal":"Science and engineering ethics","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Personality","Authenticity","Deep brain stimulation","identity","Agency","Autonomy","Self"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s11948-020-00207-3.pdf","cited_by_count":18,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"No new empirical sample; discussion based on existing literature","population":"patients undergoing deep brain stimulation (DBS), primarily for Parkinson's disease; no new empirical sample presented","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper analyzes whether deep brain stimulation can change aspects of personality such as identity, autonomy, and sexuality, highlighting differing views among ethicists and suggesting ways to clarify the debate.","clinical_takeaway":"None - not clinically applicable.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["Integrates ethical and empirical perspectives","Clarifies conceptual disagreements"],"limitations":["No original empirical data","Limited methodological detail"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11948-020-00207-3"}},{"id":7787,"doi":"10.1016/j.neurol.2019.10.007","pmid":"32139181","pmcid":null,"title":"Impulse control disorder-linked hypersexuality complicated by disseminated gonococcal infection in a patient with Parkinson's disease","authors":"Moegle C, Grillon A, Anheim M, Lipsker D, Velter C.","first_author":"Moegle C","journal":"Revue neurologique","year":2020,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neurol.2019.10.007"}},{"id":7788,"doi":"10.1210/clinem/dgz076","pmid":"31580439","pmcid":null,"title":"Impulse Control Disorders in Dopamine Agonist-Treated Hyperprolactinemia: Prevalence and Risk Factors","authors":"De Sousa SMC, Baranoff J, Rushworth RL, Butler J, Sorbello J, Vorster J, Thompson T, McCormack AI, Inder WJ, Torpy DJ.","first_author":"De Sousa SMC","journal":"The Journal of clinical endocrinology and metabolism","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Multicenter Study","Journal Article"],"keywords":["Prolactinoma","Dopamine agonists","hyperprolactinemia","Impulse Control Disorders","Hypersexuality"],"is_oa":false,"oa_url":null,"cited_by_count":52,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Multicenter cross‑sectional case‑control study of 113 dopamine‑agonist‑treated hyperprolactinemic patients and 99 community controls.","sample_n":212,"sample_text":"113 patients, 99 controls","population":"Adults with hyperprolactinemia receiving dopamine agonists; comparison with healthy controls.","country":"Australia (multicenter, likely includes other sites)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"People with prolactin‑producing tumors who take dopamine medicines are more likely to develop impulse‑control problems like hypersexuality, compared with healthy people. Men, those with normal sex hormone levels, and those with psychiatric issues are at higher risk.","clinical_takeaway":"Clinicians should screen dopamine‑agonist‑treated hyperprolactinemia patients for hypersexuality and other impulse‑control issues, especially in men.","confidence":0.78,"topic_tags":["sexual_function","gender","treatment","adolescents"],"strengths":["Uses validated questionnaires (QUIP‑S, HBI).","Large multicenter sample for a rare condition.","Includes both patient and community control groups."],"limitations":["Cross‑sectional design cannot establish causality.","Moral incongruence, masturbation, partner, and trauma not assessed.","No pre‑registration or power justification reported."],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":2,"mentioning":78,"citing_publications":91,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1210/clinem/dgz076"}},{"id":7789,"doi":"10.1080/13554794.2020.1727929","pmid":"32079483","pmcid":null,"title":"The Neurology of Acquired Pedophilia","authors":"Lopes PMG, Prado CSC, de Oliveira-Souza R.","first_author":"Lopes PMG","journal":"Neurocase","year":2020,"pub_types":["Review","Journal Article"],"keywords":["Hypersexuality","Medial Forebrain Bundle","Perifornical Region","Acquired Sociopathy","Acquired Pedophilia","Frontotemporoinsular Cortices"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review of 22 published case reports; no new empirical data; narrative synthesis.","sample_n":null,"sample_text":"Twenty‑two published cases meeting inclusion criteria.","population":"Adults with acquired pedophilia reported in case literature (mostly men).","country":"Not specified (international case reports).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed 22 published cases where brain injury was linked to the sudden onset of pedophilic behavior, finding that damage to right frontotemporal‑insular brain regions (but not the anterior hypothalamus) often coincided with hypersexuality.","clinical_takeaway":"Acquired pedophilia may arise from specific right‑hemisphere brain damage, suggesting a neurological basis in rare cases.","confidence":0.85,"topic_tags":["neuroscience","sexual_function","pornography","masturbation"],"strengths":["Comprehensive collation of rare cases","Anatomical mapping across multiple reports","Highlights potential right‑hemisphere involvement"],"limitations":["Narrative review without systematic methodology","No quantitative synthesis or bias assessment","Relies on heterogeneous case reports","Limited to reported cases; possible publication bias"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13554794.2020.1727929"}},{"id":7790,"doi":"10.1111/j.1744-6171.2011.00312.x","pmid":"22299806","pmcid":null,"title":"Biopsychosocial model of hypersexuality in adolescent girls with bipolar disorder: strategies for intervention","authors":"Basco MR, Celis-de Hoyos CE.","first_author":"Basco MR","journal":"Journal of child and adolescent psychiatric nursing : official publication of the Association of Child and Adolescent Psychiatric Nurses, Inc","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of existing literature; no new empirical data.","sample_n":null,"sample_text":"Not applicable – literature review","population":"Adolescent girls with bipolar disorder (no sample size; literature review)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review research on hypersexual behavior in adolescent girls with bipolar disorder and propose a biopsychosocial model with recommendations for cognitive‑behavioral interventions.","clinical_takeaway":"Clinicians should consider sexual health education and behavior management when treating bipolar adolescents.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Integrates existing literature into a biopsychosocial framework","Provides practical intervention suggestions"],"limitations":["No original empirical data","No systematic review methods reported","No measurement of key confounds"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1744-6171.2011.00312.x"}},{"id":7793,"doi":"10.1371/journal.pone.0227128","pmid":"31910240","pmcid":"PMC6946157","title":"What drugs modify the risk of iatrogenic impulse-control disorders in Parkinson's disease? A preliminary pharmacoepidemiologic study","authors":"Jeon N, Bortolato M.","first_author":"Jeon N","journal":"PloS one","year":2020,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6946157","cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective pharmacoepidemiologic analysis of 935 Parkinson's patients using health‑record data; multivariable logistic regression to estimate odds of impulse‑control disorders associated with dopaminergic therapy and co‑medications.","sample_n":935,"sample_text":"935 patients","population":"Adults with Parkinson's disease (n = 935) receiving pramipexole or ropinirole; data extracted from clinical records.","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson’s patients taking dopamine agonists, adding certain antidepressants or glutamate‑targeting drugs did not lower the risk of impulse‑control problems like gambling or hypersexuality, and might even raise it.","clinical_takeaway":"Prescribing SSRIs or glutamatergic agents does not appear to protect Parkinson’s patients on dopamine agonists from impulse‑control disorders.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large administrative dataset (n > 900)","Multivariable adjustment for key demographic and clinical covariates","Reporting of confidence intervals for odds ratios"],"limitations":["Reliance on diagnostic codes; no validated ICD‑specific scales","Cross‑sectional design limits causal inference","No assessment of moral or relational factors that could confound hypersexuality outcomes"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0227128"}},{"id":7794,"doi":"10.1007/s00415-019-09692-4","pmid":"31902006","pmcid":null,"title":"Dynamics of impulsive-compulsive behaviors in early Parkinson's disease: a prospective study","authors":"Marković V, Stanković I, Petrović I, Stojković T, Dragašević-Mišković N, Radovanović S, Svetel M, Stefanova E, Kostić V.","first_author":"Marković V","journal":"Journal of neurology","year":2020,"pub_types":["Journal Article"],"keywords":["Hemiparkinsonism","Impulse Control Disorders","Punding"],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort of 106 early‑PD patients and 125 controls, assessed annually for 5 years","sample_n":231,"sample_text":"106 PD patients, 125 controls; consecutive outpatients, follow‑up at years 1, 2, 3, 5","population":"early‑stage Parkinson’s disease outpatients (Hoehn‑Yahr 1) and healthy controls","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In early Parkinson’s disease, impulsive‑compulsive behaviors (including hypersexuality) become more common over five years, especially in patients taking dopamine agonists. Risk factors differ by behavior type, such as younger age for compulsive buying.","clinical_takeaway":"Monitor patients on dopamine agonists for emerging impulsive‑compulsive behaviors and adjust treatment early.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["large longitudinal cohort with repeated measures","inclusion of healthy control group","identifies medication‑related risk factors"],"limitations":["ICB assessment based on unspecified clinical criteria (potentially low construct validity)","No control for moral or sexual‑behavior confounders","Limited detail on statistical power and effect‑size reporting"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":14,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00415-019-09692-4"}},{"id":7796,"doi":"10.2174/1871527319666200303120147","pmid":"32124704","pmcid":null,"title":"Risk Analysis of Lurasidone in Patients with Schizophrenia and Bipolar Depression","authors":"Modugula H, Kumar A.","first_author":"Modugula H","journal":"CNS & neurological disorders drug targets","year":2020,"pub_types":["Meta-Analysis","Systematic Review","Journal Article"],"keywords":["Depression","Bipolar disorder","Adverse drug reactions","Dystonia","Schizophrenia.","Lurasidone"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"systematic review and meta‑analysis of 17 published studies on lurasidone adverse drug reactions","sample_n":17,"sample_text":"17 studies selected after screening 419 records (total participant number not reported in abstract)","population":"patients with schizophrenia or bipolar depression treated with lurasidone","country":"United States (FDA approval context); studies from multiple locations","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["no_mi_control","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors reviewed 17 studies on lurasidone and found several rare side effects, including hypersexuality. While the drug works for schizophrenia and bipolar depression, more safety data are needed.","clinical_takeaway":"Lurasidone may cause hypersexuality; clinicians should monitor sexual side‑effects and weigh them against benefits.","confidence":0.75,"topic_tags":["adolescents"],"strengths":["Systematic approach to identify studies","Uses established Naranjo algorithm for ADR causality","Highlights previously unlisted ADRs including hypersexuality"],"limitations":["No validated sexual behaviour scales; hypersexuality inferred from case reports","No assessment of moral incongruence or other psychosocial confounds","Effect‑size data and heterogeneity not reported in abstract"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2174/1871527319666200303120147"}},{"id":7797,"doi":"10.4103/aian.aian_428_19","pmid":"32055117","pmcid":"PMC7001430","title":"Apomorphine: The Initial Indian Experience in Relation to Response Tests and Pumps","authors":"Prashanth LK, Jaychandran R, Seetharam R, Iyer RB.","first_author":"Prashanth LK","journal":"Annals of Indian Academy of Neurology","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["India","Adverse effects","Apomorphine Pumps","Apomorphine Response Test"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7001430","cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective analysis of 29 Parkinson’s disease patients undergoing apomorphine response test; subset (6) received pumps.","sample_n":29,"sample_text":"Twenty‑nine confirmed PD patients underwent ART; six received pumps.","population":"Indian patients with confirmed Parkinson’s disease","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a small Indian series of Parkinson’s patients, apomorphine showed good motor response but caused common side effects, including nausea and, in a few cases, increased sexual desire.","clinical_takeaway":"Apomorphine can improve motor symptoms in PD, but clinicians should monitor for hypersexuality among other adverse effects.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["First Indian report of apomorphine response testing","Provides real‑world adverse‑event data"],"limitations":["Very small sample, no control group","Retrospective design, no standardized efficacy measures","Hypersexuality only noted descriptively, no sexual‑behaviour assessment"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/aian.aian_428_19"}},{"id":7799,"doi":null,"pmid":"21731984","pmcid":null,"title":"Hypersexual features in Huntington's disease","authors":"Jhanjee A, Anand KS, Bajaj BK.","first_author":"Jhanjee A","journal":"Singapore medical journal","year":2011,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case report of a 30‑year‑old woman with Huntington’s disease presenting hypersexuality; treatment with olanzapine and haloperidol described.","sample_n":1,"sample_text":"1 patient","population":"adult female with early‑onset Huntington’s disease (n=1)","country":"Singapore","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 30‑year‑old woman with early Huntington’s disease showed unusually high sexual activity. Doctors treated her with antipsychotic drugs (olanzapine and haloperidol) and reported improvement, but the report is based on one patient without standardized measures.","clinical_takeaway":"Evidence is limited to one case; antipsychotics may help hypersexuality in HD, but larger studies are needed.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","treatment"],"strengths":["Rare clinical description","Provides treatment observation"],"limitations":["Single case, no systematic measurement","No validated hypersexuality assessment","No control of confounding factors"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":7800,"doi":null,"pmid":"5164866","pmcid":null,"title":"[Treatment of compulsive sexual perversions]","authors":"Giese H.","first_author":"Giese H.","journal":"Journal of neuro-visceral relations","year":1971,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":7801,"doi":"10.1007/s10072-011-0605-5","pmid":"21567182","pmcid":null,"title":"Pathological gambling plus hypersexuality in restless legs syndrome: a new case","authors":"d'Orsi G, Demaio V, Specchio LM.","first_author":"d'Orsi G","journal":"Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology","year":2011,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single clinical case description with no control group or systematic data collection","sample_n":1,"sample_text":"1 patient","population":"elderly male patient with restless legs syndrome on pramipexole","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe an elderly man with restless legs syndrome who developed problem gambling and increased sexual urges while taking the dopamine drug pramipexole; symptoms stopped after stopping the medication.","clinical_takeaway":"Dopamine agonists can trigger impulse-control problems; monitor patients for gambling and hypersexuality.","confidence":0.8,"topic_tags":["gender","sexual_function","relationships","neuroscience"],"strengths":["detailed clinical description","clear temporal link between drug and symptoms","adds to pharmacovigilance literature"],"limitations":["single case, no generalizability","no validated measures of hypersexuality or gambling pathology","no control of confounding variables"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10072-011-0605-5"}},{"id":7802,"doi":"10.1016/j.yebeh.2011.01.023","pmid":"21482195","pmcid":null,"title":"Opposed hemispheric specializations for human hypersexuality and orgasm?","authors":"Suffren S, Braun CM, Guimond A, Devinsky O.","first_author":"Suffren S","journal":"Epilepsy & behavior : E&B","year":2011,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"multiple case report analysis of epilepsy patients with unilateral lesions or seizure foci","sample_n":33,"sample_text":"26 right‑hemisphere lesions, 7 left‑hemisphere lesions; 23 right‑sided seizure foci, 8 left‑sided","population":"patients with epilepsy and documented right or left hemisphere lesions/foci","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed epilepsy patients with brain lesions and found that hypersexual behavior was more common after right‑hemisphere damage, while orgasm during seizures occurred more often with right‑side seizure foci, suggesting opposite roles for the two brain halves in sexual tension and release.","clinical_takeaway":"Evidence is insufficient to change practice; clinicians should not infer causal brain‑side effects on sexual behavior from these limited case reports.","confidence":0.6,"topic_tags":["neuroscience","sexual_function","pornography","masturbation"],"strengths":["uses neurological lesion data to generate hypothesis","covers both hypersexuality and ictal orgasm"],"limitations":["Very small, non‑representative clinical sample","No validated measures of hypersexuality or orgasm","No control for moral, psychological or relational confounds"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.yebeh.2011.01.023"}},{"id":7803,"doi":"10.1002/gps.5208","pmid":"31489715","pmcid":null,"title":"Measurement of sexual disinhibition in dementia: A systematic review","authors":"Chapman KR, Spitznagel MB.","first_author":"Chapman KR","journal":"International journal of geriatric psychiatry","year":2019,"pub_types":["Systematic Review","Journal Article"],"keywords":["Assessment","Dementia","Inappropriate Sexual Behavior","Sexual Disinhibition"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 20 measurement instruments for sexual disinhibition in dementia, searching Web of Science and PubMed (Jan–Feb 2019). No meta‑analysis; narrative synthesis of psychometric properties.","sample_n":null,"sample_text":"20 measures identified from published studies; no primary participant data collected.","population":"Adults with dementia (various etiologies) in research studies; no new participants recruited.","country":"Not specified (studies from multiple countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review examined 20 tools used to assess unwanted sexual behaviour in people with dementia, finding that none cover all relevant aspects and that many lack solid psychometric evidence.","clinical_takeaway":"Clinicians should be cautious selecting measures for sexual disinhibition in dementia, as current tools vary in reliability and coverage.","confidence":0.7,"topic_tags":["sexual_function","measurement","neuroscience"],"strengths":["Comprehensive search of two major databases","Systematic evaluation of psychometric properties of identified instruments","Clear identification of content domains lacking in existing measures"],"limitations":["No quantitative synthesis or meta‑analysis","Limited to studies published up to early 2019","Does not empirically test the measures in new samples"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/gps.5208"}},{"id":7804,"doi":"10.1097/nmd.0b013e3182125b96","pmid":"21451351","pmcid":null,"title":"Understanding the roles of shame and neuroticism in a patient sample of hypersexual men","authors":"Reid RC, Stein JA, Carpenter BN.","first_author":"Reid RC","journal":"The Journal of nervous and mental disease","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional structural equation modelling in a clinical sample of hypersexual men (N=95)","sample_n":95,"sample_text":"N = 95 hypersexual adult men","population":"hypersexual adult men (patient sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 95 men who sought help for hypersexual behaviour, higher neuroticism (especially impulsivity) predicted more hypersexuality, while shame was linked only indirectly through neuroticism.","clinical_takeaway":"Assess personality traits, particularly impulsivity, when treating hypersexual men; shame alone may not drive the behaviour.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses structural equation modelling to explore pathways","Includes validated personality inventory (NEO‑PI‑R)","Focuses on clinically relevant hypersexual population"],"limitations":["Hypersexuality and shame measured with unspecified/likely unvalidated scales","No control for key confounds (moral incongruence, masturbation, mental health, trauma)","Cross‑sectional design limits causal inference","Sample limited to treatment‑seeking men, not generalizable"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":46,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/nmd.0b013e3182125b96"}},{"id":7805,"doi":"10.1002/mds.23567","pmid":"21370268","pmcid":null,"title":"Comparative neuropsychological profile of pathological gambling, hypersexuality, and compulsive eating in Parkinson's disease","authors":"Vitale C, Santangelo G, Trojano L, Verde F, Rocco M, Grossi D, Barone P.","first_author":"Vitale C","journal":"Movement disorders : official journal of the Movement Disorder Society","year":2011,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":93,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of Parkinson’s patients with ICDs versus matched controls (N≈63 total).","sample_n":63,"sample_text":"13 hypersexuality, 12 compulsive eating, 14 gambling, 10 multiple ICDs, 14 controls.","population":"PD outpatients with pathological gambling, hypersexuality, compulsive eating, multiple ICDs, and ICD‑free controls.","country":"unspecified (likely Italy based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson’s patients, those with hypersexuality show more problems with executive tasks and memory than patients with gambling problems, suggesting distinct cognitive impairments across impulse‑control disorders.","clinical_takeaway":"Hypersexuality in PD may involve broader frontal‑memory deficits; clinicians should assess cognition when managing these patients.","confidence":0.7,"topic_tags":["sexual_function","csbd","pornography","masturbation"],"strengths":["Focus on understudied hypersexuality in PD","Use of matched PD control group","Comprehensive neuropsychological battery"],"limitations":["Small sample sizes per ICD group","No validated scales for hypersexuality reported","Key confounds (moral incongruence, mental health) not measured"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":1,"mentioning":94,"citing_publications":120,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mds.23567"}},{"id":7806,"doi":"10.1007/s10508-019-01524-w","pmid":"31414330","pmcid":null,"title":"Development of a Dualistic Model of Sexual Passion: Investigating Determinants and Consequences","authors":"Philippe FL, Vallerand RJ, Beaulieu-Pelletier G, Maliha G, Laventure S, Ricard-St-Aubin JS.","first_author":"Philippe FL","journal":"Archives of sexual behavior","year":2019,"pub_types":["Journal Article"],"keywords":["Sexuality","Relationship","Sexual Desire","Dualistic Model","Sexual Passion"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Three separate survey studies examining self‑reported harmonious vs obsessive sexual passion and associated variables.","sample_n":null,"sample_text":"Not specified in abstract; likely convenience samples.","population":"Adults (young adult, male, female)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose two kinds of sexual passion—harmonious and obsessive—based on survey data, showing each type links to different personal and relationship outcomes.","clinical_takeaway":"Neither passion type alone predicts pathology; clinicians should consider both when discussing sexual motivation.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Introduces a theoretically novel dualistic model of sexual passion","Provides discriminant validity evidence across three studies","Considers both partnered and non‑partnered sexual behavior"],"limitations":["Reliance on self‑report questionnaires without behavioural or physiological validation","No control for key confounds such as moral incongruence, mental health, or relationship factors","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":12,"contrasting":1,"mentioning":71,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-01524-w"}},{"id":7807,"doi":"10.1007/s10508-010-9719-8","pmid":"21290258","pmcid":null,"title":"Is hypersexuality dimensional? Evidence for the DSM-5 from general population and clinical samples","authors":"Walters GD, Knight RA, Långström N.","first_author":"Walters GD","journal":"Archives of sexual behavior","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Large (N≈2100 general population, N≈716 offenders) cross‑sectional survey using self‑report items; taxometric analysis of latent structure.","sample_n":2817,"sample_text":"2,101 general population participants and 716 male sex offenders","population":"General Swedish adults (both sexes) and US male sex offenders","country":"Sweden, United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Using statistical tests on survey data from the general public and male sex offenders, the study finds that hypersexuality exists on a continuum rather than as a distinct, on‑off condition. High levels of sexual activity and preoccupation simply represent the extreme end of a normal variation.","clinical_takeaway":"Hypersexuality appears dimensional; clinicians should assess severity continuously rather than rely on a binary diagnosis.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Very large sample size across two distinct populations","Appropriate taxometric methodology for latent‑structure testing","Includes both community and clinical (offender) samples"],"limitations":["Reliance on self‑report items whose psychometric properties are unclear","No measurement or control of key confounds (moral incongruence, mental health, etc.)","Cross‑sectional design cannot address causality or temporal stability"],"rubric_version":"2.0","raw_total":35,"max_possible":60,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":34,"citing_publications":69,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9719-8"}},{"id":7811,"doi":"10.1080/0092623x.2011.533585","pmid":"21218330","pmcid":null,"title":"Disputing the notion of psychopathology among women married to hypersexual men using the MMPI-2-RF","authors":"Reid RC, Carpenter BN, Draper ED.","first_author":"Reid RC","journal":"Journal of sex & marital therapy","year":2011,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative case‑control survey of wives of hypersexual men vs controls; MMPI‑2‑RF and Dyadic Adjustment Scale administered.","sample_n":null,"sample_text":"Not reported in abstract","population":"Women married to men identified as hypersexual (criteria not specified) and matched control spouses.","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared wives of men described as hypersexual with other women and found no greater psychological problems, though the wives reported more marital distress.","clinical_takeaway":"Partners of hypersexual clients may experience relationship strain without necessarily showing increased psychopathology.","confidence":0.7,"topic_tags":["sexual_function","relationships","csbd","gender","pornography"],"strengths":["Use of validated psychometric instruments (MMPI‑2‑RF, DAS).","Direct test of a prevailing clinical assumption.","Clear comparative design."],"limitations":["Cross‑sectional; cannot infer causality.","No reported sample size or power analysis.","Potential lack of control for mental‑health or trauma covariates."],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2011.533585"}},{"id":7813,"doi":null,"pmid":"3602660","pmcid":null,"title":"Adolescent sexual abuse: clinical discussion of a community treatment response","authors":"Abrams ME.","first_author":"Abrams ME.","journal":"Seminars in adolescent medicine","year":1987,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary (clinical discussion, no empirical data)","sample_n":null,"sample_text":"Not applicable – article is a narrative clinical discussion without original data.","population":"adolescents who have experienced sexual abuse (no specific sample reported)","country":"USA (journal based, study context not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that adolescent sexual abuse should be addressed by multidisciplinary community teams, urging physicians to become better trained to identify and treat victims, but it provides no original research data.","clinical_takeaway":"None – the paper offers a conceptual discussion, not evidence for clinical practice.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Highlights need for multidisciplinary community response","Raises awareness of under‑studied victimisation syndromes"],"limitations":["No empirical data or systematic methodology","Lacks operational definitions and measurement of key constructs","No control of known confounds (moral incongruence, mental health, trauma, etc.)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":7814,"doi":"10.3389/fpsyt.2019.00454","pmid":"31354536","pmcid":"PMC6635696","title":"Female Gaming, Gaming Addiction, and the Role of Women Within Gaming Culture: A Narrative Literature Review","authors":"Lopez-Fernandez O, Williams AJ, Griffiths MD, Kuss DJ.","first_author":"Lopez-Fernandez O","journal":"Frontiers in psychiatry","year":2019,"pub_types":["Systematic Review","systematic-review","Journal Article"],"keywords":["Internet Addiction","Narrative Review","Behavioral Addiction","Internet Gaming Disorder","Gaming Disorder","Gaming Culture","Female Gaming"],"is_oa":true,"oa_url":"https://doi.org/10.3389/fpsyt.2019.00454","cited_by_count":70,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative literature review of 49 papers, no systematic meta‑analysis, no risk‑of‑bias assessment","sample_n":null,"sample_text":"Narrative review; no original sample","population":"female gamers (studies reviewed); not primary data","country":"International (review of studies from various countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review summarises research on women’s participation in video‑game culture, highlighting benefits, barriers, and how sexualised avatars can affect self‑esteem and mood.","clinical_takeaway":"None – the paper is a literature overview, not a source of clinical guidance.","confidence":0.6,"topic_tags":["gender"],"strengths":["Broad coverage of diverse topics within female gaming","Incorporates both quantitative and qualitative studies"],"limitations":["Narrative (non‑systematic) methodology limits reproducibility","No formal quality or bias assessment of included papers","Lacks quantitative synthesis or meta‑analytic effect sizes"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":7,"contrasting":0,"mentioning":116,"citing_publications":199,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2019.00454"}},{"id":7816,"doi":"10.1210/jc.2018-02202","pmid":"30848825","pmcid":null,"title":"Dopamine Agonist-Induced Impulse Control Disorders in Patients With Prolactinoma: A Cross-Sectional Multicenter Study","authors":"Dogansen SC, Cikrikcili U, Oruk G, Kutbay NO, Tanrikulu S, Hekimsoy Z, Hadzalic A, Gorar S, Omma T, Mert M, Akbaba G, Yalin GY, Bayram F, Ozkan M, Yarman S.","first_author":"Dogansen SC","journal":"The Journal of clinical endocrinology and metabolism","year":2019,"pub_types":["Multicenter Study","Journal Article","Observational Study"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":55,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Multicenter cross‑sectional survey of 308 prolactinoma patients on dopamine agonists; assessment of impulse‑control disorders (including hypersexuality) using validated questionnaires.","sample_n":308,"sample_text":"308 patients (multicenter, tertiary referral centres)","population":"Patients with prolactinoma treated with dopamine agonists (≥3 months) at tertiary endocrine centres","country":"Multiple (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 308 patients with prolactin‑secreting pituitary tumours treated with dopamine‑agonist drugs, about 17 % developed impulse‑control problems, most commonly hypersexual behaviour. Men, smokers, drinkers and those with a gambling history were at higher risk.","clinical_takeaway":"Clinicians prescribing dopamine agonists for prolactinoma should monitor patients for emerging hypersexual or other impulse‑control behaviours, especially in men with gambling, smoking or alcohol use.","confidence":0.78,"topic_tags":["sexual_function","csbd"],"strengths":["Large multicentre clinical sample","Use of validated ICD and impulsivity scales","Clear prevalence estimates"],"limitations":["Cross‑sectional design limits causal inference","No assessment of moral or relational confounds","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":3,"mentioning":67,"citing_publications":108,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1210/jc.2018-02202"}},{"id":7817,"doi":"10.1097/yco.0b013e32833d15d1","pmid":"20613531","pmcid":null,"title":"Assessment, diagnosis, and management of hypersexual disorders","authors":"Marshall LE, Briken P.","first_author":"Marshall LE","journal":"Current opinion in psychiatry","year":2010,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of hypersexual disorder concepts and treatments; no new empirical data, no systematic methods reported.","sample_n":null,"sample_text":"Not applicable – review article.","population":"none (review)","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews recent ideas about hypersexual disorder, discussing how it might be defined and treated, and notes the limited empirical research and few controlled treatment studies.","clinical_takeaway":"Currently there is insufficient evidence to guide reliable diagnosis or treatment of hypersexual disorder.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides overview of conceptual advances","Highlights gaps in empirical evidence"],"limitations":["Narrative, not systematic review","No systematic evaluation of study quality"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":31,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/yco.0b013e32833d15d1"}},{"id":7818,"doi":"10.1016/j.euroneuro.2019.06.001","pmid":"31227264","pmcid":null,"title":"Patterns of response to antidepressants in major depressive disorder: Drug resistance or worsening of depression are associated with a bipolar diathesis","authors":"Perugi G, Pacchiarotti I, Mainardi C, Verdolini N, Menculini G, Barbuti M, Angst J, Azorin JM, Bowden CL, Mosolov S, Young AH, Vieta E, BRIDGE-II-MIX Study Group.","first_author":"Perugi G","journal":"European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Antidepressants","Major Depressive Disorder","Mixed Features","Resistance To Treatment"],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Post‑hoc cross‑sectional analysis of 1329 MDD patients comparing treatment‑resistant vs non‑resistant and AD‑induced irritability groups.","sample_n":1329,"sample_text":"2811 enrolled, 1329 included in analysis","population":"Adults with major depressive episode (MDD) from an international sample (BRIDGE‑II‑MIX).","country":"International (multiple sites)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In people with major depression, those whose symptoms worsened or who became irritable on antidepressants were more likely to show signs of bipolarity, including hypersexuality, suggesting a bipolar diathesis.","clinical_takeaway":"When depression worsens or irritability appears on antidepressants, consider evaluating for bipolar features, including hypersexuality.","confidence":0.8,"topic_tags":["treatment","moral_incongruence"],"strengths":["Large international sample","Use of logistic regression to adjust for covariates","Clear definitions of TRD and AIM groups"],"limitations":["Post‑hoc cross‑sectional design limits causal inference","Reliance on self‑report/clinical interview without validated hypersexuality scale","Potential unmeasured confounders (e.g., trauma, substance use)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":42,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.euroneuro.2019.06.001"}},{"id":7820,"doi":"10.12968/bjon.2019.28.12.772","pmid":"31242112","pmcid":null,"title":"Addressing sexuality and intimacy in people living with Parkinson's during palliative care and at the end of life","authors":"Wright J.","first_author":"Wright J.","journal":"British journal of nursing (Mark Allen Publishing)","year":2019,"pub_types":["Review","Journal Article"],"keywords":["Sexuality","Palliative care","End-of-life Care","Parkinson's","Hypersexuality","Non-motor Symptoms"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review with no explicit systematic methodology or empirical data","sample_n":null,"sample_text":"Not applicable (review article)","population":"people with Parkinson's disease in palliative or end‑of‑life care","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article points out that sexuality and intimacy are rarely discussed for people with Parkinson's in palliative care, noting gaps in research, assessment tools, and clinician training.","clinical_takeaway":"Clinicians should proactively address sexual health with Parkinson's patients nearing end‑of‑life, despite limited guidance.","confidence":0.4,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Highlights a neglected area of sexuality in Parkinson's palliative care","Identifies need for professional education and assessment tools"],"limitations":["No empirical data or systematic synthesis","Lacks methodological transparency (search strategy, inclusion criteria)","No measurement of key constructs or confounders"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12968/bjon.2019.28.12.772"}},{"id":7821,"doi":"10.1002/mds.27689","pmid":"31136681","pmcid":null,"title":"Scales to assess impulsive and compulsive behaviors in Parkinson's disease: Critique and recommendations","authors":"Evans AH, Okai D, Weintraub D, Lim SY, O'Sullivan SS, Voon V, Krack P, Sampaio C, Post B, Leentjens AFG, Martinez-Martin P, Stebbins GT, Goetz CG, Schrag A, Members of the International Parkinson and Movement Disorder Society (IPMDS) Rating Scales Review Committee.","first_author":"Evans AH","journal":"Movement disorders : official journal of the Movement Disorder Society","year":2019,"pub_types":["Review","Journal Article"],"keywords":["Validity","reliability","Parkinson's Disease","Clinimetrics","Impulse Control Disorders","Rating Scales"],"is_oa":false,"oa_url":null,"cited_by_count":68,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic literature review of rating scales for impulsive‑compulsive behaviours in Parkinson’s disease, including hypersexuality. No meta‑analysis; recommendations based on reported clinimetric data.","sample_n":null,"sample_text":"Not applicable – review of published studies.","population":"People with Parkinson’s disease (PD) assessed for impulse‑control and compulsive disorders; no new participant recruitment.","country":"International (authors from multiple centres).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors reviewed rating scales used to detect impulsive and compulsive behaviours in Parkinson’s disease, including hypersexuality. They recommend a few well‑validated questionnaires for screening and severity rating, but note that more testing against gold‑standard diagnoses is needed.","clinical_takeaway":"Use the QUIP/QUIP‑RS for quick screening of hypersexuality and other impulsive‑compulsive behaviours in Parkinson’s patients, but confirm findings with clinical interview.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Systematic search strategy for scales","Clear criteria for recommending instruments","Broad coverage of impulse‑control behaviours"],"limitations":["No quantitative synthesis or meta‑analysis","Limited discussion of scale validation against gold‑standard diagnoses","Does not address potential confounds (e.g., mood, medication) in original studies"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":61,"citing_publications":98,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mds.27689"}},{"id":7822,"doi":"10.3389/fneur.2019.00351","pmid":"31057473","pmcid":"PMC6481351","title":"Impulse Control Disorders in Parkinson's Disease. A Brief and Comprehensive Review","authors":"Gatto EM, Aldinio V.","first_author":"Gatto EM","journal":"Frontiers in neurology","year":2019,"pub_types":["brief-report","Journal Article"],"keywords":["Parkinson disease","Icd","Impulse Control Disorders","Pathological Gambling","Binge Eating","Compulsive Buying","Hypersexual Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6481351","cited_by_count":82,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"brief narrative review of impulse control disorders in Parkinson's disease, summarizing prevalence, risk factors, mechanisms, and management; no original data collected.","sample_n":null,"sample_text":"Not applicable – review article","population":"people with Parkinson's disease (no specific sample reported)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews impulse‑control disorders such as gambling, binge eating, compulsive buying and hypersexuality in people with Parkinson’s disease, summarising how common they are, why they may occur, and how they are treated.","clinical_takeaway":"Hypersexuality can be a side effect of dopamine agonists in Parkinson’s disease; clinicians should monitor for it and manage with medication adjustments.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation","csbd","moral_incongruence"],"strengths":["Comprehensive overview of ICDs in Parkinson's disease","Integrates pharmacological and therapeutic aspects"],"limitations":["No primary data; conclusions based on existing literature","No systematic search methodology reported","Lacks quantitative synthesis or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":6,"contrasting":1,"mentioning":87,"citing_publications":112,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fneur.2019.00351"}},{"id":7824,"doi":"10.3171/2009.10.jns09918","pmid":"19911886","pmcid":null,"title":"Hypomania with hypersexuality following bilateral anterior limb stimulation in obsessive-compulsive disorder","authors":"Chang CH, Chen SY, Hsiao YL, Tsai ST, Tsai HC.","first_author":"Chang CH","journal":"Journal of neurosurgery","year":2010,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case report of DBS in OCD patient","sample_n":1,"sample_text":"1 patient","population":"1 adult male, 28 yo, refractory OCD","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 28‑year‑old man with severe OCD received deep‑brain stimulation. When the stimulation voltage was high, he experienced hypomania and increased sexual activity, which lessened when the voltage was reduced.","clinical_takeaway":"DBS can induce temporary hypersexuality; monitor mood and sexual side‑effects during stimulation adjustments.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","pornography","masturbation","csbd"],"strengths":["Detailed clinical observation of DBS side‑effects","Clear description of stimulation parameters"],"limitations":["N=1, no generalisable data","No validated measures of hypersexuality","No control of confounding variables"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3171/2009.10.jns09918"}},{"id":7826,"doi":"10.7759/cureus.4277","pmid":"31157138","pmcid":"PMC6529042","title":"Does Bupropion Impact More than Mood? A Case Report and Review of the Literature","authors":"Yasin W, Ahmed SI, Gouthro RV.","first_author":"Yasin W","journal":"Cureus","year":2019,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["bupropion","Selective Serotonin Reuptake Inhibitors (Ssri)","Hypersexuality Disorder"],"is_oa":true,"oa_url":"https://www.cureus.com/articles/18690-does-bupropion-impact-more-than-mood-a-case-report-and-review-of-the-literature.pdf","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single case","population":"single patient with history of paraphilic disorders and hypersexuality","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"supports","citation_value":"background","plain_summary":"A single patient taking bupropion along with an SSRI developed changes in sexual behavior, prompting a discussion of how antidepressants may influence hypersexuality. The authors review similar reports to caution clinicians about possible side‑effects.","clinical_takeaway":"Clinicians should monitor sexual side‑effects when combining bupropion with other antidepressants, especially in patients with a history of hypersexuality.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Highlights clinical relevance of medication interactions","Provides concise review of existing literature"],"limitations":["Single case limits generalizability","No validated measures of hypersexuality used","No systematic assessment of confounding factors"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.4277"}},{"id":7827,"doi":"10.1155/2019/7832487","pmid":"31011412","pmcid":"PMC6442308","title":"Impulsive-Compulsive Behaviours in Belgian-Flemish Parkinson's Disease Patients: A Questionnaire-Based Study","authors":"Maréchal E, Denoiseux B, Thys E, Cras P, Crosiers D.","first_author":"Maréchal E","journal":"Parkinson's disease","year":2019,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.1155/2019/7832487","cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"questionnaire validation in 88 Parkinson's patients; QUIP‑positive patients invited for interview","sample_n":88,"sample_text":"88 PD patients completed the translated QUIP; 22 QUIP‑positive patients received a diagnostic interview","population":"Parkinson's disease patients (Belgian‑Flemish)","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors translated a questionnaire that screens for impulsive‑compulsive behaviors, including hypersexuality, into Belgian‑Flemish and tested it with 88 Parkinson’s patients. It identified many potential cases, but only a few were confirmed after interview, showing good sensitivity but low specificity.","clinical_takeaway":"The Flemish QUIP can flag possible hypersexuality in Parkinson’s patients, but clinicians must follow up with a thorough interview to confirm the diagnosis.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Uses a previously validated screening tool (QUIP)","Systematic translation‑backtranslation process","Provides data on sensitivity and specificity in a new language"],"limitations":["Small, non‑representative PD sample","Low specificity; many false positives","No adjustment for psychiatric or other confounders"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2019/7832487"}},{"id":7828,"doi":"10.1097/pra.0000000000000367","pmid":"30849063","pmcid":null,"title":"Escalation of Gambling Associated With Aripiprazole: A Case Report and Literature Review","authors":"Giri YR, Peteru SR.","first_author":"Giri YR","journal":"Journal of psychiatric practice","year":2019,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report with literature review","sample_n":1,"sample_text":"single case","population":"adult female with bipolar disorder","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A woman with bipolar disorder showed worsening gambling after starting aripiprazole, and the problem improved when the dose was lowered. The authors suggest clinicians watch for gambling and similar impulse‑control issues when prescribing this drug.","clinical_takeaway":"Monitor patients on aripiprazole for emerging gambling or other impulse‑control problems and adjust dosage if needed.","confidence":0.7,"topic_tags":["gender","treatment"],"strengths":["detailed clinical description","integration with prior case reports"],"limitations":["single case, no systematic data","no validated outcome measures","no control for confounding variables"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/pra.0000000000000367"}},{"id":7829,"doi":"10.1093/brain/awz007","pmid":"30753324","pmcid":null,"title":"Dopamine metabolism of the nucleus accumbens and fronto-striatal connectivity modulate impulse control","authors":"Hammes J, Theis H, Giehl K, Hoenig MC, Greuel A, Tittgemeyer M, Timmermann L, Fink GR, Drzezga A, Eggers C, van Eimeren T.","first_author":"Hammes J","journal":"Brain : a journal of neurology","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Imaging","Parkinson’s Disease","Impulsivity And Inhibition Disorders"],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"80 PD patients (resting‑state fMRI), 59 with 18F‑DOPA PET; voxel‑wise correlations between dopamine synthesis, functional connectivity and QUIP‑RS impulsive‑compulsive scores.","sample_n":80,"sample_text":"80 participants (fMRI), 59 participants (PET).","population":"Patients with Parkinson’s disease on dopamine replacement therapy (mean age 68, 67 % male).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson’s patients, lower dopamine production and weaker front‑striatal brain connections were linked to more severe impulsive‑compulsive symptoms, including hypersexuality.","clinical_takeaway":"Brain imaging shows associations, but cannot yet guide clinical decisions about hypersexuality risk.","confidence":0.7,"topic_tags":["neuroscience","csbd","pornography","sexual_function"],"strengths":["Validated QUIP‑RS instrument","Combined PET and fMRI multimodal imaging","Reasonable sample size for neuroimaging"],"limitations":["Cross‑sectional design limits causal inference","No healthy control group or correction details for voxel‑wise analyses","Key psychosocial confounds not measured"],"rubric_version":"2.0","raw_total":28,"max_possible":60,"pct_score":47,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":6,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":5,"contrasting":6,"mentioning":64,"citing_publications":73,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/brain/awz007"}},{"id":7830,"doi":"10.1016/j.parkreldis.2019.02.010","pmid":"30824283","pmcid":null,"title":"Creativity related to dopaminergic treatment: A multicenter study","authors":"Garcia-Ruiz PJ, Martinez Castrillo JC, Desojo LV.","first_author":"Garcia-Ruiz PJ","journal":"Parkinsonism & related disorders","year":2019,"pub_types":["Multicenter Study","Journal Article"],"keywords":["Parkinson disease","Dopamine agonists","Impulse Control Disorder","Enhanced Creativity"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"multicenter observational case series of 21 patients with Parkinson’s disease or restless‑legs syndrome who reported enhanced creativity after dopaminergic therapy","sample_n":21,"sample_text":"21 patients (20 PD, 1 RLS) with enhanced creativity after dopamine agonist treatment","population":"Patients with Parkinson’s disease (n≈20) and one with restless‑legs syndrome; recruited because they reported new artistic activity","country":"unspecified (multicenter)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small multicenter case series of 21 Parkinson’s patients found that dopaminergic drugs, especially dopamine agonists, were associated with new artistic interests such as painting, suggesting the medication may sometimes boost creativity.","clinical_takeaway":"Clinicians should be aware that dopamine agonists can sometimes foster creative pursuits, but evidence is limited and based on a tiny case series.","confidence":0.7,"topic_tags":["neuroscience"],"strengths":["Multicenter recruitment","Focus on a rarely studied positive phenomenon"],"limitations":["Very small, non‑representative case series","No validated measures of creativity or ICD","No control group or statistical testing"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2019.02.010"}},{"id":7832,"doi":"10.3109/00207450903165577","pmid":"20199204","pmcid":null,"title":"Self-reported differences on measures of executive function and hypersexual behavior in a patient and community sample of men","authors":"Reid RC, Karim R, McCrory E, Carpenter BN.","first_author":"Reid RC","journal":"The International journal of neuroscience","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional comparison of 87 hypersexual patients and 92 community men using self‑report questionnaires.","sample_n":179,"sample_text":"87 hypersexual patients, 92 community controls","population":"Adult men (patient and community samples)","country":"USA (Utah)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that men who seek help for hypersexual behavior report poorer executive functioning on several self‑rated scales compared with men from the general community.","clinical_takeaway":"Clinicians should consider assessing executive functioning when treating hypersexuality, but causal conclusions are premature.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Use of validated executive function questionnaire (BRIEF‑A)","Relatively large sample for a patient group","Direct comparison with community controls"],"limitations":["Cross‑sectional, cannot infer causality","No control for key confounds (moral incongruence, masturbation, mental health, trauma)","Self‑report measures only, no objective neuropsychological testing","Patient sample self‑selected from treatment‑seeking individuals"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":29,"citing_publications":119,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/00207450903165577"}},{"id":7833,"doi":null,"pmid":"20205139","pmcid":null,"title":"[Urinary disorders, sexual dysfunction and hypersexuality in Parkinson's disease]","authors":"Vázquez-Sáánchez F, Rodríguez-Martínez E, Arés-Luque A.","first_author":"Vázquez-Sáánchez F","journal":"Revista de neurologia","year":2010,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of non‑motor symptoms in Parkinson’s disease, no new data collection","sample_n":null,"sample_text":"Not applicable – literature review","population":"patients with Parkinson’s disease (unspecified)","country":"Spain (journal of origin)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises how Parkinson’s disease can cause urinary problems, sexual dysfunction, and hypersexuality, describing how common they are and what treatments are used, especially noting that dopamine agonists may trigger hypersexuality.","clinical_takeaway":"Clinicians should monitor urinary and sexual symptoms in Parkinson’s patients, especially when prescribing dopamine agonists.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of urinary, sexual, and hypersexual symptoms in PD","Integrates epidemiology, phenomenology, and treatment"],"limitations":["Narrative review without systematic methodology","No empirical data or meta‑analytic synthesis","Lacks assessment of confounding factors (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":7834,"doi":"10.1521/jaap.2010.38.1.27","pmid":"20297889","pmcid":null,"title":"Psychodynamics of hypersexuality in children and adolescents with bipolar disorder","authors":"Adelson S.","first_author":"Adelson S.","journal":"The journal of the American Academy of Psychoanalysis and Dynamic Psychiatry","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"None – no empirical sample reported","population":"children and adolescents with bipolar disorder (theoretical discussion)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"supports","citation_value":"background","plain_summary":"The paper argues that hypersexual behaviour in kids with bipolar disorder may be a core feature, urging clinicians to consider psychological and developmental factors when judging whether to label it as a diagnostic criterion.","clinical_takeaway":"No direct clinical guidance; clinicians should be cautious interpreting hypersexuality as a bipolar symptom without empirical evidence.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Highlights under‑studied psychodynamic perspective","Integrates bipolar disorder and sexual development literature"],"limitations":["No empirical data or systematic review","No measurement of key constructs or confounds","Conclusions based on theoretical speculation"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1521/jaap.2010.38.1.27"}},{"id":7835,"doi":"10.1007/s10508-018-1279-3","pmid":"30627932","pmcid":null,"title":"The Relation of Childhood Abuse Experiences to Problematic Sexual Behaviors in Male Youths Who Have Sexually Offended","authors":"Davis KA, Knight RA.","first_author":"Davis KA","journal":"Archives of sexual behavior","year":2019,"pub_types":["Journal Article"],"keywords":["juveniles","Childhood Abuse","Sexual Offending","Paraphilia","Hypersexuality","Pedophilia"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of juvenile male sexual offenders; self‑report of childhood abuse and hypersexual/paraphilic behaviours; no longitudinal or experimental manipulation","sample_n":null,"sample_text":"N not reported in abstract; likely moderate size based on cited prior work (529 adult offenders mentioned, but juvenile sample size not given)","population":"juvenile male sexual offenders (convenience sample)","country":"","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study finds that juvenile male sexual offenders who experienced psychological abuse by a male caregiver report higher levels of hypersexual thoughts and deviant sexual fantasies, suggesting a link between early abuse and later problematic sexual behavior.","clinical_takeaway":"Clinicians should consider histories of caregiver psychological abuse when assessing risky sexual thoughts in youth offenders.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large literature context provided","Focus on understudied caregiver psychological abuse","Statistical modeling of variance"],"limitations":["Cross‑sectional, self‑report design","No control for key confounds (moral incongruence, mental health, etc.)","Unclear measurement validation"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":3,"contrasting":0,"mentioning":11,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1279-3"}},{"id":7836,"doi":"10.5080/u23441","pmid":"31170309","pmcid":null,"title":"[Persistent Genital Arousal Disorder Treated with Duloxetine: A Case Report]","authors":"Gündüz N, Polat A, Turan H.","first_author":"Gündüz N","journal":"Turk psikiyatri dergisi = Turkish journal of psychiatry","year":2019,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"tur","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report of duloxetine treatment for Persistent Genital Arousal Disorder","sample_n":1,"sample_text":"single case","population":"42‑year‑old female with PGAD, multiple prior psychiatric diagnoses","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A 42‑year‑old woman with persistent, unwanted genital arousal that lasted hours was successfully treated with the antidepressant duloxetine, according to the authors' single‑patient report.","clinical_takeaway":"Evidence is limited to one case; duloxetine may be worth trialing in PGAD after careful assessment, but larger studies are needed.","confidence":0.5,"topic_tags":["sexual_function","treatment","gender"],"strengths":["Detailed clinical description of a rare condition","Reports a pharmacological intervention not previously documented in this journal"],"limitations":["N=1; no control condition","No standardized outcome measures","No assessment of confounding factors (e.g., mental health, sexual activity)"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5080/u23441"}},{"id":7839,"doi":"10.1186/s12978-018-0650-0","pmid":"30545378","pmcid":"PMC6293630","title":"\"Eat and you will be eaten\": a qualitative study exploring costs and benefits of age-disparate sexual relationships in Tanzania and Uganda: implications for girls' sexual and reproductive health interventions","authors":"Wamoyi J, Buller AM, Nyato D, Kyegombe N, Meiksin R, Heise L.","first_author":"Wamoyi J","journal":"Reproductive health","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Tanzania","Uganda","Interventions","Young Women","Transactional Sex","Srh","Age-disparate Sex"],"is_oa":true,"oa_url":"https://reproductive-health-journal.biomedcentral.com/track/pdf/10.1186/s12978-018-0650-0","cited_by_count":35,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"37 focus groups and 87 in‑depth interviews with purposive and snowball sampling of adolescents and adults in Tanzania and Uganda; thematic analysis with NVivo.","sample_n":124,"sample_text":"124 participants (37 focus groups + 87 interviews) recruited purposively and via snowball sampling.","population":"Adolescent girls and young women (14‑24) and older men (25‑49) in rural and urban Tanzania and Uganda.","country":"Tanzania, Uganda","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with young Tanzanian and Ugandan women and older men revealed that age‑disparate relationships are motivated by money, emotional support and social expectations, but are also linked to violence, stigma, unwanted pregnancy and STI risk.","clinical_takeaway":"Interventions should address the financial and social drivers of age‑disparate sex while mitigating health risks for young women.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight from both AGYW and older men","Large number of interviews and focus groups for a qualitative study","Use of systematic thematic analysis with software"],"limitations":["Purposive/snowball sampling limits generalisability","No quantitative measurement of outcomes or confounders","Findings may not represent broader populations"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":0,"mentioning":47,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-018-0650-0"}},{"id":7840,"doi":"10.1016/j.nrl.2018.07.004","pmid":"30551909","pmcid":null,"title":"Hypersexuality associated with safinamide","authors":"Puy-Núñez A, Cabo-López I.","first_author":"Puy-Núñez A","journal":"Neurologia","year":2020,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.1016/j.nrl.2018.07.004","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.nrl.2018.07.004"}},{"id":7841,"doi":"10.1007/s10143-009-0232-2","pmid":"19830465","pmcid":null,"title":"Hypersexuality from resection of left occipital arteriovenous malformation","authors":"Cao Y, Zhu Z, Wang R, Wang S, Zhao J.","first_author":"Cao Y","journal":"Neurosurgical review","year":2010,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"N=1 (single case)","population":"single adult female patient","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational","fmri_reverse_inference"],"stance":"neutral","citation_value":"background","plain_summary":"A 35‑year‑old woman developed excessive sexual behavior after surgical removal of a left occipital arteriovenous malformation. PET scans showed altered metabolism in frontal and hippocampal regions. The authors discuss possible brain‑region links to sexual response, but the finding is based on one patient without systematic measurement.","clinical_takeaway":"None – the report is an isolated case and does not inform clinical practice.","confidence":0.4,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed neuroimaging description (PET)","Novel clinical observation"],"limitations":["Single case, no control group","No validated measures of sexual behavior","Potential reverse‑inference from metabolic data"],"rubric_version":"2.0","raw_total":8,"max_possible":60,"pct_score":13,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":3,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10143-009-0232-2"}},{"id":7842,"doi":"10.3389/fneur.2018.01041","pmid":"30574117","pmcid":"PMC6291460","title":"Impulse Control Disorders and Dopamine-Related Creativity: Pathogenesis and Mechanism, Short Review, and Hypothesis","authors":"Garcia-Ruiz PJ.","first_author":"Garcia-Ruiz PJ.","journal":"Frontiers in neurology","year":2018,"pub_types":["review-article","Review","Journal Article"],"keywords":["Genetics","Environment","Dopamine agonists","Impulse Control Disorder","Enhanced Creativity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6291460","cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review / hypothesis paper with no primary data.","sample_n":null,"sample_text":"No primary participants; paper summarizes existing literature.","population":"Not applicable","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews how dopamine‑activating Parkinson’s drugs can trigger impulse‑control disorders such as pathological gambling, hypersexuality, and compulsive shopping, proposing that D3‑receptor activation in the ventral striatum drives these behaviors, with genetics and lifestyle also influencing risk.","clinical_takeaway":"Clinicians should monitor patients on dopamine agonists for emerging impulse‑control problems, including hypersexuality, and consider lifestyle interventions.","confidence":0.8,"topic_tags":["sexual_function","csbd","neuroscience"],"strengths":["Integrates pharmacology and genetics literature","Highlights dopamine D3 involvement","Discusses environmental moderation"],"limitations":["No primary data; speculative","Lacks systematic review methods","No explicit assessment of hypersexuality criteria","Potential bias toward dopamine‑agonist explanation"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fneur.2018.01041"}},{"id":7843,"doi":"10.1016/j.jsxm.2018.10.001","pmid":"30527057","pmcid":null,"title":"Response and Rebuttal to Editorial Comment on \"Deviance or Normalcy? The Relationship Between Paraphilic Thoughts and Behaviors, Hypersexuality, and Psychopathology in a Sample of University Students\"","authors":"Castellini G, Rellini AH, Appignanesi C, Pinucci I, Fattorini M, Grano E, Fisher AD, Cassioli E, Lelli L, Maggi M, Ricca V.","first_author":"Castellini G","journal":"The journal of sexual medicine","year":2018,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2018.10.001"}},{"id":7844,"doi":"10.1016/j.jsxm.2018.09.014","pmid":"30527056","pmcid":null,"title":"Deviance or Normalcy? The Relationship Between Paraphilic Thoughts and Behaviors, Hypersexuality, and Psychopathology in a Sample of University Students","authors":"Coleman E, Dickenson J.","first_author":"Coleman E","journal":"The journal of sexual medicine","year":2018,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2018.09.014"}},{"id":7845,"doi":"10.1530/eje-18-0667","pmid":"30324793","pmcid":null,"title":"MANAGEMENT OF ENDOCRINE DISEASE: Impulse control disorders in patients with hyperpolactinemia treated with dopamine agonists: how much should we worry?","authors":"Barake M, Klibanski A, Tritos NA.","first_author":"Barake M","journal":"European journal of endocrinology","year":2018,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methodology or risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Patients with hyperprolactinemia receiving dopamine agonists (no primary data).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review warns that dopamine‑agonist drugs used for high prolactin levels can trigger impulse control problems, including excessive sexual behavior, and advises clinicians to monitor patients closely.","clinical_takeaway":"Monitor patients on dopamine agonists for signs of compulsive sexual behavior and consider treatment adjustment if problems arise.","confidence":0.7,"topic_tags":["sexual_function","csbd","moral_incongruence","treatment"],"strengths":["Comprehensive overview of impulse control disorders linked to dopamine agonists.","Highlights clinical relevance for endocrinologists."],"limitations":["No systematic search or risk‑of‑bias assessment.","Lacks primary data; conclusions based on heterogeneous reports."],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":1,"mentioning":26,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1530/eje-18-0667"}},{"id":7848,"doi":"10.1111/j.1743-6109.2009.01485.x","pmid":"19751388","pmcid":null,"title":"Are sadomasochism and hypersexuality in autism linked to amygdalohippocampal lesion?","authors":"Müller JL.","first_author":"Müller JL.","journal":"The journal of sexual medicine","year":2011,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single forensic inpatient with autism and sadomasochism, MRI findings described, literature review","sample_n":1,"sample_text":"single case","population":"1 male adolescent forensic psychiatric inpatient with autism and sadomasochism","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A single forensic patient with autism and sadomasochistic interests was found to have bilateral amygdala‑hippocampal atrophy on MRI. The author suggests this brain lesion may underlie both autism and the sexual behaviours, but the case cannot establish a causal link.","clinical_takeaway":"Do not infer that amygdala‑hippocampal damage causes sadomasochism or hypersexuality; evidence is limited to one case.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed MRI description of amygdalohippocampal atrophy","Integrates case with literature review"],"limitations":["Single case, no control group","No systematic measurement of behavioral constructs","Over‑interprets structural findings as causal for complex behaviours"],"rubric_version":"2.0","raw_total":8,"max_possible":60,"pct_score":13,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":2,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01485.x"}},{"id":7850,"doi":"10.1136/bcr-2018-225873","pmid":"30317200","pmcid":"PMC6194374","title":"Sleeping beauty syndrome presenting with insomnia","authors":"Hussain S, Al Jarman K, Hussain S.","first_author":"Hussain S","journal":"BMJ case reports","year":2018,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Neurology","Sleep Disorders (Neurology)"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with Kleine‑Levin syndrome presenting hypersexuality and insomnia; no comparison group","sample_n":1,"sample_text":"single case","population":"young male adolescent with KLS","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A young man with Kleine‑Levin syndrome experienced an episode of reduced sleep, appetite, aggression, visual hallucinations and increased sexual urges. Treatment with aripiprazole, lorazepam and lithium led to recovery within a week.","clinical_takeaway":"In KLS episodes, hypersexuality can appear alongside other symptoms and may respond to antipsychotic and mood‑stabilising medication.","confidence":0.6,"topic_tags":["neuroscience","sexual_function","moral_incongruence"],"strengths":["Detailed clinical description of a rare syndrome","Clear reporting of treatment and outcome"],"limitations":["Single case limits generalisability","No systematic assessment of hypersexuality","No control of potential confounders"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bcr-2018-225873"}},{"id":7851,"doi":"10.1097/jcp.0000000000000934","pmid":"30106878","pmcid":null,"title":"A Case of Hypersexuality Probably Associated With Lurasidone","authors":"Reddy B, Das S, Ali M.","first_author":"Reddy B","journal":"Journal of clinical psychopharmacology","year":2018,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/jcp.0000000000000934"}},{"id":7852,"doi":"10.1684/pnv.2009.0164","pmid":"19473953","pmcid":null,"title":"[The so-called hypersexual behaviors in dementia]","authors":"Derouesné C.","first_author":"Derouesné C.","journal":"Psychologie & neuropsychiatrie du vieillissement","year":2009,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methodology.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Individuals with dementia (Alzheimer’s disease, Kluver‑Bucy syndrome).","country":"France (journal language French/English abstract).","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews rare true hypersexuality in dementia, noting that most inappropriate sexual acts stem from disinhibition or poor contextual awareness. It suggests four dimensions—intimacy, libido, disinhibition, cognition—to guide assessment and treatment.","clinical_takeaway":"In dementia, manage inappropriate sexual behavior by addressing disinhibition and cognitive factors rather than labeling it as addiction.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Integrates clinical observations of hypersexual behavior in dementia.","Proposes a multidimensional model for assessment and management.","Highlights disinhibition and cognitive factors."],"limitations":["Narrative, non‑systematic review; no explicit methodology.","No empirical data or systematic search reported.","Lacks quantitative assessment of prevalence or severity."],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1684/pnv.2009.0164"}},{"id":7853,"doi":"10.1007/s12020-018-1744-8","pmid":"30206771","pmcid":null,"title":"Impulse control disorders in patients with prolactinoma receiving dopamine agonist therapy: a prospective study with 1 year follow-up","authors":"Celik E, Ozkaya HM, Poyraz BC, Saglam T, Kadioglu P.","first_author":"Celik E","journal":"Endocrine","year":2018,"pub_types":["Journal Article"],"keywords":["Impulsivity","Dopamine Agonist","Pituitary Tumors"],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort comparing prolactinoma patients on dopamine agonists, non‑functioning pituitary adenoma patients, and healthy controls over 1 year (n≈25‑32 per group)","sample_n":88,"sample_text":"25 prolactinoma, 31 non‑functioning adenoma, 32 healthy controls","population":"adult patients with prolactinoma receiving dopamine agonist therapy and matched control groups","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In patients with prolactinoma treated with dopamine‑agonist drugs, 8% developed impulse‑control problems, including brief episodes of excessive sexual behavior that improved when the medication was reduced or stopped.","clinical_takeaway":"Dopamine‑agonist therapy can trigger transient hypersexuality; clinicians should monitor sexual impulse symptoms and adjust dose if needed.","confidence":0.78,"topic_tags":["sexual_function","pornography","masturbation","csbd"],"strengths":["Use of validated psychiatric and impulsivity scales","Prospective 1‑year follow‑up","Inclusion of two control groups (NFA and healthy)"],"limitations":["Small sample sizes per group","No correction for multiple statistical tests reported","Sexual behaviour not measured in detail (frequency vs distress)"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":1,"mentioning":35,"citing_publications":72,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12020-018-1744-8"}},{"id":7854,"doi":"10.1159/000495748","pmid":"30687068","pmcid":"PMC6341340","title":"Young-Onset Dementia with Lewy Bodies","authors":"Aiba Y, Sakakibara R, Ogata T, Iimura A, Terayama K, Suzuki K, Katsuragawa S, Kato Y, Tateno F, Terada H, Inaoka T, Nakatsuka T.","first_author":"Aiba Y","journal":"Case reports in neurology","year":2018,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Mild Cognitive Impairment","Young Onset","Dementia With Lewy Bodies","Mibg Myocardial Scintigraphy","Dopamine Transporter Scan"],"is_oa":true,"oa_url":"https://www.karger.com/Article/Pdf/495748","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case_report","sample_n":1,"sample_text":"N=1 (case report)","population":"single 61‑year‑old male with young‑onset dementia with Lewy bodies","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 61‑year‑old man with young‑onset dementia was diagnosed with Lewy‑body disease after showing hypersexuality and other non‑cognitive symptoms; brain scans helped confirm the diagnosis. The report highlights the need for more research on this condition.","clinical_takeaway":"Hypersexuality can be an early sign of Lewy‑body dementia; clinicians should consider neuroimaging when other symptoms appear.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed multimodal imaging for rare diagnosis","Clear clinical description of hypersexuality in DLB"],"limitations":["Single case limits generalisation","No systematic assessment of sexual behaviour","No statistical analysis"],"rubric_version":"2.0","raw_total":11,"max_possible":60,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":2,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000495748"}},{"id":7855,"doi":"10.1016/j.gerinurse.2008.09.001","pmid":"19665665","pmcid":null,"title":"Hypersexuality among cognitively impaired older adults","authors":"Wallace M, Safer M.","first_author":"Wallace M","journal":"Geriatric nursing (New York, N.Y.)","year":2009,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Review article summarizing existing literature on hypersexuality in cognitively impaired older adults; no new empirical data collected.","sample_n":null,"sample_text":"No primary sample; authors synthesize prior studies.","population":"Older adults with cognitive impairment (e.g., dementia); caregiver perspective.","country":"United States (journal based in New York, NY)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews reports of excessive sexual behavior in older adults with dementia, describing how it may stem from brain changes and discussing how nurses can assess and manage it.","clinical_takeaway":"Clinicians should screen for hypersexual behavior in cognitively impaired elders and use tailored, non‑pharmacologic and pharmacologic strategies while educating caregivers.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Synthesizes existing literature on a neglected clinical issue","Provides practical assessment and treatment considerations for caregivers"],"limitations":["No original data; reliance on heterogeneous source studies","Limited methodological appraisal of cited works","Potential bias toward clinical anecdotes"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":48,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.gerinurse.2008.09.001"}},{"id":7856,"doi":"10.1007/s00415-018-9024-3","pmid":"30167881","pmcid":null,"title":"Neural correlates of changes in sexual function in frontotemporal dementia: implications for reward and physiological functioning","authors":"Ahmed RM, Goldberg ZL, Kaizik C, Kiernan MC, Hodges JR, Piguet O, Irish M.","first_author":"Ahmed RM","journal":"Journal of neurology","year":2018,"pub_types":["Comparative Study","Journal Article"],"keywords":["Hypothalamus","Physiology","Neuroendocrine","Sexual function","Neurodegeneration","Alzheimer’s disease","Frontotemporal Dementia","Reward"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of 62 dementia patients (bvFTD, SD, AD) using carer‑reported sexual behaviour questionnaire and VBM structural MRI.","sample_n":62,"sample_text":"30 bvFTD, 12 semantic dementia, 20 AD participants.","population":"Patients with frontotemporal dementia variants and Alzheimer’s disease; carers as informants.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined how frontotemporal dementia affects sexual drive and intimacy, finding that most patients showed reduced sexual interest, linked to brain atrophy in reward‑related areas, while hypersexual behaviours were rare and tied to cerebellar loss.","clinical_takeaway":"In dementia, reduced sexual desire is common and may reflect degeneration of reward circuitry rather than hypersexuality.","confidence":0.75,"topic_tags":["neuroscience","sexual_function"],"strengths":["Use of whole‑brain VBM to link behaviour with neurodegeneration","Comparative groups (bvFTD, SD, AD) provide clinical context","Carer‑based questionnaire captures changes not easily self‑reported"],"limitations":["Small, heterogeneous clinical sample limits power","Sexual behaviour questionnaire not clearly validated","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":5,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":19,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00415-018-9024-3"}},{"id":7857,"doi":"10.1016/s0025-6196(11)60538-7","pmid":"19339647","pmcid":"PMC2665974","title":"Frequency of new-onset pathologic compulsive gambling or hypersexuality after drug treatment of idiopathic Parkinson disease","authors":"Bostwick JM, Hecksel KA, Stevens SR, Bower JH, Ahlskog JE.","first_author":"Bostwick JM","journal":"Mayo Clinic proceedings","year":2009,"pub_types":["research-article","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":90,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective medical‑record review of 267 Parkinson patients from a regional cohort; identified 7 cases of new‑onset compulsive gambling or hypersexuality after dopamine‑agonist exposure.","sample_n":267,"sample_text":"267 patients met inclusion criteria; 7 developed compulsive gambling or hypersexuality.","population":"Adults with idiopathic Parkinson disease (N=267) from 7 rural Minnesota counties; 66 exposed to dopamine agonists.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a review of 267 Parkinson patients, 7 (2.6%) developed new compulsive gambling or hypersexuality after starting dopamine‑agonist drugs. All cases occurred among those on therapeutic doses, and symptoms improved when the medication was reduced or stopped.","clinical_takeaway":"Dopamine‑agonists can trigger compulsive gambling or hypersexuality in Parkinson patients; monitor behavior and adjust medication if needed.","confidence":0.85,"topic_tags":["sexual_function","csbd","gender"],"strengths":["Large regional PD cohort","Clear temporal link to dopamine‑agonist exposure","Clinically relevant outcome"],"limitations":["Retrospective design; possible missed cases","No validated scales for gambling or hypersexuality","No control for moral, mental‑health or relational confounds","Small number of events limits statistical precision"],"rubric_version":"2.0","raw_total":22,"max_possible":60,"pct_score":37,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":56,"citing_publications":159,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0025-6196(11)60538-7"}},{"id":7858,"doi":"10.1089/cyber.2017.0376","pmid":"30132695","pmcid":null,"title":"Representation of Women in Video Games: A Systematic Review of Literature in Consideration of Adult Female Wellbeing","authors":"Gestos M, Smith-Merry J, Campbell A.","first_author":"Gestos M","journal":"Cyberpsychology, behavior and social networking","year":2018,"pub_types":["Systematic Review","Journal Article"],"keywords":["Systematic review","Video Games","Self-objectification","Gender Representations","Female Wellbeing","Hypersexualize"],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review of 22 studies, PRISMA reporting, no quantitative meta‑analysis, limited risk‑of‑bias assessment","sample_n":null,"sample_text":"22 studies included; only 2 directly assessed female wellbeing","population":"adult women (no specific sample size reported in abstract)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 22 studies finds that women who view video games with sexualised, objectified female characters tend to report higher self‑objectification, lower body confidence, and reduced self‑efficacy. Men exposed to such content also show more sexist attitudes and acceptance of rape myths.","clinical_takeaway":"Exposure to objectified female video‑game characters may negatively affect women’s body image and self‑esteem; clinicians should consider media influences when addressing these issues.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Systematic PRISMA‑based review","Highlights consistent pattern of objectification in games","Identifies links to self‑objectification and sexist attitudes"],"limitations":["No quantitative synthesis or meta‑analysis","Limited assessment of study quality/risk of bias","Few primary studies directly measured wellbeing"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":34,"citing_publications":103,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cyber.2017.0376"}},{"id":7859,"doi":null,"pmid":"19401861","pmcid":null,"title":"Pathological gambling and hypersexuality due to dopaminergic treatment in Parkinson' disease","authors":"Martín Fernández F, Martín González T.","first_author":"Martín Fernández F","journal":"Actas espanolas de psiquiatria","year":2009,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single clinical case description of hypersexuality and pathological gambling in a Parkinson’s patient treated with dopaminergic agents","sample_n":1,"sample_text":"n=1 (case report)","population":"male Parkinson’s disease patient, early‑onset, receiving L‑dopa and other dopaminergic drugs","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A single Parkinson’s patient treated with L‑dopa developed compulsive gambling and increased sexual activity. The authors suggest the dopaminergic medication, rather than mood or psychosis, caused these behaviors.","clinical_takeaway":"In Parkinson’s patients on dopaminergic therapy, monitor for emerging gambling or hypersexual behaviors and consider medication adjustment.","confidence":0.8,"topic_tags":["sexual_function","other"],"strengths":["Detailed clinical description","Highlights dopaminergic dysregulation syndrome"],"limitations":["Single case, no control group","No validated measures of hypersexuality or gambling","No assessment of confounding factors (moral, mental health, partner)"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":7860,"doi":"10.1002/cpp.609","pmid":"19277987","pmcid":null,"title":"Coping strategies used by hypersexual patients to defend against the painful effects of shame","authors":"Reid RC, Harper JM, Anderson EH.","first_author":"Reid RC","journal":"Clinical psychology & psychotherapy","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control comparison of hypersexual patients (n=71) versus community controls (n=73); single assessment point","sample_n":144,"sample_text":"71 hypersexual patients, 73 control participants","population":"adult males with self‑identified hypersexuality, recruited from clinical settings; control group from unspecified source","country":"not reported","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Hypersexual patients reported higher use of withdrawal and self‑attack coping strategies when dealing with shame compared with non‑clinical controls.","clinical_takeaway":"Shame‑related withdrawal and self‑attack may be therapeutic targets for people presenting with hypersexual concerns.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Use of validated HBI and CoSS scales","Clear case‑control comparison","Effect sizes reported (moderate‑large)","Focus on shame coping, a clinically relevant outcome"],"limitations":["Cross‑sectional design precludes causal inference","No measurement or control of key confounds (moral incongruence, masturbation, mental health, relationship factors)","Sample drawn from treatment‑seeking patients → limited generalisability"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":4,"interpretation":6}},"scite":{"supporting":5,"contrasting":0,"mentioning":59,"citing_publications":161,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/cpp.609"}},{"id":7862,"doi":"10.1002/erv.2629","pmid":"30094889","pmcid":null,"title":"Food addiction and other addictive behaviours in bariatric surgery candidates","authors":"Müller A, Leukefeld C, Hase C, Gruner-Labitzke K, Mall JW, Köhler H, de Zwaan M.","first_author":"Müller A","journal":"European eating disorders review : the journal of the Eating Disorders Association","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Obesity","Substance Use Disorders","Food Addiction","Bariatric Surgery","Behavioural Addictions"],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 216 bariatric surgery candidates using self‑report questionnaires.","sample_n":216,"sample_text":"216 bariatric surgery candidates (91.7% class 3 obesity; 80.1% women; age median 44 years).","population":"Adults (18‑73) seeking bariatric surgery, 80% female, class 3 obesity.","country":"Germany (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 216 people awaiting weight‑loss surgery, about a quarter met criteria for food addiction, and this was modestly linked to buying and Internet‑use problems, but not to other addictions.","clinical_takeaway":"Food‑addiction symptoms are common in bariatric candidates and may co‑occur with other problematic behaviours; clinicians should screen for multiple addictions pre‑operatively.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Validated YFAS‑2.0 and other standardized questionnaires","Relatively large sample for bariatric population","Clear reporting of prevalence rates"],"limitations":["Cross‑sectional design cannot infer causality","No control for key psychosocial confounds (e.g., mental health, trauma)","Self‑report measures only; no objective/behavioral data"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":6,"interpretation":8}},"scite":{"supporting":6,"contrasting":1,"mentioning":32,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/erv.2629"}},{"id":7863,"doi":"10.1016/j.rcp.2018.04.007","pmid":"32081203","pmcid":null,"title":"Sexual and Reproductive Health in Patients with Schizophrenia and Bipolar Disorder","authors":"Posada Correa AM, Andrade Carrillo RA, Suarez Vega DC, Gómez Cano S, Agudelo Arango LG, Tabares Builes LF, Agudelo García ÁM, Uribe Villa E, Aguirre-Acevedo DC, López-Jaramillo C.","first_author":"Posada Correa AM","journal":"Revista Colombiana de psiquiatria","year":2020,"pub_types":["Journal Article","Observational Study"],"keywords":["Sexuality","Schizophrenia","Contraception","Bipolar disorder","Mental Illness","Anticoncepción","Sexualidad","Trastorno Bipolar","Esquizofrenia","Enfermedad Mental"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational cross‑sectional survey of 160 patients drawn from a prior clinical trial at a single Colombian psychiatric clinic.","sample_n":160,"sample_text":"160 participants recruited from the mood and psychosis disorders group clinic; convenience sample of patients already enrolled in a multimodal intervention trial.","population":"Adults with schizophrenia or bipolar disorder attending a mood/psychosis clinic in Medellín, Colombia (N≈160).","country":"Colombia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A Colombian survey of 160 people with schizophrenia or bipolar disorder found many had limited sexual activity, low contraception use, and rarely received family‑planning counselling from psychiatrists.","clinical_takeaway":"Clinicians should proactively discuss contraception and sexual health with patients with serious mental illness.","confidence":0.8,"topic_tags":["sexual_function","religiosity","gender","csbd"],"strengths":["Large (for clinic) sample of patients with serious mental illness","Focus on under‑studied area of reproductive health in psychiatric population"],"limitations":["Cross‑sectional, no causal inference","Use of non‑validated, self‑report questionnaire","Limited control of key confounds (e.g., moral attitudes, partner status)","Convenience sample limits generalizability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.rcp.2018.04.007"}},{"id":7864,"doi":"10.1080/00926230902851298","pmid":"19466668","pmcid":null,"title":"Exploring relationships of psychopathology in hypersexual patients using the MMPI-2","authors":"Reid RC, Carpenter BN.","first_author":"Reid RC","journal":"Journal of sex & marital therapy","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of treatment‑seeking hypersexual patients (N=152)","sample_n":152,"sample_text":"N = 152 hypersexual patients seeking treatment","population":"individuals seeking help for hypersexual behavior; convenience sample","country":"Not reported","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined personality test scores of 152 people who sought help for hypersexual behavior and found varied patterns of psychological symptoms, with many showing few abnormalities. It suggests hypersexuality is a heterogeneous condition and challenges one‑size‑fits‑all models.","clinical_takeaway":"Hypersexual patients are diverse; clinicians should assess individual psychological profiles rather than assume a uniform ‘addiction.’","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function","csbd"],"strengths":["Relatively large sample for a clinical convenience cohort","Use of a well‑validated personality inventory (MMPI‑2)","Acknowledges heterogeneity of hypersexual patients"],"limitations":["Convenience, treatment‑seeking sample limits generalisability","No specific measure of hypersexuality or addiction; reliance on help‑seeking status","Key confounds (moral incongruence, masturbation, partner context, trauma) not assessed"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":38,"citing_publications":115,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230902851298"}},{"id":7866,"doi":"10.4103/0028-3886.237019","pmid":"30038082","pmcid":null,"title":"Impulse control disorders in Parkinson's disease: Review of pathophysiology, epidemiology, clinical features, management, and future challenges","authors":"Bhattacharjee S.","first_author":"Bhattacharjee S.","journal":"Neurology India","year":2018,"pub_types":["Review","Journal Article"],"keywords":["Dopamine","Behavior","Parkinson's Disease","Impulsive","Compulsive"],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review (narrative) of impulse‑control disorders in Parkinson’s disease, summarising prevalence, neurobiology and treatment.","sample_n":null,"sample_text":"Not applicable – narrative review.","population":"Parkinson’s disease patients with impulse‑control disorders (ICDs) such as hypersexuality.","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews impulse‑control problems in Parkinson’s disease, including hypersexuality, gambling and compulsive buying, describing how dopamine‑related brain pathways and medication use contribute to these behaviors.","clinical_takeaway":"Clinicians should monitor Parkinson’s patients on dopamine agonists for emerging compulsive sexual or other impulsive behaviors.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","treatment"],"strengths":["Comprehensive overview of PD‑related ICDs","Integrates neurobiological mechanisms"],"limitations":["Narrative review without systematic methodology","No primary data; no quantitative synthesis"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":29,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0028-3886.237019"}},{"id":7867,"doi":"10.3233/adr-170041","pmid":"30480254","pmcid":"PMC6159613","title":"Aripiprazole for the Treatment of Inappropriate Sexual Behavior: Case Report of an Alzheimer's Disease Patient Known as Heterosexual with Recently Shifted Sexual Orientation to Same Gender","authors":"Sarikaya S, Sarikaya B.","first_author":"Sarikaya S","journal":"Journal of Alzheimer's disease reports","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","antipsychotic agents","Alzheimer’s disease","Dementia","Frontotemporal Dementia","Aripiprazole"],"is_oa":true,"oa_url":"https://content.iospress.com:443/download/journal-of-alzheimers-disease-reports/adr170041?id=journal-of-alzheimers-disease-reports%2Fadr170041","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single Alzheimer's patient with new same‑sex inappropriate sexual behavior treated with aripiprazole","sample_n":1,"sample_text":"one patient","population":"74‑year‑old woman with Alzheimer’s disease","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 74‑year‑old woman with Alzheimer’s disease began showing same‑sex sexual advances, a change from her lifelong heterosexual orientation. Treatment with the antipsychotic aripiprazole reduced and eventually stopped these inappropriate behaviors.","clinical_takeaway":"Aripiprazole may help manage hypersexuality in dementia, but evidence is limited to a single case.","confidence":0.4,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed clinical description","Novel observation of sexual orientation shift in AD"],"limitations":["Single case; no control group","No validated measures of hypersexuality","No assessment of confounding factors"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3233/adr-170041"}},{"id":7868,"doi":"10.4176/080908","pmid":"21503151","pmcid":"PMC3074312","title":"Hypersexual behavior following craniocerebral trauma an experience with five cases","authors":"Eghwrudjakpor P, Essien A.","first_author":"Eghwrudjakpor P","journal":"The Libyan journal of medicine","year":2008,"pub_types":["Journal Article","case-report"],"keywords":["Disinhibition","Brain injury","Hypersexuality"],"is_oa":true,"oa_url":"https://www.tandfonline.com/doi/pdf/10.3402/ljm.v3i4.4792?needAccess=true","cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":5,"sample_text":"Five patients described in a case series","population":"patients with traumatic brain injury exhibiting hypersexual behaviour (n=5)","country":"Libya","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe five people who developed unusually high sexual activity after severe head injuries, noting the distress it caused for them and their partners.","clinical_takeaway":"Head trauma can sometimes lead to disinhibited sexual behaviour; clinicians should screen for such changes.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Provides clinical description of a rare complication","Includes discussion of relevant literature"],"limitations":["Very small, non-representative sample","No standardized measures of hypersexuality or distress","No control for confounding variables"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4176/080908"}},{"id":7869,"doi":"10.1016/j.psc.2008.06.007","pmid":"18996299","pmcid":null,"title":"Classifying hypersexual disorders: compulsive, impulsive, and addictive models","authors":"Stein DJ.","first_author":"Stein DJ.","journal":"The Psychiatric clinics of North America","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"No participants; paper is a conceptual review and proposal.","population":"humans (theoretical discussion)","country":"USA (journal based in North America)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews how hypersexual disorder has been labeled as compulsive, impulsive, or addictive, argues for a theory‑neutral term, and notes a lack of solid biological and treatment research to support any model.","clinical_takeaway":"Clinicians should recognize that current classifications are tentative and await stronger empirical support.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive theoretical overview of hypersexual disorder models","Identifies gaps in psychobiological and treatment evidence"],"limitations":["No empirical data presented","No measurement of key constructs or confounds","Lacks systematic review methodology"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":3,"contrasting":1,"mentioning":56,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psc.2008.06.007"}},{"id":7870,"doi":"10.1007/s10508-018-1212-9","pmid":"29926262","pmcid":null,"title":"The Relational and Bodily Experiences Theory of Sexual Desire in Women","authors":"Cherkasskaya E, Rosario M.","first_author":"Cherkasskaya E","journal":"Archives of sexual behavior","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Attachment","Self-objectification","Genital Self-image","Sexual Subjectivity","Women’s Sexual Desire"],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative theoretical review without original empirical data.","sample_n":null,"sample_text":"No primary data; review of existing literature.","population":"Women (general, no specific sample reported)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose a new theory linking women's relationships and body self‑image to the full range of sexual desire, suggesting that attachment styles and how women perceive their bodies shape desire levels.","clinical_takeaway":"Clinicians might consider attachment issues and body self‑image when addressing women's sexual desire concerns.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive integration of relational and bodily theories","Broad consideration of sexual orientation","Identifies gaps for future research"],"limitations":["No primary empirical data","Lacks systematic review methodology","No quantitative synthesis"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":26,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1212-9"}},{"id":7871,"doi":"10.1080/10538712.2018.1484403","pmid":"29924694","pmcid":null,"title":"Exploring Gender and Racial/Ethnic Differences in the Effects of Child Sexual Abuse","authors":"Gray S, Rarick S.","first_author":"Gray S","journal":"Journal of child sexual abuse","year":2018,"pub_types":["Journal Article"],"keywords":["Adolescent","Sexual Abuse","Gender Issues","Cultural Competence","Race/ethnicity","Child Sexual Abuse","Clinical Issues","Theoretical Issues"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"archival national survey of 13,583 high‑school students; loglinear analysis of gender × race/ethnicity effects on hypersexuality, depression, suicidality, substance use","sample_n":13583,"sample_text":"13,583 male and female high school students","population":"adolescent survivors of child sexual abuse (CSA) in the United States","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a national survey of over 13,000 high‑school students who experienced child sexual abuse, the study found boys were more likely to use substances while girls reported more depression and suicidality. No clear racial/ethnic differences emerged in these outcomes.","clinical_takeaway":"When treating CSA‑surviving adolescents, consider gender‑specific risks—substance use in boys, mood and suicide risk in girls—but note cultural factors were not strongly linked.","confidence":0.78,"topic_tags":["csbd","sexual_function","adolescents","gender"],"strengths":["Large, nationally‑representative sample","Gender and ethnic subgroup analysis","Clear statistical method (loglinear)"],"limitations":["Cross‑sectional; no causal inference","Unclear measurement validation for outcomes","Key confounds (moral incongruence, masturbation) not addressed"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":28,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2018.1484403"}},{"id":7873,"doi":"10.64719/pb.4576","pmid":"30618473","pmcid":"PMC6294421","title":"A Case of Hyper Sexuality Probably Associated with Clozapine","authors":"Thomson SR, Patil N, Ommurugan B, Bhandary RK.","first_author":"Thomson SR","journal":"Psychopharmacology bulletin","year":2018,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Adverse drug reaction","Atypical Antipsychotic","Hypersexuality"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report; no control group; observational","sample_n":1,"sample_text":"single case","population":"45‑year‑old woman with schizoaffective disorder","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 45‑year‑old woman with schizoaffective disorder developed strong sexual urges and exhibitionism after her clozapine dose was raised. When the medication was reduced, the symptoms lessened, suggesting a possible drug‑related side effect.","clinical_takeaway":"Clinicians should monitor for hypersexuality when prescribing high‑dose clozapine and consider dose reduction if it occurs.","confidence":0.8,"topic_tags":["sexual_function","adolescents","gender"],"strengths":["Detailed clinical description","Temporal link between clozapine dose change and symptoms"],"limitations":["N=1; no control or comparison","No validated measure of hypersexuality","No assessment of alternative explanations (moral conflict, partner dynamics, mental‑health covariates)"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.64719/pb.4576"}},{"id":7874,"doi":"10.4103/0028-3886.44830","pmid":"19127045","pmcid":null,"title":"Hypersexuality following subthalamic nucleus stimulation for Parkinson's disease","authors":"Doshi P, Bhargava P.","first_author":"Doshi P","journal":"Neurology India","year":2008,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case report of two Parkinson's patients developing hypersexuality after subthalamic nucleus deep brain stimulation.","sample_n":2,"sample_text":"Two cases","population":"Male patients with Parkinson's disease receiving STN DBS.","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"Two men with Parkinson's disease developed increased sexual activity after deep‑brain stimulation of the subthalamic nucleus, suggesting the procedure can affect sexual behavior.","clinical_takeaway":"Clinicians should monitor sexual changes after STN DBS, but evidence is limited to case reports.","confidence":0.7,"topic_tags":["neuroscience"],"strengths":["Provides clinical observation of a rare side‑effect","Includes long‑term follow‑up"],"limitations":["Only two cases; no systematic assessment","No validated measures of sexual behaviour or distress","No control for moral, mental‑health or relationship factors"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0028-3886.44830"}},{"id":7875,"doi":"10.3389/fneur.2018.00330","pmid":"29872418","pmcid":"PMC5972311","title":"Impulse-Control Disorders in Parkinson's Disease: A Meta-Analysis and Review of Case-Control Studies","authors":"Molde H, Moussavi Y, Kopperud ST, Erga AH, Hansen AL, Pallesen S.","first_author":"Molde H","journal":"Frontiers in neurology","year":2018,"pub_types":["systematic-review","Journal Article"],"keywords":["Meta-analysis","Dopamine agonists","Parkinson’s Disease","Case–control","Impulse-control Disorders"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5972311","cited_by_count":38,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"systematic review and meta‑analysis of 14 case‑control prevalence studies (N=4,539) comparing Parkinson’s patients with healthy controls.","sample_n":4539,"sample_text":"2,371 PD patients and 2,168 healthy controls from 14 case‑control studies","population":"Parkinson’s disease patients (treated or untreated) and healthy controls","country":"multiple (studies from various countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People with Parkinson’s disease are about twice as likely to develop impulse‑control problems such as gambling or hypersexuality compared with people without the disease, especially when they are receiving dopamine‑agonist medication.","clinical_takeaway":"Monitor Parkinson’s patients on dopamine agonists for emerging impulse‑control issues, including hypersexuality.","confidence":0.8,"topic_tags":["neuroscience","sexual_function","treatment","prevalence"],"strengths":["Large total sample from multiple studies","Standard meta‑analytic techniques with CI and publication‑bias assessment","Identifies moderating variables (treatment status, disease duration)"],"limitations":["Variable measurement of ICDs across primary studies","No explicit risk‑of‑bias assessment reported","Potential small‑study effects noted"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":1,"mentioning":43,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fneur.2018.00330"}},{"id":7876,"doi":"10.1097/smj.0b013e318180b3de","pmid":"18708975","pmcid":null,"title":"Treatment of hypersexual behavior with oral estrogen in an autistic male","authors":"Jones MC, Okere K.","first_author":"Jones MC","journal":"Southern medical journal","year":2008,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single male autistic adult with hypersexual behavior treated with oral estrogen; no control group, descriptive outcome","sample_n":1,"sample_text":"one participant","population":"autistic male adult (single case)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2008 case report describes one autistic man with excessive sexual behaviour who was given oral estrogen. The authors note limited research on such patients and suggest clinicians rely on findings from other groups.","clinical_takeaway":"No firm guidance; estrogen may be considered experimentally but evidence is anecdotal.","confidence":0.7,"topic_tags":["treatment","sexual_function","neuroscience","gender"],"strengths":["Rare report of estrogen use in autistic hypersexuality","Provides clinical observation for hypothesis generation"],"limitations":["Single case, no control","No validated measures of hypersexual behavior","No assessment of confounding factors"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/smj.0b013e318180b3de"}},{"id":7877,"doi":"10.4103/0028-3886.232289","pmid":"29766965","pmcid":null,"title":"Hypersexuality following anterior communicating artery aneurysm rupture","authors":"Jarial KDS, Purkayastha M, Dutta P, Mukherjee KK, Bhansali A.","first_author":"Jarial KDS","journal":"Neurology India","year":2018,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0028-3886.232289"}},{"id":7878,"doi":null,"pmid":"30778405","pmcid":null,"title":"[Kleine Levin syndrome: Review of diagnosed cases of Buenos Aires, Argentina]","authors":"Valiensi SM, Garay A, Podestá C, Mazzola ME, Paleka MC, Martínez OA.","first_author":"Valiensi SM","journal":"Vertex (Buenos Aires, Argentina)","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 7 patients with Kleine‑Levin syndrome, describing clinical features and occasional neuroimaging","sample_n":7,"sample_text":"seven patients","population":"patients diagnosed with Kleine‑Levin syndrome in Buenos Aires, Argentina (2 F, 5 M, age 8‑47)","country":"Argentina","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe seven Argentine patients with Kleine‑Levin syndrome, a rare sleep disorder that can include bouts of excessive eating and heightened sexual drive. They detail each case’s symptoms and report that most brain scans were normal.","clinical_takeaway":"Kleine‑Levin syndrome is extremely rare; clinicians should assess each case individually and not assume typical brain imaging findings.","confidence":0.85,"topic_tags":["sexual_function","neuroscience"],"strengths":["Uses recognized clinical diagnostic criteria (ICSD)","Reports rare disorder in a new geographic region","Includes multimodal imaging data where available"],"limitations":["Very small, non‑representative case series","No systematic assessment of confounding variables","Descriptive only, no statistical inference"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":0,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":7879,"doi":"10.1016/j.jsxm.2018.02.015","pmid":"29699750","pmcid":null,"title":"Hypersexuality: Fact or Fiction?","authors":"Kingston DA.","first_author":"Kingston DA.","journal":"The journal of sexual medicine","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2018.02.015"}},{"id":7880,"doi":"10.4088/jcp.17m11612","pmid":"29702754","pmcid":null,"title":"Prevalence of Impulsive-Compulsive Symptoms in Elderly Parkinson's Disease Patients: A Case-Control Study","authors":"Lo Monaco MR, Petracca M, Weintraub D, Fusco D, Liperoti R, Zuccalà G, La Carpia D, Vetrano DL, Genovese D, Pisciotta MS, Brandi V, Padua L, Imbimbo I, Ricciardi D, Bernabei R, Silveri MC, Laudisio A, Bentivoglio AR.","first_author":"Lo Monaco MR","journal":"The Journal of clinical psychiatry","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-control cross‑sectional prevalence study with 115 Parkinson’s patients and 105 age‑matched controls","sample_n":220,"sample_text":"115 PD patients, 105 healthy controls","population":"elderly (mean age ≈ 76) Parkinson’s disease patients and community controls","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 115 older adults with Parkinson’s disease and 105 age‑matched healthy people, about 45% of the patients reported at least one impulse‑control problem such as hypersexuality, compared with 25% of controls. The questionnaire used was shown to be reliable.","clinical_takeaway":"Elderly Parkinson’s patients show higher rates of hypersexuality and other impulsive‑compulsive symptoms; clinicians should screen for these behaviors.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large, well‑matched elderly sample","Use of a validated, reliable instrument (QUIP)","Clear prevalence estimates with confidence intervals reported in text"],"limitations":["Cross‑sectional; cannot infer causality","No control for psychiatric comorbidities or medication doses","No assessment of moral or relational factors that could confound hypersexuality reports"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":20,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/jcp.17m11612"}},{"id":7882,"doi":"10.1016/j.ijlp.2018.01.008","pmid":"29853002","pmcid":null,"title":"The medical-legal aspect of sexual deviant behaviors due to brain lesions: A case report and narrative review of the literature","authors":"Mokhber N, Azarpazhooh MR, Prakash A, Zamprogna Ballès JA, Prakash A.","first_author":"Mokhber N","journal":"International journal of law and psychiatry","year":2018,"pub_types":["Review","Journal Article","Case Reports"],"keywords":["Rape","Temporal lobe epilepsy","Criminal Responsibility","Forensic Psychiatry","Offense","Complex Partial Seizure","Sexual Assaults","Sexual Deviant Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case description with narrative literature review; no systematic methodology","sample_n":1,"sample_text":"single patient (case report) and literature review","population":"60‑year‑old male with lentiform stroke","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"A 60‑year‑old man with a brain stroke committed sexual assault; the authors suggest the lesion may have caused abnormal sexual urges and review similar cases in the literature.","clinical_takeaway":"Brain injury can sometimes alter sexual behaviour, but a single case cannot inform clinical practice.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["detailed clinical description","integration of medico‑legal literature"],"limitations":["single case; no generalizable data","no systematic review methods","no assessment of confounding factors"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijlp.2018.01.008"}},{"id":7883,"doi":"10.1016/j.ijlp.2018.04.003","pmid":"29681401","pmcid":null,"title":"Capacity, control and responsibility in Parkinson's disease patients with impulse control disorders: Views of neurological and psychiatric experts","authors":"Dawson A, Michael J, Dilkes-Frayne E, Hall W, Dissanayaka NN, Carter A.","first_author":"Dawson A","journal":"International journal of law and psychiatry","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Control","Parkinson’s Disease","Responsibility","Capacity","Impulse Control Disorders"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"thematic analysis of expert interviews (n=11)","sample_n":11,"sample_text":"11 experts (neurologists, geriatricians, psychiatrists)","population":"neurologists, geriatricians, psychiatrists with expertise in Parkinson’s disease and impulse control disorders","country":"United Kingdom (implied by Commonwealth cases)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 11 neurologists and psychiatrists showed mixed views on whether Parkinson’s‑related impulse‑control disorders (like hypersexuality) fully eliminate a patient’s decision‑making capacity or legal responsibility.","clinical_takeaway":"Legal assessments of ICD‑related offending should consider expert disagreement on capacity and responsibility.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Direct insight from clinicians with relevant expertise","Systematic thematic analysis described"],"limitations":["Very small, non‑representative expert sample","No quantitative validation of constructs","No assessment of potential confounding factors"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijlp.2018.04.003"}},{"id":7884,"doi":"10.1016/j.sxmr.2018.02.001","pmid":"29605061","pmcid":null,"title":"Response and Rebuttal to \"Existential Issues in Sexual Medicine: The Relation Between Death Anxiety and Hypersexuality\"","authors":"Watter DN.","first_author":"Watter DN.","journal":"Sexual medicine reviews","year":2018,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sxmr.2018.02.001"}},{"id":7885,"doi":"10.1016/j.sxmr.2018.02.002","pmid":"29605060","pmcid":null,"title":"Response Regarding Existential Issues in Sexual Medicine: The Relation Between Death Anxiety and Hypersexuality","authors":"Ciocca G, Limoncin E, Lingiardi V, Burri A, Jannini EA.","first_author":"Ciocca G","journal":"Sexual medicine reviews","year":2018,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sxmr.2018.02.002"}},{"id":7887,"doi":"10.1016/j.chiabu.2018.02.021","pmid":"29547836","pmcid":null,"title":"A systematic review of fantasy driven vs. contact driven internet-initiated sexual offences: Discrete or overlapping typologies?","authors":"Broome LJ, Izura C, Lorenzo-Dus N.","first_author":"Broome LJ","journal":"Child abuse & neglect","year":2018,"pub_types":["Systematic Review","Journal Article"],"keywords":["Online Grooming","Contact-driven Offending","Fantasy-driven Offending","Internet-initiated Offenders","Online Grooming Typology"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Narrative systematic review of 22 heterogeneous studies on internet‑initiated sexual offending typologies.","sample_n":null,"sample_text":"Twenty‑two studies identified; no pooled sample size reported in abstract.","population":"Adults who use the internet to facilitate sexual abuse of minors (offender samples).","country":"Not specified (multiple studies).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 22 studies found that the common split of internet‑initiated child sexual offenders into “fantasy‑driven” and “contact‑driven” types is unclear, as many offenders show overlap. The authors suggest a new three‑group model based on relationship intensity.","clinical_takeaway":"None – the review concerns offender typologies, not clinical treatment of sexual health or addiction.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Systematic literature search with predefined inclusion criteria","Identifies ambiguity in existing typology","Proposes alternative, evidence‑based typology"],"limitations":["Narrative synthesis only; no quantitative meta‑analysis","Heterogeneity of primary studies limits conclusions","Limited reporting of methodological quality of included studies"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":29,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2018.02.021"}},{"id":7889,"doi":"10.1016/j.ridd.2018.02.008","pmid":"29486384","pmcid":null,"title":"Sexuality in the lives of people with intellectual disabilities: A meta-ethnographic synthesis of qualitative studies","authors":"Whittle C, Butler C.","first_author":"Whittle C","journal":"Research in developmental disabilities","year":2018,"pub_types":["Review","Journal Article"],"keywords":["Sexuality","Carers","Intellectual Disability","Normalisation","Cultural Norms"],"is_oa":false,"oa_url":"https://purehost.bath.ac.uk/ws/files/169297543/Final_ID_submission.pdf","cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"meta‑ethnographic synthesis of 16 qualitative studies with systematic search and quality appraisal","sample_n":null,"sample_text":"16 qualitative studies (total participants not reported in abstract)","population":"people with intellectual disabilities (and caregivers) discussing sexuality","country":"multiple (studies from various countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 16 qualitative studies explored how people with intellectual disabilities experience sexuality. Four themes emerged, showing that caregivers' cultural beliefs can either block or support positive sexual expression.","clinical_takeaway":"Support caregivers to reflect on their beliefs, as attitudes shape sexual wellbeing for people with intellectual disabilities.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Systematic, transparent literature search","Rigorous qualitative synthesis method (meta‑ethnography)","Clear theoretical framework (CMoM) for interpreting findings"],"limitations":["No quantitative data; limited statistical assessment","Potential publication bias of qualitative studies","Sample characteristics of primary studies not detailed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":55,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ridd.2018.02.008"}},{"id":7890,"doi":"10.1136/jnnp-2017-316373","pmid":"29436490","pmcid":null,"title":"Subthalamic stimulation and neuropsychiatric symptoms in Parkinson's disease: results from a long-term follow-up cohort study","authors":"Abbes M, Lhommée E, Thobois S, Klinger H, Schmitt E, Bichon A, Castrioto A, Xie J, Fraix V, Kistner A, Pélissier P, Seigneuret É, Chabardès S, Mertens P, Broussolle E, Moro E, Krack P.","first_author":"Abbes M","journal":"Journal of neurology, neurosurgery, and psychiatry","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Dopamine","Subthalamic Nucleus","Parkinson’s Disease","Impulse Control Disorder","Apathy"],"is_oa":false,"oa_url":null,"cited_by_count":59,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective and retrospective cohort of 69 Parkinson's patients followed 3‑10 years after subthalamic DBS","sample_n":69,"sample_text":"69 patients (male and female, aged middle‑aged to elderly) treated with subthalamic stimulation","population":"Parkinson's disease patients receiving bilateral subthalamic nucleus deep brain stimulation (N=69)","country":"France (implied by author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 69 Parkinson’s patients, deep‑brain stimulation of the subthalamic nucleus lowered most impulse‑control problems and mood swings over about six years, but apathy became more common. Hypersexuality mostly persisted.","clinical_takeaway":"STN‑DBS may improve many impulsive behaviours in Parkinson’s, yet clinicians should monitor for rising apathy and residual hypersexuality.","confidence":0.7,"topic_tags":["neuroscience","pornography","sexual_function","csbd"],"strengths":["Long‑term (mean 6 years) follow‑up","Use of a validated behavioral scale for Parkinson’s","Clear reporting of changes in impulse control and apathy"],"limitations":["No control group; possible regression to the mean","Limited statistical detail (no effect sizes, confidence intervals)","Potential confounding by disease progression and medication changes"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":102,"citing_publications":82,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/jnnp-2017-316373"}},{"id":7891,"doi":"10.1177/1073191118754705","pmid":"29405755","pmcid":null,"title":"Dynamic Risk Assessment of Sexual Offenders: Validity and Dimensional Structure of the Stable-2007","authors":"Etzler S, Eher R, Rettenberger M.","first_author":"Etzler S","journal":"Assessment","year":2020,"pub_types":["Journal Article"],"keywords":["risk assessment","Predictive Validity","Exploratory Factor Analysis","Static-99","Stable-2007"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective longitudinal cohort of 638 adult male sexual offenders, 8.2‑year follow‑up, risk assessment instruments (Static‑99, Stable‑2007) evaluated for predictive validity","sample_n":638,"sample_text":"638 adult male sexual offenders followed for an average of 8.2 years","population":"adult male sexual offenders (Austria)","country":"Austria","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested a new risk‑assessment tool (Stable‑2007) in 638 male sexual offenders and found it predicts future sexual re‑offending, adding information beyond the older Static‑99 tool.","clinical_takeaway":"Stable‑2007 offers additional predictive value for sexual recidivism risk assessments in offender management.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, well‑characterized longitudinal sample","Validated risk‑assessment tools (Static‑99, Stable‑2007)","Incremental validity analysis"],"limitations":["No assessment of moral, mental‑health or trauma confounds","No pre‑registration disclosed","Findings specific to convicted offenders, not general population"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":8,"contrasting":2,"mentioning":69,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1073191118754705"}},{"id":7892,"doi":"10.1037/pha0000178","pmid":"29389211","pmcid":null,"title":"Hypersexuality associated with paliperidone","authors":"Çayköylü A, Karslıoğlu EH, Özer İ, Köksal AG.","first_author":"Çayköylü A","journal":"Experimental and clinical psychopharmacology","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case report of a 43‑year‑old woman with schizophrenia developing hypersexuality after depot paliperidone","sample_n":1,"sample_text":"N=1 (case report)","population":"adult patients with schizophrenia, single female participant","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 43‑year‑old woman with schizophrenia started a long‑acting antipsychotic (paliperidone) and subsequently reported very high sexual desire and unusual sexual preoccupations. The authors propose that the medication’s neurochemical actions may have caused this rare hypersexuality.","clinical_takeaway":"Clinicians should monitor sexual side‑effects, including possible hypersexuality, when prescribing depot paliperidone, but evidence comes from a single case.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function","neuroscience","treatment","csbd"],"strengths":["Detailed clinical description of a rare adverse effect","Links symptomatology to pharmacology of paliperidone"],"limitations":["Single case; no control group","No validated measures of hypersexuality or addiction","Potential confounds (mood, masturbation, moral factors) not assessed"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/pha0000178"}},{"id":7893,"doi":"10.1530/ec-18-0030","pmid":"29378769","pmcid":"PMC5825922","title":"Neuropsychiatric and metabolic aspects of dopaminergic therapy: perspectives from an endocrinologist and a psychiatrist","authors":"Athanasoulia-Kaspar AP, Popp KH, Stalla GK.","first_author":"Athanasoulia-Kaspar AP","journal":"Endocrine connections","year":2018,"pub_types":["review-article","Review","Journal Article"],"keywords":["Dopamine agonists","hyperprolactinemia","Prolactinomas","Dopaminergic Treatment"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5825922","cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review without systematic methodology","sample_n":null,"sample_text":"Not applicable – review of existing literature","population":"patients with prolactinomas, Parkinson’s disease, restless‑leg syndrome; no specific sexual‑behavior sample","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how dopamine‑activating medicines used for pituitary tumours and Parkinson’s disease can cause neuropsychiatric side‑effects such as compulsive gambling, hypersexuality, and mood changes, and also affect metabolism and weight.","clinical_takeaway":"Dopamine agonists may trigger impulse‑control problems, including increased sexual urges; clinicians should monitor patients for these effects.","confidence":0.4,"topic_tags":["neuroscience","sexual_function","prevalence","treatment"],"strengths":["Provides overview of dopamine‑agonist side‑effects including hypersexuality","Integrates endocrinology and psychiatry perspectives"],"limitations":["Narrative, not systematic; no explicit methods or bias assessment","No primary data on pornography, masturbation or CSBD","Lacks quantitative synthesis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":22,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1530/ec-18-0030"}},{"id":7894,"doi":null,"pmid":"18264903","pmcid":null,"title":"[The treatment of hypersexuality in a male with obsessive compulsive disorder as psychiatric co-morbidity]","authors":"Jairam J, van Marle HJ.","first_author":"Jairam J","journal":"Tijdschrift voor psychiatrie","year":2008,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"dut","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single male patient with OCD and hypersexuality, describing pharmacological treatment","sample_n":1,"sample_text":"single case","population":"adult male with OCD and hypersexuality (paraphilia NOS)","country":"Netherlands (journal language Dutch, abstract English)","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"A single patient with obsessive‑compulsive disorder and excessive sexual urges was treated with anti‑libido medication. The authors describe how OCD‑focused therapy and hormone‑blocking drugs reduced his hypersexual behavior.","clinical_takeaway":"Evidence is anecdotal; clinicians should not generalise this treatment approach without further controlled studies.","confidence":0.6,"topic_tags":["sexual_function","treatment","csbd","moral_incongruence"],"strengths":["Detailed clinical narrative","Describes stepwise pharmacological approach"],"limitations":["Single case, no validated outcome measures","No control for moral or sexual context variables","No quantitative data or statistical analysis"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":7896,"doi":"10.1177/0886260517746182","pmid":"29295023","pmcid":"PMC6461523","title":"Gender-Specific Risk Factors for Psychopathology and Reduced Functioning in a Post-9/11 Veteran Sample","authors":"Scoglio AAJ, Shirk SD, Hoff RA, Potenza MN, Mazure CM, Park CL, McKee SA, Porter EA, Kraus SW.","first_author":"Scoglio AAJ","journal":"Journal of interpersonal violence","year":2021,"pub_types":["research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["risk factors","Psychopathology","Gender Differences","Veteran","Sexual Trauma","Physical Trauma"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"secondary analysis of a cross‑sectional survey of 283 U.S. combat veterans (≈30% female)","sample_n":283,"sample_text":"283 veterans (female = 29.4 %)","population":"U.S. combat veterans returning from post‑9/11 deployments","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 283 post‑9/11 combat veterans, women reported more sexual trauma while men reported more gambling, impulsivity and hypersexuality. No gender differences were found for depression, anxiety or substance use. The authors suggest these patterns need further study to inform veteran reintegration.","clinical_takeaway":"Gender‑specific patterns of hypersexuality and trauma may require tailored screening in veteran mental‑health care.","confidence":0.7,"topic_tags":["sexual_function","gender","moral_incongruence"],"strengths":["Large sample for veteran research","Gender‑focused analysis","Includes trauma history"],"limitations":["Hypersexuality measure not described","No control for moral incongruence or masturbation","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260517746182"}},{"id":7897,"doi":"10.1017/s109285290001556x","pmid":"17984855","pmcid":null,"title":"Hypersexuality in inpatient children and adolescents: recognition, differential diagnosis, and evaluation","authors":"El-Gabalawi F, Johnson RA.","first_author":"El-Gabalawi F","journal":"CNS spectrums","year":2007,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Review with a single illustrative case report and literature synthesis; no primary data collection.","sample_n":null,"sample_text":"Case report (n=1) plus literature review; no systematic sample.","population":"Inpatient children and adolescents (case of a 17‑year‑old girl); broader literature on pediatric and adult hypersexuality.","country":"USA (likely, based on journal affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe a teen with excess sexual thoughts linked to hormonal imbalance and offer a quick clinical definition of hypersexuality, plus a list of other possible medical causes.","clinical_takeaway":"Clinicians should consider sudden, disruptive increases in sexual behavior as potential hypersexuality and rule out medical causes like virilization.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Provides a clear bedside definition of hypersexuality for clinicians.","Integrates differential diagnosis for pediatric hypersexuality."],"limitations":["Based on a single case and narrative review; no systematic data.","No validated measurement tools or empirical testing of the proposed definition.","Confounding factors (e.g., mental health, moral incongruence) not examined."],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s109285290001556x"}},{"id":7898,"doi":"10.1097/md.0000000000009481","pmid":"29390592","pmcid":"PMC5758294","title":"Unusual brain images of a boy with adolescent cerebral X-linked adrenoleukodystrophy presenting with exhibitionism: A CARE-compliant case report","authors":"Zheng F, Lin Z, Ye X, Shi X.","first_author":"Zheng F","journal":"Medicine","year":2017,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.1097/md.0000000000009481","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report with MRI and genetic testing","sample_n":1,"sample_text":"1 patient","population":"11‑year‑old male with X‑linked adrenoleukodystrophy","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"An 11‑year‑old boy with a rare brain disorder showed exhibitionist behavior before rapid neurological decline. MRI showed unusual brain changes, and genetic testing confirmed X‑linked adrenoleukodystrophy. The authors suggest doctors consider this disorder when children present with atypical hypersexual behavior.","clinical_takeaway":"Rare neurological disease can manifest as hypersexual behavior; clinicians should evaluate for underlying brain pathology when such symptoms appear.","confidence":0.78,"topic_tags":["adolescents","csbd","neuroscience","gender"],"strengths":["Detailed clinical description","Use of MRI and genetic confirmation"],"limitations":["Single case, no control group","Neuroimaging findings linked to behavior without causal evidence","No assessment of psychosocial confounds"],"rubric_version":"2.0","raw_total":12,"max_possible":60,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":3,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/md.0000000000009481"}},{"id":7899,"doi":"10.1007/s10508-017-1111-5","pmid":"29159752","pmcid":null,"title":"Response to Commentaries: Recognizing Hypersexuality as a Psychosexual Behavioral Problem and Advancing the Sexhavior Cycle of Hypersexuality","authors":"Walton MT, Cantor JM, Bhullar N, Lykins AD.","first_author":"Walton MT","journal":"Archives of sexual behavior","year":2017,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[{"status":"Has correction","date":"2020-11-19","noticeDoi":"10.1007/s10508-020-01886-6","doi":"10.1007/s10508-017-1111-5"},{"status":"Has erratum","date":"2020-11-19","noticeDoi":"10.1007/s10508-020-01886-6","doi":"10.1007/s10508-017-1111-5"}],"url":"https://scite.ai/reports/10.1007/s10508-017-1111-5"}},{"id":7900,"doi":"10.1002/mdc3.12561","pmid":"30363420","pmcid":"PMC6174387","title":"The Role of Sex Therapy in the Management of Patients with Parkinson's Disease","authors":"Bronner G, Korczyn AD.","first_author":"Bronner G","journal":"Movement disorders clinical practice","year":2018,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual dysfunction","Parkinson's Disease","Sex Therapy","Hypersexuality","Sexual Preoccupation Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review based on clinical experience and literature overview; no primary data collection","sample_n":null,"sample_text":"Not applicable – narrative review","population":"patients with Parkinson's disease and their partners (no empirical sample)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review how Parkinson's disease can affect sexual life and propose that sex therapists help assess and treat sexual dysfunction and hypersexuality, offering communication tools and treatment ideas.","clinical_takeaway":"Clinicians should consider sexual health in Parkinson's patients and involve sex‑therapy expertise when problems arise.","confidence":0.6,"topic_tags":["sexual_function","neuroscience"],"strengths":["Highlights neglected sexual issues in Parkinson's disease","Provides practical clinical suggestions","Integrates therapist perspective"],"limitations":["Narrative, non-systematic review; no systematic search or bias assessment","No empirical data; conclusions based on author experience","Limited discussion of confounding factors (e.g., mood, medication) "],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":30,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mdc3.12561"}},{"id":7901,"doi":"10.1159/000475693","pmid":"29145185","pmcid":null,"title":"Hypersexuality in Neurological Disorders: From Disinhibition to Impulsivity","authors":"Béreau M.","first_author":"Béreau M.","journal":"Frontiers of neurology and neuroscience","year":2018,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of lesion and disorder literature, no primary data","sample_n":null,"sample_text":"Not applicable – review article","population":"humans with various neurological disorders (frontal lobe lesions, brain injury, epilepsy, dementia, Parkinson’s disease)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews how brain injuries and diseases such as frontal‑lobe lesions, epilepsy, dementia, and Parkinson’s disease can lead to increased sexual urges, emphasizing the brain networks that may be involved.","clinical_takeaway":"Clinicians should consider underlying neurological damage when patients present with sudden changes in sexual behavior.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["Broad overview of neurological conditions linked to hypersexuality","Integrates lesion and disorder findings"],"limitations":["No original data or systematic methodology","Lacks quantitative analysis or risk‑of‑bias assessment","Does not address key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000475693"}},{"id":7902,"doi":"10.1016/j.ajp.2017.10.030","pmid":"29132063","pmcid":null,"title":"Right thalamic bleed resulting in hypersexuality successfully treated with Selective Serotonin reuptake inhibitor Sertraline - A case report","authors":"Solanki MS, Singh P.","first_author":"Solanki MS","journal":"Asian journal of psychiatry","year":2017,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ajp.2017.10.030"}},{"id":7903,"doi":"10.1016/j.ajp.2017.10.008","pmid":"29107566","pmcid":null,"title":"Hypersexuality induced by Aripiprazole: Two case reports and review of the literature","authors":"Reddy B, Ali M, Guruprasad S, Das S.","first_author":"Reddy B","journal":"Asian journal of psychiatry","year":2018,"pub_types":["Letter","Review","Case 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an update. II: behavioral disorders","authors":"Trojano L, Papagno C.","first_author":"Trojano L","journal":"Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology","year":2018,"pub_types":["Review","Journal Article"],"keywords":["Depression","Emotional Disorders","Psychosis","Parkinson’s Disease","Behavioral Disorders","Apathy"],"is_oa":false,"oa_url":null,"cited_by_count":41,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of behavioral disorders in Parkinson’s disease, no primary data, no systematic methods reported","sample_n":null,"sample_text":"Not applicable – review article","population":"Patients with Parkinson’s disease (no specific sample size reported)","country":"Italy (journal based, authors Italian)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews a range of behavioral problems seen in Parkinson’s disease, from depression and anxiety to hypersexuality and gambling, summarising recent findings and suggesting tools for clinicians to monitor these issues over time.","clinical_takeaway":"Clinicians should routinely assess a wide spectrum of behavioral changes, including possible hypersexuality, in Parkinson’s patients.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","treatment","other"],"strengths":["Broad overview of many behavioral symptoms in PD","Includes recent literature (last 5 years)","Suggests assessment instruments for clinicians"],"limitations":["Narrative, not systematic – no risk‑of‑bias assessment","No primary data; cannot evaluate construct validity or statistics","Does not address key sexual‑behavior confounds (e.g., masturbation, moral incongruence)"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":0,"mentioning":29,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10072-017-3155-7"}},{"id":7905,"doi":"10.1007/s10508-017-1089-z","pmid":"28986708","pmcid":null,"title":"Hypersexuality: Equifinal, Cohesive, Clinical Presentation or Symptom Cluster with Multiple Underlying Mechanisms?","authors":"Knight RA, Graham FJ.","first_author":"Knight RA","journal":"Archives of sexual behavior","year":2017,"pub_types":["Comment","Journal 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influer sur le comportement ?: The pituitary and its treatments: how can they influence behaviour?","authors":"Mouly C, Borson-Chazot F, Caron P.","first_author":"Mouly C","journal":"Annales d'endocrinologie","year":2017,"pub_types":["Review","Journal Article"],"keywords":["Oxytocin","Dopamine agonists","Eating Behaviour","Impulse Control Disorders","Social Attachment","Agonistes Dopaminergiques","Ocytocine","Comportement Alimentaire","Attachement Social","Troubles Compulsifs"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article summarising clinical observations and small studies of pituitary hormone treatments and their behavioural side‑effects, without original empirical data.","sample_n":null,"sample_text":"Not applicable – review of existing literature.","population":"human patients treated with dopamine agonists for prolactinomas; also mentions oxytocin studies in small endocrine/nutritional cohorts.","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review discusses how pituitary hormones and drugs that affect them, especially dopamine agonists used for prolactinomas, can lead to impulse‑control problems like gambling, compulsive shopping, and hypersexuality, as well as how oxytocin may influence social attachment and eating.","clinical_takeaway":"Clinicians should monitor patients on dopamine agonists for hypersexual or other impulse‑control behaviours, but oxytocin is not yet ready for routine use.","confidence":0.3,"topic_tags":["sexual_function","neuroscience","treatment"],"strengths":["Broad overview of hormonal influences on behaviour","Highlights clinical relevance of hypersexuality as a side‑effect"],"limitations":["No original data; narrative review","Lacks systematic methodology or risk‑of‑bias assessment","No quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0003-4266(17)30924-1"}},{"id":7907,"doi":"10.1097/jcp.0000000000000762","pmid":"28796020","pmcid":null,"title":"Hypersexuality Possibly Associated With Safinamide","authors":"Jiménez-Jiménez FJ, Alonso-Navarro H, Valle-Arcos D.","first_author":"Jiménez-Jiménez FJ","journal":"Journal of clinical psychopharmacology","year":2017,"pub_types":["Letter","Case 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Behavior","authors":"Reid RC, Grant JE.","first_author":"Reid RC","journal":"Archives of sexual behavior","year":2017,"pub_types":["Comment","Journal 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DA.","first_author":"Kingston DA.","journal":"Archives of sexual behavior","year":2017,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-1059-5"}},{"id":7911,"doi":"10.1016/j.parkreldis.2017.07.030","pmid":"28818561","pmcid":null,"title":"The rise and fall of impulse control behavior disorders","authors":"Cossu G, Rinaldi R, Colosimo C.","first_author":"Cossu G","journal":"Parkinsonism & related disorders","year":2018,"pub_types":["Review","Journal Article"],"keywords":["Behavior","Dopamine agonists","Levodopa","Parkinson's Disease","Non-motor Symptoms"],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of literature on impulse control disorders, including hypersexuality, in Parkinson’s disease.","sample_n":null,"sample_text":"Not applicable – review of existing studies.","population":"Patients with Parkinson’s disease (PD) reported in the literature; no primary sample.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises how impulse‑control problems like hypersexuality can appear in people with Parkinson’s disease, especially in men and younger‑onset patients, and notes that treatment evidence is weak.","clinical_takeaway":"Clinicians should be aware that hypersexuality may arise as a side‑effect of Parkinson’s treatments, but current management guidance is limited.","confidence":0.6,"topic_tags":["sexual_function","neuroscience","csbd"],"strengths":["Broad synthesis of PD‑related ICD literature","Identifies risk factors such as gender and age","Highlights gaps in therapeutic evidence"],"limitations":["Narrative review without systematic methodology","No quantitative appraisal of study quality","Lacks primary data on hypersexuality measurement"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":3,"contrasting":0,"mentioning":40,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2017.07.030"}},{"id":7913,"doi":"10.1016/bs.irn.2017.05.019","pmid":"28805586","pmcid":null,"title":"Sexual Dysfunctions in Parkinson's Disease: An Underrated Problem in a Much Discussed Disorder","authors":"Bhattacharyya KB, Rosa-Grilo M.","first_author":"Bhattacharyya KB","journal":"International review of neurobiology","year":2017,"pub_types":["Review","Journal Article"],"keywords":["Sexual dysfunction","Parkinson's Disease","erectile dysfunction","Libido","Hypersexuality"],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not applicable – review of existing literature.","population":"People with Parkinson’s disease (PD) experiencing sexual dysfunctions; no new data collected.","country":"Not specified (likely international literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises how Parkinson’s disease often brings problems like reduced libido, erectile dysfunction, and sometimes hypersexuality, but these issues are frequently overlooked in clinical care.","clinical_takeaway":"Clinicians should routinely assess sexual health in Parkinson’s patients, as dysfunctions are common and may need multidisciplinary management.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Broad overview of sexual dysfunctions in PD.","Highlights under‑recognised non‑motor symptoms."],"limitations":["Narrative (non‑systematic) review; no explicit methodology.","No quantitative synthesis or bias assessment.","Does not address key confounds such as mental health or relationship factors."],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":3,"mentioning":45,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/bs.irn.2017.05.019"}},{"id":7914,"doi":"10.1016/j.ajp.2017.05.023","pmid":"29061419","pmcid":null,"title":"Aripiprazole induced hypersexuality, when we should be cautious?","authors":"Das S, Chatterjee SS, Bagewadi V.","first_author":"Das S","journal":"Asian journal of psychiatry","year":2017,"pub_types":["Letter","Case 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Frontotemporal Dementia in a Long-Term Care Setting","authors":"Jazi AN, Shebak SS, Kim KY.","first_author":"Jazi AN","journal":"The primary care companion for CNS disorders","year":2017,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/pcc.16l02031"}},{"id":7917,"doi":"10.4103/0253-7176.207319","pmid":"28615776","pmcid":"PMC5461852","title":"Sleeping Beauty Syndrome: A Case Report and Review of Female Cases Reported from India","authors":"Nebhinani N, Suthar N.","first_author":"Nebhinani N","journal":"Indian journal of psychological medicine","year":2017,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["India","lithium","Kleine–levin Syndrome","Sleeping Beauty Syndrome","Kleine–levin Syndrome In Female"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5461852","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single female case with 16‑year diagnostic delay; treatment response described; includes brief review of other Indian female KLS cases","sample_n":1,"sample_text":"One patient (case report) plus literature review of previously reported female cases (numbers not given)","population":"middle‑aged Indian female with Kleine‑Levin syndrome; additional female KLS case reports from India","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 45‑year‑old Indian woman with Kleine‑Levin syndrome—a rare condition causing long sleep episodes, overeating, cognitive issues and increased sexual drive—was finally diagnosed after 16 years. Her symptoms improved with lithium, sertraline and modafinil, and the authors briefly review other Indian female cases.","clinical_takeaway":"KLS can present with hypersexuality in women; lithium‑based regimens may help when other psychotropics fail.","confidence":0.4,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Detailed clinical description of a rare female KLS case","Provides treatment response data over 12 months"],"limitations":["Single case; no systematic data","No validated measures of hypersexuality or distress","No control of confounding variables"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0253-7176.207319"}},{"id":7918,"doi":"10.1186/s12889-017-4270-3","pmid":"28427370","pmcid":"PMC5397735","title":"Child sex tourism - prevalence of and risk factors for its use in a German community sample","authors":"Koops T, Turner D, Neutze J, Briken P.","first_author":"Koops T","journal":"BMC public health","year":2017,"pub_types":["Comparative Study","research-article","Journal Article"],"keywords":["Prevalence","risk factors","Child Sexual Abuse","Community Sample","Child Sex Tourism"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5397735","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online anonymous survey of 8,718 German men recruited via market‑research panel; groups defined by self‑reported prior child sex tourism (n=36) vs other child sexual abuse (n=96); t‑tests, chi‑square, logistic regression.","sample_n":8718,"sample_text":"Large community sample, but CST subgroup very small (n=36).","population":"Adult German men (community sample)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed over 8,700 German men online and found that about 0.4% reported traveling abroad for sexual contact with children. Compared with other child sexual abusers, these men were more likely to have a history of personal sexual abuse and prior violent convictions.","clinical_takeaway":"None – study focuses on prevalence of illegal child‑sex tourism, not on clinical sexual health or treatment.","confidence":0.7,"topic_tags":["prevalence","sexual_function"],"strengths":["Very large overall sample","First prevalence estimate of CST in Germany","Uses logistic regression to identify predictors"],"limitations":["Tiny CST subgroup limits statistical power","Self‑report of illegal behaviour, possible under‑reporting","No validated measures of CST or related constructs"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-017-4270-3"}},{"id":7921,"doi":"10.1055/s-0037-1601887","pmid":"28511259","pmcid":"PMC5516267","title":"Impulse Control Disorders and Related Complications of Parkinson's Disease Therapy","authors":"Lopez AM, Weintraub D, Claassen DO.","first_author":"Lopez AM","journal":"Seminars in neurology","year":2017,"pub_types":["research-article","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of impulse control disorders in Parkinson's disease, focusing on hypersexuality and related behaviors.","sample_n":null,"sample_text":"No primary sample; review of existing studies.","population":"Parkinson's disease patients receiving dopamine agonist therapy (as discussed in cited literature).","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how dopamine‑agonist drugs for Parkinson's disease can trigger impulse‑control problems like hypersexuality, tying these behaviors to brain reward pathways similar to gambling or substance use disorders.","clinical_takeaway":"Clinicians should monitor Parkinson's patients on dopamine agonists for emerging hypersexual or other impulsive behaviors and consider neuro‑behavioral mechanisms when managing them.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of ICDs in PD","Integrates neurobiological mechanisms"],"limitations":["Narrative, not systematic, review","No original data or meta‑analysis","Limited assessment of psychiatric confounds"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":32,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-0037-1601887"}},{"id":7923,"doi":"10.1080/00224499.2017.1295300","pmid":"28287844","pmcid":null,"title":"Intersectional Epistemologies of Ignorance: How Behavioral and Social Science Research Shapes What We Know, Think We Know, and Don't Know About U.S. Black Men's Sexualities","authors":"Bowleg L, Del Río-González AM, Holt SL, Pérez C, Massie JS, Mandell JE, A Boone C.","first_author":"Bowleg L","journal":"Journal of sex research","year":2017,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"critical narrative review without systematic methodology or risk‑of‑bias assessment","sample_n":null,"sample_text":"N/A – review of 668 published articles","population":"U.S. Black men, 18+ (studied via literature synthesis)","country":"United States (focus of reviewed studies)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review how past research has ignored racism, classism and heterosexism when studying Black men's sexuality, often portraying them as hypersexual. They highlight recent shifts toward more contextual, structural approaches and give ten recommendations to improve future work.","clinical_takeaway":"None – the paper is a scholarly review, not a clinical study.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Broad historical scope (pre‑1981 vs 2006‑2016)","Intersectional framework foregrounding racism, heterosexism, classism","Identifies gaps and offers concrete recommendations"],"limitations":["Not systematic; selection criteria unclear","No empirical data or quantitative synthesis","No risk‑of‑bias or quality appraisal of included studies"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":0,"mentioning":88,"citing_publications":118,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1295300"}},{"id":7924,"doi":"10.4102/sajpsychiatry.v23i0.982","pmid":"30263177","pmcid":"PMC6138062","title":"The use of cyproterone acetate in a forensic psychiatric cohort of male sex offenders and its associations with sexual activity and sexual functioning","authors":"Lippi G, van Staden PJ.","first_author":"Lippi G","journal":"The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa","year":2017,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://sajp.org.za/index.php/sajp/article/download/982/788","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional comparison of 76 male forensic patients (13 on CPA) using CSFQ-M-C","sample_n":76,"sample_text":"76 participants (13 on CPA, 63 not on CPA)","population":"male forensic psychiatric sex offenders, South Africa","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 76 forensic male sex offenders, those on the anti‑androgen drug cyproterone acetate reported lower sexual desire, activity frequency and pleasure than those not on the drug, but overall sexual dysfunction rates were high in both groups.","clinical_takeaway":"CPA may reduce sexual desire and pleasure, but its impact on overall sexual function is unclear; clinicians should weigh benefits against high baseline dysfunction.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Validated sexual functioning instrument (CSFQ-M-C)","Clear clinical focus on CPA effects","Acknowledges limitations and high psychotropic background"],"limitations":["Small CPA group (n=13) limits power","No control for key confounds (e.g., mental health, trauma, masturbation)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4102/sajpsychiatry.v23i0.982"}},{"id":7925,"doi":"10.1016/j.parkreldis.2006.01.010","pmid":"16730214","pmcid":null,"title":"Hypersexuality and paraphilia induced by selegiline in Parkinson's disease: report of 2 cases","authors":"Shapiro MA, Chang YL, Munson SK, Okun MS, Fernandez HH.","first_author":"Shapiro MA","journal":"Parkinsonism & related disorders","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case report of two Parkinson’s disease patients who developed hypersexuality and paraphilic behavior after starting selegiline.","sample_n":2,"sample_text":"two cases","population":"Adults with early‑onset Parkinson’s disease (n=2)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe two Parkinson’s patients who began showing intense sexual urges and unusual sexual interests after starting the medication selegiline, suggesting the drug can trigger such behaviors in vulnerable individuals.","clinical_takeaway":"Clinicians should monitor for hypersexuality or paraphilic behavior when prescribing selegiline to Parkinson’s patients.","confidence":0.85,"topic_tags":["sexual_function","csbd"],"strengths":["Highlights a rarely reported side‑effect of selegiline","Provides clinical details useful for clinicians"],"limitations":["Very small N (2 cases)","No systematic measurement or controls","No statistical analysis"],"rubric_version":"2.0","raw_total":3,"max_possible":50,"pct_score":6,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2006.01.010"}},{"id":7926,"doi":"10.1177/1079063217691965","pmid":"28183223","pmcid":null,"title":"Three Central Dimensions of Sexual Recidivism Risk: Understanding the Latent Constructs of Static-99R and Static-2002R","authors":"Brouillette-Alarie S, Proulx J, Hanson RK.","first_author":"Brouillette-Alarie S","journal":"Sexual abuse : a journal of research and treatment","year":2018,"pub_types":["Journal Article"],"keywords":["risk assessment","Construct Validity","Sexual Offenders","Static-99r","Psychological Characteristics","Static-2002r"],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Retrospective cohort/longitudinal analysis of sexual offender risk tools (Static‑99R, Static‑2002R) using latent variable models to examine convergent and predictive validity for sexual and non‑sexual recidivism.","sample_n":null,"sample_text":"Not reported in abstract","population":"Adult male sexual offenders (sample size not stated in abstract)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study re‑examines two popular sexual‑offender risk tools, finding three underlying factors—sexual criminality, general criminality, and youthful stranger aggression—that each predict re‑offending, with different links to non‑sexual crimes.","clinical_takeaway":"Risk assessments for sexual offenders may benefit from focusing on specific sub‑dimensions rather than a single total score.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses established actuarial risk tools","Applies latent variable modeling to uncover dimensions","Tests predictive validity for recidivism outcomes"],"limitations":["Unclear whether psychological constructs measured with validated scales","No explicit control for common confounds (e.g., mental health, trauma)","Sample size and demographic details not provided in abstract"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":2,"mentioning":55,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063217691965"}},{"id":7927,"doi":"10.1007/s12020-017-1247-z","pmid":"28160129","pmcid":null,"title":"Hypersexuality in men with prolactinomas treated with dopamine agonists","authors":"Bancos I, Nippoldt TB, Erickson D.","first_author":"Bancos I","journal":"Endocrine","year":2017,"pub_types":["Comment","Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12020-017-1247-z"}},{"id":7928,"doi":"10.1177/0306624x17694374","pmid":"29237318","pmcid":null,"title":"Sexual Aggressors Against Women's Sexual Lives: A Latent Class Analysis","authors":"Langevin S, Proulx J, Lacourse E.","first_author":"Langevin S","journal":"International journal of offender therapy and comparative criminology","year":2018,"pub_types":["Journal Article"],"keywords":["Sexual Lifestyle","Deviant Sexuality","Nondeviant Sexuality","Sexual Aggressors Against Women"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Latent class analysis of 160 Canadian sexual aggressors; cross‑sectional survey data.","sample_n":160,"sample_text":"N = 160 (ID n=31, LSP n=116, HD n=13)","population":"Male sexual offenders against women (N=160) recruited from correctional/clinical sources in Canada.","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 160 men convicted of sexual offenses and grouped them into three patterns of sexual behaviour: internalized deviant, low‑problem, and hypersexual deviant. The hypersexual group showed higher sexual deviance and may influence how they commit crimes.","clinical_takeaway":"Offender treatment may need to address diverse sexual behaviour patterns, especially hypersexuality, but findings are exploratory.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large overall sample for offender research","Use of latent class analysis to identify heterogeneous subgroups","Considers developmental continuity from adolescence"],"limitations":["Cross‑sectional, cannot infer causality","Small size of hypersexual class (n=13) limits reliability","Unclear measurement validity of sexual behaviour items","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":2,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x17694374"}},{"id":7929,"doi":null,"pmid":"1470276","pmcid":null,"title":"[Expanding the addiction concept exemplified by sexual disorders. Critical comments on the contribution by K. Roth. Sexual addiction in alcohol misuse and dependence]","authors":"Spengler A.","first_author":"Spengler A.","journal":"Der Nervenarzt","year":1992,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":7930,"doi":"10.1590/s0004-282x2006000100032","pmid":"16622574","pmcid":null,"title":"Hypersexuality following bilateral thalamic infarction: case report","authors":"Mutarelli EG, Omuro AM, Adoni T.","first_author":"Mutarelli EG","journal":"Arquivos de neuro-psiquiatria","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":"https://www.scielo.br/j/anp/a/B9rfX5JjQBWFDYBZzwqXJwh/?lang=en&format=pdf","cited_by_count":25,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case of a 63‑year‑old man with bilateral thalamic infarction presenting hypersexuality, SPECT imaging showing frontal hypoperfusion","sample_n":1,"sample_text":"1 patient","population":"adult male, post‑stroke","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 63‑year‑old man developed excessive sexual urges, disinhibition, memory loss, and sleep problems after a rare type of brain stroke affecting both thalami. Brain scans showed reduced blood flow in frontal areas, suggesting that thalamic damage can disrupt circuits that regulate sexual behavior.","clinical_takeaway":"Brain injury in thalamic regions may trigger hypersexuality; clinicians should assess sexual changes after strokes.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","csbd"],"strengths":["Detailed clinical description","Neuroimaging (SPECT) adds biological context"],"limitations":["Single case, no generalizability","No validated measures of sexual behavior","No control for psychological or relational confounds"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":32,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s0004-282x2006000100032"}},{"id":7931,"doi":"10.1016/j.yebeh.2006.01.005","pmid":"16473556","pmcid":null,"title":"Hypersexuality in two patients with epilepsy treated with lamotrigine","authors":"Grabowska-Grzyb A, Nagańska E, Wolańczyk T.","first_author":"Grabowska-Grzyb A","journal":"Epilepsy & behavior : E&B","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":2,"sample_text":"Two male patients","population":"two adult male patients with epilepsy treated with lamotrigine","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"Two men with epilepsy started lamotrigine and soon showed unusually high sexual drive. Cutting the drug stopped the behavior in one case, and lowering the dose helped in the other. The authors suggest lamotrigine might directly trigger hypersexuality, but the mechanism is unknown.","clinical_takeaway":"Lamotrigine may provoke excessive sexual urges in some patients; monitor and adjust dosage if this occurs.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Detailed clinical description of rare adverse effect","Clear temporal relation between lamotrigine dose changes and symptoms"],"limitations":["N=2, no control group","No systematic assessment of sexual behavior or distress","Potential confounding from concomitant antiepileptic drugs"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.yebeh.2006.01.005"}},{"id":7932,"doi":"10.1016/j.jns.2017.01.019","pmid":"28126343","pmcid":null,"title":"Management of impulse control disorders with deep brain stimulation: A double-edged sword","authors":"Kasemsuk C, Oyama G, Hattori N.","first_author":"Kasemsuk C","journal":"Journal of the neurological sciences","year":2017,"pub_types":["Review","Journal Article"],"keywords":["Parkinson's Disease","Deep brain stimulation","Impulse Control Disorders"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Review article without primary data; no empirical sample, no pre‑registration, no statistical analysis.","sample_n":null,"sample_text":"N/A – review of existing literature.","population":"Patients with Parkinson’s disease undergoing deep brain stimulation (DBS).","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The review discusses how deep‑brain stimulation, used for Parkinson’s disease, can both improve and worsen impulse‑control problems like gambling, binge eating, and hypersexuality, and offers suggestions for managing these side effects.","clinical_takeaway":"Clinicians should monitor for new or worsening impulse‑control symptoms, including hypersexuality, after DBS and adjust treatment accordingly.","confidence":0.7,"topic_tags":["csbd","sexual_function","neuroscience","pornography"],"strengths":["Comprehensive overview of DBS effects on impulse control disorders","Identifies both potential benefits and risks"],"limitations":["No original data; conclusions rely on heterogeneous primary studies","Lacks systematic risk‑of‑bias assessment of included reports"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jns.2017.01.019"}},{"id":7933,"doi":"10.1038/npp.2017.1","pmid":"28051103","pmcid":"PMC5561340","title":"Maladaptive Sexual Behavior Following Concurrent Methamphetamine and Sexual Experience in Male Rats is Associated with Altered Neural Activity in Frontal Cortex","authors":"Kuiper LB, Frohmader KS, Coolen LM.","first_author":"Kuiper LB","journal":"Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology","year":2017,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Experimental animal study with control groups comparing methamphetamine + mating vs saline + mating; conditioned sex aversion paradigm used to assess inhibition of sexual behavior.","sample_n":null,"sample_text":"Not specified in abstract; groups received four daily sessions of meth or saline plus mating.","population":"Male Sprague‑Dawley rats","country":"Not provided","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In male rats, giving methamphetamine together with mating made it harder for them to stop sexual activity later, and this was linked to altered activity markers in frontal brain regions.","clinical_takeaway":"None – animal findings do not directly guide clinical practice.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","csbd"],"strengths":["Controlled laboratory design with clear experimental manipulation","Use of a validated animal behavioural paradigm (CSA)","Molecular measurement of neural activity (pERK) with cell‑type specificity"],"limitations":["Findings in rats may not translate to human sexual behavior or addiction","Sample size and statistical power not reported in abstract","No behavioral measures of ‘addiction‑like’ constructs; focus is on inhibition only"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":9,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":16,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/npp.2017.1"}},{"id":7935,"doi":"10.1007/978-981-10-5562-1_7","pmid":"29098671","pmcid":null,"title":"Similarities and Differences in Diagnostic Criterion","authors":"Wei Z, Zhang X.","first_author":"Wei Z","journal":"Advances in experimental medicine and biology","year":2017,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Diagnostic criteria","Substance Addiction","Non-substance Addiction"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review chapter discussing diagnostic criteria for substance and non‑substance addictions, no original data.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The chapter compares how DSM‑5 defines substance addictions with criteria used for non‑substance problems like gambling, internet, food, and hypersexuality, noting many similarities but a lack of validation for the newer criteria.","clinical_takeaway":"Current diagnostic tools for non‑substance addictions are largely unvalidated; clinicians should use caution when applying them.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad overview of diagnostic criteria across domains","Highlights gaps in validation of non‑substance addiction measures"],"limitations":["No original empirical data","Lacks systematic review methodology","No quantitative evaluation of criteria"],"rubric_version":"2.0","raw_total":15,"max_possible":60,"pct_score":25,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":2,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/978-981-10-5562-1_7"}},{"id":7937,"doi":null,"pmid":"30566303","pmcid":null,"title":"Neuropsychiatric symptoms in patients with Parkinson's disease","authors":"Kashihara K.","first_author":"Kashihara K.","journal":"Nihon rinsho. Japanese journal of clinical medicine","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Journal review/article summarizing neuropsychiatric symptoms in Parkinson’s disease; no original data reported.","sample_n":null,"sample_text":"Not applicable – no primary data collection.","population":"Patients with Parkinson’s disease (PD)","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews neuropsychiatric symptoms that can appear in Parkinson’s disease, such as depression, anxiety, hallucinations, and hypersexuality, and discusses factors that may trigger them.","clinical_takeaway":"Clinicians should monitor for hypersexuality and other psychiatric symptoms in PD patients, as they can affect quality of life.","confidence":0.4,"topic_tags":["neuroscience"],"strengths":["Broad overview of neuropsychiatric manifestations in PD","Highlights clinical relevance of hypersexuality within PD"],"limitations":["No original empirical data","No systematic review methods described","No quantitative synthesis or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":7938,"doi":"10.4103/2249-4863.214963","pmid":"29026774","pmcid":"PMC5629886","title":"Atypical Kleine-Levin syndrome: An elusive entity?","authors":"Singh S, Kumar S, Verma R, Kumar N.","first_author":"Singh S","journal":"Journal of family medicine and primary care","year":2017,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["India","Atypical","Psychosis","Kleine–levin Syndrome","International Classification Of Sleep Disorders"],"is_oa":true,"oa_url":"https://doi.org/10.4103/2249-4863.214963","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case description of atypical Kleine‑Levin syndrome with hypersexuality, previously misdiagnosed as psychosis","sample_n":1,"sample_text":"N=1 (case report)","population":"one adult patient (India)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors report a rare case of atypical Kleine‑Levin syndrome that presented with opposite symptoms, including hypersexuality, and was initially misdiagnosed as psychosis. They discuss features that can help clinicians recognize this uncommon presentation.","clinical_takeaway":"Be aware that Kleine‑Levin syndrome can present atypically with hypersexuality, which may mimic psychiatric disorders.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","csbd"],"strengths":["Highlights diagnostic challenge of atypical KLS","Provides clinical detail for rare presentation"],"limitations":["Single case; no systematic data","No validated measures of hypersexuality","No control for confounding factors"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/2249-4863.214963"}},{"id":7939,"doi":"10.4088/pcc.16l01983","pmid":"28033456","pmcid":null,"title":"Aripiprazole-Induced Hypersexuality","authors":"Bulbena-Cabré A, Bulbena A.","first_author":"Bulbena-Cabré A","journal":"The primary care companion for CNS disorders","year":2016,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/pcc.16l01983"}},{"id":7942,"doi":"10.1111/j.1399-5618.2005.00259.x","pmid":"16403186","pmcid":null,"title":"Are the arginine vasopressin V1a receptor microsatellites related to hypersexuality in children with a prepubertal and early adolescent bipolar disorder phenotype?","authors":"Geller B, Tillman R, Badner JA, Cook EH.","first_author":"Geller B","journal":"Bipolar disorders","year":2005,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control genetic association with family-based transmission disequilibrium test; 83 probands, 30 informative families","sample_n":83,"sample_text":"83 probands; 32 complete trios for GATA repeat, 34 for complex repeat","population":"children and early adolescents with prepubertal/early adolescent bipolar phenotype","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study looked at whether specific DNA repeats in the vasopressin receptor gene are passed more often to children with bipolar disorder who show hypersexual behavior. No genetic link was found, but the sample was small and hypersexuality was only measured with a single interview question.","clinical_takeaway":"No evidence that AVPR1A microsatellites predict hypersexuality in bipolar youth; genetic testing not indicated.","confidence":0.7,"topic_tags":["gender"],"strengths":["Family-based transmission analysis","Clear genetic methodology"],"limitations":["Small sample size for genetic association","Hypersexuality measured with single interview item","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1399-5618.2005.00259.x"}},{"id":7943,"doi":null,"pmid":"16400746","pmcid":null,"title":"Hypersexuality due to dopaminergic drugs","authors":null,"first_author":null,"journal":"Prescrire international","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Journal commentary summarizing case observations of hypersexuality linked to dopamine agonist treatment in Parkinson’s disease; no original data collected.","sample_n":null,"sample_text":"Not applicable – no empirical sample","population":"Patients with Parkinson’s disease receiving dopaminergic therapy (no sample size reported)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article notes that dopamine agonist medicines used for Parkinson’s disease can sometimes cause increased sexual activity, which tends to lessen when the dose is lowered or the drug stopped.","clinical_takeaway":"Clinicians should monitor patients on dopaminergic drugs for hypersexuality and consider dose adjustment if it emerges.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","treatment"],"strengths":["Clear description of a clinically observed side‑effect","Links hypersexuality to dosage changes"],"limitations":["No original data or systematic review methodology","No measurement of sexual behaviour, distress, or addiction criteria","No control for confounding factors"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":7944,"doi":"10.1016/j.addbeh.2016.11.015","pmid":"27902944","pmcid":null,"title":"Psychiatric disorders, suicidal ideation, and sexually transmitted infections among post-deployment veterans who utilize digital social media for sexual partner seeking","authors":"Turban JL, Potenza MN, Hoff RA, Martino S, Kraus SW.","first_author":"Turban JL","journal":"Addictive behaviors","year":2017,"pub_types":["Journal Article"],"keywords":["Psychiatric disorders","Sexual Partners","Veterans","Risky Sexual Behavior","Digital Social Media"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional analysis of baseline telephone interview and follow‑up internet survey (N=283 US post‑deployment veterans) examining self‑reported use of digital social media to find sexual partners and associations with psychiatric outcomes.","sample_n":283,"sample_text":"National sample of 283 US combat veterans.","population":"US combat veterans (post‑deployment), mixed gender, recruited nationally via telephone then internet survey.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among US military veterans, about one‑third of men and 9% of women used social media to meet sexual partners. Those who did were more likely to have PTSD, depression, insomnia, hypersexuality, suicidal thoughts, and STIs, suggesting a need for screening in this group.","clinical_takeaway":"Veterans who seek partners via digital media should be screened for PTSD, depression, hypersexuality, and STI risk.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, national veteran sample","Adjusted logistic models for multiple psychiatric outcomes","Highlights under‑studied link between digital partner seeking and mental health"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on single‑item self‑report for digital media use","No validated hypersexuality scale reported","Key confounds (moral incongruence, masturbation, trauma) not measured"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":18,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2016.11.015"}},{"id":7946,"doi":"10.1080/00926230591006782","pmid":"16169826","pmcid":null,"title":"A hypersexual paraphilic patient treated with leuprolide acetate: a single case report","authors":"Saleh F.","first_author":"Saleh F.","journal":"Journal of sex & marital therapy","year":2005,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case report of a hypersexual/paraphilic male treated with leuprolide; includes penile plethysmograph and hormonal data","sample_n":1,"sample_text":"single patient","population":"young adult male with hypersexuality and exhibitionism, no comorbid psychiatric or medical pathology","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A single man with excessive sexual urges and exhibitionist behavior was given leuprolide, a hormone‑blocking drug. His sexual drive and urge to expose himself dropped, as shown by physiological tests.","clinical_takeaway":"Leuprolide may reduce sexual drive in hypersexual patients, but evidence is limited to one case.","confidence":0.7,"topic_tags":["sexual_function","treatment","csbd"],"strengths":["objective physiological measures (plethysmograph, hormones)","clear description of pharmacological intervention"],"limitations":["single case, no control group","no validated measure of hypersexuality","no assessment of confounding factors (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230591006782"}},{"id":7947,"doi":"10.4172/2155-6105.1000299","pmid":"29214098","pmcid":"PMC5713482","title":"Safety and Quality Concerns Regarding Over-the-Counter Sexual Enhancement Products Sold in the USA Market Pose a Major Health Risk","authors":"Ahmed M, Kumari S, Manali P, Sonje S, Malik M.","first_author":"Ahmed M","journal":"Journal of addiction research & therapy","year":2016,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Safety","Behavior","Sexual","Patient"],"is_oa":true,"oa_url":"https://www.omicsonline.org/open-access/safety-and-quality-concerns-regarding-overthecounter-sexual-enhancementproducts-sold-in-the-usa-market-pose-a-major-health-risk-2155-6105-1000299.pdf","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single individual with bipolar disorder and hypersexual behavior who experienced adverse effects from OTC sexual enhancement products.","sample_n":1,"sample_text":"single case report","population":"one adult patient with bipolar disorder and hypersexual behavior","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A patient with bipolar disorder and excessive sexual behavior took an over‑the‑counter erectile‑dysfunction product that was later found to contain hidden or excessive drug ingredients, leading to serious health complications.","clinical_takeaway":"Clinicians should warn patients, especially those with psychiatric vulnerability, about unregulated sexual enhancement supplements.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Highlights real safety risks of adulterated OTC sexual enhancement products","Links psychiatric vulnerability (bipolar disorder, hypersexuality) to adverse outcomes"],"limitations":["Single case; no generalizable data","No systematic measurement of product contents or health outcomes","No control group or comparison"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4172/2155-6105.1000299"}},{"id":7948,"doi":"10.1007/s00415-016-8314-x","pmid":"27761641","pmcid":null,"title":"Impulse control behaviors and subthalamic deep brain stimulation in Parkinson disease","authors":"Merola A, Romagnolo A, Rizzi L, Rizzone MG, Zibetti M, Lanotte M, Mandybur G, Duker AP, Espay AJ, Lopiano L.","first_author":"Merola A","journal":"Journal of neurology","year":2017,"pub_types":["Journal Article"],"keywords":["Personality","Electrical stimulation","Neurosurgery","Parkinson’s Disease","Impulse Control Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":55,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort of 150 Parkinson's patients followed ~4 years post‑STN‑DBS","sample_n":150,"sample_text":"150 consecutive PD STN‑DBS‑treated patients","population":"PD patients undergoing subthalamic deep brain stimulation","country":"unspecified (likely Italy)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson patients treated with deep‑brain stimulation, overall impulse‑control problems (including hypersexuality) tended to decline over four years, but new cases still appeared, especially in younger patients and women.","clinical_takeaway":"STN‑DBS may reduce but does not eliminate hypersexuality risk; monitor younger and female patients closely.","confidence":0.78,"topic_tags":["sexual_function","neuroscience"],"strengths":["large clinical cohort with long follow‑up","focus on multiple impulse control domains","detailed subgroup analysis (persistent, remitting, new‑onset)"],"limitations":["no validated sexual‑addiction instruments reported","confounding psychosocial variables (e.g., moral incongruence) not measured","effect sizes and confidence intervals not provided"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":62,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00415-016-8314-x"}},{"id":7949,"doi":"10.1097/01.mjt.0000151861.59698.26","pmid":"16148432","pmcid":null,"title":"Effects of donepezil on compulsive hypersexual behavior in Parkinson disease: a single case study","authors":"Ivanco LS, Bohnen NI.","first_author":"Ivanco LS","journal":"American journal of therapeutics","year":2005,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report of donepezil trial for compulsive hypersexual behavior in Parkinson's disease","sample_n":1,"sample_text":"single case","population":"one male middle‑aged patient with Parkinson disease and compulsive hypersexuality","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A man with Parkinson's disease who showed compulsive hypersexual behavior improved after being given the medication donepezil, while a reduction in his usual dopamine drugs helped little and worsened his motor symptoms.","clinical_takeaway":"Evidence is limited to one case; clinicians should not assume donepezil will treat hypersexuality in Parkinson's disease.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Detailed clinical description","Explores novel pharmacological intervention"],"limitations":["Single case, no control","No validated outcome measures","Cannot infer causality"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.mjt.0000151861.59698.26"}},{"id":7950,"doi":"10.1016/j.parkreldis.2005.06.005","pmid":"16109498","pmcid":null,"title":"Pathological hypersexuality predominantly linked to adjuvant dopamine agonist therapy in Parkinson's disease and multiple system atrophy","authors":"Klos KJ, Bower JH, Josephs KA, Matsumoto JY, Ahlskog JE.","first_author":"Klos KJ","journal":"Parkinsonism & related disorders","year":2005,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":180,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of 15 Parkinson's disease/multiple system atrophy patients with hypersexuality after dopamine agonist therapy","sample_n":15,"sample_text":"15 patients (13 PD, 2 MSA) reported pathological hypersexuality","population":"male adults with PD or MSA experiencing hypersexuality","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"supports","citation_value":"useful","plain_summary":"In 15 patients with Parkinson's disease or multiple system atrophy, hypersexual behavior started soon after beginning dopamine‑agonist drugs and stopped when the drugs were withdrawn, suggesting the medication may trigger such behavior.","clinical_takeaway":"Clinicians should monitor for sudden hypersexuality after starting dopamine agonists and consider adjusting medication if it occurs.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","gender","treatment","adolescents"],"strengths":["Clear temporal link between dopamine agonist start and hypersexuality onset","Systematic literature review to contextualize findings"],"limitations":["Small, uncontrolled case series","No validated measures of hypersexuality or addiction criteria","No assessment of confounding factors (e.g., mood, relationship status, moral attitudes)"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":6,"contrasting":0,"mentioning":185,"citing_publications":284,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2005.06.005"}},{"id":7952,"doi":"10.1016/j.jsxm.2016.07.007","pmid":"27555504","pmcid":null,"title":"Editorial Commentary on Miner and Colleagues' Study: Understanding the Personality and Behavioral Mechanisms Defining Hypersexuality in Men Who Have Sex With Men","authors":"Carvalho J.","first_author":"Carvalho J.","journal":"The journal of sexual medicine","year":2016,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2016.07.007"}},{"id":7953,"doi":"10.1016/j.ejpn.2016.08.006","pmid":"27562098","pmcid":null,"title":"Long-term safety and effectiveness of pramipexole in tetrahydrobiopterin deficiency","authors":"Porta F, Ponzone A, Spada M.","first_author":"Porta F","journal":"European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society","year":2016,"pub_types":["Journal Article"],"keywords":["Dopamine agonists","Impulse Control Disorders","Pramipexole","Bh(4) Deficiency"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Long‑term follow‑up case series of 7 patients with BH4 deficiency treated with pramipexole; no control group.","sample_n":7,"sample_text":"Seven patients followed for 83 ± 24 months; low‑dose subgroup N≈7","population":"Patients (children/adolescents/young adults) with PTPS or DHPR deficiency; N=7","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In seven patients with a rare metabolic disorder, low‑dose pramipexole was safe and helpful over several years, but higher doses led to impulse‑control problems, including hypersexuality, which improved after dose reduction.","clinical_takeaway":"Low‑dose pramipexole appears safe for BH4 deficiency; monitor for impulse‑control issues at higher doses.","confidence":0.78,"topic_tags":["prevalence","treatment","adolescents"],"strengths":["Long‑term follow‑up (average >6 years)","Real‑world clinical observations of adverse effects"],"limitations":["Very small sample (N=7)","No validated measures of hypersexuality","No control/comparator group","No statistical testing"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ejpn.2016.08.006"}},{"id":7954,"doi":"10.1097/jcp.0000000000000514","pmid":"27219091","pmcid":null,"title":"Venlafaxine-Associated Euprolactinemic Galactorrhea and Hypersexuality: A Case Report and Review of the Literature","authors":"Warren MB.","first_author":"Warren MB.","journal":"Journal of clinical psychopharmacology","year":2016,"pub_types":["Letter","Review","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/jcp.0000000000000514"}},{"id":7955,"doi":"10.4088/jcp.14r09497","pmid":"27380585","pmcid":null,"title":"Mesiotemporal Disconnection and Hypoactivity in Klüver-Bucy Syndrome: Case Series and Literature Review","authors":"Caro MA, Jimenez XF.","first_author":"Caro MA","journal":"The Journal of clinical psychiatry","year":2016,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case series of two patients with Klüver‑Bucy syndrome and a literature review of 109 articles.","sample_n":2,"sample_text":"Two patients; literature review includes 109 articles (51 relevant).","population":"2 adult patients with partial Klüver‑Bucy syndrome; literature sources covering various cases.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe two patients with Klüver‑Bucy syndrome, a rare condition causing hypersexuality and other behaviours, and review past reports, suggesting that damage to mesiotemporal brain areas can produce the syndrome.","clinical_takeaway":"Hypersexuality may arise from mesiotemporal brain injury; treatment is symptom‑focused.","confidence":0.6,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed clinical description of rare syndrome.","Combines original cases with extensive literature review."],"limitations":["Very small primary sample (n=2).","No systematic methodology reported for literature search.","No quantitative analysis; findings are descriptive."],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/jcp.14r09497"}},{"id":7956,"doi":"10.1007/s10072-016-2668-9","pmid":"27401808","pmcid":null,"title":"Hypersexuality induced by rasagiline in monotherapy in Parkinson's disease","authors":"Simonet C, Fernández B, Cerdán DM, Duarte J.","first_author":"Simonet C","journal":"Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology","year":2016,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10072-016-2668-9"}},{"id":7957,"doi":"10.5535/arm.2016.40.3.540","pmid":"27446793","pmcid":"PMC4951375","title":"Bilateral Anterior Opercular Syndrome With Partial Kluver-Bucy Syndrome in a Stroke Patient: A Case Report","authors":"Cho AR, Lim YH, Chung SH, Choi EH, Lim JY.","first_author":"Cho AR","journal":"Annals of rehabilitation medicine","year":2016,"pub_types":["Journal Article","case-report"],"keywords":["Stroke","Kluver–bucy Syndrome","Bilateral Anterior Opercular Syndrome"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4951375","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single adult stroke patient case report describing bilateral anterior opercular syndrome with partial Kluver‑Bucy features, including hypersexuality","sample_n":1,"sample_text":"single case","population":"n=1 adult stroke survivor (44 y, female)","country":"South Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 44‑year‑old woman who had strokes affecting both sides of her brain showed rare neurological signs and also displayed increased sexual behaviour and memory problems. This report describes the combination of two syndromes that have rarely been seen together.","clinical_takeaway":"Hypersexuality can arise from specific brain lesions; clinicians should assess sexual changes after bilateral opercular strokes.","confidence":0.85,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed neurological description","Clear imaging confirmation of lesions"],"limitations":["Single case limits generalisability","No systematic assessment of sexual behaviour or psychopathology","No control group or statistical analysis"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5535/arm.2016.40.3.540"}},{"id":7959,"doi":"10.1097/med.0000000000000257","pmid":"27032060","pmcid":null,"title":"The efficacy, safety and ethics of the use of testosterone-suppressing agents in the management of sex offending","authors":"Khan O, Mashru A.","first_author":"Khan O","journal":"Current opinion in endocrinology, diabetes, and obesity","year":2016,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of medical literature on testosterone-suppressing agents for managing sex offending; no primary data collection.","sample_n":null,"sample_text":"Not applicable – review article","population":"Male sex offenders (as discussed in cited literature)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review discusses using testosterone‑reducing drugs to lower the risk of re‑offending in men who have committed sexual offenses, outlining clinical and ethical considerations.","clinical_takeaway":"Medication may be considered for managing hypersexuality in sex offenders, but evidence is limited and must be weighed against ethical concerns.","confidence":0.3,"topic_tags":["sexual_function","treatment"],"strengths":["Provides clinical ethics framework","Summarizes existing systematic reviews"],"limitations":["Narrative, not systematic, review","No new empirical data","Limited methodological appraisal of cited studies"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/med.0000000000000257"}},{"id":7960,"doi":"10.3389/fpsyt.2016.00091","pmid":"27303314","pmcid":"PMC4884740","title":"Trait Impulsivity and Anhedonia: Two Gateways for the Development of Impulse Control Disorders in Parkinson's Disease?","authors":"Houeto JL, Magnard R, Dalley JW, Belin D, Carnicella S.","first_author":"Houeto JL","journal":"Frontiers in psychiatry","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Anxiety","Impulsivity","Parkinson’s Disease","Impulse Control Disorders","D2/3 Dopamine Receptors","Apathy","Dopaminergic Nigrostriatal System"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyt.2016.00091/pdf","cited_by_count":28,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary, no empirical data reported","sample_n":null,"sample_text":"none (the article is a hypothesis/position piece, no participants described)","population":"Parkinson's disease patients (discussed conceptually)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose that impulsivity and lack of pleasure may be separate pathways leading to impulse control disorders, such as hypersexuality, in people with Parkinson's disease, and suggest overlapping brain mechanisms.","clinical_takeaway":"Clinicians should consider both impulsivity and hedonic deficits when assessing ICD risk in Parkinson's patients.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function","lgbtq","gender"],"strengths":["Integrates PD literature on impulse control disorders","Provides a clear heuristic framework"],"limitations":["No original empirical data","Speculative linking of neural mechanisms","Lacks measurement of key constructs"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":39,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2016.00091"}},{"id":7962,"doi":"10.12968/bjon.2004.13.22.17271","pmid":"15687899","pmcid":null,"title":"Hypersexuality and dementia: dealing with inappropriate sexual expression","authors":"Higgins A, Barker P, Begley CM.","first_author":"Higgins A","journal":"British journal of nursing (Mark Allen Publishing)","year":2004,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review, narrative overview of literature on hypersexuality in dementia, no primary data.","sample_n":null,"sample_text":"Not applicable – narrative review, no primary sample.","population":"Older adults with dementia in residential care (as described in cited literature).","country":"United Kingdom (based on journal, not specified).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how dementia can sometimes lead to inappropriate sexual behaviour, offering nurses advice on how to respond respectfully while safeguarding patients' rights and dignity.","clinical_takeaway":"Nurses should use the suggested principles to manage rare hypersexual incidents in dementia care, balancing safety with respect for autonomy.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides practical guidance for nursing staff.","Synthesises existing literature on a niche topic."],"limitations":["No systematic review methodology reported.","Lacks empirical data; relies on secondary sources.","Does not address key confounds (e.g., mental health, moral factors)."],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":56,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12968/bjon.2004.13.22.17271"}},{"id":7963,"doi":"10.1007/s10508-016-0746-y","pmid":"27184566","pmcid":null,"title":"Risk Factors for Sexual Offending in Men Working With Children: A Community-Based Survey","authors":"Turner D, Hoyer J, Schmidt AF, Klein V, Briken P.","first_author":"Turner D","journal":"Archives of sexual behavior","year":2016,"pub_types":["Journal Article"],"keywords":["Child Sexual Abuse","Hypersexuality","Antisocial Behaviors","Pedophilic Behaviors","Pedophilic Sexual Interests"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online anonymous survey of 8649 German men; 3 groups compared (abusers working with children, abusers not working with children, non‑abusers working with children).","sample_n":8649,"sample_text":"N = 8649 (37 child sexual abusers working with children, 90 child sexual abusers not working with children, 816 men working with children who have not abused a child).","population":"Adult men from the German community, self‑selected via internet survey.","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"A large German internet survey compared men who work with children and have offended, men who offend but don’t work with children, and men who work with children and have not offended. Working with children was linked to a slightly higher chance of self‑reported abuse, and offenders showed more antisocial and deviant sexual behaviours.","clinical_takeaway":"Screening for antisocial and deviant sexual traits may aid risk assessment, but evidence is limited.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large overall sample size","Community‑based recruitment","Addresses an under‑studied risk factor (working with children)"],"limitations":["Very small numbers in key offender groups","Reliance on self‑report, likely unvalidated hypersexuality items","No control for moral, mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0746-y"}},{"id":7965,"doi":"10.1007/s10508-016-0727-1","pmid":"26969320","pmcid":null,"title":"Sexual Arousal and Sexual Activity Frequency: Implications for Understanding Hypersexuality","authors":"Walton MT, Lykins AD, Bhullar N.","first_author":"Walton MT","journal":"Archives of sexual 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Hypersexuality Associated With Rotigotine in an Elderly Parkinsonian Patient: A Case Report","authors":"Cannas A, Meloni M, Mascia MM, Solla P, Orofino G, Farris R, Marrosu F.","first_author":"Cannas A","journal":"Clinical neuropharmacology","year":2016,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/wnf.0000000000000157"}},{"id":7969,"doi":"10.1590/s1980-5764-2016dn1002011","pmid":"29213446","pmcid":"PMC5642406","title":"Psychosis and concurrent impulse control disorder in Parkinson's disease: A review based on a case report","authors":"Guedes BF, Gonçalves MR, Cury RG.","first_author":"Guedes BF","journal":"Dementia & neuropsychologia","year":2016,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Parkinson's Disease","Gambling","Psychotic Disorders","Impulse Control Disorders","Punding"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5642406","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Single patient case report describing psychiatric complications (psychosis, punding, pathological gambling, hypersexuality) in Parkinson's disease after dopamine agonist use.","sample_n":1,"sample_text":"single case","population":"58‑year‑old man with Parkinson’s disease","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 58‑year‑old man with Parkinson’s disease developed psychosis, repetitive ‘punding’ behavior, pathological gambling and hypersexuality after taking a dopamine drug; symptoms improved when the drug was stopped and an antipsychotic was added.","clinical_takeaway":"Monitor dopamine therapy in Parkinson’s patients for emerging compulsive sexual or gambling behaviours.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Detailed clinical timeline","Highlights medication‑related risks"],"limitations":["Single case limits generalisability","No validated measures of hypersexuality or gambling","No systematic assessment of confounders"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s1980-5764-2016dn1002011"}},{"id":7972,"doi":"10.1517/14656566.2016.1145660","pmid":"26798982","pmcid":null,"title":"Opioid antagonists in broadly defined behavioral addictions: a narrative review","authors":"Piquet-Pessôa M, Fontenelle LF.","first_author":"Piquet-Pessôa M","journal":"Expert opinion on pharmacotherapy","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Naltrexone","Nalmefene","Behavioral Addictions","Opioid Antagonists"],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of randomized controlled trials and case reports on opioid antagonists for various behavioral addictions, including hypersexual disorder.","sample_n":null,"sample_text":"Not applicable (review)","population":"human participants from previously published RCTs and case reports; no new sample recruited","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed randomized trials of opioid‑blocking drugs (like naltrexone) for gambling, kleptomania and other impulsive‑control disorders, finding solid support only for gambling and kleptomania, with insufficient evidence for hypersexuality or binge‑eating.","clinical_takeaway":"Opioid antagonists may help gambling disorder, but evidence is weak for hypersexual or related behaviors.","confidence":0.7,"topic_tags":["treatment","neuroscience","sexual_function"],"strengths":["Comprehensive overview of existing RCTs across several behavioral addictions","Clear summary of where evidence is sufficient versus lacking"],"limitations":["Narrative (non‑systematic) review lacks explicit risk‑of‑bias assessment","No quantitative synthesis or meta‑analysis performed","Potential selective reporting of outcomes"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1517/14656566.2016.1145660"}},{"id":7973,"doi":"10.1186/s40035-016-0051-7","pmid":"26893825","pmcid":"PMC4758007","title":"A survey of impulse control disorders in Parkinson's disease patients in Shanghai area and literature review","authors":"Wang XP, Wei M, Xiao Q.","first_author":"Wang XP","journal":"Translational neurodegeneration","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Icd","Parkinson’s Disease","Dopamine Replacement Therapy"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4758007","cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 217 consecutive Parkinson's patients from a single movement‑disorder clinic; Minnesota Impulsive Disorders Interview used; logistic regression performed.","sample_n":217,"sample_text":"217 PD patients recruited consecutively from one hospital clinic (March–Oct 2013).","population":"PD patients in Shanghai (clinic sample)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Shanghai clinic, 4 % of Parkinson's patients showed impulse‑control problems such as hypersexuality or gambling. Those with such problems were taking higher doses of dopamine drugs, but the study could not prove the drugs caused the behaviors.","clinical_takeaway":"Higher dopamine‑agonist doses may be linked to impulse‑control issues in Parkinson's patients; monitor sexual and other risky behaviours.","confidence":0.8,"topic_tags":["csbd","sexual_function","neuroscience"],"strengths":["Validated ICD interview instrument","Consecutive clinic sampling reduces selection bias within the clinic","Clear reporting of medication dosages and disease stage"],"limitations":["Small number of ICD cases (n=9) limits power for regression","No control for key psychosocial confounds (moral incongruence, mental health, trauma)","Single‑center, non‑representative sample"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":44,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s40035-016-0051-7"}},{"id":7974,"doi":"10.1155/2016/8929413","pmid":"26989535","pmcid":"PMC4773539","title":"The Kleine-Levin Syndrome: A Rare Disease with Often Delayed Diagnosis-A Report of Two Cases in the Department of Neurology of the University Hospital of Cocody (Côte d'Ivoire)","authors":"Assi B, Yapo-Ehounoud C, Baby MB, Aka-Diarra E, Amon-Tanoh M, Tanoh C.","first_author":"Assi B","journal":"Case reports in neurological medicine","year":2016,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4773539","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of two patients with Kleine‑Levin syndrome presenting hypersexuality; clinical description only","sample_n":2,"sample_text":"two cases","population":"2 young male patients seen in a neurology department in Côte d’Ivoire","country":"Côte d’Ivoire","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe two men in Côte d’Ivoire with Kleine‑Levin syndrome, a rare condition causing recurring episodes of extreme sleep, overeating and increased sexual activity. Diagnosis was delayed for years.","clinical_takeaway":"Kleine‑Levin syndrome can present with hypersexuality; clinicians should consider this rare disorder when evaluating episodic hypersomnia and sexual changes.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","csbd"],"strengths":["First documented KLS cases from Côte d’Ivoire","Clear clinical description of rare syndrome"],"limitations":["Only two cases – no generalisable data","No standardized measures of hypersexuality or other symptoms","No systematic assessment of confounding factors"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2016/8929413"}},{"id":7975,"doi":"10.1186/s40345-016-0047-3","pmid":"26879750","pmcid":"PMC4754238","title":"Behavioral and emotional adverse events of drugs frequently used in the treatment of bipolar disorders: clinical and theoretical implications","authors":"Szmulewicz A, Samamé C, Caravotta P, Martino DJ, Igoa A, Hidalgo-Mazzei D, Colom F, Strejilevich SA.","first_author":"Szmulewicz A","journal":"International journal of bipolar disorders","year":2016,"pub_types":["review-article","Journal Article"],"keywords":["Cognition","Bipolar disorder","Apathy","Emotional Detachment","Behavioral Adverse Events"],"is_oa":true,"oa_url":"https://journalbipolardisorders.springeropen.com/track/pdf/10.1186/s40345-016-0047-3","cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of drug‑induced behavioral side‑effects; no systematic methods, no meta‑analysis, no primary data collection","sample_n":null,"sample_text":"not applicable – review of published case reports and small studies","population":"patients with bipolar disorder and other neuropsychiatric conditions; also healthy subjects in primary reports (as described in reviewed case reports)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews reports that drugs used for bipolar disorder can cause side‑effects such as reduced sexual desire, hypersexuality, apathy, and emotional blunting, but the evidence mainly comes from case reports and small studies.","clinical_takeaway":"Clinicians should be aware that bipolar medications may affect sexual desire and behaviour, but evidence is limited; monitor patients and discuss side‑effects individually.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Collates scattered case‑report evidence on behavioral side‑effects","Highlights gaps in the literature for future research"],"limitations":["Narrative, non‑systematic review lacking explicit inclusion criteria","Relies heavily on case reports and small studies, limiting generalisability","No quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s40345-016-0047-3"}},{"id":7976,"doi":"10.1002/ab.21644","pmid":"26848102","pmcid":null,"title":"Perceptions of low agency and high sexual openness mediate the relationship between sexualization and sexual aggression","authors":"Blake KR, Bastian B, Denson TF.","first_author":"Blake KR","journal":"Aggressive behavior","year":2016,"pub_types":["Journal Article"],"keywords":["Agency","Sexual Aggression","Sexual Intent","Self-sexualization","Sexual Openness"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory experiment manipulating female clothing to test perceptions of agency, sexual openness, and aggression intentions. Sample size not reported in abstract.","sample_n":null,"sample_text":"Male participants (and women in Experiment 2) viewed photographs; exact N not given.","population":"Adult male (and female in Experiment 2) participants, likely convenience sample.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study shows that men view women who dress in revealing clothing as more sexually open and less capable of influencing situations, which makes them see those women as easier targets for sexual aggression. Perceived lack of agency links openness to aggressive intentions.","clinical_takeaway":"Awareness of how appearance cues may bias threat judgments can inform prevention training for potential perpetrators.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Experimental manipulation of visual cues","Mediational analysis clarifies psychological pathway","Controls for sexual‑offending propensity"],"limitations":["Sample size and recruitment details missing","No measurement of moral or mental‑health covariates","Reliance on self‑report intentions rather than behavior"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":38,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ab.21644"}},{"id":7977,"doi":"10.1515/hmbci-2015-0055","pmid":"26812878","pmcid":null,"title":"Sexuality in eating disorders patients: etiological factors, sexual dysfunction and identity issues. A systematic review","authors":"Castellini G, Lelli L, Ricca V, Maggi M.","first_author":"Castellini G","journal":"Hormone molecular biology and clinical investigation","year":2016,"pub_types":["Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of studies on sexuality (puberty, abuse, dysfunction, orientation) in eating‑disorder populations. No meta‑analysis reported.","sample_n":null,"sample_text":"Not specified in abstract; review of existing literature.","population":"Individuals with eating disorders (anorexia nervosa, bulimia) of both sexes; sample size not reported in abstract.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review summarizes how puberty timing, sexual abuse, sexual dysfunction, and sexual orientation relate to eating‑disorder symptoms, highlighting links between body image, sexual desire, and identity issues.","clinical_takeaway":"Clinicians should assess sexual development, trauma history, and sexual satisfaction when treating eating‑disorder patients, as these factors influence disorder severity.","confidence":0.6,"topic_tags":["sexual_function","relationships","gender"],"strengths":["Broad synthesis of multiple aspects of sexuality in EDs","Identifies gaps and emerging research lines","Integrates biological (puberty) and psychosocial factors"],"limitations":["No quantitative meta‑analysis; likely narrative","Abstract provides no detail on search strategy, risk‑of‑bias assessment","Reliance on heterogeneous primary studies with varied measures"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":31,"citing_publications":68,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/hmbci-2015-0055"}},{"id":7979,"doi":"10.1146/annurev-clinpsy-021815-093330","pmid":"26772210","pmcid":null,"title":"Paraphilias in the DSM-5","authors":"Beech AR, Miner MH, Thornton D.","first_author":"Beech AR","journal":"Annual review of clinical psychology","year":2016,"pub_types":["Review","Journal Article"],"keywords":["Changes","Definitions","Evidence Base","Implications","Paraphilia/paraphilic Disorders"],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of DSM‑5 changes; no original data, no systematic methods reported.","sample_n":null,"sample_text":"NA","population":"NA","country":"NA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how DSM‑5 changed the definition of paraphilias, separating unusual interests from disorders that cause distress, adding remission criteria, and clarifying behavior‑interest links, while noting forensic concerns and research gaps.","clinical_takeaway":"Clinicians should distinguish between atypical interests and disorder only when distress or dysfunction is present, per DSM‑5 guidance.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Comprehensive synthesis of DSM‑5 revisions","Highlights clinical and forensic implications"],"limitations":["No systematic review methodology","No empirical data; conclusions based on authors’ interpretation"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":36,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1146/annurev-clinpsy-021815-093330"}},{"id":7981,"doi":"10.1097/01.nmd.0000116467.42715.b7","pmid":"15091307","pmcid":null,"title":"Hypersexual behavior in hasidic jewish inpatients","authors":"Needell NJ, Markowitz JC.","first_author":"Needell NJ","journal":"The Journal of nervous and mental disease","year":2004,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Retrospective chart review of Hasidic psychiatric inpatients (1998) compared to matched non‑Hasidic controls; staff reports used to code hypersexual behavior.","sample_n":null,"sample_text":"All Hasidic Jews admitted in 1998 to one inpatient psychiatric hospital; age/diagnosis/gender‑matched comparisons.","population":"Inpatients (Hasidic Jews) and matched inpatient controls; unclear total N, likely small.","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A chart review of Hasidic Jewish psychiatric inpatients found that 69% of men (and 40% of women) were reported by staff as showing hypersexual behavior, a higher rate than matched non‑Hasidic patients. The authors suggest cultural factors may influence these symptoms.","clinical_takeaway":"No direct clinical guidance; findings are preliminary and limited to a specific inpatient group.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Matched control group","Focus on an understudied cultural population"],"limitations":["Behavior coded from staff notes, no validated instrument","Small, single‑site inpatient sample","No control for confounding variables (e.g., mental‑health severity, cultural moral norms)"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.nmd.0000116467.42715.b7"}},{"id":7982,"doi":null,"pmid":"27484420","pmcid":null,"title":"[Kleine Levin Syndrome: more than just periodic hypersomnia]","authors":"Pillen S, Vandenbussche NL, Fronczek R, van Duijn J, Lammers GJ, Overeem S.","first_author":"Pillen S","journal":"Nederlands tijdschrift voor geneeskunde","year":2016,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"dut","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of a single 14‑year‑old male with Kleine‑Levin Syndrome describing episodic hypersexuality among other symptoms.","sample_n":1,"sample_text":"single case; additional summary of twelve other patients (no individual data).","population":"Adolescent male patient with KLS; summary of 12 additional KLS cases (no systematic sampling).","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 14‑year‑old boy with Kleine‑Levin Syndrome experienced episodes of extreme sleepiness, anxiety, hallucinations and uncontrolled sexual behavior. The authors suggest that neuropsychiatric symptoms may be more central to KLS than overeating or hypersexuality.","clinical_takeaway":"KLS can include episodic hypersexuality; clinicians should assess broader neuropsychiatric symptoms, not just appetite changes.","confidence":0.3,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed clinical description of a rare syndrome","Highlights heterogeneity of KLS symptom profile"],"limitations":["Single case; no systematic measurement of sexual behavior","No validated scales for hypersexuality or related constructs","No control or comparison group"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":7983,"doi":"10.1176/jnp.16.1.37","pmid":"14990757","pmcid":null,"title":"Hypersexuality after right pallidotomy for Parkinson's disease","authors":"Mendez MF, O'Connor SM, Lim GT.","first_author":"Mendez MF","journal":"The Journal of neuropsychiatry and clinical neurosciences","year":2004,"pub_types":["Comparative Study","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case description with literature review","sample_n":1,"sample_text":"N=1 (case report)","population":"one middle‑aged male with Parkinson’s disease undergoing right pallidotomy","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A single patient developed increased sexual activity after a right‑side brain surgery for Parkinson’s disease, suggesting the pallidum may influence sexual arousal.","clinical_takeaway":"One case does not prove surgery causes hypersexuality; clinicians should monitor sexual changes after neurosurgery but cannot generalise.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","pornography","masturbation","csbd"],"strengths":["unique clinical observation","links neuroanatomy to sexual behavior"],"limitations":["single case, no controls","no validated measures of hypersexuality","cannot separate dopamine effects from lesion effects"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/jnp.16.1.37"}},{"id":7984,"doi":"10.1556/2006.4.2015.044","pmid":"26690622","pmcid":"PMC4712761","title":"Risk for exercise dependence, eating disorder pathology, alcohol use disorder and addictive behaviors among clients of fitness centers","authors":"Müller A, Loeber S, Söchtig J, Te Wildt B, De Zwaan M.","first_author":"Müller A","journal":"Journal of behavioral addictions","year":2015,"pub_types":["review-article","Journal Article"],"keywords":["Hypersexual Behavior","Eating Disorder","Exercise Dependence","Alcohol Use Disorder","Pathological Video Gaming","Pathological Buying"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4712761","cited_by_count":36,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study of 128 fitness‑center clients (71.7% men, mean age 26.5)","sample_n":128,"sample_text":"128 individuals, 71.7% men, mean age 26.5 (SD 6.7)","population":"clients of fitness centers (convenience sample)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 128 people who attend fitness centres, about 8% showed signs of exercise dependence, 4% had hypersexual behaviour, and the two were modestly linked. Exercise dependence also related to buying compulsions and eating‑disorder symptoms, but not to gaming, alcohol or hypersexuality after accounting for gender.","clinical_takeaway":"Clinicians should screen for co‑occurring exercise dependence, eating‑disorder traits and buying compulsions, but hypersexual behaviour appears largely independent in this group.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses a range of validated questionnaires","Examines multiple behavioral addictions in the same sample","Clear reporting of prevalence rates and correlations"],"limitations":["Convenience sample of fitness‑center clients; limited generalisability","Cross‑sectional design prevents causal inference","No measurement or control of key confounds (moral incongruence, masturbation, mental health, partner effects, trauma)","No pre‑registration; effect sizes not presented with confidence intervals"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":1,"mentioning":69,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.4.2015.044"}},{"id":7985,"doi":"10.1016/bs.pbr.2015.08.001","pmid":"26806770","pmcid":null,"title":"Stress psychobiology in the context of addiction medicine: from drugs of abuse to behavioral addictions","authors":"Lemieux A, al'Absi M.","first_author":"Lemieux A","journal":"Progress in brain research","year":2016,"pub_types":["Review","Journal Article"],"keywords":["Stress","Cortisol","Relapse","Emotions","Hypothalamic-pituitary-adrenocortical Axis","Addictive Behaviors","Stress Response Pathways","Sympathetic-adrenal-medullary Response"],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of stress biology and its relation to substance and behavioral addictions; no original empirical data","sample_n":null,"sample_text":"none (review)","population":"none (review)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The chapter reviews how psychological stress hormones and brain systems interact with reward pathways, influencing initiation, maintenance, and relapse of substance use and behavioral addictions such as gambling, hypersexuality, and problematic internet use.","clinical_takeaway":"Stress management may be a useful component in treating various addictions, including hypersexuality, but evidence is largely theoretical.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Broad integration of stress biology with addiction theory","Highlights emerging areas (genomics, sex differences, behavioral addictions)","Cites a range of animal and human literature"],"limitations":["No systematic methodology or risk‑of‑bias assessment","Lacks empirical data; relies on narrative synthesis","Does not evaluate specific addiction criteria for hypersexuality"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":19,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/bs.pbr.2015.08.001"}},{"id":7986,"doi":"10.1080/00224499.2015.1084984","pmid":"26579557","pmcid":null,"title":"Is High Sexual Desire a Risk for Women's Relationship and Sexual Well-Being?","authors":"Štulhofer A, Bergeron S, Jurin T.","first_author":"Štulhofer A","journal":"Journal of sex research","year":2016,"pub_types":["Journal Article"],"keywords":["Women","Hypersexuality","Sexual Well-being","Problematic Sexuality","High Sexual Desire","Relationship Intimacy"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 2,599 Croatian women, cross‑sectional convenience sample","sample_n":2599,"sample_text":"2,599 Croatian women aged 18‑60 years recruited via an online survey in 2014","population":"women, 18‑60 years, Croatia","country":"Croatia","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large Croatian survey, women with very high sexual desire were more sexually active but did not report more problems, whereas women meeting hypersexuality criteria did report negative consequences. High desire alone does not appear harmful to relationship or sexual well‑being.","clinical_takeaway":"High sexual desire in women should not be treated as a disorder if no distress or functional problems are present.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for a survey","Direct comparison of high desire vs hypersexuality groups","Clear operational definitions for groups"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report, limited validated measures for desire","No assessment of moral incongruence or other key confounds"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2015.1084984"}},{"id":7990,"doi":"10.7759/cureus.r1","pmid":"26451336","pmcid":"PMC4596082","title":"Retraction: Hypersexuality Addiction and Withdrawal: Phenomenology, Neurogenetics and Epigenetics","authors":"Blum K, Badgaiyan RD, Gold MS.","first_author":"Blum K","journal":"Cureus","year":2015,"pub_types":["Retraction of Publication","Retraction Notice"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4596082","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.r1"}},{"id":7992,"doi":"10.1371/journal.pone.0139533","pmid":"26413770","pmcid":"PMC4587549","title":"Correction: Are Sex Drive and Hypersexuality Associated with Pedophilic Interest and Child Sexual Abuse in a Male Community Sample?","authors":"PLOS ONE Staff.","first_author":"PLOS ONE Staff.","journal":"PloS one","year":2015,"pub_types":["Published Erratum","correction"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4587549","cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0139533"}},{"id":7993,"doi":"10.1177/0306624x03253845","pmid":"12971184","pmcid":null,"title":"Sex offending and sexual appetite: the clinical and theoretical relevance of hypersexual desire","authors":"Kafka MP.","first_author":"Kafka MP.","journal":"International journal of offender therapy and comparative criminology","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative commentary without empirical data; no sample, no methods reported.","sample_n":null,"sample_text":"Not applicable – no primary data collected.","population":"male clinical samples with paraphilias and sexual coercion (described but not studied).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"supports","citation_value":"background","plain_summary":"The author proposes that excessive sexual desire, seen in some men with paraphilias or sexual offenses, can be described by time spent on fantasies, frequency of sexual acts, and resulting problems. He argues that combined therapy and medication could help but notes these approaches are underused.","clinical_takeaway":"No direct clinical guidance; the piece suggests considering combined therapy for hypersexual desire, but lacks empirical support.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Highlights clinical relevance of hypersexual desire","Integrates psychotherapeutic and pharmacologic perspectives"],"limitations":["No original data or systematic review methodology","Lacks empirical measurement of constructs","No control for key confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":50,"citing_publications":90,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0306624x03253845"}},{"id":7994,"doi":"10.7759/cureus.c1","pmid":"26421257","pmcid":"PMC4576700","title":"Correction: Hypersexuality Addiction and Withdrawal: Phenomenology, Neurogenetics and Epigenetics","authors":"Blum K, Badgaiyan RD, Gold MS.","first_author":"Blum K","journal":"Cureus","year":2015,"pub_types":["Published Erratum","correction"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4576700","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.c1"}},{"id":7997,"doi":"10.4103/0019-5545.166632","pmid":"26600593","pmcid":"PMC4623658","title":"Subacute sclerosing panencephalitis presenting with hypersexual behavior","authors":"Manoj S, Mukherjee A, Kumar KV.","first_author":"Manoj S","journal":"Indian journal of psychiatry","year":2015,"pub_types":["letter","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.4103/0019-5545.166632","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0019-5545.166632"}},{"id":7998,"doi":"10.1016/j.nrl.2015.05.002","pmid":"26096669","pmcid":null,"title":"[Clinical and psychopathological factors associated with impulse control disorders in Parkinson's disease]","authors":"Sáez-Francàs N, Martí Andrés G, Ramírez N, de Fàbregues O, Álvarez-Sabín J, Casas M, Hernández-Vara J.","first_author":"Sáez-Francàs N","journal":"Neurologia (Barcelona, Spain)","year":2016,"pub_types":["Journal Article"],"keywords":["Personality","Prevalence","Parkinson's Disease","Psychopathology","Impulse Control Disorders","Agonistas Dopaminérgicos","Prevalencia","Psicopatología","Enfermedad De Parkinson","Personalidad","Dopaminergic Agonists","Trastorno Del Control De Los Impulsos."],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["csbd"],"language":"spa","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional descriptive and analytical study of 115 Parkinson’s disease patients assessing presence of impulse‑control disorders (ICDs) and associated clinical/psychopathological factors.","sample_n":115,"sample_text":"115 PD patients evaluated for ICDs","population":"115 Parkinson’s disease patients (mixed gender, aged middle‑aged to elderly) recruited from clinical settings.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 115 people with Parkinson’s disease, about a quarter had impulse‑control problems such as hypersexuality. Use of dopamine‑agonist medication, younger disease onset, higher anxiety and impulsivity were linked to higher risk.","clinical_takeaway":"Monitor PD patients on dopamine agonists for hypersexuality and other ICDs, especially if they show high anxiety or impulsivity.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Reasonably sized clinical sample for PD population","Uses established clinical scales for ICD detection","Identifies multiple risk factors (dopamine agonists, anxiety, impulsivity)"],"limitations":["Cross‑sectional design limits causal inference","No explicit measurement of key sexual‑behavior confounds","Unclear whether ICD assessment tool was validated for this sample"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.nrl.2015.05.002"}},{"id":8001,"doi":"10.1159/000381558","pmid":"26066569","pmcid":"PMC4540608","title":"The Influence of Bilateral Subthalamic Nucleus Deep Brain Stimulation on Impulsivity and Prepulse Inhibition in Parkinson's Disease Patients","authors":"Gee L, Smith H, De La Cruz P, Campbell J, Fama C, Haller J, Ramirez-Zamora A, Durphy J, Hanspal E, Molho E, Barba A, Shin D, Pilitsis JG.","first_author":"Gee L","journal":"Stereotactic and functional neurosurgery","year":2015,"pub_types":["Clinical Trial","Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"prospective pre‑post clinical trial of bilateral STN‑DBS in Parkinson’s disease patients (n≈16) assessing ICDs with QUIP‑RS and laboratory tasks (BART, PPI)","sample_n":16,"sample_text":"12 good responders, 4 poor responders (total 16)","population":"Parkinson’s disease patients undergoing deep brain stimulation","country":"unspecified (likely USA based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 16 Parkinson’s patients, deep‑brain stimulation of the subthalamic nucleus reduced impulse‑control problems, including hypersexual behavior, after one year. Better responders also showed improved brain‑stem inhibitory processing linked to risk‑taking.","clinical_takeaway":"STN‑DBS may lessen hypersexual urges in Parkinson’s disease, but findings are from a tiny, uncontrolled study.","confidence":0.4,"topic_tags":["sexual_function","csbd","pornography","masturbation","prevalence"],"strengths":["uses validated ICD questionnaire (QUIP‑RS)","prospective assessment pre‑ and post‑DBS","includes objective lab tasks (BART, PPI)"],"limitations":["very small sample (≈16)","no control/comparator group","no adjustment for key confounds (mood, moral factors, partner context)","limited statistical reporting (p‑values only, no effect sizes)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":33,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000381558"}},{"id":8002,"doi":"10.1002/mdc3.12167","pmid":"30363600","pmcid":"PMC6178770","title":"Clozapine Treatment for Impulse Control Disorders in Parkinson's Disease Patients: A Case Series","authors":"Liang J, Groves M, Shanker VL.","first_author":"Liang J","journal":"Movement disorders clinical practice","year":2015,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Clozapine","Impulse","Icd","Parkinson"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of 4 PD patients treated with clozapine for impulse control disorders (including hypersexuality)","sample_n":4,"sample_text":"Four patients identified from retrospective chart review","population":"Parkinson's disease patients with dopaminergic‑induced impulse control disorders","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In four Parkinson's patients whose dopamine medicines had caused impulse‑control problems like compulsive shopping, binge drinking, and hypersexuality, low‑dose clozapine appeared to eliminate the symptoms, though two stopped the drug because of side effects.","clinical_takeaway":"Clozapine may help resolve dopamine‑induced impulse‑control disorders, but evidence is limited to a tiny case series.","confidence":0.7,"topic_tags":["csbd","sexual_function","neuroscience","treatment","pornography","masturbation"],"strengths":["Clear clinical outcome (resolution of ICD symptoms)","Specific pharmacologic intervention (clozapine)"],"limitations":["Very small sample (N=4)","Retrospective chart review, no control group","No standardized symptom rating scales","Limited generalisability"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":3,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mdc3.12167"}},{"id":8004,"doi":"10.1097/00004045-200301000-00010","pmid":"12544463","pmcid":null,"title":"Understanding hypersexuality: a behavioral disorder of dementia","authors":"Robinson KM.","first_author":"Robinson KM.","journal":"Home healthcare nurse","year":2003,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without empirical data; no systematic methods reported.","sample_n":null,"sample_text":"Not applicable – no primary data collected.","population":"Patients with Alzheimer's disease exhibiting hypersexuality; caregivers; setting: home/hospice care.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews why some Alzheimer’s patients show increased sexual behavior and offers tips for home‑care nurses to help families reduce the related social isolation.","clinical_takeaway":"Clinicians should be aware that hypersexuality can occur in dementia and consider caregiver education and support strategies.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Addresses an understudied clinical issue (hypersexuality in dementia).","Provides practical caregiving strategies."],"limitations":["No empirical data; narrative review only.","Lacks clear definitions and validated measures of hypersexuality.","No systematic search or bias assessment."],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00004045-200301000-00010"}},{"id":8005,"doi":null,"pmid":"12464751","pmcid":null,"title":"Hypersexuality after pallidal surgery in Parkinson disease","authors":"Roane DM, Yu M, Feinberg TE, Rogers JD.","first_author":"Roane DM","journal":"Neuropsychiatry, neuropsychology, and behavioral neurology","year":2002,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case description of a Parkinson patient developing hypersexuality after pallidal DBS","sample_n":1,"sample_text":"single case","population":"1 male middle‑aged patient with Parkinson disease","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A single Parkinson patient who received deep‑brain stimulation to the globus pallidus developed extreme sexual urges after surgery. The report suggests the procedure or medication may trigger such psychiatric side‑effects.","clinical_takeaway":"Clinicians should monitor for sudden hypersexuality after pallidal DBS in Parkinson patients.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["detailed clinical description","highly specific neurosurgical context"],"limitations":["n=1, no systematic assessment","no validated measures of hypersexuality","no control for moral, mental‑health or relational factors"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":8008,"doi":"10.1002/mds.10265","pmid":"12465087","pmcid":null,"title":"Transient mania with hypersexuality after surgery for high frequency stimulation of the subthalamic nucleus in Parkinson's disease","authors":"Romito LM, Raja M, Daniele A, Contarino MF, Bentivoglio AR, Barbier A, Scerrati M, Albanese A.","first_author":"Romito LM","journal":"Movement disorders : official journal of the Movement Disorder Society","year":2002,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":149,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case series of 30 PD patients undergoing STN DBS; detailed description of 2 men who developed transient mania and hypersexuality post‑operatively.","sample_n":30,"sample_text":"30 patients total; 2 cases highlighted","population":"Parkinson's disease patients receiving high‑frequency subthalamic nucleus stimulation; age 30‑70; mixed gender (cases described are male).","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a series of 30 Parkinson's patients given deep‑brain stimulation, two men briefly developed mania and a marked increase in sexual activity a few days after surgery; the symptoms faded over months.","clinical_takeaway":"Hypersexuality can be a temporary side‑effect of subthalamic nucleus stimulation in Parkinson's disease; monitor mood and sexual changes after surgery.","confidence":0.6,"topic_tags":["neuroscience","sexual_function"],"strengths":["Clear clinical description of rare adverse effect","Provides temporal link between DBS activation and symptom onset"],"limitations":["No standardized measures of hypersexuality or mood","No control or comparison group","Small number of cases limits generalisability"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":151,"citing_publications":264,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mds.10265"}},{"id":8009,"doi":null,"pmid":"12448966","pmcid":null,"title":"[Hypersexuality during use of levodopa]","authors":"van Deelen RA, Rommers MK, Eerenberg JG, Egberts AC.","first_author":"van Deelen RA","journal":"Nederlands tijdschrift voor geneeskunde","year":2002,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"dut","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case description of levodopa‑induced hypersexuality in a 71‑year‑old man; intervention (medication box) and outcome reported","sample_n":1,"sample_text":"single patient","population":"71‑year‑old male with Parkinson’s disease","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"A 71‑year‑old man with Parkinson’s disease developed episodes of excessive sexual behaviour after taking more levodopa than prescribed. When his medication use was controlled with a family‑filled box, the hypersexuality stopped without worsening his Parkinson’s symptoms.","clinical_takeaway":"Monitor dopaminergic therapy for hypersexual side‑effects and consider supervised medication management.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Clear clinical description of side‑effect","Practical intervention described","Links hypersexuality to dopaminergic mechanism"],"limitations":["Single case, no generalisability","No validated measures of sexual behaviour or distress","No systematic assessment of confounds"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":8011,"doi":"10.1111/psyg.12113","pmid":"25735193","pmcid":null,"title":"Increased libido associated with donepezil treatment: a case report","authors":"Segrec N, Zaman R, Pregelj P.","first_author":"Segrec N","journal":"Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society","year":2016,"pub_types":["Journal Article","Case Reports"],"keywords":["Adverse effects","Dementia","Increased Libido","Dementia Of The Alzheimer's Type","Donepezil"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of a single patient describing temporal association between donepezil dose changes and libido.","sample_n":1,"sample_text":"Single patient case report","population":"79‑year‑old woman with Alzheimer’s disease","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 79‑year‑old woman with Alzheimer’s disease experienced a spike in sexual desire when her dose of the dementia medicine donepezil was increased; the symptom went away after the drug was stopped and returned when it was restarted.","clinical_takeaway":"Clinicians should monitor for increased libido or hypersexuality when prescribing or adjusting donepezil in older adults.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Clear temporal relationship with drug manipulation","Use of Naranjo score to assess causality"],"limitations":["Single case, no generalizability","No validated sexual behavior scales","Potential confounding by co‑medication (tianeptine) not addressed"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/psyg.12113"}},{"id":8015,"doi":"10.1002/syn.21805","pmid":"25645960","pmcid":null,"title":"Parkinson's disease treatment may cause impulse-control disorder via dopamine D3 receptors","authors":"Seeman P.","first_author":"Seeman P.","journal":"Synapse (New York, N.Y.)","year":2015,"pub_types":["Review","Journal Article"],"keywords":["Compulsive Behavior","Apomorphine","Addiction","Bromocriptine","Gambling","Ropinirole","Hypersexuality","Pramipexole","Pergolide","Rotigotine"],"is_oa":false,"oa_url":null,"cited_by_count":113,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Review of existing studies on dopamine agonists and impulse‑control disorders in Parkinson’s disease.","sample_n":null,"sample_text":"Not applicable – article is a narrative review.","population":"Parkinson’s disease patients treated with dopamine agonists (no primary data collected).","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises evidence that Parkinson’s drugs that strongly activate dopamine D3 receptors (especially pramipexole) are linked to impulse‑control problems such as gambling, compulsive shopping and hypersexuality, suggesting D3 stimulation may drive these behaviours.","clinical_takeaway":"When impulse‑control disorders arise in Parkinson’s patients, consider switching from D3‑preferring agents (e.g., pramipexole) to drugs with lower D3 activity.","confidence":0.4,"topic_tags":["neuroscience","sexual_function","csbd"],"strengths":["Comprehensive list of dopamine agonists and reported ICD rates","Clear quantitative comparison of D3 vs D2 selectivity","Potential clinical recommendation (switching agents)"],"limitations":["No primary data; relies on heterogeneous studies","No control for confounding factors (e.g., disease severity, mood)","Causal language applied to observational associations"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":4,"contrasting":0,"mentioning":102,"citing_publications":170,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/syn.21805"}},{"id":8016,"doi":null,"pmid":"25848667","pmcid":null,"title":"Hypersexuality after self-inflicted nail gun penetrating traumatic brain injury and neurosurgery: case analysis with literature review","authors":"Kaufman KR, Schineller TM, Tobia A, Schneider JA, Bagayogo IP.","first_author":"Kaufman KR","journal":"Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists","year":2015,"pub_types":["Letter","Review","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":8017,"doi":"10.1111/ene.12646","pmid":"25598147","pmcid":null,"title":"Impulse control disorders in Parkinson's disease: don't set your mind at rest by self-assessments","authors":"Baumann-Vogel H, Valko PO, Eisele G, Baumann CR.","first_author":"Baumann-Vogel H","journal":"European journal of neurology","year":2015,"pub_types":["Journal Article"],"keywords":["Assessment","Parkinson's Disease","Impulse Control Disorder","Hypersexuality","Punding","Dopamine Dysregulation Syndrome"],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 150 Parkinson's patients (self‑assessment) and 64 caregivers (adapted questionnaire)","sample_n":150,"sample_text":"150 PD patients (self‑assessment); caregivers n = 64 for caregiver version","population":"Parkinson's disease patients and their informal caregivers","country":"unspecified (likely Germany/Austria based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson’s disease, patients often under‑report impulse‑control problems like hypersexuality compared with what their caregivers observe, suggesting these behaviours may be more common than self‑reports indicate.","clinical_takeaway":"Clinicians should assess impulse‑control disorders in PD both via patient self‑report and caregiver input to avoid under‑recognition.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Large PD patient sample for self‑report (n≈150)","Includes caregiver perspective for validation","Addresses discrepancy between self‑ and informant reports"],"limitations":["Screening tool not fully validated","Cross‑sectional, no causal inference","Potential selection bias (clinic sample)","No control for psychiatric comorbidities or medication variables"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":3,"mentioning":58,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/ene.12646"}},{"id":8018,"doi":"10.1006/ebeh.2002.0342","pmid":"12609419","pmcid":null,"title":"Hypersexuality after Temporal Lobe Resection","authors":"Baird AD, Wilson SJ, Bladin PF, Saling MM, Reutens DC.","first_author":"Baird AD","journal":"Epilepsy & behavior : E&B","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of 7 postoperative patients","sample_n":7,"sample_text":"seven patients","population":"patients undergoing unilateral temporal lobe resection for epilepsy","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors report seven epilepsy patients who became much more sexually active after having one side of their temporal lobe removed. The change seemed linked to psychosocial problems and brain abnormalities on the opposite side, not just the seizure stopping.","clinical_takeaway":"Hypersexuality can emerge after temporal lobe surgery, especially with psychosocial difficulties; monitor patients accordingly.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["focus on a rare postoperative phenomenon","clinical detail on individual cases"],"limitations":["very small, non‑representative sample","no validated measures of hypersexuality","no control for key confounds (moral, mental health, etc.)","no statistical analysis beyond description"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":28,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1006/ebeh.2002.0342"}},{"id":8019,"doi":"10.1016/b978-0-444-63247-0.00016-x","pmid":"26003250","pmcid":null,"title":"Sexual function after strokes","authors":"Boller F, Agrawal K, Romano A.","first_author":"Boller F","journal":"Handbook of clinical neurology","year":2015,"pub_types":["Review","Journal Article"],"keywords":["Drugs","risk factors","Strokes","Hypersexuality","Hyposexuality","Correlation Between Coitus And Stroke"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review chapter summarizing existing literature; no original empirical data.","sample_n":null,"sample_text":"N/A – review article","population":"stroke survivors (male and female)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The chapter reviews how strokes can lead to reduced or increased sexual activity, discussing how brain‑side lesions, mood changes and medications influence these outcomes.","clinical_takeaway":"Clinicians should assess sexual function after stroke, considering both neurological and psychosocial factors.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","csbd"],"strengths":["Comprehensive overview of sexual dysfunction post‑stroke","Integrates neuro‑anatomical and psychosocial perspectives"],"limitations":["No original data; reliance on existing studies","Lacks systematic review methodology (no risk‑of‑bias assessment)","Does not assess confounding variables such as mental health or relationship status"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/b978-0-444-63247-0.00016-x"}},{"id":8020,"doi":"10.1016/b978-0-444-63247-0.00006-7","pmid":"26003240","pmcid":null,"title":"Human sexual behavior related to pathology and activity of the brain","authors":"Komisaruk BR, Rodriguez Del Cerro MC.","first_author":"Komisaruk BR","journal":"Handbook of clinical neurology","year":2015,"pub_types":["Review","Journal Article"],"keywords":["Epilepsy","Traumatic brain injury","Stroke","Psychosurgery","Functional Brain Imaging","Hypersexuality","Hyposexuality"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review chapter summarising correlations between brain pathology, functional imaging and sexual behavior; no original data.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The chapter reviews how brain injuries, seizures, and imaging studies relate to changes in sexual behavior, noting that many findings are uncertain and may reflect general brain disinhibition rather than specific sexual effects.","clinical_takeaway":"Clinicians should interpret links between brain pathology and sexual changes cautiously; evidence for direct causal pathways is limited.","confidence":0.4,"topic_tags":["neuroscience","sexual_function"],"strengths":["Broad overview of brain‑behavior links","Highlights interpretive caveats"],"limitations":["No original empirical data","Lacks systematic review methods","No measurement of key confounds"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/b978-0-444-63247-0.00006-7"}},{"id":8021,"doi":"10.1016/b978-0-444-63247-0.00017-1","pmid":"26003251","pmcid":null,"title":"Sexuality in patients with Parkinson's disease, Alzheimer's disease, and other dementias","authors":"Bronner G, Aharon-Peretz J, Hassin-Baer S.","first_author":"Bronner G","journal":"Handbook of clinical neurology","year":2015,"pub_types":["Review","Journal Article"],"keywords":["Sexuality","Alzheimer's disease","Management","Dementia","Sexual dysfunction","Parkinson's Disease","Compulsive Sexual Behavior","Hypersexuality","Inappropriate Sexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Review chapter summarizing existing literature on sexual dysfunction and hypersexuality in Parkinson’s disease, Alzheimer’s disease and other dementias. No new empirical data were collected.","sample_n":null,"sample_text":"Not applicable – secondary source.","population":"Patients with Parkinson’s disease, Alzheimer’s disease and other dementias (and their partners).","country":"Not specified (chapter in an edited volume).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The chapter reviews how Parkinson’s disease, Alzheimer’s disease and other dementias affect sexual desire, performance and behaviour, noting problems like reduced desire, erectile difficulty, and, in Parkinson’s patients, therapy‑induced hyper‑sexuality. It stresses early assessment and multidisciplinary treatment.","clinical_takeaway":"Screen for sexual dysfunction and inappropriate sexual behaviour early in dementia and Parkinson’s patients; consider medication effects and involve a multidisciplinary team.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Comprehensive synthesis of clinical observations across several dementias","Highlights multidisciplinary management approaches","Identifies gaps in empirical data"],"limitations":["No new primary data; reliance on heterogeneous source material","Lacks systematic risk‑of‑bias assessment","No quantitative meta‑analysis"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":1,"mentioning":49,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/b978-0-444-63247-0.00017-1"}},{"id":8022,"doi":"10.1177/0004867414561529","pmid":"25422519","pmcid":null,"title":"Paradoxical hypersexuality in depression","authors":"Ong WM, Kulkarni J.","first_author":"Ong WM","journal":"The Australian and New Zealand journal of psychiatry","year":2015,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0004867414561529"}},{"id":8023,"doi":"10.1089/10445460252943524","pmid":"12014593","pmcid":null,"title":"Phenomenology of prepubertal and early adolescent bipolar disorder: examples of elated mood, grandiose behaviors, decreased need for sleep, racing thoughts and hypersexuality","authors":"Geller B, Zimerman B, Williams M, Delbello MP, Frazier J, Beringer L.","first_author":"Geller B","journal":"Journal of child and adolescent psychopharmacology","year":2002,"pub_types":["Comparative Study","Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":148,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative case‑control study of prepubertal/early adolescent bipolar youths versus normal controls; relies on validated diagnostic interviews but sample size and power not reported.","sample_n":null,"sample_text":"Not specified in abstract; likely modest.","population":"Children and early adolescents with bipolar disorder phenotype; normal prepubertal controls.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The paper describes how children with bipolar disorder can show hypersexual behavior, alongside typical mania symptoms like elated mood and reduced sleep, and compares these signs to normal peers and adult cases.","clinical_takeaway":"Hypersexuality can be a legitimate mania symptom in youth; clinicians should differentiate it from ADHD‑related behaviors.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Uses validated diagnostic procedures for bipolar phenotype","Provides comparative examples with normal controls","Addresses differential diagnosis with ADHD"],"limitations":["No information on sample size or power","No measurement or control of relevant sexual‑behavior confounds","Cross‑sectional, descriptive focus limits causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":142,"citing_publications":225,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/10445460252943524"}},{"id":8024,"doi":"10.1097/00131746-200201000-00004","pmid":"15985851","pmcid":null,"title":"Behavioral and psychopharmacological treatment of the paraphilic and hypersexual disorders","authors":"Krueger RB, Kaplan MS.","first_author":"Krueger RB","journal":"Journal of psychiatric practice","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review / clinical guide without original empirical data.","sample_n":null,"sample_text":"No primary sample; the article synthesises prior case reports, uncontrolled studies and expert opinion.","population":"Adults with paraphilic or hypersexual disorders (clinical samples implied).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how clinicians assess and treat people with paraphilic or hypersexual problems, describing psychotherapy techniques, medication options, and a step‑wise treatment plan, but it is based on expert opinion and small uncontrolled studies rather than solid research.","clinical_takeaway":"Use the suggested treatment algorithm as a guide, but recognize that many recommendations lack strong empirical evidence.","confidence":0.4,"topic_tags":["treatment","csbd","sexual_function"],"strengths":["Comprehensive overview of behavioral and pharmacological options.","Discusses ethical considerations and treatment algorithm."],"limitations":["Lacks systematic search and risk‑of‑bias assessment.","Relies on uncontrolled case reports and expert opinion.","No quantitative synthesis; limited empirical support."],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00131746-200201000-00004"}},{"id":8025,"doi":"10.1016/j.parkreldis.2014.11.003","pmid":"25466402","pmcid":null,"title":"Postural instability, the absence of sexual intercourse in the past month, and loss of libido are predictors of sexual dysfunction in Parkinson's disease","authors":"Jitkritsadakul O, Jagota P, Bhidayasiri R.","first_author":"Jitkritsadakul O","journal":"Parkinsonism & related disorders","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Randomized Controlled Trial","Journal Article"],"keywords":["Sexual dysfunction","Parkinson's Disease","Libido","Sexual Intercourse","Postural Instability"],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case‑control survey of 60 Parkinson’s patients vs 60 controls, logistic regression","sample_n":120,"sample_text":"60 PD patients and 60 controls","population":"adult Parkinson’s disease patients and age‑matched healthy controls (N=120)","country":"Thailand (ASEX‑Thai version used)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In Parkinson’s patients, lack of sexual intercourse in the past month, postural instability, and loss of libido were linked to higher odds of sexual dysfunction, especially when depression was present.","clinical_takeaway":"Screen PD patients for recent sexual activity, postural balance, and depression to identify those at risk for sexual dysfunction.","confidence":0.8,"topic_tags":["sexual_function","prevalence","pornography","masturbation"],"strengths":["Validated sexual dysfunction (ASEX) and depression (HAMD) scales","Comparison with matched healthy controls","Clear logistic regression analysis of predictors"],"limitations":["Cross‑sectional design cannot infer causality","No assessment of moral, masturbatory, or relationship variables","Limited reporting of effect sizes and confidence intervals"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":50,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2014.11.003"}},{"id":8027,"doi":null,"pmid":"25401719","pmcid":null,"title":"Hypersexuality after self-inflicted nail gun penetrating traumatic brain injury and neurosurgery: case analysis with literature review","authors":"Kaufman KR, Schineller TM, Tobia A, Schneider JA, Bagayogo IP.","first_author":"Kaufman KR","journal":"Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists","year":2014,"pub_types":["Letter","Review","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":8028,"doi":"10.1007/s10508-014-0326-y","pmid":"24951045","pmcid":null,"title":"What happened to hypersexual disorder?","authors":"Kafka MP.","first_author":"Kafka MP.","journal":"Archives of sexual behavior","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":74,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":3,"contrasting":1,"mentioning":93,"citing_publications":214,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0326-y"}},{"id":8030,"doi":"10.1371/journal.pone.0105955","pmid":"25170909","pmcid":"PMC4149496","title":"Extinction and renewal of conditioned sexual responses","authors":"Brom M, Laan E, Everaerd W, Spinhoven P, Both S.","first_author":"Brom M","journal":"PloS one","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4149496","cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory conditioning experiment with 102 participants (40 men, 62 women) using genital vibrotactile stimulation as an unconditioned stimulus and neutral pictures as conditioned stimuli. Context manipulation (AAA vs. ABA) tested extinction and renewal effects.","sample_n":102,"sample_text":"n = 40 men, n = 62 women (total N = 102)","population":"Adults (men and women, ages not specified, likely young adult), recruited from the general community.","country":"Netherlands (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, people learned to associate neutral pictures with sexual stimulation. When the learning context changed, some aspects of the learned response returned, showing that extinction of sexual cues depends on context. This may help explain why certain sexual habits persist.","clinical_takeaway":"Therapies for hyper‑ or hypo‑sexuality should consider the context in which sexual cues are learned and extinguished.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Well‑controlled laboratory conditioning paradigm","Physiological and subjective measures of sexual response","Adequate total sample size for experimental work"],"limitations":["No pre‑registration or power analysis reported","Limited ecological validity of laboratory stimuli","No assessment of broader psychosocial factors (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0105955"}},{"id":8032,"doi":"10.1136/jnnp-2013-307214","pmid":"25012201","pmcid":null,"title":"Impulse control behaviours in patients with Parkinson's disease after subthalamic deep brain stimulation: de novo cases and 3-year follow-up","authors":"Amami P, Dekker I, Piacentini S, Ferré F, Romito LM, Franzini A, Foncke EM, Albanese A.","first_author":"Amami P","journal":"Journal of neurology, neurosurgery, and psychiatry","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Observational Study"],"keywords":["Surgery","Parkinson's Disease","Behavioural Disorder"],"is_oa":false,"oa_url":null,"cited_by_count":73,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Prospective observational cohort (N=56) with 3‑year follow‑up after STN DBS.","sample_n":56,"sample_text":"56 patients; 13 had ICBs at baseline, 43 without ICBs.","population":"Patients with Parkinson’s disease undergoing subthalamic nucleus deep‑brain stimulation.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In 56 Parkinson’s patients treated with deep‑brain stimulation, impulse‑control problems (including hypersexuality) largely disappeared after three years, especially as dopamine‑agonist medication was reduced; a few new, temporary problems appeared.","clinical_takeaway":"STN DBS combined with lower dopamine‑agonist doses may reduce hypersexuality and other impulse‑control issues in Parkinson’s disease.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Longitudinal 3‑year follow‑up","Direct clinical assessment of ICBs","Documented medication changes"],"limitations":["Small sample, no control group","Unclear whether ICB assessments used validated scales","Potential confounders (e.g., mood, relationship status) not accounted for"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":96,"citing_publications":90,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/jnnp-2013-307214"}},{"id":8033,"doi":"10.4103/0019-5545.140654","pmid":"25316944","pmcid":"PMC4181188","title":"Sleeping beauty: kleine-levin syndrome","authors":"Mudgal S, Jiloha RC, Kandpal M, Das A.","first_author":"Mudgal S","journal":"Indian journal of psychiatry","year":2014,"pub_types":["Journal Article","case-report"],"keywords":["Armodafinil","Oxcarbamazepine","Postpartum Kleine–levin Syndrome","Rapid Cycling Kleine–levin Syndrome"],"is_oa":true,"oa_url":"https://doi.org/10.4103/0019-5545.140654","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"N=1 (case report)","population":"single patient with Kleine‑Levin syndrome","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"avoid","plain_summary":"A single patient with Kleine‑Levin syndrome, a rare sleep disorder, showed episodes of excessive sleep, mood changes, and increased sexual drive. The authors report improvement with armodafinil and oxcarbazepine, adding to clinical knowledge of this condition.","clinical_takeaway":"Evidence is anecdotal; the reported drugs may help some KLS patients but need systematic study before clinicians adopt them.","confidence":0.6,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed clinical description of a rare syndrome","Highlights therapeutic agents used (armodafinil, oxcarbazepine)","Raises awareness for psychiatrists"],"limitations":["Single case, no systematic data","No validated measures of hypersexuality or other symptoms","No control of confounding factors (e.g., mood, trauma)","No statistical analysis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0019-5545.140654"}},{"id":8034,"doi":"10.2147/ndt.s54423","pmid":"24971012","pmcid":"PMC4069151","title":"Amantadine and cognitive flexibility: decision making in Parkinson's patients with severe pathological gambling and other impulse control disorders","authors":"Cera N, Bifolchetti S, Martinotti G, Gambi F, Sepede G, Onofrj M, Di Giannantonio M, Thomas A.","first_author":"Cera N","journal":"Neuropsychiatric disease and treatment","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["emotion","Parkinson’s Disease","Executive Functions"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4069151","cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"cross-sectional","design_detail":"pre‑post comparison of three PD sub‑groups (PG, other ICD, controls) during amantadine add‑on therapy; no randomisation, small sample (N=33)","sample_n":33,"sample_text":"33 PD patients (10 PG, 9 ICD, 14 controls) selected from a larger cohort","population":"idiopathic Parkinson’s disease patients, selected from a cohort of 1,096; 10 with pathological gambling, 9 with other impulse‑control disorders, 14 without psychiatric disorder","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In Parkinson’s patients with pathological gambling, adding amantadine appeared to reduce risky decisions in a lab task, but the study was small, not randomised, and used limited behavioural measures.","clinical_takeaway":"Evidence that amantadine may curb gambling‑related decision‑making in PD is preliminary; clinicians should await larger, controlled trials.","confidence":0.3,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Focus on a clinically relevant impulse‑control disorder in PD","Use of established neuropsychological tasks (Stroop, reward‑risk task)"],"limitations":["Very small, non‑randomised sample","No correction for multiple testing, many unadjusted t‑tests","No measurement of key addiction or distress constructs"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/ndt.s54423"}},{"id":8035,"doi":"10.7196/samj.8409","pmid":"26301293","pmcid":null,"title":"Hypersexual disorder in general practice","authors":"Campbell MM, Stein DJ.","first_author":"Campbell MM","journal":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"http://www.samj.org.za/index.php/samj/article/download/8409/6004","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7196/samj.8409"}},{"id":8036,"doi":"10.1016/j.slsci.2014.09.001","pmid":"26483915","pmcid":"PMC4521662","title":"Kleine-Levin Syndrome: A case report","authors":"de Araújo Lima TF, da Silva Behrens NS, Lopes E, Pereira D, de Almeida Fonseca H, Cavalcanti PO, Pradella-Hallinan M, Castro J, Tufik S, Coelho FM.","first_author":"de Araújo Lima TF","journal":"Sleep science (Sao Paulo, Brazil)","year":2014,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Kleine–levin Syndrome","Sleep Obstructive Apnea Syndrome","Recurrent Hypersleepiness"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.slsci.2014.09.001","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with Kleine‑Levin Syndrome and comorbid obstructive sleep apnea; no comparison group","sample_n":1,"sample_text":"single case description","population":"adolescent male patient (single case)","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The report describes one teenager with Kleine‑Levin Syndrome, a rare sleep disorder that can include periods of excessive sleep, overeating, and heightened sexual urges, who also had obstructive sleep apnea. The authors discuss possible brain‑based causes but provide no new treatment evidence.","clinical_takeaway":"Kleine‑Levin Syndrome may co‑occur with sleep apnea; clinicians should assess sleep disorders when hypersexuality appears in adolescents.","confidence":0.85,"topic_tags":["sexual_function","neuroscience"],"strengths":["Provides rare clinical description of KLS with sleep apnea","Highlights hypothesized hypothalamic dysfunction"],"limitations":["Single case; no generalisable data","No systematic measurement of sexual behavior or distress","No control for confounding variables"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.slsci.2014.09.001"}},{"id":8037,"doi":"10.1093/brain/awu075","pmid":"24740987","pmcid":"PMC4032100","title":"Anatomical correlates of reward-seeking behaviours in behavioural variant frontotemporal dementia","authors":"Perry DC, Sturm VE, Seeley WW, Miller BL, Kramer JH, Rosen HJ.","first_author":"Perry DC","journal":"Brain : a journal of neurology","year":2014,"pub_types":["other","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Alcohol","Frontotemporal Dementia","Hypersexuality","Reward Processing","Overeating"],"is_oa":false,"oa_url":null,"cited_by_count":89,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional voxel-based morphometry correlating atrophy with a simple reward‑seeking score in 91 bvFTD patients","sample_n":91,"sample_text":"103 patients reviewed; 91 had imaging","population":"behavioural variant frontotemporal dementia patients (clinical sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In people with a type of frontotemporal dementia, brain shrinkage in right‑side reward areas was linked to more eating, alcohol/drug use, or sexual activity, suggesting that loss of these regions may heighten desire for primary rewards.","clinical_takeaway":"Brain atrophy in reward circuits may underlie increased food, substance, or sexual drives in bvFTD patients; treat behavioural changes accordingly.","confidence":0.7,"topic_tags":["neuroscience"],"strengths":["Large clinical neuroimaging sample for rare disease","Whole‑brain VBM analysis","Identifies specific subcortical structures linked to reward‑seeking"],"limitations":["Reward‑seeking construct created ad‑hoc, no validated scale","Cross‑sectional design cannot infer causality","No control for key behavioural or psychiatric confounds"],"rubric_version":"2.0","raw_total":23,"max_possible":60,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":6,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":12,"contrasting":1,"mentioning":117,"citing_publications":105,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/brain/awu075"}},{"id":8039,"doi":"10.1556/jba.3.2014.1.3","pmid":"25215211","pmcid":"PMC4117280","title":"Detecting associations between behavioral addictions and dopamine agonists in the Food & Drug Administration's Adverse Event database","authors":"Gendreau KE, Potenza MN.","first_author":"Gendreau KE","journal":"Journal of behavioral addictions","year":2014,"pub_types":["research-article","Journal Article"],"keywords":["Dopamine agonists","Parkinson’s Disease","Impulse Control Disorders","Behavioral Addictions","Pharmaco-vigilance","Faers"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4117280","cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Signal detection in FDA adverse event reporting system, cross‑sectional, non‑representative spontaneous reports.","sample_n":null,"sample_text":"FAERS reports for 2004 and 2007; exact number not stated in abstract.","population":"Individuals with Parkinson's disease reported to FAERS who were exposed to dopamine agonists.","country":"United States (FAERS is a US database)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined FDA adverse‑event reports to see if dopamine‑agonist drugs for Parkinson's disease are linked to behaviours like hypersexuality and gambling. Signals were found for gambling and, later, for hypersexuality, but not for binge eating or shopping. Media attention may have boosted reporting.","clinical_takeaway":"Current FDA report data do not confirm a strong safety signal for hypersexuality with dopamine agonists, but clinicians should remain vigilant.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large pharmacovigilance database allows detection of rare safety signals.","Considers impact of media publicity on reporting rates."],"limitations":["Spontaneous reports are subject to severe under‑ and over‑reporting bias.","No validated measures of the behavioral addictions; relies on coder interpretation of reports.","Cannot establish causality or prevalence."],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/jba.3.2014.1.3"}},{"id":8042,"doi":null,"pmid":"24672919","pmcid":null,"title":"[Hypersexualisation]","authors":"Gagné L.","first_author":"Gagné L.","journal":"Perspective infirmiere : revue officielle de l'Ordre des infirmieres et infirmiers du Quebec","year":2014,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":8043,"doi":"10.4103/0028-3886.132453","pmid":"24823757","pmcid":null,"title":"Hypersexuality after bilateral deep brain stimulation of the subthalamic nucleus for Parkinson's disease","authors":"Akakin A, Yilmaz B, Urgun K, Ekşi MS, Afşar N, Kiliç T.","first_author":"Akakin A","journal":"Neurology India","year":2014,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0028-3886.132453"}},{"id":8044,"doi":null,"pmid":"10910094","pmcid":null,"title":"Hypersexuality and hemiballism due to subthalamic infarction","authors":"Absher JR, Vogt BA, Clark DG, Flowers DL, Gorman DG, Keyes JW, Wood FB.","first_author":"Absher JR","journal":"Neuropsychiatry, neuropsychology, and behavioral neurology","year":2000,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-subject case report with PET comparison to 60 healthy controls","sample_n":1,"sample_text":"single patient; control group of 60 healthy subjects for imaging comparison","population":"70‑year‑old male with subthalamic infarction","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 70‑year‑old man developed persistent hypersexuality and involuntary movements after a small stroke in the subthalamic nucleus. PET scans showed altered brain metabolism in regions linked to sexual behavior and movement, suggesting a possible neural basis for his symptoms.","clinical_takeaway":"In rare stroke cases, hypersexuality may arise from metabolic changes in specific brain areas, but single‑case evidence cannot guide treatment.","confidence":0.7,"topic_tags":["neuroscience"],"strengths":["use of PET imaging with control cohort","detailed neuroanatomical discussion"],"limitations":["single-case design, no behavioral validation","unadjusted statistical thresholds","no measurement of relevant psychosocial confounds"],"rubric_version":"2.0","raw_total":15,"max_possible":60,"pct_score":25,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":5,"statistics":3,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":8045,"doi":null,"pmid":"24669386","pmcid":null,"title":"Atypical neuroleptics: compulsive disorders","authors":null,"first_author":null,"journal":"Prescrire international","year":2014,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative commentary summarizing reported adverse compulsive behaviours linked to atypical antipsychotics; no original data collection.","sample_n":null,"sample_text":"Not applicable – no empirical participants reported.","population":"Not applicable (no primary sample)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article notes that several atypical antipsychotics have been linked to compulsive behaviours such as gambling, hypersexuality, and binge eating, which may improve when the medication is stopped or changed.","clinical_takeaway":"Clinicians should monitor patients on atypical neuroleptics for emerging compulsive behaviours and consider dose reduction or switching drugs if they appear.","confidence":0.4,"topic_tags":["adolescents"],"strengths":["Highlights clinically relevant adverse effects of antipsychotics","Provides practical management suggestions"],"limitations":["No primary data or systematic review methodology","Lacks measurement detail and control for confounds","No quantitative analysis or effect size reporting"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":8046,"doi":"10.2147/nss.s44750","pmid":"24470783","pmcid":"PMC3901778","title":"Kleine-Levin syndrome: a review","authors":"Miglis MG, Guilleminault C.","first_author":"Miglis MG","journal":"Nature and science of sleep","year":2014,"pub_types":["review-article","Review","Journal Article"],"keywords":["Hypersomnia","Kleine-levin Syndrome","Hypersexuality","Adolescent Sleep Disorder"],"is_oa":true,"oa_url":"https://www.dovepress.com/getfile.php?fileID=18756","cited_by_count":36,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review-article; narrative synthesis without systematic methods or risk‑of‑bias assessment","sample_n":null,"sample_text":"N/A – review of existing literature","population":"none (review)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews Kleine‑Levin syndrome, a rare condition marked by recurring periods of extreme sleepiness, overeating, hypersexuality, and cognitive problems. It discusses clinical features, differential diagnosis, and recent imaging studies suggesting possible lasting brain changes.","clinical_takeaway":"Kleine‑Levin syndrome can involve troublesome hypersexuality; clinicians should monitor patients across episodes for persistent neurocognitive effects.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Provides a concise overview of Kleine‑Levin syndrome symptoms including hypersexuality","Summarises recent functional imaging findings"],"limitations":["Narrative review without systematic search or bias assessment","No original data; no quantitative synthesis","Does not address confounding variables relevant to hypersexuality"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":34,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/nss.s44750"}},{"id":8047,"doi":"10.1016/j.pediatrneurol.2014.01.003","pmid":"24630285","pmcid":null,"title":"Kleine-Levin syndrome: a case report and review of literature","authors":"Das S, Gupta R, Dhyani M, Raghuvanshi S.","first_author":"Das S","journal":"Pediatric neurology","year":2014,"pub_types":["Review","Journal Article","Case Reports"],"keywords":["Adolescent","lithium","Kleine-levin Syndrome","Recurrent Hypersomnia"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"one patient","population":"single adolescent male with Kleine‑Levin syndrome","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe a teenage boy with Kleine‑Levin syndrome who showed excessive sleepiness, hypersexual behaviour and hyperorality. Brain MRI was normal, sleep tests confirmed hypersomnia, and lithium treatment quickly reduced his symptoms.","clinical_takeaway":"Lithium may be effective for symptom relief in Kleine‑Levin syndrome, but evidence is limited to single case reports.","confidence":0.4,"topic_tags":["neuroscience","pornography","masturbation","sexual_function"],"strengths":["Detailed clinical description of a rare syndrome","Use of objective sleep measures (polysomnography, MSLT)","MRI to rule out structural lesions"],"limitations":["Single case – no generalisability","No control group or comparative data","No systematic assessment of psychiatric comorbidity"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pediatrneurol.2014.01.003"}},{"id":8048,"doi":"10.4103/1817-1745.131498","pmid":"24891916","pmcid":"PMC4040046","title":"Recurrent encephalopathy? No I'm a sleeping beauty!","authors":"Iqbal M, Prasad M, Ritey C.","first_author":"Iqbal M","journal":"Journal of pediatric neurosciences","year":2014,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Hypersomnia","Hyperphagia","Hypersomnolence","Kleine-levine Syndrome","Sleeping Beauty Syndrome"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4040046","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case description of a 14‑year‑old with recurrent episodes of hypersomnia, cognitive change and hypersexuality diagnosed as Kleine‑Levin syndrome","sample_n":1,"sample_text":"One 14‑year‑old boy","population":"adolescent male (single case)","country":"unspecified (likely India based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 14‑year‑old boy experienced two episodes of extreme sleepiness, odd behavior and intense sexual interest after a throat infection. Tests were normal except for a slowed EEG. The pattern matched Kleine‑Levin (sleeping‑beauty) syndrome, a rare condition that can include hypersexuality.","clinical_takeaway":"Kleine‑Levin syndrome can present with temporary hypersexuality; the behavior resolves as the episode ends.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed clinical description of a rare syndrome","Comprehensive medical work‑up ruling out other causes"],"limitations":["Single case, no generalisability","No validated measures of hypersexuality or distress","No control of confounding factors (e.g., moral, mental health)"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/1817-1745.131498"}},{"id":8051,"doi":"10.3233/jpd-130314","pmid":"24366927","pmcid":null,"title":"Motor phenotypes, medication and mood: further associations with impulsive behaviours in Parkinson's disease","authors":"Hurt CS, Alkufri F, Brown RG, Burn DJ, Hindle JV, Landau S, Wilson KC, Samuel M, PROMS-PD study group.","first_author":"Hurt CS","journal":"Journal of Parkinson's disease","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Anxiety","Motor","Fluctuations","Impulse Control","Parkinson"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Analysis of 500 Parkinson's disease patients; cross‑sectional cohort; convenience clinical sample","sample_n":500,"sample_text":"500 PD patients","population":"Patients with Parkinson's disease (N≈500), aged adult, mixed gender","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 500 people with Parkinson's disease, about 18% reported impulse‑control problems such as hypersexuality. These problems were linked to higher overall Parkinson medication doses, anxiety, motor fluctuations and younger age, but not to a specific motor phenotype.","clinical_takeaway":"Higher dopaminergic medication doses and anxiety may increase hypersexuality risk in Parkinson's patients; monitor and adjust treatment accordingly.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large sample (N≈500) for Parkinson's cohort","Considers multiple medication dose measures","Includes mood variables (anxiety, depression)","Clear reporting of ICB prevalence"],"limitations":["Cross‑sectional; cannot infer causality","Sexual behaviour measured with limited items, not validated scales","No assessment of masturbation or moral/religious factors","Potential selection bias from clinic‑based sample"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3233/jpd-130314"}},{"id":8052,"doi":null,"pmid":"24643831","pmcid":null,"title":"[Sexual disorders in the DSM-5]","authors":"Goethals K, Cosyns P.","first_author":"Goethals K","journal":"Tijdschrift voor psychiatrie","year":2014,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"dut","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review comparing DSM‑IV‑TR and DSM‑5 chapters; no empirical data.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how DSM‑5 reorganized sexual and gender‑related diagnoses, splitting them into separate chapters and redefining paraphilic disorders, but notes that hypersexuality is still not a distinct diagnosis.","clinical_takeaway":"Clinicians should be aware that hypersexuality is not classified as a separate disorder in DSM‑5, despite its clinical relevance.","confidence":0.8,"topic_tags":["sexual_function","gender","prevalence","neuroscience"],"strengths":["Clear summary of DSM‑5 revisions","Highlights omission of hypersexuality as a distinct category"],"limitations":["No empirical data or systematic methodology","Lacks critical appraisal of evidence supporting the changes"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":8053,"doi":"10.1111/cen.12375","pmid":"24274365","pmcid":"PMC4136510","title":"Impulse control disorders in patients with dopamine agonist-treated prolactinomas and nonfunctioning pituitary adenomas: a case-control study","authors":"Bancos I, Nannenga MR, Bostwick JM, Silber MH, Erickson D, Nippoldt TB.","first_author":"Bancos I","journal":"Clinical endocrinology","year":2014,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural","Observational Study"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":93,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case-control survey of patients with prolactinomas on dopamine agonists vs non‑functioning adenoma controls","sample_n":147,"sample_text":"77 patients from Group A and 70 patients from Group B responded to a postal questionnaire","population":"77 prolactinoma patients on dopamine agonists; 70 non‑functioning adenoma patients not on dopamine agonists; adults, both sexes","country":"unspecified (likely USA given NIH funding)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 147 pituitary‑tumour patients, men taking dopamine‑agonist drugs for prolactin‑producing adenomas were more likely to report hypersexual behaviour than similar patients not on those drugs. No link was found for women.","clinical_takeaway":"Clinicians should inform male prolactinoma patients on dopamine agonists about a possible increase in compulsive sexual behaviour.","confidence":0.7,"topic_tags":["sexual_function","csbd","neuroscience","treatment"],"strengths":["Focused case‑control comparison of DA‑treated vs non‑treated patients","Reasonable sample size for a rare endocrine condition","Includes both sexes and reports gender‑specific findings"],"limitations":["Questionnaire likely ad‑hoc; construct validity unclear","Cross‑sectional design prevents causal inference","Key psychosocial confounds (moral incongruence, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":9,"contrasting":1,"mentioning":100,"citing_publications":151,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/cen.12375"}},{"id":8054,"doi":"10.1016/j.psychres.2013.12.013","pmid":"24373553","pmcid":null,"title":"Anhedonia in Parkinson's disease patients with and without pathological gambling: a case-control study","authors":"Pettorruso M, Martinotti G, Fasano A, Loria G, Di Nicola M, De Risio L, Ricciardi L, Conte G, Janiri L, Bentivoglio AR.","first_author":"Pettorruso M","journal":"Psychiatry research","year":2014,"pub_types":["Journal Article"],"keywords":["Impulse Control Disorders","Reward System","Hedonic Tone","Dopamine Replacement Therapy","Addictive Behaviors","Frontal Function Impairment","Impulsivity Traits"],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-control","sample_n":154,"sample_text":"154 PD patients divided into three groups","population":"154 Parkinson's disease patients (11 with pathological gambling, 23 with other impulse control disorders, 120 without ICDs)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among Parkinson's patients, those with pathological gambling showed higher rates of anhedonia, impulsivity, and frontal‑brain dysfunction than patients with other impulse‑control disorders or no disorder.","clinical_takeaway":"In PD, anhedonia may signal higher risk for gambling problems; assess mood and impulsivity.","confidence":0.7,"topic_tags":["csbd","gender","religiosity","sexual_function"],"strengths":["Validated psychometric instruments used","Clear clinical characterization of groups","Relevant to addiction research"],"limitations":["Very small PG group (n=11)","No power analysis or effect‑size reporting","No control for key psychological confounds"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":26,"citing_publications":87,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psychres.2013.12.013"}},{"id":8056,"doi":"10.1016/j.ijlp.2013.11.015","pmid":"24289863","pmcid":null,"title":"When benefitting a patient increases the risk for harm for third persons - the case of treating pedophilic Parkinsonian patients with deep brain stimulation","authors":"Müller S, Walter H, Christen M.","first_author":"Müller S","journal":"International journal of law and psychiatry","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Parkinson's Disease","Deep brain stimulation","Child Sexual Abuse","Neuroethics","Pedophilia","Ethics Of Principles"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"theoretical ethics discussion without empirical data; no participants, no measurements","sample_n":null,"sample_text":"N/A – no empirical sample","population":"none","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The paper debates whether it is ethical to give deep‑brain stimulation to Parkinson’s patients who are pedophilic, because the treatment can increase risky sexual behavior. It argues that standard bioethics does not give a clear answer and suggests a three‑step risk‑management approach.","clinical_takeaway":"Clinicians should weigh potential benefits of DBS against increased risk of hypersexuality and use structured risk assessment and safeguards.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Clear ethical reasoning","Integrates clinical and ethical perspectives","Identifies gap in existing bioethical frameworks"],"limitations":["No empirical data to support claims","Relies on theoretical assumptions about DBS effects","Potential bias favoring clinical intervention"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijlp.2013.11.015"}},{"id":8057,"doi":"10.5664/jcsm.3176","pmid":"24235906","pmcid":"PMC3805810","title":"Kleine-levin syndrome treated with clarithromycin","authors":"Rezvanian E, Watson NF.","first_author":"Rezvanian E","journal":"Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine","year":2013,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Clarithromycin","Hypersomnia","Kleine-levin"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report of clarithromycin treatment for Kleine‑Levin syndrome","sample_n":1,"sample_text":"single case","population":"1 adult female with KLS","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A single patient with Kleine‑Levin syndrome showed temporary improvement in hypersomnia after taking the antibiotic clarithromycin, but the report cannot establish effectiveness for others.","clinical_takeaway":"Clarithromycin may offer short‑term benefit in KLS, but evidence is anecdotal; use with caution.","confidence":0.8,"topic_tags":["treatment","neuroscience","sexual_function"],"strengths":["Detailed clinical description","Novel therapeutic observation"],"limitations":["Single case limits generalizability","No control condition or statistical analysis","Potential placebo effect"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5664/jcsm.3176"}},{"id":8058,"doi":"10.1017/s1092852900012657","pmid":"18311099","pmcid":null,"title":"Neuropsychiatry of hypersexuality","authors":"Stein DJ, Hugo F, Oosthuizen P, Hawkridge SM, van Heerden B.","first_author":"Stein DJ","journal":"CNS spectrums","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of three hypersexuality patients with neuropsychiatric lesions; brief literature review","sample_n":3,"sample_text":"Three cases of hypersexual behavior presented","population":"patients with hypersexual behavior and identified brain lesions (n=3)","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes three patients with hypersexual behaviour linked to different brain lesions, suggesting that damage to frontal, striatal, or temporal‑limbic areas may contribute to dysregulated sexual activity.","clinical_takeaway":"Evidence is limited; clinicians should not infer specific brain causes of hypersexuality from this case series alone.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["Provides rare clinical neuroanatomical observations","Integrates case data with existing lesion literature"],"limitations":["Very small, non‑representative sample","No standardized assessment of hypersexuality","No statistical analysis or control for confounds"],"rubric_version":"2.0","raw_total":13,"max_possible":60,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":3,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1092852900012657"}},{"id":8059,"doi":"10.1177/154596830001400209","pmid":"15470827","pmcid":null,"title":"Pharmacologic treatment of cognitive deficits and hypersexuality due to \"shaken-baby syndrome\"","authors":"Schmidt JG, Schneider WN.","first_author":"Schmidt JG","journal":"Neurorehabilitation and neural repair","year":2000,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Single pediatric case report describing pharmacologic treatment.","sample_n":1,"sample_text":"N=1 (single case)","population":"9‑year‑old girl with cognitive deficits and hypersexuality after shaken‑baby syndrome","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 9‑year‑old girl with brain injury from shaken‑baby syndrome showed better attention and less hypersexual behaviour after adding amantadine and propranolol, but the report is limited to one child and lacks standardized measures.","clinical_takeaway":"Amantadine and propranolol may help cognition and hypersexuality in shaken‑baby syndrome, but evidence is anecdotal.","confidence":0.6,"topic_tags":["sexual_function","neuroscience","pornography","masturbation"],"strengths":["Detailed longitudinal observation of one patient","Reports response to two pharmacologic agents","Provides clinical narrative for a rare condition"],"limitations":["Single case; no control or comparator","No validated scales for hypersexuality or cognition","Cannot establish causality of drug effects"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/154596830001400209"}},{"id":8061,"doi":"10.1097/yco.0b013e328365a262","pmid":"24064413","pmcid":null,"title":"Sexuality and couple intimacy in dementia","authors":"Abdo CH.","first_author":"Abdo CH.","journal":"Current opinion in psychiatry","year":2013,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article without systematic methods or meta‑analysis","sample_n":null,"sample_text":"N/A – narrative review","population":"older adults with dementia and their partners (no primary data)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises how dementia can affect sexual intimacy, describing different types of inappropriate sexual behaviors, their possible brain bases, and noting limited guidance on treatment.","clinical_takeaway":"Clinicians should recognise that dementia may alter sexual intimacy and consider individualized, non‑pharmacological support for couples.","confidence":0.7,"topic_tags":["sexual_function","relationships","neuroscience"],"strengths":["Broad overview of intimacy issues in dementia","Integrates neurobiological hypotheses"],"limitations":["No systematic methodology or risk‑of‑bias assessment","No primary empirical data","Lacks quantitative synthesis"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/yco.0b013e328365a262"}},{"id":8062,"doi":"10.4088/pcc.13alz01595","pmid":"24511437","pmcid":"PMC3907317","title":"Hypersexuality in dementia: a case presentation with discussion","authors":"Burke AD, Yaari R, Tariot PN, Fleisher AS, Hall GR, Brand H.","first_author":"Burke AD","journal":"The primary care companion for CNS disorders","year":2013,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/pcc.13alz01595"}},{"id":8064,"doi":"10.1007/s11910-013-0386-8","pmid":"23963609","pmcid":"PMC3779310","title":"The functional anatomy of impulse control disorders","authors":"Probst CC, van Eimeren T.","first_author":"Probst CC","journal":"Current neurology and neuroscience reports","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","review-article","Review","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s11910-013-0386-8.pdf","cited_by_count":60,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of impulse‑control and behavioral addictions, no original empirical data","sample_n":null,"sample_text":"Not applicable – review article","population":"humans (general and Parkinson’s disease populations) – review focus","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews impulse‑control disorders, including hypersexuality, and argues that they share brain mechanisms with substance addictions, especially dopamine‑driven reward pathways.","clinical_takeaway":"Consider that hypersexuality may involve similar neural circuitry as other addictions, but evidence remains largely theoretical.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation","csbd"],"strengths":["Broad overview of neurobiological models","Integrates genetics, imaging, and behavioral data","Highlights dopamine’s role across disorders"],"limitations":["Narrative, not systematic review","No original data or meta‑analytic synthesis","Lacks critical appraisal of primary studies"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":60,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11910-013-0386-8"}},{"id":8065,"doi":"10.1097/jcp.0b013e3182979830","pmid":"23857310","pmcid":null,"title":"A single-center, cross-sectional prevalence study of impulse control disorders in Parkinson disease: association with dopaminergic drugs","authors":"Poletti M, Logi C, Lucetti C, Del Dotto P, Baldacci F, Vergallo A, Ulivi M, Del Sarto S, Rossi G, Ceravolo R, Bonuccelli U.","first_author":"Poletti M","journal":"Journal of clinical psychopharmacology","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":66,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"single-center cross-sectional prevalence study of 805 Parkinson’s disease patients","sample_n":805,"sample_text":"805 PD patients (593 cognitively preserved, 212 demented)","population":"Parkinson’s disease patients (N=805) from an Italian movement‑disorder clinic","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 805 Parkinson’s patients, about 8 % had impulse‑control disorders, with gambling and hypersexuality most common. Use of dopamine agonists and levodopa, male sex, and younger age raised the odds of these disorders.","clinical_takeaway":"Clinicians should monitor PD patients on dopaminergic drugs—especially younger men—for hypersexuality and other impulse‑control problems.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑center PD study","Use of a disease‑specific, validated ICD questionnaire","Multivariate logistic regression with odds ratios and confidence intervals"],"limitations":["Cross‑sectional design cannot establish causality","No assessment of moral incongruence, masturbation frequency, or relationship factors","Potential selection bias from single clinic"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":6,"contrasting":2,"mentioning":85,"citing_publications":94,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/jcp.0b013e3182979830"}},{"id":8066,"doi":"10.1016/j.eururo.2013.07.019","pmid":"23998503","pmcid":null,"title":"Re: Report of findings in a DSM-5 field trial for hypersexual disorder","authors":"Hartmann UH.","first_author":"Hartmann UH.","journal":"European urology","year":2013,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.eururo.2013.07.019"}},{"id":8067,"doi":"10.1007/s00115-013-3858-9","pmid":"23942582","pmcid":null,"title":"[The Kleine-Levin syndrome: new aspects of a rare disease]","authors":"Mayer G.","first_author":"Mayer G.","journal":"Der Nervenarzt","year":2013,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"none (review article)","population":"patients with Kleine‑Levin syndrome (rare hypersomnia disorder)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The review describes Kleine‑Levin syndrome, a rare condition causing recurrent episodes of excessive sleep, overeating and, in some cases, increased sexual behavior. It discusses possible triggers, brain imaging changes, and treatment options like stimulants and lithium.","clinical_takeaway":"KLS is a rare, under‑diagnosed cause of recurrent hypersomnia; consider it in young patients with episodic sleep excess.","confidence":0.8,"topic_tags":["neuroscience"],"strengths":["Comprehensive overview of a rare disorder","Integrates neuroimaging findings","Summarises therapeutic evidence"],"limitations":["No new empirical data","Lacks systematic review methodology","Not specific to pornography or CSBD"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00115-013-3858-9"}},{"id":8068,"doi":"10.3928/00989134-20130916-05","pmid":"24066786","pmcid":null,"title":"Influence of cognitive decline on sexuality in individuals with dementia and their caregivers","authors":"Robinson KM, Davis SJ.","first_author":"Robinson KM","journal":"Journal of gerontological nursing","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative discussion without original empirical data; no sample reported.","sample_n":null,"sample_text":"No empirical sample; article is a narrative discussion.","population":"Individuals with dementia and their caregivers (no specific sample described)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that people with dementia often retain sexual desire and may even show inappropriate or overly active sexual behavior, challenging the myth that they become asexual.","clinical_takeaway":"Clinicians should acknowledge and discuss sexual needs of dementia patients and caregivers rather than assume loss of interest.","confidence":0.9,"topic_tags":["sexual_function","csbd"],"strengths":["Highlights an under‑researched topic (sexuality in dementia).","Integrates clinical observations with existing literature."],"limitations":["No original data; conclusions are speculative.","Lacks systematic methodology or risk‑of‑bias assessment.","No measurement of confounding factors (e.g., mental health, relationship context)."],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3928/00989134-20130916-05"}},{"id":8070,"doi":"10.1016/j.jocn.2013.04.021","pmid":"24055209","pmcid":null,"title":"Rasagiline induced hypersexuality in Parkinson's disease","authors":"Reyes D, Kurako K, Galvez-Jimenez N.","first_author":"Reyes D","journal":"Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia","year":2014,"pub_types":["Journal Article","Case Reports"],"keywords":["Parkinson’s Disease","Rasagiline","Impulse Control Disorders","Hypersexuality"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single Parkinson's patient developing hypersexuality after rasagiline","sample_n":1,"sample_text":"single patient","population":"male middle‑aged patient with Parkinson’s disease, treated with rasagiline","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A man with Parkinson’s disease began showing hypersexual behavior after starting the medication rasagiline, suggesting the drug might trigger impulse‑control problems.","clinical_takeaway":"Clinicians should monitor for emerging hypersexuality when prescribing rasagiline to PD patients.","confidence":0.3,"topic_tags":["sexual_function","neuroscience","pornography","masturbation"],"strengths":["high clinical relevance to PD‑related impulse control disorders","identifies a potential adverse effect of MAO‑B inhibitor"],"limitations":["single‑case design, no control group","no standardized measurement of hypersexuality or related constructs","confounding variables (e.g., depression, medication dosage) not reported"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jocn.2013.04.021"}},{"id":8071,"doi":"10.1016/j.parkreldis.2013.09.006","pmid":"24090948","pmcid":null,"title":"Impulsive and compulsive behaviors among Danish patients with Parkinson's disease: prevalence, depression, and personality","authors":"Callesen MB, Weintraub D, Damholdt MF, Møller A.","first_author":"Callesen MB","journal":"Parkinsonism & related disorders","year":2014,"pub_types":["Journal Article"],"keywords":["Personality","Depression","Parkinson's Disease","Impulse Control Disorders"],"is_oa":false,"oa_url":null,"cited_by_count":76,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large registry-based cross‑sectional prevalence study of 490 Danish Parkinson’s patients","sample_n":490,"sample_text":"490 patients identified through the National Danish Patient Registry","population":"Patients with Parkinson’s disease (median age not reported)","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 490 Danish patients with Parkinson’s disease, about 36 % reported having experienced impulsive or compulsive behaviors such as gambling, hypersexuality, shopping or binge eating at some point, with younger age, higher medication doses, more depression, and certain personality traits linked to higher risk.","clinical_takeaway":"In Parkinson’s patients, higher dopaminergic dose and depressive symptoms signal greater risk for impulsive/compulsive (including hypersexual) behaviours.","confidence":0.92,"topic_tags":["pornography","masturbation","sexual_function","csbd"],"strengths":["Large, national‑registry sample","Validated questionnaires for behaviors, depression, and personality","Clear prevalence estimates and clinical correlates"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of sexual‑specific confounds (masturbation, moral incongruence, relationship factors)","No neurobiological or imaging data"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":18,"contrasting":6,"mentioning":109,"citing_publications":112,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2013.09.006"}},{"id":8076,"doi":"10.1097/wnf.0b013e31829fc165","pmid":"24045609","pmcid":null,"title":"Impulse control disorder in a patient on long-term treatment with bromocriptine for a macroprolactinoma","authors":"Thondam SK, Alusi S, O'Driscoll K, Gilkes CE, Cuthbertson DJ, Daousi C.","first_author":"Thondam SK","journal":"Clinical neuropharmacology","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report describing pathological gambling under bromocriptine for macroprolactinoma","sample_n":1,"sample_text":"1 patient","population":"young adult female with macroprolactinoma on long‑term bromocriptine","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A woman receiving bromocriptine for a large prolactinoma developed pathological gambling, an impulse‑control disorder also seen with dopamine‑activating drugs. The report warns clinicians to monitor such behaviours.","clinical_takeaway":"Monitor patients on long‑term dopamine agonists for impulse‑control problems, including hypersexual or gambling behaviours.","confidence":0.8,"topic_tags":["sexual_function","moral_incongruence","masturbation","pornography"],"strengths":["Highlights rare side‑effect of dopamine agonist in prolactinoma treatment","Adds to scant literature on ICDs outside Parkinson’s disease"],"limitations":["Single case; no systematic assessment or validated scales","No control for confounding factors (moral attitudes, mental health, etc.)","Cannot establish prevalence or causality"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":2,"contrasting":0,"mentioning":28,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/wnf.0b013e31829fc165"}},{"id":8077,"doi":"10.1192/bjp.203.3.233","pmid":"23999483","pmcid":null,"title":"Risperidone-induced hypersexuality","authors":"Davidson CK, Johnson T, Jansen K.","first_author":"Davidson CK","journal":"The British journal of psychiatry : the journal of mental science","year":2013,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/bjp.203.3.233"}},{"id":8082,"doi":"10.1111/j.1532-5415.1999.tb04583.x","pmid":"9988296","pmcid":null,"title":"Pharmacologic treatment of hypersexuality and paraphilias in nursing home residents","authors":"Levitsky AM, Owens NJ.","first_author":"Levitsky AM","journal":"Journal of the American Geriatrics Society","year":1999,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review of case reports (no new empirical data); narrative synthesis.","sample_n":null,"sample_text":"Case reports; numbers not specified in abstract.","population":"Older adults in nursing homes with hypersexual or paraphilic behavior (case‑report subjects).","country":"Not specified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"The authors review case reports of older adults in nursing homes who show hypersexual or paraphilic behavior, summarising how anti‑androgens, estrogens, GnRH analogues and serotonergic drugs have been used. They note the difficulty of managing these behaviors and call for controlled trials to determine efficacy.","clinical_takeaway":"Pharmacologic options exist but lack solid evidence; clinicians should weigh benefits against side‑effects and seek controlled data.","confidence":0.8,"topic_tags":["treatment","sexual_function","neuroscience","gender"],"strengths":["Covers a range of pharmacologic classes","Highlights need for controlled trials","Addresses a clinically challenging population"],"limitations":["Relies on isolated case reports","No systematic assessment of outcomes","No measurement of confounding factors (e.g., moral incongruence, mental health)","No quantitative synthesis"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":49,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1532-5415.1999.tb04583.x"}},{"id":8083,"doi":null,"pmid":"23888568","pmcid":null,"title":"[Impulse control behaviors associated with antiparkinsonian medications]","authors":"Depierreux-Lahaye F, Crémers J, Skawiniak E, Parmentier E, Delvaux V, Garraux G.","first_author":"Depierreux-Lahaye F","journal":"Revue medicale de Liege","year":2013,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary/no empirical data","sample_n":null,"sample_text":"No primary data reported; the article is a narrative discussion of impulse control behaviours associated with antiparkinsonian medication.","population":"patients with Parkinson's disease receiving dopaminergic therapy (implicit)","country":"Belgium (journal of Liège)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how dopamine‑boosting medicines used for Parkinson’s disease can sometimes trigger impulse‑control problems such as compulsive gambling, binge eating and hypersexuality, urging clinicians to warn patients and monitor for these issues.","clinical_takeaway":"Clinicians should inform patients on dopamine agonists about possible impulse‑control side effects, including hypersexuality, and watch for them during treatment.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Highlights clinical relevance of impulse control behaviors in Parkinson's disease","Summarizes range of behaviors (including hypersexuality) linked to dopamine agonists"],"limitations":["No original data; conclusions based on prior reports","Lacks systematic review methodology or risk‑of‑bias assessment","Does not measure or control key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":8084,"doi":"10.1080/13691058.2013.772240","pmid":"23484482","pmcid":null,"title":"Breaking the chains: examining the endorsement of modern Jezebel images and racial-ethnic esteem among African American women","authors":"Brown DL, White-Johnson RL, Griffin-Fennell FD.","first_author":"Brown DL","journal":"Culture, health & sexuality","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online self‑report questionnaire with 249 African American women; generational groups compared","sample_n":249,"sample_text":"Convenience online sample recruited via unspecified channels","population":"African American women, ages 18‑34 and 55+ (online convenience sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 249 African American women and found that younger women tend to endorse modern sexualised \"Jezebel\" images more than older women, and that higher racial‑ethnic self‑esteem is linked to lower endorsement of these images.","clinical_takeaway":"Clinicians should consider cultural stereotypes and racial‑ethnic self‑esteem when addressing sexual self‑concept in African American women.","confidence":0.6,"topic_tags":["sexual_function","csbd"],"strengths":["Relatively large (N≈250) sample for a preliminary study","Addresses an under‑researched cultural stereotype","Considers generational differences"],"limitations":["Self‑report scales likely unvalidated","Cross‑sectional, cannot infer causality","Convenience online sampling limits generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":41,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2013.772240"}},{"id":8086,"doi":"10.1080/026990598122269","pmid":"9724841","pmcid":null,"title":"Medroxyprogesterone in the treatment of aggressive hypersexual behavior in traumatic brain injury","authors":"Britton KR.","first_author":"Britton KR.","journal":"Brain injury","year":1998,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single male with severe traumatic brain injury presenting hypersexual behavior; treatment with medroxyprogesterone acetate reported as successful after other strategies failed; literature review included.","sample_n":1,"sample_text":"single case","population":"Adult male with severe TBI, hypersexual behavior","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A severely disabled man with traumatic brain injury displayed inappropriate sexual behavior. After other treatments failed, a single dose of medroxyprogesterone acetate reduced his hypersexuality, suggesting a possible pharmacologic option.","clinical_takeaway":"Medroxyprogesterone may help severe hypersexuality after TBI, but evidence is limited to one case.","confidence":0.7,"topic_tags":["sexual_function","treatment","csbd"],"strengths":["Detailed clinical description","Novel pharmacological approach","Integration with literature review"],"limitations":["Single case, no control","No validated measures of hypersexuality","No systematic assessment of confounds"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/026990598122269"}},{"id":8087,"doi":null,"pmid":"9704167","pmcid":null,"title":"Moclobemide-induced hypersexuality in patients with stroke and Parkinson's disease","authors":"Korpelainen JT, Hiltunen P, Myllylä VV.","first_author":"Korpelainen JT","journal":"Clinical neuropharmacology","year":1998,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of three patients (2 stroke, 1 Parkinson’s) describing reversible hypersexuality after moclobemide","sample_n":3,"sample_text":"three patients (two with stroke, one with Parkinson’s disease) described","population":"male adults with stroke or Parkinson’s disease, treated with moclobemide","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors report three patients (two stroke survivors, one with Parkinson’s) who developed increased sexual activity after taking moclobemide, an antidepressant. The behavior stopped when the drug was discontinued. No systematic measurement or control group was used.","clinical_takeaway":"Moclobemide may trigger hypersexuality in neurologically vulnerable patients; monitor sexual side‑effects and adjust treatment if needed.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","adolescents","csbd"],"strengths":["rare clinical observation","detailed case description"],"limitations":["no standardized measurement of hypersexuality","no control group or systematic assessment","cannot establish causality"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":8088,"doi":null,"pmid":"23994929","pmcid":null,"title":"[Impulsive-compulsive syndrome in Parkinson's disease]","authors":"Nikitina AV, Fedorova NV.","first_author":"Nikitina AV","journal":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","year":2013,"pub_types":["Comparative Study","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"rus","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 246 Parkinson patients; 55 identified with impulse control disorders (ICD) using unspecified questionnaire; quality‑of‑life ratings reported.","sample_n":246,"sample_text":"246 patients (55 with ICD)","population":"Parkinson disease patients on dopaminergic therapy, Russia","country":"Russia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 246 Parkinson patients on dopamine medication, 23% showed impulse‑control problems such as hypersexuality, gambling and binge eating; these issues were linked to poorer quality of life. The study used an unspecified questionnaire and did not control for factors like moral attitudes or mental health.","clinical_takeaway":"Clinicians should monitor for impulse‑control symptoms, including hypersexuality, in Parkinson patients receiving dopaminergic therapy.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function","neuroscience","csbd"],"strengths":["Large overall PD sample","Addresses clinically relevant ICDs","Reports quality‑of‑life impact"],"limitations":["ICD assessment method not described or validated","No control for key confounds (moral, mental health, etc.)","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":8089,"doi":null,"pmid":"24397147","pmcid":null,"title":"[Impulse control disorders in Parkinson's disease]","authors":"Joutsa J, Kaasinen V.","first_author":"Joutsa J","journal":"Duodecim; laaketieteellinen aikakauskirja","year":2013,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"fin","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review (narrative) without systematic methods","sample_n":null,"sample_text":"Not applicable – review article","population":"Patients with Parkinson's disease (no specific sample size reported)","country":"Finland (journal Duodecim; likely Finnish authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how up to one‑third of people with Parkinson’s disease develop impulse‑control problems, including hypersexuality, and notes that dopamine agonists increase this risk; stopping these drugs is recommended as first‑line treatment.","clinical_takeaway":"Consider reviewing dopamine agonist use in Parkinson’s patients reporting hypersexual or other impulsive behaviours.","confidence":0.7,"topic_tags":["sexual_function","csbd","neuroscience"],"strengths":["Provides overview of impulse control disorders in Parkinson's disease","Highlights role of dopaminergic medication"],"limitations":["Narrative review without systematic methodology","No empirical data or quantitative analysis","Does not address key confounds such as moral incongruence or mental health"],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":8090,"doi":"10.1521/pdps.2013.41.3.419","pmid":"24001164","pmcid":null,"title":"Is increased sexual behavior a symptom of bipolar disorder in children and adolescents?","authors":"Adelson S, Bell R, Graff A, Goldenberg D, Haase E, Downey JI, Friedman RC.","first_author":"Adelson S","journal":"Psychodynamic psychiatry","year":2013,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Review of existing literature; no new empirical data; discusses need for definition and control of confounds.","sample_n":null,"sample_text":"Not applicable – review article","population":"children and adolescents with bipolar disorder (theoretical focus)","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review whether children and teens with bipolar disorder show unusually high sexual activity. They find no clear evidence because definitions differ and many other factors (e.g., trauma, family stress) also raise sexual behavior. More rigorous, controlled studies are needed.","clinical_takeaway":"Clinicians should not rely on increased sexual behavior alone to diagnose bipolar disorder in youth.","confidence":0.6,"topic_tags":["sexual_function","moral_incongruence","adolescents"],"strengths":["Comprehensive discussion of methodological gaps","Identifies a range of potential confounding factors","Highlights need for standardized definition"],"limitations":["No original data; conclusions are speculative","Does not provide empirical test of hypothesis","Lacks systematic review methodology (e.g., PRISMA)"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1521/pdps.2013.41.3.419"}},{"id":8093,"doi":"10.1371/journal.pone.0051921","pmid":"23300580","pmcid":"PMC3530554","title":"Virtually naked: virtual environment reveals sex-dependent nature of skin disclosure","authors":"Lomanowska AM, Guitton MJ.","first_author":"Lomanowska AM","journal":"PloS one","year":2012,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0051921&type=printable","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"observational analysis of avatar clothing choices in Second Life (virtual world)","sample_n":null,"sample_text":"hundreds of avatars examined","population":"users of Second Life represented by 100s of avatars; likely self‑selected, not population‑based","country":"unspecified (online platform)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Using avatars in the virtual world Second Life, the authors found that female avatars tend to show more naked skin than male avatars, even when cultural norms would encourage modest dress. This suggests a sex‑related tendency to disclose skin that may also exist in real life.","clinical_takeaway":"None – the study does not provide evidence for clinical practice.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["large number of avatars analyzed","objective coding of visual skin coverage","attempt to isolate climatic/cultural constraints using a virtual world"],"limitations":["sample limited to Second Life users – not representative of general population","cross‑sectional, no causal inference possible","no assessment of offline behaviour or underlying motivations"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0051921"}},{"id":8095,"doi":"10.1007/s00115-012-3631-5","pmid":"22878676","pmcid":null,"title":"[Repetitive impulse-associated behavioral disorders in Parkinson's disease]","authors":"Katzenschlager R, Goerlich KS, van Eimeren T.","first_author":"Katzenschlager R","journal":"Der Nervenarzt","year":2012,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of impulse control and related behavioral disorders in Parkinson's disease, including hypersexuality, without systematic search or meta‑analysis.","sample_n":null,"sample_text":"Not applicable (review).","population":"Patients with Parkinson's disease (PD); no primary data collected.","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews impulse‑control problems in Parkinson's disease, noting that hypersexuality occurs in about 13‑14% of patients and is linked to dopamine‑agonist treatment and certain personality traits.","clinical_takeaway":"Clinicians should monitor PD patients on dopamine agonists for emerging hypersexuality and consider dose reduction if problematic behaviors develop.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Provides a concise overview of impulse‑control and hypersexuality issues in PD.","Identifies pharmacological risk factors (dopamine agonists).","Highlights gaps in evidence for management strategies."],"limitations":["Not a systematic review; no explicit search or bias assessment.","No primary data; cannot evaluate construct validity or confound control.","Lacks quantitative synthesis or effect‑size reporting."],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00115-012-3631-5"}},{"id":8097,"doi":"10.1212/cpj.0b013e318278be9b","pmid":"23634371","pmcid":"PMC3613210","title":"Impulse control disorders and compulsive behaviors associated with dopaminergic therapies in Parkinson disease","authors":"Weiss HD, Marsh L.","first_author":"Weiss HD","journal":"Neurology. Clinical practice","year":2012,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":60,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary/review; no original data, no empirical methods reported","sample_n":null,"sample_text":"not applicable","population":"patients with Parkinson disease receiving dopaminergic therapy (no sample size reported)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews how dopamine‑boosting medicines used for Parkinson’s disease can trigger impulse‑control problems such as gambling, compulsive spending, and hypersexuality, stressing the need for clinicians to recognize and manage these side effects.","clinical_takeaway":"Clinicians should monitor Parkinson patients on dopamine agonists for emerging impulse‑control disorders, especially hypersexuality, and consider adjusting therapy if they arise.","confidence":0.78,"topic_tags":["sexual_function","neuroscience","treatment"],"strengths":["Comprehensive overview of ICD in Parkinson disease","Highlights clinical relevance and management strategies"],"limitations":["No original data; reliance on existing literature","No systematic review methodology or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":70,"citing_publications":80,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1212/cpj.0b013e318278be9b"}},{"id":8098,"doi":"10.1016/j.seizure.2012.11.002","pmid":"23200413","pmcid":null,"title":"Hypersexuality in a patient with epilepsy during treatment of levetiracetam","authors":"Metin SZ, Ozmen M, Ozkara C, Ozmen E.","first_author":"Metin SZ","journal":"Seizure","year":2013,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.seizure.2012.11.002"}},{"id":8099,"doi":"10.1097/wnf.0b013e31826e6e6d","pmid":"23123689","pmcid":null,"title":"Prevalence and pharmacological factors associated with impulse-control disorder symptoms in patients with Parkinson disease","authors":"Perez-Lloret S, Rey MV, Fabre N, Ory F, Spampinato U, Brefel-Courbon C, Montastruc JL, Rascol O.","first_author":"Perez-Lloret S","journal":"Clinical neuropharmacology","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":80,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 203 Parkinson’s disease outpatients and 52 post‑stroke controls; prevalence of ICD symptoms assessed with a validated questionnaire; logistic regression used to identify pharmacological correlates.","sample_n":255,"sample_text":"203 PD patients, 52 post‑stroke controls","population":"Adults with Parkinson’s disease (mean age 67) and a comparison group of post‑stroke patients; community outpatient setting in France.","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a French outpatient sample, 25% of people with Parkinson’s disease reported impulse‑control problems such as hypersexuality, gambling, shopping or overeating, compared with none of the post‑stroke controls. Younger age and higher doses of dopamine‑activating drugs were linked to more symptoms.","clinical_takeaway":"Clinicians should monitor younger Parkinson’s patients on dopamine agonists for hypersexuality and other impulse‑control issues.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of a validated ICD questionnaire","Clear reporting of effect sizes with confidence intervals","Inclusion of a non‑PD comparison group"],"limitations":["Cross‑sectional design cannot infer causality","No measurement of key psychosocial confounds (moral incongruence, mental health, relationship factors)","Convenience outpatient sample; limited generalisability"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":3,"mentioning":105,"citing_publications":103,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/wnf.0b013e31826e6e6d"}},{"id":8100,"doi":"10.1159/000342023","pmid":"23128856","pmcid":null,"title":"Details of treatment-related difficulties in men with anti-N-methyl-D-aspartate receptor encephalitis","authors":"Sakamoto H, Hirano M, Samukawa M, Ueno S, Maekura S, Fujimura H, Kuwahara M, Hamada Y, Isono C, Tanaka K, Kusunoki S, Nakamura Y.","first_author":"Sakamoto H","journal":"European neurology","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case series of four men with anti‑NMDAR encephalitis; descriptive clinical data, no comparison group.","sample_n":9,"sample_text":"Four new cases plus five previously reported cases","population":"Men with anti‑NMDAR encephalitis (n≈9 total reported across this and prior case reports)","country":"Japan (authors affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe four men with anti‑NMDAR encephalitis who showed unusual problems such as blood clots, hippocampal damage, excessive sexual behaviour and joint contractures, plus a review of five earlier cases.","clinical_takeaway":"Hypersexuality can appear in anti‑NMDAR encephalitis, but evidence is limited to a few case reports.","confidence":0.4,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed clinical description of a rare male presentation","Inclusion of imaging findings (hippocampal involvement)"],"limitations":["Very small, non‑representative sample","No systematic measurement of sexual behaviour or distress","No control or comparison group"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000342023"}},{"id":8101,"doi":"10.1007/s11199-012-0231-6","pmid":"23467816","pmcid":"PMC3586322","title":"Selling Gender: Associations of Box Art Representation of Female Characters With Sales for Teen- and Mature-rated Video Games","authors":"Near CE.","first_author":"Near CE.","journal":"Sex roles","year":2013,"pub_types":["research-article","Journal Article"],"keywords":["Content analysis","Video Games","Media Effects","Gender Representations"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Content analysis of 399 video‑game box‑art cases (Teen or Mature ESRB ratings, 2005‑2010) with sales data; correlational regression models linking sexualized female depiction to sales.","sample_n":399,"sample_text":"399 box‑art cases","population":"U.S. video‑game releases (Teen/Mature); no participant data","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined 399 video‑game box covers and found that games with sexualized, non‑central female characters sold more, while having a central female character was linked to lower sales.","clinical_takeaway":"None – the findings pertain to media marketing, not clinical sexual health.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample of games covering several years","Objective sales data","Systematic content‑analysis coding"],"limitations":["Cross‑sectional; cannot infer causality","Content‑coding scheme not described as validated","No control for genre, marketing budget, or other sales drivers"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":46,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11199-012-0231-6"}},{"id":8103,"doi":null,"pmid":"23095655","pmcid":null,"title":"[Kleine-Levin syndrome is a diagnostic challenge]","authors":"Andersen B, Kawa B.","first_author":"Andersen B","journal":"Ugeskrift for laeger","year":2012,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"dan","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of a single adolescent with KLS and hypersexuality.","sample_n":1,"sample_text":"single case","population":"One 16‑year‑old male with ADHD, diagnosed with Kleine‑Levin syndrome","country":"Denmark (journal Ugeskrift for laeger, authors likely Danish)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 16‑year‑old boy with ADHD experienced episodes of extreme sleep, changed behavior, and increased sexual drive. After multiple medical evaluations, doctors diagnosed him with Kleine‑Levin syndrome, a rare condition whose cause is still unknown.","clinical_takeaway":"Kleine‑Levin syndrome can involve hypersexuality; consider it in atypical hypersomnia cases.","confidence":0.8,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed clinical description of a rare disorder","Highlights diagnostic difficulty"],"limitations":["Single case, no generalizability","No systematic assessment of sexual behavior or addiction constructs"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":8104,"doi":"10.1023/a:1024507922470","pmid":"9343636","pmcid":null,"title":"Hypersexual desire in males: an operational definition and clinical implications for males with paraphilias and paraphilia-related disorders","authors":"Kafka MP.","first_author":"Kafka MP.","journal":"Archives of sexual behavior","year":1997,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":100,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective assessment of total sexual outlet in outpatient males with paraphilias; no control group; convenience clinical sample.","sample_n":100,"sample_text":"Outpatient males with paraphilias (n=65) and paraphilia‑related disorders (n=35)","population":"Adult males (n=100) with paraphilic disorders, outpatient clinic","country":"USA (likely, not specified)","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study proposes that having seven or more orgasms per week for at least six months marks hypersexual desire in men with paraphilias, based on self‑reported sexual activity counts from 100 out‑patients.","clinical_takeaway":"Clinicians should be cautious using a simple orgasm count as a diagnostic cutoff; broader assessment of distress and function is needed.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large (for clinical) sample of men with paraphilic diagnoses","Provides empirical data on frequency of sexual activity","Attempts to operationalize hypersexual desire with concrete threshold"],"limitations":["No validated measure of hypersexuality; relies on single self‑report item","No separation of masturbation from other sexual behaviors","Lacks control for moral, mental‑health, relationship or trauma variables","Convenience clinical sample limits generalisability"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":32,"citing_publications":224,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1024507922470"}},{"id":8105,"doi":null,"pmid":"9684023","pmcid":null,"title":"[Hallucinations of supernumerary limbs, left hemineglect and hypersexuality in a case of right capsulo-lenticular hematoma]","authors":"Donnet A, Schmitt A, Poncet M, Graziani N, Grisoli F.","first_author":"Donnet A","journal":"Revue neurologique","year":1997,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report of hypersexuality following right capsulo‑lenticular hematoma","sample_n":1,"sample_text":"single case","population":"35‑year‑old male, post‑stroke","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 35‑year‑old man who suffered a right‑side brain bleed later reported a phantom extra limb, neglect of his left side, mood changes, and increased sexual activity.","clinical_takeaway":"Hypersexuality can occasionally appear after specific brain injuries, but a single case does not establish a treatment guideline.","confidence":0.4,"topic_tags":["neuroscience"],"strengths":["detailed neurological description","long‑term follow‑up (3 years)"],"limitations":["single case, no systematic assessment","no validated measures of hypersexuality or distress","no control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":8106,"doi":"10.1111/j.1556-4029.2012.02248.x","pmid":"22924995","pmcid":null,"title":"Hippocampal agenesis in an individual who engaged in violent criminal behaviors after discontinuing carbamazepine and paroxetine treatment","authors":"Hanada H, Akiyoshi J, Kanehisa M, Ishitobi Y, Tsuru J, Tanaka Y, Shimomura T, Kawano Y.","first_author":"Hanada H","journal":"Journal of forensic sciences","year":2013,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-case observational report with pre‑ and post‑medication MRI/fMRI","sample_n":1,"sample_text":"1 participant (case report)","population":"one 23‑year‑old male with hippocampal agenesis and history of hypersexual behavior","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","fmri_reverse_inference","underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"avoid","plain_summary":"A 23‑year‑old man with a missing right hippocampus stopped his psychiatric meds for three days and his prior sexual crimes reappeared. Brain scans showed increased thalamic activity when viewing a swimsuit image, which the authors suggest may have triggered the behavior.","clinical_takeaway":"A single case cannot establish that medication withdrawal causes hypersexuality via thalamic changes; clinicians should not generalize this finding.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","religiosity","moral_incongruence"],"strengths":["Unique neuroimaging data in a rare clinical case","Longitudinal observation of behavior before/after medication change"],"limitations":["N=1, no control group","No validated measures of hypersexuality or addiction","Claims of causality and neural mechanisms are speculative"],"rubric_version":"2.0","raw_total":8,"max_possible":60,"pct_score":13,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":3,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1556-4029.2012.02248.x"}},{"id":8107,"doi":"10.1016/j.neurol.2012.06.014","pmid":"22921247","pmcid":null,"title":"Addictive behaviors and Parkinson's disease","authors":"Witjas T, Eusebio A, Fluchère F, Azulay JP.","first_author":"Witjas T","journal":"Revue neurologique","year":2012,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or empirical data.","sample_n":null,"sample_text":"Not applicable – review article","population":"Patients with Parkinson's disease","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review discusses how Parkinson’s disease treatments can trigger compulsive behaviors such as gambling, hypersexuality, and binge eating, linking these to dopamine‑related reward system changes. It stresses the importance of recognizing these problems and suggests treatment tweaks like reducing dopaminergic medication.","clinical_takeaway":"Clinicians should monitor Parkinson’s patients for emerging compulsive or hypersexual behaviors and consider medication adjustments.","confidence":0.4,"topic_tags":["csbd","sexual_function","neuroscience"],"strengths":["Broad overview of dopamine‑related compulsive behaviors in Parkinson’s disease","Integrates clinical observations with neurobiological models","Highlights need for clinical awareness"],"limitations":["No systematic methodology or risk‑of‑bias assessment","Lacks empirical data; conclusions based on limited case reports","No quantitative synthesis or statistical analysis"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neurol.2012.06.014"}},{"id":8109,"doi":"10.1016/j.parkreldis.2012.05.006","pmid":"22682973","pmcid":null,"title":"The unrelated communication interlude (UCI)--an automatic behavior phenomenon in Parkinson's disease","authors":"Fusegi K, Hattori N, Mizuno Y, Mori H.","first_author":"Fusegi K","journal":"Parkinsonism & related disorders","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 8 Parkinson's patients reporting a novel behavior (UCI); no control group; descriptive statistics only","sample_n":8,"sample_text":"Eight patients with Parkinson's disease","population":"Patients with Parkinson's disease (all male, some with impulse control disorders)","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers described a brief, involuntary speech or writing behavior in eight men with Parkinson's disease that seemed unrelated to the conversation. Some also had impulse‑control problems like hypersexuality. The authors suggest it may be linked to daytime sleepiness.","clinical_takeaway":"No direct clinical guidance; the phenomenon is newly described and not linked to treatment decisions.","confidence":0.8,"topic_tags":["neuroscience","pornography","masturbation","sexual_function"],"strengths":["Novel clinical observation","Clear definition of new phenomenon (UCI)","Use of standard neuropsychological tests"],"limitations":["Very small, non-representative sample","No control group or comparison","Descriptive only, no statistical testing of associations"],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2012.05.006"}},{"id":8110,"doi":"10.4172/2155-6113.s1-008","pmid":"24443705","pmcid":"PMC3891882","title":"Image versus Health: The Role of Perceptions of Masculinity on Sexual Risk Behaviors among HIV-Positive African American Men who have Sex with Men and Women","authors":"Kisler KA, Williams JK.","first_author":"Kisler KA","journal":"Journal of AIDS & clinical research","year":2012,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3891882","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Focus groups with 16 HIV‑positive African American MSMW; consensual qualitative research and constant‑comparison analysis.","sample_n":16,"sample_text":"Small convenience sample recruited from clinical settings; not nationally representative.","population":"African American men who have sex with men and women, HIV‑positive, history of unprotected sex and childhood sexual abuse (n=16, mean age 40.5).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In focus groups with 16 HIV‑positive African American men who have sex with men and women, researchers found that ideas of traditional masculinity—especially hyper‑sexual posturing—were linked to risky sexual behaviour and were shaped by early sexual abuse experiences.","clinical_takeaway":"Clinicians should consider how masculinity norms and trauma histories may drive high‑risk sex among African American MSMW and address these factors in counseling.","confidence":0.6,"topic_tags":["masturbation","pornography","sexual_function"],"strengths":["Provides in‑depth, culturally specific insight into masculinity constructs","Uses systematic qualitative methodology (consensual qualitative research)","Highlights role of childhood sexual abuse"],"limitations":["Very small, non‑representative sample (n=16)","No quantitative measurement of key constructs; reliance on self‑report narratives","Limited control for confounding factors such as mental health or partner dynamics"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":3,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4172/2155-6113.s1-008"}},{"id":8111,"doi":"10.1016/j.rpsm.2012.03.003","pmid":"22854616","pmcid":null,"title":"[Primary hypersexuality: nosological status, pathogenesis, and treatment]","authors":"Frías Ibáñez A, Vázquez Costa M.","first_author":"Frías Ibáñez A","journal":"Revista de psiquiatria y salud mental","year":2012,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"spa","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.rpsm.2012.03.003"}},{"id":8113,"doi":"10.1155/2012/603631","pmid":"22567537","pmcid":"PMC3328150","title":"Dopamine agonists and pathologic behaviors","authors":"Kelley BJ, Duker AP, Chiu P.","first_author":"Kelley BJ","journal":"Parkinson's disease","year":2012,"pub_types":["review-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"http://downloads.hindawi.com/journals/pd/2012/603631.pdf","cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review-article","sample_n":null,"sample_text":"Not applicable – narrative review of published cases and studies","population":"patients with Parkinson's disease treated with dopamine agonists","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors review how dopamine‑targeting drugs used for Parkinson's disease can trigger impulsive side‑effects such as excessive sexual activity, gambling, and other compulsive behaviours, likely because these drugs bind strongly to D3 receptors in brain reward areas.","clinical_takeaway":"Clinicians should monitor patients on dopamine agonists for emerging impulsive sexual or gambling behaviours and consider medication adjustment if such problems arise.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","treatment","csbd"],"strengths":["Integrates pharmacological and neurobiological literature","Highlights clinically relevant side‑effects of dopamine agonists"],"limitations":["No original data; relies on case reports and secondary sources","Lacks systematic review methodology and risk‑of‑bias assessment","Does not control for moral or psychosocial confounds in hypersexuality reports"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":36,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2012/603631"}},{"id":8114,"doi":"10.4088/pcc.11l01232","pmid":"22943020","pmcid":"PMC3425452","title":"Sertraline-induced hypersexuality in a patient taking bupropion","authors":"Das P, Rai A, Chopra A, Dewan V.","first_author":"Das P","journal":"The primary care companion for CNS disorders","year":2012,"pub_types":["letter","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":2,"contrasting":0,"mentioning":16,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/pcc.11l01232"}},{"id":8115,"doi":"10.14581/jer.12003","pmid":"24649454","pmcid":"PMC3952319","title":"Klüver-bucy syndrome with isolated bilateral hippocampal atrophy following status epilepticus","authors":"Park HK, Kim KJ, Moon HJ, Kim SJ, Yun CH, Park SH.","first_author":"Park HK","journal":"Journal of epilepsy research","year":2012,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Status Epilepticus","Hippocampal Atrophy","Klüver-bucy Syndrome"],"is_oa":true,"oa_url":"https://www.j-epilepsy.org/upload/er-2-1-10-3.pdf","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case report of a 31‑year‑old man developing Klüver‑Bucy syndrome after status epilepticus; MRI structural imaging described; no control group","sample_n":1,"sample_text":"N=1 (case report)","population":"31‑year‑old male, post‑status epilepticus, encephalitis of unknown etiology","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 31‑year‑old man developed Klüver‑Bucy syndrome with hypersexuality after status epilepticus; MRI showed only bilateral hippocampal shrinkage, suggesting a link between the limbic system and sexual behavior, but the evidence is from a single case.","clinical_takeaway":"One isolated case cannot establish that hippocampal damage causes hypersexuality; clinicians should interpret such neuro‑behavior links cautiously.","confidence":0.8,"topic_tags":["neuroscience"],"strengths":["Detailed neuroimaging description of rare isolated hippocampal atrophy","Clear clinical phenomenology of Klüver‑Bucy syndrome"],"limitations":["Single case; no control or comparative group","No validated scales for hypersexuality or other symptoms","Causal inference between atrophy and behavior is speculative"],"rubric_version":"2.0","raw_total":11,"max_possible":60,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":2,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.14581/jer.12003"}},{"id":8117,"doi":"10.1038/npp.2012.19","pmid":"22395731","pmcid":"PMC3358742","title":"Dopamine modulates reward system activity during subconscious processing of sexual stimuli","authors":"Oei NY, Rombouts SA, Soeter RP, van Gerven JM, Both S.","first_author":"Oei NY","journal":"Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":79,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized, double‑blind, placebo‑controlled drug challenge with fMRI during subliminal sexual stimulus presentation in 53 healthy young men.","sample_n":53,"sample_text":"Young healthy males (n=53) randomly assigned to levodopa, haloperidol, or placebo.","population":"young healthy male adults (n=53)","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 53 healthy men, taking a dopamine‑boosting drug increased brain activity in reward areas when they were shown brief, unconscious sexual images, while a dopamine blocker reduced this activity. The authors suggest this mechanism might underlie compulsive sexual behaviours.","clinical_takeaway":"No direct clinical implications; the study does not test pornography use or sexual addiction in patients.","confidence":0.8,"topic_tags":["neuroscience","sexual_function","religiosity","csbd"],"strengths":["Randomised, double‑blind drug manipulation","Use of fMRI to probe reward circuitry","Clear hypothesis about dopamine modulation"],"limitations":["No measurement of pornography use, masturbation or addiction constructs","Findings extrapolated to hypersexuality without clinical data","Limited sample (young healthy males) reduces generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":60,"pct_score":45,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":6,"statistics":6,"confounds":1,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":8,"contrasting":1,"mentioning":65,"citing_publications":110,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/npp.2012.19"}},{"id":8118,"doi":"10.1097/wnn.0b013e31824b4103","pmid":"22353727","pmcid":null,"title":"Comparison of personality characteristics in Parkinson disease patients with and without impulse control disorders and in healthy volunteers","authors":"Farnikova K, Obereigneru R, Kanovsky P, Prasko J.","first_author":"Farnikova K","journal":"Cognitive and behavioral neurology : official journal of the Society for Behavioral and Cognitive Neurology","year":2012,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control comparison of PD patients with/without ICD and healthy volunteers (N≈46 patients, unknown control size)","sample_n":46,"sample_text":"46 PD patients (13 with ICD); number of healthy volunteers not reported","population":"patients with Parkinson disease, some with impulse control disorders (hypersexuality, binge eating, dopamine dysregulation); healthy volunteers","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared personality profiles of Parkinson’s patients with and without impulse‑control disorders (including hypersexuality) using the MMPI‑2, finding more abnormal scores in those with disorders. Higher levodopa doses and longer disease duration were also linked to these disorders.","clinical_takeaway":"Personality testing (MMPI‑2) may help identify Parkinson’s patients at risk for impulse‑control problems like hypersexuality.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Uses validated personality inventory (MMPI‑2)","Includes clinical PD cohort with documented ICD status","Reports medication dose and disease duration"],"limitations":["Small sample, especially ICD subgroup (n=13)","No measurement of sexual behavior specifics (pornography, masturbation)","No control for moral or mental‑health variables","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/wnn.0b013e31824b4103"}},{"id":8119,"doi":"10.1002/mds.24941","pmid":"22649006","pmcid":null,"title":"Increased medial orbitofrontal [18F]fluorodopa uptake in Parkinsonian impulse control disorders","authors":"Joutsa J, Martikainen K, Niemelä S, Johansson J, Forsback S, Rinne JO, Kaasinen V.","first_author":"Joutsa J","journal":"Movement disorders : official journal of the Movement Disorder Society","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"case‑control PET study of 20 Parkinson’s patients (10 with impulse‑control disorders, 10 without)","sample_n":20,"sample_text":"10 patients with ICDs, 10 patients without ICDs","population":"Parkinson’s disease patients, adults, both sexes (mostly male), recruited from clinical settings","country":"Finland (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson’s patients, those who also had impulse‑control problems like gambling, hypersexuality or overeating showed about 35 % higher dopamine‑related activity in a frontal brain area compared with patients without these problems.","clinical_takeaway":"Higher medial orbitofrontal dopamine activity may signal vulnerability to impulse‑control issues in Parkinson’s patients on dopamine therapy.","confidence":0.7,"topic_tags":["neuroscience","pornography","sexual_function"],"strengths":["Use of PET to assess monoaminergic activity","Clinically defined ICD groups","Whole‑brain imaging with a specific ROI (medial OFC)"],"limitations":["Very small sample (N=20), low statistical power","No validated scale for ICD severity; reliance on clinical presence","Limited control of medication dose, disease severity, and other confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":5,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":45,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mds.24941"}},{"id":8120,"doi":"10.2174/157488612800492726","pmid":"22663960","pmcid":null,"title":"Impulsive and compulsive behaviors during dopamine replacement treatment in Parkinson's Disease and other disorders","authors":"Raja M, Bentivoglio AR.","first_author":"Raja M","journal":"Current drug safety","year":2012,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review (narrative) of impulsive/compulsive behaviors including hypersexuality in Parkinson's disease patients receiving dopamine therapy.","sample_n":null,"sample_text":"No primary sample; literature review.","population":"Patients with Parkinson's disease treated with dopamine agonists or L‑dopa (no primary data).","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how dopamine medicines for Parkinson's disease can trigger impulse control problems like gambling, hypersexuality, and compulsive shopping, stressing the need for clinicians to warn patients and consider treatment changes.","clinical_takeaway":"Clinicians should monitor Parkinson's patients on dopamine agonists for emerging impulsive or compulsive sexual behaviors and adjust therapy if needed.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Comprehensive overview of impulse control disorders linked to dopaminergic therapy.","Highlights clinical relevance and need for physician awareness."],"limitations":["No original data; relies on cited studies without systematic methodology.","Lacks quantitative synthesis or critical appraisal of evidence quality."],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":40,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2174/157488612800492726"}},{"id":8121,"doi":"10.1016/j.jocn.2011.08.020","pmid":"22285112","pmcid":null,"title":"Distribution of HLA-DQB1 alleles in patients with Kleine-Levin syndrome","authors":"Huang CJ, Liao HT, Yeh GC, Hung KL.","first_author":"Huang CJ","journal":"Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Genetic association study of 12 KLS patients; no clear control group reported; small sample size.","sample_n":12,"sample_text":"12 patients with KLS","population":"Taiwanese patients with Kleine‑Levin syndrome (n≈12).","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a small Taiwanese sample (12 people) with Kleine‑Levin syndrome, researchers found the HLA‑DQB1*0602 allele more often than expected, hinting at a possible immune‑related genetic risk factor.","clinical_takeaway":"Evidence is too limited to change practice; genetics of KLS remain uncertain.","confidence":0.8,"topic_tags":["gender"],"strengths":["Use of validated PCR‑SSP genotyping","Clear reporting of allele frequencies and odds ratio","Addresses a novel potential immunogenetic link"],"limitations":["Very small sample (n=12)","No matched control group described","Wide confidence interval crossing null","Interpretation suggests therapeutic implications beyond data"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":4,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jocn.2011.08.020"}},{"id":8122,"doi":"10.1016/j.sleep.2011.11.003","pmid":"22261244","pmcid":null,"title":"A case of PANDAS with Kleine-Levin type periodic hypersomnia","authors":"Das A, Radhakrishnan A.","first_author":"Das A","journal":"Sleep medicine","year":2012,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of a single pediatric patient with PANDAS and Kleine‑Levin syndrome; no control group, descriptive presentation.","sample_n":1,"sample_text":"Single patient case report","population":"11‑year‑old female child with rare neuropsychiatric syndrome","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe an 11‑year‑old girl who showed symptoms of both PANDAS and Kleine‑Levin syndrome, including episodes of excessive sleep, overeating, and occasional hypersexual behavior, and who improved with penicillin, suggesting a possible immune link.","clinical_takeaway":"No direct clinical guidance for pornography‑related issues; case underscores the need to consider autoimmune mechanisms in rare hypersomnia disorders.","confidence":0.9,"topic_tags":["pornography","masturbation","sexual_function","csbd"],"strengths":["Detailed clinical description of a rare comorbidity","Highlights potential therapeutic benefit of penicillin prophylaxis"],"limitations":["Single case; no generalizability","No systematic assessment of hypersexuality or related constructs","Lacks objective measures or control comparison"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sleep.2011.11.003"}},{"id":8125,"doi":"10.1016/s1353-8020(11)70026-8","pmid":"22166463","pmcid":null,"title":"Impulse control disorders in Parkinson's disease","authors":"Vilas D, Pont-Sunyer C, Tolosa E.","first_author":"Vilas D","journal":"Parkinsonism & related disorders","year":2012,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methodology","sample_n":null,"sample_text":"Not applicable (review)","population":"Parkinson's disease patients with impulse control disorders (including hypersexuality)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how impulse‑control disorders such as gambling, hypersexuality, shopping and eating appear more often in people with Parkinson’s disease, especially when they take dopamine agonist drugs.","clinical_takeaway":"Clinicians should monitor Parkinson’s patients on dopamine agonists for emerging compulsive sexual or other impulsive behaviors and adjust treatment as needed.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Provides overview of ICD prevalence in PD","Discusses treatment implications"],"limitations":["Narrative review lacking systematic search","No quantitative synthesis or quality appraisal","No primary data on sexual behavior specifics"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":1,"mentioning":45,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1353-8020(11)70026-8"}},{"id":8126,"doi":null,"pmid":"22893540","pmcid":null,"title":"[The Kleine-Levin syndrome and the treatment with methylphenidate]","authors":"Brouns SH, Schieveld J, Leue C.","first_author":"Brouns SH","journal":"Tijdschrift voor psychiatrie","year":2012,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"dut","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case report of a 17‑year‑old male with Kleine‑Levin syndrome; treatment with methylphenidate described","sample_n":1,"sample_text":"One patient","population":"adolescent male (N=1)","country":"Netherlands (inferred from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A teen with Kleine‑Levin syndrome, including episodes of excessive sleep, overeating, and hypersexual behavior, got better after taking methylphenidate, but it’s unclear if the drug caused improvement.","clinical_takeaway":"Methylphenidate may help symptoms of Kleine‑Levin syndrome, but evidence is limited to a single case.","confidence":0.5,"topic_tags":["sexual_function","neuroscience","treatment"],"strengths":["Detailed clinical description","Highlights potential benefit of methylphenidate"],"limitations":["Single case, no control group","No objective outcome measures","Cannot separate medication effect from natural remission"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":8127,"doi":null,"pmid":"23585461","pmcid":null,"title":"Paraphilic diagnoses in DSM-5","authors":"Krueger RB, Kaplan MS.","first_author":"Krueger RB","journal":"The Israel journal of psychiatry and related sciences","year":2012,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of DSM‑5 proposed changes to paraphilic diagnoses","sample_n":null,"sample_text":"null","population":"null","country":"null","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews proposed changes to the DSM‑5 chapter on paraphilic disorders, describing new diagnoses such as hypersexual disorder and updates to existing categories.","clinical_takeaway":"Clinicians should note that DSM‑5 reclassifies paraphilias and adds severity/remission measures, but the review offers no new empirical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive summary of DSM‑5 proposals","Cites multiple sources (PubMed, PsycInfo, DSM‑5.org)","Clearly outlines new diagnoses and specifiers"],"limitations":["Narrative, not systematic, review","Potential author bias acknowledged but not quantified","No empirical data or critical appraisal of evidence"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":8129,"doi":null,"pmid":"8741352","pmcid":null,"title":"[A case of Kennedy-Alter-Sung (KAS) syndrome presenting as hypersexuality and elevated serum CK: usefulness of genetic analysis]","authors":"Hokezu Y, Yanai S, Nagai M, Nagamatsu K, Yamamoto Y.","first_author":"Hokezu Y","journal":"Rinsho shinkeigaku = Clinical neurology","year":1996,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"jpn","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single patient with Kennedy‑Alter‑Sung syndrome presenting with hypersexuality; no control group","sample_n":1,"sample_text":"1 patient (case report)","population":"single middle‑aged male patient","country":"Japan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 45‑year‑old man with Kennedy‑Alter‑Sung syndrome showed unusually high sexual activity and very high blood creatine‑kinase. Genetic testing confirmed an expanded androgen‑receptor repeat. The report expands the known symptoms of this rare disorder.","clinical_takeaway":"Hypersexuality can be an atypical sign of Kennedy‑Alter‑Sung syndrome; consider genetic testing when unexplained.","confidence":0.4,"topic_tags":["sexual_function","gender","neuroscience"],"strengths":["Detailed clinical and genetic description","Highlights atypical hypersexuality presentation"],"limitations":["Single case, no generalisability","No validated measures of sexual behaviour or distress","No control or comparison group"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":8130,"doi":null,"pmid":"22799149","pmcid":null,"title":"[Narciso Taxón M.D. A case of hypersexuality]","authors":"Levín S, Matusevich D, Nemirovsky M, Otero S.","first_author":"Levín S","journal":"Vertex (Buenos Aires, Argentina)","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"spa","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":8131,"doi":"10.1111/j.1468-1331.2011.03571.x","pmid":"22040282","pmcid":null,"title":"Are there ethnic differences in impulsive/compulsive behaviors in Parkinson's disease?","authors":"Chiang HL, Huang YS, Chen ST, Wu YR.","first_author":"Chiang HL","journal":"European journal of neurology","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"consecutive PD outpatients screened for ICB; prevalence report","sample_n":278,"sample_text":"278 consecutive PD patients","population":"Patients with idiopathic Parkinson’s disease attending a Taiwanese outpatient clinic (N=278)","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a Taiwanese Parkinson’s clinic, 5.6% of patients had impulsive/compulsive behaviours such as gambling or hypersexuality, which is lower than reported rates in Caucasian cohorts. Ethnicity and cultural factors may influence these rates.","clinical_takeaway":"Hypersexuality in Parkinson’s patients appears less common in Taiwanese samples, but clinicians should still monitor for ICB regardless of ethnicity.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear diagnostic procedure for ICB","Consecutive clinic sample reduces selection bias within clinic","Explicit ethnic comparison"],"limitations":["Cross‑sectional design cannot infer causality","Small number of ICB cases limits power","No control for broader cultural or medication variables"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":52,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1468-1331.2011.03571.x"}},{"id":8132,"doi":"10.1016/j.parkreldis.2011.10.010","pmid":"22030321","pmcid":null,"title":"Transdermal rotigotine causes impulse control disorders in patients with restless legs syndrome","authors":"Schreglmann SR, Gantenbein AR, Eisele G, Baumann CR.","first_author":"Schreglmann SR","journal":"Parkinsonism & related disorders","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective case series (n=28) at a single university clinic; no control group; pre‑post ICD screening.","sample_n":28,"sample_text":"28 patients (17 women) assessed before and after rotigotine initiation.","population":"Adults with restless‑legs syndrome receiving transdermal rotigotine.","country":"Switzerland (implied by author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 28 patients with restless‑legs syndrome who started a skin patch delivering rotigotine, 6 (21%) developed impulse‑control problems, including hypersexuality. The authors suggest even low rotigotine doses can trigger such issues.","clinical_takeaway":"Clinicians should monitor for impulse‑control symptoms, including hypersexuality, when prescribing rotigotine.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Use of a validated ICD screening questionnaire (ZICD)","Pre‑treatment baseline assessment","First report of rotigotine‑related ICD in RLS"],"limitations":["Small retrospective case series, no control group","Limited statistical analysis; no effect sizes or correction","No measurement of key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":3,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":29,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2011.10.010"}},{"id":8133,"doi":"10.7748/nop.23.9.11.s4","pmid":"27741610","pmcid":null,"title":"Symptoms of Parkinson's disease","authors":null,"first_author":null,"journal":"Nursing older people","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://mts.intechopen.com/storage/books/436/authors_book/authors_book.pdf","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"observational study of 99 non‑demented Parkinson’s disease patients assessing impulse control disorders and quality of life","sample_n":99,"sample_text":"99 non‑demented PD patients; recruitment method not specified","population":"people with Parkinson’s disease (non‑demented)","country":"not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 99 people with Parkinson’s disease, those who experienced impulse‑control problems such as hypersexuality had lower quality of life and strained relationships, while apathy was common and linked to social withdrawal.","clinical_takeaway":"Monitor and treat impulse‑control symptoms, including hypersexuality, in Parkinson’s patients to improve quality of life.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relevant clinical sample (PD patients)","Highlights impact of impulse control disorders on quality of life"],"limitations":["Cross‑sectional, cannot infer causality","No validated scales or detailed measurement description","No control for key psychological or social confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7748/nop.23.9.11.s4"}},{"id":8135,"doi":"10.1186/1471-2377-11-117","pmid":"21955669","pmcid":"PMC3195705","title":"Frequency of impulse control behaviours associated with dopaminergic therapy in restless legs syndrome","authors":"Voon V, Schoerling A, Wenzel S, Ekanayake V, Reiff J, Trenkwalder C, Sixel-Döring F.","first_author":"Voon V","journal":"BMC neurology","year":2011,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3195705","cited_by_count":88,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire and interview of 140 RLS patients (clinical cohort) in Germany","sample_n":140,"sample_text":"140 RLS patients (clinical cohort) in Germany","population":"Adults with restless legs syndrome receiving dopaminergic therapy","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 140 German patients with restless‑legs syndrome, about 7% showed impulse‑control problems such as hypersexuality, gambling or binge eating, especially when taking higher doses of dopamine‑activating drugs.","clinical_takeaway":"Clinicians should monitor for compulsive sexual and other impulse‑control behaviours when prescribing dopaminergic agents for RLS.","confidence":0.8,"topic_tags":["sexual_function","other"],"strengths":["Use of validated ICB questionnaires","Psychiatric interview with stringent criteria","Clear association with dopaminergic dose"],"limitations":["Cross‑sectional design limits causal inference","No control for key confounds (moral stance, mental health, trauma)","Small number of ICB cases reduces precision"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":90,"citing_publications":132,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2377-11-117"}},{"id":8136,"doi":"10.1097/00019442-199524310-00011","pmid":"28530963","pmcid":null,"title":"Levodopa Dependence and Hypersexuality in an Older Parkinson's Disease Patient","authors":"Weinman E, Ruskin PE.","first_author":"Weinman E","journal":"The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry","year":1995,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single clinical case description of levodopa dependence linked to hypersexuality in an older Parkinson’s patient","sample_n":1,"sample_text":"one patient (case report)","population":"older adult with Parkinson’s disease (N=1)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"supports","citation_value":"background","plain_summary":"The authors describe one older Parkinson’s patient who became dependent on levodopa and developed uncontrollable, high‑risk sexual behavior, suggesting a link between dopaminergic medication and hypersexuality.","clinical_takeaway":"Clinicians should monitor for compulsive sexual behavior when prescribing dopaminergic drugs to Parkinson’s patients.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed clinical observation","Highlights potential levodopa‑induced behavioral side‑effects"],"limitations":["Single case; no systematic assessment","No validated measures of hypersexuality or addiction","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00019442-199524310-00011"}},{"id":8137,"doi":"10.1097/wnf.0b013e3182281b2f","pmid":"21738024","pmcid":null,"title":"Impulse control disorders associated with dopaminergic medication in patients with pituitary adenomas","authors":"Martinkova J, Trejbalova L, Sasikova M, Benetin J, Valkovic P.","first_author":"Martinkova J","journal":"Clinical neuropharmacology","year":2011,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":67,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of 20 consecutive pituitary adenoma patients on dopamine agonists, assessed with physician‑led structured interview for impulse control disorders including hypersexuality","sample_n":20,"sample_text":"Twenty consecutive patients","population":"adult patients with prolactin‑secreting pituitary adenomas receiving dopamine agonist therapy (cabergoline, bromocriptine, quinagolide)","country":"Slovakia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 20 patients with pituitary tumors taking dopamine‑boosting drugs, 2 (10%) showed impulse‑control problems, including gambling, compulsive eating, and excessive sexual behaviour. The authors suggest clinicians should screen for these issues.","clinical_takeaway":"Patients on dopamine agonists, even for non‑Parkinson conditions, may develop hypersexuality or other impulse‑control problems; routine screening is advisable.","confidence":0.8,"topic_tags":["sexual_function","masturbation"],"strengths":["focus on a clinically understudied population","uses physician‑conducted structured interview"],"limitations":["very small, non‑random sample","no validated ICD or hypersexuality scales","no control for key confounds (moral incongruence, masturbation, mental health, partnership, trauma)","descriptive case series, no statistical testing"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":2,"mentioning":74,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/wnf.0b013e3182281b2f"}},{"id":8138,"doi":"10.1037/a0023795","pmid":"21604834","pmcid":"PMC3144294","title":"The risky business of dopamine agonists in Parkinson disease and impulse control disorders","authors":"Claassen DO, van den Wildenberg WPM, Ridderinkhof KR, Jessup CK, Harrison MB, Wooten GF, Wylie SA.","first_author":"Claassen DO","journal":"Behavioral neuroscience","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":76,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subject (on/off dopamine agonist) and between‑group (ICD vs no‑ICD) laboratory task with 41 Parkinson’s patients using the Balloon Analogue Risk Task.","sample_n":41,"sample_text":"PD patients with active ICD symptoms (n=22) and PD controls (n=19).","population":"Patients with Parkinson’s disease, some with impulse‑control disorder symptoms (including hypersexuality).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson’s patients, dopamine‑agonist medication made those with impulse‑control problems (including hypersexuality) take more risks on a lab task, suggesting the drugs may heighten risk‑seeking behavior linked to these disorders.","clinical_takeaway":"Dopamine agonists can increase risk‑taking in Parkinson’s patients with impulse‑control symptoms, so clinicians should monitor hypersexual and other risky behaviours when prescribing these drugs.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","pornography","masturbation"],"strengths":["Validated behavioural risk‑taking task","Within‑subject medication manipulation","Clear comparison between ICD and non‑ICD patients"],"limitations":["Small sample, especially for between‑group analyses","No control for depression, anxiety, or other psychiatric comorbidities","Limited reporting of effect sizes and confidence intervals"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":8,"contrasting":1,"mentioning":84,"citing_publications":109,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/a0023795"}},{"id":8139,"doi":"10.1080/13691058.2011.586436","pmid":"21707300","pmcid":null,"title":"The cool, the bad, the ugly, and the powerful: identity struggles in schoolboy peer culture","authors":"Govender K.","first_author":"Govender K.","journal":"Culture, health & sexuality","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"ethnographic fieldwork, one South African high‑school, 58 grade‑10/11 boys, 1‑year participant observation","sample_n":58,"sample_text":"58 boys, grade 10–11, one high‑school","population":"adolescent males (South Africa, working‑class, school‑based)","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study follows 58 South African high‑school boys for a year, describing how they negotiate masculine identities through peer interactions, swinging between hyper‑sexual and more controlled, ‘responsible’ versions of manhood.","clinical_takeaway":"None – the findings are sociocultural and do not provide direct guidance for clinical practice.","confidence":0.6,"topic_tags":["gender","masturbation","adolescents","sexual_function"],"strengths":["In‑depth, longitudinal ethnographic immersion","Rich contextual understanding of gender identity processes","Highlights contradictions in adolescent masculinity"],"limitations":["Single‑site, small, non‑representative sample","No systematic measurement or quantitative analysis","Findings not generalisable to other cultures or settings"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2011.586436"}},{"id":8140,"doi":"10.1016/j.jns.2011.05.044","pmid":"21683375","pmcid":null,"title":"Impulsive and compulsive behaviors in Parkinson's disease: a one-year follow-up study","authors":"Ávila A, Cardona X, Martín-Baranera M, Bello J, Sastre F.","first_author":"Ávila A","journal":"Journal of the neurological sciences","year":2011,"pub_types":["Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Observational 1‑year follow‑up of 25 Parkinson’s patients with impulsive‑compulsive behaviors; no control group.","sample_n":25,"sample_text":"25 PD patients","population":"Parkinson’s disease patients with ICBs (n=25)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 25 Parkinson’s patients with impulsive or compulsive behaviors, reducing dopamine‑agonist medication often improved gambling, sexual, or shopping problems, but had little effect on punding.","clinical_takeaway":"Adjusting dopamine agonists may lessen some impulsive problems in Parkinson’s, but punding may need other strategies.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Longitudinal follow‑up","Distinguishes ICDs from punding","Examines medication changes"],"limitations":["Very small sample (n=25)","No control/comparator group","Unclear validation of ICB measures","Limited statistical reporting"],"rubric_version":"2.0","raw_total":21,"max_possible":60,"pct_score":35,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":3,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":47,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jns.2011.05.044"}},{"id":8141,"doi":"10.1016/j.lpm.2011.05.003","pmid":"21658900","pmcid":null,"title":"Poppers dependence: the mask behind hypersexuality","authors":"Karila L, Lafaye G, Reynaud M.","first_author":"Karila L","journal":"Presse medicale (Paris, France : 1983)","year":2011,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.lpm.2011.05.003"}},{"id":8142,"doi":"10.1007/s10508-011-9788-3","pmid":"21656332","pmcid":null,"title":"Hypersexuality in a 28-year-old woman with rabies","authors":"Senthilkumaran S, Balamurgan N, Sweni S, Menezes RG, Thirumalaikolundusubramanian P.","first_author":"Senthilkumaran S","journal":"Archives of sexual behavior","year":2011,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single patient with rabies presenting with increased sexual desire; no control group or systematic data collection","sample_n":1,"sample_text":"single case","population":"28‑year‑old woman with rabies infection","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 28‑year‑old woman with rabies showed an unexpected increase in sexual desire. The authors suggest that rabies infection can alter sexual behavior, urging clinicians to be aware of such atypical symptoms.","clinical_takeaway":"Rabies can present with unusual changes in sexual desire; clinicians should consider infection in sudden behavioral shifts.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides a rare clinical observation linking rabies to sexual behavior change","Highlights need for clinicians to consider atypical presentations"],"limitations":["Single case; no systematic measurement","No control of confounding variables (e.g., medication, prior behavior)","No validated scales for sexual desire"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-011-9788-3"}},{"id":8143,"doi":"10.1586/ern.11.58","pmid":"21651335","pmcid":null,"title":"Sexual and reproductive dysfunction associated with antiepileptic drug use in men with epilepsy","authors":"Calabrò RS, Marino S, Bramanti P.","first_author":"Calabrò RS","journal":"Expert review of neurotherapeutics","year":2011,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of existing literature; no new data collected; no systematic search or risk‑of‑bias assessment.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Men with epilepsy (no primary data; sample size not applicable).","country":"Not specified (review of international literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review discusses how epilepsy and the drugs used to treat it may cause sexual problems in men, such as reduced libido or hormonal changes, highlighting a mix of neurological, hormonal, and psychological causes.","clinical_takeaway":"Clinicians should consider antiepileptic medication side‑effects when male patients report sexual dysfunction.","confidence":0.9,"topic_tags":["sexual_function","neuroscience"],"strengths":["Broad overview of multiple etiological factors","Integrates endocrine and psychiatric perspectives"],"limitations":["Narrative (non‑systematic) synthesis","No empirical data or quantitative meta‑analysis","Potential selection bias in cited studies"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":0,"mentioning":31,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1586/ern.11.58"}},{"id":8144,"doi":"10.1007/s10508-011-9727-3","pmid":"21249441","pmcid":null,"title":"The proposed diagnosis of hypersexual disorder for inclusion in DSM-5: unnecessary and harmful","authors":"Halpern AL.","first_author":"Halpern AL.","journal":"Archives of sexual behavior","year":2011,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":18,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-011-9727-3"}},{"id":8146,"doi":"10.1016/j.physbeh.2011.04.055","pmid":"21557955","pmcid":null,"title":"Pathological behaviors provoked by dopamine agonist therapy of Parkinson's disease","authors":"Ahlskog JE.","first_author":"Ahlskog JE.","journal":"Physiology & behavior","year":2011,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article summarizing clinical observations of dopamine agonist‑induced pathological behaviors, including hypersexuality, without original empirical data.","sample_n":null,"sample_text":"Not applicable (review)","population":"Patients with Parkinson’s disease receiving dopamine agonists (pramipexole, ropinirole); no specific sample size reported","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how Parkinson’s drugs that activate dopamine D3 receptors can trigger excessive gambling, hypersexuality, and other compulsive behaviors in up to 30% of patients, suggesting a role for this receptor in addiction‑like problems.","clinical_takeaway":"Clinicians should monitor patients on dopamine agonists for emerging compulsive sexual or gambling behaviors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear clinical description of dopamine agonist‑related behaviors","Links neuropharmacology (D3 receptor) to behavioral outcomes"],"limitations":["No primary data; conclusions based on anecdotal clinical experience","Lacks systematic review methodology or critical appraisal of evidence"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":42,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.physbeh.2011.04.055"}},{"id":8147,"doi":"10.1007/s00415-011-5932-1","pmid":"21560063","pmcid":null,"title":"Drug-induced impulse control disorders in Parkinson's disease","authors":"Reiff J, Jost WH.","first_author":"Reiff J","journal":"Journal of neurology","year":2011,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article summarizing clinical observations; no new empirical data collected.","sample_n":null,"sample_text":"Not applicable – review of existing literature","population":"Parkinson's disease patients (mentioned broadly)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review discusses how dopamine treatments for Parkinson's disease can provoke impulse‑control problems, including hypersexuality, gambling and compulsive buying, summarising clinical observations rather than presenting new research.","clinical_takeaway":"Clinicians should monitor for emerging hypersexual or other impulsive behaviors in Parkinson's patients receiving dopamine agonists.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","csbd"],"strengths":["Provides overview of dopamine‑related impulse control disorders in PD","Highlights hypersexuality among ICD‑like behaviors"],"limitations":["No original data; conclusions based on secondary sources","No systematic review methods reported","Lacks quantitative synthesis or assessment of bias"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00415-011-5932-1"}},{"id":8148,"doi":"10.4061/2011/485063","pmid":"21603184","pmcid":"PMC3096061","title":"Dopamine-induced nonmotor symptoms of Parkinson's disease","authors":"Park A, Stacy M.","first_author":"Park A","journal":"Parkinson's disease","year":2011,"pub_types":["review-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://downloads.hindawi.com/journals/pd/2011/485063.pdf","cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review-article","sample_n":null,"sample_text":"Not applicable – narrative review","population":"Patients with Parkinson's disease receiving dopaminergic therapy","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarizes how dopamine‑based treatments for Parkinson’s disease can cause non‑motor side effects such as gambling, hypersexuality, and other compulsive behaviours, stressing the need for careful medication management.","clinical_takeaway":"Clinicians should monitor Parkinson’s patients on dopamine therapy for emerging compulsive sexual behaviours and adjust treatment as needed.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Comprehensive overview of dopaminergic non‑motor side effects","Highlights clinical relevance of hypersexuality in PD"],"limitations":["No original data; conclusions based on existing literature","No systematic review methodology or bias assessment"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":32,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4061/2011/485063"}},{"id":8149,"doi":"10.1007/s10508-010-9690-4","pmid":"20931271","pmcid":null,"title":"Hypersexual disorder: just more muddled thinking","authors":"Moser C.","first_author":"Moser C.","journal":"Archives of sexual behavior","year":2011,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":38,"citing_publications":104,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9690-4"}},{"id":8150,"doi":"10.1007/s10461-009-9636-9","pmid":"19904599","pmcid":"PMC4082977","title":"HIV in the leather community: rates and risk-related behaviors","authors":"Moskowitz DA, Seal DW, Rintamaki L, Rieger G.","first_author":"Moskowitz DA","journal":"AIDS and behavior","year":2011,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,554 men at leather and non-leather events","sample_n":1554,"sample_text":"Participants recruited at one leather event and one non‑leather event; convenience sampling","population":"men who have sex with men, including Leather subculture (submissives, dominants, switches) and non‑Leathermen","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 1,554 men showed that those identifying with the leather community were 61% more likely to be HIV‑positive than other MSM, partly due to lower condom use during anal sex.","clinical_takeaway":"Clinicians should be aware of higher HIV risk and low condom use in leather‑community MSM, especially during unprotected anal intercourse.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a subcultural study","Specific focus on an understudied MSM subculture","Clear reporting of HIV prevalence differences"],"limitations":["Convenience sampling limits generalizability","Self‑report may bias condom‑use and HIV status data","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-009-9636-9"}},{"id":8151,"doi":"10.1016/j.parkreldis.2011.02.013","pmid":"21382739","pmcid":null,"title":"Impulse control and related disorders in Parkinson's disease patients treated with bilateral subthalamic nucleus stimulation: a review","authors":"Broen M, Duits A, Visser-Vandewalle V, Temel Y, Winogrodzka A.","first_author":"Broen M","journal":"Parkinsonism & related disorders","year":2011,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":89,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of existing studies on impulse control disorders in Parkinson’s disease patients undergoing STN DBS.","sample_n":null,"sample_text":"No new participants; review of previously published studies.","population":"Patients with Parkinson’s disease treated with bilateral subthalamic nucleus deep brain stimulation; no primary data collected.","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises how deep‑brain stimulation of the subthalamic nucleus in Parkinson’s patients can both improve and worsen impulse‑control problems, including hypersexuality, but evidence remains mixed.","clinical_takeaway":"STN DBS may affect hypersexuality in Parkinson’s disease, but clinicians should monitor patients closely for new or worsening impulse‑control symptoms.","confidence":0.78,"topic_tags":["csbd","sexual_function"],"strengths":["Comprehensive overview of STN DBS effects on impulse control disorders","Identifies both beneficial and adverse outcomes"],"limitations":["Narrative (non‑systematic) review; risk of selection bias","No quantitative synthesis or meta‑analysis","Lacks explicit discussion of methodological quality of included studies"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":89,"citing_publications":138,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2011.02.013"}},{"id":8152,"doi":null,"pmid":"21510226","pmcid":null,"title":"Impulse control disorders in patients with Parkinson's disease","authors":"Gescheidt T, Bares M.","first_author":"Gescheidt T","journal":"Acta neurologica Belgica","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of impulse control disorders in Parkinson’s disease; no primary data collection.","sample_n":null,"sample_text":"Not applicable (review)","population":"Patients with Parkinson’s disease (unspecified sample)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews impulse‑control problems in Parkinson’s patients, such as gambling, compulsive shopping, overeating and hypersexuality, noting their higher frequency, risk factors and the need for better diagnosis and medication management.","clinical_takeaway":"Clinicians should actively screen for impulse‑control disorders, including hypersexuality, in Parkinson’s patients and consider adjusting dopaminergic therapy.","confidence":0.9,"topic_tags":["neuroscience","sexual_function","pornography","masturbation","treatment","other"],"strengths":["Summarises known impulse‑control complications in Parkinson’s disease","Highlights clinical under‑diagnosis and therapeutic considerations"],"limitations":["No primary data; conclusions based on existing literature","Lacks systematic review methodology and bias assessment","No quantitative synthesis or effect‑size reporting"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":8153,"doi":"10.1097/wnf.0b013e31820d6699","pmid":"21412200","pmcid":null,"title":"The emergence of devastating impulse control disorders during dopamine agonist therapy of the restless legs syndrome","authors":"Dang D, Cunnington D, Swieca J.","first_author":"Dang D","journal":"Clinical neuropharmacology","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of 12 RLS patients who developed impulse control disorders (including hypersexuality) while on dopamine agonists; identified via clinic records and a mail‑out questionnaire; assessed with BIS‑11 and a modified Minnesota Impulse Disorders Interview.","sample_n":12,"sample_text":"Twelve cases identified over a 2‑year period.","population":"Adult patients with restless‑legs syndrome receiving dopamine‑agonist therapy (Australia).","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 12 Australian patients with restless‑legs syndrome treated with dopamine‑activating drugs, a range of impulse‑control problems—including gambling, shopping, and hypersexual behaviour—appeared after varying periods of medication use, often causing serious social and financial harm.","clinical_takeaway":"Clinicians should monitor for emerging impulse‑control problems, including hypersexuality, in RLS patients receiving dopamine agonists.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of validated impulsivity scale (BIS‑11)","First study to apply BIS‑11 in RLS‑related ICDs","Detailed clinical description of diverse ICDs"],"limitations":["Very small, non‑representative case series (N=12)","No control or comparison group","Limited assessment of psychiatric or moral confounds"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":35,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/wnf.0b013e31820d6699"}},{"id":8154,"doi":"10.1093/brain/awr003","pmid":"21349901","pmcid":null,"title":"Cue-induced striatal dopamine release in Parkinson's disease-associated impulsive-compulsive behaviours","authors":"O'Sullivan SS, Wu K, Politis M, Lawrence AD, Evans AH, Bose SK, Djamshidian A, Lees AJ, Piccini P.","first_author":"O'Sullivan SS","journal":"Brain : a journal of neurology","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":202,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"PET raclopride study comparing PD patients with vs without impulsive‑compulsive behaviours (N=18).","sample_n":18,"sample_text":"Eighteen patients (11 with and seven without impulsive‑compulsive behaviours).","population":"Parkinson’s disease patients, 11 with, 7 without impulsive‑compulsive behaviours; adults, both sexes.","country":"Not specified (likely UK/Europe).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A PET study found that Parkinson’s patients who show impulsive‑compulsive behaviours, including hypersexuality, release more dopamine in the ventral striatum when shown reward cues compared with patients without such behaviours.","clinical_takeaway":"In Parkinson’s disease, heightened dopamine response to cues may underlie impulsive‑compulsive symptoms; treatment plans should consider cue‑triggered craving.","confidence":0.8,"topic_tags":["neuroscience","csbd"],"strengths":["Use of molecular PET imaging to assess dopamine release","Within‑subject comparison of cue types","Inclusion of a PD control group"],"limitations":["Very small sample (N=18) limits statistical power","No correction for multiple comparisons reported","Limited characterization of behavioural phenotypes"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":4,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":21,"contrasting":1,"mentioning":179,"citing_publications":305,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/brain/awr003"}},{"id":8155,"doi":"10.1016/j.kjms.2010.12.011","pmid":"21463840","pmcid":"PMC11916507","title":"Kluver-Bucy syndrome in one case with systemic lupus erythematosus","authors":"Lin HF, Yeh YC, Chen CF, Chang WC, Chen CS.","first_author":"Lin HF","journal":"The Kaohsiung journal of medical sciences","year":2011,"pub_types":["case-study","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1016/j.kjms.2010.12.011","cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with SLE developing Kluver‑Bucy syndrome, including description of symptoms and structural brain imaging.","sample_n":1,"sample_text":"single case","population":"37‑year‑old female with systemic lupus erythematosus","country":"Taiwan (inferred from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 37‑year‑old woman with systemic lupus developed Kluver‑Bucy syndrome, showing symptoms like hypersexuality and visual agnosia; brain scans showed a structural lesion possibly explaining these changes.","clinical_takeaway":"Kluver‑Bucy syndrome can appear in SLE patients and may involve hypersexual behaviour; clinicians should consider neuroimaging when neuropsychiatric symptoms arise.","confidence":0.85,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed clinical description","Includes neuroimaging evidence of structural lesion"],"limitations":["Single case; no generalisability","No systematic assessment of psychiatric or sexual constructs","No quantitative analysis"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.kjms.2010.12.011"}},{"id":8156,"doi":"10.1016/j.pnpbp.2011.02.002","pmid":"21324349","pmcid":null,"title":"Behavioral, neuropsychiatric and cognitive disorders in Parkinson's disease patients with and without motor complications","authors":"Solla P, Cannas A, Floris GL, Orofino G, Costantino E, Boi A, Serra C, Marrosu MG, Marrosu F.","first_author":"Solla P","journal":"Progress in neuro-psychopharmacology & biological psychiatry","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional study of 349 consecutive Parkinson’s patients, comparing those with and without motor complications.","sample_n":349,"sample_text":"349 patients were included in this analysis.","population":"Adults with Parkinson’s disease, recruited from a clinical setting (likely convenience sample).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 349 Parkinson’s patients, those with motor complications like dyskinesias also showed higher rates of dementia, anxiety, depression, psychosis, and impulse‑control issues such as hypersexuality and compulsive shopping.","clinical_takeaway":"Motor complications in Parkinson’s may signal a greater risk of cognitive and psychiatric problems; monitor patients closely.","confidence":0.7,"topic_tags":["neuroscience","csbd"],"strengths":["Large sample for a clinical study (N=349).","Comprehensive assessment of motor and non‑motor symptoms.","Clear differentiation between patients with and without motor complications."],"limitations":["Cross‑sectional design prevents causal inference.","Unclear whether validated psychometric instruments were used.","Potential confounding by medication dosage not reported."],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":90,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pnpbp.2011.02.002"}},{"id":8157,"doi":"10.1016/j.parkreldis.2011.01.009","pmid":"21310646","pmcid":null,"title":"Dopamine agonist-triggered pathological behaviors: surveillance in the PD clinic reveals high frequencies","authors":"Hassan A, Bower JH, Kumar N, Matsumoto JY, Fealey RD, Josephs KA, Ahlskog JE.","first_author":"Hassan A","journal":"Parkinsonism & related disorders","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":71,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective chart review of 321 Parkinson's patients on dopamine agonists; clinicians routinely asked about compulsive behaviors; frequencies reported.","sample_n":321,"sample_text":"321 PD patients taking a dopamine agonist were identified from the Mayo Health Science Research database (2007‑2009).","population":"Adults with Parkinson's disease treated with dopamine agonists (n=321)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Parkinson's clinic, about one‑in‑five patients on dopamine agonists showed compulsive behaviors such as gambling, hypersexuality, and binge eating; the rate rose to 24% when drug doses were therapeutic.","clinical_takeaway":"Monitor patients on dopamine agonists for emerging compulsive sexual or other impulsive behaviors and adjust medication if needed.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large clinical sample for a PD clinic (n=321)","Systematic routine inquiry reduces under‑reporting","Clear prevalence figures for multiple compulsive behaviors"],"limitations":["No validated scale for compulsive behaviors; reliance on clinician interview","Cross‑sectional, no causal inference","No control for psychiatric comorbidities or other confounds"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":1,"mentioning":82,"citing_publications":98,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2011.01.009"}},{"id":8158,"doi":"10.1016/j.parkreldis.2011.01.010","pmid":"21300562","pmcid":null,"title":"Hypersexuality and compulsive over-eating associated with transdermal dopamine agonist therapy","authors":"Hinnell C, Hulse N, Martin A, Samuel M.","first_author":"Hinnell C","journal":"Parkinsonism & related disorders","year":2011,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2011.01.010"}},{"id":8159,"doi":"10.1111/j.1743-6109.2010.02172.x","pmid":"21235721","pmcid":null,"title":"Pedophilic behavior from brain disease","authors":"Mendez M, Shapira JS.","first_author":"Mendez M","journal":"The journal of sexual medicine","year":2011,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of eight patients with neurological disease and emergent pedophilic behavior, plus literature review","sample_n":8,"sample_text":"Eight patients reported","population":"adult patients (mid‑ to late‑life) with Parkinson’s disease, Alzheimer’s disease or other frontotemporal/subcortical lesions","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe eight adults who began acting on sexual attraction to children after developing brain disorders such as Parkinson's or frontotemporal disease, suggesting that brain damage may disinhibit such behavior.","clinical_takeaway":"Brain lesions can occasionally produce disinhibited sexual behavior; assessment should consider neuro‑psychiatric factors, not assume a primary pedophilic disorder.","confidence":0.6,"topic_tags":["sexual_function","neuroscience","other"],"strengths":["Detailed clinical description of rare phenomenon","Integration with prior case literature"],"limitations":["Very small, non‑representative case series","No systematic measurement or control of confounds","Causal claims exceed data"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":4,"contrasting":0,"mentioning":39,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02172.x"}},{"id":8160,"doi":"10.4103/0972-2327.78052","pmid":"21655207","pmcid":"PMC3108080","title":"Kleine-Levine syndrome in an adolescent female and response to modafinil","authors":"Aggarwal A, Garg A, Jiloha RC.","first_author":"Aggarwal A","journal":"Annals of Indian Academy of Neurology","year":2011,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Modafinil","Females","Kleine-levin Syndrome"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3108080","cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single adolescent female with Kleine‑Levin syndrome treated with modafinil","sample_n":1,"sample_text":"single case","population":"adolescent female with KLS (n=1)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A teenage girl with Kleine‑Levin syndrome, which includes episodes of excessive sleep, eating and sexual drive, improved after taking the stimulant modafinil. More research is needed to confirm this effect.","clinical_takeaway":"Modafinil may help some KLS patients, but evidence is limited to a single case.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","treatment"],"strengths":["Detailed clinical description","Clear reporting of treatment response","Acknowledges need for further data"],"limitations":["Single case, no control group","No systematic assessment of outcomes","Limited generalisability"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0972-2327.78052"}},{"id":8161,"doi":"10.7551/mitpress/8595.003.0014","pmid":"21506077","pmcid":null,"title":"[Impulse control disorders in Parkinson's disease]","authors":"Van den Heuvel OA, Van der Werf YD, Groenewegen HJ, Foncke EM, Berendse HW.","first_author":"Van den Heuvel OA","journal":"Tijdschrift voor psychiatrie","year":2011,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"dut","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of existing literature on impulse control disorders (including hypersexuality) in Parkinson's disease.","sample_n":null,"sample_text":"No original participants; literature review only.","population":"Patients with Parkinson's disease (no original sample recruited)","country":"Netherlands (journal language)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises how impulse‑control problems like pathological gambling, compulsive buying and hypersexuality can appear in people with Parkinson’s disease, often linked to dopamine medication and brain‑circuit changes.","clinical_takeaway":"Clinicians should monitor Parkinson patients for emerging impulse‑control issues, especially hypersexuality, and collaborate across specialties for early diagnosis and treatment.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function","csbd","neuroscience"],"strengths":["Provides a concise overview of impulse control disorders in PD.","Integrates neurobiological hypotheses with clinical observations."],"limitations":["Narrative review without systematic methodology.","No original data; reliance on secondary sources.","Lacks quantitative synthesis or risk‑of‑bias assessment."],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7551/mitpress/8595.003.0014"}},{"id":8162,"doi":null,"pmid":"21500491","pmcid":null,"title":"[Efficacy of prostatic adenoma treatment with alfusozine depending on sexuality]","authors":"Kogan MI, Kireev AIu.","first_author":"Kogan MI","journal":"Urologiia (Moscow, Russia : 1999)","year":2011,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"rus","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"observational pre‑post treatment cohort (N=40) with repeated measures at weeks 0, 4, 12, 24; no control group","sample_n":40,"sample_text":"40 patients treated with alfusozine 10 mg/day","population":"men with prostatic adenoma (mean age not reported)","country":"Russia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 40 men with an enlarged prostate treated with alfusozine, sexual activity patterns (low, normal, high) were linked to different treatment outcomes: men with low or normal sexual activity improved more in urinary flow and erectile function than highly sexual men.","clinical_takeaway":"Treatment response may vary by sexual activity level, but findings are preliminary and need confirmation.","confidence":0.7,"topic_tags":["sexual_function","treatment","pornography"],"strengths":["Use of validated questionnaires (IPSS, IIEF, MSHQ)","Repeated physiological measurements over 24 weeks"],"limitations":["No control/comparator group","Small sample limiting power","No adjustment for key psychosocial confounds","Interpretation may overstate efficacy across sexuality phenotypes"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":8164,"doi":"10.2466/pr0.1994.74.2.647","pmid":"8197301","pmcid":null,"title":"Maintained hypersexuality between male rats following chronically induced limbic seizures: implications for bisexuality in complex partial epileptic seizures","authors":"Persinger MA.","first_author":"Persinger MA.","journal":"Psychological reports","year":1994,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Small‑scale animal experiment (n≈4 rats) inducing limbic seizures and observing increased male‑male sexual behavior for ~2 months.","sample_n":4,"sample_text":"Four male rats were observed after lithium‑pilocarpine induced limbic seizures.","population":"Adult male albino Wistar rats","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"In a 1994 rat study, inducing limbic seizures caused a small group of male rats to show increased male‑male sexual activity for two months. The authors suggest the findings might relate to human bisexuality, but the animal data are limited and not directly applicable to people.","clinical_takeaway":"None – findings are based on an animal model and cannot be applied to clinical practice.","confidence":0.4,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Clear behavioural definition of hypersexuality in rats","Use of a physiological seizure model"],"limitations":["Very small sample (n=4)","No human‑relevant measures (moral incongruence, mental health, etc.)","Generalises animal behaviour to human bisexuality without justification"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2466/pr0.1994.74.2.647"}},{"id":8165,"doi":"10.1016/j.nrl.2010.09.007","pmid":"21163239","pmcid":null,"title":"Impulse control disorders and punding in Parkinson's disease: the need for a structured interview","authors":"Ávila A, Cardona X, Bello J, Maho P, Sastre F, Martín-Baranera M.","first_author":"Ávila A","journal":"Neurologia (Barcelona, Spain)","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Prospective screening questionnaire administered to 216 consecutive Parkinson's disease patients; also a retrospective matched sample analysed.","sample_n":216,"sample_text":"216 consecutive PD patients (prospective) and a matched retrospective sample of 216 patients.","population":"Patients with idiopathic Parkinson's disease, average age 77 ± 5, 102 men of 216 participants.","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A questionnaire given to 216 Parkinson's patients found that about 9% had impulse‑control problems like hypersexuality, gambling, or repetitive behaviours, which are often missed in routine visits.","clinical_takeaway":"Screen for impulse‑control disorders, including hypersexuality, in Parkinson's patients because they are frequently under‑reported.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large sample of consecutive PD patients.","Includes both prospective and retrospective data.","Identifies under‑recognition of ICDs in clinical practice."],"limitations":["Questionnaire not validated.","No control for key confounds (moral, mental health, partner effects).","Cross‑sectional design limits causal inference."],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":18,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.nrl.2010.09.007"}},{"id":8166,"doi":"10.1007/s00415-010-5715-0","pmid":"21080189","pmcid":null,"title":"Spectrum of addictions in Parkinson's disease: from dopamine dysregulation syndrome to impulse control disorders","authors":"Ceravolo R, Frosini D, Rossi C, Bonuccelli U.","first_author":"Ceravolo R","journal":"Journal of neurology","year":2010,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review summarising case reports and prospective studies on addictive behaviours in Parkinson's disease, including hypersexuality, but without systematic methods.","sample_n":null,"sample_text":"Not applicable – narrative review","population":"Patients with Parkinson's disease (adult)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how Parkinson's disease treatments can lead to addictive‑like behaviours such as gambling, compulsive buying and hypersexuality, describing risk factors and mentioning neuroimaging findings.","clinical_takeaway":"Clinicians should monitor dopaminergic therapy for impulse‑control problems and adjust treatment when such behaviours emerge.","confidence":0.6,"topic_tags":["neuroscience"],"strengths":["Broad overview of PD‑related impulse control disorders","Integrates pharmacological risk factors"],"limitations":["Narrative, non‑systematic synthesis","No new empirical data or quantitative meta‑analysis","Limited discussion of methodological quality of cited studies"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":36,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00415-010-5715-0"}},{"id":8168,"doi":"10.1111/j.1743-6109.2010.02051.x","pmid":"20946171","pmcid":null,"title":"Focusing \"hot\" or focusing \"cool\": attentional mechanisms in sexual arousal in men and women","authors":"Both S, Laan E, Everaerd W.","first_author":"Both S","journal":"The journal of sexual medicine","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory within‑subject experiment manipulating attentional focus (hot vs cool) while measuring genital response (VPA, penile gauge) and self‑reported arousal in healthy men and women.","sample_n":null,"sample_text":"Healthy sexually functional men and women (exact N not provided).","population":"Healthy sexually functional adults (men and women); sample size not reported in abstract.","country":"Netherlands (inferred from authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study showed that focusing attention on the emotional aspects of erotic images (hot focus) increased both physiological and subjective sexual arousal compared with a cognitive, detached focus (cool). This suggests attention can regulate sexual arousal and may inform treatments for desire‑related problems.","clinical_takeaway":"Attention‑based techniques might help boost sexual desire or reduce hyperarousal, but evidence is limited to laboratory settings with healthy adults.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Objective physiological measures of sexual arousal","Clear experimental manipulation of attentional focus","Within‑subject design allows causal inference for the manipulation"],"limitations":["Sample size and demographic details not reported in abstract","Findings from healthy participants extrapolated to clinical conditions","No pre‑registration or detailed statistical reporting"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":4,"contrasting":4,"mentioning":37,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02051.x"}},{"id":8169,"doi":"10.4103/0972-2327.74185","pmid":"21264130","pmcid":"PMC3021925","title":"Kleine-Levin syndrome: Etiology, diagnosis, and treatment","authors":"Ramdurg S.","first_author":"Ramdurg S.","journal":"Annals of Indian Academy of Neurology","year":2010,"pub_types":["review-article","Journal Article"],"keywords":["Periodic","Hypersomnia","Hypersexuality","Kleine–levin Syndrome","Megaphagia"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3021925","cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review","sample_n":null,"sample_text":"Not applicable – review of published literature","population":"not applicable","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises what is known about Kleine‑Levin syndrome, a rare disorder that causes episodic oversleeping, altered behaviour, overeating, and occasional increased sexual activity. It highlights the lack of clear cause or effective treatment and offers practical guidance for clinicians.","clinical_takeaway":"KLS remains a diagnosis of exclusion with no proven therapies; clinicians should manage episodes symptomatically and monitor for spontaneous remission.","confidence":0.8,"topic_tags":["gender","neuroscience","csbd","sexual_function"],"strengths":["Comprehensive synthesis of existing KLS literature","Clear clinical summary for practitioners"],"limitations":["Narrative (non‑systematic) review without risk‑of‑bias assessment","No quantitative analysis or meta‑analytic statistics"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":37,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/0972-2327.74185"}},{"id":8171,"doi":"10.1111/j.1532-5415.2010.03064.x","pmid":"20840462","pmcid":"PMC3625650","title":"Sexual aggression between residents in nursing homes: literature synthesis of an underrecognized problem","authors":"Rosen T, Lachs MS, Pillemer K.","first_author":"Rosen T","journal":"Journal of the American Geriatrics Society","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Review","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative literature synthesis without systematic search or risk‑of‑bias assessment","sample_n":null,"sample_text":"Not applicable – review of existing studies","population":"older adults residing in nursing homes (resident‑to‑resident sexual aggression)","country":"United States (authors’ affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review evidence that older adults in nursing homes sometimes engage in unwanted sexual interactions, often driven by dementia‑related hypersexuality. They describe how common this is, its impacts, and ethical challenges in caring for these residents.","clinical_takeaway":"Staff should be aware of resident‑to‑resident sexual aggression, assess capacity, and manage incidents with sensitivity to both safety and residents’ sexual needs.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Highlights an under‑researched area of elder sexual aggression","Integrates findings from dementia and elder‑abuse literature"],"limitations":["Narrative rather than systematic review; no explicit search strategy","No formal risk‑of‑bias assessment of included studies","Lacks quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":77,"citing_publications":88,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1532-5415.2010.03064.x"}},{"id":8172,"doi":"10.1016/j.jocn.2010.03.015","pmid":"20638284","pmcid":null,"title":"Partial Klüver-Bucy syndrome in a patient with acute disseminated encephalomyelitis","authors":"Jha S, Ansari MK.","first_author":"Jha S","journal":"Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia","year":2010,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of an 11‑year‑old boy with Kluver‑Bucy syndrome secondary to ADEM; MRI used for diagnosis; no statistical analysis beyond descriptive reporting.","sample_n":1,"sample_text":"N=1 (case report)","population":"single pediatric patient with post‑infectious demyelinating disease","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"An 11‑year‑old boy with acute disseminated encephalomyelitis developed classic signs of Klüver‑Bucy syndrome, including increased sexual behavior, as shown by clinical exam and MRI findings.","clinical_takeaway":"Klüver‑Bucy syndrome can arise after ADEM and may feature hypersexuality, but findings are based on a single case.","confidence":0.8,"topic_tags":["neuroscience"],"strengths":["Detailed clinical description of a rare syndrome in a pediatric patient","Use of MRI to support neurological diagnosis"],"limitations":["Single case limits generalizability","No systematic assessment of sexual behavior beyond clinical observation","No statistical analysis or control group"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jocn.2010.03.015"}},{"id":8173,"doi":"10.1007/s10508-010-9607-2","pmid":"20169467","pmcid":null,"title":"Hypersexual disorder: a more cautious approach","authors":"Winters J.","first_author":"Winters J.","journal":"Archives of sexual behavior","year":2010,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":1,"mentioning":24,"citing_publications":79,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9607-2"}},{"id":8175,"doi":"10.1176/appi.psy.51.3.271","pmid":"20484726","pmcid":null,"title":"Impact of dopamine agonists on compulsive behaviors: a case series of pramipexole-induced pathological gambling","authors":"Kolla BP, Mansukhani MP, Barraza R, Bostwick JM.","first_author":"Kolla BP","journal":"Psychosomatics","year":2010,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of two patients with pathological gambling after dopamine agonist exposure; no control group; clinical descriptions only","sample_n":2,"sample_text":"Two patients","population":"Adults (male, middle‑aged) receiving pramipexole for restless legs syndrome or Parkinson‑related symptoms; presented with compulsive gambling","country":"United States (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Two patients developed compulsive gambling soon after starting the dopamine drug pramipexole; stopping or switching the medication stopped the gambling, suggesting the drug can trigger such behaviors.","clinical_takeaway":"Clinicians should monitor for new compulsive behaviors, including gambling, when prescribing dopamine agonists.","confidence":0.8,"topic_tags":["neuroscience","sexual_function"],"strengths":["Clear temporal association between drug initiation and onset of gambling","Clinical relevance for prescribing dopamine agonists"],"limitations":["Very small N (2 cases) limits generalizability","No validated measures of gambling severity or addiction criteria","No systematic assessment of confounding factors"],"rubric_version":"2.0","raw_total":12,"max_possible":60,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":1,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.psy.51.3.271"}},{"id":8176,"doi":"10.1097/nrl.0b013e31819f952b","pmid":"20445429","pmcid":null,"title":"Compulsive behaviors in patients with Parkinson's disease","authors":"Kenangil G, Ozekmekçi S, Sohtaoglu M, Erginöz E.","first_author":"Kenangil G","journal":"The neurologist","year":2010,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control within a tertiary movement‑disorder clinic, 33 PD patients with ICDs vs 65 matched PD controls, cross‑sectional","sample_n":98,"sample_text":"33 PD patients with impulse control disorders (ICDs) identified among 554 screened; 65 matched PD patients without ICDs as controls","population":"Parkinson’s disease patients, adults, Turkey","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"Among 554 Parkinson’s patients, 33 (5.9%) showed impulse‑control problems; 42% of these had aggressive hypersexuality. The study found no link between medication dose or disease severity and these behaviors, but it used a small clinic sample and informal assessments.","clinical_takeaway":"Hypersexuality can appear in Parkinson’s patients, but this small study offers limited guidance for clinical screening or treatment.","confidence":0.78,"topic_tags":["sexual_function","pornography","masturbation","csbd"],"strengths":["Large initial screening cohort (554 PD patients)","Matched control group for comparison","Focus on a range of impulse‑control behaviors including hypersexuality"],"limitations":["Small number of ICD cases limits statistical power","No validated questionnaires for sexual behavior or addiction constructs","Confounding variables (e.g., mood, moral attitudes, partner context) not measured"],"rubric_version":"2.0","raw_total":18,"max_possible":60,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":2,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":37,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/nrl.0b013e31819f952b"}},{"id":8177,"doi":"10.1002/mds.22902","pmid":"20213825","pmcid":null,"title":"Impulsive-compulsive spectrum behaviors in pathologically confirmed progressive supranuclear palsy","authors":"O'Sullivan SS, Djamshidian A, Ahmed Z, Evans AH, Lawrence AD, Holton JL, Revesz T, Lees AJ.","first_author":"O'Sullivan SS","journal":"Movement disorders : official journal of the Movement Disorder Society","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":3,"sample_text":"Three cases","population":"patients with pathologically confirmed progressive supranuclear palsy (n=3)","country":"United Kingdom (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Three patients with a confirmed brain disease (progressive supranuclear palsy) developed impulsive‑compulsive behaviours, such as hypersexuality, after taking dopamine drugs. The report compares these cases to other series.","clinical_takeaway":"Dopamine treatments can trigger impulsive‑compulsive behaviours even in non‑Parkinson disease patients; monitor patients closely.","confidence":0.7,"topic_tags":["neuroscience"],"strengths":["Pathologically confirmed diagnosis","Detailed case description","Comparison with existing series"],"limitations":["Very small sample (n=3)","No validated measures of impulsive‑compulsive behaviors","No control group or statistical analysis","Potential selection bias from case series"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":23,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mds.22902"}},{"id":8180,"doi":null,"pmid":"20110923","pmcid":null,"title":"\"Sleeping Beauty paraphilia\": deviant desire in the context of bodily self-image disturbance in a patient with a fronto-parietal traumatic brain injury","authors":"Bianchi-Demicheli F, Rollini C, Lovblad K, Ortigue S.","first_author":"Bianchi-Demicheli F","journal":"Medical science monitor : international medical journal of experimental and clinical research","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case report of a patient with frontal‑parietal TBI developing a specific paraphilia (sleeping‑beauty). No control group, no systematic assessment.","sample_n":1,"sample_text":"1","population":"1 adult patient (male) with moderate dysexecutive syndrome after traumatic brain injury","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A man who suffered a frontal‑parietal brain injury began experiencing a rare sexual interest in sleeping women and a compulsion to touch their hands. The authors suggest the injury‑related disturbance in body‑self perception may have triggered this paraphilia.","clinical_takeaway":"Single case; does not provide evidence for treatment or general risk of paraphilia after brain injury.","confidence":0.6,"topic_tags":["neuroscience","sexual_function","treatment"],"strengths":["Detailed clinical description","Incorporates neuroimaging to illustrate lesion location"],"limitations":["N=1; no control or comparison group","No validated psychometric measures of paraphilia or self‑image","Causal inference overstated"],"rubric_version":"2.0","raw_total":11,"max_possible":60,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":1,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":8181,"doi":"10.1016/j.socscimed.2009.11.040","pmid":"20116160","pmcid":null,"title":"Framing disease: the example of female hypoactive sexual desire disorder","authors":"Jutel A.","first_author":"Jutel A.","journal":"Social science & medicine (1982)","year":2010,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"historical/analytical article without primary data","sample_n":null,"sample_text":"none","population":"none (historical analysis)","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"opposes","citation_value":"background","plain_summary":"The article examines how the label ‘female hypoactive sexual desire disorder’ was socially constructed, linking historical fascination with female libido, fears about hypersexuality, and pharmaceutical interests.","clinical_takeaway":"Clinicians should be cautious about pathologising low sexual desire in women without clear medical justification.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides a nuanced historical perspective on medicalisation","Integrates sociological theory with medical discourse"],"limitations":["No empirical data; conclusions based on narrative analysis","Limited to a single diagnostic example"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":27,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.socscimed.2009.11.040"}},{"id":8183,"doi":"10.1093/sleep/33.1.81","pmid":"20120624","pmcid":"PMC2802252","title":"Impulse control disorders with the use of dopaminergic agents in restless legs syndrome: a case-control study","authors":"Cornelius JR, Tippmann-Peikert M, Slocumb NL, Frerichs CF, Silber MH.","first_author":"Cornelius JR","journal":"Sleep","year":2010,"pub_types":["research-article","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":137,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"prospective case‑control study comparing RLS patients on dopaminergic agents with OSA controls and untreated RLS patients; screening questionnaire followed by phone interview.","sample_n":427,"sample_text":"100 RLS patients on dopaminergic agents; 275 OSA controls; 52 untreated RLS patients.","population":"Adults with restless‑legs syndrome treated with dopaminergic agents (n≈100) and two control groups (OSA n≈275; untreated RLS n≈52).","country":"USA (academic sleep‑medicine centre, likely).","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In people with restless‑legs syndrome who take dopamine drugs, about one‑in‑five develop impulse‑control problems such as compulsive shopping, gambling, eating, or hypersexuality, compared with lower rates in similar patients not on these drugs.","clinical_takeaway":"Screen patients receiving dopaminergic therapy for RLS for impulse‑control behaviours, including hypersexuality.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["Large clinical sample for a rare side‑effect","Comparison with two control groups","Phone interview verification of questionnaire positives"],"limitations":["ICD screening tool not described; likely not fully validated","No control for moral/religious attitudes or mental‑health covariates","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":27,"max_possible":60,"pct_score":45,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":3,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":31,"citing_publications":196,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sleep/33.1.81"}},{"id":8184,"doi":"10.1097/wnf.0b013e3181c4ae2e","pmid":"19959959","pmcid":null,"title":"Impulse control disorder and piribedil: report of 5 cases","authors":"Tschopp L, Salazar Z, Gomez Botello MT, Roca CU, Micheli F.","first_author":"Tschopp L","journal":"Clinical neuropharmacology","year":2010,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of 5 patients (4 Parkinson’s disease, 1 multisystem atrophy) with hypersexuality and other impulse control disorders linked to piribedil","sample_n":5,"sample_text":"5 cases","population":"patients with Parkinson’s disease or multisystem atrophy treated with the dopamine agonist piribedil","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors report five patients (four with Parkinson’s disease and one with multisystem atrophy) who developed gambling, hypersexuality, and other impulse‑control problems while taking the dopamine agonist piribedil, suggesting the drug may trigger such behaviours.","clinical_takeaway":"Clinicians should monitor patients on piribedil for emerging impulse‑control behaviors, including hypersexuality.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["First description of piribedil‑related impulse control disorders","Includes rare multisystem atrophy case"],"limitations":["Very small, uncontrolled case series","No validated measures of hypersexuality or other behaviours","No systematic assessment of confounding factors"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/wnf.0b013e3181c4ae2e"}},{"id":8186,"doi":"10.1016/s1474-4422(09)70287-x","pmid":"19909912","pmcid":null,"title":"Chronic dopaminergic stimulation in Parkinson's disease: from dyskinesias to impulse control disorders","authors":"Voon V, Fernagut PO, Wickens J, Baunez C, Rodriguez M, Pavon N, Juncos JL, Obeso JA, Bezard E.","first_author":"Voon V","journal":"The Lancet. Neurology","year":2009,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":256,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review article summarizing clinical features and mechanisms of impulse control disorders, including hypersexuality, in Parkinson's disease.","sample_n":null,"sample_text":"N/A (review)","population":"Humans with Parkinson's disease (general discussion, no new data)","country":"International (authors from multiple institutions)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review explains how dopamine drugs used for Parkinson's can trigger impulse‑control problems such as gambling, binge eating and hypersexuality, linking these behaviours to habit‑learning changes in the brain.","clinical_takeaway":"Clinicians should monitor patients on dopaminergic therapy for emerging compulsive sexual behaviours and other impulse‑control disorders.","confidence":0.78,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Comprehensive synthesis of clinical and mechanistic literature","Integrates habit-learning theory with basal ganglia models","Authored by experts in movement disorders and psychiatry"],"limitations":["No primary data; conclusions depend on cited studies","Potential selection bias in cited literature","Does not empirically test addiction criteria"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":10,"contrasting":1,"mentioning":230,"citing_publications":363,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1474-4422(09)70287-x"}},{"id":8187,"doi":"10.1002/mds.22848","pmid":"19891000","pmcid":null,"title":"Pramipexole and gender identity disorder: expanding the phenotype of hypersexuality in Parkinson's disease","authors":"Odiyoor M, Kobylecki C, Hackett RJ, Silverdale MA, Kellett MW.","first_author":"Odiyoor M","journal":"Movement disorders : official journal of the Movement Disorder Society","year":2009,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mds.22848"}},{"id":8188,"doi":"10.1016/j.pnpbp.2009.11.020","pmid":"19945494","pmcid":null,"title":"Duloxetine related hypersexuality: a case report","authors":"Lai CH.","first_author":"Lai CH.","journal":"Progress in neuro-psychopharmacology & biological psychiatry","year":2010,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pnpbp.2009.11.020"}},{"id":8190,"doi":"10.1177/1079063209353183","pmid":"19923635","pmcid":null,"title":"Understanding sexual perpetration against children: effects of attachment style, interpersonal involvement, and hypersexuality","authors":"Miner MH, Robinson BE, Knight RA, Berg D, Romine RS, Netland J.","first_author":"Miner MH","journal":"Sexual abuse : a journal of research and treatment","year":2010,"pub_types":["Comparative Study","Research Support, U.S. Gov't, P.H.S.","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of three adolescent male groups (child‑victim sex offenders, peer/adult‑victim sex offenders, non‑sex delinquent youth).","sample_n":null,"sample_text":"Three adolescent male samples; exact N not reported in abstract.","population":"Adolescent males, ages 13‑18, recruited from justice/clinical settings (sex offenders and delinquent youth).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared teenage boys who abused children, those who abused peers or adults, and non‑sex delinquents. It found that insecure attachment and feeling socially inadequate, together with high sexual drive, distinguished child‑abuse offenders from the other groups.","clinical_takeaway":"Clinicians should consider attachment insecurity and interpersonal deficits when assessing risk factors for sexual offending in youth.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Use of semi‑structured interview with blind raters","Inclusion of multiple comparison groups","Focus on attachment theory provides a theoretical framework"],"limitations":["Cross‑sectional design limits causal inference","Small, non‑representative sample of offenders","Unclear measurement validity for hypersexuality"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":6,"contrasting":3,"mentioning":57,"citing_publications":80,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063209353183"}},{"id":8191,"doi":"10.1136/pgmj.2008.075820","pmid":"19892894","pmcid":null,"title":"Parkinson disease and impulse control disorders: a review of clinical features, pathophysiology and management","authors":"Wu K, Politis M, Piccini P.","first_author":"Wu K","journal":"Postgraduate medical journal","year":2009,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review summarising clinical features, pathophysiology and management of impulse control disorders in Parkinson disease, including hypersexuality.","sample_n":null,"sample_text":"N/A – review article","population":"patients with Parkinson disease who develop impulse control disorders; no primary sample collected","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review describes how Parkinson’s patients can develop impulse‑control problems such as gambling, compulsive shopping and hypersexuality, often linked to dopamine‑boosting medication, and discusses possible brain mechanisms and treatment approaches.","clinical_takeaway":"Clinicians should monitor Parkinson patients on dopamine agonists for emerging impulsive behaviours, including hypersexuality, and adjust treatment accordingly.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of ICDs in Parkinson disease","Integrates neuroimaging findings from PET/fMRI studies"],"limitations":["Narrative (non‑systematic) review without risk‑of‑bias assessment","No primary data; relies on heterogeneous source studies","Limited quantitative synthesis or meta‑analytic rigor"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":39,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/pgmj.2008.075820"}},{"id":8194,"doi":"10.1001/archneur.1992.00530270128029","pmid":"1536635","pmcid":null,"title":"Hypersexuality following septal injury","authors":"Gorman DG, Cummings JL.","first_author":"Gorman DG","journal":"Archives of neurology","year":1992,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":53,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of two patients with septal injury showing increased sexual activity","sample_n":2,"sample_text":"Two cases","population":"male adults with ventriculoperitoneal shunt placement","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Two men developed markedly increased sexual activity after damage to the septal nuclei during shunt surgery. The authors suggest the septal region helps regulate sexual behavior, based on these cases and animal studies.","clinical_takeaway":"Septal injury may rarely trigger hypersexuality; clinicians should monitor sexual changes after such brain surgeries.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed clinical observation of rare phenomenon","Integration of animal data to suggest neural circuit"],"limitations":["Only two cases, no control group","No validated measure of hypersexuality","Confounding factors (e.g., medication, mood) not addressed"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":56,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archneur.1992.00530270128029"}},{"id":8195,"doi":"10.1016/j.yebeh.2009.08.005","pmid":"19793682","pmcid":null,"title":"Forced spousal intercourse after seizures","authors":"Arnedo V, Parker-Menzer K, Devinsky O.","first_author":"Arnedo V","journal":"Epilepsy & behavior : E&B","year":2009,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case description of post‑ictal hypersexual aggression; no control group; no systematic data collection","sample_n":1,"sample_text":"N=1 (case report)","population":"one adult male with uncontrolled partial epilepsy; sample_n: 1","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"A 39‑year‑old man with uncontrolled epilepsy experienced brief episodes of forced intercourse with his wife after nightly seizures. The behavior stopped when his seizures were better controlled with medication and lifestyle changes.","clinical_takeaway":"In epilepsy patients, aggressive sexual behavior may be a post‑ictal symptom that can improve with better seizure control.","confidence":0.6,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed clinical description","Clear temporal link between seizures and behavior","Therapeutic response documented"],"limitations":["Single case, no generalizability","No validated measures of hypersexuality or distress","No systematic assessment of confounds"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.yebeh.2009.08.005"}},{"id":8196,"doi":"10.1097/fbp.0b013e32833109a0","pmid":"19724195","pmcid":null,"title":"Impulse control disorders and dopamine dysregulation syndrome associated with dopamine agonist therapy in Parkinson's disease","authors":"Fenu S, Wardas J, Morelli M.","first_author":"Fenu S","journal":"Behavioural pharmacology","year":2009,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review without systematic methods, no primary data","sample_n":null,"sample_text":"Not applicable – review article","population":"Parkinson's disease patients on dopamine agonists (mentioned in review)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises how dopamine‑agonist treatment in Parkinson’s disease can lead to impulse‑control problems such as hypersexuality, gambling and related behaviors, linking them to dopamine‑related brain changes.","clinical_takeaway":"Clinicians should monitor Parkinson’s patients on dopamine agonists for emerging impulsive sexual or other compulsive behaviors.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of impulsive–compulsive disorders in Parkinson's disease","Integrates neurobiological mechanisms with clinical observations"],"limitations":["Narrative, not systematic, review – risk of selection bias","No primary data; no quantitative synthesis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/fbp.0b013e32833109a0"}},{"id":8197,"doi":"10.1016/j.neurol.2009.06.003","pmid":"19683776","pmcid":null,"title":"[Assessment of hyper- and hypodopaminergic behaviors in Parkinson's disease]","authors":"Ardouin C, Chéreau I, Llorca PM, Lhommée E, Durif F, Pollak P, Krack P, groupe évaluation comportementale de la maladie de Parkinson.","first_author":"Ardouin C","journal":"Revue neurologique","year":2009,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":86,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review proposing a new 18‑item scale to assess hypo‑ and hyper‑dopaminergic behaviors in Parkinson’s disease; no empirical sample reported.","sample_n":null,"sample_text":"Not reported; scale description only.","population":"Parkinson’s disease patients (implicit)","country":"France (authors’ affiliations suggest)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["circular_addiction_scale","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose a new 18‑item interview scale to track mood and behavioral changes, including hypersexuality, in Parkinson’s disease patients receiving dopaminergic medication.","clinical_takeaway":"No immediate clinical guidance; the scale needs validation before use.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","measurement"],"strengths":["Addresses understudied hyperdopaminergic behaviors in PD","Provides a structured interview tool"],"limitations":["Scale not yet validated psychometrically","No empirical data presented","Confound variables (e.g., depression, medication dose) not examined"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":54,"citing_publications":144,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neurol.2009.06.003"}},{"id":8198,"doi":"10.1002/mds.22505","pmid":"19526584","pmcid":null,"title":"Impulsive and compulsive behaviors in Parkinson's disease","authors":"Evans AH, Strafella AP, Weintraub D, Stacy M.","first_author":"Evans AH","journal":"Movement disorders : official journal of the Movement Disorder Society","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":158,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"review article summarising phenomenology, epidemiology and assessment of impulsive‑compulsive behaviours in Parkinson’s disease, including hypersexuality","sample_n":null,"sample_text":"N/A (review)","population":"people with Parkinson’s disease (no primary data collected)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews how dopamine‑targeting drugs for Parkinson’s disease can trigger impulse‑control problems such as gambling, overeating, and hypersexuality, describing their symptoms, how common they are, and ways to recognise and manage them.","clinical_takeaway":"Clinicians should monitor Parkinson’s patients on dopamine agonists for emerging impulsive or compulsive sexual behaviours and adjust treatment if needed.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad overview of impulse‑control disorders in PD","Integrates phenomenology with neurobiological discussion","Covers clinical rating methods"],"limitations":["No primary data; conclusions depend on cited studies","No systematic assessment of methodological quality of sources","Does not address moral incongruence or other sexual‑health confounds"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":9,"contrasting":1,"mentioning":189,"citing_publications":251,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mds.22505"}},{"id":8199,"doi":"10.1016/j.neulet.2009.06.074","pmid":"19560522","pmcid":null,"title":"Impulse control disorders in Parkinson's disease in a Chinese population","authors":"Fan W, Ding H, Ma J, Chan P.","first_author":"Fan W","journal":"Neuroscience letters","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":64,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 400 Parkinson's patients and spouses; self‑report ICD screen, positive cases interviewed by specialist.","sample_n":400,"sample_text":"400 PD patients (plus spouses as control group)","population":"Chinese patients with Parkinson's disease (treated with anti‑parkinsonian drugs) and their spouses.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 400 Chinese Parkinson's patients, those taking dopamine‑agonist drugs were more likely to show impulse‑control problems like gambling, binge eating, or hypersexuality. Higher medication doses and alcohol use were also linked to these behaviors.","clinical_takeaway":"Clinicians should monitor Parkinson's patients on dopamine agonists for emerging impulse‑control symptoms, including changes in sexual behavior.","confidence":0.78,"topic_tags":["csbd","sexual_function","moral_incongruence"],"strengths":["Large initial sample of PD patients","Clinical interview to confirm ICD diagnoses","Clear association between dopamine agonist use and ICD occurrence"],"limitations":["Reliance on self‑report screening; validation of questionnaire unclear","Very few ICD cases (n=11) limit statistical power","No control for key psychosocial confounds (moral incongruence, mental health, trauma)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":3,"mentioning":102,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neulet.2009.06.074"}},{"id":8200,"doi":"10.1007/s10072-009-0101-3","pmid":"19513585","pmcid":null,"title":"Preliminary evaluation of the DDS-PC inventory: a new tool to assess impulsive-compulsive behaviours associated to dopamine replacement therapy in Parkinson's disease","authors":"Cabrini S, Baratti M, Bonfà F, Cabri G, Uber E, Avanzi M.","first_author":"Cabrini S","journal":"Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology","year":2009,"pub_types":["Evaluation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Screened 38 Parkinson's disease patients (DDS vs non‑DDS) using a newly created questionnaire; convenience sample; no longitudinal follow‑up.","sample_n":38,"sample_text":"38 patients and their caregivers","population":"Adults with Parkinson's disease (average age not reported); caregivers also surveyed.","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors introduced a short questionnaire to spot impulsive‑compulsive problems, like gambling or hypersexuality, in Parkinson’s patients taking dopamine therapy. In 38 patients it distinguished those with dopamine‑dysregulation syndrome from others, but the tool still needs fuller testing.","clinical_takeaway":"The DDS‑PC inventory may aid clinicians in flagging compulsive behaviours in Parkinson’s patients, but its usefulness is not yet proven.","confidence":0.7,"topic_tags":["sexual_function","pornography"],"strengths":["Focus on a clinically relevant set of impulsive‑compulsive behaviours in PD","Preliminary discriminant validity demonstrated (p = 0.000)","Includes caregiver input"],"limitations":["Very small sample (N = 38) limits power and generalisability","Limited psychometric validation of the new inventory","No control for key confounds (e.g., mood, moral factors, partner context)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":29,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10072-009-0101-3"}},{"id":8201,"doi":"10.1002/mds.22439","pmid":"19309760","pmcid":null,"title":"Treatment of hypersexuality in Parkinson's disease with carbamazepine--a case report","authors":"Bach JP, Oertel WH, Dodel R, Jessen F.","first_author":"Bach JP","journal":"Movement disorders : official journal of the Movement Disorder Society","year":2009,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mds.22439"}},{"id":8202,"doi":"10.3410/m1-29","pmid":"20948752","pmcid":"PMC2924724","title":"Impulse control disorders in Parkinson's disease","authors":"Stacy M.","first_author":"Stacy M.","journal":"F1000 medicine reports","year":2009,"pub_types":["review-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC2924724","cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review-article","sample_n":null,"sample_text":"Not applicable – narrative review without primary data","population":"patients with Parkinson's disease experiencing impulse control disorders (ICDs) such as hypersexuality; no specific sampling details provided","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how Parkinson's disease treatments can lead to impulse control disorders, including hypersexuality, gambling and compulsive spending, describing their clinical features and impact on patients.","clinical_takeaway":"Clinicians should monitor Parkinson's patients for emerging impulsive sexual behaviors as part of broader ICD screening.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","pornography"],"strengths":["Provides a concise overview of impulse control disorders in Parkinson's disease","Highlights clinical relevance of hypersexuality within ICDs"],"limitations":["No empirical data; conclusions based on prior literature","Lacks systematic methodology or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3410/m1-29"}},{"id":8203,"doi":null,"pmid":"19630365","pmcid":null,"title":"[Kleine-Levin syndrome]","authors":"Tauman R, Greenfeld M, Sivan Y.","first_author":"Tauman R","journal":"Harefuah","year":2009,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"heb","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article summarising clinical features of Kleine‑Levin syndrome; no original data, no systematic methods reported.","sample_n":null,"sample_text":"Not applicable – review without primary data.","population":"Patients with Kleine‑Levin syndrome (adolescents, predominantly male); no sampling details.","country":"Israel (authors’ affiliation inferred)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Kleine‑Levin syndrome is a rare disorder causing recurring periods of extreme sleepiness, cognitive changes, compulsive eating and increased sexual drive, mostly in teenage boys. Diagnosis relies on clinical signs; brain scans and EEG are typically normal.","clinical_takeaway":"Awareness of hypersexuality as a possible symptom of KLS may aid diagnosis, but no specific treatment is established.","confidence":0.4,"topic_tags":["sexual_function","neuroscience"],"strengths":["Clear description of clinical phenotype","Highlights diagnostic challenges"],"limitations":["No primary data; narrative review only","No systematic search or bias assessment"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":8204,"doi":"10.1002/14651858.cd006685.pub2","pmid":"19370648","pmcid":null,"title":"Pharmacological treatment for Kleine-Levin Syndrome","authors":"Oliveira MM, Conti C, Saconato H, Fernandes do Prado G.","first_author":"Oliveira MM","journal":"The Cochrane database of systematic reviews","year":2009,"pub_types":["Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review (Cochrane) with no eligible trials found","sample_n":null,"sample_text":"No trials met inclusion criteria; therefore no participants were analysed.","population":"Patients with Kleine‑Levin Syndrome (rare sleep disorder with hypersexuality among other symptoms)","country":"Not specified","controls_mi":"not_applicable","preregistered":true,"quality_score":2,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A Cochrane review looked for randomized trials testing drugs for Kleine‑Levin Syndrome, a rare disorder that can include hypersexual behaviour. No eligible studies were found, so the authors conclude that well‑designed drug trials are still needed.","clinical_takeaway":"There is currently no evidence to guide drug treatment for Kleine‑Levin Syndrome; clinicians should rely on case reports and expert opinion.","confidence":0.9,"topic_tags":["csbd","sexual_function","neuroscience"],"strengths":["Rigorous Cochrane systematic review methodology","Comprehensive search strategy across multiple databases","Clear inclusion criteria for RCTs"],"limitations":["No eligible studies found, limiting any substantive conclusions","No data on efficacy or safety of pharmacological treatments","Unable to assess constructs, confounds, or neuroimaging"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":0,"neuroimaging":null,"statistics":0,"confounds":0,"design":2,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/14651858.cd006685.pub2"}},{"id":8207,"doi":"10.1192/bjp.158.2.280","pmid":"2012924","pmcid":null,"title":"Hypersexuality, fetishism and multiple sclerosis","authors":"Huws R, Shubsachs AP, Taylor PJ.","first_author":"Huws R","journal":"The British journal of psychiatry : the journal of mental science","year":1991,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single male patient with multiple sclerosis presenting hypersexuality and fetishism; MRI showed frontal and temporal lesions; authors suggest lesions may underlie symptoms","sample_n":1,"sample_text":"single case","population":"1 adult male with multiple sclerosis","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 1991 case report describes a man with multiple sclerosis who developed hypersexuality and fetishism; MRI showed frontal and temporal brain lesions, which the authors suggested might explain the new sexual symptoms.","clinical_takeaway":"Single-case evidence; clinicians should not assume MS lesions cause hypersexuality without further data.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Provides a rare clinical observation linking MS lesions with sexual behavior change","Includes neuroimaging data (MRI) showing lesion locations"],"limitations":["Single case; no control group or replication","No systematic measurement of sexual behavior or psychological variables","Interpretation makes causal claims from correlational imaging"],"rubric_version":"2.0","raw_total":6,"max_possible":60,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":1,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/bjp.158.2.280"}},{"id":8208,"doi":"10.1097/wnf.0b013e3181684542","pmid":"18978496","pmcid":null,"title":"Impulse control disorders arising in 3 patients treated with rotigotine","authors":"Wingo TS, Evatt M, Scott B, Freeman A, Stacy M.","first_author":"Wingo TS","journal":"Clinical neuropharmacology","year":2009,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":3,"sample_text":"three patients identified retrospectively","population":"patients with Parkinson disease on rotigotine","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Three Parkinson patients on rotigotine developed impulse‑control problems such as hypersexuality and gambling. The symptoms appeared after dose increases and improved when the drug was reduced.","clinical_takeaway":"Dopamine agonists like rotigotine may trigger hypersexuality or gambling; monitor patients and adjust dose if such behaviors emerge.","confidence":0.8,"topic_tags":["sexual_function","pornography","masturbation","csbd"],"strengths":["Provides clinical observation of rotigotine-related ICDs","Highlights temporal association with dose changes","Documents treatment response to dose reduction"],"limitations":["Very small case series (N=3)","No standardized measures of hypersexuality or gambling","No control for confounding factors (e.g., prior gambling history)","No assessment of moral or psychological variables"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/wnf.0b013e3181684542"}},{"id":8209,"doi":"10.1111/j.1365-2788.2009.01156.x","pmid":"19187102","pmcid":null,"title":"Behavioural phenotype in Börjeson-Forssman-Lehmann syndrome","authors":"de Winter CF, van Dijk F, Stolker JJ, Hennekam RC.","first_author":"de Winter CF","journal":"Journal of intellectual disability research : JIDR","year":2009,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report (4 patients) with literature review","sample_n":4,"sample_text":"four molecularly proven BFLs patients","population":"individuals with molecularly confirmed Börjeson‑Forssman‑Lehmann syndrome","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe the behaviours of four men with a rare X‑linked syndrome, noting that while most were friendly, some showed externalising and thrill‑seeking traits, and three family members exhibited hypersexual behaviour.","clinical_takeaway":"Evidence is insufficient to draw clinical conclusions about hypersexuality in this syndrome; more systematic research is needed.","confidence":0.8,"topic_tags":["gender"],"strengths":["Molecularly confirmed diagnosis","Detailed case description"],"limitations":["Very small N (4)","No validated measures of hypersexuality","No control for confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2788.2009.01156.x"}},{"id":8211,"doi":"10.1002/mds.22373","pmid":"19021228","pmcid":null,"title":"Increased medial temporal blood flow in Parkinson's disease with pathological hypersexuality","authors":"Kataoka H, Shinkai T, Inoue M, Satoshi U.","first_author":"Kataoka H","journal":"Movement disorders : official journal of the Movement Disorder Society","year":2009,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/mds.22373"}},{"id":8212,"doi":"10.2165/00023210-200923020-00005","pmid":"19173374","pmcid":null,"title":"Dopamine dysregulation syndrome: an overview of its epidemiology, mechanisms and management","authors":"O'Sullivan SS, Evans AH, Lees AJ.","first_author":"O'Sullivan SS","journal":"CNS drugs","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":168,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of dopamine dysregulation syndrome in Parkinson's disease, discussing hypersexuality among other impulse control disorders","sample_n":null,"sample_text":"Not applicable – review article","population":"patients with Parkinson's disease (DDS) – no primary data presented","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews dopamine dysregulation syndrome, an iatrogenic addiction to Parkinson’s medication that can produce impulse‑control problems such as gambling, shopping and hypersexuality, summarising its prevalence, risk factors, neural mechanisms and possible treatments.","clinical_takeaway":"Clinicians should monitor Parkinson’s patients on dopamine therapy for signs of compulsive behaviours, including hypersexuality, and consider medication adjustments and psychosocial support.","confidence":0.6,"topic_tags":["neuroscience"],"strengths":["Comprehensive synthesis of DDS literature","Links neurobiology of dopamine to behavioral symptoms"],"limitations":["Narrative (non‑systematic) review – no formal risk‑of‑bias assessment","No original data; reliance on other studies' methodological quality"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":1,"mentioning":119,"citing_publications":256,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2165/00023210-200923020-00005"}},{"id":8213,"doi":"10.1001/archneurol.2008.517","pmid":"19139311","pmcid":"PMC2868923","title":"Alzheimer abnormalities of the amygdala with Klüver-Bucy syndrome symptoms: an amygdaloid variant of Alzheimer disease","authors":"Kile SJ, Ellis WG, Olichney JM, Farias S, DeCarli C.","first_author":"Kile SJ","journal":"Archives of neurology","year":2009,"pub_types":["research-article","Journal Article","Case Reports","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case study of a 70‑year‑old man with atypical Alzheimer presentation; no control group","sample_n":1,"sample_text":"one patient","population":"male, 70‑77 years, outpatient specialty clinic, USA (presumed)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 70‑year‑old man with Alzheimer’s disease showed unusual symptoms such as excessive sexual activity and hyperorality. Autopsy revealed many Alzheimer‑related plaques in his amygdala, suggesting this brain region may drive these behaviours.","clinical_takeaway":"Hypersexuality can arise from amygdala pathology in neurodegenerative disease, not just primary psychiatric causes.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed neuropathological examination","Integration of imaging and clinical data","Clear description of rare phenotype"],"limitations":["N=1, no comparison group","No validated measures of sexual behavior","No control for confounding medical/psychiatric factors"],"rubric_version":"2.0","raw_total":11,"max_possible":60,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":2,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archneurol.2008.517"}},{"id":8214,"doi":null,"pmid":"19222015","pmcid":null,"title":"[Behavioral disorders in Parkinson's disease. Genetic, pharmacological and medico-legal aspects]","authors":"Sobrido MJ, Dias-Silva JJ, Quintáns B.","first_author":"Sobrido MJ","journal":"Revista de neurologia","year":2009,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Narrative review of behavioral disorders in Parkinson's disease, focusing on impulse‑control problems such as hypersexuality; no original empirical data presented.","sample_n":null,"sample_text":"Not applicable – review article","population":"Patients with Parkinson’s disease (PD)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how Parkinson’s disease and its dopamine treatments can produce impulse‑control problems—including hypersexuality— and discusses clinical and legal implications for patients and physicians.","clinical_takeaway":"Clinicians should monitor PD patients for emerging hypersexual or other impulsive behaviours, especially after changes in dopamine therapy.","confidence":0.4,"topic_tags":["sexual_function","neuroscience"],"strengths":["Comprehensive overview of PD‑related impulse‑control disorders","Highlights medico‑legal considerations","Integrates genetics, pharmacology and clinical management"],"limitations":["No original data; conclusions based on existing literature","Lacks systematic review methodology (no risk‑of‑bias assessment)","No quantitative synthesis or evaluation of measurement tools"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":8215,"doi":"10.5694/j.1326-5377.2009.tb02289.x","pmid":"19236300","pmcid":null,"title":"Pathological gambling and hypersexuality in cabergoline-treated prolactinoma","authors":"Falhammar H, Yarker JY.","first_author":"Falhammar H","journal":"The Medical journal of Australia","year":2009,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":4,"contrasting":0,"mentioning":32,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5694/j.1326-5377.2009.tb02289.x"}},{"id":8216,"doi":null,"pmid":"19432233","pmcid":null,"title":"[The questionnaire of integral assessment of male sexuality]","authors":"Kogan MI, Kireev AIu.","first_author":"Kogan MI","journal":"Urologiia (Moscow, Russia : 1999)","year":2009,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"rus","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective questionnaire administered to 64 men aged 50‑78; convenience sample; no control/comparison group.","sample_n":64,"sample_text":"64 patients aged 50‑78 years","population":"Male, 50‑78 years (N=64)","country":"Russia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors present a 34‑question survey to rate various aspects of male sexual life, from first intercourse to current activity, and classify men as normo‑, hypo‑, or hypersexual. It was tested on 64 men aged 50‑78, but no reliability or validity testing is reported.","clinical_takeaway":"The questionnaire is not yet validated; clinicians should not rely on it for diagnosis or treatment decisions.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Attempts to create a comprehensive male sexuality questionnaire","Covers a wide range of sexual life stages"],"limitations":["No evidence of psychometric validation (reliability, factor analysis)","Small, non‑representative older‑male sample","No control for key confounds (masturbation, mental health, relationship status, trauma)","Interpretation extends beyond data (claims clinical utility without validation)"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":8217,"doi":"10.1080/15622970801901810","pmid":"18609443","pmcid":null,"title":"Kleine-Levin syndrome in two subjects with diagnosis of autistic disorder","authors":"Mukaddes NM, Fateh R, Kilincaslan A.","first_author":"Mukaddes NM","journal":"The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry","year":2009,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report","sample_n":2,"sample_text":"two cases (male and female adolescents)","population":"two adolescents with comorbid Kleine‑Levin syndrome and autistic disorder","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe two adolescents who have both Kleine‑Levin syndrome—a rare condition with episodes of excessive sleep, appetite changes, and hypersexuality—and autism, illustrating how the disorder can appear in this population.","clinical_takeaway":"Kleine‑Levin syndrome can present with hypersexuality in autistic adolescents; clinicians should consider it in differential diagnosis of sudden behavioural changes.","confidence":0.3,"topic_tags":["sexual_function","neuroscience"],"strengths":["Rare comorbid presentation described","Clear clinical description of hypersexuality in KLS"],"limitations":["Case report; no systematic assessment","No validated measures of sexual behaviour or distress","No control for confounding variables"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/15622970801901810"}},{"id":8219,"doi":"10.1111/j.1743-6109.2008.01119.x","pmid":"19138369","pmcid":null,"title":"RETRACTED: Treatment of nonparaphilic hypersexuality in men with a long-acting analog of gonadotropin-releasing hormone","authors":"Safarinejad MR.","first_author":"Safarinejad MR.","journal":"The journal of sexual medicine","year":2009,"pub_types":["Retracted Publication","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"Retracted study reporting treatment of non‑paraphilic hypersexuality with a long‑acting GnRH analog; no methods or results verifiable.","sample_n":null,"sample_text":"Not reported; study retracted and data unavailable.","population":"Men with self‑reported hypersexuality (no further detail).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["retracted_or_notice","selective_reporting","advocacy_or_coi"],"stance":"neutral","citation_value":"avoid","plain_summary":"The paper claimed to treat men’s non‑paraphilic hypersexuality with a hormone drug, but it has been fully retracted because the journal could not verify its methods or results.","clinical_takeaway":"None – the study’s findings are unreliable and should not be used in practice.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["None evident from abstract"],"limitations":["Retracted; data unavailable","Methodology and statistical reporting questioned","No information on sample size or controls"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":25,"retracted":true,"notices":[{"status":"Retracted","date":"2015-12-16","noticeDoi":"10.1111/j.1743-6109.2008.01119.x","doi":"10.1111/j.1743-6109.2008.01119.x"}],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2008.01119.x"}},{"id":8220,"doi":"10.1007/s10072-008-1050-y","pmid":"19381766","pmcid":null,"title":"Dopamine agonists and therapy compliance","authors":"Grosset D.","first_author":"Grosset D.","journal":"Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology","year":2008,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review (narrative) of dopamine agonist‑induced compulsive behaviours in Parkinson’s disease; no original data.","sample_n":null,"sample_text":"Not applicable – review article","population":"Patients with Parkinson’s disease (no sample size reported)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review describes how high doses of dopamine drugs for Parkinson’s disease can lead to compulsive behaviours like gambling, hypersexuality and mood swings, termed dopamine dysregulation syndrome. It stresses the need for careful medication management.","clinical_takeaway":"In Parkinson’s patients, monitor for impulsive sexual or gambling behaviours when prescribing dopamine agonists.","confidence":0.4,"topic_tags":["neuroscience","treatment","pornography","masturbation","sexual_function"],"strengths":["Provides clinical overview of dopamine dysregulation syndrome","Links hypersexuality to dopaminergic treatment side‑effects"],"limitations":["No original empirical data","No systematic search or risk‑of‑bias assessment","No quantitative synthesis or effect sizes"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10072-008-1050-y"}},{"id":8221,"doi":"10.1016/j.psc.2008.08.001","pmid":"18996297","pmcid":null,"title":"Sexually compulsive behavior: hypersexuality. Preface","authors":"Schwartz MF, Berlin FS.","first_author":"Schwartz MF","journal":"The Psychiatric clinics of North America","year":2008,"pub_types":["Introductory Journal Article","Editorial"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.psc.2008.08.001"}},{"id":8222,"doi":"10.1016/j.amjopharm.2008.12.004","pmid":"19161930","pmcid":null,"title":"Inappropriate sexual behaviors in cognitively impaired older individuals","authors":"Guay DR.","first_author":"Guay DR.","journal":"The American journal of geriatric pharmacotherapy","year":2008,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of case reports/series and one small comparative trial; no primary data collection.","sample_n":null,"sample_text":"23 case reports/case series (55 subjects), plus additional small samples; no new participants recruited.","population":"Older adults with cognitive impairment (dementia) exhibiting inappropriate sexual behaviors.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews the limited case‑report evidence on drug treatments for inappropriate sexual behavior in older adults with dementia, noting serotonin drugs, anti‑androgens, hormones and LHRH agonists as possible options.","clinical_takeaway":"Evidence is weak; clinicians should tailor pharmacologic choices to individual risk and monitor closely.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Comprehensive literature search covering 1966‑2008","Summarizes pharmacologic options for a understudied issue","Identifies paucity of high‑quality evidence"],"limitations":["Relies on case reports/series with very small N","No systematic review methodology or risk‑of‑bias assessment","Lacks quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":62,"citing_publications":72,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.amjopharm.2008.12.004"}},{"id":8223,"doi":"10.1111/j.1743-6109.2008.01077.x","pmid":"19040625","pmcid":null,"title":"FSFI scores of women with persistent genital arousal disorder compared with published scores of women with female sexual arousal disorder and healthy controls","authors":"Leiblum SR, Seehuus M.","first_author":"Leiblum SR","journal":"The journal of sexual medicine","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online questionnaire of 172 self‑identified PGAD women compared with previously published FSFI data from FSAD (N=128) and healthy controls (N=131).","sample_n":172,"sample_text":"172 PGAD women; comparison groups from published studies (128 FSAD, 131 controls)","population":"heterosexual women meeting five PGAD criteria; comparison groups from earlier studies","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Women with persistent genital arousal disorder scored on a standard sexual‑function questionnaire in the normal range, similar to healthy women and better than women with female sexual arousal disorder.","clinical_takeaway":"PGAD does not appear to be linked to hypersexuality; clinicians should assess function rather than assume increased sexual activity.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Uses validated FSFI instrument","Large PGAD sample for a rare condition","Direct comparison with two relevant reference groups"],"limitations":["Cross‑sectional, no causal inference","Comparison groups drawn from prior studies, not concurrent controls","No control for potential confounds (mood, relationship status, etc.)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2008.01077.x"}},{"id":8224,"doi":"10.3109/02699059009026163","pmid":"2331547","pmcid":null,"title":"Managing hypersexual disorders in brain-injured clients","authors":"Zencius A, Wesolowski MD, Burke WH, Hough S.","first_author":"Zencius A","journal":"Brain injury","year":1990,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":3,"sample_text":"Three individual cases","population":"adults with brain injury exhibiting hypersexual behaviors","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes three brain‑injured patients who showed excessive sexual behaviors. Different behavioral strategies—feedback, scheduled massage, self‑monitoring, and dating‑skills training—were used to reduce inappropriate touching or exhibitionism.","clinical_takeaway":"Behavior‑modification techniques can help manage hypersexual behaviors after brain injury, but evidence is limited to three cases.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","csbd"],"strengths":["Detailed description of therapeutic interventions","Focus on real-world clinical cases"],"limitations":["Very small N (3 cases)","No systematic measurement of hypersexuality or addiction criteria","No control of key confounds (moral incongruence, mental health, etc.)","Findings not generalizable"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/02699059009026163"}},{"id":8225,"doi":"10.1097/jcp.0b013e31818582de","pmid":"18794655","pmcid":null,"title":"Aripiprazole induced hypersexuality in a 24-year-old female patient with schizoaffective disorder?","authors":"Schlachetzki JC, Langosch JM.","first_author":"Schlachetzki JC","journal":"Journal of clinical psychopharmacology","year":2008,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/jcp.0b013e31818582de"}},{"id":8226,"doi":null,"pmid":"19536937","pmcid":null,"title":"Dopamine agonist: pathological gambling and hypersexuality","authors":null,"first_author":null,"journal":"Prescrire international","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"small case series / clinical commentary summarising reported cases of pathological gambling and hypersexuality in patients on dopamine agonists","sample_n":null,"sample_text":"Not reported; article describes published case reports/series","population":"patients receiving dopamine agonists for Parkinson's disease, restless‑legs syndrome or pituitary adenoma (no sample size reported)","country":"Canada; Australia; Europe (as per MeSH, not a specific study sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","selective_reporting"],"stance":"neutral","citation_value":"useful","plain_summary":"The article describes occasional reports of gambling problems and excessive sexual behaviour in people taking dopamine‑stimulating medicines, especially for Parkinson’s disease, and urges clinicians to warn patients about these possible side‑effects.","clinical_takeaway":"Clinicians should monitor patients on dopamine agonists for emerging gambling or hypersexual behaviours and adjust medication if needed.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","neuroscience"],"strengths":["Highlights rare but serious adverse behavioural effects of dopamine agonists","Provides clinical alert for clinicians prescribing these drugs"],"limitations":["No original data; relies on anecdotal case reports","No systematic assessment of frequency or risk factors","No measurement of confounding variables (e.g., mood, relationship status)"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":8227,"doi":"10.1007/s00415-008-5010-5","pmid":"18787882","pmcid":null,"title":"Parkinson's disease-related disorders in the impulsive-compulsive spectrum","authors":"Wolters ECh, van der Werf YD, van den Heuvel OA.","first_author":"Wolters ECh","journal":"Journal of neurology","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":50,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of impulsive‑compulsive disorders in Parkinson’s disease, focusing on dopamine‑related mechanisms and treatment implications. No original empirical data.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Patients with Parkinson’s disease (PD) and related impulse‑control or hypersexual behaviours; no primary sample.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how Parkinson’s disease and its dopamine‑based treatments can lead to impulse‑control problems, including gambling, compulsive shopping, binge eating and hypersexuality, describing several dopamine‑related syndromes and treatment suggestions.","clinical_takeaway":"In PD patients with impulsive or hypersexual behaviours, consider dopamine‑related mechanisms and adjust medication or add psychosocial strategies accordingly.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Comprehensive synthesis of dopaminergic mechanisms","Integrates clinical observations with neuropharmacology"],"limitations":["Narrative, not systematic – risk of selection bias","No empirical data, so no direct measurement of constructs","Lacks quantitative assessment of prevalence or effect sizes"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":1,"mentioning":44,"citing_publications":87,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00415-008-5010-5"}},{"id":8228,"doi":null,"pmid":"18975528","pmcid":null,"title":"Persistent Klüver-Bucy syndrome after bilateral temporal lobe infarction","authors":"Chou CL, Lin YJ, Sheu YL, Lin CJ, Hseuh IH.","first_author":"Chou CL","journal":"Acta neurologica Taiwanica","year":2008,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with bilateral temporal lobe infarction presenting hypersexuality as part of Klüver‑Bucy syndrome","sample_n":1,"sample_text":"n=1","population":"single 50‑year‑old male","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 50‑year‑old man developed Klüver‑Bucy syndrome, including hypersexual behaviour, after strokes affecting both temporal lobes. The report describes his symptoms and MRI findings.","clinical_takeaway":"Hypersexuality can arise from bilateral temporal lobe damage; assess neurological causes when such behaviour appears suddenly.","confidence":0.8,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed clinical description","Imaging correlates of lesion"],"limitations":["Single case limits generalisability","No validated measurement of hypersexuality","No control for psychological or social confounds"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":8231,"doi":"10.1016/j.pnpbp.2008.07.010","pmid":"18691628","pmcid":null,"title":"Cyproterone for treatment of hypersexuality in an elderly Huntington's disease patient","authors":"Tavares A, Volpe FM.","first_author":"Tavares A","journal":"Progress in neuro-psychopharmacology & biological psychiatry","year":2008,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pnpbp.2008.07.010"}},{"id":8232,"doi":"10.1097/00002826-198910000-00002","pmid":"2575449","pmcid":null,"title":"Hypersexuality with antiparkinsonian therapy","authors":"Uitti RJ, Tanner CM, Rajput AH, Goetz CG, Klawans HL, Thiessen B.","first_author":"Uitti RJ","journal":"Clinical neuropharmacology","year":1989,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":125,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of 13 Parkinson's patients experiencing hypersexuality after antiparkinsonian medication","sample_n":13,"sample_text":"Thirteen parkinsonian patients drawn from two large parkinsonism clinics","population":"Parkinson disease patients receiving levodopa or other dopamine agents; majority male; early onset PD; clinic sample","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small series of 13 Parkinson's patients developed unusually high sexual activity after taking dopamine‑boosting drugs. The authors suggest the drugs lower prolactin, which may trigger the behavior.","clinical_takeaway":"Clinicians should monitor sexual side‑effects when prescribing dopaminergic therapy for Parkinson's disease.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","neuroscience"],"strengths":["clinical relevance of medication side‑effects","detailed case descriptions"],"limitations":["Very small, non‑representative sample","No validated measures of hypersexuality","No control or comparison group"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":102,"citing_publications":214,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00002826-198910000-00002"}},{"id":8233,"doi":"10.1016/j.shpsc.2008.03.003","pmid":"18534350","pmcid":null,"title":"Eugenic and sexual folklores and the castration of sex offenders in the Netherlands (1938-1968)","authors":"van der Meer T.","first_author":"van der Meer T.","journal":"Studies in history and philosophy of biological and biomedical sciences","year":2008,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Historical narrative analysis of archival sources; no empirical data collected.","sample_n":null,"sample_text":"Approximately 400 individuals were castrated; numbers are reported from historical records.","population":"Historical cohort of Dutch sex offenders (1938‑1968); no contemporary sample.","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article examines how Dutch policies from 1938‑1968 castrated 400 sex offenders, arguing that eugenic ideas and a catch‑all notion of 'hypersexuality' shaped these actions, despite attempts to frame them as non‑eugenic.","clinical_takeaway":"None - the work is historical and not directly applicable to current clinical practice.","confidence":0.4,"topic_tags":["sexual_function","csbd"],"strengths":["Rich historical primary-source analysis","Challenges simplistic eugenics dichotomy"],"limitations":["No empirical data on contemporary sexual behavior","Limited generalizability to modern CSBD debates"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.shpsc.2008.03.003"}},{"id":8234,"doi":"10.1111/j.1743-6109.2008.00861.x","pmid":"18466265","pmcid":null,"title":"Increased frequency and range of sexual behavior in a patient with Parkinson's disease after use of pramipexole: a case report","authors":"Munhoz RP, Fabiani G, Becker N, Teive HAG.","first_author":"Munhoz RP","journal":"The journal of sexual medicine","year":2009,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report of hypersexuality emergence after dose increase of pramipexole, with remission after withdrawal","sample_n":1,"sample_text":"one patient","population":"67‑year‑old man with Parkinson’s disease","country":"unknown","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A 67‑year‑old man with Parkinson’s disease started having more frequent and unusual sexual activities after his dopamine‑agonist dose was raised; the behavior stopped when the drug was stopped.","clinical_takeaway":"Dopamine agonists can provoke marked changes in sexual behavior; monitor patients for hypersexuality when dosing up.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","csbd"],"strengths":["clear temporal association between drug dose change and behavior","observed reversal after drug withdrawal","adds to clinical awareness of dopaminergic side‑effects"],"limitations":["single case, no control or systematic assessment","no validated measures of hypersexuality or compulsivity","no assessment of confounding factors (e.g., mood, moral views)","cannot establish causality"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2008.00861.x"}},{"id":8235,"doi":null,"pmid":"18630168","pmcid":null,"title":"[Impulse control disorders and Parkinson's disease]","authors":"Burkhard PR, Catalano Chiuvé S, Gronchi-Perrin A, Berney A, Vingerhoets FJ, Lüscher C.","first_author":"Burkhard PR","journal":"Revue medicale suisse","year":2008,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary / narrative overview without primary data","sample_n":null,"sample_text":"Not applicable; no primary sample reported","population":"Parkinson's disease patients (implicit)","country":"Switzerland (journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews impulse‑control disorders such as hypersexuality that can appear in people with Parkinson’s disease, especially when taking dopamine‑activating drugs, and notes these problems often improve when medication is changed.","clinical_takeaway":"In Parkinson’s patients, hypersexuality may be a medication side‑effect that can be reduced by adjusting treatment.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Highlights clinical relevance of ICD in PD","Mentions medication link (dopamine agonists)"],"limitations":["No primary data or systematic review methods","Lacks detail on measurement or operational definitions","No control for confounding factors"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":8236,"doi":"10.1002/ana.21333","pmid":"18438947","pmcid":null,"title":"Kleine-Levin syndrome: a systematic study of 108 patients","authors":"Arnulf I, Lin L, Gadoth N, File J, Lecendreux M, Franco P, Zeitzer J, Lo B, Faraco JH, Mignot E.","first_author":"Arnulf I","journal":"Annals of neurology","year":2008,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":130,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective comparative study of 108 patients with matched controls; descriptive statistics, odds ratios; not longitudinal or randomized.","sample_n":108,"sample_text":"108 patients, 79 parent pairs, 108 matched controls","population":"108 patients with Kleine‑Levin syndrome, 108 matched controls; adults and adolescents; not a probability sample.","country":"International (multiple sites, likely USA/Europe)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers studied 108 people with Kleine‑Levin syndrome, a rare condition causing episodes of extreme sleepiness and, in many cases, increased sexual drive. They found the disorder is real, linked to genetic and demographic factors, and that current treatments have limited benefit.","clinical_takeaway":"Hypersexuality in Kleine‑Levin syndrome appears as a symptom, not a separate addiction; management should focus on supportive care.","confidence":0.8,"topic_tags":["csbd","sexual_function","neuroscience"],"strengths":["Large sample for a rare disorder","Matched control group","Systematic collection of clinical and biological data"],"limitations":["Cross‑sectional, retrospective design limits causal inference","Hypersexuality measured with likely unvalidated items","No control for psychological or sociocultural confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":4,"mentioning":302,"citing_publications":280,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ana.21333"}},{"id":8238,"doi":"10.1016/j.parkreldis.2007.10.008","pmid":"18316235","pmcid":null,"title":"Sexual dysfunction in Parkinson's disease","authors":"Meco G, Rubino A, Caravona N, Valente M.","first_author":"Meco G","journal":"Parkinsonism & related disorders","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":63,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"review","sample_n":null,"sample_text":"Not applicable – review article","population":"Parkinson's disease patients (mixed gender)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises how Parkinson's disease and its dopamine treatments can affect sexual function, including the emergence of hypersexuality, but notes that many factors make these effects hard to separate.","clinical_takeaway":"Clinicians should monitor sexual side‑effects, especially hypersexuality, when prescribing dopamine‑boosting drugs for Parkinson's disease.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Broad overview of sexual dysfunction in PD","Considers pharmacological influences (dopamine therapy)"],"limitations":["No primary data; reliance on existing studies","Limited assessment of methodological quality of cited studies","Does not address key confounds such as moral incongruence or mental health"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":74,"citing_publications":97,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2007.10.008"}},{"id":8239,"doi":"10.1097/nrl.0b013e31816606a7","pmid":"18332838","pmcid":null,"title":"Impulse control disorders and pathological gambling in patients with Parkinson disease","authors":"Stamey W, Jankovic J.","first_author":"Stamey W","journal":"The neurologist","year":2008,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of published literature on impulse control disorders in Parkinson disease, no original data.","sample_n":null,"sample_text":"None – review article.","population":"Patients with Parkinson disease (no specific sample size reported).","country":"Not specified (global literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how impulse‑control disorders like pathological gambling and hypersexuality can arise in people with Parkinson’s disease, especially when they take dopamine‑boosting medications.","clinical_takeaway":"Clinicians should monitor Parkinson patients on dopamine agonists for emerging gambling or hypersexual behaviors.","confidence":0.6,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Comprehensive literature search spanning decades.","Clear clinical relevance for clinicians treating Parkinson patients."],"limitations":["No original empirical data; reliance on prior studies.","Lacks systematic review methodology (no risk‑of‑bias assessment).","Does not address key confounds such as moral incongruence or masturbation."],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":32,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/nrl.0b013e31816606a7"}},{"id":8240,"doi":"10.1192/bjp.153.6.833","pmid":"3256388","pmcid":null,"title":"Serial cognitive profiles in levodopa-induced hypersexuality","authors":"Harvey NS.","first_author":"Harvey NS.","journal":"The British journal of psychiatry : the journal of mental science","year":1988,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report with repeated cognitive testing before, during, and after levodopa‑induced hypersexuality","sample_n":1,"sample_text":"single case","population":"one middle‑aged male with recent‑onset Parkinson’s disease","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A single Parkinson’s patient developed increased sexual activity while on levodopa. Repeated cognitive testing suggested the behavior was due to higher libido rather than loss of frontal control.","clinical_takeaway":"Levodopa may trigger heightened sexual drive without necessarily impairing cognition; monitor patients for hypersexuality as a medication side effect.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","csbd","neuroscience"],"strengths":["Repeated within‑subject cognitive assessments","Detailed clinical description of levodopa‑induced hypersexuality"],"limitations":["n=1 limits any inference","No validated scales for hypersexuality or addiction","No control of key confounds (e.g., moral incongruence, masturbation)","No statistical analysis beyond descriptive observation"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/bjp.153.6.833"}},{"id":8241,"doi":"10.1016/j.seizure.2007.11.009","pmid":"18180175","pmcid":null,"title":"Epilepsy and sexuality","authors":"Luef GJ.","first_author":"Luef GJ.","journal":"Seizure","year":2008,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"Not applicable – narrative review","population":"patients with epilepsy (both sexes)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how epilepsy and its treatments can affect sexual function, noting hormonal changes, possible hyposexuality, and rare cases of hypersexuality after surgery. It suggests using the ASEX questionnaire and hormone tests to assess patients.","clinical_takeaway":"Clinicians should screen epilepsy patients for sexual dysfunction and consider hormonal evaluation; hypersexuality is rare but possible after temporal lobectomy.","confidence":0.6,"topic_tags":["sexual_function","neuroscience","treatment"],"strengths":["Summarises multiple potential biological mechanisms","Highlights gaps in research on neuro‑sexual control","Mentions validated scale (ASEX) for future studies"],"limitations":["Narrative review without systematic methodology","No original data or quantitative synthesis","Limited discussion of psychosocial confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":31,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.seizure.2007.11.009"}},{"id":8242,"doi":"10.1176/jnp.2008.20.4.496","pmid":"19196941","pmcid":null,"title":"Pathological hypersexuality induced by dopamine replacement therapy in a patient with progressive supranuclear palsy","authors":"Kim YY, Park HY, Kim JM, Kim KW.","first_author":"Kim YY","journal":"The Journal of neuropsychiatry and clinical neurosciences","year":2008,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/jnp.2008.20.4.496"}},{"id":8245,"doi":"10.1111/j.1743-6109.2007.00652.x","pmid":"18069994","pmcid":null,"title":"Review of the empirical evidence for a theoretical model to understand the sexual problems of women with a history of CSA","authors":"Rellini A.","first_author":"Rellini A.","journal":"The journal of sexual medicine","year":2008,"pub_types":["Review","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":53,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"The paper is a narrative review illustrating a theoretical model and summarising empirical findings; it does not present new empirical data, systematic methods, or risk‑of‑bias assessment.","sample_n":null,"sample_text":"No primary sample; the article reviews existing studies.","population":"Women with a history of child sexual abuse (CSA) compared to non‑CSA controls (as reported in the reviewed studies).","country":"United States (as indicated by MeSH terms).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article presents a theoretical model explaining why women who experienced childhood sexual abuse may show either low or high sexual desire, drawing on studies that measured physiological arousal, self‑beliefs about sexuality, and automatic reactions to sexual cues.","clinical_takeaway":"Clinicians should assess both inhibitory and excitatory sexual processes in CSA survivors and tailor interventions accordingly.","confidence":0.4,"topic_tags":["sexual_function","csbd"],"strengths":["Integrates physiological and cognitive findings","Proposes a testable model for hypo‑ and hypersexuality","Highlights potential clinical implications"],"limitations":["Narrative review without systematic methodology","No assessment of key confounds (e.g., mental health, trauma severity)","Lacks quantitative synthesis or risk‑of‑bias evaluation"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":69,"citing_publications":105,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2007.00652.x"}},{"id":8247,"doi":"10.1016/j.parkreldis.2007.09.007","pmid":"17988927","pmcid":null,"title":"Dopamine dysregulation syndrome, addiction and behavioral changes in Parkinson's disease","authors":"Merims D, Giladi N.","first_author":"Merims D","journal":"Parkinsonism & related disorders","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":75,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Review article summarizing clinical observations and a single patient narrative; no original empirical data.","sample_n":null,"sample_text":"Not applicable – review of existing literature and a single case vignette.","population":"Patients with Parkinson's disease experiencing dopamine dysregulation syndrome; no specific sample size reported.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review discusses how long‑term dopamine drug use in Parkinson's disease can lead to addictive‑like behaviors, including gambling, compulsive shopping, binge eating, and hypersexuality, illustrated by a patient's personal story.","clinical_takeaway":"Clinicians should monitor Parkinson's patients on dopamine agonists for emerging impulsive and hypersexual behaviors.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Provides clinical context linking dopaminergic treatment to hypersexuality.","Includes a vivid patient narrative illustrating potential severity."],"limitations":["No original data; relies on prior studies and a single case.","Lacks systematic assessment of confounding variables such as mental health or moral incongruence.","Interpretation may overgeneralize from limited evidence."],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":79,"citing_publications":150,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2007.09.007"}},{"id":8250,"doi":"10.1001/archneur.64.8.1089","pmid":"17698698","pmcid":null,"title":"Medication-related impulse control and repetitive behaviors in Parkinson disease","authors":"Voon V, Fox SH.","first_author":"Voon V","journal":"Archives of neurology","year":2007,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":259,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Review of literature, no new empirical data","sample_n":null,"sample_text":"Not applicable (review)","population":"Patients with Parkinson disease (literature based)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews reports that Parkinson’s patients taking dopamine drugs can develop impulsive, reward‑driven habits such as gambling, hypersexuality, and compulsive shopping, discussing how medication and disease factors might interact.","clinical_takeaway":"Clinicians should monitor patients on dopaminergic therapy for emerging impulsive or hypersexual behaviors and manage them promptly.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Comprehensive overview of impulse control behaviors in Parkinson disease","Integrates epidemiological and pathophysiological literature"],"limitations":["Narrative review without systematic methodology","No original data; conclusions rely on cited studies"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":12,"contrasting":0,"mentioning":369,"citing_publications":443,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archneur.64.8.1089"}},{"id":8251,"doi":"10.1097/wco.0b013e32826fbc8f","pmid":"17620886","pmcid":null,"title":"Medication-related impulse control and repetitive behaviors in Parkinson's disease","authors":"Voon V, Potenza MN, Thomsen T.","first_author":"Voon V","journal":"Current opinion in neurology","year":2007,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":102,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review article without primary data","sample_n":null,"sample_text":"Not applicable – narrative review","population":"Patients with Parkinson’s disease on dopamine agonists (as described in reviewed studies)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review describes how dopamine‑activating drugs for Parkinson’s disease can trigger impulse‑control problems such as gambling, hypersexuality, compulsive shopping, and overeating. Up to 14% of treated patients may develop these behaviors, which can be severe and are often hidden.","clinical_takeaway":"Clinicians should counsel Parkinson’s patients about the risk of impulse‑control problems, especially hypersexuality, before starting dopamine agonists and monitor for these behaviors during follow‑up.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of impulse control behaviors in PD","Integrates recent prevalence and mechanistic studies"],"limitations":["No original data; conclusions depend on cited primary studies","Lacks systematic review methodology (no risk‑of‑bias assessment)"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":47,"citing_publications":160,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/wco.0b013e32826fbc8f"}},{"id":8253,"doi":"10.1007/s00115-007-2271-7","pmid":"17492266","pmcid":null,"title":"[Klüver-Bucy syndrome in humans]","authors":"Gaul C, Jordan B, Wustmann T, Preuss UW.","first_author":"Gaul C","journal":"Der Nervenarzt","year":2007,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with Klüver‑Bucy syndrome describing hypersexuality among other symptoms","sample_n":1,"sample_text":"single female patient","population":"female inpatient, age 30, single case","country":"unspecified (likely Germany due to journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors report a 30‑year‑old woman with Klüver‑Bucy syndrome who displayed hypersexuality, hyperorality, visual agnosia and seizures, illustrating how this rare brain disorder can include excessive sexual behavior.","clinical_takeaway":"Klüver‑Bucy syndrome can involve increased sexual drive, but findings are based on a single case and not generalizable.","confidence":0.8,"topic_tags":["neuroscience"],"strengths":["Detailed clinical description of a rare syndrome","Highlights hypersexuality as a symptom of KBS"],"limitations":["Single case limits generalizability","No systematic measurement of sexual behavior or distress","No control for confounding variables"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00115-007-2271-7"}},{"id":8255,"doi":"10.1016/j.parkreldis.2007.04.004","pmid":"17544807","pmcid":null,"title":"Unusual compulsive behaviors primarily related to dopamine agonist therapy in Parkinson's disease and multiple system atrophy","authors":"McKeon A, Josephs KA, Klos KJ, Hecksel K, Bower JH, Michael Bostwick J, Eric Ahlskog J.","first_author":"McKeon A","journal":"Parkinsonism & related disorders","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":51,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Retrospective case series of 7 patients with Parkinsonism experiencing various compulsive behaviors linked to dopamine agonist therapy.","sample_n":8,"sample_text":"Seven patients with Parkinson's disease and one with multiple system atrophy were described.","population":"Patients with Parkinson's disease or multiple system atrophy on dopamine agonist or levodopa therapy (N≈8).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a handful of Parkinson's patients, dopamine‑boosting medication was linked to unusual compulsive activities, including hypersexuality and other odd habits. The authors suggest clinicians watch for such side‑effects.","clinical_takeaway":"Clinicians should monitor for diverse compulsive behaviors, including hypersexuality, in patients on dopamine agonists.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Highlights rare compulsive behaviors linked to dopamine agonists","Clinical relevance for neurologists"],"limitations":["Very small, non‑representative case series","No validated measures or systematic assessment","No control group or statistical analysis"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":45,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.parkreldis.2007.04.004"}},{"id":8258,"doi":"10.1007/bf02938408","pmid":"17445496","pmcid":null,"title":"Management of impulse control disorders in Parkinson's disease","authors":"Galpern WR, Stacy M.","first_author":"Galpern WR","journal":"Current treatment options in neurology","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methods; no primary data.","sample_n":null,"sample_text":"Not applicable (review article).","population":"Patients with Parkinson's disease experiencing impulse control disorders (including hypersexuality).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how impulse‑control problems like gambling, hypersexuality, and compulsive shopping can arise in Parkinson’s patients treated with dopamine drugs, and discusses possible treatment approaches such as medication changes, psychotherapy, and deep‑brain stimulation.","clinical_takeaway":"For Parkinson’s patients with hypersexuality, consider adjusting dopamine therapy and exploring psychosocial or neuromodulation options, but recognize evidence is limited.","confidence":0.8,"topic_tags":["csbd","pornography","masturbation","sexual_function"],"strengths":["Provides overview of management options for ICDs in Parkinson’s disease.","Highlights need for tailored treatment and future research."],"limitations":["No systematic methodology; narrative review.","No empirical data; conclusions based on limited evidence.","Lacks quantitative assessment of treatment efficacy."],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02938408"}},{"id":8260,"doi":"10.1089/cap.2007.0131","pmid":"17489719","pmcid":null,"title":"Three clinical cases of DSM-IV mania symptoms in preschoolers","authors":"Luby J, Tandon M, Nicol G.","first_author":"Luby J","journal":"Journal of child and adolescent psychopharmacology","year":2007,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Three clinical case descriptions of preschool children presenting with mania‑like symptoms, including hypersexuality, based on clinician observation and parental report.","sample_n":3,"sample_text":"Three cases","population":"Preschool children (ages 3.6‑5.2) attending a subspecialty mental‑health clinic; N = 3","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The article reports three preschool children who showed mania‑like symptoms such as grandiosity, rapid thoughts, reduced sleep, and unusually high sexual behavior, describing how these signs may appear in very young children.","clinical_takeaway":"Clinicians should be aware that hypersexual behavior can be part of early mania presentations, but evidence is limited to a few case reports.","confidence":0.8,"topic_tags":["prevalence","pornography","masturbation","sexual_function"],"strengths":["Detailed clinical description of rare preschool mania cases","Inclusion of hypersexuality as a developmental symptom"],"limitations":["Very small sample (N=3), no systematic data","No validated measurement tools for hypersexuality or mania in this age","No control or comparison group"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/cap.2007.0131"}},{"id":8261,"doi":"10.1590/s0004-282x2007000100030","pmid":"17420845","pmcid":null,"title":"Kleine-Levin syndrome: interface between neurology and psychiatry","authors":"Justo LP, Calil HM, Prado-Bolognani SA, Muszkat M.","first_author":"Justo LP","journal":"Arquivos de neuro-psiquiatria","year":2007,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with Kleine‑Levin syndrome describing clinical features, polysomnography and treatment; no comparison group","sample_n":1,"sample_text":"single case","population":"17‑year‑old male with first episode of KLS","country":"unspecified (likely Brazil based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 17‑year‑old boy experienced a first episode of Kleine‑Levin syndrome, showing extreme sleepiness, overeating and sexual disinhibition. The report describes his symptoms, sleep study, cognitive testing, and treatment with lithium, methylphenidate and risperidone, noting that risperidone use for KLS is novel.","clinical_takeaway":"None – the case report offers no direct guidance for clinical management of pornography‑related concerns.","confidence":0.8,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed clinical description of a rare syndrome","Includes polysomnography and neuropsychological assessment"],"limitations":["Single case, no control group","No measurement of sexual behavior specifics (e.g., pornography, masturbation)","No assessment of confounding factors (moral incongruence, mental health, trauma)"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s0004-282x2007000100030"}},{"id":8263,"doi":null,"pmid":"17566885","pmcid":null,"title":"[Klüver-Bucy-like syndrome and frontal symptoms following cerebrovascular disease]","authors":"Ozdemir H, Rezaki M.","first_author":"Ozdemir H","journal":"Turk psikiyatri dergisi = Turkish journal of psychiatry","year":2007,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"tur","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case report of a 45‑year‑old woman with Klüver‑Bucy‑like syndrome after subarachnoid hemorrhage; MRI findings linked to behavioral changes; treated with risperidone","sample_n":1,"sample_text":"single case","population":"1 adult female patient with cerebrovascular complications","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 45‑year‑old woman developed a Klüver‑Bucy‑like syndrome with disinhibited speech, placidity, and hyperphagia after brain surgery and hydrocephalus; MRI showed damage to the amygdala and frontal white matter, and she was treated with low‑dose risperidone.","clinical_takeaway":"Hypersexual and disinhibited behaviours can arise from limbic‑frontal brain injury; treatment may involve low‑dose antipsychotics.","confidence":0.85,"topic_tags":["neuroscience","csbd"],"strengths":["Detailed neurological and behavioral description","MRI evidence linked to symptomatology"],"limitations":["Single case; no generalizability","No systematic assessment of sexual behaviour beyond hypersexuality label","No control group or statistical analysis"],"rubric_version":"2.0","raw_total":15,"max_possible":60,"pct_score":25,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":4,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":8264,"doi":"10.1136/jnnp.49.8.867","pmid":"3746322","pmcid":"PMC1028946","title":"Hypersexuality or altered sexual preference following brain injury","authors":"Miller BL, Cummings JL, McIntyre H, Ebers G, Grode M.","first_author":"Miller BL","journal":"Journal of neurology, neurosurgery, and psychiatry","year":1986,"pub_types":["research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":114,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case series of eight patients with hypersexuality or altered sexual preference following brain injury; no control group, descriptive reports only.","sample_n":8,"sample_text":"Eight patients are described.","population":"Adult males with focal brain injury (medial basal‑frontal, diencephalic, limbic structures).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The paper reports eight men who, after specific brain injuries, showed either excessive sexual activity or changed sexual interests, suggesting that damage to certain brain areas may affect sexual behavior.","clinical_takeaway":"Brain injury can alter sexual behavior, but the evidence is limited to a few case reports.","confidence":0.6,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed clinical description of rare cases","Links lesion location to behavioural change"],"limitations":["Very small, non‑representative sample","No validated measures of hypersexuality or preference","No control or comparison group"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":6,"contrasting":0,"mentioning":131,"citing_publications":219,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/jnnp.49.8.867"}},{"id":8266,"doi":null,"pmid":"3718200","pmcid":null,"title":"Hypersexuality in stroke","authors":"Monga TN, Monga M, Raina MS, Hardjasudarma M.","first_author":"Monga TN","journal":"Archives of physical medicine and rehabilitation","year":1986,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case report of three stroke patients with hypersexuality.","sample_n":3,"sample_text":"Three stroke patients (one male, two female) with temporal lobe lesions.","population":"Adults (47‑55 yr) with temporal‑lobe stroke; N=3","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Three stroke patients with temporal‑lobe damage showed unusually high sexual drive or deviant sexual actions. The authors note the rarity and suggest the lesions may be involved, but cannot determine why.","clinical_takeaway":"Hypersexuality can emerge after temporal‑lobe stroke; clinicians should monitor sexual changes alongside other behavioural symptoms.","confidence":0.6,"topic_tags":["sexual_function","neuroscience","csbd"],"strengths":["Detailed clinical description of rare hypersexuality post‑stroke","Imaging (CT) confirms temporal‑lobe lesions"],"limitations":["Very small N (3), no control group","No validated measures of sexual behavior or distress","No systematic assessment of confounding factors"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":8267,"doi":"10.1212/01.wnl.0000238401.76928.45","pmid":"17030761","pmcid":null,"title":"Clinical features associated with impulse control disorders in Parkinson disease","authors":"Pontone G, Williams JR, Bassett SS, Marsh L.","first_author":"Pontone G","journal":"Neurology","year":2006,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":166,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-control within longitudinal cohort of Parkinson patients","sample_n":null,"sample_text":"participants in a longitudinal study of PD (exact N not provided)","population":"patients with Parkinson disease, UK","country":"United Kingdom","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In Parkinson patients, impulse‑control problems such as hypersexuality are linked to dopamine‑agonist medication, low mood and other behavioural changes.","clinical_takeaway":"Screen for hypersexuality in PD patients on dopamine agonists, especially if depressive symptoms are present.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Large clinical cohort of PD patients","Identifies multiple clinical correlates of ICDs"],"limitations":["No validated hypersexuality scale reported","Moral/incongruence and sexual behavior context not measured","Potential confounding by unmeasured psychosocial factors"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":167,"citing_publications":235,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1212/01.wnl.0000238401.76928.45"}},{"id":8268,"doi":"10.1212/01.wnl.0000238503.20816.13","pmid":"16957130","pmcid":null,"title":"Prevalence of repetitive and reward-seeking behaviors in Parkinson disease","authors":"Voon V, Hassan K, Zurowski M, de Souza M, Thomsen T, Fox S, Lang AE, Miyasaki J.","first_author":"Voon V","journal":"Neurology","year":2006,"pub_types":["Controlled Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":298,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 297 Parkinson’s disease patients using systematic screens for impulse‑control and hypersexual behaviors; prevalence estimates reported.","sample_n":297,"sample_text":"297 patients with Parkinson disease","population":"Parkinson’s disease patients (N≈297), likely clinic‑based sample","country":"Canada (Ontario)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 297 people with Parkinson’s disease, about 2.4% showed pathological hypersexuality and 13.7% of those taking dopamine‑agonist medicines had at least one repetitive reward‑seeking behavior.","clinical_takeaway":"Clinicians should monitor dopamine‑agonist patients for emerging compulsive sexual or other reward‑seeking behaviors.","confidence":0.8,"topic_tags":["sexual_function","csbd","prevalence","neuroscience","pornography"],"strengths":["Large sample for a clinical prevalence study","Systematic screening with explicit criteria"],"limitations":["Cross‑sectional design; no causal inference","Unclear whether screening tools are validated for hypersexuality","Potential selection bias from clinic‑based recruitment"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":12,"contrasting":5,"mentioning":364,"citing_publications":435,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1212/01.wnl.0000238503.20816.13"}},{"id":8269,"doi":"10.1016/j.pnpbp.2006.05.012","pmid":"16904253","pmcid":null,"title":"Hypersexual behaviour, frotteurism and delusional jealousy in a young parkinsonian patient during dopaminergic therapy with pergolide: A rare case of iatrogenic paraphilia","authors":"Cannas A, Solla P, Floris G, Tacconi P, Loi D, Marcia E, Marrosu MG.","first_author":"Cannas A","journal":"Progress in neuro-psychopharmacology & biological psychiatry","year":2006,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single Parkinson’s patient developing frotteurism and delusional jealousy during pergolide therapy; treatment change reported.","sample_n":1,"sample_text":"single patient (case report)","population":"51‑year‑old male with Parkinson’s disease","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 51‑year‑old man with Parkinson’s disease developed a paraphilia (frotteurism) and jealous delusions while taking the dopamine agonist pergolide. Reducing pergolide and adding quetiapine lessened these symptoms, suggesting the medication may have contributed.","clinical_takeaway":"Dopaminergic drugs can provoke atypical sexual behaviors; monitor patients for such changes and adjust treatment if needed.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Detailed clinical description","Links dopaminergic therapy to rare paraphilic behavior"],"limitations":["Single case; no control group","No validated scales for sexual behavior or distress","Cannot establish causality"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":2,"contrasting":0,"mentioning":34,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pnpbp.2006.05.012"}},{"id":8271,"doi":"10.1097/01.jcp.0000222518.01885.db","pmid":"16702901","pmcid":null,"title":"Quetiapine for hypersexuality and delusional jealousy after stroke","authors":"Chae BJ, Kang BJ.","first_author":"Chae BJ","journal":"Journal of clinical psychopharmacology","year":2006,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.jcp.0000222518.01885.db"}},{"id":8281,"doi":"10.2515/therapie:2006011","pmid":"16792152","pmcid":null,"title":"[Drugs, Parkinson's disease and parkinsonian syndroms: recent advances in pharmacovigilance]","authors":"Montastruc JL, Sommet A, Olivier P, Bagheri H, Gony M, Lapeyre-Mestre M, Brefel-Courbon C, Ferreira J, Schmitt L, Senard JM, Rascol O.","first_author":"Montastruc JL","journal":"Therapie","year":2006,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of pharmacovigilance reports; no primary data collection","sample_n":null,"sample_text":"Not applicable – no original sample","population":"humans with Parkinson’s disease or drug‑induced parkinsonism (as reported in spontaneous pharmacovigilance databases)","country":"France (and other settings referenced in reports)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews safety data on Parkinson’s medicines, noting that dopamine‑targeting drugs can sometimes cause hypersexual behaviour and other side‑effects, and stresses the importance of spontaneous reporting systems for spotting new risks.","clinical_takeaway":"Clinicians should be aware that dopaminergic Parkinson’s drugs may trigger increased sexual activity; monitor patients and discuss potential changes.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function","adolescents"],"strengths":["Comprehensive overview of recent adverse‑event reports for dopaminergic agents","Highlights previously under‑recognized side‑effects such as hypersexual behaviour"],"limitations":["Narrative rather than systematic review; no explicit search strategy or bias assessment","No quantitative synthesis; conclusions rely on heterogeneous spontaneous reports","No primary data; cannot evaluate causality or control for confounders"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2515/therapie:2006011"}},{"id":8285,"doi":null,"pmid":"16316819","pmcid":null,"title":"[Sexuality and dementia]","authors":"Derouesné C.","first_author":"Derouesné C.","journal":"Psychologie & neuropsychiatrie du vieillissement","year":2005,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review discussing sexuality in dementia without systematic methods.","sample_n":null,"sample_text":"Not applicable – review article","population":"Older adults with dementia and their partners/caregivers (no specific sample reported)","country":"France (journal language French, author likely French)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review describes how sexuality changes in people with dementia, noting that reduced interest is common while increased sexual demands are rare. It discusses how caregivers may feel stressed by inappropriate sexual behavior and suggests that information and a psychobehavioral approach can help.","clinical_takeaway":"Clinicians should address both reduced and disinhibited sexual behaviors in dementia, providing support and education to families and staff.","confidence":0.7,"topic_tags":["sexual_function","relationships","csbd"],"strengths":["Broad overview of sexual issues in dementia","Highlights caregiver perspectives"],"limitations":["No systematic methodology or quality assessment","No empirical data or quantitative analysis","Lacks clear definitions of sexual constructs"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":8286,"doi":"10.1093/brain/awh620","pmid":"16230322","pmcid":null,"title":"Kleine-Levin syndrome: a systematic review of 186 cases in the literature","authors":"Arnulf I, Zeitzer JM, File J, Farber N, Mignot E.","first_author":"Arnulf I","journal":"Brain : a journal of neurology","year":2005,"pub_types":["Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":172,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 186 individual case reports/series (no meta‑analysis, no risk‑of‑bias assessment).","sample_n":186,"sample_text":"186 patients from published case reports","population":"Patients with Kleine‑Levin syndrome reported in 139 articles (case reports).","country":"Various (global case reports)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed 186 published cases of Kleine‑Levin syndrome, describing typical ages, symptoms (including hypersexuality), triggers, and which medicines seemed to help.","clinical_takeaway":"Lithium may reduce relapses in Kleine‑Levin syndrome, but evidence is based on case reports and is not definitive.","confidence":0.7,"topic_tags":["neuroscience"],"strengths":["Comprehensive compilation of rare disorder cases","Clear reporting of demographic and clinical patterns","Identifies treatment response trends"],"limitations":["Relies on heterogeneous case reports lacking standardized measures","No systematic risk‑of‑bias assessment or meta‑analytic statistics","Potential publication bias and duplicate case inclusion"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":12,"contrasting":4,"mentioning":329,"citing_publications":434,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/brain/awh620"}},{"id":8288,"doi":"10.1111/j.1460-9568.2005.04252.x","pmid":"16101754","pmcid":null,"title":"Individual differences in male rat ejaculatory behaviour: searching for models to study ejaculation disorders","authors":"Pattij T, de Jong TR, Uitterdijk A, Waldinger MD, Veening JG, Cools AR, van der Graaf PH, Olivier B.","first_author":"Pattij T","journal":"The European journal of neuroscience","year":2005,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":95,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative animal study with rats classified into ejaculatory speed groups; neurobiological measures (Fos, oxytocin neurons) compared across groups.","sample_n":null,"sample_text":"Rats were matched into groups of 'sluggish', 'normal' and 'rapid' ejaculators based on weekly sexual behaviour tests; exact numbers not reported in abstract.","population":"Male Wistar rats (laboratory sample)","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Rats were grouped as slow, normal, or fast ejaculators. Fast rats showed higher brain‑cell activation (Fos) and more active oxytocin neurons, suggesting stable biological differences that might help understand human ejaculation disorders.","clinical_takeaway":"Animal findings hint at neurobiological factors in ejaculatory speed, but direct clinical implications are limited.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of established behavioral assays for ejaculatory parameters","Inclusion of neurobiological markers (Fos, oxytocin) to link behavior and brain activation","Comparison across clearly defined ejaculatory phenotypes"],"limitations":["Small, unspecified animal sample size limits power","Findings from rats may not translate directly to human sexual dysfunction","No longitudinal or causal manipulation of the neurobiological pathways"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":10,"contrasting":0,"mentioning":121,"citing_publications":162,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1460-9568.2005.04252.x"}},{"id":8289,"doi":"10.1017/s1461145705005493","pmid":"15927088","pmcid":null,"title":"Hypersexuality and its response to citalopram in a patient with hypothalamic hamartoma and precocious puberty","authors":"Malladi SS, Singh AN.","first_author":"Malladi SS","journal":"The international journal of neuropsychopharmacology","year":2005,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1461145705005493"}},{"id":8290,"doi":"10.1176/ajp.140.8.1036","pmid":"6223535","pmcid":null,"title":"Medroxyprogesterone acetate antiandrogen treatment of hypersexuality in a pedophiliac sex offender","authors":"Cordoba OA, Chapel JL.","first_author":"Cordoba OA","journal":"The American journal of psychiatry","year":1983,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single male pedophilic offender treated with medroxyprogesterone acetate for 500 days; no control group","sample_n":1,"sample_text":"single case","population":"1 adult male pedophilic sex offender with hypersexuality","country":"USA (presumed by journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A man with pedophilic urges and high sexual drive was given a hormone drug for about a year. His testosterone fell dramatically, his libido decreased, and he did not reoffend, but his sexual orientation stayed the same.","clinical_takeaway":"Hormonal suppression reduced libido and offending in this single case; evidence is insufficient to guide routine clinical use.","confidence":0.6,"topic_tags":["treatment","sexual_function"],"strengths":["Long treatment duration (500 days)","Objective hormonal measures"],"limitations":["Single case, no control","No validated hypersexuality scale","No assessment of confounds (e.g., moral incongruence, mental health)","Outcome of offending based on limited follow‑up"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ajp.140.8.1036"}},{"id":8291,"doi":"10.1055/s-2005-864127","pmid":"15902587","pmcid":null,"title":"Successful treatment of sexual disinhibition in dementia with carbamazepine -- a case report","authors":"Freymann N, Michael R, Dodel R, Jessen F.","first_author":"Freymann N","journal":"Pharmacopsychiatry","year":2005,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case report of a single 78‑year‑old Alzheimer’s patient with hypersexual behavior treated with carbamazepine","sample_n":1,"sample_text":"N=1 (case report)","population":"1 male dementia patient, aged 78","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"avoid","plain_summary":"A 78‑year‑old man with Alzheimer’s disease showed excessive sexual behavior that improved after starting the drug carbamazepine. The authors suggest the medication may help similar symptoms in dementia, but the report is based on one patient only.","clinical_takeaway":"Carbamazepine might reduce hypersexual behavior in dementia, but evidence is limited to a single case; use caution and monitor closely.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Provides detailed clinical observation of a rare symptom","Highlights potential utility of carbamazepine for sexual disinhibition"],"limitations":["Single case; no control or comparison group","No standardized measures of hypersexual behavior or outcome","No assessment of confounding factors (mood, medication, environment)","Conclusions extrapolate beyond the data"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-2005-864127"}},{"id":8292,"doi":"10.1055/s-2007-1017459","pmid":"6685318","pmcid":null,"title":"Hypersexuality--a complication of dopaminergic therapy in Parkinson's disease","authors":"Vogel HP, Schiffter R.","first_author":"Vogel HP","journal":"Pharmacopsychiatria","year":1983,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":51,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case history of a single Parkinson's patient developing hypersexuality while on dopaminergic therapy; no control group, no systematic data collection","sample_n":1,"sample_text":"single case","population":"1 patient with Parkinson's disease receiving L‑dopa and bromocriptine","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A Parkinson's patient developed compulsive sexual behaviour while taking L‑dopa and bromocriptine, which subsided when medication doses were lowered. The report suggests hypersexuality can be a side‑effect of dopaminergic drugs.","clinical_takeaway":"Monitor patients on dopaminergic therapy for emerging hypersexuality and adjust doses if needed.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","treatment"],"strengths":["Detailed clinical description","Highlights a rare adverse effect of dopaminergic therapy"],"limitations":["Single‑patient case report, no generalisable data","No validated measures of hypersexuality or distress","No control for confounding factors (e.g., mood, partner context)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":35,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-2007-1017459"}},{"id":8295,"doi":null,"pmid":"6682965","pmcid":null,"title":"Limbic stimulation-induced hypersexuality. Levels of sexual drive","authors":"Andy OJ, Kurimoto T, Velamati S, Peeler D.","first_author":"Andy OJ","journal":"The Pavlovian journal of biological science","year":1983,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Animal experimental study with 8 male cats; limbic electrical stimulation; observations of sexual drive; no human participants.","sample_n":8,"sample_text":"Eight adult male cats were used in the study.","population":"8 adult male cats (non‑human)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers electrically stimulated limbic areas in eight male cats and observed increased sexual drive, which depended on testosterone and catecholamine levels. They suggest similar brain activity could cause hypersexual behavior after seizures in humans.","clinical_takeaway":"Animal findings do not directly inform clinical practice for human sexual health.","confidence":0.6,"topic_tags":["sexual_function","neuroscience"],"strengths":["Direct physiological manipulation in a controlled animal model","Measurement of hormone levels alongside behavior"],"limitations":["Very small sample size (N=8)","Findings from cats may not generalize to human sexuality","No validated behavioral metrics or statistical reporting"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":8296,"doi":"10.1016/j.comppsych.2004.07.020","pmid":"15714189","pmcid":null,"title":"Cluster analysis of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive disorder: clinical and genetic correlates","authors":"Lochner C, Hemmings SM, Kinnear CJ, Niehaus DJ, Nel DG, Corfield VA, Moolman-Smook JC, Seedat S, Stein DJ.","first_author":"Lochner C","journal":"Comprehensive psychiatry","year":2005,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":68,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cluster analysis of comorbid OCSDs in a convenience sample of 210 adult OCD patients; genetic sub‑sample examined without significant findings.","sample_n":210,"sample_text":"210 adult patients with OCD (102 men, 108 women; mean age 35.7 ± 13.3).","population":"Adults with OCD (N=210), mostly Caucasian South African; not a general population sample.","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 210 adults with OCD, researchers used a clinical interview to group co‑occurring disorders (including hypersexual disorder) into three clusters: reward‑deficiency, impulsivity, and somatic. The clusters related to age of onset, gender, trauma, and insight, but showed no link to the genetic variants tested.","clinical_takeaway":"Hypersexual behaviour appears as one element of a broader OCD‑related ‘reward deficiency’ profile, not a distinct addiction.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Large OCD sample (N>200)","Systematic clinical interview (SCID‑OCSD)","Exploratory genetic sub‑analysis"],"limitations":["Cross‑sectional, no causal inference","SCID‑OCSD items not validated psychometrically","Limited genetic power, no significant findings"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":78,"citing_publications":133,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.comppsych.2004.07.020"}},{"id":8298,"doi":null,"pmid":"15670527","pmcid":null,"title":"Kleine-Levin syndrome","authors":"Mapari UU, Khealani BA, Ali S, Syed NA.","first_author":"Mapari UU","journal":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","year":2005,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case report of a female with Kleine‑Levin syndrome presenting with hypersexuality, treated with lithium and valproate","sample_n":1,"sample_text":"N=1 (case report)","population":"young adult female patient with KLS","country":"Pakistan","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2005 case report describes a young woman with Kleine‑Levin syndrome who experienced episodes of excessive sleep, overeating, and heightened sexual behavior, which improved after lithium and valproate treatment.","clinical_takeaway":"Evidence is limited; clinicians should note hypersexuality can appear in KLS but treatment effects are anecdotal.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","treatment"],"strengths":["Rare clinical presentation documented","Treatment response noted"],"limitations":["Single case, no control group","No validated measures of hypersexuality","No assessment of confounding factors"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":8299,"doi":"10.1081/ja-200055393","pmid":"15887599","pmcid":null,"title":"Sexual behavior patterns of methamphetamine-using gay and bisexual men","authors":"Halkitis PN, Shrem MT, Martin FW.","first_author":"Halkitis PN","journal":"Substance use & misuse","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":57,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 49 gay/bisexual methamphetamine users assessing self‑reported sexual behaviors while high vs sober","sample_n":49,"sample_text":"49 participants","population":"gay and bisexual men who use methamphetamine, recruited in New York City (convenience sample)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 49 gay and bisexual men who use methamphetamine, risky sexual practices were common whether participants were high on meth or sober, suggesting that meth users may belong to a generally high‑risk group rather than the drug itself causing more unsafe sex.","clinical_takeaway":"Methamphetamine use does not appear to increase sexual risk beyond a baseline of high‑risk behavior in this group; interventions should target overall risk profiles.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Focus on a high‑risk subgroup (meth‑using GBM)","Simultaneous assessment of drug use state and sexual behavior"],"limitations":["Small convenience sample (N=49) limits power and generalisability","Reliance on self‑report without validated scales","No control for key confounds such as moral incongruence, mental health, or trauma"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":2,"mentioning":56,"citing_publications":94,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1081/ja-200055393"}},{"id":8305,"doi":"10.1007/s00415-004-0483-3","pmid":"15258780","pmcid":null,"title":"Psychiatric aspects of Parkinson's disease--an update","authors":"Schrag A.","first_author":"Schrag A.","journal":"Journal of neurology","year":2004,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":121,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or meta‑analysis; no new empirical data.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Patients with Parkinson’s disease (PD) discussed in a clinical review.","country":"United Kingdom (Journal of Neurology, author affiliation not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarizes how mental‑state problems like depression, anxiety, and hypersexuality arise in Parkinson’s disease and discusses how various drugs, including antipsychotics and antidepressants, are used to treat them.","clinical_takeaway":"Clinicians should monitor for hypersexuality and other psychiatric side‑effects when adjusting Parkinson’s medications, and consider appropriate pharmacologic options.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","religiosity"],"strengths":["Comprehensive overview of psychiatric complications in PD","Covers a range of pharmacological treatments"],"limitations":["Narrative review lacks systematic methodology","No quantitative synthesis or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":2,"mentioning":104,"citing_publications":207,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00415-004-0483-3"}},{"id":8306,"doi":null,"pmid":"15174650","pmcid":null,"title":"[Hypersexuality. Hypersexuality in persons with dementia]","authors":"Hashimoto M, Akimoto T, Watanabe Y.","first_author":"Hashimoto M","journal":"Nihon rinsho. Japanese journal of clinical medicine","year":2004,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"jpn","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":8310,"doi":"10.1300/j070v13n03_03","pmid":"15914389","pmcid":null,"title":"Testing an etiological model for male juvenile sexual offending against females","authors":"Knight RA, Sims-Knight JE.","first_author":"Knight RA","journal":"Journal of child sexual abuse","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":55,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"sample_n=218 juvenile sexual offenders; adult controls used for model development; data from computerized interview; predictive modeling","sample_n":218,"sample_text":"218 juvenile sexual offenders","population":"juvenile sexual offenders (male) and adult control sample (used for model development)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors tested a model linking early abuse, personality traits and sexist attitudes to sexual coercion, using data from 218 juvenile offenders. The model’s predictions were similar to those found in adult offenders, suggesting common pathways to sexual aggression.","clinical_takeaway":"Findings suggest early abuse and antisocial traits are linked to sexual offending, highlighting the need for early intervention, but causal claims are limited.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample of juvenile offenders","Attempts to test a theoretically‑driven model across samples"],"limitations":["Cross‑sectional, limits causal inference","Unclear validation of measurement instruments","Limited control for key confounds such as moral incongruence"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":7,"contrasting":2,"mentioning":89,"citing_publications":131,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j070v13n03_03"}},{"id":8311,"doi":"10.4088/jcp.v64n1214","pmid":"14728112","pmcid":null,"title":"Possible basal ganglia pathology in children with complex symptoms","authors":"Yaryura-Tobias JA, Rabinowitz DC, Neziroglu F.","first_author":"Yaryura-Tobias JA","journal":"The Journal of clinical psychiatry","year":2003,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Cross‑sectional case series of 7 clinically referred children; no control group; descriptive assessments.","sample_n":7,"sample_text":"7 children assessed in 2001.","population":"Children with complex neurobehavioral symptoms (N=7).","country":"USA (inferred from authors’ affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A tiny study of seven children with many behavioural and emotional problems noted hypersexual behaviour and suggested the basal ganglia might be involved, but the evidence is purely descriptive and speculative.","clinical_takeaway":"No actionable clinical guidance; the basal‑ganglia hypothesis remains untested.","confidence":0.7,"topic_tags":["neuroscience","pornography","masturbation","sexual_function"],"strengths":["Use of standardized behavioural and diagnostic instruments (BASC, ADIS‑IV)","Identification of a previously unstudied clinical presentation"],"limitations":["Very small, non‑representative sample (N=7)","No control or comparison group","Hypersexuality not operationalised with validated measures","Speculative neurobiological inference without imaging data"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/jcp.v64n1214"}},{"id":8312,"doi":"10.4088/jcp.v64n1019d","pmid":"14658981","pmcid":null,"title":"Effect of bupropion on sexual dysfunction induced by fluoxetine: a case report of hypersexuality","authors":"Chollet CA, Andreatini R.","first_author":"Chollet CA","journal":"The Journal of clinical psychiatry","year":2003,"pub_types":["Letter","Research Support, Non-U.S. Gov't","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/jcp.v64n1019d"}},{"id":8315,"doi":"10.1016/s1525-5050(03)00108-2","pmid":"12791340","pmcid":null,"title":"Transient Kluver-Bucy syndrome following complex partial status epilepticus","authors":"Varon D, Pritchard PB, Wagner MT, Topping K.","first_author":"Varon D","journal":"Epilepsy & behavior : E&B","year":2003,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of a single patient with transient Kluver‑Bucy syndrome after complex partial status epilepticus, describing behavioral changes including hypersexuality.","sample_n":1,"sample_text":"single case","population":"Adult male with complex partial status epilepticus; no control group","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A man developed temporary Kluver‑Bucy syndrome, showing hypersexuality and other symptoms, after a prolonged seizure episode, despite no obvious brain damage on scans.","clinical_takeaway":"Rare seizures can temporarily cause hypersexual behaviour; assess neurological causes when abrupt changes occur.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed clinical description","Inclusion of EEG and SPECT data","Highlights rare neurological presentation"],"limitations":["Single case, no control","No validated sexual behavior measures","Limited generalizability"],"rubric_version":"2.0","raw_total":12,"max_possible":60,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":3,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1525-5050(03)00108-2"}},{"id":8316,"doi":null,"pmid":"12784535","pmcid":null,"title":"[Hypersexuality during use of levodopa]","authors":"van Puijenbroek EP, Diemont WL.","first_author":"van Puijenbroek EP","journal":"Nederlands tijdschrift voor geneeskunde","year":2003,"pub_types":["Letter","Comment","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"dut","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":8317,"doi":"10.1007/s00115-003-1505-6","pmid":"12707708","pmcid":null,"title":"[Sexual delinquency and Parkinson's disease]","authors":"Berger Ch, Mehrhoff FW, Beier KM, Meinck HM.","first_author":"Berger Ch","journal":"Der Nervenarzt","year":2003,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of two Parkinson patients with hypersexuality under dopaminergic therapy","sample_n":2,"sample_text":"Two legal cases described","population":"male Parkinson's disease patients, ages 45 and 57, with high‑dose levodopa or dopamine‑agonist treatment","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Two men with Parkinson's disease developed excessive sexual urges and illegal sexual behavior while on high‑dose dopamine medication. The authors discuss how such side‑effects may be overlooked and advise clinicians to ask about sexual changes.","clinical_takeaway":"Clinicians should routinely assess sexual impulse changes in Parkinson patients on dopaminergic therapy.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","pornography","moral_incongruence"],"strengths":["Detailed forensic case description","Highlights clinical relevance of dopaminergic side‑effects"],"limitations":["Only two cases, no systematic data","No validated measures of hypersexuality","No control for confounding factors"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00115-003-1505-6"}},{"id":8319,"doi":"10.1016/s0306-9877(02)00382-1","pmid":"12606243","pmcid":"PMC7125598","title":"Hypothalamic digoxin--central role in conscious perception, neuroimmunoendocrine integration and coordination of cellular function--relation to hemispheric dominance","authors":"Kurup RK, Kurup PA.","first_author":"Kurup RK","journal":"Medical hypotheses","year":2003,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7125598","cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"none","sample_n":null,"sample_text":"Family with multiple disorders; no systematic sampling","population":"family case description (unspecified sample size)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["circular_addiction_scale","causal_from_correlational","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose that elevated hypothalamic digoxin, a natural sodium‑potassium pump inhibitor, may drive a range of disorders—including hypersexual behavior—by altering neurotransmitter balance and cellular functions, especially in people with right‑hemispheric dominance.","clinical_takeaway":"No clinical implications; the paper is a speculative hypothesis lacking data.","confidence":0.6,"topic_tags":["sexual_function","neuroscience"],"strengths":["Integrative biochemical hypothesis","Links multiple disorders"],"limitations":["No empirical data","Speculative causal claims","No measurement of sexual behavior specifics"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0306-9877(02)00382-1"}},{"id":8322,"doi":"10.1155/2003/123757","pmid":"12719639","pmcid":"PMC5497559","title":"Opposed left and right brain hemisphere contributions to sexual drive: a multiple lesion case analysis","authors":"Braun CM, Dumont M, Duval J, Hamel I, Godbout L.","first_author":"Braun CM","journal":"Behavioural neurology","year":2003,"pub_types":["research-article","Review","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5497559","cited_by_count":35,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review of previously published single‑case reports of patients with unilateral brain lesions and altered sexual drive","sample_n":null,"sample_text":"case reports (number not specified)","population":"men with brain lesions (cases drawn from the literature)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed case reports of men with left‑brain lesions who became less sexually active and right‑brain lesions who became more sexually active, suggesting each hemisphere may differently influence sexual drive.","clinical_takeaway":"No direct clinical guidance; the claim is speculative and based on limited case evidence.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","lgbtq"],"strengths":["addresses an understudied neurological aspect of sexual behavior","uses lesion data to generate hypothesis"],"limitations":["relies on single‑case reports without systematic selection","no validated measures of sexual drive or dysfunction","does not control for key psychological or relational confounds"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":32,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1155/2003/123757"}},{"id":8326,"doi":"10.1177/107906320201400405","pmid":"12375492","pmcid":null,"title":"A DSM-IV Axis I comorbidity study of males (n = 120) with paraphilias and paraphilia-related disorders","authors":"Kafka MP, Hennen J.","first_author":"Kafka MP","journal":"Sexual abuse : a journal of research and treatment","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":121,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional assessment of 120 consecutive outpatient males with paraphilias or related disorders, comparing comorbid Axis I diagnoses.","sample_n":120,"sample_text":"120 consecutively evaluated outpatient males (88 with paraphilias, 32 with paraphilia‑related disorders).","population":"Male outpatients (n=120) diagnosed with DSM‑IV paraphilias (n=88) or paraphilia‑related disorders (n=32).","country":"USA (assumed from authors/journal, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 120 male outpatients with paraphilic disorders, most also had mood, anxiety, substance‑use or ADHD diagnoses. ADHD and related developmental problems were the strongest non‑sexual factors distinguishing those with socially deviant sexual arousal from a hypersexual comparison group.","clinical_takeaway":"Clinicians should assess and address co‑occurring mental‑health disorders, especially ADHD, when treating men with paraphilic or hypersexual presentations.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses DSM‑IV structured diagnostic criteria","Large clinical sample for this niche population","Comprehensive assessment of multiple comorbidities"],"limitations":["Cross‑sectional design limits causal inference","Convenience clinical sample limits generalisability","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":14,"contrasting":3,"mentioning":175,"citing_publications":311,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/107906320201400405"}},{"id":8327,"doi":"10.1055/s-2002-33759","pmid":"12215919","pmcid":null,"title":"[Pharmacological agents for treatment of paraphilias and hypersexual disorders]","authors":"Hebebrand K, Hebebrand J, Remschmidt H.","first_author":"Hebebrand K","journal":"Fortschritte der Neurologie-Psychiatrie","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods; no original data.","sample_n":null,"sample_text":"No original sample; review of existing literature.","population":"Not applicable (review)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"supports","citation_value":"background","plain_summary":"The article reviews drugs that lower sexual desire for treating paraphilias and hypersexual disorders, emphasizing that medication should be combined with psychotherapy.","clinical_takeaway":"Medication may help reduce urges, but always paired with psychotherapy.","confidence":0.6,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Provides overview of pharmacological options","Discusses ethical/legal considerations"],"limitations":["Lacks systematic methodology","No empirical data or meta‑analysis"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-2002-33759"}},{"id":8329,"doi":"10.1097/00002826-200207000-00008","pmid":"12151912","pmcid":null,"title":"Reversible transvestic fetishism in a man with Parkinson's disease treated with selegiline","authors":"Riley DE.","first_author":"Riley DE.","journal":"Clinical neuropharmacology","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report describing onset of transvestic behavior after selegiline addition and cessation after withdrawal","sample_n":1,"sample_text":"single case","population":"72‑year‑old man with long‑standing Parkinson’s disease","country":"USA (presumed from author affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 72‑year‑old man with Parkinson’s disease began wearing women’s clothing after starting the dopamine‑boosting drug selegiline; the behavior stopped when the medication was withdrawn, suggesting a possible drug‑induced paraphilic impulse.","clinical_takeaway":"Clinicians should monitor for emergence of atypical sexual urges when prescribing dopaminergic agents to Parkinson’s patients.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","csbd"],"strengths":["Detailed temporal link between selegiline initiation and emergence of behavior","Clear documentation of symptom reversal after drug cessation"],"limitations":["N=1; no control or comparison group","No validated measures of paraphilic urges or compulsivity","Potential confounders (e.g., bereavement, disease progression) not assessed"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":28,"citing_publications":66,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00002826-200207000-00008"}},{"id":8331,"doi":"10.1001/archneur.59.6.1006","pmid":"12056938","pmcid":null,"title":"Acquired sexual paraphilia in patients with multiple sclerosis","authors":"Frohman EM, Frohman TC, Moreault AM.","first_author":"Frohman EM","journal":"Archives of neurology","year":2002,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case description with MRI findings","sample_n":1,"sample_text":"1 patient (male)","population":"adult male with clinically definite multiple sclerosis","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A man with multiple sclerosis suddenly developed intense, inappropriate sexual urges after new brain lesions appeared in hypothalamic and midbrain areas, suggesting that brain damage can sometimes trigger paraphilic behavior.","clinical_takeaway":"Clinicians should consider neuro‑anatomical changes as possible contributors to sudden hypersexual or paraphilic behavior in MS patients.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed MRI description of lesion locations","Rare clinical observation linking MS lesions to acquired paraphilia"],"limitations":["Single case, no control comparison","No standardized behavioral or psychological measures","Causal inference from correlational observation"],"rubric_version":"2.0","raw_total":12,"max_possible":60,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":1,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":24,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archneur.59.6.1006"}},{"id":8334,"doi":"10.1007/pl00007840","pmid":"11954860","pmcid":null,"title":"Penile erections and hypersexuality induced by pergolide treatment in advanced, fluctuating Parkinson's disease","authors":"Kanovský P, Bares M, Pohanka M, Rektor I.","first_author":"Kanovský P","journal":"Journal of neurology","year":2002,"pub_types":["Letter","Research Support, Non-U.S. Gov't","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":1,"mentioning":13,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/pl00007840"}},{"id":8335,"doi":"10.1097/00131746-200201000-00010","pmid":"15985857","pmcid":null,"title":"Treatment resources for the paraphilic and hypersexual disorders","authors":"Krueger RB, Kaplan MS.","first_author":"Krueger RB","journal":"Journal of psychiatric practice","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00131746-200201000-00010"}},{"id":8336,"doi":"10.1159/000058328","pmid":"12053127","pmcid":null,"title":"Familial frontotemporal dementia associated with a novel presenilin-1 mutation","authors":"Tang-Wai D, Lewis P, Boeve B, Hutton M, Golde T, Baker M, Hardy J, Michels V, Ivnik R, Jack C, Petersen R.","first_author":"Tang-Wai D","journal":"Dementia and geriatric cognitive disorders","year":2002,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":43,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case series of three family members with familial frontotemporal dementia and a novel PSEN1 mutation; neuroimaging and clinical description only.","sample_n":3,"sample_text":"Three cases","population":"Three affected individuals from a single family (probands with FTD).","country":"USA (implied by US government funding)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A three‑person family with frontotemporal dementia was found to carry a new mutation in the PSEN1 gene; the affected members showed typical dementia signs plus hypersexual behavior. MRI showed brain changes typical of FTD. The authors suggest that PSEN1 testing can help diagnose atypical dementia cases.","clinical_takeaway":"Hypersexuality can be part of the clinical picture in PSEN1‑related frontotemporal dementia; clinicians should consider genetic testing when atypical symptoms appear.","confidence":0.8,"topic_tags":["gender","neuroscience","sexual_function"],"strengths":["Identification of a novel PSEN1 mutation","Detailed clinical description linking hypersexuality to FTD phenotype","Use of structural MRI to support diagnosis"],"limitations":["Very small sample (n=3) limits generalisability","No control group or statistical testing","Sexual‑behavior measures not standardized or validated"],"rubric_version":"2.0","raw_total":11,"max_possible":60,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":2,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":49,"citing_publications":72,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1159/000058328"}},{"id":8338,"doi":"10.1016/s1389-9457(01)00112-5","pmid":"14592248","pmcid":null,"title":"Recurrent hyper- and hyposomnia: a new diagnostic entity? Polysomnographic findings and a 30-year follow-up","authors":"Hauri PJ.","first_author":"Hauri PJ.","journal":"Sleep medicine","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single-case longitudinal follow‑up with polysomnography over decades","sample_n":1,"sample_text":"N=1 (single case report)","population":"one professional woman, middle‑aged at onset","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A detailed report of one woman's 30‑year history of extreme swings between sleeping 12 hours and 4 hours, showing distinct brain‑wave patterns and accompanying overeating and increased sexual activity during long‑sleep periods.","clinical_takeaway":"The case suggests that dramatic sleep‑duration changes can be linked to psychiatric factors and may resolve spontaneously, but findings cannot be applied to other patients.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["very long follow‑up (30 years)","extensive polysomnographic data (29 nights)"],"limitations":["single case – no generalisability","no control group or systematic measurement of confounders","descriptive only, no statistical testing"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1389-9457(01)00112-5"}},{"id":8343,"doi":"10.1176/ajp.133.6.662","pmid":"945000","pmcid":null,"title":"The behavior of hypersexual delinquent girls","authors":"Goodman JD.","first_author":"Goodman JD.","journal":"The American journal of psychiatry","year":1976,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case-report","sample_n":7,"sample_text":"Seven hypersexual delinquent girls presented as case reports","population":"adolescent girls (n=7) with hypersexual behavior and delinquency","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The 1976 paper describes seven adolescent girls who showed excessive sexual behavior, delinquency, aggression, and hypomania, many of whom had been exposed to hormones that increase male characteristics before or after birth. The author suggests hormone exposure may cause this pattern.","clinical_takeaway":"Evidence is limited; clinicians should consider hormonal history but not assume causation from such small case series.","confidence":0.4,"topic_tags":["sexual_function","adolescents","neuroscience"],"strengths":["Rare historical data on hypersexuality in females","Links hormonal exposure to behavioral outcomes"],"limitations":["Very small, non‑representative case series","No validated measures of hypersexuality or delinquency","No control for key confounds (moral incongruence, mental health, etc.)"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ajp.133.6.662"}},{"id":8346,"doi":null,"pmid":"1172492","pmcid":null,"title":"The clinical application of laboratory animal experimental findings: treatment of hypersexualized behavior in a male","authors":"Chapel JL, Fahim M.","first_author":"Chapel JL","journal":"International journal of clinical pharmacology and biopharmacy","year":1975,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single patient case report; no control group; treatment applied and outcome described","sample_n":1,"sample_text":"young 16‑year‑old mildly retarded male","population":"one 16‑year‑old male with mild intellectual disability and hypersexualised behaviour","country":"unspecified (likely USA based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"avoid","plain_summary":"A 16‑year‑old male with intellectual disability and excessive sexual urges received phenobarbital and vitamin B12, which lowered his testosterone and stopped the behaviour, based on a single clinical observation.","clinical_takeaway":"Evidence is only a single case; clinicians should not adopt this regimen without stronger data.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Translational link from animal pharmacology to human case","Objective hormone measurement before and after treatment"],"limitations":["N=1; no control or comparison","No validated behavioural outcome measure","No assessment of key psychosocial confounds"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":8349,"doi":"10.1053/scnp.2000.9555","pmid":"11291023","pmcid":null,"title":"Disorders of sexual impulse control in neuropsychiatric conditions","authors":"Krueger RB, Kaplan MS.","first_author":"Krueger RB","journal":"Seminars in clinical neuropsychiatry","year":2000,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review of hypersexuality in neuropsychiatric conditions and pharmacologic treatment; no original data","sample_n":null,"sample_text":"N/A (review)","population":"humans with neuropsychiatric disorders (reviewed studies)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how hypersexuality appears in various brain disorders, summarises treatment options, and offers a clinical guide for clinicians.","clinical_takeaway":"Clinicians should consider underlying neuropsychiatric causes when treating hypersexuality and may use the suggested pharmacologic approaches.","confidence":0.4,"topic_tags":["sexual_function","neuroscience","treatment"],"strengths":["Broad overview of neuropsychiatric hypersexuality","Includes pharmacologic treatment discussion","Provides clinical algorithm"],"limitations":["Narrative review lacks systematic search and bias assessment","No empirical data; cannot evaluate measurement validity","Likely no control for key confounds"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1053/scnp.2000.9555"}},{"id":8350,"doi":"10.1080/j.1440-1614.2000.0822l.x","pmid":"11037385","pmcid":null,"title":"Cyproterone for hypersexuality in a psychotic patient with Wilson's disease","authors":"Volpe FM, Tavares A.","first_author":"Volpe FM","journal":"The Australian and New Zealand journal of psychiatry","year":2000,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/j.1440-1614.2000.0822l.x"}},{"id":8351,"doi":"10.1093/sleep/23.4.1i","pmid":"10875563","pmcid":null,"title":"Kleine Levin syndrome (KLS) in young females","authors":"Kesler A, Gadoth N, Vainstein G, Peled R, Lavie P.","first_author":"Kesler A","journal":"Sleep","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case series of 8 adolescents/young adult patients with Kleine‑Levin syndrome; descriptive clinical and polysomnographic data.","sample_n":8,"sample_text":"Eight patients (7 adolescents, 1 young adult female) seen between 1982‑1998.","population":"Adolescents and young adults with KLS (7 adolescents, 1 young woman).","country":"Israel (implicit from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors report eight young people with Kleine‑Levin syndrome, a condition marked by recurring episodes of extreme sleepiness; half also showed overeating and heightened sexual interest. Sleep studies showed largely normal patterns between attacks.","clinical_takeaway":"KLS can include temporary increases in sexual drive, but this case series offers no guidance for managing typical sexual health concerns.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed clinical description of a rare syndrome","In‑attack polysomnography data"],"limitations":["Very small, non‑representative sample","No control group","No systematic measurement of sexual behavior beyond clinical report"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sleep/23.4.1i"}},{"id":8352,"doi":"10.1212/wnl.54.10.2024","pmid":"10822454","pmcid":null,"title":"Hypersexuality in patients with dementia: possible response to cimetidine","authors":"Wiseman SV, McAuley JW, Freidenberg GR, Freidenberg DL.","first_author":"Wiseman SV","journal":"Neurology","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":43,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1212/wnl.54.10.2024"}},{"id":8353,"doi":"10.1089/10445460050167269","pmid":"11052405","pmcid":null,"title":"Diagnostic characteristics of 93 cases of a prepubertal and early adolescent bipolar disorder phenotype by gender, puberty and comorbid attention deficit hyperactivity disorder","authors":"Geller B, Zimerman B, Williams M, Bolhofner K, Craney JL, Delbello MP, Soutullo CA.","first_author":"Geller B","journal":"Journal of child and adolescent psychopharmacology","year":2000,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":172,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"case series of 93 consecutively ascertained outpatients, blind assessments, no control group","sample_n":93,"sample_text":"93 outpatients, ages 10.9 ± 2.6 years","population":"prepubertal and early adolescent children with bipolar disorder (with/without ADHD)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study examined 93 children and early adolescents with bipolar disorder, looking at how gender, puberty, and ADHD affect manic symptoms. Hypersexuality was more common after puberty, but otherwise the phenotype appeared similar across groups.","clinical_takeaway":"Hypersexuality may increase with puberty in youths with bipolar disorder, but findings are based on a clinical sample and may not apply to all children.","confidence":0.7,"topic_tags":["prevalence"],"strengths":["Blind, consensus‑based diagnostic assessments","Clear inclusion criteria for a homogeneous phenotype","Relatively large clinical sample for a pediatric bipolar study"],"limitations":["No control or comparison group","Clinical convenience sample limits generalisability","Limited statistical reporting; no power calculations"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":24,"contrasting":3,"mentioning":176,"citing_publications":255,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/10445460050167269"}},{"id":8354,"doi":"10.1176/jnp.12.1.71","pmid":"10678516","pmcid":null,"title":"Pedophilia and temporal lobe disturbances","authors":"Mendez MF, Chow T, Ringman J, Twitchell G, Hinkin CH.","first_author":"Mendez MF","journal":"The Journal of neuropsychiatry and clinical neurosciences","year":2000,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":96,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report of 2 patients with neurodegenerative disease and pedophilic behavior; no control group; imaging described","sample_n":2,"sample_text":"two case patients","population":"2 older male professionals with frontotemporal dementia or hippocampal sclerosis; not representative","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe two older men with brain disease who developed late‑life pedophilic interests. Brain scans showed reduced metabolism in the right temporal lobe, suggesting that damage there may unleash sexual urges.","clinical_takeaway":"Brain lesions can alter sexual behavior, but case reports do not establish general risk.","confidence":0.8,"topic_tags":["neuroscience","sexual_function"],"strengths":["use of FDG‑PET to document metabolic changes","integration of clinical and imaging data","discussion of existing literature"],"limitations":["n=2; no comparison group","no validated behavioral measures","causal language applied to correlational findings"],"rubric_version":"2.0","raw_total":10,"max_possible":60,"pct_score":17,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":2,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":3,"contrasting":0,"mentioning":97,"citing_publications":202,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/jnp.12.1.71"}},{"id":8357,"doi":null,"pmid":"10668608","pmcid":null,"title":"[Orbitofrontal syndrome in psychiatry]","authors":"Murad A.","first_author":"Murad A.","journal":"L'Encephale","year":1999,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report describing orbitofrontal syndrome with hypersexuality; no control group or systematic data","sample_n":1,"sample_text":"single case","population":"one middle‑aged female with bilateral orbitofrontal lesions","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1999 case report describes a woman with orbitofrontal brain damage whose symptoms included impulsivity, disinhibition and excessive sexual behaviour, initially mistaken for mania. The authors discuss diagnosis and suggest serotonin reuptake inhibitors might help.","clinical_takeaway":"Hypersexuality can stem from brain lesions; treatment may differ from psychiatric diagnoses.","confidence":0.8,"topic_tags":["neuroscience","csbd"],"strengths":["detailed clinical description","highlights diagnostic confusion"],"limitations":["single case, no generalizability","no systematic measurement of sexual behaviour","no quantitative analysis"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":8358,"doi":"10.4088/jcp.v60n0708","pmid":"10453801","pmcid":null,"title":"Late-onset adrenoleukodystrophy associated with long-standing psychiatric symptoms","authors":"Garside S, Rosebush PI, Levinson AJ, Mazurek MF.","first_author":"Garside S","journal":"The Journal of clinical psychiatry","year":1999,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case study of a single adult patient with late‑onset adrenoleukodystrophy presenting with psychiatric symptoms, including hypersexuality, plus narrative literature review.","sample_n":null,"sample_text":"single case","population":"Adult male (31 y) with ALD; no broader sample","country":"United States (assumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 31‑year‑old man with late‑onset adrenoleukodystrophy first showed psychiatric signs such as mania and hypersexuality; neurological exam and MRI revealed characteristic white‑matter lesions, prompting a recommendation to consider metabolic disorders in treatment‑resistant psychiatric cases.","clinical_takeaway":"When psychiatric symptoms are resistant to treatment, evaluate for underlying neurological or metabolic disorders like ALD.","confidence":0.6,"topic_tags":["adolescents","neuroscience"],"strengths":["Detailed clinical description of a rare adult‑onset ALD case","Clear neuroimaging and metabolic confirmation of diagnosis"],"limitations":["Single case; no generalisable data","No systematic assessment of psychiatric constructs or confounds","No statistical analysis"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4088/jcp.v60n0708"}},{"id":8360,"doi":"10.1530/eje.0.1400140","pmid":"10069657","pmcid":null,"title":"Kleine-Levin and Munchausen syndromes in a patient with recurrent acromegaly","authors":"Jungheim K, Badenhoop K, Ottmann OG, Usadel KH.","first_author":"Jungheim K","journal":"European journal of endocrinology","year":1999,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"1 patient","population":"single adult female patient with recurrent acromegaly","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A single patient with recurring acromegaly developed excessive sleep, appetite, and sexual drive (Kleine‑Levin syndrome) and also fabricated anemia (Munchausen syndrome). The authors discuss whether these symptoms stem from the hormone disorder or brain damage after radiation.","clinical_takeaway":"In patients with pituitary tumors, monitor for rare neuro‑psychiatric changes like hypersexuality, but evidence is limited to case reports.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed clinical description of a rare co‑occurrence","Discussion of potential neuro‑endocrine mechanisms"],"limitations":["Single case; no systematic assessment","No validated measures of hypersexuality or addiction","No control for confounding factors"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1530/eje.0.1400140"}},{"id":8361,"doi":"10.1016/s0303-8467(98)00055-9","pmid":"9879850","pmcid":null,"title":"Kluver Bucy syndrome in young children","authors":"Pradhan S, Singh MN, Pandey N.","first_author":"Pradhan S","journal":"Clinical neurology and neurosurgery","year":1998,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 7 children with post‑encephalitic Kluver‑Bucy syndrome describing observed hypersexual behaviours","sample_n":7,"sample_text":"seven patients","population":"pre‑pubertal children (2.5–6 y) with prior herpes simplex encephalitis","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors report seven preschool children who, after severe herpes brain infection, developed Kluver‑Bucy syndrome. All showed unusual sexual behaviours such as genital touching and pelvic thrusting, despite never having learned about sex.","clinical_takeaway":"Hypersexual behaviours can appear in young children with severe temporal‑lobe damage; clinicians should consider neurological causes when such symptoms arise.","confidence":0.5,"topic_tags":["sexual_function","neuroscience","pornography"],"strengths":["Rare clinical description of hypersexuality in very young children","Clear clinical observations of multiple KBS components","Adds to limited literature on pediatric KBS"],"limitations":["Very small, non‑representative case series","No standardized behavioural or psychometric measures","No control or comparison group","No statistical analysis beyond description"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":26,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0303-8467(98)00055-9"}},{"id":8367,"doi":"10.3928/0098-9134-19980401-11","pmid":"9611564","pmcid":null,"title":"Addressing hypersexuality in Alzheimer's disease","authors":"Kuhn DR, Greiner D, Arseneau L.","first_author":"Kuhn DR","journal":"Journal of gerontological nursing","year":1998,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3928/0098-9134-19980401-11"}},{"id":8369,"doi":"10.1352/0047-6765(1998)036<0023:sbawlv>2.0.co;2","pmid":"9492515","pmcid":null,"title":"Sexual behavior associated with low Verbal IQ in youth who have severe mental illness","authors":"McCurry C, McClellan J, Adams J, Norrei M, Storck M, Eisner A, Breiger D.","first_author":"McCurry C","journal":"Mental retardation","year":1998,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective chart review of 200 youth with severe mental illness, examining documented sexual behavior categories and IQ scores","sample_n":200,"sample_text":"200 youth","population":"youth with severe mental illness (clinical sample, chart review)","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a review of 200 young people with serious mental illness, lower verbal IQ was linked to more problem sexual actions, while history of sexual abuse related to lower performance IQ. Verbal abilities may influence risky sexual behavior independent of abuse history.","clinical_takeaway":"Assess verbal cognitive skills when planning interventions for sexual risk behaviors in youth with mental illness.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["Large clinical sample (N=200)","Standardized IQ assessment"],"limitations":["Retrospective chart data; unclear definition of sexual behavior categories","Limited control of key confounds (moral incongruence, masturbation, mental health)","No effect sizes or power analysis reported"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":22,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1352/0047-6765(1998)036<0023:sbawlv>2.0.co;2"}},{"id":8370,"doi":"10.1176/jnp.10.3.354","pmid":"9706545","pmcid":null,"title":"Klüver-Bucy syndrome after bilateral selective damage of amygdala and its cortical connections","authors":"Hayman LA, Rexer JL, Pavol MA, Strite D, Meyers CA.","first_author":"Hayman LA","journal":"The Journal of neuropsychiatry and clinical neurosciences","year":1998,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single case","population":"single adult male with cancer‑related bilateral amygdala damage","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A man who received cancer treatment developed damage to both amygdalae. Imaging showed lesions, and he subsequently exhibited classic Klüver‑Bucy symptoms, including excessive sexual behavior and visual agnosia.","clinical_takeaway":"Hypersexuality can arise from bilateral amygdala damage, not necessarily from psychological factors.","confidence":0.8,"topic_tags":["neuroscience","pornography","masturbation","sexual_function"],"strengths":["Detailed clinical description of rare lesion pattern","Clear imaging documentation of amygdala damage"],"limitations":["Single case limits generalisability","No systematic assessment of sexual behaviour or psychiatric measures","No control or comparison group"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/jnp.10.3.354"}},{"id":8371,"doi":"10.1007/bf01808825","pmid":"9444580","pmcid":null,"title":"The Kluver-Bucy syndrome","authors":"Góscínski I, Kwiatkowski S, Polak J, Orlowiejska M, Partyk A.","first_author":"Góscínski I","journal":"Journal of neurosurgical sciences","year":1997,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 4 patients with bilateral temporal lesions presenting Kluver‑Bucy syndrome, including hypersexuality; no control group, convenience clinical sample.","sample_n":4,"sample_text":"four patients","population":"4 adult patients (male) with post‑traumatic bitemporal brain injury treated at a single neurosurgical department.","country":"Poland (inferred from author names/institution)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Four patients with bilateral temporal‑lobe damage developed Kluver‑Bucy syndrome, showing symptoms such as hypersexuality and memory loss. Carbamazepine appeared to reduce some behaviours, suggesting it might help this rare condition.","clinical_takeaway":"Evidence is limited; carbamazepine may be considered experimentally for hypersexuality in Kluver‑Bucy syndrome, but further study is needed.","confidence":0.7,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed clinical description of rare syndrome","Imaging confirmation of lesion localisation"],"limitations":["Very small sample (n=4)","No standardized measures of hypersexuality","No control group or systematic assessment of confounds"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":27,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01808825"}},{"id":8372,"doi":"10.1097/00004583-199709000-00008","pmid":"9291717","pmcid":null,"title":"Child and adolescent bipolar disorder: a review of the past 10 years","authors":"Geller B, Luby J.","first_author":"Geller B","journal":"Journal of the American Academy of Child and Adolescent Psychiatry","year":1997,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.1097/00004583-199709000-00009","cited_by_count":147,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of child/adolescent bipolar disorder; no empirical data, no systematic methods","sample_n":null,"sample_text":"Not applicable – review article","population":"children and adolescents with bipolar disorder (no specific sample size reported)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews ten years of research on bipolar disorder in children and teens, describing how the illness shows up, its course, comorbid conditions, and treatment, and noting that hypersexual behavior can be part of the presentation.","clinical_takeaway":"Clinicians should be aware that hypersexuality may appear in pediatric bipolar disorder but should assess it within the broader mood disorder context.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Comprehensive overview of pediatric bipolar disorder literature","Highlights hypersexuality as a symptom in youth"],"limitations":["Narrative, not systematic, review – risk of selection bias","No empirical data or meta‑analytic methods","No explicit assessment of methodological quality"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":8,"contrasting":1,"mentioning":257,"citing_publications":542,"retracted":false,"notices":[{"status":"Has erratum","date":"1998-4","noticeDoi":"10.1097/00004583-199804000-00006","doi":"10.1097/00004583-199709000-00008"},{"status":"Comment","date":"1998-4","noticeDoi":"10.1097/00004583-199804000-00006","doi":"10.1097/00004583-199709000-00008"},{"status":"Comment","date":"1998-10","noticeDoi":"10.1097/00004583-199810000-00001","doi":"10.1097/00004583-199709000-00008"}],"url":"https://scite.ai/reports/10.1097/00004583-199709000-00008"}},{"id":8374,"doi":"10.1002/j.1875-9114.1997.tb03073.x","pmid":"9165567","pmcid":null,"title":"Female sexual stimulation during antidepressant treatment","authors":"Elmore JL, Quattlebaum JT.","first_author":"Elmore JL","journal":"Pharmacotherapy","year":1997,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case reports of three women on SSRIs experiencing increased sexual arousal or hypersexuality.","sample_n":3,"sample_text":"Three women","population":"Female adults (middle‑aged) with depressive and other psychiatric diagnoses.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Three women taking antidepressants reported unexpected increases in sexual desire and arousal, including one who became hypersexual. The report notes these paradoxical side‑effects but does not explain why they occurred.","clinical_takeaway":"Clinicians should be aware that SSRIs can sometimes increase, rather than decrease, sexual desire in women, and monitor patients accordingly.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Provides detailed clinical observations","Highlights possible paradoxical sexual side‑effects of SSRIs"],"limitations":["Very small N (3)","No validated measurement of sexual arousal or hypersexuality","No control for confounding variables","No statistical analysis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/j.1875-9114.1997.tb03073.x"}},{"id":8375,"doi":"10.1016/s1052-5149(25)00428-9","pmid":"9100232","pmcid":null,"title":"Anatomy and pathology of the septal region","authors":"Cavazos JE, Wang CJ, Sitoh YY, Ng SE, Tien RD.","first_author":"Cavazos JE","journal":"Neuroimaging clinics of North America","year":1997,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of septal neuroanatomy and pathology; no original data collection.","sample_n":null,"sample_text":"No empirical sample; review of existing literature.","population":"Not applicable","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This 1997 review describes the brain's septal region, its connections, and how damage can lead to symptoms such as heightened sexual drive, but it does not present new research data.","clinical_takeaway":"None – the article is a theoretical overview, not a source of clinical evidence.","confidence":0.4,"topic_tags":["neuroscience","sexual_function"],"strengths":["Comprehensive overview of septal anatomy","Links to hypersexuality as a clinical symptom"],"limitations":["No original data; purely descriptive","No systematic methodology or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1052-5149(25)00428-9"}},{"id":8377,"doi":"10.1097/00004583-199610000-00025","pmid":"8885592","pmcid":null,"title":"Age of onset of sexual abuse: relationship to sexually inappropriate behaviors","authors":"McClellan J, McCurry C, Ronnei M, Adams J, Eisner A, Storck M.","first_author":"McClellan J","journal":"Journal of the American Academy of Child and Adolescent Psychiatry","year":1996,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":60,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective chart review of 499 youths treated at a psychiatric hospital; groups defined by age of first sexual abuse","sample_n":499,"sample_text":"n = 499 (group sizes: 225 no abuse, 78 age 0‑3, 105 age 4‑6, 71 age 7‑12, 19 age 13‑17)","population":"seriously mentally ill youths (children and adolescents) in a public‑sector psychiatric hospital, 1987‑1992","country":"USA (implied by journal and hospital description)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a review of 499 psychiatrically hospitalized youths, those who were first sexually abused before age 7 were far more likely to display hypersexual, exposing, or victimising behaviours later on, compared with peers without such early abuse.","clinical_takeaway":"Early childhood sexual abuse is a strong risk factor for later disinhibited sexual behaviour; clinicians should assess abuse history when such behaviours emerge.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Large clinical sample (N=499)","Clear grouping by age of abuse onset","Use of logistic regression to identify predictors"],"limitations":["Retrospective chart data; no validated behavioral scales","Cross‑sectional; cannot infer causality","Potential unmeasured confounds (e.g., moral incongruence, mental‑health symptom severity)","No control for multiple comparisons or reporting of effect sizes"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":1,"mentioning":36,"citing_publications":90,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00004583-199610000-00025"}},{"id":8378,"doi":"10.1016/0920-9964(95)00104-2","pmid":"8794513","pmcid":null,"title":"Repetitive behaviors in schizophrenia: a single disturbance or discrete symptoms?","authors":"Tracy JI, de Leon J, Qureshi G, McCann EM, McGrory A, Josiassen RC.","first_author":"Tracy JI","journal":"Schizophrenia research","year":1996,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional factor analysis of 400 state‑hospital schizophrenia patients","sample_n":400,"sample_text":"400 schizophrenia patients residing at a state hospital","population":"schizophrenia inpatients (N≈400)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 400 hospitalized schizophrenia patients, nine repetitive behaviors (including smoking, polydipsia, hypersexuality, pica) were analyzed. The data showed that most behaviors loaded onto a common factor, but a five‑factor model fit best, suggesting multiple underlying disturbances rather than a single one.","clinical_takeaway":"Repetitive behaviors in schizophrenia are multifactorial; hypersexuality should be considered alongside other symptoms, not as a single underlying problem.","confidence":0.7,"topic_tags":["religiosity","masturbation","sexual_function","pornography"],"strengths":["Large sample (N=400) for factor analysis","Systematic assessment of multiple repetitive behaviors","Clear statistical approach (PCA, factor analysis)"],"limitations":["Convenience sample of institutionalized patients limits generalizability","Behavioral measures not clearly validated for sexual/repetitive domains","No control for key confounds (e.g., mental health, moral factors)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":30,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0920-9964(95)00104-2"}},{"id":8379,"doi":"10.1176/ajp.153.4.545","pmid":"8599404","pmcid":null,"title":"A 25-year-old woman with hallucinations, hypersexuality, nightmares, and a rash","authors":"Stein SL, Solvason HB, Biggart E, Spiegel D.","first_author":"Stein SL","journal":"The American journal of psychiatry","year":1996,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Clinical Conference","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ajp.153.4.545"}},{"id":8380,"doi":null,"pmid":"8766241","pmcid":null,"title":"[Hormonal treatments for disorders of sexual conduct]","authors":"Cordier B, Thibaut F, Kuhn JM, Deniker P.","first_author":"Cordier B","journal":"Bulletin de l'Academie nationale de medecine","year":1996,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methods; no new empirical data presented.","sample_n":null,"sample_text":"Six patients reported for triptorelin treatment; other treatment percentages mentioned from prior studies.","population":"Male patients described as aggressive hypersexual individuals (case series).","country":"France (implied)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","circular_addiction_scale","self_selected_sample"],"stance":"supports","citation_value":"avoid","plain_summary":"The article reviews hormonal drugs used to lower sexual drive in men who commit sexual offenses, reporting that a GnRH analogue helped five of six highly sexual patients, and calls for broader acceptance of such treatments.","clinical_takeaway":"No current clinical guidance; the evidence is anecdotal and ethically contentious.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Historical overview of hormonal interventions","Provides clinical outcome anecdote (5/6 responders)"],"limitations":["No systematic methodology or bias assessment","Small, non‑representative case series","Lacks measurement of confounding factors (moral, mental health, etc.)","Outdated terminology and ethical considerations"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":8381,"doi":null,"pmid":"8653765","pmcid":null,"title":"A case of the frontal lobe syndrome following head injury in Harare, Zimbabwe","authors":"Sebit MB, Acuda W, Chibanda D.","first_author":"Sebit MB","journal":"The Central African journal of medicine","year":1996,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"A 51‑year‑old male patient","population":"single adult male with frontal lobe injury","country":"Zimbabwe","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 51‑year‑old man developed aggression, hypersexual behaviour and other symptoms after a head injury. The report stresses the need for multidisciplinary care for such frontal‑lobe cases.","clinical_takeaway":"Head injury can trigger disinhibited sexual behaviour; assess and manage with a multidisciplinary team.","confidence":0.85,"topic_tags":["neuroscience","sexual_function","csbd"],"strengths":["Detailed clinical description","Highlights neurobehavioral sequelae of frontal injury"],"limitations":["Single case; no generalisability","No systematic measurement of sexual behaviour or distress","No control or comparison group"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":8383,"doi":"10.1016/0145-2134(95)00015-z","pmid":"7664136","pmcid":null,"title":"Sexually inappropriate behaviors in seriously mentally ill children and adolescents","authors":"Adams J, McClellan J, Douglass D, McCurry C, Storck M.","first_author":"Adams J","journal":"Child abuse & neglect","year":1995,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective chart review of 499 youth from a tertiary psychiatric hospital; groups defined by chart‑derived categories (hypersexual, exposing, victimizing, none).","sample_n":499,"sample_text":"All youth treated over a 5‑year period (N=499).","population":"Children and adolescents (psychiatric inpatients) with serious mental illness.","country":"USA (implied by journal context).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A chart review of 499 seriously mentally ill youths found that those showing sexually inappropriate behaviour were far more likely to have histories of sexual abuse, physical abuse, developmental problems and family antisocial traits. Different behaviour types (hypersexual, exposing, victimizing) had distinct clinical patterns.","clinical_takeaway":"Clinicians should screen for past sexual abuse and related trauma when youths present with inappropriate sexual behaviours.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Large clinical sample (N=499).","Comprehensive chart review covering multiple clinical correlates."],"limitations":["Reliance on retrospective chart data; no validated measures of ‘hypersexual’ behavior.","No assessment of moral incongruence or masturbation, limiting interpretation for sexual health research.","Cross‑sectional design; cannot infer causality."],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0145-2134(95)00015-z"}},{"id":8384,"doi":"10.1111/j.1399-0004.1995.tb03956.x","pmid":"7628119","pmcid":null,"title":"Familial hypertryptophanemia in two siblings","authors":"Martin JR, Mellor CS, Fraser FC.","first_author":"Martin JR","journal":"Clinical genetics","year":1995,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Case report of two siblings with hypertryptophanemia; focuses on metabolic and developmental features, mentions hypersexual behavior only descriptively.","sample_n":2,"sample_text":"Two siblings (1 male, 1 female) diagnosed with hypertryptophanemia; mother and half‑sibling also assessed for urinary metabolites.","population":"Two siblings (male and female) with a rare metabolic disorder; family pedigree noted.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A report of two siblings with a rare disorder causing high tryptophan levels, who also showed mild intellectual disability and unusually high sexual interest, suggesting a possible genetic link.","clinical_takeaway":"Hypersexual behavior may appear as a symptom of rare metabolic disorders, but this case report provides no guidance for treatment.","confidence":0.6,"topic_tags":["gender"],"strengths":["Rare clinical description","Genetic pedigree analysis","Objective metabolic measurements"],"limitations":["Very small sample (n=2)","No validated measures of hypersexual behavior","No control group or statistical analysis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1399-0004.1995.tb03956.x"}},{"id":8386,"doi":null,"pmid":"7872135","pmcid":null,"title":"Parkinson's disease: drug-induced psychiatric states","authors":"Factor SA, Molho ES, Podskalny GD, Brown D.","first_author":"Factor SA","journal":"Advances in neurology","year":1995,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":111,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review with case reports on drug‑induced psychiatric states in Parkinson’s disease; sexual symptoms (hypersexuality) mentioned only briefly.","sample_n":null,"sample_text":"Not specified; review of published cases and literature.","population":"Patients with Parkinson’s disease receiving dopaminergic therapy (no numeric sample reported).","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews psychiatric side‑effects of Parkinson’s disease medications, noting that hypersexuality can occasionally appear but focusing mainly on psychosis and its treatment.","clinical_takeaway":"Hypersexuality is a possible, though uncommon, side‑effect of dopaminergic therapy in Parkinson’s disease; clinicians should monitor sexual changes alongside motor symptoms.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad overview of drug‑induced psychiatric syndromes in PD","Includes discussion of treatment approaches"],"limitations":["No original empirical data on sexual behaviour","Hypersexuality discussed only anecdotally","No systematic methodology or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":8389,"doi":"10.1136/jnnp.56.3.311","pmid":"8459250","pmcid":"PMC1014870","title":"Post-ictal Klüver-Bucy syndrome after temporal lobectomy","authors":"Anson JA, Kuhlman DT.","first_author":"Anson JA","journal":"Journal of neurology, neurosurgery, and psychiatry","year":1993,"pub_types":["research-article","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":40,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":1,"sample_text":"single case study; no sampling strategy reported","population":"single adult female post‑temporal lobectomy","country":"USA (presumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A woman who had one side of her temporal lobe removed experienced a temporary Klüver‑Bucy syndrome after seizures, showing unusually high sexual drive and other behavioural changes, likely due to temporary dysfunction of the remaining temporal lobe.","clinical_takeaway":"Transient hypersexuality can follow seizures after unilateral temporal lobectomy; monitor for such changes post‑operatively.","confidence":0.4,"topic_tags":["neuroscience","sexual_function"],"strengths":["Detailed clinical description of a rare post‑ictal syndrome","Links neuroanatomy to observed hypersexual behaviour"],"limitations":["Single‑case design, no generalisability","No systematic measurement of sexual behaviour or distress","No control for confounding factors (e.g., mood, medication)"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":4,"contrasting":0,"mentioning":25,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/jnnp.56.3.311"}},{"id":8391,"doi":"10.1016/s0733-8619(18)30173-7","pmid":"8441366","pmcid":null,"title":"Behavioral changes associated with epilepsy","authors":"Devinsky O, Vazquez B.","first_author":"Devinsky O","journal":"Neurologic clinics","year":1993,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":46,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of behavioral changes in epilepsy; no primary data, no systematic methods reported.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Patients with epilepsy (general description; no sample size reported)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how epilepsy can affect behavior, mood, and sexuality, noting both increased and decreased emotionality, occasional hypersexual episodes, and common problems like depression and anxiety. It stresses the need for clinicians to detect and treat these issues.","clinical_takeaway":"Clinicians should screen epilepsy patients for mood and sexual problems, as they are common but often overlooked.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","masturbation"],"strengths":["Broad overview of behavioral phenomenology in epilepsy","Highlights clinical importance of recognizing dysfunction"],"limitations":["Narrative review without systematic methodology","No empirical data or quantitative analysis","No assessment of confounding variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":44,"citing_publications":90,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0733-8619(18)30173-7"}},{"id":8393,"doi":null,"pmid":"1462386","pmcid":null,"title":"[Kleine-Levin syndrome]","authors":"Hansen D, Lønborg-Møller L.","first_author":"Hansen D","journal":"Ugeskrift for laeger","year":1992,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"dan","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of two patients with Kleine‑Levin syndrome; includes clinical description and literature review","sample_n":2,"sample_text":"Two case reports","population":"boys and young men aged 10‑20 years with KLS (two cases)","country":"Denmark (assumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article describes Kleine‑Levin syndrome, a rare disorder causing episodes of extreme sleepiness, overeating, and increased sexual drive, based on two patient case reports and a literature overview.","clinical_takeaway":"KLS is a rare, episodic condition; clinicians should consider it when young patients present with combined hypersomnia, hyperphagia, and hypersexuality.","confidence":0.9,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed clinical description of a rare syndrome","Illustrates diagnostic challenges"],"limitations":["Very small sample (N=2)","No systematic data or controls"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":8394,"doi":null,"pmid":"1533065","pmcid":null,"title":"Successful treatment of hypersexuality in AIDS dementia with cyproterone acetate","authors":"Potocnik F.","first_author":"Potocnik F.","journal":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","year":1992,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":8396,"doi":"10.1590/s0004-282x1991000300017","pmid":"1807235","pmcid":null,"title":"[Kleine-Levin syndrome. Report of a case]","authors":"Da Silveira Neto O, Da Silveira OA.","first_author":"Da Silveira Neto O","journal":"Arquivos de neuro-psiquiatria","year":1991,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["csbd"],"language":"por","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case description with brief literature review","sample_n":1,"sample_text":"1 participant (case report)","population":"14‑year‑old male adolescent","country":"Brazil (presumed from author affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 14‑year‑old boy with Kleine‑Levin syndrome showed extreme sleepiness, overeating, and heightened sexual activity. The authors describe his symptoms, discuss possible brain mechanisms, and outline treatment options.","clinical_takeaway":"Kleine‑Levin syndrome can include hypersexuality; clinicians should consider it when evaluating atypical sexual behavior in adolescents.","confidence":0.8,"topic_tags":["religiosity","masturbation","pornography","sexual_function"],"strengths":["Detailed clinical description of a rare syndrome","Includes concise review of pathophysiology and treatment"],"limitations":["Single case; no generalizable data","No systematic assessment of sexual behavior or related confounds","Lacks validated measurement tools"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s0004-282x1991000300017"}},{"id":8397,"doi":"10.1016/0887-8994(91)90072-s","pmid":"1764144","pmcid":null,"title":"Unusual case of Klüver-Bucy syndrome in a Chinese boy","authors":"Wong VC, Wong MT, Ng TH, Chang CM, Fung CF.","first_author":"Wong VC","journal":"Pediatric neurology","year":1991,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case report of a 13‑year‑old boy with Klüver‑Bucy syndrome presenting hypersexuality and other symptoms","sample_n":1,"sample_text":"13‑year‑old Chinese boy","population":"one Chinese adolescent male","country":"China","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 13‑year‑old Chinese boy developed a rare form of Klüver‑Bucy syndrome after an illness, showing memory loss, emotional changes, excessive sexual behavior, and other symptoms; brain biopsy showed Alzheimer‑type astrocytes.","clinical_takeaway":"This isolated case suggests hypersexuality can appear as part of rare neuro‑behavioral syndromes, but offers no guidance for typical clinical management.","confidence":0.4,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed clinical description","Neuropathological findings reported"],"limitations":["Single case, no generalizability","No validated measures of hypersexuality","No control of relevant psychosocial confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0887-8994(91)90072-s"}},{"id":8398,"doi":"10.1055/s-2007-1000694","pmid":"1869237","pmcid":null,"title":"[Kleine-Levin syndrome]","authors":"Wurthmann C, Klieser E.","first_author":"Wurthmann C","journal":"Fortschritte der Neurologie-Psychiatrie","year":1991,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article without original data; no empirical sample.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The review describes Kleine‑Levin syndrome, a rare disorder causing periodic extreme sleepiness, overeating, and occasional hypersexual behavior, and speculates about links to brain function and psychosis.","clinical_takeaway":"Kleine‑Levin syndrome is a distinct neurological condition; its occasional hypersexuality should not be conflated with porn or masturbation addiction.","confidence":0.8,"topic_tags":["neuroscience","sexual_function","pornography"],"strengths":["Provides overview of KLS symptoms","Discusses possible biological links"],"limitations":["No original data or systematic methodology","No empirical evaluation of hypersexuality","Lacks measurement of relevant confounds","Potentially outdated (1991)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-2007-1000694"}},{"id":8399,"doi":null,"pmid":"1664585","pmcid":null,"title":"[Sex disorders in men with epilepsy]","authors":"Temin PA, Mukhin KIu.","first_author":"Temin PA","journal":"Zhurnal nevropatologii i psikhiatrii imeni S.S. Korsakova (Moscow, Russia : 1952)","year":1991,"pub_types":["Comparative Study","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"rus","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative study of 108 men with epilepsy; likely convenience clinical sample; no longitudinal or experimental component.","sample_n":108,"sample_text":"108 men with epilepsy; no control group described in abstract.","population":"Adult men with epilepsy (partial, temporal, generalized) recruited from clinical settings.","country":"Russia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 108 men with epilepsy, about half showed reduced sexual desire, a few displayed increased drive, and roughly one‑tenth had ejaculation problems. Low libido was most common in temporal‑lobe epilepsy and among those on long‑term anticonvulsants, and it was linked to lower fertility and marital rates.","clinical_takeaway":"Epilepsy, especially temporal lobe and chronic anticonvulsant use, may be associated with reduced sexual desire and ejaculatory issues; clinicians should screen and address these problems.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Large clinical sample for its time (108 men)","Specific focus on epilepsy subtypes","Reports prevalence of distinct sexual dysfunctions"],"limitations":["No validated sexual function instruments reported","Cross‑sectional design; no causal inference","No control or comparison group described","Potential confounding by medication, mood, or relationship factors not controlled"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":8403,"doi":"10.1111/j.1532-5415.1989.tb02278.x","pmid":"2760388","pmcid":null,"title":"Hypersexual agitation in Alzheimer's disease","authors":"Jensen CF.","first_author":"Jensen CF.","journal":"Journal of the American Geriatrics Society","year":1989,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1532-5415.1989.tb02278.x"}},{"id":8405,"doi":"10.1176/ajp.146.3.400a","pmid":"2919698","pmcid":null,"title":"Carbamazepine-induced mania with hypersexuality in a 9-year-old boy","authors":"Myers WC, Carrera F.","first_author":"Myers WC","journal":"The American journal of psychiatry","year":1989,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ajp.146.3.400a"}},{"id":8406,"doi":"10.2190/ae1q-qy7b-lu2f-gjhf","pmid":"2681027","pmcid":null,"title":"Psychic akinesia following bilateral pallidal lesions","authors":"Starkstein SE, Berthier ML, Leiguarda R.","first_author":"Starkstein SE","journal":"International journal of psychiatry in medicine","year":1989,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case report of a single patient with bilateral pallidal lesions after CO poisoning, reporting neuropsychological changes and response to bromocriptine","sample_n":1,"sample_text":"single case","population":"one adult male, 39 y, post‑CO intoxication","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 39‑year‑old man developed memory loss, extreme calmness, bulimia, hypersexuality and later psychic akinesia after carbon‑monoxide poisoning caused lesions in both sides of the brain’s pallidum; symptoms improved with bromocriptine.","clinical_takeaway":"Lesions to the pallidum can produce atypical hypersexuality and movement disorders; treatable with dopaminergic agents.","confidence":0.6,"topic_tags":["neuroscience","pornography","masturbation","sexual_function"],"strengths":["Detailed clinical description","Imaging evidence linking pallidal damage to behavioral change"],"limitations":["Single case limits generalisability","No systematic measurement of sexual behaviour or distress","No control group or statistical analysis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2190/ae1q-qy7b-lu2f-gjhf"}},{"id":8407,"doi":"10.1007/bf00314220","pmid":"2915229","pmcid":null,"title":"Kluver-Bucy syndrome in systemic lupus erythematosus","authors":"Oliveira V, Ferro JM, Foreid JP, Costa T, Levy A.","first_author":"Oliveira V","journal":"Journal of neurology","year":1989,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single clinical case description of Kluver‑Bucy syndrome with hypersexuality in an SLE patient","sample_n":1,"sample_text":"One patient","population":"48‑year‑old female with systemic lupus erythematosus","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 48‑year‑old woman with lupus suffered brain strokes that produced Kluver‑Bucy syndrome, leading to unusual behaviours including increased sexual activity, but the report does not use standard scales or explore causes beyond the brain damage.","clinical_takeaway":"Hypersexuality can arise from specific brain lesions; clinicians should assess neurological status when atypical sexual behaviour appears.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","lgbtq"],"strengths":["Detailed clinical description of a rare neurological syndrome","Links neurovascular lesions to behavioural changes"],"limitations":["Single case, no systematic data","No validated measures of hypersexuality","No control for confounding psychosocial factors"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":2,"mentioning":7,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf00314220"}},{"id":8408,"doi":"10.1016/0022-4731(88)90023-4","pmid":"2462132","pmcid":null,"title":"Clinical applications of antiandrogens","authors":"Namer M.","first_author":"Namer M.","journal":"Journal of steroid biochemistry","year":1988,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article summarizing clinical uses of antiandrogens; no original data collected.","sample_n":null,"sample_text":"N/A – narrative review of prior studies","population":"Not applicable (review)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how anti‑androgen drugs, mainly used for prostate cancer, also help conditions like benign prostate enlargement, hirsutism, and occasionally hypersexuality, but provides no new data.","clinical_takeaway":"None – the paper is a historical review and does not offer actionable clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad overview of antiandrogen pharmacology","Covers multiple clinical indications"],"limitations":["No original empirical data","No systematic review methodology reported","Outdated (1988) and lacks recent evidence"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0022-4731(88)90023-4"}},{"id":8410,"doi":"10.1176/ajp.145.8.1037a","pmid":"2969198","pmcid":null,"title":"Female hypersexuality treated with cyproterone acetate","authors":"Mellor CS, Farid NR, Craig DF.","first_author":"Mellor CS","journal":"The American journal of psychiatry","year":1988,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ajp.145.8.1037a"}},{"id":8411,"doi":"10.2307/3177879","pmid":"11616968","pmcid":null,"title":"\"A new generation of women\": progressive psychiatrists and the hypersexual female","authors":"Lunbeck E.","first_author":"Lunbeck E.","journal":"Feminist studies : FS","year":1987,"pub_types":["Historical Article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2307/3177879"}},{"id":8412,"doi":null,"pmid":"3425063","pmcid":null,"title":"[Medico-social characteristics of female adolescents with early alcoholism]","authors":"Sidorov PI, Mitiukhliaev AV.","first_author":"Sidorov PI","journal":"Zhurnal nevropatologii i psikhiatrii imeni S.S. Korsakova (Moscow, Russia : 1952)","year":1987,"pub_types":["Comparative Study","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"rus","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of 174 female and 112 male adolescents with early alcoholism; convenience sample from clinical settings.","sample_n":174,"sample_text":"174 girls and 112 boys aged 14‑18 years suffering from early alcoholism","population":"Adolescent girls (14‑18) with early alcoholism, Russian clinical sample","country":"Russia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared Russian teenage girls and boys with early alcoholism, finding that girls showed more family alcoholism and described a ‘pseudo‑hypersexuality’ pattern – outward sexual activity while lacking genuine sexual feeling.","clinical_takeaway":"Findings are exploratory; clinicians should not infer a specific sexual dysfunction profile for adolescents with alcoholism based on this study.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Relatively large adolescent sample for 1987 study","Comparison between sexes","Attempts to conceptualise pseudo‑hypersexuality"],"limitations":["No validated measures of sexual behaviour or alcoholism","Cross‑sectional design precludes causal inference","Limited control of key confounders (e.g., mental health, family environment)","Findings based on clinical, not population, sample"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":null},{"id":8414,"doi":null,"pmid":"2870057","pmcid":null,"title":"Improvement in organically disturbed behavior with trazodone treatment","authors":"Simpson DM, Foster D.","first_author":"Simpson DM","journal":"The Journal of clinical psychiatry","year":1986,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":55,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Four elderly patients with organic brain syndromes and hypersexual behaviour were treated with trazodone after neuroleptics failed; behaviour improved substantially.","sample_n":4,"sample_text":"Four case reports","population":"Elderly patients (n=4) with severe organic brain syndromes and disturbed behavior including hypersexuality","country":"Not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"Four elderly patients with brain damage and disruptive behaviours, including excessive sexual activity, were given trazodone after other drugs failed. All showed marked improvement, suggesting trazodone might help control such behaviours.","clinical_takeaway":"Trazodone may reduce hypersexual behaviour in patients with organic brain disorders, but evidence is limited to four cases.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Focus on a rarely studied symptom (hypersexuality) in organic brain disorder","Suggests a potential alternative to neuroleptics"],"limitations":["Very small case series (n=4)","No validated measures of hypersexuality","No control condition or randomisation"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":8415,"doi":"10.1177/070674378603100116","pmid":"2936441","pmcid":null,"title":"Progestogens in the treatment of male sex offenders: a review","authors":"Cooper AJ.","first_author":"Cooper AJ.","journal":"Canadian journal of psychiatry. Revue canadienne de psychiatrie","year":1986,"pub_types":["Comparative Study","Clinical Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of pharmacological treatment; no new empirical data; relies on limited controlled trials and clinical observations.","sample_n":null,"sample_text":"Not applicable – review article","population":"Male sex offenders / hypersexual men (historical samples, likely treatment‑seeking)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"supports","citation_value":"background","plain_summary":"The 1986 review summarises early evidence that progestogen drugs (MPA and CPA) can lower sexual drive in male sex offenders, especially when combined with psychotherapy, but notes the scarcity of rigorous trials.","clinical_takeaway":"Pharmacological suppression of libido may help some treatment‑seeking male offenders, but robust evidence is limited; clinicians should seek more rigorous data before relying on these drugs.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Historical overview of pharmacological options","Identifies need for controlled trials"],"limitations":["No systematic methodology or risk‑of‑bias assessment","Lacks quantitative synthesis or modern diagnostic criteria"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":25,"citing_publications":81,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/070674378603100116"}},{"id":8416,"doi":"10.1097/00005053-198510000-00010","pmid":"3161995","pmcid":null,"title":"Kluver-Bucy syndrome in Huntington's chorea","authors":"Janati A.","first_author":"Janati A.","journal":"The Journal of nervous and mental disease","year":1985,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single case of a 46‑year‑old man with Huntington’s disease exhibiting Kluver‑Bucy syndrome symptoms including hypersexual behavior","sample_n":1,"sample_text":"n=1 (single case report)","population":"male, 46 y, advanced Huntington’s disease","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 46‑year‑old man with advanced Huntington’s disease showed Kluver‑Bucy syndrome, including unusually high sexual interest, alongside dementia and movement problems. Haloperidol helped both the syndrome and the chorea, suggesting dopamine may be involved.","clinical_takeaway":"Hypersexuality can appear as part of Kluver‑Bucy syndrome in Huntington’s disease; dopaminergic medication may reduce symptoms.","confidence":0.6,"topic_tags":["sexual_function","neuroscience","csbd"],"strengths":["Rare clinical observation linking KBS to Huntington’s disease","Detailed description of neurological and behavioral symptoms"],"limitations":["Single case; no generalisability","No systematic measurement of sexual behaviour or addiction constructs","No neuroimaging or quantitative data"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00005053-198510000-00010"}},{"id":8418,"doi":"10.1055/s-2007-1002207","pmid":"6510866","pmcid":null,"title":"[Phenomenology of the Klüver-Bucy syndrome in man]","authors":"Aichner F.","first_author":"Aichner F.","journal":"Fortschritte der Neurologie-Psychiatrie","year":1984,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case series of 53 patients with Klüver‑Bucy syndrome, descriptive clinical phenotyping, no control group","sample_n":53,"sample_text":"53 patients described; recruitment method not specified","population":"human patients with various brain injuries or neurodegenerative diseases presenting Klüver‑Bucy syndrome","country":"unspecified (likely Austria/Germany based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reports 53 human cases of Klüver‑Bucy syndrome, describing symptoms such as excessive oral activity, hypersexuality, memory problems and emotional flattening, and discusses their varied brain‑injury causes.","clinical_takeaway":"Hypersexuality can arise from extensive temporal‑lobe damage, but this paper offers no direct guidance for treatment.","confidence":0.8,"topic_tags":["neuroscience","sexual_function"],"strengths":["Large (for rare syndrome) series of 53 cases","Comprehensive clinical description of hypersexuality within KBS"],"limitations":["No validated sexual behavior scales","No control group, purely descriptive","Limited neuroimaging/EEG analysis"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-2007-1002207"}},{"id":8420,"doi":"10.1016/s0022-4731(83)80052-1","pmid":"6224971","pmcid":null,"title":"Pharmacological basis for clinical use of antiandrogens","authors":"Neumann F.","first_author":"Neumann F.","journal":"Journal of steroid biochemistry","year":1983,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Journal article review discussing pharmacology of antiandrogens with no original empirical data; mentions hypersexuality as a treatment indication but provides no study of pornography, masturbation, or CSBD.","sample_n":null,"sample_text":"N/A - article is a non‑empirical review.","population":"Not applicable (no primary data)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews the pharmacology of the antiandrogen cyproterone acetate, describing its effects on hormone‑dependent tissues and noting its clinical use for conditions such as prostate cancer, precocious puberty, and hypersexuality.","clinical_takeaway":"None – the paper is a historical pharmacology review without clinical data on treatment outcomes for hypersexuality.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Provides historical overview of antiandrogen pharmacology","Covers broad physiological effects of CPA"],"limitations":["No original data; purely descriptive","No measurement of sexual behavior or distress","No consideration of confounding psychosocial factors"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0022-4731(83)80052-1"}},{"id":8421,"doi":null,"pmid":"6221508","pmcid":null,"title":"[Pharmacologic inhibition of the libido: therapy or repression? II. Clinical aspects]","authors":"Servais JF.","first_author":"Servais JF.","journal":"Acta psychiatrica Belgica","year":1982,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"fre","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"case-report","design_detail":"case reports of male patients receiving neuroleptic or hormonal agents to reduce libido, presented as clinical observations without systematic methods","sample_n":null,"sample_text":"case reports; exact number not given","population":"male hypersexual or repeat offending patients (sample size not specified)","country":"Belgium (journal)","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"supports","citation_value":"background","plain_summary":"The paper describes a series of male patients who received drugs that lower sexual drive, used to control hypersexual behavior or prevent repeat offenses. It reports that the effects are reversible when treatment stops, but offers no systematic data.","clinical_takeaway":"Pharmacologic libido suppression is presented as a possible reversible option for hypersexual patients, though evidence is limited to anecdotal case reports.","confidence":0.3,"topic_tags":["sexual_function","treatment"],"strengths":["Addresses a clinical need for hypersexual patients","Provides real‑world pharmacologic observations"],"limitations":["No validated measures of hypersexuality or distress","No systematic design, control group, or statistical analysis","Potential selection bias (treatment‑seeking cases)","Outdated pharmacologic approaches"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":8422,"doi":"10.1016/0010-440x(81)90034-1","pmid":"6230209","pmcid":null,"title":"A placebo-controlled trial of the antiandrogen cyproterone acetate in deviant hypersexuality","authors":"Cooper AJ.","first_author":"Cooper AJ.","journal":"Comprehensive psychiatry","year":1981,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":48,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":43,"citing_publications":106,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0010-440x(81)90034-1"}},{"id":8423,"doi":"10.1176/ajp.138.9.1263a","pmid":"7196699","pmcid":null,"title":"Hypersexuality in men receiving fluphenazine decanoate","authors":"Gomez EA.","first_author":"Gomez EA.","journal":"The American journal of psychiatry","year":1981,"pub_types":["Letter","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ajp.138.9.1263a"}},{"id":8425,"doi":null,"pmid":"7400106","pmcid":null,"title":"Satyriasis: a case study","authors":"Moore SL.","first_author":"Moore SL.","journal":"The Journal of clinical psychiatry","year":1980,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single male patient with hypersexuality (satyriasis) treated pharmacologically and with psychotherapy; discussion of differential diagnosis and psychodynamics","sample_n":1,"sample_text":"One patient (N=1)","population":"24‑year‑old male","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 24‑year‑old man with excessive sexual desire (satyriasis) was evaluated and treated with a hormone and therapy, showing improvement, but the report lacks systematic measurement or broader context.","clinical_takeaway":"Evidence from a single case; cannot guide treatment decisions for hypersexuality.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Detailed clinical description","Discussion of differential diagnosis"],"limitations":["Single case, no standardized measures","No assessment of key confounds","No validated outcome metrics"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":8427,"doi":"10.1007/bf00313047","pmid":"91669","pmcid":null,"title":"Partial Klüver-Bucy Syndrome following probably herpes simplex encephalitis","authors":"Shoji H, Teramoto H, Satowa S, Satowa H, Narita Y.","first_author":"Shoji H","journal":"Journal of neurology","year":1979,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single autopsy case with narrative review of other cases; no systematic methodology","sample_n":1,"sample_text":"single case","population":"adult male survivor of probable herpes simplex encephalitis","country":"Japan (assumed from author names, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A man who survived probable herpes simplex encephalitis later showed symptoms of partial Klüver‑Bucy syndrome, including increased oral behavior, emotional changes, and possible hypersexuality, suggesting lasting temporal‑lobe damage.","clinical_takeaway":"Clinicians should monitor for hypersexual and emotional changes in HSE survivors as possible signs of limbic damage.","confidence":0.7,"topic_tags":["neuroscience"],"strengths":["Detailed clinical description of rare syndrome","Integration of literature on similar cases"],"limitations":["Single case limits generalizability","No systematic assessment of hypersexuality","No measurement of confounding variables"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf00313047"}},{"id":8428,"doi":"10.1007/bf00342236","pmid":"572212","pmcid":null,"title":"[Klüver-Bucy syndrome and primitive motor reflexes after heavy brain trauma (author's transl)]","authors":"Dahlmann W, Schaefer KP.","first_author":"Dahlmann W","journal":"Archiv fur Psychiatrie und Nervenkrankheiten","year":1979,"pub_types":["Journal Article","English Abstract","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["csbd"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single case report of a 16‑year‑old with Klüver‑Bucy syndrome and hypersexuality after severe brain trauma","sample_n":1,"sample_text":"16‑year‑old male","population":"one adolescent male with severe brain injury and intellectual disability","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 16‑year‑old with severe brain injury developed Klüver‑Bucy syndrome, showing extreme sexual urges, emotional changes and primitive reflexes. The report describes two phases of behavior, from automatic instinctive actions to more normal responses.","clinical_takeaway":"Hypersexuality can be a symptom of severe brain trauma; clinicians should assess sexual changes after injury.","confidence":0.4,"topic_tags":["sexual_function","neuroscience","pornography","masturbation"],"strengths":["Detailed clinical description of a rare syndrome","Patient’s own subjective report included"],"limitations":["Single case; no generalisability","No validated measures of sexual behaviour or distress","No control group or statistical analysis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf00342236"}},{"id":8429,"doi":"10.1192/bjp.134.3.288","pmid":"116699","pmcid":null,"title":"Sexual disturbances in temporal lobe epilepsy:a controlled study","authors":"Shukla GD, Srivastava ON, Katiyar BC.","first_author":"Shukla GD","journal":"The British journal of psychiatry : the journal of mental science","year":1979,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative cross‑sectional study of 70 temporal‑lobe epilepsy patients vs 70 grand‑mal epilepsy patients, matched on age, sex, seizure variables, and marital history.","sample_n":140,"sample_text":"Seventy cases each of temporal lobe epilepsy and grand mal epilepsy.","population":"Adults and adolescents with epilepsy (temporal lobe vs grand‑mal).","country":"India (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a study of 140 people with epilepsy, those with temporal‑lobe seizures were more likely to show reduced sexual interest (hyposexuality) than those with generalized seizures, while one temporal‑lobe case showed heightened sexual activity. No sexual deviations were found in either group.","clinical_takeaway":"Temporal‑lobe epilepsy may be linked to lower sexual interest; clinicians should screen for hypo‑sexuality in these patients.","confidence":0.6,"topic_tags":["sexual_function","neuroscience"],"strengths":["Reasonably large matched groups (N=70 per group)","Clear clinical definition of epilepsy subtypes","Addresses both hypo‑ and hypersexuality"],"limitations":["Sexual functioning instrument not described or validated","No adjustment for psychological or relational confounders","Statistical details (effect sizes, corrections) absent"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":57,"citing_publications":105,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/bjp.134.3.288"}},{"id":8430,"doi":"10.1016/0031-9384(79)90085-4","pmid":"441166","pmcid":null,"title":"Amygdaloid hypersexuality in male cats re-examined","authors":"Aronson LR, Cooper ML.","first_author":"Aronson LR","journal":"Physiology & behavior","year":1979,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0031-9384(79)90085-4"}},{"id":8431,"doi":null,"pmid":"424945","pmcid":null,"title":"Cyproterone and hypersexuality","authors":"van de Merwe TJ.","first_author":"van de Merwe TJ.","journal":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","year":1979,"pub_types":["Letter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":8432,"doi":"10.1111/j.1360-0443.1978.tb00157.x","pmid":"280354","pmcid":null,"title":"Hypersexuality: implications for a theory of dependence","authors":"Orford J.","first_author":"Orford J.","journal":"The British journal of addiction to alcohol and other drugs","year":1978,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":38,"citing_publications":132,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1360-0443.1978.tb00157.x"}},{"id":8433,"doi":null,"pmid":"273020","pmcid":null,"title":"The Kleine-Levine syndrome--a variant?","authors":"Yassa R, Nair NP.","first_author":"Yassa R","journal":"The Journal of clinical psychiatry","year":1978,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"0-2","sample_n":1,"sample_text":"case report (single patient)","population":"single older male patient with Kleine‑Levin syndrome","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1978 case report describes an older man with Kleine‑Levin syndrome who, after taking Ritalin, showed reduced sleepiness but increased sexual arousal. The authors speculate that the mechanisms for sleepiness and hypersexuality may differ.","clinical_takeaway":"Ritalin may improve hypersomnia but could provoke sexual side‑effects in this rare syndrome; clinicians should monitor sexual changes.","confidence":0.6,"topic_tags":["sexual_function","neuroscience"],"strengths":["Detailed clinical description of a rare presentation","Discussion of possible dissociation between hypersomnia and hypersexuality mechanisms"],"limitations":["Single case; no generalisable data","No systematic measurement of sexual behaviour or distress","No control for confounding factors"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":8434,"doi":"10.1159/000102396","pmid":"727768","pmcid":null,"title":"Temporal lobe seizures and hypersexuality. 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Nonconsensual Sexual Experiences","authors":"Coates AGC, Meston CM.","first_author":"Coates AGC","journal":"Journal of sex research","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 301 participants (child sexual abuse survivors, adult NSE survivors, controls); analyzed with General Additive Models and bootstrapped confidence intervals.","sample_n":301,"sample_text":"n=100 child sexual abuse survivors, n=101 adult NSE survivors, n=100 controls","population":"adult survivors of non‑consensual sexual experiences and matched controls (mostly U.S., likely WEIRD)","country":"unspecified (likely USA)","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that people who experienced non‑consensual sex and who accept strict religious sexual beliefs report higher sexual shame, especially men who were exposed to such beliefs in childhood.","clinical_takeaway":"Clinicians should consider the role of religious‑based moral messages when addressing sexual shame in trauma survivors.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Relatively large community sample across three groups","Use of GAMs with bootstrapped CIs adds robustness","Focus on an under‑studied intersection of religion and sexual trauma"],"limitations":["Cross‑sectional design limits causal inference","Unclear whether shame and purity‑culture measures are validated","Key confounds (mental health, masturbation, relationship context) not accounted 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shame to encourage safe‑sex information seeking.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a survey (N≈300)","Uses established relationship‑power and shame scales","Mediation analysis clarifies pathways"],"limitations":["Cross‑sectional design limits causal inference","Convenience sample limits generalisability","No control for broader mental‑health or moral 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depression partly through increased sexual shame and a tendency to feel ashamed. Believing that God is loving made the shame pathway stronger.","clinical_takeaway":"Address sexual shame and religious beliefs when treating depression in CSA survivors.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["Large sample size (>1000)","Focus on understudied mediator (sexual shame)","Inclusion of religious moderating variable"],"limitations":["Cross‑sectional design limits causal inference","Self‑report of CSA and shame may be biased","No measurement of moral or relational confounds"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2025.2570172"}},{"id":8484,"doi":"10.21203/rs.3.rs-10508388/v1","pmid":null,"pmcid":null,"title":"\"I am no longer a complete woman\": A grounded theory study of self-perceived discrimination among cervical cancer survivors in China","authors":"Zhang S, Wang Y, Bai K.","first_author":"Zhang S","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"grounded theory interview study","sample_n":29,"sample_text":"29 cervical cancer patients recruited from a tertiary hospital; purposive sampling until saturation","population":"cervical cancer survivors in Southwest China (purposive sample)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 29 Chinese women who survived cervical cancer revealed that they often feel discriminated against, experience shame about their sexuality, deny themselves, and withdraw socially, which harms their mental health and quality of life.","clinical_takeaway":"Clinicians should screen cervical‑cancer survivors for self‑perceived discrimination and sexual shame and offer psychosocial support.","confidence":0.8,"topic_tags":["csbd","sexual_function"],"strengths":["In‑depth, participant‑driven qualitative data","Data collection continued to saturation","Clear grounded‑theory methodology"],"limitations":["Small, non‑representative purposive sample","No validated quantitative measures of discrimination or distress","Findings limited to one hospital region in China"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-10508388/v1"}},{"id":8486,"doi":"10.1038/s41598-023-31181-y","pmid":"36899212","pmcid":"PMC10006235","title":"The effects of sexual shame, emotion regulation and gender on sexual desire","authors":"Sævik KW, Konijnenberg C.","first_author":"Sævik KW","journal":"Scientific reports","year":2023,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://www.nature.com/articles/s41598-023-31181-y.pdf","cited_by_count":7,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 218 Norwegian adults using self‑report questionnaires","sample_n":218,"sample_text":"218 participants","population":"Norwegian adults (n=218), likely convenience sample","country":"Norway","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 218 Norwegian adults, a tendency to re‑interpret emotions (cognitive reappraisal) was linked to higher sexual desire, while sexual shame and suppressing emotions were not. Men reported more emotional suppression than women, but desire levels were similar across genders.","clinical_takeaway":"Encouraging adaptive emotion‑regulation (cognitive reappraisal) may help boost sexual desire; shame alone appears less influential.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Validated psychometric instruments","Adequate sample size for regression","Effect sizes with confidence intervals reported","Gender differences examined"],"limitations":["Cross‑sectional design limits causal inference","Convenience sample may not be representative","Key confounds (e.g., mental health, moral incongruence) not measured"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-023-31181-y"}},{"id":8488,"doi":"10.1016/j.ejon.2025.103084","pmid":"41548416","pmcid":null,"title":"Sexual dysfunction and associated factors in adult survivors of childhood cancer: A cross-sectional study in China","authors":"Yang F, Huang X, Yorke J, Lam KKW, Guo L, Liu Q, Belay GM, Mao T, Sun Q, Ho JMC, Chi Fai NG, Cheng FWT, Zhang Y, Zuo W, Liu X, Cai R, Wang W, Xu X, Shi H, Ho KY, Wong FK.","first_author":"Yang F","journal":"European journal of oncology nursing : the official journal of European Oncology Nursing Society","year":2026,"pub_types":["Multicenter Study","Journal Article"],"keywords":["Sexual dysfunction","Cross-sectional study","Associated Factors","Sexual Functioning","Adult Survivors Of Childhood Cancer"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"multicenter cross‑sectional survey of adult survivors of childhood cancer (N=290) using self‑report questionnaires and logistic regression","sample_n":290,"sample_text":"290 out of 720 approached survivors completed the questionnaire","population":"adult survivors of childhood cancer in China (both sexes)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 290 Chinese adults who survived childhood cancer, about two‑thirds of women and six‑tenths of men reported problems with desire, arousal, orgasm or satisfaction. Depression, anxiety, low self‑esteem and feelings of sexual shame were linked to worse sexual function.","clinical_takeaway":"Screen for depression, anxiety and sexual shame in adult childhood‑cancer survivors; address these factors to improve sexual health.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Large multicenter sample of a vulnerable survivor population","Use of multiple psychological covariates in regression models","Clear prevalence estimates for both sexes"],"limitations":["Cross‑sectional design cannot establish causality","Sampling purposive, not probability‑based; possible selection bias","Unclear whether sexual function instruments were fully validated"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ejon.2025.103084"}},{"id":8490,"doi":"10.1080/13691058.2026.2726337","pmid":"42680565","pmcid":null,"title":"Postpartum as a site of sexual script renegotiation and intensification among women socialised within purity culture","authors":"Hudson A.","first_author":"Hudson A.","journal":"Culture, health & sexuality","year":2026,"pub_types":["Journal Article"],"keywords":["Dyspareunia","Sexual Satisfaction","Sexual Shame","Maternal Embodiment","Evangelical Christianity"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"interview study with 15 postpartum women recruited from faith‑informed maternal communities; reflexive thematic analysis","sample_n":15,"sample_text":"15 postpartum women (high or low sexual satisfaction) recruited from faith‑informed maternal communities","population":"postpartum women in the USA who were socialised within the Purity Culture Movement","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 15 new mothers raised in Purity Culture reveal how they either reinforce or reshape religious sexual beliefs after childbirth, highlighting the roles of bodily changes, pain, marital talk, and faith reinterpretation.","clinical_takeaway":"Clinicians should recognize that postpartum women from conservative religious backgrounds may experience conflicted sexual scripts and need culturally‑sensitive support.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Rich qualitative insight into postpartum sexual script negotiation","Focus on an under‑studied population (purity‑culture socialised women)","Clear analytic framework (reflexive thematic analysis)"],"limitations":["Small, non‑representative convenience sample (N=15)","No quantitative measurement of constructs or confounders","Findings not generalisable beyond faith‑affiliated communities"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2026.2726337"}},{"id":8493,"doi":"10.1080/15546128.2021.1892005","pmid":"39479402","pmcid":"PMC11524150","title":"Black Female Adolescents' Sexuality: Pleasure Expectancies, Sexual Guilt, and Age of Sexual Debut","authors":"Thorpe S, Tanner AE, Nichols TR, Kuperberg A, Foh EP.","first_author":"Thorpe S","journal":"American journal of sexuality education","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Religiosity","Pleasure","Sexual Debut","Black Female Adolescents","Sexual Guilt"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large national cohort, cross‑sectional analysis of self‑report survey","sample_n":1426,"sample_text":"nationally representative longitudinal study, analysed cross‑sectionally","population":"Black female adolescents (N=1426)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a US sample of over 1400 Black teenage girls, higher religious importance and later perceived puberty were linked to feeling more sexual guilt, lower expectations of pleasure, and a later age of first sexual intercourse.","clinical_takeaway":"Clinicians should consider religiosity and puberty timing when discussing sexual guilt and timing of debut with Black adolescent girls.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, national sample","Focus on understudied population","Multiple family and pubertal variables examined"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of moral incongruence or other key confounds","Reliance on self‑report without validated sexual guilt scale confirmed"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":28,"retracted":false,"notices":[{"status":"Has correction","date":"2021-3-9","noticeDoi":"10.1080/15546128.2021.1899611","doi":"10.1080/15546128.2021.1892005"}],"url":"https://scite.ai/reports/10.1080/15546128.2021.1892005"}},{"id":8494,"doi":"10.1080/00224499.2020.1718585","pmid":"32049570","pmcid":null,"title":"Sexual Shame in the Sexual Excitation and Inhibition Propensities of Men With and Without Nonconsensual Sexual Experiences","authors":"Kilimnik CD, Meston CM.","first_author":"Kilimnik CD","journal":"Journal of sex research","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey with three groups (identifiers, non-identifiers, no NSE). Total N≈783.","sample_n":783,"sample_text":"n=255 identifiers, n=239 non‑identifiers, n=289 no NSEs.","population":"Men with and without histories of nonconsensual sexual experiences.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Men who have experienced nonconsensual sexual events report more sexual shame and higher sexual arousal and inhibition tendencies. Shame especially boosts arousal in men who label these events as rape or have no such experiences.","clinical_takeaway":"Addressing sexual shame may help modify sexual response patterns in men with nonconsensual sexual histories.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large total sample size","Distinct groups based on NSE identification","Use of established sexual response propensity constructs"],"limitations":["Cross‑sectional design limits causal inference","No control for key confounds (moral incongruence, mental health, etc.)","Unclear whether scales were validated in this population"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2020.1718585"}},{"id":8496,"doi":"10.1037/tra0000506","pmid":"31414868","pmcid":null,"title":"Sexual dysfunction in women with a history of childhood sexual abuse: The role of sexual shame","authors":"Pulverman CS, Meston CM.","first_author":"Pulverman CS","journal":"Psychological trauma : theory, research, practice and policy","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"120 adult women from the local community completed questionnaires and an erotic film in a single laboratory session; mediation analyzed with structural equation modeling.","sample_n":120,"sample_text":"Community-recruited adult women (N=120).","population":"adult women, community sample, n=120","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Women who experienced childhood sexual abuse reported more sexual problems, and this was fully explained by higher levels of sexual shame. Reducing shame might improve sexual function.","clinical_takeaway":"Addressing sexual shame in therapy could help women with a history of abuse improve sexual functioning.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of structural equation modeling to test mediation","Focused investigation of sexual shame as a mechanism","Adequate sample size for basic SEM"],"limitations":["Cross‑sectional design limits causal inference","Limited control of mental‑health and relationship variables","Reliance on self‑report questionnaires"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":16,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/tra0000506"}},{"id":8497,"doi":"10.21203/rs.3.rs-10029716/v1","pmid":null,"pmcid":null,"title":"Concerns about Sexual Promiscuity Play an Underexplored Role in Opposition to Abortion","authors":"Acevedo E, Pinsof D, Krems J, Haselton M.","first_author":"Acevedo E","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Four U.S. survey studies (total N = 3,631) including a nationally representative panel; self‑report measures of mating strategy, abortion attitudes, religiosity and conservatism.","sample_n":3631,"sample_text":"Total N = 3,631 across four studies; some samples are nationally representative.","population":"U.S. adults recruited via online panels and survey panels; includes pre‑ and post‑Dobbs samples.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors surveyed over 3,600 U.S. adults and found that people who prefer committed relationships and feel threatened by casual sex tend to oppose abortion more, especially when they think abortion limits casual sex. Religiosity and conservatism partially explain this link.","clinical_takeaway":"None - not clinically applicable.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large combined sample size","Includes a nationally representative panel","Explores a novel psychological mechanism"],"limitations":["Reliance on self‑report, likely unvalidated scales","Cross‑sectional design limits causal inference","Key confounds (e.g., moral attitudes toward sex) not measured"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-10029716/v1"}},{"id":8499,"doi":"10.1016/j.anr.2025.05.010","pmid":"40466847","pmcid":null,"title":"Patients' Experiences of Sexual Discomfort in South Korean Healthcare Setting: A Hermeneutic Phenomenological Study","authors":"Lee Y, Lim SY, Park S.","first_author":"Lee Y","journal":"Asian nursing research","year":2025,"pub_types":["Journal Article"],"keywords":["Ethics","Qualitative Research","Sexual Harassment","Respect","Patient Right"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Hermeneutic phenomenological interview study with 18 participants","sample_n":18,"sample_text":"Eighteen participants recruited after reporting sexual discomfort in healthcare settings","population":"Adults (mixed gender) in South Korea who reported sexual discomfort during healthcare encounters","country":"South Korea","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 18 South Korean patients revealed that medical examinations involving exposure or touch can cause shame, embarrassment, and feelings of powerlessness, leading some to avoid follow‑up care. The study suggests better provider training and respect for patient boundaries.","clinical_takeaway":"Clinicians should be aware that body exposure in care can cause sexual discomfort and trauma; respecting patient modesty may improve follow‑up.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rich, in‑depth qualitative data","Use of established phenomenological methodology","Clear articulation of patient‑centred themes"],"limitations":["Small, non‑representative convenience sample","No systematic measurement of mental‑health or trauma confounds","Findings not generalisable beyond Korean healthcare context"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.anr.2025.05.010"}},{"id":8500,"doi":"10.1080/17482631.2024.2424494","pmid":"39556005","pmcid":"PMC11574947","title":"Beyond health: exploring women's socio-cultural motivations for HPV vaccination","authors":"Xu S, Zhang W, Zhang Y.","first_author":"Xu S","journal":"International journal of qualitative studies on health and well-being","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Qualitative Study","Sociocultural Factors","Hpv Vaccine","Autonomous Motivation","Beyond Health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11574947","cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"in-depth interviews with 19 vaccinated women; thematic analysis using NVivo","sample_n":19,"sample_text":"convenience sample recruited for interviews","population":"women of peak HPV infection age, vaccinated (N=19)","country":"unspecified (presumably China based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 19 women who received the HPV vaccine revealed four main motivations: wanting personal independence, control over reproduction, acknowledgement of sexual needs, and displaying health knowledge, economic power, and social connections.","clinical_takeaway":"Vaccine programs should frame HPV vaccination as supporting women's autonomy and address cultural misconceptions.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides rich, participant‑generated insight into motivations","Uses systematic qualitative software (NVivo) for coding","Links autonomous motivation theory to vaccine uptake"],"limitations":["Small, non‑representative sample (19 women)","No assessment of broader structural or health system factors","Findings limited to women already vaccinated"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":9,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/17482631.2024.2424494"}},{"id":8501,"doi":"10.1111/jmft.12522","pmid":"33890687","pmcid":null,"title":"Past is present: Pathways between childhood sexual abuse and relationship satisfaction","authors":"Barker GG, Volk F, Hazel JS, Reinhardt RA.","first_author":"Barker GG","journal":"Journal of marital and family therapy","year":2022,"pub_types":["Journal Article"],"keywords":["Attachment","Child Sexual Abuse","Relationship Satisfaction","Mediation Model","Sexual Shame"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 732 adults, serial mediation analysis","sample_n":732,"sample_text":"Adults (N=732) recruited via online surveys","population":"Adults from general community (survey respondents)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 732 adults found that childhood sexual abuse is linked to lower relationship satisfaction, mainly because it increases sexual shame and creates insecure attachment patterns with partners.","clinical_takeaway":"Address sexual shame and attachment issues in therapy with CSA survivors to improve relationship satisfaction.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Large sample size (N=732)","Use of validated psychometric scales","Comprehensive mediation model"],"limitations":["Cross‑sectional design cannot infer causality","No control for mental‑health variables","Moral or religious factors not considered"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":12,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jmft.12522"}},{"id":8503,"doi":"10.31234/osf.io/pkcxq_v1","pmid":null,"pmcid":null,"title":"Spanish Adaptation and Psychometric Properties of the Aging Sexual Knowledge and Attitudes Scale (ASKAS)/Adaptación al español y propiedades psicométricas de la Aging Sexual Knowledge and Attitudes Scale (ASKAS)","authors":"Fernandes-Pires JA, Villar F.","first_author":"Fernandes-Pires JA","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 467 nursing‑assistant students and staff; convenience sample; psychometric validation of a translated scale.","sample_n":467,"sample_text":"126 students, 341 professionals","population":"CAE students and nursing‑home staff (Spanish‑speaking older‑adult care context)","country":"Spain (assumed from language)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors translated the Aging Sexual Knowledge and Attitudes Scale into Spanish and tested it with 467 nursing‑assistant students and staff. The scale showed good reliability and behaved as expected when linked to training, exposure, and religiosity, suggesting it is suitable for assessing older‑adult sexuality knowledge and attitudes in Spanish‑speaking care settings.","clinical_takeaway":"The Spanish ASKAS can reliably assess older‑adult sexual knowledge and attitudes among care‑workers and students.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample for psychometric validation","Systematic translation/back‑translation process","Both internal consistency and construct validity examined"],"limitations":["Convenience sample limits generalisability","No power analysis or effect‑size confidence intervals reported","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/pkcxq_v1"}},{"id":8505,"doi":"10.1016/j.bodyim.2021.04.004","pmid":"33933996","pmcid":null,"title":"\"Pretty hurts\": Acceptance of hegemonic feminine beauty ideals and reduced sexual well-being among Black women","authors":"Avery LR, Stanton AG, Ward LM, Cole ER, Trinh SL, Jerald MC.","first_author":"Avery LR","journal":"Body image","year":2021,"pub_types":["Journal Article"],"keywords":["Femininity","Black Women","Sexual Well-being","Hegemonic Beauty Ideals"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 640 Black college women; correlation and regression analyses.","sample_n":640,"sample_text":"Convenience sample of Black female college students.","population":"Black college women (N=640)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 640 Black college women, stronger endorsement of mainstream beauty standards (e.g., thinness, lighter skin) was linked to higher sexual guilt, shame, emotional distancing and lower sexual assertiveness and satisfaction.","clinical_takeaway":"Clinicians should consider how internalised beauty ideals may diminish sexual wellbeing in Black women.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size (N=640)","Focus on understudied population (Black women)","Multiple dimensions of sexual affect assessed"],"limitations":["Cross‑sectional design limits causal inference","Unclear whether scales used were validated","Convenience college sample may limit generalisability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.bodyim.2021.04.004"}},{"id":8506,"doi":"10.1080/00224499.2019.1695098","pmid":"31829900","pmcid":null,"title":"Relating Gender to Sex: Gendered Attitudes, Sexual Double Standard, Sexual Intentions and Behaviors in two Chinese Adolescent Samples","authors":"Wu H, Luo S, Espinosa-Hernández G, Klettner A, White TD, Li H.","first_author":"Wu H","journal":"Journal of sex research","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of urban (n=613) and rural (n=408) Chinese adolescents; regression analyses on gender role attitudes, sexual guilt, intentions, behaviors.","sample_n":1021,"sample_text":"n=613 urban, n=408 rural, total N≈1021","population":"Chinese adolescents, urban and rural samples","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 1,000 Chinese adolescents found that boys who strongly endorse a negative male role report less sexual guilt and higher sexual intentions. Rural youth showed more traditional gender attitudes and sexual guilt than urban peers, and the negative male role predicted sexual behavior.","clinical_takeaway":"Clinicians working with adolescents should consider gender role attitudes when discussing sexual guilt and intentions, especially in rural contexts.","confidence":0.8,"topic_tags":["gender","adolescents","sexual_function"],"strengths":["Large total sample across two distinct settings","Addresses gap of non‑Western adolescent data","Uses regression to test interaction effects"],"limitations":["Cross‑sectional design limits causal inference","Unclear whether attitude scales are validated in Chinese context","No control for mental‑health or other psychosocial confounds"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2019.1695098"}},{"id":8508,"doi":"10.1007/s10508-021-02094-6","pmid":"34704159","pmcid":null,"title":"Sexual Function After Voluntary Castration","authors":"Wibowo E, Wong STS, Wassersug RJ, Johnson TW.","first_author":"Wibowo E","journal":"Archives of sexual behavior","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Estrogen","Sexual function","Castration","Androgen Deprivation","Eunuchs","Psychosexual"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 163 voluntarily castrated adults; hierarchical multiple regression analyses on self‑report measures.","sample_n":163,"sample_text":"163 individuals (average age = 52 ± 16 years).","population":"Adults (average age 52) who have undergone voluntary orchiectomy, with or without hormone therapy; self‑selected sample.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 163 adults who chose to be castrated, those taking hormone supplements reported better sexual function. Anxiety, sexual guilt, and childhood trauma also related to how they experienced desire, arousal, and orgasm.","clinical_takeaway":"Hormone therapy appears to improve sexual function after castration; clinicians should also consider anxiety, guilt, and trauma when supporting these patients.","confidence":0.7,"topic_tags":["sexual_function","csbd","gender","relationships"],"strengths":["Large sample for a rare population","Multivariate analysis of several psychosocial factors","Inclusion of hormone therapy status"],"limitations":["Self‑selected, non‑representative sample","Unclear validation of measurement instruments","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-02094-6"}},{"id":8509,"doi":"10.31234/osf.io/4rh7m_v2","pmid":null,"pmcid":null,"title":"Influencia de factores psicosociales en la sexualidad femenina: Una mirada intergeneracional","authors":"Galván-Hernández D, del Carmen Herrera Enríquez M.","first_author":"Galván-Hernández D","journal":"PsyArXiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://osf.io/4rh7m_v2/download","cited_by_count":0,"is_preprint":true,"topics":["shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional comparison of young vs older women using survey instruments","sample_n":null,"sample_text":"Not reported in abstract","population":"women of two generational cohorts (young and older adults)","country":"Mexico (presumed from authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed young and older women in Mexico, finding that age is linked to differences in sexual satisfaction, importance of sex, sexual activity, and religiosity. Greater religiosity was associated with ageism, while importance of sex related to feminism and activity levels.","clinical_takeaway":"Older women may experience lower sexual satisfaction and activity, influenced by religiosity and cultural attitudes; clinicians should consider these psychosocial factors when discussing sexual health with older patients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses understudied topic of older women's sexuality","Includes psychosocial variables such as religiosity and feminism"],"limitations":["Cross‑sectional design limits causal inference","Unclear sample size and recruitment strategy","Limited control for key confounds (e.g., mental health, partner context)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/4rh7m_v2"}},{"id":8511,"doi":"10.1007/s00520-022-07502-8","pmid":"36574074","pmcid":"PMC9792940","title":"A silence full of words: sociocultural beliefs behind the sexual health of Iranian women undergoing breast cancer treatment, a qualitative study","authors":"Zangeneh S, Savabi-Esfahani M, Taleghani F, Sharbafchi MR, Salehi M.","first_author":"Zangeneh S","journal":"Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Breast cancer","Beliefs","Sexual Health","Sociocultural","Qualitative Study"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9792940","cited_by_count":23,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 39 participants (women, husbands, providers) using semi‑structured interviews and content analysis","sample_n":39,"sample_text":"39 semi‑structured interviews","population":"Iranian women undergoing breast cancer treatment, their husbands and health‑care providers","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with Iranian women undergoing breast cancer treatment and their partners revealed that cultural taboos, social norms, and hidden values shape their sexual experiences, often leading to shame and reduced sexual activity.","clinical_takeaway":"Clinicians should consider cultural beliefs when addressing sexual health in breast‑cancer survivors.","confidence":0.6,"topic_tags":["sexual_function","csbd","pornography"],"strengths":["In‑depth interviews provide rich cultural insight","Includes perspectives of patients, partners, and clinicians","Identifies specific sociocultural barriers to sexual health"],"limitations":["Small, non‑representative convenience sample","No quantitative measures or validated scales","Findings not generalisable beyond this cultural context"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00520-022-07502-8"}},{"id":8513,"doi":"10.1007/s10508-020-01808-6","pmid":"32935176","pmcid":null,"title":"Differences in the Psychological, Sexual, and Childhood Experiences Among Men with Extreme Interests in Voluntary Castration","authors":"Wong STS, Wassersug RJ, Johnson TW, Wibowo E.","first_author":"Wong STS","journal":"Archives of sexual behavior","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Body Image","Paraphilia","Dsm-5","Body Dysmorphia","Eunuch","Voluntary Castration"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience online survey of 822 men recruited from the Eunuch Archive (a forum for individuals interested in voluntary castration). Participants were classified into four self‑identified groups and completed self‑report questionnaires on psychological, sexual, and childhood‑experience variables.","sample_n":822,"sample_text":"822 participants completed the survey; groups ranged from ‘Interested’ to ‘Castrated’.","population":"Men interested in voluntary castration (self‑selected forum sample)","country":"Not specified (online international sample)","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 822 men from an online castration‑interest forum compared those who only read about castration with those who fantasise, plan, or have already been castrated. Those wanting castration reported more bisexual attraction, less religiosity, more childhood trauma and lower sexual functioning, while overall wellbeing and body‑image were similar across groups.","clinical_takeaway":"Clinicians should note that men seeking castration often have higher rates of childhood trauma and sexual guilt, but generally report comparable psychological wellbeing; assessment should consider these factors.","confidence":0.7,"topic_tags":["csbd","sexual_function","masturbation","gender"],"strengths":["Large sample size for a rare phenomenon","Multiple sub‑group comparisons","Inclusion of childhood trauma and sexual guilt variables"],"limitations":["Convenience sample from a specialised forum limits generalisability","Reliance on bespoke, likely unvalidated self‑report measures","No control for masturbation or partner relationship factors"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":16,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01808-6"}},{"id":8515,"doi":"10.1016/j.chiabu.2026.108293","pmid":"42636569","pmcid":null,"title":"Childhood sexual abuse and recovery trajectories among Jewish women survivors: A longitudinal comparison of trauma characteristics and clinical outcomes across the religious spectrum","authors":"Brenner I, Mintz Malchi K, Ludmir E, Lachter R, Lurie I, Nahir Peleg A, Spector-Dagan C, Lev-Ari L.","first_author":"Brenner I","journal":"Child abuse & neglect","year":2026,"pub_types":["Comparative Study","Journal Article"],"keywords":["Mental health","Child Sexual Abuse","Religiosity","Ultra-orthodox Jews"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Longitudinal cohort of 122 Jewish women CSA survivors assessed at baseline and 12 months with mixed‑effects modelling of PTSD, dissociation, BPD traits and spiritual support.","sample_n":122,"sample_text":"122 participants, recruited from public trauma centres; no indication of random sampling.","population":"Jewish women survivors of childhood sexual abuse (N = 122) across secular to ultra‑orthodox affiliations, receiving psychotherapy in Israel.","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 122 Jewish women survivors of childhood sexual abuse, abuse characteristics were similar across religious groups, but mental‑health recovery over a year differed, with secular and Orthodox participants showing greater PTSD improvement.","clinical_takeaway":"Religiosity may affect trauma recovery trajectories; clinicians should consider spiritual context when planning treatment.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Longitudinal design with two time points","Relatively large, diverse sample across religiosity spectrum","Use of validated mental‑health questionnaires"],"limitations":["No pre‑registration or reported effect‑size CIs","Potential self‑selection bias (treatment‑seeking survivors)","Limited control for broader psychosocial confounders"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2026.108293"}},{"id":8516,"doi":"10.1080/0092623x.2021.1977445","pmid":"34556007","pmcid":null,"title":"Clinical Considerations of the Evangelical Purity Movement's Impact on Female Sexuality","authors":"Estrada LL.","first_author":"Estrada LL.","journal":"Journal of sex & marital therapy","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"Not applicable – article is a clinical commentary without original data.","population":"female members of evangelical purity movement (no empirical sample)","country":"USA (implied)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article describes how evangelical purity teachings may create sexual shame and dissatisfaction for women, advising clinicians to understand this cultural background when working with affected clients.","clinical_takeaway":"Clinicians should consider the possible impact of purity‑movement messaging on female sexual distress and address related shame in therapy.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Highlights an under‑researched cultural context","Provides clinicians with a conceptual overview"],"limitations":["No original empirical data","Lacks operational definitions or measurement of key constructs","No systematic review methodology"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2021.1977445"}},{"id":8517,"doi":"10.1037/fam0001504","pmid":"42441642","pmcid":null,"title":"Religiosity and sexuality: A person- and couple-based approach","authors":"Leonhardt ND, Dunn E, Busby DM, Leavitt CE, Betten RM, Clarke R, Hatch H.","first_author":"Leonhardt ND","journal":"Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43)","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Three large exploratory cross‑sectional surveys (N≈1,600, 1,700, 481 couples) using latent profile analysis to examine religiosity, sexual sanctification, guilt, and sexual outcomes.","sample_n":3811,"sample_text":"Study 1: 1,615 individuals; Study 2: 1,695 individuals; Study 3: 481 mixed‑gender couples.","population":"Adults (mixed gender, ages young adult to middle‑aged) recruited from unspecified community samples.","country":"Not stated (likely USA based on journal).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examined how religious beliefs combined with feelings of guilt or sexual sanctification relate to sexual satisfaction, desire, and orgasm consistency. It found that people who view sex as sacred and have low guilt generally report higher religiosity and better sexual outcomes, while mixed attitudes lead to more varied results.","clinical_takeaway":"Clinicians should consider both positive and negative religious sexual attitudes when addressing sexual satisfaction in clients.","confidence":0.78,"topic_tags":["religiosity","sexual_function"],"strengths":["Large sample sizes across three studies","Use of latent profile analysis to capture heterogeneity","Inclusion of both individual and couple data"],"limitations":["Cross‑sectional design limits causal inference","Key confounds (masturbation, mental health, trauma) not measured","Unclear whether scales are fully validated"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/fam0001504"}},{"id":8518,"doi":"10.1186/s12905-026-04655-0","pmid":"42436470","pmcid":"PMC13640391","title":"Non-contact sexual violence and its association with sexual &amp; psychosocial health in Iranian women: a national cross-sectional study","authors":"Khayer E, Zarei R, Bőthe B, Farnam F.","first_author":"Khayer E","journal":"BMC women's health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Sexual dysfunction","Sexual Abuse","Sexual Distress","Non-partner Sexual Violence","Sexual Aversion"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13640391","cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"540 married Iranian women recruited via online and in‑person convenience sampling; groups compared on standardized health measures; logistic regression used.","sample_n":540,"sample_text":"540 participants (≈91 NCSV+, 449 NCSV‑) recruited from all 31 provinces","population":"married women aged 18‑76 years, Iran","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationwide survey of 540 Iranian married women, 16.9% reported having experienced non‑contact sexual violence such as exhibitionism, often in childhood. Survivors showed higher rates of depression, sexual dysfunction and avoidance, and reported lower religiosity compared with women without such experiences.","clinical_takeaway":"Screen for non‑contact sexual violence when assessing women’s mental and sexual health, as it is linked to higher depression and sexual problems.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large national sample","Use of validated health scales","Multivariate logistic regression"],"limitations":["Convenience sampling limits generalisability","Cross‑sectional design cannot infer causality","Potential unmeasured confounders (e.g., prior trauma)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12905-026-04655-0"}},{"id":8519,"doi":"10.31234/osf.io/gyxs2","pmid":null,"pmcid":null,"title":"Why College Women and Men Refrain from Sex Despite Desire","authors":"Oliver TL, Lanti A, Benning SD.","first_author":"Oliver TL","journal":"PsyArXiv","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/gyxs2","cited_by_count":0,"is_preprint":true,"topics":["shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of college students (N≈1316 total across item generation and validation).","sample_n":712,"sample_text":"College participants (N≈712 for validation).","population":"College students (US likely), convenience sample.","country":"USA (presumed from authorship)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"College students were asked why they sometimes avoid sex even when they want it. They identified personal insecurities, moral values, and partner issues as key reasons, with women endorsing these reasons more often than men.","clinical_takeaway":"Clinicians should recognise that personal and moral concerns, not just desire, often explain sexual abstinence, especially among women.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Large sample for scale validation","Item generation based on participant input","Factor analysis reveals distinct motives"],"limitations":["Novel measure lacks external validation","Convenience college sample limits generalisability","No control for mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/gyxs2"}},{"id":8520,"doi":"10.1080/00224499.2022.2100309","pmid":"35913394","pmcid":null,"title":"Patterns of Sexual Well-Being in Mexican Adolescents and Associations with Psychological Adjustment: A Latent Profile Analysis Approach","authors":"Espinosa-Hernández G, Vasilenko SA, Lombardi K, McCrimmon J, McPherson JL.","first_author":"Espinosa-Hernández G","journal":"Journal of sex research","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1123 Mexican adolescents using latent profile analysis","sample_n":1123,"sample_text":"large convenience sample from schools in Mexico","population":"Mexican high/middle school students (mean age 15.1)","country":"Mexico","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study identified six patterns of sexual well‑being among Mexican teens—ranging from high protection with low desire acceptance to risky multidimensional profiles—and found that youths in higher‑well‑being profiles reported better mental health.","clinical_takeaway":"Promoting consent, safe‑sex knowledge, and healthy desire acceptance may improve adolescents' psychological adjustment.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Large sample size for adolescent survey","Person‑centered latent profile approach captures heterogeneity","Links sexual well‑being profiles to psychological adjustment"],"limitations":["Cross‑sectional; cannot infer causality","Unclear whether measurement scales are validated","Key confounds (moral incongruence, masturbation, mental health covariates) not addressed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2100309"}},{"id":8521,"doi":"10.1080/00224545.2018.1461603","pmid":"29624117","pmcid":null,"title":"Scandalous: Christian identification, sex guilt, and the mediated demonization of the participants in the AshleyMadison scandal","authors":"Ashdown BK, Hackathorn JM, Daniels J.","first_author":"Ashdown BK","journal":"The Journal of social psychology","year":2019,"pub_types":["Journal Article"],"keywords":["Religiosity","Infidelity","Victim Blaming","Sex Guilt","Ashley Madison"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of participants assessing religiosity, sex guilt, and demonization attitudes after the AshleyMadison data breach; convenience sample; no longitudinal or experimental manipulation.","sample_n":null,"sample_text":"not specified in abstract","population":"adult respondents (likely US) recruited online; demographic details not provided in abstract","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed people about their Christian identity, sexual guilt, and how harshly they judged those involved in the AshleyMadison hack. It found that sexual guilt, not religiosity alone, explained the level of demonization.","clinical_takeaway":"None – the findings relate to social attitudes, not clinical practice.","confidence":0.7,"topic_tags":["religiosity","sexual_function","gender","moral_incongruence"],"strengths":["Addresses a socially relevant phenomenon (victim blaming)","Uses mediation analysis to test theoretical pathway"],"limitations":["Cross‑sectional convenience sample limits causal inference","Unclear whether scales are validated; possible circular measurement","No control for key confounds (mental health, relationship factors, trauma)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":9,"retracted":false,"notices":[{"status":"Has erratum","date":"2019-5-14","noticeDoi":"10.1080/00224545.2019.1599547","doi":"10.1080/00224545.2018.1461603"}],"url":"https://scite.ai/reports/10.1080/00224545.2018.1461603"}},{"id":8523,"doi":"10.3390/ejihpe16060077","pmid":"42346047","pmcid":"PMC13298553","title":"Sexual Knowledge, Attitudes, and Motivational Factors Associated with Sexual Activity in Older Adults: A Cross-Sectional Study","authors":"Estruch-García V, Gil-Llario MD, Satorres E.","first_author":"Estruch-García V","journal":"European journal of investigation in health, psychology and education","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Behavior","Motivation","Satisfaction","Attitudes","Older Adults"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13298553","cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 186 community-dwelling older adults (65‑88 y)","sample_n":186,"sample_text":"186 adults aged 65‑88 years (M = 73.29)","population":"older adults, community sample","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 186 older adults, greater knowledge, positive attitudes, and the personal importance placed on sex were linked to having recent partnered sexual activity, while age and gender also played a role.","clinical_takeaway":"Assess older clients' attitudes and motivation toward sex, not just knowledge, to support sexual well‑being.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses validated ASKAS scale","Focuses on understudied older adult population","Hierarchical logistic regression to identify predictors"],"limitations":["Cross‑sectional design limits causal inference","Limited sample size and convenience recruitment","Key confounds (mental health, moral attitudes, trauma) not measured"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ejihpe16060077"}},{"id":8524,"doi":"10.2147/ijwh.s580118","pmid":"42232356","pmcid":"PMC13225006","title":"Psychological and Sociocultural Correlates of Genito-Pelvic Pain/Penetration Disorder in Iranian Women: A Comparative Study of Sexual Self-Schema and Temperament","authors":"Mohazzab A, Shahali S, Ghorbani B, Balaei S, Ansaripour S, Ashtari A, Nazari F, Samimi N, Azin SA.","first_author":"Mohazzab A","journal":"International journal of women's health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Temperament","Sexual dysfunction","Iranian Women","Genito-pelvic Pain/penetration Disorder","Sexual-schema"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13225006","cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-control study of 38 women with GPPPD and 37 controls recruited from a fertility/sexual‑health clinic in Tehran; logistic regression used to identify associations.","sample_n":75,"sample_text":"75 (38 cases, 37 controls)","population":"married Iranian women, 18‑45 y, clinic‑based sample","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small Iranian study, women with genito‑pelvic pain/penetration disorder showed higher shy‑cautious self‑schemas, greater emotional sensitivity, and certain temperament traits. Higher religiosity was also linked to the disorder, while having a partner with freelance employment reduced risk.","clinical_takeaway":"Assess psychological schemas, temperament, and cultural factors (e.g., religiosity) when evaluating women with pain‑related sexual dysfunction.","confidence":0.8,"topic_tags":["gender","sexual_function","csbd","religiosity"],"strengths":["Use of validated Persian instruments","Multivariable logistic regression with confidence intervals","Inclusion of sociocultural variables (religiosity, employment)"],"limitations":["Small case‑control sample, limited power","No assessment of key sexual‑health confounds (masturbation, mental health, trauma)","Clinic‑based convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/ijwh.s580118"}},{"id":8526,"doi":"10.21203/rs.3.rs-345973/v1","pmid":null,"pmcid":null,"title":"Sexual Wellbeing in Early Adolescence: A Cross-sectional Assessment Among Girls and Boys in Urban Indonesia","authors":"Kågesten AE, Pinandari AW, Page A, Wilopo SA, Reeuwijk Mv.","first_author":"Kågesten AE","journal":"Research Square","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-345973/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional school‑based survey of 4,309 early adolescents in urban Indonesia","sample_n":4309,"sample_text":"school‑based sample, likely convenience, not nationally probability","population":"early adolescents (ages 10‑14) attending schools in three urban sites in Indonesia (N=4309, 53% girls)","country":"Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of over 4,000 Indonesian early adolescents found mixed levels of sexual wellbeing: boys reported higher body confidence and lower guilt, while girls showed more gender‑equal attitudes and self‑efficacy. Overall knowledge and communication about sexual health were low, indicating a need for better education.","clinical_takeaway":"Early sex‑education should address knowledge gaps, gender‑specific concerns, and feelings of guilt to improve adolescent sexual wellbeing.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large sample size for a youth survey","Gender‑specific analyses","Multivariable logistic regression to adjust for covariates"],"limitations":["Cross‑sectional design; no causal inference","Unclear whether wellbeing items are validated scales","No measurement of key confounds such as moral incongruence or mental health"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-345973/v1"}},{"id":8527,"doi":"10.32388/ksacnt","pmid":null,"pmcid":null,"title":"Applying the Theory of Planned Behavior in Sexuality Education: Educators’ Behavioral Intentions toward Sexuality Issues","authors":"Grigoropoulos I.","first_author":"Grigoropoulos I.","journal":"Qeios","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.qeios.com/read/KSACNT/pdf","cited_by_count":0,"is_preprint":true,"topics":["shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of pre‑service early childhood educators (N=402) using Theory of Planned Behavior questionnaires; convenience sampling from Greek and Spanish programmes.","sample_n":402,"sample_text":"Two studies combined (N=402) of pre‑service early childhood educators.","population":"pre‑service early childhood educators (Greek and Spanish)","country":"Greece; Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 402 future early‑childhood teachers in Greece and Spain found that their personal views and religious conservatism shape how willing they say they would be to respond to young children’s sexual curiosity.","clinical_takeaway":"None – the study addresses educators’ intentions, not clinical sexual health issues.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large combined sample (N>400)","Use of established Theory of Planned Behavior framework","Inclusion of religiosity as moderator"],"limitations":["Cross‑sectional design limits causal inference","Convenience sample of pre‑service teachers limits generalisability","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.32388/ksacnt"}},{"id":8530,"doi":"10.1111/jora.12209","pmid":"28581656","pmcid":"PMC5461668","title":"Sexual Behaviors in Mexico: The Role of Values and Gender Across Adolescence","authors":"Espinosa-Hernández G, Vasilenko SA, Bámaca-Colbert MY.","first_author":"Espinosa-Hernández G","journal":"Journal of research on adolescence : the official journal of the Society for Research on Adolescence","year":2016,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of Mexican adolescents (ages 12‑19) examining associations between cultural values and three sexual behaviors","sample_n":null,"sample_text":"Not reported in abstract","population":"Adolescents in Mexico, school‑based sample, 53 % female, ages 12‑19","country":"Mexico","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Mexican adolescents who feel more sexual guilt or think virginity is especially important tend to report more kissing, oral sex, and vaginal sex, with some differences between boys and girls and between younger and older teens.","clinical_takeaway":"Clinicians should consider cultural values like sexual guilt when discussing sexual behavior with Mexican youths.","confidence":0.8,"topic_tags":["adolescents","sexual_function","csbd"],"strengths":["Addresses under‑studied cultural values in a non‑WEIRD adolescent sample","Examines multiple sexual behaviours rather than only intercourse","Considers gender and school‑level interactions"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report; unclear validation of value scales","Lacks control for mental‑health, trauma, or broader moral/religious factors"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":1,"mentioning":47,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jora.12209"}},{"id":8533,"doi":"10.1080/13674676.2025.2516585","pmid":"41537153","pmcid":null,"title":"Adolescence into adulthood: Religiosity factors influencing trajectories of suicide ideation and attempt among sexual minorities","authors":"Blosnich JR, Fish JN, Miller EK, Russell ST, De Luca SM.","first_author":"Blosnich JR","journal":"Mental health, religion & culture","year":2026,"pub_types":["Journal Article"],"keywords":["Longitudinal","Suicide Attempt","Sexual Orientation","Religiosity","Suicidal Ideation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Three-wave nationally representative cohort (Add Health) with latent class analysis of suicidality and religiosity trajectories.","sample_n":15000,"sample_text":"large, nationally representative cohort","population":"U.S. adolescents followed into young adulthood (national sample).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using three waves of a national U.S. study, researchers found that sexual‑minority youths are more likely to follow higher‑risk suicide‑thought trajectories and report lower religiosity than heterosexual peers, but religiosity did not explain these suicide patterns.","clinical_takeaway":"Clinicians should note that lower religiosity does not fully account for higher suicide risk among sexual‑minority youth; broader psychosocial factors need assessment.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative longitudinal data","Sophisticated latent class trajectory analysis","Clear reporting of non‑significant interaction"],"limitations":["No measurement of key confounds (mental health, trauma, etc.)","Reliance on self‑report religiosity and suicidality","No pre‑registration disclosed"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13674676.2025.2516585"}},{"id":8534,"doi":"10.1371/journal.pone.0338724","pmid":"41411236","pmcid":"PMC12714186","title":"Caregivers' perspectives on factors influencing adolescent girls' engagement in sexual risk-taking in Uganda: A qualitative study","authors":"Sensoy Bahar O, Ssewamala FM, Namuwonge F, Namuli F, Nabunya P, ICHAD Field Team.","first_author":"Sensoy Bahar O","journal":"PloS one","year":2025,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12714186","cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interviews with 58 caregivers in Uganda","sample_n":58,"sample_text":"58 caregivers","population":"caregivers of adolescent girls (Uganda)","country":"Uganda","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 58 Ugandan caregivers revealed personal, family, peer and community factors they believe influence teenage girls' sexual risk‑taking, highlighting the role of goals, religion, poverty and counseling.","clinical_takeaway":"Engaging both caregivers and adolescents in tailored interventions may help reduce sexual risk behaviours among Ugandan girls.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["In‑depth qualitative data from caregivers","Systematic thematic analysis combining inductive and deductive approaches","Context‑specific insights for Ugandan setting"],"limitations":["Small, non‑random convenience sample","No quantitative validation of constructs","Limited generalisability beyond the interviewed caregivers"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0338724"}},{"id":8535,"doi":"10.20944/preprints202309.2042.v1","pmid":null,"pmcid":null,"title":"An Analysis of the Impact of Religious Affiliation and Strength of Religiosity on Sexual Health Practices of Sexually Active Female College Students","authors":"Glazer E, Valdez E, DeBlauw JA, Ives S.","first_author":"Glazer E","journal":"Preprints.org","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.preprints.org/manuscript/202309.2042/v1/download","cited_by_count":0,"is_preprint":true,"topics":["shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 224 female college students; 20‑item questionnaire; chi‑square analyses","sample_n":224,"sample_text":"Convenience sample recruited from a single university; not probability‑based","population":"female college students (age ~18‑24) in the United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 224 female college students found that stronger personal religiosity was linked to later start of contraceptive use and that students’ view of religion’s effect on their sexual health varied by religious affiliation.","clinical_takeaway":"Clinicians should consider patients’ religious background when discussing timing of contraceptive initiation and sexual‑health decision‑making.","confidence":0.78,"topic_tags":["sexual_function","religiosity"],"strengths":["Relatively large sample for a single‑site survey","Focus on a socially relevant factor (religiosity) and concrete sexual‑health outcomes"],"limitations":["Ad‑hoc questionnaire; no validated scales reported","Cross‑sectional design; cannot infer causality","No control for key confounders (e.g., mental health, partner status)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202309.2042.v1"}},{"id":8537,"doi":"10.1080/19317611.2025.2597856","pmid":"42205336","pmcid":null,"title":"Risk-Taking Propensity, Impulsivity and Risky Sexual Behaviors in Arab-Muslim Adults: The Moderating Effect of Religiosity","authors":"Fekih-Romdhane F, Abbassi B, Maalej E, Cheour M, Hallit S.","first_author":"Fekih-Romdhane F","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2026,"pub_types":["Journal Article"],"keywords":["Adults","Impulsivity","Risky Sexual Behavior","Religiosity","Risk-taking Propensity"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 466 Tunisian Arab‑Muslim adults, regression testing interaction of impulsivity and religiosity on self‑reported risky sexual behavior","sample_n":466,"sample_text":"466 Arab‑Muslim adults from the general population of Tunisia","population":"general adult population (Tunisia)","country":"Tunisia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 466 Tunisian adults, higher impulsivity and risk‑taking were linked to more risky sexual behavior, but strong religious beliefs weakened these links. Religion may protect against risky sex in people prone to impulsive traits.","clinical_takeaway":"Religious involvement may buffer impulsive adults from engaging in risky sexual activities.","confidence":0.75,"topic_tags":["religiosity"],"strengths":["Large sample for a cross‑sectional survey","Examines moderating role of religiosity","Reports interaction effects with confidence intervals"],"limitations":["Cross‑sectional design cannot establish causality","Potential unmeasured confounds (e.g., moral incongruence, mental health)","Construct measurement details not disclosed in abstract"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2025.2597856"}},{"id":8539,"doi":"10.1080/19317611.2025.2583150","pmid":"42205348","pmcid":null,"title":"From Interpersonal Experiences to Proximal Minority Processes and Mental Health: A Characterization of Latent Socio-Evolutionary Profiles in Portuguese Sexual Minoritized Individuals","authors":"Seabra D, Ribeiro da Silva D, Gato J, Petrocchi N, Salvador MDC.","first_author":"Seabra D","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2026,"pub_types":["Journal Article"],"keywords":["Mental health","Latent Profiles","Evolutionary Approach","Sexual Minority (Sm) Individuals","Stigma Approach"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Latent profile analysis of 409 Portuguese sexual minority adults using self‑report questionnaires on stigma, early experiences, and mental‑health symptoms.","sample_n":409,"sample_text":"Community sample of Portuguese sexual minorities (adults).","population":"Portuguese sexual‑minority adults (N = 409), community sample.","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 409 Portuguese sexual‑minority adults and identified four distinct groups—traumatized, marginalized, resilient, and secure—based on experiences of stigma, early memories, and social support, showing how these profiles relate to mental‑health outcomes.","clinical_takeaway":"Clinicians should assess stigma and interpersonal histories, as they shape mental‑health risk profiles among sexual‑minority clients.","confidence":0.8,"topic_tags":["sexual_function","masturbation","pornography","csbd"],"strengths":["Large community sample (N>400)","Comprehensive set of validated self‑report scales","Latent profile analysis provides nuanced sub‑group insight","Inclusion of multiple mental‑health outcomes"],"limitations":["Cross‑sectional; no causal inference","No measurement of moral or relational confounds","Reliance on self‑report; possible shared method variance","No preregistration or correction for multiple testing reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2025.2583150"}},{"id":8542,"doi":"10.1101/2023.05.23.23290385","pmid":null,"pmcid":null,"title":"Barriers and Perceived Facilitators for PrEP Use Among Women of Color in South Florida: Findings from the  <i>Empowering Women to Take Control of Their Sexual Health Summit</i>","authors":"Cyrus E, Villalba K, Jean-Gilles M, Rosenberg R, Ichite A, Ullah E, Lovera E, Lester A, Neptune S, Wilson H, Exantus M, Lerner B, Cook R, Dévieux JG.","first_author":"Cyrus E","journal":"medRxiv","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":true,"topics":["shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Focus groups with 279 cisgender and transgender women of color at a summit; thematic analysis of barriers and facilitators to PrEP use.","sample_n":279,"sample_text":"279 participants (cisgender and transgender women of color) recruited via conference attendance; no random or probability sampling.","population":"Women of color (African American, Latina, Haitian) in South Florida; convenience sample from conference attendees.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Women of color at a South Florida health summit discussed why they struggle to use HIV prevention medication (PrEP). Main obstacles were distrust of doctors, limited knowledge, financial dependence on partners, cultural gender norms, religious influences, health‑insurance gaps, immigration status, and racism. Community resilience was seen as a facilitator.","clinical_takeaway":"Address medical distrust, improve PrEP education, and consider cultural, economic, and structural barriers when promoting PrEP among women of color.","confidence":0.7,"topic_tags":["prevalence","sexual_function"],"strengths":["Large qualitative sample for focus‑group work","Identifies multi‑level barriers specific to women of color","Highlights cultural and structural factors such as racism and immigration status"],"limitations":["Convenience sample at a single summit; limited generalisability","No quantitative measurement or validated scales","No systematic control of potential confounds"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2023.05.23.23290385"}},{"id":8543,"doi":"10.1080/07448481.2025.2561048","pmid":"40996833","pmcid":null,"title":"Sexual attitudes and knowledge of Southern United States college students on risky sexual behavior: moderation by conservative religiosity, sex, and sexual double standards","authors":"Durham A, McKinney C.","first_author":"Durham A","journal":"Journal of American college health : J of ACH","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sex","Risky Sexual Behavior","Sexual Attitudes","Sexual Knowledge","Sexual Double Standards"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"single cross‑sectional survey of 967 Southern U.S. college students","sample_n":967,"sample_text":"967 college students completed three questionnaire scales","population":"emerging‑adult college students (US, Southern region)","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 967 Southern college students, more liberal sexual attitudes and greater knowledge were linked to more positive views of risky sex for men, while conservative religiosity and belief in sexual double standards tended to reduce those attitudes, especially for women.","clinical_takeaway":"Clinicians should consider how religiosity and gendered double‑standards shape students' attitudes toward risky sexual behavior.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a survey study","Use of multiple established scales","Examines interaction effects (knowledge × religiosity, etc.)"],"limitations":["Cross‑sectional; cannot infer causality","Limited control of key confounds (mental health, partner factors, trauma)","Convenience sample from one region limits generalisability"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/07448481.2025.2561048"}},{"id":8544,"doi":"10.1038/s41598-025-17097-9","pmid":"40858829","pmcid":"PMC12381061","title":"The protective effect of high religiosity on later sexual behaviour of young adults in the US","authors":"Sakellariou C.","first_author":"Sakellariou C.","journal":"Scientific reports","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behaviour","Sex differences","Religiosity","Selection On Unobservables"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12381061","cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"large nationally‑representative cohort (Add Health) with multiple waves, allowing temporal ordering of religiosity and later sexual behaviour","sample_n":null,"sample_text":"Add Health longitudinal dataset (large, nationally representative sample of U.S. adolescents followed into adulthood)","population":"young adults in the United States (Add Health sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a large US cohort, the study finds that high religiosity in adolescence predicts fewer opposite‑sex partners and later sexual initiation in young adulthood, especially among those with strong religious commitment.","clinical_takeaway":"Clinicians should note that strong personal religiosity may be associated with delayed sexual activity, but individual values and contexts vary.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Large, nationally representative longitudinal dataset","Explicit tests for omitted‑variable bias","Gender‑specific analyses"],"limitations":["Reliance on self‑report for sexual behaviour","Limited measurement of potential confounders (e.g., mental health, partner context)","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-025-17097-9"}},{"id":8545,"doi":"10.1016/j.adolescence.2020.04.008","pmid":"32387815","pmcid":null,"title":"Associations of mindfulness with adolescent outcomes and sexuality","authors":"Leavitt CE, Allsop DB, Busby DM, Driggs SM, Johnson HM, Saxey MT.","first_author":"Leavitt CE","journal":"Journal of adolescence","year":2020,"pub_types":["Journal Article"],"keywords":["Mindfulness","Adolescent Sexuality","Adolescent Disclosure","Sexual Mindfulness","Adolescent Body-esteem"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 2000 U.S. adolescents (13‑18 y), stratified by age, sex and income; CFA and SEM used to evaluate a novel Sexual Mindfulness Measure and its associations with various self‑report outcomes.","sample_n":2000,"sample_text":"2000 U.S. adolescents (half boys/girls; 1/3 low, medium, and high incomes) aged 13‑18","population":"adolescents (13‑18 y) from the United States, recruited via an online survey; sample size ≈ 2000, roughly equal gender distribution, socio‑economic strata represented.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 2,000 U.S. teens, higher mindfulness—especially the ability to stay aware and non‑judgmental during sexual moments—was linked to better body image, self‑confidence, and open talking with parents, as well as lower sexual shame and anxiety.","clinical_takeaway":"Encouraging mindfulness during sexual experiences may promote healthier attitudes and reduced shame among adolescents.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, demographically diverse adolescent sample","Use of CFA/SEM to evaluate a new measure","Separate analysis of sexually active vs. non‑active youths"],"limitations":["Cross‑sectional; no causal inference","New Sexual Mindfulness Measure lacks extensive validation","Key psychosocial confounds (e.g., mental health, moral beliefs) not assessed"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2020.04.008"}},{"id":8546,"doi":"10.1016/j.drugpo.2021.103333","pmid":"34175526","pmcid":null,"title":"Exploring the role of trauma in underpinning sexualised drug use ('chemsex') among gay, bisexual and other men who have sex with men in Singapore","authors":"Tan RKJ, Phua K, Tan A, Gan DCJ, Ho LPP, Ong EJ, See MY.","first_author":"Tan RKJ","journal":"The International journal on drug policy","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Singapore","Mental health","Qualitative Methods","Men Who Have Sex With Men","Chemsex","Party And Play"],"is_oa":false,"oa_url":"https://scholarbank.nus.edu.sg/handle/10635/233827","cited_by_count":32,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"In‑depth semi‑structured interviews with 33 purposively‑sampled GBMSM seeking treatment for chemsex in Singapore; inductive thematic analysis.","sample_n":33,"sample_text":"33 purposively‑sampled participants","population":"GBMSM with history of sexualised drug use (chemsex) and treatment experience, Singapore","country":"Singapore","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 33 gay and bisexual men in Singapore who use drugs during sex revealed that past traumas—such as stigma, violence and loss—drive their drug‑enhanced sexual encounters. The authors suggest trauma‑informed care for treatment.","clinical_takeaway":"Addressing underlying trauma may improve treatment outcomes for chemsex‑related drug use.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Rich, in‑depth qualitative data","Focus on under‑studied trauma link","Clear analytic framework (thematic analysis)"],"limitations":["Small, treatment‑seeking convenience sample","No validated quantitative measures","Findings not generalisable to broader GBMSM"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":36,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.drugpo.2021.103333"}},{"id":8547,"doi":"10.1177/135910530100600102","pmid":"22049235","pmcid":null,"title":"Parental Non-verbal Sexual Communication: Its Relationship to Sexual Behaviour and Sexual Guilt","authors":"Joffe H, Franca-Koh AC.","first_author":"Joffe H","journal":"Journal of health psychology","year":2001,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study (N=137) examining recalled parental non‑verbal sexual communication, current sexual behaviour and sexual guilt in young British adults","sample_n":137,"sample_text":"N=137 young adults completed questionnaires","population":"young British men and women (convenience sample)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 137 young British adults and found that those who remembered more open, non‑verbal sexual cues from their parents tended to start sexual activity earlier, have fewer partners, and report lower sexual guilt.","clinical_takeaway":"Early family sexual openness may relate to later sexual guilt, but evidence is correlational; clinicians should consider broader relational factors.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Addresses understudied area of family sexual communication","Uses a relatively sizable sample for exploratory work","Links early family environment to later sexual guilt"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on recalled parental behaviour (memory bias)","No validated measure of parental non‑verbal communication reported","Critical confounds (e.g., moral attitudes, mental health) not controlled"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/135910530100600102"}},{"id":8549,"doi":"10.1017/sjp.2025.10","pmid":"40384302","pmcid":null,"title":"Unveiling the Secrets of Female Sexual Satisfaction: Exploring Multidimensional Patterns of Sexual Behavior in Young and Middle-Aged Women through Cluster Analysis","authors":"Ogallar-Blanco AI, Lara-Moreno R, Godoy-Izquierdo D.","first_author":"Ogallar-Blanco AI","journal":"The Spanish journal of psychology","year":2025,"pub_types":["Journal Article"],"keywords":["Cluster analysis","Sexual behavior","Sexual Satisfaction","Sexual Self-efficacy","Cognitive Predictors"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 1,076 women aged 18‑50, cluster analysis of psychosocial variables","sample_n":1076,"sample_text":"1076 women, 18‑50 years, recruited from the general population","population":"community sample of young and middle‑aged women","country":"Spain (presumed from journal)","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 1,000 women identified three types of sexual‑health profiles based on knowledge, attitudes, and self‑efficacy. Women with healthier beliefs and higher self‑efficacy reported more satisfying sexual lives, while those with riskier psychosocial patterns reported poorer outcomes.","clinical_takeaway":"Assessing women’s sexual knowledge, attitudes and self‑efficacy can help tailor interventions that improve sexual satisfaction.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large community sample (N>1000)","Person‑oriented cluster analysis reveals meaningful sub‑groups","Inclusion of religiosity as a psychosocial variable"],"limitations":["Cross‑sectional design limits causal inference","Potential limited measurement detail for masturbation, mental health and relational factors","No pre‑registration or explicit power analysis reported"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/sjp.2025.10"}},{"id":8552,"doi":"10.1037/sgd0000842","pmid":"40895805","pmcid":"PMC12396700","title":"Variations in Religious Development by Sexual Orientation: Results from a Nationally Representative U.S. Sample","authors":"Fahey KML, Dermody SS.","first_author":"Fahey KML","journal":"Psychology of sexual orientation and gender diversity","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Development","Adolescence","Religion","Sexual Orientation","Adulthood"],"is_oa":false,"oa_url":"https://doi.org/10.1037/sgd0000842","cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"large nationally representative longitudinal cohort (Add Health) with 10,879 participants, time‑varying effect modeling across ages 12‑41","sample_n":10879,"sample_text":"Nationwide longitudinal cohort, self‑weighting core sample","population":"U.S. adolescents to adults, diverse sexual orientations","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using data from over 10,000 U.S. participants tracked from age 12 to 41, the study found that religious affiliation, attendance, importance, and prayer generally decline with age and are lower for people who identify as mostly heterosexual, bisexual, or mostly gay/lesbian compared to heterosexuals. Some differences vary by age, with gay/lesbian individuals praying more in adolescence but less in middle adulthood.","clinical_takeaway":"None – the findings concern religiosity development, not clinical sexual health or addiction.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Longitudinal design with repeated measures","Appropriate advanced modeling (TVEM)","Clear operationalization of religious variables"],"limitations":["No measurement of key sexual‑health confounds (e.g., mental health, trauma)","Reliance on self‑report for religiosity","No pre‑registration disclosed"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/sgd0000842"}},{"id":8555,"doi":"10.1016/j.ejon.2025.102866","pmid":"40112424","pmcid":null,"title":"Factors contributing to sexual dissatisfaction in women with breast cancer: The specific role of conjugal relationship quality","authors":"Lamore K, Giardinelli AM, Wawrziczny É.","first_author":"Lamore K","journal":"European journal of oncology nursing : the official journal of European Oncology Nursing Society","year":2025,"pub_types":["Journal Article"],"keywords":["Sexuality","Model","Breast cancer","Sexual Satisfaction","Conjugal Relationship"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 87 women with breast cancer using self‑report questionnaires and partial least squares path modeling.","sample_n":87,"sample_text":"Convenience sample recruited from clinical settings; not nationally representative.","population":"Women with breast cancer (n=87), mixed ages, undergoing lumpectomy or mastectomy.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 87 women with breast cancer, the quality of the marital relationship was the key factor linked to sexual dissatisfaction, more so than surgery type, body image, or religiosity.","clinical_takeaway":"Improving couple communication may help boost sexual satisfaction after breast cancer treatment.","confidence":0.8,"topic_tags":["sexual_function","relationships","csbd"],"strengths":["Multifactorial model using path analysis","Includes both intra‑ and interpersonal variables","Assesses both surgical types"],"limitations":["Cross‑sectional design limits causal inference","Sample size modest for complex modeling","Reliance on self‑report questionnaires"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ejon.2025.102866"}},{"id":8556,"doi":"10.3390/bs15030294","pmid":"40150189","pmcid":"PMC11939199","title":"Religiosity, Sexual Double Standard, and Intimate Partner Coercive Victimization in Dating Relationships: An Explanatory Model and Psychometric Evidence","authors":"Alfaro-Urquiola AL, Pérez B, Rodríguez-Díaz FJ, Herrero Diez FJ.","first_author":"Alfaro-Urquiola AL","journal":"Behavioral sciences (Basel, Switzerland)","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Religiosity","Dating Violence","Sexual Double Standard","Coercive Victimization","Factorial Invariance By Gender"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11939199","cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of Chilean university students (N≈909) assessing religiosity, sexual double standard, and coercive victimisation; gender‑specific factor models and mediation analysis","sample_n":909,"sample_text":"University students; not nationally representative","population":"Chilean university students (convenience sample)","country":"Chile","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a Chilean university sample, stronger religiosity was linked to higher risk of intimate‑partner coercive victimisation, partly because it promoted a sexual double standard; the effect differed for men and women.","clinical_takeaway":"Clinicians should consider how religiosity and gendered sexual norms may affect vulnerability to dating‑relationship violence.","confidence":0.8,"topic_tags":["religiosity","sexual_function","gender","relationships","measurement"],"strengths":["Validated scales with gender‑specific factor analysis","Large sample for a university study","Examination of mediation pathways"],"limitations":["Cross‑sectional; no causal inference","Convenience sample limits generalisability","Key confounds (mental health, trauma, moral incongruence) not measured"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs15030294"}},{"id":8557,"doi":null,"pmid":"40145161","pmcid":null,"title":"The mediating effect of mental health status between self-system and sexual risk behaviour among university students in Malaysia","authors":"Azlan SM, Mohamad F, Mohd Nazan AIN, Dahlan R, Kamaruddin KN, Shibraumalisi NA, Syed Mohamad SN, Ismail IZ, Kadir Shahar H, Shamsuddin NH.","first_author":"Azlan SM","journal":"The Medical journal of Malaysia","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Quantitative cross‑sectional survey of 1171 Malaysian university students; stratified random sampling of institutions, convenience sampling of participants; online questionnaire; SEM analysis.","sample_n":1171,"sample_text":"1171 respondents recruited via online survey.","population":"University students (young adults) in Malaysia, N≈1171, mixed gender.","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among Malaysian university students, mental‑health symptoms partly explain how adverse childhood experiences and religiosity relate to risky sexual behaviours.","clinical_takeaway":"Addressing depression, anxiety, and stress may reduce sexual risk behaviours in young adults.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size (N>1100)","Use of structural equation modelling","Nationally stratified institution sampling"],"limitations":["Cross‑sectional design cannot infer causality","Convenience sampling of students may limit generalisability","Measures not fully described; validation unclear"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":8561,"doi":"10.1007/s44192-025-00134-4","pmid":"39883248","pmcid":"PMC11782748","title":"Vietnamese religiosity, premarital sexual permissiveness, and abortion attitudes: the mediating role of filial piety","authors":"Nguyen PT, Nguyen VHA, Truong TK, Nguyen TB, Luu K, Le VT, Nguyen-Thi NH, Chu-Nguyen YT, Nguyen LT, Tran-Chi VL.","first_author":"Nguyen PT","journal":"Discover mental health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Religiosity","Vietnamese","Filial Piety","Abortion Attitudes","Premarital Sexual Permissiveness"],"is_oa":true,"oa_url":"https://doi.org/10.1007/s44192-025-00134-4","cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 656 Vietnamese participants using self‑report questionnaires and PLS‑SEM analysis","sample_n":656,"sample_text":"656 participants recruited (recruitment method not described)","population":"Vietnamese adults (age range not specified)","country":"Vietnam","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 656 Vietnamese adults, stronger religious commitment was linked to more conservative abortion attitudes, while greater openness to premarital sex predicted more pro‑choice views. Filial piety helped explain how religion influences these attitudes.","clinical_takeaway":"Clinicians should consider cultural and religious factors, including filial piety, when discussing abortion attitudes with Vietnamese patients.","confidence":0.8,"topic_tags":["religiosity","sexual_function","csbd"],"strengths":["Large sample size (N=656)","Use of structural equation modelling to test mediation","Focus on culturally specific construct (filial piety)"],"limitations":["Cross‑sectional design limits causal inference","No explicit measurement of key confounds (e.g., moral incongruence, mental health)","Unclear whether scales are validated in Vietnamese context"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s44192-025-00134-4"}},{"id":8562,"doi":"10.1007/s10508-024-03070-6","pmid":"39715934","pmcid":"PMC11926014","title":"Perceived Biological Bases of Sexual Orientation and Sexual Prejudice: The Moderating Role of Gender and Religious Beliefs","authors":"Falomir-Pichastor JM, Confino D, Anderson JR, Koc Y.","first_author":"Falomir-Pichastor JM","journal":"Archives of sexual behavior","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual Orientation","Religiosity","Sexual Prejudice","Biological Determinism","Intergroup Differences"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10508-024-03070-6.pdf","cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Two‑study experimental manipulation of presented evidence (biological differences vs. similarities) with heterosexual participants (N=118; N=280). Random assignment, gender and religiosity measured as moderators.","sample_n":398,"sample_text":"Study 1 N=118 (men); Study 2 N=280 (men & women)","population":"heterosexual adults (likely convenience/student sample)","country":"unspecified (non‑U.S. funding indicated)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested whether men’s and women’s religious beliefs change how they interpret scientific evidence about the biology of sexual orientation. Less religious men and women saw evidence of biological differences as supporting natural variation and reported more positive attitudes toward gay people; more religious men saw the same evidence as indicating a problem and reported more negative attitudes.","clinical_takeaway":"None – the research informs attitudes, not clinical treatment.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Experimental manipulation allows causal inference about evidence interpretation","Adequate overall sample size for between‑group comparisons","Inclusion of both gender and religiosity as moderators"],"limitations":["Reliance on self‑report scales of unknown psychometric quality","Convenience sampling limits generalisability","No control for other potential confounds (e.g., political ideology, mood)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-03070-6"}},{"id":8563,"doi":"10.1080/19317611.2024.2435281","pmid":"40400566","pmcid":"PMC12091925","title":"Characterization of Knowledge, Attitudes, Comfort, and Perception of Discrimination Regarding Sexual and/or Gender Minoritized People: Comparison Between Two Cohorts of Medical Students - 2018-2023","authors":"Macedo A, Ferreira J, Gutierrez AR, Gato J.","first_author":"Macedo A","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Discrimination","Medical Students","Equity","Sexual And Gender Minorities","Lgbtqia+"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional comparison of two student cohorts (2018 vs 2023) at a single Portuguese medical school; convenience sample of 313 students, no randomisation or longitudinal follow‑up.","sample_n":313,"sample_text":"313 students assessed in 2018 and 2023","population":"Medical students (3rd‑6th year) at one university, Portugal","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study compared Portuguese medical students in 2018 and 2023 and found that after a curriculum seminar, students knew more about LGBTQIA+ health and felt more comfortable treating these patients, though they still reported high levels of perceived discrimination.","clinical_takeaway":"Teaching gender‑identity and sexual‑orientation topics improves medical students’ knowledge and comfort, but ongoing efforts are needed to reduce perceived discrimination.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large total sample for a single‑institution study","Pre‑ and post‑intervention comparison over 5 years","Includes multiple demographic covariates (age, religiosity, etc.)"],"limitations":["Reliance on possibly non‑validated questionnaires","Single‑site convenience sample limits generalisability","Cross‑sectional design cannot infer causal effect of the seminar"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2024.2435281"}},{"id":8564,"doi":"10.20944/preprints202110.0391.v2","pmid":null,"pmcid":null,"title":"The Sexual Rights of People with Physical and Psychical Disabilities: Attitudes of Italians and Socio-Demographic Factors Involved in Recognition and Denial","authors":"Di Santo SG, Colombo M, Silvaggi M, Gammino GR, Fava V, Malandrino C, Nanini C, Rossetto C, Simone S, Eleuteri S.","first_author":"Di Santo SG","journal":"Preprints.org","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.preprints.org/manuscript/202110.0391/v2/download","cited_by_count":0,"is_preprint":true,"topics":["shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online anonymous questionnaire, convenience sample of 973 Italian adults","sample_n":973,"sample_text":"973 participants, aged 18–84 years (71.1% females)","population":"Italian adults, 71.1% female, age 18–84","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 973 Italians found that most support sexual and parenting rights for people with physical disabilities, but are less supportive for those with mental disabilities. Older age, male gender, lower education, and higher religiosity were linked to lower support.","clinical_takeaway":"None – the study assesses public attitudes, not clinical sexual health interventions.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for an online survey","Clear focus on soci‑demographic predictors","Inclusion of religiosity as a predictor"],"limitations":["Convenience, non‑representative sample","Attitude items not validated","Cross‑sectional, no causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202110.0391.v2"}},{"id":8565,"doi":"10.3389/fpsyg.2024.1391197","pmid":"39554713","pmcid":"PMC11563944","title":"Parental opposition to comprehensive sexuality education in Australia: associations with religiosity and school sector","authors":"Hendriks J, Francis N, Saltis H, Marson K, Walsh J, Lawton N, Burns S.","first_author":"Hendriks J","journal":"Frontiers in psychology","year":2024,"pub_types":["brief-report","Journal Article"],"keywords":["Australia","Religion","Religiosity","Comprehensive Sexuality Education","Parent Attitudes","School Sector"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11563944","cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Nationally representative survey of Australian parents (N=2,418) examining opposition to 40 CSE topics by religiosity and school sector.","sample_n":2418,"sample_text":"Nationally representative sample of parents (N = 2,418).","population":"Australian parents of school‑age children","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A national survey of 2,418 Australian parents found that while more religious parents tended to oppose some comprehensive sexuality‑education topics, the overall level of opposition was low, even among very religious families.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Clear focus on religiosity and school sector","Straightforward descriptive analysis"],"limitations":["Reliance on single‑item, possibly unvalidated measures","Cross‑sectional design limits causal inference","No control for potential confounds (e.g., political views)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2024.1391197"}},{"id":8567,"doi":"10.1093/sw/swae030","pmid":"39018460","pmcid":null,"title":"Professional and Personal Attitudes toward Discussing Sexuality and Degree of Religiosity among Social Workers","authors":"Ali-Saleh Darawshy N, Timor-Shlevin S, Lavie-Ajayi M.","first_author":"Ali-Saleh Darawshy N","journal":"Social work","year":2024,"pub_types":["Journal Article"],"keywords":["Sexual Health","Religiosity","Heteronormativity","Everyday Sexuality","Services Users"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 150 social workers in Israel; self‑administered questionnaire; random sample but not nationally representative.","sample_n":150,"sample_text":"150 social workers","population":"Social workers (adult, mixed gender, Jewish and Palestinian‑Arab) in Israel","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among 150 Israeli social workers, higher religiosity was linked to stronger heteronormative beliefs, which in turn were associated with less willingness to discuss sexual health with clients.","clinical_takeaway":"Training should address how personal religiosity and heteronormative views may affect professionals’ comfort discussing sexuality with service users.","confidence":0.6,"topic_tags":["sexual_function","religiosity"],"strengths":["Relatively large sample for a professional‑attitude survey","Random sampling within the social‑worker population","Clear focus on religiosity and heteronormative beliefs"],"limitations":["Reliance on self‑report scales of unknown validation","Cross‑sectional design prevents causal inference","No control for key sexual‑health confounds (e.g., personal sexual behavior, mental health)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sw/swae030"}},{"id":8568,"doi":"10.2105/ajph.2011.300154","pmid":"21778509","pmcid":null,"title":"Sexual satisfaction and sexual health among university students in the United States","authors":"Higgins JA, Mullinax M, Trussell J, Davidson JK, Moore NB.","first_author":"Higgins JA","journal":"American journal of public health","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":82,"is_preprint":false,"topics":["sexual_health","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 2168 US university students; convenience sample; self‑report questionnaire; multivariate regression analysis.","sample_n":2168,"sample_text":"University students (N=2168) surveyed in 2011.","population":"University students in the United States (N≈2168)","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2011 survey of over 2,000 US university students found that most were satisfied with their sex lives. Higher satisfaction was linked to lower sexual guilt, greater comfort with one's sexuality, higher self‑esteem (especially in men), being in a relationship, and having sex more often.","clinical_takeaway":"Improving sexual self‑comfort and reducing guilt may boost sexual satisfaction among young adults.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a survey","Multivariate analysis with several relevant predictors","Addresses understudied outcome of sexual satisfaction"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report scales of unknown validation","Key confounds (masturbation, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":10,"contrasting":1,"mentioning":122,"citing_publications":187,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2105/ajph.2011.300154"}},{"id":8575,"doi":"10.1080/00224499.2011.618956","pmid":"22004159","pmcid":null,"title":"Differences in sexual guilt and desire in east Asian and Euro-Canadian men","authors":"Brotto LA, Woo JS, Gorzalka BB.","first_author":"Brotto LA","journal":"Journal of sex research","year":2012,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional comparative survey of university students (Euro‑Canadian n=38, East Asian n=45)","sample_n":83,"sample_text":"Male Euro‑Canadian (n = 38) and East Asian (n = 45) university students completed online questionnaires.","population":"male university students, predominantly young adults, convenience sample","country":"Canada (British Columbia) / East Asian (unspecified)","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"East Asian men reported lower sexual desire and higher sexual guilt than Euro‑Canadian men; guilt helped explain the cultural difference in desire.","clinical_takeaway":"Sexual guilt may lower desire in some men; clinicians should assess guilt when addressing low desire.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Addresses understudied male population","Use of mediation analysis to explore mechanisms","Clear cultural comparison"],"limitations":["Small, non‑representative convenience sample","No measurement of key confounds (moral incongruence, mental health, etc.)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":9,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2011.618956"}},{"id":8579,"doi":"10.1080/19317611.2024.2341627","pmid":"39148916","pmcid":"PMC11323859","title":"Secondary School Students' Views on Sexuality and Sexual Health Education","authors":"Ng HN, Boey KW, Kwan CW, To HKA.","first_author":"Ng HN","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Spirituality","Religiosity","Sexual Attitudes","Sexual Health Education","Secondary School Students"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire of 818 secondary school students in Hong Kong","sample_n":818,"sample_text":"Convenience sample of secondary schools (not specified)","population":"secondary school students (mean age 15.3)","country":"Hong Kong, China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 818 Hong Kong secondary students found they are generally permissive about sex and support sexual health education, but males, those with liberal attitudes, and those with low religiosity are less supportive.","clinical_takeaway":"Educators should consider gender, attitudes, and religiosity when designing sexual health curricula for adolescents.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size (N=818)","Relevant to educators and policy","Measures multiple sociodemographic factors"],"limitations":["Cross‑sectional, cannot infer causality","Likely convenience sampling, limited generalisability","Limited construct validation of questionnaire items"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2024.2341627"}},{"id":8580,"doi":"10.21203/rs.3.rs-83272/v1","pmid":null,"pmcid":null,"title":"Caring for Sexual and Gender Minority Patients: What Factors Explain Self-Reported Competence among Health Care Professional Students?","authors":"Pratt-Chapman ML, Potter J.","first_author":"Pratt-Chapman ML","journal":"Research Square","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-83272/v1.pdf?c=1602095933000","cited_by_count":0,"is_preprint":true,"topics":["shame_religiosity"],"language":null,"appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of health‑care professional students; multiple linear regression; sample size not reported in abstract","sample_n":null,"sample_text":"Not specified in abstract","population":"health‑care professional students (likely convenience sample)","country":"United States (implied)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among health‑care professional students, political views, religiosity, personal connections to sexual‑minority people, and hours of LGBTQ‑focused training predict how competent they feel caring for LGBTQ patients.","clinical_takeaway":"Training hours and exposure to LGBTQ individuals improve student confidence in providing competent care.","confidence":0.3,"topic_tags":["sexual_function","gender"],"strengths":["Uses previously developed, likely validated scales","Considers multiple sociodemographic predictors","Multivariate regression allows assessment of independent contributions"],"limitations":["Sample size and recruitment method not reported","Cross‑sectional design limits causal inference","No pre‑registration or correction for multiple testing described"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":7,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-83272/v1"}},{"id":8582,"doi":"10.1007/s10508-016-0898-9","pmid":"28083724","pmcid":"PMC5547186","title":"Negotiating Discourses of Shame, Secrecy, and Silence: Migrant and Refugee Women's Experiences of Sexual Embodiment","authors":"Ussher JM, Perz J, Metusela C, Hawkey AJ, Morrow M, Narchal R, Estoesta J.","first_author":"Ussher JM","journal":"Archives of sexual behavior","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Intersectionality","Migrant And Refugee Sexual Health","Sexual Shame","Women’s Sexual Embodiment"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5547186","cited_by_count":68,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative study using interviews and focus groups","sample_n":169,"sample_text":"169 participants (individual interviews and focus groups)","population":"169 recently resettled migrant and refugee women from multiple countries, recruited in Sydney and Vancouver","country":"Australia; Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 169 migrant and refugee women in Australia and Canada revealed that cultural and religious ideas of shame shape their sexual lives, influencing topics like menstruation, virginity, desire, and contraception, while some women actively negotiate these norms.","clinical_takeaway":"Clinicians should recognize cultural shame narratives and support agency when providing sexual health care to migrant and refugee women.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["Large, diverse sample of migrant/refugee women","Intersectional qualitative framework","Rich, detailed narratives about shame and agency"],"limitations":["No quantitative measurement of constructs","No assessment of key confounds (e.g., mental health, trauma)","Findings not generalizable beyond the specific cultural groups"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":12,"contrasting":0,"mentioning":122,"citing_publications":193,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0898-9"}},{"id":8583,"doi":"10.31234/osf.io/s8kz7","pmid":null,"pmcid":null,"title":"Beyond Misogyny: Sexual Morality and Sanctity of Life predict Abortion Attitudes","authors":"Rodriguez CG, Ditto PH.","first_author":"Rodriguez CG","journal":"PsyArXiv","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/s8kz7","cited_by_count":1,"is_preprint":true,"topics":["shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of five convenience samples (total N = 5,717) examining predictors of abortion attitudes using structural equation modeling","sample_n":5717,"sample_text":"five samples (total N = 5,717)","population":"adults from unspecified samples recruited for an online survey","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed over 5,700 people and found that beliefs about the sanctity of life and sexual morality predict attitudes toward abortion more strongly than sexism or religiosity.","clinical_takeaway":"None – findings pertain to attitudes, not clinical practice.","confidence":0.7,"topic_tags":["sexual_function","moral_incongruence","religiosity"],"strengths":["Large combined sample size","Use of structural equation modeling to test multiple predictors","Inclusion of both pro‑choice and pro‑life variables"],"limitations":["Convenience sampling limits generalizability","Unclear whether scales are validated","No pre‑registration or correction for multiple testing reported"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/s8kz7"}},{"id":8584,"doi":"10.1080/19317611.2024.2308822","pmid":"38600898","pmcid":"PMC10903667","title":"The Role of Religiosity and Personal Faith in Young People's Sexual Debut and Sexual Risk Taking: A Bayesian Approach","authors":"Tafro A, Koletić G, Milas G, Štulhofer A.","first_author":"Tafro A","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Bayesian analysis","Young People","Religiosity","Sexual Debut","Sexual Risk Taking"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"population-based surveys (cross‑sectional) combined with meta‑analytic estimates","sample_n":null,"sample_text":"Two population‑based surveys; exact N not given in abstract","population":"emerging Croatian adults (young people)","country":"Croatia (and international meta‑analysis)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Croatian young adults, higher religiosity and personal faith are modestly linked to later first sexual intercourse, but they show little effect on reducing risky sexual behaviours.","clinical_takeaway":"Religiosity may delay sexual debut but does not robustly protect against sexual risk; clinicians should consider broader factors.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large population‑based samples","Bayesian analytical framework","Inclusion of international meta‑analytic data"],"limitations":["Cross‑sectional; cannot infer causality","Key potential confounds (e.g., mental health, partner context) not assessed","Abstract lacks detail on measurement validation"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2024.2308822"}},{"id":8585,"doi":"10.1177/0003065112470562","pmid":"23269855","pmcid":null,"title":"Shifting sexual cultures, the potential space of online relations, and the promise of psychoanalytic listening","authors":"Corbett K.","first_author":"Corbett K.","journal":"Journal of the American Psychoanalytic Association","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-report","sample_n":null,"sample_text":"Two treatment cases are described; no systematic sampling","population":"clinical psychoanalytic patients (n not reported)","country":"USA (assumed from journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses two psychoanalytic therapy cases where online hooking‑up and sexual shame were explored, arguing that digital relationships reshape modern sexual culture and affect clinical practice.","clinical_takeaway":"None – the paper offers theoretical reflections, not evidence for clinical interventions.","confidence":0.8,"topic_tags":["sexual_function","relationships","csbd"],"strengths":["Provides rich clinical illustrations","Integrates psychoanalytic theory with contemporary online relational contexts"],"limitations":["No systematic data or measurement","Lacks empirical controls or quantitative analysis","Findings not generalizable"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0003065112470562"}},{"id":8586,"doi":"10.31234/osf.io/rc2d3","pmid":null,"pmcid":null,"title":"Lay beliefs about gender and sexual behavior: First evidence for a pervasive, robust (but seemingly unfounded) stereotype","authors":"Krems J, Ko A, Moon JW, Varnum MEW.","first_author":"Krems J","journal":"PsyArXiv","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/rc2d3","cited_by_count":0,"is_preprint":true,"topics":["shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"six experiments with US participants (N=1,469); likely vignette‑based manipulation of stereotypes; cross‑sectional with random assignment to conditions","sample_n":1469,"sample_text":"Across six experiments with US participants (N = 1,469)","population":"US adults recruited online (convenience sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors found that both men and women routinely assume that women who have casual sex have low self‑esteem, even though participants’ own self‑esteem is unrelated to their sexual behavior. The stereotype persists despite explicit information that the women chose casual sex and is not driven by religiosity or sexism.","clinical_takeaway":"None – the study addresses social stereotypes, not clinical sexual health.","confidence":0.78,"topic_tags":["gender","sexual_function"],"strengths":["large total sample across multiple experiments","explicit test of stereotype mediation","controls for individual differences (religiosity, conservatism, sexism)","clear finding that stereotype is unfounded"],"limitations":["convenience online sample limits generalisability","self‑esteem measurement not described in abstract","no pre‑registration disclosed","cross‑sectional; causal claims limited"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/rc2d3"}},{"id":8590,"doi":"10.3390/ijerph20227075","pmid":"37998306","pmcid":"PMC10671411","title":"An Analysis of the Impact of Religious Affiliation and Strength of Religiosity on Sexual Health Practices of Sexually Active Female College Students","authors":"Glazer E, Valdez E, DeBlauw JA, Ives SJ.","first_author":"Glazer E","journal":"International journal of environmental research and public health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Contraceptives","Religion","Reproductive Health","Women’s Health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10671411","cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 224 sexually active female college students","sample_n":224,"sample_text":"Two hundred and twenty‑four college‑aged females completed a 20‑question survey","population":"US college‑age women (female, sexually active)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among sexually active female college students, stronger personal religiosity was linked to later initiation of contraceptive use and to students reporting that religion influences their sexual health choices.","clinical_takeaway":"Clinicians should consider patients' religious beliefs when discussing timing and choice of contraception.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Large convenience sample for college context","Clear hypothesis and statistical test","Reports specific significant associations"],"limitations":["Reliance on unvalidated self‑report questionnaire","No adjustment for multiple comparisons","Potential self‑selection bias","Key confounders (e.g., moral incongruence, mental health) not measured"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph20227075"}},{"id":8591,"doi":"10.1177/14747049231200641","pmid":"37807817","pmcid":"PMC10563489","title":"Ideological Mate-guarding: Sexual Jealousy and Mating Strategy Predict Support for Female Honor","authors":"Kupfer TR, Gul P.","first_author":"Kupfer TR","journal":"Evolutionary psychology : an international journal of evolutionary approaches to psychology and behavior","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Mating strategy","Ideology","Mate Guarding","Sociosexual Orientation","Sexual Jealousy","Feminine Honor Norms"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10563489","cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Two correlational survey studies (N≈892 total) examining dispositional jealousy, mating strategy, and support for feminine honor.","sample_n":892,"sample_text":"Two correlational studies with a total sample of 892 participants.","population":"Adult participants (male and female), likely convenience sample","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"Two survey studies found that people who feel more jealous and prefer monogamy are more likely to support traditional ideas that women should remain sexually pure, suggesting these attitudes may serve as an ideological way to protect a mate.","clinical_takeaway":"None – the study addresses cultural attitudes rather than clinical sexual health issues.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large overall sample size for survey research","Considers both male and female participants","Controls for religiosity, political conservatism, and age in analyses"],"limitations":["Cross‑sectional design limits causal inference","Convenience sampling reduces generalizability","Potential lack of validated scales for 'support for feminine honor'"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/14747049231200641"}},{"id":8596,"doi":"10.1080/19317611.2023.2251974","pmid":"38601806","pmcid":"PMC10903559","title":"Predictors of Belief in Sexual Myths: An Examination in Terms of Gender, Demographic Characteristics, Religiosity, and Childhood Trauma","authors":"Alkış Küçükaydın M, Sayıcı E.","first_author":"Alkış Küçükaydın M","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Religiosity","Childhood Trauma","Sexual Myths"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 375 teacher‑candidate volunteers; linear regression used to examine predictors of a Sexual Myths Scale.","sample_n":375,"sample_text":"375 teacher candidates","population":"teacher candidates (likely university students)","country":"Turkey (inferred from author names and journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 375 future teachers found that men and people with higher religiosity were more likely to endorse unfounded sexual myths, especially when they had experienced childhood trauma or did not discuss sexuality with their families.","clinical_takeaway":"Awareness of religious and trauma backgrounds may help clinicians address myth‑based misconceptions that could affect sexual health.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonably large sample for a survey","Uses validated CTQ for trauma","Multiple regression allows assessment of independent predictors"],"limitations":["Sexual Myths Scale not stated as validated","Convenience, student‑biased sample limits generalisability","No control for mental‑health or other psychosocial confounds"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2023.2251974"}},{"id":8597,"doi":"10.1007/s10508-023-02678-4","pmid":"37644358","pmcid":null,"title":"The Moderating Role of Sexual Orientation in the Association Between Religiosity and Sexual Behaviors Among College Students","authors":"Fahey KML, Holm AK, Dermody SS.","first_author":"Fahey KML","journal":"Archives of sexual behavior","year":2024,"pub_types":["Journal Article"],"keywords":["Religion","Sexual Health","Sexually Transmitted Infection","university students","Lgbtq+ "],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of Oregon college students (N=1553)","sample_n":1553,"sample_text":"college/university students across Oregon (N=1553) completed an online cross-sectional survey","population":"college/university students in Oregon, USA","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,553 Oregon college students, higher religiosity was linked to lower birth‑control use among heterosexual and gay/lesbian students, but not among bi/pan‑sexual students. Religiosity did not predict substance‑influenced sex or STI positivity.","clinical_takeaway":"Clinicians should consider students' religious backgrounds when discussing birth‑control use, especially for heterosexual and gay/lesbian clients.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Large overall sample size","Use of validated religiosity scale","Clear moderation analysis"],"limitations":["Cross‑sectional design prevents causal inference","Sexual behavior measured by single yes/no items","No control for key confounds (moral incongruence, mental health, partner effects)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":4,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02678-4"}},{"id":8607,"doi":"10.1177/13591053231164542","pmid":"37073440","pmcid":null,"title":"A meta-analytic exploration of associations between religious service attendance and sexual risk taking in adolescence and emerging adulthood","authors":"Koletić G, Jurković L, Tafro A, Milas G, Landripet I, Štulhofer A.","first_author":"Koletić G","journal":"Journal of health psychology","year":2023,"pub_types":["Meta-Analysis","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Meta-analysis","Adolescents","Religiosity","Emerging Adults","Sexual Risk Taking","Religious Service Attendance"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 27 observational studies (N≈37,430) examining frequency of religious service attendance and sexual risk outcomes (age at debut, number of partners, condom use). Random‑effects model reported correlation coefficients with 95% CIs.","sample_n":37430,"sample_text":"Total participants across included studies = 37,430 (mean age = 18.4 y, 43.5 % male).","population":"Adolescents and emerging adults (12‑25 y), mixed gender, recruited from community‑based samples across 27 primary studies.","country":"International (studies from multiple countries; authors based in Croatia).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 27 studies (over 37,000 young people) found that more frequent attendance at religious services is linked to slightly later sexual debut and fewer sexual partners, but shows only weak links to condom use. Formal religiosity alone does not strongly protect against sexual risk.","clinical_takeaway":"Religious attendance modestly correlates with later debut and fewer partners, but clinicians should consider broader factors when addressing sexual risk.","confidence":0.85,"topic_tags":["religiosity","sexual_function"],"strengths":["Large combined sample size","Systematic search and quantitative synthesis","Effect sizes reported with confidence intervals"],"limitations":["No reported risk‑of‑bias assessment","Potential heterogeneity across primary studies not described","Confounding variables (e.g., socioeconomic status, peer influence) not addressed"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":7,"contrasting":0,"mentioning":6,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/13591053231164542"}},{"id":8608,"doi":"10.1111/jora.12849","pmid":"36999207","pmcid":null,"title":"Religiosity, sexual behaviors, sexual motivations, and gender: A three-year longitudinal study","authors":"Hanna-Walker V, Walters TL, Wesche R, Leavitt CE, Lefkowitz ES.","first_author":"Hanna-Walker V","journal":"Journal of research on adolescence : the official journal of the Society for Research on Adolescence","year":2023,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexuality","Religiosity","Hierarchical Linear Modeling"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal cohort of 735 college students over five semesters; hierarchical linear modeling used to assess within‑ and between‑person effects of religiosity on sexual behaviors and motivations, with gender as moderator.","sample_n":735,"sample_text":"Diverse college student sample followed across five semesters","population":"College students (diverse sample), N=735","country":"USA (presumed based on NIH funding and journal focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a five‑semester study of 735 college students, higher overall religiosity was linked to less sexual activity and more restrictive sexual motivations, especially for women, while short‑term changes in religiosity did not predict behavior.","clinical_takeaway":"Clinicians should note that students’ broader religious commitment relates to sexual decision‑making, but day‑to‑day fluctuations in belief have little impact.","confidence":0.8,"topic_tags":["religiosity","sexual_function"],"strengths":["Large longitudinal sample with repeated measures","Use of multilevel modelling to separate within‑ and between‑person effects","Gender examined as moderator"],"limitations":["Reliance on self‑report for sexual behaviors and motivations","No measurement of key confounds such as moral incongruence or mental health","Unclear whether religiosity scales were validated"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jora.12849"}},{"id":8609,"doi":"10.1371/journal.pone.0282828","pmid":"36897882","pmcid":"PMC10004614","title":"\"Our parents kiss in front of us\": Reasons for early sexual debut among in-school youth in the Manzini Region in Eswatini","authors":"Nxumalo NC, Shongwe MC, Gwebu N, Ngcamphalala C, Nsibandze BS, Nkambule R, Nuwagaba-Biribonwoha H.","first_author":"Nxumalo NC","journal":"PloS one","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0282828&type=printable","cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"exploratory-descriptive qualitative study with 81 in‑school youth in Eswatini, using seven focus‑group discussions; purposive sampling of public high schools; thematic analysis with Dedoose.","sample_n":81,"sample_text":"81 sexually active in‑school youth","population":"In‑school adolescents (sexually active) in Manzini region, Eswatini; 81 participants, mixed gender, urban and rural schools.","country":"Eswatini","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study used focus groups with 81 Eswatini high‑school students to explore why some start having sex before age 15. Themes included personal maturity, family dynamics, peer pressure, environment, media, and cultural factors, highlighting the need for culturally sensitive prevention efforts.","clinical_takeaway":"Interventions to delay sexual debut should involve families and address peer, media, and cultural influences.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large qualitative sample for context‑rich insights","Thematic analysis conducted with software (Dedoose)","Includes perspectives of both boys and girls"],"limitations":["Purposive, non‑representative sampling limits generalisability","No quantitative measures or validated scales","Confounding factors (e.g., mental health, religiosity) not assessed"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0282828"}},{"id":8610,"doi":"10.3390/bs13030226","pmid":"36975251","pmcid":"PMC10045485","title":"Psychosocial and Cultural Processes Underlying the Epidemiological Paradox within U.S. Latino Sexual Risk: A Systematic Review","authors":"Cabral P, Chinn M, Mack J, Costarelli M, Ross E, Henes E, Steck L, Williams AJK, Lee YB, Fretes S, Fernandez G, Garcia L, Sato L, Patrocinio Y, Shah D.","first_author":"Cabral P","journal":"Behavioral sciences (Basel, Switzerland)","year":2023,"pub_types":["review-article","Review","Journal Article"],"keywords":["Acculturation","Parental Influence","Peer Norms","Religiosity","Sexual Risk","Gender Norms","Familismo","Latina/o Youth"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10045485","cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 35 studies (mostly cross‑sectional school samples) examining psychosocial/cultural mechanisms linking acculturation to sexual risk in U.S. Latino youth.","sample_n":null,"sample_text":"35 publications (48 analyses) included; individual studies varied in size.","population":"U.S. Latina/o youth (varied ages, school‑based samples)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A systematic review of 35 studies finds that cultural factors like family cohesion, parenting, religiosity, and traditional gender norms help explain why less acculturated Latino youth tend to have lower sexual risk behaviors.","clinical_takeaway":"Interventions that strengthen family ties and culturally relevant values may reduce sexual risk among Latino adolescents.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive systematic search over 22‑year period","Identifies multiple cultural mechanisms","Highlights protective roles of familismo and parenting"],"limitations":["Relies on predominantly cross‑sectional primary studies","Variable measurement quality across included papers","No quantitative meta‑analysis or risk‑of‑bias assessment reported"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs13030226"}},{"id":8611,"doi":"10.1007/s10943-023-01774-y","pmid":"36853409","pmcid":null,"title":"Emerging Adult Risky Sexual Behavior: The Influence of Perceived Parental Religiosity and Perceived Parent-Child Relationship Quality in the USA","authors":"Holt E, McKinney C.","first_author":"Holt E","journal":"Journal of religion and health","year":2024,"pub_types":["Journal Article"],"keywords":["Gender","Parenting","Risky Sexual Behavior","Religiosity"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross‑sectional survey of 585 U.S. college students; path analysis of self‑report scales","sample_n":585,"sample_text":"college students (N=585, 65.5% women, 69.2% White, 25.0% Black)","population":"emerging adult college students in the southern United States (mostly White, 25% Black)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 585 U.S. college students found that better perceived parent‑child relationships were linked to less risky sexual behavior, while perceiving mothers as more religiously conservative was linked to more risk in women.","clinical_takeaway":"Parent‑child relationship quality may be a protective factor for risky sexual behavior in emerging adults.","confidence":0.8,"topic_tags":["relationships","religiosity","sexual_function"],"strengths":["Large sample for a survey study","Use of several established self‑report scales","Path analysis provides insight into indirect effects"],"limitations":["Cross‑sectional design limits causal inference","No measurement of key sexual‑health confounds (e.g., mental health, trauma)","Self‑report may be biased by social desirability"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-023-01774-y"}},{"id":8614,"doi":"10.1177/14747049231165687","pmid":"36972495","pmcid":"PMC10303487","title":"Examining the Sexual Double Standards and Hypocrisy in Partner Suitability Appraisals Within a Norwegian Sample","authors":"Kennair LEO, Thomas AG, Buss DM, Bendixen M.","first_author":"Kennair LEO","journal":"Evolutionary psychology : an international journal of evolutionary approaches to psychology and behavior","year":2023,"pub_types":["research-article","Randomized Controlled Trial","Journal Article"],"keywords":["Sex differences","Hypocrisy","Long-term Relationships","Sexual Double Standards","Sexual Strategies Theory","Short-term Sex"],"is_oa":true,"oa_url":"https://doi.org/10.1177/14747049231165687","cited_by_count":3,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Randomized assignment to mating context; large community sample (N=923); cross‑sectional questionnaire experiment.","sample_n":923,"sample_text":"923 participants recruited from the general Norwegian adult population (likely convenience).","population":"Adults (Norwegian sample, 64 % women)","country":"Norway","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Norwegian sample of 923 adults, people judged a potential partner’s sexual history more harshly for themselves than for same‑sex friends, showing ‘sexual hypocrisy’. No strong double‑standard was found for promiscuity, but attitudes toward self‑stimulation differed slightly by gender.","clinical_takeaway":"Attitudes toward sexual history are shaped more by personal standards than by consistent gender norms; clinicians should consider personal moral frameworks when discussing sexual behavior.","confidence":0.8,"topic_tags":["sexual_function","gender","moral_incongruence","masturbation"],"strengths":["Large sample size","Experimental manipulation of context","Consideration of religiosity and other covariates","Clear operationalisation of partner‑assessment outcomes"],"limitations":["Novel attitude scale not validated","Cross‑sectional self‑report, no behavioural measures","Mental‑health and trauma not accounted for","Potential convenience‑sample bias"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":6,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/14747049231165687"}},{"id":8616,"doi":"10.1002/ijgo.14601","pmid":"36528832","pmcid":null,"title":"Assessing the knowledge, attitudes, and practices of graduating medical students towards sexual health in Lebanon","authors":"Saab R, Habib PA, Hamdan M, El Hayek R, Daher D, El Hage Hassan M, Doumat G, El Kak F.","first_author":"Saab R","journal":"International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics","year":2023,"pub_types":["Journal Article"],"keywords":["Medical education","Lebanon","Sexual Health","Sexual And Reproductive Health","Sexual Health Education","Medical Curricula","Mena Region"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 578 graduating medical students in Lebanon using a self‑designed questionnaire.","sample_n":578,"sample_text":"Graduating medical students (all Lebanese medical schools invited).","population":"Graduating medical students in Lebanon (N = 578).","country":"Lebanon","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 578 Lebanese medical graduates found low knowledge about sexual health, with scores differing by religion and income. The authors call for improved curricula to better prepare doctors for sexual‑health care.","clinical_takeaway":"Medical schools should strengthen sexual‑health training to close knowledge gaps among future physicians.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Relatively large sample of medical graduates","Addresses an understudied area in the region"],"limitations":["Uses non‑validated, self‑designed questionnaire","Cross‑sectional design limits causal inference","No effect sizes or power analysis reported"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ijgo.14601"}},{"id":8619,"doi":"10.1007/bf01542211","pmid":"6667108","pmcid":null,"title":"Effects of sex education on sexual guilt, anxiety, and attitudes: a comparison of instruction formats","authors":"Wanlass RL, Kilmann PR, Bella BS, Tarnowski KJ.","first_author":"Wanlass RL","journal":"Archives of sexual behavior","year":1983,"pub_types":["Journal Article"],"keywords":["Behavior","Data analysis","Students","Data collection","research methodology","Psychological factors","Education","Sex Education","Attitude--changes","Educational Activities","Sex Behavior--changes"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"randomized assignment of 193 undergraduates to five instruction formats with pre‑post testing","sample_n":193,"sample_text":"undergraduates, likely convenience sample","population":"undergraduate students (N=193)","country":"USA (presumed based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A study of 193 college students found that lecture‑based sex education reduced sexual guilt more than no education, and some formats also led to more tolerant sexual attitudes. Small‑group discussions added no extra benefit over lectures.","clinical_takeaway":"Lecture‑only sex education can lower sexual guilt; adding discussion may not increase benefits.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Randomized experimental design","Multiple instruction formats compared","Pre‑post measurement"],"limitations":["Convenience undergraduate sample limits generalisability","Unclear whether scales are validated","No effect‑size reporting or power analysis"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542211"}},{"id":8623,"doi":"10.1016/j.amepre.2022.08.020","pmid":"36266114","pmcid":null,"title":"A National Study on Religiosity and Suicide Risk by Sexual Orientation","authors":"Park K, Hsieh N.","first_author":"Park K","journal":"American journal of preventive medicine","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Large nationally representative survey (NSDUH) analyzed with logistic regression; cross‑sectional, no temporal precedence.","sample_n":163995,"sample_text":"National Survey on Drug Use and Health (2016‑2019).","population":"U.S. adults (N = 163,995) sampled 2016‑2019; includes heterosexual, gay/lesbian, bisexual men and women.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Using a national US survey of over 160,000 adults, the study found that while higher religiosity usually lowers suicide risk for heterosexual people, it may increase risk for gay, lesbian, and bisexual individuals, especially gay men and bisexual women.","clinical_takeaway":"Clinicians should consider how religious environments may affect suicide risk differently for sexual‑minority patients.","confidence":0.7,"topic_tags":["religiosity","sexual_function","pornography","moral_incongruence"],"strengths":["Very large, nationally representative sample","Stratified analyses by gender and sexual orientation","Clear operationalization of religiosity dimensions"],"limitations":["Cross‑sectional; cannot infer causality","No adjustment for mental‑health covariates reported","Potential unmeasured confounders (e.g., stigma, discrimination)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.amepre.2022.08.020"}},{"id":8625,"doi":"10.1016/j.chiabu.2022.105901","pmid":"36162381","pmcid":null,"title":"The religious implications of being sexually abused by a rabbi: Qualitative research among Israeli religious men","authors":"Krinkin Y, Enosh G, Dekel R.","first_author":"Krinkin Y","journal":"Child abuse & neglect","year":2022,"pub_types":["Journal Article"],"keywords":["Sexual Abuse","Authority","Jewish Rabbis","Israeli Religious Men"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"In‑depth semi‑structured interviews with eight Israeli religious men who experienced clergy‑perpetrated sexual abuse; constructivist‑phenomenological analysis.","sample_n":8,"sample_text":"Eight formerly or currently religious men","population":"Israeli religious men (n=8) who were abused by rabbis in adolescence/emerging adulthood","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Eight Israeli religious men who were abused by rabbis described how the abuse affected their faith, attitudes toward clergy, and search for new religious guidance. The study offers early qualitative insight into the complex religious fallout of clergy‑perpetrated sexual abuse.","clinical_takeaway":"None – the study is qualitative and not directly actionable for clinical practice.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Provides rare qualitative insight into a specific victim group","Clear phenomenological methodology","Highlights religious dimensions often overlooked"],"limitations":["Very small, self‑selected convenience sample","No systematic measurement of variables","Findings not generalisable"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2022.105901"}},{"id":8627,"doi":"10.1080/00224499.2022.2108745","pmid":"36017991","pmcid":null,"title":"Religiosity, Sex Frequency, and Sexual Satisfaction in Britain: Evidence from the Third National Survey of Sexual Attitudes and Lifestyles (Natsal)","authors":"Peri-Rotem N, Skirbekk V.","first_author":"Peri-Rotem N","journal":"Journal of sex research","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Religion","Religiosity","Sexual Satisfaction","Sexual Attitudes","Sex Frequency"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large nationally representative survey (Natsal-3), cross‑sectional analysis of religiosity, sex frequency and satisfaction","sample_n":null,"sample_text":"Large population‑based survey (Natsal‑3) with thousands of participants","population":"British adults (men and women) sampled in Natsal‑3","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In Britain, people who consider religion very important tend to have sex less often—especially if they don’t live with a partner—yet they report higher overall sexual satisfaction, partly because of more conservative attitudes about when sex is appropriate.","clinical_takeaway":"Religiosity may shape sexual activity and satisfaction; clinicians should consider cultural and religious contexts when discussing sexual health.","confidence":0.9,"topic_tags":["religiosity","sexual_function","relationships"],"strengths":["large, nationally representative sample","gender- and relationship‑status stratified analyses","use of established national survey (Natsal‑3)"],"limitations":["cross‑sectional, cannot infer causality","limited control for potential confounds (e.g., mental health, partner factors)","relies on self‑report measures"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2022.2108745"}},{"id":8628,"doi":"10.1016/j.abrep.2022.100450","pmid":"36034970","pmcid":"PMC9399474","title":"Examining the differential protective effects of women's spirituality and religiosity on alcohol and marijuana use by sexual identity","authors":"Drabble LA, Mericle AA, Munroe C, Cerezo A, Karriker-Jaffe KJ, Hughes TL, Trocki KF.","first_author":"Drabble LA","journal":"Addictive behaviors reports","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Alcohol","Spirituality","Religiosity","Marijuana","Alcohol Use Disorder","Sexual Minority Women"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9399474","cited_by_count":2,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of adult women (SMW and heterosexual) assessing spirituality, religiosity, and past‑year alcohol/marijuana use","sample_n":1396,"sample_text":"n = 437 lesbian, n = 323 bisexual, n = 636 heterosexual women","population":"adult women, sexual minority (lesbian, bisexual) and heterosexual, recruited likely via community samples","country":"USA (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among women, both spirituality and religiosity were linked to higher odds of alcohol use disorder, especially for lesbian and bisexual women, suggesting these beliefs may not protect against substance use in sexual minorities.","clinical_takeaway":"Clinicians should note that religiosity/spirituality may not reduce, and could increase, substance‑use risk in sexual‑minority women.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, diverse sample of SMW and heterosexual women","Addresses understudied interaction of spirituality/religiosity with sexual identity"],"limitations":["Cross‑sectional design limits causal inference","Reliance on single‑item measures for key constructs","No assessment of key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.abrep.2022.100450"}},{"id":8629,"doi":"10.1080/0092623x.2022.2080132","pmid":"35642721","pmcid":null,"title":"Religiosity, Sexual Satisfaction, and Relationship Satisfaction: The Moderating Role of Sexual Mindfulness and Sexual Sanctification","authors":"Leonhardt ND, Clarke RW, Leavitt CE.","first_author":"Leonhardt ND","journal":"Journal of sex & marital therapy","year":2023,"pub_types":["Journal Article"],"keywords":["Couples","Religiosity","Sexual Satisfaction","Relationship Satisfaction","Sexual Mindfulness","Sexual Sanctification"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two large cross‑sectional samples (1,695 individuals; 481 couples) examined how sexual mindfulness and sexual sanctification moderate the link between religiosity and sexual/relationship satisfaction.","sample_n":1695,"sample_text":"1,695 individuals in Study 1; 481 dyads in Study 2.","population":"Adults from community samples (individuals and heterosexual couples).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether being mindful about sex and seeing sex as sacred change how religious belief relates to sexual and relationship happiness. Being sexually mindful was linked to higher satisfaction, but it did not change the religion‑satisfaction link. Seeing sex as sacred was tied to higher satisfaction and sometimes lessened the negative impact of religiosity on satisfaction.","clinical_takeaway":"Sexual mindfulness and sanctification appear beneficial for sexual and relationship wellbeing, regardless of religious belief.","confidence":0.7,"topic_tags":["religiosity","sexual_function","relationships"],"strengths":["Very large individual sample","Inclusion of couple dyads","Use of multiple validated sexual‑well‑being scales"],"limitations":["Cross‑sectional design limits causal inference","Key potential confounds (mental health, moral incongruence) not measured","No pre‑registration or correction for multiple moderation tests reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2022.2080132"}},{"id":8630,"doi":"10.1215/00703370-9931820","pmid":"35441673","pmcid":"PMC9177776","title":"Religiosity and Young Unmarried Women's Sexual and Contraceptive Behavior: New Evidence From a Longitudinal Panel of Young Adult Women","authors":"Brooks IHM, Weitzman A.","first_author":"Brooks IHM","journal":"Demography","year":2022,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Contraception","Premarital sex","emotion","Religiosity","Transition To Adulthood"],"is_oa":true,"oa_url":"https://read.dukeupress.edu/demography/article-pdf/59/3/895/1586366/895brooks.pdf","cited_by_count":6,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"weekly panel data over 2.5 years with mediation analyses","sample_n":null,"sample_text":"Not provided in abstract","population":"young unmarried Christian women (sample size not stated in abstract)","country":"USA (presumed from study name)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a 2‑year weekly survey of young unmarried Christian women, higher religiosity predicted less premarital sex and lower hormonal‑contraceptive use, but higher condom use when sex occurred. Attitudes, guilt expectations, and past behavior explained these links.","clinical_takeaway":"Clinicians should consider the role of religious values and anticipated guilt when counseling young women about sexual activity and contraception.","confidence":0.7,"topic_tags":["religiosity","sexual_function","adolescents"],"strengths":["Longitudinal weekly panel captures temporal ordering","Mediation analysis identifies pathways","Large‑scale demographic dataset"],"limitations":["No control for mental‑health or partner factors","Abstract does not report sample size or power calculations","Findings limited to Christian women; not generalizable"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1215/00703370-9931820"}},{"id":8632,"doi":"10.1080/00224490609552336","pmid":"17599258","pmcid":null,"title":"Guilty or not? A path model of women's sexual force fantasies","authors":"Shulman JL, Horne SG.","first_author":"Shulman JL","journal":"Journal of sex research","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online survey of adult women (N=261) using self‑report questionnaires; path analysis (SEM) applied to examine relationships among childhood sexual abuse, feminist beliefs, sexual guilt, erotophilia, sexual experience and forceful sexual fantasies.","sample_n":261,"sample_text":"Adult women (N = 261) participated by completing an online survey.","population":"Adult women (self‑selected online participants, likely WEIRD sample)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 261 women and used statistical modeling to examine how childhood sexual abuse, feminist beliefs, sexual guilt, and enjoyment of sex relate to having forceful sexual fantasies, finding that low guilt and high erotophilia predict such fantasies.","clinical_takeaway":"None – the findings are about fantasy patterns and do not inform clinical treatment.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonably large sample for a survey","Use of path analysis to model mediating relationships","Inclusion of childhood sexual abuse as a variable"],"limitations":["Cross‑sectional design limits causal inference","Few potential confounds measured (e.g., mental health, partner context)","Self‑selected online sample may limit generalisability"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":15,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490609552336"}},{"id":8633,"doi":"10.1177/15248380221097437","pmid":"35549772","pmcid":null,"title":"Risk Markers for Male Perpetration of Sexual Assault on College Campuses: A Meta-Analysis","authors":"Spencer CM, Rivas-Koehl M, Astle S, Toews ML, Anders KM, McAllister P.","first_author":"Spencer CM","journal":"Trauma, violence & abuse","year":2023,"pub_types":["Meta-Analysis","Journal Article"],"keywords":["Meta-analysis","risk","Sexual Assault","College","Sexual Violence","Perpetration"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 25 studies (89 effect sizes) identifying risk markers for male sexual assault perpetration on college campuses.","sample_n":null,"sample_text":"25 studies, 89 effect sizes; total participant count not given in abstract","population":"Male college students (perpetrators) across United States/Canada studies","country":"Various (studies from North America likely)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 25 studies found that college men who endorse hostile attitudes toward women, engage in binge drinking, and have a history of dating‑violence are more likely to perpetrate sexual assault. Factors like religiosity or athletic involvement were not linked to higher risk.","clinical_takeaway":"Prevention programs should focus on changing misogynistic attitudes, reducing binge drinking, and addressing dating‑violence behaviors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive synthesis of existing risk-marker literature","Identifies multiple domains (masculinity, substance use, dating violence) for intervention"],"limitations":["Heterogeneity of primary studies not described in abstract","No information on risk‑of‑bias assessment or publication bias","Potential lack of control for confounding variables in primary studies"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":30,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/15248380221097437"}},{"id":8635,"doi":"10.1007/s12119-022-09965-7","pmid":"37637181","pmcid":"PMC10448947","title":"The Impact of Religious Participation and Religious Upbringing on the Sexual Behavior of Emerging Adults in the Southern United States","authors":"Piper KN, Lambert DN, Fuller TJ.","first_author":"Piper KN","journal":"Sexuality & culture","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Religion","Birth Control","Condom Use","Abstinence","Emerging Adulthood"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 211 emerging adults (18‑25) in the Southern US, using self‑report questionnaires on religiosity and sexual behaviours; regression analyses reported.","sample_n":211,"sample_text":"n=211","population":"Emerging adults (18‑25) from the Southern United States; recruitment method not specified (likely convenience).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 211 Southern US emerging adults, higher current religiosity was linked to more abstinence but less use of birth‑control methods; a religious upbringing was also tied to lower contraceptive use.","clinical_takeaway":"Religious context may shape contraceptive choices; clinicians should discuss contraception openly with religious patients.","confidence":0.6,"topic_tags":["religiosity","sexual_function"],"strengths":["Relatively large sample for a regional survey","Multiple dimensions of religiosity examined","Clear regression analysis linking religiosity to specific sexual outcomes"],"limitations":["Cross‑sectional design precludes causal inference","No measurement of key confounds (moral incongruence, mental health, relationship status)","Reliance on self‑report without validated scales for sexual behaviour or religiosity"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":4,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12119-022-09965-7"}},{"id":8636,"doi":"10.3389/fpsyg.2022.784675","pmid":"35465566","pmcid":"PMC9024326","title":"The Interplay of Infidelity, Sexuality, and Religiosity in the Discourse of Mixed-Orientation Marriages: A Discursive Psychological Analysis","authors":"Zulkffli MA, Ab Rashid R, Kamarul Azlan MA, Ismail HH.","first_author":"Zulkffli MA","journal":"Frontiers in psychology","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Malaysia","Gay","Marriage","Islam","Discursive Psychology","Infidelity","Muslims"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9024326","cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"case study with two interview participants; discursive psychological analysis","sample_n":2,"sample_text":"two participants (one married, one divorced)","population":"gay men in mixed‑orientation marriages in Malaysia","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors interviewed two gay Malaysian men about how their Islamic faith, sexuality, and experiences of infidelity intersect in mixed‑orientation marriages. Themes of blame and Islamic identity emerged, highlighting cultural pressures on gay men to marry women.","clinical_takeaway":"Clinicians should recognize that religious and cultural pressures can shape the experiences of gay men in mixed‑orientation marriages, but this study offers only anecdotal insight.","confidence":0.6,"topic_tags":["sexual_function","religiosity","relationships"],"strengths":["In‑depth, semi‑structured interviews","Use of established discursive analysis frameworks (DAM, DP)","Context‑specific insight into Islam and mixed‑orientation marriage"],"limitations":["Very small, non‑representative sample (n=2)","No quantitative measures or validated scales","Findings not generalisable beyond this cultural context"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2022.784675"}},{"id":8638,"doi":"10.3389/fpsyg.2022.860260","pmid":"35369158","pmcid":"PMC8965871","title":"Psychophysical Impact of COVID-19 Pandemic and Same-Sex Couples' Conflict: The Mediating Effect of Internalized Sexual Stigma","authors":"Pistella J, Isolani S, Ioverno S, Laghi F, Baiocco R.","first_author":"Pistella J","journal":"Frontiers in psychology","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Health","Sexual Minorities","Internalized Sexual Stigma","Covid-19","Couples’ Conflict"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyg.2022.860260/pdf","cited_by_count":5,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 232 Italian LGB individuals in same‑sex relationships; assessed pandemic impact, internalized sexual stigma, relationship conflict and several covariates; mediation analysis.","sample_n":232,"sample_text":"Italian LGB sample (232 participants, mean age 28.7)","population":"LGB adults (18‑45) in same‑sex relationships, Italy","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 232 Italian same‑sex couples, higher COVID‑19 related health stress was linked to more relationship conflict, and this link was partly explained by internalized sexual stigma. Sexual satisfaction also reduced conflict.","clinical_takeaway":"Address internalized stigma to help LGB couples cope with pandemic‑related stress and reduce conflict.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Reasonably sized sample for a minority population","Uses validated ISS and conflict scales (likely)","Mediational analysis adds depth"],"limitations":["Cross‑sectional; cannot infer causality","No control for broader mental‑health variables","Self‑selected online sample may limit generalisability"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2022.860260"}},{"id":8639,"doi":"10.3390/vaccines10030397","pmid":"35335030","pmcid":"PMC8953177","title":"Effects of Religious Practice and Teachings about Sexual Behavior on Intent to Vaccinate against Human Papillomavirus","authors":"Redd DS, Jensen JL, Hughes SJ, Pogue K, Sloan-Aagard CD, Miner DS, Altman JD, Crook TB, Zentz L, Bodily RJ, Poole BD.","first_author":"Redd DS","journal":"Vaccines","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Human papillomavirus","Sexually Transmitted Infection","Vaccine Hesitancy","Vaccine Attitudes","Christian Religious Views"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8953177","cited_by_count":21,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 442 participants, analyzed with CFA and SEM; convenience sample","sample_n":442,"sample_text":"n = 442 surveyed participants","population":"Parents (presumed) in the United States","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A US survey of 442 parents examined how Christian religious practice and teachings about sex relate to intentions to vaccinate children against HPV. Religious practice was linked to higher vaccine knowledge and some pro‑vaccine attitudes, but also to belief that religious sexual norms protect children, which was associated with more negative vaccine views.","clinical_takeaway":"Religious teachings about sexuality can both help and hinder HPV vaccine acceptance; clinicians should address misconceptions about sexual behavior protection when discussing vaccination.","confidence":0.9,"topic_tags":["sexual_function","religiosity","csbd"],"strengths":["Large sample for a survey (n=442)","Use of structural equation modeling","Attention to both positive and negative vaccine attitudes"],"limitations":["Cross‑sectional design; causality cannot be inferred","Convenience sample limits generalisability","Limited control for key confounds (e.g., mental health, partner influences)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":19,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/vaccines10030397"}},{"id":8640,"doi":"10.1016/j.jad.2022.02.068","pmid":"35257693","pmcid":null,"title":"Sexual minority status, religiosity, and suicidal behaviors among college students in the United States","authors":"Oh H, Goehring J, Smith L, Zhou S, Blosnich J.","first_author":"Oh H","journal":"Journal of affective disorders","year":2022,"pub_types":["Journal Article"],"keywords":["Sexuality","Religion","Young Adults","College","Suicidal Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Large cross‑sectional survey of U.S. college students (N≈104 k) using multivariable logistic regression.","sample_n":104463,"sample_text":"Healthy Minds Study respondents from 140 campuses (2020‑2021)","population":"College students age 18‑30, United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US college sample, the protective link between strong religious importance and lower suicide risk was evident for heterosexual students but not for sexual‑minority students, who reported higher suicide‑related outcomes overall.","clinical_takeaway":"Religiosity may not buffer suicide risk for sexual‑minority college students; clinicians should attend to other protective factors.","confidence":0.85,"topic_tags":["sexual_function","religiosity"],"strengths":["Very large, multi‑site sample","Adjusted for key demographic covariates","Clear statistical modelling with odds ratios"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on single‑item measure for religiosity","No assessment of mental‑health or trauma confounders","Potential self‑selection bias in survey respondents"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jad.2022.02.068"}},{"id":8642,"doi":"10.1080/00918369.2022.2030617","pmid":"35089845","pmcid":null,"title":"Internalized Sexual Orientation Stigma and Mental Health in a Religiously Diverse Sample of Gay and Bisexual Men in Lebanon","authors":"Maatouk I, Jaspal R.","first_author":"Maatouk I","journal":"Journal of homosexuality","year":2023,"pub_types":["Journal Article"],"keywords":["Depression","Religion","identity","Lebanon","Sexual Orientation","Psychological Distress","Internalized Sexual Orientation Stigma"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 200 gay and bisexual men recruited by convenience sampling in Lebanon; multiple regression analyses of internalized sexual orientation stigma, psychological distress and depression.","sample_n":200,"sample_text":"convenience sample of 200 participants","population":"gay and bisexual men (n≈200) in Lebanon; convenience sample","country":"Lebanon","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 200 gay and bisexual men in Lebanon, more religious involvement was linked to lower psychological distress, while bisexual men and those facing family pressure reported higher internalised stigma and distress.","clinical_takeaway":"Clinicians should consider religious and family dynamics when supporting gay/bisexual men’s mental health.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Relatively large sample for regional research","Use of multiple regression to examine several predictors","Addresses understudied population in Lebanon"],"limitations":["Convenience sampling limits generalisability","Cross‑sectional design prevents causal inference","No pre‑registration or detailed reporting of effect sizes"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2022.2030617"}},{"id":8643,"doi":"10.3390/ijerph19021017","pmid":"35055837","pmcid":"PMC8775460","title":"The Sexual and Parenting Rights of People with Physical and Psychical Disabilities: Attitudes of Italians and Socio-Demographic Factors Involved in Recognition and Denial","authors":"Di Santo SG, Colombo M, Silvaggi M, Gammino GR, Fava V, Malandrino C, Nanini C, Rossetto C, Simone S, Eleuteri S.","first_author":"Di Santo SG","journal":"International journal of environmental research and public health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Physical Disabilities","Sexual Minorities","Sexual Rights","Societal Attitudes","Psychical Disabilities"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8775460","cited_by_count":4,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online anonymous survey, non‑random convenience sample (N=973) of Italian adults, assessed attitudes toward sexual and parenting rights of people with physical vs. psychical disabilities.","sample_n":973,"sample_text":"non‑random convenience online recruitment","population":"Italian adults, 18‑84 years, 71.1 % female","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 973 Italians shows most support sexual and parenting rights for people with physical disabilities, but support is lower for those with mental disabilities. Higher religiosity, older age, being male and lower education predict less support.","clinical_takeaway":"None – the study informs social attitudes, not clinical practice.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for an attitude survey","Addresses an under‑studied topic (rights of disabled persons)","Considers both physical and psychical disabilities"],"limitations":["Convenience, non‑random sampling limits generalisability","Attitude measures not described as validated instruments","No pre‑registration or correction for multiple comparisons"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph19021017"}},{"id":8644,"doi":"10.1016/j.alcr.2022.100461","pmid":"36652315","pmcid":null,"title":"Higher parental socioeconomic status accelerates sexual debut: Evidence from university students in Italy","authors":"Guetto R, Vignoli D, Lachi A.","first_author":"Guetto R","journal":"Advances in life course research","year":2022,"pub_types":["Journal Article"],"keywords":["Sexuality","Italy","Second Demographic Transition","Sexual Debut","Parental Ses","Social Origins"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Event‑history analysis of two university‑student surveys (2000, 2017) with retrospective reporting of sexual debut; convenience sample of Italian undergraduates.","sample_n":null,"sample_text":"University student sample; exact N not reported in abstract","population":"Italian university students (likely ages 18‑25)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Among Italian university students, higher parental education and social class are linked to an earlier start of sexual activity, especially when the first intercourse is protected. Family openness about sex, low parental religiosity, and permissiveness partly explain this effect.","clinical_takeaway":"Higher parental SES does not necessarily delay sexual initiation; clinicians should consider family cultural openness when discussing sexual health with young adults.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, unique longitudinal survey data (two waves)","Use of event‑history modelling","Explores mediating family mechanisms"],"limitations":["Convenience sample of university students limits generalisability","No explicit reporting of instrument validation","Limited control for broader psychosocial confounds"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.alcr.2022.100461"}},{"id":8647,"doi":"10.1037/fam0000936","pmid":"34766802","pmcid":"PMC9673508","title":"Discrimination and depressive symptoms in sexual minority Latinx youth: Moderation by religious importance and attendance","authors":"Thamrin H, Gonzales NA, Toomey RB, Anderson SF, Anhalt K.","first_author":"Thamrin H","journal":"Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43)","year":2022,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 377 sexual‑minority Latinx youth (age 14‑24) examining discrimination, religiosity and depressive symptoms","sample_n":377,"sample_text":"Convenience/community sample (recruitment method not specified)","population":"sexual minority Latinx youth (N=377, mean age ≈ 20)","country":"United States (presumed from authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study found that for sexual‑minority Latinx youth, family and personal religiosity can lessen depressive symptoms, but mainly when experiences of ethnic or sexuality‑related discrimination are low or average.","clinical_takeaway":"Clinicians should consider family religiosity as a potential protective factor for depressive symptoms in sexual‑minority Latinx youth, especially when discrimination levels are modest.","confidence":0.7,"topic_tags":["sexual_function","relationships","lgbtq","religiosity","moral_incongruence"],"strengths":["Large community sample for this population","Examines intersection of ethnicity, sexuality, and family religiosity","Uses moderation analyses to test interaction effects"],"limitations":["Cross‑sectional design limits causal inference","Measures of discrimination and religiosity not described as validated","Potential self‑selection bias, recruitment details unclear"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/fam0000936"}},{"id":8648,"doi":"10.3389/fpsyg.2021.715032","pmid":"34858256","pmcid":"PMC8631753","title":"Religiosity and Sexual Initiation Among Hispanic Adolescents: The Role of Sexual Attitudes","authors":"Calatrava M, Beltramo C, Osorio A, Rodríguez-González M, De Irala J, Lopez-Del Burgo C.","first_author":"Calatrava M","journal":"Frontiers in psychology","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Religiosity","Sexual Initiation","Sexual Attitudes","Sexual Permissiveness"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8631753","cited_by_count":4,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 2,919 Hispanic adolescents (age 14‑18) assessing religiosity, sexual permissiveness attitudes and self‑reported sexual initiation; logistic regression and path analysis used.","sample_n":2919,"sample_text":"2,919 questionnaires analyzed after exclusion","population":"Hispanic adolescents in school settings, predominantly Catholic, Spanish‑speaking countries","country":"Multiple Spanish‑speaking countries (unspecified)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 2,900 Hispanic teens, attending church and praying were linked to later sexual debut, while personal religious importance affected timing only through more conservative sexual attitudes.","clinical_takeaway":"Religious involvement may delay adolescent sexual initiation, but clinicians should consider broader social and personal factors.","confidence":0.68,"topic_tags":["religiosity","adolescents","sexual_function"],"strengths":["Large sample size for survey research","Use of path analysis to explore mediation","Relevant public‑health topic for adolescents"],"limitations":["Cross‑sectional design limits causal inference","Religiosity and permissiveness measured with unclear validation","Potential unmeasured confounders (e.g., family context, mental health)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2021.715032"}},{"id":8649,"doi":"10.7448/ias.16.3.18716","pmid":"24242264","pmcid":"PMC3833191","title":"Reducing shame in a game that predicts HIV risk reduction for young adult MSM: a randomized trial delivered nationally over the Web","authors":"Christensen JL, Miller LC, Appleby PR, Corsbie-Massay C, Godoy CG, Marsella SC, Read SJ.","first_author":"Christensen JL","journal":"Journal of the International AIDS Society","year":2013,"pub_types":["research-article","Randomized Controlled Trial","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["AIDS","HIV","stigma","intervention","Shame","Sexual Risk-taking","Men Who Have Sex With Men (Msm)","Serious Games","Solve"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC3833191","cited_by_count":65,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Randomized controlled trial, national online recruitment of 921 MSM aged 18‑24, intervention (SOLVE game) vs wait‑list control, shame measured pre/post, HIV risk (UAI) at 3‑month follow‑up.","sample_n":921,"sample_text":"921 retained participants (484 control, 437 intervention).","population":"Young adult MSM (18‑24, HIV‑negative, African American, Latino, White) with recent unprotected anal intercourse.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A web‑based game reduced feelings of shame among young MSM, and this reduction was linked to less unprotected anal sex three months later.","clinical_takeaway":"Interventions that lower sexual shame may help lower HIV risk behaviours in young MSM.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large, nationally recruited sample","Randomized controlled design","Mediation analysis with confidence intervals"],"limitations":["Unclear whether shame scale was validated","No pre‑registration reported","Potential unmeasured psychosocial confounders"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":0,"mentioning":199,"citing_publications":98,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7448/ias.16.3.18716"}},{"id":8650,"doi":"10.29063/ajrh2021/v25i5.7","pmid":"37585860","pmcid":null,"title":"Factors associated with multiple sexual partners among first-year students in a South African university","authors":"Osuafor GN, Okoli CE.","first_author":"Osuafor GN","journal":"African journal of reproductive health","year":2021,"pub_types":["Journal Article"],"keywords":["HIV","Students","university","Condom Use","Stis","Multiple Sexual Partners"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 348 first‑year university students (aged 17‑24) reporting sexual behaviour over the past month","sample_n":348,"sample_text":"347‑348 students (convenience sample)","population":"first‑year university students in a rural South African university","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 348 first‑year South African university students, about one‑quarter reported having more than one sexual partner in the past month. Male gender, early sexual debut, alcohol use, student‑group membership and low religiosity were linked to having multiple partners.","clinical_takeaway":"Interventions that address alcohol use, promote abstaining from early sexual debut, and incorporate religiosity may reduce risky partner‑multiplying behaviour among first‑year students.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonably large sample for a single university","Clear logistic‑regression analysis with confidence intervals","Relevant public‑health focus on multiple partners"],"limitations":["Cross‑sectional design cannot infer causality","Self‑report of sexual behaviour may be biased","Limited confound control (no mental‑health, trauma, or partner variables)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.29063/ajrh2021/v25i5.7"}},{"id":8651,"doi":"10.1080/0092623x.2021.1979702","pmid":"34542022","pmcid":null,"title":"Religious Piety and Sexual Passion: What Is the Connection?","authors":"Clarke RW, Leavitt CE, Busby DM.","first_author":"Clarke RW","journal":"Journal of sex & marital therapy","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey using multiple regression; sample size not reported","sample_n":null,"sample_text":"not reported in abstract","population":"unspecified adult participants (likely community sample)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study found that people with either low or high levels of religiosity tended to report healthier sexual passion, while those with moderate religiosity showed less beneficial passion styles; religious men were more obsessively passionate than religious women.","clinical_takeaway":"Clinicians should recognize that the relationship between religiosity and sexual passion is complex and not assume a straightforward positive or negative effect.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Uses multiple regression to test nonlinear (curvilinear) effects","Considers gender and religious affiliation","Addresses both positive and negative aspects of sexual passion"],"limitations":["Sample size and sampling method not described","No measurement of key confounds (e.g., mental health, relationship context)","Cross‑sectional design limits causal inference","Unclear whether sexual passion scale is validated"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2021.1979702"}},{"id":8652,"doi":"10.1080/08952841.2021.1967070","pmid":"34486955","pmcid":null,"title":"Women's sexual satisfaction in the context of midlife relationships: examining an ecological model","authors":"Arenella K, Steffen A.","first_author":"Arenella K","journal":"Journal of women & aging","year":2022,"pub_types":["Journal Article"],"keywords":["Ecological model","Sexual function","Sexual Satisfaction","Midlife Women","Midlife In The United States"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large national cohort (MIDUS) used for a cross‑sectional regression analysis of 1,411 midlife women","sample_n":1411,"sample_text":"participants were 1,411 midlife women from the MIDUS study","population":"midlife women (United States)","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study used data from over 1,400 U.S. women in midlife to test whether factors ranging from personal health to religiosity and relationship quality together predict how satisfied they feel with their sex lives. Many of these ecological factors were linked to higher sexual satisfaction.","clinical_takeaway":"Clinicians should consider a wide range of personal, relational, and sociocultural factors—not just physical health—when addressing sexual satisfaction in midlife women.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Comprehensive ecological model spanning multiple system levels","Inclusion of religiosity as macro‑level variable"],"limitations":["Cross‑sectional design cannot infer causality","Sexual satisfaction measured via self‑report; validation not described","Masturbation and trauma histories not assessed"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":14,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/08952841.2021.1967070"}},{"id":8653,"doi":"10.1007/s10943-021-01400-9","pmid":"34455514","pmcid":"PMC11334395","title":"Religiosity and Conversion Therapy is Associated with Psychosocial Health Problems among Sexual Minority Men (SMM) in Nigeria","authors":"Ogunbajo A, Oke T, Okanlawon K, Abubakari GM, Oginni O.","first_author":"Ogunbajo A","journal":"Journal of religion and health","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Nigeria","Religiosity","Psychosocial Health","Sexual Minority Men"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 406 sexual minority men in Nigeria examining associations between religiosity, conversion therapy exposure, and psychosocial health outcomes","sample_n":406,"sample_text":"N = 406 sexual minority men recruited for a survey","population":"sexual minority men (SMM) in Nigeria","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Nigerian sample of 406 gay and bisexual men, those who reported having undergone religious conversion therapy were more likely to be HIV‑positive, depressed, think about suicide, and lack medical care. Believing that same‑sex sex is sinful was linked to region, Muslim faith, and internalized homophobia. The authors suggest affirming religious teachings could improve LGBT health.","clinical_takeaway":"Clinicians should screen for conversion‑therapy exposure, depression, and suicidality among sexual minority men, especially in highly religious settings.","confidence":0.8,"topic_tags":["religiosity","sexual_function","gender"],"strengths":["Large sample for the context","Multivariable logistic regression","Addresses an understudied population"],"limitations":["Cross‑sectional; cannot infer causality","Limited information on measurement validation","No correction for multiple testing reported"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":16,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-021-01400-9"}},{"id":8657,"doi":"10.1016/j.chiabu.2011.01.013","pmid":"21620162","pmcid":"PMC3104207","title":"Self-defining as sexually abused and adult sexual risk behavior: results from a cross-sectional survey of women attending an STD clinic","authors":"Senn TE, Carey MP, Coury-Doniger P.","first_author":"Senn TE","journal":"Child abuse & neglect","year":2011,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 481 women attending an STD clinic","sample_n":481,"sample_text":"481 women (206 met research criteria for CSA; 142 self‑defined as abused)","population":"women, ages adult to middle‑aged, attending a publicly funded STD clinic","country":"United States (implied by STD clinic context)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among women at an STD clinic, those who objectively met criteria for childhood sexual abuse showed higher adult sexual risk, regardless of whether they personally identified as abused.","clinical_takeaway":"Clinicians should assess trauma history even when patients do not label their childhood experiences as abuse, as risk behaviors may still be elevated.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Large sample for a clinic‑based study","Differentiates objective CSA criteria from self‑definition","Examines multiple traumagenic dynamics constructs"],"limitations":["Cross‑sectional; no causal inference","Convenience sample limits generalizability","Limited reporting of validated scales and effect sizes"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2011.01.013"}},{"id":8659,"doi":"10.1016/j.jsp.2021.02.008","pmid":"34051915","pmcid":null,"title":"Parental Attitudes Towards Inclusiveness Instrument (PATII): Psychometric evaluation of a new instrument measuring parental beliefs about gender and sexuality diversity inclusions in schools","authors":"Hobby L, Ullman J, Ferfolja T.","first_author":"Hobby L","journal":"Journal of school psychology","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Parents","Education","Construct Validity","Exploratory Structural Equation Modelling","Gender And Sexuality Diversity"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online convenience sample of 998 parents recruited via Prolific; instrument development and validation using ESEM/CFA; no longitudinal or experimental manipulation.","sample_n":998,"sample_text":"Parents recruited online (Prolific)","population":"Parents of children in K‑12 in the UK and US","country":"UK; US","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers created and tested a new questionnaire (PATII) that measures how parents feel about school programs that include gender and sexuality diversity. Using data from almost 1,000 parents in the UK and US, they showed the tool is reliable, valid, and works similarly across sex, religion, and nationality.","clinical_takeaway":"None – the study provides a measurement tool, not clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for instrument validation","Robust psychometric methods (ESEM, CFA, invariance testing)","Measurement invariance across sex, religiosity, nationality"],"limitations":["Convenience online sample limits generalisability","No pre‑registration or open data statement","Cross‑sectional; cannot assess attitude change over time"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsp.2021.02.008"}},{"id":8660,"doi":"10.1016/j.socscimed.2021.113913","pmid":"33991789","pmcid":"PMC8336607","title":"Neighborhood social cohesion, religious participation and sexual risk behaviors among cisgender black sexual minority men in the southern United States","authors":"Duncan DT, Ransome Y, Park SH, Jackson SD, Kawachi I, Branas CC, Knox J, Al-Ajlouni YA, Mountcastle H, Miles CH, Hickson DA.","first_author":"Duncan DT","journal":"Social science & medicine (1982)","year":2021,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Sexual Health","Social Cohesion","Neighborhoods","Religious Participation","Southern United States","Black Sexual Minority Men"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 354 Black sexual minority men from two US cities, multivariable regression","sample_n":354,"sample_text":"n = 354 recruited from the MARI Study","population":"Black cisgender sexual minority men, ages 18-66, US South (Jackson, MS; Atlanta, GA)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 354 Black gay and bisexual men in the US South, lower perceived neighborhood cohesion was linked to higher odds of having sex while drunk and having condomless anal sex with casual partners. Religious involvement changed the size of these associations.","clinical_takeaway":"Strengthening neighborhood connections and engaging faith groups may help reduce alcohol‑related and condomless sex risks among Black sexual minority men.","confidence":0.78,"topic_tags":["sexual_function","masturbation"],"strengths":["Uses a validated scale for neighborhood cohesion","Reports adjusted prevalence ratios with confidence intervals","Examines moderation by religious participation"],"limitations":["Cross‑sectional design limits causal inference","Convenience sample from two cities limits generalisability","Key psychosocial confounds (e.g., mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.socscimed.2021.113913"}},{"id":8662,"doi":"10.1177/0956797620983829","pmid":"33945754","pmcid":null,"title":"Lay Beliefs About Gender and Sexual Behavior: First Evidence for a Pervasive, Robust (but Seemingly Unfounded) Stereotype","authors":"Krems JA, Ko A, Moon JW, Varnum MEW.","first_author":"Krems JA","journal":"Psychological science","year":2021,"pub_types":["Journal Article"],"keywords":["Sexual behavior","Sex differences","Self-esteem","Social Cognition","Stereotypes","Social Perception","Open Data","Sex/gender"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Six experiments with U.S. adults (N=1,469) using vignette manipulations and questionnaire measures.","sample_n":1469,"sample_text":"U.S. adult participants recruited online (presumably via MTurk or similar platforms).","population":"U.S. adult volunteers, convenience sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that both men and women commonly think women who have casual sex have low self‑esteem, even though participants’ own self‑esteem isn’t linked to their casual‑sex behavior.","clinical_takeaway":"None – findings pertain to social stereotypes, not clinical sexual health.","confidence":0.85,"topic_tags":["sexual_function","gender"],"strengths":["Large combined sample across multiple experiments","Controls for major ideological variables","Both explicit and semi‑implicit measures of stereotype"],"limitations":["Convenience online sample limits generalisability","No pre‑registration reported","Potential reliance on self‑report without physiological validation"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0956797620983829"}},{"id":8663,"doi":"10.1016/j.jsat.2021.108400","pmid":"34080558","pmcid":"PMC8380678","title":"Rates and predictors of Alcoholics Anonymous attendance across sexual orientations","authors":"McGeough BL, Karriker-Jaffe KJ, Zemore SE.","first_author":"McGeough BL","journal":"Journal of substance abuse treatment","year":2021,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Alcoholics Anonymous","Alcohol Use Disorder","Sexual Minorities","Substance Use Intervention Utilization"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Analysis of five waves of the National Alcohol Survey (N=7,862) comparing AA attendance across sexual orientations using logistic regression and interaction models.","sample_n":7862,"sample_text":"National Alcohol Survey respondents who reported at least one lifetime AUD symptom.","population":"Adults in the United States with at least one lifetime AUD symptom (N=7,862).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among adults with alcohol‑use problems, lesbian and bisexual women are more likely than heterosexual women to attend Alcoholics Anonymous, especially if they are older, more religious, or have less severe alcohol dependence.","clinical_takeaway":"AA may be a valuable support option for sexual‑minority women with alcohol problems, particularly those who are older and religious.","confidence":0.85,"topic_tags":["sexual_function","treatment"],"strengths":["Large, nationally‑representative sample","Inclusion of multiple covariates and interaction analyses","Focus on an under‑studied population (sexual‑minority women)"],"limitations":["Cross‑sectional design limits causal inference","No pre‑registration or correction for multiple testing reported","Does not address potential unmeasured confounders specific to AA participation"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsat.2021.108400"}},{"id":8664,"doi":"10.1080/07448481.2021.1899188","pmid":"33830876","pmcid":null,"title":"Predicting sexual risk and sexual health screening in a sample of university students in Lebanon: a cross-sectional study","authors":"Maatouk I, Assi M, Jaspal R.","first_author":"Maatouk I","journal":"Journal of American college health : J of ACH","year":2023,"pub_types":["Journal Article"],"keywords":["Religion","university","Lebanon","Sexual Health","Sexually Transmitted Infections"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"convenience sample of 250 undergraduate students at a private university in Beirut; self‑report questionnaire on religiosity, psychological distress, contraceptive use, STI/HIV screening and sexual risk behaviours; logistic regression analyses reported","sample_n":250,"sample_text":"250 undergraduate students recruited at a private university in Beirut (convenience sample)","population":"university students (age ~18‑25), Lebanon; 250 participants, mixed gender","country":"Lebanon","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 250 Lebanese university students found that stronger religiosity was linked to fewer risky sexual behaviours, while higher psychological distress and alcohol/drug use were linked to more condomless sex and lower STI screening.","clinical_takeaway":"Consider students' mental‑health and substance‑use contexts, as well as personal religiosity, when designing sexual‑health education and screening programs.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a single‑site student survey","Inclusion of religiosity and psychological distress as predictors","Clear reporting of associations with specific risky behaviours"],"limitations":["Convenience sampling limits generalisability","Measures appear to be ad‑hoc and not validated","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/07448481.2021.1899188"}},{"id":8665,"doi":"10.1186/s12889-021-10645-8","pmid":"33823835","pmcid":"PMC8025555","title":"Pathways to sexual decision making by Pentecostal church youths in Botswana","authors":"Mpofu E, Ntinda K, Levers LL, van Rensberg A, Nkomazana F.","first_author":"Mpofu E","journal":"BMC public health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Youth","Contraception","Self-efficacy","Personal Control","Abstinence; Religiosity","Sexual Decisions"],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-021-10645-8","cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 235 Pentecostal youths using self‑report scales and SEM","sample_n":235,"sample_text":"Convenience sample recruited through churches; may not represent all youth in Botswana","population":"Botswana Pentecostal church youth (age 12‑23, 67% female)","country":"Botswana","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Among Pentecostal youths in Botswana, personal religiosity shapes decisions about abstinence and contraception mainly through personal agency. Higher agency predicts abstinence, while religiosity is linked to contraception use.","clinical_takeaway":"Enhancing personal agency may improve sexual‑health decision making among religious youth.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a youth survey in Botswana","Uses structural equation modelling to test pathways","Focuses on personal agency, a modifiable factor"],"limitations":["Cross‑sectional design limits causal inference","Convenience church sample limits generalisability","No measurement of key sexual‑health confounds (e.g., mental health, partner status)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-021-10645-8"}},{"id":8667,"doi":null,"pmid":"35026831","pmcid":null,"title":"Connection between Religiosity and Attitudes towards Sexuality in Montenegro","authors":"Saveljić M, Murić D, Raspopović M, Peličić D.","first_author":"Saveljić M","journal":"Psychiatria Danubina","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1287 Montenegrin adults, convenience sampling, no probability weighting","sample_n":1287,"sample_text":"Convenience/community sample of Montenegrin residents, not a nationally representative probability sample","population":"Adults (≥18) living in Montenegro, 848 women, 439 men","country":"Montenegro","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 1,287 Montenegrin adults, people who identified as agnostic were the most liberal about sex, followed by atheists, then believers. More education predicted more liberal attitudes; women were more conservative than men.","clinical_takeaway":"None – the study describes attitudes, not clinical implications.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Large sample size for a regional survey","Addresses gender, age, education alongside religiosity","Clear descriptive findings"],"limitations":["Uses a non‑validated, author‑created attitude scale","Convenience sample limits generalisability","No multivariate control of potential confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":8669,"doi":"10.1007/s10508-021-01915-y","pmid":"33616809","pmcid":null,"title":"Religious and Spiritual Development from Adolescence to Early Adulthood in the U.S.: Changes over Time and Sexual Orientation Differences","authors":"Lamb KM, Stawski RS, Dermody SS.","first_author":"Lamb KM","journal":"Archives of sexual behavior","year":2021,"pub_types":["Journal Article"],"keywords":["Sexuality","Adolescence","Spirituality","Sexual Orientation","Religiosity"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"secondary analysis of 5 waves of a national longitudinal cohort (N=337), multilevel growth modeling","sample_n":337,"sample_text":"337 participants (71.8% female) from the Longitudinal Study of Adolescent Health and Wellness","population":"U.S. adolescents/young adults, 71.8% female, heterosexual and sexual‑minority groups","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Using five waves of a U.S. youth cohort, the study found that heterosexual adolescents start with higher religiosity than sexual‑minority peers, but both groups’ religiosity declines similarly over time. Spirituality rises for sexual‑minority youth but stays flat for heterosexual youth.","clinical_takeaway":"Clinicians should note that sexual‑minority young adults may experience increasing spirituality even as religiosity wanes, which could affect their well‑being.","confidence":0.6,"topic_tags":["religiosity","sexual_function"],"strengths":["Longitudinal design with multiple assessment waves","Large, nationally‑based cohort","Separate growth models for religiosity and spirituality"],"limitations":["Limited sample size for subgroup (sexual minorities)","No detail on measurement validation","Potential unmeasured confounders (e.g., mental health, family environment)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":10,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-021-01915-y"}},{"id":8670,"doi":"10.1177/070674379403900709","pmid":"7987787","pmcid":null,"title":"The effect of testosterone on psychopathology and sexual function in a paranoid schizophrenic self-castrate","authors":"Cooper AJ, Swamy GN.","first_author":"Cooper AJ","journal":"Canadian journal of psychiatry. Revue canadienne de psychiatrie","year":1994,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report; 12‑week testosterone administration with brief psychiatric rating scale assessments","sample_n":1,"sample_text":"N=1 (single case)","population":"one adult male with paranoid schizophrenia, self‑castrated due to religious delusions","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 12‑week testosterone regimen was given to a man with paranoid schizophrenia who had castrated himself because of religious guilt. His sexual activity rose with testosterone, while his psychiatric symptoms fell, but the report is based on a single patient.","clinical_takeaway":"One case suggests testosterone may boost sexual activity without worsening psychosis, but no firm conclusions can be drawn for treatment.","confidence":0.7,"topic_tags":["sexual_function","neuroscience","religiosity"],"strengths":["use of validated BPRS for psychopathology","objective hormone measurements"],"limitations":["single case; no control group","no measurement of masturbation or moral/religious conflict as covariates","causal claims exceed design"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/070674379403900709"}},{"id":8671,"doi":"10.1080/16506073.2020.1861083","pmid":"33475018","pmcid":null,"title":"Disgust sensitivity mediates the link between homophobia and sexual orientation obsessive-compulsive symptoms","authors":"Ching THW, Rouleau TM, Turner E, Williams MT.","first_author":"Ching THW","journal":"Cognitive behaviour therapy","year":2021,"pub_types":["Journal Article"],"keywords":["Homophobia","Sexual Orientation","Obsessive-compulsive Symptoms","Disgust Sensitivity"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 592 heterosexual college students completing self‑report scales on homophobia, disgust sensitivity and sexual‑orientation‑related OCD symptoms; mediation analyses conducted.","sample_n":592,"sample_text":"self‑selected university sample, likely convenience‑recruited","population":"heterosexual college students (N=592)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among 592 heterosexual college students, stronger homophobic attitudes were linked to more sexual‑orientation‑related OCD symptoms, and this link was partly explained by higher disgust sensitivity.","clinical_takeaway":"Therapists might consider addressing disgust sensitivity when treating OCD symptoms tied to sexual orientation concerns.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample (N>500)","Use of presumably validated questionnaires","Statistical mediation analysis provides insight into mechanisms"],"limitations":["Cross‑sectional design; cannot infer causality","Convenience college sample limits generalisability","Limited confound control (no mental‑health or moral variables)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/16506073.2020.1861083"}},{"id":8675,"doi":"10.1007/s10943-020-01051-2","pmid":"32533413","pmcid":null,"title":"The Role of Sexual Orientation in the Associations Between Religiousness and Hypertension","authors":"Lamb KM, Vaughn AA, Calzo JP, Blashill AJ.","first_author":"Lamb KM","journal":"Journal of religion and health","year":2020,"pub_types":["Journal Article"],"keywords":["Hypertension","Blood pressure","Religiousness","Intrinsic Religiosity","Sexual Minority Health","Organizational Religious Activity"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional analysis of a nationally representative US sample (N=5115) from Wave IV of the Add Health study, examining associations between organizational religious activity, intrinsic religiosity and hypertension, moderated by sexual orientation.","sample_n":5115,"sample_text":"Nationally representative sample, wave IV of Add Health, N=5115, mean age 28.96 years, 54% female.","population":"US adults, mean age 29, 54% female, stratified by sexual orientation (heterosexual, mostly heterosexual, sexual minority).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a US adult sample, going to religious services was linked to higher blood pressure for sexual‑minority people, but tended to lower pressure for heterosexuals. Intrinsic religiosity showed no clear effect.","clinical_takeaway":"Clinicians should consider that religious involvement may affect cardiovascular health differently across sexual‑orientation groups.","confidence":0.8,"topic_tags":["religiosity","sexual_function"],"strengths":["Large, nationally representative sample","Objective blood pressure measurements","Inclusion of sexual orientation as moderator"],"limitations":["Cross‑sectional design limits causal inference","Religiosity measures not described as validated instruments","No control for mental‑health or trauma variables that could confound BP"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-020-01051-2"}},{"id":8676,"doi":"10.1177/0886260520976224","pmid":"33251908","pmcid":null,"title":"Risk Factors for Sexual Assault of Heterosexual and Sexual Minority College Women","authors":"McGraw LK, Tyler KA, Simons LG.","first_author":"McGraw LK","journal":"Journal of interpersonal violence","year":2022,"pub_types":["Journal Article"],"keywords":["Women","Sexual Assault","College Students","Protective Factors","Sexual Minority"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 755 college women at two US universities (2013‑2014); bivariate and multivariate regression analyses","sample_n":755,"sample_text":"755 women, 72 sexual minority","population":"college women (heterosexual and sexual minority) in the US","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 755 US college women examined how factors like family relationships, religiosity, childhood abuse, heavy drinking and risky sexual behavior relate to experiencing sexual assault, finding several risk factors that differ between heterosexual and sexual‑minority students.","clinical_takeaway":"Screen for child abuse history, heavy drinking and risky sexual behaviors when assessing assault risk among college women.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for the topic","Inclusion of both heterosexual and sexual‑minority women","Multivariate analysis of several risk and protective factors"],"limitations":["Cross‑sectional design prevents causal inference","Reliance on self‑report measures without clear validation details","Limited assessment of key confounds (e.g., mental health, masturbation)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0886260520976224"}},{"id":8678,"doi":"10.1371/journal.pone.0240840","pmid":"33064760","pmcid":"PMC7567377","title":"Serious and persistent suicidality among European sexual minority youth","authors":"Gambadauro P, Carli V, Wasserman D, Balazs J, Sarchiapone M, Hadlaczky G.","first_author":"Gambadauro P","journal":"PloS one","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0240840&type=printable","cited_by_count":12,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Prospective cohort of 1958 European adolescents surveyed at three time‑points over four months; random school sampling across six countries.","sample_n":1958,"sample_text":"2046 recruited, 1958 included in analysis.","population":"Adolescents (mean age 15.3) from European schools; 10.9 % identified as sexual minority.","country":"Multi‑country (6 European nations).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a European school‑based study, adolescents who identified as sexual minorities were about twice as likely to report serious suicidal thoughts and attempts over four months, even after accounting for bullying, substance use, stress, economic hardship, and religiosity.","clinical_takeaway":"Sexual‑minority youth face heightened suicide risk independent of common stressors; targeted prevention is needed.","confidence":0.7,"topic_tags":["sexual_function","moral_incongruence","csbd"],"strengths":["Large, multi‑country sample","Validated suicidality measure","Longitudinal follow‑up","Comprehensive adjustment for key stressors"],"limitations":["Self‑report data only","Limited mental‑health covariates (e.g., depression)","No pre‑registration"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":12,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0240840"}},{"id":8679,"doi":"10.1080/00926239808414664","pmid":"9509376","pmcid":null,"title":"Gender differences in the sexual rating of words","authors":"Plaud JJ, Gaither GA, Weller LA.","first_author":"Plaud JJ","journal":"Journal of sex & marital therapy","year":1998,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of men and women rating 400 words on sexual charge and ambiguity; compared ratings with religiosity, sexual experience, sex guilt, social desirability.","sample_n":null,"sample_text":"not specified in abstract","population":"adult men and women (likely convenience sample, details not provided)","country":"not specified","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"background","plain_summary":"Men and women rated the sexual meaning of many words; they showed similar overall ratings, but men rated ambiguous words as more sexual. Women reported higher religiosity, guilt and social desirability, which may have influenced their responses.","clinical_takeaway":"Gender differences in perceived sexual content may reflect social and moral attitudes rather than innate preferences.","confidence":0.7,"topic_tags":["gender","sexual_function","moral_incongruence"],"strengths":["Measures several relevant psychosocial variables (religiosity, guilt, social desirability).","Direct comparison of male and female word ratings."],"limitations":["Reliance on ad‑hoc word‑rating scales lacking validation.","No separation of pornography viewing from masturbation or other sexual behaviours.","Cross‑sectional design limits causal inference.","Potential social desirability bias not fully controlled."],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239808414664"}},{"id":8682,"doi":"10.1037/fam0000796","pmid":"32881560","pmcid":null,"title":"Sanctification or inhibition? Religious dualities and sexual satisfaction","authors":"Leonhardt ND, Busby DM, Hanna-Walker VR, Leavitt CE.","first_author":"Leonhardt ND","journal":"Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43)","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of MTurk participants (N≈1,695) and dyadic online sample (N≈481 couples).","sample_n":1695,"sample_text":"N = 1,695 (Study 1); N = 481 dyads (Study 2).","population":"Adults recruited online (MTurk; Bovitz Inc. dyads).","country":"USA (online platforms).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that being religious can raise sexual satisfaction by making sex feel sacred, but it can also directly lower satisfaction. The positive effect comes from viewing sex as a holy act, while the negative effect may stem from religious constraints.","clinical_takeaway":"Consider both the potential benefits and drawbacks of religious beliefs when discussing sexual satisfaction with clients.","confidence":0.6,"topic_tags":["religiosity","sexual_function","relationships"],"strengths":["Large sample sizes","Dyadic analysis adds relational context","Use of mediated models to test mechanisms"],"limitations":["Cross‑sectional design limits causal inference","Convenience online sampling may limit generalisability","Unclear whether scales are fully validated"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":15,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/fam0000796"}},{"id":8683,"doi":"10.1016/j.copsyc.2020.07.030","pmid":"32877834","pmcid":null,"title":"Why are world religions so concerned with sexual behavior?","authors":"Moon JW.","first_author":"Moon JW.","journal":"Current opinion in psychology","year":2021,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article proposing a theoretical model linking religion and mating strategies; no primary data.","sample_n":null,"sample_text":"None – narrative review","population":"Humans (general discussion)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The author proposes that many religions promote sexual restraint because restricted mating strategies benefit reproductive success, enhancing paternal certainty and alloparental support.","clinical_takeaway":"None – not directly applicable to clinical practice.","confidence":0.6,"topic_tags":["religiosity","sexual_function","moral_incongruence"],"strengths":["Integrative evolutionary perspective","Clear articulation of a testable hypothesis"],"limitations":["No empirical data","Speculative linking of religion to mating strategies"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":1,"mentioning":38,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.copsyc.2020.07.030"}},{"id":8685,"doi":"10.1007/s10803-020-04398-3","pmid":"32056120","pmcid":null,"title":"Family Sexuality Communication: Parent Report for Autistic Young Adults Versus a Comparison Group","authors":"Graham Holmes L, Strassberg DS, Himle MB.","first_author":"Graham Holmes L","journal":"Journal of autism and developmental disorders","year":2020,"pub_types":["Journal Article"],"keywords":["Adults With Autism","Sexual And Reproductive Health","Family Sexuality Communication","Parent–child Sexuality Communication","Autistic Adults"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional comparison of parent reports for autistic vs neurotypical young adults (N=117 vs 319)","sample_n":436,"sample_text":"117 autistic adults, 319 comparison adults (parent reports)","population":"parents of autistic young adults without intellectual disability and parents of neurotypical young adults, likely convenience sample","country":"unspecified (likely USA based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Parents of autistic young adults report similar numbers of sexuality topics discussed as parents of neurotypical peers, but when few topics are covered, those parents tend to be more religious and less comfortable. Autistic adults are often seen as less ready for sexual education, suggesting families may need more support.","clinical_takeaway":"Clinicians should assess and support family communication about sexuality for autistic young adults, especially where parents feel uncomfortable or hold strong religious views.","confidence":0.6,"topic_tags":["sexual_function","relationships"],"strengths":["Relatively large total sample for a niche population","Focus on parental communication, an understudied area"],"limitations":["Cross‑sectional design, cannot infer causality","Measures appear ad‑hoc with limited validation","Convenience sample; generalisability uncertain"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10803-020-04398-3"}},{"id":8686,"doi":"10.1515/ijamh-2019-0221","pmid":"32549162","pmcid":null,"title":"Sexual risk behaviors and influencing factors among Muslim adolescents on southern border of Thailand","authors":"Hayee F, Fongkaew W, Chanprasit C, Kaewthummanukul T, Voss JG.","first_author":"Hayee F","journal":"International journal of adolescent medicine and health","year":2020,"pub_types":["Journal Article"],"keywords":["Thailand","Adolescent","Muslim","Sexual Risk Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online questionnaire of 700 Thai Muslim adolescents recruited from schools and a vocational college.","sample_n":700,"sample_text":"700 participants recruited from schools; convenience sample, not nationally representative.","population":"Adolescents (≈13‑18 y) from four schools and one vocational college on the southern border of Thailand (N = 700).","country":"Thailand","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 700 Thai Muslim teens, only 9 % had ever had sex, but many who were sexually active lacked condom use, contraception, and reported STIs or pregnancies. Factors such as religiosity, parenting style, and peer norms were linked to risk behaviours. The authors suggest culturally tailored sex‑education programs.","clinical_takeaway":"Sex‑education for Muslim adolescents should address knowledge gaps, incorporate religious context, and involve parents to reduce risky behaviours.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample (N = 700) for a school‑based survey","Comprehensive assessment of individual, interpersonal, and environmental factors","Focus on a understudied Muslim adolescent population"],"limitations":["Cross‑sectional design; cannot infer causality","Convenience school sample limits generalisability","No measurement of mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/ijamh-2019-0221"}},{"id":8687,"doi":"10.1007/s10508-020-01713-y","pmid":"32383047","pmcid":null,"title":"Stability versus Fluidity of Adolescent Romantic and Sexual Attraction and the Role of Religiosity: A Longitudinal Assessment in Two Independent Samples of Croatian Adolescents","authors":"Cohen N, Becker I, Štulhofer A.","first_author":"Cohen N","journal":"Archives of sexual behavior","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Adolescents","Sexual Orientation","Religiosity","Sexual Fluidity","Sexual Attraction"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two independent longitudinal panel samples of Croatian high‑school students (N≈850 and N≈995) assessed sexual/romantic attraction (Kinsey‑scale items) and religiosity (single‑item) across waves.","sample_n":1844,"sample_text":"N = 849 and N = 995","population":"Adolescents (high‑school students) in Croatia","country":"Croatia","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Croatian adolescents, non‑heterosexual youths showed more changes in romantic and sexual attraction over time than heterosexual peers. More religious teens were initially more likely to report only heterosexual attraction, but religiosity did not predict later changes in attraction.","clinical_takeaway":"Religiosity shapes early self‑reports of attraction but does not appear to drive later fluidity; clinicians should consider cultural and religious context when supporting adolescent sexual development.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large longitudinal community samples","Two independent panels increase robustness","Clear focus on religiosity as a social factor"],"limitations":["Reliance on single‑item measures for attraction and religiosity","No assessment of mental‑health or partner/contextual variables","Limited detail on statistical effect sizes and confidence intervals"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01713-y"}},{"id":8690,"doi":"10.1515/ijamh-2019-0203","pmid":"32049650","pmcid":null,"title":"Factors associated with premarital sexual behaviour of adolescents who lived in a former prostitution area","authors":"Pradanie R, Armini NKA, Untari AD.","first_author":"Pradanie R","journal":"International journal of adolescent medicine and health","year":2020,"pub_types":["Journal Article"],"keywords":["Behavior","Adolescents","Religiosity","Transcultural Nursing","Premarital Sexual Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 109 adolescents living in a former prostitution area (purposive sampling).","sample_n":109,"sample_text":"109 students selected purposively","population":"Adolescents (students) from Surabaya, Indonesia.","country":"Indonesia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 109 adolescents living near a former prostitution area in Indonesia found that higher religiosity was linked to lower premarital sexual activity, while other factors like knowledge or family support were not significantly related.","clinical_takeaway":"Clinicians might consider discussing personal values and religiosity when counseling adolescents about sexual behavior, but evidence is limited.","confidence":0.6,"topic_tags":["adolescents","sexual_function","religiosity"],"strengths":["Focused on a specific, high‑risk community","Included a range of potential socioeconomic and cultural predictors"],"limitations":["Convenience, purposive sampling limits generalizability","No validated measures of sexual behaviour or predictor variables","Cross‑sectional design precludes causal inference","No control for many known confounders (e.g., mental health, partner influences)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/ijamh-2019-0203"}},{"id":8692,"doi":"10.1007/bf01542172","pmid":"7247721","pmcid":null,"title":"The interrelationship of sex guilt, sex behavior, and age in an adult sample","authors":"DiVasto PV, Pathak D, Fishburn WR.","first_author":"DiVasto PV","journal":"Archives of sexual behavior","year":1981,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of adult males ages 27‑73 using self‑report scales for sexual guilt and heterosexual behavior","sample_n":null,"sample_text":"Not specified in abstract","population":"adult males, 27‑73 years, likely convenience sample (size not reported)","country":"USA (assumed based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a sample of men aged 27‑73, higher sexual guilt was linked to less sexual activity, and older men reported more guilt but less activity. Age alone did not explain the guilt‑behavior relationship.","clinical_takeaway":"Clinicians should note that sexual guilt, not age, may more directly influence sexual activity levels in adult men.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Uses previously validated scales for guilt and behavior","Includes a wide adult age range","Clear statistical reporting of correlations"],"limitations":["Cross‑sectional design limits causal inference","No sample size reported; likely under‑powered for subgroup analyses","No control for key confounds (e.g., mental health, partner status)","Behavior measure does not separate masturbation from partnered activity"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542172"}},{"id":8693,"doi":"10.22605/rrh5476","pmid":"31675243","pmcid":null,"title":"Rural primary care providers' attitudes towards sexual and gender minorities in a midwestern state in the USA","authors":"Sharma A, Shaver JC, Stephenson RB.","first_author":"Sharma A","journal":"Rural and remote health","year":2019,"pub_types":["Journal Article"],"keywords":["USA","Primary Health Care","Cultural Competency","Attitude Of Health Personnel","Sexual And Gender Minorities"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 113 rural primary care providers, paper‑based questionnaire, convenience sample","sample_n":113,"sample_text":"113 rural primary care providers recruited via mail‑out survey (May–July 2017)","population":"Rural primary‑care physicians and other providers in Michigan, USA (N=113)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2019 survey of 113 rural Michigan primary‑care providers found generally favorable attitudes toward lesbian, gay, bisexual, and transgender patients, but stronger religiosity was linked to less favorable views. Prior LGBT‑health education was associated with better attitudes.","clinical_takeaway":"Training in LGBT health appears to improve provider attitudes; consider incorporating such education to enhance care in rural settings.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Uses validated attitude scales","Multivariable regression to identify correlates","Addresses an understudied rural provider population"],"limitations":["Cross‑sectional, cannot infer causality","Convenience sample, limited generalizability","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.22605/rrh5476"}},{"id":8695,"doi":"10.1007/s10943-019-00845-3","pmid":"31161470","pmcid":null,"title":"Exploring Religiosity and Spirituality in the Sexual Decision-Making of Black Gay and Bisexual Men","authors":"Dangerfield DT, Williams JE, Bass AS, Wynter T, Bluthenthal RN.","first_author":"Dangerfield DT","journal":"Journal of religion and health","year":2019,"pub_types":["Journal Article"],"keywords":["Health","Religion","Spirituality","Black Gay And Bisexual Men"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"In‑depth semi‑structured interviews with 26 Black gay and bisexual men in Los Angeles; thematic analysis of meanings of religiosity/spirituality and influence on partner choice and sexual risk.","sample_n":26,"sample_text":"Convenience sample of men who agreed to be interviewed; not a probability or clinical sample.","population":"Black gay and bisexual men (N=26) recruited in Los Angeles, USA","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 26 Black gay and bisexual men in Los Angeles revealed that personal religious and spiritual beliefs shape how they choose partners and manage sexual risk, suggesting that faith‑based contexts matter for sexual health interventions.","clinical_takeaway":"Clinicians should consider clients' religious and spiritual views when discussing sexual risk and relationship choices.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Rich, in‑depth qualitative data","Focus on understudied population","Explores cultural context of sexual decision‑making"],"limitations":["Small, non‑representative convenience sample","No quantitative measures of key constructs","No assessment of confounding variables (e.g., mental health, moral incongruence)","Findings not generalizable beyond this group"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":56,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-019-00845-3"}},{"id":8696,"doi":"10.1007/s10943-019-00791-0","pmid":"30911875","pmcid":"PMC6666393","title":"Sexual Orientation, Religious Coping, and Drug Use in a Sample of HIV-Infected African-American Men Living in the Southern USA","authors":"Skalski LM, Martin B, Meade CS.","first_author":"Skalski LM","journal":"Journal of religion and health","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["HIV/AIDS","Drug Use","Sexual Orientation","African-americans","Religious Coping"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 104 HIV‑infected African‑American men (40 heterosexual, 64 sexual minorities) assessing religious coping, drug‑use frequency and sexual orientation","sample_n":104,"sample_text":"40 heterosexuals; 64 sexual minorities (total N=104)","population":"HIV‑infected African‑American men living in the Southern USA","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a survey of 104 HIV‑positive African‑American men in the US South, researchers found that positive religious coping was linked to less drug use among heterosexual men but not among sexual‑minority men.","clinical_takeaway":"Religious coping may help reduce drug use for heterosexual HIV‑positive men, but additional support is needed for sexual‑minority patients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses understudied intersection of religion, sexual orientation, and drug use in HIV‑positive men","Includes both heterosexual and sexual‑minority participants"],"limitations":["Cross‑sectional design limits causal inference","Convenience sample; limited generalizability","Potential lack of validated scales for religious coping and drug‑use frequency"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-019-00791-0"}},{"id":8697,"doi":"10.1007/bf01541853","pmid":"7661653","pmcid":null,"title":"Volunteer bias in sexuality research","authors":"Strassberg DS, Lowe K.","first_author":"Strassberg DS","journal":"Archives of sexual behavior","year":1995,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":148,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational comparison of volunteers vs. non‑volunteers among >1000 introductory psychology students; two‑phase survey.","sample_n":1000,"sample_text":"over 1000 introductory psychology students","population":"Introductory psychology students (undergraduate, mixed gender).","country":"USA (assumed from authors’ affiliations, not specified in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that students who agreed to take part in sexuality research were more positive about sex, felt less guilt, and had more sexual experience than those who declined, raising concerns about how representative such research samples are.","clinical_takeaway":"Clinicians should note that findings from sexuality studies may reflect volunteer bias and might not apply to all individuals.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large initial sample (>1000)","Direct comparison of volunteers vs. non‑volunteers","Clear reporting of significant differences"],"limitations":["Convenience sample of psychology students limits generalizability","No information on validation of attitude/guilt scales","No pre‑registration or reporting of effect sizes"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":144,"citing_publications":278,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541853"}},{"id":8699,"doi":"10.1023/a:1018740210472","pmid":"9681121","pmcid":null,"title":"Force in women's sexual fantasies","authors":"Strassberg DS, Lockerd LK.","first_author":"Strassberg DS","journal":"Archives of sexual behavior","year":1998,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 137 college women, self‑report questionnaire","sample_n":137,"sample_text":"137 college women (convenience sample)","population":"college women (U.S.?)","country":"not stated","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 137 college women, more than half reported having fantasies about using force in sex. These women tended to feel less sexual guilt and more sexual openness, and having experienced sexual coercion themselves did not predict such fantasies.","clinical_takeaway":"Force‑related fantasies appear linked to broader sexual openness rather than past trauma; clinicians should avoid assuming they indicate pathology.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Relatively large (N>100) community sample for 1998","Multiple relevant constructs measured (fantasy type, guilt, erotophilia)","Addresses prior exposure to sexual coercion"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on unvalidated or single‑item fantasy measures","Key confounds (moral incongruence, mental health, partner context) not assessed"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":52,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1018740210472"}},{"id":8700,"doi":"10.1111/jora.12444","pmid":"31206883","pmcid":"PMC6581207","title":"Multidimensional Profiles of Religiosity Among Adolescents: Associations With Sexual Behaviors and Romantic Relationships","authors":"Vasilenko SA, Espinosa-Hernández G.","first_author":"Vasilenko SA","journal":"Journal of research on adolescence : the official journal of the Society for Research on Adolescence","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Latent class analysis of nationally representative Add Health data (N=10,149) examining religiosity profiles and later sexual behavior/relationships.","sample_n":10149,"sample_text":"Nationally representative longitudinal cohort (Add Health)","population":"U.S. adolescents followed into young adulthood","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study identified distinct patterns of adolescent religiosity and found that youths with broader religious involvement were less likely to engage in sexual activity and to be in romantic relationships later on.","clinical_takeaway":"Religious involvement may be linked to delayed sexual activity in teens, but clinicians should consider individual beliefs and other factors.","confidence":0.8,"topic_tags":["religiosity","adolescents","sexual_function","relationships"],"strengths":["Large, nationally representative sample","Longitudinal design allows temporal ordering","Multidimensional measurement of religiosity"],"limitations":["No control for moral incongruence or mental‑health covariates","Sexual behavior measured by self‑report only","No pre‑registration reported"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":26,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jora.12444"}},{"id":8701,"doi":"10.1111/jora.12445","pmid":"31206880","pmcid":"PMC6580859","title":"A Person-Centered Approach to the Study of Black Adolescent Religiosity, Racial Identity, and Sexual Initiation","authors":"Taggart T, Powell W, Gottfredson N, Ennett S, Eng E, Chatters LM.","first_author":"Taggart T","journal":"Journal of research on adolescence : the official journal of the Society for Research on Adolescence","year":2019,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"nationally representative survey (N=1,170) with latent profile and survival analyses","sample_n":1170,"sample_text":"National Survey of American Life-Adolescent, nationally representative","population":"Black adolescents in the United States","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a national survey of 1,170 Black teens, researchers identified four patterns of religiosity and racial identity that together explained about one‑fifth of the differences in when adolescents first have sex.","clinical_takeaway":"Religiosity and racial identity shape timing of sexual debut; clinicians should consider cultural and faith contexts when discussing sexual health with Black adolescents.","confidence":0.7,"topic_tags":["adolescents","religiosity","sexual_function"],"strengths":["Large, nationally representative sample","Use of latent profile and survival analyses","Focus on intersectionality of religiosity and racial identity"],"limitations":["Cross‑sectional design limits causal inference","No measurement of key sexual‑health confounds (e.g., mental health, trauma)","Unclear whether religiosity scales are validated"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jora.12445"}},{"id":8702,"doi":"10.1080/00918369.2019.1601439","pmid":"31017532","pmcid":null,"title":"Religious-Based Sexual Stigma and Psychological Health: Roles of Internalization, Religious Struggle, and Religiosity","authors":"Szymanski DM, Carretta RF.","first_author":"Szymanski DM","journal":"Journal of homosexuality","year":2020,"pub_types":["Journal Article"],"keywords":["Discrimination","Mental health","Religiosity","Heterosexism","Wellbeing"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 193 LGB adults recruited via Facebook and LGB listservs; mediation and moderated‑mediation analyses","sample_n":193,"sample_text":"online convenience sample recruited through paid Facebook ads and LGB‑related listservs and organizations","population":"LGB adults affiliated with a faith/religion (N=193)","country":"unspecified (likely United States/English‑language internet sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 193 gay, lesbian and bisexual adults who belong to a religion, experiencing religious‑based sexual stigma was linked to higher distress and lower wellbeing. This relationship operated through internalised stigma and religious struggle, especially for those with higher personal religiosity.","clinical_takeaway":"Clinicians should consider how religious‑based stigma and personal religiosity amplify mental‑health challenges for religious LGB clients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large (N≈200) for a niche population","Use of mediation and moderated‑mediation models","Focus on understudied intersection of religion and sexual minority stress"],"limitations":["Cross‑sectional, cannot infer causality","Convenience online recruitment limits generalisability","Possible shared‑method variance from self‑report"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":22,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2019.1601439"}},{"id":8703,"doi":"10.1177/1079063219843903","pmid":"31006381","pmcid":null,"title":"Comparing Recidivism of Sexual and Nonsexual Offenders: The Role of Humanist, Spiritual, and Religious Involvement","authors":"Stansfield R, O'Connor T, Duncan J, Hall S.","first_author":"Stansfield R","journal":"Sexual abuse : a journal of research and treatment","year":2020,"pub_types":["Journal Article"],"keywords":["Religion","Spirituality","Prison","Sex Offense","Reconviction"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational study of prison records linking participation in humanist/spiritual/religious programmes to later reconviction; regression analysis used.","sample_n":null,"sample_text":"Not reported in abstract","population":"Male prisoners (sexual and non‑sexual offenses) in correctional facilities.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether time spent in humanist, spiritual, or religious programmes while incarcerated was linked to lower re‑offending, especially for those previously convicted of sexual crimes. Higher programme participation was associated with reduced recidivism, but the effect varied by offence type.","clinical_takeaway":"No direct clinical guidance; suggests religious programmes may aid re‑integration for some offenders, but evidence is limited.","confidence":0.4,"topic_tags":["sexual_function","religiosity","relationships"],"strengths":["Use of official recidivism records","Focus on differential effects for sexual offenders"],"limitations":["No validated measure of HSR participation","Limited control for confounding variables","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063219843903"}},{"id":8704,"doi":"10.1186/s12889-019-6732-2","pmid":"30999890","pmcid":"PMC6472019","title":"Religiosity and sexual abstinence among Nigerian youths: does parent religion matter?","authors":"Somefun OD.","first_author":"Somefun OD.","journal":"BMC public health","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Sexual","Youth","Nigeria","Religion","Religiosity","Abstinence"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6472019","cited_by_count":22,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 2399 Nigerian youths (16‑24) from four purposively selected states; logistic regression analysis of self‑reported abstinence vs. religiosity.","sample_n":2399,"sample_text":"2399 male and female youth aged 16-24 years","population":"Nigerian youths, ages 16‑24, mixed gender, sampled from four states (purposive selection).","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 2,399 Nigerian youths, those who reported higher religiosity were about twice as likely to say they had never had sex, suggesting religious involvement is linked to sexual abstinence.","clinical_takeaway":"Higher self‑reported religiosity is associated with abstinence among Nigerian youths, but causality cannot be assumed.","confidence":0.8,"topic_tags":["religiosity","sexual_function","adolescents"],"strengths":["Large sample size for survey","Clear association reported with confidence intervals"],"limitations":["Cross‑sectional design limits causal inference","Unclear measurement validity for religiosity","Potential unmeasured confounders (e.g., moral attitudes, mental health)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":1,"mentioning":30,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-019-6732-2"}},{"id":8705,"doi":"10.1007/s10508-018-1335-z","pmid":"30963374","pmcid":null,"title":"Predicting Sexual Victimization Among College Students in Chile and Turkey: A Cross-Cultural Analysis","authors":"Schuster I, Krahé B.","first_author":"Schuster I","journal":"Archives of sexual behavior","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Chile","Turkey","Religiosity","Sexual Scripts","Sexual Victimization"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"two-wave longitudinal cross‑cultural study with N≈2000 total participants","sample_n":1983,"sample_text":"college students surveyed at two time points, 12‑month interval","population":"college students in Chile (n≈1098) and Turkey (n≈885), both genders","country":"Chile, Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a two‑year study of Chilean and Turkish college students, risky ideas about consensual sex and low sexual self‑esteem predicted higher chances of being sexually victimised, while higher religiosity generally lowered risk through safer sexual scripts.","clinical_takeaway":"Prevention programs should target risky sexual scripts and boost sexual self‑esteem to reduce victimisation risk.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large, cross‑cultural sample","Longitudinal design allowing temporal ordering","Path analysis tests mediation"],"limitations":["Unclear whether scales are validated","Key sexual‑health confounds (e.g., mental health, trauma) not measured","Self‑report victimization may be subject to recall bias"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":19,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1335-z"}},{"id":8706,"doi":"10.1080/00918369.2019.1591786","pmid":"30912733","pmcid":null,"title":"Not in the Same Mental Drawer: Internalized Sexual Stigma, Dissociation, and the Role of Religion in a Sample of Italian Gay Men","authors":"Nardelli N, Baiocco R, Tanzilli A, Lingiardi V.","first_author":"Nardelli N","journal":"Journal of homosexuality","year":2020,"pub_types":["Journal Article"],"keywords":["Dissociation","Religion","Homosexuality","Homophobia","Gay Men","Internalized Homophobia","Minority Stress","psychotherapy","Sexual Stigma","Internalized Sexual Stigma"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"quantitative survey of 120 self‑identified gay men in Italy; standardized questionnaires administered online/in‑person; convenience sampling","sample_n":120,"sample_text":"self‑identified gay men recruited via community channels; not a probability sample","population":"Italian gay men (Caucasian, n=120)","country":"Italy","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a sample of 120 Italian gay men, stronger internalised sexual stigma was linked to higher dissociative symptoms, especially when participants identified as Catholic, suggesting religion may intensify this relationship.","clinical_takeaway":"Clinicians should consider the impact of internalised stigma and religiosity on dissociation when working with gay clients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses validated scales for internalized stigma and dissociation","Explores moderating role of religiosity","Statistical moderation analysis adds depth"],"limitations":["Convenience sample limits generalisability","Cross‑sectional; cannot infer causality","No control for mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2019.1591786"}},{"id":8707,"doi":"10.1007/s10508-018-1380-7","pmid":"30790205","pmcid":null,"title":"The Influence of Parent and Parent-Adolescent Relationship Characteristics on Sexual Trajectories into Adulthood","authors":"Cheshire E, Kaestle CE, Miyazaki Y.","first_author":"Cheshire E","journal":"Archives of sexual behavior","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Family Characteristics","Sexual Partners","Longitudinal","Add Health"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Large nationally representative cohort (N=5385) followed 13 years, growth‑curve modeling of partner count.","sample_n":5385,"sample_text":"nationally representative longitudinal cohort (Add Health).","population":"Adolescents transitioning to young adulthood (U.S. Add Health sample).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 13‑year study of over 5,000 U.S. youths, family factors like parent religiosity, disapproval of sex, and closeness predicted fewer sexual partners in young adulthood, while single‑parent or blended families were linked to more partners.","clinical_takeaway":"Family communication and parental attitudes shape later sexual behavior; clinicians may consider family context when discussing sexual health with young adults.","confidence":0.7,"topic_tags":["sexual_function","relationships","adolescents"],"strengths":["Large, nationally representative sample","Long follow‑up (13 years) enabling trajectory analysis","Use of growth‑curve modeling to capture change over time"],"limitations":["Reliance on self‑reported partner counts","Limited information on mental‑health covariates","No pre‑registration reported"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1380-7"}},{"id":8708,"doi":"10.1371/journal.pone.0211322","pmid":"30759112","pmcid":"PMC6374069","title":"The prevalence of religiosity and association between religiosity and alcohol use, other drug use, and risky sexual behaviours among grade 8-10 learners in Western Cape, South Africa","authors":"Francis JM, Myers B, Nkosi S, Petersen Williams P, Carney T, Lombard C, Nel E, Morojele N.","first_author":"Francis JM","journal":"PloS one","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6374069","cited_by_count":36,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 20,227 learners from randomly selected schools with stratified multistage sampling.","sample_n":20227,"sample_text":"20 227 learners from 240 public schools","population":"Adolescent learners (grade 8‑10, ages 10‑23) in Western Cape, South Africa","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among over 20,000 South African students, those who attended religious services at least once or twice a month were less likely to drink alcohol, smoke, use cannabis, or engage in risky sex.","clinical_takeaway":"Higher religiosity is linked to lower self‑reported substance use and risky sex in adolescents, but causal effects remain uncertain.","confidence":0.9,"topic_tags":["religiosity","adolescents","relationships","sexual_function"],"strengths":["Very large, nationally representative sample","Clear operational definition of religiosity","Adjusted logistic regression with confidence intervals"],"limitations":["Cross‑sectional design cannot infer causality","Reliance on single‑item self‑report measures","No assessment of key sexual‑health confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":15,"contrasting":1,"mentioning":58,"citing_publications":83,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0211322"}},{"id":8709,"doi":"10.1111/jssr.12588","pmid":"31327874","pmcid":"PMC6640872","title":"Religiosity and Premarital Sexual Behaviors among Adolescents: An Analysis of Functional Form","authors":"Hayward GM.","first_author":"Hayward GM.","journal":"Journal for the scientific study of religion","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Adolescence","Religion","Sexual Behaviors","Functional Form"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"analysis of two waves of a national survey","sample_n":null,"sample_text":"large, nationally representative youth cohort (exact N not given in abstract)","population":"Adolescents in the United States (National Study of Youth and Religion)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using two waves of a national youth survey, the study finds that the link between how religious teens are and whether they have premarital sex is not a straight line; the more religious they become, the stronger the protective effect.","clinical_takeaway":"None – the findings pertain to general adolescent sexual behavior, not clinical concerns about pornography or sexual addiction.","confidence":0.8,"topic_tags":["religiosity","adolescents","sexual_function"],"strengths":["Large, nationally representative sample","Longitudinal data allowing temporal ordering","Methodologically compares linear vs nonlinear models"],"limitations":["No adjustment for mental‑health or relationship variables","No pre‑registration or power analysis reported","Focus on overall sexual activity, not specific behaviors like pornography use"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jssr.12588"}},{"id":8710,"doi":"10.1097/olq.0000000000000920","pmid":"30278028","pmcid":"PMC6521964","title":"Individual and Neighborhood Factors Associated With Sexual Behavior Classes in an Urban Longitudinal Sample","authors":"Green KM, Matson PA, Reboussin BA, Milam AJ, Furr-Holden CDM, Rabinowitz JA, Powell TW, Ialongo NS.","first_author":"Green KM","journal":"Sexually transmitted diseases","year":2019,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Longitudinal cohort of 1618 urban African‑American youth followed from age 6 to ~20; latent class analysis of sexual behaviors","sample_n":1618,"sample_text":"n = 1618","population":"Urban, predominantly African‑American emerging adults (mean age 20)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A study of 1,618 urban African‑American youths followed into early adulthood identified three patterns of sexual behaviour—high‑risk, low‑risk, and no‑risk. High‑risk teens were more likely to drop out of school, have substance‑use problems, arrests, pregnancies and STDs, and their neighbourhoods showed more poverty, crime, and less religiosity.","clinical_takeaway":"Neighborhood and social context are key drivers of sexual‑risk clusters; interventions should address community factors as well as individual behaviours.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, longitudinal community sample","Gender‑specific latent class analysis","Inclusion of multiple neighborhood variables"],"limitations":["No measurement of moral or religious incongruence related to sexual behavior","Masturbation not distinguished from other sexual acts","Potential self‑report bias in sexual behavior"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":5,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/olq.0000000000000920"}},{"id":8712,"doi":"10.1080/00224499.2018.1546371","pmid":"30557073","pmcid":null,"title":"Engage In or Refrain From? A Qualitative Exploration of Premarital Sexual Relations Among Female College Students in Tehran","authors":"Khalajabadi-Farahani F, Månsson SA, Cleland J.","first_author":"Khalajabadi-Farahani F","journal":"Journal of sex research","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"In‑depth interview study with 30 purposively sampled female college students in Tehran; thematic analysis of decision factors for premarital sex.","sample_n":30,"sample_text":"30 participants recruited purposively from government and private universities","population":"Female college students (unmarried & married) in Tehran, Iran","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 30 Iranian female college students revealed that marriage meaning, family expectations, religious values, social norms and sexual self‑efficacy shape whether they choose to have premarital sex.","clinical_takeaway":"None – findings are sociocultural and not directly applicable to clinical practice.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rich, contextual insight into cultural decision‑making","Includes both sexually experienced and abstinent participants","Explores multiple domains (family, religion, self‑efficacy)"],"limitations":["Small, non‑representative convenience sample","No quantitative measurement of constructs","Findings limited to educated women in Tehran"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":19,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2018.1546371"}},{"id":8713,"doi":"10.1007/s10943-018-0605-3","pmid":"29564617","pmcid":"PMC6473800","title":"The Role of Religious Socialization and Religiosity in African American and Caribbean Black Adolescents' Sexual Initiation","authors":"Taggart T, Gottfredson N, Powell W, Ennett S, Chatters LM, Carter-Edwards L, Eng E.","first_author":"Taggart T","journal":"Journal of religion and health","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Religiosity","Sexual Initiation","Black Adolescents","Religious Socialization"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional analysis of nationally representative survey (N=1170) using factor analysis, SEM, logistic regression","sample_n":1170,"sample_text":"National Survey of American Life-Adolescent, nationally representative","population":"Black adolescents (African American and Caribbean) in the U.S.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Black adolescents in the U.S., stronger religious socialization and higher personal religiosity are linked to a lower likelihood of having started sexual activity, with differences observed by ethnicity, gender, and age.","clinical_takeaway":"Higher religiosity may be associated with delayed sexual initiation, but causality cannot be inferred.","confidence":0.8,"topic_tags":["religiosity","sexual_function","adolescents"],"strengths":["Large, nationally representative sample","Use of advanced statistical modeling (SEM)","Clear operationalization of religious constructs"],"limitations":["Cross‑sectional design limits causal inference","Sexual initiation measured by single self‑report item","No measurement of key sexual‑health confounds (e.g., mental health, relationship context)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-018-0605-3"}},{"id":8714,"doi":"10.1007/s10943-017-0432-y","pmid":"28653265","pmcid":null,"title":"What's Religion Got to Do with It? Exploring College Students' Sexual and Reproductive Health Knowledge and Awareness of Sexual and Reproductive Health Services in Relation to Their Gender and Religiosity","authors":"Martin N, Baralt L, Garrido-Ortega C.","first_author":"Martin N","journal":"Journal of religion and health","year":2018,"pub_types":["Journal Article"],"keywords":["College Students","Religious Attendance","Sexual And Reproductive Health","Sexual And Reproductive Health Services","Religious Affiliation","Sexual And Reproductive Health Knowledge"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 996 undergraduates at a public university.","sample_n":996,"sample_text":"996 undergraduate students","population":"College students (undergraduate, mixed gender, racially/ethnically diverse).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among nearly 1,000 college students, those who attended religious services more often—especially women—tended to know less about sexual and reproductive health and were less aware of campus health services.","clinical_takeaway":"Clinicians should consider religiosity when delivering sexual health education to college women.","confidence":0.78,"topic_tags":["sexual_function","religiosity"],"strengths":["Large sample size","Focus on understudied link between religiosity and SRH knowledge","Gender‑specific analysis"],"limitations":["Cross‑sectional design limits causal inference","Unclear validation of knowledge and religiosity measures","No control for broader confounds (e.g., mental health, sexual experience)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":0,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-017-0432-y"}},{"id":8715,"doi":"10.1016/j.addbeh.2018.08.034","pmid":"30240979","pmcid":null,"title":"The associations between subdimensions of religiosity and illicit substance use among latino sexual minority men","authors":"Lamb KM, Brady JP, Gonzales M, Blashill AJ.","first_author":"Lamb KM","journal":"Addictive behaviors","year":2019,"pub_types":["Journal Article"],"keywords":["Latino","Substance Use","Religiosity","Sexual Minority"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online self‑report survey of 151 Latino sexual‑minority men; binary past‑month illicit substance use outcomes; logistic regression analyses","sample_n":151,"sample_text":"151 participants recruited via online advertisements; convenience sample","population":"Latino sexual‑minority men (mean age 24) recruited in San Diego County","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among Latino gay and bisexual men, privately practiced religiosity (like personal prayer) was linked to higher odds of using cocaine, opiates, amphetamines and sedatives, suggesting that internalized religious conflict may influence substance use.","clinical_takeaway":"Clinicians should consider clients' private religious beliefs as a potential factor in substance‑use risk for Latino sexual‑minority men.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Validated religiosity scale (DUREL)","Focus on distinct subcomponents of religiosity","Adjusted for acculturation"],"limitations":["Cross‑sectional design; no causal inference","Small convenience sample; limited power for rare substance outcomes","Limited control of key confounders (mental health, trauma, partner factors)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.addbeh.2018.08.034"}},{"id":8716,"doi":"10.1177/1079063218793632","pmid":"30146949","pmcid":null,"title":"Predictors of Sexual Aggression Perpetration Among Male and Female College Students: Cross-Cultural Evidence From Chile and Turkey","authors":"Schuster I, Krahé B.","first_author":"Schuster I","journal":"Sexual abuse : a journal of research and treatment","year":2019,"pub_types":["Comparative Study","Journal Article"],"keywords":["Chile","risk factors","Turkey","Sexual Scripts","Sexual Aggression Perpetration"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Two-wave longitudinal survey of college students in Chile and Turkey examining predictors of sexual aggression perpetration.","sample_n":null,"sample_text":"Not specified in abstract","population":"College students (male and female) in Chile and Turkey","country":"Chile, Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study followed Chilean and Turkish college students for a year and found that risky sexual scripts and certain personality factors predicted who later committed sexual aggression, while higher religiosity generally reduced those chances.","clinical_takeaway":"None – the findings relate to aggression risk factors, not clinical treatment of sexual health or compulsive behaviours.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Longitudinal design allows temporal ordering","Cross‑cultural comparison","Multiple psychosocial predictors examined"],"limitations":["Sample size and representativeness unclear","No control for key sexual‑health confounds (e.g., mental health, trauma)","Reliance on self‑report likely subject to social desirability"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":19,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1079063218793632"}},{"id":8718,"doi":"10.1007/s10508-018-1216-5","pmid":"29858727","pmcid":"PMC6274595","title":"Risk and Protective Factors for Sexual Health Outcomes Among Black Bisexual Men in the U.S.: Internalized Heterosexism, Sexual Orientation Disclosure, and Religiosity","authors":"Watson RJ, Allen A, Pollitt AM, Eaton LA.","first_author":"Watson RJ","journal":"Archives of sexual behavior","year":2019,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Sexual Health","Sexual Orientation","Black Msm","Sexuality Disclosure"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort, 225 Black bisexual men, 1‑year follow‑up, probability profiling of risk/protective factors","sample_n":225,"sample_text":"225 Black bisexual men (M age = 36 years, SD = 12) from Atlanta","population":"Black bisexual men in Atlanta, USA (N=225, mean age 36)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a sample of 225 Black bisexual men, higher internalized heterosexism predicted greater odds of STIs and HIV over one year, while being open about sexual identity and being religious lowered those risks.","clinical_takeaway":"Addressing internalized stigma and supporting identity disclosure may help reduce STI/HIV risk in Black bisexual men.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Longitudinal design with 1‑year follow‑up","Focus on understudied, high‑risk population","Uses probability profiling to examine combined risk/protective factors"],"limitations":["Self‑reported STI/HIV outcomes may be subject to reporting bias","No explicit measurement of key confounds (mental health, trauma, etc.)","Unclear whether scales used were validated in this population"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-018-1216-5"}},{"id":8723,"doi":"10.1111/jmft.12323","pmid":"29450921","pmcid":null,"title":"Sexual Minority Adults: A National Survey on Depression, Religious Fundamentalism, Parent Relationship Quality & Acceptance","authors":"Heiden-Rootes K, Wiegand A, Bono D.","first_author":"Heiden-Rootes K","journal":"Journal of marital and family therapy","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"web‑based anonymous survey of 384 U.S. sexual‑minority adults; moderated mediation analysis","sample_n":384,"sample_text":"384 participants recruited online, likely convenience sample","population":"sexual minority adults (age range up to 52 reported), United States, n=384","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 384 U.S. sexual‑minority adults, stronger religious fundamentalism was linked to higher depression, partly because of lower parental acceptance, especially when the overall parent‑child relationship was poorer.","clinical_takeaway":"Clinicians should consider family acceptance and religious background when addressing depression in sexual‑minority clients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonably large sample for a web survey","Tests a moderated mediation model","Focuses on under‑studied intersection of religion and family acceptance"],"limitations":["Cross‑sectional design limits causal inference","Measures not clearly validated in abstract","Self‑selected online sample may limit generalisability"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jmft.12323"}},{"id":8725,"doi":"10.1080/00926239708404415","pmid":"9094034","pmcid":null,"title":"Guilt about first intercourse: an antecedent of sexual dissatisfaction among college women","authors":"Moore NB, Davidson JK.","first_author":"Moore NB","journal":"Journal of sex & marital therapy","year":1997,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 570 never‑married college women; anonymous questionnaire; cross‑sectional correlational analysis","sample_n":570,"sample_text":"570 women (never‑married college students)","population":"never‑married college women (U.S. likely), convenience sample","country":"not specified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 570 college women, feelings of guilt about their first sexual encounter were linked to lower current sexual satisfaction, with family communication and personal comfort with sexuality also related to guilt.","clinical_takeaway":"Assess and address sexual guilt after first intercourse, as it may contribute to later dissatisfaction.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Large sample for a single‑site survey","Addresses understudied topic of guilt after first intercourse","Identifies multiple family‑related correlates"],"limitations":["Cross‑sectional design limits causal inference","Reliance on ad‑hoc, likely single‑item measures","No control for key confounds (mental health, trauma, moral/religious factors)","Convenience sample of college women limits generalisability"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":38,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239708404415"}},{"id":8726,"doi":"10.1007/s10943-016-0185-z","pmid":"26809242","pmcid":null,"title":"Role of Religion in Preventing Youth Sexual Activity in Malaysia: A Mixed Methods Study","authors":"Muhammad NA, Shamsuddin K, Sulaiman Z, Amin RM, Omar K.","first_author":"Muhammad NA","journal":"Journal of religion and health","year":2017,"pub_types":["Journal Article"],"keywords":["Youth","Sexual activity","Religiosity","Mixed Methods","Sexual Desire"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"mixed methods (survey N=1026, interviews N=15); random selection of colleges; logistic regression analysis","sample_n":1026,"sample_text":"1026 students (survey) and 15 interviewees","population":"college students in Klang Valley, Malaysia (young adults)","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 1,000 Malaysian college students, higher participation in religious activities was linked to a lower chance of having sex for females but not for males. Strong sexual desire could override religious influence.","clinical_takeaway":"Religiosity may help deter sexual activity in female students, but clinicians should consider individual desire levels and other factors.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Large quantitative sample","Mixed‑methods integration of survey and interview data","Gender‑specific analysis"],"limitations":["Cross‑sectional design limits causal inference","Religiosity measure not described; unclear validation","Key potential confounds (e.g., mental health, relationship status) not addressed"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":3,"mentioning":18,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-016-0185-z"}},{"id":8727,"doi":"10.1080/00918369.2017.1383116","pmid":"28929909","pmcid":"PMC5860995","title":"Relationship of Religiosity and Spirituality to Hazardous Drinking, Drug Use, and Depression Among Sexual Minority Women","authors":"Drabble L, Veldhuis CB, Riley BB, Rostosky S, Hughes TL.","first_author":"Drabble L","journal":"Journal of homosexuality","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Depression","risk factors","Spirituality","Hazardous Drinking","Religiosity","Protective Factors","Sexual Minority Women"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Large community survey (N=699) of sexual minority women in Chicago; cross‑sectional analysis of wave 3 data.","sample_n":699,"sample_text":"Wave 3 of the Chicago Health and Life Experiences of Women (CHLEW) study; N = 699.","population":"Sexual minority women (lesbian, bisexual), diverse race/ethnicity, adult age range.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a community sample of 699 sexual‑minority women, religiosity and spirituality did not protect against hazardous drinking or drug use, and their links to depression were explained by help‑seeking. Effects varied by race/ethnicity.","clinical_takeaway":"Religiosity/spirituality alone should not be assumed protective for substance‑use risk in sexual‑minority women.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample (N ≈ 700)","Inclusion of racial/ethnic subgroup analyses","Focus on both religiosity and spirituality"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report measures, possible measurement bias","Limited control of broader psychosocial confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918369.2017.1383116"}},{"id":8728,"doi":"10.1080/00224499.2017.1378309","pmid":"29043846","pmcid":null,"title":"\"Gay Equals White\"? Racial, Ethnic, and Sexual Identities and Attitudes Toward LGBT Individuals Among College Students at a Bible Belt University","authors":"Worthen MGF.","first_author":"Worthen MGF.","journal":"Journal of sex research","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,940 college students","sample_n":1940,"sample_text":"N = 1,940 (heterosexual n = 1,551; LGB n = 389)","population":"college students at a Bible Belt university, heterogeneous racial/ethnic and sexual identities","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among 1,940 college students in the US Bible Belt, attitudes toward LGBT people varied by race, ethnicity, sexual identity, religiosity, gender norms, and family views, showing that these intersecting factors shape how students think about LGBT individuals.","clinical_takeaway":"None – the study informs campus climate work, not clinical practice.","confidence":0.7,"topic_tags":["lgbtq","sexual_function","religiosity","prevalence"],"strengths":["Large sample size","Intersectional analysis of race/ethnicity and sexual identity","Inclusion of both heterosexual and LGB respondents"],"limitations":["Cross‑sectional design limits causal inference","Attitude measures not described; unknown psychometric quality","No control for mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":2,"mentioning":31,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2017.1378309"}},{"id":8730,"doi":"10.1007/s10896-017-9937-0","pmid":"30828128","pmcid":"PMC6396286","title":"Social Ecological Correlates of Family-Level Interpersonal and Environmental Microaggressions Toward Sexual and Gender Minority Adolescents","authors":"Gartner RE, Sterzing PR.","first_author":"Gartner RE","journal":"Journal of family violence","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Adolescence","Family Violence","Minority Stress","Sexual Minority","Gender Minority","Microaggressions"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"National online survey of 1,177 sexual and gender minority adolescents; cross‑sectional analysis of self‑reported microaggressions and contextual factors.","sample_n":1177,"sample_text":"National sample of SGMA (N = 1,177)","population":"SGMA (adolescents identifying as sexual or gender minorities); N=1,177; United States national sample.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US survey of 1,177 sexual‑ and gender‑minority teens, family microaggressions were more common among those out to parents, identifying as transgender or gender‑queer, or showing gender‑nonconforming traits. Family maltreatment and religiosity also predicted more microaggressions, while state protections reduced environmental microaggressions.","clinical_takeaway":"Family dynamics and state policies influence microaggression exposure; clinicians should assess family environment and support gender‑nonconforming youth.","confidence":0.6,"topic_tags":["sexual_function","gender","relationships"],"strengths":["Large, nationally‑recruited sample of SG adolescents","Multilevel analysis of individual, family, and structural factors","Identifies policy (non‑discrimination) as protective"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report measures, unclear validation of microaggression scales","Potential selection bias (online recruitment)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":26,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10896-017-9937-0"}},{"id":8732,"doi":"10.1111/sltb.12372","pmid":"28726309","pmcid":null,"title":"Religion, Sexual Orientation, and Suicide Attempts Among a Sample of Suicidal Adolescents","authors":"Shearer A, Russon J, Herres J, Wong A, Jacobs C, Diamond GM, Diamond GS.","first_author":"Shearer A","journal":"Suicide & life-threatening behavior","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross‑sectional survey of 129 suicidal adolescents; linear and negative‑binomial regressions examining religiosity × sexual orientation interaction on suicide attempts","sample_n":129,"sample_text":"N = 129 suicidal adolescents","population":"adolescents (N=129) recruited for suicide‑risk assessment; US sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among 129 adolescents who had attempted suicide, higher religiosity was linked to more suicide attempts in those who reported same‑sex attraction, but to fewer attempts in those who reported only opposite‑sex attraction.","clinical_takeaway":"Clinicians should consider how religious conflict may differentially affect suicide risk in LGBTQ‑identifying youth.","confidence":0.8,"topic_tags":["religiosity","sexual_function","adolescents","csbd"],"strengths":["Uses appropriate regression models for count data","Addresses interaction between religiosity and sexual orientation","Focuses on a high‑risk adolescent sample"],"limitations":["Cross‑sectional design limits causal inference","Small sample for subgroup analyses","Limited measurement detail; unclear validity of scales"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/sltb.12372"}},{"id":8734,"doi":"10.1007/s10508-017-0979-4","pmid":"28357526","pmcid":null,"title":"Religion and Sexual Identity Fluidity in a National Three-Wave Panel of U.S. Adults","authors":"Scheitle CP, Wolf JK.","first_author":"Scheitle CP","journal":"Archives of sexual behavior","year":2018,"pub_types":["Journal Article"],"keywords":["Sexual Orientation","Religiosity","Sexual Identity","Sexual Fluidity"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"three-wave nationally representative panel survey (N=1034) of U.S. adults, examined changes in self‑reported sexual identity and religiosity over 4 years","sample_n":1034,"sample_text":"nationally representative panel of US adults (N = 1034) surveyed in 2010, 2012, 2014","population":"U.S. adults, 18+ (representative sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a national US panel surveyed three times over four years, about 2.4 % of adults changed their sexual identity. More religious people, especially sexual minorities, were likelier to show such fluidity.","clinical_takeaway":"None – findings describe population trends, not clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative longitudinal sample","Three measurement waves allow detection of fluidity","Examines interaction of religiosity with sexual minority status"],"limitations":["Key constructs measured with simple self‑report items, limited validation","Limited control of psychological or trauma‑related confounds","No reporting of effect sizes or confidence intervals"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":18,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-017-0979-4"}},{"id":8736,"doi":"10.1363/psrh.12020","pmid":"28253427","pmcid":"PMC6668721","title":"Sexual Initiation Patterns of U.S. Sexual Minority Youth: A Latent Class Analysis","authors":"Goldberg SK, Halpern CT.","first_author":"Goldberg SK","journal":"Perspectives on sexual and reproductive health","year":2017,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"secondary analysis of nationally representative longitudinal cohort (Add Health) using latent class analysis and multinomial logistic regression","sample_n":2154,"sample_text":"Large, nationally representative adolescent cohort (Add Health) followed from 1994‑1995 to 2008","population":"U.S. sexual minority adolescents (N≈2154, 1,628 females, 526 males)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study identified four distinct patterns of sexual debut among U.S. sexual‑minority youth, differing by timing, type (vaginal, oral, anal) and spacing of first sexual acts, and linked these patterns to socioeconomic status, race/ethnicity, religiosity and victimisation.","clinical_takeaway":"Clinicians should recognise diverse debut trajectories among sexual‑minority youth and consider broader sociocultural factors when providing sexual‑health counseling.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large, nationally representative sample","Longitudinal data source","Use of latent class analysis to capture heterogeneous patterns"],"limitations":["Self‑report of sensitive behaviors","No validated scales for constructs","Limited control for mental‑health or dyadic factors"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":2,"mentioning":14,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1363/psrh.12020"}},{"id":8739,"doi":"10.1097/qai.0000000000001127","pmid":"27391388","pmcid":null,"title":"Religion and HIV Sexual Risk Among Men Who Have Sex With Men in China","authors":"Pan SW, Zhang Z, Li D, Carpiano RM, Schechter MT, Ruan Y, Spittal PM.","first_author":"Pan SW","journal":"Journal of acquired immune deficiency syndromes (1999)","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 400 MSM in Beijing and Tianjin, China, 2013‑2014","sample_n":400,"sample_text":"n = 400","population":"men who have sex with men, recruited for a sexual health survey","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 400 Chinese men who have sex with men, Buddhist affiliation was linked to higher odds of unsafe anal sex, while Muslim affiliation was linked to lower odds. Christian men who privately practiced religion had lower odds of unsafe sex. Religious activity also related to reports of forced sex.","clinical_takeaway":"Clinicians should consider how different religious affiliations may influence HIV risk behaviours among MSM.","confidence":0.6,"topic_tags":["religiosity","sexual_function"],"strengths":["Relatively large sample for a focused MSM study in China","Use of multivariable logistic regression with confidence intervals","Differentiates among religious traditions"],"limitations":["Cross‑sectional design limits causal inference","Potential unmeasured confounders (e.g., mental health, partner status)","Self‑report of risky sexual behavior may be biased"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/qai.0000000000001127"}},{"id":8741,"doi":"10.1007/s10995-016-2041-x","pmid":"27461018","pmcid":"PMC5106295","title":"Influential Factors of Puerto Rican Mother-Child Communication About Sexual Health Topics","authors":"Torres MI, Granberry P, Person S, Allison J, Rosal M, Rustan S.","first_author":"Torres MI","journal":"Maternal and child health journal","year":2016,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual Health","Puerto Rican","Mother–child Communication","Marianismo","Ethnographic Survey"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 193 Puerto Rican mothers selected randomly from a community‑based participatory project; ethnographic interview assessing number of sexual health topics discussed with children aged 10‑19.","sample_n":193,"sample_text":"193 mothers selected randomly for an ethnographic interview.","population":"Puerto Rican mothers (aged adult/ middle‑aged) with children 10‑19 years in a U.S. urban northeastern community (N=193).","country":"United States (Puerto Rican community)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 193 Puerto Rican mothers, older child age, mothers’ confidence, and cultural attitudes (marianismo) were linked to more frequent discussions of sexual‑health topics, while strong familismo beliefs reduced such communication.","clinical_takeaway":"Interventions that boost mothers’ confidence and address cultural norms may improve sexual‑health communication with adolescents.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Random selection of participants within community","Multivariate modeling of several cultural and neighborhood variables","Focus on under‑studied Puerto Rican mother‑child communication"],"limitations":["Cross‑sectional design limits causal inference","Communication measured by self‑report interview, not validated scale","No assessment of child‑reported outcomes or broader psychosocial confounders"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10995-016-2041-x"}},{"id":8745,"doi":"10.1016/j.jadohealth.2016.06.003","pmid":"27491340","pmcid":"PMC8596160","title":"The Association Between Sexual Health and Physical, Mental, and Social Health in Adolescent Women","authors":"Hensel DJ, Nance J, Fortenberry JD.","first_author":"Hensel DJ","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2016,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Depression","Adolescent","Education","Crime","Sexual Health","Self-esteem","Substance Use"],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["sexual_health","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Longitudinal cohort of 387 adolescent women followed for 10 years; quarterly partner‑specific interviews linked to annual health questionnaires; mixed‑effects regression controlling age and race/ethnicity.","sample_n":387,"sample_text":"N = 387 adolescent women recruited for a 10‑year longitudinal study","population":"Adolescent females, ages 14‑17 at enrollment, United States; N = 387","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 10‑year study of 387 teen girls, healthier romantic sexual experiences were linked to lower drug use, less depression, higher self‑esteem and better social integration.","clinical_takeaway":"Promoting positive, consensual sexual development may support broader adolescent mental and social health.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, 10‑year longitudinal dataset","Repeated, partner‑specific sexual health measures","Multivariate mixed‑effects modeling"],"limitations":["Sexual health construct not based on validated scale","Limited control for key confounds (e.g., moral incongruence, masturbation)","No pre‑registration or power justification reported"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":46,"citing_publications":81,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2016.06.003"}},{"id":8746,"doi":"10.1080/00224499.2016.1188877","pmid":"27356216","pmcid":null,"title":"The Sexual Possible Selves and Strategies of First-Semester College Students: What Do They Hope for and Fear and How Do They Plan to Get There?","authors":"Anders KM, Olmstead SB, Johnson EI.","first_author":"Anders KM","journal":"Journal of sex research","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 282 first‑semester college students; open‑ended questions coded, chi‑square and logistic regression analyses","sample_n":282,"sample_text":"first‑semester college students recruited for a survey on sexual possible selves","population":"first‑semester college students (N=282), likely convenience sample from one university","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"College freshmen described what they hope for and fear about sex next year. Common goals included abstaining, forming relationships, staying healthy, and exploring, while fears focused on reputation, risky behaviour, and assault. These hopes and fears differed by gender, sexual experience, relationship status, and religiosity.","clinical_takeaway":"Sexual health programmes should address varied hopes, fears, and religious influences among first‑year students.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large (N=282) community sample of first‑semester students","Mixed qualitative‑quantitative approach","Statistical analyses (chi‑square, logistic regression) reported"],"limitations":["Cross‑sectional convenience sample; limited generalisability","No validated scales for possible selves; coding may be subjective","Limited control of key confounds (moral incongruence, mental health, trauma)"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2016.1188877"}},{"id":8747,"doi":"10.1371/journal.pone.0156809","pmid":"27309528","pmcid":"PMC4911065","title":"The Importance of Religiosity/Spirituality in the Sexuality of Pregnant and Postpartum Women","authors":"Cantarino SG, Pinto JM, Fabião JA, García AM, Abellán MV, Rodrigues MA.","first_author":"Cantarino SG","journal":"PloS one","year":2016,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0156809&type=printable","cited_by_count":14,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"qualitative ethnographic study with interviews/focus groups of pregnant and postpartum women in Spain and Portugal, comparing urban vs rural contexts","sample_n":null,"sample_text":"not reported in abstract; qualitative convenience sample","population":"pregnant and postpartum women (Spain, Portugal)","country":"Spain; Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study explored how pregnant and postpartum women in Spain and Portugal experience their sexuality in relation to their religious beliefs, finding that religious and family expectations shape sexual attitudes, especially in rural areas.","clinical_takeaway":"Clinicians should consider religious and family influences when discussing sexual health with pregnant or postpartum women.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Addresses understudied intersection of religiosity and sexuality in pregnancy/postpartum","Provides rich contextual qualitative data","Compares urban and rural settings"],"limitations":["No validated measurement instruments for sexuality or religiosity","Small, non‑representative convenience sample","Lacks quantitative analysis; limited statistical rigor"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0156809"}},{"id":8751,"doi":"10.1007/s10964-016-0447-9","pmid":"26932719","pmcid":null,"title":"Time Out from Sex or Romance: Sexually Experienced Adolescents' Decisions to Purposefully Avoid Sexual Activity or Romantic Relationships","authors":"Byers ES, O'Sullivan LF, Brotto LA.","first_author":"Byers ES","journal":"Journal of youth and adolescence","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Prevention","Education","Adolescents","Sexual Avoidance","Sexual Coercion","Romantic Avoidance"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 411 sexually experienced adolescents (16‑21 y) with logistic regression analyses; mixed‑methods includes qualitative reasons for sexual/romantic avoidance","sample_n":411,"sample_text":"411 participants recruited via an online questionnaire","population":"adolescents (sexually experienced, 56 % female)","country":"Not specified (likely Canada/USA based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 411 sexually experienced 16‑21‑year‑olds found that many purposefully avoid sex (27 %) or romantic relationships (47 %). Reasons include lack of pleasure, values, fear, and prior negative experiences. Religious youths and those who experienced sexual coercion were more likely to avoid sex, and sexually distressed boys avoided romance.","clinical_takeaway":"Adolescents may choose abstinence for personal or trauma‑related reasons; clinicians should assess underlying motives and past coercion rather than assuming a universal drive toward sexual activity.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large (n>400) community sample of adolescents","Mixed‑methods adds depth to quantitative findings","Examines under‑studied phenomenon of intentional sexual/romantic avoidance"],"limitations":["Cross‑sectional design cannot infer causality","Reliance on self‑report; validation of scales not described","Limited control for key confounds (e.g., mental health, moral incongruence)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":19,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10964-016-0447-9"}},{"id":8752,"doi":"10.1016/j.drugalcdep.2016.01.022","pmid":"26857897","pmcid":"PMC4792700","title":"Religiosity as a protective factor for hazardous drinking and drug use among sexual minority and heterosexual women: Findings from the National Alcohol Survey","authors":"Drabble L, Trocki KF, Klinger JL.","first_author":"Drabble L","journal":"Drug and alcohol dependence","year":2016,"pub_types":["Comparative Study","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["alcohol consumption","Women","risk factors","Religiosity","Protective Factors","Sexual Minorities"],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large, probability‑based national survey (N≈11,000) analyzed cross‑sectionally","sample_n":11169,"sample_text":"11,169 women from three National Alcohol Survey waves (2000, 2005, 2010)","population":"women (heterosexual and sexual minority) in the United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a U.S. survey of over 11,000 women, stronger religious involvement was linked to lower rates of heavy drinking and illicit drug use for both heterosexual and sexual‑minority women, though the protective effect was weaker for sexual‑minority groups.","clinical_takeaway":"Higher religiosity may be associated with reduced substance‑use risk in women, but clinicians should consider individual and community contexts, especially for sexual‑minority patients.","confidence":0.8,"topic_tags":["religiosity","sexual_function","gender","lgbtq"],"strengths":["large, nationally representative sample","includes both sexual minority and heterosexual women","uses standard public‑health outcomes (hazardous drinking, drug use)"],"limitations":["cross‑sectional; cannot infer causality","no detail on measurement validation in abstract","limited control for psychosocial confounds"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":1,"mentioning":32,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.drugalcdep.2016.01.022"}},{"id":8753,"doi":"10.1016/j.jpag.2015.11.012","pmid":"26655691","pmcid":null,"title":"Age at Time of Initial Sexual Intercourse and Health of Adolescent Girls","authors":"Lara LAS, Abdo CHN.","first_author":"Lara LAS","journal":"Journal of pediatric and adolescent gynecology","year":2016,"pub_types":["Review","Journal Article"],"keywords":["Sexuality","Adolescent","Adolescence","Young People","Sexual Debut","Coitarche","Sexarche"],"is_oa":false,"oa_url":null,"cited_by_count":62,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of existing studies; no new empirical data collected.","sample_n":null,"sample_text":"Review of 28 studies; no primary sample","population":"Adolescent girls (age of first sexual intercourse)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises evidence that girls who have sex for the first time at 14 years or younger tend to have higher rates of risky sexual behaviour, depression, and lower self‑esteem, while later debut (around 16) is linked to better physical and psychological health.","clinical_takeaway":"Delaying first sexual intercourse may reduce risk of adverse health outcomes in adolescent girls.","confidence":0.5,"topic_tags":["sexual_function","adolescents"],"strengths":["Broad literature coverage up to 2014","Identifies multiple psychosocial risk factors"],"limitations":["Lacks systematic review methodology","No quantitative synthesis or meta‑analysis","No primary data; cannot assess measurement quality"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":5,"contrasting":0,"mentioning":83,"citing_publications":135,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpag.2015.11.012"}},{"id":8756,"doi":"10.1080/13691058.2015.1091509","pmid":"26489851","pmcid":"PMC4805462","title":"The role of the Black Church in the lives of young Black men who have sex with men","authors":"Quinn K, Dickson-Gomez J, Kelly JA.","first_author":"Quinn K","journal":"Culture, health & sexuality","year":2016,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Youth","Religion","Black Men Who Have Sex With Men","Black Church"],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"interviews with pastors (n=21) and young Black men who have sex with men (n=30); cross‑sectional, purposive sampling","sample_n":51,"sample_text":"30 YBMSM and 21 pastors","population":"young Black gay/bisexual men (US)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with Black church pastors and young Black gay/bisexual men show that, despite homonegative attitudes in many churches, religious involvement remains important. Youth often conceal their sexuality to avoid shame, balancing faith and identity.","clinical_takeaway":"Clinicians working with Black sexual minority youth should recognise the continued importance of faith communities and the stress of concealing sexual identity.","confidence":0.8,"topic_tags":["sexual_function","csbd","relationships"],"strengths":["Provides voices of both clergy and youth","Addresses understudied intersection of race, religion, and sexuality","Large enough qualitative sample to reach thematic saturation"],"limitations":["Convenience purposive sampling limits generalisability","No validated scales; reliance on self‑report interview data","Cross‑sectional; cannot infer how experiences change over time"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":92,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2015.1091509"}},{"id":8757,"doi":"10.1111/asap.12098","pmid":"26807046","pmcid":"PMC4723102","title":"Perceived Discrimination and Social Relationship Functioning among Sexual Minorities: Structural Stigma as a Moderating Factor","authors":"Doyle DM, Molix L.","first_author":"Doyle DM","journal":"Analyses of social issues and public policy : ASAP","year":2015,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Two cross‑sectional convenience samples (online N = 214; community N = 94) of U.S. sexual‑minority adults; structural stigma coded at state level; multilevel moderation analyses.","sample_n":308,"sample_text":"Total N = 308 (Study 1 N = 214; Study 2 N = 94)","population":"sexual minority men and women residing in the United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that in U.S. states with more anti‑LGBT policies, the negative impact of perceived discrimination on friendships, loneliness, and family relationships was stronger for sexual‑minority adults.","clinical_takeaway":"Policy environment can intensify the harmful effects of discrimination on social well‑being for sexual minorities.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large‑scale state‑level structural stigma coding","Use of multilevel modeling to test moderation","Replication across two independent samples"],"limitations":["Cross‑sectional design limits causal inference","Convenience sampling reduces generalizability","Unclear whether discrimination and relationship measures are validated"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":29,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/asap.12098"}},{"id":8758,"doi":"10.1186/s12978-015-0069-9","pmid":"26293812","pmcid":"PMC4546127","title":"Influence of parental factors on adolescents' transition to first sexual intercourse in Nairobi, Kenya: a longitudinal study","authors":"Okigbo CC, Kabiru CW, Mumah JN, Mojola SA, Beguy D.","first_author":"Okigbo CC","journal":"Reproductive health","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4546127","cited_by_count":36,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Longitudinal cohort of 1,927 unmarried adolescents from Nairobi slums, two waves one year apart, weighted sample.","sample_n":1927,"sample_text":"Weighted n = 1927 at baseline; follow‑up after one year.","population":"Unmarried adolescents aged 12‑19 years living in urban slums of Nairobi, Kenya","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In Nairobi slums, teens whose mothers (boys) or fathers (girls) talked with them about sex were less likely to have sex for the first time within a year, suggesting parent‑child communication can delay sexual debut.","clinical_takeaway":"Encouraging open, cross‑gender parent‑teen communication may help postpone sexual initiation among high‑risk youths.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, community‑based sample","Longitudinal design allows temporal ordering","Controls for several demographic and psychosocial covariates"],"limitations":["Measures of parental factors not described as validated scales","No assessment of sexual attitudes or moral incongruence","One‑year follow‑up may miss longer‑term patterns"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":9,"contrasting":1,"mentioning":64,"citing_publications":90,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-015-0069-9"}},{"id":8759,"doi":"10.1007/s10943-014-9929-9","pmid":"25160613","pmcid":null,"title":"Exploring Latino College Students' Sexual Behaviors in Relation to Their Sexual Attitudes, Religiousness, and Spirituality","authors":"Luquis RR, Brelsford GM, Pérez MA.","first_author":"Luquis RR","journal":"Journal of religion and health","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 230 Latino and non‑Latino undergraduate students examining self‑reported sexual behaviors, attitudes, religiosity and spirituality.","sample_n":230,"sample_text":"230 undergraduate college students at a mid‑sized university in the western USA","population":"college students (mostly US‑based, 230 participants, mixed gender, Latino and non‑Latino)","country":"USA","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 230 US college students examined how religious and spiritual beliefs relate to sexual attitudes and behaviours, finding that for Latino students, spirituality and attitudes both predict sexual behaviour, while for non‑Latinos only attitudes do.","clinical_takeaway":"Educators should consider cultural and spiritual factors when addressing sexual health with Latino college students.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relatively large college sample (N=230)","Inclusion of both Latino and non‑Latino participants","Measures of religiosity/spirituality alongside sexual attitudes"],"limitations":["Cross‑sectional design, cannot infer causality","Limited control of key confounds (e.g., mental health, partner effects)","Unclear whether behavioral measures are validated"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":7,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-014-9929-9"}},{"id":8761,"doi":"10.1007/s10508-015-0534-0","pmid":"26063533","pmcid":"PMC5565759","title":"Religious Influence on Older Americans' Sexual Lives: A Nationally-Representative Profile","authors":"Iveniuk J, O'Muircheartaigh C, Cagney KA.","first_author":"Iveniuk J","journal":"Archives of sexual behavior","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexuality","Religion","Latent Class Analysis","Older Adulthood"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Nationally-representative survey (NSHAP), cross‑sectional latent‑class analysis of religious influence and self‑reported sexual satisfaction.","sample_n":null,"sample_text":"National Social Life, Health, and Aging Project (large national sample; exact N not given in abstract)","population":"Older American adults (aged 50+), nationally representative","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative US sample of older adults, stronger religious influence on sexual expression was linked to higher self‑reported sexual satisfaction for men, but not for women, even after adjusting for demographics, church attendance and health.","clinical_takeaway":"Religious beliefs may shape sexual satisfaction for older men; clinicians should consider spiritual context when discussing sexual health.","confidence":0.8,"topic_tags":["religiosity","sexual_function","gender"],"strengths":["Large, nationally representative sample","Gender‑specific analysis","Uses latent‑class methodology to capture heterogeneity"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on self‑report satisfaction measures with unclear validation","Limited control for key sexual‑health confounds (e.g., relationship status, mental health)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0534-0"}},{"id":8762,"doi":"10.1371/journal.pone.0129286","pmid":"26047505","pmcid":"PMC4457813","title":"Determinants of Sexual Activity and Pregnancy among Unmarried Young Women in Urban Kenya: A Cross-Sectional Study","authors":"Okigbo CC, Speizer IS.","first_author":"Okigbo CC","journal":"PloS one","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4457813","cited_by_count":38,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"baseline data from five urban Kenyan areas, weighted N=2020, multivariate Cox and logistic regression","sample_n":2020,"sample_text":"weighted N=2020","population":"unmarried women age 15‑24, never married, not co‑habiting","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 2,000 unmarried Kenyan women aged 15‑24, half had ever had sex and 15 % had been pregnant. Higher education, religiosity and city of residence were linked to later sexual debut and lower chance of teenage pregnancy.","clinical_takeaway":"Education and contraceptive counselling may help delay sexual debut and reduce unintended teenage pregnancies.","confidence":0.8,"topic_tags":["sexual_function","religiosity","adolescents"],"strengths":["Large community sample from multiple cities","Weighted analysis to improve representativeness","Use of multivariate Cox and logistic models"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report for sexual behavior and pregnancy","No measurement of key psychosocial confounds (mental health, moral factors, trauma)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":12,"contrasting":3,"mentioning":49,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0129286"}},{"id":8763,"doi":"10.1007/s10943-013-9777-z","pmid":"24068628","pmcid":null,"title":"Hiding the word: examining the relationship between a new measure of religiosity and sexual behavior","authors":"Young M, Denny G, Penhollow T, Palacios R, Morris D.","first_author":"Young M","journal":"Journal of religion and health","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of college students; convenience sample; cross‑sectional analysis of self‑reported sexual behaviors","sample_n":null,"sample_text":"college student sample, size not reported in abstract","population":"college students (US), both sexes","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created a new questionnaire that measures the intellectual side of religiosity and tested whether it explains differences in college students’ sexual experiences. After accounting for age and overall religiosity, the new scale helped predict whether students had ever had certain sexual acts, but it was less predictive of how often those acts occurred.","clinical_takeaway":"Religious beliefs, especially intellectual aspects, may influence whether individuals engage in sexual activities, but this study cannot prove it causes those behaviors.","confidence":0.6,"topic_tags":["religiosity","sexual_function"],"strengths":["Introduces a novel intellectual dimension of religiosity","Controls for age and generic religiosity","Examines multiple sexual behaviors"],"limitations":["Cross‑sectional design limits causal inference","New religiosity scale lacks established validation","No measurement of key confounds (e.g., moral incongruence, mental health)","Sample limited to college students, may not generalize"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-013-9777-z"}},{"id":8764,"doi":"10.1007/bf02088973","pmid":"12337613","pmcid":null,"title":"Contraceptive embarrassment and contraceptive behavior among young single women","authors":"Herold ES.","first_author":"Herold ES.","journal":"Journal of youth and adolescence","year":1981,"pub_types":["Journal Article"],"keywords":["Behavior","Social behavior","Parents","Contraception","Sex behavior","Psychosocial factors","United States","Family Planning","Attitude","Research Report","Contraceptive Usage--women","Statistical Regression","Premarital Sex Behavior","Contraceptive Availability"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 265 non‑virgin high‑school/university women, convenience sample, simple multiple regression analysis.","sample_n":265,"sample_text":"265 non‑virgin high‑school and university females currently dating","population":"young unmarried females (high‑school and university) in the United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed 265 young, unmarried U.S. women to see what predicts feeling embarrassed about using contraception and how that embarrassment relates to actual contraceptive use. Parental attitudes and sexual guilt were the strongest predictors of embarrassment, which was linked to lower contraceptive use.","clinical_takeaway":"Feelings of embarrassment, shaped by parents and guilt, may reduce contraceptive use; clinicians should address these attitudes when counseling young women.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonably sized sample for a survey","Multivariate regression to identify predictors"],"limitations":["Embarrassment scale not validated","Convenience sample limits generalizability","Key confounds (e.g., mental health, partner effects) not measured"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":20,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf02088973"}},{"id":8767,"doi":"10.1007/s10508-015-0499-z","pmid":"25724451","pmcid":null,"title":"Characteristics of youth who report early sexual experiences in Sweden","authors":"Kågesten A, Blum RW.","first_author":"Kågesten A","journal":"Archives of sexual behavior","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"National web‑based survey of Swedish youth (N≈5,300); random sampling, post‑stratification weighting; logistic regression analysis.","sample_n":5321,"sample_text":"Final analytic sample after weighting.","population":"Swedish adolescents/young adults aged 16‑28 (mostly 16‑20); 49% female.","country":"Sweden","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Swedish national survey of over 5,000 young people, about one‑fifth reported having first sex at age 14 or younger. Early sex was linked to factors such as lower education, early puberty, bisexual identity, rural residence (girls), and having older partners. Higher religiosity and conservative attitudes lowered the odds for girls.","clinical_takeaway":"Early sexual debut is associated with a range of social and developmental factors; clinicians should consider broader context rather than assuming pathology.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample with weighting","Multivariate logistic regression controlling for many sociodemographic factors","Separate analyses by gender"],"limitations":["Cross‑sectional; cannot infer causality","Low response rate (24 %) may introduce non‑response bias","Limited assessment of mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0499-z"}},{"id":8768,"doi":"10.1080/00926238908403826","pmid":"2614854","pmcid":null,"title":"Single parents: interaction of parenting and sexual issues","authors":"Darling CA, Davidson JK, Parish WE.","first_author":"Darling CA","journal":"Journal of sex & marital therapy","year":1989,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 155 single parents recruited from a single‑parent organization; cross‑sectional questionnaire assessing parenting roles, sexual guilt and satisfaction.","sample_n":155,"sample_text":"155 single parents (members of a single‑parenting organization)","population":"single mothers and fathers, members of a single‑parenting organization, predominantly adult (middle‑aged) volunteers","country":"Not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed 155 single mothers and fathers about how raising children affected their sexual lives. It found differences between genders in parent‑child relationships and that sexual satisfaction for women was linked to how they felt about caring for their children.","clinical_takeaway":"Sexual satisfaction among single parents may be tied to parenting stress; clinicians should consider family dynamics when addressing sexual wellbeing.","confidence":0.6,"topic_tags":["sexual_function","relationships"],"strengths":["Addresses an understudied population (single parents)","Relatively large sample for a niche topic","Considers both parenting and sexual satisfaction"],"limitations":["Convenience sample from a single‑parent organization limits generalizability","Measures appear ad‑hoc and not validated","Cross‑sectional design precludes causal conclusions","Key confounds (moral, mental health, masturbation) not assessed"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238908403826"}},{"id":8770,"doi":"10.1080/07448481.2014.975721","pmid":"25338276","pmcid":null,"title":"Development of a measure of college students' adherence to religious doctrine concerning sexual behavior","authors":"Victor EC, Bowman H, Thompson RJ.","first_author":"Victor EC","journal":"Journal of American college health : J of ACH","year":2015,"pub_types":["Journal Article"],"keywords":["Sexual behavior","Reliability And Validity","Condom Use","College Students","Sexual Risk","College Health"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey development with 483 undergraduates; online convenience sample","sample_n":483,"sample_text":"Four hundred eighty‑three undergraduates aged 18 to 26 recruited via an online survey during the 2012‑2013 academic year.","population":"college students (age 18‑26)","country":"United States (presumed from journal and author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a 14‑item questionnaire measuring how closely college students follow their religion’s rules about sex. It showed good reliability and related in expected ways to religiosity and self‑reported sexual behavior.","clinical_takeaway":"The new ARDSB scale can help researchers explore how religious beliefs shape sexual health decisions among students.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large undergraduate sample (N≈480)","Rigorous psychometric development (PCA, reliability, concurrent validity)","Clear description of scale items and factor structure"],"limitations":["Cross‑sectional convenience sample; limited generalisability","No assessment of key confounds (masturbation, mental health, trauma, partner effects)","No power analysis or effect‑size reporting"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/07448481.2014.975721"}},{"id":8771,"doi":"10.1007/s10508-014-0361-8","pmid":"25277691","pmcid":null,"title":"Do American States with more religious or conservative populations search more for sexual content on google?","authors":"MacInnis CC, Hodson G.","first_author":"MacInnis CC","journal":"Archives of sexual behavior","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"State‑level ecological analysis using Google Trends data from two years; regressions control for basic demographics.","sample_n":50,"sample_text":"U.S. states (N≈50)","population":"All 50 U.S. states (aggregate data).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that U.S. states with higher levels of religiosity or conservatism also show higher Google search activity for sexual content, suggesting a possible private interest that contrasts with public opposition to non‑traditional sex.","clinical_takeaway":"None – the findings describe population‑level patterns, not individual clinical risk.","confidence":0.7,"topic_tags":["sexual_function","religiosity","pornography","gender"],"strengths":["Large, nationally representative unit of analysis (all states).","Uses objective, anonymized Google search data.","Controls for basic demographic covariates."],"limitations":["Ecological design cannot infer individual behaviour (ecological fallacy).","No measurement of key individual‑level confounds (e.g., moral incongruence, masturbation).","Statistical approach not pre‑registered; effect‑size reporting unclear."],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":2,"mentioning":45,"citing_publications":100,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-014-0361-8"}},{"id":8773,"doi":"10.1007/s10461-014-0714-2","pmid":"24510402","pmcid":null,"title":"The influence of religion on sexual HIV risk","authors":"Shaw SA, El-Bassel N.","first_author":"Shaw SA","journal":"AIDS and behavior","year":2014,"pub_types":["Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 137 studies examining religion and sexual HIV risk behaviours; no meta‑analysis, risk‑of‑bias assessment not described.","sample_n":null,"sample_text":"Aggregated across 137 primary studies; individual study sizes not reported in abstract","population":"Human participants from multiple observational studies worldwide; no single sample size","country":"Various (global)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review looks at how religion relates to behaviours that affect HIV risk. Most studies find that greater religiosity is linked to lower sexual risk, although the link is weaker for condom use. The authors discuss how religion can both increase and decrease HIV risk and note gaps in the research.","clinical_takeaway":"Higher religiosity may be associated with reduced sexual HIV risk, but clinicians should consider multiple factors beyond religion when assessing risk.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Comprehensive inclusion of 137 studies","Clear categorisation of religion measures"],"limitations":["No quantitative meta‑analysis or pooled effect sizes","Unclear risk‑of‑bias assessment for included studies","Potential heterogeneity not statistically examined"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":37,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-014-0714-2"}},{"id":8774,"doi":"10.1037//0022-3514.45.1.188","pmid":"6886965","pmcid":null,"title":"Alcohol, sexual arousal, and self-control","authors":"Abrams DB, Wilson GT.","first_author":"Abrams DB","journal":"Journal of personality and social psychology","year":1983,"pub_types":["Controlled Clinical Trial","Clinical Trial","Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"controlled laboratory experiment using a balanced placebo design with random assignment","sample_n":null,"sample_text":"not disclosed in abstract","population":"adult males (sample size not reported in abstract)","country":"USA (U.S. government funded)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested how alcohol affects men’s ability to wait before watching an erotic film, measuring delay time, penile response, and self‑report scales. Higher alcohol doses did not change waiting time overall, but personal locus‑of‑control influenced the effect.","clinical_takeaway":"Alcohol may impair self‑control over sexual cues, especially in individuals with an external locus of control.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["objective physiological measure (penile tumescence)","balanced placebo design","multiple doses of alcohol"],"limitations":["sample size not reported, likely small","no effect‑size reporting or preregistration","limited assessment of potential psychological confounds"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0022-3514.45.1.188"}},{"id":8775,"doi":"10.1080/00926237808403025","pmid":"731713","pmcid":null,"title":"Sexual behavior and guilt among women: a cross-generational comparison","authors":"Keller JF, Eakes E, Hinkle D, Hughston GA.","first_author":"Keller JF","journal":"Journal of sex & marital therapy","year":1978,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Comparative study of 45 married women across three age groups (15 per group) examining sexual behavior and guilt.","sample_n":45,"sample_text":"Convenience sample; small; likely under‑powered for between‑group comparisons.","population":"Married women, age 20‑30, 40‑50, 60+ (N=45)","country":"USA (assumed from journal, not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 45 married women, younger participants reported more sexual activity but less guilt, while older women reported less activity and more guilt. Age was linked to both behavior and guilt levels.","clinical_takeaway":"Sexual guilt appears to increase with age; clinicians should consider age‑related attitudes when addressing sexual well‑being.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Direct comparison across three age cohorts","Clear reporting of significant differences","Focus on both behavior and affect (guilt)"],"limitations":["Very small sample; limited statistical power","Likely use of non‑validated ad‑hoc scales","No control for moral, mental‑health or relationship variables","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926237808403025"}},{"id":8776,"doi":"10.1007/s10943-012-9651-4","pmid":"23054481","pmcid":"PMC3985388","title":"Religiosity and risky sexual behaviors among an African American church-based population","authors":"Hawes SM, Berkley-Patton JY.","first_author":"Hawes SM","journal":"Journal of religion and health","year":2014,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 255 adult African American church members","sample_n":255,"sample_text":"255 adult African American church-based participants","population":"adult African American church attendees (N=255)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 255 African‑American church members, higher religiosity was linked to sexual risk factors such as many lifetime partners and inconsistent condom use, indicating ongoing HIV risk in this group.","clinical_takeaway":"Clinicians should consider religious contexts when discussing HIV risk with African‑American church populations.","confidence":0.8,"topic_tags":["religiosity","sexual_function"],"strengths":["Relatively large sample for this population","Focus on a specific community (church) enabling targeted insights","Uses multiple demographic predictors"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report, likely unvalidated measures","No control for key confounds such as mental health or partner effects"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":14,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-012-9651-4"}},{"id":8777,"doi":"10.1037//0022-3514.51.4.844","pmid":"3783428","pmcid":null,"title":"The use of subliminal psychodynamic activation in the study of repression","authors":"Geisler C.","first_author":"Geisler C.","journal":"Journal of personality and social psychology","year":1986,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"lab experiment with subliminal verbal stimuli; two groups (N=33 total); recall test before/after exposure","sample_n":33,"sample_text":"33 female undergraduates","population":"female undergraduates selected for high sexual guilt","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a lab study, 33 female students with high sexual guilt were shown subliminal messages that either heightened or reduced sexual conflict, then tested on memory recall. The conflict‑intensifying messages altered recall only for the group judged to have more advanced personality development.","clinical_takeaway":"Findings are limited; no direct clinical implications for sexual health or therapy.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Controlled laboratory manipulation","Use of neutral and conflict‑related stimuli","Clear experimental protocol"],"limitations":["Very small sample (N=33)","Constructs (repression, personality development) inferred, not validated","No measurement of key confounds (moral, mental health, etc.)","Interpretation may overstate evidence for repression"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037//0022-3514.51.4.844"}},{"id":8779,"doi":"10.1007/s10943-012-9580-2","pmid":"22395750","pmcid":null,"title":"Adolescent sexual risk-taking in the informal settlements of Nairobi, Kenya: understanding the contributions of religion","authors":"Obeng Gyimah S, Kodzi I, Emina J, Adjei J, Ezeh A.","first_author":"Obeng Gyimah S","journal":"Journal of religion and health","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of adolescents in Nairobi informal settlements; likely convenience sample; cross‑sectional analysis of religiosity vs. self‑reported risky sexual behaviours","sample_n":null,"sample_text":"Not specified in abstract","population":"adolescents in informal settlements of Nairobi, Kenya","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined whether how religious Kenyan adolescents are relates to their involvement in risky sexual activities. Using survey data from Nairobi’s informal settlements, the authors found an association suggesting that stronger religiosity may be linked to less risky behaviour.","clinical_takeaway":"Religiosity may be a protective factor against risky sexual behaviour among Kenyan adolescents, but evidence is correlational.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Focus on understudied population (Kenyan informal settlements)","Addresses an important public‑health question"],"limitations":["Likely cross‑sectional, limiting causal inference","No information on sample size or power","Key confounders (mental health, trauma, partner effects) not measured"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-012-9580-2"}},{"id":8780,"doi":"10.1515/ijamh-2012-0118","pmid":"23612634","pmcid":null,"title":"Differential effects of religiosity on sexual initiation among Nigerian in-school adolescents","authors":"Asubiaro OY, Fatusi AO.","first_author":"Asubiaro OY","journal":"International journal of adolescent medicine and health","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 1350 in‑school adolescents; Cox regression on self‑reported age at sexual debut.","sample_n":1350,"sample_text":"randomly selected in‑school adolescents","population":"In‑school adolescents, Lagos State, Nigeria (N=1350)","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 1,350 Nigerian school adolescents, higher internal religiosity lowered the chance of girls starting sex, while higher external religiosity lowered the chance for boys. Age, puberty, HIV knowledge and peer influences also mattered.","clinical_takeaway":"Religiosity appears linked to delayed sexual debut, but causality is unclear; interventions should consider gender‑specific protective factors.","confidence":0.78,"topic_tags":["sexual_function","religiosity","adolescents"],"strengths":["Large sample size","Use of survival analysis (Cox) with confidence intervals","Gender‑specific analysis"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report for sexual behavior and religiosity","Limited control of key confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":55,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1515/ijamh-2012-0118"}},{"id":8781,"doi":"10.1080/07448481.2014.947994","pmid":"25102282","pmcid":null,"title":"Assessing God locus of control as a factor in college students' alcohol use and sexual behavior","authors":"Moore EW.","first_author":"Moore EW.","journal":"Journal of American college health : J of ACH","year":2014,"pub_types":["Journal Article"],"keywords":["Alcohol","Sexual behavior","Religiosity","Locus Of Control"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 324 college students assessing God locus of control, alcohol use, and sexual behavior; principal components and multivariate analyses.","sample_n":324,"sample_text":"College students aged 18‑24 (N = 324) completed a survey between April 2012 and March 2013.","population":"College students aged 18‑24 (N=324) recruited from a university setting.","country":"United States","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed 324 U.S. college students and found that stronger belief that God controls one's behavior was linked to lower rates of drinking alcohol and having sex, suggesting this belief may influence health‑related choices.","clinical_takeaway":"Clinicians should note that religious beliefs about divine control can shape students' alcohol and sexual decisions, but should assess each client individually.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Relatively large sample for a college survey","Introduces a novel religiosity construct (God locus of control)","Uses multivariate analysis to explore associations"],"limitations":["Cross‑sectional design cannot infer causality","Key sexual‑health confounds (moral incongruence, masturbation, mental health) not measured","Self‑report data may be biased"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[{"status":"Has correction","date":"2014-12-13","noticeDoi":"10.1080/07448481.2014.992723","doi":"10.1080/07448481.2014.947994"},{"status":"Has erratum","date":"2014-12-13","noticeDoi":"10.1080/07448481.2014.992723","doi":"10.1080/07448481.2014.947994"}],"url":"https://scite.ai/reports/10.1080/07448481.2014.947994"}},{"id":8783,"doi":"10.1176/ajp.125.1.89","pmid":"5657378","pmcid":null,"title":"Sexual guilt and culturally sanctioned delusions in Liberia, West Africa","authors":"Wintrob RM.","first_author":"Wintrob RM.","journal":"The American journal of psychiatry","year":1968,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/ajp.125.1.89"}},{"id":8784,"doi":"10.1080/00224499.2013.821443","pmid":"24168055","pmcid":null,"title":"Risky sexual behavior among young adult Latinas: are acculturation and religiosity protective?","authors":"Smith SJ.","first_author":"Smith SJ.","journal":"Journal of sex research","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"nationally representative longitudinal survey (Add Health) with structural equation modeling","sample_n":1168,"sample_text":"nationally representative longitudinal sample of young adult Latinas","population":"self‑identified Latinas, young adult (N=1,168)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative study of 1,168 young adult Latinas, higher intrinsic religiosity and stronger acculturation were linked to lower risky sexual behavior, while higher extrinsic religiosity predicted more risk.","clinical_takeaway":"Consider both the type of religiosity and acculturation level when designing sexual‑health interventions for Latina women.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["large, nationally representative sample","use of structural equation modeling","separate examination of intrinsic vs extrinsic religiosity"],"limitations":["unclear whether religiosity and acculturation scales are validated","no control for key sexual‑health confounds (e.g., mental health, partner status)","cross‑sectional analysis within longitudinal dataset"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":1,"mentioning":35,"citing_publications":89,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2013.821443"}},{"id":8785,"doi":"10.1016/j.adolescence.2013.08.005","pmid":"24215966","pmcid":"PMC3951108","title":"Developmental trajectories of religiosity, sexual conservatism and sexual behavior among female adolescents","authors":"Aalsma MC, Woodrome SE, Downs SM, Hensel DJ, Zimet GD, Orr DP, Fortenberry JD.","first_author":"Aalsma MC","journal":"Journal of adolescence","year":2013,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Longitudinal study","Adolescence","Religion","Sexual Conservatism"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"longitudinal cohort of 328 adolescent females with three‑wave surveys; structural equation modelling of trajectories","sample_n":328,"sample_text":"young women recruited from community schools, longitudinal follow‑up","population":"female adolescents (US, Indiana), community sample","country":"USA","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study followed 328 teenage girls and found that as their religiosity fell, they became less sexually conservative, which was linked to more sexual activity over time.","clinical_takeaway":"Changes in religious attitudes may influence teens' sexual behavior; clinicians should consider cultural and moral context when discussing sexual health.","confidence":0.78,"topic_tags":["adolescents","religiosity","sexual_function"],"strengths":["large longitudinal sample","use of structural equation modelling","focus on socio‑sexual attitudes"],"limitations":["relies on self‑report surveys","limited control of key confounds (mental health, partner effects)","no validation details for scales"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":24,"citing_publications":92,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2013.08.005"}},{"id":8786,"doi":"10.1007/s10935-013-0315-2","pmid":"23917789","pmcid":"PMC3832128","title":"Adolescents' religious discordance with mothers: is there a connection to sexual risk behavior during emerging adulthood?","authors":"Grossman JM, Tracy AJ, Noonan AE.","first_author":"Grossman JM","journal":"The journal of primary prevention","year":2013,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"longitudinal analysis of Add Health Wave I & III (adolescent‑mother religious discordance → emerging adult sexual risk)","sample_n":null,"sample_text":"large national cohort (Add Health) – exact N not reported in abstract","population":"U.S. adolescents and their mothers (Add Health cohort)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study followed teens and their mothers for 6‑7 years and found that when mothers were more religious than their children, the teens later took more sexual risks; the opposite pattern was seen for prayer frequency.","clinical_takeaway":"Family religious differences may influence young adults' sexual risk decisions; clinicians might consider family religiosity dynamics when counseling about sexual health.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Longitudinal design provides temporal precedence","Large, nationally representative dataset (Add Health)","Novel focus on parent‑child religious discordance"],"limitations":["Reliance on self‑report for both religion and sexual risk","Limited control for known confounds (mental health, relationship factors, trauma)","No explicit reporting of effect sizes or power calculations"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10935-013-0315-2"}},{"id":8787,"doi":"10.1007/s10943-011-9512-6","pmid":"21735321","pmcid":"PMC3250557","title":"Religiosity and sexual involvement within adolescent romantic couples","authors":"LeJeune BC, Zimet GD, Azzouz F, Fortenberry JD, Aalsma MC.","first_author":"LeJeune BC","journal":"Journal of religion and health","year":2013,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal analysis of 374 adolescent couples (748 participants) using the National Longitudinal Study of Adolescent Health dataset.","sample_n":748,"sample_text":"374 couples (748 participants) from a national longitudinal study.","population":"Adolescent romantic couples (U.S.)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a national study of 374 teen couples, both personal and shared religious beliefs were linked to less sexual activity, showing that couple‑level religiosity shapes how adolescents engage in sex.","clinical_takeaway":"Consider adolescents' religious context when discussing sexual behavior; couple religiosity may influence sexual decisions.","confidence":0.7,"topic_tags":["adolescents","religiosity","sexual_function","relationships"],"strengths":["Large, nationally representative longitudinal dataset","Dyadic analysis captures couple‑level effects","Clear operationalization of religiosity and sexual involvement"],"limitations":["Potentially limited validation details for the religiosity and sexual behavior scales","Key confounds (masturbation, mental health, trauma) not addressed","No effect‑size reporting or power justification in abstract"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-011-9512-6"}},{"id":8788,"doi":"10.1016/j.adolescence.2013.04.002","pmid":"23849661","pmcid":"PMC3760281","title":"Testing two process models of religiosity and sexual behavior","authors":"Vasilenko SA, Duntzee CI, Zheng Y, Lefkowitz ES.","first_author":"Vasilenko SA","journal":"Journal of adolescence","year":2013,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual behavior","Religiosity","Motivations For Sex"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"College student longitudinal survey (3 semesters), N=610, web questionnaires.","sample_n":610,"sample_text":"N = 610 college students (53.8% female, mean age = 18.5).","population":"Emerging adults (college students), diverse ethnicity, United States.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A three‑semester study of 610 U.S. college students found that religiosity reduces sexual activity mainly because religious youths internalize norms about sex, not because religion suppresses pleasure motives.","clinical_takeaway":"Clinicians should consider internalized religious norms when discussing adolescents' sexual decisions, rather than assuming religiosity directly overrides sexual desire.","confidence":0.6,"topic_tags":["sexual_function","religiosity","adolescents"],"strengths":["Large longitudinal sample","Diverse ethnic composition","Focused mediation analysis"],"limitations":["Self‑report only, no validated psychometric detail in abstract","Limited control of key confounds (e.g., moral incongruence, mental health)","No pre‑registration or power justification reported"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":22,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2013.04.002"}},{"id":8789,"doi":"10.1007/s11199-012-0135-5","pmid":"23687403","pmcid":"PMC3653341","title":"Gender, Ethnicity, Religiosity, and Same-sex Sexual Attraction and the Acceptance of Same-sex Sexuality and Gender Non-conformity","authors":"Collier KL, Bos HM, Merry MS, Sandfort TG.","first_author":"Collier KL","journal":"Sex roles","year":2013,"pub_types":["research-article","Journal Article"],"keywords":["Adolescence","Ethnicity","Sexual Orientation","Religiosity","Gender Non-conformity"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1,518 secondary school students in Amsterdam","sample_n":1518,"sample_text":"N = 1,518 adolescents (48.1% female, 32.3% non‑Western ethnicity)","population":"adolescents (mean age 14.6), mixed gender, mixed ethnicity, Netherlands","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among Dutch adolescents, being male, non‑Western, and more religious predicts lower acceptance of same‑sex sexuality and gender non‑conformity; religiosity’s negative effect is stronger for those who themselves experience same‑sex attraction.","clinical_takeaway":"None – the study addresses attitudes, not clinical issues.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, diverse adolescent sample","Intersectional analysis of multiple demographic factors","Clear statistical interaction reported"],"limitations":["Cross‑sectional design limits causal inference","Unclear whether attitude scales are validated","No effect‑size reporting in abstract"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":0,"mentioning":23,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11199-012-0135-5"}},{"id":8790,"doi":"10.1007/s10508-013-0106-0","pmid":"23657811","pmcid":"PMC3779659","title":"Predictors of sexual hookups: a theory-based, prospective study of first-year college women","authors":"Fielder RL, Walsh JL, Carey KB, Carey MP.","first_author":"Fielder RL","journal":"Archives of sexual behavior","year":2013,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":56,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort of first‑year college women (N=483) with baseline survey and nine monthly follow‑ups; outcomes were self‑reported counts of oral and vaginal hookups.","sample_n":483,"sample_text":"483 first‑year college women","population":"first‑year college women (U.S., 67 % White)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a year‑long study of 483 first‑year college women, researchers tracked how often participants engaged in oral or vaginal hookups and identified what predicted those encounters. Intentions to hook up, impulsivity, sensation‑seeking, prior hookups, alcohol and marijuana use increased the odds, while religiosity, self‑esteem and having married parents reduced them.","clinical_takeaway":"Risk assessment for casual sexual activity should consider impulsivity, substance use and personal values alongside prior behavior.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large prospective sample with multiple follow‑ups","Use of validated psychometric scales for personality and religiosity","Comprehensive modeling of many risk/protective factors"],"limitations":["Convenience sample of one university limits generalisability","Self‑report of sexual behavior may be subject to recall/social desirability bias","No pre‑registration or open data"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":6,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":2,"mentioning":108,"citing_publications":106,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-013-0106-0"}},{"id":8791,"doi":"10.3109/13625187.2013.777829","pmid":"23547890","pmcid":"PMC3656140","title":"Religiosity, religious affiliation, and patterns of sexual activity and contraceptive use in France","authors":"Moreau C, Trussell J, Bajos N.","first_author":"Moreau C","journal":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","year":2013,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Randomly sampled national health survey (2005 Health Barometer) of 13,129 adults aged 15‑44 in France; logistic regression used to examine associations between self‑reported religiosity and sexual/contraceptive behaviours.","sample_n":13129,"sample_text":"Random probability sample drawn from national health barometer; large, demographically diverse.","population":"Adults 15‑44 years, both sexes, France (N≈13,129)","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationwide French survey, people who regularly practice religion tend to start sex later and use contraception less often, especially among young adults, with patterns differing by gender and faith.","clinical_takeaway":"Clinicians should consider patients’ religious practices when discussing sexual health and contraceptive options.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Appropriate multivariable logistic regression","Clear operationalisation of religiosity and contraceptive outcomes"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report; no validation of measures reported","Key psychological or relational confounders (e.g., mental health, partner influence) not assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":1,"mentioning":22,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/13625187.2013.777829"}},{"id":8792,"doi":"10.1080/00224499.2012.721098","pmid":"23301620","pmcid":"PMC4826156","title":"Associations between sexual abstinence ideals, religiosity, and alcohol abstinence: a longitudinal study of Finnish twins","authors":"Winter T, Karvonen S, Rose RJ.","first_author":"Winter T","journal":"Journal of sex research","year":2014,"pub_types":["Twin Study","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"population-based Finnish twin cohort, ages 17–24, within‑family discordant twin comparisons","sample_n":null,"sample_text":"Population‑based twin sample from Finland; exact N not reported in abstract","population":"Finnish twins (both sexes), N not specified in abstract","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In Finnish twins, belief that sex should be saved for romance drops from age 17 to 24. Those who are religious and who avoid alcohol are more likely to hold this ideal, and the link between alcohol‑free status and abstinence ideals holds even when twins share the same family background.","clinical_takeaway":"Religious and alcohol‑abstinence attitudes predict support for sexual abstinence; clinicians should consider broader value systems when discussing sexual expectations.","confidence":0.7,"topic_tags":["sexual_function","religiosity","adolescents"],"strengths":["Longitudinal twin design allows control for shared family environment","Within‑family discordant twin analysis strengthens causal inference","Population‑based sample reduces selection bias"],"limitations":["Constructs measured with unspecified self‑report items; unclear validation","No assessment of key sexual‑behavior confounds (masturbation, moral incongruence, mental health, relationship factors, trauma)","Effect sizes and power not reported in abstract"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2012.721098"}},{"id":8793,"doi":"10.1080/07448481.2013.799480","pmid":"23768223","pmcid":"PMC3703302","title":"The paradox of risk: historically black college/university students and sexual health","authors":"Younge SN, Corneille MA, Lyde M, Cannady J.","first_author":"Younge SN","journal":"Journal of American college health : J of ACH","year":2013,"pub_types":["research-article","Review","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Review of 24 cross‑sectional empirical studies (2000‑2013) on sexual health among HBCU students; no meta‑analysis or risk‑of‑bias assessment.","sample_n":null,"sample_text":"24 empirical cross‑sectional studies (total N not reported).","population":"Historically Black College/University students (college‑age, United States)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A review of 24 studies found that HBCU students have similar or higher rates of perceived HIV risk, religious involvement, HIV testing, condom use, and substance use compared with peers, indicating that structural factors—rather than just personal choices—affect sexual health on these campuses.","clinical_takeaway":"Clinicians should consider community and institutional influences when addressing sexual health with HBCU students.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad survey of existing literature","Identifies structural factors beyond individual risk"],"limitations":["Relies exclusively on cross‑sectional studies","No quantitative synthesis or bias assessment","Limited to studies up to 2013"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":24,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/07448481.2013.799480"}},{"id":8794,"doi":"10.1371/journal.pone.0051745","pmid":"23272156","pmcid":"PMC3522702","title":"Qualitative inquiry into premarital sexual behaviours and contraceptive use among multiethnic young women: implications for education and future research","authors":"Wong LP.","first_author":"Wong LP.","journal":"PloS one","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0051745&type=printable","cited_by_count":11,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross‑sectional focus‑group study with 34 groups (185 participants) drawn from schools and universities in Malaysia","sample_n":185,"sample_text":"185 participants across 34 focus groups","population":"young Malaysian women (secondary school and university students), multi‑ethnic","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Focus‑group interviews with 185 Malaysian young women revealed limited knowledge about sex and contraception, frequent unprotected premarital sex, and influences such as ethnicity, religion, peers, and parental monitoring.","clinical_takeaway":"Sex education programs should target knowledge gaps and cultural barriers to condom use among Malaysian youth.","confidence":0.8,"topic_tags":["sexual_function","prevalence"],"strengths":["Large, multi‑ethnic qualitative sample","Theoretically informed interview guide","Provides context‑specific insights for interventions"],"limitations":["No validated quantitative measures of constructs","Cross‑sectional, cannot infer causality","Does not address key confounds (e.g., moral incongruence, mental health)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":29,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0051745"}},{"id":8795,"doi":"10.1007/s12160-012-9375-4","pmid":"22618963","pmcid":"PMC4349630","title":"Moderation and mediation of an effective HIV risk-reduction intervention for South African adolescents","authors":"O'Leary A, Jemmott JB, Jemmott LS, Bellamy S, Ngwane Z, Icard L, Gueits L.","first_author":"O'Leary A","journal":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","year":2012,"pub_types":["research-article","Randomized Controlled Trial","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"cluster-randomized controlled trial with follow‑up at 3, 6 and 12 months","sample_n":null,"sample_text":"Not reported in abstract","population":"South African sixth‑grade adolescents (both sexes)","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A school‑based program in South Africa reduced teens’ sexual activity and unsafe sex for up to a year. Its success was stronger for youths living with their father, with stricter parents or higher religiosity, and was driven by increased confidence to avoid risky situations.","clinical_takeaway":"Interventions that boost self‑efficacy and parental expectations can lower adolescent risky sexual behavior.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Cluster‑RCT with longitudinal follow‑up","Theory‑driven mediation analysis","Identified moderators relevant to context"],"limitations":["Sample size not disclosed in abstract","Limited reporting of effect sizes and power","No pre‑registration"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":46,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12160-012-9375-4"}},{"id":8796,"doi":"10.1007/s10943-011-9527-z","pmid":"21822743","pmcid":null,"title":"Religiosity, spirituality, sexual attitudes, and sexual behaviors among college students","authors":"Luquis RR, Brelsford GM, Rojas-Guyler L.","first_author":"Luquis RR","journal":"Journal of religion and health","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 960 students from four northeastern colleges; logistic regression analysis of self‑reported attitudes, religiosity, spirituality and sexual behaviours","sample_n":960,"sample_text":"four northeastern colleges, convenience sample of undergraduates","population":"college students (N=960)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among 960 U.S. college students, how religious or spiritual they are and their sexual attitudes were linked to whether they were sexually active, with attitudes playing a larger role for women.","clinical_takeaway":"Clinicians should consider students' religious and spiritual views when discussing sexual health, but cannot assume these factors cause behaviour.","confidence":0.6,"topic_tags":["religiosity","sexual_function"],"strengths":["large sample for a single‑site survey","uses multivariate logistic models","examines gender differences"],"limitations":["cross‑sectional; cannot infer causality","no control for key sexual‑health confounds (e.g., mental health, relationship status)","measurements likely self‑report and not validated in abstract"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":2,"mentioning":56,"citing_publications":90,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-011-9527-z"}},{"id":8797,"doi":null,"pmid":"2379906","pmcid":null,"title":"[AIDS--how much anxiety can the human mind tolerate? Sexual guilt anxiety--the death drive--solidarity of suspicion]","authors":"Krüger S.","first_author":"Krüger S.","journal":"Fortschritte der Medizin","year":1990,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["shame_religiosity"],"language":"ger","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":8798,"doi":"10.1017/s0021932012000168","pmid":"22716919","pmcid":null,"title":"Religion, religiosity and premarital sexual attitudes of young people in the informal settlements of Nairobi, Kenya","authors":"Gyimah SO, Kodzi I, Emina J, Cofie N, Ezeh A.","first_author":"Gyimah SO","journal":"Journal of biosocial science","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of young people in informal settlements","sample_n":null,"sample_text":"Not specified in abstract","population":"young adults in Nairobi informal settlements","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed young people in Nairobi’s informal settlements and found that those belonging to Pentecostal/Evangelical churches held more conservative views about premarital sex than other Christians, with higher religiosity linked to stricter attitudes.","clinical_takeaway":"None – the findings describe attitudes, not clinical outcomes.","confidence":0.8,"topic_tags":["religiosity","sexual_function"],"strengths":["Large urban youth sample","Focus on religious denomination differences","Clear theoretical framework (reference group theory)"],"limitations":["Cross‑sectional, cannot infer causality","Unclear measurement validation","Potential selection bias in informal settlement sampling"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0021932012000168"}},{"id":8799,"doi":"10.1080/00224499.2012.666816","pmid":"22524318","pmcid":"PMC3407304","title":"Predictors of extradyadic sexual involvement in unmarried opposite-sex relationships","authors":"Maddox Shaw AM, Rhoades GK, Allen ES, Stanley SM, Markman HJ.","first_author":"Maddox Shaw AM","journal":"Journal of sex research","year":2013,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort, US-representative sample (N=933) followed for 20 months","sample_n":933,"sample_text":"representative US sample","population":"unmarried opposite‑sex partners, age 18‑35, USA","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 20‑month study of 933 U.S. adults in opposite‑sex relationships, lower relationship satisfaction, negative communication, aggression, and lack of plans to marry predicted later cheating, while how often they had sex did not.","clinical_takeaway":"Relationship quality and communication problems, not sexual frequency, are key risk factors for future infidelity.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Large, nationally representative longitudinal sample","Prospective design allows temporal ordering of predictors","Broad set of relationship‑ and demographic‑level predictors examined"],"limitations":["Reliance on self‑report questionnaires; possible reporting bias","No detail on validity of specific scales used","Moral or religious motivations for infidelity not examined"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":63,"citing_publications":101,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2012.666816"}},{"id":8800,"doi":"10.1007/s10508-012-9924-8","pmid":"22441770","pmcid":null,"title":"Is religiosity a barrier to sexual and reproductive health? Results from a population-based study of young Croatian adults","authors":"Puzek I, Stulhofer A, Božičević I.","first_author":"Puzek I","journal":"Archives of sexual behavior","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"national probability survey of 1,005 Croatian adults aged 18‑25","sample_n":1005,"sample_text":"national probability sample, n = 1,005","population":"young Croatian adults (both sexes)","country":"Croatia","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a national survey of 1,005 Croatian youths, higher religiosity was only weakly linked to lower sexual risk and did not strongly predict chlamydia infection, especially among women.","clinical_takeaway":"Religious affiliation alone should not be assumed to protect young people from sexual health risks.","confidence":0.9,"topic_tags":["religiosity","sexual_function"],"strengths":["Large, nationally representative sample","Objective infection outcome (chlamydia testing)","Multi‑dimensional assessment of religiosity"],"limitations":["Cross‑sectional; cannot infer causality","Limited control of other confounders (mental health, relationship factors)","Reliance on self‑reported sexual behaviour"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-012-9924-8"}},{"id":8801,"doi":"10.1007/s10508-012-9918-6","pmid":"22441769","pmcid":null,"title":"Sex guilt mediates the relationship between religiosity and sexual desire in East Asian and Euro-Canadian college-aged women","authors":"Woo JS, Morshedian N, Brotto LA, Gorzalka BB.","first_author":"Woo JS","journal":"Archives of sexual behavior","year":2012,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 539 university women (Euro‑Canadian n=178, East Asian n=361) completing self‑report questionnaires on religiosity, spirituality, fundamentalism, sex guilt and sexual desire; mediation analyses conducted.","sample_n":539,"sample_text":"Euro‑Canadian (n=178) and East Asian (n=361) female university students","population":"female college‑aged students (age ~18‑24), primarily from Canada and East Asia; convenience university sample","country":"Canada, East Asia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among college women from Canada and East Asia, stronger religious beliefs were linked to higher sex guilt, which in turn was associated with lower sexual desire. The study suggests that feeling guilty about sex may explain how religiosity impacts desire.","clinical_takeaway":"Sex guilt can reduce sexual desire; clinicians should consider moral or religious concerns when addressing low desire in women.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Large, ethnically diverse sample","Use of mediation analysis to explore mechanisms","Clear operational definitions of religiosity dimensions"],"limitations":["Cross‑sectional design limits causal inference","Key confounds (mood, relationship status, trauma) not measured","Reliance on self‑report questionnaires; validation not specified"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":24,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-012-9918-6"}},{"id":8802,"doi":"10.2989/16085906.2012.671268","pmid":"25870898","pmcid":null,"title":"Predictors of sexual behaviour among church-going youths in Nairobi, Kenya: a cross-denominational study","authors":"Miller AN, Wa Ngula K, Musambira G.","first_author":"Miller AN","journal":"African journal of AIDS research : AJAR","year":2012,"pub_types":["Journal Article"],"keywords":["Gender","Sub-Saharan Africa","Religion","Health Indicators","Social Capital","Abstinence","Christian Denominations"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of church‑going youths in Nairobi; denominational groups compared on self‑reported sexual experience and intentions; logistic analyses reported","sample_n":null,"sample_text":"unspecified; likely convenience sample of church members","population":"church‑going youths (Kenya)","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of Nairobi youths attending different Christian churches found that those in Pentecostal/evangelical congregations were less likely to have had sex than peers in mainline churches, and that personal and community religiosity explained these differences.","clinical_takeaway":"Religious commitment and community engagement are associated with delayed sexual activity among Kenyan church‑going youths; clinicians should consider cultural and faith contexts when discussing sexual health.","confidence":0.7,"topic_tags":["sexual_function","religiosity","adolescents"],"strengths":["large community‑based sample of youths","focus on denominational differences","use of mediation analysis to explore mechanisms"],"limitations":["cross‑sectional design limits causal inference","self‑report of sexual behaviour may be biased by social desirability","no measurement of key confounds (mental health, trauma, masturbation)","sample limited to church‑going youths; not generalisable to all Kenyan youths"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2989/16085906.2012.671268"}},{"id":8803,"doi":"10.1001/archpediatrics.2011.657","pmid":"22312172","pmcid":"PMC3433801","title":"Associations between sexuality education in schools and adolescent birthrates: a state-level longitudinal model","authors":"Cavazos-Rehg PA, Krauss MJ, Spitznagel EL, Iguchi M, Schootman M, Cottler L, Grucza RA, Bierut LJ.","first_author":"Cavazos-Rehg PA","journal":"Archives of pediatrics & adolescent medicine","year":2012,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"state-level prospective cohort (24 US states, 1997‑2005)","sample_n":24,"sample_text":"Twenty‑four states","population":"Girls aged 15‑17 years, aggregated at the state level","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"States that taught more sexuality‑education topics in schools tended to have lower teen birthrates, but this link disappeared after accounting for state religiosity, politics, and other demographics.","clinical_takeaway":"Sexuality education alone may not reduce teen births; broader state characteristics matter.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, multi‑year state‑level dataset","Controls for key demographic and political confounders","Clear operational definitions of exposure and outcome"],"limitations":["Ecological design limits individual‑level inference","No power analysis or confidence intervals reported","Sample limited to 24 states; may not capture national variability"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":6,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archpediatrics.2011.657"}},{"id":8804,"doi":"10.1177/1077801211436138","pmid":"22410773","pmcid":"PMC3844285","title":"Surviving the storm: the role of social support and religious coping in sexual assault recovery of African American women","authors":"Bryant-Davis T, Ullman SE, Tsong Y, Gobin R.","first_author":"Bryant-Davis T","journal":"Violence against women","year":2011,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":52,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 413 African American female sexual assault survivors; confirmatory factor analysis and structural equation modeling.","sample_n":413,"sample_text":"413 African American female sexual assault survivors","population":"African American women survivors of sexual assault (N=413)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 413 African American women who survived sexual assault, greater social support was linked to lower depression and PTSD, while more religious coping was linked to higher symptoms.","clinical_takeaway":"Enhancing social support may aid recovery; clinicians should monitor how religious coping relates to trauma symptoms.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample of a specific, often under‑studied population","Use of validated symptom measures","Advanced statistical modeling (CFA, SEM)"],"limitations":["Cross‑sectional design limits causal inference","Convenience sample; may not generalise beyond survivors who participated","No measurement of moral or religious distress that could confound religious coping effects"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":1,"mentioning":71,"citing_publications":93,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1077801211436138"}},{"id":8807,"doi":"10.1007/s10508-011-9811-8","pmid":"21887586","pmcid":null,"title":"Sexual stereotypes and practices of university students in Turkey","authors":"Boratav HB, Çavdar A.","first_author":"Boratav HB","journal":"Archives of sexual behavior","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 471 university students from four Turkish universities","sample_n":471,"sample_text":"471 students (273 women, 198 men) from four universities in Turkey","population":"university students (young adults, mean age ~20‑21)","country":"Turkey","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 471 Turkish university students examined messages about sexuality, religious beliefs, and sexual experiences, finding that most students receive restrictive messages, men report more partners, and religiosity relates to attitudes and behaviours.","clinical_takeaway":"Clinicians should be aware that cultural and religious messages shape young adults' sexual attitudes and experiences, but the study does not provide evidence for clinical interventions.","confidence":0.7,"topic_tags":["sexual_function","csbd","moral_incongruence"],"strengths":["Large sample for a single‑country survey","Inclusion of religiosity as a variable","Comprehensive range of sexual‑behavior items"],"limitations":["Likely uses ad‑hoc questionnaires rather than validated scales","Cross‑sectional design limits causal inference","Key confounds (masturbation, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":5,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-011-9811-8"}},{"id":8808,"doi":"10.1007/s10508-011-9792-7","pmid":"21796485","pmcid":null,"title":"Non-erotic cognitive distractions during sexual activity in sexual minority and heterosexual young adults","authors":"Lacefield K, Negy C.","first_author":"Lacefield K","journal":"Archives of sexual behavior","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 200 college students (100 lesbian/gay, 100 heterosexual), matched on gender, age, ethnicity","sample_n":200,"sample_text":"100 sexual‑minority (lesbian/gay) and 100 heterosexual college students (96 males, 104 females)","population":"young adult college students, US (likely), self‑selected via university recruitment","country":"USA (presumed)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 200 college students found that lesbian and gay participants reported more distracting thoughts about body image, performance and STI risk during sex than heterosexual peers.","clinical_takeaway":"Clinicians should be aware that sexual‑minority young adults may experience more body‑image and health‑related distractions during sex, which could affect sexual satisfaction.","confidence":0.7,"topic_tags":["csbd","pornography","masturbation","sexual_function"],"strengths":["Reasonable sample size for a survey","Matched groups on key demographics","Includes measures of anxiety, self‑esteem and religiosity"],"limitations":["Primary outcome measure appears ad‑hoc and unvalidated","Cross‑sectional design cannot infer causality","No control for masturbation or partner context"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":18,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-011-9792-7"}},{"id":8809,"doi":"10.1080/00224499.2010.494257","pmid":"20544469","pmcid":null,"title":"Religiosity and sexual risk behavior among Croatian college students, 1998-2008","authors":"Stulhofer A, Soh D, Jelaska N, Baćak V, Landripet I.","first_author":"Stulhofer A","journal":"Journal of sex research","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Repeated cross‑sectional surveys of first‑year university students in 1998, 2003 and 2008.","sample_n":null,"sample_text":"Convenience sample of students; not nationally representative.","population":"University of Zagreb first‑year undergraduates (Croatia).","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among Croatian first‑year university students, more religious upbringing and personal religiosity were linked to lower sexual knowledge and delayed sexual debut for women, but did not lead to higher condom use. Overall, religiosity did not strongly protect against STI‑related risk.","clinical_takeaway":"Religious beliefs alone may not reduce STI risk; sexual education remains essential.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Multi‑year data allow observation of trends.","Separate analysis by gender.","Addresses both knowledge and behavior."],"limitations":["Self‑report measures, likely unvalidated.","Convenience university sample limits generalisability.","No control for key sexual‑health confounders (e.g., mental health, partner effects)."],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":29,"citing_publications":97,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2010.494257"}},{"id":8810,"doi":null,"pmid":"21888148","pmcid":null,"title":"Project genesis: self-reported religiosity and spirituality and sexual risk-taking in young African-American women attending a historically African-American college","authors":"Thomas TL, Freeman A.","first_author":"Thomas TL","journal":"Journal of National Black Nurses' Association : JNBNA","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pilot convenience sample of 100 female students; anonymous health‑risk survey with added religiosity/spirituality items; correlation analysis","sample_n":100,"sample_text":"convenience sample of female students at an HBCU","population":"young African‑American women (college students, N=100)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a pilot study of 100 African‑American college women, higher self‑reported religiosity and spirituality did not predict lower sexual risk‑taking, suggesting those beliefs alone may not protect against STI risk.","clinical_takeaway":"Religiosity alone may not reduce risky sexual behavior; interventions should address additional factors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Focused on understudied population","Clear reporting of sample size"],"limitations":["Convenience sample limits generalisability","Likely unvalidated measures","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":8812,"doi":"10.1080/13691058.2011.566356","pmid":"21462006","pmcid":null,"title":"Challenging Pentecostal moralism: erotic geographies, religion and sexual practices among township youth in Cape Town","authors":"Burchardt M.","first_author":"Burchardt M.","journal":"Culture, health & sexuality","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"ethnographic fieldwork with township Pentecostal youth; convenience sampling; no quantitative measures","sample_n":null,"sample_text":"not reported in abstract","population":"Xhosa‑speaking Pentecostal youth in Cape Town townships","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A qualitative study of Xhosa‑speaking Pentecostal youth in Cape Town shows that despite church teachings, most young people view sexuality independently of religion, favoring romantic ideals over premarital abstinence.","clinical_takeaway":"None – the study offers cultural insight rather than clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","religiosity","csbd"],"strengths":["Provides rich cultural context","Highlights disconnect between church doctrine and youth practice"],"limitations":["No systematic sampling or size reporting","Lacks quantitative measurement of constructs","Findings not generalisable beyond the specific setting"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2011.566356"}},{"id":8813,"doi":"10.1080/00224499.2010.521868","pmid":"20960362","pmcid":"PMC4558903","title":"Identifying the causal pathways from religiosity to delayed adolescent sexual behavior","authors":"Hull SJ, Hennessy M, Bleakley A, Fishbein M, Jordan A.","first_author":"Hull SJ","journal":"Journal of sex research","year":2011,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Longitudinal cohort of virgin adolescents followed for one year to assess sexual debut and behavior index.","sample_n":null,"sample_text":"Not reported in abstract","population":"Adolescent virgins (baseline), unspecified sample size, likely convenience or school‑based recruitment in the US.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study followed teenage virgins for a year and found that higher religiosity predicted later onset of sex and lower scores on a seven‑step sexual activity scale, with attitudes toward sex partly explaining this link.","clinical_takeaway":"Higher religiosity may be associated with delayed sexual activity in adolescents, but causality is not proven.","confidence":0.8,"topic_tags":["religiosity","adolescents","sexual_function"],"strengths":["Longitudinal design permits temporal ordering","Uses a theoretically grounded integrative model","Considers both coital and non‑coital behaviors"],"limitations":["No explicit measurement of key confounds (e.g., mental health, partner context)","Sexual behavior index appears ad‑hoc without reported validation","Causal language may exceed observational evidence"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":46,"citing_publications":109,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2010.521868"}},{"id":8816,"doi":"10.1089/jwh.2010.1949","pmid":"21524202","pmcid":null,"title":"Religiosity and sexual risk behaviors among Latina adolescents: trends from 1995 to 2008","authors":"Edwards LM, Haglund K, Fehring RJ, Pruszynski J.","first_author":"Edwards LM","journal":"Journal of women's health (2002)","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional analysis of three NSFG waves (n≈267‑400 per wave).","sample_n":1063,"sample_text":"Combined n≈267 (1995) + 306 (2002) + 400 (2006‑2008).","population":"Unmarried Latina females, ages 15‑21, United States (1995, 2002, 2006‑2008).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Latina teens in the U.S., higher importance of religion and frequent church attendance were linked to later sexual debut, fewer partners, and higher odds of remaining a virgin. The protective effect of religious importance waned over the 1995‑2008 period, while attendance remained stable.","clinical_takeaway":"Religiosity may be a protective factor for sexual risk in Latina adolescents, but its influence varies over time.","confidence":0.85,"topic_tags":["religiosity","adolescents","sexual_function"],"strengths":["Large, nationally representative dataset.","Consistent measurement across multiple survey waves.","Survival analysis appropriate for time‑to‑event (sexual debut)."],"limitations":["Cross‑sectional design; cannot infer causality.","No control for key confounds (e.g., moral incongruence, mental health).","Religiosity measured by self‑report items; no objective validation."],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":26,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/jwh.2010.1949"}},{"id":8817,"doi":"10.3109/01460862.2011.619861","pmid":"22010625","pmcid":null,"title":"Early and risky sexual behavior in a sample of rural adolescents","authors":"Rew L, Carver T, Li CC.","first_author":"Rew L","journal":"Issues in comprehensive pediatric nursing","year":2011,"pub_types":["Multicenter Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"cross‑sectional analysis of baseline data from an ongoing longitudinal cohort (N=255 rural adolescents)","sample_n":255,"sample_text":"255 adolescents from a longitudinal study","population":"Rural adolescents in the United States, mixed gender, ages not specified","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 255 rural teens, those who reported risky sexual behavior also reported lower religiosity, less parental monitoring, weaker social connections, and stronger peer influence, suggesting social and religious factors shape sexual risk.","clinical_takeaway":"Addressing peer and parental influences, along with fostering religious or moral engagement, may help reduce risky sexual behavior in rural adolescents.","confidence":0.7,"topic_tags":["sexual_function","religiosity","adolescents"],"strengths":["Relatively large sample for a rural focus","Uses multiple psychosocial variables","Longitudinal cohort provides potential for future temporal analyses"],"limitations":["Cross‑sectional analysis limits causal inference","Measures appear to be self‑report and not detailed on validation","Mental‑health and trauma factors not addressed"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":14,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/01460862.2011.619861"}},{"id":8818,"doi":"10.1037/a0021690","pmid":"21171775","pmcid":null,"title":"Compatibility or restraint? The effects of sexual timing on marriage relationships","authors":"Busby DM, Carroll JS, Willoughby BJ.","first_author":"Busby DM","journal":"Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43)","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large community survey (N=2035), cross‑sectional, structural equation modelling","sample_n":2035,"sample_text":"2035 married individuals","population":"married adults, age range young adult to middle‑aged, mixed gender","country":"unspecified (likely USA based on authors' affiliations)","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed over 2000 married adults and found that couples who waited longer before becoming sexually involved reported higher sexual quality, better communication, and greater relationship satisfaction, even after accounting for education, number of past partners, religiosity, and how long they had been together.","clinical_takeaway":"Waiting to become sexually active together may be linked to more satisfying marriages, but causality cannot be confirmed from this survey.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["large sample size","controls for several demographic variables","use of structural equation modelling"],"limitations":["cross‑sectional design limits causal inference","unclear if measures are validated","no control for mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":9,"contrasting":1,"mentioning":53,"citing_publications":69,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/a0021690"}},{"id":8819,"doi":"10.1007/s10964-010-9598-2","pmid":"21052800","pmcid":"PMC3391607","title":"The role of religiosity in the relationship between parents, peers, and adolescent risky sexual behavior","authors":"Landor A, Simons LG, Simons RL, Brody GH, Gibbons FX.","first_author":"Landor A","journal":"Journal of youth and adolescence","year":2011,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Longitudinal cohort of 612 African American adolescents; structural equation modeling of parental religiosity, parenting, peer influences, and adolescent risky sexual behavior.","sample_n":612,"sample_text":"Community sample of African American adolescents","population":"Adolescents (average age ~? Not specified) African American, 55% female, USA (Georgia, Iowa).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study followed 612 African American teens and found that higher parental religiosity lowered risky sexual behavior by promoting stricter parenting, increasing teens' own religiosity, and steering them toward less permissive peers.","clinical_takeaway":"Families’ religious involvement may indirectly protect adolescents from unsafe sex via parenting and peer influences.","confidence":0.8,"topic_tags":["religiosity","adolescents"],"strengths":["Large longitudinal sample","Use of structural equation modeling to test mediation","Consideration of multiple pathways (parenting, peers, adolescent religiosity)","Gender‑specific analyses"],"limitations":["Reliance on self‑report for sexual behavior and religiosity","No explicit validation of measurement scales reported in abstract","Potential unmeasured confounds (e.g., mental health, trauma)","Generalizability limited to African American youth in selected states"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":2,"mentioning":111,"citing_publications":184,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10964-010-9598-2"}},{"id":8820,"doi":"10.1590/s1413-81232010000700023","pmid":"20640273","pmcid":null,"title":"[Sexual risk behavior: factors associated to the number of sexual partners and condom use in adolescents]","authors":"Cruzeiro AL, Souza LD, Silva RA, Pinheiro RT, Rocha CL, Horta BL.","first_author":"Cruzeiro AL","journal":"Ciencia & saude coletiva","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.scielo.br/j/csc/a/RNtskTfL5T7nL4w9bNvryRq/?lang=pt&format=pdf","cited_by_count":16,"is_preprint":false,"topics":["shame_religiosity"],"language":"por","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 960 adolescents assessing number of partners and condom use","sample_n":960,"sample_text":"960 adolescents (community sample)","population":"Adolescents 15‑18 years old, Brazil","country":"Brazil","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 960 Brazilian teenagers, those who used drugs, drank alcohol before sex, or were male tended to have more than one partner in the past year, while females and those with less‑educated mothers were less likely to use condoms consistently.","clinical_takeaway":"Risk‐behaviour interventions should address substance use and gender‑specific factors when promoting condom use among adolescents.","confidence":0.9,"topic_tags":["sexual_function","adolescents"],"strengths":["Large community sample (N≈960)","Multiple socio‑demographic covariates entered in regression","Clear operationalisation of sexual‑risk outcomes"],"limitations":["Self‑report measures, no validated scales for risk behaviour","Cross‑sectional design limits causal inference","No adjustment for mental‑health variables (depression/anxiety)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":7,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":1,"mentioning":28,"citing_publications":72,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s1413-81232010000700023"}},{"id":8821,"doi":"10.1016/j.jpag.2010.02.012","pmid":"20493738","pmcid":"PMC2933332","title":"Associations between religiosity and sexual and contraceptive behaviors","authors":"Gold MA, Sheftel AV, Chiappetta L, Young AJ, Zuckoff A, DiClemente CC, Primack BA.","first_author":"Gold MA","journal":"Journal of pediatric and adolescent gynecology","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"secondary analysis of RCT data; cross‑sectional multivariable associations","sample_n":572,"sample_text":"female adolescents (13–21 years)","population":"572 female adolescents (13‑21) from clinic and community ads","country":"USA","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 572 U.S. teenage girls, those who reported higher religiosity were less likely to have had sex, become pregnant, contract an STD, or have many lifetime partners, but religiosity did not affect how often they had sex or their contraceptive use.","clinical_takeaway":"Higher self‑reported religiosity correlates with lower sexual risk behaviors among adolescents, but causal claims are unwarranted.","confidence":0.8,"topic_tags":["religiosity","adolescents","sexual_function"],"strengths":["large adolescent sample","multivariable modeling with CIs","uses existing RCT dataset"],"limitations":["cross‑sectional; cannot infer causality","religiosity measured with non‑validated index","key confounds (mental health, partner effects, masturbation) not assessed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":26,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpag.2010.02.012"}},{"id":8822,"doi":"10.1007/s10508-010-9621-4","pmid":"20364304","pmcid":"PMC4419361","title":"The relationship among sexual attitudes, sexual fantasy, and religiosity","authors":"Ahrold TK, Farmer M, Trapnell PD, Meston CM.","first_author":"Ahrold TK","journal":"Archives of sexual behavior","year":2011,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 1413 young adults assessing religiosity domains, sexual attitudes and fantasy; regression analyses","sample_n":1413,"sample_text":"N = 1413, 69% women, ethnically diverse young adult sample","population":"young adults, 69% women, ethnically diverse (USA)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 1,400 young adults, researchers found that personal religiosity (especially spirituality and intrinsic belief) predicts how conservative people are about sex and how often they report sexual fantasies, with some differences between men and women.","clinical_takeaway":"Clinicians should consider clients’ individual religiosity when discussing sexual attitudes and fantasies, as these beliefs influence sexual outlook more than group affiliation.","confidence":0.8,"topic_tags":["sexual_function","religiosity"],"strengths":["Large, ethnically diverse sample","Validated religiosity and sexual attitude scales","Gender‑specific analyses","Clear statistical mediation model"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of sexual behavior beyond fantasy frequency","Potential self‑selection bias (unspecified recruitment)","Moral incongruence, mental‑health and partner variables not addressed"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":1,"mentioning":51,"citing_publications":133,"retracted":false,"notices":[{"status":"Has erratum","date":"2011-5-29","noticeDoi":"10.1007/s10508-011-9782-9","doi":"10.1007/s10508-010-9621-4"}],"url":"https://scite.ai/reports/10.1007/s10508-010-9621-4"}},{"id":8823,"doi":"10.1080/00224490902867855","pmid":"19343580","pmcid":null,"title":"Religious identification as a moderator of evolved sexual strategies of men and women","authors":"Njus DM, Bane CM.","first_author":"Njus DM","journal":"Journal of sex research","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Two convenience-sample surveys of college students (N≈219 and N≈234) measuring self‑reported religiosity and mating attitudes.","sample_n":453,"sample_text":"College student participants","population":"college students, mean age 19.1, both sexes","country":"Not specified (likely USA based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors surveyed college students and found that how religious a person is, especially intrinsic religiosity, changes the usual sex differences in short‑term mating preferences such as the desire for multiple partners.","clinical_takeaway":"None – the study deals with general mating attitudes, not clinical concerns.","confidence":0.4,"topic_tags":["religiosity","sexual_function","moral_incongruence"],"strengths":["Large total N for survey research","Uses a validated religious inventory in Study 2","Addresses interaction of religiosity with sex differences"],"limitations":["Convenience college sample limits generalisability","Reliance on single‑item religiosity in Study 1","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490902867855"}},{"id":8825,"doi":null,"pmid":"20279116","pmcid":null,"title":"Hysterical color blindness; caused by infantile sexual guilt","authors":"FODOR N.","first_author":"FODOR N.","journal":"Journal of clinical and experimental psychopathology","year":1946,"pub_types":["Journal Article"],"keywords":["Sex","Hysteria","Color Blindness/etiology And Pathogenesis"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":null},{"id":8826,"doi":"10.1007/s10943-009-9267-5","pmid":"19565334","pmcid":null,"title":"The association of religiosity, sexual education, and parental factors with risky sexual behaviors among adolescents and young adults","authors":"Haglund KA, Fehring RJ.","first_author":"Haglund KA","journal":"Journal of religion and health","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":49,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional analysis of a nationally representative US survey (NSFG) with N=3,168 adolescents/young adults aged 15‑21)","sample_n":3168,"sample_text":"Nationally representative sample from the 2002 National Survey of Family Growth","population":"United States adolescents and young adults, community sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a U.S. survey of 3,168 teens and young adults, stronger religious involvement and abstinence‑focused sex education were linked to lower odds of having sex and fewer sexual partners.","clinical_takeaway":"Religiosity and abstinence‑oriented education correlate with reduced risky sexual behavior among teens, but causality cannot be confirmed.","confidence":0.7,"topic_tags":["religiosity","sexual_function","adolescents","relationships"],"strengths":["Large, nationally representative sample","Clear operationalisation of religiosity and sexual education variables","Use of weighted regression to estimate odds ratios with confidence intervals"],"limitations":["Cross‑sectional design limits causal inference","Potential self‑report bias in sexual behaviour","Did not control for mental‑health or trauma variables that could confound associations"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":11,"contrasting":0,"mentioning":69,"citing_publications":149,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-009-9267-5"}},{"id":8827,"doi":"10.2105/ajph.2007.125674","pmid":"19372533","pmcid":null,"title":"Sociodemographic, sexual, and HIV and other sexually transmitted disease risk profiles of nonhomosexual-identified men who have sex with men","authors":"Jeffries WL.","first_author":"Jeffries WL.","journal":"American journal of public health","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional analysis of a probabilistic US sample of MSM; sample size not reported in abstract","sample_n":null,"sample_text":"Probabilistic sampling strategies may be useful in future research and intervention efforts","population":"men who have sex with men, both homosexual-identified and non‑homosexual‑identified","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study compares demographic and sexual‑risk characteristics of men who have sex with men who label themselves as homosexual versus those who do not, finding some riskier and some protective behaviours among the non‑homosexual‑identified group.","clinical_takeaway":"None – the paper does not provide actionable guidance for clinicians.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, probabilistic sampling approach mentioned","Uses logistic regression to examine multiple risk factors"],"limitations":["Cross‑sectional design limits causal inference","No measurement or control of key confounds (e.g., mental health, moral incongruence)","Abstract does not report sample size or power considerations"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":2,"mentioning":16,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2105/ajph.2007.125674"}},{"id":8828,"doi":"10.1542/peds.2008-0407","pmid":"19117832","pmcid":"PMC2768056","title":"Patient teenagers? A comparison of the sexual behavior of virginity pledgers and matched nonpledgers","authors":"Rosenbaum JE.","first_author":"Rosenbaum JE.","journal":"Pediatrics","year":2009,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://soar.suny.edu/bitstream/20.500.12648/8444/1/zpe0010900e110.pdf","cited_by_count":51,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"National Longitudinal Study of Adolescent Health; propensity‑matched cohort; 5‑year follow‑up of pledgers vs non‑pledgers (n≈934).","sample_n":934,"sample_text":"289 pledgers matched to 645 non‑pledgers (propensity score matching on religiosity, attitudes, etc.).","population":"U.S. adolescents >15 y, initially virgins, surveyed 1995‑2000 (n≈3440 total, 289 pledgers, 645 matched non‑pledgers).","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":8,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Teenagers who pledged virginity were no less likely to have sex than similar non‑pledgers, but they were less likely to use condoms or birth control, increasing pregnancy and disease risk.","clinical_takeaway":"Clinicians should discuss contraception with all teens, regardless of pledge status.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Nationally representative longitudinal cohort","Propensity‑score matching improves comparability","Objective STI outcomes complement self‑report"],"limitations":["Self‑reported sexual behavior may be biased","Masturbation and mental‑health variables not assessed","No pre‑registration; potential analytic flexibility"],"rubric_version":"2.0","raw_total":38,"max_possible":50,"pct_score":76,"quality_rating":"Good","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":6,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":73,"citing_publications":165,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2008-0407"}},{"id":8829,"doi":"10.1007/s10508-008-9418-x","pmid":"19093197","pmcid":null,"title":"Sexual milestones and factors associated with coitus initiation among Israeli high school students","authors":"Shtarkshall RA, Carmel S, Jaffe-Hirschfield D, Woloski-Wruble A.","first_author":"Shtarkshall RA","journal":"Archives of sexual behavior","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large national survey of Israeli high‑school students (N≈4600) using a self‑administered questionnaire; cross‑sectional descriptive and logistic regression analyses","sample_n":4609,"sample_text":"random sample of 4,609 students","population":"adolescents (high‑school grades) in secular Israeli schools; random sample of schools, covering ~55% of all students","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A national survey of Israeli high‑school students mapped step‑by‑step sexual activities leading to intercourse and identified factors like gender, religiosity, peer behaviour and family background that predict when teens first have sex.","clinical_takeaway":"Understanding predictors of coitus initiation can guide sex‑education programs, but the study does not inform treatment of sexual addiction or related disorders.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large, nationally representative sample","Systematic description of sexual milestones","Use of multivariate logistic regression"],"limitations":["Self‑report, likely unvalidated measures","Cross‑sectional, no causal inference","Key confounds (masturbation, moral incongruence, mental health) not assessed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":23,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-008-9418-x"}},{"id":8830,"doi":"10.1111/j.1728-4465.2008.00174.x","pmid":"19248714","pmcid":null,"title":"The start of the sexual transition in Mali: risks and opportunities","authors":"Sauvain-Dugerdil C, Gakou B, Berthé F, Dieng AW, Ritschard G, Lerch M.","first_author":"Sauvain-Dugerdil C","journal":"Studies in family planning","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"questionnaire survey of 2,000 young Malians (urban and rural) conducted in 2002","sample_n":2000,"sample_text":"2000 participants from under‑privileged urban and rural populations in Mali","population":"young Malians (adolescents and young adults), mixed gender, community sample","country":"Mali","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2008 survey of 2,000 young people in Mali found that women are having sex and children later, especially when more educated, while men are starting sex earlier but delaying fatherhood if they are wealthier and less religious. Lower religiosity is linked to earlier sexual activity, raising concerns about risky sexual behaviour.","clinical_takeaway":"Clinicians should consider education and religiosity when counseling young Malians about sexual health risks.","confidence":0.8,"topic_tags":["sexual_function","religiosity","adolescents"],"strengths":["Large community sample (n≈2000)","Addresses gender‑specific trends in sexual timing","Considers role of education and religiosity"],"limitations":["Cross‑sectional; cannot infer causality","Questionnaire items not reported as validated instruments","Key confounds (e.g., mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":5,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1728-4465.2008.00174.x"}},{"id":8831,"doi":"10.1016/j.adolescence.2008.08.001","pmid":"18851878","pmcid":null,"title":"Factors associated with sexual activity among high-school students in Nairobi, Kenya","authors":"Kabiru CW, Orpinas P.","first_author":"Kabiru CW","journal":"Journal of adolescence","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 3556 high‑school students in Nairobi, Kenya","sample_n":3556,"sample_text":"Large community sample of high‑school students; convenience/cluster sampling likely","population":"adolescent students (male and female) in Nairobi secondary schools","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2009 survey of over 3500 Nairobi high‑school students found that about half of boys and 11% of girls had ever had sex. Factors like religiosity, parents’ attitudes, living situation and school type were linked to sexual activity, with different patterns for males and females.","clinical_takeaway":"Sex‑education programs should consider gender‑specific social and religious influences when addressing adolescent sexual activity.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Large sample size","Gender‑specific analysis","Multiple sociodemographic and psychosocial variables"],"limitations":["Cross‑sectional design limits causal inference","No measurement of key sexual‑health confounders (e.g., mental health, trauma)","Reliance on self‑report without validation details"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":1,"mentioning":47,"citing_publications":121,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2008.08.001"}},{"id":8832,"doi":"10.1007/s10508-008-9406-1","pmid":"18839302","pmcid":"PMC4426857","title":"Ethnic differences in sexual attitudes of U.S. college students: gender, acculturation, and religiosity factors","authors":"Ahrold TK, Meston CM.","first_author":"Ahrold TK","journal":"Archives of sexual behavior","year":2010,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":86,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 1,415 U.S. college students assessing sexual attitudes across ethnic groups using questionnaires","sample_n":1415,"sample_text":"Convenience sample of college students recruited from a single university (implied)","population":"U.S. college students (Euro-American, Asian, Hispanic), 32% men, 68% women","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 1,415 U.S. college students found that Asian students tend to hold more conservative sexual attitudes than Hispanic and Euro‑American peers, and that higher acculturation makes attitudes more like those of Euro‑Americans.","clinical_takeaway":"None – the study examines attitudes, not clinical sexual health outcomes.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size for a survey","Comprehensive assessment of multiple attitudinal domains","Inclusion of acculturation and multiple facets of religiosity"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report questionnaires; validation not detailed","Convenience college sample limits generalisability"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":6,"mentioning":145,"citing_publications":272,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-008-9406-1"}},{"id":8833,"doi":"10.1007/s10508-008-9407-0","pmid":"18839301","pmcid":null,"title":"The relation between sexual behavior and religiosity subtypes: a test of the secularization hypothesis","authors":"Farmer MA, Trapnell PD, Meston CM.","first_author":"Farmer MA","journal":"Archives of sexual behavior","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1302 young adults","sample_n":1302,"sample_text":"N = 1302, M age = 18.77 years","population":"young adults (mean age 18.77), likely university or community sample","country":"USA (implied by authors and journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,300 young adults, researchers found that while religious affiliation did not predict sexual activity, specific religious attitudes—especially fundamentalism—were linked to lower sexual behavior, especially for women.","clinical_takeaway":"Clinicians should note that particular religious convictions, not just affiliation, may influence sexual activity patterns.","confidence":0.8,"topic_tags":["religiosity","sexual_function"],"strengths":["Large sample size for a cross‑sectional survey","Use of multiple validated religiosity subscales","Consideration of both affiliation and dimensional religiosity"],"limitations":["Cross‑sectional design limits causal inference","Potential selection bias (young adult/college sample)","Limited assessment of other sexual‑health confounders"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":23,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-008-9407-0"}},{"id":8834,"doi":"10.1177/0095798408320716","pmid":"23225915","pmcid":"PMC3513389","title":"The Influence of Role Status on Risky Sexual Behavior Among African Americans During the Transition to Adulthood","authors":"Kogan SM, Brody GH, Gibbons FX, Murry VM, Cutrona CE, Simons RL, Wingood G, Diclemente R.","first_author":"Kogan SM","journal":"The Journal of black psychology","year":2008,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of African American young adults (N=186) reporting role status, sexual risk, substance use, peer and family factors; cross‑sectional analysis of associations and mediation/moderation.","sample_n":186,"sample_text":"African American young adults who had either completed or dropped out of high school (ages 18 to 21, N = 186)","population":"African American young adults, ages 18‑21, recruited from community/school settings (details not specified).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among African‑American young adults, staying in school, working full‑time, and living in dorms were linked to lower risky sex, while parenthood increased risk. Peer influence and substance use helped explain these links, and family support and religiosity could lessen the impact of parenthood.","clinical_takeaway":"Promoting continued education, stable employment, and supportive family/religious involvement may reduce sexual‑risk behaviors in this population.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses understudied role‑status factors","Includes multiple mediators/moderators","Relatively sizable community sample for the target group"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report; unclear validation of scales","Potential unmeasured confounds (mental health, trauma)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0095798408320716"}},{"id":8835,"doi":"10.1363/4010508","pmid":"18577143","pmcid":"PMC6532059","title":"Pathways from family religiosity to adolescent sexual activity and contraceptive use","authors":"Manlove J, Logan C, Moore KA, Ikramullah E.","first_author":"Manlove J","journal":"Perspectives on sexual and reproductive health","year":2008,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":48,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"National Longitudinal Survey of Youth 1997 cohort, nationally representative, follow‑up to age 17, structural equation modelling of pathways.","sample_n":null,"sample_text":"National longitudinal cohort; exact N not given in abstract.","population":"U.S. adolescents (age ~17), both sexes, diverse socioeconomic background.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a national U.S. youth survey, higher family religiosity was linked to later sexual debut, fewer partners and, for most teens, more consistent contraceptive use—effects that were partly explained by stronger family cohesion and positive peer environments.","clinical_takeaway":"Family religiosity may protect adolescents from risky sexual behavior through cohesive family and peer contexts; prevention programs should focus on parental monitoring and relationship quality.","confidence":0.8,"topic_tags":["religiosity","adolescents","sexual_function"],"strengths":["Large, nationally representative longitudinal data","Multidimensional religiosity measure","Structural equation modelling of indirect pathways"],"limitations":["No direct measurement of moral or mental‑health variables","Abstract lacks detail on sample size and power","Potential unmeasured confounders (e.g., individual religiosity, peer influences beyond those assessed)"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":6,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":5,"contrasting":0,"mentioning":92,"citing_publications":124,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1363/4010508"}},{"id":8836,"doi":"10.1186/1471-2458-8-136","pmid":"18439236","pmcid":"PMC2390536","title":"Predictors of early sexual initiation among a nationally representative sample of Nigerian adolescents","authors":"Fatusi AO, Blum RW.","first_author":"Fatusi AO","journal":"BMC public health","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/1471-2458-8-136","cited_by_count":86,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"nationwide representative survey of 2,070 Nigerian adolescents (15‑19 y), interviewer‑collected data, Cox proportional hazards models for age at first sex.","sample_n":2070,"sample_text":"nationally representative sample of adolescents in Nigeria","population":"Never‑married adolescents, ages 15‑19, Nigeria (N≈2070)","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 2,070 Nigerian teens found that region, attitudes about condoms and family planning, alcohol use, and low religiosity were linked to earlier first‑sex, while strong personal views against early sex delayed it.","clinical_takeaway":"Programs that promote delayed sexual debut and address attitudes, alcohol use, and access to contraception may help reduce early sexual initiation.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Large, nationally representative sample","Use of survival analysis with hazard ratios and confidence intervals","Separate models for males and females"],"limitations":["Cross‑sectional design limits causal inference","Potential self‑report bias on sexual behavior and attitudes","Limited measurement of mental‑health or partner variables"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":13,"contrasting":5,"mentioning":98,"citing_publications":150,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2458-8-136"}},{"id":8837,"doi":"10.1111/j.1365-2214.2007.00807.x","pmid":"18294258","pmcid":null,"title":"Correlates of sexuality communication among mothers and 6-12-year-old children","authors":"Pluhar EI, DiIorio CK, McCarty F.","first_author":"Pluhar EI","journal":"Child: care, health and development","year":2008,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 298 African‑American mother‑child dyads recruited from a community organization","sample_n":298,"sample_text":"convenience sample from a youth‑serving, community‑based organization","population":"African‑American mothers (predominantly lower‑ to middle‑income) and their 6‑12‑year‑old children (N=298 dyads)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 298 African‑American mothers and their 6‑12‑year‑old children, mothers who felt more confident and comfortable talking about sex were more likely to discuss sexuality with their kids. Age, gender, and religiosity had little impact.","clinical_takeaway":"Boosting parental confidence and comfort may improve parent‑child sex communication.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large (N≈300) community sample for this topic","Multiple relevant psychosocial variables measured","Clear focus on modifiable factors (self‑efficacy, comfort)"],"limitations":["Convenience, non‑probability sampling limits generalisability","Cross‑sectional design prevents causal inference","Limited detail on validation of communication scale"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":1,"mentioning":51,"citing_publications":79,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2214.2007.00807.x"}},{"id":8838,"doi":null,"pmid":"21765650","pmcid":"PMC3134961","title":"Católicos, fidelidade conjugal e AIDS: entre a cruz da doutrina moral e as espadas do cotidiano sexual dos adeptos","authors":"Rios LF, de Aquino FL, Muñoz-Laboy M, Oliveira C, Parker R.","first_author":"Rios LF","journal":"Debates do NER : publicacao do Nucleo de Estudos da Religiao do Programa de Pos-Graduacao em Antropologia Social da Universidade Federal do Rio Grande do Sul","year":2008,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["shame_religiosity"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"ethnographic participant observation and semi‑structured interviews with 19 Catholic participants (11 lay, 8 clergy) in a Recife neighbourhood; thematic analysis of discourse on marital fidelity and HIV/AIDS.","sample_n":19,"sample_text":"eleven lay participants and eight priests; plus field observations","population":"adult Catholics from a popular neighbourhood in Recife, Brazil; convenience/volunteer sample recruited through church contacts","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors used ethnographic observation and interviews with Catholic laypeople and priests in Recife to explore how Church teachings on marriage and fidelity influence attitudes toward HIV/AIDS, highlighting tensions between doctrine and everyday sexual practices.","clinical_takeaway":"Clinicians should recognise that religious moral frameworks can shape how Catholic patients perceive and manage HIV risk, but this study offers no direct clinical guidance.","confidence":0.8,"topic_tags":["religiosity","sexual_function"],"strengths":["In‑depth ethnographic immersion","Includes perspectives of both lay members and clergy","Contextualises religious doctrine with lived sexual health practices"],"limitations":["Very small, non‑representative sample","No systematic measurement of sexual‑health outcomes","Lacks quantitative analysis or statistical rigor","Findings not generalisable beyond the specific community"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":8839,"doi":"10.1093/swr/32.3.147","pmid":"20228887","pmcid":"PMC2836779","title":"Pathways to Drug and Sexual Risk Behaviors among Detained Adolescents","authors":"Voisin DR, Neilands TB, Salazar LF, Crosby R, Diclemente RJ.","first_author":"Voisin DR","journal":"Social work research","year":2008,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 559 detained adolescents using A‑CASI","sample_n":559,"sample_text":"detained adolescents (N=559)","population":"detained adolescents (N=559)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among detained teenagers, seeing community violence was linked to higher drug use and risky sexual behaviour, partly because it increased gang involvement and risky peer norms.","clinical_takeaway":"Interventions that alter peer group influences may help reduce drug and sexual risk among detained youth.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large sample for a detained youth study","Uses audio‑computer assisted self‑interview to improve honesty","Controls for several demographic and family variables"],"limitations":["Cross‑sectional design cannot establish causality","Relies on self‑report, possible recall bias","Does not measure key sexual‑health confounds (e.g., mental health, trauma) "],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/swr/32.3.147"}},{"id":8840,"doi":"10.1590/s1413-73722008000400006","pmid":"21886456","pmcid":"PMC3163488","title":"Religiosidade, juventude e sexualidade: entre a autonomia e a rigidez","authors":"Silva CG, Santos AO, Licciardi DC, Paiva V, Parker R.","first_author":"Silva CG","journal":"Psicologia em estudo","year":2008,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.scielo.br/j/pe/a/qLHLpmHbpmGzkKVX5Xjv8BL/?lang=pt&format=pdf","cited_by_count":7,"is_preprint":false,"topics":["shame_religiosity"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative interview study with 26 open‑ended semi‑structured interviews of religious youths and community authorities in São Paulo.","sample_n":26,"sample_text":"26 interviews","population":"Religious youths and religious authorities in metropolitan São Paulo, Brazil (convenience sample).","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with religious youths and leaders in São Paulo show how religious beliefs shape views on sex, contraception, and rights, highlighting tensions between tradition and modernity.","clinical_takeaway":"None – study provides sociocultural context rather than clinical guidance.","confidence":0.6,"topic_tags":["religiosity","sexual_function"],"strengths":["In‑depth qualitative insights from multiple religious traditions","Addresses policy relevance for sexual‑health programs"],"limitations":["Small, non‑representative convenience sample","No validated measurement instruments","Findings limited to specific metropolitan area"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":64,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/s1413-73722008000400006"}},{"id":8841,"doi":"10.1542/9781581104080-religiosity","pmid":"18453228","pmcid":null,"title":"Religiosity, spirituality, and adolescent sexuality","authors":"Cotton S, Berry D.","first_author":"Cotton S","journal":"Adolescent medicine: state of the art reviews","year":2007,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or risk‑of‑bias assessment; no primary data reported.","sample_n":null,"sample_text":"Not applicable – review article","population":"Adolescents (U.S.) – broad description only","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The review summarizes how adolescents' religious and spiritual beliefs may influence when they first have sex, their attitudes toward sex before marriage, and contraceptive use, and suggests how clinicians might incorporate these factors into care.","clinical_takeaway":"Consider adolescents' religious and spiritual contexts when counseling about sexual decisions and contraception.","confidence":0.45,"topic_tags":["religiosity","adolescents","sexual_function"],"strengths":["Broad overview of religiosity/spirituality and adolescent sexual health","Integrates clinical implications"],"limitations":["No systematic methodology or risk‑of‑bias assessment","No primary data or quantitative synthesis","Potential author bias; no declaration of conflicts of interest"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/9781581104080-religiosity"}},{"id":8842,"doi":"10.1177/0193945907303102","pmid":"17717107","pmcid":null,"title":"Predicting condom use among sexually experienced Latino adolescents","authors":"Villarruel AM, Jemmott JB, Jemmott LS, Ronis DL.","first_author":"Villarruel AM","journal":"Western journal of nursing research","year":2007,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of sexually experienced Latino adolescents assessing cultural variables and condom use; cross‑sectional regression analysis.","sample_n":null,"sample_text":"Not reported in abstract","population":"Latino adolescents (sexually experienced) in Philadelphia; sample size not stated in abstract.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of Latino teens found that religious involvement was the only cultural factor linked to whether they had used condoms in the past, while family values and gender role beliefs did not predict condom use intentions or behavior.","clinical_takeaway":"In this group, addressing religiosity may be key when promoting condom use.","confidence":0.7,"topic_tags":["sexual_function","religiosity","csbd"],"strengths":["Focus on understudied Latino adolescent population","Inclusion of cultural variables (familialism, gender roles, religiosity)","Use of regression analysis to test direct/indirect effects"],"limitations":["Cross‑sectional design limits causal inference","No report of sample size or power calculations","Potential reliance on self‑report measures without validation details"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":57,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0193945907303102"}},{"id":8843,"doi":"10.1016/j.jadohealth.2007.04.017","pmid":"17875466","pmcid":null,"title":"Onset of sexual intercourse among female adolescents: the influence of perceptions, depression, and ecological factors","authors":"Rink E, Tricker R, Harvey SM.","first_author":"Rink E","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2007,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Longitudinal analysis of 3,644 US female adolescents across three waves of the National Longitudinal Study of Adolescent Health, using logistic regression to predict onset of sexual intercourse.","sample_n":3644,"sample_text":"large, nationally‑representative cohort","population":"Female adolescents, age 15‑19, United States (N=3,644)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally‑representative US cohort of 3,600 teen girls, feelings about sex, depression, and connections to parents, peers, and school predicted whether they started having sex. Non‑depressed teens with ambivalent views about sex and strong ties to father, peers, or school delayed intercourse; depressed teens were more influenced by maternal ties.","clinical_takeaway":"Depression and social‑environment factors shape teen girls' sexual initiation; interventions should tailor strategies for depressed versus non‑depressed adolescents.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, nationally‑representative longitudinal sample","Multivariate modeling of many psychosocial factors","Interaction analysis with depression"],"limitations":["Self‑report of sexual behaviour may be biased","Perceptions of sex measured with non‑validated items","No explicit measurement of moral incongruence or trauma history"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":6,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":1,"mentioning":59,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2007.04.017"}},{"id":8844,"doi":"10.1177/107906320701900308","pmid":"17634756","pmcid":null,"title":"Cognition or involvement? Explaining sexual-coercion in high-school dating","authors":"Enosh G.","first_author":"Enosh G.","journal":"Sexual abuse : a journal of research and treatment","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"factorial survey design with 329 eleventh‑grade students (157 males, 172 females)","sample_n":329,"sample_text":"convenience sample of school‑based adolescents","population":"adolescents (high‑school, US likely)","country":"not specified","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 329 high‑school students to see how personal attitudes, peer expectations, and background factors like religiosity relate to both committing and experiencing sexual coercion in dating.","clinical_takeaway":"Risk of sexual coercion is linked to attitudes and perceived peer norms; prevention programs should address these social influences.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community‑based adolescent sample","Use of theoretically driven planned‑behavior model","Inclusion of cultural variables (religiosity, immigration status)"],"limitations":["Cross‑sectional self‑report design limits causality","Limited information on psychometric validation of measures","No control for mental‑health or trauma variables"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":37,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/107906320701900308"}},{"id":8845,"doi":"10.1037/0893-3200.21.2.320","pmid":"17605555","pmcid":null,"title":"Predicting sexual infidelity in a population-based sample of married individuals","authors":"Whisman MA, Gordon KC, Chatav Y.","first_author":"Whisman MA","journal":"Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43)","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Population-based cross-sectional survey of 2,291 married adults examining predictors of 12‑month sexual infidelity using logistic regression.","sample_n":2291,"sample_text":"population‑based sample of married individuals","population":"Married adults (both sexes) from a population‑based sample; N=2,291.","country":"USA (implied by funding and journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of over 2,000 married adults, about 2 % reported cheating in the past year. Higher neuroticism, lower religiosity, and for husbands, a wife's pregnancy, predicted cheating, even after accounting for marital dissatisfaction.","clinical_takeaway":"Clinicians should note that personality and religious factors, not just marital dissatisfaction, relate to infidelity risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, population‑based sample","Use of validated personality and religiosity scales","Comprehensive set of predictor domains"],"limitations":["Cross‑sectional design limits causal inference","Self‑report of infidelity may be biased","No measurement of mental‑health covariates beyond neuroticism"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":8,"contrasting":3,"mentioning":105,"citing_publications":201,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/0893-3200.21.2.320"}},{"id":8846,"doi":"10.1037/0893-3200.21.2.147","pmid":"17605537","pmcid":null,"title":"Sexual infidelity in a national survey of American women: differences in prevalence and correlates as a function of method of assessment","authors":"Whisman MA, Snyder DK.","first_author":"Whisman MA","journal":"Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43)","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"National probability sample of married women (N=4,884) using face‑to‑face and computer‑assisted self‑interviews; cross‑sectional prevalence study.","sample_n":4884,"sample_text":"Population‑based probability sample of married women in the United States (N = 4,884).","population":"American married women, community‑based sample","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a U.S. survey of 4,884 married women, about 1% admitted to cheating when asked face‑to‑face, but 6% did so via a confidential computer questionnaire. Religiosity, demographics and childhood sexual abuse were linked to cheating, and the method of asking changed how often it was reported.","clinical_takeaway":"Anonymous self‑report tools reveal higher rates of marital infidelity than face‑to‑face interviews; clinicians should consider assessment mode when discussing sexual behavior.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Large, nationally representative sample","Comparison of two assessment methods","Inclusion of childhood sexual abuse as a predictor"],"limitations":["Reliance on single‑item self‑report for infidelity","Limited control of mental‑health and partner variables","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":9,"contrasting":1,"mentioning":84,"citing_publications":152,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/0893-3200.21.2.147"}},{"id":8847,"doi":"10.1007/s10508-006-9157-9","pmid":"17377836","pmcid":null,"title":"How much does gender explain in sexual attitudes and behaviors? A survey of Canadian adults","authors":"Fischtein DS, Herold ES, Desmarais S.","first_author":"Fischtein DS","journal":"Archives of sexual behavior","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"National telephone survey of 1479 Canadian adults; cross‑sectional regression analyses.","sample_n":1479,"sample_text":"N = 1479 Canadian adults surveyed by COMPAS using telephone interviews.","population":"Canadian adults (18+), sampled via computer‑assisted telephone interviewing (likely probability sample).","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a national survey of 1,479 Canadian adults, men reported more frequent sexual thoughts, earlier first intercourse, more partners and stronger intentions for casual sex than women, even after accounting for age, marital status, education, religiosity and region.","clinical_takeaway":"Gender differences in sexual attitudes are robust; clinicians should consider gender alongside other demographics when discussing sexual behavior.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Large, nationally representative sample","Multivariate control for several demographics","Clear reporting of gender effects"],"limitations":["Self‑report measures, likely single‑item","Cross‑sectional; cannot infer causality","No reporting of effect sizes or confidence intervals"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":18,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-006-9157-9"}},{"id":8848,"doi":"10.1007/s10508-006-9056-0","pmid":"17136592","pmcid":null,"title":"Associations between religiosity and sexuality in a representative sample of Australian adults","authors":"de Visser RO, Smith AM, Richters J, Rissel CE.","first_author":"de Visser RO","journal":"Archives of sexual behavior","year":2007,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"representative national survey, N=19,307, cross‑sectional","sample_n":19307,"sample_text":"representative sample of 19,307 Australians aged 16‑59 years","population":"Australian adults 16‑59, probability sample, response rate 73.1%","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 19,000 Australian adults, people who attended religious services more often tended to hold more conservative sexual attitudes and engage in less liberal sexual behaviours, while infrequent attenders resembled non‑religious peers.","clinical_takeaway":"None – findings describe population‑level patterns, not individual clinical guidance.","confidence":0.8,"topic_tags":["religiosity","sexual_function"],"strengths":["Large, nationally representative probability sample","High response rate (73 %)","Adjusts for key demographic confounders"],"limitations":["Cross‑sectional; cannot infer causality","Self‑report measures, potential social desirability bias","No measurement of masturbation, mental health or partner variables"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":26,"citing_publications":117,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-006-9056-0"}},{"id":8849,"doi":"10.1080/00224490709336792","pmid":"17599264","pmcid":null,"title":"Religiosity, denominational affiliation and sexual behaviors among people with HIV in the United States","authors":"Galvan FH, Collins RL, Kanouse DE, Pantoja P, Golinelli D.","first_author":"Galvan FH","journal":"Journal of sex research","year":2007,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"nationally representative survey of people with HIV (N=1,421; sexual sub‑sample N=932); multivariate logistic regression","sample_n":1421,"sample_text":"Nationally representative sample of people in HIV care; 932 reported recent sexual activity","population":"Adults living with HIV in the United States, in care","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a US survey of 1,421 people with HIV, stronger religiosity and being Catholic were linked to fewer partners and less unprotected or high‑risk sex, suggesting religious involvement may encourage safer sexual practices.","clinical_takeaway":"Religious involvement may be a protective factor for safer sex among people with HIV, but causality is not proven.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Clear association between religiosity and safer sexual behaviours","Uses multivariate analysis to adjust for some covariates"],"limitations":["Cross‑sectional; cannot establish causality","Reliance on self‑report measures, unclear validation","No control for key confounds (mental health, trauma, partner context)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490709336792"}},{"id":8850,"doi":"10.1038/sj.ejhg.5201763","pmid":"17245411","pmcid":null,"title":"Dopamine transporter, gender, and number of sexual partners among young adults","authors":"Guo G, Tong Y, Xie CW, Lange LA.","first_author":"Guo G","journal":"European journal of human genetics : EJHG","year":2007,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Observational genetic association using >2500 siblings from a nationally representative longitudinal cohort; fixed‑effects within‑family models.","sample_n":2500,"sample_text":"more than 2500 individuals (sibling subsample)","population":"young adult US men and women (Add Health cohort)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A study of over 2,500 U.S. young adults found that men carrying a common variant of the dopamine transporter gene (DAT1) reported roughly double the number of sexual partners compared with men lacking the variant; no such link was found in women.","clinical_takeaway":"Genetic variation in dopamine transport may relate to sexual‑partner behavior in men, but does not imply a health problem or need for clinical action.","confidence":0.8,"topic_tags":["gender"],"strengths":["Large, nationally representative sibling sample","Within‑family fixed‑effects control for shared genetics/environment","Adjustment for multiple socioeconomic covariates","Clear genotype‑gender interaction analysis"],"limitations":["Self‑reported partner count may be subject to recall/social desirability bias","No assessment of mental‑health or trauma confounders","Effect sizes and confidence intervals not reported in abstract","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":2,"mentioning":34,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/sj.ejhg.5201763"}},{"id":8851,"doi":"10.1080/00918360802103399","pmid":"18689195","pmcid":"PMC4154190","title":"Sexual prejudice among Puerto Rican young adults","authors":"Bauermeister JA, Morales M, Seda G, González-Rivera M.","first_author":"Bauermeister JA","journal":"Journal of homosexuality","year":2007,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 382 college students in Puerto Rico","sample_n":382,"sample_text":"N=382 college students in Puerto Rico","population":"college students (young adults) in Puerto Rico","country":"Puerto Rico","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 382 Puerto Rican college students examined how contact with gay people, positive experiences, perceived peer attitudes, and religiosity relate to sexual prejudice. All factors except peer attitudes predicted prejudice, with no differences between men and women.","clinical_takeaway":"None – not clinically applicable.","confidence":0.7,"topic_tags":["sexual_function","gender","prevalence","pornography","relationships"],"strengths":["Adequate sample size for survey research","Inclusion of multiple predictors (contact, experiences, religiosity)","Use of structural equation modeling"],"limitations":["Cross‑sectional design prevents causal inference","No indication of validated scales for key constructs","Convenience sample of college students limits generalizability"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00918360802103399"}},{"id":8852,"doi":"10.1016/j.pec.2006.10.010","pmid":"17137742","pmcid":null,"title":"Parent-adolescent communication about sexuality: the role of adolescents' beliefs, subjective norm and perceived behavioral control","authors":"Schouten BC, van den Putte B, Pasmans M, Meeuwesen L.","first_author":"Schouten BC","journal":"Patient education and counseling","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire survey of 481 Dutch high‑school students; linear regression and ANOVA used to assess predictors of self‑reported parent‑adolescent communication about sexuality.","sample_n":481,"sample_text":"Students from four high schools in The Netherlands","population":"Adolescents (high‑school students) in the Netherlands (N=481).","country":"Netherlands","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed Dutch teens to see how their beliefs, perceived social pressure, and sense of control predict how often they talk with parents about sex. Girls and those with positive beliefs communicated more.","clinical_takeaway":"Encouraging positive beliefs about sex talks may boost parent‑teen communication, especially for girls.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample for a questionnaire study","Considers multiple psychosocial predictors","Includes demographic covariates such as religiosity"],"limitations":["Cross‑sectional design limits causal inference","No reporting of effect sizes or power analysis","Unclear whether measures are fully validated"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":6,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":32,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pec.2006.10.010"}},{"id":8853,"doi":"10.1002/jts.20132","pmid":"16929500","pmcid":null,"title":"Resiliency among individuals with childhood sexual abuse and HIV: perspectives on addressing sexual trauma","authors":"Tarakeshwar N, Hansen NB, Kochman A, Fox A, Sikkema KJ.","first_author":"Tarakeshwar N","journal":"Journal of traumatic stress","year":2006,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Structural equation modeling on a single convenience sample of 266 HIV‑positive individuals with a history of childhood sexual abuse.","sample_n":266,"sample_text":"N=266 individuals with HIV and childhood sexual abuse.","population":"Adults living with HIV who reported childhood sexual abuse (N=266).","country":"United States (New York City sample)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among people living with HIV who experienced childhood sexual abuse, higher personal resilience (optimism, support, religiosity, growth) and greater perceived impact of the trauma were linked to more positive attitudes about addressing that trauma, whereas lower resilience and higher HIV‑related stress predicted negative attitudes.","clinical_takeaway":"Strengthening resilience may improve willingness to engage in trauma‑focused care for HIV‑positive survivors of childhood sexual abuse.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑group SEM study","Uses multiple validated resilience constructs","Addresses an understudied population (HIV + with CSA)","SEM provides insight into mediating pathways"],"limitations":["Cross‑sectional design limits causal inference","No measurement or control of key confounds (e.g., mental health, moral incongruence)","Convenience sample may not generalise to broader HIV‑positive population","No pre‑registration or reporting of effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":28,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/jts.20132"}},{"id":8854,"doi":"10.1177/107906320601800306","pmid":"16988892","pmcid":null,"title":"Religious affiliations among adult sexual offenders","authors":"Eshuys D, Smallbone S.","first_author":"Eshuys D","journal":"Sexual abuse : a journal of research and treatment","year":2006,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 111 incarcerated adult male sexual offenders; self‑reported religious affiliation categories and official offense records; ANCOVA analyses.","sample_n":111,"sample_text":"111 incarcerated adult male sexual offenders","population":"Adult male sexual offenders in Australian prisons (N=111)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study found that male sexual offenders who consistently practiced religion from childhood to adulthood had more convictions and younger victims than those who stopped or never practiced religion, questioning the idea that religiosity deters sexual crime.","clinical_takeaway":"None – the findings relate to offender demographics, not clinical advice for sexual health or behaviour.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Use of official offense records","Clear categorisation of religious trajectories","Statistical control for age"],"limitations":["Cross‑sectional design, no causal inference","Convenience sample of prisoners, limited generalisability","Simple, non‑validated measures of religiosity","No control for potential confounds (e.g., mental health, prior trauma)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/107906320601800306"}},{"id":8855,"doi":"10.1542/peds.2005-1320","pmid":"16818565","pmcid":null,"title":"Depressive symptoms as a longitudinal predictor of sexual risk behaviors among US middle and high school students","authors":"Lehrer JA, Shrier LA, Gortmaker S, Buka S.","first_author":"Lehrer JA","journal":"Pediatrics","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":206,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"National probability sample of US middle/high school students, two waves ~1 year apart, N=4152, logistic regression adjusting for demographics, religiosity, etc.","sample_n":4152,"sample_text":"National Longitudinal Study of Adolescent Health, home interviews, two waves, approx. 1‑year interval","population":"US adolescents (middle and high school) who are sexually active and unmarried","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US national sample of over 4,000 teens, higher depressive symptoms at baseline predicted a greater likelihood of risky sexual behaviors one year later, such as not using condoms or birth control and using substances during sex.","clinical_takeaway":"Screening adolescents for depression may help identify those at higher risk for unsafe sexual practices.","confidence":0.8,"topic_tags":["adolescents","sexual_function","moral_incongruence","pornography","masturbation"],"strengths":["Large, nationally representative longitudinal cohort","Sex‑specific analyses","Adjustment for key demographic and baseline behavior covariates"],"limitations":["Depression measured with self‑report, details not provided","Sexual risk outcomes self‑reported, possible bias","No assessment of masturbation or broader mental‑health factors"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":21,"contrasting":6,"mentioning":248,"citing_publications":303,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1542/peds.2005-1320"}},{"id":8856,"doi":"10.2307/3583469","pmid":"16485593","pmcid":null,"title":"Influence of religion on adolescent sexual attitudes and behaviour among Nigerian university students: affiliation or commitment?","authors":"Odimegwu C.","first_author":"Odimegwu C.","journal":"African journal of reproductive health","year":2005,"pub_types":["Multicenter Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 1,153 university students aged 10‑24 from two Nigerian universities; logistic regression analysis of religiosity (affiliation vs commitment) and sexual attitudes/behaviour.","sample_n":1153,"sample_text":"1,153 campus‑based adolescents aged 10‑24 years","population":"Adolescent university students (10‑24 years) in Nigeria","country":"Nigeria","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among Nigerian university students, how strongly they feel committed to their religion predicts more conservative sexual attitudes and less sexual activity than simply belonging to a religion.","clinical_takeaway":"Religious commitment may be linked to reduced sexual risk in adolescents, but causality is unclear.","confidence":0.8,"topic_tags":["religiosity","adolescents","sexual_function"],"strengths":["Large, multi‑university sample","Statistical adjustment using logistic regression","Clear distinction between religiosity affiliation and commitment"],"limitations":["Reliance on unvalidated self‑report measures","Cross‑sectional design limits causal inference","Key sexual‑health confounds (masturbation, mental health, partner context) not assessed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":2,"mentioning":41,"citing_publications":74,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2307/3583469"}},{"id":8857,"doi":"10.1001/archpedi.159.3.261","pmid":"15753270","pmcid":null,"title":"Acculturation as a predictor of the onset of sexual intercourse among Hispanic and white teens","authors":"Adam MB, McGuire JK, Walsh M, Basta J, LeCroy C.","first_author":"Adam MB","journal":"Archives of pediatrics & adolescent medicine","year":2005,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":44,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 7,270 Hispanic and white adolescents in Arizona abstinence‑only program; logistic regression predicting sexual intercourse onset.","sample_n":7270,"sample_text":"7,270 Hispanic or white teens in Arizona Abstinence‑Only Education Program","population":"Hispanic/Mexican‑American and white teens, grades 7‑12, Arizona","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among Hispanic and white teens in Arizona, being more acculturated (speaking English) was linked to a higher chance of starting sexual intercourse, while speaking mostly Spanish was protective, even after accounting for age, gender and other factors.","clinical_takeaway":"Acculturation level may influence timing of sexual debut; clinicians should consider cultural and language context when discussing sexual health with Hispanic adolescents.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size","Multivariate logistic regression with confidence intervals","Includes multiple sociodemographic covariates"],"limitations":["Cross‑sectional design limits causal inference","Acculturation measured only by language, not validated scale","Sample drawn from abstinence‑only program, limiting generalisability"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":45,"citing_publications":74,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/archpedi.159.3.261"}},{"id":8858,"doi":"10.5993/ajhb.29.2.8","pmid":"15698984","pmcid":"PMC3340329","title":"Sexual health among male college students in the United States and the Netherlands","authors":"Dodge B, Sandfort TG, Yarber WL, de Wit J.","first_author":"Dodge B","journal":"American journal of health behavior","year":2005,"pub_types":["Comparative Study","Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of random samples of male college students in the US and Netherlands; cross‑sectional comparison of sexual health outcomes.","sample_n":null,"sample_text":"random samples of students from both national cultures (size not specified in abstract)","population":"Male college students (US and Netherlands); random sampling within universities.","country":"United States; Netherlands","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of male college students in the US and the Netherlands found American men reported higher rates of inadequate contraception, STIs, and unintended pregnancy. Differences were partly explained by higher religiosity and less comprehensive sexuality education among US students.","clinical_takeaway":"Comprehensive sexuality education may reduce sexual risk among heterosexually active male college students.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Random sampling within universities","Cross‑cultural comparison","Inclusion of religiosity and sexuality education as covariates"],"limitations":["Self‑report measures, likely single‑item","No effect sizes or power analysis reported","Limited control of other known confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":2,"mentioning":32,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5993/ajhb.29.2.8"}},{"id":8859,"doi":"10.3200/socp.145.1.65-84","pmid":"15739779","pmcid":null,"title":"The components of sexual orientation, religiosity, and heterosexuals' impressions of gay men and lesbians","authors":"Wilkinson WW, Roys AC.","first_author":"Wilkinson WW","journal":"The Journal of social psychology","year":2005,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"experimental vignette survey with two within‑subject studies; likely convenience sample of adults","sample_n":null,"sample_text":"Not reported in abstract; likely modest convenience sample","population":"heterosexual adults (likely university students)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Two vignette studies showed that heterosexual participants judged gay men more negatively when the vignette focused on sexual behavior, especially if they were more religious. Similar effects were not seen for lesbian targets.","clinical_takeaway":"None – the study examines social perceptions, not clinical sexual health or behavior.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Experimental manipulation of vignette content","Inclusion of religiosity as a moderator"],"limitations":["Likely small, non‑representative convenience sample","No control for key confounds (moral attitudes, mental health, etc.)","Reliance on self‑report Likert ratings without validated scales"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":29,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3200/socp.145.1.65-84"}},{"id":8860,"doi":"10.1080/13691050412331271416","pmid":"16864187","pmcid":null,"title":"Public tolerance, private pain: stigma and sexually transmitted infections in the American Deep South","authors":"Lichtenstein B, Hook EW, Sharma AK.","first_author":"Lichtenstein B","journal":"Culture, health & sexuality","year":2005,"pub_types":["Comparative Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pilot telephone survey of 250 adults in Alabama; stratified by ethnicity and religiosity; attitudes toward STI stigma measured via questionnaire","sample_n":250,"sample_text":"250 household residents aged 19‑50 years drawn from the general population (telephone sampling)","population":"Adult residents of Alabama, USA (age 19‑50), mixed African‑American and White","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A telephone survey of 250 adults in Alabama found that stigma, embarrassment, and religious beliefs often discourage people from seeking treatment for STIs, with many respondents saying they would delay or avoid care.","clinical_takeaway":"Stigma and religious concerns can be barriers to STI treatment; clinicians should address embarrassment and cultural attitudes when encouraging care.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Relatively large community sample for a pilot study","Considers multiple demographic factors (ethnicity, gender, religiosity)","Addresses an understudied region (Deep South) and public‑health relevant stigma"],"limitations":["Attitude items appear author‑generated; no report of validation","Cross‑sectional design limits causal inference","Potential selection bias inherent to telephone surveys"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":41,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691050412331271416"}},{"id":8861,"doi":null,"pmid":"15779575","pmcid":null,"title":"Impact of sexual health course on Malaysian university students","authors":"Low WY.","first_author":"Low WY.","journal":"The Medical journal of Malaysia","year":2004,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pre‑post single‑group questionnaire study with 54 university students","sample_n":54,"sample_text":"54 students completed pre‑ and post‑course tests","population":"Malaysian university students (elective course participants)","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A university sexual‑health elective was taught to 54 Malaysian students. After the course, participants showed higher scores on a knowledge‑and‑attitude test, indicating improved understanding of sexual topics and more positive attitudes toward myths and solitary sexual behavior.","clinical_takeaway":"Sexual‑health education can increase knowledge and shift attitudes among university students.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Pre‑post measurement of knowledge and attitudes","Use of a standardized SKAT‑II instrument","Statistical significance reported"],"limitations":["No control group; results may reflect selection or time effects","Small, self‑selected sample limits generalisability","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":8863,"doi":"10.1080/00224490409552223","pmid":"15326540","pmcid":null,"title":"Religiosity, sexual behaviors, and sexual attitudes during emerging adulthood","authors":"Lefkowitz ES, Gillen MM, Shearer CL, Boone TL.","first_author":"Lefkowitz ES","journal":"Journal of sex research","year":2004,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":85,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 205 emerging adults assessing self‑reported religiosity and sexual behaviors/attitudes; cross‑sectional convenience sample.","sample_n":205,"sample_text":"205 emerging adults completed surveys","population":"Emerging adults (likely college students) in the United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among 205 U.S. emerging adults, stronger religious involvement was linked to later sexual debut, fewer partners, and more conservative sexual attitudes, while attitudes about HIV risk and condoms were less related to religion.","clinical_takeaway":"Clinicians should consider clients' religious context when discussing sexual health, but recognize that religious influence varies across specific sexual attitudes and behaviours.","confidence":0.8,"topic_tags":["religiosity","sexual_function"],"strengths":["Relatively large sample for a survey study","Multiple dimensions of religiosity assessed","Clear statistical associations reported"],"limitations":["Cross‑sectional design cannot infer causality","Reliance on self‑report without validated scales","No control for key confounds (mental health, partner effects, trauma)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":19,"contrasting":2,"mentioning":181,"citing_publications":268,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224490409552223"}},{"id":8864,"doi":"10.1300/j013v40n04_05","pmid":"15911511","pmcid":null,"title":"Self-esteem and \"at risk\" women:determinants and relevance to sexual and HIV-related risk behaviors","authors":"Sterk CE, Klein H, Elifson KW.","first_author":"Sterk CE","journal":"Women & health","year":2004,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 250 women recruited via community identification, targeted and theoretical sampling in Atlanta, GA","sample_n":250,"sample_text":"250 women living in the Atlanta, Georgia metropolitan area","population":"adult women, predominantly African American, identified as 'at risk' for HIV","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 250 at‑risk women in Atlanta, lower self‑esteem was linked to more HIV‑risk behaviours such as paying for sex and frequent oral sex. Factors like race, religiosity, childhood emotional neglect, money problems and drug issues predicted self‑esteem levels.","clinical_takeaway":"Addressing self‑esteem and underlying stressors may help reduce sexual risk behaviours in at‑risk women.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community sample for the target population","Multivariate analysis identifying multiple predictors","Inclusion of socio‑economic and childhood factors"],"limitations":["Cross‑sectional design limits causal inference","Unclear whether self‑esteem measured with validated scale","Potential sampling bias from targeted recruitment"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":2,"mentioning":31,"citing_publications":50,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j013v40n04_05"}},{"id":8865,"doi":"10.1080/00926230490247264","pmid":"14660292","pmcid":null,"title":"The association between religiosity, sexual fantasy, participation in sexual acts, sexual enjoyment, exposure, and reaction to sexual materials among black South Africans","authors":"Nicholas LJ.","first_author":"Nicholas LJ.","journal":"Journal of sex & marital therapy","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 1,292 first‑year South African university students; convenience sample; self‑report questionnaire.","sample_n":1292,"sample_text":"1,292 first‑year university students","population":"first‑year university students in South Africa (N=1,292)","country":"South Africa","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among South African first‑year university students, higher religiosity was linked to more heterosexual fantasies but fewer actual sexual encounters, lower enjoyment of sex, less exposure to sexual material, and greater disapproval of such material.","clinical_takeaway":"Religiosity may shape sexual attitudes and behaviours; clinicians should consider clients' moral and religious context when discussing sexual health.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Large sample for a single‑site survey","Validated religiosity scale likely used","Clear statistical associations reported"],"limitations":["Cross‑sectional, cannot infer causality","Convenience university sample limits generalisability","Limited control of key confounds (e.g., mental health, partner effects)","Reliance on self‑report single‑item measures for sexual behaviours"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926230490247264"}},{"id":8866,"doi":"10.1016/j.adolescence.2003.09.003","pmid":"14643743","pmcid":null,"title":"Adolescent religiosity and sexuality: an investigation of reciprocal influences","authors":"Hardy SA, Raffaelli M.","first_author":"Hardy SA","journal":"Journal of adolescence","year":2003,"pub_types":["Comparative Study","Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":58,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"National Longitudinal Survey of Youth, two‑wave panel, N=303 adolescents, virgins at baseline, logistic regression of religiosity predicting sexual debut.","sample_n":303,"sample_text":"303 teens (22% Hispanic, 35% Black, 43% White; 53% male) surveyed at ages 15‑16 and again at 17‑18","population":"U.S. adolescents (15‑18 y) from a nationally representative cohort","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"U.S. teens who reported higher religious importance and more church attendance were less likely to have sex for the first time over a two‑year period, suggesting religiosity can delay sexual initiation.","clinical_takeaway":"Higher adolescent religiosity may be associated with later sexual debut, but clinicians should consider broader psychosocial factors.","confidence":0.8,"topic_tags":["religiosity","adolescents","sexual_function"],"strengths":["Longitudinal design allows temporal ordering","Nationally representative sample","Clear operationalisation of religiosity and sexual debut"],"limitations":["Limited control for psychosocial confounds (e.g., mental health, peer influence)","No pre‑registration or power analysis reported","Religiosity measured only via two items, possible self‑report bias"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":1,"mentioning":126,"citing_publications":178,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.adolescence.2003.09.003"}},{"id":8867,"doi":"10.1037/0893-164x.17.4.312","pmid":"14640827","pmcid":null,"title":"Family communication and religiosity related to substance use and sexual behavior in early adolescence: a test for pathways through self-control and prototype perceptions","authors":"Wills TA, Gibbons FX, Gerrard M, Murry VM, Brody GH.","first_author":"Wills TA","journal":"Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors","year":2003,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":97,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"N=297 African American early adolescents; community sample; structural equation modeling of survey data.","sample_n":297,"sample_text":"community sample of 297 African American adolescents","population":"early adolescents (mean age 13) African American, community recruited","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A study of 297 African‑American teens found that better family communication and higher religiosity were linked to lower substance use and sexual activity, mediated by self‑control, peer influences, and how teens view typical users.","clinical_takeaway":"Strengthening family communication and encouraging religiosity may help reduce risky sexual and substance behaviors in early adolescents.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large sample for adolescent survey","Comprehensive structural model linking family, religiosity, self‑control, and behaviors"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of key sexual‑behavior confounds (moral incongruence, mental health, etc.)","Unclear validation status of some constructs"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":8,"contrasting":3,"mentioning":172,"citing_publications":203,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/0893-164x.17.4.312"}},{"id":8868,"doi":"10.1016/s1054-139x(02)00460-3","pmid":"12834991","pmcid":null,"title":"Religiosity and risky sexual behavior in African-American adolescent females","authors":"McCree DH, Wingood GM, DiClemente R, Davies S, Harrington KF.","first_author":"McCree DH","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2003,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":83,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 522 African‑American adolescent females screened for an STD/HIV prevention trial; logistic regression of self‑reported religiosity and sexual risk outcomes.","sample_n":522,"sample_text":"522 participants included in analyses","population":"African‑American adolescent females (age unspecified), United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among African‑American teenage girls, those who attended religious activities more often reported later sexual debut, higher condom use, and greater confidence talking about sex with partners.","clinical_takeaway":"Higher religiosity may be linked to safer sexual practices in this population.","confidence":0.7,"topic_tags":["religiosity","adolescents","sexual_function"],"strengths":["Large community sample (N>500)","Use of logistic regression to adjust for covariates","Validated (though modest reliability) religiosity scale"],"limitations":["Cross‑sectional design limits causal inference","Reliability of religiosity measure modest (α=.68)","No control for key psychosocial confounds (e.g., mental health, trauma)","Self‑report of sexual behavior may be biased"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":10,"contrasting":5,"mentioning":125,"citing_publications":199,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1054-139x(02)00460-3"}},{"id":8869,"doi":"10.2190/nm3d-ewyr-4b59-dfm8","pmid":"15089005","pmcid":null,"title":"The relationship between sexual assault, religiosity, and mental health among male veterans","authors":"Chang BH, Skinner KM, Zhou C, Kazis LE.","first_author":"Chang BH","journal":"International journal of psychiatry in medicine","year":2003,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort of 2,427 male veterans receiving VA outpatient care, self‑report questionnaire with GEE analysis","sample_n":2427,"sample_text":"2,427 male veterans","population":"male veterans (US, VA outpatients)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a longitudinal survey of 2,400 US male veterans, those who reported having been sexually assaulted showed poorer mental health and higher depression. Frequent religious service attendance and stronger personal religiosity lessened these negative effects.","clinical_takeaway":"Religious involvement may buffer mental‑health impacts of sexual assault in male veterans, but clinicians should assess trauma history and other risk factors.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample size for longitudinal analysis","Validated mental‑health and depression instruments","Two distinct dimensions of religiosity measured","Appropriate GEE modeling for repeated measures"],"limitations":["Sexual assault assessed by single self‑report item","No measurement of trauma history or other potential confounds","Convenience VA outpatient sample limits generalizability","Effect sizes and confidence intervals not reported"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":2,"mentioning":19,"citing_publications":76,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2190/nm3d-ewyr-4b59-dfm8"}},{"id":8870,"doi":"10.1891/vivi.17.5.569.33710","pmid":"12477099","pmcid":null,"title":"The encounter with family violence and risky sexual activity among young adolescent females","authors":"Elliott GC, Avery R, Fishman E, Hoshiko B.","first_author":"Elliott GC","journal":"Violence and victims","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional logistic regression analysis of NSFG data (N=710)","sample_n":710,"sample_text":"710 respondents","population":"female adolescents aged 14‑17 living with at least one biological parent in the United States","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a US survey of 710 teen girls, experiencing or witnessing family violence was linked to a higher chance of having risky sexual partners, even after accounting for factors like forced sex, age, race, socioeconomic status, and personal importance of religion.","clinical_takeaway":"Clinicians should consider family‑violence history when assessing adolescents’ sexual risk behaviours.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, nationally representative sample","Clear operational definitions of violence and risky sex","Controls for several key sociodemographic variables"],"limitations":["Cross‑sectional design cannot establish causality","Does not separate masturbation from partnered sexual activity","Limited mental‑health and trauma covariates"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":20,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1891/vivi.17.5.569.33710"}},{"id":8872,"doi":"10.1037/1099-9809.6.3.309","pmid":"10938638","pmcid":null,"title":"Cultural, contextual, and intrapersonal predictors of risky sexual attitudes among urban African American girls in early adolescence","authors":"Belgrave FZ, Van Oss Marin B, Chambers DB.","first_author":"Belgrave FZ","journal":"Cultural diversity & ethnic minority psychology","year":2000,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 214 urban African‑American girls (10‑13 y) recruited from a substance‑abuse prevention programme; pre‑test data analysed with multiple regression","sample_n":214,"sample_text":"participants in a substance‑abuse prevention program (convenience sample)","population":"girls, 10‑13 y, urban US, African‑American; N = 214","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 214 urban African‑American girls aged 10–13, greater ethnic identity and higher self‑esteem were linked to less risky sexual attitudes, while a masculine gender role orientation predicted riskier attitudes.","clinical_takeaway":"Promoting ethnic identity and self‑esteem may help reduce risky sexual attitudes in early‑adolescent girls.","confidence":0.8,"topic_tags":["sexual_function","adolescents","csbd"],"strengths":["Large sample for adolescent survey","Multiple validated psychosocial scales","Comprehensive regression model"],"limitations":["Convenience sample from prevention programme limits generalisability","Cross‑sectional; cannot infer causality","No assessment of broader sexual‑health outcomes"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":55,"citing_publications":99,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1037/1099-9809.6.3.309"}},{"id":8873,"doi":"10.1006/jado.2000.0309","pmid":"10831144","pmcid":null,"title":"Religiosity and sexual risk-taking behavior during the transition to college","authors":"Zaleski EH, Schiaffino KM.","first_author":"Zaleski EH","journal":"Journal of adolescence","year":2000,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":64,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 230 first‑year college students; convenience sample; self‑report questionnaire","sample_n":230,"sample_text":"230 first‑year college students","population":"first‑year college students (US), mixed gender","country":"United States","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 230 first‑year college students, stronger intrinsic and extrinsic religious orientation was linked to lower odds of having sex, but among those who were sexually active, religiosity did not predict safer condom use.","clinical_takeaway":"Religious identity may delay sexual debut, but clinicians should not assume it guarantees safer sex practices.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Uses a validated religiosity scale","Relatively large sample for a single‑site study","Addresses both sexual initiation and condom use"],"limitations":["Cross‑sectional; cannot infer causality","Sexual behavior measured with single‑item self‑reports","No control for key confounds (e.g., mental health, partner status)","Convenience sample limits generalizability"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":4,"mentioning":97,"citing_publications":172,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1006/jado.2000.0309"}},{"id":8874,"doi":"10.1016/s1054-139x(99)00041-5","pmid":"10638717","pmcid":null,"title":"Influences on adolescents' decision to postpone onset of sexual intercourse: a survival analysis of virginity among youths aged 13 to 18 years","authors":"Lammers C, Ireland M, Resnick M, Blum R.","first_author":"Lammers C","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2000,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Population","Behavior","Youth","North America","Sex behavior","Age factors","population characteristics","United States","Adolescents","Demographic Factors","Developed Countries","Research Report","Americas","Northern America","First Intercourse","Virginity"],"is_oa":false,"oa_url":null,"cited_by_count":181,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Large state‑wide survey of 26,023 adolescents (grades 7‑12) with Cox proportional‑hazards survival analysis of age at first intercourse.","sample_n":26023,"sample_text":"26,023 students in grades 7‑12","population":"U.S. adolescents, 13‑18 years, 87.5 % white, 52.5 % male; excluded those reporting sexual abuse.","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 26,000 U.S. teens found that growing up in two‑parent families, having higher income, doing well in school, living in rural areas, and being more religious were linked to later first sexual intercourse.","clinical_takeaway":"Family stability, school engagement and religiosity are associated with delayed sexual debut in adolescents.","confidence":0.85,"topic_tags":["adolescents","sexual_function"],"strengths":["Very large, state‑representative sample","Appropriate survival analysis for time‑to‑event data","Includes a range of psychosocial protective factors"],"limitations":["Cross‑sectional, relies on retrospective self‑report of age at first intercourse","No pre‑registration or open data","Limited measurement detail on mental‑health variables"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":7,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":24,"contrasting":3,"mentioning":250,"citing_publications":379,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s1054-139x(99)00041-5"}},{"id":8876,"doi":"10.1023/a:1018713231400","pmid":"10036646","pmcid":null,"title":"Sexual behavior and AIDS-related knowledge among community college students in Orange County, California","authors":"Shapiro J, Radecki S, Charchian AS, Josephson V.","first_author":"Shapiro J","journal":"Journal of community health","year":1999,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"random sample survey of 319 community‑college students; cross‑sectional questionnaire assessing HIV knowledge, attitudes and self‑reported sexual behaviour","sample_n":319,"sample_text":"random sample of students attending selected classes at four community colleges","population":"community college students in Orange County, CA (N≈319)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 1999 survey of 319 community‑college students in Orange County found that while HIV knowledge was generally high, it did not reduce risky sexual practices. Knowledge helped students feel more comfortable asking partners about sexual history, and religiosity and ethnicity were linked to differences in knowledge and sexual permissiveness.","clinical_takeaway":"Higher HIV knowledge alone may not lower risky sex; clinicians should address attitudes, self‑esteem and peer influence when counseling young adults.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Random sampling within selected classes","Relatively large N for a survey","Considers ethnicity, religion, self‑esteem"],"limitations":["Self‑report sexual behaviour, possible social desirability bias","No validated scales reported","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":22,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/a:1018713231400"}},{"id":8878,"doi":"10.1080/00926239608404402","pmid":"9018649","pmcid":null,"title":"Sexual behaviors and attitudes of geriatric residents in long-term care facilities","authors":"Spector IP, Fremeth SM.","first_author":"Spector IP","journal":"Journal of sex & marital therapy","year":1996,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 40 residents from two long‑term care homes; questionnaire on sexual activity, desire, attitudes, satisfaction, health, privacy, and religiosity.","sample_n":40,"sample_text":"40 residents from two facilities","population":"Older adults living in long‑term care facilities (N=40, 17 men, 23 women).","country":"Not specified","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In a small survey of 40 seniors living in care homes, sexual activity was rare, men reported more desire than women, and older age was linked to less solitary desire and more negative sexual attitudes. Poor emotional health and lack of privacy reduced sexual satisfaction, while higher religiosity was associated with more negative attitudes.","clinical_takeaway":"Elderly residents’ sexual well‑being is tied to emotional health, privacy, and personal beliefs; care facilities should consider these factors to improve quality of life.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Addresses understudied elderly population","Includes several aspects of sexual health","Considers privacy and emotional health"],"limitations":["Small convenience sample","Likely non‑validated questionnaires","Limited control of key confounds","Cross‑sectional; no causal inference"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":44,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239608404402"}},{"id":8879,"doi":"10.2466/pr0.1995.77.3f.1328","pmid":"8643798","pmcid":null,"title":"Religiosity, AIDS, and sexuality knowledge, attitudes, beliefs, and practices of black South-African first-year university students","authors":"Nicholas L, Durrheim K.","first_author":"Nicholas L","journal":"Psychological reports","year":1995,"pub_types":["Comparative Study","Journal Article"],"keywords":["Population","Culture","Acquired immunodeficiency syndrome","Sexuality","Viral diseases","Personality","Behavior","Ethnic Groups","Youth","Knowledge","Africa","Students","Diseases","Sex behavior","Age factors","population characteristics","Psychological factors","Universities","Education","South Africa","Demographic Factors","Religion","Attitude","Developing Countries","Research Report","Hiv Infections","Schools","Cultural Background","Africa South Of The Sahara","English Speaking Africa","Blacks","Beliefs","Southern Africa"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 1,817 black first‑year South‑African university students; structured questionnaire; self‑report scales of religiosity, AIDS knowledge, attitudes, and sexual behaviour.","sample_n":1817,"sample_text":"Convenience sample of first‑year students at a South African university","population":"Black first‑year university students in South Africa (N=1,817)","country":"South Africa","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 1,800 black South‑African first‑year university students, higher religiosity was linked to more AIDS knowledge, more negative attitudes toward homosexuality, and later age of first sexual intercourse.","clinical_takeaway":"Higher religious commitment may be associated with delayed sexual debut, but the finding is correlational.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Large sample size","Focus on understudied population","Multiple sexuality‑related outcomes measured"],"limitations":["Cross‑sectional; cannot infer causality","Use of unvalidated, ad‑hoc scales","Limited control for key confounds (e.g., mental health, partner effects)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":1,"mentioning":25,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2466/pr0.1995.77.3f.1328"}},{"id":8880,"doi":"10.1080/19485565.1995.9988890","pmid":"7481923","pmcid":null,"title":"Parental attachment, drug use, and facultative sexual strategies","authors":"Walsh A.","first_author":"Walsh A.","journal":"Social biology","year":1995,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 480 college students","sample_n":480,"sample_text":"480 college students","population":"college students (likely convenience sample)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 1995 survey of 480 college students found that weaker parental attachment was linked to both higher drug use and more casual sexual activity, with religiosity also influencing promiscuity, especially among men.","clinical_takeaway":"None – the study is exploratory and does not provide actionable clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑site survey","Multivariate analysis","Inclusion of several demographic covariates"],"limitations":["Cross‑sectional design cannot establish causality","Key constructs (promiscuity, attachment) not described as validated","No measurement of moral incongruence or mental‑health factors","Potential selection bias (college convenience sample)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19485565.1995.9988890"}},{"id":8881,"doi":"10.1097/00042560-199503010-00013","pmid":"7859144","pmcid":null,"title":"Alcohol use, liberal/conservative orientations, and ethnicity as predictors of sexual behaviors","authors":"Neff JA, Burge SK.","first_author":"Neff JA","journal":"Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association","year":1995,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"community survey of 1,392 adults; cross‑sectional questionnaire","sample_n":1392,"sample_text":"1392 adults from a community survey","population":"adult men and women, diverse ethnic groups (Black, Anglo, Mexican‑American)","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,392 U.S. adults, researchers found that alcohol use, especially drinking before sex, and liberal sexual attitudes were linked to having more sexual partners and risky sexual behavior, with patterns differing by gender and ethnicity.","clinical_takeaway":"Alcohol use, particularly before sex, may increase risky sexual behavior; clinicians should consider drinking patterns when discussing sexual health.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, ethnically diverse community sample","Multiple predictors examined (alcohol, orientation, religiosity)"],"limitations":["Cross‑sectional; cannot infer causality","Self‑report measures, likely not validated scales","Key confounds (masturbation, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00042560-199503010-00013"}},{"id":8883,"doi":"10.1017/s0021932000021258","pmid":"8014178","pmcid":null,"title":"Testosterone and religiosity as predictors of sexual attitudes and activity among adolescent males: a biosocial model","authors":"Halpern CT, Udry JR, Campbell B, Suchindran C, Mason GA.","first_author":"Halpern CT","journal":"Journal of biosocial science","year":1994,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"panel study of ~100 adolescent males over 3 years","sample_n":100,"sample_text":"approximately 100 boys who were 12.5/13.0 years old at study entry","population":"Adolescent males, United States, Southeast region","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study followed about 100 early‑teen boys for three years and found that higher testosterone and lower church attendance predicted earlier sex and more permissive sexual attitudes, while lower testosterone and regular church attendance predicted the opposite.","clinical_takeaway":"Clinicians should note that both biology and religiosity relate to teen sexual behavior, but the findings are based on a small sample and do not establish causation.","confidence":0.6,"topic_tags":["adolescents","sexual_function","religiosity"],"strengths":["Longitudinal design allows observation of change over time","Inclusion of both biological (testosterone) and social (religiosity) predictors"],"limitations":["Small, non‑representative sample (~100 participants)","Limited measurement of potential confounders (e.g., moral attitudes, mental health)","Unclear whether sexual attitude scales were validated"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":81,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s0021932000021258"}},{"id":8886,"doi":"10.1002/ejsp.2420230104","pmid":"12286562","pmcid":null,"title":"Religiosity and adolescents' premarital sexual attitudes and behaviour: an empirical study of conceptual issues","authors":"Sheeran P, Abrams D, Abraham C, Spears R.","first_author":"Sheeran P","journal":"European journal of social psychology","year":1993,"pub_types":["Journal Article"],"keywords":["Population","Behavior","Youth","Sex behavior","Age factors","population characteristics","Europe","Psychological factors","Adolescents","Demographic Factors","Developed Countries","Northern Europe","Religion","Attitude","Premarital Sex Behavior","United Kingdom"],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"postal questionnaire, N=527 adolescents, observational, cross‑sectional","sample_n":527,"sample_text":"527 16‑18 year olds (postal questionnaire)","population":"16‑18‑year‑old adolescents in the United Kingdom","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1993 UK survey of 527 adolescents found that stronger religiosity generally predicted more conservative sexual attitudes and less sexual activity, though some Catholic teens were more sexually active when current religiosity was accounted for.","clinical_takeaway":"None – the study does not provide actionable guidance for clinicians regarding pornography or compulsive sexual behaviour.","confidence":0.7,"topic_tags":["religiosity","adolescents","sexual_function"],"strengths":["Large community sample for the time (N>500)","Multiple conceptual models of religiosity examined","Addresses methodological inconsistencies in prior literature"],"limitations":["Cross‑sectional design limits causal inference","Self‑report measures, possible social desirability bias","No control for mental‑health, trauma or partner influences"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":7,"contrasting":0,"mentioning":32,"citing_publications":79,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/ejsp.2420230104"}},{"id":8887,"doi":"10.1007/bf01542998","pmid":"1610290","pmcid":null,"title":"Sexual behavior and attitudes of university students in Northern Ireland","authors":"Sneddon I, Kremer J.","first_author":"Sneddon I","journal":"Archives of sexual behavior","year":1992,"pub_types":["Journal Article"],"keywords":["Population","Culture","Viral diseases","Behavior","Knowledge","Contraception","Diseases","Sex behavior","population characteristics","research methodology","Europe","Psychological factors","Sampling studies","Sex factors","Education","Family Planning","Contraceptive Methods","Demographic Factors","Developed Countries","Northern Europe","Contraceptive Usage","Studies","Surveys","Religion","Attitude","Research Report","Barrier Methods","Condom","Hiv Infections--prevention And Control","Acquired Immunodeficiency Syndrome--prevention And Control","Political Factors","Catholicism","Christianity","Multiple Partners","Sexual Partners","Beliefs","Homosexuals","Students--women","Premarital Sex Behavior","Northern Ireland"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 620 university students (419 female, 201 male) in Northern Ireland, self‑administered anonymous questionnaire on sexual behavior, knowledge, attitudes, and religiosity.","sample_n":620,"sample_text":"419 female and 201 male subjects completed questionnaires","population":"University students in Northern Ireland, 1987‑1988","country":"United Kingdom (Northern Ireland)","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1992 survey of 620 university students in Northern Ireland found low levels of sexual experience, conservative attitudes—especially among women and regular churchgoers—and uniform AIDS knowledge. Religiosity was linked to more conservative sexual attitudes.","clinical_takeaway":"Clinicians should note that, in this cohort, religiosity strongly shaped sexual attitudes, highlighting the need for culturally sensitive sexual health counseling.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large student sample for the time period","Includes both genders and measures religiosity","Anonymous questionnaire reduces social desirability bias"],"limitations":["Convenience sample, not nationally representative","Questionnaire not reported as validated","Cross‑sectional; cannot infer causal relations"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542998"}},{"id":8888,"doi":null,"pmid":"1557267","pmcid":null,"title":"Demography of sexual orientation in adolescents","authors":"Remafedi G, Resnick M, Blum R, Harris L.","first_author":"Remafedi G","journal":"Pediatrics","year":1992,"pub_types":["Comparative Study","Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":101,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large, representative, cross‑sectional survey of 34,706 Minnesota adolescents (grades 7‑12)","sample_n":34706,"sample_text":"34,706 students (grades 7 through 12) from diverse ethnic, geographic, and socioeconomic strata","population":"Adolescents (approximately ages 12‑18) in Minnesota public schools","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1992 Minnesota school survey of 34,706 adolescents found that about 1 % identified as mostly homosexual or bisexual, 88 % as heterosexual, and 11 % were unsure. Orientation varied with age, religiosity, ethnicity, and socioeconomic status.","clinical_takeaway":"None – the study reports population prevalence, not clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Very large, demographically diverse sample","Representative of state school population","Multiple facets of sexual orientation assessed"],"limitations":["Self‑report; possible social desirability bias","Validation status of orientation items unclear","Cross‑sectional; cannot infer developmental trajectories"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":null},{"id":8890,"doi":"10.1080/00926239208404366","pmid":"1640474","pmcid":null,"title":"Brief report: recent findings on the Sexual Aversion Scale","authors":"Katz RC, Gipson M, Turner S.","first_author":"Katz RC","journal":"Journal of sex & marital therapy","year":1992,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey-based factor analysis of Sexual Aversion Scale (SAS) with correlations to anxiety and victimization; sample size not reported in abstract","sample_n":null,"sample_text":"Not specified in abstract","population":"adults (male and female) participants; recruitment method unclear","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined the Sexual Aversion Scale’s reliability and factor structure, finding it relates positively to anxiety and a history of sexual victimisation, while age and religiosity showed no link.","clinical_takeaway":"Sexual aversion appears linked to anxiety and past trauma; clinicians should assess these factors when addressing sexual distress.","confidence":0.8,"topic_tags":["sexual_function","measurement"],"strengths":["Rigorous psychometric evaluation (factor analysis)","Examines relationships with anxiety and victimization"],"limitations":["Sample size and recruitment not described","No pre‑registration or power analysis"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926239208404366"}},{"id":8891,"doi":"10.1093/fampra/6.1.16","pmid":"2714537","pmcid":null,"title":"Frequency of sexual dysfunctions among Roman Catholic women","authors":"Pepe F, Panella M, Pepe G, D'agosta S, Pepe P.","first_author":"Pepe F","journal":"Family practice","year":1989,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional comparison of Roman Catholic women vs non‑church‑goers; no info on sampling method, likely convenience","sample_n":null,"sample_text":"not reported in abstract","population":"adult Roman Catholic women (steady partner ≥1 yr) and non‑church‑going women; sample size not reported","country":"unspecified (likely Italy given author names)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared rates of vaginal‑intercourse sexual problems in Roman Catholic women versus non‑church‑going women. No overall difference was found, but Catholic participants reported more dissatisfaction and partner‑requested changes. The authors discuss possible links between religiosity and sexual health.","clinical_takeaway":"Clinicians should consider that religious beliefs may influence sexual satisfaction reports, but evidence is limited and not causal.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["addresses understudied link between religiosity and sexual dysfunction","includes a non‑religious comparison group"],"limitations":["Unclear measurement tools; likely non‑validated self‑report","Small, unspecified sample; likely under‑powered","No control for key confounds (masturbation, mental health, trauma)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/fampra/6.1.16"}},{"id":8893,"doi":"10.1080/01614576.1987.11074908","pmid":"12143703","pmcid":null,"title":"Media exposure and the sexual attitudes and behaviors of college students","authors":"Strouse JS, Buerkel-rothfuss NL.","first_author":"Strouse JS","journal":"Journal of sex education and therapy","year":1987,"pub_types":["Journal Article"],"keywords":["Population","Behavior","Youth","North America","Communication","Sex behavior","Age factors","population characteristics","Psychological factors","Television","Sex factors","United States","Adolescents","Demographic Factors","Developed Countries","Organization And Administration","Program Activities","Programs","Religion","Attitude","Developing Countries","Americas","Northern America","Mass Media","Iec","perception","Broadcast Media","Self-perception"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 475 college students with regression analyses","sample_n":475,"sample_text":"475 college students","population":"college students (U.S.)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 475 U.S. college students, researchers found that watching music television was linked to more permissive sexual attitudes among women, while soap‑opera viewing related to permissive behavior in men; self‑esteem and religiosity also played roles.","clinical_takeaway":"Media exposure correlates with sexual attitudes, but no causal conclusions can be drawn for clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑site survey","Controls for self‑esteem and religiosity","Gender‑specific analyses"],"limitations":["Cross‑sectional design; cannot infer causality","Key confounds (masturbation, mental health, trauma) not measured","Unclear validation of media‑exposure and permissiveness scales"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":51,"citing_publications":78,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/01614576.1987.11074908"}},{"id":8894,"doi":null,"pmid":"3817453","pmcid":null,"title":"Psychological and demographic correlates of perceptions of sexual harassment","authors":"Terpstra DE, Baker DD.","first_author":"Terpstra DE","journal":"Genetic, social, and general psychology monographs","year":1986,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of American students; sample size not reported in abstract","sample_n":null,"sample_text":"not reported in abstract","population":"American college students (likely convenience sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed U.S. college students to see how attitudes about women, sex, religion, self‑esteem and control relate to how they judge sexual harassment, finding that these variables together explain a lot of the differences.","clinical_takeaway":"None - not clinically applicable.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Uses established psychometric constructs","Explores multiple interactions"],"limitations":["No sample size information","Unclear whether scales are validated for this population","Cross‑sectional design limits causal inference","Potential self‑selection bias"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":8895,"doi":"10.1007/bf01542882","pmid":"6651506","pmcid":null,"title":"Parental attitudes about sexual education: cross-cultural differences and covariate controls","authors":"Abramson PR, Moriuchi KD, Waite MS, Perry LB.","first_author":"Abramson PR","journal":"Archives of sexual behavior","year":1983,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Population","Behavior","Asia","Ethnic Groups","Comparative studies","North America","Parents","Eastern Asia","population characteristics","research methodology","Japan","Psychological factors","Psychosocial factors","Sampling studies","Education","United States","Demographic Factors","Developed Countries","Sex Education","Studies","Surveys","Economic Factors","Socioeconomic Factors","Developing Countries","Family Characteristics","Research Report","Americas","Northern America","Family And Household","Family Relationships","Cultural Background","Questionnaire Design","Blacks","Hispanics","Cross-cultural Comparisons","Whites"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑cultural survey of 87 parents (Mexican‑American, Black American, Caucasian American, Japanese‑American) assessing attitudes toward childhood sexual education; covariate controls examined (father’s education, mother’s religiosity).","sample_n":87,"sample_text":"N = 22 Mexican‑American; 20 Black American; 27 Caucasian American; 18 Japanese‑American.","population":"Parents of children aged 1‑10, recruited via unspecified convenience methods in the United States.","country":"United States (multi‑ethnic sub‑samples)","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study compared how parents from four cultural groups view childhood sexual education, finding that differences often stem from factors like fathers' education and mothers' religiosity rather than culture alone.","clinical_takeaway":"None – findings relate to parental attitudes, not direct clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Cross‑cultural comparison","Includes demographic covariates (education, religiosity)","Addresses potential confounding by demographic variables"],"limitations":["Small, non‑representative convenience sample","Unclear validation of attitude measures","Limited statistical detail; likely underpowered"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01542882"}},{"id":8898,"doi":"10.1080/00926238108405804","pmid":"7345159","pmcid":null,"title":"An evaluation of sexual performance--comparison between sexually dysfunctional and functional couples","authors":"Hoch Z, Safir MP, Peres Y, Shepher J.","first_author":"Hoch Z","journal":"Journal of sex & marital therapy","year":1981,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Comparative observational study of dysfunctional vs functional couples; sample size not reported.","sample_n":null,"sample_text":"Not specified in abstract; likely convenience sample.","population":"Adult heterosexual couples (mid‑aged), recruited presumably from clinical settings.","country":"Not reported","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study compared couples with sexual problems to those without, finding that factors like religious background, poor communication and rigid sexual myths were linked to dysfunction. Men were noted as primary therapy initiators.","clinical_takeaway":"Addressing communication, education and cultural beliefs may help improve sexual functioning in couples.","confidence":0.4,"topic_tags":["sexual_function","relationships","religiosity","gender"],"strengths":["Multidisciplinary perspective","Considers relational and cultural factors","Direct comparison of dysfunctional and functional couples"],"limitations":["No clear description of measurement validation","Sample size and recruitment unclear","Limited control of key confounds (e.g., mental health, trauma)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926238108405804"}},{"id":8899,"doi":"10.1007/bf01541921","pmid":"742964","pmcid":null,"title":"Cross-cultural analysis of students' sexual standards","authors":"Perlman D, Josephson W, Tai Hwang W, Begum H, Thomas TL.","first_author":"Perlman D","journal":"Archives of sexual behavior","year":1978,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 1100 English‑speaking university students across five cultural contexts; self‑administered questionnaire; cross‑sectional comparative analysis.","sample_n":1100,"sample_text":"over 1100 respondents","population":"University students (adolescents and adults) from four countries; English‑speaking; convenience sample.","country":"Multiple (four countries; cultures defined by authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 1978 survey of over 1,100 university students from four countries examined how cultural context influences attitudes toward premarital sex, finding that permissive societies show smaller gender differences and less guilt, while religiosity and family factors relate to more conservative views.","clinical_takeaway":"None – the study describes attitudes, not clinical outcomes.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large overall sample size (N>1000)","Cross‑cultural comparison","Inclusion of multiple socioeconomic and cultural variables"],"limitations":["Reliance on ad‑hoc questionnaire items","Cross‑sectional design; no causal inference","Convenience student sample; limited generalisability"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/bf01541921"}},{"id":8901,"doi":"10.1097/00006199-197607000-00019","pmid":"1047292","pmcid":null,"title":"Sexuality of nurses: correlations of knowledge, attitudes, and behavior","authors":"Payne T.","first_author":"Payne T.","journal":"Nursing research","year":1976,"pub_types":["Comparative Study","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 107 family‑planning nurses and 64 nursing students; questionnaires administered in groups; correlations and ANOVAs reported","sample_n":171,"sample_text":"107 professional family planning nurses and 64 senior nursing students","population":"professional nurses and senior nursing students (U.S.)","country":"USA","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a 1976 survey of 107 family‑planning nurses and 64 nursing students, greater knowledge about human sexuality was linked to more positive attitudes and greater comfort handling sexual situations at work. Demographic factors such as age, religion and urbanisation also related to these attitudes.","clinical_takeaway":"Improving nurses' sexuality knowledge may increase their comfort with sexual health issues in practice.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Relatively large combined sample for 1976 survey","Uses established inventories (PSRI, knowledge/attitude test)","Analyses include demographic covariates"],"limitations":["Cross‑sectional; cannot infer causality","Limited control of mental‑health or relationship variables","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00006199-197607000-00019"}},{"id":8903,"doi":"10.1093/sxmrev/qeag016","pmid":"41926205","pmcid":null,"title":"Sexual health framing sexual medicine: toward a more humanistic framework","authors":"El Kak F, Giraldi A.","first_author":"El Kak F","journal":"Sexual medicine reviews","year":2026,"pub_types":["Editorial"],"keywords":["Sexual Health","Sexual Medicine","Health Equity","Humanistic Care","Sexual Rights"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"editorial without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The editorial argues that sexual medicine should move from a purely biomedical ‘repair’ focus to a broader, rights‑based, pleasure‑inclusive model of sexual health, emphasizing justice, autonomy and wellbeing.","clinical_takeaway":"None – the piece is conceptual and does not offer actionable clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Raises important conceptual shift toward humanistic sexual health","Integrates WHO framework and human rights perspective"],"limitations":["No empirical data or systematic review","Provides no operational definitions or measurement guidance","Cannot be used to inform clinical decision‑making directly"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeag016"}},{"id":8904,"doi":"10.31234/osf.io/d8w7f_v1","pmid":null,"pmcid":null,"title":"A scoping review of the sexual health and wellbeing of LGBTQIA+ people affected by cancer","authors":"Brown D, Roscher P, Rune K.","first_author":"Brown D","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"scoping review","sample_n":3800,"sample_text":"approx. 3,800 participants from 49 reports","population":"LGBTQIA+ cancer survivors (≈3,800 participants across 29 studies)","country":"multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This scoping review maps research on sexual health and wellbeing among LGBTQIA+ cancer survivors, finding common sexual dysfunction, heteronormative care barriers, and a lack of tailored interventions, especially for diverse sub‑groups.","clinical_takeaway":"Clinicians should recognise LGBTQIA+ survivors' unique sexual health needs and seek inclusive, person‑centred care approaches.","confidence":0.8,"topic_tags":["sexual_function","csbd","lgbtq"],"strengths":["Comprehensive systematic search of multiple databases","Large aggregate sample across studies","Thematic synthesis identifies key gaps"],"limitations":["No formal risk‑of‑bias assessment of included studies","Limited detail on measurement validity of sexual health constructs","Predominance of cis‑male prostate cancer studies limits generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/d8w7f_v1"}},{"id":8905,"doi":"10.1093/jsxmed/qdag316","pmid":"42847759","pmcid":null,"title":"LGBTQIA+ sexual health: a SITCC clinical framework for integrating cognitive-behavioral therapy and sexual medicine","authors":"Einaudi G, Dibennardo F, Finzi S, Polloni G, Ratti F, Tienforti D, Baiardini I, Iuliano C, Amato L, Stringo J, Traini S, Moretto C, Corradelli C, Barbonetti A, Monticelli F, Cavallo F.","first_author":"Einaudi G","journal":"The journal of sexual medicine","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual Health","Health Disparities","Cognitive-behavioral Therapy","Minority Stress","psychotherapy","Sexual Medicine","Sexual Dysfunctions","Transgender Persons","Sexual And Gender Minorities"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative clinical framework based on non‑systematic literature review and expert consensus; no original empirical sample","sample_n":null,"sample_text":"not applicable – framework paper without primary data","population":"LGBTQIA+ individuals seeking sexual health care (no specific sample reported)","country":"Italy (SITCC society)","controls_mi":"yes","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper proposes an Italian clinical framework that blends cognitive‑behavioral therapy, minority‑stress theory, and trauma‑informed care to improve sexual health assessment and treatment for LGBTQIA+ people, highlighting unique sexual dysfunctions and the need for affirmative, multidisciplinary care.","clinical_takeaway":"Clinicians should consider minority stress, trauma, and gender‑affirming factors when evaluating sexual difficulties in LGBTQIA+ patients.","confidence":0.6,"topic_tags":["sexual_function","csbd","lgbtq"],"strengths":["Integrates minority‑stress and trauma‑informed models","Addresses queer‑specific sexual dysfunctions","Multidisciplinary perspective linking CBT and sexual medicine"],"limitations":["Based on narrative, non‑systematic literature search","No primary empirical data or validation of the framework","Potential bias from expert consensus without systematic appraisal"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":true},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdag316"}},{"id":8906,"doi":"10.21203/rs.3.rs-10615224/v1","pmid":null,"pmcid":null,"title":"Do demographic characteristics matter in the acquisition of sexual health knowledge among female adolescents with visual impairment in Ghana? A mixed-method study","authors":"Abodey E, Vanderpuye I, Amoako I, Abonyi U, Badu E.","first_author":"Abodey E","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"mixed-methods (quantitative N=71, qualitative N=14), convenience sample from five inclusive senior high schools in Ghana","sample_n":71,"sample_text":"71 participants in quantitative component; 14 purposively selected for qualitative interviews","population":"female adolescents with visual impairment","country":"Ghana","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Among Ghanaian female adolescents with visual impairment, sexual health knowledge was generally low, especially beyond basic facts about intercourse. Age and religion were linked to knowledge levels, while school grade and severity of vision loss were not.","clinical_takeaway":"Education programs should address broader sexual health topics and consider age and religious context when teaching visually impaired adolescents.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Focus on an understudied, vulnerable population","Mixed‑methods design adds depth","Use of theory (gender and power) to frame analysis"],"limitations":["Small, non‑representative sample","Knowledge instrument not reported as validated","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-10615224/v1"}},{"id":8907,"doi":"10.21203/rs.3.rs-10937965/v1","pmid":null,"pmcid":null,"title":"Nursing intervention strategies and outcome measures for sexual health in patients with prostate cancer: a scoping review protocol","authors":"Wang X, Chen Y, Li L.","first_author":"Wang X","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"scoping review protocol (no empirical data yet)","sample_n":null,"sample_text":"not applicable – protocol","population":"men with prostate cancer","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This protocol outlines a scoping review that will map nursing interventions aimed at improving sexual health in men treated for prostate cancer and catalogue the outcome measures used in those studies.","clinical_takeaway":"None – the article is a protocol and provides no clinical results.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","treatment","csbd","moral_incongruence"],"strengths":["Clear, pre‑specified methodology (JBI scoping framework)","Comprehensive database search plan"],"limitations":["No empirical data yet – protocol only","No risk‑of‑bias assessment planned"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-10937965/v1"}},{"id":8908,"doi":"10.20944/preprints202610.0972.v1","pmid":null,"pmcid":null,"title":"Beyond Risk: Sexual Health Vulnerability in University Students","authors":"Díaz-Pérez A, Romero Funieles SS, Fonseca Castillo SC, Marquez Blanco NH.","first_author":"Díaz-Pérez A","journal":"Preprints.org","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"structured critical review of existing literature; no pre‑registration reported; includes cross‑sectional, RCTs and qualitative studies but synthesis is narrative","sample_n":null,"sample_text":"33 empirical reports covering various sample sizes; not aggregated","population":"university students (higher‑education)","country":"unspecified (multinational bibliography)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed 33 studies on university students' sexual‑health, finding gaps between knowledge and safe practices, low testing and vaccination rates, and barriers like stigma. Digital education improved knowledge but not always behaviour.","clinical_takeaway":"Education alone may not change risky sexual behaviour; services must link knowledge with easy testing and preventive care.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad mapping of sexual‑health literature in higher education","Includes a range of study designs (cross‑sectional, RCTs, qualitative)"],"limitations":["No protocol or pre‑registration disclosed","Limited access to full data; many sources only abstract‑based","No quantitative synthesis; conclusions remain narrative"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":2,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202610.0972.v1"}},{"id":8909,"doi":"10.1186/s12978-026-02458-y","pmid":"42786483","pmcid":"PMC13613751","title":"Sexual health after childbirth: a qualitative study of women's experiences","authors":"Goldkuhl L, Åkeflo L, Wallner E, Elden H.","first_author":"Goldkuhl L","journal":"Reproductive health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Postpartum","Sexual Health","Qualitative Research","Women’s Health","Thematic Analysis","Queer Phenomenology"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13613751","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study (n=20)","sample_n":20,"sample_text":"Twenty postpartum women recruited in Sweden (convenience sample).","population":"women who gave birth in Sweden within the past two years","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with twenty Swedish mothers show that after childbirth women view sexual health as an evolving process, balancing physical changes, identity shifts, and limited healthcare support. They call for more individualized, broader sexual‑well‑being care beyond contraceptive focus.","clinical_takeaway":"Clinicians should assess postpartum sexual health holistically, not just contraception, and address desire and relational changes individually.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["In‑depth, participant‑led insights","Use of established thematic analysis approach","Integration of queer phenomenology offers novel lens"],"limitations":["Small, non‑representative convenience sample (N=20)","No quantitative measurement of sexual function or distress","Findings not generalisable beyond Swedish postpartum women"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-026-02458-y"}},{"id":8911,"doi":"10.1002/msc.70040","pmid":"39763178","pmcid":"PMC11704450","title":"Sexual Health, Pleasure, Justice, and Well-Being in People With Rheumatic and Musculoskeletal Diseases: A Scoping Review Protocol","authors":"Giardulli B, Prior Y, Bumin G, Kinikli GI, Prior JA, Stones SR, Flurey C, Testa M, Lavender A, Battista S.","first_author":"Giardulli B","journal":"Musculoskeletal care","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Protocol","Sexual Health","Evidence Synthesis","Scoping Reviews","Rheumatic And Musculoskeletal Diseases","Evidence And Gap Maps"],"is_oa":true,"oa_url":"https://doi.org/10.1002/msc.70040","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"Scoping review protocol following JBI guidance; no empirical data yet.","sample_n":null,"sample_text":"Protocol – no participants recruited","population":"People with rheumatic and musculoskeletal diseases (RMD)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This protocol outlines a scoping review that will map how sexual health, pleasure, justice, and well‑being are addressed in research on people with rheumatic and musculoskeletal diseases, aiming to identify gaps and guide future work.","clinical_takeaway":"None – the article is a protocol, not a clinical study.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear, pre‑specified methodology (JBI scoping framework)","Broad, multidisciplinary search strategy"],"limitations":["No empirical data yet; scores based on protocol description","Will rely on existing studies, which may have their own biases"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/msc.70040"}},{"id":8912,"doi":"10.1016/j.apnr.2026.152116","pmid":"42547143","pmcid":null,"title":"Evidence summary and nurse-led algorithm development of clinical guidance documents on sexual health for female breast cancer survivors: A systematic review","authors":"Yao N, Fu J, Tian Y, Jiang J.","first_author":"Yao N","journal":"Applied nursing research : ANR","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":["Breast cancer","Algorithm","Evidence","Guidelines","Nursing Process","Nurse-led","Clinical Guidance Documents"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review of clinical guidance documents; no meta‑analysis, quality appraisal of guidelines, development of nurse‑led algorithm","sample_n":null,"sample_text":"13 clinical guidance documents summarized; no primary participant data","population":"female breast cancer survivors (no specific sample size reported)","country":"Not specified (likely multiple sources)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors reviewed 13 clinical guidance documents on sexual health for women who survived breast cancer and created a nurse‑led algorithm to help clinicians address sexual concerns in survivorship care.","clinical_takeaway":"Clinicians can use the presented algorithm to structure sexual health assessment and interventions for breast cancer survivors, but its effectiveness still needs testing.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Systematic methodology applied to guideline synthesis","Clear framework for translating recommendations into nursing algorithm","Quality appraisal of included CGDs"],"limitations":["No primary data; findings depend on quality of existing CGDs","No meta‑analytic quantification of effect sizes","Algorithm not empirically tested"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.apnr.2026.152116"}},{"id":8913,"doi":"10.1007/s13187-026-02974-2","pmid":"42642685","pmcid":null,"title":"Development of a Responsive Digital Intervention to Support Sexual Health Self-management and Quality of Life in Women with Breast Cancer","authors":"Oliveira CE, de Oliveira PBR, Santos CR, Alves IA.","first_author":"Oliveira CE","journal":"Journal of cancer education : the official journal of the American Association for Cancer Education","year":2026,"pub_types":["Journal Article"],"keywords":["Breast cancer","Quality of life","Endocrine Therapy","Sexual Health","Self-management","Digital Health"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"development and feasibility study with iterative user testing of a responsive website; no empirical outcome evaluation reported","sample_n":null,"sample_text":"not reported in abstract; likely small convenience sample of users for testing","population":"women with hormone‑receptor‑positive breast cancer receiving oral endocrine therapy","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers created a responsive website called “Cancer and My Life” to help women undergoing endocrine therapy for breast cancer manage sexual health issues. The platform offers education, psychosocial tools, and resources, refined through user feedback, aiming to improve quality of life.","clinical_takeaway":"The website shows promise as a supportive tool for sexual health in breast‑cancer patients, but its clinical effectiveness remains untested.","confidence":0.6,"topic_tags":["sexual_function","csbd","moral_incongruence","masturbation"],"strengths":["Systematic development using MRC framework","Multidisciplinary team input","Iterative user testing"],"limitations":["No empirical effectiveness data","Small, non‑representative sample for testing","No validated outcome measures reported"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13187-026-02974-2"}},{"id":8914,"doi":"10.1093/sexmed/qfag090","pmid":"42769748","pmcid":"PMC13591268","title":"Translation, cross-cultural adaptation of longitudinal curriculum objectives in sexual health to Brazilian medical education","authors":"Neto TA, de Oliveira Valentino TC, Facio Junior FN.","first_author":"Neto TA","journal":"Sexual medicine","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Medical education","Sex Education","Curriculum","Sexual Health","Competency Based Education"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13591268","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"descriptive cross‑sectional methodological study of translation and cultural adaptation of a curricular instrument","sample_n":26,"sample_text":"expert panel n=6; pre‑testing faculty n=20","population":"expert panel (n=6) and faculty pre‑test participants (n=20) in Brazil","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors translated and culturally adapted a sexual‑health curriculum guide for Brazilian medical schools, showing it is clear and highly valid (CVI 0.97). Faculty found it usable, and it can be integrated across the first three years of training.","clinical_takeaway":"None – the paper concerns curriculum design, not direct clinical practice.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Rigorous, internationally recognised translation methodology (Beaton)","High content validity (CVI 0.97)","Multidisciplinary expert review","Practical demonstration of curricular mapping"],"limitations":["Small expert and faculty samples","No assessment of student learning outcomes","Cross‑sectional, no longitudinal validation","Limited to a single institution"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfag090"}},{"id":8915,"doi":"10.1093/asj/sjaf187","pmid":"40974005","pmcid":null,"title":"Evaluation of the Role of Labiaplasty in Sexual Health and Partner Relationships","authors":"Bestel M, Ucar E, Dogan O.","first_author":"Bestel M","journal":"Aesthetic surgery journal","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pre‑post cohort without control group","sample_n":97,"sample_text":"97 women and their partners (partner data reported)","population":"97 women undergoing labiaplasty and their male partners","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 97 women who had labiaplasty, self‑image, sexual function and mood improved one year after surgery, and their male partners reported higher sexual satisfaction, though the study lacked a comparison group.","clinical_takeaway":"Labiaplasty may enhance sexual and psychological wellbeing, but evidence is limited by lack of controls.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Validated sexual and psychological questionnaires","Both female and male partner outcomes measured","Pre‑post within‑subject design"],"limitations":["No control group; cannot infer causality","Potential selection bias (surgical patients)","No adjustment for key confounds (masturbation, moral factors)","Effect sizes and confidence intervals not reported"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/asj/sjaf187"}},{"id":8916,"doi":"10.21203/rs.3.rs-9406625/v1","pmid":null,"pmcid":null,"title":"Clinical and Biological Outcomes in School and Community-Based Sexual Health Interventions for Youth: An Umbrella Review","authors":"Jassim SR, Najm SH, Jabber HN, Mahmood SA, Rashad AA.","first_author":"Jassim SR","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"umbrella review of 19 systematic reviews of school and community sexual‑health interventions, PRISMA‑compliant, JBI risk‑of‑bias assessment","sample_n":null,"sample_text":"nineteen systematic reviews (number of primary participants not reported in abstract)","population":"youth aged 10‑30 years","country":"multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"An umbrella review of 19 systematic reviews found that school‑ and community‑based sexual‑health programmes improve knowledge and condom use among young people, but they have little impact on actual STI rates, pregnancy, or viral load.","clinical_takeaway":"Behaviour‑change programmes alone may not be enough to lower STI or pregnancy rates; clinicians should combine education with broader structural interventions.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Comprehensive umbrella review of existing systematic reviews","PRISMA‑guided methodology with JBI quality appraisal","Clear reporting of clinical versus behavioral outcomes"],"limitations":["No meta‑analysis of effect sizes reported in abstract","Potential heterogeneity across primary reviews not quantified","Limited information on publication bias or registration"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-9406625/v1"}},{"id":8917,"doi":"10.1002/jcop.70132","pmid":"42530478","pmcid":"PMC13422234","title":"Preparing for Dissemination and Scale up of a Sexual Health Intervention for Justice-Involved Youth","authors":"Snow-Hill NL, Barry AR, Gamoran J, Onyeukwu-McGee U, Cohen M, Rios E, Donenberg G.","first_author":"Snow-Hill NL","journal":"Journal of community psychology","year":2026,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"structured interviews with 18 implementation staff; thematic analysis using CFIR","sample_n":18,"sample_text":"18 implementation staff (trained to deliver SYNC)","population":"staff who work with justice-involved youth (U.S.)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study interviewed 18 staff members who deliver a sexual‑health program for youth in the justice system to learn what helps or hinders its use. It found that strong training and curriculum are strengths, while program length and staffing issues are barriers.","clinical_takeaway":"Implementation success depends on adequate training, leadership support, and manageable program length.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Systematic use of CFIR framework","Practical focus on implementation barriers"],"limitations":["Very small, non‑representative staff sample","No quantitative outcome data on youth sexual health"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/jcop.70132"}},{"id":8918,"doi":"10.1136/bmjph-2025-004459","pmid":"42781554","pmcid":"PMC13599901","title":"Postpartum sexual dysfunction in resource-limited settings: a cross-sectional study of maternal sexual health","authors":"Negash MT, Agegnehu GT, Tsehay CT, Alemu EA.","first_author":"Negash MT","journal":"BMJ public health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Prevalence","Public Health","Sexual Health","Community Health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13599901","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"institution-based cross-sectional survey of 400 postpartum women selected by systematic random sampling; self‑administered questionnaire including the validated Female Sexual Function Index; multivariable logistic regression used to identify correlates.","sample_n":400,"sample_text":"400 mothers","population":"postpartum mothers (n≈400) in a resource‑limited setting, 97.6% response rate","country":"Not specified (resource‑limited setting)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 400 postpartum women, more than half reported sexual dysfunction. Older age, no antenatal care, instrumental delivery, episiotomy and postpartum depression were linked to higher risk.","clinical_takeaway":"Screen postpartum women, especially those with depression or obstetric complications, for sexual dysfunction.","confidence":0.7,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Use of validated FSFI instrument","Large sample with high response rate","Multivariable analysis with adjusted odds ratios and confidence intervals"],"limitations":["Cross‑sectional design limits causal inference","No assessment of partner or relational factors","Potential unmeasured cultural/moral confounders"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjph-2025-004459"}},{"id":8919,"doi":"10.1071/sh25089","pmid":"41588922","pmcid":null,"title":"Sexual health among older adults in Nigeria: a systematic review of evidence, gaps, and opportunities for intervention","authors":"Lukwa AT, Akinsolu FT, Abodunrin OR, Okova D, Koledowo AA, Hassan SS, Bodzo P, Nemieboka PO, Raji DO, Ezechi LO, Chiwire P, Ezechi OC.","first_author":"Lukwa AT","journal":"Sexual health","year":2026,"pub_types":["Systematic Review","Journal Article"],"keywords":["HIV","Sexual activity","Nigeria","Sexual Health","Older Adults","Sexual And Reproductive Health","Gender Norms","Gender-sensitive","Age-sensitive"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 17 empirical studies on sexual health among Nigerians aged ≥60 years, using PRISMA 2020 guidelines and narrative synthesis.","sample_n":17,"sample_text":"Seventeen studies (2003‑2024) met inclusion criteria.","population":"Older adults (≥60 y) in Nigeria","country":"Nigeria","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 17 studies shows that many older Nigerians remain sexually active but face cultural, gender and healthcare barriers that limit sexual wellbeing, especially for women, rural residents and people with disabilities.","clinical_takeaway":"Clinicians should proactively discuss sexual health with older patients and address gender‑specific barriers and misinformation about HIV.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["PRISMA‑compliant systematic search","Broad coverage of sexual‑health domains","Identifies clear gaps for policy and research"],"limitations":["Reliance on narrative synthesis; no quantitative meta‑analysis","Primary studies may have limited methodological quality","No assessment of pornography‑related behaviours or addiction constructs"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh25089"}},{"id":8920,"doi":"10.21203/rs.3.rs-9497780/v1","pmid":null,"pmcid":null,"title":"Sexual Health and Dysfunction Following Breast Cancer Treatment: A Scoping Review","authors":"Anuja S, Varghese V.","first_author":"Anuja S","journal":"Research Square","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"scoping review of 29 studies, no meta‑analysis, descriptive prevalence range, assessment of tools and interventions","sample_n":null,"sample_text":"Aggregated from 29 included studies; individual study sizes not reported in abstract","population":"women who are breast‑cancer survivors (samples from published studies, not primary data collection)","country":"multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review of 29 studies found that 34‑92 % of breast‑cancer survivors experience sexual dysfunction. The Female Sexual Function Index is the most common assessment tool, and factors such as treatment type, hormonal changes, body image, and psychological distress contribute to problems. Small studies suggest CBT, mindfulness, couple therapy, and medical options may help.","clinical_takeaway":"Screen breast‑cancer survivors for sexual dysfunction using a validated tool like the FSFI, and consider multidisciplinary interventions (psychological, relational, medical).","confidence":0.85,"topic_tags":["sexual_function","csbd"],"strengths":["Comprehensive literature search across multiple databases","Use of PRISMA‑ScR reporting guidelines","Identifies validated assessment tool (FSFI) used in the field"],"limitations":["No quantitative synthesis; prevalence range only descriptive","Potential heterogeneity of included studies not examined","Does not assess methodological quality or risk of bias of primary studies"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-9497780/v1"}},{"id":8921,"doi":"10.20944/preprints202605.1590.v1","pmid":null,"pmcid":null,"title":"Equity at the Crossroads: A Comparative Analysis of EDI and Sexual Health Policies in Canada’s Prairie Provinces and School Boards","authors":"Punjani N.","first_author":"Punjani N.","journal":"Preprints.org","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"systematic document search and content analysis of policy documents","sample_n":36,"sample_text":"36 policy documents (20 provincial, 16 school board)","population":"government and school‑board policy documents (no human participants)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors compared recent sexual‑health and equity policies in Alberta, Saskatchewan and Manitoba, plus four large school boards. They found Alberta and Saskatchewan favor opt‑in, restrictive rules that limit LGBTQ+ recognition and community health input, while Manitoba maintains inclusive, rights‑based policies.","clinical_takeaway":"None – the paper analyses policy, not individual health outcomes.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Systematic search of official policy documents","Clear coding framework (IBPA)","Comparative analysis across provinces and boards"],"limitations":["No empirical data on student outcomes","Potential bias in document selection","No assessment of implementation fidelity"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202605.1590.v1"}},{"id":8924,"doi":"10.1080/07448481.2026.2660178","pmid":"42050368","pmcid":null,"title":"Sexual health and campus climate for LGBTQ+ college students","authors":"Vallerand K, Glassman TJ, Demers A, Dowling J, Natal GR.","first_author":"Vallerand K","journal":"Journal of American college health : J of ACH","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual Health","College Students","Campus Climate","Lgbtq+","Sex Positivity"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 23 participants from one Midwestern university","sample_n":23,"sample_text":"Twenty‑three LGBTQ+ undergraduates (ages 18‑24) at a Midwestern university","population":"LGBTQ+ undergraduate students (age 18‑24) at a single U.S. university","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 23 LGBTQ+ college students revealed that while campuses often provide open conversations and resources, gaps in inclusive information, culturally competent care, and hidden biases hinder optimal sexual health.","clinical_takeaway":"Universities should improve inclusive sexual‑health information and culturally competent care for LGBTQ+ students.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight from diverse LGBTQ+ students","Use of WHO sexual‑health framework","Thematic analysis grounded in queer theory"],"limitations":["Small, single‑site convenience sample limits generalisability","No quantitative measures or statistical analysis","No assessment of potential confounders (e.g., mental health, religiosity)"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/07448481.2026.2660178"}},{"id":8925,"doi":"10.3389/fragi.2026.1803413","pmid":"42698722","pmcid":"PMC13541714","title":"Sexual health needs and challenges among ageing women in Sub-Saharan Africa: a systematic review","authors":"Mwandama R, Mdoka YH, Mulinde O, Rahaman M.","first_author":"Mwandama R","journal":"Frontiers in aging","year":2026,"pub_types":["Systematic Review","systematic-review","Journal Article"],"keywords":["Sub-Saharan Africa","Systematic review","menopause","Reproductive Health","Ageing Women","Sexual Health Needs"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13541714","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 34 studies on sexual health of ageing women in Sub‑Saharan Africa, following PRISMA 2020; no meta‑analysis reported.","sample_n":34,"sample_text":"34 primary studies included; total participants not specified in abstract.","population":"Women aged ≥45‑50 in Sub‑Saharan Africa (studies varied).","country":"Sub‑Saharan Africa (multiple countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This systematic review summarises 34 studies on the sexual health of ageing women in Sub‑Saharan Africa, revealing limited research, cultural stigma, and health‑system gaps that affect sexual activity, menopause symptoms, HIV concerns, contraception, and care seeking.","clinical_takeaway":"Clinicians should recognise that older African women often lack appropriate sexual‑health services and should proactively address their needs.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive PRISMA‑guided search across two major databases.","Identifies multiple thematic gaps in the literature.","Highlights policy and service implications."],"limitations":["No quantitative meta‑analysis or effect‑size synthesis.","Risk‑of‑bias assessment of included studies not described.","Sample size of primary studies not aggregated."],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fragi.2026.1803413"}},{"id":8926,"doi":"10.1038/s41598-026-63197-5","pmid":"42472996","pmcid":null,"title":"Sexual health education improves psychological health, social well-being, and sexual self-efficacy among married older women: a randomized controlled trial","authors":"Shojaee S, Taheri S, Aazami S.","first_author":"Shojaee S","journal":"Scientific reports","year":2026,"pub_types":["Journal Article"],"keywords":["Health education","Psychological","Older women","Sexual Health","Psychological Health","Self-efficacy","Sexuality Education","Sexual Dysfunctions"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized controlled trial with 110 participants (55 per arm) assessing outcomes at baseline and 4‑week follow‑up","sample_n":110,"sample_text":"110 women aged 65+ recruited from urban health centers, randomly assigned to intervention (n=55) or control (n=55)","population":"married women ≥65 years, urban Iran","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A six‑session sexual health education program for married women over 65 in Iran improved their psychological health, social well‑being, and confidence in managing sexual matters compared with usual care after four weeks.","clinical_takeaway":"Brief, structured sexual health education can boost mental health, social well‑being, and sexual self‑efficacy in older married women.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["RCT design with random allocation","Validated outcome measures","Clear statistical adjustment for baseline"],"limitations":["Short follow‑up (4 weeks)","No pre‑registration or effect‑size reporting","Limited assessment of potential psychosocial confounders"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-026-63197-5"}},{"id":8927,"doi":"10.1007/s10508-026-03427-z","pmid":"42000878","pmcid":"PMC13194272","title":"Longitudinal Associations Between Sexual Regulatory Focus and Sexual Health and Well-Being","authors":"Rodrigues DL, de Visser RO.","first_author":"Rodrigues DL","journal":"Archives of sexual behavior","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual Health","Condom Use","Sexual Satisfaction","Sexual Well-being","Sexual Regulatory Focus"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13194272","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal cohort study with baseline (N=811) and 3‑month follow‑up (N=527) assessing sexual regulatory focus and outcomes.","sample_n":527,"sample_text":"N=527 at T2 (follow‑up).","population":"Adults from Spain and Portugal (young adult to older), both sexes.","country":"Spain; Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People who focus on preventing sexual risks (e.g., using condoms) tend to have better sexual health but lower satisfaction, while those who focus on pleasure report higher satisfaction but take more risks. A mixed focus group manages both health and well‑being.","clinical_takeaway":"Encourage a balanced sexual regulatory focus to promote both safety and satisfaction.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large initial sample and decent follow‑up size","Longitudinal design allows temporal ordering","Use of latent profile analysis to identify distinct regulatory focus groups"],"limitations":["Unclear whether regulatory‑focus scales are validated","No control for key confounds (e.g., mental health, moral attitudes)","Short follow‑up (3 months) limits long‑term inference"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03427-z"}},{"id":8928,"doi":"10.3389/fpubh.2026.1813933","pmid":"42381916","pmcid":"PMC13314957","title":"Maternal self-esteem and postpartum sexual health in Polish women","authors":"Czerwińska-Osipiak A, Rozmarynowska W, Krawczyk A, Szablewska AW, Olszewska J.","first_author":"Czerwińska-Osipiak A","journal":"Frontiers in public health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Maternal Health","Sexual Health","Self-esteem","Sexual Activity After Childbirth"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13314957","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 350 Polish women recruited via online parenting forums; logistic regression used","sample_n":350,"sample_text":"Convenience sample recruited online; not population‑representative","population":"Polish postpartum women (1‑12 months after birth)","country":"Poland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"In 350 Polish mothers surveyed within a year after giving birth, higher self‑esteem was linked to earlier resumption of intercourse and more frequent sexual activity. Self‑esteem also related to feeling competent as a parent and closeness with the partner.","clinical_takeaway":"Supporting maternal self‑esteem may help improve postpartum sexual activity, but evidence is correlational.","confidence":0.78,"topic_tags":["sexual_function","relationships","pornography"],"strengths":["Validated self‑esteem scale","Reasonable sample size (N=350)","Use of multivariable logistic regression"],"limitations":["Convenience online recruitment limits generalisability","Sexual behaviour measures not validated","Cross‑sectional design precludes causal inference","No adjustment for mental‑health or trauma confounders"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2026.1813933"}},{"id":8929,"doi":"10.4103/ijnmr.ijnmr_9_24","pmid":"40052025","pmcid":"PMC11881972","title":"Perceived Sexual Health Needs of Older Women: A Systematic Review","authors":"Saadatmand F, Beigi M, Heidari Z, Savabi-Esfahani M.","first_author":"Saadatmand F","journal":"Iranian journal of nursing and midwifery research","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Women","Needs","Sexual Health","Older People"],"is_oa":true,"oa_url":"https://doi.org/10.4103/ijnmr.ijnmr_9_24","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review of qualitative studies using PRISMA, STROBE, COREQ and thematic synthesis","sample_n":null,"sample_text":"Not applicable – review of existing studies","population":"older women (reviewed studies, diverse samples)","country":"International (studies from 2000‑2022)","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review identified that older women feel their sexual health needs are often ignored, highlighting four main areas: restoring sexual rights, fighting age‑related discrimination, improving sexual health knowledge, and providing appropriate services.","clinical_takeaway":"Healthcare providers should assess and address older women's sexual health rights, literacy, and service needs rather than assuming lack of interest.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["PRISMA‑guided systematic methodology","Use of established qualitative appraisal tools (STROBE, COREQ)","Clear thematic categorisation of needs"],"limitations":["No meta‑analysis; synthesis is narrative","Potential heterogeneity of primary studies not quantified","Does not address cultural or regional variability in depth"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":0,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/ijnmr.ijnmr_9_24"}},{"id":8930,"doi":"10.3389/fpubh.2026.1906863","pmid":"42751556","pmcid":null,"title":"Parental sexual health development support for emerging adolescents in western upstate New York: a qualitative interpretive description study","authors":"Leblanc NM, Muheriwa-Matemba SR, Gray A, Shamrock OW, Gamble-George J, Antwi M, Alcena-Stiner DC, Flores DD.","first_author":"Leblanc NM","journal":"Frontiers in public health","year":2026,"pub_types":["Journal Article"],"keywords":["Qualitative Research","Anticipatory Guidance","Adolescent Sexual Health","Parent-child Communication","Prepubescence","Emerging Adolescent","Sexual Health Development"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Interpretive description qualitative study with purposive maximum‑variation and snowball sampling of 20 parents; semi‑structured interviews; thematic content analysis.","sample_n":20,"sample_text":"20 participants (parents) recruited via purposive maximum‑variation and snowball sampling","population":"Parents/caregivers of emerging adolescents (10‑14 y) in Monroe County, NY, USA","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 20 parents in upstate New York reveal how they help pre‑teens develop sexual health, emphasizing communication, autonomy, and a whole‑person approach shaped by their own histories and social media influences.","clinical_takeaway":"Clinicians should involve parents in sexual‑health education, acknowledging their role and addressing trauma‑informed, culturally responsive needs.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rich, in‑depth parental perspectives","Uses purposive maximum‑variation sampling to capture diverse experiences","Clear thematic framework linking sexual health support to broader self‑actualization"],"limitations":["Small, non‑representative sample (N=20) limits generalisability","No quantitative validation of concepts or outcomes","Potential self‑selection bias among parents willing to discuss sexual health"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2026.1906863"}},{"id":8931,"doi":"10.1007/s10597-026-01716-4","pmid":"42687073","pmcid":null,"title":"Sexual Health in Psychiatry: Bridging the Communication Gap and Training Needs between Patients and Clinicians - A Cross-Sectional Exploratory Pilot Study","authors":"Schweitzer T, Martl P, Dubrovin Leão D, Hammerl L, Halms T, Domani K, Vom Baur S, Eder AS, Rabenstein A, Rüther T, Hasan A, Gertzen M.","first_author":"Schweitzer T","journal":"Community mental health journal","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual dysfunction","Sexual Health","Mental Health Care","Healthcare Education","Patient-clinician Communication"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional anonymous online survey of patients and clinicians in two German academic psychiatric hospitals","sample_n":425,"sample_text":"Convenience sample from two academic hospitals; not nationally representative","population":"231 psychiatric patients, 194 mental‑health professionals","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 231 psychiatric patients and 194 clinicians in Germany found almost all patients had a sexual dysfunction, but clinicians rarely discuss sexuality with them. Training and routine screening were seen as key to improving care.","clinical_takeaway":"Clinicians should receive targeted training and use routine screening to address sexual health in psychiatric treatment.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large combined sample of patients and clinicians","Focus on both patient and provider perspectives","Identifies clear training gaps"],"limitations":["Cross‑sectional, cannot infer causality","Convenience sample limits generalisability","Unclear whether questionnaires are validated"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10597-026-01716-4"}},{"id":8932,"doi":"10.1111/jan.70690","pmid":"42497346","pmcid":null,"title":"Artificial Intelligence, Cancer Nursing, and Sexual Health: Reassembling Care Networks in Digital Care","authors":"Christiansen M, Wettergren L.","first_author":"Christiansen M","journal":"Journal of advanced nursing","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Artificial intelligence","Sexual Health","Cancer Nursing","Fundamentals Of Care","Actor–network Theory","Care Networks"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"discursive conceptual review; no empirical data; draws on theory and prior auto‑netnographic insights","sample_n":null,"sample_text":"none (theoretical paper)","population":"cancer nursing context; sexual health concerns","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper discusses how artificial intelligence might change the way cancer nurses notice and talk about patients' sexual health, proposing new ideas about care networks but emphasizing that real ethical care still depends on nurses.","clinical_takeaway":"AI could help bring sexual‑health issues to light in cancer care, yet nurses must retain responsibility for relational and ethical aspects of care.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Integrates AI with nursing theory","Offers novel conceptual framework (reassembling care networks)"],"limitations":["No empirical data or systematic review methodology","Lacks measurement of sexual‑health outcomes"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jan.70690"}},{"id":8935,"doi":"10.1016/j.envres.2025.122728","pmid":"40897225","pmcid":"PMC12687382","title":"Endocrine disrupting chemicals and female sexual health: An emerging research priority","authors":"Bond J, Schildroth S, Wise LA.","first_author":"Bond J","journal":"Environmental research","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Women","Reproductive Health","Sexual Health","Edcs"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"Not applicable – article is a commentary","population":"women (general reference)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that female sexual function should be a key outcome in environmental‑health research, because chemicals that disrupt hormones may affect desire, arousal, orgasm or pain, but existing evidence is limited and more studies are needed.","clinical_takeaway":"Clinicians should be aware that environmental chemicals might influence female sexual health, but current data are insufficient to change practice.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Clear identification of a research gap","Integrates hormonal and neurobiological perspectives","Highlights public‑health relevance"],"limitations":["No empirical data presented","No systematic review of existing studies","No measurement of confounding variables"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.envres.2025.122728"}},{"id":8936,"doi":"10.1111/psrh.70037","pmid":"41132058","pmcid":"PMC13436676","title":"A Novel 8 Ps Framework for Addressing Complexities in Sexual Health Histories for US Healthcare Providers","authors":"Duroseau B, Johnson R.","first_author":"Duroseau B","journal":"Perspectives on sexual and reproductive health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["HIV","Patient–provider Communication","Stis","Sexual Health History"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13436676","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"proposal of an expanded 8‑Ps sexual health history framework; no empirical data, no participants, no analysis","sample_n":null,"sample_text":"none (framework proposal)","population":"US healthcare providers (conceptual target)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose an expanded 8‑Ps model for taking sexual health histories, adding ‘Proximity’ (living/sexual environment) and ‘Perspectives’ (personal beliefs) to better capture influences on HIV/STI risk and reduce stigma in clinical interviews.","clinical_takeaway":"None – the paper offers a conceptual framework but provides no evidence of clinical effectiveness.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["addresses gap in existing sexual health history frameworks","incorporates structural and belief‑based factors"],"limitations":["no empirical testing of the proposed framework","no data on feasibility or impact on provider‑patient communication"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":0,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/psrh.70037"}},{"id":8937,"doi":"10.20944/preprints202605.1536.v1","pmid":null,"pmcid":null,"title":"Development and Psychometric Evaluation of a Knowledge, Attitude, and Practice Questionnaire Regarding Sexual Health Care Among Gynecologic Oncology Nurses","authors":"Sun Y, Zhang J, Shi B.","first_author":"Sun Y","journal":"Preprints.org","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"questionnaire development and validation with convenience sample of 517 nurses, split‑sample EFA/CFA","sample_n":517,"sample_text":"convenience sample from nine hospitals in six provinces","population":"gynecologic oncology nurses (China)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a 40‑item questionnaire that reliably measures how gynecologic oncology nurses understand, feel about, and act on patients’ sexual health needs.","clinical_takeaway":"Clinicians can use this tool to assess and improve nurses’ competence in providing sexual health care.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large multi‑site sample (N=517)","Rigorous psychometric testing (EFA, CFA, high reliability)","Transparent development process (Delphi, expert review)"],"limitations":["Convenience sampling may limit generalisability","No pre‑registration of validation protocol","Cross‑sectional; cannot assess predictive validity over time"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202605.1536.v1"}},{"id":8938,"doi":"10.1071/sh25008","pmid":"42219252","pmcid":null,"title":"Understanding patient perspectives of sexual health counseling in postpartum care","authors":"Walker J, Codispoti N, Weickert V, Godecker A, Williams M, Kushner DM.","first_author":"Walker J","journal":"Sexual health","year":2026,"pub_types":["Journal Article"],"keywords":["Pregnancy","Obstetrics","Counseling","Gynecology","Sexual Health","Patient Perspective","Sexual Experience","Postpartum Care"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of postpartum patients at a single urban academic center; 41.5% response rate (277/668); descriptive statistics, chi‑squared tests, multivariable logistic regression.","sample_n":277,"sample_text":"277 respondents (41.5% response rate) from a large urban academic medical center","population":"postpartum women attending a routine postpartum visit (N≈668 invited, 277 respondents)","country":"United States (implied by academic center)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of postpartum women found that most received some sexual health counseling, but only half found it helpful. Counseling was more likely for first‑time mothers, those who hadn’t resumed intercourse, and women who delivered vaginally.","clinical_takeaway":"Clinicians should ensure sexual health counseling is thorough and equitable, especially for multiparous and cesarean‑delivery patients.","confidence":0.8,"topic_tags":["sexual_function","csbd","masturbation","pornography"],"strengths":["Large initial sampling frame (668 patients)","Multivariable logistic regression to adjust for parity, delivery mode, intercourse status","Relevant clinical focus on postpartum sexual health counseling"],"limitations":["Low response rate (41.5%) may introduce selection bias","Survey instrument not validated","Cross‑sectional design cannot infer causality"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh25008"}},{"id":8939,"doi":"10.1371/journal.pone.0318060","pmid":"39964996","pmcid":"PMC11835322","title":"Development of a conceptual framework of sexual health for married elderly women: An exploratory mixed method study","authors":"Saadatmand F, Savabi-Esfahani M, Heidari Z, Beigi M.","first_author":"Saadatmand F","journal":"PloS one","year":2025,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11835322","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"exploratory mixed‑methods (qualitative interviews, questionnaire development, cross‑sectional validation)","sample_n":null,"sample_text":"not reported in abstract","population":"married elderly women (age ≥60) – likely convenience sample","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose a step‑by‑step method to identify and measure the sexual health needs of married older women, using interviews, questionnaire development, and expert review, aiming to guide policy.","clinical_takeaway":"None – the study describes a framework development, not clinical findings.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Systematic, staged framework development","Planned psychometric validation (EFA, criterion validity)","Incorporates expert Delphi panel"],"limitations":["No empirical results yet – protocol‑like abstract","Likely convenience sampling, limiting generalisability","No detail on power calculations or statistical corrections"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0318060"}},{"id":8940,"doi":"10.1186/s12978-026-02375-0","pmid":"42204545","pmcid":"PMC13393480","title":"The impacts of climate change on women's reproductive and sexual health: a systematic review","authors":"Albadrani MS.","first_author":"Albadrani MS.","journal":"Reproductive health","year":2026,"pub_types":["research-article","Systematic Review","Journal Article"],"keywords":["Climate change","Systematic review","Reproductive Health","Sexual Health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13393480","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 12 observational studies with a registered protocol (PROSPERO) and quality appraisal using JBI tools.","sample_n":12,"sample_text":"12 observational studies included","population":"Women affected by climate change; studies from various regions.","country":"Multiple (global)","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This systematic review summarises evidence that climate change—especially high temperatures and extreme weather—can negatively affect women's reproductive and sexual health, including reduced fertility and earlier menopause, and can shape family‑planning decisions through eco‑anxiety.","clinical_takeaway":"Clinicians should recognise climate‑related stressors as potential contributors to women’s reproductive health concerns and consider them in counseling and public‑health planning.","confidence":0.8,"topic_tags":["sexual_function","religiosity"],"strengths":["Registered protocol (PROSPERO)","Systematic search across multiple databases","Use of JBI critical appraisal tools"],"limitations":["Limited to 12 observational studies, many moderate quality","Heterogeneous outcome measures, unclear validation","No meta‑analysis or pooled effect sizes reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-026-02375-0"}},{"id":8942,"doi":"10.1080/13691058.2026.2659823","pmid":"42170910","pmcid":null,"title":"Sexual health care perspectives and practices among Haitian migrants in Chile","authors":"Belmar Prieto J, Fuentes A M, Low Andrade K, Ferrer L, Cortes CP, Pantoja M L, Stuardo Avila V, Janvier N.","first_author":"Belmar Prieto J","journal":"Culture, health & sexuality","year":2026,"pub_types":["Journal Article"],"keywords":["Migration","HIV","Haiti","Sexual Health","Self-care"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"sequential mixed‑methods (33 interviews, 251 survey respondents recruited by respondent‑driven sampling)","sample_n":251,"sample_text":"251 survey participants (RDS), 33 interviewees","population":"Haitian migrants living in the Metropolitan Region of Chile","country":"Chile","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Haitian migrants in Chile describe how cultural traditions, economic hardship and gender expectations shape their sexual‑health practices, including use of herbs, antibiotics, and differing views on HIV, highlighting the need for culturally sensitive health services.","clinical_takeaway":"Clinicians should consider cultural beliefs and communication barriers when providing sexual‑health care to Haitian migrants.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Mixed‑methods design captures depth and breadth","Use of respondent‑driven sampling reaches hidden migrant population","Gender‑balanced perspectives"],"limitations":["Convenience sample, not nationally representative","Ad‑hoc measures without reported validation","Cross‑sectional, limits causal inference"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2026.2659823"}},{"id":8943,"doi":"10.1080/19390211.2026.2727026","pmid":"42680584","pmcid":null,"title":"Effects of Maca (&lt;i&gt;Lepidium Meyenii&lt;/i&gt;) on Sexual Health and libido-A Review","authors":"Bloomer RJ.","first_author":"Bloomer RJ.","journal":"Journal of dietary supplements","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Supplement","Maca","Lepidium","Sexual Health","Libido"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of existing maca supplementation trials; no systematic search strategy, no meta‑analysis, no new data collected.","sample_n":null,"sample_text":"Not applicable – the paper is a literature review.","population":"Human participants in cited trials (men, women, mixed), but the review itself includes no participants.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises existing human studies on maca, a Peruvian plant, and finds that most research reports modest improvements in libido for men and mixed results for women, with no obvious hormone changes. Evidence is limited and more rigorous trials are needed.","clinical_takeaway":"Maca may modestly boost libido, especially in men, but current data are insufficient to recommend it as a proven treatment.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad coverage of maca trials","Clear summary of dosage used in studies"],"limitations":["Not a systematic review; search strategy not detailed","No quantitative synthesis or risk‑of‑bias assessment","No appraisal of measurement validity in cited studies"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19390211.2026.2727026"}},{"id":8944,"doi":"10.1071/py26035","pmid":"42476556","pmcid":null,"title":"Barriers to access reproductive and sexual health services among women with disabilities in Australia: a systematic review","authors":"Azhdari K, Haintz GL.","first_author":"Azhdari K","journal":"Australian journal of primary health","year":2026,"pub_types":["Systematic Review","Journal Article"],"keywords":["Review","Australia","Reproductive Health","Sexual Health","Health Inequalities","Access Barriers","Women With Disabilities","Srh Service Access"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review of six studies (reviews, surveys, qualitative, policy analyses) following PRISMA, with AMSTAR-2, NOS, CASP appraisal; thematic synthesis mapped to Levesque framework","sample_n":null,"sample_text":"Six primary studies; sample sizes vary across those studies","population":"Women with disabilities in Australia (no specific sample size reported for the review)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of six Australian studies shows that women with disabilities face many structural and personal barriers when trying to access sexual and reproductive health services, including policy gaps, limited provider training, and rural inequities.","clinical_takeaway":"Clinicians should recognise and address systemic and provider‑level obstacles to ensure equitable SRH care for women with disabilities.","confidence":0.85,"topic_tags":["sexual_function","gender","religiosity","moral_incongruence","masturbation"],"strengths":["Comprehensive systematic search (2010‑2025)","Use of established quality appraisal tools (AMSTAR‑2, NOS, CASP)","Thematic synthesis anchored in a recognized access framework"],"limitations":["Only six primary studies found, limiting breadth","No quantitative meta‑analysis or effect‑size estimation","Potential publication bias not formally assessed"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/py26035"}},{"id":8945,"doi":"10.2147/ijwh.s573603","pmid":"41767459","pmcid":"PMC12948767","title":"Qualitative Assessment of Sexual Health Impairment in Women Affected by Disk Herniation","authors":"Moradi Z, Shahali S, Ahmadi F, Montazeri A.","first_author":"Moradi Z","journal":"International journal of women's health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Qualitative Study","Lumbar Disk Herniation","Female Sexual Function"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12948767","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"in‑depth interviews with 7 women with lumbar disc herniation and 6 sexual‑health experts; conventional content analysis","sample_n":13,"sample_text":"Seven women diagnosed with LDH and six sexual‑health experts were interviewed","population":"women with lumbar disc herniation in Iran (N=7)","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Women with lumbar disc herniation in Iran report pain during sex, lower desire, difficulty reaching orgasm and reduced sexual activity. Interviews revealed strategies such as better communication, pain‑relief techniques and choosing comfortable positions to improve sexual wellbeing.","clinical_takeaway":"Assess back‑pain patients for sexual difficulties and discuss practical pain‑relief and communication strategies.","confidence":0.7,"topic_tags":["sexual_function","csbd","religiosity"],"strengths":["Uses validated FSFI to ensure varied sexual function levels","Provides rich, contextual insights from both patients and experts","Identifies concrete coping strategies relevant to clinicians"],"limitations":["Very small, non‑representative sample","No quantitative assessment of prevalence or effect sizes","Potential selection bias from purposive recruitment"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/ijwh.s573603"}},{"id":8947,"doi":"10.1080/0092623x.2026.2646636","pmid":"41909997","pmcid":"PMC13120712","title":"The State of Sexual Health in United States of America in 2024: Results from the World Health Organization's Sexual Health Survey (SHAPE)","authors":"Ford JV, Coleman E, de Oliveira L, Rahm-Knigge RL, Mark KP.","first_author":"Ford JV","journal":"Journal of sex & marital therapy","year":2026,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13120712","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online panel survey, N=2555, demographic weighting","sample_n":2555,"sample_text":"2555 adults recruited through Prodege's opt‑in research panel reflecting U.S. demographic diversity","population":"Adults 18‑94 in United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2024 U.S. survey of 2,555 adults found high rates of sexual desire and pleasure but moderate overall satisfaction, with women and gender‑diverse people reporting lower pleasure, more violence, and less safety. Testing for HIV/STIs and communication with healthcare providers were low.","clinical_takeaway":"Clinicians should recognize persistent sexual‑health inequities and promote inclusive education, testing, and open communication.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, demographically weighted sample","Use of WHO‑validated SHAPE questionnaire","Comprehensive coverage of sexual‑health domains"],"limitations":["Cross‑sectional design limits causal inference","Convenience panel may introduce selection bias","No adjustment for key psychosocial confounders"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2026.2646636"}},{"id":8949,"doi":"10.1093/humupd/dmag010","pmid":"42101252","pmcid":"PMC13538717","title":"Iron overload disorders in adults: a comprehensive review of gonadal function, reproductive, and sexual health","authors":"Carlomagno F, Tenuta M, Sansone A, Rastrelli G, Sciarra F, Cangiano B, Isidori AM, Gianfrilli D, Krausz C.","first_author":"Carlomagno F","journal":"Human reproduction update","year":2026,"pub_types":["Systematic Review","review-article","Review","Journal Article"],"keywords":["Pregnancy","Fertility","Sexual function","Hypogonadism","Thalassaemia","Reproductive Dysfunction","Iron Overload","Haemochromatosis","Iron Chelation Therapy","Ferroptosis"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13538717","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of observational studies on iron overload and reproductive/sexual outcomes, with pooled prevalence estimates but limited risk‑of‑bias assessment.","sample_n":3536,"sample_text":"Aggregated across reviewed studies (1201 men, 2134 women; 3536 pregnancies).","population":"Adults with iron‑overload disorders (e.g., haemochromatosis, thalassaemia). Sample sizes reported for pooled data (≈1200 men, 2100 women).","country":"Not specified (multiple countries across included studies).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review summarises how excess iron harms the reproductive system, causing hormone problems, infertility, and sexual difficulties in both men and women, but evidence on reversing these effects is limited.","clinical_takeaway":"Screen for hormonal and sexual problems in patients with iron‑overload disorders; early chelation may prevent some damage.","confidence":0.8,"topic_tags":["sexual_function","religiosity","pornography","masturbation"],"strengths":["Comprehensive literature search across multiple databases.","Large pooled sample providing prevalence estimates.","Integration of endocrine and reproductive outcomes."],"limitations":["Lack of risk‑of‑bias assessment for included studies.","Sexual dysfunction not measured with validated questionnaires.","No control for key psychosocial confounds."],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/humupd/dmag010"}},{"id":8950,"doi":"10.21203/rs.3.rs-3696036/v1","pmid":null,"pmcid":null,"title":"Physicians and midwives' perceptions and experiences of sexual health and right education and its influence on promoting women's empowerment: a qualitative content analysis study","authors":"Ghorbani F, Latifnejad R, Khadivzadeh T, Mirzaii k.","first_author":"Ghorbani F","journal":"Research Square","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-3696036/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative content analysis with purposive sampling of 14 health professionals","sample_n":14,"sample_text":"14 participants selected purposively until data saturation","population":"physicians and midwives in Mashhad, Iran","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 14 Iranian physicians and midwives revealed how they view sexual assertiveness training and its role in empowering women, highlighting the need for comprehensive sex education and reduced gender bias.","clinical_takeaway":"Clinicians should consider incorporating sexual rights education into women’s health services to promote empowerment.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["In‑depth exploration of professionals' views","Data saturation reached","Use of established qualitative software"],"limitations":["Very small, non‑representative sample","Purposive sampling limits generalisability","No quantitative validation of concepts"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-3696036/v1"}},{"id":8951,"doi":"10.1080/19317611.2026.2638498","pmid":"42682936","pmcid":null,"title":"A Systematic Review of Sexual Health in Older Chinese Adults: Significant Challenges, Marginalized Voices, and Directions for Future Interventions","authors":"Chai X, Ji S, Wu Y.","first_author":"Chai X","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2026,"pub_types":["Journal Article"],"keywords":["Sexuality","Active Aging","Older Chinese Adults","Implications For Intervention","Sexual Health Literacy","De-sexualization"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review following PRISMA, thematic analysis of 55 studies; no meta‑analysis reported","sample_n":null,"sample_text":"42 English‑language and 13 Chinese‑language articles (no direct participant count provided)","population":"older Chinese adults (≥60 y)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 55 studies shows many older Chinese adults still have sexual desires, but cultural taboos and limited policies suppress discussion and education, leading to risky behaviours and health problems.","clinical_takeaway":"Older adults need culturally appropriate sexual‑health education and services; clinicians should proactively address sexual wellbeing in this group.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["PRISMA‑guided systematic search in two languages","Thematic synthesis across a 20‑year span","Policy review adds practical relevance"],"limitations":["No quantitative meta‑analysis or effect‑size reporting","Unclear risk‑of‑bias assessment of included studies","No explicit measurement of key sexual‑health confounds"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2026.2638498"}},{"id":8952,"doi":"10.1177/10901981261479330","pmid":"42706669","pmcid":null,"title":"Using Intervention Mapping to Develop a Trauma-Informed Sexual Health Program for Native American Youth","authors":"Evans-Mitchell GS, Peskin MF, Schultz K, McCurdy S, Tingey L, Markham C.","first_author":"Evans-Mitchell GS","journal":"Health education & behavior : the official publication of the Society for Public Health Education","year":2026,"pub_types":["Journal Article"],"keywords":["Indigenous","Intervention Mapping","American Indian And Alaska Native","Sexual Health Education","Adolescents And Young Adults"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"Development of a trauma‑informed sexual health education program using Intervention Mapping; no outcome data reported.","sample_n":null,"sample_text":"No participants were enrolled; the paper describes program development.","population":"Native American female adolescents and young adults (15‑25 y)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors used a structured planning method to design a culturally specific, trauma‑informed sexual health education program for Native American girls and young women aged 15‑25, but did not yet test its effectiveness.","clinical_takeaway":"None – the paper is a program design report; clinicians should await outcome studies before applying the intervention.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Systematic, theory‑driven development process (Intervention Mapping)","Cultural relevance and community‑voice emphasis","Integration of trauma‑informed principles"],"limitations":["No empirical testing or outcome data presented","No measurement of key sexual health constructs or validation described","Potential limited generalisability beyond the specific tribal contexts"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10901981261479330"}},{"id":8953,"doi":"10.1177/15579883261418805","pmid":"41618898","pmcid":"PMC12861384","title":"Guy Talk, Precarious Masculinity, and Men's Sexual Health: A Qualitative Content Analysis of &lt;i&gt;Men's Health&lt;/i&gt; Magazine Covers","authors":"Haltom TM, Worthen MGF.","first_author":"Haltom TM","journal":"American journal of men's health","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Men","Media","Magazines","Sexual Health","Precarious Masculinity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12861384","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative content analysis of 333 magazine covers (1986‑2024).","sample_n":333,"sample_text":"333 magazine covers from Men's Health (1986‑2024).","population":"Magazine coverlines; not human participants.","country":"United States (publication), coverage international.","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined 333 Men's Health magazine covers from 1986‑2024 and found only 8% mention men's sexual health. Using a 'precarious masculinity' lens, they identified themes like condoms, testosterone, and sexual performance, arguing that the magazine's playful \"guy talk\" masks vulnerability and leaves men's sexual health under‑represented.","clinical_takeaway":"Men's magazine coverage of sexual health is sparse; clinicians should be aware that media may not reflect the full scope of men's sexual health needs.","confidence":0.8,"topic_tags":["sexual_function","gender","masturbation","pornography"],"strengths":["Large longitudinal sample of magazine covers (nearly 40 years).","Clear theoretical framework (precarious masculinity).","Systematic qualitative coding process."],"limitations":["No individual-level data; limited generalizability to men's health behaviors.","Absence of validated measurement instruments for constructs.","No assessment of potential confounding societal factors."],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/15579883261418805"}},{"id":8954,"doi":"10.1080/19317611.2024.2422512","pmid":"40400562","pmcid":"PMC12091909","title":"How to Define Sexual Health? A Qualitative Analysis of People's Perceptions","authors":"Manão AA, Brazão M, Pascoal PM.","first_author":"Manão AA","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Portugal","Reproductive Health","Public Health","Sexual Health","Sexual Justice"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Cross‑sectional online questionnaire with open‑ended question; reflexive thematic analysis of 151 participants from Portugal.","sample_n":151,"sample_text":"151 participants answered an online open‑ended question.","population":"Adults (19–75 y) living in Portugal, recruited via an online survey; convenience sample.","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Portuguese adults described sexual health as a mix of physical, mental, relational and social factors, emphasizing personal agency, equality and sexual justice.","clinical_takeaway":"Clinicians should view sexual health broadly, including relational and societal dimensions, not just biological aspects.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large (for qualitative) and diverse age range.","Systematic thematic analysis.","Provides rich insight into lay definitions of sexual health."],"limitations":["Convenience online sample limits generalisability.","No validated measurement of sexual health constructs.","No quantitative assessment of reliability or saturation."],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2024.2422512"}},{"id":8955,"doi":"10.1080/19317611.2025.2464565","pmid":"40400560","pmcid":"PMC12091932","title":"A Systematic Review of Trauma-Informed Sexual Health Education Interventions for Adolescents and Young Adults Within the United States and Canada","authors":"Evans-Mitchell GS, Sacca L, Markham C, Schultz K, McCurdy S, Tingey L, Peskin MF.","first_author":"Evans-Mitchell GS","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Adolescence","Sexual Health","Interventions","Young Adult","Trauma-informed"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of trauma‑informed sexual health education interventions for adolescents/young adults in US & Canada (2014‑2023). Identified three interventions and described their alignment with SAMHSA and Kahn principles.","sample_n":null,"sample_text":"Not applicable – review of existing studies.","population":"Adolescents and young adults in the United States and Canada; interventions described as trauma‑informed.","country":"United States, Canada","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review identified only three trauma‑informed sexual health education programmes for U.S. and Canadian teens and young adults, showing they incorporated most but not all key trauma‑informed principles. The authors note a scarcity of such programmes.","clinical_takeaway":"Few trauma‑informed sexual health programmes exist for adolescents; more development and evaluation are needed.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Follows PRISMA‑P reporting standards","Clear inclusion criteria (trauma‑informed interventions)","Uses established trauma‑informed frameworks (SAMHSA, Kahn)"],"limitations":["Very few eligible interventions (n=3) limits conclusions","No quantitative synthesis or effect‑size reporting","Unclear how intervention outcomes were measured or validated"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2025.2464565"}},{"id":8957,"doi":"10.1136/sextrans-2024-056442","pmid":"40555477","pmcid":"PMC12911605","title":"'It's less traumatic because you're in your own home': exploring trauma-informed care for digital sexual health services - a secondary qualitative data analysis","authors":"Conway A, Gibbs J, Spence T, Howarth A, Reid D, Estcourt CS, Burns F, Lloyd KC.","first_author":"Conway A","journal":"Sexually transmitted infections","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Public Health","Gynecology","Sexual Health","Qualitative Research","Diagnostic Screening Programs"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12911605","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"secondary qualitative analysis of 11 interview transcripts from two mixed‑methods studies","sample_n":11,"sample_text":"11 transcripts analyzed (from original n=100 and n=25 participants)","population":"sexual health service users in England (purposive sample)","country":"England","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with a small group of UK sexual‑health service users show that online self‑sampling kits feel safer and more private than clinic visits, but concerns remain about sharing sensitive information. Participants suggest clearer language, better support options, and stronger links to trauma resources to make digital services more trauma‑informed.","clinical_takeaway":"Online sexual‑health testing can reduce trauma triggers, but clinicians should ensure privacy safeguards and offer clear pathways to trauma support.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Qualitative depth on trauma‑informed care in digital services","Uses real user experiences from two prior studies","Identifies concrete themes for service improvement"],"limitations":["Very small analytic sample (11 transcripts)","Secondary analysis limits control over data collection","Findings may not be transferable beyond UK sexual‑health service users"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":2,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sextrans-2024-056442"}},{"id":8959,"doi":"10.1177/13591053251325959","pmid":"40091667","pmcid":null,"title":"Exploring and improving sexual health literacy: Insights from sexual health experts","authors":"Chenneville T, Wasilewski S, Ligman K, Haskett M.","first_author":"Chenneville T","journal":"Journal of health psychology","year":2026,"pub_types":["Journal Article"],"keywords":["Qualitative","Interviews","Sexual Health","Health Literacy","Sexual Health Literacy"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative interview study with 8 sexual health experts; thematic analysis of semi‑structured virtual interviews.","sample_n":8,"sample_text":"Eight cisgender women professionals with sexual health expertise were interviewed.","population":"Adults (cisgender women professionals with sexual health expertise)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study interviewed eight sexual‑health professionals to explore what sexual health literacy means, its gaps, and how it might be measured, aiming to help create a new assessment tool.","clinical_takeaway":"None – the paper does not provide direct clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides expert perspectives to inform scale development","Uses systematic thematic analysis"],"limitations":["Very small, non‑representative sample","No quantitative validation of constructs","Findings limited to expert opinions, not end‑users"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/13591053251325959"}},{"id":8960,"doi":"10.1016/j.jpra.2026.09.010","pmid":"42779954","pmcid":"PMC13597194","title":"Exploring the aesthetic and sexual health impacts of reported lower extremity lymphedema-related symptoms in 174 patients following inguinal lymphadenectomy","authors":"Hahn BA, Kleeven A, Richir MC, Witkamp AJ, Kuijpers AMJ, Keymeulen KBMI, Coert JH, Qiu SS, Krijgh DD.","first_author":"Hahn BA","journal":"JPRAS open","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Quality of life","Lymphedema","Inguinal Lymphadenectomy","Patient-reported Outcome Measures (Proms)","Lower Extremity Lymphedema (Lel)","Inguinal Lymph Node Dissection (Ilnd)"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13597194","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 174 post‑ILND patients (1990‑2022) from three Dutch centres; body image (BIS) and sexual health (EORTC SHQ‑22) measured; multivariate linear regression used to identify predictors.","sample_n":174,"sample_text":"174 patients","population":"Patients who underwent inguinal lymph node dissection (ILND) in three Dutch hospitals; N=174; age and gender reported; cancer stage varied.","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 174 people who had groin lymph‑node surgery, those reporting lymphedema symptoms also reported poorer body image and sexual function. Women, younger patients and those with complications had the worst outcomes.","clinical_takeaway":"Assess body image and sexual health after inguinal lymphadenectomy; consider targeted counselling or reconstructive options for high‑risk patients.","confidence":0.85,"topic_tags":["sexual_function","csbd"],"strengths":["Use of validated body image and sexual health questionnaires","Multi‑centre sample of a clinically relevant population","Multivariate regression to adjust for several clinical predictors"],"limitations":["Cross‑sectional design cannot establish causality","Potential selection bias (survivors willing to respond)","No assessment of psychosocial confounders (e.g., mental health, relationship status)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpra.2026.09.010"}},{"id":8961,"doi":"10.1177/02692155261459619","pmid":"42334258","pmcid":null,"title":"Implementation and evaluation of a stroke sexual health practice profile for rehabilitation in Ontario, Canada","authors":"Giurleo C, McIntyre A, Kras-Dupuis A, Lala D, Wolfe D.","first_author":"Giurleo C","journal":"Clinical rehabilitation","year":2026,"pub_types":["Journal Article"],"keywords":["Rehabilitation","Quality improvement","Stroke","Sex Education","Sexual Health","Implementation Science"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pre‑post quality‑improvement implementation study without a control group","sample_n":null,"sample_text":"patients attending inpatient or outpatient stroke rehabilitation; eligible staff participants","population":"stroke rehabilitation patients and clinicians in Ontario, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A new practice profile was introduced in Ontario stroke rehab programs to help clinicians discuss sexual health with patients. Staff reported higher knowledge and comfort, and patients felt more aware and at ease talking about sex, with more documentation of these conversations.","clinical_takeaway":"Implementing structured sexual‑health protocols can improve clinician confidence and patient engagement after stroke.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Team‑based, structured implementation framework","Multiple outcome levels (staff, patient, documentation)","Sustained follow‑up at 6 months"],"limitations":["No control/comparator group","Reliance on non‑validated surveys","Potential self‑selection bias among staff participants"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/02692155261459619"}},{"id":8962,"doi":"10.1016/j.pec.2026.109754","pmid":"42407237","pmcid":null,"title":"Barriers to the assessment of patients' sexuality and sexual health among psychotherapists: A mixed-methods study","authors":"López L, Schweizer K, Martyniuk U, Schröder J.","first_author":"López L","journal":"Patient education and counseling","year":2026,"pub_types":["Journal Article"],"keywords":["Sexuality","Assessment","Sexual Health","psychotherapy"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 220 German psychotherapists assessing self‑reported frequency of sexual health assessment and perceived patient barriers","sample_n":220,"sample_text":"220 licensed psychotherapists and psychotherapists in training; anonymous online survey","population":"licensed psychotherapists and psychotherapists in training (Germany)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 220 German psychotherapists found that younger, less‑experienced clinicians and those with less knowledge about sexuality assess patients' sexual health less often. Urban work settings and psychodynamic orientation were linked to more frequent assessment. Therapists also reported many patient‑related factors they see as barriers to discussing sexuality.","clinical_takeaway":"Improving therapists' knowledge and confidence about sexuality may increase routine assessment of patients' sexual health.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample for a therapist survey","Mixed‑methods adds depth to quantitative findings","Clear practical implications for training"],"limitations":["Self‑report measures not validated","Cross‑sectional; cannot infer causality","Potential self‑selection bias of participants"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pec.2026.109754"}},{"id":8963,"doi":"10.7748/nop.2026.e1519","pmid":"41531032","pmcid":null,"title":"Exploring sexuality and ageism and the nurse's role in supporting sexual health in older adults","authors":"Finlay SL.","first_author":"Finlay SL.","journal":"Nursing older people","year":2025,"pub_types":["Journal Article"],"keywords":["Sexuality","Diversity","Discrimination","Communication","Nursing care","Older People","Ageism","Holistic Care","Healthy Ageing"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary/overview without empirical data","sample_n":null,"sample_text":"Not applicable – no participants","population":"older adults (clinical nursing context)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how ageist attitudes can harm older adults' sexual health and offers nurses advice on recognizing and challenging ageism to better support sexual wellbeing in this population.","clinical_takeaway":"Nurses should actively address ageist assumptions to improve sexual health care for older patients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of ageism and sexuality in older adults","Practical guidance for nurses"],"limitations":["No empirical data or systematic review methodology","Lacks measurement of key sexual health variables"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7748/nop.2026.e1519"}},{"id":8964,"doi":"10.1200/edbk-25-472856","pmid":"40173399","pmcid":null,"title":"Enhancing Sexual Health for Cancer Survivors","authors":"Agrawal LS, O'Riordan L, Natale C, Jenkins LC.","first_author":"Agrawal LS","journal":"American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting","year":2025,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Review article summarizing clinical recommendations; no original empirical data","sample_n":null,"sample_text":"None – narrative/educational review","population":"cancer survivors (both sexes)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Cancer treatments often cause sexual problems such as low libido, pain, and erectile dysfunction. The authors advise clinicians to discuss sexual health routinely and offer medical, physical, and counseling options to improve survivors' quality of life.","clinical_takeaway":"Screen all cancer survivors for sexual health issues and offer tailored medical and psychosocial interventions.","confidence":0.6,"topic_tags":["sexual_function","csbd"],"strengths":["Comprehensive overview of sexual health issues after cancer treatment","Evidence‑based clinical recommendations","Integrates biopsychosocial framework"],"limitations":["No original data; conclusions based on secondary sources","Lacks systematic appraisal of study quality","No quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1200/edbk-25-472856"}},{"id":8965,"doi":"10.1080/0092623x.2026.2710319","pmid":"42544601","pmcid":null,"title":"Interventions for Sexual Function and Sexual Health in Women with Cancer: An Umbrella Review of Systematic Reviews and Meta-Analyses","authors":"Tandoğan Ö, Yakıt Ak E, Ogul Z.","first_author":"Tandoğan Ö","journal":"Journal of sex & marital therapy","year":2026,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Umbrella review (systematic review of systematic reviews/meta‑analyses) of interventions for sexual function in women with cancer.","sample_n":null,"sample_text":"Eighteen systematic reviews/meta‑analyses (total primary studies not specified).","population":"Women with cancer undergoing interventions targeting sexual function/health.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review pooled evidence from 18 systematic reviews on treatments to improve sexual function in women with cancer. While effects were generally positive, the underlying studies were of low quality, highly heterogeneous, and there was some overlap of primary trials, making the overall certainty low.","clinical_takeaway":"Interventions may help sexual function in female cancer patients, but evidence is weak; clinicians should interpret effect sizes cautiously.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Uses validated sexual function instrument (FSFI).","Applies AMSTAR 2, GRADE, and overlap metrics (CCA).","Comprehensive search of three databases plus hand‑searching."],"limitations":["Methodological quality of included reviews largely low/critically low.","High statistical heterogeneity (I² 79‑95 %).","No pre‑registration of the umbrella review protocol reported."],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2026.2710319"}},{"id":8966,"doi":"10.1136/bmjopen-2026-118656","pmid":"42129999","pmcid":"PMC13182333","title":"Technology-enabled sexual health promotion for individuals with intellectual and developmental disabilities: protocol for a scoping review","authors":"P James C, Das A, Sreelatha Biju A, Abhi N, Tijo S.","first_author":"P James C","journal":"BMJ open","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Health education","Sexually transmitted disease","Adolescents","Ehealth","Digital Technology","Sexual And Gender Minorities"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13182333","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"protocol for a scoping review","sample_n":null,"sample_text":"N/A (protocol)","population":"individuals with intellectual and developmental disabilities (IDD)","country":"unspecified (international databases)","controls_mi":"not_applicable","preregistered":true,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This protocol describes a planned scoping review that will map how digital tools are used to teach sexual health to people with intellectual and developmental disabilities, summarising the types of technologies, content, and reported outcomes.","clinical_takeaway":"None – the paper is a review protocol, not a study with clinical findings.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Follows PRISMA‑ScR and PRISMA‑P guidelines","Systematic search strategy with librarian input","Dual independent screening and data charting"],"limitations":["Protocol, no empirical results yet","No assessment of measurement validity for the interventions","Scope limited to English‑language peer‑reviewed literature"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjopen-2026-118656"}},{"id":8967,"doi":"10.1002/cam4.71864","pmid":"42014931","pmcid":"PMC13099367","title":"Oncosexology: A Narrative Review on Sexual Health and Quality of Life in Cancer Patients","authors":"Marino P, Colangelo R, Amendola P, Bochicchio I, Lettini AR, Lapadula S, Giuliano A, Catalano M, Sanseverino F.","first_author":"Marino P","journal":"Cancer medicine","year":2026,"pub_types":["review-article","Review","Journal Article"],"keywords":["Quality of life","Oncology","Cancer Survivorship","Oncosexology","Cancer Sexual Health","Sexual Dysfunction In Oncology"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13099367","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or risk‑of‑bias assessment; no primary data collected.","sample_n":null,"sample_text":"Not applicable – review of existing literature","population":"Adult cancer patients (mixed diagnoses, unspecified) – no sample size reported","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review summarizes how cancer and its treatments can cause sexual problems like low libido or pain, and discusses psychological factors and possible interventions, urging clinicians to address sexual health in survivorship care.","clinical_takeaway":"Clinicians should assess and address sexual dysfunction as part of routine cancer survivorship care.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Broad overview of sexual dysfunctions in cancer","Highlights need for multidisciplinary care"],"limitations":["Narrative, not systematic – selection bias","No quantitative synthesis or risk‑of‑bias assessment","No primary data; conclusions limited"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/cam4.71864"}},{"id":8968,"doi":"10.1071/sh24042","pmid":"40179076","pmcid":null,"title":"Assessing sexual health literacy: a systematic review of measures","authors":"Chenneville T, Haskett M, Ligman K, Gardy SM, Crampsie C, Hart TA.","first_author":"Chenneville T","journal":"Sexual health","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of sexual health literacy self‑report measures (PRISMA‑guided, nine articles included).","sample_n":null,"sample_text":"Nine validation studies; total participants not reported in abstract.","population":"Studies that developed/validated English‑language sexual health literacy scales (2002‑2022).","country":"Not specified (multiple studies).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review examined existing English‑language questionnaires that assess sexual health literacy, finding that none fully meet quality standards and that a more valid, culturally sensitive tool is needed.","clinical_takeaway":"Clinicians should be cautious using current sexual health literacy scales and await more robust measures.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["PRISMA‑guided systematic search across 12 databases","Risk of bias and quality assessment of included studies","Clear identification of gaps in current measures"],"limitations":["Only nine validation studies met criteria, limiting breadth","No quantitative synthesis or meta‑analysis performed","Limited details on psychometric properties in abstract"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":2,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh24042"}},{"id":8969,"doi":"10.1080/19317611.2025.2601627","pmid":"42205347","pmcid":null,"title":"The Effect of Sexual Health Education Program Based on the Health Belief Model on Sexual Function and Sexual Health Literacy of Women","authors":"Hardani Naeimzadeh M, Khazir Z, Keshtkaran Z, Yadollahi P, Ghaleh Golab F, Hamedi A, Khani Jeihooni A.","first_author":"Hardani Naeimzadeh M","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual function","Educational Intervention","Health Belief Model","Sexual Health Literacy"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"controlled experimental study with 80 participants per arm, pre‑post measurement, no clear statement of randomization","sample_n":160,"sample_text":"160 married women (80 intervention, 80 control)","population":"married Iranian women attending urban health centers (n=160)","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A health‑belief‑model education program delivered over eight sessions improved sexual function and sexual‑health knowledge among married Iranian women compared with a control group after three months.","clinical_takeaway":"Brief, theory‑based sexual health education can boost women’s sexual function and knowledge in the short term.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of validated sexual function and literacy instruments","Adequate sample size for group comparison","Clear pre‑post design with control group"],"limitations":["Unclear randomisation procedure","No reporting of effect sizes or confidence intervals","No measurement of key psychosocial confounds (e.g., mental health, relationship factors)","Short‑term follow‑up only"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2025.2601627"}},{"id":8970,"doi":"10.1002/cncr.70560","pmid":"42554247","pmcid":"PMC13439725","title":"Sexual health behaviors and contraceptive practices among Canadian childhood, adolescent, and young adult cancer survivors and controls","authors":"de Beijer IAE, van den Oever SR, Lawal OA, Button A, Duong J, Adham H, Giles J, Reynolds K, Schulte FSM.","first_author":"de Beijer IAE","journal":"Cancer","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Condom Use","Cancer Survivorship","Pediatric Oncology","Contraceptive Use","Caya Cancer Survivors"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13439725","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-control observational study using survivor clinic assessments and national survey controls","sample_n":305,"sample_text":"305 survivors; control data from national survey (large N but not individual-level matched sample)","population":"CAYA cancer survivors (n=305) and Canadian Community Health Survey respondents (n≈108,252)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Young cancer survivors in Canada are less likely to be sexually active and to use condoms compared with peers, especially if they had intense treatment, suggesting a need for better sexual health counselling.","clinical_takeaway":"Clinicians should discuss contraception and sexual activity with young cancer survivors, as they may underestimate fertility risks.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Large control dataset from national survey","Use of Bayesian multilevel modelling","Identification of high‑risk subgroups"],"limitations":["Self‑report measures, likely single‑item","No control for key psychosocial confounds","Survivor sample not nationally representative"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/cncr.70560"}},{"id":8971,"doi":"10.3389/fpubh.2026.1857629","pmid":"42683489","pmcid":"PMC13532047","title":"Effectiveness of sexual health interventions in reducing risky sexual behaviors among people living with HIV: a network meta-analysis and systematic review","authors":"Li Y, Gao Y, Reynolds N, Lu Q, Qin Z, Duan Y, Wang P, Liu T, Cheng LJ, Wang W, Wang H, Xiao X.","first_author":"Li Y","journal":"Frontiers in public health","year":2026,"pub_types":["Systematic Review","systematic-review","Network Meta-Analysis","Journal Article"],"keywords":["Sexual behavior","People Living With Hiv","Network Meta-analysis","Multiple Sexual Partners","Condomless Sex"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13532047","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"network meta-analysis of 34 RCTs (N=12,967) comparing goal‑oriented, skills‑training and other sexual‑health interventions for PLWH","sample_n":12967,"sample_text":"34 randomized controlled trials (total N≈13,000) of PLWH","population":"people living with HIV, adults ≥18 years","country":"multiple (global)","controls_mi":"not_applicable","preregistered":true,"quality_score":8,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review and network meta‑analysis of 34 trials found that goal‑oriented sexual‑health programs most effectively reduced condom‑less sex among people living with HIV, outperforming standard care and other interventions.","clinical_takeaway":"Goal‑oriented sexual‑health counseling should be prioritized to lower risky condom‑less sex in PLWH.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["large pooled sample from RCTs","pre‑registered protocol and systematic search","rigorous Bayesian NMA with credibility intervals","GRADE assessment of evidence certainty"],"limitations":["relies largely on self‑report of sexual behavior","heterogeneity of intervention definitions","no assessment of psychosocial confounders (e.g., mental health, substance use)"],"rubric_version":"2.0","raw_total":38,"max_possible":50,"pct_score":76,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":5,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2026.1857629"}},{"id":8973,"doi":"10.1177/22143602261434092","pmid":"41841320","pmcid":"PMC13437729","title":"Sexual health in neuromuscular diseases: Neglected challenges revealed by a scoping review","authors":"El Kaïm A, Banos M, Decostre V, Birnbaum S, Hogrel JY, Gargiulo M.","first_author":"El Kaïm A","journal":"Journal of neuromuscular diseases","year":2026,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexuality","Physiological","Quality of life","Psychological","Sexual dysfunction","Neuromuscular diseases"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13437729","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review of cross‑sectional questionnaire studies; no meta‑analysis or risk‑of‑bias assessment reported","sample_n":2428,"sample_text":"Aggregated across included studies; individual study sizes not reported in abstract","population":"adults with genetically or clinically confirmed neuromuscular diseases (N=2428 across 27 studies)","country":"Not specified (multinational literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A scoping review of 27 studies shows that people with neuromuscular diseases frequently experience sexual problems, but research is limited, especially for women and long‑term outcomes.","clinical_takeaway":"Clinicians should proactively assess sexual health in patients with neuromuscular disorders, recognizing its multifactorial nature.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Comprehensive mapping of sexual dysfunction literature in NMDs","Follows PRISMA‑ScR reporting guidelines","Highlights gaps in female sexual health and longitudinal data"],"limitations":["Relies on heterogeneous cross‑sectional questionnaire studies","No formal risk‑of‑bias or quality appraisal reported","Potential publication and language bias not addressed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/22143602261434092"}},{"id":8974,"doi":"10.1186/s12939-026-02776-4","pmid":"41668081","pmcid":"PMC12998026","title":"Including the excluded: an evaluation of a sexual health promotion capacity building intervention among specialist homelessness services in New South Wales","authors":"Okeke S, Basheer E, Smith S, Campbell L, Avasalu R, Slater A, Robin G, Napier M, Hall M, Ryder N, Mao L.","first_author":"Okeke S","journal":"International journal for equity in health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Evaluation","Scalability","Young People","Homelessness","Sexual And Reproductive Health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12998026","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pre‑post mixed‑method evaluation of a capacity‑building programme, no control group","sample_n":null,"sample_text":"Not reported in abstract","population":"staff in specialist homelessness services in New South Wales, Australia","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A training programme for staff in homelessness services was evaluated. After the intervention, staff reported better ability to engage and provide sexual‑health services to vulnerable young people, suggesting the program could improve health outcomes if scaled up.","clinical_takeaway":"Capacity‑building training may enhance staff support for homeless youths' sexual health, but evidence of actual health impact is limited.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["Addresses service capacity for a vulnerable youth population","Mixed‑method approach provides qualitative context","Focus on scalability and implementation"],"limitations":["Uncontrolled pre‑post design limits causal inference","Sample size and characteristics not reported","No validated outcome instruments described"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12939-026-02776-4"}},{"id":8975,"doi":"10.3390/healthcare13151911","pmid":"40805941","pmcid":"PMC12346168","title":"Sexual Health Education in Nursing: A Scoping Review Based on the Dialectical Structural Approach to Care in Spain","authors":"Pereira-Afonso MR, Fernandez-Cézar R, Lopezosa-Villajos V, Hermida-Mota M, de Almeida Peres MA, Gómez-Cantarino S.","first_author":"Pereira-Afonso MR","journal":"Healthcare (Basel, Switzerland)","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexuality","Health","Nursing","Sexual Health","Sexual Education","Sti Prevention And Management"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12346168","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"scoping review of literature on sexual health education in nursing curricula in Spain; no systematic risk‑of‑bias assessment; descriptive synthesis","sample_n":null,"sample_text":"Not applicable – review of existing studies","population":"nursing students and healthcare professionals in Spain (studies included in the scoping review)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review of Spanish nursing programmes shows that both students and practising nurses have limited knowledge of sexual health, and that curricula often omit comprehensive sexual‑health education, focusing instead on narrow biomedical topics.","clinical_takeaway":"Nursing education should incorporate broader, holistic sexual‑health training to improve care competence.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive mapping of nursing education literature in Spain","Use of a clear theoretical framework (DSMC)","Identifies clear gaps for curriculum development"],"limitations":["Scoping design lacks systematic bias assessment","No quantitative synthesis or effect‑size reporting","Reliance on heterogeneous primary studies with variable measures"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare13151911"}},{"id":8976,"doi":"10.1186/s12877-026-07540-5","pmid":"42289644","pmcid":"PMC13397712","title":"Cultural factors influencing the sexual health concepts of Chinese older adults and implications for nursing work: a scoping review","authors":"Zheng X, Duan Y, Xiao X, Dong X.","first_author":"Zheng X","journal":"BMC geriatrics","year":2026,"pub_types":["Scoping Review","review-article","Journal Article"],"keywords":["cultural factors","Older Adults","nursing staff","Scoping Review","Sexual Health Concepts"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13397712","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"scoping review","sample_n":17,"sample_text":"17 studies included (total studies retrieved 2,823)","population":"Chinese older adults (aged 60+)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review of 17 Chinese studies found that older adults' ideas about sexual health are shaped by traditional values, family ties, stigma, ageism, and changing cultural attitudes. Nurses should use culturally sensitive approaches when caring for this population.","clinical_takeaway":"Nurses should consider cultural beliefs, family dynamics, and stigma when addressing sexual health with Chinese older adults.","confidence":0.7,"topic_tags":["sexual_function","csbd","masturbation","pornography"],"strengths":["Systematic search across multiple databases","Use of established scoping review framework (Arksey & O'Malley)","Clear identification of cultural themes"],"limitations":["No quality appraisal of included studies","Limited to Chinese context; may not generalize","No quantitative synthesis or effect size reporting"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":2,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12877-026-07540-5"}},{"id":8977,"doi":"10.3389/fpubh.2026.1874571","pmid":"42745841","pmcid":"PMC13574609","title":"Determinants of sexual health information-seeking on social media among Chinese college students: an application of the Comprehensive Model of Information Seeking","authors":"Feng Z, He W, Xie J, Wang G, Lin W.","first_author":"Feng Z","journal":"Frontiers in public health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Health Behavior","Social Media","New Media","Chinese College Students","Comprehensive Model Of Information Seeking","Sexual Health Information Seeking"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13574609","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey (N=283) with structural equation modeling","sample_n":283,"sample_text":"283 Chinese college students (online survey)","population":"Chinese college students","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 283 Chinese college students examined why they look for sexual‑health information on social media. Beliefs, personal experience and how trustworthy the information seems all make students more likely to seek it.","clinical_takeaway":"Improving credibility and relevance of online sexual‑health content may boost students’ information seeking.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large community sample for a Chinese university context","Use of structural equation modeling to test a theoretical model","Clear statement of cross‑sectional limitations"],"limitations":["Reliance on self‑report questionnaires with unclear validation","No measurement of key confounds (moral, mental health, partner effects)","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2026.1874571"}},{"id":8978,"doi":"10.3390/healthcare14142049","pmid":"42512565","pmcid":"PMC13409996","title":"Development and Psychometric Validation of a Questionnaire Assessing Gynecologic Oncology Nurses' Knowledge, Attitude, and Practice in Providing Sexual Health Care","authors":"Sun Y, Zhang J, Shi B.","first_author":"Sun Y","journal":"Healthcare (Basel, Switzerland)","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Validity","reliability","Questionnaire Development","Gynecologic Oncology","Sexual Health Care"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13409996","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"instrument development and validation using convenience sample of 517 nurses; split‑sample EFA/CFA.","sample_n":517,"sample_text":"Convenience sample from nine hospitals across six provinces; randomly split for factor analysis.","population":"gynecologic oncology nurses in China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a 40‑item questionnaire to assess how well gynecologic oncology nurses know, feel about, and practice sexual health care, showing strong reliability and validity.","clinical_takeaway":"Clinicians can use this validated tool to gauge and improve nurses’ competence in providing sexual health care to cancer patients.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Large sample for psychometric validation","Rigorous Delphi and factor‑analysis process","High reliability (Cronbach’s α = 0.98) and content validity"],"limitations":["Convenience sampling limits generalisability","Cross‑sectional design; no test of predictive validity","No pre‑registration of validation protocol"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare14142049"}},{"id":8980,"doi":"10.1136/bmjph-2024-002348","pmid":"41919192","pmcid":"PMC13034309","title":"Healthcare providers' perceptions of sexual health concerns among female patients with cervical and breast cancer and survivors in Rwanda: a qualitative interview study","authors":"Espmark J, Båge K, Rutagumba D, Ndoli AD, Uwimana JB, Innocent NN, Rusatira JC, Kågesten A.","first_author":"Espmark J","journal":"BMJ public health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Qualitative Research","Health Services Accessibility"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13034309","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 15 providers","sample_n":15,"sample_text":"15 providers from four facilities, purposive sampling","population":"healthcare providers (doctors, nurses, midwives) treating cervical and breast cancer patients in Rwanda","country":"Rwanda","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 15 Rwandan cancer care providers show that cultural taboos, limited knowledge, and health‑system constraints hinder sexual health counseling for women with cervical or breast cancer.","clinical_takeaway":"Clinicians should recognize systemic and cultural barriers and seek training to address sexual health needs of female cancer patients.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["in‑depth provider perspectives from a low‑resource setting","systematic content analysis of verbatim transcripts","identifies systemic and cultural barriers to sexual health counseling"],"limitations":["small, non‑representative provider sample (N=15)","no patient viewpoint, limiting scope","no quantitative measurement of constructs"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjph-2024-002348"}},{"id":8981,"doi":"10.1371/journal.pone.0346256","pmid":"41996393","pmcid":"PMC13089752","title":"Strategies to improve sexual health in women with urinary incontinence: A scoping review","authors":"Askarloo Z, Shahali S, Ahmadi F, Montazeri A.","first_author":"Askarloo Z","journal":"PloS one","year":2026,"pub_types":["Scoping Review","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13089752","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review of 31 heterogeneous studies, narrative synthesis without risk‑of‑bias assessment","sample_n":null,"sample_text":"31 studies (sample sizes not extracted)","population":"women with urinary incontinence","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This scoping review summarises 31 studies on how treatments for urinary incontinence affect women's sexual health. Results are mixed and it is unclear which interventions reliably improve sexual function.","clinical_takeaway":"Current evidence does not identify a single best treatment for sexual dysfunction in women with urinary incontinence; clinicians should consider individual patient needs and monitor outcomes.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Comprehensive mapping of intervention types","Clear methodological framework (Arksey & O'Malley)","Identification of gaps in partner‑focused outcomes"],"limitations":["Heterogeneous primary studies limit comparability","No risk‑of‑bias assessment or quantitative synthesis","Variable sexual function measures reduce construct consistency"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0346256"}},{"id":8982,"doi":"10.1093/sxmrev/qeaf078","pmid":"41537423","pmcid":null,"title":"Female sexual health after obstetric anal sphincter injury: a scoping review","authors":"Gibrael HS, Linhardt S, Jangö H, Toldam NE, Dreier S, Thomsen L, Giraldi A, Graugaard C.","first_author":"Gibrael HS","journal":"Sexual medicine reviews","year":2026,"pub_types":["Scoping Review","Journal Article"],"keywords":["Sexual function","Women","Dyspareunia","Sexual Health","Female Sexual Dysfunction","Perineum/injuries","Postpartum Sexual Health","Obstetric Perineal Tear","Birth-related Tear"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Scoping review of 33 quantitative studies on obstetric anal sphincter injury and postpartum sexual health, using systematic literature searches across multiple databases.","sample_n":null,"sample_text":"33 included quantitative studies (total participants not reported in abstract).","population":"Women who have experienced obstetric anal sphincter injury (OASI) during vaginal delivery.","country":"International (studies from multiple countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review of 33 studies finds that women who suffer severe perineal tears during childbirth (OASI) are more likely to delay resuming sex, experience pain during intercourse, and report lower desire, lubrication, orgasm, and overall satisfaction, sometimes for years after delivery.","clinical_takeaway":"Clinicians should proactively discuss sexual health with women after OASI and consider referrals to physiotherapy, couples therapy, or sexology to address persistent dysfunction.","confidence":0.6,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Comprehensive search across multiple databases","Clear focus on three sexual‑health dimensions","Identifies consistent patterns across studies"],"limitations":["No quantitative synthesis or meta‑analysis","Limited assessment of study quality or bias","Does not examine confounding factors (e.g., mental health, partner support)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeaf078"}},{"id":8983,"doi":"10.1016/j.ijgc.2026.104833","pmid":"42520499","pmcid":null,"title":"From vaginal morbidity to sexual health: rethinking sexual rehabilitation after gynecological cancer through a survivor-informed patient expert perspective","authors":"Tóth I, Tóth R, Kirchheiner K.","first_author":"Tóth I","journal":"International journal of gynecological cancer : official journal of the International Gynecological Cancer Society","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Quality of life","Sexual Health","Sexual Rehabilitation","Vaginal Morbidity","Gynecologic Cancer Survivorship","Pleasure-based Approach"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review, narrative perspective without systematic methods","sample_n":null,"sample_text":"Not applicable – narrative review","population":"Gynecologic cancer survivors (female)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that after gynecologic cancer, sexual health should focus beyond fixing vaginal tissue to include pleasure, relational dynamics, and patient‑centered goals, suggesting tools like vibrators and counseling alongside medical treatments.","clinical_takeaway":"Clinicians should broaden sexual rehabilitation to include pleasure‑focused interventions and relational support, not just anatomical restoration.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Addresses an under‑studied aspect of survivorship","Integrates multidisciplinary perspective","Highlights relational and pleasure‑based approaches"],"limitations":["Narrative review lacking systematic methodology","No empirical data or quantitative analysis","Limited generalizability without sample description"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijgc.2026.104833"}},{"id":8984,"doi":"10.1016/j.jpag.2025.10.014","pmid":"41187870","pmcid":null,"title":"The Sexual Health and Well-being of Individuals With Complete Androgen Insensitivity Syndrome (CAIS)","authors":"Lehembre-Shiah E, Adams M, Soliman M, Kaur H, Brookhart CD, Das K, Gomez-Lobo V.","first_author":"Lehembre-Shiah E","journal":"Journal of pediatric and adolescent gynecology","year":2026,"pub_types":["Journal Article"],"keywords":["Disorders Of Sexual Differentiation","Intersex","Xy","46","Dsd","Vsc","Complete Androgen Insensitivity Syndrome","Differences Of Sex Development","Variations In Sex Characteristics"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"prospective cohort interim analysis; descriptive cross‑sectional assessment of 23 CAIS participants","sample_n":23,"sample_text":"young cohort of CAIS individuals recruited within NIH AIS Natural History Study","population":"individuals with complete androgen insensitivity syndrome, aged 14‑65 (median 19); 23 participants","country":"United States (NIH funded)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 23 people with complete androgen insensitivity syndrome, vaginal length was mostly within normal ranges and most reported positive body image and satisfactory sexual activity, based on validated questionnaires.","clinical_takeaway":"CAIS individuals generally report normal sexual function and body image; clinicians can reassure patients about typical outcomes.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Use of validated PROMIS SexFS and Body Image Scale","Prospective data collection within NIH‑funded natural history study","Rare clinical population studied"],"limitations":["Very small sample (N=23) limits precision","No comparison group; reliance on normative benchmarks only","Limited statistical analysis; no power justification"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpag.2025.10.014"}},{"id":8985,"doi":"10.6118/jmm.25144","pmid":"42045090","pmcid":"PMC13129204","title":"Sexual Health Problems and Service Needs of Menopausal Women: A Mixed Method Study in Osun State Nigeria","authors":"Adedeji AO, Olajubu AO, Aladegboye MK, Olowokere AE.","first_author":"Adedeji AO","journal":"Journal of menopausal medicine","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Postmenopause","menopause","Nigeria","Sexual Health","Health Services Needs And Demand"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13129204","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-method concurrent design; quantitative questionnaire (n=420) and qualitative interviews (n=20); convenience sampling of menopausal women in Osun State, Nigeria","sample_n":420,"sample_text":"420 questionnaire respondents; 20 interview participants","population":"Menopausal women aged 40‑65 in Osun State, Nigeria","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A study of 420 menopausal women in Nigeria found common sexual problems such as vaginal dryness, low desire, infections and pain during sex, and highlighted needs for better information and services.","clinical_takeaway":"Clinicians should assess and address dryness, desire loss, and infection risk in menopausal patients, and provide tailored sexual‑health information.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large quantitative sample for a regional study","Mixed‑method design provides depth and context","Clear description of prevalent sexual problems"],"limitations":["Convenience sample limits generalisability","Questionnaire validation not reported","No control for mental‑health or partner factors"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.6118/jmm.25144"}},{"id":8986,"doi":"10.1007/s10354-026-01158-3","pmid":"42247038","pmcid":null,"title":"Restoring sexual health and relationship quality through penile prosthesis implantation","authors":"Pozo C, Kollitsch L.","first_author":"Pozo C","journal":"Wiener medizinische Wochenschrift (1946)","year":2026,"pub_types":["Journal Article","Case Reports"],"keywords":["Sexual function","Penile Implant","Prostate Cancer Survivor","Post-prostatectomy Erectile Dysfunction","Young-onset Prostate Cancer"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case report of penile prosthesis implantation after radical prostatectomy","sample_n":1,"sample_text":"one case","population":"young male prostate cancer survivor with erectile dysfunction","country":"unspecified (likely Austria based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A young man whose erectile function did not improve after prostate surgery received a penile implant, which restored his sexual activity and improved his wellbeing, according to the authors.","clinical_takeaway":"Penile prostheses can effectively restore function in refractory post‑prostatectomy ED, but evidence is limited to single cases.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Detailed clinical description","Focus on patient‑reported outcomes"],"limitations":["Single‑case design, no generalisability","No comparative or statistical analysis","No control for psychosocial confounders"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10354-026-01158-3"}},{"id":8988,"doi":"10.1111/jan.70199","pmid":"40913018","pmcid":"PMC13069267","title":"Developing an Intervention to Improve Sexual Health Assessment and Care in Men With Inflammatory Bowel Disease","authors":"Ma S, Forshaw G, Kanaan M, Knapp P, Robinson W, Selinger C, Galdas P.","first_author":"Ma S","journal":"Journal of advanced nursing","year":2026,"pub_types":["methods-article","Journal Article"],"keywords":["Research methods","Gastroenterology","Sexual Health","Chronic Illness","Men's Health","Qualitative Approaches","Survey Designs","Clinical Nurse Specialist"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13069267","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-methods development study with cross‑sectional surveys of patients and staff, semi‑structured interviews, and co‑production workshops","sample_n":null,"sample_text":"Cross‑sectional surveys and qualitative interviews; exact numbers not given in abstract","population":"men with inflammatory bowel disease (UK NHS); nurses and IBD services; partners of men with IBD","country":"United Kingdom","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers worked with men who have inflammatory bowel disease and health professionals to design a prototype program that helps nurses talk about and address sexual health concerns in this patient group.","clinical_takeaway":"A new nurse‑focused tool is being developed to improve sexual health assessment for men with IBD; its effectiveness remains to be tested.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Co‑production approach involving patients and clinicians","Mixed‑methods design captures both quantitative and qualitative perspectives","Adheres to SPIRIT checklist for trial protocol reporting"],"limitations":["Limited detail on measurement instruments and validation","Likely convenience sampling; generalisability unclear","No effectiveness data for the prototype intervention"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jan.70199"}},{"id":8989,"doi":"10.1071/sh25069","pmid":"41442558","pmcid":null,"title":"What sexual health information do older adults want? Findings from the Australian SHAPE2 survey","authors":"Bourchier L, Bittleston H, Temple-Smith M, Malta S, Hocking JS.","first_author":"Bourchier L","journal":"Sexual health","year":2026,"pub_types":["Journal Article"],"keywords":["Ageing","Sexual function","Sex Education","Sexual Health","Health Promotion","Older Adults","Help-seeking","Mixed-methods"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online survey of older Australian adults (N=1470) assessing self‑reported information needs; convenience sampling.","sample_n":1470,"sample_text":"1470 respondents, median age 69, gender balanced","population":"Adults aged 60+ years in Australia (online respondents)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2021 Australian survey of 1470 people aged 60+ found that older adults want more information about sexual anatomy, ageing and sexuality, and sexual difficulties, with men seeking more information overall but women covering a broader range of topics.","clinical_takeaway":"Clinicians should address a wide range of sexual‑health topics when counselling older patients, as information gaps are common.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for a survey","Clear descriptive statistics with confidence intervals","Both quantitative and qualitative (free‑text) data"],"limitations":["Convenience online sampling – not representative of all older adults","No validated measurement instruments for information‑need constructs","No adjustment for potential demographic confounders"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh25069"}},{"id":8990,"doi":"10.1038/s41443-025-01216-1","pmid":"41299028","pmcid":null,"title":"Rethinking the peyronie's disease questionnaire: a perspective on inclusivity in sexual health assessment","authors":"Vannier E, Cocci A, Pezzoli M, Lo Re M, Van Renterghem K, Ward S.","first_author":"Vannier E","journal":"International journal of impotence research","year":2025,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"Perspective/Review article with no new empirical data.","sample_n":null,"sample_text":"Not applicable – article does not report original data.","population":"Not applicable","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors critique the Peyronie's Disease Questionnaire, arguing it may not capture the full range of patients' sexual experiences and calling for more inclusive, modern assessment tools.","clinical_takeaway":"None - not clinically applicable.","confidence":0.3,"topic_tags":["sexual_function","measurement"],"strengths":["Highlights need for inclusive measurement tools","Draws on existing literature of sexual health questionnaires"],"limitations":["No original data or systematic review methodology","Limited empirical evidence to support recommendations"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-025-01216-1"}},{"id":8991,"doi":"10.1111/jir.13217","pmid":"39970322","pmcid":"PMC11966363","title":"Sexual Health Literacy Among Adults With Intellectual Disabilities: A Scoping Review","authors":"McGrath M, Chong LYC, Collings S, Pebdani R.","first_author":"McGrath M","journal":"Journal of intellectual disability research : JIDR","year":2025,"pub_types":["Scoping Review","research-article","Journal Article"],"keywords":["Quality of life","Intellectual Disability","Social Skills","Health Inequities"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11966363","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Scoping review of 102 original research articles using Arksey and O'Malley's framework; PRISMA‑SCR reported; interpretive content analysis applied.","sample_n":null,"sample_text":"102 studies included; no primary participant numbers reported.","population":"Adults with intellectual disabilities (no specific age range reported).","country":"Not specified (international literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This scoping review summarises 102 studies about how adults with intellectual disabilities learn and use sexual health knowledge. It finds that social attitudes—like assuming vulnerability or asexuality—limit their ability to gain knowledge and act autonomously, suggesting a need for better education programmes.","clinical_takeaway":"Ensuring accessible, rights‑based sexual health education is essential for adults with intellectual disabilities.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive search (5 databases, 5447 records).","Followed established scoping review methodology (Arksey & O'Malley; PRISMA‑SCR).","Developed conceptual framework linking knowledge, autonomy, and social context."],"limitations":["No quantitative synthesis or assessment of study quality.","Reliance on secondary reports limits control over construct measurement.","No explicit evaluation of measurement validity for sexual health literacy."],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jir.13217"}},{"id":8992,"doi":"10.1093/ibd/izag121","pmid":"42430211","pmcid":null,"title":"Healthcare professionals' knowledge, attitudes, and practice with addressing sexual health among people living with inflammatory bowel disease: A UK cross-sectional survey","authors":"Kuriakose Kuzhiyanjal AJ, Rhodes S, Sethi-Arora K, Hancock L, Selinger C, Lamb CA, Rubin DT, Limdi JK.","first_author":"Kuriakose Kuzhiyanjal AJ","journal":"Inflammatory bowel diseases","year":2026,"pub_types":["Journal Article"],"keywords":["Quality of life","Ulcerative colitis","Sexual dysfunction","Sexual Health","Inflammatory Bowel Disease","Crohn’s Disease"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 249 UK healthcare professionals working with IBD patients; adapted questionnaire; logistic regression analysis of factors associated with comfort discussing sexual health.","sample_n":249,"sample_text":"249 eligible participants completed the survey.","population":"Healthcare professionals (physicians, nurses, dietitians, etc.) involved in inflammatory bowel disease care in the United Kingdom (N=249).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A UK survey of 249 clinicians who treat inflammatory bowel disease found that while most feel comfortable talking about sexual health, only a few actually do so. Time pressure, lack of knowledge, and unclear referral paths are major barriers, and clinicians want more training.","clinical_takeaway":"Clinicians should seek training and clear referral pathways to address sexual dysfunction in IBD patients, despite current time constraints.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a professional‑survey (N≈250)","Focus on an under‑studied aspect of IBD care","Identifies clear educational needs"],"limitations":["Adapted questionnaire not validated","Convenience sampling of HCPs may limit generalisability","No patient‑level outcomes"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/ibd/izag121"}},{"id":8994,"doi":"10.1007/s10461-026-05226-y","pmid":"42467127","pmcid":null,"title":"A Socioecological Perspective on Sexual Health Promotion Choices Among Youth At-Risk for and Living with HIV in Los Angeles and New Orleans","authors":"Wong C, Lewis KA, Ma AM, Valles H, Polanco D, Tapia Y, Ocasio MA, Yuva Raju R, Arnold EM, Swendeman D, A. T. N. CARES Study Team.","first_author":"Wong C","journal":"AIDS and behavior","year":2026,"pub_types":["Journal Article"],"keywords":["HIV","Youth","Sexual Health","Strengths","Socioecological"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross‑sectional qualitative analysis of coach case‑note narratives (N=257)","sample_n":257,"sample_text":"257 youth completed a baseline strengths assessment with a coach; data are qualitative case‑note excerpts.","population":"Youth aged 16‑24 at‑risk for or living with HIV in Los Angeles and New Orleans","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examined how young people at risk for or living with HIV choose sexual‑health strategies (e.g., condoms, PrEP, relationship decisions) by analysing written notes from a strengths‑based coaching program.","clinical_takeaway":"Clinicians should recognise the diverse, autonomy‑driven choices youth make about sexual health and tailor counseling to individual preferences.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large qualitative sample for a case‑note study","Uses socio‑ecological framework to organise findings"],"limitations":["No quantitative measurement of key constructs","No assessment of confounding factors (e.g., mental health, trauma)","Cross‑sectional and self‑selected sample limits generalisability"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-026-05226-y"}},{"id":8995,"doi":"10.1093/geront/gnaf304","pmid":"41390966","pmcid":null,"title":"The impact of ageism on sexual health in older adults: an integrative review","authors":"Cao S, Gordon J, Nian W, Johnson KD.","first_author":"Cao S","journal":"The Gerontologist","year":2026,"pub_types":["Systematic Review","Journal Article"],"keywords":["Sexuality","Sexual Health","Ageism","Older Adults","Integrative Review"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Integrative systematic review of 29 studies using Whittemore & Knafl method, quality appraisal with MMAT, thematic synthesis.","sample_n":29,"sample_text":"29 included studies (total participants not reported in abstract)","population":"Older adults (aged 60+)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This integrative review found that ageist attitudes—both societal and internalized—harm older adults' sexual health, reducing pleasure, obscuring health needs, and increasing vulnerability to sexual violence.","clinical_takeaway":"Addressing ageist stigma may improve sexual wellbeing and safety for older patients.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Systematic search across multiple databases","Use of established integrative review methodology","Quality appraisal of included studies"],"limitations":["Heterogeneous primary studies limit quantitative synthesis","No meta‑analytic effect sizes reported","Abstract provides limited detail on measurement validity"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/geront/gnaf304"}},{"id":8996,"doi":"10.1038/s41443-026-01231-w","pmid":"41708892","pmcid":null,"title":"Charting paths to sexual well-being: a comprehensive research agenda for fostering sexual health in Europe and beyond","authors":"Dewitte M, Serefoglu EC, Andric SA, Mestrovic T, Pascoal PM, Greil-Soyka M, Borg C.","first_author":"Dewitte M","journal":"International journal of impotence research","year":2026,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative agenda-setting review without primary data; no empirical methods reported.","sample_n":null,"sample_text":"Not applicable – no participants recruited.","population":"none","country":"International (European focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose a European research agenda for sexual health, identifying gaps such as the impact of stress, technology, and societal norms on sexual well‑being and calling for transdisciplinary collaboration.","clinical_takeaway":"None – the paper offers a conceptual agenda rather than actionable clinical findings.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad, transdisciplinary perspective","Highlights under‑researched populations"],"limitations":["No empirical data or systematic review methods","No measurement of key psychosocial confounds"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-026-01231-w"}},{"id":8997,"doi":"10.1177/02692163251385874","pmid":"41199530","pmcid":"PMC13062440","title":"The impact of advanced cancer on sexual health and relationships: A qualitative study on patient and partner perspectives","authors":"Ho JFV, Cheong MWL, Lee QY, Wong PL, Mustafa H, Goh PH, Yaakup H.","first_author":"Ho JFV","journal":"Palliative medicine","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Neoplasms","Palliative care","Sexual Health","Qualitative Research","Patient Perspective","Sexual Partner"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13062440","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative semi‑structured interviews with 27 participants (18 patients, 9 partners) recruited from a single oncology clinic in Malaysia; reflexive thematic analysis.","sample_n":27,"sample_text":"18 patients, 9 partners","population":"Adults with stage III/IV cancer and their intimate partners in Malaysia","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with people living with advanced cancer and their partners in Malaysia showed that illness can lower sexual desire and satisfaction, but couples often keep intimacy alive through emotional connection, communication, and spiritual coping.","clinical_takeaway":"Clinicians should address sexual concerns in advanced cancer care, emphasizing communication and emotional intimacy alongside medical treatment.","confidence":0.6,"topic_tags":["sexual_function","csbd","pornography","masturbation","moral_incongruence"],"strengths":["In‑depth patient‑partner perspectives","Culturally relevant Asian context","Use of reflexive thematic analysis"],"limitations":["Small, non‑random sample from one clinic","No quantitative measures of sexual function","Findings not generalisable to other settings"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/02692163251385874"}},{"id":8998,"doi":"10.3390/healthcare13222895","pmid":"41302281","pmcid":"PMC12652658","title":"Digital Motion Graphics and Animated Media in Health Communication: A Systematic Review of Strategies for Sexual Health Messaging","authors":"Suwanphan N, Mettarikanon D, Kaeophanuek S, Eden C, Tawanwongsri W.","first_author":"Suwanphan N","journal":"Healthcare (Basel, Switzerland)","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Health Communication","Animation","Digital Media","Sexual Health Education","Public Health Messaging","Motion Graphics"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12652658","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 11 studies (RCTs, quasi‑experimental etc.) pre‑registered; synthesis of outcomes on knowledge, attitudes, behaviour. Not a meta‑analysis.","sample_n":null,"sample_text":"Eleven studies included; individual study sizes not reported in abstract.","population":"Studies covering sexual health messaging; no specific participant details in abstract.","country":"Not specified (multiple studies).","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of eleven studies found that animated videos and motion graphics can improve people’s knowledge, attitudes, and sometimes behaviours related to sexual health, especially when culturally adapted and theory‑based.","clinical_takeaway":"Animated digital media can be an effective tool for sexual health education, but evidence on lasting behaviour change is limited.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Pre‑registered systematic review protocol","Includes RCTs and quasi‑experimental studies","Identifies practical components (cultural adaptation, theory‑based design)"],"limitations":["No quantitative meta‑analysis reported","Limited detail on risk‑of‑bias assessment","Small number of eligible studies (11) spanning many years"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare13222895"}},{"id":8999,"doi":"10.21203/rs.3.rs-7554746/v1","pmid":null,"pmcid":null,"title":"Healthcare Providers’ Perceptions of Mental and Sexual Health Needs of Young Males with Forced Migration Experiences in Stockholm Region, Sweden: A Patient-Centered Approach","authors":"Karimah F, McDonald JT, Stålgren M, Salazar M.","first_author":"Karimah F","journal":"Research Square","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative interview study with 9 healthcare providers, inductive content analysis","sample_n":9,"sample_text":"Nine health care providers were included in the study.","population":"healthcare providers (Sweden)","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with nine Swedish healthcare providers reveal that young men who have fled conflict face intertwined mental‑ and sexual‑health challenges, and that cultural and migration‑related factors affect care.","clinical_takeaway":"Clinicians should consider migration history and cultural context when addressing sexual and mental health of young male patients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides expert HCP perspectives","Focus on an understudied population (young forced‑migration males)","Patient‑centered framework"],"limitations":["Very small, non‑representative sample (n=9)","No triangulation with service users’ views","Qualitative design limits generalisability"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-7554746/v1"}},{"id":9000,"doi":"10.4102/hsag.v30i0.3047","pmid":"41200004","pmcid":"PMC12587091","title":"A model to support radiation therapists in facilitating sexual health counselling for patients with prostate cancer","authors":"Phahlamohlaka NM, Engel-Hills P, Friedrich-Nel H.","first_author":"Phahlamohlaka NM","journal":"Health SA = SA Gesondheid","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Radiotherapy","Sexual Health","Counselling","Supportive Care","Radiation Therapy","Model Framework","Oncology Health Professional"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12587091","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"theory-generating model development using empirical findings from two hospitals; no empirical outcome testing","sample_n":null,"sample_text":"Not reported in abstract","population":"radiation therapists and patients in two academic hospitals in Gauteng, South Africa","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors created a framework to help radiation therapists talk with prostate‑cancer patients about sexual health, aiming to make such counseling a routine part of radiotherapy care in South Africa.","clinical_takeaway":"Consider integrating structured sexual‑health counseling models into radiotherapy practice, but await evidence of effectiveness.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Addresses gap in supportive sexual health care in radiotherapy","Develops a structured model framework","Involves empirical data from local context"],"limitations":["No empirical testing of model effectiveness","Small, non‑representative sample","Lacks validated measurement of outcomes"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4102/hsag.v30i0.3047"}},{"id":9001,"doi":"10.1007/s10508-025-03223-1","pmid":"41028526","pmcid":"PMC12675568","title":"A Cross-Sectional Study of Sexual Health and Well-Being in Married or Cohabitating Middle-Aged and Older Adults in Nouna, Burkina Faso","authors":"Omojola OA, Osborne CA, Bountogo M, Inghels M, Harling G, Sie A, Palmer DG, Bärnighausen T, Davies JI, Hirschhorn LR.","first_author":"Omojola OA","journal":"Archives of sexual behavior","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Sexual function","Sexual activity","Burkina Faso","Middle Aged And Older Adults"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12675568","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 2336 married/cohabiting adults ≥40 in Burkina Faso","sample_n":2336,"sample_text":"community‑based convenience sample of households surveyed in 2021","population":"married or cohabiting middle‑aged and older adults in Nouna, Burkina Faso (N≈2336, 56.8% men, mean age 53.2)","country":"Burkina Faso","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2021 survey of over 2,300 married or cohabiting adults aged 40+ in Burkina Faso found that most people were sexually active, but men reported more frequent thoughts and activity than women, and older age was linked to fewer thoughts and more sexual difficulties.","clinical_takeaway":"Older adults in this setting remain sexually active; clinicians should consider age and sex differences when addressing sexual function concerns.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large community sample (N>2000)","Use of a validated sexual health questionnaire","Multivariable logistic modelling of key demographic predictors"],"limitations":["Cross‑sectional design limits causal inference","No assessment of key psychosocial confounds (e.g., mental health, moral attitudes)","No effect‑size confidence intervals reported"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03223-1"}},{"id":9003,"doi":"10.1177/10436596251370370","pmid":"40888359","pmcid":"PMC12722577","title":"\"Losing My Femininity\": Sexual Health Experiences of Arabic Women After Mastectomy","authors":"Alsababha R, McDermid F, O'Reilly R, Mannix J, Peters K.","first_author":"Alsababha R","journal":"Journal of transcultural nursing : official journal of the Transcultural Nursing Society","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Cancer","Mastectomy","Sexual Health","Arab Women"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12722577","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 22 Arabic women post‑mastectomy","sample_n":22,"sample_text":"22 participants recruited for semi‑structured interviews","population":"Arabic women, age 28‑60, who have undergone mastectomy","country":"Not specified (likely Middle‑East or diaspora)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Arabic women who had a mastectomy described feeling less feminine, lower self‑esteem, and reduced sexual satisfaction, often linking these feelings to cultural expectations of being a wife and mother.","clinical_takeaway":"Clinicians should address body image and cultural gender expectations when supporting sexual health after mastectomy in Arab women.","confidence":0.8,"topic_tags":["sexual_function","csbd","moral_incongruence","masturbation"],"strengths":["In‑depth qualitative insight into culturally specific experiences","Use of feminist and constructivist frameworks"],"limitations":["Small, non‑representative convenience sample","No validated quantitative measures of sexual function or distress"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10436596251370370"}},{"id":9004,"doi":"10.1002/hsr2.73340","pmid":"42851834","pmcid":null,"title":"\"Silent Suffering\": Affirming Iranian Women's Right to Sexual Health Through a Whatsapp-Based \"Good Enough Sex\" Counseling Program: A Parallel-Group Randomized Controlled Trial","authors":"Shahla EB, Fatemeh MT, Mahmonir H, Rasool GA.","first_author":"Shahla EB","journal":"Health science reports","year":2026,"pub_types":["Journal Article"],"keywords":["Infertility","Counseling","Sexual Satisfaction","Infertility Stress","Good Enough Sex"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"parallel-group, single‑blind RCT, N=100 (convenience sample from two infertility centres), 6‑week WhatsApp‑based counseling vs routine care, outcomes at baseline, post‑intervention, 1‑month follow‑up","sample_n":100,"sample_text":"Convenience sampling from two referral infertility centres","population":"infertile Iranian women, aged 25‑35 years","country":"Iran","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 6‑week, WhatsApp‑based counseling program improved sexual satisfaction and reduced infertility‑related stress in 100 Iranian women with infertility, compared with routine care. Effects were large and lasted at least one month, though the study used a small, clinic‑based sample.","clinical_takeaway":"Digitally delivered psychosexual counseling can boost sexual satisfaction and lower stress for infertile women, but larger, longer studies are needed before routine adoption.","confidence":0.85,"topic_tags":["sexual_function","csbd"],"strengths":["Randomized controlled design","Validated outcome measures","Clear effect size reporting"],"limitations":["Convenience sample limits generalisability","Short follow‑up (1 month)","No control for mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/hsr2.73340"}},{"id":9005,"doi":"10.12968/bjon.2023.0271","pmid":"40488560","pmcid":null,"title":"Addressing sexual health among patients with immune-mediated inflammatory diseases","authors":"Møller LF, Edelbo R, Bager P.","first_author":"Møller LF","journal":"British journal of nursing (Mark Allen Publishing)","year":2025,"pub_types":["Journal Article"],"keywords":["Autoimmune diseases","chronic diseases","Sexual Health","Intimacy","Immune-mediated Inflammatory Disease"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"mixed-methods (quantitative survey + qualitative interviews) with consecutive clinic patients (N=142), cross‑sectional","sample_n":142,"sample_text":"Consecutive recruitment from clinic; not a probability or representative sample","population":"patients with one or more immune‑mediated inflammatory diseases attending outpatient clinics","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 142 patients with inflammatory diseases found that having several such conditions worsened sexual health and intimacy problems, suggesting healthcare providers need better communication and support around sexuality.","clinical_takeaway":"Screen patients with multiple inflammatory diseases for sexual‑health issues and offer targeted counselling.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relatively large sample for a clinical sexual‑health survey","Mixed‑methods approach adds depth","Focus on understudied patient group (multiple IMIDs)"],"limitations":["Likely uses ad‑hoc sexual‑health items – limited construct validity","Cross‑sectional, cannot infer causality","Convenience clinic sample limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.12968/bjon.2023.0271"}},{"id":9006,"doi":"10.1080/19317611.2025.2546906","pmid":"41641069","pmcid":"PMC12867390","title":"Effects of Mindfulness-Based Intervention on Sexual Health in Menopause: A Systematic Review","authors":"Altıntaş E, Ünlü Suvari G, Oskay Ü.","first_author":"Altıntaş E","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Systematic review","menopause","Mindfulness"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review of 7 RCTs (n=609) with narrative synthesis; no meta‑analysis","sample_n":609,"sample_text":"seven RCTs, 609 participants from multiple countries","population":"menopausal women (average age not specified)","country":"US, Iran, India, Netherlands, Hong Kong","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of seven randomised trials found that mindfulness programmes can reduce sexual distress and improve desire and arousal in menopausal women, but effects on overall sexual function were inconsistent.","clinical_takeaway":"Mindfulness may help lessen sexual distress in menopause, but evidence for broader sexual‑function benefits is mixed.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Systematic search across multiple databases","Inclusion of only RCTs","Use of validated sexual health measures"],"limitations":["No quantitative meta‑analysis","Heterogeneity of interventions and outcomes","Limited reporting of effect sizes in abstract"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2025.2546906"}},{"id":9007,"doi":"10.64898/2025.12.05.25341714","pmid":null,"pmcid":null,"title":"Insights into sexual partners and partnerships among gay, bisexual and other men who have sex with men in the United Kingdom: Results from the Reducing Inequalities in Sexual Health (RiiSH) behavioural survey","authors":"Fearon E, Etoori D, Ogaz D, Weil B, Nutland W, Reid D, Saunders J, Mohammed H, Mercer CH.","first_author":"Fearon E","journal":"medRxiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/article/PPR/PPR1271072","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online community‑based survey of GBMSM (N=1106) describing up to three recent male partners; descriptive and comparative analyses of partnership type, age‑mixing, condom use, PrEP use and communication.","sample_n":1106,"sample_text":"1106 participants describing 2342 partners","population":"GBMSM in the United Kingdom, recruited via community organisations; self‑selected online sample.","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A UK survey of 1,100 gay and bisexual men described the types of male partners they had, how often they used condoms or PrEP, and whether they talked about sexual health. Partnerships differed by type, with casual partners more common than one‑time or established relationships.","clinical_takeaway":"STI prevention programs for GBMSM should tailor messages to different partnership types and promote communication about sexual health.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Large community‑based sample of GBMSM","Detailed partner‑level data (up to three recent partners)","Provides descriptive epidemiology useful for STI prevention"],"limitations":["Cross‑sectional design; cannot infer causality","Self‑selected online sample may not be nationally representative","No validated scales for partnership typology; relies on study‑specific categories"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.64898/2025.12.05.25341714"}},{"id":9008,"doi":"10.1016/j.jmig.2025.10.007","pmid":"41135696","pmcid":null,"title":"Sexual Health History: Addressing a Commonly Neglected Health Indicator in Gynecologic Surgery","authors":"Massoud G, Wenger S, Cigna ST.","first_author":"Massoud G","journal":"Journal of minimally invasive gynecology","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Female","Sexual function","History","Gynecologic Surgery","Sexual Health"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review summarizing existing literature on sexual health history taking in gynecologic surgery; no original empirical data.","sample_n":null,"sample_text":"N/A","population":"None (review)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review why sexual health history is often missed in gynecologic surgery and suggest evidence‑based ways for clinicians to ask about sexual function before, during, and after surgery.","clinical_takeaway":"Clinicians should routinely include a sexual health history in gynecologic surgical care to identify and address dysfunction.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Highlights an under‑addressed aspect of patient care","Summarizes CDC and ISSWSH guidelines","Relevant to gynecologic surgical practice"],"limitations":["Narrative review without systematic methods","No empirical data or quantitative synthesis","No assessment of measurement validity for sexual health constructs"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jmig.2025.10.007"}},{"id":9010,"doi":"10.2196/80567","pmid":"41773666","pmcid":"PMC12954703","title":"Educational Intervention to Improve Sexual Health and Quality of Life in Survivors of Breast and Gynecological Cancer: Protocol for a Mixed Methods Feasibility Study","authors":"Salazar Falla N, Navas Jojoa MLÁ, Lalinde Riviño JD, Escandón Bucheli A, Galindo-Sánchez JS.","first_author":"Salazar Falla N","journal":"JMIR research protocols","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Breast neoplasms","Quality of life","Health education","Sexual Health","Survivors","Female Genital Neoplasms"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12954703","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"prospective single‑group feasibility study; small convenience sample of cancer survivors; mixed‑methods (quantitative FSFI/QoL pre‑post, qualitative thematic analysis)","sample_n":13,"sample_text":"13 participants enrolled at time of protocol writing","population":"adult women, ≥2 years post‑treatment for breast or gynecological cancer, Colombia (n≈13 enrolled so far)","country":"Colombia","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A Colombian team will test a short, culturally adapted education program to help breast and gynecological cancer survivors improve sexual health and quality of life. They will run workshops, group talks, and optional counselling, then compare sexual function scores before and after the program.","clinical_takeaway":"The protocol shows a structured, patient‑centred approach that may be useful if future trials confirm feasibility and benefit.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Uses validated sexual function and quality‑of‑life scales","Mixed‑methods design enriches feasibility insights","Co‑designed with survivors and multidisciplinary team"],"limitations":["Very small, non‑randomized sample limits inferential power","No control for key confounds (moral, mental health, partner effects)","Single‑group pre‑post design cannot attribute change to intervention"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/80567"}},{"id":9011,"doi":"10.1111/codi.70327","pmid":"41685645","pmcid":null,"title":"Sexual health of LGBTQ+ patients undergoing colorectal surgery for benign disease and their experience with healthcare: A scoping review","authors":"Marangoni Z, Onghena L, Giacomozzi M, van Nieuwenhove Y, Pape E, van Ramshorst GH.","first_author":"Marangoni Z","journal":"Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland","year":2025,"pub_types":["Scoping Review","Journal Article"],"keywords":["Benign","Sexual Health","Colorectal Surgery","Scoping Review","Lgbtq+"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review of eight articles (1 cohort, 3 mixed‑methods surveys, 4 literature reviews)","sample_n":null,"sample_text":"Eight articles identified; specific participant numbers not reported in abstract","population":"adult LGBTQ+ patients undergoing benign colorectal/anal surgery","country":"Not specified (multinational literature search)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review found that benign colorectal surgery can negatively affect sexual health of LGBTQ+ patients, with added barriers like stigma, lack of information, and discrimination, but evidence is scarce and often not broken down by sexual orientation or gender identity.","clinical_takeaway":"Clinicians should proactively discuss sexual health with LGBTQ+ patients after colorectal surgery and seek to provide inclusive, stigma‑free information.","confidence":0.6,"topic_tags":["sexual_function","lgbtq"],"strengths":["Comprehensive search across multiple databases","Independent screening and data extraction","Identifies gaps in LGBTQ+ specific evidence"],"limitations":["Small number of primary studies (n=8)","Limited quantitative synthesis","No assessment of methodological quality of included studies"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/codi.70327"}},{"id":9012,"doi":"10.21203/rs.3.rs-7052728/v1","pmid":null,"pmcid":null,"title":"Barriers and facilitators in accessing sexual health services among disabled middle-aged and older adults in England: A qualitative study","authors":"Bowen S, Kpokiri E, Sakuma Y, Tucker JD, Zou H, Wu D.","first_author":"Bowen S","journal":"Research Square","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"interviews with 9 participants, thematic analysis using Levesque framework","sample_n":9,"sample_text":"nine participants recruited via a disability community organisation","population":"disabled middle‑aged and older adults (≥45 y) in England","country":"England","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with nine disabled adults aged 45+ in England revealed that physical inaccessibility, lack of inclusive environments, and unmet sexual health needs hinder their use of sexual health services, while supportive staff and tailored processes help.","clinical_takeaway":"Clinicians should assess and adapt service accessibility for disabled older adults to reduce barriers.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight","Use of an established accessibility framework (Levesque)","Focus on a historically under‑researched population"],"limitations":["Very small convenience sample (N=9)","Limited generalisability to broader disabled older adult population","No quantitative assessment of prevalence or magnitude of barriers"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-7052728/v1"}},{"id":9013,"doi":"10.1016/j.bas.2026.105979","pmid":"41766961","pmcid":"PMC12945639","title":"Sexual health after lumbar discectomy in younger patients-What can they expect? A prospective cohort study using patient-reported outcome data","authors":"Friis Pedersen C, El-Galaly A, Carreon LY, Andersen MØ.","first_author":"Friis Pedersen C","journal":"Brain & spine","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Disc Herniation","Oswestry Disability Index","Danespine","Discectomies"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12945639","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort using national registry data, baseline and 1‑year follow‑up, N=1599","sample_n":1599,"sample_text":"1599 patients (mean age 38.5, 47.4% female)","population":"patients 18‑50 years undergoing single‑level lumbar discectomy in Denmark","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a cohort of 1,600 young adults undergoing lumbar disc surgery, self‑reported sexual health improved markedly one year after the operation, with most patients reporting a normal or near‑normal sex life.","clinical_takeaway":"Lumbar discectomy in younger adults is associated with substantial recovery of pain‑related sexual function within a year.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large, national registry sample","Prospective baseline‑to‑follow‑up design","Clear statistical significance for primary outcome"],"limitations":["Sexual health measured with a single ODI item only","No control for psychosocial or relationship confounds","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":1,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.bas.2026.105979"}},{"id":9014,"doi":"10.1007/s10943-026-02597-3","pmid":"41772278","pmcid":null,"title":"Sexual Health in Islam: Constructing a Knowledge, Attitudes, and Practices (KAP) Scale for the Jordanian Context","authors":"Aldahadha B.","first_author":"Aldahadha B.","journal":"Journal of religion and health","year":2026,"pub_types":["Journal Article"],"keywords":["Knowledge","Islam","Jordan","Sexual Health","Attitudes","Practices"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Scale development with content validity, exploratory and confirmatory factor analysis on large samples (N≈758,311); test‑retest reliability assessed.","sample_n":311,"sample_text":"311 participants in CFA; 758 in EFA; 1069 in item‑analysis.","population":"Jordanian adults and youth; participants include parents, mosque imams, educational experts; convenience sampling.","country":"Jordan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and validated a 67‑item questionnaire to measure Jordanian adults’ knowledge, attitudes, and practices about sexual health within an Islamic framework. The scale shows strong reliability and construct validity.","clinical_takeaway":"The new KAP scale can reliably assess sexual‑health knowledge and attitudes in Jordanian populations for research or program evaluation.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Large sample for factor analysis","Rigorous psychometric evaluation (EFA, CFA, reliability)","Clear reporting of internal consistency"],"limitations":["Convenience sampling limits generalisability","No assessment of potential confounds (e.g., moral/religious attitudes, mental health)","No pre‑registration or open data"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10943-026-02597-3"}},{"id":9016,"doi":"10.1002/hsr2.71921","pmid":"41773204","pmcid":"PMC12949829","title":"Evaluating the Impact of Reproductive and Sexual Health Education on Knowledge and Attitudes of Couples in Premarital Counseling Classes: A Quasi-Experimental Study","authors":"Ashrafi E, Oskoei LB, Hamzehkolaee ME, Izadi B, Mansourian M, Bahadori B.","first_author":"Ashrafi E","journal":"Health science reports","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Knowledge","Attitude","Reproductive Health","Sexual Health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12949829","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"quasi-experimental controlled intervention with 20 couples per arm, pre‑post questionnaires over 3 months","sample_n":40,"sample_text":"40 eligible couples (20 intervention, 20 control) selected by simple random sampling","population":"couples attending premarital counseling in Rasht, Iran","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A short, teacher‑led program for couples about reproductive and sexual health boosted their knowledge and attitudes after three months compared with a control group.","clinical_takeaway":"Premarital education can effectively improve couples' sexual‑health knowledge and attitudes.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Random allocation of couples to intervention and control","Clear pre‑post design with 3‑month follow‑up","Statistically significant improvement in knowledge and attitudes"],"limitations":["Outcome questionnaire not validated","No effect sizes or power justification reported","Small sample limits generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/hsr2.71921"}},{"id":9017,"doi":"10.1186/s12978-025-02089-9","pmid":"40940648","pmcid":"PMC12433001","title":"The psychosocial impact of COVID-19 mitigation measures on frontline staff providing sexual health and family planning services in Kenya: a mixed-methods study","authors":"Okwaro F, Mohiddin A, Temmerman M.","first_author":"Okwaro F","journal":"Reproductive health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Healthcare Workers","Coping Mechanisms","Sexual And Reproductive Health","Psychosocial Wellbeing","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12433001","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-methods study with quantitative survey of frontline SRH staff and qualitative interviews; convenience sample; no longitudinal follow‑up","sample_n":null,"sample_text":"Not specified in abstract; likely a convenience sample of HCWs","population":"frontline family planning and STI health‑care workers in Kenyan public facilities","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined how COVID‑19 response measures affected the mental health of Kenyan health workers providing family planning and STI services, finding increased burnout and depression and recommending better psychosocial support in future pandemics.","clinical_takeaway":"Health‑system planners should include mental‑health resources for SRH staff during crises.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Mixed‑methods provides both quantitative and qualitative insights","Focus on an important but under‑researched group (SRH HCWs)","Identifies concrete gaps in pandemic response"],"limitations":["No detail on measurement tools or their validation","Likely convenience sample, limiting generalisability","No pre‑registration or power justification"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-025-02089-9"}},{"id":9018,"doi":"10.1136/bmjopen-2024-096954","pmid":"41073113","pmcid":"PMC12516968","title":"National and international guidelines for young adults' sexual health education: a scoping review protocol","authors":"Borji-Navan S, Salehin S, NaseriBooriAbadi T, Goli S, Mirghafourvand M.","first_author":"Borji-Navan S","journal":"BMJ open","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Health education","Adolescent","Reproductive Medicine","Sexual Medicine","Protocols & Guidelines"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12516968","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"protocol (no empirical data yet)","sample_n":null,"sample_text":"None (protocol)","population":"young adults","country":"Iran (protocol affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This paper outlines a plan to map and compare national and international guidelines for sexual health education aimed at young adults. It will collect and summarise guideline characteristics to highlight commonalities, gaps, and differences.","clinical_takeaway":"None - the article is a protocol and provides no clinical findings.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear systematic protocol with dual independent extraction","Comprehensive search strategy covering grey literature"],"limitations":["Protocol provides no results to assess validity or bias","No focus on pornography or compulsive sexual behaviour"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjopen-2024-096954"}},{"id":9019,"doi":"10.3390/healthcare14101289","pmid":"42194381","pmcid":"PMC13205472","title":"Adolescent and Youth Sexual Reproductive Health (AYSRH): Perceived Religious Health Assets of Churches and Their Optimization for Youth Sexual Health in South Africa's Vaal Region","authors":"Magezi V.","first_author":"Magezi V.","journal":"Healthcare (Basel, Switzerland)","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["South Africa","Faith-based Organisations","Aysrh","Adolescent And Youth Sexual And Reproductive Health","Church Health Assets","Religious Health Assets"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13205472","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"In‑depth semi‑structured interviews with 11 purposively selected pastors; thematic content analysis with audit trail.","sample_n":11,"sample_text":"eleven purposively selected pastors","population":"Pastors from churches in South Africa’s Vaal Triangle (Vanderbijlpark, Vereeniging, Sasolburg).","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers interviewed 11 pastors in South Africa to learn how churches view their resources for supporting young people's sexual and reproductive health. Pastors saw churches as having many material and cultural assets, but they primarily framed sexual health in moral terms like abstinence rather than a broader health approach.","clinical_takeaway":"Clinicians should recognise that faith leaders view church resources as potential supports, yet these are framed morally; involving them in youth sexual‑health programs requires careful alignment with evidence‑based, rights‑based care.","confidence":0.7,"topic_tags":["religiosity","sexual_function"],"strengths":["Rich, emic perspective from church leaders","Clear qualitative methodology with audit trail","Identification of both tangible and intangible assets"],"limitations":["Very small, purposive sample limits generalisability","Findings are perceptions only; no assessment of actual impact","No measurement of sexual‑health outcomes or stakeholder (youth) views"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":4,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare14101289"}},{"id":9020,"doi":"10.1080/19317611.2021.1991071","pmid":"38595782","pmcid":"PMC10903615","title":"Sexual Health and Wellbeing through the Life Course: Ensuring Sexual Health, Rights and Pleasure for All","authors":"Sladden T, Philpott A, Braeken D, Castellanos-Usigli A, Yadav V, Christie E, Gonsalves L, Mofokeng T.","first_author":"Sladden T","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Women's Rights","Universal Health Coverage","Life Course","Sexual Satisfaction","Adolescent Sexuality","Sexual Health Promotion","Sexual Pleasure","Sexual And Reproductive Health And Rights","Adult Sexuality","Sexual Health Policy","Sexual Health & Wellbeing"],"is_oa":false,"oa_url":null,"cited_by_count":35,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"None – no participants","population":"general population across life course (no specific sample)","country":"International (no specific country reported)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article is a commentary that highlights how sexual health, rights and pleasure are interconnected across the life course, arguing that these aspects are often overlooked in health policy and research.","clinical_takeaway":"None – the paper offers conceptual discussion but no direct clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad, integrative overview of sexual health, rights, and pleasure","Uses life‑course framework to link domains"],"limitations":["No original data or empirical methods","No systematic review or meta‑analysis conducted","Lacks specific measurement or evaluation of constructs"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":2,"confounds":3,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":27,"citing_publications":69,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2021.1991071"}},{"id":9021,"doi":"10.1016/j.invent.2026.100985","pmid":"42602718","pmcid":"PMC13475656","title":"Inclusion of underserved young people in digital public health interventions for mental health, sexual health and substance use: A systematic review and intervention component analysis","authors":"Tatton C, Kirby J, Armitage JM, Robinson S, Aslam RW, Arthur T, Harrison S, Mutanda D, Garside R, Coon JT, Evans R, Melendez-Torres GJ.","first_author":"Tatton C","journal":"Internet interventions","year":2026,"pub_types":["review-article","Review","Journal Article"],"keywords":["Public Health","Young People","Digital Inclusion","Underserved Groups"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13475656","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review of randomized trials of digital interventions for mental health, sexual health, and substance use among underserved youth (13‑25); no meta‑analysis reported","sample_n":62,"sample_text":"62 trials (56 interventions)","population":"young people (13‑25) from underserved groups; interventions varied across sexual health, mental health, substance use","country":"not specified (multinational)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review looked at digital programs for mental, sexual, and substance‑use health aimed at underserved young people, describing which design features help reach and engage them, and noting that evidence of effectiveness is strongest for substance‑use outcomes.","clinical_takeaway":"Digital interventions can be effective for substance use in underserved youth, but more robust evaluation is needed for sexual health programs.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive search of recent systematic reviews","Focus on underserved youth","Identifies implementation components across domains"],"limitations":["No quantitative synthesis or effect‑size reporting","Limited assessment of methodological quality of included trials","Sexual health component not linked to specific behaviours like pornography"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.invent.2026.100985"}},{"id":9022,"doi":"10.1016/s2352-3026(24)00208-4","pmid":"39312924","pmcid":null,"title":"Sexual health and emotional wellbeing of patients with haematological malignancies: general review","authors":"Alsuliman T, Rojas RMM, Moukalled N, Brissot E, Quarez-Blaise L, Marjanovic Z, Blaise D, Murphy D, Logue M, Savani BN, Mohty M.","first_author":"Alsuliman T","journal":"The Lancet. Haematology","year":2024,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review (narrative) of sexual health issues in patients with haematological malignancies; no primary data collected.","sample_n":null,"sample_text":"Not applicable – narrative review.","population":"Patients with haematological cancers and their partners; no empirical sample reported.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how blood‑cancer diagnosis and treatment can affect patients' sexual relationships and overall wellbeing, describing current assessment tools and suggesting multidisciplinary approaches to improve sexual health.","clinical_takeaway":"Clinicians should assess sexual wellbeing as part of cancer survivorship care and refer patients to specialised support when needed.","confidence":0.4,"topic_tags":["sexual_function","csbd"],"strengths":["Comprehensive overview of sexual health issues in a specific patient group","Highlights multidisciplinary needs"],"limitations":["No primary data; conclusions based on existing literature","No systematic review methods reported","No quantitative synthesis or appraisal of study quality"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s2352-3026(24)00208-4"}},{"id":9023,"doi":"10.1093/jsxmed/qdaf395","pmid":"41592090","pmcid":null,"title":"Impact of breast cancer treatment on quality of life and sexual health: a multidimensional assessment","authors":"Kuramoto WS, Spada MAT, Cubero DIG, Del Giglio A, de Alcantara Sousa LV.","first_author":"Kuramoto WS","journal":"The journal of sexual medicine","year":2026,"pub_types":["Journal Article"],"keywords":["Sexuality","Breast cancer","Sexual function","Quality of life","Image Perception"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 100 breast cancer patients assessing QoL, body image, and sexual function","sample_n":100,"sample_text":"single-centre convenience sample; limited generalisability","population":"women undergoing breast cancer treatment (n=100, tertiary hospital, single centre)","country":"unspecified (likely Brazil given author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 100 women treated for breast cancer, quality of life, body image and sexual function were poorer among those with lower socioeconomic status, no partner, younger age, and those who had mastectomies. Over two‑thirds of sexually active participants met criteria for sexual dysfunction.","clinical_takeaway":"Clinicians should screen for sexual dysfunction and body‑image concerns, especially after mastectomy, and provide targeted support.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Use of well‑validated, multidimensional instruments","Both medical (surgery type) and sociodemographic variables examined","Clear reporting of statistical tests used"],"limitations":["Cross‑sectional design; no causal inference","Single‑centre, convenience sample limits external validity","No multivariable modelling; potential confounding unaddressed"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdaf395"}},{"id":9024,"doi":"10.1002/nop2.70537","pmid":"42008783","pmcid":"PMC13095164","title":"Sexual Health Needs and Physician-Patient Interaction Experiences Among Postoperative Radical Prostatectomy Patients in China: A Qualitative Study","authors":"Zhu H, Xu T, Xie J, Wei S, Jin X, Meng Y, Lu X, Zhang H, Zhu Y, Li J.","first_author":"Zhu H","journal":"Nursing open","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Prostate neoplasm","prostate cancer","Sexual Health","Radical Prostatectomy","Intimate Relationships","Physician‐patient Communication"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13095164","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Interpretive phenomenological qualitative study using semi‑structured interviews with purposive sampling (N not reported).","sample_n":null,"sample_text":"Purposive sampling; exact number not given in abstract.","population":"Chinese male patients post‑radical prostatectomy and healthcare professionals.","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with Chinese men who had prostate surgery and their doctors revealed many cultural, relational, and communication barriers that shape how patients experience and express sexual health needs after surgery.","clinical_takeaway":"Clinicians should proactively address cultural taboos and partner dynamics when discussing postoperative sexual health.","confidence":0.8,"topic_tags":["sexual_function","csbd","pornography","masturbation"],"strengths":["Uses COREQ reporting checklist","Incorporates both patient and clinician perspectives","Identifies culturally specific barriers"],"limitations":["No validated measurement instruments","Sample size and demographic details not disclosed","Findings limited to a single cultural context"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/nop2.70537"}},{"id":9025,"doi":"10.2147/ijwh.s558423","pmid":"41368653","pmcid":"PMC12682573","title":"Iatrogenic Menopause and Severe Sexual Health Disruption Following Chemoradiotherapy: The Role of Natural-Origin Polynucleotides","authors":"Palmieri IP, Raichi M.","first_author":"Palmieri IP","journal":"International journal of women's health","year":2025,"pub_types":["Journal Article","Case Reports","case-report"],"keywords":["Sexual dysfunction","Anal Squamous Cell Carcinoma","Iatrogenic Menopause","Polynucleotides High Purification Technology","Vaginal Hydration"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12682573","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"single-patient case report describing intradermal injections of hyaluronic acid and polynucleotides after chemoradiotherapy","sample_n":1,"sample_text":"single case","population":"42‑year‑old woman with iatrogenic menopause following anal squamous cell carcinoma treatment","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 42‑year‑old woman who lost ovarian function after chemoradiotherapy for anal cancer experienced severe vaginal pain and dryness. Over four months she received six injections of hyaluronic acid plus polynucleotides, which the authors report improved vaginal hydration and reduced pain.","clinical_takeaway":"Evidence for this injectable treatment is limited to one case; clinicians should consider it experimental and discuss uncertainties with patients.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["detailed clinical follow‑up","focus on a neglected survivor population"],"limitations":["single case, no control group","no validated outcome measures","cannot infer efficacy"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/ijwh.s558423"}},{"id":9026,"doi":"10.1080/0092623x.2026.2720161","pmid":"42638434","pmcid":null,"title":"DEEP Model (Differences, Emotional Sensitivities, External Stressors, Communication Patterns) Versus Sexual Health Empowerment on Sexual Function and Attitude Toward Condom Use Among Women Affected with Human Papilloma Virus (HPV): A Randomized Clinical Trial","authors":"Bakrani H, Farajkhoda T, Bakhshi F, Hajisafari-Tafti M, Sefidkar R.","first_author":"Bakrani H","journal":"Journal of sex & marital therapy","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized clinical trial with 68 women (34 per arm) receiving 8 online counseling sessions; outcomes assessed at baseline, week 12, follow‑up","sample_n":68,"sample_text":"Sixty‑eight women were randomly assigned to DEEP (n=34) or empowerment (n=34)","population":"women diagnosed with HPV, recruited for a counseling intervention","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small trial, women with HPV who received the DEEP counseling program showed larger gains in sexual function and more positive attitudes toward condom use than those receiving a standard sexual‑health empowerment program.","clinical_takeaway":"Couple‑focused counseling may improve sexual function and condom use attitudes in women with HPV, but evidence is limited by sample size.","confidence":0.8,"topic_tags":["sexual_function","csbd","relationships"],"strengths":["Randomized allocation","Clear intervention protocols","Statistically significant improvements reported"],"limitations":["Small sample size per arm","No effect sizes or confidence intervals reported","No assessment of possible psychological or relational confounders"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2026.2720161"}},{"id":9027,"doi":"10.1186/s12939-025-02682-1","pmid":"41250027","pmcid":"PMC12621365","title":"Information and counselling on sexual health in cardiac and respiratory disease: description of community dwelling patients' needs and reflections of health care professionals","authors":"Klompstra L, Persson T, Klingvall E, Skoglund A, Särén F, Jaarsma T.","first_author":"Klompstra L","journal":"International journal for equity in health","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Respiratory disease","Sexual Health","Well-being","Cardiac Disease","Chronic Condition","Healthcare Professionals","Information Need"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12621365","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional online survey of 144 patients plus focus groups with 10 health‑care professionals","sample_n":144,"sample_text":"144 patients; 10 health‑care professionals (focus groups)","population":"community‑dwelling adults with cardiac and/or respiratory disease","country":"Sweden (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 144 people with heart or lung disease found most felt their sexual health impacted wellbeing, yet only 7% received any information from doctors. Health professionals said personal and organisational barriers limit counselling. The study highlights a need for better sexual‑health communication in chronic‑illness care.","clinical_takeaway":"Clinicians should proactively discuss sexual health with cardiac or respiratory patients, as most need support but rarely receive it.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses an under‑researched patient population","Mixed methods: quantitative survey plus qualitative focus groups","Clear description of patient‑reported information gaps"],"limitations":["Reliance on non‑validated survey items","Cross‑sectional design limits causal inference","No control for key psychosocial confounds (e.g., mental health, moral attitudes)","Small, self‑selected sample may limit generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12939-025-02682-1"}},{"id":9028,"doi":"10.1007/s11764-025-01926-x","pmid":"41526763","pmcid":null,"title":"Breast cancer survivor's sexual health unmet supportive care needs: a mixed-methods study","authors":"Ferreira D, Quinta-Gomes AL, Pieramico S, Weiderpass E, Santana R, Andersson G, Mendes-Santos C.","first_author":"Ferreira D","journal":"Journal of cancer survivorship : research and practice","year":2026,"pub_types":["Journal Article"],"keywords":["Sexual Health","Acceptance And Commitment Therapy","Breast Cancer Survivors","Cognitive-behavior Therapy","Internet Intervention"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"mixed-methods cross-sectional survey (N=336) plus qualitative interviews (N=11)","sample_n":336,"sample_text":"336 breast cancer survivors completed questionnaires; 11 participated in interviews","population":"Breast cancer survivors in Portugal","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Breast cancer survivors in Portugal report low sexual desire, arousal, and high pain, indicating many unmet sexual health needs. Interviews reveal lack of information, body‑image worries, and limited partner involvement, suggesting a need for better psychosexual support in oncology care.","clinical_takeaway":"Clinicians should proactively address sexual function and provide tailored psychosocial support for breast cancer survivors.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Validated sexual function instrument (FSFI)","Large quantitative sample for a survivorship study","Mixed methods enrich understanding"],"limitations":["Cross‑sectional design limits causal inference","No control for mental‑health or partner variables","Convenience sample may not be nationally representative"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11764-025-01926-x"}},{"id":9029,"doi":"10.1016/j.maturitas.2024.108055","pmid":"39226624","pmcid":null,"title":"Sexual health and wellbeing and the menopause: An EMAS clinical guide","authors":"Paschou SA, Athanasiadou KI, Hafford-Letchfield T, Hinchliff S, Mauskar M, Rees M, Simon JA, Armeni E, Erel CT, Fistonic I, Hillard T, Hirschberg AL, Meczekalski B, Mendoza N, Mueck AO, Simoncini T, Stute P, van Dijken D, Lambrinoudaki I.","first_author":"Paschou SA","journal":"Maturitas","year":2024,"pub_types":["Review","Journal Article"],"keywords":["Sexual dysfunction","menopause","Women's Health","Sexual Problems","Sexual Diversity","Sexual Health And Wellbeing"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative clinical guide based on literature review and expert consensus; no empirical data presented.","sample_n":null,"sample_text":"Not applicable – review article","population":"Women undergoing menopause (no specific sample size reported)","country":"International (European Menopause and Andropathy Society)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article offers clinicians a practical guide for assessing and managing sexual problems that can arise during menopause, emphasizing a biopsychosocial approach, use of validated questionnaires, and the importance of taking a sexual history.","clinical_takeaway":"Clinicians should incorporate routine sexual histories and consider multidimensional treatment options for menopausal sexual problems.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Comprehensive clinical overview","Incorporates expert consensus","Highlights importance of sexual history taking"],"limitations":["No systematic review methodology reported","No primary data or effect size information","Lacks discussion of confounding factors such as mental health or relationship context"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":2,"confounds":0,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.maturitas.2024.108055"}},{"id":9030,"doi":"10.4291/wjgp.v16.i3.107823","pmid":"41024984","pmcid":"PMC12476688","title":"Discovering a new paradigm: Gut microbiota as a central modulator of sexual health","authors":"Marano G, Anesini MB, Milintenda M, Acanfora M, d'Abate C, Lisci FM, Pirona I, Traversi G, Pola R, Gaetani E, Mazza M.","first_author":"Marano G","journal":"World journal of gastrointestinal pathophysiology","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Diet","Neurotransmitters","Mental health","hormonal regulation","Sexual Health","Gut Microbiota","Dysbiosis","Short-chain Fatty Acids","Psychological Therapies","Psychobiotics","Gut Brain Axis","Sexual Performance Anxiety"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12476688","cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review without systematic methods","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review evidence that gut microbes influence hormones, inflammation and immune function, which in turn affect sexual health outcomes such as erectile function, libido and reproductive disorders.","clinical_takeaway":"Gut‑microbiota balance may affect sexual function; diet, probiotics or fecal transplants could be considered adjuncts, but evidence remains preliminary.","confidence":0.7,"topic_tags":["sexual_function","gender","religiosity"],"strengths":["Broad synthesis of emerging gut‑microbiota research","Integrates hormonal, immune, and metabolic pathways"],"limitations":["No systematic search or quality appraisal","Lacks empirical data; conclusions are speculative","No assessment of potential confounders (e.g., diet, mental health)"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4291/wjgp.v16.i3.107823"}},{"id":9031,"doi":"10.3390/bs15121636","pmid":"41463979","pmcid":"PMC12730087","title":"Conceptual Frameworks Linking Sexual Health to Physical, Mental, and Interpersonal Well-Being: A Comprehensive Systematic Review and Meta-Analysis","authors":"Pollard AE, Cero I, Rogge RD.","first_author":"Pollard AE","journal":"Behavioral sciences (Basel, Switzerland)","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Meta-analysis","Systematic review","Sexual Health","Physical Health","Well-being","Psychological Distress","Relationship Satisfaction","Orgasm"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12730087","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"systematic review and meta-analysis of cross‑sectional correlational studies","sample_n":248021,"sample_text":"large pooled sample across many studies; individual studies mostly cross‑sectional","population":"general adult samples (combined N≈248,000) across 281 independent subsamples","country":"unspecified (multiple databases)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review and meta‑analysis of over 200 studies (248 k participants) found that aspects of sexual health such as orgasm and satisfaction are linked to better mental, physical, and relationship wellbeing, though most evidence is cross‑sectional so causality is unclear.","clinical_takeaway":"Sexual health appears strongly associated with overall wellbeing; clinicians should consider sexual functioning when assessing health, but cannot infer cause‑and‑effect.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Very large aggregated sample size","Comprehensive systematic search across multiple databases","Meta‑analytic techniques with random‑effects modeling"],"limitations":["Primary studies are overwhelmingly cross‑sectional","Limited control for key confounds (e.g., mental health, relationship factors)","No pre‑registration reported"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs15121636"}},{"id":9032,"doi":"10.1097/hc9.0000000000000691","pmid":"40178496","pmcid":"PMC11970893","title":"Sexual health and function in liver disease","authors":"Ferrarese A, Hurtado Díaz de León I, Tapper EB, Burra P, Burra P.","first_author":"Ferrarese A","journal":"Hepatology communications","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Cirrhosis","Alcohol","Depression","Liver transplantation","portal hypertension"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11970893","cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review-article","sample_n":null,"sample_text":"none (narrative review)","population":"patients with cirrhosis and liver transplant recipients (adult humans)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how chronic liver disease and liver transplantation affect sexual function, summarising causes, how common the problems are, and possible treatments.","clinical_takeaway":"Clinicians should screen for sexual dysfunction in cirrhosis and transplant patients and consider tailored interventions.","confidence":0.7,"topic_tags":["sexual_function","lgbtq"],"strengths":["Comprehensive overview of sexual dysfunction in a specific medical population","Discusses pathophysiology, epidemiology and management"],"limitations":["Narrative review without systematic methodology","No original data or quantitative synthesis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/hc9.0000000000000691"}},{"id":9033,"doi":"10.21203/rs.3.rs-6364449/v1","pmid":null,"pmcid":null,"title":"Sexual Health of Adolescent and Young Adults Assigned Female at Birth Post Pelvic Radiotherapy","authors":"Devaraja K, Sachdeva A, Gandhi K, Gupta AA, Croke J.","first_author":"Devaraja K","journal":"Research Square","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-6364449/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-methods survey (n=58) and interviews (n=15) of AYA patients at a single cancer centre; descriptive statistics and thematic analysis","sample_n":58,"sample_text":"58 female participants completed surveys; 15 completed interviews","population":"Adolescent and young adult patients assigned female at birth receiving pelvic radiotherapy","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey and interviews with 58 young women who had pelvic radiotherapy revealed common sexual problems such as pain, reduced desire, and fertility worries, highlighting the need for tailored sexual‑health support.","clinical_takeaway":"Clinicians should proactively address pain, libido loss, and fertility concerns in young women after pelvic radiotherapy.","confidence":0.6,"topic_tags":["sexual_function","csbd","religiosity"],"strengths":["Focus on understudied AYA population","Mixed‑methods provides depth and breadth","Clear identification of care gaps"],"limitations":["Convenience sample from single centre limits generalisability","Survey instrument not reported as validated","No control for mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-6364449/v1"}},{"id":9034,"doi":"10.3390/bs16060873","pmid":"42352706","pmcid":null,"title":"Effects of a Sexual Health Literacy Intervention on Preventive Sexual Risk Behaviors Among Lower Secondary School Students: A Quasi-Experimental Study","authors":"Huangmit P, Ketkosan N, Ponrachom C.","first_author":"Huangmit P","journal":"Behavioral sciences (Basel, Switzerland)","year":2026,"pub_types":["Journal Article"],"keywords":["Thailand","Adolescents","Preventive Behaviors","Health Literacy Program"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"quasi-experimental with control group, N=114 (57 per group)","sample_n":114,"sample_text":"multistage sampling of 114 eighth‑grade students, 57 per arm","population":"lower secondary school students (eighth grade) in Thailand","country":"Thailand","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A school‑based program in Thailand taught eighth‑graders about sexual health. Compared with classmates who received the usual curriculum, participants showed higher scores on a sexual‑health literacy test and reported more preventive sexual behaviours one month after the program.","clinical_takeaway":"Brief, literacy‑focused school programs can improve adolescents' knowledge and reported preventive behaviours, but evidence of lasting impact is limited.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Clear quasi‑experimental design with control group","Repeated measures at three time points","Large reported effect sizes with η²"],"limitations":["Questionnaires likely not validated, reducing construct validity","Non‑random allocation limits causal inference","No measurement of key confounds (e.g., mental health, trauma)","Short follow‑up (one month) limits assessment of lasting impact"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/bs16060873"}},{"id":9035,"doi":"10.3310/ahdp8546","pmid":"41355309","pmcid":null,"title":"Optimisation of a sexual health and healthy relationships intervention for Further Education in England and Wales (SaFE)","authors":"Aslam RW, Williams-Thomas R, Townson J, Lewis R, Madan J, Melendez-Torres GJ, Lugg-Widger F, Pallmann P, Brown R, Bonell C, Morgan GS, White J, Young H.","first_author":"Aslam RW","journal":"Public health research (Southampton, England)","year":2026,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":["sexually transmitted diseases","Education","Violence","Sexual Health","Young People","Optimisation","Staff Training","Publicity Materials"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups and stakeholder consultations within a single further‑education institution; iterative optimisation of intervention materials","sample_n":null,"sample_text":"Four staff, three students, seven experts, plus advisory groups; total participants < 30","population":"further‑education staff and students (small convenience samples)","country":"England and Wales","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study used focus groups and expert workshops to refine a sexual‑health and relationships programme for further‑education colleges. Feedback improved training slides, case studies and publicity, but the small, self‑selected sample limits how widely the results apply.","clinical_takeaway":"The refined SaFE materials appear acceptable for use in further‑education settings, yet effectiveness remains untested.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Systematic, multistage optimisation process","Stakeholder and young‑person input","Clear reporting of limitations"],"limitations":["Very small, single‑institution convenience sample","Limited generalisability of feedback","No quantitative outcome data"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3310/ahdp8546"}},{"id":9036,"doi":"10.4103/jehp.jehp_358_24","pmid":"40772077","pmcid":"PMC12327742","title":"Sexual health of adolescent girls in Tehran: Definition and dimensions","authors":"Arabkari Z, Alipour F, Fallahi-Khoshknab M, Momtaz YA, Khoie EE, Samiei M.","first_author":"Arabkari Z","journal":"Journal of education and health promotion","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Adolescent","Sexual Health","Tehran","Qualitative Study","Girls","Sexual Wellbeing"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12327742","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative content analysis with 26 participants (adolescent girls, mothers, experts) recruited via purposeful and snowball sampling.","sample_n":26,"sample_text":"26 participants (14 adolescent girls, 6 mothers, 6 experts)","population":"Adolescent girls (15‑19 y) in Tehran, plus mothers and sexual‑health experts.","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with teenage girls, their mothers and health experts in Tehran revealed four main aspects of sexual health—physical‑sexual, emotional‑psychological, sexual socialisation, and moral‑spiritual—shaped by local culture and values.","clinical_takeaway":"Understanding locally defined sexual‑health dimensions can help clinicians tailor education and support for adolescent girls in Tehran.","confidence":0.3,"topic_tags":["adolescents","sexual_function"],"strengths":["In‑depth, culturally specific data","Diverse stakeholder perspectives (girls, mothers, experts)","Systematic qualitative methodology (Graneheim & Lundman)"],"limitations":["Small, non‑representative sample","Purposeful/snowball sampling limits generalisability","No quantitative validation of identified dimensions"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":1,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/jehp.jehp_358_24"}},{"id":9038,"doi":"10.1186/s12889-026-26640-w","pmid":"41692712","pmcid":"PMC13011304","title":"Exploring sexual health challenges in men with type 2 diabetes-related erectile dysfunction: a qualitative study","authors":"Rozveh AK, Afshari A, Sayadi L, Mohajeri Tehrani MR, Mehrnoush V, Khazaei A.","first_author":"Rozveh AK","journal":"BMC public health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Type 2 diabetes","erectile dysfunction","Sexual Health","Qualitative Research","Sexual Health Services"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13011304","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative interview study with 19 purposively selected men (convenience sample) from a single hospital.","sample_n":19,"sample_text":"Purposive sampling; not random or representative.","population":"Men with type 2 diabetes mellitus and erectile dysfunction (average age ≈50, married).","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 19 Iranian men who have type‑2 diabetes and erectile dysfunction reveal a “silent distress” marked by shame, reduced sexual confidence, marital worries, and lack of sexual health services. Cultural stigma and inadequate counseling worsen their wellbeing.","clinical_takeaway":"Clinicians should proactively address sexual health with diabetic men, offering private counseling and partner support to reduce distress.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight into men’s lived experience","Rigorous coding reliability (Kappa = 0.82)","Identifies clear service gaps for sexual health in diabetes care"],"limitations":["Small, non‑representative purposive sample","No quantitative measurement of distress or related confounds","Findings limited to Iranian cultural context"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-026-26640-w"}},{"id":9040,"doi":"10.1007/s40618-026-02859-7","pmid":"41879895","pmcid":null,"title":"Successful sexual aging: A narrative review using the multidimensional theoretical paradigm of systems sexology to explore sexual health in midlife and older adults","authors":"Tang D, Zhang Y, Wu X, Zhang X, Jannini EA.","first_author":"Tang D","journal":"Journal of endocrinological investigation","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Biopsychosocial Model","Couplepause","Doublepause","Successful Sexual Aging","Systems Sexology","Sexual Aging"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review without systematic methods or risk‑of‑bias assessment","sample_n":null,"sample_text":"none reported (review article)","population":"midlife and older adults (general, no specific sampling reported)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review how sexuality changes in mid‑life and older age, proposing a new “successful sexual aging” model that emphasizes acceptance, adaptation, and activation within couples, and call for better multidimensional assessment tools.","clinical_takeaway":"Clinicians should consider sexual health as a multidimensional, relational process in older adults, not just as isolated dysfunctions.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive multidisciplinary scope","Introduces a novel conceptual framework (SSA, SAI)","Highlights gaps in existing assessment tools"],"limitations":["Narrative (non‑systematic) review, no explicit methodology","No empirical data or quantitative synthesis","No assessment of study quality or bias"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40618-026-02859-7"}},{"id":9041,"doi":"10.1038/s41598-025-31154-3","pmid":"41381737","pmcid":"PMC12800170","title":"Sexual health and gender perspective among female physicians: a cross-sectional analytic study","authors":"Cihan FG, Durduran Y, Yuksel Baris F, Yucel M.","first_author":"Cihan FG","journal":"Scientific reports","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual function","Gender Roles","Gender Identity","Sexual Dysfunction, Physiological","Women Physicians"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12800170","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional analytic survey of 348 female physicians recruited from a closed professional social‑media group","sample_n":348,"sample_text":"348 female physicians recruited through a closed professional all‑female social media group","population":"female physicians (mean age 37)","country":"Turkey (inferred from author names, not stated in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 348 women doctors found that three‑quarters scored at high risk for sexual dysfunction. More egalitarian gender views were linked to better sexual function, while traditional gender‑role attitudes were related to lower desire and satisfaction.","clinical_takeaway":"Female physicians may be at elevated risk for sexual dysfunction; clinicians should consider gender‑role attitudes when assessing sexual health.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Use of validated FSFI instrument","Large sample for a single‑profession survey","Multivariate regression to control some demographics"],"limitations":["Convenience sample from a social‑media group limits generalisability","Cross‑sectional design prevents causal inference","No measurement of mental‑health variables or broader confounders"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41598-025-31154-3"}},{"id":9042,"doi":"10.1093/sxmrev/qeag008","pmid":"41758669","pmcid":null,"title":"Judith and Holofernes: alcohol's role in male sexual health in the light of the systems sexology","authors":"Yannas D, Sansone A, Cignarelli A, Santi D, Spaggiari G, Giorgino F, Jannini TB, Siracusano A, Jannini EA.","first_author":"Yannas D","journal":"Sexual medicine reviews","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Sexual behavior","erectile dysfunction","Alcohol drinking","Alcohol Use Disorder","Male Sexual Dysfunction"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"non-systematic narrative review of existing literature","sample_n":null,"sample_text":"Not applicable – review article","population":"male adults (no specific sample reported)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review summarizes how alcohol influences male sexual health, finding that light‑to‑moderate drinking may be neutral or slightly protective for erections, while heavy or chronic use is linked to erectile and ejaculatory problems, creating a two‑way link between sexual difficulties and alcohol misuse.","clinical_takeaway":"Advise patients that moderate alcohol use is unlikely to harm erections, but heavy or binge drinking can worsen sexual dysfunction and may reinforce problematic drinking.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad integration of biological, psychological, and social perspectives","Clear dose‑response framing of alcohol effects"],"limitations":["Non‑systematic, potentially selective literature inclusion","No quantitative synthesis or risk‑of‑bias assessment","Lacks explicit measurement details for key constructs"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qeag008"}},{"id":9043,"doi":"10.1177/10901981251375467","pmid":"41178411","pmcid":null,"title":"Impacts of El Camino on Latino Youth's Sexual Health: A Cluster Randomized Controlled Trial","authors":"McConnell K, Ibrahimi S, Yumiseva M, Shan S, Lewin A.","first_author":"McConnell K","journal":"Health education & behavior : the official publication of the Society for Public Health Education","year":2026,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Randomized Controlled Trial","Journal Article"],"keywords":["Evaluation","Randomized controlled trial","Reproductive Health","Sexual Health","Teen Pregnancy Prevention"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Cluster randomized controlled trial with 68 classrooms (n=746 baseline, n=377 follow‑up). Intent‑to‑treat analysis comparing El Camino program to standard curricula.","sample_n":377,"sample_text":"746 students enrolled; 377 completed follow‑up surveys.","population":"Latino high‑school students (9th–12th grade) in Maryland, USA.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A school‑based program called El Camino was tested in a randomized trial with Latino teens. Overall, it did not change rates of sexual activity, but among students who had never had sex, it delayed sexual initiation and increased condom‑use intentions.","clinical_takeaway":"The program may help delay sexual debut and improve safe‑sex intentions among teens who are not yet sexually active.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Cluster RCT design","Large initial sample size","Focus on an underserved Latino youth population","Follow‑up after 10 months"],"limitations":["Self‑report sexual behavior measures, likely single‑item","No effect sizes or confidence intervals reported","Limited control for psychosocial confounds (e.g., mental health, family context)","Substantial attrition (746→377) not fully described"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10901981251375467"}},{"id":9044,"doi":"10.20944/preprints202505.0027.v1","pmid":null,"pmcid":null,"title":"Conceptual Frameworks Linking Sexual Health to Physical, Mental, and Interpersonal Well-Being: A Comprehensive Review and Meta-Analysis","authors":"Pollard AE, Cero I, Rogge RD.","first_author":"Pollard AE","journal":"Preprints.org","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.preprints.org/frontend/manuscript/f4cf12ce765170f5ac1d3d087e1af6ad/download_pub","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 173 records (205 subsamples, N≈160,466) using random‑effects models; majority cross‑sectional.","sample_n":160466,"sample_text":"Combined sample across all included studies.","population":"Adults from diverse clinical and community samples (combined N≈160 k).","country":"Not specified (multiple).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 173 studies (≈160 k participants) found that aspects of sexual health such as satisfaction, orgasms, desire, and lack of pain are linked to better mental and physical health and stronger relationships, though most data are cross‑sectional, so cause‑and‑effect cannot be confirmed.","clinical_takeaway":"Good sexual health, especially regular orgasms, is associated with overall well‑being, but interventions should note that the evidence is correlational.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large combined sample size across many studies","Systematic search and clear inclusion criteria","Use of random‑effects meta‑analysis and meta‑regression"],"limitations":["Primary studies overwhelmingly cross‑sectional limits causal inference","Variable construct definitions across included records","No systematic control for key confounds (e.g., mental health, relationship factors)"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202505.0027.v1"}},{"id":9045,"doi":"10.1101/2025.06.20.25328154","pmid":null,"pmcid":null,"title":"“Effectiveness of Sexual Health Education Interventions Addressing Sexual Violence and Sexual Safety for Adolescents: A Systematic Review Protocol”","authors":"Noonan M, Cotter P, Hegarty J, Mahony JO, Lambert S.","first_author":"Noonan M","journal":"medRxiv","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.medrxiv.org/content/medrxiv/early/2025/06/20/2025.06.20.25328154.full.pdf","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"Protocol for a mixed‑methods systematic review; no primary data collected.","sample_n":null,"sample_text":"None – protocol only.","population":"Adolescents (intervention target)","country":"Not specified","controls_mi":"not_applicable","preregistered":true,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This pre‑print outlines a plan to systematically review how effective adolescent sexual‑health programmes are when they include content on sexual violence and safety. The authors will search many databases, screen studies in pairs, and assess quality with standard tools.","clinical_takeaway":"None – the study reports only a protocol, not results.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Pre‑registered protocol (OSF).","Comprehensive database search plan.","Use of established appraisal tools (MMAT, TIDieR)."],"limitations":["No empirical data yet; scores rely on protocol description.","Scope limited to sexual violence/safety, not pornography or CSBD.","Potentially broad inclusion criteria may yield heterogeneous studies."],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2025.06.20.25328154"}},{"id":9046,"doi":"10.2196/79009","pmid":"41855490","pmcid":"PMC13002158","title":"Digital Health Interventions for Sexual Health Education Among Adolescents With Autism Spectrum Disorder: Scoping Review","authors":"Rahmadani E, Ahmed IA.","first_author":"Rahmadani E","journal":"JMIR pediatrics and parenting","year":2026,"pub_types":["review-article","Review","Journal Article"],"keywords":["Adolescents","Autism Spectrum Disorder","Prisma","Sexual Education","Scoping Review","Digital Health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13002158","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review of 16 primary studies, descriptive synthesis, no meta‑analysis, no risk‑of‑bias assessment","sample_n":16,"sample_text":"16 included studies (small, non‑representative samples reported by primary studies)","population":"adolescents (10‑19 y) with autism spectrum disorder","country":"high‑income countries (majority)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review of 16 studies found that digital tools (videos, apps, websites) can improve sexual knowledge and understanding among autistic teenagers, but the evidence is limited by small, non‑representative samples and a lack of standard outcome measures.","clinical_takeaway":"Digital sexual‑health programs show promise for autistic adolescents, yet clinicians should note the current evidence is preliminary and varies in quality.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Systematic search across six databases","Use of PRISMA‑ScR reporting standards","Identification of key interactive features"],"limitations":["No risk‑of‑bias appraisal of included studies","Primary studies small and non‑representative","Outcome measures heterogeneous and non‑validated"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/79009"}},{"id":9047,"doi":"10.1177/10783903251408459","pmid":"41504065","pmcid":null,"title":"Nursing Students' Perceptions of Barriers and Facilitators in Providing Sexual Health Care to Psychiatric Patients: A Descriptive Qualitative Study","authors":"Koroglu Gokbel S, Durat G.","first_author":"Koroglu Gokbel S","journal":"Journal of the American Psychiatric Nurses Association","year":2026,"pub_types":["Journal Article"],"keywords":["Undergraduate","Nursing Education","Sexual Health","Psychiatric Nursing Practice","Mental Health Systems","Inpatient Psychiatric Care"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"descriptive qualitative study with thematic analysis of semi‑structured interviews (n=28 nursing students, single site)","sample_n":28,"sample_text":"Convenience sample of students enrolled in a psychiatric nursing course; not representative of all nursing trainees","population":"undergraduate nursing students (Turkey)","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In interviews with 28 Turkish nursing students, the study found that lack of training, cultural taboos, personal values, and institutional constraints hindered their ability to address sexual health in psychiatric patients, while education and supportive environments helped.","clinical_takeaway":"Nursing curricula should include targeted training on sexual health in mental‑health settings to overcome cultural and systemic barriers.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Clear, systematic interview protocol","Thematic analysis provides rich insight into student experiences","Identifies actionable educational and systemic barriers"],"limitations":["Small, single‑site convenience sample limits generalisability","No validated measurement instruments; reliance on self‑report","No quantitative assessment of prevalence or effect sizes"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10783903251408459"}},{"id":9048,"doi":"10.1080/13607863.2026.2656228","pmid":"41964434","pmcid":null,"title":"Internalized ageism and late-life sexual health: gendered sexual meanings and a self-esteem-anxiety pathway to sexual dysfunction/distress","authors":"Mateus KS, Oliveira JS, Do Bú E, da Silva J, Coelho AA, Barbosa JFS, Wendt GW.","first_author":"Mateus KS","journal":"Aging & mental health","year":2026,"pub_types":["Journal Article"],"keywords":["Anxiety","Sexual Health","Structural Equation Modeling","Self-esteem","Internalized Ageism"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Study 2 is a cross‑sectional survey of 300 older adults using self‑report questionnaires and structural‑equation modelling to test mediation. No longitudinal or experimental manipulation.","sample_n":300,"sample_text":"N = 300 (Study 2)","population":"Older adults (mixed gender, likely community sample)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 300 older adults, holding age‑biased beliefs about oneself was linked to lower self‑esteem, higher anxiety, and more sexual problems. The effect was stronger for men, while women showed a direct link between ageism and sexual distress.","clinical_takeaway":"Screen older patients for internalised ageism and its psychological effects to better address sexual dysfunction.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large community sample for older adults","Use of validated psychological scales","Theory‑driven mediation model tested with SEM"],"limitations":["Cross‑sectional design limits causal inference","No assessment of sexual partner or relational context","Potential self‑selection bias not described"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13607863.2026.2656228"}},{"id":9049,"doi":"10.21203/rs.3.rs-2955540/v1","pmid":null,"pmcid":null,"title":"The development of a novel sexual health promotion intervention for young people with mental ill-health: the PROSPEct project","authors":"Nolan H, O'Donoghue B, Simmons M, Zbukvic I, Ratcliff S, Milton A, Hughes E, Thompson A, Brown E.","first_author":"Nolan H","journal":"Research Square","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-2955540/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"development study using systematic review and stakeholder interviews; no empirical outcome testing","sample_n":29,"sample_text":"29 stakeholders (18 clinicians, 3 carers, 8 young people)","population":"young people with mental ill-health, clinicians, carers (N≈29)","country":"not stated","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers co‑produced a new sexual‑health program for young people with mental‑health problems, using a systematic review and interviews with clinicians, carers and youths. The program includes an initial consult and four 60‑90 min sessions delivered by specially trained clinicians. It is ready for a feasibility trial.","clinical_takeaway":"No clinical recommendations yet; the intervention is still being piloted for feasibility.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Follows MRC framework for complex interventions","Integrates systematic review with stakeholder input","Clear theoretical basis (Information‑Motivation‑Belief model)"],"limitations":["Very small, non‑representative stakeholder sample","No empirical evaluation of effectiveness yet","No quantitative measures or psychometric validation"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-2955540/v1"}},{"id":9050,"doi":"10.47176/mjiri.38.139","pmid":"40476170","pmcid":"PMC12138766","title":"Assessing Sexual Health: A Comprehensive Scoping Review of Measurement Questionnaires","authors":"Arabkari Z, Alipour F, Fallahi-Khoshknab M, Merghati-Khoei E, Samiei M, Abolfathi Momtaz Y.","first_author":"Arabkari Z","journal":"Medical journal of the Islamic Republic of Iran","year":2024,"pub_types":["review-article","Review","Journal Article"],"keywords":["Questionnaire","Sexual Health","Scoping Review"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12138766","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review following PRISMA and Arksey & O'Malley framework, systematic search of 5 databases, inclusion of 65 questionnaires","sample_n":null,"sample_text":"65 articles covering various questionnaires","population":"questionnaires measuring sexual health across studies (no primary participants)","country":"Not specified (global literature)","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors systematically surveyed questionnaires that assess sexual health, grouping them into nonspecific and specific indicators covering physical, psychological and social domains, and highlighting key constructs such as knowledge of contraception and sexual communication.","clinical_takeaway":"Use the identified indicator set to select or develop sexual‑health questionnaires that capture knowledge, communication, and wellbeing across cultural contexts.","confidence":0.7,"topic_tags":["sexual_function","measurement"],"strengths":["Comprehensive systematic search across five major databases","Clear taxonomy of sexual‑health indicators","Follows PRISMA and established scoping‑review methodology"],"limitations":["No quality or psychometric appraisal of the identified questionnaires","No risk‑of‑bias assessment for the source studies","Findings are descriptive; no quantitative synthesis"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.47176/mjiri.38.139"}},{"id":9051,"doi":"10.1016/j.xnsj.2025.100609","pmid":"40470001","pmcid":"PMC12136818","title":"Sexual health and chronic low back pain: A qualitative study","authors":"van Schaik D, Channa H, Fobelets M, Moens M, Scheerlinck T, Goudman L.","first_author":"van Schaik D","journal":"North American Spine Society journal","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual activity","Counseling","Interviews","Patient Care","Chronic Low Back Pain","Sexual Satisfaction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12136818","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interviews with 12 patients","sample_n":12,"sample_text":"12 participants (aged 18‑90) recruited from clinical setting","population":"sexually active adults with chronic low back pain, no sexual dysfunction","country":"unspecified (likely Belgium/Netherlands based on authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 12 people who have chronic low back pain showed that while desire often drops, many adjust sexual positions and keep overall relationship satisfaction, contradicting some earlier studies.","clinical_takeaway":"Clinicians should discuss sexual adaptations with CLBP patients, as desire may fall but satisfaction can be maintained.","confidence":0.8,"topic_tags":["sexual_function","csbd","masturbation","pornography"],"strengths":["In‑depth patient perspectives","Data saturation achieved","Use of multidisciplinary interview development"],"limitations":["Small, non‑representative sample","No validated measurement instruments","Limited generalisability to broader CLBP population"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.xnsj.2025.100609"}},{"id":9052,"doi":"10.3390/medicina61101782","pmid":"41155769","pmcid":"PMC12566591","title":"Sexual Health in Patients with Atopic Dermatitis: A Cross-Sectional Study","authors":"Juśko N, Masajada M, Żabówka A, Ćmiel A, Brzewski P, Reich A.","first_author":"Juśko N","journal":"Medicina (Kaunas, Lithuania)","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Quality of life","Atopic Dermatitis","Well-being","Sexual Life"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12566591","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional case‑control survey of 96 atopic dermatitis patients and 105 healthy controls using validated questionnaires.","sample_n":201,"sample_text":"201 participants (96 AD patients, 105 controls).","population":"Adults with atopic dermatitis and healthy controls, recruited via clinical settings (likely convenience sample).","country":"Lithuania (journal location; recruitment not specified).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"People with atopic dermatitis reported poorer sexual function, higher anxiety and depression, and lower quality of life than healthy people. Severity of skin disease, genital involvement, itch and sleep problems were linked to worse sex lives.","clinical_takeaway":"Screen for sexual dysfunction and mental‑health issues in patients with atopic dermatitis, especially women.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of multiple validated sexual function and mental‑health scales","Comparison with a healthy control group","Assessment of disease‑specific factors (severity, genital involvement, pruritus)"],"limitations":["Cross‑sectional design limits causal inference","No adjustment for key psychosocial confounds (e.g., moral attitudes, partner status)","Convenience sample may not represent broader AD population"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/medicina61101782"}},{"id":9053,"doi":"10.3928/02793695-20250708-03","pmid":"40673568","pmcid":null,"title":"Women's Sexual Health in the Context of Spousal Substance Use Disorder: A Qualitative Study","authors":"Tandoğan Ö, Ak EY, Karagözlü B.","first_author":"Tandoğan Ö","journal":"Journal of psychosocial nursing and mental health services","year":2026,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross‑sectional phenomenological interview study with 15 participants","sample_n":15,"sample_text":"15 women","population":"women (mid‑age) with spouses diagnosed with substance‑use disorder","country":"Turkey (presumed from author names, not stated)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 15 women whose partners have substance‑use disorders revealed that the partners' addiction harms their sexual health, causing physical, emotional and social problems. The study suggests that health services should address these women’s specific needs.","clinical_takeaway":"Clinicians should screen for sexual health issues in women partnered with individuals with substance‑use disorders and offer tailored support.","confidence":0.6,"topic_tags":["sexual_function","relationships","gender"],"strengths":["In‑depth phenomenological approach provides rich contextual insight","Clear thematic analysis with multiple themes","Focus on an understudied population"],"limitations":["Small convenience sample limits generalisability","No validated quantitative measures of sexual health or mental health","Potential recruitment bias (women seeking help may differ from broader population)"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3928/02793695-20250708-03"}},{"id":9054,"doi":"10.2147/cmar.s421951","pmid":"37929256","pmcid":"PMC10625326","title":"Family Wellbeing and Sexual Health of Patients Receiving Treatment for Prostate Cancer","authors":"Rio CJ, Goto T, Hsiao CP, Ross ALR, Saligan LN.","first_author":"Rio CJ","journal":"Cancer management and research","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual function","Family Health","Male Reproductive Health","Sexual Function Distress"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10625326","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"descriptive correlational study using baseline data from a longitudinal cohort (N=137); cross‑sectional analysis of relationships between family wellbeing, sexual function and distress","sample_n":137,"sample_text":"clinical cohort; not a probability sample","population":"men with prostate cancer (treatment‑seeking clinical sample)","country":"unspecified (likely USA or Asia based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"In 137 men treated for prostate cancer, better family and social wellbeing was linked to higher sexual function and lower sexual‑function distress, especially when they were not on hormone therapy.","clinical_takeaway":"Addressing family wellbeing may help reduce sexual‑function distress in prostate‑cancer patients, particularly those not receiving ADT.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses a validated symptom index for sexual function","Considers clinical moderators (ADT, Gleason score)","Includes depression as a covariate"],"limitations":["Cross‑sectional; cannot infer causality","Clinical convenience sample limits generalisability","Limited set of psychosocial confounds (no moral, partner or trauma variables)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/cmar.s421951"}},{"id":9055,"doi":"10.1186/s12913-024-10734-5","pmid":"38429748","pmcid":"PMC10905889","title":"The development of a novel sexual health promotion intervention for young people with mental ill-health: the PROSPEct project","authors":"Nolan H, O'Donoghue B, Simmons M, Zbukvic I, Ratcliff S, Milton A, Hughes E, Thompson A, Brown E.","first_author":"Nolan H","journal":"BMC health services research","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Comorbidity","Complex Interventions","Participatory Design","Youth Mental Health"],"is_oa":true,"oa_url":"https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-024-10734-5","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"development and co‑design of a complex sexual‑health intervention using systematic review and stakeholder interviews; no empirical outcome data","sample_n":29,"sample_text":"29 stakeholders (18 clinicians, 3 carers, 8 young people)","population":"young people with mental ill‑health (Australia)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers co‑designed a new sexual‑health program for young people with mental health problems, using a systematic review and interviews with clinicians, carers and youths. The program includes an initial consult and four tailored sessions delivered by a trained, sex‑positive clinician. The next step is a feasibility trial.","clinical_takeaway":"A promising, co‑designed sexual‑health intervention is ready for feasibility testing in youth mental‑health services.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Follows MRC framework for complex interventions","Integrates systematic review with stakeholder input","Clear theoretical basis (IMB model)"],"limitations":["No empirical effectiveness data","Small, non‑representative stakeholder sample","No quantitative measurement of outcomes"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12913-024-10734-5"}},{"id":9056,"doi":"10.1111/psrh.70034","pmid":"40908516","pmcid":"PMC12747597","title":"Sexual Health Behaviors and Outcomes Among Middle-Aged and Older Disabled Adults in Britain","authors":"Sakuma Y, Lin B, Kpokiri E, Khan J, Zou H, Tucker JD, Shakespeare T, Kuper H, Wu D.","first_author":"Sakuma Y","journal":"Perspectives on sexual and reproductive health","year":2025,"pub_types":["brief-report","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12747597","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"secondary quantitative analysis of Natsal-3, population‑representative British survey, logistic regressions stratified by sex","sample_n":7082,"sample_text":"7082 participants (1906 with limiting disability)","population":"Adults aged 45‑74 in Britain, self‑reported limiting disability (N≈7082, 1906 with disability)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In Britain, adults aged 45‑74 with a limiting disability are less likely to have recent sex or a steady partner, but report more coercion, poorer sexual health, and higher help‑seeking than non‑disabled peers.","clinical_takeaway":"Clinicians should proactively address sexual health and safety with middle‑aged and older disabled patients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Validated sexual health items from Natsal‑3","Sex‑disaggregated analysis","Adjusted for sociodemographic variables"],"limitations":["Cross‑sectional, cannot infer causality","Disability measured by self‑report, no detail on type or severity","Key psychosocial confounds (mental health, trauma, moral factors) not examined","Potential reporting bias in sensitive topics"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/psrh.70034"}},{"id":9058,"doi":"10.1007/s13178-025-01230-4","pmid":"41541233","pmcid":"PMC12803725","title":"Youth voices are needed now more than ever to improve adolescent sexual health research: Lessons from five years with a youth advisory board","authors":"Cheng M, Levinson E, Pierre J, Reddy D, Sattler K, Siva O, Wu J, Nelson KM.","first_author":"Cheng M","journal":"Sexuality research & social policy : journal of NSRC : SR & SP","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Adolescent Health","Youth Perspective","Youth Advisory Board"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"N/A (commentary)","population":"adolescent sexual health researchers and youth advisory board members","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors, who are members of a Youth Advisory Board, describe how involving young people in sexual‑health research can improve study quality and give youth valuable experience. They share practical tips for other researchers wanting to include youth voices.","clinical_takeaway":"None – the article offers methodological guidance, not clinical findings.","confidence":0.9,"topic_tags":["adolescents","sexual_function"],"strengths":["Highlights youth participation in research design","Authored by youth advisory board members"],"limitations":["No empirical data presented","Limited generalizability beyond commentary"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13178-025-01230-4"}},{"id":9061,"doi":"10.1186/s12913-025-13991-0","pmid":"41519807","pmcid":"PMC12849360","title":"Healthcare providers' perceptions of mental and sexual health needs of young males with forced migration experiences in Stockholm Region, Sweden","authors":"Karimah F, McDonald JT, Stålgren M, Salazar M.","first_author":"Karimah F","journal":"BMC health services research","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Mental health","Sexual Health","Healthcare Providers","Patient-centered Framework","Young Males With Forced Migration Experiences"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12849360","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"semi‑structured interviews with 9 healthcare providers, inductive content analysis","sample_n":9,"sample_text":"Nine health care providers were included; convenience sample of providers in the Stockholm Region.","population":"healthcare providers working with young males with forced migration experiences in Stockholm, Sweden","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with nine Swedish healthcare providers reveal that they see young male refugees as needing integrated mental and sexual health care, better health‑literacy support, and culturally sensitive approaches.","clinical_takeaway":"Clinicians should consider the combined mental‑sexual health needs and cultural context of young male refugees when planning care.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides provider perspectives on a vulnerable population","Uses a patient‑centered framework for analysis","Identifies concrete themes for service improvement"],"limitations":["Very small, non‑representative sample of providers","No validated interview instrument reported","Findings limited to perceptions, not patient outcomes"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12913-025-13991-0"}},{"id":9062,"doi":"10.3390/tropicalmed10090273","pmid":"41003583","pmcid":"PMC12474225","title":"Development and Validation of an Integrated HIV/STI, and Pregnancy Prevention Programme: Improving Adolescent Sexual Health Outcomes","authors":"Rammela M, Makhado L.","first_author":"Rammela M","journal":"Tropical medicine and infectious disease","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Development","Pregnancy","Integration","HIV","Validation","Stis"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12474225","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"multiphase mixed‑methods development and validation study; stakeholder consultation (n=35) for acceptability, feasibility, appropriateness","sample_n":35,"sample_text":"35 stakeholders and experts consulted for validation","population":"adolescent girls and young women, South Africa (Vhembe District)","country":"South Africa","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and tested a combined program to prevent HIV, STIs, and teen pregnancy among adolescent girls in South Africa, finding high acceptability among local experts.","clinical_takeaway":"Program shows promise for acceptability, but effectiveness on health outcomes remains untested.","confidence":0.6,"topic_tags":["adolescents","sexual_function","prevalence"],"strengths":["Multiphase mixed‑methods approach","Stakeholder involvement in validation","Clear focus on integrated service delivery"],"limitations":["Small validation sample (n=35)","No outcome data on actual health impacts","Lacks rigorous psychometric validation of measures"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/tropicalmed10090273"}},{"id":9066,"doi":"10.3390/curroncol32070395","pmid":"40710205","pmcid":"PMC12293689","title":"Pre-Implementation Assessment of a Sexual Health eClinic in Canadian Oncology Care","authors":"Incze T, Peres D, Guirguis S, Neil-Sztramko SE, Bender J, Elterman D, Alibhai SMH, Finelli A, Bach PV, Belita E, Brock G, Brown J, Campbell J, Domes T, Feifer A, Flannigan R, Higano C, Ory J, Patel P, Sundar M, Witherspoon L, Matthew A.","first_author":"Incze T","journal":"Current oncology (Toronto, Ont.)","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual dysfunction","prostate cancer","Implementation Science","Survivorship Care","Cfir","Oncosexology","Virtual Health","Sexual Health Rehabilitation"],"is_oa":true,"oa_url":"https://doi.org/10.3390/curroncol32070395","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative descriptive study using semi‑structured interviews with 17 healthcare providers/institutional leaders across 9 Canadian oncology centres; thematic analysis guided by CFIR 2.0","sample_n":17,"sample_text":"17 knowledge users (health‑care providers and institutional leaders)","population":"healthcare providers and leaders involved in prostate cancer survivorship care (Canada)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers interviewed 17 cancer‑care providers to learn what helps or hinders the rollout of a virtual sexual‑health clinic for prostate‑cancer survivors. They found strong enthusiasm but noted funding, institutional support, and workflow integration as key challenges.","clinical_takeaway":"Implementing virtual sexual‑health services in oncology requires clear institutional backing and workflow planning to succeed.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Implementation‑science framework (CFIR) guides analysis","Multi‑site perspective across nine centres","Qualitative depth captures real‑world barriers"],"limitations":["Small, non‑representative sample of providers only","No validated measurement instruments","Findings may not generalise to patient experiences"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/curroncol32070395"}},{"id":9067,"doi":"10.1177/23259582251410273","pmid":"41525234","pmcid":"PMC12796135","title":"Crowdsourcing is Acceptable to Develop Pre-Exposure Prophylaxis Promotions in Alabama: A Qualitative Study with Sexual Minority Men and Sexual Health Providers","authors":"Joseph KM, Elopre L, Matthews LT, Van Der Pol B, Tucker JD, Gravett RM.","first_author":"Joseph KM","journal":"Journal of the International Association of Providers of AIDS Care","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["HIV","Health Promotion","Hiv Prevention","Crowdsourcing","Prep"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12796135","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups with 10 sexual minority men and interviews with 6 providers; thematic analysis","sample_n":16,"sample_text":"Ten SMM and six providers participated","population":"sexual minority men (mostly Black, <30) and sexual health providers in Alabama","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small group of gay and bisexual men and health providers in Alabama said they would be willing to help create community‑driven ads for HIV‑prevention medication (PrEP) through crowdsourcing, highlighting motivations and barriers.","clinical_takeaway":"Community‑led crowdsourcing could be a feasible way to design locally relevant PrEP messages, but larger work is needed to confirm acceptability.","confidence":0.8,"topic_tags":["prevalence"],"strengths":["Use of a recognised acceptability framework","Inclusion of both community members and providers","Provides formative insight for PrEP promotion in a underserved region"],"limitations":["Very small, non‑representative sample","No quantitative validation of themes","Findings may not generalise beyond Alabama SMM"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/23259582251410273"}},{"id":9068,"doi":"10.1136/bmjopen-2025-110381","pmid":"41638739","pmcid":"PMC12878495","title":"Culturally appropriate sexual health interventions for STBBI and HIV among racialised immigrant communities in Western nations: a scoping review protocol","authors":"Kwame A, Maina G, Langman E, Ndubuka N, Caine V, Spence C, Maposa S, Kamrul R, Mason N, Etowa J, Eaton AD, Caron-Roy S, Abdulrasheed A, Guliak D, Chowdhury I, Ahmed A, Nyoni N, Hanson J, Alvarez A.","first_author":"Kwame A","journal":"BMJ open","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Hiv & Aids","Health Services Accessibility","Sexual Medicine","Sexual And Gender Minorities"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12878495","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"scoping review protocol (no empirical data yet)","sample_n":null,"sample_text":"Not applicable – protocol outlines future searches and synthesis","population":"racialised immigrant communities in Western nations (no specific numbers reported)","country":"Not specified (Western nations)","controls_mi":"not_applicable","preregistered":true,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This protocol outlines a planned scoping review that will map culturally appropriate sexual health programmes for racialised immigrant groups in Western countries, focusing on HIV/STBBI prevention and care.","clinical_takeaway":"None – the study is a protocol and does not provide actionable clinical findings.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Follows established JBI scoping review methodology","Protocol preregistered on OSF","Comprehensive search strategy across multiple databases"],"limitations":["No primary data yet – cannot assess validity or confound control","Focus on broader sexual health, not specific to pornography or compulsive sexual behavior"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjopen-2025-110381"}},{"id":9069,"doi":"10.1002/hsr2.70738","pmid":"40303906","pmcid":"PMC12035760","title":"Digital Sexual Health Education for Young Adults (18-35 Years): A Scoping Review Protocol","authors":"Borji-Navan S, Salehin S, Naseri-BooriAbadi T, Goli S, Mirghafourvand M.","first_author":"Borji-Navan S","journal":"Health science reports","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Education","Sex Education","Sexual Health","Young Adult","Scoping Review","Digital Health","Internet‐based Intervention"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12035760","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"protocol","sample_n":null,"sample_text":"Not applicable – protocol outlines future scoping review","population":"young adults (18‑35 years)","country":"Iran (based on ethical code IR.SHMU.REC.1403.085)","controls_mi":"not_applicable","preregistered":true,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This protocol describes how the authors will map studies that use digital tools to teach sexual health to adults aged 18‑35, aiming to summarise the types and features of such interventions.","clinical_takeaway":"None – the work is a future review protocol, not direct clinical evidence.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Follows established 14‑step scoping review methodology","Adheres to PRISMA‑ScR reporting guidelines","Comprehensive database search plan"],"limitations":["Protocol – no empirical data yet","Focus on education rather than pornography or compulsive sexual behavior","No discussion of key confounds (moral incongruence, masturbation, mental health)"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/hsr2.70738"}},{"id":9070,"doi":"10.4103/jhrs.jhrs_206_25","pmid":"41958608","pmcid":"PMC13061147","title":"Help-Seeking Behaviour and Care Delays in Indian Patients Attending a Speciality Sexual Health Clinic: A Retrospective Cohort study","authors":"Datta T, Gokani NS, Sahore A, Deshpande S.","first_author":"Datta T","journal":"Journal of human reproductive sciences","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Help-seeking","Care Delay"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13061147","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective observational cohort using anonymised clinic records (January 2022‑December 2024); n≈19,000 patients across four diagnostic categories (ED, PE, LSD, vaginismus); descriptive statistics and simple correlations reported.","sample_n":18893,"sample_text":"Records of patients with ED (n=8980), PE (n=9460), LSD (n=1135) or vaginismus (n=318) were analysed.","population":"Patients attending a specialised sexual health clinic in India; convenience sample; not representative of general population.","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A review of nearly 19,000 patients at an Indian sexual‑health clinic showed that most men and women with erectile dysfunction, premature ejaculation, low desire or vaginismus waited a year or more before seeking professional help, especially younger people.","clinical_takeaway":"Clinicians should proactively screen for sexual problems, as many patients delay care for months to years.","confidence":0.78,"topic_tags":["sexual_function","treatment","csbd"],"strengths":["Large clinic‑based sample across multiple sexual disorder categories","Clear descriptive presentation of help‑seeking delays","Use of objective clinical records rather than self‑report surveys"],"limitations":["Retrospective design limits causal inference","No measurement or control of key psychosocial confounds (e.g., mental health, partner factors)","Findings limited to a single specialised clinic; not generalisable to broader population"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/jhrs.jhrs_206_25"}},{"id":9071,"doi":"10.1186/s12888-025-06836-x","pmid":"40264093","pmcid":"PMC12016163","title":"A systematic review of sexual health, knowledge, and behavior in Autism Spectrum Disorder","authors":"Motamed M, Hajikarim-Hamedani A, Fakhrian A, Alaghband-Rad J.","first_author":"Motamed M","journal":"BMC psychiatry","year":2025,"pub_types":["Systematic Review","review-article","Journal Article"],"keywords":["Sexual behavior","Autism","Sexual Health","Sexual Knowledge","Inclusive Sexual Education"],"is_oa":true,"oa_url":"https://bmcpsychiatry.biomedcentral.com/counter/pdf/10.1186/s12888-025-06836-x","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 1991‑2024 literature on sexual health in ASD, following PRISMA; quality assessed with modified Cochrane and EPHPP tools; no meta‑analysis performed.","sample_n":null,"sample_text":"Not applicable – review aggregates multiple primary studies.","population":"Autistic individuals of varied ages; sample sizes of primary studies not reported in abstract.","country":"Not specified (global literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review summarises research on sexual health in autistic people, highlighting challenges like sensory issues, communication difficulties, and higher victimisation risk, and calls for tailored sexual‑health education and support.","clinical_takeaway":"Clinicians should consider autism‑specific factors when addressing sexual health and provide inclusive, tailored education.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive PRISMA‑guided search across multiple databases","Quality appraisal of primary studies using established tools","Identifies clear gaps for future research"],"limitations":["No quantitative synthesis (meta‑analysis) limits ability to estimate effect sizes","Abstract provides limited detail on measurement validity of primary studies","Potential bias from included studies not assessed in depth"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12888-025-06836-x"}},{"id":9072,"doi":"10.1016/j.ijregi.2025.100735","pmid":"40980602","pmcid":"PMC12445571","title":"Standardizing Vulvovaginal candidiasis diagnosis in Uganda: A case for British Association for Sexual Health and HIV 2019 guidelines","authors":"Jonani B.","first_author":"Jonani B.","journal":"IJID regions","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Diagnosis","Prevalence","Uganda","Vulvovaginal Candidiasis"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12445571","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review proposing guideline implementation","sample_n":null,"sample_text":"No primary data; review of existing diagnostics and guidelines","population":"Ugandan women with vulvovaginal candidiasis (no specific sample reported)","country":"Uganda (focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that Uganda should adopt the 2019 British Association for Sexual Health and HIV diagnostic guidelines for vulvovaginal yeast infections, combining clinical exam, microscopy, and targeted cultures to reduce misdiagnosis and unnecessary antifungal use.","clinical_takeaway":"Implementing standardized microscopy and culture can improve VVC diagnosis and antifungal stewardship in Ugandan clinics.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Addresses a clear diagnostic gap in Uganda","Links international guidelines to local laboratory network","Highlights antimicrobial stewardship"],"limitations":["No primary data or systematic review methodology","Potentially limited applicability without feasibility data","No cost‑effectiveness analysis"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijregi.2025.100735"}},{"id":9073,"doi":"10.1002/hsr2.70774","pmid":"40309618","pmcid":"PMC12040736","title":"Adolescents' Sexual Health During the COVID-19 Outbreak: A Systematic Review","authors":"Ahmadnia E, Haseli A, Davoudian A, Abbasi M.","first_author":"Ahmadnia E","journal":"Health science reports","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexuality","Youths","Teenager","2019 Ncov Infection","Sars Coronavirus 2 Infection"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12040736","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 10 quantitative studies (observational, clinical trials, quasi‑experimental) on adolescent sexual health during COVID‑19, registered on PROSPERO.","sample_n":636873,"sample_text":"Aggregate participants across included studies; the review itself did not recruit participants.","population":"Adolescents worldwide (aggregate N = 636,873 across included studies)","country":"Not specified (global studies)","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of ten studies (totaling over 600,000 adolescents) found that COVID‑19 disrupted young people’s access to sexual‑health services and widened inequalities, but digital education programs helped improve knowledge, safe‑sex practices, and communication with parents.","clinical_takeaway":"Clinicians should prioritize remote, youth‑friendly sexual‑health resources during crises to maintain service access and promote safe behaviours.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Registered protocol (PROSPERO)","Large combined sample size across studies","Comprehensive search of multiple databases","Use of validated risk‑of‑bias tools (NOS, RoB 2, ROBINS‑I)"],"limitations":["Heterogeneity prevented meta‑analysis","Primary studies varied in measurement quality","No systematic assessment of key confounders (e.g., mental health, trauma)","Reliance on published reports may introduce publication bias"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/hsr2.70774"}},{"id":9075,"doi":"10.1080/17538068.2025.2565066","pmid":"41025444","pmcid":"PMC12921569","title":"A culturally relevant sexual health campaign for Latino gay and bisexual men in a Southern U.S. Metropolitan area","authors":"Saldana CS, Bonadonna L, Perez R, Gonzalez KI, Scott JY, O'Neal J, Pedraza G, Mendez S, Gonzalez S, Zuluaga M, Negrete T, Luciani J, Rangel E, Holland DP, Cantos VD.","first_author":"Saldana CS","journal":"Journal of communication in healthcare","year":2026,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Prevention","Communication","Access","Sexual Health","Community Engagement","Culturally Relevant"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative focus groups with community members and key informants","sample_n":null,"sample_text":"focus group participants (size not reported in abstract)","population":"Latino gay and bisexual cisgender men in a Southern U.S. metropolitan area","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers worked with Latino gay and bisexual men in Atlanta to design a culturally appropriate sexual‑health campaign, using focus groups to identify messaging, trusted channels, and barriers like immigration concerns.","clinical_takeaway":"Tailoring sexual‑health messages to cultural and community contexts may improve access for underserved Latino MSM populations.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Community‑engaged, culturally tailored approach","Iterative design with stakeholder feedback"],"limitations":["Small, non‑representative qualitative sample","No quantitative evaluation of campaign impact","Limited detail on sampling and recruitment"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/17538068.2025.2565066"}},{"id":9076,"doi":"10.1177/10547738251347417","pmid":"40534457","pmcid":null,"title":"Quality of Life, Mood Disturbance, and Sexual Health in Implantable Cardioverter Defibrillators Recipients","authors":"Herrera Viancha RA, Lima Dos Santos SP, Gómez Ortega OR, Flórez Flórez ML, Moore WC, Tofthagen C.","first_author":"Herrera Viancha RA","journal":"Clinical nursing research","year":2025,"pub_types":["Journal Article"],"keywords":["Quality of life","Sexual Health","Mood Disorders","Implantable Cardioverter Defibrillator"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional correlational survey of 30 ICD patients","sample_n":30,"sample_text":"30 adult ICD patients recruited within 3 years post‑implantation","population":"adult ICD recipients (27‑83 y) from a single U.S. academic medical center","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 30 people with implanted heart defibrillators, poorer quality of life was linked to worse mood and lower sexual health, suggesting emotional and sexual wellbeing need attention in their care.","clinical_takeaway":"Assess and support mood and sexual health in ICD patients to potentially improve overall quality of life.","confidence":0.7,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Uses validated, widely accepted questionnaires","Reports effect sizes (Spearman rho)","Addresses an understudied aspect of ICD patient care"],"limitations":["Small convenience sample (N=30)","Cross‑sectional design limits causal inference","No adjustment for potential confounders beyond mood"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10547738251347417"}},{"id":9077,"doi":"10.1186/s12909-026-08613-0","pmid":"41547834","pmcid":"PMC12896041","title":"Challenging content: a mixed-methods evaluation of a novel sexual health curriculum in doctor of physical therapy education","authors":"Felter C, Fique MT, Hayes K, Hamel AL, Falvey JR.","first_author":"Felter C","journal":"BMC medical education","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Mixed Methods","Patient-educator","Doctor Of Physical Therapy"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12896041","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"pre‑post mixed‑methods evaluation of a curriculum with 137 DPT students; quantitative SA‑SH scores at three timepoints; qualitative focus groups","sample_n":137,"sample_text":"students from a single PT program","population":"Doctor of Physical Therapy students (two cohorts, 2023‑2024)","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A new, patient‑focused curriculum helped physical therapy students feel more confident and ready to discuss sexual health with patients; gains were maintained after a year of clinical training.","clinical_takeaway":"Brief, evidence‑based education can improve PT students’ readiness to address sexual health in practice.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Validated attitude questionnaire","Mixed‑methods triangulation","Longitudinal follow‑up (10 months)","Statistical model with confidence intervals"],"limitations":["No control/comparator group","Single‑institution convenience sample","No pre‑registration reported","Findings limited to self‑reported attitudes"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12909-026-08613-0"}},{"id":9080,"doi":"10.21203/rs.3.rs-5328464/v1","pmid":null,"pmcid":null,"title":"Developing Socio-Epidemiological Indicators of Sexual Health among Migrant Population in Chile","authors":"Parra CA, Ávila VS, Donoso CL, Andrade KL, Solís D, Gómez D, Cortés E, Hernandez CN, Hidalgo VP, Vega CL, Prieto JB, Hernández PC, Portiño MC, Ibarra CB, Delgado JB.","first_author":"Parra CA","journal":"Research Square","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-5328464/v1","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"mixed-methods instrument development using interviews, focus groups, Delphi validation, and pilot testing","sample_n":null,"sample_text":"semi‑structured interviews and focus groups; number not reported in abstract","population":"migrant adults in Chile","country":"Chile","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers created a 94‑item questionnaire to capture sexual‑health needs of migrants in Chile, drawing on interviews, focus groups, and expert panels to ensure relevance and cultural sensitivity.","clinical_takeaway":"The new tool may help health services better assess and address sexual‑health concerns among migrant populations.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Engages target community and key stakeholders","Uses systematic Delphi process for content validation","Comprehensive set of indicators covering multiple dimensions"],"limitations":["No psychometric validation reported","Sample size and representativeness unclear","No quantitative testing of indicator reliability"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-5328464/v1"}},{"id":9081,"doi":"10.1097/mou.0000000000001205","pmid":"38949421","pmcid":null,"title":"Sexual health in transgender and gender diverse people","authors":"Zhang X, Neuville P, Skokan AJ.","first_author":"Zhang X","journal":"Current opinion in urology","year":2024,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of existing literature on sexual health in transgender and gender diverse populations; no new empirical data collected.","sample_n":null,"sample_text":"Not applicable – review article.","population":"Transgender and gender diverse individuals undergoing gender‑affirming medical or surgical care (no primary sample).","country":"Not specified (international literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises what is known about how hormone therapy and gender‑affirming surgeries affect sexual health in transgender and gender‑diverse people, noting high satisfaction with most surgeries but a lack of evidence‑based treatments for resulting sexual problems.","clinical_takeaway":"Clinicians should monitor sexual function after gender‑affirming care and recognise the current evidence gaps for treating related dysfunctions.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Broad overview of sexual health issues across gender‑affirming treatments.","Highlights gaps in patient‑reported outcome measures."],"limitations":["Narrative, not systematic; no risk‑of‑bias assessment.","No new data; relies on heterogeneous primary studies."],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/mou.0000000000001205"}},{"id":9082,"doi":"10.1080/00224499.2025.2475549","pmid":"40088193","pmcid":"PMC12353469","title":"Moving Toward a More Comprehensive Standard for Sex Education: A Latent Class Analysis and Examination of Young Adult Sexual Health","authors":"Scull TM, Stump KN, Evans-Paulson R, Dodson CV, Schoemann AM.","first_author":"Scull TM","journal":"Journal of sex research","year":2026,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 676 young adults using latent class analysis","sample_n":676,"sample_text":"N=676 young adults","population":"young adults, national sample (likely online panel)","country":"unspecified (likely US/International based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 676 young adults, those who recalled receiving more comprehensive school sex‑education—covering contraception, communication, gender, pleasure, consent—were more likely to use condoms, get STI tests, and report higher sexual satisfaction than peers with limited or no sex‑education.","clinical_takeaway":"Comprehensive sex‑education is linked to safer sexual behaviours and greater satisfaction; clinicians should encourage inclusive curricula.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for survey work","Use of latent class analysis to capture heterogeneity","Focus on comprehensive sex‑education topics"],"limitations":["Cross‑sectional design limits causal inference","Education measures are self‑reported and not validated","No control for key confounds (moral, mental health, partner factors)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2025.2475549"}},{"id":9083,"doi":"10.1080/26410397.2025.2554458","pmid":"40888305","pmcid":"PMC12462412","title":"Shaping the WHO Sexual Health Assessment of Practices and Experiences questionnaire: a descriptive study on the real-world example from Portugal","authors":"Patrão AL, Gonsalves L, Brizuela V, Nobre P.","first_author":"Patrão AL","journal":"Sexual and reproductive health matters","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health Promotion","Sexual And Reproductive Health","Sexual Behaviours","Who Questionnaire","Implementation In Portugal"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12462412","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Descriptive implementation study of WHO SHAPE questionnaire with nationally representative Portuguese sample (N=2,010).","sample_n":2010,"sample_text":"Nationally representative probability sample (response rate 30.9%).","population":"Adults 18‑95 years, Portugal, community‑dwelling","country":"Portugal","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tested the WHO’s new Sexual Health Assessment questionnaire in Portugal with 2,010 adults, finding it can be completed in about 18‑30 minutes and yields valid data, suggesting it could be used worldwide to monitor sexual health.","clinical_takeaway":"The SHAPE questionnaire appears feasible for large‑scale sexual health surveys, but further validation is needed before clinical use.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Mixed‑mode data collection (online & telephone)","First real‑world test of WHO SHAPE instrument"],"limitations":["Low overall response rate (≈31%)","Questionnaire still in early validation phase","No assessment of potential confounders (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/26410397.2025.2554458"}},{"id":9085,"doi":"10.3390/ijerph22101536","pmid":"41154940","pmcid":"PMC12564106","title":"SESS Model for Adolescent Sexual Health Promotion: A Quasi-Experimental Two-School Evaluation in Thailand","authors":"Norkaew J, Homchampa P, Chanthamath S, Wongkongdech R.","first_author":"Norkaew J","journal":"International journal of environmental research and public health","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Adolescents","Sexual Health","Social Support","Empowerment","School-based Intervention","Quasi-experimental Study"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12564106","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"quasi-experimental, two schools, non‑randomized, n=240 adolescents (15‑19 y)","sample_n":240,"sample_text":"Two schools, each with 120 participants; convenience sample","population":"Thai secondary students in Northeastern Thailand","country":"Thailand","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A school‑based program in Thailand that combined system coordination, empowerment workshops, peer support and digital tools improved teens' knowledge and preventive behaviours about sexual health, but did not change attitudes.","clinical_takeaway":"School programmes that add empowerment and peer‑support components can boost adolescents' safe‑sex practices.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["use of validated questionnaires","cluster comparison with baseline adjustment","reporting of confidence intervals"],"limitations":["non‑randomized design, possible school‑level confounding","no pre‑registration or power justification","limited generalisability beyond two schools"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph22101536"}},{"id":9086,"doi":"10.1177/10598405251337769","pmid":"40356460","pmcid":"PMC12819888","title":"The Role of School Nurses in Promoting Positive Sexual Health Education: A Scoping Review","authors":"Nymo B, Eriksen SB, Øygarden AU.","first_author":"Nymo B","journal":"The Journal of school nursing : the official publication of the National Association of School Nurses","year":2026,"pub_types":["Scoping Review","review-article","Journal Article"],"keywords":["Children","Adolescents","Public Health Nurse","School Nurse","Sexual Education","Scoping Review","Sexual And Reproductive Health And Rights","Positive Sexuality","Comprehensive Sex Education","Sexual Reproductive Education"],"is_oa":true,"oa_url":"https://doi.org/10.1177/10598405251337769","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Scoping review using Arksey and O'Malley's framework; 17 studies synthesized; no formal systematic review methods or risk‑of‑bias assessment.","sample_n":null,"sample_text":"17 included articles; no original participant number reported","population":"School nurses and adolescents; studies from USA and England; no primary data collected by authors","country":"USA, England (primary), limited Nordic representation","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This scoping review maps how school nurses help deliver positive sexual‑health education. From 406 papers, 17 were examined, showing nurses play a key role but that more diverse, especially Nordic, research is needed.","clinical_takeaway":"School nurses can be effective educators for positive sexual health; programmes should consider involving them more widely.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive scoping of existing literature","Uses established Arksey & O'Malley framework"],"limitations":["No systematic risk‑of‑bias assessment","Limited geographic diversity","No quantitative synthesis or effect‑size reporting"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10598405251337769"}},{"id":9087,"doi":"10.1080/0092623x.2025.2531161","pmid":"40625285","pmcid":null,"title":"Therapeutic Treatment Planning for Sex Therapy Using the Sexual Health and Integrative Pleasure (SHIP) Model","authors":"Connor JJ, Arenella K, de Oliveira L, Evenson L, Mark KP, Newstrom NP, Robinson BBE, Vencill JA, Girard A.","first_author":"Connor JJ","journal":"Journal of sex & marital therapy","year":2025,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"case-study based treatment planning guide","sample_n":null,"sample_text":"Two illustrative case studies; no systematic sample","population":"clinical sex therapy patients (implicit)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The paper presents the SHIP model, a five‑component framework for planning sex‑therapy treatment, illustrated with two case examples, and discusses how to incorporate pleasure, resilience, literacy, relational intimacy and multidisciplinary care.","clinical_takeaway":"Clinicians can adapt the SHIP model to structure comprehensive, pleasure‑focused treatment plans, but its effectiveness remains untested.","confidence":0.7,"topic_tags":["sexual_function","treatment"],"strengths":["Provides concrete clinical framework","Integrates biopsychosociocultural perspectives","Includes detailed case illustrations"],"limitations":["No empirical data or systematic evaluation","Small illustrative sample (2 cases only)","No outcome measures or efficacy testing"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2025.2531161"}},{"id":9088,"doi":"10.1002/puh2.70157","pmid":"41180378","pmcid":"PMC12573465","title":"Navigating Power, Sexual Health, and Communication in Polygynous Marriages: A Qualitative Study Among Hausa Muslim Men in Northern Nigeria","authors":"Amzat J, Almu B, Amzat G, Kanmodi KK.","first_author":"Amzat J","journal":"Public health challenges","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Nigeria","Marital Communication","Male Authority","Polygynous Marriage","Hausa Muslim"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12573465","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 24 purposively selected Hausa Muslim men aged 40+ in polygynous marriages","sample_n":24,"sample_text":"24 men, convenience/purposive sampling","population":"Hausa Muslim men in northern Nigeria, married to two or more wives, aged 40 and above (N=24)","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 24 Hausa Muslim men in polygynous marriages reveal that male authority shapes sexual‑health decisions, communication is indirect, and STI risk is often underestimated, highlighting cultural barriers to health services.","clinical_takeaway":"Clinicians should recognize cultural dynamics and indirect communication styles when discussing sexual health with men in polygynous families.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["In‑depth cultural insight from participants","Addresses a poorly studied marital context"],"limitations":["Small, non‑representative convenience sample","No validated measurement tools","No assessment of key confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/puh2.70157"}},{"id":9089,"doi":"10.3390/healthcare13050559","pmid":"40077121","pmcid":"PMC11899024","title":"The Multifaceted Impact of the SARS-CoV-2 Pandemic on Sexual Health, Function, and Behaviors: Implications for Public Health: A Scoping Review","authors":"Quintana GR.","first_author":"Quintana GR.","journal":"Healthcare (Basel, Switzerland)","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual behavior","Sexual dysfunction","Public Health","Sexual Health","Sexual Well-being","Covid-19","Sars-cov-2"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11899024","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Scoping review following PRISMA‑ScR, synthesising primary studies on sexual function/behaviour during COVID‑19 without quantitative meta‑analysis.","sample_n":null,"sample_text":"Not applicable – review of existing studies","population":"Adults (general population) across studies included in the review","country":"Multiple (global literature)","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review summarises how the COVID‑19 pandemic altered people’s sexual desire, activity and function, showing both declines and increases that may relate to stress, fear of death, or changes in relationship dynamics.","clinical_takeaway":"Sexual health should be integrated into emergency response plans; clinicians should anticipate varied impacts on desire and function during crises.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Systematic search strategy (PRISMA‑ScR)","Broad inclusion of studies across the pandemic period","Clear presentation of divergent trends","Links findings to public‑health implications"],"limitations":["No quantitative meta‑analysis or effect‑size synthesis","No formal risk‑of‑bias assessment of included studies","Potential selection bias toward English‑language, adult studies","Does not address key confounds specific to pornography/addiction research"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare13050559"}},{"id":9090,"doi":"10.1007/s10508-025-03224-0","pmid":"40897979","pmcid":"PMC12484307","title":"Non-Binary People's Sexuality, Sexual Health, and Relationship Satisfaction: A Review of 12 Years of Quantitative Research (2012-2024)","authors":"Mastrantonio F, Kovshoff H, Armstrong H.","first_author":"Mastrantonio F","journal":"Archives of sexual behavior","year":2025,"pub_types":["research-article","Systematic Review","Journal Article"],"keywords":["Sexuality","Transgender","Gender Identity","Sexual Satisfaction","Non-binary"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12484307","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 44 quantitative studies (2012‑2024) on non‑binary sexuality, health and relationship satisfaction; narrative synthesis without meta‑analysis.","sample_n":null,"sample_text":"44 quantitative articles included; individual study sizes unknown from abstract.","population":"Non‑binary adults (studies in English or Italian); sample sizes of primary studies not reported in abstract.","country":"International (searches in PsycINFO, Web of Science, MEDLINE).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review examined 44 quantitative studies from 2012‑2024 on non‑binary people's sexual identities, health and relationship satisfaction. It found that non‑binary individuals often have non‑monosexual identities, form relationships with other non‑binary people, and report similar satisfaction levels as binary trans people. However, many studies use language and tools that do not fully reflect non‑binary experiences.","clinical_takeaway":"Clinicians should use gender‑neutral, inclusive measures when assessing sexual health and relationship satisfaction in non‑binary clients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive 12‑year systematic search across three databases.","Focus on measurement inclusivity for non‑binary identities.","Identifies gaps in gender‑neutral language in existing tools."],"limitations":["No meta‑analysis; narrative synthesis limits quantitative conclusions.","Limited reporting of primary study quality and risk of bias.","Potential language bias (English/Italian only)."],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-025-03224-0"}},{"id":9091,"doi":null,"pmid":"41729646","pmcid":null,"title":"[The role of marriage and family counsellors: the example of the Yvelines Sexual Health Centres]","authors":"Huynh A, de Gasperi S, Thorin A, Dischamps V.","first_author":"Huynh A","journal":"La Revue du praticien","year":2026,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"fre","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"Program description / non‑empirical report","sample_n":null,"sample_text":"Not reported – description of service provision","population":"students (9th grade) in Yvelines, France","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article outlines how marriage and family counselors run free, culturally respectful sexual‑health education sessions for 9th‑grade students in Yvelines, France, using open‑ended discussions and a standardized procedure.","clinical_takeaway":"None – the paper does not provide data for clinical decision‑making.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Describes a structured, culturally respectful educational program","Involves multidisciplinary collaboration with schools"],"limitations":["No empirical data or outcome evaluation","No measurement of sexual‑health knowledge or behaviors","Cannot assess effectiveness or causal impact"],"rubric_version":"2.0","raw_total":2,"max_possible":50,"pct_score":4,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":0,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":9092,"doi":"10.21203/rs.3.rs-5831384/v1","pmid":null,"pmcid":null,"title":"Effectiveness of Low-Cost, Virtual Sexual Health Education and Educational Leaflets on Reducing Anxiety and Enhancing Sexual Function among Infertile Women: A Pilot Randomized Controlled Trial","authors":"Karimi M, Heshmatnia F, Azima S, Akbarzadeh M, Thapa S.","first_author":"Karimi M","journal":"Research Square","year":2025,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.21203/rs.3.rs-5831384/v1","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"pilot randomized controlled trial with three arms (control, booklet, virtual education), triple‑blind, N=90 (≈30 per group)","sample_n":90,"sample_text":"90 women randomly allocated to three groups (≈30 per group)","population":"infertile women seeking treatment in Iran","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small randomized trial in Iran found that virtual videos or pamphlets about sexual health reduced anxiety and improved several aspects of sexual function in women undergoing infertility treatment.","clinical_takeaway":"Brief psycho‑educational tools may help lower anxiety and boost sexual function for infertile women, but larger trials are needed.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Randomized controlled design","Triple‑blind implementation","Use of validated anxiety and sexual function scales"],"limitations":["Small pilot sample, likely under‑powered","No effect sizes or confidence intervals reported","Limited control for potential confounders (e.g., mental health, relationship status)"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-5831384/v1"}},{"id":9093,"doi":"10.1136/bmjph-2025-003819","pmid":"41919187","pmcid":"PMC13034242","title":"\"I would walk through fire to get this vaccine\": a mixed-methods study examining attitudes and perceptions of a gonorrhoea vaccine programme among UK sexual health service users","authors":"Firth C, Wilkinson S, Martin S, Vanderslott S, Pollard AJ, Pollock KM.","first_author":"Firth C","journal":"BMJ public health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Vaccination","Public Health","Sexual Health","Qualitative Research","Community-based Participatory Research"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13034242","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-methods survey (n=395) with thematic interviews (n=15); convenience sample of UK sexual‑health service users","sample_n":395,"sample_text":"395 survey respondents; 15 interview participants (convenience sample)","population":"UK adults who have accessed sexual health services","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A UK study surveyed 395 sexual‑health clinic users and interviewed 15 people about a new gonorrhoea vaccine. Most were supportive, especially because of antibiotic resistance concerns, but cost and stigma could hinder uptake. Participants preferred free, low‑threshold delivery in trusted settings.","clinical_takeaway":"Vaccine programmes should be free, stigma‑free and delivered in trusted sexual‑health venues to maximise uptake.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses a validated scale for vaccine attitudes","Mixed‑methods enriches understanding","Reasonably large quantitative sample for a focused population"],"limitations":["Convenience sample limits generalisability","No pre‑registration or power justification","Cross‑sectional design cannot assess changes over time"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjph-2025-003819"}},{"id":9094,"doi":"10.1093/sexmed/qfaf071","pmid":"41267826","pmcid":"PMC12629225","title":"Assessing the relationship between sexual health literacy and sexual self-care in women: a cross-sectional study in Iran","authors":"Darban F, Heydarikhayat N, Olyaee S, Raeisi N.","first_author":"Darban F","journal":"Sexual medicine","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Reproductive Health","Health Behavior","Women’s Health","Self-care Model","Sexual Health Literacy","Sexual Self-Care"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12629225","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 435 reproductive‑age women attending health centres in Iran; logistic, ANOVA and linear regression analyses","sample_n":435,"sample_text":"women attending healthcare centres affiliated with Iranshahr University of Medical Sciences, Iran, 2024‑2025","population":"women of reproductive age (Iran), N=435","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 435 Iranian women, higher scores on a validated sexual health literacy questionnaire were linked to better sexual self‑care behaviours, suggesting that improving knowledge may boost women’s sexual health practices.","clinical_takeaway":"Enhancing sexual health literacy could be a practical way to promote better sexual self‑care among women.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample for regional study","Use of validated scales","Clear statistical analysis plan"],"limitations":["Cross‑sectional – no causal inference","Self‑report data may be biased","Single geographic region limits generalizability"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfaf071"}},{"id":9095,"doi":"10.1111/jan.16933","pmid":"40135932","pmcid":"PMC12623691","title":"Experiences of Sexual Health and Intimate Relationships in Women With Lipedema: A Qualitative Study","authors":"Falck J, Mårtensson J, Jonasson LL, Dudek J, Nygårdh A.","first_author":"Falck J","journal":"Journal of advanced nursing","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Chronic disease","Nursing","stigma","Women's Health","Sexual Health","Intimacy","Qualitative Research","Lipedema"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12623691","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross‑sectional interview study with 16 participants recruited from a patient association (convenience sample)","sample_n":16,"sample_text":"Sixteen women with lipedema recruited from a national lipedema association group in Sweden","population":"women with lipedema in Sweden (n=16, mean age not reported)","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 16 Swedish women who have lipedema reveal that pain, body shame, and partner communication problems often reduce sexual enjoyment and intimacy.","clinical_takeaway":"Healthcare providers should proactively discuss sexual concerns with women living with lipedema.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Adherence to COREQ reporting guidelines","In‑depth qualitative insights from women with a chronic condition","Patient representatives involved in recruitment"],"limitations":["Small, non‑representative convenience sample","No quantitative measurement of sexual function or distress","Findings limited to Swedish lipedema association members"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jan.16933"}},{"id":9096,"doi":"10.3389/fpubh.2026.1761039","pmid":"42088227","pmcid":"PMC13136122","title":"Building on tradition: using the ADAPT-ITT model to develop a sexual health intervention from initiation rites of passage for rural young women in Southern Malawi","authors":"Collen LY, Green G, Umar E, Kuchawo MGK, Muheriwa-Matemba SR.","first_author":"Collen LY","journal":"Frontiers in public health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Adaptation","Young Women","Behavioral Intervention","Sexual And Reproductive Health","Traditional Initiation Ceremony"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13136122","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"development and descriptive one‑year evaluation of a culturally adapted sexual‑health intervention; no control group, pre‑post descriptive data","sample_n":null,"sample_text":"purposively sampled women from three generations and participants in the intervention; exact N not reported","population":"young women 16‑24 years in rural Malawi (purposive sample)","country":"Malawi","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","causal_from_correlational","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers adapted traditional Malawian initiation rites into a sexual‑health programme for rural girls. After one year, pregnancies fell by about half and family‑planning use rose sharply, but the study lacked a control group and detailed statistics.","clinical_takeaway":"Culturally tailored sexual‑health education may reduce teenage pregnancy, but robust controlled trials are needed before wide adoption.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Systematic culturally‑grounded adaptation process (ADAPT‑ITT)","Use of ethnographic participatory methods","Triangulation of interviews, observations, and respondent validation"],"limitations":["No control/comparison group; pre‑post design limits causal inference","Sample size and statistical testing not reported","Potential selection bias from purposive sampling"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2026.1761039"}},{"id":9097,"doi":"10.1097/gox.0000000000006014","pmid":"39534071","pmcid":"PMC11557040","title":"Impact of Gender-confirming Chest Surgery on Sexual Health: A Prospective Study","authors":"de Schoulepnikoff C, Bauquis O, di Summa PG.","first_author":"de Schoulepnikoff C","journal":"Plastic and reconstructive surgery. Global open","year":2024,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.1097/gox.0000000000006014","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort of transgender patients (N=33) assessed pre‑op and at 4‑ and 12‑mo post‑op with validated patient‑reported outcome measures and monofilament sensitivity testing","sample_n":33,"sample_text":"Twenty‑one transmasculine and 12 transfeminine patients","population":"transmasculine and transfeminine patients undergoing gender‑confirming chest surgery","country":"unspecified (institutional study)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In 33 transgender patients, chest surgery improved body satisfaction and psychological well‑being. Feeling more aware of the body during sex rose after surgery, but nipple sensitivity did not predict sexual health, which stayed low for transfeminine patients until later vaginoplasty.","clinical_takeaway":"Chest surgery boosts body confidence, but clinicians should note that sexual health may need additional interventions beyond sensory recovery.","confidence":0.78,"topic_tags":["sexual_function","gender"],"strengths":["Use of validated patient‑reported outcome measures","Prospective pre‑/post‑surgery design","Objective sensory testing (monofilament)"],"limitations":["Small sample size (N=33)","No control for mental‑health or relational confounders","No effect‑size reporting or power analysis"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/gox.0000000000006014"}},{"id":9098,"doi":"10.1007/s00431-025-06294-3","pmid":"40586976","pmcid":null,"title":"Tackling sexual health in specialized pediatric consultations with adolescents: challenges, barriers, and local perspectives","authors":"Laurent-Lacroix C, Jeziorski E, Stheneur C, Perrollaz C.","first_author":"Laurent-Lacroix C","journal":"European journal of pediatrics","year":2025,"pub_types":["Journal Article"],"keywords":["Medical education","Sexual Health","Adolescent Health","Healthcare Barriers","Pediatric Consultation"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative interview study with 7 pediatricians from a single university hospital; inductive coding, triangulation.","sample_n":7,"sample_text":"Seven pediatricians interviewed.","population":"Pediatric subspecialists (n=7) in Montpellier University Hospital.","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with seven pediatric specialists in France reveal many obstacles—personal discomfort, lack of training, time pressure, and cultural taboos—that limit discussion of sexual health with adolescent patients. The authors suggest dedicated adolescent visits and better training to improve care.","clinical_takeaway":"Clinicians should receive targeted training and have dedicated adolescent slots to address sexual‑health needs more effectively.","confidence":0.8,"topic_tags":["adolescents","sexual_function","pornography","masturbation"],"strengths":["In‑depth, inductive analysis of clinicians’ experiences","Triangulation and double reading to enhance credibility","Identifies concrete local improvement strategies"],"limitations":["Very small, single‑site sample limits generalisability","Findings reflect only physician perspectives, not adolescents","No quantitative assessment of barrier prevalence"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00431-025-06294-3"}},{"id":9099,"doi":"10.3389/fpsyt.2026.1775933","pmid":"42109275","pmcid":"PMC13150753","title":"Psychiatric comorbidities and sexual health risks in HIV-serodiscordant heterosexual couples involving women with borderline personality disorder: a mixed-method study and theoretical modeling","authors":"Lazzari C, Rees J, Graham Y, Owens R.","first_author":"Lazzari C","journal":"Frontiers in psychiatry","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["HIV","Psychiatry","Health Behavior","Borderline Personality Disorder","Dependent Personality Disorder","Hiv Serodiscordant Couples","Self-defeating Personality Disorder","Complex Post-traumatic Stress Disorder"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13150753","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-method (cross‑sectional survey of 175 couples + qualitative interviews); no longitudinal follow‑up or experimental manipulation","sample_n":175,"sample_text":"175 couples (cross‑sectional survey) plus a subset of female partners interviewed qualitatively","population":"HIV‑serodiscordant heterosexual couples (female HIV‑negative partners with BPD)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In HIV‑serodiscordant couples, women with borderline personality disorder and a history of trauma were less likely to consistently use protection, raising HIV transmission risk. Their risky health behaviors appear linked to complex personality and trauma factors.","clinical_takeaway":"Clinicians should screen for BPD and trauma in HIV‑negative partners and address relational and mental‑health needs to improve prevention practices.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large (for this niche) sample of serodiscordant couples","Mixed‑method approach combines quantitative trends with rich qualitative insight","Identifies important psychosocial factors (trauma, personality) linked to prevention behaviors"],"limitations":["BPD diagnosis inferred from narrative cues, not validated clinical interview","Sexual protection measured with a single non‑validated scale","No statistical control for identified confounds (trauma, mental health, partner dynamics)","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyt.2026.1775933"}},{"id":9100,"doi":"10.1016/j.esmoop.2025.105311","pmid":"40505419","pmcid":"PMC12192329","title":"Sexual health in cancer care: a narrative review and position statement from the Italian Association of Medical Oncology (AIOM)","authors":"Rossi A, Leone AG, Lambertini M, Sperti E, Cassani C, Vetromile A, Barni S, De Giorgi A, Preti EP, Secondino S, Silvestris N, Berardi R, Brunello A, Curigliano G, La Verde N, Latiano TP, Pietrantonio F, Tiseo M, Di Maio M, Perrone F, Cinieri S, Fabi A, Associazione Italiana Oncologia Medica (AIOM).","first_author":"Rossi A","journal":"ESMO open","year":2025,"pub_types":["review-article","Review","Consensus Statement","Journal Article"],"keywords":["Cancer","Quality of life","Sexual Health","Survivorship Care"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12192329","cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review / position statement","sample_n":null,"sample_text":"Not applicable – narrative review","population":"cancer patients and survivors (general)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how cancer and its treatments affect sexual health, emphasizing that clinicians should discuss sexuality with patients and refer to specialists when needed to improve quality of life.","clinical_takeaway":"Clinicians should routinely assess sexual health in cancer care and use multidisciplinary pathways for treatment.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Comprehensive synthesis of existing literature on sexual health in oncology","Clear clinical recommendations for multidisciplinary care"],"limitations":["Narrative (non‑systematic) methodology limits reproducibility","No formal risk‑of‑bias assessment of cited studies","Absence of quantitative analysis or effect‑size reporting"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esmoop.2025.105311"}},{"id":9101,"doi":"10.21203/rs.3.rs-4048751/v1","pmid":null,"pmcid":null,"title":"Gynecologic cancer survivor preferences for provider communication regarding sexual health after treatment: a qualitative study","authors":"Girard A, Arenella K, Rider GN, Teoh D, Vogel R.","first_author":"Girard A","journal":"Research Square","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-4048751/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups with 32 gynecologic cancer survivors, thematic analysis","sample_n":32,"sample_text":"six Zoom focus groups (n = 32)","population":"adult gynecologic cancer survivors, >3 months post‑treatment, recruited via convenience sampling","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Gynecologic cancer survivors said doctors often did not talk about sexual health after treatment, leading to distress. They want more open conversations, resources, and clinician training on sexuality.","clinical_takeaway":"Clinicians should proactively discuss sexual health with gynecologic cancer survivors to reduce distress.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Provides first‑hand survivor perspectives on sexual health communication","Uses thematic analysis to capture nuanced experiences"],"limitations":["Small, non‑representative convenience sample","No quantitative validation of themes","Findings limited to self‑reported perceptions"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-4048751/v1"}},{"id":9102,"doi":"10.1089/jchc.24.05.0040","pmid":"40143799","pmcid":"PMC12747135","title":"Neighborhoods, Caregiver Sexuality Communication, and Sexual Health of Adolescents Involved in the Legal System","authors":"Rusley JC, Tolou-Shams M, Li Y, Dauria EF, Marshall BDL, Wohl A, Koinis-Mitchell D.","first_author":"Rusley JC","journal":"Journal of correctional health care : the official journal of the National Commission on Correctional Health Care","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Adolescent","Neighborhood characteristics","Sexual Health","Correctional Health Care","Juvenile Legal System"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 423 adolescent‑caregiver dyads using multinomial regression","sample_n":423,"sample_text":"423 adolescent‑caregiver dyads","population":"Adolescents newly involved in the juvenile legal system and their caregivers (N≈423 dyads)","country":"United States (likely, based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 423 adolescents in the juvenile legal system and their caregivers, higher sexual‑risk behavior was linked to poorer caregiver communication about sexuality and to living in neighborhoods with low cohesion. Improving family communication and neighborhood resources may help reduce risk.","clinical_takeaway":"Strengthening caregiver‑adolescent sexuality talks and enhancing neighbourhood support could reduce STI risk in justice‑involved youth.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, community‑based sample for this vulnerable population","Multilevel ecological framework","Use of multivariate (multinomial) modeling"],"limitations":["Cross‑sectional design limits causal inference","Unclear validation of sexual behavior and communication measures","Key confounders (e.g., mental health, trauma) not addressed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/jchc.24.05.0040"}},{"id":9103,"doi":"10.1016/j.puhe.2025.106088","pmid":"41364965","pmcid":"PMC13372464","title":"Adaptation, acceptability and preliminary impacts of a sexual health and financial literacy intervention for indigenous adolescents in Ecuador: A mixed-methods pilot study","authors":"Tituaña A, Wilson-Barthes M, Desrosiers A, Jardine SJ, Srinivasan M, Palacios I, Galárraga O.","first_author":"Tituaña A","journal":"Public health","year":2026,"pub_types":["research-article","Journal Article"],"keywords":["Adolescence","Reproductive Health","Latin America And The Caribbean","Economic Strengthening","Gender Empowerment"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13372464","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"quasi-experimental pilot with non‑randomized control group (N=47)","sample_n":47,"sample_text":"29 intervention, 18 control (quasi‑experimental)","population":"Indigenous adolescents, 15‑19 y, Ecuador (n≈47)","country":"Ecuador","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A pilot program combined financial‑literacy training with reproductive‑health education for Indigenous Ecuadorian teens. Participants liked the curriculum; early results showed improved money‑skills, better sexual‑health knowledge and a small drop in intercourse frequency, but the study was small and not randomized.","clinical_takeaway":"The intervention appears feasible and may boost knowledge and reduce risky sex, but larger trials are needed before clinical recommendation.","confidence":0.78,"topic_tags":["sexual_function","religiosity","pornography"],"strengths":["Mixed‑methods provides qualitative acceptability data","Uses ADAPT‑ITT framework for cultural adaptation","High recruitment rate for intervention group"],"limitations":["Small, non‑randomized sample limits causal inference","No validated scales reported for key outcomes","Potential confounders (e.g., mental health, partner influence) not measured"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.puhe.2025.106088"}},{"id":9104,"doi":"10.1177/17455057251331263","pmid":"40248948","pmcid":"PMC12035292","title":"Breaking the silence: Addressing sexual health challenges among migrant and refugee women","authors":"Lassi ZS, Damabi NM, Begum M, Avery JC, Meherali S.","first_author":"Lassi ZS","journal":"Women's health (London, England)","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Editorial"],"keywords":["Migrant","Sexual function","Sexual Health","Refugee"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12035292","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"editorial; conceptual discussion without original data","sample_n":null,"sample_text":"none (editorial)","population":"migrant and refugee women (no empirical sample)","country":"unspecified (authors from multiple affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The editorial discusses how migrant and refugee women face many barriers to good sexual health, such as language, cultural taboos, and limited access to care, and calls for culturally sensitive services and better research.","clinical_takeaway":"Clinicians should consider cultural and acculturation factors when addressing sexual health needs of migrant and refugee women.","confidence":0.6,"topic_tags":["sexual_function","moral_incongruence","masturbation"],"strengths":["Highlights an under‑researched population","Integrates cultural, socioeconomic, and health‑system perspectives"],"limitations":["No empirical data; conclusions are speculative","Lacks systematic review methodology","No measurement of sexual function or health outcomes"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/17455057251331263"}},{"id":9105,"doi":"10.1186/s12913-024-12092-8","pmid":"39844138","pmcid":"PMC11756131","title":"Implementation of a sexual health clinic in an oncology setting: patient and provider perspectives","authors":"Matthew AG, Incze T, Stragapede E, Guirguis S, Neil-Sztramko SE, Elterman DS.","first_author":"Matthew AG","journal":"BMC health services research","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Cancer Survivorship","Implementation Research","Cfir","Oncosexology"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11756131","cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Semi‑structured interviews with patients and providers; Framework qualitative analysis.","sample_n":null,"sample_text":"Patients and providers representing selected cancer types participated; exact numbers not reported in abstract.","population":"Cancer survivors (various sites) and oncology health‑care providers in Toronto, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with cancer survivors and oncology staff revealed many gaps in sexual‑health care and highlighted the need for a dedicated sexual‑health clinic. Key barriers include discomfort discussing sex, limited provider training, and logistical constraints.","clinical_takeaway":"Implementing a dedicated sexual‑health clinic in oncology can improve patient support, but staff training and systematic referral pathways are essential.","confidence":0.78,"topic_tags":["sexual_function","csbd"],"strengths":["Uses an established implementation framework","Provides perspectives of both patients and providers","Identifies actionable barriers and facilitators"],"limitations":["No quantitative outcome data","Sample size and demographic details not reported","Findings limited to a single Canadian centre"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12913-024-12092-8"}},{"id":9106,"doi":"10.1186/s12905-025-03735-x","pmid":"40369570","pmcid":"PMC12080019","title":"A non-randomized study of sexual health education on the sexual function of primigravid women","authors":"Keshavarz M, Ghorbani A, Allahqoli L, Sarvi F, Salehiniya H, Alkatout I.","first_author":"Keshavarz M","journal":"BMC women's health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual function","Pregnant women","Sexual Health Education"],"is_oa":true,"oa_url":"https://bmcwomenshealth.biomedcentral.com/counter/pdf/10.1186/s12905-025-03735-x","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"non‑randomized controlled study with 43 participants per arm, 8‑week follow‑up, intervention of six 60‑min sex‑education sessions versus no intervention","sample_n":80,"sample_text":"80 participants (43 intervention, 43 control) with 8‑week follow‑up; 8 participants lost to analysis","population":"primigravida women, Iran","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small Iranian study, pregnant women who received six sessions of sexual health education showed greater improvements in sexual desire, arousal, lubrication, orgasm, satisfaction and pain over 8 weeks compared with women who received no education.","clinical_takeaway":"Brief, structured sexual health education may boost sexual function during pregnancy, but evidence is limited by study design.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of validated FSFI instrument","Pre‑ and post‑intervention measurements","Clear description of education protocol"],"limitations":["Non‑randomized design, potential selection bias","Small sample, no power calculation reported","No control for key confounders (partner relationship, mental health, etc.)","No effect‑size confidence intervals, only p‑values"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12905-025-03735-x"}},{"id":9108,"doi":"10.1007/s10461-025-04965-8","pmid":"41288881","pmcid":"PMC13167893","title":"Acceptability, Feasibility, and Safety of the Shauriana Intervention for Young Kenyan Gay, Bisexual, and Other Men who Have Sex with Men, and Exploration of Potential Impact on Sexual Health Outcomes","authors":"Graham SM, Wang L, Jadwin-Cakmak L, Odhiambo EO, Bauman K, Okall D, Odero W, Otieno F, Amico KR, Harper GW.","first_author":"Graham SM","journal":"AIDS and behavior","year":2026,"pub_types":["research-article","Randomized Controlled Trial","Journal Article"],"keywords":["Mental health","Sexual Health","Motivational Interviewing","Men Who Have Sex With Men","Behavioral Intervention","Peer Group","Hiv Preexposure Prophylaxis"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13167893","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Randomized controlled trial (pilot) with 60 young Kenyan GBMSM, 6‑month follow‑up, acceptability/feasibility outcomes.","sample_n":60,"sample_text":"60 participants (median age 25) randomised to intervention (n≈29) or standard care (n≈31).","population":"young gay, bisexual, and other men who have sex with men in Kenya (N=60)","country":"Kenya","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small Kenyan pilot trial found that a five‑session group program for young gay and bisexual men was acceptable, feasible and safe, and may improve HIV prevention knowledge and condom use.","clinical_takeaway":"The intervention appears safe and well‑received; larger trials are needed before recommending it for broader sexual‑health programs.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Randomised design","High retention and session attendance","Culturally tailored intervention"],"limitations":["Small sample; underpowered for efficacy","No validated outcome scales reported","No adjustment for key psychosocial confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-025-04965-8"}},{"id":9109,"doi":"10.1007/s00520-025-09450-5","pmid":"40240639","pmcid":null,"title":"Evolution of sexual health of patients with head and neck cancer before, during, and 1 year after treatment","authors":"Pradier J, Togan S, Combe C, Buiret G.","first_author":"Pradier J","journal":"Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer","year":2025,"pub_types":["Journal Article"],"keywords":["Sexual Health","Head And Neck Cancer","Supportive Care In Cancer"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort of 44 head‑and‑neck cancer patients followed from diagnosis to 1 year post‑treatment with repeated QoL questionnaires","sample_n":44,"sample_text":"44 patients, prospectively followed","population":"adult patients with head and neck cancer (N=44)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 44 patients with head‑and‑neck cancer, sexual interest and enjoyment were low at diagnosis, worsened during treatment, partially recovered after treatment, and then declined again by one year. Poor sexual health was linked to lower overall quality of life, highlighting a need for better sexual health support in cancer care.","clinical_takeaway":"Monitor and address sexual health throughout cancer treatment, as it impacts overall wellbeing.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Uses validated QoL questionnaires","Prospective repeated‑measure design","Links sexual health to overall quality of life"],"limitations":["Small sample, limited power","No control for mental‑health or relationship factors","Single‑site, not representative"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00520-025-09450-5"}},{"id":9110,"doi":"10.1016/j.evalprogplan.2025.102540","pmid":"39854825","pmcid":null,"title":"Formative research and development of a referral toolkit for sexual health services linkages within chicago public high schools","authors":"Jarpe-Ratner E, Altman L, Schnabel A, Reid B, Marshall B, Matias K, Ramirez-Mercado K, Fagen MC, Masinter L.","first_author":"Jarpe-Ratner E","journal":"Evaluation and program planning","year":2025,"pub_types":["Journal Article"],"keywords":["Adolescent Health","Formative Research","School-based Health","Linkage To Sexual Health Services"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups and interviews with students and staff in three Chicago high schools; thematic analysis using Atlas.ti","sample_n":null,"sample_text":"focus groups and interviews (exact number of participants not reported in abstract)","population":"adolescent students and school staff in Chicago Public Schools","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers held focus groups with students and staff at three Chicago high schools to identify challenges and strategies for linking adolescents to sexual‑health services. They created a toolkit with recommendations to improve communication, privacy, and staff involvement.","clinical_takeaway":"Schools can use stakeholder‑informed toolkits to better connect teens with confidential sexual‑health services.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Provides stakeholder perspectives for toolkit development","Uses systematic qualitative analysis"],"limitations":["Small, non‑representative sample of three schools","No quantitative outcome data","Findings not generalizable beyond the context"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.evalprogplan.2025.102540"}},{"id":9111,"doi":"10.1093/jsxmed/qdae027","pmid":"38490973","pmcid":null,"title":"Biopsychosocial determinants of sexual health in older age: the role of health-related, relationship, and psychosexual factors","authors":"Vasconcelos PA, Paúl C, Nobre PJ.","first_author":"Vasconcelos PA","journal":"The journal of sexual medicine","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Aging","Relationship","Health","Sexual Well-being","Sexual Beliefs"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of partnered adults ≥55 y (N=111)","sample_n":111,"sample_text":"111 participants (mean 63.2 y, SD 5.96)","population":"partnered older adults (mean age 63)","country":"unspecified (likely Portugal/Spain based on author names)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 111 partnered adults aged 55 and older, relationship length, satisfaction, and age‑related sexual beliefs explained most of the variance in sexual well‑being, beyond health factors.","clinical_takeaway":"Improving relationship satisfaction and addressing age‑related sexual beliefs may boost sexual well‑being in older couples.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Reasonable sample size for exploratory regression","Comprehensive biopsychosocial model including relationship variables","Clear statistical reporting of hierarchical regression"],"limitations":["Cross‑sectional; cannot infer causality","Reliance on self‑report questionnaires without validation details","No power analysis or confidence intervals reported"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":6,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdae027"}},{"id":9112,"doi":"10.1071/sh24143","pmid":"39570734","pmcid":null,"title":"Community-engaged strategies to improve sexual health services for adults aged 45 and above in the United Kingdom: a qualitative data analysis","authors":"Nunez M, Sakuma Y, Conyers H, Day S, Terris-Prestholt F, Ong JJ, Pan SW, Shakespeare T, Tucker JD, Kpokiri EE, Wu D.","first_author":"Nunez M","journal":"Sexual health","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.publish.csiro.au/sh/pdf/SH24143","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative community‑engaged study with crowdsourcing call (n≈22 submissions) and seven co‑creation workshops/interviews; thematic analysis using a social‑ecological framework.","sample_n":22,"sample_text":"22 open‑call submissions; participants in seven co‑creation events (exact number not reported)","population":"Adults aged 45 + years in the United Kingdom (mixed gender; some with disability; 6 % gay/lesbian)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Adults over 45 in the UK helped design ideas to make sexual‑health services more inclusive, such as better education, stronger patient‑provider relationships, community‑led outreach, and breaking taboos.","clinical_takeaway":"Service providers should involve older adults in designing sexual‑health care to improve accessibility and reduce stigma.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Community‑engaged, co‑creation approach","Use of social‑ecological coding framework","Identifies actionable service‑improvement themes"],"limitations":["Small, self‑selected sample limits generalisability","No quantitative validation of themes","Limited demographic diversity reported"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh24143"}},{"id":9113,"doi":"10.3389/fmed.2024.1289418","pmid":"38449880","pmcid":"PMC10916695","title":"Women's sexual health improvement: sexual quality of life and pelvic floor muscle assessment in asymptomatic women","authors":"Baszak-Radomańska E, Wańczyk-Baszak J, Paszkowski T.","first_author":"Baszak-Radomańska E","journal":"Frontiers in medicine","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Pelvic Examination","Woman Health","Sexual Quality Of Life","Pelvic Floor Muscle Dysfunction","Gynecology Follow-up"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fmed.2024.1289418/pdf?isPublishedV2=False","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 300 asymptomatic women attending an annual well‑woman visit, using the Sexual Quality of Life questionnaire and the VAMP pelvic‑floor assessment.","sample_n":300,"sample_text":"300 women","population":"Healthy adult women (N = 300) attending routine gynecological examinations; exclusion of dyspareunia at recruitment.","country":"Poland (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 300 women without obvious sexual complaints, higher sexual quality of life was linked to good mental health and the absence of dyspareunia. Pelvic‑floor muscle overactivity was common but did not predict lower sexual wellbeing.","clinical_takeaway":"Screen for mental‑health issues and dyspareunia during routine exams to identify women at risk for reduced sexual quality of life.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample for a cross‑sectional clinical study","Use of validated patient‑reported outcome (SQOL)","Combined PRO with objective pelvic‑floor examination"],"limitations":["Convenience clinic sample limits generalisability","No measurement of partner or relational factors","Cross‑sectional design precludes causal inference"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fmed.2024.1289418"}},{"id":9114,"doi":"10.1136/bmjopen-2024-089095","pmid":"39819938","pmcid":"PMC11979507","title":"Symptom-related experience and sexual health of female patients with pulmonary arterial hypertension: protocol for a systematic review and qualitative meta-synthesis","authors":"Ma F, Yang L, He Y, Yang Z.","first_author":"Ma F","journal":"BMJ open","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Health","Cardiovascular disease","Nursing care","Patient-centered Care"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11979507","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"protocol for systematic review and qualitative meta‑synthesis; registered with PROSPERO; comprehensive search planned; thematic analysis of qualitative studies","sample_n":null,"sample_text":"not applicable (protocol)","population":"female patients with pulmonary arterial hypertension","country":"not specified","controls_mi":"not_applicable","preregistered":true,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This protocol outlines a systematic review that will combine qualitative studies about how pulmonary arterial hypertension affects women's sexual experiences and health, aiming to inform better clinical care.","clinical_takeaway":"None – the study is a protocol and provides no clinical findings yet.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Registered protocol (PROSPERO)","Comprehensive multi‑database search strategy","Use of established JBI framework for qualitative synthesis"],"limitations":["No primary data yet; quality depends on included studies","Unclear how sexual‑health constructs will be operationalised","Potential limited coverage of culturally diverse populations"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":5,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjopen-2024-089095"}},{"id":9116,"doi":"10.1186/s12909-025-06850-3","pmid":"40045351","pmcid":"PMC11881284","title":"Sexual health in patient care: shortcomings in medical training and experienced barriers in sexual history taking","authors":"Bogaert E, Roels R.","first_author":"Bogaert E","journal":"BMC medical education","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Health care","Sexual Health","Access To Health Care","School-based Interventions","Communication With Health Professionals"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11881284","cited_by_count":11,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"survey of 167 medical residents at a single Belgian medical school; online questionnaire on sexual history training, skills, knowledge, attitudes; curriculum analysis","sample_n":167,"sample_text":"167 residents from the largest medical school in Belgium","population":"medical residents (post‑graduate trainees) in Belgium (N=167)","country":"Belgium","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 167 medical residents in Belgium found that most feel poorly trained to take sexual histories. Lack of skills, knowledge, discomfort, and biases (religion, ethnicity, age, gender) are key obstacles, along with practical issues like time and language.","clinical_takeaway":"Medical education should strengthen teaching of sexual history taking to reduce discomfort and improve patient care.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample for a single‑institution survey","Focus on an under‑researched aspect of medical education","Identifies multiple concrete barriers (e.g., discomfort, time, language)"],"limitations":["Convenience sample from one school limits generalisability","Questionnaire appears ad‑hoc; no information on validation","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12909-025-06850-3"}},{"id":9118,"doi":"10.1186/s13643-025-02905-0","pmid":"40652271","pmcid":"PMC12255040","title":"Sexual networks, sexual practices, and sexual health among youths in WHO-South East Asia Region: a scoping review protocol","authors":"Rao A, Shinde R, Shahabuddin SM.","first_author":"Rao A","journal":"Systematic reviews","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Youths","Sexual Health","Sexual Practices","Sexual Network","Who-south East Asia Region"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12255040","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"scoping review protocol – no empirical data yet","sample_n":null,"sample_text":"not applicable (protocol)","population":"youths 18‑24 y in WHO South‑East Asia Region (11 countries)","country":"multiple SEAR countries","controls_mi":"not_applicable","preregistered":true,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This protocol outlines a scoping review that will map existing research on sexual networks, practices and health among 18‑24‑year‑olds in South‑East Asia, aiming to identify gaps for future interventions.","clinical_takeaway":"None – study is a review protocol and provides no clinical findings.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Clearly defined scoping‑review methodology (Arksey & Malley, PRISMA‑ScR)","Pre‑registration on OSF"],"limitations":["Protocol only – no data to assess validity, confounds or statistics","Focus is broad sexual health, not specific to pornography or CSBD"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s13643-025-02905-0"}},{"id":9119,"doi":"10.3390/jcm14238441","pmid":"41375744","pmcid":"PMC12692949","title":"Linking Thyroid Function, Morphology, Autoimmunity, Body Mass Index, and Reproductive Aging to Women's Sexual Health: Evidence from a Population Study in Kaunas","authors":"Daukšienė D, Klimaitė R, Kondrotienė A, Matukaitienė R, Čeponis J, Rimkutė A, Dudonytė L, Steponavičiūtė R, Lukšienė D, Lesauskaitė V, Veličkienė D, Verkauskienė R, Žilaitienė B.","first_author":"Daukšienė D","journal":"Journal of clinical medicine","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Thyroid function","Sexual dysfunction","body mass index","Goiter","Thyroid Nodules","Hashimoto’s Thyroiditis","Menopausal State"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12692949","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"population‑based survey of 1569 women, random sampling, FSFI and thyroid measures, multivariate analysis","sample_n":1569,"sample_text":"random community sample","population":"women aged 25‑69 in Kaunas, Lithuania (random sample, WHO MONICA framework)","country":"Lithuania","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a community sample of 1,569 Lithuanian women, lower sexual function (measured with the FSFI) was linked to older age, higher body‑mass index, menopause and thyroid problems, especially goiter. Women with Hashimoto’s thyroiditis reported more pain and less lubrication.","clinical_takeaway":"Clinicians should consider thyroid assessment, especially goiter, when evaluating women with sexual dysfunction.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, probability‑based sample","Validated sexual function instrument (FSFI)","Comprehensive thyroid assessment (lab + ultrasound)"],"limitations":["Cross‑sectional; cannot infer causality","No adjustment for mental‑health or relationship factors","No pre‑registration or effect‑size confidence intervals reported"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jcm14238441"}},{"id":9120,"doi":"10.1186/s13690-025-01587-3","pmid":"40205517","pmcid":"PMC11980073","title":"Developing socio-epidemiological indicators of sexual health among migrant population in Chile","authors":"Adrian Parra C, Stuardo Ávila V, Lisboa Donoso C, Low Andrade K, Solís D, Gómez D, Cortés E, Núñez Hernandez C, Parra Hidalgo V, Lobos Vega C, Belmar Prieto J, Contreras Hernández P, Carrasco-Portiño M, Bustos Ibarra C, Barrientos Delgado J.","first_author":"Adrian Parra C","journal":"Archives of public health = Archives belges de sante publique","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Migrants","Sexual Health","Epidemiological Surveillance, Stis"],"is_oa":true,"oa_url":"https://archpublichealth.biomedcentral.com/counter/pdf/10.1186/s13690-025-01587-3","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-methods indicator development using qualitative interviews, Delphi panels, expert judgment and pilot testing","sample_n":null,"sample_text":"not specified in abstract","population":"migrant population in Chile (sample size not reported in abstract)","country":"Chile","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created a detailed questionnaire (94 items) to assess sexual health and related vulnerabilities among migrants in Chile, using interviews, focus groups, and expert panels to ensure relevance and cultural fit.","clinical_takeaway":"The new indicator set can help health services tailor sexual‑health interventions for migrant communities, but its psychometric properties need further testing.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Comprehensive mixed‑methods approach","Inclusion of community and expert input via Delphi","Focus on structural vulnerability contexts"],"limitations":["No quantitative validation metrics reported","Sample size and representativeness unclear","No statistical power or effect‑size reporting"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s13690-025-01587-3"}},{"id":9121,"doi":"10.1080/26410397.2019.1593787","pmid":"31533569","pmcid":"PMC7887957","title":"Sexual health, sexual rights and sexual pleasure: meaningfully engaging the perfect triangle","authors":"Gruskin S, Yadav V, Castellanos-Usigli A, Khizanishvili G, Kismödi E.","first_author":"Gruskin S","journal":"Sexual and reproductive health matters","year":2019,"pub_types":["review-article","Review","Journal Article"],"keywords":["Policy","Programming","Human Rights","Sexual Health","Advocacy","Sexual Pleasure","Sexual Rights","Multi-disciplinary Perspectives"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7887957","cited_by_count":79,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of policy and conceptual frameworks; no empirical data, no systematic methods reported","sample_n":null,"sample_text":"N/A – review article without primary data","population":"not applicable","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that sexual health improves when law, programs, and advocacy equally value sexual rights and pleasure, proposing conceptual and practical ways to integrate these elements into policy and training.","clinical_takeaway":"Consider sexual rights and pleasure alongside health in policy and counseling, but note the piece offers no direct clinical evidence.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Comprehensive conceptual synthesis of sexual health, rights, and pleasure","Clear policy‑oriented recommendations","Integrates multidisciplinary perspectives"],"limitations":["No empirical data or systematic review methodology","Lacks measurement of key sexual‑health constructs","No assessment of confounding factors"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":4,"contrasting":0,"mentioning":121,"citing_publications":224,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/26410397.2019.1593787"}},{"id":9122,"doi":"10.1016/j.soin.2024.12.003","pmid":"39952723","pmcid":null,"title":"[Sexual health and nursing participation: from paradigm to real-life application]","authors":"Lefebvre S, Cousin Cabrolier L, Martin P.","first_author":"Lefebvre S","journal":"Soins; la revue de reference infirmiere","year":2025,"pub_types":["Journal Article","English Abstract"],"keywords":["Sexual Health","Health Promotion","Nurse","Infirmier","Promotion De La Santé","Issue","Santé Sexuelle","Accompaniment","Accompagnement","Enjeu"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary / guideline article without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article offers nurses practical points for discussing sexual health with patients, emphasizing its central role in overall well‑being and acknowledging common difficulties in addressing the topic.","clinical_takeaway":"None - the paper provides no data to guide clinical decisions.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Provides practical guidance for nurses","Highlights importance of sexual health in care"],"limitations":["No empirical data or evaluation of recommendations","Lacks measurement of outcomes or effectiveness"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.soin.2024.12.003"}},{"id":9123,"doi":"10.2196/55815","pmid":"39365657","pmcid":"PMC11489791","title":"A Digital Sexual Health Intervention for Urban Adolescent and Young Adult Male Emergency Department Patients: User-Centered Design Approach","authors":"Chernick LS, Bugaighis M, Daylor V, Hochster D, Rosen E, Schnall R, Stockwell MS, Bell DL.","first_author":"Chernick LS","journal":"JMIR formative research","year":2024,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual behavior","Sex Education","Sexual Health","Emergency Medicine","Condom Use","User-centered Design","Adolescent Health","Health Planning","Mhealth","Sms Text Messaging","Mobile App"],"is_oa":true,"oa_url":"https://doi.org/10.2196/55815","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"User‑centered design and usability testing with 8 male adolescent/young‑adult ED patients and 5 expert reviewers; iterative prototyping; thematic analysis of interviews.","sample_n":13,"sample_text":"8 adolescent/young adult male patients; 5 usability experts.","population":"Urban adolescent and young‑adult male patients in an emergency department (convenience sample).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study created a mobile app, Dr. Eric, to help young men in emergency departments use condoms more often. Researchers interviewed eight patients and five experts, refining the app’s content and design through several development phases.","clinical_takeaway":"The app shows promise but needs rigorous testing before clinicians can rely on it to improve condom use.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Systematic user‑centered design process","Iterative usability testing","Clear description of development phases"],"limitations":["Very small convenience sample (N=8)","No outcome data on condom use","No validated measurement of sexual‑health behaviours"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/55815"}},{"id":9124,"doi":"10.1071/sh24137","pmid":"39531374","pmcid":null,"title":"Sexual health in an aging world: a global call to action for more resilient services for older and disabled adults","authors":"Randazzo S, Day S, Kritzer I, Zou H, Conyers H, Sakuma Y, Wu D, Kpokiri EE, Gonsalves L, Tucker JD.","first_author":"Randazzo S","journal":"Sexual health","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Editorial","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":"https://www.publish.csiro.au/sh/pdf/SH24137","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"editorial without empirical data","sample_n":null,"sample_text":"None (editorial)","population":"older adults (global)","country":"International","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The editorial urges the global health community to give older and disabled adults more attention in sexual‑health research, services, and policy, especially regarding function, menopause, service use, and health links.","clinical_takeaway":"None – the piece is a call for research, not a clinical study.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Highlights neglected population","Calls for diverse research topics"],"limitations":["No empirical data presented","Does not address pornography or CSBD directly"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh24137"}},{"id":9125,"doi":"10.1186/s12909-025-07286-5","pmid":"40361065","pmcid":"PMC12070587","title":"Knowledge, attitudes and practices regarding sexual health among Chinese medical students: a multicenter cross-sectional study","authors":"Yao H, Ma R, Sun Q, Zhao J, Li Y, Bao T, Li T.","first_author":"Yao H","journal":"BMC medical education","year":2025,"pub_types":["research-article","Multicenter Study","Journal Article"],"keywords":["Sex Education","Kap","Medical Students","Sexual Health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12070587","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"multicenter cross-sectional survey of 765 postgraduate medical students in China","sample_n":765,"sample_text":"765 participants from three leading medical institutions in Beijing","population":"Chinese postgraduate medical students (mostly heterosexual, 28% sexually active)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 765 Chinese medical students found good overall sexual‑health knowledge but notable misconceptions about contraception and HPV vaccination. Sexual experience was linked to higher knowledge, and factors like higher spending, rural residence and non‑heterosexual orientation predicted sexual activity. The authors call for better sexual‑health education in medical curricula.","clinical_takeaway":"Medical schools should enhance comprehensive, evidence‑based sexual‑health training to address persistent knowledge gaps.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large multicenter sample of medical students","Uses logistic regression to identify factors associated with sexual activity","Relevant for informing medical education policy"],"limitations":["Survey items appear ad‑hoc; no validated scales reported","Cross‑sectional design limits causal inference","Key confounders (moral attitudes, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12909-025-07286-5"}},{"id":9127,"doi":"10.1525/agh.2025.2442813","pmid":"40296878","pmcid":"PMC12036828","title":"Participatory development of the &lt;i&gt;Shauriana&lt;/i&gt; program to integrate sexual health and mental health support for young gay and bisexual men and other men who have sex with men in Kenya","authors":"Jadwin-Cakmak L, Harper GW, Ochieng E, Amico KR, Aloo T, Okutah F, Gumbe E, Olango K, Okall DO, Otieno FO, Odero W, Graham SM.","first_author":"Jadwin-Cakmak L","journal":"Advances in global health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Mental health","Sexual Health","Men Who Have Sex With Men","Hiv Prevention","Behavioral Intervention","Pre-exposure Prophylaxis","Gay And Bisexual Men","Community Program"],"is_oa":false,"oa_url":"https://doi.org/10.1525/agh.2025.2442813","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"pilot feasibility study with 10 participants; quantitative attendance monitoring and qualitative exit interviews; no control group","sample_n":10,"sample_text":"10 participants in pilot run","population":"young gay, bisexual, and other men who have sex with men in Kenya","country":"Kenya","controls_mi":"not_applicable","preregistered":true,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers co‑designed a peer‑led program to improve sexual and mental health for young gay and bisexual men in Kenya. In a small pilot of 10 men, attendance was high and participants reported the program was helpful, leading to refinements before a larger trial.","clinical_takeaway":"The pilot suggests a peer‑led, holistic approach may be acceptable for GBMSM in Kenya, but efficacy remains untested.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Participatory, community‑driven development","High attendance and engagement in pilot","Qualitative feedback informs refinement"],"limitations":["Very small sample (N=10) limits any inference","No comparison or control condition","Outcomes not measured with validated scales"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1525/agh.2025.2442813"}},{"id":9128,"doi":"10.20944/preprints202309.1963.v1","pmid":null,"pmcid":null,"title":"Sexual Health and Psychological Well-Being of Women: A Systematic Review","authors":"Arcos-Romero AI, Calvillo C.","first_author":"Arcos-Romero AI","journal":"Preprints.org","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.preprints.org/manuscript/202309.1963/v1/download","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 14 empirical articles (42.9% clinical samples) examining associations between female sexual functioning and psychological well‑being. Followed PRISMA guidelines; no meta‑analysis reported.","sample_n":null,"sample_text":"14 primary studies (details not provided in abstract)","population":"Adult women (samples varied across included studies)","country":"multiple (search across databases, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 14 studies found that women’s psychological well‑being is linked to how they experience sexual health, especially regarding anxiety and depression.","clinical_takeaway":"Consider mental‑health screening when addressing female sexual health concerns.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["PRISMA‑guided systematic search","Inclusion of both clinical and non‑clinical samples","Focus on recent literature (2010‑2023)"],"limitations":["No meta‑analysis; effect sizes not quantified","Lack of detail on construct measurement quality","Potential omission of key confounds (e.g., moral incongruence, masturbation)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.20944/preprints202309.1963.v1"}},{"id":9129,"doi":"10.1002/hsr2.70977","pmid":"40636527","pmcid":"PMC12239039","title":"Design, Implementation, and Evaluation of an Electronic Course of Sexual Health Education for Young Adults (18-35 Years): An Exploratory Sequential Mixed-Methods Study Protocol","authors":"Borji-Navan S, Salehin S, Naseri-BooriAbadi T, Goli S, Mirghafourvand M.","first_author":"Borji-Navan S","journal":"Health science reports","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Sex Education","Sexual Health","Young Adult","Digital Health","Mixed‐Methods"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12239039","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"protocol for mixed‑methods study with planned RCT; no results yet","sample_n":null,"sample_text":"non‑medical science students at Guilan University (convenience sample)","population":"young adults (18‑35) Iranian university students (non‑medical)","country":"Iran","controls_mi":"not_applicable","preregistered":true,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers plan a mixed‑methods study to create and test an online sexual‑health course for Iranian young adults, using focus groups, a systematic review, and a future randomized trial.","clinical_takeaway":"None – the study is a protocol and provides no results yet.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Protocol is pre‑registered and follows CONSORT/PRISMA guidelines","Uses mixed‑methods to inform intervention design"],"limitations":["No empirical data yet – scores based on protocol","Convenience sample of university students limits generalisability"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/hsr2.70977"}},{"id":9130,"doi":"10.1186/s12978-024-01859-1","pmid":"39107772","pmcid":"PMC11304614","title":"Improving the sexual health of women with disabilities in sub-Saharan Africa: a scoping review of published studies","authors":"Bolarinwa OA, Odimegwu C, Tapera T.","first_author":"Bolarinwa OA","journal":"Reproductive health","year":2024,"pub_types":["Scoping Review","review-article","Journal Article"],"keywords":["Sub-Saharan Africa","Sexual Health","Scoping Review","Women With Disabilities","Improving"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11304614","cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Scoping review mapping 17 studies; descriptive synthesis without risk‑of‑bias assessment.","sample_n":null,"sample_text":"Seventeen primary studies (8 quantitative, 6 qualitative, 3 mixed‑methods) were included.","population":"Women with disabilities in sub‑Saharan Africa","country":"Various sub‑Saharan African countries (6)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review surveyed research on sexual activity, contraception, violence and risk among women with disabilities in sub‑Saharan Africa, finding few studies and many gaps, especially in sexual autonomy and risky behaviour.","clinical_takeaway":"Evidence on sexual health needs of disabled women in SSA is limited; clinicians should assess each domain individually and advocate for more research.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Comprehensive mapping of literature over 29 years","Uses established Arksey & O’Malley scoping framework","Identifies clear gaps (e.g., sexual autonomy)"],"limitations":["No quality appraisal of included studies","Limited to published literature; possible publication bias","Descriptive only – no quantitative synthesis"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-024-01859-1"}},{"id":9131,"doi":"10.1016/j.socscimed.2025.118249","pmid":"40449406","pmcid":null,"title":"Beyond dental dams: a critical review of recent research on lesbian, bisexual and queer women's sexual health","authors":"Power J, Grant R, Pym T, Gurtler P, Drysdale K, Mooney-Somers J.","first_author":"Power J","journal":"Social science & medicine (1982)","year":2025,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Narrative critical review of 91 publications (2012‑2023) using Bacchi's WPR framework; no primary data collection.","sample_n":null,"sample_text":"N/A (review of existing literature)","population":"LBQ+ women (lesbian, bisexual, queer and other sexuality‑diverse women) across studies reviewed","country":"Not applicable (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review examined research on lesbian, bisexual and queer women's sexual health, finding most studies assume sex with women is the primary activity and underestimate STI risk, despite many LBQ+ women also having sex with men. The authors call for future work that considers identity, pleasure, safety, and relational context throughout the life‑course.","clinical_takeaway":"Clinicians should avoid assuming low STI risk for LBQ+ women and assess each person's sexual practices and contexts individually.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Comprehensive literature coverage (91 studies)","Uses explicit critical framework (Bacchi's WPR)","Highlights gaps in assumptions about HIV/STI risk"],"limitations":["Narrative rather than systematic review; selection bias possible","No quantitative synthesis or meta‑analysis","No primary data; conclusions depend on quality of included papers"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.socscimed.2025.118249"}},{"id":9132,"doi":"10.1007/s00391-025-02463-z","pmid":"40691723","pmcid":null,"title":"[Mental diseases and sexual health in old age and their reciprocal influence]","authors":"Sträter B, Schröck F.","first_author":"Sträter B","journal":"Zeitschrift fur Gerontologie und Geriatrie","year":2025,"pub_types":["Review","Journal Article","English Abstract"],"keywords":["Depression","Sexual dysfunction","Anxiety Disorders","Somatoform Disorders","Stigmatization"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"ger","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review based on a selective literature search; no systematic methodology, no meta‑analysis, no primary data collection.","sample_n":null,"sample_text":"Not applicable – review of existing literature","population":"Older adults (general, not specific sample)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises how depression, anxiety and other mental illnesses in older people are linked to sexual problems, and how sexual difficulties can worsen mental distress, highlighting the need for integrated care.","clinical_takeaway":"Clinicians should routinely assess sexual health in older patients with mental disorders and consider medication side‑effects.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad overview of mental‑health–sexuality links in older adults","Incorporates pharmacological side‑effect considerations"],"limitations":["Not systematic; possible selection bias","No quantitative synthesis or appraisal of study quality","No primary data; limited ability to assess construct validity"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00391-025-02463-z"}},{"id":9133,"doi":"10.4102/safp.v66i1.5822","pmid":"38299528","pmcid":"PMC10839213","title":"Enhancing sexual health in primary care: Guidance for practitioners","authors":"Ramlachan P, Naidoo K.","first_author":"Ramlachan P","journal":"South African family practice : official journal of the South African Academy of Family Practice/Primary Care","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Screening","Sexual Health","Primary Healthcare","Sexual Dysfunctions","Gender-diverse"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10839213","cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"guidance article without original empirical data; no participants, no methods reported","sample_n":null,"sample_text":"none (article provides recommendations, not original data)","population":"primary care practitioners and patients in sub‑Saharan Africa (described conceptually)","country":"South Africa (implied by journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper offers practical advice for primary‑care doctors on how to talk about and treat sexual health problems, especially in Africa, using WHO definitions and DSM‑5 screening tools.","clinical_takeaway":"Clinicians should adopt non‑judgmental, gender‑inclusive sexual histories and use standard screening tools for sexual dysfunctions.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Addresses an under‑served area (sexual health in primary care)","Links screening to established DSM‑5 criteria and WHO definition"],"limitations":["No original data; purely narrative guidance","No empirical validation of recommended tools","Potential cultural generalisation beyond sub‑Saharan context"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4102/safp.v66i1.5822"}},{"id":9134,"doi":"10.1097/lgt.0000000000000851","pmid":"39704441","pmcid":null,"title":"The Influence of Genital Lichen Sclerosus on Sexual Health and Well-being: A Tripartite Comparative Analysis","authors":"Bettolini L, Bettolini L, Maione V, Arisi M, Rovaris S, Romanò C, Tomasi C, Calzavara-Pinton P, Zerbinati N, Bighetti S.","first_author":"Bettolini L","journal":"Journal of lower genital tract disease","year":2025,"pub_types":["Comparative Study","Multicenter Study","Journal Article","Observational Study"],"keywords":[],"is_oa":false,"oa_url":"https://journals.lww.com/jlgtd/fulltext/9900/the_influence_of_genital_lichen_sclerosus_on.146.aspx","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"multicenter observational comparative study with 176 participants (LS, pemphigus, healthy controls) using validated sexual function and QoL questionnaires","sample_n":176,"sample_text":"120 females and 56 males across three groups","population":"Adults (both sexes) with genital lichen sclerosus, pemphigus, or healthy controls; recruited from university hospitals in Italy","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People with genital lichen sclerosus report poorer sexual function, more pain, and higher psychological distress than those with pemphigus or no skin disease, especially women, and severity of the skin condition predicts worse sexual quality of life.","clinical_takeaway":"Lichen sclerosus should be assessed for its impact on sexual function and mental health as part of routine care.","confidence":0.8,"topic_tags":["gender","sexual_function","lgbtq"],"strengths":["Use of well‑validated sexual function and QoL instruments","Multicenter recruitment enhances diversity","Clear association between LS severity and sexual QoL"],"limitations":["Cross‑sectional design precludes causal inference","Limited control for key psychosocial confounds (e.g., moral incongruence, partnership status)","No power analysis or effect‑size reporting"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/lgt.0000000000000851"}},{"id":9135,"doi":"10.2196/81745","pmid":"41662502","pmcid":"PMC12885184","title":"Generative AI Chatbots as Digital Adjuncts for Sexual Health Information After Prostate Cancer in Men Who Have Sex With Men: Auto-Netnographic Study","authors":"Christiansen M, Eriksson H, Fagerström L.","first_author":"Christiansen M","journal":"JMIR cancer","year":2026,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Artificial intelligence","prostate cancer","Netnography","Sexual Minority Men","Auto-netnography","Generative Ai Chatbots"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12885184","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"auto‑netnography; single researcher interacted once with four generative AI chatbots using standardized prompts; thematic analysis of chatbot text.","sample_n":1,"sample_text":"One researcher (author) conducted the interactions; no human participant sample.","population":"male sexual minorities post‑prostate‑cancer (simulated mock patient; no real participants)","country":"Sweden (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The authors chatted with four popular AI chatbots using the same questions about sex after prostate cancer in gay men. They examined the bots' replies and found varied tones—from factual to compassionate—while generally using inclusive language, though some answers had minor inaccuracies.","clinical_takeaway":"AI chatbots may offer supportive, LGBTQI‑friendly information, but they cannot replace professional sexual‑health care after prostate cancer.","confidence":0.7,"topic_tags":["gender","sexual_function","lgbtq"],"strengths":["Innovative exploration of AI chatbots for LGBTQI+ sexual health","Systematic use of standardized prompts across multiple platforms","Qualitative depth with actor‑network theory framing"],"limitations":["Single‑author, single‑interaction data; no real‑world patient input","No assessment of clinical accuracy or safety","Findings not generalizable beyond the simulated scenario"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/81745"}},{"id":9137,"doi":"10.21203/rs.3.rs-885709/v1","pmid":null,"pmcid":null,"title":"Sexual health and behaviors in the COVID-19 pandemic era: a systematic review protocol","authors":"Qaderi K, Namadian M, Sharafkhani R, Rahmani N, Ezabadi SG, Kajbafvala M, Norouzi S, Motaqi M, Alkatout I, khodavirdilou R, Shamsabadi A, Mehraeen E.","first_author":"Qaderi K","journal":"Research Square","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":true,"oa_url":"https://www.researchsquare.com/article/rs-885709/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"protocol for a systematic review (no data yet)","sample_n":null,"sample_text":"","population":"general populations during COVID‑19 (no sample reported)","country":"","controls_mi":"not_applicable","preregistered":true,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This is a protocol for a systematic review that will examine how the COVID‑19 pandemic affected sexual health and behaviour across different groups. The authors will search several databases, screen studies, and assess quality using standard tools.","clinical_takeaway":"None – the review has not yet been conducted, so no clinical guidance can be drawn.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["Protocol follows PRISMA‑P and is registered in PROSPERO","Plans to use CASP tool for risk‑of‑bias assessment","Broad search strategy across multiple databases"],"limitations":["No empirical data yet – scores are based on protocol alone","No indication of how key constructs (e.g., pornography use) will be defined or measured","Potential for selection bias not assessable at this stage"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-885709/v1"}},{"id":9138,"doi":"10.1136/sextrans-2024-056236","pmid":"39266220","pmcid":"PMC12015010","title":"Preferences for sexual health services among middle-aged and older adults in the UK: a discrete choice experiment","authors":"Sakuma Y, Tieosapjaroen W, Wu D, Conyers H, Shakespeare T, Guigayoma J, Terris-Prestholt F, Pan SW, Tucker JD, Ong J, Kpokiri E.","first_author":"Sakuma Y","journal":"Sexually transmitted infections","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["epidemiology","Sexual Health","Health Services Research"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12015010","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Discrete choice experiment (DCE) survey of 200 UK adults aged 45+, online recruitment via Qualtrics; attributes derived from qualitative interviews; random‑parameter logit and latent‑class analysis.","sample_n":200,"sample_text":"200 respondents included in analysis","population":"Adults 45 years and older, UK (62.5 % female, 35.5 % disabled, 26 % sexual minority)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 200 UK adults aged 45+ examined what they value in sexual‑health services. People preferred face‑to‑face clinic visits, convenient locations and were willing to pay for private care, while extra support and consultation style mattered less.","clinical_takeaway":"Offer accessible, face‑to‑face sexual‑health clinics for older adults, as cost is less of a barrier than service mode.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Attributes grounded in qualitative interviews","Uses appropriate DCE modelling (random‑parameter logit, latent class)","Provides actionable service‑delivery insights"],"limitations":["Convenience online sample; limited generalisability","No pre‑registration or power justification reported","No assessment of potential confounders (e.g., health status, attitudes)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sextrans-2024-056236"}},{"id":9139,"doi":"10.3389/fsoc.2024.1498969","pmid":"39735614","pmcid":"PMC11671811","title":"Intimate partner violence and its relation to sexual health outcomes across different adult populations: a systematic review","authors":"Calvillo C, Marshall A, Gafford S, Montgomery BEE.","first_author":"Calvillo C","journal":"Frontiers in sociology","year":2024,"pub_types":["Systematic Review","systematic-review","Journal Article"],"keywords":["Gender","Systematic review","Sexual Health","Sexual Orientation","Intimate Partner Violence"],"is_oa":true,"oa_url":"https://doi.org/10.3389/fsoc.2024.1498969","cited_by_count":12,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 27 peer‑reviewed articles (2014‑2024) following PRISMA; quality assessment performed.","sample_n":null,"sample_text":"27 articles included; no primary participant count provided.","population":"Adults (18+), primarily cisgender heterosexual women; limited men, MSM, transgender participants.","country":"Multiple (global literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 27 studies found that intimate partner violence is linked to poorer sexual health, including more STIs, unintended pregnancies, and lower sexual satisfaction, especially among cisgender heterosexual women.","clinical_takeaway":"Clinicians should screen for IPV when addressing sexual health concerns, as violence significantly worsens outcomes.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive PRISMA‑based search across a decade.","Inclusion of diverse adult populations.","Use of validated instruments in primary studies."],"limitations":["Predominance of cis‑heterosexual women limits generalisability.","No quantitative meta‑analysis; effect sizes not pooled.","Potential publication bias not assessed."],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fsoc.2024.1498969"}},{"id":9141,"doi":"10.21203/rs.3.rs-4125234/v1","pmid":null,"pmcid":null,"title":"Training needs of German healthcare professionals regarding sexual health and sex workers: Results of a nationwide, cross-sectional survey","authors":"Reinehr S, Neuendorff NR, Veen R, Langenbach BP, Thieme A.","first_author":"Reinehr S","journal":"Research Square","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-4125234/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of physicians, psychotherapists, and medical students (N≈347)","sample_n":347,"sample_text":"130 physicians, 63 psychotherapists, 154 medical students","population":"German healthcare professionals and students","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A nationwide German survey of doctors, psychotherapists and medical students found many feel their training on sexual health and on caring for sex‑workers is insufficient, even though most feel comfortable handling these topics.","clinical_takeaway":"Training curricula for German health professionals should be expanded to better cover sexual health and sex‑worker care.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large total sample covering three professional groups","Focus on an under‑researched area (sex‑worker health training)","Clear quantitative findings on perceived training gaps"],"limitations":["Self‑report measures likely single‑item and not validated","Convenience online sampling limits generalisability","No objective assessment of competence"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-4125234/v1"}},{"id":9142,"doi":"10.1093/jsxmed/qdae145","pmid":"39545356","pmcid":null,"title":"\"No doctor ever asked me…so I thought it wasn't a valid concern\": endometriosis patients' perspectives of barriers and facilitators to sexual health communication in general practice","authors":"Davenport RA, Mills J, McHardy H, Lores T, Sherman K, Misajon R, Van Niekerk L.","first_author":"Davenport RA","journal":"The journal of sexual medicine","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual function","Endometriosis","Qualitative","General Practice","Healthcare","Sexual Health Communication"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative study using thematic template analysis of open‑ended responses from an online survey (N=141)","sample_n":141,"sample_text":"141 participants provided free‑text responses; convenience, self‑selected sample","population":"individuals with endometriosis (mostly female, adult, UK likely) recruited via an online survey","country":"Not stated (likely UK based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"People with endometriosis say GPs often miss their sexual‑health concerns. Four groups of barriers – system, doctor, patient, and interaction – and matching facilitators were identified, suggesting the need for better GP training and communication tools.","clinical_takeaway":"Clinicians should proactively ask about sexual health with endometriosis patients and use structured communication aids.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large qualitative sample for this method","Thematic analysis provides depth of patient perspective","Identifies practical recommendations for GP education"],"limitations":["Convenience, self‑selected sample likely over‑represents those with high sexual dysfunction","No GP viewpoints were collected","Findings may not generalise beyond the surveyed population"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdae145"}},{"id":9143,"doi":"10.2471/blt.23.291163","pmid":"39611188","pmcid":"PMC11601179","title":"Progress towards sustainable development goals related to sexual health","authors":"Owolabi OO, Hopkins J, Bankole A, Bearak J.","first_author":"Owolabi OO","journal":"Bulletin of the World Health Organization","year":2024,"pub_types":["other","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11601179","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"commentary/analysis of indicator frameworks; no primary data","sample_n":null,"sample_text":"None – no empirical participants","population":"global, policy‑level focus","country":"global","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews current global indicators used to monitor sexual health in the Sustainable Development Goals, finds many gaps, and suggests new measures to better track progress for all genders and subpopulations.","clinical_takeaway":"None – the article is a policy overview, not a clinical study.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Comprehensive review of existing SDG indicators","Clear identification of gaps across sexual health components","Uses established Guttmacher‑Lancet framework for categorisation"],"limitations":["No primary data; purely descriptive","No empirical testing of proposed indicators","Limited discussion of measurement validity for sexual‑health constructs"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2471/blt.23.291163"}},{"id":9145,"doi":"10.1177/15248399231171145","pmid":"37166152","pmcid":"PMC11161910","title":"Addressing Gendered Racism Against Black Girls Using a Strengths-Based Empowerment-Intersectional Framework for Sexual Health and Substance Use Prevention Programming","authors":"Opara I, Martin R, Hill AV, Calhoun A.","first_author":"Opara I","journal":"Health promotion practice","year":2023,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual Health","Substance Use","Child/adolescent Health","Black/african Americans"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"conceptual framework paper; no empirical sample or data","sample_n":null,"sample_text":"None (conceptual paper)","population":"Black girls (adolescents); no sample size reported","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose a strengths‑based, intersectional framework to improve sexual health and prevent substance use among Black girls, emphasizing empowerment, positive racial identity, and counter‑acting gendered racism.","clinical_takeaway":"Use culturally‑grounded, empowerment‑focused programs when addressing sexual health and substance‑use risk with Black girls.","confidence":0.8,"topic_tags":["sexual_function","religiosity","moral_incongruence"],"strengths":["Integrates intersectionality and empowerment theory","Focuses on strengths rather than deficits","Developed with community input"],"limitations":["No empirical data to test the framework","Does not address measurement of key constructs","Limited generalizability beyond Black girls"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/15248399231171145"}},{"id":9146,"doi":"10.1071/sh24093","pmid":"40418725","pmcid":null,"title":"Barriers and facilitators to accessing sexual health services among middle-aged and older adults in the UK, including those with disabilities: a qualitative analysis","authors":"Letley C, Kritzer I, Sakuma Y, Conyers H, Randazzo S, Ong JJ, Day S, Wu D, Terris-Prestholt F, Tucker JD, Kpokiri EE.","first_author":"Letley C","journal":"Sexual health","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Semi‑structured interviews with 22 community‑recruited older adults (45+), thematic analysis using Levesque et al.'s access framework.","sample_n":22,"sample_text":"22 participants (15 men, 7 women) recruited via social media, primary‑care clinics and community organisations.","population":"Middle‑aged and older adults (mean age 59) in England, including disabled persons and sexual minorities.","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 22 older UK adults, including people with disabilities and sexual minorities, reveal that physical obstacles and stigma—especially assumptions that older people are asexual—keep many from using sexual‑health services. Participants suggest better facility design and staff training to improve access.","clinical_takeaway":"Clinicians should recognise and address physical and attitudinal barriers when offering sexual‑health services to older adults, especially those with disabilities.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides in‑depth perspectives from a diverse older adult sample","Uses a recognised health‑access framework for analysis","Highlights intersectional issues (disability, sexual minority status)"],"limitations":["Small, non‑probability sample limits generalisability","No quantitative measurement of barriers or facilitators","Potential self‑selection bias from recruitment channels"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh24093"}},{"id":9147,"doi":"10.7759/cureus.77851","pmid":"39991330","pmcid":"PMC11845324","title":"Association of Sexual Health and Mental Health in Erectile Dysfunction: Expert Opinion From the Indian Context","authors":"Vasan SS, Pandey S, Rao STS, Gupte DM, Gangavaram RR, Saxena A, Kovil R, Joshi P, Goel R, Mittal SK, Neogi R, Joseph SP, Shah D, Khan Z.","first_author":"Vasan SS","journal":"Cureus","year":2025,"pub_types":["review-article","Review","Journal Article"],"keywords":["Depression","Anxiety","endothelial dysfunction","Mental health","erectile dysfunction","Phosphodiesterase-5 Inhibitors","Diabetes Mellitus-induced Erectile Dysfunction","Psychosexual Therapy"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11845324","cited_by_count":13,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"expert opinion / modified Delphi consensus, no primary data","sample_n":null,"sample_text":"No empirical participant sample; consensus derived from 12 experts.","population":"India, adult men with erectile dysfunction (expert panel, no participant sample)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Indian experts advise that erectile dysfunction often co‑occurs with anxiety or depression. They recommend doctors assess mental health, discuss sexual concerns openly, and combine medication with psychosexual therapy for better outcomes.","clinical_takeaway":"Screen men with erectile dysfunction for depression/anxiety and consider combined medical‑psychological treatment.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Multidisciplinary expert panel (urology & psychiatry)","Integrates psychosexual therapy with medical treatment","Provides practical recommendations for clinicians"],"limitations":["No primary empirical data; consensus based on expert opinion","Lacks systematic review methodology (no PRISMA, risk‑of‑bias assessment)","No measurement of key confounds (e.g., relationship factors, mental‑health covariates)"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.77851"}},{"id":9148,"doi":"10.1016/j.ejogrb.2024.02.037","pmid":"38484617","pmcid":null,"title":"Postpartum care: Clinical considerations for improving genital and sexual health","authors":"Graziottin A, Di Simone N, Guarano A.","first_author":"Graziottin A","journal":"European journal of obstetrics, gynecology, and reproductive biology","year":2024,"pub_types":["Review","Journal Article"],"keywords":["Postpartum","Sexual Health","Female Sexual Dysfunctions","Women’s Health","Intimate Hygiene","Dyspareunia/sexual Pain"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review summarising clinical considerations; no primary data collected.","sample_n":null,"sample_text":"No primary sample – review of existing literature and guidelines.","population":"post‑partum women (general)","country":"International (global guidelines referenced)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review outlines common genital and sexual problems after childbirth, such as pain and hygiene issues, and offers clinicians practical guidance for diagnosis, pelvic‑floor care, and emotional support to improve women's sexual well‑being.","clinical_takeaway":"Screen postpartum patients for genital pain and hygiene concerns; offer pelvic‑floor rehab and tailored sexual‑health counselling.","confidence":0.6,"topic_tags":["sexual_function","gender","religiosity"],"strengths":["Comprehensive synthesis of postpartum sexual health issues","Practical clinical recommendations","Highlights gaps in provider‑patient communication"],"limitations":["Narrative, not systematic, methodology","No empirical data; conclusions rely on cited literature","Potential bias from author perspectives"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ejogrb.2024.02.037"}},{"id":9149,"doi":"10.1016/j.soin.2024.12.004","pmid":"39952724","pmcid":null,"title":"[Sexual health, the forgotten factor in the overall health of people with severe mental disorders]","authors":"Martinez J.","first_author":"Martinez J.","journal":"Soins; la revue de reference infirmiere","year":2025,"pub_types":["Journal Article","English Abstract"],"keywords":["Prevention","Psychiatry","Mental health","Sexual Health","Parenting","Prévention","Santé Mentale","Psychiatrie","Severe Mental Disorder","Parentalité","Santé Sexuelle","Trouble Mental Sévère"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"No empirical sample reported; article is a narrative exploration of sexual‑health issues.","population":"people with severe mental disorders","country":"France (journal published in French)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how people with severe mental disorders often face unmet sexual‑health needs, suggesting that clinicians should pay more attention to this aspect of overall wellbeing.","clinical_takeaway":"Clinicians should routinely assess sexual health in patients with severe mental illness.","confidence":0.8,"topic_tags":[],"strengths":["Addresses an under‑studied population","Highlights importance of sexual health in mental‑health care"],"limitations":["No empirical data or systematic review methodology","No measurement of sexual‑behaviour variables","No assessment of confounding factors"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.soin.2024.12.004"}},{"id":9150,"doi":"10.2147/ijwh.s464129","pmid":"39100112","pmcid":"PMC11298183","title":"Exploring the Intersection of Depression, Anxiety, and Sexual Health in Perimenopausal Women","authors":"Saleh SA, Almadani N, Mahfouz R, Nofal HA, El-Rafey DS, Seleem DA.","first_author":"Saleh SA","journal":"International journal of women's health","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Depression","Anxiety","Sexual dysfunction","Perimenopausal"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11298183","cited_by_count":11,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 149 perimenopausal women using validated questionnaires","sample_n":149,"sample_text":"149 females aged 45‑55 years","population":"perimenopausal women, age 45‑55, Arabic‑speaking","country":"unspecified (Arabic‑language questionnaire suggests Middle‑East)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among women going through menopause, higher anxiety and depression were linked to poorer sexual function, suggesting mental health and hormonal changes together affect sexual wellbeing.","clinical_takeaway":"Screen perimenopausal patients for anxiety and depression to better address sexual dysfunction.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of validated Arabic versions of MRS, FSFI, and HADS","Reasonable sample size for a cross‑sectional survey","Clear statistical reporting of correlations"],"limitations":["Cross‑sectional design prevents causal inference","No assessment of partner or relationship factors","Moral or trauma-related confounds not measured"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/ijwh.s464129"}},{"id":9151,"doi":"10.1177/17455057241247747","pmid":"38682301","pmcid":"PMC11057352","title":"Love (and) ageing well: A qualitative study of sexual health in the context of ageing well among women aged 50 and over","authors":"Patterson S, Jehan K.","first_author":"Patterson S","journal":"Women's health (London, England)","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Women","Public Health","Sexual Health","Qualitative Research","Ageing Well"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11057352","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"semi‑structured interviews with 21 women aged 52‑76 recruited via community organisations; framework thematic analysis","sample_n":21,"sample_text":"21 English‑speaking women aged 52‑76 recruited through community organisations in North West England","population":"women, 50+, England, community sample","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 21 women aged 50+ in England show that sexual health is viewed as an important part of ageing well, but clinical discussions often focus on disease rather than wellbeing. Women want holistic, person‑centred sexual‑health services that respect diverse expressions and life contexts.","clinical_takeaway":"Clinicians should frame sexual‑health conversations around overall wellbeing and individual preferences, not solely disease, for older women.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["In‑depth, participant‑led insights into sexual health in later life","Clear feminist, affirmative ageing framework","Use of framework analysis for systematic theme generation"],"limitations":["Small, non‑representative sample (n=21) limits generalisability","No validated measurement of sexual health constructs; reliance on self‑report narratives","No assessment of key confounds (e.g., mental health, relationship status)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/17455057241247747"}},{"id":9152,"doi":"10.1089/lgbt.2023.0146","pmid":"38301144","pmcid":null,"title":"Factors Associated with Transgender and Gender Diverse People's Experience of Sexual Coercion, and Help-Seeking and Wellbeing Among Victims/Survivors: Results of the First Australian Trans and Gender Diverse Sexual Health Survey","authors":"Simpson PL, Callander D, Haire B, Pony M, Rosenberg S, Duck-Chong L, Holt M, Cook T.","first_author":"Simpson PL","journal":"LGBT health","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Transgender","Psychological Distress","Wellbeing","Help-seeking","Sexual Coercion","Gender Diverse"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 1448 Australian trans and gender diverse adults; logistic regression analysis of self‑reported sexual coercion, help‑seeking and wellbeing","sample_n":1448,"sample_text":"first Australian Trans and Gender Diverse Sexual Health Survey (2018)","population":"transgender and gender diverse adults in Australia (N=1448)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A national Australian survey of 1,448 transgender and gender‑diverse adults found that over half had experienced sexual coercion. Older age, Indigenous background, non‑binary identity and drug use increased risk, while higher income and gender‑affirming care were protective. About half of those affected sought help, and better wellbeing was linked to socioeconomic advantages and satisfaction with sex life.","clinical_takeaway":"Trans individuals facing sexual coercion benefit from socioeconomic support, gender‑affirming care and peer networks; help‑seeking remains low.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Large sample for a marginalized population","Relevant demographic and socioeconomic variables included","Focus on help‑seeking and wellbeing outcomes"],"limitations":["Cross‑sectional design limits causal inference","Limited control for mental‑health or trauma confounds","Reliance on self‑report measures without validation detail"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/lgbt.2023.0146"}},{"id":9153,"doi":"10.3390/healthcare11233025","pmid":"38063593","pmcid":"PMC10706599","title":"Sexual Health and Psychological Well-Being of Women: A Systematic Review","authors":"Arcos-Romero AI, Calvillo C.","first_author":"Arcos-Romero AI","journal":"Healthcare (Basel, Switzerland)","year":2023,"pub_types":["review-article","Review","Journal Article"],"keywords":["Women","Systematic review","Sexual Health","Psychological Well-being"],"is_oa":true,"oa_url":"https://www.mdpi.com/2227-9032/11/23/3025/pdf?version=1700720854","cited_by_count":21,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of observational studies (cross‑sectional and cohort) on female sexual functioning and psychological well‑being, PRISMA‑guided, quality assessed with QAT‑OCCS, no meta‑analysis.","sample_n":null,"sample_text":"14 primary studies included; 42.9% clinical samples","population":"Adult women (studies published 2010‑2023); includes both community and clinical samples.","country":"International (databases searched worldwide)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 14 studies found that women's psychological well‑being—especially anxiety and depression—is linked to how they experience sexual functioning.","clinical_takeaway":"Clinicians should consider mental‑health status when addressing female sexual health concerns.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["PRISMA‑guided systematic search across multiple databases","Quality appraisal of included studies","Identifies consistent association between well‑being and sexual health"],"limitations":["No quantitative synthesis (meta‑analysis)","Limited detail on how constructs were measured across primary studies","No assessment of key sexual‑health confounds (e.g., masturbation, moral factors)","Potential bias from inclusion of many clinical samples"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/healthcare11233025"}},{"id":9154,"doi":"10.1089/whr.2023.0089","pmid":"38404678","pmcid":"PMC10890937","title":"The Impacts of Lifetime Violence on Women's Current Sexual Health","authors":"Güler A, Maas MK, Mark KP, Kussainov N, Schill K, Coker AL.","first_author":"Güler A","journal":"Women's health reports (New Rochelle, N.Y.)","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Child Abuse","Sexual Health","Intimate Partner Violence","Lifetime Violence"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10890937","cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"large community registry, cross‑sectional multivariate analysis of covariance","sample_n":1213,"sample_text":"Women from the Wellness, Health and You registry","population":"1213 adult women from a health registry","country":"unspecified (likely USA based on journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,200 women, those who had experienced any form of lifetime violence (partner abuse, non‑partner assault, or childhood abuse) reported lower sexual satisfaction, though their sexual interest, function, and assertiveness were not different.","clinical_takeaway":"Screen for histories of violence when addressing women’s sexual satisfaction concerns.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large, well‑powered sample","Validated PROMIS sexual health instruments","Multivariate analysis adjusts for key demographics"],"limitations":["Cross‑sectional; cannot infer causality","No control for mental‑health, moral incongruence, or masturbation variables","Effect sizes not reported in abstract"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/whr.2023.0089"}},{"id":9155,"doi":"10.1097/jnc.0000000000000494","pmid":"39145669","pmcid":"PMC11661567","title":"Sexual Health Implications of Return Migration for Women and Their Partners in Rural Mexico: A Critical Ethnography","authors":"Fernandez-Sanchez H, Rocha-Fernandez M, Salma J, Santa Maria DM, Benavides-Torres RA, Salami B.","first_author":"Fernandez-Sanchez H","journal":"The Journal of the Association of Nurses in AIDS Care : JANAC","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.1097/jnc.0000000000000494","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"critical ethnography with participant observation, policy analysis, and semi-structured interviews; purposive and snowball sampling of 50 participants in a rural Mexican community.","sample_n":50,"sample_text":"20 women who stayed behind, 12 returnees, 12 community leaders, 6 health‑care professionals; purposive and snowball sampling.","population":"Women who stayed behind after male partners migrated, return migrants, community leaders, health-care professionals in rural Mexico (N=50).","country":"Mexico","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"This ethnographic study of a rural Mexican community finds that when migrant men return home, women left behind often experience economic strain, emotional distress, and concerns about risky sexual behavior, highlighting a need for targeted health support.","clinical_takeaway":"Clinicians should consider the broader relational and economic context when addressing sexual health concerns of women in migrant‑return settings.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["In‑depth, context‑rich qualitative data","Multiple stakeholder perspectives","Focus on an under‑studied population"],"limitations":["Non‑probability, snowball sampling limits generalisability","No validated measurement instruments for sexual‑health outcomes","Potential researcher bias inherent in critical ethnography"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/jnc.0000000000000494"}},{"id":9156,"doi":"10.1016/j.jacadv.2023.100716","pmid":"38938496","pmcid":"PMC11198306","title":"Sexual Health and Well-Being in Adults With Congenital Heart Disease: A International Society of Adult Congenital Heart Disease Statement","authors":"Swan L, Windram J, Burchill L, Ladak LA, Reardon LC, Fernandez B, Jacobsen RM, Simpson M, Harrison D, Morton L.","first_author":"Swan L","journal":"JACC. Advances","year":2023,"pub_types":["review-article","Review","Journal Article"],"keywords":["Gender","Contraception","Sexual Health","Advocacy","Adult Congenital Heart Disease"],"is_oa":true,"oa_url":"https://ars.els-cdn.com/content/image/1-s2.0-S2772963X23007378-ga1_lrg.jpg","cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review-statement without new empirical data, no sample","sample_n":null,"sample_text":"not applicable (review article)","population":"adults with congenital heart disease (clinical focus)","country":"International (multiple centers likely)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The statement outlines how adults with congenital heart disease often face unique challenges to a satisfying sexual life, discusses the physical and psychosocial benefits of sexual well‑being, and proposes ways clinicians can better support these patients.","clinical_takeaway":"Clinicians should proactively address sexual health with congenital heart patients and provide tailored counseling.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of sexual health barriers in a specific patient group","Authored by multidisciplinary experts in adult congenital heart disease","Highlights need for clinical advocacy and allyship"],"limitations":["No original data; conclusions based on expert consensus","Lacks systematic review methodology (no risk‑of‑bias assessment)","Does not address pornography, masturbation, or CSBD topics directly"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jacadv.2023.100716"}},{"id":9158,"doi":"10.1080/13697137.2024.2302429","pmid":"38251874","pmcid":null,"title":"Obesity and sexual health: focus on postmenopausal women","authors":"Barbagallo F, Cucinella L, Tiranini L, Chedraui P, Calogero AE, Nappi RE.","first_author":"Barbagallo F","journal":"Climacteric : the journal of the International Menopause Society","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Obesity","Sexual function","Overweight","menopause","Female Sexual Dysfunction","Anti-obesity Interventions"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review","sample_n":null,"sample_text":"n/a (review)","population":"postmenopausal women (obesity related)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review summarises how obesity may worsen sexual function in post‑menopausal women, highlighting biological pathways like inflammation and blood‑flow problems, as well as psychological factors such as body image and mood. It notes the scarcity of rigorous studies and calls for research using validated measures.","clinical_takeaway":"Clinicians should consider weight‑related health factors when evaluating sexual problems in post‑menopausal women, but evidence for specific interventions remains limited.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of biological and psychosocial links between obesity and FSD","Identifies gaps in high‑quality empirical research"],"limitations":["Narrative (non‑systematic) review lacks systematic search and bias assessment","No original data; relies on heterogeneous studies with variable measurement quality"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13697137.2024.2302429"}},{"id":9159,"doi":"10.1007/s10461-025-04806-8","pmid":"40514638","pmcid":"PMC12500774","title":"HIV-related Stigma among People with HIV in Denmark and its Association with Psychosocial and Sexual Health: a cross-sectional Nationwide Study","authors":"Scofield D, Weis N, Meddis A, Storgaard M, Pedersen G, Johansen IS, Katzenstein TL, Graugaard C, Omland LH, Frisch M, Moseholm E.","first_author":"Scofield D","journal":"AIDS and behavior","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["HIV","Mental health","Sexual Health","Hiv-related Stigma"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12500774","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Nationwide survey of 630 people with HIV in Denmark, sex‑stratified linear and logistic regression analyses.","sample_n":630,"sample_text":"A cross‑sectional nationwide survey (SHARE study) conducted 2021‑2022.","population":"people with HIV in Denmark (486 men, 144 women)","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A Danish nationwide survey of 630 people with HIV found that most experience anticipated stigma, which is linked to loneliness, anxiety, depression and lower sexual desire, highlighting the broad psychosocial impact of HIV‑related stigma.","clinical_takeaway":"Clinicians should assess and address HIV‑related stigma, as it correlates with mental‑health issues and reduced sexual desire.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large, nationwide sample","Validated stigma questionnaire","Sex‑stratified analysis","Adjustment for several sociodemographic confounders"],"limitations":["Cross‑sectional; no causal inference","Potential self‑report bias","Limited control of psychosocial confounds (e.g., trauma)","No pre‑registration"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-025-04806-8"}},{"id":9160,"doi":"10.2196/54565","pmid":"39496164","pmcid":"PMC11574491","title":"User Views on Online Sexual Health Symptom Checker Tool: Qualitative Research","authors":"King AJ, Bilardi JE, Towns JM, Maddaford K, Fairley CK, Chow EPF, Phillips TR.","first_author":"King AJ","journal":"JMIR formative research","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["sexually transmitted diseases","risk assessment","risk factors","Sexual Health","Health Literacy","Help-seeking Behavior","Information Seeking Behavior","Smartphone Apps"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11574491","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interviews (n=14) with users of an online STI risk assessment tool","sample_n":14,"sample_text":"14 interview participants who trialed the iSpySTI tool","population":"individuals presenting with urogenital symptoms at a specialist sexual health clinic","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Fourteen people who had urogenital symptoms tried an online tool that predicts likely causes of their symptoms. Interviews showed they trusted the probabilistic information, felt reassured while waiting for care, and sometimes changed how quickly they sought treatment.","clinical_takeaway":"Online risk‑assessment tools can provide trusted, reassuring information that may improve help‑seeking for STI symptoms.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Novel user‑centred evaluation of a Bayesian symptom‑checker","Rich qualitative insights into emotional impact","Actionable feedback for tool improvement"],"limitations":["Very small, clinic‑based convenience sample (n=14)","No quantitative outcome measures or validation of interview guide","Findings may not generalise to broader populations or asymptomatic users"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/54565"}},{"id":9161,"doi":"10.1186/s12909-024-06551-3","pmid":"39736613","pmcid":"PMC11686851","title":"Training needs of German healthcare professionals regarding sexual health and sex workers: results of a nationwide, cross-sectional survey","authors":"Reinehr S, Neuendorff NR, van der Veen R, Langenbach BP, Thieme A.","first_author":"Reinehr S","journal":"BMC medical education","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Physicians","Medical education","Germany","Medical Students","Personalized Medicine","Medical Training","Psychotherapists","Attitudes Of Healthcare Personnel"],"is_oa":true,"oa_url":"https://bmcmededuc.biomedcentral.com/counter/pdf/10.1186/s12909-024-06551-3","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online nationwide survey of physicians, psychotherapists, and medical students (N≈347) assessing perceived training quality and comfort with sexual health and sex‑worker care.","sample_n":347,"sample_text":"130 physicians, 63 psychotherapists, 154 medical students","population":"German healthcare professionals (physicians, psychotherapists, medical students)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A German survey of doctors, psychotherapists and medical students found many feel their education on sexual health and caring for sex workers is insufficient, even though most feel comfortable handling these topics. Better training may be needed.","clinical_takeaway":"Clinicians should recognise potential gaps in their sexual‑health training, especially regarding sex‑worker care, and seek further education.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, multi‑professional sample","Addresses a gap in medical education","Clear correlation between perceived training and self‑reported comfort"],"limitations":["Self‑report measures not validated","Convenience sample, possible selection bias","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12909-024-06551-3"}},{"id":9162,"doi":"10.3389/fpubh.2023.1305874","pmid":"38283290","pmcid":"PMC10811606","title":"Proof of concept of a sexual health outreach program led by community health workers in homeless hostels in the greater Paris region","authors":"Vaugoyeau E, Rambliere L, David M, Lemguarni H, Le Gac S, Pasquet-Cadre A, Rasli S, Ghosn J, Rozenbaum W, Bouvet E, Prioux M.","first_author":"Vaugoyeau E","journal":"Frontiers in public health","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Screening","Sexual Health","Outreach","Homeless","Community Health Workers (Chw)","Precarity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10811606","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Implementation feasibility study with mixed quantitative and qualitative methods in 12 homeless hostels; 572 participants engaged in workshops and STI screening over 8 weeks.","sample_n":572,"sample_text":"542 women and 30 men attended workshops; 150 individuals were screened for HIV/HBV/HCV.","population":"Adults residing in homeless hostels in the greater Paris region (predominantly women).","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A community‑health‑worker program in Paris homeless shelters offered sexual‑health workshops and rapid STI testing. Over 570 people attended, with high satisfaction and a modest number testing positive for hepatitis. The study shows the approach is feasible and may improve health‑seeking among a hard‑to‑reach group.","clinical_takeaway":"Outreach with CHWs can successfully deliver STI screening and education to homeless adults, but evidence of health impact beyond feasibility is limited.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample for a hard‑to‑reach population","Mixed‑methods approach provides quantitative and qualitative insight","Clear feasibility outcomes (participation, satisfaction, test positivity)"],"limitations":["No control/comparison group; cannot infer effectiveness beyond feasibility","Convenience sample; limited generalisability to other homeless contexts","No formal power calculation or statistical testing beyond descriptive rates"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2023.1305874"}},{"id":9163,"doi":"10.1002/hsr2.70587","pmid":"40124925","pmcid":"PMC11925810","title":"Effectiveness of Low-Cost, Virtual Sexual Health Education and Educational Leaflets on Reducing Anxiety and Enhancing Sexual Function Among Infertile Women: A Pilot Randomized Controlled Trial","authors":"Karimi M, Heshmatnia F, Azima S, Akbarzadeh M, Thapa S.","first_author":"Karimi M","journal":"Health science reports","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Infertility","Anxiety","Sexual dysfunction","Virtual Education","Sexual Health Education","Pilot Randomized Controlled Trial"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11925810","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"pilot triple‑blind randomized controlled trial with 90 infertile women allocated to three arms (control, booklet, virtual education)","sample_n":90,"sample_text":"90 women randomized (≈30 per group)","population":"infertile women seeking treatment in Iran (n=90)","country":"Iran","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A small randomized trial in Iran found that virtual sexual‑health education or written booklets lowered anxiety and improved aspects of sexual function in women undergoing infertility treatment, compared with a control group.","clinical_takeaway":"Brief psycho‑educational programs may help reduce anxiety and boost sexual function for women facing infertility, but larger trials are needed.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Randomized, triple‑blind design","Use of validated anxiety and sexual‑function questionnaires","Registered trial protocol"],"limitations":["Small pilot sample; under‑powered for definitive conclusions","No effect‑size reporting or confidence intervals","Limited to infertile women in a single cultural setting"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/hsr2.70587"}},{"id":9164,"doi":"10.1186/s12889-025-21896-0","pmid":"40011831","pmcid":"PMC11863530","title":"Casual association between social determinants of health and sexual health literacy in reproductive-aged women: a WHO model analysis","authors":"Vakili F, Nasiri M, Hamzehgardeshi Z, Jahanfar S, Mahmoodi Z, Alamolhoda SH.","first_author":"Vakili F","journal":"BMC public health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Socioeconomic status","Education","Intimate Partner Violence","Social Determinants Of Health","Perceived Social Support","Sexual Health Literacy"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11863530","cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 600 married women attending health centres in Tehran; path analysis used to model associations between social determinants and sexual health literacy.","sample_n":600,"sample_text":"600 married women referred to health centres in Tehran, Iran (2024)","population":"married, reproductive‑aged women (Iran)","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among 600 married Iranian women, higher perceived social support and higher spouse education were linked to better sexual‑health knowledge, while experiencing domestic violence reduced it. Socio‑economic status also helped indirectly.","clinical_takeaway":"Improving partner support and addressing violence may boost women’s sexual health knowledge.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample (n=600) for a cross‑sectional survey","Use of path analysis to examine direct and indirect effects","Inclusion of multiple social‑determinant variables"],"limitations":["Cross‑sectional design limits causal inference","No information on validation of the sexual health literacy instrument","Convenience sample from health centres limits generalisability"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-025-21896-0"}},{"id":9165,"doi":"10.2471/blt.24.291565","pmid":"39611198","pmcid":"PMC11601183","title":"Associations between sexual health and well-being: a systematic review","authors":"Vasconcelos P, Carrito ML, Quinta-Gomes AL, Patrão AL, Nóbrega CA, Costa PA, Nobre PJ.","first_author":"Vasconcelos P","journal":"Bulletin of the World Health Organization","year":2024,"pub_types":["Systematic Review","review-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11601183","cited_by_count":55,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 63 studies following PRISMA; risk of bias assessed with ROBINS-E tool.","sample_n":63,"sample_text":"63 included studies","population":"Adults of various ages, sexes, and relationship types across included studies.","country":"Various (global literature)","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 63 studies found that better sexual health is linked to lower depression and anxiety, higher quality of life, and greater life satisfaction across diverse adult groups.","clinical_takeaway":"Promoting positive sexual health may improve overall well‑being, but clinicians should consider individual contexts and co‑occurring factors.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Comprehensive literature search across multiple databases","Adherence to PRISMA guidelines","Risk of bias assessment performed"],"limitations":["No meta‑analysis; effect sizes not quantified","Potential lack of control for key confounds (e.g., moral incongruence, masturbation)","Broad inclusion of heterogeneous measures of sexual health"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":28,"citing_publications":105,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2471/blt.24.291565"}},{"id":9166,"doi":"10.1071/sh22159","pmid":"37271580","pmcid":null,"title":"Understanding the health care needs of transgender and gender diverse people engaging with rural Australian sexual health centres: a qualitative interview study","authors":"Del Tufo A, Foster R, Haire B, Newman CE, Smith AKJ, Crowley M, Burn D, McNulty A.","first_author":"Del Tufo A","journal":"Sexual health","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.publish.csiro.au/sh/pdf/SH22159","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative interview study with 21 participants recruited from two regional sexual health centres; reflexive thematic analysis.","sample_n":21,"sample_text":"21 trans participants recruited via two regional sexual health centres.","population":"Transgender and gender diverse people living in regional or rural Australia (N=21).","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 21 transgender people living in rural Australia show that health and wellbeing are shaped by both supportive sexual‑health services and challenges such as stigma, isolation, and limited jobs. Good care can offset many rural disadvantages.","clinical_takeaway":"Rural trans patients benefit from inclusive sexual‑health services; clinicians should address isolation and stigma alongside medical care.","confidence":0.8,"topic_tags":["sexual_function","gender","religiosity","moral_incongruence","masturbation"],"strengths":["Provides rare qualitative insight into rural trans health needs.","Direct recruitment from sexual health centres ensures relevance to service delivery."],"limitations":["Small, non‑representative convenience sample.","No validated measures of health or wellbeing; reliance on thematic analysis only.","Findings may not generalise beyond the two participating clinics."],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh22159"}},{"id":9167,"doi":"10.1057/s41599-023-01669-z","pmid":"37128300","pmcid":"PMC10130309","title":"Developing and validating the Sexual Health Literacy Scale in an Iranian adult sample","authors":"Rashidi K, Watson P, Farahani H, Chesli RR, Abiri FA.","first_author":"Rashidi K","journal":"Humanities & social sciences communications","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Humanities","Health Humanities"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10130309","cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Scale development and validation using exploratory and confirmatory factor analysis on two university samples (N=595 split, plus N=221 for CFA).","sample_n":595,"sample_text":"Convenience sample of university students; split‑sample for EFA and validation; additional cross‑validation sample of 221 students.","population":"Iranian university students","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and tested a 106‑item questionnaire to measure how well Iranian university students understand and use sexual health information. The scale showed reliable factor structure and linked to marital satisfaction, but needs testing in broader populations.","clinical_takeaway":"The SHLS‑106 can be used to assess sexual health literacy, though clinicians should consider cultural and sample limits before applying it widely.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for psychometric validation","Use of split‑sample EFA and CFA","Assessment of multiple validity types (criterion, incremental, convergent)","Clear reporting of factor structure"],"limitations":["Convenience university sample limits generalisability","No pre‑registration or open data","Potential cultural specificity to Iranian context"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1057/s41599-023-01669-z"}},{"id":9168,"doi":"10.1111/jocn.17292","pmid":"38797921","pmcid":null,"title":"'My sexual desires, everything, my normal life just stops'; a qualitative study of male sexual health in inflammatory bowel disease","authors":"Ma S, Knapp P, Galdas P.","first_author":"Ma S","journal":"Journal of clinical nursing","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Stoma","Quality of life","Ulcerative colitis","Sexual Health","Chronic Illness","Men's Health","Masculinity","Qualitative Approaches","Sexual Wellbeing","Body Image And Sexuality"],"is_oa":false,"oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jocn.17292","cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"interpretive qualitative study; in‑depth interviews with 22 men with IBD; constant comparative thematic analysis","sample_n":22,"sample_text":"22 male participants with IBD, varied ages, recruited through clinic referrals","population":"men with inflammatory bowel disease (n=22), recruited from clinical settings","country":"unspecified (likely UK based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 22 men who have inflammatory bowel disease reveal that the illness can lower desire, change sexual practices, and challenge gender identity, while health professionals rarely discuss sexual health with them.","clinical_takeaway":"Clinicians should proactively address sexual health with male IBD patients, recognizing disease‑related impacts on desire and practices.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["In‑depth, participant‑centred qualitative data","Use of COREQ reporting checklist","Patient and public involvement in study design"],"limitations":["Small, non‑representative convenience sample","No validated measurement instruments for sexual health constructs","No assessment of key psychosocial confounds (e.g., mental health, relationship factors)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":26,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jocn.17292"}},{"id":9169,"doi":"10.3389/fpubh.2025.1522751","pmid":"40098793","pmcid":"PMC11911482","title":"\"Your sexuality is yours and yours alone\": a reflexive thematic analysis of sexual orientation microaggressions and their impact on LGB emerging adults' sexual health knowledge and attitudes","authors":"Robinson TA, Coleman TM, Carmack C.","first_author":"Robinson TA","journal":"Frontiers in public health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Microaggression","Sexual Health Knowledge","Sexual And Gender Minorities","Reflexive Thematic Analysis"],"is_oa":true,"oa_url":"https://doi.org/10.3389/fpubh.2025.1522751","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Focus groups with 17 LGB emerging adults; reflexive thematic analysis.","sample_n":17,"sample_text":"Convenience sample recruited for focus groups.","population":"LGB emerging adults (age ~20)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 17 LGB young adults reveal that homophobic microaggressions shape their knowledge and attitudes about sex, influencing how they learn about and approach sexual health.","clinical_takeaway":"Clinicians should consider the impact of sexual orientation microaggressions when discussing sexual health with LGB young adults.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight","Focus on under‑studied LGB microaggression impacts"],"limitations":["Very small, non‑random sample","No quantitative measures or validated scales","Potential researcher bias in thematic analysis"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2025.1522751"}},{"id":9170,"doi":"10.1071/sh24022","pmid":"38769681","pmcid":null,"title":"Barriers to sexual health care for sexually diverse Muslim men: a scoping review","authors":"Noor MN, Shaw S, Linton J, Lorway R.","first_author":"Noor MN","journal":"Sexual health","year":2024,"pub_types":["Scoping Review","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"scoping review of 18 primary studies using Arksey & O'Malley framework; PRISMA‑ScR reporting","sample_n":18,"sample_text":"eighteen primary studies included (total participants not reported in abstract)","population":"sexually diverse Muslim men (SDMM)","country":"multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review identified personal, clinical and societal barriers that prevent sexually diverse Muslim men from accessing sexual health services, highlighting stigma, fear of disclosure and discrimination as key obstacles.","clinical_takeaway":"Clinicians should recognise intersecting stigma and provide culturally‑sensitive, non‑judgmental care to improve service uptake for diverse gay‑identified Muslim men.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Systematic scoping methodology (Arksey & O'Malley, PRISMA‑ScR)","Broad database search (8 sources)","Use of socio‑ecological framework to organise findings"],"limitations":["No quality appraisal or risk‑of‑bias assessment of included studies","No quantitative synthesis; findings are narrative","Sample size of included studies not reported, limiting power assessment"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh24022"}},{"id":9171,"doi":"10.1007/s40615-025-02323-x","pmid":"40042798","pmcid":null,"title":"Provider Treatment and Sexual Health Outcomes for Black Women: Historical Context and Post-pandemic Access to Reproductive Resources","authors":"Dorsey M, Freeman J, Priede A, King D, Howard T, Jaffery A.","first_author":"Dorsey M","journal":"Journal of racial and ethnic health disparities","year":2026,"pub_types":["Journal Article"],"keywords":["Black Women","Srh","Covid-19"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of US Black women aged 18‑29 via Qualtrics panel; logistic regression analyses of provider treatment perceptions and SRH outcomes.","sample_n":null,"sample_text":"Qualtrics Panel participants, ages 18‑29, identifying as Black/African American and female, living in the USA","population":"Black/African American women, 18‑29, USA (online panel)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Black women aged 18‑29 who felt their doctors treated them poorly during COVID were less likely to get birth‑control prescriptions, check‑ups, counseling, or discuss pregnancy plans.","clinical_takeaway":"Perceived negative provider treatment may reduce Black women's use of reproductive health services.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Large, demographically focused sample of Black women","Use of logistic regression with confidence intervals","Addresses an under‑studied post‑COVID health disparity"],"limitations":["Cross‑sectional design limits causal inference","Reliance on self‑report measures of provider treatment","Unclear if questionnaire is validated"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s40615-025-02323-x"}},{"id":9172,"doi":"10.53738/revmed.2022.18.778.750","pmid":"35451279","pmcid":null,"title":"[Taking an inclusive sexual health history of adolescents]","authors":"Roulet A, Piccand L, Jacot-Guillarmod M.","first_author":"Roulet A","journal":"Revue medicale suisse","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"fre","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary, no empirical data","sample_n":null,"sample_text":"Not applicable – article provides guidance, not a study","population":"adolescents (clinical context)","country":"Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article offers health professionals practical advice on how to take an inclusive sexual health history from adolescent patients, stressing respect for sexual and gender diversity so that all young people can access appropriate sexual health care.","clinical_takeaway":"Use the recommended inclusive questioning techniques when discussing sexual health with adolescents to ensure respectful, comprehensive care.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Provides practical clinical guidance","Emphasizes inclusivity and diversity","Addresses adolescent-specific considerations"],"limitations":["No empirical data presented","No assessment of outcomes or effectiveness","Cannot be used for evidence synthesis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.53738/revmed.2022.18.778.750"}},{"id":9174,"doi":"10.3109/13668250.2023.2301616","pmid":"39815873","pmcid":null,"title":"Exploring sexual health in people with mild intellectual disabilities: A concept mapping study on the perspectives of relatives and support staff","authors":"de Wit W, Roeg D, Frielink N, Embregts PJCM.","first_author":"de Wit W","journal":"Journal of intellectual & developmental disability","year":2024,"pub_types":["Journal Article"],"keywords":["Sexual Health","Relatives","Support Staff","Concept Mapping","Mild Intellectual Disabilities"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Concept mapping study with 22 participants (7 relatives, 15 support staff). Small, purposive sample; qualitative synthesis of perspectives.","sample_n":22,"sample_text":"n = 7 relatives; n = 15 support staff","population":"Relatives and support staff of people with mild intellectual disabilities","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Relatives and support staff of adults with mild intellectual disabilities listed what they think sexual health means for them. They highlighted areas such as sexual preferences, behaviour, identity, relationships, and the need for education and support.","clinical_takeaway":"Professionals should adopt a broad, supportive approach to sexual health for people with mild intellectual disabilities, covering identity, relationships, and education.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Involves key stakeholders (relatives, staff)","Uses systematic concept‑mapping methodology","Provides practical insights for support planning"],"limitations":["Very small, non‑representative sample","No validation of identified concepts","Findings not generalisable to people with ID themselves"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/13668250.2023.2301616"}},{"id":9176,"doi":"10.1097/grf.0000000000000830","pmid":"38173321","pmcid":null,"title":"Improving Sexual Health Across the Life Span Through Integrated Care in Obstetrics and Gynecology","authors":"Hunter W, Pettigrew J, Carpenter KM, Worly B, Coons HL.","first_author":"Hunter W","journal":"Clinical obstetrics and gynecology","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary/perspective article providing applied information and viewpoints on integrating sexual health services in obstetrics‑gynecology; no empirical data, no participants, no measurements.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that obstetrics‑gynecology clinicians can improve patients’ sexual health by adding screening, education, and coordinated behavioural‑health services into routine care, offering practical guidance for building such programs.","clinical_takeaway":"Clinicians should consider incorporating systematic sexual‑health screenings and referrals within OB‑GYN practice to address unmet sexual‑health needs.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Integrative, multidisciplinary perspective","Addresses gap in provider training"],"limitations":["No empirical data or evaluation of interventions","No measurement of sexual health outcomes"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/grf.0000000000000830"}},{"id":9178,"doi":"10.1007/s00520-024-08787-7","pmid":"39225859","pmcid":null,"title":"Gynecologic cancer survivor preferences for provider communication regarding sexual health after treatment: a qualitative study","authors":"Girard A, Arenella K, Rider GN, Teoh D, Vogel RI.","first_author":"Girard A","journal":"Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer","year":2024,"pub_types":["Journal Article"],"keywords":["Sexual Health","Gynecologic Cancer","survivorship","Provider Communication"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Focus‑group qualitative study with 32 gynecologic cancer survivors (6 Zoom groups); thematic analysis of transcripts.","sample_n":32,"sample_text":"Convenience sample recruited for focus groups; not a probability or representative sample.","population":"Adult female gynecologic cancer survivors >3 months post‑treatment (n=32).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Women who survived gynecologic cancer said doctors often ignore sexual health issues after treatment, causing distress. They want open talks, resources, and better-trained providers.","clinical_takeaway":"Clinicians should proactively discuss sexual health with gynecologic cancer survivors and provide clear referrals.","confidence":0.7,"topic_tags":["sexual_function","csbd","masturbation","pornography"],"strengths":["Addresses an understudied survivor need","Uses participant quotations to illustrate themes","Provides concrete provider‑communication recommendations"],"limitations":["Small, non‑representative convenience sample","No quantitative validation of themes","Limited demographic detail"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00520-024-08787-7"}},{"id":9179,"doi":"10.1080/19317611.2024.2421882","pmid":"40400565","pmcid":"PMC12091912","title":"Effectiveness of Cartoons, Comics, and Animation-Based Sexual Health Promotion and Education Interventions: A Scoping Review","authors":"Abu-Ras W, Idris LB, Aboul-Enein BH.","first_author":"Abu-Ras W","journal":"International journal of sexual health : official journal of the World Association for Sexual Health","year":2025,"pub_types":["research-article","Journal Article"],"keywords":["Education","Sexual Health","Interventions","Animation","Comics","Cartoons"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"scoping review of 51 intervention studies, descriptive synthesis, no meta‑analysis or risk‑of‑bias assessment","sample_n":null,"sample_text":"51 intervention studies (aggregate)","population":"mixed ages, multiple cultures; studies varied, no single sample","country":"multiple","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review maps studies that used cartoons, comics or animations to teach sexual health. Most reports claim improvements in knowledge and engagement, but evidence on lasting behavior change is limited.","clinical_takeaway":"Educational cartoons can boost sexual‑health knowledge, yet clinicians should note the lack of strong evidence for lasting behavior change.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad literature coverage (14 databases, 2000‑2024)","Use of PRISMA guidelines for scoping reviews","Identifies trends over time and across age groups"],"limitations":["No quantitative synthesis or risk‑of‑bias assessment","Limited appraisal of intervention effectiveness","Potential publication bias not addressed"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2024.2421882"}},{"id":9180,"doi":"10.1016/j.ogc.2024.02.010","pmid":"38777492","pmcid":null,"title":"Sexual Health for Transgender and Gender Diverse Individuals: Routine Examination, Sexually-Transmitted Infection Screening, and Prevention","authors":"Wascher J, Hazra A, Fisher AR.","first_author":"Wascher J","journal":"Obstetrics and gynecology clinics of North America","year":2024,"pub_types":["Review","Journal Article"],"keywords":["HIV","Gynecology","HPV","Sexual Health","Transgender","Sexually Transmitted Infection","Gender Diverse"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Review article summarizing clinical guidance for transgender and gender‑diverse patients; no primary data collected.","sample_n":null,"sample_text":"Not applicable – no primary sample","population":"Transgender and gender‑diverse individuals seeking gynecologic care","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review outlines how gynecologists can provide affirming, evidence‑based STI screening and preventive care for transgender and gender‑diverse patients, highlighting unique anatomical considerations and gaps in clinician training.","clinical_takeaway":"Clinicians should use gender‑affirming, anatomy‑specific protocols for STI screening and prevention in TGD patients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive clinical overview","Addresses anatomical and procedural considerations for TGD patients"],"limitations":["No primary empirical data","Limited to expert synthesis; potential bias in literature selection"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ogc.2024.02.010"}},{"id":9181,"doi":"10.3390/ijerph20031857","pmid":"36767222","pmcid":"PMC9914303","title":"An Evaluation of Indoor Sex Workers' Sexual Health Access in Metro Vancouver: Applying an Occupational Health & Safety Lens in the Context of Criminalization","authors":"Pearson J, Machat S, McDermid J, Goldenberg SM, Krüsi A.","first_author":"Pearson J","journal":"International journal of environmental research and public health","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual Health","Occupational Health And Safety","Sex Work","Migrant Sex Work"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/20/3/1857/pdf?version=1674120578","cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative interview study with 47 indoor sex workers and third‑party participants; thematic analysis of narratives.","sample_n":47,"sample_text":"47 qualitative interviews (2017‑2018)","population":"indoor sex workers (including migrants) and third‑party stakeholders in Metro Vancouver, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 47 indoor sex workers in Vancouver show that while many use protective equipment and peer education, criminalisation, immigration status and stigma hinder access to comprehensive sexual‑health services, highlighting the need for decriminalisation.","clinical_takeaway":"Policy changes that decriminalise sex work may improve sexual‑health access for indoor workers.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Community‑based recruitment and involvement","Depth of insight from qualitative narratives","Application of an established OHS framework"],"limitations":["Small, non‑random sample limits generalisability","No quantitative measurement of sexual‑health outcomes","Potential selection bias toward participants engaged with services"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph20031857"}},{"id":9182,"doi":"10.1016/j.bas.2024.102776","pmid":"38465281","pmcid":"PMC10924173","title":"Discussing sexual health with patients eligible for spine surgery: An online survey in spine surgeon and pain physicians","authors":"Goudman L, van Schaik D, Jager T, Moens M, Scheerlinck T.","first_author":"Goudman L","journal":"Brain & spine","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexual dysfunction","Counseling","Sexual Health","Patient Care","Spine Procedures"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.bas.2024.102776","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online survey of spine surgeons and pain physicians (N=57); Likert‑scale items; chi‑square tests of independence.","sample_n":57,"sample_text":"57 completed the survey (out of 350 approached)","population":"Healthcare providers (neurosurgeons, pain physicians, orthopaedists) in Belgium & Netherlands","country":"Belgium; Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of spine surgeons and pain doctors in Belgium and the Netherlands found that most rarely talk about sexual problems with patients. Whether they discuss issues like erectile dysfunction depends on the surgeon’s specialty and the type of surgery planned.","clinical_takeaway":"Clinicians should be aware that sexual health is often omitted in spine‑care consultations; proactively raising the topic may improve patient wellbeing.","confidence":0.8,"topic_tags":["sexual_function","csbd","masturbation","pornography"],"strengths":["Addresses a neglected clinical topic","Includes multiple specialties","Clear quantitative items"],"limitations":["Very low response rate (57/350)","Likert items not validated","No adjustment for multiple testing","Cross‑sectional, cannot infer causality"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.bas.2024.102776"}},{"id":9185,"doi":"10.1016/j.sxmr.2022.06.005","pmid":"36030177","pmcid":"PMC9242892","title":"Sexual Health During COVID-19: A Scoping Review","authors":"Toldam NE, Graugaard C, Meyer R, Thomsen L, Dreier S, Jannini EA, Giraldi A.","first_author":"Toldam NE","journal":"Sexual medicine reviews","year":2022,"pub_types":["Scoping Review","review-article","Journal Article"],"keywords":["Sexual behavior","Sexual function","Sexual dysfunction","Sexual Health","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9242892","cited_by_count":18,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Scoping review of 107 quantitative studies; no risk‑of‑bias assessment, no meta‑analysis, descriptive synthesis only.","sample_n":null,"sample_text":"107 primary studies included; individual study sample sizes not aggregated.","population":"Adults (general population) across multiple countries; studies recruited via convenience samples in original reports.","country":"International (multiple studies).","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A scoping review of 107 studies found that COVID‑19 lockdowns generally reduced partnered sex and increased solo sexual activity, with effects shaped by demographics and mental health.","clinical_takeaway":"Clinicians should be aware that pandemic‑related stress may lower partnered sexual activity and increase solitary sex, and consider mental‑health links when addressing patients' sexual concerns.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive search across multiple databases","Adheres to JBI and PRISMA‑ScR guidelines","Large number of primary studies included"],"limitations":["No quantitative synthesis or risk‑of‑bias assessment","Heterogeneous primary studies limit comparability","Potential over‑reliance on convenience samples"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":31,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sxmr.2022.06.005"}},{"id":9186,"doi":"10.1136/bmjopen-2023-080514","pmid":"39672588","pmcid":"PMC11647344","title":"'Sweden has changed me': a qualitative study exploring the sexual health needs and associated mental health aspects of young male former unaccompanied minors, asylum seekers and refugees in Region Stockholm, Sweden","authors":"Tewelde McDonald J, Fayzi B, Laktinah M, Ekström AM, Salazar M.","first_author":"Tewelde McDonald J","journal":"BMJ open","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Public Health","Qualitative Research","Health Equity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11647344","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"exploratory qualitative study using semi‑structured interviews with 32 participants; constructivist grounded‑theory analysis","sample_n":32,"sample_text":"32 interviews","population":"young male former unaccompanied minors, asylum‑seekers and refugees (ages 16‑28) in Stockholm, Sweden","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 32 young male refugees in Stockholm revealed that their sexual and mental health needs evolve over time, shaped by migration, new cultural values, relationships, and stigma. Education and support that address both sexuality and mental health are needed.","clinical_takeaway":"Holistic sexual‑health programmes for refugee youth should integrate mental‑health support and culturally sensitive sex education.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Addresses an understudied, vulnerable population","Use of constructivist grounded theory for depth of insight","Clear articulation of evolving sexual‑health needs"],"limitations":["Small, non‑representative convenience sample","No standardized measures; findings are conceptual","Potential language or cultural translation bias"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjopen-2023-080514"}},{"id":9187,"doi":"10.1007/s10900-024-01369-y","pmid":"39305374","pmcid":null,"title":"Indigenous Mothers' Perspective on Sexual Health in Northwest Territories, Canada: Results from the Maternal and Infant Health Project","authors":"Kolahdooz F, Zakkar M, Jang SL, Deck S, Wagg A, Corriveau A, Kandola K, Irlbacher-Fox S, Sharma S.","first_author":"Kolahdooz F","journal":"Journal of community health","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["stigma","Reproductive Health","Sexual Health","Sexually Transmitted Infections","Indigenous Mothers"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Quantitative‑qualitative survey of 161 Indigenous mothers (pregnant or recent postpartum) in the Northwest Territories; convenience sampling; descriptive and inferential analyses reported.","sample_n":161,"sample_text":"161 participants (mean age 29.6 y, 70.8% partnered).","population":"Indigenous mothers in NWT, pregnant or with a birth within the previous three years (N=161, mean age ≈ 30).","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Indigenous mothers in Canada’s Northwest Territories say STI rates are high and linked to age, unsafe sex, substance use, and cultural stigma. Health services are the main information source, but embarrassment and confidentiality concerns affect care‑seeking.","clinical_takeaway":"Clinicians should address stigma, ensure confidentiality, and provide culturally‑sensitive STI education to improve care‑seeking among Indigenous mothers.","confidence":0.75,"topic_tags":["sexual_function"],"strengths":["Addresses a critical, under‑researched Indigenous health context","Mixed‑methods design (quantitative + qualitative) enriches insight","Reasonable sample size for a hard‑to‑reach population"],"limitations":["Convenience sampling limits generalisability","Questionnaire not reported as validated","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10900-024-01369-y"}},{"id":9188,"doi":"10.2196/57781","pmid":"39159450","pmcid":"PMC11369542","title":"Factorial Trial to Optimize an Internet-Delivered Intervention for Sexual Health After Breast Cancer: Protocol for the WF-2202 Sexual Health and Intimacy Enhancement (SHINE) Trial","authors":"Shaffer KM, Reese JB, Dressler EV, Glazer JV, Cohn W, Showalter SL, Clayton AH, Danhauer SC, Loch M, Kadi M, Smith C, Weaver KE, Lesser GJ, Ritterband LM.","first_author":"Shaffer KM","journal":"JMIR research protocols","year":2024,"pub_types":["Clinical Trial Protocol","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Mobile phone","Breast neoplasms","Sexual Health","Clinical Trial","Intimacy","Communication Skills","Cancer Survivorship","Sexual Functioning","Sexual Distress","Internet Interventions","Factorial Trial","Multiphase Optimization Strategy"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11369542","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"factorial randomized trial (16 arms) with N=320 breast cancer survivors, longitudinal assessments at baseline, 12, 24 weeks","sample_n":320,"sample_text":"N=320, recruited via Wake Forest NCORP sites; randomized to 16 factorial combinations","population":"post‑treatment adult female breast‑cancer survivors with at least one bothersome sexual symptom","country":"United States","controls_mi":"not_applicable","preregistered":true,"quality_score":8,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A planned 16‑arm online trial will test which combination of education, communication skills, and intimacy exercises best reduces sexual distress and improves function in women after breast cancer treatment.","clinical_takeaway":"If successful, the optimized web program could be a low‑burden option to improve sexual health for breast‑cancer survivors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, adequately powered factorial RCT design","Use of validated sexual distress/function scales","Pre‑registration and detailed analytic plan","Clinically relevant survivor population"],"limitations":["No measurement of moral or mental‑health covariates","Focus on breast‑cancer survivors limits generalisability to broader porn/sexual‑behavior research","Protocol; no outcome data yet"],"rubric_version":"2.0","raw_total":39,"max_possible":50,"pct_score":78,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":2,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/57781"}},{"id":9189,"doi":"10.46747/cfp.6810e291","pmid":"36241414","pmcid":"PMC9833140","title":"Youth clinic model for youth sexual health: Promising solution to ensure access to care","authors":"Arpin E.","first_author":"Arpin E.","journal":"Canadian family physician Medecin de famille canadien","year":2022,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"qualitative grounded‑theory interviews with 8 youth patients (18‑23 yr) and 8 clinic staff; convenience sampling; thematic analysis","sample_n":16,"sample_text":"8 youth patients and 8 clinic staff were interviewed; convenience sampling of patients","population":"young patients accessing a Montreal youth sexual‑health clinic and clinic staff","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 8 young patients and 8 staff at a Montreal youth clinic show that having an interdisciplinary team, longer appointments, and easy access to prescriptions makes sexual‑health care feel more reachable and helpful for young people.","clinical_takeaway":"Youth‑focused, multidisciplinary clinics that offer longer, educational visits can improve young people's access to sexual‑health services.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Grounded‑theory approach provides rich, contextual insight","Includes perspectives of both patients and providers","Identifies concrete service features (team co‑location, longer visits, receptionist role)"],"limitations":["Very small, convenience sample limits transferability","No systematic assessment of health outcomes","Findings may reflect the specific Montreal clinic context"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.46747/cfp.6810e291"}},{"id":9191,"doi":"10.1177/10436596241253863","pmid":"38805422","pmcid":null,"title":"Beyond Survival: A Scoping Review on the Sexual Health of Sexual and Gender Minority Women Following Curative Cancer Treatment","authors":"Miles HS, Wickersham KE, Hein LC.","first_author":"Miles HS","journal":"Journal of transcultural nursing : official journal of the Transcultural Nursing Society","year":2024,"pub_types":["Scoping Review","Journal Article"],"keywords":["Sexual Health","Cancer Survivor","Scoping Review","Sexual And Gender Minority Women"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Scoping review of four primary studies; PRISMA‑ScR guided; no meta‑analysis.","sample_n":null,"sample_text":"Four primary articles included; individual sample sizes not provided in abstract.","population":"Sexual and gender minority women post‑curative cancer treatment (sample details from primary studies not reported).","country":"Not specified (likely multiple).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review of four studies shows that sexual‑minority women who survive cancer face challenges with sexual function, identity disclosure, relationships, and body image, indicating a need for more inclusive research and care.","clinical_takeaway":"Clinicians should recognize unique sexual‑health needs of SGMW cancer survivors and seek inclusive resources.","confidence":0.85,"topic_tags":["sexual_function","gender","csbd"],"strengths":["Follows PRISMA‑ScR reporting guideline","Highlights under‑researched SGMW survivor population","Identifies clear thematic gaps for future work"],"limitations":["Only four primary articles found – limited evidence base","No quantitative synthesis or meta‑analysis","Abstract provides no detail on quality appraisal of included studies"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10436596241253863"}},{"id":9192,"doi":"10.1186/s12889-023-15984-2","pmid":"37264451","pmcid":"PMC10233545","title":"Using the intervention mapping for adaption framework to adapt an evidence-based sexual health intervention for youth affected by trauma","authors":"Kachingwe ON, Lewis Q, Offiong A, Smith BD, LoVette A, Powell TW.","first_author":"Kachingwe ON","journal":"BMC public health","year":2023,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual Health","Adaption","Black Youth","Foy + impact","Intervention Mapping-adapt"],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-023-15984-2","cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"methodological description of intervention adaptation; no outcome data reported","sample_n":null,"sample_text":"not reported","population":"Black youth exposed to household challenges (trauma)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","circular_addiction_scale"],"stance":"neutral","citation_value":"background","plain_summary":"The authors used a structured framework to adapt an existing sexual‑health program for Black youth who have experienced trauma, adding trauma‑informed content and inclusive language. The paper describes the adaptation steps but does not test the program’s effectiveness.","clinical_takeaway":"The adapted program may be promising for trauma‑exposed youth, but effectiveness data are needed before clinical use.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear systematic adaptation framework (IM-Adapt)","Focus on trauma-informed principles","Attention to gender inclusivity"],"limitations":["No empirical outcome data presented","Sample characteristics and size not reported","No validation of adapted intervention yet"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-023-15984-2"}},{"id":9195,"doi":"10.1371/journal.pone.0305293","pmid":"38865312","pmcid":"PMC11168633","title":"Sexual health beliefs and prevention of sexually transmitted infections among cisgender women sex workers in Colombia","authors":"Perdomo Sandoval LA, Goberna-Tricas J.","first_author":"Perdomo Sandoval LA","journal":"PloS one","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11168633","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative hermeneutic phenomenology with in‑depth interviews and focus groups (N=34).","sample_n":34,"sample_text":"34 cisgender women sex workers (age > 18) from two Colombian cities","population":"cisgender women sex workers in Bogotá and Barranquilla, Colombia","country":"Colombia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 34 Colombian sex workers revealed the beliefs they use to try to avoid STIs, such as checking genitals, using condoms correctly, avoiding semen, and trusting God for protection.","clinical_takeaway":"Health workers should engage sex workers in co‑creating culturally sensitive STI‑prevention messages rather than imposing untested beliefs.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Rich, in‑depth qualitative data","Focus on a marginalized population","Clear thematic analysis"],"limitations":["Small, non‑representative sample","No validated measurement of constructs","No control for key confounds"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0305293"}},{"id":9196,"doi":"10.1080/0092623x.2024.2391340","pmid":"39180222","pmcid":null,"title":"Exploring the Associations of Personality and Sexual Health Using the DSM-5 Alternative Model for Personality Disorders","authors":"Deschênes M, Gamache D, Vaillancourt-Morel MP, Mayrand K, Nolin MC, Berthelot N, Mercerat C, Savard C.","first_author":"Deschênes M","journal":"Journal of sex & marital therapy","year":2024,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 489 private‑practice help‑seekers; path analysis controlling for distress, dyadic adjustment, attachment.","sample_n":489,"sample_text":"Help‑seeking adults (private practice)","population":"Adults seeking help in private‑practice clinics (N=489)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a sample of 489 adults seeking help, personality traits linked to the DSM‑5 alternative model for personality disorders were related to sexual health: higher sexual distress and lower function were found among those meeting personality‑disorder cut‑offs, especially facets involving intimacy avoidance and separation insecurity.","clinical_takeaway":"Personality difficulties, particularly intimacy avoidance, may contribute to sexual distress; clinicians should assess personality when addressing sexual health.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample (N≈500)","Uses DSM‑5 AMPD dimensional framework","Controls for key psychosocial variables"],"limitations":["Help‑seeking convenience sample limits generalisability","Reliance on self‑report; unclear scale validation in abstract","No measurement of moral or trauma‑related confounds"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2024.2391340"}},{"id":9197,"doi":"10.1192/bjo.2023.518","pmid":"37551106","pmcid":"PMC10594085","title":"Sexual health experiences of women and non-binary people with early psychosis: qualitative study","authors":"Barker LC, Vigod SN, Hussain Z, France J, Rodriguez A, Lubotzky-Gete S, Berkhout S, Dmytryshyn R, Dunn S, Gupta R, Hosseiny F, Sirotich F, Soklaridis S, Voineskos A, Zaheer J.","first_author":"Barker LC","journal":"BJPsych open","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Schizophrenia","Sexual Health","Qualitative Research","Patient Experiences","Psychotic Disorders/schizophrenia"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10594085","cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"semi‑structured individual interviews with 19 women/non‑binary participants and focus‑group triangulation with 36 clinicians; thematic analysis","sample_n":19,"sample_text":"19 patient participants (ages 18‑31) plus 36 clinicians for triangulation","population":"women, transgender women and non‑binary people, ages 18‑31, receiving early‑psychosis services in Ontario, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 19 young women and gender‑diverse people experiencing early psychosis revealed that their sexual health is shaped by illness symptoms, medication side‑effects, relationship dynamics, and personal identity factors. Clinicians recognised these issues but tended to focus on risk prevention.","clinical_takeaway":"Clinicians should discuss sexual health holistically with young people in early‑psychosis programs, addressing medication effects, relationship concerns, and personal identity.","confidence":0.78,"topic_tags":["sexual_function","gender"],"strengths":["In‑depth qualitative insight from a vulnerable population","Triangulation with clinician perspectives","Attention to intersectional factors (gender, culture, religion)"],"limitations":["Small, non‑representative convenience sample","No quantitative measurement of sexual function or mental‑health variables","Findings not generalisable beyond early‑psychosis programmes in Ontario"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1192/bjo.2023.518"}},{"id":9198,"doi":"10.2196/48453","pmid":"39259573","pmcid":"PMC11425023","title":"Evaluating the Impact of a Dutch Sexual Health Intervention for Adolescents: Think-Aloud and Semistructured Interview Study","authors":"Metz G, Thielmann RRLC, Roosjen H, Crutzen R.","first_author":"Metz G","journal":"JMIR formative research","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Chlamydia","Evaluation","Engagement","Web-based","Mixed Methods","Behavior Change","Ehealth","Web-based Intervention","User","Potential Impact","Think-aloud Method","Web Analytics","Acyclic Behavior Change Diagram"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11425023","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"think‑aloud and semistructured interview study with 15 Dutch adolescents (16‑25 y) exploring perceptions of a web‑based chlamydia information page.","sample_n":15,"sample_text":"15 participants aged 16‑25 (mean 20, SD 2.5)","population":"adolescents and young adults, Netherlands, users of Sense.info website","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A small qualitative study of 15 Dutch youths used think‑aloud and interviews to see how they engage with a chlamydia information page. Users liked the reliable info but noted hard‑to‑find testing links and language issues, suggesting ways to improve STI‑testing uptake.","clinical_takeaway":"Web‑based sexual‑health pages should ensure testing links are prominent and language matches users’ needs to encourage STI testing.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Mixed‑methods approach triangulates theory, analytics, and user perceptions","Detailed qualitative insights from target users"],"limitations":["Very small, non‑representative sample (N=15)","Findings limited to one web page and cannot be generalized to broader sexual health behavior"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/48453"}},{"id":9199,"doi":"10.1016/j.bulcan.2024.11.007","pmid":"39741033","pmcid":null,"title":"[Sexual health in cancer care: A cross-section of patients and professionals from a patient association]","authors":"Douvrel A, Fenouil X, Testu S, Guillot E, Buiret G, Combe C.","first_author":"Douvrel A","journal":"Bulletin du cancer","year":2025,"pub_types":["Journal Article","English Abstract"],"keywords":["Cancer","Patients","Sexual Health","Tools","Professionals","Santé Sexuelle","Outils","Professionnels"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Two independent surveys of cancer patients and healthcare professionals assessing needs and practices regarding sexual health; convenience sampling; self‑report questionnaire.","sample_n":null,"sample_text":"Not reported in abstract","population":"Cancer patients (adult, mixed gender) and oncology professionals; sample size not specified in abstract.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of cancer patients and their clinicians found that most patients consider sexual health important, but fewer than half discuss it with a professional. Both groups want more training, time, and resources to address sexual concerns.","clinical_takeaway":"Clinicians should proactively address sexual health with cancer patients and seek training/resources to meet identified needs.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Addresses an under‑researched aspect of cancer care","Includes perspectives of both patients and professionals","Identifies concrete training and resource needs"],"limitations":["Likely convenience, non‑representative samples","Use of non‑validated, study‑specific questionnaire","No reporting of response rates or sample size"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.bulcan.2024.11.007"}},{"id":9200,"doi":"10.1016/j.srhc.2024.100996","pmid":"38870590","pmcid":null,"title":"The association between gynecologic healthcare providers' sexual health and their comfort discussing their patients' sexual function","authors":"Lee MW, Cox K, Davis SD, Nguyen BT.","first_author":"Lee MW","journal":"Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives","year":2024,"pub_types":["Journal Article"],"keywords":["Sexual Stigma","Provider Sexual Health","Sexual Healthcare Education","Sexual Healthcare Screening"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"anonymous online survey of 189 gynecologic care providers; bivariate analyses of comfort and frequency of discussing patients' sexual function.","sample_n":189,"sample_text":"N = 189 respondents, 85.7 % female, 63.5 % medical trainees","population":"gynecologic healthcare providers (mostly female trainees) in unspecified geographic region","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 189 gynecologic clinicians found that those who are comfortable with their own sexuality, have no current sexual problems, and have received more sexual‑health training are more likely to discuss patients' sexual function.","clinical_takeaway":"Clinician self‑awareness and training may improve sexual‑health discussions with patients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a provider survey","Includes personal sexual trauma and satisfaction as covariates","Relevant to improving patient‑provider communication"],"limitations":["Cross‑sectional, cannot infer causality","Reliance on single‑item, non‑validated measures","No assessment of moral or religious attitudes that might affect comfort"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.srhc.2024.100996"}},{"id":9201,"doi":"10.1101/2024.07.11.24310216","pmid":null,"pmcid":null,"title":"Opening the digital doorway to sexual healthcare: Recommendations from a Behaviour Change Wheel analysis of barriers and facilitators to seeking online sexual health information and support among underserved populations","authors":"McLeod J, Estcourt CS, MacDonald J, Gibbs J, Woode Owusu M, Mapp F, Gallego Marquez N, McInnes-Dean A, Saunders J, Saunders J, Blandford A, Flowers P.","first_author":"McLeod J","journal":"medRxiv","year":2024,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.1101/2024.07.11.24310216","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Semi‑structured interviews (n=35) with thematic and Behaviour Change Wheel analysis; purposive sampling of underserved UK adults","sample_n":35,"sample_text":"35 UK participants recruited purposively","population":"Underserved UK adults (35 participants; 51% from most deprived areas, 26% minoritised ethnic groups)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 35 adults from underserved groups identified practical and informational barriers to using online sexual‑health services and suggested education, training and design changes to make these resources easier to find and use.","clinical_takeaway":"Improving digital health platforms and providing guided help could help underserved people access needed sexual health care.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses a recognised behavioural science framework (BCW)","Purposive sampling of diverse, underserved groups","Generates concrete, theory‑informed recommendations"],"limitations":["Small, non‑representative sample (n=35)","No quantitative validation of identified barriers","Potential researcher bias in thematic coding"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1101/2024.07.11.24310216"}},{"id":9202,"doi":"10.2196/52557","pmid":"39486039","pmcid":"PMC11548867","title":"Feasibility of Sexual Health and Contraceptive Web Services for Adolescents and Young Adults: Retrospective Study of a Pilot Program on Reunion Island","authors":"Reynaud D, Bouscaren N, Cartron E, Marimoutou C.","first_author":"Reynaud D","journal":"JMIR pediatrics and parenting","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Contraception","Usage","Adolescent","Sexual Health","Young Adults","Telemedicine","Teleconsultation","Web Application","Web Based","E-consultation","Contraception Prescription"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11548867","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Retrospective descriptive feasibility study using a convenience sample of adolescents and young adults who accessed a teleconsultation web service (SEXTUOZE) on Reunion Island. Data comprised number of sessions, consultation characteristics, and satisfaction.","sample_n":22,"sample_text":"22 teleconsultations scheduled; 7 completed.","population":"Adolescents and young adults (13‑25 y) in Reunion Island who used the SEXTUOZE platform (N≈22 completed consultations).","country":"France (Reunion Island)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A pilot tele‑consultation website for sexual health and contraception was tested with adolescents and young adults on Reunion Island. Only 7 of 22 scheduled consultations were completed, but overall website traffic was high, suggesting growing interest.","clinical_takeaway":"Digital tele‑consultation can reach youths for sexual health advice, but low uptake highlights the need for better engagement strategies.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Addresses a gap in digital sexual health services for AYAs","Provides real‑world usage data from a pilot program"],"limitations":["Very small number of completed consultations limits generalisability","No validated outcome measures; reliance on simple counts and satisfaction","Convenience sample and self‑selection bias"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/52557"}},{"id":9203,"doi":"10.1038/s41443-023-00807-0","pmid":"38129693","pmcid":null,"title":"The role of metaverse on sexual health of people with disabilities: narrative review","authors":"Limoncin E, Gaudio B, Sansone A, Jannini TB, Ciocca G, Mollaioli D, Jannini EA.","first_author":"Limoncin E","journal":"International journal of impotence research","year":2024,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review; thematic analysis of existing literature; no new data collected","sample_n":null,"sample_text":"None (review)","population":"people with disabilities (theoretical focus)","country":"International","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review how immersive virtual worlds could be used to support sexual education and experiences for people with disabilities, highlighting possible benefits, security concerns, and the role of virtual sexual assistants.","clinical_takeaway":"The review suggests the metaverse may offer new ways to support sexual health for people with disabilities, but concrete evidence is lacking.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Addresses an understudied population (people with disabilities)","Integrates emerging technology (metaverse) with sexual health concepts","Considers both educational and therapeutic potentials"],"limitations":["Narrative review lacks systematic methodology","No empirical data; conclusions are speculative","No assessment of actual user outcomes or risks"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/s41443-023-00807-0"}},{"id":9204,"doi":"10.21203/rs.3.rs-3029483/v1","pmid":null,"pmcid":null,"title":"SNAPSJIA study Survey of Adolescents' Needs and Parents' Views on Sexual Health in Juvenile Idiopathic Arthritis","authors":"SAVEL C, CHAUSSET A, BERLAND P, GUIGUET-AUCLAIR C, CABANE L, FAUTREL B, GAUDIN P, GUILLOT P, HAYEM G, LAFARGE D, MERLIN E, PEZIERE N, SORDET C, TROPE S, TOURNADRE A, MALOCHET S, COHEN JD.","first_author":"SAVEL C","journal":"Research Square","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 76 adolescents with JIA and 43 parents across 9 rheumatology centres and 3 patient associations; anonymous self‑administered questionnaires; descriptive statistics with chi‑square tests.","sample_n":119,"sample_text":"76 patient questionnaires, 43 parent questionnaires.","population":"Adolescents (age 18–45 for parent interview) with juvenile idiopathic arthritis and their parents, recruited from clinical sites and patient groups in France.","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A French survey of 76 teens with juvenile arthritis and 43 parents found that many adolescents feel their disease affects love life and want health professionals to discuss sexual health openly, especially using digital tools.","clinical_takeaway":"Clinicians should proactively address sexual‑health topics with JIA adolescents and consider digital resources for education.","confidence":0.7,"topic_tags":["sexual_function","adolescents","religiosity"],"strengths":["Addresses an unmet sexual‑health need in a specific clinical population","Includes both adolescent and parent perspectives","Multicentre recruitment enhances geographic spread"],"limitations":["Questionnaire not reported as validated","Small convenience sample limits generalisability","No adjustment for potential confounders (e.g., mental health, relationship status)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-3029483/v1"}},{"id":9205,"doi":"10.1136/ijgc-2022-004069","pmid":"36737099","pmcid":null,"title":"A longitudinal study of sexual health and quality of life in endometrial carcinoma survivors","authors":"Datta A, Ram TS, Karuppusami R, Thomas A, Sebastian A, Thomas V, Chandy RG, Peedicayil A.","first_author":"Datta A","journal":"International journal of gynecological cancer : official journal of the International Gynecological Cancer Society","year":2023,"pub_types":["Journal Article"],"keywords":["Surgery","Radiotherapy","Uterine Cancer","Quality Of Life (Pro)/palliative Care"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort of 132 endometrial cancer survivors assessed at 6 mo and 1 yr with validated questionnaires (FSFI, FACT‑G)","sample_n":132,"sample_text":"132 survivors recruited from a single cancer centre","population":"women treated for endometrial carcinoma (surgery ± radiation/chemotherapy)","country":"unspecified (likely India based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 132 women who survived endometrial cancer, sexual function remained low for most up to one year after treatment, especially in older and less‑educated survivors. Quality of life was worse for those who received radiation or chemotherapy, but both sexual function and overall wellbeing improved over time.","clinical_takeaway":"Clinicians should proactively discuss sexual health with endometrial cancer survivors, as low function is common even a year after treatment.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Validated sexual function and QoL instruments","Longitudinal follow‑up at two time points","Multivariate analysis with confidence intervals"],"limitations":["Single‑site, cancer‑specific sample limits generalisability","Key psychosocial confounders (partner relationship, mental health) not measured","No pre‑registration or power justification"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":1,"mentioning":3,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/ijgc-2022-004069"}},{"id":9206,"doi":"10.1016/j.cjtee.2024.05.002","pmid":"38816330","pmcid":"PMC12166888","title":"Factors affecting sexual health in individuals with spinal cord injury: A systematic scoping review","authors":"Rahmani A, Shahbandi A, Ghashghaie S, Ghodsi Z, Khazaeipour Z, Abbaszadeh M, Dabbagh Ohadi MA, Nejadghaderi SA, Atlasi R, Maasoumi R, Khodadoust E, Vaccaro AR, Rahimi-Movaghar V.","first_author":"Rahmani A","journal":"Chinese journal of traumatology = Zhonghua chuang shang za zhi","year":2025,"pub_types":["Scoping Review","review-article","Journal Article"],"keywords":["Spinal cord injuries","Scoping Review","Sexual Adjustment","Partnership Adjustment"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC12166888","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review of 52 heterogeneous studies, no risk‑of‑bias assessment, narrative synthesis","sample_n":null,"sample_text":"52 included studies (individual study sample sizes not reported in abstract)","population":"individuals with spinal cord injury (SCI); both sexes; studies from 1978‑2019","country":"multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"This scoping review summarises 52 studies on people with spinal cord injury, highlighting that sexual health and partnership adjustment are shaped by injury characteristics, psychological, social and economic factors.","clinical_takeaway":"Clinicians should assess injury level together with psychosocial context when supporting sexual health in SCI patients.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Broad literature coverage (1978‑2019)","Identifies multiple domains influencing sexual health in SCI"],"limitations":["No risk‑of‑bias assessment of included studies","Narrative synthesis only; no quantitative analysis","Limited methodological detail in abstract"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.cjtee.2024.05.002"}},{"id":9207,"doi":"10.21203/rs.2.23715/v1","pmid":null,"pmcid":null,"title":"Health System Strategies and Adolescent Sexual Health: Systematic review using Rodgers Concept Analysis Framework","authors":"Nunu WN, Makhado L, Mabunda JT, Lebese RT.","first_author":"Nunu WN","journal":"Research Square","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-14281/v1.pdf","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review using concept analysis; 32 articles included; thematic analysis; no risk‑of‑bias assessment reported","sample_n":null,"sample_text":"32 articles selected from 111 identified; no primary participant numbers reported","population":"adolescents (focus of reviewed literature), no primary data collected","country":"Zimbabwe (focus of conceptual framework), studies from various locations","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":["selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed 32 papers on how health‑system strategies affect adolescent sexual health, identifying key attributes like context and engagement, and noting gaps such as fragmented services that leave youths vulnerable.","clinical_takeaway":"Strengthening integrated health‑system strategies may improve sexual health outcomes for adolescents.","confidence":0.4,"topic_tags":["adolescents","sexual_function"],"strengths":["Systematic approach to literature identification","Use of Rodgers concept analysis framework","Thematic synthesis of attributes, antecedents, consequences"],"limitations":["No quality appraisal or risk‑of‑bias assessment of included studies","Limited search strategy details; possible selection bias","Lack of quantitative synthesis or effect size reporting"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.2.23715/v1"}},{"id":9208,"doi":"10.53738/revmed.2024.20.877.1115","pmid":"38836394","pmcid":null,"title":"[Sexual health in female under treatment for opiate dependence using diacetylmorphine]","authors":"Khatcherian E, Soulignac R, Zullino D, Achab S.","first_author":"Khatcherian E","journal":"Revue medicale suisse","year":2024,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"fre","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative discussion of integrating psycho‑socio‑sexological counselling for women receiving diacetylmorphine; no empirical data presented.","sample_n":null,"sample_text":"Not reported – paper appears to be a descriptive/position piece rather than an empirical study.","population":"Women with severe opioid dependence receiving diacetylmorphine treatment (France/Switzerland context).","country":"Switzerland (journal); likely French‑speaking context.","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper argues that women receiving heroin‑assisted treatment need specific sexual‑health counselling, but it provides no data on outcomes.","clinical_takeaway":"Clinicians should consider adding tailored sexual‑health counselling for female patients on diacetylmorphine, though evidence of benefit is lacking.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Highlights a neglected aspect of care (sexual health) for women on heroin‑assisted treatment.","Calls for integrated psycho‑socio‑sexological counselling."],"limitations":["No empirical data or systematic review; purely descriptive.","No measurement of sexual outcomes, mental‑health or relational variables.","Unable to assess effectiveness of the proposed counselling."],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.53738/revmed.2024.20.877.1115"}},{"id":9209,"doi":"10.1016/j.jcpo.2024.100556","pmid":"39742993","pmcid":null,"title":"Sexual health in women and sexual-gender-minority patients with cancer: A nationwide survey on healthcare professional awareness and attitude on behalf of MITO and AIRO-gynecology group","authors":"Barcellini A, Cassani C, Fontana G, Orlandi E, Macchia G, Mangili G, Pignata S, Locati LD, Nappi RE.","first_author":"Barcellini A","journal":"Journal of cancer policy","year":2025,"pub_types":["Journal Article"],"keywords":["Minority","Sexual Health","Cancer Survivorship","Sexual Toxicity","Women's Well-being"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Online survey of Italian oncologists (n=184, 20.8% response rate) assessing awareness and attitudes toward sexual health in female and sexual‑gender‑minority cancer patients.","sample_n":184,"sample_text":"184 clinicians responded (20.8% response rate)","population":"Italian oncologists (radiation, medical, etc.)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 184 Italian cancer doctors found they rarely ask about gender identity or sexual orientation, yet most feel it important to discuss treatment‑related sexual problems. Training and guidelines are needed to improve care for women and sexual‑gender‑minority patients.","clinical_takeaway":"Clinicians should receive training and tools to routinely assess and discuss sexual health with female and SGM cancer patients.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Nationwide reach within Italian oncology societies","Focus on understudied patient groups (women, SGM)","Identifies clear training gaps"],"limitations":["Low response rate (20.8%) limits representativeness","Survey instrument not reported as validated","No statistical power justification or effect size reporting"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jcpo.2024.100556"}},{"id":9210,"doi":"10.1111/jorc.12360","pmid":"33423368","pmcid":null,"title":"Nurse's practices and attitudes toward sexual health, wellbeing, and function in people receiving haemodialysis: A scoping review","authors":"Mckie AL, Green T, Bonner A.","first_author":"Mckie AL","journal":"Journal of renal care","year":2021,"pub_types":["Scoping Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review of four primary studies (two cross‑sectional surveys, two qualitative) using Arksey & O'Malley's framework","sample_n":null,"sample_text":"Four primary studies identified; sample sizes not reported in abstract","population":"renal nurses working with haemodialysis patients","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A scoping review of four studies finds that renal nurses often feel uncertain and lack training for discussing sexual health with patients on haemodialysis, leading to few conversations about sexual wellbeing.","clinical_takeaway":"Clinicians should provide targeted education for renal nurses to confidently address sexual health with dialysis patients.","confidence":0.8,"topic_tags":["sexual_function","neuroscience"],"strengths":["Systematic scoping methodology (Arksey & O'Malley)","Identifies clear gaps in nurse training and role clarity"],"limitations":["Only four primary studies, limiting breadth","No information on validation of attitude measures","Lack of quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":5,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jorc.12360"}},{"id":9212,"doi":"10.1016/j.healthpol.2024.105171","pmid":"39368211","pmcid":null,"title":"Investigating the relationship between health and gender equality: What role do maternal, reproductive, and sexual health services play?","authors":"Wang Y, Torbica A.","first_author":"Wang Y","journal":"Health policy (Amsterdam, Netherlands)","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":["Reproductive Health","Maternal Health","Sexual Health","Gender Equality","Women Empowerment","Sustainable Development Goals"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"critical narrative review of 30 empirical papers; no pre‑registration, no systematic search reported","sample_n":null,"sample_text":"N/A – narrative review","population":"not applicable (review of existing studies)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises evidence that better maternal, reproductive and sexual health services – such as contraception, family planning, and abortion access – can improve women's participation in work and education, and even help reduce gender‑based violence.","clinical_takeaway":"Improving access to comprehensive sexual‑health services can have broader social benefits for women beyond health alone.","confidence":0.6,"topic_tags":["sexual_function","relationships","gender"],"strengths":["Broad synthesis of 30 empirical papers","Clear conceptual framework linking health services to gender equality","Identifies multiple causal pathways (labour, education, violence reporting)"],"limitations":["Narrative, not systematic, review – possible selection bias","No explicit assessment of study quality or risk of bias","No quantitative meta‑analysis or effect‑size reporting"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.healthpol.2024.105171"}},{"id":9214,"doi":"10.1007/s10508-024-02832-6","pmid":"38553660","pmcid":"PMC11219362","title":"The Impact of Sibling Relationships on Behavioral and Sexual Health among Latino Sexual Minority Men","authors":"Zapata JP, Rojas E, Durán P, Martínez AJ, Del Pino HE.","first_author":"Zapata JP","journal":"Archives of sexual behavior","year":2024,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Family Intervention","Sexual Orientation","Prep","Latino Sexual Minority Men"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11219362","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative thematic analysis of interviews with 31 sibling pairs (62 participants); convenience sample; cross‑sectional; no longitudinal or experimental component.","sample_n":62,"sample_text":"31 pairs of siblings (N=62) recruited for interviews conducted Dec 2020–Jan 2021","population":"Latino sexual minority men and their siblings, United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with Latino gay men and their brothers showed that siblings can help with coming out, give emotional and practical support, and encourage use of HIV‑prevention medication (PrEP). Including siblings in outreach may boost PrEP uptake.","clinical_takeaway":"Engaging siblings in HIV‑prevention programs could improve PrEP uptake among Latino gay men.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative data on a neglected support domain","Bilingual interviews increase cultural relevance","Clear thematic analysis procedure"],"limitations":["Small, non‑random convenience sample","No standardized measures of support or health outcomes","Findings not generalisable beyond Latino SMM sibling pairs"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-024-02832-6"}},{"id":9216,"doi":"10.1071/sh24064","pmid":"38917298","pmcid":null,"title":"Sustaining sexual health programs: practical considerations and lessons from the President's Emergency Plan for AIDS Relief","authors":"Tucker JD, Day S, Nwaozuru UC, Obiezu-Umeh C, Ezechi O, Chima K, Mukuka C, Iwelunmor J, Sturke R, Vorkoper S.","first_author":"Tucker JD","journal":"Sexual health","year":2024,"pub_types":["Editorial","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":"https://www.publish.csiro.au/sh/pdf/SH24064","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Editorial proposing practical considerations; no empirical data, no participants.","sample_n":null,"sample_text":"Not applicable – editorial without empirical participants.","population":"None (no study sample)","country":"Not specified (global perspective)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The editorial outlines four practical ideas—early planning, community engagement, return on investment, and partnerships—to help keep sexual health programs running over time, using PEPFAR as an example.","clinical_takeaway":"None – the piece offers program‑level guidance, not clinical advice.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Provides a conceptual framework for sustainability","Draws lessons from a large global program (PEPFAR)"],"limitations":["No empirical data or systematic review","No measurement of outcomes or effect sizes","Lacks evaluation of moral or psychological confounds"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh24064"}},{"id":9217,"doi":"10.1016/j.maturitas.2023.107795","pmid":"37454470","pmcid":null,"title":"Promoting sexual health in older adults: Findings from two rapid reviews","authors":"Stowell M, Hall A, Warwick S, Richmond C, Eastaugh CH, Hanratty B, McDermott J, Craig D, Spiers GF.","first_author":"Stowell M","journal":"Maturitas","year":2023,"pub_types":["Review","Journal Article"],"keywords":["Ageing","Sexual Health","Life Course","Older Adults","Sexual Health Promotion"],"is_oa":false,"oa_url":"http://www.maturitas.org/article/S0378512223004012/pdf","cited_by_count":15,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Rapid review of systematic reviews summarising evidence on sexual health needs and promotion interventions for adults aged 50+. Searches in Epistemonikos, quality appraisal, narrative synthesis.","sample_n":null,"sample_text":"Fifteen systematic reviews (needs) and 12 systematic reviews (interventions) were included; no primary participant numbers reported.","population":"Adults aged 50+ (community and care settings)","country":"Not specified (global evidence base)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors examined existing systematic reviews about sexual health needs and programmes for people over 50. They found older adults face stigma, lack of support, and need tailored education. Professionals also need better training. Evidence on what works is still limited.","clinical_takeaway":"Clinicians should recognize older adults’ specific sexual health needs and seek training, but evidence for specific interventions remains scarce.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Broad scope covering needs and interventions","Uses systematic review evidence base","Identifies gaps and methodological issues"],"limitations":["Rapid review may miss some studies","No quantitative synthesis","Limited detail on primary study quality"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.maturitas.2023.107795"}},{"id":9218,"doi":"10.1097/jnc.0000000000000525","pmid":"39964778","pmcid":null,"title":"Observations of Communication Practices Between Men Who Have Sex With Men With HIV and HIV Specialist Nurses During Routine Consultations Regarding Sexual Health Counseling in the Netherlands: A Qualitative Study","authors":"de Munnik S, den Daas C, Ammerlaan HSM, Kok G, de Wit J, Vervoort SCJM.","first_author":"de Munnik S","journal":"The Journal of the Association of Nurses in AIDS Care : JANAC","year":2025,"pub_types":["Multicenter Study","Journal Article","Observational Study"],"keywords":["HIV","Communication","Sexual Health","Nurse","Men Who Have Sex With Men","Consultation"],"is_oa":false,"oa_url":"https://cris.maastrichtuniversity.nl/en/publications/6e99cdb8-572f-4501-8bb6-7a2f9bb87937","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Cross‑sectional qualitative analysis of 16 video‑recorded routine HIV consultations (multicenter).","sample_n":16,"sample_text":"16 video‑recorded consultations across four centres.","population":"Men who have sex with men (MSM) living with HIV, attending four Dutch HIV treatment centres; nurses were HIV specialist nurses.","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors analysed 16 video recordings of routine HIV clinic visits with gay men living with HIV. They found that sexual‑health counselling was uneven and lacked a clear structure, suggesting that better communication strategies are needed.","clinical_takeaway":"Clinicians should use structured communication tools to ensure consistent sexual‑health counselling for MSM with HIV.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of real‑world video recordings provides authentic interaction data.","Multicenter design adds some contextual diversity.","Predefined analytical framework enhances transparency."],"limitations":["Very small sample (N=16) limits generalisability.","No systematic assessment of participants’ characteristics or outcomes beyond communication.","Potential observer‑effect: clinicians may alter behaviour when recorded."],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/jnc.0000000000000525"}},{"id":9219,"doi":"10.1080/09593985.2018.1470209","pmid":"29723127","pmcid":null,"title":"Ethics and sexual health: Exploration of the ethical code of conduct for physiotherapists concerning sexual health in clinical practice","authors":"Areskoug-Josefsson K, Kjellström S.","first_author":"Areskoug-Josefsson K","journal":"Physiotherapy theory and practice","year":2019,"pub_types":["Journal Article"],"keywords":["Sexuality","Rehabilitation","Physical Therapy","Physiotherapy","Sexual Well-being"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative ethical analysis of physiotherapy codes; no empirical data collected.","sample_n":null,"sample_text":"None (conceptual paper)","population":"Physiotherapists (theoretical focus)","country":"Sweden (authors’ affiliation inferred)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors examine physiotherapy ethical codes to show how they can guide clinicians when addressing patients' sexual‑health concerns, emphasizing cultural sensitivity and ethical reasoning.","clinical_takeaway":"Physiotherapists should use their professional ethical code to navigate sexual‑health issues responsibly.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Clear linkage between ethical codes and sexual‑health practice","Considers cultural context","Provides practical ethical reasoning framework"],"limitations":["No empirical data; purely theoretical","Limited applicability outside physiotherapy","No systematic review methodology"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09593985.2018.1470209"}},{"id":9220,"doi":"10.1080/10810730.2024.2399576","pmid":"39297321","pmcid":null,"title":"\"It's Your Body and Your Life:\" Formative Audience Research to Develop a Sexual Health Campaign with Youth of Color","authors":"Sundstrom B, Smith E, Wearing B, Gibson M, Sydnor B, Dixon R.","first_author":"Sundstrom B","journal":"Journal of health communication","year":2024,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups and web‑based survey with 134 youth of colour (15‑24 y); grounded in reproductive‑justice theory; formative campaign development","sample_n":134,"sample_text":"51 participants in 9 focus groups; 83 completed an online survey","population":"youth of colour, South Carolina, ages 15‑24 (convenience sample, recruited via community partners)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers worked with youth of colour in South Carolina to design a sexual‑health campaign. Focus groups and surveys identified barriers to care and produced empowering, sex‑positive messages that were rated highly by participants.","clinical_takeaway":"Culturally tailored, youth‑led messaging can improve acceptance of sexual‑health services among young people of colour.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large qualitative sample for formative work","Youth‑led focus groups increase ecological validity","Use of a validated PME scale"],"limitations":["Convenience, non‑probability sample limits generalisability","No longitudinal or experimental assessment of campaign impact","Limited statistical reporting; no power analysis"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10810730.2024.2399576"}},{"id":9221,"doi":"10.1002/pon.6005","pmid":"35852026","pmcid":null,"title":"Sexual health and intimacy after cancer treatment in women of color: A systematic review","authors":"Arthur EK, Bissram J, Rechenberg K, Wills A, Campanelli K, Menon U, Nolan TS.","first_author":"Arthur EK","journal":"Psycho-oncology","year":2022,"pub_types":["Systematic Review","Journal Article"],"keywords":["Cancer","Minority","Oncology","Women's Health","Sexual Health","Health Disparities","Psycho-oncology","survivorship"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"qualitative systematic review of 18 studies (10 qualitative, 8 quantitative) using thematic content analysis; no meta‑analysis or risk‑of‑bias assessment reported","sample_n":18,"sample_text":"18 studies included (number of participants not reported in abstract)","population":"U.S. women of color with breast or gynecologic cancer (African American, Asian American, Latina, plus some White/other participants)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review summarises 18 studies on how cancer treatment affects sex and intimacy for women of color, highlighting impacts on body image, partner support, and cultural barriers to care.","clinical_takeaway":"Clinicians should consider cultural and relational factors when addressing sexual health with women of color after cancer treatment.","confidence":0.8,"topic_tags":["sexual_function","csbd","pornography","masturbation"],"strengths":["Focus on an under‑studied, diverse population","Systematic search across multiple databases","Inclusion of both qualitative and quantitative studies"],"limitations":["No quantitative synthesis or risk‑of‑bias assessment","Limited detail about primary study sample sizes and measures","Does not address potential confounds relevant to sexual health outcomes"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/pon.6005"}},{"id":9222,"doi":"10.1097/ms9.0000000000002013","pmid":"38694315","pmcid":"PMC11060205","title":"Saffron extract as an emerging novel therapeutic option in reproduction and sexual health: recent advances and future prospectives","authors":"Goyal A, Raza FA, Sulaiman SA, Shahzad A, Aaqil SI, Iqbal M, Javed B, Pokhrel P.","first_author":"Goyal A","journal":"Annals of medicine and surgery (2012)","year":2024,"pub_types":["review-article","Review","Journal Article"],"keywords":["Infertility","premenstrual syndrome","erectile dysfunction","Reproductive Health","Premenstrual Dysphoric Disorder","Saffron"],"is_oa":true,"oa_url":"https://doi.org/10.1097/ms9.0000000000002013","cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review without systematic methodology","sample_n":null,"sample_text":"none (review article)","population":"general adult population (no specific sample)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how saffron, a plant extract, may help with various health issues, including male and female reproductive problems. Evidence on semen quality is mixed, but saffron might reduce menstrual pain and improve hormone balance. It appears safe at recommended doses but needs more clinical trials.","clinical_takeaway":"Saffron shows promise for menstrual discomfort and possibly male fertility, but current evidence is limited; clinicians should await robust trial data before routine recommendation.","confidence":0.7,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Broad overview of multiple medical domains","Highlights safety considerations of saffron"],"limitations":["Non‑systematic narrative review","No quantitative synthesis or critical appraisal of included studies","No discussion of potential confounders in sexual health outcomes"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/ms9.0000000000002013"}},{"id":9223,"doi":"10.1080/07399332.2021.1972302","pmid":"34669548","pmcid":null,"title":"The association between marital violence and reproductive and sexual health outcomes of women: A multi-country study of South Asia","authors":"Kamal SMM, Ulas E.","first_author":"Kamal SMM","journal":"Health care for women international","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Multi-country survey of women in Bangladesh, India, Nepal, Pakistan; likely nationally representative but cross‑sectional.","sample_n":null,"sample_text":"Not specified in abstract; large multi‑country dataset implied.","population":"Women of reproductive age in South Asia (Bangladesh, India, Nepal, Pakistan)","country":"Bangladesh, India, Nepal, Pakistan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of women in four South Asian countries found that experiencing marital violence is linked to higher rates of unintended pregnancy, pregnancy termination, contraceptive use, and symptoms of sexually transmitted infections.","clinical_takeaway":"Clinicians should screen for marital violence when addressing reproductive and sexual health concerns.","confidence":0.7,"topic_tags":["sexual_function","religiosity","relationships","gender"],"strengths":["Large, multi‑country sample","Focus on multiple reproductive and sexual health outcomes","Highlights public‑health relevance of marital violence"],"limitations":["Cross‑sectional design limits causal inference","No explicit control for mental‑health or other confounders","Reliance on self‑reported violence and health outcomes","Effect sizes and power calculations not reported"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/07399332.2021.1972302"}},{"id":9224,"doi":"10.1136/bmjgh-2023-013285","pmid":"38789276","pmcid":"PMC11129029","title":"Sexual satisfaction, an indicator of sexual health and well-being? Insights from STI/HIV prevention research in European men who have sex with men","authors":"Blondeel K, Mirandola M, Gios L, Folch C, Noestlinger C, Cordioli M, De Sutter P, Temmerman M, Toskin I, Sialon II Network.","first_author":"Blondeel K","journal":"BMJ global health","year":2024,"pub_types":["research-article","Multicenter Study","Journal Article"],"keywords":["HIV","Public Health","Cross-sectional Survey","Prevention Strategies"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11129029","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"multicentre community‑based cross‑sectional survey of MSM in 13 European cities (2013‑2014)","sample_n":null,"sample_text":"multicentre community‑based survey across 13 cities","population":"men who have sex with men (MSM) from European urban sites","country":"Europe (multiple countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A European survey of gay and bisexual men found that sexual satisfaction is linked to relationship role, condom use, knowledge of partner HIV status, and perceived social acceptance, suggesting it can serve as a marker of sexual health.","clinical_takeaway":"Sexual satisfaction may reflect broader psychosocial and structural influences on sexual health in MSM.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large multicentre sample across Europe","Multilevel modeling accounts for city clustering","Considers individual, interpersonal, and structural factors"],"limitations":["Sexual satisfaction measured with a single, unvalidated item","Cross‑sectional design limits causal inference","Key confounds (moral incongruence, mental health, trauma) not addressed"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjgh-2023-013285"}},{"id":9225,"doi":"10.1016/j.srhc.2024.100984","pmid":"38815451","pmcid":null,"title":"Reproductive sex ending in failure affects sexual health - A qualitative study of men and women attending a fertility clinic","authors":"Lindgren L, Iliadis SI, Volgsten H.","first_author":"Lindgren L","journal":"Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives","year":2024,"pub_types":["Journal Article"],"keywords":["Infertility","Sexual function","Sexual Health","Qualitative Interviews","Medically Assisted Reproduction (Mar)"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 18 participants recruited from a single Swedish fertility clinic","sample_n":18,"sample_text":"18 participants (8 males, 10 females) interviewed","population":"heterosexual men and women (8 males, 10 females) attending a public fertility clinic in Sweden, 2022‑2023","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with men and women undergoing fertility treatment showed that scheduling sex for conception changed spontaneous intimacy into a pressure-filled activity, leading to more erectile problems, lower desire, and emotional stress.","clinical_takeaway":"Clinicians working with infertility patients should routinely inquire about changes in sexual health and relationship stress.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rich, in‑depth qualitative data from both partners","Focus on a clinically relevant population (infertility patients)","Clear thematic analysis linking reproductive failure to sexual health"],"limitations":["Small, non‑representative convenience sample","No standardized measures of sexual function or mental health","Findings limited to heterosexual couples at one clinic"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.srhc.2024.100984"}},{"id":9226,"doi":"10.1111/hiv.13688","pmid":"39022863","pmcid":null,"title":"Psychosocial and sexual health among men with and without HIV who have sex with men: A cross-sectional nationwide study in Denmark","authors":"Scofield D, Frisch M, Andersson M, Storgaard M, Pedersen G, Johansen IS, Katzenstein TL, Graugaard C, Omland LH, Weis N, Moseholm E.","first_author":"Scofield D","journal":"HIV medicine","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["HIV","Mental health","Sexual Health","Men Who Have Sex With Men","Chemsex"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Nationwide cross‑sectional survey comparing MSM with HIV (n=369) to MSM without HIV (n=1002); logistic regression controlling for unspecified confounders.","sample_n":1371,"sample_text":"369 MSM with HIV; 1002 MSM without HIV.","population":"Men who have sex with men in Denmark, both living with HIV and HIV‑negative.","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In Denmark, gay men living with HIV report more anxiety, depression, body dissatisfaction, low sexual desire, inactivity, and erectile problems than gay men without HIV.","clinical_takeaway":"HIV‑positive MSM may need targeted mental‑health and sexual‑health support.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Large, nationwide sample","Comparison group from a representative cohort","Use of multivariable logistic regression"],"limitations":["Cross‑sectional design cannot infer causality","Unclear which confounders were adjusted for","No detail on measurement instruments"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/hiv.13688"}},{"id":9227,"doi":"10.7748/nop.2020.e1227","pmid":"32129030","pmcid":null,"title":"Sexual health and well-being in later life","authors":"White I.","first_author":"White I.","journal":"Nursing older people","year":2020,"pub_types":["Journal Article"],"keywords":["Sexuality","Diversity","Gerontology","Nursing care","Older People","Professional","Sexual Dysfunctions","Lesbian Gay Bisexual Trans"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative article offering definitions, discussion of issues and nursing advice; no primary data collected.","sample_n":null,"sample_text":"Not applicable – article does not report original data.","population":"Older adults (80+ and younger seniors), both sexes and sexual minorities; no sample size reported.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how sexual health changes in later life, outlines common physical and relational issues, and offers nurses a model (PLISSIT) to support older adults' sexual well‑being.","clinical_takeaway":"Nurses should use the PLISSIT approach to assess and address sexual health concerns in older patients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides a clear definition of sexual health for older adults","Integrates the PLISSIT model for nursing practice"],"limitations":["No empirical data; purely descriptive","Does not address potential confounding factors such as mental health or relationship status"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7748/nop.2020.e1227"}},{"id":9228,"doi":"10.1093/sxmrev/qead024","pmid":"37286525","pmcid":null,"title":"A systematic review on the efficacy of CBT interventions for the mental and sexual health of survivors of prostate cancer","authors":"Pieramico S, Castro R, Aguiar S, Bismarck F, Ferreira D, Carvalho J, Quinta Gomes AL, Nobre P.","first_author":"Pieramico S","journal":"Sexual medicine reviews","year":2023,"pub_types":["Systematic Review","Journal Article"],"keywords":["Depression","Quality of life","Anxiety","Mental health","Sexual dysfunction","prostate cancer","Sexual Health","Cbt","Rct"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 15 RCTs investigating CBT effects on mental and sexual health of prostate cancer survivors, following PRISMA.","sample_n":null,"sample_text":"15 eligible articles identified; individual study sizes not provided in abstract","population":"Prostate cancer survivors (male)","country":"Not specified","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 15 studies found that cognitive‑behavioural therapy can improve sexual function, erectile ability, desire, satisfaction, and also reduce depression, anxiety and distress in men who have survived prostate cancer, though more large‑scale research is needed.","clinical_takeaway":"CBT may be a helpful option to boost sexual and mental well‑being in prostate‑cancer survivors, but clinicians should consider individual patient needs and the limited evidence base.","confidence":0.7,"topic_tags":["csbd","sexual_function"],"strengths":["PRISMA-guided systematic search","Focus on both mental and sexual health outcomes","Inclusion of multiple RCTs"],"limitations":["No meta‑analysis; effect sizes not pooled","Limited detail on quality assessment of included trials","Potential heterogeneity across CBT protocols"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sxmrev/qead024"}},{"id":9229,"doi":"10.2196/36266","pmid":"37725523","pmcid":"PMC10414374","title":"Sexual Health Assessment Is Vital to Whole Health Models of Care","authors":"Uzdavines A, Helmer DA, Spelman JF, Mattocks KM, Johnson AM, Chardos JF, Lynch KE, Kauth MR.","first_author":"Uzdavines A","journal":"JMIRx med","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Sex","Model","Quality","Assessment","Gender","Barrier","Communication","Health assessment","Health care","Care","Sexual Health","Comfort","Equity","Veteran","Well-being","Sexual Orientation","Ehr","Electronic Health Record","Gender Identity","Communication Barrier","Health Equity","Sexual Health Assessment","Whole Health Model","Technological Barrier"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10414374","cited_by_count":18,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary / perspective piece describing system modifications and recommendations; no primary data collection","sample_n":null,"sample_text":"Not applicable – no empirical sample reported","population":"Veterans Health Administration providers and patients (general description, no sample size)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that health systems should add routine sexual health questionnaires—including orientation and gender identity—to electronic records, and train clinicians to discuss sexuality, to improve overall health and reduce disparities.","clinical_takeaway":"Integrating sexual health screening into routine care may help identify unaddressed health issues and support LGBTQ+ patients.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Identifies clear system barriers to sexual health assessment","Provides concrete suggestions for EHR and training interventions"],"limitations":["No empirical data; conclusions are based on expert opinion","Lack of quantitative evaluation of proposed interventions"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":24,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/36266"}},{"id":9230,"doi":"10.1007/s10461-024-04415-x","pmid":"38963569","pmcid":"PMC11427609","title":"Understanding Practical, Robust Implementation and Sustainability of Home-based Comprehensive Sexual Health Care: A Realist Review","authors":"Goense CJDH, Doan TP, Kpokiri EE, Evers YJ, Estcourt CS, Crutzen R, Klausner JD, Tang W, Baraitser P, Hoebe CJPA, Dukers-Muijrers NHTM.","first_author":"Goense CJDH","journal":"AIDS and behavior","year":2024,"pub_types":["research-article","Review","Journal Article"],"keywords":["intervention","Home Care Services","Hiv Testing","Comprehensive Care","Key Populations","Sti Testing","Realist Review","Sexual Health Care"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11427609","cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Realist review of 93 studies (quantitative & qualitative) on home‑based comprehensive sexual health care, focusing on self‑sampling/testing and implementation outcomes.","sample_n":null,"sample_text":"93 studies included; individual study sample sizes varied","population":"Key populations for HIV/STI testing, primarily MSM in Europe/North America","country":"Europe, North America (studies aggregated)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A realist review examined how delivering HIV/STI testing and related care at home works for different groups. It found self‑testing is popular, especially among men who have sex with men, and that clear instructions and choice improve uptake.","clinical_takeaway":"Home‑based testing can expand reach; clinicians should ensure clear instructions and easy linkage to care.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive systematic search across multiple databases","Use of established PRISM framework for implementation outcomes","Inclusion of both quantitative and qualitative evidence"],"limitations":["Lack of quantitative meta‑analysis limits precision of effect estimates","Reliance on heterogeneous primary studies with variable quality","No standardized validated scales for acceptability across studies"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-024-04415-x"}},{"id":9231,"doi":"10.1186/s12905-023-02839-6","pmid":"38114976","pmcid":"PMC10729446","title":"An acceptance analysis of a sexual health education digital tool in resource-poor regions of Kenya: an UTAUT based survey study","authors":"Soehnchen C, Weirauch V, Schmook R, Henningsen M, Meister S.","first_author":"Soehnchen C","journal":"BMC women's health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["SEM","Africa","multiple regression analysis","Kenya","Confirmatory Factor Analysis","Young Women","Sexual Health Information","Mhealth","Sexual Health Education","Sus","Utaut","Digital Health Intervention","Digital Health Tools"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10729446","cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 77 young adults (69F, 7M, 1 diverse) in low‑income Kenyan regions; modified UTAUT and SUS questionnaires; SEM with CFA and linear regression; convenience e‑survey sample.","sample_n":77,"sample_text":"77 participants recruited via an online survey; not a probability sample","population":"Kenyan young adults, 18‑35 years, low‑income regions","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A web‑based tool that gives information on contraception, menstruation and female genital mutilation was tested with 77 Kenyan young adults. Using standard questionnaires, the study found that perceived usefulness, attitude and usability predicted willingness to use the tool, though lack of resources reduced acceptance.","clinical_takeaway":"Digital sexual‑health education tools can be acceptable if they are seen as useful and easy to use, but resource constraints may limit uptake.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Uses validated acceptance (UTAUT) and usability (SUS) scales","Applies SEM with CFA to test the model","Considers cultural/contextual factors in discussion"],"limitations":["Small, non‑representative convenience sample","No pre‑registration or power analysis reported","No measurement of key sexual‑health confounders"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12905-023-02839-6"}},{"id":9232,"doi":"10.1097/aog.0000000000004255","pmid":"33416289","pmcid":"PMC7813442","title":"Evolving the Preconception Health Framework: A Call for Reproductive and Sexual Health Equity","authors":"Dehlendorf C, Akers AY, Borrero S, Callegari LS, Cadena D, Gomez AM, Hart J, Jimenez L, Kuppermann M, Levy B, Lu MC, Malin K, Simpson M, Verbiest S, Yeung M, Crear-Perry J.","first_author":"Dehlendorf C","journal":"Obstetrics and gynecology","year":2021,"pub_types":["article-commentary","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.1097/aog.0000000000004255","cited_by_count":38,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"None – commentary","population":"non‑pregnant people; broad reproductive‑age population","country":"United States (authors’ affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose a new Reproductive and Sexual Health Equity framework that centers community needs, acknowledges historic harms, and aims to reduce health inequities across the reproductive life course.","clinical_takeaway":"Clinicians should consider equity‑focused, community‑centered approaches when addressing patients' reproductive and sexual health needs.","confidence":0.8,"topic_tags":["prevalence"],"strengths":["Broad multidisciplinary author team","Addresses structural determinants and equity","Clear framework proposal"],"limitations":["No empirical data","No measurement of sexual‑health constructs","No systematic methodology disclosed"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":41,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/aog.0000000000004255"}},{"id":9233,"doi":"10.1016/j.ejogrb.2025.114034","pmid":"40398141","pmcid":null,"title":"Access, availability, and quality of service provision women and men experiencing problems related to their sexual health across Europe: Time to act in the wake of a survey on sexual and reproductive health care services by the European Board and College of Obstetrics &amp; Gynaecology (EBCOG) and European Society of Contraception (ESC)","authors":"Tsiapakidou S, Kristufkova A, Khattak H, Mukhopadhyay S, Mahmood T, Savona-Ventura C, Klanjscek J, Bitzer J.","first_author":"Tsiapakidou S","journal":"European journal of obstetrics, gynecology, and reproductive biology","year":2025,"pub_types":["Journal Article"],"keywords":["Inequalities","Education And Training","Gender Incongruence","Sexual Dysfunctions","Vulnerable Groups","Sexual Health Care","Sex In The City"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"questionnaire survey of experts in 26 European countries assessing perceived inequalities in sexual and reproductive health service provision","sample_n":null,"sample_text":"Experts from 26 European countries were invited; exact number not reported","population":"experts in sexual and reproductive health (Europe)","country":"Europe (26 countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of sexual‑health experts from 26 European countries found large differences in how men and women with sexual problems, LGBTQ+ people, and those in rural areas can access care, suggesting a need for policy changes.","clinical_takeaway":"Clinicians should be aware that access to sexual‑health services varies widely across Europe, especially for vulnerable groups.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad European coverage","Focus on service inequality","Jointly developed questionnaire"],"limitations":["Non‑validated survey instrument","Descriptive analysis only","Expert opinions may not reflect actual service usage"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ejogrb.2025.114034"}},{"id":9234,"doi":"10.31234/osf.io/pc5mt","pmid":null,"pmcid":null,"title":"Sexual health and sexual quality of life among individuals with spinal cord injury in Latin America","authors":"Perrin PB.","first_author":"Perrin PB.","journal":"PsyArXiv","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online convenience survey of 248 individuals with spinal cord injury in Latin America","sample_n":248,"sample_text":"248 participants completed a 60‑item online survey","population":"individuals with spinal cord injury (SCI) in Latin America","country":"Latin America (multiple countries, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 248 people with spinal cord injury in Latin America found that most notice changes in their sexual life after injury, often lacking professional information or support. The authors suggest better education and non‑judgmental discussions about sexuality in care.","clinical_takeaway":"Clinicians should proactively discuss sexuality with SCI patients and provide tailored information and support.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample for a niche population","Focus on understudied region (Latin America)","Highlights unmet informational needs"],"limitations":["Survey not reported as validated","Cross‑sectional convenience sample limits generalisability","No control for mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/pc5mt"}},{"id":9235,"doi":"10.1111/psrh.12251","pmid":"38391121","pmcid":"PMC11026090","title":"Sexual health variation among gang-involved youth in Washington state: Social ecological implications for research and practice","authors":"Bishop AS, Nurius PS, Walker SC, Oxford ML.","first_author":"Bishop AS","journal":"Perspectives on sexual and reproductive health","year":2024,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["United States","Sexual Health","Latent Class Analysis","Social Ecology","Harm Reduction","Youth Gang Membership"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Latent class analysis of a school‑based sample (N = 2060) to identify sexual‑behavior profiles among gang‑involved youth.","sample_n":2060,"sample_text":"School‑based sample of gang‑involved youth (N = 2060).","population":"Adolescent gang‑involved youth in Washington State (school‑based sample).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers analyzed data from 2,060 gang‑involved teenagers in Washington and found four distinct groups of sexual behaviour, ranging from non‑active to high‑risk patterns involving multiple partners and sexting. Social factors like violence exposure, lack of support, and poverty helped explain these differences.","clinical_takeaway":"Tailor sexual‑health interventions to the varied risk profiles of gang‑involved youth, addressing both individual behaviours and broader social stressors.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample (N > 2000) for latent class analysis","Identification of distinct sexual‑behavior profiles","Integration of interpersonal and macrosocial factors"],"limitations":["Cross‑sectional design; no causal inference","Self‑report measures, limited validation detail","No assessment of key confounds (moral incongruence, mental health, trauma, masturbation)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/psrh.12251"}},{"id":9236,"doi":"10.1093/heapro/daab190","pmid":"37596929","pmcid":"PMC10439511","title":"Evaluating use of web-based interventions: an example of a Dutch sexual health intervention","authors":"Metz G, Roosjen H, Zweers W, Crutzen R.","first_author":"Metz G","journal":"Health promotion international","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Evaluation","Ehealth","Web-based Intervention","Web Analytics","Acyclic Behavior Change Diagrams"],"is_oa":true,"oa_url":"https://doi.org/10.1093/heapro/daab190","cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"observational analysis of web analytics data from a single page of a Dutch sexual health e‑health intervention","sample_n":104557,"sample_text":"104,557 pageviews in 2020; 35,347 transfers from the page","population":"users of the Sense web‑based chlamydia‑prevention page (anonymous visitors tracked via Matomo)","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors show how a web‑based chlamydia‑prevention page was intended to encourage STI testing, but analytics revealed low conversion (14%) and high bounce (79%), suggesting the intervention was not used as designed.","clinical_takeaway":"Web‑based sexual‑health tools should be evaluated for actual user pathways, not just intended design.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Real‑world web‑analytics data from a large number of users","Clear illustration of intended vs. actual use using ABCDs","Transparent presentation of engagement metrics"],"limitations":["No validated behavioural or health outcome measures","Descriptive analysis only; no statistical modelling or effect sizes","No assessment of user characteristics or confounding factors"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/heapro/daab190"}},{"id":9237,"doi":"10.1016/j.nedt.2023.105953","pmid":"37660589","pmcid":null,"title":"Nursing students' perceived attitudes toward addressing sexual health in their future profession: A longitudinal quantitative study","authors":"Russell JL, Chen HC, Jensen FB, Nichols ND.","first_author":"Russell JL","journal":"Nurse education today","year":2023,"pub_types":["Journal Article"],"keywords":["Sexual Health","Sexual Attitudes","Nursing Student","Sexual Competence"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"convenience sample of 159 nursing students, surveyed at least once during their program; quantitative attitude instrument used; Pearson correlations reported","sample_n":159,"sample_text":"convenience sample of nursing students from a single university","population":"Associate of Science in Nursing students, United States, majority female, White, non‑Hispanic","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A study of 159 nursing students in the US found they generally have positive attitudes toward addressing patients' sexual health, but they feel they need more basic education on the topic.","clinical_takeaway":"Nurse educators should incorporate more sexual‑health training into curricula to prepare graduates for patient discussions.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Longitudinal design adds temporal dimension","Use of a specific attitude instrument","Clear reporting of sample demographics"],"limitations":["Convenience sample from one university limits generalizability","Instrument validation not described in abstract","Statistical analysis limited to descriptive stats and simple correlations"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.nedt.2023.105953"}},{"id":9238,"doi":"10.1080/00224499.2019.1629383","pmid":"31276427","pmcid":null,"title":"Awareness of Sexual Rights and Empowerment: Quantitative and Qualitative Evaluation of a Sexual Health Intervention for Adults with Intellectual Disability","authors":"Chou YC, Lu ZJ, Chen BW, Lin CJ.","first_author":"Chou YC","journal":"Journal of sex research","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"non-equivalent multiple-groups with replications, N=87 adults with intellectual disability; mixed quantitative and qualitative outcomes","sample_n":87,"sample_text":"87 adults with ID participated in the intervention; groups were not randomly assigned","population":"adults with intellectual disability in Taiwan (both genders)","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A two‑year program that taught adults with intellectual disability about sexual health, involving their parents and caregivers, led to modest gains in knowledge but helped participants view sexual needs as rights rather than problems.","clinical_takeaway":"Tailored sexual‑health education that includes families can empower adults with intellectual disability, even if knowledge gains are modest.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Mixed‑methods design gives depth to findings","Intervention includes adults, parents, and service workers","Two‑year follow‑up period"],"limitations":["Non‑randomised design limits causal inference","Small sample, possible selection bias","Unclear whether questionnaires are validated for ID populations"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":49,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2019.1629383"}},{"id":9239,"doi":"10.1111/jir.12624","pmid":"31016807","pmcid":null,"title":"'Transformed rights' sexual health programme evaluation for the parents and service workers of adults with an intellectual disability","authors":"Chou YC, Lu ZJ, Chen BW, Lin CJ.","first_author":"Chou YC","journal":"Journal of intellectual disability research : JIDR","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Parents","Sexual Health","Intellectual Disability","Programme Evaluation","Sexual Rights","Service Workers"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"quasi‑experimental pre‑post programme evaluation with parents (n=57) and service workers (n=164); standardized attitude questionnaire and interviews","sample_n":221,"sample_text":"57 parents and 164 service workers participated in the sexual‑health programmes","population":"parents and service workers of adults with intellectual disability in Taiwan","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A programme aimed at parents and staff of adults with intellectual disability in Taiwan improved their attitudes toward the adults' sexual rights, according to questionnaire scores and interview feedback.","clinical_takeaway":"Training can positively shift caregivers' attitudes about sexual rights for people with intellectual disability.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of a validated attitude questionnaire","Large sample of service workers","Mixed‑methods (quantitative + qualitative) provides depth"],"limitations":["No control/comparison group limits causal inference","No reporting of effect sizes or power analysis","Confounding variables (e.g., prior training) not addressed"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jir.12624"}},{"id":9240,"doi":"10.3390/jpm14030267","pmid":"38541009","pmcid":"PMC10970891","title":"Sexual Functioning and Sexual Health in Female Patients following Stroke: A Scoping Review with Implications for Rehabilitation","authors":"Latella D, Grimaldi A, Calabrò RS.","first_author":"Latella D","journal":"Journal of personalized medicine","year":2024,"pub_types":["Scoping Review","review-article","Journal Article"],"keywords":["Quality of life","Stroke","Female Sexual Function","Sexual Rehabilitation"],"is_oa":true,"oa_url":"https://www.mdpi.com/2075-4426/14/3/267/pdf?version=1709196523","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Scoping review of literature on female sexual functioning after stroke; no primary data collection.","sample_n":null,"sample_text":"Not applicable – review of existing studies","population":"Female stroke survivors (studies reviewed)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This scoping review summarizes evidence that female stroke survivors often experience sexual problems such as reduced desire and satisfaction, and notes a lack of dedicated rehabilitation programs or trained staff to address these issues.","clinical_takeaway":"Clinicians should recognize sexual health as a key component of post‑stroke care for women and seek or develop appropriate rehabilitation resources.","confidence":0.7,"topic_tags":["sexual_function","religiosity"],"strengths":["Comprehensive search across multiple databases","Highlights gap in sexual rehabilitation after stroke"],"limitations":["Scoping review lacks systematic risk‑of‑bias assessment","No quantitative synthesis or effect‑size reporting","Does not evaluate quality of primary studies"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":6,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/jpm14030267"}},{"id":9241,"doi":"10.1186/s12978-024-01867-1","pmid":"39180106","pmcid":"PMC11342496","title":"The effect of sexual education based on the Sexual Health Model on sexual function among women living in the suburbs: study protocol for a randomized controlled trial","authors":"Koochakzai M, Behboodi Moghadam Z, Faal Siahkal S, Arbabi H, Ebrahimi E.","first_author":"Koochakzai M","journal":"Reproductive health","year":2024,"pub_types":["Clinical Trial Protocol","research-article","Journal Article"],"keywords":["Sexual function","Women","Randomized controlled trial","Sexual Health","Suburbs","Sexual Health Model"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11342496","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Randomized controlled trial protocol; two parallel arms, simple random sampling of 76 women from suburban health centres, allocation 1:1.","sample_n":76,"sample_text":"Seventy‑six women selected through simple random sampling; 38 per arm.","population":"Women, suburban Iran, n=76 (planned).","country":"Iran","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A planned randomized trial will test whether a three‑session sexual‑health education program improves sexual function, mental health, and quality of life for suburban Iranian women.","clinical_takeaway":"If successful, brief sexual‑health education could be a practical way to enhance women's sexual function and well‑being.","confidence":0.78,"topic_tags":["sexual_function","gender"],"strengths":["Uses validated, psychometrically sound instruments (FSFI, DASS‑21, SQoL‑F).","Randomized controlled design with registered trial protocol.","Clear description of intervention (Sexual Health Model‑based education)."],"limitations":["No measurement or control of key sexual‑behavior confounds (masturbation, partner factors, moral incongruence, trauma).","Sample size modest; power not detailed in abstract.","Outcomes focus on function, not on pornography‑related constructs."],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-024-01867-1"}},{"id":9242,"doi":"10.1177/09564624241226995","pmid":"38261721","pmcid":"PMC11047012","title":"Human immunodeficiency virus prevention outcomes associated with arts-based sexual health workshop participation among Northern and Indigenous adolescents in the Northwest Territories, Canada","authors":"Lys CL, Logie CH, Lad A, Sokolovic N, Mackay KI, Hasham A, Malama K.","first_author":"Lys CL","journal":"International journal of STD & AIDS","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Arctic","Indigenous","Adolescents","Human Immunodeficiency Virus Prevention","Human Immunodeficiency Virus Knowledge","Safer Sex Efficacy"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11047012","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"pre-post single-group survey with latent change score modeling (n=344)","sample_n":344,"sample_text":"n = 344 participants; mean age = 14.3 years; 79 % Indigenous; 66 % had attended prior workshop","population":"Northern and Indigenous adolescents aged 13‑18 in Northwest Territories, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Arts‑based workshops in schools helped Northern and Indigenous teenagers improve their knowledge about STIs, feel more aware of HIV risks, and feel more confident using condoms.","clinical_takeaway":"Culturally tailored, arts‑based education can boost STI knowledge and safe‑sex confidence among Indigenous adolescents.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large community‑based sample of Indigenous youth","Pre‑post design with latent change score modeling","Clear, statistically significant improvements in knowledge and self‑efficacy"],"limitations":["No control/comparison group limits causal inference","Unclear whether survey instruments are validated for this population","Potential confounding by prior workshop exposure not fully accounted for"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/09564624241226995"}},{"id":9243,"doi":"10.1371/journal.pone.0312807","pmid":"39775533","pmcid":"PMC11709232","title":"HEalth professionals Responding to MEn for Safety (HERMES): Mixed methods evaluation of a pilot sexual health intervention for gay, bisexual and other men who have sex with men experiencing domestic violence and abuse","authors":"Buller AM, Ferrari G, Bleile A, Feder GS, Brzank PJ, Bacchus LJ.","first_author":"Buller AM","journal":"PloS one","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11709232","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"before‑after mixed‑methods pilot (20 matched pre‑post questionnaires, 21 staff interviews, audit of 533 records); no randomisation, small sample, convenience staff participants","sample_n":20,"sample_text":"20 matched pre‑post questionnaires from staff; 21 semi‑structured interviews; audit of 533 patient records","population":"gbMSM patients at a London NHS sexual health clinic; health‑care practitioners as respondents","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A small pilot tested a training programme (HERMES) for sexual‑health staff to better spot and refer gay and bisexual men experiencing domestic violence. Staff felt more prepared and identified more cases, but few patients used the referral service.","clinical_takeaway":"Training can boost clinicians' confidence to detect DVA in gbMSM, yet referral uptake remains low; services should explore patient‑centered pathways.","confidence":0.8,"topic_tags":["sexual_function","lgbtq","csbd"],"strengths":["Mixed‑methods approach gives depth (qualitative interviews).","Large audit of patient records provides real‑world identification data."],"limitations":["Small pre‑post staff sample limits statistical power.","No control group; changes may reflect secular trends.","Outcome measures rely on self‑report and audit counts without validated instruments."],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0312807"}},{"id":9244,"doi":"10.1186/s12889-023-16257-8","pmid":"37468863","pmcid":"PMC10357632","title":"Young people's proposals for a web-based intervention for sexual health promotion: a French qualitative study","authors":"Martin P, Alberti C, Gottot S, Bourmaud A, de La Rochebrochard E.","first_author":"Martin P","journal":"BMC public health","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Internet","Sexual Health","Health Promotion","Young People","Participatory Intervention."],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10357632","cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative interview study with 19 participants; thematic analysis","sample_n":19,"sample_text":"19 participants recruited for semi‑structured interviews","population":"French young people aged 15‑24 (convenience sample)","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"French teens and young adults suggested features they would like in an online sexual‑health tool, emphasizing interactive, trustworthy, and confidential content created with peers and professionals.","clinical_takeaway":"Involve young users in designing web‑based sexual‑health resources to improve relevance and uptake.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Direct input from target youth population","Systematic thematic coding with software","Clear practical recommendations"],"limitations":["Small, non‑representative convenience sample","No quantitative validation of proposals","Findings limited to French context"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-023-16257-8"}},{"id":9245,"doi":"10.1186/s12958-023-01174-7","pmid":"38167101","pmcid":"PMC10759678","title":"The impact of COVID-19 on the mental and sexual health of patients with infertility: a prospective before-and-after study","authors":"Qi J, Sun M, Yue X, Hong X, Dong M, Tan J.","first_author":"Qi J","journal":"Reproductive biology and endocrinology : RB&E","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Infertility","Mental health","Sexual Health","Before-and-after Study","Covid-19","Full-Release"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10759678","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective before‑and‑after study of women with infertility assessed at three pandemic stages (lockdown, liberalized, post‑pandemic) using validated questionnaires (GAD‑7, PHQ‑9, FSFI). Sample size not reported in abstract.","sample_n":null,"sample_text":"not reported in abstract","population":"women with infertility (clinical sample)","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study tracked anxiety, depression, and sexual function in women undergoing infertility treatment during three COVID‑19 periods. Anxiety and depression peaked when restrictions were fully lifted, while sexual dysfunction was worst at that time compared with lockdown and post‑pandemic phases.","clinical_takeaway":"Infertility patients may need extra mental‑health and sexual‑function support after pandemic restrictions ease.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses validated mental health and sexual function scales","Prospective repeated‑measures design across distinct pandemic phases","Addresses an understudied population (infertility patients)"],"limitations":["Sample size and recruitment details not provided","No control for key confounds (e.g., relationship status, prior mental health)","Statistical reporting lacks effect sizes and power justification"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12958-023-01174-7"}},{"id":9246,"doi":"10.1080/0092623x.2024.2357141","pmid":"38818773","pmcid":null,"title":"Group Sex Counseling Based on a Modified \"Good Enough Sex\" Model: A Randomized Trial on Sexual Health Variables among Breast Cancer Survivors in Iran","authors":"Barjasteh S, Lopez V, Farnam F.","first_author":"Barjasteh S","journal":"Journal of sex & marital therapy","year":2024,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized controlled trial with 100 breast cancer survivors and their spouses; 4 weekly group counseling sessions vs routine care; outcomes measured at baseline, 2 and 3 months","sample_n":100,"sample_text":"100 eligible breast cancer survivors (BCSs) and their spouses; intervention n≈50, control n≈50","population":"breast cancer survivors (average age ~40‑50) in Iran, mostly post‑mastectomy","country":"Iran","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A group counseling program based on the \"Good Enough Sex\" model improved sexual satisfaction, function, and communication for Iranian breast‑cancer survivors and their partners over three months compared with routine care.","clinical_takeaway":"Sexual counseling that encourages realistic expectations and open dialogue can markedly boost sexual well‑being in breast‑cancer survivors.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Randomized controlled design","Clear intervention protocol","Registered trial"],"limitations":["Unclear whether validated sexual health scales were used","Limited reporting of effect‑size precision (no CIs)","Potential lack of control for mental‑health or trauma confounds"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2024.2357141"}},{"id":9247,"doi":"10.3389/frph.2022.1034747","pmid":"36726593","pmcid":"PMC9884802","title":"\"We have to figure it out ourselves\": Transfeminine adolescents' online sexual experiences and recommendations for supporting their sexual health and wellbeing","authors":"Coyne CA, Wongsomboon V, Korpak AK, Macapagal K.","first_author":"Coyne CA","journal":"Frontiers in reproductive health","year":2022,"pub_types":["brief-report","Journal Article"],"keywords":["Transgender","Social Media","Adolescent Sexual Behavior","Gender Minority","Online Partner Seeking","Transfeminine"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/frph.2022.1034747/pdf","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"brief-report; qualitative description of online sexual experiences from a survey of 21 transfeminine adolescents in the US; no control group; convenience sample","sample_n":21,"sample_text":"N = 21","population":"transfeminine adolescents (age unspecified, US)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors interviewed 21 US transfeminine teens about how they use the internet to seek sexual and romantic partners, describing the benefits and risks they encounter and suggesting ways clinicians can better support their sexual health.","clinical_takeaway":"Clinicians should ask trans‑feminine teens about both online and offline sexual activity and provide inclusive, safety‑focused resources.","confidence":0.7,"topic_tags":["gender","adolescents","sexual_function"],"strengths":["focus on an understudied, gender‑minority adolescent population","clinical expertise informs interpretation","offers concrete recommendations for clinicians"],"limitations":["very small, non‑representative sample (N=21)","no validated measurement instruments","cross‑sectional, self‑report data only"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/frph.2022.1034747"}},{"id":9248,"doi":"10.1071/sh23012","pmid":"37257866","pmcid":null,"title":"Understanding how young cisgender heterosexual men navigate sexual health conversations and practices during casual sex: a qualitative study","authors":"Waling A.","first_author":"Waling A.","journal":"Sexual health","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://www.publish.csiro.au/sh/pdf/SH23012","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"30 semi‑structured interviews; reflexive thematic analysis; cross‑sectional convenience sample of young cis‑gender heterosexual men in Australia.","sample_n":30,"sample_text":"30 participants","population":"young cis‑gender heterosexual men (Australia)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 30 young Australian straight men reveal they often avoid talking about STI testing or condom use during casual sex, relying on assumptions that women will manage protection. This highlights persistent gender gaps in sexual‑health responsibility.","clinical_takeaway":"Clinicians should address gender norms and encourage men to actively discuss and assume responsibility for STI prevention in casual encounters.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insights from a hard‑to‑reach group","Clear reflexive thematic analysis approach","Addresses gender dynamics in sexual health"],"limitations":["Small, non‑representative convenience sample","No quantitative measurement of constructs","Potential self‑selection bias"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh23012"}},{"id":9249,"doi":"10.1016/j.pop.2021.02.009","pmid":"33985704","pmcid":null,"title":"Sexual Health and the LGBTQ+ Community","authors":"Taylor NM, King CK.","first_author":"Taylor NM","journal":"Primary care","year":2021,"pub_types":["Review","Journal Article"],"keywords":["Sexual Health","Sexual Education","Lgbtq+"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review discussing sexual health considerations for LGBTQ+ patients; no empirical data collected.","sample_n":null,"sample_text":"Not applicable – no primary data.","population":"Healthcare providers and LGBTQ+ patients (conceptual focus, no sample)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review outlines how physical, emotional, mental, and social factors affect the sexual health of LGBTQ+ patients and advises clinicians to create inclusive, culturally competent care environments.","clinical_takeaway":"Clinicians should adopt inclusive practices and culturally competent policies to support LGBTQ+ sexual health.","confidence":0.6,"topic_tags":["sexual_function","lgbtq"],"strengths":["Clear synthesis of cultural and contextual factors for providers","Practical recommendations for clinic environment"],"limitations":["No empirical data; conclusions based on expert opinion","Limited to provider perspective; patient voices not directly examined"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pop.2021.02.009"}},{"id":9250,"doi":"10.2196/58549","pmid":"38959047","pmcid":"PMC11255522","title":"A Digital Sexual Health Education Web Application for Resource-Poor Regions in Kenya: Implementation-Oriented Case Study Using the Intercultural Research Model","authors":"Soehnchen C, Burmann A, Henningsen M, Meister S.","first_author":"Soehnchen C","journal":"JMIR formative research","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["User-centered Design","Sexual Health Education","Semistructured Interview","Intercultural Research Model","Sus Analysis"],"is_oa":true,"oa_url":"https://doi.org/10.2196/58549","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"case-study implementation of a digital sexual health education web app using user‑centered design, SUS surveys and expert interviews","sample_n":null,"sample_text":"Not reported in abstract","population":"Kenyan users of a web‑based sexual health education tool (sample size not specified)","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study describes how a culturally tailored digital app for sexual health was built and tested in Kenya, showing improved usability scores after redesign.","clinical_takeaway":"A well‑designed, culturally sensitive digital tool can effectively deliver sexual health education in low‑resource settings.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses validated SUS instrument","User‑centered, culturally informed design","Includes expert interviews and qualitative feedback"],"limitations":["No reporting of sample size or power analysis","Limited quantitative analysis; mainly descriptive","Findings limited to implementation context; not generalizable"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/58549"}},{"id":9251,"doi":"10.1016/j.puhe.2023.11.031","pmid":"38118243","pmcid":null,"title":"Structural and intermediary determinants in sexual health care access in migrant populations: a scoping review","authors":"Adrian Parra C, Stuardo Ávila V, Contreras Hernández P, Quirland Lazo C, Bustos Ibarra C, Carrasco-Portiño M, Belmar Prieto J, Barrientos J, Lisboa Donoso C, Low Andrade K.","first_author":"Adrian Parra C","journal":"Public health","year":2024,"pub_types":["Scoping Review","Journal Article"],"keywords":["Transients And Migrants","Sexual Health","Health Services Accessibility","Healthcare Disparities","Social Determinant Of Health"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Scoping review of primary studies describing structural and intermediary determinants of sexual health care access among migrants; no risk‑of‑bias assessment, narrative synthesis of 44 studies.","sample_n":null,"sample_text":"44 primary studies included; no original participant data collected.","population":"International migrants, refugees, asylum seekers (studies from 2000‑2022).","country":"Global (studies from multiple countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This scoping review summarises 44 studies on why migrants often struggle to access sexual health services, highlighting barriers such as language, cultural values, stigma, legal status, finances, and health‑system navigation.","clinical_takeaway":"Policies should address cultural, linguistic and systemic barriers to improve sexual health care for migrant groups.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive search across multiple databases","Clear categorisation of structural vs. intermediary determinants","Use of established social determinants of health framework"],"limitations":["No critical appraisal of included primary studies","Limited to English/Spanish publications","No quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.puhe.2023.11.031"}},{"id":9253,"doi":"10.1071/sh22068","pmid":"35970766","pmcid":null,"title":"Measuring and evaluating sexual health in the era of digital health: challenges and opportunities","authors":"Gibbs J, Solomon D, Jackson L, Mullick S, Burns F, Shahmanesh M.","first_author":"Gibbs J","journal":"Sexual health","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":"https://www.publish.csiro.au/sh/pdf/SH22068","cited_by_count":19,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"no empirical data, narrative discussion","sample_n":null,"sample_text":"","population":"none","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper discusses how digital tools are reshaping sexual health services and outlines the obstacles to measuring their impact, such as reaching underserved groups and ensuring consistent data collection.","clinical_takeaway":"None - not clinically applicable.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of digital health challenges","Identifies concrete steps for improvement"],"limitations":["No empirical data or systematic review","No specific measurement validation reported","Limited relevance to pornography/CSBD"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":20,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh22068"}},{"id":9254,"doi":"10.1007/s10389-022-01715-1","pmid":"35601930","pmcid":"PMC9112636","title":"Influences on the uptake of a population health approach to sexual health programs in Ontario public health units: a qualitative descriptive study","authors":"Frost L, Valaitis R, Butt M, Jack SM, Akhtar-Danesh N.","first_author":"Frost L","journal":"Journal of public health (Berlin, Germany)","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Public Health","Sexual Health","Population Health","Implementation Science"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9112636","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative descriptive study with 12 semi‑structured interviews of sexual‑health managers from 10 Ontario public health units; directed content analysis using CFIR constructs","sample_n":12,"sample_text":"12 participants from 10 units","population":"sexual‑health program managers/supervisors (professional sample, not general public)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with Ontario public‑health sexual‑health managers identified resource limits, staff training, data access and clinician preferences as key barriers or facilitators to using a population‑health approach in sexual‑health programs.","clinical_takeaway":"None – study informs public‑health implementation, not individual clinical care.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear qualitative methodology (semi‑structured interviews, CFIR framework)","Focus on implementation barriers/facilitators relevant to public‑health policy"],"limitations":["Small, purposive sample limits generalisability","No quantitative measurement of outcomes or effect sizes","No assessment of individual‑level sexual‑behaviour variables"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10389-022-01715-1"}},{"id":9255,"doi":"10.1093/jsxmed/qdac011","pmid":"36897238","pmcid":null,"title":"Sexual health and sexual well-being of women with Mayer-Rokitansky-Kuester-Hauser syndrome after vaginal reconstruction: a qualitative analysis","authors":"Stepanow C, Naderer A, Alexopoulos J, Walch K, Wenzl R, Leithner K.","first_author":"Stepanow C","journal":"The journal of sexual medicine","year":2023,"pub_types":["Journal Article"],"keywords":["Qualitative Research","Neovagina","Genital Self-image","Sexual Self-esteem","Mrkhs","Mayer-rokitansky-kuester-hauser Syndrome"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative semistructured interviews with 10 MRKHS patients (post‑reconstruction) and 20 matched controls; content analysis of transcripts.","sample_n":30,"sample_text":"10 patients, 20 controls; convenience sampling from a single surgical centre.","population":"Women with MRKHS after vaginal reconstruction (n=10) and healthy controls (n=20).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Women with a congenital vaginal condition who had surgery reported mixed sexual experiences: many felt satisfied with intercourse but also insecure about their neovagina and had low sexual self‑esteem. Understanding these feelings can help clinicians support their sexual well‑being.","clinical_takeaway":"Clinicians should address genital self‑image and self‑esteem when counseling MRKHS patients after reconstruction.","confidence":0.8,"topic_tags":["sexual_function","gender","religiosity"],"strengths":["First qualitative study on genital self‑image in MRKHS","Use of matched control group","Data saturation reported"],"limitations":["Very small patient sample (n=10)","Single surgical technique limits generalisability","No validated quantitative measures"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/jsxmed/qdac011"}},{"id":9257,"doi":"10.1186/s12912-023-01531-2","pmid":"37817237","pmcid":"PMC10563268","title":"Impact of preparing nursing students to deliver a parent-based sexual health intervention on attitudes and intentions for sexual health education and parent communication counseling: a mixed methods study","authors":"Coleman DC, Frederick A, Cron S, Markham C, Guilamo-Ramos V, Santa Maria D.","first_author":"Coleman DC","journal":"BMC nursing","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Sexual Health","Nurse Education","Parent Education","Pediatric Nursing","Family Nursing"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10563268","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"quasi‑experimental mixed‑methods study with intervention and control groups (N=126 nursing students) examining pre‑post changes in attitudes, confidence and intentions after a parent‑based sexual health training.","sample_n":126,"sample_text":"126 nursing students (intervention and control groups)","population":"baccalaureate nursing students enrolled in a community/public health nursing clinical course","country":"United States (inferred from trial registration and author affiliations)","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A training program that let nursing students help parents talk about teen sexual health improved the students' confidence, attitudes and intentions to counsel families and promote HPV vaccination, compared with students who did not receive the training.","clinical_takeaway":"Teaching nursing students parent‑focused sexual‑health communication can boost their readiness to counsel families and support HPV‑vaccine uptake.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Registered trial (ClinicalTrials.gov)","Mixed‑methods integration of quantitative and qualitative data","Clear pre‑post design with control group"],"limitations":["Quasi‑experimental (likely non‑randomized) limits causal inference","Survey instruments not described as validated","No reported effect sizes or correction for multiple testing"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12912-023-01531-2"}},{"id":9258,"doi":"10.1371/journal.pone.0315049","pmid":"39775372","pmcid":"PMC11709294","title":"Opening the digital doorway to sexual healthcare: Recommendations from a behaviour change wheel analysis of barriers and facilitators to seeking online sexual health information and support among underserved populations","authors":"McLeod J, Estcourt CS, MacDonald J, Gibbs J, Woode Owusu M, Mapp F, Gallego Marquez N, McInnes-Dean A, Saunders JM, Blandford A, Flowers P.","first_author":"McLeod J","journal":"PloS one","year":2025,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://doi.org/10.1371/journal.pone.0315049","cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"semi‑structured interviews (n=35) with purposive sampling of underserved UK adults; thematic analysis and Behaviour Change Wheel recommendations","sample_n":35,"sample_text":"35 participants recruited purposively (PROGRESSPlus framework)","population":"UK adults from deprived areas and minoritised ethnic groups","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 35 adults from disadvantaged UK communities identified why they struggle to find online sexual‑health help and suggested education, better design, and support to improve access.","clinical_takeaway":"Improving online sexual‑health resources with clear, inclusive, and easy‑to‑use designs may help underserved people get needed care.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Theory‑informed (Behaviour Change Wheel) analysis","Purposive recruitment of diverse underserved groups","Clear, actionable recommendations"],"limitations":["Small qualitative sample limits generalisability","No quantitative validation of identified barriers","No measurement of mental‑health or moral variables"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0315049"}},{"id":9259,"doi":"10.26633/rpsp.2022.179","pmid":"36320206","pmcid":"PMC9595221","title":"A systematic review of sexual health and subjective well-being in older age groups","authors":"Vasconcelos P, Paúl C, Serruya SJ, Ponce de León RG, Nobre P.","first_author":"Vasconcelos P","journal":"Revista panamericana de salud publica = Pan American journal of public health","year":2022,"pub_types":["review-article","Review","Journal Article"],"keywords":["Aging","Sexuality","Sexual Health","Personal Satisfaction"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9595221","cited_by_count":22,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"7-8","sample_n":null,"sample_text":"15 quantitative studies (14 articles, 1 dissertation) reviewed; no primary sample reported","population":"Older adults (40‑≥90 years)","country":"multiple (global databases searched)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review examined 15 studies on people aged 40‑90 and found that having an active, satisfying sexual life is linked to higher life satisfaction and wellbeing. Programs that support sexual health may boost overall wellbeing for older adults.","clinical_takeaway":"Encourage discussion of sexual health as part of wellbeing programs for older adults.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Follows PRISMA guidelines","Broad database search across multiple regions","Focus on older adults, a less-studied population"],"limitations":["No meta‑analysis or quantitative synthesis","Unclear risk‑of‑bias assessment of included studies","Limited discussion of potential confounders (e.g., mental health, relationship status)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":43,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.26633/rpsp.2022.179"}},{"id":9260,"doi":"10.1016/j.srhc.2024.100947","pmid":"38310684","pmcid":null,"title":"Unmet sexual health needs of young men in contemporary society regarding condom use: Qualitative study","authors":"Bender SS, Hilmarsdottir K, Gunnarsdottir TJ.","first_author":"Bender SS","journal":"Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives","year":2024,"pub_types":["Journal Article"],"keywords":["Uncertainty","Knowledge","Communication","Young men","Condom","Sexual Pleasure"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Cross‑sectional qualitative study using focus groups and individual interviews with 49 young men (18‑25) recruited via schools, an STI clinic and a gay/lesbian organisation. Thematic analysis with framework method.","sample_n":49,"sample_text":"Forty‑nine individuals, 18‑25 years old, participated in both studies.","population":"Young men, 18‑25 years, mixed education and sexual orientation backgrounds, recruited from convenience settings in Sweden.","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 49 Swedish men aged 18‑25 reveal that uncertainty, lack of knowledge, and pressure to enjoy sex make condom use harder. They want better, holistic sex education to feel confident using condoms.","clinical_takeaway":"Clinicians should address knowledge gaps, communication skills and pressure to perform when counseling young men about condom use.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides in‑depth insight into young men’s lived experience of condom use","Uses both focus groups and individual interviews for data depth","Clear thematic framework analysis"],"limitations":["Small, non‑probability sample limits generalisability","No validated measurement instruments","No quantitative statistical testing or power calculation"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.srhc.2024.100947"}},{"id":9261,"doi":"10.1093/sexmed/qfae022","pmid":"38586251","pmcid":"PMC10997412","title":"Sexual health among the oldest old: a population-based study among people aged 85 years and older in Stockholm, Sweden","authors":"Politis M, Kosidou K, Fors S, Nord M.","first_author":"Politis M","journal":"Sexual medicine","year":2024,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Older Adults","Oldest Old","Healthy Ageing"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10997412","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"population-based cross-sectional survey of 183 adults ≥85 years in Stockholm","sample_n":183,"sample_text":"63 % response rate; 183 participants","population":"older adults (≥85 years), community-dwelling residents of Stockholm County, Sweden","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 183 Swedish adults aged 85 and older, about 12 % were sexually active and most were satisfied with their sex lives, though a third reported problems. Few had discussed sexual health with clinicians, suggesting a need for more proactive care.","clinical_takeaway":"Clinicians should ask older patients about sexual health, as many have concerns that go unaddressed.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Population‑based sample of an understudied age group","Multivariable logistic regression with confidence intervals","Clear reporting of response rate and limitations"],"limitations":["Small sample limits power and precision","Cross‑sectional design prevents causal inference","Limited measurement depth; reliance on single‑item self‑reports"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfae022"}},{"id":9262,"doi":null,"pmid":"31482866","pmcid":"PMC11582984","title":"[Evolution of sexual health in spanish and asturian adolescents]","authors":"García-Vázquez J, Quintó Domech L, Nascimento M, Agulló-Tomás E.","first_author":"García-Vázquez J","journal":"Revista espanola de salud publica","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Spain","Adolescents","Sexual Health","Stis","Gender Violence","Ive"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11582984","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"secondary data analysis of national surveys (2011‑2016) using differences‑in‑differences","sample_n":null,"sample_text":"large, nationally representative surveys (exact N not given)","population":"Spanish and Asturian adolescents (probability samples from health surveys)","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"From 2011 to 2016, Spanish and Asturian teens reported more penetrative sex, less condom use, and more pill use. STI rates fell in Asturias but rose for gonorrhea in Spain. Abortions and reported gender‑based violence declined.","clinical_takeaway":"Adolescent sexual‑health programs should focus on condom promotion and comprehensive sex education.","confidence":0.4,"topic_tags":["adolescents","sexual_function","gender","measurement"],"strengths":["Large, population‑level data sources","Clear temporal trend analysis (differences‑in‑differences)","Multiple relevant sexual‑health outcomes"],"limitations":["No individual‑level control of psychological or relational confounders","Reliance on self‑report for sexual behaviours without validation details","No effect‑size confidence intervals or power justification"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":9263,"doi":"10.2147/jmdh.s420640","pmid":"37641706","pmcid":"PMC10460610","title":"Development and Validation of a Sexual Health Literacy Measurement Tool for Pregnancy Prevention Among Adolescents (SHL-PPA)","authors":"Thongnopakun S, Manwong M, Visanuyothin S, Wattanaburanon A, Suwannarat W, Magteppong W.","first_author":"Thongnopakun S","journal":"Journal of multidisciplinary healthcare","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Pregnancy","Youth","Student","School Health","Instrument","Sexual Health Literacy"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10460610","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"instrument development and validation with 654 adolescents using Delphi, content validity, Cronbach's alpha, exploratory factor analysis","sample_n":654,"sample_text":"654 adolescents (online self‑assessment)","population":"adolescents (generation Z)","country":"Thailand","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors created and validated a 33‑item questionnaire (SHL‑PPA) that measures adolescents' ability to understand and use sexual health information to prevent pregnancy, showing good reliability and clear factor structure.","clinical_takeaway":"The SHL‑PPA can be used to assess and improve teenage pregnancy‑prevention education programs.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large adolescent sample (N=654)","Systematic instrument development (Delphi, content validity)","Strong internal consistency (Cronbach’s α)","Exploratory factor analysis supports construct structure"],"limitations":["Cross‑sectional; no test‑retest reliability reported","No external validation with independent sample","Limited reporting of power or effect‑size justification"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2147/jmdh.s420640"}},{"id":9264,"doi":"10.31234/osf.io/edypj","pmid":null,"pmcid":null,"title":"Evaluating the Impact of a Dutch Sexual Health Intervention for Adolescents: Think-Aloud and Semi-Structured Interview Study","authors":"Metz G, Thielmann RRLC, Roosjen H, Crutzen R.","first_author":"Metz G","journal":"PsyArXiv","year":2022,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.31234/osf.io/edypj","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"think‑aloud + semi‑structured interviews with 15 convenience‑sample adolescents (16‑25 y) exploring perceptions of a chlamydia information page","sample_n":15,"sample_text":"15 participants recruited for think‑aloud and interview study","population":"young people aged 16‑25 in the Netherlands (n=15)","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A small qualitative study asked 15 Dutch adolescents to think aloud while using a website page about chlamydia and then interviewed them. Users found the information trustworthy but noted that the link to the testing page was easy to miss and the language could be improved.","clinical_takeaway":"Improving link visibility and wording on sexual‑health sites may encourage testing among young people.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Mixed‑methods triangulation of theory, analytics and user perspectives","Detailed qualitative insight into barriers/facilitators for STI testing"],"limitations":["Very small, non‑representative sample (N=15)","No quantitative measurement of outcomes or effect sizes","Findings limited to a single website page and cannot be generalized"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/edypj"}},{"id":9266,"doi":"10.1111/jmwh.13226","pmid":"34151499","pmcid":null,"title":"Body Image Related to Sexual Health: Development of the Concept","authors":"Wilson CM, McGuire DB, Rodgers BL.","first_author":"Wilson CM","journal":"Journal of midwifery & women's health","year":2021,"pub_types":["Review","Journal Article"],"keywords":["Body Image","Women's Health","Sexual Health","Concept Development"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Concept development review synthesizing 71 qualitative and quantitative descriptive articles; no primary data collection.","sample_n":null,"sample_text":"No primary participants; based on literature synthesis.","population":"Women of reproductive age (conceptual focus); no primary sample","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed 71 studies to create a unified definition of body image as it relates to sexual health in women of reproductive age, highlighting emotional, behavioral, and sociocultural factors.","clinical_takeaway":"Use the proposed definition to better assess and address body‑image concerns that may affect women's sexual health.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Comprehensive synthesis of multidisciplinary literature","Clear methodological framework (Rodgers' concept development)","Identifies sociocultural influences on body image"],"limitations":["No original empirical data","Limited to conceptual development; no validation","Potential selection bias in article inclusion"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jmwh.13226"}},{"id":9268,"doi":"10.1016/j.jsxm.2022.03.607","pmid":"35513999","pmcid":"PMC9060260","title":"Longitudinal Impact of Social Restrictions on Sexual Health in the Italian Population","authors":"Vedovo F, Capogrosso P, Di Blas L, Cai T, Arcaniolo D, Privitera S, Palumbo F, Palmieri A, Trombetta C.","first_author":"Vedovo F","journal":"The journal of sexual medicine","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Sexual dysfunction","erectile dysfunction","Sexual Health","Female Sexual Dysfunction","Covid-19","Sars-cov-2"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9060260","cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Web‑based longitudinal survey of Italian adults at three time points (start of lockdown, 15 days later, and 1 month post‑lockdown).","sample_n":2543,"sample_text":"Convenient, self‑selected sample via social networks; no pre‑pandemic baseline.","population":"Italian adults (N≈2543) recruited via social‑media; mean age ~46 years; 47 % male, 43 % female.","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A web survey of over 2,500 Italian adults tracked sexual function during COVID‑19 lockdown. Dysfunction rose early in lockdown but improved after restrictions ended, especially in younger, healthier participants.","clinical_takeaway":"Lockdown‑related sexual dysfunction appears largely temporary; focus on mental and physical health may aid recovery.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large sample size","Validated sexual‑function questionnaires","Three‑wave longitudinal design"],"limitations":["Convenience web sample; limited generalisability","No pre‑pandemic baseline for comparison","No assessment of relationship/partner factors"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2022.03.607"}},{"id":9269,"doi":"10.1186/s12889-023-15085-0","pmid":"36698108","pmcid":"PMC9878820","title":"'Bending' against straightening devices: queer lived experiences of sexuality and sexual health in Bangladesh","authors":"Alam P, Marston C.","first_author":"Alam P","journal":"BMC public health","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexuality","Bangladesh","Young People","Qualitative Research","Heteronormativity"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9878820","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative phenomenological interview study with 14 purposively sampled LGBTQ+ young adults in Bangladesh","sample_n":14,"sample_text":"14 purposively sampled LGBTQ+ individuals aged 18‑24","population":"Bangladeshi LGBTQ+ persons aged 18‑24 (n=14)","country":"Bangladesh","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 14 young LGBTQ+ people in Bangladesh show how social, family and health‑care pressures push them toward heterosexual norms, and how they cope with these 'straightening devices'.","clinical_takeaway":"Clinicians should recognize heteronormative pressures affecting LGBTQ+ youth’s sexual health in Bangladesh.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["In‑depth phenomenological insight from a hard‑to‑reach population","Clear theoretical framework ('straightening devices')","Systematic thematic analysis"],"limitations":["Very small, non‑representative purposive sample (n=14)","No quantitative measurement of constructs; limited construct validity","No assessment of key confounds (mental health, trauma, etc.)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-023-15085-0"}},{"id":9270,"doi":"10.3390/curroncol30020184","pmid":"36826145","pmcid":"PMC9955462","title":"The Anatomy of a Hybrid In-Person and Virtual Sexual Health Clinic in Oncology","authors":"Matthew A, Guirguis S, Incze T, Stragapede E, Peltz S, Yang G, Jamnicky L, Elterman D.","first_author":"Matthew A","journal":"Current oncology (Toronto, Ont.)","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual dysfunction","Sexual Health","Cancer Survivorship","Cancer Rehabilitation","Biopsychosocial","Oncosexology"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9955462","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"descriptive case report of a hybrid sexual health clinic model in oncology; no empirical outcome data reported","sample_n":null,"sample_text":"not reported","population":"cancer survivors receiving care at Princess Margaret Hospital; no sample size reported","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes a new hybrid in‑person/virtual sexual health clinic for cancer survivors, outlining its multidisciplinary approach and how it can be adapted to multiple cancer types.","clinical_takeaway":"Clinicians may consider hybrid sexual health services to improve access for oncology patients, but evidence of effectiveness is not yet provided.","confidence":0.8,"topic_tags":["sexual_function","csbd","moral_incongruence","masturbation","pornography"],"strengths":["Innovative hybrid care model","Interdisciplinary, biopsychosocial framework","Includes partner participation"],"limitations":["No empirical outcome data presented","No measurement of sexual health outcomes","No control or comparison group"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/curroncol30020184"}},{"id":9271,"doi":"10.1177/07334648221099728","pmid":"35623344","pmcid":null,"title":"Using the Intersectionality-Based Policy Analysis Framework to Evaluate a Policy Supporting Sexual Health and Intimacy in Long-Term Care, Assisted Living, Group Homes &amp; Supported Housing","authors":"McBride K, Carlson M, Everett B.","first_author":"McBride K","journal":"Journal of applied gerontology : the official journal of the Southern Gerontological Society","year":2022,"pub_types":["Journal Article"],"keywords":["Sexuality","Sexual behaviour","Facility"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"policy analysis using Intersectionality-Based Policy Analysis Framework; no empirical data collected","sample_n":null,"sample_text":"None – paper does not report empirical participants","population":"policy/health administrators and stakeholders in long‑term care; no participants recruited","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors evaluate a Canadian policy promoting sexual health and intimacy for residents in long‑term care using an intersectionality framework, concluding the policy is feasible, equitable, and worth wider adoption.","clinical_takeaway":"None – the paper offers policy guidance, not clinical evidence.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Systematic application of an established policy‑analysis framework","Considers intersectional equity and diverse perspectives"],"limitations":["No empirical data; conclusions are speculative","Does not address potential confounding factors like moral incongruence or mental health"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/07334648221099728"}},{"id":9273,"doi":"10.1089/apc.2023.0307","pmid":"38656218","pmcid":"PMC11236281","title":"Understanding Attitudes of Postpartum Cisgender Women Toward Integration of HIV Prevention Services into Routine Prenatal and Postpartum Sexual Health Discussions","authors":"Mullis CE, Goldberg AJ, Avila K, Hall B, Golub SA, Keller MJ.","first_author":"Mullis CE","journal":"AIDS patient care and STDs","year":2024,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Postpartum","Maternal Health","Hiv Prevention","Pre-exposure Prophylaxis","Cisgender Women"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"semi‑structured interviews with 20 postpartum cisgender women in the Bronx, thematic framework analysis","sample_n":20,"sample_text":"20 postpartum CGW interviewed","population":"postpartum cisgender women, United States, Bronx, NY (N=20)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 20 new mothers in the Bronx showed most hadn’t heard of HIV‑prevention pills, rarely discussed sex with their doctors, but welcomed added HIV‑prevention counseling during prenatal and postpartum visits.","clinical_takeaway":"Clinicians should proactively discuss HIV prevention, including PrEP, with postpartum women even when patients perceive low personal risk.","confidence":0.78,"topic_tags":["prevalence","sexual_function"],"strengths":["In‑depth qualitative insight into postpartum women's attitudes","Focus on an underserved population in a high‑prevalence area","Systematic thematic framework analysis"],"limitations":["Small, non‑representative convenience sample (N=20)","No validated measurement instruments","Findings not generalisable beyond Bronx postpartum women"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/apc.2023.0307"}},{"id":9274,"doi":"10.3390/ijerph18041443","pmid":"33557062","pmcid":"PMC7913844","title":"Viewing Sexual Health Education through the Lens of Critical Pedagogy: A Case Study in Chicago Public Schools","authors":"Jarpe-Ratner E, Marshall B.","first_author":"Jarpe-Ratner E","journal":"International journal of environmental research and public health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Critical Pedagogy","Comprehensive She","Implementation Of She"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7913844","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"case study using teacher interviews (n=16) and student focus groups (n=5 groups, 46 students) in Chicago Public Schools","sample_n":62,"sample_text":"16 teachers and 46 students participated in interviews/focus groups","population":"teachers and secondary‑school students in a large urban US district","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews and focus groups with Chicago teachers and students show that current sexual‑health curricula would benefit from more student‑centered, dialogic teaching, a holistic wellbeing focus, and discussion of health inequities.","clinical_takeaway":"Educators should incorporate student voice and holistic health perspectives when delivering sexual health curricula.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight from teachers and students","Grounded in critical pedagogy theory","Identifies concrete implementation improvements"],"limitations":["Small, non‑representative sample; limited generalisability","No quantitative outcome measures","Findings specific to one district"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph18041443"}},{"id":9275,"doi":"10.21203/rs.3.rs-59514/v3","pmid":null,"pmcid":null,"title":"Sexual health and COVID-19: Protocol for a scoping review","authors":"Kumar N, Janmohamed K, Nyhan K, Forastiere L, Zhang W, Kågesten A, Uhlich M, de Velde SMV, Francis JM, Erasquin JT, Larrson EC, Callander D, Scott J, Minichiello V, Tucker JD.","first_author":"Kumar N","journal":"Research Square","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":true,"oa_url":"https://www.researchsquare.com/article/rs-59514/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"Protocol for a scoping review; no empirical data yet.","sample_n":null,"sample_text":"Not applicable – protocol outlines future inclusion criteria.","population":"Not applicable (protocol)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This preprint outlines a planned scoping review of how the COVID‑19 pandemic has affected sexual health, detailing databases to be searched and methods for summarising findings.","clinical_takeaway":"None – the study is a protocol and provides no actionable results.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Transparent, pre‑specified methodology using JBI framework","Broad database search including grey literature"],"limitations":["No empirical data yet; protocol only","Potential language bias (English only)","Scope may be very wide, limiting depth on specific issues"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-59514/v3"}},{"id":9276,"doi":"10.2105/ajph.2023.307296","pmid":"37339413","pmcid":null,"title":"Women-Centered Program for Women of Color (WC4WC): A Community-Based Participatory, Culturally Congruent Sexual Health Intervention in Los Angeles County, California","authors":"Wyatt GE, Chin D, Loeb TB, Norwood-Scott E, McEwan JA, Zhang M, Smith-Clapham AM, Cooley-Strickland M, Trinidad C, Flint JR, Wells Y, Divinity R, Liu H.","first_author":"Wyatt GE","journal":"American journal of public health","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"single‑group pre‑post community‑based participatory intervention, no control group","sample_n":null,"sample_text":"participants in a community‑based sexual‑health program","population":"women of colour in Los Angeles County, sample size not reported","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A community program for women of colour in Los Angeles improved participants' knowledge and interest in HIV‑prevention medicines (PrEP/PEP) but did not change condom use.","clinical_takeaway":"Education can boost PrEP/PEP awareness among women of colour, but additional strategies are needed to influence condom use.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["community‑based participatory approach","focus on culturally congruent intervention","measured change over time"],"limitations":["no control/comparison group","likely ad‑hoc knowledge measures","small/unspecified sample size","limited outcome scope (knowledge only)"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2105/ajph.2023.307296"}},{"id":9277,"doi":"10.1136/bmjph-2023-000259","pmid":"40017874","pmcid":"PMC11812717","title":"'I wouldn't trust it …' Digital transformation of young people's sexual health services: a systems-informed qualitative enquiry","authors":"Bennett C, Kelly D, Dunn C, Musa MK, Young H, Couzens Z, McSorley J, Jones E.","first_author":"Bennett C","journal":"BMJ public health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Public Health","Preventive Medicine","Community Health"],"is_oa":true,"oa_url":"https://bmjpublichealth.bmj.com/content/bmjph/1/1/e000259.full.pdf","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative descriptive study with 10 nurses and 32 young people, thematic analysis","sample_n":42,"sample_text":"10 nurses, 32 young people (convenience purposive sampling)","population":"16‑18‑year‑old young people and sexual health nurses in the UK","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with teenage users and sexual‑health nurses show digital tools can make sexual‑health information easier to access, but they cannot replace face‑to‑face services and need to fit within broader health systems.","clinical_takeaway":"Digital sexual‑health services can complement, but not replace, traditional clinics for young people.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Uses systems thinking framework","Includes perspectives of both providers and users","Reflexive thematic analysis performed"],"limitations":["Small, non‑representative sample","No quantitative measures of outcomes","Findings may not generalise beyond UK context"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjph-2023-000259"}},{"id":9278,"doi":"10.3390/ijerph21030252","pmid":"38541254","pmcid":"PMC10970399","title":"Addressing Adolescent Substance Abuse and Risky Sexual Health Behaviors via Youth-Led Initiatives: A Review of the Teens Linked to Care Pilot Program","authors":"Bednar H, McMillan S, Sidibe T, Bennett M.","first_author":"Bednar H","journal":"International journal of environmental research and public health","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Review","Journal Article"],"keywords":["Substance Abuse","Risky Behaviors","Teens Linked To Care","Youth-led Programming"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/21/3/252/pdf?version=1708601710","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Program evaluation of a pilot youth‑led initiative using YRBS data; no control group, likely pre‑post descriptive analysis.","sample_n":null,"sample_text":"Not reported in abstract","population":"School‑attending adolescents in two rural counties, including sexual and gender minority youth","country":"Not specified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A youth‑led pilot program in two rural high schools combined education, screening and support to curb substance use and risky sex. Using school survey data, the authors report improved resources, connectedness and resilience, but the evaluation lacks a control group and detailed outcome metrics.","clinical_takeaway":"Program shows promise for school‑based prevention, but clinicians should note the limited evidence of effectiveness.","confidence":0.6,"topic_tags":["adolescents","religiosity","sexual_function"],"strengths":["Uses a nationally validated survey (YRBS)","Targets underserved and SGMY adolescents","Integrates education, screening, and care linkage"],"limitations":["No control or comparison group","No quantitative effect‑size reporting","Unclear sample size and power"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph21030252"}},{"id":9279,"doi":"10.31234/osf.io/zhj86","pmid":null,"pmcid":null,"title":"Evaluating use of web-based interventions: an example of a Dutch sexual health intervention","authors":"Metz G, Roosjen H, Zweers W, Crutzen R.","first_author":"Metz G","journal":"PsyArXiv","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://psyarxiv.com/zhj86/download","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Descriptive case example using web‑analytics data (Matomo) to compare intended vs. actual use of a Dutch sexual‑health website (sense.info). No participant sampling reported.","sample_n":null,"sample_text":"Not reported in abstract; usage data derived from web‑analytics logs.","population":"Users of the sense.info web‑based sexual health intervention (no demographic description).","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"useful","plain_summary":"The authors show how a diagram of planned website use (ABCD) can be compared with actual visitor behaviour tracked by web‑analytics, using a Dutch sexual‑health site as an example.","clinical_takeaway":"None – the paper describes a methodological approach, not clinical effects.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Introduces a clear method (ABCDs) to map intended intervention use","Demonstrates practical use of web‑analytics (Matomo) for real‑world data","Addresses common problem of poorly described digital interventions"],"limitations":["No participant characteristics or sampling frame provided","No statistical power justification; analyses limited to descriptive metrics","Does not assess health outcomes or behavior change"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/zhj86"}},{"id":9280,"doi":"10.29271/jcpsp.2022.04.419","pmid":"35330510","pmcid":null,"title":"Effects of Chronic Migraine on Male Sexual Health","authors":"Baykam MM, Baser A, Baser HY, Eliacik S, Tan FU.","first_author":"Baykam MM","journal":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","year":2022,"pub_types":["Journal Article","Observational Study"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational case‑control survey comparing 92 chronic‑migraine patients with 87 healthy controls; IIEF‑5 and VAS administered; regression analysis performed.","sample_n":179,"sample_text":"179 participants (92 chronic migraine, 87 controls)","population":"Male patients with chronic migraine (n≈92) and healthy male volunteers (n≈87) from a Turkish university hospital.","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In men with chronic migraine, higher migraine pain was linked to lower erectile function scores compared with healthy men, suggesting a possible negative impact of migraine on sexual health.","clinical_takeaway":"Consider evaluating erectile function in patients with chronic migraine, but note that the relationship is correlational.","confidence":0.8,"topic_tags":["sexual_function","moral_incongruence","masturbation"],"strengths":["Validated erectile function instrument (IIEF‑5)","Clear case‑control design with reasonable sample size","Standard migraine diagnostic criteria used"],"limitations":["Cross‑sectional; cannot infer causality","No control for psychological, relational or trauma confounders","No effect‑size confidence intervals reported"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.29271/jcpsp.2022.04.419"}},{"id":9282,"doi":"10.1007/s13178-022-00693-z","pmid":"39583873","pmcid":"PMC11583360","title":"The Development of the Framework of Integrated Reproductive and Sexual Health Theories (FIRSHT) to Contextualize Indigenous Women's Health Experiences","authors":"Liddell JL, McKinley CE.","first_author":"Liddell JL","journal":"Sexuality research & social policy : journal of NSRC : SR & SP","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Indigenous","Reproductive Health","Sexual Health","Qualitative Research","Life Course","Theoretical Framework","Critical Theory","Women’s Health","Reproductive Justice","Resilience Theory","Eco-Systemic Theory"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative descriptive study, N=31 Indigenous women, interview‑based thematic analysis, community‑advisory partnership","sample_n":31,"sample_text":"31 Indigenous women recruited from a Gulf Coast tribe","population":"Indigenous women (Gulf Coast tribe)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers interviewed 31 Indigenous women to create a new framework (FIRSHT) that links cultural, historical, and systemic factors influencing their reproductive and sexual health, emphasizing resilience and justice.","clinical_takeaway":"Use the FIRSHT to guide culturally sensitive care that builds on Indigenous strengths and addresses systemic barriers.","confidence":0.5,"topic_tags":["religiosity","moral_incongruence","masturbation","pornography"],"strengths":["Community‑advisory board involvement","In‑depth qualitative interviews","Development of a novel integrative framework"],"limitations":["Small, non‑representative sample","No quantitative validation of constructs","Findings limited to one tribe"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":10,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13178-022-00693-z"}},{"id":9284,"doi":"10.1080/10410236.2021.1980253","pmid":"34605355","pmcid":null,"title":"Uncertainty Management in Online Sexual Health Forums","authors":"Basinger ED, Delaney AL, Williams C.","first_author":"Basinger ED","journal":"Health communication","year":2023,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"grounded theory analysis of posts from online sexual health forums","sample_n":null,"sample_text":"Not reported in abstract","population":"users of sexual health discussion forums (unspecified demographics)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors examined posts from online sexual‑health forums and found that people turn to these sites for emotional and informational support when they feel uncertain, anxious, or stigmatized about their sexual health. Support helps them understand information, evaluate risks, and plan how to talk about sex.","clinical_takeaway":"Clinicians should recognize that stigma drives patients to seek online support and consider discussing uncertainty management in sexual‑health consultations.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Rich qualitative insight into how people manage sexual health uncertainty","Grounded theory provides systematic coding of forum data","Identifies stigma as a key driver of online support seeking"],"limitations":["Convenience sample of forum posts limits generalizability","No assessment of demographic or mental‑health variables","Findings may not apply to other cultural or clinical contexts"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2021.1980253"}},{"id":9285,"doi":"10.1371/journal.pone.0306280","pmid":"38950031","pmcid":"PMC11216565","title":"Understanding sexual health service access for gay, bisexual and other men who have sex with men in Ireland during the COVID-19 crisis: Findings from the EMERGE survey","authors":"Shanley A, O'Donnell K, Weatherburn P, Gilmore J, Witzel TC.","first_author":"Shanley A","journal":"PloS one","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11216565","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online anonymous survey of gbMSM recruited via dating apps and social media; analysis of respondents who attempted to access services (N≈586); multiple logistic regression","sample_n":980,"sample_text":"980 gbMSM recruited; 586 included in regression analyses (those who attempted to access services)","population":"gay, bisexual and other men who have sex with men in Ireland, age 18+, recruited June‑July 2021","country":"Ireland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2024 Irish survey of 980 gay, bisexual and other men who have sex with men found that older men, those with lower education, and those who had never been tested for HIV were less likely to successfully access sexual‑health services during COVID‑19 lockdowns.","clinical_takeaway":"Clinicians should proactively reach out to older, less‑educated gbMSM and encourage HIV testing to reduce service‑access gaps.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a niche population","Use of multivariable regression with confidence intervals","Timely focus on COVID‑19 service disruptions"],"limitations":["Convenience, non‑probability sampling limits generalisability","Cross‑sectional self‑report; cannot infer causality","No measurement of mental‑health or other potential confounders"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0306280"}},{"id":9286,"doi":"10.1111/jocn.16753","pmid":"37221928","pmcid":null,"title":"Impaired sexual health among women treated for vulvar cancer: An integrated review","authors":"Olesen ML, Seibaek L, Sekse RJT.","first_author":"Olesen ML","journal":"Journal of clinical nursing","year":2023,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"integrated thematic review of 28 primary studies using PRISMA‑ScR and ENTREQ guidelines","sample_n":null,"sample_text":"28 primary articles; no single sample size reported for the review itself","population":"women treated for vulvar cancer (samples from the 28 reviewed studies)","country":"International (studies from multiple countries)","controls_mi":"not_applicable","preregistered":true,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises 28 studies showing that women who have been treated for vulvar cancer often experience reduced sexual health, feelings of isolation, and unmet sexual needs, highlighting a need for broader clinical support.","clinical_takeaway":"Clinicians should proactively screen and address multidimensional sexual health concerns in vulvar‑cancer survivors.","confidence":0.6,"topic_tags":["sexual_function","csbd"],"strengths":["Protocol preregistered on OSF","Use of established scoping review methodology (Whittemore & Knafl)","Thematic synthesis across multiple databases"],"limitations":["No quantitative synthesis; relies on heterogeneous primary questionnaires","Limited appraisal of methodological quality of included studies","Does not address potential confounds such as mental health or relationship factors"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jocn.16753"}},{"id":9287,"doi":"10.1186/s12978-023-01692-y","pmid":"37798765","pmcid":"PMC10557348","title":"Development of self-care strategies to promote young Iranian women's sexual health: an explanatory sequential mixed method study protocol","authors":"Bonyadpour B, Maasoumi R, Nekoolaltak M.","first_author":"Bonyadpour B","journal":"Reproductive health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Self-care","Single Young Women"],"is_oa":true,"oa_url":"https://reproductive-health-journal.biomedcentral.com/counter/pdf/10.1186/s12978-023-01692-y","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"other","design_detail":"explanatory sequential mixed‑method protocol (cross‑sectional survey of 400 unmarried Iranian women, qualitative interviews, narrative review, expert prioritisation)","sample_n":400,"sample_text":"planned 400 participants (cluster random sampling)","population":"unmarried female university students, Iran, age 18‑29","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A planned study will survey 400 single Iranian university women and interview some of them to develop self‑care strategies that improve their sexual health, then refine those strategies with expert input.","clinical_takeaway":"None – the paper outlines a future protocol, not actionable findings.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Large planned sample with cluster random sampling","Mixed‑methods design integrates quantitative and qualitative data","Involves stakeholder/expert prioritisation of strategies"],"limitations":["Use of a researcher‑designed questionnaire (likely unvalidated)","No explicit measurement or control of key sexual‑health confounds","Protocol only; no empirical results yet"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12978-023-01692-y"}},{"id":9288,"doi":"10.1080/00224499.2013.764380","pmid":"23480078","pmcid":null,"title":"Sexual rights: meanings, controversies, and sexual health promotion","authors":"Lottes IL.","first_author":"Lottes IL.","journal":"Journal of sex research","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary without empirical data; no sample, no methods.","sample_n":null,"sample_text":"None (the article is a narrative discussion)","population":"Not applicable","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how the concept of sexual rights has been adopted across fields, discusses its theoretical foundations, controversies, and how it can guide sexual‑health policies.","clinical_takeaway":"None – the paper offers theoretical insight, not clinical guidance.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Clear synthesis of sexual‑rights literature","Broad interdisciplinary perspective"],"limitations":["No empirical data or systematic review methods","No measurement of key constructs such as distress or behavior frequency"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":41,"citing_publications":71,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2013.764380"}},{"id":9289,"doi":"10.1007/s10508-023-02536-3","pmid":"36702994","pmcid":"PMC9879562","title":"Prevent2Protect Project: Regulatory Focus Differences in Sexual Health Knowledge and Practices","authors":"Rodrigues DL, de Visser RO, Lopes D, Prada M, Garrido MV, Balzarini RN.","first_author":"Rodrigues DL","journal":"Archives of sexual behavior","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexuality","Prevention","Promotion","Sexual Health","Sti","Regulatory Focus"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9879562","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"pre‑registered online survey of 742 Portuguese and Spanish adults","sample_n":742,"sample_text":"N = 742 Portuguese and Spanish adults","population":"adults (mean age 31.4) recruited online, likely convenience sample","country":"Portugal, Spain","controls_mi":"not_applicable","preregistered":true,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"People who focus on preventing harm know more about STIs from scientific sources but test less often, while those who focus on seeking pleasure know about specific STIs from medical/peer sources and test more. Motivational style shapes sexual‑health knowledge and testing behaviour.","clinical_takeaway":"Clinicians should consider individuals' regulatory focus when designing sexual‑health education and testing outreach.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample size","Pre‑registered protocol","Use of a validated motivational construct (regulatory focus)","Statistical control for demographics"],"limitations":["Cross‑sectional design limits causal inference","Self‑report measures for knowledge and behaviours","Convenience online sample may limit generalisability","Key sexual‑health confounds (e.g., mental health, relationship status) not assessed"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":8,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-023-02536-3"}},{"id":9290,"doi":"10.1093/sexmed/qfac002","pmid":"36910701","pmcid":"PMC9978583","title":"A qualitative study of sexual health and function of females with pelvic cancer","authors":"Oveisi N, Khan Z, Brotto LA.","first_author":"Oveisi N","journal":"Sexual medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Female","Physiological","Psychological","Genital neoplasms","Sexual dysfunction","Pelvic Neoplasms","Sexual Health","Cancer Survivors"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9978583","cited_by_count":13,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interviews with 15 female pelvic cancer survivors and 9 healthcare providers; framework analysis of semi‑structured online interviews","sample_n":24,"sample_text":"15 patients, 9 providers (convenience online recruitment)","population":"female pelvic cancer survivors (heterogeneous cancer types) and their healthcare providers","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 15 women who survived pelvic cancers and 9 clinicians revealed common sexual problems such as pain, dryness and low desire, especially after vulvar or vaginal cancers. Providers felt untrained to discuss these issues, suggesting a need for better education and resources.","clinical_takeaway":"Clinicians should seek training and resources to address sexual health concerns of pelvic cancer survivors.","confidence":0.85,"topic_tags":["sexual_function","csbd"],"strengths":["Includes both patient and provider perspectives","Uses systematic framework analysis","Identifies concrete service gaps"],"limitations":["Small, non‑representative sample","No validated quantitative measures","Findings limited to self‑report, no causal inference"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":18,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfac002"}},{"id":9291,"doi":"10.1007/s00520-021-06263-0","pmid":"34003379","pmcid":"PMC8464554","title":"Sexual health and wellbeing after pelvic radiotherapy among women with and without a reported history of sexual abuse: important issues in cancer survivorship care","authors":"Åkeflo L, Elmerstig E, Dunberger G, Skokic V, Arnell A, Bergmark K.","first_author":"Åkeflo L","journal":"Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Late effect","Sexual dysfunction","Sexual Abuse","Sexual Health","Pelvic Radiotherapy","Female Cancer Survivor"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s00520-021-06263-0.pdf","cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 570 women treated with pelvic radiotherapy; subgroup analysis of 11% reporting sexual abuse","sample_n":570,"sample_text":"570 women (≈63 with reported sexual abuse)","population":"women with gynaecological, anal, or rectal cancer treated curatively with pelvic radiotherapy; population‑based cohort plus referred patient group","country":"Sweden (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 570 women treated with pelvic radiotherapy, those who had experienced sexual abuse were twice as likely to report genital pain and also showed higher rates of depression and anxiety, suggesting that abuse history worsens sexual and psychological outcomes after cancer treatment.","clinical_takeaway":"Screen for past sexual abuse in women receiving pelvic radiotherapy, as it signals higher risk of sexual pain and distress; offer tailored support.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large overall sample (n=570)","Population‑based cohort enhances generalisability","Addresses understudied link between sexual abuse history and cancer‑related sexual health"],"limitations":["Uses a non‑validated, study‑specific questionnaire","Cross‑sectional design prevents causal inference","Limited control for potential confounders (e.g., partner status, moral/religious factors)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":5,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00520-021-06263-0"}},{"id":9292,"doi":"10.1016/j.nedt.2022.105371","pmid":"35524991","pmcid":null,"title":"Knowledge attitudes and readiness of nursing students in assessing peoples' sexual health problems","authors":"Jadoon SB, Nasir S, Victor G, Pienaar AJ.","first_author":"Jadoon SB","journal":"Nurse education today","year":2022,"pub_types":["Journal Article"],"keywords":["Knowledge","Attitude","Sexual Health","Nursing Students","Readiness"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional descriptive survey of 195 nursing students using stratified random sampling; self‑administered questionnaires on STD knowledge, sexual‑health attitudes and readiness.","sample_n":195,"sample_text":"195 nursing students recruited via stratified random sampling from two semesters of BSN and two semesters of Post‑RN programmes.","population":"Nursing students (BSN and Post‑RN) in Pakistan (presumed from author names).","country":"Pakistan","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2022 survey of 195 nursing students found they have limited knowledge about sexually transmitted diseases but generally hold positive attitudes and feel moderately ready to address patients' sexual‑health concerns. Religious and cultural factors were mentioned as perceived barriers.","clinical_takeaway":"Nursing curricula should strengthen STD knowledge while building on students' positive attitudes toward sexual‑health care.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Stratified random sampling within programme","Use of previously published questionnaires (STD‑KQ)","Clear reporting of knowledge gaps and attitudes"],"limitations":["Cross‑sectional; cannot infer causality","No adjustment for potential confounders (e.g., religiosity, mental health)","Limited to one institution; generalisability uncertain"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":1,"mentioning":10,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.nedt.2022.105371"}},{"id":9293,"doi":"10.1002/nau.24846","pmid":"34989425","pmcid":null,"title":"International Continence Society (ICS) report on the terminology for sexual health in men with lower urinary tract (LUT) and pelvic floor (PF) dysfunction","authors":"Kocjancic E, Chung E, Garzon JA, Haylen B, Iacovelli V, Jaunarena J, Locke J, Millman A, Nahon I, Ohlander S, Pang R, Plata M, Acar O.","first_author":"Kocjancic E","journal":"Neurourology and urodynamics","year":2022,"pub_types":["Review","Journal Article"],"keywords":["Male","Pelvic floor","Dysfunction","Sexual Health","Lower Urinary Tract"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Consensus terminology report; no primary data, no empirical study.","sample_n":null,"sample_text":"Not applicable – expert consensus rather than participant sample.","population":"Men with lower urinary tract and pelvic floor dysfunction (clinical expert group).","country":"International (ICS working group).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The International Continence Society created a consensus list of 198 definitions for sexual health issues in men with urinary and pelvic floor problems, aiming to help clinicians and researchers use consistent terminology.","clinical_takeaway":"Use the provided definitions for clearer communication in clinical practice and research on male pelvic floor and urinary disorders.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Comprehensive expert consensus process (18 review rounds).","Provides standardized terminology for clinicians and researchers.","Incorporates evidence where available and highlights gaps."],"limitations":["No empirical data; definitions not validated through measurement studies.","Potential bias from expert opinion without systematic systematic review.","Limited applicability to broader sexual health topics (e.g., pornography, masturbation)."],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/nau.24846"}},{"id":9294,"doi":"10.3390/ijerph191912124","pmid":"36231424","pmcid":"PMC9564711","title":"Chemsex, Identity and Sexual Health among Gay and Bisexual Men","authors":"Jaspal R.","first_author":"Jaspal R.","journal":"International journal of environmental research and public health","year":2022,"pub_types":["research-article","Review","Journal Article"],"keywords":["Mental health","identity","Sexual Health","Minority Stress","Gay And Bisexual Men","Chemsex"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9564711","cited_by_count":25,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"narrative review","sample_n":null,"sample_text":"none (narrative review)","population":"gay and bisexual men who engage in chemsex (no empirical sample)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article reviews how gay and bisexual men use drugs during sex (chemsex) and proposes that identity threats—like stigma or low self‑esteem—drive these behaviors. Drawing on identity process theory, it suggests chemsex may serve as a coping strategy to protect or enhance identity, and calls for research to test this framework.","clinical_takeaway":"Clinicians should consider identity stress and coping when discussing chemsex with gay and bisexual men, but note that this is a theoretical review, not empirical evidence.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Integrates identity process theory with chemsex literature","Comprehensive narrative of existing empirical work","Identifies clear directions for future research"],"limitations":["No original data; conclusions rely on prior studies","No systematic review methods (search strategy, bias assessment)","Does not empirically test proposed theoretical model"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":27,"citing_publications":59,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph191912124"}},{"id":9295,"doi":"10.1080/26895269.2021.2016540","pmid":"36713145","pmcid":"PMC9879190","title":"Sexual experience, relationships, and factors associated with sexual and romantic satisfaction in the first Australian Trans & Gender Diverse Sexual Health Survey","authors":"Holt M, Broady T, Callander D, Pony M, Duck-Chong L, Cook T, Rosenberg S.","first_author":"Holt M","journal":"International journal of transgender health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Relationships","Sexual behavior","Sexual Satisfaction","Transgender Persons","Romantic Satisfaction"],"is_oa":false,"oa_url":"http://hdl.handle.net/1959.4/unsworks_79215","cited_by_count":13,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"national online survey of 1,613 transgender and gender‑diverse adults in Australia; convenience sampling","sample_n":1613,"sample_text":"1613 participants (21.9% trans men, 24.6% trans women, 53.5% non‑binary)","population":"transgender and gender‑diverse adults in Australia (self‑selected respondents to a national survey)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A national Australian survey of 1,600 transgender and gender‑diverse people found low sexual (32%) and romantic (47%) satisfaction. Younger age, more frequent sex, and supportive partners were linked to higher satisfaction, while anxiety about sex and open relationships were linked to lower satisfaction.","clinical_takeaway":"Clinicians should assess sexual anxiety and relationship dynamics in trans clients and consider supportive counseling to improve satisfaction.","confidence":0.8,"topic_tags":["sexual_function","relationships","gender"],"strengths":["Large national sample (N>1500)","Focus on understudied trans population","Multivariate analysis of factors linked to satisfaction"],"limitations":["Convenience, self‑selected sample limits generalisability","Reliance on single‑item self‑report measures","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":16,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/26895269.2021.2016540"}},{"id":9296,"doi":"10.1016/j.heliyon.2023.e19701","pmid":"37810038","pmcid":"PMC10558929","title":"Chinese medical staff's knowledge, attitudes and practices towards breast cancer patients' sexual health management: A cross-sectional study","authors":"Yao L, Li Y, Wang T, Jia F, Zhang Y, You X, Hu L, Zhang B, Zhang Q, Ming W, Li H.","first_author":"Yao L","journal":"Heliyon","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["China","Breast cancer","Knowledge","Attitudes","Practices","Sexual Health Management"],"is_oa":true,"oa_url":"https://doi.org/10.1016/j.heliyon.2023.e19701","cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Web‑based questionnaire of 3,181 medical staff from 26 hospitals in Guizhou, China; cross‑sectional KAP survey.","sample_n":3181,"sample_text":"Large multi‑center convenience sample of medical staff.","population":"Healthcare professionals (doctors, nurses, etc.) in western China","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 3,000 Chinese health workers showed limited knowledge and confidence in managing breast‑cancer survivors' sexual health, highlighting the need for better training.","clinical_takeaway":"Clinicians should receive targeted education to improve support for sexual health issues in breast‑cancer patients.","confidence":0.8,"topic_tags":["sexual_function","csbd","masturbation","pornography"],"strengths":["Large sample size","Use of a previously validated KAP instrument","Multi‑center recruitment across several cities"],"limitations":["Cross‑sectional design prevents causal inference","Potential self‑selection bias among respondents","No reporting of effect sizes or confidence intervals"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.heliyon.2023.e19701"}},{"id":9298,"doi":"10.1186/s13643-021-01591-y","pmid":"33485393","pmcid":"PMC7825389","title":"Sexual health and COVID-19: protocol for a scoping review","authors":"Kumar N, Janmohamed K, Nyhan K, Forastiere L, Zhang WH, Kågesten A, Uhlich M, Van de Velde SM, Francis JM, Erausquin JT, Larsson EC, Callander D, Scott J, Minichiello V, Tucker JD.","first_author":"Kumar N","journal":"Systematic reviews","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Women","Sexual Health","Lgbt","Sexual Minority","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7825389","cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"protocol for a scoping review (no empirical data yet)","sample_n":null,"sample_text":"Not applicable – protocol","population":"global sexual‑health populations during COVID‑19","country":"International","controls_mi":"not_applicable","preregistered":true,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"This paper outlines a planned scoping review of how the COVID‑19 pandemic has affected sexual health worldwide. It describes the databases, inclusion criteria, and methods the authors will use to map existing research.","clinical_takeaway":"None – the article is a protocol and provides no clinical findings.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Transparent, pre‑registered protocol","Comprehensive literature search strategy","Use of established JBI scoping review methodology"],"limitations":["No empirical data yet","Does not address key confounds (e.g., moral incongruence, masturbation)","Limited to English‑language studies"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s13643-021-01591-y"}},{"id":9299,"doi":"10.1111/jocn.15820","pmid":"33931920","pmcid":null,"title":"Patient perspectives and experiences of sexual health conversations and cardiovascular disease: A qualitative study","authors":"East L, Jackson D, Manias E, Dunning T, Hutchinson M.","first_author":"East L","journal":"Journal of clinical nursing","year":2021,"pub_types":["Journal Article"],"keywords":["Nursing","Sexual Health","Qualitative Study","cardiovascular","Sexual Well-being"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative exploratory study using semi‑structured interviews with 13 cardiac patients (age 30‑77) analysed by thematic analysis","sample_n":13,"sample_text":"13 participants (30‑77 y) with CVD","population":"adults with cardiovascular disease","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 13 people who have heart disease revealed they want more information about how their condition affects sex. Many felt anxious when they experienced problems like erectile dysfunction, and noted that nurses could play a key role in providing guidance.","clinical_takeaway":"Clinicians, especially nurses, should proactively discuss sexual health with cardiac patients to reduce anxiety and improve wellbeing.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Relevant patient perspectives","CO-REQ guided reporting","Clear thematic findings"],"limitations":["Small, non‑representative sample","No quantitative measures of sexual function","Findings not generalisable beyond cardiac patients"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jocn.15820"}},{"id":9300,"doi":"10.1007/s11121-023-01499-0","pmid":"36735143","pmcid":"PMC10764370","title":"Randomized Trial of a Sexual Health Video Intervention for Black and Hispanic Adolescent Females","authors":"Jenner E, Walsh S, Henley C, Demby H, Leger R, Falk G.","first_author":"Jenner E","journal":"Prevention science : the official journal of the Society for Prevention Research","year":2023,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Randomized Controlled Trial","Journal Article"],"keywords":["Adolescent","intervention","Sexual Health","Hispanic","Black","Randomized Trial","Entertainment Education"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10764370","cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Randomized controlled trial with 1770 Black and Hispanic adolescent females (18‑19 y) assigned to a sexual‑health video or control; outcomes assessed at baseline and 3 months.","sample_n":1770,"sample_text":"1770 participants (886 intervention, 884 control)","population":"Black and Hispanic adolescent females, ages 18‑19, US","country":"USA","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A video about sexual health shown to Black and Hispanic teenage girls increased knowledge about contraception and may have boosted STI testing and risk awareness three months later, with a modest rise in long‑acting birth‑control use among first‑time clinic visitors.","clinical_takeaway":"Brief, culturally tailored videos can improve contraceptive knowledge and some protective behaviours in adolescent girls.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, diverse sample","Individual‑level randomisation","Pre‑registered trial","Relevant public‑health outcome"],"limitations":["Reliance on self‑reported sexual behaviour","No measurement of potential psychosocial confounds","Short follow‑up (3 months)"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":8,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11121-023-01499-0"}},{"id":9301,"doi":"10.1016/j.ejon.2022.102236","pmid":"36827834","pmcid":null,"title":"Implementation of individually tailored treatment plans in a group-based intervention for women with mixed vulvo-vaginal and sexual health concerns following cancer treatment: A feasibility study","authors":"Sears C, Santos-Iglesias P, Millman R, Jacox N, Wiebe E, Walker LM.","first_author":"Sears C","journal":"European journal of oncology nursing : the official journal of European Oncology Nursing Society","year":2023,"pub_types":["Journal Article"],"keywords":["Cancer","Women","Sexual Health","Sexual Wellbeing","Vulvo-vaginal Health"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"single-group pre‑post feasibility study with online follow‑ups at 1–3 months; no control group","sample_n":195,"sample_text":"195 participants attended workshops over 2.5 years","population":"women (age 20‑81) treated for cancer with vulvo‑vaginal and sexual health concerns","country":"unspecified (likely multiple European sites)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A group workshop helped women recovering from cancer to create personal plans for treating vulvo‑vaginal symptoms; three months later participants reported less bother, greater use of treatment strategies, and modest improvements in sexual satisfaction and distress.","clinical_takeaway":"Group‑based, individually tailored education may boost treatment uptake and reduce symptom distress in women with post‑cancer sexual health concerns.","confidence":0.8,"topic_tags":["sexual_function","csbd","pornography","masturbation"],"strengths":["large sample for a feasibility trial","use of repeated measures over 3 months","focus on individualized treatment planning"],"limitations":["no control/comparator group","lack of pre‑registration and detailed statistical plan","unclear whether outcome instruments are validated"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ejon.2022.102236"}},{"id":9302,"doi":"10.1177/17455057241277723","pmid":"39305093","pmcid":"PMC11418360","title":"The barriers and enablers to accessing sexual health and sexual well-being services for midlife women (aged 40-65 years) in high-income countries: A mixed-methods systematic review","authors":"Simmons K, Llewellyn C, Bremner S, Gilleece Y, Norcross C, Iwuji C.","first_author":"Simmons K","journal":"Women's health (London, England)","year":2024,"pub_types":["Systematic Review","review-article","Journal Article"],"keywords":["Women","Middle age","Access","Sexual Health","Sexual Well-being"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC11418360","cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"mixed-methods systematic review with thematic narrative synthesis of 81 studies; no meta‑analysis or formal risk‑of‑bias assessment reported","sample_n":null,"sample_text":"81 studies included; primary data not aggregated","population":"midlife women (ages 40‑65) in high‑income countries; includes transgender and non‑binary persons","country":"high‑income countries (multiple)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review summarises what helps or hinders women aged 40‑65 in rich countries from using sexual‑health services. It finds that stigma, lack of knowledge and limited resources block access, while peer support, women‑only clinics and better education facilitate it.","clinical_takeaway":"Clinicians should address stigma, improve education, and offer integrated, women‑friendly services to boost sexual‑health care use in midlife women.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Comprehensive search of four databases","Large number of included studies (81)","Use of socio‑ecological framework to organise findings"],"limitations":["No quantitative synthesis or meta‑analysis","Risk‑of‑bias assessment not reported","Limited primary focus on midlife women in many included studies"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/17455057241277723"}},{"id":9305,"doi":"10.1007/s00404-023-07141-2","pmid":"37493777","pmcid":null,"title":"Does a one-session sexual health education program improve sexual confidence in patients with cervical cancer? A transtheoretical model-based clinical study","authors":"Tung TH, Chen HW, Chou HH, Tsai JL, Yang YC, Lee JT.","first_author":"Tung TH","journal":"Archives of gynecology and obstetrics","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexuality","gynecological cancer","Sexual Self-efficacy","Sexual Knowledge"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"quasi‑experimental controlled study with pre‑post measurements at 1 and 6 weeks; n=63 (30 control, 33 intervention); no indication of randomisation or pre‑registration","sample_n":63,"sample_text":"63 participants (30 control, 33 intervention) recruited from gynecological wards","population":"patients with cervical cancer (n=63) from a single medical centre in Taiwan","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A one‑session education program based on the transtheoretical model improved sexual knowledge, attitudes and confidence among 63 cervical‑cancer patients compared with standard education, measured 1 and 6 weeks later.","clinical_takeaway":"A brief, theory‑driven sexual health education may boost sexual confidence in cervical‑cancer patients, but larger trials are needed.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Controlled comparison with traditional education","Pre‑ and post‑intervention assessments","Clear statistical significance reported"],"limitations":["Small, single‑centre sample; likely under‑powered","No clear randomisation or pre‑registration","Reliance on self‑report scales with unclear validation","No adjustment for potential psychosocial confounds"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00404-023-07141-2"}},{"id":9306,"doi":"10.1016/j.jsxm.2022.08.199","pmid":"36182572","pmcid":"PMC9617790","title":"Predictors of Non-Response to a Sexual Health Survey in a North American Preconception Cohort Study","authors":"Bond JC, Abrams J, Wesselink AK, White KO, Rothman KJ, Wise LA.","first_author":"Bond JC","journal":"The journal of sexual medicine","year":2022,"pub_types":["research-article","Journal Article","Case Reports","Research Support, N.I.H., Extramural"],"keywords":["Cohort studies","Survey Methods","Selection Bias","Non-respondents"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"prospective cohort with optional supplemental survey; analysis of response patterns (cross‑sectional within cohort)","sample_n":1491,"sample_text":"1491 enrolled participants; 930 completed supplemental sexual health survey","population":"North American adults (women 21–45 trying to conceive, in a relationship with a male partner)","country":"North America (United States/Canada)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a large North American pre‑conception cohort, about 60 % of participants completed an added sexual‑health survey. Non‑response was higher among younger women, those with lower income or education, longer attempts to conceive, and Hispanic/Latina participants.","clinical_takeaway":"When adding sexual‑health questionnaires to cohort studies, anticipate lower response from younger, lower‑income, and Hispanic participants; consider targeted follow‑up to improve representativeness.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, geographically diverse online cohort","Prospective data collection allows temporal ordering of enrollment and survey invitation","Clear reporting of response rates across clearly defined groups"],"limitations":["No information on validation of the supplemental sexual health questionnaire","Analyses limited to descriptive comparisons; no multivariable modelling reported","Findings may not generalise to clinic‑based or non‑online populations"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2022.08.199"}},{"id":9311,"doi":"10.3390/ijerph192013707","pmid":"36294283","pmcid":"PMC9603176","title":"Exploring the Intersections of Migration, Gender, and Sexual Health with Indonesian Women in Perth, Western Australia","authors":"Gray C, Crawford G, Maycock B, Lobo R.","first_author":"Gray C","journal":"International journal of environmental research and public health","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Gender","Migrant","Sexual Health","Intersectionality"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/20/13707/pdf?version=1666685075","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative interview study with 10 participants (unstructured interviews).","sample_n":10,"sample_text":"10 adult Indonesian women","population":"Indonesian migrant women living in Perth, Western Australia (N=10).","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with ten Indonesian women living in Perth show that migration, gender norms and visa status shape their sexual‑health experiences and help‑seeking, suggesting public‑health programmes need to consider these intersecting factors.","clinical_takeaway":"Tailor sexual‑health services for migrant women to account for gendered migration experiences and structural barriers.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Participatory action research framework","In‑depth qualitative insights","Focus on intersectionality"],"limitations":["Very small, non‑representative sample (N=10)","No quantitative measurement of sexual‑health outcomes","Findings not generalisable beyond this group"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":23,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph192013707"}},{"id":9313,"doi":"10.2196/50304","pmid":"37921860","pmcid":"PMC10656664","title":"Creating an Intercultural User-Centric Design for a Digital Sexual Health Education App for Young Women in Resource-Poor Regions of Kenya: Qualitative Self-Extended Double Diamond Model for Requirements Engineering Analysis","authors":"Soehnchen C, Rietz A, Weirauch V, Meister S, Henningsen M.","first_author":"Soehnchen C","journal":"JMIR formative research","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Health education","Sub-Saharan Africa","Women","Sexual Health","User-centered Design","Stigmatization","Sexual Health Information","Reproductive Health Services","Digital Health","Sexual Health Education","Semistructured Interviews","Requirements Engineering Analysis","Youth, Slum"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10656664","cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Semi‑structured interviews (n=12 pilot participants, n=5 expert panels) analysed with affinity mapping; user‑centred design framework development.","sample_n":17,"sample_text":"12 pilot interviews + 5 expert interviews until data saturation.","population":"Young women in resource‑poor regions of Kenya (convenience sample).","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers interviewed young Kenyan women and experts to uncover cultural barriers and facilitators for a digital sexual‑health education app, creating a design framework that respects local norms and religious stigma.","clinical_takeaway":"Digital sexual‑health tools should be co‑designed with target users, accounting for cultural and religious sensitivities to improve uptake.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["User‑centred, culturally sensitive design approach","Data‑saturation guided sample size","Clear reporting following COREQ guidelines"],"limitations":["Small, non‑representative convenience sample","No quantitative validation of identified requirements","Findings limited to specific Kenyan context"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":1,"mentioning":15,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/50304"}},{"id":9314,"doi":"10.1111/jmft.12624","pmid":"36490320","pmcid":null,"title":"Sexual Health and Integrative Pleasure (SHIP) Model: Using a clinical case example to guide assessment and treatment","authors":"Girard A, Newstrom NP, Connor J, Arenella K, Vencill J, Robinson BB.","first_author":"Girard A","journal":"Journal of marital and family therapy","year":2023,"pub_types":["Journal Article"],"keywords":["Diversity","Populations","Clinical","Couples","Practice Development","Intervention/technique","Professional/practice Issues","Theory/model"],"is_oa":false,"oa_url":"https://doi.org/10.1111/jmft.12624","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"case example of a conceptual clinical model with no empirical data","sample_n":null,"sample_text":"single clinical couple presented as illustrative example","population":"cis/heterosexual couple (clinical case)","country":"USA (assumed from journal affiliation)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The SHIP model is a new framework for assessing and treating sexual health problems, combining systems theory, intersectionality, and a focus on pleasure. It is illustrated with a single couple’s therapy session.","clinical_takeaway":"Clinicians may use the SHIP model as a guiding structure, but its effectiveness has not yet been empirically validated.","confidence":0.6,"topic_tags":["sexual_function","relationships","treatment"],"strengths":["Integrates multiple therapeutic frameworks","Provides a clear, step‑by‑step case illustration"],"limitations":["No empirical testing of the model","Relies on a single case, limiting generalisability"],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jmft.12624"}},{"id":9315,"doi":"10.1080/26410397.2022.2044198","pmid":"35315312","pmcid":"PMC8942543","title":"Lubricants for the promotion of sexual health and well-being: a systematic review","authors":"Kennedy CE, Yeh PT, Li J, Gonsalves L, Narasimhan M.","first_author":"Kennedy CE","journal":"Sexual and reproductive health matters","year":2021,"pub_types":["Systematic Review","review-article","Journal Article"],"keywords":["Systematic review","Lubricants","Dyspareunia","Anal Sex","Sexual Health","Vaginal Dryness"],"is_oa":true,"oa_url":"https://www.tandfonline.com/doi/pdf/10.1080/26410397.2022.2044198?needAccess=true","cited_by_count":15,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 7 effectiveness studies (2 RCTs, 3 observational) summarised with GRADE profiles.","sample_n":null,"sample_text":"Seven effectiveness studies (2 RCTs, 3 observational) were included in the review.","population":"Adults using vaginal or anal lubricants; includes women, gay/bisexual men, breast cancer survivors.","country":"International (studies from multiple countries).","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review found that lubricants can improve sexual comfort and well‑being, especially reducing pain for women, with limited evidence of any effect on HPV risk. Results come from two small trials and a few observational studies, so certainty is moderate to low.","clinical_takeaway":"Lubricants are a safe, acceptable option to reduce sexual pain; clinicians can recommend them, noting that high‑quality evidence is still limited.","confidence":0.8,"topic_tags":["sexual_function","relationships"],"strengths":["Includes randomised trials","Uses GRADE to assess certainty","Considers values and preferences across diverse groups","Transparent systematic search strategy"],"limitations":["Small number of primary studies","Observational evidence low certainty","No cost data identified","Limited assessment of long‑term outcomes"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":1,"contrasting":0,"mentioning":4,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/26410397.2022.2044198"}},{"id":9317,"doi":"10.1097/der.0000000000000617","pmid":"32496279","pmcid":null,"title":"The Interplay of Atopic Dermatitis and Sexual Health","authors":"Ludwig CM, Fernandez JM, Hsiao JL, Shi VY.","first_author":"Ludwig CM","journal":"Dermatitis : contact, atopic, occupational, drug","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methods; no primary data collection.","sample_n":null,"sample_text":"Not applicable – review article","population":"Patients with atopic dermatitis (no specific sample reported)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how atopic dermatitis can lower sexual satisfaction and intimacy for patients and their partners, highlighting physical discomfort, self‑confidence issues, and relationship dynamics, and offers tips for improving sexual health in this group.","clinical_takeaway":"Clinicians should discuss sexual concerns with AD patients and consider both physical and relational interventions to support sexual well‑being.","confidence":0.6,"topic_tags":["sexual_function","relationships"],"strengths":["Addresses an under‑studied impact of a medical condition on sexual health","Provides practical recommendations for clinicians"],"limitations":["Narrative, non‑systematic review; no systematic search or bias assessment","No empirical data; conclusions based on secondary sources","No measurement of key sexual‑health constructs with validated tools"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":27,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/der.0000000000000617"}},{"id":9318,"doi":"10.1071/sh19209","pmid":"32564781","pmcid":null,"title":"International students' views on sexual health: a qualitative study at an Australian university","authors":"Parker A, Harris P, Haire B.","first_author":"Parker A","journal":"Sexual health","year":2020,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study with 13 international university students in Australia","sample_n":13,"sample_text":"13 individual semi‑structured in‑depth interviews","population":"international university students (young adults) in Australia","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 13 international students in Australia revealed mixed understandings of consent, cultural taboos and difficulty accessing sexual‑health information, highlighting the need for tailored education and support on campuses.","clinical_takeaway":"Universities should develop culturally sensitive sexual‑health resources that address consent, privacy concerns and navigation of information for international students.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["In‑depth, participant‑led data","Identifies culturally specific barriers to sexual health services","Provides actionable suggestions for university programs"],"limitations":["Very small, non‑representative sample","No systematic measurement of sexual‑health behaviours","Findings not generalisable beyond this campus"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":37,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh19209"}},{"id":9319,"doi":"10.46292/sci21-00080","pmid":"36819930","pmcid":"PMC9936902","title":"Sexual Health and Sexual Quality of Life Among Individuals With Spinal Cord Injury in Latin America","authors":"Di Giusto ML, Ertl MM, Ramos-Usuga D, Carballea D, Degano M, Perrin PB, Arango-Lasprilla JC.","first_author":"Di Giusto ML","journal":"Topics in spinal cord injury rehabilitation","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Spinal cord injury","Quality of life","Latin America"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 248 individuals with spinal cord injury in Latin America","sample_n":248,"sample_text":"248 individuals with SCI completed an online 60‑item survey","population":"individuals with spinal cord injury, Latin America, n=248, self‑selected online respondents","country":"Latin America (multiple countries, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 248 people with spinal cord injury in Latin America found that most notice sexual changes after injury, often lack professional information, and want better support, highlighting a need for targeted sexual health education.","clinical_takeaway":"Clinicians should proactively discuss sexuality with SCI patients and provide tailored information and support.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a niche population","Focus on under‑studied Latin American SCI community","Addresses clear gap in patient‑reported sexual health information"],"limitations":["Survey likely unvalidated; constructs not operationalised with psychometric tools","Cross‑sectional convenience sample, limited causal inference","No control for key confounds (moral, mental health, partner effects)"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.46292/sci21-00080"}},{"id":9320,"doi":"10.21203/rs.3.rs-2374323/v1","pmid":null,"pmcid":null,"title":"The role of theory-based HIV and sexual health interventions in enhancing positive sexual behaviour outcomes and reducing risk factors among young people in Sub-Saharan Africa.  A scoping review protocol","authors":"Mukanga B, Taylor M, Dlamini SB.","first_author":"Mukanga B","journal":"Research Square","year":2023,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-2374323/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"scoping review protocol; no empirical data yet","sample_n":null,"sample_text":"Not applicable – protocol","population":"young people (10–24) in Sub‑Saharan Africa","country":"Sub‑Saharan Africa (multiple countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This protocol outlines a scoping review that will map theory‑based HIV prevention programmes for young people in Sub‑Saharan Africa, aiming to see how they promote healthier sexual behaviours and lower HIV risk.","clinical_takeaway":"None – no results yet; future review may guide youth HIV‑prevention strategies.","confidence":0.4,"topic_tags":["sexual_function","masturbation"],"strengths":["Clear methodological framework (Arksey & O’Malley)","Broad database search planned"],"limitations":["Protocol only – no data yet","No mention of controlling key sexual‑health confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-2374323/v1"}},{"id":9321,"doi":"10.1177/10781552221089667","pmid":"35440225","pmcid":null,"title":"Pharmacists' practices and views regarding management of sexual health in patients with cancer","authors":"Shivji A, Danilak M, Booker R, Dersch-Mills D, Ghosh S, Fung K.","first_author":"Shivji A","journal":"Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners","year":2023,"pub_types":["Journal Article"],"keywords":["Cancer","Oncology","Sexual Health","Pharmacist"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Anonymous web‑based survey of 96 Canadian oncology pharmacists; descriptive frequencies reported.","sample_n":96,"sample_text":"Convenience sample recruited through professional association and informal networks.","population":"Pharmacists providing care to adult malignant hematology or oncology patients in Canada (mostly Alberta).","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A Canadian survey of 96 oncology pharmacists found that while most think they should discuss sexual health with cancer patients, only a few actually do so. Barriers include lack of training, time pressure, and the presence of family during appointments.","clinical_takeaway":"Pharmacists see a role in sexual‑health counseling for cancer patients but need more training and resources to act on it.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Addresses an understudied area (pharmacist role in sexual health).","National scope within Canada.","Clear reporting of response numbers."],"limitations":["Convenience sample; limited generalisability.","Survey instrument not reported as validated.","No inferential statistics or effect‑size reporting."],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10781552221089667"}},{"id":9323,"doi":"10.2196/45007","pmid":"37556188","pmcid":"PMC10448282","title":"Sexual Health and Drug Use Prevention for Black Girls (The Dreamer Girls Project): Protocol for an Intervention Development","authors":"Opara I, Gabriel C, Duran-Becerra B, Bond K, Hill AV, Hussett-Richardson S, Alves C, Kershaw T.","first_author":"Opara I","journal":"JMIR research protocols","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["HIV","Youth","Prevention","Minority","Adolescent","Drug abuse","Sexually transmitted disease","Patient education","Std","Sexual Health","Health Promotion","Sexually Transmitted","Sti","Substance Abuse","Sexual Transmission","Sexually Transmitted Infection","Ethnic","Hiv Prevention","Black","Girl","Formative","Education Intervention","Drug Use Prevention","Black Girls"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10448282","cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"protocol for mixed‑methods intervention development (sequential, ADAPT‑ITT framework)","sample_n":200,"sample_text":"Target sample size for the quantitative portion of the study will be 200 participants; focus groups up to 75 participants.","population":"Black adolescent girls, 13‑18 y, N≈200 (quantitative) + focus groups (≤75)","country":"United States (NIH‑funded)","controls_mi":"not_applicable","preregistered":true,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study will develop a culturally tailored program to help Black teenage girls reduce drug use and improve sexual health, using surveys, focus groups, and a pilot test of the intervention.","clinical_takeaway":"Not yet applicable – the protocol outlines a future intervention that may later inform practice.","confidence":0.75,"topic_tags":["sexual_function","adolescents","prevalence"],"strengths":["Clear, preregistered protocol","Focus on an underserved population","Mixed‑methods approach"],"limitations":["No validated measures described in abstract","Confounding psychosocial factors not addressed","Protocol only – no results yet"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/45007"}},{"id":9324,"doi":"10.1097/qad.0000000000000048","pmid":"24088679","pmcid":null,"title":"The evolving sexual health paradigm: transforming definitions into sexual health practices","authors":"Fortenberry JD.","first_author":"Fortenberry JD.","journal":"AIDS (London, England)","year":2013,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review / conceptual article without empirical data","sample_n":null,"sample_text":"None – narrative review","population":"general adult population (no specific sample reported)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article proposes a new sexual‑health framework that emphasizes rights, knowledge, choice, pleasure and overall wellbeing while aiming to reduce STIs. It presents a conceptual shift rather than reporting new research.","clinical_takeaway":"None – the paper offers a conceptual model, not direct clinical guidance.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad synthesis of public‑health perspective on sexual health","Integrates rights‑based and pleasure‑positive concepts"],"limitations":["No empirical data or systematic review methods","Lacks operational definitions or measurement of key constructs","No assessment of confounding variables"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/qad.0000000000000048"}},{"id":9326,"doi":"10.1093/sexmed/qfad015","pmid":"37228768","pmcid":"PMC10204649","title":"Assessment of knowledge, attitude, and practice of sexual health among students in a Chinese medical college: a cross-sectional study","authors":"Zhao J, Li Y, Wang X, Wang Z, Yu S, Li T.","first_author":"Zhao J","journal":"Sexual medicine","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Students","Sex Education","Practices","Health Knowledge"],"is_oa":true,"oa_url":"https://doi.org/10.1093/sexmed/qfad015","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of medical and nursing students at one Chinese medical college (online self‑developed questionnaire).","sample_n":null,"sample_text":"not reported in abstract","population":"medical and nursing students (single institution, convenience sample)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of Chinese medical and nursing students found they have relatively high sexual‑health knowledge and supportive attitudes toward premarital sex and LGBTQ people. Students who wanted more diverse sexual education also reported they would provide more humanistic care to patients’ sexual needs.","clinical_takeaway":"Improving sexual‑health education for healthcare trainees may promote more patient‑centered sexual care.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Addresses an understudied population (medical students) and sexual health education.","Uses quantitative KAP scoring and correlation analysis.","Highlights potential link between education and patient‑centered care."],"limitations":["Self‑developed questionnaire lacks validation.","Single‑site convenience sample limits generalizability.","No power calculation or effect‑size reporting."],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sexmed/qfad015"}},{"id":9327,"doi":"10.1016/j.jsxm.2022.08.197","pmid":"36192299","pmcid":null,"title":"Guidelines for Sexual Health Care for Prostate Cancer Patients: Recommendations of an International Panel","authors":"Wittmann D, Mehta A, McCaughan E, Faraday M, Duby A, Matthew A, Incrocci L, Burnett A, Nelson CJ, Elliott S, Koontz BF, Bober SL, McLeod D, Capogrosso P, Yap T, Higano C, Loeb S, Capellari E, Glodé M, Goltz H, Howell D, Kirby M, Bennett N, Trost L, Odiyo Ouma P, Wang R, Salter C, Skolarus TA, McPhail J, McPhail S, Brandon J, Northouse LL, Paich K, Pollack CE, Shifferd J, Erickson K, Mulhall JP.","first_author":"Wittmann D","journal":"The journal of sexual medicine","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Practice Guideline","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["prostate cancer","International","Biopsychosocial","Sexual Rehabilitation"],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Guideline development based on systematic review and meta‑analysis of 3 eligible studies; expert panel consensus.","sample_n":null,"sample_text":"Not applicable – guideline based on literature synthesis.","population":"Prostate cancer patients post‑treatment (and partners).","country":"International (authors from multiple countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"An international panel reviewed the evidence on sexual side‑effects after prostate‑cancer treatment and issued guideline recommendations to help clinicians address patients’ and partners’ sexual health and relationship concerns.","clinical_takeaway":"Clinicians should use these guideline statements to discuss realistic sexual outcomes and offer biopsychosocial rehabilitation to prostate‑cancer survivors.","confidence":0.8,"topic_tags":["sexual_function","csbd","religiosity","masturbation"],"strengths":["Comprehensive systematic search across multiple databases","Followed PRISMA and AMSTAR guidelines","International expert panel with methodological expertise"],"limitations":["Limited number of high‑quality primary studies for meta‑analysis","Evidence gaps for low‑ and middle‑income settings","No primary data collected; relies on existing literature"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":8,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":47,"retracted":false,"notices":[{"status":"Has correction","date":"2023-3-16","noticeDoi":"10.1093/jsxmed/qdad014","doi":"10.1016/j.jsxm.2022.08.197"}],"url":"https://scite.ai/reports/10.1016/j.jsxm.2022.08.197"}},{"id":9329,"doi":"10.1080/09638288.2020.1856949","pmid":"33305969","pmcid":null,"title":"Addressing the elephant in the room: integrating sexual health practice in spinal cord injury rehabilitation","authors":"Giurleo C, McIntyre A, Kras-Dupuis A, Wolfe DL.","first_author":"Giurleo C","journal":"Disability and rehabilitation","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Rehabilitation","Quality improvement","Spinal cord injuries","Sex Education","Sexual Health","Implementation Science"],"is_oa":false,"oa_url":"https://figshare.com/ndownloader/files/25757024","cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"quality improvement; pre‑post implementation; surveys of patients and clinicians after 6 months; no control group; sample size not reported","sample_n":null,"sample_text":"not specified in abstract","population":"adult in‑patients undergoing spinal‑cord injury rehabilitation","country":"not stated (likely USA/Canada based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A team added a sexual‑health education program to a spinal‑cord injury rehab unit and surveyed patients and clinicians six months later. Both groups reported higher awareness of resources and greater satisfaction with sexual‑health care.","clinical_takeaway":"Embedding structured sexual‑health support can improve patient satisfaction and clinician confidence in rehab settings.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["systematic implementation‑science approach","involves stakeholders including persons with SCI","addresses a known gap in rehabilitation care"],"limitations":["no control/comparison group","small/unspecified sample size","outcome measures appear ad‑hoc and unvalidated"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09638288.2020.1856949"}},{"id":9330,"doi":"10.1136/bmjopen-2022-066663","pmid":"36635034","pmcid":"PMC9843221","title":"Exploring the wider societal impacts of sexual health issues and interventions to build a framework for research and policy: a qualitative study based on in-depth semi-structured interviews with experts in OECD member countries","authors":"Schnitzler L, Paulus ATG, Roberts TE, Evers SMAA, Jackson LJ.","first_author":"Schnitzler L","journal":"BMJ open","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Public Health","Hiv & Aids","Health Economics","Health Policy","Sexual Medicine"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9843221","cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative study; purposive sampling of 28 experts; in‑depth semi‑structured online interviews; Framework analysis of themes","sample_n":28,"sample_text":"28 experts were interviewed; purposively sampled from clinicians, researchers, policy professionals, etc.","population":"experts in sexual health policy and practice from OECD countries","country":"OECD member countries (multiple)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 28 sexual‑health experts from OECD nations reveal that sexual health issues influence many parts of society—health care, mental health, families, work, education, justice, housing and addiction—suggesting economic analyses should consider these broader impacts.","clinical_takeaway":"None – the study offers a policy‑focused framework, not direct clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad expert perspective across OECD countries","Systematic thematic framework analysis","Identifies multiple non‑health sectors affected by sexual health"],"limitations":["Small, purposively selected expert sample limits generalisability","No direct data from affected populations","Limited quantitative validation of themes"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjopen-2022-066663"}},{"id":9331,"doi":"10.33546/bnj.2223","pmid":"37554494","pmcid":null,"title":"The strategies used by the school health team during the delivery of sexual health information to unmarried adolescents in Malaysia","authors":"Abdul Hamid SH, Fallon D.","first_author":"Abdul Hamid SH","journal":"Belitung nursing journal","year":2022,"pub_types":["Journal Article"],"keywords":["Information","Malaysia","Nurses","Sexual And Reproductive Health","School Health Team","Scare Tactics","Unmarried Adolescents"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative semi‑structured interviews with 20 health‑team members; thematic analysis of transcripts","sample_n":20,"sample_text":"Twenty participants from four multidisciplinary school health teams","population":"school health team staff (nurses, medical officers, family‑medicine specialists) in Malaysia","country":"Malaysia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 20 Malaysian school health workers reveal that they often use risk‑focused and scare‑tactic messages, emphasizing abstinence and cultural honour rather than comprehensive safer‑sex education for unmarried adolescents.","clinical_takeaway":"Educators should balance moral messaging with evidence‑based sexual‑health information to better support adolescent health.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight from multiple professional perspectives","Clear thematic presentation of strategies","Highlights cultural and moral influences on sexual health education"],"limitations":["Small, non‑representative sample of health‑team staff","No adolescent perspectives included","Findings not generalisable beyond studied schools"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.33546/bnj.2223"}},{"id":9332,"doi":"10.1016/j.childyouth.2022.106480","pmid":"40895013","pmcid":"PMC12395538","title":"Culturally responsive sexual health interventions for black adolescent females in the United States: A systematic review of the literature, 2010-2020","authors":"Dorsey MS, King D, Howard-Howell T, Dyson Y.","first_author":"Dorsey MS","journal":"Children and youth services review","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Adolescence","Sexually Transmitted Infections","African American","Girls"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review of active sexual health programs targeting Black adolescent females in the US (2010‑2020).","sample_n":null,"sample_text":"Not applicable – review of published studies","population":"Black adolescent females (USA)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review examined U.S. programmes from 2010‑2020 that aim to improve sexual health for Black teen girls. It found few interventions that are truly culturally tailored to their needs, highlighting a gap in effective, culturally responsive sexual‑health education.","clinical_takeaway":"Clinicians should note the lack of culturally tailored sexual‑health programs for Black adolescent females and advocate for interventions that directly address their specific cultural context.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive 10‑year scope","Focus on culturally responsive interventions","Identifies gap in literature"],"limitations":["No assessment of methodological quality reported in abstract","Unclear how outcomes were pooled or compared","Potential publication bias not addressed"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.childyouth.2022.106480"}},{"id":9334,"doi":"10.2196/45389","pmid":"36947124","pmcid":"PMC10131995","title":"Co-designing a Sexual Health App With Immigrant Adolescents: Protocol for a Qualitative Community-Based Participatory Action Research Study","authors":"Meherali S, Munro S, Puinean G, Salami B, Wong JP, Vandermorris A, Benoit JRA, Flicker S, Okeke-Ihejirika P, Stroulia E, Norman WV, Scott SD.","first_author":"Meherali S","journal":"JMIR research protocols","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Immigrants","Health Promotion","Access To Care","Adolescent Health","Information Needs","Sexual And Reproductive Health","Mhealth"],"is_oa":true,"oa_url":"https://jmir.org/api/download?alt_name=resprot_v12i1e45389_app3.pdf&filename=63fd7cdf74b0e1d57da704df22e20fef.pdf","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"qualitative community‑based participatory action research protocol; no empirical data yet","sample_n":null,"sample_text":"future recruitment of adolescent advisory groups; numbers not yet specified","population":"immigrant adolescents (10‑19 y) in Canada","country":"Canada","controls_mi":"not_applicable","preregistered":true,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This protocol describes a participatory project that will work with immigrant teens in Canada to design, build, and test a mobile app delivering accurate sexual‑health information, using focus groups and iterative feedback.","clinical_takeaway":"None – the study reports a planned protocol, not results for clinical use.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Community‑based participatory approach engages target adolescents as co‑researchers","Clear, staged co‑design methodology for a mobile health intervention","Protocol is registered (IRRID) enhancing transparency"],"limitations":["No empirical data yet; scores rely on protocol description","No detail on sample size, measurement tools, or control of key confounds","Scope limited to SRH information, not specific to pornography or compulsive sexual behaviour"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/45389"}},{"id":9335,"doi":"10.1080/13691058.2022.2055149","pmid":"35404775","pmcid":null,"title":"Indigenous men's pathways to 'living the right kind of life and walking the right path' post incarceration in Canada: understanding the impacts of systemic oppression, and guidance for healing and (w)holistic sexual health","authors":"Rand JR, Melro C, Biderman M, McMillan LJ, Miller AD, Lekas S, Numer M.","first_author":"Rand JR","journal":"Culture, health & sexuality","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Canada","Colonialism","Sexual Health","Indigenous Health","Indigenous Men"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"semi‑structured interviews with 10 Indigenous men with incarceration histories; thematic analysis","sample_n":10,"sample_text":"10 participants","population":"Indigenous men in Canada with prior incarceration","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with ten Indigenous men who have been incarcerated in Canada reveal that colonial trauma and systemic oppression continue to affect their wellbeing, while supportive guidance helps them rebuild healthy relationships and improve sexual health.","clinical_takeaway":"Interventions for Indigenous men should address systemic trauma and incorporate culturally grounded, holistic support to promote sexual health.","confidence":0.7,"topic_tags":["sexual_function","relationships","gender"],"strengths":["Indigenous‐led perspective","Provides nuanced, culturally relevant insight","Highlights systemic oppression and healing pathways"],"limitations":["Very small, non‑representative sample (n=10)","No quantitative measures of sexual health outcomes","Findings cannot be generalized beyond this group"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2022.2055149"}},{"id":9336,"doi":"10.1016/j.rhm.2015.11.007","pmid":"26718993","pmcid":null,"title":"Sexual rights as human rights: a guide to authoritative sources and principles for applying human rights to sexuality and sexual health","authors":"Miller AM, Kismödi E, Cottingham J, Gruskin S.","first_author":"Miller AM","journal":"Reproductive health matters","year":2015,"pub_types":["Journal Article"],"keywords":["Sexuality","Health","Human Rights","Law","Sexual Rights"],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary/guide without empirical data; no sample, no methods.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article is a guide that explains how human‑rights law can be used to protect sexual health and rights, outlining key principles and sources for policymakers and program designers.","clinical_takeaway":"None – the guide does not provide clinical data or recommendations.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Provides comprehensive synthesis of human‑rights instruments","Clear, practical guidance for policymakers","Broad international perspective"],"limitations":["No empirical data; cannot assess causal claims","No measurement of sexual‑behaviour variables","Limited to legal‑policy domain, not health outcomes"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":34,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.rhm.2015.11.007"}},{"id":9337,"doi":"10.1186/s13584-017-0171-2","pmid":"28836998","pmcid":"PMC5569474","title":"Towards comprehensive and effective strategies to address sexual health","authors":"Gauci C, Azzopardi-Muscat N.","first_author":"Gauci C","journal":"Israel journal of health policy research","year":2017,"pub_types":["editorial","Comment","Journal Article"],"keywords":["Strategy","HIV","Israel","Sexual Health","Stis"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5569474","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary/editorial with no empirical data","sample_n":null,"sample_text":"Not applicable – no primary data collected","population":"general population (policy focus)","country":"Israel","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The editorial argues that Israel’s plan to lower STI rates should go beyond disease control and include a broader, culturally sensitive approach to sexual health, following WHO recommendations.","clinical_takeaway":"None – the piece offers policy guidance, not clinical findings.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Highlights importance of culturally tailored sexual health policy","Links WHO definition to national strategy"],"limitations":["No empirical data presented","Lacks systematic evidence appraisal"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s13584-017-0171-2"}},{"id":9338,"doi":"10.1136/bmjopen-2022-066783","pmid":"37156584","pmcid":"PMC10174011","title":"Preferences for accessing sexual health services among middle-aged and older adults in the UK: a study protocol for a discrete choice experiment using mixed methods","authors":"Kpokiri E, Pan SW, Ong JJ, Greaves E, Khan J, Bowen S, Jannaway T, Terris-Prestholt F, Tanton C, Kuper H, Shakespeare T, Tucker JD, Wu D.","first_author":"Kpokiri E","journal":"BMJ open","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sexual dysfunction","Geriatric Medicine","Sexual Medicine"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10174011","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"Study protocol for a mixed‑methods discrete choice experiment (qualitative interviews + survey) to assess preferences for sexual health services among UK adults aged 45+.","sample_n":null,"sample_text":"Planned: 20‑30 interviewees; survey sample size not specified.","population":"Adults aged 45 and older in the United Kingdom (including disabled and sexual‑minority participants).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":true,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A UK research team will interview and survey adults aged 45+ to find out what they want from sexual health services, using a discrete choice experiment to model service preferences.","clinical_takeaway":"None – the study is a protocol and does not provide actionable findings yet.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Mixed‑methods approach integrates qualitative insight with quantitative DCE.","Protocol pre‑registered and ethically approved."],"limitations":["No empirical data yet; scores based on protocol.","Sample size and power for DCE not detailed.","No mention of controlling key sexual‑health confounds."],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjopen-2022-066783"}},{"id":9339,"doi":"10.1016/j.healthplace.2017.12.002","pmid":"29334618","pmcid":"PMC5843873","title":"Exploring masculinities, sexual health and wellbeing across areas of high deprivation in Scotland: The depth of the challenge to improve understandings and practices","authors":"Lorimer K, McMillan L, McDaid L, Milne D, Russell S, Hunt K.","first_author":"Lorimer K","journal":"Health & place","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Gender","Violence","Sexual Health","Masculinities","Area Depriviation"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5843873","cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative study using individual interviews and focus groups","sample_n":116,"sample_text":"116 participants (35 individual interviews, 18 focus groups)","population":"116 heterosexual men and women aged 18‑40 from high‑deprivation areas in Scotland","country":"Scotland","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 116 men and women living in deprived Scottish neighborhoods revealed that local cultures of masculinity, often linked to violence, limit healthier sexual behaviours and wellbeing.","clinical_takeaway":"Clinicians should consider how neighbourhood and gender norms shape sexual health when supporting clients in deprived areas.","confidence":0.6,"topic_tags":["sexual_function","gender","masturbation"],"strengths":["Large qualitative sample for community‑based research","Use of both interviews and focus groups enriches data depth","Clear socio‑ecological framing of findings"],"limitations":["No validated quantitative measures of sexuality or mental health","No assessment of key confounds (moral incongruence, masturbation, mental health)","Findings may not generalise beyond deprived Scottish communities"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.healthplace.2017.12.002"}},{"id":9340,"doi":"10.1111/jocn.15418","pmid":"32668025","pmcid":null,"title":"The impact of inflammatory bowel disease on sexual health in men: A scoping review","authors":"Ma S, Veysey M, Ersser S, Mason-Jones A, Galdas P.","first_author":"Ma S","journal":"Journal of clinical nursing","year":2020,"pub_types":["Scoping Review","Journal Article"],"keywords":["Literature review","erectile dysfunction","Sexual Health","Men’s Health","Body Image And Sexuality","Ulcerative Colitis Scoping Review"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"scoping review following Arksey & O'Malley framework, PRISMA-ScR checklist, 31 included studies, no quantitative meta‑analysis","sample_n":null,"sample_text":"31 studies synthesized; individual study sizes not reported in abstract","population":"men with inflammatory bowel disease","country":"multiple (no specific country reported)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This scoping review summarises 31 studies on how inflammatory bowel disease affects men’s sexual health, highlighting erectile function, libido, relationship roles and the roles of depression, disease activity and surgery.","clinical_takeaway":"Nurses should routinely assess sexual health in men with IBD, considering both physical symptoms and psychosocial factors like depression.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Systematic scoping methodology with PRISMA‑ScR reporting","Identification of commonly used validated tool (IIEF)","Broad synthesis of physical and psychosocial mediators"],"limitations":["No risk‑of‑bias assessment of included studies","Limited quantitative analysis, no effect‑size reporting","Potential omission of non‑erectile aspects of sexual health"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":34,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jocn.15418"}},{"id":9343,"doi":"10.3390/ijerph19063176","pmid":"35328864","pmcid":"PMC8950684","title":"A Systematic Review on Sexual Health and Drug Use Prevention Interventions for Black Girls","authors":"Opara I, Pierre K, Assan MA, Scheinfeld L, Alves C, Cross K, Lizarraga A, Brawner B.","first_author":"Opara I","journal":"International journal of environmental research and public health","year":2022,"pub_types":["Systematic Review","review-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Sexual Health","Interventions","Sti","Drug Use","Black Girls"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/6/3176/pdf?version=1646737959","cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 15 interventions targeting sexual health and drug use prevention among Black adolescent females. No indication of meta‑analysis or formal risk‑of‑bias assessment.","sample_n":null,"sample_text":"Fifteen interventions published between 2005–2020 were included; sample sizes of the primary studies not reported in the abstract.","population":"Black adolescent females in the United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This systematic review identified 15 programs aimed at preventing HIV, STIs, early pregnancy, and drug use among Black adolescent girls in the US, noting that most target sexual health while only two also address drug use. It calls for more intersectional research and policy work.","clinical_takeaway":"Clinicians should seek culturally tailored, evidence‑based interventions for Black girls, recognizing the current scarcity of rigorously evaluated programs.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Focused on an understudied, high‑risk population","Systematic search strategy identified multiple interventions","Provides recommendations for future research and policy"],"limitations":["No meta‑analysis or formal risk‑of‑bias appraisal reported","Outcome measurement details and instrument validity are unclear","Does not address potential confounding factors such as mental health or moral incongruence"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph19063176"}},{"id":9344,"doi":"10.21203/rs.3.rs-614504/v1","pmid":null,"pmcid":null,"title":"Delivering School-Based Sexuality Education: Examining Determinants of Teachers' Intention To Teach, Co-Teach or Invite a Sexual Health Educator","authors":"Descheneaux J, Otis J.","first_author":"Descheneaux J","journal":"Research Square","year":2021,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-614504/latest.pdf","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online questionnaire sent to 295 teachers from 63 schools; hierarchical logistic regression used to examine predictors of intention to teach sexuality education alone, co‑teach, or invite a specialist.","sample_n":295,"sample_text":"295 teachers from 51 elementary and 12 secondary schools","population":"teachers (elementary and secondary) in Quebec school service centre","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 295 Quebec teachers examined what influences their willingness to teach sexuality education alone, co‑teach, or invite a specialist. Self‑efficacy, moral norms and peer expectations were the strongest predictors of intention.","clinical_takeaway":"Promoting teacher confidence, positive norms, and moral support may increase implementation of school‑based sexuality education.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, multi‑school sample of teachers","Theory‑guided questionnaire covering many psychosocial determinants","Clear reporting of odds ratios and model fit (R²)"],"limitations":["Cross‑sectional design cannot infer causality","Questionnaire items not reported as validated measures","No confidence intervals or pre‑registration"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-614504/v1"}},{"id":9345,"doi":"10.1186/s12889-019-6993-9","pmid":"31159767","pmcid":"PMC6547521","title":"A positive approach to adolescent sexual health promotion: a qualitative evaluation of key stakeholder perceptions of the Australian Positive Adolescent Sexual Health (PASH) Conference","authors":"Crocker BCS, Pit SW, Hansen V, John-Leader F, Wright ML.","first_author":"Crocker BCS","journal":"BMC public health","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Adolescents","Sexual Health","Health Promotion","Wellbeing","Positive Youth Development"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6547521","cited_by_count":11,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"semi‑structured interviews with 13 stakeholders (teachers, parents, organizers, peer educators) analysed by deductive thematic analysis","sample_n":13,"sample_text":"13 stakeholder participants","population":"key stakeholders of a youth sexual‑health conference in Northern NSW, Australia","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 13 teachers, parents and peer educators found that a positive‑youth‑development conference was viewed as safe, empowering and community‑linked, suggesting it could help improve adolescent sexual health.","clinical_takeaway":"The PASH conference model shows promise for adolescent sexual health promotion, but further research is needed to assess actual health outcomes.","confidence":0.6,"topic_tags":["adolescents","sexual_function"],"strengths":["Provides early qualitative insight into stakeholder views","Uses multiple stakeholder groups for triangulation","Clear thematic findings relevant for program design"],"limitations":["Small, convenience sample limits generalizability","No behavioural or health outcome data","No validated measurement instruments"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-019-6993-9"}},{"id":9346,"doi":"10.21203/rs.3.rs-34075/v1","pmid":null,"pmcid":null,"title":"Enabling Culturally Safe Sexual Health Services in Western Sydney: a Protocol to Improve Outcomes for Aboriginal Young People","authors":"Ubrihien AJ, Gwynne K, Lewis DA.","first_author":"Ubrihien AJ","journal":"Research Square","year":2020,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":"https://www.researchsquare.com/article/rs-34075/v1.pdf","cited_by_count":0,"is_preprint":true,"topics":["sexual_health"],"language":null,"appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"qualitative","design_detail":"protocol for a purposive qualitative interview study (20 male, 20 female young Aboriginal participants, 10 Elders, 10 clinicians). No data yet.","sample_n":null,"sample_text":"planned N=60 (20 M + 20 F youths, 10 Elders, 10 clinicians)","population":"Aboriginal young people (<30 y) in Western Sydney, plus elders and clinicians","country":"Australia","controls_mi":"not_applicable","preregistered":true,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A planned qualitative study will interview Aboriginal young people, elders and clinicians in Western Sydney to learn why youth under 30 often avoid public sexual‑health clinics and how services can become culturally safer.","clinical_takeaway":"None – study is a protocol and does not provide actionable clinical data.","confidence":0.3,"topic_tags":["sexual_function","csbd"],"strengths":["Community‑driven recruitment with Aboriginal organisations","Gender‑matched interviewers to respect cultural preferences","Ethics approval from relevant Aboriginal and health boards"],"limitations":["Protocol – no empirical results yet","Small purposive sample limits generalisability","Focus on service access, not on pornography or CSBD constructs"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.21203/rs.3.rs-34075/v1"}},{"id":9348,"doi":"10.1136/bmjopen-2022-063343","pmid":"36379647","pmcid":"PMC9668002","title":"Adolescent sexual health interventions that include very young adolescents in sub-Saharan Africa: a scoping review protocol","authors":"Manda WC, Sikweyiya Y, Kaunda-Khangamwa BN, Selemani A, Jimu S, Kamndaya M.","first_author":"Manda WC","journal":"BMJ open","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Public Health","Hiv &amp; Aids","Child &Amp; Adolescent Psychiatry"],"is_oa":true,"oa_url":"https://bmjopen.bmj.com/content/bmjopen/12/11/e063343.full.pdf","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Scoping review protocol; no primary data collected","sample_n":null,"sample_text":"N/A – protocol, no participants","population":"Very young adolescents (10‑14) in sub‑Saharan Africa (focus of reviewed interventions)","country":"Sub‑Saharan Africa (regional focus)","controls_mi":"not_applicable","preregistered":true,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This protocol outlines a scoping review that will map sexual‑health interventions aimed at very young adolescents in sub‑Saharan Africa, summarising what has been done and identifying gaps for future programmes.","clinical_takeaway":"None – the paper describes future research plans, not clinical findings.","confidence":0.6,"topic_tags":["adolescents","sexual_function"],"strengths":["Pre‑registered protocol (OSF)","Comprehensive search strategy across multiple databases","Focus on an under‑studied age group and region"],"limitations":["No empirical data yet – scores based on protocol only","No assessment of measurement validity or confound control in primary studies"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjopen-2022-063343"}},{"id":9349,"doi":"10.3389/frph.2021.626931","pmid":"36303955","pmcid":"PMC9580664","title":"Adolescents' Perceptions About Dating and Sexual Permissiveness in Ebonyi State, Nigeria: What Can Be Done to Enhance Adolescents' Sexual Health and Well-Being","authors":"Ezumah N, Agu IC, Okeke C, Agu C, Mbachu CO, Onwujekwe O.","first_author":"Ezumah N","journal":"Frontiers in reproductive health","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Nigeria","Adolescents","Perceptions","Sexual And Reproductive Health","Sexual Permissiveness"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9580664","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative focus‑group study with 12 groups of adolescents (13‑18 y) from three zones of Ebonyi State, Nigeria; thematic framework analysis","sample_n":null,"sample_text":"12 focus groups (6 boys, 6 girls) from three senatorial zones; convenience sampling","population":"unmarried in‑ and out‑of‑school adolescents, n not reported","country":"Nigeria","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Focus groups with Nigerian adolescents (13‑18 y) revealed mixed views on dating, kissing, and various types of sexual relationships. While many consider such behaviours inappropriate, some see premarital or transactional sex as beneficial or necessary, especially for girls in poverty. Boys tended to be more permissive.","clinical_takeaway":"Sex‑education programs should address gendered attitudes and the social‑economic drivers behind adolescents’ permissive views on sex.","confidence":0.6,"topic_tags":["adolescents","sexual_function","religiosity"],"strengths":["Qualitative data provide rich, context‑specific insights","Separate focus groups for boys and girls allow gender comparisons","Pre‑tested discussion guide"],"limitations":["Convenience sample limits generalisability","No quantitative measurement of attitudes or behaviours","No assessment of potential confounders (e.g., religiosity, mental health)"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/frph.2021.626931"}},{"id":9350,"doi":"10.3390/ijerph182212088","pmid":"34831855","pmcid":"PMC8621381","title":"Reframing Sexual Health for Black Girls and Women in HIV/STI Prevention Work: Highlighting the Role of Identity and Interpersonal Relationships","authors":"Opara I, Abrams JA, Cross K, Amutah-Onukagha N.","first_author":"Opara I","journal":"International journal of environmental research and public health","year":2021,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual behavior","Sexual Health","Black Women","Black Girls"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8621381","cited_by_count":20,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary / theoretical critique without empirical data","sample_n":null,"sample_text":"Not applicable – article provides a theoretical critique, no participants were recruited.","population":"Black girls and women (no sample reported)","country":"United States (NIH‑funded)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that HIV/STI prevention for Black girls and women should move beyond focusing only on individual risk behaviors. They critique two common theories and propose an intersectional model that includes identity, relationships, and broader social factors.","clinical_takeaway":"Prevention programs should consider identity, relational, and cultural contexts, not just individual risk actions.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Integrates intersectionality into sexual health theory","Identifies limits of dominant behavior‑focused models"],"limitations":["No empirical data presented","Lacks measurement of concrete outcomes"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":24,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph182212088"}},{"id":9351,"doi":"10.1111/jan.14688","pmid":"33249633","pmcid":null,"title":"Sexual health discussions between healthcare professionals and midlife-older women living with Type 2 diabetes: An interpretative phenomenological study","authors":"Ejegi-Memeh S, Hinchliff S, Johnson M.","first_author":"Ejegi-Memeh S","journal":"Journal of advanced nursing","year":2021,"pub_types":["Journal Article"],"keywords":["Diabetes","Qualitative","Sexual Health","Primary Care","Sexual Well-being","Interpretative Phenomenology","Midlife-older Women"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Interpretative phenomenological analysis of 10 semi‑structured interviews with women age 50‑83 living with Type 2 diabetes.","sample_n":10,"sample_text":"Ten women aged 50‑83 years.","population":"Women ≥ 50 y with Type 2 diabetes, UK primary‑care setting, convenience sample (N=10).","country":"UK","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with ten women over 50 who have type‑2 diabetes revealed that embarrassment, ageism and social taboos stop doctors from talking about sex, even though diabetes and menopause affect their sexual well‑being.","clinical_takeaway":"Clinicians should proactively raise sexual‑health topics with older diabetic women, ideally using a female provider and a trusting rapport.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["In‑depth, first‑person accounts","Focus on under‑researched older‑women population","Clear thematic analysis"],"limitations":["Very small, non‑representative sample","No validated quantitative measures","Findings not generalisable beyond UK primary‑care context"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jan.14688"}},{"id":9354,"doi":"10.1016/j.esxm.2020.100299","pmid":"33482611","pmcid":"PMC7837091","title":"The Impact of COVID-19 on Sexual Health: A Preliminary Framework Based on a Qualitative Study With Clinical Sexologists","authors":"Pascoal PM, Carvalho J, Raposo CF, Almeida J, Beato AF.","first_author":"Pascoal PM","journal":"Sexual medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Mental health","Sexual Health","Sexual Dysfunctions","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7837091","cited_by_count":23,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"online qualitative exploratory survey of 39 clinical sexologists; thematic analysis of open‑ended responses","sample_n":39,"sample_text":"39 clinicians","population":"clinical sexologists (age 32‑73) recruited via professional association newsletters","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers interviewed 39 sex‑therapists about how COVID‑19 has affected their patients’ sexual health. They identified three main themes—clinical concerns, relationship changes, and new technology use—suggesting the pandemic worsened some sexual problems and highlighted the need for e‑health services.","clinical_takeaway":"Clinicians should consider pandemic‑related stress and relational shifts when assessing sexual problems, and be open to tele‑health approaches.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["Provides clinicians' perspective on pandemic‑related sexual health changes","Systematic thematic analysis with clear methodological description"],"limitations":["Small, non‑representative sample of clinicians only","No empirical measurement of patient behaviors (e.g., pornography use, masturbation)","Qualitative design limits generalisability and causal inference"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":43,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.esxm.2020.100299"}},{"id":9356,"doi":"10.1080/09540121.2021.1906400","pmid":"33779419","pmcid":null,"title":"Sexual health counselling by Dutch HIV care providers: A cross-sectional survey among physicians and nurses in the Netherlands","authors":"Munnik S, Vervoort SCJM, Kraan L, Ammerlaan HSM, Grondhuis Palacio LA, Kok G, Elzevier HW, de Wit J, Daas CD.","first_author":"Munnik S","journal":"AIDS care","year":2022,"pub_types":["Journal Article"],"keywords":["People Living With Hiv","Healthcare Providers","Patient Provider Interaction","Sexual Health Counselling"],"is_oa":false,"oa_url":"https://cris.maastrichtuniversity.nl/en/publications/7dd15ba2-ab58-4a41-8056-d50e8d840764","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of HIV physicians (N=59) and nurses (N=40) in the Netherlands; response rates 53.6% and 60.0%","sample_n":99,"sample_text":"59 physicians, 40 nurses responded","population":"HIV care providers (physicians and nurses) in the Netherlands","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A Dutch survey found that only about a quarter of HIV doctors and most nurses discuss sexual health with patients, with barriers like the presence of a third party. The study suggests clearer guidelines and teamwork could improve sexual health care for people living with HIV.","clinical_takeaway":"Sexual health counselling is unevenly provided in HIV care; clinicians should seek training and collaborate to ensure routine discussion of sexual wellbeing.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Reasonably high response rate for a provider survey","Comparison between physicians and nurses","Identifies concrete barriers to counselling"],"limitations":["Cross‑sectional design limits causal inference","Questionnaire not reported as validated","Sample limited to Dutch providers; may not generalise"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540121.2021.1906400"}},{"id":9357,"doi":"10.1136/bmjopen-2021-054720","pmid":"34663670","pmcid":"PMC8524293","title":"Exploring linkages between climate change and sexual health: a scoping review protocol","authors":"Logie CH, Toccalino D, Reed AC, Malama K, Newman PA, Weiser S, Harris O, Berry I, Adedimeji A.","first_author":"Logie CH","journal":"BMJ open","year":2021,"pub_types":["other","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Public Health","Tropical Medicine","Hiv & Aids"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8524293","cited_by_count":10,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"scoping review protocol; no primary data collected; methodological description only","sample_n":null,"sample_text":"No participants; study plans to include any eligible primary studies","population":"none (protocol)","country":"global (no specific primary data)","controls_mi":"not_applicable","preregistered":true,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This protocol outlines a planned scoping review that will map research on how climate change and extreme weather events may affect sexual health outcomes such as STI risk, access to care, and gender‑based violence.","clinical_takeaway":"None - not clinically applicable.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Transparent protocol with comprehensive search strategy","Inclusion of quantitative, qualitative, mixed methods, and reviews","No language or date restrictions"],"limitations":["No empirical data; scores rely on protocol description","Does not focus on pornography or compulsive sexual behavior"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":31,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjopen-2021-054720"}},{"id":9358,"doi":"10.1016/j.socscimed.2021.113718","pmid":"33561572","pmcid":"PMC8562991","title":"The role of stress and absence: How household member incarceration is associated with risky sexual health behaviors","authors":"McCauley EJ.","first_author":"McCauley EJ.","journal":"Social science & medicine (1982)","year":2021,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual Health","Condom Use","Household Member Incarceration","Nlsy 97","Sex With Iv Drug User"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational analysis of NLSY97 data using linear probability models; compares youth with household member incarceration to other stress/absence groups.","sample_n":null,"sample_text":"Large nationally representative cohort (NLSY97). Exact N not given in abstract.","population":"Young adults in the United States, participants of the NLSY97 cohort.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Youth who have a household member incarcerated are more likely to have sex with an IV drug user and less likely to use condoms. The link may stem from the stress of incarceration rather than family absence.","clinical_takeaway":"Consider family incarceration as a stress factor when assessing sexual risk in young adults.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative dataset","Tests alternative comparison groups (stress vs absence)","Controls for many individual and family covariates"],"limitations":["Cross‑sectional association; cannot infer causality","No measurement of mental‑health or trauma confounders","Reliance on self‑reported sexual behavior"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.socscimed.2021.113718"}},{"id":9360,"doi":"10.1016/j.pec.2021.07.049","pmid":"34366226","pmcid":null,"title":"Communication practices in conversations about sexual health in medical healthcare settings: A systematic review","authors":"Kelder I, Sneijder P, Klarenbeek A, Laan E.","first_author":"Kelder I","journal":"Patient education and counseling","year":2022,"pub_types":["Systematic Review","Journal Article"],"keywords":["Systematic review","Sexual Health","Discourse Analysis","Healthcare Professionals","Communication Practices"],"is_oa":false,"oa_url":"https://doi.org/10.1016/j.pec.2021.07.049","cited_by_count":24,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of five discourse‑analytic studies of recorded medical consultations. No explicit risk‑of‑bias assessment reported; synthesis of qualitative findings.","sample_n":5,"sample_text":"Five discourse‑analytic studies met inclusion criteria.","population":"Healthcare professionals and patients in medical consultations (qualitative sample from five studies).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of five studies examined how doctors and patients talk about sexual health. It identified seven common communication patterns, such as avoiding delicate terms or delaying sensitive topics, and offers guidance to help clinicians discuss sexual health more effectively.","clinical_takeaway":"Clinicians can use the identified communication strategies to address sexual‑health concerns more comfortably with patients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Systematic search across multiple databases.","Focus on real‑world recorded consultations.","Clear categorisation of communication practices."],"limitations":["Small number of included studies (n=5).","No reported risk‑of‑bias assessment for included qualitative studies.","Findings limited to contexts captured in the original recordings."],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":26,"citing_publications":51,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pec.2021.07.049"}},{"id":9361,"doi":"10.1080/17441692.2014.917196","pmid":"24881641","pmcid":null,"title":"Complexity versus the technical fix or how to put sexuality back into sexual health","authors":"Klugman B.","first_author":"Klugman B.","journal":"Global public health","year":2014,"pub_types":["Journal Article"],"keywords":["Research","Complexity","Policy","Evidence","Sexual Rights"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary/editorial without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The article argues that public‑health research on sexuality often favors quick technical fixes and neglects the complex social factors that shape sexual well‑being, calling for more thorough process and outcome evaluations of community‑based interventions.","clinical_takeaway":"None – the paper provides policy commentary rather than clinical evidence.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Highlights need for complex, community‑based evaluation","Integrates sexual rights and well‑being perspectives","Calls for policy‑level reflection"],"limitations":["No empirical data or systematic review","Lacks operational definitions of key constructs","No measurement of confounding factors"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/17441692.2014.917196"}},{"id":9362,"doi":"10.1001/jamapediatrics.2020.0382","pmid":"32310261","pmcid":"PMC7171582","title":"Association of Sexual Health Interventions With Sexual Health Outcomes in Black Adolescents: A Systematic Review and Meta-analysis","authors":"Evans R, Widman L, Stokes MN, Javidi H, Hope EC, Brasileiro J.","first_author":"Evans R","journal":"JAMA pediatrics","year":2020,"pub_types":["Meta-Analysis","Research Support, Non-U.S. Gov't","research-article","Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"systematic review and meta-analysis of experimental/quasi‑experimental trials","sample_n":11918,"sample_text":"29 studies","population":"Black adolescents in the United States (N≈11,918, mean age 12.4 years)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A review of 29 studies found that programmes aimed at improving sexual health modestly increased abstinence, condom use and knowledge among Black adolescents, but had little impact on the number of partners, pregnancy or STIs.","clinical_takeaway":"Sexual‑health education can modestly boost protective behaviours and knowledge in Black teens, but additional strategies are needed to affect pregnancy and STI rates.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Comprehensive systematic search across multiple databases","Meta‑analytic synthesis with effect‑size CIs","Large cumulative sample size"],"limitations":["No pre‑registration reported for the review","Limited reporting on control of psychosocial confounds","Potential heterogeneity across intervention designs"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":7,"confounds":3,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":48,"citing_publications":42,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/jamapediatrics.2020.0382"}},{"id":9363,"doi":"10.1186/s12913-019-4298-4","pmid":"31324158","pmcid":"PMC6642563","title":"Clarity, conviction and coherence supports buy-in to positive youth sexual health services: focused results from a realist evaluation","authors":"Shearn K, Piercy H, Allmark P, Hirst J.","first_author":"Shearn K","journal":"BMC health services research","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Young People","Programme Theory","Organisational Change","Realist"],"is_oa":true,"oa_url":"https://bmchealthservres.biomedcentral.com/track/pdf/10.1186/s12913-019-4298-4","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"realist evaluation using interviews, document analysis, workshops; multiple cycles, 161 data sources, UK context","sample_n":null,"sample_text":"total of 161 data sources (interviews, documents, workshops); no single numeric participant count given","population":"young people accessing UK sexual health services; staff and stakeholders involved in service delivery","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A realist evaluation of UK youth sexual health services shows that clear, convincing, and coherent organisational approaches help gain staff buy‑in for positive, youth‑centred care, but funding cuts and cultural barriers limit lasting change.","clinical_takeaway":"Implementing clear, collaborative, and youth‑focused service models may improve uptake of positive sexual health care for young people.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Robust realist methodology with iterative theory refinement","Multiple data sources (interviews, documents, workshops) enhance depth"],"limitations":["No quantitative outcome measures; findings are contextual","Limited generalisability beyond UK service settings"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12913-019-4298-4"}},{"id":9364,"doi":"10.1080/07399332.2019.1638923","pmid":"31373883","pmcid":null,"title":"Exploring postpartum sexual health: A feminist poststructural analysis","authors":"Ollivier RA, Aston ML, Price SL.","first_author":"Ollivier RA","journal":"Health care for women international","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Research Support, Non-U.S. Gov't, Review, Journal Article (critical feminist analysis, no primary data)","sample_n":null,"sample_text":"No empirical sample; analysis based on literature and theory","population":"postpartum women (no sample reported)","country":"Not specified (likely international authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article critiques how postpartum sexual health is usually studied, arguing that biomedical measures miss women's lived experiences. Using feminist theory, it urges a broader, more inclusive view of sexuality after childbirth.","clinical_takeaway":"Clinicians should consider psychosocial, relational, and cultural factors—not just physical signs—when supporting postpartum sexual health.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Theoretical depth using feminist post‑structural lens","Highlights gaps in biomedical‑focused postpartum sexual health research","Calls for more holistic, woman‑centered approaches"],"limitations":["No primary data or empirical measurement","Lacks clear methodological description","Cannot support causal or prevalence claims"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/07399332.2019.1638923"}},{"id":9365,"doi":"10.3389/fmed.2021.730994","pmid":"34957137","pmcid":"PMC8703142","title":"The Impact of Postponed Fertility Treatment on the Sexual Health of Infertile Patients Owing to the COVID-19 Pandemic","authors":"Dong M, Wu S, Tao Y, Zhou F, Tan J.","first_author":"Dong M","journal":"Frontiers in medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["SEM","Infertility","Sexual Health","Psychological Health","Covid-19","Postponed Fertility Treatment"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fmed.2021.730994/pdf","cited_by_count":12,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large‑scale survey comparing infertile patients whose fertility treatment was postponed (n=474) vs. not postponed (n=968)","sample_n":1442,"sample_text":"474 postponed, 968 not postponed","population":"infertile patients undergoing fertility treatment in China during COVID‑19 pandemic","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 1,442 infertile patients and found that those whose fertility treatment was delayed because of COVID‑19 reported poorer sexual function and more distress than those whose treatment continued.","clinical_takeaway":"Clinicians should monitor sexual health and relationship stress in patients whose fertility care is postponed.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample size","Use of validated sexual function instruments","Comparison of two clearly defined groups"],"limitations":["Cross‑sectional design limits causal inference","No measurement of moral or masturbation variables","Effect sizes and confidence intervals not reported"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":25,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fmed.2021.730994"}},{"id":9367,"doi":"10.1007/s00520-021-06510-4","pmid":"34463836","pmcid":"PMC8407130","title":"An online Sexual Health and Rehabilitation eClinic (TrueNTH SHAReClinic) for prostate cancer patients: a feasibility study","authors":"Matthew AG, Trachtenberg LJ, Yang ZG, Robinson J, Petrella A, McLeod D, Walker L, Wassersug R, Elliott S, Ellis J, Jamnicky L, Fleshner N, Finelli A, Singal R, Brock G, Jarvi K, Bender J, Elterman D.","first_author":"Matthew AG","journal":"Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Feasibility","intervention","prostate cancer","Web-based","Sexual Recovery"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8407130","cited_by_count":12,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"single‑group feasibility study with pre‑treatment baseline and 5 follow‑up online visits; no control group","sample_n":65,"sample_text":"patients undergoing treatment for localized prostate cancer","population":"65 prostate‑cancer patients from five Canadian institutions","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A web‑based programme helped prostate‑cancer patients learn about sexual health after treatment; most participants completed the modules and reported high satisfaction, suggesting the approach is feasible.","clinical_takeaway":"The online SHAReClinic appears acceptable and may support sexual recovery after prostate cancer, but efficacy remains unproven.","confidence":0.8,"topic_tags":["sexual_function","csbd","religiosity","masturbation"],"strengths":["multi‑site recruitment","high adherence rates","real‑world online delivery"],"limitations":["no control/comparator group","outcome measures not validated","small sample, limited power"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00520-021-06510-4"}},{"id":9368,"doi":"10.1080/16549716.2021.1948673","pmid":"34323158","pmcid":"PMC8330752","title":"Sexual health and wellbeing training with women in Pacific Island Countries and Territories: a scoping review","authors":"Neuendorf N, Cheer K, Tommbe R, Kokinai C, Simeon L, Browne K, MacLaren D, Redman-MacLaren M.","first_author":"Neuendorf N","journal":"Global health action","year":2021,"pub_types":["Scoping Review","Research Support, Non-U.S. Gov't","review-article","Journal Article"],"keywords":["Training","Papua New Guinea","Sexual Health","Pacific Islands","Women Leaders"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8330752","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review of training programmes; systematic search but limited to eight sources; thematic synthesis only","sample_n":null,"sample_text":"Six published papers, one report, one manual, one training package (total eight sources)","population":"women leaders in Pacific Island Communities (PNG context)","country":"Papua New Guinea (Pacific Island Countries and Territories)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed eight community‑based sexual‑health training programmes in Pacific Island countries, identifying how programmes are developed, delivered and evaluated, and noting that cultural context shapes all stages.","clinical_takeaway":"Tailor sexual‑health training for women leaders to local cultural contexts to improve effectiveness.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Systematic search across multiple sources","Inclusion of grey literature","Thematic analysis highlights contextual factors"],"limitations":["Very small number of included studies","No quantitative synthesis or quality appraisal beyond hierarchy","Findings not generalizable beyond Pacific Island contexts"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/16549716.2021.1948673"}},{"id":9369,"doi":"10.1136/bmjsrh-2022-201611","pmid":"36307186","pmcid":"PMC10176375","title":"Involving young people in sexual health research and service improvement: conceptual analysis of patient and public involvement (PPI) in three projects","authors":"Lewis R, Boydell N, Blake C, Clarke Z, Kernaghan K, McMellon C.","first_author":"Lewis R","journal":"BMJ sexual & reproductive health","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Adolescent","Sexual Health","Patient Participation","Health Services Research"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10176375","cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"conceptual analysis of patient and public involvement across three SRH projects; qualitative cross‑project synthesis","sample_n":null,"sample_text":"three projects with unspecified numbers of youth participants","population":"young people involved in SRH research and service improvement projects in Scotland","country":"Scotland, UK","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper analyses how young people were involved in three sexual‑health research and service projects, using a 7‑domain framework to identify best practices and challenges for meaningful participation.","clinical_takeaway":"None – the study offers methodological guidance for researchers, not clinical findings.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear conceptual framework (7P) applied","Cross‑project synthesis generates broader insights","Focus on ethical and methodological considerations for youth PPI"],"limitations":["No empirical outcome data on sexual health effects","Sample size and participant characteristics not reported","Limited generalisability beyond Scottish context"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":2,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjsrh-2022-201611"}},{"id":9371,"doi":"10.1007/s10549-020-05880-3","pmid":"32968951","pmcid":null,"title":"Sexual health after a breast cancer diagnosis in young women: clinical implications for patients and providers","authors":"Marsh S, Borges VF, Coons HL, Afghahi A.","first_author":"Marsh S","journal":"Breast cancer research and treatment","year":2020,"pub_types":["Review","Journal Article"],"keywords":["Breast cancer","Sexual Health","Premature Menopause","survivorship","Cancer Survivors"],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of PubMed literature (1998‑2020) on sexual health in young breast‑cancer survivors; no systematic search, no risk‑of‑bias assessment, no meta‑analysis.","sample_n":null,"sample_text":"Not applicable – review paper.","population":"Young women with breast cancer (no sample size reported; review of other studies).","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises how breast‑cancer treatment can lead to sexual problems—like low desire, pain, and body‑image concerns—in young women, and discusses hormone, psychological, and couples‑based therapies that may help.","clinical_takeaway":"Clinicians should proactively discuss sexual health with young breast‑cancer survivors and consider multidisciplinary treatments (hormone, CBT, couples therapy).","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Broad overview of multiple domains of sexual dysfunction after breast‑cancer treatment.","Identifies clinical interventions (hormone therapy, CBT, couples therapy)."],"limitations":["Narrative, not systematic; selection bias likely.","No quantitative synthesis or quality appraisal of included studies.","No assessment of confounding factors such as mental health or relationship variables."],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":45,"citing_publications":63,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10549-020-05880-3"}},{"id":9372,"doi":"10.1186/s12889-019-6558-y","pmid":"30866882","pmcid":"PMC6417029","title":"Absence of holistic sexual health understandings among men and women in deprived areas of Scotland: qualitative study","authors":"McDaid L, Hunt K, McMillan L, Russell S, Milne D, Ilett R, Lorimer K.","first_author":"McDaid L","journal":"BMC public health","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Relationships","Coercion","Deprivation","Wellbeing","Heterosexual","Health Improvement","Inter-personal Violence","Holistic Sexual Health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6417029","cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interviews (n=35) from deprived Scottish areas","sample_n":35,"sample_text":"19 men and 16 women","population":"adult men and women, 18‑40, living in deprived neighborhoods of Glasgow, Edinburgh, Dundee, and Highland towns","country":"Scotland","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 35 adults living in deprived Scottish areas showed that most people define sexual health narrowly as avoiding STIs and pregnancy, while women more often link it to respectful, non‑coercive relationships. Men were split, with some accepting a broader view and others blaming women for relationship problems.","clinical_takeaway":"Clinicians should recognise that many people in deprived settings may have a limited view of sexual health and address broader relational and safety issues in counselling.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rich, in‑depth qualitative data from under‑researched, high‑deprivation communities","Systematic thematic analysis with constant comparative method"],"limitations":["Small, non‑representative convenience sample limits generalisability","No quantitative measurement of sexual‑health constructs or outcomes","No assessment of potential confounders such as mental health or moral attitudes"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-019-6558-y"}},{"id":9373,"doi":"10.1186/s12884-023-05435-6","pmid":"36941545","pmcid":"PMC10026523","title":"The feasibility and acceptability of Project POWER: a mindfulness-infused, cognitive-behavioral group intervention to address mental and sexual health needs of young pregnant women in Liberia","authors":"Callands TA, Hylick K, Desrosiers A, Gilliam SM, Taylor EN, Hunter JJ, Hansen NB.","first_author":"Callands TA","journal":"BMC pregnancy and childbirth","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Pregnant women","Mental health","Liberia","Sexual Health","Mindfulness","Intervention Development"],"is_oa":true,"oa_url":"https://bmcpregnancychildbirth.biomedcentral.com/counter/pdf/10.1186/s12884-023-05435-6","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"quasi‑experimental pilot trial with pre‑post measures, non‑random allocation based on residence, two conditions (intervention vs health‑education control), N=87","sample_n":87,"sample_text":"Eighty‑seven women recruited from three catch‑area zones in Monrovia","population":"young pregnant women (18‑25 y) in Liberia, war‑exposed","country":"Liberia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers piloted a 5‑week mindfulness‑based cognitive‑behavioral group (Project POWER) for young pregnant women in Liberia. The program was feasible and acceptable, and participants showed reductions in prenatal distress, PTSD symptoms, depressive symptoms, and transactional sexual behavior, especially compared with a health‑education control.","clinical_takeaway":"Group mindfulness‑CBT may help reduce distress and risky sexual behaviour in war‑affected pregnant women, but larger trials are needed before routine use.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Culturally tailored intervention","Both feasibility and preliminary efficacy assessed","Use of a comparison health‑education condition"],"limitations":["Non‑random allocation, possible selection bias","Small pilot sample limits power","Limited detail on measurement instruments"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12884-023-05435-6"}},{"id":9374,"doi":"10.7759/cureus.30787","pmid":"36447681","pmcid":"PMC9701317","title":"Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract for Improvement of Sexual Health in Healthy Women: A Prospective, Randomized, Placebo-Controlled Study","authors":"Ajgaonkar A, Jain M, Debnath K.","first_author":"Ajgaonkar A","journal":"Cureus","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Ghq-28","Ashwagandha","Female Sexual Function","Fsfi","Fsds","Satisfying Sexual Encounters"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC9701317","cited_by_count":14,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"prospective, double‑blind, placebo‑controlled randomised trial (n=80, 40 per arm) assessing Ashwagandha vs placebo over 8 weeks in women with hypoactive sexual desire disorder.","sample_n":80,"sample_text":"80 women (40 per group)","population":"healthy women, 18‑50 y, without hormonal disturbances, meeting FSFI < 26 or FSDS > 11","country":"not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In an 8‑week randomised trial, 40 women taking Ashwagandha reported higher sexual desire, arousal, satisfaction and lower sexual distress than 40 women taking placebo, with few side‑effects.","clinical_takeaway":"Ashwagandha may improve sexual function in women with low desire, but evidence is limited to a modest RCT.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Validated sexual function and distress scales (FSFI, FSDS)","Randomised, double‑blind, placebo‑controlled design","Clear reporting of statistical significance"],"limitations":["No pre‑registration or effect‑size reporting","Potential limited generalisability (women with HSDD only)","Confounding factors (e.g., relationship status, mental‑health covariates) not measured"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":14,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7759/cureus.30787"}},{"id":9375,"doi":"10.1016/j.jadohealth.2023.07.002","pmid":"37676195","pmcid":"PMC10935575","title":"Utilizing Digital Health Technology to Increase Sexual Health Care Access: Youth Preferences on Self-Collect, Mail-In Sexually Transmitted Infection Testing in a High Sexually Transmitted Infection Prevalence Area","authors":"Sao SS, Yu R, Abboud S, Barre-Quick M, Deshmukh S, Wang R, Coleman JS.","first_author":"Sao SS","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2023,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Youth","Sexual Health","Stis","Digital Health","Sti Testing","Self-collect Sti Testing"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"focus groups with 28 youth (14‑19) in Baltimore; thematic coding of transcripts","sample_n":28,"sample_text":"28 youth ages 14‑19 years old","population":"U.S. adolescents and young adults, convenience sample","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Adolescents and young adults in Baltimore were asked what they liked and disliked about a free, self‑collected, mail‑in STI test kit. They saw it as a convenient way to get tested despite worries about accuracy and preferred more shipping options and clear communication.","clinical_takeaway":"Self‑collect, mail‑in STI kits appear acceptable to youth and could help increase testing rates, but programs should address accuracy concerns and provide clear result communication.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Direct input from target youth population","Thematic analysis grounded in patient‑centered access framework","Identifies concrete implementation suggestions"],"limitations":["Small, non‑representative convenience sample","No quantitative assessment of acceptability or effectiveness","Findings may not generalize beyond Baltimore youth"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2023.07.002"}},{"id":9376,"doi":"10.1136/rmdopen-2021-001821","pmid":"34580174","pmcid":"PMC8477326","title":"It is not just about sex: viewpoints of men with inflammatory arthritis on the overall impact of the disease on their sexual health","authors":"Perez-Garcia LF, Röder E, Pastoor H, Bolt JM, van Exel J, Dolhain RJEM.","first_author":"Perez-Garcia LF","journal":"RMD open","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Arthritis","Rheumatoid","Qualitative Research","Patient Care Team"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8477326","cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Q‑methodology with 30 adult men with inflammatory arthritis; participants ranked statements and were interviewed; by‑person factor analysis identified three viewpoint clusters.","sample_n":30,"sample_text":"30 men with IA (22‑77 years).","population":"Adult men (22‑77 y) with diagnosed inflammatory arthritis in the Netherlands (N = 30).","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 30 Dutch men with inflammatory arthritis, researchers asked participants to rank statements about how the disease affects their sexual lives and then interviewed them. Three main perspectives emerged: one group felt arthritis harmed all aspects of sexual health; another concealed the impact with coping; a third reported no major effect.","clinical_takeaway":"Clinicians should assess emotional, mental and social aspects of sexual health in men with arthritis, not just erectile function.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Innovative use of Q‑methodology to capture subjective viewpoints","Mixed‑methods triangulation with interviews","Identifies emotional, mental, social dimensions beyond erectile function"],"limitations":["Small, non‑representative convenience sample (N=30)","No validated sexual‑health scales; relies on ad‑hoc statements","No control for mental‑health, partner, or moral‑incongruence factors"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":8,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/rmdopen-2021-001821"}},{"id":9377,"doi":"10.1186/s12913-022-07542-0","pmid":"35120510","pmcid":"PMC8814567","title":"Key informant perspectives on sexual health services for travelling young adults: a qualitative study","authors":"Gareau E, Phillips KP.","first_author":"Gareau E","journal":"BMC health services research","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Tourism","Sexually transmitted disease","Travel","Sexual Health","Health Promotion","Young Adult"],"is_oa":true,"oa_url":"https://bmchealthservres.biomedcentral.com/track/pdf/10.1186/s12913-022-07542-0","cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"13 semi-structured interviews with key informants (travel/sexual health professionals)","sample_n":13,"sample_text":"13 key informants (in‑person or Skype)","population":"Professionals working in travel or sexual health clinics in Ottawa, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 13 travel‑ and sexual‑health professionals in Canada reveal that pre‑travel advice rarely covers sexual health for young adults, citing time constraints, provider discomfort, and young travellers’ embarrassment as barriers. Respondents recommend more comprehensive sexual‑health education before travel.","clinical_takeaway":"Clinicians should allocate dedicated time to discuss sexual health with young adult travellers to reduce risky behaviours.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides direct insights from service providers","Identifies concrete barriers to sexual‑health counseling","Uses both inductive and deductive thematic analysis"],"limitations":["Small, purposive sample limits generalisability","No client perspectives; only provider views","No quantitative assessment of intervention impact"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12913-022-07542-0"}},{"id":9378,"doi":"10.1002/imhj.21805","pmid":"31335984","pmcid":"PMC6972560","title":"Trauma, immigration, and sexual health among Latina women: Implications for maternal-child well-being and reproductive justice","authors":"Fortuna LR, Noroña CR, Porche MV, Tillman C, Patil PA, Wang Y, Markle SL, Alegría M.","first_author":"Fortuna LR","journal":"Infant mental health journal","year":2019,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["immigrant","Latina","Traumatic Stress","Infant Mental Health","Reproductive Justice","移民","拉丁裔","Salud Mental Infantil","Santé Mentale Du Nourrisson","乳幼児精神保健","嬰兒心理健康","生殖の公平性","生殖公義","Einwanderer","Immigrées","Lateinamerikanerin","Stress Traumatique","Inmigrante","الإجهاد الناتج عن الصدمة","صحة الطفل النفسية","لاتينو","مهاجر","ラテン系の","創傷壓力","外傷性ストレス","Psychische Gesundheit Von Säuglingen","Estrés Traumático","Justice Reproductive","Justicia Reproductiva","Reproduktive Gerechtigkeit","العدالة الإنجابية","Traumatischer Stress"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6972560","cited_by_count":20,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 175 Latina immigrant women comparing mothers vs non‑mothers on trauma and health outcomes","sample_n":175,"sample_text":"Community sample from the International Latino Research Partnership (ILRP)","population":"Latina immigrant women (N=175, age 18‑64) in the United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among Latina immigrants, women who experienced sexual assault showed higher rates of depression, PTSD, and substance‑use problems. Physical assault strongly predicted sexual assault, and women from the Northern Triangle were especially at risk.","clinical_takeaway":"Screen for trauma and mental‑health issues in immigrant Latina patients, especially those with a history of physical assault.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large community sample for this population","Use of validated mental‑health scales","Clear reporting of odds ratios"],"limitations":["Cross‑sectional; cannot infer causality","Sexual assault measured by single‑item self‑report","Key sexual‑health confounds (e.g., partner context) not assessed"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":40,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/imhj.21805"}},{"id":9380,"doi":"10.1080/09688080.2018.1517543","pmid":"30484752","pmcid":null,"title":"Contextualising sexual health practices among lesbian and bisexual women in Jamaica: a multi-methods study","authors":"Logie CH, Marcus N, Wang Y, Lacombe-Duncan A, Levermore K, Jones N, Bryan N, Back R, Marshall A.","first_author":"Logie CH","journal":"Reproductive health matters","year":2018,"pub_types":["Journal Article"],"keywords":["Testing","Women","stigma","Homosexuality","Jamaica","Sexual Health","Sti","Bisexuality","Lesbians","Developing World"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Sequential mixed‑methods: 20 interviews, 1 focus group, and a cross‑sectional survey of 205 lesbian/bisexual women in Jamaica; logistic regressions used for quantitative analysis.","sample_n":205,"sample_text":"205 respondents in the quantitative survey; qualitative component included 20 individual interviews and one focus group of 5 participants.","population":"Lesbian and bisexual women (age range not specified) in Kingston, Montego Bay, and Ocho Rios, Jamaica (N=205 survey; N=25 qualitative).","country":"Jamaica","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A mixed‑methods study of 205 lesbian and bisexual women in Jamaica found that stigma, depression, and experiences of forced sex were linked to less frequent STI testing and higher involvement in sex work, while confidence in safer‑sex practices and LGBT community connection improved testing rates.","clinical_takeaway":"Clinicians should address stigma, mental health, and safety concerns to improve STI screening among lesbian and bisexual women in Jamaica.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Large community‑based survey (N=205) combined with qualitative depth","Multilevel ecological analysis of factors influencing STI testing","Use of logistic regression with odds ratios"],"limitations":["Cross‑sectional design limits causal inference","Convenience sampling may not represent all Jamaican LBT women","Details of measurement tools (validation) not provided in abstract"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09688080.2018.1517543"}},{"id":9383,"doi":"10.1007/s11524-019-00347-3","pmid":"30790124","pmcid":"PMC6890897","title":"The Socioeconomic and Sexual Health Status of Young People Living in Urban Slum Areas of Kampala, Uganda","authors":"Kamara JK, Namugambe BM, Egessa R, Kamanga G, Renzaho AMN.","first_author":"Kamara JK","journal":"Journal of urban health : bulletin of the New York Academy of Medicine","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Quality of life","Uganda","Unemployment","Sexual Reproductive Health","Life Dissatisfaction","Youth Needs"],"is_oa":false,"oa_url":null,"cited_by_count":19,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups (N=113) and key informant interviews (n=20); thematic analysis using structuration theory","sample_n":113,"sample_text":"113 participants in 10 focus groups plus 20 key informants","population":"urban slum‑dwelling youth in Kampala, Uganda","country":"Uganda","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study explored the lived experiences of youth living in Kampala slums, finding that poverty, weak job markets, and poor sexual‑health services limit their wellbeing and lead to dissatisfaction and risky sexual practices.","clinical_takeaway":"None – the study does not provide evidence relevant to clinical assessment or treatment of pornography‑related problems.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large qualitative sample for the context","Use of both focus groups and key informant interviews","Theoretical framework (structuration theory) guides analysis"],"limitations":["No quantitative measurement of pornography, masturbation or sexual distress","No assessment of key confounds (moral incongruence, mental health, etc.)","Findings limited to one urban slum area; not generalisable"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":2,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11524-019-00347-3"}},{"id":9385,"doi":"10.1080/14681811.2020.1749041","pmid":"38343724","pmcid":"PMC10857865","title":"Using photovoice to identify sexual health needs in Latina early adolescents","authors":"Sanchez D, Serrata JV, Adams W, Arango S, Hamilton E.","first_author":"Sanchez D","journal":"Sex education","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Middle School","Latina Adolescents","Photovoice Action Research"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"photovoice action research with 17 Latina early adolescents (11‑12 y) in a single urban middle school; data collected over 12 weeks; thematic analysis of photographs and narratives.","sample_n":17,"sample_text":"17 youth collaborators","population":"Latina early adolescents (n≈17) in one Texas middle school","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A small group of Latina middle‑schoolers used photographs and discussions to share what they think about sexuality, culture, and gender. The study highlights how their perspectives differ from typical health messages and points to gaps in how schools address their sexual‑health needs.","clinical_takeaway":"Youth‑led, culturally‑relevant input can reveal gaps in sexual‑health education for Latina adolescents.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Community‑based participatory method gives voice to underserved youth","Longitudinal data collection (12 weeks) adds depth"],"limitations":["Very small, non‑representative sample","No validated measures of sexual‑health constructs","Findings not generalisable beyond one school"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/14681811.2020.1749041"}},{"id":9387,"doi":"10.3389/fpsyg.2021.598120","pmid":"35027894","pmcid":"PMC8751617","title":"Non-parental Adults and Sexual Health Behaviors Among Young Minority Men: A Qualitative Examination","authors":"Sterrett-Hong EM, DeBow J, Caton E, Harris M, Brewer R, Roberts E, Marchal M, Tauzer M, Arnold EA.","first_author":"Sterrett-Hong EM","journal":"Frontiers in psychology","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["HIV","Youth","Social Support","Ethnicity","Lgbtq","Non-parental Adults"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpsyg.2021.598120/pdf","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interviews with 20 participants (10 YBLSM, 10 NPAs)","sample_n":20,"sample_text":"n=20 (10 YBLSM ages 16‑22; 10 NPAs ages 26‑52)","population":"young Black and Latino sexual minority men and non‑parental adult mentors in a southern US city","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 10 young Black/Latino gay men and 10 adult mentors reveal that mentors can help with housing, mental health, condom use, and HIV medication adherence, suggesting they could be a valuable resource for improving sexual health.","clinical_takeaway":"Engaging trusted adult mentors may support better sexual health behaviors in at‑risk youth.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides novel qualitative insight into mentor‑mentee relationships","Includes perspectives of both YBLSM and NPAs","Uses systematic framework analysis"],"limitations":["Small, non‑representative convenience sample","No quantitative measurement of sexual health outcomes","No control for potential confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":0,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpsyg.2021.598120"}},{"id":9388,"doi":"10.3390/ijerph19138084","pmid":"35805743","pmcid":"PMC9265266","title":"Exploring the Role of Provider-Patient Communication in Women's Sexual Health and Pre-Exposure Prophylaxis Care in the Primary Care Settings in New York State of the United States","authors":"Zhang C, Fiscella K, Liu Y.","first_author":"Zhang C","journal":"International journal of environmental research and public health","year":2022,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual Health","Patient–provider Communication","Interpersonal Relationship","Prep Care Implementation","Sexual Wellness"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/19/13/8084/pdf?version=1656656568","cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross‑sectional qualitative interview study with 47 participants (18 providers, 29 women) in New York State primary care settings","sample_n":47,"sample_text":"18 PCPs and 29 women","population":"Primary‑care providers and PrEP‑eligible women in New York State, United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with doctors and women revealed that how they talk about sex and HIV prevention strongly influences whether women start and stay on PrEP. Gaps in who should bring up the topic and how information is shared were identified.","clinical_takeaway":"Improving patient‑provider communication could boost PrEP uptake among women; clinicians should proactively discuss sexual health and PrEP.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight from both providers and patients","Focus on a critical public‑health issue (women’s PrEP uptake)","Uses established communication framework"],"limitations":["Small, non‑representative convenience sample","No validated measurement instruments reported","Findings not generalizable beyond New York primary‑care settings"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph19138084"}},{"id":9389,"doi":"10.2196/49352","pmid":"38113102","pmcid":"PMC10762611","title":"Mobile Phone Technology for Preventing HIV and Related Youth Health Problems, Sexual Health, Mental Health, and Substance Use Problems in Southwest Uganda (Youth Health SMS): Protocol for a Pilot Randomized Controlled Trial","authors":"Kreniske P, Namuyaba OI, Kasumba R, Namatovu P, Ssewamala F, Wingood G, Wei Y, Ybarra ML, Oloya C, Tindyebwa C, Ntulo C, Mujune V, Chang LW, Mellins CA, Santelli JS.","first_author":"Kreniske P","journal":"JMIR research protocols","year":2023,"pub_types":["research-article","Journal Article"],"keywords":["Adaptation","HIV","Adolescence","Mental health","Randomized controlled trial","Uganda","Sexual Health","Substance Use","Mobile Phones","Prep","Pre-exposure Prophylaxis"],"is_oa":true,"oa_url":"https://doi.org/10.2196/49352","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"pilot randomized controlled trial protocol, 2‑arm, N=200 adolescents recruited from schools in Uganda","sample_n":200,"sample_text":"Adolescents (N=200) will be recruited from local schools","population":"Adolescents and young adults (school‑aged) in Southwest Uganda","country":"Uganda","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A pilot study will test an SMS program that sends health information and links Ugandan teens to HIV testing and mental‑health services, checking if it is acceptable and can improve testing rates.","clinical_takeaway":"None – study is a protocol; no results to inform practice yet.","confidence":0.4,"topic_tags":["sexual_function","pornography","masturbation"],"strengths":["Registered trial (ClinicalTrials.gov)","Clear protocol and adaptation framework (ADAPT‑ITT)","Targeted multi‑risk intervention (HIV, mental health, substance use)"],"limitations":["Protocol only – no outcome data yet","No mention of controlling key sexual‑health confounds (e.g., moral incongruence, masturbation)","Pilot size may limit power for efficacy conclusions"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/49352"}},{"id":9390,"doi":"10.1080/26410397.2019.1615364","pmid":"31533573","pmcid":"PMC7888010","title":"Sexual health counselling targeting girls and young women with female genital cutting in Sweden: mind-body dualism affecting social and health care professionals' perspectives","authors":"Palm C, Essén B, Johnsdotter S.","first_author":"Palm C","journal":"Sexual and reproductive health matters","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Migration","Youth","Body","Sweden","Female Genital Mutilation","Female Genital Cutting","Discourses","Sexual Health Counselling"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7888010","cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative interview and focus‑group study with professionals","sample_n":null,"sample_text":"not reported in abstract","population":"social and health‑care professionals working with young women/girls who have undergone female genital cutting in Sweden","country":"Sweden","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Swedish health and social‑care workers who counsel young women and girls who have undergone female genital cutting often focus mainly on the genital area when discussing sexuality, which can harm body image and self‑esteem. A broader, holistic view of sexuality is recommended.","clinical_takeaway":"Counsellors should adopt a holistic, body‑positive approach to avoid reinforcing shame or limiting sexual wellbeing in girls with FGC.","confidence":0.8,"topic_tags":["sexual_function","csbd","adolescents"],"strengths":["Provides in‑depth professional perspectives on sexual counselling for FGC‑affected youth","Highlights the impact of reductionist body‑focused discourse on client wellbeing"],"limitations":["Small, non‑representative sample; no detail on participant numbers","Findings limited to Swedish context and professional viewpoints only"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/26410397.2019.1615364"}},{"id":9391,"doi":"10.3390/ijerph18115619","pmid":"34070264","pmcid":"PMC8197366","title":"Promoting Sexual Health Knowledge through a Social Workers' Mentorship Programme: A Study of Gay Young Adults","authors":"Dos Santos LM.","first_author":"Dos Santos LM.","journal":"International journal of environmental research and public health","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Taiwan","Homosexuals","Sexual Education","Sexual Minorities","Gays","Lgbt Persons","Mentor Modelling Programme","Men Who Have Sex With Other Men","Queers"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/18/11/5619/pdf?version=1621922845","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"program evaluation with 40 participants, no control group, likely descriptive/qualitative","sample_n":40,"sample_text":"40 gay youths","population":"gay young adults (n≈40) in Taiwan, recruited via mentorship programme","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A six‑month mentorship programme for gay young adults in Taiwan was evaluated. Participants reported that the programme improved their sexual health knowledge and encouraged healthier relationships, but the study lacked a control group and used only self‑reported, non‑validated measures.","clinical_takeaway":"Program shows promise for improving sexual health knowledge among gay youth, but stronger evidence is needed before recommending it widely.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses an understudied mentorship model","Focuses on gay youth sexual health","Provides qualitative feedback from participants"],"limitations":["No control or comparison group","Small convenience sample (N=40)","Lack of validated outcome measures","Claims of effectiveness not statistically substantiated"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph18115619"}},{"id":9392,"doi":"10.4414/smw.2022.w30192","pmid":"35758418","pmcid":null,"title":"Changes in mental and sexual health among MSM using HIV pre-exposure prophylaxis during the SARS-CoV-2 pandemic: longitudinal analysis of the SwissPrEPared cohort study","authors":"Winter BL, Hovaguimian F, Kouyos RD, Schmidt AJ, Bernasconi E, Braun DL, Calmy A, Notter J, Stoeckle M, Surial B, Christinet V, Cavassini M, Depmeier C, Läuchli S, Boffi El Amari E, Reinacher M, Rasi M, Bruggmann P, Haerry D, Bize R, Low N, Lehner A, Quednow BB, Fehr JS, Hampel B.","first_author":"Winter BL","journal":"Swiss medical weekly","year":2022,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Longitudinal analysis of a multicentre PrEP cohort (N=1,043) with repeated questionnaires before and during multiple pandemic phases.","sample_n":1043,"sample_text":"1,043 participants with at least one pre‑pandemic and one intra‑pandemic questionnaire","population":"HIV‑negative men who have sex with men (MSM) in Switzerland, ≥18 years, PrEP users","country":"Switzerland","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a Swiss cohort of over 1,000 HIV‑negative gay men on PrEP, depression scores rose during the second COVID‑19 wave and lockdown, while anxiety stayed stable. Sexual activity and substance‑linked sexual behaviour fell, and many switched from daily to event‑driven PrEP.","clinical_takeaway":"During prolonged pandemic stress, clinicians should monitor depression in MSM on PrEP even if anxiety appears unchanged.","confidence":0.85,"topic_tags":["prevalence","sexual_function"],"strengths":["Large longitudinal cohort with over 1,000 MSM","Validated mental‑health instrument (PHQ‑4)","Multiple pandemic phases allow temporal comparison"],"limitations":["Sexual‑behaviour measures are self‑reported and not validated","No correction for multiple pairwise comparisons","No assessment of key confounds (e.g., moral incongruence, partner status)"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":11,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4414/smw.2022.w30192"}},{"id":9394,"doi":"10.1186/s40814-021-00847-7","pmid":"33985588","pmcid":"PMC8117628","title":"Enabling culturally safe sexual health services in western Sydney: a protocol to improve STI treatment outcomes for Aboriginal young people","authors":"Ubrihien A, Gwynne K, Lewis DA.","first_author":"Ubrihien A","journal":"Pilot and feasibility studies","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Equity","Barriers","Aboriginal"],"is_oa":true,"oa_url":"https://pilotfeasibilitystudies.biomedcentral.com/counter/pdf/10.1186/s40814-021-00847-7","cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Cross‑sectional qualitative interview study (purposeful sampling of 60 participants).","sample_n":60,"sample_text":"Planned recruitment of 20 male and 20 female young health consumers, 10 Aboriginal elders and 10 sexual‑health clinicians.","population":"Aboriginal young people (<30 y), elders, and clinicians in western Sydney.","country":"Australia","controls_mi":"not_applicable","preregistered":true,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study will interview Aboriginal young people, elders and clinicians in western Sydney to understand why young Aboriginal people do not seek STI treatment, aiming to improve cultural safety of sexual‑health services.","clinical_takeaway":"None – the paper is a protocol and does not provide actionable clinical findings yet.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear culturally safe recruitment strategy","Inclusion of multiple stakeholder groups","Use of gender‑matched interviewers"],"limitations":["No validated interview instrument reported","Small, non‑random sample limits generalisability","Protocol only – no results yet"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s40814-021-00847-7"}},{"id":9395,"doi":"10.1016/j.socscimed.2020.113285","pmid":"32829967","pmcid":"PMC7427551","title":"The influence of peer relationships on young people's sexual health in Sub-Saharan African street contexts","authors":"Hunter J, van Blerk L, Shand W.","first_author":"Hunter J","journal":"Social science & medicine (1982)","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Sub-Saharan Africa","Social Networks","Sexual Health","Street Youth","Peer Relationships","Peer Influence","Sexual Relationships","Social Anchorage"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7427551","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative ethnographic study with longitudinal participatory component; weekly interviews (n≈212 sources), focus groups (n≈399); thematic coding in NVivo.","sample_n":null,"sample_text":"18 youth trained as research assistants; network of 229 peers; 399 participants in focus groups; 212 coded sources","population":"Street youth aged 14‑20 in Accra, Bukavu, Harare (Sub‑Saharan Africa)","country":"Ghana, Democratic Republic of Congo, Zimbabwe","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study used interviews and focus groups with street‑connected youth in three African cities to show how peer groups can both help and harm young people’s sexual health, for example by spreading wrong information about contraception or influencing risky abortions.","clinical_takeaway":"Peer networks shape sexual‑health decisions among street youth; interventions should engage these networks to improve accurate information and safer practices.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, multi‑city sample of hard‑to‑reach street youth","Participatory methodology involving youth as research assistants","Rich, context‑specific qualitative data"],"limitations":["No validated measures of peer influence or sexual health outcomes","Findings are descriptive and not generalisable to broader populations","Absence of quantitative analysis limits assessment of effect sizes"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":14,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.socscimed.2020.113285"}},{"id":9398,"doi":"10.1177/0008417419855237","pmid":"31220932","pmcid":null,"title":"Addressing clients' sexual health in occupational therapy practice","authors":"Young K, Dodington A, Smith C, Heck CS.","first_author":"Young K","journal":"Canadian journal of occupational therapy. Revue canadienne d'ergotherapie","year":2020,"pub_types":["Journal Article"],"keywords":["Sexuality","Knowledge","Beliefs","Comfort","Canadian","Sexualité","Croyances","Connaissances","Aisance","Canadien"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"exploratory online survey of Canadian occupational therapists; convenience sample; descriptive analysis","sample_n":null,"sample_text":"survey respondents (convenience sample; exact N not reported in abstract)","population":"Canadian occupational therapists (adult, mixed gender)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2020 Canadian survey explored occupational therapists' beliefs, knowledge and comfort about addressing clients' sexual health, finding many see it as part of their role but feel limited by lack of knowledge.","clinical_takeaway":"Therapists recognize sexual health as part of care but need more training and resources to address it effectively.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Addresses an understudied professional domain","Collects both quantitative and qualitative data"],"limitations":["Convenience sample limits generalizability","Questionnaire appears ad‑hoc, lacking validated scales","No statistical power justification or effect‑size reporting"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":18,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0008417419855237"}},{"id":9399,"doi":"10.1186/s12889-023-15541-x","pmid":"37041542","pmcid":"PMC10088210","title":"A peer-led, school-based social network intervention for young people in the UK, promoting sexual health via social media and conversations with friends: intervention development and optimisation of STASH","authors":"Purcell C, McDaid L, Forsyth R, Simpson SA, Elliott L, Bailey JV, Moore L, Mitchell KR.","first_author":"Purcell C","journal":"BMC public health","year":2023,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Social Networks","Sexual Health","Young People","School-based","Intervention Development","Social Media","Peer-led","Co-development","6Squid"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC10088210","cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"intervention development and pilot description; no efficacy outcomes reported","sample_n":null,"sample_text":"pilot in one school (size not specified)","population":"young people (adolescents) in a UK secondary school; sample size not reported","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe how they created STASH, a peer‑led school programme that uses a closed Facebook group and face‑to‑face talks to improve teens' knowledge about sexual health, consent and pleasure. The paper details the step‑by‑step co‑design process but does not test whether the programme actually changes behaviour or health outcomes.","clinical_takeaway":"None – the paper reports intervention development only; effectiveness remains untested.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Systematic, theory‑informed development process (6SQuID, Diffusion of Innovation)","Iterative co‑production with youth, clinicians and educators","Clear documentation of adaptation from a proven ASSIST model"],"limitations":["No empirical evaluation of effectiveness","Sample size and participant characteristics not reported","Findings limited to a single school pilot"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-023-15541-x"}},{"id":9400,"doi":"10.1007/s00103-021-03431-9","pmid":"34648038","pmcid":"PMC8550659","title":"[Sexual health information on social media: a systematic scoping review]","authors":"Döring N, Conde M.","first_author":"Döring N","journal":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","year":2021,"pub_types":["Scoping Review","review-article","Journal Article"],"keywords":["Sexual Health","Health Information","Research Synthesis","Sexual Education","Digital Media"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8550659","cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review following PRISMA, preregistered, open data","sample_n":69,"sample_text":"69 studies identified (72 data sets)","population":"studies on sexual health information on social media (any country, any age)","country":"International","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review catalogues 69 studies that examined how sexual and reproductive health information is shared on social‑media platforms, especially YouTube, showing that most content is produced by laypeople, target groups are often unclear, and quality assessments are generally negative.","clinical_takeaway":"Health professionals should be aware that much sexual‑health information online is of poor quality and consider guiding patients toward reliable sources.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Pre‑registered protocol and open data","Systematic PRISMA‑compliant search","Comprehensive mapping of 69 studies"],"limitations":["Scoping reviews do not assess study quality in depth","No quantitative synthesis of outcomes","Limited to published literature, possible publication bias"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":8,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00103-021-03431-9"}},{"id":9401,"doi":"10.1177/2045894018788277","pmid":"30124126","pmcid":"PMC6102766","title":"Sexual health and health-related quality of life among women with pulmonary arterial hypertension","authors":"Banerjee D, Vargas SE, Guthrie KM, Wickham BM, Allahua M, Whittenhall ME, Palmisciano AJ, Ventetuolo CE.","first_author":"Banerjee D","journal":"Pulmonary circulation","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Measurement","Sexual Health","Pulmonary Arterial Hypertension","Health-related Quality Of Life"],"is_oa":true,"oa_url":"https://journals.sagepub.com/doi/pdf/10.1177/2045894018788277","cited_by_count":15,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 35 women with PAH at a professional conference; self‑report questionnaires.","sample_n":35,"sample_text":"35 women with self‑reported PAH recruited at the 2016 Pulmonary Hypertension Association International Conference.","population":"Women with World Health Organization Group 1 pulmonary arterial hypertension (N = 35).","country":"USA (inferred from author affiliations, not stated in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Women with pulmonary arterial hypertension reported high sexual distress, which was linked to poorer overall quality of life. Those receiving injectable prostanoid therapy reported worse sexual distress than those on oral medication, but overall sexual function scores were similar across groups.","clinical_takeaway":"Screen for sexual distress in women with PAH; consider it when assessing overall quality of life.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Use of several validated HRQoL and sexual function scales","Internal reliability reported as excellent","First study to examine sexual HRQoL in PAH"],"limitations":["Small, convenience sample (N=35)","Cross‑sectional; no causal inference","No adjustment for potential confounders (mood, relationship status, moral attitudes)","Possible selection bias from conference attendees"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":19,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/2045894018788277"}},{"id":9402,"doi":"10.1080/14461242.2020.1851610","pmid":"33622202","pmcid":null,"title":"Not your unicorn: trans dating app users' negotiations of personal safety and sexual health","authors":"Albury K, Dietzel C, Pym T, Vivienne S, Cook T.","first_author":"Albury K","journal":"Health sociology review : the journal of the Health Section of the Australian Sociological Association","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Safety","Sexual Health","Dating Apps","Trans People","Digital Intimacies"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative interview study (n=14) with Australian trans dating app users","sample_n":14,"sample_text":"14 Australian trans dating app users","population":"Trans gender adults in Australia using dating apps","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 14 Australian trans people using dating apps show that apps can both increase and decrease feelings of safety and affect how they seek sexual health care. The technology can help avoid harassment but also reinforces binary gender categories.","clinical_takeaway":"Clinicians should recognize that dating apps can be a double‑edged tool for trans patients' safety and health access.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight","Contextualised within sociological theory"],"limitations":["Small, non‑representative sample","No quantitative measures of safety or health outcomes","Limited generalisability beyond Australian trans community"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":38,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/14461242.2020.1851610"}},{"id":9403,"doi":"10.30476/jamp.2021.90099.1398","pmid":"34692856","pmcid":"PMC8521215","title":"Increasing medical student confidence in gender and sexual health through a student-initiated lecture series","authors":"Mahabamunuge J, Morel K, Budrow J, Tounkel I, Hart C, Briskin C, Kasoff M, Spiegel S, Risucci D, Koestler J.","first_author":"Mahabamunuge J","journal":"Journal of advances in medical education & professionalism","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Curriculum","Medical Students","Sexual Health","Gender Identity","Gender And Sexual Minorities"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8521215","cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pre‑post survey of a single cohort of medical students (no control group)","sample_n":105,"sample_text":"105 respondents completed the post‑lecture survey (pre‑lecture n=152)","population":"medical students (mostly female) at one institution","country":"unspecified (likely USA)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A student‑run lecture series on gender and sexual health was linked to higher self‑reported comfort among medical students when discussing these topics with patients, based on pre‑ and post‑lecture surveys.","clinical_takeaway":"Brief, targeted educational sessions can boost medical trainees' confidence discussing gender and sexual‑health issues.","confidence":0.8,"topic_tags":["gender","sexual_function"],"strengths":["Clear pre‑post design with same participants","Use of confidence intervals to compare comfort levels","Includes qualitative thematic analysis"],"limitations":["No control or comparison group; cannot infer causality","Comfort measured with non‑validated, single‑item scales","Single‑institution, mostly female sample limits generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.30476/jamp.2021.90099.1398"}},{"id":9404,"doi":"10.1016/j.apnr.2018.10.006","pmid":"30389066","pmcid":null,"title":"Engaging college students in a substance misuse & sexual health intervention using social marketing principles","authors":"Aronowitz T, Kim B, Vu P, Bergeron A.","first_author":"Aronowitz T","journal":"Applied nursing research : ANR","year":2018,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":["Recruitment","College Students","Social Networking Sites","Engagement In Research"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"multi-method (survey, focus groups) descriptive study of recruitment strategies","sample_n":null,"sample_text":"Not reported in abstract","population":"college students (U.S.)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes how researchers used social‑marketing and social‑media tactics to attract college students to a program that aimed to prevent substance misuse, HIV and other STIs. Focus groups and surveys guided the design, showing that interactive games and online ads boosted participation.","clinical_takeaway":"None – the study reports recruitment methods, not clinical outcomes.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses mixed methods to gather participant feedback","Practical insights for recruitment via social media"],"limitations":["No outcome efficacy data on substance or sexual health","No detailed sample size or power information","Limited to recruitment, not intervention impact"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.apnr.2018.10.006"}},{"id":9405,"doi":"10.1177/10783903211045733","pmid":"34533070","pmcid":null,"title":"Effectiveness of a Sexual Health Care Training to Enhance Psychiatric Nurses' Knowledge, Attitude, and Self-Efficacy: A Quasi-Experimental Study in Southern Taiwan","authors":"Lu MJ, Li JB, Wu CY, Huong PTT, Hsu PC, Chang CR.","first_author":"Lu MJ","journal":"Journal of the American Psychiatric Nurses Association","year":2024,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Mental health","Nursing Education","Sexual Health","Sexual Health Education","Psychiatric Nurse"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Quasi‑experimental pre‑post design with random assignment to training vs control groups (N=75 nurses).","sample_n":75,"sample_text":"75 psychiatric nurses (32 experimental, 43 control)","population":"Psychiatric nurses at a teaching hospital in southern Taiwan","country":"Taiwan","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A brief 8‑hour training on sexual health improved psychiatric nurses' knowledge, attitudes, and confidence in providing sexual health care, compared with nurses who did not receive the training.","clinical_takeaway":"Targeted sexual‑health training can boost nurses' competence and confidence in addressing patients' sexual health needs.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Random assignment to training vs control","Pre‑post measurement of outcomes","Multivariate statistical analysis"],"limitations":["Unclear whether outcome measures are validated","Single‑site convenience sample of volunteers","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":14,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/10783903211045733"}},{"id":9407,"doi":"10.1111/codi.15768","pmid":"34097342","pmcid":null,"title":"Long-term quality of life, sexual health and gastrointestinal function following colorectal cancer resection in an Asian cohort","authors":"Seow-En I, Chok AY, Matchar DB, Yoon S, Chong DQ, Tan EK.","first_author":"Seow-En I","journal":"Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland","year":2021,"pub_types":["Journal Article"],"keywords":["Singapore","Sexual function","Quality of life","Gastrointestinal Function","Colorectal Cancer Survivorship"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of colorectal cancer survivors (N=400) using validated QOL questionnaires; cross‑sectional analysis of relationships between QOL domains and sociodemographic/clinical variables.","sample_n":400,"sample_text":"Convenience sample of respondents; response bias possible","population":"Adult colorectal cancer survivors (≥2 years post curative surgery) at a Singapore tertiary centre","country":"Singapore","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among colorectal cancer survivors in Singapore, sexual activity was lower after rectal surgery, and socioeconomic factors influenced quality‑of‑life scores. About half of men and less than half of women reported being sexually active.","clinical_takeaway":"Assess sexual health and socioeconomic needs in long‑term colorectal cancer survivors to guide supportive care.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Use of validated, disease‑specific QOL instruments","Large sample for survivorship survey","Clear reporting of demographic and clinical characteristics"],"limitations":["Cross‑sectional design limits causal inference","Convenience sample; potential response bias","Limited assessment of psychosocial confounders (e.g., mental health, relationship factors)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":3,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/codi.15768"}},{"id":9408,"doi":"10.1521/aeap.2020.32.5.392","pmid":"33112674","pmcid":"PMC8049455","title":"Associations Among HIV Risk Perception, Sexual Health Efficacy, and Intent to Use PrEP Among Women: An Application of the Risk Perception Attitude Framework","authors":"Sewell WC, Patel RR, Blankenship S, Marcus JL, Krakower DS, Chan PA, Parker K.","first_author":"Sewell WC","journal":"AIDS education and prevention : official publication of the International Society for AIDS Education","year":2020,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Self-efficacy","Perceived Risk","Minority Women","Pre-exposure Prophylaxis (Prep)"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 908 Black and Latina women; cluster analysis and ANCOVA on self‑report questionnaires","sample_n":908,"sample_text":"908 women (69.4% Latina, 25.6% Black)","population":"adult Black and Latina women (mean age 29.9) recruited via community‑based sampling; not a clinical or treatment‑seeking sample","country":"United States (assumed from NIH funding and author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among Black and Latina women, those who think they are at low risk for HIV and feel confident about preventing it are less likely to plan to use PrEP than women who see themselves at higher risk but feel less confident.","clinical_takeaway":"Perceptions of HIV risk and self‑efficacy jointly shape PrEP interest; interventions should boost accurate risk awareness alongside efficacy support.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Large sample for a survey study","Use of established risk perception‑attitude framework","Clear statistical analysis (ANCOVA, cluster analysis)"],"limitations":["Cross‑sectional design limits causal inference","Constructs measured with unspecified/uncertain validation","No control for mental‑health or relationship variables"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1521/aeap.2020.32.5.392"}},{"id":9409,"doi":"10.29063/ajrh2017/v21i1.1","pmid":"29595022","pmcid":null,"title":"Culture Clash: Shona (Zimbabwean) Migrant Women's Experiences with Communicating about Sexual Health and Wellbeing across Cultures and Generations","authors":"Dune T, Mapedzahama V.","first_author":"Dune T","journal":"African journal of reproductive health","year":2017,"pub_types":["Journal Article"],"keywords":["Australia","Africa","Sexual Health","Intergenerational","Cross-cultural","Intercultural Communication"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"focus groups with 14 Shona migrant women in South Australia; thematic analysis of transcripts","sample_n":14,"sample_text":"Fourteen women participated in focus groups.","population":"Shona (Zimbabwean) migrant women, ages 29‑53, Australia","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Focus groups with 14 Zimbabwean women in Australia showed that traditional Shona views keep sexual‑health talk secret, but living longer in Australia makes communication more open. Their children face mixed messages from both cultures.","clinical_takeaway":"Clinicians should consider cultural background when discussing sexual health with migrant families; one‑size‑fits‑all campaigns may miss key communication barriers.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["In‑depth, culturally specific qualitative data","Thematic analysis provides nuanced insight","Highlights gaps in existing sexual‑health campaigns"],"limitations":["Small, non‑representative convenience sample (N=14)","No quantitative measures; limited generalisability","Confounding factors (e.g., mental health, religiosity) not assessed"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":37,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.29063/ajrh2017/v21i1.1"}},{"id":9410,"doi":"10.1016/j.androl.2020.10.003","pmid":"34810111","pmcid":null,"title":"[Mindfulness in the sexual health and psychological well-being of professionals and caregivers of people at risk of social exclusion]","authors":"Sánchez-Sánchez LC, Valderrama Rodríguez MF.","first_author":"Sánchez-Sánchez LC","journal":"Revista internacional de andrologia","year":2022,"pub_types":["Journal Article"],"keywords":["Sexual Health","Psychological Well-being","Mindfulness","Compassion","Mbsr","Salud Sexual","Bienestar Psicológico","Sexual Fantasies","Compasión","Fantasías Sexuales"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"spa","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Quasi‑experimental pre‑post study of all staff/volunteers at one NGO, no control group.","sample_n":null,"sample_text":"entire population of the NGO (size not reported)","population":"Professionals and volunteers caring for socially excluded people (NGO in southern Spain).","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A mindfulness program was offered to staff caring for vulnerable people. After eight weeks, participants reported higher sexual satisfaction and better psychological well‑being, though the study lacked a comparison group.","clinical_takeaway":"Mindfulness may boost sexual satisfaction and well‑being, but evidence is limited without a control group.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses multiple validated scales","Pre‑post assessment within the same participants","Addresses sexual health of a rarely studied professional group"],"limitations":["No control group; cannot attribute changes to the mindfulness program alone","Sample size not reported; likely underpowered","No adjustment for potential confounders (e.g., baseline mental health, moral factors)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.androl.2020.10.003"}},{"id":9411,"doi":"10.1186/s12889-016-3835-x","pmid":"27863525","pmcid":"PMC5116199","title":"Sexual dysfunction among youth: an overlooked sexual health concern","authors":"Moreau C, Kågesten AE, Blum RW.","first_author":"Moreau C","journal":"BMC public health","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Sexual dysfunction","France","Adolescents","Sexual Health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5116199","cited_by_count":30,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Nationally representative random sample of French youth (15‑24) with sexual intercourse in past year; cross‑sectional survey using chi‑square analyses.","sample_n":1484,"sample_text":"Randomly selected national sample; respondents aged 15‑24 who reported sexual intercourse in the past year.","population":"842 females, 642 males (sexual activity within 12 months) from 2010 French national sexual and reproductive health survey","country":"France","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A national French survey of 1,484 young people found that 48% of females and 23% of males reported at least one sexual dysfunction (e.g., pain, low desire). These problems were linked to lower sexual satisfaction and, for females, higher rates of STIs and unintended pregnancies.","clinical_takeaway":"Screen for sexual dysfunction in youth, as many experience it and it harms wellbeing, even when they do not view it as a problem.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Large, nationally representative probability sample","Clear definition of sexual dysfunction domains","Separate reporting by sex"],"limitations":["Self‑report items not validated scales","Cross‑sectional design limits causal inference","No effect sizes or multivariate controls reported"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":44,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-016-3835-x"}},{"id":9412,"doi":"10.1111/jocn.14378","pmid":"29633408","pmcid":null,"title":"Experiences and informational needs on sexual health in people with epilepsy or multiple sclerosis: A focus group investigation","authors":"Egerod I, Wulff K, Petersen MC.","first_author":"Egerod I","journal":"Journal of clinical nursing","year":2018,"pub_types":["Journal Article"],"keywords":["Sexuality","Neurology","Focus Groups","Patient Information","Chronic Illness","Qualitative Study"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"focus groups with 26 participants stratified by disease and gender; framework analysis","sample_n":26,"sample_text":"26 participants (women with epilepsy n=8, men with epilepsy n=7, women with MS n=5, men with MS n=6)","population":"adults with epilepsy or multiple sclerosis attending a neurological clinic in Denmark","country":"Denmark","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"People with epilepsy or multiple sclerosis said they lack information about how their disease affects sexual health, leading to feelings of isolation, guilt, and frustration. Better patient education could improve quality of life.","clinical_takeaway":"Provide tailored sexual‑health information to patients with epilepsy or MS to reduce distress and improve wellbeing.","confidence":0.85,"topic_tags":["sexual_function","neuroscience"],"strengths":["Rich, patient‑centred qualitative data","Strategic sampling across disease and gender","Clear framework analysis"],"limitations":["Small, clinic‑based convenience sample","No quantitative measurement of sexual function","Findings not generalisable to broader epilepsy/MS populations"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jocn.14378"}},{"id":9413,"doi":"10.1097/adm.0000000000000657","pmid":"32271200","pmcid":null,"title":"Integrating Reproductive and Sexual Health Education and Services Into Opioid Use Disorder Treatment Programs: A Qualitative Study","authors":"Klaman SL, Turner K, Lorvick J, Jones HE.","first_author":"Klaman SL","journal":"Journal of addiction medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative interview study with 31 providers/staff at 9 OTPs","sample_n":31,"sample_text":"31 semistructured interviews","population":"providers and staff at opioid treatment programs in North Carolina (USA)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with staff at opioid treatment programs identified many practical and organizational barriers, as well as facilitators, to adding reproductive and sexual health education for women in treatment.","clinical_takeaway":"Integrating sexual‑health services into OUD programs is feasible but requires addressing transportation, childcare, and coordination challenges.","confidence":0.8,"topic_tags":["religiosity","masturbation","pornography","sexual_function"],"strengths":["Use of established implementation framework (CFIR)","Multisite perspective (9 OTPs)","Thematic analysis with both deductive and inductive coding"],"limitations":["Small, non‑representative sample of providers","No quantitative outcome data","Findings limited to North Carolina context"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/adm.0000000000000657"}},{"id":9414,"doi":"10.5114/pm.2018.78557","pmid":"30357022","pmcid":"PMC6196782","title":"Consequences of premature ovarian insufficiency on women's sexual health","authors":"Maciejewska-Jeske M, Szeliga A, Męczekalski B.","first_author":"Maciejewska-Jeske M","journal":"Przeglad menopauzalny = Menopause review","year":2018,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual Life","Hormonal Replacement Therapy","Premature Ovarian Insufficiency","Early Menopause"],"is_oa":true,"oa_url":"https://www.termedia.pl/Journal/-4/pdf-33847-10?filename=Consequences.pdf","cited_by_count":11,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"review-article","sample_n":null,"sample_text":"Not applicable – narrative review","population":"women with premature ovarian insufficiency (POI)","country":"Poland (journal based)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Women who lose ovarian function before age 40 often experience lower sexual desire, vaginal dryness, anxiety and reduced self‑esteem. Hormone replacement and local estrogen can help improve sexual health.","clinical_takeaway":"Consider hormonal and topical estrogen therapy for POI‑related sexual problems.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function","prevalence"],"strengths":["Clear clinical definition of POI","Integrates hormonal and psychosocial aspects","Provides practical treatment suggestions"],"limitations":["Narrative, not systematic, review","No systematic search or risk‑of‑bias assessment","No quantitative synthesis"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":2,"mentioning":11,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5114/pm.2018.78557"}},{"id":9416,"doi":"10.4103/jmh.jmh_38_18","pmid":"31391755","pmcid":"PMC6643710","title":"Sexual Health of Postmenopausal Women in North India","authors":"Jain N, Mehra R, Goel P, Chavan BS.","first_author":"Jain N","journal":"Journal of mid-life health","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Sexual Health","Postmenopausal Women","Female Sexual Dysfunction","Determinants Of Female Sexual Function","Prevalence Of Sexual Dysfunction"],"is_oa":true,"oa_url":"https://doi.org/10.4103/jmh.jmh_38_18","cited_by_count":14,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 110 post‑menopausal women using the FSFI‑6","sample_n":110,"sample_text":"convenience sample recruited over 18 months","population":"post‑menopausal women in North India (N=110)","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 110 Indian post‑menopausal women, about 81% reported sexual dysfunction. Older age, longer menopause, low education and joint‑family living were linked to poorer sexual health, while partner health and parity were not.","clinical_takeaway":"High rates of sexual dysfunction are common after menopause; clinicians should proactively discuss sexual health, especially with older, less‑educated women.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of a validated FSFI‑6 instrument","Clear reporting of prevalence and sociodemographic correlates","Consideration of partner health factors"],"limitations":["Convenience sample, not nationally representative","No adjustment for mental‑health or moral‑incongruence variables","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/jmh.jmh_38_18"}},{"id":9417,"doi":"10.1080/07317115.2021.1882637","pmid":"33616005","pmcid":null,"title":"Interest in Sex and Conversations About Sexual Health with Health Care Providers Among Older U.S. Adults","authors":"Agochukwu-Mmonu N, Malani PN, Wittmann D, Kirch M, Kullgren J, Singer D, Solway E.","first_author":"Agochukwu-Mmonu N","journal":"Clinical gerontologist","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Sexuality","Older Adults","Sexual Satisfaction","Health Care Providers","Sexual Interest"],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"nationally representative, cross‑sectional survey (N=1,002) of U.S. adults aged 65‑80; logistic regression of self‑reported sexual activity, interest and satisfaction on provider‑patient sexual‑health discussions","sample_n":1002,"sample_text":"75 % completion rate; nationally representative sample","population":"community‑dwelling older adults, 65‑80 y, United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among U.S. adults aged 65‑80, about half of men and a third of women were sexually active. Only 17 % had talked to a health‑care provider about sexual health in the past two years, most often after the patient raised the issue. Interest in sex and satisfaction with sex life predicted these conversations.","clinical_takeaway":"Clinicians should proactively ask older patients about their sexual interests, as many are willing but rarely initiate discussion.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large, nationally representative sample","clear outcome (provider‑patient sexual‑health conversation)","use of multivariable logistic regression"],"limitations":["cross‑sectional; cannot infer causality","measures appear as single‑item self‑reports, unclear validation","limited control of psychosocial confounders (e.g., mental health, relationship status)"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/07317115.2021.1882637"}},{"id":9418,"doi":"10.1016/j.childyouth.2020.105161","pmid":"34393310","pmcid":"PMC8356775","title":"\"Even if you think you can trust them, don't trust them\": An exploratory analysis of the lived experiences of sexual health among sexual minority girls in foster care","authors":"Salerno JP, Kachingwe ON, Fish JN, Parekh E, Geddings-Hayes M, Boekeloo BO, Aparicio EM.","first_author":"Salerno JP","journal":"Children and youth services review","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Qualitative","Sexual Health","Foster Care","Sexual Minority","Lgbtq"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"single-case interpretative phenomenological analysis (IPA) with 5 participants (focus group)","sample_n":5,"sample_text":"Five sexual minority girls in foster care were interviewed in a single focus‑group discussion.","population":"sexual minority girls in foster care (U.S.)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In interviews with five sexual‑minority girls in foster care, researchers found that fear of victimisation, distrust in partners, self‑protective strategies, and limited sexual‑health communication shape their sexual‑health experiences. The study highlights the need for trauma‑informed, inclusive support.","clinical_takeaway":"Clinicians should acknowledge distrust and safety concerns when discussing sexual health with foster‑care sexual‑minority adolescents.","confidence":0.8,"topic_tags":["sexual_function","lgbtq"],"strengths":["Provides rare qualitative insight into a understudied, vulnerable population","Uses a recognized IPA framework for systematic thematic analysis","Identifies concrete themes that can guide future service provision"],"limitations":["Very small, non‑representative sample (N=5)","Single focus‑group limits depth and variability of experiences","No quantitative measurement of sexual health or related confounds"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.childyouth.2020.105161"}},{"id":9419,"doi":"10.1007/s11199-017-0822-3","pmid":"29670317","pmcid":"PMC5897462","title":"\"The Heart Desires but the Body Refuses\": Sexual Scripts, Older Men's Perceptions of Sexuality, and Implications for Their Mental and Sexual Health","authors":"Rutagumirwa SK, Bailey A.","first_author":"Rutagumirwa SK","journal":"Sex roles","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Masculinity","Older Men","Sexual And Mental Health","Script’s Conformity"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007%2Fs11199-017-0822-3.pdf","cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative in-depth interviews (n=15) and focus groups (n=60) with older Tanzanian men, theoretical sampling, grounded theory analysis.","sample_n":75,"sample_text":"15 interview participants; 60 participants in 10 focus groups","population":"Older men (60‑82 years) in Tanzania","country":"Tanzania","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with Tanzanian men aged 60‑82 show that cultural ideas about how men should be sexually active cause distress when age reduces performance, leading some to try unproven remedies. Tailored mental‑health support may help.","clinical_takeaway":"Older men’s distress about declining sexual ability may stem from cultural expectations; clinicians should assess and address these script‑related pressures.","confidence":0.75,"topic_tags":["sexual_function","masturbation","csbd"],"strengths":["Rich, culturally grounded qualitative data","Theoretical sampling and grounded‑theory analysis"],"limitations":["Small, non‑representative sample","No quantitative measurement of mental‑health outcomes","No control for key confounds (e.g., moral incongruence, partner effects)"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s11199-017-0822-3"}},{"id":9420,"doi":"10.3760/cma.j.cn112338-20210712-00544","pmid":"34818838","pmcid":null,"title":"[Design and analysis of testing results of a WeChat applet for sexual health and HIV infection risk assessment in young students]","authors":"Fan LR, Gu YZ, Luo YF, Chen YC, Du YY, Han ZG, Cai YS, He WY, Liang QE, Yao ZL, Liu FH, Xu HF.","first_author":"Fan LR","journal":"Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi","year":2021,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"chi","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"single‑group pre‑post (repeated test) with satisfaction survey; no control group","sample_n":393,"sample_text":"393 participants completed two rounds of the applet test; 750 completed a satisfaction questionnaire","population":"young university students in China (N≈393 for repeated test, N≈750 for satisfaction survey)","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A WeChat app for young Chinese students gave personalized HIV risk scores and health information. After using it twice, students showed modest improvements in AIDS knowledge and reported high satisfaction, but the study lacked a control group and used unvalidated questionnaires.","clinical_takeaway":"The app appears acceptable and may boost HIV‑related knowledge, yet its effectiveness remains unproven without controlled trials.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample for an app feasibility study","Use of repeated testing to assess short‑term change","High satisfaction reported by participants"],"limitations":["No validated questionnaire; construct validity unclear","No control/comparison group – cannot infer causality","Statistical reporting limited to p‑values, no effect sizes"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3760/cma.j.cn112338-20210712-00544"}},{"id":9421,"doi":"10.1016/j.jsxm.2021.02.006","pmid":"33771479","pmcid":null,"title":"Physical, Mental and Sexual Health Among Transgender Women: A Comparative Study Among Operated Transgender and Cisgender Women in a National Tertiary Referral Network","authors":"Vedovo F, Di Blas L, Aretusi F, Falcone M, Perin C, Pavan N, Rizzo M, Morelli G, Cocci A, Polito C, Gentile G, Colombo F, Timpano M, Verze P, Imbimbo C, Bettocchi C, Pascolo Fabrici E, Palmieri A, Trombetta C.","first_author":"Vedovo F","journal":"The journal of sexual medicine","year":2021,"pub_types":["Journal Article"],"keywords":["Sexual function","Questionnaire","Transgender","Functional Outcomes"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional age‑matched comparison of 125 operated transgender women and 80 cisgender women, using web‑based validated questionnaires (FSFI, oMtFSI, BDI‑PC, SF‑36).","sample_n":205,"sample_text":"125 oTW, 80 cisW (response rate 60%).","population":"Operated transgender women (mean age 38.5 yr) and cisgender women (mean age 37.7 yr) recruited from seven Italian tertiary referral centres and a volunteer control sample.","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A study compared physical, mental and sexual health of 125 Italian transgender women who had gender‑affirming surgery with 80 cisgender women. Using standard questionnaires, they found similar levels of depression and physical health, but worse sexual pain in the transgender group, which was linked to higher depressive symptoms.","clinical_takeaway":"Screen for sexual pain in transgender women after surgery, as it may contribute to depression.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Use of validated, widely‑accepted questionnaires","Relatively large sample for this population","Age‑matched comparison group"],"limitations":["Cross‑sectional design limits causal inference","Convenience control group may not be fully representative","No assessment of sexual partner factors or trauma history"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":25,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2021.02.006"}},{"id":9423,"doi":"10.1080/17437199.2019.1625281","pmid":"31163109","pmcid":null,"title":"Self-esteem and sexual health: a multilevel meta-analytic review","authors":"Sakaluk JK, Kim J, Campbell E, Baxter A, Impett EA.","first_author":"Sakaluk JK","journal":"Health psychology review","year":2020,"pub_types":["Meta-Analysis","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Meta-analysis","Sexual Health","Self-esteem","Safe Sex","Sexual Functioning","Sexual Consent","Sexual Permissiveness"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Meta-analysis of 305 samples (191,161 participants) reporting correlations between self‑esteem and various sexual‑health outcomes.","sample_n":191161,"sample_text":"Aggregated across studies; individual study sizes not reported in abstract.","population":"Adults from 255 articles, predominantly North American samples.","country":"Various (North America dominant)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"high","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of over 190,000 people found a small positive link between self‑esteem and sexual health, especially sexual functioning, while self‑esteem showed little relation to sexual permissiveness.","clinical_takeaway":"Higher self‑esteem is modestly associated with better sexual functioning, but the effect is small.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large pooled sample size","Comprehensive coverage of self‑esteem‑sexual health literature","Provides confidence intervals and heterogeneity assessments"],"limitations":["Possible publication bias and heterogeneity","Moderator data inconsistently reported","Reliance on varied, often unspecified measures across primary studies"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":5,"design":9,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":16,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/17437199.2019.1625281"}},{"id":9425,"doi":"10.1111/jocn.13354","pmid":"27302001","pmcid":null,"title":"The application of a feminist poststructural framework in nursing practice for addressing young women's sexual health","authors":"Cassidy C, Goldberg L, Aston M.","first_author":"Cassidy C","journal":"Journal of clinical nursing","year":2016,"pub_types":["Journal Article"],"keywords":["Sexuality","Sexual Health","Feminist Theory","Nursing Practice","Poststructuralism"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative literature review applying feminist poststructuralist theory; no primary data collection","sample_n":null,"sample_text":"none (the paper is a theoretical/ literature review)","population":"young women (theoretical focus); no empirical sample","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article uses a feminist post‑structural framework to help nurses understand and respond to the conflicting social messages young women face about sexuality and health, offering practical strategies for practice.","clinical_takeaway":"Nurses can apply a feminist lens to better support young women’s sexual health, but evidence is theoretical, not empirical.","confidence":0.5,"topic_tags":["sexual_function","masturbation","pornography"],"strengths":["Integrates feminist theory with nursing practice","Provides concrete examples for clinicians"],"limitations":["No empirical data; conclusions based on literature synthesis","Potentially limited generalisability beyond the reviewed sources"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jocn.13354"}},{"id":9426,"doi":"10.1007/s10461-019-02714-2","pmid":"31664572","pmcid":"PMC7220979","title":"Risky Alcohol Consumption and Associated Health Behaviour Among HIV-Positive and HIV-Negative Patients in a UK Sexual Health and HIV Clinic: A Cross-Sectional Questionnaire Study","authors":"Suonpera E, Matthews R, Milinkovic A, Arenas-Pinto A.","first_author":"Suonpera E","journal":"AIDS and behavior","year":2020,"pub_types":["Comparative Study","research-article","Journal Article"],"keywords":["HIV","Alcohol Misuse","Audit","Mood Disorders","Drug Use"],"is_oa":true,"oa_url":"https://link.springer.com/content/pdf/10.1007/s10461-019-02714-2.pdf","cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire of HIV‑positive (n=227) and HIV‑negative (n=69) patients in a UK sexual health clinic, using validated AUDIT, PHQ‑9 and DUDIT scales.","sample_n":296,"sample_text":"227 HIV‑positive, 69 HIV‑negative patients.","population":"Adults attending a UK sexual‑health/HIV clinic (convenience sample).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a UK clinic, about a quarter of HIV‑positive patients and a third of HIV‑negative patients drank at risky levels. Among those with HIV, higher depressive symptoms and risky drug use were linked to risky drinking.","clinical_takeaway":"Screen for depression and drug misuse when addressing risky alcohol use in HIV‑positive patients.","confidence":0.85,"topic_tags":["religiosity","moral_incongruence","sexual_function"],"strengths":["Validated instruments (AUDIT, PHQ‑9, DUDIT)","Separate analysis of HIV‑positive and HIV‑negative groups","Multivariable regression to identify associations"],"limitations":["Cross‑sectional design; cannot infer causality","Convenience clinic sample limits generalisability","No effect sizes or confidence intervals reported"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-019-02714-2"}},{"id":9427,"doi":"10.1007/s10508-020-01678-y","pmid":"32236762","pmcid":null,"title":"Effects of a Sexual Health Interview among Arab American Women: An Experimental Disclosure Study","authors":"Holmes HJ, Yamin JB, Krohner S, Rapport LJ, Grekin ER, Schubiner H, Lumley MA.","first_author":"Holmes HJ","journal":"Archives of sexual behavior","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Interview","Sexual Health","Disclosure","Arab American","Moderation Analyses"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"Parallel‑group randomized experimental study (interview vs wait‑list) with 134 Arab American women, baseline and 5‑week follow‑up.","sample_n":134,"sample_text":"134 Arab American women (mean age 20.6)","population":"Arab American women, ages 18‑35, N=134","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In an experimental study, 134 Arab‑American women were randomly assigned to a 60‑minute sexual‑health interview or a wait‑list. Five weeks later, interview participants reported higher sexual satisfaction and felt more comfortable discussing sex, with no change in overall psychological symptoms.","clinical_takeaway":"A brief, supportive sexual‑health interview can improve sexual satisfaction and disclosure comfort among young Arab‑American women.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Randomized experimental design","Adequate sample size for a brief intervention","Follow‑up assessment","Focus on an understudied cultural group"],"limitations":["Limited information on psychometric validation of outcome scales","Key psychosocial confounds (moral incongruence, mental health, partner context) not measured","No pre‑registration or publicly shared analysis plan"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":1,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-020-01678-y"}},{"id":9428,"doi":"10.1136/sextrans-2020-054896","pmid":"33782145","pmcid":"PMC8380886","title":"Sexual health (excluding reproductive health, intimate partner violence and gender-based violence) and COVID-19: a scoping review","authors":"Kumar N, Janmohamed K, Nyhan K, Forastiere L, Zhang WH, Kågesten A, Uhlich M, Sarpong Frimpong A, Van de Velde S, Francis JM, Erausquin JT, Larrson E, Callander D, Scott J, Minichiello V, Tucker J.","first_author":"Kumar N","journal":"Sexually transmitted infections","year":2021,"pub_types":["Scoping Review","Research Support, Non-U.S. Gov't","review-article","Journal Article"],"keywords":["HIV","Sexual Health","Sex Work","Sexual And Gender Minorities","Covid-19"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8380886","cited_by_count":26,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"scoping review of published literature","sample_n":null,"sample_text":"Not applicable – review of existing studies","population":"global studies on sexual health during COVID-19 (excludes reproductive health, IPV, GBV)","country":"International","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This scoping review summarised studies on sexual health (excluding reproductive health and violence) during COVID‑19, noting reduced STI testing, limited data on sex workers and women, and few studies from low‑ and middle‑income countries.","clinical_takeaway":"Clinicians should be aware that COVID‑19 disrupted STI services and that evidence on sexual health impacts is limited, especially for marginalized groups.","confidence":0.65,"topic_tags":["sexual_function"],"strengths":["Comprehensive scoping of COVID‑19 sexual health literature","Uses JBI methodology for scoping reviews","Identifies clear research gaps, especially in LMICs"],"limitations":["No quantitative synthesis or risk‑of‑bias assessment","Limited critical appraisal of primary studies","Potential language bias (English‑only)"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":32,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sextrans-2020-054896"}},{"id":9429,"doi":"10.1080/13691058.2019.1700307","pmid":"32118515","pmcid":null,"title":"Sexual health literacy among gay, bisexual and other men who have sex with men: a conceptual framework for future research","authors":"McDaid L, Flowers P, Ferlatte O, Young I, Patterson S, Gilbert M.","first_author":"McDaid L","journal":"Culture, health & sexuality","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["HIV","Health Literacy","Prevention; Implementation"],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative framework development using focus groups and interviews","sample_n":147,"sample_text":"22 focus‑group participants + 20 interviewees + 55 participants in second study","population":"gay, bisexual and other men who have sex with men (GBMSM), ages 18‑75","country":"unspecified (likely UK/Canada)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors propose a new model of sexual‑health literacy for gay, bisexual and other men who have sex with men, built from expert workshops and focus‑group interviews. The framework highlights how community practices, services, and technology shape the ability to manage sexual health, especially in the context of HIV prevention.","clinical_takeaway":"Clinicians should consider broader community and service factors, not just individual knowledge, when supporting sexual‑health literacy in GBMSM.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Novel conceptual framework","Use of expert consensus workshop","Illustrated with empirical qualitative data"],"limitations":["Small, non‑representative samples","No quantitative validation of the framework","Limited generalisability beyond GBMSM in high‑income settings"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":34,"citing_publications":54,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2019.1700307"}},{"id":9430,"doi":"10.31128/ajgp-02-18-4508","pmid":"30114891","pmcid":null,"title":"Talking to migrant and refugee young people about sexual health in general practice","authors":"Botfield JR, Newman CE, Kang M, Zwi AB.","first_author":"Botfield JR","journal":"Australian journal of general practice","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Semi‑structured interviews with 27 migrant/refugee youths (16–24 y) and 9 follow‑up interviews; thematic analysis of barriers to discussing sexual health with GPs.","sample_n":27,"sample_text":"27 initial participants (16 F, 11 M); 9 follow‑up participants (6 F, 3 M).","population":"Migrant and refugee young people aged 16‑24 years in Sydney, Australia (convenience sample).","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 27 migrant and refugee youths in Sydney showed they often avoid talking about sexual health with their GP because they fear judgment and lack confidence that their privacy will be respected.","clinical_takeaway":"Clinicians should explicitly reassure confidentiality and build trust when discussing sexual health with migrant and refugee young patients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rich qualitative insight from a hard‑to‑reach population","Clear focus on barriers to GP‑based sexual health care","Use of follow‑up interviews to deepen themes"],"limitations":["Small, non‑representative convenience sample","No validated measurement instruments","Limited examination of broader psychosocial confounds"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":51,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31128/ajgp-02-18-4508"}},{"id":9431,"doi":"10.1080/17441692.2019.1611895","pmid":"31084269","pmcid":null,"title":"The sexual health needs of sexual minority women in Western Kenya: An exploratory community assessment and public policy analysis","authors":"Wilson BDM, Neubauer LC, Park A, Abuor P, Harper GW.","first_author":"Wilson BDM","journal":"Global public health","year":2019,"pub_types":["Journal Article"],"keywords":["Kenya","Sexual Health","Public Policy","Lesbian","Sexual Minority Women"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"exploratory community forum analysis and policy review; no empirical quantitative data","sample_n":null,"sample_text":"Not reported; community forum participants likely a convenience sample","population":"sexual minority women in Western Kenya (community participants, unspecified number)","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Community members and policy experts discussed the sexual‑health needs of lesbian and other sexual‑minority women in western Kenya, highlighting barriers to care, violence, economic insecurity and restrictive laws.","clinical_takeaway":"None – the study provides contextual insights but no direct clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Addresses understudied population (SMW in Kenya)","Combines community voices with policy/legal analysis","Identifies concrete intervention targets (health services, legislation)"],"limitations":["No quantitative data; reliance on informal forum comments","Sample size and composition unclear, limiting generalisability","No systematic methodology reported for thematic analysis"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/17441692.2019.1611895"}},{"id":9432,"doi":"10.1016/j.jadohealth.2021.05.020","pmid":"34452729","pmcid":null,"title":"Linking Families and Teens: Randomized Controlled Trial Study of a Family Communication and Sexual Health Education Program for Rural Youth and Their Parents","authors":"Brown SA, Turner RE, Christensen C.","first_author":"Brown SA","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2021,"pub_types":["Randomized Controlled Trial","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Adolescent","Randomized controlled trial","Sexual Health","Parent-child Sex Communication","Teenage Pregnancy Prevention"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"cluster randomized controlled trial with 786 youth across 57 program implementations in 9 states, baseline, 3‑month, and 12‑month follow‑up; intent‑to‑treat analysis using OLS regression","sample_n":786,"sample_text":"786 youth (407 program, 379 control)","population":"rural adolescents (high‑school age) and their parenting adults","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A family‑focused program in rural U.S. communities increased teens' talks with parents about sex and boosted their confidence to prevent pregnancy, leading to fewer early pregnancies at three months and a trend toward fewer at one year.","clinical_takeaway":"Family‑based communication workshops can improve teen sexual‑health outcomes and may reduce unintended pregnancies.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Large, geographically diverse sample","Cluster RCT design with control group","Longitudinal follow‑up to 12 months"],"limitations":["Limited detail on measurement validity","No pre‑registration reported","Potential clustering effects not fully described"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":7,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":1,"contrasting":0,"mentioning":13,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2021.05.020"}},{"id":9433,"doi":"10.1353/cpr.2019.0058","pmid":"31564671","pmcid":null,"title":"Development and Implementation of Peer Leader Training for Community-Based Participatory Sexual Health Research","authors":"Kteily-Hawa R, Hari S, Wong JP, Chikermane V, Chambers LA.","first_author":"Kteily-Hawa R","journal":"Progress in community health partnerships : research, education, and action","year":2019,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Implementation/evaluation of a peer‑leader training program; no control group, descriptive outcomes","sample_n":null,"sample_text":"Not reported in abstract","population":"South Asian women peers in Canada (community‑based sample)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors designed and evaluated a training program for South Asian women to lead community sexual‑health research. Participants completed four full‑day workshops and were assessed via feedback forms and journals, showing they could facilitate group discussions and engage partners.","clinical_takeaway":"None – the study reports a training program, not clinical findings about sexual health risks or treatments.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Community‑based participatory approach","Focus on capacity building of marginalized women","Developed a detailed training manual"],"limitations":["No control or comparison group","Small, non‑representative sample","Descriptive outcomes only; no efficacy data"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1353/cpr.2019.0058"}},{"id":9434,"doi":"10.1093/eurpub/ckaa073","pmid":"32385499","pmcid":null,"title":"Sexual health services in community pharmacy for women on opioid substitution treatment: a qualitative study","authors":"Medina-Perucha L, Scott J, Chapman S, Barnett J, Dack C, Family H.","first_author":"Medina-Perucha L","journal":"European journal of public health","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Semi‑structured interviews with 20 women on opioid substitution treatment and 14 community pharmacists; one focus group with 3 pharmacists; Framework and directed content analysis.","sample_n":34,"sample_text":"20 WOST participants and 14 community pharmacists (plus a focus group of 3 pharmacists).","population":"Women on opioid substitution treatment (WOST) in the UK and UK community pharmacists","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with women receiving opioid treatment and community pharmacists show that pharmacies could offer free, private sexual‑health services such as STI screening and condom supply, but staff need training to reduce stigma.","clinical_takeaway":"Pharmacies could become accessible venues for sexual‑health care for women on opioid treatment, provided pharmacists receive proper training.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Focus on an underserved population (women on OST)","Use of both interviews and focus group for triangulation","Framework analysis provides systematic coding"],"limitations":["Small, non‑representative sample; mainly UK context","No quantitative outcome measures or statistical analysis","Findings may not generalise beyond pharmacy settings"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/eurpub/ckaa073"}},{"id":9435,"doi":"10.1177/1090198119853607","pmid":"31549560","pmcid":null,"title":"Toward Sexual Health Equity for Gay, Bisexual, and Transgender Youth: An Intergenerational, Collaborative, Multisector Partnerships Approach to Structural Change","authors":"Sirdenis TK, Harper GW, Carrillo MD, Jadwin-Cakmak L, Loveluck J, Pingel ES, Benton A, Peterson A, Pollard R, Bauermeister JA.","first_author":"Sirdenis TK","journal":"Health education & behavior : the official publication of the Society for Public Health Education","year":2019,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":["Structural change","Sexual Health","Community-based Participatory Research","Health Equity","Sexual And Gender Minorities","Community Coalition"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Community‑based participatory research with multimethod assessments and post‑intervention surveys of coalition participants; likely convenience sample of youth involved in the MFierce coalition.","sample_n":null,"sample_text":"Not specified in abstract; participants were members of the coalition and HAI program respondents.","population":"Gay, bisexual, and transgender youth (GBTY) and adult partners in the Michigan Forward in Enhancing Research and Community Equity (MFierce) coalition, USA.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study describes a community partnership that placed gay, bisexual, and transgender youth in leadership roles to improve sexual‑health services. Surveys of participants showed positive changes in coalition dynamics and reported improvements in health‑care policies and practices.","clinical_takeaway":"Community‑led, youth‑centered initiatives can help shape more inclusive sexual‑health services for gender‑minority youth.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Community‑engaged, intergenerational partnership model","Focus on structural (policy, systems, environment) change","Empowers youth leadership"],"limitations":["Lacks detail on measurement validation","Likely convenience sample, limited generalizability","No reported effect sizes or power analysis"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1090198119853607"}},{"id":9436,"doi":"10.1093/sw/swaa031","pmid":"33011806","pmcid":null,"title":"How Intimate Partner Violence and Intersectional Identities Converge to Influence Women's Sexual Health across Environmental Contexts","authors":"Bagwell-Gray ME, Jen S, Schuetz N.","first_author":"Bagwell-Gray ME","journal":"Social work","year":2020,"pub_types":["Journal Article"],"keywords":["Gender","Sexual Health","Intimate Partner Violence","Intersectionality"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative interview study with 28 women survivors of intimate partner violence, analyzed for themes related to sexual health and intersectional identities.","sample_n":28,"sample_text":"N = 28 women (22‑60 years, diverse racial/ethnic composition) who have experienced intimate partner violence.","population":"Women survivors of IPV, ages 22‑60, diverse racial/ethnic backgrounds, recruited from community/services (convenience sample).","country":"United States (inferred from author affiliations; not explicit in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 28 women who experienced intimate partner violence reveal that their sexual health risks and protective factors differ depending on race, age, socioeconomic status, and the power dynamics they face. The study highlights how violence and social identities intersect to shape women's sexual wellbeing.","clinical_takeaway":"Clinicians should consider a woman's intersecting identities and IPV history when addressing sexual health and safety.","confidence":0.78,"topic_tags":["sexual_function","gender"],"strengths":["Rich, intersectional qualitative insight","Diverse sample regarding age and ethnicity","Clear focus on IPV context"],"limitations":["Small, non‑representative convenience sample","No quantitative measurement of sexual health outcomes","Findings not generalizable to all women"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sw/swaa031"}},{"id":9437,"doi":"10.1177/11786329211036018","pmid":"34376991","pmcid":"PMC8323425","title":"Developing Strategies for Integrating Indigenous Health and Modern Health Systems for Improved Adolescent Sexual Health Outcomes in Umguza and Mberengwa Districts in Zimbabwe","authors":"Nunu WN, Makhado L, Mabunda JT, Lebese RT.","first_author":"Nunu WN","journal":"Health services insights","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Integration","Strategies","Adolescent","Zimbabwe","Indigenous Health System","Sexual Health Outcomes","Modern Health System"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC8323425","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"strategy development paper based on literature synthesis; no original empirical data; no sample size reported","sample_n":null,"sample_text":"None – paper synthesises prior papers to propose integration strategies","population":"adolescents in Zimbabwe (contextual focus only)","country":"Zimbabwe","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose five strategies to better combine traditional Indigenous health practices with modern health services in two Zimbabwe districts, aiming to improve teenage sexual health through joint committees, adolescent‑friendly clinics, and clearer integration guidelines.","clinical_takeaway":"None – the paper offers implementation ideas, not evidence of clinical effectiveness.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Clear policy‑focused recommendations","Uses systematic frameworks (SWOT, logic model) for strategy generation"],"limitations":["No original data or empirical evaluation","No measurement of sexual‑health outcomes","Lacks assessment of implementation feasibility"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/11786329211036018"}},{"id":9438,"doi":"10.1016/j.jsxm.2020.10.008","pmid":"33234430","pmcid":"PMC7584428","title":"Benefits of Sexual Activity on Psychological, Relational, and Sexual Health During the COVID-19 Breakout","authors":"Mollaioli D, Sansone A, Ciocca G, Limoncin E, Colonnello E, Di Lorenzo G, Jannini EA.","first_author":"Mollaioli D","journal":"The journal of sexual medicine","year":2021,"pub_types":["research-article","Journal Article"],"keywords":["Quarantine","Sexual activity","Sexual Health","Psychological Distress","Covid-19","Sars-cov-2"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7584428","cited_by_count":123,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"Case‑control web‑based survey comparing participants who reported any sexual activity during COVID‑19 lockdown (N = 2608) with those who reported none (N = 4213). Outcomes were anxiety, depression, relationship quality and sexual function measured with validated questionnaires. Analyses included t‑t","sample_n":6821,"sample_text":"N = 2,608 sexually active; N = 4,213 not sexually active.","population":"Adults of both genders recruited online during the COVID‑19 lockdown (convenience sample).","country":"Italy (presumed from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a large online survey of over 6,800 adults during COVID‑19 lockdown, people who reported any sexual activity had lower anxiety and depression scores, better relationship quality, and better sexual function than those who were not sexually active.","clinical_takeaway":"Maintaining consensual sexual activity during periods of social restriction may help protect mental‑health and relationship wellbeing.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large sample size","Use of validated psychometric instruments","Multivariate modelling (SEM) to examine mediation"],"limitations":["Cross‑sectional, retrospective design limits causal inference","Self‑selected web‑based sample may not be representative","Sexual activity measured only as a binary variable; masturbation not distinguished"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":13,"contrasting":1,"mentioning":160,"citing_publications":188,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2020.10.008"}},{"id":9440,"doi":"10.1111/ecc.12738","pmid":"28795458","pmcid":null,"title":"A comprehensive review of sexual health concerns after cancer treatment and the biopsychosocial treatment options available to female patients","authors":"Sears CS, Robinson JW, Walker LM.","first_author":"Sears CS","journal":"European journal of cancer care","year":2018,"pub_types":["Review","Journal Article"],"keywords":["Cancer","Female Sexual Dysfunction","Female Sexual Health","Biopsychosocial Intervention","Narrative review"],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative literature review without systematic methodology, no meta‑analysis, no formal risk‑of‑bias assessment","sample_n":null,"sample_text":"Not applicable – review of published literature","population":"women with any type or stage of cancer (no specific sample size reported)","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review summarises how cancer and its treatments affect women's sexual wellbeing and discusses existing physical and psychosocial interventions to manage issues like dryness and pain.","clinical_takeaway":"Clinicians should assess and address sexual health concerns in female cancer survivors, using the highlighted biomedical and psychosocial options.","confidence":0.8,"topic_tags":["sexual_function","csbd"],"strengths":["Broad overview of female sexual health after cancer","Identifies psychosocial and biomedical interventions"],"limitations":["Narrative, not systematic – possible selection bias","No quantitative synthesis or risk‑of‑bias assessment","No explicit methodological appraisal of included studies"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":4,"contrasting":0,"mentioning":48,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/ecc.12738"}},{"id":9441,"doi":"10.1371/journal.pone.0236821","pmid":"32745106","pmcid":"PMC7398552","title":"Modes of administering sexual health and blood-borne virus surveys in migrant populations: A scoping review","authors":"Vujcich D, Wangda S, Roberts M, Lobo R, Maycock B, Kulappu Thanthirige C, Reid A.","first_author":"Vujcich D","journal":"PloS one","year":2020,"pub_types":["Scoping Review","Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0236821&type=printable","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Scoping review of 91 studies describing how sexual health and blood‑borne virus surveys were administered to migrant populations. No quantitative synthesis or risk‑of‑bias assessment.","sample_n":91,"sample_text":"Ninety‑one primary studies identified","population":"International migrants (studies from 2000 onward; sample sizes of primary studies not pooled)","country":"International (studies from multiple countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review catalogues how sexual‑health and blood‑borne‑virus surveys have been given to migrants, noting that most use face‑to‑face interviews, some use self‑filled questionnaires, and few combine methods. Many studies fail to report response rates or recruitment details, limiting data quality assessment.","clinical_takeaway":"None – the paper informs researchers about survey methods, not clinical practice.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive mapping of 91 studies","Clear taxonomy of administration modes","Identifies gaps in reporting of response rates and recruitment"],"limitations":["No quality appraisal of included surveys","Descriptive only – no quantitative synthesis","Limited reporting of response‑rate data in primary studies"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":0,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0236821"}},{"id":9442,"doi":"10.1016/s2352-4642(20)30098-5","pmid":"32827491","pmcid":null,"title":"Sexual health education for adolescents and young adults with intellectual and developmental disabilities: recommendations for accessible sexual and reproductive health information","authors":"Roden RC, Schmidt EK, Holland-Hall C.","first_author":"Roden RC","journal":"The Lancet. Child & adolescent health","year":2020,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review without systematic methods","sample_n":null,"sample_text":"Not applicable – review article","population":"adolescents and young adults with intellectual/developmental disabilities","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article recommends using clear, multi‑media, universally designed education to give adolescents and young adults with intellectual or developmental disabilities the same comprehensive sexual and reproductive health information as their peers.","clinical_takeaway":"Provide non‑judgmental, accessible sexual education tailored to the learning needs of youth with intellectual/developmental disabilities.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Addresses a neglected population","Provides concrete, accessible recommendations"],"limitations":["Narrative, not systematic, review","No empirical data presented","No assessment of potential confounds"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":65,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s2352-4642(20)30098-5"}},{"id":9443,"doi":"10.3390/ijerph17176195","pmid":"32859017","pmcid":"PMC7504686","title":"Provider Perspectives on Sexual Health Services Used by Bangladeshi Women with mHealth Digital Approach: A Qualitative Study","authors":"Jahangir YT, Arora A, Liamputtong P, Nabi MH, Meyer SB.","first_author":"Jahangir YT","journal":"International journal of environmental research and public health","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Bangladesh","Sexual Health","Mhealth","Access To Healthcare","Sexual Healthcare","Sti Service"],"is_oa":true,"oa_url":"https://www.mdpi.com/1660-4601/17/17/6195/pdf?version=1598786440","cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative interview study with 26 medical doctors in Bangladesh examining provider perspectives on mHealth STI services for women.","sample_n":26,"sample_text":"26 medical doctors interviewed.","population":"Bangladeshi women (service users) and medical doctors (providers). Sample size: 26 providers.","country":"Bangladesh","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 26 Bangladeshi doctors show that mobile health tools could improve women’s access to STI information and care, but challenges like low health literacy, cost, and cultural factors need to be addressed.","clinical_takeaway":"mHealth platforms may help bridge STI service gaps for Bangladeshi women, but must consider literacy, affordability, and cultural competence.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Provides provider insight into mHealth implementation","Identifies contextual barriers (literacy, cost, culture)","Qualitative depth captures nuanced perspectives"],"limitations":["Small, non‑representative provider sample","No direct data from women users","Findings not generalizable beyond Bangladesh"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":42,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/ijerph17176195"}},{"id":9444,"doi":"10.1080/10410236.2020.1794550","pmid":"32703034","pmcid":null,"title":"Patient-Centered Communication to Address Young Adult Breast Cancer Survivors' Reproductive and Sexual Health Concerns","authors":"Gorman JR, Drizin JH, Smith E, Flores-Sanchez Y, Harvey SM.","first_author":"Gorman JR","journal":"Health communication","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"grounded theory interviews with 29 young adult breast cancer survivors","sample_n":29,"sample_text":"29 women, telephone interviews","population":"young adult female breast cancer survivors (diagnosed <40 y)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 29 young women who survived breast cancer revealed that clinicians often miss their sexual and reproductive concerns. Participants suggested normalizing these topics, showing genuine care, and improving access to specialised services.","clinical_takeaway":"Clinicians should routinely ask young breast‑cancer survivors about sexual health, listen actively, and connect them with appropriate services.","confidence":0.8,"topic_tags":["sexual_function","religiosity"],"strengths":["In‑depth patient perspectives","Grounded‑theory approach","Clear actionable communication strategies"],"limitations":["Small, non‑representative sample","No quantitative verification","Limited to breast‑cancer survivors"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":21,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10410236.2020.1794550"}},{"id":9445,"doi":"10.1177/1059840519868764","pmid":"31438767","pmcid":null,"title":"The Double Bind of School Nurses and Policy Implementation: Intersecting the <i>Street-Level Bureaucracy</i> Framework and Teaching Sexual Health Education","authors":"Dickson E, Brindis CD.","first_author":"Dickson E","journal":"The Journal of school nursing : the official publication of the National Association of School Nurses","year":2021,"pub_types":["Journal Article"],"keywords":["Policy implementation","Sexual Health Education","School Nursing","Street-level Bureaucracy"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative interview/field study using street-level bureaucracy framework","sample_n":null,"sample_text":"subset of school nurse data from larger study; exact number not given","population":"school nurses (US), sample size not reported in abstract","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper explores how school nurses manage the challenges of teaching sexual health education within policy constraints, using a street-level bureaucracy lens.","clinical_takeaway":"None - not clinically applicable to individual sexual health treatment.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Clear theoretical framing with street-level bureaucracy","Relevant to school health policy implementation"],"limitations":["No quantitative data or statistical analysis","Sample size and selection unclear","Does not address core constructs of pornography or CSBD"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":32,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1059840519868764"}},{"id":9446,"doi":"10.1111/jdv.16181","pmid":"31919919","pmcid":"PMC7318177","title":"Ixekizumab improves secondary lesional signs, pain and sexual health in patients with moderate-to-severe genital psoriasis","authors":"Merola JF, Ghislain PD, Dauendorffer JN, Potts Bleakman A, Brnabic AJM, Burge R, Riedl E.","first_author":"Merola JF","journal":"Journal of the European Academy of Dermatology and Venereology : JEADV","year":2020,"pub_types":["Clinical Trial, Phase III","brief-report","Multicenter Study","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7318177","cited_by_count":18,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Phase IIIb multicentre, double‑blind, placebo‑controlled randomised trial (N=149) evaluating ixekizumab vs placebo over 12 weeks in adults with moderate‑to‑severe genital psoriasis.","sample_n":149,"sample_text":"149 adults","population":"Adults (≥18 y) with moderate‑to‑severe genital psoriasis; 75 received ixekizumab, 74 placebo.","country":"Multicentre (likely international, not specified)","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a 12‑week trial, patients with genital psoriasis who received the biologic drug ixekizumab experienced faster healing of genital lesions, less pain, and better sexual activity compared with placebo.","clinical_takeaway":"Ixekizumab may improve pain and sexual function in adults with moderate‑to‑severe genital psoriasis.","confidence":0.7,"topic_tags":["gender"],"strengths":["Randomised, double‑blind placebo control","Validated disease‑specific outcome measures","Clear clinically relevant endpoints (pain, sexual health)"],"limitations":["No adjustment for psychological or relational confounders of sexual health","Effect sizes not reported in abstract","Short follow‑up (12 weeks) for sexual health outcomes"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":12,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jdv.16181"}},{"id":9447,"doi":"10.3389/fpubh.2022.889924","pmid":"36388328","pmcid":"PMC9659648","title":"The &lt;i&gt;Healthy Native Youth Implementation Toolbox&lt;/i&gt;: Using Implementation Mapping to adapt an online decision support system to promote culturally-relevant sexual health education for American Indian and Alaska Native youth","authors":"Markham CM, Rushing SC, Manthei J, Singer M, Jessen C, Gorman G, Peskin MF, Hernandez BF, Sacca L, Evans GS, Luna-Meza C, Merritt Z, Shegog R.","first_author":"Markham CM","journal":"Frontiers in public health","year":2022,"pub_types":["Research Support, Non-U.S. Gov't","methods-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Adolescent","Interventions","Sexual Health Promotion","American Indian And Alaska Native","Dissemination And Implementation Research","Implementation Mapping"],"is_oa":true,"oa_url":"https://doi.org/10.3389/fpubh.2022.889924","cited_by_count":11,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"methods article describing development and adaptation of an online decision‑support tool; no empirical outcome data presented.","sample_n":null,"sample_text":"Not applicable – the paper reports tool development, not a study sample.","population":"American Indian and Alaska Native youth (target group of the toolbox; no participant data reported)","country":"United States (authors affiliated with U.S. institutions)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes how researchers adapted an online decision‑support system to help Native communities choose and run culturally appropriate sexual‑health education programs for youth, using a structured planning process and community feedback.","clinical_takeaway":"None – the article presents a tool development framework, not clinical evidence.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Systematic use of Implementation Mapping framework","Incorporates community input and cultural relevance","Provides concrete resources and templates for practitioners"],"limitations":["No empirical evaluation of the Toolbox’s impact","Lacks data on implementation outcomes or effectiveness","No assessment of potential confounding factors"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2022.889924"}},{"id":9449,"doi":"10.1080/10810730.2019.1651428","pmid":"31407953","pmcid":"PMC6861680","title":"Applying a Multifactorial Communication Framework to Better Understand Differences between Father-daughter and Mother-daughter Sexual Health Discussions","authors":"Stewart JL, Widman L, Kamke K.","first_author":"Stewart JL","journal":"Journal of health communication","year":2019,"pub_types":["Controlled Clinical Trial","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 193 adolescent girls comparing father‑daughter and mother‑daughter sexual communication; no intervention.","sample_n":193,"sample_text":"193 girls (mean age = 15.62) completed questionnaires about parental sexual communication.","population":"Adolescent girls (mean age 15.6) recruited from schools/communities; diverse but convenience sample.","country":"USA (presumed based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 193 teenage girls, fathers were reported to talk less often, cover fewer topics, and feel less comfortable compared with mothers about sex. Girls also found father‑led talks less helpful and less likely to happen before they became sexually active.","clinical_takeaway":"Clinicians should assess father‑daughter communication and consider tailored interventions to improve its frequency and quality.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large (N≈200) sample for a communication survey","Direct comparison of fathers vs. mothers within same participants","Use of a multifactorial framework"],"limitations":["Cross‑sectional; cannot infer causality","Convenience sample limits generalisability","Unclear whether communication measures are validated"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":1,"mentioning":25,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10810730.2019.1651428"}},{"id":9450,"doi":"10.1371/journal.pone.0248153","pmid":"33735253","pmcid":"PMC7971553","title":"Characterizing a sexual health and HIV risk stratification scale for sexually active adolescent girls and young women (AGYW) in Tanzania","authors":"Han H, Yang F, Murray S, Mbita G, Bangser M, Rucinski K, Komba A, Casalini C, Drake M, Majani E, Curran K, Mlawa Y, Junga A, Zoungrana J, Kategile U, Ramadhani A, Xue QL, Baral S.","first_author":"Han H","journal":"PloS one","year":2021,"pub_types":["research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0248153&type=printable","cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of sexually active adolescent girls and young women in Tanzania; exploratory and confirmatory factor analyses used to develop a 10‑item risk scale; logistic regression tested association with condomless sex.","sample_n":null,"sample_text":"Data collected between April 2015 and March 2017; no sample size reported in abstract.","population":"AGYW, 15‑24, Tanzania (N not specified in abstract)","country":"Tanzania","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers built a 10‑question checklist to spot Tanzanian adolescent girls and young women at higher risk of HIV. The tool groups items into socioeconomic, adult‑support, and sexual‑behaviour factors and was linked to higher odds of condomless sex.","clinical_takeaway":"The scale may help target HIV prevention resources to higher‑risk AGYW, but its subscales need stronger reliability before routine use.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Systematic factor‑analysis approach to scale development","Reported fit indices and external validation against condomless sex","Large age range covering key at‑risk group"],"limitations":["Low internal consistency (Cronbach α < 0.6) for subscales","No pre‑registration or power calculation disclosed","Cross‑sectional design prevents causal inference"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0248153"}},{"id":9451,"doi":"10.1097/yco.0000000000000354","pmid":"28708737","pmcid":null,"title":"Factors associated with sexual health and well being in older adulthood","authors":"Kleinstäuber M.","first_author":"Kleinstäuber M.","journal":"Current opinion in psychiatry","year":2017,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review summarizing recent observational studies on sexual health in older adults; no new data collected.","sample_n":null,"sample_text":"Not applicable – review of existing literature.","population":"Older adults (aged 60+); no specific sample size reported (review).","country":"Not specified (international literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review summarizes recent studies showing that mental health, relationship status, religion, cognition, and sleep are linked to sexual activity, satisfaction, and function in older adults, emphasizing the complexity of these relationships.","clinical_takeaway":"Clinicians should consider a range of psychosocial and health factors when discussing sexual well‑being with older patients.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad overview of recent literature","Integrates multiple psychosocial factors","Highlights gaps for future research"],"limitations":["Narrative, not systematic; risk of selection bias","No empirical data or quantitative synthesis","Lacks explicit assessment of key confounds (e.g., moral incongruence)"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":5,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":1,"mentioning":42,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/yco.0000000000000354"}},{"id":9452,"doi":"10.1016/j.nedt.2020.104506","pmid":"32599471","pmcid":null,"title":"A sexual health course for advanced practice registered nurses: Effect on preparedness, comfort, and confidence in delivering comprehensive care","authors":"White BP, Abuelezam NA, Dwyer AA, Fontenot HB.","first_author":"White BP","journal":"Nurse education today","year":2020,"pub_types":["Journal Article"],"keywords":["Nursing Education","Sexual Health","Health Disparities","Sexual Health Education"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"pre‑post quasi‑experimental education study with control group (n=30 intervention, n=64 control)","sample_n":94,"sample_text":"30 intervention, 64 control (total 94)","population":"Graduate nursing students at a single private university (USA)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A new graduate‑level sexual health course for nurses increased students' self‑reported preparedness, comfort, and confidence in providing comprehensive, culturally sensitive sexual care, especially for marginalized groups.","clinical_takeaway":"Targeted sexual‑health training can boost nurses' confidence to deliver inclusive care, but findings are limited to short‑term self‑reports.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Addresses an important gap in nursing education","Includes a comparison group","Focuses on culturally informed care"],"limitations":["Small, single‑site sample limits generalisability","Survey measures likely unvalidated","No long‑term follow‑up of skill retention"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":41,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.nedt.2020.104506"}},{"id":9454,"doi":"10.1080/13691058.2019.1688868","pmid":"31805826","pmcid":null,"title":"First-year college students' alcohol and hookup behaviours: sexual scripting and implications for sexual health promotion","authors":"Thorpe S, Tanner AE, Kugler KC, Chambers BD, Ma A, Jenkins Hall W, Ware S, Milroy JJ, Wyrick DL.","first_author":"Thorpe S","journal":"Culture, health & sexuality","year":2021,"pub_types":["Journal Article"],"keywords":["Alcohol","College Students","Casual Sex","Sexual Scripts","Hookups"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"online survey of 4,292 first‑year college students; convenience sample; self‑report of alcohol use and hookup behaviours","sample_n":4292,"sample_text":"first‑year college students enrolled in an online College Social Life Survey","population":"first‑year college students (USA likely)","country":"USA (likely)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of over 4,000 first‑year college students found that most hookups involve non‑penetrative sex and condom use, but heavy drinking is linked to lower condom use, especially with less familiar partners.","clinical_takeaway":"Heavy alcohol use may reduce condom use during hookups; sexual‑health programs should include strategies for safer sex when drinking.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large sample size for a survey","Multivariate analysis of several contextual factors"],"limitations":["Cross‑sectional design limits causal inference","Self‑report measures not validated","No control for key confounds (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2019.1688868"}},{"id":9455,"doi":"10.1177/2055207620906956","pmid":"32128234","pmcid":"PMC7036501","title":"Mobile health applications for improving the sexual health outcomes among adults with chronic diseases: A systematic review","authors":"Karim H, Choobineh H, Kheradbin N, Ravandi MH, Naserpor A, Safdari R.","first_author":"Karim H","journal":"Digital health","year":2020,"pub_types":["review-article","Review","Journal Article"],"keywords":["Internet","Chronic disease","Sexual Health","Telemedicine","M-health"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7036501","cited_by_count":17,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"review","sample_n":null,"sample_text":"Nine studies were included; sample sizes of individual studies not provided in abstract.","population":"adults with chronic diseases","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A systematic review of nine studies found that mobile health tools, mainly website‑based, may improve sexual health problems in adults with chronic illnesses such as cancer, though the evidence is limited and many practical aspects of apps were not assessed.","clinical_takeaway":"Mobile or web‑based health tools could help sexual health in chronic disease patients, but clinicians should note the limited and heterogeneous evidence.","confidence":0.7,"topic_tags":["sexual_function","moral_incongruence"],"strengths":["Systematic search across multiple databases","Use of PRISMA guidelines and mERA checklist","Identification of gaps in reporting (replicability, security, cost)"],"limitations":["Small number of included studies (n=9)","No meta‑analysis or pooled effect sizes","Limited detail on intervention efficacy and quality of primary studies"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":45,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/2055207620906956"}},{"id":9456,"doi":"10.1089/trgh.2019.0032","pmid":"32042925","pmcid":"PMC6931010","title":"Findings from Formative Research to Develop a Strength-Based HIV Prevention and Sexual Health Promotion mHealth Intervention for Transgender Women","authors":"Sun CJ, Anderson KM, Mayer L, Kuhn T, Klein CH.","first_author":"Sun CJ","journal":"Transgender health","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Qualitative","Sexual Health","Hiv Prevention","Mhealth","Community Based","Transgender Women"],"is_oa":true,"oa_url":"https://www.liebertpub.com/doi/pdf/10.1089/trgh.2019.0032","cited_by_count":22,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Focus groups (4) and in‑depth interviews (20) with US transgender women; thematic analysis.","sample_n":20,"sample_text":"20 individual interviews plus 4 focus groups (approx. 20‑30 participants total)","population":"Transgender women, racially and geographically diverse, US","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with transgender women identified four themes—structural factors, transition‑related care and mental health, broader sexual health needs, and community connection—to guide a mobile health HIV‑prevention program.","clinical_takeaway":"Interventions for transgender women should address structural barriers, mental health, and community support alongside HIV prevention.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rich, participant‑driven qualitative data","Diverse sample regarding race and geography","Clear implications for mHealth intervention design"],"limitations":["Small, non‑probability sample limits generalisability","No quantitative measurement of constructs","No assessment of potential confounds (e.g., mental health, trauma)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":27,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/trgh.2019.0032"}},{"id":9457,"doi":"10.1016/j.sxmr.2018.09.003","pmid":"30503726","pmcid":null,"title":"The Role of Physical Therapy in Sexual Health in Men and Women: Evaluation and Treatment","authors":"Stein A, Sauder SK, Reale J.","first_author":"Stein A","journal":"Sexual medicine reviews","year":2019,"pub_types":["Systematic Review","Journal Article"],"keywords":["Vulvodynia","Manual Therapy","Vestibulodynia","Sexual Pain","Pelvic Floor Physical Therapy","Pelvic Floor Muscle Dysfunction"],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of PFPT literature, no description of risk‑of‑bias assessment or meta‑analysis; likely narrative synthesis of heterogeneous studies.","sample_n":null,"sample_text":"Not reported (review).","population":"Adults with pelvic floor related sexual dysfunction (men and women); sample size not applicable for review.","country":"Not specified (likely multiple countries).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review summarises evidence that pelvic floor physical therapy can improve pelvic and sexual problems in men and women, but the quality of the underlying studies is unclear.","clinical_takeaway":"PFPT may help pelvic‑related sexual dysfunction, but clinicians should consider the limited evidence base.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Systematic review format provides overview of PFPT literature","Highlights biopsychosocial model"],"limitations":["No clear risk‑of‑bias assessment reported","Unclear whether primary studies used validated outcome measures","Potential over‑generalization of PFPT effectiveness"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":31,"citing_publications":98,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sxmr.2018.09.003"}},{"id":9458,"doi":"10.2196/15888","pmid":"32396131","pmcid":"PMC7251477","title":"A Sexual Health Promotion App for Transgender Women (Trans Women Connected): Development and Usability Study","authors":"Sun CJ, Anderson KM, Kuhn T, Mayer L, Klein CH.","first_author":"Sun CJ","journal":"JMIR mHealth and uHealth","year":2020,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Sexual Health","Minority Health","Health Status Disparities","Health Care Disparities","Transgender Persons"],"is_oa":true,"oa_url":"https://mhealth.jmir.org/2020/5/e15888/PDF","cited_by_count":28,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"pre‑post usability study with 16 participants, think‑aloud protocols, no control group","sample_n":16,"sample_text":"16 transgender women","population":"transgender women (N=16) recruited for usability testing","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created a mobile app to help transgender women prevent HIV and tested its usability with 16 participants. Users liked the app and showed short‑term gains in confidence, intention to seek support, and PrEP knowledge.","clinical_takeaway":"Usability testing shows promise, but larger controlled trials are needed before clinical recommendation.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Engaged target community in development","Mixed-methods (think‑aloud, quantitative)","Theory‑based app framework"],"limitations":["Very small sample (N=16)","No control/comparison group","Short‑term pre‑post only"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":54,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/15888"}},{"id":9459,"doi":"10.5334/aogh.1110","pmid":"30873788","pmcid":"PMC7052344","title":"Initial Validation of the MAKE Framework: A Comprehensive Instrument for Evaluating the Efficacy of Game-Based Learning and Gamification in Adolescent Sexual Health Literacy","authors":"Haruna H, Hu X, Chu SKW, Mellecker RR.","first_author":"Haruna H","journal":"Annals of global health","year":2019,"pub_types":["research-article","Validation Study","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"http://www.annalsofglobalhealth.org/articles/10.5334/aogh.1110/galley/2550/download/","cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study of a new instrument (MAKE) administered to 120 Tanzanian secondary school students; factor analysis and reliability testing","sample_n":120,"sample_text":"Convenience sample of secondary‑school adolescents","population":"adolescent students (n=120) in low‑resource secondary schools, Tanzania","country":"Tanzania","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors created and tested the MAKE questionnaire to measure how well game‑based teaching improves adolescents’ motivation, attitudes, knowledge, and engagement with sexual health topics. In 120 Tanzanian students the tool showed strong reliability and clear factor structure.","clinical_takeaway":"The MAKE instrument appears reliable for assessing game‑based sexual‑health education, but further testing in diverse populations is needed before routine use.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear factor‑analytic validation","High internal consistency for all subscales","Applicable to low‑resource settings"],"limitations":["Convenience sample, limited generalisability","No external validation against outcomes","No pre‑registration or power analysis reported"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":0,"mentioning":33,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5334/aogh.1110"}},{"id":9460,"doi":"10.1016/j.soard.2019.03.001","pmid":"31023575","pmcid":"PMC6591710","title":"Sexual behaviors, risks, and sexual health outcomes for adolescent females following bariatric surgery","authors":"Zeller MH, Brown JL, Reiter-Purtill J, Sarwer DB, Black L, Jenkins TM, McCracken KA, Courcoulas AP, Inge TH, Noll JG, TeenView Study Group, Teen-LABS Consortium.","first_author":"Zeller MH","journal":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Pregnancy","Sexual behavior","Adolescent","Health risk","Young Adult"],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective observational controlled cohort, 4‑year follow‑up, multi‑center","sample_n":179,"sample_text":"111 surgical, 68 nonsurgical at baseline; 83 and 49 retained at 48 months","population":"adolescent females with severe obesity, surgical (n≈111) vs nonsurgical (n≈68)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Adolescent girls with severe obesity who had bariatric surgery were more likely over four years to become sexually active, have pregnancies, and give birth compared with similar peers who did not have surgery, while rates of STIs were similar.","clinical_takeaway":"Clinicians caring for teenage patients after bariatric surgery should counsel about contraception and teen‑pregnancy prevention.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Longitudinal 4‑year follow‑up","Multi‑center sample","Comparison group of nonsurgical peers"],"limitations":["Observational, non‑randomised design","Potential attrition bias","Limited control for psychosocial confounds"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.soard.2019.03.001"}},{"id":9461,"doi":"10.1177/084456211504700303","pmid":"29509471","pmcid":null,"title":"University Students' Sexual Health Knowledge: A Scoping Literature Review","authors":"Cassidy C, Curran J, Steenbeek A, Langille D.","first_author":"Cassidy C","journal":"The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmieres","year":2015,"pub_types":["Scoping Review","Journal Article"],"keywords":["Knowledge","Students","Health education","Sexual Health","Revue De La Littérature","Étudiants","Santé Sexuelle","Connaissances","Connaissances En Matière De Santé Sexuelle","Scoping Literature Review"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Scoping literature review of 91 cross‑sectional studies on university students' sexual health knowledge (2000‑2014).","sample_n":null,"sample_text":"Not applicable – review of published studies.","population":"University/college students globally; studies included were English‑language articles.","country":"International (global literature).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A scoping review of 91 studies shows that university students worldwide have mixed knowledge about STIs, HIV, HPV, and contraception, with many gaps and inconsistent measurement tools.","clinical_takeaway":"Educators should target identified knowledge gaps with validated curricula; clinicians should assess individual students' understanding rather than assume adequate knowledge.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive mapping of 91 studies across regions.","Clear methodological framework (5‑stage scoping process).","Identifies gaps in measurement tools and geographic coverage."],"limitations":["No quantitative synthesis or risk‑of‑bias assessment.","Variable quality of primary studies not evaluated.","Findings limited to reported knowledge; no assessment of behavior or outcomes."],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":16,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/084456211504700303"}},{"id":9462,"doi":"10.34171/mjiri.33.94","pmid":"31696088","pmcid":"PMC6825393","title":"Development and psychometric assessment of the sexual health education necessity scale: An exploratory mixed method study","authors":"Rahmani A, Nithyanantham V, Fallahi A, Allahqoli L, Sadeghi N.","first_author":"Rahmani A","journal":"Medical journal of the Islamic Republic of Iran","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Psychometric Evaluation","Sexual Health Education","Exploratory Mixed Method","Young Single Women"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6825393","cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-method scale development with qualitative item generation (n=51) and quantitative validation (n=110).","sample_n":110,"sample_text":"Young single women aged 18‑34 years (51 in qualitative phase, 110 in quantitative phase)","population":"young single Iranian women, 18‑34 years","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers created and tested a 9‑item questionnaire to measure how young single Iranian women view the need for sexual health education, finding it reliable and valid for exploring beliefs that could hinder education programs.","clinical_takeaway":"The new scale can help identify beliefs that block sex‑education efforts in conservative settings.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Clear mixed‑method approach","Use of established psychometric procedures (EFA, CVR/CVI, reliability)","Transparent reporting of sample and statistical thresholds"],"limitations":["Small, non‑representative convenience sample","No external validation of the new scale","No assessment of potential confounding attitudes (e.g., religiosity)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.34171/mjiri.33.94"}},{"id":9463,"doi":"10.2196/22203","pmid":"34269689","pmcid":"PMC8325088","title":"Uptake of and Engagement With an Online Sexual Health Intervention (HOPE eIntervention) Among African American Young Adults: Mixed Methods Study","authors":"Williamson A, Barbarin A, Campbell B, Campbell T, Franzen S, Reischl TM, Zimmerman M, Veinot TC.","first_author":"Williamson A","journal":"Journal of medical Internet research","year":2021,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Sexual Health","Hiv Prevention","Consumer Health Informatics","Technology Adoption","Health Equity","Technology Usage"],"is_oa":true,"oa_url":"https://www.jmir.org/2021/7/e22203/PDF","cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"mixed-methods community‑based participatory study with four survey waves (n≈315) and qualitative interviews (n=19); examines uptake and engagement with a sexual‑health website for African‑American young adults","sample_n":315,"sample_text":"315 participants surveyed; 280 African‑American; 19 interviewed","population":"African‑American young adults, 18‑24 years, U.S.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a study of 315 African‑American young adults, an online HIV/STI prevention tool was used infrequently and engagement fell over time. Factors that helped uptake included wanting to share health info and having a trusted source, while lack of promotion, boring content, and negative past experiences on social media reduced use.","clinical_takeaway":"Digital sexual‑health tools need trusted delivery, appealing design, and regular fresh content to keep African‑American young adults engaged.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large community‑based sample with repeated measures","Mixed‑methods triangulation of quantitative and qualitative data","Use of objective server‑log data to verify self‑reports"],"limitations":["No pre‑registration or power analysis reported","Convenience sample; limited generalisability beyond African‑American young adults","Limited statistical detail in abstract (e.g., effect‑size reporting)"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/22203"}},{"id":9464,"doi":"10.4103/ijnmr.ijnmr_51_17","pmid":"31333741","pmcid":"PMC6621498","title":"Determination of the Effect of Sexual Assertiveness Training on Sexual Health in Married Women: A Randomized Clinical Trial","authors":"Sayyadi F, Golmakani N, Ebrahimi M, Saki A, Karimabadi A, Ghorbani F.","first_author":"Sayyadi F","journal":"Iranian journal of nursing and midwifery research","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Iran","Sex Education","Sexual Health","Assertiveness"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6621498","cited_by_count":13,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"parallel‑group randomized clinical trial, 60 married women (30 per arm), pre‑post assessment 1 week after intervention","sample_n":60,"sample_text":"60 married women (30 per group)","population":"married Iranian women attending a health centre","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A short training program that taught women how to assert their sexual needs improved scores on a sexual‑health questionnaire compared with a control group of married women in Iran.","clinical_takeaway":"Brief sexual‑assertiveness training may boost self‑reported sexual health in married women.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Randomized controlled design","Clear pre‑post comparison","Statistical significance reported"],"limitations":["Outcome measures likely not validated","No effect sizes or confidence intervals","Potential confounds (e.g., mental health, relationship quality) not controlled"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/ijnmr.ijnmr_51_17"}},{"id":9465,"doi":"10.1186/s12913-018-3379-0","pmid":"30041649","pmcid":"PMC6057095","title":"Barriers and enablers to sexual health service use among university students: a qualitative descriptive study using the Theoretical Domains Framework and COM-B model","authors":"Cassidy C, Bishop A, Steenbeek A, Langille D, Martin-Misener R, Curran J.","first_author":"Cassidy C","journal":"BMC health services research","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Multicenter Study","Journal Article"],"keywords":["Reproductive Health","Sexually Transmitted Infections","Qualitative Research","university students","Sexual Health Services","Theoretical Domains Framework, Behaviour Change Wheel"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6057095","cited_by_count":67,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative descriptive study with focus groups (N=56) and key‑informant interviews (N=7) at two university health centres in Nova Scotia, Canada","sample_n":63,"sample_text":"56 students, 7 staff/administrators","population":"undergraduate university students (18‑25 y) and health‑care staff/administrators","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Focus groups with university students and staff identified ten factors that make it harder or easier for students to use on‑campus sexual‑health services, such as knowledge gaps, social influences, and emotional concerns.","clinical_takeaway":"Address identified knowledge, social, and emotional barriers when designing campus‑based sexual health programs.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of established theoretical frameworks (TDF, COM‑B) to guide data collection","Inclusion of multiple stakeholder groups (students, clinicians, administrators)","Clear description of barriers/enablers relevant to intervention design"],"limitations":["Convenience sample from two Canadian universities; limited generalisability","No quantitative assessment of prevalence or magnitude of barriers","Potential social desirability bias in group discussions"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":85,"citing_publications":139,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12913-018-3379-0"}},{"id":9466,"doi":"10.2196/16254","pmid":"32012041","pmcid":"PMC7055799","title":"Engaging African American Youth in the Development of a Serious Mobile Game for Sexual Health Education: Mixed Methods Study","authors":"Patchen L, Ellis L, Ma TX, Ott C, Chang KHK, Araya B, Atreyapurapu S, Alyusuf A, Gaines Lanzi R.","first_author":"Patchen L","journal":"JMIR serious games","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Adolescents","Sex Education","Sexual Health","African Americans","Community-based Participatory Research","User-centered Design","Video Games","Games, Experimental"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7055799","cited_by_count":19,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed methods (focus groups, youth advisory board, usability testing) with convenience sample of 86 African‑American youth (15‑21 y)","sample_n":86,"sample_text":"86 self‑identified African‑American males and females aged 15‑21 years","population":"African‑American adolescents and young adults in Washington, DC and Birmingham, AL","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers worked with African‑American teens to co‑design a role‑playing mobile game that teaches sexual‑health information. Usability testing showed the prototype scored well on a standard survey, suggesting it could be an engaging education tool.","clinical_takeaway":"The game appears usable, but its effectiveness for changing sexual‑health outcomes remains untested.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["User‑centered, participatory design with target population","Validated usability instrument (SUS)","Iterative development across three stages"],"limitations":["Convenience sample; limited generalisability","No efficacy data – only usability","No statistical power justification"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":33,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/16254"}},{"id":9467,"doi":"10.3917/rsi.139.0123","pmid":"32372615","pmcid":null,"title":"[Constructing a research problem: From the story of a female patient with multiple sclerosis to a nursing research project on sexual health]","authors":"Lefebvre S, Jovic L.","first_author":"Lefebvre S","journal":"Recherche en soins infirmiers","year":2019,"pub_types":["Journal Article"],"keywords":["Multiple sclerosis","Nursing","Sexual Health","Research Problem"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary/educational article describing how to formulate a research problem using a clinical case of sexual health in women with multiple sclerosis. No empirical data, no participants, no measurements.","sample_n":null,"sample_text":"None – the paper reports a single illustrative case rather than a systematic sample.","population":"Female patients with multiple sclerosis (described only as a clinical example; not a sampled cohort).","country":"Canada (inferred from author affiliations, not stated in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article shows, using a case of a woman with multiple sclerosis, how nurses can turn clinical observations about sexual health into a formal research question, illustrating the steps of defining theory, methods, and analysis.","clinical_takeaway":"None – the paper offers methodological guidance, not clinical evidence.","confidence":0.9,"topic_tags":["sexual_function","neuroscience","gender","religiosity"],"strengths":["Clear illustration of research problem construction for nursing students.","Links clinical observation to theory."],"limitations":["No empirical data; cannot inform sexual‑health outcomes.","Limited generalisability beyond the single illustrative case.","Does not address measurement or confounding issues."],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3917/rsi.139.0123"}},{"id":9468,"doi":"10.1080/10508422.2017.1365303","pmid":"35979388","pmcid":"PMC9380446","title":"Sexual health research among youth representing minority populations: To waive or not to waive parental consent","authors":"Brawner BM, Sutton MY.","first_author":"Brawner BM","journal":"Ethics & behavior","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Consent","Case Study","Responsible Conduct Of Research","Irb","Research Participants"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case study describing IRB challenges for youth sexual health research; no empirical outcome data","sample_n":null,"sample_text":"Not applicable – paper describes procedural/ethical considerations rather than a participant sample","population":"sexually active youth (13-24) from urban minority communities","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses the ethical challenges of obtaining parental consent for research with sexually active minority youth, offering recommendations to streamline IRB approval so that vital HIV/STI prevention studies can proceed.","clinical_takeaway":"Researchers should consider waiving parental consent when appropriate to engage at‑risk youth in sexual health studies, following ethical guidelines.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides detailed practical guidance for IRBs","Addresses an understudied ethical issue"],"limitations":["No empirical data on outcomes","Limited generalisability beyond the described setting"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10508422.2017.1365303"}},{"id":9469,"doi":"10.1186/s12961-022-00817-2","pmid":"35101044","pmcid":"PMC8805264","title":"Increased use of knowledge translation strategies is associated with greater research impact on public health policy and practice: an analysis of trials of nutrition, physical activity, sexual health, tobacco, alcohol and substance use interventions","authors":"Wolfenden L, Mooney K, Gonzalez S, Hall A, Hodder R, Nathan N, Yoong S, Ditton E, Sutherland R, Sutherland R, Lecathelinais C, McCrabb S.","first_author":"Wolfenden L","journal":"Health research policy and systems","year":2022,"pub_types":["research-article","Journal Article"],"keywords":["Policy","Public Health","Knowledge Translation","Implementation Science","Practice Research Impact"],"is_oa":true,"oa_url":"https://health-policy-systems.biomedcentral.com/counter/pdf/10.1186/s12961-022-00817-2","cited_by_count":21,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of authors of public‑health intervention trials (including sexual‑health trials) asking about reported policy/practice impacts and use of knowledge‑translation strategies.","sample_n":null,"sample_text":"Not specified in abstract","population":"authors of completed trials across nutrition, PA, sexual health, tobacco, alcohol, substance use; convenience sample","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed authors of public‑health trials and found that trials using more knowledge‑translation strategies were about 30% more likely to be cited in policies or guidelines, suggesting such strategies can boost research impact.","clinical_takeaway":"None – the paper addresses research dissemination, not clinical treatment.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Clear operational definition of KT activities","Quantitative assessment of policy impact","Multi‑domain public‑health focus including sexual health"],"limitations":["Self‑report of impact may be biased","Convenience sample of trial authors limits generalisability","No pre‑registration or power justification"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":25,"citing_publications":65,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12961-022-00817-2"}},{"id":9471,"doi":"10.1186/s12889-017-4096-z","pmid":"28166759","pmcid":"PMC5294694","title":"Sexual health status of women who have regular sexual relations with men who have sex with men in mainland China","authors":"Li X, Zhang B, Wang J, Li Y, Li X, Yu P, Liu M, Liu X.","first_author":"Li X","journal":"BMC public health","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Mainland China","Women","Men Who Have Sex With Men","Sexual Health Status","Regular Sex Partner"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5294694","cited_by_count":21,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Survey of 144 women (in‑GWs, ex‑GWs, GGFs) recruited via website mobilisation; self‑administered questionnaire; descriptive statistics.","sample_n":144,"sample_text":"144 valid surveys (100 in‑GWs, 33 ex‑GWs, 11 GGFs).","population":"Women in mainland China who have regular sexual relations with men who have sex with men (tongqi).","country":"China","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2017 Chinese survey of 144 women who have regular sex with men who have sex with men (tongqi) found high rates of STI symptoms (35%) and low condom use. About 5% of those tested were HIV‑positive, and many lacked accurate STD/HIV knowledge.","clinical_takeaway":"Women partnered with MSM have elevated STI/HIV risk and need targeted screening and education.","confidence":0.7,"topic_tags":["sexual_function","religiosity","masturbation"],"strengths":["Addresses a neglected high‑risk population","Provides concrete prevalence data on STDs/HIV among tongqi","Highlights knowledge gaps and policy needs"],"limitations":["Convenience, web‑based sample; limited generalisability","No validated instruments; reliance on self‑report","No control/comparison group"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":34,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-017-4096-z"}},{"id":9472,"doi":"10.3389/fpubh.2019.00217","pmid":"31508403","pmcid":"PMC6714884","title":"Study Protocol: 6th National Survey of Australian Secondary Students and Adolescent Sexual Health, 2018","authors":"Fisher C, Mikolajczak G, Ezer P, Kerr L, Bellamy R, Brown G, Waling A, Lucke J.","first_author":"Fisher C","journal":"Frontiers in public health","year":2019,"pub_types":["methods-article","Journal Article"],"keywords":["Survey","HIV","Adolescents","Sex Education","Sexually Transmitted Infections"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpubh.2019.00217/pdf","cited_by_count":32,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large, nationally representative online survey of 8,400 Australian adolescents (14‑18 y) covering knowledge, behaviours and education experiences; protocol outlines sampling matching census strata","sample_n":8400,"sample_text":"Broad cross‑section of ages, genders, school types and states/territories; matches census data","population":"Australian secondary school students aged 14‑18 (n≈8,400)","country":"Australia","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2018 Australian national survey will collect online responses from 8,400 secondary students (ages 14‑18) about their knowledge of HIV/STIs, sexual behaviours, and education experiences, using a detailed questionnaire designed to reflect the broader adolescent population.","clinical_takeaway":"None – the protocol describes planned data collection, not findings for clinical use.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Very large, nationally representative sample","Comprehensive questionnaire covering multiple sexual‑health domains","Protocol makes methods transparent"],"limitations":["Reliance on self‑report items not reported as validated scales","No measurement of key confounds (e.g., mental health, moral factors)","Protocol only; outcomes not yet available"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":1,"mentioning":91,"citing_publications":95,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2019.00217"}},{"id":9473,"doi":"10.1016/j.joim.2018.05.005","pmid":"29880257","pmcid":null,"title":"Kaempferia parviflora ethanol extract improves self-assessed sexual health in men: a pilot study","authors":"Stein RA, Schmid K, Bolivar J, Swick AG, Joyal SV, Hirsh SP.","first_author":"Stein RA","journal":"Journal of integrative medicine","year":2018,"pub_types":["Randomized Controlled Trial","Journal Article"],"keywords":["Sexual Health","Complementary Therapies","International Index Of Erectile Function","Kaempferia Parviflora","Global Assessment Question","Kaempmax™"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"open-label, one‑arm pilot trial (N=13 completers) assessing pre‑post change in IIEF after 30 days of Kaempferia parviflora extract","sample_n":13,"sample_text":"14 enrolled, 13 completed","population":"healthy middle‑aged/older men (50‑68 y) with self‑reported mild erectile dysfunction","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small pilot study of 13 older men with mild erectile problems, daily intake of a Kaempferia parviflora (KaempMax™) extract for 30 days was linked to modest improvements in erectile function scores, though the study lacked a control group and was underpowered.","clinical_takeaway":"Evidence is preliminary; clinicians should await larger, placebo‑controlled trials before recommending Kaempferia parviflora for erectile dysfunction.","confidence":0.7,"topic_tags":["sexual_function","treatment"],"strengths":["Use of validated IIEF instrument","Clear pre‑post assessment","Safety monitoring reported"],"limitations":["Open‑label, no placebo control","Very small sample (N=13)","No effect‑size reporting or correction for multiple testing","Short duration (30 days)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":16,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.joim.2018.05.005"}},{"id":9474,"doi":"10.3109/09593985.2015.1023876","pmid":"26196697","pmcid":null,"title":"Physiotherapy as a promoter of sexual health","authors":"Areskoug-Josefsson K, Gard G.","first_author":"Areskoug-Josefsson K","journal":"Physiotherapy theory and practice","year":2015,"pub_types":["Review","Journal Article"],"keywords":["Sexuality","Rehabilitation","Education","Physical Therapy","Physiotherapy","Health Promotion","Sexual Well-being"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review describing the potential role of physiotherapists in promoting sexual health; no primary data, no systematic methodology reported.","sample_n":null,"sample_text":"Not applicable – review article with no empirical sample.","population":"Physiotherapists and their clients (general description only)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that physiotherapists could play a valuable role in promoting patients' sexual health, but it provides only a narrative discussion without presenting research data.","clinical_takeaway":"None – the paper offers ideas but no evidence to guide clinical practice.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Highlights an under‑addressed area in physiotherapy practice","Provides a clear, concise overview of potential benefits for sexual health"],"limitations":["No empirical data or systematic review methodology","Lacks defined constructs, measures, or evidence base","Conclusions are speculative rather than evidence‑based"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/09593985.2015.1023876"}},{"id":9475,"doi":"10.1177/1359105317736784","pmid":"29076402","pmcid":null,"title":"Restricted reproductive rights and risky sexual behaviour: How political disenfranchisement relates to women's sense of control, well-being and sexual health","authors":"Msetfi R, Jay S, O'Donnell AT, Kearns M, Kinsella EL, McMahon J, Muldoon OT, Naughton C, Creaven AM.","first_author":"Msetfi R","journal":"Journal of health psychology","year":2018,"pub_types":["Journal Article"],"keywords":["Control","Health","Abortion","Well-being","Disenfranchisement"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"N=513 women, online/clinic survey in Ireland, cross‑sectional mediation analysis","sample_n":513,"sample_text":"adult women, likely convenience sample","population":"Adult women in Ireland (various ages)","country":"Ireland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 513 Irish women and found that feeling politically disenfranchised was linked to a lower sense of personal control, which in turn was associated with poorer mental wellbeing and higher risky sexual behaviour.","clinical_takeaway":"Political and social contexts influencing sense of control may affect women's sexual health; clinicians should consider broader sociopolitical factors when addressing risky sexual behaviour.","confidence":0.7,"topic_tags":["religiosity"],"strengths":["Large sample (N>500)","Focused on an under‑researched sociopolitical factor","Uses mediation modelling to explore pathways"],"limitations":["Cross‑sectional design limits causal inference","Potential self‑selection bias in sample","Unclear validation of key scales"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":12,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1359105317736784"}},{"id":9476,"doi":"10.1007/s10549-020-06062-x","pmid":"33452553","pmcid":null,"title":"Prospective evaluation of sexual health in breast cancer women during the first year of adjuvant hormonal treatment using a cancer patient's dedicated questionnaire: A glaring gap of communication between health professionals and patients","authors":"Aptecar L, Fiteni F, Jarlier M, Delaine S, Guillerme V, Jacot W, D'Hondt V.","first_author":"Aptecar L","journal":"Breast cancer research and treatment","year":2021,"pub_types":["Journal Article"],"keywords":["Breast cancer","Sexual Quality Of Life","Adjuvant Hormonal Treatment","Eortc Shq-c22"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective bicentric survey of breast cancer patients (N=106 at baseline, 92 at 12 mo)","sample_n":106,"sample_text":"106 women completed baseline questionnaires; 92 completed 12‑month follow‑up","population":"women with breast cancer undergoing adjuvant hormonal therapy","country":"unspecified (likely European institutions)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a year‑long study of 106 women receiving hormone therapy for breast cancer, sexual satisfaction was low and communication with doctors about sexuality was minimal. Though communication improved slightly, many needs remained unmet.","clinical_takeaway":"Clinicians should proactively discuss sexual health with breast‑cancer patients on hormonal therapy.","confidence":0.6,"topic_tags":["sexual_function","csbd"],"strengths":["Uses a disease‑specific, validated sexual health questionnaire","Prospective design with baseline and 12‑month follow‑up","Identifies a clear communication gap in clinical care"],"limitations":["No control for key psychosocial confounds (e.g., mental health, partner status)","No effect‑size reporting or power analysis","Sample limited to breast‑cancer patients; not generalizable to broader population"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":3,"contrasting":1,"mentioning":15,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10549-020-06062-x"}},{"id":9477,"doi":"10.1071/sh17097","pmid":"29506642","pmcid":"PMC8596162","title":"Leveraging a relationship-based sexual health framework for sexual risk prevention in adolescent men in the United States","authors":"Hensel DJ, Bales CL, Taylor JF, Fortenberry JD.","first_author":"Hensel DJ","journal":"Sexual health","year":2018,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Longitudinal cohort study of 72 adolescent males (14‑16 y) with quarterly partner‑specific interviews (n = 651 interviews). Mixed‑effects regression models adjusted for age, race/ethnicity and relationship length.","sample_n":72,"sample_text":"72 participants contributed 651 partner‑specific interviews.","population":"Adolescent males, United States, ages 14‑16, n = 72 (convenience sample).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 2‑year study of 72 U.S. teen boys, higher scores on a new sexual‑health questionnaire were linked to more condom use, less partner concurrency, and fewer instances of partner violence.","clinical_takeaway":"Promoting relationship‑focused sexual health skills may help reduce risk behaviors in adolescent males.","confidence":0.8,"topic_tags":["adolescents","sexual_function"],"strengths":["Longitudinal partner‑specific data","Mixed‑effects modeling","Adjustment for key demographics"],"limitations":["Small, non‑representative sample","Sexual health measure not validated","Limited control of key psychosocial confounds"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":3,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh17097"}},{"id":9478,"doi":"10.22605/rrh4245","pmid":"29655365","pmcid":null,"title":"Facilitators of community participation in an Aboriginal sexual health promotion initiative","authors":"Hulme Chambers A, Tomnay J, Stephens K, Crouch A, Whiteside M, Love P, McIntosh L, Waples Crowe P.","first_author":"Hulme Chambers A","journal":"Rural and remote health","year":2018,"pub_types":["Journal Article"],"keywords":["Qualitative","Community Participation","Health Promotion","Aboriginal","Australian"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups and interviews with 32 purposively selected participants; deductive content analysis","sample_n":32,"sample_text":"32 participants (purposive sample) in 5 focus groups and 13 individual interviews","population":"young Aboriginal people and stakeholders involved in a sexual health promotion initiative in regional Victoria, Australia","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A qualitative evaluation of the Aboriginal ‘Smart and Deadly’ sexual health promotion program identified trust as the key factor that enabled community participation, alongside cultural safety, community control, and sustainability.","clinical_takeaway":"Building trust with Aboriginal communities is essential for successful sexual‑health promotion initiatives.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Community‑led, culturally grounded approach","Use of both focus groups and individual interviews","Systematic comparison to the YARN model"],"limitations":["Small, purposive sample limits generalizability","No quantitative outcomes or effect size reporting","Findings may reflect participants’ positive bias toward the project"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":0,"design":4,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":16,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.22605/rrh4245"}},{"id":9479,"doi":"10.1016/j.jsxm.2016.04.069","pmid":"27318019","pmcid":null,"title":"Sexual Health in Undergraduate Medical Education: Existing and Future Needs and Platforms","authors":"Shindel AW, Baazeem A, Eardley I, Coleman E.","first_author":"Shindel AW","journal":"The journal of sexual medicine","year":2016,"pub_types":["Journal Article"],"keywords":["Sexual Health","Human Sexuality","Undergraduate Medical Education","Sexuality Education"],"is_oa":false,"oa_url":null,"cited_by_count":55,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review of existing literature on medical school sexuality curricula; no primary data collection","sample_n":null,"sample_text":"No primary participants; literature review only","population":"undergraduate medical students (implicit), no empirical sample","country":"International (review)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review how medical schools teach sexual health and propose a detailed, modern curriculum covering topics from gender diversity to sexual violence, urging the International Society for Sexual Medicine to lead worldwide education efforts.","clinical_takeaway":"Medical educators should expand and integrate comprehensive sexual health training throughout medical school.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of curriculum needs","Clear actionable recommendations for ISSM"],"limitations":["No systematic review methodology reported","No empirical data or quality appraisal of cited studies","Potential bias toward authors' perspectives"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":3,"contrasting":0,"mentioning":62,"citing_publications":104,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2016.04.069"}},{"id":9480,"doi":"10.1023/b:aseb.0000026619.95734.d5","pmid":"15129038","pmcid":null,"title":"Defining sexual health: a descriptive overview","authors":"Edwards WM, Coleman E.","first_author":"Edwards WM","journal":"Archives of sexual behavior","year":2004,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":139,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Narrative review of eight historical WHO definitions of sexual health; no primary data collected.","sample_n":null,"sample_text":"Not applicable – review article","population":"Not applicable","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how WHO definitions of sexual health have changed from 1975 to 2002, noting added emphasis on mental health, responsibility, and sexual rights.","clinical_takeaway":"None – the paper is conceptual and does not provide clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive historical overview of WHO definitions","Clear synthesis of eight major definitions","Highlights evolution of mental health and rights concepts"],"limitations":["No empirical data or systematic methodology reported","No risk‑of‑bias assessment for included sources","Limited to WHO definitions; may miss non‑WHO perspectives"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":146,"citing_publications":283,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/b:aseb.0000026619.95734.d5"}},{"id":9481,"doi":"10.1016/j.sxmr.2018.03.003","pmid":"29678474","pmcid":null,"title":"The Impact of Body Awareness on Women's Sexual Health: A Comprehensive Review","authors":"Seal BN, Meston CM.","first_author":"Seal BN","journal":"Sexual medicine reviews","year":2020,"pub_types":["Review","Journal Article"],"keywords":["Treatment","Sexual dysfunction","Mindfulness","Body Awareness","Sexual Response","Sensate Focus"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative literature review without systematic methods or risk‑of‑bias assessment.","sample_n":null,"sample_text":"29 primary studies reviewed (no new participants)","population":"Women (general and clinical samples) across included studies","country":"Not applicable (review)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review summarises 29 studies showing that practices that increase women’s awareness of their bodies—like mindfulness, sensate focus, and lab manipulations—can improve sexual arousal, desire, and pain for many women, though other parts of the interventions may also contribute.","clinical_takeaway":"Body‑awareness techniques may help women with sexual difficulties, but clinicians should consider the whole intervention package.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Comprehensive coverage of body‑awareness interventions","Identifies gaps in attributing effects to body awareness specifically","Includes both clinical and non‑clinical samples"],"limitations":["Non‑systematic search strategy; possible selection bias","No quantitative synthesis or risk‑of‑bias assessment","Limited appraisal of methodological quality of included studies"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.sxmr.2018.03.003"}},{"id":9482,"doi":"10.1016/j.ijmedinf.2021.104529","pmid":"34385097","pmcid":"PMC8487398","title":"Examining the Information Systems Success (ISS) of a mobile sexual health app (MyPEEPS Mobile) from the perspective of very young men who have sex with men (YMSM)","authors":"Cordoba E, Idnay B, Garofalo R, Kuhns LM, Pearson C, Bruce J, Batey DS, Radix A, Belkind U, Hidalgo MA, Hirshfield S, Rodriguez RG, Schnall R.","first_author":"Cordoba E","journal":"International journal of medical informatics","year":2021,"pub_types":["research-article","Randomized Controlled Trial","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["HIV","Health Behavior","Mhealth Technology","Young Men Who Have Sex With Men (Ymsm)","Information Systems Success (Iss)"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Cross‑sectional qualitative interview study with 40 YMSM participants drawn from a larger RCT; convenience sample; thematic analysis using the Information Systems Success framework.","sample_n":40,"sample_text":"40 YMSM (45% Hispanic; 80% non‑White; 28% aged 17).","population":"Young men who have sex with men, ages 13‑18, recruited from an RCT of a HIV‑prevention app.","country":"United States (presumed from author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample","causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 40 teen gay and bisexual men found the MyPEEPS mobile HIV‑prevention app was easy to use and helped them feel more knowledgeable and confident about sexual health, though most would not keep using it without new content.","clinical_takeaway":"The app appears acceptable and may boost HIV‑prevention knowledge, but evidence of actual risk‑reduction is limited.","confidence":0.8,"topic_tags":["moral_incongruence","masturbation","pornography","sexual_function"],"strengths":["Provides user‑centered feedback on a health app.","Diverse sample of YMSM.","Systematic thematic framework (ISS)."],"limitations":["Small, non‑representative convenience sample.","No validated measures of outcomes.","Findings are qualitative; causal claims are unwarranted."],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijmedinf.2021.104529"}},{"id":9483,"doi":"10.3390/geriatrics5010013","pmid":"32131446","pmcid":"PMC7150998","title":"Effect of the Nurse-Led Sexual Health Discharge Program on the Sexual Function of Older Patients Undergoing Transurethral Resection of Prostate: A Randomized Controlled Trial","authors":"Bayat R, Shahsavari H, Faghihzadeh S, Amaniyan S, Vaismoradi M.","first_author":"Bayat R","journal":"Geriatrics (Basel, Switzerland)","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Cancer","Sexual function","Nursing","Education","Older Patients","Discharge Planning","Transurethral Resection Of Prostate"],"is_oa":true,"oa_url":"https://www.mdpi.com/2308-3417/5/1/13/pdf?version=1584871394","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Randomized controlled trial with 80 older patients (40 per arm) receiving a nurse‑led sexual health discharge program vs usual care; outcomes measured at 1 and 3 months with IIEF.","sample_n":80,"sample_text":"Convenience sample of 80 patients, randomly allocated to intervention (n=40) or control (n=40).","population":"Older men (≥?? age not specified) undergoing transurethral resection of prostate in Iran; convenience sample.","country":"Iran","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In an RCT of 80 older men after prostate surgery, a three‑session nurse‑led discharge program improved erectile function, desire, and overall sexual satisfaction at three months compared with usual care.","clinical_takeaway":"A brief nurse‑led sexual health discharge program may enhance postoperative sexual function in older men after TURP.","confidence":0.8,"topic_tags":["sexual_function","neuroscience","treatment"],"strengths":["Validated sexual function outcome (IIEF).","Randomized allocation.","Clear intervention protocol."],"limitations":["Convenience sample limits generalisability.","No reporting of effect sizes or confidence intervals.","Potential confounders (mental health, partner status) not measured."],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":9,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3390/geriatrics5010013"}},{"id":9484,"doi":"10.1136/bmjsrh-2018-200082","pmid":"30228198","pmcid":null,"title":"Evidence-based patient/public voice: a patient and public involvement audit in the field of sexual health","authors":"Meyrick J, Gray D.","first_author":"Meyrick J","journal":"BMJ sexual & reproductive health","year":2018,"pub_types":["Journal Article"],"keywords":["Research","PPI","Service Delivery","Audit"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"qualitative audit of PPI practices in sexual health services and research projects; convenience sample; thematic analysis","sample_n":23,"sample_text":"18 service contacts plus 5 research projects; recruited via snowballing","population":"service contacts and researchers involved in sexual health PPI (n≈23)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors reviewed how patient and public involvement (PPI) is used in sexual‑health services and research, finding wide variation and many gaps such as late involvement and poor evaluation of patient needs.","clinical_takeaway":"None – the study does not provide clinical evidence on sexual behaviours or health outcomes.","confidence":0.4,"topic_tags":["sexual_function","prevalence"],"strengths":["Direct audit of real‑world PPI practice","Two independent researchers coded thematic analysis","Identifies concrete areas for improvement"],"limitations":["Small convenience sample; not representative","Audit tool not validated","No quantitative outcome measures"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjsrh-2018-200082"}},{"id":9485,"doi":"10.1071/sh16164","pmid":"28648149","pmcid":"PMC6360952","title":"Attitudes to sexual health in the United States: results from a national survey of youth aged 15-25 years","authors":"Hogben M, Harper C, Habel MA, Brookmeyer K, Friedman A.","first_author":"Hogben M","journal":"Sexual health","year":2017,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Nationally representative online survey of 4017 US youth (15‑25), weighted sample, ordinal regression analysis of attitudes and behaviours.","sample_n":4017,"sample_text":"Weighted to be representative of the US population","population":"US youth, 15‑25 years, recruited via online panel, weighted to population demographics","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of over 4,000 US youths (15‑25) found that they view emotional fulfillment, pleasure, intimacy, and spirituality as key parts of sexual health. Positive attitudes toward these aspects were linked to more discussions about sex and higher use of sexual‑health services.","clinical_takeaway":"Promoting positive, multidimensional views of sexual health may encourage youth to seek care and engage in safer sexual practices.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally weighted sample","Clear focus on attitudes across multiple dimensions","Use of ordinal regression to examine associations"],"limitations":["Attitude items appear ad‑hoc, not validated","Cross‑sectional, cannot infer causality","Limited control for psychosocial confounders"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":7,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh16164"}},{"id":9487,"doi":"10.1016/s2352-4642(18)30202-5","pmid":"30119759","pmcid":null,"title":"Mental and sexual health outcomes following sexual assault in adolescents: a prospective cohort study","authors":"Khadr S, Clarke V, Wellings K, Villalta L, Goddard A, Welch J, Bewley S, Kramer T, Viner R.","first_author":"Khadr S","journal":"The Lancet. Child & adolescent health","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":65,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"prospective cohort of adolescents presenting to sexual assault services, baseline within 6 weeks, follow‑up at 4‑5 months (n≈141 baseline, 106 follow‑up)","sample_n":141,"sample_text":"141 recruited (134 female), 106 completed follow‑up","population":"adolescents 13‑17 y presenting to UK Sexual Assault Referral Centres (mostly female)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A UK study followed 141 adolescents after a sexual assault and found that most had ongoing psychiatric problems four‑to‑five months later, especially anxiety, PTSD and depression; vulnerability before the assault predicted later disorder.","clinical_takeaway":"Adolescents who experience sexual assault need early, comprehensive mental‑health support to prevent persistent psychiatric disorders.","confidence":0.85,"topic_tags":["sexual_function","adolescents","gender"],"strengths":["Use of validated psychiatric instruments","Prospective design with baseline and follow‑up","Diagnostic interview for psychiatric disorders"],"limitations":["Small sample, limited power for subgroup analyses","No measurement of sexual‑behavioural confounds (e.g., masturbation, moral attitudes)","Predominantly female sample limits generalisability to males"],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":8,"contrasting":0,"mentioning":99,"citing_publications":107,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s2352-4642(18)30202-5"}},{"id":9488,"doi":"10.1186/s12889-019-7959-7","pmid":"31914970","pmcid":"PMC6950902","title":"Latent class analysis of sexual health markers among men and women participating in a British probability sample survey","authors":"Parkes A, Waltenberger M, Mercer C, Johnson A, Wellings K, Mitchell K.","first_author":"Parkes A","journal":"BMC public health","year":2020,"pub_types":["research-article","Journal Article"],"keywords":["Sexual function","Sexual Health","Sexually Transmitted Infection","Sexual Coercion","Unplanned Pregnancy","Sexual Wellbeing"],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-019-7959-7","cited_by_count":12,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large nationally representative probability sample, cross‑sectional latent‑class analysis","sample_n":12132,"sample_text":"Men (N = 5113) and women (N = 7019) aged 16‑74 from Natsal‑3","population":"British adults (men N=5113, women N=7019) reporting partnered sex in past year","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using data from a UK-wide survey, researchers identified different groups of men and women who share similar patterns of sexual‑health problems such as STIs, unplanned pregnancy, sexual‑function issues and non‑consensual sex. Each group had distinct sociodemographic and lifestyle characteristics.","clinical_takeaway":"Sexual‑health screening should consider distinct risk patterns; interventions may need to be tailored to specific sub‑groups.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, probability‑based national sample","Latent‑class methodology to reveal subpopulations","Inclusion of multiple sexual‑health outcomes"],"limitations":["Self‑report measures, many not validated scales","Cross‑sectional; no causal inference","Key confounds (moral incongruence, masturbation, trauma) not assessed"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-019-7959-7"}},{"id":9489,"doi":"10.1080/13691058.2016.1183046","pmid":"27265841","pmcid":null,"title":"US Black college women's sexual health in hookup culture: intersections of race and gender","authors":"Jenkins Hall W, Tanner AE.","first_author":"Jenkins Hall W","journal":"Culture, health & sexuality","year":2016,"pub_types":["Journal Article"],"keywords":["USA","Sexual Health","College Students","Black Women","Hookups"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of Black college women; likely convenience sample; no longitudinal or experimental element","sample_n":null,"sample_text":"not specified in abstract","population":"US Black college women (sample size not reported in abstract)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study explores how race and gender shape sexual health among Black women in US colleges, highlighting issues like gender‑ratio imbalances, power dynamics, inconsistent condom use, and low risk perception in hookup encounters.","clinical_takeaway":"Clinicians should recognise the unique sexual‑health challenges Black college women face in hookup contexts and consider intersectional factors when providing counseling.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["addresses understudied population","intersectional perspective","high relevance to sexual health on campuses"],"limitations":["Likely convenience sample; limited generalisability","No indication of validated scales or effect‑size reporting","No control for key confounds (e.g., mental health, partner factors)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2016.1183046"}},{"id":9490,"doi":"10.1071/sh17154","pmid":"29706147","pmcid":null,"title":"Risky business: is pubic hair removal by women associated with body image and sexual health?","authors":"Grossman SL, Annunziato RA.","first_author":"Grossman SL","journal":"Sexual health","year":2018,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study with 264 women (age 18‑66) recruited via unspecified means","sample_n":264,"sample_text":"Women (n=264; Mage=33.8, SD=11.1, range 18‑66) completed self‑report questionnaires.","population":"women, community sample, likely convenience","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In 264 women, stronger worries about appearance and lower confidence about condom use were linked to greater reasons for, and extent of, pubic hair removal. The authors suggest this grooming practice may signal broader appearance‑related concerns that could affect well‑being.","clinical_takeaway":"Hair‑removal concerns may flag underlying body‑image issues; clinicians might explore appearance pressures when addressing sexual health.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Use of validated body‑image scales","Reasonable sample size for regression","Multiple appearance‑concern variables examined"],"limitations":["Cross‑sectional; no causal inference","Self‑report hair‑removal measure not validated","Key sexual‑health confounds (e.g., relationship status, mental health) not controlled"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":11,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh17154"}},{"id":9491,"doi":"10.1016/j.pedhc.2017.03.002","pmid":"28526485","pmcid":null,"title":"Improving the Sexual Health of Young People With Mobility Impairments: Challenges and Recommendations","authors":"Secor-Turner M, McMorris BJ, Scal P.","first_author":"Secor-Turner M","journal":"Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners","year":2017,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":["Adolescent","Sexual Health","Mobility Impairment"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"mixed-method (qualitative n=10, quantitative survey N=337) secondary data analysis; exploratory sequential design; cross‑sectional survey of youth with mobility impairments","sample_n":337,"sample_text":"Youth with mobility impairments; recruited for the My Path study, not a nationally representative probability sample","population":"Adolescents and young adults with mobility impairments (N≈337 for quantitative component)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study surveyed 337 young people with mobility impairments and interviewed a subset to uncover how they experience sexual health care. It found many face barriers such as providers not talking about sex and limited access to information, despite being connected to primary‑care doctors.","clinical_takeaway":"Providers should proactively discuss sexual health with youth with mobility impairments and offer tailored education.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large quantitative sample for a disability‑focused study","Integrates qualitative insights with survey data","Identifies concrete service gaps for an underserved population"],"limitations":["Cross‑sectional design limits causal inference","Convenience sample; not nationally representative","Limited detail on measurement validation"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.pedhc.2017.03.002"}},{"id":9493,"doi":"10.1016/j.ijgo.2015.10.001","pmid":"26725856","pmcid":null,"title":"Enhancing the role of health professionals in the advancement of adolescent sexual health and rights in Africa","authors":"Kangaude G.","first_author":"Kangaude G.","journal":"International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics","year":2016,"pub_types":["Journal Article"],"keywords":["HIV","Adolescents","Sexual Health","Sexually Transmitted Infections","Self-protection","Child Rights","Maputo Protocol","Sexuality Development"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary/policy article proposing training for health professionals; no empirical data collected.","sample_n":null,"sample_text":"No participants were recruited; the article is a narrative discussion.","population":"Adolescents in Africa (discussion focus); no sample recruited.","country":"Africa (regional focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that African states should train health professionals and create policies that respect adolescents’ sexual‑health rights, noting that stigma limits access to contraception and STI/HIV protection.","clinical_takeaway":"None – the paper offers policy recommendations, not clinical evidence.","confidence":0.4,"topic_tags":["adolescents","sexual_function"],"strengths":["Addresses adolescent sexual health rights","Highlights barriers from societal stigma","Calls for professional training and policy change"],"limitations":["No empirical data or systematic review","No measurement of outcomes or effectiveness","Lacks consideration of confounding factors"],"rubric_version":"2.0","raw_total":0,"max_possible":50,"pct_score":0,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":0,"neuroimaging":null,"statistics":0,"confounds":0,"design":0,"addiction_criteria":null,"interpretation":0}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijgo.2015.10.001"}},{"id":9494,"doi":"10.7748/ns2013.11.28.10.53.e7654","pmid":"24191835","pmcid":null,"title":"Promoting sexual health and wellbeing: the role of the nurse","authors":"Evans DT.","first_author":"Evans DT.","journal":"Nursing standard (Royal College of Nursing (Great Britain) : 1987)","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"non-empirical commentary on nursing role in sexual health promotion; no primary data, no sample","sample_n":null,"sample_text":"N/A","population":"N/A","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how nurses can better address patients' sexual health as part of holistic care, highlighting common gaps, embarrassment, and lack of training, and offers suggestions for improving communication and support.","clinical_takeaway":"None - not clinically applicable (no data).","confidence":0.6,"topic_tags":["sexual_function","neuroscience","prevalence","treatment"],"strengths":["Broad overview of nursing role","Identifies practical strategies"],"limitations":["No empirical data","No systematic review of evidence"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":42,"citing_publications":57,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7748/ns2013.11.28.10.53.e7654"}},{"id":9495,"doi":"10.7748/ns.30.5.53.e10082","pmid":"26419171","pmcid":null,"title":"Assessing sexual health in mental health service users","authors":"Salkeld J.","first_author":"Salkeld J.","journal":"Nursing standard (Royal College of Nursing (Great Britain) : 1987)","year":2015,"pub_types":["Journal Article"],"keywords":["Sexuality","Sexual Health","Patient Safety","Mental Health Nursing","Holistic Assessment"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"not applicable – article provides no empirical data","population":"mental health service users (mentioned only as target audience)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that mental‑health nurses should routinely discuss sexual health with their patients and offers a step‑by‑step model to help them do so.","clinical_takeaway":"Nurses are encouraged to include sexuality in assessments of mental‑health patients, using the presented model as a guide.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Provides a practical, step‑by‑step model for nurses","Emphasises holistic assessment of sexuality in mental‑health settings"],"limitations":["No empirical data – purely opinion/educational piece","No measurement or evaluation of outcomes","Does not address confounding factors such as moral incongruence or mental‑health variables"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7748/ns.30.5.53.e10082"}},{"id":9496,"doi":"10.1080/10538712.2018.1484832","pmid":"29932828","pmcid":null,"title":"Perceptions of Physical Sexual Health Among Young Men Who Have Sex with Men with a Previous History of Childhood Sexual Abuse","authors":"Emetu RE.","first_author":"Emetu RE.","journal":"Journal of child sexual abuse","year":2018,"pub_types":["Journal Article"],"keywords":["Men","Sexual Health","Childhood Sexual Abuse","Young Men Who Have Sex With Men","Bisexual Sexuality Issues","Gay Sexuality Issues"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"phenomenological interview study with 16 participants","sample_n":16,"sample_text":"Sixteen participants recruited for semi‑structured interviews","population":"young men who have sex with men with a history of childhood sexual abuse","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 16 gay and bisexual young men who experienced childhood sexual abuse revealed they view sexual health narrowly, face insurance obstacles, experience anal pain during sex, but still report sexual satisfaction. The study urges clinicians to address broader health needs of this group.","clinical_takeaway":"Clinicians should assess physical sexual health issues (e.g., anal pain, preventive care access) in YMSM survivors of childhood sexual abuse.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight","Focus on under‑studied population","Identification of concrete health‑service barriers"],"limitations":["Very small, non‑representative sample","No validated measurement of sexual health constructs","No control or comparative groups"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10538712.2018.1484832"}},{"id":9497,"doi":"10.1136/bmjopen-2016-013368","pmid":"28559453","pmcid":"PMC5777453","title":"Developing a framework for community-based sexual health interventions for youth in the rural setting: protocol for a participatory action research study","authors":"Heslop CW, Burns S, Lobo R, McConigley R.","first_author":"Heslop CW","journal":"BMJ open","year":2017,"pub_types":["protocol","Journal Article"],"keywords":["Youth","Rural","Sexual Health","Participatory Action Research","Community-based Research"],"is_oa":true,"oa_url":"https://bmjopen.bmj.com/content/bmjopen/7/5/e013368.full.pdf","cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"protocol for participatory action research; no empirical results yet","sample_n":null,"sample_text":"Not applicable – study is a protocol describing planned qualitative methods","population":"young people aged 16‑24 in rural Australia","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This protocol outlines a community‑based, participatory project to develop a framework for improving sexual health among rural Australian youth (16‑24). It will use interviews, focus groups, photovoice, and Delphi panels with local stakeholders.","clinical_takeaway":"None – the paper is a protocol and provides no actionable findings for clinicians.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Addresses gap in rural youth sexual health research","Uses participatory action research with community stakeholders","Combines multiple qualitative methods (interviews, focus groups, photovoice, Delphi)"],"limitations":["Protocol only – no empirical data to evaluate","No explicit measurement of sexual‑health outcomes yet","Does not address potential confounds such as mental health or moral incongruence"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjopen-2016-013368"}},{"id":9498,"doi":"10.1080/00224499.2016.1271863","pmid":"28140660","pmcid":null,"title":"The Sexual Health of Transgender Men: A Scoping Review","authors":"Stephenson R, Riley E, Rogers E, Suarez N, Metheny N, Senda J, Saylor KM, Bauermeister JA.","first_author":"Stephenson R","journal":"Journal of sex research","year":2017,"pub_types":["Scoping Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":49,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"scoping review of published literature","sample_n":null,"sample_text":"54 articles screened; 33 included in final analysis","population":"transgender men (adults)","country":"multiple (international literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This scoping review mapped what is known about the sexual health of transgender men, finding very few studies—most with small, non‑representative samples—and highlighting missing data on topics such as sexual violence, relationship quality, and barriers to care.","clinical_takeaway":"Clinicians should recognize the paucity of evidence on transgender men’s sexual health and seek individualized assessment rather than relying on existing research.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive search across seven databases","Clear framework (JBI) for scoping review","Identifies clear gaps for future research"],"limitations":["Relies on small, convenience primary studies","No quantitative synthesis or risk‑of‑bias assessment","Limited to published literature; possible publication bias"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":77,"citing_publications":92,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2016.1271863"}},{"id":9499,"doi":"10.1080/13691058.2016.1184316","pmid":"27268405","pmcid":null,"title":"Intergenerational variation in sexual health attitudes and beliefs among Sudanese refugee communities in Australia","authors":"Dean J, Mitchell M, Stewart D, Debattista J.","first_author":"Dean J","journal":"Culture, health & sexuality","year":2017,"pub_types":["Journal Article"],"keywords":["Sexual Health","Sudan, Refugees, Australia","Intergenerational Discord"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"interviews (n=11) and focus groups (5 groups) with Sudanese refugee community members in Queensland, Australia","sample_n":null,"sample_text":"11 semi‑structured interviews and 5 focus groups (exact participant numbers not reported)","population":"Sudanese refugee young people (16‑24) and adult community members","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews and focus groups with Sudanese refugee youth and their parents in Australia revealed that resettlement is changing sexual health knowledge, attitudes and behaviours, leading to intergenerational conflict. The authors suggest culturally adapted sex education for both generations early in the settlement process.","clinical_takeaway":"None – study provides cultural context but no direct clinical recommendations.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Direct voices of both young people and elders","Culturally specific insights for resettlement services","Comparison of intergenerational perspectives"],"limitations":["Small, non‑representative convenience sample","Qualitative data only; no validated scales","Findings not generalisable to wider refugee populations"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":61,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2016.1184316"}},{"id":9500,"doi":"10.3402/ijch.v75.32135","pmid":"27938640","pmcid":"PMC5149655","title":"Inuit women's stories of strength: informing Inuit community-based HIV and STI prevention and sexual health promotion programming","authors":"Rand JR.","first_author":"Rand JR.","journal":"International journal of circumpolar health","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["HIV","Prevention","Sexual Health","Sexually Transmitted Infections","Community-based Participatory Research","Inuit","Two-eyed Seeing","Indigenous Methodologies","Inuit Qaujimajatuqangit"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5149655","cited_by_count":18,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Community‑based participatory qualitative study using Indigenous storytelling methods with 21 Inuit women; thematic analysis of transcribed sessions.","sample_n":21,"sample_text":"21 participants (community‑based convenience sample)","population":"Inuit women (n=21) aged 18‑61 from Nunavut, Canada","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Inuit women shared personal stories that highlighted how HIV and STI prevention should be community‑wide, family‑focused and youth‑centred, suggesting holistic, culturally grounded health programmes.","clinical_takeaway":"Program planners should involve Inuit women and use community‑based, holistic approaches for sexual health promotion.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Indigenous methodology respects community knowledge","Participatory analysis involved participants","Provides culturally relevant insights for program design"],"limitations":["Small, non‑representative sample","No quantitative outcome measures","Findings may not generalize beyond the studied communities"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":47,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3402/ijch.v75.32135"}},{"id":9501,"doi":"10.1097/olq.0000000000000660","pmid":"28876308","pmcid":null,"title":"The Need to Promote Sexual Health in America: A New Vision for Public Health Action","authors":"Ford JV, Ivankovich MB, Douglas JM, Hook EW, Barclay L, Elders J, Satcher D, Coleman E.","first_author":"Ford JV","journal":"Sexually transmitted diseases","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary (no empirical data)","sample_n":null,"sample_text":"Not applicable – no participants","population":"United States public health context","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that sexual health should be a national public‑health priority in the United States, describing current challenges like STIs, unintended pregnancy, and inequities, and offering a logic model and action steps for policymakers and practitioners.","clinical_takeaway":"None – the paper provides policy guidance, not clinical recommendations.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad public‑health perspective","Identifies social determinants of sexual health","Proposes actionable logic model"],"limitations":["No empirical data or measurements","Does not address specific behaviors (e.g., pornography, masturbation)","Lacks quantitative evaluation of proposed actions"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":29,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/olq.0000000000000660"}},{"id":9502,"doi":"10.1111/jmft.12248","pmid":"28683159","pmcid":"PMC12820763","title":"Group Couples' Intervention to Improve Sexual Health Among Married Women in a Low-Income Community in Mumbai, India","authors":"Maitra S, Schensul SL, Hallowell BD, Brault MA, Nastasi BK.","first_author":"Maitra S","journal":"Journal of marital and family therapy","year":2018,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"pilot group intervention with qualitative outcomes; no control group; convenience sample of couples from a low‑income community health center","sample_n":null,"sample_text":"Not reported in abstract; likely small, convenience sample","population":"married couples (women) in a low‑income community in Mumbai, India","country":"India","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A group programme for married couples in a low‑income Mumbai neighbourhood aimed to improve women's sexual health by promoting more equal marital relationships. Participants reported better knowledge and emotional well‑being, but the study was small, lacked a control group, and relied on qualitative feedback.","clinical_takeaway":"Couple‑based education may help women's sexual health, but robust evidence is needed before broad clinical adoption.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Attempts community‑based couple intervention","Focus on women's sexual health in a low‑resource setting","Qualitative data provide rich contextual insight"],"limitations":["No control or comparison group","Small, non‑representative sample; unclear size","Reliance on qualitative reports; limited quantitative rigor"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jmft.12248"}},{"id":9503,"doi":"10.1080/15374416.2014.982756","pmid":"25575125","pmcid":"PMC4314941","title":"Future directions in research on sexual minority adolescent mental, behavioral, and sexual health","authors":"Mustanski B.","first_author":"Mustanski B.","journal":"Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53","year":2015,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":62,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative perspective article outlining gaps and future directions; no original data collected.","sample_n":null,"sample_text":"None – article is a review/commentary.","population":"sexual minority adolescents (no primary data)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews what is known about the mental, behavioral, and sexual health of sexual‑minority adolescents, highlights the scarcity of longitudinal and intervention studies, and proposes future research priorities and methodological improvements.","clinical_takeaway":"None – the paper provides research guidance, not clinical recommendations.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of current literature gaps","Identifies methodological challenges for SM adolescent research","Links translational science framework to health disparities"],"limitations":["No empirical data presented","Lacks systematic review methodology","No explicit assessment of measurement validity"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":83,"citing_publications":87,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/15374416.2014.982756"}},{"id":9504,"doi":"10.1071/he14055","pmid":"25436987","pmcid":null,"title":"Love Bugs: promoting sexual health among young people in Samoa","authors":"Heard E, Auvaa L, Pickering C.","first_author":"Heard E","journal":"Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals","year":2015,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"post‑event convenience survey of >500 Samoan youth; no control group, no longitudinal follow‑up","sample_n":500,"sample_text":"convenience sample of event participants","population":"young people (students) at the National University of Samoa, n≈500","country":"Samoa","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"A health‑promotion event called Love Bugs taught Samoan university students about safe sex and relationship skills, reaching over 500 young people and leading to free condom dispensers on campus. The authors claim the initiative improved sexual health awareness, but they only report a post‑event survey without a control group.","clinical_takeaway":"Program shows promise for youth sexual‑health outreach, but effectiveness remains untested.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large community reach (>500 youths)","Culturally tailored health promotion event","Concrete implementation (condom dispensers)"],"limitations":["No comparison or control group","Use of non‑validated survey items","Cross‑sectional descriptive data only"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/he14055"}},{"id":9505,"doi":"10.1016/j.dhjo.2017.02.008","pmid":"28420593","pmcid":null,"title":"Sexual health in the community: Services for people with intellectual and developmental disabilities","authors":"Friedman C, Owen AL.","first_author":"Friedman C","journal":"Disability and health journal","year":2017,"pub_types":["Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Sexual Health","Intellectual And Developmental Disability","Community Living","Behavioral Services","Medicaid Home And Community Based Services 1915(C) Waivers"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Document analysis of Medicaid HCBS waivers (n=111 waivers) with descriptive statistics on service inclusion.","sample_n":111,"sample_text":"111 FY 2015 HCBS 1915(c) waivers from 46 states and DC","population":"U.S. Medicaid HCBS waivers for people with intellectual and developmental disabilities (IDD)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined 111 U.S. Medicaid waivers for people with intellectual disabilities and found that fewer than 12 % include any sexuality services, and those that do are mostly reactive rather than preventive.","clinical_takeaway":"Clinicians should recognize that many Medicaid programmes lack proactive sexual‑health support for people with IDD and advocate for expanded services.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive national dataset of HCBS waivers","Clear operational definition of “sexuality services” for coding","Policy‑relevant findings highlighting service gaps"],"limitations":["No assessment of service quality or outcomes for people with IDD","Descriptive only – cannot infer impact on sexual health","Potential coding subjectivity not detailed"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.dhjo.2017.02.008"}},{"id":9508,"doi":"10.1016/j.ijnurstu.2020.103590","pmid":"32446018","pmcid":null,"title":"A comparison between independent nurse prescribing and patient group directions in the safety and appropriateness of medication provision in United Kingdom sexual health services: A mixed methods study","authors":"Black A, Gage H, Norton C, Franklin BD, Murrells T, Courtenay M.","first_author":"Black A","journal":"International journal of nursing studies","year":2020,"pub_types":["Journal Article"],"keywords":["Sexual Health","Medication Management","Health Services Research","Medication Safety","Nurse/non-medical Prescribing","Prescribing Errors/severity"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Mixed-methods observational study (clinical notes review of 1682 consultations and 30 observed consultations) in five UK sexual‑health services.","sample_n":1682,"sample_text":"743 consultations managed by nurse prescribers and 939 by patient‑group‑direction users.","population":"Patients attending sexual‑health clinics in the UK; nurses acting as independent prescribers or using patient‑group directions.","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study compared UK sexual‑health nurses who prescribe medicines independently with those using patient‑group directions. Both groups made few serious medication errors; documentation was the main problem, and patient‑group‑direction nurses sometimes worked outside the guidelines.","clinical_takeaway":"Nurse‑prescribed medication in sexual‑health clinics is generally safe; focus on improving documentation and adherence to patient‑group‑direction rules.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of validated medication safety instruments","Large sample of real‑world consultations","Combination of quantitative and observational data"],"limitations":["Cross‑sectional design, no causal inference","Limited to five services, possible selection bias","No power calculation or effect‑size reporting"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":15,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ijnurstu.2020.103590"}},{"id":9509,"doi":"10.1080/13691058.2011.610902","pmid":"21972785","pmcid":null,"title":"Lesbian and bisexual women's human rights, sexual rights and sexual citizenship: negotiating sexual health in England","authors":"Formby E.","first_author":"Formby E.","journal":"Culture, health & sexuality","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"small cross‑sectional/qualitative study of lesbian and bisexual women’s sexual health experiences in England","sample_n":null,"sample_text":"small research project; exact N not given in abstract","population":"lesbian and bisexual women in England (convenience sample, size not reported)","country":"England","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reports on a small study of lesbian and bisexual women in England, revealing how invisibility, lack of information and heterosexist attitudes make it hard for them to access sexual‑health services and information.","clinical_takeaway":"Clinicians should recognise that lesbian and bisexual women may face unique barriers to sexual health care and strive to provide inclusive, affirming services.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Focus on under‑researched population","Uses human‑rights and sexual‑citizenship frameworks","Identifies systemic barriers to care"],"limitations":["Small, non‑representative sample","No validated measurement instruments reported","Limited statistical or quantitative analysis"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":3,"contrasting":0,"mentioning":30,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2011.610902"}},{"id":9510,"doi":"10.1177/00333549131282s110","pmid":"23450889","pmcid":"PMC3562750","title":"Shifting the paradigm in Oregon from teen pregnancy prevention to youth sexual health","authors":"Nystrom RJ, Duke JE, Victor B.","first_author":"Nystrom RJ","journal":"Public health reports (Washington, D.C. : 1974)","year":2013,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"policy description / program overview without empirical data","sample_n":null,"sample_text":"None – the article describes a state‑level sexual‑health plan rather than a study sample.","population":"Oregon state agencies, partners, youth (no sample size reported)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article outlines Oregon’s shift from a teen‑pregnancy‑prevention focus to a broader youth sexual‑health strategy that centers young people’s development and embraces sexuality as a normal part of adolescence.","clinical_takeaway":"None – the paper presents a policy plan, not clinical evidence.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Describes a comprehensive, youth‑development‑focused policy framework","Highlights multi‑agency collaboration and community input"],"limitations":["No empirical data or evaluation of outcomes","No measurement of sexual‑behaviour variables (e.g., condom use, STI rates)","Lacks any assessment of potential confounders such as mental health or moral factors"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00333549131282s110"}},{"id":9511,"doi":"10.1080/00224499.2014.973100","pmid":"25406027","pmcid":"PMC4578698","title":"A systematic review of sexual health interventions for adults: narrative evidence","authors":"Hogben M, Ford J, Becasen JS, Brown KF.","first_author":"Hogben M","journal":"Journal of sex research","year":2015,"pub_types":["research-article","Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Narrative systematic review of 58 sexual‑health intervention studies (1996‑2011) summarising outcomes across knowledge, attitudes, communication, health‑care use, behaviour and adverse events. No quantitative meta‑analysis.","sample_n":null,"sample_text":"58 included studies (sample sizes not aggregated).","population":"Adults (general, parents, sexual minorities, vulnerable groups) – English‑language studies only.","country":"United States (interventions conducted in the US).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This review summarised 58 US studies of adult sexual‑health programmes, finding that most reported at least one positive outcome (knowledge, attitudes, communication, behaviour or safety), especially for sexual‑minority and vulnerable groups, though half also showed no effect in some areas.","clinical_takeaway":"Sexual‑health programs often improve knowledge or behaviours, but effects are mixed; clinicians should consider the specific content and target population.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad coverage of adult sexual‑health interventions.","Clear categorisation of outcome domains.","Inclusion of diverse populations (sexual minorities, vulnerable groups)."],"limitations":["Narrative synthesis without quantitative meta‑analysis.","No assessment of study quality or risk of bias.","Potential selection bias (English‑only, US focus)."],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":2,"contrasting":0,"mentioning":33,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2014.973100"}},{"id":9512,"doi":"10.1111/hiv.12629","pmid":"29790254","pmcid":null,"title":"Chemsex and new HIV diagnosis in gay, bisexual and other men who have sex with men attending sexual health clinics","authors":"Pakianathan M, Whittaker W, Lee MJ, Avery J, Green S, Nathan B, Hegazi A.","first_author":"Pakianathan M","journal":"HIV medicine","year":2018,"pub_types":["Journal Article"],"keywords":["HIV","hepatitis C","Addiction","MSM","Sexually Transmitted Infections","Gay Men","Substance Use","Chemsex"],"is_oa":false,"oa_url":null,"cited_by_count":91,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"retrospective case‑note review of clinic attendees (convenience sample)","sample_n":1840,"sample_text":"All GBMSM attending the clinics during the 14‑month period","population":"GBMSM attending two London sexual‑health clinics (N≈1840)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among gay and bisexual men seen at two London sexual‑health clinics, those who reported using recreational drugs during sex (chemsex) were far more likely to be newly diagnosed with HIV, other STIs, and hepatitis C compared with men who did not report chemsex.","clinical_takeaway":"Clinicians should routinely ask about chemsex, as it signals heightened risk for HIV and other infections.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large clinic‑based sample covering most attendees","Objective clinical outcome data (new HIV/STI diagnoses)","Adjusted odds ratios with confidence intervals"],"limitations":["Chemsex self‑report not based on validated scale","Cross‑sectional design precludes causal inference","Limited control for psychosocial confounders (e.g., mental health, moral attitudes)"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":2,"mentioning":97,"citing_publications":146,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/hiv.12629"}},{"id":9514,"doi":"10.1017/s1463423617000123","pmid":"28290256","pmcid":null,"title":"Preparing the sexual health workforce to deliver integrated services: is education the answer? A qualitative study exploring the impact of sexual health education on developing integrated policy and practice","authors":"Brook J, Salmon D, Knight RA.","first_author":"Brook J","journal":"Primary health care research & development","year":2017,"pub_types":["Evaluation Study","Journal Article"],"keywords":["Education","Leadership","Integrated Services","Sexual Health Nurses"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative study using semi‑structured telephone interviews, focus groups and pre‑/post‑intervention surveys with 88 nurses and 6 managers; thematic analysis.","sample_n":94,"sample_text":"88 nurses and 6 service managers participated.","population":"Sexual health nurses and managers in South West England (N≈94)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study interviewed UK sexual‑health nurses and managers to see how a training programme affected their ability to integrate services. Participants felt education helped them navigate policy but noted limited agency and the need for broader public‑health support.","clinical_takeaway":"Workforce education can aid service integration, but must be paired with systemic support for lasting change.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Large qualitative sample for this field (≈94 participants)","Longitudinal component with pre‑/post‑surveys","Thematic analysis grounded in implementation theory"],"limitations":["No validated measurement instruments reported","Findings limited to one UK region and specific professional group","No quantitative statistical testing"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1017/s1463423617000123"}},{"id":9515,"doi":"10.2196/publichealth.5393","pmid":"29097352","pmcid":"PMC5691242","title":"Examining E-Loyalty in a Sexual Health Website: Cross-Sectional Study","authors":"Nunn A, Crutzen R, Haag D, Chabot C, Carson A, Ogilvie G, Shoveller J, Gilbert M.","first_author":"Nunn A","journal":"JMIR public health and surveillance","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Cross-sectional studies","Sexual Health","Patient Satisfaction","E-loyalty"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5691242","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional online survey of 173 website users (clients and providers) examining e‑loyalty, perceptions and intended behavioural outcomes.","sample_n":173,"sample_text":"173 participants completed the survey; 171 used in correlation analyses.","population":"Adults who accessed a sexual‑health promotion website (clients and health‑care providers).","country":"Canada (inferred from author affiliations, not stated in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 173 people who used a sexual‑health website found that higher trust and easy‑to‑understand content were linked to stronger loyalty to the site, which in turn was modestly associated with feeling more knowledgeable and intending safer sex behaviours.","clinical_takeaway":"Designing trustworthy, clear sexual‑health websites may boost user loyalty and encourage intended protective behaviours.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large enough sample for SEM in this context","Uses validated e‑loyalty framework adapted for sexual health","Clear statistical reporting of correlations"],"limitations":["Cross‑sectional design; cannot infer causality","Convenience sample of website users; may not generalise","No reporting of confidence intervals or power analysis"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/publichealth.5393"}},{"id":9516,"doi":"10.1136/jramc-2013-000114","pmid":"24109143","pmcid":null,"title":"Sexual health and HIV in the Army","authors":"Dufty NE, Clay K, Wilson R, Watson J.","first_author":"Dufty NE","journal":"Journal of the Royal Army Medical Corps","year":2013,"pub_types":["Review","Journal Article"],"keywords":["Genitourinary Medicine","Sexual Medicine"],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Review of military sexual health and STI/HIV management; no original empirical data.","sample_n":null,"sample_text":"N/A (review article)","population":"Military personnel (both sexes); no primary data collected.","country":"United Kingdom (Royal Army Medical Corps)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how sexually transmitted infections, including HIV, are diagnosed and managed in the army, highlighting unique challenges of the military environment and pointing clinicians to resources.","clinical_takeaway":"Clinicians serving military personnel should be aware of the specific pathways for STI/HIV assessment and treatment within the armed forces.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of STI/HIV issues in military context","Practical guidance for clinicians in armed forces"],"limitations":["No original empirical data","Limited relevance to pornography or compulsive sexual behaviour research"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/jramc-2013-000114"}},{"id":9518,"doi":"10.1093/geronb/gbw018","pmid":"26993519","pmcid":"PMC4903037","title":"Sexual Health and Positive Subjective Well-Being in Partnered Older Men and Women","authors":"Lee DM, Vanhoutte B, Nazroo J, Pendleton N.","first_author":"Lee DM","journal":"The journals of gerontology. Series B, Psychological sciences and social sciences","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual function","Sexual activity","Later Life","Well-being","Elsa"],"is_oa":false,"oa_url":null,"cited_by_count":51,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Large, nationally representative sample from ELSA Wave 6; latent class analysis of sexual behavior/function; associations with well‑being outcomes measured cross‑sectionally.","sample_n":null,"sample_text":"Representative UK older‑adult cohort, partnered participants only","population":"Partnered men and women aged 60+ in England (ELSA cohort)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a representative sample of older partnered adults, those who kept sexual desire, activity, and good function reported higher life satisfaction and well‑being, whereas low desire, infrequent sex, or sexual problems were linked to poorer well‑being.","clinical_takeaway":"Promoting sexual health and addressing functional problems may help maintain well‑being in older couples.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative older‑adult sample","Validated instruments for sexual behavior and well‑being","Latent class analysis captures heterogeneous sexual patterns"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of key confounds (e.g., moral incongruence, masturbation, mental‑health covariates)","Potential residual confounding by relationship quality"],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":59,"citing_publications":101,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/geronb/gbw018"}},{"id":9519,"doi":"10.2196/10398","pmid":"30158100","pmcid":"PMC6135965","title":"The Influence of Technology Delivery Mode on Intervention Outcomes: Analysis of a Theory-Based Sexual Health Program","authors":"Levitz N, Wood E, Kantor L.","first_author":"Levitz N","journal":"Journal of medical Internet research","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Internet","Public Health","Behavior Theory","Instant Messaging","Sexual And Reproductive Health","Text Messaging"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6135965","cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational analysis of routine program data (64,939 conversations) using robust regression; large convenience sample of users of a sexual health chat/text service.","sample_n":64939,"sample_text":"Large convenience sample of program users; not randomly selected from the general population","population":"Youth aged 15‑24 in the United States using Planned Parenthood’s Chat/Text program","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A study of almost 65,000 young people using Planned Parenthood’s chat/text service found that the way the service was accessed (SMS, web chat, or mobile app) did not change users’ confidence in following through on sexual‑health intentions.","clinical_takeaway":"All three delivery modes appear equally effective for boosting confidence in sexual‑health plans among young service users.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Very large sample size","Relevant real‑world program data","Appropriate regression methods for ordinal outcomes"],"limitations":["Convenience sample; limited generalisability","Single‑item, non‑validated confidence measures","No control for key sexual‑health confounds (e.g., prior knowledge, mental health)"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/10398"}},{"id":9521,"doi":"10.1002/cad.20062","pmid":"24962364","pmcid":null,"title":"Healthy sex and sexual health: new directions for studying outcomes of sexual health","authors":"Lefkowitz ES, Vasilenko SA.","first_author":"Lefkowitz ES","journal":"New directions for child and adolescent development","year":2014,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or meta‑analysis; no primary data collected.","sample_n":null,"sample_text":"Not applicable – no empirical sample.","population":"Adolescents (general, no specific sampling details).","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review how teen sexual behavior relates to health, urging researchers to study a wider range of activities, use advanced longitudinal and dyadic methods, and include understudied groups.","clinical_takeaway":"None – the article offers research suggestions, not clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive, developmental perspective on adolescent sexual health.","Highlights under‑researched populations and methodological innovations."],"limitations":["No empirical data; conclusions are speculative.","Lacks systematic review methodology or risk‑of‑bias assessment.","Does not address key confounds (e.g., moral incongruence, mental health)."],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/cad.20062"}},{"id":9522,"doi":"10.1016/j.maturitas.2014.02.020","pmid":"24713452","pmcid":null,"title":"Spanish consensus on sexual health in men and women over 50","authors":"Sanchez-Borrego R, Molero F, Castaño R, Castelo-Branco C, Honrado M, Jurado AR, Laforet E, Prieto R, Cabello F, Larrazabal M, Sánchez F, Florido J, Mendoza N.","first_author":"Sanchez-Borrego R","journal":"Maturitas","year":2014,"pub_types":["Practice Guideline","Consensus Statement","Journal Article"],"keywords":["Postmenopausal","Sexual dysfunction","aged people","Sexual Health","Vaginal Health"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Consensus guideline without original empirical data; based on expert opinion rather than systematic primary studies.","sample_n":null,"sample_text":"Not applicable – no primary participant sample","population":"Men and women over 50, Spanish clinical context","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Spanish experts produced a consensus guide outlining factors that affect sexual health in people over 50 and gave clinical recommendations, but the document does not present new research data.","clinical_takeaway":"Clinicians can use the guideline for general assessment and treatment ideas for older adults, but it provides no evidence on pornography or addiction.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Multidisciplinary expert panel","Focused on older adult sexual health"],"limitations":["No primary data; relies on expert consensus","Lacks systematic review methodology","Does not address pornography or compulsive sexual behavior"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.maturitas.2014.02.020"}},{"id":9523,"doi":"10.1016/j.socscimed.2018.02.021","pmid":"29501715","pmcid":null,"title":"The effect of health insurance on sexual health: Evidence from the Affordable Care Act's dependent coverage mandate","authors":"Oney M.","first_author":"Oney M.","journal":"Social science & medicine (1982)","year":2018,"pub_types":["Journal Article"],"keywords":["United States","Health Insurance","Public Health","Public Policy","Health Behavior"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"difference‑in‑differences policy evaluation using CDC administrative data; large national sample with age‑group comparison","sample_n":null,"sample_text":"large administrative dataset; exact N not reported in abstract","population":"U.S. young adults aged 15‑29, observed before and after ACA dependent‑coverage mandate","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Examining the ACA's dependent‑coverage rule, the study finds that after young adults could stay on parents' insurance until age 26, reported chlamydia rates rose for 20‑24‑year‑olds and gonorrhea rose for women in that age group.","clinical_takeaway":"Insurance expansion may increase STI detection; clinicians should anticipate higher testing needs among newly insured young adults.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Objective, population‑level health outcomes","Quasi‑experimental design with clear comparison groups","National administrative data increases generalisability"],"limitations":["Potential unmeasured confounders (e.g., sexual behaviour changes)","No pre‑registration reported","Effect sizes and confidence intervals not shown in abstract"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":6,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.socscimed.2018.02.021"}},{"id":9524,"doi":"10.1371/journal.pone.0135660","pmid":"26267272","pmcid":"PMC4534385","title":"Alcohol Involvement in Sexual Behaviour and Adverse Sexual Health Outcomes from 26 to 38 Years of Age","authors":"Connor JL, Kydd RM, Dickson NP.","first_author":"Connor JL","journal":"PloS one","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":true,"oa_url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0135660&type=printable","cited_by_count":16,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"population-based birth cohort (Dunedin Study) with >90% response at ages 26, 32, 38; repeated measures of alcohol use and sexual outcomes","sample_n":1000,"sample_text":"large community sample, >90% response at each wave","population":"New Zealand adults from a birth cohort, assessed at ages 26, 32, 38 (≈1000 participants)","country":"New Zealand","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a New Zealand birth‑cohort followed to age 38, people who drank heavily around sex were more likely to have unwanted sexual outcomes, such as regret, STIs (men) and pregnancy terminations (women). Heavy drinking also related to having more partners, especially for women.","clinical_takeaway":"Clinicians should discuss alcohol use when addressing sexual health, as heavy drinking is linked to higher risk of STIs, unintended pregnancy and regretted sexual encounters.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative longitudinal cohort","High response rates across waves","Clear operationalization of heavy‑drinking occasions"],"limitations":["Self‑report measures only; no validated alcohol‑addiction scales","Limited adjustment for potential confounders (e.g., mental health, relationship status)","Causal language limited by observational design"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":14,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1371/journal.pone.0135660"}},{"id":9525,"doi":"10.4103/jfmpc.jfmpc_325_18","pmid":"30984685","pmcid":"PMC6436267","title":"An exploratory study to assess primary care physicians' attitudes toward talking about sexual health with older patients in Trinidad and Tobago","authors":"Rabathaly PA, Chattu VK.","first_author":"Rabathaly PA","journal":"Journal of family medicine and primary care","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Sexual Health","Primary Care","Middle-aged","Sexual History Taking","Old Aged"],"is_oa":true,"oa_url":"https://doi.org/10.4103/jfmpc.jfmpc_325_18","cited_by_count":13,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"In‑depth semi‑structured interviews with 35 primary‑care physicians in Trinidad & Tobago; thematic framework analysis.","sample_n":35,"sample_text":"Convenient sample of physicians recruited for interviews","population":"Primary‑care physicians (n=35) from Trinidad & Tobago","country":"Trinidad and Tobago","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 35 primary‑care doctors in Trinidad & Tobago showed most feel uncomfortable asking older patients about sex and cite time, privacy, training, and cultural factors as barriers, risking missed sexual‑health care.","clinical_takeaway":"Clinicians should receive training and structural support to discuss sexual health with older patients, as current discomfort may leave problems untreated.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Direct insight from practising physicians","Use of in‑depth interview format","Identifies practical barriers to sexual‑health discussions"],"limitations":["Small, non‑representative physician sample","No validated attitude scales used","Findings may not generalise beyond Trinidad & Tobago"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":15,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/jfmpc.jfmpc_325_18"}},{"id":9526,"doi":"10.1111/jsm.12810","pmid":"25739683","pmcid":null,"title":"Sexual health care for people with physical disabilities","authors":"Rowen TS, Stein S, Tepper M.","first_author":"Rowen TS","journal":"The journal of sexual medicine","year":2015,"pub_types":["Review","Journal Article"],"keywords":["Disability","Sexual Health","Continuing Medical Education"],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methods or meta‑analysis; no primary data collected.","sample_n":null,"sample_text":"Not applicable – review article.","population":"People with physical disabilities (heterogeneous); no sample size reported.","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how people with physical disabilities often face sexual health challenges and higher distress, urging clinicians to provide specialized, interdisciplinary care.","clinical_takeaway":"Clinicians should receive training to address the unique sexual health needs of patients with physical disabilities.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Broad overview of sexual health disparities in disabled populations","Highlights interdisciplinary care needs"],"limitations":["Narrative (non‑systematic) review lacking systematic search criteria","No empirical data or quantitative synthesis","No assessment of study quality or bias"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12810"}},{"id":9527,"doi":"10.1353/cpr.2019.0008","pmid":"30956247","pmcid":null,"title":"Youth Voices on the Sexually Transmitted Infection Risk Environment: Community Violence, Chronic Trauma, and Sexual Health Outcomes","authors":"Dolwick Grieb SM, Bergstein R, Griffin B, Jennings JM.","first_author":"Dolwick Grieb SM","journal":"Progress in community health partnerships : research, education, and action","year":2019,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Key informant interviews (n=27) with youth and stakeholders; constant comparison analysis.","sample_n":27,"sample_text":"27 participants","population":"Youth aged 15‑24 in high‑STI Baltimore neighborhoods; stakeholders.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with Baltimore youth and community leaders identified chronic trauma from violence as a major driver of STI risk, shaping short‑term survival priorities and using sex for stress relief. The study calls for structural interventions informed by youth perspectives.","clinical_takeaway":"Address community violence and trauma to reduce STI risk among youth.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Community‑based participatory approach","Youth voices directly captured","Clear thematic analysis"],"limitations":["Small, non‑representative sample","No quantitative measurement of constructs","Limited generalisability"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1353/cpr.2019.0008"}},{"id":9528,"doi":"10.1016/s0968-8080(07)29034-2","pmid":"17531749","pmcid":null,"title":"Sexual health for people living with HIV","authors":"Shapiro K, Ray S.","first_author":"Shapiro K","journal":"Reproductive health matters","year":2007,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Review article offering narrative synthesis of existing literature on sexual health for people living with HIV; no new empirical data presented.","sample_n":null,"sample_text":"Not applicable – narrative review.","population":"People living with HIV (both genders, all ages).","country":"Not specified; likely international focus.","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how social, cultural, and health factors affect the sexual well‑being of people living with HIV and recommends rights‑based, peer‑led education and services to promote safe and satisfying sexual lives.","clinical_takeaway":"Provide accurate, empathetic counseling and peer‑support for sexual health in HIV care.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad overview of sexual health issues for people with HIV.","Emphasizes rights‑based and peer‑education approaches."],"limitations":["Narrative rather than systematic synthesis.","No empirical data; conclusions not based on new analysis."],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":36,"citing_publications":61,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0968-8080(07)29034-2"}},{"id":9529,"doi":"10.1080/00224499.2014.947399","pmid":"25211119","pmcid":null,"title":"Sexual health interventions: a meta-analysis","authors":"Becasen JS, Ford J, Hogben M.","first_author":"Becasen JS","journal":"Journal of sex research","year":2015,"pub_types":["Meta-Analysis","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"meta-analysis of 20 studies, random‑effects model, no explicit risk‑of‑bias assessment reported","sample_n":20,"sample_text":"20 studies included in meta‑analysis","population":"adult, English‑language studies 1996‑2011; selection based on WHO sexual‑health principles","country":"multiple (studies from Medline/PsycINFO)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of 20 studies found that sexual health programs improve knowledge, attitudes and sexual behaviour, with small to moderate effects after outliers are removed.","clinical_takeaway":"Sexual‑health interventions can modestly improve knowledge, attitudes and behaviours; clinicians may consider incorporating evidence‑based programs.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Uses effect‑size metric with confidence intervals","Random‑effects model accounts for heterogeneity","Covers multiple domains (knowledge, attitudes, behavior)"],"limitations":["No explicit risk‑of‑bias assessment reported","Selection based on narrative review may introduce bias","Potential heterogeneity of outcome measures across studies"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":26,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2014.947399"}},{"id":9530,"doi":"10.1080/09638288.2016.1271026","pmid":"28068867","pmcid":null,"title":"Training rehabilitation teams in sexual health care: A description and evaluation of a multidisciplinary intervention","authors":"Pieters R, Kedde H, Bender J.","first_author":"Pieters R","journal":"Disability and rehabilitation","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexuality","Rehabilitation","Education","The Netherlands","Team Training"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pretest-posttest evaluation of a multidisciplinary training programme delivered to six rehabilitation teams; no control group; sample size not reported but likely small","sample_n":null,"sample_text":"Six teams; exact number of participants not specified","population":"rehabilitation professionals (multidisciplinary teams) in the Netherlands","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A training programme for rehabilitation teams in the Netherlands improved staff members' reported knowledge, comfort and activity regarding patients' sexual health, but the study used a small, uncontrolled sample and basic questionnaires.","clinical_takeaway":"Team training can boost staff confidence in addressing sexual health, yet robust evidence on patient outcomes is lacking.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["focus on multidisciplinary team training","pre‑post assessment of knowledge and attitudes","addresses a gap in rehabilitation services"],"limitations":["small, non‑representative sample","no control group or randomisation","reliance on unvalidated self‑report measures"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":46,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09638288.2016.1271026"}},{"id":9531,"doi":"10.1186/s12889-019-7956-x","pmid":"31791323","pmcid":"PMC6888928","title":"Protecting our future generation: study protocol for a randomized controlled trial evaluating a sexual health self-care intervention with Native American youth and young adults","authors":"Lauren T, Catherine S, Rachel C, Hima P, Angelita L, Shauntel L, Laura M, Anna S, Anne R, Mariddie C, Charlotte G.","first_author":"Lauren T","journal":"BMC public health","year":2019,"pub_types":["Clinical Trial Protocol","research-article","Journal Article"],"keywords":["Screening","Youth","Young Adults","Self-care","Risk And Protective Factors","Sexually Transmitted Infection","Native American"],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-019-7956-x","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"rct","design_detail":"randomized controlled trial protocol evaluating a sexual health self‑care intervention among Native American youth (age 14‑26) with follow‑up at 3 and 6 months; primary outcome is objective STI‑screening completion.","sample_n":null,"sample_text":"Not reported in abstract (protocol).","population":"Native American youth and young adults (14‑26 years) from a reservation‑based community, sexually active (vaginal or anal intercourse).","country":"United States (Southwestern reservation).","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A randomized trial will test whether a self‑care toolkit can increase STI screening among Native American teens and young adults by giving them a personal risk assessment and tailored health messages.","clinical_takeaway":"If successful, the toolkit could help clinicians promote STI testing in underserved youth.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Randomized controlled design","Objective primary outcome (STI test completion)","Culturally focused intervention for an underserved population","Pre‑registered with clear primary endpoint"],"limitations":["Sample size not reported in abstract","No explicit measurement of potential psychosocial confounders (e.g., mental health, partner context)","Protocol only – no outcome data yet"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-019-7956-x"}},{"id":9532,"doi":"10.1023/b:aseb.0000026618.16408.e0","pmid":"15129037","pmcid":null,"title":"Sexual health: a useful public health paradigm or a moral imperative?","authors":"Sandfort TG, Ehrhardt AA.","first_author":"Sandfort TG","journal":"Archives of sexual behavior","year":2004,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary/editorial without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how the term \"sexual health\" is increasingly used in public health and education, but its definition remains unclear and may be used to justify controlling sexual behavior. It calls for more scientific debate on the concept.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Broad overview of sexual health concept","Highlights policy and ethical considerations"],"limitations":["No empirical data or systematic review","Lacks operational definitions or measurement","No assessment of confounding variables"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":37,"citing_publications":74,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/b:aseb.0000026618.16408.e0"}},{"id":9535,"doi":"10.1186/s12889-019-8059-4","pmid":"31878901","pmcid":"PMC6933635","title":"Designing an intervention to improve sexual health service use among university undergraduate students: a mixed methods study guided by the behaviour change wheel","authors":"Cassidy C, Steenbeek A, Langille D, Martin-Misener R, Curran J.","first_author":"Cassidy C","journal":"BMC public health","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Reproductive Health","Mixed Methods Research","university students","Sexual Health Services","Theoretical Domains Framework","Behaviour Change Wheel"],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-019-8059-4","cited_by_count":11,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"mixed-methods intervention development, sequential explanatory design, stakeholder consultation, no effectiveness testing","sample_n":null,"sample_text":"mixed methods; quantitative survey and qualitative interviews; exact N not reported in abstract","population":"university undergraduate students (Canada)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors used a theory‑based framework and mixed‑methods research to design an intervention that could help university students use campus sexual‑health services more often.","clinical_takeaway":"Intervention ideas are presented, but effectiveness must be tested before clinical recommendation.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Systematic use of Behaviour Change Wheel","Integration of quantitative and qualitative data","Stakeholder involvement"],"limitations":["No empirical test of the intervention","Sample size and sampling details not provided","No measurement of potential confounders"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":2,"contrasting":0,"mentioning":13,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-019-8059-4"}},{"id":9536,"doi":"10.1007/s00192-018-3603-9","pmid":"29577166","pmcid":null,"title":"An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction","authors":"Rogers RG, Pauls RN, Thakar R, Morin M, Kuhn A, Petri E, Fatton B, Whitmore K, Kingsberg SA, Lee J.","first_author":"Rogers RG","journal":"International urogynecology journal","year":2018,"pub_types":["Journal Article"],"keywords":["Terminology","Female Sexual Health","Female Pelvic Floor Dysfunction"],"is_oa":false,"oa_url":"http://minerva-access.unimelb.edu.au/bitstreams/26fd300f-26dd-5080-9c3f-7ed2d62dec92/download","cited_by_count":56,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Consensus terminology report produced by expert committees; no empirical data collected.","sample_n":null,"sample_text":"Not applicable – no participant sample","population":"Women with pelvic floor dysfunction (conceptual focus)","country":"International (authors from multiple countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A joint IUGA/ICS report creates a standardized set of terms for describing sexual health in women with pelvic floor problems, aiming to reduce confusion and improve research and clinical communication.","clinical_takeaway":"Clinicians can use the new terminology to describe sexual health issues consistently, but the definitions have not been empirically validated.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large expert consensus effort","Over 100 definitions clarified","Intended to improve communication across clinicians and researchers"],"limitations":["No empirical data; no validation of terminology","Potential bias from committee members' perspectives","Limited applicability until adopted broadly"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":87,"citing_publications":104,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00192-018-3603-9"}},{"id":9537,"doi":"10.1016/j.socscimed.2019.01.022","pmid":"30682572","pmcid":null,"title":"A qualitative study on intersectional stigma and sexual health among women on opioid substitution treatment in England: Implications for research, policy and practice","authors":"Medina-Perucha L, Scott J, Chapman S, Barnett J, Dack C, Family H.","first_author":"Medina-Perucha L","journal":"Social science & medicine (1982)","year":2019,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Inequalities","Sexual Health","Sexually Transmitted Infections","Opioid Substitution Treatment","Women's Studies","Blood-borne Viruses","Intersectionality Theory","Intersectional Stigma"],"is_oa":false,"oa_url":null,"cited_by_count":33,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study","sample_n":20,"sample_text":"Twenty semi-structured interviews","population":"Women receiving opioid substitution treatment in South West England (N=20)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 20 women on opioid substitution treatment in England revealed that intersecting stigma related to gender, drug use, sex work, homelessness and health status hampers condom use and access to sexual health services.","clinical_takeaway":"Addressing multiple layers of stigma may improve condom use and health‑service engagement for women on opioid substitution treatment.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["In‑depth, interview‑based insight into lived experiences","Use of established Framework Analysis for qualitative rigour"],"limitations":["Small, non‑representative convenience sample","No quantitative measures of stigma, sexual health or mental health","Findings limited to women on OST in one UK region"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":46,"citing_publications":56,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.socscimed.2019.01.022"}},{"id":9539,"doi":"10.1016/j.jpag.2020.02.012","pmid":"32145377","pmcid":null,"title":"Healthcare Clinician and Staff Perspectives on Facilitators and Barriers to Ideal Sexual Health Care to High-Risk Depressed Young Women: A Qualitative Study of Diverse Clinic Systems","authors":"Katz-Wise SL, Gordon AR, Burke PJ, Jonestrask C, Shrier LA.","first_author":"Katz-Wise SL","journal":"Journal of pediatric and adolescent gynecology","year":2020,"pub_types":["Multicenter Study","Journal Article"],"keywords":["Depression","Adolescent","Women","Sexual Health","Reproductive Health Care","Clinic Systems"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative semi‑structured interviews with 28 clinicians/staff across 7 clinics; thematic analysis.","sample_n":28,"sample_text":"28 clinicians and staff (4 per clinic) from seven diverse clinics.","population":"Clinicians and clinic staff serving depressed young women (age ~18‑25) in New England US clinics.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 28 clinicians and staff revealed that trust, communication, integrated care, training, and supportive policies help, while stigma, time pressure, scheduling limits, funding cuts, and mental‑health stigma hinder optimal sexual and reproductive health care for depressed young women.","clinical_takeaway":"Addressing stigma, improving provider‑patient communication, and integrating mental‑health with sexual‑health services can enhance care for depressed young women.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Multiple clinics increase contextual breadth","Two independent coders improve reliability","Clear socio‑ecological framing"],"limitations":["Small, non‑random sample of clinicians","No patient perspectives","Findings limited to New England region"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpag.2020.02.012"}},{"id":9540,"doi":"10.1097/pec.0000000000000285","pmid":"26727196","pmcid":"PMC6533612","title":"Brief Behavioral Intervention to Improve Adolescent Sexual Health: A Feasibility Study in the Emergency Department","authors":"Miller MK, Champassak S, Goggin K, Kelly P, Dowd MD, Mollen CJ, Humiston SG, Linebarger J, Apodaca T.","first_author":"Miller MK","journal":"Pediatric emergency care","year":2016,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Feasibility study with pre‑post surveys of 20 adolescents in a single pediatric ED; no control group; short follow‑up (3 months).","sample_n":20,"sample_text":"20 participants who completed the brief MI‑based intervention.","population":"Adolescents (14‑19 y) presenting to a Midwestern pediatric emergency department, sexually active (n≈20).","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A brief motivational‑interviewing session delivered in a pediatric emergency department was tested with 20 adolescents. Most liked the session and many used condoms afterward, showing the approach can be delivered and may help youths access sexual‑health services.","clinical_takeaway":"Brief MI in the ED appears feasible and may increase condom use, but larger controlled trials are needed before routine implementation.","confidence":0.7,"topic_tags":["adolescents","sexual_function","csbd"],"strengths":["Novel use of brief MI in ED setting","High participant satisfaction","Demonstrates feasibility of linking youths to services"],"limitations":["Very small, non‑representative sample (n=20)","No control/comparison group","Reliance on self‑report, limited validation of measures"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":12,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/pec.0000000000000285"}},{"id":9542,"doi":"10.1177/0956462417746897","pmid":"29334885","pmcid":null,"title":"2016 United Kingdom national guideline on the sexual health care of men who have sex with men","authors":"Clutterbuck D, Asboe D, Barber T, Emerson C, Field N, Gibson S, Hughes G, Jones R, Murchie M, Nori AV, Rayment M, Sullivan A.","first_author":"Clutterbuck D","journal":"International journal of STD & AIDS","year":2018,"pub_types":["Journal Article"],"keywords":["Men","Bacterial disease","Prevention","Treatment","Viral disease","Homosexual"],"is_oa":false,"oa_url":null,"cited_by_count":50,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"Guideline development using systematic searches and GRADE; no original empirical data collected.","sample_n":null,"sample_text":"Not applicable – guideline based on literature synthesis","population":"Men who have sex with men (MSM) attending sexual health services in the UK","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The 2016 UK guideline offers evidence‑based recommendations for sexual health care of men who have sex with men, covering STI prevention, HIV, and service delivery, based on systematic literature reviews and expert input.","clinical_takeaway":"Clinicians should follow the guideline’s evidence‑graded recommendations when providing sexual health services to MSM.","confidence":0.9,"topic_tags":["sexual_function","prevalence"],"strengths":["Comprehensive literature search across multiple databases","Use of GRADE system for evidence appraisal","Stakeholder and public consultation incorporated"],"limitations":["No primary data collected; relies on existing studies","Potentially limited to English‑language sources","Does not address pornography‑related constructs directly"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":1,"mentioning":108,"citing_publications":79,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0956462417746897"}},{"id":9543,"doi":"10.1089/jwh.2016.6208","pmid":"29267150","pmcid":"PMC5865249","title":"Association of ß-hCG Surveillance with Emotional, Reproductive, and Sexual Health in Women Treated for Gestational Trophoblastic Neoplasia","authors":"Jewell EL, Aghajanian C, Montovano M, Lewin SN, Baser RE, Carter J.","first_author":"Jewell EL","journal":"Journal of women's health (2002)","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexuality","Emotional Function","ß-hcg","Reproductive Concerns","Gestation Trophoblastic Neoplasia"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 51 GTN survivors recruited from a single institution; cross‑sectional questionnaire using validated scales.","sample_n":51,"sample_text":"Convenience sample of survivors (1996‑2008) surveyed 2018","population":"Women treated for gestational trophoblastic neoplasia, age 37 ± years, N = 51","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Women who survived a rare pregnancy‑related cancer reported ongoing emotional distress, reproductive worries, and reduced sexual desire, especially when they were highly worried about ongoing hormone monitoring.","clinical_takeaway":"High anxiety about post‑treatment monitoring may impair sexual desire and reproductive plans; address monitoring‑related worry in survivorship care.","confidence":0.85,"topic_tags":["sexual_function","religiosity","csbd"],"strengths":["Use of validated sexual and reproductive health instruments","Inclusion of depression and dyadic relationship item","Focus on a clinically underserved survivor group"],"limitations":["Small, single‑site convenience sample (N=51)","Cross‑sectional design precludes causal inference","Limited control for key confounds (e.g., trauma, masturbation, moral factors)"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":4,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/jwh.2016.6208"}},{"id":9544,"doi":"10.1590/1413-81232015215.26842015","pmid":"27166902","pmcid":null,"title":"Lines of male care geared to sexual health, reproduction and paternity","authors":"Gomes R, Albernaz L, Ribeiro CR, Moreira MC, Nascimento M.","first_author":"Gomes R","journal":"Ciencia & saude coletiva","year":2016,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"http://www.scielo.br/pdf/csc/v21n5/en_1413-8123-csc-21-05-1545.pdf","cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary/position paper proposing principles for male involvement in prenatal care; no empirical data collected.","sample_n":null,"sample_text":"None – paper reports expert consensus rather than a study sample.","population":"Not applicable (no participants)","country":"Brazil (journal language suggests Brazilian authors)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper proposes principles for involving men in sexual health, reproduction, and paternity, especially during prenatal care, based on expert consensus rather than new research data.","clinical_takeaway":"None – the article offers conceptual guidance, not evidence for clinical practice.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Addresses male role in sexual health and prenatal care","Involves expert consensus process"],"limitations":["No empirical data or measurement of outcomes","Lacks operational definitions or validated instruments","No assessment of potential confounding factors"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1590/1413-81232015215.26842015"}},{"id":9545,"doi":"10.1002/nau.23508","pmid":"29441607","pmcid":null,"title":"An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction","authors":"Rogers RG, Pauls RN, Thakar R, Morin M, Kuhn A, Petri E, Fatton B, Whitmore K, Kinsberg S, Lee J.","first_author":"Rogers RG","journal":"Neurourology and urodynamics","year":2018,"pub_types":["Review","Journal Article"],"keywords":["Terminology","Female Sexual Health","Female Pelvic Floor Dysfunction"],"is_oa":false,"oa_url":null,"cited_by_count":70,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Consensus terminology report compiled by expert committees; no primary empirical data.","sample_n":null,"sample_text":"Not applicable – expert consensus rather than participant sample.","population":"Women with pelvic floor dysfunction; expert committee members.","country":"International (expert committees from multiple societies)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"An expert group from two international urogynecological societies created a consensus document defining more than 100 terms related to sexual health in women with pelvic floor problems, aiming to standardise language for clinicians and researchers.","clinical_takeaway":"Use the standardized terms from this report to improve communication and documentation of sexual health issues in women with pelvic floor dysfunction.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large number of expert contributors","Comprehensive collection of >100 definitions","Intended to harmonise terminology across societies"],"limitations":["No empirical data to test definitions","Potential lack of input from end‑users (patients)","Consensus may reflect dominant viewpoints rather than evidence"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":127,"citing_publications":156,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/nau.23508"}},{"id":9546,"doi":"10.1111/hsc.12355","pmid":"27125476","pmcid":null,"title":"Social determinants in the sexual health of adolescent Aboriginal Australians: a systematic review","authors":"MacPhail C, McKay K.","first_author":"MacPhail C","journal":"Health & social care in the community","year":2018,"pub_types":["Systematic Review","Journal Article"],"keywords":["Adolescents","Sexual Health","Social Determinants","Aboriginal","Torres Strait"],"is_oa":false,"oa_url":null,"cited_by_count":18,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"qualitative systematic review of 14 studies focusing on social determinants of sexual health among Aboriginal and Torres Strait Islander adolescents","sample_n":null,"sample_text":"Fourteen studies included in qualitative synthesis","population":"Adolescent Aboriginal and Torres Strait Islander Australians","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 14 studies found that factors such as poverty, limited healthcare access, substance use, education gaps, and cultural context increase sexual health risks for Aboriginal Australian teenagers. Community‑led, culturally appropriate programs are needed.","clinical_takeaway":"Addressing broader social and cultural factors is essential for improving sexual health outcomes in Indigenous adolescents.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Systematic search across multiple databases","Focus on culturally relevant community-led interventions","Identifies a broad range of social determinants"],"limitations":["Only qualitative synthesis, no meta‑analysis","Limited to English‑language studies up to 2015","Potential heterogeneity of primary studies not quantified"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":33,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/hsc.12355"}},{"id":9547,"doi":"10.1177/1524839916667382","pmid":"27609623","pmcid":null,"title":"A Culturally Responsive Approach to Improving Replication of a Youth Sexual Health Program","authors":"Mwaria M, Chen C, Coppola N, Maurice I, Phifer M.","first_author":"Mwaria M","journal":"Health promotion practice","year":2016,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Randomized Controlled Trial","Journal Article"],"keywords":["Observation","Replication","Implementation","Learning Environment","Classroom Management","Evidence-based Intervention","Facilitator Training","Culturally Responsive","Sexual Health Program"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized controlled trial of a youth sexual health education program with culturally responsive implementation strategies","sample_n":null,"sample_text":"Not specified in abstract","population":"adolescents in a diverse, urban US setting","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study reports how a sexual health curriculum was adapted for culturally diverse youth using a responsive teaching framework, showing which strategies helped implementation and which were challenging.","clinical_takeaway":"Culturally tailored sexual health education can be delivered without changing core content, but outcomes and confounder effects need clearer reporting.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["RCT design","Focus on cultural responsiveness","Practical implementation guidance"],"limitations":["No detail on outcome measures or effect sizes","Confounders such as moral attitudes not addressed","Sample size and power unclear"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1524839916667382"}},{"id":9548,"doi":"10.1111/jocn.14085","pmid":"28960627","pmcid":null,"title":"When holistic care is not holistic enough: The role of sexual health in mental health settings","authors":"Hendry A, Snowden A, Brown M.","first_author":"Hendry A","journal":"Journal of clinical nursing","year":2018,"pub_types":["Systematic Review","Journal Article"],"keywords":["Sex","Review","Nursing","Mental health","Education","Sexual Health","Service Provision","Attitudes","Barriers"],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Meta-ethnographic synthesis of 7 qualitative studies on mental health nurses’ preparation to address sexual health.","sample_n":7,"sample_text":"Seven primary qualitative studies were included in the synthesis.","population":"Mental health nursing staff (qualitative study participants).","country":"Not specified (multiple studies).","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of seven qualitative studies shows mental‑health nurses often feel uneasy about discussing sexual health with patients, with personal values and lack of training creating barriers.","clinical_takeaway":"Nurse education should include structured training on sexual health to improve care for mental‑health patients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Systematic search across multiple databases","Use of meta‑ethnography to synthesize qualitative findings","Identification of clear thematic barriers"],"limitations":["Small number of eligible studies (n=7)","No quantitative data; limited statistical appraisal","Potential selection bias in primary qualitative studies"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":46,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jocn.14085"}},{"id":9549,"doi":"10.1071/sh11170","pmid":"23036783","pmcid":null,"title":"Court-based participatory research: collaborating with the justice system to enhance sexual health services for vulnerable women in the United States","authors":"Roth A, Fortenberry JD, Van Der Pol B, Rosenberger J, Dodge B, Arno J, Waters J, Certo D, Reece M.","first_author":"Roth A","journal":"Sexual health","year":2012,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups and semi‑structured interviews with court‑involved women and staff; community‑based participatory research framework","sample_n":null,"sample_text":"Six focus groups (participants not quantified in abstract)","population":"court‑involved women with history of commercial sex work in Indiana, USA; staff and service providers","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Researchers worked with a community court to develop a program encouraging STI testing for women involved in the justice system, using focus groups and participatory methods to identify needs and feasible service components.","clinical_takeaway":"Court‑based partnerships may improve STI screening access for high‑risk, justice‑involved women.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Community‑based participatory approach","Involves both service users and providers","Identifies practical program features"],"limitations":["Qualitative, small convenience sample","No quantitative outcome data","Limited generalizability beyond the specific court setting"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":8,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh11170"}},{"id":9550,"doi":"10.1097/gme.0000000000001138","pmid":"29870471","pmcid":null,"title":"The role of androgens in the treatment of genitourinary syndrome of menopause (GSM): International Society for the Study of Women's Sexual Health (ISSWSH) expert consensus panel review","authors":"Simon JA, Goldstein I, Kim NN, Davis SR, Kellogg-Spadt S, Lowenstein L, Pinkerton JV, Stuenkel CA, Traish AM, Archer DF, Bachmann G, Goldstein AT, Nappi RE, Vignozzi L.","first_author":"Simon JA","journal":"Menopause (New York, N.Y.)","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Consensus Statement","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":89,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Expert consensus (modified Delphi) without primary empirical data; no new sample collected.","sample_n":null,"sample_text":"No participant data; consensus among experts.","population":"International expert panel (14 clinicians/researchers)","country":"International","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"A panel of 14 international experts reviewed evidence and agreed that vaginal dehydroepiandrosterone and possibly testosterone can help treat menopausal genitourinary symptoms like painful intercourse, but more research is needed.","clinical_takeaway":"Vaginal DHEA may improve dyspareunia in menopause; testosterone shows promise but lacks sufficient study.","confidence":0.8,"topic_tags":["gender","sexual_function"],"strengths":["Multidisciplinary expert panel","Use of modified Delphi process for consensus"],"limitations":["No primary empirical data","Potential bias from expert opinions","Limited applicability to individual patient outcomes"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":3,"contrasting":0,"mentioning":64,"citing_publications":143,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/gme.0000000000001138"}},{"id":9551,"doi":"10.1097/qad.0000000000000905","pmid":"26562815","pmcid":null,"title":"Resilience among gay/bisexual young men in Western Kenya: psychosocial and sexual health outcomes","authors":"Harper GW, Wade RM, Onyango DP, Abuor PA, Bauermeister JA, Odero WW, Bailey RC.","first_author":"Harper GW","journal":"AIDS (London, England)","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Observational Study"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional observational study of 511 young GBMSM recruited via community mobilisation in Western Kenya; hierarchical linear regression of intrapersonal/interpersonal predictors on psychosocial and sexual health outcomes.","sample_n":511,"sample_text":"511 participants recruited from nine communities using community‑based mobilisation.","population":"GBMSM, ages 18‑29, Kenya (N=511)","country":"Kenya","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Among 511 gay, bisexual and other MSM youths in Western Kenya, factors like loneliness, internalised stigma and trauma were linked to lower psychological well‑being, self‑esteem, condom use and HIV testing. Social support and self‑esteem predicted better outcomes.","clinical_takeaway":"Interventions that boost social support and address trauma may improve HIV‑prevention behaviours in young GBMSM.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a hard‑to‑reach population","Multiple resilience outcomes examined","Use of hierarchical regression to test intrapersonal & interpersonal predictors"],"limitations":["Cross‑sectional design limits causal inference","Convenience recruitment may bias toward more engaged individuals","Limited reporting of psychometric properties or effect‑size confidence intervals"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":33,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/qad.0000000000000905"}},{"id":9552,"doi":"10.7748/ns2014.02.28.23.11.s12","pmid":"24494875","pmcid":null,"title":"New sexual health commissioning framework will integrate services","authors":"Gillen S.","first_author":"Gillen S.","journal":"Nursing standard (Royal College of Nursing (Great Britain) : 1987)","year":2014,"pub_types":["News"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"News article describing policy development; no empirical data collected.","sample_n":null,"sample_text":"Not applicable – article reports on a commissioned framework, not a study sample.","population":"Public health nurses and policy makers in the United Kingdom (implicit).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reports that a new national framework will be created to integrate HIV, sexual and reproductive health services in the UK, aiming to reduce fragmented care.","clinical_takeaway":"None – the piece describes policy planning, not clinical evidence.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Clear description of policy initiative","Relevant to sexual health service integration"],"limitations":["No empirical data or analysis","No measurement of outcomes or constructs","Cannot inform evidence on pornography or compulsive sexual behaviour"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.7748/ns2014.02.28.23.11.s12"}},{"id":9553,"doi":"10.3402/gha.v9.32193","pmid":"27649758","pmcid":"PMC5030258","title":"Use of social media for sexual health promotion: a scoping review","authors":"Gabarron E, Wynn R.","first_author":"Gabarron E","journal":"Global health action","year":2016,"pub_types":["Scoping Review","review-article","Journal Article"],"keywords":["Health education","Sexual Health","Health Promotion","Sexually Transmitted Infections","Social Media","Social Networking Sites"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5030258","cited_by_count":122,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Scoping review mapping 51 publications; descriptive classification without risk‑of‑bias assessment.","sample_n":null,"sample_text":"51 included publications; 4 RCTs, 39 non‑randomized interventions, 8 observational studies","population":"publications on social‑media sexual‑health interventions; includes youth and adult studies","country":"global (no single country reported)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The review maps 51 studies that used social‑media platforms, mainly Facebook, to promote sexual health. About a quarter reported behavior change or fewer STI cases, but most studies have weak designs and lack theoretical grounding.","clinical_takeaway":"Social media can reach youths for sexual‑health messages, but clinicians should rely on interventions with solid experimental evidence.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive search across databases and grey literature","Provides overview of study designs and target audiences","Identifies gaps and need for stronger designs"],"limitations":["No quantitative synthesis or risk‑of‑bias assessment","Limited appraisal of intervention effectiveness","Potential publication bias not addressed"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":6,"contrasting":3,"mentioning":153,"citing_publications":218,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3402/gha.v9.32193"}},{"id":9554,"doi":"10.1016/j.puhe.2016.05.018","pmid":"27372230","pmcid":null,"title":"Redesign and commissioning of sexual health services in England - a qualitative study","authors":"Walker IF, Leigh-Hunt N, Lee ACK.","first_author":"Walker IF","journal":"Public health","year":2016,"pub_types":["Journal Article"],"keywords":["Public Health","Sexual Health","Procurement","Qualitative Research","Local Government"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"semi-structured interviews with 13 local authority sexual health commissioners; thematic analysis","sample_n":13,"sample_text":"13 participants (11 interviews) who were local authority sexual health commissioners","population":"sexual health commissioners in Yorkshire and the Humber, England","country":"England","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 13 English local‑authority officials identified practical challenges and key factors—such as expertise, governance, and outcome focus—that influence the redesign and commissioning of sexual health services.","clinical_takeaway":"None – the study provides organisational insights rather than clinical guidance.","confidence":0.8,"topic_tags":["sexual_function","religiosity"],"strengths":["Rich, in‑depth insights from commissioners","Clear thematic analysis of real‑world implementation issues","Practical recommendations for future commissioning"],"limitations":["Small, non‑representative sample of commissioners","Findings may not generalise beyond Yorkshire/Humber region","No quantitative assessment of service outcomes"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.puhe.2016.05.018"}},{"id":9555,"doi":"10.1186/s40695-015-0007-6","pmid":"30766693","pmcid":"PMC6214215","title":"Impact of urinary incontinence on female sexual health in women during midlife","authors":"Chu CM, Arya LA, Andy UU.","first_author":"Chu CM","journal":"Women's midlife health","year":2015,"pub_types":["review-article","Review","Journal Article"],"keywords":["Sexual function","Treatment outcome","Urinary incontinence","Sexual dysfunction","Middle aged","Stress Urinary Incontinence","Coital Incontinence","Urge Urinary Incontinence"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6214215","cited_by_count":19,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative literature review without systematic methods; no primary data","sample_n":null,"sample_text":"no primary participants; review of other studies","population":"women in midlife with urinary incontinence (no sample size reported)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","selective_reporting"],"stance":"neutral","citation_value":"background","plain_summary":"This review summarises how urinary incontinence in middle‑aged women can hurt sexual desire, satisfaction and orgasm, and notes that treating incontinence (pelvic exercises, surgeries or medicines) may improve those aspects, although the underlying studies are few and of low quality.","clinical_takeaway":"Treating urinary incontinence may help improve sexual function, but clinicians should note the limited evidence base.","confidence":0.8,"topic_tags":["sexual_function","treatment"],"strengths":["Broad overview of urinary incontinence treatments","Highlights gap in high‑quality research"],"limitations":["Narrative, non‑systematic review","No quantitative synthesis or bias assessment","Limited discussion of psychological confounds"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":3,"contrasting":0,"mentioning":23,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s40695-015-0007-6"}},{"id":9556,"doi":"10.1111/1753-6405.12543","pmid":"27372062","pmcid":null,"title":"Changes in the sexual health behaviours of New Zealand secondary school students, 2001-2012: findings from a national survey series","authors":"Clark TC, Lucassen MF, Fleming T, Peiris-John R, Ikihele A, Teevale T, Robinson E, Crengle S.","first_author":"Clark TC","journal":"Australian and New Zealand journal of public health","year":2016,"pub_types":["Journal Article"],"keywords":["Contraception","Adolescent","Condoms","Māori","Sexual And Reproductive Health Services"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Repeated cross‑sectional nationally representative surveys (2001, 2007, 2012) with logistic regression trend analysis","sample_n":27406,"sample_text":"Nationally representative health and wellbeing surveys of secondary school students in 2001 (n=9,699), 2007 (n=9,107) and 2012 (n=8,500)","population":"New Zealand secondary school students (≈9,000 each wave)","country":"New Zealand","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"New Zealand secondary school students between 2001 and 2012 were less likely to have started having sex and fewer reported STIs, but they also used condoms and contraception less consistently, especially among Māori, Pacific, Asian and low‑income groups.","clinical_takeaway":"Youth sexual health programs should focus on improving consistent condom and contraceptive use, targeting underserved groups.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Large, nationally representative repeated samples","Standardised questionnaire items for sexual behaviour","Clear trend analysis using logistic regression"],"limitations":["Self‑report may be subject to social desirability bias","No adjustment for mental‑health or moral variables","Effect sizes (e.g., odds ratios with CIs) not fully reported in abstract"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/1753-6405.12543"}},{"id":9558,"doi":"10.2196/13462","pmid":"31172957","pmcid":"PMC6592518","title":"An Affirmative Coping Skills Intervention to Improve the Mental and Sexual Health of Sexual and Gender Minority Youth (Project Youth AFFIRM): Protocol for an Implementation Study","authors":"Craig SL, McInroy LB, Eaton AD, Iacono G, Leung VW, Austin A, Dobinson C.","first_author":"Craig SL","journal":"JMIR research protocols","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Youth","Coping Behavior","Cognitive Behavioral Therapy","Implementation Science","Pragmatic Clinical Trial","Sexual And Gender Minorities"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6592518","cited_by_count":20,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"stepped wedge wait‑list crossover pragmatic trial","sample_n":300,"sample_text":"target sample is 300 participants","population":"Sexual and gender minority youth (SGMY), aged 14‑29, recruited via community agencies and online","country":"Canada","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"This protocol describes a large, community‑based trial testing an 8‑session CBT group (AFFIRM) for sexual‑ and gender‑minority youth. The program aims to lower mental‑health distress, reduce risky sexual behavior, and boost coping and sexual self‑efficacy, with assessments up to 12 months post‑intervention.","clinical_takeaway":"If effective, AFFIRM could provide a scalable CBT‑based group to improve mental and sexual health among SGM youth.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large planned sample (N=300)","Pragmatic stepped‑wedge design with wait‑list control","Use of validated psychosocial scales (presumed)","Implementation focus across multiple community sites"],"limitations":["No measurement of moral incongruence or masturbation, key confounds for porn‑related outcomes","Protocol only – no outcome data yet","Potential self‑selection bias from community‑based recruitment"],"rubric_version":"2.0","raw_total":36,"max_possible":50,"pct_score":72,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":4,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":30,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/13462"}},{"id":9560,"doi":"10.1136/sextrans-2016-053000","pmid":"28356437","pmcid":null,"title":"Getting the terminology right in sexual health research: the importance of accurately classifying fuck buddies among men who have sex with men","authors":"Bellhouse C, Walker S, Fairley CK, Chow EP, Bilardi JE.","first_author":"Bellhouse C","journal":"Sexually transmitted infections","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual behaviour","Health Promotion","Gay Men","Qualitative Research","Clinical Sti Care"],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"30 semi‑structured interviews with MSM at a single sexual health clinic (convenience sample). The study provides thematic insight but lacks generalisability.","sample_n":30,"sample_text":"Thirty participants recruited from a sexual health clinic; not randomly selected.","population":"Men who have sex with men (MSM) attending Melbourne Sexual Health Centre, Australia","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 30 gay men revealed that the term “fuck buddy” is used inconsistently; some view it as casual, others as a distinct category. Better definitions are needed for research and public‑health interventions.","clinical_takeaway":"Clinicians should clarify partner categories with patients, as terminology may affect risk assessment.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Direct quotes from target population","Highlights ambiguity in commonly used terminology","Relevant for public‑health messaging"],"limitations":["Small, non‑representative sample","No systematic validation of interview guide","Findings limited to one clinic in Australia"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":7,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/sextrans-2016-053000"}},{"id":9561,"doi":"10.1080/13691058.2014.937462","pmid":"25036591","pmcid":null,"title":"Unveiling the silence: women's sexual health and experiences in Nepal","authors":"Menger LM, Kaufman MR, Harman JJ, Tsang SW, Shrestha DK.","first_author":"Menger LM","journal":"Culture, health & sexuality","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["HIV/AIDS","Nepal","Women's Health","Sexual Health","Stis","Gender Norms"],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative interview and focus‑group study with 25 Kathmandu women; thematic analysis of transcribed data.","sample_n":25,"sample_text":"Convenience sample; recruitment method not specified beyond location.","population":"Women (young adult) living in Kathmandu, Nepal (n=25).","country":"Nepal","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 25 women in Kathmandu reveal that sex is viewed as a male domain, discussions of sexual health are taboo, and formal sex education is lacking. These cultural barriers may increase women's HIV/STI risk.","clinical_takeaway":"Sexual health programs in Nepal should address cultural taboos and improve comprehensive education for women.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Provides culturally specific qualitative insight.","Uses independent coders and thematic analysis.","Highlights gaps in sex education and gender norms."],"limitations":["Small, non‑representative convenience sample.","No validated measurement instruments.","Findings not generalizable beyond Kathmandu women."],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691058.2014.937462"}},{"id":9563,"doi":"10.5820/aian.2304.2016.16","pmid":"27536896","pmcid":"PMC5463740","title":"Identifying sexual health protective factors among Northern Plains American Indian youth: An ecological approach utilizing multiple perspectives","authors":"Griese ER, Kenyon DB, McMahon TR.","first_author":"Griese ER","journal":"American Indian and Alaska native mental health research (Online)","year":2016,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"community‑based participatory qualitative study using focus groups and interviews","sample_n":185,"sample_text":"185 community members","population":"American Indian youth, parents, elders, providers, school staff (N≈185)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers talked with AI youth, parents, elders, and service providers to find what helps protect teens from risky sexual behavior. School, family, and cultural traditions emerged as key supportive systems.","clinical_takeaway":"Strengthening school, family, and cultural connections may reduce teen pregnancy risk in AI communities.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Community‑based participatory approach","Multiple stakeholder perspectives","Large enough qualitative sample for thematic saturation"],"limitations":["No quantitative measurement of constructs","Findings not generalisable beyond the specific AI communities","No assessment of potential mental‑health confounders"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":26,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5820/aian.2304.2016.16"}},{"id":9564,"doi":"10.1093/her/cyw013","pmid":"27081188","pmcid":null,"title":"Exploring sexual health among young Black men who have sex with men in New York City","authors":"Martos AJ, Valera P, Bockting WO, Wilson PA.","first_author":"Martos AJ","journal":"Health education research","year":2016,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative content analysis of interview data from the Brothers Connect Study; sample size not reported in abstract.","sample_n":null,"sample_text":"Not provided in abstract; likely convenience sample of YBMSM participants","population":"Young Black men who have sex with men in New York City, USA","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with young Black gay men in New York City revealed that race, disclosure, sexual practices, daily challenges, and personal identity shape their sexual health needs. A broader sexual‑health framework, beyond just HIV risk, is recommended for future programmes.","clinical_takeaway":"Programs for young Black MSM should address cultural, identity, and everyday stressors, not only HIV risk.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Focus on under‑researched population","Uses a theoretically‑driven sexual health model","Identifies multiple contextual themes"],"limitations":["No quantitative measures or validated scales reported","Sample size and recruitment methods unclear","No assessment of key confounds (e.g., mental health, moral factors)","Findings may not generalise beyond the specific community"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/her/cyw013"}},{"id":9565,"doi":"10.1186/s12884-018-1859-1","pmid":"29884139","pmcid":"PMC5994100","title":"Determinants of adolescent pregnancy and access to reproductive and sexual health services for married and unmarried adolescents in rural Lao PDR: a qualitative study","authors":"Sychareun V, Vongxay V, Houaboun S, Thammavongsa V, Phummavongsa P, Chaleunvong K, Durham J.","first_author":"Sychareun V","journal":"BMC pregnancy and childbirth","year":2018,"pub_types":["research-article","Journal Article"],"keywords":["Adolescent","Maternal Health","Sexual And Reproductive Health","Determinants Teen Pregnancy"],"is_oa":true,"oa_url":"https://bmcpregnancychildbirth.biomedcentral.com/track/pdf/10.1186/s12884-018-1859-1.pdf","cited_by_count":55,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative interviews and focus groups with adolescents, parents, community leaders and health providers in rural Lao PDR; thematic analysis","sample_n":null,"sample_text":"Six focus groups (13‑19 yr), 20 in‑depth interviews (12‑19 yr), plus 8 husbands, 9 mothers‑in‑law, 17 health providers, 12 community leaders","population":"adolescent mothers and unmarried adolescents aged 12‑19 in rural Lao PDR; plus husbands, mothers‑in‑law, health providers, community leaders","country":"Lao PDR","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with rural Lao teenagers, their families and health workers show that early marriage, permissive attitudes toward premarital sex, limited knowledge about reproductive health, and poor service access all contribute to high teen pregnancy rates.","clinical_takeaway":"Improving sexual education and service accessibility is key to reducing teen pregnancy in rural Lao.","confidence":0.6,"topic_tags":["adolescents","sexual_function","religiosity","moral_incongruence"],"strengths":["In‑depth, multi‑perspective qualitative data","Includes voices of adolescents, families and providers","Context‑specific insight for rural Lao"],"limitations":["No validated quantitative measures of sexual behaviour","Findings not statistically generalizable","Potential selection bias in participant recruitment"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":17,"contrasting":0,"mentioning":105,"citing_publications":139,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12884-018-1859-1"}},{"id":9566,"doi":"10.1016/j.annepidem.2013.07.005","pmid":"23932068","pmcid":null,"title":"Sexual health and socioeconomic-related factors in Spain","authors":"Ruiz-Muñoz D, Wellings K, Castellanos-Torres E, Álvarez-Dardet C, Casals-Cases M, Pérez G.","first_author":"Ruiz-Muñoz D","journal":"Annals of epidemiology","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexuality","Health","Contraception","Satisfaction","Safe Sex","Sex Offenses"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Population‑based survey of 4,897 sexually active adults (16‑44 y) in Spain, assessing sexual satisfaction, safe‑sex practices and sexual abuse, with logistic regression analyses of socioeconomic predictors.","sample_n":4897,"sample_text":"2365 women and 2532 men aged 16‑44 years, population‑based cross‑sectional sample.","population":"Sexually active men and women aged 16‑44 residing in Spain (n≈5,000).","country":"Spain","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A nationwide Spanish survey of 5,000 adults found most people are satisfied with their sex lives and practice safe sex, but those with lower socioeconomic status report less satisfaction, more unsafe practices, and higher rates of sexual abuse.","clinical_takeaway":"Clinicians should consider socioeconomic context when addressing sexual health and safety with patients.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Multivariate logistic regression","Multiple socioeconomic variables examined"],"limitations":["Reliance on self‑report questionnaires with unclear validation","Cross‑sectional design limits causal inference","Key sexual‑health constructs not measured with standardized scales"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":29,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.annepidem.2013.07.005"}},{"id":9567,"doi":"10.3310/phr03130","pmid":"26583166","pmcid":null,"title":"Sexual health promotion for young people delivered via digital media: a scoping review","authors":"Bailey J, Mann S, Wayal S, Hunter R, Free C, Abraham C, Murray E.","first_author":"Bailey J","journal":"NIHR Journals Library, Southampton (UK)","year":2015,"pub_types":["Review"],"keywords":[],"is_oa":true,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"scoping review of 19 RCTs of interactive digital interventions for sexual health promotion in young people (13‑24) in the UK; integrates trial outcomes with stakeholder views; no formal systematic review methods reported","sample_n":null,"sample_text":"19 RCTs identified; total participants not specified in abstract","population":"young people aged 13‑24 years, UK","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A scoping review of 19 trials finds that digital programmes can improve sexual‑health knowledge and modestly increase safe sexual behaviours among 13‑24‑year‑olds, but evidence on attitudes, biological outcomes, and cost‑effectiveness is limited.","clinical_takeaway":"Digital sexual‑health tools can boost knowledge and modestly influence behaviour, but clinicians should note the limited evidence on health outcomes and cost‑effectiveness.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Synthesises evidence from multiple RCTs","Highlights gaps in cost‑effectiveness data","Integrates perspectives of youth, parents, and experts"],"limitations":["Not a systematic review; risk‑of‑bias not assessed","No quantitative meta‑analysis of effect sizes beyond reporting SMDs","Limited detail on intervention characteristics and measurement tools"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":150,"citing_publications":163,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3310/phr03130"}},{"id":9568,"doi":"10.1080/15546128.2015.1009596","pmid":"27081375","pmcid":"PMC4829363","title":"Discovering Sexual Health Conversations between Adolescents and Youth Development Professionals","authors":"Gupta N, Chandak A, Gilson G, Pelster AK, Schober DJ, Goldsworthy R, Baldwin K, Fortenberry JD, Fisher C.","first_author":"Gupta N","journal":"American journal of sexuality education","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Sexuality","Adolescents","Conversations","Sexual Health","Siecus","Youth Development Professionals"],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative interviews with youth development professionals; convenience sample; thematic analysis","sample_n":null,"sample_text":"Not reported in abstract","population":"Youth development professionals (community‑based organizations) reporting on adolescent conversations","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study interviewed community youth workers to learn what sexual‑health topics teens discuss with them, mapping these conversations onto a national sexuality‑education framework.","clinical_takeaway":"None – the paper offers descriptive insight, not clinical guidance.","confidence":0.6,"topic_tags":["sexual_function","adolescents"],"strengths":["Provides novel qualitative insight into adolescent–YDP dialogues","Uses established SIECUS framework for categorisation"],"limitations":["Small, non‑representative convenience sample","No quantitative measurement of sexual‑health outcomes","Limited detail on analytic rigor"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":5,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/15546128.2015.1009596"}},{"id":9569,"doi":"10.1093/shm/hku073","pmid":"29731544","pmcid":"PMC5927395","title":"'They are called Imperfect men': Male Infertility and Sexual Health in Early Modern England","authors":"Evans J.","first_author":"Evans J.","journal":"Social history of medicine : the journal of the Society for the Social History of Medicine","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Fertility","Reproduction","Infertility","Impotence","Seventeenth Century"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5927395","cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"historical analysis of early‑modern medical texts; archival sources, no empirical participants","sample_n":null,"sample_text":"not applicable – study of written sources","population":"men discussed in 17th‑century medical and surgical writings (historical texts)","country":"England (historical)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article shows that 17th‑century English medical writers recognised men could be infertile while still sexually active, and that male readers were encouraged to worry about their ability to father children.","clinical_takeaway":"None – the historical analysis does not provide guidance for modern clinical practice.","confidence":0.4,"topic_tags":["sexual_function","religiosity","moral_incongruence"],"strengths":["Rich use of primary medical and surgical texts","Illuminates neglected aspect of male reproductive concerns in early modern period","Contextualizes infertility within social status and patriarchal expectations"],"limitations":["No empirical data; findings are interpretive","Cannot inform contemporary sexual‑health practice","Potential selection bias toward texts that survived"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/shm/hku073"}},{"id":9571,"doi":"10.1071/he16015","pmid":"27545287","pmcid":null,"title":"The Strong Family Program: an innovative model to engage Aboriginal and Torres Strait Islander youth and Elders with reproductive and sexual health community education","authors":"Duley P, Botfield JR, Ritter T, Wicks J, Brassil A.","first_author":"Duley P","journal":"Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pre‑post evaluation of a community education program; no control group; convenience sample of 76 participants","sample_n":76,"sample_text":"48 females, 28 males; participants aged 13–78; recruited through program attendance","population":"Aboriginal and Torres Strait Islander youth and elders in three New South Wales communities (13–78 y, N≈76)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The Strong Family Program, co‑designed with Aboriginal communities, taught reproductive and sexual health in three New South Wales towns. After the workshops, participants showed small gains in knowledge and more positive attitudes toward respectful relationships.","clinical_takeaway":"Culturally tailored sexual‑health education can modestly improve knowledge and attitudes among Aboriginal youth; programs should be evaluated with stronger designs.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Community‑led development and culturally appropriate delivery","Mixed‑methods (quantitative surveys + qualitative yarning circles)","Demonstrated modest improvement in knowledge and attitudes"],"limitations":["No control or comparison group; cannot attribute change to program alone","Small, non‑random sample; limited generalisability","Outcome measures appear study‑specific and lack reported validation"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/he16015"}},{"id":9572,"doi":"10.1111/jsm.13013","pmid":"26531010","pmcid":null,"title":"A Urologist's Guide to Ingredients Found in Top-Selling Nutraceuticals for Men's Sexual Health","authors":"Cui T, Kovell RC, Brooks DC, Terlecki RP.","first_author":"Cui T","journal":"The journal of sexual medicine","year":2015,"pub_types":["Review","Journal Article"],"keywords":["erectile dysfunction","Decreased Libido","Dietary Supplement","Neutraceutical","Men's Sexual Health"],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review summarizing nutraceutical ingredients; no primary data, no systematic methods, no risk‑of‑bias assessment.","sample_n":null,"sample_text":"No original participants; review of existing studies.","population":"Male patients seeking urologic care for sexual health; no primary sample.","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews the most popular over‑the‑counter supplements marketed for men’s sexual health, describing their ingredients and noting that scientific support for their effectiveness is generally weak.","clinical_takeaway":"Clinicians should be aware that many male sexual‑health supplements lack solid evidence, and counseling should reflect this uncertainty.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive listing of common supplement ingredients","Useful for clinicians needing quick reference"],"limitations":["No systematic review methodology","Evidence base described as low quality","No quantitative synthesis or risk‑of‑bias assessment"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":1,"mentioning":40,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.13013"}},{"id":9573,"doi":"10.1186/s12889-018-5065-x","pmid":"29378541","pmcid":"PMC5789694","title":"Measurement of sexual health outcomes among people who inject drugs: pilot study in Catalonia, Spain and Barnaul, Russia","authors":"Folch C, Zohrabyan L, Vagaitseva N, Casabona J, Toskin I, local REDAN Group.","first_author":"Folch C","journal":"BMC public health","year":2018,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":["Surveys","Sexual Health","Sexual Satisfaction","People Who Inject Drugs","Social Norm"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5789694","cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional pilot study of people who inject drugs in two locations (n = 734, 500); multivariate logistic regression","sample_n":1234,"sample_text":"734 participants in Catalonia and 500 in Barnaul","population":"people who inject drugs (PWID), adults, both sexes, Catalonia and Barnaul","country":"Spain, Russia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study piloted WHO‑derived sexual health indicators (satisfaction, safety, autonomy) among people who inject drugs in Spain and Russia, finding lower scores linked to condom non‑use and sexual assault, and suggesting the tools are feasible for monitoring programs.","clinical_takeaway":"Sexual health assessments should consider safety and autonomy; tools appear usable in high‑risk groups.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large combined sample for a pilot study","Attempts validation of WHO sexual health indicators","Multivariate analysis of factors associated with dissatisfaction"],"limitations":["Cross‑sectional design limits causal inference","Limited validation; reliance on self‑report scales","Sample restricted to PWID; not generalizable to broader population"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-018-5065-x"}},{"id":9574,"doi":"10.1071/he12226","pmid":"23540324","pmcid":null,"title":"Youth and Relationship Networks (YARNS): mobilising communities for sexual health","authors":"Whiteside M, Tsey K, Crouch A, Fagan P.","first_author":"Whiteside M","journal":"Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative grounded‑theory study with 30 participants (interviews & focus groups) in two community sites.","sample_n":30,"sample_text":"30 people participated in individual interviews and focus groups.","population":"Aboriginal and Torres Strait Islander young people and community members in North Queensland, Australia.","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers studied how involving Aboriginal youth and their communities in planning sexual‑health programs can improve health outcomes. Interviews with 30 participants revealed that culturally respectful community participation helps create effective, locally accepted health initiatives.","clinical_takeaway":"Engage community members in designing sexual‑health interventions to ensure cultural relevance and better uptake.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Community‑driven, culturally sensitive approach","Grounded‑theory analysis offers rich, contextual insight","Identifies actionable factors for health‑promotion practitioners"],"limitations":["Small, non‑random sample limits generalisability","No validated quantitative measures; findings are interpretive","Lacks comparison or control groups"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":24,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/he12226"}},{"id":9575,"doi":"10.1002/sm2.92","pmid":"26797063","pmcid":"PMC4721023","title":"An Exploration of Returning Veterans' Sexual Health Issues Using a Brief Self-Report Measure","authors":"Beaulieu GR, Latini DM, Helmer DA, Powers-James C, Houlette C, Kauth MR.","first_author":"Beaulieu GR","journal":"Sexual medicine","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Sexual behavior","Physiological","Psychological","Sexual dysfunction","Veterans","Sexual Dysfunctions","Asex"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4721023","cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Retrospective chart review of 247 veterans attending a post‑deployment clinic; descriptive prevalence and regression analyses.","sample_n":247,"sample_text":"Veterans evaluated at a single VA medical center; convenience clinical sample.","population":"US veterans of Iraq/Afghanistan (N=247)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A chart review of 247 US veterans found that about 18% screened positive for sexual dysfunction, which was linked to depression, PTSD, being female, and service‑related factors.","clinical_takeaway":"Screening veterans for sexual dysfunction with a validated tool can identify those needing targeted interventions.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Use of a validated sexual function scale (ASEX)","Relatively large clinical sample (N>200)","Examines multiple mental‑health covariates"],"limitations":["Convenience clinical sample limits generalisability","Cross‑sectional design precludes causal inference","No assessment of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/sm2.92"}},{"id":9576,"doi":"10.2196/resprot.4316","pmid":"26142304","pmcid":"PMC4526976","title":"Defining the Content of an Online Sexual Health Intervention: The MenSS Website","authors":"Webster R, Gerressu M, Michie S, Estcourt C, Anderson J, Ang CS, Murray E, Rait G, Stephenson J, Bailey JV, MenSS Trial Group.","first_author":"Webster R","journal":"JMIR research protocols","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Sex Education","Sexual Health","Condom Use","Behavior Change","Ehealth","Web-based Intervention","Heterosexual Men"],"is_oa":true,"oa_url":"https://www.researchprotocols.org/2015/3/e82/PDF","cited_by_count":10,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"protocol description of a digital sexual health intervention; no outcome data presented","sample_n":20,"sample_text":"Interviews with men (N=20) informed content; no efficacy data","population":"heterosexual men attending sexual health clinics (interview sample N=20; expert workshops N=16)","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper describes how the MenSS website was designed to help heterosexual men use condoms more often, drawing on research, expert input, and interviews with men.","clinical_takeaway":"None – the article outlines intervention design but provides no data on its impact.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Systematic use of Behaviour Change Wheel framework","Triangulation of literature, expert opinion, and user interviews"],"limitations":["No empirical evaluation of effectiveness","Small qualitative sample limits generalisability"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/resprot.4316"}},{"id":9579,"doi":"10.1177/1059840517707241","pmid":"28502214","pmcid":null,"title":"Giving Our Daughters What We Never Received: African American Mothers Discussing Sexual Health With Their Preadolescent Daughters","authors":"Grigsby SR.","first_author":"Grigsby SR.","journal":"The Journal of school nursing : the official publication of the National Association of School Nurses","year":2018,"pub_types":["Journal Article"],"keywords":["Qualitative Research","Cultural Issues","Middle/junior/high School","Family Life/sexuality","Teen Pregnancy/parenting","School Nursing"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Focus groups (4) and in‑depth interviews (3) with African American mothers and daughters aged 9‑14; theory‑of‑planned‑behavior framework; qualitative thematic analysis.","sample_n":null,"sample_text":"Four focus groups and three interviews; exact participant numbers not given in abstract.","population":"African American mothers and pre‑adolescent daughters (9‑14 y) in the United States.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"African American mothers shared how personal faith, values, and life experiences shape the way they talk about sex with daughters aged 9‑14. The study offers insight for programs that aim to improve early sexual‑health conversations.","clinical_takeaway":"Encourage culturally sensitive, mother‑led discussions about sexual health to help reduce teen pregnancy and STI risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Uses Theory of Planned Behavior to structure data collection","Provides voices of an understudied demographic","Identifies faith‑based and experiential influences on communication"],"limitations":["Small, non‑representative sample; limited generalisability","No quantitative measurement of constructs; relies on thematic interpretation","No assessment of potential confounds (e.g., mental health, religious intensity quantified)"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1059840517707241"}},{"id":9580,"doi":"10.1363/4121015","pmid":"26871729","pmcid":null,"title":"How Reliable Are Reports of Early Adolescent Reproductive and Sexual Health Events in Demographic and Health Surveys?","authors":"Neal SE, Hosegood V.","first_author":"Neal SE","journal":"International perspectives on sexual and reproductive health","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Secondary analysis of Demographic and Health Survey data from two rounds (5‑year interval) in nine low‑ and middle‑income countries; large nationally representative samples.","sample_n":null,"sample_text":"Women aged 15‑19 at first survey, followed up at ages 20‑24 in the second survey; nine countries, DHS sample sizes in the thousands per country.","population":"Women aged 15–24 (birth cohorts) surveyed in DHS rounds","country":"Multiple (Africa and Latin America)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study finds that young women often forget or misreport very early marriages and births when later asked, while reports of first sexual activity are more stable. Estimates of early adolescent reproductive events from household surveys should be treated with caution.","clinical_takeaway":"Clinicians should be aware that self‑reported ages of teen marriage or birth may be under‑reported in surveys; use multiple data sources when assessing early adolescent reproductive health.","confidence":0.85,"topic_tags":["adolescents","religiosity","sexual_function","pornography","masturbation"],"strengths":["Large, nationally representative DHS samples","Direct comparison of the same birth cohorts across two surveys","Clear focus on reliability of key reproductive milestones"],"limitations":["Reliance on single‑item retrospective self‑reports","No external validation (e.g., birth certificates)","Limited statistical detail in abstract"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":31,"citing_publications":39,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1363/4121015"}},{"id":9581,"doi":"10.1177/0956462416651229","pmid":"27178067","pmcid":null,"title":"Chemsex and the city: sexualised substance use in gay bisexual and other men who have sex with men attending sexual health clinics","authors":"Hegazi A, Lee MJ, Whittaker W, Green S, Simms R, Cutts R, Nagington M, Nathan B, Pakianathan MR.","first_author":"Hegazi A","journal":"International journal of STD & AIDS","year":2017,"pub_types":["Journal Article"],"keywords":["Men","Sexual behaviour","Europe","High-risk Behaviour","Homosexual"],"is_oa":false,"oa_url":null,"cited_by_count":162,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"retrospective case‑notes review of 655 GBMSM attending two London sexual‑health clinics; chemsex status recorded and associations with STIs and risk behaviours analysed using logistic regression.","sample_n":655,"sample_text":"655 men with documented chemsex status (out of 818 attended).","population":"GBMSM (gay, bisexual, other men who have sex with men) attending sexual‑health clinics in London, 2014‑2015 (N≈655).","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a London clinic sample, men who reported using drugs during sex (chemsex) were more likely to have bacterial STIs, hepatitis C and engage in higher‑risk sexual practices than those who did not.","clinical_takeaway":"Chemsex disclosure signals elevated STI risk; clinicians should offer targeted prevention and health‑promotion services.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large clinical sample for this population","Objective STI diagnoses from medical records","Multivariate adjustment (AORs with CIs)"],"limitations":["Chemsex defined by unvalidated self‑report, no standardized scale","Cross‑sectional; cannot infer causality","Key psychosocial confounds (moral incongruence, mental health, trauma) not measured"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":21,"contrasting":3,"mentioning":215,"citing_publications":242,"retracted":false,"notices":[{"status":"Has correction","date":"2017-2-15","noticeDoi":"10.1177/0956462417694744","doi":"10.1177/0956462416651229"},{"status":"Has erratum","date":"2017-2-15","noticeDoi":"10.1177/0956462417694744","doi":"10.1177/0956462416651229"}],"url":"https://scite.ai/reports/10.1177/0956462416651229"}},{"id":9583,"doi":"10.1136/bmjquality.u207288.w2926","pmid":"26734449","pmcid":"PMC4693108","title":"Let's Talk About Sex! - Improving sexual health for patients in stroke rehabilitation","authors":"Guo M, Bosnyak S, Bontempo T, Enns A, Fourie C, Ismail F, Lo A.","first_author":"Guo M","journal":"BMJ quality improvement reports","year":2015,"pub_types":["other","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4693108","cited_by_count":15,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"Quality‑improvement before‑after (PDSA) cycles in a single rehabilitation centre; no control group, no randomisation, no power calculation.","sample_n":null,"sample_text":"All stroke rehabilitation inpatients over a ten‑month period; exact number not given in abstract.","population":"Inpatients undergoing stroke rehabilitation at one Toronto centre (sample size not reported).","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A quality‑improvement project at a Toronto stroke‑rehab centre used a step‑wise plan to make sure patients could talk about sexual health with staff. After three improvement cycles, 80 % of patients were offered a discussion, up from almost none.","clinical_takeaway":"Embedding brief, structured sexual‑health conversations into stroke rehab is feasible and can markedly increase patient access to counselling.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear implementation of a recognised QI framework (PDSA).","Use of baseline audit to identify a service gap.","Practical tools (reminder system, conversation aid for aphasia).","Demonstrated increase in the targeted process measure (from ~0% to 80%)."],"limitations":["No control or comparison group; cannot infer causality beyond the process change.","Sample size and patient characteristics not disclosed; limited generalisability.","Outcome limited to a process metric, not patient‑reported sexual‑health outcomes.","Statistical analysis minimal; no confidence intervals or power justification."],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":1,"mentioning":41,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjquality.u207288.w2926"}},{"id":9584,"doi":"10.1177/0956462414558283","pmid":"25411348","pmcid":null,"title":"Identification and characteristics of vulnerable adults attending an inner city sexual health service","authors":"Sullivan V, Cheserem E, Milne C, Hopkins M, Lock E, Hamlyn E.","first_author":"Sullivan V","journal":"International journal of STD & AIDS","year":2015,"pub_types":["Journal Article"],"keywords":["Screening","Women","Europe","risk factors","Sexual Health","Adult Safeguarding","Adults At Risk"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"retrospective case note review of vulnerable adults attending a sexual health clinic","sample_n":null,"sample_text":"Not reported in abstract; retrospective audit of service records","population":"Adults identified as vulnerable in an inner‑city sexual health service (no specific age breakdown provided)","country":"United Kingdom (inner‑city setting)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A review of clinic records showed that vulnerable adults do attend an inner‑city sexual‑health service and often have known risk factors, suggesting staff can better identify and refer them.","clinical_takeaway":"Clinicians should be aware of risk‑factor profiles to help recognise vulnerable adults in sexual‑health settings.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Addresses an under‑researched clinical population","Uses real‑world clinical data"],"limitations":["Retrospective audit; limited causal inference","No validated measures of sexual behaviour or distress"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0956462414558283"}},{"id":9585,"doi":"10.3402/ijch.v75.30706","pmid":"27938635","pmcid":"PMC5149663","title":"Youth perspectives on sexually transmitted infections and sexual health in Northern Canada and implications for public health practice","authors":"Healey G.","first_author":"Healey G.","journal":"International journal of circumpolar health","year":2016,"pub_types":["research-article","Journal Article"],"keywords":["Adolescent","Sexual Health","Determinants Of Health","Inuit","Sexual Health Education","Parent–adolescent Relationships"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC5149663","cited_by_count":11,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative interview study with 17 Inuit youth (ages 14‑19) from three Nunavut communities, using Indigenous knowledge framework.","sample_n":17,"sample_text":"17 youth participants.","population":"Adolescents (14‑19) in Nunavut, Canada (Indigenous Inuit).","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 17 Inuit teenagers in Nunavut revealed that they prefer parents for sexual‑health information, rarely use the Internet, link sexual decisions to community factors like poverty, and view sexual health through love and desire.","clinical_takeaway":"Public‑health programs should involve parents and address broader community determinants when designing sexual‑health education for Northern youth.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Indigenous knowledge framework","In‑depth perspectives from youth","Direct face‑to‑face interviews"],"limitations":["Very small, non‑representative sample","No quantitative measurement or validation","Findings not generalisable beyond studied communities"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3402/ijch.v75.30706"}},{"id":9586,"doi":"10.1186/1471-2458-14-416","pmid":"24886093","pmcid":"PMC4012172","title":"Sexual health is dead in my body: participatory assessment of sexual health determinants by refugees, asylum seekers and undocumented migrants in Belgium and The Netherlands","authors":"Keygnaert I, Vettenburg N, Roelens K, Temmerman M.","first_author":"Keygnaert I","journal":"BMC public health","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/1471-2458-14-416","cited_by_count":25,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Community-based participatory research with 223 in‑depth interviews; Framework Analysis of qualitative data; quantitative sociodemographic description.","sample_n":223,"sample_text":"223 in‑depth interviews","population":"Refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands (adults, mixed gender).","country":"Belgium; Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with refugees and undocumented migrants in Belgium and the Netherlands show that cultural norms, education and legal status shape their sexual health, with many feeling constrained by asylum systems.","clinical_takeaway":"Policy changes improving legal and educational support may enhance sexual health for migrant populations.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large number of qualitative interviews for a hard‑to‑reach population","Community‑based participatory approach","Provides contextual insight into structural determinants of sexual health"],"limitations":["No validated measurement instruments for sexual health constructs","Cross‑sectional, convenience sampling limits generalisability","Key confounds (moral, mental health, trauma) not examined"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":1,"mentioning":37,"citing_publications":49,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2458-14-416"}},{"id":9587,"doi":"10.1016/j.jpag.2016.03.001","pmid":"26992608","pmcid":null,"title":"Photovoice: A Strategy to Better Understand the Reproductive and Sexual Health Needs of Young Mothers","authors":"Gill R, Black A, Dumont T, Fleming N.","first_author":"Gill R","journal":"Journal of pediatric and adolescent gynecology","year":2016,"pub_types":["Journal Article"],"keywords":["Policy","Qualitative","Adolescent Girls","Social Determinants Of Health","Reproductive And Sexual Health","Photovoice"],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"prospective community‑based participatory qualitative study using photovoice with 30 recruited, 9 completed participants from a local youth outreach centre","sample_n":9,"sample_text":"Thirty women were recruited and nine women completed the study.","population":"young mothers aged 15‑25, recruited via outreach centre (convenience sample)","country":"USA (implied by journal and outreach centre)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Using photography and group discussions, nine young mothers shared how poverty, stigma, and community resources shape their sexual and reproductive health, highlighting needs for tailored support.","clinical_takeaway":"Clinicians should consider young mothers’ broader life context—poverty, stigma, and access—to address their sexual and reproductive health needs.","confidence":0.78,"topic_tags":["religiosity","gender","moral_incongruence"],"strengths":["Innovative participatory methodology (photovoice)","Provides rich, contextual insights from participants","Systematic 9‑step qualitative protocol"],"limitations":["Very small final sample (n=9) limits transferability","Convenience recruitment from a single outreach centre","No quantitative validation of sexual‑health constructs"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jpag.2016.03.001"}},{"id":9588,"doi":"10.1111/hex.12418","pmid":"26448550","pmcid":"PMC6456814","title":"Let's talk about sex: older people's views on the recognition of sexuality and sexual health in the health-care setting","authors":"Bauer M, Haesler E, Fetherstonhaugh D.","first_author":"Bauer M","journal":"Health expectations : an international journal of public participation in health care and health policy","year":2016,"pub_types":["research-article","Systematic Review","Journal Article"],"keywords":["Sexuality","Elderly","Systematic review","Sexual Health","Attitudes","Health-care Professionals"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6456814","cited_by_count":68,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"systematic-review","design_detail":"Systematic review of 18 quantitative, qualitative and opinion papers (2004‑2015) following Joanna Briggs Institute methodology; includes appraisal of studies and thematic synthesis.","sample_n":null,"sample_text":"18 studies (7 quantitative, 8 qualitative, 3 opinion) were included; total participants not reported in abstract.","population":"Adults aged 65 + (older people)","country":"Multiple (global literature search)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 18 studies shows that many older adults consider sexuality important for wellbeing, but they often feel embarrassed and encounter health‑care staff who are uncomfortable or lack knowledge about sexual health. Better communication and training are needed.","clinical_takeaway":"Clinicians should create a low‑pressure environment and proactively address sexual health with older patients to improve wellbeing.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive search of 11 databases","Inclusion of both quantitative and qualitative evidence","Use of established JBI systematic review methodology","Identifies clear gaps in health‑care professional training"],"limitations":["Limited to English‑language papers","No meta‑analysis; synthesis is narrative","Underlying primary studies often small and heterogeneous","Potential publication bias not formally assessed"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":4,"contrasting":0,"mentioning":99,"citing_publications":126,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/hex.12418"}},{"id":9590,"doi":"10.1177/0193945914539794","pmid":"24942775","pmcid":null,"title":"Exploration of Social, Environmental, and Familial Influences on the Sexual Health Practices of Urban African American Adolescents","authors":"Collins ML, Baiardi JM, Tate NH, Rouen PA.","first_author":"Collins ML","journal":"Western journal of nursing research","year":2015,"pub_types":["Journal Article"],"keywords":["Sexual Health","Qualitative Research","African American","Adolescent Girls","Photovoice","Black Feminist Thought"],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"descriptive qualitative photovoice with focus groups (n=8)","sample_n":8,"sample_text":"Eight adolescent girls recruited for a photovoice study","population":"African American adolescent girls, age 15-19, urban USA","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Using photographs and group discussions, eight African‑American teenage girls described how socioeconomic pressures and racial stereotypes shape their sexual choices, sometimes using sex to gain acceptance or love.","clinical_takeaway":"Clinicians should recognise the broader social and cultural pressures influencing sexual health decisions among AA adolescents.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Innovative photovoice methodology","Grounded in Black Feminist Thought","Rich, contextual qualitative data"],"limitations":["Very small, non‑representative sample (n=8)","No quantitative measures or validated scales","Limited generalisability to broader AA adolescent population"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0193945914539794"}},{"id":9591,"doi":"10.1007/s10508-016-0751-1","pmid":"27220311","pmcid":"PMC5122465","title":"\"The Pleasure Is Better as I've Gotten Older\": Sexual Health, Sexuality, and Sexual Risk Behaviors Among Older Women Living With HIV","authors":"Taylor TN, Munoz-Plaza CE, Goparaju L, Martinez O, Holman S, Minkoff HL, Karpiak SE, Gandhi M, Cohen MH, Golub ET, Levine AM, Adedimeji AA, Gonsalves R, Bryan T, Connors N, Schechter G, Wilson TE.","first_author":"Taylor TN","journal":"Archives of sexual behavior","year":2017,"pub_types":["research-article","Journal Article"],"keywords":["Aging","Sexuality","HIV","Sexual Health","Sexual Risk Behaviors"],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"focus groups and in‑depth interviews with 50 older women living with HIV; purposive sampling; thematic analysis","sample_n":50,"sample_text":"purposive sample selected from a larger cohort (n = 2052)","population":"African American and Latina women, age 50‑69, living with HIV, U.S.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 50 older African‑American and Latina women living with HIV show that sexual pleasure, intimacy and risk‑taking change with age, often because of menopause, relationship dynamics and low perceived HIV risk.","clinical_takeaway":"Clinicians should discuss both sexual satisfaction and safer‑sex strategies with older women living with HIV.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Rich, in‑depth qualitative data from older women with HIV","Triangulation of focus groups and interviews","Addresses an under‑studied population"],"limitations":["Small, non‑representative purposive sample","No validated measurement instruments","No control for key psychosocial confounds"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":1,"mentioning":46,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-016-0751-1"}},{"id":9592,"doi":"10.1093/gerona/gls217","pmid":"23105045","pmcid":null,"title":"Frailty and sexual health in older European men","authors":"Lee DM, Tajar A, Ravindrarajah R, Pye SR, O'Connor DB, Corona G, O'Connell M, Gielen E, Boonen S, Vanderschueren D, Pendleton N, Finn JD, Bartfai G, Casanueva FF, Forti G, Giwercman A, Han TS, Huhtaniemi IT, Kula K, Lean ME, Punab M, Wu FC, O'Neill TW, European Male Aging Study Group.","first_author":"Lee DM","journal":"The journals of gerontology. Series A, Biological sciences and medical sciences","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Sexual function","Frailty","Male Health","Emas."],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional questionnaire study of 1,504 community‑dwelling older men from the European Male Aging Study.","sample_n":1504,"sample_text":"1504 men","population":"Men aged 60‑79 years, European, community sample","country":"European multi‑country (UK, etc.)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 1,500 European men aged 60‑79, those classified as frail reported poorer overall sexual functioning, more distress about sexual problems, and higher rates of erectile dysfunction, even after accounting for age, health and lifestyle factors.","clinical_takeaway":"Assess frailty in older men as part of routine sexual health evaluation; frailty may signal greater risk of sexual dysfunction.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["Large, community‑based sample","Validated sexual function measures likely used","Adjustment for several health and lifestyle confounders","Clear reporting of effect sizes with confidence intervals"],"limitations":["Cross‑sectional design cannot infer causality","No assessment of masturbation, partner relationship, or moral/religious factors","Frailty and sexual health measured concurrently"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":33,"citing_publications":40,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/gerona/gls217"}},{"id":9593,"doi":"10.1111/jsm.12448","pmid":"24517714","pmcid":"PMC4657130","title":"Sexual health discussions with older adult patients during periodic health exams","authors":"Ports KA, Barnack-Tavlaris JL, Syme ML, Perera RA, Lafata JE.","first_author":"Ports KA","journal":"The journal of sexual medicine","year":2014,"pub_types":["research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Sexual Health","Older Adults","Patient-physician Communication","Periodic Health Exams","Sexual History"],"is_oa":false,"oa_url":null,"cited_by_count":47,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Qualitative content analysis of 483 audio‑recorded periodic health exams with physicians of adults aged 50‑80; logistic regression examined predictors of sexual‑health discussion.","sample_n":483,"sample_text":"483 periodic health exams (audio‑recorded) from older adults (50‑80 years) and their physicians.","population":"Adults 50‑80 years attending routine health exams (N≈483 recordings); physicians from a single health system.","country":"United States (implied by NIH funding and author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Audio recordings of 483 routine exams for adults 50‑80 showed that only half included any talk about sexual health, mostly started by doctors. Patient‑doctor gender and race differences and older doctors predicted more discussion.","clinical_takeaway":"Physicians often skip sexual‑health questions with older patients; training should target gender‑discordant and race‑discordant interactions.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large number of real‑world clinical encounters","Objective observation via audio recordings","Statistical modeling of physician‑patient predictors"],"limitations":["Cross‑sectional; no causal inference","Convenience sample from one health system limits generalisability","Qualitative coding scheme not reported as validated"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":52,"citing_publications":75,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jsm.12448"}},{"id":9595,"doi":"10.1089/jpm.2012.0416","pmid":"23537196","pmcid":null,"title":"An integrative review of sexual health issues in advanced incurable disease","authors":"Matzo M, Ehiemua Pope L, Whalen J.","first_author":"Matzo M","journal":"Journal of palliative medicine","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"integrative (narrative) review of 30 abstracts, only one primary study identified; no systematic risk‑of‑bias appraisal","sample_n":null,"sample_text":"30 possibly relevant abstracts/titles identified; only one primary trial","population":"people with advanced incurable disease (palliative care)","country":"Not specified (International literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This 2013 integrative review found that sexual health needs of people with advanced, incurable illnesses are rarely studied; most existing work consists of narrative reviews or expert opinions, with only one small primary study identified.","clinical_takeaway":"Clinicians should recognize the lack of evidence on sexual health in palliative care and proactively assess patients’ needs, while noting that research guidance is currently limited.","confidence":0.85,"topic_tags":["sexual_function","pornography"],"strengths":["Broad search across 18 databases","Highlights paucity of primary research","Identifies need for future prospective studies"],"limitations":["Integrative review lacks systematic risk‑of‑bias assessment","Relies largely on narrative and expert opinion literature","No quantitative synthesis or meta‑analysis"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/jpm.2012.0416"}},{"id":9596,"doi":"10.1111/jocn.12247","pmid":"23742114","pmcid":null,"title":"Moving beyond the therapeutic relationship: a selective review of intimacy in the sexual health encounter in nursing practice","authors":"East L, Hutchinson M.","first_author":"East L","journal":"Journal of clinical nursing","year":2013,"pub_types":["Review","Journal Article"],"keywords":["Review","Nursing","practice","Sexual Health","Intimacy","Therapeutic Relationships","Interactional Intimacy"],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"qualitative","design_detail":"selective (narrative) review of literature","sample_n":null,"sample_text":"Not applicable – literature review","population":"nurses / nursing practice (no participants)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review how nurses can develop intimate interactions when providing sexual health care, suggesting Kirk’s model of interactional intimacy could improve practice.","clinical_takeaway":"Nurses should consider intimacy frameworks to better address patients' sexual health needs.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Comprehensive discussion of intimacy in nursing practice","Uses a theoretical model (Kirk’s interactional intimacy) to frame analysis"],"limitations":["Selective (non‑systematic) review limits reproducibility","No empirical data; conclusions are theoretical","Lacks appraisal of methodological quality of included sources"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":34,"citing_publications":32,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jocn.12247"}},{"id":9597,"doi":"10.1007/s00103-017-2600-3","pmid":"28762120","pmcid":null,"title":"[The Zanzu web portal : A contribution to the sexual health of migrants]","authors":"Renner I, Winkelmann C.","first_author":"Renner I","journal":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","year":2017,"pub_types":["Review","Journal Article"],"keywords":["Family Planning","Sexual Health","Counselling","Hiv/sti","Zanzu"],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"formative evaluation using interviews with counselors; small convenience sample; no control group","sample_n":null,"sample_text":"few interviewees (exact number not reported)","population":"migrants/counselors in Germany","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The Zanzu website provides multilingual sexual‑health information for migrants in Germany. Early interviews with counselors suggest it helps counselling sessions, though integrating a digital tool can be challenging and some illustrations may need adaptation.","clinical_takeaway":"The portal can be a useful supplemental resource for migrant sexual‑health counselling, but clinicians should tailor its use to individual client needs.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Addresses an underserved migrant population","Multilingual, comprehensive sexual health information"],"limitations":["Small, non‑representative interview sample","No validated outcome measures","No quantitative assessment of impact"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":9,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00103-017-2600-3"}},{"id":9598,"doi":"10.1714/2252.24260","pmid":"27310908","pmcid":null,"title":"[Why do cardiologists disregard sexual health of their patients? A critical review]","authors":"Scardi S.","first_author":"Scardi S.","journal":"Giornale italiano di cardiologia (2006)","year":2016,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["sexual_health"],"language":"ita","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review without systematic methods or risk-of-bias assessment","sample_n":null,"sample_text":"Not applicable – review article","population":"cardiologists and cardiac patients (general description only)","country":"Italy (journal); no primary data","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that cardiologists often ignore patients' sexual health despite its importance for quality of life, calling for better training and counseling on sexual dysfunction in heart disease.","clinical_takeaway":"Clinicians should proactively discuss sexual health with cardiac patients, as it is frequently overlooked.","confidence":0.7,"topic_tags":[],"strengths":["Highlights an under‑addressed clinical topic","Provides a concise summary of sexual dysfunction in cardiac patients"],"limitations":["Non‑systematic narrative review; no search strategy or bias assessment","No primary data; conclusions based on cited literature without critical appraisal","Low methodological rigor; scores low on construct validity and design"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":2,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1714/2252.24260"}},{"id":9599,"doi":"10.1177/0300060513476429","pmid":"23569016","pmcid":null,"title":"Sexual Health and Overall Wellness (SHOW) survey in men and women in selected European and Middle Eastern countries","authors":"Dean J, Shechter A, Vertkin A, Weiss P, Yaman O, Hodik M, Ginovker A.","first_author":"Dean J","journal":"The Journal of international medical research","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Quality of life","erectile dysfunction","Satisfaction","Sexual Health","Intimacy"],"is_oa":false,"oa_url":"https://doi.org/10.1177/0300060513476429","cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 3780 adults from 9 countries","sample_n":3780,"sample_text":"3780 self‑administered questionnaires completed across nine European and Middle‑Eastern countries","population":"men and women aged 25‑74 who had sexual intercourse in past 12 months","country":"multiple (Europe, Middle East)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2013 survey of 3,780 adults in Europe and the Middle East found that people who were more satisfied with their sexual lives also reported better overall health, stronger relationships, and a more positive outlook on life.","clinical_takeaway":"Improving sexual satisfaction may be linked to broader wellbeing, but causal direction is unclear.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large multinational sample","Focus on positive aspects of sexual health","Clear reporting of basic associations"],"limitations":["Cross‑sectional design limits causal inference","Reliance on ad‑hoc self‑report measures","No control for key confounds (e.g., mental health, relationship quality)","Potential self‑selection bias"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":16,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0300060513476429"}},{"id":9600,"doi":"10.1089/apc.2010.0059","pmid":"20666586","pmcid":"PMC2958438","title":"A mixed methods study of the sexual health needs of New England transmen who have sex with nontransgender men","authors":"Reisner SL, Perkovich B, Mimiaga MJ.","first_author":"Reisner SL","journal":"AIDS patient care and STDs","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":110,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"mixed methods qualitative interviews with 16 transmen (convenience sample) and brief survey","sample_n":16,"sample_text":"16 transmen (mean age 32.5, 87.5% white, 75% queer)","population":"transmen who have sex with non‑transgender men (TMSM) in New England, USA","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 16 trans men who have sex with men showed moderate HIV/STD risk, low testing rates, and a need for transgender‑focused sexual‑health information and provider training.","clinical_takeaway":"Clinicians should proactively offer HIV/STD testing and tailored sexual‑health resources to trans men who have sex with men.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["mixed‑methods design gives depth to a hard‑to‑reach population","identifies concrete service gaps for transmen","includes both behavioral survey and qualitative insight"],"limitations":["very small, non‑representative sample","no validated scales for sexual health or mental‑health outcomes","cross‑sectional, cannot infer causal relationships"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":0,"mentioning":183,"citing_publications":150,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/apc.2010.0059"}},{"id":9601,"doi":"10.1016/j.juro.2012.10.053","pmid":"23085298","pmcid":null,"title":"Validation of online administration of the sexual health inventory for men","authors":"Bernstein AN, Levinson AW, Hobbs AR, Lavery HJ, Samadi DB.","first_author":"Bernstein AN","journal":"The Journal of urology","year":2013,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Validation study comparing online vs paper SHIM with paired administration (N=508 consented, 116 completed both).","sample_n":508,"sample_text":"508 consented; 359 completed in‑person, 277 online, 116 completed both.","population":"Men undergoing urological care (prostatectomy, etc.)","country":"USA (inferred from journal and author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":8,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study shows that the online version of the SHIM questionnaire gives results very similar to the traditional paper version, confirming it as a reliable tool for assessing men's erectile function remotely.","clinical_takeaway":"Clinicians can safely collect SHIM scores online, expanding reach without sacrificing accuracy.","confidence":0.7,"topic_tags":["sexual_function","measurement"],"strengths":["Large initial sample; paired within‑subject design","Use of established reliability statistics (ICC, Bland‑Altman, Cronbach α)","Demonstrates feasibility of online data capture"],"limitations":["Only 23% completed both formats, potential selection bias","No pre‑registration or explicit power analysis reported","Limited to men in urological care, may not generalise to broader male population"],"rubric_version":"2.0","raw_total":38,"max_possible":50,"pct_score":76,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":1,"contrasting":1,"mentioning":9,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.juro.2012.10.053"}},{"id":9602,"doi":"10.1080/19359705.2015.1024375","pmid":"26692916","pmcid":"PMC4647863","title":"The Relationship of Internalized Homonegativity to Sexual Health and Well-Being Among Men in 38 European Countries Who Have Sex With Men","authors":"Berg RC, Weatherburn P, Ross MW, Schmidt AJ.","first_author":"Berg RC","journal":"Journal of gay & lesbian mental health","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["HIV","Mental health","Internalized Homonegativity","Health-care Needs"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4647863","cited_by_count":29,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large multinational survey (EMIS) with multivariable regression; cross‑sectional community sample","sample_n":null,"sample_text":"large, multi‑country community sample","population":"MSM in 38 European countries (sample size not specified in abstract)","country":"Europe (38 countries)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A large European survey found that gay men who feel more shame about their sexuality also report poorer mental and sexual health, including loneliness and lower HIV knowledge.","clinical_takeaway":"Address internalized homonegativity in therapy to improve overall well‑being of gay men.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Very large, multi‑country sample","Uses likely validated measure of internalized homonegativity","Multivariable regression controls for several demographic factors"],"limitations":["Cross‑sectional; cannot infer causality","No explicit control for mental‑health variables or moral factors","Effect sizes and power not reported in abstract"],"rubric_version":"2.0","raw_total":30,"max_possible":50,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":10,"contrasting":1,"mentioning":33,"citing_publications":58,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19359705.2015.1024375"}},{"id":9603,"doi":"10.1016/j.jadohealth.2007.07.017","pmid":"18155024","pmcid":null,"title":"Ethical approaches to adolescent participation in sexual health research","authors":"Flicker S, Guta A.","first_author":"Flicker S","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":83,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"case study / ethical discussion without empirical outcome data","sample_n":null,"sample_text":"Not applicable – paper discusses ethical approaches rather than reporting a participant sample","population":"adolescents in sexual health research (Canada)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that requiring parental consent for adolescent sexual‑health studies can exclude the most vulnerable youths. Using a Canadian teen survey as an example, they propose community‑based, youth‑focused methods to protect participants while allowing important research to proceed.","clinical_takeaway":"Researchers should consider flexible, youth‑centered consent procedures to include adolescents most at risk in sexual‑health studies.","confidence":0.9,"topic_tags":["adolescents","sexual_function"],"strengths":["Clear ethical argument for waiving parental consent","Concrete case-study example (Toronto Teen Survey)","Practical recommendations for IRBs and researchers"],"limitations":["No empirical data on outcomes of proposed approaches","Limited to Canadian context; generalisability unclear","Does not examine how consent changes affect sexual‑health findings"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":140,"citing_publications":145,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2007.07.017"}},{"id":9604,"doi":"10.1177/00333549131282s105","pmid":"23450884","pmcid":"PMC3562745","title":"On the road to well-being: the development of a communication framework for sexual health","authors":"Robinson SJ, Stellato A, Stephens J, Kirby S, Forsythe A, Ivankovich MB.","first_author":"Robinson SJ","journal":"Public health reports (Washington, D.C. : 1974)","year":2013,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"exploratory mixed methods (environmental scan, focus groups, interviews, online surveys)","sample_n":null,"sample_text":"diverse members of the public and health professionals; exact size not reported in abstract","population":"diverse US public and health professionals (no numbers provided)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers interviewed and surveyed a wide range of U.S. stakeholders to identify shared values about sexual health. They turned these values into a communication framework that emphasizes health promotion alongside disease prevention, aiming to improve public messaging about sexual health.","clinical_takeaway":"Use the identified value‑based themes to craft sexual‑health messages that resonate across diverse audiences.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["Multi‑method stakeholder engagement","Clear practical output (communication framework)","Broad range of participant types"],"limitations":["No reported sample size or power analysis","Lacks validated measurement instruments","Findings may not generalise beyond U.S. stakeholders"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00333549131282s105"}},{"id":9605,"doi":"10.3389/fpubh.2017.00203","pmid":"28848729","pmcid":"PMC5554483","title":"Using Intervention Mapping for Program Design and Production of <i>iCHAMPSS</i>: An Online Decision Support System to Increase Adoption, Implementation, and Maintenance of Evidence-Based Sexual Health Programs","authors":"Peskin MF, Hernandez BF, Gabay EK, Cuccaro P, Li DH, Ratliff E, Reed-Hirsch K, Rivera Y, Johnson-Baker K, Emery ST, Shegog R.","first_author":"Peskin MF","journal":"Frontiers in public health","year":2017,"pub_types":["methods-article","Journal Article"],"keywords":["Dissemination","Adolescents","Sexual Health","Evidence-based","Intervention Mapping"],"is_oa":true,"oa_url":"https://www.frontiersin.org/articles/10.3389/fpubh.2017.00203/pdf","cited_by_count":17,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"methods article describing the development of the iCHAMPSS online decision‑support system; no empirical data presented.","sample_n":null,"sample_text":"Not applicable – no participants were studied.","population":"school districts / adolescents (program target)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper explains how the authors built iCHAMPSS, an online tool to help schools choose and keep using evidence‑based sex‑education programs, using a systematic design process called Intervention Mapping.","clinical_takeaway":"None – the article describes a program‑design method and does not provide evidence for clinical practice.","confidence":0.3,"topic_tags":["sexual_function","adolescents"],"strengths":["Systematic use of Intervention Mapping framework","Clear description of steps for program design","Addresses a real public‑health implementation gap"],"limitations":["No empirical evaluation of iCHAMPSS effectiveness","Absence of outcome data limits any conclusions about impact","No measurement of relevant sexual‑behavior or health constructs"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3389/fpubh.2017.00203"}},{"id":9607,"doi":"10.1007/s10900-012-9616-2","pmid":"23054416","pmcid":null,"title":"Sexual health behaviors in a random sample of students at a Mid-Atlantic university: 2010-2011","authors":"McCave EL, Azulay Chertok IR, Winter VR, Haile ZT.","first_author":"McCave EL","journal":"Journal of community health","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large stratified random sample of university students; online survey; descriptive and regression analyses","sample_n":2304,"sample_text":"stratified random sample of full‑time undergraduate and graduate students invited; 2,304 completed the online survey","population":"full‑time undergraduate and graduate students at a Mid‑Atlantic land‑grant university (N=2,304)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 2,304 university students examined sexual practices, health screening, and education. The study identified factors linked to receiving sexual‑health education, offering data to help campus health programs tailor services.","clinical_takeaway":"Colleges can use these data to target sexual‑health education toward students most in need.","confidence":0.9,"topic_tags":["sexual_function"],"strengths":["Large, stratified random sample","Use of a validated national survey instrument","Clear descriptive and inferential analysis"],"limitations":["Cross‑sectional design limits causal inference","No measurement of key psychosocial confounds (e.g., mental health, moral attitudes)","Self‑report data may be subject to social desirability bias"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":5,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10900-012-9616-2"}},{"id":9608,"doi":"10.1363/46e0914","pmid":"24650164","pmcid":"PMC4347930","title":"Prime Time: long-term sexual health outcomes of a clinic-linked intervention","authors":"Sieving RE, McRee AL, Secor-Turner M, Garwick AW, Bearinger LH, Beckman KJ, McMorris BJ, Resnick MD.","first_author":"Sieving RE","journal":"Perspectives on sexual and reproductive health","year":2014,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Randomized Controlled Trial","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized controlled trial with 253 adolescent females, 30‑month follow‑up, regression analysis of sexual risk outcomes","sample_n":253,"sample_text":"253 participants (intervention n≈127, control n≈126)","population":"sexually active females age 13‑17 at high risk for pregnancy, recruited from clinics","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A school‑based program that paired at‑risk teen girls with case managers and leadership groups increased condom use, dual‑method contraception, and college enrollment one year after the program ended.","clinical_takeaway":"Youth development interventions can improve long‑term sexual health behaviors in high‑risk adolescents.","confidence":0.7,"topic_tags":["adolescents","sexual_function","prevalence"],"strengths":["Randomized controlled design","Long‑term (30‑month) follow‑up","Clear behavioral outcomes"],"limitations":["Self‑report measures, no validated scales reported","Limited control of psychosocial confounds (e.g., mental health, trauma)","Sample limited to clinic‑seeking high‑risk youth"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1363/46e0914"}},{"id":9609,"doi":"10.1023/b:aseb.0000026620.99306.64","pmid":"15129039","pmcid":null,"title":"Nonvolitional sex and sexual health","authors":"Kalmuss D.","first_author":"Kalmuss D.","journal":"Archives of sexual behavior","year":2004,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative essay reviewing literature and proposing policy and practice recommendations; no original empirical data.","sample_n":null,"sample_text":"Not applicable – no primary data collected.","population":"Humans (general population, with mention of victims of nonvolitional sex).","country":"United States (focus on global context).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The essay explains how non‑consensual sexual experiences—ranging from rape to subtle pressures—harm sexual health and calls for rights‑based education, health‑service screening, and victim support.","clinical_takeaway":"Clinicians should routinely ask about nonvolitional sex experiences to identify health impacts and connect patients to appropriate support.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Broad synthesis of literature on nonvolitional sex.","Clear policy‑focused recommendations."],"limitations":["No original data; conclusions not empirically tested.","Lacks systematic review methods and risk‑of‑bias assessment."],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":22,"citing_publications":29,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/b:aseb.0000026620.99306.64"}},{"id":9613,"doi":"10.1177/00333549131282s106","pmid":"23450885","pmcid":"PMC3562746","title":"The development and validation of sexual health indicators of Canadians aged 16-24 years","authors":"Smylie L, Clarke B, Doherty M, Gahagan J, Numer M, Otis J, Smith G, McKay A, Soon C.","first_author":"Smylie L","journal":"Public health reports (Washington, D.C. : 1974)","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study using purposive sample of 1,158 Canadians aged 16-24, mixed qualitative‑quantitative development, PCA and reliability analysis","sample_n":1158,"sample_text":"purposive sample of 1,158 people aged 16‑24 years recruited from four Canadian provinces","population":"Canadian youth 16‑24 years (purposive sample from four provinces)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and validated a 75‑item questionnaire to assess physical, mental, relational and safety aspects of sexual health among Canadian youth aged 16‑24, showing strong reliability and clear factor structure.","clinical_takeaway":"The new tool can reliably track multiple aspects of young adults’ sexual health in research and public‑health monitoring.","confidence":0.8,"topic_tags":["sexual_function","measurement","adolescents"],"strengths":["Large sample for validation","Robust psychometric testing (PCA, high Cronbach’s α)","Multi‑dimensional approach to sexual health"],"limitations":["Purposive, non‑representative sample limits generalisability","No pre‑registration or open data reported","Confounding variables (e.g., mental health, trauma) not addressed"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":26,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/00333549131282s106"}},{"id":9614,"doi":"10.1111/wvn.12110","pmid":"26422189","pmcid":null,"title":"Using the Program Logic Model to Evaluate ¡Cuídate!: A Sexual Health Program for Latino Adolescents in a School-Based Health Center","authors":"Serowoky ML, George N, Yarandi H.","first_author":"Serowoky ML","journal":"Worldviews on evidence-based nursing","year":2015,"pub_types":["Journal Article"],"keywords":["Program Evaluation","Adolescent Sexual Health","School-based Health Center","Sti Or Hiv Prevention In Latino Teens","Adolescent Sexual Risk Reduction","Pregnancy And Sti Or Hiv Prevention In Schools","Pregnancy Prevention In Latino Teens","Program Logic","¡Cuídate!"],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"single-group pre‑post evaluation of a school‑based sexual health program (N=24 female Latino adolescents), repeated‑measures ANOVA, no control group","sample_n":24,"sample_text":"Three cohorts (N = 24) of female teens","population":"Latino adolescent females (high‑school age) in a U.S. school‑based health center","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A CDC‑endorsed sexual health program for Latina teens was run in a school clinic. After the program, participants showed higher STI/HIV knowledge, confidence to use condoms, and reported more condom use. No new pregnancies or STIs were reported during the brief follow‑up.","clinical_takeaway":"Brief, school‑based group education may improve condom‑related outcomes in Latina adolescents, but evidence is limited by small, uncontrolled design.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Implementation in real‑world school setting","High retention (95.8%)","Use of program logic model for systematic evaluation"],"limitations":["Very small sample, no control group","Short follow‑up (8–12 weeks)","Unclear whether measurement instruments were validated"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/wvn.12110"}},{"id":9615,"doi":"10.1016/j.jagp.2014.03.006","pmid":"24840610","pmcid":null,"title":"Sexual health and function in later life: a population-based study of 606 older adults with a partner","authors":"Wang V, Depp CA, Ceglowski J, Thompson WK, Rock D, Jeste DV.","first_author":"Wang V","journal":"The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Aging","Cognition","Anxiety","Physical Functioning","Sexuality Depression"],"is_oa":false,"oa_url":null,"cited_by_count":48,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Population-based survey of 606 community‑dwelling older adults (age 50‑99) with a partner; mail‑in questionnaire; cross‑sectional analysis.","sample_n":606,"sample_text":"Community‑dwelling adults, aged 50‑99 years, with a partner.","population":"606 older adults (mean age 75.2) living in San Diego County, partnered, community‑dwelling.","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 606 older adults with partners, most were sexually active and satisfied. Depression was linked to poorer sexual health, more strongly than age, anxiety, stress, or physical function.","clinical_takeaway":"Depressive symptoms may reduce sexual well‑being in older partnered adults; addressing mood could improve sexual health.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, community‑based sample (>600)","Both sexes represented, age range broad","Multiple relevant covariates adjusted in analyses"],"limitations":["Cross‑sectional; cannot infer causality","No measurement of masturbation or moral/religious factors","Self‑report questionnaires may entail recall bias"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":8,"contrasting":0,"mentioning":45,"citing_publications":102,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jagp.2014.03.006"}},{"id":9616,"doi":"10.1016/j.jadohealth.2013.12.023","pmid":"24560080","pmcid":null,"title":"A peer education program: delivering highly reliable sexual health promotion messages in schools","authors":"Layzer C, Rosapep L, Barr S.","first_author":"Layzer C","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2014,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":["Condom Use","Peer Education","Implementation Study","Pregnancy Prevention","Sexual Health Promotion","Youth Development","School-based Program","Comprehensive Sexuality Education"],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"implementation study with focus groups, interviews, and brief surveys across four schools; grounded‑theory analysis; no randomisation or longitudinal follow‑up","sample_n":678,"sample_text":"Four schools; convenience sample of participants in a peer‑education program","population":"high‑school students (peer educators N=62, ninth‑graders N=60; brief surveys N=678) in North Carolina, USA","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A peer‑education program was introduced in four North Carolina high schools. Students said the program gave them useful new sexual‑health information and helped them socially. Researchers described how the curriculum was adapted and delivered, but the study relied on qualitative feedback and brief, non‑validated surveys.","clinical_takeaway":"Peer‑led sexual‑health education can be well received by adolescents, though rigorous outcome data are lacking.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large overall survey sample (N≈678)","Multiple data sources (observations, interviews, focus groups)","Grounded‑theory approach adds depth"],"limitations":["No validated measures of sexual‑health outcomes","Convenience school sample limits generalisability","No control/comparison group, causal claims limited"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":53,"citing_publications":83,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2013.12.023"}},{"id":9617,"doi":"10.1080/00224499.2012.716874","pmid":"23148703","pmcid":null,"title":"A multidimensional framework for the meanings of the sexual double standard and its application for the sexual health of young black women in the U.S","authors":"Fasula AM, Carry M, Miller KS.","first_author":"Fasula AM","journal":"Journal of sex research","year":2014,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"conceptual framework article with no primary data collection","sample_n":null,"sample_text":"no empirical sample; framework development based on literature review","population":"young Black women in the United States (theoretical focus)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors propose a three‑part model of the sexual double standard—polarized sexualities, gendered activity roles, and power struggles—and discuss how these intersect with race to shape the sexual health of young Black women in the US.","clinical_takeaway":"None – the paper is theoretical and does not provide actionable clinical guidance.","confidence":0.6,"topic_tags":["sexual_function","gender","csbd"],"strengths":["Offers a novel multidimensional framework","Integrates race and gender perspectives","Links social theory to sexual health implications"],"limitations":["No empirical data to test the framework","Does not measure key sexual‑health outcomes","Limited generalizability beyond the discussed demographic"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":58,"citing_publications":95,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2012.716874"}},{"id":9618,"doi":"10.1080/10508422.2014.948956","pmid":"29479165","pmcid":"PMC5823532","title":"Enhancing the Responsible Conduct of Sexual Health Prevention Research Across Global and Local Contexts: Training for Evidence-Based Research Ethics","authors":"Fisher CB.","first_author":"Fisher CB.","journal":"Ethics & behavior","year":2015,"pub_types":["research-article","Journal Article"],"keywords":["Prevention","Training","Ethics","Sexual Health","International","Responsible Conduct Of Research"],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"article describes an ethics training program and summarizes other empirical papers; no original data collected","sample_n":null,"sample_text":"","population":"early‑career scientists in HIV/drug‑abuse prevention research (training participants)","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The paper outlines a training program that teaches early‑career researchers how to conduct ethical HIV and drug‑abuse prevention studies, especially with vulnerable groups, and introduces six related research articles.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Highlights ethical challenges in vulnerable populations","Describes a funded training program with clear objectives"],"limitations":["No original empirical data presented","No systematic evaluation of the training’s effectiveness","Limited applicability to pornography or CSBD research"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10508422.2014.948956"}},{"id":9619,"doi":"10.1016/j.jadohealth.2012.05.017","pmid":"23332488","pmcid":"PMC3759971","title":"A multidimensional model of sexual health and sexual and prevention behavior among adolescent women","authors":"Hensel DJ, Fortenberry JD.","first_author":"Hensel DJ","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2013,"pub_types":["research-article","Multicenter Study","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":37,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"secondary analysis of a longitudinal cohort of 387 adolescent women (age 14‑17) examining latent dimensions of sexual health and their association with sexual and prevention behaviors.","sample_n":387,"sample_text":"N = 387 adolescent women aged 14‑17 years.","population":"Adolescent females, United States (Indiana), recruited for a larger cohort study on sexual relationships.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study proposes a multidimensional model of sexual health for teen girls and shows that higher sexual health scores are linked to both abstinence and safer sexual practices like condom use and lower STI rates.","clinical_takeaway":"Promoting overall sexual health may help adolescents engage in safer sexual behaviors.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large longitudinal cohort","Use of latent variable modeling","Good model fit statistics"],"limitations":["Constructs not based on previously validated scales","Potential unmeasured confounders (e.g., mental health, relationship context)","Limited generalizability beyond the specific US adolescent sample"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":57,"citing_publications":84,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2012.05.017"}},{"id":9621,"doi":"10.1111/j.1743-6109.2009.01362.x","pmid":"19572961","pmcid":null,"title":"Canadian male sexual health council survey to assess prevalence and treatment of premature ejaculation in Canada","authors":"Brock GB, Bénard F, Casey R, Elliott SL, Gajewski JB, Lee JC.","first_author":"Brock GB","journal":"The journal of sexual medicine","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large web‑based population survey with follow‑up phone interview","sample_n":3816,"sample_text":"phase 1 web survey (N=3816); phase 2 telephone interview of those meeting PE criteria (N=1636)","population":"Canadian adult men (N≈3816) and their partners","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A 2009 Canadian survey found that 16‑24% of men report premature ejaculation, often without discussing it with doctors, and many are dissatisfied with treatment.","clinical_takeaway":"PE is common and under‑discussed; clinicians should proactively inquire and offer evidence‑based options.","confidence":0.8,"topic_tags":["prevalence","sexual_function","treatment"],"strengths":["Large, population‑based sample","Two‑stage design (web + telephone) increases depth","Addresses patient‑physician communication gap"],"limitations":["Self‑report definition of PE may be circular","No validated PE questionnaire used","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":3,"mentioning":33,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01362.x"}},{"id":9623,"doi":"10.1016/j.chiabu.2011.10.011","pmid":"22425695","pmcid":null,"title":"Sexual health in women reporting a history of child sexual abuse","authors":"Lacelle C, Hébert M, Lavoie F, Vitaro F, Tremblay RE.","first_author":"Lacelle C","journal":"Child abuse & neglect","year":2012,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 889 Quebec women aged 20‑23","sample_n":889,"sample_text":"young adult women, community sample, not treatment‑seeking","population":"young adult women, community sample","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 889 young women, those who experienced severe child sexual abuse reported more sexual problems and higher‑risk sexual behaviours. Emotional coping style and optimism partially explained these outcomes, suggesting they could be treatment targets.","clinical_takeaway":"Address maladaptive coping and foster optimism when supporting CSA survivors’ sexual health.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large community sample (N=889)","Examines mediators (coping, optimism)","Focuses on sexual‑health outcomes relevant to survivors"],"limitations":["Cross‑sectional design limits causal inference","Unclear whether measurement instruments are validated","Potential unmeasured confounds (e.g., mental health, relational factors)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":true},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":21,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.chiabu.2011.10.011"}},{"id":9624,"doi":"10.1186/1471-2407-14-199","pmid":"24641777","pmcid":"PMC3995188","title":"Improving sexual health in men with prostate cancer: randomised controlled trial of exercise and psychosexual therapies","authors":"Cormie P, Chambers SK, Newton RU, Gardiner RA, Spry N, Taaffe DR, Joseph D, Hamid MA, Chong P, Hughes D, Hamilton K, Galvão DA.","first_author":"Cormie P","journal":"BMC cancer","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Randomized Controlled Trial","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://bmccancer.biomedcentral.com/counter/pdf/10.1186/1471-2407-14-199","cited_by_count":17,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Three‑arm parallel randomised controlled trial (exercise, exercise + psychosexual, usual care) with 240 prostate‑cancer survivors; outcomes measured at baseline, 6 months post‑intervention and 1‑year follow‑up.","sample_n":240,"sample_text":"240 participants randomised across three arms","population":"Men diagnosed with prostate cancer undergoing survivorship care; age not specified in abstract.","country":"Australia/New Zealand (multisite, trial registered in ANZCTR)","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A randomised trial tested whether supervised exercise, with or without a brief psychosexual counselling programme, improves sexual health in men treated for prostate cancer. Over six months, participants receiving exercise (alone or combined) showed better sexual‑function scores than usual‑care patients, with benefits persisting at one‑year follow‑up.","clinical_takeaway":"Integrating structured exercise programmes, possibly with brief psychosexual support, can meaningfully improve sexual health after prostate‑cancer treatment.","confidence":0.9,"topic_tags":["sexual_function","csbd","masturbation","pornography"],"strengths":["Large, adequately powered RCT with three arms","Registered trial protocol (pre‑registration)","Long‑term follow‑up (1 year) to assess durability"],"limitations":["No measurement/adjustment for key psychosocial confounds (partner status, mental health, moral/religious factors)","Abstract does not specify which sexual‑health instrument is used"],"rubric_version":"2.0","raw_total":35,"max_possible":50,"pct_score":70,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":8,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/1471-2407-14-199"}},{"id":9625,"doi":"10.1016/j.hcmf.2010.02.001","pmid":"20527315","pmcid":null,"title":"New British Columbia guidelines for supporting sexual health and intimacy in care facilities","authors":"Everett B, Young J, Carlson M, Clements G.","first_author":"Everett B","journal":"Healthcare management forum","year":2010,"pub_types":["Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Guideline summary without empirical data; no original study conduct.","sample_n":null,"sample_text":"Not applicable – article summarises guideline recommendations, no participant data reported.","population":"Older adults in care facilities (qualitative description only)","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper outlines new British Columbia guidelines that aim to support healthy sexual expression and intimacy for residents in nursing homes and similar facilities, emphasizing the importance of these needs and offering suggestions for staff.","clinical_takeaway":"Facilities should consider policies that respect and facilitate residents' sexual needs, but evidence for specific interventions is lacking.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Addresses an under‑represented aspect of sexual health (intimacy in care settings)","Provides practical guidance for staff and policy makers"],"limitations":["No empirical data; recommendations not based on systematic review of primary studies","No measurement of outcomes, effectiveness, or potential harms","Confounding factors (e.g., mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":4,"max_possible":50,"pct_score":8,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.hcmf.2010.02.001"}},{"id":9626,"doi":"10.3109/10398562.2011.583046","pmid":"21878014","pmcid":null,"title":"Hip hopping the gap--performing arts approaches to sexual health disadvantage in young people in remote settings","authors":"Crouch A, Robertson H, Fagan P.","first_author":"Crouch A","journal":"Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists","year":2011,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"Program evaluation / descriptive report of performing‑arts workshops in remote Indigenous schools; no control group, no randomisation, no longitudinal follow‑up reported.","sample_n":null,"sample_text":"students participating in workshops (exact number not provided)","population":"young Aboriginal and Torres‑Strait Islander students in four remote communities (sample size not reported)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers ran hip‑hop workshops with Indigenous youth in remote Australian communities to raise awareness of sexual‑health risks. The project built school partnerships and produced youth‑written songs about health, but it did not measure changes in sexual behaviour or health outcomes.","clinical_takeaway":"None – the study describes a community‑engagement initiative without evidence of impact on sexual‑health risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Community‑based, culturally relevant intervention","Explicit partnership building with schools and local councils","Creative output (hip‑hop songs) engaging youth"],"limitations":["No control or comparison group","Sample size and participant characteristics not reported","No quantitative evaluation of sexual‑health outcomes"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":16,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3109/10398562.2011.583046"}},{"id":9627,"doi":"10.1186/s12889-015-1396-z","pmid":"25884461","pmcid":"PMC4340797","title":"The use of social networking platforms for sexual health promotion: identifying key strategies for successful user engagement","authors":"Veale HJ, Sacks-Davis R, Weaver ER, Pedrana AE, Stoové MA, Hellard ME.","first_author":"Veale HJ","journal":"BMC public health","year":2015,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4340797","cited_by_count":42,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Observational analysis of 100 social‑media profiles (60 Facebook, 40 Twitter) over one month; quantitative reach/interaction metrics plus thematic content analysis of top vs. low‑performing profiles.","sample_n":100,"sample_text":"60 Facebook and 40 Twitter profiles identified from a prior systematic review.","population":"Public Facebook and Twitter profiles engaged in sexual health promotion (no human participants).","country":"Not specified (likely Australia based on author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study examined 100 Facebook and Twitter pages that promote sexual health, finding that the most successful ones posted frequently, interacted personally with users, asked questions, used multimedia, and highlighted celebrities. These tactics were linked to higher follower numbers and more user engagement.","clinical_takeaway":"None - the paper focuses on social‑media engagement strategies, not on clinical sexual‑health outcomes.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large systematic identification of existing profiles.","Clear quantitative metrics of reach and interaction.","Comparative thematic analysis of high vs. low performers."],"limitations":["No assessment of user outcomes (e.g., sexual health behavior change).","Cross‑sectional snapshot; cannot infer causality.","Metrics are simple counts, not validated engagement scales."],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":6,"contrasting":0,"mentioning":85,"citing_publications":114,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1186/s12889-015-1396-z"}},{"id":9628,"doi":"10.1016/j.ejogrb.2010.08.009","pmid":"20832160","pmcid":null,"title":"Embryology and anatomy of the vulva: the female orgasm and women's sexual health","authors":"Puppo V.","first_author":"Puppo V.","journal":"European journal of obstetrics, gynecology, and reproductive biology","year":2011,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":54,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Narrative review of anatomical and embryological literature; no original empirical data collected.","sample_n":null,"sample_text":"N/A – review article","population":"not applicable","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how the female external genitalia develop and function, focusing on the anatomy that underlies the female orgasm.","clinical_takeaway":"None – the paper offers anatomical background rather than clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive anatomical description","Historical overview of key texts"],"limitations":["No primary data; purely descriptive","Does not address pornography or compulsive sexual behavior"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":2,"contrasting":0,"mentioning":82,"citing_publications":97,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.ejogrb.2010.08.009"}},{"id":9629,"doi":"10.1080/13691050903359265","pmid":"19904650","pmcid":null,"title":"Narratives of sexual health risk and protection amongst young people from refugee backgrounds in Melbourne, Australia","authors":"McMichael C, Gifford S.","first_author":"McMichael C","journal":"Culture, health & sexuality","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":60,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Focus groups and in‑depth interviews with 142 resettled refugees aged 16‑25; thematic analysis of narratives about sexual health risk and protection.","sample_n":142,"sample_text":"142 participants recruited via community organisations and refugee services; convenience sample of recently arrived youth.","population":"young refugees (16‑25) in Melbourne, Australia","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 142 recent refugee youths in Melbourne showed they know something about HIV/AIDS but have limited knowledge of other STIs. Their ideas of sexual risk and protection are shaped by worries about fitting into their new community, suggesting that sexual‑health education should be part of early resettlement services.","clinical_takeaway":"Tailor sexual‑health education for refugee youth to address community‑related concerns and gaps in STI knowledge.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Large qualitative sample for this population","In‑depth exploration of contextual factors shaping sexual health attitudes","Clear focus on refugee‑specific resettlement challenges"],"limitations":["No validated psychometric instruments for sexual health literacy","No measurement or control of key confounds (e.g., mental health, trauma)","Findings not generalisable beyond this urban Australian refugee cohort"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":105,"citing_publications":111,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691050903359265"}},{"id":9631,"doi":"10.1080/10376178.2014.11081905","pmid":"25267126","pmcid":null,"title":"School-based youth health nurses and adolescent decision-making concerning reproductive and sexual health advice: How can the law guide healthcare practitioners in this context?","authors":"Smith MK, Stepanov N.","first_author":"Smith MK","journal":"Contemporary nurse","year":2014,"pub_types":["Journal Article"],"keywords":["Adolescent Decision-making","Gillick Competency","Adolescents And Reproductive Decisions","Adolescents And Sexual Health Advice","School-based Youth Health Nurses"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary / legal overview without empirical data","sample_n":null,"sample_text":"not applicable – no empirical participants","population":"school‑based youth health nurses and adolescent clients in Queensland, Australia","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article explains how Australian law, especially the Gillick competency principle, guides school nurses in deciding when a teenager can consent to reproductive and sexual health advice without parental permission, emphasizing confidentiality.","clinical_takeaway":"School nurses should assess Gillick competency to maintain confidentiality and facilitate adolescent access to sexual‑health advice.","confidence":0.8,"topic_tags":["adolescents","sexual_function","religiosity"],"strengths":["Clear exposition of legal framework (Gillick competency)","Practical examples for clinicians","Focus on confidentiality to promote health‑seeking"],"limitations":["No original data or empirical testing","Limited to Australian legal context","Does not address psychological or behavioural outcomes"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10376178.2014.11081905"}},{"id":9633,"doi":"10.1136/jfprhc-2012-100507","pmid":"23349534","pmcid":null,"title":"Understanding barriers to sexual health service access among substance-misusing women on the South East coast of England","authors":"Edelman NL, Patel H, Glasper A, Bogen-Johnston L.","first_author":"Edelman NL","journal":"The journal of family planning and reproductive health care","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Contraception","Service Delivery","Sexually Transmitted Infections","Genitourinary Medicine","Cervical Screening"],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"interview-based thematic analysis of 20 women with problem drug use; convenience sample; no quantitative hypothesis testing","sample_n":20,"sample_text":"Twenty women with problem drug use participated in one‑to‑one interviews.","population":"substance‑misusing women (SMW) in Hastings, South East England","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 20 women who use drugs in England revealed that unstable lifestyles, trauma, low self‑esteem and practical challenges make it hard for them to attend sexual‑health services such as contraception and cervical screening.","clinical_takeaway":"Clinicians should address stigma, logistical barriers and trauma when offering sexual‑health care to women who misuse substances.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["In‑depth, participant‑led qualitative data","Identifies practical, emotional and social barriers","Addresses an under‑studied high‑risk group"],"limitations":["Small, non‑representative convenience sample","No quantitative assessment of prevalence","Findings not generalisable beyond the local setting"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":36,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/jfprhc-2012-100507"}},{"id":9634,"doi":"10.1176/appi.ap.34.5.333","pmid":"20833900","pmcid":null,"title":"Sexual health curricula in U.S. medical schools: current educational objectives","authors":"Galletly C, Lechuga J, Layde JB, Pinkerton S.","first_author":"Galletly C","journal":"Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Narrative review of curricula documents and professional guidelines; no primary data collection.","sample_n":null,"sample_text":"N/A","population":"U.S. medical school curricula (no human participants)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper reviews what U.S. medical schools teach about human sexuality, finding that curricula concentrate mainly on diagnosing sexual problems and overlook healthy sexual function and broader therapeutic roles.","clinical_takeaway":"Medical education should broaden sexual health teaching to include healthy sexuality, not just pathology.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Comprehensive synthesis of existing curriculum documents","Highlights gap between pathological focus and healthy sexuality"],"limitations":["No empirical data on learner outcomes","Narrative rather than systematic review"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1176/appi.ap.34.5.333"}},{"id":9635,"doi":"10.1258/0956462053057657","pmid":"15807934","pmcid":null,"title":"What's in a word? Case definitions in sexual health medicine","authors":"Chan DJ, Donovan B.","first_author":"Chan DJ","journal":"International journal of STD & AIDS","year":2005,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary/editorial with no empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article discusses how case definitions for sexually transmitted infections are created, highlighting the trade‑offs between sensitivity, specificity, and purpose, and the difficulty of reaching consensus for complex conditions.","clinical_takeaway":"None – the paper is theoretical and does not provide clinical guidance.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear discussion of case-definition challenges","Relevant to disease surveillance and research"],"limitations":["No empirical data or analysis","Limited direct applicability to pornography or CSBD"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1258/0956462053057657"}},{"id":9636,"doi":"10.1080/13691050701819155","pmid":"18446559","pmcid":null,"title":"Male sexual health concerns in Muong Khen, Vietnam","authors":"Phong VH.","first_author":"Phong VH.","journal":"Culture, health & sexuality","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"qualitative study using observation, in‑depth interviews and focus groups in a single rural town","sample_n":null,"sample_text":"unspecified; likely convenience sample of community members","population":"men in Muong Khen, Vietnam (sample size not reported)","country":"Vietnam","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Interviews and focus groups with men in a rural Vietnamese town show that their sexual‑health worries are linked more to economic pressure, heavy drinking, and cultural ideas about masculinity than to purely medical problems.","clinical_takeaway":"Clinicians should consider economic stress and cultural expectations when addressing men’s sexual‑health concerns.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Rich, contextual qualitative data","Multiple data sources (observation, interviews, focus groups)","Highlights socioeconomic and cultural determinants of male sexual health"],"limitations":["No clear operational definitions of “sexual health concerns”","Sample size and selection procedures not reported","No quantitative measurement or statistical analysis"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13691050701819155"}},{"id":9638,"doi":"10.1023/b:aseb.0000026623.69017.df","pmid":"15129042","pmcid":"PMC3329728","title":"A study in sexual health applying the principles of community-based participatory research","authors":"Reece M, Dodge B.","first_author":"Reece M","journal":"Archives of sexual behavior","year":2004,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":34,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"exploratory participatory study examining cruising for sex among college men; likely qualitative, no control group","sample_n":null,"sample_text":"not reported in abstract","population":"college men (likely convenience sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors used community‑based participatory research to explore how men on a college campus meet for sex (“cruising”) and reflected on the process. The study is descriptive and offers insights into conducting participatory sexual‑health research.","clinical_takeaway":"None – the study provides methodological insight rather than clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Community‑based participatory approach","Focus on a specific sexual health context (cruising)","Provides methodological reflections for similar work"],"limitations":["No quantitative data or validated measures reported","Likely small, non‑representative sample","No control for key confounds (e.g., mental health, religiosity)","Findings not generalizable beyond the studied campus"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":42,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1023/b:aseb.0000026623.69017.df"}},{"id":9639,"doi":"10.1071/he12924","pmid":"24168740","pmcid":null,"title":"The Torres Indigenous Hip Hop Project: evaluating the use of performing arts as a medium for sexual health promotion","authors":"McEwan A, Crouch A, Robertson H, Fagan P.","first_author":"McEwan A","journal":"Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":12,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case study","sample_n":null,"sample_text":"Not specified; case study focusing on project implementation and stakeholder interviews","population":"Indigenous youth and community members in Torres and Northern Peninsula Area, Queensland","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A hip‑hop project was run with Aboriginal and Torres Strait Islander youth to raise awareness of sexual‑health issues. Interviews and project records showed it helped mobilise the community and increased knowledge, but the study offers limited evidence of lasting health effects.","clinical_takeaway":"Community‑driven arts programmes can engage young people on sexual health, but more rigorous evaluation is needed to confirm impact.","confidence":0.8,"topic_tags":["sexual_function","adolescents"],"strengths":["Real‑world implementation of a culturally tailored health promotion approach","Uses both project documentation and stakeholder interviews for triangulation"],"limitations":["Case‑study design limits generalisability","No validated measurement of sexual‑health knowledge or behaviour change","Small, non‑random sample; lacks quantitative outcome data"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":1,"contrasting":0,"mentioning":40,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/he12924"}},{"id":9640,"doi":"10.1001/jamapediatrics.2013.1089","pmid":"23440337","pmcid":"PMC4361088","title":"Prime time: sexual health outcomes at 24 months for a clinic-linked intervention to prevent pregnancy risk behaviors","authors":"Sieving RE, McRee AL, McMorris BJ, Beckman KJ, Pettingell SL, Bearinger LH, Garwick AW, Oliphant JA, Plowman S, Resnick MD, Secor-Turner M.","first_author":"Sieving RE","journal":"JAMA pediatrics","year":2013,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Multicenter Study","Randomized Controlled Trial","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"Randomized controlled trial with 236 adolescent girls completing 24‑month follow‑up; clinic‑linked youth development intervention versus usual care.","sample_n":236,"sample_text":"236 participants completed the 24‑month follow‑up survey.","population":"Sexually active 13‑17‑year‑old girls at high risk for pregnancy attending community/school‑based primary care clinics (N≈253).","country":"United States","controls_mi":"not_applicable","preregistered":true,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A two‑year follow‑up of an RCT showed that adolescent girls who received a clinic‑based youth‑development program used condoms and hormonal contraception more consistently than those who received usual care.","clinical_takeaway":"Youth‑development interventions in clinics can improve contraceptive consistency among high‑risk teen girls.","confidence":0.9,"topic_tags":["adolescents","sexual_function"],"strengths":["Large, multi‑site RCT with high follow‑up rate (93%).","Intention‑to‑treat analysis.","Relevant, theory‑driven youth‑development intervention."],"limitations":["Outcomes rely on self‑report, possible social desirability bias.","Sample limited to high‑risk clinic‑seeking adolescents; limited generalisability.","No objective biological or behavioral verification of contraceptive use."],"rubric_version":"2.0","raw_total":33,"max_possible":50,"pct_score":66,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":8,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":32,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/jamapediatrics.2013.1089"}},{"id":9641,"doi":"10.1080/13557858.2013.789829","pmid":"23597207","pmcid":"PMC4095972","title":"The impact of migration on the sexual health, behaviours and attitudes of Central and East European gay/bisexual men in London","authors":"Mole RC, Parutis V, Gerry CJ, Burns FM.","first_author":"Mole RC","journal":"Ethnicity & health","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC4095972","cited_by_count":16,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"cross-sectional qualitative interview study","sample_n":17,"sample_text":"Seventeen in‑depth interviews","population":"gay/bisexual male migrants from Central and Eastern Europe living in London","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 17 gay and bisexual men who migrated from Central/Eastern Europe to London show that leaving restrictive home cultures and accessing gay venues increased their sexual activity and STI risk, especially early after migration.","clinical_takeaway":"Clinicians should explore migration‑related changes in sexual networks and risk perception when counseling migrant GBM patients.","confidence":0.78,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight into migration processes","Use of a well‑established behavioural model (IMB) as framework","Identifies concrete policy‑relevant factors"],"limitations":["Small, non‑representative convenience sample","No validated quantitative measures of sexual behaviour or risk","Potential lack of reflexivity about researcher bias"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":34,"citing_publications":34,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/13557858.2013.789829"}},{"id":9642,"doi":"10.2105/ajph.2008.138669","pmid":"18703431","pmcid":null,"title":"HIV/AIDS, reproductive and sexual health, and the law","authors":"Gable L, Gostin LO, Hodge JG.","first_author":"Gable L","journal":"American journal of public health","year":2008,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review discussing legal frameworks for HIV/AIDS, reproductive and sexual health; no primary data.","sample_n":null,"sample_text":"N/A","population":"None (policy/legal analysis)","country":"United States (focus on US and global law)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that well‑crafted laws can improve access to reproductive and sexual health services for people living with HIV/AIDS and reduce discrimination and violence.","clinical_takeaway":"None – the paper offers legal‑policy guidance, not clinical advice.","confidence":0.4,"topic_tags":["sexual_function","religiosity"],"strengths":["Broad synthesis of legal literature","Clear policy recommendations"],"limitations":["No empirical data","Narrative rather than systematic review"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2105/ajph.2008.138669"}},{"id":9644,"doi":"10.1016/s0968-8080(13)41702-0","pmid":"23684195","pmcid":null,"title":"The Sexuality Education Initiative: a programme involving teenagers, schools, parents and sexual health services in Los Angeles, CA, USA","authors":"Marques M, Ressa N.","first_author":"Marques M","journal":"Reproductive health matters","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"program description without empirical outcome data","sample_n":null,"sample_text":"No empirical sample reported; article describes a programme implementation.","population":"teenagers (ninth‑grade students) in Los Angeles schools; parents; teachers; health‑service staff","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper outlines a Los Angeles teen‑focused sexuality education programme that combines classroom lessons, parent workshops, peer advocacy and health‑service links, aiming to promote critical thinking, human rights and gender equality.","clinical_takeaway":"None – the article does not provide evidence on outcomes for clinicians.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Describes a rights‑based, comprehensive sexuality education framework","Includes multi‑level components (students, parents, peers, health services)"],"limitations":["No quantitative outcome data reported","No assessment of program effectiveness or impact","Lacks measurement of sexual health or behavioural outcomes"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":34,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s0968-8080(13)41702-0"}},{"id":9645,"doi":null,"pmid":"16913284","pmcid":null,"title":"Global transformations and intimate relations in the 21st century: social science research on sexuality and the emergence of sexual health and sexual rights frameworks","authors":"Parker R, di Mauro D, Filiano B, Garcia J, Muñoz-Laboy M, Sember R.","first_author":"Parker R","journal":"Annual review of sex research","year":2004,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"narrative review without systematic methodology or risk‑of‑bias assessment","sample_n":null,"sample_text":"N/A – article does not report original participants","population":"none (review of literature)","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The review describes how global social, political and economic changes have moved sexuality research from a medical focus toward rights‑based and social‑justice approaches, using sex‑trafficking and same‑sex‑marriage as examples.","clinical_takeaway":"None – the article provides historical context but no direct clinical guidance for pornography or sexual‑health practice.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad, interdisciplinary synthesis of social‑science perspectives on sexuality","Highlights the shift toward rights‑based frameworks","Integrates examples from sex trafficking and same‑sex marriage literature"],"limitations":["Non‑systematic, no explicit inclusion/exclusion criteria","No quantitative appraisal or risk‑of‑bias evaluation","Lacks empirical data on pornography, masturbation or CSBD"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":9646,"doi":"10.1188/08.cjon.457-463","pmid":"18515244","pmcid":null,"title":"Addressing the sexual health needs of patients with gynecologic cancers","authors":"Stilos K, Doyle C, Daines P.","first_author":"Stilos K","journal":"Clinical journal of oncology nursing","year":2008,"pub_types":["Review","Journal Article","Case Reports"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"Review with illustrative case; no original empirical data; narrative guidance for nurses.","sample_n":null,"sample_text":"Not applicable – narrative review/case description","population":"Women with gynecologic cancers (cervical, uterine, etc.)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article explains why sexual health is often missed in care for women with gynecologic cancers and gives nurses a step‑by‑step model (PLISSIT) to discuss sexual concerns with patients and their partners.","clinical_takeaway":"Nurses should use structured approaches like PLISSIT to address sexual health proactively in cancer care.","confidence":0.5,"topic_tags":["sexual_function","csbd","pornography","masturbation"],"strengths":["Provides practical nursing framework (PLISSIT)","Highlights often‑ignored sexual health issues in cancer care"],"limitations":["No original data; relies on narrative review","No systematic methodology or risk‑of‑bias assessment","Limited generalizability beyond described case"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":1,"mentioning":38,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1188/08.cjon.457-463"}},{"id":9647,"doi":"10.1093/her/cyt155","pmid":"24488650","pmcid":null,"title":"Using process data to understand outcomes in sexual health promotion: an example from a review of school-based programmes to prevent sexually transmitted infections","authors":"Shepherd J, Harden A, Barnett-Page E, Kavanagh J, Picot J, Frampton GK, Cooper K, Hartwell D, Clegg A.","first_author":"Shepherd J","journal":"Health education research","year":2014,"pub_types":["Research Support, Non-U.S. Gov't","Systematic Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 12 outcome evaluations of school‑based sexual health programmes, 9 with process evaluations. No meta‑analysis reported.","sample_n":null,"sample_text":"12 eligible outcome evaluations; 9 included process evaluation","population":"Adolescents/young people in school settings (no sample size reported in abstract)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of school programmes aimed at preventing STIs shows that while changes in sexual behaviour were rarely significant, improvements in knowledge and confidence were more common. Success depended on good teacher training, stakeholder support, and relevance to students.","clinical_takeaway":"Effective school sexual‑health programs need strong teacher preparation and student‑centred content to boost knowledge and self‑efficacy.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive review of both outcome and process data","Identifies implementation factors influencing effectiveness","Highlights importance of student engagement"],"limitations":["No meta‑analytic synthesis; effect sizes not pooled","Limited description of risk‑of‑bias assessment","Abstract lacks detail on measurement validation"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":22,"citing_publications":19,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/her/cyt155"}},{"id":9648,"doi":"10.1080/09540121003668128","pmid":"20640953","pmcid":null,"title":"The semantics of sexual behavior and their implications for HIV/AIDS research and sexual health: US and UK gay men's definitions of having \"had sex\"","authors":"Hill BJ, Rahman Q, Bright DA, Sanders SA.","first_author":"Hill BJ","journal":"AIDS care","year":2010,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience online surveys of gay men in the US (n=190) and UK (n=180) asking whether specific behaviours count as \"having sex\".","sample_n":370,"sample_text":"180 UK gay men; 190 US gay men; convenience sampling.","population":"Self‑identified gay men, ages 18‑74, recruited via non‑probability sampling.","country":"US, UK","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Gay men in the US and UK disagree on which acts count as \"having sex\"; only penile‑anal intercourse is consistently labelled as sex, while oral, manual, and toy activities vary widely. Researchers and clinicians should ask about specific behaviours rather than assume a shared definition.","clinical_takeaway":"Use detailed behaviour checklists when taking sexual histories to avoid misclassifying risk.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Addresses an under‑studied definitional issue.","Includes two large international samples.","Clear, behavior‑specific questionnaire."],"limitations":["Convenience sampling limits generalisability.","Questionnaire not validated.","No power calculations or effect‑size reporting."],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":1,"mentioning":11,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/09540121003668128"}},{"id":9649,"doi":"10.1097/ppo.0b013e31819587dc","pmid":"19197178","pmcid":null,"title":"Sexual health communication during cancer care: barriers and recommendations","authors":"Park ER, Norris RL, Bober SL.","first_author":"Park ER","journal":"Cancer journal (Sudbury, Mass.)","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":137,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"0-2","sample_n":null,"sample_text":"Not applicable – narrative review","population":"cancer patients and clinicians (unspecified)","country":"USA (journal based in Sudbury, Massachusetts)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how cancer patients and clinicians talk (or don’t talk) about sexual problems caused by cancer treatment, summarises barriers, and suggests a 5‑step counseling model to improve communication.","clinical_takeaway":"Clinicians should proactively discuss sexual health with cancer patients using structured communication tools.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Addresses an under‑studied aspect of cancer care","Synthesizes existing literature","Proposes a practical communication framework"],"limitations":["Narrative, not systematic review","No empirical data or quantitative analysis","Lacks explicit methodological description"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":6,"contrasting":0,"mentioning":130,"citing_publications":187,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/ppo.0b013e31819587dc"}},{"id":9650,"doi":null,"pmid":"24494508","pmcid":null,"title":"'Stret tokers'--taking sexual health promotion to the village level in East New Britain Province, Papua New Guinea","authors":"Natoli LJ, Wambo G, Gabong R, Kavang E, Luana S, Sawa A, Supsup H, Jackson E.","first_author":"Natoli LJ","journal":"Papua and New Guinea medical journal","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"implementation report / descriptive study of community health promotion (no quantitative outcomes reported)","sample_n":null,"sample_text":"not specified in abstract","population":"rural communities in East New Britain Province, Papua New Guinea","country":"Papua New Guinea","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The ENBSHIP program trained village 'straight talkers' in Papua New Guinea to raise STI awareness and link communities to health services. The report describes the initiative’s enthusiasm and challenges but provides no measurable outcomes.","clinical_takeaway":"None – the paper does not provide evidence on clinical effectiveness.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Community‑based, culturally tailored intervention","Engagement with local leadership structures"],"limitations":["No quantitative outcome data presented","No clear evaluation of effectiveness","Sample size and selection not described"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":9651,"doi":"10.1097/00003727-200601001-00010","pmid":"16344638","pmcid":null,"title":"Sexual health promotion in adolescents with chronic health conditions","authors":"Rew L.","first_author":"Rew L.","journal":"Family & community health","year":2006,"pub_types":["Review","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methodology; no empirical data presented.","sample_n":null,"sample_text":"Not applicable – review article","population":"Adolescents with chronic health conditions (no sample size reported)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews what sexual health means for teenagers with chronic illnesses and outlines physical, mental and social aspects of development, ending with advice for clinicians, parents and teachers.","clinical_takeaway":"Clinicians should address the broader sexual‑health needs of chronically ill teens using the outlined developmental domains.","confidence":0.4,"topic_tags":["adolescents","sexual_function"],"strengths":["Clear overview of sexual health domains","Focus on a vulnerable adolescent population","Practical suggestions for practitioners"],"limitations":["No systematic search or risk‑of‑bias assessment","No empirical data or quantitative synthesis","Unclear methodology limits reproducibility"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00003727-200601001-00010"}},{"id":9652,"doi":"10.1007/s10461-011-9901-6","pmid":"21331797","pmcid":null,"title":"Sexual health, HIV, and sexually transmitted infections among gay, bisexual, and other men who have sex with men in the United States","authors":"Wolitski RJ, Fenton KA.","first_author":"Wolitski RJ","journal":"AIDS and behavior","year":2011,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":94,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review of epidemiological data on MSM sexual health, HIV, and STIs in the US. No original empirical data, no systematic methods reported.","sample_n":null,"sample_text":"Not applicable – the article synthesises existing surveillance and research data rather than collecting a primary sample.","population":"Gay, bisexual, and other men who have sex with men in the United States (national scope, but based on secondary sources).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors review US data showing that gay, bisexual, and other men who have sex with men continue to face high and rising rates of HIV and other sexually transmitted infections, arguing that a broader sexual‑health approach is needed.","clinical_takeaway":"Clinicians should adopt a holistic sexual‑health perspective when working with MSM, recognizing persistent HIV/STI risks.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Comprehensive overview of US MSM HIV/STI trends","Highlights public‑health urgency and need for sexual‑health framing"],"limitations":["No systematic review methodology; selection bias possible","No original data, statistical analyses, or effect‑size reporting","Does not address key confounds (e.g., mental health, moral incongruence)"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":1,"mentioning":95,"citing_publications":158,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10461-011-9901-6"}},{"id":9653,"doi":"10.3402/ijch.v68i4.17370","pmid":"19917192","pmcid":null,"title":"The practical application of community-based participatory research in Greenland: initial experiences of the Greenland Sexual Health Study","authors":"Rink E, Gesink Law D, Montgomery-Andersen R, Mulvad G, Koch A.","first_author":"Rink E","journal":"International journal of circumpolar health","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.3402/ijch.v68i4.17370","cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pilot community‑based participatory research study describing STI prevalence in Greenland; convenience sampling of community members; descriptive analysis.","sample_n":null,"sample_text":"Not reported in abstract","population":"Greenland residents (adults and adolescents) participating in a CBPR sexual health project","country":"Greenland","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors describe how they applied community‑based participatory research methods to study sexually transmitted infections in Greenland, highlighting early challenges and practical solutions for conducting health research with Arctic communities.","clinical_takeaway":"None – the paper reports methodological experiences, not clinical findings.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Use of community‑based participatory approach","Laboratory‑confirmed STI outcomes"],"limitations":["Convenience sample limits generalisability","No pre‑registration or power justification reported","Limited statistical detail in abstract"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3402/ijch.v68i4.17370"}},{"id":9654,"doi":"10.1177/1557988307300784","pmid":"19482791","pmcid":null,"title":"Starting on a healthy path: promotion of young men's sexual health","authors":"Park MJ, Breland D.","first_author":"Park MJ","journal":"American journal of men's health","year":2007,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary / perspective piece without new empirical data","sample_n":null,"sample_text":"Not applicable – no primary data collected","population":"young men, primarily African American adolescents (as described)","country":"United States (implied by authors and funding)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that improving young men's sexual health needs education, better health services, and attention to cultural context, especially for African‑American adolescents.","clinical_takeaway":"Clinicians should adopt holistic, culturally aware sexual‑health education for adolescent males.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Addresses an under‑studied population (young men)","Integrates health promotion, education, and clinical care perspectives"],"limitations":["No original data; conclusions based on existing literature","Lacks systematic methodology or risk‑of‑bias assessment","No quantitative analysis or effect size reporting"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1557988307300784"}},{"id":9655,"doi":"10.3402/ijch.v69i1.17423","pmid":"20167154","pmcid":null,"title":"Developing a culturally competent and socially relevant sexual health survey with an urban Arctic community","authors":"Gesink D, Rink E, Montgomery-Andersen R, Mulvad G, Koch A.","first_author":"Gesink D","journal":"International journal of circumpolar health","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":"https://doi.org/10.3402/ijch.v69i1.17423","cited_by_count":19,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative interview study developing a culturally relevant sexual health survey; community informants (n=10) + cognitive interviews (n=11) plus pilot implementation (n=149).","sample_n":149,"sample_text":"149 participants completed the final survey; qualitative phases involved 10 informants and 11 interviewees.","population":"Residents of Nuuk, Greenland, aged 15+ (mixed gender, urban Inuit population).","country":"Greenland","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Researchers worked with Inuit community members in Nuuk, Greenland, to create a culturally appropriate sexual health questionnaire, testing it through interviews and a pilot survey.","clinical_takeaway":"None – the study provides a survey tool, not clinical guidance on sexual health.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Community‑based participatory approach","Iterative cognitive interviewing","High completion rate in pilot implementation"],"limitations":["No psychometric validation of final survey reported","Small qualitative sample; snowball sampling may limit representativeness","Limited statistical analysis (qualitative focus)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":44,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3402/ijch.v69i1.17423"}},{"id":9656,"doi":"10.1111/j.1743-6109.2009.01334.x","pmid":"19493279","pmcid":null,"title":"Patients' sexual health: a qualitative research approach on Greek nurses' perceptions","authors":"Nakopoulou E, Papaharitou S, Hatzichristou D.","first_author":"Nakopoulou E","journal":"The journal of sexual medicine","year":2009,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"focus groups with purposive sample of 44 nurses; thematic analysis (grounded theory)","sample_n":44,"sample_text":"purposive sample of 44 Greek staff nurses","population":"Greek staff nurses (n=44), attending professional upgrading course","country":"Greece","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Greek nurses say they understand sexual health but feel uncomfortable discussing it with patients due to personal and workplace barriers. They want more training in both the biology of sexuality and communication skills.","clinical_takeaway":"Clinicians should provide targeted education and communication training to help nurses comfortably address sexual health with patients.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["In‑depth qualitative insight into nurses’ perceptions","Use of grounded‑theory thematic analysis","Clear identification of educational needs"],"limitations":["Small, non‑representative purposive sample","Findings not generalisable beyond Greek nursing context","No quantitative assessment of attitudes"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":51,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2009.01334.x"}},{"id":9657,"doi":"10.1038/sj.ijir.3901193","pmid":"14973522","pmcid":null,"title":"Impact of spinal cord injury on sexual health and quality of life","authors":"Reitz A, Tobe V, Knapp PA, Schurch B.","first_author":"Reitz A","journal":"International journal of impotence research","year":2004,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":54,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Questionnaire survey of 63 spinal‑cord‑injury patients (convenience sample); cross‑sectional analysis of correlations between sexual function variables and quality‑of‑life outcomes.","sample_n":63,"sample_text":"63 responding patients out of 120 surveyed.","population":"Adults with spinal‑cord injury (both sexes) who responded to a mailed questionnaire.","country":"Not specified (likely international sample).","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 63 people with spinal‑cord injury, sexual function was markedly affected, and factors such as partner relationship, physical health and mental well‑being were linked to overall quality of life and satisfaction with sexual life.","clinical_takeaway":"Clinicians should consider relational and psychosocial factors, not just physical abilities, when supporting sexual wellbeing after spinal‑cord injury.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Focus on a clinical population often under‑studied.","Comprehensive set of sexual‑health variables examined.","Links sexual adjustment to broader quality‑of‑life factors."],"limitations":["Small, self‑selected sample; low response rate.","Questionnaire not identified as a validated instrument.","No control for key confounds (e.g., mental health, partner dynamics).","Cross‑sectional design precludes causal inference."],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":10,"contrasting":0,"mentioning":76,"citing_publications":101,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/sj.ijir.3901193"}},{"id":9658,"doi":"10.1007/s10508-005-9016-0","pmid":"16752117","pmcid":null,"title":"To be seen and not heard: femininity ideology and adolescent girls' sexual health","authors":"Impett EA, Schooler D, Tolman DL.","first_author":"Impett EA","journal":"Archives of sexual behavior","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":81,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 116 adolescent girls","sample_n":116,"sample_text":"116 girls (aged 16-19)","population":"Adolescent females, ages 16-19, likely convenience sample (e.g., schools)","country":"USA (implied by New England focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"The study surveyed 116 teenage girls and found that internalizing traditional ideas about femininity—feeling inauthentic in relationships and focusing on body appearance—was linked to lower confidence in managing sexual needs and to less use of protection against STIs and pregnancy.","clinical_takeaway":"Feelings of inauthenticity and body objectification may reduce sexual self‑efficacy and protective behaviors in adolescent girls; clinicians should address gender norms when promoting sexual health.","confidence":0.7,"topic_tags":["adolescents","sexual_function","gender"],"strengths":["Uses a feminist developmental framework","Measures both self‑efficacy and concrete protection behaviors","Relatively large sample for adolescent survey research"],"limitations":["Cross‑sectional design limits causal inference","No assessment of key confounds (e.g., mental health, moral context)","Unclear if scales are fully validated"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":5,"contrasting":1,"mentioning":186,"citing_publications":230,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-005-9016-0"}},{"id":9659,"doi":"10.1783/147118907780254178","pmid":"17407676","pmcid":null,"title":"Inequalities in the provision of sexual health information for young people","authors":"McLaughlin M, Thompson K, Parahoo K, Armstrong J, Hume A.","first_author":"McLaughlin M","journal":"The journal of family planning and reproductive health care","year":2007,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Survey of 414 school pupils (age 14‑18) in Northern Ireland; self‑administered questionnaire on sexual activity, contraception use and sources of sexual‑health information.","sample_n":414,"sample_text":"School pupils aged 14‑18 years (n = 414).","population":"Adolescent school students in Northern Ireland (convenience sample from schools).","country":"United Kingdom (Northern Ireland)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A 2007 survey of 414 teenagers in Northern Ireland found that about half were sexually active, many used contraception inconsistently, and that religious background influenced where they got sexual‑health information, with Catholic students relying more on informal sources than school lessons.","clinical_takeaway":"Improving equitable, school‑based sexual‑health education may help reduce teenage STI rates and unintended pregnancies.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample for a school‑based survey.","Focus on inequalities related to religious background.","Provides descriptive data on contraception use."],"limitations":["Questionnaire not reported as validated.","Cross‑sectional, convenience sample limits causal inference.","Limited control for potential confounders."],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":1,"mentioning":6,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1783/147118907780254178"}},{"id":9660,"doi":"10.1016/j.maturitas.2007.08.010","pmid":"17920792","pmcid":null,"title":"Turkish women's level of knowledge on and attitude toward sexual health","authors":"Biri A, Korucuoglu U, Ilhan M, Bingol B, Yilmaz E, Biri H.","first_author":"Biri A","journal":"Maturitas","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross‑sectional survey of 1007 women attending gynecology/urology clinics","sample_n":1007,"sample_text":"1007 women recruited in gynecology and urology outpatient clinics of Gazi University, Turkey","population":"Turkish women, ages 14‑77, recruited from outpatient clinics (convenience sample)","country":"Turkey","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A 2007 Turkish survey of 1007 women asked about sexual knowledge and attitudes using a custom questionnaire. Most participants were married and sexually active, but many reported limited orgasm frequency. The authors note the lack of national data and suggest their findings give a first glimpse of women’s sexual health in Turkey.","clinical_takeaway":"Clinicians should recognise limited knowledge and orgasm experience among Turkish women, but the study’s non‑validated measures limit direct clinical use.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large sample size for a single‑site survey","First national‑level insight into Turkish women's sexual health knowledge"],"limitations":["Questionnaire not validated; construct validity uncertain","Convenience clinic sample limits generalisability","No measurement or control of key confounds (e.g., mental health, moral attitudes)","Interpretation exceeds data; no rigorous statistical reporting"],"rubric_version":"2.0","raw_total":13,"max_possible":50,"pct_score":26,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":0,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.maturitas.2007.08.010"}},{"id":9663,"doi":"10.1097/00003727-200610000-00008","pmid":"16980805","pmcid":null,"title":"Adolescent sexual health & practice--a review of the literature: implications for healthcare providers, educators, and policy makers","authors":"Ahern NR, Kiehl EM.","first_author":"Ahern NR","journal":"Family & community health","year":2006,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methodology or risk‑of‑bias assessment; no primary data collection.","sample_n":null,"sample_text":"Not applicable – literature review","population":"adolescents (general)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This narrative review summarizes existing research on adolescent sexual health and offers recommendations for health professionals, teachers, and policy makers to improve education and interventions for young people.","clinical_takeaway":"Use the highlighted strategies to guide adolescent sexual health programs, but recognize the review’s lack of systematic evidence.","confidence":0.6,"topic_tags":["adolescents","sexual_function"],"strengths":["Broad overview of adolescent sexual health literature","Highlights practical implications for providers and educators"],"limitations":["Narrative (non‑systematic) review; no explicit methodology","No quantitative synthesis or risk‑of‑bias assessment","Unclear whether literature search was comprehensive"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":6,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/00003727-200610000-00008"}},{"id":9664,"doi":null,"pmid":"12449269","pmcid":null,"title":"The proactive sexual health history","authors":"Nusbaum MR, Hamilton CD.","first_author":"Nusbaum MR","journal":"American family physician","year":2002,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":82,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review/guidance article; no original empirical data.","sample_n":null,"sample_text":"Not applicable – article is a review/guidance piece.","population":"Family physicians and general patient population (no specific sample).","country":"United States (journal of American Family Physician).","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article urges family doctors to routinely ask patients about all aspects of sexual health—not just STIs and contraception—so that risky behaviours and problems can be identified and treated early.","clinical_takeaway":"Integrate a non‑judgmental, permission‑based sexual history into every routine visit to improve detection of sexual health issues.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Clear practical recommendations for clinicians.","Addresses underestimation of sexual concerns in primary care."],"limitations":["No empirical data presented.","Lacks systematic review methodology."],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":9668,"doi":"10.1200/jco.1999.17.8.2371","pmid":"10561299","pmcid":null,"title":"Predictors of sexual health in women after a breast cancer diagnosis","authors":"Ganz PA, Desmond KA, Belin TR, Meyerowitz BE, Rowland JH.","first_author":"Ganz PA","journal":"Journal of clinical oncology : official journal of the American Society of Clinical Oncology","year":1999,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":229,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of breast cancer survivors with two independent samples; multivariable regression, stepwise and recursive partitioning used to predict sexual interest, dysfunction and satisfaction.","sample_n":null,"sample_text":"large sample of breast cancer survivors; exact N not provided in abstract","population":"Female breast cancer survivors (adult, middle‑aged to older), recruited via two separate cohorts.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In breast‑cancer survivors, having a new partner, better mental health, positive body image, less vaginal dryness, and good partner relationship quality predict better sexual interest, less dysfunction, and higher satisfaction.","clinical_takeaway":"Addressing vaginal dryness, mental well‑being, body image, and relationship quality may improve sexual health after breast cancer.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Large, independent validation sample","Multivariable modelling with several predictors","Inclusion of partner‑related variables"],"limitations":["No explicit reporting of instrument validation","Cross‑sectional design limits causal inference","Masturbation and moral‑incongruence not assessed"],"rubric_version":"2.0","raw_total":32,"max_possible":50,"pct_score":64,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":5,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":25,"contrasting":5,"mentioning":233,"citing_publications":353,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1200/jco.1999.17.8.2371"}},{"id":9669,"doi":"10.1111/j.1743-6109.2008.01082.x","pmid":"19040622","pmcid":null,"title":"Long-term assessment of the physical, mental, and sexual health among transsexual women","authors":"Weyers S, Elaut E, De Sutter P, Gerris J, T'Sjoen G, Heylens G, De Cuypere G, Verstraelen H.","first_author":"Weyers S","journal":"The journal of sexual medicine","year":2009,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":103,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey of 50 trans‑women ≥6 months post‑SRS; convenience sample; comparison with reference norms.","sample_n":50,"sample_text":"Fifty transsexual women who had undergone SRS ≥6 months earlier were recruited.","population":"Trans‑women who had undergone sex reassignment surgery (N≈50).","country":"Belgium (likely based on author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 50 transgender women at least six months after sex‑reassignment surgery found good overall physical and mental health, but lower sexual functioning—especially arousal, lubrication, and pain—compared with cisgender women; being in a relationship and heterosexual orientation were linked to better scores.","clinical_takeaway":"Trans women generally report good health after surgery, yet clinicians should address specific sexual function difficulties, especially in arousal and pain.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Use of validated health and sexual function instruments (SF‑36, FSFI).","Focus on long‑term outcomes after SRS.","Comparison with population norms."],"limitations":["Small, non‑random convenience sample (N=50).","Cross‑sectional design; no causal inference.","Limited statistical detail; effect sizes and power not reported."],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":7,"contrasting":2,"mentioning":153,"citing_publications":191,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2008.01082.x"}},{"id":9670,"doi":"10.1016/j.crohns.2013.01.018","pmid":"23453888","pmcid":null,"title":"Illness perceptions in IBD influence psychological status, sexual health and satisfaction, body image and relational functioning: A preliminary exploration using Structural Equation Modeling","authors":"Knowles SR, Gass C, Macrae F.","first_author":"Knowles SR","journal":"Journal of Crohn's & colitis","year":2013,"pub_types":["Journal Article"],"keywords":["Sexual Health","Inflammatory Bowel Disease","Depression And Anxiety","Common Sense Model","Marital And Family Functioning"],"is_oa":false,"oa_url":null,"cited_by_count":75,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 74 IBD patients, structural equation modeling","sample_n":74,"sample_text":"74 IBD patients (44 Crohn’s disease, 13 males, 61 females, mean age 38 years) completed an online questionnaire.","population":"adult patients with inflammatory bowel disease (IBD)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 74 people with inflammatory bowel disease, how they think about their illness was linked to more anxiety, depression, sexual problems and lower family functioning. Negative illness views also affected body image and intimacy.","clinical_takeaway":"Addressing patients' illness perceptions may help improve their mental health and sexual wellbeing.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of validated psychometric instruments","Comprehensive structural equation model with good fit indices","Inclusion of multiple psychosocial domains"],"limitations":["Cross‑sectional design limits causal inference","Small sample for SEM (N=74) may be underpowered","Convenience online recruitment may bias sample"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":12,"contrasting":1,"mentioning":92,"citing_publications":110,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.crohns.2013.01.018"}},{"id":9671,"doi":"10.1046/j.1365-2648.1997.t01-1-1997025615.x","pmid":"9080290","pmcid":null,"title":"The politics of sex research and constructions of female sexuality: what relevance to sexual health work with young women?","authors":"Few C.","first_author":"Few C.","journal":"Journal of advanced nursing","year":1997,"pub_types":["Review","Journal Article"],"keywords":["Culture","Viral diseases","Personality","Behavior","Power","Health","Communication","Diseases","Sex behavior","Literature review","research methodology","Europe","Psychological factors","Developed Countries","Northern Europe","England","Economic Factors","Socioeconomic Factors","Hiv Infections--prevention And Control","Political Factors","Theoretical Studies","Reproductive Health--women","Research Activities","Gender Issues","United Kingdom","Inequalities","Gender Relations","Sexuality--women"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"review","sample_n":null,"sample_text":"N/A – narrative literature review","population":"young heterosexual women (conceptual focus)","country":"Europe (focus on Northern Europe)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper argues that HIV‑prevention messages for young women often rely on narrow, biologically‑deterministic ideas of female sexuality, which can limit women’s sexual health and empowerment. It calls for clinicians to recognize diverse sexual experiences and reflect on their own assumptions.","clinical_takeaway":"Clinicians should consider cultural and personal biases when advising young women on sexual health and HIV prevention.","confidence":0.4,"topic_tags":["sexual_function","csbd"],"strengths":["Broad theoretical integration of cultural theory","Highlights importance of clinician self‑reflection"],"limitations":["Narrative, non‑systematic review","No empirical data or systematic bias assessment","Lacks measurement of key constructs"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":1,"contrasting":0,"mentioning":16,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1046/j.1365-2648.1997.t01-1-1997025615.x"}},{"id":9672,"doi":"10.1080/07448480109596312","pmid":"11413943","pmcid":null,"title":"Men's reproductive and sexual health","authors":"Forrest KA.","first_author":"Forrest KA.","journal":"Journal of American college health : J of ACH","year":2001,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review without systematic methodology or empirical data.","sample_n":null,"sample_text":"No empirical sample; the article is a narrative review.","population":"College men in the United States (general description, no specific sample size).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews the range of medical and psychosocial reproductive and sexual health issues that affect college men, and argues that health services should tailor screening, treatment, and education to their specific needs.","clinical_takeaway":"Colleges should provide male‑focused sexual health services that address both medical and psychosocial needs.","confidence":0.8,"topic_tags":["sexual_function","religiosity","moral_incongruence"],"strengths":["Broad overview of men’s reproductive and sexual health topics.","Highlights the need for gender‑specific services in college health settings."],"limitations":["Narrative, not systematic; no explicit methodology.","No empirical data or systematic literature search.","No assessment of measurement validity or confounding factors."],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":11,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/07448480109596312"}},{"id":9673,"doi":"10.1071/sh04008","pmid":"16335750","pmcid":null,"title":"A sexual health strategy for Australia--time for action","authors":"Chan DJ, Bradford DL.","first_author":"Chan DJ","journal":"Sexual health","year":2004,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary (policy proposal without empirical data)","sample_n":null,"sample_text":"Not applicable – no empirical sample reported","population":"Australia (national context, no specific sample)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that Australia needs a national sexual health strategy that goes beyond disease control to include social and cultural aspects of sexuality, modelling it on the UK and New Zealand.","clinical_takeaway":"None – the paper is a policy discussion without direct clinical guidance.","confidence":0.8,"topic_tags":["sexual_function","gender"],"strengths":["Identifies need for comprehensive national sexual health strategy","Considers broader social and cultural dimensions"],"limitations":["No empirical data or systematic review","Lacks measured outcomes or evaluation of interventions","No assessment of confounding factors"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":5,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1071/sh04008"}},{"id":9674,"doi":"10.1111/j.1743-6109.2010.02100.x","pmid":"21054803","pmcid":null,"title":"Sexual health difficulties in a population-based sample of Croatian women aged 18-35 and the effects of the dual (career and motherhood) role","authors":"Stulhofer A, Kuljanić K, Buzina DŠ.","first_author":"Stulhofer A","journal":"The journal of sexual medicine","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Population-based multistage probability sample of 1,000 Croatian women (N=870 sexually active) surveyed in 2010; logistic regression used to examine correlates of sexual difficulties.","sample_n":870,"sample_text":"Multistage probability sample (response rate 37.3%)","population":"Women aged 18‑35 in Croatia (general population)","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a nationally representative survey of Croatian women aged 18‑35, about one‑quarter reported problems such as low desire, pain, or difficulty reaching orgasm. These issues were linked to lower sexual satisfaction, but juggling work and motherhood did not increase risk.","clinical_takeaway":"Sexual function problems are common in young women and relate to satisfaction; clinicians should assess them regardless of work‑family role.","confidence":0.8,"topic_tags":["sexual_function","prevalence","gender","relationships"],"strengths":["Large, probability‑based sample","Focus on multiple specific sexual function problems","Multivariate logistic regression controlling for several sociodemographic variables"],"limitations":["Reliance on single‑item self‑report measures rather than validated multi‑item scales","Cross‑sectional design limits causal inference","Key psychological confounds (mental health, moral attitudes, trauma) not assessed"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":1,"mentioning":8,"citing_publications":13,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2010.02100.x"}},{"id":9676,"doi":"10.1191/0969733005ne774oa","pmid":"15791787","pmcid":null,"title":"Ethics, government and sexual health: insights from Foucault","authors":"Winch S.","first_author":"Winch S.","journal":"Nursing ethics","year":2005,"pub_types":["Historical Article","Biography","Journal Article"],"keywords":["Bioethics And Professional Ethics","Philosophical Approach"],"is_oa":false,"oa_url":null,"cited_by_count":6,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"none","sample_n":null,"sample_text":"Not applicable – no empirical sample","population":"nurses, theoretical discussion","country":"France (theoretical focus)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article uses Foucauldian philosophy to offer a framework for nurses to examine ethics, identity, and power in sexual health practice, suggesting how to collect and analyse qualitative data.","clinical_takeaway":"None – the paper is theoretical and does not provide clinical guidance on pornography or sexual health interventions.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Provides a conceptual framework for ethics in sexual health nursing","Integrates Foucauldian theory with research methodology"],"limitations":["No empirical data on pornography or sexual behaviour","Lacks operational definitions or measurement of key constructs"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":21,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1191/0969733005ne774oa"}},{"id":9677,"doi":"10.1111/j.1743-6109.2008.01092.x","pmid":"19215618","pmcid":null,"title":"Screening for erectile dysfunction in men with lifelong premature ejaculation--Is the Sexual Health Inventory for Men (SHIM) reliable?","authors":"McMahon CG.","first_author":"McMahon CG.","journal":"The journal of sexual medicine","year":2009,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"prospective observational study of 78 men with lifelong PE; SHIM self‑administered, IELT measured with stopwatch across four intercourse attempts","sample_n":78,"sample_text":"78 participants (convenience/clinic sample)","population":"men with lifelong premature ejaculation, mean age 33.2 years","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In men with lifelong premature ejaculation, about one‑third score low on the SHIM questionnaire despite having normal erectile function measured by timing intercourse, suggesting the SHIM can give false‑positive erectile dysfunction results in this group.","clinical_takeaway":"Clinicians should interpret low SHIM scores cautiously in premature‑ejaculation patients, confirming erectile function with objective measures before excluding them from studies or treatment.","confidence":0.6,"topic_tags":["sexual_function","prevalence"],"strengths":["Uses validated SHIM questionnaire","Objective IELT measurement with stopwatch","Prospective data collection"],"limitations":["Convenience clinic sample, not representative","No power calculation or confidence intervals reported","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":24,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1743-6109.2008.01092.x"}},{"id":9680,"doi":"10.1007/s00520-008-0563-5","pmid":"19139928","pmcid":null,"title":"Nurses' knowledge, attitudes, and practices regarding provision of sexual health care in patients with cancer: critical review of the evidence","authors":"Kotronoulas G, Papadopoulou C, Patiraki E.","first_author":"Kotronoulas G","journal":"Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer","year":2009,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":89,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"critical (non‑systematic) literature review of 18 original studies, no risk‑of‑bias assessment, narrative synthesis","sample_n":null,"sample_text":"18 original research articles were analyzed; individual study sizes not given","population":"oncology nurses (no sample size reported)","country":"not specified (multinational literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A review of 18 studies shows that oncology nurses recognise sexual health as part of care but often lack knowledge and confidence to discuss it with patients, leading to missed opportunities to address sexual concerns.","clinical_takeaway":"Clinicians should receive targeted training and resources to improve nurses' ability to discuss sexuality with cancer patients.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Broad three‑decade coverage of nursing literature","Identifies multiple actionable factors influencing care","Highlights consistent knowledge/skill gaps"],"limitations":["Not systematic; selection bias likely","No formal quality or bias appraisal of included studies","No quantitative synthesis or effect‑size reporting"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":13,"contrasting":1,"mentioning":128,"citing_publications":155,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s00520-008-0563-5"}},{"id":9681,"doi":"10.1097/01.nur.0000304181.36568.a7","pmid":"18091126","pmcid":null,"title":"Sexual health and quality of life among male veterans with intestinal ostomies","authors":"Symms MR, Rawl SM, Grant M, Wendel CS, Coons SJ, Hickey S, Baldwin CM, Krouse RS.","first_author":"Symms MR","journal":"Clinical nurse specialist CNS","year":2008,"pub_types":["Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"case-control mixed-methods secondary analysis of male veterans with ostomies vs surgical controls (N≈481, response rate 49%)","sample_n":481,"sample_text":"Four hundred eighty-one male veterans (response rate 49%)","population":"male U.S. veterans with intestinal ostomies","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Veteran men with intestinal ostomies reported more erectile problems and less sexual activity than similar men without ostomies; those who stayed sexually active had better overall quality of life.","clinical_takeaway":"Addressing sexual concerns after ostomy surgery may improve overall well‑being.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["large sample for a clinical sub‑population","mixed quantitative‑qualitative approach","use of a disease‑specific QoL instrument"],"limitations":["cross‑sectional case‑control design limits causal inference","low response rate (49%) raises selection bias","limited control for psychosocial confounders"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":37,"citing_publications":69,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/01.nur.0000304181.36568.a7"}},{"id":9682,"doi":"10.1111/j.1365-2036.2010.04235.x","pmid":"20070284","pmcid":"PMC2923484","title":"Changes in quality of life and sexual health are associated with low-dose peginterferon therapy and disease progression in patients with chronic hepatitis C","authors":"Snow KK, Bonkovsky HL, Fontana RJ, Kim HY, Sterling RK, Di Bisceglie AM, Morgan TR, Dienstag JL, Ghany MG, HALT-C Trial Group.","first_author":"Snow KK","journal":"Alimentary pharmacology & therapeutics","year":2010,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Multicenter Study","Randomized Controlled Trial","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"rct","design_detail":"randomized controlled trial comparing low‑dose peginterferon maintenance therapy with no additional treatment in chronic hepatitis C patients; outcomes measured longitudinally over 3.5 years with repeated‑measures ANCOVA","sample_n":1049,"sample_text":"large, multicenter cohort","population":"517 patients receiving peginterferon, 532 untreated; adults with advanced fibrosis or cirrhosis (total N≈1049)","country":"USA (multicenter HALT‑C trial)","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a large hepatitis‑C trial, men who received long‑term peginterferon reported poorer sexual health and quality of life than untreated patients, especially when their liver disease progressed.","clinical_takeaway":"Peginterferon maintenance may worsen sexual health in men with advanced hepatitis C; monitor sexual function during therapy.","confidence":0.85,"topic_tags":["sexual_function"],"strengths":["Large, multicenter randomized sample","Longitudinal follow‑up over 3.5 years","Use of validated HRQOL instrument (SF‑36)"],"limitations":["Sexual health measured only by a single SF‑36 subscale, not a validated sexual‑function questionnaire","Potential confounding by disease severity and mood not fully accounted","No effect‑size reporting or pre‑registration"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":6,"confounds":2,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":0,"mentioning":16,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1365-2036.2010.04235.x"}},{"id":9683,"doi":"10.1016/j.gyobfe.2005.03.027","pmid":"15908256","pmcid":null,"title":"[Couple, sexuality and sexual health]","authors":"Lachowsky M, Grivel T, Lemaire A, Elia D.","first_author":"Lachowsky M","journal":"Gynecologie, obstetrique & fertilite","year":2005,"pub_types":["Review","Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["sexual_health"],"language":"fre","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Narrative review without systematic methods; no primary data.","sample_n":null,"sample_text":"Not applicable – review article","population":"Adults (men, women) discussed in literature; no sample size reported","country":"France (primary authorship), but literature reviewed is international","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how attitudes toward male sexuality and erectile dysfunction have changed over the past 50 years, emphasizing cultural pressures and the impact on couples.","clinical_takeaway":"None – the paper provides a narrative overview without actionable clinical guidance.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Broad historical overview of sexuality and ED","Considers cultural shifts in male sexual health"],"limitations":["No systematic search strategy reported","Lacks empirical data or quantitative synthesis","No measurement of key constructs or control of confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":4,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.gyobfe.2005.03.027"}},{"id":9684,"doi":"10.3310/hta14300","pmid":"20561461","pmcid":null,"title":"School-linked sexual health services for young people (SSHYP): a survey and systematic review concerning current models, effectiveness, cost-effectiveness and research opportunities","authors":"Owen J, Carroll C, Cooke J, Formby E, Hayter M, Hirst J, Lloyd Jones M, Stapleton H, Stevenson M, Sutton A.","first_author":"Owen J","journal":"Health technology assessment (Winchester, England)","year":2010,"pub_types":["Systematic Review","Journal Article"],"keywords":[],"is_oa":true,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"systematic review of quantitative and qualitative studies plus a service‑mapping questionnaire; no meta‑analysis performed, risk‑of‑bias assessment not reported","sample_n":null,"sample_text":"questionnaire sent to all UK school nurses; low response rate; qualitative interviews with service coordinators; systematic review of published studies (mostly US)","population":"young people (adolescents) in UK schools; service providers (school nurses, health coordinators)","country":"United Kingdom (service mapping); United States (evidence from review)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A review of school‑based and school‑linked sexual health services in the UK found three main service models and showed that such services do not increase sexual activity, but evidence for reducing teen births or STIs is limited and mainly from the US. More robust UK research is needed.","clinical_takeaway":"Current school sexual health services appear safe, but stronger evidence is needed to confirm they lower teen pregnancies or STIs.","confidence":0.7,"topic_tags":["sexual_function","adolescents"],"strengths":["Comprehensive mapping of UK school‑linked sexual health service models","Systematic review integrates quantitative and qualitative evidence","Identifies clear gaps in evaluation and cost‑effectiveness data"],"limitations":["Low questionnaire response rate and regional under‑representation","No formal meta‑analysis or risk‑of‑bias assessment reported","Reliance on US studies for effectiveness outcomes, limiting UK relevance"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":48,"citing_publications":95,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.3310/hta14300"}},{"id":9685,"doi":"10.1089/jwh.2006.15.390","pmid":"16724887","pmcid":null,"title":"Female street sex workers in Hong Kong: moving beyond sexual health","authors":"Wong WC, Holroyd EA, Gray A, Ling DC.","first_author":"Wong WC","journal":"Journal of women's health (2002)","year":2006,"pub_types":["Comparative Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Cross‑sectional survey comparing 89 street‑based female sex workers with a non‑sex‑working reference group, adjusted for age, education, marital status and health status.","sample_n":89,"sample_text":"89 FSWs surveyed; comparison sample size not reported","population":"Female street sex workers in Hong Kong (n≈89) and a comparison group of non‑sex‑working women (size not specified).","country":"Hong Kong","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of 89 street‑based female sex workers in Hong Kong found they have lower quality‑of‑life scores than other women, reflecting feelings of helplessness, low self‑esteem and limited access to health and safety resources.","clinical_takeaway":"Clinicians should recognise the heightened vulnerability and poorer quality of life among street sex workers and consider targeted support and advocacy.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Use of validated WHOQOL‑BREF instrument","Adjustment for key sociodemographic variables","Provides comparative data with non‑sex‑working women"],"limitations":["Convenience sample; limited generalisability","Small sample size without power justification","No measurement of mental‑health or trauma confounders"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":26,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/jwh.2006.15.390"}},{"id":9687,"doi":null,"pmid":"16978501","pmcid":"PMC1784238","title":"Talking parents, healthy teens: a worksite-based program for parents to promote adolescent sexual health","authors":"Eastman KL, Corona R, Schuster MA.","first_author":"Eastman KL","journal":"Preventing chronic disease","year":2006,"pub_types":["Research Support, U.S. Gov't, P.H.S.","research-article","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC1784238","cited_by_count":10,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary / program description without primary outcome data","sample_n":null,"sample_text":"No primary data; description of intervention development","population":"parents of adolescents (worksite participants); no sample size reported","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"useful","plain_summary":"The article describes a workplace‑based program that teaches parents how to talk with their teens about sexuality, using eight lunchtime sessions. It outlines the program’s development, theory, and components but does not present data on whether it improves teen sexual health.","clinical_takeaway":"None – the paper offers a program model but no evidence of effectiveness for clinicians to apply.","confidence":0.7,"topic_tags":["adolescents","sexual_function"],"strengths":["Clear theoretical framework for parent intervention","Innovative worksite recruitment strategy"],"limitations":["No empirical outcome data presented","No measurement of key sexual health or behavior outcomes","Absence of control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":null},{"id":9688,"doi":"10.1080/10532528.2002.10559801","pmid":"12836728","pmcid":null,"title":"Sexual health: the emergence, development, and diversity of a concept","authors":"Giami A.","first_author":"Giami A.","journal":"Annual review of sex research","year":2002,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":36,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative historical review of the sexual health concept; no primary data collection.","sample_n":null,"sample_text":"Not applicable – article is a conceptual review.","population":"Not applicable","country":"Not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article traces how the WHO’s concept of sexual health has been adopted and adapted by different nations and organizations, showing that political and cultural contexts shape its definition and implementation.","clinical_takeaway":"None – the paper offers historical and policy context, not clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Comprehensive historical overview","Clear comparison of policy documents across countries","Identifies lack of international consensus"],"limitations":["No empirical data","No systematic methodology reported","Potential author bias in interpretation"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":0,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":171,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10532528.2002.10559801"}},{"id":9689,"doi":"10.1891/rtnp.2005.19.4.357","pmid":"16350598","pmcid":null,"title":"The social construction and conceptualization of sexual health among Mexican American women","authors":"Davila YR.","first_author":"Davila YR.","journal":"Research and theory for nursing practice","year":2005,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"ethnographic, semi‑structured interviews with 20 clinic‑based Mexican American women","sample_n":20,"sample_text":"20","population":"Mexican American women attending a sexual and reproductive health clinic (N=20)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"background","plain_summary":"Interviews with 20 Mexican American women revealed how cultural expectations shape their ideas about sexual health, highlighting themes like self‑sacrifice, silence, and taking personal control.","clinical_takeaway":"Clinicians should consider cultural narratives when discussing sexual health with Mexican American patients.","confidence":0.6,"topic_tags":["sexual_function","csbd"],"strengths":["In‑depth, culturally specific insight","Use of participant‑centered thematic analysis","Clear description of emergent themes"],"limitations":["Small, non‑representative convenience sample","No quantitative measurement of sexual health constructs","Findings limited to clinic‑attending women"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":1,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":1,"mentioning":8,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1891/rtnp.2005.19.4.357"}},{"id":9690,"doi":"10.1038/sj.ijir.3901327","pmid":"15875061","pmcid":null,"title":"The Sexual Health Inventory for Men (SHIM): a 5-year review of research and clinical experience","authors":"Cappelleri JC, Rosen RC.","first_author":"Cappelleri JC","journal":"International journal of impotence research","year":2005,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":241,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Narrative review of the SHIM literature without original empirical data.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors review 5‑years of research using the Sexual Health Inventory for Men (SHIM), a validated questionnaire for assessing erectile dysfunction, summarising its widespread clinical and research use.","clinical_takeaway":"SHIM remains a well‑validated, widely used tool for screening and grading erectile dysfunction in men.","confidence":0.9,"topic_tags":["sexual_function","measurement"],"strengths":["Comprehensive catalogue of SHIM usage","Highlights impact on clinical practice"],"limitations":["Narrative, not systematic, review","No new data or meta‑analytic synthesis"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":0,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":248,"citing_publications":349,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1038/sj.ijir.3901327"}},{"id":9691,"doi":null,"pmid":"8716096","pmcid":null,"title":"Sexual health care in British Columbia: a model of service delivery","authors":"Breen S, Rines B.","first_author":"Breen S","journal":"SCI nursing : a publication of the American Association of Spinal Cord Injury Nurses","year":1996,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"descriptive model of sexual health service delivery for spinal‑cord‑injury patients; no empirical data, no comparison group","sample_n":null,"sample_text":"not reported – description of program rather than a study sample","population":"people with spinal cord injury receiving rehabilitation in British Columbia","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article describes a 20‑year‑old sexual health program for people with spinal‑cord injuries in British Columbia, outlining how clinicians assess, educate, and support clients and families about sexual outcomes after injury.","clinical_takeaway":"Clinicians can consider adopting a similar multidisciplinary sexual‑health model to improve care for spinal‑cord‑injury patients.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Provides a concrete, practice‑focused description of a sexual health program","Addresses client‑centered assessment and education for a specific disability group"],"limitations":["No empirical data or outcome evaluation presented","Lacks systematic measurement of any constructs","Cannot assess effectiveness or generalisability"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":9692,"doi":"10.1080/119-01460860151062424","pmid":"11878552","pmcid":null,"title":"Sexual health practices of homeless youth: a model for intervention","authors":"Rew L.","first_author":"Rew L.","journal":"Issues in comprehensive pediatric nursing","year":2001,"pub_types":["Research Support, U.S. Gov't, P.H.S.","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"Not applicable – article presents a conceptual model and review of literature rather than original empirical data.","population":"homeless adolescents (U.S.)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article proposes a model describing how homeless adolescents engage in sexual health behaviors and suggests ways community programs could address high rates of sexually transmitted infections.","clinical_takeaway":"Use the model to guide tailored sexual health interventions for homeless youth.","confidence":0.5,"topic_tags":["sexual_function"],"strengths":["Comprehensive synthesis of existing literature on homeless youth sexual health","Offers a clear conceptual model for future intervention development"],"limitations":["No original empirical data; conclusions are based on secondary sources","Lacks quantitative measurement of constructs or outcomes","Potentially limited generalizability beyond U.S. homeless youth"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":12,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/119-01460860151062424"}},{"id":9693,"doi":"10.1089/apc.2006.20.858","pmid":"17192151","pmcid":null,"title":"Systematic development of a self-help and motivational enhancement intervention to promote sexual health in HIV-positive men who have sex with men","authors":"Van Kesteren NM, Kok G, Hospers HJ, Schippers J, De Wildt W.","first_author":"Van Kesteren NM","journal":"AIDS patient care and STDs","year":2006,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"development study using Intervention Mapping; no empirical outcome data reported","sample_n":null,"sample_text":"not applicable – study describes intervention development rather than testing","population":"HIV‑positive men who have sex with men","country":"Netherlands (inferred from author affiliations)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors used Intervention Mapping to design a self‑help guide and motivational‑interviewing program aimed at improving sexual functioning and safer sex among HIV‑positive gay men. The paper details the step‑by‑step development process but does not present outcome data.","clinical_takeaway":"No direct clinical guidance; the described program may be worth testing in future trials.","confidence":0.4,"topic_tags":["sexual_function"],"strengths":["Systematic, theory‑driven intervention development","Clear description of mapping process and methods"],"limitations":["No empirical testing of the intervention provided","No outcome data, so effectiveness uncertain","Limited information on measurement validity"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":2,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":17,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1089/apc.2006.20.858"}},{"id":9694,"doi":null,"pmid":"10628080","pmcid":null,"title":"[Adolescence and \"sexual health\"]","authors":"Jäger H.","first_author":"Jäger H.","journal":"Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany))","year":1999,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"ger","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary without empirical data","sample_n":null,"sample_text":"none (commentary)","population":"adolescents (general)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that adolescent sexual health programs should prioritize young people's own concerns and confidence, using culturally aware education and supportive professionals rather than solely medical experts.","clinical_takeaway":"Clinicians should listen to adolescents' personal worries and provide non‑judgmental, evidence‑based guidance.","confidence":0.4,"topic_tags":["adolescents","sexual_function"],"strengths":["Highlights importance of adolescent voice in sexual health education","Calls for integrated, culturally sensitive approaches"],"limitations":["No empirical data presented","Lacks operational definitions or measurement of constructs","No analysis of confounding factors"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":null},{"id":9695,"doi":null,"pmid":"15726676","pmcid":null,"title":"Development and validation of questionnaire measuring attitudes towards sexual health among university students","authors":"Nemcić N, Novak S, Marić L, Novosel I, Kronja O, Hren D, Marusić A, Marusić M.","first_author":"Nemcić N","journal":"Croatian medical journal","year":2005,"pub_types":["Validation Study","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"validation study of a new Likert‑type questionnaire; convenience sample of 336 university students and adult women; factor analysis and internal consistency reported","sample_n":336,"sample_text":"convenience sample; not randomly selected; gender and study‑field groups","population":"medical and non‑medical university students and adult working women in Croatia","country":"Croatia","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers created and tested a 50‑item questionnaire measuring university students' attitudes toward sexual health. The scale showed good reliability, but it was only validated in a convenience sample from Croatia.","clinical_takeaway":"The questionnaire appears reliable for assessing sexual‑health attitudes, yet further validation in diverse populations is needed before clinical use.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large enough sample for factor analysis","High internal consistency (α=0.91)","Clear reporting of item reduction process"],"limitations":["Convenience, single‑country sample limits generalisability","No external validation or test‑retest reliability","No pre‑registration or effect‑size reporting"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":null},{"id":9696,"doi":null,"pmid":"10441919","pmcid":null,"title":"Femininity as a barrier to positive sexual health for adolescent girls","authors":"Tolman DL.","first_author":"Tolman DL.","journal":"Journal of the American Medical Women's Association (1972)","year":1999,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"survey of 148 eighth‑grade girls; regression analyses; supplemental case interview (n=46)","sample_n":148,"sample_text":"148 eighth‑grade adolescent girls completed a questionnaire; 46 were interviewed in depth","population":"adolescent girls (8th grade) in Northwestern United States","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 148 eighth‑grade girls found that those who endorse more traditional ideas about femininity tend to report lower positive sexual health, suggesting that gender beliefs may hinder healthy sexual development.","clinical_takeaway":"Clinicians should consider how gender norms affect adolescent girls' sexual wellbeing and address restrictive femininity beliefs in counseling.","confidence":0.6,"topic_tags":["sexual_function","gender","adolescents"],"strengths":["Reasonable sample size for exploratory survey","Combined quantitative and qualitative data","Focus on feminist framework"],"limitations":["Reliance on likely unvalidated self‑report scales","Cross‑sectional design prevents causal inference","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":null},{"id":9699,"doi":null,"pmid":"8653776","pmcid":null,"title":"Reproductive and sexual health: a research and developmental challenge","authors":"Mbizvo MT.","first_author":"Mbizvo MT.","journal":"The Central African journal of medicine","year":1996,"pub_types":["Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":2,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Review article without original empirical data; broad discussion of reproductive and sexual health in Africa; no primary study design.","sample_n":null,"sample_text":"No primary sample; review synthesizes existing literature","population":"General adult population in Africa (implicitly), no specific sample size reported","country":"Africa (general)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews the many challenges to reproductive and sexual health in Africa, including STIs, unwanted pregnancy, and gender inequality, calling for better education and research.","clinical_takeaway":"None - not clinically applicable to pornography or compulsive sexual behaviour.","confidence":0.7,"topic_tags":["religiosity","sexual_function","masturbation"],"strengths":["Broad overview of reproductive and sexual health issues in Africa","Highlights policy and education gaps"],"limitations":["No original data; no empirical methods described","No specific measurement of pornography, masturbation, or CSBD constructs","Lacks systematic review methodology details"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":null},{"id":9701,"doi":"10.1016/0020-7489(94)00041-h","pmid":"7665318","pmcid":null,"title":"Factors that influence the provision of sexual health care by Dutch cancer nurses","authors":"Gamel C, Hengeveld MW, Davis B, Van der Tweel I.","first_author":"Gamel C","journal":"International journal of nursing studies","year":1995,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"descriptive‑correlational survey of 104 Dutch cancer nurses","sample_n":104,"sample_text":"Convenience sample of oncology nursing staff","population":"Dutch cancer nurses (n=104)","country":"Netherlands","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 104 Dutch cancer nurses found that greater knowledge and personal comfort with sexuality were linked to more frequent provision of sexual health care to patients.","clinical_takeaway":"Improving nurses' knowledge and comfort with sexual topics may increase sexual health services for cancer patients.","confidence":0.78,"topic_tags":["sexual_function","neuroscience","measurement","treatment"],"strengths":["Clear theoretical framework (Theory of Reasoned Action)","Use of multiple regression to identify independent predictors","Reasonable sample size for nursing survey"],"limitations":["Cross‑sectional design cannot establish causality","Unclear whether survey items are validated instruments","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":4,"contrasting":0,"mentioning":44,"citing_publications":41,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/0020-7489(94)00041-h"}},{"id":9702,"doi":null,"pmid":"10994132","pmcid":null,"title":"[Social marketing campaigns as an instrument of influence on the attitude and behavior of youth in the area of sexual health]","authors":"Alekseeva E.","first_author":"Alekseeva E.","journal":"Zhurnal mikrobiologii, epidemiologii i immunobiologii","year":2000,"pub_types":["Journal Article","English Abstract"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"rus","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"pre‑post sociological questionnaire without control group; likely convenience sample of Moscow youth; no clear power calculation","sample_n":null,"sample_text":"young people in Moscow (pre‑campaign questionnaire; post‑campaign questionnaire after 8 months)","population":"young people in Moscow (age not specified)","country":"Russia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"A social‑marketing campaign in Moscow aimed to improve young people's knowledge and safe‑sex behaviour regarding HIV/AIDS. Pre‑ and post‑campaign questionnaires suggested the campaign increased knowledge and aligned attitudes with safer practices.","clinical_takeaway":"Campaigns can shift self‑reported attitudes, but evidence of actual behaviour change is limited without control data.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["addresses public‑health need","includes pre‑ and post‑campaign data"],"limitations":["no control/comparison group","unclear sample size and representativeness","potential self‑report bias"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":4}},"scite":null},{"id":9703,"doi":"10.2989/16085906.2002.9626543","pmid":"25871708","pmcid":null,"title":"'Before we were sleeping, now we are awake': Preliminary evaluation of the Stepping Stones sexual health programme in The Gambia","authors":"Paine K, Hart G, Jawo M, Ceesay S, Jallow M, Morison L, Walraven G, McAdam K, Shaw M.","first_author":"Paine K","journal":"African journal of AIDS research : AJAR","year":2002,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":16,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"Quasi‑experimental community evaluation with two intervention villages and two control villages; mixed methods including questionnaires (25% adult sample) at three time points, in‑depth interviews and focus groups.","sample_n":null,"sample_text":"Random sample of 25% of the adult population in each village; total N not specified","population":"Adults in four villages in The Gambia (sample size not reported in abstract)","country":"The Gambia","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A pilot community programme in The Gambia taught people about HIV and family planning. After workshops, participants showed better knowledge, said they would use condoms more, and reported less marital conflict, but the study’s methods limit confidence in these findings.","clinical_takeaway":"The programme shows promise for improving sexual health knowledge and condom use, but stronger evidence is needed before wider adoption.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Community‑based participatory approach","Mixed‑methods evaluation","Use of control villages"],"limitations":["No information on questionnaire validation","Unclear sample size and power","Potential uncontrolled confounders"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2989/16085906.2002.9626543"}},{"id":9704,"doi":"10.1080/00926237708402993","pmid":"592427","pmcid":null,"title":"The evaluation of sexual health services in a medical setting","authors":"Held JP, Logan C, Maddock JW, Weiss DS, Cole TM.","first_author":"Held JP","journal":"Journal of sex & marital therapy","year":1977,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"longitudinal","design_detail":"pre‑post evaluation of a university‑based sexual health service; no control group; 411 clients immediate post‑treatment, 131 at one‑year follow‑up","sample_n":411,"sample_text":"411 immediate post‑treatment, 131 at 1‑year follow‑up","population":"clients seeking counseling at a medical school sexual health unit (self‑selected service users)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"A university sexual‑health clinic evaluated its counseling programs using client satisfaction and pre/post questionnaires, reporting most clients improved after treatment and at one‑year follow‑up.","clinical_takeaway":"Program shows promise, but lack of control group limits strength of conclusions.","confidence":0.7,"topic_tags":["sexual_function","csbd"],"strengths":["Large sample for service evaluation","Pre/post and 1‑year follow‑up data"],"limitations":["No control or comparison group","Unclear measurement instruments and validation","Clients are self‑selected service seekers"],"rubric_version":"2.0","raw_total":20,"max_possible":50,"pct_score":40,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00926237708402993"}},{"id":9782,"doi":"10.1080/23268743.2018.1434110","pmid":null,"pmcid":null,"title":"Constructing a crisis: porn panics and public health","authors":"Webber V, Sullivan R.","first_author":"Webber V","journal":"Porn Studies","year":2018,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":42,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary/position paper; no empirical data, no sample, no methods.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"strongly-opposes","citation_value":"background","plain_summary":"The authors argue that labeling pornography as a public‑health crisis is unjustified because it does not meet the criteria used for true public‑health problems, and that this framing diverts resources for political reasons.","clinical_takeaway":"None – the paper provides no clinical data or recommendations.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Clear articulation of public‑health definition criteria","Highlights lack of global‑agency endorsement"],"limitations":["No empirical data or systematic review","Relies on rhetorical argument rather than evidence","Potential advocacy bias"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/23268743.2018.1434110"}},{"id":9783,"doi":"10.1177/1461444819872539","pmid":null,"pmcid":null,"title":"Exposing children to pornography: How competing constructions of childhood shape state regulation of online pornographic material","authors":"Keen C, France A, Kramer R.","first_author":"Keen C","journal":"New Media & Society","year":2020,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"thematic analysis of qualitative interviews with key stakeholders","sample_n":null,"sample_text":"key stakeholders at the negotiation table (likely purposive sample)","population":"policy stakeholders (UK and Australia)","country":"United Kingdom; Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper examines how UK and Australian policymakers now view children as 'savvy' and responsible for online porn, moving away from earlier ideas of them as vulnerable, which reduces state regulation and shifts protection responsibility to families.","clinical_takeaway":"None - the study is about policy, not clinical guidance.","confidence":0.7,"topic_tags":["pornography","csbd","moral_incongruence","sexual_function"],"strengths":["Provides nuanced policy analysis","Highlights shifting discourse on childhood agency"],"limitations":["Small, non‑representative stakeholder sample","No empirical data on children's actual exposure or outcomes"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":7,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1461444819872539"}},{"id":9785,"doi":"10.1152/jn.00230.2007","pmid":"17596422","pmcid":null,"title":"Pleasure rather than salience activates human nucleus accumbens and medial prefrontal cortex","authors":"Sabatinelli D, Bradley MM, Lang PJ, Costa VD, Versace F.","first_author":"Sabatinelli D","journal":"Journal of neurophysiology","year":2007,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":155,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subject fMRI experiment presenting erotic/romantic, unpleasant, and neutral pictures; sample size not reported in abstract.","sample_n":null,"sample_text":"Not specified in abstract; typical fMRI studies of this era use ≈12–20 participants per condition.","population":"Adults (adolescents and adults mentioned in mesh; likely mixed)","country":"USA (Journal of Neurophysiology, authors affiliated with US institutions)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"When people looked at erotic or romantic photos, brain areas linked to reward (the nucleus accumbens and medial prefrontal cortex) became more active than when they viewed equally arousing but unpleasant images.","clinical_takeaway":"None – the study maps brain responses to visual pleasure and does not inform clinical practice.","confidence":0.7,"topic_tags":["neuroscience","sexual_function","pornography"],"strengths":["Use of well‑validated affective image sets","Clear within‑subject contrast of pleasant vs unpleasant stimuli","Neuroimaging focus on reward‑related regions"],"limitations":["Likely small fMRI sample limiting statistical power","No assessment of participants’ sexual attitudes, moral incongruence, or mental‑health variables","Potential reverse inference about reward without behavioral corroboration"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":5,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":26,"contrasting":1,"mentioning":167,"citing_publications":225,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1152/jn.00230.2007"}},{"id":9789,"doi":"10.1016/j.neubiorev.2013.02.002","pmid":"23415703","pmcid":null,"title":"Processing of primary and secondary rewards: a quantitative meta-analysis and review of human functional neuroimaging studies","authors":"Sescousse G, Caldú X, Segura B, Dreher JC.","first_author":"Sescousse G","journal":"Neuroscience and biobehavioral reviews","year":2013,"pub_types":["Meta-Analysis","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":554,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"meta-analysis","design_detail":"Quantitative ALE meta-analysis of 87 fMRI studies (1452 participants) comparing monetary, erotic and food rewards.","sample_n":1452,"sample_text":"Aggregated across 87 studies.","population":"Human participants from published neuroimaging studies; no new sample recruited.","country":"Multiple (international studies).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A meta‑analysis of brain scans shows that money, food, and erotic images activate a common reward network, with some brain areas more active for specific reward types.","clinical_takeaway":"None – the study does not provide direct clinical guidance for sexual health or addiction.","confidence":0.7,"topic_tags":["neuroscience","religiosity","sexual_function","moral_incongruence"],"strengths":["Large aggregated sample provides high statistical power.","Rigorous ALE methodology with whole‑brain correction.","Clear differentiation of primary vs. secondary rewards."],"limitations":["No direct measurement of sexual behavior or pathology.","Confounding variables (e.g., mood, religiosity) not addressed.","Interpretation limited to reward processing, not clinical relevance."],"rubric_version":"2.0","raw_total":36,"max_possible":60,"pct_score":60,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":8,"statistics":7,"confounds":2,"design":9,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":56,"contrasting":4,"mentioning":637,"citing_publications":851,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neubiorev.2013.02.002"}},{"id":9791,"doi":"10.1002/hbm.10014","pmid":"11870922","pmcid":"PMC6871831","title":"Areas of brain activation in males and females during viewing of erotic film excerpts","authors":"Karama S, Lecours AR, Leroux JM, Bourgouin P, Beaudoin G, Joubert S, Beauregard M.","first_author":"Karama S","journal":"Human brain mapping","year":2002,"pub_types":["Comparative Study","Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":330,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"functional MRI comparison of 20 males vs 20 females viewing erotic vs neutral film clips; cross‑sectional","sample_n":40,"sample_text":"20 male and 20 female subjects","population":"healthy adult volunteers, 20 male, 20 female","country":"Canada","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Using fMRI, the study found that men report stronger sexual arousal than women when watching erotic clips, and show greater hypothalamic activation. Both sexes activate similar brain regions, but hypothalamus activity is higher in men and relates to their reported arousal.","clinical_takeaway":"None – the study describes normal gender differences in brain response to erotica, not clinical pathology.","confidence":0.78,"topic_tags":["neuroscience","sexual_function","gender"],"strengths":["Direct neural measurement with fMRI","Gender‑matched sample","Inclusion of neutral baseline condition"],"limitations":["Small sample for neuroimaging standards","No control for moral, mental‑health or sexual‑behavior confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":5,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":9,"contrasting":0,"mentioning":155,"citing_publications":506,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/hbm.10014"}},{"id":9792,"doi":"10.1097/wnr.0b013e3282f85c01","pmid":"18388729","pmcid":null,"title":"Nucleus accumbens activation mediates the influence of reward cues on financial risk taking","authors":"Knutson B, Wimmer GE, Kuhnen CM, Winkielman P.","first_author":"Knutson B","journal":"Neuroreport","year":2008,"pub_types":["Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":94,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"event‑related fMRI, within‑subject cue‑manipulation, N≈15‑20 heterosexual men, mediation analysis","sample_n":null,"sample_text":"15 heterosexual men (approx.)","population":"adult male volunteers (heterosexual)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found that viewing erotic pictures briefly increased activity in the brain's reward area and led men to take greater financial risks, suggesting that sexual cues can sway decision‑making.","clinical_takeaway":"None – the findings pertain to experimental cue effects, not clinical assessment or treatment.","confidence":0.7,"topic_tags":["pornography","csbd","neuroscience"],"strengths":["Within‑subject experimental manipulation","Use of neuroimaging to test mediation","Clear behavioral outcome (risk‑taking task)"],"limitations":["Small fMRI sample, limited power","Male‑only, convenience recruitment","No correction for multiple comparisons reported"],"rubric_version":"2.0","raw_total":32,"max_possible":60,"pct_score":53,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":5,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":13,"contrasting":1,"mentioning":163,"citing_publications":233,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/wnr.0b013e3282f85c01"}},{"id":9793,"doi":"10.1523/jneurosci.3109-12.2012","pmid":"23077042","pmcid":"PMC3516184","title":"Neural substrate of the late positive potential in emotional processing","authors":"Liu Y, Huang H, McGinnis-Deweese M, Keil A, Ding M.","first_author":"Liu Y","journal":"The Journal of neuroscience : the official journal of the Society for Neuroscience","year":2012,"pub_types":["research-article","Randomized Controlled Trial","Journal Article","Research Support, N.I.H., Extramural"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":325,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Simultaneous EEG‑fMRI recording with single‑trial ERP analysis; correlational analysis between LPP amplitude and BOLD signal.","sample_n":null,"sample_text":"Not specified in abstract","population":"Human adults (young adult, adolescent); sample size not reported in abstract","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"background","plain_summary":"The study recorded brain activity with EEG and fMRI while participants viewed emotional pictures, finding that a brain signal called the late positive potential (LPP) is linked to activity in visual and emotion‑related brain areas.","clinical_takeaway":"None – the findings pertain to basic emotion neuroscience, not to clinical sexual health.","confidence":0.7,"topic_tags":["neuroscience","csbd","sexual_function"],"strengths":["Simultaneous EEG‑fMRI provides multimodal data","Use of single‑trial ERP analysis","Clear reporting of brain regions linked to LPP"],"limitations":["Cross‑sectional correlational design limits causal inference","Sample size and demographic details not provided in abstract","No pre‑registration or multiple‑comparison correction described"],"rubric_version":"2.0","raw_total":31,"max_possible":60,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":6,"statistics":5,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":32,"contrasting":1,"mentioning":343,"citing_publications":437,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1523/jneurosci.3109-12.2012"}},{"id":9794,"doi":"10.1016/j.neuroimage.2008.01.040","pmid":"18329905","pmcid":null,"title":"Distinguishing specific sexual and general emotional effects in fMRI-subcortical and cortical arousal during erotic picture viewing","authors":"Walter M, Bermpohl F, Mouras H, Schiltz K, Tempelmann C, Rotte M, Heinze HJ, Bogerts B, Northoff G.","first_author":"Walter M","journal":"NeuroImage","year":2008,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":149,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"fMRI study with 21 healthy adults viewing erotic pictures; within‑subject contrasts of sexual intensity vs. general emotional arousal.","sample_n":21,"sample_text":"21 participants (11 males, 10 females) scanned with fMRI while viewing erotic pictures.","population":"healthy adult volunteers (11 male, 10 female)","country":"Germany","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a small fMRI study, researchers showed that brain areas like the ventral striatum and hypothalamus respond specifically to how sexually intense pictures are, while other regions reflect general emotional arousal.","clinical_takeaway":"Findings are exploratory; no direct clinical implications for pornography or sexual health practice.","confidence":0.7,"topic_tags":["sexual_function","neuroscience"],"strengths":["Use of fMRI to dissociate sexual vs. general emotional arousal","Within‑subject design controls for individual variability","Both sexes included"],"limitations":["Very small sample for neuroimaging (N=21)","No validated behavioural or psychometric measures of sexual response reported","Potential lack of correction for multiple comparisons not specified"],"rubric_version":"2.0","raw_total":25,"max_possible":60,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":4,"statistics":4,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":22,"contrasting":2,"mentioning":195,"citing_publications":217,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.neuroimage.2008.01.040"}},{"id":9796,"doi":"10.1177/1363460714531433","pmid":null,"pmcid":null,"title":"‘Don’t push your immorals on me’: Encouraging anti-porn advocacy in The Church of Jesus Christ of Latter-Day Saints","authors":"Sumerau JE, Cragun RT.","first_author":"Sumerau JE","journal":"Sexualities","year":2015,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"Qualitative archival analysis of LDS Church materials; no empirical participant data.","sample_n":null,"sample_text":"Not applicable – study uses archival documents rather than participant cohorts.","population":"Church leaders and organizational archives; no human subject sample.","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors analyse LDS Church documents to show how church leaders promoted anti‑porn campaigns, created media, celebrated activism, and lobbied on laws over the past 40 years.","clinical_takeaway":"None – the article does not provide data relevant to clinical assessment or treatment.","confidence":0.8,"topic_tags":["religiosity","sexual_function","csbd","pornography"],"strengths":["Rich use of primary archival sources","Provides sociocultural context for anti‑porn discourse","Highlights role of religious institutions in shaping public debate"],"limitations":["No empirical data on individual pornography use or outcomes","Lacks measurement of key sexual‑health constructs","Potential author bias toward anti‑porn perspective"],"rubric_version":"2.0","raw_total":11,"max_possible":50,"pct_score":22,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":25,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1363460714531433"}},{"id":9797,"doi":"10.1177/1363460720932387","pmid":null,"pmcid":null,"title":"The totalizing meritocracy of heterosex: Subjectivity in NoFap","authors":"Hartmann M.","first_author":"Hartmann M","journal":"Sexualities","year":2021,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"critical discourse analysis of NoFap YouTube videos; no empirical participant data","sample_n":null,"sample_text":"Not applicable – analysis of publicly posted videos rather than recruited participants","population":"online NoFap community (heterosexual men) represented in publicly available videos","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The paper analyzes YouTube videos from the NoFap community, showing how they promote a meritocratic, heterosexual ideal of masculinity that links abstaining from masturbation to becoming a 'real man.'","clinical_takeaway":"None – the study offers cultural insight, not clinical evidence.","confidence":0.8,"topic_tags":["pornography","masturbation","sexual_function","csbd"],"strengths":["Provides a nuanced cultural critique of NoFap discourse","Uses primary video material from the community"],"limitations":["No empirical data on participants’ behaviours or mental health","Lacks quantitative analysis or measurement of key constructs","Potential bias from author’s interpretive stance"],"rubric_version":"2.0","raw_total":7,"max_possible":50,"pct_score":14,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":4,"contrasting":1,"mentioning":58,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1363460720932387"}},{"id":9798,"doi":"10.1007/s13178-019-00404-1","pmid":null,"pmcid":null,"title":"The Campaign Against Sex Work in the United States: A Successful Moral Crusade","authors":"Weitzer R.","first_author":"Weitzer R","journal":"Sexuality Research and Social Policy","year":2020,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":38,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"N/A","population":"N/A","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article reviews how feminist and religious groups in the US have revived a moral campaign against pornography, linking it to addiction, trafficking, and health harms despite a lack of scientific evidence.","clinical_takeaway":"None – the piece is a policy commentary without clinical data.","confidence":0.8,"topic_tags":["pornography","moral_incongruence","sexual_function"],"strengths":["Provides detailed historical overview of anti‑pornography campaigns","Highlights lack of empirical evidence for claims","Integrates legal and policy perspectives"],"limitations":["No original data or systematic review methodology","Relies on argumentation rather than empirical assessment","Potential author bias against anti‑pornography groups"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":36,"citing_publications":47,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13178-019-00404-1"}},{"id":9800,"doi":"10.1080/10714420802306544","pmid":null,"pmcid":null,"title":"Porn and Me(n): Sexual Morality, Objectification, and Religion at the Wheelock Anti-Pornography Conference","authors":"Boulton C.","first_author":"Boulton C","journal":"The Communication Review","year":2008,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"qualitative interview essay with four anti‑pornography conference participants; no systematic sampling","sample_n":4,"sample_text":"Four male interviewees (convenient, self‑selected anti‑pornography attendees)","population":"men (N≈4) who attended an anti‑pornography conference; not representative","country":"USA","controls_mi":"no","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"opposes","citation_value":"background","plain_summary":"The author interviews four men from an anti‑pornography conference, describing their struggle to balance sexual desires with moral and religious beliefs, and critiques radical feminist views on pornography.","clinical_takeaway":"None – the essay offers no clinically actionable evidence on pornography use or sexual health.","confidence":0.8,"topic_tags":["pornography","sexual_function","moral_incongruence","religiosity"],"strengths":["Provides insider perspective from anti‑pornography activists","Touches on intersection of sexuality, morality, and religion"],"limitations":["Very small, non‑representative sample (N=4)","No systematic data collection or analytic rigor","Lacks measurement of key confounds (moral incongruence, masturbation, mental health, etc.)"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10714420802306544"}},{"id":9801,"doi":"10.1080/23268743.2018.1434170","pmid":null,"pmcid":null,"title":"A new diagnosis for old fears? Pathologizing porn in contemporary US discourse","authors":"Oeming M.","first_author":"Oeming M","journal":"Porn Studies","year":2018,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"commentary","design_detail":"Commentary without empirical data; discusses sociopolitical aspects of porn addiction discourse.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"strongly-opposes","citation_value":"background","plain_summary":"The article argues that US ‘porn addiction’ discourse is driven by religious, conservative, and profit‑seeking groups that silence dissenting research.","clinical_takeaway":"None – the paper offers no clinical data or guidance.","confidence":0.3,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence"],"strengths":["Highlights sociopolitical influences on the porn addiction narrative","Raises awareness of potential bias in research funding"],"limitations":["No empirical data or systematic analysis","Lacks methodological transparency","Potential author bias without disclosed COI"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":18,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/23268743.2018.1434170"}},{"id":9802,"doi":"10.1080/23268743.2015.1083882","pmid":null,"pmcid":null,"title":"Porn in church: moral geographies of homosexuality in Uganda","authors":"van Klinken A, Zebracki M.","first_author":"van Klinken A","journal":"Porn Studies","year":2016,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"commentary / cultural analysis without empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"Uganda (focus of analysis)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"background","plain_summary":"The article examines how Ugandan anti‑homosexuality and anti‑pornography bills use pornographic imagery to demonise gay people, portraying them as a threat to the nation’s Christian morals.","clinical_takeaway":"None – the paper offers sociopolitical analysis, not clinical evidence.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Provides contextual insight into Ugandan legislative discourse","Highlights the symbolic linking of porn and homosexuality"],"limitations":["No empirical data or systematic analysis","Findings not generalizable beyond discourse analysis"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/23268743.2015.1083882"}},{"id":9803,"doi":"10.5325/studamerjewilite.39.1.0117","pmid":null,"pmcid":null,"title":"“Oppression by Orgasm”: Pornography and Antisemitism in Far-Right Discourses in the United States Since the 1970s","authors":"Kerl K.","first_author":"Kerl K","journal":"Studies in American Jewish Literature (1981-)","year":2020,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"theoretical discourse analysis of far‑right texts, no empirical participants","sample_n":null,"sample_text":"none","population":"none","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The article examines how far‑right groups in the United States have historically claimed that Jews run a “porn conspiracy,” using anti‑porn sentiment to spread antisemitic ideas.","clinical_takeaway":"None – the paper does not provide clinical information about pornography use or sexual health.","confidence":0.4,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence"],"strengths":["Original historical perspective on far‑right rhetoric","Links sexuality to broader sociopolitical analysis"],"limitations":["No empirical data on pornography use or health outcomes","Lacks measurement of key constructs (use, distress, etc.)","Conclusions about “oppression” are ideological rather than evidence‑based"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.5325/studamerjewilite.39.1.0117"}},{"id":9804,"doi":"10.1080/10720162.2016.1140603","pmid":null,"pmcid":null,"title":"The Development and Deployment of the Idea of Pornography Addiction Within American Evangelicalism","authors":"Thomas JN.","first_author":"Thomas JN","journal":"Sexual Addiction & Compulsivity","year":2016,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"archival content analysis of evangelical magazine articles (1956‑2014)","sample_n":null,"sample_text":"none (archival documents)","population":"none (historical texts)","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The paper reviews how American evangelical magazines have talked about ‘pornography addiction’ from 1956 to 2014, showing that these messages likely shape believers’ perceptions of being addicted rather than reflecting actual user behavior.","clinical_takeaway":"Clinicians should consider cultural and religious messaging as a factor influencing clients’ perceived pornography problems.","confidence":0.8,"topic_tags":["pornography","religiosity","csbd"],"strengths":["Extensive historical time span (1956‑2014)","Focused on a specific cultural discourse (evangelical magazines)","Provides context for contemporary self‑perceived addiction claims"],"limitations":["No empirical data on individuals’ behaviour or distress","No validated measures of addiction or related constructs","Interpretations may reflect author’s perspective on evangelical messaging"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":62,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10720162.2016.1140603"}},{"id":9805,"doi":"10.1177/1363460717740248","pmid":null,"pmcid":null,"title":"‘I want that power back’: Discourses of masculinity within an online pornography abstinence forum","authors":"Taylor K, Jackson S.","first_author":"Taylor K","journal":"Sexualities","year":2018,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":53,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"qualitative discourse analysis of Reddit forum posts","sample_n":null,"sample_text":"Posts from the NoFap subreddit were analysed; exact number not given in abstract.","population":"men participating in the NoFap pornography‑abstinence subreddit","country":"Not specified (online forum, likely international)","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study examines how men on the NoFap Reddit forum talk about masculinity while pledging to avoid porn and masturbation, showing they link abstinence to ideals of ‘real’ manhood and reject feminist critiques of porn.","clinical_takeaway":"Clinicians should recognise that motivations for porn abstinence can be tied to cultural ideas of masculinity, not just compulsive use.","confidence":0.8,"topic_tags":["pornography","masturbation"],"strengths":["In‑depth qualitative insight into masculinity discourse","Novel focus on a specific online abstinence community","Provides an alternative to user‑effects models"],"limitations":["Self‑selected, forum‑based sample limits generalisability","No measurement of actual pornography or masturbation behaviour","No quantitative assessment of mental‑health or moral variables"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":2,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":0,"mentioning":94,"citing_publications":60,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1363460717740248"}},{"id":9806,"doi":"10.1177/2378023120908472","pmid":null,"pmcid":null,"title":"Do People in Conservative States Really Watch More Porn? A Hierarchical Analysis","authors":"Perry SL, Whitehead AL.","first_author":"Perry SL","journal":"Socius: Sociological Research for a Dynamic World","year":2020,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":8,"is_preprint":false,"topics":["bibliography","curated","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"expert","relevance":"core","evidence_level":"cross-sectional","design_detail":"Multi-Level Hierarchical Sociological Analysis","sample_n":null,"sample_text":"Large national dataset nested within US states","population":null,"country":null,"controls_mi":"yes","preregistered":false,"quality_score":9,"certainty":"moderate","red_flags":[],"stance":"opposes","citation_value":"essential","plain_summary":"Resolves the viral claim that religious/conservative states watch more pornography. Shows that observant religious individuals actually view pornography less frequently than secular peers, but state-level search metrics are inflated by moral anxiety, shame-driven searches for \"porn addiction,\" and non-practicing residents.","clinical_takeaway":"Clarifies that the \"Utah Paradox\" is driven by intense moral incongruence and shame-based help-seeking rather than secret hyper-consumption.","confidence":1,"topic_tags":["moral_incongruence"],"strengths":["Corrects the ecological fallacy of earlier state-level aggregate studies (e.g., Edelman 2009)","Separates individual religious practice from regional cultural environment"],"limitations":["Self-report individual frequency measures"],"rubric_version":"2.0","raw_total":52,"max_possible":60,"pct_score":87,"quality_rating":"Excellent","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":true,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":9,"neuroimaging":null,"statistics":9,"confounds":9,"design":8,"addiction_criteria":8,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/2378023120908472"}},{"id":9807,"doi":"10.1093/sf/soaa035","pmid":null,"pmcid":null,"title":"Constructing Pornography Addiction’s Harms in Science, News Media, and Politics","authors":"Burke K, MillerMacPhee A.","first_author":"Burke K","journal":"Social Forces","year":2020,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"content analysis of 600+ documents (scientific studies, news articles, policy resolutions); systematic but no primary human data","sample_n":600,"sample_text":"over 600 documents","population":"documents/public discourse (no human participants)","country":"not applicable","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The paper examines how scientists, journalists, and politicians have increasingly described pornography as an addiction, using biomedical language to argue that it harms individuals and society, even though the underlying scientific studies are mostly inconclusive.","clinical_takeaway":"None – the article analyzes discourse, not clinical evidence of pornography‑related harm.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Large and diverse document corpus","Systematic content‑analysis methodology","Clear link to sociological theory of knowledge"],"limitations":["No primary human data on pornography use or harm","No measurement of behavioral or psychological constructs","Potential selection bias in document sample"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":5,"confounds":1,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/sf/soaa035"}},{"id":9809,"doi":"10.1111/jssr.12052","pmid":null,"pmcid":null,"title":"Outsourcing Moral Authority: The Internal Secularization of Evangelicals’ Anti‐Pornography Narratives","authors":"Thomas JN.","first_author":"Thomas JN","journal":"Journal for the Scientific Study of Religion","year":2013,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":56,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"qualitative","design_detail":"content analysis of evangelical magazine articles spanning 1956‑2010","sample_n":null,"sample_text":"Christianity Today articles (1956‑2010)","population":"published texts; no human participants","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study examined evangelical magazine articles from 1956‑2010 and found that while opposition to porn stayed strong, the moral arguments shifted from religious to secular reasoning, relying more on human rights and psychological health.","clinical_takeaway":"None – the paper does not provide clinically relevant data on pornography use or sexual health.","confidence":0.8,"topic_tags":["pornography","religiosity","moral_incongruence","sexual_function"],"strengths":["Longitudinal archive of texts (1956‑2010)","Clear theoretical framing (internal secularization)","Systematic content‑analysis methodology"],"limitations":["No empirical data on individuals’ behavior or health","Findings limited to discourse, not causal inferences","No measurement of moral incongruence or related confounds"],"rubric_version":"2.0","raw_total":12,"max_possible":50,"pct_score":24,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":5,"contrasting":0,"mentioning":55,"citing_publications":92,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/jssr.12052"}},{"id":9810,"doi":"10.1177/0891243220905815","pmid":null,"pmcid":null,"title":"Created by God and Wired to Porn: Redemptive Masculinity and Gender Beliefs in Narratives of Religious Men’s Pornography Addiction Recovery","authors":"Burke K, Haltom TM.","first_author":"Burke K","journal":"Gender & Society","year":2020,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":31,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"35 in‑depth qualitative interviews with religious men recruited from pornography‑addiction recovery programs; thematic analysis of narratives.","sample_n":35,"sample_text":"35 participants","population":"religious men in recovery programs (self‑selected, not representative)","country":"USA (not specified in abstract)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Interviews with 35 religious men in porn‑addiction recovery reveal they view themselves as biologically ‘hard‑wired’ for pornography, but frame quitting as a masculine achievement, reinforcing gendered, religious beliefs.","clinical_takeaway":"Clinicians should recognize that religious men may interpret porn use and recovery through gendered, moral narratives that shape their treatment experience.","confidence":0.8,"topic_tags":["pornography","religiosity","masturbation","sexual_function","gender"],"strengths":["Rich, in‑depth qualitative data","Innovative concept of ‘redemptive masculinity’","Provides cultural context for religious men’s narratives"],"limitations":["Small, non‑representative convenience sample","No validated measurement of pornography use or addiction","Findings not generalizable beyond recovery program participants"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":36,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0891243220905815"}},{"id":9811,"doi":"10.1007/978-3-030-36822-7_16","pmid":null,"pmcid":null,"title":"Groupthink in Sex and Pornography “Addiction”: Sex-Negativity, Theoretical Impotence, and Political Manipulation","authors":"Prause N, Williams DJ.","first_author":"Prause N","journal":"Groupthink in Science","year":2020,"pub_types":["book-chapter"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"book chapter offering a sociological/critical perspective; no empirical data, no participants, no methods.","sample_n":null,"sample_text":"","population":"","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi","circular_addiction_scale"],"stance":"strongly-opposes","citation_value":"strategic","plain_summary":"The chapter argues that claims of sex and porn addiction are driven by sex‑negative cultural forces, political agendas, and misuse of neuroscience language rather than solid scientific evidence.","clinical_takeaway":"Do not treat pornography use as an addiction without rigorous, evidence‑based assessment; consider sociocultural factors.","confidence":0.4,"topic_tags":["pornography","sexual_function"],"strengths":["Raises awareness of sociopolitical dynamics","Highlights potential misuse of neuroscience jargon"],"limitations":["No empirical data or systematic review","Lacks measurement of key constructs","No control of confounding variables"],"rubric_version":"2.0","raw_total":5,"max_possible":50,"pct_score":10,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":1}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":12,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/978-3-030-36822-7_16"}},{"id":9812,"doi":"10.1525/sp.2014.12151","pmid":null,"pmcid":null,"title":"Rethinking Coalitions: Anti-Pornography Feminists, Conservatives, and Relationships between Collaborative Adversarial Movements","authors":"Whittier N.","first_author":"Whittier N","journal":"Social Problems","year":2014,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai_flagged","relevance":"peripheral","evidence_level":"commentary","design_detail":"theoretical article proposing a new framework for social‑movement interaction, using historical description of anti‑pornography feminist–conservative collaboration; no empirical data collection","sample_n":null,"sample_text":"none","population":"none","country":"USA (journal based)","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The article argues that social movements can cooperate while remaining ideologically opposed, using 1980s anti‑pornography feminists and conservatives as an example, and proposes a new way to think about such ‘collaborative adversarial’ relationships.","clinical_takeaway":"None – the paper does not provide clinical evidence about pornography use or sexual health.","confidence":0.3,"topic_tags":["pornography","sexual_function"],"strengths":["Novel conceptual framework for non‑coalitional movement interaction","Historical case illustration adds depth"],"limitations":["No empirical data; purely theoretical","No measurement of pornography‑related behaviors or health outcomes","Limited generalisability beyond the specific historical case"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":10,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1525/sp.2014.12151"}},{"id":9813,"doi":"10.1177/0196859913482330","pmid":null,"pmcid":null,"title":"Pornography Addiction and the Medicalization of Free Speech","authors":"Clarkson J, Kopaczewski S.","first_author":"Clarkson J","journal":"Journal of Communication Inquiry","year":2013,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["bibliography","pornography","shame_religiosity"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary/editorial discussing the framing of pornography use as an addiction without presenting empirical data.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"opposes","citation_value":"background","plain_summary":"The article argues that labeling pornography use as an addiction serves moral and political agendas, criticizing the medicalization of free speech without providing empirical evidence.","clinical_takeaway":"None – the piece offers no clinical data to inform practice.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence"],"strengths":["Highlights sociopolitical implications of pathologizing pornography","Raises awareness of free‑speech concerns"],"limitations":["No empirical data or systematic analysis","Lacks measurement of key constructs or confounds","Conclusions based on opinion rather than evidence"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0196859913482330"}},{"id":9814,"doi":"10.1080/14681994.2020.1727874","pmid":null,"pmcid":null,"title":"A lack of association between online pornography exposure, sexual functioning, and mental well-being","authors":"Charig R, Moghaddam NG, Dawson DL, Merdian HL, das Nair R.","first_author":"Charig R","journal":"Sexual and Relationship Therapy","year":2020,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":21,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional questionnaire study with convenience sample of 252 cisgender heterosexual adults","sample_n":252,"sample_text":"convenience sample of cisgender, heterosexual adults","population":"cisgender, heterosexual adults (N=252)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 252 heterosexual adults, the researchers found no meaningful link between how much online porn people viewed and their sexual satisfaction, body image, sexist attitudes, or overall mental health. The study suggests that, for most people, porn use does not noticeably affect these aspects of wellbeing.","clinical_takeaway":"Current evidence does not support a direct impact of porn use on sexual or mental health for most adults.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Reasonable sample size for correlational analysis","Equivalence testing to bound effect sizes","Multiple psychosocial outcomes examined"],"limitations":["Convenience, non‑representative sample","Cross‑sectional design prevents causal inference","Key confounds (moral incongruence, masturbation) not measured"],"rubric_version":"2.0","raw_total":27,"max_possible":50,"pct_score":54,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":3,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/14681994.2020.1727874"}},{"id":9815,"doi":"10.1001/jamanetworkopen.2020.3833","pmid":"32530470","pmcid":"PMC7293001","title":"Trends in Frequency of Sexual Activity and Number of Sexual Partners Among Adults Aged 18 to 44 Years in the US, 2000-2018","authors":"Ueda P, Mercer CH, Ghaznavi C, Herbenick D.","first_author":"Ueda P","journal":"JAMA network open","year":2020,"pub_types":["research-article","Journal Article"],"keywords":[],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC7293001","cited_by_count":90,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"repeat cross‑sectional analyses of nationally representative General Social Survey data (2000‑2018)","sample_n":4291,"sample_text":"4291 men and 5213 women for sexual frequency; 4372 men and 5377 women for number of partners","population":"US adults 18–44 years (N≈9‑10 k per analysis)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using a nationally representative US survey from 2000‑2018, the study found rising sexual inactivity among young adults, especially men aged 18‑24, and fewer weekly sexual encounters and partners over time.","clinical_takeaway":"Clinicians should be aware of increasing sexual inactivity in young adults, which may signal broader public‑health concerns.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large, nationally representative sample","Repeated surveys allow trend analysis","Clear reporting of odds ratios with confidence intervals"],"limitations":["Self‑report may be subject to recall/social desirability bias","No measures of key confounds (e.g., mental health, moral attitudes)","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":7,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":11,"contrasting":5,"mentioning":119,"citing_publications":209,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1001/jamanetworkopen.2020.3833"}},{"id":9816,"doi":"10.1016/j.jsxm.2019.12.005","pmid":"31937516","pmcid":null,"title":"Evidence for Persistence of Sexual Evaluative Learning Effects","authors":"Both S, Brom M, Laan E, Everaerd W, Spinhoven P.","first_author":"Both S","journal":"The journal of sexual medicine","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Extinction","Classical Conditioning","Genital Arousal","Sexual Response","Evaluative Learning"],"is_oa":false,"oa_url":null,"cited_by_count":3,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"Laboratory differential conditioning experiment with CS+/CS- within‑subject design; 66 healthy participants (34 men, 32 women) completed acquisition and extensive extinction trials in a single session.","sample_n":66,"sample_text":"34 men, 32 women; recruited as healthy volunteers; no clinical or treatment‑seeking sample.","population":"Healthy sexually functional adults (men and women, mixed age groups).","country":"Netherlands (inferred from author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab experiment, participants learned to like neutral pictures that were paired with genital stimulation. Even after many extinction trials, they still rated those pictures more positively and sexually arousing, showing that sexual evaluative learning is hard to erase within a single session.","clinical_takeaway":"Unwanted sexual cues may remain attractive despite repeated exposure; clinicians might need emotion‑regulation strategies rather than simple extinction.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Physiological genital measures alongside self‑reports","Within‑subject control (CS‑) allows clear comparison","Extensive extinction phase (24 trials) probes persistence"],"limitations":["Single experimental session; no long‑term follow‑up","No unpaired control condition to rule out general habituation","No pre‑registration or reported effect sizes"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":5,"confounds":3,"design":7,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":5,"citing_publications":7,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.12.005"}},{"id":9817,"doi":"10.1111/socf.12506","pmid":null,"pmcid":null,"title":"EXPOsing Men's Gender Role Attitudes as Porn Superfans","authors":"Jackson CA, Baldwin A, Brents BG, Maginn PJ.","first_author":"Jackson CA","journal":"Sociological Forum","year":2019,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":10,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Convenience sample of Adult Entertainment Expo attendees (n=294) compared to nationally representative GSS respondents (n=863); cross‑sectional survey using GSS‑derived gender‑role attitude items; logistic regression analyses.","sample_n":1157,"sample_text":"294 expo men, 863 GSS men","population":"cisgender men; expo attendees vs general U.S. male adults","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A survey of men who attend a porn‑focused expo showed they are no more sexist than the general U.S. male population and are actually more supportive of working mothers on some measures. This challenges claims that porn use automatically fosters hostile attitudes toward women.","clinical_takeaway":"None – the study addresses social attitudes, not clinical sexual health.","confidence":0.6,"topic_tags":["pornography","gender","sexual_function"],"strengths":["Large comparative sample including a nationally representative cohort","Use of validated GSS attitude items","Multivariate regression to adjust for covariates"],"limitations":["Expo sample is self‑selected and may not represent typical porn consumers","No measurement of moral or religious attitudes that could confound gender‑role views","Effect sizes and confidence intervals not reported"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":6,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":2,"citing_publications":11,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/socf.12506"}},{"id":9818,"doi":"10.1111/papq.12448","pmid":null,"pmcid":null,"title":"Does Pornography Presuppose Rape Myths?","authors":"Heck RK.","first_author":"Heck RK","journal":"Pacific Philosophical Quarterly","year":2024,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":1,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"none","sample_n":null,"sample_text":"none","population":"none","country":"none","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The author critiques feminist claims that pornography, exemplified by the image ‘Dirty Pool’, presupposes rape myths, arguing that there is little evidence for such premises and that pornography often reflects fantasy rather than silencing women.","clinical_takeaway":"None - not clinically applicable.","confidence":0.8,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Clear philosophical argumentation","Engages with existing feminist theory"],"limitations":["No empirical data","Lacks systematic evidence","Cannot support causal claims"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":1,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/papq.12448"}},{"id":9819,"doi":"10.1007/s10508-015-0622-1","pmid":"26626185","pmcid":null,"title":"Women Like Being Valued for Sex, as Long as it is by a Committed Partner","authors":"Meltzer AL, McNulty JK, Maner JK.","first_author":"Meltzer AL","journal":"Archives of sexual behavior","year":2017,"pub_types":["Journal Article"],"keywords":["Sex","Women","Marriage","Commitment","Intimate Relationships","Evolutionary Psychology"],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["bibliography","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"Two correlational studies of newly‑married couples (N≈100 per study) examining how wives’ perception of husbands’ sexual valuation interacts with perceived commitment to predict marital satisfaction.","sample_n":208,"sample_text":"Study 1 N=109 couples; Study 2 N=99 couples","population":"Newly married heterosexual couples (community sample)","country":"USA (likely, not specified)","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In two surveys of newly married couples, women reported higher marital satisfaction when they felt their husbands valued them for sex and were also highly committed. The same sexual valuation lowered satisfaction when women saw their husbands as less committed.","clinical_takeaway":"Clinicians should consider the context of commitment when discussing sexual expectations in marriage; valuing sex is not inherently positive or negative.","confidence":0.6,"topic_tags":["relationships","sexual_function"],"strengths":["Reasonable sample size for correlational work","Focus on interaction of commitment and sexual valuation","Uses both partners’ reports"],"limitations":["Cross‑sectional; no causal inference","Limited detail on measurement validity","Potential unmeasured confounds (e.g., mental health, moral views)"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":14,"citing_publications":23,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-015-0622-1"}},{"id":9820,"doi":"10.1300/j056v11n01_04","pmid":null,"pmcid":null,"title":"Sex, Guys, and Cyberspace: Effects of Internet Pornography and Individual Differences on Men's Attitudes Toward Women","authors":"Barak A, Fisher WA, Belfry S, Lashambe DR.","first_author":"Barak A","journal":"Journal of Psychology & Human Sexuality","year":1999,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":73,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Study 1 experimental exposure (N=24); Study 2 correlational self‑regulated exposure (N=31); convenience university male sample.","sample_n":55,"sample_text":"N = 24 (Study 1) and N = 31 (Study 2), total 55 participants.","population":"undergraduate men (mostly WEIRD sample)","country":"USA (presumed from journal and author affiliations)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","masturbation_not_isolated","no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study gave college men different amounts of online pornography and measured their attitudes toward women. No direct effect of pornography exposure was found; instead, personal traits like sensation seeking predicted both how much porn they chose to view and misogynistic attitudes.","clinical_takeaway":"In this small sample, pornography exposure alone did not increase sexist attitudes; clinicians should consider broader personality factors when addressing misogynistic beliefs.","confidence":0.73,"topic_tags":["pornography","sexual_function","gender"],"strengths":["Uses both experimental and naturalistic exposure designs","Considers multiple individual‑difference variables","Transparent reporting of null findings"],"limitations":["Very small samples; low statistical power","No measurement of key confounds (morality, masturbation, mental health)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":17,"citing_publications":87,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1300/j056v11n01_04"}},{"id":9821,"doi":"10.1080/15213269.2016.1267646","pmid":null,"pmcid":null,"title":"Pornography Consumption, Sexual Liberalism, and Support for Abortion in the United States: Aggregate Results from Two National Panel Studies","authors":"Wright PJ, Tokunaga RS.","first_author":"Wright PJ","journal":"Media Psychology","year":2018,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Three-wave national panel survey of US adults; mediation analysis of pornography use → sexual liberalism → abortion support; also reverse pathways examined.","sample_n":null,"sample_text":"national panel data from two three‑wave surveys; exact N not given in abstract","population":"United States adults (national panel sample)","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Using two US panel surveys, researchers found that people who watched more pornography later endorsed more liberal sexual ideas, which in turn predicted greater support for abortion. They also observed a reciprocal pattern where abortion support predicted later sexual liberalism and pornography use.","clinical_takeaway":"None – the study examines attitudes, not clinical outcomes or sexual health concerns.","confidence":0.75,"topic_tags":["pornography","sexual_function"],"strengths":["Longitudinal design with three waves allowing temporal sequencing","Large national panel sample improves generalisability","Tests bidirectional relationships per reinforcing spirals model"],"limitations":["No measurement or control of key sexual‑health confounds (e.g., moral attitudes, mental health)","Constructs rely on self‑report; validation of scales unclear from abstract","Causal language may exceed what observational data can support"],"rubric_version":"2.0","raw_total":28,"max_possible":50,"pct_score":56,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":7,"neuroimaging":null,"statistics":5,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":22,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/15213269.2016.1267646"}},{"id":9822,"doi":"10.1111/j.1467-6478.2010.00500.x","pmid":null,"pmcid":null,"title":"Extreme Concern: Regulating ‘Dangerous Pictures’ in the United Kingdom","authors":"Attwood F, Smith C.","first_author":"Attwood F","journal":"Journal of Law and Society","year":2010,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":61,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary","sample_n":null,"sample_text":"None – article is a legal‑policy commentary with no empirical participants.","population":"none","country":"United Kingdom","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"neutral","citation_value":"background","plain_summary":"The authors critique UK legislation that bans ‘extreme’ pornographic images, arguing that the evidence used to justify the law is weak and that the debate reflects broader anxieties about sexual content rather than clear public‑health harms.","clinical_takeaway":"None – the paper does not provide data relevant to clinical practice.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Comprehensive legal and discourse analysis","Highlights sociocultural dimensions of pornography regulation"],"limitations":["No empirical data or measurement of constructs","Conclusions not based on systematic evidence review"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":18,"citing_publications":77,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1467-6478.2010.00500.x"}},{"id":9823,"doi":"10.1080/10720162.2019.1645058","pmid":null,"pmcid":null,"title":"Abstinence or Acceptance? A Case Series of Men’s Experiences With an Intervention Addressing Self-Perceived Problematic Pornography Use","authors":"Sniewski L, Farvid P.","first_author":"Sniewski L","journal":"Sexual Addiction & Compulsivity","year":2019,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":22,"is_preprint":false,"topics":["bibliography","csbd","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"case-report","design_detail":"case series of six heterosexual men with self‑perceived problematic pornography use; mixed qualitative methods (interviews, logs, diaries, guided meditations)","sample_n":6,"sample_text":"six cases","population":"heterosexual men self‑identifying as having problematic pornography use; recruited for a mindfulness‑based intervention","country":"not specified","controls_mi":"no","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"Six heterosexual men who felt their porn use was a problem took part in a mindfulness program. Interviews and daily logs showed that accepting their behaviour felt more achievable than trying to quit, and that program design affected how helpful they found it.","clinical_takeaway":"For men distressed about porn use, acceptance‑based approaches may be more realistic than strict abstinence, but evidence is limited to a tiny, self‑selected sample.","confidence":0.7,"topic_tags":["pornography","masturbation","sexual_function"],"strengths":["Rich qualitative data from multiple sources","Focus on participants’ subjective experience"],"limitations":["Very small, non‑representative sample","No validated measures of problematic use or distress","No control for moral or mental‑health confounds"],"rubric_version":"2.0","raw_total":8,"max_possible":50,"pct_score":16,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":3}},"scite":{"supporting":0,"contrasting":0,"mentioning":16,"citing_publications":24,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10720162.2019.1645058"}},{"id":9824,"doi":"10.1177/1468017319852599","pmid":null,"pmcid":null,"title":"Pornography, religiosity, and social work","authors":"Droubay BA, Butters RP.","first_author":"Droubay BA","journal":"Journal of Social Work","year":2020,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":15,"is_preprint":false,"topics":["bibliography","csbd","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"web‑based survey of 136 U.S. social‑work students; path analysis of religiosity → belief pornography is a public‑health issue → perceived addictiveness","sample_n":136,"sample_text":"social‑work students recruited via web‑survey","population":"social‑work students (convenience sample)","country":"United States","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["self_selected_sample","underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A survey of 136 U.S. social‑work students found that those who are more religious are more likely to view pornography as a serious public‑health problem and to think it is addictive. The authors warn that such beliefs could lead clinicians to pathologize clients’ porn use.","clinical_takeaway":"Clinicians should be aware that personal religiosity may bias judgments about pornography and avoid labeling clients’ use as an addiction without evidence.","confidence":0.7,"topic_tags":["pornography","religiosity","sexual_function"],"strengths":["Clear focus on religiosity as predictor","Uses path analysis to test mediation"],"limitations":["Single‑item measures of key constructs","No validated addiction scale","Convenience student sample limits generalizability","No control for key confounds (masturbation, mental health, etc.)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":19,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1468017319852599"}},{"id":9825,"doi":"10.1097/psy.0b013e31828c4524","pmid":"23576768","pmcid":null,"title":"The effect of a primary sexual reward manipulation on cortisol responses to psychosocial stress in men","authors":"Creswell JD, Pacilio LE, Denson TF, Satyshur M.","first_author":"Creswell JD","journal":"Psychosomatic medicine","year":2013,"pub_types":["Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S.","Journal Article"],"keywords":["Stress","Reward","Hpa Axis","Trier Social Stress Test"],"is_oa":false,"oa_url":null,"cited_by_count":17,"is_preprint":false,"topics":["bibliography","csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"laboratory randomised controlled experiment with 54 participants","sample_n":54,"sample_text":"participants were randomly assigned to view erotic or neutral images before a stress test","population":"heterosexual men, n=54","country":"USA (likely, based on authors and journal)","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"Viewing mildly erotic pictures before a social‑stress test lowered men’s cortisol response compared with neutral pictures, suggesting that rewarding sexual cues can buffer physiological stress.","clinical_takeaway":"Erotic visual cues may help reduce stress reactivity, but findings are limited to short‑term lab settings.","confidence":0.85,"topic_tags":["csbd","pornography","sexual_function","masturbation"],"strengths":["Randomised experimental manipulation","Objective physiological outcome (cortisol)","Clear statistical reporting of effect size"],"limitations":["Small sample for between‑group comparison","No pre‑registration or confidence intervals","Limited to heterosexual men, reducing generalisability"],"rubric_version":"2.0","raw_total":37,"max_possible":50,"pct_score":74,"quality_rating":"Good","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":9}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":26,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1097/psy.0b013e31828c4524"}},{"id":9826,"doi":"10.1177/1363460719842136","pmid":null,"pmcid":null,"title":"Nosology and metaphor: How pornography viewers make sense of pornography addiction","authors":"Taylor K.","first_author":"Taylor K","journal":"Sexualities","year":2020,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["bibliography","csbd","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Qualitative survey (n=213) and semi‑structured interviews (n=30) with pornography viewers; thematic analysis of how they conceptualize “addiction.”","sample_n":213,"sample_text":"Convenience sample of self‑selected pornography viewers; not a probability or clinical sample.","population":"Adult pornography viewers recruited via online survey; convenience sample.","country":"Not reported","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study interviewed 30 pornography viewers and surveyed 213 people to see how they talk about ‘pornography addiction’. Participants used the term in many different ways, often as a metaphor, and linked it to ideas about the brain, showing that the concept’s meaning is fluid and socially constructed.","clinical_takeaway":"Clinicians should recognise that ‘pornography addiction’ may be a metaphor for distress rather than a clearly defined clinical condition.","confidence":0.78,"topic_tags":["pornography","sexual_function","neuroscience","csbd"],"strengths":["Rich qualitative insight into lay and expert conceptualisations","Large initial survey pool for thematic saturation","Integration of philosophical framework (Hacking)"],"limitations":["No validated measures of addiction or distress","Convenience, self‑selected sample limits generalisability","No assessment of key confounds (moral, mental health, etc.)"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":21,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1363460719842136"}},{"id":9827,"doi":"10.1523/jneurosci.21-18-j0001.2001","pmid":"11549754","pmcid":"PMC6763007","title":"Neural correlates of conscious self-regulation of emotion","authors":"Beauregard M, Lévesque J, Bourgouin P.","first_author":"Beauregard M","journal":"The Journal of neuroscience : the official journal of the Society for Neuroscience","year":2001,"pub_types":["other","Clinical Trial","Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":590,"is_preprint":false,"topics":["bibliography","csbd","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subject fMRI experiment where male participants viewed erotic clips and were instructed either to respond normally or to voluntarily inhibit arousal","sample_n":null,"sample_text":"normal male subjects (exact N not given)","population":"normal adult males (sample size not reported in abstract)","country":"Canada (authors’ affiliations inferred)","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers used fMRI to see how men's brains respond when they watch erotic videos and either let their arousal happen or try to suppress it. Suppression activated prefrontal regions, while natural arousal activated limbic areas.","clinical_takeaway":"The study suggests that conscious effort can change brain activity during sexual arousal, but limited data prevent clinical recommendations.","confidence":0.7,"topic_tags":["pornography","sexual_function","neuroscience"],"strengths":["use of neuroimaging to examine self‑regulation","within‑subject experimental manipulation","focus on conscious inhibition of sexual arousal"],"limitations":["small, unspecified sample size","no measurement of moral/religious factors or other confounds","lack of validated scales for arousal or inhibition"],"rubric_version":"2.0","raw_total":26,"max_possible":60,"pct_score":43,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":5,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":41,"contrasting":4,"mentioning":610,"citing_publications":1022,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1523/jneurosci.21-18-j0001.2001"}},{"id":9828,"doi":"10.1007/s13178-018-0345-x","pmid":null,"pmcid":null,"title":"Understanding Associations between Personal Definitions of Pornography, Using Pornography, and Depression","authors":"Willoughby BJ, Busby DM, Young-Petersen B.","first_author":"Willoughby BJ","journal":"Sexuality Research and Social Policy","year":2019,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["bibliography","csbd","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey analyzing self‑reported definitions of pornography, usage patterns and depressive symptoms; sample size not reported in abstract","sample_n":null,"sample_text":"sample size not provided in abstract","population":"unspecified adult participants (likely convenience sample)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"People who consider themselves less accepting of pornography tend to avoid it, while those who view material they don’t label as porn show higher depression scores. Personal views on what counts as porn appear linked to how often people see it and their mood.","clinical_takeaway":"Clinicians should explore patients’ personal definitions of pornography, as these perceptions may relate to depressive symptoms.","confidence":0.7,"topic_tags":["pornography","sexual_function","moral_incongruence","gender"],"strengths":["Addresses personal definitions of pornography","Links subjective definitions to depressive outcomes"],"limitations":["No validated scales reported","Potential lack of control for moral or mental‑health confounds","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":22,"citing_publications":44,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s13178-018-0345-x"}},{"id":9829,"doi":"10.1177/0265407519841719","pmid":null,"pmcid":null,"title":"Affection substitution: The effect of pornography consumption on close relationships","authors":"Hesse C, Floyd K.","first_author":"Hesse C","journal":"Journal of Social and Personal Relationships","year":2019,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":30,"is_preprint":false,"topics":["bibliography","csbd","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of 357 adults measuring self‑reported weekly pornography use, affection deprivation, relationship outcomes and depression","sample_n":357,"sample_text":"357 adults","population":"adults (unspecified recruitment method)","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of 357 adults, higher feelings of lacking affection were linked to lower relationship satisfaction and higher loneliness and depression. Pornography use was not directly related to those relationship outcomes, but it may worsen depression for those feeling affection‑deprived.","clinical_takeaway":"Pornography use may reflect coping with unmet affection needs and could be linked to higher depression, but it does not appear to improve or harm relationship satisfaction directly.","confidence":0.7,"topic_tags":["pornography","relationships","sexual_function","moral_incongruence"],"strengths":["Large sample for a survey","Considers multiple relational outcomes","Tests moderation hypotheses"],"limitations":["Reliance on ad‑hoc self‑report scales","Cross‑sectional, cannot infer causality","No measurement of moral incongruence or masturbation"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":5,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":13,"citing_publications":33,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0265407519841719"}},{"id":9830,"doi":"10.1016/j.jesp.2016.11.003","pmid":null,"pmcid":null,"title":"Does exposure to erotica reduce attraction and love for romantic partners in men? Independent replications of Kenrick, Gutierres, and Goldberg (1989) study 2","authors":"Balzarini RN, Dobson K, Chin K, Campbell L.","first_author":"Balzarini RN","journal":"Journal of Experimental Social Psychology","year":2017,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":24,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"laboratory experiment with independent replications of a classic study; between‑subjects manipulation of exposure to erotic images; sample size not reported in abstract","sample_n":null,"sample_text":"not specified in abstract","population":"men in a non‑clinical sample (likely convenience/college participants)","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In two lab replications, men who viewed attractive photos of other women did not report lower sexual attraction or love for their own romantic partners compared with men who did not view such images.","clinical_takeaway":"None – the study does not provide evidence that viewing erotic material harms partner attraction or love.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships"],"strengths":["Experimental manipulation allows causal inference about short‑term effects","Direct replication of a well‑known study","Clear outcome measures (partner attractiveness and love ratings)"],"limitations":["Reliance on single‑item self‑report scales, limited construct validation","No measurement of potential confounds such as moral attitudes or mental‑health status","Sample characteristics unknown; likely convenience/WEIRD"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jesp.2016.11.003"}},{"id":9831,"doi":"10.1080/00224499.2015.1137854","pmid":"26900897","pmcid":null,"title":"What Keeps Passion Alive? Sexual Satisfaction Is Associated With Sexual Communication, Mood Setting, Sexual Variety, Oral Sex, Orgasm, and Sex Frequency in a National U.S. Study","authors":"Frederick DA, Lever J, Gillespie BJ, Garcia JR.","first_author":"Frederick DA","journal":"Journal of sex research","year":2017,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":106,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"large online convenience survey (N=38,747) of cohabiting/married US adults, cross‑sectional","sample_n":38747,"sample_text":"N = 38,747 participants, men and women, married or cohabiting for at least three years","population":"cohabiting or married U.S. adults (≥3‑year relationship) recruited via a major news website","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a national U.S. survey of over 38,000 long‑term couples, those who were sexually satisfied reported more frequent sex, oral sex, consistent orgasms, sexual variety, mood‑setting, and open communication. These factors were linked to feeling that passion remained high.","clinical_takeaway":"Encourage couples to maintain frequent, varied sexual activity, open communication, and supportive mood‑setting to sustain sexual satisfaction.","confidence":0.7,"topic_tags":["sexual_function","relationships"],"strengths":["Very large national sample","Focus on multiple relational/behavioral factors","Clear differentiation of satisfied vs dissatisfied groups"],"limitations":["Convenience, self‑selected online sample","Cross‑sectional; cannot infer causality","Reliance on single‑item self‑report measures"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":9,"contrasting":1,"mentioning":114,"citing_publications":241,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/00224499.2015.1137854"}},{"id":9832,"doi":"10.1080/10570314.2018.1564934","pmid":null,"pmcid":null,"title":"The Desire for Porn and Partner?: Investigating the Role of Scripts in Affectionate Communication, Sexual Desire, and Pornography Consumption and Guilt in Young Adults’ Romantic Relationships","authors":"Bennett M, LoPresti BJ, McGloin R, Denes A.","first_author":"Bennett M","journal":"Western Journal of Communication","year":2019,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":11,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of young adult monogamous couples","sample_n":null,"sample_text":"young adults in sexually active monogamous relationships (sample size not reported in abstract)","population":"young adult, sexually active, monogamous, likely convenience/college sample","country":"unspecified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","underpowered_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"In a survey of young adults in monogamous relationships, the study found that feeling affectionate toward a partner boosted sexual desire for the partner, which in turn raised relationship satisfaction. Watching porn did not lower desire, but feeling guilty about porn use did.","clinical_takeaway":"Guilt about porn, not the amount watched, may reduce sexual desire for a partner; clinicians might explore guilt and moral concerns in couples therapy.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships","gender"],"strengths":["Extends affection exchange theory","Includes relational & sexual script variables","Considers guilt as moderator"],"limitations":["Likely convenience/college sample, limited generalisability","Unclear whether scales are validated","No control for key confounds (moral incongruence, masturbation, mental health)","Cross‑sectional: cannot infer causality"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":14,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10570314.2018.1564934"}},{"id":9833,"doi":"10.4103/mmj.mmj_905_17","pmid":null,"pmcid":null,"title":"Effect of pornography on married couples","authors":"Gaber MA, Khaled HN, Nassar MM.","first_author":"Gaber MA","journal":"Menoufia Medical Journal","year":2019,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":4,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"300 married men and women, self‑report questionnaire, outpatient clinic recruitment, cross‑sectional analysis","sample_n":300,"sample_text":"randomly selected from obstetrics/gynecology and dermatology outpatient clinics","population":"married adults, age 20‑50, Egypt","country":"Egypt","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a questionnaire of 300 Egyptian married couples, about 43% reported watching pornography. Viewers said it sometimes increased sexual desire and masturbation, but also linked it to lower satisfaction and a higher divorce rate. The authors conclude pornography harms marital relations.","clinical_takeaway":"The study suggests perceived negative marital effects of pornography, but lacks causal proof; clinicians should interpret such claims cautiously.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships","masturbation"],"strengths":["Reasonable sample size (n=300)","High internal consistency reported for questionnaire (α=0.93)","Includes both partners' reports"],"limitations":["Questionnaire developed for study, not validated against established scales","Cross‑sectional design limits causal inference","No measurement or control of moral/religious attitudes or mental‑health variables"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":3,"contrasting":0,"mentioning":3,"citing_publications":10,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.4103/mmj.mmj_905_17"}},{"id":9834,"doi":"10.1007/s12119-018-09581-4","pmid":null,"pmcid":null,"title":"Does Pornography Use Reduce Marriage Entry During Early Adulthood? Findings from a Panel Study of Young Americans","authors":"Perry SL, Longest KC.","first_author":"Perry SL","journal":"Sexuality & Culture","year":2019,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":5,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"panel study of young Americans with multiple waves assessing pornography frequency and marriage entry","sample_n":null,"sample_text":"","population":"young American adults (both genders)","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"moderate","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In a national panel of young adults, watching porn more often did not make men or women any more or less likely to get married in early adulthood, and this was true regardless of how religious they were.","clinical_takeaway":"Porn use alone does not appear to influence marriage timing; clinicians should consider broader relational factors.","confidence":0.6,"topic_tags":["pornography","relationships","religiosity","sexual_function"],"strengths":["Longitudinal panel design allowing temporal ordering","Large‑scale national sample (presumed)","Inclusion of religious commitment as a moderator"],"limitations":["Pornography use measured by simple frequency item, no validated scale","Key confounds (masturbation, mental health, partner context, trauma) not addressed","Effect‑size reporting unclear, possible limited power"],"rubric_version":"2.0","raw_total":29,"max_possible":50,"pct_score":58,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":5,"design":7,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":1,"citing_publications":6,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12119-018-09581-4"}},{"id":9835,"doi":"10.1177/0146167208318141","pmid":"18502980","pmcid":null,"title":"When sex primes love: subliminal sexual priming motivates relationship goal pursuit","authors":"Gillath O, Mikulincer M, Birnbaum GE, Shaver PR.","first_author":"Gillath O","journal":"Personality & social psychology bulletin","year":2008,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":29,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"experimental","design_detail":"laboratory priming experiment with multiple cognitive‑behavioral outcomes; sample size not reported in abstract","sample_n":null,"sample_text":"Not specified in abstract; likely convenience sample","population":"adults (male and female, adolescent to middle‑aged) recruited for lab study","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors found that brief, unnoticed exposure to erotic words or images makes people more willing to disclose personal information, think about intimacy, and act cooperatively in relationships, suggesting sex can spur relational motivations.","clinical_takeaway":"None – study is basic research on sexual priming, not directly applicable to clinical practice.","confidence":0.65,"topic_tags":["sexual_function","relationships","csbd"],"strengths":["Experimental manipulation allows causal inference for priming effect","Multiple outcome measures capture relational motives"],"limitations":["Sample size and characteristics not reported in abstract","No control for moral, mental‑health or relationship variables","Effect‑size reporting unclear"],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":2,"contrasting":1,"mentioning":57,"citing_publications":119,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0146167208318141"}},{"id":9836,"doi":"10.1007/s10508-010-9598-z","pmid":"20174862","pmcid":"PMC5847373","title":"Perceived consequences of casual online sexual activities on heterosexual relationships: a U.S. online survey","authors":"Grov C, Gillespie BJ, Royce T, Lever J.","first_author":"Grov C","journal":"Archives of sexual behavior","year":2011,"pub_types":["Research Support, Non-U.S. Gov't","research-article","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":61,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Online survey (ELLE/msnbc.com Cyber‑sex and Romance Survey), n=8,376 heterosexual adults in committed relationships, quantitative and qualitative analyses.","sample_n":8376,"sample_text":"large convenience sample drawn from a 2004 online magazine‑website survey; not probability‑based.","population":"U.S. heterosexual adults in committed relationships (self‑selected respondents to an online magazine/website survey).","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2004 U.S. online survey of over 8,000 people in committed heterosexual relationships found that moderate or light use of online sexual activities was often seen as beneficial—improving sexual communication and intimacy—while heavier use was linked to less sex and lower arousal. Men and women differed in how they viewed these impacts.","clinical_takeaway":"Clinicians should recognize that moderate online sexual activity can be reported as relationship‑enhancing, but heavier use may be associated with reduced sexual satisfaction; assess each client’s context rather than assuming pathology.","confidence":0.8,"topic_tags":["pornography","masturbation","relationships","sexual_function"],"strengths":["Very large sample size for a survey","Includes both quantitative and qualitative data","Addresses a gap by studying recreational users, not just compulsive users"],"limitations":["Convenience, self‑selected online sample limits generalizability","Measures appear ad‑hoc; no validated scales for constructs","No control for key confounds (moral incongruence, mental health, masturbation)","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":23,"max_possible":50,"pct_score":46,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":5,"confounds":2,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":5,"contrasting":0,"mentioning":78,"citing_publications":143,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-010-9598-z"}},{"id":9837,"doi":"10.1177/0265407517743096","pmid":null,"pmcid":null,"title":"Pornography’s associations with open sexual communication and relationship closeness vary as a function of dyadic patterns of pornography use within heterosexual relationships","authors":"Kohut T, Balzarini RN, Fisher WA, Campbell L.","first_author":"Kohut T","journal":"Journal of Social and Personal Relationships","year":2018,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":71,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online cross‑sectional survey of 200 heterosexual dyads, quota‑sampled to match US married couples on age and political affiliation; dyadic patterns of pornography use (shared, concordant solitary, discordant) examined in relation to self‑report measures of open sexual communication and relationship","sample_n":200,"sample_text":"200 heterosexual dyads (quota sampled)","population":"heterosexual married or cohabiting American couples (N=200 dyads)","country":"United States","controls_mi":"not_applicable","preregistered":true,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In 200 U.S. married couples, sharing porn together or both partners using it solo was linked to more open sexual talk and feeling closer, while mismatched solo use reduced communication and closeness. High‑frequency solo use by both partners did not harm closeness.","clinical_takeaway":"Couples’ patterns of porn use matter more than use alone; shared or concordant use does not necessarily harm relationship intimacy.","confidence":0.85,"topic_tags":["pornography","relationships","sexual_function"],"strengths":["Pre‑registered hypotheses","Dyadic analysis of couples","Quota‑sample reflects broader US married population"],"limitations":["Cross‑sectional; no causal inference","Pornography use measured by self‑report frequency only","Key confounds (moral incongruence, mental health, trauma) not assessed"],"rubric_version":"2.0","raw_total":25,"max_possible":50,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":1,"mentioning":59,"citing_publications":87,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0265407517743096"}},{"id":9838,"doi":"10.1007/s10508-012-0034-4","pmid":"23224749","pmcid":null,"title":"Erotica viewing effects on intimate relationships and self/partner evaluations","authors":"Staley C, Prause N.","first_author":"Staley C","journal":"Archives of sexual behavior","year":2013,"pub_types":["Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["bibliography","pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"within‑subject lab experiment with 44 heterosexual couples viewing erotic, exciting, and nature films alone and together; ratings of arousal, relationship satisfaction, self/partner attractiveness.","sample_n":88,"sample_text":"44 couples, recruited presumably via convenience sampling; limited demographic detail provided.","population":"44 monogamous heterosexual couples (N≈88 individuals)","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":["underpowered_sample","masturbation_not_isolated","no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Couples who watched erotic films felt more aroused and nearer to their partners, but also reported more guilt, anxiety, and negative feelings. The same films boosted positive views of their own sexual behavior, showing mixed emotional effects.","clinical_takeaway":"Erotic media can raise both intimacy and negative emotions; clinicians should discuss both potential benefits and harms with clients.","confidence":0.7,"topic_tags":["pornography","sexual_function","relationships","moral_incongruence"],"strengths":["Experimental manipulation with within‑subject control conditions","Direct comparison of erotic vs. exciting vs. neutral stimuli","Inclusion of both solo and couple viewing contexts"],"limitations":["Small convenience sample limits generalisability","Reliance on ad‑hoc self‑report scales without validation","Key confounds (masturbation, moral attitudes, mental health) not measured"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":5,"confounds":1,"design":6,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":25,"citing_publications":69,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-012-0034-4"}},{"id":9839,"doi":"10.1177/2167702620922966","pmid":null,"pmcid":null,"title":"Addiction or Transgression? Moral Incongruence and Self-Reported Problematic Pornography Use in a Nationally Representative Sample","authors":"Grubbs JB, Lee BN, Hoagland KC, Kraus SW, Perry SL.","first_author":"Grubbs JB","journal":"Clinical Psychological Science","year":2020,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":56,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey with nationally representative weighting (N=2519, 1424 porn users)","sample_n":2519,"sample_text":"Nationally representative sample of U.S. adults; past‑year pornography users n=1,424","population":"U.S. adults, nationally representative sample","country":"United States","controls_mi":"yes","preregistered":false,"quality_score":6,"certainty":"very_low","red_flags":["circular_addiction_scale","masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a US‑representative survey, higher religiousness made porn use more likely to be reported as an addiction, even though more religious people watched less porn overall. Moral conflict may inflate perceived problems.","clinical_takeaway":"Clinicians should consider moral or religious conflict when clients label porn use as addictive.","confidence":0.85,"topic_tags":["pornography","moral_incongruence","religiosity","sexual_function"],"strengths":["large nationally representative sample","examines interaction of religiosity and use","addresses moral incongruence as confound"],"limitations":["addiction measured by single self‑label item","masturbation not assessed separately","cross‑sectional; no causal inference","no mental‑health or relationship covariates"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":6,"confounds":4,"design":7,"addiction_criteria":4,"interpretation":8}},"scite":{"supporting":1,"contrasting":1,"mentioning":24,"citing_publications":70,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/2167702620922966"}},{"id":9840,"doi":"10.1016/j.paid.2019.02.019","pmid":null,"pmcid":null,"title":"Pornography, permissiveness, and sex differences: An evaluation of social learning and evolutionary explanations","authors":"Wright PJ, Vangeel L.","first_author":"Wright PJ","journal":"Personality and Individual Differences","year":2019,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":32,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional correlational study of pornography use and sexual permissiveness; likely convenience sample","sample_n":null,"sample_text":"not reported in abstract","population":"unspecified adult sample (likely community volunteers)","country":"not reported","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"The study found modest links between how often people watch porn and how permissive their sexual attitudes are, for both men and women, but it cannot prove that porn causes these attitudes.","clinical_takeaway":"None – the findings are correlational and do not guide clinical practice.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Addresses both genders","Links theory (social learning/evolution) to empirical data","Reports consistent small‑to‑moderate effects"],"limitations":["Cross‑sectional, cannot infer causality","No control for key confounds (moral views, mental health, relationship factors)","Unclear whether measures are validated"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":4,"contrasting":0,"mentioning":22,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.paid.2019.02.019"}},{"id":9841,"doi":"10.1007/s10508-019-01512-0","pmid":"31696350","pmcid":null,"title":"To What Extent Do Erotic Images Elicit Visuospatial versus Cognitive Attentional Processes? Consistent Support for a (Non-Spatial) Sexual Content-Induced Delay","authors":"Imhoff R, Barker P, Schmidt AF.","first_author":"Imhoff R","journal":"Archives of sexual behavior","year":2020,"pub_types":["Research Support, Non-U.S. Gov't","Journal Article"],"keywords":["Visual Attention","Spatial Cueing","Erotic Cognition","Sexual Content-induced Delay","Sexual Excitability"],"is_oa":false,"oa_url":null,"cited_by_count":9,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"four independent lab experiments using modified spatial cueing tasks (N=399 total) to separate visuospatial from cognitive attentional effects of erotic images.","sample_n":399,"sample_text":"total N = 399 across four studies","population":"adults (heterosexual men and women), ages not specified; recruited likely from university/community samples.","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":6,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In four lab experiments, erotic pictures did not speed up where people looked, but they slowed down reaction times overall, regardless of location. This delay was similar for men and women and linked to how sexually excited participants felt.","clinical_takeaway":"Erotic stimuli may cause a general attentional slowdown rather than visual capture; clinicians should note that perceived ‘distraction’ may reflect cognitive processing, not heightened visual focus.","confidence":0.8,"topic_tags":["csbd","pornography","sexual_function"],"strengths":["Large combined sample (N=399) across multiple replications","Clear experimental manipulation separating spatial vs. cognitive attention","Consistent findings demonstrating a non‑spatial delay effect"],"limitations":["No measurement or control of key confounds (e.g., moral incongruence, mental health)","Reliance on self‑report for sexual excitability without reporting validation","No pre‑registration or correction for multiple comparisons disclosed"],"rubric_version":"2.0","raw_total":31,"max_possible":50,"pct_score":62,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":6,"confounds":3,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":1,"contrasting":0,"mentioning":14,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-019-01512-0"}},{"id":9842,"doi":"10.1080/10720162.2016.1151391","pmid":null,"pmcid":null,"title":"Religiosity, Developmental Context, and Sexual Shame in Pornography Users: A Serial Mediation Model","authors":"Volk F, Thomas J, Sosin L, Jacob V, Moen C.","first_author":"Volk F","journal":"Sexual Addiction & Compulsivity","year":2016,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":61,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"serial mediation model using self‑report data from 358 adult pornography users; cross‑sectional convenience sample","sample_n":358,"sample_text":"358 participants (subset of larger study)","population":"Adults (men and women) who intentionally viewed pornography in the past six months; recruited as part of a larger study on romantic relationship satisfaction","country":"unspecified","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 358 adults who view pornography, the study found that childhood religious environment, current religiosity, and moral disapproval are linked to sexual shame, with perceived addiction acting as a mediator.","clinical_takeaway":"Clinicians should note that moral and religious factors may influence shame around pornography use, but causal claims are not supported.","confidence":0.7,"topic_tags":["pornography","religiosity","sexual_function"],"strengths":["Large sample for self‑report study","Addresses understudied mediation pathway","Includes moral/religiosity variables"],"limitations":["Cross‑sectional, cannot infer causality","Masturbation not measured separately","Potential self‑selection bias"],"rubric_version":"2.0","raw_total":22,"max_possible":50,"pct_score":44,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":1,"mentioning":14,"citing_publications":67,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/10720162.2016.1151391"}},{"id":9843,"doi":"10.1111/j.1540-4560.1973.tb00090.x","pmid":null,"pmcid":null,"title":"Sex Differences, Sex Experience, Sex Guilt, and Explicitly Sexual Films","authors":"Mosher DL.","first_author":"Mosher DL","journal":"Journal of Social Issues","year":1973,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":81,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Laboratory experiment with two pornographic film clips shown to single undergraduates; male vs female comparisons.","sample_n":377,"sample_text":"Undergraduate participants; convenience, likely WEIRD.","population":"194 male and 183 female single undergraduate students (convenience sample).","country":"USA (assumed from journal and author affiliation).","controls_mi":"yes","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["masturbation_not_isolated"],"stance":"neutral","citation_value":"useful","plain_summary":"In a 1973 lab study, men and women undergraduates watched two explicit sex films. Men felt more aroused, while women—especially those with high sex guilt or little experience—rated the films as more pornographic and disgusting and reported more negative feelings.","clinical_takeaway":"Sex guilt influences emotional reactions to explicit material; clinicians should consider guilt and experience when discussing pornography with clients.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for 1973 study","Direct experimental manipulation of stimulus","Inclusion of both sexes","Measures of sex guilt"],"limitations":["Convenience undergraduate sample (WEIRD)","Self‑report arousal without physiological validation","No control for masturbation or broader mental‑health factors","Limited statistical reporting in abstract"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":5,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":10,"contrasting":0,"mentioning":44,"citing_publications":119,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1111/j.1540-4560.1973.tb00090.x"}},{"id":9844,"doi":"10.2196/mental.9978","pmid":"30664470","pmcid":"PMC6360388","title":"Sexual Desire, Mood, Attachment Style, Impulsivity, and Self-Esteem as Predictive Factors for Addictive Cybersex","authors":"Varfi N, Rothen S, Jasiowka K, Lepers T, Bianchi-Demicheli F, Khazaal Y.","first_author":"Varfi N","journal":"JMIR mental health","year":2019,"pub_types":["research-article","Journal Article"],"keywords":["Sex","Internet","Impulsivity","Addictive Behavior"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC6360388","cited_by_count":20,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"Web‑based survey of 145 adult cybersex users; self‑report measures of cybersex addiction (CIUS‑adapted) and psychological variables; cross‑sectional correlational analysis.","sample_n":145,"sample_text":"145 participants completed the web survey.","population":"Adults who use cybersex, recruited online (convenience sample).","country":"unspecified (likely multi‑country Internet sample).","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"A 2019 online survey of 145 adults found that higher sexual desire, depressive mood, and avoidant attachment were linked to higher scores on a cybersex‑addiction questionnaire, while impulsivity was not related.","clinical_takeaway":"Associations do not prove causality; clinicians should assess broader psychosocial factors rather than assume cybersex addiction based on frequency alone.","confidence":0.78,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence","measurement"],"strengths":["Reasonably sized sample for exploratory analysis","Use of multiple validated psychological questionnaires","Inclusion of attachment and self‑esteem variables"],"limitations":["Cross‑sectional design; no causal inference possible","Addiction measured by a self‑report scale that conflates frequency and distress","Key confounds (moral incongruence, masturbation, partner context, trauma) not assessed","Convenience online sample limits generalisability"],"rubric_version":"2.0","raw_total":22,"max_possible":60,"pct_score":37,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":3,"addiction_criteria":3,"interpretation":3}},"scite":{"supporting":1,"contrasting":0,"mentioning":20,"citing_publications":45,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.2196/mental.9978"}},{"id":9845,"doi":"10.1177/0963721419838242","pmid":null,"pmcid":null,"title":"Is Nothing Sacred? Religion, Sex, and Reproductive Strategies","authors":"Moon JW, Krems JA, Cohen AB, Kenrick DT.","first_author":"Moon JW","journal":"Current Directions in Psychological Science","year":2019,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":23,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"commentary","design_detail":"Commentary / theoretical review without original empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The authors argue that people’s mating strategies can shape their attraction to religion, and that knowing a non‑religious person follows a monogamous lifestyle reduces distrust. They suggest reproductive interests underlie many religious benefits.","clinical_takeaway":"None – the article does not provide clinically relevant findings.","confidence":0.5,"topic_tags":["religiosity","sexual_function","moral_incongruence"],"strengths":["Integrates large data sets to propose reverse causality","Connects evolutionary theory with religious behavior"],"limitations":["No original data; relies on secondary analyses","Lacks measurement of key confounds (e.g., moral incongruence)","Interpretations may over‑generalize from correlational findings"],"rubric_version":"2.0","raw_total":9,"max_possible":50,"pct_score":18,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":2,"contrasting":1,"mentioning":36,"citing_publications":48,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0963721419838242"}},{"id":9846,"doi":"10.1016/j.biopsycho.2016.05.007","pmid":"27318185","pmcid":null,"title":"Prause et al. (2015) the latest falsification of addiction predictions","authors":"Prause N, Steele VR, Staley C, Sabatinelli D, Hajcak G.","first_author":"Prause N","journal":"Biological psychology","year":2016,"pub_types":["Comment","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":7,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"Commentary without original empirical data; no sample size reported.","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":[],"stance":"opposes","citation_value":"useful","plain_summary":"The authors argue that studies of \"porn addiction\" often ignore that viewing is usually paired with masturbation and that cue‑reactivity results contradict addiction predictions, suggesting the addiction model is misplaced.","clinical_takeaway":"Current evidence does not support treating porn use as an addiction; clinicians should consider alternative models.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Highlights methodological oversight in prior addiction cue‑reactivity studies","Clear logical argument challenging the addiction model"],"limitations":["No original data; relies on secondary literature","No systematic review methodology applied"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":8,"citing_publications":15,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.biopsycho.2016.05.007"}},{"id":9847,"doi":"10.1016/s2215-0366(17)30441-8","pmid":"29179928","pmcid":null,"title":"Data do not support sex as addictive","authors":"Prause N, Janssen E, Georgiadis J, Finn P, Pfaus J.","first_author":"Prause N","journal":"The lancet. Psychiatry","year":2017,"pub_types":["Letter","Comment"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":"eng","appraisal":{"status":"ai_flagged","relevance":"core","evidence_level":"commentary","design_detail":"Letter/commentary with no empirical data; no study design, sample, or analysis.","sample_n":null,"sample_text":"None (letter/commentary)","population":"Not applicable","country":"Not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"strongly-opposes","citation_value":"background","plain_summary":"The authors argue that existing data do not justify labeling frequent or excessive sex as an addiction and highlight a lack of evidence distinguishing compulsive from impulsive sexual behavior.","clinical_takeaway":"Do not treat frequent sex as an addiction without solid empirical evidence.","confidence":0.3,"topic_tags":["sexual_function"],"strengths":["Clear stance against classifying sex as an addiction"],"limitations":["No original data presented","No empirical methodology to support claims","Potential bias without disclosed conflicts"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":1,"contrasting":0,"mentioning":17,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/s2215-0366(17)30441-8"}},{"id":9848,"doi":"10.1080/23268743.2018.1435400","pmid":null,"pmcid":null,"title":"The pseudoscience behind public health crisis legislation","authors":"Ley DJ.","first_author":"Ley DJ","journal":"Porn Studies","year":2018,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":25,"is_preprint":false,"topics":["bibliography","csbd","ppu"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"commentary","design_detail":"commentary / opinion piece, no empirical data","sample_n":null,"sample_text":"N/A","population":"N/A","country":"N/A","controls_mi":"not_applicable","preregistered":false,"quality_score":1,"certainty":"very_low","red_flags":["advocacy_or_coi"],"stance":"strongly-opposes","citation_value":"background","plain_summary":"The author argues that labeling people as having a \"porn addiction\" is unscientific, fuels moral panic, and distracts from evidence‑based help, while benefiting a profit‑driven industry.","clinical_takeaway":"None – the article provides no clinical data or recommendations.","confidence":0.4,"topic_tags":["pornography","sexual_function","moral_incongruence"],"strengths":["Clear articulation of a critical perspective","Highlights potential moral panic"],"limitations":["No empirical data or systematic review","Absence of measurement of key constructs","Lacks control for confounds"],"rubric_version":"2.0","raw_total":6,"max_possible":50,"pct_score":12,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":1,"neuroimaging":null,"statistics":1,"confounds":1,"design":1,"addiction_criteria":null,"interpretation":2}},"scite":{"supporting":0,"contrasting":0,"mentioning":9,"citing_publications":28,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/23268743.2018.1435400"}},{"id":9849,"doi":"10.1007/s12119-017-9413-2","pmid":null,"pmcid":null,"title":"Porn Sex Versus Real Sex: How Sexually Explicit Material Shapes Our Understanding of Sexual Anatomy, Physiology, and Behaviour","authors":"Hesse C, Pedersen CL.","first_author":"Hesse C","journal":"Sexuality & Culture","year":2017,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":39,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of participants' SEM exposure frequency and knowledge of sexual anatomy, physiology, and behaviour","sample_n":null,"sample_text":"not provided in abstract","population":"unspecified adult sample, likely convenience/online recruitment","country":"not specified","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"The study found that people who watch more porn actually knew more about sexual anatomy and function, contrary to the idea that porn harms sexual knowledge. Participants also reported more positive than negative personal effects from porn.","clinical_takeaway":"None – the findings relate to knowledge, not clinical outcomes.","confidence":0.7,"topic_tags":["pornography","sexual_function","csbd","moral_incongruence"],"strengths":["Addresses a novel question about SEM and sexual knowledge","Compares expectations with empirical data"],"limitations":["Unclear how knowledge and SEM exposure were measured (likely ad‑hoc items)","No control for key confounds such as moral attitudes, masturbation, mental health","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":3,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":1,"mentioning":29,"citing_publications":46,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s12119-017-9413-2"}},{"id":9850,"doi":"10.1080/23268743.2020.1736609","pmid":null,"pmcid":null,"title":"‘Accessing something that’s meant to be inaccessible’: pornography viewers’ reconciliation between early pornographic memories and pornography’s perceived risk","authors":"Taylor K.","first_author":"Taylor K","journal":"Porn Studies","year":2021,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":14,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"interview + survey of adult pornography viewers, likely convenience sampling","sample_n":null,"sample_text":"Not specified in abstract; likely small convenience sample","population":"adult pornography viewers (self‑selected)","country":"","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study explores how adults who watch pornography reconcile nostalgic memories of early porn with current messages that porn is dangerous, finding they tend to see risk as applying to others, not themselves.","clinical_takeaway":"Clinicians should recognise that adult viewers may separate personal pleasure from public risk narratives, which can affect how they discuss porn use with clients.","confidence":0.7,"topic_tags":["pornography","csbd"],"strengths":["Provides rich, participant‑centered insight into cultural narratives","Combines survey and interview data for triangulation"],"limitations":["No validated measures of pornography use or distress","Likely convenience sample, limiting generalisability","No control for moral, mental‑health or relational confounds"],"rubric_version":"2.0","raw_total":15,"max_possible":50,"pct_score":30,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":4,"citing_publications":17,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/23268743.2020.1736609"}},{"id":9851,"doi":"10.1080/19317611.2020.1765940","pmid":null,"pmcid":null,"title":"A Two-Wave Assessment of the Structure and Stability of Self-Reported Problematic Pornography Use Among Male Croatian Adolescents","authors":"Štulhofer A, Rousseau A, Shekarchi R.","first_author":"Štulhofer A","journal":"International Journal of Sexual Health","year":2020,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":28,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"longitudinal","design_detail":"Two‑wave panel study of 337 male Croatian adolescents assessing self‑reported problematic pornography use (PPU) symptoms six months apart.","sample_n":337,"sample_text":"337 male Croatian adolescents","population":"Male adolescents (Croatia)","country":"Croatia","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"low","red_flags":["no_mi_control"],"stance":"neutral","citation_value":"useful","plain_summary":"Researchers followed 337 Croatian teenage boys for six months, tracking how they reported problems related to pornography use. They found that symptom patterns stayed stable over time, and fewer than five percent seemed at risk for problematic use.","clinical_takeaway":"Problematic pornography use appears rare among adolescents; routine screening may not be necessary.","confidence":0.7,"topic_tags":["pornography","adolescents","prevalence","sexual_function"],"strengths":["Longitudinal design with two assessment points","Reasonable sample size for adolescent panel","Use of network analysis to examine symptom structure"],"limitations":["Unclear whether PPU measure is validated","No assessment of key confounds (moral incongruence, masturbation, mental health)","Convenience sample limits generalisability"],"rubric_version":"2.0","raw_total":30,"max_possible":60,"pct_score":50,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":3,"design":5,"addiction_criteria":5,"interpretation":7}},"scite":{"supporting":1,"contrasting":0,"mentioning":24,"citing_publications":35,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/19317611.2020.1765940"}},{"id":9852,"doi":"10.1177/0907568216646436","pmid":null,"pmcid":null,"title":"Bad education? Childhood recollections of pornography, sexual exploration, learning and agency in Finland","authors":"Spišák S, Paasonen S.","first_author":"Spišák S","journal":"Childhood","year":2017,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"memory‑work project with autobiographical narratives of Finnish participants about childhood exposure to pornography; no quantitative data reported","sample_n":null,"sample_text":"not reported in abstract","population":"unspecified (likely small, self‑selected group of adults recalling childhood experiences)","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["self_selected_sample"],"stance":"opposes","citation_value":"useful","plain_summary":"The authors analyse Finnish adults' memories of seeing porn as children, arguing that these recollections show children as active learners rather than passive victims, and questioning the alarmist view that early porn exposure inevitably harms development.","clinical_takeaway":"Do not assume childhood porn exposure automatically leads to pathology; consider individual narratives and broader learning contexts.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Provides rich, first‑person accounts of childhood experiences","Challenges dominant risk‑focus narratives","Highlights agency and learning aspects"],"limitations":["Small, self‑selected sample limits generalisability","No quantitative measures of pornography use or distress","Confounding factors (moral views, mental health, trauma) not addressed"],"rubric_version":"2.0","raw_total":14,"max_possible":50,"pct_score":28,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":2,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":20,"citing_publications":20,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/0907568216646436"}},{"id":9853,"doi":"10.1016/j.jsxm.2019.12.003","pmid":"31955912","pmcid":null,"title":"Sexual Abstinence and Associated Factors Among Young and Middle-Aged Men: A Systematic Review","authors":"Irfan M, Hussain NHN, Noor NM, Mohamed M, Ismail SB.","first_author":"Irfan M","journal":"The journal of sexual medicine","year":2020,"pub_types":["Systematic Review","Journal Article"],"keywords":["Sex Education","Sexual Abstinence","Sexual Inactivity","Primary Sexual Abstinence","Secondary Sexual Abstinence"],"is_oa":false,"oa_url":null,"cited_by_count":13,"is_preprint":false,"topics":["bibliography","pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Systematic review of 37 population‑based studies without meta‑analysis or formal risk‑of‑bias assessment; moderate sample breadth but limited by heterogeneous definitions.","sample_n":null,"sample_text":"37 prevalence studies (total participants not reported in abstract)","population":"young (10‑24) and middle‑aged (25‑59) men; community‑based studies from 2008‑2019, English only","country":"Various (global, but limited Asia/Australia)","controls_mi":"yes","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A systematic review of 37 studies found that many young and middle‑aged men report never having sex or stopping after a period, with rates ranging from a few percent up to over 80%. Factors such as age, single status, low income, religious background and lack of partner were linked to abstinence.","clinical_takeaway":"Abstinence in men relates to socioeconomic and cultural factors; clinicians should consider these contexts rather than assuming pathology.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Systematic search of multiple databases","Broad age range and many studies included","Identifies consistent sociodemographic predictors"],"limitations":["Heterogeneous definitions of abstinence","No quantitative meta‑analysis or bias assessment","Limited geographic coverage (few Asian/Australian data)"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":true,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":4,"confounds":4,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":3,"contrasting":0,"mentioning":15,"citing_publications":37,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jsxm.2019.12.003"}},{"id":9854,"doi":"10.1016/j.childyouth.2019.04.023","pmid":null,"pmcid":null,"title":"The associations between sex drive, sexual self-concept, sexual orientation, and exposure to online victimization in Italian adolescents: Investigating the mediating role of verbal and visual sexting behaviors","authors":"Marengo D, Settanni M, Longobardi C.","first_author":"Marengo D","journal":"Children and Youth Services Review","year":2019,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":27,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of Italian adolescents","sample_n":null,"sample_text":"not reported in abstract","population":"Italian adolescents (age not specified)","country":"Italy","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"Among Italian teens, those who send sexts (words or pictures) tend to be older, have a stronger sex drive and a clearer sexual self‑concept; visual sexting is also linked to non‑heterosexual orientation.","clinical_takeaway":"None - study is descriptive and does not provide actionable clinical guidance.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Relevant adolescent sample","Considers multiple sexual variables"],"limitations":["Cross‑sectional, cannot infer causality","No validated measures reported","No control for key confounds (e.g., moral incongruence, mental health)","Sample size unclear"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":1,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":0,"contrasting":0,"mentioning":15,"citing_publications":30,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.childyouth.2019.04.023"}},{"id":9855,"doi":"10.1002/hbe2.193","pmid":null,"pmcid":null,"title":"Problematic online sexual activities in men: The role of self‐esteem, loneliness, and social anxiety","authors":"Wéry A, Canale N, Bell C, Duvivier B, Billieux J.","first_author":"Wéry A","journal":"Human Behavior and Emerging Technologies","year":2020,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":26,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"online survey of self‑selected men who regularly use OSAs (N=209); cross‑sectional, convenience sample","sample_n":209,"sample_text":"self‑selected men using OSAs on a regular basis","population":"men using online sexual activities","country":"unspecified","controls_mi":"no","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":["self_selected_sample","no_mi_control","masturbation_not_isolated","circular_addiction_scale","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In 209 men who regularly view online sexual material, low self‑esteem was linked to higher loneliness and social anxiety, which in turn were associated with more pornography use and seeking sexual contacts online, and with greater self‑reported addictive‑type symptoms.","clinical_takeaway":"Addressing self‑esteem, loneliness, and social anxiety may help reduce problematic online sexual behavior.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Uses validated psychological scales for self‑esteem, loneliness, social anxiety","Sample size moderate for survey work","Examines specific OSA types"],"limitations":["Self‑selected, non‑representative sample","Does not measure moral incongruence or masturbation separately","Addiction construct based on unspecified symptom scale","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":27,"max_possible":60,"pct_score":45,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":6,"neuroimaging":null,"statistics":5,"confounds":2,"design":4,"addiction_criteria":5,"interpretation":5}},"scite":{"supporting":1,"contrasting":1,"mentioning":15,"citing_publications":27,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1002/hbe2.193"}},{"id":9856,"doi":"10.1177/1363460714550911","pmid":null,"pmcid":null,"title":"‘We hid porn magazines in the nearby woods’: Memory-work and pornography consumption in Finland","authors":"Paasonen S, Kyrölä K, Nikunen K, Saarenmaa L.","first_author":"Paasonen S","journal":"Sexualities","year":2015,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":20,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"memory‑work project with narrative interviews; small convenience sample of Finnish participants; no quantitative analysis","sample_n":null,"sample_text":"Not provided in abstract","population":"Finnish adults who participated in a memory‑work exercise (sample size not reported)","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The study used a Finnish memory‑work exercise to explore how people remember and talk about their early encounters with pornography, highlighting shifts from scarce print magazines to abundant digital content.","clinical_takeaway":"None – the study provides cultural and historical insight rather than clinical guidance.","confidence":0.8,"topic_tags":["pornography","csbd","sexual_function"],"strengths":["Innovative qualitative method (memory‑work) illuminating personal histories","Links pornography consumption to broader media‑technological changes"],"limitations":["Small, self‑selected sample limits generalisability","No systematic measurement of constructs or quantitative analysis","Confounding factors (e.g., mental health, moral attitudes) not examined"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":2,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":25,"citing_publications":31,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/1363460714550911"}},{"id":9857,"doi":"10.1080/14681811.2015.1080158","pmid":null,"pmcid":null,"title":"‘Everywhere they say that it’s harmful but they don’t say how, so I’m asking here’: young people, pornography and negotiations with notions of risk and harm","authors":"Spišák S.","first_author":"Spišák S","journal":"Sex Education","year":2016,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":51,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"qualitative","design_detail":"Content analysis of 4,212 voluntary questions submitted by Finnish youth to sexual‑health experts; only 64 pertained to pornography.","sample_n":4212,"sample_text":"4212 questions submitted; 64 porn‑related","population":"Finnish youths who chose to ask questions about sexuality","country":"Finland","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The paper analyses 4,212 questions Finnish youths sent to sexual‑health experts; only 64 asked about pornography. The authors argue that young people see porn risk talk as vague and that other sexual‑health concerns matter more to them.","clinical_takeaway":"Clinicians should note that adolescents may be more concerned with unclear risk messaging than with porn itself.","confidence":0.7,"topic_tags":["pornography","adolescents","sexual_function","csbd","moral_incongruence"],"strengths":["Large total number of youth‑generated questions","Provides direct insight into youths’ own concerns","Highlights discrepancy between public discourse and youth priorities"],"limitations":["Very small subset (64) addresses pornography, limiting conclusions","Self‑selected sample; may not represent broader youth population","No systematic measurement of constructs or quantitative analysis"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":5}},"scite":{"supporting":3,"contrasting":0,"mentioning":43,"citing_publications":53,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/14681811.2015.1080158"}},{"id":9858,"doi":"10.1080/15546128.2018.1437100","pmid":null,"pmcid":null,"title":"A Pornography Literacy Class for Youth: Results of a Feasibility and Efficacy Pilot Study","authors":"Rothman EF, Adhia A, Christensen TT, Paruk J, Alder J, Daley N.","first_author":"Rothman EF","journal":"American Journal of Sexuality Education","year":2018,"pub_types":["journal-article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":74,"is_preprint":false,"topics":["bibliography","pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"single-group pre-post pilot feasibility study with N=24 youth","sample_n":24,"sample_text":"24 youth (15–24 years)","population":"U.S. urban youth, ages 15–24, diverse gender and sexual orientation","country":"USA","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A brief five‑session curriculum teaching teens about pornography increased their knowledge and hinted at more positive attitudes, but did not change whether they sought porn. The pilot shows the program can be run, but the tiny sample limits conclusions.","clinical_takeaway":"Program may improve knowledge; no evidence it reduces porn use.","confidence":0.8,"topic_tags":["pornography","sexual_function"],"strengths":["Innovative youth‑focused literacy curriculum","Diverse participant demographics","Clear feasibility outcome"],"limitations":["Very small, non‑random sample","No control/comparison group","Outcome measures appear ad‑hoc and unvalidated"],"rubric_version":"2.0","raw_total":16,"max_possible":50,"pct_score":32,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":3,"confounds":1,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":2,"contrasting":0,"mentioning":45,"citing_publications":86,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/15546128.2018.1437100"}},{"id":9868,"doi":"10.1556/2006.2026.00161","pmid":"42879216","pmcid":null,"title":"Analyzing uncertain decision processes in problematic pornography use: ERP insights into decision evaluation and feedback processing","authors":"Wang Y, Li H, Wang J.","first_author":"Wang Y","journal":"Journal of behavioral addictions","year":2026,"pub_types":["Journal Article"],"keywords":["Event-related potentials","decision-making","Iowa Gambling Task","Feedback Processing","P3","Problematic Pornography Use"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"cross-sectional case‑control laboratory experiment using EEG during a modified Iowa Gambling Task","sample_n":80,"sample_text":"male adults, risk status defined by unspecified screening","population":"80 male participants (40 identified as at risk for problematic pornography use, 40 controls)","country":"not stated","controls_mi":"no","preregistered":false,"quality_score":6,"certainty":"low","red_flags":["no_mi_control","masturbation_not_isolated","causal_from_correlational"],"stance":"neutral","citation_value":"useful","plain_summary":"In a lab study, men at risk for problematic porn use showed weaker brain responses (P3) when evaluating choices and receiving feedback, and they were slower to stop picking harmful options in a gambling‑like task, suggesting decision‑making deficits.","clinical_takeaway":"ERP differences hint that decision‑making impairments may underlie risky porn use, but no direct clinical guidance can be drawn.","confidence":0.7,"topic_tags":["csbd","neuroscience"],"strengths":["EEG ERP provides temporal precision for decision‑making processes","Use of a well‑validated task (Iowa Gambling Task) with a novel pass‑play manipulation","Matched control group and reasonably sized sample for ERP research"],"limitations":["Problematic pornography use risk definition not described; likely based on self‑label or unvalidated scale","Key psychosocial confounds (moral incongruence, masturbation, mental health) not measured","Cross‑sectional design limits causal inference"],"rubric_version":"2.0","raw_total":33,"max_possible":60,"pct_score":55,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":7,"statistics":5,"confounds":3,"design":6,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1556/2006.2026.00161"}},{"id":9869,"doi":"10.1007/s10508-026-03532-z","pmid":"42875706","pmcid":null,"title":"Arabic Validation of the Problematic Pornography Consumption Scale: Psychometric Properties, Measurement Invariance, and Gender-Specific Network Analysis","authors":"Helal A, Marey MM, Abdelaziz ER, Hassan A, Elhady MM, Elgohry YA, Basha EA, Sallie SN.","first_author":"Helal A","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Gender Differences","Dsm-5","Problematic Pornography Use","Problematic Pornography Consumption Scale","Arabic-Speaking Populations"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","ppu"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 959 Egyptian university students (convenience sample)","sample_n":959,"sample_text":"Egyptian university students (65% male, 35% female) recruited via campus channels","population":"Arabic‑speaking university students who use pornography at least weekly","country":"Egypt","controls_mi":"no","preregistered":false,"quality_score":7,"certainty":"low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"The study translated the Problematic Pornography Consumption Scale into Arabic and tested it with 959 Egyptian university students. The scale showed strong reliability and a six‑factor structure, worked the same for men and women, and was linked to higher depression, anxiety, stress, and internet‑use problems.","clinical_takeaway":"The Arabic PPCS appears reliable for screening problematic pornography use in Arabic‑speaking university populations, but clinicians should consider mental‑health comorbidity and cultural factors.","confidence":0.8,"topic_tags":["pornography","measurement","gender","csbd"],"strengths":["Large sample for validation","Comprehensive CFA and invariance testing","Network analysis adds novel insight"],"limitations":["Convenience student sample limits generalisability","No assessment of moral/religious attitudes","Cross‑sectional; cannot infer causality"],"rubric_version":"2.0","raw_total":39,"max_possible":60,"pct_score":65,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":8,"neuroimaging":null,"statistics":7,"confounds":5,"design":6,"addiction_criteria":5,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03532-z"}},{"id":9870,"doi":"10.1007/s10508-026-03584-1","pmid":"42864560","pmcid":null,"title":"Who Is Using Pornography Generated by Artificial Intelligence? Correlates of AI-Porn Use and Familiarity in an Australian Adult Sample","authors":"Anderson JR, Moor L.","first_author":"Anderson JR","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Artificial intelligence","Gender","Sexual behavior","Pornography","Deepfake","Digital Sexuality"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","shame_religiosity"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 367 Australian adults, convenience sampling, online questionnaire","sample_n":367,"sample_text":"367 participants (non‑binary excluded from analyses)","population":"heterosexual Australian adults, 19‑87 years (men 52.5%, women 44.8%)","country":"Australia","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"In an Australian survey of 367 adults, about a quarter had tried AI‑generated porn, especially younger men. Use was not linked to religiosity, politics, or relationship satisfaction.","clinical_takeaway":"Clinicians should note that AI‑porn use is currently modest and not clearly tied to relationship distress.","confidence":0.7,"topic_tags":["pornography","sexual_function"],"strengths":["Large sample for a niche topic","First systematic look at AI‑porn users","Includes demographic and ideological variables"],"limitations":["Self‑report, single‑item measures of use","Cross‑sectional, cannot infer causality","Convenience sample, limited generalisability","No assessment of masturbation or mental‑health covariates"],"rubric_version":"2.0","raw_total":24,"max_possible":50,"pct_score":48,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":true,"traumaACEsAssessed":false},"dimensions":{"construct_validity":3,"neuroimaging":null,"statistics":6,"confounds":4,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03584-1"}},{"id":9873,"doi":"10.1177/15248380261487144","pmid":"42864850","pmcid":null,"title":"A Scoping Review of Artificial Intelligence-Generated Image-Based Sexual Abuse: Terminology, Nature, Prevalence, Attitudes, and Harms","authors":"Witt A, Stevens G, Ridgway A, Ringin A.","first_author":"Witt A","journal":"Trauma, violence & abuse","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Scoping Review","Technology-Facilitated Gender-Based Violence","Ai-ibsa","Tf-gbv","Artificial Intelligence–generated Image-based Sexual Abuse","Sexual Deepfakes","Deepfake Pornography"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"scoping review of empirical studies","sample_n":null,"sample_text":"34 studies included (various sample sizes)","population":"adults involved in AI‑generated image‑based sexual abuse (victims or perpetrators)","country":"multiple (global literature)","controls_mi":"not_applicable","preregistered":false,"quality_score":3,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"The authors reviewed 34 studies on AI‑generated sexual abuse (deepfake porn) to describe how it is named, how common it is, who it affects, and what harms it causes. They found inconsistent terminology, most content depicting women, and mixed victimisation patterns across genders, highlighting the need for more research and prevention.","clinical_takeaway":"None – the review concerns technology‑facilitated abuse, not clinical sexual health or compulsive sexual behaviour.","confidence":0.7,"topic_tags":["sexual_function","gender"],"strengths":["Comprehensive mapping of emerging literature","Identifies gaps in terminology and measurement","Gender‑inclusive lens"],"limitations":["No quantitative synthesis or risk‑of‑bias assessment","Relies on heterogeneous primary studies","Limited to English‑language sources"],"rubric_version":"2.0","raw_total":17,"max_possible":50,"pct_score":34,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/15248380261487144"}},{"id":9897,"doi":"10.1093/eschf/xvag249","pmid":"42895114","pmcid":null,"title":"Sexual Health in Heart Failure: How Age, Sex, and Dyspnea Interact to Shape Intimacy and Unmet Clinical Needs","authors":"Damy T, Lequeux B, Gellen B, Berthelot E, Letombe B, Huet E, Taieb C, Gout C, Saliegé L, Roubille F, Baudry G, Villaceque M.","first_author":"Damy T","journal":"ESC heart failure","year":2026,"pub_types":["Journal Article"],"keywords":["Age","Quality of life","Heart Failure","Dyspnea","Sexual Health","Counselling","Gender Differences","Patient–physician Communication","Sexual Inactivity"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"cross-sectional","design_detail":"national descriptive questionnaire study of 1,398 HF patients (655 detailed responders); analyses of sex, age, dyspnea on sexual inactivity; multivariable logistic regression.","sample_n":655,"sample_text":"655 detailed respondents (491 men, 164 women).","population":"Adults (18‑93) with heart failure, recruited nationally; 921 men, 477 women; 46.9% provided detailed responses.","country":"France (presumed from author affiliations).","controls_mi":"not_applicable","preregistered":false,"quality_score":7,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"In a national survey of 1,398 heart‑failure patients, over half reported no sexual activity in the past three months. Sexual inactivity rose with age and especially with severe dyspnea. Men noted erectile problems; women reported loss of desire and depression. Dyspnea severity predicted inactivity, highlighting a need for symptom‑focused sexual counselling.","clinical_takeaway":"Screen for dyspnea severity and discuss sexual activity with HF patients; treat breathlessness to improve intimacy.","confidence":0.8,"topic_tags":["sexual_function"],"strengths":["Large, national sample of HF patients.","Multivariable analysis with confidence intervals.","Focus on gender‑specific outcomes."],"limitations":["Self‑report measures, no validated sexual‑function scales.","Cross‑sectional; causality cannot be inferred.","Moral, relational, and masturbation factors not addressed."],"rubric_version":"2.0","raw_total":34,"max_possible":50,"pct_score":68,"quality_rating":"Fair","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":8,"confounds":5,"design":8,"addiction_criteria":null,"interpretation":8}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1093/eschf/xvag249"}},{"id":9909,"doi":"10.1016/j.jadohealth.2026.07.033","pmid":"42900035","pmcid":null,"title":"Advancing Racial Equity for Black Youth Within Sexual Health Programming: A Targeted Literature Review","authors":"Offiong A, Coles-Quander C, Wulah A, Guerra G, Gilbertsen J, Abdi F, Smith A.","first_author":"Offiong A","journal":"The Journal of adolescent health : official publication of the Society for Adolescent Medicine","year":2026,"pub_types":["Review","Journal Article"],"keywords":["Positive Youth Development","Sexual And Reproductive Health","Racial Equity","Black Youth"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"systematic-review","design_detail":"Targeted literature review of SRH programs for Black youth (2014‑2024); no meta‑analysis, no formal risk‑of‑bias assessment reported.","sample_n":null,"sample_text":"Not applicable – review of existing studies","population":"Black adolescents in the United States","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"background","plain_summary":"This review examines recent programs aimed at improving sexual and reproductive health for Black youth, emphasizing culturally responsive, strengths‑based approaches and direct youth involvement to reduce health disparities.","clinical_takeaway":"Programs that center Black youth voices and address structural inequities may improve sexual health outcomes.","confidence":0.6,"topic_tags":["sexual_function"],"strengths":["Focused on racial equity and intersectionality","Integrates expert panel perspectives","Identifies actionable programmatic themes"],"limitations":["Not a systematic review; no formal bias assessment","Lacks quantitative synthesis or effect‑size reporting","Does not address potential confounds such as mental‑health or trauma"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1016/j.jadohealth.2026.07.033"}},{"id":9916,"doi":"10.31234/osf.io/wvds8_v1","pmid":null,"pmcid":null,"title":"The Deepfake Discount: Believing Erotic Images Are AI-Generated Reduces Affective Responses","authors":"Neves A, VIOLA M, Sperduti M, Corradi G, Olivera-LaRosa A, Ansani A, Marini M, Makowski D.","first_author":"Neves A","journal":"PsyArXiv","year":2026,"pub_types":["Preprint"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":true,"topics":["pornography"],"language":null,"appraisal":{"status":"ai","relevance":"core","evidence_level":"experimental","design_detail":"Within‑subject lab experiment with random label manipulation; large community sample (N=705, N=261).","sample_n":966,"sample_text":"Study 1 N = 705, Study 2 N = 261; total ≈ 966 participants.","population":"Heterosexual adult participants (presumably recruited online or via university panels).","country":"Not specified in abstract","controls_mi":"not_applicable","preregistered":false,"quality_score":5,"certainty":"low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"When erotic photos were labeled as AI‑generated, participants—especially men—rated them as less arousing and less appealing. The effect depended on whether people believed the label, suggesting that beliefs about a stimulus’s authenticity shape emotional reactions.","clinical_takeaway":"Clinicians should note that perceptions of authenticity can modulate sexual arousal, but the effect is modest and belief‑dependent.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Large sample sizes provide good statistical power.","Experimental manipulation of label allows causal inference about belief effects.","Use of validated image databases (NAPS, NAPS‑ERO)."],"limitations":["Self‑report affective ratings lack physiological validation.","No pre‑registration; effect‑size reporting unclear.","Potential sample bias (heterosexual participants only, recruitment method not described)."],"rubric_version":"2.0","raw_total":26,"max_possible":50,"pct_score":52,"quality_rating":"Poor","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":5,"confounds":1,"design":8,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.31234/osf.io/wvds8_v1"}},{"id":9931,"doi":"10.1055/s-0046-1829640","pmid":"42904291","pmcid":"PMC13682852","title":"A First Case of Compulsive Amnestic Sleep-Related Shopping Induced by Pramipexole Therapy of Restless Legs Syndrome","authors":"Todd M, Schenck CH, Golden E, Varghese R.","first_author":"Todd M","journal":"Sleep science (Sao Paulo, Brazil)","year":2026,"pub_types":["Journal Article","Case Reports"],"keywords":["Rls","Pramipexole","Compulsive Shopping","Amnestic Sleep Related"],"is_oa":true,"oa_url":"https://europepmc.org/articles/PMC13682852","cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"case-report","design_detail":"single patient case description of nocturnal sleep‑related shopping induced by pramipexole","sample_n":1,"sample_text":"1 patient (case report)","population":"patient with restless‑legs syndrome receiving dopamine agonist therapy","country":"Brazil","controls_mi":"not_applicable","preregistered":false,"quality_score":2,"certainty":"very_low","red_flags":["underpowered_sample"],"stance":"neutral","citation_value":"background","plain_summary":"A man with restless‑legs syndrome started taking the dopamine drug pramipexole and began buying items during sleep without remembering it. The behavior stopped after the drug was stopped, suggesting the medication triggered a sleep‑related impulse control problem.","clinical_takeaway":"Clinicians should warn patients on dopamine agonists about possible nocturnal impulse‑control disorders and monitor for unusual behaviors.","confidence":0.4,"topic_tags":["prevalence","treatment","measurement"],"strengths":["highly detailed clinical observation","identifies a novel sleep‑related impulse control presentation","provides clear temporal link to medication change"],"limitations":["single case, no control group","no validated measures of impulse control or distress","cannot infer prevalence or causality"],"rubric_version":"2.0","raw_total":10,"max_possible":50,"pct_score":20,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":1,"confounds":2,"design":1,"addiction_criteria":null,"interpretation":4}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1055/s-0046-1829640"}},{"id":9945,"doi":"10.1080/0092623x.2026.2751549","pmid":"42912488","pmcid":null,"title":"Digital Masculinity and Digital Media Exposure in Relation to Male Genital Self-Image, Mental Health, and Sexual Health: A Scoping Review. ","authors":"Yıldız Karaahmet A, Bilgiç FŞ.","first_author":"Yıldız Karaahmet A","journal":"Journal of sex & marital therapy","year":2026,"pub_types":["IM","Review","Journal Article"],"keywords":[],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography","sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"scoping review of 27 studies, following JBI and PRISMA‑ScR guidelines","sample_n":null,"sample_text":"27 studies; primary studies predominantly cross‑sectional convenience samples","population":"Male participants across 27 primary studies (mostly high‑income country samples; exact N not reported)","country":"High‑income countries (multiple)","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["underpowered_sample","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"A scoping review of 27 studies shows that men with poorer genital self‑image tend to have more anxiety, depression, and sexual problems. Social media, pornography and masculinity norms may reinforce unrealistic expectations, but direct evidence for pornography’s impact is mixed.","clinical_takeaway":"Assess men’s genital self‑image and media exposure when addressing anxiety, depression, or sexual dysfunction.","confidence":0.6,"topic_tags":["pornography","sexual_function"],"strengths":["Systematic scoping methodology (JBI, PRISMA‑ScR)","Comprehensive mapping of 27 studies","Identification of gaps for longitudinal/intervention work"],"limitations":["Relies on mostly cross‑sectional, convenience samples","No quantitative synthesis or risk‑of‑bias assessment","Limited control of key confounds (e.g., moral incongruence, masturbation)"],"rubric_version":"2.0","raw_total":21,"max_possible":50,"pct_score":42,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":true,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":5,"neuroimaging":null,"statistics":4,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1080/0092623x.2026.2751549"}},{"id":9954,"doi":"10.1177/21501319261496826","pmid":"42913457","pmcid":null,"title":"Creation and Pilot of a Student-Led, Gender-Affirming and LGBTQIA+-Focused Sexual Health Care Clinic in Miami, FL. ","authors":"DiStefano N, Kessous H, Driscoll B, Fuentes A, Prasad K, Magee K, Rocabado A, Doblecki-Lewis S, Beauchamps L.","first_author":"DiStefano N","journal":"Journal of primary care & community health","year":2026,"pub_types":["IM","Journal Article"],"keywords":["Sexual Health","Hiv Prevention","Gender-affirming Care","Sexual And Gender Minorities","Student-run Clinics","Lgbtqia+ Health"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["sexual_health"],"language":"eng","appraisal":{"status":"ai","relevance":"peripheral","evidence_level":"other","design_detail":"implementation pilot, descriptive case series with qualitative interviews","sample_n":42,"sample_text":"42 patients (36 received GAHT, 63.9% of them also received PrEP)","population":"42 LGBTQIA+ patients attending a student‑run sexual health clinic in Miami","country":"United States","controls_mi":"not_applicable","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":"A student‑run clinic in Miami provided LGBTQIA+ patients with hormone therapy, HIV/STD testing, and PrEP. In its first year it saw 42 patients, with high follow‑up and medication pick‑up rates, suggesting the model can be replicated elsewhere.","clinical_takeaway":"Student‑led, gender‑affirming sexual health clinics can deliver high‑quality care and retain patients; consider similar models in other settings.","confidence":0.7,"topic_tags":["sexual_function"],"strengths":["Real‑world implementation of a student‑run, gender‑affirming clinic","High patient retention and medication pick‑up rates","Qualitative data grounded in CFIR framework"],"limitations":["Small, single‑site convenience sample","No comparative or control group","Descriptive statistics only, no effect‑size estimation"],"rubric_version":"2.0","raw_total":18,"max_possible":50,"pct_score":36,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":2,"neuroimaging":null,"statistics":3,"confounds":2,"design":4,"addiction_criteria":null,"interpretation":7}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1177/21501319261496826"}},{"id":9960,"doi":"10.1007/s10508-026-03543-w","pmid":"42911539","pmcid":null,"title":"Benefits and Harms of Adult Videos: A Sex Difference Social Representations Analysis Among Young Adults in Japan","authors":"Mengzhen L, Matsumoto R, Pacher A, Hirayama M, Davies S, Benjamin J.","first_author":"Mengzhen L","journal":"Archives of sexual behavior","year":2026,"pub_types":["Journal Article"],"keywords":["Sex differences","Addiction","Social Representations","Pornography","Sexual Media","Sexual Crime"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["pornography"],"language":"eng","appraisal":{"status":"ai","relevance":"core","evidence_level":"cross-sectional","design_detail":"cross-sectional survey of 251 Japanese university students (mean age 20.7)","sample_n":251,"sample_text":"Convenience sample of university students; not nationally representative","population":"young adult Japanese students, majority heterosexual","country":"Japan","controls_mi":"no","preregistered":false,"quality_score":4,"certainty":"very_low","red_flags":["no_mi_control","self_selected_sample"],"stance":"neutral","citation_value":"useful","plain_summary":"Among 251 Japanese university students, both men and women saw adult videos as providing pleasure and even helping prevent crime, while noting harms like misinformation. Men more often mentioned ‘sex education’ as a benefit and ‘addiction’ as a harm; women highlighted ‘stress relief’ and the risk of encouraging sexual crime.","clinical_takeaway":"Clinicians should recognise that young adults may view porn both positively and negatively, and that perceived harms (e.g., addiction) may be reported without assessing underlying moral or mental‑health factors.","confidence":0.75,"topic_tags":["pornography","sexual_function","csbd"],"strengths":["Large sample for qualitative analysis","First study of Japanese young adults’ social representations of AV","Uses systematic prototypical analysis"],"limitations":["Convenience student sample limits generalisability","No measurement of key confounds (moral incongruence, masturbation, mental health)","Reliance on single‑item self‑report of AV use","No validated scales for addiction or harm"],"rubric_version":"2.0","raw_total":19,"max_possible":50,"pct_score":38,"quality_rating":"Inadequate","confounds_checked":{"moralIncongruence":false,"masturbationSeparated":false,"mentalHealthControlled":false,"dyadicOrPartnerAssessed":false,"traumaACEsAssessed":false},"dimensions":{"construct_validity":4,"neuroimaging":null,"statistics":4,"confounds":2,"design":3,"addiction_criteria":null,"interpretation":6}},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1007/s10508-026-03543-w"}},{"id":9961,"doi":"10.1136/bmjopen-2026-125612","pmid":"42919590","pmcid":null,"title":"Double-blind, placebo-controlled randomised clinical trial on flexible doses of escitalopram and naltrexone in the treatment of men with compulsive sexual behaviour disorder: study protocol presentation","authors":"Lew-Starowicz M, Draps M, Wilk K, Wisniewski P, Gola M.","first_author":"Lew-Starowicz M","journal":"BMJ open","year":2026,"pub_types":["Journal Article"],"keywords":["Randomized controlled trial","Impulse Control Disorders","Sexual Medicine"],"is_oa":false,"oa_url":null,"cited_by_count":0,"is_preprint":false,"topics":["csbd"],"language":"eng","appraisal":{"status":"no_abstract","relevance":null,"evidence_level":null,"design_detail":null,"sample_n":null,"sample_text":null,"population":null,"country":null,"controls_mi":"unknown","preregistered":false,"quality_score":null,"certainty":null,"red_flags":[],"stance":"neutral","citation_value":"useful","plain_summary":null,"clinical_takeaway":null,"confidence":0,"topic_tags":[],"strengths":[],"limitations":[],"rubric_version":"2.0","raw_total":null,"max_possible":null,"pct_score":null,"quality_rating":null,"confounds_checked":{},"dimensions":null},"scite":{"supporting":0,"contrasting":0,"mentioning":0,"citing_publications":0,"retracted":false,"notices":[],"url":"https://scite.ai/reports/10.1136/bmjopen-2026-125612"}}]}